聯合健康 (UNH) 2024 Q1 法說會逐字稿

Good morning, and welcome to the UnitedHealth Group First Quarter 2024 Earnings Conference Call. (Operator Instructions) As a reminder, this call is being recorded.

早安，歡迎參加聯合健康集團 2024 年第一季財報電話會議。 （操作員說明）謹此提醒，此通話正在錄音。

Here are some 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 included in our current and periodic filings.

以下是一些介紹性資訊。本次電話會議包含美國聯邦證券法規定的前瞻性陳述。這些陳述存在風險和不確定性，可能導致實際結果與歷史經驗或當前預期有重大差異。對一些風險和不確定性的描述可以在我們向美國證券交易委員會提交的報告中找到，包括我們目前和定期提交的文件中包含的警告聲明。

This call will also reference non-GAAP amounts. A reconciliation of the non-GAAP to GAAP amounts is available on the financial and earnings 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 in our Form 8-K dated April 16, 2024, which may be accessed from the Investor Relations page of the company's website.

此次電話會議也將參考非公認會計原則金額。非 GAAP 與 GAAP 金額的調整表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資訊包含在我們今天早上發布的收益報告和日期為 2024 年 4 月 16 日的 8-K 表格中，您可以從公司網站的投資者關係頁面訪問該表格。

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

我現在將會議交給聯合健康集團執行長安德魯威蒂 (Andrew Witty)。

Good morning, and thank you for joining us today. We have a lot to cover. First, we'll discuss the status and impact of the Change Healthcare cyberattack. Then we'll turn to the performance of our businesses, which continue to grow and perform well.

早安，感謝您今天加入我們。我們有很多事情要講。首先，我們將討論 Change Healthcare 網路攻擊的現狀和影響。然後我們將轉向我們業務的業績，這些業務持續成長且表現良好。

It's important to underscore at the outset that even as we have devoted significant attention to addressing the Change Healthcare attack, the vast majority of the 400,000 people of this enterprise have remained as usual, intensely focused on delivering for all those we serve. That dedication is reflected in our overall performance this quarter. Directly as a result of their hard work and the broad performance of our diversified businesses, we're able to reconfirm our full year adjusted earnings outlook even as we absorb $0.30 to $0.40 per share in business disruption impacts related to Change Healthcare.

首先需要強調的是，儘管我們投入了大量精力來解決 Change Healthcare 攻擊，但該企業 40 萬名員工中的絕大多數人仍然像往常一樣，專注於為我們所服務的所有人提供服務。這種奉獻精神反映在我們本季的整體業績中。直接由於他們的辛勤工作和我們多元化業務的廣泛業績，即使我們吸收了每股 0.30 至 0.40 美元的與 Change Healthcare 相關的業務中斷影響，我們也能夠重新確認我們的全年調整後盈利前景。

Now turning to Change Healthcare. This was an unprecedented attack by a malicious actor on the U.S. health system. We promptly disconnected the affected services and turned our focus to two main areas, restoration and support. The attack disrupted the ability of care providers to file claims and be paid for their work. We moved quickly to fill this gap.

現在轉向改變醫療保健。這是惡意行為者對美國醫療系統發動的史無前例的攻擊。我們立即斷開了受影響的服務，並將重點轉向兩個主要領域：恢復和支援。這次攻擊破壞了護理提供者提出索賠和獲得工作報酬的能力。我們迅速採取行動來填補這一空白。

Fortunately, we were able to bring to bear the substantial resources of UnitedHealth Group to drive the recovery and begin to mitigate the impact. Resources, which are stand-alone Change Healthcare, would not have had access to on its own. These are the resources and the philosophy that underpinned our remediation of healthcare.gov back in 2013 and our distribution of CMS COVID Emergency Relief Fund to care providers in 2020. Here, we assisted care providers in financial need, providing over $6 billion in funding, all at no cost to them.

幸運的是，我們能夠利用聯合健康集團的大量資源來推動復甦並開始減輕影響。資源是獨立的 Change Healthcare，無法自行存取。這些資源和理念支撐著我們在2013 年對healthcare.gov 進行補救，以及在2020 年向護理提供者分發CMS COVID 緊急救濟基金。的資金援助，這一切對他們來說都是免費的。

We rapidly deployed resources to develop alternative solutions and move promptly to restore claims and payment services. We've made substantial progress, and we will not rest until care providers connectivity needs are met. And to help care providers mitigate workflow disruptions and help ensure the uninterrupted delivery of care, for a period of time, we suspended some care management activities. I'm immensely grateful for our colleagues who continue to work tirelessly day and night to restore services, free up funds for providers and protect the broader health system.

我們迅速部署資源來開發替代解決方案，並迅速採取行動恢復索賠和支付服務。我們已經取得了實質進展，在滿足照護提供者的連結需求之前我們不會休息。為了幫助護理提供者減輕工作流程中斷並確保不間斷地提供護理，我們在一段時間內暫停了一些護理管理活動。我非常感謝我們的同事，他們日以繼夜地繼續不懈地工作，以恢復服務、為提供者騰出資金並保護更廣泛的衛生系統。

Let me touch on two more items we know are of interest to you. First is care activity. The central point is that overall care patterns are consistent with what we anticipated last year heading into 2024 and within the outlook we shared with you in November. The second item is the essential value of Medicare Advantage to seniors.

讓我談談我們知道您感興趣的另外兩個項目。首先是護理活動。中心點是，整體護理模式與我們去年對 20​​24 年的預期以及我們在 11 月與您分享的展望一致。第二項是Medicare Advantage對老年人的本質價值。

Here are what we see are some of the core facts regarding Medicare Advantage: it drives better health outcomes; provides a higher value, significantly more comprehensive benefit for people, all at a lower cost of beneficiaries and taxpayers; and is more popular with and valuable to seniors than traditional Medicare.

以下是我們看到的有關 Medicare Advantage 的一些核心事實： 它可以帶來更好的健康結果；為人們提供更高價值、更全面的福利，而受益者和納稅人的成本卻更低；比傳統的醫療保險更受老年人歡迎，也更有價值。

Medicare Advantage consumers spend on average, 45% less on premiums and out-of-pocket costs than those in traditional Medicare. That translates into nearly $2,400 in savings annually, and several times more for the country's most underserved and medically challenged populations. That's one of the many reasons why more than half of seniors choose Medicare Advantage today versus 30% 10 years ago and why we believe these offerings will continue to grow strongly for years to come.

Medicare Advantage 消費者的平均保費和自付費用比傳統 Medicare 的消費者少 45%。這意味著每年可節省近 2,400 美元，對於該國服務最匱乏和醫療困難的人群來說，這一數字是數倍。這就是為什麼今天超過一半的老年人選擇 Medicare Advantage（而 10 年前只有 30%）的眾多原因之一，也是我們相信這些產品在未來幾年將繼續強勁增長的原因之一。

2025 is the second year of the significant 3-year phased funding reductions to Medicare Advantage introduced by CMS last year. Here, in early 2024, we're at the beginning of our thoughtful, responsible 3-year plan we developed last year to adapt to those changes. Our strategy continues to focus on providing as much stability as possible in the reduced funding environment, improving outcomes and experiences for the consumers we're privileged to serve, and delivering the performance you expect from us. We believe our long-term perspective and the deliberate multiyear approach we began last year is serving us well, putting us into a position of sustainable competitive strength.

2025 年是 CMS 去年推出的 Medicare Advantage 三年分階段資金大幅削減計劃的第二年。 2024 年初，我們正處於去年制定的深思熟慮、負責任的三年計劃的開始，以適應這些變化。我們的策略繼續專注於在資金減少的環境中提供盡可能多的穩定性，改善我們有幸服務的消費者的成果和體驗，並提供您對我們的期望。我們相信，我們的長期視角和去年開始的深思熟慮的多年方法對我們很有幫助，使我們處於可持續競爭優勢的地位。

Among a handful of notable business developments to share, UnitedHealthcare was honored to secure major Medicaid wins in Virginia, Texas and Michigan. While we were disappointed in the outcome in Florida, we'll be seeking to better understand the process and considerations there. There is a substantial pipeline of Medicaid RFPs, and we're confident that our offerings will resonate in other states as well.

在值得分享的一些值得注意的業務發展中，聯合醫療保健很榮幸在維吉尼亞州、德克薩斯州和密西根州獲得了重大醫療補助。雖然我們對佛羅裡達州的結果感到失望，但我們將尋求更好地了解那裡的過程和考慮因素。醫療補助 RFP 有大量的管道，我們相信我們的產品也會在其他州引起共鳴。

UnitedHealthcare's commercial benefits continued their momentum for last year, growing to serve 2 million more people in the first quarter, the largest increase in years. This growth was across UHC's commercial customer segments from individuals up through the largest of employers. This is further evidence of our innovative and consumer-centric products have established a footing for sustained growth.

UnitedHealthcare 的商業福利延續了去年的勢頭，第一季服務人數增加了 200 萬人，這是多年來的最大增幅。這種成長遍及 UHC 的商業客戶群，從個人到最大的雇主。這進一步證明我們的創新和以消費者為中心的產品已經為持續成長奠定了基礎。

We also see continued momentum at Optum Rx coming off last year's record selling season with a recent win in Hawaii and the renewal of our contract with the Department of Veteran Affairs. We're grateful for the opportunity to support them. And Optum Health is tracking well to achieve its objective of growing to serve another 750,000 patients in value-based arrangements this year, in partnership with many payers.

我們還看到 Optum Rx 在去年創紀錄的銷售季中繼續保持強勁勢頭，最近在夏威夷取得了勝利，並與退伍軍人事務部續簽了合約。我們很感激有機會支持他們。 Optum Health 正在順利實現其目標，即今年與許多付款人合作，透過基於價值的安排為另外 750,000 名患者提供服務。

Before I turn it over to John Rex, our President and Chief Financial Officer, I want to acknowledge Dirk McMahon, recently retired after more than 20 years of service. I'd like to thank him for his leadership and partnership. Dirk has left an indelible mark on this company through the example he set and the many of our leaders he has mentored, John?

在我將其交給我們的總裁兼財務長 John Rex 之前，我要感謝 Dirk McMahon，他在服務了 20 多年後最近退休了。我要感謝他的領導和合作。德克透過他樹立的榜樣以及他指導過的許多領導者為這家公司留下了不可磨滅的印記，約翰？

Thank you, Andrew. This morning, I'll first provide color on some of the unique items in the quarter directly related to the Change Healthcare cyberattack, followed by care activity trends, business updates and finally, thoughts on the remainder of '24. But first, let me start at the most fundamental level.

謝謝你，安德魯。今天早上，我將首先介紹本季與 Change Healthcare 網路攻擊直接相關的一些獨特項目，然後是護理活動趨勢、業務更新，最後是對 24 年剩餘時間的想法。但首先，讓我先從最基本的層面開始。

The UnitedHealth Group businesses continued to grow and performed well during the quarter, and we are encouraged by the momentum and the many opportunities to serve we're seeing across the enterprise. On the Change Healthcare cyberattack. As Andrew noted, our guiding focus throughout has been to make sure patient care is delivered and care providers access to funding is secured as we work to bring back services fully. The cyber impacts in the quarter totaled about $870 million or $0.74 per share. At this distance, we estimate the full year impact will be $1.15 to $1.35 per share.

聯合健康集團業務在本季度繼續成長並表現良好，我們對整個企業的發展勢頭和眾多服務機會感到鼓舞。關於改變醫療保健網路攻擊。正如安德魯指出的那樣，我們自始至終的指導重點是確保在我們努力全面恢復服務的過程中提供患者護理並確保護理提供者獲得資金。本季的網路影響總計約為 8.7 億美元，即每股 0.74 美元。按照這個距離，我們估計全年影響將為每股 1.15 美元至 1.35 美元。

Let me break that down into its key components. Of the $870 million, about $595 million were direct costs due to the clearinghouse platform restoration and other response efforts, including medical expenses directly relating to the temporary suspension of some care management activity. For the full year, we estimate these direct costs at $1 billion to $1.15 billion or $0.85 to $0.95 per share. It's important to note these direct costs are included in net earnings, but are excluded from adjusted earnings per share.

讓我將其分解為關鍵組成部分。在 8.7 億美元中，約 5.95 億美元是由於清算所平台恢復和其他應對工作而產生的直接費用，包括與暫時中止某些護理管理活動直接相關的醫療費用。對於全年，我們估計這些直接成本為 10 億至 11.5 億美元，即每股 0.85 至 0.95 美元。值得注意的是，這些直接成本包含在淨利潤中，但不包括在調整後每股收益中。

The other components affecting our results relates to the disruption of ongoing Change Healthcare business. This is driven by the loss of revenues associated with the affected services, all while incurring the support and costs to keep these capabilities fully ready to return to service. Notably, these effects are not excluded from adjusted earnings. In the first quarter, this impact was about $280 million or $0.25 per share. At this distance, we currently estimate the business disruption at $350 million to $450 million or $0.30 to $0.40 per share for the year. This, of course, will depend on the ultimate timing of service and transaction volume restoration.

影響我們業績的其他因素與正在進行的變革醫療保健業務的中斷有關。這是由於與受影響的服務相關的收入損失，同時產生了支援和成本，以確保這些功能完全準備好恢復服務。值得注意的是，這些影響並沒有被排除在調整後的收益之外。第一季度，這一影響約為 2.8 億美元，即每股 0.25 美元。按照這個距離，我們目前估計今年的業務中斷為 3.5 億至 4.5 億美元，即每股 0.30 至 0.40 美元。當然，這將取決於服務和交易量恢復的最終時間。

These elements are broken out for you in supplemental tables provided with our press release this morning. Of course, we will provide regular updates on our progress and outlook throughout the course of the year. While much of Change Healthcare's functionality and services have been restored, we are working hard to restore more. And the objective we all share is for an even stronger Change Healthcare to be fully returned to expected performance levels next year. I'll come back to some of these elements in more detail in just a moment.

今天早上我們新聞稿中提供的補充表格中為您詳細列出了這些要素。當然，我們將在一年中定期更新我們的進展和展望。雖然 Change Healthcare 的大部分功能和服務已經恢復，但我們正在努力恢復更多功能和服務。我們共同的目標是讓醫療保健變得更強大，明年完全恢復到預期的績效水準。稍後我將更詳細地討論其中一些元素。

Turning to underlying care patterns. The headline is that these continue within our expectations. Outpatient care activity among seniors remains consistent with the elevated levels we began seeing in the first half of '23 and for which we planned. So we continue to be comfortable with the outlook we established last June when we filed our 2024 Medicare Advantage benefit offerings. The winter seasonal activity we discussed with you in January, particularly related to strong vaccine uptake, higher respiratory illness incidents and related physician office visits has subsided. Overall inpatient care activity also remains within our expectations.

轉向基礎護理模式。標題是這些繼續在我們的預期之內。老年人的門診護理活動與我們在 23 年上半年開始看到的以及我們計劃的較高水平保持一致。因此，我們仍然對去年 6 月提交 2024 年 Medicare Advantage 福利產品時確定的前景感到滿意。我們在一月份與您討論過的冬季季節性活動，特別是與疫苗接種量增加、呼吸道疾病事件增加和相關醫生就診有關的活動已經消退。整體住院護理活動也仍在我們的預期之內。

The first quarter medical care ratio at 84.3% included roughly 40 basis points or about $340 million related to the temporary suspension of some care management activities. These have been recently reinstated. The majority of the remaining $325 million of full year medical expense impact included in our outlook will land in the second quarter. Notably, we did not reflect any favorable earnings impacting medical reserve development in the quarter. Out of prudence, due to the potential for the cyberattack to affect claims receipt timing, we reflected an additional $800 million of claims reserves. We'll continue with a judicious view as we progress over the next several quarters.

第一季的醫療照護比率為 84.3%，其中包括與暫時中止某些護理管理活動相關的約 40 個基點或約 3.4 億美元。這些最近已恢復。我們的展望中剩餘的 3.25 億美元全年醫療費用影響大部分將在第二季發生。值得注意的是，我們沒有反映出任何影響本季醫療儲備發展的有利獲利。出於謹慎考慮，由於網路攻擊可能影響索賠接收時間，我們額外反映了 8 億美元的索賠準備金。隨著我們在接下來幾個季度的進展，我們將繼續保持明智的觀點。

Turning to the performance of our businesses. The most important takeaway is they are growing and performing at a level, which allows us to maintain the adjusted earnings per share objectives we established last November, even while taking on the business disruption impacts of the Change Healthcare attack. At UnitedHealthcare, revenues of $75.4 billion grew nearly $5 billion. Within our domestic commercial membership, we're off to a strong start, powered by disciplined growth, serving 2.1 million new consumers in the first quarter. We are encouraged by the momentum and positive customer response to our differentiated offerings and look forward to building further upon that momentum heading into '25.

轉向我們業務的績效。最重要的收穫是它們的成長和表現達到了一定水平，這使我們能夠維持去年 11 月制定的調整後每股收益目標，即使在承受 Change Healthcare 攻擊造成的業務中斷影響的情況下也是如此。 UnitedHealthcare 的收入為 754 億美元，成長了近 50 億美元。在我們的國內商業會員中，我們有了一個良好的開端，在嚴格成長的推動下，第一季為 210 萬新消費者提供服務。我們對我們的差異化產品的勢頭和積極的客戶反應感到鼓舞，並期待在 25 世紀進一步鞏固這一勢頭。

For Medicare Advantage. As you would anticipate, we are deeply into our '25 planning activities. As we finalize our '25 benefit designs over the next several weeks, we will build competitive offerings that once again, appropriately reflect the funding and cost environment. We approached this last year with a deliberate 3-year plan, which continues firmly on track and positions us well going into '25.

對於 Medicare Advantage。正如您所預料的，我們正在深入 '25 規劃活動。當我們在接下來的幾週內最終確定 '25 福利設計時，我們將建立有競爭力的產品，再次適當地反映資金和成本環境。去年，我們透過深思熟慮的 3 年計劃來實現這一目標，該計劃繼續堅定地走在正軌上，並為我們進入 25 世紀做好準備。

Our Medicaid business ended the first quarter with 7.7 million members. As Andrew noted, key wins in Texas, Virginia and Michigan demonstrate the value state customers see in our offerings. In Virginia, UHC was the highest scoring plan with particular strength in member-centric care, benefits and service delivery, quality and value-based payments. In Texas, UHC was awarded the maximum number of possible service areas, expanding the number of people we will have the opportunity to serve. And in Michigan, UHC achieved perfect scores in such critical consumer-centric areas as social determinants of health and health equity, further solidifying our value proposition.

我們的醫療補助業務截至第一季末擁有 770 萬名會員。正如安德魯所指出的那樣，德克薩斯州、維吉尼亞州和密西根州的重大勝利證明了該州客戶在我們的產品中看到的價值。在維吉尼亞州，全民健康覆蓋是得分最高的計劃，在以會員為中心的護理、福利和服務交付、品質和基於價值的支付方面特別有優勢。在德克薩斯州，UHC 獲得了盡可能多的服務區域，從而擴大了我們有機會服務的人數。在密西根州，全民健康覆蓋在健康的社會決定因素和健康公平等以消費者為中心的關鍵領域取得了滿分，進一步鞏固了我們的價值主張。

Optum Health's revenues grew by 16% to $26.7 billion as we increased the number of patients served and are on track to approach 5 million patients in value-based care by year-end. For the most complex patients that Optum Health serves, we have engaged 75% through the first quarter this year, a significant increase in the number of patients engaged over last year. This reflects progressively earlier connectivity with patients and the ability to improve their health outcomes and experiences more rapidly.

隨著我們服務的患者數量增加，Optum Health 的收入增加了 16%，達到 267 億美元，並預計在年底前為接近 500 萬名患者提供基於價值的護理。對於 Optum Health 服務的最複雜的患者，我們今年第一季的參與率為 75%，比去年的參與人數顯著增加。這反映出越來越早地與患者建立聯繫以及更快地改善他們的健康結果和體驗的能力。

Optum Rx revenues grew 12% to $30.8 billion, driven by new planned starts, continued expansion within existing partnerships and growth within pharmacy services. Optum Insight, as you know, is where the Change Healthcare business resides. In the quarter, about $500 million of the $870 million total impact is within Optum Insight. Just under half of this are direct response costs, think clearinghouse restoration activities, which we have excluded from adjusted earnings. And slightly over half are the business disruption effects, which are not excluded from adjusted earnings.

在新計劃啟動、現有合作夥伴關係持續擴張以及藥房服務成長的推動下，Optum Rx 收入成長 12% 至 308 億美元。如您所知，Optum Insight 是變革醫療保健業務的所在地。本季 8.7 億美元的總影響中約有 5 億美元來自 Optum Insight。其中不到一半是直接回應成本，想想票據交換所恢復活動，我們已將其排除在調整後的收益之外。略多於一半的影響是業務中斷的影響，這些影響不排除在調整後的收益之外。

For many of the impacted Change Healthcare services, transaction volume drives revenues. So the effect of the attack in the period is one of keeping all the lights brightly burning at full readiness to resume services, while revenue production was essentially suspended. To be clear, the Optum Insight team did the critical and right thing, promptly shutting off services and finding any method possible to keep the care system working, including helping clients find alternative solutions. Coming out of this incident, the team will be working tirelessly with customers to recover transaction volumes and demonstrate that Change Healthcare is ready to serve and is more valuable than ever. Beyond Change Healthcare, the Optum Insight revenue backlog increased to nearly $33 billion, growth of over $2 billion from a year ago, driven by health system partnerships to provide business process and information technology services.

對於許多受影響的 Change Healthcare 服務而言，交易量推動了收入。因此，這段時期攻擊的影響之一是讓所有的燈都亮著，做好恢復服務的準備，而收入生產基本上是暫停。需要明確的是，Optum Insight 團隊做了關鍵且正確的事情，立即關閉服務並尋找任何可能的方法來保持護理系統正常運行，包括幫助客戶找到替代解決方案。經歷這次事件後，團隊將不懈地與客戶合作，以恢復交易量，並證明 Change Healthcare 已做好服務準備，並且比以往任何時候都更有價值。除了 Change Healthcare 之外，在提供業務流程和資訊技術服務的醫療系統合作夥伴關係的推動下，Optum Insight 的收入積壓增至近 330 億美元，比一年前增長了 20 億美元以上。

A couple of other items of note that were affected by the cyberattack. Days claims payable in the first quarter were 47.1 compared to the 47.9 in the fourth quarter '23 and 47.8 a year ago. The accelerated payments to care providers and the Brazil sale reduced what would have been our reported measure for the quarter by about 3 days. The medical cost payable balance increased $1.6 billion from year-end '23 to $34 billion. The change reflects a $3 billion increase in the incurred, but not yet reported component or IBNR. This is the result of the prudent ongoing claims receipt assessment, offset by a $1.6 billion reduction in the fully processed claims component due to care provider payments acceleration.

其他一些受網路攻擊影響的值得注意的項目。第一季的應付理賠天數為 47.1 天，而 2023 年第四季為 47.9 天，去年同期為 47.8 天。對護理提供者的加速付款和巴西銷售將我們本季報告的指標減少了約 3 天。應付醫療費用餘額較 2023 年底增加 16 億美元，達 340 億美元。這項變更反映了已發生但尚未報告的部分或 IBNR 增加了 30 億美元。這是審慎的持續索賠收據評估的結果，但由於護理提供者付款加速而導致完全處理的索賠部分減少了 16 億美元，從而抵消了這一結果。

Cash flows from operations in the quarter were $1.1 billion, impacted by about $3 billion due to the funding acceleration to care providers and collection extensions to affected customers and were additionally impacted by the timing of some public sector receipts.

本季營運現金流為11 億美元，由於向護理服務提供者提供的資金加速和對受影響客戶的收款範圍擴大而受到約30 億美元的影響，此外還受到一些公共部門收款時間的影響。

To summarize, a continued focus on better serving patients and the health system underpins our mission and growth drivers, which remain strong. And as we move further into this year, the broadly strong performance across our enterprise allows us to continue to expect full year adjusted earnings per share in the range of $27.50 to $28 even as we incorporate the $0.30 to $0.40 per share of business disruption impacts.

總而言之，持續關注更好地服務患者和衛生系統是我們的使命和成長動力的基礎，而這些仍然強勁。隨著今年的進一步推進，我們企業的普遍強勁業績使我們能夠繼續預期全年調整後每股收益在27.50 美元到28 美元的範圍內，即使我們考慮了每股0.30 美元到0.40 美元的業務中斷影響。

Now I'll turn it back to Andrew.

現在我會把它轉回給安德魯。

Thank you, John. As we look out over the next several years, we, like many others, see a health care environment in need of improvements in quality, value, simplification and consumer responsiveness. While we're a comparatively small part of the $5 trillion U.S. health system, UnitedHealth Group's strategy is focused on helping to meet those very needs, and we're well positioned to do so.

謝謝你，約翰。展望未來幾年，我們和許多其他人一樣，看到醫療保健環境需要在品質、價值、簡化和消費者回應能力方面進行改進。雖然我們在價值 5 兆美元的美國衛生系統中只佔相對較小的一部分，但聯合健康集團的戰略重點是幫助滿足這些需求，而且我們完全有能力做到這一點。

Our focus are on understanding opportunities to align incentives, notably led via our value-based care offerings demonstrates what can be achieved through partnership and realignment of ways of working. Our commitment to improving all we do for consumers stimulates our drive to help bring care to patients where they need and want it, at prices and with an experience worthy of the 2020s. We have a proven commitment to making available our insights and innovations widely and quickly throughout the market alongside our relentless multipayer orientation at Optum. We remain committed to partnering with others throughout health care to help make the health system more modern and responsive. Our success depends on enabling partners and customers outside our company to succeed.

我們的重點是了解調整激勵措施的機會，特別是透過我們基於價值的護理產品來引導，這表明透過合作夥伴關係和工作方式的調整可以實現什麼目標。我們致力於改善為消費者所做的一切，這激發了我們的動力，以值得 2020 年代的價格和體驗，幫助為患者提供他們需要和想要的護理。我們堅定地致力於在整個市場上廣泛、快速地提供我們的見解和創新，同時我們堅持不懈地以多支付者為導向。我們仍然致力於在整個醫療保健領域與其他人合作，幫助使衛生系統更加現代化和反應靈敏。我們的成功取決於幫助公司以外的合作夥伴和客戶成功。

The combination of this strategic design, strengths and behaviors underpins our high confidence in our ability to navigate the inevitable environmental change and challenge. And it reinforces our confidence in our ability to perform and grow strongly as you have come to expect from us.

這種策略設計、優勢和行為的結合鞏固了我們對應對不可避免的環境變化和挑戰的能力的高度信心。這增強了我們對我們能夠按照您對我們的期望表現和強勁發展的能力的信心。

With that, operator, we'll turn to questions.

接線員，接下來我們將開始提問。

(Operator Instructions) And we'll go first to Lisa Gill with JPMorgan.

（操作員說明）我們先去找摩根大通的麗莎吉爾。

I just want to go back to your comment around your 3-year plan as it pertains to V28. Does the 2025 final bid change anything around that plan? And how do I think about the impact in the quarter of V28 in both Optum Health as well as on the UnitedHealth side?

我只想回到您對與 V28 相關的 3 年計劃的評論。 2025 年的最終投標是否會改變該計劃？我該如何看待 V28 本季對 Optum Health 以及 UnitedHealth 的影響？

Lisa, thanks so much for the question. Yes, as we said a few times and certainly repeated this morning, we've looked at the changes that CMS finalized last year really thoughtfully and we see this as a 3-year strategy and response. Obviously, it's phased in over 3 years. We want to make sure we don't do anything that chases short-term growth, for example, but puts a lot -- puts at risk long-term sustainability. What you're also not going to see from us is a kind of knee-jerk reaction between growth and margin. We want to be very focused on ensuring that year in, year out, we're a super reliable performer in this environment.

麗莎，非常感謝你的提問。是的，正如我們多次說過並且今天早上肯定重複的那樣，我們非常認真地研究了 CMS 去年最終確定的變更，我們將其視為一項為期 3 年的戰略和應對措施。顯然，它已經分階段進行了3年多。例如，我們希望確保我們不會做任何追求短期成長的事情，而是將長期永續性置於風險之中。您也不會從我們這裡看到成長和利潤之間的下意識反應。我們希望非常專注於確保年復一年，我們在這種環境中成為超級可靠的表演者。

As you look at the most recent final rate, I don't think it really changes the story. Obviously, it's a little disappointing that we don't think CMS really reflected what we've seen over the last year in terms of actual in-market medical trend. But in reality, it's just a little extra pressure for '25 on top of what we'd already seen previously. We're well positioned for that in terms of all the work we've been doing really from the get-go last year. Really, from February last year, we've been gaining ourselves lined up for this.

當您查看最新的最終匯率時，我認為這並沒有真正改變情況。顯然，我們認為 CMS 並沒有真正反映我們去年在實際市場醫療趨勢方面所看到的情況，這有點令人失望。但實際上，除了我們之前已經看到的情況之外，這只是 25 年的一點額外壓力。就去年我們從一開始所做的所有工作而言，我們已經做好了充分的準備。確實，從去年二月開始，我們就一直為此排隊。

You're seeing that reflected in Q1 in a few really key features, right? So you're seeing really strong cost control inside the company as you'd absolutely expected us to do. Making sure that we're -- not incur any expense we don't need to support our members and patients on the outside of the organization. You saw us take a very thoughtful bid strategy last year. And of course, we continue to focus on how to make sure that we manage medical costs as effectively as possible, ensuring quality of care delivered and avoiding waste.

您在第一季的一些非常關鍵的功能中看到了這一點，對吧？因此，您會看到公司內部非常強大的成本控制，正如您絕對期望我們所做的那樣。確保我們不會承擔任何我們不需要的費用來支持組織外部的會員和患者。您看到我們去年採取了非常深思熟慮的出價策略。當然，我們繼續關注如何確保盡可能有效地管理醫療成本，確保提供的護理品質並避免浪費。

All of that plays through. I'm very, very pleased with how this first quarter has played out in that respect. If you look at the performance of Optum Health and our MA business within UnitedHealthcare, both very strong performers during this quarter, despite the pressure that's been incurred on them from the rate notice last year. And I think that bodes super well for the rest of this year and the strategy we've laid out for the next 3.

所有這些都在發揮作用。我對第一季在這方面的表現感到非常非常滿意。如果你看看 Optum Health 和 UnitedHealthcare 內的 MA 業務的表現，儘管去年的費率通知給他們帶來了壓力，但它們在本季度的表現都非常強勁。我認為這對於今年剩餘時間以及我們為未來三年制定的策略來說是一個非常好的兆頭。

We'll go next to Josh Raskin with Nephron Research.

接下來我們將訪問 Nephron Research 的 Josh Raskin。

Can you just explain what medical costs you categorized as accommodations to support care providers? I think the UM management that you guys are talking about. What puts a certain medical expense in that bucket? And then when you look at your actual claims received or claims processed inventories, what percentage of a normal or expected quarter, did you actually see in the quarter versus how much did you just sort of put into IBNR?

您能否解釋一下您將哪些醫療費用歸類為支持護理人員的住宿費用？我認為你們正在談論的UM管理。是什麼將一定的醫療費用放入該桶中？然後，當您查看實際收到的索賠或索賠處理的庫存時，您在該季度實際看到的正常或預期季度的百分比是多少，與您剛剛投入 IBNR 的金額相比？

Josh, thanks so much. I'm going to ask Brian Thompson in a second just to give you a little bit more color on the first part of your question. Listen, I think by the time we got to the end of the quarter, we had the overwhelming majority of what we'd anticipate in receipt -- in terms of claims received into the organization because it's always a little bit tricky to be absolute about that because you're kind of comparing against what you would have expected. And as you obviously know, every quarter, you see corrections both up and down in terms of actual claims submissions catching up with what you may have estimated. And that's been, obviously, the feature of this marketplace. But overall, I would say UHC claims receipt was very, very close to normal by the time we closed the quarter. But maybe, Brian, you could give a little more color commentary on how you would characterize some of that relief we gave.

喬什，非常感謝。我稍後會問 Brian Thompson，以便為您問題的第一部分提供更多資訊。聽著，我認為到本季末時，我們已經收到了我們預期的絕大多數內容——就組織收到的索賠而言，因為要絕對地對待總是有點棘手。的預期進行比較。正如您顯然知道的那樣，每個季度您都會看到實際索賠提交量的上下修正，以趕上您的估計。顯然，這就是這個市場的特徵。但總的來說，我想說，到本季結束時，全民健康保險索賠收據已經非常非常接近正常水平。但也許，布萊恩，你可以就如何描述我們所給予的一些救濟提供更多色彩的評論。

Sure. I appreciate the question. Yes, Josh, I believe we started March 8. And what we did, I call it foregone utilization management protocols and those are really in two categories. The first is we suspended our inpatient level of care reviews where we assess for appropriateness of inpatient versus outpatient. And that was the lion's share of our adjustment. And we've got a long history of understanding those elements. It's just a unit cost adjustment. So pretty simple and easy to estimate and adjust for.

當然。我很欣賞這個問題。是的，喬什，我相信我們從 3 月 8 日開始。 我們所做的，我稱之為放棄的利用率管理協議，這些協議實際上分為兩類。首先，我們暫停了住院病患的照護等級審查，評估住院病患與門診病患的適當性。這就是我們調整的最大部分。我們對這些元素的理解有著悠久的歷史。這只是單位成本的調整。非常簡單且易於估計和調整。

The second element inside those practices was some outpatient prior authorizations that we also suspended. Those were a smaller element inside this quarter. Those will play out a little bit more in next quarter as you think about that lag between notice and actual -- date. But again, pretty easy for us to estimate. These are practices we've had in place for a very long time and feel comfortable about the adjustment that we made.

這些做法中的第二個要素是我們也暫停了一些門診事先授權。這些是本季內較小的因素。當你考慮到通知和實際日期之間的滯後時，這些將在下個季度發揮更多作用。但同樣，我們很容易估計。這些是我們長期以來的做法，並且對我們所做的調整感到滿意。

Brian, thanks so much. And just again, to confirm, as you heard from John, we've brought those processes back into play in the last few days.

布萊恩，非常感謝。再次確認，正如您從約翰那裡聽到的那樣，我們在過去幾天中重新啟用了這些流程。

We'll go next to A.J. Rice with UBS.

我們會去 A.J. 旁邊。賴斯與瑞銀。

Congratulations on working through all this. Maybe just to make sure I understand a little more. The $800 million reserve that you're holding out, and you did comment that you didn't take any prior period development on the bottom line. I guess it sounds like you've used the word prudent several times in describing that. How much -- yes, just maybe to follow up on the last question. How much of that is things that either from which you get insight from Optum Health or from your own ability to look at prior year claims versus what you've seen so far is what you really think is going to happen? And how much of that is sort of add-on just because of the moving parts out there?

恭喜您完成了這一切。也許只是為了確保我了解更多。您持有 8 億美元的儲備金，並且您確實評論說您沒有將任何前期開發作為底線。我想聽起來你在描述這一點時已經多次使用了“謹慎”這個詞。多少——是的，也許只是為了跟進最後一個問題。其中有多少是您從 Optum Health 獲得的見解或您自己查看前一年索賠的能力以及您迄今為止所看到的情況是您真正認為將會發生的事情？其中有多少是由於移動部件而產生的附加功能？

And then it sounds like you're basically saying that the care dynamics are similar. Is there anything you call out, outpatient, inpatient, that suggests any variance relative to your MLR assumptions for the year when you started out?

聽起來你基本上是在說護理動態是相似的。您指出的門診患者、住院患者是否有任何事情表明與您開始時的當年 MLR 假設有任何差異？

So I'm going to ask John just to comment on the $800 million more specifically. I mean I think as we said a couple of times, A.J., really not seeing anything stand out in terms of care pattern differentiation from what we really expected. I mean as we mentioned earlier, that kind of pressure we saw at the end of Q4 and rolling into the very beginning of the year around some kind of winter syndrome vaccination dynamics, we talked about a lot last time. As expected, that did subside. Beyond that, I would -- which was what we were anticipating. Beyond that, I wouldn't say there's anything really to call out within all of that. John, could you maybe go a little deeper on the $800 million?

所以我想請約翰對這 8 億美元做出更具體的評論。我的意思是，我認為正如我們多次所說的，A.J.，在護理模式與我們真正期望的差異方面，確實沒有看到任何突出的東西。我的意思是，正如我們之前提到的，我們在第四季度末看到了這種壓力，一直到今年年初，圍繞著某種冬季綜合症疫苗接種動態，我們上次談到了很多。正如預期的那樣，這種情況確實有所緩解。除此之外，我會——這正是我們所期待的。除此之外，我不會說其中有什麼真正值得指出的。約翰，你能更深入地談談這 8 億美元嗎？

Yes. Yes. So picking up on comment, Andrew had made earlier. So what you're really doing there is estimating what you didn't see. So claims receipts that you may have not received in the quarter and trying to make an accommodation for that, as you said, a prudent combination for that just to acknowledge that there clearly had to be some disruption in the quarter and claims patterns. And so you're trying to make some estimation in that zone to anticipate that.

是的。是的。因此，安德魯早些時候發表了評論。所以你真正要做的就是估計你沒有看到的東西。因此，您可能在本季度未收到索賠收據，並試圖為此做出調整，正如您所說，這是一個謹慎的組合，只是為了承認本季和索賠模式顯然必須出現一些中斷。所以你試圖在該區域進行一些估計來預測這一點。

So you put it somewhere in the zone, it's not zero and it's not $800 million. It's somewhere in between, probably as you think about those elements and where you might land. And so as we look out, and you should expect that we'll probably continue with a judicious view of this over the next several quarters, actually also. We want to make sure that we've got full visibility into this, that the claims are flowing.

所以你把它放在這個區域的某個地方，它不是零，也不是 8 億美元。它介於兩者之間，可能是當您考慮這些元素以及您可能著陸的位置時。因此，當我們展望未來時，您應該期望我們可能會在接下來的幾個季度繼續對此保持明智的看法，實際上也是如此。我們希望確保我們對此有充分的了解，並且索賠正在順利進行。

And as we sit here on April 16, it does -- we see at UHC, we see a fairly normal claims receipts and payments flows going on at this point. But we really want to be careful on that because we know there are certain care providers out there that maybe have been left out a bit. And so we'll continue to be very judicious next quarter also in terms of assessing that.

當我們 4 月 16 日坐在這裡時，確實如此——我們在 UHC 看到，我們看到此時的索賠收據和付款流程相當正常。但我們真的要小心這一點，因為我們知道有些護理提供者可能被排除在外。因此，下個季度我們在評估方面也將繼續非常明智。

We'll go next to Justin Lake with Wolfe Research.

我們將與沃爾夫研究中心一起去賈斯汀湖旁邊。

First, I just wanted to quickly follow up on A.J.'s question here around the $800 million. Can you just be specific around is that conservative related to 2023? Meaning you would have had up to $800 million of development that would have benefited the quarter? Or are you saying that you just took extra reserves that impacted Q1? Because we're looking at an MLR that's 50 basis points above where you kind of expected it and yet you're saying trend is in line. So we're trying to figure out did -- was there a 50 basis point miss? Or are you saying that really, that's just the conservatism here.

首先，我只想快速跟進 A.J. 關於 8 億美元的問題。您能否具體說明一下這種保守與 2023 年有關嗎？這意味著您將有高達 8 億美元的開發資金使本季受益？或者您是說您只是採取了影響第一季的額外儲備？因為我們看到的 MLR 比您的預期高出 50 個基點，但您卻說趨勢是一致的。所以我們試著弄清楚是否存在 50 個基點的偏差？或者你真的是這麼說的，這只是這裡的保守主義。

And then any -- my question was really around the relative visibility on cost trend, right? Last year, it was somewhat opaque. You kind of told us that there was some uncertainty and then that uncertainty turned to certainty around, trend is higher in Q2. How do you feel about your visibility this year? Do we have to wait until 2Q to kind of be able to declare that, "Hey, we're kind of through this, and you're not seeing what the rest of the industry is seeing?" Or do you think we probably have to get that updated again in the second quarter? And lastly, any commentary on Q2 MLR, where you think you end up in the full year range for MLR, would certainly be helpful if you could provide.

然後，我的問題實際上是關於成本趨勢的相對可見性，對嗎？去年，它有點不透明。您告訴我們存在一些不確定性，然後不確定性變成了確定性，第二季的趨勢更高。您對今年的知名度有何感想？我們是否必須等到第二季度才能宣布，“嘿，我們已經度過了這個難關，而您沒有看到行業其他公司所看到的情況？”或者您認為我們可能需要在第二季再次更新？最後，如果您能提供有關第二季度 MLR 的任何評論，您認為您最終處於 MLR 的全年範圍內，那麼肯定會有所幫助。

Okay, Justin. Thanks for those questions. Let me -- I'm going to ask John in a second just to go back and again, just give you a little bit more definition around the $800 million, as you asked.

好吧，賈斯汀。謝謝你提出這些問題。讓我——我稍後會問約翰，請他再一次為您提供有關 8 億美元的更多定義，正如您所要求的那樣。

And just in terms of cost trend, and let me make a couple of comments and ask Brian maybe to go a little deeper as well and then come back to John. As I look at the cost trend this year versus last year, some big differences. So last year, really, I think the core of the story of what led to that sort of step shift, if I can put it that way, in early Q2 of last year, I think that was really a hindsight tells us that was really around a kind of post-COVID or end of COVID story playing out in terms of capacity coming on stream, most importantly, and to some degree, a pent-up demand. I actually, think the capacity coming on stream was as much an issue as a driver of that as anything else.

就成本趨勢而言，讓我發表一些評論，並請布萊恩也可以更深入一些，然後回到約翰。當我觀察今年與去年的成本趨勢時，發現了一些很大的差異。所以去年，我真的認為導致這種轉變的故事的核心，如果我可以這樣說的話，在去年第二季度初，我認為這確實是一個事後諸葛亮告訴我們，這真的是圍繞一種後新冠疫情或新冠疫情結束的故事，在產能投產方面展開，最重要的是，在某種程度上，是被壓抑的需求。事實上，我認為投產的產能與其他因素一樣都是一個問題，也是其驅動因素。

So I think to some degree, a one-off. We don't see anything like that. We've seen much more stabilization. We haven't seen a step down from that trend. We'd be super clear about that. We haven't seen it kind of go back down again, but we've certainly seen that kind of sustained activity without aggressive acceleration. And then the other thing I would say to you is as you would expect, given that shift we saw last year in the intervening year, we've put in a lot of sensing mechanisms across our organization, both in UHC and Optum to look for early warning signals of changes. Quite a low granularity in terms of trying to figure out how this pattern plays out. Now as all our actuaries and any actual will tell you that the gold standard of knowledge on trend is a paid claim. But nonetheless, we've tried to put in place a lot more prospective sensing capability. And again, that's kind of consistent with what we're sharing with you.

所以我認為在某種程度上，這是一次性的。我們沒有看到這樣的事情。我們看到了更加穩定的情況。我們還沒有看到這種趨勢有所下降。我們對此非常清楚。我們還沒有看到它再次下降，但我們確實看到了這種持續的活動，但沒有大幅加速。然後我要對你說的另一件事是，正如你所期望的，考慮到我們去年在中間一年看到的轉變，我們在整個組織中（在UHC 和Optum 中）引入了很多感測機制來尋找變化的預警信號。試圖弄清楚這種模式如何發揮作用的粒度相當低。現在，我們所有的精算師和任何實際精算師都會告訴您，趨勢知識的黃金標準是有償索賠。但儘管如此，我們還是嘗試了更多的前瞻性感測能力。再說一遍，這與我們與您分享的內容是一致的。

So we're not really anticipating a big change there. I mean, obviously, the future is the future. But as we sit today, everything looks pretty much as expected. Brian, you may want to give a bit more from a UHC perspective.

因此，我們並不真正期待那裡會發生重大變化。我的意思是，顯然，未來就是未來。但當我們今天坐下來時，一切看起來都與預期一致。 Brian，您可能想從全民健康覆蓋的角度提供更多資訊。

Yes. Thanks, Andrew. And I think you summarized it well. I'll reiterate what you heard from John, which is what we're seeing in these underlying service types, inpatient, outpatient, et cetera, are in line with what we had planned for. So I'll reiterate that.

是的。謝謝，安德魯。我認為你總結得很好。我將重申您從約翰那裡聽到的內容，這就是我們在住院、門診等這些基礎服務類型中所看到的，與我們的計劃一致。所以我會重申這一點。

And just to add to that level of improved visibility this year over last. Certainly, COVID being the biggest driver but also redeterminations. Last year, we were at the beginning of that. This year, we're nearing the end of that. So two key unknowns a year ago, I think that contributed to perhaps a little less visibility, both of which I think we've really got a better view to this year.

只是為了增加今年比去年更高的能見度。當然，新冠疫情是最大的推動因素，但也是重新決定的因素。去年，我們才剛開始。今年，我們已接近尾聲。因此，我認為一年前的兩個關鍵未知因素可能導致可見度降低，我認為我們對今年的情況確實有更好的看法。

And the last thing I'll just point out is, as we pace through 1/1, I also feel good about our business mix. Again, early in the stages of a valuation of that, but how our growth has changed and what we've seen in those profiles from the growth that you're seeing in our commercial business to the growth in our Medicare business as well, really feel good about all those elements. So yes, optimistic about the rest of the year and how it's playing out against what we had planned for.

我要指出的最後一件事是，隨著我們的步伐邁向 1/1，我也對我們的業務組合感到滿意。再說一次，在估值的早期階段，但我們的成長發生了怎樣的變化，以及我們在這些資料中看到的內容，從我們商業業務的增長到我們醫療保險業務的增長，真的對所有這些元素感覺良好。所以，是的，我們對今年剩餘時間以及它與我們計劃的實施情況持樂觀態度。

Great. Thanks, Brian. John?

偉大的。謝謝，布萊恩。約翰？

Yes, Justin. So I think the way you look at it. So overall, the net view being so we didn't let any earnings or medical care ratio impacting development flow through into the quarter. And when you look at it, so we can come out of this normative course of assessments would have indicated some potential for favorable development in the quarter.

是的，賈斯汀。所以我認為你看待它的方式。因此，總體而言，我們的淨觀點是，我們沒有讓任何影響發展的收益或醫療保健比率流入本季度。當你看到它時，我們可以從這個規範的評估過程中得出結論，這將表明本季度有一些有利發展的潛力。

We would -- we took a position also that there was a likelihood that there were claims we didn't receive and so -- in terms of the claims completion factors and such and so how that may have impacted that. And so you're really netting that all off in the course of the quarter to try to just normalize that out, not having any impact from any of those -- from those elements. And taking a pretty prudent view of where you might be in terms of the claims you received.

我們也認為，我們可能沒有收到索賠，因此，就索賠完成因素等而言，這可能會產生怎樣的影響。因此，您確實在本季度中將所有這些都消除了，試圖將其正常化，而不會受到任何這些因素的影響。並以相當謹慎的態度看待您收到的索賠情況。

In terms of your question on Q2 MCR. At this distance, I'd put it in a similar ZIP code to 1Q, including similar impact from the cyber effects that we had also. And as I noted in response to A.J.'s question, we'll be -- continue to be very judicious as we look at those patterns also on claims received. So we'll continue with a judicious view of how we think about development and those impacts as we step out here in the next couple of quarters and make sure we're getting our claims receipt timing is fully incurred here.

關於您關於第二季 MCR 的問題。在這個距離上，我會將其放在與 1Q 類似的郵遞區號中，包括我們也受到的網路效應的類似影響。正如我在回答 A.J. 的問題時指出的那樣，我們將繼續非常明智地審視收到的索賠中的這些模式。因此，當我們在接下來的幾個季度來到這裡時，我們將繼續明智地看待我們如何看待發展和這些影響，並確保我們在這裡完全收到索賠收據時間。

We'll go next to Stephen Baxter with Wells Fargo.

接下來我們將與富國銀行一起去史蒂芬‧巴克斯特。

The business disruption costs that you projected beyond the first quarter are, I think, smaller maybe than most had expected despite the fact that we've heard commentary from stakeholders reducing their dependence on Change Healthcare during the quarter? I guess what are you seeing different customers on that front? I guess how much of that recovery do you have on the revenue line? Do you have a line of sight to versus you have to drive throughout the balance of the year to get to that no -- into 2025 that you seem to expect?

我認為，您預計第一季之後的業務中斷成本可能比大多數人預期的要小，儘管我們已經聽到利益相關者的評論，減少了他們在本季度對 Change Healthcare 的依賴？我想您在這方面看到不同的客戶是什麼？我猜你的收入有多少復甦？您是否認為您必須在今年剩餘的時間裡不斷努力才能達到您所期望的 2025 年？

Yes, Stephen, thanks so much. So I'm going to ask Roger Connor, who runs Optum Insight to give you a little detail on this. First off, so I just want to -- I want to take a moment to pay credit to the teams for the speed in which they brought back the overwhelming majority, the functionality of Change Healthcare after the attack. It's been an extraordinary example of really the resources of UHG. And frankly, the support of many of the biggest companies across America in the tech environment coming in to help recover from this particular attack, which was straight out an attack on the U.S. health system and designed to create maximum damage, I think. We've got through that very well in terms of the remediation and the build back functionality. And Roger, maybe you could share a little bit of what you'll see in -- in terms of customer dynamics over the next few months.

是的，史蒂芬，非常感謝。因此，我將請 Optum Insight 的經營者 Roger Connor 為您提供有關此問題的一些詳細資訊。首先，我想花點時間向這些團隊表示讚揚，因為他們在攻擊後恢復了絕大多數功能，即 Change Healthcare 的功能。這是 UHG 資源的一個非凡例子。坦白說，美國科技環境中許多最大的公司的支持有助於從這次特殊的攻擊中恢復過來，我認為這是對美國衛生系統的直接攻擊，旨在造成最大的傷害。我們在修復和重建功能方面已經很好地解決了這個問題。羅傑，也許您可以分享一些您將在接下來幾個月的客戶動態方面看到的內容。

Yes, we'll do. Stephen, thanks very much for the question. So the way that we're thinking about the whole cyberattack response is two key areas of focus. First of all as Andrew mentioned, good progress on system restoration. If you look at the biggest areas where we have the largest number of customers at pharmacy, claim and payment, we're up to 80% functionality, and that's continuing to improve day by day.

是的，我們會做的。史蒂芬，非常感謝你的提問。因此，我們考慮整個網路攻擊回應的方式是兩個關鍵的關注領域。首先，正如安德魯所提到的，系統復原方面取得了良好進展。如果你看看我們在藥局、理賠和付款方面擁有最多客戶的最大領域，我們的功能高達 80%，而且還在不斷改進。

Now we've still got work to do. We've got another set of products coming online in the number in the coming weeks, but pleased with that progress. I think your question is really about our next focus, which is recovering the business. And this is about bringing those products back, actually bringing them back stronger where we can. We're adding functionality, where we can, too. But then also bringing back customers who, because of the outage, have to go elsewhere to get things like their clearance size and support.

現在我們還有工作要做。我們將在未來幾週內推出另一組產品，但我們對這項進展感到滿意。我認為你的問題實際上是關於我們的下一個重點，即恢復業務。這是為了讓這些產品回歸，實際上是盡可能讓它們變得更強。我們也在盡可能地添加功能。但同時也會帶回那些因為停電而不得不去其他地方獲取諸如清倉規模和支援之類的東西的客戶。

Now we're confident in our ability to do that. Why? Well, first of all, the portfolio and the differentiation we have, which is good. But also, as you can imagine, we're talking to those customers all the time and they want their functionality back. They like what they've got, their -- with change, and they want to get that back. So we're working with them to ensure that we can actually do that. Also, we provided financial support to a number of our clients and they appreciate that. They have said to us that they appreciate it. It's a signal that we are committed both to them, but then also to this marketplace as well. So when you add those elements up, Stephen, that's where we're confident. We've got more work to do. This has been a heavy lift, and we're going to continue that work, but that's why we're confident in getting back to that baseline performance in 2025.

現在我們對自己有能力做到這一點充滿信心。為什麼？嗯，首先，我們擁有的產品組合和差異化，這很好。而且，正如您可以想像的那樣，我們一直在與這些客戶交談，他們希望恢復功能。他們喜歡他們所擁有的，他們的——隨著改變，他們想要拿回來。因此，我們正在與他們合作，以確保我們能夠真正做到這一點。此外，我們也為許多客戶提供了財務支持，他們對此表示讚賞。他們對我們表示很感激。這是一個信號，表明我們不僅致力於它們，而且也致力於這個市場。所以當你把這些元素加起來時，史蒂芬，這就是我們有信心的地方。我們還有更多工作要做。這是一項艱鉅的任務，我們將繼續這項工作，但這就是為什麼我們有信心在 2025 年恢復到基準效能。

Roger, thanks so much. And I think, Stephen, what you heard in Roger's response there is a couple of really important features of the character of UnitedHealth Group. Super high resilience and we will always stand by our customers and clients. And when an attack like this happens, which puts our customers and clients at risk, we will do whatever it takes to make sure they get through that. Whether it's technical fixes or financial support, we are going to stand by our clients who, in this case, are the providers and the systems across America who look after American patients. And we will do that. And I think that means a lot to a lot of people, and it's an important capability to have running through the backbone of American Healthcare.

羅傑，非常感謝。史蒂芬，我認為您在羅傑的回應中聽到的是聯合健康集團的幾個非常重要的特徵。超高的彈性，我們將永遠支持我們的客戶和客戶。當發生這樣的攻擊時，我們的客戶和客戶將面臨風險，我們將盡一切努力確保他們度過難關。無論是技術修復還是財務支持，我們都將支持我們的客戶，在這種情況下，他們是美國各地照顧美國患者的醫療服務提供者和系統。我們會這麼做的。我認為這對許多人來說意義重大，這是貫穿美國醫療保健支柱的重要能力。

We'll go next to Kevin Fischbeck with Bank of America.

接下來是美國銀行的凱文‧菲施貝克 (Kevin Fischbeck)。

Just want to go more, a little bit more into the visibility that you guys think that you have into claims today. It sounds like you feel like you're largely back. But I guess where would you say today that you are from a percent of visibility into claims versus the same time last year?

只是想更多地了解你們今天所認為的索賠的可見性。聽起來你覺得自己基本上回來了。但我想你今天會說，與去年同期相比，你對索賠的了解程度是多少？

And I know that there's forecasted improvement, but there's a lot of focus on the ability to price 2025 correctly. So by the time you're submitting your MA bids, how much back to normal -- what percent of that would you think you'll be from the claims for spec that point?

我知道預計會有改善，但人們非常關注 2025 年正確定價的能力。因此，當您提交 MA 出價時，有多少會恢復正常 - 您認為此時的規格索賠將有多少百分比？

And finally, I'm used to hearing you guys reiterate 13% to 16% long-term EPS growth, but I didn't hear that in the prepared remarks. I just wasn't sure that was due to time or whether there was anything that you were trying to say there.

最後，我習慣聽到你們重申 13% 至 16% 的長期每股收益成長，但我在準備好的發言中沒有聽到這一點。我只是不確定這是由於時間原因或你是否想在那裡說些什麼。

All right. So I'm going to ask John to comment on your substantive question, Kevin, and I'm going to ask you just to stay on the line for my last paragraph of closing comments for the second part of your question. John?

好的。所以我要請約翰對你的實質問題發表評論，凱文，我要請你保持在線，聽我對你的問題第二部分的最後一段結束語。約翰？

Kevin, so as we say here today on April 16, UHC is pretty much back to normal levels in terms of claims submission activity. We view it as normalized now. That we're seeing claims flowing like they -- we'd expect them to be flowing and moving along. So that's all progressing quite well, which assists a lot with the piece that you were just describing here in terms of where we think that is. And as we move forward, look over the next month plus to finalize our bid submissions and such. So feel good about that in terms of our visibility and insights.

Kevin，正如我們今天 4 月 16 日在這裡所說的那樣，UHC 在索賠提交活動方面幾乎恢復到正常水平。我們現在認為它已正常化。我們看到索賠像他們一樣流動 - 我們希望他們能夠流動並繼續前進。因此，一切進展順利，這對您剛才在這裡描述的我們認為的內容有很大幫助。隨著我們的前進，請展望下個月，以完成我們的投標提交等。因此，就我們的可見性和洞察力而言，您對此感到滿意。

Thanks so much, John, and thanks so much, Kevin.

非常感謝，約翰，非常感謝，凱文。

We'll go next to Nathan Rich with Goldman Sachs.

接下來我們將討論高盛的內森·里奇 (Nathan Rich)。

I wanted to ask on the reported DOJ investigation. I'd be curious, as the company had kind of dialogue with the DOJ and do you have a sense of time line for what the next steps might be as we look about what the possible outcome of this process could be?

我想問司法部調查的報導。我很好奇，因為該公司與司法部進行了某種對話，當我們研究這一過程可能產生的結果時，您是否對下一步可能採取的行動有一個時間表？

Nathan, thanks so much for the question. Listen, I think you'd probably expect we comment on these sorts of matters, and I don't think it will be appropriate to do so today and certainly we never have done in the past. So it's not something we're going to get into in the call, but appreciate the interest.

內森，非常感謝你的提問。聽著，我想你可能希望我們對這類問題發表評論，但我認為今天這樣做是不合適的，當然我們過去從未這樣做過。因此，這不是我們在電話中討論的內容，但感謝您的關注。

We'll move next to Andrew Mok with Barclays.

我們將搬到巴克萊銀行的安德魯莫克 (Andrew Mok) 旁邊。

Commercial risk and ASO membership both came in above the high end of your initial guidance. Can you help us understand what drove the membership -- reach better membership results for each segment?

商業風險和 ASO 會員資格均高於您最初指導的上限。您能否幫助我們了解會員資格的推動因素—為每個細分市場實現更好的會員資格結果？

Thanks so much for the question. I'll ask Dan Kueter, who runs our E&I business from UHC to respond to that. Dan?

非常感謝您的提問。我會請 UHC 負責 E&I 業務的 Dan Kueter 對此做出回應。擔？

And thanks for the question. Certainly encouraged with the broad-based growth, share gained growth, I would say, in our individual segment, our local market segment and our national accounts business. Some of the key drivers underlying that, about 1/3 of our group growth gains were attached to our most innovative products and the expansion of those into 37 states now on a fully insured basis to be -- and also fully available nationally on an ASO fee-based business, specifically inside the risk business.

謝謝你的提問。我想說，在我們的個人細分市場、本地市場細分和國民帳戶業務中，當然受到廣泛增長的鼓舞，份額獲得了增長。一些關鍵驅動因素是，我們集團大約1/3 的成長收益來自於我們最具創新性的產品，並將這些產品擴展到37 個州，這些產品現在已在完全保險的基礎上，並且還可以在ASO 上在全國全面使用收費業務，特別是風險業務。

Our individual and family exchange-based plans were a significant driver of the growth. We've seen some latency from membership. We expected that would have come in from redeterminations into the final portions of 2023 now begin to emerge into 2024. That's been a significant contributor to that risk-based growth in the first quarter.

我們的個人和家庭交換計劃是成長的重要推動力。我們發現會員資格存在一些延遲。我們預計，這一點將在 2023 年最後部分重新確定後出現，現在開始出現在 2024 年。

As a punchline, I like our growth. I look the pricing, very much like the profile of both the groups and the consumers that we're attracting. And finally, I'm really pleased with the consumer experience that our teams are delivering to those that we serve -- as for the question.

作為一個笑點，我喜歡我們的成長。我查看了定價，非常類似於我們所吸引的群體和消費者的概況。最後，我對我們的團隊為我們服務的客戶提供的消費者體驗感到非常滿意——就這個問題而言。

Thanks so much. And as you saw, Dan's organization delivered an extraordinary 2 million member growth in the first quarter, one of the highest growth rates we've seen for many, many years. And I think that really comes down to relentless focus on modernization of service offer and then delivery of that service offer. And I'm very proud of the whole team in the UHC commercial businesses domestically for what they've done.

非常感謝。正如您所看到的，Dan 的組織在第一季實現了 200 萬會員的驚人成長，這是我們多年來見過的最高成長率之一。我認為這實際上取決於對服務現代化以及服務交付的不懈關注。我為國內 UHC 商業業務的整個團隊所做的一切感到非常自豪。

We'll go next to Lance Wilkes with Bernstein.

我們將和伯恩斯坦一起去蘭斯威爾克斯旁邊。

A question on Optum Health. As we're looking at outlook there, we've been really focused on capacity growth in the systems. Do you guys have any insights for your capacity growth in Optum Health? Obviously, you've been taking some cost actions there. So interested in hiring trends. And then second, have you been renegotiating risk deals? I know that there was likely some of that for '24. What's the outlook for that and the impact of that in '24 and the outlook of that for '25?

關於 Optum Health 的問題。當我們展望那裡的前景時，我們真正關注的是系統容量的成長。你們對 Optum Health 的產能成長有什麼見解嗎？顯然，您已經在那裡採取了一些成本行動。對招聘趨勢非常感興趣。其次，您是否一直在重新協商風險交易？我知道 24 年可能會有一些這樣的事。 24 年的前景和影響以及 25 年的前景是什麼？

Yes, Lance, thanks so much. And I'm glad you've asked about Optum Health, I'm going to ask Dr. Desai to respond to that. Amar runs our Optum Health business, been doing a great job of continuing to mature that business for us, which for me, I think, is one of the great headlines of Optum Health. Its continuous maturation as a sophisticated value-based care delivery organization. Amar, maybe you could respond to Lance's question.

是的，蘭斯，非常感謝。我很高興您詢問了 Optum Health 的問題，我將請 Desai 博士對此做出回應。 Amar 負責經營我們的 Optum Health 業務，在繼續推動我們業務的成熟方面做得非常出色，我認為這對我來說是 Optum Health 的頭條新聞之一。作為一個複雜的、基於價值的護理提供組織，它不斷成熟。阿瑪爾，也許你可以回答蘭斯的問題。

Thanks for the question, Lance. I'll take the first one in terms of hiring trends. We continue to work with more providers in a deeper way, continuing to grow across a range of arrangements. As you know, physicians across the country work with us and contracted affiliate arrangements as well as employee arrangements, and we continue to have strong partnership and growth both organically and also through some of our inorganic M&A activity.

謝謝你的提問，蘭斯。我將選擇第一個關於招募趨勢的問題。我們繼續與更多供應商進行更深入的合作，在一系列安排中繼續發展。如您所知，全國各地的醫生都與我們合作，並簽訂了附屬機構安排和員工安排，我們繼續透過有機方式和一些無機併購活動保持牢固的合作夥伴關係和成長。

We don't see a capacity constraint there. In fact, we've continued to see incredible growth with our payer partners to the second part of your question, the risk partner growth continues to increase across multiple payers. It's being driven by some of the funding and benefit dynamics that are out there, folks are looking for a real stable partner to be able to grow with. We have worked with them continuously in terms of our contracts, both looking at the benefit and funding changes and ensuring that the funding level is appropriate for the risk that we're taking on and to be able to provide very high-quality care across our membership. So we're very proud of the growth we've had, and we'll continue to do so.

我們在那裡沒有看到容量限制。事實上，對於您問題的第二部分，我們繼續看到我們的付款合作夥伴取得了令人難以置信的成長，多個付款人的風險合作夥伴的成長繼續增加。它是由一些資金和利益動態推動的，人們正在尋找一個真正穩定的合作夥伴來共同成長。我們根據合約不斷與他們合作，既關注福利和資金變化，又確保資金水平適合我們所承擔的風險，並能夠在我們的整個服務範圍內提供非常高品質的照護。因此，我們對我們所取得的成長感到非常自豪，並且我們將繼續這樣做。

We'll go next to Sarah James with Cantor Fitzgerald.

接下來我們將和康托·菲茨傑拉德一起去莎拉·詹姆斯。

We wanted to understand a little bit better the $3 billion in IBNR. So just at the back of the envelope, math suggests if 15% to 20% of claims from UHC run through change, post event, that would be like assuming 1/3 of the change, related claims are. Is that in the ballpark of where your change completion factor assumptions were? And keeping that conservative assumption of the claims like throughout the year, what does that imply for the seasonality of the remaining $0.41 to $0.61 GAAP impact from change?

我們希望更了解 30 億美元的 IBNR。因此，在信封的後面，數學表明，如果 UHC 的 15% 到 20% 的索賠在事件發生後發生變化，那就相當於假設 1/3 的變化，相關索賠也是如此。這與您的變更完成因素假設大致相符嗎？保持對全年情況的保守假設，這對於 GAAP 變化帶來的 0.41 美元到 0.61 美元的 GAAP 影響的季節性影響意味著什麼？

Sarah James, thanks so much. John?

莎拉詹姆斯，非常感謝。約翰？

Yes. So I don't know if I'd kind of go right with some of those stats that you pulled out in terms of where those fell. But there's some insights that can offer on that. So one of the elements we wanted to break out on the IBNR component, so as you know, what we report on the balance sheet you received this morning, medical cost payable, is a combination of IBNR and medical claims payable. And so we're hoping to describe some more transparency for you as you looked at the quarter and such.

是的。所以我不知道我是否會正確對待你從哪些方面得出的一些統計數據。但對此可以提供一些見解。因此，我們想要在 IBNR 組成部分中分解的要素之一，如您所知，我們在您今天早上收到的資產負債表上報告的應付醫療費用是 IBNR 和應付醫療索賠的組合。因此，當您查看本季等內容時，我們希望為您描述更多的透明度。

But the $3 billion increase in IBNR is significant. And then offsetting that on that line item would have been really the funding advances, the component where we just made sure that as soon as the claim was in-house process, we were speeding it out the door to get it to providers. That was one of the components, in addition to the interest-free loans we made, that we were helping the provider community with.

但 IBNR 的 30 億美元成長意義重大。然後在該行項目上抵消這一點實際上是資金預付款，我們只是確保一旦索賠進入內部流程，我們就會加速將其送出大門以將其交付給提供者。除了我們提供的無息貸款之外，這是我們為提供者社區提供幫助的組成部分之一。

As you talked -- as you discussed kind of where we were, let say, today, we feel that UnitedHealthcare is essentially a normalized levels in terms of claims receipts. As we sit here, we're going to be super prudent how we look at that because we know there are providers out there that are -- could still be having trouble submitting claims and still having troubles with payment flows and such. And so we're going to be very appropriately constrained in how we think about that dynamic playing out here over the next couple of quarters. But really that -- those are the kind of mechanics of what's going on between the IBNR component, the use spotlighted and the full line of medical cost payable.

正如您所說，當您討論我們今天所處的情況時，我們認為聯合醫療保險在索賠收據方面基本上處於正常化水平。當我們坐在這裡時，我們將非常謹慎地看待這個問題，因為我們知道有些提供者仍然可能在提交索賠方面遇到困難，並且在支付流程等方面仍然存在問題。因此，我們將非常適當地限制我們如何看待接下來幾季的動態變化。但實際上，這些是 IBNR 組成部分、重點使用和應付醫療費用全線之間發生的機制。

We'll go next to Gary Taylor with Cowen.

我們將和考恩一起去加里·泰勒旁邊。

Just wanted to follow up on that point, John. My understanding is on the IBNR that you report in your Qs and Ks includes unprocessed claims inventories. So the $3 billion, is that just going to tie to the number we see when the Q comes out? Are you saying the $3 billion really is true unreported claims at this point?

只是想跟進這一點，約翰。我的理解是您在 Q 和 K 中報告的 IBNR 包括未處理的索賠清單。那麼 30 億美元是否會與 Q 發佈時我們看到的數字相符？您是說目前這 30 億美元確實是真實未申報的索賠嗎？

Thanks so much, Gary. John?

非常感謝，加里。約翰？

$3 billion is IBNR directly, that is to your point. That is the IBNR component of it, Gary.

30億美元直接是IBNR，這就是你的觀點。這就是 IBNR 的組成部分，加里。

We'll go next to Erin Wright with Morgan Stanley.

接下來我們將與摩根士丹利一起討論艾琳·賴特 (Erin Wright)。

On capital deployment, you didn't change your expectations for share repurchases. But how should we think about the priorities more broadly, whether it's M&A or otherwise and your ability to be opportunistic on that front?

在資金配置方面，您對股票回購的預期沒有改變。但我們應該如何更廣泛地考慮優先事項，無論是併購還是其他方面，以及您在這方面投機取巧的能力？

Erin, thanks so much. I'll ask John to comment on it.

艾琳，非常感謝。我會請約翰對此發表評論。

Yes, Erin. Yes, we didn't update any of those components here. We continue to take a very balanced view in terms of how we think about our opportunities. You saw certainly, we had activity in the quarter from in terms of both share repurchase and dividends. Also, we continue with robust opportunities in the marketplace, in terms of other capabilities that we are looking at. So that all continues strong. So you'll see us continue to balance those out nicely in terms of the opportunities that are out there and with capacities really to approach all those elements strongly.

是的，艾琳。是的，我們沒有在這裡更新任何這些元件。我們在如何看待我們的機會方面繼續採取非常平衡的觀點。您當然看到了，我們在本季在股票回購和股息方面都有活動。此外，就我們正在尋找的其他能力而言，我們繼續在市場上擁有強大的機會。這樣一切都會持續強勁。因此，您會看到我們繼續在現有機會方面很好地平衡這些因素，並有能力真正強大地處理所有這些因素。

Yes. You know what? And I continue to see very interesting diverse pipeline of M&A opportunity across the marketplace in terms of business areas that we have interest in. As I think you see some of the funding changes play out across the next few years, I suspect that may also create new opportunities for us as different companies assess their positions. I think how we look at this situation is we have a good strong strategy for how we navigate through this dynamic. You're seeing that play out super well in first quarter performance of Optum Health and UHC. And I think it gives us a sense of real confidence as we look not just in terms of our performance, but potentially how we might think about M&A opportunity. And as you rightly said, it'd be somewhat opportunistic if those moments arrive.

是的。你知道嗎？就我們感興趣的業務領域而言，我繼續看到整個市場上非常有趣的多樣化併購機會。著不同的公司評估自己的地位，我們面臨新的機會。我認為我們如何看待這種情況是我們有一個很好的強有力的策略來應對這種動態。您將看到 Optum Health 和 UHC 第一季的業績表現非常出色。我認為這給了我們一種真正的信心，因為我們不僅關注我們的業績，還關注我們如何看待併購機會。正如你所說，如果這些時刻到來，那就有點機會主義了。

We'll go next to Whit Mayo with Leerink Partners.

接下來我們將與 Leerink Partners 一起去 Whit Mayo。

Just back on the 2025 rate notice. I think you're -- if I'm hearing you correctly, it sounds like you're framing this is modestly disappointing but perhaps manageable. Just any more color on growth expectations for next year? And then if you could elaborate on the broker-agent changes, what this could potentially mean for your strategy? Seems like a meaningful change. I don't know if you think about investing more into captive broker strategies? Just any color would be helpful.

剛剛回到 2025 年利率通知。我認為你——如果我沒聽錯的話，聽起來你是在說這有點令人失望，但也許是可以控制的。對明年的成長預期還有更多的看法嗎？然後，如果您能詳細說明經紀商和代理商的變化，這對您的策略可能意味著什麼？看起來是個有意義的改變。不知道您是否考慮更多投資自保經紀商策略？任何顏色都會有幫助。

Thanks so much for the question. I mean, obviously, we're not going to get into -- give it kind of '25 numbers or expectations just yet. But Tim Noel, who runs our M&R business, certainly give you some good perspective on the rest of your question. Tim?

非常感謝您的提問。我的意思是，顯然，我們還不會給出 25 個數字或期望。但負責我們 M&R 業務的 Tim Noel 肯定會為您回答其餘問題提供一些很好的觀點。提姆？

Yes, Whit, thanks for the question. So on the final notice and some of the distribution elements of that, we continue to believe that there's opportunities to improve the distribution environment in Medicare Advantage and have been in a dialogue with CMS for several years on how to do that. Some of the elements of the final notice that were published recently are directly in line with some of our recommendations. And some of them are relatively consistent, but not totally as we had conceived them. I would also say right now, it's a little bit early to comment on how this might rebalance some of the channel mix as still some questions on how some of the key elements of that will be rolled out. So we're still waiting for a little bit more detail before we can get more specific on how it impacts go-to-market in '25.

是的，惠特，謝謝你的提問。因此，關於最終通知和其中的一些分配要素，我們仍然相信有機會改善 Medicare Advantage 的分配環境，並且多年來一直與 CMS 就如何做到這一點進行對話。最近發布的最終通知的一些內容與我們的一些建議直接一致。其中一些是相對一致的，但並不完全像我們想像的那樣。我還想說，現在評論這可能會如何重新平衡一些管道組合還為時過早，因為對於如何推出其中的一些關鍵要素仍然存在一些疑問。因此，我們仍在等待更多細節，然後才能更具體地了解它如何影響 25 年的上市。

We'll go next to Ann Hynes with Mizuho Securities.

接下來我們將討論瑞穗證券的安‧海因斯 (Ann Hynes)。

So I would say your commentary on care patterns is definitely more positive than what investors feared. And you referenced several times that trend came in line with your expectations. Can you actually tell us what growth rates you're assuming like the major trend categories and guidance? Whether that's inpatient and outpatient, maybe some year-over-year growth versus historical averages? And within that, can you specifically talk about what you're assuming for MA? That would be great.

所以我想說，你對護理模式的評論肯定比投資者擔心的更加積極。您多次提到這一趨勢符合您的預期。您能否實際告訴我們您假設的成長率（例如主要趨勢類別和指引）是多少？無論是住院還是門診，與歷史平均相比是否可能出現一些同比增長？其中，您能具體談談您對 MA 的假設嗎？那太好了。

John, would you like to start there?

約翰，你想從這裡開始嗎？

Ann, so the components that I would call outliers are the similar components that we've talked about for a while here in terms of trend outlooks. So in particular, still go back to outpatient care for senior. What we've seen in orthopedic, cardiac, those kind of categories primarily have been the big factors. I think you brought up a really important point though. So the percentage growth in those was much bigger last year. You're coming off an environment where both the supply side had been constrained and the willingness of seniors, in particular, consumers to access that environment had been constrained for a couple of years. So those percentage factors were quite significant. You heard us talk about very significant levels on those double-digit levels of last year as we looked at those.

安，所以我稱之為異常值的成分與我們在趨勢前景方面討論過一段時間的類似成分相同。所以特別是老人家還是要回到門診治療。我們在骨科、心臟等類別中看到的主要是重要因素。我認為你提出了一個非常重要的觀點。所以去年這些百分比的成長就大得多。您正處於一個供應方面受到限制的環境中，而且老年人（特別是消費者）進入該環境的意願多年來一直受到限制。所以這些百分比因素非常重要。當我們研究這些數據時，您聽到我們談論了去年兩位數水平的非常重要的水平。

The way we look at those really, though, is because you would expect that to start normalizing in terms of the percentage change. So you really look at that in terms of the number of units consumed per patient served, and so you look at those levels. That we're talking about, we're seeing those kind of continue at those levels, they're continuing at those levels with the number of units consumed, delivered. But those percentage levels, of course, would start normalizing out a little bit in terms of what you've seen.

不過，我們真正看待這些問題的方式是因為你會期望它開始以百分比變化的形式正常化。因此，您實際上會根據每個患者所服務的消耗單位數量來看待這一點，因此您會考慮這些水平。我們正在談論的，我們看到這種情況繼續在這些水平上，它們隨著消耗和交付的單位數量繼續在這些水平上。但當然，根據您所看到的情況，這些百分比水平會開始稍微正常化。

So that continues to be the area. It's outpatient care for seniors. It's those categories that we'd call real outlier areas versus our historical levels of trend factors. The other historical levels of trend factors remain much closer to cut our traditional views that we've always had as a company.

所以這仍然是這個區域。這是針對老年人的門診照護。這些類別我們稱之為真正的離群區域，而不是我們的歷史趨勢因素水準。趨勢因素的其他歷史水準仍然更接近我們作為一家公司一直以來的傳統觀點。

In the quarter, other things you look at, just to get indications. And by the way, we kind of vastly expanded all those areas, first fill. So you've heard us talk about that a lot. Also first fills in the quarter, an indication of outpatient care, physician visit activity, kind of normalize in there also in terms of stabilizing for us and the many other factors that the company has historically looked at.

在本季度，您會關注其他事情，只是為了獲得跡象。順便說一句，我們極大地擴展了所有這些領域，首先是填充。所以你已經聽我們談過很多次了。此外，該季度還首先填充了門診護理、醫生就診活動的跡象，在我們的穩定性以及公司歷史上關注的許多其他因素方面也處於正常化狀態。

Thanks, John. And maybe ask Brian, maybe to give you a little bit more from a UHC perspective. And then maybe Heather also from an Optum perspective, in a second, just maybe reflect a little bit on the work you're doing in terms of how we -- obviously, medical trend is one thing. Then there's a question of how well we're able to engage with folks to actually help them manage their cost and maybe come to you in a second, Heather, on some of the work that you're leading at Optum. So Brian, first.

謝謝，約翰。也許可以問問 Brian，也許可以從 UHC 的角度為您提供更多資訊。然後也許希瑟也從 Optum 的角度來看，一會兒，也許只是反思你正在做的工作，即我們如何——顯然，醫療趨勢是一回事。接下來的問題是，我們是否能夠與人們互動，真正幫助他們管理成本，也許稍後會來找你，Heather，討論你在 Optum 領導的一些工作。所以布萊恩，首先。

Sure. I think John said it well, the first headline is what we're seeing is what we planned for. But as he alluded to, some of those elements, we plan for them to be elevated year-over-year. And I don't want to lose sight of unit costs. We've talked for some time that multiyear provider group and hospital contracts renew a little later than perhaps the inflation we've seen. And that is up year-over-year.

當然。我認為約翰說得很好，第一個標題是我們所看到的就是我們計劃的。但正如他所提到的，我們計劃將其中一些要素逐年提高。我不想忽視單位成本。一段時間以來，我們一直在談論多年供應商集團和醫院合約的續約時間可能比我們所看到的通貨膨脹晚一些。而且這數字逐年上升。

The biggest driver was the outpatient. We're really pleased to see that in line with, as John explained. But also, we've been able to see increases in Specialty Rx. We planned for those. Those are in our pricing appropriately, et cetera. And we've certainly worked hard to create more access in the behavioral space. So all of those elements are modestly up, but up as we had planned for. And they'll hopefully sound familiar to you because we spoke to all of these at our investor conference as we ended the year. So I think that's what I would summarize ahead to John's commentary, Heather?

最大的推動因素是門診病人。正如約翰所解釋的那樣，我們真的很高興看到這一點。而且，我們也看到專業治療的增加。我們計劃了這些。這些都在我們的定價中，等等。當然，我們也努力在行為領域創造更多的機會。因此，所有這些因素都略有上升，但正如我們計劃的那樣。希望您對它們聽起來很熟悉，因為我們在年底的投資者會議上與所有這些人進行了交談。所以我想這就是我在約翰的評論之前總結的內容，希瑟？

So I would say, incredibly consistent on the Optum side. So maybe just focusing on the medical first. So I mean, I think you've heard us say this. When you look -- when we came out of last year, looking into this year, our focus was on the behavioral health, those outpatient sites consistent with UnitedHealthcare. And what was very important for Optum Health was using that capacity, that armor explained in our physicians as well as those wraparound services and our investments to ensure that we were looking at those care patterns.

所以我想說，Optum 方面的一致性令人難以置信。所以也許先關注醫療。所以我的意思是，我想你已經聽過我們這麼說過。當你看——當我們去年結束時，展望今年，我們的重點是行為健康，那些與聯合醫療保健一致的門診網站。對 Optum Health 來說非常重要的是利用這種能力、我們的醫生解釋的盔甲以及那些全方位服務和我們的投資，以確保我們專注於這些護理模式。

So we feel really good about coming into this year. That work we've done. John referenced, engagement with particularly the most complex numbers, 75% already engaged. And that PCP engagement -- that member engagement is incredibly important, whether it's with our PCP directly or is with some of our own care management wraparound services because it identifies affordability opportunities incredibly quickly.

所以我們對今年的到來感覺非常好。我們已經完成了這項工作。約翰提到，特別是最複雜的數字，75% 的人已經參與了。 PCP 參與度－會員參與度非常重要，無論是直接與我們的 PCP 合作，還是與我們自己的一些護理管理綜合服務合作，因為它可以非常快速地識別可負擔的機會。

It also identifies chronic disease that needs to be managed, and it gets them connected to primary care quickly. So that's our focus for the year, and that's why we feel good about that our ability to control utilization on the medical side, particularly and again, what we'll remind you is a reduced funding environment as we go into this year. So that's what brings us value-based care proposition incredible value to all of our payers.

它還可以識別需要管理的慢性疾病，並讓他們快速與初級保健聯繫起來。這就是我們今年的重點，這就是為什麼我們對我們在醫療方面控制利用率的能力感到滿意，特別是，我們要再次提醒您的是，隨著我們進入今年，融資環境會減少。這就是我們基於價值的照護主張為所有付款人帶來難以置信的價值的原因。

On the pharmacy side, I'd call it same things. For our clients, that specialty trend is a focus, and we bring those products and solutions and that's why we've seen growth on the PBM side and our pharmacies around our clinical model and the continued innovative products that we're bringing to bear. So you're seeing pull-through in the diversified growth and strength of the performance in the Rx side as well.

在藥房方面，我會稱之為相同的東西。對於我們的客戶來說，這種專業趨勢是一個焦點，我們帶來了這些產品和解決方案，這就是為什麼我們看到PBM 方面和我們的藥房圍繞著我們的臨床模式和我們帶來的持續創新產品的增長。因此，您也看到了 Rx 方面的多元化成長和業績實力的拉動。

Thanks so much, Heather. Just one number Heather just shared with you there, which I'm very pleased of and is a significant improvement year-over-year is that 75% engagement of the most complex members in Optum Health. And just for that, that means 3 out of every 4 most complex, most disadvantaged folks in the country have had a direct engagement with us in the first 3 months of the year.

非常感謝，希瑟。 Heather 剛剛與大家分享的一個數字是 Optum Health 中最複雜的成員的參與度達到了 75%，這一數字讓我感到非常高興，並且與去年同期相比是一個顯著的進步。正因為如此，這意味著全國每 4 個最複雜、最弱勢群體中就有 3 個在今年前 3 個月與我們進行了直接接觸。

That's a great rate of touch. Opens the door then for us really getting to know those folks, helping the system, helping bring the system to support the many of these people, particularly those who are trapped in their homes or have just not had access to that kind of care opportunity. That engagement is the first step of doing that. We really believe that is a key to how we not only deliver an effective care delivery from a cost point of view, but also make sure they get the very best quality that they deserve. So really pleased to see that step up year-over-year. I think we have time for one last question. If we could take that question, please, Jana.

這是一個很棒的接觸率。這為我們真正了解這些人打開了大門，幫助系統，幫助系統支持許多人，特別是那些被困在家裡或無法獲得這種護理機會的人。這種參與是做到這一點的第一步。我們確實相信，這是我們不僅從成本角度提供有效護理服務，而且確保他們獲得應有的最佳品質的關鍵。非常高興看到這一年比一年的進步。我想我們還有時間回答最後一個問題。如果我們可以回答這個問題，賈娜。

So we'll go to our last question from Jessica Tassan with Piper Sandler.

我們將回答傑西卡·塔桑和派珀·桑德勒提出的最後一個問題。

(technical difficulty) few more details maybe on the...

（技術難度）可能還有更多細節...

Sorry, we missed the beginning of your question, yes.

抱歉，我們錯過了你問題的開頭，是的。

Sorry about that. I mean just in the more details maybe around the launch of Change 2.0. If you could talk a little about what payer receptivity the reconnection has been? Whether change retain its legacy data rights post breach? And then just any change or updated thoughts on kind of the long-term thesis on change or something like a real-time transparent payments and decision support network?

對於那個很抱歉。我的意思是更詳細的內容，可能是在 Change 2.0 的發布前後。您能否談談付款人對重新連結的接受程度如何？變更後是否保留其遺留資料權利？然後，關於變革的長期論文或諸如實時透明的支付和決策支援網絡之類的東西有任何變化或更新的想法嗎？

Thanks very much for the question. Let me ask Roger to kick that one off.

非常感謝您的提問。讓我請羅傑開始。

Yes, Jessica, thanks very much for the question. First of all, on your first part, Change 2.0. Again, we're just confident in terms of our ability to reconnect. I mentioned the level of functional restoration that we have. You can imagine now the next [phase] of this is working with payer and provider and to reconnect them and a see if way in an appropriate way. And all of the conversations that we're having with them are positive as we work though it.

是的，傑西卡，非常感謝你的提問。首先，在第一部分，Change 2.0。再說一遍，我們對重新建立聯繫的能力充滿信心。我提到了我們的功能恢復水準。現在您可以想像，下一階段是與付款人和提供者合作，並以適當的方式重新連接它們並查看是否可行。在我們工作過程中，我們與他們進行的所有對話都是正面的。

As I mentioned there's still work to do, and that's going to take us a little bit of time, but we're continuing to work through that functionality. I think it's important also to recognize where Change sets in the overall Optum Insight portfolio. Change Healthcare is about 15% of our projected revenue for this year. And when you look at -- that means I've got thousands of people who are continuing to work on other products outside of change not impacted by this. And their underlying performance this quarter has been strong. If you adjust for the Change, that business' earnings actually grew by around 10%.

正如我所提到的，仍有工作要做，這將花費我們一些時間，但我們將繼續研究該功能。我認為認識到變革在整個 Optum Insight 產品組合中的位置也很重要。改變醫療保健約占我們今年預計收入的 15%。當你看到時，這意味著我有成千上萬的人在變化之外繼續開發其他產品，而不受此影響。他們本季的基本表現一直很強勁。如果根據變化進行調整，該企業的收入實際上增加了 10% 左右。

But what we haven't slowed either as you mentioned, is our innovation agenda. The excitement of the Change portfolio across the inside portfolio is what we can bring to this market to transform it from an innovation point of view. And the real-time settlement work that we're doing, plus work that we've been doing with Optum Health on value-based care and provider risk enablement, that's all still going ahead. So in terms of our innovation agenda and the performance of the underlying business within Optum Insight, we're very positive.

但正如您所提到的，我們並沒有放慢創新議程。整個內部投資組合的變革投資組合令人興奮的是我們可以為這個市場帶來什麼，並從創新的角度進行改造。我們正在做的即時結算工作，加上我們與 Optum Health 一起在基於價值的照護和提供者風險支援方面所做的工作，這些都仍在進行中。因此，就我們的創新議程和 Optum Insight 內基礎業務的績效而言，我們非常樂觀。

Roger, thanks so much. And yes, absolutely. Change Healthcare, an important acquisition for the group. And I think important for the country that we own Change Healthcare without UnitedHealth Group owning Change Healthcare. This attack would likely still have happened, and it would have left Change Healthcare, I think extremely challenged to come back because it was a part of UnitedHealth Group.

羅傑，非常感謝。是的，絕對是如此。 Change Healthcare，該集團的一項重要收購。我認為對我們國家來說很重要的是，我們擁有 Change Healthcare，而聯合健康集團不擁有 Change Healthcare。這次攻擊很可能仍然會發生，而且它將離開 Change Healthcare，我認為回來面臨極大的挑戰，因為它是聯合健康集團的一部分。

We've been able to bring it back. We're going to bring it back much stronger than it was before. And secondarily, all of the reasons that we were interested in bringing the Change Healthcare capabilities and customer connectivity closer to UnitedHealth Group still absolutely holds fast in terms of the potential innovation around things like real-time settlement, clinical decision support capabilities. All of those products are the future service of the future, which ought to be characteristics of a modern health care environment.

我們已經能夠把它帶回來了。我們將把它帶回來，比以前更強大。其次，我們對將 Change Healthcare 功能和客戶連接更接近 UnitedHealth Group 感興趣的所有原因在即時結算、臨床決策支援功能等潛在創新方面仍然絕對有效。所有這些產品都是未來的服務，這應該是現代醫療保健環境的特徵。

Those are all the reasons why we believe Change and UHG were better together. The cyber attack has, unfortunately, created another true validation of why that was the right thing to do because it meant the UHG was in a position to resolve this much more quickly than I think would ever have been imaginable in a stand-alone situation.

這些都是我們相信 Change 和 UHG 結合在一起效果更好的原因。不幸的是，網路攻擊再次真正驗證了為什麼這是正確的做法，因為這意味著 UHG 能夠比我想像的在獨立情況下更快地解決這個問題。

Thanks, everybody, for all of your questions this morning. It's been a bit more of a complex quarter for sure this time around, but one that's also showed the depth and breadth of our company's capabilities. We're recovering quickly from the Change Healthcare attack and are a stronger, more capable company as a result. We're continuing to build our business based on the five strategic growth that we're relentlessly focused on. And we're steadfastly confident in our ability to achieve our 13% to 16% long-term growth objective as we look to the years ahead.

謝謝大家今天早上提出的所有問題。這次無疑是一個更複雜的季度，但也展現了我們公司能力的深度和廣度。我們正在從變革醫療保健的攻擊中迅速恢復，因此成為更強大、更有能力的公司。我們將繼續根據我們不懈關注的五個策略成長來發展我們的業務。展望未來，我們對實現 13% 至 16% 長期成長目標的能力充滿信心。

We very much appreciate all of your time and attention this morning. Thank you.

我們非常感謝您今天早上的所有時間和關注。謝謝。

This does conclude today's conference. We thank you for your participation.

今天的會議到此結束。我們感謝您的參與。