聯合健康 (UNH) 2025 Q2 法說會逐字稿

Good morning, and welcome to the UnitedHealth Group second-quarter 2025 earnings conference call. A question-and-answer session will follow UnitedHealth Group's prepared remarks. As a reminder, this call is being recorded.

早安，歡迎參加聯合健康集團 2025 年第二季財報電話會議。聯合健康集團的準備好的發言之後將進行問答環節。提醒一下，本次通話正在錄音。

Here are some important introductory information. This call contains forward-looking statements under US 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.

以下是一些重要的介紹資訊。本次電話會議包含美國聯邦證券法規定的前瞻性陳述。這些聲明受風險和不確定性的影響，可能導致實際結果與歷史經驗或當前預期有重大差異。

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.

我們向美國證券交易委員會提交的報告中包含了一些風險和不確定性的描述，包括我們目前和定期提交的文件中包含的警示性聲明。

This call will also reference non-GAAP amounts. A reconciliation of the non-GAAP to GAAP amount is available in the Financial and Earnings Reports section of the company's Investor Relations page at www.unitedhealthgroup.com.

本次電話會議也將參考非公認會計準則金額。非 GAAP 與 GAAP 金額的對帳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中找到。

Information presented on this call is contained in the earnings release we issued this morning and in our Form 8-K dated July 29, 2025, which may be accessed from our Investor Relations page of the company's website.

本次電話會議中提供的資訊包含在我們今天上午發布的收益報告和 2025 年 7 月 29 日的 8-K 表格中，可從公司網站的投資者關係頁面存取。

I will now turn the conference over to the Chairman and Chief Executive Officer of UnitedHealth Group, Stephen Hemsley.

現在，我將會議交給聯合健康集團董事長兼執行長史蒂芬‧赫姆斯利。

Thank you. Good morning, and thank you for joining. Today, our prepared remarks will be a little longer than usual, so we will be allowing more time for your questions. As we begin, I want to recognize and thank our employees who have been so dedicated to serving our patients, consumers, and customers during a prolonged challenging period for our business.

謝謝。早安，感謝您的加入。今天，我們準備的發言會比平常稍長一些，因此我們將留出更多時間來回答大家的提問。首先，我要表揚並感謝我們的員工，他們在我們業務長期面臨挑戰的時期一直致力於為我們的患者、消費者和客戶提供服務。

And I'd like to thank our leadership team, many of whom are new in their roles, for their willingness to join me in looking hard at our businesses, getting a grounded assessment of our action plans, rebaselining our outlook, and moving at pace to advance the performance of each of our businesses.

我還要感謝我們的領導團隊，其中許多人都是新上任的，感謝他們願意與我一起認真審視我們的業務，對我們的行動計劃進行紮實的評估，重新調整我們的前景，并快速採取行動，提高我們每項業務的業績。

This morning, I know you are eager to get into the underlying details of our revised financial outlook, which we will do. But at this moment, I believe it's also important to convey the tone we're setting at this enterprise. More than anything, it is a tone of change and reform borne out of recommitment to our mission to help people live healthier lives and help make the health system work better for everyone.

今天上午，我知道你們渴望了解我們修訂後的財務前景的具體細節，我們將會這樣做。但此時此刻，我認為傳達我們在這項事業中設定的基調也很重要。最重要的是，這是一種變革和改革的基調，源於我們對幫助人們過上更健康的生活並幫助衛生系統更好地為每個人服務的使命的重新承諾。

It's a mission that requires a commitment to a culture of values, of service, responsibility, integrity, and humility. We pair that mission-driven ambition of reform with a keen sense of the opportunity and the expectation to perform better than we ever have.

這項使命需要致力於價值觀、服務、責任、誠信和謙遜的文化。我們將以使命為導向的改革雄心與敏銳的機會意識以及比以往表現更好的期望結合起來。

As we continue to assess the state of our businesses, it is very apparent that some require a fundamental reorientation, others require building and nurturing, and others must be reconsidered and redirected to original purpose.

當我們繼續評估我們的業務狀況時，很明顯有些業務需要從根本上重新定位，有些業務需要建造和培育，還有一些業務必須重新考慮並重新回到最初的目的。

We also recognize the need and the opportunity to revisit and address critical processes and fundamental business practices, both internal and market-facing. We're acutely aware we have an enormous responsibility for providing care for millions of people and for protecting the government and private programs we partner in.

我們也認識到重新審視和解決內部和麵向市場的關鍵流程和基本業務實踐的必要性和機會。我們深知，我們肩負著為數百萬人提供醫療服務以及保護我們合作的政府和私人計畫的巨大責任。

As such, we have embarked on a real cultural shift in our relationship with regulators and all external stakeholders. We intend to be proactively engaged, constructive, and responsive to the concerns of all stakeholders and in our engagement with them.

因此，我們與監管機構和所有外部利害關係人的關係開始了真正的文化轉變。我們打算積極主動地參與、建設性地回應所有利害關係人的關切並與他們接觸。

We have the chance to reposition our enterprise as a far more modern, reliable, consumer, and provider-friendly enterprise using new technologies and approaches, and we're going to pursue that course. Pursuit of these opportunities aligns to and enables our reform and change mandate and allows us to better achieve our mission and to steadily perform better in doing so.

我們有機會利用新技術和新方法將我們的企業重新定位為更現代化、可靠、消費者和供應商友好的企業，我們將繼續朝著這個方向努力。追求這些機會符合並支持我們的改革和變革使命，並使我們能夠更好地實現我們的使命，並在實現這一使命的過程中穩步取得更好的表現。

We are on this course against a challenging environment, which includes a generational pullback in Medicare funding set in motion in 2023 and playing out through 2026; unprecedented medical cost trends, measured in both intensity of services used as well as unit prices and more aggressive care provider coding and billing technologies; the prospects for further contraction of the Medicaid and exchange markets; the growing need to invest in the opportunities new technologies offer, and the expectation of all health care entities to offer a better experience for consumers, customers, care providers, and employees.

我們正面臨著嚴峻的挑戰，包括 2023 年開始並持續到 2026 年的醫療保險資金縮減；前所未有的醫療成本趨勢（以所用服務的強度和單位價格以及更積極的護理提供者編碼和計費技術來衡量）；醫療補助和交易市場進一步萎縮的前景；對新技術提供的機會進行更好的員工

And finally, the continuing public controversy over long-standing practices and complexities across the entire health care sector, particularly managed care, which bears the critical roles for coverage for care management and for pricing for the intensity of the cost and services used in the benefit products and programs for the entire health care market. As a leading provider of health services, we must help advance a better health system.

最後，公眾對整個醫療保健行業長期存在的實踐和複雜性的爭議持續不斷，特別是管理式醫療，它對整個醫療保健市場中醫療管理的覆蓋範圍以及福利產品和計劃所使用的成本和服務強度的定價起著關鍵作用。作為領先的醫療服務提供者，我們必須協助推動更好的醫療體系。

We are committed to engaging in these pursuits with a sense of purpose and better partnership with all stakeholders, transparency in our business and reporting practices, and continued integrity in all we do. Beyond the environmental factors that are affecting the entire sector, and more specifically to us, we've made pricing and operational mistakes as well as others. They are getting the needed attention.

我們致力於以使命感和與所有利害關係人更好的夥伴關係來參與這些追求，在我們的業務和報告實踐中保持透明度，並在我們所做的一切中保持誠信。除了影響整個產業（尤其是對我們）的環境因素之外，我們還犯了定價和營運錯誤以及其他錯誤。他們正在得到應有的關注。

Our critical processes, including risk status, care management, pharmaceutical services ,and others are being reviewed by independent experts, and they will be reviewed every year and reported on, as these processes can be reviewed at any time by outside stakeholders.

我們的關鍵流程，包括風險狀況、護理管理、醫藥服務等，正在接受獨立專家的審查，並且每年都會進行審查並報告，因為這些流程可能隨時受到外部利益相關者的審查。

While we believe in our oversight and the integrity of these processes, wherever they are determined to be at variance with prescribed practice, they will be promptly remediated and we'll continue on this path.

雖然我們相信我們的監督和這些流程的完整性，但只要確定它們與規定的做法不符，我們就會及時糾正，並將繼續沿著這條道路前進。

All of the foregoing is fully addressable. We can steadily restore our performance to levels consistent with our mission and stakeholder expectations, all as we strengthen an institutional culture aligned to that mission and accountable for performance.

上述所有內容都是完全可以解決的。我們可以穩步恢復我們的績效，達到與我們的使命和利益相關者期望相符的水平，同時我們也要加強與我們的使命相符並對績效負責的機構文化。

Over the last 60 days or more, we have made extensive management and operational changes aligned to this agenda of reform and performance. Other such changes to leadership, to our businesses, our culture, our approaches and practices and to our Board, governance, and succession oversight as appropriate, will continue to be made as we proceed through this period.

在過去 60 多天裡，我們根據這項改革和績效議程進行了廣泛的管理和營運變革。在此期間，我們將繼續對領導層、我們的業務、我們的文化、我們的方法和實踐以及我們的董事會、治理和繼任監督進行適當的其他變更。

With those thoughts in mind, Tim Noel and Patrick Conway, heads of UnitedHealthcare and Optum, respectively, will walk through some of the specifics in their businesses. John Rex will discuss financial performance and the elements affecting our outlook, and I'll come back with some closing thoughts, and then we'll have ample time for questions and answers.

基於這些想法，聯合健康保險和 Optum 的負責人 Tim Noel 和 Patrick Conway 將介紹各自業務中的一些具體細節。約翰·雷克斯將討論財務表現和影響我們前景的因素，然後我會總結一些想法，然後我們將有足夠的時間進行問答。

Thank you, Steve. I'll start by emphasizing that we are approaching our business with greater humility, greater transparency and a renewed determination to meet your expectations and our standards. The primary driver of the UnitedHealthcare earnings shortfall for 2025 is that our pricing assumptions were well short of actual medical costs.

謝謝你，史蒂夫。首先我要強調的是，我們正以更謙遜、更透明的態度來開展業務，並更加堅定地決心滿足您的期望和我們的標準。聯合健康保險 2025 年獲利不足的主要原因是我們的定價假設遠低於實際醫療成本。

Our current view for 2025 reflects $6.5 billion more in medical costs than we anticipated in our initial outlook. A little over half, or $3.6 billion, of this is in our broad-based Medicare portfolio. About one-third, or $2.3 billion, is in the commercial business, split evenly between ACA plans and our employer business. The remaining trend pressure is related to Medicaid, most notably due to elevated behavioral trend.

我們目前對 2025 年的預測顯示，醫療費用將比我們最初的展望高出 65 億美元。其中略多於一半（即 36 億美元）屬於我們廣泛的醫療保險投資組合。約三分之一（即 23 億美元）用於商業業務，平均分配給 ACA 計劃和我們的雇主業務。剩餘的趨勢壓力與醫療補助有關，最顯著的原因是行為趨勢的上升。

In addition to trend-driven issues, the updated 2025 outlook removes about $1 billion from previously planned portfolio actions that we are no longer pursuing. It also reflects about $850 million of other items, including unfavorable prior period items, primarily from 2024, and recognition of several one-time settlements.

除了趨勢驅動的問題外，更新後的 2025 年展望還從我們不再實施的先前計劃的投資組合行動中剔除了約 10 億美元。它還反映了約 8.5 億美元的其他項目，包括主要來自 2024 年的不利前期項目，以及幾項一次性結算的確認。

We know these are serious challenges. We are humbled by them, and we'll carry that sense of humility more deeply into our culture. But we also believe we can resolve our current issues and recapture our earnings growth potential.

我們知道這些都是嚴峻的挑戰。他們令我們感到謙卑，我們會將這種謙卑之心更深地融入我們的文化中。但我們也相信，我們能夠解決當前的問題並重新獲得獲利成長潛力。

Let me now provide an update on where each business stands, starting with Medicare. When we prepared our 2025 Medicare Advantage offerings back in the first half of 2024, we significantly underestimated the accelerating medical trend and did not modify benefits or plan offerings sufficiently to offset the pressures we are now experiencing.

現在讓我介紹一下每個業務的最新情況，首先是醫療保險。當我們在 2024 年上半年準備 2025 年醫療保險優勢計劃時，我們嚴重低估了醫療趨勢的加速，並且沒有充分修改福利或計劃以抵消我們現在面臨的壓力。

This was compounded by the magnitude of plan exits across the sector and the extent to which we now see care providers placing further service intensity into the health system. The increasingly flexible orientation to which our Medicare networks and plan designs have evolved over recent years left us less able to address these trends in year.

這個問題因整個行業計劃退出的規模以及我們現在看到的醫療服務提供者在醫療系統中進一步加大服務強度的程度而變得更加複雜。近年來，我們的醫療保險網絡和計劃設計變得越來越靈活，這讓我們更難以應對這些趨勢。

On trend, specifically, the increase in care activity across individual and group Medicare Advantage we saw earlier this year has now affected complex populations and our Medicare Supplement business as well.

具體來說，從趨勢上看，我們今年早些時候看到的個人和團體醫療保險優勢計劃的護理活動增加，現在已經影響到複雜人群和我們的醫療保險補充業務。

Across Medicare Advantage, physician and outpatient care together represent 70% of the pressure year-to-date. However, inpatient utilization has accelerated through Q2, and we expect will comprise a relatively larger portion of the pressure over the full year.

在醫療保險優勢計劃中，醫生和門診護理合計佔年初至今壓力的 70%。然而，住院病人利用率在第二季度有所加速，我們預計這將在全年的壓力中佔據相對較大的比例。

We continue to see utilization increases in ER and observation stays and consistently see more services being offered and bundled as part of each ER visit and clinical encounter. In short, most encounters are intensifying in services and costing more. The higher trend is broad-based geographically and across our membership, including our large retained membership base.

我們持續看到急診室和觀察住院的利用率不斷增加，並且持續看到每次急診室就診和臨床就診中提供和捆綁了更多的服務。簡而言之，大多數遭遇的服務都在加劇，而且費用也在增加。這種上升趨勢在地理範圍和我們的會員範圍廣泛，包括我們龐大的保留會員基礎。

To put this into context, we had initially assumed Medicare Advantage medical cost trend of just over 5% when configuring our 2025 bids, in line with our normalized trend experience in 2024. We now expect full year 2025 trend to be approximately 7.5%.

具體來說，在配置 2025 年投標時，我們最初假設 Medicare Advantage 醫療成本趨勢略高於 5%，這與我們在 2024 年的正常化趨勢經驗一致。我們現在預計 2025 年全年趨勢約為 7.5%。

Medicare Supplement, which typically is representative of overall care activity levels and cost trends in Medicare fee-for-service broadly, is up similarly in 2025 compared to historical levels. We expect that trend to be over 11% this year versus 8% to 9% in recent years, further confirming the broad-based nature of the care activity and the coding and billing patterns we are seeing.

醫療保險補充保險通常代表醫療保險按服務收費的整體護理活動水準和成本趨勢，與歷史水準相比，2025 年也將出現類似的上漲。我們預計今年這一趨勢將超過 11%，而近年來這一趨勢為 8% 至 9%，這進一步證實了護理活動的廣泛性質以及我們所看到的編碼和計費模式。

On Commercial, we are seeing higher-than-expected medical cost increases, particularly in outpatient care and although to a lesser extent, inpatient care. Orthopedic spending and pharmacy infusions are notable factors here.

在商業方面，我們看到醫療費用的成長高於預期，特別是門診護理，儘管程度較輕，但住院護理也是如此。骨科支出和藥局輸液是這裡值得注意的因素。

In the ACA business, the revenue impact resulting from a difference between the morbidity that we price for and what we experienced is the primary cause of our underperformance. One example of the elevated commercial trend is group fully insured. There, trend is approaching 11%, which is approximately 100 basis points higher than our initial expectations.

在 ACA 業務中，我們定價的發病率和我們所經歷的發病率之間的差異所造成的收入影響是我們業績不佳的主要原因。商業趨勢上升的一個例子就是團體全額保險。那裡的趨勢接近 11%，比我們最初的預期高出約 100 個基點。

Moving to Medicaid. Similar elevated trends are apparent and further affected by increasing and unanticipated acceleration of cost in Behavioral Health, where trend is running at 20% as well as in Pharmacy and Home Health. We anticipate the existing rate and acuity mismatch will extend well into next year. Beyond these segment-specific factors, there are other broad drivers of higher medical costs.

轉向醫療補助。類似的上升趨勢顯而易見，並受到行為健康領域成本增加和意外加速的影響，其中趨勢為 20%，藥房和家庭保健領域也是如此。我們預計現有的利率和敏銳度不匹配狀況將持續到明年。除了這些特定領域的因素外，還有其他因素導致醫療成本上漲。

There has been a marked increase in health care cost due in part to increases in service intensity per encounter. For example, in Medicare Advantage, higher frequency of physician rounding, testing, and related services of specialists and in ER settings are contributing to elevated outpatient spend. In addition to strongly responsive pricing for 2026, which I will speak to in a moment, we are intensifying our remediation actions.

醫療保健成本明顯增加，部分原因是每次就診的服務強度增加。例如，在醫療保險優勢計劃中，醫生巡視、檢查以及專科醫生和急診室相關服務的頻率更高，導致門診支出增加。除了我稍後會談到的針對 2026 年的強有力的定價之外，我們還在加強補救措施。

We have stepped up our audit, clinical policy and payment integrity tools to protect customers and patients from unnecessary costs. These efforts ensure care is delivered in appropriate settings and grounded in safety and quality, while also identifying waste and abuse in outlier coding and billing practices.

我們加強了審計、臨床政策和支付誠信工具，以保護客戶和患者免受不必要的費用。這些努力確保在適當的環境中提供護理，並以安全和品質為基礎，同時也能識別異常編碼和計費實踐中的浪費和濫用。

We are shifting to narrower networks and focusing on more disciplined managed products, particularly in Medicare Advantage. And we have scaled our AI efforts across health plan operations, which improves the patient and provider service experiences while driving cost savings.

我們正在轉向更窄的網絡，並專注於更有紀律的管理產品，特別是在醫療保險優勢計劃中。我們已經將人工智慧的運用擴展到整個健康計畫營運中，這不僅改善了患者和提供者的服務體驗，也節省了成本。

Lastly, in Medicaid, we continue to actively engage with state partners using both past experience and data-driven insights to show the need for immediate and more regular rate updates. Taken together, this work is helping restore our operational muscle and reclaiming executional rigor, helped by modern tools and driven by a relentless focus on improvement.

最後，在醫療補助方面，我們繼續積極與州合作夥伴合作，利用過去的經驗和數據驅動的見解來表明立即和更定期更新費率的必要性。總的來說，在現代工具的幫助下以及在對改進的不懈關注的推動下，這項工作有助於恢復我們的營運能力並重新獲得執行嚴謹性。

Turning now to 2026. Our pricing strategy is intensely focused on margin recovery and moving back towards our earnings growth targets. In Medicare, we have historically targeted an operating margin range of 3% to 5%. Now with the changes from the Inflation Reduction Act on the Part D program, which resulted in higher revenue but do not impact earnings, the equivalent target margin range is in the 2% to 4% range.

現在轉向 2026 年。我們的定價策略主要集中於利潤率的恢復以及向獲利成長目標邁進。在醫療保險領域，我們歷來的目標是將營業利潤率控制在 3% 至 5% 之間。現在，隨著《通貨膨脹削減法案》對 D 部分計劃的修改，收入增加但不會影響收益，相應的目標利潤率範圍在 2% 至 4% 之間。

We are working intensively to remediate Medicare through pricing, product design, and benefit changes that will enable us to be within the lower half of the targeted margin ranges in 2026 and advancing further in 2027. Our Medicare Advantage pricing strategy for 2026 assumes a trend approaching 10% compared to our current 7.5% trend expectation.

我們正在透過定價、產品設計和福利變化等方式積極改善醫療保險，這將使我們在 2026 年達到目標利潤率範圍的下半部分，並在 2027 年取得進一步進展。我們針對 2026 年醫療保險優勢計畫的定價策略假設趨勢將接近 10%，而我們目前的趨勢預期為 7.5%。

This accounts for trend acceleration and incorporates factors such as changes in fee schedules and the continuation of higher yields from provider coding and billing practices. Considering the continued cost trends and funding pressures and the need to support margin recovery, we have made significant adjustments to benefits.

這解釋了趨勢加速，並包含了費用表變化以及提供者編碼和計費實踐持續獲得更高收益等因素。考慮到持續的成本趨勢和資金壓力以及支持利潤率恢復的需要，我們對福利進行了重大調整。

Additionally, and unfortunately, given these pressures, we have made the difficult decision to exit plans that currently serve over 600,000 members, primarily in less managed products such as PPO offerings. We have taken similar approaches for Medicare supplement, Group MA, and stand-alone Part D pricing for next year. We will be watching the market closely as the 2026 Medicare offerings become public so we can better assess our market positioning and respond quickly.

此外，不幸的是，鑑於這些壓力，我們做出了艱難的決定，退出目前為超過 60 萬名會員提供服務的計劃，主要是 PPO 產品等管理較少的產品。我們對明年的醫療保險補充保險、團體 MA 和獨立 D 部分的定價也採取了類似的方法。隨著 2026 年醫療保險產品的公開，我們將密切關注市場，以便我們能夠更好地評估我們的市場定位並迅速做出反應。

For Commercial, because renewals occur over the course of the year, we are able to price for changes more dynamically. Our pricing will anticipate higher trend continuing into 2026 and 2027. We expect increased membership decline as well as shifts into both level-funded and self-funded product categories because of higher medical cost trends.

對於商業而言，由於續約發生在一年之中，我們能夠更動態地對變更進行定價。我們的定價預計上漲趨勢將持續到 2026 年和 2027 年。由於醫療成本趨勢上升，我們預計會員人數將進一步下降，並將轉向水平資助和自籌資金的產品類別。

In the individual exchange business, while we are prepared to continue to participate in the majority of the 30 markets we currently serve, we will approach them far more conservatively for 2026. We may need to make the difficult decision to exit select markets if we are unable to achieve the rates necessary for higher market-wide morbidity.

在個人交易業務中，雖然我們準備繼續參與目前服務的 30 個市場中的大多數市場，但對於 2026 年，我們將採取更保守的態度。如果我們無法達到提高市場發病率所需的比率，我們可能需要做出退出特定市場的艱難決定。

Additionally, due to the projected expiration of premium subsidies across the ACA market, our membership should decline significantly, and we are mindful of the potential for adverse selection dynamics as we reprice these offerings for next year.

此外，由於整個 ACA 市場保費補貼預計即將到期，我們的會員數量將大幅下降，我們在明年重新定價這些產品時，也注意到了逆向選擇動態的可能性。

In Medicaid, there remains a lag between funding levels and member health risk, and we expect this to continue into 2026, resulting in additional margin compression in the business, including a loss within the nondual segment of Medicaid in 2026.

在醫療補助計劃中，資金水平和成員健康風險之間仍然存在滯後，我們預計這種情況將持續到 2026 年，導致業務利潤率進一步壓縮，包括 2026 年醫療補助計劃非雙重部分的虧損。

Membership losses from early adoption of recent legislation is also factored into our initial views for 2026. Wherever states support responsible funding for Medicaid, we remain committed to serving people through that program and view this as integral to our mission.

我們對 2026 年的初步預測也考慮了近期立法過早通過而導致的會員流失。無論哪個州支持對醫療補助計劃進行負責任的資助，我們都會繼續致力於透過該計劃為人民服務，並將其視為我們使命不可或缺的一部分。

The American health system's long-standing cost problem is accelerating. We are embracing our responsibility to continue to drive better health outcomes while trying to keep health care affordable for all Americans.

美國醫療體系長期存在的成本問題正加速惡化。我們肩負起責任，繼續推動改善醫療結果，同時努力讓所有美國人都能負擔醫療費用。

The operational and pricing strategies I have described reflect our understanding of the challenges we face as a company and a society and our dedication to responsibly navigating the current financial pressures so that we can set a stable course for the future.

我所描述的營運和定價策略反映了我們對公司和社會所面臨的挑戰的理解，以及我們致力於負責任地應對當前財務壓力，以便為未來制定穩定的方向。

I'll now turn it over to Patrick Conway, CEO of Optum.

現在我將把發言權交給 Optum 執行長 Patrick Conway。

Thanks, Tim. Clearly, Optum's performance this year has also not met expectations, yours or ours. Echoing Tim and Steve, we are approaching this with humility and the need for deep analysis of key issues and commitment to substantially improved execution. Serving our patients and customers is at the heart of our mission and business, and we have the opportunity to truly help make the health system better for everyone.

謝謝，蒂姆。顯然，Optum 今年的表現也沒有達到您的期望或我們的期望。與蒂姆和史蒂夫的觀點一致，我們以謙遜的態度對待此事，需要深入分析關鍵問題並致力於大幅提高執行力。服務我們的患者和客戶是我們使命和業務的核心，我們有機會真正幫助改善每個人的醫療系統。

To do that, we need to refocus on our performance discipline with a bias for action and transparency for all stakeholders. We have launched our agenda of change at Optum, starting with the evolution of our leadership team. Roger Connor brings tremendous experience in organizational execution as our Chief Financial Officer. Krista Nelson is a deeply experienced health care operator, now in the new role of Chief Operating Officer of OptumHealth.

為了實現這一目標，我們需要重新關注我們的績效紀律，並專注於對所有利害關係人的行動和透明度。我們已經在 Optum 啟動了變革議程，首先是領導團隊的變革。作為我們的財務官，羅傑·康納 (Roger Connor) 在組織執行方面擁有豐富的經驗。克里斯塔·尼爾森 (Krista Nelson) 是一位經驗豐富的醫療保健運營商，目前擔任 OptumHealth 的首席營運長。

Dhivya Suryadevara is already reenergizing product development, marketing, and service as the new CEO of OptumInsight. And John Mahrt brings his unmatched pharmacy services experience to bolster the already compelling offerings of OptumRx.

作為 OptumInsight 的新任首席執行官，Dhivya Suryadevara 已經為產品開發、行銷和服務注入了新的活力。John Mahrt 憑藉其無與倫比的藥房服務經驗，進一步增強了 OptumRx 原本就頗具吸引力的產品。

These are not the only people in new roles, and there will be more. We are taking these and many other steps swiftly to enable Optum to recapture its historic momentum. Let me turn now to a review of our businesses, starting with OptumHealth, where improved execution is needed most, and we are experiencing the greatest pressures to our business. Our belief remains steadfast. Value-based care has the potential to transform health care.

擔任新職務的人並不只有這些人，而且還會有更多的人。我們正在迅速採取這些措施以及其他許多措施，以使 Optum 重新獲得其歷史性的發展勢頭。現在讓我來回顧一下我們的業務，首先是 OptumHealth，該部門最需要改善執行力，我們的業務也面臨最大的壓力。我們的信念依然堅定。基於價值的照護有可能改變醫療保健。

Yet even as we struggle to align this model with new funding dynamics, it consistently delivers better outcomes. Tim highlighted the challenges of rising health care unit cost, accelerating service volumes, and provider coding intensity, which further underscores that value-based care remains the most effective method for compensating providers to improve and sustain a patient's health in contrast to simply increasing the volume and price of services.

儘管我們努力使該模式與新的融資動態保持一致，但它始終能帶來更好的結果。蒂姆強調了醫療保健單位成本上升、服務量增加和提供者編碼強度增加的挑戰，這進一步強調，與簡單地增加服務量和價格相比，基於價值的護理仍然是補償提供者改善和維持患者健康的最有效方法。

Research consistently supports this premise, showing Medicare Advantage patients in fully accountable arrangements are 20% less likely to be hospitalized and experience 11% fewer ER visits compared to those in fee-for-service. We are early in our value-based care journey. We know we have real and self-inflicted executional challenges, and we bear the responsibility to get this right, recognizing that urgent work lies ahead.

研究一致支持此前提，顯示與按服務收費的患者相比，享有完全責任制安排的醫療保險優勢計劃的患者住院可能性降低 20%，急診就診次數減少 11%。我們正處於基於價值的護理之旅的早期階段。我們知道，我們面臨現實的、自身造成的執行挑戰，我們有責任把這件事做好，同時也意識到眼前還有迫切的工作要做。

We have spent a decade assembling a care delivery model today serving nearly 20 million patients across three lines of business: Value-based care, fee-for-service care delivery and services, the latter two of which help further enable value-based care.

我們花了十年時間建立一個醫療服務模式，目前為三個業務領域的近 2000 萬名患者提供服務：基於價值的護理、按服務收費的醫療服務和服務，後兩者有助於進一步實現基於價值的護理。

The first category, value-based care, has grown to account for approximately 65% of OptumHealth's revenues and serves 5 million patients in fully accountable arrangements. I'll provide more details on this in a moment. But first, we'll detail the gap to our original OptumHealth outlook.

第一類是基於價值的護理，已成長至佔 OptumHealth 收入的約 65%，並以完全負責任的方式為 500 萬名患者提供服務。我稍後會提供更多有關此問題的詳細資訊。但首先，我們將詳細說明與我們最初的 OptumHealth 觀點之間的差距。

Overall, OptumHealth earnings in 2025 are approximately $6.6 billion below our expectations. To break this down, approximately $3.6 billion, or 55%, is concentrated in our value-based care business with three principal drivers of roughly equal weight.

總體而言，OptumHealth 2025 年的收益比我們的預期低約 66 億美元。具體來說，約有 36 億美元（55%）集中在我們的基於價值的護理業務上，其中有三個主要驅動因素的權重大致相等。

Number one, the mix of enrollment, including more complex and duly eligible members and more new to Optum patients who are underserved; two, accelerated medical trend, particularly physician and outpatient in Medicare and Behavioral and Medicaid; and three, underestimation of new members' risk status as they come into our care and suboptimal execution of the V28 risk model transition.

第一，入院結構複雜，包括更複雜且符合適當資格的會員，以及更多服務不足的 Optum 新患者；第二，醫療趨勢加速，特別是醫療保險、行為和醫療補助中的醫生和門診患者；第三，低估了新會員在接受我們的護理時的風險狀況，並且 V28 風險模型轉換的執行不夠理想。

Second category, another $2 billion, or 30%, relates to the decision to discontinue previously planned portfolio actions, and about $1 billion, or 15%, from a combination of lower service volumes in our services businesses, some nonrecurring prior period impacts, and the slowing of tuck-in acquisitions. For example, on lower service volumes, in 2025, we planned for approximately 20 million fee-for-service visits in our care delivery clinics, and we are tracking 19 million visits or 5% below this expectation.

第二類，另外 20 億美元（30%）與決定停止先前計劃的投資組合行動有關，另外約 10 億美元（15%）則源於我們服務業務的服務量下降、一些非經常性的前期影響以及放緩的補充收購。例如，在服務量較低的情況下，到 2025 年，我們計劃在我們的醫療服務診所進行約 2000 萬次收費服務就診，但我們追蹤的實際就診量為 1900 萬次，比預期低 5%。

Let me dive a bit deeper, specifically into factors affecting our value-based care business. First, V28. This industry-wide shift is effectively a price reduction that we now estimate creating an $11 billion headwind over three years for OptumHealth with $7 billion that will be realized through 2025. That is $2 billion and $1 billion, respectively, more than our initial estimates, while we also overestimated the impact and misexecuted the planned efforts to offset these V28 funding cuts.

讓我深入探討一下，特別是影響我們基於價值的護理業務的因素。首先，V28。這一全行業轉變實際上是一種價格降低，我們現在估計，這將在三年內為 OptumHealth 帶來 110 億美元的不利影響，其中 70 億美元將在 2025 年實現。這分別比我們最初的估計高出 20 億美元和 10 億美元，同時我們也高估了影響並錯誤執行了抵消 V28 資金削減的計劃努力。

Second, enrollment mix. Consistent with Q1, in 2025, we have an unanticipated number of new to OptumHealth patients who are previously underserved. These new patients are largely in markets where numerous plan exits occurred. They include complex patients who require time to be managed effectively by us. This mix impact implies negative margins near double digits for these new patients, which will improve meaningfully in 2026.

第二，招生結構調整。與第一季一致，到 2025 年，OptumHealth 將迎來數量超出預期、先前服務不足的患者。這些新患者大多位於出現大量計劃退出的市場。其中包括病情複雜的患者，我們需要時間來進行有效的治療。這種混合影響意味著這些新患者的負利潤率接近兩位數，但到 2026 年將會有顯著改善。

Lastly, the elevated medical trend we recognized in the second quarter was exacerbated by insufficient pricing within UnitedHealthcare and other payer partners, pulling through in the form of insufficient capitation rates for Optum. Despite these headwinds, Optum's fully accountable value-based care business is delivering an operating margin of about 1% in 2025.

最後，我們在第二季度認識到的醫療趨勢上升因 UnitedHealthcare 和其他付款合作夥伴的定價不足而加劇，以 Optum 的人頭費率不足的形式出現。儘管面臨這些不利因素，Optum 完全負責任的基於價值的護理業務仍將在 2025 年實現約 1% 的營業利潤率。

This compares to full year operating margins of over 3% in 2024 and nearly 5% in 2023. A large part of the mis-execution addressing the V28 funding cuts was due to non-standardized and overly localized management approach, which we are addressing with urgency.

相較之下，2024 年全年營業利益率超過 3%，2023 年全年營業利益率接近 5%。解決 V28 資金削減問題的失敗很大程度上是由於管理方法不規範和過於本地化，我們正在緊急解決這個問題。

We are driving to a consistent and much more concentrated regional operating model with four market leaders. We are evaluating our position in each market. We will shift risk back to the original underwriters until we have the hardened capacity to navigate it under value-based constructs.

我們正在推行與四大市場領導者保持一致且更集中的區域營運模式。我們正在評估我們在每個市場中的地位。我們會將風險轉移回原來的承銷商，直到我們擁有在基於價值的架構下應對風險的強大能力。

And Optum will be much more disciplined in taking risk arrangements and product designs and constructs that allow value-based care to have its intended impact. The margin compression reflects significant growth in new membership cohorts with nearly 40% of patients served today having come in since the beginning of 2024. It also reflects the pull-through from Medicare Advantage pricing dislocation Tim described and the V28 payment cuts.

Optum 將更嚴格地制定風險安排、設計和建構產品，以使基於價值的醫療服務發揮其預期作用。利潤率的壓縮反映了新會員數量的顯著增長，目前服務的患者中近 40% 是 2024 年初之後加入的。這也反映了蒂姆所描述的醫療保險優勢計劃定價錯位和 V28 支付削減的影響。

Regarding patient cohorts, in our value-based care practices, margins improve the longer patients remain. Our most mature value-based care cohorts, those from 2021 and prior, are operating at an estimated 8%-plus margin in 2025. Those in 2022 and 2023 cohorts are operating at a 2% margin. The 2024 through 2025 groups are at negative margins.

關於患者群體，在我們基於價值的護理實踐中，患者住院時間越長，利潤就越高。我們最成熟的基於價值的護理群體（即 2021 年及之前的群體）在 2025 年的利潤率預計超過 8%。2022 年和 2023 年隊列的利潤率為 2%。2024 年至 2025 年的組別利潤率為負。

Strong physician engagement, appropriate medical diagnosis, and improved consistent quality of care continues to drive year-over-year improvement in a cohort's financial performance and in their health. But it's taking too long and there's too much variability in results among practices, and we are actively addressing those factors.

強大的醫生參與度、適當的醫療診斷以及持續改善的護理品質持續推動著患者群體的財務表現和健康狀況逐年改善。但它花費的時間太長，而且實踐結果差異太大，我們正在積極解決這些因素。

That's the overall picture of what is happening. I'll turn now to remediation. Our plan for improvement has four key elements. First and foremost, we are improving the implementation and consistency of our clinical model, which is anchored in primary care and supported by wraparound services that continue to outperform on quality and cost.

這就是正在發生事情的總體情況。我現在要談談補救措施。我們的改進計劃有四個關鍵要素。首先，我們正在改善臨床模式的實施和一致性，該模式以初級保健為基礎，並由在品質和成本方面持續表現優異的全方位服務提供支援。

Second, we are committed to margin recovery in value-based care. We've aligned our 2026 benefits and product portfolio and footprint with our payer partners to address the final year of V28 headwinds. We plan to cease arrangements for about 200,000 patients largely in fully accountable PPO products, representing approximately 40% of the PPO patients we serve today. We expect to keep narrowing our exposure beyond 2026.

其次，我們致力於價值型醫療的利潤復原。我們已與付款合作夥伴協調了 2026 年的福利、產品組合和足跡，以應對 V28 逆風的最後一年。我們計劃停止為大約 20 萬名患者安排主要採用完全負責的 PPO 產品，這約占我們目前服務的 PPO 患者的 40%。我們預計 2026 年後我們的投資範圍將持續縮小。

We are increasing rates to reflect the higher risk profiles and acuity we are seeing and expect to continue. We believe the combination of these activities will mitigate about half of the remaining $4 billion V28 headwind in 2026. The remainder of our offset will come from operating cost discipline and consistent execution of our care programs, which enhance engagement, diagnosis accuracy and quality outcomes, and reduce overall cost of care.

我們正在提高利率，以反映我們所看到的更高的風險狀況和敏銳度，並且預計這種趨勢將持續下去。我們相信，這些活動的結合將減輕 2026 年剩餘的 40 億美元 V28 逆風的約一半。我們剩餘的補償將來自營運成本紀律和護理計劃的持續執行，這將提高參與度、診斷準確性和品質結果，並降低整體護理成本。

With 2026 being the final year of V28 phase-in, you should expect 2026 value-based care margins to remain relatively consistent with the 1% margin we are achieving this year and then begin to advance again in 2027 and beyond.

2026 年是 V28 逐步實施的最後一年，您應該預期 2026 年基於價值的護理利潤率將與我們今年實現的 1% 利潤率保持相對一致，然後在 2027 年及以後再次開始增長。

We are optimizing our portfolio of clinical practices. We are managing our fee-for-service and fully accountable risk practices to align with performance expectations, transitioning to partial risk or service arrangements where necessary, and exiting fully accountable products in certain markets.

我們正在優化我們的臨床實踐組合。我們正在管理我們的收費服務和完全負責任的風險實踐，以符合績效預期，在必要時過渡到部分風險或服務安排，並退出某些市場的完全負責任的產品。

Third, we are aggressively advancing operational disciplines across our portfolio of businesses. The more concentrated operating model I mentioned earlier plays into more standardized approaches, predictable outcomes, and lower operating costs.

第三，我們正在積極推動我們業務組合的營運紀律。我之前提到的更集中的營運模式體現了更標準化的方法、可預測的結果和更低的營運成本。

We will complete the final stages of our technology integration, which will enable meaningful advances with emerging technologies like AI to drive efficiency gains. For 2026, we expect to deliver almost $1 billion in cost reductions.

我們將完成技術整合的最後階段，這將使人工智慧等新興技術取得有意義的進步，從而提高效率。到 2026 年，我們預計成本將削減將近 10 億美元。

Finally, beyond value-based care, OptumHealth also includes fee-for-service care delivery, including home care, ambulatory surgical care, and medical practices that are not yet fully accountable but support value-based care. These, together, account for 15% of OptumHealth's revenues. Most of these businesses are performing well and operate at low double-digit margins.

最後，除了基於價值的護理之外，OptumHealth 還包括按服務收費的護理服務，包括家庭護理、門診手術護理以及尚未完全負責但支持基於價值的護理的醫療實踐。這些加起來佔 OptumHealth 收入的 15%。這些企業大多表現良好，利潤率均維持在兩位數的低點。

However, the primary care and multi-specialty medical practices that are not yet fully accountable are running at negative margins, generating hundreds of millions of losses this year alone, placing the overall fee-for-service care delivery business in the mid-single digit margin range.

然而，尚未完全承擔責任的初級保健和多專業醫療機構的利潤率為負，僅今年一年就產生了數億美元的損失，導致整體按服務收費的醫療服務業務的利潤率處於個位數的中等水平。

So we are actively working to improve payment yields and productivity while growing these high-value services and fee-for-service margins. We are targeting growth for these services, which are projected to deliver strong year-over-year earnings growth in 2026.

因此，我們正在積極努力提高支付收益和生產力，同時增加這些高價值服務和按服務收費的利潤率。我們的目標是實現這些服務的成長，預計到 2026 年這些服務的獲利將實現強勁的年成長。

The third component of OptumHealth services is comprised of businesses, including managed behavioral health, military and veterans, and health financial services. These account for about 20% of OptumHealth revenues and combined have an almost 10% operating margins.

OptumHealth 服務的第三部分由管理行為健康、軍事和退伍軍人以及健康金融服務等業務組成。這些業務約佔 OptumHealth 收入的 20%，總計營業利益率接近 10%。

Overall, at OptumHealth, while we expect continued pressure for the rest of this year, we anticipate meaningful improvement in our operations and with earnings growth in 2026, albeit with a longer path to recovery in our value-based care business.

總體而言，雖然我們預計 OptumHealth 今年剩餘時間將繼續面臨壓力，但我們預計 2026 年我們的營運和盈利將實現顯著改善，儘管我們基於價值的護理業務的復甦之路會更長。

We now see OptumHealth long-term margins in the 6% to 8% range and about 5% for value-based care specifically as we see significant growth opportunity for the decade to come. The overall blended margin will reflect the early year investment losses generated by new cohorts. OptumHealth is early in its development and mixed execution is a clear setback, but the long-term growth potential and expectations remain intact and significant.

我們現在看到 OptumHealth 的長期利潤率在 6% 至 8% 之間，而基於價值的照護的利潤率約為 5%，因為我們看到未來十年的巨大成長機會。整體混合利潤率將反映新客戶群產生的年初投資損失。OptumHealth 正處於發展初期，混合執行是一個明顯的挫折，但長期成長潛力和預期仍然完好且顯著。

Moving to OptumInsight. There's a great need and appetite for technology and data products to help the health system perform more efficiently and effectively, yet OptumInsight has not fully capitalized on this opportunity.

轉向 OptumInsight。人們對科技和數據產品有著極大的需求和渴望，以幫助醫療系統更有效率、更有效地運作，但 OptumInsight 尚未充分利用這個機會。

That's largely due to an unfocused suite of products, lagging innovation and longer-than-expected impact from last year's cyberattack, which unfortunately, came at the expense of being able to drill down on business innovation, operations, and growth. But as I mentioned earlier, we have a talented team in place now and continue to recruit talent to develop the next generation of products rooted in AI.

這主要是由於產品套件缺乏重點、創新滯後以及去年網路攻擊的影響比預期的要長，不幸的是，這以犧牲深入開展業務創新、營運和成長的能力為代價。但正如我之前提到的，我們現在已經擁有一支才華橫溢的團隊，並將繼續招募人才來開發基於人工智慧的下一代產品。

As it relates specifically to 2025, we are adjusting our outlook downward by $1 billion. About half of this is due to more gradual recovery than initially expected in some of our volume-based businesses due to Change Healthcare and one-time cyber-related expenses. The other half is due to pausing previously planned portfolio actions so that we can prioritize growth and innovation across our broader portfolio.

由於它與 2025 年具體相關，我們將前景下調了 10 億美元。其中約有一半是由於我們的一些基於數量的業務由於 Change Healthcare 和一次性網路相關費用而比最初預期的復甦更為緩慢。另一半是由於暫停先前計劃的投資組合行動，以便我們能夠優先考慮更廣泛的投資組合中的成長和創新。

At OptumRx, client retention remains high and consistent with past years. We expect revenue growth of $18 billion or 13% and earnings growth of just over $200 million or nearly 4%, driven by low-margin specialty drugs.

在 OptumRx，客戶保留率仍然很高，與過去幾年保持一致。我們預計，受低利潤特種藥物的推動，營收將成長 180 億美元，即 13%，獲利將成長略高於 2 億美元，即近 4%。

Compared to the strong revenue growth rate, our earnings growth has been constrained by four main factors. The removal of portfolio actions from our plan is roughly $150 million headwind; another $50 million is from a couple of ancillary businesses where we are taking aggressive corrective actions and adjusting plans; and the impact of initial launch phase of our private label business, Nuvaila is a roughly $150 million headwind.

與強勁的營收成長率相比，我們的獲利成長受到四個主要因素的限制。從我們的計劃中取消投資組合行動將帶來約 1.5 億美元的不利影響；另外 5000 萬美元來自一些輔助業務，我們正在對這些業務採取積極的糾正措施和調整計劃；而我們的自有品牌業務 Nuvaila 的初始啟動階段的影響將帶來約 1.5 億美元的不利影響。

As it matures, we see Nuvaila delivering affordability for our clients and consumers and strong earnings for OptumRx. Additionally, GLP-1s, which can benefit appropriate patients, continue to impact earnings, representing $160 million headwind for our pharmacy services businesses.

隨著它的成熟，我們看到 Nuvaila 為我們的客戶和消費者帶來了負擔得起的產品，並為 OptumRx 帶來了強勁的收益。此外，可以使合適的患者受益的 GLP-1 繼續影響收益，對我們的藥房服務業務造成 1.6 億美元的逆風。

After three months in this role, I want to thank the thousands of people serving in Optum and to let external stakeholders know that the problems are fixable and that Optum will continue to drive long-term growth and make the most of our opportunity to serve people.

在擔任這個職位三個月後，我想感謝在 Optum 工作的數千名員工，並讓外部利益相關者知道，這些問題是可以解決的，Optum 將繼續推動長期成長，並充分利用我們的機會為人們服務。

I'll turn it over to our President and Chief Financial Officer, John Rex.

我將把它交給我們的總裁兼財務長約翰·雷克斯。

Thanks, Patrick. I'll first walk through second-quarter results, then provide some color around the underlying assumptions within our reestablished '25 outlook. Starting with the second quarter, UnitedHealth Group reported revenues of nearly $112 billion, a 13% increase over the prior year, which reflected growth across UnitedHealthcare and Optum. Adjusted earnings per share of $4.08 was below the same period last year. This was due primarily to the pricing and medical cost trend factors at UnitedHealthcare and OptumHealth.

謝謝，派崔克。我將首先介紹第二季的業績，然後對我們重新制定的 25 年展望中的一些基本假設進行一些說明。從第二季開始，聯合健康集團報告其收入接近 1,120 億美元，比上年增長 13%，這反映了聯合健康保險和 Optum 的成長。調整後每股收益為 4.08 美元，低於去年同期。這主要是由於 UnitedHealthcare 和 OptumHealth 的定價和醫療成本趨勢因素。

Included is about $1.2 billion in discrete items. A little over half reflects the recognition of unfavorable impacts to our ACA exchange offerings, which I will describe later in more detail. The remainder is the settlement of several outstanding items, which have been in dispute or for which collection has recently become questionable. Most of these items arise from prior years. The full-year '25 outlook we've offered today accommodates $1 billion in additional potential such items that we may seek to resolve in the year.

其中包括約 12 億美元的離散項目。略多於一半的受訪者表示，他們認識到 ACA 交易所產品將受到不利影響，我將在稍後對此進行更詳細的描述。剩餘款項用於解決幾項未償付的項目，這些項目有爭議或最近收款出現問題。這些項目大部分來自前幾年。我們今天提供的 25 年全年展望涵蓋了我們今年可能尋求解決的額外 10 億美元潛在問題。

Now on to business overviews. At UnitedHealthcare, second-quarter revenues grew by over $12 billion to $86.1 billion, while operating earnings declined by $1.9 billion to $2.1 billion, primarily due to the medical trend factors Tim discussed. Within our Medicare businesses, year-to-date Medicare Advantage growth is 650,000 people, including those who are duly eligible for Medicaid and Medicare.

現在來討論業務概況。聯合健康保險第二季營收成長逾 120 億美元，達到 861 億美元，而營業利潤則下降 19 億美元，至 21 億美元，這主要歸因於提姆所討論的醫療趨勢因素。在我們的醫療保險業務中，今年迄今為止，醫療保險優勢計劃的成長人數為 65 萬人，其中包括有資格享受醫療補助和醫療保險的人。

As noted, the second-quarter results reflect just over $600 million of unfavorable impacts from our ACA exchange business, which includes acceleration of anticipated second half losses with the establishment of a premium deficiency reserve. This is due to the higher patient morbidity that is pervasive across the entire exchange market.

如上所述，第二季度的業績反映了我們 ACA 交易業務略高於 6 億美元的不利影響，其中包括由於建立保費不足準備金而加速了預期的下半年虧損。這是由於整個交易市場的患者發病率較高。

Given competitive market dynamics, we have less member growth within our commercial offerings than initially anticipated. ACA exchange drives about one-third of our reduced commercial risk member growth outlook for '25, with group insured comprising much of the rest.

鑑於競爭激烈的市場動態，我們商業產品的會員成長速度低於最初的預期。ACA 交易所推動了我們 25 年降低商業風險會員成長前景的約三分之一，其餘大部分由團體保險推動。

As outlined earlier, our Medicaid offerings continue to experience pressure from the lag in state rate updates relative to the health status of the members being served. Our state partners remain highly engaged in ongoing rate conversations, and we are closely attuned to the federal funding changes and the continued pace of medical cost trends, particularly in behavioral health.

如前所述，由於州政府費率更新相對於服務對象健康狀況存在滯後，我們的醫療補助計劃持續面臨壓力。我們的州合作夥伴仍然高度參與正在進行的費率對話，我們密切關注聯邦資金變化和醫療成本趨勢的持續變化，特別是在行為健康領域。

Moving to Optum. OptumHealth revenues were $25.2 billion in the second quarter, a decline of $1.8 billion from last year. This was driven by the previously noted contract adjustments and the effects of the Medicare funding reductions.

移至 Optum。OptumHealth 第二季營收為 252 億美元，較去年同期下降 18 億美元。這是由先前提到的合約調整和醫療保險資金削減的影響所致。

OptumHealth now expects to add 300,000 new value-based care patients this year, compared to the initial 650,000 outlook as it seeks to focus on improving operating performance. As noted, we've updated our long-term target margin objective for OptumHealth to the 6% to 8% range.

OptumHealth 目前預計今年將增加 30 萬名新的基於價值的護理患者，而最初的預期是 65 萬名，因為它正致力於提高營運績效。如上所述，我們已將 OptumHealth 的長期目標利潤率更新為 6% 至 8% 的範圍。

OptumInsight had revenues of $4.8 billion, an increase of $285 million, or 6% year over year. We continue to progress on customer recovery following last year's cyber event, albeit pacing more slowly than expected, and this is a component of the reduced full-year outlook. The contract revenue backlog at the end of the second quarter was $32.1 billion.

OptumInsight 的營收為 48 億美元，比去年同期增加 2.85 億美元，增幅為 6%。在去年的網路事件之後，我們在客戶恢復方面繼續取得進展，儘管進展速度比預期要慢，這也是全年預期下調的一個因素。第二季末的合約收入積壓為321億美元。

OptumRx second-quarter revenues grew $6 billion or 19% over last year to $38.5 billion, driven by new customer adds, as well as continued contribution from specialty products. Total adjusted scripts were $414 million, compared to $399 million in the year-ago quarter.

OptumRx 第二季營收比去年同期成長 60 億美元（19%），達到 385 億美元，這得益於新客戶的增加以及特色產品的持續貢獻。調整後的劇本總收入為 4.14 億美元，去年同期為 3.99 億美元。

Moving on to 2025 guidance. Our adjusted earnings outlook is at least $16 per share. Revenues will approach $448 billion, growth of 11% over '24. We now expect a full-year medical care ratio of 89.25%, plus or minus 25 basis points. This compares to the initial 86.5% midpoint we offered at the end of last year, with the increase driven by the factors discussed. Within this, seasonal pacing compared to historical measures is impacted somewhat by the Part D coverage gap modifications due to the Inflation Reduction Act.

繼續推進 2025 年指導。我們的調整後獲利預期為每股至少 16 美元。營收將接近 4,480 億美元，比 24 年成長 11%。我們現在預計全年醫療保健率為 89.25%，上下浮動 25 個基點。相較之下，我們去年年底提供的初始中點為 86.5%，而這一增長是由所討論的因素推動的。其中，與歷史指標相比，季節性節奏在一定程度上受到《通貨膨脹削減法案》對 D 部分覆蓋範圍差距修改的影響。

With first-half results at the midpoint, that places the second half at just under 91.5%, with the fourth quarter expected to be the highest, and at this distance, a relatively proportionate distribution on either side. The full-year outlook contemplates a total of $1.6 billion of potential settlement items, an incremental $1 billion over the $600 million recognized in the second quarter.

如果將上半年的結果作為中間值，那麼下半年的結果將略低於 91.5%，預計第四季度的結果將最高，並且按照這個距離，兩邊的分佈相對均衡。全年展望考慮了總計 16 億美元的潛在和解項目，比第二季確認的 6 億美元增加 10 億美元。

Our tax rate for the year is now estimated at about 18.5%, affected by our revised earnings outlook as expected benefits remain steady while earnings declined. The lower tax expense in the second quarter reflects the year-to-date recognition of the updated full-year effective tax rate. We expect the second half rate to be just over 20%. Full-year '25 cash flows from operations are expected to be about $16 billion or 1.1 times net income.

由於預期福利保持穩定而獲利下降，受此影響，我們今年的稅率目前估計約為 18.5%。第二季較低的稅費反映了年初至今對更新後的全年有效稅率的確認。我們預計下半年的利率將略高於20%。預計 25 年全年營運現金流約為 160 億美元，即淨收入的 1.1 倍。

In June, we increased our dividend by 5%, and we will strike a balance as to how we use capital over the near term, being thoughtful about maintaining a strong balance sheet and credit rating, and mindful of long-standing commitments, including the pending Amedisys transaction.

6 月份，我們將股息提高了 5%，我們將在短期內平衡如何使用資本，認真考慮如何保持強勁的資產負債表和信用評級，並注意長期承諾，包括待決的 Amedisys 交易。

Our updated share count of 912 million to 914 million compares to the original outlook of 918 million to 923 million and considers only share repurchase completed earlier this year. We will continue to balance and assess our capital priorities as we progress to returning to the performance levels we know we can achieve.

我們更新後的股票數量為 9.12 億至 9.14 億股，而最初預期為 9.18 億至 9.23 億股，並且僅考慮了今年稍早完成的股票回購。隨著我們逐步恢復到我們知道能夠實現的績效水平，我們將繼續平衡和評估我們的資本優先事項。

With that, I will hand it back over to Steve before we head into Q&A.

說完這些，在我們進入問答環節之前，我會把它交還給史蒂夫。

Thanks, John. This is a challenging year for our enterprise, but I feel strongly we can overcome these challenges as we've done before. I can see the depth of the commitment of our team. We are regaining the intensity, the precision, and the executional disciplines required to perform consistently and reliably. Our customers and our shareholders deserve it and the health system expects us to function at our full potential.

謝謝，約翰。對我們的企業來說，這是充滿挑戰的一年，但我堅信我們能夠像以前一樣克服這些挑戰。我可以看到我們團隊的奉獻精神有多深。我們正在重新獲得持續可靠地執行任務所需的強度、精確度和執行紀律。我們的客戶和股東值得擁有這一切，醫療系統也期望我們能充分發揮自己的潛力。

As we look towards 2026 and beyond, we expect the efforts we discussed throughout today's call to steadily improve our performance. It begins with respecting pricing basics, advancing our foresight acumen, and just better, more intense, more decisive overall management.

展望 2026 年及以後，我們期望在今天的電話會議上討論的努力能夠穩步提高我們的業績。首先要尊重定價基本原則，提升我們的預見能力，以及更好、更嚴格、更果斷的整體管理。

We will be driving better business practices, better consumer and provider experience, and accelerating investments in key areas to both strengthen our foundations and modernize our businesses anchored in practical innovations and scaled AI applications. We are continuing to evaluate the investments we need to make in the near term to meet our long-term growth potential, while acknowledging the challenging environment in the year ahead.

我們將推動更好的商業實踐、更好的消費者和提供者體驗，並加快對關鍵領域的投資，以加強我們的基礎，並以實際創新和規模化的人工智慧應用為基礎實現業務現代化。我們正在繼續評估短期內需要進行的投資，以滿足我們的長期成長潛力，同時也認識到未來一年的挑戰環境。

As I mentioned at our shareholder meeting in June, we're rebuilding the trust through both change and through increased transparency. That includes work to ensure a wide range of stakeholders have confidence in the integrity of our company and our business practices. This work is moving forward in our assessment of key policies, practices, and associated processes by the end of the third quarter and our first performance measures report in the fourth quarter.

正如我在六月的股東大會上提到的那樣，我們正在透過變革和提高透明度來重建信任。這包括努力確保廣大利害關係人對我們公司的誠信和商業行為有信心。這項工作正在推進中，我們將在第三季末對關鍵政策、實踐和相關流程進行評估，並在第四季度發布第一份績效衡量報告。

We have retained independent experts to oversee and assist in these reviews, including the Analysis Group and FTI Consulting. We will use this to continually strengthen and advance our strong compliance environment.

我們聘請了獨立專家來監督和協助這些審查，包括 Analysis Group 和 FTI Consulting。我們將利用這一點不斷加強和推進我們強大的合規環境。

Looking to 2026, at this distance, I would expect solid but moderate earnings growth. As we look further ahead, we see our earnings growth outlook strengthening quickly in 2027 and pacing steadily upward over the succeeding years.

展望 2026 年，我預計獲利將保持穩健但溫和的成長。展望未來，我們預計我們的獲利成長前景將在 2027 年迅速增強，並在接下來的幾年中穩步上升。

Now let's open it up for questions. Operator, please.

現在讓我們開始提問。接線員，請說。

(Operator Instructions) A.J. Rice, UBS.

（操作員指示） A.J. Rice，瑞銀。

Hi, everybody. Maybe just to drill down a little bit on OptumHealth if I could. You're talking about some rate increases or how you're pricing for a much higher trend in MA on the insurance side. I would assume that had some trickle-down benefit to OptumHealth.

大家好。如果可以的話，我可能只是想深入了解一下 OptumHealth。您正在談論一些費率上漲或如何針對 MA 保險方面的更高趨勢進行定價。我認為這會對 OptumHealth 產生一些涓滴效益。

When you're talking about having margin consistent with this year, next year on the physician piece, does that not contemplate some benefit from that repricing? And maybe as well talk about your discussions with the outside plans that OptumHealth contracts.

當您談到今年、明年醫生部分的利潤與今年保持一致時，是否考慮到重新定價帶來的一些好處？也許您也可以談談您與 OptumHealth 簽約的外部計劃的討論。

I mean, are you seeing them make similar steps toward pricing for a more reasonable margin next year that you're trying to do at UHC?

我的意思是，您是否看到他們明年採取類似措施，以更合理的利潤定價，就像您在 UHC 嘗試的那樣？

It certainly does, A.J. Patrick, do you want to comment?

確實如此，A.J.帕特里克，你想評論一下嗎？

Yeah. Thanks, A.J., for the question. Let me take the pieces and parts. So yes, in terms of the pricing across payers, UnitedHealthcare and other payers, as they adjust pricing, that flows into our capitation rates. That is a tailwind versus the headwind we saw this year.

是的。謝謝 A.J. 提出這個問題。讓我把零件拿走。所以是的，就付款人之間的定價而言，聯合健康保險和其他付款人調整定價時，這會影響到我們的人頭費率。這是我們今年看到的順風，而不是逆風。

We're also working with our payer partners on benefit reductions, which we talked about. So significant benefit reductions across payer partners and a much tighter, transparent bidirectional dialogue in this year, which I think sets us up better for next year.

我們也正在與我們的付款夥伴就削減福利進行合作，我們已經討論過這個問題。因此，今年付款方合作夥伴的福利大幅減少，雙向對話更加緊密、透明，我認為這為明年做好了更好的準備。

Those combinations, we think, mitigate 50% of the headwind of V28, which, as you heard, we sized at $4 billion for next year. The other two components that will mitigate the other 50%. One, operating cost reductions where we continue to hone our model using AI and other tools, generating operating cost reductions.

我們認為，這些組合可以減輕 V28 50% 的不利影響，正如您所聽到的，我們明年的 V28 規模為 40 億美元。另外兩個組件將減輕另外 50% 的影響。第一，降低營運成本，我們繼續使用人工智慧和其他工具來完善我們的模型，從而降低營運成本。

And then next, deep engagement with the patient cohorts we see. So as you heard, as we mature and remain stable in those cohorts, you have increased performance over time. So as you pace into 2026, as you heard, we believe we can maintain those margins at the 1% level.

接下來，我們將與我們看到的患者群體進行深入的接觸。正如您所聽到的，隨著我們在這些群體中逐漸成熟並保持穩定，您的表現會隨著時間的推移而提高。因此，正如您所聽到的，隨著步入 2026 年，我們相信我們可以將利潤率維持在 1% 的水平。

Obviously, we'll continue to do the work each day to see if there's any upside to that potential. But the approach this year with our payers has been tight, close and I think will bear benefits going into 2026.

顯然，我們將繼續每天努力，看看這種潛力是否有任何好處。但今年我們與付款人採取的措施一直很嚴格、密切，我認為這將對 2026 年帶來好處。

Thank you, Pat.

謝謝你，帕特。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

Thanks, good morning. Appreciate all the detail. I wanted to focus on the run rate out of '25 into 2026. So it looks like you're about $5 of earnings for the second half. If I add about $1 for the discrete items that John mentioned, you're about $6, given typical seasonality, maybe that's like $13 of run rate earnings. So I wanted to see if that's reasonable math first. And then what are the moving parts that drive EPS growth specifically?

謝謝，早安。感謝所有細節。我想重點關注 2025 年至 2026 年的運行率。因此看起來你下半年的收益約為 5 美元。如果我為約翰提到的離散項目添加約 1 美元，那麼大約是 6 美元，考慮到典型的季節性，也許這相當於 13 美元的運行率收益。所以我想先看看這是否是合理的數學。那麼，具體推動每股盈餘成長的因素有哪些呢？

Maybe you could talk to where your MA margins are this year versus where you expect them to be next year? Thanks.

也許您可以談談今年的 MA 利潤率是多少以及您預計明年的利潤率是多少？謝謝。

Hey, Justin. Good morning. It's John Rex. Just a few comments on that. So yes, your overall assessment of second half is correct. A few things I'd point to, and then I think I'd ask Tim and Bobby to comment a little bit also on as we talk about Medicare Advantage margins and where that goes. I mean the key elements here, so yes, we are looking at getting some things behind us in terms of the actions we're taking, we anticipate taking in the second half.

嘿，賈斯汀。早安.我是約翰·雷克斯。對此我僅發表幾點評論。所以是的，你對下半場的整體評估是正確的。我想指出幾件事，然後我想請蒂姆和鮑比在我們討論醫療保險優勢計劃的利潤率及其走向時發表一些評論。我的意思是這裡的關鍵要素，所以是的，我們正在考慮在我們正在採取的行動方面取得一些進展，我們預計將在下半年採取行動。

And as you know really quite well, 80% of our premium revenues reprice on January 1. So a very significant impact in terms of that as you move into that next year in terms of the impact that creates in terms of off the run rate that you see going into the second half. And I'd ask Bobby to maybe comment a little bit specifically on your piece on Medicare Advantage.

如您所知，我們 80% 的保費收入將於 1 月 1 日重新定價。因此，就進入明年而言，這將對下半年的運行率產生非常重大的影響。我想請 Bobby 對您關於醫療保險優勢計劃的文章做一點具體評論。

Yeah. Thanks, Justin, for the question. Thanks, John. So just when you think about 2026 or 2025, where we're likely to pencil out for the balance of the year here is more in the low end of the new normal range that Tim outlined in his prepared remarks.

是的。謝謝賈斯汀提出這個問題。謝謝，約翰。因此，當您考慮 2026 年或 2025 年時，我們可能會計算出今年的剩餘時間，這更多地處於蒂姆在準備好的發言中概述的新常態範圍的低端。

So I think the 2% to 2.5% range, and I'm talking about all broad-based UHC Medicare in that bucket. And then given the actions that we're taking for 2026, so the meaningful benefit cuts, the planned reductions, the trend that we're pricing towards, we do believe that will allow us to overcome some of the headwinds, again, tied to V28 funding cuts and that embedded trend and expand those margins to a range of 2.5% to 3%. So think about us then getting to the midpoint of that range by 2027 and advancing from there. Thanks for the question.

所以我認為範圍是 2% 到 2.5%，我指的是這個範圍內的所有廣泛的 UHC 醫療保險。然後考慮到我們為 2026 年採取的行動，即有意義的福利削減、計劃中的削減以及我們定價的趨勢，我們確實相信這將使我們能夠克服一些不利因素，這些因素與 V28 資金削減和根深蒂固的趨勢有關，並將這些利潤率擴大到 2.5% 至 3% 的範圍。因此，想像一下我們在 2027 年達到該範圍的中點，然後從那裡繼續前進。謝謝你的提問。

So Justin, yeah, really the math that you're looking at here is continued trend accelerations that we look at through the end of the year, while our revenues are staying the same. And then we get to Jan 1, where the vast majority of our premium revenues reset, and that's really the impact that you're seeing in terms of as you look at that 2H run rate and where we come out.

賈斯汀，是的，你在這裡看到的數學結果是持續的趨勢加速，直到今年年底，而我們的收入保持不變。然後到了 1 月 1 日，我們的絕大部分保費收入都會重置，這就是您在查看下半年運行率和我們的業績時所看到的影響。

Thank you.

謝謝。

Josh Raskin, Nephron Research.

Josh Raskin，Nephron Research。

Thanks. Good morning. I appreciate some of the commentary you've made on '26 and '27 even. Do you have an updated view on your long-term EPS growth rate that was formerly cited at 13% to 16% at the enterprise level? And then I heard the target margins obviously updated for OptumHealth, but do you have updated target margins for maybe UHC in its entirety as well as the other two segments within Optum?

謝謝。早安.我甚至很欣賞您對 26 年和 27 年所做的一些評論。您對企業層面長期每股盈餘成長率（先前提到的 13% 至 16%）有什麼新看法嗎？然後我聽說 OptumHealth 的目標利潤率顯然已經更新，但您是否已經更新了整個 UHC 以及 Optum 內其他兩個部門的目標利潤率？

Yeah. Thanks, Josh, for the question. As you can appreciate, as we're just coming back on stream, in the near term, our growth rates do not reflect, I think, the potential of this enterprise. It's somewhat academic, but I expect we will pace back steadily to low double-digit ranges and continue to advance from there. And I think importantly, the framework for our long-term growth outlook remains very much intact.

是的。謝謝喬希提出這個問題。正如您所理解的，由於我們剛剛恢復運營，我認為短期內我們的成長率並不能反映出該企業的潛力。這有點學術性，但我預計我們將穩步回到兩位數的低位範圍，並從那裡繼續前進。我認為重要的是，我們的長期成長前景框架仍然完好無損。

Reasonable year-over-year organic growth from within well-run businesses, the compounding effect of deliberate productivity gains, the compounding effect of capital applied in the form of share buybacks as we return value and capital to shareholders, and the compounding effect of capital use in evolving the business model toward a more expansive view of the health care markets that is less fragmented and more integrated to better serve consumers and the overall system.

經營良好的企業內部實現合理的同比增長、刻意提高生產力的複合效應、以股票回購形式應用的資本的複合效應（我們向股東返還價值和資本），以及在商業模式演變過程中使用資本的複合效應，使醫療保健市場變得更加廣闊，更加分散，更加整合，從而更好地服務消費者和整個系統。

And the components of that should allow us to continue to grow at strong levels we've experienced in the past, and that's our outlook on it.

這些因素應該能讓我們繼續保持過去所經歷的強勁成長水平，這就是我們對此的展望。

And Josh, just maybe a little bit on margins because maybe Tim has a comment, and he made some comments on Medicare, in particular, with the IRA changes. And Tim, maybe if you just could reflect on those.

喬希，可能只是稍微談了一下利潤率，因為蒂姆可能有評論，他對醫療保險，特別是愛爾蘭共和軍的變化發表了一些評論。提姆，也許你可以思考一下這些。

good afternoon, Josh. Thank you. Yeah. So we talked about the reframing of the broad-based Medicare Advantage targeted margin range, really not all that different, just the mechanical implications of more revenue coming through the IRA without necessarily any incremental earnings.

下午好，喬希。謝謝。是的。因此，我們討論了重新制定廣泛的醫療保險優勢目標利潤範圍，實際上並沒有什麼不同，只是透過 IRA 獲得更多收入的機械含義，而不一定會產生任何增量收益。

And then as Bobby just talked about, we see that pacing closer to the midpoint in 2026 and getting there in 2027. On the Commercial business, 2026 will be a year where we'll not get all the way into our targeted margin range of 7% to 9%, but certainly see a path to get there thereafter. So really no change bottom line to the targeted margin range across UHC.

然後，正如 Bobby 剛才談到的，我們看到這一步伐在 2026 年接近中點，並在 2027 年到達那裡。就商業業務而言，到 2026 年，我們雖然無法完全實現 7% 至 9% 的目標利潤率，但肯定會看到此後實現這一目標的途徑。因此，UHC 的目標利潤範圍底線實際上沒有變化。

John, any more.

約翰，再也沒有了。

I think just maybe Tim's comment that he made on the call in terms of how he thinks about Medicare Advantage with the addition of those IRA dollars and such. And it doesn't change really the productivity of the business. It's just that piece of the revenue impacts the margin calculation that came in -- a piece of revenue that came in without really any earnings attached to when it came in. So similar profile.

我認為也許蒂姆在電話會議上就如何看待醫療保險優勢計劃加上 IRA 美元等問題發表了評論。但它實際上並沒有改變企業的生產力。只是這部分收入會影響利潤率的計算——這部分收入在產生時其實沒有任何收益。輪廓如此相似。

And in general, I don't think we've actually ever seen the full portfolio of Optum perform to its full potential. So I think there's -- that should be strongly additive as well as the emergence of the OptumInsight businesses, the strong margins that are coming off the platform of more technology-enabled services. So those elements play in, but it is so early in our restart that to me, the discussion of a long-term growth rate seems somewhat academic other than the framework for our historical outlook remains fully intact.

總的來說，我認為我們實際上從未看到過 Optum 的全部產品組合發揮其全部潛力。所以我認為這應該具有很強的附加性，就像 OptumInsight 業務的出現一樣，強勁的利潤率來自於更多技術支援服務的平台。因此，這些因素都在發揮作用，但是我們重啟的時間還為時過早，對我而言，除了我們的歷史展望框架仍然完整之外，長期增長率的討論似乎有些學術性。

Next question.

下一個問題。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Okay. Great. Thanks. In your commentary around the guidance reduction, you mentioned across a number of businesses that you had portfolio actions that you're delaying. Can you talk a little bit about what exactly those types of actions were across the businesses?

好的。偉大的。謝謝。在有關減少指導的評論中，您提到在許多業務中，您正在推遲投資組合行動。能否稍微談談各個企業具體採取了哪些行動？

And are those potential savings still something that you think you're going to execute on? Or are those not the right way to think about is adding those up and then coming up with an earnings power number at some point over the next couple of years? Thanks.

您是否仍然認為您會實現這些潛在的節省？或者這些不是正確的思考方式，而是把這些加起來，然後在未來幾年的某個時候得出盈利能力數字？謝謝。

Clarify the question. I'm not sure I understand portfolio actually. What the --

澄清一下問題。我不確定我是否真正理解了投資組合。什麼--

Yeah. You mentioned a number of things like when you're trying to bridge thing like the Medicare Advantage results this year versus what you assumed would happen. I think you put some buckets in there saying that you were going to do some things and then you decided to put them on pause. Is that not the right way to think about it?

是的。您提到了許多事情，例如當您試圖將今年的醫療保險優勢計劃結果與您預期會發生的情況進行比較時。我認為你把一些桶子放在那裡說你要做某事然後你決定暫停它們。這不是正確的思考方式嗎？

These are on transactions. Yeah. So that's a good question because I do think that, that needs to be clarified. The company pursued valuation of the portfolio of all of its businesses last year. And we're taking actions to position some of the businesses and divested some.

這些是關於交易的。是的。這是個好問題，因為我確實認為這需要澄清。該公司去年對其所有業務的投資組合進行了估值。我們正在採取行動，調整部分業務並剝離部分業務。

That I think, is evident in our results. And as I came in and looked at that, my orientation is to pursue more of the performance of the business portfolio that we have, make those businesses perform to their full potential.

我認為，這一點從我們的結果中就可以看出來。當我加入並看到這一點時，我的方向是追求我們現有業務組合的更多績效，讓這些業務充分發揮其潛力。

I think that portfolio needs to be considered in light of what I think the real performance potential is. And so we stopped that entire activity. And some of that was considered in the outlook in the current year, and that has been withdrawn completely.

我認為需要根據我認為的真正業績潛力來考慮投資組合。因此我們停止了整個活動。其中一些內容已在今年的展望中考慮，但已完全撤回。

And we are focused on the performance of the businesses that we have, and we'll pick up portfolio assessment somewhere down the road. But right now, our focus is on the portfolio that we have, and we have removed any of that from our outlook.

我們專注於現有業務的表現，並將在未來的某個時候進行投資組合評估。但目前，我們的重點是我們現有的投資組合，並且我們已將其中任何一項從我們的展望中剔除。

Next question, please. Kevin, does that answer your question?

請回答下一個問題。凱文，這回答了你的問題嗎？

Actually, maybe just to clarify. So are these businesses that you thought you were going to be losing money and you're now going to keep them and focusing on the earnings power going forward? Or was there something around gains on sales or things like that, that you were going to recognize from divesting things that you're not going to include in the guidance?

事實上，也許只是為了澄清一下。那麼，您是否曾經認為這些業務會虧損，而現在您要保留它們並專注於未來的獲利能力？或者是否存在與銷售收益或類似的東西有關的東西，你會透過剝離一些你不會包括在指導中的產品來實現這些收益？

I think that's a much more complex issue, Kevin. I think the motivations for those transactions all have different reasons. Some of those businesses, we thought were better in the hands of others. Others want to be, let's say, not core, but we're really not debating that right now. I think all solid businesses, and we'll continue to run them and optimize their performance and then consider their long-term standing in our portfolio.

我認為這是一個更為複雜的問題，凱文。我認為這些交易的動機都有不同的原因。我們認為，其中一些業務交給其他人管理會更好。其他人則不想成為核心成員，但我們現在真的不想討論這個問題。我認為所有穩健的企業，我們都會繼續經營並優化其業績，然後考慮它們在我們投資組合中的長期地位。

Next question, please.

請回答下一個問題。

Lance Wilkes, Bernstein.

蘭斯威爾克斯、伯恩斯坦。

Great. Can you talk a little bit about the management process and strategic review process that you've undertaken with the company and where you are to date with that, maybe providing some insight into what the management process was previously and the changes you've made to it?

偉大的。您能否談談您在公司所採取的管理流程和策略審查流程，以及目前的進展，或許可以讓您了解一下先前的管理流程以及您對其進行的改變？

And then from a strategic review process, would you say you're completed with any strategic review? Or are there any time line associated with future strategic review? Thanks.

然後從策略審查流程來看，您是否認為您已經完成了任何策略審查？或者是否有與未來策略審查相關的時間表？謝謝。

Well, I'm not sure I know what you mean by strategic review, but just to thematically address this, probably just 70-plus days in. returning to what I would call very basic fundamental discipline. So much greater intensity around depth of review of the businesses, underlying financial levers, et cetera, core of the economic levers in the businesses.

嗯，我不確定我是否明白您所說的戰略審查是什麼意思，但只是從主題上來解決這個問題，可能只需要 70 多天。回到我所說的非常基本的基本紀律。對企業、潛在財務槓桿等企業經濟槓桿核心的深度審查力度大為增強。

Basically, just a much more intensive monthly management review of business performance, not just on financials, but on operating metrics, on relationships with the external stakeholders, on future potential, on the progress made, on remediation efforts and programs offsetting some of the headwinds that we have discussed this morning like V28 and so forth.

基本上，這只是對業務績效進行更深入的月度管理審查，不僅包括財務狀況，還包括營運指標、與外部利益相關者的關係、未來潛力、取得的進展、補救措施和抵消我們今天上午討論過的一些不利因素的計劃，例如 V28 等。

So just a really comprehensive business-by-business review and assessment of the performance prospects of the businesses, I'd say, relatively in the near term, much more broader engagement of the management team and engaging our resources across the enterprise to take just a very fresh objective look at all of the businesses, the progress made in terms of their undertakings and maybe refocusing those things to things that, let's say, a more narrow, more concentrated agenda of priorities, faster decision-making, changes in people.

因此，我認為，只需對各個業務的業績前景進行真正全面的逐一審查和評估，相對而言，在短期內，管理團隊將更加廣泛地參與，並調動整個企業的資源，以全新的客觀視角審視所有業務及其所取得的進展，並可能將這些事情的重點重新放在更狹窄、更集中的優先事項議程、更快的決策和人員變動上。

There have been, I think, as Pat described, pretty far-reaching changes across the entire Optum portfolio. That is still in motion across our other businesses and across corporate. So I'm just basically rambling to give you a sense that it is a much more intensive everyday engagement. We have returned to monthly business meetings. We are focused on six underlying directions along those lines.

我認為，正如帕特所描述的，整個 Optum 產品組合發生了相當深遠的變化。這項措施仍在我們的其他業務和整個公司範圍內實施。所以我基本上只是漫無目的地閒聊，讓你們感覺到這是一項更密集的日常活動。我們已恢復每月一次的業務會議。我們將重點放在以下六個基本方向。

And the leadership team has really engaged exceptionally well. We have returned to work across the enterprise, just to give you an example of things like that. And I just think there is a new tone and a new expectation setting in. And then we are going to continue to drill down on these businesses and get much more granular, particularly as we get in and complete the 2026 planning process. So I think that gives you a feel for it.

領導團隊的參與度確實非常高。我們已經在整個企業內恢復了工作，這只是給你一個類似的例子。我只是覺得，一種新的基調和新的期望正在形成。然後，我們將繼續深入研究這些業務，並進行更細緻的研究，特別是當我們進入並完成 2026 年規劃過程時。所以我認為這會讓你對此有所感受。

Great. Thanks.

偉大的。謝謝。

Sure.

當然。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾。

Thanks very much. Good morning. Steve, when you talked about 2026, you talked about the steady improvement, but you also said you need to evaluate investments. How should I think about that for '26? Are there incremental costs that you need to bring online, other investments that you need to make in the business as we think about '26? And if we do have incremental investments in '26, how do we think about the returns on those investments and the timeline?

非常感謝。早安.史蒂夫，當您談到 2026 年時，您談到了穩步改善，但您也說過您需要評估投資。我該如何考慮 26 年的事？當我們考慮 26 年時，您是否需要增加線上成本，或在業務上進行其他投資？如果我們在 26 年確實有增量投資，我們如何考慮這些投資的回報和時間表？

So coming into returning to this environment, you obviously looked at particularly with the results at the cost structures, the organizational approaches that have been taken and so forth. And I think there are meaningful cost opportunities within the enterprise, and we are pursuing them with urgency.

因此，回到這個環境後，您顯然會特別關注成本結構、已採取的組織方法等的結果。我認為企業內部存在著重大的成本機會，我們正在緊急追求這些機會。

But I also believe that we should be balanced that there are areas that we have underinvested, and they include areas of OptumInsight, where Patrick talked about the performance challenges there. OptumInsight, I think, can be a remarkable business, but we need to pay more attention to it, make sure it has stable and deep leadership. And we need to make the investments in updating the product offerings, which are largely a portfolio of point-to-point solutions.

但我也相信，我們應該保持平衡，有些領域我們投資不足，其中包括 OptumInsight 領域，而派崔克在那裡談到了那裡的性能挑戰。我認為 OptumInsight 可以成為一家卓越的企業，但我們需要更多地關注它，確保它擁有穩定而深厚的領導力。我們需要投資更新產品，這些產品主要是點對點解決方案的組合。

And with the technology capacities we have and the expertise we have, make them much more compelling end-to-end impacts. And that would be just one example. I think our AI agenda, Sandeep, has gotten real traction on that agenda, and I intend to accelerate it to really infuse this entire enterprise with an AI-first orientation and also use that as a means to develop the capabilities to, again, revitalize products really across the enterprise.

憑藉我們現有的技術能力和專業知識，我們可以使它們產生更引人注目的端到端影響。這只是一個例子。Sandeep，我認為我們的人工智慧議程已經獲得了真正的關注，我打算加速這一進程，真正將人工智慧優先的導向融入整個企業，並以此作為一種手段來開發能力，再次真正振興整個企業的產品。

I'd also tell you that, again, in what I'll view as OptumInsight. Dhivya, who is leading that business, the fintech agenda for that could also be compelling and has also been underinvested. And we have an excellent and distinctive platform there, and we need to push forward on that.

我也會再告訴你，我認為這是 OptumInsight。領導該業務的 Dhivya 表示，該業務的金融科技議程也可能引人注目，但投資不足。我們在那裡擁有一個優秀而獨特的平台，我們需要在此基礎上繼續努力。

So I think there are so many areas of opportunity that really are near term for us. Do I think they will translate? I think they'll translate into good contributions for '26. But I think not only do we need a little money, we need a little bit of time.

所以我認為，對我們來說，確實有許多近期的機會領域。我認為他們會翻譯嗎？我認為它們會為 26 年做出良好貢獻。但我認為我們不僅需要一點錢，還需要一點時間。

And so I do think '27, '28 is really where you're going to see acceleration in those for sure in '27. So does that give you a feel for those kinds of things? And I don't know, Patrick or Dhivya, if you have other commentary?

因此，我確實認為 27、28 年確實是你會看到這些領域加速發展的時期，27 年肯定是如此。那麼這是否讓您對這些事情有了感覺？我不知道 Patrick 或 Dhivya 還有其他評論嗎？

So just briefly building what Steve said and then Dhivya, feel free to add on. Look, I think OptumInsight and Optum Financial and the AI agenda are a large area of opportunity. As we interact with clients and customers, we hear that from payers, providers, others. They want our support in those areas. So I think it's both external and internal, internal on cost savings, external on growth and innovation, as Steve alluded to.

因此，我只是簡單概括史蒂夫所說的內容，然後 Dhivya 可以隨意添加。看，我認為 OptumInsight 和 Optum Financial 以及 AI 議程是一個巨大的機會領域。當我們與客戶和顧客互動時，我們會從付款人、供應商和其他人那裡聽到這些。他們希望我們在這些領域提供支援。所以我認為這既是外部的，也是內部的，內部注重成本節約，外部注重成長和創新，正如史蒂夫所提到的。

And Dhivya, I'll turn it over to you if you want to add more.

Dhivya，如果您想添加更多內容，我會將其交給您。

Yeah. Lisa, coming into this business and just giving it a fresh look, there is a lot to be optimistic about in both of these businesses, OptumInsight and Optum Financial. There's some structural tailwinds when you think about it.

是的。Lisa，進入這個行業並以全新的眼光看待它，OptumInsight 和 Optum Financial 這兩家公司都有很多值得樂觀的地方。如果你仔細想想就會發現有一些結構性的順風。

Firstly, as Steve said, payers and providers are looking for tech-forward solutions to help solve their problems and the headwinds that they face. And coming in, I'm finding that we have deep customer relationships and domain knowledge that will help us do that.

首先，正如史蒂夫所說，付款人和提供者正在尋找技術先進的解決方案來幫助解決他們的問題和麵臨的阻力。我發現，我們擁有深厚的客戶關係和領域知識，這將有助於我們做到這一點。

On top of that, combining OptumInsight and Optum Financial, we're able to create unified solutions that are going to offer the market a lot more financial flexibility, and that's something that the market really needs. So what we're doing is taking all these trends, and we're coming up with a product portfolio that's AI-based.

最重要的是，透過結合 OptumInsight 和 Optum Financial，我們能夠創造出統一的解決方案，為市場提供更多的財務彈性，而這正是市場真正需要的。因此，我們正在做的是抓住所有這些趨勢，並提出基於人工智慧的產品組合。

And we're launching -- we've already launched this year an AI-powered RCM solution. Later this year, we'll be launching an AI-powered real-time coordination of benefits. So think of this as early innings in our product journey, and we're going to have more launches coming out in the coming quarters and years, which makes me very optimistic about the future of the business.

我們正在推出——我們今年已經推出了由人工智慧驅動的 RCM 解決方案。今年晚些時候，我們將推出由人工智慧驅動的福利即時協調系統。因此，請將此視為我們產品之旅的早期階段，我們將在未來幾季和幾年推出更多產品，這讓我對業務的未來非常樂觀。

As Steve said, this is not an area we've focused in, in the past, but we have the right strategy, we have the right investments and we have the right team to go execute. Thank you.

正如史蒂夫所說，這不是我們過去關注的領域，但我們有正確的策略，有正確的投資，也有合適的團隊去執行。謝謝。

And I'll just make two other comments and one pretty basic, and that is you come in and you take a look and you see cost opportunities for sure and the corporate versions of the business units. And you basically are sitting back saying, we're going to pull those back, and we're going to make the investments in the businesses that we think can produce remarkable performance for us going forward, high-margin businesses, et cetera.

我只想提出另外兩則評論，一則非常基本，那就是你進來看一下，你一定會看到成本機會和業務部門的企業版本。而你基本上是坐下來說，我們要把這些撤回來，我們要對那些我們認為可以為我們未來帶來顯著業績的業務、高利潤業務等等進行投資。

And that plays into the long-term growth view, and that is if we execute on those, which have always been in our strategic sights, the contributions of those can be distinctive and plays into a very positive long-term growth outlook.

這對長期成長前景有影響，也就是說，如果我們執行這些始終在我們的策略視野中的目標，那麼這些目標的貢獻將是顯著的，並對長期成長前景產生非常積極的推動作用。

Next question, please.

請回答下一個問題。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Yeah. Hi. Thanks. I think you suggested the long-term target margin for value-based care is now 5%. I think this is also what you suggested the business earned as recently as 2023 before the onset of V28. So it just would be helpful to better understand, I guess, what were the old value-based care target margins to compare the 5% to?

是的。你好。謝謝。我認為您建議的價值型護理的長期目標利潤率現在為 5%。我認為這也是您所說的 V28 開始之前，即 2023 年企業所賺取的利潤。因此，我猜這將有助於更好地理解，與 5% 相比，舊的基於價值的護理目標利潤率是多少？

And I heard you loud and clear talk about expected stability in 2026. Can you better help us understand the margin drivers beyond 2026 with the exception maybe of the MA repricing, which we already understand to get back to that 5%? Thank you.

我清楚地聽到您談論了 2026 年預期的穩定。您能否更好地幫助我們了解 2026 年以後的利潤驅動因素（也許除了 MA 重新定價，我們已經了解要回到 5％ 的水平）？謝謝。

Yeah. So maybe we'll start with Patrick and then if John wants to comment about the change in perspective on margins there. Patrick?

是的。因此，也許我們應該從派崔克開始，然後如果約翰想評論那裡的利潤率觀點的變化。派崔克？

Yeah. So thanks, Stephen, for the question. So you did hear correctly, OptumHealth margin all in 6% to 8%. Value-based care, as we sit today, estimating around that 5% level. Really, the issue is the significant revenue hit to the system with V28 and what that meant and adjusting the impact.

是的。所以，感謝史蒂芬提出這個問題。所以您沒聽錯，OptumHealth 的利潤率都在 6% 到 8% 之間。就我們今天所討論的基於價值的護理而言，其水準估計在 5% 左右。真正的問題是 V28 對系統收入造成的巨大打擊，以及這意味著什麼，以及如何調整影響。

I'd point you back to the cohorts that we called out. I think this is critical. In years one and two, which is about 40% of our membership as we stand today in 2025, negative margins. Years three to four cohorts, 2% margins. Year 5%-plus, 8%-plus margins.

我想讓你回顧一下我們召集的那些同夥。我認為這是關鍵。第一年和第二年，也就是我們今天 2025 年會員人數的 40% 左右，利潤率為負。第三至第四年，利潤率為 2%。年利潤率5%以上，8%以上。

If you look at the progression, as we focus on taking risk in markets that we were confident in our ability to perform and in products, primarily HMO, confident in our ability to perform, focused on employed and contracted positions, you should see those cohorts shift.

如果你看一下進展情況，你會發現當我們專注於在我們有信心履行職責的市場和產品（主要是 HMO）中承擔風險時，我們對自己的履行職責的能力充滿信心，並專注於受僱和合約職位，你應該會看到這些群體發生轉變。

So years one to two will be more in the range of 25% to 30% of the portfolio. Years 5%-plus, more 40%-plus. That gets you to that 5% range in terms of margins. And then as you heard on the services businesses, we've got services businesses often with a margin around 10%.

因此，第一年到第二年的比例將介於投資組合的 25% 到 30% 之間。幾年內成長 5% 以上，甚至超過 40%。這樣您的利潤率就達到了 5% 的範圍。正如您在談到服務業務時所聽到的，我們的服務業務利潤率通常在 10% 左右。

We'll continue to grow those. And I'd call out in care delivery fee-for-service. We have an opportunity for both growth and margin improvement. Home health, low double digits. Surgical centers in the range of 20%.

我們將繼續發展這些。我會呼籲醫療服務按服務收費。我們擁有實現成長和提高利潤的機會。家庭健康，低兩位數。外科中心的比例在 20% 左右。

But in care deliveries in our clinics, we've got opportunities and especially in some regions to improve performance, improve that margin portfolio and improve the performance of the care delivery service bucket.

但在我們診所的醫療服務中，我們有機會，特別是在某些地區，提高績效，改善利潤組合，並提高醫療服務的整體績效。

And Stephen, considering the change in the OptumHealth margin target, most of that is driven by really the value-based care perspective. And what's going on there is really we are being a little more circumspect about how long it takes to get these practices into the zone that we need them to be in.

史蒂芬，考慮到 OptumHealth 利潤目標的變化，其中大部分實際上是由基於價值的護理觀點所驅動的。而現在發生的事情是，我們確實更加謹慎地考慮需要多長時間才能讓這些實踐達到我們所需的水平。

So the appropriate amount of time to get them performing as they should perform, that's a component there. The conversion for those that are still mostly fee-for-service and getting those into a position of where they can actually also start becoming fully accountable practices, important elements in that. And then this perspective that at 5 million patients served today, the addressable market is much, much larger than that.

因此，讓他們發揮應有水準的適當時間是一個組成部分。對於那些仍然主要收取服務費的機構進行轉換，並讓它們實際上也可以開始成為完全負責任的做法，這是其中的重要因素。從這個角度來看，今天服務的患者有 500 萬，可尋址市場比這大得多。

And that we will be continuing to do this for a decade as Patrick stated in his prepared comments and the investments that takes. So a little more circumspect about the investments that we need to put in to bring these into full production. Patrick noted that some of the longest-standing vintages or cohorts of members are performing at 8% plus margins.

正如帕特里克在其準備好的評論和所需的投資中所述，我們將繼續這樣做十年。因此，對於實現這些產品的全面生產所需的投資，我們需要更加謹慎。派崔克指出，一些歷史最悠久的酒莊或會員群體的利潤率都超過了 8%。

But it just -- we're giving ourselves more time to get there and also giving ourselves times more investment room, maybe echoing a little on what Steve said in terms of the investments we need to make into getting them fully ready and to be performing and that we'll be making these investments for the next decade as we grow this business.

但這只是——我們給自己更多的時間來實現這一目標，也給自己更多的投資空間，也許這與史蒂夫所說的有點相似，我們需要進行投資才能讓它們充分準備並發揮作用，並且隨著我們業務的增長，我們將在未來十年進行這些投資。

Or more. So 6% to 8% becomes a much more rational and better guidance outlook. So good question. Thank you for asking it. Next, please.

甚至更多。因此，6% 到 8% 成為一個更合理且更好的指導前景。這個問題問得真好。謝謝你問這個問題。有請下一位。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，費茲傑拉領唱者。

Thank you. Can you talk about any changes you've made in your management review process of underwriting assumptions and conservatism? And the independent party review that you talked about, does that involve any of your underwriting process? Thank you.

謝謝。您能談談您在承保假設和保守主義的管理審查流程中所做的任何改變嗎？您談到的獨立方審查是否涉及您的承保流程？謝謝。

So yes. So first, I'll have maybe Tim comment about underwriting perspectives as well and maybe then Dan Schumacher because from an enterprise point of view, we are looking at, let's say, strengthening underwriting and making sure that we are taking a total enterprise view from an underwriting point of view. So Tim, do you want to start?

是的。因此，首先，我可能會讓 Tim 對承保觀點發表評論，然後也許讓 Dan Schumacher 評論一下，因為從企業的角度來看，我們正在考慮加強承保，並確保我們從承保的角度採取整個企業的視角。那麼提姆，你想開始嗎？

Yeah. Thanks for the question, Sarah. So with respect to underwriting and the processes associated with that, we still feel like we have very strong people, processes in place to submit product filings to analyze and assess our business. And I think that's one of the reasons why we have a very clear view on what's happened in 2025.

是的。謝謝你的提問，莎拉。因此，就核保和相關流程而言，我們仍然覺得我們有非常強大的人員和流程來提交產品文件來分析和評估我們的業務。我認為這就是我們對 2025 年發生的事情有非常清晰的認識的原因之一。

If there's one change, the change would be that, I think we're a little bit more respectful of the environment that we're in and the dynamic nature of it, and we're contemplating that as we think about our pricing in all of our businesses, Commercial, Medicare.

如果有一個變化的話，這個變化就是，我認為我們會更加尊重我們所處的環境及其動態性質，我們在考慮所有業務、商業、醫療保險的定價時也會考慮到這一點。

And then we're going to use those data and analytics on the Medicaid side to approach our state partners with data-driven insights as we talk about how to configure rates appropriately moving forward so that revenue matches the new acuity of these populations.

然後，我們將利用醫療補助方面的這些數據和分析結果，向我們的州合作夥伴提供數據驅動的見解，討論如何適當地配置未來的費率，以便收入與這些人群的新敏銳度相匹配。

But no fundamental change in the processes and people. We're very strong there. And these analytics will frankly drive the approach that we're seeing, which I think is appropriate and respectful of what's going on broadly in the health care industry. Dan?

但流程和人員並沒有根本性的改變。我們在那裡非常強大。坦白說，這些分析將推動我們所看到的方法，我認為這是適當的，並且尊重醫療保健行業普遍存在的狀況。擔？

Sarah, this is Dan. So at the enterprise level, we are working to strengthen our forecasting process. We've implemented an internal audit review that examines our guidance and the work that we put into that. But also, we're strengthening our actuarial resource base. And to Tim's point, we'll be looking at the underlying trend builds across the company and across membership cohorts as well as the revenue composition.

莎拉，這是丹。因此，在企業層面，我們正在努力加強我們的預測流程。我們實施了內部審計審查，以審查我們的指導方針和為此所做的工作。而且，我們也在加強我們的精算資源基礎。正如提姆所說，我們將關注整個公司和會員群體的潛在趨勢以及收入組成。

Obviously, revenue is complex when you think about the interactions between risk model changes and so forth. So we'll be doing that as well. And likewise, building out and strengthening our analytics, taking advantage of new approaches, working with Sandeep on the AI front and pulling in signals earlier and being able to adapt to those more quickly and then propagate them rapidly across the enterprise. So those are some of the things that we have underway.

顯然，當你考慮風險模型變化等之間的相互作用時，收入是複雜的。所以我們也會這樣做。同樣，我們建立並加強了我們的分析能力，利用新方法，與 Sandeep 在人工智慧方面展開合作，更早地獲取訊號，並能夠更快地適應這些訊號，然後在整個企業中迅速傳播。這些就是我們正在進行的一些事情。

And I think we already use third-party experts in our processes. So that would not be anything new. And I think we probably use as much or most of the resources in the marketplace along those lines and have for years.

我認為我們已經在流程中使用了第三方專家。所以這並不是什麼新鮮事。我認為我們可能已經以這種方式使用了市場上大部分或大部分的資源，並且已經這樣做了很多年。

But at the end of the day, as those processes come to closure, judgments are made about market reads and how markets are predicted to perform. And I think those judgments are some of the areas that are sensitive in terms of our outlook right now.

但最終，隨著這些過程的結束，我們將對市場解讀和市場表現預測做出判斷。我認為這些判斷是我們目前展望中比較敏感的領域之一。

And the oversight of those judgments and the conservativeness of them is also something we are taking into place and broadening those decisions across the enterprise. So good question, but it is definitely among the processes that are under review across the enterprise.

我們也對這些判斷及其保守性進行了監督，並在整個企業範圍內擴大了這些決策。這是個好問題，但這絕對是整個企業正在審查的流程之一。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Hi. Good morning. I wanted to follow up on Medicare margins. If we think about the three patient populations in Medicare Advantage, retail group and special needs, can you compare the relative margin profiles and different paths of margin recovery for each, including which population is most addressable near term? Thanks.

你好。早安.我想追蹤醫療保險的利潤率。如果我們考慮醫療保險優勢計劃、零售群體和特殊需求這三種患者群體，您能否比較每種群體的相對利潤狀況和不同的利潤恢復路徑，包括哪個群體最適合短期內解決？謝謝。

Yeah. Hey, good morning, Andrew, Bobby here. So yeah, again, overall margins for '25, think about 2% to 2.5%, '26 expanding to 2.5% to 3%. We talked about early in the year some of the pressures that we were seeing in the group business, in particular, with the trend pressure overweight in that area. I would say that phenomenon has continued.

是的。嘿，早上好，安德魯，我是鮑比。所以，是的，25 年的整體利潤率約為 2% 至 2.5%，26 年將擴大至 2.5% 至 3%。我們在今年年初討論了我們在集團業務中看到的一些壓力，特別是該領域的趨勢壓力過大。我想說這種現象仍在持續。

We continue to see certainly pressure on the medical side across all populations, but that one in particular has been elevated. Group, as you note, does have the opportunity to reprice each year, not dissimilar from individual MA.

我們繼續看到所有人群在醫療方面都面臨壓力，但這壓力尤其加大。正如您所說，集團確實有機會每年重新定價，這與個人 MA 並無不同。

And we are pursuing those discussions with our group customers. So think about the majority of those being able to be repriced on a given year, and that is absolutely the path that we're moving down. On the retail and SNP portions, I would say both performing generally in line.

我們正在與集團客戶進行這些討論。因此，想想其中大多數能夠在某一年重新定價，這絕對是我們正在走的路。在零售和 SNP 部分，我認為兩者的表現總體上是一致的。

Obviously, more of our growth this year is coming in both the D-SNP and C-SNP space. We saw that in AEP. We've continued to see that as the year has progressed. On balance, that growth is accretive to the enterprise. Those are areas that we're going to continue to focus.

顯然，我們今年的成長主要來自 D-SNP 和 C-SNP 領域。我們在 AEP 中看到了這一點。隨著時間的推移，我們不斷看到這種情況。總的來說，這種成長對企業來說是有益的。這些是我們將繼續關注的領域。

I think we have the broad care management tools really that best equip us in partnership with some of our value-based care providers like Optum to really effectively manage that population. So that's going to be an area you continue to see us lean into heavily and bring the full capabilities and assets of the enterprise.

我認為我們擁有廣泛的護理管理工具，這些工具可以讓我們與 Optum 等一些基於價值的護理提供者合作，真正有效地管理該人群。因此，您將會看到我們繼續大力發展這一領域，並發揮企業的全部能力和資產。

And on the retail side, we talked about, obviously, the different approach we're taking to trend for 2026. And a different approach that we're taking to the products, the benefits, exiting a significant number of plans and obviously impacting, as Tim noted, about 600,000-plus members that is predominantly in the PPO space. I think about roughly one-third of those as full market or submarket exits.

在零售方面，我們顯然討論了針對 2026 年趨勢所採取的不同方法。我們對產品和福利採取了不同的方法，退出了大量計劃，顯然對 PPO 領域的約 60 萬多名會員產生了影響，正如 Tim 指出的那樣。我認為其中大約三分之一是完全市場或次市場退出。

So meaningful adjustments coming both on the individual side and the group side to help advance that margin progression for '26.

因此，個人和團體方面都將進行有意義的調整，以幫助提高 26 年的利潤率。

Thank you. Next question, please.

謝謝。請回答下一個問題。

Ann Hynes, Mizuho Securities.

瑞穗證券的安‧海因斯 (Ann Hynes)。

Great. Thank you. I don't know if you addressed it on the call, but can you remind us what your target margin is for Medicaid and what you expect it to be in 2026? And then just a follow-up, John, you had talked about 80% of the premium next year will increase because the pricing cycle should improve in 2026 for the industry. Can you give us a compounded increase that you expect, that would be great.

偉大的。謝謝。我不知道您是否在電話中提到了這個問題，但您能否提醒我們醫療補助的目標利潤是多少以及您預計 2026 年的利潤是多少？然後，約翰，您剛才說明年保費將上漲 80%，因為 2026 年該行業的定價週期應該會改善。您能否告訴我們您預期的複合成長率，那就太好了。

Michael?

麥可？

Thank you for the question. For 2025, we expect breakeven performance for our non-dual or core Medicaid business under Community and State. Our 2025 Medicaid earnings outlook is down modestly due to persistent high medical trend, stemming from care usage levels that are really higher than we realized in the final stages of redetermination.

謝謝你的提問。到 2025 年，我們預計社區和州下的非雙重或核心醫療補助業務將達到損益兩平。由於醫療使用水平確實高於我們在重新確定的最後階段所認識到的水平，因此，由於醫療趨勢持續高漲，我們對 2025 年醫療補助收益的預期略有下降。

And also increased service intensity per encounter as identified within our claims data. We do expect some degradation with our cost-benefits ratio driven by the 12- to 18-month lag that we see in our core Medicaid rating cycle process.

而且根據我們的索賠數據，每次遭遇的服務強度也增加了。我們確實預計我們的成本效益比會有所下降，這是由於我們在核心醫療補助評級週期過程中看到的 12 到 18 個月的滯後所致。

And as we think about 2026, we contemplate negative margins at that time, anywhere from negative 1% to negative 1.7%. Thank you for the question.

當我們考慮 2026 年時，我們預計那時的利潤率將為負值，從負 1% 到負 1.7%。謝謝你的提問。

And this is John. Following up on the rest of your question here, a few comments. So I'm going to ask some of the UnitedHealthcare people to contribute to this here. But as Bobby and Tim have explained, a lot of what happens in Medicare Advantage, as you know, is the benefit redesign and then the cost trend assumptions they're building in, and they've talked to looking towards about a 10% trend for 2026 with the actual rate of premium increase determined by what CMS has come out with. But let's get a little deeper into that and talk about specific components, maybe even getting into commercial and some of the things that we're doing in there.

這是約翰。針對您在此提出的其餘問題，我提出幾點評論。因此，我將請一些聯合健康保險 (UnitedHealthcare) 的員工為此做出貢獻。但正如 Bobby 和 Tim 所解釋的那樣，醫療保險優勢計劃中發生的很多事情，正如你所知，是福利的重新設計，然後是他們正在構建的成本趨勢假設，他們已經談到預計 2026 年的趨勢將達到 10%，實際保費增長率由 CMS 公佈的數據決定。但讓我們更深入地討論這個問題，並討論具體的組成部分，甚至可能涉及商業以及我們正在做的一些事情。

Tim, I'll lead it with you and just --

提姆，我會和你一起領導--

Yeah. So answering the question around our long-term margins in the Medicaid business itself, excluding the dual special needs plans in Community and State, the rated margin that we attempt to attain with the states is around the 2% margin. Historically, we've talked that blending to a 3% to 5% margin within the Community and State segment.

是的。因此，在回答有關醫療補助業務本身的長期利潤率的問題時，不包括社區和州的雙重特殊需求計劃，我們試圖與各州實現的額定利潤率約為 2%。從歷史上看，我們已經討論過社區和州部門內 3% 到 5% 的混合利潤率。

Given the adjustments we've talked about around Medicare Advantage broadly moving from 3% to 5% to 2% to 4% because of the impact of the Inflation Reduction Act, we'd expect that to be mirrored in the Community and State growth targets. So 2% to 4% still in Community and State are adjusted to in Community and State and Medicaid would be a 2% targeted margin.

鑑於我們所討論的醫療保險優勢計劃的調整，由於《通貨膨脹削減法案》的影響，該計劃的稅率大致從 3% 至 5% 變為 2% 至 4%，我們預計這將反映在社區和州的增長目標中。因此，社區和州的 2% 到 4% 仍會調整為社區和州的 2%，而醫療補助的目標利潤率將是 2%。

And Ann, in terms of the point you were making about premium increases one would expect in '26 as you go into that overall on the 80% of premiums renewals. So Bobby and Tim shaping up what happens in those businesses, those government program businesses and the premiums coming from those customers and then what they're doing in the benefit design underneath there.

安，就您提到的保費上漲而言，26 年預計保費將上漲，因為總體而言，80% 的保費續保。因此，Bobby 和 Tim 正在製定這些業務、這些政府計劃業務以及這些客戶的保費，然後他們在其中的福利設計中做了什麼。

And then maybe it would be helpful if Dan Kueter comment a little bit on some of the pricing expectations in Commercial markets and what he is seeing there because that's another important part of what's driving that premium increase in that marketplace.

然後，如果 Dan Kueter 對商業市場的一些定價預期以及他所看到的情況發表一些評論，也許會有所幫助，因為這是推動該市場保費上漲的另一個重要因素。

Yeah, John, sure can. In 2025, as noted in Tim's remarks, trend in the commercial group business has materialized 100 basis points above our expectation, which has created some trend and margin pressure. So we are well below our margin range for the Commercial business of 7% to 9% this year.

是的，約翰，當然可以。2025 年，正如蒂姆在評論中指出的那樣，商業集團業務的趨勢將比我們的預期高出 100 個基點，這帶來了一些趨勢和利潤壓力。因此，我們今年的商業業務利潤率遠低於 7% 至 9% 的範圍。

As we look to 2026, we're pricing for margin recovery in both the exchange business and the group business. This will lift our margins to be closer to but modestly short of our target margin range of 7% to 9%. We expect to recover into that range for 2027 has been previously noted. To provide that margin expansion and recovery in 2026 with our trend outlook to be above 11%, we are pricing with that fully in mind.

展望 2026 年，我們將針對交易所業務和集團業務的利潤率復甦進行定價。這將使我們的利潤率更接近但略低於我們的目標利潤率範圍 7% 至 9%。我們預計到 2027 年將恢復到先前提到的範圍。為了實現 2026 年利潤率的擴大和復甦，而我們的趨勢預測為 11% 以上，我們在定價時充分考慮到了這一點。

Ann, this is Dan. Just to round it out in terms of the premium increases, to what Dan just described in the Commercial business, you should think in terms of double digit on that one. On the Medicaid side, we're operating at about a combined 6% premium increase in '25 and would expect that to be comparable as we move into 2026. And then obviously, on the Medicare side, as John mentioned, that would track with what the CMS adjustments were.

安，這是丹。就保費上漲而言，正如丹在商業業務中所描述的那樣，您應該以兩位數來考慮這一點。在醫療補助方面，2025 年我們的綜合保費漲幅約為 6%，預計到 2026 年這一數字將保持不變。然後顯然，在醫療保險方面，正如約翰所提到的，這將與 CMS 的調整保持一致。

Okay. Next question.

好的。下一個問題。

Matthew Gillmor, KeyBanc.

馬修·吉爾摩（Matthew Gillmor），KeyBanc。

Hey. Thanks for the question. So the settlements you called out that are part of the discrete items. Can you give some detail on the nature of those settlements? Are those mostly tied to value-based care contracts in OptumHealth? And if that's the case, can we think about the OptumHealth outlook for '25 as being burdened by about $1.5 billion of those settlements that hopefully don't repeat next year?

嘿。謝謝你的提問。所以，您提到的定居點是獨立專案的一部分。您能否詳細說明一下這些定居點的性質？這些是否主要與 OptumHealth 中基於價值的護理合約相關？如果情況確實如此，我們是否可以認為 OptumHealth 對 25 年的前景將承受約 15 億美元的和解金負擔，但願明年不會再發生這樣的事情？

Yeah, Matt, John Rex here. So I wouldn't call it necessarily mostly tied to that. It is across businesses. Think of these things as ranging from elements like you've described, but I would put it more in the context potentially in some areas it's company receivables we have from other companies that we started to question whether or not they're collectible. And so as that moved into that zone, we've taken some provisioning for those.

是的，馬特，我是約翰雷克斯。所以我並不認為這必然與此有關。它涉及各個行業。想想這些事情，它們包括您所描述的各種元素，但我會把它放在更可能的背景中，在某些領域，我們從其他公司獲得的公司應收款，我們開始質疑它們是否可以收回。因此，當它進入該區域時，我們已經為它們採取了一些準備措施。

Other areas were just disputed items. And in this business, there can be disputed items that persist for some period of time. And I think as we were taking a fresh look and we are coming to -- come out with our outlook for the year, making sure that we had contemplated all those so we could get some of those settlement items out of the way.

其他領域只是有爭議的事項。在這個行業中，可能會存在一些持續一段時間的爭議事項。我認為，當我們重新審視並製定年度展望時，我們會確保我們已經考慮到了所有這些問題，以便我們能夠解決一些解決方案。

So think about it as both in the zone of receivables where we question the collectibility, maybe a dispute with a customer over amounts and these dating back a year or more sometimes in terms of where they might be. Sometimes with providers also in terms of areas that we were looking at.

因此，請將其視為在應收帳款領域中我們對可收回性提出質疑，也許是與客戶就金額發生爭議，並且這些爭議有時可以追溯到一年或更早以前。有時我們也會與供應商討論我們正在關注的領域。

So it's really a collection of items that we came at. But I wouldn't call it predominantly. I mean, there's certainly a good amount of that sitting in OptumHealth, too. But I wouldn't call it predominant in terms of those amounts. So that gives you a little flavor for some of the items that we're trying to --

所以這其實是我們所收集的物品的集合。但我不會稱之為主要。我的意思是，OptumHealth 中肯定也存有大量這樣的資金。但從數量上看，我不會稱其為主要。這樣你就能稍微了解我們正在嘗試的一些項目--

Generally split them so they get some idea of what they're overcoming.

通常將他們分開，這樣他們就能了解他們正在克服什麼。

Yeah. I would say within OptumHealth, think of that in the zone of, if I take the full amount of probably about $0.5 billion or so sitting within OptumHealth, we called out on the call, Tim called out on the call, $850 million within UnitedHealthCare and then a couple of hundred million in OptumInsight.

是的。我想說，在 OptumHealth 內部，想想這個區域，如果我把 OptumHealth 內部大約 5 億美元的全部金額拿出來，我們打電話，蒂姆打電話，在 UnitedHealthCare 內部有 8.5 億美元，然後在 OptumInsight 內部有幾億美元。

And a little under $100 million in that zone in OptumRx and then a smattering of a few other items, probably accounting for about $100 million or so that would be, I'd call it, corporate items and such that across the enterprise.

OptumRx 在那個區域的投資略低於 1 億美元，然後還有一些其他項目，大概佔了 1 億美元左右，我稱之為整個企業的企業項目等。

So that should give you the granularity you need, okay?

這樣就應該能給你所需的粒度了，好嗎？

Got it. Thank you.

知道了。謝謝。

Next question, please.

請回答下一個問題。

Jessica Tassan, Piper Sandler.

傑西卡·塔桑、派珀·桑德勒。

Hi. Thanks so much for taking the question and for the detail this morning. When we think about the Medicare margin recovery, can you help us understand the split and timing between MLR improvement and then incremental operating leverage, if any? And your updated MA margin targets fully contemplate the benefit of efficiencies you might harvest from AI at UHC. Thanks.

你好。非常感謝您今天早上提出這個問題並提供詳細資訊。當我們考慮醫療保險利潤率恢復時，您能否幫助我們了解 MLR 改善和增量營運槓桿之間的差異和時間（如果有的話）？並且，您更新後的 MA 利潤目標充分考慮了您可能從 UHC 的 AI 中獲得的效率效益。謝謝。

Yeah. Good morning, Jessica. Thanks for the question. So obviously, when we've outlined a number of actions that we're taking to pursue the margin recovery this morning, they've really been items oriented around what we're doing with optimizing our plan design, ensuring that we're investing in durable and plans that are designed around care management, enabling care management. We've made meaningful benefit adjustments. So all the levers that are in our control related to the product design.

是的。早安，潔西卡。謝謝你的提問。因此，顯然，當我們今天早上概述了為追求利潤率復甦而採取的一系列行動時，這些行動實際上都是圍繞我們正在做的事情展開的，即優化我們的計劃設計，確保我們投資於持久的計劃以及圍繞護理管理設計的計劃，從而實現護理管理。我們做出了有意義的福利調整。因此，我們控制的所有槓桿都與產品設計有關。

Operational cost efficiency is absolutely something that we will continue to drive. We are partnered incredibly closely with Sandeep and the team at Optum around different use cases of how AI can not only drive efficiency, but also help inform the forecasting, help inform the early insights and help us make decisions faster in terms of both how we respond to headwinds or challenges as well as how we identify solutions and can bring those to stakeholders.

提高營運成本效率絕對是我們將繼續努力的方向。我們與 Sandeep 和 Optum 團隊就不同的用例進行了密切合作，探討人工智慧如何不僅可以提高效率，還可以幫助提供預測，幫助提供早期見解，並幫助我們更快地做出決策，包括如何應對逆風或挑戰，以及如何確定解決方案並將其帶給利益相關者。

So think about all of those really in the mix as we think about opportunities to leverage those efficiencies, drive margins and certainly will be supportive of our '27 and beyond range that I've talked about where we'll be at the midpoint or above in that 2% to 4% guidance.

因此，當我們考慮利用這些效率、提高利潤率的機會時，請真正考慮所有這些因素，並且肯定會支持我們 27 年及以後的範圍，我已經談到過，我們將處於 2% 到 4% 指導的中間點或以上。

Okay. We have time for one more question. So please, next.

好的。我們還有時間再回答一個問題。那麼，下一位請發言。

Ben Hendrix, RBC Capital Markets.

加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Ben Hendrix。

Great. Thank you for squeezing me in. In light of your business line review and your reorientation of some businesses and balancing that with the sustained commitment to value-based care. I'm wondering if there's any change as to how you're thinking about the breadth and scale of care capabilities that you want to add to support VBC. And specifically, I'm thinking about commitment to assets like the pending Amedisys acquisition and the expected closing there. THanks.

偉大的。謝謝你把我擠進來。鑑於您對業務線的審查以及對某些業務的重新定位，並將其與對基於價值的護理的持續承諾相平衡。我想知道您對想要添加以支持 VBC 的護理能力的廣度和規模的看法是否有任何變化。具體來說，我正在考慮對資產的承諾，例如即將進行的 Amedisys 收購以及預期的完成。謝謝。

Sure. Do you want to comment on Amedisys? And then Patrick, maybe comment about the broader question there.

當然。您想對 Amedisys 進行評論嗎？然後帕特里克，也許可以對那裡更廣泛的問題發表評論。

Yeah, Ben, John Rex. Yeah, we're looking forward to closing the Amedisys transaction here as we work through the process. We are still working through that process. So as I mentioned in my capital comments on the call earlier, I mentioned that's one of the items in our minds as we think about the rest of the year. But we continue to work through that process with the regulators and so productive way.

是的，本，約翰雷克斯。是的，我們期待在完成整個流程的同時完成 Amedisys 交易。我們仍在努力完成這項過程。因此，正如我之前在電話會議上的資本評論中提到的那樣，我提到這是我們在考慮今年剩餘時間時考慮的事情之一。但我們會繼續與監管機構合作完成這項流程，並保持高效率。

But committed to those assets and certainly very committed to capabilities where we can serve people in the home, super important in terms of foundational part of value-based care in terms of how we actually serve them and serve them well, gives us a lot more reach into serving other people also, and I'll have Patrick maybe comment a bit.

但是，致力於這些資產，當然也非常致力於我們能夠為家庭中的人們提供服務的能力，就基於價值的護理的基礎部分而言，就我們如何實際為他們服務並為他們提供良好的服務而言，這非常重要，這讓我們能夠更多地為其他人服務，我想讓帕特里克發表一些評論。

Yeah. So thanks for the question, Ben. I'll hit on the clinical rationale and then pass it off to Krista to hit some clinical operational points. As many of you know, I'm a practicing physician. It's about patient need.

是的。謝謝你的提問，本。我將闡述臨床原理，然後將其交給 Krista 來闡述一些臨床操作要點。你們很多人都知道，我是一名執業醫師。這是關於患者的需求。

For value-based care, we need clinical assets. We need assets in the home and capabilities and clinicians in the home. We need mental and behavioral. We need specialty care. We need ambulatory surgical centers. You need serious illness care. You need the breadth.

對於基於價值的護理，我們需要臨床資產。我們需要家庭資產、能力和家庭臨床醫生。我們需要精神和行為。我們需要專業護理。我們需要門診手術中心。您需要重症照護。你需要廣度。

We have those component parts in OptumHealth and those allow us to serve people's physical, mental, social, and financial needs. To broaden it out, OptumInsight as well. That platform for value-based care is distinctive. It has huge growth potential, as John described earlier and Steve.

OptumHealth 擁有這些組成部分，它們使我們能夠滿足人們的生理、心理、社會和財務需求。進一步來說，OptumInsight 也是如此。這個基於價值的護理平台非常獨特。正如約翰和史蒂夫先前所描述的，它具有巨大的成長潛力。

And importantly, it's a pathway to a better performing US health system that achieves better health outcomes, better experience, and lower cost for the people we serve. I would like Krista to just talk briefly because then you have to execute on that with Fidelity everywhere about some of the work there.

重要的是，這是一條通往更有效率美國醫療體系的途徑，可以為我們服務的人們帶來更好的醫療結果、更好的體驗和更低的成本。我希望 Krista 能簡單談談，因為之後你必須與 Fidelity 一起在各地進行一些工作。

Yeah. Thank you so much for the question. So I think what I'll just add, Patrick commented a lot on the work we're doing across our value-based care platform to stabilize the business and provide meaningful growth in the future.

是的。非常感謝您的提問。所以我想我要補充的是，帕特里克對我們在基於價值的護理平台上所做的工作發表了很多評論，以穩定業務並在未來實現有意義的成長。

Maybe just a couple of comments on some of the other care delivery services that we offer that really enable that integrated delivery system to come to life. Whether that is investments in ancillary services, whether that's growth in home health, whether that's growth in our ASC platform, those will be things that we consider.

也許我只是對我們提供的真正使綜合交付系統得以實現的其他一些護理服務發表一些評論。無論是對輔助服務的投資，還是家庭保健的成長，還是我們 ASC 平台的成長，這些都是我們會考慮的事情。

But most urgently and importantly, the team is really focused on how do we make sure we drive the best productivity, the best performance, the best payment yields, and some of the near-term opportunities we have to deliver on our services businesses in the short term, while we enable further growth for the long term. Thanks for the question.

但最緊迫和最重要的，團隊真正關注的是我們如何確保推動最佳生產力、最佳績效、最佳支付收益，以及我們必須在短期內實現服務業務的一些近期機會，同時實現長期的進一步成長。謝謝你的提問。

Thanks, Krista. So that's all we have time for today. I would thank you all for joining us. We look forward to speaking with you again in a few months. I think you'll find those discussions will be even more specific and detailed, as well a little deeper from a strategic point of view as we continue to progress through our review here.

謝謝，克里斯塔。今天我們的時間就這麼多。我感謝大家的加入我們。我們期待幾個月後再次與您交談。我認為，隨著我們繼續進行審查，您會發現這些討論將更加具體和詳細，並且從戰略角度來看也會更加深入。

And we look forward to those engagements and the engagements with you that we'll have in the meantime before our next quarterly review. So thank you for joining us. We appreciate your interest and attention. Thanks.

我們期待在下一次季度審查之前與您進行這些接觸。感謝您加入我們。我們感謝您的關注和關注。謝謝。

And ladies and gentlemen, this concludes today's call. Thank you for your participation. You may now disconnect.

女士們、先生們，今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。