Oscar Health Inc (OSCR) 2024 Q4 法說會逐字稿

Good evening. My name is Rob, and I will be your conference operator today. At this time, I would like to welcome everyone to Oscar Health's fourth-quarter and full-year 2024 earnings conference call. (Operator Instructions)

晚安.我叫羅布，今天我將擔任您的會議主持人。現在，我歡迎大家參加 Oscar Health 的 2024 年第四季和全年財報電話會議。（操作員指令）

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

現在，我將會議交給財務與投資人關係副總裁克里斯‧波托查爾 (Chris Potochar)。

Good evening, everyone. Thank you for joining us for our fourth-quarter and full-year 2024 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.hioscar.com.

大家晚上好。感謝您參加我們的 2024 年第四季和全年財報電話會議。Oscar 執行長 Mark Bertolini； 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.hioscar.com 存取此電話會議。

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. Any remarks that Oscar makes for the future constitute forward-looking statements within the meaning of Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995.

我們的業績詳情及其他管理評論均可在我們的收益報告中找到，您也可以在我們的投資者關係網站 ir.hioscar.com 上找到該報告。 Oscar 對未來的任何評論均構成 1995 年私人證券訴訟改革法案中安全港條款所定義的前瞻性陳述。

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 period ended September 30, 2024, filed with the Securities and Exchange Commission and other filings with the SEC, including our annual report on Form 10-K for the period ended December 31, 2024, to be filed with the SEC.

由於各種重要因素，實際結果可能與這些前瞻性陳述所示的結果有重大差異，包括我們向美國證券交易委員會提交的截至 2024 年 9 月 30 日的 10-Q 表季度報告和向美國證券交易委員會提交的其他文件中討論的因素，包括我們向美國證券交易委員會提交的截至 2024 年 12 月 31 日的年度報告 10-K 表。

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今天的當前預期。奧斯卡預計後續事件和發展可能會導致估計發生變化。儘管公司可能選擇在未來某個時間點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 2024 earnings press release available on the company's Investor Relations website at ir.hioscar.com.

電話會議也將提及某些非公認會計準則指標。這些指標與最直接可比較的 GAAP 指標的對帳可在公司投資者關係網站 ir.hioscar.com 上的第四季度和 2024 年全年收益新聞稿中找到。

We have not provided a quantitative reconciliation of estimate of full year 2025 adjusted EBITDA as described on this call to GAAP net income because Oscar is unable without making unreasonable efforts to calculate certain reconciling items with confidence.

我們沒有提供本次電話會議中所述的 2025 年全年調整後 EBITDA 估計與 GAAP 淨收入的定量對賬，因為 Oscar 無法在不付出不合理努力的情況下自信地計算某些對賬項目。

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

接下來，我想將電話轉給我們的執行長馬克貝爾托里尼 (Mark Bertolini)。

Good evening. Thank you, Chris, and thank you all for joining us. This afternoon, Oscar reported the strongest year of financial performance in our history. Our results were driven by record high membership, bottom line profitability and continued product innovation.

晚安.謝謝你，克里斯，也謝謝大家加入我們。今天下午，奧斯卡報告了我們歷史上最強勁的年度財務業績。我們的業績得益於創紀錄的高會員數量、底線盈利能力和持續的產品創新。

Oscar reached two significant milestones in 2024. First, we reported total company adjusted EBITDA profitability, growing to $199 million, a $245 million year-over-year improvement. Second, we achieved net income profitability. Net income was $25 million, a $296 million increase over the prior year.

奧斯卡在 2024 年達到了兩個重要的里程碑。首先，我們報告了公司調整後的 EBITDA 總獲利成長至 1.99 億美元，比去年同期成長 2.45 億美元。二是實現淨利扭虧為盈。淨收入為 2,500 萬美元，比上年增加 2.96 億美元。

Our improved bottom line was driven by strong performance in all parts of our business. We grew total revenue by 57% year-over-year to $9.2 billion. Our medical loss ratio was stable year-over-year, increasing 10 basis points to 81.7%. We also drove greater efficiency in our business as our SG&A ratio improved more than 500 basis points year-over-year to 19.1% through operating leverage and disciplined expense management.

我們獲利水準的提高得益於我們業務各個部分的強勁表現。我們的總收入年增57%，達到92億美元。我們的醫療損失率年比維持穩定，增加了10個基點，達到81.7%。透過營運槓桿和嚴格的費用管理，我們的銷售、一般及行政開支比率同比改善了 500 多個基點，達到 19.1%，從而提高了業務效率。

Our 2024 performance reflects the strategic plan and our ability to deliver long-term profitable growth. Overall, 2024 was an exceptional year for Oscar. Our results reflect our growing maturity as a company and we are committed to delivering at least 20% revenue CAGR and a 5% operating margin by 2027. Scott will review our fourth-quarter and full year results in a few moments. First, I will cover key business highlights.

我們的 2024 年業績反映了策略計畫以及我們實現長期獲利成長的能力。總的來說，2024 年對奧斯卡來說是非凡的一年。我們的業績反映了我們公司日益成熟，我們致力於在 2027 年實現至少 20% 的收入複合年增長率和 5% 的營業利潤率。斯科特稍後將回顧我們的第四季和全年業績。首先，我將介紹主要的業務亮點。

Oscar is one of the largest ACA carriers following the 2025 open enrollment period. The individual market grew 13% year-over-year to a record 24 million lives. Our growth outpaced the market by close to 3 times at 37%. We are now privileged to serve 1.8 million members as of February 1, 2025. Our competitively priced products, technology, and superior member experience drove strong growth in retention across Oscar's 18-state footprint.

Oscar 是 2025 年開放註冊期後最大的 ACA 營運商之一。個人市場年增13%，達到創紀錄的2,400萬人。我們的成長率達到 37%，是市場的近三倍。截至 2025 年 2 月 1 日，我們很榮幸能夠為 180 萬會員提供服務。我們具有競爭力的產品價格、技術和卓越的會員體驗推動了 Oscar 覆蓋 18 個州的會員保留率強勁成長。

Our disciplined pricing strategy gives us another year of above-market growth, which we expect will drive significant year-over-year increase in operating margin with continued administrative cost efficiencies and improved MLR performance.

我們嚴謹的定價策略使我們又一年實現了高於市場的成長，我們預計這將推動營業利潤率同比大幅增長，同時持續提高管理成本效率並改善 MLR 性能。

Our above-market growth demonstrates Oscar's growing prominence across our service areas. We drove market share gains with strong positions in key Oscar states, including Florida, Tennessee, and Texas. We also performed well in new geographies, including North Carolina. The strength of our IFP brand, network and expansive products portfolio also led to new ICRA growth across our footprint. We grew our ICRA membership with gains in Atlanta, Columbus, Kansas City, Miami, and New Jersey markets.

我們高於市場的成長表明 Oscar 在我們的服務領域中日益突出的地位。我們憑藉在佛羅裡達州、田納西州和德克薩斯州等奧斯卡重點州的強勢地位推動了市場份額的成長。我們在北卡羅來納州等新的地區也表現良好。我們 IFP 品牌、網路和廣泛的產品組合的實力也推動了 ICRA 在我們的業務範圍內實現新的成長。我們的 ICRA 會員數量不斷增加，涵蓋亞特蘭大、哥倫布、堪薩斯城、邁阿密和新澤西等市場。

Oscar's high-value products continue to resonate in the market. We are attracting new members and creating a loyal membership base with plans built for individual needs.

奧斯卡的高價值產品持續在市場上引起共鳴。我們正在透過針對個人需求制定的計劃來吸引新會員並建立忠實的會員基礎。

We had strong enrollment in our new tech-first HMO and multi-condition plan. Our condition-focused plans addressing diabetes asthma and COPD had high retention. Our Spanish-first solutions attracted more Hispanic and Latino members, engaging them with culturally relevant providers, health resources and care teams. Our leading NPS is proof that Oscar is meeting rising consumer expectations.

我們的新技術優先 HMO 和多條件計畫擁有大量註冊用戶。我們針對糖尿病、氣喘和慢性阻塞性肺病等病症的計畫具有很高的保留率。我們的以西班牙語為優先的解決方案吸引了更多的西班牙裔和拉丁裔會員，並讓他們接觸到文化相關的供應商、醫療資源和護理團隊。我們領先的 NPS 證明 Oscar 滿足了消費者日益增長的期望。

Consumers have more control over their health care with Oscar. Our plans are meeting consumer demand for choice, transparency and affordability, a value proposition that drove new employee initiations in open enrollment. We introduced new services with ICRA platforms, including convenience shop, buy and enroll solutions and personal care guides to welcome employees to Oscar.

有了 Oscar，消費者可以更好地控制自己的醫療保健。我們的計劃滿足了消費者對選擇、透明度和可負擔性的需求，這一價值主張推動了新員工在公開招募中的入職。我們透過 ICRA 平台推出了新服務，包括便利商店、購買和註冊解決方案以及個人護理指南，以歡迎員工加入 Oscar。

We will build on this momentum in 2025 and introduce more solutions for employers and employees. Oscar is positioned to take share from traditional group plans and engaged employers that do not offer insurance today.

2025年，我們將在此基礎上再接再厲，為雇主和員工推出更多解決方案。Oscar 的目標是從傳統團體計劃和目前不提供保險的雇主手中奪取市場份額。

Oscar's powerful technology platform continues to unlock long-term value across all areas of the business. AI remains central to our strategy, and we are realizing its potential faster than others in the market. We are personalizing clinical care. Our team is integrating large language models into more of our capabilities, including tools that keep follow-up care on track after ER visits. Initial results show the tool lowered readmission rates by close to 10% for a major health system client.

Oscar 強大的技術平台將繼續為各個業務領域釋放長期價值。人工智慧仍然是我們策略的核心，我們正在比市場上的其他人更快實現它的潛力。我們正在個性化臨床護理。我們的團隊正在將大型語言模型整合到我們的更多功能中，包括在急診室就診後保持後續護理順利的工具。初步結果顯示，該工具使大型醫療系統客戶的再入院率降低了近 10%。

We continue to reduce provider administrative tasks. More than 50% of onboarding and post-care instructions today are AI-powered in Oscar Urgent Care. Our actions are reducing provider paperwork, improving speed to care.

我們持續減少提供者的管理任務。目前，Oscar Urgent Care 中超過 50% 的入職和後期護理指導都是由人工智慧提供的。我們的行動是減少提供者的文書工作，提高照護速度。

We are also deploying applications at greater speeds, significantly reducing implementation time. All of this is possible because of our industry-leading platform, which continues to fuel major strides in operational efficiency, member engagement, and affordability.

我們還以更快的速度部署應用程序，從而大大縮短了實施時間。所有這一切都歸功於我們領先業界的平台，該平台不斷推動營運效率、會員參與度和可負擔性的重大進步。

In summary, 2024 was another remarkable year for the company. We generated record revenue, drove all-time high membership and achieved both adjusted EBITDA and net income profitability for the first time in Oscar's history. These milestones are a solid foundation for strong profitable growth in 2025. We have a proven playbook to mature our existing markets and enter new ones with the technology to efficiently scale the profitable business.

總而言之，2024 年對公司來說又是非凡的一年。我們創造了創紀錄的收入，會員人數創歷史新高，並在奧斯卡歷史上首次實現了調整後 EBITDA 和淨收入的利潤。這些里程碑為2025年強勁的獲利成長奠定了堅實的基礎。我們擁有一套行之有效的策略來完善現有市場並利用技術進入新市場，從而有效地擴大獲利業務。

As I have said before, Oscar is committed to having the strongest leadership team in the individual market. Today, we are welcoming health care veteran, Janet Liang, to our team to help drive our next phase of growth. Janet joins as President of Oscar Insurance and will be responsible for all insurance functions. She comes to Oscar from Kaiser Permanente, where she served as Group President and Chief Operating Officer of Care Delivery. Janet has strong operational expertise and a track record of growing markets.

正如我之前所說，Oscar 致力於在個人市場上擁有最強大的領導團隊。今天，我們歡迎醫療保健資深人士 Janet Liang 加入我們的團隊，以協助推動我們下一階段的發展。珍妮特 (Janet) 加入 Oscar Insurance 擔任總裁，並將負責所有保險職能。在加入 Oscar 之前，她曾擔任 Kaiser Permanente 集團總裁兼護理服務首席營運長。Janet 擁有豐富的營運專業知識和良好的市場發展記錄。

Oscar is stronger than ever. Our growth in the individual markets growth demonstrated its durability and the power of reorienting health care around the consumer. The market is giving consumers the ability to choose plans that fit their needs, which is driving competition, lower costs, and the lowest uninsured rate in our country's history.

奧斯卡比以往任何時候都更強大。我們在單一市場的成長證明了它的持久性和圍繞消費者重新定位醫療保健的力量。市場讓消費者選擇適合自己需求的計劃，從而推動競爭、降低成本，並實現我國史上最低的無保險率。

Direct-to-consumer markets simply work better. The individual market will continue to unlock new growth and replace traditional insurance models and Oscar is leading the way.

直接面向消費者的市場運作得更好。個人市場將繼續釋放新的成長點並取代傳統保險模式，而 Oscar 正引領這一潮流。

I am incredibly proud of the Oscar team and their leadership in achieving our best year yet. We look forward to delivering strong results for our members and partners in 2025.

我為奧斯卡團隊及其領導力感到無比自豪，讓我們取得了迄今為止最好的一年。我們期待在 2025 年為我們的會員和合作夥伴取得優異的成績。

I will now turn the call over to Scott. Scott?

現在我將電話轉給史考特。史考特？

Thank you, Mark, and good evening, everyone. 2024 was a strong year for Oscar. We delivered the best financial performance in the company's history including above-market growth and adjusted EBITDA and net income profitability. We are well positioned to achieve our long-term targets of at least 20% top line compound annual revenue growth and a 5% operating margin by 2027.

謝謝你，馬克，大家晚上好。 2024 年對奧斯卡來說是豐收的一年。我們實現了公司歷史上最好的財務業績，包括高於市場的成長、調整後的 EBITDA 和淨收入利潤。我們有能力實現我們的長期目標，即在 2027 年實現至少 20% 的營業收入複合年增長率和 5% 的營業利潤率。

I'll touch on a few fourth quarter highlights before shifting to our full year performance. Total revenue increased 67% year-over-year to approximately $2.4 billion in the fourth quarter. The fourth quarter medical loss ratio increased by 170 basis points year-over-year. And the fourth quarter adjusted EBITDA loss was approximately $113 million, essentially flat year-over-year.

在談論我們的全年業績之前，我將先談談第四季度的一些亮點。第四季總營收年增67%至約24億美元。第四季醫療損失率年增了170個基點。第四季調整後EBITDA虧損約1.13億美元，與去年同期基本持平。

Turning to the full year. Total revenue increased 57% year-over-year to $9.2 billion, driven primarily by membership growth during the 2024 open enrollment, strong retention and special enrollment period member additions. The full year medical loss ratio was 81.7%, a slight 10 basis point year increase.

展望全年。總收入年增 57% 至 92 億美元，主要得益於 2024 年開放註冊期間的會員成長、強勁的保留率以及特殊註冊期間的會員增加。全年醫療損失率為81.7%，較去年同期略有增加10個基點。

Overall utilization for the year was modestly favorable compared to our pricing expectations, and we had continued favorable prior period development. Strong SEP membership growth during the year was a headwind for the full year MLR and we increased our risk transfer payable in the fourth quarter based on the most recent interim risk adjustment report. Our risk transfer as a percentage of premiums for 2024 was largely consistent year-over-year at approximately 14.5%.

與我們的定價預期相比，今年的整體利用率略有改善，並且我們延續了前期的良好發展。今年 SEP 會員數量強勁增長，這對全年 MLR 來說是一個阻力，根據最新的中期風險調整報告，我們增加了第四季度的風險轉移應付款項。我們 2024 年的風險轉移佔保費的百分比與去年同期基本持平，約 14.5%。

Switching to administrative costs. The 2024 SG&A expense ratio significantly improved by 520 basis points year-over-year to 19.1%, driven by higher fixed cost leverage and variable cost efficiencies. In 2024, we delivered on our commitment for adjusted EBITDA profitability.

轉向管理費用。由於固定成本槓桿率和變動成本效率提高，2024 年銷售、一般及行政費用率較去年同期大幅改善 520 個基點至 19.1%。2024年，我們兌現了調整後EBITDA獲利的承諾。

For the full year, adjusted EBITDA was $199 million, representing a substantial $245 million year-over-year improvement. We also reported net income profitability of $25 million.

全年調整後的 EBITDA 為 1.99 億美元，較上年同期大幅增加 2.45 億美元。我們也報告了2500萬美元的淨利潤。

Shifting to the balance sheet. Our capital position remains very strong. We ended the year with $4 billion of cash and investments, including $190 million of cash and investments at the parent. As of December 31, 2024, our insurance subsidiaries had approximately $1.2 billion of capital and surplus, including $774 million of excess capital driven by strong operating performance.

轉向資產負債表。我們的資本狀況依然強勁。截至年底，我們的現金和投資總額為 40 億美元，其中包括母公司的 1.9 億美元現金和投資。截至 2024 年 12 月 31 日，我們的保險子公司擁有約 12 億美元的資本和盈餘，其中包括由強勁的營運表現推動的 7.74 億美元的超額資本。

Given the excess capital in our insurance subsidiaries, we expect funding of our 2025 growth capital requirements to have minimal impact on parent cash. With respect to quota share reinsurance, we expect our ceding percentage to be largely consistent year-over-year at approximately 50% in 2025.

鑑於我們保險子公司的過剩資本，我們預計 2025 年成長資本需求的融資對母公司現金的影響將微乎其微。對於份額再保險，我們預計到 2025 年我們的分保比例將與去年同期基本保持一致，約為 50%。

Before I turn to the 2025 outlook, I want to highlight that starting with our first quarter 2025 results, we'll be shifting the focus of our conversations to earnings from operations rather than adjusted EBITDA, while we will continue to provide both metrics. We believe earnings from operations is the best metric to show our progress towards our goal of a 5% operating margin by 2027.

在談到 2025 年展望之前，我想強調一下，從 2025 年第一季度的業績開始，我們將把討論的重點轉移到營業利潤而不是調整後的 EBITDA，同時我們將繼續提供這兩個指標。我們相信，營業利益是顯示我們實現 2027 年 5% 營業利益率目標進度的最佳指標。

Turning now to 2025 full year guidance. We expect to execute on our strategic plan and deliver above-market growth and meaningful margin expansion this year. We expect total revenues to be in the range of $11.2 billion to $11.3 billion driven by solid retention and another year of above-market growth during open enrollment.

現在談談 2025 年全年指引。我們預計今年將執行我們的策略計劃並實現高於市場的成長和有意義的利潤率擴大。我們預計總收入將在 112 億美元至 113 億美元之間，這得益於穩定的保留率和開放註冊期間又一年高於市場的成長。

We remain committed to our disciplined pricing strategy, balancing growth and profitability. We expect our medical loss ratio to be in the range of 80.7% to 81.7%, representing a 50 basis point year-over-year improvement at the midpoint. Our outlook reflects lower year-over-year SEP member additions as Medicaid redeterminations are largely complete.

我們將繼續致力於嚴謹的定價策略，平衡成長和獲利。我們預期醫療損失率在 80.7% 至 81.7% 之間，中間值較上年同期改善 50 個基點。我們的展望反映出，由於醫療補助計劃的重新確定基本完成，SEP 成員新增數量比去年同期下降。

On MLR seasonality, we expect the first quarter to be the lowest and the fourth quarter to be the highest as members meet their deductibles. For 2025, we expect risk adjustment as a percentage of premiums to be largely consistent year-over-year based on our updated membership mix.

就 MLR 季節性而言，我們預計第一季的 MLR 水平最低，而第四季度的 MLR 水平最高，因為會員必須滿足免賠額。到 2025 年，根據我們更新的會員結構，我們預計風險調整佔保費的百分比將與去年同期基本保持一致。

We expect our SG&A expense ratio to be in the range of 17.6% to 18.1%, representing an approximate 125 basis points year-over-year improvement at the midpoint. As a reminder, this ratio includes stock-based compensation expense, which in 2024 was approximately $110 million. With respect to seasonality, we expect our SG&A expense ratio to modestly increase each quarter as the year progresses.

我們預計銷售、一般及行政費用率將在 17.6% 至 18.1% 之間，中間值較上年同期提高約 125 個基點。提醒一下，該比率包括股票薪酬費用，2024 年約為 1.1 億美元。就季節性而言，我們預計隨著時間的推移，我們的銷售、一般及行政費用率每季都會小幅增加。

We expect earnings from operations to be in the range of $225 million to $275 million, representing a significant $193 million improvement year-over-year at the midpoint. We would expect adjusted EBITDA to be roughly $140 million higher than earnings from operations. Additionally, we expect positive net income in 2025.

我們預計營業利潤將在 2.25 億美元至 2.75 億美元之間，與去年同期相比將大幅增加 1.93 億美元。我們預計調整後的 EBITDA 將比營業利潤高出約 1.4 億美元。此外，我們預計 2025 年淨收入為正。

In closing, 2024 was a successful year for Oscar. We delivered strong growth, adjusted EBITDA, and net income profitability and we've turned the page to the next chapter in the company's trajectory. One of continuing to meet consumers' needs with differentiated and innovative product offerings and meaningfully improve financial performance.

總而言之，2024 年對奧斯卡來說是成功的一年。我們實現了強勁的成長、調整後的 EBITDA 和淨收入獲利，公司的發展軌跡翻開了新的一頁。一是持續透過差異化和創新的產品滿足消費者的需求，並大幅提高財務表現。

And with that, I will turn the call over to the operator for the Q&A portion of our call.

說完這些，我將把電話轉給接線生，進行電話的問答部分。

(Operator Instructions)

（操作員指令）

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Hi, thanks. There's a lot of focus in the market currently about payment integrity and the individual health exchanges and potential changes from certain reverification programs being back in place for this year that may have been relaxed in prior periods.

嗨，謝謝。目前市場非常關注支付完整性和個人健康保險交換，以及今年恢復某些重新驗證計劃可能帶來的變化，而這些重新驗證計劃在之前時期可能已經放寬。

So I guess, could you give us a, more of a detailed discussion around what you're seeing when it comes to things like effectuation rates and then what you're assuming in terms of enrollment declines throughout the year is potentially maybe there could be an above average lapse in payment rates? Any kind of detailed discussion around the assumptions you're making on this issue would be greatly helpful. Thank you.

所以我想，您能否就您所看到的情況，例如實施率等方面，以及您認為全年入學人數下降的情況，是否可能出現支付率高於平均水平的下降，給我們更詳細的討論一下？圍繞您對此問題所做的假設進行的任何詳細討論都將非常有幫助。謝謝。

Sure. This is Mark. I'll start with defining effectuated membership, which is new enrollment, which obviously is pass muster with the government and getting people into the plan and then renewals. That's the gross number. If we were to report that number as it sits today for us, it will be 1.98 million members.

當然。這是馬克。我首先要定義有效會員資格，即新登記的會員，這顯然要通過政府的審核，讓人們加入計劃，然後再進行續約。這是總數。如果我們按照今天的數字來報告，那麼會員人數將是 198 萬人。

We have decided to start tracking actual numbers -- members we can put premiums on and numbers on. And so today, the number we shared with you, 1.8 million, is our knowledge of 1.8 million people who have paid their premiums. And therefore, they are in the plan and the number against which we put together guidance for revenue. So we believe there's about a 9.1% impact of effectuation against actually what will show up paid by the end of the first quarter. Scott?

我們已經決定開始追蹤實際數字——我們可以為會員設定保費和數字。所以今天我們要跟大家分享的數字 180 萬，是我們所知的 180 萬已繳保費的人的數字。因此，它們都包含在計劃中，我們根據這些數字制定收入指導。因此，我們認為，與第一季末實際支付的金額相比，生效的影響約為 9.1%。史考特？

Steve, I think that what we tried to do in providing the information of -- we would think that affectation rates year-over-year should be about the same, which is exactly what we've seen. But we also know what -- how many of the new members have paid already, and so 1.8 million members have started making payments for us. And we think that is the most relevant number to look at and that's why we provided that.

史蒂夫，我認為我們在提供資訊時嘗試做的是——我們認為同比受影響率應該大致相同，這正是我們所看到的。但我們也知道有多少新會員已經付款，因此 180 萬會員已經開始為我們付款。我們認為這是最相關的數字，這就是我們提供它的原因。

With respect to what's going on overall with payment integrity issues, I'd just make a few comments. Number one, the issues of verifying social security numbers, verifying that you've got all the right data as Mark talked about, that's already happened in open enrollment. The broker of record restrictions, those things have already happened through open enrollment. So we believe most of those types of issues are behind us.

關於支付完整性問題的整體情況，我只想發表一些評論。第一，正如馬克所提到的，核實社會安全號碼、核實你是否獲得所有正確數據的問題，在公開招生中已經發生了。經紀人記錄限制，這些事情已經透過公開招生發生了。因此我們相信大多數此類問題都已經過去了。

And with respect to the questions around file to reconcile, that topic I think is actually quite complicated. And so just to simplify things, the way that filed to reconcile is working, CMS and IRS worked on what portion of members in the ACA have not filed for '22 and '23.

關於文件核對的問題，我認為這個主題實際上相當複雜。為了簡化事情，CMS 和 IRS 按照備案方式進行核對，核對了 ACA 中哪些成員沒有提交 '22 和 '23 備案。

They send a notice to those members in November that highlighted, hey, you need to complete your file to reconcile process. And it instructed people to go on to the CMS website and click a box that said I have completed my file, the reconcile process. If they didn't do that, they would have lost their subsidy in open enrollment. And so as of January 1, they would be getting a full premium unsubsidized and they would not be included in our February 1 paid count should they have not paid the full premium amount.

他們在 11 月向這些成員發送了一份通知，強調說，嘿，你們需要完成你們的文件以進行核對流程。它引導人們進入 CMS 網站並點擊一個框，顯示「我已完成我的文件，即協調過程」。如果他們不這樣做，他們就會失去公開招生的補助。因此，從 1 月 1 日起，他們將獲得全額保費（無補貼），如果他們沒有支付全額保費，他們將不會被計入我們 2 月 1 日的已付費計數中。

Now we understand that CMS and the IRS will go back and verify in April that for those who clicked the box that said I did file to reconcile that, that in fact happened. Again, this is members -- these are people that were in the ACA in '22 and '23. That's the basis of what they're making the adjustment for, we've incorporated our estimate of what that file to reconcile process may do. And so we have built that into our full year revenue guidance that we gave the Street.

現在我們了解到，CMS 和 IRS 將在四月份回去核實，對於那些點擊了「我確實提交了文件來核對」方塊的人來說，這確實發生了。再說一遍，這些都是成員 - 這些人是 1922 年和 1923 年 ACA 的成員。這就是他們進行調整的基礎，我們已經將我們對該文件與協調過程可能產生的影響的估計納入其中。因此，我們將其納入了我們向華爾街提供的全年收入預期中。

So again, 1.8 million members is the number of members that are paying Oscar as of February 1. We've built in all of the risks that we see from this file the reconcile process as well as the other CMS payment integrity thing. We have put that into our guidance.

再次重申，截至 2 月 1 日，支付 Oscar 費用的會員人數為 180 萬人。我們已經將從此文件中看到的所有風險納入了協調流程以及其他 CMS 支付完整性事項中。我們已將其納入我們的指導之中。

And we think that growing roughly 23% down on revenue year-over-year is a remarkable delivery against our plans, and we are super excited about what '25 is going to bring for us in terms of our ability to grow margin and deliver terrific results for our shareholders.

我們認為，營收年增約 23% 已經是我們計畫中了不起的成績，而且我們對 25 年將為我們帶來的利潤成長能力和為股東帶來出色業績的能力感到非常興奮。

And just for a comparison year-over-year, last year, our difference between effectuated and paying customers was 4.1%. Because we looked at the file and we had some rate changes in markets where we had zero premium members that actually started to have to pay, we assume those people would not ultimately renew and so we took that up to 9.1%.

與去年同期相比，去年，實際客戶和付費客戶之間的差異為 4.1%。因為我們查看了文件，發現在那些沒有高級會員實際開始付費的市場上，我們的費率發生了一些變化，我們假設這些人最終不會續約，因此我們將費率上調至 9.1%。

Yeah, and that's an actual -- those are the actual numbers between effectuation and payment rates. Those are the differences that Mark indicated.

是的，這是實際的——這些是生效率和支付率之間的實際數字。這些就是馬克指出的差異。

Okay, thanks. I'll jump back in the queue.

好的，謝謝。我將重新回到隊列中。

Josh Raskin, Nephron Research.

喬希‧拉斯金 (Josh Raskin)，腎元研究公司。

Hi, thanks. That was a super helpful answer to the last one. I'll start with the -- I guess two questions here. Just the MLR came in above the high end of guidance despite the lower revenues. So I heard the higher risk transfer payable. Maybe you could quantify that. But were there any other one-timers or any drivers of the MLR increase?

嗨，謝謝。這是對最後一個問題的超級有用的回答。我首先要問的是──我想這裡有兩個問題。儘管收入較低，但 MLR 仍高於指導上限。所以我聽說需要支付更高的風險轉移費。也許你可以量化這一點。但是，還有其他一次性事件或任何導致 MLR 成長的驅動因素嗎？

And then just this move to income -- adjusted -- earnings from operations, is there any material change to interest expense coming in the next year or two? I'm just curious if that seems to be the biggest difference between EBITDA and the new metric.

然後只是轉向收入 - 調整後的 - 營業利潤，未來一兩年內利息支出會發生重大變化嗎？我只是好奇這是否是 EBITDA 和新指標之間最大的差異。

Just I'll start with one point that I think is really important to understand. Our utilization came in as expected, actually slightly better. So what you're seeing in the change of the MLR is not worsening utilization. It's the relative risk of our book versus others and the impact of risk adjustment settlements at the end of the year. Scott?

我首先要講的是我認為非常重要的一點。我們的利用率符合預期，實際上略有改善。因此，您在 MLR 變化中看到的並不是利用率的惡化。這是我們的帳簿相對於其他帳簿的相對風險，以及年底風險調整結算的影響。史考特？

Yeah. So I think that on the MLR, I'll start there. So for MLR, as Mark just talked about, what we have seen is utilization actually came in slightly favorable to what we would have anticipated. And we saw risk or development proceeding as we would have anticipated based on the claims that we've had.

是的。因此我認為，我將從 MLR 開始。因此對於 MLR，正如馬克剛才談到的，我們看到利用率實際上略高於我們的預期。並且我們看到風險或發展進程正如我們根據收到的索賠所預料的那樣。

And when we got the fourth quarter risk report from our friends at Wakely, we observed that in several markets, there had been an increase in the risk scores of the market versus what we were expecting. So we took that information and updated our accruals for that.

當我們從 Wakely 的朋友那裡獲得第四季度風險報告時，我們發現在幾個市場中，市場的風險評分比我們的預期增加。因此，我們獲取了這些資訊並更新了我們的應計項目。

So that is really what drove the pressure in MLR. It also -- as a result, when you increase your risk transfer, it also drove a shortfall in revenue. So it was the same thing driving both those effects.

這正是 MLR 面臨壓力的真正原因。因此，當你增加風險轉移時，也會導致收入不足。因此，造成這兩種效果的原因是同一因素。

I would also point out that we had favorable prior period development in the fourth quarter, which offsets some of the pressure from the risk adjustment true-up and those same drivers had an effect on the full year MLR but to a lesser degree.

我還要指出的是，我們在第四季度取得了良好的前期發展，這抵消了風險調整帶來的部分壓力，這些相同的驅動因素對全年 MLR 產生了影響，但程度較小。

Got you. And then just the interest expense.

明白了。然後只是利息支出。

And then on interest, I think that interest is -- the biggest delta between adjusted EBITDA and earnings from operations is going to be stock compensation and depreciation amortization.

然後關於利息，我認為利息是——調整後的 EBITDA 和營業利潤之間最大的差距將是股票補償和折舊攤提。

And we would anticipate that, as I said in my talking points, it's about $140 million difference between earnings from operations and adjusted EBITDA in terms of our 2025 guidance. So those are the biggest drivers. But by the way, on interest expense, I would expect that to be consistent year-over-year because we don't have any indebtedness.

正如我在談話要點中所說，我們預計，根據我們 2025 年的指引，營業利潤和調整後 EBITDA 之間的差額約為 1.4 億美元。所以這些就是最大的驅動力。但順便說一句，就利息支出而言，我預計將與去年同期保持一致，因為我們沒有任何債務。

Okay. All right, thanks.

好的。好的，謝謝。

Michael Ha, Baird.

麥可·哈，貝爾德。

Yeah. So I think in 2025 guidance, there might be some confusion amongst investors about the new EBIT guide versus what that implied on EBITDA. And Scott, I think you just answered it, but just wanted to very clearly clarify -- to clear up any confusion.

是的。因此，我認為在 2025 年的指引中，投資者可能會對新的 EBIT 指南及其對 EBITDA 的暗示感到困惑。斯科特，我想你剛剛回答了這個問題，但我只是想非常清楚地澄清一下——以消除任何混淆。

If we take your $225 million to $275 million starting EBIT guide back out G&A, back out stock-based comp, the implied EBITDA guide would be around $400 million, right? So that's basically roughly in line with Street.

如果我們將您的 2.25 億至 2.75 億美元的起始 EBIT 指南從 G&A 中扣除，從股票薪酬中扣除，隱含的 EBITDA 指南將在 4 億美元左右，對嗎？這基本上與 Street 的觀點大致一致。

Yeah. So the top end of our guidance for earnings from operations is $275 million, add $140 million to that should get you to around $415 million, which would be the top end of adjusted EBITDA.

是的。因此，我們預計營業利潤的最高值為 2.75 億美元，再加上 1.4 億美元，應該會達到 4.15 億美元左右，這將是調整後 EBITDA 的最高值。

Got it. And then just to clarify, so 1.8 million people have paid their premium. So from now through April, when the final FPR recheck happens, is it fair to say the low scenario is now already built in. And from now through April, you can only potential upside membership via FTR recheck exactly so --

知道了。然後需要澄清的是，已有 180 萬人支付了保費。因此，從現在到四月，當進行最後一次 FPR 重新檢查時，是否可以說低情境已經內建了。從現在到四月份，你只能透過 FTR 重新檢查來獲得潛在的會員資格，因此--

That's exactly right, Michael. That's what we're trying to do -- like this is -- you've seen us do this both in our Investor Days to try to make this simple for you guys. So we took out the risk of effectuation being higher than ultimately the membership that we would realize. So we're starting with paid members.

完全正確，邁克爾。這就是我們正在嘗試做的 - 就像這樣 - 你們已經看到我們在投資者日上做了這些事情，試圖讓這一切對你們來說變得簡單。因此，我們消除了實際效果高於最終實現的會員數量的風險。因此我們從付費會員開始。

There's a potential that we could see some of the people that haven't paid as of this state, actually make a payment and become finally effectuated out into the first quarter. But at this point, we've built the risk in, and so there's more upside to our plan than downside.

我們可能會看到，一些目前尚未付款的人實際上已經付款，並最終在第一季付清。但目前，我們已經將風險考慮在內，因此我們的計劃的好處大於壞處。

And again, that's largely in the renewal book and largely around people we thought that we're going to go away from zero dollar plans to having to pay out of pocket.

再說一次，這主要是在續約書中，主要是圍繞著那些我們認為將要從零美元計劃轉向必須自掏腰包支付的人。

Got it. And if I could squeeze in one more. The Oscar '25 earnings bridge, what makes it so attractive in our opinion, right, all the additional SEP lives in '24 retaining those members, capturing a full year risk adjustment revenue to be 10% MLR improvement. And if my math is right, just a very large part of the bridge in the 25%.

知道了。如果我可以再擠一點的話。在我們看來，Oscar '25 收益橋之所以如此有吸引力，是因為所有額外的 SEP 都存在於 '24 中，保留了這些成員，獲得了全年風險調整收入，實現了 10% 的 MLR 改善。如果我的計算正確的話，那 25% 之內只是橋樑的很大一部分。

So with that said, I'm wondering how is your retention rate on those SEP lives? And are there any notable dynamics whether it's member mix shift or anything else that might prevent you in any way from seeing that powerful MLR tailwind play out?

那麼，我想知道這些 SEP 生命的保留率如何？是否存在任何值得注意的動態，無論是成員組合變化還是其他任何可能以任何方式阻止您看到強大的 MLR 順風發揮作用的因素？

Look, I think that as we talked about in our talking points, we had solid retention. A year ago, the retention was incredibly high. We were expecting that. We expected a little bit softer retention. We saw that, but we still saw terrific retention and we sell retention in the SEP cohort.

看，我認為，正如我們在談話要點中談到的那樣，我們擁有穩固的保留率。一年前，保留率高得令人難以置信。我們期待著這一點。我們預計保留率會稍微低一些。我們看到了這一點，但我們仍然看到了極好的保留率，並且我們在 SEP 群體中銷售保留率。

So all of the dynamics of building momentum and building that SEP membership in '24 is playing out with the growth that we're seeing in 2025. We also have high confidence that those members from last year who came in through SEP will also have an MLR in 2025 that looks like the rest of OE. So all of that is built into our guidance.

因此，24 年間建立勢頭和建立 SEP 成員資格的所有動態都將隨著我們在 2025 年看到的成長而發揮作用。我們也非常有信心，去年透過 SEP 加入的成員在 2025 年也將擁有與 OE 其他成員一樣的 MLR。所以所有這些都已納入我們的指導之中。

And again, utilization in '24 for us was really good. It was favorable to our expectations. So we think that we've got a lot of momentum going to '25 in terms of the performance of our MLR.

再一次，24 年我們的利用率確實很好。這符合我們的預期。因此我們認為，就我們的 MLR 性能而言，我們擁有很大的發展勢頭，可以達到 25 年。

And the risk scores will mature on that SEP population, which we did not get full advantage of in 2024. So we'll see that happen. The demographics are largely the same, 52% male, 48% female, largely 71% in silver plans.

風險評分將在 SEP 族群中成熟，而我們在 2024 年並未充分利用這一點。所以我們會看到這種情況發生。人口統計數據大致相同，52% 為男性，48% 為女性，其中銀計劃用戶佔 71%。

I think the issue that we saw in ICRA was actually people choosing more gold and bronze plans. As we saw the ICRA membership come in small sample, but still an interesting dynamic and a different way of purchasing.

我認為我們在 ICRA 中看到的問題實際上是人們選擇更多的黃金和青銅計劃。正如我們所見，ICRA 的會員樣本雖然很小，但仍然是一種有趣的動態和不同的購買方式。

Great. Thank you very much.

偉大的。非常感謝。

(Operator Instructions) Jonathan Yong, UBS.

(操作員指示) Jonathan Yong，瑞銀。

Hi, thanks for taking question. I guess just in relation to the 1.8 million lives, are you assuming any attrition throughout the year as people get jobs or perhaps to stop paying throughout the year? Or are you assuming a full static 1.8 million lives.

你好，謝謝你提問。我想，僅就 180 萬人的生命而言，您是否認為隨著人們找到工作或可能全年停止支付工資，全年都會出現人員流失？或者你假設生命總數為 180 萬。

And then just on G&A, does that step down from the 1.98 to 1.8, does that -- you obviously have a good G&A ratio for this year, but does that change kind of your how the trajectory of it might look moving forward?

然後就 G&A 而言，它是否會從 1.98 降至 1.8，這是否 — — 您今年的 G&A 比率顯然很好，但這是否會改變您未來的發展軌跡？

I think that on the SG&A, we see continued opportunity for SG&A improvement. That's going to be -- we've seen that in our guidance. I would just say that in 2025, we are making some investments to continue to accelerate our opportunities for growth and efficiency.

我認為，在銷售、一般及行政開支方面，我們看到了持續改善銷售、一般及行政開支的機會。那將是—我們已經在我們的指導中看到了這一點。我只想說，到 2025 年，我們將進行一些投資，以繼續加速我們的成長和效率機會。

So that's already baked into the guidance. So the fact that we're improving our SG&A performance while continuing to invest in our future, I think, is a strong example of how we think long term for the company. And then with respect to --

所以這已經融入到指導之中了。因此，我認為，我們在繼續投資未來的同時提高銷售、一般及行政開支績效，就是我們如何為公司進行長遠考慮的一個有力例證。然後關於--

The operated -- the point on the operating leverage, it's based on the 1.8 billion. So if the fluctuation comes down from 1.98 to 1.8, we still have a -- I think at 1.8.

經營槓桿的點是基於 18 億美元。因此，如果波動從 1.98 降至 1.8，我們仍然有 - 我認為是 1.8。

Yeah. And basically, on your churn question, we anticipate that membership will be roughly flat throughout the year. We would anticipate -- we believe that we'll see lapse that's at or around what we've experienced historically, potentially with some -- a little bit of pressure from what I talked about in terms of the April final CMS process. We've built that into our expectations.

是的。基本上，關於您提到的會員流失問題，我們預計全年會員數量將基本保持穩定。我們預計 - 我們相信我們將會看到與我們歷史上經歷過的差不多的失誤，可能還會有一些 - 就像我在 4 月份最終 CMS 流程中所談論的那樣，帶來一點壓力。我們已將其納入我們的預期。

And then we expect that some of the factors that drove growth in this market in terms of new people coming in, whether it's through the gig economy or through other sources of growth, but have been the bedrock of what's been driving the ACA over the last couple of years that we expect those to continue. So again, flat membership throughout the year.

然後，我們預計，推動該市場成長的一些因素，無論是透過零工經濟還是透過其他成長來源，都增加了新人進入，但這些因素也是過去幾年推動 ACA 的基石，我們預計這些因素將繼續下去。因此，全年會員人數保持不變。

And on the AI front, we did not project AI enhancements in our three-year projections that we shared with you in June. But last year, we put in 11 new use cases. And this coming year, we're going to -- we have 10 more in the pipeline for just the first quarter.

在人工智慧方面，我們在六月與大家分享的三年預測中並沒有預測人工智慧的增強。但去年，我們增加了 11 個新用例。而明年，光是第一季我們就有 10 項新計畫。

So we continue to find ways to use these tools to help us drive the SG&A down. And that's why, quite frankly, our numbers ahead of where we thought we were going to be when we put together a three-year projections.

因此，我們繼續尋找方法來使用這些工具來幫助我們降低銷售、一般和行政費用。坦白說，這就是為什麼我們的數字超出了我們制定三年預測時的預期。

Great. Thanks.

偉大的。謝謝。

Jessica Tassan, Piper Sandler.

傑西卡·塔桑，派珀·桑德勒。

Hi guys. Thank you for taking the question. My first one is a quick one. Can you just quantify the total prior period development in 2024 and then specifically in the fourth quarter?

嗨，大家好。感謝您回答這個問題。我的第一個很快。您能否量化 2024 年以及第四季的整體前期發展？

Yeah. So prior period development for the full year was $126 million, and it was $62 million in the fourth quarter.

是的。因此，全年前期開發支出為 1.26 億美元，第四季為 6,200 萬美元。

Awesome. And then can you maybe discuss Oscar's pricing strategy and kind of specifically the extent to which your silver plans are priced above the benchmark and how that pricing kind of ensures that Oscar is only really enrolling active and intentional premium paying members?

驚人的。然後，您能否討論一下 Oscar 的定價策略，特別是您的銀色計劃定價高於基準的程度，以及這種定價如何確保 Oscar 只招募活躍且有意付費的會員？

First off, we always take an approach to pricing, which is we want to have disciplined pricing strategy that balances our desire to both grow the book and to create margin for us. So that's kind of thing one.

首先，我們始終採取一種定價方法，即我們希望有嚴謹的定價策略來平衡我們增加訂單量和為我們創造利潤的願望。這就是第一件事。

When we think about the different pricing for each of the metal tiers, we do that primarily with the view of we want all of our book to perform in a way that creates margin for the business. So that's probably the most important lens.

當我們考慮每個金屬層級的不同定價時，我們這樣做主要是為了希望我們所有的帳簿都能以能為企業創造利潤的方式運作。所以這可能是最重要的鏡頭。

So we build up what we think the trend is going to be. And then we create margin by basically having affordability initiatives that allow us to experience an MLR that is below the -- or experience an increase in medical cost that is below the trend. So that's kind of what we do there.

所以我們建構了我們認為的趨勢。然後，我們透過實施可負擔性措施來創造利潤，這些措施使我們能夠經歷低於 MLR 的水平——或經歷低於趨勢的醫療成本成長。這就是我們在那裡做的事情。

With respect to zero dollar and the comments you made around is there more risk of fraud, we are engaged with CMS in trying to do everything we can to make sure that we only have valid members. And CMS is actually the one who does all of the income verification.

關於零美元以及您提出的是否存在更多詐欺風險的評論，我們正在與 CMS 合作，盡一切努力確保我們只有有效會員。而 CMS 實際上是負責所有收入驗證的人。

What we do is we police the brokers that we do business with. We are actively looking at to try to find any kind of irregularities or things that we see brokers doing that cause us to question if there's something going on that we should be talking to CMS about. We report those brokers to CMS. They are the ones that do those investigations.

我們所做的就是監督與我們有業務往來的經紀人。我們正在積極尋找任何違規行為或經紀人所做的事情，這些事情讓我們懷疑是否發生了什麼事情，需要與 CMS 進行溝通。我們向 CMS 舉報這些經紀人。他們就是進行這些調查的人。

But we don't have any interest in having any kind of members that are there without being there on purpose. And we do everything we can to support CMS' payment integrity efforts.

但我們不希望有任何非故意出席的成員。我們竭盡全力支持 CMS 的支付誠信工作。

What we have found in a number of our zero premium plans, there are large number of members that don't use care, all that significantly and that's largely as an insurance policy for them in case there's an accident or someone gets ill, they don't lose the house. So it's a very different purchasing decision. They're buying a plan at zero premium that gives them some coverage for catastrophic events.

我們發現，在我們的許多零保費計劃中，有大量會員不使用醫療保險，這很重要，因為這對他們來說主要是一份保險，以防發生事故或有人生病，他們不會失去房子。所以這是一個非常不同的購買決定。他們購買的保險計劃不需支付保費，就能獲得一定的災難事件保障。

That's really helpful. Thank you.

這真的很有幫助。謝謝。

Adam Ron, Bank of America.

美國銀行的亞當‧羅恩 (Adam Ron)。

Hey, I just got a question about SG&A. It seems like last quarter, you guided to to 19.4% and then you printed 19.1% for the year. So in the quarter, that implies a pretty significant outperformance. So curious what's driving that, if that's related to AI or so just -- for example, if people like slowed your hiring or something you could point to that would be helpful.

嘿，我剛剛對銷售、一般及行政費用 (SG&A) 有疑問。好像上個季度，您預期的是 19.4%，然後您公佈的全年成長率是 19.1%。因此，在本季度，這意味著相當顯著的優異表現。所以我很好奇是什麼推動了這一進程，如果這與人工智慧有關，或者只是——例如，如果人們放慢了你的招募速度或你可以指出一些有幫助的事情。

Yeah. Look, I think that SG&A is just a bright spot in terms of, number one, in the quarter, I think that we saw just continued strong performance of our initiatives of making sure that we drive variable efficiencies and that we achieve our fixed cost leverage. So all of the improvement there is sustainable and we'll move into 2025.

是的。看，我認為銷售、一般及行政開支是本季度的一個亮點，首先，我認為我們看到我們的舉措繼續表現強勁，確保我們提高可變效率，並實現固定成本槓桿。因此，那裡的所有改進都是可持續的，我們將進入 2025 年。

Overall SG&A, I think that Mark previously described seeing some water melons on the floor. I think we have been very successful at harvesting those water melons and a lot of what you see in SG&A is really from the blocking and tackling.

總體而言，銷售、一般及行政開支，我認為馬克之前描述過看到地板上有一些西瓜。我認為我們在收穫這些西瓜方面非常成功，你在銷售、一般及行政開支 (SG&A) 中看到的許多收入實際上都來自於阻擋和解決。

And then we're starting to see the front end of a lot of the AI initiatives that we've been running and talking about the -- our ability to be a more efficient company, and I think there's more opportunity for us to drive that into the future. And we've just started to see the first round of the effects of that on our cost structure.

然後，我們開始看到我們正在運行的許多人工智慧計畫的前端，並談論——我們成為一家更有效率的公司的能力，我認為我們有更多的機會推動這一進程。我們剛開始看到這對我們的成本結構產生的第一輪影響。

If I could squeeze one more in. I thought it was interesting that the new hires coming from Kaiser given Mark is typically kind of bearish on capitation. So curious if Janet has a different view on that or change of strategy on value-based care. But I appreciate all the questions.

如果我能再擠進一個。考慮到馬克通常對人頭稅持悲觀看法，我認為來自凱撒的新員工很有趣。所以我很好奇珍妮特是否對此有不同的看法或基於價值的護理策略的改變。但我感謝大家提出的問題。

So Kaiser is not capitated. Kaiser practice is a different form of medicine and they organize in a way to practice better.

因此，Kaiser 不受人頭稅約束。凱撒醫療實踐是一種不同的醫學形式，他們以更好的方式組織起來。

So I would say that she brings to us some skills that we -- as we evaluate value-based contracts and whether or not they work effectively, should bring some really strong skills and she did an amazing job in turning around Hawaii when she -- when that program got in trouble, and she's anxious to join us. So we're very pleased to have her.

所以我想說，她為我們帶來了一些技能，當我們評估基於價值的合約以及它們是否有效運作時，應該帶來一些非常強大的技能，當該項目陷入困境時，她在扭轉夏威夷的局面方面做得非常出色，她渴望加入我們。所以我們非常高興她能來。

Appreciate it.

非常感謝。

And that concludes today's conference call. Thank you for your participation. You may now disconnect.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。