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.

各位早安，歡迎參加聯合健康集團（UnitedHealth Group）2022 年第一季財報電話會議。聯合健康集團的預先準備發言結束後，將進行問答環節。並提醒各位，本次電話會議正在錄音。

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.

以下為一些重要的開場資訊。本次電話會議包含依據美國聯邦證券法所作之「前瞻性陳述」。此等陳述存在風險與不確定性，可能導致實際結果與歷史經驗或目前預期出現重大差異。部分風險與不確定性的說明可見於我們向美國證券交易委員會（SEC）提交的報告中，包括我們近期定期申報文件所載之警示性聲明。

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.

本次電話會議亦將提及非 GAAP 金額；非 GAAP 與 GAAP 金額之調節表可於公司投資人關係網站（www.unitedhealthgroup.com）之「財務與盈餘報告」專區取得。本次電話會議所呈現之資訊包含於我們今晨發布的盈餘新聞稿中，該新聞稿隨附於 2022 年 4 月 14 日之 Form 8-K，並可自公司網站之投資人關係頁面查閱。

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

現在我將把會議交給聯合健康集團執行長 Andrew Witty。請開始。

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。各位早安，也感謝各位今天與我們一同參與。進入本季之前，我們已為今年設定明確目標：推動長期策略的強力執行並實現高品質的多元化成長；在每一次消費者體驗與每一個接觸點追求卓越；並運用科技協助所有利害關係人改善可近性、可負擔性、健康結果與體驗。從我們的業績可見，我們正達成這些目標。

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.

我想以感謝我的同仁作為今天早晨電話會議的開場——Optum 與 UnitedHealthcare 的 35 萬名員工。他們的投入與努力，讓我們今天有信心將 2022 年調整後每股盈餘（adjusted EPS）展望上調至每股 21.20 至 21.70 美元的區間。

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 11 月的投資人會議上，我們說明了推動長期每股盈餘 13% 至 16% 成長率的 5 個關鍵領域。在第一個領域——價值導向照護（value-based care）交付——OptumHealth 在第一季延續強勁動能，展現其整合式方法與高臨床品質的特色。年初表現強勁後，我們目前預期 2022 年在價值導向安排下新增 60 萬名病患，高於原先估計的 50 萬名。我們的方法著重於在最符合所服務病患需求的場域提供優質照護。我們與 LHC Group 的待完成合併，將強化我們在居家以及其他門診地點提供照護與支持的能力。

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.

在第二個成長領域——健康福利（health benefits）——我們正快速提升方案供給的品質、創新與對消費者的吸引力，並將價值導向照護擴大到規模化。在 Medicare Advantage（聯邦醫療保險優勢計畫）方面，我們在福利穩定性與強化之間的策略性平衡，再次帶動強勁成長。我們仍按計畫在 2022 年額外服務 80 萬人，符合我們去年 11 月所設定的預期。

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.

在商業保險（commercial benefits）市場，我們的創新方案（例如醫師主導與虛擬優先（virtual-first）方案）在過去一年新增服務 35 萬人。這凸顯消費者對這些以高品質基層照護為核心的保障選項之偏好。在最近一次開放投保期間，加入我們個人交易所（individual exchange）方案的新投保人中，近 90% 選擇了具顯著虛擬組成的方案，且近 30% 選擇了虛擬優先方案。展望 2023 年，您將看到我們擴大此類方案供給。

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.

在第三個成長領域——健康科技（health technology）——我們持續推進去年啟動的重大新醫療體系合作夥伴關係，包括與 SSM Health 的廣泛合作；其 11,000 名醫療提供者為整個美國中西部地區的人們提供照護。我們正協助醫療體系夥伴減輕行政負擔，並建立營運量能，使其能專注於提供高品質的病患照護與體驗。這些合作遠超傳統的收入循環管理（revenue cycle management），臨床與科技功能都變得同等重要。

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（health financial services）方面的發展工作，致力於為醫療提供者、支付方與消費者精簡並簡化支付流程，同時降低摩擦、提升速度與便利性。以我們 1 月推出的全新整合式消費者卡為例。許多人通常會分別持有用於臨床照護、藥局福利、食品補助計畫、健身、獎勵計畫等不同卡片。我們已將這些福利整合至單一卡片，大幅簡化消費者與醫療提供者的體驗。而且未來我們還會做得更多。

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.

最後是藥事服務（pharmacy services）。專科藥物的高成本是我們健康保險計畫夥伴最迫切的議題之一。我們運用 Optum 先進的分析能力，與健康計畫合作，讓臨床醫師可取得即時的醫療與藥事分析資訊，並與以病患為中心的福利方案設計相協調，使臨床醫師能在照護現場（point of care）判斷最有效且最適切的治療。我們的初步成果非常正面，協助將專科成本降低超過 15%。整體而言，OptumRx 本季表現、健康的續約留存率與強勁的銷售管線，為成長奠定了良好基礎。

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——從擴大居家與更廣泛的價值導向照護供給、到強化 Medicare Advantage、再到簡化照護的資金支付方式——旨在為消費者創造更大價值，並更廣泛地對全美各種需求層級的家庭、個人與社區生活帶來深遠影響；這也是我們公司每一天所有同仁的重要動力。

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

接下來將由我們的總裁兼營運長 Dirk McMahon 進一步分享這些工作。Dirk？

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，Andrew。在醫療照護中，消費者體驗最重要的面向莫過於便利地取得高品質照護——不是理論上的可近性，而是人們在需要的時間與地點能獲得照護。以檢測為例，我們看到有很大的機會改善消費者體驗。對於結直腸癌等疾病的檢測，往往會成為人們的負擔。因此，很多時候人們不願意處理這些麻煩，導致早期病況未被診斷，直到情況變得非常嚴重才獲得所需照護；這不僅不利健康，也會在未來造成不必要的更高強度治療與更高成本。

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.

和各位許多人一樣，我們觀察到病患更願意嘗試並採用多種類型慢性病的居家檢測。然而，人們首先要找到檢測，接著還要確保結果能回到醫師的工作流程中，這可能具有挑戰。病患需要致電醫療提供者取得處方，前往不同地點領取檢測，然後再想辦法把載有檢測結果的那張紙送進本就忙碌的診所作業流程。

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，我們推出了一套整合式解決方案，涵蓋檢測結果要進入診所系統所需依序完成的所有任務。相較於多步驟流程，這項數位化賦能的解決方案使取得必要篩檢的人數增加近 10%。我們也正將這項關鍵能力擴大提供給更多人，並提供更多類型的檢測。

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.

如各位所知，第一季往往對於奠定我們全年其餘期間的營運成功最具影響力。人們在一開始所獲得的體驗是否順暢，會對消費者與客戶的觀感與購買決策產生長期影響——不僅是接下來 3 個月，往往是未來數年。因此，我們認為此時提供一份本季的績效成績單將相當即時且有幫助。簡短版本是：我們要向 Optum 與 UnitedHealthcare 的同仁致上深深的感謝。

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.

這點或許在 OptumHealth 之價值導向安排下，為眾多新服務對象進行導入（onboarding）時最為明顯。投入系統準備，以及對醫師與員工的訓練，對於奠定為這些新病患提供高品質照護的基礎、並擴展至新地理區域，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，在俄亥俄州與紐約州，我們觀察到後急性期（post-acute）趨勢出現早期改善，例如在營運的第一季內，專業護理機構（skilled nursing facility）收治（admit）人次下降 25%。這證明我們後急性期能力的深度整合，能協助病患轉銜至最符合其需求的照護場域；同時也反映我們在地照護交付組織以病患為中心的導向，以及其對照護連續性的高度警覺與投入。

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，我們的數位投資持續服務我們的照護提供者，並協助推進我們邁向無紙化體驗的努力。在第一季，我們數位入口網站的造訪量持續增加，同時提供者支援成本較歷史平均下降約 12%。重要的是，僅在本第一季，相較去年，我們已推動使用數位文件而非紙本的提供者增加了 38%。

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

我們預期本季所採取的努力，將在未來 5 年節省 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.

在交棒給 John 之前，讓我簡要——讓我簡要談一下我們與 Change Healthcare 的待完成合併。到目前為止，應該很清楚，我們深切致力於協助為病患、付款方與提供者打造更簡單、更智慧且更具適應性的醫療體系。Optum 與 Change Healthcare 的結合，將連結並簡化醫療提供者與付款方仰賴以服務病患的核心臨床、行政與支付流程。

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.

提升效率並降低摩擦將使整個醫療體系受益，帶來更低成本與所有利害關係人更佳的體驗。我們與 Change Healthcare 的延長協議，反映我們堅定相信此結合在改善醫療方面的潛在效益，以及我們成功克服對此合併挑戰的能力。

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

接下來，我將把時間交給財務長 John Rex。

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，Dirk，各位早安。我們 2022 年第一季的表現，使我們處於有利位置以達成全年財務與成長目標。營收較去年同期第一季增加 100 億美元或 14%，達到 800 億美元，Optum 與 UnitedHealthcare 皆呈現雙位數成長。這項強勁且多元化的成長主要來自有機成長，且在我們的服務與福利兩大營運平台之間貢獻均衡。與一年前相比，我們為 OptumHealth 增加了超過 100 萬名服務對象，在價值導向關係中支援的病患增加 30%，處方量增加超過 2,000 萬張，並在我們的健康福利產品中多服務了 150 萬人。

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.

我先就本季期間的照護型態提供一些補充說明，接著再談各個事業。如各位所預期，由於本季初 COVID 發生率達到高峰，照護型態出現相當大的變化。例如在 1 月，我們約有 40,000 例與 COVID 相關的住院，為疫情爆發以來任何月份的最高值；到了 3 月，已降至約 2,000 例。

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.

整體而言，本季照護水準大致回到基準水準，但我們觀察到部分領域略低於歷史基準，例如急診與兒科就診。不過，我們並不假設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.

至於在疫情高峰期間延後就醫可能對人們造成的較長期健康影響，截至目前，我們並未看到許多人原先預期的病情嚴重度上升。例如，初次腫瘤相關診斷的水準與歷史平均一致。當然，我們的核心重點仍是讓人們獲得所需照護；我們也很欣慰地看到關鍵篩檢已回到正常化水準。

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.

接著談業務表現。OptumHealth 第一季營收成長 34%，營業利益成長超過 40%。每位消費者的營收成長 33%。主要驅動因素是以價值為基礎安排（value-based arrangements）所服務的病患人數增加。我們持續擴充價值導向照護產品，例如擴大數位照護與到府服務，[讓我們有]機會以更廣、更深的方式服務更多人。我們預期未來多年將持續強勁成長。

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 營收年增 13%。營收待履約（backlog）為 228 億美元，較前一年增加 20 億美元或 10%。我們不斷擴大的醫療體系合作夥伴關係正推動此成長，我們預期這些合作的數量與廣度將持續增加。OptumRx 營收成長 11% 至 240 億美元，反映去年期間所取得新業務關係的強勁動能。對於這些擴張，我們通常會在初期數月投入相當多的投資，以確保為客戶提供強勁的表現與價值。

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.

接著談 UnitedHealthcare。營收成長 14%，由各項業務共同帶動。我們的 Medicare Advantage 產品仍按計畫可新增最多 800,000 人，其中約 3/4 來自個人與團體 Medicare Advantage，其餘來自雙重特殊需求計畫（dual special needs plans）。新進入 Medicare 的高齡族群，基於其所提供的價值，愈來愈多選擇 Medicare Advantage。而我們今年達成的 5 星品質計畫表現，使我們能在全年持續為我們的計畫產品招募投保人。

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.

我們 Medicaid 產品所服務的人數在第一季增加超過 150,000 人，目前接近 800 萬人。我們對今年剩餘期間的成長展望，仍納入一項預期：當公共衛生緊急狀態結束後，各州將恢復資格重新認定，導致溫和的淨流失。第一季商業保險投保人數符合我們的預期。按費用計價安排（fee-based arrangements）下所服務人數的下降，主要由 3 項先前已知的客戶轉換所致，但已被核心成長所抵銷。

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.

我們預期在 2022 年推進過程中，整體服務人數將增加，主要受惠於市場對我們近期推出的創新產品的強勁回應，以及雇主健康福利所涵蓋總人數的持續復甦；後者通常會落後於已公布的就業成長。

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.

我們的資本承載能力仍然強勁。第一季營運活動現金流為 53 億美元，約為淨利的 1 倍，符合我們的預期。我們也仍預期全年現金流約 240 億美元，約為淨利的 1.2 倍。本季我們透過股利與庫藏股回購向股東返還近 40 億美元，並以 38% 的負債對資本比率結束本季。展望今年完成 LHC 與 Change 兩項結合案，我們仍將具備充足的能力，擴大我們服務人們並協助他們過更健康生活的方式。

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.

如先前所述，基於此成長展望，我們今日將調整後每股盈餘展望上調至每股 21.20 至 21.70 美元的區間。我們也仍預期季節性型態將更符合我們的歷史經驗，全年獲利略低於 50% 將落在上半年。

Now I'll turn it back to Andrew.

現在我把時間交還給 Andrew。

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，John。我希望各位能認出我們去年提出、作為永續成長指引的那些一致主題。我們對於在各項業務中落實執行與持續改善的專注，將是我們在 2022 年強勁開局之上持續延續的特質。

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

那麼，接線員，請開放提問。每位來電者請提一題。

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

（接線員指示）我們現在接聽第一個問題，來自 JPMorgan 的 Lisa Gill。

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?

John，我想回到你對使用量趨勢的評論。你提到 3 月住院人數已降到 2,000，但基準水準似乎正在回落、趨於溫和；你也談到急診室以及 impedes。但你能否談談你在商業保險與政府方案之間所看到的差異？

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?

第二，聽起來你其實不太預期仍有大量被壓抑的需求。我這樣理解對嗎？那麼當我們走向今年下半年時，我該如何看待這個趨勢？

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.

Lisa，非常感謝你的提問。我先請 John 回應第一部分。然後 Brian Thompson，也許你可以談談需求的部分；另外 Brian，也請在其中補充一下是否有任何病情嚴重度（acuity）轉變的跡象。我想這會對正在收聽的朋友有所幫助。先請 John。

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.

Lisa，我是 John。是的，第一季我們在你提到的不同類別中，仍看到類似的使用量趨勢：商業保險略高一些，政府方案略低一些。但整體而言，一切都在回到更接近基準水準的趨勢上。

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.

並且如你在此恰當指出的，我們仍然看到一些差異化的零星區塊，例如阻礙因素以及急診部門。這一直是我們觀察到的趨勢，尚未到我們會預期——會預期它將持續下去的程度，但這是我們注意到的消費者差異。

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.

另外就你提到的評論，Brian 會更深入說明，但就病情嚴重度（acuity）的潛在變化而言，這是我們在疫情初期就談過的：人們錯過治療後，可能會如何回到醫療體系。這仍是我們在非常——許多類別上都極度密切關注的事情。我特別談到腫瘤科以及我們在那些領域看到的情況。所以很高興看到大家去做篩檢。不過，我們尚未看到先前的預期——也就是因為早期錯過治療，發生率可能實際上會上升。

And Brian, could you offer a little more commentary?

Brian，你能再補充一些評論嗎？

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。謝謝你，John，也謝謝你的提問，Lisa。我認為 John 已經總結得很好。如你所預期，這一季有點不尋常，因為很明顯 1 月的住院與感染水準較高，而到了 3 月則明顯惡化下降到較低水準。所以在同一季內有點像兩個故事。

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.

如 John 所提到的，商業保險更接近基準水準，Medicaid 最低，Medicare 介於兩者之間。從服務類型來看，住院略高於基準，但那主要是 1 月我們看到較高住院量所致。而當我們看門診醫師就診時，確實令人鼓舞，因為它在本季一路加速，某種程度上抵銷並且與感染水準下降一致。

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.

就病毒株動態而言，我再指出一點：Omicron 明顯比我們在 Delta 時期看到的嚴重度更低。我們看到的住院大約只有當時的一半。但再次印證 John 所說的，確實沒有延後就醫（deferred care）的跡象；我們在整個疫情期間都密切追蹤這點，觀察篩檢、診斷、嚴重度與病程進展。通常在出現大規模感染後，會在 2 到 3 個月內很快回到基準水準。而我們在本季結束時正處於那樣的狀態。因此，當我們邁向下一季時，對目前的狀況感覺良好。

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.

很好。John、Brian，非常感謝你們的說明。是的，這確實——這一季很明顯可分成兩個部分：1 月，以及 2 月與 3 月在本季中隨著 Omicron 影響轉變而向前推進的情況。而且——但我認為你從 John 與 Brian 兩位聽到的內容，確實反映出活動正回到大致的基準水準，只是有 1、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，我們正像鷹一樣緊盯，觀察是否有任何關於病情嚴重度轉移（acuity shift）的新趨勢。顯然，從病患福祉的角度來看，這非常重要。但到目前為止，我們幾乎沒有看到這方面的訊號。不過也許仍在早期階段。Lisa，非常感謝你的提問。

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

接下來我們將請 Credit Suisse 的 A.J. Rice 提問。

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.

我想我可以問一下，顯然整體市場對通膨壓力有很多討論。我的感覺是你們的收入與成本匹配得相當好，特別是在保險端。但我想知道你們是否能花幾分鐘稍微談談——我知道 Optum 有很多不同的事情在進行。當我們進入一個可能有更大通膨壓力的時期時，你們覺得收入與成本的匹配狀況如何？有沒有任何壓力點？有沒有任何地方其實對你們是有幫助的？請評論一下。

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.，非常感謝你的提問。我先做幾點評論，然後我可能請 Dirk 從更宏觀的角度談談。接著再請 Brian 也談一下 UnitedHealthcare（UHC）投資組合內部的情況。

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，我想非常清楚地說：我們的重點始終是為客戶、會員與病患爭取最好的價值主張。我認為在通膨時期，我們非常嚴肅地承擔這份責任。因此，確保在體系中真正有人為依賴我們的人爭取到最好的交易，讓他們能持續良好地取得醫療服務並在需要時獲得所需照護，這是我們非常專注的事情。

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，針對我們所依賴的各種投入要素，已建立一些非常長期的安排，這顯然很重要。Brian 可能稍後會從 UHC 的角度談一點。不過，無論你看的是我們的 OptumRx 投資組合——我們將持續專注於為藥品取得盡可能最低的價格——或是你看我們經營業務的方式，去尋找生產力來源以抵銷通膨壓力；作為整體議程，在這個時點，UnitedHealth Group 各個部分將首先、最優先地盡一切所能，保護依賴我們的人免受通膨力量的影響。

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，Dirk，也許你可以更廣泛地接著談談我們在公司裡做的一些事情，然後再交給 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.

好的。謝謝你，Andrew。是的。首先，是的，我們一直對人們在醫療照護上面臨的挑戰保持敏感，特別是從成本角度來看。這也是我們推動可負擔性（affordability）議程的一大原因，該議程真正聚焦於總醫療成本（total cost of care），為人們降低總醫療成本。同時，在這些通膨時期，我們也會告訴大家如何從他們向我們購買的福利中獲得更多。我們也做了一些之前談過的事情，例如在市場上推出一些很好的產品，像是我們的虛擬產品，在那些市場中比其他主流產品低 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.

而如 Andrew 所說，我們在技術上非常努力，以提升生產力。從生產力角度來看，我們想做的一件事是藉此讓我們能對員工進行有針對性的投資，並且——或者以保費的形式把效益回饋給大家。所以這些是我們在生產力面向正在推進的事情。

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.

從更廣泛的勞動力策略角度來看，去年秋天隨著所謂「大離職潮」的推進，我們對員工做了一些投資、一些有針對性的投資。在第一季，我們進行了正常的績效調薪週期並加薪。因此，從內部角度來看，我們正努力做正確的事。但展望今年剩餘時間，我們將必須——持續在臨床人員以及客服人員等領域進行有針對性的投資，因為我們在那些領域看到較高的流失率。

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

以上是我們正在做的事情的概括。Brian，你來吧。

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.

好的。謝謝你，Dirk。如你所預期，UnitedHealthcare 內部在管理上有良好的紀律，我對我們目前的狀態感到滿意，其中之一就是依據我們對未來成本的前瞻觀點來定價。包括通膨在內。顯然，我們有一些醫療服務提供者（provider）合約確實提供多年期的可預測性，但這與其說是讓我們免受整體通膨環境影響，不如說是我們有責任如 Dirk 所提到的，去降低那個總成本。

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.

而我比以往任何時候都更受到鼓舞的是，像是價值導向照護（value-based care）、消費者透明度，能引導大家在體系中導航，去到合適的服務端（appropriate site of service）；並且具備數位化工具以確保我們能促成那種虛擬互動，以及急性後期照護（post-acute）與居家創新，真正避免那些昂貴的住院。這些就是我們可以真正推動、用來抵銷整體成本的要素。

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。Brian，我覺得你說得非常好。我們對通膨的回應就是創新，就這麼簡單。我們要為依賴我們的人帶來最佳結果的方式，就是持續創新：我們如何在公司內部運作以交付更高的生產力；我們如何為會員與病患提供更有效率的醫療體系可近性；我們如何利用虛擬照護平台等工具；以及我們如何真正把價值導向照護的價值落地，並把 UnitedHealthcare 與 Optum 之間正在進行的所有工作具體化——這將對我們非常有幫助，確保我們能代表依賴我們的人妥善管理並度過這段期間。A.J.，非常感謝你的提問。

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

我們現在接聽下一個問題，來自 Stephens 的 Scott Fidel。

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.

我想問一個關於 LHCG 收購案的問題。我想分成兩個部分。第一，當你們對 LHGG 的資產進行投資組合檢視時，我想了解你們是否已經就是否計畫保留所有關鍵資產（不含居家健康照護）做出決定，特別是想到安寧療護（hospice）與個人照護（personal care）。

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.

另外，我也想請教，當你們展望把 LHCG 整合進 Optum 更廣泛的臨床平台時，你們看到哪些關鍵的協同效益？尤其是考量到你們在居家照護（home-based care）版圖中已經擁有的一些相鄰資產，例如 Landmark 與 naviHealth。

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.

Scott，非常感謝你的提問。我等一下會請 Wyatt Decker 來就這個問題多做一些回應。

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.

關於 LHC，我們非常自豪能與 LHC 董事會達成協議，讓兩個組織結合在一起。當然，這筆交易尚未完成交割，所以我不會談太多細節。不過我想先說幾點。

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.

而且我很榮幸，甚至就在週一，實際上也花了不少時間與 LHC 的創辦人及領導團隊相處。這個組織內部由 Keith 與 Ginger 自創立以來所建立的文化，正向得令人難以置信。這真的是一家有溫度的公司，真正把病患與其家屬放在第一位。

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.

他們在所有營運線上的影響力都非常卓越，也能對許多經常被排除在照護之外的人們的生活帶來重大改變。這其實是在為許多原本不容易取得醫療照護的人打開可近性，這點非常重要。我非常喜歡我在那個組織所看到的各個面向，也非常期待能成功把它納入 UnitedHealth Group 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.

我也想說，這也是為什麼我會請 Decker 醫師再更深入說明：我們正以很快的速度整合我們的居家與社區（home and community）能力。若你看看真正的驅動因素，除了我們對診所的價值導向（value-based）策略之外，還有我們居家與社區服務的快速成長；這個服務把 naviHealth、Landmark 整合在一起，並且隨著時間推進，當 LHC 加入組織後也會與之對齊，而這一切是建立在我們原本的 Optima Home 產品之上。這是一套非常卓越的能力組合，讓我們在例如服務 D-SNP 人口方面具備非常好的定位，而這在過去是做不到的。正如你先前聽 John 提到的，這也是我們第一季成長的一大部分。

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

在這樣的背景之下，我把時間交給 Decker 醫師，請他提供更多細節。

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.

好的，謝謝你，Andrew。Scott，也謝謝你的提問。我們對與 LHC Group 的結合感到非常興奮。我想 Andrew 說得很好：他們自 1994 年在路易斯安那州一個小社區創立以來，就一直有著長期的文化傳承——致力於服務他人，並在居家照護的情境中幫助人們活出最健康的生活。他們發展出多項能力，確實能非常好地補強 Andrew 所提到、我們正在成長的居家與社區平台。因此我們對此非常期待。

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.

他們提供的照護品質非常出色。舉例來說，他們在 Stars 品質評等中的表現，比全國居家健康照護的平均水準高出整整 33%。而我們也同樣重視品質與服務，因此我們認為這是非常好的契合。

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.

接著延伸你的問題與 Andrew 的評論。當我們把居家健康照護與我們已經納入居家與社區平台、較為複雜的急性後期照護（post-acute care）以及居家複雜照護（complex care in the home）等服務整合在一起時，我們看到了顯著的協同效益，而且這些效益還會持續成長。

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.

這也開始回應一個問題：為什麼在價值導向（value-based）的架構下，要把居家照護交付好一直這麼困難？我們的願景是，透過這一整套完整的服務組合，把它們以具差異化的方式串接起來，協助人們獲得更好的醫療照護結果。一開始，我們會在急性後期照護場景中立即推動部署。謝謝你的提問。

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.

謝謝你，Decker 醫師。A.J.，也非常感謝你的提問。我想再留給你一個關於 LHC 的想法。也讓你知道，從品質角度來看，LHC 的服務提供者中有 85% 的評等是 4 星或以上。我的意思是，這幾乎說明了你需要知道的所有事情：這個組織是什麼樣子，以及為什麼我們希望它成為我們大家庭的一員。我們認為它將為全國各地的會員與家庭帶來很好的可近性與很高的品質。A.J.，非常感謝你的提問。

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

我們現在接聽下一個問題，來自 Wolfe Research 的 Justin Lake。

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?

我想問一個關於價值導向照護（value-based care）的问题。首先，隨著你們對滲透率展望的改善，我很好奇：如果你退一步看你們整體的價值導向照護營運，並以人頭計酬（capitation）的滲透率來衡量，能否和我們分享那個數字？也就是說，以你們醫師及其病患的總可服務市場（TAM）來看，目前已有多少人處於價值導向照護之中？未來仍有多少潛力可望導入？

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?

另外，考量到這個領域競爭激烈，我覺得有趣的是，業界有些傳聞說你們在休士頓做了一筆大型收購，或可能正在進行一筆大型收購。你能談談那邊的併購（M&A）案源嗎？在競爭之下，你們是否仍認為它像 3 到 5 年前那樣強勁？

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.

Justin，非常感謝你的提問。我等一下會請 Brian 從價值導向照護的「前進方向」談談他的看法。我覺得從支付方（payer）的角度來聽這個觀點非常有意思，因為 Brian 和他的團隊所關注的，顯然是如何為仰賴他們的人提供最佳的結果與價值。

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.

但在我把時間交給他之前，先說幾點。我們可能——我不確定是否需要對潛在上限做太多推測。我會聚焦的是目前正在發生的成長速度。也就是 Brian 所帶領的 Medicare Advantage 成長動能；以及在 Decker 醫師的組織之下，有 60 萬人進入 OptumCare 的價值導向人頭計酬環境。我们的重點在於確保我們能在未來多年持續維持這樣的轉移與成長水準。

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.

至於最終的天花板在哪裡，我認為其實取決於我們是否有能力持續在市場上提供極具創新且高品質的能力。而這將持續吸引非常大量的人希望加入並從中受益。所以我對「天花板可能是多少」的思考相對少；我更被激勵、也更興奮的是：在每次 50 萬、60 萬這樣的轉移速度下，我們同時推動轉移、成長並贏得外部業務的能力，才是我們會聚焦的重點。

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

所以在這個基礎上，Brian，我想請你從你的角度再多談一些。

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。我想和你說的類似，對我而言，重點比較不在一個數字。我會說，仍然有很長的跑道。過去主要是地理擴張；現在遠不止如此。我們已經進入雙重資格（duals）族群，涵蓋複雜照護、也涵蓋居家。廣度與規模才是真正的核心。

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.

而 UnitedHealthcare 也有非常強的誘因，與 Optum 持續走在這段旅程上。當你想到我們最佳的留任水準、想到滿意度、想到我們在哪些地方有最低的趨勢從而帶來最佳的福利、最佳的品質與最佳的成長，所有這些成果都出現在我們與 Optum 合作的時候。所以我們很強——我們有很強的誘因繼續這件事；而我也感到鼓舞，因為前方仍然有很長的跑道。

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.

Brian，非常感謝。Justin，回到你第二個關於案源（pipeline） 的問題。如你所料，我們不會對交易揣測發表評論。但我先提出幾點一般性的看法。

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.

你在第一季看到，我們成功完成交割並宣布將 Refresh Health 納入組織。這是一門由 Steve Gold 和他的團隊打造的優秀業務，協助我們在 OptumHealth 之內擴展行為健康（behavioral）服務交付能力，形成非常好的互補。我們在全國從福利端業務已擁有最大的行為健康網路，因此也會持續在那裡運作。

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.

我會說，整體而言，我們的機會案源其實可能比以往任何時候都更為多元，也可能比以往任何時候都更深。因此，從潛在的資本部署能力來看，我們對此相當樂觀。我們持續——如你所見，我們持續非常嚴謹地確保：在我們看到的眾多機會之中，我們聚焦於那些首先且最重要的是，能夠緊密契合我們核心策略、也就是我先前提到的那 5 個成長領域的機會。Refresh Mental Health 就是一個很好的例子，正好落在我們的價值導向（value-based）主張之中，因為我們相信需要把行為健康管理與醫療管理並行帶入。

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.

所以首先，它們必須位於我們策略架構的核心。我們必須相信我們所迎接加入 UnitedHealth Group 的領導團隊之文化與能力。當然，經濟性也必須符合我們嚴格的期望，以支持我們 13% 到 16% 的長期成長企圖，以及股東理所當然期待的報酬。

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.

因此這推動我們向前。我對我們持續部署資本的能力很有信心，而這一直是協助我們實現長期成長的關鍵要素。希望這能讓你對我們目前的狀況有一些了解，Justin。

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

接下來我們將接聽 Cowen 的 Gary Taylor 的提問。

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?

我有個問題。現在我們在思考 OptumHealth 的成長類型，Andrew，你剛才談到的、以及數百億美元的按人頭計費風險（capitated risk），我們該如何看待準備金提列（reserving）？如果 OptumHealth 是一家獨立公司，我們會如何針對其承擔的風險提列準備金？我推測來自 UHC 的按人頭計費在合併報表中會被抵銷（elimination）。那其他付款方的醫療費用應計（medical expense accrual），John，是不是就直接流入你們的總醫療應計裡？還是資產負債表上有其他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。Gary，非常感謝。我直接請 John 來回應。

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.

Gary，我是 John。是的，它會流入其中，而且會出現在你看到其他項目發生時相同的位置。你對於如何看待 UnitedHealthcare 業務與外部業務之間的抵銷是正確的；外部業務當然不會被抵銷。但就我們如何為這些安排適當提列準備金而言，會在同一個位置呈現。

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

接下來我們將接聽美國銀行（Bank of America）的 Kevin Fischbeck 的提問。

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。很棒。我想回到 OptumHealth 的成長談一下。你能談談是什麼驅動了那多出來的 10 萬人嗎？那是有機成長（organic）嗎？是交易帶動的嗎？是直接簽約（direct contracting）嗎？是 United 內部的嗎？還是外部的？有沒有什麼方式可以理解這個成長以及其驅動因素？

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?

然後我想更一般性地問，當你們思考該領域的交易時，你們如何看待估值倍數（multiples），不論是以盈餘為基礎，或是以你們認為把該診所轉為按人頭計費後、長期最終可能達到的盈餘水準為基礎？

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?

Kevin，你可以把問題的第二部分再重複一次嗎？我剛剛中間有點聽不到。可以請你再重複一下嗎？

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.

抱歉。好的。第二部分是關於交易倍數與醫師。我是說，我不確定你們怎麼思考：是看實際盈餘，還是看大概 5 年後、當你把該診所完全轉為按人頭計費後的常態化盈餘（normalized earnings）。只是想了解我們應該如何看待你們在這個領域投入資本所帶來的報酬。

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。很棒。Kevin，謝謝你的提問。我先把第一部分交給 Decker 醫師回應，談談那額外的 10 萬人、使我們達到 60 萬人，是從哪裡來的；由他來說明會更好。

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.

至於我們如何看待在這個領域的投資，我會說每一筆幾乎都是獨特的情況，對吧？我的意思是，每位醫師、每家診所都不同；他們的歷史、處境、動態都非常不一樣。顯然，我們會在一個更廣的視角下評估：不僅是他們迄今為止達成了什麼，更是我們如何結合我們其餘能力，為病患以及這些環境的使用者創造機會與價值。而這才是真正驅動我們經濟評估的因素。

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.

我想你可以看到的是：我們理解並持續學習如何在價值導向（value-based）的框架內做得更好，以及我們如何運用這些組織的專長，讓我們有信心能夠非常公平地回饋選擇加入我們組織的人。這也驅動了我們能成功整合全國各地一些非常傑出的人才及其團隊。我也非常高興他們能留在組織內。

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.

而且能看到 OptumHealth 持續強化自身作為一個由醫師領導的組織，真的非常好。我認為這與外面許多其他機構形成鮮明對比。這是一個在組織各個層級都由醫師領導的組織，這對於這個地方的核心精神與運作脈動開始如何跳動，帶來巨大的差異。我認為這正是支撐我們許多貢獻與競爭力的基礎。

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.

在此，Decker 醫師，作為組織的醫師領導者，也許你可以稍微談談你如何成功推升這個成長率。

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，Andrew，很樂意。Kevin，謝謝你的問題。你真正看到的是：我們花了將近 10 年打造的一個飛輪，如今已經累積了相當大的動能。我們投資在人員、科技、數據，並建立網路，在既有地理區域加深布局，同時也進入新的地理區域。所有這些都持續帶來效益，坦白說也帶來成長。

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.

你的問題是成長來源：新增的那 10 萬人是否來自有機成長？答案是肯定的。我們在開放投保期（open enrollment）與會員留任方面看到強勁成果。而且我們不僅有 4 星計畫，還有 5 星計畫，能夠全年為病患辦理投保。這對雙重資格（duals）族群也同樣適用。

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.

最後我想補充一點：今年這些成長中，有三分之一來自雙重特殊需求（dual special needs）族群。這些人往往難以取得照護，而我們能透過居家與社區提供照護，也就是在他們家中提供全方位（wraparound）的解決方案。因此，這也是另一種協助我們成長的模式。謝謝。

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

Wyatt，非常感謝。Kevin，也非常感謝你的提問。十分感激。

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

接下來我們將接聽富國銀行（Wells Fargo）的 Stephen Baxter 的提問。

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.

只是針對先前一個問題的追問。我想更直接地請教一下我們目前正經歷的顯著較高利率環境。希望您能談談，隨著你們的投資到期並以更高利率再投資，您預期這在未來幾年將如何影響投資組合。

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?

另外，我想我們應該如何看待這對你們所設定的 EPS 成長率目標的影響？這種潛在的上行或順風，會被用來抵消其他地方的通膨壓力，或是較疲弱的經濟背景嗎？還是你們認為，這其實可能在未來幾年對我們的獲利成長形成淨順風？

Stephen, thanks so much for the question. John?

Stephen，非常感謝你的提問。John？

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，利率只要高於 0%，整體而言都會對我們有幫助，因為我們正進入那樣的環境。不過確實需要一些時間，正如你在這裡非常精準指出的。所以我或許可以提供幾個觀點。

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.

我們約 700 億美元的現金與投資中，大約 40% 連結浮動利率。這會是你首先要切入看的部分。其餘 60% 則是在固定利率環境中。因此如你所暗示的，這些會隨時間到期並以更高利率再投資。但就這一塊而言，若以「第 1 年」的影響來看，幾乎不會有太大影響。

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.

我用一個假設來說明。假設利率上升 100 個基點。那會影響到那 40%，或說大約 280 億美元、與浮動利率連結的現金投資。你會先在這裡看到影響。所以把它放在這個範圍來看，這個組成部分大約是 280 億美元。那麼投資收益的影響約為 2.8 億美元。

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.

這裡要注意的是，我們也有大約 100 億美元的浮動利率負債。可以把它想成是把其餘部分轉為浮動的交換合約（swaps）——以及商業本票。因此這也會對那 2.8 億美元形成大約 1 億美元的抵銷。所以如果你以第一次利率上升 100 個基點後、往後推 12 個月來看，大概就是這個區間。

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.

投資組合其餘部分，也就是另外 60%，會在數年期間逐步到期；大致上可以想成每年約有 50 億美元到期。這些到期後的再投資節奏，就是你應該預期的步調。

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

John，非常感謝你。Stephen，也非常感謝你的提問。

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

接下來我們將接受 Nephron 的 Josh Raskin 的提問。

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?

我想請你談談在地方市場的策略，更多是 Optum 這邊在像紐約或休士頓（或可能很快是休士頓）這類市場。我特別好奇的是，你們覺得需要在多大程度上雇用、掌控或擁有醫療服務交付系統（delivery system），以及我們應該如何看待長期的成功與成長。這主要是在交付端嗎？這也會在保險給付端（benefit side）有所體現嗎？

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.

Josh，非常感謝。這其實是個很好的問題。我會說——而且我也會請 Wyatt 為你更深入說明——在 Optum 過去十年左右的發展過程中，我認為我們對於正確的營運方式的看法，公平地說，已經演進了不少。不僅是在我們與醫師之間應採取何種關係組合，也包括醫師相對於進階執業臨床人員（advanced practice clinicians）及其他人員的角色，以及在診所為主的環境與居家為主的環境中，各自應扮演的角色。尤其在最近——我不知道——大概最近 24 個月，我認為我們在思考方式上已經有相當大的推進。

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.

所以我先這樣框架——我現在就交給 Wyatt。不過我會把它框在三個面向，Josh：地點、彼此之間的關係型態，以及臨床人員的類型。我認為這些都是正在演變的動態，而我們也越來越有明確的觀點。Wyatt，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.

好的。謝謝你，Andrew，也謝謝 Josh 的提問。Andrew 的框架非常精準。因此我們的思考，坦白說，價值型醫療（value-based medicine）的實務也正在演進，因為我們能夠進入居家、提供虛擬照護與行為健康照護，以及全面性的服務，甚至能夠克服像社會決定因素（social determinants）這類問題。

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.

因此在像紐約州這類主要仍以按服務計費（fee-for-service）為主的市場，我們確實看到轉向價值型照護的機會。這會是受雇醫師、合作（affiliated）醫師與簽約醫師的組合。但更重要的是，越來越多地把我們在 Optum 內所提供的所有解決方案整合起來，包括 OptumRx、企業內其他單位，以及 OptumHealth，一起用來協助人們取得最佳的醫療照護結果、降低整體照護成本，並且讓照護對醫療消費者而言非常便利。這是市場上的差異化。謝謝。

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

Wyatt，非常感謝。Josh，也謝謝你的提問。

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

接下來我們將接受 Morgan Stanley 的 Ricky Goldwasser 的提問。

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

所以 OptumRx 的 EBIT 以中個位數成長。我們是否應該把這視為某種穩態（steady-state）的基準成長？

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?

另外，如果我們考慮到像 [Humira 生物相似藥累計] 可能在明年某個時點上市。那麼在我們看到本季表現的基礎上，高個位數的 EBIT 成長是否是我們建模時一個合理的水準？

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?

再追問一個。我記得 Dirk 在事先準備的發言中提到到府檢測（in-home testing）。這是你們主要聚焦在 Medicare 與雙重資格（dual）族群嗎？還是也會提供給商業保險（commercial）族群？另外——你們在這個策略上是否有與全國性實驗室合作？

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.

Ricky，非常感謝你的問題。在我請 Heather 更深入說明之前，我們先處理你的第一個問題——先回答你的第二個問題。也許我先請 Tim Noel 從你所關注的 Medicare 業務角度，談談到府檢測的機會與動態。

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，Ricky，我是 Tim Noel。非常感謝你的提問。到府檢測確實是我們高度聚焦的領域。顯然其中有一部分與我們每年在 STARS 方面所做的工作相關，用以補齊與 STAR 評量方法相關的一些缺口。

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.

但更近期，我們真正聚焦的是接觸那些我們知道在丙型肝炎（hep C）與糖尿病等疾病上可能被低估診斷（underdiagnosed）的人群。為此，我們在過去一年已接觸約 100 萬名我們懷疑可能被低估診斷的會員，並提供到府檢測方案，接著由我們在 Optum 的 HouseCalls 夥伴來完成交付。完成率相當令人鼓舞，去年是 35%，我們也會持續評估擴大這個計畫。這將非常有助於我們了解哪些疾病狀況被低估診斷，並能更好地加以治療。

Tim, thanks so much. And Dirk?

Tim，非常感謝。Dirk？

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。Tim 解釋得非常好。Ricky，直接回答你的問題：我們是從 Medicare 開始，並會在推進過程中逐步延伸到商業保險。但我剛才特別談到的是從 Medicare 起步。

Excellent. Thanks so much.

很好。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.

在我把話交給 Heather 來更深入談 OptumRx 之前，Ricky，正如你所提到的，特別是進入明年時，我們在生技製藥方面某種程度上將進入一個新週期，因為會有生物相似藥（biosimilar）的機會。很明顯你提到的是其中一個非常重要、極具規模的案例。因此這顯然會是一個非常動態的環境，而我們——Heather 的團隊正全力投入並為此做準備。

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，當我回顧時，很高興看到第一季成長率的加速。這要歸功於在開發正確的產品與服務、推動我們的留存率，當然還有得標率方面所投入的大量努力。我會關注的一件事是我們眼前的投標機會數量，也就是接下來會出現什麼。過去大約 12 個月左右看到這個數字一路攀升，真的非常有意思。

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.

所以市場正在啟動。考量過去幾年，你聽到這點應該不會太意外，但它確實正在啟動。因此我們看到越來越多的業務進入市場。對於我們持續維持非常、非常高的留存率，也感到非常安心。

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

而 Heather 現在或許可以稍微談談，她如何看待未來 1 到 2 年這些因素將如何發展。Heather？

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。是的，也許我就延續 Andrew 的說法。首先，也許 Ricky，回到你的問題。你可以看到我們不僅對藥房福利（PBM）業務的成長保持不懈的專注，也同樣聚焦於藥房服務以及直接面向消費者（direct-to-consumer）的業務。因此，這將持續支持我們的營收成長，也會支持留存率，以及 PBM 會員數的持續成長——也就是會員成長。

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.

此外，隨著我們展望未來這幾年，這些藥房服務會變得愈來愈重要。你說得沒錯——從我們的角度來看，長期期待的多項生物相似藥（biosimilar）機會，以及其他專科服務，將為我們的會員帶來多重機會。我認為，我們透過藥房服務方案所提供的服務，將不僅推動我們業務營收（top line）的成長，也會持續推動獲利成長；就如同我們對今年指引的承諾，你看到的是中到高個位數的成長。更長期來看，則大致放緩至中個位數。

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.

而這正是我們不懈地專注於，將藥房服務的價值導入我們的客戶、病患以及客戶的消費者，並確保我們持續推動客戶願意付費的工具與服務。這些客戶包括我們外部客戶組合（external book of clients）、我們的 UnitedHealthcare 客戶，也包括我們的藥房服務客戶，例如社區藥局客戶；他們確實需要像我們的行為健康服務這類的服務與方案，來整合一個碎片化的系統。

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.

所以我會從整體來看。隨著我們向前推進，像是我們的臨床分析工具、PBM 專科方案管理服務——Andrew 今天早些時候在講稿中也提到——以及我們持續推動以藥師作為轉型核心的方式，將是我們真正用來成長業務的途徑。

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.

很好。Heather，非常感謝。Ricky，也非常感謝你的提問。我們只剩下最後一個問題的時間了。Emma，請進行最後一題。

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

當然。我們現在接聽最後一個問題，來自 Barclays 的 Steven Valiquette。

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?

很好。為了把電話會議中談到的許多事情串起來：針對 2022 年 EPS 指引上調 0.90 美元，我想請你們再多提供一些細節，說明這個較佳展望中，有多少是由 Optum 部門特別是相較於 UHC 部門所驅動，或是由公司層級的其他因素所驅動。我猜可能主要是 Optum，且可能是其中的 OptumHealth。但另外，除了 Optum 之外，還有哪些表現更好、值得特別點出的部分？

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.

Steven，非常感謝。我想你可能口誤了。我們今年把指引區間上下限各上調了 0.10 美元，先再次確認這點。不過你聽我說，這次上調基本上是基於第一季的強勁表現、今年開局良好。我們對此感覺很好。當然，一如往常，我們的世界裡有很多變動因素；你也聽到像 Brian 這樣的人，對第一季的一些動態做了相當詳細的說明。整體來看，當一切匯聚在一起時，今年的走勢大致與我們去年 11 月向各位所說的預期一致。強勁表現來自我們所有業務的執行力支撐。

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.

我會說，Optum 與 UnitedHealthcare 的所有核心業務在今年一開始都表現良好。我們當然也持續非常專注於在各業務內的執行。而我認為你們持續看到的——也希望你們今天在對話中有聽到一些，且這也確實反映在結果上——是兩個組織之間的協同機會正在逐步實現。

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.

你們聽到很多關於價值導向照護（value-based care）。而這整個價值導向照護模式，我們相信它確實有能力改變體驗，不僅是病患，也包括醫師與支付方。這是兩個組織共同合作的成果。居家照護（in-home care）的發展也是一樣，非常明顯是由兩個組織共同合作所帶動。

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.

而且我們愈來愈看到，隨著我們透過資本部署與一些併購來強化在這些領域的能力——例如 naviHealth、Landmark 等組織——這也進一步帶動了強勁的外部成長。因此，這非常、非常清楚地展現：在照護思維方式上建立這類根本性的創新，不僅對 UnitedHealthcare 具有吸引力，當然也對許多其他支付方具有吸引力，並且完全強化我們作為多支付方（multi-payer）組織的深度承諾：在 Optum 建立的產品與服務，不僅適用於 UHC，也適用於各類支付方。這就是你們看到支撐業務的因素，也支撐我們對今年剩餘期間上調展望的信心。

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

希望這能讓你清楚理解。我們也非常感謝你最後這個問題，Steven。

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.

也謝謝今天早上所有參與電話會議的各位。我們真誠感謝你們的興趣與關注。我希望你們今天在會議中聽到的是：我們對長期策略有強烈的信心，以及——我再重申一次——對執行的高度紀律與專注。我們的目標是為消費者創造價值、推進我們的使命，並在本季以及未來多年交付高品質且多元化的成長。我們期待在 7 月下次通話時，再與各位分享進展。

Thank you so much, and appreciate your attention today.

非常感謝，也感謝各位今天的關注。

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

各位女士、先生，今天的會議到此結束。各位現在可以掛線。