1Life Healthcare Inc (ONEM) 2022 Q1 法說會逐字稿

Good day, and welcome to the One Medical's First Quarter 2022 Earnings Results Call. (Operator Instructions) Please be advised that today's call may be recorded.

大家好，歡迎參加 One Medical 2022 年第一季財報電話會議。 （操作員指示）請注意，今天的通話可能會被錄音。

I would now like to turn the call over to Ken Goff. You may begin.

現在我想將電話轉給肯·戈夫。你可以開始了。

Thank you, operator. Hello, everyone, and welcome to One Medical's First Quarter 2022 Earnings Call. I'm Ken Goff, Head of Investor Relations, and I'm joined today by Amir Dan Rubin, Chair and CEO of One Medical; and Bjorn Thaler, Chief Financial Officer of One Medical.

謝謝您，接線生。大家好，歡迎參加 One Medical 2022 年第一季財報電話會議。我是投資人關係主管 Ken Goff，今天與我一起參加會議的還有 One Medical 董事長兼執行長 Amir Dan Rubin；以及 One Medical 財務長 Bjorn Thaler。

A complete disclosure of our results can be found in our press release issued earlier as well as in our related Form 8-K, all of which are available on our website at investor.onemedical.com. As a reminder, today's call is being recorded, and a replay will be available on our website.

有關我們業績的完整揭露可在我們之前發布的新聞稿以及相關的 8-K 表格中找到，所有這些文件均可在我們的網站 investor.onemedical.com 上查閱。提醒一下，今天的通話正在錄音，重播將在我們的網站上提供。

As part of today's commentary, we will make forward-looking statements. These statements are based on management's current views, expectations and assumptions and are subject to multiple risks and uncertainties. Actual results may differ materially, and we disclaim any obligation to update any forward-looking statements or outlook. Please refer to the risk factors on our most recent annual as updated from time to time by our other reports and filings with the SEC, including our quarterly reports.

作為今天評論的一部分，我們將做出前瞻性陳述。這些聲明是基於管理階層目前的觀點、預期和假設，並受多重風險和不確定性的影響。實際結果可能有重大差異，我們不承擔更新任何前瞻性陳述或展望的義務。請參閱我們最近年度報告中的風險因素，這些因素會透過我們向美國證券交易委員會提交的其他報告和文件（包括我們的季度報告）不時更新。

We believe that the COVID-19 pandemic continues to create particular complexity when it comes to providing a forward-looking view of business, and we are providing our guidance on a good faith basis per recent SEC recommendations. We would like to specifically caution investors that our future performance will be harder to predict for the foreseeable future. Our forward-looking statements are based on assumptions that we believe to be reasonable as of today's date, May 4, 2022. Information contained in today's statement should not be relied upon as representing our estimates as of any subsequent date.

我們認為，COVID-19 疫情在提供前瞻性業務觀點方面繼續帶來特別的複雜性，我們正在根據美國證券交易委員會 (SEC) 的最新建議，真誠地提供指導。我們要特別提醒投資人，在可預見的未來，我們的未來表現將更難以預測。我們的前瞻性聲明是基於我們認為截至今天（2022 年 5 月 4 日）合理的假設。

Of note, it is One Medical's policy to neither reiterate nor adjust financial guidance provided on today's call, unless it is also done through a public disclosure, such as a press release or through the filing of a Form 8-K.

值得注意的是，One Medical 的政策是既不會重申也不會調整今天電話會議上提供的財務指導，除非透過公開揭露（例如新聞稿）或透過提交 8-K 表格來進行。

Today, we will discuss certain non-GAAP metrics that we believe aid in the understanding of our financial results. A historical reconciliation to comparable GAAP metrics can be found in today's earnings release. During the call, we may offer incremental metrics to provide greater insights into the dynamic of our business. These details may be onetime in nature, and we may or may not provide updates in the future.

今天，我們將討論一些我們認為有助於理解財務結果的非 GAAP 指標。在今天的收益報告中可以找到與可比較 GAAP 指標的歷史對帳表。在通話過程中，我們可能會提供增量指標，以便更深入地了解我們的業務動態。這些細節可能只是一次性的，我們可能會或可能不會在將來提供更新。

Finally, I'll remind you that we closed the acquisition of Iora on September 1 of last year, meaning that their results are not included in any comparisons made to the first quarter of 2021.

最後，我要提醒您，我們在去年 9 月 1 日完成了對 Iora 的收購，這意味著他們的業績未包含在與 2021 年第一季的任何比較中。

And with that, I'll turn the call over to Amir.

說完這些，我會把電話轉給阿米爾。

Thank you, Ken, and thank you, everyone, for joining us.

謝謝 Ken，也謝謝大家加入我們。

In the first quarter of 2022, One Medical continued to perform, innovate and grow, with its innovative primary care model built for purpose to delight members with better health, better care, lower costs within a better team environment.

2022 年第一季度，One Medical 繼續表現、創新和發展，其創新的初級保健模式旨在讓會員在更好的團隊環境中享受更好的健康、更好的護理、更低的成本。

In terms of financial performance, Q1 revenue of $254.1 million exceeded the high end of our guidance range by more than $4 million. For Senior Health At-Risk Care, the medical claims expense ratio decreased by 10 percentage points compared to the fourth quarter of 2021. Non-GAAP profitability measures also outperformed, with care margin and adjusted EBITDA both coming in above the high end of their respective guidance range. And looking ahead, we continue to be extremely excited about our ability to transform health care at scale across all stages of life for multiple key stakeholders, including for members, employers, providers and health networks.

在財務表現方面，第一季的營收為 2.541 億美元，比我們預期的高點高出 400 多萬美元。對於老年健康風險護理，醫療索賠費用率與 2021 年第四季度相比下降了 10 個百分點。展望未來，我們將繼續對自己能夠為包括會員、雇主、供應商和醫療網絡在內的多個關鍵利益相關者大規模轉變生命週期各個階段的醫療保健的能力感到非常興奮。

In terms of members, our total member count grew to 767,000 in the quarter, up 28% compared to the first quarter of 2021. This membership count included 728,000 consumer and enterprise members, up 22% year over year and in the high end of our guidance range. It also included 39,000 at-risk members, which was above the top end of our guidance range, up more than 80% compared to Iora's pre-acquisition at-risk member count from Q1 2021, driven by growth from direct contracting, a program that began in Q2 of last year as well as Medicare Advantage.

就會員數量而言，本季我們的會員總數增長至767,000 人，比2021 年第一季增長28%。 。它還包括 39,000 名高風險會員，高於我們指導範圍的上限，與 Iora 收購前 2021 年第一季的高風險會員數量相比增長了 80% 以上，這得益於直接簽約計劃的增長。去年第二季開始實施的計劃以及Medicare Advantage 計劃。

With our human-centered and technology-powered model, we continue to delight our members. For example, we continue developing our machine learning models, enabling us to even more seamlessly respond to member inquiries and share test results with even faster response times. With our senior health At-Risk Care, we continued to see significant improvements in our medical claims expense ratios, reaching 84% in the quarter, down a full 10 percentage points sequentially. As you may recall from last quarter, we showed continued improvements in medical claims expense ratios across all our cohorts of At-Risk patients on a year-over-year basis.

我們以人為本、科技驅動的模式，持續為會員帶來滿意的服務。例如，我們繼續開發我們的機器學習模型，使我們能夠更無縫地回應會員查詢並以更快的回應時間分享測試結果。透過我們的老年人健康風險護理，我們的醫療索賠費用率繼續顯著改善，本季達到 84%，比上一季下降了整整 10 個百分點。您可能還記得，上個季度，我們顯示所有高風險患者群體的醫療索賠費用率比去年同期持續改善。

We also continued innovating our member experience and care management approach for our most vulnerable seniors through our One Medical At-Home program, building upon Iora's previous efforts. Through One Medical At-Home, we bring together in-home care teams, in-office providers and virtual team members, connected through our technology, to deliver outcomes to complex patients. We leverage our analytics and machine learning models to identify vulnerable members who could be well served by this intensive model and who, on average, have 9 chronic conditions.

我們也以 Iora 先前的努力為基礎，透過「一站式醫療居家」計劃，繼續為最脆弱的老年人創新會員體驗和護理管理方法。透過 One Medical At-Home，我們將家庭護理團隊、辦公室服務提供者和虛擬團隊成員聚集在一起，透過我們的技術進行連接，為複雜的患者提供治療結果。我們利用分析和機器學習模型來識別弱勢成員，這些成員可以透過這種強化模型得到很好的服務，並且平均患有 9 種慢性病。

One Medical At-Home has allowed us to provide better care while further reducing avoidable costs in complications. For example, compared to matched historical cohorts, patients in the program with the highest risk profile had a statistically significant reduction in costs over 6 months, averaging 26% less spend than non-enrollees with a similar baseline spending risk.

One Medical At-Home 讓我們能夠提供更好的護理，同時進一步降低可避免的併發症成本。例如，與配對的歷史群組相比，風險狀況最高的計劃中的患者的費用在 6 個月內具有統計上顯著的降低，平均比具有相似基線支出風險的未參加者減少 26%。

In addition to delighting our members, we continue delivering outstanding value to existing and new employer accounts, including from national multi-market clients. As our geographic footprint grows, we continue to see an increase in interest from larger multi-market employers, a positive validation of our national strategy. We are also seeing employers further recognize how our primary care, hybrid in-person and virtual-based model can deliver differentiated clinical outcomes and value-based care results, addressing backlogs of deferred care to prevent avoidable morbidity and cost down the road.

除了讓我們的會員滿意之外，我們還繼續為現有和新的雇主帳戶提供卓越的價值，包括來自全國多市場的客戶。隨著我們的地理覆蓋範圍不斷擴大，我們不斷看到來自大型多市場雇主的興趣日益增加，這是對我們國家策略的積極驗證。我們也看到雇主進一步認識到我們的初級保健、混合面對面和虛擬模式如何提供差異化的臨床結果和基於價值的護理結果，解決延期護理的積壓問題，以防止可避免的發病率和日後的成本。

For example, with a large employer, we recently further rolled out programs to address chronic disease conditions, many of which may be exacerbated by people deferring care during the pandemic. One such program is One Medical Healthy Heart, which focuses metabolic and cardiovascular risk and includes a risk assessment by a primary care provider, followed by a series of virtual and in-person interactions with a health coach and exercise guide. In rolling out Healthy Heart with an employer, 80% of the participants saw a reduction in low-density lipoprotein or LDL, also known as the bad cholesterol, with 60% of participants experiencing a greater than 20% LDL reduction. LDL-cholesterol is bad because high levels can add to risk of heart attack and stroke.

例如，我們最近與一家大型雇主合作，進一步推出了針對慢性病的計劃，其中許多疾病可能會因人們在疫情期間推遲治療而加劇。其中一個項目是“一個醫療健康心臟”，該項目重點關注代謝和心血管風險，包括由初級保健提供者進行的風險評估，然後與健康教練和運動指導進行一系列虛擬和麵對面的互動。在與雇主合作「健康心臟」計畫的過程中，80% 的參與者的低密度脂蛋白或LDL（也稱為壞膽固醇）有所減少，其中60% 的參與者的LDL 減少了20% 以上。 LDL 膽固醇是有害的，因為高水平的 LDL 膽固醇會增加心臟病發作和中風的風險。

Another program we recently rolled out with an employer called One Medical Healthy Mind is an expansion of our mindset behavioral health solution set, and focuses on mental well-being and resilience. Healthy Mind combines primary care visits with cognitive testing, wellness coaching and, when needed, support by a therapist. Through One Medical Healthy Mind, participants at this employer saw an average, 52% increase in health confidence scores, a standardized score that measures confidence in capabilities and motivation to look after one's health. Through healthy mind and mindset more broadly, employers are seeing how One Medical can promote employee self-efficacy and engagement, which are important steps to improve physical and mental well-being.

我們最近與一家雇主合作推出的另一個項目名為“One Medical Healthy Mind”，它是我們心態行為健康解決方案集的擴展，重點關注心理健康和復原力。健康心靈將初級保健訪問與認知測試、健康指導以及必要時的治療師支持相結合。透過「One Medical Healthy Mind」項目，該雇主的參與者的健康信心分數平均提高了 52%，這是一個衡量對照顧自己健康的能力和動力的信心的標準化分數。透過更廣泛的健康心靈和心態，雇主們看到了 One Medical 如何提高員工的自我效能和參與度，這是改善身心健康的重要步驟。

Given these dramatic improvement levels, we are now scaling the Healthy Heart and Healthy Mind programs to additional employers. Accordingly, we are demonstrating with these programs just as we've demonstrated with our impact program for diabetes and chronic conditions and our other mindset behavioral solutions that our differentiated, modernized hybrid model of longitudinal primary care can deliver outsized impacts for better health and better value.

鑑於這些顯著的改善水平，我們現在正在將「健康心臟」和「健康心靈」計畫擴展到更多雇主。因此，我們透過這些項目證明，就像我們透過針對糖尿病和慢性病的影響項目以及其他思維方式行為解決方案所證明的那樣，我們差異化的、現代化的縱向初級保健混合模式可以帶來巨大的影響，從而實現更好的健康和更高的價值。

In addition to delighting members and employers, we are also health care delivery for One Medical providers and staff. We continue to advance our technology team and processes to reduce administrative burdens faced by our providers, allowing them to spend more time focused on patient care, whether working virtually or in-person in more markets across the country.

除了讓會員和雇主滿意之外，我們還為 One Medical 的提供者和員工提供醫療服務。我們將繼續改進我們的技術團隊和流程，以減輕我們的供應商面臨的管理負擔，使他們能夠花更多時間專注於患者護理，無論是在全國更多市場進行虛擬工作還是親自工作。

As we mentioned last quarter, One Medical was recently ranked by Ford and Statista as one of American's best midsized employers. Furthermore, our strong mission-driven culture has enabled us to hire more primary care providers in Q1 than in any other quarter ever reported in the history of One Medical.

正如我們在上個季度所提到的，One Medical 最近被福特和 Statista 評為美國最佳中型雇主之一。此外，我們強大的使命驅動文化使我們在第一季僱用的初級保健提供者比 One Medical 歷史上任何其他季度都要多。

Turning to our health network partners. We continued advancing our partnerships to further own the complexity of coordinating care across a continuum of setting on behalf of members and payers and to further deliver value-based integrated care experiences.

轉向我們的健康網路合作夥伴。我們繼續推進我們的合作夥伴關係，以進一步掌握代表會員和付款人在整個過程中協調護理的複雜性，並進一步提供基於價值的綜合護理體驗。

As mentioned on last quarter's call, we recently entered into a partnership with Hartford Healthcare in Connecticut, which will bring us into our 29th in-person market. Additionally, we continue to field further interest from existing and potential new health network partners to partner with us on commercial and senior health opportunities.

正如上個季度的電話會議上所提到的，我們最近與康乃狄克州的哈特福德醫療保健建立了合作夥伴關係，這將使我們進入第 29 個面對面市場。此外，我們將繼續吸引現有和潛在的新的健康網路合作夥伴的關注，與他們合作開發商業和老年健康機會。

We also continue to expand our partnerships with more health plans for senior health At-Risk care. We now have senior health payer relationships in place with 9 different Medicare Advantage plans with an average of more than 4 plans per market. We have also grown our potential for more at-risk lives through direct contracting, all of which together gives us more avenues for member growth and retention in the future.

我們也將繼續擴大與更多健康計畫的合作，為老年人提供健康風險照護。我們目前與 9 種不同的醫療保險優勢計劃建立了老年健康支付方關係，平均每個市場有超過 4 個計劃。我們也透過直接簽約擴大了我們為更多高風險生命提供照護的潛力，所有這些都為我們未來會員的成長和保留提供了更多的途徑。

Additionally, we believe we are delivering outstanding results for members and health plans, with one of our health plans just notifying us last week that we are a top performer with an equivalent Medicare Stars' quality rating of 4.8 out of 5 stars. And speaking of at-risk care, we have been highly effective and ahead of our expectations in integrating Iora's care management capabilities, analytical models, technology providers and teams into our combined organization. Accordingly, we believe we are positioning ourselves to uniquely serve every stage of life across the nation under multiple reimbursement models with high-quality virtual and in-person value-based care.

此外，我們相信我們正在為會員和健康計劃提供出色的成果，我們的一項健康計劃上週剛剛通知我們，我們的表現名列前茅，獲得了相當於 Medicare Stars 質量評級 4.8 星（滿分 5 星）。說到高風險護理，我們在將 Iora 的護理管理能力、分析模型、技術提供者和團隊整合到我們的合併組織中方面非常有效，並且超出了我們的預期。因此，我們相信，我們正以獨特的方式在多種報銷模式下為全國各地生活的每個階段提供高品質的虛擬和麵對面的基於價值的護理。

In summary, we are off to a strong start for the year, making impacts for our key stakeholders through our human-centered and technology-powered model. We outperformed our expectations in the quarter, reflecting strong execution against our strategic operating plan. We believe we have never been better positioned to serve more people in more markets across every stage of life with better health, better care, better value and a better team environment.

總而言之，我們今年開局良好，透過以人為本、技術驅動的模式為我們的主要利害關係人帶來影響。本季我們的業績超乎預期，反映出我們策略營運計畫的強勁執行。我們相信，我們從未像現在這樣有能力為更多市場、更多人潮、每個人生階段提供更佳的健康、更佳的照護、更佳的價值和更佳的團隊環境。

Now let me turn it to One Medical's CFO, Bjorn Thaler.

現在讓我把話題轉到 One Medical 的財務長 Bjorn Thaler 身上。

Thank you, Amir, and hello to everyone joining us on today's call.

謝謝你，阿米爾，也向參加今天電話會議的所有人問好。

As Amir discussed, One Medical today reported a strong first quarter 2022 results. We outperformed on our revenue and non-GAAP profitability metrics while continuing to show strong growth across business. We are seeing good progress in our integration of our senior and commercial businesses, and we are well positioned to create long-term value for our members, employees, enterprise customers, health network partners and shareholders by providing high-quality care that improves health outcomes and helps lower total health care costs.

正如阿米爾所討論的，One Medical 今天公佈了強勁的 2022 年第一季業績。我們的營收和非公認會計準則獲利指標表現出色，同時業務持續呈現強勁成長。我們在老年業務和商業業務整合方面取得了良好進展，我們有能力透過提供改善健康狀況的高品質護理，為我們的會員、員工、企業客戶、醫療網絡合作夥伴和股東創造長期價值並有助於降低整體醫療保健成本。

On this call, I will walk through our first quarter revenue drivers, discuss our outperformance on non-GAAP profitability metrics, touch on our balance sheet and cash position, and provide commentary on our improved outlook for the rest of the year.

在這次電話會議上，我將介紹我們第一季的收入驅動因素，討論我們在非GAAP 盈利指標上的優異表現，談及我們的資產負債表和現金狀況，並對我們今年剩餘時間的改善前景發表評論。

I will remind you that we closed the acquisition of Iora on September 1 of last year, meaning that their results are not included in any comparisons made to the first quarter of 2021.

我要提醒您的是，我們在去年 9 月 1 日完成了對 Iora 的收購，這意味著他們的業績未包含在與 2021 年第一季的任何比較中。

Turning to our first quarter revenue guidance. We finished the first quarter of 2022 with 767,000 members, representing growth of 28% over last year and coming in above the midpoint of our guidance. Consumer and Enterprise members grew 22% year-over-year to 728,000. We were pleased with this performance, which is consistent with the expectations we had on our last call. Excluding the impact from approximately 18,000 to 25,000 vaccine certification members added mostly in the third quarter of last year, this represents growth of approximately 18% year-over-year.

談到我們第一季的營收指引。 2022 年第一季度，我們的會員數量為 767,000 名，較去年同期成長 28%，高於我們預期的中位數。消費者和企業會員數量年增22%，達到728,000人。我們對這次的表現感到滿意，這與上次通話時的期望一致。除去去年第三季新增的約 18,000 至 25,000 名疫苗認證成員的影響，這一數字年增約 18%。

As a reminder, these members were asked by their employers to verify their vaccination status through One Medical, but have not previously used us for primary care and who we believe may churn in 2022.

提醒一下，這些會員的雇主要求他們透過 One Medical 驗證他們的疫苗接種狀況，但之前並未使用過我們的初級保健服務，我們認為他們可能會在 2022 年流失。

Turning to our At-Risk membership. We finished the quarter with 39,000 members, 1,000 members above the high end of our guidance and representing a sequential growth rate of 18% compared to the fourth quarter of 2021. This includes the 13,000 direct contracting members that we discussed on our last earnings call.

轉向我們的高風險會員資格。本季結束時，我們的會員數量為39,000 名，比我們預期的高點高出1,000 名，與2021 年第四季相比，季增率為18%。上討論的13,000 名直接簽約會員。

Looking ahead, please keep in mind that we made the decision not to add incremental direct contracting members throughout the year in 2022, and we will instead take care of these patients on a fee-for-service basis throughout this year, until the next alignment date on January 1, 2023.

展望未來，請記住，我們決定在 2022 年全年不增加增量直接簽約會員，而是在今年全年以按服務收費的方式照顧這些患者，直到下一次調整日期為2023年1月1日。

Moving on to revenue. Total net revenue for the first quarter grew 109% year-over-year to $254.1 million, $4 million above the high end of the guidance range we issued on our last earnings call. Our growth was primarily driven by the inclusion of our At-Risk business, with Medicare revenues contributing $127.4 million to total net revenue in Q1. This Medicare revenue consists of $124.6 million in capitated revenue, up 29% sequentially compared to Q4 of 2021, driven primarily by an increase in at-risk members. Also included in our Medicare revenue are $2.8 million in fee-for-service and other Medicare revenue.

繼續討論收入。第一季的總淨收入年增 109% 至 2.541 億美元，比我們在上次財報電話會議上發布的指導範圍上限高出 400 萬美元。我們的成長主要得益於風險業務的納入，其中醫療保險收入為第一季的總淨收入貢獻了 1.274 億美元。該醫療保險收入包括 1.246 億美元的按人頭計算的收入，與 2021 年第四季相比環比增長 29%，主要原因是高風險成員數量的增加。我們的醫療保險收入還包括 280 萬美元的按服務收費收入和其他醫療保險收入。

First quarter commercial revenue came in at $126.7 million, $6.7 million above the top end of our guidance and up 4% year-over-year. This commercial revenue consists of membership revenue of $24.2 million, a growth of 20% year-over-year and similar to our growth in consumer and enterprise members and fee-for-service and partnership revenue of $102.4 million, up 3% year-over-year.

第一季商業收入為 1.267 億美元，比我們預期的最高值高出 670 萬美元，比去年同期成長 4%。商業收入包括會員收入 2,420 萬美元，年成長 20%，與消費者和企業會員的成長類似，以及收費服務和合作夥伴收入 1.024 億美元，年成長 3% -年。

This quarter's commercial revenue growth was driven by our strong growth in commercial members and higher-than-expected reimbursement rates. It was also impacted by year-over-year decline in COVID-related revenue and by capacity constraints early in the year due to providers being sidelined due to the Omicron variant. Our 2-year Q1 commercial revenue compound annual growth rate was a strong 27%.

本季的商業收入成長得益於我們商業會員的強勁成長和高於預期的報銷率。它也受到了與去年同期 COVID 相關的收入下降以及年初供應商因 Omicron 變種而被擱置導致的產能限制的影響。我們第一季商業收入的兩年複合年增長率高達 27%。

Moving down to P&L. Medical claims expense for the quarter was $105 million, translating to an 84% medical claims expense ratio, a 10 percentage point improvement compared to the fourth quarter of 2021. This is despite the impact from the Omicron variant, particularly in January, and moreover the continued impact of COVID infections, deferred care and missed care throughout the pandemic.

轉到損益表。本季的醫療理賠費用為1.05 億美元，醫療理賠費用率為84%，與2021 年第四季相比改善了10 個百分點。而且在整個疫情期間，COVID 感染、延遲治療和錯過治療的持續影響。

We believe that the work we are doing to help our members prevent or better manage their illnesses and reduce avoidable hospitalizations or other procedures by appropriately documenting their health status will enable us to continue to drive down this ratio over time.

我們相信，透過適當記錄會員的健康狀況，我們正在進行的工作可以幫助我們的會員預防或更好地管理他們的疾病，並減少可避免的住院或其他程序，這將使我們能夠隨著時間的推移繼續降低這一比例。

Cost of care was $101.4 million in the first quarter, up 45% year-over-year, primarily due to the addition of our senior business, continued investments in our patient-facing staff, our ongoing service expansion and opening 6 new offices in the quarter. Despite these investments, care margin came in at a strong $47.8 million, $2.8 million above the high end of our guidance range equating to 19% of revenue.

Cost of care was $101.4 million in the first quarter, up 45% year-over-year, primarily due to the addition of our senior business, continued investments in our patient-facing staff, our ongoing service expansion and opening 6 new offices in the四分之一.儘管進行了這些投資，但護理利潤仍高達 4,780 萬美元，比我們的指導範圍高端高出 280 萬美元，相當於收入的 19%。

First quarter SG&A came in at $119.5 million or 47% of revenue, down from 63% in the first quarter of 2021. Our goal is to continue to show improvements in operating expenses as a percent of revenue as we scale the business and make responsible investments in future growth opportunities.

第一季的銷售、一般及行政開支為1.195 億美元，佔營收的47%，低於2021 年第一季的63%。改善營運費用佔收入的百分比未來的成長機會。

Adjusted EBITDA came in at negative $28.9 million in the quarter, $1.1 million above the top end of our guidance range, driven by our revenue outperformance while we continue to make purposeful investments in the business.

本季調整後的 EBITDA 為負 2,890 萬美元，比我們預期範圍的最高端高出 110 萬美元，這得益於我們收入表現優異，同時我們繼續對業務進行有目的的投資。

Turning now to the balance sheet. We ended the quarter with $428.5 million in cash and marketable securities, a decrease of $73.4 million from the end of 2021. This was primarily driven by $55.1 million in cash used for operating activities. Net working capital was a capped at $24.6 million in the quarter, primarily driven by seasonality and the timing of when we receive certain payments.

現在來看看資產負債表。本季末，我們的現金和有價證券為 4.285 億美元，比 2021 年底減少 7,340 萬美元。本季淨營運資本上限為 2,460 萬美元，主要受季節性和我們收到某些付款的時間影響。

We also had $19.2 million in capital expenditures over the course of the first quarter as we continued to invest in our geographic expansion and technology. We continue to believe our cash and marketable security balance, together with our ability to moderate our discretionary spending, will provide us with sufficient liquidity to fuel our growth.

由於我們繼續在地域擴張和技術方面進行投資，第一季我們還完成了 1,920 萬美元的資本支出。我們仍然相信，我們的現金和有價證券餘額，加上我們控制可自由支配支出的能力，將為我們提供足夠的流動性來推動我們的成長。

Now let us turn to guidance. For the full year 2022, we are maintaining our guidance range for Consumer and Enterprise members of 790,000 to 810,000. For At-Risk members, we are now expecting to land between 41,000 and 43,000, a 1,000-member increase from our previous guidance on both the top and bottom end of the range. We are increasing our 2022 total net revenue guidance by $10 million on both the top and bottom end, and now expect to range between $1.055 billion and $1.095 billion. We are raising both the top and bottom end of our commercial revenue guidance by $5 million to $535 million and $555 million. And we are also raising the top and bottom end of our Medicare revenue range by $5 million, with the new range being $520 million to $540 million.

現在讓我們來談談指引。對於 2022 年全年，我們維持消費者和企業會員的指導範圍為 790,000 至 810,000。對於高風險會員，我們目前預計其數量將在 41,000 至 43,000 人之間，比我們之前對該範圍的上限和下限的預測均增加了 1,000 人。我們將 2022 年總淨收入預期的上限和下限均上調 1,000 萬美元，目前預計在 10.55 億美元至 10.95 億美元之間。我們將商業收入預期的上限和下限均上調 500 萬美元，分別達到 5.35 億美元和 5.55 億美元。我們也將醫療保險收入範圍的上限和下限提高 500 萬美元，新的範圍為 5.2 億美元至 5.4 億美元。

Our increased expectations for revenue are also allowing us to raise our expectations for care margin in 2022, now expected to range between $200 million and $220 million, an increase of $5 million on both the top and bottom end of the range.

我們對收入預期的提高也使我們能夠提高對 2022 年護理利潤的預期，目前預計在 2 億美元至 2.2 億美元之間，範圍的上限和下限均增加 500 萬美元。

Looking at adjusted EBITDA, we expect some of the outperformance to flow through to the bottom line, while also investing some of it back into the business. As such, we are raising the bottom end range by $5 million, with the new adjusted EBITDA range expected to be between negative $130 million and negative $115 million.

從調整後的 EBITDA 來看，我們預期部分優異表現將轉化為利潤，同時也將部分投資於業務。因此，我們將底端範圍提高 500 萬美元，新的調整後 EBITDA 範圍預計在負 1.3 億美元至負 1.15 億美元之間。

For the second quarter, we expect total members to range between 779,000 and 790,000 members. Consumer and Enterprise members are expected to come in between 740,000 and 750,000. And At-Risk members are expected to be between 39,000 and 40,000.

我們預計第二季會員總數將在 779,000 至 790,000 人之間。消費者和企業會員數量預計在 740,000 至 750,000 之間。預計高風險成員人數在 39,000 至 40,000 之間。

Total net revenue for the second quarter is expected to range between $255 million and $270 million. Commercial revenue is expected to come in between $125 million and $135 million. And Medicare revenue is expected to be between $130 million and $135 million.

預計第二季總淨收入在 2.55 億美元至 2.7 億美元之間。預計商業收入將在 1.25 億美元至 1.35 億美元之間。醫療保險收入預計在 1.3 億美元至 1.35 億美元之間。

2Q care margin is expected to be between $45 million and $55 million, which implies a margin of 19% at the midpoint. Adjusted EBITDA is expected to range from negative $40 million to negative $30 million, reflecting our revenue and care margin guidance as well as continued investments in our people and services.

預計第二季護理利潤率在 4,500 萬美元至 5,500 萬美元之間，中間值利潤率為 19%。調整後的 EBITDA 預計在負 4000 萬美元至負 3000 萬美元之間，反映了我們的收入和護理利潤率指導以及對我們的員工和服務的持續投資。

In conclusion, One Medical is off to a great start in 2022, continuing to post strong financial results by growing our membership base, employer relationships, health networks, partnerships and geographic footprint. We believe that our model of taking care of members, both in-person and digitally, both episodic and longitudinally, and across all stages of life highlights our ability to support all of our members in whatever way they prefer.

總而言之，One Medical 在 2022 年取得了良好的開端，透過擴大我們的會員基礎、雇主關係、健康網絡、合作夥伴關係和地理覆蓋範圍，繼續取得強勁的財務業績。我們相信，我們照顧會員的模式，無論是面對面還是數位方式，無論是偶發性還是縱向的，以及涵蓋生活的各個階段，都凸顯了我們以會員喜歡的任何方式為他們提供支持的能力。

And with that, we will open up the call for questions. Operator?

現在，我們將開始提問。操作員？

(Operator Instructions) Our first question comes from Ricky Goldwasser with Morgan Stanley.

（操作員指示）我們的第一個問題來自摩根士丹利的 Ricky Goldwasser。

Congrats on the good quarter and the guidance for the second half of the year. Just wanted to get more context and more color on what you're seeing in the marketplace in terms of core utilization environment on the commercial side, on the legacy One Medical and same for Iora.

恭喜本季的良好業績以及下半年的良好預期。只是想獲得更多背景資訊和細節，以了解您在市場上看到的商業方面的核心利用環境、傳統的 One Medical 和 Iora 的情況。

Ricky, and to all of you celebrating, May the fourth be with you. But getting to our topic here. Yes, on the consumer and enterprise side, we're seeing movements more towards, I'll call it, a more normalized primary care utilization experience, seeing a decline in, certainly, the COVID testing experience and progression towards, I'll call it, more of a normal primary care experience on the commercial side.

瑞奇，以及所有慶祝的人們，願獨立日與你們同在。但我們現在來談談主題。是的，在消費者和企業方面，我們看到更多的趨勢是，我稱之為更規範化的初級保健利用體驗，當然，COVID 測試體驗正在下降，並且正在朝著我稱之為它更像是商業方面的正常初級保健體驗。

And on the senior health side, the At-Risk side, as we said, we were really pleased to see a 10 percentage points reduction in our blended medical claims expense ratio. Certainly saw some spikes in January due to Omicron, but have seen those come down. And also, as I spoke about in my prepared remarks, we've done a lot of work in managing complex patients, including real effort on our One Medical At Home program, which is a program that had started in the Iora days but we built on top of this that risk stratifies our population, looks for rising risks, very complex seniors and manages them very proactively through team-based care, including going into the home.

在老年健康方面，也就是風險方面，正如我們所說，我們非常高興地看到我們的綜合醫療索賠費用率降低了 10 個百分點。 1 月由於 Omicron 的影響確實出現了一些峰值，但之後已經下降。而且，正如我在準備好的發言中提到的，我們在管理複雜患者方面做了很多工作，包括真正致力於我們的“One Medical At Home”計劃，該計劃早在Iora 時代就已啟動，但我們後來建立了除此之外，我們對人口進行風險分層，尋找不斷上升的風險，尋找病情非常複雜的老年人，並透過團隊照護（包括進入家中）積極地管理他們。

Okay. And then one follow-up. We get a lot of questions from investors around just kind of like cash burn and cash position. So if you could just kind of share with us sort of kind of like your thought in terms cash position. And just sources of how philosophically you think about sort of approach for capital raise.

好的。然後進行一次後續行動。我們收到投資者的許多問題，例如現金消耗和現金狀況。所以如果您可以與我們分享您對現金狀況的想法。這只是您從哲學角度思考籌集資金方法的來源。

Yes. So we obviously ended the quarter with cash and marketable securities of $428.5 million. And overall, we feel that we are appropriately capitalized here considering our business and also our goals at this time. Yes, as we mentioned on the last call already, we do have several levels available to us to moderate our cash burn if that is something that we decide to do. For example, we will be always thoughtful about office openings, both on the at-risk and commercial side. Obviously, that is a lever that we can pull.

是的。因此，我們在本季結束時的現金和有價證券總額顯然達到 4.285 億美元。總體而言，考慮到我們目前的業務和目標，我們認為我們的資本已經足夠充足。是的，正如我們在上次電話會議上提到的那樣，如果我們決定這樣做的話，我們確實有幾個可用的等級來控制我們的現金消耗。例如，我們對辦公室的開設總是深思熟慮，既從風險方面考慮，也從商業方面考慮。顯然，這是我們可以拉動的槓桿。

We can also pull another lever around direct contracting members, where we've decided to exercise our option and not involve those during the year, but instead bringing them into this relationship in January of '23 instead. Those are just some of the things that really are going to help us on the cash side, if it is something that we feel like we need to do.

我們也可以對直接簽約成員採取另一種手段，我們決定行使我們的選擇權，在年內不讓他們參與，而是在23年1月讓他們加入這種關係。如果我們覺得有必要做這些事情，那麼這些只是在現金方面真正對我們有幫助的一些事情。

And probably I think, most importantly, we continue to make significant strides on just operating and executing in our core business. We've reduced our medical claims expense ratio by 10 percentage points in Q1 compared to the fourth quarter of '21. We'll continue to create leverage across our operations. We are continuing to improve our adjusted EBITDA margin, up from negative 18% in 4Q of '21 to negative 11% in Q1 of 2022.

我認為，最重要的是，我們在核心業務的營運和執行方面繼續取得重大進展。與 21 年第四季相比，我們第一季的醫療索賠費用率降低了 10 個百分點。我們將繼續在我們的營運中創造槓桿作用。我們正在繼續提高調整後的 EBITDA 利潤率，從 21 年第四季的負 18% 上升至 2022 年第一季的負 11%。

So you put that all together, and we feel really good about where we are today, the levels that we have, the cash balance that we have, the operations and trajectory. And at the same time, we'll also certainly dynamically monitor the capital structure going forward and market conditions and make sure that we maximize our strategic opportunities for long-term shareholder growth.

所以把所有這些放在一起，我們對目前的狀況、我們擁有的水平、我們擁有的現金餘額、營運和發展軌跡感到非常滿意。同時，我們也將動態監控未來的資本結構和市場狀況，確保最大限度地利用我們的策略機會，實現長期股東成長。

Our next question comes from Lisa Gill with JPMorgan.

下一個問題來自摩根大通的麗莎吉爾 (Lisa Gill)。

I just want to dig a little into to membership. And just get your thoughts. First, let's start with the enterprise One Medical side of things. Bjorn, I think last quarter, you talked about a little bit longer of a sales cycle. We heard Bjorn talk today about the verification -- the vaccine verification.

我只是想稍微深入了解一下會員資格。並了解您的想法。首先，讓我們從企業One Medical方面開始。比約恩，我想上個季度你談到了銷售週期稍微長一點。今天我們聽了比約恩談論疫苗驗證。

So my first question would be, when we think about the vaccine verification, one, have you been successful in converting any of those members over? And then secondly, how do we think about the pipeline conversion when we think about the commercial market?

所以我的第一個問題是，當我們考慮疫苗驗證時，第一，你是否成功地讓任何一位成員轉變了疫苗？其次，當我們考慮商業市場時，我們如何考慮管道轉換？

Yes. Absolutely. And maybe I'll take sort of the first one and then I'll hand it over to Amir to talk a little bit about the pipeline that we are seeing, which continues to be very strong.

是的。絕對地。也許我會先談第一個問題，然後我會把它交給阿米爾，讓他談談我們所看到的管道，它仍然非常強勁。

Under vaccine verification members, we obviously are convinced of the value proposition that we have to our members. Consumer members, as a reminder, they renew with us 9 out of 10x. Enterprise members, again, 9 out of 10x plus. So very strong value proposition. And we continue to believe that it resonates really, really well. And I think you see it in our results today.

在疫苗驗證成員的指導下，我們顯然堅信我們對成員的價值主張。提醒一下，消費者會員 10 次中有 9 次會與我們續約。企業會員再次獲得 10 倍以上的 9 倍。因此價值主張非常強。我們始終相信，它會產生非常非常好的共鳴。我想您可以從我們今天的成果中看到這一點。

These members, just as a reminder, they signed up with us basically because their employers said, you need to. So we are now treating this opportunity to really market to those employees, to educate them about One Medical and what we offer and all the benefits that we bring. But yes, as we stated earlier, at this time, we don't necessarily expect to retain most of these. I think it will be as frankly as upside relative to the guidance that we provided today.

需要提醒的是，這些會員之所以與我們簽約，基本上是因為他們的雇主說，你需要這樣做。因此，我們現在正抓住這個機會向這些員工推銷，讓他們了解 One Medical 以及我們提供的產品和我們帶來的所有好處。但是，正如我們之前所說，目前，我們不一定期望保留其中的大部分。坦白說，我認為與我們今天提供的指引相比，這將是上行的。

Yes, in terms of the commercial side, on the enterprise side, we feel great about our positioning. We've never been in more kind of conversations with larger and larger employers being invited to engage with them. And that's partly due to our growing multi-market presence, and we think that's very powerful. Again, those conversations may take longer if they're larger and larger employers, but we believe we have just such a differentiated approach here. It's not a single-point solution.

是的，就商業方面、企業方面而言，我們對我們的定位感到非常滿意。我們從未進行過如此多的對話，並邀請越來越多的大型雇主與他們接觸。這在一定程度上歸功於我們在多市場中的不斷增長的影響力，我們認為這是非常強大的。再說一次，如果雇主規模越來越大，這些對話可能需要更長的時間，但我們相信我們在這裡採取了這種差異化的方法。這不是一個單點解決方案。

As we talked about today, it's a longitudinal primary care. It's helping on heart health and managing cholesterol and managing, not just behavioral health, but overall resilience. Or as we've talked about in the past, is showing we can take down the cost of care as well. So we feel great about the commercial pipeline and the opportunities there and the conversations that we're having.

正如我們今天所討論的，這是一種縱向初級保健。它有助於心臟健康和膽固醇管理，不僅管理行為健康，還管理整體復原力。或者正如我們過去談到的那樣，表明我們也可以降低護理成本。因此，我們對商業管道和其中的機會以及我們正在進行的對話感到非常滿意。

I mean, just to follow up on that. I just want to understand, though, we've heard from others that employers still are somewhat focused on getting people back to the office. Obviously, we've already had the vaccine verification. They're focused on some other things. Do you feel like the environment is any different, would be, right, the first part of my question.

我的意思是，只是為了跟進這一點。不過，我只是想了解一下，我們從其他人那裡聽說，雇主仍然相當注重讓員工重返辦公室。顯然，我們已經進行了疫苗驗證。他們專注於其他一些事情。您覺得環境有什麼不同嗎？

And then secondly, when we about some of the things you talked about today like healthy heart and healthy mind, is there an incremental PMPM cost or an incremental cost to the employer for that? Or is that included in the current membership dollar amount?

其次，當我們談論您今天談到的一些事情，例如心臟健康和心智健康時，這是否會為雇主帶來增量 PMPM 成本或增量成本？或者這已包含在當前會員費用中嗎？

Yes, thank you, Lisa. I'll start with the latter. That's included in our current program. So we're just extending kind of the capabilities and reach in our program. We have other things for cardiometabolic disorders, diabetes, sleep. So these are really addressing the need that employers and employees are seeing sometimes exacerbated by deferred care, sometimes as much as a couple of years of deferred care to -- these are just more and more proof points that we can add to our model, right? We were good in times at kind of the crunch of the pandemic and health there, but we're also great at addressing longitudinal care.

是的，謝謝你，麗莎。我先從後者開始。這包含在我們目前的計劃中。因此，我們只是擴展了我們程式的功能和影響力。我們還有其他針對心臟代謝失調、糖尿病、睡眠等的藥物。因此，這些確實解決了雇主和僱員有時因延期護理而加劇的需求，有時甚至需要延期幾年的護理——這些只是我們可以添加到我們的模型中的越來越多的證據點，對吧？我們在疫情和衛生最嚴重時期表現良好，但我們在處理縱向護理方面也表現出色。

And again, this is largely due to the fact that it's not point solutions, right? It's not flavor of the month. We can integrate and we can do whole person care. So in that regard, we're seeing great enthusiasm in conversations from our perspective for our organization with employers. And like I said, never had more with the larger and larger employers, that's really been a great area of additional conversation and growth.

再說一次，這主要是因為它不是點解決方案，對嗎？這不是本月的流行口味。我們可以進行整合並提供全人護理。因此從這個方面來看，從我們組織的角度來看，與雇主的對話表現出極大的熱情。正如我所說的那樣，我們從未與越來越大的雇主有過如此多的合作，這確實是一個很好的額外對話和成長領域。

Our next question comes from Daniel Grosslight with Citi.

下一個問題來自花旗銀行的丹尼爾‧格羅斯萊特。

It seems like you've been managing your clinical costs quite well, which is a little bit different than what some of the large health systems have been seeing in 1Q, particularly with some of their nursing staff. So I'm curious if you're seeing any wage pressure within your staff, particularly the nurses, and how you're managing through those pressures?

看來你們一直很好地管理著臨床成本，這與一些大型醫療系統在第一季的情況略有不同，特別是對於一些護理人員而言。所以我很好奇，您是否發現您的員工，特別是護理師面臨薪資壓力，以及您如何應對這些壓力？

Yes. Thanks, Daniel, good to hear from you. Yes, unlike the major hospital systems, the -- our model is not a nurse-heavy model in terms of staffing, even though we have a fantastic nurses and we do use nurses. But that is not a major component of our staffing, so I'd say that's different. We're obviously not immune to what's happening in the economy and looking at salaries. But again, not really seeing that in particular. And again, nurses are not a major group that we use in our staffing models.

是的。謝謝，丹尼爾，很高興收到你的來信。是的，與大型醫院系統不同，在人員配置方面，我們的模式不是以護士為主的模式，儘管我們擁有優秀的護士，而且我們確實使用護士。但這不是我們人員配置的主要組成部分，所以我認為這是不一樣的。顯然，我們無法免受經濟和薪資變化的影響。但同樣，並沒有真正看到這一點。再說一次，護理師不是我們人員配置模型中的主要群體。

But I guess kind of broader, are you seeing any wage within your clinical care teams, whether it's providers or even intake folks?

但我想從更廣泛的角度來看，您是否看到臨床護理團隊中有工資，無論是服務提供者還是接收人員？

Yes, I'd say on the provider front, as we mentioned, we've never hired more providers than in Q1, so we feel we're well positioned. Obviously, we have to keep tabs on what happens market by market, but I think we're keeping tabs on that. And then across other positions, we certainly have to be competitive with the market. But I'd say, nothing outside, and certainly, all of these things are factored into our projections in our guidance.

是的，我想說，在供應商方面，正如我們所提到的，我們從未僱用比第一季更多的供應商，因此我們覺得我們處於有利地位。顯然，我們必須密切關注每個市場發生的情況，但我認為我們正在密切關注這一點。然後在其他職位上，我們當然必須與市場保持競爭力。但我想說，沒有什麼外在因素，當然，所有這些因素都已在我們的指導預測中考慮。

Got it, okay. And then just on the Medicare side of the business, you saw a nice uplift in PMPMs on the capitated side. I calculated around a 16% sequential increase in capitated PMPMs this quarter. I just wanted to get your thoughts on the reason for that uplift this quarter, and how we should think about the cadence of PMPMs for the rest of the year.

知道了，好的。然後僅在業務的醫療保險方面，您就會看到按人頭計算的 PMPM 有了顯著的提升。我計算出本季以人頭計算的 PMPM 環比成長了約 16%。我只是想聽聽您對本季成長原因的看法，以及我們應該如何看待今年剩餘時間 PMPM 的節奏。

Yes. So I think there are a couple of things sort of going on here. Obviously, in many ways, this is sort of a new year, right? And a lot of the deferred care, the pent-up demand that you saw last year is sort of starting to make its way into reimbursement rates for this year. So that's definitely something that we are starting to see.

是的。所以我認為這裡發生了幾件事。顯然，從很多方面來說，這都可以算是新的一年，對吧？而許多延期治療，也就是去年被壓抑的需求，已經開始影響今年的報銷率。所以這絕對是我們開始看到的事情。

The cohorts that we have continue to mature. And I think that's another level that you're starting to see here as well. As I think of the last of the year, obviously, we have -- we do expect to continue to sign up new members throughout the year. Those tend to come in at a little bit of a lower sort of average reimbursement because they do tend to not be well managed when they come to us early on.

我們的隊伍不斷成熟。我認為這也是您在這裡開始看到的另一個層次。當我想到今年的最後一年時，顯然，我們確實希望全年繼續招募新會員。這些費用的平均報銷金額往往會比較低，因為在早期報銷時往往無法得到很好的管理。

So we'll see a little bit of that headwind here for the rest of the year. But really what you're seeing, I think, in many ways, is the fruits of the labor that all of our providers and team members have done the last 12 to 24 months in making sure that we take good care of our existing members. And as they mature and as the documentation on them gets better, you start to see that uplift.

因此，在今年剩餘時間內，我們將會看到一些逆風。但我認為，在很多方面，您所看到的實際上是我們所有供應商和團隊成員在過去 12 到 24 個月內辛勤勞動的成果，我們努力確保現有會員得到良好的照顧。隨著它們的成熟和相關文獻的完善，你會開始看到這種提升。

Our next question comes from Jessica Tassan with Piper Sandler.

下一個問題來自派珀桑德勒 (Piper Sandler) 的傑西卡塔桑 (Jessica Tassan)。

So just at the midpoint of guidance, I think it's implying the consumer and enterprise membership is a little skewed towards the last 3 quarters of the year. So just interested if there are any sort of specific deals to call out, and what the reasons might be for the somewhat back half-weighted strength.

因此，僅在指導的中間點，我認為這意味著消費者和企業會員人數略微偏向今年最後三個季度。所以我只是感興趣是否有任何具體的交易需要提及，以及造成這種後半加權實力略微下降的原因是什麼。

Yes. I don't think any particular thing to call out in general. But certainly, as we get towards the end of the year and head into the beginning of kind of benefit cycles for certain employers and certainly times where we tend to add lives, particularly in the larger employers, but we feel great about the performance growth of 22% year-over-year and in the top half of our guidance range. And as I mentioned before, feel really positive about the conversations that we're having with employers, including with multi-market and larger and larger employers.

是的。我不認為有什麼特別的事情需要整體強調。但可以肯定的是，隨著我們接近年底，進入某些雇主的福利週期的開始，當然也是我們傾向於增加員工的時候，特別是在大型雇主中，但我們對業績增長感到非常高興同比增長22 %，並且處於我們預期範圍的上半部。正如我之前提到的，我們對與雇主的對話感到非常積極，包括與多市場和越來越大的雇主的對話。

So I'd say, overall, that's positive. And again, just some of the points that I mentioned before, I think employers are looking to us as a great benefit that could really differentiate on the recruitment and retention, but also as a great benefit that can help manage the cost of care. We mentioned in the past, the study that we published in JAMA that showed we took out 45% of the cost of care. And we've also mentioned and has a study that shows we have approximately twice the average impact on reducing blood sugar for diabetes patients moving them from uncontrolled to controlled status.

因此我想說，總的來說，這是積極的。再次強調，我之前提到過一些觀點，我認為雇主認為我們提供的福利不僅可以在招募和留任方面真正有所區別，還可以幫助管理照護成本。我們之前提到過，我們在 JAMA 上發表的研究表明，我們承擔了 45% 的護理費用。我們也提到，有一項研究表明，我們對糖尿病患者血糖降低的影響大約是平均值的兩倍，使他們從不受控制的狀態轉變為受控的狀態。

Today, we talked about with the healthy heart program, reducing bad cholesterol on 80% of the patients. We've talked in the past about the mindset impact, reducing anxiety and stress greater than 50%. And today, I talked about healthy mind, increasing basically people's confidence in their ability and resilience to take care of their health and their motivation. So I think all of that portends well for our positioning going forward, so we feel really good about it.

今天，我們討論了健康心臟計畫如何降低 80% 患者的壞膽固醇。我們過去曾談論過心態的影響，可以減少 50% 以上的焦慮和壓力。今天，我談到了健康心態，從根本上增強人們對自己照顧健康和動力的能力和韌性的信心。所以我認為所有這些都預示著我們未來的定位將會很好，所以我們對此感覺非常良好。

That's helpful. And then just a quick follow-up. Can you just remind us of the seasonality dynamics around medical cost ratio within the Medicare population? Does 1Q tend to be the low watermark or if you kind of stop loss insurance dynamics kick in around the fourth quarter. What do you expect that to look like seasonally each quarter of the year?

這很有幫助。然後只是快速的跟進。您能否提醒我們醫療保險族群中醫療費用比率的季節性動態？第一季是否傾向於成為低水位線，或者止損保險動態是否會在第四季左右開始發揮作用。您預計每年每季的季節表現會是怎樣的？

Yes. I think there are obviously lots of valuables in here, including variants in terms of COVID, that could cause some sort of near-term fluctuations here. But generally speaking, we would expect slightly higher medical change expenses in the first and the fourth quarter of the year and slightly lower ones over Q2 and Q3. However, it's probably not something that is going to be super pronounced. But as a margin, it's probably what you can expect.

是的。我認為這裡面顯然有很多有價值的東西，包括 COVID 的變種，這些都可能會導致某種短期波動。但總體而言，我們預計今年第一季和第四季的醫療變化費用將略高，而第二季和第三季的醫療變化費用將略低。然而，這可能不會變得非常明顯。但作為保證金，這可能正是您所期望的。

Our next question comes from Sarah James from Barclays.

下一個問題來自巴克萊銀行的莎拉詹姆斯 (Sarah James)。

As you guys are starting to expand your product offering, adding some of these cardio and behavioral aspects, is it a changing your conversation at all with payers with respect to value-based care or where the relationship may go in the future?

當你們開始擴大產品範圍，增加一些有氧和行為方面的產品時，這是否會改變你們與付款人關於基於價值的護理的對話，或者未來的關係會如何發展？

Yes, thanks for that, Sarah. I'd say, absolutely, and in a real positive sense. I think what people are seeing is that we add multiple benefits for employers, for payers. We're a great tool that recruit and retain. And as we said in the past, we have 40-plus percent activation when we roll out an employer. And we've also shared in the past that 85% of companies now offer us 2 dependents. We've also just talked about, and for your question, Sarah, the clinical impact that we can have, whether it's diabetes or we've talked about HIV care in -- for example, in New York City, 0 patients last year progressing in Q4 from HIV to AIDS. Ranked #1, so managing complex patients.

是的，謝謝你，莎拉。我想說，絕對是這樣的，而且是非常正面的意義。我認為人們看到的是我們為雇主和付款人增加了多項福利。我們是招募和留住人才的絕佳工具。正如我們過去所說的那樣，當我們推出雇主時，我們的活化率超過 40％。我們過去也曾分享過，現在有 85% 的公司為我們提供 2 位受扶養人。我們也剛剛談到了，對於你的問題，莎拉，我們可以產生的臨床影響，無論是糖尿病還是艾滋病毒治療——例如，在紐約市，去年有 0 名患者病情進展第四季度，艾滋病病毒( HIV) 感染轉為愛滋病。排名第一，因此可以管理複雜的患者。

Talk about here today how we're leveraging our One Medical At Home with our most complex At-Risk senior patients. These are patients with 9 chronic conditions, very acute. And we're seeing the benefits of managing them intensively and been able to reduce their costs on a MASH cohort perspective, about 26%. So I think these are definitely things that payers are recognizing.

今天在這裡討論我們如何利用「一個家庭醫療」 (One Medical At Home) 來治療最複雜的高風險老年患者。這些患者患有 9 種慢性病，病情非常嚴重。我們看到了密集管理的好處，並且能夠從 MASH 群體的角度降低成本，約 26%。所以我認為這些肯定是付款人認可的事情。

And I think if you step back, it is also because we have a fundamentally different model, right? This is not a fee-for-service kind of uber-staffed kind of model. It's a salary model of longitudinal primary care, where you not just throw point solutions at problems, but can have integrated whole-person solutions. And I think certainly, health plan payers, employers are definitely recognizing those differences.

而且我認為，如果你退一步考慮，這也是因為我們有一個根本不同的模型，對嗎？這不是一種按服務收費的超級人員配備模式。這是一種縱向初級保健薪酬模式，您不僅可以針對問題提供點解決方案，還可以提供全面的全人解決方案。我認為，醫療保險計劃支付者和雇主肯定認識到了這些差異。

Our next question comes from Sandy Draper with Guggenheim Partners.

下一個問題來自古根漢合夥人公司的桑迪德雷珀。

This is Mitchell on for Sandy. So you raised your full year commercial revenue outlook by $5 million, but didn't change the membership outlook. So just wondering what's the biggest change against what you initially set out?

這是米切爾代替桑迪上場的。因此，您將全年商業收入預期提高了 500 萬美元，但沒有改變會員收入預期。所以想知道與您最初設定的相比最大的變化是什麼？

Yes, great question. In many ways, we obviously outperformed on our commercial revenue guidance for Q1. And in many ways, I'm sort of thinking about this really being one of the drivers to just state the full year as well. Just as a reminder, going into the year, when we gave guidance for the full year just about 10 weeks ago, we said that we don't see in-office visits return quite as fast as we had seen in the past. And I think directionally, that's still the case.

是的，很好的問題。從很多方面來看，我們第一季的商業收入明顯超出預期。從很多方面來看，我認為這實際上也是全年業績的驅動因素之一。提醒一下，進入今年，當我們在大約 10 週前給出全年指導時，我們說過，我們認為門診量恢復的速度不會像過去那麼快。我認為從方向上看，情況仍然如此。

However, we did see a meaningful increase in -- a meaningful return to more normal office utilization patterns in March, which, in many ways, contributed to the outperformance that we had in Q1 on the commercial revenue side. And we're sort of expecting to call that through the year.

然而，我們確實看到了有意義的成長——3 月份辦公室利用率模式有意義地恢復到更正常的狀態，這在很大程度上促成了我們在第一季商業收入方面的出色表現。我們預計今年內就能實現這個目標。

Our next question comes from George Hill with Deutsche Bank.

下一個問題來自德意志銀行的喬治·希爾。

I'm going to ask first the flip side of the question you just answered, which is, I imagine, as you've seen the in-person utilization pick up, I guess I was going to ask, could you talk about what you've seen in the telehealth utilization kind of starting from January maybe the end of March or the end of April. If you're willing to comment on that and just kind of what the trend just looks like there from a general telehealth perspective.

我首先要問的是你剛剛回答的問題的另一面，我想，正如你所看到的，面對面的利用率有所提高，我想我要問的是，你能談談你我們看到遠程醫療的使用情況從一月開始，可能是三月底或四月底。如果您願意對此發表評論，請談談從一般遠距醫療的角度來看這種趨勢是什麼樣的。

Yes. In many ways, it really is the flip side. So we've certainly seen a shift throughout the quarter, frankly, back from digital to in-person. Yes, certainly, we continue to have a fair number of visits that are happening digitally, and that's obviously a big driver of our member satisfaction. But we have seen particularly, in March, probably more pronounced return to the office, so to speak. And that's definitely the dynamics that we've seen.

是的。從很多方面來看，這確實是另一面。因此，坦白說，我們確實看到了整個季度的轉變，從數位化轉向面對面。是的，當然，我們仍然有相當數量的數位訪問，這顯然是我們會員滿意度的一個重要驅動力。但我們可以特別在三月看到，人們重返辦公室的現象可能更為明顯。這確實是我們所看到的動態。

Okay, and 2 more quick ones. Number one, the last time you guys gave formal guidance, the environment, as it related to COVID, it was still pretty uncertain because we had Omicron kind of spiking. Are you guys now seeing COVID as kind of a headwind or a tailwind as you think about 2022?

好的，還有另外 2 個很快的問題。首先，上次你們給予正式指引時，與 COVID 相關的環境仍然相當不確定，因為我們遇到了 Omicron 的激增。當您考慮 2022 年時，您現在是否將 COVID 視為逆風或順風？

And then, Amir, the one I have for you is, there's a tremendous amount of chatter right now in the market about companies looking to bulk up their care delivery capability, either through partnership or through acquisition. Would just love any commentary you'd be willing to share about the conversations that the company is having, kind of how it thinks about where it is in their corporate life cycle?

然後，阿米爾，我要告訴你的是，目前市場上有大量關於公司希望透過合作或收購來增強其醫療服務能力的討論。您是否願意就公司正在進行的對話發表任何評論，例如公司如何看待自己在企業生命週期中的位置？

Yes. I mean, on your first question on COVID, before I hand it over to Amir here, we, at this point, don't necessarily factor in a meaningful return of COVID for the rest of the year, so to speak. We saw COVID-related -- direct COVID-related volumes, think of this as testing, vaccines, et cetera, meaningfully and drop off in Q1. We continue to believe that we'll see a little more of direct COVID-related revenue in Q2, but we really see that diminish here very, very quickly throughout the rest of the year. And our guidance right now does assume that, that's going to come back.

是的。我的意思是，關於你關於 COVID 的第一個問題，在把它交給阿米爾之前，我們目前還不一定考慮到 COVID 在今年剩餘時間內會有意義地捲土重來。我們看到與 COVID 相關的——直接與 COVID 相關的交易量，例如檢測、疫苗等，在第一季顯著下降。我們仍然相信，第二季與新冠肺炎疫情相關的直接收入將略有增加，但我們確實看到，今年剩餘時間內，這一數字將非常非常快地減少。我們目前的指導確實假設這種情況會再次發生。

Obviously, to the extent that it does, a lot of it is going to depend on the details, right? People going to go back into testing mode, which all else equal, could probably be a tailwind to us. Are we going to see more hospitalizations? And could be a potential headwind on the At-Risk business. Or are we going to go back into lockdown? So there are many different ways this could play out. And our guidance right now does not assume any meaningful contribution one way or the other of COVID for the rest of the year.

顯然，如果確實如此，很大程度上還是取決於細節，對嗎？人們將重新進入測試模式，在其他條件相同的情況下，這對我們來說可能是一個順風。我們會看到更多的住院病例嗎？這可能會對高風險業務造成潛在的阻力。或者我們要再次進入封鎖狀態？因此，這種情況可能會有多種不同的結果。我們目前的指導意見並不認為 COVID 會在今年剩餘時間內以某種方式做出任何有意義的貢獻。

Yes. I think to the second part of your question, I mean, we're focused on growing One Medical and making it into the default option for health care in the United States. And I think that's what we're hopefully on the path to doing and growing. As you've heard today, really, a great and differentiated model that's kind of omnichannel hybrid, if you will, right, in-person and digital, can address kind of the whole person's needs. So we feel great about our positioning and the work we're doing.

是的。我認為對於您問題的第二部分，我的意思是，我們專注於發展 One Medical 並使其成為美國醫療保健的預設選項。我認為這正是我們希望做到和成長的事情。正如您今天所聽到的，實際上，一個偉大的差異化模型是一種全通路混合模型，如果您願意的話，面對面和數位化的結合，可以滿足整個人的需求。因此，我們對自己的定位和所做的工作感到非常滿意。

Our next question comes from David Larsen with BTIG.

下一個問題來自 BTIG 的 David Larsen。

Can you talk a little bit more about the 10% improvement in the medical cost ratio for the Medicare Iora business, just any incremental detail that you can give on that? Like did you tighten up the referral patterns? Was it largely COVID related? I mean, COVID activity was high in January. Just any additional color around that would be very helpful. And how sustainable is that? Should we expect another 10% improvement next quarter?

您能否再詳細談談 Medicare Iora 業務醫療成本比率提高 10% 的情況，可以提供一些細節嗎？例如，你是否加強了推薦模式？這主要與 COVID 有關嗎？我的意思是，一月份 COVID 活動很活躍。周圍的任何附加顏色都會非常有幫助。這種做法的可持續性如何？我們是否應該期待下個季度再實現 10% 的改善？

Yes, thanks for the question. Well, we feel great about the work we're doing, and increasingly, this is a common organization. As we've mentioned in the past, we've also begun taking risk in, if you will, legacy One Medical markets. And we've been really, I think, ahead of our expectations on where we are on that integration, whether it's our care management capabilities, our technology, and building our programs like the One Medical At Home program, which is really built on from kernels that we had in Iora, but really expanding now.

是的，謝謝你的提問。嗯，我們對於我們所做的工作感到非常高興，而且這越來越成為一個普通的組織。正如我們過去提到的那樣，如果您願意的話，我們也開始在傳統的 One Medical 市場中承擔風險。我認為，我們在整合方面的進展確實超出了我們的預期，無論是我們的護理管理能力、我們的技術，還是我們的項目建設，例如“One Medical At Home”項目，這個項目實際上是建立在我們在Iora 中擁有的內核，但現在確實在不斷擴展。

So we feel that we have great capabilities built into our technology, built into workflows that are humming as they've probably never hummed before, whether that's appropriately capturing documentation, whether it's using machine learning models to identify which patients are at rising risk, and so that we can proactively reach out to them to help manage their condition.

因此，我們覺得我們的技術已經具備了強大的功能，並且已經融入了前所未有的工作流程，無論是恰當地記錄文檔，還是使用機器學習模型來識別哪些患者的風險正在上升，以及這樣我們就可以主動聯絡他們，幫助他們管理病情。

And also, our model is -- leverages digital and in-person, as we've talked in the past about. Still, 5:1 ratio of digital to in-person on the senior health side. So we believe that those are great opportunities for us. I think the impact overall is pretty broad-based reduction in hospitalization, certainly COVID-specific costs through after spikes in January, as we talked about.

而且，正如我們過去談到的，我們的模式是利用數位和麵對面。儘管如此，老年健康方面的數位化與面對面的比例仍為5：1。因此我們相信這對我們來說是絕佳的機會。我認為整體影響是住院費用大幅減少，尤其是在 1 月新冠肺炎疫情相關費用激增之後，正如我們所討論的。

And we believe we will continue to be able to improve that performance. Of course, as you add new cohorts, as Bjorn mentioned earlier, then you have to manage those as well. But as you heard today, the medical claims expense ratio, if you will, part of our care margin assumptions, and we increased our guidance for care margins by $5 million. So I think that overall, we feel very good about our work there.

而我們相信我們能夠繼續提高這一表現。當然，正如 Bjorn 之前提到的，當你添加新的同伴時，你也必須管理他們。但正如您今天所聽到的，醫療索賠費用率，如果您願意的話，是我們護理利潤率假設的一部分，我們將護理利潤率指導價提高了 500 萬美元。所以我認為總的來說，我們對在那裡的工作感覺非常滿意。

Great. And then let's say MA rates increased by 4% or 8%, 1/1/23, will we see a 4% or 8% improvement in your medical cost ratio? Will you be able to capture a lot of that from the plan? Or are they going to keep that?

偉大的。然後假設 MA 費率增加 4% 或 8%，那麼在 1/1/23，我們會看到醫療成本比率改善 4% 或 8% 嗎？你能從該計劃中獲取很多資訊嗎？或者他們會保留這個嗎？

Well, I think a lot of that still remains to be seen on plan benefit design and what ends up flowing through. So I think it's too early to say.

嗯，我認為在計劃福利設計和最終結果方面仍有很多問題有待觀察。所以我認為現在說還太早。

Okay. Congrats on a great quarter, and well done, Rishika, I guess, as well.

好的。恭喜您度過了一個美好的季度，我想，Rishika 也做得很好。

Our next question comes from Brian Tanquilut with Jefferies.

我們的下一個問題來自 Jefferies 的 Brian Tanquilut。

Congrats on the quarter. It's Jack Slevin on for Brian.

恭喜本季取得佳績。傑克·斯萊文代替布萊恩上場。

A couple of quick ones for you. First, I just want to make sure I understood, Bjorn, your comments around DCE and the fee-for-service patients on the Medicare side there. So if we look at those, those patients that you've elected to go the fee-for-service route this year, is the thought that those are going to be claims aligned in 2023? And if so, can you give us a number on just how many patients we're talking about?

給您簡單提幾個問題。首先，Bjorn，我只是想確保我理解了你關於 DCE 以及醫療保險方面的按服務收費患者的評論。那麼，如果我們來看看那些您今年選擇採用按服務收費方式的患者，是否認為這些索賠將在 2023 年解決？如果是的話，您能告訴我們具體有多少個病人嗎？

Yes. I mean, the way I think about it is, we are building a great pool of patients that have experience with our service, that have experience with our providers, that we have great insights into on what is their health status and we are building that relationship, right? And then certainly, as open enrollment comes up as the calendar flips into 2023, certainly, we do expect that, that is going to be sort of the first pool that we're going to go to, to say, "Hey, you have experienced us, do you want to join us?"

是的。我的意思是，我的想法是，我們正在建立大量患者資源，這些患者對我們的服務有經驗，對我們的提供者有經驗，我們對他們的健康狀況有很深入的了解，我們正在建立這些患者資源。當然，隨著日曆翻到 2023 年，開放註冊即將到來，我們確實預計，這將是我們要去的第一個選拔池，我們會說，「嘿，你有體驗過我們，你想加入我們嗎？

Some of them might be claims-aligned. Others of them might voluntarily align to us and say, yes, you are my provider. And then there are others that might end up enrolling in Medicare Advantage plans and still say, "Yes, but I leave you, One Medical, to be my provider".

其中一些可能與索賠一致。其他人可能會自願與我們結盟並說，是的，你是我的供應商。還有一些人可能最終會加入醫療保險優勢計劃，並且仍然說，「是的，但是我讓 One Medical 來做我的供應商」。

So yes, it could be a couple of different things. But that's really the best way, in many ways, that I can go to and say, "You've experienced us. We work well together. We fit well together. Let's take care of you through our At-Risk model".

是的，這可能是幾件不同的事情。但在很多方面，這確實是最好的方式，我可以說：「您已經體驗過我們。我們合作得很好。我們很合得來。讓我們透過我們的風險模型來照顧您」。

Okay, got it. That's helpful. And then, obviously, early days, Iora. Maybe around less than a couple of quarters here with you all running through the P&L. But as we look at sort of the broader thesis on some of those members aging into Medicare, right, and converting over to the Iora side, is there any commentary you can provide on what that looked like over this first turn to 1/1/22? And any success you had with -- thus far, with people turning 65 and electing to do the Iora route?

好的，明白了。這很有幫助。然後，顯然是早期的 Iora。大概用不了幾個季度，你們就會看到所有的損益表。但是，當我們研究一些成員年齡增長到醫療保險，然後轉向 Iora 方面的更廣泛的論點時，您能否對第一次轉向 1/1/ 的情況提供一些評論？ 22？到目前為止，對於年滿 65 歲並選擇走 Iora 路線的人，您取得過什麼成功嗎？

Yes. Well, maybe a few comments just to reiterate what I said before. We're now one blended company with one blended technology team, operations, clinical teams, and that's gone really well. So increasingly, what's the Iora side or One Medical side will be harder to disentangle. As I mentioned, we have taken global risk, capitated risk, at-risk in "legacy One Medical". So specific to your question, we have, and we believe that's performing well. And those are folks who have already aged in or are aging in.

是的。好吧，也許一些評論只是為了重申我之前說過的話。我們現在是一家混合公司，擁有一個混合技術團隊、營運團隊和臨床團隊，而且進展非常順利。因此，越來越難以分辨 Iora 和 One Medical 到底是誰。正如我所提到的，我們已經承擔了「傳統第一線醫療」中的全球風險、人頭風險和風險。所以具體到你的問題，我們已經這麼做了，而且我們認為效果很好。這些人已經老了或正在老了。

And I think we're still in the early days of this, but I think we have tremendous opportunities to further grow and age people in from under 65, and to Medicare if they turn 65. And in general, we manage patients really well. You've seen from the clinical outcomes that we presented through the years here on the One Medical side. So they're well managed, well cared for and positions us very well as they potentially age into at-risk relationships.

我認為我們仍處於早期階段，但我認為我們有巨大的機會進一步發展和吸引65 歲以下的老年人，如果他們年滿65 歲，則可以享受醫療保險。非常好。您已經從我們多年來在 One Medical 方面展示的臨床結果中看到了這一點。因此，他們得到了很好的管理，很好的照顧，並且在他們可能老去並陷入高風險關係時，我們處於非常有利的位置。

Our next question comes from Ryan Daniels with William Blair.

我們的下一個問題來自 William Blair 的 Ryan Daniels。

Nick Spiekhout on for Ryan. I guess, we have kind of an increase in care margin. At the same time, you guys are now seeing more and more kind of in-office visits and in-office utilization coming up. Just wondering if you can kind of describe that dynamic a little bit. Provide a little color there.

尼克·斯皮科特 (Nick Spiekhout) 替換瑞安 (Ryan)。我想，我們的護理利潤率有所提高。同時，你們現在看到越來越多的辦公室訪問和辦公室利用情況。只是想知道您是否可以稍微描述一下這種動態。在那裡提供一點顏色。

Yes, I can start. I think what you're seeing here is, frankly, the benefit of actually sort of fully employed fixed-cost model that we are building here and that we built, right? So as volumes come back into the offices, we are paying our providers on a fixed salary basis, right? It's not like they are sort of -- to Amir's point, being paid click fees. It's not like they're being paid on work RVUs or other sort of volume metrics.

是的，我可以開始。坦白說，我認為您在這裡看到的實際上是我們正在構建的、並且已經構建的充分利用固定成本模型的好處，對嗎？因此，隨著業務量恢復到辦公室，我們會按照固定薪資的方式向供應商付款，對嗎？這並不像他們那樣——正如阿米爾所說，獲得點擊費。他們並不是根據工作 RVU 或其他數量指標獲得報酬。

So as members come back in, as we take care of them in-person, you really see, I think that, to some extent, the margin expansion that's built into the model here by employee and providers, by making sure that we do their right thing by our members, by spending time with them rather than having sort of more of an uber-doctor-type model. I think that's really what you see flow through the P&L here. As revenues increase, you see the leverage in the rest of the P&L.

因此，當會員回來時，當我們親自照顧他們時，你真的會看到，我認為，在某種程度上，利潤率的擴大是由員工和供應商建立在這個模型中的，透過確保我們做到他們為我們的會員做正確的事情，花時間與他們相處，而不是採用那種超級醫生式的模式。我認為這確實就是您在這裡的損益表中看到的流程。隨著收入的增加，您會看到其餘損益表中的槓桿作用。

And I would just say, circling back around to some of the earlier questions asked, this shows the power of the model, right? We have really high engagement, whether it's across our commercial population, consumer and enterprise or senior at-risk population. We can manage patients, certainly, if they have on-demand issues, but we can manage them longitudinally. We can reach out to them, whether it's digitally or in-person.

我只想說，回到之前提出的一些問題，這顯示了該模型的威力，對嗎？我們的參與度非常高，無論是商業人口、消費者、企業或高風險老年族群。當然，如果患者有按需問題，我們可以對他們進行管理，但我們可以對他們進行縱向管理。我們可以聯繫到他們，無論是透過網路還是面對面。

And this is why we believe we have such a robust model, why we believe we can transform health care because we actually can have really high engagement, can make an impact on quality metrics, can have people come in if they need to see us or see them remotely, but have these ongoing relationships, yes.

這就是為什麼我們相信我們擁有如此強大的模型，為什麼我們相信我們可以改變醫療保健，因為我們實際上可以實現高度參與，可以對品質指標產生影響，可以讓人們在需要時進來，或者可以遠端看到他們，但卻能維持持續的關係，是的。

Thank you. This concludes the question-and-answer session. I'd like to turn the call back over to Amir Rubin for any closing remarks.

謝謝。問答環節到此結束。我想將電話轉回給阿米爾·魯賓 (Amir Rubin)，請他做最後發言。

Well, may the fourth be with you all. Thanks, everybody, for joining us today, and we'll see you next time. Have a great evening. Thanks, everyone.

好吧，願第四個新年與你們同在。感謝大家今天的參與，我們下次再見。祝您有個愉快的夜晚。謝謝大家。

This concludes today's program. You may now disconnect.

今天的節目到此結束。您現在可以斷開連線。