Oscar Health Inc (OSCR) 2024 Q1 法說會逐字稿

Good morning. My name is Allie, and I will be your conference operator today. At this time, I would like to welcome everyone to Oscar Health's first quarter 2024 earnings conference call. Please note that this call is being recorded. (Operator Instructions) I will now turn the conference over to Chris Potochar, Vice President of Treasury and Investor Relations. Please go ahead.

早安.我叫艾莉，今天我將擔任你們的會議操作員。此時此刻，我歡迎大家參加 Oscar Health 2024 年第一季財報電話會議。請注意，此通話正在錄音。（操作員指示）我現在將會議轉交給財務與投資人關係副總裁 Chris Potochar。請繼續。

Good morning, everyone. Thank you for joining us for our first quarter 2024 earnings call. Mark Bertolini, Oscar's Chief Executive Officer, and Scott Blackley, Oscar's Chief Financial Officer, will host this morning's call. This call can also be accessed through our investor relations website at ir.hioscar.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.hioscar.com.

大家，早安。感謝您參加我們的 2024 年第一季財報電話會議。Oscar 執行長 Mark Bertolini 和 Oscar 財務長 Scott Blackley 將主持今天上午的電話會議。您也可以透過我們的投資者關係網站 ir.hioscar.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，請參閱我們的收益報告，該報告可在我們的投資者關係網站 ir.hioscar.com 上找到。

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. 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 annual report on Form 10-K for the period ended December 31, 2023, filed with the SEC and other filings with the SEC, including our quarterly report on Form 10-Q for the quarterly period ended March 31, 2024, to be filed with the SEC.

Oscar 對未來發表的任何言論均構成 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。由於各種重要因素，包括我們向 SEC 提交的截至 2023 年 12 月 31 日的 10-K 表格年度報告和其他文件中討論的因素，實際結果可能與這些前瞻性陳述所示的結果存在重大差異向SEC 提交的信息，包括我們將向SEC 提交的截至2024 年3 月31 日的季度報告10-Q 表格。

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.

此類前瞻性陳述是基於截至目前的當前預期。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 first quarter earnings press release available on the company's investor relations website at ir.hioscar.com. With that, I would like to turn the call over to our CEO, Mark Bertolini.

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 指標的調節可以在公司投資者關係網站 ir.hioscar.com 上發布的第一季財報新聞稿中找到。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)。

Good morning. Thank you, Chris, and thank you all for joining us this morning. This morning Oscar reported strong first quarter results with solid year-over-year improvement across all core metrics.

早安.謝謝克里斯，也謝謝大家今天早上加入我們。今天早上，奧斯卡公佈了強勁的第一季業績，所有核心指標均較去年同期穩定改善。

Underlying our first quarter performance, we reported total revenue of $2.1 billion. Our revenue increased 46% year over year, led by strong retention, above market membership growth during open enrollment and SCP member additions.

我們第一季的總營收為 21 億美元。我們的營收年增 46%，這得益於開放註冊期間的強勁保留率、高於市場的會員成長以及 SCP 會員增加。

Oscar achieved an important milestone in the quarter. We reported positive net income for the first time in our history. We generated $178 million of net income, a significant $217 million improvement year over year. Our medical loss ratio improved 210 basis points year over year to 74.2%, an overall utilization was in line with our expectations.

奧斯卡在本季度實現了一個重要的里程碑。我們歷史上首次報告了正淨利潤。我們實現了 1.78 億美元的淨利潤，年比大幅成長 2.17 億美元。我們的醫療損失率年增 210 個基點至 74.2%，整體利用率符合我們的預期。

In addition, we achieved total company adjusted EBITDA of $219 million, a $168 million improvement versus the prior year. Our strong momentum positions us to deliver on our total company adjusted EBITDA profitability target this year. We are seeing real earnings power in our insurance business. The business has scaled to a point where we are driving strong membership growth and improved profitability. We are delivering on our commitments, and we remain on a solid path to grow sustainably over the long term.

此外，我們公司調整後的 EBITDA 總額達到 2.19 億美元，比前一年增加了 1.68 億美元。我們強勁的勢頭使我們能夠實現今年公司調整後的 EBITDA 獲利目標。我們在保險業務中看到了真正的獲利能力。該業務已擴大到我們正在推動會員強勁成長並提高獲利能力的程度。我們正在兌現我們的承諾，並繼續走在長期可持續成長的堅實道路上。

In a few moments, Scott will provide a more detailed review of our first quarter results. First, I will cover key business highlights. Oscar closed the quarter with a strong 2024 open enrollment period alongside record enrollment in the ACA marketplace.

稍後，斯科特將對我們第一季的業績進行更詳細的回顧。首先，我將介紹主要業務亮點。Oscar 以 2024 年開放註冊期的強勁表現以及 ACA 市場註冊人數創紀錄的成績結束了本季度。

Total membership increased 42% year over year, exceeding our expectations. We captured share in existing and expansion markets and drove superior customer satisfaction and record high retention. Our growth demonstrates that our value proposition continues to resonate with consumers. Oscar's affordable and personalized plans driven by our disciplined pricing and total cost of care initiatives attract consumers.

會員總數年增 42%，超出了我們的預期。我們在現有和擴展市場中佔據了份額，並提高了卓越的客戶滿意度和創紀錄的高保留率。我們的成長顯示我們的價值主張繼續引起消費者的共鳴。Oscar 的實惠且個人化的計劃受到我們嚴格的定價和總護理成本計劃的推動，吸引了消費者。

Our superior member experience, driven by our technology retains them. We ended the quarter with another record high NPS of 66. During the quarter, we continued to meet consumer needs through our technology. We drove more members to affordable benefit rich plans in key states where other carriers retreated, including Georgia and Kansas.

在我們的技術驅動下，我們卓越的會員體驗留住了他們。本季結束時，NPS 再次創下新高，達到 66。本季度，我們繼續透過我們的技術滿足消費者的需求。我們推動更多會員在其他航空公司撤退的關鍵州（包括喬治亞州和堪薩斯州）購買負擔得起的福利豐富的計劃。

We also launched new products for our fast-growing and diverse member population, which attracted differentiated member profiles in several new geographies. As an example, we launched our Spanish first program, HolaOscar, to better support our Hispanic and Latino member base in Georgia.

我們也針對快速成長且多元化的會員群體推出了新產品，吸引了幾個新地區的差異化會員。例如，我們推出了第一個西班牙語計畫 HolaOscar，以更好地支持我們在喬治亞的西班牙裔和拉丁裔會員群。

The program drives personalized care interventions through our engagement capabilities in their native language. Early results show 247% growth in 93% retention in our Spanish speaking membership in Georgia in just one year. Our teams also successfully launched diabetes focused campaigns through HolaOscar. Hispanic adults or 70% more likely than non-Hispanic adults to be diagnosed with diabetes.

該計劃透過我們以他們的母語參與的能力來推動個人化護理幹預措施。早期結果顯示，短短一年內，我們格魯吉亞西班牙語會員的保留率就增加了 247%，保留率達 93%。我們的團隊也透過 HolaOscar 成功發起了以糖尿病為重點的活動。西班牙裔成年人被診斷出患有糖尿病的可能性比非西班牙裔成年人高 70%。

Our campaigns introduce culturally relevant messaging to increase diabetes screening rates, including eye exams and kidney screenings and close gaps in care, tailored health engagement programs like these help drive our strong NPS of 87 among Spanish speakers.

我們的活動引入了與文化相關的訊息，以提高糖尿病篩檢率，包括眼科檢查和腎臟篩檢以及縮小護理差距，此類客製化的健康參與計劃有助於推動西班牙語使用者的 NPS 高達 87。

Finally, we continue to externalize key aspects of our member engagement and experienced capabilities to power the health care system through +Oscar. Our efforts are gaining traction. In the quarter, all of our clients added more lives to our campaign builder platform, including a key provider group that expanded the relationship by 35,000 lives.

最後，我們繼續將我們的會員參與度和經驗豐富的能力的關鍵方面具體化，透過 +Oscar 為醫療保健系統提供動力。我們的努力正在獲得關注。本季度，我們的所有客戶都為我們的活動建立平台增加了更多生命，其中包括一個關鍵提供者集團，該團隊將我們的關係擴大了 35,000 個生命。

We are pleased with +Oscar's momentum. We continue to mature the product set and have an active RFP pipeline. Our strong performance in the quarter sets a solid foundation for 2024 and positions us to achieve our total company adjusted EBITDA profitability goal.

我們對+Oscar 的勢頭感到滿意。我們不斷完善產品集並擁有活躍的 RFP 管道。我們本季的強勁表現為 2024 年奠定了堅實的基礎，並使我們能夠實現公司調整後 EBITDA 的整體獲利目標。

Looking ahead, we remain focused on long term strategic priorities that enable us to play a leading role in expanding the individual market. The ACA now has more than 21 million people enrolled and is and as the fastest growing health insurance segment driven by the gig economy, consumerization and government policies.

展望未來，我們仍然專注於長期策略重點，使我們能夠在擴大個人市場方面發揮主導作用。ACA 目前已有超過 2,100 萬人加入，並且是在零工經濟、消費化和政府政策推動下成長最快的健康保險領域。

The market has reached a size that makes it a permanent, attractive option, supporting our country's most diverse and vulnerable populations, filling a critical gap in the insurance market. The ACA's continued growth affirms that individual plans meet consumer needs of affordability, access and quality and are a viable alternative to the conventional employer-based models.

這個市場的規模已使其成為一種永久的、有吸引力的選擇，支持我國最多樣化和最脆弱的人群，填補了保險市場的關鍵空白。ACA 的持續成長證實了個人計畫滿足了消費者對負擔能力、機會和品質的需求，並且是傳統的基於雇主的模式的可行替代方案。

We see a long-term opportunity to grow the individual market by serving a broader set of consumers and markets. With this in mind, we are not renewing the Cigna + Oscar small-group offering in 2025 to better align with our strategic direction. We continue to believe in the value of small businesses and look forward to serving this market in new ways in the future.

我們看到了透過服務更廣泛的消費者和市場來發展個人市場的長期機會。考慮到這一點，我們不會在 2025 年更新 Cigna + Oscar 小團體產品，以更好地符合我們的策略方向。我們仍然相信小型企業的價值，並期待未來以新的方式服務這個市場。

In summary, we are off to a good start in 2024. Oscar is building a highly competitive franchise in the ACA market, and the business has a sizable runway ahead to further scale and grow. We continue to execute, drive the excellence required to run a mature company and generate solid business returns.

總而言之，我們在 2024 年有了一個好的開始。Oscar 正在 ACA 市場上打造極具競爭力的特許經營權，而該業務還有很大的發展前景，可以進一步擴大規模和發展。我們繼續執行、推動營運成熟公司所需的卓越性並產生豐厚的業務回報。

I am confident in Oscar's long term growth prospects. We look forward to sharing more details on our long-term strategic plan, including our echo strategy at Oscar's upcoming Investor Day on June 7 in New York.

我對奧斯卡的長期發展前景充滿信心。我們期待分享有關我們長期策略計畫的更多細節，包括我們在即將於 6 月 7 日在紐約舉行的奧斯卡投資者日上的迴聲策略。

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

這樣，我會將電話轉給史考特。史考特？

Thank you, Mark, and good morning, everyone. Our first quarter financial results demonstrate a solid start to the year. We continue to deliver on our commitments and reported approximately $178 million of net income in the first quarter or $0.62 per diluted share, an important milestone for Oscar.

謝謝你，馬克，大家早安。我們第一季的財務表現證明了今年的良好開局。我們繼續履行我們的承諾，第一季淨利潤約為 1.78 億美元，攤薄後每股收益為 0.62 美元，這是 Oscar 的一個重要里程碑。

We are well positioned to achieve our target for total company adjusted EBITDA profitability this year. Before I get into the details of our financial performance this quarter, as a reminder, we implemented a new financial reporting structure beginning with the first quarter in order to increase transparency and improve comparability.

我們有能力實現今年公司調整後 EBITDA 獲利能力的目標。在我詳細介紹本季的財務表現之前，請注意，我們從第一季開始實施了新的財務報告結構，以提高透明度並提高可比性。

Our discussion of financial results and guidance is focused on performance of the total company. In conjunction with today's earnings release, we filed an 8-K, which includes supplemental information on 2023 quarterly results under our new financial reporting framework.

我們對財務表現和指導的討論重點是整個公司的業績。結合今天的財報發布，我們提交了 8-K，其中包括新財務報告框架下 2023 年季度業績的補充資訊。

Turning to our financial performance, total revenue increased 46% year over year to $2.1 billion in the first quarter, driven by higher membership, rate increases and lower risk adjustment as a percentage of premiums. We ended the quarter with more than 1.4 million members, an increase of 42% year over year.

就我們的財務表現而言，第一季的總收入年增 46%，達到 21 億美元，這主要得益於會員數量增加、費率上漲以及風險調整佔保費的百分比降低。截至本季末，我們的會員數量超過 140 萬，年增 42%。

Membership growth was driven by strong retention, growth in existing markets and our service areas as well as robust SEP member additions. On medical costs, the first quarter medical loss ratio improved by 210 basis points year over year to 74.2%, driven by our disciplined pricing strategy and total cost of care initiatives. Overall, utilization trends were in line with our expectations at this point in the year.

會員數量的成長是由現有市場和服務領域的強勁保留、成長以及 SEP 會員的強勁成長所推動的。在醫療費用方面，在我們嚴格的定價策略和總護理成本措施的推動下，第一季醫療損失率年減 210 個基點至 74.2%。整體而言，今年此時的利用率趨勢符合我們的預期。

Switching to administrative costs, the first quarter SG&A expense ratio significantly improved by approximately 870 basis points year over year to 18.4%. The significant year-over-year improvement was driven by variable cost efficiencies and improved fixed cost leverage as well as lower risk adjustment as a percentage of premiums, which collectively resulted in 505 basis points over year-over-year improvement in the ratio.

轉向管理成本，第一季 SG&A 費用率較去年同期顯著改善約 870 個基點至 18.4%。年比顯著改善是由可變成本效率、固定成本槓桿改善以及風險調整佔保費的百分比降低所推動的，這些因素共同導致該比率同比改善 505 個基點。

The remaining 365 basis points of improvement was due to accelerated stock-based compensation expense recognized the result of the cancellation of the founders awards, which we recognized in the prior year period. We continue to make significant progress on improving profitability.

其餘 365 個基點的改善是由於我們在上一年期間確認了取消創始人獎勵的結果，加速了基於股票的補償費用的確認。我們在提高獲利能力方面持續取得重大進展。

Net income of approximately $178 million was significantly improved by $217 million year over year in the first quarter. Total company adjusted EBITDA of $219 million also significantly improved by $168 million year over year in the first quarter.

第一季淨利約1.78億美元，較去年同期大幅提高2.17億美元。第一季公司調整後 EBITDA 總額為 2.19 億美元，年比也大幅提高 1.68 億美元。

Shifting to the balance sheet, our capital position remains very strong. We ended the first quarter with approximately $3.7 billion of cash and investments, including $159 million of cash and investments at the parent. As of March 31, 2024, our insurance subsidiaries had approximately $990 million of capital in surplus, including $540 million of excess capital, which was driven by our strong operating performance.

轉向資產負債表，我們的資本狀況仍然非常強勁。第一季末，我們擁有約 37 億美元的現金和投資，其中包括母公司的 1.59 億美元現金和投資。截至2024年3月31日，我們的保險子公司擁有約9.9億美元的盈餘資本，其中超額資本為5.4億美元，這是由我們強勁的經營業績所推動的。

Turning now to our 2024 full year guidance. Based on the first quarter results, we are reaffirming all of our full year guidance metrics. We expect total revenues in the range of $8.3 billion to $8.4 billion. A medical loss ratio in the range of 80.2% to 81.2%, an SG&A expense ratio in the range of 20.5% to 21%.

現在轉向我們的 2024 年全年指導。根據第一季的業績，我們重申了所有全年指引指標。我們預計總收入在 83 億美元至 84 億美元之間。醫療損失率介於80.2%至81.2%之間，SG&A費用率介於20.5%至21%之間。

We continue to expect to achieve total company adjusted EBITDA profitability in the range of $125 million to $175 million. As a reminder, as the new policy year matures, our overall per member claims levels may change with corresponding impacts to our estimate for risk transfer.

我們仍預期公司調整後 EBITDA 總獲利能力將介於 1.25 億美元至 1.75 億美元之間。提醒一下，隨著新保單年度的成熟，我們的每位會員的整體索賠水準可能會發生變化，並對我們對風險轉移的估計產生相應的影響。

Such changes would impact the numerator and the denominator of the MLR, but we would not expect them to have an impact on our per-member underwriting economics. In addition, we continue to expect our quarterly MLR seasonality to be similar to 2023, although with a steeper slope.

此類變化將影響 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。此外，我們繼續預期季度 MLR 季節性將與 2023 年類似，但斜率更陡。

In closing, we've had a solid start to the year. We delivered net income profitability for the first time in Oscar's history, and we are well positioned to achieve total company adjusted EBITDA profitability this year.

最後，我們今年有了一個好的開始。我們在奧斯卡歷史上首次實現了淨利潤盈利，並且我們已做好充分準備，今年將實現公司調整後 EBITDA 盈利。

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. In closing, our first quarter performance lays a strong foundation for 2024. Oscar continues to deliver on our commitments, and I can see the momentum in our business. We are confident we will achieve our total company adjusted EBITDA goal this year.

謝謝你，斯科特。最後，我們第一季的業績為 2024 年奠定了堅實的基礎。奧斯卡繼續履行我們的承諾，我可以看到我們業務的勢頭。我們有信心今年將實現公司調整後 EBITDA 的總體目標。

Our team remains focused on our long-term growth objectives, which position us to capture emerging innovation opportunities in health care. Oscar is purpose-built to meet the rising expectations of consumers and bring the market more tech first solutions.

我們的團隊仍然專注於我們的長期成長目標，這使我們能夠抓住醫療保健領域新興的創新機會。Oscar 旨在滿足消費者不斷增長的期望，並為市場帶來更多技術優先的解決方案。

I want to thank all of our employees for their efforts in delivering another strong quarter. As I walk the halls, I feel our team's dedication and passion. Their commitment to serving our members and partners drives our continued results, which we laid out in our impact report last month.

我要感謝我們所有員工為實現又一個強勁季度所做的努力。當我走過大廳時，我感受到我們團隊的奉獻和熱情。他們對服務我們的會員和合作夥伴的承諾推動了我們持續取得成果，我們在上個月的影響報告中列出了這一點。

We continue to build a more sustainable and equitable future, both at Oscar and in the communities we serve. I look forward to speaking with many of you at our Investor Day next month. With that, I will turn the call over to the operator for the Q&A portion of our call.

我們繼續在奧斯卡和我們服務的社區中建立一個更永續和公平的未來。我期待在下個月的投資者日與你們中的許多人交談。這樣，我將把電話轉給接線員進行電話的問答部分。

(Operator Instructions) Stephen Baxter, Wells Fargo.

（操作員說明）Stephen Baxter，富國銀行。

Hi. Thanks for the question. So, wanted to get an update on the expectations around the performance of your membership growth in 2024. I guess how does the mix of those numbers compare to your expectations? And can you update us on where you sit in terms of metal mix and how that's changed year over year?

你好。謝謝你的提問。因此，我想了解有關 2024 年會員成長績效預期的最新資訊。我想這些數字的組合與您的預期相比如何？您能否向我們介紹一下您在金屬組合方面的最新情況以及每年的變化？

And then I guess the last question would just be -- it sounds like you're not necessarily expecting risk adjustment to be a big swing factor in terms of the guidance and where you sit for the full year. Obviously, the first quarter I think looks like a pretty solid starting point to kind of use your phrasing. What would you need to see in order to lead the upside that it feels like you saw in the first quarter flowed through to the guide? Thank you.

然後我想最後一個問題是——聽起來你不一定認為風險調整會成為指導和全年的重大搖擺因素。顯然，我認為第一季看起來是使用你的措辭的一個非常堅實的起點。您需要看到什麼才能引領您在第一季看到的上升趨勢流向指南？謝謝。

Thanks, Steve. We reported 1.4 million members and that spend stronger SEP growth than we expected this early in the year. We're not sure if that's a pull forward or what's going to happen later in the year or it will continue to grow over time. And as we look at that growth rate, if it is longer over time, Medicaid Redetermination is through November. We would expect that we're going to have less and less insight on risk adjusters later in the year, which will work against us in the quarters, but we'll recover in the first quarter of next year when we get that data all of submitted through CMS. Scott?

謝謝，史蒂夫。我們報告有 140 萬會員，且 SEP 的成長比我們年初的預期要強勁。我們不確定這是否是一種拉動，或者今年晚些時候會發生什麼，或者它會隨著時間的推移而繼續增長。當我們觀察成長率時，如果隨著時間的推移成長率更長，則醫療補助重新確定將持續到 11 月。我們預計，今年稍後我們對風險調整者的了解會越來越少，這將在本季度對我們不利，但當我們獲得所有數據時，我們將在明年第一季恢復過來。 。史考特？

Yes. So Steve, number one, I think that we're super excited about a strong first quarter, strong membership growth, medical expenses on plan, SG&A that was slightly favorable to what we were expecting. So a good start to the year with respect to the SCP membership growth, as we told you in our call, at the end of the year for Q4.

是的。所以史蒂夫，第一，我認為我們對第一季的強勁表現、強勁的會員成長、計劃中的醫療費用、SG&A 略高於我們的預期感到非常興奮。因此，正如我們在第四季度年底的電話會議中告訴您的那樣，SCP 成員成長是今年的良好開端。

We did anticipate in our plan that we would see strong SCP growth and that growth typically has an MLR that's about 10% higher than what we would see in OE. We have a history of retaining a high portion of those members. So in the next year, they tend to of MLRs that looked just like other OE members. So grabbing that SCP this year is a good thing for 2025.

我們在計劃中確實預期我們會看到 SCP 的強勁增長，而這種增長的 MLR 通常比我們在 OE 中看到的高出約 10%。我們有保留大部分成員的歷史。因此，在接下來的一年裡，他們傾向於使用看起來與其他 OE 成員一樣的 MLR。因此，今年抓住 SCP 對於 2025 年來說是一件好事。

In the current year, as Mark talked about, the big question for us at the moment is, we saw really robust SEP membership growth in Q1. And is that a trend that's going to persist or is that a pull forward of membership at this point in time, we just don't have enough visibility to know for certain.

正如馬克所說，今年我們面臨的一個大問題是，我們在第一季看到了真正強勁的 SEP 會員成長。這種趨勢是否會持續下去，或者是目前會員數量的增加，我們只是沒有足夠的知名度來確定。

And so that's impacting a little bit of our full year guidance and thinking about if we do see more SEP growth in the back half, that will come with some MLR impacts. And we just think we've got a great position to start the year with a strong first quarter.

因此，這對我們的全年指導產生了一些影響，並考慮到如果我們確實看到下半年 SEP 出現更多增長，這將帶來一些國土資源部的影響。我們只是認為，我們在今年伊始就處於有利位置，第一季表現強勁。

Adam Ron, Bank of America.

亞當‧羅恩，美國銀行。

Hey. Thanks for the question. I think in the past, you've mentioned that you don't want Oscar to be a single product line company, but this quarter you're exiting Medicare Advantage, and it sounds like exiting the Cigna and after small-group relationship. So would love to hear a little bit more color on what exactly is the rationale behind the exit?

嘿。謝謝你的提問。我想在過去，您曾提到您不希望 Oscar 成為一家單一產品線的公司，但本季度您將退出 Medicare Advantage，這聽起來像是退出 Cigna 並在小團體關係之後。那麼想聽聽更多關於退出背後的理由是什麼嗎？

First, Cigna + Oscar and then to the extent, we still believe that the company won't be a single product line business, like what are the major opportunities? Is it health IT and you see it grow as a separate line? So just more color on what you expect from those two businesses?

首先是Cigna+Oscar，然後到了某個程度，我們仍然認為該公司不會是單一產品線的企業，例如主要的機會是什麼？是健康IT嗎？那麼，您對這兩家公司的期望有更多的色彩嗎？

Because it seems like the services revenue only grew like 12% in the quarter. And so would just love to hear longer term what the expectation around that are or if there are things beyond Cigna and health IT that you see opportunity in? Thanks.

因為本季服務收入似乎只成長了 12% 左右。因此，我很想知道從長遠來看對此的期望是什麼，或者除了 Cigna 和健康 IT 之外，您是否還看到了機會？謝謝。

Thanks, Adam. We did pull out Medicare in large part because the provider relationships we had in place were unsustainable. And there wasn't anything we could do to fix them from the standpoint of getting to a profitable product. We do anticipate entering the market a different way, which we'll talk about in June when we have our Investor Day.

謝謝，亞當。我們確實取消了醫療保險，很大程度上是因為我們現有的醫療服務提供者關係不可持續。從獲得可獲利產品的角度來看，我們無能為力來解決這些問題。我們確實預計會以不同的方式進入市場，我們將在六月投資者日時討論這一點。

But the near term opportunity for us is [Ecra]. And with it grow, we believe we have access to over 70 million lives in the under 50 and middle market segments, and we'll talk a lot about the significant progress we've made on that onset of products and the pilots we'll be doing this year and launching in the '25. And I think on C + O, we tried, both companies tried very hard over the last five years to get the thing to a place where from an underwriting standpoint it was profitable.

但我們近期的機會是[埃克拉]。隨著它的發展，我們相信我們可以接觸到 50 歲以下和中等市場領域超過 7000 萬人的生活，我們將大量談論我們在該產品的推出和試點方面取得的重大進展今年開始，並在25 年推出。我認為在 C + O 上，我們嘗試過，兩家公司在過去五年中都非常努力地嘗試讓該項目從承保的角度來看能夠盈利。

I think owner economics get in the way when you have different pieces of the revenue stream go into different organizations. And we just couldn't rationalize that in a way that would make the product work longer term. But more importantly, we do believe [Ecra] is the solution for small group and middle market, and we believe that that will be much bigger opportunity we want to focus on getting that right.

我認為，當收入流的不同部分進入不同的組織時，所有者經濟學就會成為障礙。我們只是無法以一種使產品能夠長期發揮作用的方式合理化這一點。但更重要的是，我們確實相信 [Ecra] 是小團體和中型市場的解決方案，我們相信這將是更大的機會，我們希望專注於實現這一目標。

Plus, Oscar, we have more going on now about how we use that platform, externalized platform, we need work and investment on it in order to make sure it's ready for the market in a way that clients can use it appropriately as a full platform. So today, we're rolling out components. We'll have more to say about +Oscar, when we get to the Investor Day engines.

另外，奧斯卡，我們現在有更多關於如何使用該平台、外部化平台的事情，我們需要對其進行工作和投資，以確保它為市場做好準備，以便客戶可以將其作為完整的平台適當使用。所以今天，我們正在推出組件。當我們談到投資者日引擎時，我們將更多地談論+奧斯卡。

Thanks.

謝謝。

John Ransom, Raymond James.

約翰·蘭塞姆，雷蒙德·詹姆斯。

Hey, good morning. I'm just looking at your SG&A line and new look out few years, what do you think is the sustainable level of SG&A to revenue to kind of get you to your ultimate targeted margin?

嗨，早安。我只是看一下你們的 SG&A 線和幾年的新展望，你們認為 SG&A 與收入的可持續水平是多少，才能讓你們達到最終的目標利潤？

Yeah, John, thanks for the question. Look, we certainly were excited about the performance of SG&A year over year, significant improvement in that line item. The improvement there, obviously, we called out the one-timer related to the founder's award, but the rest of the improvement is sticky, and we'll continue going forward, seeing a lot of impacts of our technology, making our operations more efficient.

是的，約翰，謝謝你的提問。看，我們當然對 SG&A 的同比表現感到興奮，該項目的顯著改善。顯然，那裡的改進，我們提出了與創始人獎項相關的一次性改進，但其餘的改進是粘性的，我們將繼續前進，看到我們的技術的許多影響，使我們的運營更加高效。

We're seeing fixed cost leverage, and those are two things that I think will continue for us. We'll get into more of where we think our destination economics are for the business at the Investor Day. But I would say that we anticipate that there's still more improvement that we will expect in SG&A over the future and that the trends that we've seen thus far gives us confidence that we'll be able to continue to drive it and to give a better level to the future.

我們看到了固定成本槓桿，我認為這兩件事對我們來說將持續下去。我們將在投資者日更多地討論我們認為我們的目的地經濟對企業的影響。但我想說的是，我們預計未來 SG&A 還會有更多改進，而且我們迄今為止看到的趨勢使我們有信心繼續推動它並提供未來更好的水平。

Thank you.

謝謝。

Joshua Raskin, Nephron.

約書亞·拉斯金，尼弗龍。

Thanks. Good morning. Just first clarification on Cigna + Oscar. What's the revenue expectation this year embedded in the $8.3 billion to $8.4 billion?

謝謝。早安.首先對 Cigna + Oscar 進行澄清。今年 83 億至 84 億美元的營收預期是多少？

And then my real question is from the risk adjuster payable down meaningfully year over year despite the increase in premiums. I know that was all expected, but I'm curious if you've got any external data at this point that's sort of a first look or anything preliminary from weekly or anyone else?

然後我真正的問題是，儘管保費增加，但應付的風險調整員卻逐年大幅下降。我知道這都是預料之中的，但我很好奇您目前是否有任何外部數據，這些數據是初步的，還是來自每週或其他任何人的初步數據？

And then how much of that improvement do you think is just better execution and coding? And how much of that is your membership more sort of a more normal riskful?

那麼您認為這種改進有多少只是更好的執行和編碼？其中有多少是你的會員資格屬於更正常的風險？

Okay. I'm sure I'm going to miss one of those questions, Josh, but I'll comment on the risk transfer. So, you know, risk transfer at this point in the year is mainly an internal estimate. We don't have a lot of external data. The risk transfer, we're expecting that the percentage of risk transfer is going to increase throughout the year.

好的。喬希，我確信我會錯過其中一個問題，但我會就風險轉移發表評論。所以，你知道，今年這個時候的風險轉移主要是內部估計。我們沒有很多外部資料。風險轉移，我們預計全年風險轉移的百分比將會增加。

Part of that's just driven by seasonality of the book. But there's also as SCP members come in, they have typically they're younger and we end up having a higher risk transfer with that group. And so as we are expecting SCP growth throughout the year into the second half, that will drive risk transfer going up. So at this point, I would say that we have a very good process for collecting the codes that we need to support risk transfer.

部分原因是這本書的季節性所致。但隨著 SCP 成員的加入，他們通常會更年輕，我們最終會與該群體進行更高的風險轉移。因此，我們預計 SCP 全年到下半年都會成長，這將推動風險轉移上升。因此，在這一點上，我想說我們有一個非常好的流程來收集支援風險轉移所需的程式碼。

I think that that's an area that having a lot of history in ACA, we've got some very strong processes, including deployment of AI and other techniques that allow us to get things at a very efficient way. And we delivered a lot of value in that process. So feel good about the opportunity for us to convert making certain that we get full credit for the medical care that our members are receiving.

我認為這是 ACA 歷史悠久的一個領域，我們有一些非常強大的流程，包括部署人工智慧和其他技術，使我們能夠以非常有效的方式獲得東西。我們在這個過程中創造了很多價值。因此，對我們轉換的機會感到高興，確保我們的會員所接受的醫療護理得到充分的認可。

And then just to C + O revenues.

然後就是C+O收入。

Oh, sorry, that was the one I forgot. On C + O, I think that for the for 2024, that's probably in the range of $250 million to $260 million of revenue, has minimal impact to the bottom line, and going forward, when that book goes into runoff in 2025, it will be a much smaller revenue impact. But in both years, we would expect the bottom line to be insignificant.

噢，抱歉，那是我忘了的。關於 C + O，我認為到 2024 年，這可能會帶來 2.5 億至 2.6 億美元的收入，對利潤的影響微乎其微，展望未來，當這本書在 2025 年進入決選階段時，它將對收入的影響要小得多。但我們預計這兩年的利潤微不足道。

Perfect. Thanks.

完美的。謝謝。

Nathan Rich, Goldman Sachs.

內森·里奇，高盛。

Great. Good morning and thanks for the questions. Maybe just following up on the MLR, it seemed like the underlying cost trend performance was in line with your expectations. You kind of mentioned the steeper slope and just be curious kind of how that MLR compare to your plan in the first quarter and any change in how you're thinking about cadence over the balance of the year?

偉大的。早安，感謝您的提問。也許只是跟進國土資源部，潛在的成本趨勢表現似乎符合您的預期。您提到了更陡的坡度，只是想知道 MLR 與您第一季的計劃相比如何，以及您對今年餘下時間的節奏的看法有何變化？

And then longer term, maybe how you're seeing the long-term opportunity for MLR? I know some of your peers kind of operate in the high 70% range. Is that do you feel like you can get to a level with your member mix and geographic exposure that would be more consistent with kind of those peer levels over time?

從長遠來看，您如何看待 MLR 的長期機會？我知道您的一些同行的工作效率在 70% 左右。您是否認為隨著時間的推移，您的會員組合和地理曝光度可以達到與這些同行水準更加一致的水平？

Sure, Nathan. On MLR, I think that the MLR we saw in the first quarter was more or less consistent with our expectations where we saw utilization that was on plan. There's always puts and takes in utilization. But in summary, pretty much what we were anticipating. At this point in the year, you don't have that huge amount of visibility into the full year performance of your book. And so it's still early days in terms of what we would takeaway from the performance thus far in the year.

當然，內森。關於 MLR，我認為我們在第一季看到的 MLR 或多或少與我們的預期一致，我們看到了計劃中的利用率。利用率總是有投入和投入。但總而言之，這幾乎符合我們的預期。今年的這個時候，您對圖書的全年表現沒有太多的了解。因此，就我們從今年迄今為止的表現中得出的結論而言，現在還為時過早。

But I would say that it's comforting that we're seeing what we expected. And so we do think that first quarter MLR is a good starting point for the rest of the year. There is MLR seasonality than we've seen that historically in our business, and we would expect it to be there again this year. The addition of SCP members throughout the year, we've talked about the risk adjustment dynamics of those members that do have some adverse effects. And so that's another component of seasonality. And I think that we'll see that this year.

但我想說的是，令人欣慰的是我們看到了我們所期望的結果。因此，我們確實認為第一季的 MLR 是今年剩餘時間的一個好起點。MLR 的季節性比我們在業務中歷史上看到的要多，我們預計今年會再次出現這種情況。隨著全年 SCP 成員的增加，我們討論了這些成員的風險調整動態，這些成員確實產生了一些不利影響。這是季節性的另一個組成部分。我認為今年我們會看到這一點。

With respect to MLR in the future, I would say that there's two components of that. One is your pricing and we are always committed to making sure that we maintain disciplined pricing and that we have a price point that allows us to achieve the growth objectives that we want. So we balance those things out.

關於未來的 MLR，我想說有兩個組成部分。一是您的定價，我們始終致力於確保維持嚴格的定價，並確保我們的價格點能夠使我們實現我們想要的成長目標。所以我們平衡這些事情。

I think we've got opportunities in total cost of care for us to continue to improve medical expenses in a way that we always want to support our members. And so we think we see opportunities to continue to drive that down.

我認為我們在總護理費用方面有機會以我們始終希望支持我們的會員的方式繼續改善醫療費用。因此，我們認為我們看到了繼續降低這種情況的機會。

But ultimately, we'll balance out the objectives of having a pricing in the market that allow us to grow and driving total cost of care that can eat into trend of expenses over time. But really there's no reason that our business can't perform at MLR levels that are competitive with the rest of our industry peers.

但最終，我們將平衡市場定價的目標，使我們能夠成長並推動總護理成本，隨著時間的推移，這可能會影響費用趨勢。但事實上，我們的業務沒有理由不能達到與其他同業競爭的 MLR 水準。

Thank you.

謝謝。

John Ransom, Raymond James.

約翰·蘭塞姆，雷蒙德·詹姆斯。

Hey, good morning. I want you to know, I follow the rules and just ask one question. So, you guys give me a gold star. The only MLR questions, if we look at the year-over-year improvement, what would you say are the key kind of in order of magnitude, what was a key attribute there?

嗨，早安。我想讓你知道，我遵守規則，只問一個問題。所以，你們給我一顆金星。國土資源部唯一的問題是，如果我們看看逐年的改善，您認為關鍵的數量級是什麼？

I know you have a new PBM contract. You have adjusted your pricing. Your mix has changed, but if you looked at the kind of menu of all those things. What were the kind of top one, two or three drivers of your MLR improvement year over year? Thanks.

我知道您有新的 PBM 合約。您已調整定價。你的組合已經改變了，但如果你看看所有這些東西的菜單。您的 MLR 逐年改進的首要、第二或三個驅動因素是什麼？謝謝。

Yeah. I think that the first thing I would just call out is pricing and margin expansion and being thoughtful about pricing for the risks that we were going to take, really seeing that be a significant driver and it's the most important driver in the year-over-year performance.

是的。我認為我要指出的第一件事是定價和利潤率擴張，並考慮我們將要承擔的風險的定價，真正看到這是一個重要的驅動因素，而且是全年最重要的驅動因素 -年表現。

We had a small amount of prior period development this year. It was in the first quarter was about $17 million favorable, which was really run out on 2023 claims. So that was good. And the thing I would just say with MLR, the fact that what we're seeing at MLR are trends that I'm confident are going to persist is probably the most important takeaway I would have from the first quarter MLR performance.

今年我們進行了少量的前期開發。第一季的優惠金額約為 1700 萬美元，而 2023 年的索賠金額實際上已用完。所以那很好。我想對 MLR 說的是，我們在 MLR 看到的趨勢我相信將持續下去，這可能是我從第一季 MLR 表現中得到的最重要的收穫。

And then the PBM, how much should that help?

然後是 PBM，這會有多大幫助？

I'm sorry, say again?

對不起，再說一次？

The PBM, (multiple speakers)

PBM（多位發言者）

Oh, the PBM. And the PBM, like we're not going to call out specifically the impact of that. It is embedded in the performance. Obviously, it really ultimately gets into what did you price for, we built that PBM into the pricing, and we are seeing margin. And so, clearly PBM is a significant driver of our ability to price at a level and can that was competitive and continue to drive margin improvements.

哦，PBM。對於 PBM，我們不會具體指出其影響。它嵌入到表演中。顯然，它最終會影響您的定價，我們將 PBM 納入定價中，我們看到了利潤。因此，顯然 PBM 是我們定價能力的重要驅動力，並且能夠具有競爭力並繼續推動利潤率提高。

Thank you.

謝謝。

We have reached the end of the question-and-answer session. Thank you for attending today's conference call. Have a wonderful day, and you may now disconnect.

我們的問答環節已經結束。感謝您參加今天的電話會議。祝你有美好的一天，現在你可以斷開連接了。