聯合健康 (UNH) 2025 Q3 法說會逐字稿

Good morning, and welcome to the UnitedHealth Group's third quarter 2025 earnings conference call. (Operator Instructions) As a reminder, this call is being recorded. 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.

早安，歡迎參加聯合健康集團 2025 年第三季財報電話會議。（操作員指示）提醒一下，此通話正在被錄音。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 we file with the Securities and Exchange Commission, including the cautionary statements included in our current and periodic filings. This call will also reference non-GAAP amounts. A reconciliation of the non-GAAP to GAAP amount is available on the financial and earnings reports section of the company's Investor Relations page at www.unitedhealthgroup.com.

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告聲明。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找到。

Information presented on this call is contained in the earnings release we issued this morning and in our Form 8-K dated October 28, 2025, which may be accessed from the 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 10 月 28 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。

Good morning. Thank you for joining us today. Our enterprise continues to advance on the improvement path first discussed with you in July. We've been introducing new leaders, strengthening underperforming businesses, identifying both opportunities and inefficiencies and importantly, recommitting to the mission and culture of this company. We're getting at the core of the underperformance issues with fresh perspectives, intent on positioning our organization as a positive and innovative leader helping to advance next era of health care.

早安.感謝您今天加入我們。我們的企業繼續沿著七月首次與您討論的改進道路前進。我們一直在引進新的領導者，加強表現不佳的業務，發現機會和低效率，更重要的是，重新致力於公司的使命和文化。我們正在以全新的視角深入研究績效不佳問題的核心，致力於將我們的組織定位為積極創新的領導者，幫助推動醫療保健的新時代。

A keen sense of urgency in this effort is consistent throughout the enterprise. At the same time, recognizing the pace of progress varies across our businesses, depending upon their challenges and opportunities. Some efforts will require more time and investment. Others will show more immediate progress. Repricing within UnitedHealthcare is on track to drive solid operating earnings growth from margin improvement within that business in 2026.

整個企業對此項努力始終抱持強烈的迫切感。同時，我們也意識到，各個業務的進步速度各不相同，這取決於它們面臨的挑戰和機會。有些努力需要更多的時間和投資。其他人將會表現出更直接的進步。聯合健康保險內部的重新定價預計將在 2026 年推動該業務利潤率的提高，從而實現穩健的營業利潤成長。

In our less mature businesses such as OptumHealth and OptumInsight, our efforts to improve operations and make needed investments will show more measured progress in 2026 and will take more time to fully bear fruit. As Patrick Conway will discuss, our belief in the need for an impact of value-based care remains intact, as is our confidence in returning to expected performance standards.

在我們不太成熟的業務中，例如 OptumHealth 和 OptumInsight，我們改善營運和進行必要投資的努力將在 2026 年取得更顯著的進展，並且需要更多時間才能完全取得成果。正如 Patrick Conway 所討論的，我們仍然堅信需要基於價值的護理來產生影響，我們對恢復預期績效標準的信心也依然堅定。

And throughout the company, we will ensure we are focused on activities that align with our long-term future and be very disciplined about moving on from those that do not. We're committed to returning to the consistent enterprise-wide performance levels you should expect of us.

在整個公司範圍內，我們將確保專注於符合我們長期未來的活動，並嚴格控制那些不符合的活動。我們致力於恢復您所期望的企業範圍內一致的績效水準。

Within OptumHealth, the team has taken concrete steps that will refocus the business back to its original mission, actions that will narrow networks with more emphasis on appropriately aligned physicians, geographies, the right clinical services and the right benefit offerings for the members we serve. We are also keeping sharp focus on the continued competitiveness of UnitedHealthcare as evidenced by our recent Medicare Star scores showing improvement year-over-year, and that work remains intense now for payment year 2028 Star's performance.

在 OptumHealth 內部，團隊已採取具體措施，將業務重新聚焦於其最初的使命，這些行動將縮小網絡，更加註重為我們服務的會員提供適當匹配的醫生、地理位置、正確的臨床服務和正確的福利。我們也密切關注聯合健康保險的持續競爭力，我們最近的 Medicare Star 評分顯示其逐年提高，目前我們仍在為 2028 年支付年度的 Star 表現而努力。

As we look ahead to the next few years, we will consistently emphasize the fundamental execution discipline that has long been a key trade of this company. and I'm gratified to see the quick and enthusiastic response to this enterprise emphasis from our leadership team. External challenges will remain, including continued headwinds in 2026 and from the third year of nearly $50 billion in industry-wide Medicare cuts by the previous administration as well as Medicaid funding and program pressures. Even so, I'm confident we will return to solid earnings growth next year given the operational rigor and more prudent pricing.

展望未來幾年，我們將始終強調長期以來一直是本公司關鍵業務的基本執行紀律。我很高興看到我們的領導團隊對這項企業重點做出了迅速而熱情的回應。外部挑戰仍然存在，包括2026年的持續阻力，以及上屆政府第三年削減近500億美元的全行業醫療保險，以及醫療補助資金和計畫壓力。即便如此，我相信，鑑於營運的嚴謹性和更審慎的定價，我們明年的獲利將恢復穩健成長。

While we are still finalizing 2026 plans and intend to share full guidance with you in January, current analyst consensus captures a likely stepping off point for next year. We intend to balance our earnings growth ambitions in 2026 with investments and actions that will drive higher and sustainable double-digit growth beginning in 2027 and advancing from there.

雖然我們仍在敲定 2026 年計劃並打算在 1 月與您分享完整的指導，但目前分析師的共識已經確定了明年可能的起點。我們打算透過投資和行動來平衡 2026 年的獲利成長目標，從而從 2027 年開始實現更高且可持續的兩位數成長。

That is the perspective we're keeping front of mind. Our longer-term outlook will be refreshed as we continue to execute over the next year. As we've been doing these last few months, we will continue to engage actively with both investors and the broader stakeholder community and plan to convene our investor conference in the back half of 2026.

這是我們始終牢記的觀點。隨著我們明年繼續執行，我們的長期前景將會更新。正如我們過去幾個月所做的那樣，我們將繼續積極與投資者和更廣泛的利害關係人社群互動，並計劃在 2026 年下半年召開投資者會議。

This morning, Tim Noel and Patrick Conway will provide details on the progress of UnitedHealthcare and Optum, respectively. Our Chief Financial Officer, Wayne DeVeydt; will review third quarter results. I'm pleased to welcome Waynef to our leadership team. He has the right experience, values and expertise to help guide UnitedHealth Group at this moment in our development, and he's off to a fast start. So with that, Tim, you want to take it?

今天上午，Tim Noel 和 Patrick Conway 將分別介紹 UnitedHealthcare 和 Optum 的進展。我們的財務長 Wayne DeVeydt 將審查第三季的業績。我很高興歡迎 Waynef 加入我們的領導團隊。他擁有豐富的經驗、價值觀和專業知識，可以幫助指導聯合健康集團目前的發展，而且他已經取得了快速的進展。那麼，提姆，你想接受它嗎？

Thanks, Steve. For the current year, overall UnitedHealthcare performance remains in line with the expectations we offered in the second quarter. Medical cost trends remained historically high but consistent with our second quarter guidance, and we expect that to continue throughout the remainder of 2025.

謝謝，史蒂夫。就今年而言，聯合健康保險的整體表現與我們在第二季給出的預期一致。醫療成本趨勢仍處於歷史高位，但與我們第二季度的指導一致，我們預計這種情況將持續到 2025 年剩餘時間。

Turning to our efforts for 2026, a vital element has been our pricing. Since our last update with you, we've repriced the vast majority of our UHC risk businesses, including Medicare Advantage and to varying degrees, our commercial fully insured and residual ACA offerings. Trend experience for the third quarter continues to validate the actuarial forecasts underpinning our 2026 pricing actions. Taken together, these actions position each of our businesses on a clear path towards margin growth in 2026 with the exception of Medicaid, which I will discuss in a moment.

談到我們 2026 年的努力，一個至關重要的因素就是我們的定價。自上次與您更新以來，我們已對絕大多數 UHC 風險業務重新定價，包括 Medicare Advantage 以及不同程度的商業全額保險和剩餘 ACA 產品。第三季的趨勢經驗持續驗證了我們 2026 年定價行動所依據的精算預測。總的來說，這些舉措使我們的每項業務都走上了 2026 年利潤成長的明確道路，醫療補助除外，我稍後會討論這一點。

Our Medicare business continues to perform in line with the expectations we shared last quarter. That's true for care activity and medical cost trends, and importantly, for the mix of clinical activity and utilization across physician, outpatient and inpatient. We forecast a full year 2025 trend of approximately 7.5% in Medicare Advantage, consistent with our previous expectations. As we shared with you last quarter, trend remains elevated across Medicare overall with our Med Sup offerings still seeing medical cost trends in excess of 11%.

我們的醫療保險業務繼續按照我們上個季度的預期表現。這對於護理活動和醫療成本趨勢來說是正確的，更重要的是，對於醫生、門診和住院患者的臨床活動和利用率的組合也是如此。我們預測 2025 年全年醫療保險優勢計畫的趨勢約為 7.5%，與我們先前的預期一致。正如我們在上個季度與您分享的那樣，整個醫療保險的趨勢仍然保持上升趨勢，我們的 Med Sup 產品的醫療成本趨勢仍然超過 11%。

In individual Medicare Advantage, we continue to believe an expected 10% medical cost trend for 2026 has us positioned appropriately. This trend assumes assumption reflects a continuation of the elevated care activity levels observed in 2025, known impacts from fee schedule changes and continued expansion of aggressive provider coding and billing practices. We have taken a similarly prudent view across all our Medicare product offerings for 2026, including Medicare Supplement, Group MA and stand-alone Part D.

在個人醫療保險優勢計劃中，我們仍然相信，2026 年預計 10% 的醫療成本趨勢將使我們處於適當的位置。這一趨勢假設反映了 2025 年觀察到的護理活動水準持續提高、費用表變化的已知影響以及積極的提供者編碼和計費實踐的持續擴展。我們對 2026 年的所有醫療保險產品都採取了同樣審慎的態度，包括醫療保險補充保險、團體保險 MA 和獨立的 D 部分。

For Medicare Advantage, we're now about 2 weeks into the annual enrollment period and early results are in line with our strategic positioning for 2026. Our plan for next year reflects a conservative path focused on margin growth. We made significant adjustments to benefits and executed targeted plant exits and network reductions to offset elevated medical trends and government funding decreases.

對於醫療保險優勢計劃 (Medicare Advantage)，我們現在已進入年度註冊期約 2 週，早期結果符合我們 2026 年的策略定位。我們明年的計畫體現了注重利潤成長的保守路線。我們對福利進行了重大調整，並實施了有針對性的工廠退出和網路縮減，以抵消醫療趨勢的上升和政府資金的減少。

As a result of our planned actions as well as competitive market dynamics, we expect membership contraction of approximately 1 million members in total Medicare Advantage, including individual and group markets. We expect these actions will drive margin improvements in 2026 with potential for further advancements in 2027 that will position us to reach the upper half of our 2% to 4% targeted margin range, all of which is supported by strong Star's results. As Steve mentioned earlier, we already have shifted focus to the next Star's performance period including incremental investments made in the fourth quarter.

由於我們計劃採取的行動以及競爭激烈的市場動態，我們預計包括個人和團體市場在內的整個醫療保險優勢計劃的會員人數將減少約 100 萬人。我們預計這些措施將推動 2026 年利潤率的提高，並有可能在 2027 年進一步提高，使我們達到 2% 至 4% 目標利潤率範圍的上半部分，所有這些都得到了 Star 強勁業績的支持。正如史蒂夫之前提到的，我們已經將重點轉移到下一個 Star 的業績期，包括第四季度的增量投資。

Turning to commercial. We are focused on pricing and cost management efforts to support 2026 margin recovery. At this point, approximately 60% of our group commercial insured offerings have been priced for next year. Our commercial pricing reflects the elevated cost levels we've seen this year, which we expect to persist in 2026. While we expect our group fully insured business to contract in line with the broader market, we continue to see strong traction for our self-funded offerings. We expect the vast majority of our employer insurance businesses to be repriced for 2026 and to return to our normal margin range in 2027.

轉向商業。我們專注於定價和成本管理工作，以支持 2026 年利潤率的恢復。目前，我們大約 60% 的團體商業保險產品已經確定了明年的保費價格。我們的商業定價反映了我們今年看到的成本水準上升，我們預計這種趨勢將持續到 2026 年。雖然我們預計我們的團體全險業務將隨著大盤的萎縮而萎縮，但我們的自籌資金產品仍然保持強勁成長勢頭。我們預計，絕大多數雇主保險業務將在 2026 年重新定價，並在 2027 年恢復正常利潤範圍。

Moving to ACA markets. We have submitted rate filings in nearly all of the 30 states where we participate that reflect 2025 morbidity and experience. These include average rate increases of over 25%. Where we are unable to reach agreement on sustainable rates, we are enacting targeted service area reductions. We believe these actions will establish a sustainable premium base while likely reducing our ACA enrollment by approximately two-thirds. These actions should drive margin improvement in our employer and individual segment in 2026, though still below our targeted 7% to 9% range.

轉向 ACA 市場。我們已經向我們參與的幾乎所有 30 個州提交了反映 2025 年發病率和經驗的費率文件。其中包括平均利率上漲超過 25%。如果我們無法就永續費率達成一致，我們將制定有針對性的服務區域削減措施。我們相信這些措施將建立可持續的保費基礎，同時可能將我們的 ACA 註冊人數減少約三分之二。這些措施應會推動我們 2026 年雇主和個人部門的利潤率提高，儘管仍低於我們 7% 至 9% 的目標範圍。

In Medicaid, the path to recovery will be more challenging. States have not funded in line with actual cost trends. So funding levels are not sufficient to cover the health needs of state enrollees. While we're making steady progress in bridging this gap with states, the mismatch between rate adequacy and member acuity will likely extend through 2026.

在醫療補助計劃下，復健之路將更具挑戰性。各州尚未根據實際成本趨勢提供資金。因此，資金水準不足以滿足州參保人員的健康需求。雖然我們在縮小與各州之間的差距方面取得了穩步進展，但費率充足性和會員敏銳度之間的不匹配可能會持續到 2026 年。

To date, we have received 2026 draft rates on almost half of our contracts, which have a January 1 rate cycle, and we continue to advocate for rate updates to better reflect our ongoing experience with elevated trends. Our team is focused on addressing drivers unique to these markets, especially behavioral health and will continue to push for appropriate funds.

到目前為止，我們已經收到了幾乎一半合約的 2026 年草案利率，這些合約的利率週期為 1 月 1 日，我們將繼續倡導利率更新，以更好地反映我們持續的利率上升趨勢經驗。我們的團隊專注於解決這些市場特有的驅動因素，尤其是行為健康問題，並將繼續爭取適當的資金。

As I said last quarter, wherever states support responsible funding for Medicaid, we remain committed to serving people through that program and view this as integral to our mission. As we indicated in July, we anticipate Medicare margins will be breakeven for 2025. As we look to 2026, we expect margins to decline further as existing cost trends continue and the current rate environment does not change. Looking at UnitedHealthcare overall, the underlying business continues to perform well in serving consumers, plans and program sponsors.

正如我上個季度所說，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。正如我們在 7 月指出的那樣，我們預計 2025 年醫療保險利潤率將實現收支平衡。展望 2026 年，我們預期利潤率將進一步下降，因為現有成本趨勢持續且當前利率環境沒有改變。縱觀聯合健康保險的整體情況，其基礎業務在服務消費者、計劃和項目贊助商方面繼續表現良好。

To give you some examples of how we're enhancing the experience for these cohorts. Nearly 85% of member inquiries are served digitally. When members call us, 90% of calls are answered within 30 seconds and 95% of members' questions are resolved in the first interaction. So 95% of our claims are automatically processed immediately. We're delivering more value, ease, simplicity and guidance throughout the UHC member experience. We're also aggressively scaling AI and machine learning capabilities to enhance these experiences and optimize core performance.

舉一些例子來說明我們如何提升這些群體的體驗。近 85% 的會員諮詢都是透過數位方式處理的。當會員致電我們時，90% 的電話會在 30 秒內接聽，95% 的會員問題會在第一次互動中解決。因此，我們的 95% 的索賠都會立即自動處理。我們為 UHC 會員的整個體驗提供更多價值、便利、簡單和指導。我們也積極擴展人工智慧和機器學習能力，以增強這些體驗並優化核心效能。

While 2025 remains a transition year, the pressure we experienced is largely a result of mispricing and suboptimal market positioning. We remain humbled by the challenges of this environment and the lessons we've had to learn once again, but confident that we are in solid footing to recapture our performance potential.

雖然 2025 年仍然是一個過渡年，但我們所面臨的壓力很大程度上是由於錯誤定價和不理想的市場定位造成的。我們仍然對這種環境的挑戰和我們必須再次學習的教訓感到謙卑，但我們有信心，我們有足夠的基礎來重新發揮我們的績效潛力。

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

接下來，我將把發言權交給 Optum 執行長 Patrick Conway。

Thanks, Tim. I will spend the majority of my time today updating you on our efforts to restore OptumHealth to its original intent around value-based care, which experience continues to show us is the optimal model deliver the right care at the right time in the right setting for the best outcomes at the lowest cost to the people we serve, particularly in light of current cost trends and the market dominance of the large health systems. Over the last few years, through a period of rapid expansion, OptumHealth's strategy around value-based care strayed from the initial intent of the model.

謝謝，蒂姆。今天，我將用大部分時間向大家介紹我們為恢復 OptumHealth 的初衷（即基於價值的醫療服務）所做的努力，經驗不斷向我們表明，這種模式是最佳模式，能夠在正確的時間、正確的環境下提供正確的醫療服務，以最低的成本為我們服務的人帶來最佳的結果，特別是考慮到當前的成本趨勢和大型醫療系統的市場主導地位。在過去的幾年裡，經過一段快速擴張時期，OptumHealth 圍繞價值型醫療的策略偏離了模式的初衷。

Three critical issues emerged. First, the provider network grew too large; second, the rapid pace of expansion and slower pace of integration resulted in operating inconsistencies exacerbated by relying too much on affiliated physicians who are less aligned with core VBC policies. And lastly, OptumHealth was accepting risk in products and services less suited for a clinically oriented value-based model. Understanding these issues has helped us better pursue the steps needed to get back to the original intent of OptumHealth and value-based care.

出現了三個關鍵問題。首先，提供者網路規模過大；其次，擴張速度過快而整合速度過慢導致營運不一致，而過度依賴與核心 VBC 政策不太一致的附屬醫生則加劇了這種不一致。最後，OptumHealth 接受的產品和服務風險較不適合臨床導向的價值型模式。了解這些問題有助於我們更好地採取必要措施，回歸 OptumHealth 和基於價值的護理的初衷。

Over the past six months, we have made significant leadership changes to better drive an integrated VBC provider model. Under the leadership of Krista Nelson, our Chief Operating Officer, we are focusing our efforts on three key connected areas to drive better performance. First, returning to the original intended clinical framework that best supports VBC. Second, moving towards narrower, more integrated and dedicated value-based care provider model and network. And third, focusing on the appropriate managed benefit product and patient base.

在過去的六個月中，我們進行了重大的領導層變動，以更好地推動整合的 VBC 提供者模式。在營運長 Krisa Nelson 的領導下，我們正集中精力於三個關鍵的相關領域，以推動更好的績效。首先，回到最能支持 VBC 的原始臨床框架。第二，邁向更狹窄、更全面、更專注的基於價值的照護提供者模式和網絡。第三，關注適當的管理福利產品和病患群體。

Within this framework, our team has made solid progress, especially in bringing greater discipline to how we approach risk arrangements, which will benefit the business in 2026. This includes partnering with payers on benefit adjustments and appropriate rates to match the risk and mix of the populations we serve. At this point, we are close to completion and over 90% of our value-based payer contracts for next year and are on track to reach our goal of offsetting approximately half of the 2026 V28 headwind through payer contracting.

在此框架內，我們的團隊取得了紮實的進展，特別是在加強風險安排的規範性方面，這將使 2026 年的業務受益。這包括與付款人合作調整福利和適當的費率，以配合我們所服務人群的風險和結構。目前，我們已接近完成明年基於價值的付款人合約的 90% 以上，並有望實現透過付款人合約抵消 2026 年 V28 逆風約一半的目標。

We are also pursuing market and product exits, including from lower-performing PPO contracts. As indicated last quarter, we have finalized exits for 200,000 lives in 2026, the majority of which are PPO. While still early in the Medicare annual enrollment period, we expect total OptumHealth value-based care membership to shrink by approximately 10% in 2026 before returning to growth in 2027. We also continue to intentionally shape our care provider network to prioritize high-performing partners who demonstrate strong patient engagement and consistently positive outcomes. We are moving to employed or contractually dedicated positions wherever possible.

我們也正在尋求市場和產品退出，包括業績較差的 PPO 合約。正如上個季度所指出的，我們已完成 2026 年 20 萬人的生命退出，其中大多數是 PPO。雖然仍處於 Medicare 年度登記期的早期階段，但我們預計 OptumHealth 價值型醫療會員總數將在 2026 年減少約 10%，然後在 2027 年恢復成長。我們也將繼續有意塑造我們的護理提供者網絡，優先考慮那些表現出強烈患者參與度和持續積極成果的高績效合作夥伴。我們正在盡可能地轉向受僱或合約制專職職位。

We are separating from providers who are less aligned with the VBC model. The targeted network actions we've taken over the last 60 days will result in fewer providers in our networks starting in 2026. Within our markets and their related networks, we are working to more fully integrate our clinical practices to ensure greater performance consistency.

我們正在與那些不太符合 VBC 模型的提供者分道揚鑣。我們在過去 60 天採取的有針對性的網路行動將導致從 2026 年開始我們的網路中的提供者數量減少。在我們的市場及其相關網路中，我們正在努力更全面地整合我們的臨床實踐，以確保更高的效能一致性。

The team is refining our portfolio and accelerating a consistent national operating model for regionally led high-performing OptumHealth practices that reduces fixed cost drives purchasing economies, align technology and most importantly, ensures continued high-quality care. These actions increase our confidence in our ability to meet our V28 cost reduction targets in 2026 and strengthen our operating foundations for the long term.

該團隊正在完善我們的產品組合，並加速建立一致的全國運營模式，以支持區域主導的高績效 OptumHealth 實踐，從而降低固定成本，推動購買經濟，協調技術，最重要的是，確保持續提供高品質的護理。這些措施增強了我們實現2026年V28成本削減目標的信心，並鞏固了我們長期的營運基礎。

Lastly, our engagements clinical work at Optum continue to track with our expectations for meaningfully reducing medical cost trends, engaging with over 85% of our high-risk members in 2025, which accounts for the remaining V28 pressure offsets in 2026.

最後，我們在 Optum 進行的臨床工作繼續符合我們對大幅降低醫療成本趨勢的期望，到 2025 年將與超過 85% 的高風險會員進行合作，這將佔 2026 年剩餘的 V28 壓力抵消。

Bottom line, getting back to the basics of our VBC model will be good for the people we serve and for our business. As a point of reference, our 2026 CMS star rating projections show 80% of Optum at home members and 4+ Star plans and nearly 100% of our [active] members in 4+ Star plans. Evidence of our quality of care is underscored by a strong MPS of 90 at our highest-performing facilities.

總而言之，回歸 VBC 模型的基礎對於我們服務的物件和我們的業務都是有益的。作為參考，我們的 2026 年 CMS 星級評定預測顯示，80% 的 Optum 在家會員和 4 星以上計劃以及幾乎 100% 的 [活躍] 會員都參與了 4 星以上計劃。我們最高績效設施的 MPS 高達 90，充分證明了我們的護理品質。

For the third quarter, OptumHealth performance was in line with our expectations, reflecting the natural seasonality in our business and the pull forward of some investments. Within this, we expect to end 2025 with margins of just under 3%, which includes value-based care margins under 1%. We expect margin improvement across all of OptumHealth in 2026 even in the face of the third year of the Medicare funding cuts. We believe these efforts will drive further acceleration in 2027 towards our long-term margin targets of 6% to 8%.

第三季度，OptumHealth 的業績符合我們的預期，反映了我們業務的自然季節性和一些投資的提前性。在此範圍內，我們預計到 2025 年利潤率將略低於 3%，其中包括低於 1% 的基於價值的護理利潤率。即使面臨醫療保險經費削減的第三年，我們預計 2026 年 OptumHealth 整體的利潤率仍將有所提高。我們相信，這些努力將推動我們在 2027 年進一步加速實現 6% 至 8% 的長期利潤率目標。

Turning to OptumHealth's fee-based care services, as we discussed last time, these were not performing to their potential. We are adopting more consistent and rigorous processes to better manage these practices for growth and appropriate profitability. We are seeing early results in our East region, which serves nearly 5 million patients, where we have generated a 3% per visit productivity increase quarter-over-quarter, driven by targeted improvements in scheduling, workflow efficiency and patient acquisition. We have similar undertakings in motion in our South and West regions.

談到 OptumHealth 的收費護理服務，正如我們上次討論的那樣，這些服務並未發揮其潛力。我們正在採用更一致和嚴格的流程來更好地管理這些實踐，以實現成長和適當的獲利能力。我們在東部地區看到了早期成果，該地區服務了近 500 萬名患者，由於在排班、工作流程效率和患者獲取方面有針對性的改進，我們的每次就診生產力環比提高了 3%。我們在南部和西部地區也進行了類似的工作。

As for OptumInsight, we continue to perform solidly but not at the level of the potential for these services. Under the leadership of Sandeep Dadlani, we now see the alignment of our end-to-end technology and AI innovation efforts coming into formation. We will make the investments needed to accelerate the advancement of this distinctive platform that serves the expanse of the health system. We are confident in our plan will ignite top line revenue and operating earnings in line with our long-term growth targets.

至於 OptumInsight，我們的表現仍然穩健，但尚未達到這些服務的潛力水準。在桑迪普·達德拉尼 (Sandeep Dadlani) 的領導下，我們現在看到端到端技術和人工智慧創新努力的結合正在形成。我們將進行必要的投資，以加速這項服務於整個醫療系統的獨特平台的發展。我們相信，我們的計劃將推動營業收入和營業利潤的成長，符合我們的長期成長目標。

At OptumRx, we continue to perform well with double-digit revenue growth in our pharmacies and a strong selling season for our pharmacy offerings. Our products are resonating in the market with stronger customer retention and new customer growth. At this stage, we expect new membership growth in 2026 will be more than offset by expected membership attrition from the UnitedHealthcare business. Importantly, our team remains disciplined around pricing, transparency and quality outcomes for our customers at a time when the pharmaceutical industry continues to drive cost ever higher.

在 OptumRx，我們的藥局營收持續保持兩位數成長，藥局產品銷售旺季表現強勁，業績表現良好。我們的產品在市場上引起強烈反響，客戶保留率更高，新客戶成長更快。現階段，我們預期 2026 年新會員的成長將被聯合健康保險業務的預期會員流失所抵銷。重要的是，在製藥業成本不斷上漲的背景下，我們的團隊仍然嚴格遵守客戶的定價、透明度和品質結果。

Today, we offer full rebate pass-through arrangements to all of our customers with nearly 85% of them participating. We were the first in our industry to announce this arrangement back in the beginning of the year and we expect 95% of our customers will be in these arrangements in 2027 with the remainder in full rebate pass-through by 2028. And we have increased payments on branded drugs to over 14,000 and independent retail pharmacies as part of our commitment to a balanced pricing approach.

今天，我們為所有客戶提供全額回饋轉嫁安排，其中近 85% 的客戶提供參與。我們是業內首家在今年年初宣布這項安排的公司，我們預計到 2027 年，95% 的客戶將採用這種安排，其餘客戶到 2028 年將獲得全額回饋。作為我們致力於平衡定價方法的一部分，我們增加了超過 14,000 家獨立零售藥局的品牌藥品付款。

Thanks for your time today. I'll now turn it over to Wayne DeVeydt.

感謝您今天抽出時間。現在我將把發言權交給 Wayne DeVeydt。

Good morning, everyone. I'd like to begin by expressing my sincere appreciation to Steve, Tim, Patrick and all of my colleagues at UnitedHealth Group for the warm welcome. It's truly an honor to be part of this team and to contribute to our shared mission.

大家早安。首先，我要向史蒂夫、提姆、派崔克以及聯合健康集團所有同事的熱情歡迎表示誠摯的感謝。能夠成為這個團隊的一員並為我們共同的使命做出貢獻，我感到非常榮幸。

Today, I'd like to cover three important topics. First, I'll provide an overview of our quarterly performance and how it informs our outlook for the rest of the year. I will then discuss our capital and liquidity framework as we look ahead to 2026, particularly in terms of resuming share buybacks and strategic acquisition activities. And finally, I'll offer some insights into our expectations for 2026.

今天，我想談三個重要話題。首先，我將概述我們的季度業績以及它如何影響我們對今年剩餘時間的展望。然後，我將討論我們展望 2026 年的資本和流動性框架，特別是在恢復股票回購和策略收購活動方面。最後，我將對我們對 2026 年的期望提出一些見解。

Moving to the quarter. Today, we reported adjusted earnings per share of $2.92, which was slightly ahead of our expectations. These results reflect steady execution while we work through our longer-term improvement plans. We've balanced immediate performance with strategic investments that will support our future growth and natural diversification.

轉到季度。今天，我們報告調整後的每股收益為 2.92 美元，略高於我們的預期。這些結果反映了我們在執行長期改善計畫時的穩定執行。我們在當前業績和支持未來成長和自然多樣化的策略投資之間取得了平衡。

Some details for the quarter. We delivered revenues of over $113 billion, reflecting 12% year-over-year growth driven by domestic membership expansion of over 780,000 lives year-to-date. We ended the third quarter with total domestic membership of more than 50 million. Our medical care ratio of 89.9% in the quarter compares to 85.2% in the same quarter last year. with the full year trending towards the lower end of the projections we offered last quarter. As Tim stated, medical cost trends, while historically high, remain consistent with our outlook for 2025 and align with our pricing actions for 2026.

本季的一些細節。我們實現了超過 1,130 億美元的收入，年增 12%，這得益於年初至今國內會員人數增加超過 78 萬人。截至第三季度，我們的國內會員總數已超過 5,000 萬人。本季我們的醫療保健率為 89.9%，而去年同期為 85.2%。全年趨勢接近我們上個季度提出的預測的低端。正如提姆所說，醫療成本趨勢雖然處於歷史高位，但仍與我們對 2025 年的展望一致，並與我們對 2026 年的定價行動保持一致。

The operating cost ratio of 13.5% in the quarter reflects larger investments in technology and people than originally contemplated when guidance was set in 2Q. Specifically, we invested more than $450 million in broad-based employee incentives and in contributions to the UnitedHealth Foundation, both critically important for strengthening our relationships with our workforce and with local communities in the health system at large. And investments were proportionately greater in OptumHealth and OptumInsight.

本季 13.5% 的營運成本比率反映出對技術和人員的投資比第二季制定指導方針時最初設想的要大。具體來說，我們投資了超過 4.5 億美元用於廣泛的員工激勵和向聯合健康基金會捐款，這對於加強我們與員工以及整個醫療系統中當地社區的關係至關重要。對 OptumHealth 和 OptumInsight 的投資也隨之增加。

Finally, our earnings were supported by strong cash flows of 2.3 times net income and an overall increase in days claims payable of 1.7 days sequentially.

最後，我們的獲利得到了強勁現金流的支持，現金流為淨收入的 2.3 倍，而索賠支付天數總體環比增加了 1.7 天。

Turning to our capital and liquidity framework. As previously communicated, we have paused our strategic acquisitions and share buyback while we dedicate our cash to returning to a long-term debt-to-capital ratio around 40% and interest coverage ratio is in line with historic levels. In the third quarter, our debt-to-capital ratio remained stable at 44.1%, reflecting continued actions to improve cash efficiency, offset by the completion of the Amedisys transaction late in the third quarter which represented a net cash disbursement of $3.4 billion.

轉向我們的資本和流動性框架。如同先前所傳達的，我們已暫停策略性收購和股票回購，同時我們將投入現金，使長期債務資本比率恢復到 40% 左右，利息覆蓋率與歷史水平一致。第三季度，我們的債務資本比率保持穩定在 44.1%，這反映了我們持續採取行動提高現金效率，但第三季末完成的 Amedisys 交易（淨現金支出 34 億美元）抵消了這一影響。

We expect our debt-to-capital ratio to trend closer to 40% in the second half of 2026. Accordingly, while we have not finalized plans for 2026, we anticipate we may be in a position to reinstate our historical capital deployment practices later in the year. Finally, we generated operating cash flow from operations of $5.9 billion. We still expect to close this year with $16 billion in operating cash flow or 1.1 times net income.

我們預計，到 2026 年下半年，我們的債務資本比率將接近 40%。因此，雖然我們尚未最終確定 2026 年的計劃，但我們預計我們可能會在今年稍後恢復我們的歷史資本配置做法。最後，我們從營運中產生了 59 億美元的營運現金流。我們仍預期今年的營業現金流將達到 160 億美元，即淨收入的 1.1 倍。

Looking ahead to 2026. As Steve mentioned, we will provide formal guidance with our fourth quarter results in January. We are comfortable with current consensus and within that, we are making the requisite investments needed to accelerate our returns in 2026 and to position our company for meaningfully stronger growth in 2027 and beyond.

展望2026年。正如史蒂夫所提到的，我們將在一月份提供第四季度業績的正式指導。我們對目前的共識感到滿意，並在此基礎上進行必要的投資，以加速我們在 2026 年的回報，並為公司在 2027 年及以後實現更強勁的增長做好準備。

We are optimistic in our ability to execute on our 2026 plans, but there are remaining headwinds we will have to overcome. Items to keep in mind include, we're entering the final year of V28, which represents a more than $6 billion headwind to the overall enterprise. As you heard from Tim and Patrick, we've taken numerous actions around benefit design, cost control and member engagement to substantially offset this impact.

我們對執行 2026 年計畫的能力充滿信心，但仍需克服一些阻力。需要記住的是，我們即將進入 V28 的最後一年，這對整個企業來說意味著超過 60 億美元的逆風。正如提姆和派崔克所說，我們在福利設計、成本控制和會員參與方面採取了多項措施，以大幅抵消這種影響。

Further investment in OptumHealth and OptumInsight is needed and we are accelerating some of those investments as noted in our third quarter results. We are also accelerating our pace of AI applications to fundamentally advance a vast spectrum of processes and capabilities we expect will structurally improve our enterprise performance.

需要對 OptumHealth 和 OptumInsight 進行進一步投資，正如我們第三季業績所示，我們正在加快其中一些投資。我們也正在加快人工智慧應用的步伐，以從根本上推動廣泛的流程和能力，我們期望這將從結構上改善我們的企業績效。

Our effective tax rate is expected to return to a more normalized level in 2026 as compared to 2025. And finally, investment income should continue to move lower as interest rates decline. From a tailwind perspective, our repricing efforts will be a catalyst for earnings growth as we begin returning to our long-term target margins with particularly solid year-over-year results expected in our Commercial and Medicare businesses.

與 2025 年相比，我們的有效稅率預計將在 2026 年恢復到更正常的水平。最後，隨著利率下降，投資收益應該會繼續下降。從順風角度來看，隨著我們開始恢復長期目標利潤率，我們的重新定價努力將成為獲利成長的催化劑，預計我們的商業和醫療保險業務將實現特別穩健的年比業績。

We also expect stability and a measured return to growth in our Optum entities, with aspects of that growth being reinvested in the business, specifically OptumHealth and OptumInsight. These investments may slow 2026 growth, but should accelerate growth in 2027, more in line with historical expectations. We will be paying down debt and identifying opportunities to further reduce our interest expense as a result of the declining rate environment.

我們也期望 Optum 實體能夠保持穩定並實現穩定成長，並將部分成長重新投資於業務，特別是 OptumHealth 和 OptumInsight。這些投資可能會減緩 2026 年的成長，但應該會加速 2027 年的成長，更符合歷史預期。在利率下降的環境下，我們將償還債務並尋找機會進一步降低利息支出。

And finally, we're taking an aggressive step on affordability initiatives that should improve overall medical trend relative to our pricing. While we have a number of moving parts to manage for the remainder of this year, we also have concrete plans to execute on all the items we discussed this morning that will position us for the type of growth you've come to expect from UnitedHealth Group.

最後，我們正在積極採取可負擔性舉措，這將改善與我們的定價相關的整體醫療趨勢。雖然我們在今年剩餘時間內需要管理許多活動部分，但我們也制定了具體的計劃來執行我們今天上午討論的所有項目，這將使我們達到您對聯合健康集團所期望的增長類型。

Thanks for your time this morning. I'll now turn it back to Steve.

感謝您今天上午抽出時間。現在我將把話題轉回給史蒂夫。

Thanks, Wayne. As I hope you clearly -- you heard clearly, this team and our 400,000 colleagues are focused on delivering on all fronts for the people we're privileged to serve and for our shareholders. As I said in the outset, we're being very disciplined. This plays out day to day as this management team recognizes the need to manage our costs, both in the short term as well as structurally. And through another lens, throughout the quarter, we have continued to evaluate the company's businesses with fresh perspectives and with continued confidence in our progress and our overall direction. We expect to complete that assessment in the fourth quarter as we position for 2026 and the years ahead.

謝謝，韋恩。我希望你們清楚地——你們清楚地聽到，這個團隊和我們的 40 萬名同事正致力於為我們有幸服務的人們和我們的股東提供全方位的服務。正如我在一開始所說的，我們非常自律。隨著管理團隊意識到需要管理我們的成本（無論是短期還是結構性成本），這種情況每天都在發生。從另一個角度來看，整個季度，我們繼續以新的視角評估公司的業務，並對我們的進展和整體方向保持信心。我們預計在第四季度完成該評估，為 2026 年及未來幾年做好規劃。

A few themes emerge from these efforts. We are dedicating our energies to serving US health care needs and we'll be reducing our footprint in international markets that do not support these needs. We will be finalizing our initiatives for recovery of the remaining outstanding loan balances from the care provider support programs associated with the 2024 Change Healthcare cyber attack.

這些努力呈現出幾個主題。我們正致力於滿足美國的醫療保健需求，並將減少在無法滿足這些需求的國際市場上的足跡。我們將最終確定從與 2024 年 Change Healthcare 網路攻擊相關的護理提供者支援計劃中追回剩餘未償還貸款餘額的計劃。

For OptumHealth, we are consolidating locations and completing plans addressing the geographic markets in which we will serve patients all intended to operationally advance and scale the leading value-based clinical care business of OptumHealth. And we are realigning Optum Financial services within our OptumInsight Services platform.

對於 OptumHealth，我們正在整合地點並完成針對地理市場的計劃，我們將在這些市場為患者提供服務，旨在在營運上推進和擴大 OptumHealth 領先的基於價值的臨床護理業務。我們正在 OptumInsight 服務平台內重新調整 Optum Financial 服務。

While we have not yet finalized these plans, many of these actions are underway, and we believe they will improve both our focus and long-term performance. We are in the process of quantifying the accounting, tax and cash implications of our plans. At this stage, our preliminary work would imply a non-GAAP substantially noncash low single-digit billion-dollar charge. We will provide further details on our fourth quarter call as we conclude these efforts.

雖然我們尚未最終確定這些計劃，但其中許多行動正在進行中，我們相信它們將提高我們的重點和長期表現。我們正在量化我們計劃的會計、稅收和現金影響。在現階段，我們的初步工作意味著非公認會計準則下非現金的低個位數十億美元的費用。在完成這些工作後，我們將在第四季度電話會議上提供更多詳細資訊。

Simply put, we will end 2025 well positioned for a return to solid growth in 2026, acceleration in 2027 and a clear focus on our long-standing mission and strategy. An important reason for my confidence in our outlook is the way I see our people embracing a renewed focus on the mission, culture and values of our company. How we go about things in the sensitive area of health care is as essential as what we do, and we are bringing new energy to that imperative each day.

簡而言之，我們將在 2025 年結束時做好充分準備，以便在 2026 年恢復穩健成長，在 2027 年加速成長，並明確關注我們的長期使命和策略。我對我們的前景充滿信心的一個重要原因是，我看到我們的員工重新專注於公司的使命、文化和價值觀。我們如何處理敏感的醫療保健領域的事情與我們所做的工作同樣重要，我們每天都在為這項重要任務注入新的活力。

Now operator, let's open it up for questions.

接線員，現在讓我們開始提問。

(Operator Instructions)

（操作員指示）

Josh Raskin, Nephron Research.

Josh Raskin，腎元研究。

I appreciate all that detail this morning. I was wondering if you could just give us a more updated view or a more specific view on the sub businesses in OptumHealth. I'm specifically looking to understand how much of the revenue base is coming from capitated premiums from health plans and within that, how much from your biggest customer, UHC.

我很感謝今天早上提供的所有細節。我想知道您是否可以為我們提供關於 OptumHealth 子業務的更新觀點或更具體的觀點。我特別想了解收入基礎中有多少來自健康計劃的人頭保費，以及其中有多少來自你們最大的客戶 UHC。

And then how much of the remainder is fee-for-service billings from your employed physicians? And then maybe some of the moving parts, I heard a little bit of the membership details as you think about stepping into 2026, at least directionally.

那麼剩餘的費用中有多少是您僱用的醫生按服務收取的費用？然後也許是一些活動部分，我聽到了一些會員細節，當你考慮進入 2026 年時，至少在方向上。

Sure. Why don't we just start with Patrick and then finish with Kris?

當然。我們為什麼不先從派崔克開始，然後再以克里斯結束呢？

Sounds great. So thanks, Josh, for the question. High level, the breakdown on revenue is as we described last quarter, 65% VBC, 15% care delivery fee-for-service and our payer, employer services. Within VBC, it's about two-third of our book of business is serving UnitedHealthcare, the rest of diverse array of payers. Within growth potential as we close out this year, as you heard, we plan to close 2025 just under that 3% margin with VBC margins under 1%. And then we're taking the actions this year to set us up for 2, and I'll let Krista cover that portion.

聽起來很棒。所以，感謝喬希提出這個問題。高層次上，收入的細分正如我們上個季度所描述的那樣，65％的 VBC，15％的醫療服務收費和我們的付款人，雇主服務。在 VBC 內部，我們約三分之二的業務是為 UnitedHealthcare 服務，其餘的則是為各種付款人服務。正如您所聽到的，在我們今年結束時的成長潛力範圍內，我們計劃在 2025 年結束時實現略低於 3% 的利潤率，其中 VBC 利潤率低於 1%。然後，我們今年將採取行動，為 2 做好準備，我會讓 Krista 負責這部分。

Yes. Thanks for the question, Josh. So I think as we are pacing into 2026, we remain anchored and committed to the long-term potential of this business. the 6% to 8% margin that we outlined in the second quarter. And within that, the 5% commitment to our value-based care agenda. We continue to work a robust set of actions and opportunities with clear line of sight and frankly, a lot of the ambition to the work ahead. And again, just remain optimistic on our positioning for the long term.

是的。謝謝你的提問，喬希。因此，我認為，隨著我們邁入 2026 年，我們仍將堅定不移地致力於這項業務的長期潛力。我們在第二季度概述了 6% 至 8% 的利潤率。其中，5% 致力於我們基於價值的護理議程。我們將繼續採取一系列強有力的行動，抓住機遇，並有清晰的思路，坦白說，對未來的工作充滿雄心壯志。再次強調，我們對於長期定位仍保持樂觀。

A.J. Rice, UBS.

瑞銀的 A.J. Rice。

Thanks, everybody. Maybe just I'll stick on the Optum theme. I appreciate the comments on OptumInsight and the comment about need for investment. Can you just sort of comment a little more deeply on your view of where OptumInsight sits competitively at this point? Where are those investments need to go and the time frame for seeing a reacceleration of growth there?

謝謝大家。也許我會堅持使用 Optum 主題。我很欣賞對 OptumInsight 的評論以及關於投資需求的評論。您能否更深入地評論一下您對 OptumInsight 目前競爭地位的看法？這些投資需要投向哪裡？何時才能看到那裡重新加速成長？

Sure. I actually think that Optum's competitive position is actually pretty strong. We have a really nice base of business and continue to grow that. But I think the potential is much greater. So Sandeep, do you want to offer some views?

當然。我確實認為 Optum 的競爭地位實際上相當強。我們擁有非常好的業務基礎，並將繼續發展。但我認為潛力要大得多。那麼 Sandeep，你想提供一些觀點嗎？

Sure. Thanks, A.J. Look, four weeks into the role, I'm super impressed with the talent, the domain knowledge, the customer franchise and the mission. I'm particularly excited by the momentum of some of our AI first new products in the portfolio. I mean just last week, you must have seen we launched Optum Real, which was inspired by innovation at UnitedHealthcare. This is the first real-time platform for claims and reimbursements anywhere in the industry. And just our early pilots are showing dramatic results in streamlining what I think is one of the most complex pain points for payers and providers.

當然。謝謝，A.J. 看，任職四周後，我對他們的才華、領域知識、客戶特許經營權和使命印象深刻。我對我們產品組合中一些 AI 首發新產品的發展勢頭感到特別興奮。我的意思是，就在上週，您一定已經看到我們推出了 Optum Real，它的靈感來自於 UnitedHealthcare 的創新。這是業界首個即時索賠和報銷平台。我們的早期試點在簡化我認為是付款人和提供者最複雜的痛點之一方面取得了顯著成果。

I'll give you another example. We recently launched Optum Integrity One. This is the most advanced AI auto coating tool in the market, and it's driving demand among health systems and hospitals looking to improve middle revenue cycle automation and performance. I mean just some metrics for ambulatory outpatient claims coding, this showed 73% productivity over prevailing solutions. And for hospital inpatient coding, it showed 23% increase in productivity.

我再舉一個例子。我們最近推出了 Optum Integrity One。這是市場上最先進的人工智慧自動塗層工具，它正在推動醫療系統和醫院對提升中間收入週期自動化和性能的需求。我的意思是，僅針對門診索賠編碼的一些指標，這表明生產力比現行解決方案高出 73%。對於住院病人編碼，其生產力提高了 23%。

A third one is Crimson AI. This is an AI first clinical analytics platform that has created six wins in the last 90 days itself. This helps providers with their surgical costs and operating room optimization. Just the average return on investment for any provider system investing in Crimson AI has been 13:1. So look, in my first few interactions with our top clients, they've expressed tremendous excitement and anticipation for our new AI-based offerings.

第三個是Crimson AI。這是一個人工智慧優先的臨床分析平台，僅在過去 90 天內就取得了六項勝利。這有助於提供者降低手術成本並優化手術室。任何投資 Crimson AI 的提供者係統的平均投資回報率為 13:1。所以，在我與我們的頂級客戶的最初幾次互動中，他們對我們的基於人工智慧的新產品表達了極大的興奮和期待。

They've also provided feedback on where we can do better. But it's clear that our traditional services in OptumInsight have to evolve to AI-first services, then to products and eventually to platforms. We are well on our way with this journey. We're beginning to build powerful AI products like the ones I mentioned. We are rationalizing and modernizing some of the existing legacy products that have great market presence.

他們也為我們可以做得更好的地方提供了回饋。但很明顯，OptumInsight 中的傳統服務必須發展為 AI 優先服務，然後是產品，最終是平台。我們的旅程進展順利。我們開始建立像我提到的那樣的強大的人工智慧產品。我們正在對一些現有的、具有巨大市場佔有率的傳統產品進行合理化和現代化改造。

And then finally, we're investing in an AI-first workforce. Remember, I come from the tech role where we built 10,000 AI builders and we're building AI for sales teams. So we are investing, as earlier noted, in building, growing new products and offerings, and I'm incredibly excited about the possibilities. We want to simplify health care with AI and OptumInsight is the best company to do it. Thank you for the question.

最後，我們正在投資一支以人工智慧為先的勞動力隊伍。請記住，我來自技術領域，我們培養了 10,000 名 AI 建構者，並且正在為銷售團隊建立 AI。因此，正如前面所提到的，我們正在投資開發和發展新產品和新服務，我對這些可能性感到非常興奮。我們希望利用人工智慧簡化醫療保健，而 OptumInsight 是實現這一目標的最佳公司。謝謝你的提問。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

Thanks. First, let me congratulate and welcome Wayne back to the sector. Good to have you back. My question here is for Tim. Wanted to confirm, you talked about getting your commercial margins back to the 7% to 9% target range for 2027. Just wanted to make sure I heard that right.

謝謝。首先，我要祝賀並歡迎韋恩重返該行業。很高興你回來。我的問題是針對提姆的。想確認一下，您談到了 2027 年將商業利潤率恢復到 7% 到 9% 的目標範圍。只是想確認一下我聽得對不對。

And then in terms of the current baseline for '25, I'm kind of backing into a margin in the 3% to 5% range for Commercial, Tim. Is that in the right ballpark?

然後，就 25 年的當前基線而言，我認為商業利潤率將在 3% 到 5% 之間，Tim。這大概準確嗎？

Yes. Thanks, Justin, for the question. So the commercial business, as we've talked about for 2026 and as a result of our pricing actions, we'll make meaningful progress as you think about the work being done across the ACA and the other commercial products to chip away at a return to that 7.9% long-term margin. We view 2026 as a year where we're probably still 150 basis points below that low end of the margin. But again, given how the pricing is being received in the marketplace, some of the opportunities that we see around controlling our costs in the future, we still feel as though that longer-term margin range of 7% to 9% is attainable.

是的。謝謝賈斯汀提出這個問題。因此，正如我們談到的 2026 年商業業務以及我們的定價行動一樣，我們將取得有意義的進展，正如您考慮在 ACA 和其他商業產品中所做的工作以逐步實現 7.9% 的長期利潤率一樣。我們認為，到 2026 年，我們的利潤率可能仍將比該低端低 150 個基點。但是，考慮到市場對定價的接受程度，以及我們看到的未來​​控製成本的一些機會，我們仍然覺得 7% 到 9% 的長期利潤率範圍是可以實現的。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Just wanted to ask for some additional color on the membership declines you're expecting in Medicare Advantage in 2026. Can you help us think about the breakout between individual duals and group? And then at the industry level, CMS is expecting enrollment growth to be pretty flat in 2025? I guess, first, does the company agree with that assessment? And second, how are you thinking about the type of industry growth you might see as we move into 2027 and beyond.

只是想詢問一些有關您預計 2026 年 Medicare Advantage 會員人數下降的更多資訊。您能幫助我們思考個人對決和團體賽之間的突破嗎？那麼從產業層級來看，CMS 預計 2025 年入學人數成長將保持穩定嗎？我想，首先，公司是否同意這項評估？其次，您如何看待我們進入 2027 年及以後可能會看到的產業成長類型。

I think Bobby Hunter is best for this, go to it.

我認為 Bobby Hunter 最適合做這件事，去吧。

Yes. Great. Thanks, Stephen. So I'll hit the membership item first. Tim mentioned in the prepared remarks, approximately 1 million membership contraction for 2026 across MA. That does include both group and individual. Obviously, we've been pretty clear about the fact that we're exiting products impacting about 600,000 members. So think about that as kind of your first core element of how you build to that 1 million.

是的。偉大的。謝謝，史蒂芬。因此我首先要打會員項目。提姆在準備好的發言中提到，到 2026 年，馬薩諸塞州的會員人數將減少約 100 萬人。這確實包括團體和個人。顯然，我們已經非常清楚，我們正在退出的產品將影響大約 60 萬名會員。因此，請將其視為實現 100 萬目標的第一個核心要素。

And I would say the balance of the bridge to the full 1 million is pretty evenly split between the pressure inside of our group MA business as a result of taking a really disciplined approach to pricing there. some dislocation that will exist in the group customers as a result of some other more aggressive competitor actions.

我想說，實現 100 萬的平衡相當平均地分配在我們集團 MA 業務內部的壓力之間，這是因為我們對那裡的定價採取了非常嚴謹的方法，而由於其他一些更激進的競爭對手的行動，集團客戶中會出現一些混亂。

And then the other kind of 50% of that bridge from the 600,000 to the 1 million representing a pretty even split across our individual MA business. Obviously, really early in AEP at this point, but that's kind of the way I see it from this distance.

然後，從 60 萬到 100 萬的橋樑的另外 50% 代表了我們各個 MA 業務的相當均勻的分配。顯然，AEP 目前還處於早期階段，但從這個角度來看，我就是這麼認為的。

When you think about growth overall, I would expect 2026 to be probably more in line with the general progression and growth that we're seeing in 2025. And that's largely a result of continued benefit cuts in the marketplace, continued plan closures and then some disruption in the broker community related to pretty broad commission changes. I absolutely believe in the long-term growth potential of MA, and I think we can grow above those levels as you step out further.

當你考慮整體成長時，我預計 2026 年可能會與我們在 2025 年看到的整體進展和成長更加一致。這主要是由於市場福利持續削減、計劃持續關閉以及與相當廣泛的佣金變化相關的經紀人社區的一些混亂造成的。我絕對相信 MA 的長期成長潛力，並且我認為隨著我們進一步發展，我們可以超越這些水平。

Ultimately, right now, though, medical trend pressure is increasing the cost of health care and the funding cuts of the program are degrading choice, access and value to the consumer that's a real impact in the 35 million Medicare eligibles who rely on MA right now to make health care affordable. So still absolutely believe in the differentiated value proposition of MA but can I underscore the importance of stability in the program as we look to the longer-term growth rate and opportunity for MA. Thanks for the question.

但最終，目前醫療趨勢壓力正在增加醫療保健成本，而該計劃的資金削減正在降低消費者的選擇、獲取和價值，這對目前依賴 MA 來負擔醫療保健費用的 3500 萬醫療保險合格者產生了實際影響。因此，我仍然絕對相信 MA 的差異化價值主張，但當我們著眼於 MA 的長期成長率和機會時，我能否強調該計劃的穩定性的重要性。謝謝你的提問。

Kevin Fischbeck, Bank of America

凱文‧菲施貝克，美國銀行

Great. I was wondering if you could talk a little bit more about OptumHealth. The pullback in retrenchment, I guess, and the refocus on certain types of plans, I guess, if we went back a number of years, I would have thought that value-based care could potentially serve the majority of MA lives. I mean is there a TAM that you're thinking about? Like what -- if you look at the market today and numbers you want to focus on what percentage of MA really lends itself to a successful value-based care model? And I guess, how penetrated is that today?

偉大的。我想知道您是否可以再多談談 OptumHealth 的情況。我想，如果我們回顧幾年前的情況，我們會發現，裁員的減少以及對某些類型計劃的重新關注，基於價值的護理可能會服務於大多數 MA 的生活。我的意思是，您是否考慮過 TAM？例如——如果你看看今天的市場和數字，你想關注的是 MA 中有多少比例真正適合成功的基於價值的護理模式？我想，如今這種現象的滲透程度如何？

I'll have Krista respond to this, but I think we remain very positive and actually think MA should move more to value-based care and those themes just picking up exactly what Bobby said. So Krista, maybe you want to talk a little bit about the future of value-based care.

我會讓克里斯塔對此作出回應，但我認為我們仍然非常積極，實際上認為 MA 應該更多地轉向基於價值的護理，而這些主題正是鮑比所說的。那麼克里斯塔，也許你想談談基於價值的護理的未來。

Yes, absolutely. Kevin, thanks so much for the question. So as we mentioned in our opening remarks, we are deeply committed to value-based care and research continues to validate the impact that it can have. We know fee-for-service rewards volume. We know that value-based care aligns incentives. And when you look across OptumHealth, we've got an incredible set of assets that really enable an integrated delivery system to create value in the market that we are focused in.

是的，絕對是。凱文，非常感謝你的提問。正如我們在開場白中提到的那樣，我們堅定地致力於基於價值的護理，並且研究將繼續驗證其可能產生的影響。我們知道按服務收費的獎勵金額。我們知道基於價值的護理可以協調激勵措施。縱觀 OptumHealth，我們擁有一套令人難以置信的資產，這些資產真正使整合交付系統能夠在我們關注的市場中創造價值。

And so I just think about the potential. It really is limitless. I think what you're seeing from us is a focus and operating discipline and really kind of getting back to some of our core so that we are able to expand and grow in the future. And we're really deepening our presence in the markets. We're focused on the appropriate network on the appropriate providers on the appropriate risk footprint portfolio so that we are positioned for long-term success inside value-based care.

所以我只是考慮潛力。它確實是無限的。我認為您從我們這裡看到的是一種專注和營運紀律，並且真正回歸到我們的一些核心，以便我們能夠在未來擴展和發展。我們確實正在深化我們在市場上的影響力。我們專注於適當的網路、適當的提供者和適當的風險足跡組合，以便我們在基於價值的照護領域取得長期成功。

Which implies you have to have an aligned to the right products. You have to have it aligned to the right processes and disciplines, and that alignment is really what we're returning to. So good question.

這意味著您必須選擇正確的產品。您必須使其與正確的流程和學科保持一致，而這種一致性正是我們要回歸的。這個問題問得好。

George Hill, Deutsche Bank.

德意志銀行的喬治·希爾。

Yes. We saw a pretty significant step up in what I would call discretionary expenses in the quarter compared to Q2. You talked a lot about the need for investment in a lot of the business lines. I guess as you think about those numbers, can you talk about -- can you quantify the step-up in investments that were incurred in Q3? And how much of those should we think of as run rate investments versus onetime investments where we'll see leverage going forward?

是的。與第二季相比，本季的可自由支配支出出現了相當顯著的成長。您多次談到許多業務線的投資必要性。我想，當您考慮這些數字時，您能談談—您能量化第三季發生的投資成長嗎？其中有多少是我們應該視為運行率投資，有多少是一次性投資（未來我們將看到槓桿作用）？

Sure. Wayne, just take it.

當然。韋恩，拿著吧。

Yes. Thanks, George. I would say of the $450 million plus that we discussed, about one-third of that is a commitment to our foundation, which had not been funded at the levels that it should have been in the past and clearly puts us on a runway for multiple years of activities around the foundation. So view it as not necessarily run rate into next year, but nonetheless, something that we believe is part of our encoring core, and we'll continue to do it in the outer years.

是的。謝謝，喬治。我想說，在我們討論的 4.5 億美元以上中，大約有三分之一是對我們基金會的承諾，過去基金會的資助水平並沒有達到應有的水平，這顯然為我們在基金會開展多年的活動奠定了基礎。因此，我們認為這不一定是明年的運行率，但儘管如此，我們相信這是我們核心的一部分，我們將在未來幾年繼續這樣做。

The delta of that then is all investments in our people. You heard Sandeep talk a bit about OptumInsight, and that cultivated with the number of resources we have there and aligning incentives around the execution that we expect. So I would view much of that as being recurring in nature, part of our core business and the investments we'll continue to make in the expansion that we see both in OptumHealth and in AI specifically.

那麼，其中的增量就是對我們員工的所有投資。您聽到 Sandeep 談論了一些有關 OptumInsight 的事情，以及我們在那裡擁有的資源數量以及圍繞我們預期的執行情況調整激勵措施。因此，我認為其中很大一部分是重複性的，是我們核心業務的一部分，也是我們將繼續在 OptumHealth 和 AI 領域進行擴張的投資。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾。

I just had a question around utilization and how to think about it here in the back half of the year. Clearly, this quarter came in a little bit better than what we were expecting, but we're looking at what's happening with the exchanges looking at the step-up in Part D. So can you maybe just talk about your expectation going into the fourth quarter? And specific to Part D, are you expecting a big step-up as we think about the fourth quarter?

我只是對利用率以及如何在今年下半年考慮它有一個疑問。顯然，本季的表現比我們預期的要好一些，但我們正在關注交易所的情況，並關注 D 部分的成長。那麼您能否談談您對第四季的預期？具體到 D 部分，您是否預期第四季會大幅成長？

Tim, do you want to take this?

提姆，你想接受這個嗎？

Yes. Thanks, Lisa, for the question. So as I think about utilization, really tracking in line with the expectations that we called out in last quarter's call, really across all of the product lines, the general commercial business, including the ACA as well as Medicare and Medicaid. And also on the Part D portion of the business, also tracking in line with expectations.

是的。謝謝麗莎提出這個問題。因此，當我考慮利用率時，它確實符合我們在上個季度的電話會議上提出的預期，涵蓋所有產品線、一般商業業務，包括 ACA 以及醫療保險和醫療補助。D 部分業務也符合預期。

Clearly, there is quite a bit of seasonality that's always at play in the health insurance business. I think you can think of normal seasonality, first half to second half as 60% in the first half in terms of earnings contribution, 40% in the second half.

顯然，健康保險業務總是受到相當大的季節性影響。我認為你可以認為這是正常的季節性，上半年到下半年的獲利貢獻為上半年的 60%，下半年的 40%。

This year, given some of the trends that we've seen, a little bit more of a bias towards earnings in the first half of the year versus the second half of the year, but really kind of trends tracking with how we expected them to track, consistent with what we guided in the second quarter and the seasonality really just kind of a byproduct of the business. And also some of the additional spend that we have on things like a seasonal ramp in AEP with respect to Medicare.

今年，鑑於我們所看到的一些趨勢，我們對上半年的盈利的偏向性要大於對下半年的盈利的偏向性，但實際上趨勢與我們預期的趨勢一致，與我們在第二季度的指導一致，季節性實際上只是業務的一種副產品。此外，我們還在醫療保險方面的 AEP 季節性成長等方面增加了一些額外支出。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

I wanted to follow up on the Medicare Part D drug benefit for next year. It looks like the benefit for Tier 3 branded drugs changed from a co-pay to coinsurance across most of your MAPD and stand-alone Part D plans. Can you elaborate on your experience with the co-pay structure in 2025? And what drove that decision to change the benefit structure in 2026?

我想跟進明年的醫療保險 D 部分藥物福利。看起來，在大多數 MAPD 和獨立的 D 部分計劃中，第 3 級品牌藥物的福利已從共同支付變為共同保險。您能詳細說明一下您對 2025 年共同支付結構的經驗嗎？那麼，是什麼促使我們做出 2026 年改變福利結構的決定呢？

Yes. Andrew. So I would say just kind of big picture, we take a multiyear metered approach to our benefit planning that includes, as you can appreciate, managing and balancing many different variables, and that's particularly important given the dynamics around V28 and the phased approach there. The other element, perhaps, just to kind of call out as you think about how we decided the modifications to make the benefit design for Part D in particular.

是的。安德魯。因此，我想說，從總體上看，我們對我們的福利規劃採取了多年計量的方法，其中包括管理和平衡許多不同的變量，考慮到 V28 周圍的動態和分階段的方法，這一點尤其重要。另一個因素，也許，只是在您思考我們如何決定修改以特別針對 D 部分進行福利設計時需要指出的。

For 2026 with some uncertainty around the demo program and how that would continue to persist or not into 2026. So we took what we felt was an appropriately kind of cautious approach there, pulling all the levers available to us to ensure that we would be well positioned on the overall benefit design regardless of how the demo came into 2026.

對於 2026 年的演示計劃以及其是否會持續到 2026 年存在一些不確定性。因此，我們採取了我們認為適當的謹慎態度，利用一切可用資源來確保無論 2026 年的演示結果如何，我們都能在整體福利設計上處於有利地位。

So as I look now kind of where we sit from a benefit design standpoint with the coinsurance we have on Tier 3, the deductibles that we have kind of broadly across MAPD and I feel pretty aligned to industry there. And I would expect us to have continued good performance as we step then into 2026. As it relates to '25, really on the MAPD side, no concerns around selection, mix or outlook given the prevalence of deductibles that we put on our MAPD offerings. And on PDP, really kind of no material contributor or risk to rest of your outlook on that one either. So overall, feel pretty good about how we're stepping into '26 on PDP.

因此，我現在從福利設計的角度來看待我們在第 3 層級的共同保險，以及我們在 MAPD 範圍內廣泛的免賠額，我覺得這與那裡的行業非常一致。我希望我們在 2026 年能夠繼續保持良好的表現。就 '25 而言，實際上在 MAPD 方面，考慮到我們在 MAPD 產品中設定的免賠額的普遍性，無需擔心選擇、組合或前景。而對於 PDP 而言，實際上對你的其他展望也沒有任何實質的貢獻或風險。所以總的來說，對於我們如何在 PDP 上邁入 26 年，我感覺相當不錯。

Ann Hynes, Mizuho Securities.

安‧海因斯 (Ann Hynes)，瑞穗證券。

Great. My question is focused on Medicaid. On the last call, I believe, you said margins should be in the negative 1% to negative 1.5% range. Is that still a good bogey. And just like looking with the One Big Beautiful Bill, is there anything that would prevent like a path to Medicaid margin recovery in 2007 and 2028?

偉大的。我的問題主要集中在醫療補助。我相信，在上次通話中，您說過利潤率應該在-1%到-1.5%的範圍內。這還是一個好的柏忌嗎？就像《一項偉大的美麗法案》一樣，有什麼因素會阻礙 2007 年和 2028 年醫療補助利潤率的恢復嗎？

Mike, do you want to take that?

麥克，你想接受這個嗎？

Yes, Ann, thanks for the question. As Tim indicated, our view for Medicaid has not changed from last quarter. We expect breakeven in 2026 as we are in 2025. As we think about 2026, we expect some margin degradation due to the continued dislocation of premium funding and what we're seeing in terms of elevated medical cost trends. But we do see 2026 as the trough for that performance.

是的，安，謝謝你的提問。正如蒂姆所指出的，我們對醫療補助的看法與上個季度相比沒有改變。我們預計 2026 年將實現收支平衡，就像 2025 年一樣。展望 2026 年，我們預期利潤率會有所下降，這是由於保費融資的持續混亂以及醫療成本趨勢的上升。但我們確實認為 2026 年將是這一表現的低谷。

Our elevated trends are driven as the industry has by specialty pharmacy, behavioral health and also as we look at home health services. We think, over time, the One Big Beautiful Bill, there will be some transformation and work as we collaborate with states. But we see over time about an 18- to 24-month period, we will be able to return to a rate of margins. of around 2%.

我們的上升趨勢是由行業專業藥房、行為健康以及家庭保健服務所推動的。我們認為，隨著時間的推移，隨著我們與各州的合作，「一個美麗的大法案」將會發生一些轉變並發揮作用。但我們看到，大約 18 到 24 個月後，我們的利潤率將能夠恢復到 2% 左右。

Lance Wilkes, Bernstein.

蘭斯威爾克斯、伯恩斯坦。

Great. Could you talk a little bit about the employer market? And specifically, what's the medical cost trends you're seeing this year and next? And given the pressures on employers, what are some of the strategies they're looking at for the '26 and looking out to '27 on the selling seasons, in particular, any interest in adoption of value-based care? Are they using more Surest, things like that?

偉大的。能談談雇主市場嗎？具體來說，您認為今年和明年的醫療費用趨勢如何？考慮到雇主面臨的壓力，他們針對 26 年和 27 年的銷售旺季考慮了哪些策略，特別是對採用基於價值的照護有什麼興趣？他們是否使用了更多 Surest 之類的產品？

Dan?

擔？

Yes. Thanks, Lance, for the question. Trends for 2025 and our outlook for 2026 remain in line with what we shared in the guidance last quarter. Trends are approximately 11%, and that is how we have priced into 2026, and I'll just share that with 50% of our January insured business resolved at this point, encouraged by both the yield on persistency and rate to deliver the margin expansion that Tim spoke about in light that trend of approximately 11%.

是的。謝謝 Lance 提出的問題。2025 年的趨勢和我們對 2026 年的展望與我們上個季度的指導意見中分享的內容一致。趨勢約為 11%，這就是我們對 2026 年的定價方式，我只想分享一下，目前我們 1 月份保險業務的 50% 已經得到解決，這受到持續性收益率和利率的鼓舞，以實現 Tim 所說的利潤率擴張，因為趨勢約為 11%。

You're right, health care affordability is top of mind for all employers and we hear that this selling and renewal season, as we always do, but even a little bit louder given the trends and the pricing associated with it. Employers are evaluating a host considerations you referenced, Surest and Surest continues to be a leading product for us, continuing to capture share. And that has continued to grow and has a robust pipeline already as we look toward the jumbo selling season of 2027.

您說得對，醫療保健的可負擔性是所有雇主最關心的問題，我們聽說這個銷售和續約季節和往常一樣，但考慮到趨勢和相關的定價，這種關注度甚至更高。雇主正在評估您提到的一系列考慮因素，Surest 和 Surest 仍然是我們的主導產品，繼續佔據市場份額。當我們展望 2027 年的大型銷售季節時，這一數字仍在繼續增長，並且已經擁有強大的銷售管道。

I might highlight some additional things that employers are looking at as well. Integrated advanced advocacy solutions that we sell in our product portfolio continue to capture employer attention as they help us bring together more synergistic approaches to care.

我可能會強調雇主也在關注的一些其他事項。我們在產品組合中銷售的整合式高級宣傳解決方案繼續吸引雇主的關注，因為它們幫助我們整合更具協同作用的護理方法。

That includes value-based care, as you referenced, tighter coordination between medical benefits and Rx benefits which employers are continuing to do on an increasing basis as we see more and more employers moving to combining medical and Rx benefits and satisfied very much so with how we're advancing in that way with OptumRx. So those are a couple of highlights that I would offer that are on top of mind for employers certainly for 2026 and already as we look forward into 2027. Thanks for the question, Lance.

正如您所提到的，這包括基於價值的護理，醫療福利和 Rx 福利之間的更緊密協調，隨著我們看到越來越多的雇主開始將醫療和 Rx 福利結合起來，雇主正在繼續越來越多地這樣做，並且對我們通過 OptumRx 以這種方式取得的進展感到非常滿意。因此，這些是我想提出的幾個要點，對於 2026 年以及展望 2027 年而言，這些要點都是雇主最關心的問題。謝謝你的提問，蘭斯。

Scott Fidel, Goldman Sachs.

高盛的史考特·菲德爾。

I appreciate the update on the capital deployment timing returning to the normal plan. Can you also just update us on sort of the dividend and what your our view is on the dividend and that looking forward.

我很欣賞有關資本部署時間恢復正常計劃的最新消息。您能否向我們介紹一下股息的情況以及您對股息和未來的看法。

And then curious just around -- I know that there's going to need to be possibly some portfolio rationalizations occurring in OptumHealth and other businesses as you pursue the new approach. Is there a way that you can sort of frame that for us in terms of, I don't know, whether it's sort of revenue or just more philosophically, how you're thinking about the asset base in OH and maybe more broadly around where -- and around potential rational dates that could occur.

然後我很好奇——我知道，隨著你們推行新方法，OptumHealth 和其他企業可能需要進行一些投資組合合理化。您是否可以從收入的角度，或者更哲學的角度，為我們解釋一下這個問題，您如何看待俄亥俄州的資產基礎，以及更廣泛地說，圍繞可能發生的潛在合理日期。

Sure. The dividend will start with Wayne and then I'll start with the Optum and give it to Krista and to Patrick. So Wayne?

當然。紅利將從韋恩開始，然後我將從 Optum 開始，並將其分配給克里斯塔和帕特里克。那麼韋恩？

Thanks, Steve. Scott. There are no changes in our historical dividend practices nor do we expect those to change going forward. We will maintain the dividend as we've done the next prioritization as we're paying down debt will then revert back to the buyback program and then our strategic acquisition. So view it as no changes and then hopefully back into our normal capital deployment activities back half of next year.

謝謝，史蒂夫。斯科特。我們的歷史股利做法沒有變化，我們也不期望這些做法在未來會改變。我們將維持股息，因為我們已經完成了下一個優先事項，因為我們正在償還債務，然後將恢復回購計劃，然後進行策略性收購。因此，可以將其視為沒有變化，然後希望明年上半年能夠恢復正常的資本部署活動。

And then just broadly, related to OptumHealth, helping people understand, we are very much committed to this. We are just reshaping it back to the way we had originally conceived it and believe that it has the most impact on value and we're really just taking the right steps to bring that back into form so that we can really move and grow and advance it in the construct of that disciplined model we had going forward. So Krista, do you want to talk a little bit about that?

然後從廣義上講，與 OptumHealth 相關，幫助人們理解，我們非常致力於此。我們只是將它重塑回我們最初設想的樣子，並相信它對價值的影響最大，我們實際上只是採取正確的步驟將其恢復原狀，以便我們能夠真正地在構建我們前進的規範模型中前進、成長和推進它。那麼克里斯塔，你想談談這個嗎？

Yeah, I can just add to that. Thanks for the question. So yeah. So Scott, as Steve mentioned, we are really kind of taking a look at the whole like integrated delivery system. We have a combination of value-based care assets, some assets that are focused more on fee-for-service, but truly enable that value-based care agenda. And it's really important to ensure that kind of integrated model can deliver the best outcomes.

是的，我可以補充一點。謝謝你的提問。是的。所以斯科特，正如史蒂夫所提到的，我們確實在研究整個整合交付系統。我們擁有基於價值的護理資產組合，其中一些資產更側重於按服務收費，但真正實現了基於價值的護理議程。確保這種綜合模型能夠產生最佳結果非常重要。

And so as we're thinking about the portfolio rationalization, we taking into account a combination of things like where we have the right clinical quality, where we have the best operating cost performance, where we have the right engagement and where that model can really be brought to life for both value-based and those kind of fee-for-service service lines as well.

因此，當我們考慮投資組合合理化時，我們會綜合考慮多種因素，例如我們在哪裡擁有正確的臨床質量，我們在哪裡擁有最佳的營運成本績效，我們在哪裡擁有正確的參與度，以及該模型在基於價值的服務線和按服務收費的服務線中真正發揮作用。

And so I think those are the ways in which we're kind of looking at the model. So it's a market focus. We are looking at rooftops. We are again looking at the populations, the risk, the products. And I think through all of that, there will be an output of some actions that we'll take in the near term to position us for long-term success of that integrated model.

所以我認為這就是我們看待模型的方式。所以這是一個市場焦點。我們正在看屋頂。我們再次關注人口、風險和產品。我認為，透過所有這些，我們將在短期內採取一些行動，為該綜合模式的長期成功做好準備。

Likely withdraw from a few geographic markets, likely reshape the practices within certain markets where we remain, likely shape, let's say, the primary delivery system along line with the complementary services, things along those that nature, all very logical, all actually more constructive, but to be constructive, sometimes you have to take some things away. And Brian?

可能會退出一些地理市場，可能會重塑我們仍保留的某些市場的做法，可能會塑造主要的交付系統以及補充服務，這些事情的本質都非常合乎邏輯，實際上都更具建設性，但為了具有建設性，有時你必須拿走一些東西。還有布萊恩？

In the -- to add one point across Optum and connect a couple of questions. In the face of escalating cost trends, what we hear from our payer partners, from employers and from patients and providers as they want a value-based care system that delivers better quality, better experience and lower cost of care. And that's what Optum is delivering to our various customers.

在——在 Optum 上新增一個點並連接幾個問題。面對不斷上升的成本趨勢，我們從付款合作夥伴、雇主以及患者和提供者那裡聽到的消息是，他們希望建立一個基於價值的護理系統，提供更好的品質、更好的體驗和更低的護理成本。這就是 Optum 向我們的各個客戶提供的服務。

Erin Wright, Morgan Stanley.

艾琳·賴特，摩根士丹利。

Great. So I have a follow-up on that front. Is there anything you can quantify or break down for us in terms of those steps to turn around OptumHealth? Like how much is just walking away from risk? How much is fixing the fee-for-service business? And presumably, that could be addressed a little bit quicker, right? And how much is just integrating into a consolidated operating model?

偉大的。因此，我對這方面有後續行動。您能否為我們量化或分解扭轉 OptumHealth 局面所需的步驟？比如說，多少才算逃避風險？搞定收費服務業務要多少錢？而且大概可以更快解決這個問題，對嗎？那麼有多少只是融入了合併營運模式呢？

And then what sort of incremental investments that you can quantify at this point that needs to go into that business as well? Presumably, does this all get you to 6% to 8% margin in 2028 and it's just back end weighted. Is that the right way to think about it?

那麼，您現在可以量化哪些類型的增量投資需要投入該業務？據推測，這一切是否會讓您在 2028 年獲得 6% 到 8% 的利潤率，而且這只是後端加權。這是正確的思考方式嗎？

I think directionally, I don't think we can achieve the level of precision you might be looking for something like that just because this does blend together. But Krista, do you want to respond.

我認為從方向上看，我認為我們無法達到你所尋求的那種精確度，只是因為它們確實融合在一起了。但是克里斯塔，你想回應嗎？

Yeah, thanks for the question, Erin. So let me just kind of start where you ended, which is likely more back half weighted, but you should expect progress throughout here. And while we might see faster progress in some fee-for-service improvement, Patrick highlighted whether that's kind of productivity or scheduling or improving access or collection rate. you will also start to see some progress on our value-based portfolio as well.

是的，謝謝你的提問，艾琳。因此，讓我從您結束的地方開始，這很可能是後半部分的加權，但您應該期待在這裡取得進展。雖然我們可能會看到某些按服務收費改進方面取得更快的進展，但帕特里克強調，這是否是一種生產力或調度或改善訪問或收集率。您還將開始看到我們基於價值的投資組合取得一些進展。

So think of things like medical management, the work we're doing with our payers, the work we're doing to curate our network, also the work we're doing to manage operating cost discipline. So these things really all come together in this integrated model, but maybe some faster progress in certain areas while you'll still continue to see kind of progress against the holistic model.

所以想想醫療管理之類的事情，我們與付款人一起做的工作，我們為管理網路所做的工作，以及我們為管理營運成本紀律所做的工作。因此，這些事情實際上都在這個綜合模型中結合在一起，但在某些領域可能會取得更快的進展，而你仍然會繼續看到相對於整體模型的進展。

But for example, you kind of -- a little bit of further ahead in the Eastern region on this and seeing some impact on that, and that's a good example of how this will progress, right? So a pickup in terms of volume there, greater capture, greater reach.

但是，例如，你有點 - 東部地區在這方面稍微領先一點，並且看到了一些影響，這是這將如何發展的一個很好的例子，對嗎？因此，就數量而言，那裡有所回升，捕獲量更大，覆蓋範圍更大。

Dave Windley, Jefferies.

戴夫溫德利 (Dave Windley)，傑富瑞 (Jefferies)。

My question is related somewhat. But I think earlier in the call, you quantified that half of your headwind, I think the V28 headwind for 2026, you plan to mitigate through recontracting. And I wanted to make sure I understood, is that across the portfolio of payers? Are you mostly harvesting that from the UHC portion, the non-UHC portion? And then is the -- did I hear correctly that VBC lives you expect to decline by 10%. Is that interwoven in that at all?

我的問題有點相關。但我認為在早些時候的通話中，您量化了一半的逆風，我認為是 2026 年的 V28 逆風，您計劃通過重新簽約來緩解。我想確保我理解了，這是否適用於所有付款人？您主要從 UHC 部分還是非 UHC 部分獲取這些嗎？然後是——我是否正確聽過，您預計 VBC 壽命將下降 10%。這和那有什麼關係嗎？

So Krista, do you want to respond?

那麼克里斯塔，你想回應嗎？

Yes, absolutely. So yes, so -- like Patrick mentioned, so we sought to overcome half of the V28 headwind through our payer contracting efforts, which would include all payers. And we have completed that, and we're about 90% complete with our contracting with line of sight to the rest by the end of the year. So I feel good about that. That encompasses rates as well as product and benefits. And we've talked a little bit about some market exits inside of that. So exiting more than 40% of our PPL footprint was also kind of part of that exercise, but again, across all of our payers.

是的，絕對是。是的，就像帕特里克提到的那樣，我們試圖透過付款人承包努力（包括所有付款人）來克服一半的 V28 阻力。我們已經完成了這項工作，到今年年底，我們的合約已完成約 90%，其餘部分也將完成。所以我對此感覺很好。這包括費率以及產品和福利。我們已經討論過其中的一些市場退出問題。因此，退出超過 40% 的 PPL 足跡也是該活動的一部分，但同樣，涉及我們所有的付款人。

And then you asked about membership as well with the approximately 10% reduction as we pace into next year. again, we probably will see even some additional PPO exit as part of the work we continue to do with all of our payers and the work that we're going to do to finish that work. But then that would be just really a direct result of actions we're taking to optimize our portfolio. So again, products, market, footprint and the risk that is appropriate for this model.

然後您也詢問了會員人數，隨著我們進入明年，會員人數將減少約 10%。同樣，我們可能會看到一些額外的 PPO 退出，這是我們繼續與所有付款人合作的工作的一部分，也是我們為完成這項工作而要做的工作的一部分。但這實際上只是我們為優化投資組合而採取的行動的直接結果。所以再次強調，產品、市場、足跡和風險都適合這個模式。

Leaning to products that lend themselves to management.

傾向於適合管理的產品。

Exactly.

確切地。

Jessica Tassan, Piper Sandler.

傑西卡·塔桑、派珀·桑德勒。

Can you describe just the tone of any recent conversations you may have had with CMS their receptivity and posture towards MA. What do you think CMS is focused on from a Star's risk adjustment and MA rate perspective? And what is UHC lobbying for?

您能否描述一下您最近與 CMS 進行的任何對話的語氣以及他們對 MA 的接受度和態度。從 Star 的風險調整和 MA 利率角度來看，您認為 CMS 的重點是什麼？那麼 UHC 遊說的目的是什麼？

You guys can decide which one to respond to that. We're not lobbying for anything in particular. So please?

你們可以決定對哪一個做出回應。我們並沒有在為任何特定的事情進行遊說。那麼請問？

Yes. Thanks, Jessica, for the question. As I think about CMS receptivity, we've been encouraged and continue to be very encouraged of the receptivity of this administration to have conversations with industry about ways to modernize and ways to improve this already very popular program. This is in direct contrast to what we experienced over the previous administration.

是的。謝謝傑西卡提出這個問題。當我思考 CMS 的接受度時，我們感到鼓舞，並將繼續受到鼓舞，因為本屆政府的接受度很高，可以與業界討論如何現代化以及如何改進這個已經非常受歡迎的項目。這與我們上一屆政府所經歷的形成了鮮明對比。

And we've always enjoy and appreciate the efforts to be able to have these fact-based conversations around how to modernize the program and feel like that's the best way to get to constructive answer and a constructive way to move forward.

我們一直很享受並讚賞能夠就如何使該計劃現代化進行這些基於事實的對話的努力，並認為這是獲得建設性答案和建設性前進的最佳方式。

So encouraged again on just the level of activity and the level of conversation that we have with the administration, and we'll continue to do that and continue to bring to them ideas that we think are ideas that are the best path forward that provides some level of stability for beneficiaries and also modernize the program in the process.

因此，我們再次鼓勵大家關注我們與政府之間的活動水平和對話水平，我們將繼續這樣做，並繼續向他們提出我們認為是最佳前進道路的想法，為受益人提供一定程度的穩定性，並在此過程中實現計劃的現代化。

Yeah, absolutely. So we have time for one question remaining.

是的，絕對是。所以我們還有時間回答最後一個問題。

Whit Mayo, Leerink Partners.

惠特·梅奧 (Whit Mayo)，Leerink Partners。

All right. Tim, I was just hoping that you could comment more on the provider coding stuff that you were talking about. We hear pushback on that for many health systems. And then maybe any observations that you could share on the independent dispute resolution process and actions you're taking there or the impact on trend.

好的。提姆，我只是希望你能對你正在談論的提供者編碼內容發表更多評論。我們聽到許多衛生系統對此表示反對。然後，也許您可以分享一些關於獨立爭議解決流程和您採取的行動或對趨勢的影響的觀察。

Yeah. Thanks for the question, Whit. So when I think about some of what we're seeing in trend, there certainly is a meaningful portion of it that is related to more service intensity per encounter being built by health systems and by providers.

是的。謝謝你的提問，惠特。因此，當我思考我們所看到的一些趨勢時，其中肯定有很大一部分與醫療系統和醫療服務提供者正在建立的每次就診的更高服務強度有關。

Some of the ways that's coming through are higher-cost sites of service where lower costs are available, think, lab, think ER and surgery. I'm also seeing more services being attached to ER visits and hospital visits, an increase in the number of specialists that are rounding per inpatient days and then a bias towards some higher DRG weighting than we've seen in the past. And it is happening fairly consistently across the country, but then also have some very significant outliers.

實現這一目標的方法之一是將成本較高的服務場所轉變為成本較低的場所，例如實驗室、急診室和手術室。我還看到更多的服務與急診室就診和醫院就診相關，按住院天數巡診的專家數量有所增加，並且與過去相比，出現了對更高 DRG 權重的傾向。這種情況在全國各地相當普遍，但也存在一些非常明顯的異常現象。

And one part of what we're doing is we are addressing these outliers. We have to. We have to keep medical costs and health care affordable for consumers, [portable] for states, the federal government. So we will be taking some network actions where we need you to keep health care affordable. We're also making more use of AI in our payment integrity programs, increasing some of our payment policy efforts as well as our clinical affordability programs to address some of what we're seeing.

我們正在做的工作之一就是解決這些異常值。我們必須。我們必須確保醫療費用和醫療保健對消費者來說是可以負擔的，對各州和聯邦政府來說是可以負擔的。因此，我們將採取一些網路行動，以確保醫療保健費用能夠負擔得起。我們還在支付誠信計劃中更多地使用人工智慧，加強一些支付政策力度以及臨床可負擔性計劃，以解決我們看到的一些問題。

As I think about the IDR process, it's not something that would spike out in terms of a material trend driver from this distance, but certainly something that we're keeping an eye on pretty carefully.

當我思考 IDR 過程時，我認為從這個距離來看，它不會成為突出的物質趨勢驅動因素，但肯定會是我們正在密切關注的事情。

Great. So thanks, great conversation today. That's all we really have time for. I want to thank you all for joining us, and we look forward to talking with you again and engaging with you before we get to January. And in January, we will provide both our year-end results as well as guidance for 2026. So thank you all for joining us this morning.

偉大的。謝謝，今天的談話很愉快。我們真正有時間做的就這些。我要感謝大家的參與，我們期待在一月到來之前再次與你們交談並進行交流。明年一月份，我們將公佈年終業績以及 2026 年的預期。感謝大家今天早上加入我們。