Oscar Health Inc (OSCR) 2023 Q4 法說會逐字稿

Good evening. My name is Bob, and I'll be your conference operator today. At this time, I would like to welcome everyone to Oscar Health Fourth Quarter and Full Year 2023 earnings conference call. At this time, all lines have been placed on mute to prevent any background noise. After the speakers' remarks, there will be a question and answer session. If you'd like to ask a question during this time, please press the star followed by the number one on your telephone keypad. If you'd like to withdraw your question, please press the star followed by the one once again.

晚安.我叫鮑勃，今天我將擔任你們的會議接線生。此時此刻，我謹歡迎大家參加 Oscar Health 第四季和 2023 年全年財報電話會議。此時，所有線路均已置於靜音狀態，以防止任何背景噪音。演講者發言後，將進行問答環節。如果您想在此期間提問，請按電話鍵盤上的星號，然後再按數字 1。如果您想撤回問題，請再次按星號，然後再按星號。

Thank you. I will now turn the conference over to Chris Pitcher, Vice President of Treasury and Investor Relations.

謝謝。我現在將會議交給財務和投資者關係副總裁克里斯·皮徹 (Chris Pitcher)。

Good evening, everyone. Thank you for joining us for our fourth quarter and full year 2023 earnings call. Mark Bertolini, Oscar's Chief Executive Officer, and Scott Blackley, Oscar's Chief Financial Officer, will host this evening's call. This call can also be accessed through our Investor Relations website at ir dot Hi, Oscar.com. full details of our results and additional management commentary are available in our earnings release, which can be found on our Investor Relations website at ir dot Hi, Oscar.com. Any remarks that Oscar makes about the future constitute forward-looking statements within the meaning of Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995, and actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in our quarterly report on Form 10 Q for the quarterly period ended September 30, 2023, filed with the SEC and other filings with the SEC, including our annual report on Form 10-K for the period ended December 31, 2023, to be filed with the SEC. Such forward-looking statements are based on current expectations as of today, Oscar anticipates that subsequent events and developments may cause estimates to change. While the Company may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so.

各位晚上好。感謝您參加我們的 2023 年第四季和全年財報電話會議。Oscar 執行長 Mark Bertolini 和 Oscar 財務長 Scott Blackley 將主持今晚的電話會議。您也可以透過我們的投資者關係網站 ir dot Hi, Oscar.com 存取本次電話會議。有關我們業績的完整詳細資訊和其他管理層評論可在我們的收益發布中找到，該發布可以在我們的投資者關係網站 ir dot Hi, Oscar.com 上找到。 Oscar 對未來所做的任何言論均構成 1995 年《私人證券訴訟改革法案》安全港條款含義內的前瞻性陳述，由於各種因素，實際結果可能與這些前瞻性陳述所表明的結果存在重大差異。重要因素，包括我們向SEC 提交的截至2023 年9 月30 日的季度報告中討論的10 Q 表格以及向SEC 提交的其他文件，包括截至12 月31 日的10-K 表格年度報告，2023 年，向SEC 備案。此類前瞻性陳述基於截至今天的當前預期，奧斯卡預計後續事件和事態發展可能會導致估計發生變化。雖然公司可能選擇在未來某個時候更新這些前瞻性陳述，但我們明確表示不承擔任何這樣做的義務。

The call will also refer to certain non-GAAP measures. A reconciliation of these measures to the most directly comparable GAAP measures can be found in the fourth quarter and full year 2023 earnings press release available on the company's Investor Relations website at ir dot.

此次電話會議也將提及某些非公認會計準則措施。這些指標與最直接可比較的 GAAP 指標的調整可以在公司投資者關係網站 ir dot 上發布的 2023 年第四季和全年收益新聞稿中找到。

Hi, Oscar.com. With that, I would like to turn the call over to our CEO, Mark Bertolini.

你好，奧斯卡網站。說到這裡，我想將電話轉給我們的執行長馬克貝爾托里尼 (Mark Bertolini)。

Thank you, Chris.

謝謝你，克里斯。

Good evening, everyone.

各位晚上好。

When I joined, Oscar, I highlighted three priorities for the business. One, achieve insurance company adjusted EBITDA profitability in 2023 to achieve total company adjusted EBITDA profitability for 2020 for three, continue to enhance the value of our technology to the plus Oscar business and bring more of our capabilities to market. We have made major progress toward achieving these priorities. We closed out 2023 with another strong quarter, driving financial performance for the full year and achieving the first of our priorities. The insurance company generated $169 million of adjusted EBITDA profitability in 2023, a milestone Oscar committed to in early 2022, our medical loss ratio improved 370 basis points year over year to 81.6% below the low end of our guidance range for the full year. Overall claims trends were favorable relative to our expectations. Utilization trends by category remained consistent throughout the year, with inpatient performance in line outpatient and pharmacy slightly above and professional well below total company adjusted EBITDA improved by $417 million versus the prior year to a loss of $45 million. Our strong momentum positions us well to achieve the second priority I mentioned total company adjusted EBITDA profitability in 2020 for our business is well positioned for sustainable, long-term growth and margin expansion. We exceeded our 2024 open enrollment expectations, we expect to serve over 1.3 million members. We continued to see strong retention, which we believe is driven by our superior member experience. Our disciplined pricing and for 2024 is allowing us to grow our membership well above the market while driving margin expansion. We expect another year of MLR improvement given our pricing strategy and total cost of care initiatives, including significant PBM savings and enhanced payment integrity efforts. We also anticipate continued operational cost improvements, including vendor savings from our enhanced scale and the benefit of operating leverage as we return to growth.

奧斯卡，當我加入時，我強調了公司​​的三個優先事項。一、實現保險公司2023年調整後EBITDA獲利能力達到2020年公司調整後EBITDA獲利能力三成，持續提升我們的技術對加奧斯卡業務的價值，把我們更多的能力推向市場。我們在實現這些優先事項方面取得了重大進展。我們以另一個強勁的季度結束了 2023 年，推動了全年的財務表現並實現了我們的首要任務。該保險公司在2023 年實現了1.69 億美元的調整後EBITDA 盈利能力，這是Oscar 在2022 年初承諾的里程碑，我們的醫療損失率同比下降了370 個基點，比我們全年指導範圍的下限低了81.6%。整體索賠趨勢相對於我們的預期有利。按類別劃分的使用率趨勢全年保持一致，門診和藥房的住院表現略高於，而專業病人的表現則遠低於公司調整後的EBITDA 總額，與上一年相比增加了4.17 億美元，虧損4500 萬美元。我們強勁的勢頭使我們能夠很好地實現我提到的 2020 年公司調整後 EBITDA 盈利能力的第二個優先事項，因為我們的業務已做好了可持續、長期增長和利潤擴張的準備。我們超越了 2024 年開放註冊的預期，預計將為超過 130 萬名會員提供服務。我們繼續看到強勁的保留率，我們相信這是由我們卓越的會員體驗所推動的。我們嚴格的定價和 2024 年的定價使我們能夠將會員數量遠高於市場水平，同時推動利潤率擴張。鑑於我們的定價策略和總護理成本舉措，包括顯著的 PBM 節省和增強的支付完整性工作，我們預計 MLR 將迎來一年的改善。我們也預期營運成本將持續改善，包括我們規模擴大帶來的供應商節省以及我們恢復成長時營運槓桿的好處。

Finally, our technology is making the healthcare experience more seamless for over 1 million Oscar members, 500,000 client lives. We now serve through plus Oscar from the providers who care for them overall, 2023 was an exceptional year for Oscar. We are delivering on our commitments and are on a solid path deliver sustained growth with improved margins.

最後，我們的技術正在為超過 100 萬 Oscar 會員和 50 萬名客戶提供更無縫的醫療保健體驗。我們現在透過整體關心他們的供應商提供 Oscar 服務，2023 年對 Oscar 來說是非凡的一年。我們正在兌現我們的承諾，並走在實現持續成長和提高利潤率的堅實道路上。

Now I will turn to our business highlights this past open enrollment marked Oscar's 11th year as a prominent player in the ACA market. We expanded into 165 new counties that are now privileged to serve over 1.3 million members across 20 states. Our above-market growth was driven by strong retention and new members in both existing and expansion markets. Consumers choose us for our affordable and innovative plan designs, and they stay with us for our superior member experience. Our NPS continues to be an industry-leading 60. We continue to grow in key states for Oscar, including Florida, Georgia and Ohio. We also outperformed our expectations in new service areas, including Cincinnati, West Central Tennessee, Topeka and Iowa. We believe our superior member experiences meeting members' needs and continue to demonstrate we can launch succeed in new markets outside of major metropolitan areas. We introduced new products to meet the needs of our fast-growing and diverse member population, including expanding our chronic illness plans, diabetes care and breathe easy to new markets. We also launched an enhanced Spanish first experience to deliver culturally authentic experience to our growing Spanish-speaking member base. Consumers expect a level of convenience and accessibility and healthcare comparable to the best consumer companies in the U.S. Oscar makes us experience possible through our full stack technology. Since inception, Bhaskar has been focused on building our technological infrastructure and end to end experience. We believe this stack offers greater control over the member experience, engagement and affordability. Our platform has fueled major strides in our operational efficiency. We launched powerful capabilities to digitalize our more interactions with providers and members and automate a growing number of clinical and administrative workflows.

現在我將談談我們的業務亮點，過去的公開招生標誌著 Oscar 作為 ACA 市場的傑出參與者第十一個年頭。我們擴展到 165 個新縣，現在很榮幸為 20 個州的超過 130 萬會員提供服務。我們高於市場的成長是由現有市場和擴張市場中的強勁保留和新會員推動的。消費者選擇我們是因為我們經濟實惠且創新的計劃設計，他們選擇我們是因為我們卓越的會員體驗。我們的 NPS 繼續保持業界領先 60。我們在奧斯卡的關鍵州繼續發展，包括佛羅裡達州、喬治亞州和俄亥俄州。我們在辛辛那提、田納西州中西部、托皮卡和愛荷華州等新服務區域的表現也超出了我們的預期。我們相信我們卓越的會員體驗能夠滿足會員的需求，並繼續證明我們能夠在主要大都市地區以外的新市場取得成功。我們推出了新產品，以滿足快速增長的多元化會員群的需求，包括擴大我們的慢性病計劃、糖尿病護理和輕鬆進入新市場。我們也推出了增強的西班牙語首次體驗，為我們不斷增長的西班牙語會員群提供原始的文化體驗。消費者期望獲得與美國最好的消費品公司相當的便利性、可及性和醫療保健水平。自成立以來，Bhaskar 一直專注於建立我們的技術基礎設施和端到端體驗。我們相信這個堆疊可以更好地控制會員體驗、參與度和承受能力。我們的平台大大提高了我們的營運效率。我們推出了強大的功能，使我們與提供者和會員的更多互動數位化，並使越來越多的臨床和管理工作流程自動化。

We have a high-powered features.

我們具有高性能的特點。

As an example, we leveraged automation to support members more effectively and efficiently during open enrollment. We enhanced our member services IVR and launched a high-powered secure messaging feature. Self-service features like these make it faster and easier for members to get the answers they need and allow our care team to support more complex member needs. While membership increase this open enrollment call volume remained steady, call abandonment rates decreased and member satisfaction increase. We are making our superior member experience and innovative technology available to others in the health care system, enabling a higher quality experience for consumers and driving better engagement, outcomes and business performance for clients. We are pleased with the traction of Campaign Builder Plus Oscar's engagement and automation platform Campaign Builder and now serves approximately 500,000 client lives. In addition to the 1.3 million members enrolled in Oscar health insurance Campaign Builder clients saw impressive results in the second half of 2023 one payer clients, our retention rate of over 96% for Medicare Advantage members engaged with the retention program. Our diabetes care gap program for another client resulted in over 40% of the eligible population, completing a preventative diabetes screening within 90 days of engaging with the campaign. We are encouraged with these proof points and committed to bringing more capabilities to market power more of the health care system.

例如，我們利用自動化在公開註冊期間更有效地支援會員。我們增強了會員服務 IVR，並推出了高效能的安全訊息功能。此類自助服務功能使會員能夠更快、更輕鬆地獲得所需的答案，並使我們的護理團隊能夠支援更複雜的會員需求。雖然會員數量增加，但開放註冊呼叫量保持穩定，呼叫放棄率下降，會員滿意度提高。我們正在為醫療保健系統中的其他人提供卓越的會員體驗和創新技術，為消費者提供更高品質的體驗，並為客戶帶來更好的參與、成果和業務績效。我們對 Campaign Builder Plus Oscar 的參與和自動化平台 Campaign Builder 的吸引力感到滿意，現在為大約 50 萬名客戶提供服務。除了註冊奧斯卡健康保險 Campaign Builder 客戶的 130 萬名會員在 2023 年下半年單付款人客戶取得了令人印象深刻的成果外，我們參與保留計劃的 Medicare Advantage 會員的保留率超過 96%。我們為另一位客戶提供的糖尿病護理差距計劃使超過 40% 的符合資格人群在參與活動後 90 天內完成了預防性糖尿病篩檢。我們對這些證據感到鼓舞，並致力於將更多的能力推向市場，為醫療保健系統提供更多的權力。

As we've shared on prior calls, AI continues to be a part of our overall strategy to ensure and technology can deliver a superior member experience, improve health outcomes, MI provider needs and lower costs. We continue to build our use cases, including integrating Openet IGBT technology into Campaign Builder. We believe our AI-powered tools can be easily incorporated into client workflows to support their strategic business objectives and patient needs. Our outperformance in 2023 sets a solid foundation for us to deliver on our target for total company adjusted EBITDA profitability in 2024, our strategic priorities include one wanting a great company with market-leading, sustainable, scalable operations, too, continually investing in our superior member experience, three, harnessing our technology to power others and for continuing to innovate market offerings to extend beyond the ACA.

正如我們在先前的電話會議中分享的那樣，人工智慧仍然是我們整體策略的一部分，以確保技術能夠提供卓越的會員體驗、改善健康結果、滿足 MI 提供者的需求並降低成本。我們繼續建立我們的用例，包括將 Openet IGBT 技術整合到 Campaign Builder 中。我們相信我們的人工智慧工具可以輕鬆整合到客戶的工作流程中，以支援他們的策略業務目標和患者需求。我們在2023 年的優異表現為我們實現2024 年公司調整後EBITDA 盈利能力的目標奠定了堅實的基礎，我們的戰略重點包括希望成為一家擁有市場領先、可持續、可擴展運營的偉大公司，並不斷投資我們的優勢會員體驗，三，利用我們的技術為他人提供動力，並持續創新市場產品以超越 ACA。

Our strategic priorities also include the long-term growth opportunity we see in the individual market and the potential we see to serve a broader set of customers, including employers and employees. The ACA is the fastest-growing segment of health insurance with over 21 million people enrolled in individual insurance plans on exchanges for 2024, Oscar is well positioned to capitalize and innovate on the strong market growth as well as leading the industry in trends driving the future of health care. After was purpose built with a focus on accessibility, affordability and a superior member experience member experiences in our DNA. We believe we are best positioned to win in an increasingly digital and consumer centric marketplace. We look forward to sharing more on our long-term strategic plan at our next Investor Day in June in New York.

我們的策略重點還包括我們在個人市場中看到的長期成長機會以及我們看到的為更廣泛的客戶（包括雇主和員工）提供服務的潛力。ACA 是健康保險中成長最快的部分，到2024 年，將有超過2,100 萬人在交易所加入個人保險計劃，Oscar 處於有利地位，能夠利用強勁的市場成長並進行創新，並在推動未來的趨勢方面引領業界的醫療保健。After 的設計重點是我們 DNA 中的可及性、可負擔性和卓越的會員體驗。我們相信，我們最有能力在日益數位化和以消費者為中心的市場中獲勝。我們期待在六月於紐約舉行的下一次投資者日分享更多關於我們長期戰略計劃的資訊。

With that, I will turn the call over to Scott.

這樣，我會將電話轉給史考特。

Thank you, Mark.

謝謝你，馬克。

And good evening, everyone.

大家晚上好。

We delivered strong financial results in each quarter of 2023, with most core metrics exceeding our expectations. For the full year, we delivered on our commitment for insurance company adjusted EBITDA profitability in 2023 and have a clear line of sight into achieving total company adjusted EBITDA profitability this year.

我們在 2023 年每季都取得了強勁的財務業績，大多數核心指標都超出了我們的預期。全年來看，我們兌現了保險公司在 2023 年調整後 EBITDA 盈利能力的承諾，並對今年實現公司調整後 EBITDA 盈利能力有明確的目標。

I will touch on a few fourth quarter highlights before shifting to our full year performance, we had a strong close to 2023. Our fourth quarter medical loss ratio significantly improved by 520 basis points to 86.4%. And our fourth quarter total company adjusted EBITDA loss was $112 million, a $78 million year-over-year improvement. We ended the year with approximately 1 million members. Membership increased 5% quarter over quarter, driven by higher retention due to lower lapse rates and increased special enrollment additions.

在轉向我們的全年業績之前，我將談談第四季度的一些亮點，我們在 2023 年末表現強勁。我們第四季的醫療損失率顯著改善了 520 個基點，達到 86.4%。第四季公司調整後 EBITDA 虧損總額為 1.12 億美元，較去年同期減少 7,800 萬美元。截至年底，我們擁有約 100 萬會員。由於會員流失率降低和特殊註冊人數增加，會員留任率提高，會員數量較上季增加 5%。

Turning to the full year direct and assumed policy premiums were approximately $6.6 billion, a 3% decrease year over year and modestly above the high end of our guidance range. This was driven by lower membership, partially offset by rate increases. The full year medical loss ratio was 81.6%, a 370 basis point year-over-year improvement from below the low end of our guidance range. Overall, utilization trends were modestly favorable relative to our expectations for the full year, and we delivered medical soft cost savings through our total cost of care initiatives. As Mark mentioned, utilization trends within specific service categories remained consistent throughout the year. On risk adjustment, our risk transfer as a percentage of direct and assumed policy premiums for 2023 was lower year over year at approximately 14% due to our member profiles having shifted closer to the overall ACA population. The December Wakely report resulted in only modest updates to our risk transfer estimates.

全年直接保費和假設保費約為 66 億美元，年減 3%，略高於我們指導範圍的上限。這是由於會員數量減少造成的，但部分被費率上漲所抵消。全年醫療損失率為 81.6%，較去年同期下降 370 個基點，低於我們指導範圍的下限。總體而言，利用率趨勢相對於我們對全年的預期較為有利，並且我們透過總護理成本計劃實現了醫療軟成本節約。正如馬克所提到的，特定服務類別的使用趨勢全年保持一致。在風險調整方面，我們的風險轉移佔 2023 年直接保費和假定保單保費的百分比同比較低，約為 14%，因為我們的會員概況已更接近 ACA 總體人口。12 月的 Wakely 報告僅對我們的風險轉移估計進行了適度更新。

Switching to administrative costs, the 2023 insurance company administrative expense ratio improved 270 basis points year over year to 17.9%, driven by distribution optimization and lower risk transfer per member as a percent of premiums compared to the prior year. Partially offsetting these positive developments was a $29 million provision for credit losses on risk sharing receivables, which mainly impacted the fourth quarter. This relates to a small number of provider risk deals, which have since been terminated the 2023 insurance company combined ratio significantly improved by approximately 640 basis points year over year to 99.5%, driven by both an improved MLR and administrative cost efficiencies. In 2023, we achieved insurance company adjusted EBITDA of $169 million, representing a $450 million year-over-year improvement. And that was above the high end of our guidance range. Our adjusted administrative expense ratio improved 350 basis points year over year to 21% for the full year in line with our expectations. The lower adjusted administrative expense ratio was driven by the same factors that impacted the insurance company administrative ratio as well as higher net investment income. We have made significant progress on improving our profitability. Our full year total company adjusted EBITDA was a loss of $45 billion, a substantial $417 million year over year improvement and better than the high end of our guidance range over the past two years. Adjusted EBITDA as a percentage of premiums before ceded reinsurance has improved by approximately 15 points.

轉向管理成本，2023 年保險公司的管理費用率同比提高 270 個基點，達到 17.9%，這得益於分銷優化以及每位會員的風險轉移佔保費的百分比較上年下降的推動。風險分擔應收帳款信用損失準備金 2,900 萬美元部分抵消了這些積極進展，這主要影響了第四季度。這與少數提供者風險交易有關，這些交易已被終止。2023 年，我們保險公司調整後的 EBITDA 達到 1.69 億美元，年增 4.5 億美元。這超出了我們指導範圍的上限。調整後的全年管理費用率年增 350 個基點至 21%，符合我們的預期。調整後的管理費用率較低是由影響保險公司管理費用率的相同因素以及較高的淨投資收入所驅動的。我們在提高獲利能力方面取得了重大進展。我們全年公司調整後 EBITDA 虧損 450 億美元，較去年同期大幅改善 4.17 億美元，優於過去兩年指導範圍的上限。調整後的 EBITDA 佔分出再保險前保費的百分比提高了約 15 個百分點。

Shifting to the balance sheet, our capital position remains very strong. We ended the year with $2.9 billion of cash and investments, including $234 million of cash and investments at the parent. As of December 31st, 2023, our insurance subsidiaries had approximately $800 million of capital and surplus, including $248 million of excess capital, driven by our strong operating performance. As a reminder, the higher capital requirements for new carriers in Florida, our largest state expired for us at the start of this year. As of January first, 2024, we expect a lower capital ratio requirement to generate an additional $140 million of excess capital in our insurance subsidiaries. Given the excess capital in our insurance subsidiaries, funding of our 2024 growth capital requirements will have minimal impact on parent cash with respect to quota share reinsurance. In 2024, we expect to increase our ceding percentage from around 45% of premiums before ceded reinsurance to the low 50% range.

轉向資產負債表，我們的資本狀況仍然非常強勁。截至年底，我們擁有 29 億美元的現金和投資，其中包括母公司的 2.34 億美元現金和投資。截至2023年12月31日，我們的保險子公司擁有約8億美元的資本和盈餘，其中超額資本為2.48億美元，這得益於我們強勁的經營業績。提醒一下，我們最大的州佛羅裡達州對新營運商的更高資本要求已於今年年初到期。截至 2024 年 1 月 1 日，我們預期較低的資本比率要求將為我們的保險子公司額外產生 1.4 億美元的超額資本。鑑於我們保險子公司的資本過剩，我們 2024 年成長資本要求的資金將對配額份額再保險方面的母公司現金影響最小。到 2024 年，我們預計將分出再保險的分出比例從分出再保險前保費的 45% 左右提高到 50% 左右。

Before I turn to the 2024 outlook, I want to discuss a new financial reporting structure that we will roll out beginning with our first quarter 2024 results in order to increase transparency and improve comparability. We will be revising our presentation of the income statement to more closely align with our peers and our discussion of financial results and guidance will focus on the performance of the total company. For 2024, we will provide guidance for total revenue, medical loss ratio, SG&A expense ratio and total company adjusted EBITDA in today's earnings release, we included supplemental information on the 2024 financial outlook, including full year 2023 results for these measures, as well as details on the components of the metrics and calculations.

在談到 2024 年展望之前，我想討論我們將從 2024 年第一季業績開始推出的新財務報告結構，以提高透明度並提高可比性。我們將修改損益表的列報方式，以便與同業更加一致，我們對財務表現和指導的討論將側重於整個公司的業績。對於2024 年，我們將在今天的收益發布中提供總收入、醫療損失率、SG&A 費用率和公司調整後EBITDA 總額的指導，我們提供了有關2024 年財務前景的補充信息，包括這些措施的2023 年全年結果，以及有關指標和計算組成部分的詳細資訊。

Turning now to the 2024 full year guidance, we expect to build on the strong momentum in 2023 and achieve total company adjusted EBITDA profitability in 2024, we expect total revenues in the range of $8.3 billion to $8.4 billion based on strong retention above market growth during the 2024 open-enrollment period in SCP. member additions throughout the year as Medicaid redeterminations continue on Medicaid redeterminations, our 2024 guidance contemplates strong SEP additions and assumes higher acuity and partial year risk adjustment dynamics for these members. We are pleased with our strong open enrollment growth and expected to result in overall a healthier membership profile. We expect our medical loss ratio to be in the range of 80.2% to 81.2%, representing a 90 basis point improvement year over year at the midpoint for 2024, we price for medical cost trends and expect MLR improvements to be driven by our total cost of care initiatives, including PBM savings. We expect our quarterly MLR seasonality to be similar to 2023. Although with a steeper slope for 2024, we expect a higher risk transfer as a percentage of premiums as compared to 2023 based on our updated membership mix as the new policy year business matures, our overall per-member claims levels may change with corresponding impacts on our estimate for risk transfer, such changes impact the numerator and denominator of our MLR, but we would not expect them to have an impact on our per-member underwriting economics. We expect our SG&A expense ratio to be in the range of 20.5% to 21%, representing a 350 basis point year-over-year improvement at the midpoint. This ratio includes stock-based compensation expense, which in 2023 was approximately $160 million and included a one-time charge of $46 million related to accelerated stock-based compensation expense recognized as a result of the cancellation of the founders awards. We expect our SG&A expense ratio to be fairly consistent in the first three quarters with a modest uptick in the fourth quarter. We expect total company adjusted EBITDA to be in the range of $125 million to $175 million, representing an almost $200 million year-over-year improvement at the midpoint In closing, 2023 was a pivotal year for Oscar. We delivered on our commitments for insurance company, adjusted EBITDA profitability, and we are well positioned to return to growth and achieve total company adjusted EBITDA profitability this year.

現在轉向2024 年全年指引，我們預計將在2023 年的強勁勢頭基礎上再接再厲，並在2024 年實現公司調整後EBITDA 盈利能力，我們預計總收入將在83 億美元至84 億美元之間，基於2023 年強勁的保留率高於市場成長水準。隨著醫療補助重新確定繼續進行，我們的 2024 年指南考慮了強勁的 SEP 增加，並假設這些成員具有更高的敏銳度和部分年度風險調整動態。我們對開放註冊人數的強勁成長感到高興，並預計整體會員狀況將更加健康。我們預計我們的醫療損失率將在 80.2% 至 81.2% 範圍內，到 2024 年中點將同比改善 90 個基點，我們根據醫療成本趨勢進行定價，並預計 MLR 的改善將由我們的總成本推動護理舉措，包括PBM 節省。我們預計季度 MLR 季節性將與 2023 年類似。儘管2024 年的斜率更陡，但隨著新保單年度業務的成熟，根據我們更新的會員組合，我們預計風險轉移佔保費的百分比將比2023 年更高，但我們的整體每位會員索賠水平可能會發生變化，並對根據我們對風險轉移的估計，此類變化會影響我們的 MLR 的分子和分母，但我們預計它們不會對我們的每位會員承保經濟產生影響。我們預計 SG&A 費用率將在 20.5% 至 21% 之間，中位數較去年同期改善 350 個基點。這一比率包括股票薪酬費用，2023 年約為 1.6 億美元，其中包括因取消創始人獎勵而確認的加速股票薪酬費用相關的一次性費用 4,600 萬美元。我們預計前三個季度的銷售管理及行政費用率將相當穩定，第四季將小幅上升。我們預計公司調整後 EBITDA 總額將在 1.25 億美元至 1.75 億美元之間，中間值年增近 2 億美元。我們兌現了對保險公司的承諾，調整了 EBITDA 盈利能力，並且我們已做好準備，今年將恢復增長並實現公司調整後 EBITDA 盈利能力。

And with that, let me turn the call back over to Mark for closing remarks.

接下來，讓我將電話轉回給馬克，請他發表結束語。

Thank you, Scott. I would like to close by looking back at the financial metrics we shared with analysts in connection with Oscar's initial public offering in 2021, we said we expected to achieve the following in 2023, nearly 1 million members, $5.7 billion in direct and assumed policy premiums and 83% MLR for the total company. Adjusted EBITDA loss of $222 million today, Oscar has far exceeded these metrics. We are a prominent player in the fastest growing segment of health insurance. We demonstrated the power of our superior member experience and technology by exceeding our projections for open enrollment. We achieved insurance company profitability and outperformed our expectation for total company adjusted EBITDA in 2023. We are returning to growth and have a clear line of sight into delivering on our target for total company adjusted EBITDA profitability in 2024, we have done what we said we would do phosphorus delivering on its commitments. I would like to thank the Oscar team. We are powered by our people, their hard work and dedication make all of this possible. With that, I would like to turn the call over to the operator for the Q&A portion of our call.

謝謝你，斯科特。最後，我想回顧一下我們與分析師分享的有關 Oscar 2021 年首次公開募股的財務指標，我們表示預計在 2023 年實現以下目標：近 100 萬會員、57 億美元的直接保費和假設保費整個公司的MLR 為83%。今天調整後的 EBITDA 損失為 2.22 億美元，奧斯卡已經遠遠超過了這些指標。我們是成長最快的健康保險領域的傑出參與者。透過超越我們對公開註冊的預測，我們展示了我們卓越的會員經驗和技術的力量。我們實現了保險公司獲利，並超越了我們對 2023 年公司調整後 EBITDA 總額的預期。我們正在恢復成長，並且對實現 2024 年公司調整後 EBITDA 盈利能力的目標有著清晰的目標，我們已經做到了我們所說的磷業務，兌現了其承諾。我要感謝奧斯卡團隊。我們的動力來自於我們的員工，他們的辛勤工作和奉獻精神使這一切成為可能。這樣，我想將電話轉給接線員進行電話問答部分。

At this time, I would like to remind our teleconference participants in order to ask a question, please press star followed by the number one on your telephone keypad. We kindly request that analysts limit their questions to one and if time permits, you may hold for a second question, and we'll pause for just a moment compile the Q&A roster. Our first question comes from the line of Adam Rumley of Bank of America. Please go ahead.

此時，我想提醒我們的電話會議參與者要提問，請按電話鍵盤上的星號，然後按數字一。我們懇請分析師將他們的問題限制為一個，如果時間允許，您可以提出第二個問題，我們將暫停片刻來整理問答名冊。我們的第一個問題來自美國銀行的 Adam Rumley。請繼續。

Hey, guys, congrats on the strong results and thinking about, you know, the adjusted EBITDA trajectory from here, you're on track to do something like 2% half from a margin perspective in 2024. And I think in the past, you've talked about total company maybe on a pretax basis being closer to 5%. And so the difference between those two things is still in a roughly 3 to 500 basis points of margin improvement. And this year was sort of outsized from a revenue growth perspective. And so what do you see as like the major levers in terms of being able to close that gap between the two percentage of EBITDA and 5% pretax margin, given you probably shouldn't expect to kind of like 40% revenue growth here from here and maybe some of the, you know, lower hanging fruit around PBM contract renegotiation aren't as readily available. And so just thinking about what the major levers are from here would be helpful.

嘿，夥計們，恭喜你們取得了強勁的業績，並考慮一下，從這裡開始調整後的 EBITDA 軌跡，從利潤率的角度來看，你們有望在 2024 年實現 2% 左右的目標。我想在過去，您曾談到公司的稅前利潤可能接近 5%。因此，這兩件事之間的差異仍然是利潤率改善了大約 3 到 500 個基點。從營收成長的角度來看，今年的規模有點過大。那麼，您認為能夠縮小 EBITDA 和 5% 稅前利潤率這兩個百分比之間差距的主要槓桿是什麼，因為您可能不應該期望從這裡開始會有 40% 的收入增長您知道，圍繞PBM 合約重新談判的一些唾手可得的成果可能沒那麼容易實現。因此，只要思考這裡的主要槓桿是什麼就會有所幫助。

Thanks, Adam.

謝謝，亞當。

Mark Bertolini here from both start with big categories. First, we have a fixed costs to grow to a much larger size. So fixed cost leverage will be pretty robust. No matter how much we grow, although we anticipate and continue to anticipate that 20% growth year over year is achievable and secondly, we have in our variable operating expense, been able to leverage large language models on the back end of the system and just for an extra day to bid on our on call volumes, we actually handled the call volumes we had this year with 200 less people answering the phones. So we continue to see big operating opportunities on the variable cost side, we are in the midst of looking at provider contracts, particularly hospital contracts. And we now have a matrix of contracts that we need to get to optimal level from the standpoint of both terms and rates. And so we have a list based on and on renewals and market size, we're going to begin those conversations with our provider partners not just because we have more market share, but because we have better relationships with them in the way we deal with them day-in and day-out on utilization management than our reimbursement and paying claims?

馬克·貝托里尼（Mark Bertolini）從這兩個方面都從大類別開始。首先，我們有固定的成本來擴大規模。因此，固定成本槓桿將非常強勁。無論我們成長多少，儘管我們預計並繼續預期同比成長 20% 是可以實現的，其次，我們在可變營運費用中能夠在系統後端利用大型語言模型，並且只需為了額外一天的時間來競標我們的接聽電話量，我們實際上處理了今年的通話量，接聽電話的人數減少了200 人。因此，我們繼續在可變成本方面看到巨大的運營機會，我們正在研究提供者合同，特別是醫院合約。現在我們有了一個合約矩陣，我們需要從條款和費率的角度達到最佳水平。因此，我們有一個基於續訂和市場規模的清單，我們將開始與我們的提供者合作夥伴進行這些對話，不僅因為我們擁有更多的市場份額，而且因為我們在處理問題的方式上與他們有更好的關係他們日復一日地進行使用管理而不是我們的報銷和支付索賠？

Scott, anything that?

史考特，有什麼嗎？

Yes, Adam, I think that we certainly think there is room to run in terms of continuing to drive MLR performance through disciplined pricing. And we see continued opportunity to drive total cost of care down on allowing us to both grow and to take margin.

是的，Adam，我認為我們當然認為在透過嚴格的定價繼續推動 MLR 績效方面還有空間。我們看到了持續降低總護理成本的機會，使我們能夠實現成長並獲得利潤。

Mark talked about admin efficiency. I think there's also plenty of room for us to continue to drive favorable performance there.

馬克談到了管理效率。我認為我們還有足夠的空間繼續在那裡取得良好的業績。

And then I think that just broader speaking, we really believe that this market is going to continue to attract individualized consumers and that's where we really shine on building innovative plans. And if we can continue to see that development in the market, we think that we have a terrific opportunity to continue to grow the Company. Obviously, fixed cost leverage is going to be our friend. So we think we've got all the bones in place to get to that over time.

然後我認為，從更廣泛的角度來說，我們確實相信這個市場將繼續吸引個人化消費者，而這正是我們真正擅長制定創新計畫的地方。如果我們能夠繼續看到市場的發展，我們認為我們有一個絕佳的機會來繼續發展公司。顯然，固定成本槓桿將成為我們的朋友。因此，我們認為隨著時間的推移，我們已經具備了實現這一目標的所有基礎。

Sam, if I could just sneak one more in maybe more shorter term on both CVS and Cigna have been seeing somewhat varied performance from these changes as opposed to you spent $10 million on CVS in particular, has been complaining about the special enrollment charges are having less of an opportunity or risk code members who joined the middle of the year, and that's something that and Oscar has struggled with in the past, but doesn't appear to be impacting results this year. And so if you could just square that commentary of like are you seeing outsized pressure from the midyear enrollment dynamic? And does that argue that core MLR results are higher than what's been reported? And does that is that how we should contemplate 2025 MLR improvement from here. Just wanted to understand the very performance versus some of your competitors things.

Sam，如果我能在更短的時間內再在CVS 和Cigna 上再多做一次的話，他們已經看到這些變化帶來的表現有所不同，而不是你在CVS 上花費了1000 萬美元，他一直在抱怨特殊註冊費用年中加入的代碼成員機會或風險較少，這是奧斯卡過去一直在努力解決的問題，但似乎不會影響今年的業績。因此，如果你能糾正這樣的評論，你是否會看到年中招生動態帶來的巨大壓力？這是否顯示核心 MLR 結果高於報告的結果？這就是我們應該如何從這裡考慮 2025 年 MLR 的改進嗎？只是想了解與某些競爭對手相比的性能。

And look, I think that we've been experienced SEP for years. We certainly understand the dynamics of how duration factors impact those members. We build that into our price assumptions this year, we've seen SEP members that have performed more or less consistent with our historical experience with them. So nothing for us that that has caused us any challenges in terms of onboarding those members.

看，我認為我們已經經歷了 SEP 多年。我們當然了解持續時間因素如何影響這些成員的動態。我們將這一點納入今年的價格假設中，我們看到 SEP 成員的表現或多或少與我們的歷史經驗一致。因此，這對我們來說並沒有給我們在加入這些成員方面帶來任何挑戰。

With respect to 2024, we assumed that we would be growing the SCP. membership would come in into the second half of the year, and we've built that into our guidance for MLR. It's an area that's challenging, certainly on but we've got we've got experience there. We've got, you know, I think a reasonable expectation of how those members going to perform based on what we've seen and through the end of the year and into this year, and they have a morbidity and profile that is kind of what we're expecting. So there's always some risk with growth and with new members but we think that we've set we've built those risks into the guidance that we gave you today.

就 2024 年而言，我們假設我們會發展 SCP。會員資格將於今年下半年開始，我們已將其納入國土資源部的指導中。這是一個充滿挑戰的領域，當然，但我們在這方面擁有豐富的經驗。你知道，我認為根據我們所看到的以及今年年底和今年的情況，我們對這些成員的表現有一個合理的預期，他們的發病率和概況是這樣的我們期待什麼。因此，成長和新成員總是存在一些風險，但我們認為我們已經將這些風險納入了今天給你們的指導中。

Great. Thanks.

偉大的。謝謝。

Thank you. Our next question comes from the line of Josh Raskin from Nephron Research. Please go ahead.

謝謝。我們的下一個問題來自 Nephron Research 的 Josh Raskin。請繼續。

Hi, thanks and good evening. Do you think the stability of the exchanges and certainly the growth that we're seeing in the markets attracting sort of these new larger competitors, are you seeing overall rational behavior from them and how lasting you think the competition is?

你好，謝謝，晚上好。您認為交易所的穩定性以及我們在市場中看到的成長是否吸引了這些新的更大的競爭對手，您是否看到他們的整體理性行為以及您認為競爭的持久性如何？

I would say that rational behavior was not necessarily in place last year and I would in 2023, and we'll open enrollment for 2023 in large part because some people have not priced accordingly to how the market works.

我想說，去年理性行為不一定到位，2023 年我也會這樣做，我們將在 2023 年開放招生，很大程度上是因為有些人沒有根據市場運作方式進行定價。

I mean, as you well know, and part of what we found even when I was with that in the markets, is that the minimum loss ratios that were put in place for pricing don't allow you to underprice and then price up business after you get share because you have to give back rebates. And so this going into with a mindset that we will grow with disciplined pricing is an important piece. And we saw some of that this year for 2020 for open enrollment, where people took their prices up plus the business in your Georgia is one of those markets. And when we look at our rates in those markets, we are where everybody else is now pretty much with increases that are in the 8% to 9% range. So we are and we felt that we have we go into this with open eyes and deep understanding of this market over time. And we believe that we have priced accordingly and we've been disciplined about it stable and rational pricing.

我的意思是，正如您所知，即使我在市場上，我們發現的部分內容是，定價所採用的最低損失率不允許您低估價格，然後在定價之後抬高業務價格。你必須返還回扣。因此，我們將透過嚴格的定價來實現成長，這種心態非常重要。今年我們在 2020 年的公開招生中看到了一些這樣的情況，人們提高了價格，而喬治亞州的業務就是這些市場之一。當我們查看這些市場的費率時，我們發現我們的費率幾乎與其他市場相同，增幅在 8% 到 9% 的範圍內。因此，我們認為，隨著時間的推移，我們會以開放的眼光和對這個市場的深入了解進入這個領域。我們相信我們已經進行了相應的定價，並且我們一直對其定價保持穩定和合理的紀律。

And then just secondly, the midpoint of EBITDA guidance of $150 million at the holdco level, what does that mean for cash flow from operations? And can you just help us with the moving parts on at the parent cash balance for 2024. And you know, I am sort of thinking about the Florida capital that's not needed sort of versus the growth. I'm just trying to figure out what we should think about cash flow from operations? And then what does that mean for PowerCash?

其次，控股公司 EBITDA 指引的中點為 1.5 億美元，這對營運現金流意味著什麼？您能否幫助我們解決 2024 年母公司現金餘額的變動問題？你知道，我正在考慮佛羅裡達州首府的不需要與經濟成長之間的關係。我只是想弄清楚我們應該如何看待營運現金流？那麼這對 PowerCash 意味著什麼？

Yes.

是的。

So Josh, I think that the importance of the adjusted EBITDA metric for total company is the doubt would with the growth, we'll be getting additional cash prior to paying the risk transfer estimates. And we would anticipate that the total company will be cash flow positive will be building capital in our insurance subsidiaries. And in terms of those subsidiaries, what we would be looking to do going forward is prioritizing one funding the growth that we hope to continue to have to distributing capital to the parent to offset parent expenses and three that they will be absorbing more of the holding company costs over time. So we feel like we've got a good situation with capital and cash and would expect to be cash flow positive next year or excuse me in 2024.

所以喬希，我認為調整後的 EBITDA 指標對整個公司的重要性是值得懷疑的，隨著成長，我們將在支付風險轉移估算之前獲得額外的現金。我們預計整個公司的現金流將為正，並將在我們的保險子公司中建立資本。就這些子公司而言，我們未來要做的事情是優先考慮一項為增長提供資金，我們希望繼續向母公司分配資本以抵消母公司的支出，三項是它們將吸收更多的控股隨著時間的推移，公司的成本。因此，我們覺得我們的資本和現金狀況良好，預計明年或 2024 年現金流為正。

Thank you.

謝謝。

Thank you. Our next question comes from the line of Nathan Rich from Goldman Sachs. Please go ahead.

謝謝。我們的下一個問題來自高盛的內森·里奇（Nathan Rich）。請繼續。

Great.

偉大的。

Good afternoon and congrats on the strong quarter. I maybe wanted to start by asking that you could maybe break down the composition of the membership growth a little bit more between markets, maybe you entered for 2024 versus growth in existing markets and you also talked about a healthier membership base. Could you maybe just expand on what you're seeing there?

下午好，恭喜季度表現強勁。我可能想先問一下，您是否可以進一步細分市場之間的會員成長組成，也許您考慮的是 2024 年與現有市場的成長，並且您還談到了更健康的會員基礎。您能否擴展一下您在那裡看到的內容？

Yes.

是的。

Why don't I start and then Mark can maybe talk about some of the on the membership growth. But overall, when we look at the demographics and kind of the morbidity of the group that we're seeing, I would characterize it as number one. It's younger than So we certainly, with this growth have seen younger members coming in more than at a little more than a year beyond our in terms of the total population, number two, I would I would characterize it is we've seen a shift of more of our membership in 2024 towards brands, excuse me, from bronze to silver. And so that that is another dynamic that we've seen. Overall, I would say that our membership being healthier is representative of the fact that we think we're going to have a higher risk transfer this year. So the dynamics of that membership younger, healthier and until the plants are probably the things I would I would kind of point out, Mark, you want to cover the state-by-state.

為什麼我不開始，然後馬克也許可以談一些關於會員成長的問題。但總的來說，當我們觀察我們所看到的該群體的人口統計和發病率時，我將其描述為第一。它比我們更年輕 所以，隨著這種增長，我們當然看到年輕成員的加入比我們的總人口多一年多一點，第二，我想我會說這是我們看到的轉變抱歉，到2024 年，我們的會員資格將會從銅牌變成銀牌。這是我們看到的另一個動態。總的來說，我想說，我們的會員更健康代表了這樣一個事實：我們認為今年的風險轉移將會更高。因此，該會員的動態更年輕，更健康，直到植物可能是我想要的東西，我想指出，馬克，你想覆蓋各州。

Sure UM, strong retention was the biggest part of our growth. I would say that and also provide stabilization in risk adjustment as we go forward into this year. That was obviously helpful for us last year. And we did grow new members in existing markets, Georgia, Florida, Ohio, Tennessee, Iowa and Missouri. But we also outperformed expectations in new markets where we did some service area expansion, Cincinnati on Tennessee, and some of the rural markets in Iowa and Georgia.

當然，強大的保留率是我們成長的最大部分。我想說的是，隨著我們進入今年，風險調整也會變得穩定。去年這顯然對我們有幫助。我們確實在現有市場（喬治亞州、佛羅裡達州、俄亥俄州、田納西州、愛荷華州和密蘇裡州）增加了新成員。但我們在新市場（田納西州辛辛那提）以及愛荷華州和喬治亞州的一些農村市場的表現也超出了預期，我們在這些市場上進行了一些服務區域擴張。

Great.

偉大的。

And maybe just a quick follow-up. I think in the past, the Company has talked about a target MLR in the low 80% range. You've pretty much got it to that level for 2024. So I guess as we think beyond this year, do you think there's still kind of improvement in MLR that can be had or will more of the margin expansion, I guess, come from leveraging your growth that you might see.

也許只是快速跟進。我認為過去，公司曾談論過 80% 範圍內的目標 MLR。到 2024 年，您幾乎已經達到了這個水平。因此，我想，當我們思考今年之後的情況時，您認為 MLR 是否仍有改進，或者更多的利潤率擴張，我想，來自於利用您可能看到的成長。

We definitely have room in the MLR.

我們在 MLR 中肯定有空間。

I'm going to put a finer point on that. Remember, our PBM contract has year over year step improvements that are built into that contract. So without doing anything, our pharmacy costs would be lower in 2025. So a lot of the things that you're seeing in the run rate that's benefiting 24 we would anticipate have incremental improvements into 25 and we would expect to continue to we drive down the costs of care.

我將對此提出更詳細的觀點。請記住，我們的 PBM 合約中包含逐年改進的內容。因此，如果不採取任何措施，到 2025 年我們的藥品成本將會更低。因此，您在運行率中看到的許多事情都使 24 人受益，我們預計將逐步改善到 25 人，並且我們預計將繼續降低護理成本。

Great.

偉大的。

Thanks very much.

非常感謝。

As a reminder, if you'd like to ask a question, please press the star followed by the one on your telephone. Our next question comes from the line of Steven Baxter from Wells Fargo. Please go ahead.

提醒一下，如果您想提問，請按星號，然後按電話上的星號。我們的下一個問題來自富國銀行的史蒂文·巴克斯特。請繼續。

Hi, thanks. I just wanted to follow up on the PBM discussion. I know in the past you've talked about the savings being spread out over 2024 and 2025. So it could be here. Some of that's still in front of you. Can you give us a sense of maybe what inning we're in in the PBM savings exit in 2024.

你好謝謝。我只是想跟進 PBM 討論。我知道您過去曾談到將節省費用分攤到 2024 年和 2025 年。所以它可能在這裡。其中一些仍然在您面前。您能否讓我們了解 2024 年 PBM 儲蓄退出正處於哪個階段？

And then just a second on kind of the profile of membership you're looking for in 2024. Just wondering, it sounds like now that you've gotten to insurance company profitability. I would think that growth that you're seeing from inside the open enrollment period would seemingly come on it, incremental profitable margins, but perhaps you're taking a more conservative stance I start out. So would love some insight into how you're thinking about the profitability of the growth? And then just last one, you know, exiting this year, where do you think you'll be on some of the payment integrity efforts that you've talked about in the past?

然後簡單介紹一下您在 2024 年尋找的會員資格類型。只是想知道，聽起來現在您已經實現了保險公司的利潤。我認為您在開放註冊期內看到的成長似乎會隨之而來，即利潤率的增量，但也許您一開始就採取了更保守的立場。那麼想了解一下您如何看待成長的獲利能力嗎？最後一個，你知道，今年退出，你認為你在過去談到的一些支付誠信方面的努力會取得什麼進展？

Thanks.

謝謝。

I mean, I tried to remember all those. So if we miss one and I'm not being cute, Charlie, please come back on.

我的意思是，我試著記住所有這些。所以，如果我們錯過了一個，而我表現得不夠可愛，查理，請回來。

So you know, when I think about where we might be going from a overall starting with kind of the M, the R. I think there's opportunities there around the PBM where the PBM actually goes out till 2026. And so we have a contract where each year we will see benefits and this was the 1st year was the largest step change, but there's continued to be meaningful improvements in that contract over the remaining term. So that is that's something that we can put in the bank, and we're pleased with our partnership there with our provider.

所以你知道，當我考慮我們可能從 M、R 類的整體開始走向何方時。因此，我們簽訂了一份合同，每年我們都會看到收益，這是第一年是最大的一步變化，但該合約在剩餘期限內繼續進行有意義的改進。所以這就是我們可以存入銀行的東西，我們對與供應商的合作關係感到滿意。

And I would add that we also have the opportunity for volume. More volume gets us more discounts than we initially anticipated. And then thirdly, there's an opportunity to work on the MAC list on quarter after quarter on the on the on the payment integrity issues, we'll see full year effect on what we've done for last year this year, but we have more to go this year. So we'll continue to improve upon those, particularly as we apply AI models to the back of the business and go after on things that we now pay vendors for and then adding on last but not least, we still have a lot of provider relationships that we can affect in markets that were vintage markets where the Company started had no volume and was able to move on those medical costs. So we have room on medical cost across the board.

我想補充一點，我們也有機會擴大銷售量。更多的銷量為我們帶來了比我們最初預期更多的折扣。第三，我們有機會在支付完整性問題上逐季處理 MAC 清單，我們將看到今年對去年所做工作的全年影響，但我們還有更多今年去。因此，我們將繼續改進這些，特別是當我們將人工智慧模型應用於業務後台並追求我們現在向供應商付款的事情時，最後但並非最不重要的一點是，我們仍然擁有很多供應商關係我們可以影響那些公司開始的老式市場，沒有銷售量，並且能夠轉移這些醫療費用。因此，我們在醫療費用方面還有空間。

And then Steve, probably the last piece on your question on member economics, I would say that we would anticipate that all of the growth that we're seeing in open enrollment is contribution margin positive. So at this point, growth is great for the bottom line. And we also expect to see continued enrollment through the special enrollment period. And while those members come at a we've talked about this in the past with about a 10% higher MLR and there are other durational impacts that we talked about that in the 1st year and then they look exactly like the rest of OE. if we can retain those people. So it is it is certainly the case that depending on when you get those members in the year, the economics can be challenging in the 1st year, but we've built that into the plan. So that's are those are already built into our guidance, and we are excited to have the opportunity to add more members through special enrollment period in addition to the success that we've already had in open enrollment.

然後史蒂夫，可能是你關於會員經濟學問題的最後一篇文章，我想說，我們預計我們在公開註冊中看到的所有增長都是貢獻邊際正值。因此，在這一點上，成長對於獲利來說是非常有利的。我們也希望在特殊招生期間看到繼續招生。雖然這些成員來參加我們過去討論過的問題，MLR 大約提高了 10%，並且我們在第一年討論過其他持續影響，但它們看起來與 OE 的其他部分完全相同。如果我們能留住這些人。因此，根據一年中何時獲得這些成員，第一年的經濟狀況可能會面臨挑戰，但我們已將其納入計劃中。因此，這些已經納入我們的指導中，除了我們在公開註冊方面已經取得的成功之外，我們很高興有機會透過特殊註冊期添加更多成員。

Thanks for all the color.

感謝所有的顏色。

Thank you.

謝謝。

Our next question comes from the line of Adam rand of Bank of America. Please go ahead.

我們的下一個問題來自美國銀行的亞當蘭德。請繼續。

Hey, thanks for squeezing me back. And I just have one more question. I get a lot of questions on the Affordable Care Act subsidy and then there are some government estimates out there. You know, if the subsidies were to go away what would happen to the market size? And so just wondering on if you have any comments on what you'd expect it to do to the market and maybe relative to like what you're the mix of members looks like relative to who is using a PTC. And so first on that, and second, you mentioned before you look at G&A as fixed versus variable, like maybe this would be a helpful framework for us of, you know, if we're able to think about how much of the G&A is fixed versus variable, how that would flow into earnings.

嘿，謝謝你把我拉回來。我還有一個問題。我收到了很多關於《平價醫療法案》補助的問題，還有一些政府的估計。你知道，如果補貼取消，市場規模會發生什麼變化？因此，想知道您是否對它對市場的預期有何評論，以及您的會員組合與使用 PTC 的人員的關係。首先，第二，您在將 G&A 視為固定與可變之前提到過，就像這對我們來說可能是一個有用的框架，您知道，如果我們能夠考慮 G&A 的比例是多少固定與可變，這將如何流入收益。

And then finally, I said if the subsidies were to go away, which obviously nobody can predict, is it fair to say that margin would degrade? Or is there a reason to believe there's there are some levers you could pull to kind of offset that?

最後，我說如果補貼取消（顯然沒人能預測），那麼可以說利潤率會下降嗎？或者是否有理由相信可以採取一些槓桿來抵消這種影響？

Correct?

正確的？

Well, the last part of your question, Adam, we believe that we have an opportunity to provide services at a different price point that could help folks when and when and if the enhanced subsidies go away, um, but going up to the more general level, I will say we have some interesting looks at our data this open enrollment. And in this open enrollment, 63% of new ACA consumers are from red states and 76% during the open enrollment in the year over year in the ACR market growth is in red states. So I kind of find it hard that the political dynamic that was going on six, eight years ago is going to be the same relative to the Republican Party ongoing after a group of people that largely are going to be their own constituents. We'll see we have a planning version on our strategic plan of having it go away and all the things that we would need to do with product in order to make things affordable folks in the group, we worry about most of the people in the 100% to 200% federal poverty level that have zero premium plans and would potentially be paying somewhere around 60 or 70 bucks a month. That's the place where we think the impact is that we're planning against that defined solutions for it relative to fixed versus variable?

好吧，亞當，你問題的最後一部分，我們相信我們有機會以不同的價格提供服務，這可以在增強補貼消失時為人們提供幫助，嗯，但要擴展到更普遍的範圍級別，我會說我們對這次公開招生的數據做了一些有趣的觀察。在本次公開註冊中，63% 的新 ACA 消費者來自紅色州，而在 ACR 市場同比增長的公開註冊期間，76% 來自紅色州。因此，我覺得很難說六、八年前發生的政治動態與共和黨在一群主要成為自己選民的人之後所發生的政治動態是一樣的。我們會看到我們有一個關於讓它消失的戰略計劃的規劃版本，以及我們需要對產品做的所有事情，以便讓團隊中的人們負擔得起，我們擔心團隊中的大多數人100% 到200 % 的聯邦貧窮線，擁有零保費計劃，每月可能需要支付60 或70 美元左右。這就是我們認為影響是我們正在計劃相對於固定與可變的已定義解決方案的地方？

Scott, I'll let you decide.

史考特，我會讓你決定。

Yes, like I'm on fixed versus variable. I think that's information that we will look forward to sharing more about with you when we have our Investor Day in June.

是的，就像我在固定與可變之間的比較。我認為，當我們在六月舉辦投資者日時，我們將期待與您分享更多相關資訊。

Awesome.

驚人的。

Thank you.

謝謝。

Thank you. Ladies and gentlemen, as we have no further questions at this time, we will conclude today's conference call. We thank you for participating, and you may now disconnect.

謝謝。女士們、先生們，由於我們目前沒有其他問題，我們將結束今天的電話會議。我們感謝您的參與，您現在可以斷開連接。