聯合健康 (UNH) 2023 Q1 法說會逐字稿

Good morning and welcome to the UnitedHealth Group First Quarter 2023 Earnings Conference Call. A question-and-answer session will follow UnitedHealth Group's prepared remarks. As a reminder, this call is being recorded.

早上好，歡迎來到聯合健康集團 2023 年第一季度收益電話會議。問答環節將遵循 UnitedHealth Group 準備好的評論。提醒一下，此通話正在錄音中。

Here is 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 description of some of the risks and uncertainties can be found in the reports that we file with the Securities and Exchange Commission, including the cautionary statements including -- included in our current and periodic filings.

這裡有一些重要的介紹信息。本次電話會議包含美國聯邦證券法規定的前瞻性陳述。這些陳述受風險和不確定因素的影響，這些風險和不確定因素可能導致實際結果與歷史經驗或當前預期存在重大差異。在我們向美國證券交易委員會提交的報告中可以找到對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告聲明。

This call will also reference non-GAAP amounts. A reconciliation of the non-GAAP to GAAP amounts is available on the financial and earning reports section of the company's Investor Relations page at www.unitedhealthgroup.com. Information presented on this call is contained in the earnings release we issued this morning and Form 8-K dated April 14, 2023, which may be accessed from the Investor Relations page of the company's website.

此調用還將參考非 GAAP 金額。非 GAAP 與 GAAP 金額的對賬可在公司投資者關係頁面 www.unitedhealthgroup.com 的財務和收益報告部分找到。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報告和日期為 2023 年 4 月 14 日的 8-K 表格中，可從公司網站的投資者關係頁面訪問。

I will now turn the conference over to the Chief Executive Officer of UnitedHealth Group, Andrew Witty.

我現在將會議轉交給 UnitedHealth Group 的首席執行官 Andrew Witty。

Thank you. Good morning and thank you all for joining us today. Growth in the quarter was strong and well balanced across Optum and UnitedHealthcare with revenue increasing 15% to $92 billion. This broad-based growth, combined with the continued focus of our colleagues on tight execution, helped us deliver first quarter adjusted earnings per share of $6.26, up 14% over last year.

謝謝。早上好，感謝大家今天加入我們。本季度 Optum 和 UnitedHealthcare 的增長強勁且均衡，收入增長 15% 至 920 億美元。這種基礎廣泛的增長，加上我們同事對嚴格執行的持續關注，幫助我們實現了第一季度調整後每股收益 6.26 美元，比去年增長 14%。

Year-to-date, UnitedHealthcare increased the number of people served in the U.S. by 1.2 million, about half of this total within our commercial offerings. At OptumHealth, we're now serving nearly 700,000 more patients under fully accountable value-based arrangements compared to just December 2022.

年初至今，UnitedHealthcare 在美國的服務人數增加了 120 萬，約占我們商業服務總數的一半。在 OptumHealth，與 2022 年 12 月相比，我們現在在基於價值的全面負責安排下為近 700,000 名患者提供服務。

Given the strength of these results, we're increasing our adjusted earnings per share outlook for the full year to a range of $24.50 to $25 per share.

鑑於這些業績的強勁表現，我們將調整後的全年每股收益預期上調至每股 24.50 美元至 25 美元。

I know one topic is front of mind for you this morning. So I'll start with Medicare Advantage. With the 2024 Medicare Advantage notice in hand, we now have greater clarity for the short- to midterm evolution of this important program. Our teams are working through the implications of the changes for 2024 and we'll be ready to submit bids in just a few weeks.

我知道今天早上您首先想到的是一個話題。所以我將從 Medicare Advantage 開始。有了 2024 年 Medicare Advantage 通知，我們現在對這一重要計劃的短期到中期發展有了更清晰的認識。我們的團隊正在研究 2024 年變化的影響，我們將在短短幾週內準備好提交投標。

While we remain concerned about some of the potential unintended consequences of the changes of the risk adjustment model, particularly around adequate diagnosis and support for people with diabetes, complex behavioral needs and more, we do appreciate CMS' decision to phase-in the changes. This phase-in will allow for more time to minimize the impacts on beneficiaries as we lean on the multiple levers available to us, including our ability to manage costs and our relentless focus on member and patient needs.

雖然我們仍然擔心風險調整模型變化的一些潛在意外後果，特別是圍繞對糖尿病患者的充分診斷和支持、複雜的行為需求等，但我們非常感謝 CMS 分階段實施這些變化的決定。由於我們依靠可用的多種槓桿，包括我們管理成本的能力以及我們對會員和患者需求的不懈關注，因此這一階段將留出更多時間來最大程度地減少對受益人的影響。

We expect the many years of work and investment our teams have put into products and value differentiation as well as quality measures such as Star scores will enable us to continue to offer leading value to Medicare beneficiaries and to grow strongly for years to come. We're committed to working with CMS as stewards of the MA program, especially with its long-stated goal of promoting value-based care, which remains the best solution to promote equitable access, better health care outcomes, exceptional experiences and lower cost for the system.

我們預計，我們的團隊多年來在產品和價值差異化以及星級評分等質量指標方面的工作和投資，將使我們能夠繼續為 Medicare 受益人提供領先的價值，並在未來幾年實現強勁增長。我們致力於作為 MA 計劃的管理者與 CMS 合作，特別是其長期制定的促進基於價值的護理的目標，這仍然是促進公平獲取、更好的醫療保健結果、卓越的體驗和更低的成本的最佳解決方案系統。

And importantly, it best supports people who have historically been underserved and who face fragmented, less effective care under traditional fee-for-service.

重要的是，它最好地支持那些歷來服務不足的人，以及在傳統的按服務收費的情況下面臨碎片化、效率低下的護理的人。

Seniors know that with MA versus fee-for-service, they can access a more integrated and comprehensive suite of critical health benefits, including prescription medicines, vision, dental and hearing care. They can seek care in more convenient settings. They experience better health outcomes, such as an over 40% lower rate of avoidable hospitalizations and consistently derive much greater value. In fact, the typical Medicare Advantage senior spent about $2,000 a year less out of pocket compared to seniors in traditional Medicare. And well over 90% of seniors in Medicare Advantage report they are highly satisfied with their coverage and care. That's why more than 30 million Americans, fully half of all seniors, choose Medicare Advantage today.

老年人知道，通過 MA 與按服務收費相比，他們可以獲得更綜合、更全面的關鍵健康福利，包括處方藥、視力、牙科和聽力保健。他們可以在更方便的環境中就醫。他們體驗到更好的健康結果，例如可避免的住院率降低了 40% 以上，並且始終獲得更大的價值。事實上，與傳統 Medicare 的老年人相比，典型的 Medicare Advantage 老年人每年自掏腰包少花 2,000 美元。超過 90% 的 Medicare Advantage 老年人表示他們對他們的保險範圍和護理非常滿意。這就是為什麼今天有超過 3000 萬美國人（佔所有老年人的一半）選擇 Medicare Advantage 的原因。

Over the past year, we focused on improving the consumer experience across our company. This consumer orientation is foundational in support of each of our growth priorities, including our approach to value-based care. For example, this year, we expect to serve more than 4 million patients in fully accountable value-based care arrangements through Optum, about double where we were at the end of 2021. These patients will be members of UnitedHealthcare benefit plans or one of the many other plans served by Optum. Many of them are in Medicare Advantage. And increasingly, we are serving people with Medicaid or commercial benefits, an important growth focus for the coming years.

在過去的一年裡，我們專注於改善整個公司的消費者體驗。這種以消費者為導向是支持我們每個增長重點的基礎，包括我們基於價值的護理方法。例如，今年，我們預計將通過 Optum 為超過 400 萬患者提供完全負責任的基於價值的護理安排，大約是 2021 年底的兩倍。這些患者將成為 UnitedHealthcare 福利計劃的成員或其中之一Optum 提供的許多其他計劃。他們中的許多人都在 Medicare Advantage 中。我們越來越多地為人們提供醫療補助或商業利益，這是未來幾年的一個重要增長重點。

We spent well more than a decade investing in essential infrastructure and offering extensive practice transition support to enable tens of thousands of care providers to participate in this comprehensive value-based approach. By integrating traditional ambulatory care with specialty, behavioral and pharmacy care across in-clinic, virtual and in-home settings, we're delivering measurably better health outcomes for patients, all while improving access and lowering costs for people and the health care system overall.

我們花了十多年時間投資基本基礎設施並提供廣泛的實踐過渡支持，使數以萬計的護理提供者能夠參與這種基於價值的綜合方法。通過將傳統的門診護理與臨床、虛擬和家庭環境中的專業、行為和藥房護理相結合，我們正在為患者提供明顯更好的健康結果，同時改善人們和整個醫療保健系統的可及性和降低成本.

Our focus on consumers is helping to drive growth within health benefits, including strong growth in our commercial offerings and our early indications are for continued robust commercial growth in 2024. From our employee-centered Surest insurance offer, to our innovative financial services for both members and care providers, to our improved pharmacy home delivery services and 0 co-pays on life-saving drugs, through all of these initiatives and more, we are firmly on track to put the member, patient and consumer at the very heart of what we do.

我們對消費者的關注有助於推動健康福利的增長，包括我們的商業產品的強勁增長，我們的早期跡象表明 2024 年商業將持續強勁增長。從我們以員工為中心的 Surest 保險產品，到我們為兩個成員提供的創新金融服務和護理提供者，到我們改進的藥房送貨上門服務和 0 救生藥物的共付額，通過所有這些舉措以及更多，我們堅定地走上了將會員、患者和消費者置於我們服務核心的軌道做。

One last note on UnitedHealthcare benefits and the resumption of Medicaid redeterminations. Now that the process has started, we're working with our state partners and others to provide as much information and support as possible so people can understand and access their best coverage options. And we expect to be serving more people in our benefit programs when this process is completed.

關於 UnitedHealthcare 福利和恢復 Medicaid 重新確定的最後一個說明。現在這個過程已經開始，我們正在與我們的州合作夥伴和其他人合作，提供盡可能多的信息和支持，以便人們能夠了解和獲得他們最好的保險選擇。當這個過程完成時，我們希望在我們的福利計劃中為更多人提供服務。

And now I'll turn it over to UnitedHealth Group President and Chief Operating Officer, Dirk McMahon. Dirk?

現在我將把它交給 UnitedHealth Group 總裁兼首席運營官 Dirk McMahon。短劍？

Thanks, Andrew. Picking up on redeterminations. For many months, we have been preparing to help people when this activity resumes, as it now has in over 20 states. We are working closely with Medicaid members to navigate eligibility guidelines and help find alternative coverage options if they are no longer Medicaid-eligible. This effort includes live outreach calls to educate and assist members with renewal process to ensure they retain their existing coverage or can transition to other plans.

謝謝，安德魯。接受重新決定。幾個月來，我們一直在準備在這項活動恢復時幫助人們，就像現在在 20 多個州所做的那樣。我們正在與 Medicaid 成員密切合作，以了解資格指南，並在他們不再符合 Medicaid 資格時幫助尋找替代保險選項。這項工作包括通過實時外展電話來教育和協助會員完成續保流程，以確保他們保留現有的承保範圍或可以過渡到其他計劃。

We are also engaged with employers to extend annual enrollment periods and drive awareness for employees who are eligible for coverage. With extended eligibility and increased subsidies, many people will qualify for other plans, some with no monthly premium. UnitedHealthcare is executing our detailed plans to ensure as many people as possible have uninterrupted access to coverage and care if they are no longer eligible for Medicaid.

我們還與雇主合作，延長每年的註冊期限，並提高有資格獲得保險的員工的意識。隨著資格的擴大和補貼的增加，許多人將有資格參加其他計劃，其中一些人無需每月支付保費。 UnitedHealthcare 正在執行我們的詳細計劃，以確保盡可能多的人在不再符合 Medicaid 資格的情況下能夠不間斷地獲得保險和護理。

Let me now turn to the opportunity we have to more deeply and effectively serve people in their homes. Nearly all of the patients we'll add this year in fully accountable value-based relationships will have access to support through our home-based platform. Consumers value and benefit from services delivered in the home and we have expanded our capabilities to serve that need. I'll highlight 4 of our key capabilities in this important area.

現在讓我談談我們必須更深入、更有效地在家中為人們服務的機會。我們今年將在完全負責任的基於價值的關係中增加的幾乎所有患者都可以通過我們的家庭平台獲得支持。消費者重視家庭服務並從中受益，我們已經擴展了滿足這一需求的能力。我將重點介紹我們在這一重要領域的 4 項關鍵能力。

First, patient assessments, in-home clinical visits designed to identify care needs and help patients with other physical and social needs. This year, we expect to make more than 2.5 million visits to patients' homes and we continue to expand the scope of the clinical services offered in that setting.

首先，患者評估、家庭臨床訪問旨在確定護理需求並幫助有其他身體和社會需求的患者。今年，我們預計到訪患者家中的次數將超過 250 萬次，並且我們將繼續擴大在該環境中提供的臨床服務範圍。

Next, care transitions. This entails supporting patients into and through post-acute settings, helping people to avoid hospital readmissions after an inpatient stay. This year, we will manage nearly 12 million care transitions, about twice as many as just 3 years ago. This plays an important role in helping people return safely home and in connecting patients with additional in-home support.

接下來，護理過渡。這需要支持患者進入和度過急性期後的環境，幫助人們避免住院後再次入院。今年，我們將管理近 1200 萬次護理過渡，大約是 3 年前的兩倍。這在幫助人們安全回家以及為患者提供額外的家庭支持方面發揮著重要作用。

Third area, senior community care. This is clinical care for seniors who live in skilled nursing and assisted living facilities and dedicated senior housing. Our clinical teams provide additional layers of care and on-call resources. And they coordinate among patients and their primary care provider, facility staff and caregivers, all contributing to strong quality of care and outcomes.

第三個領域，老年社區關懷。這是為住在熟練護理和輔助生活設施和專用高級住房中的老年人提供的臨床護理。我們的臨床團隊提供額外的護理層和隨叫隨到的資源。他們在患者及其初級保健提供者、設施工作人員和護理人員之間進行協調，所有這些都有助於提高護理質量和結果。

And the fourth area of clinical capability is individual care and coordination for Medicare dual and chronic special needs patients. These patients frequently require a more individualized approach to care. On average, these patients are managing 9 different chronic conditions and taking multiple medications. Our high-touch approach leads to better outcomes, including an over 15% reduction in hospitalizations, high patient satisfaction with an NPS of nearly 80 with 99% of our patients in a 4-star or higher plan.

臨床能力的第四個領域是針對 Medicare 雙重和慢性特殊需求患者的個體護理和協調。這些患者通常需要更加個性化的護理方法。平均而言，這些患者正在管理 9 種不同的慢性病並服用多種藥物。我們的高接觸方法帶來更好的結果，包括住院率減少 15% 以上，患者滿意度高，NPS 接近 80，我們 99% 的患者都在四星級或更高的計劃中。

Our recent combination with LHC Group expands in-home capabilities. LHC provides high-quality, compassionate home health, hospice and post-acute care services with over 12 million patient encounters each year. We will learn from and build upon LHC's capabilities, expanding the scope and acuity of the care we can provide in a patient's health.

我們最近與 LHC Group 的合併擴展了家庭服務能力。 LHC 每年接待超過 1200 萬名患者，提供優質、富有同情心的家庭健康、臨終關懷和急症後護理服務。我們將學習並藉鑑 LHC 的能力，擴大我們可以為患者健康提供護理的範圍和敏銳度。

And finally, shifting to pharmacy care services. OptumRx just completed another strong growth season. We are winning new relationships by offering the lowest cost and strong service across a wide variety of customers from health plans, to labor and governments and to commercial employers. We help customers obtain the best net cost and we use our clinical expertise to help treat conditions that call for specialty medications.

最後，轉向藥房服務。 OptumRx 剛剛完成了另一個強勁的增長季節。我們通過為從健康計劃、勞工和政府到商業雇主的廣泛客戶提供最低的成本和強大的服務來贏得新的關係。我們幫助客戶獲得最佳的淨成本，並利用我們的臨床專業知識來幫助治療需要特殊藥物的病症。

In addition, consumers are benefiting from efforts such as Price Edge, which gives them the best-price option whether on or off benefit; UnitedHealthcare's introduction last year of 0-cost life-saving drugs; and our ability to manage the introduction of biosimilars on equal footing with the existing branded product. In short, we have consumers' backs.

此外，消費者正從 Price Edge 等努力中受益，這為他們提供了最優惠的價格選擇，無論是否受益； UnitedHealthcare去年推出0成本救命藥；以及我們在與現有品牌產品同等的基礎上管理生物仿製藥引入的能力。簡而言之，我們有消費者的支持。

With that, let me hand it over to Chief Financial Officer, John Rex.

有了這個，讓我把它交給首席財務官約翰雷克斯。

Thank you, Dirk. Fundamental execution has long been an essential aspect of UnitedHealth Group's ability to deliver for all those we serve. We know that if we meet or exceed our commitments and strive to live up to our potential, we will continue to generate high-quality durable growth.

謝謝你，德克。長期以來，基本執行力一直是 UnitedHealth Group 為我們所服務的所有人提供服務的能力的一個重要方面。我們知道，如果我們達到或超越我們的承諾並努力發揮我們的潛力，我們將繼續實現高質量的持久增長。

Our first quarter performance was highlighted by the strong and accelerating growth achieved across the businesses of UHC and Optum. We accomplished this while continuing to expand upon the foundation, which will drive the future growth you have come to expect from us.

UHC 和 Optum 業務實現的強勁和加速增長突顯了我們第一季度的業績。我們在實現這一目標的同時繼續擴大基礎，這將推動您對我們的未來增長的期望。

Revenue in the first quarter of $92 billion grew by nearly $12 billion or 15% over the prior year with double-digit growth at both Optum and UnitedHealthcare. This growth was achieved by serving more people across all our businesses and importantly, by serving them more comprehensively. UnitedHealth Group served -- UnitedHealthcare served about 1.2 million more people in the first 3 months of the year with strong growth across commercial, Medicare and Medicaid. Optum revenues grew 25% to $54 billion.

第一季度的收入為 920 億美元，比上年增長近 120 億美元或 15%，其中 Optum 和 UnitedHealthcare 均實現兩位數增長。這種增長是通過為我們所有業務中的更多人提供服務而實現的，重要的是，通過更全面地為他們提供服務。 UnitedHealth Group 服務——UnitedHealthcare 在今年前 3 個月為大約 120 萬人提供服務，在商業、醫療保險和醫療補助方面實現強勁增長。 Optum 收入增長 25% 至 540 億美元。

Care patterns remain largely consistent with recent trends. For example, inpatient trends continue to reflect the growing long-term movement towards ambulatory sites of care. Today, nearly 2/3 of orthopedic procedures are performed in outpatient and other ambulatory settings compared to under 1/4 just 5 years ago. Physician office activity continues to trend toward historic levels, while a few categories such as pediatrics remain lower. Emergency room visits remain modestly lower than historical levels with consumers seemingly more comfortable with virtual and walk-in care. Cancer and cardiac screenings are occurring at roughly pre-pandemic levels, helped in part by focused efforts to ensure people are obtaining appropriate preventive care. As always, we continue to closely analyze data for indications which could signal increasing acuity but have yet to see those emerge.

護理模式在很大程度上與最近的趨勢保持一致。例如，住院病人的趨勢繼續反映出越來越多的人轉向門診護理場所。如今，近 2/3 的骨科手術是在門診和其他門診進行的，而 5 年前這一比例不到 1/4。醫師辦公室活動繼續趨向於歷史水平，而兒科等少數類別仍然較低。急診室就診率仍略低於歷史水平，消費者似乎對虛擬和步入式護理更滿意。癌症和心臟篩查大致處於大流行前的水平，部分原因是集中努力確保人們獲得適當的預防保健。一如既往，我們繼續密切分析數據，尋找可能表明敏銳度提高但尚未出現的跡象。

Looking now at the performance of the individual businesses in the first quarter. OptumHealth revenues grew by 38% to $23 billion as we expanded the number of patients served under value-based care arrangements. Revenue per consumer served grew by 34% driven by the increase in value-based care patients and in the levels of care we can offer. OptumInsight revenues grew 40% to $4.5 billion. The revenue backlog reached $30.7 billion, an increase of nearly $8 billion over last year, in part due to the addition of Change Healthcare.

現在來看一季度個體業務的表現。隨著我們擴大在基於價值的護理安排下服務的患者數量，OptumHealth 的收入增長了 38% 至 230 億美元。由於基於價值的護理患者數量的增加以及我們可以提供的護理水平的提高，每位服務消費者的收入增長了 34%。 OptumInsight 的收入增長了 40%，達到 45 億美元。收入積壓達到 307 億美元，比去年增加近 80 億美元，部分原因是 Change Healthcare 的加入。

As we have discussed before, in the first half, we expect to continue to increase our integration and investment activities, which were a component in the first quarter results and we expect they will accelerate into the second quarter.

正如我們之前所討論的，在上半年，我們預計將繼續增加我們的整合和投資活動，這是第一季度業績的組成部分，我們預計它們將加速進入第二季度。

OptumRx revenues grew 15%, surpassing $27 billion, driven by strong double-digit growth across the businesses, including in our community and home delivery pharmacies. Script growth of 26 million over last year was driven by exceptional customer retention as well as new customer adds.

OptumRx 的收入增長了 15%，超過 270 億美元，這得益於包括我們的社區和送貨上門藥房在內的各業務強勁的兩位數增長。腳本比去年增長了 2600 萬，這主要得益於卓越的客戶保留率和新客戶的增加。

We continue to see strong growth in NPS for our specialty businesses, up nearly 10 points since last year. At UnitedHealthcare, revenues of over $70 billion grew 13% with growth in the number of people served across all of our major benefit categories. For example, in commercial, we set out to serve up to 1 million more people this year and are pacing well to that objective given our first quarter performance. Offerings for large employers led the gains as did our newer and more affordable offerings serving both employers and individuals.

我們繼續看到我們專業業務的 NPS 強勁增長，自去年以來增長了近 10 個百分點。在 UnitedHealthcare，超過 700 億美元的收入增長了 13%，我們所有主要福利類別的服務人數都在增長。例如，在商業方面，我們計劃今年再服務多達 100 萬人，並且鑑於我們第一季度的表現，我們正在朝著這一目標邁進。面向大型雇主的產品領漲，我們為雇主和個人提供的更新、更實惠的產品也是如此。

Within Medicare Advantage, we shared with you in November our intention to add 800,000 to 900,000 new members in this year and we now expect to exceed the upper end of that range. The consistent consumer receptivity to our offerings underscores the product stability and value we provide for seniors.

在 Medicare Advantage 中，我們在 11 月與您分享了我們打算在今年增加 800,000 至 900,000 名新會員，我們現在預計會超過該範圍的上限。消費者對我們產品的一貫接受度凸顯了我們為老年人提供的產品穩定性和價值。

Medicaid membership grew 570,000 over the year ago quarter. We continue to have momentum in Medicaid with recent wins in Indiana and Texas. And we are honored to advance our existing service to the people of North Carolina, as the state moves towards expanding managed Medicaid offerings.

醫療補助會員人數比去年同期增長了 570,000 人。隨著最近在印第安納州和德克薩斯州的勝利，我們在醫療補助計劃方面繼續保持勢頭。隨著北卡羅來納州逐步擴大託管醫療補助計劃，我們很榮幸能夠向北卡羅來納州人民推進我們現有的服務。

Our capital capacities remain strong. Cash flows from operations in the quarter at $16.3 billion reflected an additional CMS payment. Adjusting for this effect, first quarter cash flows from operations were consistent with our outlook and we continue to track well with our full year view to approach $28 billion, about 1.2x net income.

我們的資本能力依然強勁。本季度運營產生的現金流量為 163 億美元，反映了一筆額外的 CMS 付款。針對這一影響進行調整後，第一季度運營現金流與我們的預期一致，我們繼續跟踪我們的全年預期，接近 280 億美元，約為淨收入的 1.2 倍。

In the quarter, we returned over $3.5 billion to shareholders through dividends and share repurchases and deployed about $8 billion of growth capital to expand our capabilities to serve more people and grow far into the future.

本季度，我們通過股息和股票回購向股東返還了超過 35 億美元，並部署了約 80 億美元的增長資本，以擴大我們為更多人服務的能力，並實現長遠發展。

As Andrew mentioned, based upon this growth outlook, today, we increased our full year 2023 adjusted earnings outlook to a range of $24.50 to $25 per share. We expect the first half, second half earnings progression to be broadly consistent with our longer-term historical patterns with the second half comprising just slightly more than half of the full year.

正如安德魯提到的那樣，基於這一增長前景，今天，我們將 2023 年全年調整後的收益預期上調至每股 24.50 美元至 25 美元。我們預計上半年、下半年的收益增長將與我們的長期歷史模式大致一致，下半年僅略高於全年的一半。

Now I'll turn it back to Andrew.

現在我將把它轉回給安德魯。

Thanks, John. Our comments on this call gives us a flavor of why we're confident in our outlook for the year and our long-term 13% to 16% earnings per share growth target. Our growth is broad-based and it's driven within and increasingly across our businesses, bolstered, as always, by an enterprise focus on execution on behalf of those we serve.

謝謝，約翰。我們對此次電話會議的評論讓我們了解了為什麼我們對今年的前景和我們 13% 至 16% 的長期每股收益增長目標充滿信心。我們的增長基礎廣泛，它在我們的業務內部推動並越來越多地跨越我們的業務，一如既往地受到企業專注於代表我們所服務的人執行的支持。

With that, operator, let's open it up for questions. (Operator Instructions)

有了這個，接線員，讓我們打開它來提問。 （操作員說明）

(Operator Instructions) And we will go ahead and take our first question from A.J. Rice with Credit Suisse.

（操作員說明）我們將繼續並回答 A.J. 的第一個問題。瑞士信貸的大米。

Maybe just because it's been in the news as well the whole review of PBMs and some of the approaches the industry has had historically, maybe I'll just ask you guys to remind us what your approach is relative to rebates, spread pricing and so forth. And then I know OptumRx does a lot more than a traditional PBM. Maybe give people some perspective on the breadth of OptumRx relative to some of the things that are specifically being discussed in Washington today, if possible.

也許只是因為它已經出現在新聞中以及對 PBM 的整個審查以及該行業歷史上採用的一些方法，也許我只想請你們提醒我們你們的方法與回扣、差價定價等相關.然後我知道 OptumRx 比傳統的 PBM 做得更多。如果可能的話，也許可以讓人們對 OptumRx 的廣度相對於今天在華盛頓特別討論的一些事情有一些看法。

Yes. A.J., thanks so much for the question. Let me make a couple of comments and then I'm going to hand to Heather Cianfrocco, who looks after our OptumRx business. So first off, I mean, I think the entire space of pharmacy is a critical one within health care. It's the most common touch point for the health system. It's also an incredibly significant part of the system in terms of where innovation comes into the marketplace. So where an important set of activities which need to be delivered effectively on behalf of patients, members, consumers.

是的。 A.J.，非常感謝你提出這個問題。讓我發表一些評論，然後我將交給負責我們的 OptumRx 業務的 Heather Cianfrocco。所以首先，我的意思是，我認為整個藥房領域是醫療保健領域的一個關鍵領域。這是衛生系統最常見的接觸點。就創新進入市場而言，它也是系統中非常重要的一部分。因此，需要代表患者、會員和消費者有效開展一系列重要活動。

Having said that, of course, it's all about affordability and value for money. And there is a real risk, if you see situations where you have essentially monopoly holders, so let's say, drug companies that have a monopoly over a particular product, there needs to be a counterbalance in terms of the price negotiation to make sure that those prices are effectively procured on behalf of members who otherwise would just not have that kind of ability to negotiate.

話雖如此，當然，這都是關於負擔能力和物有所值的。並且存在真正的風險，如果你看到基本上壟斷持有人的情況，比方說，對特定產品具有壟斷地位的製藥公司，需要在價格談判方面進行平衡，以確保那些價格是代表成員有效採購的，否則他們就沒有那種談判能力。

That's really the central role that the PBMs play here. There are various mechanisms in which the PBM operates. The rebate mechanism is one that historically has been used in this way. As you well know, A.J., Optum, OptumRx in particular, has led the way in terms of transparency and making sure that, for example, the overwhelming majority of rebates are passed back to the payers of those drugs, typically the plans or the employers who commission us to procure on their behalf.

這確實是 PBM 在這裡發揮的核心作用。 PBM 運行的機制多種多樣。回扣機制是歷史上以這種方式使用的機制。如您所知，A.J.、Optum、尤其是 OptumRx，在透明度方面處於領先地位，並確保，例如，絕大多數回扣被轉回給這些藥物的付款人，通常是計劃或雇主誰委託我們代表他們採購。

As we look more broadly across the whole landscape of the pharmacy marketplace, there are a few things that I think we strongly believe in and we continue to advocate for very significantly. #1, there needs to be a counterbalance to the drug company pricing and the only players in the market right now who are really advocating hard for reducing cost is the PBM.

當我們更廣泛地審視整個藥房市場時，我認為有幾件事是我們堅信的，我們將繼續大力倡導。 #1，需要平衡製藥公司的定價，目前市場上唯一真正大力倡導降低成本的參與者是 PBM。

#2, at Optum, we are committed to lowest net cost. And whether we get there through rebate or we get there through lower list prices, we don't mind. We're very happy when people cut list prices because that cuts cost. We're very happy when we secure increased rebates because that cuts costs. So we continue to focus on that lowest net cost and we're super committed to transparency. We're also committed to finding ways in which we can bring benefits directly to patients, which is why we led last year with 0 cost pay for the UnitedHealthcare books of business initially for life-saving drugs.

#2，在 Optum，我們致力於最低的淨成本。無論我們是通過回扣還是通過較低的標價來實現目標，我們都不介意。當人們降低目錄價格時，我們感到非常高興，因為這樣可以降低成本。當我們獲得增加的回扣時，我們會非常高興，因為這會降低成本。因此，我們繼續專注於最低的淨成本，並且我們超級致力於透明度。我們還致力於尋找可以直接為患者帶來好處的方法，這就是為什麼我們去年以 0 成本支付 UnitedHealthcare 最初用於救命藥物的業務賬簿而領先。

So that's kind of the big landscape. Now there's more detail in areas that maybe Heather could take you into and I'll pass to her now to give you a little bit more. Heather?

這就是一種大景觀。現在，在 Heather 可能會帶您進入的領域中有更多細節，我現在將傳遞給她，為您提供更多信息。希瑟？

Sure. Thank you. And maybe I will just supplement and just say -- A.J., thank you. We are -- certainly, it is in the news. We're mindful of the interest in this essential service. But I guess I'd also point you to the client need for these essential services. Our PBM services not just negotiate with pharmaceutical manufacturers to drive that lowest net cost for drugs available, as Andrew mentioned, but the clinical supports and services through the pharmacy and therapeutics committees and pipeline reviews, that network administration and all of the benefit administration and consultation that we provide to clients of all sizes and types from government to employer to large, sophisticated health plans.

當然。謝謝。也許我只是補充一下，然後說——A.J.，謝謝。我們 - 當然，它在新聞中。我們注意到對這項基本服務的興趣。但我想我還會指出客戶對這些基本服務的需求。正如安德魯提到的那樣，我們的 PBM 服務不僅與製藥商談判以推動可用藥物的最低淨成本，而且還通過藥房和治療委員會以及管道審查、網絡管理以及所有福利管理和諮詢提供臨床支持和服務我們為各種規模和類型的客戶提供服務，從政府到雇主，再到大型、複雜的健康計劃。

And I take validation in the fact that, that business model is needed by our clients and it's appreciated. The transparent business model of OptumRx, together with the innovative capabilities, some of our differentiated strategies, like the biosimilar strategy that Andrew mentioned that not just brought competition into the market by bringing up to 3 biosimilars at parity with the originator on the formulary, accepting the high list price and the list price and putting those together and offering them to the clients from our consumer tools like our latest Price Edge that does scan across the market and compares the cash pricing with the members' real-time out-of-pocket cost to make sure they get the best price.

我接受了這樣一個事實的驗證，即我們的客戶需要這種商業模式，並且受到讚賞。 OptumRx 透明的商業模式，加上創新能力，我們的一些差異化戰略，比如安德魯提到的生物仿製藥戰略，不僅通過在處方集上引入多達 3 種與原研藥同等的生物仿製藥，為市場帶來競爭，接受高標價和標價並將它們放在一起，並通過我們的消費者工具（例如我們最新的 Price Edge）將它們提供給客戶，該工具確實掃描整個市場並將現金定價與會員的實時自付費用進行比較以確保他們獲得最優惠的價格。

Those are innovative offerings that I'm really proud that our clients find valuable. And we evolve with those needs. So I think I'd point us to the fact that we had a very strong selling season, one of the highest over the last years, in terms of retention and new clients, shows that the services are needed. We'll continue to evolve our business models to our clients' needs while we continue to engage policymakers and others to make sure that everybody understands the essential value of that PBM service, the distinctive capabilities and transparent business model of OptumRx and in addition, make sure that we ensure client choice and we preserve that function.

這些都是創新產品，我為我們的客戶認為有價值而感到非常自豪。我們隨著這些需求而發展。所以我想我要指出的是，我們有一個非常強勁的銷售季節，在保留和新客戶方面是過去幾年中最高的銷售季節之一，表明需要這些服務。我們將繼續根據客戶的需求發展我們的商業模式，同時我們繼續與政策制定者和其他人接觸，以確保每個人都了解 PBM 服務的基本價值、OptumRx 的獨特能力和透明的商業模式，此外，確保我們確保客戶選擇並保留該功能。

But I guess that also -- I'll just take the opportunity to say, you're right. OptumRx is so much more than just our PBM, which is incredibly important to our clients. We are so proud of them. I'm so proud of the team. You saw the growth in our pharmacies but from our community pharmacies that it just celebrated a 700th opening of our behavioral health pharmacy, a very distinctive offering in the market to our specialty with not just high NPS but a 24/7 clinical model and distinctive capabilities for those members that really benefit from specialty drugs but in oftentimes, need our patient support and assistance, including financial.

但我想這也是——我想藉此機會說，你是對的。 OptumRx 不僅僅是我們的 PBM，它對我們的客戶來說非常重要。我們為他們感到驕傲。我為球隊感到驕傲。您看到了我們藥房的增長，但從我們的社區藥房來看，它剛剛慶祝了我們行為健康藥房的第 700 家開業，這是我們專業市場上非常獨特的產品，不僅具有高 NPS，而且具有 24/7 全天候臨床模式和獨特的功能對於那些真正受益於特殊藥物但經常需要我們患者支持和幫助的會員，包括經濟上的幫助。

And then, of course, our infusion business, which is very intimate in providing services in the home and we rely on over 1,100 nurses to do that every day. So incredibly proud of the breadth of service across OptumRx but very mindful that our job in the PBM is to serve our clients and preserve their choice.

然後，當然是我們的輸液業務，它非常貼心地提供家庭服務，我們每天依靠 1,100 多名護士來做這件事。為 OptumRx 的廣泛服務感到無比自豪，但非常注意我們在 PBM 中的工作是為我們的客戶服務並保留他們的選擇。

Thanks, Heather. And all of that said, I think what is also really validating here, A.J., just look at the growth rate in the first quarter, 15% growth. It really reflects the competitiveness of the portfolio we have. And as I talk to our clients, what they really appreciate is the degree to which we're innovating the pharmacy model, more and more transparency, more and more pressure on bringing down those costs. That's why people are moving to us and it's why they're not leaving us, record levels of retention within this portfolio.

謝謝，希瑟。綜上所述，我認為這裡真正驗證的是 A.J.，看看第一季度的增長率，15% 的增長率。它確實反映了我們擁有的產品組合的競爭力。當我與我們的客戶交談時，他們真正欣賞的是我們創新藥房模式的程度、越來越多的透明度以及越來越多的降低這些成本的壓力。這就是人們轉向我們的原因，也是他們不離開我們的原因，在這個投資組合中保持創紀錄的水平。

And just as a marker, about half of our revenues in the OptumRx portfolio come from non-PBM activities. That's all the stuff that Heather just referred to in the second part of her answer. Super nicely balanced business, great growth profile because we're delivering for clients and for their members and employees. So A.J., thanks for raising that question. It's an important topic and we appreciate having the chance to share it.

作為一個標誌，我們在 OptumRx 產品組合中的收入中約有一半來自非 PBM 活動。這就是 Heather 在她回答的第二部分中提到的所有內容。超級平衡的業務，巨大的增長前景，因為我們正在為客戶及其成員和員工提供服務。 A.J.，謝謝你提出這個問題。這是一個重要的話題，我們很高興有機會分享它。

We'll take our next question from Lisa Gill with JPMorgan.

我們將從摩根大通的 Lisa Gill 那裡回答下一個問題。

I'm going to stick to the PBM side for a minute and just really wanted to hear your comments around GLP-1 drugs. One, how do we think about the cost trend as you think about it from the managed care side of your business? And then secondly, how do we think about really truly managing this new cost of drug that's coming from a pharmacy perspective?

我將堅持 PBM 方面一分鐘，只是真的想听聽您對 GLP-1 藥物的評論。第一，我們如何看待成本趨勢，就像您從業務的管理式醫療方面考慮的那樣？其次，我們如何考慮真正真正地管理這種來自藥房角度的新藥物成本？

Yes. Lisa, it's a great question. I think, actually, it would be super interesting to hear from the UnitedHealthcare perspective on that. So I may just ask Brian Thompson, the CEO of UHC, to comment there, please.

是的。麗莎，這是一個很好的問題。我認為，實際上，從 UnitedHealthcare 的角度來聽聽這件事會非常有趣。所以我可能會請 UHC 的首席執行官布賴恩湯普森在那裡發表評論。

Sure, Andrew. Lisa, let me start with the trends that we're seeing here in 2023 are as planned, overall medical and pharmacy. It's really a good start to the year with our assumptions being validated as we kick off 2023. With respect to GLP, obviously, a lot of discussion. I would say no real change to either our insights or our position. We have seen an increase in trend in GLP-1s. The overwhelming majority of that is in diabetic care and it is as we had expected, low single digits in terms of weight loss use.

當然，安德魯。麗莎，讓我從我們在 2023 年在這裡看到的趨勢開始，這是按計劃進行的，整體醫療和製藥。這真的是今年的一個良好開端，我們的假設在 2023 年開始時得到了驗證。關於 GLP，顯然有很多討論。我會說我們的見解或我們的立場沒有真正的改變。我們已經看到 GLP-1 的趨勢有所增加。其中絕大多數用於糖尿病護理，正如我們預期的那樣，在減肥使用方面只有低個位數。

I would say that our on-label usage has been well managed with our authorization requirements. And I think it's important to put it in the context of our overall medical. Keep in mind, pharmacy is about 20% of our overall spend in any one therapeutic class. This one certainly included less than 1%. So increased year-over-year, overwhelming majority in diabetic care, well managed in terms of off-label use and consistent with what we had planned for.

我會說我們的標籤上使用已根據我們的授權要求得到很好的管理。我認為將其置於我們整體醫療的背景下很重要。請記住，藥房約占我們在任何一種治療課程中總支出的 20%。這個當然包括不到1%。因此逐年增加，絕大多數在糖尿病護理方面，在標籤外使用方面得到很好的管理，並且與我們的計劃一致。

Yes. No. Listen, Brian puts it super well, Lisa. I think from where we sit, as we roll forward -- listen, first of all, it's good news that we're seeing innovation in areas like weight management. That obviously is going to be an important aspect of consideration for people, particularly with comorbidities. Diabetes is an obvious example of that, #1.

是的。不，聽著，布萊恩說得非常好，麗莎。我認為從我們坐的位置來看，當我們向前推進時——聽著，首先，我們在體重管理等領域看到了創新，這是個好消息。這顯然將成為人們考慮的一個重要方面，尤其是合併症。糖尿病就是一個明顯的例子，#1。

#2, I think as time plays out, what's going to be super critical here is some of the -- we need to get focused on the facts and reality of this marketplace. We need to really be clear about which patients really do benefit from these medicines and make sure we properly understand how they're going to use those medicines. So there's a lot still to learn, I think, as these things progress through their final phases.

#2，我認為隨著時間的流逝，這裡最關鍵的是——我們需要關注這個市場的事實和現實。我們需要真正弄清楚哪些患者確實從這些藥物中受益，並確保我們正確了解他們將如何使用這些藥物。所以我認為，隨著這些事情進入最後階段，還有很多東西需要學習。

And then finally, of course, we got to see the prices be affordable and that's going to be a key element of how this evolves. And obviously, we keep a close eye on the prices we see in Europe. And just as -- you heard a little bit, our focus on the pharmacy side of the business, of course, encouraged by our insurance side of the business. We're going to be looking for the very, very best pricing on these medicines and we're going to advocate on behalf of members and consumers to get that.

最後，當然，我們必須看到價格是可以承受的，這將是它如何發展的關鍵因素。顯然，我們密切關注我們在歐洲看到的價格。正如 - 你聽到一點，我們專注於業務的藥房方面，當然，受到我們業務保險方面的鼓勵。我們將尋找這些藥物的非常、非常好的定價，我們將代表會員和消費者進行宣傳以實現這一目標。

So still plenty to come here. I think early days, nothing particularly out of expectations, still very much in the range that Brian just described. Lisa, thanks for the question.

所以還有很多可以來這裡。我認為早期並沒有什麼特別出乎意料的，仍然在布賴恩剛剛描述的範圍內。麗莎，謝謝你的提問。

We'll take our next question from Stephen Baxter with Wells Fargo.

我們將接受來自富國銀行的斯蒂芬巴克斯特的下一個問題。

I wanted to ask about the changes the company is making to prior authorization later this year. It would be great to get some background on why you felt like these changes were necessary and how you're going to work to manage the cost implications of the changes once they're made.

我想問一下公司今年晚些時候對事先授權所做的更改。最好能了解一些背景知識，了解為什麼您認為這些更改是必要的，以及您將如何管理更改完成後的成本影響。

Yes. Steven, thanks so much for the question. I'll ask Brian to address that.

是的。史蒂文，非常感謝你提出這個問題。我會請 Brian 解決這個問題。

Steven, thanks for the question. Yes, beginning in the third quarter of this year, we will be eliminating about 20% of our authorization volumes overall. We're also going to be eliminating most medical authorizations altogether for provider groups and systems that have demonstrated a high-quality care and adherence to the requirements over time. I'd say that might be another 10% of our volumes overall.

史蒂文，謝謝你的提問。是的，從今年第三季度開始，我們將取消大約 20% 的授權量。我們還將完全取消大多數醫療授權，這些供應商團體和系統已經證明了高質量的護理並隨著時間的推移遵守了要求。我想說這可能是我們整體銷量的另外 10%。

We'll continue to evaluate with some new analytics that we have in partnership with OptumInsight and surveillance capabilities to see if there's some additional opportunities over time. Really, though, this is a culmination of a lot of things. And first and foremost, I would say it's our intensifying focus on the consumer experience, really a desire for us to streamline processes, get the latency out of the process. And like I said, leverage new technologies to really get to speed of decisioning and really get to point of care.

我們將繼續使用我們與 OptumInsight 和監視功能合作的一些新分析進行評估，看看隨著時間的推移是否還有一些額外的機會。不過，實際上，這是很多事情的高潮。首先，我想說的是我們越來越關註消費者體驗，我們真的希望簡化流程，消除流程中的延遲。就像我說的，利用新技術真正加快決策速度並真正到達護理點。

I will say, we're constantly reviewing our prior authorizations but we need to balance, obviously, what we reduce with that need to guard against clinical quality and patient safety. And I would say in this really robust process that we've started here over the last several months that it's really demonstrated the importance of the authorizations that we do have in place.

我會說，我們一直在審查我們之前的授權，但顯然，我們需要平衡我們減少的內容與保護臨床質量和患者安全的需要。我要說的是，在過去幾個月我們在這裡開始的這個非常強大的過程中，它確實證明了我們現有授權的重要性。

So really encouraged by our surveillance capabilities. Don't anticipate any pressure on trend because of it and really see this as a win and satisfier for both our customers and our provider groups alike.

我們的監控能力讓我們深受鼓舞。不要因為它而預期任何趨勢壓力，真正將其視為對我們的客戶和我們的供應商群體的勝利和滿足。

Yes. Brian, thanks so much. I might just add, I think as we play out over the next year or 2, this is also an exciting area for where UHC and OptumInsight can collaborate, lot of technology opportunity to be leveraged here, Stephen.

是的。布萊恩，非常感謝。我可能只是補充說，我認為隨著我們在接下來的一兩年內進行比賽，這也是 UHC 和 OptumInsight 可以合作的一個令人興奮的領域，這裡有很多技術機會可以利用，斯蒂芬。

And also as you think about the integration of the Change organization into OptumInsight, that gives us new perspective in terms of how we can create network connectivity, to take friction out as well.

此外，當您考慮將 Change 組織整合到 OptumInsight 中時，這為我們提供了關於如何創建網絡連接以及消除摩擦的新視角。

So how do we -- well, you just heard a little bit there from Brian, is how we kind of streamline this space. It's still got an important role at its core. Then there's a ton of opportunity we can bring to really take out a lot of that friction by leveraging technology and the capabilities that we're building up within the new OptumInsight. So really an interesting space across the whole organization. Thanks so much, Stephen and Brian.

那麼我們如何 - 好吧，你剛剛從布賴恩那裡聽到了一點，我們如何簡化這個空間。它仍然在其核心中發揮著重要作用。然後，我們可以帶來大量機會，通過利用我們在新 OptumInsight 中建立的技術和能力，真正消除很多摩擦。所以在整個組織中確實是一個有趣的空間。非常感謝，斯蒂芬和布賴恩。

Next question comes from Justin Lake with Wolfe Research.

下一個問題來自 Justin Lake 和 Wolfe Research。

Just wanted to sneak in a couple of quick numbers questions. First, on EPS seasonality. It looks like second quarter -- it sounds like you might be looking at closer to kind of flattish EPS year-over-year. Wondering if you can kind of walk through the moving parts there. I know you talked about spending more money on Change, for instance.

只是想偷偷問幾個快速的數字問題。首先，關於 EPS 季節性。看起來像第二季度——聽起來你可能會看到每股收益同比持平。想知道您是否可以瀏覽那裡的活動部件。例如，我知道您談到要在 Change 上花更多的錢。

And then just anything on DCP, what range should we be thinking about there in terms of going forward? Is this a kind of -- it went down in the quarter. Is this a more normal range? Kind of where do you see that kind of settling out for the year?

然後關於 DCP 的任何事情，我們應該在前進方面考慮什麼範圍？這是一種——它在本季度下降了。這是一個更正常的範圍嗎？你在哪裡看到今年的那種解決方案？

Yes. Justin, thanks so much. I'll ask John Rex to comment there, please.

是的。賈斯汀，非常感謝。請讓 John Rex 發表評論。

Justin, so a few thoughts here in terms of seasonality comments. So yes, this quarter reflected some impacts actually from Change also, so I wouldn't call that seasonality. But these are investments we're making as we integrate and we build OptumInsight for the future. And I'd put that in the zone of $100 million or so of impact in the quarter and expect that to be a little bit higher actually in the second quarter also.

賈斯汀，這裡有一些關於季節性評論的想法。所以是的，這個季度也反映了一些來自變化的影響，所以我不會稱之為季節性。但這些是我們在整合和為未來構建 OptumInsight 時所做的投資。我會把它放在本季度 1 億美元左右的影響範圍內，並預計第二季度實際上也會高一點。

In terms of full year seasonality, also, I just want to give a little commentary on that. I expect that to be kind of in the zone of what we have historically done, where you see just a little bit more than half of the earnings generated in the second half of the year versus the first half of the year. So more similar to, if you look to kind of pre-2019 and back, those kind of patterns, that we would typically show.

另外，就全年季節性而言，我只想對此發表一些評論。我希望這會在我們歷史上所做的事情的範圍內，你會看到下半年產生的收益與上半年相比略多於一半。所以更類似於，如果你看看 2019 年前後的那種模式，我們通常會展示這些模式。

On your commentary -- on your question on DCPs and expectations there, at this level, I would tell you, it's probably more in the level that we typically would have run also pre-pandemic, in terms of the levels of days claims payable that we would typically run.

關於你的評論——關於你關於 DCP 和期望的問題，在這個級別，我會告訴你，就應付索賠的天數水平而言，它可能更多地處於我們通常在大流行前也會運行的水平我們通常會跑步。

A few things just in terms of commentary and just seeing some of the impacts, just so that get really close on it. So in addition to being at what we would consider to be kind of normalized levels here, some business mix impacts. Some of the areas we're growing in and growing rapidly in have somewhat faster payment cycles. In the first quarter, there's usually a little impact also from Part D seasonality. And kind of on the sequential move there, I'd say there's a little -- just a little bit of day count impact also in terms of -- that was affecting those.

僅就評論和看到一些影響而言的一些事情，只是為了真正接近它。因此，除了我們認為這裡的標準化水平之外，一些業務組合也會產生影響。我們正在成長和快速成長的一些領域有更快的支付週期。在第一季度，D 部分的季節性通常也會產生一些影響。並且在連續移動方面，我想說有一點 - 也只是一點點天數影響 - 這正在影響那些。

Thanks so much, John. Thanks, Justin.

非常感謝，約翰。謝謝，賈斯汀。

Next question comes from Nathan Rich with Goldman Sachs.

下一個問題來自高盛的 Nathan Rich。

I wanted to ask on Medicare Advantage and the phase-in of the risk model changes by CMS. I guess, how might the prospect for lower rate growth over the next few years impact the relative attractiveness of Medicare Advantage for seniors and the growth of that market? And do you think the risk model changes have any impact on how providers are viewing the attractiveness of full-risk arrangements?

我想詢問 Medicare Advantage 以及 CMS 對風險模型變更的逐步引入。我想，未來幾年增長率較低的前景會如何影響 Medicare Advantage 對老年人的相對吸引力以及該市場的增長？您認為風險模型的變化對供應商如何看待全風險安排的吸引力有任何影響嗎？

Nathan, thanks so much for the question. So listen, I think as you sort of step back here, a couple of things I'd probably just want to make super clear. First off, we really appreciate CMS' decision to phase-in these changes. That was important and we're very glad to see that. It really allows for the transition to be managed effectively really with we think and a bit -- certainly, our goal is to have a transition here, which really protects the beneficiaries, make sure that it doesn't in any way kind of damage the program. Of course, it requires us to do things a little differently in some areas. But fundamentally, we think that was really important and we very, very much appreciate that.

內森，非常感謝你提出這個問題。所以聽著，我想當你回到這裡時，有幾件事我可能只想說得非常清楚。首先，我們非常感謝 CMS 決定逐步實施這些更改。這很重要，我們很高興看到這一點。它確實允許通過我們的思考和一點點有效地管理過渡——當然，我們的目標是在這裡進行過渡，這真正保護了受益人，確保它不會以任何方式損害程序。當然，這需要我們在某些方面做一些不同的事情。但從根本上說，我們認為這非常重要，我們非常非常感謝這一點。

As we kind of look out to 2024, we're going to be guided by 2 really important principles here, Nathan. #1, we're going to be doing what's absolutely right for the beneficiaries as we always do. So that's going to guide us in terms of how we are active. And #2, we're going to be driving to sustain our robust membership growth in this space.

當我們展望 2024 年時，我們將遵循 2 條非常重要的原則，Nathan。 #1，我們將一如既往地做對受益人絕對正確的事情。所以這將指導我們如何活躍。 #2，我們將努力維持我們在這個領域的強勁會員增長。

We believe this is an incredibly important program for seniors. We think value-based care as a piece of this program is a crucial and best way of managing members to give them the best quality outcome, best experience and best cost outcome.

我們相信這對老年人來說是一個非常重要的項目。我們認為，作為該計劃的一部分，基於價值的護理是管理會員的關鍵且最佳方式，可為他們提供最佳質量結果、最佳體驗和最佳成本結果。

Given our established capabilities and our ability to focus on cost management as well as the broad portfolio of value-based services, clinics, in-house activities provided by Optum, we feel super confident in our ability to manage the evolving funding landscape.

鑑於我們既有的能力和我們專注於成本管理的能力，以及 Optum 提供的基於價值的服務、診所、內部活動的廣泛組合，我們對我們管理不斷變化的資金格局的能力充滿信心。

So overall, yes, it's changed but kind of this change every year. This is a little different change to the changes we've had in other years but it's all -- these programs are always evolving. We feel, given the portfolio of capabilities we have, super well equipped to be able to pull different levers to be responsive to this, to make sure that we can look after beneficiaries.

所以總的來說，是的，它發生了變化，但每年都有這種變化。這與我們在其他年份所做的更改略有不同，但僅此而已——這些程序一直在發展。我們認為，鑑於我們擁有的能力組合，我們具備超強的裝備，能夠拉動不同的槓桿來對此做出響應，以確保我們能夠照顧受益人。

I'd also say that the experience we've seen in Optum, the popularity of value-based care for physicians, the way in which they like to be able to concentrate and focus on patients longitudinally, so really think about how to understand, diagnose, prevent, treat, manage that patient through the whole cycle rather than just sporadically through a fee-for-service intervention, that's a sustaining popular thing.

我還要說的是，我們在 Optum 中看到的經驗，醫生基於價值的護理的流行，他們喜歡能夠縱向集中註意力和關注患者的方式，所以真正考慮如何理解，在整個週期中診斷、預防、治療和管理患者，而不是零星地通過按服務收費的干預，這是一個持續流行的事情。

We brought in about 10,000 or more new clinicians last year between physicians and advanced practice clinicians. I think we're going to do about the same this year. Honestly, we're seeing significant numbers of people coming in. And we would continue to expect to see value-based care continue to be a very important part of the future growth of the marketplace and, of course, for us.

去年，我們在醫生和高級實踐臨床醫生之間引進了大約 10,000 名或更多新臨床醫生。我認為我們今年將做同樣的事情。老實說，我們看到大量的人進來。我們將繼續期望看到基於價值的護理繼續成為市場未來增長的一個非常重要的部分，當然，對我們來說也是如此。

So as we sit today, of course, we have to do things to respond to the changing environment. We feel good about our ability to do it. And I appreciate the question, Nathan.

因此，當我們今天坐下時，當然，我們必須做一些事情來應對不斷變化的環境。我們對自己的能力感到滿意。我很欣賞這個問題，Nathan。

And we will move on to our next question from Josh Raskin with Nephron Research.

我們將繼續下一個來自 Nephron Research 的 Josh Raskin 的問題。

I want to stay on MA and maybe more specifically, if you could speak to the impact to both, I guess, UnitedHealthcare and OptumCare and more specifically, how you plan to balance the need to maintain attractive benefits to grow that membership against your ability to achieve target margins?

我想留在 MA 上，也許更具體地說，如果你能談談對 UnitedHealthcare 和 OptumCare 的影響，更具體地說，你計劃如何平衡維持有吸引力的福利以增加會員資格的需要與你的能力達到目標利潤率？

And maybe do you think the industry will grow at similar rates? It sounds like you don't see a material impact long term but I'm just curious if you think 2024 as an industry growth rate looks similar to what we've seen in recent years? And maybe within that, how you expect UHC to fare?

也許您認為該行業會以類似的速度增長？聽起來您看不到長期的實質性影響，但我很好奇您是否認為 2024 年的行業增長率與我們近年來看到的相似？也許在其中，您期望 UHC 的表現如何？

Yes. Josh, thanks so much for the question. Let me ask Brian to give you a few thoughts. Brian?

是的。喬希，非常感謝你提出這個問題。讓我請布賴恩給你一些想法。布萊恩？

Josh, thanks for the question. I'll just reiterate, I think what Andrew said. Certainly, this 3-year phase-in gives us an opportunity to minimize this impact on beneficiaries. And I will just reiterate the optimism that Andrew shared. Because of that, that gives us time to really evaluate our cost structure.

喬希，謝謝你的提問。我只是重申一下，我認為安德魯說過的話。當然，這 3 年的逐步實施讓我們有機會盡量減少對受益人的影響。我只想重申 Andrew 所表達的樂觀態度。因此，這讓我們有時間真正評估我們的成本結構。

First and foremost, I think that's the consideration that we are deeply focused on to make sure that we manage this impact. Look, it's not the first time that we have had to navigate a rate environment like this. So I'll just say we remain optimistic about MA and the value prop that it has broadly. We certainly feel very good about our market position in it. We intend to grow again in 2024, as Andrew had said. We expect the marketplace to continue to grow in 2024. And we continue to lead with the strong momentum that we've demonstrated for many years now.

首先，我認為這是我們深切關注的考慮因素，以確保我們管理好這種影響。看，這不是我們第一次不得不在這樣的利率環境中導航。所以我只想說我們對 MA 及其廣泛的價值支撐持樂觀態度。我們當然對我們在其中的市場地位感到非常滿意。正如安德魯所說，我們打算在 2024 年再次增長。我們預計市場將在 2024 年繼續增長。我們將繼續以多年來展示的強勁勢頭引領市場。

So we're obviously in the middle of our benefit planning but I can just share with you that we are encouraged and optimistic.

因此，我們顯然正在製定福利計劃，但我可以與您分享我們感到鼓舞和樂觀。

Great. Thanks so much, Brian. I appreciate it. Thanks, Josh.

偉大的。非常感謝，布萊恩。我很感激。謝謝，喬希。

We'll take our next question from Lance Wilkes with Bernstein.

我們將與伯恩斯坦一起接受 Lance Wilkes 的下一個問題。

Could you talk a little bit about OptumCare and the full-risk patients you've got, specifically the non-UnitedHealthcare patients? And how is the progress going as far as growing that? And how do you see this MA rate environment and high premium environment in commercial employer impacting and potentially accelerating your ability to add non-UHC risk patients?

你能談談 OptumCare 和你的全危患者，特別是非 UnitedHealthcare 患者嗎？就增長而言，進展如何？您如何看待商業雇主的這種 MA 費率環境和高保費環境會影響並可能加速您增加非 UHC 風險患者的能力？

So Lance, thanks so much for the question. Let me just make a couple of upfront comments and I'll ask Dr. Wyatt Decker, who looks after OptumHealth, to give you a little more detail.

蘭斯，非常感謝你提出這個問題。讓我做一些預先的評論，我會請負責 OptumHealth 的 Wyatt Decker 博士為您提供更多細節。

So first off, you're seeing now, as we head toward the full year here, 4 million or so fully capitated lives within OptumHealth, still under full delegation. That's an incredible progression over the last 2 or 3 years. It's what's really -- you can see a real differentiation. Super important to remember that, that is being supported not just by clinics. Oftentimes, people think about just clinics. Within OptumHealth, this is really broadly integrated support service. So this could be Optima Home. This is in the clinic, it's behavioral, it's virtual. It's a really comprehensive set of capabilities that underpin that and we believe provides fantastic service for the members who are delegated. You see that growth rate continuing to be super strong, 700,000 already transferred this year. It's extraordinary first quarter for OptumHealth.

所以首先，你現在看到的是，當我們在這裡邁向全年時，OptumHealth 內仍有 400 萬左右的全額生活，仍在完全授權之下。在過去的 2 或 3 年裡，這是一個令人難以置信的進步。這才是真正的 - 你可以看到真正的區別。記住這一點非常重要，這不僅得到診所的支持。通常，人們只想到診所。在 OptumHealth 中，這是真正廣泛集成的支持服務。所以這可能是 Optima Home。這是在診所裡，它是行為的，它是虛擬的。這是一套非常全面的功能，可以支撐這一點，我們相信可以為委派的成員提供出色的服務。你看增長速度繼續非常強勁，今年已經轉移了700,000。對於 OptumHealth 來說，這是非凡的第一季度。

As you step back and look underneath the hood of all of that, of course, UHC is a big piece of it. But there is a very substantial non-UHC delegation quantum in there, which continues to grow well. And as I mentioned in my opening comments, an increase in diversification of that value base as a treatment strategy as it moves into commercial risk and also Medicaid. So really important diversification.

當你退後一步，看看所有這一切的背後時，當然，UHC 是其中的重要組成部分。但是那裡有一個非常可觀的非 UHC 委託數量，並且繼續增長良好。正如我在開場白中提到的那樣，隨著它進入商業風險和醫療補助計劃，增加價值基礎的多樣化作為一種治療策略。所以非常重要的多元化。

Maybe just talk a little bit why, give a little more detail in terms of how you're thinking about the next year or so.

也許只是談談原因，就您對明年左右的想法提供更多細節。

Yes. Well, thank you, Lance and thank you, Andrew. I would underscore some of Andrew's comments. But most particularly, we have developed a comprehensive and differentiated clinical model of care for value-based care. And that is appealing to all of the large national payers who we work with closely, Lance.

是的。好吧，謝謝你，蘭斯，謝謝你，安德魯。我要強調安德魯的一些意見。但最特別的是，我們已經為基於價值的護理開發了一種全面且差異化的臨床護理模式。蘭斯，這對我們密切合作的所有大型國家付款人都很有吸引力。

And so you'll see us continuing to grow our book of value-based care lives with all national payers and regional payers who see the value that we're able to provide both to them and to the members and hence, patients that we serve.

因此，您會看到我們繼續與所有國家付款人和地區付款人一起發展我們基於價值的護理生活，他們看到我們能夠為他們和會員以及我們所服務的患者提供的價值.

And you heard a little bit earlier today from Dirk McMahon on our comprehensive home and community offerings and that's just one of our many platforms. And we weave these together in a comprehensive fashion and we think about not just the member, but the person or patient at the other side of this who's on a journey of health care. And some have multiple chronic diseases. Some want to focus on staying healthy and well and some have catastrophic issues that we have to help them navigate effectively. And our ability to do that is unique and differentiated in the health care industry.

你今天早些時候從 Dirk McMahon 那裡聽說了我們全面的家庭和社區產品，這只是我們眾多平台之一。我們以全面的方式將它們編織在一起，我們不僅考慮會員，還考慮處於醫療保健旅程另一端的人或患者。還有一些患有多種慢性疾病。有些人想專注於保持健康和健康，有些人則遇到了災難性的問題，我們必須幫助他們有效地應對這些問題。我們做到這一點的能力在醫療保健行業是獨一無二的。

So I think you'll see continued growth with multiple payers. We have enjoyed that this year and will continue to do so as the year progresses. And as Andrew touched on, we really view ourselves not as solely a senior health care provider but as a provider for all walks and ages of lives and particularly commercial. So we have commercial offerings in Texas, in California and Massachusetts today and they're a meaningful part of our 4 million fully capitated lives already today. And you'll see us continuing to grow in those established markets with commercial and multiple payers as well as going into new markets. Thank you.

所以我認為你會看到多個付款人的持續增長。今年我們很享受這一點，並將隨著時間的推移繼續這樣做。正如安德魯談到的那樣，我們真的認為自己不僅是一家高級醫療保健提供者，而且是各行各業，尤其是商業領域的提供者。所以我們今天在得克薩斯州、加利福尼亞州和馬薩諸塞州都有商業產品，它們已經成為我們今天 400 萬完全按人頭生活的重要組成部分。你會看到我們在那些擁有商業和多個付款人的成熟市場中繼續發展，並進入新市場。謝謝。

Thanks, Wyatt. Lance, thanks so much for the question.

謝謝，懷亞特。蘭斯，非常感謝你提出這個問題。

Next question comes from Kevin Fischbeck with Bank of America.

下一個問題來自美國銀行的 Kevin Fischbeck。

I just want to go back to MA for a minute. You guys -- it sounds like you're saying the MA changes that are happening are not significant enough to -- in isolation as a individual component to take you off your 13% to 16% EPS growth targets over the next few years. I just want to clarify that.

我只想回到馬薩諸塞州一分鐘。伙計們——聽起來你們是在說正在發生的 MA 變化還不夠重要——作為一個獨立的組成部分，在未來幾年內，你無法實現 13% 到 16% 的 EPS 增長目標。我只想澄清一下。

But then I understand that the 3-year phase-in is important to allow you to adjust to it. But at the same time, trying to understand, if there's a way to think about this. Are you thinking about the impact as being ratable? Or is it a scenario where it's easier to offset it in the beginning because there's always low-hanging fruit and it's harder to offset the impact in year 3? Or is it the opposite, where it's harder to offset the impact in year 1 because you don't have enough time to adjust and it's easier to impact in year 3 as you have more and more time to adjust? Just trying to figure out if there's a difference in how this will play out over the next 3 years and how we should think about your growth?

但後來我明白了 3 年的逐步實施對於讓你適應它很重要。但與此同時，試圖了解是否有辦法考慮這個問題。您是否認為這種影響是可評價的？還是在一開始就更容易抵消它的情況，因為總是有唾手可得的果實，而在第 3 年更難抵消影響？或者恰恰相反，由於您沒有足夠的時間進行調整，因此在第 1 年更難抵消影響，而隨著您有越來越多的調整時間，在第 3 年更容易產生影響？只是想弄清楚這在未來 3 年的表現是否會有所不同，以及我們應該如何考慮您的成長？

Kevin, thanks so much for the question. So to your first point, no, you're absolutely right. We remain firmly of the view that the 13% to 16% long-term growth rate of adjusted earnings per share is very much the zone we're in. We -- you see that again this quarter. We continue to believe that is very much in our horizon as we go forward. Obviously, any given quarter might vary around that but that very much is the zone we expect and I made that comment a little bit earlier. So for sure on that.

凱文，非常感謝你提出這個問題。所以對於你的第一點，不，你是絕對正確的。我們仍然堅信，調整後每股收益 13% 至 16% 的長期增長率正是我們所處的區域。我們 - 你在本季度再次看到這一點。我們繼續相信，在我們前進的過程中，這在我們的視野中非常重要。顯然，任何給定的季度可能會有所不同，但這正是我們所期望的區域，我早些時候發表了評論。所以可以肯定的是。

Listen, as far as this -- the phase-in comes, this will all depend -- different companies will behave differently, I suspect, through all of this. And we see, of course, this change here. We will be making changes to some things in our costs and other areas, as Brian talked about earlier on. Other providers may choose to do things differently.

聽著，就此而言——分階段到來，這一切都取決於——我懷疑，在所有這些過程中，不同的公司會有不同的行為。當然，我們在這裡看到了這種變化。正如 Brian 之前所說，我們將對成本和其他領域的某些方面進行更改。其他供應商可能會選擇不同的做法。

How it plays out, I think, is actually going to be a little bit of a competitive environment, actually and I think it's not something we probably want to get too much into in terms of predicting or sharing exactly how we're going to respond to this. We're getting close to a bid cycle. It's a super important time. We are deeply fixated on making sure that we continue to grow. To do that, we need to make sure that our bids are super competitive. And we're working on that and we'll work our way through it.

我認為，它的結果實際上會有點競爭環境，實際上，我認為就預測或分享我們將如何應對而言，我們可能不想過多參與對此。我們正在接近投標週期。這是一個超級重要的時刻。我們堅定地致力於確保我們繼續發展。為此，我們需要確保我們的出價具有超強競爭力。我們正在努力解決這個問題，我們將努力解決它。

And as I said earlier, the phase-in gives us confidence that we can align with where CMS wants to end up in a way which gives the best chance of beneficiaries being looked after appropriately and that's what we want to try and do. Thanks so much for the question.

正如我之前所說，分階段實施讓我們有信心，我們可以與 CMS 最終的目標保持一致，從而為受益人提供最佳的適當照顧機會，這就是我們想要嘗試做的事情。非常感謝你的問題。

Next question comes from Erin Wright with Morgan Stanley.

下一個問題來自摩根士丹利的 Erin Wright。

On your commercial risk membership, can you speak to what you are seeing there? And is there anything to glean in terms of how Surest is tracking relative to your expectations?

關於您的商業風險會員資格，您能談談您在那裡看到的情況嗎？關於 Surest 相對於您的期望的跟踪情況，有什麼可以收集的嗎？

Erin, thanks so much for the question. I'm going to ask [Dan Kito], who runs our E&I business to respond. Dan?

艾琳，非常感謝你提出這個問題。我要請負責我們 E&I 業務的 [Dan Kito] 做出回應。擔？

Yes. Thanks, Andrew. Thanks, Erin, for the question. And yes, our momentum in the first quarter clearly continued the momentum we had in the back half of last year and puts us well on track, as John said in his prepared remarks, to meet our investor conference goal -- investor conference targets rather, of [$850 million to $1.5 billion] growth.

是的。謝謝，安德魯。謝謝艾琳提出這個問題。是的，我們在第一季度的勢頭顯然延續了去年下半年的勢頭，並且正如約翰在準備好的發言中所說，使我們步入正軌，以實現我們的投資者會議目標——更確切地說，投資者會議目標， [8.5 億至 15 億美元] 的增長。

Surest was a component of that. Surest was a component, about -- accounting for about 25% of our growth in the quarter as that product continues to be adopted. We've shared before that 1 in 9 of our national accounts actually have that product today. We're continuing to see that expand down into the middle market currently as the growth of that product continues. And we also are beginning to experience take-up now on a fully insured basis for that product on a risk basis.

Surest 是其中的一個組成部分。 Surest 是一個組成部分，約占我們本季度增長的 25%，因為該產品繼續被採用。之前我們已經分享過，今天有九分之一的國民賬戶實際上擁有該產品。隨著該產品的持續增長，我們目前繼續看到它向下擴展到中間市場。而且我們現在也開始在風險基礎上對該產品進行完全保險的基礎上的接受。

We shared at the investor conference that Surest was available in 12 states on an insured basis with a year-end target for this year of upwards of 35 states. We currently offer that product in 25 states. So it is a meaningful contributor to our growth and we expect it to be so for the remainder of the year and into the future. Thanks for the question, Erin.

我們在投資者會議上分享了 Surest 在 12 個州的保險基礎上可用，今年年底目標是超過 35 個州。我們目前在 25 個州提供該產品。因此，它對我們的增長做出了有意義的貢獻，我們預計在今年剩餘時間和未來都會如此。謝謝你的問題，艾琳。

Dan, thank you so much. And I just might add something here, Erin, as well. I mean, I think you can see in this Q, you saw it as we rolled into the second half of last year, we're optimistic for the rest of this year. I said earlier that we are expecting continued robust growth on commercial insurance into '24. We really feel like this engine has lit up again and it's super important for the organization. Alongside the fantastic growth you're seeing in the government books of business, in Medicaid and Medicare, we're now seeing the commercial business really come to the fore again, which is a fantastic thing to see within the company.

丹，非常感謝你。艾琳，我也可以在這裡添加一些內容。我的意思是，我認為你可以在這個 Q 中看到，你在我們進入去年下半年時看到了它，我們對今年剩餘時間持樂觀態度。我之前說過，我們預計商業保險將在 24 世紀持續強勁增長。我們真的覺得這個引擎又亮了起來，這對組織來說非常重要。除了您在政府業務簿、醫療補助和醫療保險中看到的驚人增長，我們現在看到商業業務真正再次脫穎而出，這在公司內部是一件了不起的事情。

What you've also just heard a little bit is the way in which Optum is developing its capability to be ready to add even more value to the commercial. So just as that Optum business has built up strength to complement UHC's leadership in Medicare, for example, you just heard Dr. Decker talking about doing the same thing in commercial. As that growth comes in from Dan's organization, you can see how that could play out, is the super important shift and having all those engines fire in simultaneously is really good for us and it's what's driving this growth we're seeing in Q1.

您還剛剛聽到一點點是 Optum 正在開發其能力以準備為商業增加更多價值的方式。因此，正如 Optum 業務已經建立實力以補充 UHC 在醫療保險領域的領導地位一樣，例如，你剛剛聽到 Decker 博士談論在商業領域做同樣的事情。隨著 Dan 組織的增長，你可以看到它是如何發揮作用的，這是一個非常重要的轉變，讓所有這些引擎同時啟動對我們來說真的很好，這就是推動我們在第一季度看到的增長的原因。

So thanks for the question, Erin.

所以謝謝你的問題，艾琳。

Next question comes from Ben Hendrix with RBC Capital Markets.

下一個問題來自 RBC Capital Markets 的 Ben Hendrix。

We've received a number of questions on the EMIS acquisition in the U.K., especially now with the CMA's phase 2 investigation. And I know you can't comment on that specifically. But I was wondering if you could recap the key strategic priorities with this acquisition and discuss the specific capabilities within the platform that OptumInsight or other businesses can leverage.

我們收到了一些關於英國 EMIS 收購的問題，尤其是現在 CMA 的第二階段調查。我知道你不能對此發表具體評論。但我想知道您是否可以通過此次收購重述關鍵戰略重點，並討論 OptumInsight 或其他企業可以利用的平台內的具體功能。

Yes. Ben, thanks so much for the question. Yes, obviously, I can't get into the detail of the regulatory review. But a couple of things to say. So for a long time, many years, Optum has had a business in the U.K. Obviously, the U.K. is a very different type of marketplace to the U.S., but it has a couple of interesting -- very interesting components.

是的。本，非常感謝你提出這個問題。是的，很明顯，我無法深入了解監管審查的細節。但有幾件事要說。所以很長一段時間以來，Optum 一直在英國開展業務。顯然，英國是一個與美國截然不同的市場類型，但它有幾個有趣的 - 非常有趣的組成部分。

One is, you've got very much a primary care-dominated environment, which is obviously very akin to big pieces of OptumHealth. And it's also a marketplace which has looked to develop its abilities around data and connectivity.

一是，你有一個非常以初級保健為主的環境，這顯然非常類似於 OptumHealth 的大塊。它也是一個希望發展其圍繞數據和連接的能力的市場。

EMIS, which is the company we are very keen to partner with, we think could be a very important complement to Optum capabilities, particularly as it speaks to helping us connect some of our software capabilities, data analytic capabilities to primary care providers. About 40% of British primary care providers are connected into the EMIS networks. We think that gives a great opportunity to bring fantastic value to the physician practices and then ultimately to the National Health Service.

EMIS 是我們非常渴望與之合作的公司，我們認為它可能是對 Optum 功能的一個非常重要的補充，特別是當它談到幫助我們將我們的一些軟件功能、數據分析功能連接到初級保健提供者時。大約 40% 的英國初級保健提供者連接到 EMIS 網絡。我們認為這提供了一個很好的機會，可以為醫生的實踐帶來巨大的價值，然後最終為國家衛生服務體繫帶來巨大的價值。

And what we'd like to believe, if we're able to go through that transaction, is that it can really allow us to start to create another node of innovation alongside all of our other technology platforms to start to develop technology software platforms and the like, which not only could be used in a market like the U.K. but in other economies around the world which perhaps have slightly different shaped health care systems to the U.S. health care system.

我們願意相信，如果我們能夠完成那筆交易，它真的可以讓我們開始與我們所有其他技術平台一起創建另一個創新節點，開始開發技術軟件平台和等等，它不僅可以用於像英國這樣的市場，還可以用於世界上其他經濟體，這些經濟體的醫療保健系統可能與美國的醫療保健系統略有不同。

So we see this as good for the U.K. We think it's potentially an interesting opportunity to further enhance our investments and progress in technology and software development. And it's why we're keen to continue the process to get the transaction done. And obviously, we will be working diligently on that. Thanks so much for the question, Ben.

所以我們認為這對英國有利。我們認為這可能是一個有趣的機會，可以進一步加強我們在技術和軟件開發方面的投資和進步。這就是為什麼我們熱衷於繼續完成交易的過程。顯然，我們將為此努力工作。非常感謝你提出這個問題，本。

Next question comes from Scott Fidel with Stephens.

下一個問題來自 Scott Fidel 和 Stephens。

Was actually hoping just to revisit the full year revenue guidance. Just given the first quarter, clearly, you were pacing better than The Street and you've since closed LHCG. And you're now looking to eclipse the high end of your MA target for the year. So clearly, it seems like there's a lot of upside momentum relative to the initial guidance you gave at Investor Day. I know you don't typically update the revenue guidance intra-quarter or during the quarters but certainly interested if maybe you can give us some refined thinking around that.

實際上只是希望重新審視全年收入指導。就第一季度而言，很明顯，你的節奏比 The Street 好，而且你已經關閉了 LHCG。而您現在正在尋求超越今年 MA 目標的高端。很明顯，相對於你在投資者日給出的初步指導，似乎有很多上行勢頭。我知道您通常不會在季度內或季度內更新收入指導，但如果您可以就此給我們一些改進的想法，您肯定會感興趣。

Yes. Thanks so much. Let me ask John to comment.

是的。非常感謝。讓我請約翰發表評論。

Scott, yes, good strength and growth really across the businesses in the quarter. And we're through some of those areas really across both UHC and Optum in terms of the strength we're seeing in terms of membership growth; in terms of the performance of the other businesses, OptumRx, a call-out here in terms of the strength they've seen in terms of their new customer wins and retention; and OptumHealth in its growth in value-based lives. So all strong contributors to that.

斯科特，是的，本季度的業務確實具有良好的實力和增長。就我們在會員增長方面看到的實力而言，我們確實在 UHC 和 Optum 之間經歷了其中一些領域；就其他業務的表現而言，OptumRx，就他們在贏得新客戶和保留客戶方面所看到的實力而言，這裡是一個亮點；和 OptumHealth 在基於價值的生活中的增長。所以所有強大的貢獻者。

And yes, we're a little ahead of kind of where the view was in terms of the external view on revenue guidance. So certainly, we're positively biased in terms of the type of growth that we're seeing across the enterprise. Happy to see that. You're also right, probably not doing any updates here in the first quarter in terms of that full year view at this distance but really a strong place to start the year. Thank you.

是的，我們在收入指導的外部觀點方面領先於某種觀點。因此，可以肯定的是，就我們在整個企業中看到的增長類型而言，我們存在積極的偏見。很高興看到這一點。你也是對的，第一季度可能沒有在這個距離的全年視圖方面做任何更新，但確實是今年開始的好地方。謝謝。

Thanks, John.

謝謝，約翰。

Our last question will come from David Windley with Jefferies.

我們的最後一個問題將來自 Jefferies 的 David Windley。

I wanted to ask another question on MA and value-based care. I'm wondering if the risk model, Andrew, changes your views about the target member in MA, that is, say, most attractive to target between individual MA versus duals.

我想問另一個關於 MA 和基於價值的護理的問題。我想知道風險模型，安德魯，是否改變了你對 MA 中目標成員的看法，也就是說，在個人 MA 與雙重目標之間最具吸引力的目標。

And in value-based care, seeing the nice growth, particularly interesting to us that the eliminations grew a lot, which I'm inferring is intercompany between OptumHealth and UHC. And I'm wondering if that is a signal that duals were a big part of the value-based care add in the first quarter. So kind of a [weeds] question but strategically, basically interested to know if duals are still a very important target for MA.

在基於價值的護理中，看到良好的增長，我們特別感興趣的是消除增長了很多，我推斷這是 OptumHealth 和 UHC 之間的公司間關係。我想知道這是否表明雙胞胎是第一季度基於價值的護理增加的重要組成部分。這是一個 [雜草] 問題，但從戰略上講，基本上有興趣知道對偶是否仍然是 MA 的一個非常重要的目標。

So David, thanks so much for the question. So you're quite right, the eliminations are -- a big piece of that is the Optum Health UHC dynamic and not surprising because you see such a high rate transfer in Q1. A large fraction of that 700,000 is UHC, not -- obviously, others as well but a large fraction. And of course, within that, as we guided last year, significant proportion of dual special need patients who -- most complex patients, really, I think, particularly appropriate patients to benefit from a value-based care approach where you have a really integrated wraparound sort of capabilities. So it's certainly true on all of that.

大衛，非常感謝你提出這個問題。所以你是對的，消除是——其中很大一部分是 Optum Health UHC 的動態，這並不奇怪，因為你在第一季度看到瞭如此高的轉移率。這 700,000 人中有很大一部分是 UHC，顯然，其他人也是如此，但很大一部分。當然，正如我們去年指導的那樣，其中很大一部分雙重特殊需要的患者——我認為，最複雜的患者，真的，特別適合從基於價值的護理方法中受益的患者，你有一個真正綜合的環繞式功能。所以這一切都是真的。

I'm going to slightly disagree with your premise here. We're not in the business of targeting a certain type of member or patient. We want to look after Medicare patients and members, whether they are community MA, whether they're dual special need, whether they're complex or not, whether they're early in their disease in an aging patent or advanced in their disease in an aging patent. And then the job for our organization is to mix and match our capabilities to do that as efficiently as possible.

我在這里略微不同意你的前提。我們不以特定類型的會員或患者為目標。我們想照顧 Medicare 患者和成員，無論他們是社區 MA，他們是否有雙重特殊需要，他們是否複雜，無論他們處於老年疾病的早期還是疾病晚期一項老化的專利。然後我們組織的工作就是混合和匹配我們的能力，以盡可能高效地做到這一點。

And the great thing about OptumHealth, David, is that we have such an interesting portfolio of capabilities, which allow us to dial up and down our activities in response to what the patient needs and the way in which they need to be looked after.

大衛，OptumHealth 的偉大之處在於我們擁有如此有趣的功能組合，這使我們能夠根據患者的需求和需要照顧的方式調整我們的活動。

So I would say we're going to be continuing to lean in across the board. It's just as important to us to grow in dual special needs as well as community MA. And I'd say that the progress we make in terms of impacting these folks' lives and the reason why over 90% of members describe this as a high-satisfaction space is because they -- these people need the support at this stage of their life. And we think that between the programs that UHC offer and then the backup that OptumHealth brings in terms of deep clinical engagement really makes a difference and that's what drives us.

所以我想說我們將繼續全面傾斜。在雙重特殊需求和社區 MA 中成長對我們來說同樣重要。我要說的是，我們在影響這些人的生活方面取得的進步以及超過 90% 的成員將其描述為高滿意度空間的原因是因為他們——這些人在他們的這個階段需要支持生活。我們認為，在 UHC 提供的計劃與 OptumHealth 在深度臨床參與方面帶來的支持之間，確實有所作為，這就是我們的動力。

David, appreciate the question. Thank you very much and I'm afraid we're at the end of the call. I hope you leave this call with a sense of our optimism and focus on continued growth for the year ahead. We remain intent on expanding our ability to help improve health care at the system and individual levels and executing with excellence for all those we serve. And we look forward to sharing our progress on this journey with you again in July. In the meantime, thank you so much for your questions and your attention this morning. Thank you.

大衛，欣賞這個問題。非常感謝，恐怕我們已經結束通話了。我希望您帶著我們的樂觀情緒結束這次電話會議，並專注於來年的持續增長。我們仍然致力於擴大我們的能力，以幫助改善系統和個人層面的醫療保健，並為我們所服務的所有人提供卓越的服務。我們期待在 7 月再次與您分享我們在這一旅程中取得的進展。同時，非常感謝您今天早上提出的問題和關注。謝謝。

And with that, that does conclude today's call. Thank you for your participation. You may now disconnect.

這樣，今天的電話會議就結束了。感謝您的參與。您現在可以斷開連接。