聯合健康 (UNH) 2022 Q1 法說會逐字稿

Good morning, and welcome to the UnitedHealth Group First Quarter 2022 Earnings Conference Call. A question-and-answer session will follow UnitedHealth Group's prepared remarks. And as a reminder, this call is being recorded.

早上好，歡迎參加聯合健康集團 2022 年第一季度收益電話會議。問答環節將在聯合健康集團準備好的評論之後進行。提醒一下，這個電話正在被錄音。

Here are some important introductory information. This call contains forward-looking statements under U.S. federal securities laws. These statements are subject to risks and uncertainties that could cause the actual results to differ materially from the historical experience or present expectations. A description of some of the risks and uncertainties can be found in the reports that we file with the Securities and Exchange Commission, including the cautionary statements included in our current periodic filings.

以下是一些重要的介紹性信息。本次電話會議包含美國聯邦證券法下的前瞻性陳述。這些陳述受到風險和不確定性的影響，可能導致實際結果與歷史經驗或當前預期存在重大差異。一些風險和不確定性的描述可以在我們提交給證券交易委員會的報告中找到，包括我們當前定期提交的警告聲明。

This call will also reference non-GAAP amounts, a recorrelation of the non-GAAP to the GAAP amounts available on the financial and earnings reports section of the company's Investor Relations page at www.unitedhealthgroup.com. Information presented on this call is contained in the earnings release we issued this morning in our Form 8-K dated April 14, 2022, which will be accessed from the Investor Relations page of the company's website.

本次電話會議還將參考非 GAAP 金額，即非 GAAP 與公司投資者關係頁面 www.unitedhealthgroup.com 的財務和收益報告部分中可用的 GAAP 金額的相關性。本次電話會議中提供的信息包含在我們今天上午在 2022 年 4 月 14 日的 8-K 表中發布的收益報告中，該報告可從公司網站的投資者關係頁面訪問。

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

我現在將把會議轉交給聯合健康集團的首席執行官 Andrew Witty。請繼續。

Thank you. Good morning, and thank you all for joining us today. Coming into this quarter, we set clear objectives for the year: To drive strong execution of our long-term strategy and deliver high-quality diversified growth; pursue excellence in every consumer experience and at every touch point; and apply technology to help all stakeholders to improve access, affordability, outcomes and experiences. As our results show, we're delivering on these objectives.

謝謝你。早上好，感謝大家今天加入我們。進入本季度，我們制定了明確的年度目標：推動長期戰略的有力執行，實現高質量的多元化增長；在每一個消費者體驗和每一個接觸點追求卓越；並應用技術幫助所有利益相關者改善可及性、可負擔性、成果和體驗。正如我們的結果所示，我們正在實現這些目標。

I would like to start this morning's call by thanking my colleagues, the 350,000 people of Optum and UnitedHealthcare. Their dedicated work gives us the confidence today to increase our 2022 adjusted earnings per share outlook to a range of $21.20 to $21.70 per share.

我想以感謝我的同事、Optum 和 UnitedHealthcare 的 350,000 名員工開始今天上午的電話會議。他們的專注工作使我們今天有信心將 2022 年調整後的每股收益展望提高到每股 21.20 美元至 21.70 美元的範圍。

At our November investor conference, we described 5 key areas to drive our long-term 13% to 16% earnings per share growth rate. In the first area, value-based care delivery, OptumHealth continued its robust momentum into the first quarter, characterized by its integrated approach and high clinical quality. After a strong start to the year, we now expect to add 600,000 patients under value-based arrangements during 2022 compared to our initial estimate of 500,000. Our approach focuses on providing quality care in the setting that makes most sense for the patients we serve. Our pending combination with LHC Group will reinforce our ability to deliver care and support in the home as well as in other ambulatory locations.

在我們 11 月的投資者會議上，我們描述了推動我們長期 13% 至 16% 的每股收益增長率的 5 個關鍵領域。在第一個領域，基於價值的護理服務，OptumHealth 在第一季度繼續保持強勁勢頭，其特點是其綜合方法和高臨床質量。在今年開局強勁之後，我們現在預計 2022 年將在基於價值的安排下增加 600,000 名患者，而我們最初估計為 500,000 名。我們的方法側重於在對我們服務的患者最有意義的環境中提供優質護理。我們即將與 LHC 集團的合併將加強我們在家中以及其他門診地點提供護理和支持的能力。

Within the second growth area, health benefits, we're rapidly advancing the quality, innovation and consumer appeal of our plan offerings and bringing value-based care to scale. In Medicare Advantage, our strategic balance of benefit stability and enhancements once again helped to deliver strong growth. We remain well on track to serve an additional 800,000 people in 2022, consistent with the expectations we set last November.

在第二個增長領域，健康福利，我們正在迅速提升我們計劃產品的質量、創新和消費者吸引力，並將基於價值的護理規模化。在 Medicare Advantage 中，我們在福利穩定性和增強方面的戰略平衡再次幫助實現了強勁增長。我們仍有望在 2022 年為額外的 800,000 人提供服務，這與我們去年 11 月設定的預期一致。

In the commercial benefits market, our innovative offerings such as physician-led and virtual-first plans have grown to serve 350,000 more people over the past year. This underscores the consumer appeal for these high-quality primary care-based coverage options. Nearly 90% of newly enrolled people in our individual exchange offerings selected plans with significant virtual components in the most recent open enrollment period, and nearly 30% selected a virtual-first offering. You'll see us expand such offerings as we look forward to 2023.

在商業福利市場，我們的創新產品（例如以醫生為主導的計劃和虛擬優先計劃）在過去一年中已經發展到為 350,000 多人提供服務。這凸顯了消費者對這些基於初級保健的高質量保險選擇的吸引力。在我們的個人交換產品中，近 90% 的新註冊人員在最近的開放註冊期間選擇了具有重要虛擬組件的計劃，近 30% 的人選擇了虛擬優先產品。您會看到我們在期待 2023 年擴展此類產品。

In our third growth area, health technology, we continue to execute on the major new health system partnerships initiated last year, including a broad relationship with SSM Health and its 11,000 providers caring for people throughout the Midwest. We are helping our health system partners alleviate administrative burdens and create an operational capacity for these organizations to focus on delivering high-quality patient care and experiences. These partnerships move far beyond traditional revenue cycle management with both clinical and technology features becoming important.

在我們的第三個增長領域，衛生技術，我們繼續執行去年啟動的主要新衛生系統合作夥伴關係，包括與 SSM Health 及其在中西部地區照顧人們的 11,000 家供應商的廣泛關係。我們正在幫助我們的衛生系統合作夥伴減輕行政負擔，並為這些組織創造運營能力，以專注於提供高質量的患者護理和體驗。這些合作夥伴關係遠遠超出了傳統的收入周期管理，臨床和技術特徵變得越來越重要。

Fourth, our developing efforts in health financial services, streamlining and simplifying payments for providers, payers and consumers while reducing friction and increasing speed and convenience. Consider our new integrated consumer card which we introduced in January. Many people typically have separate cards for clinical care, pharmacy benefits, food assistance programs, fitness, rewards programs and more. We've combined these benefits into a single card, vastly simplifying the experience for consumers and providers. And we plan to do even more in the future.

第四，我們在健康金融服務方面的發展努力，簡化和簡化了提供者、支付者和消費者的支付，同時減少摩擦並提高速度和便利性。考慮一下我們在一月份推出的新型綜合消費卡。許多人通常擁有用於臨床護理、藥房福利、食品援助計劃、健身、獎勵計劃等的單獨卡片。我們將這些優勢整合到一張卡片中，極大地簡化了消費者和提供商的體驗。我們計劃在未來做更多的事情。

And finally, pharmacy services. The high cost of specialty drugs is one of the most pressing issues for our health plan partners. Drawing upon all of Optum's advanced analytical capabilities, we're collaborating with health plans to provide clinicians access to real-time medical and pharmacy analytics, which are coordinated with a patient-specific benefit plan design, enabling clinicians to determine the most effective and appropriate therapies at the point of care. Our initial results are highly positive, helping to lower specialty costs by over 15%. Overall, OptumRx's performance in the quarter, healthy retention rates and strong sales pipeline provide a great foundation for growth.

最後，藥房服務。特殊藥物的高成本是我們的健康計劃合作夥伴最緊迫的問題之一。利用 Optum 的所有先進分析能力，我們正在與健康計劃合作，為臨床醫生提供實時醫療和藥學分析，這些分析與針對患者的福利計劃設計相協調，使臨床醫生能夠確定最有效和最合適的方案在護理點進行治療。我們的初步結果非常積極，有助於將專業成本降低 15% 以上。總體而言，OptumRx 在本季度的表現、健康的保留率和強大的銷售渠道為增長提供了良好的基礎。

These efforts, from expanding in-home and broad based -- broad value-based care offerings, to enhancements to Medicare Advantage, to simplifying how to finance care, are designed to create greater value for consumers and more broadly have a profound impact on the lives of families and individuals and communities with all levels of need across America, which is a powerful motivation for all of us at this company each and every day.

這些努力，從擴大家庭和基於廣泛價值的護理產品，到增強醫療保險優勢，再到簡化護理融資方式，旨在為消費者創造更大的價值，並更廣泛地對美國各地有各種需要的家庭、個人和社區的生活，這對我們這家公司的每一個人來說都是一個強大的動力。

Dirk McMahon, our President and Chief Operating Officer, will now share more about these efforts. Dirk?

我們的總裁兼首席運營官 Dirk McMahon 現在將分享更多有關這些努力的信息。短劍？

Thank you, Andrew. There is no more important aspect of the consumer experience in health care than convenient access to quality care. Not theoretical access, but care when and where people need it. Testing, for instance, is an area where we see significant opportunity to improve the consumer experience. It can be a burden for people to test for conditions such as colorectal cancer. As a result, too often, people just won't deal with the hassle, early stage condition, and as a result, early stage conditions go undiagnosed and people don't get the care they need until things get really serious, which is bad for their health and results in unnecessarily higher-intensity treatments and costs in the future.

謝謝你，安德魯。消費者在醫療保健方面的體驗沒有比方便地獲得優質醫療服務更重要的方面了。不是理論上的訪問，而是關心人們何時何地需要它。例如，測試是我們看到改善消費者體驗的重要機會的領域。檢測結直腸癌等疾病可能是人們的負擔。結果，人們常常不會處理麻煩的早期疾病，結果，早期疾病未被診斷出來，人們在事情變得非常嚴重之前得不到他們需要的護理，這很糟糕為了他們的健康，並在未來導致不必要的高強度治療和成本。

Like many of you, we have observed more willingness by patients for trial and adoption of in-home testing for many types of chronic conditions. However, it can be challenging for people to first find tests and then make sure the results get back into a doctor's workflow. Patients need to call providers for a prescription, go to disparate locations to pick up the test and then somehow get the piece of paper with the test result into an already-busy clinic operation.

像你們中的許多人一樣，我們觀察到患者更願意對多種慢性病進行試驗和採用家庭測試。然而，對於人們來說，首先找到測試然後確保結果回到醫生的工作流程中可能具有挑戰性。患者需要打電話給提供者開處方，去不同的地方取測試，然後以某種方式將帶有測試結果的紙帶入已經很忙的診所操作。

At UnitedHealthcare, we've introduced an integrated solution that addresses all of the tasks that need to occur sequentially for test results to get into a clinic system. This digitally enabled solution is resulting in nearly 10% increase in people obtaining necessary screening versus a multistep process. We are expanding this vital capability to more people and making additional types of tests available as well.

在 UnitedHealthcare，我們引入了一個集成解決方案，該解決方案解決了為將測試結果輸入診所繫統而需要按順序執行的所有任務。與多步驟流程相比，這種數字化解決方案使獲得必要篩查的人數增加了近 10%。我們正在將這一重要功能擴展到更多人，並提供其他類型的測試。

As many of you know, the first quarter tends to be the most impactful in setting us up for operational success for the remainder of the year. The ease of that initial experience for people has a lasting impact on consumer and customer perceptions and buying decisions, not just for the next 3 months, but often for years to come. So we thought it would be timely and helpful to provide a bit of a performance report card for the quarter. A short version, this is where we owe a great thank you to the people of Optum and UnitedHealthcare.

正如你們許多人所知，第一季度往往對我們在今年剩餘時間裡取得運營成功的影響最大。人們最初體驗的便利性對消費者和客戶的看法以及購買決策產生了持久的影響，不僅在接下來的 3 個月內，而且通常在未來幾年內。因此，我們認為提供一些本季度的績效報告卡是及時且有幫助的。一個簡短的版本，這是我們非常感謝 Optum 和 UnitedHealthcare 員工的地方。

Perhaps nowhere was this more apparent than in the onboarding of the many new people served under value-based arrangements within OptumHealth. Investing in the preparation of systems and training in physicians and staff was critical in laying the groundwork to provide high-quality care for these new patients and expanding into new geographies.

在 OptumHealth 基於價值的安排下服務的許多新員工的入職培訓中，這一點可能最為明顯。投資於系統準備和對醫生和員工的培訓對於為這些新患者提供高質量護理和擴展到新地區奠定基礎至關重要。

For example, in Ohio and New York, we are observing early improvements in post-acute trends, such as skilled nursing facility admits declining 25% in just the first quarter of operation. It's a testament to the deep integration of our post-acute capabilities for transitioning patients to the most appropriate setting for their needs as well as a patient-centric orientation of our local care delivery organizations and their vigilance on care continuity.

例如，在俄亥俄州和紐約州，我們觀察到急性期後趨勢的早期改善，例如專業護理機構承認僅在第一季度運營就下降了 25%。這證明了我們在急性期後將患者轉移到最適合他們需求的環境的能力的深度整合，以及我們當地護理提供組織以患者為中心的定位以及他們對護理連續性的警惕性。

At UnitedHealthcare, our digital investments are continuing to serve our care providers and helping advance our efforts to move to a paperless experience. In the first quarter, visits to our digital portal continued to increase while provider support costs declined about 12% from historical averages. Importantly, we have driven a 38% increase in providers using digital documents instead of paper in just this first quarter compared to last year.

在 UnitedHealthcare，我們的數字投資將繼續為我們的護理提供者服務，並幫助推進我們向無紙化體驗邁進的努力。第一季度，對我們數字門戶的訪問量繼續增加，而提供商支持成本比歷史平均水平下降了約 12%。重要的是，與去年相比，僅在第一季度，我們就推動使用數字文檔而不是紙質文檔的提供商增加了 38%。

We expect the efforts we have taken in this quarter will save 80 tons of paper over the next 5 years.

我們預計我們在本季度所做的努力將在未來 5 年內節省 80 噸紙張。

Before handing off to John, let me briefly -- let me turn briefly to our pending combination with Change Healthcare. By now, it should be clear we are deeply committed to helping achieve a simpler, more intelligent and adaptive health system for patients, payers and providers. The combination of Optum and Change Healthcare will connect and simplify core clinical, administrative and payment processes health care providers and payers depend on to serve patients.

在移交給 John 之前，讓我簡要介紹一下我們與 Change Healthcare 的待定組合。到目前為止，應該清楚的是，我們堅定地致力於幫助為患者、支付者和提供者建立一個更簡單、更智能和適應性更強的醫療系統。 Optum 和 Change Healthcare 的結合將連接和簡化醫療保健提供者和支付者為患者服務所依賴的核心臨床、管理和支付流程。

Increasing efficiency and reducing friction will benefit the entire health system, resulting in lower costs and a better experience for all stakeholders. Our extended agreement with Change Healthcare reflects our firm belief in the potential benefits of this combination to improve health care and in our ability to successfully overcome the challenge to this merger.

提高效率和減少摩擦將使整個衛生系統受益，從而降低成本並為所有利益相關者提供更好的體驗。我們與 Change Healthcare 的擴展協議反映了我們堅信這種合併對改善醫療保健的潛在好處以及我們成功克服這次合併挑戰的能力的堅定信念。

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

有了這個，現在我將把它交給首席財務官約翰雷克斯。

Thank you, Dirk, and good morning, everyone. Our first quarter 2022 performance positions us well to deliver on our full year financial and growth objectives. Revenues grew by $10 billion or 14% to $80 billion over the year-ago first quarter, with double-digit growth at both Optum and UnitedHealthcare. This strong diversified growth was largely organic with balanced contributions from across both our services and benefits operating platforms. Compared to a year ago, we are adding over 1 million more people to OptumHealth, supporting 30% more patients in value-based relationships, providing over 20 million more prescriptions and serving 1.5 million more people across our health benefit offerings.

謝謝你，德克，大家早上好。我們 2022 年第一季度的業績使我們能夠很好地實現我們的全年財務和增長目標。與去年同期相比，第一季度收入增長了 100 億美元或 14%，達到 800 億美元，Optum 和 UnitedHealthcare 均實現了兩位數的增長。這種強勁的多元化增長在很大程度上是有機的，來自我們的服務和福利運營平台的平衡貢獻。與一年前相比，我們在 OptumHealth 中增加了超過 100 萬人，在基於價值的關係中支持的患者增加了 30%，提供了超過 2000 萬張處方，並在我們的健康福利產品中為超過 150 萬人提供了服務。

I'll start by providing a little color on care patterns over the course of the quarter and then turn to our individual businesses. As you'd expect, there was considerable variation in care patterns due to the COVID incidence peak early in the quarter. For example, in January, we had about 40,000 COVID-related hospitalizations, the highest of any month since the onset of the pandemic. By March, these had declined to around 2,000.

我將首先在本季度的過程中為護理模式提供一點顏色，然後轉向我們的個人業務。正如您所料，由於本季度初的 COVID 發病率高峰，護理模式存在相當大的差異。例如，在 1 月份，我們有大約 40,000 例與 COVID 相關的住院治療，這是自大流行開始以來的最高月。到 3 月，這些數字已降至 2,000 左右。

Overall, care in the quarter was about at baseline levels, though we observe pockets that are modestly below historical baseline, such as emergency department and pediatric visits. However, we are not assuming this is a permanent shift in consumer behavior.

總體而言，本季度的護理大致處於基線水平，儘管我們觀察到一些部分略低於歷史基線，例如急診科和兒科就診。但是，我們並不認為這是消費者行為的永久性轉變。

As it relates to potential longer-term health impacts on people due to care which was deferred during the height of the pandemic, thus far, we are not seeing the increasing acuity that many expected. For example, initial oncology-related diagnoses levels are consistent with historical averages. Of course, our core focus remains on getting people the care they need, and we are encouraged that critical screens are occurring at normalized levels.

由於它與由於在大流行高峰期間被推遲的護理而對人們的潛在長期健康影響有關，因此到目前為止，我們並沒有看到許多人預期的敏銳度不斷提高。例如，最初的腫瘤相關診斷水平與歷史平均值一致。當然，我們的核心重點仍然是讓人們得到他們需要的護理，我們受到鼓舞的是，關鍵篩查正以正常水平進行。

Moving now to business performance. OptumHealth revenue grew 34% in the first quarter, and earnings from operations rose over 40%. Revenue per consumer grew 33%. This was driven primarily by the increasing number of patients served under value-based arrangements. Continued augmentation of our value-based care offerings, such as expanding digital care and our services into the home, [gives us the] opportunity to serve more people much more broadly and deeply. And we expect to grow strongly for years to come.

現在轉向業務績效。 OptumHealth 第一季度收入增長 34%，運營收益增長超過 40%。每位消費者的收入增長了 33%。這主要是由於在基於價值的安排下服務的患者數量不斷增加。繼續擴大我們基於價值的護理產品，例如將數字護理和我們的服務擴展到家庭，[給我們]機會更廣泛和更深入地為更多人服務。我們預計未來幾年將強勁增長。

OptumInsight revenue grew 13% year-over-year. The revenue backlog was $22.8 billion, growth of $2 billion or 10% over the prior year. Our expanding health system partnerships are contributing to this growth, and we expect the number and breadth of these partnerships to continue to grow. OptumRx revenues grew 11% to $24 billion, reflecting the strength of new business relationships secured over the course of last year. We typically incur significant investments in the early months of these expansions to assure strong performance and value for our customers.

OptumInsight 收入同比增長 13%。收入積壓為 228 億美元，比上年增長 20 億美元或 10%。我們不斷擴大的衛生系統夥伴關係正在促進這種增長，我們預計這些夥伴關係的數量和廣度將繼續增長。 OptumRx 收入增長 11% 至 240 億美元，反映了去年建立的新業務關係的實力。我們通常會在這些擴張的最初幾個月進行大量投資，以確保為我們的客戶提供強勁的業績和價值。

Turning to UnitedHealthcare. Revenue growth of 14% was driven across the businesses. Our Medicare Advantage offerings remain on track to add up to 800,000 people. About 3/4 will be in individual and group Medicare Advantage and the remainder in dual special needs plans. New seniors aging into Medicare are increasingly selecting Medicare Advantage based on the value it offers. And the 5-star quality plan performance we achieved this year enables us to enroll people in our plan offerings through the year.

轉向聯合醫療。各業務部門的收入增長了 14%。我們的 Medicare Advantage 產品仍有望增加多達 800,000 人。大約 3/4 將用於個人和團體 Medicare Advantage，其餘用於雙重特殊需求計劃。進入 Medicare 的新老年人越來越多地根據 Medicare Advantage 提供的價值選擇它。我們今年取得的 5 星級質量計劃績效使我們能夠在全年招募人員參與我們的計劃產品。

People served by our Medicaid offerings grew by over 150,000 in the first quarter and is now approaching 8 million. Our growth outlook for the remainder of the year continues to incorporate an expectation that states will resume eligibility redeterminations when the public health emergency lapses, resulting in modest net attrition. First quarter commercial enrollment was in line with our expectations. The decline in people served under fee-based arrangements was driven by 3 previously known customer transitions, which were offset by core growth.

第一季度，我們的 Medicaid 產品服務的人數增加了 150,000 多人，現在接近 800 萬人。我們對今年剩餘時間的增長展望繼續包含這樣一種預期，即各州將在公共衛生緊急事件過去後恢復資格重新確定，從而導致適度的淨減員。第一季度商業招生符合我們的預期。在收費安排下服務的人數下降是由 3 次已知的客戶轉換推動的，這些轉換被核心增長所抵消。

We see the number of people served overall increasing as we progress through '22, driven by the strong market response to our more recently introduced innovative offerings as well as the continued recovery in the total number of people covered by employer health benefits, which typically lags reported job growth.

隨著我們在 22 年的進展，我們看到整體服務的人數增加，這是由於市場對我們最近推出的創新產品的強烈反應以及雇主健康福利所涵蓋的總人數的持續恢復，這通常滯後報告就業增長。

Our capital capacity remains strong. First quarter cash flows from operations of $5.3 billion or 1x net income were consistent with our expectations. And we continue to expect full year cash flows of about $24 billion or 1.2x net income. We returned nearly $4 billion to shareholders in the quarter through dividends and share repurchases, and ended the quarter with a debt-to-capital ratio of 38%. And as we look toward completing both the LHC and Change combinations this year, we will continue to have ample capacities to expand upon the ways we can serve people and help them to live healthier lives.

我們的資本能力依然強勁。第一季度運營現金流為 53 億美元或淨收入的 1 倍，符合我們的預期。我們繼續預計全年現金流量約為 240 億美元或淨收入的 1.2 倍。我們在本季度通過股息和股票回購向股東返還了近 40 億美元，本季度末的債務資本比率為 38%。在我們期待今年完成 LHC 和 Change 組合的同時，我們將繼續擁有充足的能力來擴展我們為人們服務並幫助他們過上更健康生活的方式。

As noted earlier, based on this growth outlook, today, we increased our adjusted earnings outlook to a range of $21.20 to $21.70 per share. And we continue to expect the seasonal pattern to be more consistent with our historical experience with just under 50% of the full year earnings in the first half.

如前所述，基於這一增長前景，今天，我們將調整後的盈利前景提高至每股 21.20 美元至 21.70 美元的範圍。我們繼續預計季節性模式將與我們的歷史經驗更加一致，上半年的全年收益略低於 50%。

Now I'll turn it back to Andrew.

現在我將把它轉回給安德魯。

Thank you, John. I hope that you will recognize the consistent themes that we laid out last year as our guidepost for sustainable growth. Our focus on execution and continuous improvement across our businesses is a characteristic that we're going to sustain as we build upon this strong start to 2022.

謝謝你，約翰。我希望您能認識到我們去年提出的一貫主題，作為我們可持續增長的指南。我們對業務執行和持續改進的關注是我們在 2022 年強勁開局的基礎上將保持的一個特點。

And with that, operator, let's open it up for questions. One per caller, please.

有了這個，操作員，讓我們打開它來提問。請每位來電者一個。

(Operator Instructions) We will now take our first question from Lisa Gill from JPMorgan.

（操作員說明）我們現在將向摩根大通的 Lisa Gill 提出第一個問題。

John, I just want to go back to your comments around utilization trends. You talked about hospitalization now down to 2,000 here in March, but baseline somewhat moderating back, but you talked about ER and impedes. But can you maybe just talk about the difference of what you're seeing in commercial versus government?

約翰，我只想回到你關於使用趨勢的評論。您談到三月份的住院人數現在下降到 2,000 人，但基線有所緩和，但您談到了 ER 和阻礙。但是你能不能談談你在商業和政府中看到的區別？

And then secondly, it sounds like you are not really anticipating that there's still a lot of pent-up demand. Am I hearing that correctly? And how do I think about the trend as we move here towards the back half of the year?

其次，聽起來你並沒有真正預料到仍有很多被壓抑的需求。我沒聽錯嗎？我如何看待今年下半年的趨勢？

Lisa, thanks so much for the question. Let me ask John to respond to the first part. And then Brian Thompson, maybe you could just speak to a little bit the demand piece. And maybe Brian, pick up within that any sense of acuity shifts. I think that would be helpful for the folks who are listening. John first.

麗莎，非常感謝這個問題。讓我請約翰回答第一部分。然後是 Brian Thompson，也許你可以稍微談談需求部分。也許布賴恩，在任何敏銳度變化中都可以接受。我認為這對正在傾聽的人會有所幫助。先說約翰。

Lisa, it's John. Yes, so in the first quarter, still seeing similar trends in terms of utilization across the different categories you talked about. A little bit higher in commercial, a little bit lower in government programs. But everything kind of trending back more to those baseline levels overall.

麗莎，是約翰。是的，所以在第一季度，您談到的不同類別的使用率仍然有相似的趨勢。商業項目高一點，政府項目低一點。但總體而言，一切都趨向於回到這些基線水平。

And pointing out, as you appropriately noted here, we were still seeing some pockets here of differentiation, such as impedes and emergency department. That's been a trend we've seen, not to the point yet where we'd expect to -- where we'd expect that to continue, but a consumer difference that we've noted.

並指出，正如您在此處適當指出的那樣，我們仍然在這裡看到一些差異化的地方，例如障礙和急診室。這是我們已經看到的趨勢，但還沒有達到我們預期的程度——我們預計這種趨勢會持續下去，但我們已經註意到了消費者的差異。

Also on your comment, and Brian will go into this much more deeply, but as it relates to the potential for acuity, this is something we talked about very early on in the pandemic as people were missing treatments and how might they come back into the system. It's still something we're extremely watchful for across very -- a lot of categories. I spoke specifically to oncology and what we're seeing in those areas. So good to see people getting their screenings. What we haven't seen, though, is this expectation we had for the incidence rates might actually come up because of missed treatments over that, the earlier period.

同樣根據您的評論，Brian 將對此進行更深入的探討，但由於它與潛在的敏銳度有關，這是我們在大流行初期就談到的事情，因為人們缺少治療以及他們如何重新回到系統。這仍然是我們在非常多的類別中非常關注的事情。我專門談到了腫瘤學以及我們在這些領域看到的情況。很高興看到人們得到他們的放映。然而，我們沒有看到的是，我們對發病率的預期實際上可能會因為早期錯過治療而出現。

And Brian, could you offer a little more commentary?

還有布賴恩，你能再多發表一點評論嗎？

Sure. Thanks, John, and thanks for the question, Lisa. I think John summed it up nicely. As you expected, the quarter was odd in that, obviously, there was stronger levels of hospitalizations and infections in January, and that clearly deteriorated down to a lower level in March. So kind of a tale of 2 stories inside the quarter.

當然。謝謝，約翰，謝謝你的問題，麗莎。我認為約翰總結得很好。正如你所料，這個季度很奇怪，很明顯，1 月份的住院和感染水平更高，而 3 月份明顯惡化到較低的水平。就像這個季度內的 2 個故事一樣。

As John alluded to, commercial, a little more close to baseline with Medicaid being the lowest and Medicare in between. When you think about service type, inpatient running slightly above baseline, but that was really a function of January in those higher hospitalizations that we saw. And really encouraged as we look at physician visits because those accelerated through the quarter, sort of offsetting and consistent with the reduction in infection levels.

正如約翰所暗示的那樣，商業，更接近基線，醫療補助最低，醫療保險介於兩者之間。當您考慮服務類型時，住院人數略高於基線，但這實際上是我們看到的那些較高住院人數的一月份的函數。當我們看到醫生就診時真的很受鼓舞，因為這些在本季度加速，有點抵消並與感染水平的降低一致。

On strain dynamics, maybe another thing I'll point out, clearly less severe in Omicron than what we saw in Delta. We saw hospitalizations at about half the level that we saw. But again, confirming what John said, really no signs of deferred care, and we've been watching this closely throughout the pandemic, looking at screens, diagnosis, severity, progression. And it usually cycles through pretty quickly after we've seen large infections, within 2 to 3 months to get back to baselines. And that's where we're at right now leaving the quarter. So feel good about where we're at as we pace forward into the next quarter.

關於應變動力學，也許我要指出另一件事，在 Omicron 中明顯不如我們在 Delta 中看到的嚴重。我們看到的住院人數大約是我們看到的水平的一半。但是，再次確認約翰所說的話，確實沒有延遲護理的跡象，我們在整個大流行期間一直在密切關注這一點，查看屏幕、診斷、嚴重程度和進展。在我們看到大規模感染後，它通常會很快循環，在 2 到 3 個月內恢復到基線。這就是我們現在離開本季度的地方。因此，當我們進入下一個季度時，對我們所處的位置感覺良好。

Great. John, Brian, thanks so much for that. Yes, it was a very -- it was definitely a quarter of 2 parts in terms of January and then how February and March moved forward with the shift in impacts of Omicron during this quarter. And -- but I think what you've heard from both John and Brian really reflects the kind of movement back towards kind of baseline activities with 1 or 2 exceptions.

偉大的。約翰，布賴恩，非常感謝。是的，這是一個非常 - 就 1 月份而言，它絕對是 2 個部分的四分之一，然後是 2 月和 3 月如何隨著 Omicron 在本季度的影響轉變而向前發展。而且 - 但我認為你從 John 和 Brian 那裡聽到的確實反映了向基線活動的那種運動，只有 1 或 2 個例外。

Rest assured, we are really watching like a hawk to see any evolving trends around acuity shift. Obviously, that's super important from a patient welfare perspective. But so far, we haven't seen very many signals of that at all. But it's maybe still early days. Lisa, thanks so very much for the question.

請放心，我們真的像鷹一樣觀察著圍繞敏銳度轉變的任何演變趨勢。顯然，從患者福利的角度來看，這非常重要。但到目前為止，我們還沒有看到太多這樣的信號。但這可能還為時尚早。麗莎，非常感謝這個問題。

We will now take our next question from A.J. Rice from Credit Suisse.

我們現在將回答 A.J. 的下一個問題。瑞士信貸大米。

Just thought I might ask, where obviously a lot of discussion in the broad market about inflationary pressures. And my sense is you're pretty well matched, particularly on the insurance side. But I wonder if you might take a few minutes and just sort of think -- I know there's a lot of different things going on in Optum. How do you feel as we enter a period where there may be a little more inflationary pressure that you're matched revenue versus cost? Is there any pressure points? Is there any places where it's actually helpful to you? Maybe comment on that.

剛想我可能會問，哪裡明顯有很多關於通脹壓力的大盤討論。我的感覺是你們很相配，尤其是在保險方面。但我想知道您是否可以花幾分鐘時間想一想——我知道 Optum 正在發生很多不同的事情。當我們進入一個通脹壓力更大的時期，您的收入與成本相匹配時，您有何感受？有壓力點嗎？有沒有對你真正有用的地方？也許對此發表評論。

A.J., thanks so much for the question. I'll make a couple of comments then I'll maybe ask Dirk a little bit to reflect on the broader perspective. And then Brian, again, just to talk a little bit within the UHC portfolio.

A.J.，非常感謝這個問題。我會發表一些評論，然後我可能會請 Dirk 稍微思考一下更廣泛的視角。然後布賴恩，再次，只是在 UHC 產品組合中談一點。

I mean, generally speaking, I want to make it super clear. Our focus always is to try and get the very best value proposition for our clients, members and patients. And I think, at a time of inflation, that responsibility, we carry really seriously. So making sure that there are advocates really in the system to get the best deal possible for the folks who rely on us to continue to get good access to health care services and the care they need when they need it is something we're very focused on.

我的意思是，一般來說，我想讓它超級清楚。我們的重點始終是嘗試為我們的客戶、會員和患者獲得最佳價值主張。而且我認為，在通貨膨脹時期，我們非常認真地承擔了這一責任。因此，確保系統中有真正的倡導者，以便為依賴我們的人們繼續獲得良好的醫療保健服務和他們需要的護理，這是我們非常關注的事情在。

So we're fortunate to have some very long-term positions in place with a wide range of inputs that we rely on, which is obviously important. Brian may talk a little bit to that in a second from a UHC perspective. But whether you look at our OptumRx portfolio, where we're going to continue to focus on getting really the lowest possible price for pharmaceuticals, or whether you look at the way in which we run our business to seek out sources of productivity to offset inflationary pressures, as an overall agenda, this is a time where UnitedHealth Group in all of its parts is going to be, first and foremost, do everything it can to protect the people who rely on us from the forces of inflation.

因此，我們很幸運能夠擁有一些非常長期的職位，並提供我們所依賴的廣泛投入，這顯然很重要。從 UHC 的角度來看，Brian 可能會在幾秒鐘內談一談。但是，無論您查看我們的 OptumRx 產品組合，我們將繼續專注於獲得盡可能低的藥品價格，或者您是否查看我們開展業務以尋找生產力來源以抵消通貨膨脹的方式壓力，作為一個總體議程，現在是聯合健康集團在其所有部門將首先竭盡全力保護依賴我們的人們免受通貨膨脹力量的影響。

With that backdrop, maybe Dirk, you could pick up a little bit more broadly some of the things we're doing in the company, and then pass to Brian.

在這樣的背景下，也許 Dirk，你可以更廣泛地了解我們在公司所做的一些事情，然後交給 Brian。

Yes. So thanks, Andrew. Yes. So first of all, yes, we're always sensitive to the challenges that people face in health care, specifically from a cost perspective. That's a big reason why we have affordability agenda that's really focused on total cost of care, lowering total cost of care for people. And also, telling people in these inflationary times, how they get more out of their benefits that they purchase from us. We've also done things we've talked before about getting really some good products in the marketplace, like our virtual products, which are 15% lower than other prevailing products in those markets.

是的。所以謝謝，安德魯。是的。所以首先，是的，我們總是對人們在醫療保健中面臨的挑戰很敏感，特別是從成本的角度來看。這就是我們制定真正關注總護理成本、降低人們總護理成本的負擔能力議程的一個重要原因。而且，告訴人們在這些通貨膨脹時期，他們如何從他們從我們那裡購買的福利中獲得更多收益。我們還做了一些我們之前談到的在市場上獲得真正好的產品的事情，比如我們的虛擬產品，它比這些市場上的其他流行產品低 15%。

And as Andrew said, we're working really hard on technology to improve productivity. One of the things we're trying to do from a productivity standpoint is do that to enable us to make targeted investments in our people and to -- or otherwise pass that through in the form of premiums to folks. So those are things from a productivity standpoint that we're on.

正如安德魯所說，我們正在努力開發技術以提高生產力。從生產力的角度來看，我們試圖做的一件事就是這樣做，以使我們能夠對我們的員工進行有針對性的投資，並以其他方式將其以溢價的形式傳遞給人們。所以從生產力的角度來看，這些都是我們所關注的。

From a labor strategy standpoint, more broadly, at the last fall as the sort of the great resignation progressed, we made some investments, targeted investments in our people. In the first quarter, we had our normal merit review cycle with raises. So we're trying to make, from an internal perspective, the right thing to do. But as we look forward in -- for the remainder of the year, we're going to have to make -- continue to make targeted investments in areas like clinicians and in customer service folks where we see higher levels of attrition.

從勞工戰略的角度來看，更廣泛地說，去年秋天，隨著大辭職的進展，我們進行了一些投資，有針對性地投資於我們的員工。在第一季度，我們進行了正常的績效評估週期和加薪。因此，我們試圖從內部角度做正確的事情。但正如我們所期待的那樣——在今年剩下的時間裡，我們將不得不繼續在臨床醫生和客戶服務人員等領域進行有針對性的投資，我們認為這些領域的人員流失率更高。

So that's a broad brush as to what we're doing. Brian, go ahead.

所以這是對我們正在做的事情的粗略描述。布賴恩，繼續。

Yes. Thanks, Dirk. As you might expect, there are good disciplines in management inside UnitedHealthcare that I'm pleased with where we're at, pricing to our forward view of costs being one. Including inflation. Obviously, we have some provider agreements that do offer multiyear predictability, but this is less about being insulated from the overall inflation environment and more about our responsibility to drive down that total cost as Dirk alluded to.

是的。謝謝，德克。正如您所料，UnitedHealthcare 內部有良好的管理紀律，我對我們所處的位置感到滿意，我們對成本的前瞻性看法是其中之一。包括通貨膨脹。顯然，我們有一些供應商協議確實提供了多年的可預測性，但這與其說是與整體通脹環境隔離，不如說是我們有責任像 Dirk 所暗示的那樣降低總成本。

And I'm more encouraged than ever on things like value-based care, consumer transparency, to navigate the system to get, to the appropriate side of service, having the tools digitally to ensure we can enable that virtual engagement and post-acute and home innovation to really avoid those expensive hospital stays. So those are the elements that we can really drive to try to offset the overall cost.

我比以往任何時候都更鼓勵基於價值的護理、消費者透明度、導航系統以獲得適當的服務方面、擁有數字化工具以確保我們能夠實現虛擬參與和急性後和家庭創新，真正避免那些昂貴的住院費用。因此，這些是我們真正可以推動以抵消總體成本的要素。

Yes. Brian, very well said, I think. And our response to inflation is innovation, simple as that. The way in which we're going to get the best outcome for folks who rely on us is to continue to innovate. How we work inside the company to deliver greater productivity, how we deliver efficient access to the system for members and patients, how we take advantage of things like virtual care platforms, and how we truly bring to life the value of value-based care and all of the work that's going on between UnitedHealthcare and Optum, that is going to be a tremendous aid to us in ensuring that we can manage through this on behalf of the people who rely on us. So A.J., thanks so much for the question.

是的。布賴恩，說得很好，我想。我們對通貨膨脹的反應就是創新，就這麼簡單。我們要為依賴我們的人們獲得最佳結果的方式是繼續創新。我們如何在公司內部工作以提高生產力，我們如何為會員和患者提供對系統的有效訪問，我們如何利用虛擬護理平台等東西，以及我們如何真正實現基於價值的護理的價值和UnitedHealthcare 和 Optum 之間正在進行的所有工作，這將極大地幫助我們確保我們能夠代表依賴我們的人進行管理。所以 A.J.，非常感謝這個問題。

We will now take our next question from Scott Fidel from Stephens.

我們現在將向斯蒂芬斯的斯科特菲德爾提出下一個問題。

I had a question just on the LHCG acquisition. And I guess, a two-parter. First, just as you've conducted a portfolio review of LHGG's assets, just interested if you've made a decision yet on whether you plan to retain all of the key assets separate from home health, particularly thinking about hospice and personal care.

我有一個關於 LHCG 收購的問題。我猜，一個兩方。首先，就像您對 LHGG 的資產進行了投資組合審查一樣，您是否已經決定是否計劃將所有關鍵資產與家庭健康分開保留，特別是考慮臨終關懷和個人護理。

And then would just also be interested just on some of the key synergies that you're seeing as you look out to integrate LHCG into Optum's broader clinical platform, particularly when thinking about some of the more adjacent assets, such as Landmark and naviHealth that you already have in the home-based care umbrella.

然後也會對您看到的一些關鍵協同效應感興趣，因為您希望將 LHCG 整合到 Optum 更廣泛的臨床平台中，特別是在考慮一些更相鄰的資產時，例如您的 Landmark 和 naviHealth已經有了居家護理的保護傘。

Scott, thanks so much for the question. And I'm going to ask Wyatt Decker in a second to give you a little more response on this.

斯科特，非常感謝這個問題。我馬上要請懷亞特·德克爾（Wyatt Decker）給你更多的回應。

LHC, we're incredibly proud of coming to an agreement with the LHC Board to bring together the 2 organizations. Obviously, it's a transaction which hasn't closed yet, so I'm not going to go into too much detail about it. But let me say a few things.

LHC，我們非常自豪能夠與 LHC 董事會達成協議，將這兩個組織聯合起來。顯然，這是一個尚未完成的交易，所以我不會對此進行過多的詳細介紹。但是讓我說幾件事。

And I had the great pleasure, even on Monday, actually, to spend some good time with the founders and the leadership team of LHC. Unbelievable positive culture inside the organization that's been built up by Keith and Ginger since they first founded it. Really a company with a true heart and really puts patients first and their families first.

實際上，即使在星期一，我也很高興能與 LHC 的創始人和領導團隊共度美好時光。 Keith 和 Ginger 自創立之初就在組織內部建立了令人難以置信的積極文化。真的是一家真心實意的公司，真的把病人放在第一位，把家人放在第一位。

Extraordinary impact in all of their lines of operations and how they can have a significant impact on the lives of people who very often are excluded from care. This is really about opening up access to a lot of people who would not otherwise find easy access to the system is really important. And I like very much all of the aspects I've seen at that organization. Look forward very much to successfully bringing it into the UnitedHealth Group portfolio.

對他們所有業務線的非凡影響，以及他們如何對經常被排除在護理之外的人的生活產生重大影響。這實際上是為了向許多人開放訪問權限，否則他們將無法輕鬆訪問該系統非常重要。我非常喜歡我在該組織看到的所有方面。非常期待將其成功納入聯合健康集團的投資組合。

I would also say, and this is why I'm going to ask Dr. Decker to take a little bit more deeper dive, we're really moving at speed to bring together our home and community capabilities. And if you look at what's really driving, alongside our value-based strategy for the clinics, the rapid growth of our home and community offering, which has brought together the naviHealth, Landmark, will over time align with LHC when it joins into the organization, built on our original Optima Home product. It's an extraordinary set of capabilities and it's positioning us very well to, for example, serve the D-SNP population in a way which historically would not have been possible. And that, as you've heard from John earlier, is a big piece of our growth in the first quarter.

我還要說，這就是為什麼我要請 Decker 博士進行更深入的研究，我們真的在加快速度，將我們的家庭和社區能力結合起來。如果你看看真正推動的是什麼，以及我們基於價值的診所戰略，我們的家庭和社區產品的快速增長，將 naviHealth、Landmark 結合在一起，隨著時間的推移，當 LHC 加入該組織時，它將與 LHC 保持一致，建立在我們最初的 Optima Home 產品之上。這是一組非凡的能力，它使我們能夠很好地定位，例如，以歷史上不可能的方式為 D-SNP 人群服務。正如您之前從約翰那裡聽到的那樣，這是我們第一季度增長的重要組成部分。

And maybe with that backdrop, I'll pass to Dr. Decker to give you a little more detail.

也許在這樣的背景下，我會轉給德克爾博士給你更多細節。

Yes. Thank you, Andrew. And Scott, thank you for the question. We are very excited with the combination of LHC Group. I think Andrew said it well. They have a long-standing culture, since their founding in a small community in Louisiana in 1994, of commitment to serve others and help people live their healthiest lives in a home care setting. They've developed multiple capabilities which actually really nicely complement our growing home and community platform that Andrew touched on. So very excited about that.

是的。謝謝你，安德魯。斯科特，謝謝你的提問。我們對 LHC 集團的合併感到非常興奮。我認為安德魯說得很好。自 1994 年在路易斯安那州的一個小社區成立以來，他們擁有悠久的文化，致力於為他人服務並幫助人們在家庭護理環境中過上最健康的生活。他們開發了多種功能，實際上很好地補充了 Andrew 談到的我們不斷發展的家庭和社區平台。對此非常興奮。

The quality of care that they provide is remarkable. It's a full 33% higher in the Stars quality ratings than the national average for home health care, just as an example. And we share this commitment to quality and service. So we feel it's a really good alignment.

他們提供的護理質量非常出色。舉個例子，它在 Stars 質量評級中比全國家庭醫療保健平均水平高出 33%。我們分享對質量和服務的承諾。所以我們覺得這是一個非常好的對齊方式。

And then building on your question and Andrew's comments. As we weave home health care together with the more kind of complex offerings of post-acute care and complex care in the home that we've already brought into our home community platform, we see remarkable synergies, and this will continue to grow.

然後以您的問題和 Andrew 的評論為基礎。當我們將家庭醫療保健與我們已經引入家庭社區平台的更複雜的急性後護理和家庭複雜護理產品結合在一起時，我們看到了顯著的協同效應，並且這種協同效應將繼續增長。

And it also begins to address the question of why has it been so hard to have home care be delivered in a value-based construct? And our vision is, with these comprehensive set of offerings, stitching it together in a way that is differentiated and helps people get better health care outcomes. Initially, we'll help deploy them in the post-acute care setting right out of the gate. Thanks for the question.

它還開始解決為什麼在基於價值的結構中提供家庭護理如此困難的問題？我們的願景是，通過這些全面的產品組合，以一種差異化的方式將它們拼接在一起，幫助人們獲得更好的醫療保健結果。最初，我們將幫助他們立即部署到急性後護理環境中。謝謝你的問題。

Thanks, Dr. Decker. And A.J., thanks so much for the question. I'll maybe leave you with one thought on LHC, actually. And just for your awareness, 85% of LHC providers are 4-star or better rating from a quality perspective. I mean, that just tells you everything you need to know about that organization and why we want it to be part of our family. We think it's going to great -- bring great access, great quality to members and families across the country. A.J., thanks so much for the question.

謝謝，德克爾博士。還有 A.J.，非常感謝這個問題。實際上，我可能會讓您對 LHC 有一個想法。僅出於您的認識，從質量角度來看，85% 的 LHC 供應商是 4 星或更高評級。我的意思是，這只是告訴您您需要了解的有關該組織的所有信息以及我們為什麼希望它成為我們家庭的一部分。我們認為這會很棒——為全國各地的會員和家庭帶來便利的訪問、優質的服務。 A.J.，非常感謝這個問題。

We will now take our next question from Justin Lake, Wolfe Research.

我們現在將向沃爾夫研究的賈斯汀湖提出我們的下一個問題。

Wanted to ask a question about value-based care. First, kind of with the improvement in the outlook for penetration there. I'm curious, if you were to step back and look at the entire kind of value-based care operation you have and think about the penetration in terms of capitation, if you could share that number with us. Meaning the total TAM there of your physicians and their patients, how many of them are already in value-based care, and what's the potential still to come?

想問一個關於基於價值的護理的問題。首先，隨著那裡滲透前景的改善。我很好奇，如果您退後一步，看看您擁有的整個基於價值的護理業務，並考慮按人頭計算的滲透率，您是否可以與我們分享這個數字。這意味著您的醫生及其患者的總 TAM，其中有多少人已經在基於價值的護理中，還有什麼潛力？

And then just given all the competition in the space. I thought it's interesting, there's been some industry chatter that you made a large acquisition or might be making a large acquisition in Houston. Can you talk about the M&A pipeline there? And given the competition, do you still see it as being as robust as it was, let's say, 3 to 5 years ago?

然後只是考慮了該領域的所有競爭。我認為這很有趣，有一些業內人士說您進行了大規模收購，或者可能正在休斯頓進行大規模收購。你能談談那裡的併購渠道嗎？考慮到競爭，您是否仍然認為它像 3 到 5 年前一樣強大？

Justin, thanks so much for the question. I'm going to ask -- in a second, I'll ask Brian just to reflect a little bit on the kind of direction of travel for value-based care. I think it's super interesting to hear the perspective from a payer perspective because obviously, what Brian and his team are looking for is how do they deliver the very best outcome and value for the folks who rely on him.

賈斯汀，非常感謝這個問題。我要問 - 稍後，我會問布賴恩，只是想稍微思考一下基於價值的護理的發展方向。我認為從付款人的角度聽到這個觀點非常有趣，因為顯然，Brian 和他的團隊正在尋找的是他們如何為依賴他的人們提供最好的結果和價值。

But before I go to that, a couple of things. We probably -- I'm not sure we need to kind of go into a ton of speculation on what the potential would be. Where I would focus on is look at the rate of growth that's going on right now. So that movement in terms of growth of Medicare Advantage that Brian is leading, that growth, 600,000 folks coming into the OptumCare value-based capitated environment under Dr. Decker's organization. We're focused on knowing that we are able to sustain that level of transfer and growth over many years to come.

但在我開始之前，有幾件事。我們可能 - 我不確定我們是否需要對潛力進行大量猜測。我將重點關注的是目前正在發生的增長率。因此，就 Brian 領導的 Medicare Advantage 增長運動而言，600,000 人進入了 Decker 博士組織下的 OptumCare 基於價值的資本化環境。我們專注於知道我們能夠在未來許多年保持這種水平的轉移和增長。

So what the ultimate ceiling is on that, I think actually, is a product of our ability to continue to deliver a fantastically innovative and high-quality capability in the marketplace. And that's going to continue to attract very large numbers of folks who want to be part of it and benefit from it. So I'm a little less thoughtful about what could the ceiling be? I'm much more motivated by and excited by the way in which we're, at these 500,000, 600,000 rates moving across, our ability to both move and grow and win external business as part of that agenda is going to be the thing that we're focused on.

因此，我認為實際上，最終的上限是我們能夠繼續在市場上提供極具創新性和高質量能力的產物。這將繼續吸引大量想要參與其中並從中受益的人。所以我對天花板可能是什麼不太考慮？我對我們以這 500,000、600,000 的速度移動的方式更加激勵和興奮，作為該議程的一部分，我們移動和增長以及贏得外部業務的能力將成為我們專注於。

So maybe with that, Brian, I'd ask you to go a little further from your perspective.

所以也許有了這個，Brian，我會要求你從你的角度走得更遠一點。

Yes. I think similar to what you said, for me, it's less about a number. I will say there's a lot of runway left. It's been about geographic expansion historically. Now it's much more than that. We've moved into duals, it's about complex care, it's about home. So the breadth and scale is really at the core of it.

是的。我認為與您所說的類似，對我來說，這不是一個數字。我會說還有很多跑道。從歷史上看，這是關於地理擴張的。現在遠不止這些。我們已經搬進了雙人房，這是關於復雜的護理，是關於家的。所以廣度和規模確實是它的核心。

And UnitedHealthcare is deeply incented to continue this journey with Optum. When you think about our best retention levels, when you think about satisfaction, when you think about where we have the lowest trend that drives the best benefits, the best quality and the best growth, all of those outcomes come when we partner with Optum. So we're strong -- we have strong incentives to continue this, and I'm encouraged because there's still a lot of runway left.

UnitedHealthcare 非常願意與 Optum 一起繼續這一旅程。當您考慮我們的最佳保留水平時，當您考慮滿意度時，當您考慮我們在哪些方面具有推動最佳收益、最佳質量和最佳增長的最低趨勢時，當我們與 Optum 合作時，所有這些結果都會出現。所以我們很強大——我們有強烈的動機繼續這樣做，我很受鼓舞，因為還有很多跑道。

Brian, thanks so much. And Justin, just to come back to your second question around pipeline. As you'd expect, we don't comment on transactions speculation. But let me just make a few general points.

布賴恩，非常感謝。還有賈斯汀，回到你關於管道的第二個問題。如您所料，我們不對交易猜測發表評論。但是，讓我提出一些一般性的觀點。

You saw during Q1, we successfully closed and announced the bringing of Refresh Health into the organization. Great business built by Steve Gold and his team, helping us build out our behavioral delivery capabilities, within OptumHealth, complements super nicely. Our largest behavioral health network that we already have across the country from the benefit side of the business, so continue to operate there.

您在第一季度看到，我們成功關閉並宣布將 Refresh Health 引入組織。 Steve Gold 和他的團隊建立的偉大業務，幫助我們在 OptumHealth 內建立我們的行為交付能力，非常好地補充。我們最大的行為健康網絡已經在全國范圍內從業務的利益方面建立起來，因此請繼續在那裡運營。

I'd say, overall, our pipeline of opportunities, I actually think is probably as diverse as it's ever been and probably deeper than it's ever been. So I think from a potential capital deployment capability, I think we feel pretty optimistic about that. We continue -- as you see, we continue to be extremely disciplined about ensuring, of all the very many opportunities that we see, that we focus on the ones which, first and foremost, nestle centrally within our core strategies, those 5 growth areas I touched on earlier. Refresh Mental Health is a great example of that, sits right into that value-based proposition in terms of how we believe we need to bring behavioral health management alongside medical management.

我想說，總的來說，我們的機會管道，我實際上認為可能與以往一樣多樣化，而且可能比以往任何時候都更深。所以我認為從潛在的資本部署能力來看，我認為我們對此感到非常樂觀。我們將繼續——如您所見，我們將繼續非常自律，以確保在我們看到的所有眾多機會中，我們專注於首先在我們的核心戰略中佔據中心位置的那些 5 個增長領域我之前接觸過。 Refresh Mental Health 就是一個很好的例子，就我們認為需要將行為健康管理與醫療管理相結合的方式而言，它正是基於價值的主張。

So first off, they need to sit centrally within our strategic framework. We need to believe in the culture and the capability of the leadership teams that we're welcoming into UnitedHealth Group. And of course, the economics have to fit with our demanding expectations to support our long-term growth ambitions of 13% to 16%, and also the returns that our shareholders rightly expect.

因此，首先，他們需要在我們的戰略框架內處於中心位置。我們需要相信我們歡迎加入聯合健康集團的領導團隊的文化和能力。當然，經濟必須符合我們苛刻的期望，以支持我們 13% 至 16% 的長期增長目標，以及我們股東正確期望的回報。

So that drives us forward. I feel confident about our ability to continue to deploy capital, which has always been a key element of helping us deliver long-term growth. So hope that gives you a little sense of where we stand, Justin.

所以這推動我們前進。我對我們繼續部署資本的能力充滿信心，這一直是幫助我們實現長期增長的關鍵因素。所以希望這能讓你對我們的立場有所了解，賈斯汀。

We will now take our next question from Gary Taylor from Cowen.

我們現在將向 Cowen 的 Gary Taylor 提出我們的下一個問題。

I just had a question. Now that we're thinking about OptumHealth, the type of growth, Andrew, that you were just talking about and really tens of billions dollars of capitated risk, how do we think about the reserving? If OptumHealth was a stand-alone company, how do we think about reserving against that risk it's taking? I presume capitates from UHC is an elimination. Is all the other payer medical expense accrual, is that just rolling through your total medical accrual, John? Or is there somewhere else on the balance sheet where there's payable numbers we should be paying attention to?

我只是有一個問題。現在我們正在考慮 OptumHealth，安德魯，你剛才談到的增長類型以及真正的數百億美元的人頭風險，我們如何看待準備金？如果 OptumHealth 是一家獨立的公司，我們如何看待它所承擔的風險？我認為 UHC 的大寫是一種淘汰。是所有其他付款人的醫療費用應計，這只是通過您的總醫療應計，約翰？還是資產負債表上的其他地方有我們應該注意的應付數字？

Yes. Gary, thanks so much. Let me go straight to John to respond to that.

是的。加里，非常感謝。讓我直接去找約翰回應。

Gary, it's John. Yes, it'll be rolling through and it would be in the same place that you'd be seeing everything else in terms of how those occur. You're right in terms of how you think about eliminations with UnitedHealthcare business versus external business, which would not be eliminated, of course. But all in the same place in terms of how we would be appropriately reserving for those arrangements.

加里，是約翰。是的，它會滾滾而來，它會在同一個地方，你會看到其他一切是如何發生的。就您如何看待 UnitedHealthcare 業務與外部業務的消除而言，您是正確的，當然，外部業務不會被消除。但就我們如何為這些安排進行適當保留而言，所有這些都在同一個地方。

We'll now take our next question from Kevin Fischbeck from Bank of America.

我們現在將向美國銀行的 Kevin Fischbeck 提出我們的下一個問題。

Okay. Great. I wanted to go back to the growth in OptumHealth for a minute. Can you talk a little bit about what drove that 100,000 higher number? Is that an organic number? Is that driven by deals? Is it direct contracting? Is it internally United? Is it external? Is there some way to kind of think about that growth and what drove it?

好的。偉大的。我想回到 OptumHealth 的發展一分鐘。你能談談是什麼推動了這個數字增加了 100,000 嗎？是有機數嗎？這是由交易驅動的嗎？是直接簽約嗎？是內部聯合嗎？是外部的嗎？有什麼方法可以思考這種增長以及推動它的因素嗎？

And then I guess, just generally speaking, when you think about deals in that space, how are you thinking about multiples, either on earnings, or on where you think the longer-term earnings can eventually be when you move that practice to capitation?

然後我想，一般來說，當您考慮該領域的交易時，您如何考慮倍數，無論是收益，還是您認為當您將這種做法轉移到人頭時最終可能獲得的長期收益？

Kevin, could you just repeat the second part of the query? I just lost you in the middle of that. Just could you just repeat that?

凱文，你能重複查詢的第二部分嗎？我只是在這中間失去了你。你能重複一遍嗎？

Sorry. Yes. Just the second part was just about deal multiples and physicians. So I mean, I don't know how you think about it, whether it's on the actual earnings or whether it's on kind of a normalized earnings in 5 years once you move that practice entirely to capitation. Just trying to think about how we should think about the returns on the capital you're spending in this area.

對不起。是的。只是第二部分只是關於交易倍數和醫生。所以我的意思是，我不知道你如何看待它，無論是實際收益，還是一旦你將這種做法完全轉移到人頭上，它是否是 5 年內的正常收益。只是想想想我們應該如何看待你在這個領域花費的資本回報。

Yes. Okay. Great. Listen, Kevin, thanks so much. I'll hand to Dr. Decker to respond to you on the first part of where that extra 100,000 taking us up to 600,000 is coming from. And it'd be good for you to hear that from him.

是的。好的。偉大的。聽著，凱文，非常感謝。我將交給 Decker 博士來回答您的第一部分，即額外的 100,000 將我們帶到 600,000 的來源。聽他這麼說對你有好處。

I think in terms of how we think about how we invest in this space, I'd say each one is pretty much a unique situation, right? I mean, every doctor, clinic, they're all different. They've all got tremendously different histories, situations, dynamics. And obviously, we take a view within a broad piece of not just what have they achieved to date, but how alongside the rest of our capabilities can we build opportunities and value for patients and the utilizers of those environments. And that's what really drives our kind of economic assessment.

我認為就我們如何看待我們如何在這個領域進行投資而言，我想說每一個都是一個獨特的情況，對吧？我的意思是，每個醫生，每個診所，都是不同的。他們都有截然不同的歷史、情況和動態。顯然，我們不僅要考慮他們迄今為止取得的成就，還要考慮如何與我們的其他能力一起為患者和這些環境的利用者創造機會和價值。這才是真正推動我們進行經濟評估的原因。

Now I think what you can see is the way in which we understand and seek to continue to learn how to work better and better within the value-based envelope and how we can utilize the skills of these organizations allows us be confident in being able to very fairly reward people who choose to join our organization. And that's what's driving our ability to be successful integrators of some phenomenal people and their teams across the country. And I'm so pleased they stay inside the organization.

現在我認為您可以看到的是我們理解並尋求繼續學習如何在基於價值的信封內更好地工作以及我們如何利用這些組織的技能使我們有信心能夠非常公平地獎勵選擇加入我們組織的人。這就是推動我們成為全國一些傑出人物及其團隊的成功集成者的能力。我很高興他們留在組織內。

And it's super nice to be able to see OptumHealth continue to strengthen itself as a physician-led organization. And I think that is really contrasting to many others out there. This is an organization led by physicians at every level of the organization, and it makes a huge difference in terms of the way the heart and soul of this place is starting to beat. And I think that's what underpins a lot of our contribution and competitiveness.

很高興能夠看到 OptumHealth 繼續加強自身作為一個以醫生為主導的組織。而且我認為這與那裡的許多其他人形成鮮明對比。這是一個由組織各個級別的醫生領導的組織，就這個地方的心臟和靈魂開始跳動的方式而言，它產生了巨大的差異。我認為這就是我們的貢獻和競爭力的基礎。

With that, Dr. Decker, as the physician leader of the organization, maybe you could just reflect a little bit on how you're successfully driving up that growth rate.

有了這個，德克爾博士，作為該組織的醫生領導，也許你可以稍微反思一下你是如何成功地提高增長率的。

Sure, Andrew, happy to do it. And Kevin, thanks for the question. What you're really seeing is the result of almost 10 years of building a flywheel that now has significant momentum. We've invested in people, in technology, in data and building out networks and deepening in our established geographies as well as going into new geographies. All of that continues to yield benefits and frankly growth.

當然，安德魯，很高興這樣做。還有凱文，謝謝你的問題。您真正看到的是近 10 年製造飛輪的結果，該飛輪現在具有顯著的動力。我們在人員、技術、數據和建立網絡方面進行了投資，並在我們已建立的地區以及進入新的地區進行了深化。所有這些都將繼續產生效益並坦率地增長。

Your question is rate. Is it organic growth that added that additional 100,000? And the answer is yes. We saw strong results in open enrollment, member retention. And we of course have not only 4-star plans, but 5-star plans that are able to enroll patients year-round. That's also true of duals.

你的問題是利率。是有機增長增加了額外的 100,000 人嗎？答案是肯定的。我們在公開註冊和會員保留方面看到了強勁的成果。當然，我們不僅有 4 星級計劃，還有能夠全年招募患者的 5 星級計劃。對偶也是如此。

And one final point that I'll note is that we are now, 1/3 of this growth this year, is in the dual special needs population. And these are individuals that have difficulty accessing care, and we're able to provide care with home and community, meaning wraparound solutions in their home. So it's another model that helps us grow. Thank you.

我要指出的最後一點是，我們現在，今年增長的 1/3 是雙重特殊需求人口。這些人難以獲得護理，我們能夠為家庭和社區提供護理，這意味著在他們家中提供全方位的解決方案。所以這是另一種幫助我們成長的模式。謝謝你。

Wyatt, thank you so much. Kevin, thanks so much for the question. Much appreciated.

懷亞特，非常感謝。凱文，非常感謝這個問題。非常感激。

We will now take our next question from Stephen Baxter from Wells Fargo.

我們現在將向富國銀行的斯蒂芬巴克斯特提出下一個問題。

Just a follow-up on a previous question. I wanted to ask a little bit more directly about significantly higher interest rate environment we're currently experiencing. Was hoping you could talk a little bit about how you expect this will impact the investment portfolio over the next couple of years as your investments mature and are reinvested at higher rates.

只是對上一個問題的跟進。我想更直接地詢問我們目前正在經歷的顯著更高的利率環境。希望您能談談您的預期，隨著您的投資成熟並以更高的利率再投資，這將如何影響未來幾年的投資組合。

And I guess also, how should we think about this as impacting EPS growth rate you target? Is this potential upside or tailwind is going to be used to offset inflationary pressures elsewhere or maybe a softer economic backdrop? Or is this something you think could actually be a net tailwind to our earnings growth over the next few years?

我還想，我們應該如何看待這會影響您的目標每股收益增長率？這種潛在的上行或順風將被用來抵消其他地方的通脹壓力，或者可能是一個疲軟的經濟背景？還是您認為這實際上可能是我們未來幾年盈利增長的淨順風？

Stephen, thanks so much for the question. John?

斯蒂芬，非常感謝這個問題。約翰？

Yes, certainly, anything more than 0% interest rates is going to be helpful to us overall as we move in that environment. But it does take some time, as I think as you're accurately pointing out here. So maybe a few perspectives I could offer on that.

是的，當然，當我們在那種環境中移動時，任何超過 0% 的利率都會對我們整體有所幫助。但這確實需要一些時間，正如我認為你在這裡準確指出的那樣。所以也許我可以提供一些觀點。

Roughly 40% of our $70 billion in cash and investments is tied to floating rates. So that would be the first cut you'd want to take of that. The other 60% would be in the fixed rate environment. So as you are alluding to, those will mature and be reinvested at higher rates over time. But not much of that piece would have any year 1 impact, call it, in terms of how one would think about that.

在我們 700 億美元的現金和投資中，大約 40% 與浮動利率掛鉤。所以這將是你想要的第一個削減。其他 60% 將處於固定利率環境中。因此，正如您所暗示的那樣，隨著時間的推移，這些將成熟並以更高的利率進行再投資。但就人們如何看待這一點而言，那篇文章的大部分內容不會對第一年產生任何影響，稱之為。

So maybe just to give you a hypothetical here. Say you had a 100 basis point increase in interest rates. So that would impact that 40% or call it roughly $28 billion of cash investments that are tied to floating rates. So that would be the first place you'd see that. So put that in the zone of it's really about $28 billion in that component. So $280 million impact on investment income.

所以也許只是在這裡給你一個假設。假設您的利率提高了 100 個基點。因此，這將影響這 40% 或稱其為與浮動利率掛鉤的大約 280 億美元現金投資。所以這將是你第一個看到的地方。因此，將其放在該區域中，該組件實際上約為 280 億美元。因此，2.8 億美元對投資收入的影響。

Important to note on that, we also have about $10 billion of floating rate liabilities. So think about the swaps floating the rest of -- commercial paper. So that would also have about $100 million offset to that $280 million. So that would be the zone I'd put you in, if you think about getting 12 months out from a first 100 basis point increase, that would be the zone.

需要注意的是，我們還有大約 100 億美元的浮動利率負債。因此，請考慮浮動其餘部分的掉期 - 商業票據。因此，這也將抵消約 1 億美元的 2.8 億美元。所以這將是我讓你進入的區域，如果你考慮從最初的 100 個基點增加 12 個月，那將是區域。

The rest of that portfolio, the other 60%, will roll off over a period of years, call it, think of that probably maybe $5 billion a year rolling off as those things mature. And that would be the pacing that you should expect.

該投資組合的其餘部分，即另外 60%，將在幾年內滾滾，所謂的，想想隨著這些事情的成熟，每年可能滾滾 50 億美元。這將是您應該期待的節奏。

John, thank you very much, Stephen, thanks so much for the question.

約翰，非常感謝你，斯蒂芬，非常感謝這個問題。

We will now take our next question from Josh Raskin from Nephron.

我們現在將向 Nephron 的 Josh Raskin 提出下一個問題。

I was wondering if you could speak to the local market strategy, more on the Optum side in markets like New York or Houston or maybe Houston soon. I'm specifically curious about how much of the delivery system you feel you need to employ, control, own, and how we should be thinking about sort of long-term success and growth. Is that on the delivery side? Does that manifest on the benefit side as well?

我想知道你是否可以談談當地的市場戰略，更多的是在紐約或休斯頓等市場的 Optum 方面，或者可能很快休斯頓。我特別好奇你覺得你需要使用、控制、擁有多少交付系統，以及我們應該如何考慮長期的成功和增長。是在交付方面嗎？這是否也體現在利益方面？

Josh, thanks so much. It's a great question, actually. And I would say -- and again, I'm going to ask Wyatt to go much deeper for you on this. I would say that, over the decade or so that this has been developing at Optum, I think our views are probably, it's fair to say, evolved quite a bit in terms of what the right way to operate. And not only in terms of what might be the right blend of relationships with ourselves and the physicians, also, the role of physicians versus advanced practice clinicians and others and also the role of what happens in a clinic-based environment versus a home-based environment. And I'd say particularly over the last, I don't know, maybe the last 24 months, I think that has moved on quite a lot in terms of how we're thinking about this.

喬希，非常感謝。這是一個很好的問題，實際上。我會說 - 再一次，我要請懷亞特在這方面為你更深入。我想說的是，在 Optum 發展的這十年左右的時間裡，我認為我們的觀點可能，公平地說，在正確的操作方式方面發生了相當大的變化。不僅在與我們自己和醫生的關係的正確融合方面，還有醫生與高級實踐臨床醫生和其他人的角色，以及在臨床環境與家庭環境中發生的事情的作用環境。我要特別說的是過去，我不知道，也許是過去的 24 個月，我認為就我們如何考慮這個問題而言，這已經發生了很大的變化。

So I would just frame it -- I'm going to hand right now to Wyatt. But I would just frame it, maybe, Josh, in those 3 dimensions, right? Location, kind of relationship between and then type of clinician, are, I think, evolving dynamics around which we're becoming more and more opinionated. Maybe on that, Wyatt, you could go a little deeper.

所以我只是把它框起來——我現在要交給懷亞特。但我會在這 3 個維度中對它進行構圖，也許，喬希，對吧？我認為，位置、臨床醫生之間的關係類型和類型，是不斷發展的動態，我們越來越固執己見。也許在這一點上，懷亞特，你可以再深入一點。

Yes. Thanks, Andrew, and thanks, Josh, for the question. Andrew framed it up very accurately. And so our thinking and frankly the practice in value-based medicine is evolving as we're able to go into the home, provide virtual care and behavioral care and comprehensive services, even that overcome things like social determinants.

是的。謝謝安德魯，謝謝喬希的問題。安德魯非常準確地構築了它。因此，隨著我們能夠走進家中，提供虛擬護理和行為護理以及綜合服務，我們的思想和坦率地說基於價值的醫學實踐正在不斷發展，甚至可以克服諸如社會決定因素之類的問題。

So in markets like New York State that have primarily been fee-for-service, we do see an opportunity to move to value-based care. And it's a blend of employed physicians and affiliated and contracted physicians. But increasingly, it is bringing all of the solutions that we offer within Optum, including OptumRx and other places in the enterprise and OptumHealth to bear on helping people get the best health care outcomes possible, lower the total cost of care and actually make care very convenient for health care consumers. And that's a differentiator in the marketplace. Thanks.

因此，在像紐約州這樣主要是按服務收費的市場中，我們確實看到了轉向基於價值的護理的機會。它是受僱醫生和附屬和簽約醫生的混合體。但越來越多地，它正在將我們在 Optum 內提供的所有解決方案（包括 OptumRx 和企業中的其他地方以及 OptumHealth）帶入幫助人們獲得可能的最佳醫療保健結果、降低總護理成本並實際上使護理變得非常方便醫療保健消費者。這是市場上的差異化因素。謝謝。

Wyatt, thanks so much. And Josh, thanks for the question.

懷亞特，非常感謝。喬希，謝謝你的問題。

We will now take our next question from Ricky Goldwasser from Morgan Stanley.

我們現在將向摩根士丹利的 Ricky Goldwasser 提出我們的下一個問題。

So OptumRx grew EBIT mid-single digits. Should we think about this as sort of a steady-state baseline growth?

所以 OptumRx 的息稅前利潤增長了中個位數。我們是否應該將其視為一種穩態基線增長？

And if we think about sort of [Humira bio accrual] coming to market some time next year. Is high single-digit EBIT growth sort of a reasonable place for us to model on top of what we've seen sort of this quarter?

如果我們考慮明年某個時候上市的 [Humira bio accrual]。高個位數的息稅前利潤增長是我們在本季度所見的基礎上進行建模的合理位置嗎？

And just one follow-up. I think, Dirk, you talked about in-home testing in your prepared remarks. Is this something that you're focusing on sort of the Medicare and dual book? Or is this also an offering to the commercial book? And is that -- and are you working with the national labs on that strategy?

只有一次跟進。我想，德克，你在準備好的評論中談到了家庭測試。這是您關注的醫療保險和雙重書籍嗎？或者這也是對商業書籍的一種奉獻？那是 - 你是否正在與國家實驗室合作制定該戰略？

Ricky, thanks so much for the questions. Before I go to Heather, let's tackle your first question -- your second question first. And maybe I'll go to Tim Noel to comment a little bit from the perspective of the Medicare book that you were looking at in terms of the home testing opportunity and dynamic.

瑞奇，非常感謝你的問題。在我去找希瑟之前，讓我們先解決你的第一個問題——你的第二個問題。也許我會去蒂姆·諾爾（Tim Noel）從您正在查看的家庭測試機會和動態方面的醫療保險書的角度發表評論。

Yes, Ricky, Tim Noel here. Thank you very much for the question. In-home testing is certainly a huge area of focus for us. There's obviously a component of it that relates to some of the work that we do on an annual basis with respect to STARS and closing some of those gaps related to the STAR measurement methodology.

是的，瑞奇，蒂姆·諾埃爾在這裡。非常感謝您的提問。家庭測試無疑是我們關注的一個巨大領域。很明顯，其中的一部分與我們每年針對 STARS 所做的一些工作有關，並縮小了與 STAR 測量方法相關的一些差距。

But more recently, we've really been focused on reaching out to people that we know to be underdiagnosed for conditions like hep C and diabetes. And in doing this, we've reached out over the last year to about 1 million members who we suspect to be underdiagnosed and offering in-home testing solutions that are then delivered by our HouseCalls partners over at Optum. These completion rates have been really promising, 35% last year, and we'll continue to evaluate expanding this program. That will do a really nice job of helping us understand where conditions are underdiagnosed and can be better treated.

但最近，我們真正專注於接觸那些我們知道被診斷為丙肝和糖尿病等疾病的人。在這樣做的過程中，我們在去年接觸了大約 100 萬我們懷疑診斷不足的成員，並提供了家庭測試解決方案，然後由我們的 HouseCalls 合作夥伴在 Optum 提供。這些完成率確實很有希望，去年達到了 35%，我們將繼續評估擴展該計劃。這將很好地幫助我們了解哪些情況未被充分診斷並且可以得到更好的治療。

Tim, thanks so much. And Dirk?

蒂姆，非常感謝。德克呢？

Yes. So Tim did a great job explaining. Ricky, in direct answer to your question, we have started with Medicare and we'll move to commercial as we sort of proceed along. But this is -- Medicare start was what I was talking about specifically.

是的。所以蒂姆做了很好的解釋。瑞奇，直接回答你的問題，我們已經從醫療保險開始，我們將在繼續進行的過程中轉向商業。但這是 - 醫療保險開始是我具體談論的內容。

Excellent. Thanks so much.

優秀的。非常感謝。

Now just before I hand over to Heather to go deeper on the OptumRx piece. Ricky, as you alluded to, as we roll into next year in particular, we're coming into a kind of a bit of a new cycle for pharma in a way in terms of the biosimilar opportunities. And obviously, you refer to one very significant one, really an important one. So it's clearly going to be a super dynamic environment, which we're -- Heather's team is absolutely engaged in and getting ready for.

現在就在我交給 Heather 深入研究 OptumRx 之前。 Ricky，正如你所提到的，當我們特別進入明年時，就生物仿製藥的機會而言，我們正在進入一種新的製藥週期。很明顯，你指的是一個非常重要的，非常重要的。所以這顯然將是一個超級動態的環境，我們——Heather 的團隊絕對參與其中並做好了準備。

I would just say, as I look, very pleased to see that acceleration of growth rate during the first quarter. And that's down to a tremendous amount of hard work in terms of developing the right product and service driving our retention and of course win rate. And one of the things I keep an eye on is the number of bid opportunities that we have in front of us, right, in terms of what's coming. And it's been super interesting to see that ratchet up over the last 12 months or so.

我只想說，在我看來，很高興看到第一季度的增長率加速。這要歸功於在開發正確的產品和服務方面付出了巨大的努力，從而提高了我們的保留率，當然還有贏得率。我關注的一件事是我們面前的競標機會的數量，對，就即將發生的事情而言。在過去 12 個月左右的時間裡，看到這種情況越來越多，真是太有趣了。

So the market is activating. I don't think you'd be super surprised to hear that, given the last couple of years, but it is activating. So we're seeing more and more business come to market. Been super reassured by our sustained very, very high retention rates.

所以市場是活躍的。鑑於過去幾年，我認為您聽到這個消息不會感到非常驚訝，但它正在激活。因此，我們看到越來越多的業務進入市場。我們持續非常非常高的保留率讓我們非常放心。

And Heather now maybe can reflect a little bit on how she sees that all playing out over the next year or 2. Heather?

希瑟現在也許可以稍微反思一下她如何看待未來一兩年的一切。希瑟？

Thank you. Yes, maybe I'll just build on what Andrew said. Just first, maybe, Ricky, to your question. You can see our relentless focus on not just growth in the pharmacy benefit business, but also the pharmacy services and the direct-to-consumer. So that will continue to support our top line growth. That will support that retention and continued growth -- membership growth in the PBM.

謝謝你。是的，也許我會在安德魯所說的基礎上再接再厲。瑞奇，也許首先要回答你的問題。您可以看到我們不懈地關注藥房福利業務的增長，以及藥房服務和直接面向消費者的業務。因此，這將繼續支持我們的收入增長。這將支持這種保留和持續增長——PBM 中的成員增長。

But in addition, those pharmacy services become increasingly important as we look at the future in these coming years, you're right, there's -- as we look, long anticipated introduction of multiple opportunities in biosimilar and other specialty services for our members. The services that we offer through our pharmacy services programs are really, I think, going to drive not just the growth in our -- the top line of our business, that continued push in our earnings, which as committing to our guidance for this year, which you see it as a mid- to high actually single digits. And then longer term, kind of moderating in the mid-single digits.

但此外，隨著我們展望未來幾年的未來，這些藥房服務變得越來越重要，你是對的，正如我們所期待的那樣，我們期待已久的為我們的會員引入生物仿製藥和其他專業服務的多種機會。我認為，我們通過藥房服務計劃提供的服務確實不僅會推動我們業務的增長，還會繼續推動我們的收入增長，這將致力於我們今年的指導，您將其視為中高實際個位數。然後是長期，在中個位數中緩和。

And that's really that relentless focus on pushing the value in from the pharmacy services into our clients and into our patients and our clients' consumers and making sure that we continue to drive the tools and services that our clients will pay for. Those are our clients, our external book of clients, our UnitedHealthcare client, and that's also our pharmacy services clients like our community pharmacy clients, which really need services and offerings like our behavioral health services that really integrate a fragmented system.

這確實是不懈地專注於將藥房服務的價值推向我們的客戶、我們的患者和客戶的消費者，並確保我們繼續推動客戶願意支付的工具和服務。這些是我們的客戶，我們的外部客戶手冊，我們的 UnitedHealthcare 客戶，還有我們的藥房服務客戶，比如我們的社區藥房客戶，他們確實需要像我們的行為健康服務這樣真正整合分散系統的服務和產品。

So I'd look at the whole thing. And as we move forward, the tools like our clinical analytics, our PBM specialty program management services that were referenced in -- by Andrew early in our script this morning, as well as our continued push to transform using our pharmacists as the way we're really going to grow our business.

所以我會看看整個事情。隨著我們向前邁進，我們的臨床分析、我們的 PBM 專業項目管理服務等工具被 Andrew 今天早上在我們的腳本中引用，以及我們繼續推動以我們的藥劑師作為我們的方式進行轉型。重新真正發展我們的業務。

Great. Heather, thanks so much. And Ricky, thank you very much for the question. We just have time for 1 last question. So Emma, maybe go to the last question.

偉大的。希瑟，非常感謝。 Ricky，非常感謝你的提問。我們只有時間回答最後一個問題。所以艾瑪，也許去最後一個問題。

Certainly. We will now take our final question from Steven Valiquette from Barclays.

當然。我們現在將向巴克萊銀行的 Steven Valiquette 提出最後一個問題。

Great. So just to tie a lot of things together that have been talked about on the call. With the $0.90 increase in EPS guidance for '22, just wanted to ask for a little bit more color on how much of this better outlook is driven by the Optum segment in particular versus the UHC segment versus any other factors at the corporate level. I'm guessing it's maybe mostly driven by Optum and maybe OptumHealth within that. But also what else, ex Optum, is maybe performing better that's worth calling out as well?

偉大的。因此，只需將電話會議中討論過的很多事情聯繫在一起。隨著 '22 年每股收益指引增加 0.90 美元，我只想要求更多的色彩來說明這種更好的前景在多大程度上是由 Optum 部門推動的，特別是與 UHC 部門相比，與公司層面的任何其他因素相比。我猜它可能主要由 Optum 驅動，也可能由 OptumHealth 驅動。但還有什麼，前 Optum，可能表現得更好，也值得一提？

Steven, thanks so much. I think maybe you misspoke. It's a -- we increased our guidance range this year by $0.10, both at the top and the bottom of the guidance range, just to reconfirm that. But listen, that raise is essentially based on the strong performance of Q1, good start to the year. We feel good about that. while as always, there's a lot of moving parts in our world, and you've heard from people like Brian in some detail about some of the dynamic of the first quarter, actually, as it all comes together, the year is kind of shaping up pretty much in line with the expectations we were laying out to you all in November last year. Strong performance is supported by execution across all of our businesses.

史蒂文，非常感謝。我想也許你說錯了。這是一個 - 我們將今年的指導範圍增加了 0.10 美元，無論是在指導範圍的頂部還是底部，只是為了再次確認這一點。但是聽著，這次加薪基本上是基於第一季度的強勁表現，這是今年的良好開端。我們對此感覺良好。雖然與往常一樣，我們的世界有很多動態的部分，你已經從像 Brian 這樣的人那裡詳細了解了第一季度的一些動態，實際上，隨著這一切的結合，這一年正在形成幾乎符合我們在去年 11 月向大家提出的期望。我們所有業務的執行力都支持強勁的業績。

I would say all of the core businesses of Optum, of UnitedHealthcare, have started the year well. We continue to be very focused on the execution of those within those businesses, of course. And I think what you're continuing to see, and I hope you've heard some of that in the conversation today, and it's certainly reflecting through the results, is the synergy opportunities which are coming to life between the 2 organizations.

我想說 Optum 和 UnitedHealthcare 的所有核心業務今年開局良好。當然，我們將繼續非常關注這些業務的執行。而且我認為您將繼續看到，並且我希望您在今天的對話中聽到了其中的一些內容，並且肯定會通過結果反映出來，這就是兩個組織之間正在出現的協同機會。

You heard a lot about value-based care. Now that whole value-based care model, which we believe is truly capable of transforming experiences, not just for patients, but for physicians and payers. That's a product of the 2 organizations working together. The development of in-home care, same thing, very much being led by the 2 organizations working together.

你聽說過很多關於基於價值的護理。現在，我們認為整個基於價值的護理模式真正能夠改變體驗，不僅對患者，而且對醫生和付款人。這是兩個組織合作的產物。家庭護理的發展，同樣的事情，很大程度上是由兩個組織共同領導的。

And increasingly, what we're seeing, as we strengthen our capabilities in areas like that with our deployment of capital and some of the acquisitions we've been making, so for example organizations like naviHealth, Landmark and others. That's then driving strong external growth as well. So really, really demonstrating how building these kind of fundamental innovations in the way in which care can be thought about can then not just be attractive to UnitedHealthcare, of course, but also to many other payers and completely reinforces our deep commitment to be a multi-payer organization, building products and services in Optum which work not just for UHC, but for payers across the spectrum. And that's what you're seeing supporting the business. And it supports our confidence in raising the outlook for the rest of this year.

而且，我們越來越多地看到，隨著我們通過資本部署和我們一直在進行的一些收購來增強我們在此類領域的能力，例如 naviHealth、Landmark 等組織。這也推動了強勁的外部增長。因此，真的，真的證明瞭如何以可以考慮護理的方式構建這些基本創新，當然不僅對 UnitedHealthcare 有吸引力，而且對許多其他付款人也有吸引力，並完全強化了我們成為多- 付款人組織，在 Optum 構建產品和服務，這些產品和服務不僅適用於 UHC，而且適用於各個領域的付款人。這就是您所看到的支持業務的方式。它支持我們對提高今年剩餘時間前景的信心。

So I hope that gives you a clear sense of that, and very much appreciate that final question, Steven.

所以我希望這能讓你清楚地了解這一點，非常感謝最後一個問題，史蒂文。

And thank you to everybody else for joining the call this morning. We truly appreciate your interest and your attention. I hope what you heard in the call today is a strong sense of the confidence in our long-term strategy, and as I just said again, an intensely disciplined focus in its execution. We're aiming to create value for consumers, advancing our mission and delivering high-quality diversified growth in this quarter and for many years to come. We look forward to sharing that progress with you again when we next talk in July.

感謝大家今天早上加入電話會議。我們非常感謝您的關注和關注。我希望你在今天的電話會議中聽到的是對我們長期戰略的強烈信心，正如我剛才所說的那樣，在執行過程中高度自律。我們的目標是為消費者創造價值，推進我們的使命，並在本季度和未來多年實現高質量的多元化增長。我們期待在 7 月的下次會談時再次與您分享這一進展。

Thank you so much, and appreciate your attention today.

非常感謝，感謝您今天的關注。

Ladies and gentlemen, that will conclude today's conference. You may now all disconnect.

女士們，先生們，今天的會議到此結束。您現在可以全部斷開連接。