UnitedHealth Group 2023 Q2 Earnings Call
发布时间 2023-07-15 12:15:28 来源
Welcome to the UnitedHealth Group 2nd Quarter 2023 earnings conference call.
欢迎参加联合健康集团2023年第二季度盈利电话会议。
A question and answer session will follow UnitedHealth Group's prepared remarks.
UnitedHealth Group将进行问答环节，紧随其准备好的发言。
As a reminder, this call is being recorded.
作为提醒，此通话正在被录音。
Here is some important introductory information.
这里是一些重要的入门信息。
This call contains forward-looking statements under U.S. federal securities laws.
此通话包含根据美国联邦证券法的前瞻性声明。
These statements are subject to risk and uncertainties that could cause actual results to differ materially from historical experience or present expectations.
这些陈述存在风险和不确定性，可能导致实际结果与历史经验或现有预期有很大的不同。
A description of some of the risk and uncertainties can be found in the reports that we file with the Securities and Exchange Commission, including the cautionary statements included in our current and periodic filings.
一些风险和不确定性的描述可以在我们提交给证券交易委员会的报告中找到，包括我们当前和定期提交的文件中包含的警示性声明。
This call will also reference non-gap amounts.
这个电话还将涉及非差额金额。
A reconciliation of the non-gap to gap amounts is available on the Financial and Earnings Report section of the company's investor relations page at www.unitedhealthgroup.com.
公司非通用准则到通用准则金额的调和情况可以在公司投资者关系页面（www.unitedhealthgroup.com）的财务和收益报告部分找到。
Information presented on this call is contained in the earnings release we issued this morning and in our Form 8K dated July 14th, 2023, which may be accessed from the investor relations page of the company's website.
在这次电话会议中提供的信息内容包含在我们今天发布的收益公告以及我们于2023年7月14日发布的8K表格中，您可以从公司网站的投资者关系页面上获得。
I will now turn the conference over to the Chief Executive Officer of UnitedHealth Group, Andrew Whitty.
我现在将会把会议的主持权交给UnitedHealth Group的首席执行官Andrew Whitty。
Thank you and good morning and thank you all for joining us.
谢谢大家的加入，早上好。
As we discussed a number of weeks ago, during the quarter we saw a somewhat higher than usual range of movement in certain areas of care activity.
正如我们几周前讨论的，季度期间我们在部分护理活动领域看到了比平常更大的波动范围。
As you'd expect, this inevitably impacted some elements of our business.
正如你所预期的那样，这不可避免地对我们业务的一些元素产生了影响。
But we overcame these dynamics with strength in other areas.
但是我们凭借在其他方面的实力克服了这些不利因素。
Our second quarter performance reflects the capabilities, agility and dedication of our people as they responded to the changes.
我们第二季度的表现反映出我们员工的能力、灵活性和奉献精神，他们积极应对了变化。
As a team, we're confident in our ability to robustly grow in this fluid healthcare environment.
作为一个团队，我们对自己在这个多变的医疗环境中能够稳健地成长充满信心。
Indeed, as I hope you saw in our release today, revenue growth in the quarter was strong and well balanced across our enterprise, increasing by more than $12 billion to nearly $93 billion.
事实上，正如我希望你在我们今天发布的报告中所看到的，本季度的营收增长强劲，且在我们整个企业范围内保持了良好的平衡，增加了超过120亿美元，达到近930亿美元。
Let me provide a few highlights of our growth.
让我给你们提供一些我们增长的亮点。
First, the number of patients served by OptumHealth under fully accountable value-based care arrangements grew by more than $900,000 over this time last year.
首先，与去年同期相比，OptumHealth在完全责任制价值导向护理安排下服务的病患人数增长了超过90万人。
Among the new patients we welcomed, a significant number have complex needs.
在我们迎来的新患者中，有相当多的人有复杂的需求。
These people have serious health challenges, limited economic resources and often living communities where it can be difficult to access high quality care.
这些人面临严重的健康挑战，经济资源有限，而且通常居住在难以获得高质量护理的社区中。
Our ability to support their needs is distinctive and a direct result of the investments we have made to provide coordinated and comprehensive medical, pharmacy and behavioral care.
我们能够支持他们的需求是独特的，并且是我们在提供协调和全面医疗、药房和行为护理方面所做投资的直接结果。
Foundational capabilities that will help the patients we serve live healthier lives and drive growth far into the future.
基础能力将帮助我们服务的患者过上更健康的生活，并在未来推动增长。
OptumRx and OptumInsight revenue grew double digits on expanded capabilities and products that are generating new sales and opportunities.
OptumRx和OptumInsight的收入双位数增长，这得益于扩展能力和产品，这些产品正在产生新的销售和机会。
UnitedHealthcare's growth was strong and diversified as well.
联合健康保险公司的增长势头强劲且多元化。
Today we're serving nearly 1.6 million more people in our commercial and public sector program offerings than we did last year.
如今，我们的商业和公共部门的计划服务对象较去年增加了近160万人。
This durable growth, driven by our colleagues' relentless focus on quality and execution, enabled us to achieve second quarter adjusted earnings per share of $6.14, and to strengthen our full year outlook to between $24.70 to $25 per share.
通过我们同事对质量和执行的坚持不懈关注，这种持续的增长使我们在第二季度实现了每股调整后盈利6.14美元，并将我们的全年预期调高至每股24.70至25美元。
We know there is great interest in understanding the recent care activity I just mentioned.
我们知道大家对于刚刚提及的最新照护活动非常感兴趣。
So I'll give you an overview of how we're seeing care plans progress and how we're responding.
所以，我将为您概述我们如何看待护理计划的进展以及我们如何做出回应。
I do want to underscore the most critical point first.
我确实想强调首要的关键点。
Making high quality care more affordable and accessible is at the core of our mission.
我们的使命核心是让高质量护理更加负担得起和易于获得。
Having more people obtaining the care they need is a positive trend for individuals and our health system and society.
让更多的人获得所需的医疗保健是对个人、我们的医疗系统和社会来说都是一个积极的趋势。
As we discussed several weeks ago, during the second quarter we observed increased care patterns, notably in outpatient surgeries for seniors, and especially with certain orthopedic procedures, which may have been postponed.
正如我们几周前讨论的，第二季度我们观察到了护理模式的增加，尤其是老年人的门诊手术，尤其是一些可能被推迟的骨科手术。
John will provide some additional detail on this later.
约翰稍后将提供一些额外的细节。
As we looked to 2024, we have developed compelling Medicare Advantage offerings.
当我们展望2024年时，我们已经开发出了引人注目的医疗保险优势计划。
Our teams were of course thoughtful both in our response to the CMS rate notice and in incorporating these care activity trends into our June benefit filings.
当然，我们的团队在回应CMS费率通知以及将这些护理活动趋势纳入我们6月份的福利申报中时都非常考虑周全。
Even in this challenging funding environment, we continue to prioritize the stability and affordability our members have come to rely on from United Healthcare.
即使在这个具有挑战性的资金环境中，我们仍然将稳定性与可负担性作为我们的首要考虑，以满足我们的会员们从联合保健所依赖的需求。
We're confident that next year we will once again grow at a pace exceeding that of the broader market.
我们有信心，明年我们的增长速度将再次超过整个市场。
While of a much lesser impact than senior outpatient care, we also are seeing increased care activity and behavioral.
尽管对患者门诊护理的影响要小得多，但我们也注意到护理活动和行为上有了增加。
Over the past few years, behavioral care patterns have been accelerating as people increasingly feel comfortable seeking services.
在过去的几年里，随着人们对寻求服务越来越感到舒适，行为护理模式加快发展。
Just since last year, the percentage of people who are accessing behavioral care has increased by double digits.
自从去年以来，寻求心理护理的人数已经出现了两位数的增长。
From our perspective, it's an encouraging sign that more people are seeking help. Yet, the ongoing shortage of qualified care providers has caused significant access challenges. To address the issue, Optum Health has expanded its network by tens of thousands of care professionals this year. And we are developing our benefit offerings, assuming demand for behavioral care services will continue to rise.
从我们的角度来看，更多人寻求帮助是一个令人鼓舞的迹象。然而，持续存在的合格护理人员短缺问题导致了严重的服务难题。为了解决这个问题，阿普特姆健康今年已经扩大了其数万名护理专业人员的网络。我们正在开发我们的福利计划，假设对行为护理服务的需求将继续增长。
Optum Health's value-based care models are continuing to deliver especially strong and measurable results for people. Today, serving more than 4 million patients and dozens of payers. Optum Health and the patients and payers it serves share a common desire to seek improved health outcomes and experiences, while ultimately lowering the costs of care.
Optum Health的价值导向护理模式持续为人们带来强大且可量化的成果。如今，Optum Health为超过400万患者和数十家支付者提供服务。Optum Health与其所服务的患者和支付者都有着共同的愿望，即追求改善健康结果和体验，同时最终降低护理成本。
We're pleased to see more evidence supporting the efficacy of value-based care. Last month, researchers at Yale Medicine, working in collaboration with Optum, published a peer-reviewed study about in-home visits, an important element in our value-based care approach. The study found patients who received our in-home preventative wellness assessments, compared with those who hadn't, made fewer emergency department visits, and spent fewer nights in hospitals across four common conditions (Depression, hypertension, coronary artery disease, and type 2 diabetes). They also experienced reduced wait times for follow-up primary care.
我们很高兴看到越来越多的证据支持以价值为基础的医疗的有效性。上个月，耶鲁医学院的研究人员与Optum合作，发表了一项经过同行评审的研究，内容是关于我们以价值为基础的医疗方法中的重要要素之一——上门访视。该研究发现，接受我们上门预防性健康评估的患者与未接受的患者相比，在四种常见疾病（抑郁症、高血压、冠心病和2型糖尿病）方面，急诊就医次数较少，住院时间减少。他们还在后续初级护理方面经历了等待时间的减少。
Yale Medicine's research follows another peer-reviewed study published in JAMA in December, which found Medicare Advantage patients in Optum's fully accountable care model showed significantly better health outcomes compared to people in Medicare fee-for-service. Optum Health patients fared better on each of eight key metrics, including hospital readmissions and emergency department visits. We see these results as compelling validation of the value-based care approach and signal more strongly its promise and potential as we expand these care models to many millions more patients in the years ahead.
耶鲁医学的研究紧随十二月份《美国医学会期刊》刊登的另一项同行评审研究，该研究发现与医疗费用为服务的医疗保险相比，优持康健全负责任护理模式下的医疗保险受益人在健康成果方面明显更好。优持康健病人在八个关键指标，包括住院返院率和急诊就医次数等方面取得更好的效果。我们认为这些结果令人信服，证明了以价值为导向的护理方法的价值，并表明我们在未来几年将在更多病人身上扩展这些护理模式的前景和潜力更加强大。
I'll now turn it over to United Health Group President and Chief Operating Officer Dirk McMahon to elaborate on how we're focusing on affordability, transparency, and simplicity for the people we serve.
我现在将把发言权交给United Health Group总裁兼首席运营官Dirk McMahon，他将详细阐述我们如何致力于为我们服务对象提供经济性、透明度和简易性。
Dirk, thanks Andrew. Making high quality care more affordable and more accessible is what we do. So it is really great to see people getting the care they need, especially as our teams are working to build more capacity and our benefit networks and care delivery resources to accommodate consumers' evolving needs.
Dirk，谢谢Andrew。我们的工作是使优质护理更加负担得起和更易获得。因此，看到人们得到他们所需的护理真是太好了，尤其是我们的团队正在努力增加能力，完善我们的福利网络和护理资源，以适应消费者不断变化的需求。
Affordability is vital. For far too many people, cost remains the most significant barrier to high quality care. We are leaning in-hard on behalf of consumers, employers, and health plans to lower out-of-pocket costs and drive greater affordability throughout the system. As you heard from Andrew, recently we've seen an uptick in outpatient surgeries. Finding the most appropriate site of service is crucial because the cost of those procedures can differ dramatically depending upon where they are performed. Overall, evidence shows that comparable procedures performed in ambulatory surgery centers cost about half as much as traditional settings with comparable outcomes. For consumers, that translates into many hundreds of dollars in out-of-pocket cost savings for just a single procedure. And the patient satisfaction levels at our centers are among the highest in health care, with NPS approaching 90.
负担能力至关重要。对于太多人来说，费用仍然是高质量护理的最大障碍。我们正在代表消费者、雇主和医疗计划大力推动降低个人费用，并推动整个医疗系统更加负担得起。正如安德鲁所说，最近我们看到门诊手术有所增加。找到最适合的服务地点至关重要，因为这些手术的费用可能会因地点不同而截然不同。总体来说，证据显示，在门诊手术中进行的可比手术费用大约只有传统环境中的一半，并且效果相当。对于消费者而言，这意味着仅仅一次手术就可以节省数百美元的个人费用。我们医疗中心的患者满意度在医疗行业中属于最高水平之一，NPS 接近90。
Also high on our affordability agenda is continuing to lower the cost of prescription drugs. Our customers, including employers, unions, health plans, and governments, count on us to help them access the most effective medicines at the lowest possible cost. In fact, pharmacy benefit managers like ours are the only link in the drug supply chain whose main purpose is to improve affordability for everyone. We go further by recommending benefit designs and providing tools to help consumers navigate their options and find the best value for their prescriptions. A recently launched feature called Price Edge, which provides the lowest cost option for a patient's medication, already has delivered millions of dollars in consumer out-of-pocket savings.
在我们的可负担性议程中，降低处方药费用的成本仍然是一个重要目标。我们的客户，包括雇主、工会、健康计划和政府，都依赖我们帮助他们以最低可能的费用获得最有效的药物。实际上，像我们这样的药物福利经理是药物供应链中唯一一个主要目标是为每个人提高可负担性的链接。我们通过推荐福利设计和提供工具来帮助消费者选择并找到处方药的最佳价值，进一步助其掌握自己的选择。最近推出的名为“价格优势”的功能已经为消费者节省了数百万美元的费用。
（尽量易读翻译）我们致力于降低处方药费用的成本，在我们的日程中是很重要的事情。我们的客户，包括雇主、工会、健康计划和政府，指望我们帮助他们以最低的费用获得最有效的药物。实际上，像我们这样的药物福利经理是药物供应链中惟一一个专注于提高每个人可负担性的链接。我们通过推荐福利设计和提供工具，帮助消费者了解自己的选择，并找到处方药的最佳价值。最近推出的名为“价格优势”的功能已经使消费者节省了数百万美元的费用。
Specialty drug costs continue to be a focus of every customer OptimRx works with. Our differentiated approach to specialty is designed to serve the unique needs of patients, payers, providers, and farmer partners, and has allowed us to greatly expand our access to limited distribution drugs. We work to tailor our programs with individualized, single point of contact care, for rare disease, and clinical excellence programs for conditions such as MS, autoimmune diseases, and cancer. Finance working with OptimRx to implement all our specialty medication management programs can save up to 20% on their specialty drug costs.
特殊药物的成本继续是OptimRx与每个客户合作的关注重点。我们针对特殊药物的独特需求，采取了区别对待的方法，旨在为患者、支付者、提供者和农业合作伙伴提供服务，并使我们能够大大扩大对限制销售药物的获取。我们努力根据个体化的需求定制项目，为罕见疾病提供单点联系护理，并为诸如多发性硬化、自身免疫性疾病和癌症等疾病提供卓越的临床服务。与OptimRx合作实施我们的所有特殊药物管理计划，财务部门可以节省高达20%的特殊药物费用。
Mostly related to specialty, biosimilars are another area where we are helping drive affordability and consumer choice. Earlier this year, we began offering Amgevita, a biosimilar to Humera, at parity, ensuring patients and their doctors have more options to choose from when deciding on a course of care. Recently, OptimRx and UnitedHealthcare announced the addition of two new Humera biosimilars, Siltizo and Hyremos to our standard prescription drug list also at parity. This increased competition for the innovator drug will result in double-digit savings for our customers.
主要与特殊药物有关，生物相似药物是另一个我们在帮助推动价格可负担性和消费者选择性方面发挥作用的领域。今年早些时候，我们开始提供Amgevita，这是一种与Humera相似的生物药物，价格相当，确保患者和他们的医生在决定治疗方案时有更多选择。最近，OptimRx和UnitedHealthcare宣布将两种新的Humera生物类似药物Siltizo和Hyremos添加到我们的标准处方药清单中，价格也相当。这种对创新药物的增加竞争将为我们的客户带来两位数的节省。
You might also recall that a year ago, we announced our initiative to offer life-saving drugs at no cost to our customers. This benefit is available to everyone in UnitedHealthcare's group-fully insured commercial plants and has been adopted by more than 500 of our self-funded customers, increasing adherence and saving people millions of dollars.
也许你还记得一年前我们宣布的一个措施，即为我们的客户提供免费的救命药物。这一福利适用于美国合全保险商业计划的所有人，并且已经被我们的500多个自资办理的客户采纳，有效提高了药物依从性并为人们节省了数百万美元。
Finally, another important customer innovation that is making the health system simpler is OptimFinancial's integrated card, which enables seamless access to benefits, programs and rewards for more than 13 million consumers who have been issued the card since we've broadly rolled it out at the start of the year. Adoption and satisfaction levels have been very strong, making it much simpler for seniors to navigate the system and understand their benefits, and creating a more satisfying consumer experience. These and many other results are validating our strategic approach to health care. I know from my many meetings with customers that these affordability, transparency and simplicity initiatives are resonating. They are a key reason for our continued growth in a highly competitive environment and for our confidence in maintaining our momentum as we look ahead.
最后，另一个重要的客户创新是OptimFinancial的一体化卡，该卡使超过1300万消费者能够无缝访问福利、项目和奖励。自从今年初广泛推出以来，对该卡的采用和满意度非常高，使得老年人更容易使用这个系统，理解他们的福利，并创造出更令人满意的消费者体验。这些以及其他许多结果证实了我们在医疗保健方面的战略方法。通过与客户的多次会议，我知道这些价格合理、透明度和简易性的倡议产生了积极影响。它们是我们在竞争激烈的环境中持续增长的关键原因，并使我们有信心在未来保持势头。
With that, let me hand it over to Chief Financial Officer John Rex. Thank you, Dirk. Adaptability and delivering greater value for the people we serve continue as foundational elements for our enterprise. These last few months are a good example, identifying evolving market trends, moving quickly to help people get the care they need, incorporating our broad and multifaceted insights into planning, and importantly, delivering our commitments to you, our shareholders. These traits underpin our confidence not only in achieving our goals for 23, but also as we look toward 24 and beyond.
随着这个，我将把话题交给首席财务官约翰·雷克斯。谢谢，迪尔克。适应性和为我们服务的人们提供更大价值的能力，仍然是我们企业的基石。过去几个月是一个很好的例子，我们确定了不断变化的市场趋势，迅速采取行动来帮助人们获得他们所需的护理，将我们广泛而多层次的见解纳入规划中，更重要的是，履行我们对您，即我们的股东的承诺。这些特点不仅支撑着我们对于实现2023年目标的信心，同时也使我们能够展望2024年以及更久远的未来。
Before reviewing our business results, let me elaborate on the care patterns Andrew described earlier. To illustrate, in the second quarter, outpatient care activity among seniors was a few hundred basis points above our expectations. As we've highlighted specific orthopedic and cardiac procedures had increases far above that level of variation. And as we developed and filed our 2024 Medicare Advantage offerings, we assume that these levels of heightened care activity will persist throughout next year. Overall care activity among our Medicaid and commercial populations is consistent with our expectations. As always, we continue to intensely analyze trends that may indicate more severe disease progression, which could point to rising acuity. For example, in areas such as cancer or cardiovascular disease, we see no such evidence while continuing to monitor closely.
在回顾我们的业务成果之前，请允许我详细阐述一下之前安德鲁所描述的护理模式。为了说明，第二季度，老年人的门诊护理活动超出了我们的预期几百个基点。正如我们所强调的，特定的骨科和心脏手术的增长远远超过了那种水平的变异。在我们制定并提交2024年医疗保险优势计划时，我们认为这种加强护理活动的水平将持续到明年。我们的医疗补助和商业人口的整体护理活动与我们的预期一致。正如以往一样，我们继续深入分析可能表明更严重疾病进展的趋势，这可能预示着加重的严重程度。例如，在癌症或心血管疾病等领域，我们看不到这样的证据，但我们仍在密切监测。
With that, let's turn to our second quarter results. Revenue of 92.9 billion grew by nearly 12.6 billion or 16% over the prior year, with double digit growth at both Optum and United Healthcare. Optum Health revenues grew by 36% to 23.9 billion, driven by an increase in the number of patients served, a growing mix of patients with more complex needs, and the expanding scope of care services we can offer. Operating margins reflect the higher care activity patterns we have discussed, with seniors comprising a significant majority of value-based patients served. OptumRx revenues grew by 15%, surpassing 28 billion, driven by continued new customer wins, and strong double digit growth across our specialty, infusion, and community pharmacies. Crit growth of nearly 7% reflects continued demand for our affordable solutions that give customers choice and simplify the pharmacy experience, such as biosimilar access and digital pharmacy tools. Partway into the 24-selling season, this momentum continues with strong client additions.
随着这一点, 让我们转向我们的第二季度业绩。929亿的收入增长了近126亿，同比增长16%，Optum和United Healthcare都有两位数的增长。Optum Health的收入增长了36%，达到了239亿，这是由于服务人数增加、复杂需求患者比例增加以及我们能够提供的护理服务范围扩大所推动的。经营利润率反映出了我们所讨论的较高护理活动模式，其中老年人占大多数价值型患者。OptumRx的收入增长了15%，超过了280亿，这是由于不断赢得新客户和特殊、输液和社区药房的强劲两位数增长所推动的。接近销售季的一半，这一势头还在继续，客户增加强劲。
OptumInsight revenues grew 42% to nearly 4.7 billion. The revenue backlog reached over 31 billion, an increase of 8 billion over last year, in part due to the addition of change healthcare. The integration and investment activities discussed on previous calls have gone well and are setting the stage for the next phase of growth for OptumInsight.
OptumInsight的收入增长了42%，达到近47亿美元。收入积压额达到310亿美元，较去年增加了80亿美元，部分原因是由于加入了Change Healthcare。在以前的电话会议上讨论的整合和投资活动进展顺利，为OptumInsight的下一阶段增长奠定了基础。
Turning to United Healthcare, our commercial business added nearly 500,000 people in the first half and continues its growth, with the 24-selling season indications tracking favorably. Within our public sector programs, we continue to expect growth of over 900,000 Medicare advantage members this year, and our Medicaid performance remains strong as we continue to support states as they initiate redeterminations. Comprehensive outreach efforts to help individuals retain coverage are under way, so it is still early as most states began this work only recently.
转向美国联合保健，我们的商业业务在上半年增加了近50万人，并且持续增长，24个销售季迹象也显示良好。在公共领域项目中，我们预计今年Medicare优势会员人数将增长超过90万人，我们的医疗补助表现也依然强劲，因为我们继续支持各州进行重新确定。全面的外联工作已经展开，以帮助个人保持覆盖，目前这项工作刚刚开始，大多数州只是最近开始。
Our capital capacities are strong, adjusted cash flows from operations were at 10.4 billion or nearly two times net income in the second quarter, and 15.6 billion were nearly 1.4 times net income in the first half. In the first six months of this year, we returned 8.3 billion to shareholders through dividends and share repurchases, and in June, our Board of Directors increased the dividend by 14%.
我们的资金实力雄厚，经营活动的调整现金流量在第二季度达到104亿美元，几乎是净利润的两倍，并且在上半年达到156亿美元，几乎是净利润的1.4倍。今年前6个月，我们通过股息和股份回购向股东返还了83亿美元，并且在6月份，我们的董事会将股息提高了14%。
As Andrew mentioned, based upon our growth outlook and the trends discussed, today we were able to strengthen and narrow our full-year 23 adjusted earnings outlook to a range of $24.70 to $25 per share. Within this, we expect a relatively balanced pacing in the second half. Now, I'll turn it back to Andrew.
正如安德鲁所提到的，根据我们的增长前景和讨论的趋势，我们今天能够加强和缩小我们的全年23年调整后收益的展望范围，为每股24.70美元到25美元之间。在这个范围内，我们预计下半年的增长节奏相对平衡。现在，我将把话题转回给安德鲁。
John, thank you. Overall, the United Health Group, looking to the second half of the year, and into 2024 and beyond, were confident that we're capturing the current landscape in our planning decisions, which in turn gives us confidence in our ability to sustain the growth momentum shown in our first half, and continue to demonstrate the adaptability, performance, and mission-driven purpose of this enterprise, especially in evolving environments. With that operator, let's open it up for questions. One per call, please. Floor is now open for questions.
约翰，谢谢你。总体而言，联合健康集团展望到今年下半年，以及2024年及以后，我们对于我们在规划决策中捕捉到了当前格局充满信心，从而使我们对于保持上半年所展示的增长势头的能力以及在不断变化的环境中展示出的适应性、表现和使命驱动的目标充满信心。现在让我们开始提问。每个人一次提一个问题，请。现在开放提问。
At this time, if you have a question or a comment, please press star 1 on your touch-tone phone. You may remove yourself from the queue by pressing star 2 on your touch-tone phone. We ask you to limit yourself to one question. If you ask multiple questions, we will only be answering the first question so we can respond to everyone in the queue this morning.
当前，如果您有任何问题或评论，请在您的触摸电话上按下星号1。您可以通过在您的触摸电话上按下星号2来退出队列。我们要求您限制自己提出一个问题。如果您提出多个问题，我们只会回答第一个问题，以便我们能够在今天早晨回应队列中的所有人。
We'll take our first question from AJ Rice with Credit Suisse. Thanks. Hi, everybody. Maybe I appreciate the comments about what you're seeing in the care demand. Maybe on the optimum health side, you guys, obviously, top lines, continues to be very strong there. There's a little bit of margin degradation from the first quarter to second quarter. How much of that relates to what you're describing around senior utilization? I know you've got a cap-tated component and you've got a fee-for-service component. I think last quarter, you also said that the growth and membership would be something that would pressure margin short-term, obviously, be a long-term positive. Then there's a lot of other things in Optum Health. Are they helping or hurting margin? Give us a little bit of flavor for what's happening underneath the aggregate number.
我们将从瑞士信贷的AJ Rice提出第一个问题。谢谢。大家好。也许我感谢你们关于养老需求的评论。也许在健康服务方面，你们的主营业务仍然非常强劲。从第一季度到第二季度，利润率有些下降。这与你们所描述的老年人利用率有多大的关系？我知道你们有一项资本制度的组成部分和按服务收费的组成部分。我记得上个季度，你们还说增长和会员数量将在短期内对利润率造成压力，但从长期来看会是一个积极因素。然后在Optum Health还有很多其他因素。它们是在帮助还是在损害利润率？请给我们一些了解整体数字背后正在发生的情况的味道。
AJ, thanks so much for the question. First off, let me start off. I'm super pleased with the performance of Optum Health overall. When you look at the growth of that business, and particularly the expansion of the number of patients who were now looking after the value-based arrangements now, about 4 million folks, not just from UAC, but of course, from many other payers as well. Really strong validation of the model that we've been building, and you can continue to see us extend that.
AJ，非常感谢你的问题。首先，让我开始说。我对Optum Health整体的表现非常满意。当你看到这个业务的增长，特别是那些参与价值基础安排的患者数量的增加，约有400万人，不仅来自UAC，当然还来自许多其他付款方。这真的是对我们一直在建立的模式的强有力验证，你可以看到我们会继续推广这一模式。
In terms of the margin compression during the queue, really, I'd say there are a couple of dynamics to that. One is trend, and you very much echo in the senior trend comments you've heard as make earlier in the quarter, and I think is well understood. A second element of that, which specifically affects Optum Health, is the behavioral growth.
从排队期间的利润压缩来看，实际上，我会说有几个动态因素。其中一个是趋势，在这方面，你非常明确地回应了你在季初已经听到的高级趋势评论，我认为这是众所周知的。第二个影响特别关注Optum Health的因素是行为增长。
I mentioned that in my prepared comments, AJ, around continued strong growth in behavioral. That certainly has played its part within Q2 for Optum Health. Then the third area is a good news story, but with short-term implications. That's really the growth of the membership that's come in this year. As you know, we've grown very strongly this year, actually a little ahead of our expectations. We've also brought in a very significant number of complex patients. As we invest in helping those folks manage their care better, that puts a little pressure on the margin in the short run. But that's really laying super strong foundation stones, not just for as we move through the year, but into 24, 25, 26.
在我的发言中，AJ，我提到了行为领域的持续强劲增长。这在Optum Health的第二季度发挥了重要作用。然后第三个方面是一个好的消息，但会有短期影响。那就是今年入会人数的增长。正如你所知，今年我们的增长非常强劲，实际上超出了我们的预期。我们也吸引了很多病情复杂的患者。随着我们在帮助这些人更好地管理他们的护理方面的投资增加，短期内会对利润率造成一些压力。但这真的为我们不仅为今年，还有24年、25年、26年奠定了非常坚实的基础。
So those three elements, the senior trend piece, the behavioral piece, and then the effect of the strong growth is really what explains what goes on. We're going to continue to lean into that growth very assertively.
因此，这三个元素，即高级趋势领域、行为模式以及强劲增长的影响，真正解释了发生的情况。我们将继续积极倾斜向这种增长。
AJ, thanks so much. All right. Well, the next two that leaves again with JP Morgan. Thanks very much. Good morning. I just want to understand, when I think about the guide to the upper end for the full year MLR, how much of that is driven by this MA outpatient trend versus behavioral. And when I think about behavioral utilization, is that being driven by a particular population or is it more broad based? And how do I just think about behavioral as a percentage of your cost?
非常感谢AJ。好的，接下来的两个问题又和摩根大通有关。非常感谢。早上好。我只是想了解一下，当我考虑到全年MLR的上限指导时，有多少是由MA门诊趋势和行为驱动的。当我考虑到行为利用率时，是否是由特定人群驱动的，还是更广泛的。我该如何将行为作为你们成本的百分比来思考呢？
So, Lisa, thanks so very much for that. Let me ask John to just context for you a little bit the balance between the senior and behavioral and then maybe ask Dr. Decca to just give you a little bit of commentary around the type of consultation that we're dealing with in terms of the growth.
所以，丽莎，非常感谢你的贡献。让我请约翰为你简单解释一下高级和行为方面的平衡，然后再请德卡医生就我们所处理的增长咨询类型发表一些评论。
Lisa, good morning. It's John. So in terms of your question, the majority of the guide to the upper end of the full year is driven by what we've described in terms of the activity, the care activity we're seeing among seniors in outpatient. So that's a core there. In terms of behavioral, what we've noticed in behavioral is an increase in the number of people accessing care. Andrew has this in his comments, but a very, very significant increase even just since a year ago in terms of the number of people that are looking to access care. It's a great thing. We are planning on that continuing. We don't see why that trend slows down. So we're designing your benefits for that to continue. As you recall, I know Lisa, behavioral resides within Optum Health. And so that's a kind of an impact that we see in that component. And Wyatt, maybe some other commentary.
早上好，Lisa，我是John。关于你的问题，全年结果中绝大部分是由我们所描述的门诊护理活动驱动的，我们在老年人中观察到了这样的情况。所以这是一个核心因素。在行为方面，我们注意到看病的人数有所增加。Andrew在他的评论中提到了这一点，但是与一年前相比，寻求看病的人数甚至有了非常非常显著的增长。这是一件好事。我们计划继续这个趋势。我们看不出为什么这个趋势会放缓。因此，我们为此设计了你们的福利。正如你所记得的，Lisa，行为方面属于Optum Health的范畴。这是我们在这个领域所看到的一种影响。Wyatt，也许还有其他的评论。
Yeah, absolutely. Thank you, Lisa. So you asked about the types of consultations and care being provided within behavioral and we're seeing across the board increase in utilization. But what's encouraging from a public health perspective is it isn't strictly young people. It's across the board. We're seeing 30, 40, 50 year olds accessing behavioral health care for needed care for conditions like anxiety, depression, substance use disorder. And our commitment is to make sure that they have access to that care. So as you heard from Andrew earlier, we've expanded our behavioral health care network. And we also a couple years ago very thoughtfully launched a behavioral care provider services. And we now have ambulatory services available in 37 states. And we have self-paced modules for things like anxiety and depression. And we add a therapist as appropriate. So you'll see us continuing to make sure our members have access as well as providing innovative scalable solutions for behavioral health care needs across the age spectrum. Thank you.
是的，绝对是的。谢谢你，丽莎。你问及了行为健康咨询和护理的类型，我们发现在使用方面普遍增加。但从公共卫生角度来看，鼓舞人心的是，不仅仅是年轻人，各个年龄段都有人寻求行为健康护理，以获得治疗焦虑、抑郁、物质使用障碍等问题的所需护理。我们承诺确保他们能获得这种护理。正如你之前从安德鲁那里听到的，我们扩大了我们的行为健康护理网络。几年前，我们还有意启动了行为护理提供者服务。我们现在在37个州提供门诊服务，并且我们提供针对焦虑和抑郁等问题的自主学习模块。我们会根据需要添加治疗师。所以你会看到我们继续确保我们的会员能够获得护理，并为各个年龄层提供创新可扩展的行为健康护理解决方案。谢谢。
Thank you so much. So, Lisa, I think you got it there. Overall, it's very much around the senior trend phenomena within Optum Health that the behavioral piece plays its part. We see that very much as an area where we will continue to step up and make sure that we're delivering the care in the way that why it just described to you.
非常感谢你。所以，莉莎，我想你理解了。总的来说，这与Optum Health内部的老年趋势现象非常相关，行为因素起到了一定的作用。我们非常认为这是一个我们将继续加强并确保我们以所描述的方式提供照护的领域。
Next question, please. We'll go next to Nathan Ridge with Goldman Sachs. Hi, good morning. Thanks for the question. John, you mentioned the balance pacing of EPS in the back half of the year between 3Q and 4Q. Could you talk about your expectations for MCR specifically between the two quarters? And, you know, how are you thinking about the trend of care activity as we head into the back half of the year, given what you're seeing with respect to demand as well as some of the supply bottlenecks that, you know, to care being delivered, maybe being removed and, you know, do those factors differ significantly between Medicare and the commercial or Medicaid lines of business. Thank you.
下一个问题，请。我们接下来要与高盛的内森·里奇(Nathan Ridge)进行讨论。嗨，早上好。谢谢你的问题。约翰，你提到年后半年EPS的平衡节奏在第三季度和第四季度之间。你能谈谈你对这两个季度的MCR的预期吗？而且，鉴于你对需求的看法以及由于供应瓶颈所导致的一些可能被解决的护理交付问题，你对于护理活动的趋势是如何思考的呢？这些因素在医疗保险、商业保险或医疗补助业务之间是否有显著差异？谢谢。
Nate, good morning. Thanks for the question. Yeah, in terms of the balance pacing, the way I described that is and MCR and how that feeds in. We'd expect the MCR to be a little bit lower in the 3Q than we saw in the 2Q. Some of that seasonality as you would fully expect. So within the context of balance, expect earnings to be a little bit higher marginally in 3Q than 4Q because of that typical factor in there. And thinking of an MCR somewhere in the zone of between kind of what we saw in the 1Q and 2Q just, but a seasonality factor. Important in that is we expect the kind of general pacing of care activity to remain consistent. That's what we've actually been seeing here. So since we've talked about this, and as we've looked at the level of care activity across the company, these elements we talked about in terms of senior outpatient care are really remaining. Remaining stable the levels we talked to. And our expectations that continues in that level.
早上好，Nate。谢谢你的问题。是的，在平衡节奏方面，我所说的是医疗索赔率(MCR)及其对业绩的影响。我们预计，第三季度的MCR将会比第二季度稍低一些，这在季节性上是符合预期的。所以在平衡方面，预计第三季度的利润会稍微高一些，因为这是一个典型的因素。关于MCR，我们预计将在第一季度和第二季度之间，加上季节性因素。重要的是，我们预计照护活动的整体速度将保持一致，这是我们目前所看到的情况。自从我们谈到这个问题以来，通过对公司的照护活动水平进行观察，我们看到了我们所谈论的高龄门诊照护的稳定水平。我们对这种稳定性将会持续下去的预期。
So as you look out to the second half of this year, our expectation that continues at those levels that we've been seeing would be, I mentioned a few hundred basis points above our expectations in the senior business. That continues. The only underlying factor is a little bit of seasonality that you would see occurring there. Right. Thanks so much, gentlemen. Thanks, Nate. Next question.
所以当你看向今年下半年时，我们对于维持目前的水平仍然抱有期望，我提到的高于我们对高级业务的预期几个百分点会继续存在。这种情况将持续下去。唯一的潜在因素是一点季节性的影响。好的。非常感谢，先生们。谢谢，内特。下一个问题。
Well, the next two, Justin Lake with Wolf Research. Thanks. Good morning. My question is on commercial trend that you mentioned it's in line with expectations. Wanted to delve a little bit deeper. I think you might have said previously that you'd priced for commercial trend to be above normal this year. So some conservatism. So does that mean that it's running above normal, but in line with your pricing at this point, if it's above normal, can you tell us how to emerge. Versus Q for Q, I mean, you get it up tick versus into Q versus one Q or four Q. And then just lastly, any insight on the commercial components, you know, is outpatient of pressure here as well.
好的，接下来是Justin Lake和Wolf Research。早上好。我想问一下您提到的商业趋势与预期相符，想深入了解一下。我记得您之前可能说过您定价时预计商业趋势会高于正常水平，所以有些保守。这是否意味着商业趋势目前超过了正常水平，但与您的定价相符？如果超过正常水平，您能告诉我们如何分阶段浮现的吗？与上一季度相比，我是说，与第一季度或第四季度相比，您是有所提高还是相等？最后，您能否提供一些关于商业组成部分的见解，例如门诊方面是否也承受了压力？
Thanks, Justin, thanks so much for the question. I mean, so, so really not much to see here in all honesty. First off, where we came into the year we, as you alluded to, we price for some anticipation of unit cost inflation. We've seen some of that come through within that. Everything is tracking very much within our expectations. So, you know, we set the year anticipating a little bit of price cost growth, if you will. But beyond that, really nothing to know. And we feel good about where we sit here. Thanks so much. Next question.
感谢贾斯汀的问题，非常感谢。老实说，在这里真的没有很多要注意的。首先，和你所提到的一样，我们进入这一年的时候，我们对单位成本通胀预期已经进行了定价。在这方面，我们确实看到了一些成本上涨的情况。一切都完全符合我们的预期。所以，我们在设定年度计划时，预计会有一点价格成本增长。但除此之外，真的没有什么需要知道的了。我们对目前的状况感到满意。非常感谢。下一个问题。
So the next two, Raskin with nephron research. Hi, thanks. Good morning. Do you think any of the increased utilization you're seeing on the M A side was self inflicted in the sense that you've really augmented benefits dramatically in the last year really last two years. Perhaps that's encouraged or even catalyzed sort of an over utilization of trends relative to historical patterns and expectations. And then how did you address the utilization trends in your benefit designs for 24 I know their sensitivity about saying something on a public call, but but maybe his broad changes that you've expected.
所以接下来的两个，是关于Raskin和nephron研究的。嗨，谢谢。早上好。你认为我们在并购方面看到的利用率增加中，是否有一部分是自招的，因为在过去一年甚至过去两年中，你们确实大幅增加了福利。也许这种增加鼓励甚至催化了与历史模式和预期相比的过度利用趋势。然后，你们如何在为24年的福利设计中处理利用趋势？我知道在公共电话上说出某些话可能会引起敏感，但也许有一些你们预期的广泛变化。
Josh, thanks so much for the question. I'm going to ask Tim Nold to give you a little bit more commentary. But, you know, I think bottom line, I don't really think the benefits are driving this. I think this is, you know, when you look at the concentration of what we're seeing in terms of the outpatients, the orthopedics in particular, those sorts of areas, it looks very much more like a kind of deferment of care.
谢谢你的问题，Josh。我打算让Tim Nold给你更详细的评论。但是，你知道，我认为最关键的是，并不是因为利益驱动。我认为这更像是一种对护理的推迟，特别是在我们看到的门诊、骨科等领域集中的情况下。
Super interesting when you look at maybe what changed a little bit within that we've seen a shift in the fraction of people who once they have been essentially recommended for surgery actually go through and complete the procedure. You know, arguably what might drive that change is one, more supply. So actually it's more possible to go get it done. But two, maybe a little less reticent from an individual to go into a facility in a post COVID environment versus a COVID environment. That feels like the thing that shifted.
当你仔细观察一下可能发生的微小变化时，会发现这是非常有趣的。我们注意到，在被推荐进行手术之后，实际上进行并完成手术的人数比例发生了变化。可以说，这种变化可能的驱动因素有两个。首先，现在更容易获得手术服务，供给更多了。其次，在新冠疫情后的环境和疫情期间，人们进入医疗机构可能会变得更加勇敢一些。这似乎是发生了改变的主要原因。
Maybe ask Tim to just add a little bit to that as well, Tim. Yeah, thanks, Josh. Consistent with Andrew said, you know, when we look at potential drivers, you know, everything from acuity to benefits added to make some membership, everything is really tracking very normally in in line with what we would expect. So nothing to call out there, but certainly something that we look at closely and carefully each and every year and this year being no different with respect to your question regarding benefits.
也许还可以让蒂姆补充一点，蒂姆。是的，谢谢，乔什。与安德鲁所说的一致，你知道，当我们看潜在的驱动因素时，从敏锐度到增加福利再到增加一些会员权益，一切都非常正常，符合我们的预期。所以没有什么特别需要指出的，但这确实是我们每年都会仔细关注的方面，今年对于你关于福利方面的问题并无不同。
So I think one thing to keep in mind is that the more important driver to our benefit decisions this year where the changes to the risk model certainly been talking a lot about care patterns, but that has far less of an impact on the benefits filed. And is really one of many assumptions that we make inside of our bids. But we feel very confident in our ability to provide stability to the benefits that seniors value most things like zero copays for primary care visits.
所以，我认为要记住的一件事是，今年影响我们福利决策的更重要因素是风险模型的变化。我们确实谈论了很多关于护理模式的话题，但这对福利申请的影响要小得多。这只是我们在投标中做出的许多假设之一。但我们对我们能够为老人所看重的福利提供稳定性非常有信心，比如零支付主要保健服务的费用。
Zero copays for tier one drugs, keeping zero monthly plan premiums where we had them in the past and keeping level out of pocket maximums. So it's very important things for benefits for stability and we were able to preserve those so we're really happy about that. So, you know, I'm balanced combined with, you know, the great momentum we see in our value proposition, the great partnerships we have and confidence from the pro community. We feel really good about the benefits be filed and also as we talked about in open remarks, really confident in seeing that momentum pull through into some great growth results next year.
一级药物零免赔额，保持过去的零月度计划保费，并保持固定的最高自费金额。因此，对于稳定的福利来说，这些都是非常重要的事情，我们能够保护这些，所以我们对此非常满意。因此，我很平衡，结合我们在价值主张方面看到的良好势头，我们拥有的良好合作伙伴关系以及来自专业社区的信心，我们对福利文件感到非常满意，正如我们在开场白中所谈论的那样，对于明年的出色增长结果也充满信心。
And thanks so much and Josh, thanks very much for the question next question. We'll go next to Lance Wilkes with Bernstein. Yeah, a question on the commercial side of the business. Can you talk a little bit about membership and in the fee based business being down and also maybe related to that and your outlook going forward in Medicaid, or you see any trends with respect to recapture of those sorts of members or anything that's driving, you know, the opportunity for either growth in membership or maybe you're seeing in account attrition due to weakness in the economy. Thanks.
非常感谢Josh提出的问题，非常感谢。接下来请Lance Wilkes与伯恩斯坦银行提问。关于商业业务方面有一个问题。您能否谈一下会员资格和基于费用的业务的下滑情况，也可以与此相关的是您在医疗补助方面的前景，您是否注意到任何关于重新吸引这些成员的趋势，或者是由于经济疲软导致账户流失的机会。谢谢。
Lance, thanks so much for the question. Before I hand it to Dan Keeter, who looks after RE and I business, I just want to make a couple of kind of high level comments. We're seeing overall a very strong performance from our commercial business this year and also setting up it feels like very well for the 24th season. We seem fantastic overall growth, as I mentioned, in terms of membership. And that's been led very much by a lot of the product innovation that the team have been putting together and into the marketplace and we see that continue in pretty assertively as we roll into 24.
Lance，非常感谢你的问题。在我转给负责RE和I业务的丹·基特之前，我想简要谈一下几个高层次的观点。今年我们的商业业务表现非常强劲，并为第24个季度做好了非常好的准备。我提到过，在会员数量方面我们已经实现了非常出色的整体增长。这在很大程度上要归功于团队一直在市场推出的许多产品创新，而我们预计这种态势在进入第24个季度时将会继续保持。
Just with that kind of backdrop, maybe Dan, if you could, you know, be a little respond to a specific questions, that'd be great. Yeah, Lance, thanks for the question. This is on track for the full year, and what you see in Q2 really is represented by the contraction of one large customer in our fee based business. Your question about attrition and re-determination. The outcome of those, which will be some puts and takes, will probably determine where within our range we will fall, but the punchline is we're on track to hit our range for this year. Thanks.
在这种背景下，如果丹可以的话，能够对具体问题做出一些回应，那就太好了。是的，兰斯，感谢你的问题。对于整年来说，我们的情况还是在轨道上的，第二季度的情况实际上是由于我们的一位大客户在我们的按费用计算的业务中的减少所导致的。你问我们关于流失和重新评估的问题。这些结果会有些波动，可能会决定我们在范围内的具体位置，但重点是我们正朝着今年的目标范围发展。谢谢。
Thanks, Dan. Thanks so much, Lance Lickway. And just to be super clear as well, that client loss that Dan just referred to. We knew about that about a year ago, very much within our expectations and forecast plan. It was something we were anticipating and make no impact at all to our full year expectation. But thanks so much for the question. And next question, please.
谢谢，丹。非常感谢，兰斯·利克韦。同时，我想再次明确一下，丹刚才提到的客户损失。我们大约一年前就已经知道了，完全在我们的预期和预测计划之内。这是我们预料到的事情，对我们整个年度的预期没有任何影响。非常感谢你的提问。下一个问题请。
Well, the next two, Kevin Fishbeck with Bank of America. Great, thanks. I just want to follow up on the optimum health, because the margin there was obviously pressured in the quarter. And I just want to understand how the margin normalization, which we think about that over the next couple of years. I mean, you can, on the M.A. side, you can be priced for things that sound like you saw it in time for your bids and costs have come in line with the way that you price may be just confirmed that piece first.
好的，接下来是来自美国银行的Kevin Fishbeck。非常好，谢谢。我只想追问一下关于最佳健康的问题，因为上一季度该领域的利润显然受到了压力。我只是想了解一下，我们在未来几年中如何实现利润率的正常化。我的意思是，在并购方面，您可以为听起来即将竞价的事物定价，而成本可能与您的定价方式相吻合。先请您证实一下。
But then since within Optum Health, you're also relying on other providers and how they priced for 2020 or, you know, how are you thinking about the market? Your below target this year is this something you can get back to next year or just a multi year thing, depending on how others price or the leverage within your control or is this, you know, kind of, you know, a longer term normalization. Thanks.
但由于Optum Health内部还依赖其他提供商以及他们对2020年的定价情况，您对市场的看法是怎样的？您今年的目标低于预期，这是明年可以弥补的还是一个多年的情况，取决于其他人的定价或您所能掌控的杠杆力量，还是说这是一个较长期的正常化过程？谢谢。
Thank Kevin, thanks so much for the question. So, so first off, you know, as I mentioned earlier, the pressure is really coming from those three sources, the senior trend phenomena that we've talked a lot about the very specific Optum piece around behavioral and then the growth in the book and within that very much the complex care patient, which as I'm going to repeat again, is an extremely positive element of our growth going forward that that's going to be an extraordinarily important foundation stone for the future of the company. We're going to continue to lean into that growth first and foremost. We do expect to see margins continue to strengthen, particularly as you roll through into 24. You're absolutely right. We've we believe we've caught this in our pricing for next year, but more importantly, the longer time we have to look after folks and wrap around care, we can we can deliver much better outcomes for them as we talked about earlier. And we can also make the economic proposition better. It really builds much more sustainable capability. All of that will kick in as well as we roll through subsequent quarters and years. This is going to be a continuing building pressure. I feel very good about that range we've laid out for Optum health over the next several years. And actually, you know, I think, you know, if I had the choice on a slightly suppressed margin in Q two or the very significant growth that we've taken in, I'll take the growth all day long and I'll take that growth because it's going to underpin years of growth going forward. Appreciate the question, Kevin. Next question.
谢谢你的问题，Kevin，非常感谢。所以，首先，正如我之前提到的，这种压力主要来自三个方面，即我们一直在讨论的高级趋势现象、关于行为的Optum细分市场以及我们所说的复杂护理患者的增长。重申一遍，复杂护理患者是我们未来增长非常重要的基石，这是非常积极的。我们将继续专注于这种增长。我们预计利润率将继续增强，尤其是在2024年之后。你完全正确。我们相信我们已经在明年的定价中考虑到了这一点，但更重要的是，我们有更长时间来关心人们并提供全面的护理，我们可以为他们带来更好的结果，正如我们之前所讨论的。我们还可以改善经济效益。这真的可以建立更可持续的能力。随着未来几个季度和年份的过去，所有这些都会起作用。这将是一个持续增加的压力。关于Optum健康在未来几年的范围，我对我们已经制定的目标范围感到非常满意。实际上，你知道的，如果我选择在Q2略微抑制利润率或者选择我们已经取得的非常显著的增长，我会毫不犹豫地选择增长，并且我会选择增长，因为它将为未来几年的增长奠定基础。感谢你的问题，Kevin。下一个问题。
Over next to Gary Taylor with Cowan. Hi, good morning. I just want to talk about some of the are asked about some of the levers and offset because it is a little counterintuitive to hear the commentary intercorder about higher. And then you know, your largest profit segment, Optum health with lower margin. And so, you know, this quarter, obviously investment income was was far stronger. The street was looking for at least versus our model GNA was better. But I know moving into the back half. I think you believe there's more time potentially to pull some of those GNA levers. So could you just talk about investment income GNA or what other offsets there might be in the back half and how much of that is carrying forward into your 24 thinking at this point?
在和Cowan一起坐到Gary Taylor旁边。嗨，早上好。我想谈谈一些关于杠杆和抵消的问题，因为听到关于更高的业务投入但利润率较低的Optum健康部门的评论有点与直觉相反。所以，显然这个季度的投资收入要强得多。市场希望至少与我们的模型相符。GNA也有所改善。但是我知道在下半年，你们可能有更多时间来推动一些GNA的杠杆。所以，你能否谈谈投资收入、GNA或者其他可能的抵消措施，以及这些在你们对2024年的考虑中有多少持续作用？
Yeah, very much appreciate the question. Let me ask John to make some comments for that, John.
嗯，非常感谢您的问题。让我请约翰就此发表一些评论，约翰。
Good morning, Gary. It's John. So, yes, you're right. The investment income has frankly been growing strongly over the past number of quarters and continues to grow. Some of that is the backdrop of the rising interest rate environment, as you know, very well. Some of that is also a result of very active management by our treasury teams in terms of deploying, deploying more and more cash balances into interest bearing accounts and such as they've been working hard of that over the past few quarters and advancing the productivity of that cash.
早上好，Gary。我是John。所以，是的，你说得对。投资收益在过去几个季度一直表现出强劲增长，并且仍在增长。其中一部分原因是利率环境的提高，正如你非常了解的那样。另一部分原因是我们财务团队非常积极地管理，将越来越多的现金余额部署到利息收益的账户中，他们在过去几个季度努力提高了现金的生产力。
After coming off of a period of many years of a zero interest rate environment. So a lot of elements in that in any given quarter, we can experience some some gains from our investment portfolio. So that can be gained from anything from our regular fixed income investments to anything from our diverse venture holdings and so those come in just they come in at different points in time. And perhaps sometimes they're a little bit less predictable, but kind of our typically in a similar zone, frankly, not not outside. I don't expect those kind of things. I don't count on those kind of things, frankly, every quarter. That's not a thing we look at, but they are their elements that we've seen over time and kind of the zones and kind of the zones that we're experiencing, even now.
在经历了多年的零利率环境后。所以在任何季度，我们的投资组合都可能会有一些收益。这些收益可以来自我们的固定收益投资或者多元化的风险投资，而且它们会在不同的时间点出现。有时候可能不太可预测，但通常来说，它们在一个相似的区间内，不会超出这个范围。我不指望每个季度都有这种收入，我们并不特别关注这一点，但这些是我们长期以来观察到的因素，也是我们目前正在体验的区间。
Yeah. Thanks, Gary. Thanks, John. And maybe after to also comment a little bit as you think about the GNA side of the equation going forward. Maybe reflect a little bit on the work you're leading around technology and other interventions as we look to drive down our overall costs.
嗯，谢谢，加里。谢谢，约翰。在思考未来的GNA方面的问题时，或许你们也可以稍微谈谈一下。或者反思一下你们在技术和其他干预措施方面所带领的工作，以期降低我们的整体成本。
Yeah. You know, Gary, what I would say is much of the focus. We've really been applying a lot of artificial intelligence, machine learning and natural language processing. Long term, we think there's great hope for those and some of the short term things that we're working on in those areas, like using generative AI to help more efficiently write medical appeal letters. Things like optimizing our provider search and all of our digital properties with natural language processing and AI. Doing a lot of work, improving our payment integrity models using AI to detect waste, fraud and abuse. And then a lot in the GNA world to answer basic questions in our call centers, like leveraging our benefit bots to reduce the number of calls and the labor associated with that. For simple questions like, is X, Y, or Z disease covered or how I met my deductible? From a long range perspective, however, I'm really optimistic about our significant data sets. Our ability to take advantage of whatever new technology comes down the pike to improve healthcare. I'm really excited about it. So thanks for the question.
是的。你知道，Gary，我想说的是很大一部分关注点。我们一直在大力应用人工智能、机器学习和自然语言处理。从长远来看，我们认为这些领域有很大的希望，我们正在努力研究一些相关的短期项目，比如利用生成式人工智能更高效地撰写医疗上诉信。还有像使用自然语言处理和人工智能来优化我们的服务供应商搜索和所有数字化平台。我们正在通过使用人工智能改进我们的支付诚信模型来检测浪费、欺诈和滥用行为。而在GNA世界中，我们也在努力回答呼叫中心的基本问题，比如利用我们的效益机器人来减少呼叫数量和相关劳动力。对于一些简单的问题，比如某种疾病是否有覆盖范围或者如何达到我的免赔额，我都能做出回答。然而，从长期来看，我对我们庞大的数据集非常乐观。我们有能力利用任何新技术来改善医疗保健。我对此非常兴奋。所以谢谢你的问题。
Yeah, Dirk, thanks so much. And I think, Gary, overall, and I think I tried to elude at the very beginning, you know, obviously when you see a movement in care activity like we saw in the quarter, it's been great to see the range of levers that we've been able to see. And then the range of levers that we have within the organization to respond. And you've seen what we've been able to do in the very short run. And, you know, as you would expect that we have more and more of those levers as you roll through into the, you know, the medium and longer term outlooks as both John and Dirk have described both in the financial side of the company, but also critically in the core operating structure of the company, which we're going to continue to bear down on very, very assertively consequence of all of that is that even with the backdrop of, you know, some of the fluidity we've seen, we're able to continue to commit to the investment behind growth and the investment behind looking after patients as well as we possibly can and giving people a fantastic experience, which is what we think bills super sustainable shareholder value. So that's very much the priority that we're focused on.
是的，Dirk，非常感谢。并且我认为，Gary，总体而言，我一开始就试图逃避你知道，在我们看到季度内的护理活动的变化时，我们所能看到的杠杆范围非常大，而且我们在组织内部也有很多应对的杠杆。你已经看到我们在非常短的时间内所能做的。当然，随着进入中长期展望，无论是在公司的财务方面，还是在核心运营结构方面，我们都有越来越多的这些杠杆。正如John和Dirk所描述的，我们将继续非常有力地专注于这一切的结果是，即使在我们看到的一些不稳定性的背景下，我们仍然能够继续致力于投资增长和关心病人的投资，并尽可能给人们提供出色的体验，这正是我们认为构建超级可持续的股东价值的重点。所以这绝对是我们关注的优先事项。
Next question. We'll go next to George Hill with Deutsche Bank.
下一个问题。我们接下来请德意志银行的George Hill发言。
Yeah. Good morning, guys. And thanks for taking the question. I guess, John, I want to talk a little bit more about your expectations for the senior book in 24. You guys kind of talked about that you expect the current elevated trend to continue and price for it when you think about the M.A. bids. I guess kind of talk about like what drove, like what drives the visibility there from what you see now in order to like looking all the way out to 24. And should we think of the pricing as just kind of conservatism on UNH's part or like I'm kind of interested in the data that drives visibility. Thank you.
是的。大家早上好。谢谢你们回答我的问题。我想和约翰谈谈你对24号高年级教材的期望。你们提到你们预计当前的上升趋势将会持续，并且在考虑到并购出价时进行了定价。我想了解一下，从你现在所见到的情况一直到24号的可见度，驱动这种可见度的是什么。我们应该把价格看作是优良医疗联合健康保持审慎态度的一种体现，还是你们对数据推动可见度感兴趣？谢谢。
Hey, George, thanks for the question. I'm actually going to ask Tim Noel, who leads the Medicare business to respond to that.
嘿，乔治，谢谢你的问题。事实上，我将要求负责医疗保险业务的蒂姆·诺埃尔回答这个问题。
Yeah. Thanks for the question. I'll start by reiterating one thing. It's an important point. The biggest item that was shaping this year's bid thinking was around the risk model changes. The outpatient care patterns of false plays a far smaller role there. But that said, having the ability to incorporate the latest data, anything we've learned recently into our Medicare advantage bids is extremely important in each and every year, especially given how we see both key revenue and medical elements firm up inside of Q2. And being able to incorporate the latest thinking that we have in our bed filings is really, really important. And because of that, we've designed a bid process that is very nimble and able to accommodate play changes.
是的，谢谢您的问题。我将首先重申一件事，这是一个重要的观点。塑造今年投标思维的最重要因素是风险模型的变化。门诊护理模式在这方面起着较小的作用。但是话虽如此，能够将最新数据、我们最近所学到的一切纳入我们的医疗保险优势投标中对每一年来说都非常重要，尤其是考虑到我们在第二季度内看到关键收入和医疗因素稳固的情况。能够将我们在投标申请中拥有的最新思维纳入其中非常重要。正因如此，我们设计了一个非常灵活的投标流程，以适应场景变化。
This year, out of a respect for a developing trend, we made the assumption that some of these early indications that we were seeing in the outpatient care patterns we have talked about would remain durable. And as we sit here today, as John has talked about, these assumptions have validated and they've also stabilized and we feel confident that we've made the appropriate accommodations inside of our 2024 bids for all of us. Thank you.
今年，出于对一个发展中趋势的尊重，我们做出了一个假设，即我们所讨论的门诊护理模式中一些早期迹象将持续存在。正如约翰所说，我们今天坐在这里时，这些假设已经得到验证，并且它们也稳定下来，我们对我们为我们所有人在2024年的报价做出了适当的调整，感到有信心。谢谢。
Tim, thanks so much. Jennifer, we have time for one last question. So let's say the last question. Thank you.
谢谢你，Tim。Jennifer，我们还有时间问最后一个问题。所以，说出最后一个问题。谢谢你。
We'll take our last question from Scott Adele with Stevens. Hi, thanks was hoping maybe you could drill a little bit into the announcement of the a metastasis acquisition. And maybe in particular, you know, just talk about sort of strategy for ramping up the exposure here, given the tough near term reimbursement environment for home health and and then some maybe some early thoughts around some of the integrations or synergy that you could generate from integrating a metastasis in LHCG together. Thanks.
我们来听一下来自斯蒂文斯的斯科特·阿黛尔的最后一个问题。嗨，谢谢，希望您能稍微详细介绍一下对LHCG收购a metastasis的公告，特别是关于在目前困难的家庭保健费用报销环境下，如何增加曝光度的策略，以及关于将a metastasis和LHCG整合在一起能够带来的一些整合效应或协同效应的初步想法。谢谢。
Scott, thanks so much for the question. Well, you know, first of all, you know, we're obviously very pleased to have come to an agreement on the transaction with a medicine. So we appreciate that. But as you'd expect, it's we're now in the very early stages of that process. It wouldn't be appropriate to talk about anything specific in that regard. If I if I just take it maybe a level higher, it's no secret that we're very strong believers in the value of home health and no secret that we believe that value at home health capabilities when combined with other activities in terms of wrapping care around patients is a really important element of future value based care, particularly as you speak towards complex patients, many of whom may be struggling to get out of the home. Maybe maybe don't have quite the same kind of relationship with the clinic as you might often expect. So we do think that the general area is an important area. As I said, as far as the specifics are concerned, I think we're now we'll go through our the regular kind of process and, you know, we'll update you as appropriate, but probably not much more to say today. Thanks so much, Scott, for the question and thank you, everybody, for joining us this morning.
感谢你的问题，Scott。首先，我们非常高兴与Medicine达成交易协议，我们对此表示感激。但正如你所预期的那样，我们现在正处于交易的早期阶段，所以对于具体细节我们暂时不方便透露。如果从一个更高的角度来看，我们非常坚信家庭医疗的价值，并认为将家庭医疗能力与其他医疗活动相结合，为患者提供全方位的关爱是未来基于价值的医疗的重要组成部分，尤其是对于那些复杂患者，他们中的很多人可能很难离开家庭，与诊所的关系也不太常规。所以我们确实认为这个领域非常重要。至于具体细节，我认为我们会按照常规流程进行，适当的时候会向你更新，但今天可能没有更多的内容。非常感谢你的问题，Scott，也感谢大家今天早上的参与。
We very much appreciate your time. And we hope you take away from this call our confidence in our ability to continue to perform and grow strongly while we pursue our mission and build the foundations for continued growth in 2024 and beyond. And we very much looking, we are very much looking forward to sharing more on our progress with you again in October. Thanks so much for your time this morning. And I hope you guys conclude today's conference. We thank you for your participation.
非常感谢您的时间。我们希望您从此次通话中能感受到我们对于能够继续高效增长并追求我们的使命并为2024年及其以后的持续增长奠定基础的信心。同时，我们非常期待在十月份再次与您分享我们的进展。非常感谢您今天早上的时间。希望您们能够圆满结束今天的会议。感谢您的参与。