Humana Inc. (HUM) 2026 Q3 法說會逐字稿

Good day and thank you for standing by. Welcome to Humana's third quarter 2026 earnings call. (Operator Instructions) Please be advised that today's conference is being recorded. I would now like to hand the conference over to Lisa Stoner, Vice President of Investor Relations. Please go ahead.

大家好，感謝您稍候。歡迎參加 Humana 2026 年第三季財報電話會議。(接線員指示) 請注意，今天的會議將被錄音。現在我想將會議交給投資人關係副總裁 Lisa Stoner。請開始。

Thank you, and good morning. We will begin this morning with brief remarks from Jim Rechtin, Humana's President and Chief Executive Officer; and Chief Financial Officer, Celeste Mellet. Following these remarks, we will host a question-and-answer session with industry analysts.

謝謝，早安。今天早上我們將先由 Humana 總裁兼執行長 Jim Rechtin，以及財務長 Celeste Mellet 發表簡短談話。在這些談話之後，我們將與產業分析師進行問答環節。

Before we begin our discussion, I need to advise call participants of our cautionary statement. Certain of the matters discussed in this conference call are forward-looking and involve a number of risks and uncertainties, actual results could differ materially. Investors are advised to read the detailed risk factors discussed in our latest Form 10-K, our other filings with the Securities and Exchange Commission and our third quarter 2026 earnings press release as they relate to forward-looking statements along with other risks discussed in our SEC filings. We undertake no obligation to publicly address or update any forward-looking statements in future filings or communications regarding our business or results.

在開始討論之前，我需要向與會者宣讀我們的警示性聲明。本次電話會議中討論的某些事項屬於前瞻性陳述，並涉及多項風險與不確定性，實際結果可能會有重大差異。建議投資人閱讀我們最新的 Form 10-K、我們向美國證券交易委員會（SEC）提交的其他文件，以及我們 2026 年第三季財報新聞稿中與前瞻性陳述相關的詳細風險因素，並一併參考我們 SEC 申報文件中討論的其他風險。我們不承擔在未來申報或溝通中就本公司業務或業績公開回應或更新任何前瞻性陳述的義務。

Today's press release and posted remarks, our historical financial news releases, and our filings with the SEC are all also available on our Investor Relations site. Call participants should note that today's discussion includes financial measures that are not in accordance with generally accepted accounting principles or GAAP. Management's explanation for the use of these non-GAAP measures and reconciliations of GAAP to non-GAAP financial measures are included in today's press release.

今天的新聞稿與已發布的講稿、我們過往的財務新聞稿，以及我們向 SEC 提交的申報文件，也都可在我們的投資人關係網站上取得。與會者請注意，今天的討論包含不符合一般公認會計原則（GAAP）的財務衡量指標。管理階層對使用這些非 GAAP 指標的說明，以及 GAAP 與非 GAAP 財務衡量指標之間的調節表，均已包含在今天的新聞稿中。

Any reference to earnings per share or EPS made during this conference call refer to diluted earnings per common share. Finally, this call is being recorded for replay purposes. That replay will be available on the Investor Relations page of Humana's website, humana.com, later today.

本次電話會議中任何對每股盈餘或 EPS 的提及，均指普通股稀釋後每股盈餘。最後，本通話將被錄音以供重播。重播內容將於今日稍晚在 Humana 官網 humana.com 的投資人關係頁面提供。

With that, I'll turn it over to Jim.

接下來我把時間交給 Jim。

Thank you, Lisa. Good morning, everyone, and thank you for joining us. We have just one headline today, and that is that we are in a good place, execution is strong and improving, signs point to our strategy working, we are increasingly seeing the tangible results of our team's good work, the results are positive for our members, our patients and their health, and the results are contributing to our margin and earnings growth recovery, which is moving from on plan toward being ahead of plan.

謝謝你，Lisa。各位早安，也感謝大家加入我們。今天我們只有一個重點：我們目前處於良好狀態，執行力強且持續改善，跡象顯示我們的策略正在奏效；我們愈來愈能看到團隊努力工作的具體成果；這些成果對我們的會員、病患及其健康都是正面的，同時也正在推動我們的利潤率與獲利成長復甦，進展正從符合計畫走向超前計畫。

As usual, I will frame my comments today around the four drivers of our business: one, product and experience, which drive customer retention and growth two, clinical excellence, which delivers clinical outcomes and medical margin three, highly efficient operations and four, capital allocation and growth in both CenterWell and Medicaid.

如同以往，我今天的評論將圍繞我們業務的四大驅動因素：第一，產品與體驗，推動客戶留存與成長；第二，臨床卓越，帶來臨床結果與醫療利潤率；第三，高效率營運；第四，資本配置，以及 CenterWell 與 Medicaid 的成長。

Let's start with product and experience. Our 2026 membership, both new and returning, is performing in line to better than expected. Our 2027 product positioning also appears to be in line with expectations. Our product portfolio positions us largely as we expected at the time of bids. We believe our portfolio will deliver the margin progression in '27 that is necessary to put us on track for a 3%-plus margin in 2028. And importantly, our portfolio is focused on providing our members simple, affordable and predictable coverage. It does this by protecting the benefits and services that seniors consistently identify as most important.

先從產品與體驗談起。我們 2026 年的會員表現（包含新加入與續保）符合預期甚至優於預期。我們 2027 年的產品定位看起來也符合預期。我們的產品組合在投標時所預期的定位大致一致。我們相信，我們的產品組合將在 2027 年帶來必要的利潤率逐步改善，使我們朝 2028 年達成 3% 以上利潤率的目標邁進。更重要的是，我們的產品組合聚焦於為會員提供簡單、可負擔且可預期的保障。其方式是保護長者一再認為最重要的福利與服務。

So far, AEP performance is ahead of our initial expectations. Our recapture or retention of our members impacted by planned exits has been particularly strong, but we are also seeing new sales ahead of plan. And while it remains very early in AEP, we currently anticipate that our membership will be up for 2027.

截至目前，AEP 的表現優於我們最初的預期。我們對受計畫性退出影響之會員的回收（recapture）或留存表現尤其強勁，同時新銷售也超出計畫。雖然 AEP 仍處於非常早期階段，但我們目前預期 2027 年的會員數將增加。

Turning to clinical excellence, I'm just going to say again that we are thrilled with our bonus year '28 or BY '28 results. Our Star ratings approached the highest ratings Humana has ever achieved with a member-weighted Star rating of 4.17. I am proud of this team. This is truly the result of 65,000 associates working together to drive better experiences and health outcomes for our members.

接著談臨床卓越。我再說一次，我們對 28 獎勵年度（bonus year '28，簡稱 BY '28）的成果感到非常振奮。我們的星級評等接近 Humana 歷來最高水準，會員加權星級評等為 4.17。我為這個團隊感到驕傲。這確實是 65,000 名同仁共同努力的成果，為會員帶來更好的體驗與健康結果。

I'm going to provide just a few examples to bring this to life. Compared with the prior year, 663,000 more care opportunities were met. 534,000 additional members completed an annual preventative visit. 28,000 members received an overdue mammogram. This allowed us to identify 600 previously undetected breast cancers, many at an earlier stage than they otherwise would have been found.

我提供幾個例子讓大家更具體感受。與前一年相比，我們多完成了 663,000 個照護機會。另有 534,000 名會員完成年度預防性就診。有 28,000 名會員補做了逾期的乳房攝影檢查。這讓我們得以辨識出 600 例先前未被發現的乳癌，其中許多是在更早期就被發現，否則可能會更晚才被診斷出來。

93,000 members completed an overdue colorectal cancer screening. This allowed us to identify 100 previously undetected cases of pre-cancers and cancers. And 73,000 members living with diabetes received an overdue eye exam. This allowed us to identify 17,000 previously undetected diagnoses of diabetes-related eye disease, which is a leading cause of vision loss. Detecting these conditions early is critical to successfully treating them and managing the conditions.

有 93,000 名會員完成了逾期的大腸直腸癌篩檢。這讓我們得以辨識出 100 例先前未被發現的癌前病變與癌症案例。另有 73,000 名糖尿病會員補做了逾期的眼科檢查。這讓我們得以辨識出 17,000 例先前未被診斷的糖尿病相關眼疾，而這是視力喪失的主要原因之一。及早偵測這些狀況，對於成功治療與管理病情至關重要。

The improvement that the team has driven in the Stars program over the last two years is truly remarkable and is driving a real difference for our members. From a financial perspective, as we shared in the 8-K and audio file in October, our BY '28 results significantly exceed our goal of top quartile. As a reminder, results at roughly top quartile is the level of Stars performance that we believe is necessary to sustain a 3% margin and have competitive product.

團隊在過去兩年於星級（Stars）計畫所推動的改善確實非常顯著，並為我們的會員帶來實質差異。從財務角度來看，正如我們在 10 月的 8-K 與音訊檔中分享的，我們的 BY '28 成果顯著超越我們「前四分位」的目標。提醒一下，約在前四分位的成果，是我們認為維持 3% 利潤率並具備具競爭力產品所需的星級表現水準。

At or near top quartile performance is what is sustainable on an ongoing basis. We will have years close to top quartile, we will have years slightly above top quartile, and we will have years like this year well above top quartile. However, we will manage the business assuming a level that approximates top quartile. That means our benefit structure and our broader cost structure must be tuned to and work closer to top quartile results, not at top decile.

達到或接近前四分位的表現，才是長期可持續的水準。我們會有接近前四分位的年度，也會有略高於前四分位的年度，並且也會有像今年這樣遠高於前四分位的年度。然而，我們將以接近前四分位的水準來管理業務。這表示我們的福利結構以及更廣泛的成本結構，必須調整到並更貼近前四分位的成果水準運作，而不是以前十分位（top decile）的水準為假設。

As a result, we anticipate a one-time tailwind in 2028. We expect to utilize some of this tailwind for one-time investments. These investments will help solidify our Stars capability and accelerate our efforts to improve the customer experience and improve clinical outcomes. We also expect additional one-time return to shareholders. We do not believe we can productively invest the full tailwind, and thus we will pass some through to shareholders.

因此，我們預期 2028 年將出現一次性的順風（tailwind）。我們預計會運用其中一部分順風來進行一次性投資。這些投資將有助於鞏固我們的星級能力，並加速我們改善客戶體驗與提升臨床結果的努力。我們也預期會有額外的一次性回饋股東。我們認為無法有效率地把全部順風都投入再投資，因此將把其中一部分回饋給股東。

Once we have more information on 2028, which includes competitive dynamics, membership and product dynamics and regulatory environment, we will quantify the level of and the expected use of the tailwind. We will decide how much we will invest and we will explain roughly how much will pass through to earnings.

當我們取得更多關於 2028 年的資訊後（包括競爭態勢、會員與產品動態以及監管環境），我們將量化順風的規模以及預期用途。我們將決定投資的金額，並大致說明有多少將反映到盈餘中。

Now turning to BY '29 stars, we continue to drive strong operational performance, running roughly 5% ahead of last year's quality improvement rate on a per member basis in key HEDIS metrics at the end of Q3. We feel confident that we will achieve our goal of top quartile performance for BY '29. Regarding highly efficient operations, our multi-year transformation is progressing as anticipated, and we look forward to providing a more detailed update on this work at a December investor event.

接著談 BY '29 星級評等，我們持續推動強勁的營運表現；截至第三季末，在關鍵 HEDIS 指標上，以每位會員為基礎計算的品質改善率約較去年領先 5%。我們有信心達成 BY '29 前四分位表現的目標。至於高效率營運，我們的多年期轉型正按預期推進，我們也期待在 12 月的投資人活動中就這項工作提供更詳細的更新。

Finally, let me turn to capital allocation. I'll start with Medicaid, where we have implemented contracts in six new states over the last three years. With our Medicaid footprint now spanning 13 states, including 11 active states and contracts awarded with implementations pending in Georgia and Texas.

最後，讓我談談資本配置。我先從 Medicaid 談起，過去三年我們已在六個新州落地執行合約。目前我們的 Medicaid 版圖已涵蓋 13 個州，其中 11 個州已在營運中，另在喬治亞州與德州已獲得合約，正等待導入實施。

Our Medicaid membership has grown by 104,000 members in 2026, largely driven by the start of the Michigan HIDE SNP and the statewide Illinois FIDE SNP programs, as well as the carve-in of Dual eligibles in the South Carolina Medicaid program. We are excited about these integrated dual programs and we believe we are uniquely capable of delivering great outcomes for members and for states.

我們的 Medicaid 會員數在 2026 年增加了 104,000 人，主要由密西根州 HIDE SNP 與伊利諾州全州 FIDE SNP 計畫的啟動所帶動，另外也包括南卡羅來納州 Medicaid 計畫中雙重資格者（Dual eligibles）的 carve-in。我們對這些整合式雙重資格計畫感到振奮，並相信我們具備獨特能力，能為會員與各州帶來優異成果。

Within CenterWell Primary Care, we have driven strong growth this year, adding nearly 147,000 members or 30% growth, including the acquisition of MaxHealth in the first quarter. And we recently established a new partnership with BlackRock, which we are very excited about, Celeste will touch on this more in a moment.

在 CenterWell Primary Care 方面，我們今年推動了強勁成長，新增近 147,000 名會員，約 30% 的成長，其中包含第一季收購 MaxHealth。此外，我們近期與 BlackRock 建立了新的合作夥伴關係，我們對此非常期待，Celeste 稍後會再多談一些。

In conclusion, we are driving strong execution across the company, which has us on a positive trajectory. We are pleased with our 2026 performance to date and our increased full year outlook. We are incredibly proud of our BY '28 Stars results and expect to maintain top quartile results for BY '29. We are positioned as we expected for the 2027 AEP and we expect to make meaningful progress on MA margin expansion next year. And finally, we remain on track to deliver on our Investor Day commitments in 2028, which we will mark to market for you at the investor update on December 10.

總結來說，我們在全公司範圍內展現強勁的執行力，使我們走在正向軌道上。我們對截至目前的 2026 年表現以及上調的全年展望感到滿意。我們對 BY '28 Stars 的成果感到無比自豪，並預期在 BY '29 仍能維持前四分位的表現。我們在 2027 年 AEP 的準備狀態符合預期，並預期明年在 MA 利潤率擴張方面取得實質進展。最後，我們仍按計畫在 2028 年達成投資人日的承諾，並將於 12 月 10 日的投資人更新會議上向各位進行最新進度說明。

With that, I will turn it to Celeste for a few remarks before the Q&A.

接下來，我把時間交給 Celeste，在 Q&A 之前先做幾點補充。

Thank you, Jim. I will touch on our '26 performance and improved full year EPS outlook before providing more detail on our continued balance sheet efficiency and capital optimization progress, including the recently announced JV with BlackRock.

謝謝你，Jim。我會先談談我們 2026 年的表現與上調的全年 EPS 展望，接著會更詳細說明我們持續提升資產負債表效率與資本最佳化的進展，包括近期宣布與 BlackRock 成立的合資企業（JV）。

Starting with '26, based on available information to date, cost trends are in line to better than our expectations for both new and existing members. Our performance to date supports an increase in our full year adjusted EPS outlook from at least $9 to at least $9.50.

先從 2026 年談起，根據目前可得資訊，新會員與既有會員的成本趨勢符合、甚至優於我們的預期。截至目前的表現支持我們將全年調整後 EPS 展望由至少 9 美元上調至至少 9.50 美元。

We also continue to maintain and build prudent reserves with IBNR up sequentially despite the seasonal shift where pharmacy costs make up a greater proportion of total benefit costs as we move through the year. All in, we are executing and delivering results better than initial guidance and remain on track to double our individual MA pretax margin this year, excluding the Stars headwind.

我們也持續維持並建立審慎的準備金，儘管隨著年度推進、藥局成本在總給付成本中的占比因季節性因素提高，IBNR 仍較前一季上升。整體而言，我們的執行與交付成果優於最初指引，並仍按計畫在今年將個人 MA 稅前利潤率提高一倍（不含 Stars 的逆風影響）。

Turning to the balance sheet. We have continued our efforts to increase the efficiency of the balance sheet and fortify our foundation, and our significant progress reflects relentless focus on execution. We expect two major transactions to close this quarter. First, we will complete the divestment of our minority interest in Gentiva. Total pretax proceeds will be approximately $900 million.

接著談資產負債表。我們持續致力於提升資產負債表效率並強化基礎，而我們的重大進展反映出對執行的持續專注。我們預期本季將完成兩筆重大交易。第一，我們將完成出售在 Gentiva 的少數股權。稅前總收益約為 9 億美元。

In addition, we recently announced and closed a new joint venture with BlackRock, which replaces the previous long-standing JVs with Welsh, Carson. Our new JV has substantially enhanced our balance sheet efficiency and increased our financial flexibility while significantly reducing our cost of capital, reflecting the maturity of the business.

此外，我們近期宣布並完成與 BlackRock 的新合資企業（JV），以取代先前與 Welsh, Carson 長期合作的 JV。新的 JV 大幅提升了我們的資產負債表效率並增加財務彈性，同時顯著降低資本成本，反映出該業務的成熟度。

With the new structure, we will have the option to purchase clinics from the JV beginning in 2028. If we have not acquired all of the clinics by the end of 2033, BlackRock will have the right to exit the JV through a sale process, and we have the right to submit the first offer to acquire any remaining clinics. Importantly, the significantly reduced cost of capital under the new arrangement drives a substantial reduction of the JV-related liabilities on the balance sheet.

在新的架構下，我們將自 2028 年起擁有向 JV 購買診所的選擇權。若至 2033 年底我們仍未收購所有診所，BlackRock 將有權透過出售程序退出 JV，而我們有權優先提出第一個報價以收購任何剩餘診所。重要的是，新安排下顯著降低的資本成本，將推動資產負債表上與 JV 相關負債的大幅下降。

We anticipate that this transaction will drive a reduction of approximately 130 basis points in the GAAP debt-to-cap ratio in the fourth quarter. Further, we no longer need to fund the previously pending put option in 2027, which, if debt funded, would have increased our debt-to-cap ratio by approximately 130 basis points next year, all else equal. We will continue to evaluate a pipeline of initiatives to drive further efficiency and resiliency.

我們預期此交易將在第四季使 GAAP 負債對資本比率（debt-to-cap ratio）下降約 130 個基點。此外，我們不再需要在 2027 年為先前尚待履行的賣權（put option）提供資金；若當時以舉債方式籌資，在其他條件不變下，明年將使我們的負債對資本比率增加約 130 個基點。我們將持續評估一系列措施，以進一步提升效率與韌性。

Before going to Q&A, let me reiterate the headline that Jim shared. We have momentum. We are executing on our Investor Day commitments, and delivering on the earnings power and value of the company while driving better health outcomes and experiences for our members and our patients.

在進入 Q&A 之前，讓我重申 Jim 分享的重點。我們正處於動能之中。我們正在落實投資人日的承諾，並在推動會員與病患更佳健康結果與體驗的同時，交付公司的獲利能力與價值。

I will now turn the call back to Lisa to start the Q&A.

現在我把電話交回給 Lisa，開始 Q&A。

Thank you, Celeste. (Event Instructions) Operator, please introduce the first caller.

謝謝你，Celeste。（活動指示）接線員，請介紹第一位來電者。

Stephen Baxter, Wells Fargo.

Stephen Baxter，Wells Fargo。

I was hoping you could expand a little bit more on the 2027 commentary, I guess, maybe potential list of headwinds and tailwinds. And then just thinking about meaningful progress in individual MA margins, any general sense of what we should be expecting on that front based on what you know today?

我希望你們能再多延伸說明一下對 2027 年的評論，我想可能是一些潛在逆風與順風的清單。另外，關於個人 MA 利潤率的「實質進展」，就你們目前所知，對這方面我們大致應該期待什麼？

Stephen, as we stand here today, we, going into '27, don't have any known headwinds other than carrying the Stars headwind we have from this year. So no incremental headwinds, and we do have a number of tailwinds. First, we continue to transform our business and are working to reduce both our OpEx and improve our medical costs really through driving better care outcomes. Second, we are continuing to move through the J-curves for Medicaid and PCO. Third, as we've talked about earlier in the year, we have significantly improved our product position and price for margin.

Stephen，以我們今天所處的狀況來看，展望 2027 年，除了延續今年的 Stars 逆風之外，我們沒有任何已知的逆風。因此沒有新增的逆風，而且我們有多項順風。第一，我們持續推動業務轉型，並致力於降低營運費用（OpEx），同時透過推動更好的照護成果來改善醫療成本。第二，我們持續走過 Medicaid 與 PCO 的 J 曲線。第三，如同我們今年稍早所談，我們已顯著改善產品定位與定價，以提升利潤率。

That was our number one priority in terms of our approach to bids this year. And then finally, we expect fewer new members, which should lead to a lower year one headwind associated with marketing and onboarding and costs like that.

這是我們今年投標策略中最優先的事項。最後，我們預期新增會員會較少，這應可降低與行銷、導入（onboarding）及相關成本所帶來的第一年逆風。

It's too early to call out where we expect the margin to land precisely for 2027. A lot of that will be driven by the ultimate membership size and composition as it relates to AEP. And while it's early and we have a good directional view, we're happy with what we're seeing. We don't know our retention yet, and we want to see where those numbers land. I would say it's safe to assume that we will make a material improvement, both on a Stars adjusted and Stars unadjusted basis that we would expect to be well into the profitability range, even reflecting the Stars headwind for next year.

目前仍言之過早，尚無法精確指出我們預期 2027 年利潤率會落在何處。其中很大一部分將取決於與 AEP 相關的最終會員規模與組成。雖然現在還早，但我們對方向性有不錯的掌握，也對目前看到的情況感到滿意。我們尚未掌握留存率（retention），也希望先看看那些數字最終落點。我認為可以合理假設，我們將會有實質改善；無論是經 Stars 調整或未調整的基礎，我們預期都會明顯進入獲利區間，即便反映明年的 Stars 逆風亦然。

Justin Lake, Wolfe Research.

Justin Lake，Wolfe Research。

Maybe you can give us a little more color on cost trends in the quarter and kind of how you're seeing coming out of the year, and for '27, how you're thinking about it? And then can you just give us a little more color on the call out you had in CenterWell. The year-over-year decline was pretty material, and you talked about one specific market and group of patients being pressured?

也許你們可以再多提供一些本季成本趨勢的細節，以及你們如何看待今年結束時的走勢，並且對 2027 年你們的思考是什麼？另外，也請再多談談你們在 CenterWell 提到的那點。年對年下滑相當明顯，而你們提到某個特定市場與某一群病患受到壓力？

Justin, so in terms of the cost trends, as we talked about last quarter, we're at the lower end of the range that we had expected for the year, which was 7% to 8%. We're continuing to see better-than-expected performance on the inpatient side, both in terms of APTs and cost per admission. And a lot of that favorability will continue to flow through to value-based providers who have driven pretty significant improvement this year. But we're also seeing favorability on the Part D side, which is really what's helping us to drive our guidance up this year.

Justin，就成本趨勢而言，如同我們在上一季所談到的，我們目前處於今年原先預期區間（7%到8%）的較低端。我們持續看到住院端的表現優於預期，無論是在每千人住院次數（APT）或每次入院成本方面。而這些有利因素將持續反映到價值導向（value-based）的提供者身上，這些提供者今年帶動了相當顯著的改善。但我們也在Part D端看到有利因素，這正是幫助我們今年上調指引的關鍵。

Going into next year, we are expecting trend to be higher predominantly driven by the health technology pipeline. So overall, we expect Part D to increase 14% to 15%, driven by the health technology pipeline. We have priced that into our bids, both on the MAPD side and the PDP side of things. On the med cost side, we are expecting things to be slightly higher as well. So overall, in the 8% to 9% core trend versus our range of 7% to 8% trend for this year.

展望明年，我們預期趨勢會更高，主要由健康科技（health technology）產品線/研發管線所驅動。整體而言，我們預期Part D將成長14%到15%，由健康科技管線帶動。我們已將此反映在我們的投標報價中，包含MAPD端與PDP端。在醫療成本端，我們也預期會略高一些。因此整體來看，核心趨勢約在8%到9%，相較於今年7%到8%的趨勢區間。

And then in terms of PCO, so we are seeing some pressure in one geography related to a particular set of patients. And we believe we've been able to put a ring around that and the steps to improve that have already been taken by CenterWell and the payer partners, including Humana. So we have seen on the CenterWell side, a number of changes in terms of their contracting, including terms with payers -- terming payers and the terms with the remaining payers improving their positioning.

接著談PCO，我們在某一個地理區域看到一些壓力，與特定一群病患有關。我們相信已經把這個問題控制在可管理的範圍內，而改善的步驟也已由CenterWell與付款方合作夥伴（包含Humana）採取。因此在CenterWell端，我們看到其在合約方面做了多項調整，包括合約終止（terming）部分付款方，以及與保留的付款方重新談定條款以改善其定位。

And then on the payer side, including Humana, there are a number of factors, significantly improved benefit design and then also pretty aggressive network management. There are some outlying facilities in Florida that have been driving some of the pressure, and we've seen partners across the payer universe take action to address that.

而在付款方端（包含Humana），也有多項因素，包括顯著改善的給付設計，以及相當積極的網絡管理。佛羅里達州有一些離群的機構一直在造成部分壓力，我們也看到付款方體系中的合作夥伴已採取行動來處理。

Ann Hynes, Mizuho.

Ann Hynes，瑞穗（Mizuho）。

So thank you for the directional commentary on MA membership for next year. I know that you highlighted growth for 2027. But directionally, can you provide any more growth expectations besides that it will not be as much as 2026? And within that, maybe just some commentary on the competitive AEP. Any surprises in the competitive environment? Because I thought before you thought membership might be like flat to down for next year.

謝謝你們對明年MA會員數方向性的評論。我知道你們提到2027年會有成長。但就方向而言，除了不會像2026年那麼多之外，能否再提供一些成長預期？另外，也想請你們評論一下競爭性的AEP（年度選擇期）。競爭環境有任何意外嗎？因為我記得你們之前認為明年會員數可能會持平到下滑。

Yes. Thanks for the question. The product positioning is largely in line with where we expected. What we're seeing is we're seeing outperformance from our distribution channel partners. That really has been the difference. We made a bunch of moves a year ago to improve the quality of our distribution partners, and that is paying some dividends this year. It's been a very good -- it's achieved a number of good results for us.

是的，謝謝你的問題。產品定位大致符合我們的預期。我們看到的是來自我們通路合作夥伴的表現優於預期。這確實是主要差異所在。我們在一年前做了許多動作來提升通路合作夥伴的品質，而今年已開始帶來一些成果。這對我們而言是非常好的一年——也取得了多項良好成果。

We don't expect anything like last year, obviously, and it's really too early to try to put a number on it at this point. While we have good visibility into new sales, and we have good visibility into our retention of members that were on plans that we exited, which is a good sign for retention, we don't really have a good handle on retention at this point. We just don't have the data on that at this point in time. And so when you kind of add it all up, it's hard to give a clear range on exactly where we expect to be.

我們當然不預期會像去年那樣，而且現在要嘗試給出一個數字還太早。雖然我們對新銷售有很好的能見度，也對我們退出的方案中會員的留存情況有很好的能見度——這對留存是個好訊號——但目前我們對整體留存其實還沒有很好的掌握。我們現在確實還沒有相關數據。因此把所有因素加總起來後，很難就我們預期會落在哪裡給出明確區間。

Yes. And if I can add to that, what we -- from what we see across the larger players, I think they're all -- we're all better positioned than perhaps expected, especially given the number of plan exits across most of the major players. As Jim mentioned, we think a lot of our performance is driven by our really strong relationships with our broker partners. But I do think there has been some consolidation of some smaller plans, which is driving a bit better performance from the larger players.

是的。如果我可以補充一下，從我們對大型業者的觀察來看，我認為大家——我們所有人——的定位都比原先預期更好，特別是考量到多數主要業者都有不少方案退出。如Jim所提到，我們認為我們的表現很大一部分是由我們與經紀人合作夥伴之間非常強的關係所驅動。但我也確實認為，一些較小型方案有所整併，這讓大型業者的表現稍微更好一些。

Matthew Gillmor, KeyBanc.

Matthew Gillmor，KeyBanc。

I just wanted to follow up on the PCO costs from the earlier question from Justin. Can you quantify the impact from those higher costs? And do you expect to be able to mitigate all of that for the 2027 period?

我想就Justin先前提到的PCO成本再追問一下。你們能量化這些較高成本的影響嗎？以及你們是否預期在2027年期間能把這些影響全部緩解？

We have never broken out the overall contribution of PCO. I would say to the enterprise, it's not -- the impact is not meaningful. It is to PCO itself. We expect to offset most of what we're seeing with the actions that we -- that CenterWell has taken, Humana Plan has taken as well as the other payers have taken. Based on what we know today, it should address most of the pressure.

我們從未拆分揭露PCO的整體貢獻。我會說，對整個企業層面而言，影響並不重大。但對PCO本身而言是有影響的。我們預期能以CenterWell已採取的行動、Humana計畫端採取的行動，以及其他付款方採取的行動，抵銷我們目前看到的大部分影響。以我們今天所掌握的情況來看，這些措施應可解決大部分壓力。

David Windley, Jefferies.

David Windley，Jefferies。

I wanted to maybe put a finer point on a couple of earlier ones around margins. So I think your expectations for this year were on the individual MA to run slightly below breakeven. You're probably maybe slightly above breakeven. So 300-ish basis points to your 3% target. Stars perhaps two-thirds of that.

我想針對先前幾個關於利潤率的問題再更精準一些。我認為你們今年對個人MA的預期是略低於損益兩平。而你們現在可能略高於損益兩平。因此距離你們3%的目標大約還有300個基點左右。Stars（星級）可能占其中約三分之二。

I guess I was wondering if we could -- if you agree with that and if we could get perhaps a little bit more thinking on how much operationally this coming year you might span given that the Stars kicks in and delivers a lot of that. And then, Jim, the outperformance part of that Stars, any -- if not, how you would split it, the thoughts that drive -- the decision factors that would influence how you would split it?

我想請教你們是否同意這樣的看法，以及是否能多談一些：在Stars開始生效並帶來其中很大一部分貢獻的情況下，明年在營運面你們還可能需要補上多少。另外，Jim，關於Stars的超預期表現部分——如果你不打算拆分——你會如何拆分？以及哪些考量因素會影響你們如何拆分的決策？

Yes. Let me start with the back end of that question. So again, we will not be ready to quantify this until late next year or possibly even in the 2027 fourth quarter call. We'll have to see how things develop. There's a couple of things that we have to look at.

是的。我先從你問題的後半段開始。同樣地，我們要到明年較晚的時候，甚至可能要到2027年第四季電話會議，才會準備好量化這件事。我們必須看看事情如何發展。有幾件事我們需要觀察。

So one is the exact size of what the tailwind will be is not something that you can precisely quantify today. There's a whole bunch of factors that play into that. One is we will see the gap between us and our top quartile target shrink over the course of the next 15 months. Our competitors will take actions that will improve their average Stars scores. we will have limited actions that we can take to improve ours, like we will take what actions we can, but we will have limited actions that we can take. So you will see that shrink over time.

第一，順風（tailwind）的確切規模不是你今天就能精準量化的。這牽涉到很多因素。其中之一是，在接下來15個月內，我們與「前四分位」目標之間的差距會逐步縮小。我們的競爭對手會採取行動來提升他們的平均Stars分數。我們能採取的行動會相對有限——我們會盡可能採取可行的行動，但我們能做的仍有限。因此你會看到這個差距隨時間縮小。

The second thing that will obviously impact the final tailwind is going to be the size and the mix of our membership, both this year and what we're seeing in AEP a year from now. That will have a meaningful impact and what that impact is, it is hard to forecast at this point in time. So that's really step one for us.

第二個會明顯影響最終順風規模的因素，是我們的會員規模與組合（mix），包括今年以及我們在一年後AEP所看到的情況。這會帶來有意義的影響，而影響的幅度在此刻很難預測。所以這對我們而言確實是第一步。

The second step then is our really looking at from an operational capacity standpoint, what can we productively invest to the degree that we have opportunities that increase overall enterprise value over time, we want to take advantage of that. But there will be an operational capacity limitation to -- that we're going to have to manage through. And that is something that we will better understand 12 months from now than you're trying to predict it today. But those are really the factors that we will take into account.

第二步則是，從營運產能的角度來看，我們能夠以具生產力的方式投資哪些項目；只要我們有能隨時間提升整體企業價值的機會，我們就希望把握。但在營運產能上會有一個限制——我們必須加以管理並克服。而這件事，我們在12個月後會比你今天試圖預測時更清楚。但這些確實就是我們會納入考量的因素。

And what we do know, and I'll just stress this again, is the tailwind will be sufficient. Even with all of the factors that I just described, it will be sufficiently large that we will not be able to productively invest all of it. We're not going to spend money to spend money, obviously. And so we know that there will be something. There's just a whole host of things that have to play out before we know exactly what that looks like.

我們確實知道的一點——我再強調一次——是順風將會足夠強。即便考量我剛才描述的所有因素，它的規模也會大到讓我們無法把全部都以具生產力的方式投出去。顯然，我們不會為了花錢而花錢。因此我們知道一定會有剩餘。只是，在我們確切知道那會長什麼樣子之前，還有一大堆事情需要逐步發展。

Yes. And if I could, a couple of things on Stars. One, I wouldn't get too far ahead of us in terms of what that tailwind will be. Don't forget about the 30% offset with the value-based care providers. And also, what we're going to talk to you about next month at the investor update, and we continuously talk to you about, and this is how we're planning is like what are our sustainable earnings. So we will talk about '28 in that manner. And then, of course, we will give you that -- as we get closer, we will give you what we think the upside will be and how we will spend it.

是的。如果可以的話，關於Stars我補充幾點。第一，不要在順風會有多大這件事上走得太前面。別忘了，與價值導向照護（value-based care）提供者之間有30%的抵銷。另外，我們下個月在投資人更新會議上會跟各位談、而且我們也一直在談、並且我們就是以此來做規劃的，是：我們的可持續獲利（sustainable earnings）是什麼。所以我們會以那樣的方式來談2028年。當然，隨著時間更接近，我們會告訴你我們認為上行空間會是多少，以及我們會如何運用它。

Now as it relates to your question on margin, I'm certainly not going to comment on your estimate of where we are. But I'd say don't underestimate the other actions we are taking here to improve the margin of MA and the rest of our businesses. We said our number one priority in AEP was to price for margin. Our number two priority was retention, which helps with margin. And then third -- just in third was growth.

至於你問到的利潤率，我當然不會評論你對我們目前水準的估計。但我想說，不要低估我們正在採取的其他行動，這些行動用來改善MA以及我們其他業務的利潤率。我們說過，在AEP期間我們的第一優先事項是以利潤率為導向定價。第二優先是留存（retention），這也有助於利潤率。第三——才是成長。

We also have been undergoing a significant transformation. You'll continue to have those additional tailwinds into next year, both on the operating cost side and the medical cost side of things. So Stars is important, but it is not the only thing we are working to improve here and not the only thing we are making significant progress on.

我們也正在進行一項重大的轉型。無論在營運成本端或醫療成本端，這些額外的順風都會延續到明年。因此Stars很重要，但它不是我們為了改善現況而努力的唯一事情，也不是我們取得顯著進展的唯一領域。

Jason Cassorla, Guggenheim Securities.

Jason Cassorla，Guggenheim Securities。

I wanted to ask about capital deployment. You've been pretty busy this year on the M&A front, and you've shown material improvements to your debt-to-cap ratio. I guess as earnings and cash flow expand for you in the coming years, can you remind us in terms of how you're thinking about both future acquisition priorities as well as your thoughts around perhaps restarting share repurchase activity or anything else along those lines would be helpful?

我想問關於資本配置。你們今年在併購（M&A）方面相當忙碌，而且你們的負債對資本比率（debt-to-cap ratio）也有實質改善。我想，隨著未來幾年你們的盈餘與現金流擴張，你們能否提醒我們：你們如何看待未來的收購優先順序，以及你們對於可能重新啟動庫藏股回購或其他類似措施的想法？任何相關說明都會很有幫助。

Let me start and then Celeste will jump in as well. At a high level, what we would emphasize is that we are -- well, number one, our biggest use of capital is actually the Insurance business as we grow. So our single biggest use of capital is funding reserves. And we just -- we want to make sure that, that's clear to everybody. Beyond that, the places where we will deploy capital is Medicaid and CenterWell. And obviously, that's not all M&A. That's a combination of both organic growth and M&A. And the focus continues to be in the places where we have been growing and investing over the course of the last couple of years.

我先開始，Celeste也會補充。從高層次來說，我們要強調的是——第一，我們最大的資本用途其實是保險業務本身，因為我們在成長。所以我們單一最大的資本用途是提存準備金（funding reserves）。我們只是——希望大家都能清楚這一點。除此之外，我們會配置資本的領域是Medicaid和CenterWell。而且顯然，這不全是併購；這是有機成長與併購的組合。我們的重點仍然放在過去幾年我們一直在成長與投資的那些領域。

So obviously, we've had a lot of organic growth in Medicaid and a lot of that growth has been focused on these HIDE, FIDE and Dual SNP plans. We continue to invest in the PCO business, which we think is an important part of the portfolio. It is both a good stand-alone business and it reinforces all the things that we are trying to do within Medicare Advantage, which is drive quality, it's drive Stars, it's drive better outcomes and experience for our members, and it's managing total medical cost at the end of the day. So expanding our footprint in PCO continues to be a priority.

很明顯地，我們在Medicaid有很多有機成長，而其中很大一部分成長聚焦在這些HIDE、FIDE以及Dual SNP方案。我們也持續投資PCO業務，我們認為這是投資組合中很重要的一部分。它本身就是一門很好的獨立業務，同時也強化我們在Medicare Advantage內想做的所有事情：推動品質、推動Stars、為會員帶來更好的結果與體驗，並且在最後管理整體醫療成本。因此，擴大我們在PCO的版圖仍然是優先事項。

Again, that's not just M&A. A lot of that is organic. And the decisions between organic and M&A are driven by what is available in the market and what is the price of what is in the market. And so we will be very thoughtful in what is going to deliver the best return on capital. Is it organic? Or is it M&A? And we look at those in the same bucket, so to speak. We don't have a separate target for either one. We look at those in the same bucket. So that's kind of how we think about it big picture.

再說一次，這不只是併購，其中很大一部分是有機成長。而在有機成長與併購之間的決策，取決於市場上有哪些標的可得，以及市場上標的的價格。因此，我們會非常審慎地判斷什麼能帶來最佳的資本報酬。是有機成長？還是併購？我們把兩者放在同一個籃子裡來看，可以這麼說。我們不會為任何一種設定獨立目標。我們把兩者放在同一個籃子裡看。這大致就是我們從整體角度的思考方式。

Celeste, what would you add?

Celeste，你會補充什麼？

Yes. And just to clarify, in terms of the capital deployed to Insurance, it's the capital required to go into the subsidiaries. So when you grow membership, when you grow premium, you need to put capital into the subsidiaries. As you know, we put substantial capital, much of which we had freed up from balance sheet work we had done into our insurance subsidiaries this year.

好的。再澄清一下，關於配置到保險的資本，指的是需要投入到子公司的資本。所以當你增加會員數、增加保費規模時，你就需要把資本投入子公司。如你所知，今年我們把大量資本投入到保險子公司，其中很大一部分是我們透過資產負債表相關工作所釋放出來的資本。

But also, in addition to what Jim was speaking about with M&A, we will, as our earnings power recovers, begin to grow our dividend again. We would like to get that payout ratio to a more normalized level before we do that. But it's important to us to grow our dividend. We know that's important to shareholders.

另外，除了Jim提到的併購之外，隨著我們的獲利能力恢復，我們也會再次開始提高股利。在那之前，我們希望先把配息率（payout ratio）拉回到較正常的水準。但對我們而言，提高股利很重要。我們知道這對股東很重要。

We have been doing buybacks enough to offset dilution. I would expect that we would increase that. But keep in mind that buybacks are very onerous from a debt-to-cap perspective. So you basically get twice as much bang for your buck investing in your business than you do buybacks or I should -- it's twice as onerous to the debt to cap.

我們一直有在做回購，至少足以抵銷稀釋。我預期我們會提高這個規模。但請記住，從負債對資本（debt-to-cap）的角度來看，回購的負擔非常沉重。所以基本上，把資金投資在你的業務上，比起回購能得到兩倍的效益；或者我應該說——對負債對資本而言，回購的負擔是兩倍。

And finally, I just want to say we're in a position where we actually -- versus a year or two years ago, we are -- we have the ability to make choices, and we will be very prudent about managing our balance sheet given the volatility of the business overall and ensuring we retain our flexibility and our ability to operate through any environment. But we're really pleased to be in a position where we can make choices. We're not -- we don't have any puts. We don't have to spend a lot of money next year. Buying in clinics that we can buy later, we love that business, but a lot more flexibility than we had a year ago or two years ago.

最後，我只想說，我們目前所處的位置——相較於一年前或兩年前——我們有能力做選擇；而且考量到整體業務的波動性，我們會非常審慎地管理資產負債表，確保我們保有彈性，以及在任何環境下運作的能力。但我們真的很高興能處在一個可以做選擇的位置。我們——我們沒有任何被迫性的條款（puts）。我們明年不必花很多錢。像是收購診所這類事情，我們可以之後再買；我們喜歡那門業務，但我們擁有比一年前或兩年前更大的彈性。

A.J. Rice, UBS.

A.J. Rice，瑞銀（UBS）。

Historically, Humana was consistently -- and I know it's a little bit of a different metric than what you're saying you're focused on now, but you were 90% or so 4-star rated across your membership. And so that was quite a bit higher than a top quartile and you consistently managed -- the business consistently managed for that. Now you're saying you're focusing on benefit design, reinvestment to manage toward a top quartile performance. Is that just give you more predictability around the business sort of minimize volatility? I guess it seems like a change, maybe it's not, but I wonder if you'd comment on that.

從歷史上看，Humana 一直都能做到——我知道這跟你們現在說你們聚焦的指標有點不同——在你們的會員中，大約有 90% 是 4 星評等。因此那水準遠高於前四分位數，而你們也一直——公司也一直以此作為經營管理的目標。但現在你們說你們正聚焦於福利設計、再投資，以朝向前四分位數的表現來管理。這樣做只是為了讓業務更可預測、某種程度上降低波動嗎？我猜這看起來像是一個改變，也許其實不是，但我想請你們評論一下。

And then specifically to the earnings recovery in May occurs, I know you've been at 30% outsourced to providers and shared risk arrangements for a while. Do you think you'll have the opportunity to step that up over time? Or is the 30% sort of a number that you're comfortable with and just will sustain?

另外，特別針對 5 月發生的獲利回升，我知道你們有一段時間大約 30% 是外包給醫療提供者並採用風險分攤安排。你們認為未來有機會逐步提高這個比例嗎？還是說 30% 這個數字你們已經覺得合適，並會維持下去？

Yes. A.J., thank you for the question. Let me try to clarify the commentary around Stars to start, and then we'll come back to the second question there. So there's a couple of things going on when it comes to Stars that kind of philosophically, we're trying to ground into how we run the business.

是的。A.J.，謝謝你的提問。我先嘗試釐清我們對星級（Stars）的評論，然後再回到第二個問題。關於星級這件事，從理念上來說，我們在思考如何把它落實到我們經營業務的方式上，裡面有幾個面向正在發生。

You are right. For a long time, we were able to manage Stars to a 90% 4-star level. And obviously, our goal is not to hit top quartile. Our goal is to be the absolute best that we can be at Stars year in and year out. And we would love to be at 90% year in and year out. That is what we're going to be fighting to achieve every year. It's what we owe our patients and our members.

你說得沒錯。很長一段時間，我們都能把星級管理在 90% 達到 4 星的水準。而且很明顯，我們的目標不是只做到前四分位數。我們的目標是年復一年在星級上做到我們所能做到的最好。我們也很希望能年復一年都維持在 90%。這就是我們每一年都會努力爭取達成的目標。這是我們對病患與會員應盡的責任。

The nature of the top quartile metric is a couple of things. One, we put too much emphasis on 4 stars as opposed to the mix of 3.5, 4 and 4.5. And we wanted more orientation to the PMPM impact of each of those step-ups in star ratings. We wanted that internally because we need that kind of focus internally, and we want that externally because we think it's important that our investors are thinking about the overall PMPM impact, not merely the 4-star percentage impact. So that's part of our thinking.

前四分位數這個指標的本質有幾個點。第一，我們過度強調 4 星，而不是 3.5、4 與 4.5 的組合。我們希望更聚焦於每一次星級提升對每會員每月（PMPM）影響的方向。我們內部需要這樣的聚焦，因為我們需要那種內部的專注；我們也希望對外如此，因為我們認為投資人應該思考的是整體的 PMPM 影響，而不只是 4 星占比的影響。這是我們思考的一部分。

Part of our thinking is we need a minimum threshold by which we know that we can run the business successfully. And that minimum threshold is what informs how we manage our cost structure and how we manage our benefit structure. And it forces us to put more discipline in how we manage those two things.

我們思考的另一部分是：我們需要一個最低門檻，讓我們知道在那個水準下仍能成功經營這項業務。而這個最低門檻會反過來影響我們如何管理成本結構，以及如何管理福利結構。它也迫使我們在管理這兩件事上更有紀律。

So our sitting here saying, hey, we'd love to be at 90% or let's just say, we'd love to be at top decile, but we're going to manage the business at top quartile. That is a disciplined action for us. That is a way for us every single year to say, can our cost structure survive at top quartile. Can our benefits work at top quartile? Can this business be successful long term? We are forcing ourselves to be more disciplined.

所以我們坐在這裡說，嘿，我們很希望能做到 90%，或是說，我們很希望能做到前十分位數（top decile），但我們會以前四分位數來管理這門生意。對我們而言，這是一個有紀律的作法。這是一種讓我們每一年都能問自己：在前四分位數的情境下，我們的成本結構能否承受？我們的福利設計在前四分位數的情境下能否運作？這門生意長期而言能否成功？我們是在強迫自己更有紀律。

And I do think that we have probably not conveyed that as effectively as we could since Investor Day last year. But I think it's important for everybody to understand that. This is for us to manage the business with discipline. We want to and expect to outperform every year, like that's what we expect of ourselves. But we need to know that target that allows us to understand how we manage the other elements of the business. So that's the logic for what we're doing. And look, over time, we welcome feedback around it, but that's the logic for what we're doing. And now let me go to the other question. Celeste, what was the other question?

而且我確實認為，自從去年投資人日以來，我們可能沒有把這件事表達得像我們本來可以做得那麼有效。但我認為讓大家理解這點很重要。這對我們而言，是為了以紀律來管理業務。我們希望、也預期每一年都能超越——這就是我們對自己的要求。但我們需要知道那個目標，才能理解我們要如何管理業務的其他要素。所以這就是我們這麼做的邏輯。而且你看，隨著時間推進，我們也歡迎大家對此提出回饋，但這就是我們這麼做的邏輯。現在我來回答另一個問題。Celeste，另一個問題是什麼？

I can take that question. Yes, A.J., just to clarify what Jim was saying, we did call out the top quartile goal at our Investor Day last year. I think I got lost a little bit because there were so many other numbers and moving pieces. But as it relates to your second question, and you were a little blurry on our end, so I'm going to guess as to what I think you were asking.

那個問題我可以回答。是的，A.J.，為了釐清 Jim 的意思，我們確實在去年投資人日提出了前四分位數的目標。我想因為還有很多其他數字與變動因素，所以這點有點被淹沒了。至於你的第二個問題，因為你那邊的聲音在我們這端有點模糊，所以我會先猜測我理解你在問什麼。

We are -- we have shifted slightly in terms of our thinking about providers. We very much believe that value-based care can drive excellent health outcomes, and we obviously are investing that ourselves in our own business. But we're really focused on aligning our members to high-quality providers. Not every high-quality provider wants to do risk. Not every high-quality provider wants to be a value-based provider. We don't want to not partner with excellent providers who don't take risk. We want to embrace them as well to ensure that our members are getting the best quality care.

我們——在對醫療提供者（providers）的看法上，我們的思維稍微有一些轉變。我們非常相信價值導向照護（value-based care）能帶來優異的健康結果，而我們也很明顯正在我們自身業務中投入資源。但我們真正聚焦的是讓會員與高品質的醫療提供者對接。不是每一位高品質的提供者都想承擔風險（do risk）。也不是每一位高品質的提供者都想成為價值導向的提供者。我們不希望因為對方不承擔風險，就不與那些優秀的提供者合作。我們也希望接納他們，以確保我們的會員能獲得最高品質的照護。

As it relates to this quarter, in particular, in terms of our percent in value-based care, we've been really focusing on strengthening the infrastructure and governance needed to manage those relationships effectively and efficiently. And at times, that can lead to us parting ways with some of them where we don't view them as appropriate value-based care providers because they're not driving the health outcomes that we would expect.

就本季而言，特別是在我們價值導向照護占比方面，我們一直在著力強化有效且高效率管理這些合作關係所需的基礎設施與治理機制。而有時候，這會導致我們與其中一些合作方分道揚鑣，因為我們認為他們並不適合作為價值導向照護的提供者，原因是他們沒有帶來我們所期望的健康結果。

So again, I'd focus you on high-quality providers. It doesn't mean you're going to see a material change in percent of value-based care, but we want to ensure every day that our members are getting the best care possible.

所以再次強調，我會請你把焦點放在高品質的提供者。這不代表你會看到價值導向照護占比出現重大的變化，但我們希望每天都能確保會員獲得盡可能最好的照護。

Kevin Fischbeck, Bank of America.

Kevin Fischbeck，美國銀行（Bank of America）。

Just one clarification question and then the real question. As far as this Extra Stars earnings in 2028, I just want to make sure you were going to say we're hitting our 2028 number and then this is a onetime benefit on top of an excess of that is where you think it's going to land right now. But then I guess the real question is, you talked about the progression on the Medicaid -- sorry, on the Medicare individual margin, but there is another, I don't know, $7 or $8 of EPS to get to that $40 number that comes from Medicaid, CenterWell, capital deployment, Group MA. So how do we think about that progression of that earnings stream? Is that ratable in '27, '28? Is there a reason to think it's going to be more back-end loaded or front-end loaded there?

先問一個釐清問題，然後再問真正的問題。關於 2028 年這個 Extra Stars 的獲利，我只是想確認一下：你們是要說你們會達到 2028 年的數字，而這會是在你們認為目前會落點的水準之上、一次性的額外利益嗎？但我想真正的問題是：你們談到 Medicaid——抱歉，是 Medicare 個人業務利潤率的改善路徑，但要到 40 美元那個數字，還有另外大概 7 或 8 美元的 EPS 來自 Medicaid、CenterWell、資本配置、團體 MA。那我們該如何看待那條獲利來源的進展？在 27、28 年會是平均、線性地增加嗎？有沒有理由認為它會更偏後段發力或前段發力？

Let me start, and then I think Celeste will probably jump in here as well. I'll come back to the Stars question. I think, Kevin, what you were asking is for us to clarify, yes, we've hit our target and we're well above our target. And if we're managing the business at our target, meaning our cost structure and et cetera, then there should be some overage, some benefit above where we manage the business to on a day-to-day basis. That is accurate.

我先回答，然後我想 Celeste 也可能會補充。我會回到星級的問題。Kevin，我想你是在請我們釐清：是的，我們已達到目標，而且遠高於目標。如果我們是以目標水準來管理業務——也就是我們的成本結構等等——那麼相對於我們日常管理所依據的水準，應該會有一些超額、一些額外的好處。這是正確的。

And then the question, of course, is then what are we going to do with that. And we do expect to invest some, and we do expect some of it to pass through to earnings. And the exact quantification is what we won't have for some period of time, but that is how we're thinking about it. And then on your second question, again, I can't remember and pass to Celeste.

然後問題當然就是，我們接下來要怎麼處理這件事。我們確實預期會投入一部分資金，也確實預期其中一部分會反映到盈餘上。至於精確的量化，我們在一段時間內還無法提供，但我們的思考方向就是如此。至於你的第二個問題，我同樣記不太清楚了，交給 Celeste。

Yes. So I just want to make sure you're clear on what Jim was saying. Yes, the Stars performance would be in excess of our target for 2028. And Jim did say upfront that we are running towards ahead of plan. And if you think about the things that we laid out, if you think about the waterfall that we gave you at our Investor Day last year that we will update for you next month, across every single line item, we are ahead, and we will show that to you.

是的。我只是想確保你清楚 Jim 剛才的意思。是的，Stars 的表現會高於我們 2028 年的目標。而且 Jim 一開始就說過，我們目前的進度領先於計畫。如果你回頭看我們列出的各項內容、以及去年投資人日給你的那張瀑布圖（我們下個月會更新給你），在每一個單項上我們都領先，我們也會向你展示。

So the 95% of members in 4+ Star plans this year would be upside to that. And we will size that for you as we get closer depending on all of the factors. So as it relates to '27, again, given where we are in AEP, I'm not going to tell you exactly how far we'll get to. But the same factors that have us ahead of '28 will effectively make our -- steepen the slope to the path. So you will see improvement versus what we would have previously expected in '27 as well as in '28. And there are a number of factors, some of which I have called out already, the overall cost transformation, moving through the J curves for Medicaid and Medicare.

因此，今年有 95% 的會員在 4+ 星計畫中，這會是額外的上行空間。我們會在更接近時點、視所有因素而定，為你量化其規模。至於 2027 年，再次強調，考量我們目前在 AEP 的狀況，我不會告訴你我們確切能達到多遠。但讓我們在 2028 年領先的同樣因素，將會有效地讓我們——使這條路徑的斜率變得更陡。所以你會看到 2027 年相較於我們先前預期的改善，以及 2028 年的改善。而這背後有多項因素，其中一些我已經提過，包括整體成本轉型、以及 Medicaid 與 Medicare 的 J 曲線推進。

Don't forget that we have undertaken a very significant recontracting effort in our group MA business. So last year, we had -- we were very significantly negative in group MA. Excluding the Stars headwind, we have improved 500 basis points. Now you won't see the full benefit of that until we get our stars back in 2028, 500 basis points. So it's -- again, I said this earlier, it's not just Stars that we're delivering on, it is across the board.

別忘了，我們在團體 MA 業務上已展開非常重大的重新簽約（recontracting）工作。所以去年我們在團體 MA 上——表現非常顯著為負。若排除 Stars 的逆風，我們已改善了 500 個基點。不過在 2028 年我們把星等拿回來之前，你不會看到這 500 個基點的全部效益。所以——我先前也說過，我們交付的不只是 Stars，而是全面性的改善。

Scott Fidel, Goldman Sachs.

Scott Fidel，高盛。

Thought it might be helpful if you could spend a little time just talking about how the strategy has sort of evolved around deploying reinsurance in the Medicare Advantage business. It seemed like there was a pretty substantial increase in the use of the reinsurance this year. And just curious in terms of like as we think about the primary effects of that on the P&L and revenue and costs or balance sheet, just sort of -- if you can sort of walk us through the mechanics of that.

我想如果你能花點時間談談，在 Medicare Advantage 業務中運用再保險的策略是如何演進的，可能會很有幫助。看起來今年再保險的使用有相當大幅度的增加。我也想了解，當我們思考其對損益表（P&L）、收入與成本或資產負債表的主要影響時——如果你能帶我們走一遍其運作機制。

And then more importantly, on the go forward in terms of the reinsurance, is that something that you look to sort of sustain? Or was that more of something that was like a bit more of a one-off for this year and then you look to recede and reduce that? Just mostly curious in sort of how you're thinking about approaching that for 2027.

然後更重要的是，展望未來在再保險方面，這會是你們打算維持的做法嗎？還是說這比較像是今年的一次性措施，之後你們會回撤並降低使用？主要是想了解你們對 2027 年在這方面的思考。

Scott, we -- when we looked at -- I guess, our lack of reinsurance, our view was there was a lot more efficient way to manage the amount of capital that was required to be put into the subs. So -- and that was, to some extent, I think, making us uncompetitive. The way I think about it is that previously about -- we were putting about 12% of premiums into the subs. It's probably just under 10% at the moment, and we are close to where we would want to be. If we grow a bit this year -- we'll grow a bit this year, we, maybe do a little bit more. But you won't see a substantial change in terms of, I think, the overall use of reinsurance into 2027.

Scott，我們——當我們檢視——我想是我們缺乏再保險的狀況時，我們的看法是：其實有更有效率的方法來管理需要投入子公司（subs）的資本量。所以——而這在某種程度上，我認為讓我們缺乏競爭力。我的理解是，以前我們大約——會把約 12% 的保費投入子公司。目前大概略低於 10%，而且我們已接近我們希望達到的水準。如果今年我們成長一些——我們今年會成長一些——我們可能會再多做一點。但我認為在 2027 年之前，你不會看到再保險整體使用上有顯著變化。

That cost is reflected in our -- the run rate is reflected in our numbers for this year. It is -- I would say it's definitely cheaper than debt funding. You obviously don't get the NII pickup, but we believe there are more efficient ways to use -- if we decide to use debt, we believe there are better ways to apply that debt. So we will obviously reexamine this year in, year out and figure out the optimal way to deploy capital to fund ourselves, consider all the costs, but I wouldn't expect to change in the next couple of years. We're pretty happy with where we are right now.

那項成本已反映在我們——今年的數字中已反映其運行水準（run rate）。我會說，這肯定比以債務融資更便宜。當然你不會得到淨利息收入（NII）的提升，但我們相信，如果我們決定使用債務，還有更有效率的方式來運用——我們相信有更好的方式來配置那筆債務。因此我們會逐年重新檢視，找出最優的資本部署方式來為自身融資，並考量所有成本，但我不預期未來幾年會有改變。我們對目前的狀況相當滿意。

Andrew Mok, Barclays.

Andrew Mok，巴克萊。

I wanted to follow up on your comment around your capitated partners. It sounded like you absorbed most of the Stars-related headwind and shielded your capitated partners from the downside when you lost your bonus revenue. So I just want to better understand how the mechanics of this work with the bonus revenue flowing through to your capitated partners back on the way up?

我想追問你剛才提到的按人頭付費（capitated）的合作夥伴。聽起來在你們失去獎金收入（bonus revenue）時，你們吸收了大部分與 Stars 相關的逆風，並保護了你們的按人頭付費合作夥伴免於承受下行影響。所以我想更清楚了解，當獎金收入在回升時，流向你們按人頭付費合作夥伴的機制是如何運作的？

Yes. So yes, we did insulate our value-based care providers to some extent, particularly the higher quality ones. We wanted to ensure that just given the overall challenges in MA that they were protected. And we -- the way we allocated it was based on performance. So the best performers got the greatest benefit or the greatest contribution from us.

是的。所以是的，我們在某種程度上確實保護了我們的價值型照護（value-based care）提供者，特別是品質較高的那些。我們希望確保，鑑於 MA 整體的挑戰，他們能受到保護。而我們——分配方式是依據績效表現。因此表現最好的，從我們這裡獲得最大的好處或最大的貢獻。

As you think about the upside to top quartile, right, that is incremental. So you're going to have the full cap offset. If you're thinking just up to where we were targeting, yes, you would see the reversal of that where -- or you wouldn't see as much of the offset, right, because we're already offsetting some of that for them. But when you get above where we were targeting, that is all incremental. That is -- you still have the 30% cap offset. And we can -- you can follow up with Lisa if you have more questions, but you really have to think about the target and then on top of it, what's below, what's above.

當你思考上行到前四分位（top quartile）時，對吧，那是增量的。所以你會有完整的上限（cap）抵銷。如果你只是思考回到我們原本的目標水準，是的，你會看到那部分的反轉——或者你不會看到那麼多的抵銷，對吧，因為我們已經替他們抵銷了一部分。但當你高於我們原本的目標時，那就全部都是增量。也就是——你仍然有 30% 的上限抵銷。如果你還有更多問題可以再跟 Lisa 追問，但你真的必須以目標為基準，然後再看其下方是什麼、上方是什麼。

George Hill, Deutsche Bank.

George Hill，德意志銀行。

I guess I'll just make my point of clarification, Celeste. It sounds like if I'm thinking about 2027, you guys are pricing to about 8.5% trend, but trend is currently running, call it, maybe 7-ish. So the question is, as we think about margin expansion for 2027, kind of how much of it is coming from the pricing initiatives versus how much of it is coming from internal cost control initiatives? And kind of should we think of this level of conservatism as kind of what Jim termed like the new normal disciplined operating model?

Celeste，我想我只是做個釐清。聽起來如果我在想 2027 年，你們的定價是以大約 8.5% 的趨勢率（trend）為基礎，但目前的趨勢率大概在 7% 左右。所以問題是，當我們思考 2027 年的利潤率擴張時，其中有多少來自定價措施，又有多少來自內部成本控管措施？另外，我們是否應該把這種保守程度視為 Jim 所說的那種「新常態」的紀律化營運模式？

So to be clear, I said 8% to 9%. I did not say 8.5%, is the range. And the reason for that, as I called out, is in large part driven by our expectation of a very robust health technology pipeline, really driving Part D, the Part D component up to 14% to 15% this year, we're closer to 11% to 12%. And then the med cost on the margin a little bit higher as well.

所以先說清楚，我說的是 8% 到 9%。我沒有說 8.5%，那是區間。而之所以如此，正如我提到的，很大一部分是由於我們預期健康科技產品線（pipeline）會非常強勁，將會推動 D 部分（Part D）——也就是 Part D 的組成——今年上升到 14% 到 15%，而我們目前更接近 11% 到 12%。另外，邊際上的醫療成本也會略高一些。

We don't price or look at trend in terms of operating -- I mean, it is part of operating discipline, but you have to be able to justify the costs that you price into your bids. You can't just add to be conservative. You have to really be able to justify those expenses. And based on the various pieces, in particular, on the Part D side, it drives that higher trend, and that is reflected in our bids.

我們在定價或看待趨勢時，不會以營運——我的意思是，這確實是營運紀律的一部分——來衡量，但你必須能夠合理化你在投標報價中納入的成本。你不能只是為了保守就一味加上去。你必須真正能夠合理說明那些費用。而基於各個不同的因素，特別是在 Part D 端，它推動了較高的趨勢，並且這也反映在我們的投標報價中。

And I would say in terms of the improvement for 2027, a large part of it is going to be driven by the pricing, but you will have continued upside from some of the other components. We had a benefit from our transformation this year. We had a nice tailwind. If you recall back at the beginning of the year, we walked through all of the things we had done to offset the Stars headwind. We would have very little earnings if we hadn't taken action to offset the Stars headwind. So we have some of that already. The real incremental progress is going to be because of the pricing.

我會說，就 2027 年的改善而言，其中很大一部分將由定價所驅動，但你也會從其他一些組成要素中持續獲得上行空間。我們今年從轉型中獲益。我們有不錯的順風。如果你回想年初，我們逐一說明了我們為了抵消 Stars 逆風所做的所有事情。如果我們沒有採取行動來抵消 Stars 逆風，我們的獲利將會非常少。所以其中有一部分我們已經具備了。真正的增量進展將會是因為定價。

Yes. And let me just layer one more thing on there, which is -- the way that I would think about what we're trying to do to manage the business, it's less about conservatism and it's more about discipline. It is about running the business in a way where we are planning across multiple years, looking out and understanding how the external environment may change, good or bad, being prepared to be able to adapt to those things and then running with a level of discipline in year that we are holding ourselves accountable across all pieces -- all of the drivers of this business.

是的。再補充一點——我看待我們試圖管理業務的方式，是較少關於保守，而更多關於紀律。這是關於以一種我們跨多年規劃的方式來經營業務，向外看並理解外部環境可能如何變化，無論好壞，做好準備以便能夠適應這些變化，並且在年度內以一定程度的紀律運行，讓我們在所有面向——這項業務的所有驅動因素——都對自己負責。

The four things that I talk about every single quarter, we need to be operating against all four of those things every single day, every single week, every single quarter, every single year. And so we have to make decisions internally that create visibility and clarity into all four of those elements in a way that our team can go execute successfully against those. That is what we're doing. That is why we're disciplined about saying what is top quartile and how do we manage to that.

我每一季都會談到的四件事，我們需要每天、每週、每季、每年都圍繞這四件事來運作。因此，我們必須在內部做出決策，以一種能讓我們的團隊對這四個要素都具備可視性與清晰度的方式，讓團隊能夠成功地去執行。這就是我們正在做的事。這也是為什麼我們有紀律地去界定什麼是前四分位（top quartile），以及我們如何朝那個目標管理。

That is why we are disciplined about saying, how do you manage the balance sheet in a way where even when you just had a couple of years of depressed earnings, you can actually take your debt to cap down, right? We took our debt to cap down in a couple of years that were very difficult for the business, and we did that because we were disciplined about how we're managing the balance sheet. That is how we want to manage the entire business. And it is less about conservatism, and it is much more about just being disciplined so that we know that we are delivering quarter after quarter, year after year.

這也是為什麼我們有紀律地去說，如何以一種方式管理資產負債表，使得即便你剛經歷了幾年獲利受壓，你仍然可以把債務資本比（debt to cap）降下來，對吧？在對業務非常艱難的幾年裡，我們把債務資本比降下來了，而我們之所以能做到，是因為我們在管理資產負債表方面很有紀律。這就是我們希望管理整個業務的方式。這較少是關於保守，而更多是關於保持紀律，讓我們知道自己能夠一季接一季、年復一年地交付成果。

With that, I want to go back and I want to kind of close where we started this conversation today. we are in a good place. We are executing. We have a strategy that, again, all signs are pointing to, it is working. We are increasingly seeing the results of that, and we're seeing the results of our team doing really good work, and this is moving us towards being ahead of plan. You can see this in our earnings guidance today. You can see this in our top quartile and better results in Stars. You can see this in how we are successfully managing a robust growth -- membership growth in 2026.

說到這裡，我想回到並且大致收束我們今天這段對話一開始的地方。我們處於一個良好的位置。我們正在執行。我們有一個策略，而且再次強調，各種跡象都顯示它正在奏效。我們愈來愈看到其成果，也看到我們團隊做得非常出色的工作所帶來的成果，這正推動我們走向超前於計畫。你可以在我們今天的盈餘指引中看到這一點。你可以在我們 Stars 達到前四分位及更佳的結果中看到這一點。你也可以在我們如何成功管理強勁成長——2026 年會員成長——中看到這一點。

And each one of these milestones is evidence that we are, in fact, planning across multiple years, preparing for the possibility that there may be unexpected external factors that we have to navigate, and we're operating with an improved level of operating discipline day in and day out. We're turning clear goals into action across our team in a shared way. So yes, we have individual accountability, but we also have shared accountability to hit numbers. We're acting and moving earlier, and we make it easier for the people that we're serving for our members and our patients.

而這些每一個里程碑都證明，我們確實是在跨多年進行規劃，為可能出現的、我們必須因應的意外外部因素做好準備，並且日復一日以更高水準的營運紀律在運作。我們正以共同的方式，將清晰的目標轉化為全團隊的行動。所以，是的，我們有個人問責，但我們也有共同問責來達成數字目標。我們更早採取行動並提前推進，並且讓我們所服務的人——我們的會員與病患——更容易獲得服務。

These milestones and momentum are all improving our outlook for the next couple of years and beyond the next couple of years. These are things that create sustained value over time. I'm truly proud of how our team has responded over the course of the last couple of years. I'm thrilled that more of that is visible externally, but I'm actually more energized about what we can achieve going forward and where we're headed.

這些里程碑與動能都在改善我們對未來幾年以及更長遠的展望。這些都是能隨時間創造持續價值的事情。我真的為我們團隊在過去幾年中的回應方式感到自豪。我很高興外界能更清楚地看到其中更多成果，但其實我對我們未來能達成什麼、以及我們將前往的方向，更感到振奮。

And so with that, I just want to say thank you for joining us this morning and for your interest in Humana. And I want to say thank you to the 65,000 associates who serve our members and our patients every day. They are what make all of this happen. And we appreciate your support, and we hope you have a great day. Thank you.

因此，說到這裡，我只想感謝各位今天早上加入我們，並且感謝各位對 Humana 的關注。我也想向每天服務我們會員與病患的 65,000 名同仁致謝。正是他們讓這一切得以實現。我們感謝各位的支持，也希望各位今天一切順利。謝謝。

This concludes today's conference call. Thank you for participating. You may now disconnect.

今天的電話會議到此結束。感謝各位參與。您現在可以掛線。