聯合健康 (UNH) 2022 Q3 法說會逐字稿

Good day, everyone, and welcome to the UnitedHealth Group Third Quarter 2022 Earnings Conference Call. A question-and-answer session will follow UnitedHealth Group's prepared remarks. As a reminder, this call is being recorded. Here are some important introductory information. This call contains forward-looking statements under U.S. Federal Securities Laws. These statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations. A decision -- I'm sorry, a description of some of these risks and uncertainties can be followed in the reports that we file with the Securities and Exchange Commission, including the cautionary statements included in our current and periodic filings. This call will also reference non-GAAP amounts in reconciliation of the non-GAAP to GAAP amounts is available on the Financial & Earnings Reports' section of the company's Investor Relations page at www.unitedhealthgroup.com.

大家好，歡迎參加聯合健康集團 2022 年第三季度收益電話會議。問答環節將在聯合健康集團準備好的評論之後進行。提醒一下，此通話正在錄音中。以下是一些重要的介紹性信息。本次電話會議包含美國聯邦證券法下的前瞻性陳述。這些陳述受到風險和不確定性的影響，可能導致實際結果與歷史經驗或當前預期存在重大差異。一個決定——對不起，我們向證券交易委員會提交的報告中可以遵循對其中一些風險和不確定性的描述，包括我們當前和定期提交的文件中的警示性聲明。本次電話會議還將參考非 GAAP 金額，以將非 GAAP 金額與 GAAP 金額對賬，該金額可在公司投資者關係頁面的財務和收益報告部分獲取，網址為 www.unitedhealthgroup.com。

Information presented on this call is contained in the earnings release we issued this morning and in our Form 8-K dated October 14, 2022, which may be accessed from the Investor Relations page of the company's website. I will now turn the call over to our Chief Executive Officer of UnitedHealth Group, Andrew Witty. Please go ahead.

本次電話會議中提供的信息包含在我們今天上午發布的收益發布和日期為 2022 年 10 月 14 日的 8-K 表中，可從公司網站的投資者關係頁面訪問。我現在將把電話轉給聯合健康集團的首席執行官 Andrew Witty。請繼續。

Thank you. Good morning, and thank you all for joining us today. As we approach the final stretch of 2022, let me start by recognizing our colleagues, the people of Optum and UnitedHealthcare who continue to work diligently day in and day out for those we serve. Their efforts allow us to deliver durable and balanced growth and to increase our 2022 adjusted earnings outlook to a range of $21.85 to $22.05 per share.

謝謝你。早上好，感謝大家今天加入我們。當我們接近 2022 年的最後階段時，讓我首先感謝我們的同事、Optum 和 UnitedHealthcare 的員工，他們繼續日復一日地為我們所服務的人辛勤工作。他們的努力使我們能夠實現持久和平衡的增長，並將我們 2022 年調整後的盈利前景提高到每股 21.85 美元至 22.05 美元的範圍內。

As an enterprise, we remain focused on our mission and on advancing our growth strategies. Our aim is to serve more people through value-based care and expanded health benefits offerings, a robust foundation on which to consistently drive strong growth into 2023 and beyond. Consumers want value, especially in the current economic environment, and that means high quality care that is more accessible, more affordable and more responsive to their individual needs. In the past quarter, we've accelerated efforts to deliver on this critical consumer proposition, launching several initiatives to reach more people in more communities while deepening relationships with those we already serve. For example, in September, we announced a long-term collaboration with Walmart to provide Optum technology and expertise that will enable America's largest retailer to provide value-based care to consumers in its clinics.

作為一家企業，我們始終專注於我們的使命和推進我們的增長戰略。我們的目標是通過基於價值的護理和擴大的健康福利產品為更多人提供服務，這是在 2023 年及以後持續推動強勁增長的堅實基礎。消費者想要價值，尤其是在當前的經濟環境中，這意味著更容易獲得、更實惠且更能滿足他們個人需求的高質量護理。在過去的一個季度，我們加快了實現這一關鍵消費者主張的努力，推出了幾項舉措以覆蓋更多社區中的更多人，同時加深與我們已經服務的人的關係。例如，在 9 月，我們宣布與沃爾瑪建立長期合作關係，以提供 Optum 技術和專業知識，使美國最大的零售商能夠為其診所的消費者提供基於價值的護理。

Starting in 2023, we will jointly develop 15 Walmart health clinics in Florida and Georgia and will extend into additional geographies over time. As we expand the collaboration, there will be broad opportunities to address social determinants of health by improving access to benefits such as healthy foods, medications, dental and vision services and more.

從 2023 年開始，我們將在佛羅里達州和佐治亞州聯合開發 15 家沃爾瑪健康診所，並將隨著時間的推移擴展到其他地區。隨著我們擴大合作，將有廣泛的機會通過改善獲得健康食品、藥物、牙科和視力服務等福利的機會來解決健康的社會決定因素。

We also launched a distinctive partnership with Red Ventures, a digital media company connecting tens of millions of consumers each month to its clients' products and services through a broad portfolio of proprietary digital content platforms. This partnership called RVO Health combines Red Ventures popular health and wellness platforms, including health line and health grades, with Optum's consumer marketplace, the Optum Store and the Optum Perks prescription discount card.

我們還與 Red Ventures 建立了獨特的合作夥伴關係，Red Ventures 是一家數字媒體公司，通過廣泛的專有數字內容平台組合，每月將數千萬消費者與其客戶的產品和服務聯繫起來。這種名為 RVO Health 的合作夥伴關係將 Red Ventures 流行的健康和健康平台（包括健康產品線和健康等級）與 Optum 的消費者市場、Optum Store 和 Optum Perks 處方折扣卡相結合。

RVO Health will enable us to engage with more than 100 million active monthly visitors seeking the health advice and insights they need introducing them to relevant products and services through a customized end-to-end digital platform. Affordability is an essential component of value in health care, especially when it determines access to the life-saving medicines people need for themselves and their families.

RVO Health 將使我們能夠與超過 1 億活躍的月度訪客進行互動，尋求他們需要的健康建議和見解，通過定制的端到端數字平台向他們介紹相關產品和服務。可負擔性是醫療保健價值的重要組成部分，尤其是當它決定了人們獲得自己和家人所需的救命藥物時。

In July, we announced 0 consumer cost share on drugs for diabetes, severe allergic reactions and other emergency situations starting in January for those we serve with commercial insured benefits. Now we are working with self-funded employers who are exploring how they can provide these vital medications for 0 co-pay. So far, this benefit will be available to more than 1 million additional people.

7 月，我們宣布從 1 月開始，我們為那些享有商業保險福利的人提供治療糖尿病、嚴重過敏反應和其他緊急情況的藥物的 0 消費者成本分攤。現在，我們正在與自籌資金的雇主合作，他們正在探索如何以 0 共付額的價格提供這些重要藥物。到目前為止，這項福利將提供給超過 100 萬額外的人。

And we are actively engaging with many additional employers. We're also improving access to essential medicines for those even without health benefits coverage. For example, Optum Store launched a new partnership with Sanofi to help consumers without insurance obtain insulin for $35 a month, and they will be able to have it delivered to their home.

我們正在積極與許多其他雇主合作。我們還在改善那些即使沒有醫療福利保險的人獲得基本藥物的機會。例如，Optum Store 與賽諾菲（Sanofi）建立了新的合作夥伴關係，幫助沒有保險的消費者以每月 35 美元的價格獲得胰島素，他們將能夠將其送到家中。

Turning to health benefits. Today, nearly half of American seniors are enrolled in Medicare Advantage plans compared to about 25% a decade ago. And MA plays a vital role in serving those consumers who are significantly more diverse, have lower incomes and more complex care needs than the average senior. There are compelling reasons why seniors increasingly choose MA.

轉向健康益處。如今，近一半的美國老年人參加了 Medicare Advantage 計劃，而十年前這一比例約為 25%。 MA 在服務於那些比普通老年人更多樣化、收入更低、護理需求更複雜的消費者方面發揮著至關重要的作用。老年人越來越多地選擇 MA 有令人信服的原因。

Through Medicare Advantage, people are experiencing better health outcomes than in traditional fee-for-service Medicare across a wide spectrum of measures. For example, MA members with diabetes have over 50% lower rates of any category of complication and over 70% lower rates of serious complication. This is due to our ability to provide deeper, more coordinated levels of care.

通過 Medicare Advantage，人們在各種措施中體驗到比傳統的按服務收費的 Medicare 更好的健康結果。例如，患有糖尿病的 MA 成員的任何類別並發症發生率降低 50% 以上，嚴重並發症發生率降低 70% 以上。這是因為我們有能力提供更深入、更協調的護理水平。

And this is accomplished at lower cost. People served by MA spend as much as 40% less compared to those in Medicare Fee-for-Service and this high value for people is delivered at a lower net cost to the government. We are confident our differentiated offerings will once again this year resonate with consumers who are even more focused on affordability, value and simplicity given the rising cost of daily life.

這是以較低的成本實現的。與醫療保險按服務收費相比，由 MA 服務的人們的支出減少了 40%，而且這種對人們的高價值是以較低的淨成本交付給政府的。我們相信，鑑於日常生活成本不斷上漲，我們的差異化產品今年將再次引起消費者的共鳴，他們更加註重可負擔性、價值和簡單性。

Today, in The United States, more people than ever have access to health benefits, an important milestone on the path towards universal coverage, an objective we have long supported. Much of this expanded coverage has occurred in Medicaid. Looking to 2023 and given the potential resumption of eligibility redeterminations next year, a high priority for our team is assuring continuity of access and care for those we serve.

今天，在美國，獲得健康福利的人比以往任何時候都多，這是實現全民覆蓋道路上的一個重要里程碑，也是我們長期以來支持的一個目標。這種擴大的覆蓋範圍大部分發生在醫療補助計劃中。展望 2023 年，鑑於明年可能會恢復資格重新確定，我們團隊的首要任務是確保為我們服務的人提供訪問和護理的連續性。

The initiatives our team is pursuing to help assure continuous coverage include launching direct outreach and partnering with states and community organizations to identify those at risk and help them retain their benefit coverage. Partnering with national retailers and pharmacies to educate consumers about available coverage options and assistance while they are shopping in store and engaging with employers to extend annual enrollment periods and drive education efforts to employees who are eligible for coverage.

我們的團隊為幫助確保持續覆蓋而採取的舉措包括啟動直接外展活動以及與州和社區組織合作以識別處於風險中的人並幫助他們保持其福利覆蓋範圍。與全國零售商和藥房合作，在消費者在商店購物時向他們宣傳可用的保險選項和援助，並與雇主合作以延長年度註冊期限，並推動對有資格獲得保險的員工的教育工作。

Underpinning our growing consumer agenda is an ambitious multiyear effort to deepen and expand our enterprise technology capabilities. The recent combination of OptumInsight and Change Healthcare reflects our accelerating efforts to help create more effective and simple experiences for consumers, payers and care providers while lowering costs across the health system.

支持我們不斷增長的消費者議程的是一項雄心勃勃的多年努力，旨在深化和擴展我們的企業技術能力。 OptumInsight 和 Change Healthcare 最近的結合反映了我們正在加速努力幫助為消費者、支付者和護理提供者創造更有效和簡單的體驗，同時降低整個醫療系統的成本。

I want to formally welcome our newest colleagues, the talented and compassionate team at Change Healthcare, with whom we have just started working to build upon our shared vision for a more effective and adaptive health system for all participants.

我想正式歡迎我們最新的同事，即 Change Healthcare 才華橫溢且富有同情心的團隊，我們剛剛開始與他們一起努力，建立我們共同的願景，為所有參與者建立一個更有效和適應性更強的衛生系統。

With that, I'll turn it over to President and Chief Operating Officer, Dirk McMahon.

有了這個，我將把它交給總裁兼首席運營官 Dirk McMahon。

Thank you, Andrew. As Andrew just mentioned, we are very excited about the recent combination of Change Healthcare and OptumInsight. With a grand total of 11 days of integration work behind us, I thought I would provide a bit more commentary on how together we can make the health system simpler and more efficient.

謝謝你，安德魯。正如 Andrew 剛剛提到的，我們對 Change Healthcare 和 OptumInsight 最近的結合感到非常興奮。在我們總共進行了 11 天的整合工作之後，我想我會提供更多評論，說明我們如何共同使衛生系統更簡單、更高效。

Overall, Change brings a robust transaction network built on strong payer and provider connectivity. Together, our focus areas include: first, improving the quality of health care delivery by offering critical point-of-care insights aligned to evidence-based medical standards within the workflow of physicians. Second, simplifying administration by fully automating claims transactions, including editing in the EDI stream, improving claim accuracy.

總體而言，Change 帶來了建立在強大的付款人和提供商連接之上的強大交易網絡。我們的重點領域包括：首先，通過在醫生的工作流程中提供與循證醫學標準相一致的關鍵護理點洞察力，提高醫療保健服務的質量。其次，通過全自動理賠交易簡化管理，包括在 EDI 流中進行編輯，提高理賠準確性。

Lastly, we are reducing friction in the payment process by providing patient benefits and payment obligations at point of service and applying payment integrity at its upfront. Our teams have started out of the gate working intensively together to make these visions a reality and to create the next era of growth for OptumInsight.

最後，我們通過在服務點提供患者福利和支付義務並在前期應用支付完整性來減少支付過程中的摩擦。我們的團隊從一開始就開始緊密合作，以使這些願景成為現實，並為 OptumInsight 創造下一個增長時代。

We are very confident that our combined capabilities will enable us to better serve all health care constituents. Beyond OptumInsight, as you might imagine, I spend a lot of time engaging customers of all sizes, operating in almost every sector and representing diverse employee populations. Across these customers, no matter the person or the industry, I hear the same consistent message. The need for deeper levels of support and more resources to comprehensively meet health needs in both a traditional but also increasingly focused on behavioral health.

我們非常有信心，我們的綜合能力將使我們能夠更好地服務於所有醫療保健人員。除了 OptumInsight，您可能會想像，我花了很多時間與各種規模的客戶打交道，幾乎在每個行業都開展業務並代表不同的員工群體。在這些客戶中，無論是個人還是行業，我都聽到了同樣一致的信息。需要更深層次的支持和更多資源來全面滿足傳統的健康需求，同時也越來越關注行為健康。

Companies want to provide a broader range of resources and deeper levels of support for their employees and their families and the groundwork we have been building is resonating in this rapidly evolving area. Here's what we're doing about it. First, we're tackling access. We have expanded our behavioral health network by 25% over the last couple of years including a growing complement of behavioral clinical practices owned and operated by Optum.

公司希望為其員工及其家人提供更廣泛的資源和更深層次的支持，而我們一直在建立的基礎正在這個快速發展的領域引起共鳴。這就是我們正在做的事情。首先，我們正在處理訪問問題。在過去的幾年裡，我們的行為健康網絡擴大了 25%，其中包括 Optum 擁有和運營的行為臨床實踐的不斷增加。

And as many of you know, behavioral health is a 24/7 challenge. So we are continuing to expand our portfolio of digital offerings supporting a range of needs, allowing patients to get resources when they need them. We have also made significant improvements to help consumers access vital information more easily through improved navigation tools, guiding consumers to the appropriate condition-specific level of behavioral health is a challenge we are prioritizing.

正如你們許多人所知，行為健康是一個 24/7 的挑戰。因此，我們將繼續擴展我們的數字產品組合，以支持一系列需求，讓患者在需要時獲得資源。我們還進行了重大改進，通過改進的導航工具幫助消費者更輕鬆地訪問重要信息，引導消費者達到適當的特定條件的行為健康水平是我們優先考慮的挑戰。

These new experiences have improved customer satisfaction, and we are getting people to the right care more quickly. Behavioral health plays an integral role of the overall health and well-being of the people we serve. So you will all continue to -- so you will continue to see us increasing access, quality and affordability in this clinically important and sensitive area.

這些新體驗提高了客戶滿意度，我們正在讓人們更快地獲得正確的護理。行為健康在我們服務的人們的整體健康和福祉中起著不可或缺的作用。所以你們都將繼續 - 所以你們將繼續看到我們在這個臨床上重要和敏感的領域增加可及性、質量和可負擔性。

Another tenet of our consumer focus is meeting people where they are, which includes expanding our clinical capabilities to care for people, more holistically, in their homes. We know that at home care settings, especially for people with mobility challenges and highly complex health needs can improve outcomes, elevate patient experience and result in better care.

我們關註消費者的另一個宗旨是在人們所在的地方與他們會面，這包括擴大我們的臨床能力，以更全面地在家中照顧人們。我們知道，在家庭護理環境中，尤其是對於行動不便和需要高度複雜的健康需求的人，可以改善結果、提升患者體驗並帶來更好的護理。

So we bring together teams with medical, behavioral and palliative experience in addition to our home infusion capabilities of OptumRx. By doing so, we help patients and their families keep multiple chronic conditions in check while significantly reducing the need for care in acute and post-acute settings, a real positive for them. The expanding clinical breadth and deepening integration of our value-based care offerings are moving us beyond the conscience of traditional clinical settings, creating an opportunity for us to serve more people more effectively.

因此，除了 OptumRx 的家庭輸液能力外，我們還匯集了具有醫療、行為和姑息治療經驗的團隊。通過這樣做，我們幫助患者及其家人控制多種慢性病，同時顯著減少急性和急性後環境中的護理需求，這對他們來說是真正的積極因素。不斷擴大的臨床廣度和基於價值的護理產品的深化整合使我們超越了傳統臨床環境的良知，為我們創造了更有效地為更多人服務的機會。

With that, now I'll turn it over to Chief Financial Officer, John Rex.

有了這個，現在我將把它交給首席財務官約翰雷克斯。

Thank you, Dirk. As those of you listening know well, numbers can tell a story, and the story our numbers tell is one of broad-based growth and substantial near- and long-term potential. So let me walk through some of those numbers with you. In the third quarter, UnitedHealth Group revenues of $81 billion grew 12% or $8.6 billion, highlighted by broad-based double-digit growth at both Optum and UnitedHealthcare.

謝謝你，德克。聽的人都知道，數字可以講述一個故事，而我們的數字所講述的故事是基礎廣泛的增長和巨大的近期和長期潛力之一。所以讓我和你一起來看看其中的一些數字。第三季度，聯合健康集團的收入為 810 億美元，增長 12% 或 86 億美元，其中 Optum 和 UnitedHealthcare 均實現了兩位數的廣泛增長。

Care patterns in the quarter remained similar to those of the second quarter, and our planning for next year anticipates care patterns continue to normalize. We're encouraged to see people obtaining preventive screenings at levels broadly consistent with longer-term norms. And we are maintaining our focus on getting people the care they need.

本季度的護理模式與第二季度相似，我們對明年的計劃預計護理模式將繼續正常化。我們很高興看到人們在與長期規範大體一致的水平上獲得預防性篩查。我們將繼續專注於為人們提供所需的護理。

And acuity patterns remain stable, but as always, we are highly respectful of and watchful for evolving medical cost trends. Looking now at the performance of our specific businesses. OptumHealth's third quarter revenue increased 34% year-over-year as revenue per consumer grew 31%. The growth continues to be led by the increasing number of patients served under value-based care relationships and the expanding types of care settings offered by Optum from meeting behavioral needs to comprehensively serving people in their homes, to higher acuity ambulatory surgery.

敏銳度模式保持穩定，但一如既往，我們高度尊重和警惕不斷變化的醫療成本趨勢。現在看看我們特定業務的表現。 OptumHealth 第三季度收入同比增長 34%，每位消費者的收入增長 31%。增長繼續受到基於價值的護理關係下服務的患者數量的增加以及 Optum 提供的護理環境類型的不斷擴大，從滿足行為需求到全面服務於家中的人們，再到更高敏銳度的門診手術。

OptumInsight's revenue grew 18% in the quarter, led by continued market growth across payer and provider services. And the revenue backlog increased by $1.8 billion year-over-year to $24.1 billion. OptumRx revenue grew 8% reflecting growth in people served and continued expansion of the pharmacy care businesses, including specialty, home delivery and community pharmacies.

OptumInsight 本季度的收入增長了 18%，這主要得益於支付方和提供商服務的市場持續增長。收入積壓同比增加 18 億美元，達到 241 億美元。 OptumRx 收入增長 8%，反映了服務人數的增長和藥房護理業務的持續擴張，包括專業藥房、送貨上門和社區藥房。

Pharmacy care services revenue growth continues to show momentum growing double digits in the quarter compared to the prior year. And new customer sales and retention have been strong. Turning to UnitedHealthcare. Revenue grew by 11% with all businesses contributing. The number of people served domestically by our commercial insured offerings increased by more than 100,000 over the past half year, as we continue to experience strong growth in our newer, more affordable consumer-centric offerings.

與去年同期相比，本季度藥房護理服務收入增長繼續呈現兩位數增長的勢頭。新客戶的銷售和保留一直很強勁。轉向聯合醫療。在所有業務的貢獻下，收入增長了 11%。在過去半年裡，我們的商業保險產品在國內服務的人數增加了 100,000 多人，因為我們在更新、更實惠的以消費者為中心的產品方面繼續經歷強勁增長。

Product such as Surest, which provides consumers with greater certainty and choice over their health benefits and also our virtual first health offerings. People served by our Medicare Advantage offerings continue to grow strongly, increasing 800,000 so far this year. The recently released 2024 plan year star ratings were consistent with our long-term planning expectations with 81% of our members in 4-star or better plans, a level we expect will rise as plan refinements are finalized. UnitedHealthcare enters 2023 serving more people in 4- and 5-star plans than any other health plan.

諸如 Surest 之類的產品，它為消費者提供了更大的確定性和選擇，以了解他們的健康益處以及我們的虛擬第一健康產品。我們的 Medicare Advantage 產品服務的人數繼續強勁增長，今年迄今增加了 800,000 人。最近發布的 2024 年計劃年度星級評級與我們的長期計劃預期一致，我們 81% 的會員處於 4 星或更好的計劃中，我們預計隨著計劃細化的最終確定，這一水平將會上升。 UnitedHealthcare 進入 2023 年，為 4 星和 5 星計劃中的人提供服務，超過任何其他健康計劃。

The number of people we serve through our Medicaid offerings has grown by 350,000 year-to-date. Most recently, we were awarded the opportunity to continue to serve the people of Nebraska in TANF, CHIP and long-term care programs. UnitedHealthcare achieved the highest score both overall and in each of the individual categories, reflecting our ability to deliver differentiated solutions aligned to our state customers' needs.

迄今為止，我們通過 Medicaid 產品服務的人數增加了 350,000 人。最近，我們獲得了繼續在 TANF、CHIP 和長期護理計劃中為內布拉斯加州人民服務的機會。 UnitedHealthcare 在整體和各個類別中均獲得最高分，這反映了我們提供符合州客戶需求的差異化解決方案的能力。

And we continue to see strength in our dual special needs offerings with exceptional consumer satisfaction, demonstrated by a Net Promoter Score of 80. Our capital capacities remain strong. Year-to-date, adjusted cash flows from operations were $21 billion or 1.3x net income. We ended the quarter with a debt-to-capital ratio of 38% providing ample ability to continue to further build upon vital capabilities, which benefit both the people we serve and the broader health system.

我們繼續看到我們的雙重特殊需求產品的實力以及卓越的消費者滿意度，淨推薦值 80 分證明了這一點。我們的資本能力仍然強勁。年初至今，調整後的經營現金流為 210 億美元，即淨收入的 1.3 倍。本季度末，我們的債務資本比率為 38%，為繼續進一步建立重要能力提供了充足的能力，這對我們所服務的人民和更廣泛的衛生系統都有利。

And we have returned $10.5 billion to shareholders in the first 9 months of the year through dividends and share repurchases. As noted earlier, given the strength of our business performance, this morning, we updated our 2022 adjusted earnings outlook to a range of $21.85 to $22.05 per share. So we think these numbers are telling the story of an enterprise striving to conclude a strong 2022, a year broadly featuring diversified growth today and making foundational investments for our long-term future. Now I'll turn it back to Andrew.

今年前 9 個月，我們通過股息和股票回購向股東返還了 105 億美元。如前所述，鑑於我們的業務表現強勁，今天上午，我們將 2022 年調整後的盈利前景更新至每股 21.85 美元至 22.05 美元的範圍。因此，我們認為這些數字正在講述一家企業努力結束強勁的 2022 年的故事，這一年今天廣泛呈現多元化增長，並為我們的長期未來進行基礎投資。現在我將把它轉回給安德魯。

Thanks, John. As is customary with the close of a third quarter, we will offer early observations about next year while reserving most of this conversation for our November 29 investor conference. Our businesses are growing and operating well with strong momentum and a keen enterprise focus on executing on our strategic growth priorities.

謝謝，約翰。按照第三季度末的慣例，我們將提供對明年的早期觀察，同時將大部分對話保留在 11 月 29 日的投資者會議上。我們的業務正在增長並運營良好，勢頭強勁，企業專注於執行我們的戰略增長優先事項。

Among a few highlights. The Optum Health care delivery businesses are rapidly advancing their value-based capacities, expanding the scope and settings of care offered and creating a long runway for growth. And we see our innovative and consistently highly valued Medicare Advantage plans as well positioned to grow strongly again next year.

在幾個亮點中。 Optum 醫療保健提供業務正在迅速提升其基於價值的能力，擴大所提供的護理範圍和環境，並為增長創造了一條長長的跑道。我們看到我們創新且始終高度重視的 Medicare Advantage 計劃將在明年再次強勁增長。

At this distance, we view a majority of the 2023 analyst estimates as reasonably reflecting performance levels we would expect to offer in November with the current consensus at the top end of our likely initial earnings outlook range. And as you have come to expect, we continue to strive toward our long-term 13% to 16% earnings per share growth goal.

在這個距離上，我們認為大多數 2023 年分析師的估計合理地反映了我們預計在 11 月提供的業績水平，目前的共識是我們可能的初始盈利前景範圍的高端。正如您所期望的那樣，我們將繼續努力實現每股收益增長 13% 至 16% 的長期目標。

We look forward to discussing this with you in much greater detail in person at our investor conference in New York. I hope you're getting a sense of an organization that has long been the case is focused sharply on executing with excellence in all we do, so that we can meet and exceed our commitments to our customers, clinicians, consumers, and the communities we serve and, of course, to our employees and to you, our shareholders.

我們期待在紐約的投資者會議上與您更詳細地討論這個問題。我希望您能了解一個長期以來一直專注於以卓越執行我們所做的一切的組織，以便我們能夠滿足並超越我們對客戶、臨床醫生、消費者和我們社區的承諾服務於我們的員工，當然還有我們的股東。

With that, operator, let's open it up for questions, one per caller please.

有了這個，接線員，讓我們打開它來提問，每個來電者一個。

(Operator Instructions) And we'll first hear from A.J. Rice of Credit Suisse.

（操作員說明）我們將首先收到 A.J. 的來信。瑞信的賴斯。

Thanks for the comments. As you think about '23 and you're going through the process of pricing discussions with your commercial employer groups and so forth. Is the basic concept -- I know, John, you said continue to return to normal utilization.

感謝您的評論。當您考慮 23 年時，您正在與您的商業雇主團體等進行定價討論。是基本概念——我知道，約翰，你說繼續恢復正常使用。

Is the basic view, is that we would project a medical cost trend off of this year that's more in that traditional 4, 5% range, mid-single digits. And we've heard some discussion about maybe there being an unusual bump up in addition to the medical -- traditional medical cost trend to allocate something for providers dealing with their labor issues.

基本觀點是，我們將預測今年的醫療成本趨勢將更多地處於傳統的 4%、5% 範圍內，中個位數。我們已經聽到一些討論，除了醫療之外，可能還會出現不尋常的上漲——傳統的醫療成本趨勢為提供者分配一些東西來處理他們的勞工問題。

Is your discussion with employers, is that something you're seeing getting put in place?

您與雇主的討論是否已落實？

So A.J., thanks so much for the question. And obviously, a key aspect of planning for next year that you're focused on. Just let me make a couple of broader comments and I might just ask Brian Thompson to reflect a little bit more detail on that as well from the UnitedHealthcare perspective.

所以 A.J.，非常感謝這個問題。顯然，這是您關注的明年計劃的一個關鍵方面。讓我發表一些更廣泛的評論，我可能會請布賴恩湯普森從 UnitedHealthcare 的角度反映更多細節。

Obviously, for the last couple of years, there's been a lot of focus on the effect of COVID as you think about impacts on medical cost trend. I think as we've rolled through this year, honestly, I think it's become much less about COVID. There's now -- I think there's a blend of possibly a little bit of COVID effect in the system, but cost of living effects, things like inflation, things like capacity constraints in the system as the labor market tightness has affected different parts of the system at different moments.

顯然，在過去幾年中，當您考慮對醫療成本趨勢的影響時，人們非常關注 COVID 的影響。我認為隨著我們今年的發展，老實說，我認為關於 COVID 的事情已經變得不那麼重要了。現在有——我認為系統中可能混合了一點點 COVID 效應，但生活成本效應、通貨膨脹等因素、系統中的能力限制等因素，因為勞動力市場緊張影響了系統的不同部分在不同的時刻。

So I think this whole issue has become actually more complicated in some ways because there's more influences on what you need to think through going forward. With that maybe sort of high-level perspective, maybe, Brian, you might just go a little deeper in terms of how you've been translating some of that as you've been thoughtful about pricing going forward.

所以我認為整個問題在某些方面實際上變得更加複雜，因為對你需要思考的未來有更多影響。或許，布賴恩，從那種高層次的角度來看，你可能會更深入地了解你是如何翻譯其中一些內容的，因為你一直在考慮未來的定價。

Sure, Andrew. Thank you. And thank you for the question, A.J. Brian Thompson here. As we do look forward, I would say that we have planned and priced for our cost trend a little higher than historical norms. And I think to some of the points that Andrew made, some of them are pretty obvious and inevitable.

當然，安德魯。謝謝你。謝謝你的問題，A.J.布賴恩湯普森在這裡。正如我們所期待的那樣，我想說我們已經為我們的成本趨勢進行了計劃和定價，其成本趨勢略高於歷史標準。我認為對於 Andrew 提出的一些觀點，其中一些是非常明顯和不可避免的。

The first just being the reality that 2022 is a lower starting point. In addition to that, contributing is labor and inflationary costs. And just being respectful of what we don't know, again, probably the pacing of care patterns and how they return to normal are certainly included in that. I would certainly suggest though at the same time, we're working really hard to manage down the impact of these trends on both our consumers and employers alike.

第一個只是現實，2022 年是一個較低的起點。除此之外，還有勞動力和通貨膨脹成本。再次尊重我們不知道的事情，可能護理模式的節奏以及它們如何恢復正常當然也包括在其中。我當然會建議，但與此同時，我們正在努力降低這些趨勢對我們的消費者和雇主的影響。

And you mentioned how we're negotiating with our provider partners. I would say we've really seen emergence of value-based arrangements at a faster pace than perhaps historically. So we're not just seeing unit costs accelerate at a higher rate. And in addition, just more product designs that are meaningfully lowering those price points for end consumers, whether it's virtually enriched products, we mentioned that a little bit.

你提到了我們如何與我們的供應商合作夥伴進行談判。我想說，我們確實看到基於價值的安排的出現速度可能比歷史上更快。因此，我們不僅看到單位成本以更高的速度增長。此外，只是更多的產品設計有意義地降低了最終消費者的價格點，無論是實際上豐富的產品，我們都提到了一點。

We've talked a lot about Surest and how that consumer choice model is really driving not only a lower price point, but first dollar coverage is really emerging as a priority for those folks that we support and serve every day. So those are some elements and dynamics not only in the product side, but how we're looking to our forward view of costs.

我們已經談了很多關於 Surest 的內容，以及消費者選擇模式如何真正推動不僅價格更低，而且第一美元的覆蓋範圍確實成為我們每天支持和服務的那些人的首要任務。因此，這些不僅是產品方面的一些元素和動態，而且是我們如何看待我們對成本的前瞻性看法。

Yes. Brian, thanks so much. And I think, A.J., one of the key points, I'm sure you'll have taken away from what Brian is saying there is, look, there's a degree of -- there's some unavoidable pressures in the macro environment that everybody is well aware of but we're really doing something about that on behalf of our members and our clients and our customers.

是的。布賴恩，非常感謝。而且我認為，A.J.，其中一個關鍵點，我相信你會從布賴恩所說的話中拿走，看，在一定程度上——宏觀環境中存在一些不可避免的壓力，每個人都很好知道，但我們確實在代表我們的會員、我們的客戶和我們的客戶做一些事情。

Our focus is to bring innovation into the marketplace, whether that's through the way we design plans like Surest in UnitedHealthcare, the way we develop the value-based platform in OptumCare, all of which are designed to develop to deliver high-quality care at more affordable levels for folks and then to ensure that, that is something that can rely on year after year after year. So a stability of confidence in the health care that they can come to expect.

我們的重點是將創新帶入市場，無論是通過我們在 UnitedHealthcare 中設計 Surest 等計劃的方式，還是在 OptumCare 中開發基於價值的平台的方式，所有這些都旨在開發以提供更高質量的護理服務人們可以負擔得起的水平，然後確保這一點，這是可以年復一年地依賴的東西。因此，他們可以期待對醫療保健的信心穩定。

So that's how we're really viewing this. It's obviously a dynamic environment, but we're extremely focused, as you can tell, on making sure we have strong responses to it. Thanks, A.J.

這就是我們真正看待這個的方式。這顯然是一個動態的環境，但正如您所知，我們非常專注於確保我們對此有強烈的反應。謝謝，A.J.

Next, we'll hear from Josh Raskin of Nephron Research.

接下來，我們將聽取 Nephron Research 的 Josh Raskin 的來信。

Can you refresh us on the components of OptumHealth and sort of how much of that revenue is now coming from OptumCare? And then how many of those consumers are within OptumHealth or actually Optum Care consumers and maybe how many are in some form of risk arrangement and then how many are in full capitation? I think you've given some of those numbers, just looking for a refresh.

您能否向我們介紹 OptumHealth 的組成部分，以及現在有多少收入來自 OptumCare？那麼這些消費者中有多少在 OptumHealth 或實際上是 Optum Care 消費者中，也許有多少處於某種形式的風險安排中，然後有多少是全人頭？我想你已經給出了其中一些數字，只是在尋找更新。

Yes, Josh, good to hear your voice, and thanks so much for the question. So a very good, very strong quarter, continued strong performance from OptumHealth overall. I'll pass in a second to Dr. Wyatt Decker to give you a little more flavor on that.

是的，喬希，很高興聽到你的聲音，非常感謝你的提問。所以一個非常好的、非常強勁的季度，OptumHealth 的整體表現持續強勁。我稍後會轉給 Wyatt Decker 博士，讓您對此有更多了解。

Just let me pick out one of those aspects, which is a question you asked about the fully capitated lives within there. So if you think about OptumCare, obviously, a subset of OptumHealth, has about 20 million or so folks who we look after through that platform. Probably, you're still a little under 15% of that number in fully capitation arrangements. So that really tells you -- despite the very strong impact that's having, you can see the way that's reflected through this sustained 34% growth in average revenue per consumer served in OptumHealth. A lot of that is influenced by the capitation shift, but it's still a really small fraction of the total number of lives that we look after in that part of our organization.

讓我挑出其中一個方面，這是你問的一個關於那裡完全人均生活的問題。因此，如果您考慮 OptumCare，顯然，OptumHealth 的一個子集擁有大約 2000 萬我們通過該平台照顧的人。可能，在完全按人頭安排的情況下，您仍然略低於該數字的 15%。所以這真的告訴你——儘管產生了非常強大的影響，但你可以看到 OptumHealth 服務的每位消費者平均收入持續增長 34% 所反映的方式。其中很大一部分受到了按人頭轉移的影響，但它仍然只是我們組織該部分所照顧的生命總數的一小部分。

So a lot of runway there, and that's what really underpins our long-term confidence in sustained growth particularly in OptumCare, which is a key piece of OptumHealth and maybe now pass to Wyatt to give you a little bit more context of how it all fits together. Wyatt?

所以那裡有很多跑道，這才是我們對持續增長的長期信心的真正基礎，特別是在 OptumCare 方面，這是 OptumHealth 的一個關鍵部分，現在可能會交給 Wyatt，讓你更多地了解這一切是如何適應的一起。懷亞特？

Yes. Thanks, Andrew, and thank you, Josh, for the question. Absolutely correct is the importance of capitated and value-based care to both our strategic business model to continue to offer comprehensive health care solutions to our nation citizens as well as to our optimistic outlook on growth.

是的。謝謝安德魯，謝謝喬希的問題。絕對正確的是，以人為本和以價值為基礎的護理對我們的戰略商業模式（繼續為我們的國家公民提供全面的醫療保健解決方案）以及我們對增長的樂觀前景的重要性。

Today, over 2/3 of our revenue are derived from value-based care constructs, and that will continue to grow. As Andrew pointed out, we have ample pathways for growth. You'll see us going deeper and broader in the markets that we serve today as well as going into new markets like the Pacific Northwest and the Northeast.

今天，我們超過 2/3 的收入來自基於價值的護理結構，並且將繼續增長。正如安德魯指出的那樣，我們有充足的增長途徑。您會看到我們在我們今天服務的市場中更深入、更廣闊，以及進入太平洋西北部和東北部等新市場。

And what I'm excited about is, increasingly we're bringing together the platforms that we have talked about historically and that Dirk touched on today. So think of home and community is helping us bring value-based constructs to a broader set of populations and servicing more comprehensively those we serve in OptumCare.

令我興奮的是，我們越來越多地將我們在歷史上討論過的平台和德克今天談到的平台結合在一起。因此，想想家庭和社區正在幫助我們將基於價值的結構帶給更廣泛的人群，並更全面地為我們在 OptumCare 服務的人提供服務。

So you'll hear me talking a lot about OptumHealth and our capitated and value-based [risk labs] because increasingly, we're bringing all of the services; behavioral, virtual, financial as well as clinics to bear to grow our value-based population.

所以你會聽到我談論很多關於 OptumHealth 和我們的資本化和基於價值的[風險實驗室]，因為我們越來越多地提供所有服務；行為、虛擬、金融以及診所來增加我們以價值為基礎的人口。

Next, we'll hear from Nathan Rich of Goldman Sachs.

接下來，我們將聽取高盛的 Nathan Rich 的消息。

I think non-COVID utilization has been running a bit below baseline this year, but you mentioned kind of care pattern is continuing to normalize. How are you thinking about that concept of normalization for both the fourth quarter? And can you maybe just talk about the factors that you think could have the biggest impact on the recovery in non-COVID utilization volumes as we get into next year?

我認為今年非 COVID 的利用率一直低於基線，但你提到的護理模式正在繼續正常化。您如何看待第四季度的正常化概念？您能否談談您認為在我們進入明年時可能對非 COVID 使用量的恢復產生最大影響的因素？

Yes. Listen, Nathan, thanks for the question. As I said a little earlier, I think a good way to think about this is what has historically been a COVID narrative becomes much more a blended narrative around things like capacity constraints in the system, the cost of living, the folks' ability to -- or desire to access the system right now, which is an area we are working super hard to try and ensure is sustained.

是的。聽著，內森，謝謝你的提問。正如我之前所說，我認為思考這個問題的一個好方法是，歷史上的 COVID 敘述變得更像是一個混合敘述，圍繞系統中的容量限制、生活成本、人們的能力—— - 或希望立即訪問該系統，這是我們正在努力嘗試並確保持續的領域。

Plus, of course, volatility in things like COVID and flu, particularly as you go through Q4, Q1 over the next few months. So I think all of that is essentially in the mix. We're taking, I think, a reasonably balanced view of how this is going to play out. We've seen now for the bulk of this year, a reasonably stable pattern of care utilization across the portfolio.

此外，當然還有 COVID 和流感等事物的波動性，尤其是在接下來的幾個月中經歷第四季度和第一季度時。所以我認為所有這些本質上都是混合的。我認為，我們正在對這將如何發揮作用採取合理平衡的觀點。在今年的大部分時間裡，我們已經看到整個投資組合的護理利用模式相當穩定。

We're taking a normal year view for flu. So we're not particularly staking ourselves out to say flu is either going to be very low, as we've seen in the last couple of years, or very high. We just don't know. There's really no evidence to support any decision at this point in time. So we've taken a very balanced view as we look forward into flu, which, as you well know, can affect Q4s or Q1s differentially year-to-year.

我們對流感的看法是正常的。因此，我們並沒有特別強調說流感要么會非常低，就像我們在過去幾年看到的那樣，要么會非常高。我們只是不知道。目前確實沒有證據支持任何決定。因此，我們在展望流感時採取了非常平衡的觀點，眾所周知，流感會逐年對第四季度或第一季度產生不同的影響。

And that's essentially how we're tackling all of this. We feel very confident about the way we're planning for the next quarter and particularly as we roll into next year. And obviously, we'll course correct as things like flu reveal themselves to us. Thanks for the question. Next question.

這就是我們解決所有這些問題的方式。我們對下一季度的計劃方式非常有信心，特別是在我們進入明年的時候。顯然，當流感之類的事情向我們展示時，我們當然會糾正。謝謝你的問題。下一個問題。

Justin Lake, Wolfe Research.

賈斯汀湖，沃爾夫研究。

A couple of membership questions. First, I would love to hear your thoughts on the potential for what happens with Medicaid membership in your mind post redeterminations kind of starting? And then any kind of early view on Medicare Advantage, given the open enrollment kicked in here, what do you think for 2023 in terms of the market?

幾個會員問題。首先，我很想听聽您對重新決定開始後您腦海中的醫療補助會員資格可能會發生什麼的想法？然後是任何關於 Medicare Advantage 的早期觀點，鑑於這裡開始開放招生，您對 2023 年的市場有何看法？

Thanks, Justin. So I'll ask Tim Spilker and then Tim Noel to comment in a second. Just a couple of kind of introductory thoughts really on your questions. As I said in my prepared comments at the beginning of the call, Justin, redeterminations is a really important potential issue for next year and is something that, as an organization, we are going to -- we are really leaning into.

謝謝，賈斯汀。所以我會請 Tim Spilker 和 Tim Noel 稍後發表評論。關於您的問題，只有幾種介紹性的想法。正如我在電話會議開始時準備好的評論中所說的那樣，賈斯汀，重新決定是明年一個非常重要的潛在問題，作為一個組織，我們將要這樣做——我們真的很傾向於這樣做。

We're very focused on, and that's because we're concerned that through a redetermination cycle during '23 and '24, depending on when the public health emergency comes to an end, could lead to a situation where folks get dislodged from their coverage. And that would be a huge setback in terms of the progress that's been made over the last many years to extend coverage.

我們非常關注，這是因為我們擔心通過 23 年和 24 年的重新確定週期，取決於公共衛生緊急事件何時結束，可能會導致人們被排除在他們的保險範圍之外.就過去多年擴大覆蓋範圍所取得的進展而言，這將是一個巨大的挫折。

So we are really focused on how we can ensure that people are retaining coverage. Tim will talk in a second around some of the ways in which we feel confident we can help but it is a really important area, and it's an area where we hope the entire industry and its participants all lean in to make sure that people don't get lost in the system as things go through a redetermination cycle.

因此，我們真正專注於如何確保人們保留覆蓋範圍。蒂姆將在稍後談論我們有信心可以提供幫助的一些方式，但這是一個非常重要的領域，我們希望整個行業及其參與者都參與其中，以確保人們不這樣做'當事情經歷一個重新確定的周期時，不會迷失在系統中。

So that's going to be a super important area. Let me ask Tim Spilker to go a little deeper on that and then pass it straight to Tim Noel to talk about open enrollment. Go ahead.

所以這將是一個非常重要的領域。讓我請蒂姆·斯皮爾克（Tim Spilker）再深入一點，然後直接將其傳遞給蒂姆·諾爾（Tim Noel）來談論公開招生。前進。

Yes. Thanks for the question. So first, maybe just some of the numbers. So we're assuming the PHE will end in January and redeterminations will resume in Q1. And we'll share more detail in November around the specifics, but we're very respectful of a variety of factors that are in play.

是的。謝謝你的問題。所以首先，也許只是一些數字。因此，我們假設 PHE 將在 1 月結束，重新確定將在第一季度恢復。我們將在 11 月分享更多細節，但我們非常尊重各種正在發揮作用的因素。

Certainly the pacing that will vary by state. And then, of course, how consumers respond and behave in terms of the change. So as Andrew mentioned, we're working hard with our customers. This will be a big lift for states, a really long-term effort over the course of 12 to 14 months. So we're trying to do our part through data sharing, through outreach to consumers, engaging communities, engaging providers and then really connecting with individuals where they access care, so places like pharmacies.

當然，節奏會因州而異。然後，當然，消費者在變化方面的反應和行為方式。正如安德魯所說，我們正在與客戶一起努力。這對各州來說將是一個巨大的提升，是 12 到 14 個月的長期努力。因此，我們正努力通過數據共享、與消費者接觸、參與社區、與提供者互動，然後真正與他們獲得醫療服務的個人建立聯繫，例如藥店等地方，儘自己的一份力量。

So we're proud of that work, and we're proud of our ability to be able to support members as they go through this change. With that, I'll hand it over to Tim.

因此，我們為這項工作感到自豪，我們為能夠在成員經歷這一變化時為他們提供支持而感到自豪。有了這個，我會把它交給蒂姆。

Yes. Justin, thanks for the question. Tim Noel here. So first, if I may start just with kind of an end cap on 2022. John mentioned in the opening remarks that right now, we've grown about 800,000 Medicare lives and that's consistent with the guidance we gave at our investor conference last year, and we are on pace to end this year '22 with full year growth of 900,000 lives.

是的。賈斯汀，謝謝你的問題。蒂姆·諾埃爾在這裡。所以首先，如果我可以從 2022 年的結束上限開始。約翰在開場白中提到，現在，我們已經增加了大約 800,000 名醫療保險人的生命，這與我們去年在投資者會議上給出的指導一致，我們正在努力以 900,000 條生命的全年增長結束今年 '22。

So feel good about the way our value proposition has resonated in '22 and feel like that momentum will head into 2023. So great feedback from the broker community around our product positioning, how we're investing, our emphasis on investments in the most utilized benefits like drugs and like dental benefits. So feel very good heading into AEP tomorrow.

因此，我們對我們的價值主張在 22 年引起共鳴的方式感覺良好，並且感覺這種勢頭將持續到 2023 年。經紀人社區對我們的產品定位、我們的投資方式、我們對投資最常用的投資的重視程度非常好像藥物和牙科福利一樣的好處。所以明天進入 AEP 感覺非常好。

With respect to the industry, over the long-term basis, we've kind of guided to 8% to 9% Medicare Advantage industry growth. I don't have any reason to see it differently from this vantage point for 2023. And once again, I like my chances to outperform the industry in '23 and have share gaining growth.

就行業而言，從長期來看，我們已經將 Medicare Advantage 行業的增長引導至 8% 至 9%。從 2023 年的這個有利位置來看，我沒有任何理由對此有所不同。再一次，我希望自己有機會在 23 年超越行業並獲得份額增長。

Stephen Baxter of Wells Fargo.

富國銀行的斯蒂芬·巴克斯特。

Wanted to ask about OptumInsight. As you work to grow this business and add new anchor partners, I would love to hear what you're hearing from your health system customers given the challenges they're facing? How is the pipeline developing? Can you remind us, I guess, how much revenue coverage you have for next year at this point?

想問問OptumInsight。在您努力發展這項業務並增加新的主要合作夥伴時，鑑於他們面臨的挑戰，我很想听聽您從衛生系統客戶那裡聽到的信息？管道發展如何？你能提醒我們，我猜，你明年的收入覆蓋率是多少？

And then just lastly, any update on expectations for change accretion post the divestiture of claims expense?

最後，關於剝離索賠費用後的變化增長預期的任何更新？

Stephen, thanks so much for the question. I'm going to ask Dan Schumacher to respond to the first part of that question, and John Rex will pick up the point on the change accretion piece. So Dan, go ahead.

斯蒂芬，非常感謝這個問題。我將請 Dan Schumacher 回答該問題的第一部分，John Rex 將在變化累積部分上指出這一點。所以丹，繼續。

Sure. Thank you, Steve. Appreciate the question. Obviously, health system partners are under a lot of pressure. And we talked about some of them from the macroeconomic backdrop in terms of shifting side of care and labor shortages, wage inflation, things like that. So as we engage with the market, we find that health systems are very responsive because we present an opportunity to be able to address some of those short-term needs, but then really importantly, on the mid- to long term, we become a key accelerant in some of their transformation initiatives, things like their preparedness for value-based care as an example, or how they engage digitally with patients.

當然。謝謝你，史蒂夫。欣賞這個問題。顯然，衛生系統合作夥伴承受著很大的壓力。我們從宏觀經濟背景中談到了其中一些問題，比如護理和勞動力短缺、工資通脹等方面的轉變。因此，當我們與市場打交道時，我們發現衛生系統反應迅速，因為我們提供了一個能夠滿足其中一些短期需求的機會，但真正重要的是，從中長期來看，我們將成為他們的一些轉型計劃中的關鍵促進因素，例如他們對基於價值的護理的準備，或者他們如何與患者進行數字化互動。

And so those are some of the areas that we've been expanding our reach. We have a robust pipeline, and that pipeline has been growing and conversations have been advancing. And what's been really encouraging is from our existing relationships, we've been able to drive really strong outcomes, and that gives us confidence around the performance. And so we're excited to see how that develops over time and that will continue to be a contributor.

因此，這些是我們一直在擴大影響範圍的一些領域。我們有一個強大的管道，並且該管道一直在增長，並且對話一直在推進。真正令人鼓舞的是我們現有的關係，我們已經能夠取得非常強勁的成果，這讓我們對業績充滿信心。因此，我們很高興看到它隨著時間的推移如何發展，並將繼續成為貢獻者。

In terms of our backlog, it represents about 1/4 of our backlog and not surprisingly less in terms of current revenue contribution. And as it relates to coverage into next year, we have well north of half coverage on revenue as we look into next year.

就我們的積壓而言，它約占我們積壓的 1/4，就當前的收入貢獻而言，不足為奇。而且由於它與明年的覆蓋率有關，因此在我們展望明年時，我們的收入覆蓋率遠遠超過一半。

Thanks, Dan. John?

謝謝，丹。約翰？

Yes. On accretion for Change, so yes, it will be accretive next year. In terms of the magnitude of that, really, the important factors and considerations are when it closes within the year, certain expectations in terms of the integration costs that we will -- and investments we will like to make in the business and when we get that done earlier in the year versus later in the year for a close and then what it has in terms of impact on the out year, an important consideration as we bring that in, I think of a full out year view.

是的。關於變革的增值，所以是的，明年它將是增值的。就其規模而言，實際上，重要的因素和考慮因素是它何時在年內結束，對我們將要進行的整合成本的某些預期 - 以及我們希望在業務中進行的投資以及我們何時獲得這是在今年早些時候完成的，而不是在今年晚些時候完成的，然後是它對未來一年的影響，這是我們引入這一點時的一個重要考慮因素，我想到了一個全年的觀點。

Also, as I'm sure you are very aware, the divestiture that occurred in terms of -- with the closing also having an impact on the magnitude of that. So 2 important things there. Maybe just actually knowing that you've got models to do here also and as you think about it, 4Q and how that might play in the 4Q.

此外，我相信你非常清楚，發生的資產剝離 - 關閉也對剝離的幅度產生了影響。所以有兩件重要的事情。也許只是實際上知道您在這裡也有模型要做，並且當您想到它時，4Q 以及它在 4Q 中可能會如何發揮作用。

So we wouldn't expect Change to be additive to OptumInsight's operating earnings in the fourth quarter. A few elements on that. One, the second half for Change is, I know you understand well, is it's lower half seasonally in terms of earnings. First half typically considerably stronger than the second half.

因此，我們預計 Change 不會增加 OptumInsight 第四季度的營業收入。一些元素。一，Change 的後半部分，我知道你很清楚，就收入而言，它是季節性的下半部分。上半年通常比下半年強得多。

So the impact there and how that comes in. Clearly, there will be transaction costs that we'll be incurring here. So really, as you think about your modeling purposes, roughly in the zone of $800 million of revenue coming in to the OptumInsight segment without any impact on operating earnings. And of course, coming back on my comments is how we think about impact going forward.

所以那裡的影響以及它是如何產生的。顯然，我們將在這裡產生交易成本。所以真的，當你考慮你的建模目的時，大約有 8 億美元的收入進入 OptumInsight 部門，而不會對運營收益產生任何影響。當然，回到我的評論是我們如何看待未來的影響。

We will look to the point -- to the extent possible, do any acceleration on other important integration activities. So we can bring the potential benefits of the combination of OptumInsight and Change the health system more quickly, could see that potentially in the over $100 million in terms of incremental cost that we might look to do and pull that ahead.

我們將著眼於這一點——在可能的範圍內，對其他重要的整合活動進行任何加速。因此，我們可以更快地帶來 OptumInsight 和 Change the health system 組合的潛在好處，可以看到我們可能希望做的超過 1 億美元的增量成本，並將其推進。

But all of that is incorporated in the 2020 -- in the outlook that we provided this morning, the '22 outlook and our '23 observations also.

但所有這些都包含在 2020 年——我們今天早上提供的展望、'22 展望和我們的 '23 觀察中。

Thanks, John. And I think John tees up a really important point that I just want to reemphasize, which is within the guidance we've given you today for the closeout of '22 and '23, not only are we anticipating obviously continued very strong growth in revenues and the consequential flow through the business, but you're also seeing us create the space to make sure we can make the right investments.

謝謝，約翰。而且我認為約翰提出了一個非常重要的觀點，我只想再次強調，這在我們今天為 22 年和 23 年結束時為您提供的指導範圍內，我們不僅預計收入顯然會持續強勁增長以及隨之而來的業務流程，但您也看到我們創造空間以確保我們能夠做出正確的投資。

So whether that's in making sure we get the integration of change done as promptly as we can, whether it's how we invest in our consumer capabilities, which really started to get going in Q3 and will continue through Q4 and beyond or whether it's increasing our investment in our employees to make sure that we're responsive to the cost-of-living pressures.

因此，無論是確保我們盡快完成變革的整合，還是我們如何投資於我們的消費者能力，這在第三季度真正開始並將持續到第四季度及以後，或者它是否增加了我們的投資在我們的員工中，以確保我們能夠應對生活成本壓力。

So really important that you see that and very much taken into consideration as we thought through our work going forward. The other thing I would just also add is that I don't want to -- I think you all understand how important the Change integration is for OptumInsight. This is -- it's a great moment to bring together tremendous complementary skills, capabilities, technologies, perspectives on the marketplace.

非常重要的是，您看到這一點並在我們思考我們未來的工作時非常重視這一點。我還要補充的另一件事是我不想——我想你們都明白變更集成對於 OptumInsight 的重要性。這是 - 這是一個將巨大的互補技能、能力、技術和市場觀點結合在一起的好時機。

And so as we roll through the next 2 or 3 quarters, we really anticipate a kind of new OptumInsight emerging from this integration. And we're very excited to have Neil de Crescenzo as well as Dan Schumacher working together to lead these 2 organizations as this work goes on. So a lot of energy potentially being released in this space. And as John said, we've incorporated into our guidance points the space to potentially make the right investments going forward.

因此，在接下來的 2 或 3 個季度中，我們真的預計這種整合會出現一種新的 OptumInsight。我們很高興 Neil de Crescenzo 和 Dan Schumacher 一起工作，在這項工作繼續進行時領導這兩個組織。所以很多能量可能會在這個空間中釋放出來。正如約翰所說，我們已經將未來可能做出正確投資的空間納入我們的指導點。

Scott Fidel of Stephens.

斯蒂芬斯的斯科特·菲德爾。

I know that continuity of care has been a big focus here, especially with redeterminations coming back. And just interested in that context how you're thinking about potential footprint expansions in the ACA exchanges for 2023 and beyond. It looks like also there has been some favorable policy developments and then some competitive changes to that could be positive for the market. So just interested in your thinking on exchange strategy for both next year and longer term.

我知道護理的連續性一直是這裡的一個重點，尤其是在重新確定的情況下。只是對這種情況感興趣，您如何考慮 2023 年及以後 ACA 交易所的潛在足跡擴展。看起來也有一些有利的政策發展，然後一些競爭性變化可能對市場有利。所以只是對你對明年和長期交易策略的思考感興趣。

No, I really appreciate that question. As you know, this is an area where we've been building up very substantially over the last couple or 3 years and maybe ask Brian to give you a little bit more detail on that.

不，我真的很感激這個問題。如您所知，這是我們在過去幾年或三年中一直在大力建設的領域，也許請 Brian 為您提供更多詳細信息。

Sure, Andrew. Thanks for the question, Scott. And we agree totally. We see the exchanges is really emerging as a meaningful place and a broader coverage criteria across this country. And it's certainly important to us to be more relevant each and every year.

當然，安德魯。謝謝你的問題，斯科特。我們完全同意。我們看到，交易所確實正在成為一個有意義的地方，並且在這個國家擁有更廣泛的覆蓋標準。對我們來說，每年都更加相關當然很重要。

In fact, while we're expanding into 4 new states in 2023, our footprint is expanding meaningfully. I think we're going from around 40% of the addressable market here, leaving 2022 to nearly 2/3 by the end of next year and again -- or by the start of next year, I should suggest. So again, reasons aligned with yours. It's important that we are where folks are.

事實上，雖然我們將在 2023 年擴展到 4 個新州，但我們的足跡正在顯著擴大。我認為我們將從這裡的潛在市場的 40% 左右，到 2022 年到明年年底再到近 2/3 - 或者到明年年初，我應該建議。再說一次，原因與您的一致。重要的是我們在人們所在的地方。

And as we manage through this redetermination process working not only with our employer partners or distribution partners in our states, but making sure we have product ourselves to make sure that these folks can get enrolled in. And we're encouraged by our progress. We like how we're positioned here, leaving 2022 both from a footprint and receptivity and growth and a performance perspective and looking forward to expanding again in '23.

當我們通過這個重新確定過程進行管理時，不僅與我們在我們州的雇主合作夥伴或分銷合作夥伴合作，而且確保我們自己有產品以確保這些人可以加入。我們對我們的進步感到鼓舞。我們喜歡我們在這裡的定位，從足跡、接受度、增長和績效的角度來看，離開 2022 年，並期待在 23 年再次擴張。

Great. Thanks so much, Brian. Thank you for that question.

偉大的。非常感謝，布賴恩。謝謝你的問題。

Kevin Fischbeck of Bank of America.

美國銀行的凱文·菲施貝克。

Great. I want to go back to trend, again, if I can. Can you give a little more color in the quarter about how trends looked across the 3 different payers? And when you talk about normalization in 2023, should we expect all 3 of them to be kind of back to normal?

偉大的。如果可以的話，我想再次回歸潮流。您能否在本季度進一步說明 3 個不同付款人的趨勢如何？當你談到 2023 年的正常化時，我們是否應該期望它們三個都恢復正常？

Or do you have a view that the government, which has been lagging a little bit, will still kind of take a little bit longer to get back to normal?

或者您是否認為政府已經滯後了一點，仍然需要更長的時間才能恢復正常？

Kevin, thanks so much for the question. Maybe I'll ask Brian to make a couple of comments on that.

凱文，非常感謝這個問題。也許我會請Brian 對此發表一些評論。

Sure. Thanks for the question, Kevin. Maybe I'll start with service type, and it's really a focus on inpatient, that has been the driver, and it really was the driver last quarter as well. So when I look at third quarter, it's largely a repeat of what we saw in the second quarter.

當然。謝謝你的問題，凱文。也許我會從服務類型開始，它實際上是對住院病人的關注，這一直是驅動程序，上個季度也是真正的驅動程序。因此，當我查看第三季度時，它在很大程度上是我們在第二季度看到的重複。

Beyond inpatient, some variation, I would say, all other service types so largely near, at, or even slightly above normal levels. To your question, now, on lines of business, I might just suggest other than inpatient commercial, pretty much at normal care patterns. Medicare is seeing some interesting developments. I'd say maybe signs of more durable shifts inside of service, particularly urgent care is a little lower -- excuse me, a little higher, but ER is a little lower, and that's certainly a good trade for the system overall.

除了住院病人，我想說的是，所有其他服務類型都在很大程度上接近、達到甚至略高於正常水平。對於你的問題，現在，在業務範圍內，我可能只是建議除了住院商業以外，幾乎是正常的護理模式。醫療保險正在看到一些有趣的發展。我想說也許服務內部更持久的轉變跡象，特別是緊急護理有點低 - 對不起，有點高，但 ER 有點低，這對於整個系統來說肯定是一個很好的交易。

Outpatient surgeries in Medicare seem to be back to normal. But again, as I had mentioned, inpatient a little bit lower. And again, Medicaid, consistent with the other lines of business, lower in inpatient and physicians starting to trend back.

Medicare 的門診手術似乎已恢復正常。但同樣，正如我所提到的，住院人數要低一些。同樣，與其他業務一致，醫療補助在住院病人和醫生中的比例開始下降。

So again, that's largely a repeat of what I had suggested last quarter inpatient really being the most notable element inside it.

再說一次，這在很大程度上重複了我在上個季度提出的建議，住院病人確實是其中最值得注意的元素。

Brian, thanks so much, and thank you for the question, Kevin.

布萊恩，非常感謝，謝謝你的問題，凱文。

Next we have from Lisa Gill of JPMorgan.

接下來是摩根大通的 Lisa Gill。

When we think about membership in the commercial market, I'm just curious how employers are currently talking to you about that trend going into '23. And if you can just give us an update on your thoughts around if we move into a recessionary type of environment what that could mean for the health plan business?

當我們考慮商業市場的會員資格時，我只是好奇雇主目前如何與您談論進入 23 年的趨勢。如果我們進入衰退類型的環境，您可以向我們提供您的最新想法，這對健康計劃業務意味著什麼？

Lisa, thanks so much for the question. And I'll pass that actually to our new Head of ENI, our commercial insurance business, (inaudible) Dan, would you like to answer that?

麗莎，非常感謝這個問題。我將把它轉達給我們的新 ENI 負責人，我們的商業保險業務，（聽不清）Dan，你願意回答這個問題嗎？

Yes. Thanks, Andrew, for the introduction. And Lisa, thanks for the question. As you know, at this point in the year, our national accounts business for 2023 is largely resolved, but the other segments of our business are not resolved. As we look at that national accounts performance, we're very pleased with what we've seen in terms of a very strong renewal year and also a strong sales year, which leaves us confident in a growth year for national accounts for 2023.

是的。謝謝安德魯的介紹。還有麗莎，謝謝你的問題。如您所知，今年這個時候，我們2023年的國民賬戶業務基本解決了，但我們業務的其他部分還沒有解決。當我們看到國民賬戶的表現時，我們對我們看到的非常強勁的續約年和強勁的銷售年感到非常滿意，這讓我們對 2023 年國民賬戶的增長充滿信心。

The other lines of the business are yet to resolve. Specifically related to your question about recessionary impacts, we're certainly well aware of those. However, I would note at this point, based on our Q3 performance, we have seen net hiring among our customers. So we have not yet seen an emergence of recessionary impact in our commercial book of business.

其他業務線尚未解決。特別是關於你關於衰退影響的問題，我們當然很清楚這些。但是，我現在要指出，根據我們第三季度的表現，我們已經看到客戶的淨招聘。因此，我們的商業業務賬簿中尚未出現衰退影響。

Looking forward to 2023, we will assess the continued evolving economic situation and provide additional guidance as that becomes more clear. Thanks for the question, Lisa.

展望 2023 年，我們將評估持續變化的經濟形勢，並在形勢變得更加清晰時提供更多指導。謝謝你的問題，麗莎。

Dan, thanks so very much for that and Lisa, thank you for the question. So last question, please, operator.

丹，非常感謝，麗莎，謝謝你的問題。最後一個問題，請接線員。

Absolutely. Our final question for today will come from Gary Taylor of Cowen.

絕對地。我們今天的最後一個問題將來自 Cowen 的 Gary Taylor。

I just want to come back to '23 for a moment. I think the current Street consensus is about 13% earnings growth off your updated '22 guidance. And I was hoping maybe this would be a year where you wouldn't have to say initially that look to be at the high end of the initial range.

我只想回到 23 年。我認為當前的華爾街共識是，與您更新的 '22 指導相比，收益增長約為 13%。而且我希望這可能是您不必說最初看起來處於初始範圍的高端的一年。

And obviously, I understand guidance has often come up over the course of the year. But when I think about '23, I just want to make sure I'm capturing what you're saying. You talked about redeterminations. You talked about some incremental investments in consumer and employees. And you also talked about, I think, just sort of healthy respect, as you might call it, for maybe utilization continuing to normalize.

顯然，我理解在這一年中經常出現指導。但是當我想到 23 年時，我只想確保我能捕捉到你在說什麼。你談到了重新決定。您談到了對消費者和員工的一些增量投資。我認為，您還談到了一種健康的尊重，正如您所說的那樣，也許使用率會繼續正常化。

Could you rank those for us in terms of how you're thinking those headwinds weigh on '23 a little bit? Is there anything else you would say is material enough to add to that list?

您能否根據您認為這些逆風對 23 年的影響如何為我們排名？你還有什麼要說的足夠重要的東西可以添加到該列表中嗎？

Gary, thanks so much for the question. I mean if you kind of just think about the blend of headwinds, tailwinds for 2023. In terms of headwinds, I'd probably say the external environment, the inflationary pressures, obviously, in among that mix. Question on whether or not we see any kind of economic slowdown. As you just heard, we're not really seeing that yet in terms of our marketplace, but we've got to be thoughtful about that, and we want to make sure that we go into the year, not assuming anything overly optimistic.

加里，非常感謝這個問題。我的意思是，如果你只是考慮一下 2023 年的逆風和順風的混合。就逆風而言，我可能會說外部環境和通脹壓力，顯然是其中之一。關於我們是否看到任何形式的經濟放緩的問題。正如您剛剛聽到的那樣，就我們的市場而言，我們還沒有真正看到這一點，但我們必須對此深思熟慮，我們希望確保我們進入這一年，不要假設任何過於樂觀的事情。

It would be great to have pleasant surprises on that dimension, of course. Utilization levels, I spent a lot of time on this call talking about that as we start to see that continue to normalize. And then the investments. I mean those are really the 4 areas of investments in our business and you recited those very nicely. Now on the other side, you think about the tailwinds for the business.

當然，在那個維度上有驚喜會很棒。利用率水平，我在這次電話會議上花了很多時間談論這個，因為我們開始看到它繼續正常化。然後是投資。我的意思是，這確實是我們業務的 4 個投資領域，您很好地背誦了這些內容。現在在另一方面，您考慮業務的順風。

Very strong income and momentum for the organization. OptumHealth's growth in patients served, the evolution of the at-home platform, which has got over the last 2.5, 3 years, has moved to a very significant scale, complementing our clinic platform strong capabilities that we're demonstrating in Medicare Advantage.

該組織的收入和動力非常強勁。 OptumHealth 服務的患者數量增長，過去 2.5 年、3 年的家庭平台發展已達到非常顯著的規模，補充了我們在 Medicare Advantage 中展示的臨床平台強大能力。

You look at those really driving tailwinds for the organization, very substantial. The scale of those organizations and what we're able to do very material. And then I'd also say our ability to continue to deploy capital effectively in the marketplace is another one of the things to really think about. And it's interesting, actually, just to pause for a second today and contrast where we are today versus where we were a year ago.

您會看到那些真正為組織帶來好處的因素，非常可觀。這些組織的規模以及我們能夠做的事情非常重要。然後我還要說，我們繼續在市場上有效部署資本的能力是另一個需要真正考慮的事情。實際上，有趣的是，今天暫停一下，對比一下我們今天和一年前的情況。

So year-to-date, 2021, we have deployed about $5 billion of capital in M&A., which was about the full year number in the end. As of today, we've spent $20 billion in 2022. So in terms of our ramp-up of capital deployment, and you heard from John Rex earlier, we have very substantial continued capacity. And obviously, the marketplace is getting interesting around that space. We've talked several times to you in the past about the diverse pipeline of opportunities that we see, probably a diverse as we've ever seen.

因此，到 2021 年為止，我們已經在併購中部署了大約 50 億美元的資金，這大約是年底的全年數字。截至今天，我們在 2022 年已經花費了 200 億美元。因此，就我們增加資本部署而言，您之前從 John Rex 那裡聽說過，我們擁有非常可觀的持續產能。顯然，市場在這個領域變得越來越有趣。過去，我們曾多次與您討論過我們看到的各種機會管道，可能是我們所見過的各種機會。

Very much opportunities we see across a number of our key growth platforms. And as we all know, the market is beginning to be very discriminating in terms of value. So we'll see how that plays out for us, but I think you have to expect that to be a tailwind for us as well going into next year.

我們在許多關鍵增長平台上看到了很多機會。眾所周知，市場在價值方面開始變得非常歧視。所以我們會看看這對我們有什麼影響，但我認為你必須期待這對我們來說是一個順風，以及進入明年。

With that, Gary, thanks so much for the question. And thanks, everybody, for your time and questions today. We do hope you're taking away the impression of a company confident in its opportunities and ability to grow. Deeply aware of where and how we need to continue to build and improve and fully committed to our mission of helping people live healthier lives and helping make the health system work better for everyone.

有了這個，加里，非常感謝這個問題。感謝大家今天的時間和問題。我們確實希望您能消除公司對其機會和發展能力充滿信心的印象。深刻意識到我們需要在哪里以及如何繼續建設和改進，並完全致力於幫助人們過上更健康的生活和幫助使衛生系統更好地為每個人服務的使命。

I want to thank you for your attention, and we look forward to meeting many of you in person in New York later in the quarter. Thank you.

我要感謝您的關注，我們期待在本季度晚些時候在紐約與你們中的許多人見面。謝謝你。

And that does conclude today's conference. Thank you all for your participation. You may now disconnect.

這確實結束了今天的會議。謝謝大家的參與。您現在可以斷開連接。