Operator

Welcome to the UnitedHealth Group Investor Conference. Introducing UnitedHealth Group Chief Executive Officer, Stephen Hemsley.

主持人

欢迎来到联合健康集团投资者大会。现在请出联合健康集团首席执行官斯蒂芬·汉姆斯利。

Stephen Hemsley   CEO & Non-Independent Non-Executive Chairman

Good morning. Welcome to our 2015 Investor Conference. We thank you for taking time out of your schedules to spend the day with UnitedHealth Group. We hope to make good use of the time and make this session as valuable as possible.

斯蒂芬·汉姆斯利 首席执行官兼非独立非执行董事长

早上好。欢迎参加我们的2015年投资者大会。感谢您抽出宝贵时间与联合健康集团共度这一天。我们希望能够充分利用这段时间，使本次会议尽可能具有价值。

And before we start the day in earnest, I'll give you the briefest sense of how we are viewing our businesses and opportunities, and then turn to some of the issues we're pretty sure that are on your minds.

在正式开始今天的议程前，我先简要介绍一下我们对自身业务和发展机遇的看法，然后再谈谈我们相信各位也很关注的一些问题。

Broadly speaking, we continue to see distinctive momentum across the diversified benefits and services platforms that comprise UnitedHealth Group today. Our opportunities are expanding as the list of impediments is narrowing. In your vernacular, headwinds are diminishing as the capabilities and performance momentum of this enterprise are strengthening.

从整体来看，联合健康集团旗下多元化福利和服务平台持续展现出显著的发展势头。随着阻碍因素逐渐减少，我们的发展机会正在扩大。用你们的术语来说，逆风正在减弱，而我们的能力和业绩动能正日益增强。

In the benefits business, UnitedHealthcare is seeking -- is seeing much stronger market response in open-enrollment season in its Medicare Advantage offerings. And the Medicaid business continues to expand, grow and diversify its market positions.

在福利业务方面，UnitedHealthcare在医保优势计划的开放注册季获得了显著更强的市场反响。而医疗补助业务也在持续扩张、增长，并在市场上不断拓展多样化的布局。

There is still much to accomplish to more effectively meet the health and social needs of America's most vulnerable individuals, and we're honored to play a role in serving valued government partners in these efforts as well as in support for military service members, veterans and their families. Aside from the exchange products, all our commercial benefit offerings are growing and performing well and are positioned well for a strong 2016.

要更有效地满足美国最弱势群体的健康和社会需求，我们仍有许多工作要做。我们很荣幸能在这一过程中与重要的政府合作伙伴携手合作，并支持军人、退伍军人及其家庭。除了交易所产品以外，我们的所有商业福利产品都在增长、表现良好，并已为强劲的2016年打下坚实基础。

Within the services business, it is easy to overlook the fact that while comparatively large Optum is still in the early days of what we expect to be a long, far-reaching and impactful journey, each of the businesses is delivering strong, double-digit top and bottom line growth. Market recognition for Optum continues to grow in the United States and is beginning to reach into international markets.

在服务业务方面，虽然Optum在体量上已相当可观，但实际上它仍处在我们认为将是一个长期、深远并富有影响力的发展旅程的早期阶段。旗下各项业务目前都在实现强劲的双位数营收和利润增长。Optum在美国的市场认知度持续提升，并开始进入国际市场。

With those headlines, let me turn to some of the questions that may be top of mind for you. Two years ago, I offered a top 10 list. Last year, about 6 or so on a variety of topics. This morning, let's just focus on the one that is likely of particular interest, the performance of our exchange products. And I'll break this into a few areas of commentary.

在概述完上述重点内容后，我来谈谈你们可能最关心的一些问题。两年前我曾列出“十大关注点”，去年是大约六个话题。今年早上，我们聚焦一个尤为重要的主题：我们的交易所产品的表现。我将从几个方面对此进行说明。

First, what happened? As we indicated over the course of this year, we, along with others in the benefits industry, had been closely watching exchange trends. We have been staying optimistic this market would improve, but ultimately our own experience worsened. Broader marketplace indicators were also not showing participant growth or the improved risk balance we had anticipated and that are essential to sustain this as a market.

首先，发生了什么？正如我们今年以来所指出的那样，我们与其他福利行业的同行一样，一直密切关注交易所市场的趋势。我们一直保持乐观，认为这个市场会改善，但最终我们的自身体验却变得更糟。更广泛的市场指标也没有显示出参与人数的增长，或我们原本预期的风险平衡的改善，而这些因素对于维持市场的可持续性至关重要。

We concluded we should recognize that situation with you sooner rather than later. And so why now? The facts for us became pretty clear. We could not sustain the eroding level of losses on our exchange products, and we needed to reflect where the pressure was and deal with it. We were not seeing any significant improvement in the direction of these trends, the growth of the risk pool and the fluid entry and exit patterns. And above all, we felt we needed to address and cap it for 2016 and then determine to what level, if any, we would continue to engage in this product going forward.

我们得出的结论是，应当尽早而不是延迟地与各位坦率地沟通这一情况。那么，为什么是现在？对我们而言，事实已经非常清楚：我们无法承受交易所产品不断加剧的亏损水平，我们需要认清压力所在并加以应对。我们未看到这些趋势方向有任何显著改善，包括风险池的增长以及参与者的进出动态。最关键的是，我们觉得必须在2016年对这一局面加以控制，然后再决定未来是否以及在多大程度上继续参与这一产品。

So is this a specific UnitedHealthcare problem or a more fundamental structural issue with exchange products overall? I think only time will tell -- really tell on this one. We simply endeavored to provide a timely perspective on our own performance in this product and on the early indications we were observing.

那么，这是UnitedHealthcare特有的问题，还是交易所产品整体上更深层的结构性问题？我认为，只有时间能真正回答这个问题。我们只是努力从自身参与这一产品的实际表现以及我们观察到的早期迹象中，提供一个及时的观点。

When I stand back and look at this on a market-by-market, product-by-product basis for our participation, here's what I see. We sold into markets where we were already strong. With lean networks, our product content and pricing were at market levels, our risk pool for the exchanges is actually better than the market average. If our product offerings were too broad, it was not a significant factor in our loss experience. And then given the large portion of structural exchange cost that come from insurance taxes, exchange fees and commissions, everyone has to have operating costs as low as possible.

当我退一步，从市场逐个、产品逐项的角度回顾我们的参与情况时，我看到的是这样的图景：我们进入的市场原本就是我们具有竞争力的地区；凭借精简的网络，我们的产品内容和定价水平处于市场水平，我们在交易所的风险池实际上优于市场平均水平。如果我们的产品种类过于广泛，也并不是导致亏损的主要原因。此外，考虑到交易所结构性成本中很大一部分来自保险税、交易所费用和佣金，所有参与者都必须将运营成本降到最低。

Over the years, we found that rarely does any single factor emerge. But instead, many ultimately contribute. So there likely won't be a single, broadly accepted marketplace conclusion for some time.

多年来我们发现，很少有某一个单一因素能独立主导结果。相反，最终往往是多种因素共同作用。因此，在相当长一段时间内，市场上可能都不会出现一个广泛接受的单一结论。

Certainly, our own losses and the performance of our own business was the most meaningful element in forming our view. I am sure our own approach and execution could have been better. Yet indications in the broader marketplace led us to believe others were seeing similar indicators in varying degrees, and structural contributors clearly became factors to be considered.

当然，我们自身的亏损以及业务表现是促成我们观点的最主要因素。我确信我们自身的策略和执行可以做得更好。然而，从更广泛市场观察到的迹象让我们相信，其他公司也在不同程度上遇到类似的情况，而结构性因素显然也成为必须纳入考量的部分。

So who is to blame? You're looking at them. It was, for us, a bad decision. Ultimately, I take accountability for sitting out the exchange market in year 1 so we could in theory observe, learn and see how the market experience would develop. This was a prudent going-in position. In retrospect, we should have stayed out longer. It will take more than a season or 2 for this market to develop.

那么，谁应该承担责任？你们看到的就是——我们自己。这对我们来说，是一次错误的决策。最终，我要为我们在第一年选择不参与交易所市场而承担责任——那时我们希望通过旁观来观察、学习并了解市场会如何发展。这原本是一个审慎的入场姿态。但回过头来看，我们应该再多观望一段时间。这个市场的发展需要的远不止一两个季度。

We saw it as a market in the early stages of formation that needed to be served, and we were attracted and did not want to miss the growth potential. We did not believe it would form this slowly, be this porous or become this severe.

我们当初认为，这是一个处于初期成形阶段的市场，需要被服务，我们也因此被吸引，不想错过其增长潜力。我们并未预料到，这个市场的发展会如此缓慢、结构如此松散、问题会变得如此严重。

So finally, how are you thinking going forward. The potential considerations are not particularly new or novel when it comes to creating a sustainable benefits pool, basic concepts such as broader and sustained individual participation, real discipline in maintaining the integrity of the benefit pool, flexibility in coverage options and underwriting with a focus on balanced pool formation, solvency and sustainability, to name a few.

那么最后，展望未来我们的思考是什么？在构建一个可持续的福利池时，需要考量的因素其实并不新颖，比如更广泛且持续的个人参与、维持福利池完整性的严明纪律、保障方案的灵活性，以及以风险池平衡、偿付能力和可持续性为核心的承保策略等等。

As you know, while we have pulled back aggressively this year, we have not made final decisions about this market for 2017. That call will need to be made in the first half of 2016. It will be a product-by-product, market-by-market determination. We will not knowingly lose money in this product line in 2017. And keep in mind that any such decisions to pull back in a particular offering are not necessarily permanent in nature.

如你们所知，虽然我们今年已经大幅收缩了参与，但尚未对2017年的市场作出最终决定。我们将在2016年上半年做出相关决策，并将依据具体产品和具体市场分别判断。我们不会在2017年在这个产品线上继续容忍明知会亏损的情况。同时请注意，任何关于撤出特定产品的决定都不必然是永久性的。

I'll remind you that in 1999, we made similar pullbacks like this and for similar reasons with Medicare, and we really never got serious about Medicaid until about 2002. And today, we are a leader in both markets.

As was the case in those markets, we understand full well that people being served through exchanges need and should have access to care. Many of them have health conditions that need attention, and we have been committed publicly for more than 20 years to ensuring access to quality health care for Americans and remain intent on finding sustainable ways to make that a durable reality. And indeed we hope the exchange market will ultimately evolve into a viable coverage option for Americans. But in the end, it was simply this. As you will see today, looking broadly at our enterprise, we have an exceptional portfolio of businesses and innovative products and services. They are growing and improving each quarter and each year and delivering powerful results to those who we serve and to shareholders.

正如在上述两个市场中一样，我们非常清楚，通过交易所获得服务的人群是需要且应该享有医疗服务的。他们中很多人有健康问题亟需关注，而我们20多年来一直公开承诺，为美国民众提供优质医疗服务的可及性，并将持续努力寻找可持续的方法，使这一目标成为长期现实。我们的确希望交易所市场最终能发展成为美国人可行的医疗保障选项。但归根到底，现实是这样的：如你们今天所看到的，我们拥有出色的业务组合和创新的产品与服务，这些业务每个季度、每年都在持续增长和改善，为我们服务的对象和股东带来强劲的成果。

We will not allow one relatively small product line with one market segment to impair that critical agenda.

我们不会让一个相对较小的产品线、一个市场细分板块，影响我们这一重要的发展议程。

Absent our participation in the exchange in the -- in 2015, our per-share earnings would have well exceeded \$6.40 per share, and our 2016 earnings guidance to you this morning would have been considerably stronger, both years well within our long-term growth range.

如果没有参与2015年的交易所市场，我们的每股收益将远超6.40美元，而我们今早提供的2016年业绩指引也将更为强劲，这两个年度的表现都将落在我们长期增长目标范围之内。

I'll be back towards the end of the day to offer some forward-looking thoughts, more in the zones where we typically spend the majority of these sessions with you. We look forward to spending the day with you, and thank you for joining us.

在今天会议的尾声阶段，我会再回来，分享一些前瞻性的思考，更多聚焦于我们通常在此类会议中与大家深入探讨的那些领域。我们期待与各位共度接下来的时间，也感谢大家的到来。

And now John Penshorn will set up the flow for the rest of the session today. Thank you, and thanks for being here.

接下来将由John Penshorn安排今天会议余下的议程。谢谢大家，再次感谢各位出席。

John Penshorn; Senior Vice President

Good morning. Welcome to our investor conference. I'd like to begin by observing Steve has already made some forward-looking statements, and we hope to continue them today. So we need to remind you that today's presentations will include forward-looking statements that are subject to risks and uncertainties and actual results may differ materially. These risks and uncertainties can be found in the cautionary statements in our SEC filings and are summarized in our investor conference materials that are posted on our website. Our posted materials also contain a reconciliation of the non-GAAP financial measures referred to in our remarks, which are reconciled to the most comparable GAAP measures.

John Penshorn，高级副总裁

早上好，欢迎参加我们的投资者大会。我想先提一下，Steve 刚才已经发表了一些前瞻性声明，我们今天也希望继续沿着这个方向展开。因此我们需要提醒大家，今天的演示内容将包括一些前瞻性声明，这些声明都受到风险和不确定性的影响，实际结果可能与之存在重大差异。相关的风险和不确定性可在我们提交给美国证券交易委员会（SEC）的文件中的警示性声明中找到，我们也已在官网发布的投资者大会材料中进行了总结。此外，我们发布的材料还包括对非GAAP财务指标的调节说明，这些指标已与最可比的GAAP指标进行了对账。

So welcome in the room and on the web. We are live streaming for the first time this year. And continuing that digital thought, as you came into the room, you were probably, hopefully, offered either a physical book or a digital package, single-page sheet.

欢迎各位来到现场或通过网络线上参与。今年我们首次进行现场直播。延续数字化的理念，大家入场时应该收到了纸质资料册或是一个数字化资料包，或者是一张单页概览。

We have a digital package on the web, and the digital package includes all of the materials as well as links that take you to other materials for UnitedHealth Group. And so it's more comprehensive.

我们在网上提供了完整的数字化资料包，其中包含了所有演示资料，并附有链接可跳转至联合健康集团的其他相关资料，因此它内容更全面。

And that sets up a question and a dilemma. We are a modern, forward-thinking, technology-oriented organization, and we hand out these thick books every year. And we asked you last year, do you value the books? And the feedback was overwhelmingly positive, yes. And so the question I have for you to think about is, is this the last year for a physical book? Should we be moving to a digital package where you download that on your PC? There's tools you can annotate directly onto that. I'll be interested in your thoughts on this afterwards.

这也引出了一个问题和一个小小的困境。我们是一家现代化、面向未来、以技术为导向的公司，但每年仍然发放这些厚重的资料册。去年我们曾问过大家是否重视这些纸质资料，结果反馈非常积极——大家都说“重视”。所以我要请大家思考一个问题：今年会不会是我们最后一次发放纸质资料？我们是否应该转向以数字资料包为主，由大家自行下载到电脑上？这些资料包还有注释功能。我很想听听大家会后的看法。

This morning at our conference, we're going to do a few things. It's going to be similar to what we've done in the past but different. We wanted more content, faster tempo, keep everything that we've done before but actually further improve the experience.

今天上午的会议，我们将会进行几项内容安排，与以往类似，但也会有所不同。我们希望提供更多内容、节奏更快，在保留过去一切优点的同时，进一步提升整体体验。

Part of the challenge is finding ways to draw you into the provision of benefits and services. And so you see these screens up here this year, and you'll see shortly how that plays. And I'll be up afterwards at the end to talk about the product and innovation showcase and the seminars and what we're going to do with those things. So hopefully, you get a valuable experience from today and find an opportunity to really engage in the business that's behind the model.

其中一个挑战，是如何让各位更深入地理解我们在福利和服务上的实践。今年你们看到现场布置了这些显示屏，稍后你们就会看到它们的具体用途。我将在最后回到台上，介绍产品与创新展示、专题讲座环节，以及我们将如何展开这些内容。希望大家今天能获得一次有价值的体验，也能有机会真正接触并参与到我们业务模型背后的实践中来。

Some takeaways today. I think you should find an organization that is hungry, motivated, driven to succeed; an organization that is focused on quality, on execution and on growth; and a leadership team that believes that fulfilling our mission, helping people to live healthier lives and helping the health system to perform better for everyone, will drive growth and will advance shareholder value.

今天你们应该能够感受到，我们是一家渴望进步、充满动力、以成功为导向的组织；是一家专注于质量、执行力和增长的组织；我们的领导团队坚信，履行我们的使命——帮助人们过上更健康的生活、让整个医疗体系更高效地服务于大众——这将推动公司增长，并带动股东价值提升。

Thank you.

谢谢大家。

Operator

Introducing, UnitedHealth Employer & Individual Chief Executive Officer, Jeff Alter.

主持人

现在请出联合健康集团雇主与个人业务部门首席执行官，Jeff Alter。

Jeff Alter   Former CEO of UnitedHealthcare Employer & Individual Business

Good morning I'm pleased to be here with my colleagues, Steve Nelson, Austin Pittman and Dan Schumacher. Together, we lead UnitedHealthcare, and today, each of us will share examples of how our people are advancing UnitedHealthcare's strategies, deepening our capabilities and the quality of products and services and raising growth and earnings performance.

Jeff Alter

早上好，我很高兴与我的同事 Steve Nelson、Austin Pittman 和 Dan Schumacher 一同出席今天的会议。我们共同领导 UnitedHealthcare，今天我们将各自分享具体案例，展示我们的员工如何推进 UnitedHealthcare 的战略、深化能力与产品服务质量，并提升增长和盈利表现。

Our success starts with our mission, and we strive to get it right for people every time. When we fulfill our mission, growth follows. To achieve our mission, we have a long-standing, intentional integration approach.

我们的成功始于我们的使命，我们始终努力每一次都为客户做到最好。当我们践行使命，增长自然随之而来。为了实现这一使命，我们长期坚持有意图的整合方法。

We integrate 4 core facets of our business so they work together: modern benefit designs, distinctive consumer empowerment, targeted clinical engagement and accountable delivery system. Foundational to this approach is our ability to collect, analyze and use data to create actionable information. Using the analytics we derive from demographic claims and clinical data, we identify those people most in need of care, drive better decision-making at both the individual and system levels and form a complete view of a person's experience. We're taking our strong data and analytics capabilities to the next level.

我们将四个核心业务要素整合为一体，使它们协同工作：现代化福利设计、独特的消费者赋能、针对性的临床干预，以及负责任的医疗服务体系。这一方法的基础是我们收集、分析和运用数据的能力，以转化为可执行的信息。通过对人口、理赔和临床数据的分析，我们能够识别最需要医疗的人群，推动个人和系统层面的更优决策，并建立对个人健康体验的全面认知。我们正将强大的数据与分析能力提升到新水平。

Our people are the face of UnitedHealthcare, and they're equipped with information to improve care and service. In the last 2 years, we've created or redeployed thousands of physicians at local market touch points across the entire health care continuum: in hospitals, with care providers, in neighborhood clinics, in people's homes and on the phone, providing service to thousands of people every day. We believe our future success will be measured by how we facilitate their care.

我们的员工是 UnitedHealthcare 的形象代表，他们配备了信息工具以提升护理和服务水平。在过去两年中，我们在本地市场各个医疗接触点增设或重新部署了数千名医生——包括医院、医疗服务机构、社区诊所、居民家庭以及电话咨询中心，每天为数以千计的人群提供服务。我们相信，未来的成功将以我们在协助客户获得医疗服务方面的成效来衡量。

Our investment in people is changing how we support consumers, and it's also changing our relationships with care providers. We'll talk about both today. Together, our mission, the integration of core assets, data and information, plus a long-term investment in our people, are delivering value to customers in 3 areas: enabling better health, providing more consumers with a superior experience and creating affordable products and services.

我们在人才方面的投资不仅改变了我们支持消费者的方式，也正在重塑我们与医疗服务提供者之间的关系。今天我们都会提到这些内容。我们的使命、核心资产的整合、数据与信息的应用，加上对员工的长期投入，正在为客户在三个方面创造价值：实现更好的健康、提供更卓越的消费体验、打造更可负担的产品与服务。

Today, we'll show you what that value we deliver looks like in the marketplace and what it feels like for people.

今天我们将展示，这些价值在市场上的体现，以及对用户而言的实际感受。

First is better health. Every day, across all our local markets and all our benefit offerings, our employee doctors, nurses and clinical workers partner with care providers to serve thousands of patients. Our approach to better health is information-driven, multifaceted, comprehensive and patient centered. We organize care resources around the individuals and their needs.

首先是更好的健康。在我们的每一个本地市场和所有福利产品中，每天都有我们的员工医生、护士和临床人员与医疗服务提供者合作，为数以千计的患者提供服务。我们实现更好健康的方式是以信息为驱动、多维度、全面且以患者为中心的。我们围绕个人及其需求组织护理资源。

We know 5% of the population is consuming over 50% of the nation's health care costs. But it's not the same 5% every year. People move in and out of this group. And it's part of the challenge. One way we address this challenge is through our patient-centered care model. Our data helps us identify and sometimes even predict high-risk, vulnerable patients earlier and integrate their medical, social and behavioral care. Built on a foundation of shared accountability, the patient-centered care model couples high-performing care providers with our unique data and analytics to support an impactful, high-touch approach. Physicians and other care team members coordinate all aspects of a patient's care. We do this for people, people like Danielle \[ph].

我们知道，5%的人群消耗了全美超过50%的医疗支出。但这5%的人群并不是年年都一样，人们会进出这个高风险群体，这是一个挑战。我们应对这一挑战的方式之一是建立以患者为中心的护理模式。我们的数据帮助我们更早识别甚至预测高风险、脆弱人群，并整合他们的医疗、社会与行为健康需求。在共同问责的基础上，该护理模式将高绩效的医疗服务提供者与我们独有的数据和分析能力相结合，支持一种高接触、深影响的服务方式。医生和其他医疗团队成员协调患者护理的所有方面。我们所做的一切，都是为了人——比如像 Danielle 这样的人。

\[Presentation]

Jeff Alter   Former CEO of UnitedHealthcare Employer & Individual Business

By focusing on 100,000 of our most frail consumers across our Medicaid, Medicare and commercial plans, we've improved care, reduced hospitalizations up to 30% and expect to realize \$110 million in cost savings in 2015.

通过聚焦我们Medicaid、Medicare和商业计划中最虚弱的10万名消费者，我们改善了护理服务，使住院率最高下降了30%，并预计在2015年实现1.1亿美元的成本节省。

The patient-centered model is only one of the innovative ways we collaborate with care providers to improve quality. Today, our health plans are tailored to each community's unique needs.

以患者为中心的模式只是我们与医疗服务提供者合作提升质量的众多创新方式之一。如今，我们的健康计划都是根据每个社区的独特需求量身定制的。

Our networks are flexible and make it easy for consumers to identify and access high-quality, cost-effective health care professionals. We build our networks around the best-performing physicians and provide information and financial incentives that motivate individuals to use them. We also share technology and data with local care providers and reward them for delivering better care at lower cost.

我们的网络具有高度灵活性，使消费者能够轻松识别并接触到高质量、具成本效益的医疗专业人员。我们围绕表现最优的医生构建网络，并提供信息与经济激励，鼓励个人使用这些资源。我们还与本地医疗服务提供者共享技术与数据，并对他们以更低成本提供更优服务的行为进行奖励。

Our well-established Premium Designation Program measures the quality and cost effectiveness of 350,000 physicians across 27 specialties. It helps reduce unnecessary treatments and improve performance. Our top premium physicians deliver higher-quality care and average 18% lower cost.

我们成熟的“优选认证项目”评估覆盖27个专业领域、共35万名医生的质量与成本效益。这一项目有助于减少不必要的治疗并提升医疗表现。获得顶级优选认证的医生，其服务质量更高，平均成本低18%。

When a patient isn't receiving the appropriate care, we call that a gap in care. Closing gaps in care has become a key metric for rating clinical quality in Medicare and is important in addressing consumers' needs.

当患者未能获得适当护理时，我们称之为“护理差距”。弥合护理差距已成为Medicare评估临床质量的重要指标，同时也是满足消费者需求的关键。

We use our starves -- STARSHub platform to identify at-risk members, coordinate care and close gaps. It allows us to monitor and track performance across each star's measure. We can drill down into specific clinical programs, pull up member-level details and identify underperforming provider groups who could benefit from additional coaching.

我们使用名为“STARSHub”的平台识别高风险成员、协调护理并弥合差距。该平台能让我们对每个“星级”指标进行监控和追踪。我们可以深入查看具体的临床项目、提取成员层级的数据，并识别表现不佳但可通过额外辅导获得提升的服务提供者群体。

At the individual level, every single Medicare patient's gap in care is assigned to a specific individual at UnitedHealthcare by name. That person is responsible for making sure that patient's gap is closed. This intensive care management approach is having a major impact.

在个人层面，每一位Medicare患者的护理差距都会被明确分配给UnitedHealthcare内部的某位具体员工负责，该员工负责确保该护理差距被有效弥合。这种精细化的护理管理方式正在产生显著的影响。

\[Presentation]

Jeff Alter   Former CEO of UnitedHealthcare Employer & Individual Business

We've made solid progress helping people get better health care. As a result, we are now on track to have 63% or more of our Medicare members in 4-star plans by payment year 2017. That's nearly double the level of a year ago. And by payment year 2018, we expect 80% or more of our Medicare members will be in a 4-star plan.

我们在帮助人们获得更好医疗方面取得了实质性进展。因此，到2017年支付年度，我们有望实现63%或以上的Medicare会员加入四星级计划，这一比例几乎是去年同期的两倍。到2018年支付年度，我们预计将有80%以上的Medicare会员处于四星级计划中。

Our focus on quality and improvement in stars are among the reasons we're optimistic about the future. Growth and consistent, solid performance will continue in our Medicare franchise. It further strengthens the value we bring to our Medicare Advantage members, where our average premium is currently half the industry average.

我们对质量的专注以及星级提升，是我们对未来保持乐观的重要原因之一。我们的Medicare业务将持续实现增长和稳定、扎实的表现。我们为Medicare Advantage会员带来的价值将进一步增强，目前我们的平均保费仅为行业平均水平的一半。

We're bringing the insights we've gained around closing gaps in care for seniors to both our commercial and Medicaid populations. Steve described the advances we've made in helping people get better care. But for many people, their physical health is affected by factors that appear to have little or nothing to do with clinical performance, things like basic nutrition or lack of stable housing, employment or transportation, or even access to a bank account. Estimates suggest that addressing social factors like these could reduce health care costs by 10% to 20% for complex populations.

我们正在将过去在弥合老年人护理差距方面积累的经验应用到我们的商业保险与Medicaid人群中。Steve 介绍了我们在帮助人们获得更好医疗方面取得的进展。但对于很多人来说，他们的身体健康受到一些看似与临床表现无关的因素影响，比如基础营养、缺乏稳定的住房、就业或交通工具，甚至是没有银行账户。据估算，对于复杂人群，解决这些社会因素可以减少10%至20%的医疗支出。

Today, \$1 trillion is spent in over 100 government programs aimed at supporting low-income consumers, and they often operate independently with separate budgets, different enrollment criteria and siloed technology. This makes it very difficult for the people who need help and difficult for the government to manage. It's a challenging problem but a meaningful opportunity to serve consumers in a new way. To address this market need, we created myConnections.

目前，美国在超过100项旨在支持低收入人群的政府项目上投入了1万亿美元，而这些项目通常是相互独立运作的，拥有不同的预算、入选标准以及封闭的技术平台。这种碎片化使得需要帮助的人难以获得支持，也使政府的管理变得困难。这是一个复杂的问题，但也提供了以全新方式服务消费者的重要机遇。为应对这一市场需求，我们开发了 myConnections 项目。

\[Presentation]

Jeff Alter   Former CEO of UnitedHealthcare Employer & Individual Business

We've launched myConnections programs in Arizona and plan to expand to Michigan and New York soon.

我们已在亚利桑那州启动了 myConnections 项目，并计划很快扩展至密歇根州和纽约州。

Our programs are already making a difference. In the first 2 months alone, we initiated job training for over 120 individuals and placed 70 people in full-time jobs.

这些项目已初见成效。在启动的前两个月里，我们为超过120人提供了职业培训，并为70人安排了全职工作岗位。

Now let's turn to the individual consumer experience. People want convenience, streamlined service and quick access to the health system. So we're reducing the hassles and giving consumers more choice and personal attention.

现在我们来看个人消费者的体验。人们希望获得便利、简化的服务流程以及对医疗系统的快速接入。因此，我们正在减少繁琐流程，为消费者提供更多选择和个性化关注。

It starts by meeting people where they are. Our technologies and tools help them find the right care at the right time and manage costs. Take one of the most common acts in health care, visiting the doctor. Even getting an appointment to see a doctor can be a frustrating experience. Our flexible care delivery options make it easier to access care when and where people need it.

这一切始于“在用户所在之处与之相遇”。我们的技术和工具帮助他们在正确的时间找到合适的护理服务，并控制成本。以就医为例——这是最常见的医疗行为之一，但仅仅预约医生就常常让人感到沮丧。我们的灵活服务方式使人们能够在他们需要的时间和地点更方便地获得护理。

Telehealth gives consumers the ability to consult with a care provider by video to get a diagnosis or a prescription. Today, we provide video-based virtual visits on an open platform in 47 states and the District of Columbia. And we will go to people who can't physically visit a doctor and for whom virtual visits won't work. This year, UnitedHealthcare nurses visited 1 million seniors in their homes to coordinate care, order social services and close gaps. And next year, we will do more.

远程医疗使消费者能够通过视频与医护人员会诊，获取诊断或处方。如今，我们在47个州和哥伦比亚特区通过开放平台提供基于视频的虚拟就诊服务。对于那些无法亲自就医、也无法使用虚拟方式的人群，我们会上门服务。今年，UnitedHealthcare 的护士已上门拜访了100万名老年人，为他们协调护理、申请社会服务并弥合护理差距。明年我们会做得更多。

Our market-leading consumer tools and personalized programs educate and motivate people to adopt healthier behaviors and guide them to better health. In January, we launched Diabetes Navigator, a comprehensive diabetes management program.

我们行业领先的消费者工具和个性化项目能够教育并激励人们采取更健康的行为，引导他们走向更好的健康。今年1月，我们推出了 Diabetes Navigator，一项全面的糖尿病管理计划。

About 25% of the 3 million seniors in our Medicare Advantage programs have diabetes, but a diabetic care plan can be difficult to follow. Our Navigator care teams fully integrate patient care, reward people for completing preventive screenings and help them schedule appointments. To date, 170,000 office visits have been scheduled, and participants are 50% more likely to monitor their blood sugar levels compared to those not enrolled in the program. With statistics like these, we expect to materially impact this challenging disease in coming years.

在我们的 Medicare Advantage 计划中，有300万名老年人，其中大约25%患有糖尿病，但糖尿病护理计划通常较难执行。我们的 Navigator 护理团队全面整合患者护理，为完成预防性筛查的患者提供奖励，并帮助他们安排就诊。截至目前，已安排了17万个门诊预约，参与者监测血糖的可能性比未参与项目者高出50%。凭借这些数据，我们有信心在未来几年内对这一复杂疾病产生实质性影响。

More broadly, 3 years ago, we introduced our Advocate4Me service model and continue to advance this platform. Advocate4Me was a mindset shift in how we serve consumers. Members are connected to an advocate, who supports them from beginning to end. They're a single point of contact who anticipates a person's needs using predictive analytics. An individual may call us about a claim. But if we see they haven't filled a prescription or failed to schedule a follow-up visit, we seize the opportunity to help them do all 3. And people love it. Over 93% of the people we serve said they trust the information they receive from an advocate, and 95% of the people say their interaction with an advocate was outstanding. Let's hear how it works.

从更广的层面看，我们在三年前推出了 Advocate4Me 服务模式，并持续完善这一平台。Advocate4Me 是我们服务消费者方式上的一次观念转变。会员将与一名服务代表相连，由其从头到尾提供支持。这是一个通过预测性分析预判客户需求的唯一联系人。比如，一个客户可能是因为理赔问题来电，但如果我们发现他还没取药或没安排复诊，我们就会抓住这个机会帮他一并完成。而客户也非常满意。我们服务的客户中，超过93%表示信任 advocate 提供的信息，95%表示与 advocate 的互动体验非常出色。接下来，让我们看看这个模式是如何运作的。

\[Presentation]

Jeff Alter   Former CEO of UnitedHealthcare Employer & Individual Business

Our advocates have written and sent over 450,000 personal notes to our consumers. And the most fulfilling part for us is that people often write back to thank our advocates for their help. By January, 25 million people will have access to Advocate4Me through our commercial, Medicare and Medicaid plans.

我们的服务代表已经为消费者写下并寄出了超过45万封个人便笺。而最令我们感到满足的是，许多消费者会写信回来说感谢 advocate 的帮助。到明年1月，将有2500万人通过我们的商业、Medicare 和 Medicaid 计划获得 Advocate4Me 服务。

Our third value is affordable products. Consumers are searching for financial certainty and security. To manage costs, UnitedHealthcare partners with care providers to raise clinical effectiveness and help consumers become smarter health care shoppers.

我们的第三个核心价值是“可负担的产品”。消费者正在寻找财务上的确定性和保障。为了控制成本，UnitedHealthcare 与医疗服务提供者合作，以提升临床效果，并帮助消费者成为更聪明的医疗服务选择者。

For example, our Health4Me smartphone app allows consumers to find in-network providers, manage claims and pay bills on the go. And myHealthcare Cost Estimator provides price and quality information for over 750 common medical services.

例如，我们的 Health4Me 智能手机应用程序让消费者可以随时随地查找网络内医疗服务提供者、管理理赔和支付账单。而 myHealthcare Cost Estimator 提供超过750项常见医疗服务的价格和质量信息。

The Health4Me app has been downloaded over 1.7 million times, and people have used our cost estimator to generate nearly \$8 billion in treatment estimates. People are 7% more likely to choose a primary care physician that's premium-designated and nearly 10% more likely to select a premium orthopedist when they to use our cost estimator. This helps employers reduce their total benefit costs.

Health4Me 应用程序的下载量已超过170万次，用户通过我们的成本估算工具已生成近80亿美元的治疗估价。使用成本估算器的消费者，选择获得优选认证的全科医生的概率提高了7%，选择优选骨科医生的概率提高了近10%。这有助于雇主降低总体福利成本。

One of the most effective ways to help our plan sponsors manage cost is by creating products that align with their specific benefit strategy. Our affordable plans are tailored to the unique price needs of each customer. We use our components of our intentional integration approach, modern benefits, accountable care delivery and clinical engagement as key cost levers.

帮助计划发起方控制成本的最有效方式之一是创建与其具体福利策略相契合的产品。我们的可负担计划根据每位客户独特的价格需求量身定制。我们运用有意整合策略中的关键组成部分——现代化福利、负责任的医疗服务体系和临床介入——作为主要的成本控制杠杆。

Different network configurations achieve a range of savings. A managed access network can reduce medical costs by up to 4.5%. Using a premium physician in that same network can reduce -- can produce additional savings of up to 5%. All told, by managing a network alone, we can reduce an open-access PPO cost structure by almost 20%.

不同的网络配置可以实现不同幅度的节约。在受控访问网络中，医疗成本最多可降低4.5%；若在同一网络中使用优选医生，还可再节省最多5%。总体而言，仅通过网络管理，我们就能将开放式 PPO 的成本结构降低近20%。

We also create savings through our clinical programs and innovative products. Our patient-centered care model can realize total medical cost savings of up to 3%. Programs like Real Appeal and UnitedHealthcare Motion \[ph] help people lose weight and adopt healthier behaviors. UnitedHealthcare Motion \[ph] uses activity trackers to promote exercise and offers convenient Telehealth options for consumers. It can produce cost savings of up to 8% for the employer.

我们还通过临床项目和创新产品来创造节约空间。我们的以患者为中心的护理模式可以实现最高达3%的总医疗费用节省。像 Real Appeal 和 UnitedHealthcare Motion 这样的项目，帮助人们减重并养成更健康的生活习惯。UnitedHealthcare Motion 使用活动追踪器鼓励锻炼，并为消费者提供便捷的远程医疗服务，能够为雇主带来最多8%的成本节省。

By combining tiered networks, clinical integration, and innovative products in different ways, we build flexible benefit plans that align with any employer strategy and price point. Today, 33% of our commercial customers are served through one of our affordable plan offerings. That's double the number of people from 5 years ago. And over the next 5 years, we expect to serve fully 2/3 of our commercial clients through one of these plans.

通过将分级网络、临床整合和创新产品以多种方式组合在一起，我们打造出灵活的福利计划，以契合各种雇主的战略与价格需求。如今，我们33%的商业客户通过某种可负担计划获得服务，这一比例是五年前的两倍。未来五年内，我们预计将有三分之二的商业客户通过这些计划获得服务。

Let's go a little deeper into how we deliver cost savings by working with providers. We're creating affordable products in 2 ways: through value-based programs and strategic provider partnerships. Some of our most advanced relationships are with care providers in our value-based programs. Aligned incentives are generating higher value and better care. We offer a full suite of value-based programs along the entire risk and accountability continuum, from programs aimed at achieving specific metrics to bundled payments, to programs that manage entire population health.

接下来深入谈谈我们如何通过与医疗服务提供者合作来实现成本节省。我们有两种方式打造可负担产品：一是基于价值的项目，二是战略性的服务提供者合作关系。我们最先进的一些合作关系正是与参与价值导向项目的医疗服务方建立的。在激励机制一致的情况下，我们能够产生更高的价值和更优的医疗服务。我们提供覆盖整个风险和问责范围的全套价值导向项目，从专注于实现具体指标的项目，到打包支付模式，再到管理整个人群健康的计划。

Today, over 13 million people receive care through our value-based programs with access to 110,000 physicians and over 1,000 hospitals. Many of these people are treated at one of our ACOs. Our goal for 2015 was to have 750 ACOs and \$43 billion in value-based spend before the end of 2015. And I'm pleased to say we will meet that goal and have a crisp focus on achieving \$65 billion in value-based spend by 2018.

目前已有超过1300万人通过我们的价值导向项目接受护理服务，覆盖11万名医生和超过1000家医院。这些人中有很多是在我们的责任医疗组织（ACOs）中接受治疗。我们2015年的目标是年底前建立750家ACO，并实现430亿美元的价值导向支出。令人高兴的是，我们将实现这一目标，并专注于在2018年前实现650亿美元的支出目标。

We're creating the most valued, strategic provider relationships in the industry, using a model from our commercial business. Five years ago, we adopted a new approach to our largest national accounts. Customers of this scale are essentially running their own health plan, and that's what we focused on. Our perspective shifted from viewing them as our national consumer to serving their health plan.

我们正在以商业业务为模板，打造业内最具价值和战略性的医疗服务方合作关系。五年前，我们对最大的全国性客户采用了全新方式。这类客户的规模使他们实际上相当于运营自己的健康保险计划，我们的重点也正是支持他们的这部分业务。我们的视角从“他们是我们的全国性客户”转变为“我们在服务他们的健康保险计划”。

We focus on how we could help them run their plan more strategically by understanding their broader long-term objectives and then supporting them differently, finding where our data and tools and insights could have a maximum impact. We call these private health plans, and they have been highly successful. Our customer satisfaction scores are significantly higher, client retention is longer and our business is growing.

我们专注于如何帮助他们以更具战略性的方式管理其保险计划——通过了解他们更广泛的长期目标，并以不同的方式为其提供支持，从而找出我们的数据、工具与洞察力最能产生价值的地方。我们将其称为“私人健康计划”，这类计划获得了极大成功。我们的客户满意度显著提升，客户保留周期更长，业务持续增长。

Now we're taking the same focused strategic partner approach to our top care provider relationships, aligning strategies to achieve a common goal. Listen to one of our partners, Dr. Al Kurose from Coastal Medical group in Rhode Island, talk about how UnitedHealthcare and Coastal are improving care together for consumers.

现在我们将这种专注的战略合作模式拓展到我们最关键的医疗服务提供者关系中，通过战略协同实现共同目标。下面请听我们在罗德岛的合作伙伴——Coastal Medical集团的Al Kurose医生，讲述UnitedHealthcare与Coastal如何携手为消费者改善医疗服务。

\[Presentation]

Jeff Alter   Former CEO of UnitedHealthcare Employer & Individual Business

We hope you can feel how positive we are about the opportunities ahead, opportunities to enable better health, to redefine the consumer experience and to drive greater affordability and to grow.

Jeff Alter

我们希望你们能够感受到我们对未来机会的乐观态度——这些机会包括提升健康水平、重新定义消费者体验、提升医疗可负担性并实现增长。

Now I'll turn it over to Dan Schumacher to review our financial results.

接下来我将把时间交给 Dan Schumacher，由他来回顾我们的财务业绩。

Daniel Schumacher   Former CEO of OptumInsight

Thank you, Jeff. At UnitedHealthcare, we are able to produce the value you've just seen because we are a vibrant, growing enterprise doing business across multiple geographies and products: specialty benefits like vision and dental, military benefits, small groups and national employers, the developmentally disabled and long-term services, dual eligibles and seniors across a variety of products. There's many more, but you get the idea.

Daniel Schumacher（OptumInsight前首席执行官）

谢谢你，Jeff。UnitedHealthcare之所以能够创造出刚才所展示的这些价值，是因为我们是一家充满活力、不断成长的企业，在多个地区和产品线展开业务——包括视力与牙科等专业福利、军人福利、小型企业与全国性雇主、发育障碍人群及长期护理服务、双重合格人群（Medicare与Medicaid双重覆盖者）和各类老年人群等。还有许多其他业务，但各位已经大致了解了我们的覆盖范围。

We are a strong and well-positioned franchise. We are unmatched in breadth and solidly profitable, both at the state level and across our 3 primary businesses. And we're growing with domestic organic growth of nearly 10 million individuals in just the past 6 years.

我们是一个强大且具备良好战略定位的业务体系。在覆盖广度方面无可匹敌，在州一级和我们三大核心业务中都保持了稳健的盈利能力。在过去六年中，我们在美国本土实现了近1000万人的自然增长。

Today, we serve nearly 50 million consumers across both our domestic and international businesses. When we end this year, we will have grown our medical membership by more than 1.2 million people with all major product lines growing domestically.

目前，我们在本土和国际业务中共服务将近5000万消费者。到今年年底，我们的医疗会员人数将增加超过120万人，所有主要产品线在美国本土市场均实现增长。

This is true even after excluding growth in individual public exchanges, which you know has challenged our performance. Excluding the individual public exchange, our organic enrollment growth through the first 3 quarters of the year was more than our 5 largest publicly traded competitors combined.

Looking ahead to 2016, we expect our differentiated products and capabilities to continue to drive strong growth performance. Specifically, we see a growth range of nearly 1.6 million people at the midpoint, an increase over 2015 of more than 350,000 people.

展望2016年，我们预计差异化产品和能力将继续推动强劲增长。具体来说，我们预计新增会员人数中位数将达到约160万人，比2015年增长超过35万人。

Inside the outlook, our commercial fully insured enrollment will be relatively flat. This includes pretty stable enrollment in the individual line of business and strong small business and middle-market growth, offset by declines in a third-party private exchange, driven primarily by one large national employer. Our commercial self-funded enrollment will grow nicely in 2016 on higher new sales volume and better overall retention.

在这一展望中，我们商业全面承保业务的注册人数将保持相对平稳。这其中包括个人业务的稳定注册，小型企业和中型市场的强劲增长，但也受到某大型全国性雇主引发的第三方私人交易所注册量下降的影响。我们的商业自筹资金业务（即雇主自担型计划）将在2016年实现良好增长，得益于更高的新销售量和更好的整体客户保留率。

In our Medicare business, we are just wrapping up a very successful open-enrollment period and expect full year growth in our Medicare Advantage offering of 400,000 people, at the high end of our range, and again expect to see consistent growth in our Medicare Supplement offering. Enrollment in our Part D offering will contract by approximately 600,000 people as we intentionally reposition this offering for growth in 2017 and beyond.

在我们的 Medicare 业务方面，我们刚刚结束了一个非常成功的开放注册期，预计全年 Medicare Advantage（医保优势计划）注册人数将增长40万人，处于我们预测区间的高端，并预计 Medicare Supplement（补充医疗保险）也将持续稳定增长。我们主动调整 Part D（处方药保险）业务定位，为2017年及以后做好增长准备，因此该产品的注册人数将在今年缩减约60万人。

In our Medicaid business, we expect another strong growth year, adding 500,000 people at the midpoint of our guidance. We continue to grow in our existing foundation, where we have successfully retained 100% of the programs we participate in. And we are building on that foundation with state expansions in Iowa and California, further geographic expansions in places like Michigan and New York and new program wins in states such as Texas, Louisiana and Mississippi. These new programs are often aimed at increasingly more complex populations where the needs are greater and, frankly, our enterprise is uniquely more capable. We believe we are just getting started.

在我们的 Medicaid 业务中，我们预计将迎来又一个强劲增长年，按预测中值计算，预计将新增注册人数50万人。我们继续在现有基础上扩大业务，并且在我们参与的所有项目中成功实现了100%的保留率。基于这一基础，我们正通过在爱荷华州和加利福尼亚州的项目扩展、密歇根州和纽约州等地的地理拓展，以及德克萨斯州、路易斯安那州和密西西比州等地的新项目中标，持续扩大版图。这些新项目往往面向需求更高、情况更复杂的人群，而坦率地说，我们的企业在应对这些人群方面具有独特优势。我们相信这只是一个开始。

To round out our enrollment conversation, our international business has successfully strengthened pricing and underwriting disciplines, and we expect to return to growth in 2016, adding 150,000 people at the midpoint of our guidance. Overall, a strong and growing enterprise.

在总结注册人数增长部分时，我们的国际业务已成功加强定价与承保纪律，预计将在2016年恢复增长，按预测中值预计将新增15万人。整体来看，我们是一家强大而不断增长的企业。

Moving to medical costs. We expect our 2015 commercial net medical trend to close the year at approximately 5.5%, which is at the low end of the range we provided 1 year ago. This result reflects the effectiveness of our strong medical management disciplines as utilization continues to be restrained.

接下来说医疗成本。我们预计2015年商业保险的净医疗成本增长率将收于大约5.5%，处于我们一年前提供的区间下限。这一结果反映出我们严格的医疗管理制度卓有成效，因为医疗服务使用率仍受到良好控制。

2015 marked the seventh consecutive year of absolute declines in hospital admissions on a per capita basis in all of our benefits businesses. Looking ahead to 2016, we project the commercial net medical trend to increase slightly and to be in a range of 6%, plus or minus 50 basis points. This reflects consistent unit cost increases of around 4% and a slight increase in utilization to approximately 2%. It is our goal each year to effectively manage medical cost to ensure consumers get the right care at the right time and in the right setting. This year is no exception.

2015年是我们所有福利业务人均住院率连续第七年实现绝对下降。展望2016年，我们预计商业保险的净医疗成本增长率将略有上升，预计将在6%上下50个基点的范围内。这一增长反映出单位成本持续约增长4%，以及使用率小幅上升至约2%。我们每年的目标都是有效控制医疗成本，确保消费者在正确的时间、地点获得适当的治疗，今年也不例外。

Underneath those high-level expectations, let's look at the components. As in past years, facility unit costs continue to be the primary driver of cost increases, and we see that in our expectations for the inpatient and outpatient trend categories. We also expect higher pharmacy trends in 2016 due to an expected increase in specialty therapy utilization and new drugs coming through the pipeline.

在这些高层预期之下，我们来看看具体构成。与往年一样，医疗设施单位成本仍是成本上升的主要驱动因素，我们在住院和门诊趋势类别中也看到了这一趋势。由于专科治疗使用率的预期上升以及多种新药即将上市，我们也预计2016年药品支出趋势将走高。

Meanwhile, our physician trends remained consistent year-over-year, driven by our continued controls on out-of-network physician utilization and costs.

与此同时，我们的医生服务趋势保持同比稳定，这得益于我们持续控制非网络内医生的使用和相关成本。

We expect to close 2015 with revenue of more than \$131 billion, exceeding the midpoint of the range we provided one year ago by almost \$4 billion.

我们预计2015年全年收入将超过1310亿美元，较一年前给出的预期区间中值高出近40亿美元。

We expect earnings of \$6.8 billion, and I'll show you what this looks like on a pro forma basis in just a minute.

我们预计全年净利润为68亿美元，稍后我将以备考形式向大家展示这些数据的表现。

In 2016, we will continue to grow, diversify and strengthen our businesses, increasing revenue by approximately 9% or more than \$11 billion to a range of \$142.5 billion to \$143.5 billion.

在2016年，我们将继续实现业务增长、多元化发展并强化核心能力，预计收入将增长约9%，即增长超过110亿美元，达到1425亿至1435亿美元的区间。

Our revenue growth rate is outpacing our enrollment growth rate as we expand our Medicaid business into more complex populations where the revenue content is much higher and as we build on our leadership position in the Medicare market.

我们的收入增长率正超过注册人数增长率，这是因为我们正将 Medicaid 业务拓展至更复杂人群中，这些人群的每人收入贡献更高；同时，我们也在 Medicare 市场持续巩固领先地位。

Across UnitedHealth Group, we expect our 2015, which we discussed back in November. Also, our medical care ratios reflect the reclassification of certain PBM-related costs into medical from operating, which increases the ratio by 30 to 40 basis points in all periods presented. The specific impact by year is included in the footnote.

在整个 UnitedHealth Group 中，我们对2015年的预期与11月的讨论一致。此外，我们的医疗费用比率反映了部分PBM相关成本从运营成本分类为医疗成本的重分类，这一变动在所展示的各个时期中都使比率上升了30至40个基点。具体年度影响已在脚注中说明。

We continue to be strong stewards of our operating costs, where we expect to maintain or slightly improve our operating cost ratio on a year-over-year basis. Our strong advances in productivity also help us fund further investments in our people, our data and analytics and our technologies that drive the value my colleagues discussed this morning.

我们继续严格管控运营成本，预计我们的运营成本比率将同比持平或略有改善。我们在生产效率方面取得的显著进步，也为我们在人才、数据分析及技术方面的进一步投入提供了资金支持，这些正是我的同事们今天上午所提到的价值创造来源。

Turning to our earnings outlook. We expect 2016 earnings from operations in the range of \$7.6 billion to \$7.8 billion. This is an increase over 2015 of more than \$800 million to \$1 billion.

接下来是我们的盈利展望。我们预计2016年的运营利润将在76亿至78亿美元之间，较2015年增长超过8亿至10亿美元。

To give you better insight into the underlying earnings performance of our business, I have provided a pro forma view of UnitedHealth Group's earnings per share and UnitedHealthcare's operating earnings, which exclude the losses centered in individual public exchange-compliant products that we discussed back in November.

为便于大家更好理解我们业务的核心盈利表现，我提供了 UnitedHealth Group 每股收益及 UnitedHealthcare 运营利润的备考视图，其中剔除了我们在11月提到的，集中于个人公共交易所合规产品的亏损。

In 2015, UnitedHealthcare's operating earnings of \$6.8 billion includes more than \$700 million of these losses. Absent this challenging performance, UnitedHealthcare operating earnings would have been \$7.5 billion and comfortably above the high end of our expected earning range from a year ago.

2015年，UnitedHealthcare 实现的68亿美元运营利润中包含了超过7亿美元的相关亏损。如果不计这部分压力业务的影响，UnitedHealthcare 的运营利润将达到75亿美元，轻松超出我们一年前所设定的盈利区间上限。

Our 2016 earnings are expected to grow to \$7.6 billion to \$7.8 billion or 12% to 15%. This includes approximately \$225 million of continued losses related primarily to the individual exchange-compliant products. Excluding these losses from both years, we expect our underlying earnings to grow in the range of 4% to 7% as our enrollment growth continues to orient more towards our government-based businesses.

我们预计2016年的运营利润将增长至76亿至78亿美元，同比增长12%至15%。这一预测中包含约2.25亿美元的持续亏损，主要来自个人交易所合规产品。若将这两年该部分亏损一并剔除，我们的核心盈利增长将在4%至7%区间，因为我们的注册增长持续向政府项目型业务倾斜。

During the first half of 2016, we will be evaluating the viability of the insurance exchange product category for us, and we will determine the extent to which we can continue to serve the public exchange markets in 2017. In the meantime, note that we have taken and will continue to take aggressive steps to minimize the impact.

在2016年上半年，我们将评估交易所保险产品类别对我们是否具备可持续性，并据此决定我们在2017年是否、以及在多大程度上继续参与公共交易所市场。与此同时，请注意，我们已采取并将继续采取果断措施，以最大限度减轻影响。

As for UnitedHealth Group, no matter how you look at it, our year-over-year earnings per share growth rate is squarely in our long-term earnings growth range of 13% to 16%. Dave Wichmann will provide more perspective on this shortly.

就 UnitedHealth Group 而言，无论从哪个角度看，我们的每股收益同比增长率都稳稳处于我们长期预期的13%至16%增长区间。稍后 Dave Wichmann 将对此提供更多说明。

Today, we focus on the results of our efforts: better health, a superior care experience and a choice of affordable products. It's my hope that you will leave here knowing we remain restless. There is too much unmet need across health care, too many opportunities. As the most diverse and capable player in our industry, UnitedHealthcare is positioned to seize them. We have the data, our people are ready. And we're picking up the pace in our relationships with consumers, in our collaboration with care providers, in the speed and creativity of our innovation and in the results we produce. The value we offer the marketplace will grow more distinctive as we continue to realize the full potential of this enterprise.

今天，我们聚焦的是我们所付出努力所取得的成果：更好的健康、更卓越的医疗体验和更可负担的产品选择。我希望你们离开时会清楚一点——我们从未满足。医疗领域仍有太多尚未满足的需求、太多机遇等待把握。作为本行业中最具多样性和能力的参与者，UnitedHealthcare 已为抓住这些机会做好准备。我们拥有数据，员工已整装待发。我们正在加快与消费者的互动节奏、与医疗服务方的合作节奏、创新的速度与创造力，以及我们最终交付的成果。随着我们不断释放企业的全部潜力，我们为市场所提供的价值将愈加显著。

Thank you.

谢谢大家。

Richard Migliori   Executive VP & Senior Advisor

Good morning. I'm Dr. Richard Migliori, and I serve as the Chief Medical Officer for UnitedHealth Group. You heard John and Jeff mention our mission of helping people live healthier lives by making the health system work better for everybody.

Richard Migliori 执行副总裁兼高级顾问

早上好，我是 Richard Migliori 医生，担任 UnitedHealth Group 的首席医疗官。你们刚才听到 John 和 Jeff 提到，我们的使命是：通过让医疗体系为所有人更好地运作，帮助人们过上更健康的生活。

One of the worst things we do to ourselves in terms of threatening our health is something we do every day, particularly as professionals. That's sitting down, puts stress on your back, it cuts your blood vessels, it puts stress on your major joints. So towards our mission, I'm going to invite you please to stand up, to greet the people next to you, shake it out a little bit.

我们每天都会做一件非常损害健康的事情，尤其是作为职业人士——那就是“久坐”。它对背部造成压力，压迫血管，增加主要关节的负担。为了回应我们的使命，我邀请大家现在站起来，和身边的人打个招呼，活动一下身体。

That's wonderful. Okay. Please take your seats.

非常好。好，请大家重新入座。

And please enjoy the rest of our conference.

请大家继续享受今天的会议内容。

Operator

Introducing, Optum's Chief Executive Officer, Larry Renfro.

主持人

接下来请出 Optum 首席执行官 Larry Renfro。

Larry Renfro   Former Vice Chairman

Good morning. Let me try that again. Good morning, y'all. I'm Larry Renfro. It is again my honor and privilege to represent the great people of Optum and share the progress we are making in serving and advancing health systems around the world.

Larry Renfro 前副董事长

早上好。让我再试一次——大家早上好！我是 Larry Renfro。今天再次有幸代表 Optum 优秀的团队，与大家分享我们在服务并推动全球医疗体系发展方面所取得的进展，这让我感到无比荣幸。

We are now entering the fifth year of the One Optum story that I introduced to you in 2011. Since that time, we have had more and more opportunities to work with health system participants to solve problems and drive transformation.

我们正在迈入 One Optum 故事的第五个年头，该故事最初由我在2011年提出。从那时起，我们与各类医疗体系参与者合作的机会越来越多，致力于解决问题、推动转型。

Our people have focused on these opportunities with purpose and determination and have made significant progress. Strong execution for our customers has enabled us to become a force for positive change that is helping create a healthier world.

我们的团队始终以明确的目标和坚定的意志把握这些机遇，并取得了显著进展。为客户提供卓越执行力，使我们成为推动正向变革的重要力量，助力建设一个更健康的世界。

As you will see and hear over the course of the day, Optum's portfolio spans the broadest of ranges, from guiding a mother through her first pregnancy to supporting leaders of nationally scaled health systems and everything in between.

在今天的会议中，你们将看到并听到 Optum 业务组合的广泛覆盖——从指导一位母亲经历她的首次怀孕，到为全国性规模的医疗系统领导者提供支持，以及这两者之间的一切。

When the One Optum story began in 2011, our revenues were under \$30 billion. This coming year, we will be nearly triple that level. We will have more than quadrupled our operating earnings.

当 One Optum 故事在2011年开始时，我们的年收入尚不足300亿美元。而在即将到来的一年中，我们的收入将接近当初的三倍，运营利润更是增长超过四倍。

When we started this story, we had 35,000 employees. Today, we have a vibrant global workforce exceeding 100,000 people, predominantly clinicians, technologists and service professionals.

在这个故事起步之初，我们的员工总数为3.5万人。如今，我们拥有一支超过10万人的充满活力的全球团队，其中大多数是临床人员、技术人员和服务专业人士。

The average OptumHealth engagement is 3x larger than in 2011, and the OptumInsight revenue backlog has nearly tripled. We are on track to achieve one year early our goal of building 8 to 10 larger, deeper and more comprehensive relationships.

OptumHealth 的平均客户合作规模是 2011 年的 3 倍，OptumInsight 的收入积压量几乎增长了三倍。我们有望提前一年实现构建 8 至 10 个更大规模、更深入、更全面合作关系的目标。

OptumRx is now honored to serve 66 million people, 50 million more than when we began this story. While we are encouraged by the accomplishments of the last few years, there is still much to do. We are still striving to get things right the first time, every time. But let me be careful. We are still in the very, very early chapters of our story with a decades-long growth opportunity and a \$1 trillion global marketplace. We remain sharply focused on the purpose-driven mission that has inspired our work from the beginning: helping make health systems work better for everyone.

OptumRx 目前服务人数已达 6600 万人，比我们最初开始讲述这个故事时多了 5000 万人。虽然我们对过去几年所取得的成果感到振奋，但仍有许多工作要做。我们仍在努力实现“每一次、第一次就做对”的目标。但我要谨慎地说，我们仍处于这个长期故事的早期篇章中，面前是一个持续数十年的增长机遇和一个规模达 1 万亿美元的全球市场。我们依然坚定不移地聚焦在激励我们从一开始就前行的使命上：帮助让医疗体系为所有人运作得更好。

Our customers face a relentless pace of change and their challenges are more complex and urgent than ever. They operate at the center of care systems that are accelerating away from a focus on volume to a focus on value, to better quality at a lower cost. And our customers must meet the needs of a consumer whose influence and expectations are growing. Success requires new approaches, stronger engagement and advanced capabilities. It takes more than point solutions to meet these challenges.

我们的客户正面临日益加快的变革节奏，其挑战也比以往任何时候都更复杂、更紧迫。他们位于医疗服务系统的核心，而该系统正加速从“以量为本”向“以价值为本”转变，以更低成本实现更高质量。同时，他们还必须满足影响力和期望值日益提升的消费者需求。成功需要新的方法、更强的参与度和更先进的能力，仅靠单点解决方案已无法应对这些挑战。

That is why we have remained focused on serving our customers as One Optum, simplifying, aligning and integrating our business to deliver the more comprehensive solutions they need to succeed in the decades ahead.

这正是我们坚持以 One Optum 的方式服务客户的原因——我们持续简化、统一并整合我们的业务，以提供客户在未来几十年里取得成功所需的更全面解决方案。

And these needs are global, regardless of the mix of private and public funding models around the world. In every customer interaction today, we strive to deliver and expand upon the promise of One Optum. It enables us not just to help with specific customer problems, but to work with them. To help evolve the fragmented health care world into a higher-functioning, more-effective system. As health care becomes more connected, collaborative relationships are the key to a better future for those who provide care, those who pay for care and those who need care. For Optum, it is truly about relationships. And we believe that our unique and expanding relationships with each of these groups set us apart.

这些需求具有全球性，无论世界各地是采用私人、公共还是混合的融资模式。在我们与客户的每一次互动中，我们都努力兑现并扩展 One Optum 的承诺。这不仅仅意味着帮助他们解决具体问题，更是与他们携手合作，帮助将目前支离破碎的医疗体系进化为一个功能更高效、协同更紧密的系统。随着医疗日益互联互通，协作关系将成为医疗服务提供者、医疗费用支付者和患者未来发展的关键。对 Optum 来说，一切关乎“关系”。我们相信，正是我们与上述各方所建立的独特且不断扩展的关系，使我们在行业中脱颖而出。

Today, I would like to focus on those relationships. How we are developing and expanding on them and striving every day to earn the trust of our clients. I will update you on how we are transforming health systems and creating growth, one relationship at a time. I will discuss our key relationships with health benefit sponsors, including employers, care providers, governments and the consumer. As the emphasis grows on quality and cost, so does our support for those who pay for health benefits. They include commercial and public health plans and employers, all of whom share the goals of better quality, better outcomes and better consumer experiences at lower cost.

今天，我想重点谈谈这些关系：我们如何建立并拓展这些关系，并如何每天都在努力赢得客户的信任。我将向大家更新我们如何在每一段合作关系中转变医疗系统并实现增长。我会讨论我们与健康福利支付方的关键合作关系，包括雇主、医疗服务提供者、政府以及消费者。随着质量和成本成为焦点，我们对健康福利支付方的支持也日益增强。他们包括商业与公共健康计划方和雇主——他们的共同目标是：以更低的成本实现更高的质量、更好的结果和更出色的消费者体验。

Today, we serve 300 health plans and 80% of the Fortune 100 employers, as they move toward those goals every day. We provide them with a comprehensive set of capabilities they need to effectively serve and manage their populations. Our health management service group engages millions of people with a focus on improving the health of individuals in a coordinated cost-effective way. We combine innovative wellness programs, advanced care and disease management, and personal patient advocacy to create a more unified health experience for our consumers and better value for health plans and employers.

目前，我们为300家健康保险计划和80%的《财富》100强企业提供服务，助力他们日复一日朝着各自的目标前进。我们为这些客户提供了一整套全面的能力体系，帮助他们有效服务并管理人群健康。我们的健康管理服务团队与数百万人群建立接触，致力于以协调且具有成本效益的方式改善个体健康。我们将创新健康计划、先进的医疗与慢病管理方案以及患者个人权益倡导服务相结合，为消费者创造统一的健康体验，同时为健康计划方和雇主带来更大的价值。

We are among the largest behavioral health managers, with a network of more than 150,000 clinicians. We integrate these services with medical and pharmacy benefits to enable whole-person care. And as consumers take on more responsibility for the financial aspects of their health care, Optum Bank is one of the largest health care financial services providers.

我们是美国最大的行为健康管理机构之一，拥有由超过15万名临床专家组成的服务网络。我们将行为健康服务与医疗和药品福利整合，支持以人为本的整体健康管理。随着消费者在健康支出中承担的责任越来越大，Optum Bank 已成为领先的医疗金融服务提供商之一。

Another important way we meet the goals of employers and health plans is through our growing role, as a direct provider of care. When we talk about advancing patient-centered care today, we talk from experience as a care provider. Today, we serve over 7 million people across our care delivery businesses, we are truly multi-payer. Collaborating directly with health plans and employers to serve the needs of local communities.

我们实现雇主和健康计划方目标的另一重要方式，是通过我们日益增长的直接医疗服务提供者角色。当我们今天谈论推进以患者为中心的医疗时，是基于我们自身作为医疗服务方的实践经验。目前，我们在直接护理业务中服务逾700万人，真正实现了多付款方合作模式，直接与健康计划方及雇主合作，满足本地社区的健康需求。

Our care providers draw on capabilities from across Optum, including clinical and financial expertise, advanced administrative tools and modern technology to improve operations that allow doctors to focus on patients. These collaborations are delivering results. For example, in 1 year, we increased the number of people effectively controlling hypertension by 15% across the populations we serve. During the same period, we raised by 10% the number of diabetic patients who are effectively controlling their blood sugar. Our skilled physicians also help people stay out of the hospital, which is good for patients and those who help pay for their care. Over the past 3 years, 30-day readmissions across our practices have been reduced by 12%.

我们的医疗服务团队依托 Optum 在临床与财务方面的专业能力、先进的管理工具与现代化技术，持续优化运营流程，让医生能专注于为患者服务。这些合作已取得显著成效。例如，仅在一年内，我们所服务人群中高血压得到有效控制的人数增长了15%；同期，血糖有效控制的糖尿病患者人数增长了10%。我们的专业医生也帮助患者减少住院，这对患者及其支付方都是利好。在过去3年里，我们各诊所的30天再入院率下降了12%。

To help make this more tangible, let me take you to the local level, where the direct delivery of care happens. Several years ago, Harvard professor Atul Gawande began watching trends in Southwest Texas, which had some of the highest per-capita Medicare costs in the country. A major reason, he wrote in the New Yorker Magazine, was over-utilization of care. This year, he took another look at Southwest Texas and discovered a group of physicians having remarkable success in achieving better outcomes at a lower cost. Dr. Gawande found a patient-centered care model that focuses on care quality and patient satisfaction, rather than number of visits. While a doctor may spend more time with fewer patients on a given day, this emphasis on quality over quantity is working for the patient and the practice. Those doctors that Atul Gawande found are part of Optum Care.

为帮助大家更具象地理解这一点，我想带大家深入本地层面——这是直接医疗服务的第一线。几年前，哈佛大学教授 Atul Gawande 开始关注德克萨斯州西南部的趋势，当地人均 Medicare 成本曾位居全国前列。他在《纽约客》杂志中写道，主要原因之一是医疗过度使用。今年他再次观察德州西南部，发现一群医生以更低的成本实现了更好的治疗结果。Gawande 医生发现，他们采用的是以患者为中心的医疗模式，强调医疗质量与患者满意度，而不是单纯就诊次数。医生每天可能接待的患者更少，但每位患者获得的服务时间更长——这种“重质不重量”的模式正是对患者和医疗实践双方都有益的。而这群医生，正是 Optum Care 的一部分。

I would like you to hear directly from Dr. Hernandez from Optum Care.

接下来，让我们直接听听来自 Optum Care 的 Hernandez 医生的分享。

Daniel Schumacher   Former CEO of OptumInsight

I'm Dr. Carlos Hernandez. I'm an internal medicine physician. I take care of the sickest of the sick. I call those patients my MVPs, my most vulnerable population. Today, medicine is practiced in an acute care setting, which means it's fee-for-service, it's expensive, it's duplicative, uncoordinated, and it can lead to unnecessary testing and unnecessary procedures. In fee-for-service medicine, if I do something, I get paid for it. If I don't do it, I don't get paid.

Daniel Schumacher（OptumInsight前CEO）

我是 Carlos Hernandez 医生，一名内科医生。我照顾的是病情最严重的病人，我称他们为“我的MVP”——即“最脆弱人群”。如今的医疗是在急性护理环境中进行的，也就是说，这是按服务计费的模式，代价高昂、重复低效、缺乏协调，还会导致不必要的检查和治疗。在这种按服务计费体系下，我做一项检查，就有收入；不做，就没有。

Now let me tell you about how we practice medicine, our model of care. Our model of care takes the sickest, most complex ill patients, and puts them and our doctors at the center of the universe. And surrounded by a coordinated team of health care professionals, case managers, social workers, triage nurses, hospitalists, and a palliative \[ph] care team. This team will deliver the care whenever and wherever it's needed. In other words, the right care, at the right time, in the right place, for the right reason.

现在让我告诉你，我们是如何实践医学的。我们的医疗模式是将最严重、最复杂的病患，以及我们的医生，置于整个医疗宇宙的中心。周围由一个协调的专业团队支持，包括个案经理、社会工作者、分诊护士、住院医师以及缓和医疗团队。这个团队会在任何时间、任何地点，提供患者真正需要的护理服务。换句话说，就是在正确的时间、地点，以正确的理由提供正确的治疗。

So what has this done -- what has this model of care done for our sickest population in South Texas? It has measurably improved the outcomes for these patients, and it's led to a measurable decrease in health care costs. In fact, 16% reduction in admissions, a 35% reduction in readmissions and a 43% decrease in cardiology costs. A national publication that compared our patients with a Medicare age and disease-matched population in Texas showed that if you were our patient, your chances of dying were 40% less. Now that's the way medicine should be practiced: Coordinated, improving the health care outcomes of our population, decreasing the health care costs and increasing patient satisfaction. We should expect nothing less.

那么这个模式对德州南部这些最重症的患者带来了什么？它显著改善了治疗结果，并明显降低了医疗支出。事实上，住院率下降了16%，再入院率下降了35%，心脏病相关开支减少了43%。一家全国性出版物将我们患者与德州Medicare年龄与病情匹配的对照组进行比较，发现如果你是我们的病人，你的死亡几率会降低40%。这才是真正应该推行的医疗方式：协调有序、提升健康结果、降低医疗成本、提高患者满意度——我们不应期望更少。

Larry Renfro   Former Vice Chairman

Thank you, Carlos. One of the most innovative ways we create value for health plans and employers is through our distinctive approach to pharmacy care services. This year, we joined forces with Catamaran. Turning a long-time systems and technology partner into a unique new force in the pharmacy care space. We now manage 1 billion scripts annually, while serving 66 million members and managing \$80 billion in total pharmacy spend. But this combination is about much more than scale, it better enables us to redefine the pharmacy experience through a differentiated approach, we call synchronization. This approach shifts the focus from legacy PBM models, centered on drug volume, to one that adds a distinctive whole-patient care experience, driving better medical outcomes and lower downstream care costs.

Larry Renfro 前副董事长

谢谢你，Carlos。我们为健康保险计划和雇主创造价值的最具创新性的方式之一，是通过我们独特的药品护理服务模式。今年，我们与 Catamaran 合并，将长期的系统与技术合作伙伴转变为药品护理领域的新力量。目前我们每年管理约10亿张处方，服务6600万名会员，药品支出总额达800亿美元。但这次整合不仅仅是规模上的扩张，它使我们能通过一种名为“同步化”（synchronization）的差异化方法重新定义药房体验。这种方法不再是传统 PBM（药品福利管理）那种以药品数量为核心的模式，而是围绕“整合式患者体验”展开，带来更优的医疗结果和更低的后续治疗成本。

Synchronization targets many of the biggest challenges in health care. A growing demand for medicines and their arising costs, chronic illness on the rise and a fragmented system that operates in silos, which leads to disconnected care. Synchronization breaks down the silos to connect care across medical, pharmacy and behavioral needs, and helps people achieve their best health. And it is powered by our rich data resources. We are able to mobilize and apply comprehensive individual-level health care data through the connections our pharmacy members make with us 250,000x each day. This helps us understand, all of their health needs and opportunities. And it starts at a single pharmacy touch point, through which we leverage the entire scope of Optum's capabilities.

同步化直击当今医疗领域面临的诸多挑战：药品需求与成本持续攀升、慢性病患持续增加、医疗体系割裂运营，导致护理服务彼此脱节。同步化打破这些孤岛，实现医疗、药房和行为健康之间的协调连接，帮助人们实现最佳健康状态。其背后依托的是我们丰富的数据资源。我们每天通过药房成员与我们的25万次交互，动员并应用全面的个体级健康数据。这让我们能了解他们所有的健康需求和潜在机会。而这一切从一次简单的药房接触点开始，通过它我们能够调动 Optum 全部能力。

Please welcome, Mark Thierer.

请欢迎 Mark Thierer。

Mark Thierer

Good morning. I'm Mark Thierer and I'm the CEO of OptumRx. I think maybe the best way to get a feel for synchronization is to actually see it in action. So let me introduce Christina. Christina is a 60-year-old patient. She was recently hospitalized with a lung infection. Good news is she's is discharged and went home. Christina went home overwhelmed, like many of us who leave the hospital, with a stack of discharge instructions and actually a stack of prescriptions. So the first thing she did was she phoned up OptumRx and got a health care advocate on the phone with really a list of questions about these medications. Our advocate connected her to an OptumRx nurse adviser, who had a window into Christina's comprehensive health history. This includes all her medications, her medical history, it includes her behavioral health claims, it also includes laboratory values, a comprehensive view of her health history.

Mark Thierer

早上好，我是 Mark Thierer，OptumRx 的首席执行官。我想，想要真正理解“同步化”这一理念，最好的方式就是看看它在实践中的表现。所以让我为大家介绍一位患者——Christina。Christina 是一位60岁的女性，最近因肺部感染住院。好消息是，她已经康复出院，回到了家中。但像许多出院患者一样，Christina 感到不知所措，带着一叠出院说明和一堆处方回了家。她做的第一件事是拨打了 OptumRx 的电话，找到了我们的健康倡导专员，向他提出了关于这些药物的一系列问题。我们的专员将她转接给一位 OptumRx 护理顾问，该顾问能查看 Christina 的完整健康记录，包括她的所有药物、医疗历史、行为健康理赔信息以及实验室检验数据，能够全面了解她的健康状况。

She was then connected to an OptumRx nurse and a pharmacist, and because it turns out she was struggling with finances and she was also struggling to get around from a mobility standpoint. So together, our pharmacist and our nurse counseled Christina. She discussed a lower-cost medication, to call her doctor and get a lower-cost med for hypertension, and also suggested use home delivery, a convenient, simple, low-cost method for receiving your medications. Our pharmacist then took the time to give a complete medicine cabinet review for Christina, all the meds that she's on and the importance of staying on your medications and staying adherent. After all these interaction, Christina finds herself much better informed, much better engaged and on her way to better health.

随后，她又被转接给 OptumRx 的护士和药剂师。因为我们发现她在经济方面有困难，同时行动能力也受限。于是，药剂师和护士一起为 Christina 提供了咨询服务。他们建议她联系医生更换为低成本的降压药，并推荐她使用家庭送药服务——这是一种便捷、简单、费用低廉的药品获取方式。我们的药剂师还专门为她进行了一个完整的“药箱评估”，帮助她了解自己正在服用的所有药物，以及坚持服药、保持依从性的重要性。在这一系列交流后，Christina 感觉自己信息更加清晰、参与度更高，也更有信心走向更好的健康状态。

So I think this shows the power of synchronization. Getting a 360-degree view of the whole person, all focused on driving better outcomes at a lower cost. Health care is amazing. And I have never, in my entire career, seen a more robust set of assets than we have here at Optum. And I truly believe that the power of synchronization will be a game changer in our industry.

我认为，这个案例充分展示了“同步化”的力量：我们以360度视角全面了解每位患者，目标是以更低的成本带来更优的治疗结果。医疗行业是令人惊叹的，而在我整个职业生涯中，我从未见过像 Optum 这样如此完备的资源体系。我真心相信，“同步化”的力量将彻底改变整个行业的格局。

Larry Renfro   Former Vice Chairman

Thank you, Mark. Synchronization is already the pharmacy model for many millions of members served by OptumRx. The potential to expand is large, as our employer, health plan and government clients look to more deeply integrate their medical and pharmacy benefits. With synchronization, we are engaging members, improving outcomes and reducing costs. Synchronization members showed a of 5% to 10% decline in both inpatient and ER admissions. They had more than a 45% greater likelihood of participating in clinical programs, a key to driving better adherence and outcomes.

谢谢你，Mark。同步化已成为 OptumRx 为数百万会员提供药房服务的核心模式。随着我们的雇主客户、健康保险计划方以及政府客户日益寻求更深入地整合医疗与药品福利，同步化还有巨大的扩展潜力。通过同步化，我们能够提升会员参与度、改善治疗结果并降低成本。数据显示，参与同步化项目的会员，其住院率和急诊就诊率下降了5%到10%；他们参与临床项目的可能性提高了45%以上，而这正是改善依从性和疗效的关键。

10% of patients had a medical consultation, where an OptumRx pharmacist found gaps in care that needed to be addressed. Early results show medical cost reductions of up to \$20 per member, per month. For health systems to work better, they must first work better for those on the front lines who deliver care. Care providers today are pressured like never before to elevate quality while driving down cost. They are also grappling with major changes that impact them directly, including growing competition and consolidation among providers themselves, payer consolidation and more empowered consumers who expect greater convenience and simplicity. Providers everywhere are taking action to adapt and succeed in this dynamic environment, including transitioning to value-based care by adopting fee-for-performance models.

在10%的病例中，OptumRx 的药剂师在会诊中发现了需及时解决的护理缺口。早期结果显示，每名会员每月的医疗成本可减少多达20美元。若要让医疗系统运行得更好，首先必须让前线医疗服务人员的工作方式更高效。如今的服务提供者前所未有地面临着在提高质量的同时压缩成本的巨大压力。他们也在应对一系列直接影响自身的重大变革，包括医疗服务提供方之间日益加剧的竞争与整合、支付方的合并，以及消费者主导权的增强，后者对医疗服务的便捷性与简洁性提出了更高期待。为适应并在这一动态环境中取得成功，医疗提供者正在采取行动，其中包括向基于绩效的付费模式过渡，实现价值导向医疗。

We are able to bring doctors the capabilities they need to modernize the critical systems that health care runs on, including advanced technology and tools that improve clinical workflow and connectivity and claims management. Interactive practice management tools that connect them with patient information, claims and other important data, where and when they need it. And analytic solutions powered by nearly 80 million lives of clinical data and 170 million lives of claims data.

我们能够为医生提供现代化所需的关键能力，以更新医疗体系所依赖的基础系统——包括提升临床工作流程、信息互联互通以及理赔管理的先进技术与工具。我们还提供交互式的诊所管理工具，帮助医生在任何时间、任何地点连接患者信息、理赔记录及其他重要数据。此外，我们的分析解决方案拥有近8000万份临床数据和1.7亿份理赔数据支持。

Optum One is our proprietary analytics platform.We just introduced it in 2014 and already, today, it is used to design and deliver care by 130,000 clinicians in more than 500 hospitals and 5,000 clinics. Optum One connects physicians with the largest and most comprehensive data set in the market today. Beyond our 250 million clinical and administrative lives, our data set includes 8 billion lab results, 4 billion determinations and 3 billion medical procedures.

Optum One 是我们的专有分析平台。 自2014年推出以来，Optum One 目前已被超过500家医院和5,000家诊所中的13万名临床医生用于医疗方案设计与服务实施。Optum One 将医生与当今市场上最大最全面的数据集连接在一起。除了2.5亿份临床和管理数据外，该平台还包含80亿份实验室结果、40亿次诊断判断和30亿项医疗程序记录。

Let's hear directly from the person driving the Optum One product. A.G.?

接下来，让我们直接听听 Optum One 产品背后的推动者 A.G. 的分享。

A.G. Breitenstein Former Partner

Good morning. My name is A.G. Breitenstein, I'm the Chief Product Officer for Optum Analytics. As a public health professional who started her career in Boston working with homeless kids at high-risk for HIV, I can't think of no more exciting time to be working in health care. For the first time, we have a real chance to solve for the market failures that have driven costs up and quality down. Optum One and the data that we're aggregating through this system is a key to this realignment. Billions of data points on nearly 80 million Americans being updated every single day. The integration of clinical data, claims data, spanning years of longitudinal detail at the patient level. This is a totally unique asset and it's allowing us to build statistical and analytic models that are helping us move from a reactive model, struggling to focus on volume, to a proactive model where we can start to focus on health. Here are just a few examples.

A.G. Breitenstein（前合伙人）

早上好，我是 A.G. Breitenstein，Optum Analytics 的首席产品官。我是一名公共健康专业人士，职业生涯起步于波士顿，曾与高风险感染 HIV 的无家可归儿童一起工作。对我来说，没有比现在更激动人心的时刻来投身医疗行业了。我们首次真正有机会解决那些导致成本上升、质量下降的市场失灵问题。Optum One 以及我们通过该平台汇聚的数据，是推动这一转变的关键。我们每天更新的数据点数量以数十亿计，覆盖近8000万美国人。这些数据整合了临床信息与理赔信息，涵盖患者层面的多年纵向细节。这是一个完全独特的资产，使我们能够构建统计与分析模型，从而实现从以量为导向、被动响应的模式，转向以健康为中心、积极主动的模式。以下是几个例子。

Mercy, one of the largest Catholic health systems, is using Optum One and our data to proactively identify patients with untreated hypertension and diabetes. Using our information, they've been able to lower their rates of hypertension by 12% while improving diabetic blood sugar control by a whopping 80%. HealthEast, an integrated delivery network, is using of predictive models in CHF and COPD to target patients months before hospitalizations and ED visits occur. Putting home-based programs in place, they were able to start to reduce the hospitalization rate by 39% and the ER rate by 30%. Results like these are empowering consumers and empowering providers to develop new models to take risk and afford a new health care system with payers that's focused on health, reducing costs and improving lives. As I think back to the homeless kids that I worked with in Boston, I can think of no better way to keep the faith of a better, safer, more cost-effective health system. Thank you.

Mercy 是美国最大的天主教健康系统之一，他们正在使用 Optum One 及我们的数据，主动识别那些未接受治疗的高血压和糖尿病患者。借助我们的信息，他们将高血压患者比例降低了12%，糖尿病患者的血糖控制率提升了惊人的80%。HealthEast 是一家整合型医疗交付网络，他们使用预测模型识别心衰（CHF）和慢阻肺（COPD）患者，提前数月干预、预防住院和急诊发生。通过推行家庭护理计划，他们已将住院率降低了39%，急诊率降低了30%。这些成果正在赋能消费者和医疗服务者，帮助他们建立起新的风险承担模式，并与支付方一道构建一个更关注健康、控制成本、改善生活的全新医疗体系。回想起我在波士顿与无家可归儿童共事的日子，我再也想不出比这更令人振奋的方式去守护一个更好、更安全、更具成本效益的医疗体系。谢谢大家。

Larry Renfro Former Vice Chairman

Thank you, A.G. In addition to improving care for their patients, care providers everywhere are addressing the urgent need to improve their day-to-day operations. We enable a modern approach that powers health systems to run the business of care delivery at scale. Today, 4 out of 5 hospitals and tens of thousands of physician practices use our revenue management solutions to manage every dollar that flows through their operations, from the time the first appointment is scheduled, to the time the final bill is settled.

Larry Renfro 前副董事长

谢谢你，A.G。除了致力于提升患者护理质量，全球的医疗服务提供者也在应对日常运营亟需改善的现实问题。我们提供现代化方法，帮助医疗系统在大规模层面高效运营护理服务业务。如今，80%的医院和数万家医生诊所都在使用我们的收入管理解决方案，管理从首次预约开始到最终结算为止的每一笔收入流动。

We also help health care organizations of every sort to work better with payers and patients; ensure accurate, complete documentation in billing; improve cash flow and overall financial performance; and deliver better, simplified experiences for patients.

我们还帮助各种类型的医疗机构更高效地与支付方和患者协作；确保账单记录准确、完整；提升现金流和整体财务表现；并为患者提供更简洁、更优质的就医体验。

We combine 3 key services to meet the goals of each care provider: Technology solutions, end-to-end managed services and practice management support. These solutions can work individually or together. From the point of patient registration, through coding and documentation and finally, to billing and collections.

我们通过三大关键服务帮助每一位医疗服务者达成目标：技术解决方案、端到端托管服务，以及诊所运营支持。这些服务既可独立应用，也可组合使用，涵盖从患者登记、编码与文档处理，到账单出具与费用催收的全过程。

You may recall, we launched Optum360, 2 years ago, with Dignity Health. While still early, the results and impact of this collaboration have been significant. Dignity has achieved a system-wide decrease in accounts receivable of more than $0.5 billion, and they are being settled a full 8 days faster. Optum360 is also supporting Dignity's transition to ICD-10. Our documentation technology helps physicians to meet demanding requirements and improve productivity more than 50% across care facilities.

你可能还记得，两年前我们与 Dignity Health 联合推出了 Optum360。虽然这一合作仍处于早期阶段，但已经取得了显著成果和深远影响。Dignity Health 的应收账款在系统层面上减少了超过5亿美元，账款的结算时间也加快了整整8天。Optum360 还支持 Dignity 实现向 ICD-10（国际疾病分类第十版）的过渡。我们的文档技术帮助医生满足更高要求，在各类医疗机构中整体生产效率提升了超过50%。

Last year, another national care leader, Northwell Health, formerly North Shore-LIJ, joined Optum360, extending these solutions to one of the largest systems in the Northeast, serving over 4 million patients across more than 20 facilities. And earlier this year, we expanded our relationship with the Mayo Clinic to focus together on revenue management that creates a more convenient and transparent experience for patients.

去年，另一家全国性医疗领导机构 Northwell Health（原名 North Shore-LIJ）也加入了 Optum360，将这些解决方案拓展到了美国东北地区最大的医疗系统之一，覆盖超过20家机构，为400多万患者提供服务。今年早些时候，我们还扩大了与 Mayo Clinic 的合作，聚焦于收入管理，共同为患者打造更加便捷、透明的就医体验。

To support all of our partners, Optum360 brings together thousands of technology experts and customer service advocates operating through a national network of service centers and on-site support. Last year, we extended our capabilities to ambulatory settings by delivering revenue and practice management support to independent and health system-affiliated physician practices.

为了支持所有合作伙伴，Optum360 汇聚了数千名技术专家和客户服务专员，并通过遍布全国的服务中心网络与现场支持团队开展工作。去年，我们将服务拓展至门诊环境，为独立及隶属于医疗系统的医生诊所提供收入与运营管理支持。

In this area specifically, we have helped physician practices achieve up to a 25% reduction in accounts receivable days. We also drive physician productivity improvements. One large national client experienced reductions of 7% in practice overhead cost and 50% in staff turnover. This reduced operating losses by $15,000 per physician. For another practice, our solutions and operational support enable each doctor to care for one additional patient per day, on average, by reducing the time they spend on administrative work.

在这方面，我们帮助医生诊所将应收账款天数缩短了最多25%。我们还显著提升了医生的工作效率。例如，某全国性大客户诊所的运营开支减少了7%，员工流失率下降了50%，每位医生的运营亏损减少了1.5万美元。另一家诊所则借助我们的解决方案和运营支持，使每位医生每天平均能多看一位患者，得益于行政工作时间的有效压缩。

Our relationships with governments help address their fundamental challenges, expanding access to high-quality care and services, managing limited dollars and meeting the changing needs of consumers. Today, we serve over 100 state, federal and municipal agencies across a broad scope of engagements. We have helped millions of Americans to gain access to quality, affordable health care through our work with public exchanges.

我们与政府的合作致力于帮助其解决核心挑战，包括扩大优质医疗服务的覆盖范围、在预算有限的情况下进行高效管理，以及应对消费者需求的不断变化。如今，我们与超过100家州级、联邦级和市政机构开展了广泛合作。通过参与公共交易所项目，我们已帮助数百万美国人获得了高质量、可负担的医疗保障。

Our program integrity solutions help states more effectively manage Medicaid programs and save hundreds of millions of dollars by detecting fraud, waste and abuse. And 40% of all Medicaid recipients are supported by Optum services. Perhaps our best-known One Optum success story to date is our support of the federal and state exchange marketplaces, to which we have brought uniquely deep expertise and broad capabilities. This remains a strong example of our ability to mobilize quickly and bring the right people and capabilities to solve urgent problems.

我们的计划完整性解决方案帮助各州更高效地管理 Medicaid 项目，通过识别欺诈、浪费与滥用行为，为州政府节省了数亿美元。目前全美有40%的 Medicaid 受益人正在接受 Optum 服务。也许我们最广为人知的 One Optum 成功案例，就是我们为联邦和各州的交易市场提供支持——在这一过程中，我们展现了独特而深厚的专业能力与全面资源整合力。这充分体现了我们迅速响应、调配合适团队与技术来解决紧迫问题的能力。

Earlier this year, we completed our work as the lead contractor for HealthCare.gov, having helped establish a strong and reliable platform that continues to work well for consumers. Our work has also contributed to a smooth 2016 open enrollment process for the state exchanges we serve, including Massachusetts and Vermont. They now have stable exchange platforms that work well for people seeking coverage.

今年早些时候，我们完成了作为 HealthCare.gov 首席承包商的工作，帮助建立了一个强大而可靠的平台，该平台至今仍为消费者提供良好服务。我们的工作也为我们所服务的州级交易所（包括马萨诸塞州和佛蒙特州）顺利开展2016年的开放注册做出了贡献。目前，这些州的交易平台已趋稳定，能够有效满足有保障需求民众的使用。

Turning to a different area of government support. The services we provide to the men and women of the armed forces and military veterans are among the most important work we do as an organization. Through Logistics Health, Inc. and Optum company, we are a proud partner to the Veterans Administration and Department of Defense. Our national work of over 18,000 care providers now serves 500,000 service members and military veterans each year. We provide services through clinics, virtual channels [ph] and through group service events that bring doctors and clinicians to service members at times and places that are convenient to them.

谈到另一类政府支持，我们为现役军人和退伍军人提供的服务，是我们公司最重要的工作之一。通过 Logistics Health, Inc.（LHI）——一家 Optum 子公司，我们很自豪能与退伍军人事务部（VA）和国防部（DoD）合作。我们在全国范围内拥有超过1.8万名医疗服务人员，每年为约50万名现役和退伍军人提供服务。这些服务涵盖诊所、虚拟渠道，以及团体服务活动，后者可以在服务人员方便的时间与地点为他们提供医疗支持。

On a typical weekend, we deliver 30,000 services through more than 200 events. And nationwide, LHI supports more than 70 Department of Veterans Affairs medical centers. LHI provides clinical disability exams to veterans to help them more quickly receive VA benefits. Veterans face severe health care challenges, including long delays in getting needed care. When in fact, they should be the first in line for care. Optum is well positioned to aid the Veterans Administration as it transforms to become a more consumer-centric organization where access barriers are removed. We have opportunities to expand our services to the VA in ways that leverage our broader portfolio of technology, administrative services and clinical programs.

在一个普通的周末，我们通过200多场服务活动交付约3万次服务。LHI 在全国范围内支持超过70家退伍军人事务部医疗中心。LHI 为退伍军人提供临床残疾评估，帮助他们更快获得 VA 福利。退伍军人面临严峻的医疗挑战，其中包括获得所需护理服务时的长期延误。事实上，他们本应是最优先获得护理的人群。Optum 完全有能力支持 VA 转型为一个更以消费者为中心的组织，打破现有的准入障碍。我们也有机会将我们的技术、行政服务和临床项目更广泛地应用到退伍军人体系中，进一步拓展服务范围。

[Presentation]

Larry Renfro Former Vice Chairman

The work of LHI meets a growing and urgent need for the federal government. But as you saw, the impact is also powerful on a personal level. It leads directly to perhaps the most fundamental relationship, the one we share with the consumer. In a real sense, the positive impact we are having on consumers, directly and indirectly, is the best testament to the One Optum approach. Every challenge we help solve, every innovative solution we develop and every relationship we establish, ultimately benefits the people who rely on the system and deserve the best possible care and experience.

Larry Renfro 前副董事长

LHI 所开展的工作正好回应了联邦政府日益增长的紧迫需求。但正如你们所见，其影响也在个人层面上体现得尤为深远。这些工作直接触及了最根本的关系——我们与消费者之间的联系。从某种意义上说，我们对消费者产生的积极影响，无论是直接的还是间接的，都是 One Optum 战略最好的证明。我们所解决的每一个挑战、开发的每一个创新方案、建立的每一段合作关系，最终都将惠及那些依赖于这个体系、理应获得最佳照护和体验的人们。

But as consumers take more control of their health, their expectations grow. They are writing a bigger portion of the check. And as a result, are demanding better choice, options and guidance. They want the same combination of quality, value and simplicity in health care that they have come to expect in other parts of their lives. They now count on flawless next-day delivery of just about everything. Seamless integration of various personal digital devices and instant updates on hundreds of family members, friends and acquaintances. So it is striking that of all the major industries, health care, the most intensely personal, is among the least developed on this front. That should change and is changing. And it is an opportunity for Optum. Consumers want care where and when they need it. And importantly, on their own personal terms. Nowhere do we have more of an opportunity to deliver the convenience and quality consumers demand than in the direct delivery of care.

但随着消费者对自身健康掌控力的增强，他们的期望值也在提升。他们承担着更大比例的医疗费用，因此对选择、方案和指导的需求也更高。他们希望医疗服务能像生活中其他领域一样，兼具高质量、高价值和简便体验。他们已习惯了几乎所有商品的次日无误配送、个人设备的无缝连接，以及对亲友社交圈的即时更新。令人惊讶的是，在所有主要行业中，医疗作为最具个性化的行业，却在这一方面最不发达。这种状况应当改变，正在改变，也正是 Optum 的机会所在。消费者希望在自己需要的时间和地点获得服务，更重要的是——以他们自己的方式。没有比“直接医疗服务”更适合我们满足消费者对便利性与质量的期待的领域了。

MedExpress and its innovative neighborhood care centers, which we welcomed to Optum this year, is a great example. We offer a broad set of urgent care, wellness, prevention, lab services, medical imaging and other services in convenient locations where people live and work. Making quality care more accessible also reduces costs. MedExpress can provide as much as 90% of the care that patients receive in the ER and for as little as 10% of the cost.

MedExpress 及其创新的社区诊疗中心就是一个很好的例子，今年它正式加入了 Optum。我们在居民生活与工作便利地点提供广泛服务，包括急诊、健康管理、预防服务、化验检测、医学影像等多种医疗服务。提升优质护理的可及性也能有效降低成本。MedExpress 能够提供高达90% 急诊室能提供的服务，成本却仅为其十分之一。

Please welcome, Dr. Alderman.

请欢迎 Alderman 医生。

Frank Alderman

Good morning. I'm Frank Alderman, Founder, Physician, Chief Executive Officer of MedExpress. As an ER physician myself, in addition to treating truly emergent patients, I saw, first hand, how the majority of patients presenting to the ER were, in fact, not emergent. Presenting with common illnesses, broken bones, sprained ankles and bloody noses. This creates a significant impact on the patient experience, our health care teams and of course, costs. All highlighting the need for an innovative outpatient health care delivery model. From this, the vision of MedExpress began. The goal was to provide access to high-quality, patient-centric, affordable care in a welcoming environment. Essentially making health care easier for the individual consumer. We've developed a consistent and scalable model focused on high quality and not just meeting, but exceeding patient expectations.

Frank Alderman

早上好。我是 Frank Alderman，MedExpress 的创始人、医生兼首席执行官。作为一名急诊医生，我在亲自救治真正危急的病人的同时，也深切看到，大多数来急诊室的患者其实并非真正紧急，他们往往是感冒、骨折、扭伤、流鼻血等常见病症。这种现象对患者体验、医疗团队运作，乃至整个成本结构都造成了不小的冲击。这一切凸显出我们迫切需要一种创新的门诊医疗服务模式。MedExpress 正是从这个理念诞生的。我们的目标是在一个温馨的环境中，为患者提供高质量、以患者为中心且可负担的医疗服务。本质上，是要让医疗变得对个人消费者“更简单”。我们构建了一种标准化、可复制、可扩展的服务模式，专注于医疗质量，不仅满足、更是超越患者的期望。

Today, MedExpress operates at the convergence of health care and retail. We are health care services delivered at retail, and we measure success one patient at a time. Our centers are warm, welcoming and convenient. Our scope of services is broad. It spans urgent care, employer health services and basic wellness and prevention. Our visits are efficient, but never rushed, averaging less than 1 hour in total duration. Our centers are open 12 hours a day, 7 days a week, and in network with all major insurance plans.

如今，MedExpress 运营于医疗与零售交汇的前沿。我们是在零售环境中提供医疗服务，并以“每位患者的满意度”为衡量成功的标准。我们的门诊中心温馨、友好且方便，服务范围广泛，涵盖急诊、雇主健康服务，以及基础健康与预防项目。就诊过程高效而不匆忙，平均不到一小时。我们的中心每天营业12小时，每周7天，并与所有主流保险计划网络兼容。

All patients of MedExpress receive a follow-up call after their visit. We enjoy high patient satisfaction and, therefore, loyalty. In fact, 90% of our patient state they are likely to recommend our centers to friends and family. And 65% of our patients have visited us before. We truly are their front door into the health care ecosystem. Our growth is reflective of this satisfaction and loyalty. In 2015 alone, we will serve approximately 3 million patient visits across 14 states. MedExpress strives to coordinate care across the health care continuum. And it is our goal to expand upon this successful model of care delivery, to meet the needs of consumers in their communities across the entire country and beyond.

每位就诊 MedExpress 的患者，都会在看诊后接到回访电话。我们拥有极高的患者满意度，因此也收获了强大的忠诚度。事实上，有90%的患者表示愿意将我们的中心推荐给朋友与家人，65%的患者曾多次光顾。我们真正成为了他们进入医疗生态系统的第一入口。这种满意度与忠诚度直接推动了我们的增长。仅在2015年，我们就在14个州完成了约300万次患者接诊。MedExpress 正努力实现医疗服务在整个健康护理链条上的协调，并以扩展这一成功模式为目标，满足全美各地、乃至海外社区消费者不断增长的健康需求。

Larry Renfro Former Vice Chairman

Thank you, Frank. Another important way we make health care more personal and more effective is through our HouseCalls program. It is exactly as the name implies. Optum nurse practitioners engage with members we have identified as at-risk or needing support in the convenience and the comfort of their homes. Our nurse practitioners, armed with secure smart tablets instead of black leather bags, help patients follow prescribed treatment plans, make annual visits to their physicians and get appropriate vaccinations. They also help coordinate care with doctors.

Larry Renfro 前副董事长

谢谢你，Frank。我们让医疗变得更贴心、更有效的另一种重要方式，是通过我们的 HouseCalls（上门问诊）项目。顾名思义，该项目由 Optum 的执业护士主动出击，在患者家中——一个既便利又舒适的环境中，与我们识别出的高风险或需要额外支持的会员互动。我们的护士不再是带着黑色皮包，而是携带安全的智能平板电脑，上门协助患者遵循处方治疗计划、完成年度体检以及接种必要疫苗。他们还会协助协调与医生之间的持续护理工作。

We are helping people get the care they need. And in the process, helping save millions of dollars in preventable cost. We are able to identify both medical and emotional conditions and help ensure they are addressed before they result in something more serious and costly. At the end of this year, our HouseCalls nurse practitioners will have made $1 million at home, face-to-face visits with people who truly need and benefit from our help. Those visits have identified 40,000 clinically urgent and sometimes life-threatening health issues. We have also made nearly 700,000 referrals to health management programs to close gaps in care. In addition, Optum pharmacists have followed up with almost 200,000 members to consult on their medication as a result of a HouseCalls visit.

我们正在帮助人们获得他们真正需要的医疗服务，同时也在过程中节省数百万美元的可预防性支出。通过这些上门问诊，我们能够及早识别出患者的身体或情绪健康问题，并在这些问题演变为更严重、更昂贵的状况前及时处理。到今年年底，HouseCalls 项目的执业护士将完成 100 万次面对面的上门问诊，服务真正需要帮助并从中受益的人群。这些问诊已识别出 4 万起具有临床紧急性甚至危及生命的健康问题；我们还为接近 70 万人推荐了健康管理计划，用以弥补护理缺口。此外，Optum 的药剂师在 HouseCalls 访问后对近 20 万名会员进行了药物使用的跟进咨询。

[Presentation]

Now I would like to introduce John Rex, Optum's Chief Financial Officer, who will discuss business priorities and financial performance.

现在让我介绍 Optum 的首席财务官 John Rex，他将讲述公司的业务重点与财务表现。

John Rex President & CFO

Thank you, Larry. Good morning. I just have to take a minute to look at all these familiar faces in the room. It's great to see you. I know how busy your schedules are and just appreciate you taking time to come and visit with us today and spend an entire day with us. So far, you've heard about how we are expanding relationships and driving value for our customers. Now focus on how we have executed on our commitments this year.

John Rex 总裁兼首席财务官

谢谢你，Larry。早上好。我想花一点时间，看一看在座的各位熟悉面孔。非常高兴见到你们。我知道你们的日程非常紧张，感谢你们今天抽出整整一天时间来与我们相聚。到目前为止，你们已经听到我们如何拓展合作关系，并为客户创造价值。接下来，我将聚焦我们在本年度如何兑现这些承诺。

We continue to measure progress against the core business priorities we have shared with you in prior gatherings. I'll provide examples of how we're advancing these. A key part of serving our customers as One Optum is a constant focus on alignment and execution, areas where we continue to make strong progress in 2015. This included the ongoing alignment and integration of our full Optum product portfolio. We are taking existing products to new health care market segments and integrating our capabilities to drive more customer value.

我们始终围绕过去几次会议中与各位分享的核心业务重点来衡量进展。接下来我将用具体例子说明我们在这些方面的推进成果。作为 One Optum 服务客户的一部分，我们持续聚焦“业务协同”和“执行落地”这两个方面，而这正是我们在 2015 年取得显著进展的领域。这包括我们持续推动 Optum 全产品组合的协同与整合，把现有产品引入新的医疗市场细分领域，并将不同能力融合在一起，为客户创造更大价值。

For example, this year we further integrated our population health management services into a cohesive solution that incorporates care management, wellness programs and patient support. This meets the growing needs of health benefit sponsors and their members. In 2015, we also introduced new scaled services into the marketplace. We successfully transitioned 11 million members to Rally, our modern consumer engagement platform. We now serve nearly 4x as many members as were on this platform just 1 year ago. And by the end of next year, we expect to serve 17 million members.

例如，今年我们进一步整合了人口健康管理服务，将护理管理、健康计划与患者支持整合成一个统一的解决方案，以满足健康福利赞助方及其成员不断增长的需求。2015年，我们还向市场推出了多个规模化的新服务。我们成功将1100万名会员迁移至我们的现代化消费者互动平台 Rally。当前，我们服务的 Rally 平台用户数量是一年前的近4倍。到明年年底，我们预计将服务1700万名会员。

We implemented a patient-centric care model, an integrated clinical initiative in all 21 states, where we support UnitedHealthcare Medicaid programs. This has deployed hundreds of local health care professionals directly into the communities where they're needed the most. And this fall, our advanced technology solutions led our provider and health plan partners through the transition to ICD-10.

我们在支持 UnitedHealthcare Medicaid 计划的21个州全面实施了以患者为中心的护理模式，也就是一项综合性临床计划。该模式已将数百名本地医疗专业人员部署至最需要服务的社区。今年秋季，我们的先进技术解决方案也帮助医疗服务提供方和健康保险合作伙伴顺利完成了向 ICD-10 的转型。

We continue to simplify our business and manage costs across Optum. Our ongoing focus on aligning our shared services organization is driving efficiencies while improving of consumer experiences. Over the past 2 years, we have reduced the number of service center sites by 30%, creating more scaled and capable delivery operations. In just the past year, our cost per administrative call have declined 9% and the cost per transaction processed has improved 8%. We also continue to drive efficiencies in mail-ordered drug fulfillment. This year, we achieved an additional 10% reduction in the fill cost per script, this on top of last year's 20% reduction. Through productivity, ongoing sourcing and vendor optimization we achieved more than $200 million in savings just this year.

我们持续在 Optum 内部简化业务流程并管控成本。我们持续优化共享服务体系，对齐组织结构，从而在提升消费者体验的同时，提高运营效率。过去两年中，我们将服务中心数量减少了30%，从而建立了更具规模和能力的交付体系。仅过去一年，我们的每通行政服务电话成本下降了9%，每笔交易处理成本降低了8%。我们还在邮寄药品配送上持续优化效率。今年，我们在每张处方的配送成本上又实现了10%的节省，加上去年的20%，两年累计节省显著。通过提升生产力、优化采购与供应商管理，我们在今年一年内共实现逾2亿美元的成本节约。

And in technology, we continue to move our development and hosting services to cloud-based computing. We have seen cycle times improve from weeks to just hours, a better than 80% improvement. And the efficiencies of cloud computing have allowed us to avoid spending hundreds of millions on another data center.

在技术层面，我们持续将开发和托管服务迁移至云平台。开发周期从几周缩短至数小时，提升幅度超过80%。云计算带来的效率提升，也使我们免于为新建数据中心而投入数亿美元的支出。

Today, we have also highlighted the role that more expansive relationships play in our growth strategy. In fact, revenues from our top 25 customer relationships have quadrupled over the last 3 years. And this year alone, OptumHealth and OptumInsight average customer award sizes have doubled. Also, the ongoing -- while still very early -- Optum Care market expansion has connected us with more patients. In 2015, we'll touch 7 million consumers across our various direct care delivery channels. That's up from 3 million just 1 year ago.

今天，我们也强调了广泛合作关系在我们增长战略中的关键作用。实际上，在过去三年中，我们前25大客户关系所带来的收入增长了四倍。今年，OptumHealth 和 OptumInsight 的平均客户合同金额也实现了翻倍。同时，尽管仍处于早期阶段，Optum Care 的市场拓展已经让我们接触到更多患者。2015年，我们通过各类直接护理渠道服务的消费者数量将达到700万，而一年前这一数字还只有300万。

And finally, to strengthen our ability to drive growth as One Optum, early this year, we established a new cross-Optum growth office. This has further unified our sales teams and enabled greater end-to-end visibility into services and solutions for our customers.

最后，为了提升 One Optum 框架下的增长推动能力，我们在年初设立了新的跨业务增长办公室。这一举措进一步统一了销售团队，也增强了我们为客户提供的服务与解决方案的端到端可视性。

Now on to the numbers. I'll provide an overview of our 2015 performance and a look ahead to 2016. Specifically here, I'll highlight some of the key metrics that you may find useful to understand the growth drivers across our core businesses. We expect to finish the year strong, with each business delivering double-digit top and bottom line growth. Our revenue will be over $67 billion, growth of 40%, driven by strong organic growth across our businesses as well as the Catamaran combination.

现在让我们来看看具体的数字。我将简要回顾我们2015年的整体表现，并展望2016年。同时，我会重点介绍一些有助于你们理解核心业务增长动因的关键指标。今年，我们有望以强劲表现收官——各项业务的收入与利润都将实现两位数增长。我们全年营收预计将超过670亿美元，同比增长40%，主要由业务的有机增长与对 Catamaran 的整合共同驱动。

Even excluding Catamaran, growth for OptumRx was in the double digits. Our earnings will be of $4.2 billion, an increase of 28%. The key drivers here include our pharmacy care services business; expansion within technology-enabled services, including revenue management, payment integrity and our connectivity businesses; and continued growth within care delivery and population health management. As expected, our 2015 operating margin of 6.3% is impacted by the growth in OptumRx. Excluding Catamaran, we will be within the margin guidance range we established at this time last year.

即便不计入 Catamaran 的整合效应，OptumRx 今年的增长仍实现了两位数。我们全年利润预计达到 42 亿美元，同比增长 28%。这一增长主要受益于：我们的药品护理服务业务；技术赋能型服务（如收入管理、支付完整性和互联互通业务）的拓展；以及护理交付与人口健康管理的持续增长。正如预期，OptumRx 的扩张对我们 2015 年 6.3% 的营业利润率产生了一定影响。但如果不计入 Catamaran，我们仍将处于去年此时设定的利润率指导区间内。

Turning to 2016, we expect our momentum to continue. Revenue will reach $80 billion, growth of approximately 20%. Earnings will expand by over 30% to a range of $5.55 billion to $5.7 billion. And we expect margin expansion of 60 to 90 basis points. Within OptumHealth, we expect revenue growth of 16% to 18%.

展望 2016 年，我们预计增长势头将持续。收入将达到 800 亿美元，同比增长约 20%。利润将增长逾 30%，达到 55.5 亿至 57 亿美元区间。我们预计利润率将扩大 60 至 90 个基点。在 OptumHealth 业务板块中，我们预期收入增长为 16% 至 18%。

We'll end this year with more than 77 million unique consumers served, that's up from 63 million at the end of last year. The 3-year compound annual growth rate for unique consumers served within OptumHealth is about 9%. Product mix plays a role here in terms of the top and bottom line impact. For example, a standalone HSA consumer does not have as great an impact as one that spans our care delivery and our population health businesses. So over time, as we continue to deepen customer relationships, we expect increasing impact per consumer served.

今年我们将累计服务超过 7700 万名独立消费者，高于去年末的 6300 万名。OptumHealth 在过去三年中服务的独立消费者数量的复合年增长率约为 9%。产品结构在收入和利润方面的影响也不容忽视。例如，单一的 HSA 账户客户，其贡献远不及同时涵盖护理交付与人口健康管理的客户。随着我们与客户关系的加深，未来每位消费者所带来的影响将持续增长。

Turning to OptumInsight, we'll end this year with a revenue backlog of $10.5 billion, growth of over 20%. Over the past 3 years, the OptumInsight backlog CAGR is 18%. Now for those of you here that also follow the health care information technology sectors, I know you're well aware that revenue backlog is a key growth indicator for these types of businesses. So let me add a few thoughts here in terms of how you might utilize this metric as you assess our growth and visibility.

再来看 OptumInsight，我们今年的收入积压将达到 105 亿美元，同比增长超过 20%。在过去三年中，该板块的收入积压复合年增长率为 18%。对关注医疗信息技术领域的朋友而言，你们都知道收入积压（revenue backlog）是此类业务增长的关键指标。以下是我对该指标如何用于评估我们增长与可见性的几点补充说明。

Of the ending 2015 backlog, we expect nearly 60% to be recognized in next year's OptumInsight's revenues. From a top line visibility perspective, that equates to over 80% of the full year 2016 OptumInsight revenue outlook. One more metric that you may find useful in assessing this is the average backlog duration of about 20 months. And for OptumRx, revenue will grow by over 20%, which includes a full year impact from Catamaran. We expect that adjusted scripts should be about $1 billion.

我们预计 2015 年底的积压收入中，将有近 60% 在明年的 OptumInsight 收入中实现确认。从收入可见性角度看，这已覆盖 2016 年全年 OptumInsight 收入展望的 80% 以上。另一个有参考价值的指标是：我们的平均收入积压周期约为 20 个月。至于 OptumRx，其收入预计增长超过 20%，其中包括整合 Catamaran 的全年影响。我们预计调整后的处方数量将达到约 10 亿张。

There are several items impacting our 2016 revenue guidance for OptumRx that I would like to highlight here. First, our largest health plan customers are forecasting lower Part B enrollment, much of this around the subsidy business. Second, top line growth is also being impacted by other market factors, including the already well-known coop closures and a single large customer transitioning to a claims processing-only arrangement for a portion of their book. However, given the margin profile of the businesses affected, the bottom line is not materially impacted. In fact, today, we are raising our long-term OptumRx margin outlook from 3% to 4% to a range of 3% to 5%.

关于 OptumRx 2016 年收入指导，我想强调几项影响因素：首先，我们最大的健康保险客户预计其 Medicare Part B 参保人数将下降，主要是受到补贴业务变化的影响；其次，其他市场因素也对增长产生了影响，包括多个合作医疗组织（co-op）已知的关闭，以及一家大型客户将部分业务转为仅限理赔处理的模式。然而，受影响业务的利润率结构决定了这些变化对净利润影响不大。事实上，我们今天将 OptumRx 的长期利润率展望从 3%-4% 上调至 3%-5% 区间。

Lastly, in terms of visibility into total Optum revenue, 2 points. We entered the year with revenue coverage exceeding 90% of the full year $80 billion plan and with a robust sales pipeline.

最后关于 Optum 总体收入的可见性，有两个要点：我们在年初就已实现超 90% 的全年 800 亿美元收入覆盖，并拥有强劲的销售管道作为后盾。

With that, I appreciate the opportunity to speak with you again this morning. And I'll hand it back to Larry, for his closing thoughts.

以上就是我今天早上的发言内容，感谢再次有机会与各位交流。接下来交还给 Larry，总结会议要点。

Larry Renfro Former Vice Chairman

Thank you, John. Today, we have just skimmed the surface of how Optum is making an impact on health care by making a difference for our customers and consumers. By helping them succeed, we are advancing the growth strategy that has been guiding Optum from the start, to advance care, empower consumers and to modernize systems infrastructure. Each day, we have the privilege of earning our customers' trust through the quality of work. And that is translating to growth in a diverse and dynamic marketplace. Our priorities and objectives remain constant.

Larry Renfro 前副董事长

谢谢你，John。今天我们只是浅尝辄止地介绍了 Optum 如何通过为客户和消费者带来实质性改变，从而在整个医疗行业产生影响。通过帮助他们取得成功，我们也在推进从 Optum 创立以来就始终坚持的增长战略：提升医疗服务、赋能消费者、现代化系统基础设施。每天，我们都有机会凭借高质量的服务赢得客户的信任，而这正是我们在多元且充满活力的市场中实现增长的根本所在。我们的重点与目标始终如一。

As I shared with you last year at this time, we continue to expect over half of our earnings growth in the next 5 years will come from 5 key market opportunities: In care delivery, next-generation pharmacy care services, technology-enabled products and services, an active government sector and broad international needs. I hope you saw examples of our impact in many of these areas today. And we will continue to execute on them with the full strength of our capabilities and collaboration as One Optum.

正如我在去年这个时候向各位所分享的，我们预计未来五年超过一半的利润增长将来自五大关键市场机会：医疗服务交付、下一代药品护理服务、技术赋能的产品与服务、活跃的政府板块，以及广阔的国际市场需求。我希望你们今天已经在上述多个领域看到了我们的影响力。未来我们也将继续以 One Optum 的全方位能力与协同效能坚定推进这些战略重点。

The 100,000 people of Optum are more inspired than ever to fulfill our potential. As I collaborate with them each day, 3 factors strike me. First, a strong sense of mission and purpose and the responsibility that comes with embracing our focus on making health care work better for everyone. Second, a deep resolve and courage to solve the largest, toughest and most complex challenges facing health care, in full collaboration with all participants across the health care system. And third, a real urgency to work together as never before to capture the tremendous opportunity in front of us.

Optum 拥有的 10 万名员工，如今比以往任何时候都更有激情去实现我们的潜力。每天与他们合作时，有三点令我印象深刻。第一，是他们强烈的使命感与责任感，源自我们“让医疗体系为每个人运转得更好”这一目标。第二，是他们解决医疗行业中最大、最难、最复杂问题的决心与勇气，这一过程离不开与整个医疗生态系统中所有参与者的紧密协作。第三，是他们前所未有的紧迫感与团结协作的精神，以抓住我们面前巨大的发展机会。

Thank you for your time today. And for your interest and support throughout these formative years of our One Optum story. We look forward to sharing our continued progress over the years and decades to come. Thank you.

感谢大家今天的宝贵时间，也感谢你们在 One Optum 成长历程中始终给予的关注与支持。我们期待在未来的数年乃至数十年中，继续与大家分享我们的进展成果。谢谢！

Operator

Introducing UnitedHealth Group President and Chief Financial Officer, David Wichmann.

主持人

请欢迎 UnitedHealth Group 总裁兼首席财务官 David Wichmann。

David Wichmann Former CEO & Director

Good morning. And thank you, again, for spending time with us today. One comment we hear from you pretty consistently after these sessions is that United Group has a whole lot to offer. I've heard you refer to these offerings as materials, as products, as capabilities and even, sometimes, very enthusiastically, as stuff. Well, as my colleagues have shown you this morning, and you will see later, we still have a lot of stuff. I happen to think it gets more impactful and useful every year, but I agree there's a lot of it. What this volume of stuff is not, however, is random. In the areas in which we engage fit very consciously into the trends that are shaping health care today and, in our view, for the next decade plus.

David Wichmann 前首席执行官兼董事

早上好，再次感谢各位今天抽出时间与我们相聚。在以往的会议之后，我们经常听到你们的反馈：UnitedHealth Group 拥有非常丰富的“资源”。有些人称之为“材料”，有些称之为“产品”或“能力”，甚至有些人兴奋地称之为“东西（stuff）”。正如我的同事们今天上午向大家展示的那样，稍后你们还会看到，我们确实拥有很多“东西”。我个人认为，这些“东西”每年都变得更有影响力、更具实用性，尽管我也承认，它们确实数量庞大。但我要强调的是，这些“东西”并非杂乱无章。我们所涉及的每个领域都经过深思熟虑，紧密契合当前及未来十年以上塑造医疗行业的趋势。

You have heard them woven throughout the morning's presentations. Now I will touch on them explicitly, so you get a better feel for how we are oriented strategically for the coming years. This 5 areas shouldn't be surprising: Consumers, service and value-oriented health care delivery, emerging technology and information, growth in the U.S. health care benefits market and lastly, receptivity in international markets.

在今天上午的演讲中，你们已经听到这些主题被反复提及。现在我将明确列出这五个战略重点领域，帮助大家更清晰地了解我们未来几年的战略方向。这五个领域并不令人意外：消费者、以服务和价值为导向的医疗交付、新兴技术与信息、美国健康福利市场的增长，以及国际市场的接受度。

Let's start with the consumer. It's not a revelation to say consumers are steadily becoming a more powerful force in shaping how health care is delivered and paid for. But here's the truth that doesn't get talked about in forums like this. Those consumers don't like it so far. They are unhappy with their health care experience. And we are included as targets of that unhappiness.

我们先从“消费者”谈起。说消费者正逐步成为决定医疗服务提供和支付方式的重要力量，这早已不是什么新鲜事。但在类似的论坛中，一个常被忽略的事实是：消费者目前对医疗体验并不满意。他们对医疗体系的体验感到不满，而我们也是他们不满情绪的对象之一。

I suspect some of you may have personal experiences that explain why. People are shouldering more of the direct financial burden of health care. And when it's their money at work, they look at the quality and level of the service experience differently, and it is simply not on par with other services they receive. So the challenge to us is very clear. As people pay more of the total, they want more convenient, high-quality health care at a lower price point.

我相信在座的各位中，也有不少人亲身经历过这种不满。人们承担着越来越多的医疗费用，而当这些钱是自己掏出来的，他们看待服务质量的角度就不一样了。而目前医疗服务的整体体验，明显无法与他们在其他领域所接受的服务相提并论。因此，我们面临的挑战十分明确：既然消费者支付得更多，他们就要求获得更便捷、更高质量、更具性价比的医疗服务。

That's why development of consumer-facing health care delivery services has such a high priority for us. These are things like pharmacy services, our own local care delivery practices, MedExpress urgent care, orthology, orthopedics, Real Appeal diabesity services and house calls and other home-based outreach services.

这也是为什么我们高度重视面向消费者的医疗服务交付模式的发展。包括药房服务、本地医疗实践、MedExpress 急诊服务、正骨治疗、骨科、Real Appeal 代谢病防治服务、上门问诊以及其他家庭延伸服务。

On the benefits front, consumer-directed and performance-based plan designs are dominating growth in the commercial market. We are seeing meaningful signs that similar features will make their way into government programs and Medicaid, where managed products are widely adopted, and in Medicare where, again, Medicare Advantage, Supplement and Part D offerings are highly popular with seniors. More and more these products have some level of consumer cost sharing, support for clinical and administrative needs, assistance with decision-making and tools for driving behavioral change with information, methods and incentives.

在健康福利方面，以消费者为导向、基于绩效的计划设计正引领商业市场的增长趋势。我们也看到有力迹象表明，这类特征正逐步进入政府计划和 Medicaid 市场，后者已广泛采用管理式保险产品；在 Medicare 中也是如此，其中 Medicare Advantage、Supplement 和 Part D 深受老年人欢迎。这类产品越来越多地具备一定程度的费用共担机制，支持临床和行政需求，协助决策，并通过信息、方法和激励机制推动行为改变。

We recognize, though, that the transition to these plans can be unsatisfying to consumers. It's a big change for many. So we have to continue to work with them to ensure they both -- they and society are realizing all of the greater long-term value these plans provide. That's why prevention and wellness take on new contexts and rely upon very different approaches in a consumer market.

我们也认识到，向这类新型计划的过渡对许多消费者而言并不轻松。这是一次重大的变革。因此我们必须继续与他们保持协作，确保他们个人与整个社会都能真正获得这些计划在长期所能带来的更大价值。这也正是为什么在“消费者主导”市场中，预防与健康管理需要全新的语境与完全不同的方法。

During the product showcase today, you'll see examples. Take a look at Real Appeal to see how we offer entertaining products that driver better engagement and outcomes in weight loss and diabetes prevention. Or check out United in Motion and see why already thousands of United Healthcare members are changing their lifestyle behaviors using motion-tracking devices today, under their health benefit program. Spend some time with our Health4Me app, which brings full digital administration to your mobile device. Or see Rally connect and how it simplifies -- it's simplifying physician search and cost transparency on a multi-payer basis. Last, it's well worth your time to take the time to understand our Advorcate4Me intelligent service model.

今天的产品展示中，你将看到不少实例。比如 Real Appeal，它是一款结合娱乐元素的健康产品，能够提升用户参与度并改善减重与糖尿病预防效果；再如 United in Motion，你可以了解为何已有数千名 UnitedHealthcare 会员通过运动追踪设备，借助其健康福利计划，积极改变生活方式。不妨也了解一下我们的 Health4Me 应用程序，它将完整的数字化管理功能带入你的移动设备；或者试试 Rally Connect，它正在为多支付方体系下的医生搜索与费用透明化提供简化方案。最后，我特别建议你深入了解一下我们的 Advorcate4Me 智能服务模型，绝对值得花时间体验。

As you heard earlier, we apply intelligence on front end of a call to determine whether it's best answered by the administrator, wellness coordinator or nurse, based on our knowledge of your interactions with us and your predictive needs. Some of these products have multi-payer relationships and capabilities comparable to free-standing companies. But we operate at scale with higher performance precision and accuracy. Indeed, the consumer has become a powerful force in health care. Distinguished engagement, service and value of delivery will be key to driving future loyalty and growth.

如你们早前所听，我们在电话接通前就运用智能判断应由哪类人员——管理员、健康协调员或护士——来响应，根据的是我们对你与我们互动历史的了解和你的预测性需求分析。这些服务产品中有不少拥有多支付方的协作关系和能力，堪比独立运营的公司。但我们在更大规模下运行，同时具备更高的性能精度和服务准确性。的确，如今消费者已成为医疗行业中的一股强大推动力。卓越的互动体验、服务水平和价值交付将是未来赢得用户忠诚度与推动增长的关键所在。

Care delivery modernization is, in many respects, rooted in this same consumer trend. People want a better, more effective and convenient experience for their money. And that's why we have pursued investments so aggressively in these areas over the past few years. Beyond the consumer-facing and reputation-enhancing elements of this opportunity, lie health system performance improvement and cost containment. The challenge, of course, is how to deliver it all. Care providers are seeking greater efficiencies and compliance support from patient admissions through post-discharge follow-up care. They are looking to reduce cycle times, enhance adherence to evidence-based practices, close gaps in care and improve regulatory compliance. This is the source of our ideas to form and build Optum360 and MedSynergies.

医疗服务的现代化在很大程度上正是源于这一消费者趋势。人们希望花的钱换来更好、更高效、更便捷的就医体验。这正是我们过去几年积极投资这些领域的原因所在。除了面向消费者和提升品牌声誉的部分，这一机会背后更关乎整个医疗体系的效率提升与成本控制。当然，挑战在于如何真正实现这些目标。医疗服务提供者正在寻求在患者入院至出院后随访全流程中获得更高的效率与合规支持。他们希望缩短服务周期、增强循证医疗实践的遵守程度、弥补护理缺口并提高监管合规性。Optum360 和 MedSynergies 的建立与发展正是基于这些需求的构想而来。

Upward pressures will continue on cost for medical technologies, new procedures, new devices and new drugs. Mark Thierer touched on this with synchronization, and Dan Rosenthal covered how we are working directly with care providers through ACO arrangements, tailoring networks and incentives to achieve better quality, as evidenced by better HEDIS, STARS and consumer and physician Net Promoter Scores.

医疗科技、新疗法、新设备、新药品等领域的成本压力仍将持续上升。Mark Thierer 通过“同步化”触及了这一点，Dan Rosenthal 则进一步阐述我们如何通过 ACO（责任医疗组织）合作模式，与医疗服务方直接合作，定制网络和激励机制，以提升服务质量——这些体现在 HEDIS、STARS 指标以及消费者和医生的净推荐值（NPS）等方面的持续改善。

Reforming the way health care is paid for will also be a key factor in advancing delivery performance, as the substantial majority of delivery payments will be based on measurable health outcomes. This increases the value of care engagement and quality for payers and care providers. Steve Nelson's discussion of STARS, our STARSHub demo in the back, and the seminar on clinical engagement, all give you a better sense of this critical element. People want a better, more effective and convenient health care experience for their money. And clinical practice is evolving in response. Our services and business development initiatives align well to achieving necessary improvements.

医疗支付方式的改革也将是提升服务表现的关键因素。未来大多数医疗服务的支付将基于可衡量的健康成果，这使得“患者参与度”与“服务质量”对支付方与服务提供者来说更具价值。Steve Nelson 对 STARS 的讲解、我们在现场展示区的 STARSHub 演示，以及关于临床参与度的专题研讨，都帮助大家更好理解这个至关重要的转变。消费者希望他们的钱换来的是更好、更高效、更便捷的医疗体验，而临床实践也正随之演进。我们的服务与业务拓展工作都与推动这些必要的改善目标高度契合。

The growing prominence of information and technology is obvious. And you don't need or want me to opine on it. There are less obvious yet highly important ways in which we are applying information and technology to enhance the fundamental relationship in health care, that between the patient and the doctor. From our view, it is essential that information and technology work to deepen that relationship, not disrupt it.

信息与科技的重要性日益凸显，这无需我多言。但值得一提的是，我们在一些不那么显眼但却极为关键的方面运用信息与技术，来增强医疗中最核心的关系——医生与患者之间的联系。在我们看来，信息与技术的使命是“加深”这一关系，而不是“干扰”它。

Start at the beginning of that relationship. How someone finds a doctor. That search is vital in our more mobile society, and we are making it an easier and better experience with Rally's icon-based search. Rally shows very simply relevant quality and efficiency designations, average comparative cost information based on specific benefit plan and network arrangements, a consumer-specific to do list outlining individual gaps in care and account and deductible balances. Soon we will add online scheduling, which enables a consumer to see open schedule times for their care provider, set an appointment and receive confirmation in the same transaction from any device. And of course, consumers can pay their bills with our existing online payment capabilities.

从关系的起点说起——如何找到医生。在当今流动性极强的社会中，这一环节至关重要。我们正借助 Rally 的图标化搜索功能，简化并优化这一体验。Rally 能直观展示与特定保险计划及网络结构相关的医生质量与效率评级、平均费用对比信息，还提供个人专属的健康待办清单，列出护理缺口、账户余额与免赔额等信息。不久后，我们将推出在线预约功能，让消费者在任意设备上查看医生的空档时间，预约并实时确认。此外，消费者还能通过我们现有的在线支付功能轻松缴费。

What is the essential, of course, is making these useful from the care professional's perspective. The appointment will be shared with them through our care provider tool called Link. Physicians and their practice support teams will see their daily schedule in an easy-to-use format, with key information right at their fingertips, the nature of the visit, benefit eligibility and payment information. There is so much more that Link and Rally have to offer, a fully functioning private insurance market, a full suite of benefits administration capabilities, leading wellness and engagement tools and many other products and services offered to improve physician practice performance.

当然，关键在于从医疗专业人员的角度确保这些工具真正实用。通过我们为医疗服务提供者设计的工具 Link，预约信息会同步至他们系统中。医生及其诊所支持团队可在一个易用界面中查看每日日程安排，所需关键信息尽在掌握，包括就诊性质、福利资格信息以及支付细节。Link 与 Rally 所提供的远不止于此——包括完整运行的私人保险市场、全套福利管理功能、领先的健康促进与互动工具，以及多项专为提升医生执业效率而设计的产品与服务。

With first quarter 2016 connections to 600,000 care providers and 25 million consumers across a couple of handfuls of initial third-party payers and intermediaries in the United States, Canada and Brazil, we are well on our way to connecting the health system digitally in ways no other company is or can.

截至 2016 年第一季度，我们已与 60 万名医疗服务提供者和 2500 万名消费者建立了连接，覆盖美国、加拿大与巴西的数家初始第三方支付方与中介机构。我们正在以前所未有的方式实现医疗体系的数字化连接，这种能力，是目前其他任何公司都难以比拟的。

Let's move on to the evolution of the U.S. health care markets and the growth opportunities underlying shifting demographics, coverage expansions and emerging needs of our military and veterans.

接下来，让我们转向美国医疗市场的演进，以及其背后所蕴含的人口结构变化、医保覆盖扩张、军人及退伍军人群体新兴需求等增长机遇。

As an overall experience, we see health care in the United States working better for more people. Much improvement still needs to be made, but we view it as a steadier evolutionary process in comparison to the last decade. With Medicare Advantage funding levels essentially in line with traditional Fee-for-Service Medicare, the opportunities to serve seniors with complete -- comparatively better benefits in a more modern system will accelerate. Medicare Advantage is the lower total cost, higher coverage, consumer-responsive solution. It continues to become the health care vehicle of choice for the growing majority of seniors. Combined with an aging U.S. population, the potential for industry-wide membership growth should extend well past the next decade.

从整体体验来看，美国的医疗服务正在为越来越多的人带来改善。尽管仍有许多改进空间，但相较于过去十年，这一转型更趋平稳可持续。随着 Medicare Advantage（优势医疗保险）的资金支持水平基本与传统按服务计费的 Medicare 相当，我们预计为老年人提供更全面、福利更优且更现代化服务的机会将持续加速。Medicare Advantage 提供的是一种总体成本更低、覆盖更广、消费者响应度更高的解决方案，正持续成为大多数老年人首选的医疗保障形式。叠加美国人口老龄化趋势，我们认为该行业的会员增长潜力将持续超过未来十年的周期。

Individual U.S. state Medicaid programs have their own specific sets of pressures. States are migrating to private sector solutions at a strong pace to drive greater value, insight and quality. Medicaid is a $500 billion and growing sector, and we believe it will continue transitioning to managed care over the next decade or so, with sizable market adjacencies and improving the delivery of social services to support better health, as Austin Pittman described earlier.

美国各州的 Medicaid 项目面临着各自特有的压力。各州正加速向私营解决方案迁移，以实现更高的价值、更强的数据洞察力和更优质的服务。Medicaid 是一个规模达 5000 亿美元且仍在增长的市场，我们认为在未来十年左右，它将持续向管理式医疗转型，并在与其邻近市场领域产生协同，同时也会改善社会服务的交付方式，以更好地支持整体健康——正如 Austin Pittman 早前所述。

We see how applying managed care to better serve America's military and veterans is a largely untapped high-potential solution to current performance and cost pressures in these 2 sectors. We see opportunity in helping sort out a better approach to delivering sustainable solutions to serve the 32 million non-elderly uninsured, whether through a viable insurance exchange or other public-private partnership. And we see opportunity to make the health system work better for all in the fast-growing, more than $0.5 trillion health care services market in the United States. So we agree. The U.S. health care market is robust and growing. And for us, after $70 billion in investments and 20 years of building and integrating, we are well positioned. We have the product, capability, presence and quality to seize this opportunity for distinguished growth.

我们也看到，将管理式医疗引入军人及退伍军人领域，是一个尚未被充分开发、但极具潜力的方案，有望缓解这两个系统当前面临的服务表现与成本压力。此外，我们也看到为美国 3200 万未参保的非老年人群体提供可持续解决方案的机会，无论是通过可行的保险交易平台，还是其他形式的公私合作机制。同时，我们还看到整个美国快速增长、规模已超 0.5 万亿美元的医疗服务市场，为整个体系的改善创造了巨大机会。因此我们完全同意——美国医疗市场充满活力，并持续扩张。而对我们来说，经过 700 亿美元的投资和 20 年的持续建设与整合，我们已经具备了抓住这一增长机遇的产品、能力、市场覆盖和服务质量。

Now, much of the same narrative is seen internationally. Many countries are facing the same challenges as we are in the United States: aging populations, higher demand for services and constrained budgets to pay for it all. These markets are big. We size the non-U.S. global market at approximately $5 trillion, roughly split, $500 billion in services and $4.5 trillion in health care delivery and insurance. We see growing interest in capabilities and offerings like ours, which could be shaped to help solve these problems. And that is true regardless of the specific national model for health care, from completely government paid to hybrid approaches. Like here, they are learning how to put primary care services at the center point for high-quality health care and how to aggregate and synthesize data, and then make that data actionable for their citizens and their care providers. We are becoming much more relevant to them, particularly through Optum's unique capabilities, whether in the U.K., India or Brazil, our ability to deliver solutions to broad and complex challenges -- not just sell individual products -- and to deliver them as an operator -- not as a consultant -- has fundamentally changed the nature of our discussions.

如今，国际市场上也在上演着与美国相似的故事。许多国家都面临着与我们相同的挑战：人口老龄化、对医疗服务需求日益增长，以及预算受限难以覆盖所有成本。这些市场规模庞大。我们估算，非美国全球市场的规模约为5万亿美元，其中5000亿美元属于服务领域，其余4.5万亿美元则涵盖医疗服务交付和保险业务。各国对于我们所具备的能力和服务方案兴趣日益浓厚，而这些能力可以根据具体国情定制，帮助解决普遍存在的问题。无论是完全由政府承担的医疗模式，还是混合型制度，这一点都成立。与美国一样，他们正在学习如何以基层医疗服务为核心构建高质量的医疗体系，如何聚合并提炼数据，并将其转化为患者与医疗服务方可用的行动指引。我们在这些市场中越来越具有相关性，尤其是凭借 Optum 独特的能力，不论是在英国、印度还是巴西，我们不仅提供单一产品，而是能够应对广泛且复杂的问题，并作为实际运营方交付解决方案，而非仅仅是顾问角色，这一点已从根本上改变了我们与这些国家的对话方式。

What you've seen from this stage today and will see at the sessions later, all drives the growth of our business in 2016 and for the next 10 years. The financial outlook for our businesses that John Rex and Dan Schumacher walked you through demonstrates how delivering customer and consumer value translates into growth and returns. I will touch briefly on highlights of the consolidated financial picture, but ask you to rely on the supplemental financial slides and information we have provided in your materials.

今天在主舞台上展示的内容，以及稍后你们将会在各环节看到的一切，都将支撑我们在2016年乃至未来十年的业务增长。John Rex 与 Dan Schumacher 先前所讲的财务展望已经清晰地表明，为客户与消费者创造价值，如何最终转化为增长与回报。我将在这里简要提及财务整体现状的重点内容，但也请各位参考我们提供的补充幻灯片与材料中包含的财务细节信息。

We expect our 2016 revenues to be $180 billion to $181 billion, a 15% growth rate over 2015. This growth is driven by the addition of nearly 1.6 million medical members at the midpoint of our expected range across all market segments and geographies, and 20% growth at Optum. We expect that revenue growth to drive a further acceleration in our rate of earnings per share growth. We project GAAP net earnings in a range of $7.10 to $7.30 per share, and adjusted net earnings in the range of $7.60 to $7.80 per share, both in line with our 13% to 16% long-term growth rate. As you will see, we will provide you with adjusted EPS from this point forward. In our case, adjusted EPS is just GAAP EPS adjusted for after-tax intangible amortization. Our goal is to help you measure our earnings performance in a manner more comparable to others who report on this basis. We assume consensus estimates will reflect our outlook for adjusted net earnings per share of $7.60 to $7.80 from this point forward. Our cash flow should strengthen even further next year, growing to $9.5 billion to $10 billion. That's an increase of $1 billion to $1.5 billion over our 2015 projection. We will use that cash to fund investments in technology, innovation and M&A and to reduce debt and return capital to shareholders, consistent with past practices. I believe you will find we are well capitalized and have ample cash flows and capacities to strategically grow and diversify the business, consistent with past investment practices.

我们预计 2016 年营收将在1800亿至1810亿美元之间，较2015年增长15%。这一增长主要由新增约160万名医疗会员带动，涵盖多个细分市场与地区，Optum 部门则实现20%的增长。我们预计，这一收入增长将进一步推动每股收益增速加快。预计GAAP净收益每股为7.10至7.30美元，调整后净收益为每股7.60至7.80美元，两者均符合我们长期13%-16%的增长目标。从现在起，我们将持续提供“调整后每股收益”这一指标。在我们的定义中，该指标即GAAP每股收益减去税后无形资产摊销，目的是帮助大家更可比地衡量我们的盈利表现，与其他按该口径报告的公司保持一致。我们预期市场对我们每股净收益的共识预测将落在7.60至7.80美元之间。现金流方面，预计明年将进一步增强，达到95亿至100亿美元，较2015年预估增长10至15亿美元。我们将继续按照既往方式，将这些现金用于技术、创新、并购投资，同时还债并回馈股东。我相信你们会发现，我们资金充足、现金流强劲，有能力根据战略方向拓展与多元化业务，延续我们一贯的投资策略。

There are some key elements underneath these consolidated numbers: An improving consolidated care ratio as we address our performance on public exchanges, an improving operating cost ratio due to continued productivity improvements and a favorable business mix, a slight improvement in our tax rate and relatively consistent share count and lower leverage ratio as we prioritize debt repayment over share repurchase in 2016. Product, geographic market and business diversification will continue. Notably, Optum, as a percentage of UnitedHealth Group's revenues and operating earnings, will have grown to 45% and 42%, respectively.

这些汇总数据背后还有几个关键组成因素：随着我们改进在公共交易所的表现，整体医疗赔付率（care ratio）持续改善；生产力提升与业务结构优化推动运营成本比率下降；税率略有改善；股本规模保持相对稳定；杠杆率下降——这是因为我们在2016年优先偿还债务，而非回购股票。我们的产品、地理市场与业务结构的多样化将持续推进。尤其值得一提的是，Optum 占 UnitedHealth Group 总营收与运营利润的比例，分别将增长至45%和42%。

In closing, I'd like to leave you with a couple of thoughts about what I believe makes us truly distinctive, and I hope worth your continued consideration as a long-term investment. First, as I said at the start, we have a lot to offer. And every company has its versions and everyone says their offerings are special. But UnitedHealth Group covers the broadest range of health care benefits and services, and as you have seen today, we actually put all those pieces together. Think about the capabilities as the muscles and our ability to connect them as the tendons. That is the strength we bring to customers, especially in larger relationships. We can focus a complex multiplicity of health care resources on a single point of need as no other company does.

最后，我想与你们分享几点我认为我们真正与众不同之处，也希望你们继续将我们视为一个值得长期持有的投资标的。第一，正如我开场所说，我们有很多可以提供的内容。当然，几乎每家公司都会这么说。但 UnitedHealth Group 是覆盖医疗福利与服务最广泛的企业之一，更重要的是，如今天所展示的，我们确实能把这些能力系统性地整合在一起。可以将这些能力视作“肌肉”，而我们的整合能力就像“肌腱”，让这些肌肉协调运行。这正是我们在面对大型客户关系时所具备的独特实力。我们能将复杂多样的医疗资源聚焦于一个核心需求点，这是其他公司所无法做到的。

Second, much of what you saw here today was about what we do. But in today's world, who we are matters just as much. We have been on a journey at our company the last 5 years to evolve our culture. We have become a better place to work and a better organization to do business with. And we needed to. We know this journey has no endpoint, and we are eager and committed to keep moving forward.

第二，你们今天看到的大部分是我们“做什么”，但在今天这个时代，“我们是谁”同样重要。过去五年，我们一直在推动企业文化的演进，使公司成为一个更值得工作的地方，也成为一个更值得合作的组织。这是我们必须要走的一步。我们也知道，这一旅程没有终点，我们愿意，也已做好准备，持续前行。

Third and lastly, there is much discussion in health care today about consolidation and companies getting bigger, while we have been big for some time and continued to grow. We have experience with big and have learned some tough lessons about managing it over the years. But what you'll be hearing from us in the months ahead is that it is the quality of our work that will be even more differentiating for us. Industrial-scale solutions are fine, but they have to work better on a human level. We're committed to getting after quality like never before. We are a strategic health care enterprise, made up of 200,000 of the finest women and men in health care. We're firmly rooted in and committed to our culture, exercising our core competencies, operating through 2 business platforms and focused on our mission: to help people live healthier lives and to help make the health care system work better for everyone, including the 127 million people in 125 countries that we are privileged to serve today. With our people and resources and the clear health care needs we can help with, we believe our best years are still to come. Thank you.

第三，也是最后一点，如今关于医疗行业整合与企业变大的讨论很多，而我们本身已是一个庞大的企业，并且还在不断增长。我们对“大型企业如何运作”已有充分经验，也从过往中学到了不少教训。但接下来的几个月里，你们将更多听到我们聚焦的关键词是“质量”。工业规模的解决方案固然重要，但它必须在人性层面上发挥更好的作用。我们承诺，以前所未有的投入来追求卓越质量。我们是一家战略性的医疗健康企业，拥有20万名最优秀的医疗行业专业人才。我们坚定扎根于自身文化，发挥核心能力，通过两大业务平台运行，专注于我们的使命：帮助人们生活得更健康，帮助医疗体系为所有人运转得更好——包括我们今天有幸服务的125个国家的1.27亿人。凭借我们的团队、资源和面前清晰的医疗需求，我们坚信：最好的时光，还在前方。谢谢大家。

Operator

Welcome back UnitedHealth Group Chief Executive Officer, Stephen Hemsley.

主持人

欢迎 UnitedHealth Group 首席执行官 Stephen Hemsley 回到现场。

Stephen Hemsley – CEO & Non-Independent Non-Executive Chairman

Thank you. I think my colleagues today did a great job of laying out for you the growing market opportunities and capabilities of our businesses. I think you can see we are well deployed against most of the important health care markets and trends. We're established in these markets, yet there is ample opportunity for further growth and expansion, both organically and through measured acquisitions. We are focused and have strong momentum, fueled by steady fundamental execution, as well as an innovation pipeline addressing the core trends of consumerism, the application of modern technology and data analytics and to help care providers in the transition to accountability and payment reform. We are stronger than we were this time last year on almost any measure of performance quality, customer satisfaction, brand and reputation status, program compliance or employee engagement. And we have actions and plans in place to accelerate and harden that improving performance trend in 2016 and beyond.

Stephen Hemsley – 首席执行官兼非独立非执行董事长

谢谢大家。我认为今天我的同事们已经非常清楚地阐述了我们业务所面对的市场机遇和能力扩展。我相信你们可以看到，我们在大多数关键医疗市场与趋势中已实现良好布局。这些市场我们已深耕多年，同时在有机增长和稳健并购方面仍存在广阔扩展空间。我们专注明确、动能强劲，这一切得益于稳定扎实的基本执行力，以及聚焦消费者趋势、现代技术与数据分析应用、帮助医疗服务提供者向问责制和支付改革过渡的创新项目。无论是在绩效质量、客户满意度、品牌与声誉地位、合规性还是员工参与度方面，我们的整体表现都优于去年同期。我们已经制定了行动方案和计划，在 2016 年及以后加速并巩固这种持续改善的趋势。

When you look longer range, say, in 10-year intervals, you recognize the compelling trends that will continue to powerfully benefit and help grow this enterprise. I will offer just a few to make the point. In 1995, the managed Medicare market penetration was just 9%. In 2005, it was 13%; and in 2015, it is 31%. And as the total Medicare population has grown, from 37 million in 1995 to 55 million this year. If I use the same data for Medicaid, it was roughly 30% in 1995, 60% in 2005 and today, over 70%, with still very low penetration among the highest-need and highest-cost population where really it has the most impact. There were 32 million Medicaid eligibility -- eligibles in 1995 and there are 72 million today.

从更长远的视角来看，比如以 10 年为周期，你会发现一些强劲趋势将持续为我们的企业带来推动力与增长动力。以下我列举几个例子来说明这一点。1995 年，Medicare 管理式医疗市场的渗透率仅为 9%；到了 2005 年为 13%；2015 年已达到 31%。与此同时，Medicare 覆盖人群也从 1995 年的 3700 万人增长至今年的 5500 万人。以 Medicaid 为例，1995 年其管理式医疗渗透率约为 30%，2005 年为 60%，而如今则超过 70%，其中高需求、高成本人群的渗透率仍然偏低，而实际上这些人群才是管理式医疗最有成效的目标群体。1995 年有 3200 万人具备 Medicaid 资格，而如今已增至 7200 万人。

Using consumer-directed, kind of high-deductible plans as a surrogate for the consumer movement, there were none in 1995. They were first measured by Kaiser in 2006 at 4% of the marketplace. And today, they represent roughly 1/4 of the commercial insurance market and much larger in the large national benefits marketplace. Overall drug spend in the U.S. was about $50 billion in 1995, and it will approach $400 billion as we close 2015.

再以消费者主导的高免赔额计划来衡量“消费驱动”趋势——1995 年市场上尚未出现此类产品。Kaiser 首次在 2006 年进行统计时，该类计划占市场份额仅为 4%；而今天，其占比已达商业保险市场的四分之一，并在大型国家福利市场中占比更高。美国整体药品支出从 1995 年的 500 亿美元，增长至 2015 年即将结束时的 4000 亿美元。

If you use ACOs as a surrogate for care provider accountability or payment reform, there weren't any in 1995 or in 2005. And literally, there are thousands today. Payment reform's well on its way. And in 2005, there were limited or no discussions of items like telemedicine, digital medicine, mobile applications, cloud-based services, consumer wearables, home monitoring, consumer incentives or price and quality transparency in health care at all. These are trends reflecting a real generational migration across the social health -- the social marketplace of health care.

若以 ACO（责任医疗组织）作为衡量医疗服务提供者问责机制或支付改革的代表——在 1995 年或 2005 年都尚不存在 ACO，而如今已有数千家。支付改革已经深入推进。而在 2005 年，诸如远程医疗、数字医疗、移动应用、云服务、可穿戴设备、家庭健康监测、消费者激励机制、以及医疗服务的价格和质量透明化等话题，在行业中几乎无人讨论。这些趋势，真实反映了医疗社会市场环境正在发生的代际迁移。

And if I quickly translate these trends back into UnitedHealth Group, in 1995, UnitedHealth Group reported revenues of $5.7 billion and earnings of $259 million. There was no Optum. We were 100% domestic health benefits, 95% of which were commercial in nature. By 2005, we were split 15% services and 85% benefits. Our commercial-to-government benefit mix moved roughly to 75-25. Now moving into 2016, services are 45% of our earnings base, and the commercial-to-government benefit split is roughly in the 50-50 zone. International is now roughly 3%, and that earnings base of $13.5 billion well more than doubles the 1995 revenues. And 35% of our current earnings are coming from businesses we were not even in 10 years ago.

将上述趋势迅速映射到 UnitedHealth Group 的自身发展：1995 年，我们的收入为 57 亿美元，净利润为 2.59 亿美元。当时尚未有 Optum，全部业务来自美国本土的健康福利服务，其中 95% 属于商业保险。2005 年，服务业务占比达 15%，福利业务 85%；商业与政府保险的占比约为 75% 对 25%。而到了 2016 年，服务类业务已占我们利润基数的 45%，商业与政府保险比例约为 50 对 50。国际业务占比约为 3%。当前我们年利润基数已达 135 亿美元，是 1995 年收入的两倍以上。更值得注意的是，我们当前 35% 的利润来源于 10 年前尚未涉足的业务领域。

So can you imagine what 2025 might look like? I won't speculate on what the numbers might be, but following these patterns, we will once again become a very different enterprise, an enterprise consciously built to adapt and thrive in the broader health care trends. To fully realize these long-term growth opportunities, we need to execute well and consistently in the short range, stronger quarter-to-quarter and year-to-year execution with fewer mistakes. That is where my focus and that of our leadership team is turning now at full force. The long-range opportunities are there, and our businesses are well positioned. Stronger and more consistent execution in 2 highly complementary performance zones will distinguish us.

那么你能想象2025年会是什么样子吗？我不会对具体数字作出预测，但如果延续这些趋势，我们将再次成为一个完全不同的企业——一个有意识地构建、能够适应并蓬勃发展于更广阔医疗趋势之中的企业。要真正实现这些长期增长机遇，我们必须在短期内稳定、出色地执行战略，实现季度与年度的持续改进并减少失误。这正是我和我们的领导团队目前全力以赴关注的重点。长远机会已摆在我们面前，我们的业务也已经做好了准备。我们将在两个高度互补的绩效领域实现更强大、更一致的执行，这将成为我们的差异化标志。

The first is growth. We will elevate and become more methodical and rigorous in developing growth disciplines around customer relationships and retention, deeper product and service penetration, stickier technology and service relationships, prospect development and conversion and leveraging underlying strategies and disciplines around customer satisfaction performance. Elevating these will accelerate and sustain organic growth.

第一个领域是“增长”。我们将系统化并严格推进一套增长纪律体系，包括客户关系与留存、产品与服务的深入渗透、更具粘性的技术与服务连接、潜在客户的开发与转化、以及以客户满意度为核心的策略与管理机制。通过提升这些方面，我们将加快并维持有机增长的势头。

The second area of focus is quality. Executional precision along lines that respect and adhere to both the core disciplines of our businesses and their essential processes, as well as taking into consideration the trust and loyalty of the broad and far-ranging markets and customers we serve and our standing as a solution, serving the large social market needs of health care in the U.S. and across the globe. In the end, quality will trump scale.

第二个重点领域是“质量”。我们将在执行中实现高度精准，同时坚持各项业务的核心原则与关键流程，重视我们在广泛市场和客户群体中所赢得的信任与忠诚，也维护我们作为解决方案提供者的地位——服务于美国及全球医疗领域的重大社会性需求。归根结底，质量将胜过规模。

Our focus on customer and stakeholder satisfaction using Net Promoter Score performance disciplines, serves as a common ground for both our growth and quality agendas. Net Promoter Score is objective, measurable, rigorous in both short and long-term intervals. It can be compared to the market to assess relative performance against competitors as well as other industries. It can be used as a predictive tool to complement purely financial modeling. And we will correlate it with per-share earnings and shareholder value.

我们对客户与利益相关者满意度的关注，将通过 Net Promoter Score（净推荐值）作为衡量标准，为“增长”与“质量”这两大战略目标提供统一的执行框架。Net Promoter Score 是客观、可衡量、可在短期与长期维度严格执行的指标，它可以与市场数据进行对比，用于评估我们在竞争者和其他行业中的相对表现，也可作为一种预测性工具，补充传统财务模型。我们将其与每股收益（EPS）及股东价值挂钩。

As a business, we are focused on driving and growing EPS, that is a given and a core accountability to you, making Net Promoter Score really a potent NPS system, important visible dimension of performance, fully aligned to advancement and compensation on a level virtually equivalent to EPS will drive growth and retention. It will serve to elevate and sustain our quality performance and its consistency to its full potential and drive earnings and per-share value.

作为一家企业，我们的目标是推动并增长每股收益，这无疑是我们对你们——投资者——最根本的责任。因此，我们将 Net Promoter Score 打造成一个强有力的系统，它将成为一项关键的可视化绩效维度，与晋升与薪酬挂钩，其重要性几乎与 EPS 等同。这一机制将推动我们的增长与客户留存，并帮助我们实现高质量表现的持续提升与一致性，从而驱动盈利与每股价值。

High quality. A methodical growth focus. A relentless, precise execution every day will enable us to achieve our mission of helping people live healthier lives and making the health care system work better for everyone, and we hope it will continue to earn your interest and your support.

高质量、系统化的增长战略、日复一日的精准执行，将使我们实现使命——帮助人们过上更健康的生活，使医疗体系更好地为每个人运作。我们也希望，能够持续赢得你们的关注与支持。

And with that, I will thank you all very much for your participation, and I will ask Larry and Dave and Dan Schumacher and John Rex and John Penshorn to join me on stage for question and answer and discussion period as we close the day.

最后，我由衷感谢各位的参与。接下来我将邀请 Larry、Dave、Dan Schumacher、John Rex 和 John Penshorn 上台，进入问答环节并展开闭幕讨论。谢谢大家。

John Penshorn;Senior Vice President

Good morning, Janice \[ph], let's start right here.

John Penshorn；高级副总裁

早上好，Janice \[音]，我们就从这里开始吧。

Stephen Hemsley   CEO & Non-Independent Non-Executive Chairman

James \[ph] can't have a question.

Stephen Hemsley 首席执行官兼非独立非执行董事长

James \[音] 不能提问。

Unknown Attendee

Gentlemen, how do you prioritize your capital allocation views, not across dividends and buyback and things of that sort, but rather across the benefits business, the Optum business and your international views?

不知名与会者

各位先生，你们如何优先考虑资本配置的方向？我不是在问分红或回购之类的事项，而是想了解你们在福利业务、Optum业务以及国际业务方面是如何权衡的？

David Wichmann   Former CEO & Director

Let me start.

David Wichmann 前首席执行官兼董事

让我先来回答。

John Penshorn;Senior Vice President

Sure.

John Penshorn；高级副总裁

好的。

David Wichmann   Former CEO & Director

Great question. So the -- we have a -- you're talking about mainly around CapEx and then also how we allocate capital for M\&A or open-sourcing innovation through M\&A processes. The allocation process -- generally speaking, we have a clear view about where we want to grow our business, what capabilities, market presence both geographically, as well as product market presence we're trying to establish in the market. We have priorities around that. And our bias lately has been more towards building Optum's capabilities, as you've seen particularly in the local care delivery business and the Optum360 business, as well as expanding our care provider services more broadly for that business. The second area of focus has been really around international as well, and our particular focus there is to continue to build out what is already a very strong market position in Brazil, despite the fact that the country has some challenges today, we still see it as a very robust and growing marketplace. Those things, alongside CapEx, are all prioritized based upon return, but return alone can't be the sole measure.

David Wichmann 前首席执行官兼董事

这个问题非常好。你提到的主要是资本性支出（CapEx），以及我们如何为并购（M\&A）或通过并购方式引入创新进行资本分配。总体来说，我们对公司的成长方向有明确的看法，我们知道希望在哪些能力、哪些地理市场和哪些产品市场领域建立影响力。我们在这些方面设定了优先级。最近，我们的倾向更多是加强Optum的能力，正如你所看到的，尤其是在本地医疗服务业务和Optum360业务方面，同时也更广泛地扩展该业务的医疗服务提供者能力。第二个关注重点是国际业务，特别是在巴西，我们已经拥有非常强的市场地位，尽管这个国家目前面临一些挑战，但我们仍然认为它是一个充满活力且不断增长的市场。这些内容，加上资本性支出，都是根据回报优先排序的，但回报并不能成为唯一衡量标准。

Oftentimes, some of the things we wish to pursue don't want to be pursued. And so as a result of that, we have to prioritize based upon our ability to actually accomplish things. But generally speaking, it's based on return. In every instance, we look for our returns from our investments to be greater than the cost of capital of the target company in the case of M\&A. So we're looking at their weighted average cost of capital and looking to drive returns in excess of that, and that is our primary measure in evaluation. And lastly, I'd just say on the inside of the business, in terms of the capital allocation process around the \$1.7 billion of spend, once you get through maintenance CapEx, it's really around prioritizing the growth of CapEx aspects of that across the 2 businesses. And they -- we do that annually through a budgetary process and then the businesses live within their capital allocations from that point forward for the next year.

我们想要推进的一些项目有时候并不具备推进的条件，因此我们必须根据实际能否实现进行优先排序。但总体来说，回报是核心依据。在每一次并购的评估中，我们都要求投资回报率必须高于目标公司的资本成本。我们会看它们的加权平均资本成本，并力求实现超过这个门槛的回报，这是我们评估的主要标准。最后，我还想说，在公司内部，每年大约17亿美元的资本支出中，除去维护性的CapEx之后，剩下的就主要是围绕两大业务的增长型CapEx进行优先排序。我们通过年度预算流程完成这项安排，之后各个业务部门就会按照这个资本配置框架在接下来的一年内运作。

John Penshorn;Senior Vice President

So let's take that a little bit further, Larry or John or Dan, can you talk about that from a business operator's standpoint? How you think about the expanding -- expansion of capabilities that you look for in the market and how you see the capital you apply in your businesses developing?

John Penshorn；高级副总裁

我们再深入一点，Larry、John 或 Dan，你们能不能从业务经营者的角度谈谈？你们在市场中是如何看待能力扩张的，又是如何看待你们投入到各自业务中的资本发展方向？

Larry Renfro   Former Vice Chairman

Why don't I start, and then you can do what you want, John. This is typical. I start, and John cleans it up. So I think you heard a little bit in the speech, there's really 5 growth areas the way we look at it from our standpoint. And today, we're looking at capabilities and tuck-ins as kind of how we go about this in terms of what we're trying to do at Optum. So there is a purpose for everything that we do. So government services being one of the key areas that we are concentrating on at all times, that would be state, federal as well as what we might be doing international and what we're doing with the military. I say the second area is what Dave referenced, and that would be our care delivery, what we're doing with physician practices and how we're tying it in to everything we are working on. I think the third area, you know what we're doing, because we jumped into it this year with both feet, and that's pharmacy care services and what we're doing with Catamaran and the programs we're developing. Fourth area, the way I would look at it would be our technology and our enabled services, Optum360, what we do with BPO and how we're trying to expand all of that. And the last area that we'll all kind of talk a little bit about today, would be international. And I would just take those first 4 areas and wrap it in everything that we have to offer and so forth, we would take that internationally as well. So that's kind of our focus.

Larry Renfro 前副董事长

那我先说，然后你可以接着补充，John。这很常见，我先讲，然后John来收尾。我想你们在演讲中已经听到一点我们的观点，从我们的角度看，增长大致有五个方向。目前，我们在Optum的策略是围绕能力建设和“补充型收购（tuck-ins）”进行推进，每一项行动都是有明确目标的。第一项重点是政府服务，这包括州政府、联邦政府，以及我们的国际项目和与军方的合作。第二项是Dave刚才提到的医疗服务交付，我们在医生执业领域的布局，以及如何将这些整合进我们整体业务体系中。第三项你们也很清楚，因为我们今年全力投入了，那就是药房护理服务，包括我们在Catamaran方面的合作以及我们正在开发的各种项目。第四个方向是我们的技术和服务支持，比如Optum360、业务流程外包（BPO）等领域的扩展。最后一个方向就是国际业务。我们计划将前四项能力整合后带入国际市场，这就是我们当前的关注重点。

John Rex   President & CFO

And so the business that Larry just described, as we've talked about previously, will be over 50% of our growth as we think about Optum going forward. These are critical focus areas for us. And then keep in mind that in many cases, it's very organic. Think about Optum360 and how that business has just been stood up in just the last few years, the scale of that business today. That wasn't an acquisition. That was standing up a business. So in terms of capital needs, getting directly to your question, so there's the pieces of businesses that we look at where we want to expand and grow. There are very significant pieces that are purely organic and how -- in terms of how fund them and how we look at allocating capitals, but that directs our processes very deep down in the organization when we're looking about where we want to allocate capital across Optum.

John Rex 总裁兼首席财务官

正如我们之前所讨论的，Larry刚才所描述的这些业务，将占Optum未来增长的50%以上。这些是我们高度关注的重点领域。而且要注意的是，其中很多增长是有机产生的。比如Optum360，这个业务在过去几年里从无到有地建立起来，现在已经达到相当的规模。它不是通过收购得来的，而是从头创建的。回到你刚才问的关于资本需求的问题，我们确实有一些业务领域需要扩张和成长，其中相当一部分是完全通过内部孵化实现的。在如何为这些业务提供资金、如何分配资本方面，我们有着深入到组织各层级的流程，这也指引着我们在Optum内部如何进行资本配置。

Daniel Schumacher   Former CEO of OptumInsight

For UnitedHealthcare, obviously, on the M\&A front, we have scale. So our orientation on the M\&A side is more around capabilities. And I would think, in terms of those key areas around the consumer interaction and our engagement with providers, those will be the areas that would be of greater interest to us as an enterprise at this point of our development. And then, in terms of our CapEx and our investment inside, obviously, we've got a large-scale organization that requires a certain amount of maintenance capital. But beyond that, we are prioritizing our growth opportunities on a risk-adjusted basis, and we try to put our money in places that we think will yield the greatest return, the greatest benefit overall. So that's how we think about it between the M\&A and the inside CapEx as well.

Daniel Schumacher 前OptumInsight首席执行官

就UnitedHealthcare而言，在并购方面我们已经具备规模优势。因此，我们在并购上的关注点更多是提升能力。在当前的发展阶段，我们更感兴趣的领域包括与消费者的互动、与医疗服务提供者的合作等关键环节。在资本支出和内部投资方面，我们作为一家大型组织，确实需要维持一定规模的维护性资本支出。但除此之外，我们会根据风险调整后回报进行增长机会的优先排序，努力将资金投入到我们认为能够带来最大回报和整体效益的地方。因此，无论是并购还是内部CapEx，我们都是以这样的方式来思考和决策的。

John Penshorn;Senior Vice President

Thank you. Teresa \[ph] ?

John Penshorn；高级副总裁

谢谢你。Teresa \[音]，你请。

Albert Rice   UBS Investment Bank

It's A.J. Rice at UBS. Just -- I want to come back to the 1% to 2% of your revenues that have been in the news in the last week or so. Thanks for the comments, Steve, about it. Just maybe to follow-up and get a little more on that. You guys have implemented significant increases for 2016. That's not turning the business to profitability at any stretch based on your guidance. I know, a few years ago, when you were faced with pressure under Medicare Advantage, you took some hard choices on benefit design, provider network, pairing. First of all, is there anything that you see that you can do in the next 12 -- 2 \[ph] months to get you in a position where you can achieve the profitability you need to stay in the business long term? Or second, is this really just the governments got to fix this. And if that's the case, what are you asking -- what would you like to see the government do?

Albert Rice 瑞银投资银行

我是瑞银的A.J. Rice。我想回到最近一周新闻中提到的，占你们收入1%到2%的那部分业务。谢谢Steve刚才的评论，我想再深入问一些。你们在2016年做出了大幅的保费提升，但根据你们的指引，这并不能让该业务实现盈利。我记得几年前，你们在面临Medicare Advantage压力时，曾在福利设计、服务网络、配对策略上做出过艰难的选择。那现在的问题是：第一，你们是否认为在接下来的12个月或更短时间内，有什么措施可以帮助你们达到所需的盈利水平，从而长期留在这个市场中？第二，或者说这根本就得靠政府来解决？如果是这样，你们希望政府采取哪些措施？

Stephen Hemsley   CEO & Non-Independent Non-Executive Chairman

I'll just offer some kind of reaction comments to that. There are always things that we can do in terms of improving our products and improving our business. I touched on some of them in my comments with respect to operating costs and product designs and so forth. But I actually think we have taken most of those steps. I think the real disconnect for us is the formation of that marketplace itself, the timing of the formation, the -- its risk profile and the disconnect in the economics of that for creating a sustainable marketplace. So certainly, there are things that we can do. And we talk about it as one marketplace, it's not. Right? It's many markets, the exchanges across the country, and it's a spectrum of products. So there will be markets and products -- and there are -- where we are doing fine, and expect we will continue to. But if you step back and look at it broadly, it is really the slow formation of that marketplace and the formation of it, smaller than it has -- was anticipated and some of the other attributes that we touched on that is going to make us approach that much more slowly, much more thoughtfully and selectively.

Stephen Hemsley 首席执行官兼非独立非执行董事长

我来回应一下这个问题。在改善产品和优化业务方面，我们始终可以有所作为。我在之前的发言中提到了一些，例如运营成本、产品设计等方面。但坦率地说，这些我们大多数都已经做了。对我们而言，真正的问题在于这个市场本身的形成方式、形成的时间点、其风险结构，以及市场机制本身在经济逻辑上的脱节，无法支撑一个可持续的市场。所以，当然，我们还有一些可以做的事情。我们常说“市场”，但其实它并不是一个统一市场，对吧？这是由全国各地的多个交易所组成的，每个市场下都有不同种类的产品。因此，在某些市场和产品领域，我们表现良好，也预期会继续良好。但如果从更宏观的角度看，问题出在市场形成缓慢、规模比预期小，还有其他一些我们提到的结构性因素。这些因素将促使我们采取更加缓慢、更加审慎、有选择性的方式来参与这一市场。

Are there things that can be done to improve that? I think I touched on some of those in our commentary as well. I don't know how much of those are really within the control of policymakers and so forth. You need a robust marketplace. You need a large, well-balanced pool. You need to exercise discipline within that pool. You need to be attentive to the rules of engagement in it, so that it can really operate like a marketplace. So I think we laid out some themes along those lines. It's a balance. There are things that can be done on both sides.

那是否可以做些事来改善这个情况？我想我在之前的讲话中也提到过一些。我不确定其中有多少是政策制定者真正能够控制的。你需要一个健全的市场体系，你需要一个规模庞大、结构平衡的风险池，你还需要对这个风险池内保持纪律性，并且要认真对待市场运行的规则，这样它才能真正发挥市场的功能。所以我们确实提出了一些相关的主题。归根结底，这需要一种平衡。双方——也就是市场参与者和政府——都可以做出努力。

John Penshorn;Senior Vice President

Okay. Fran \[ph]? Yes. Scott is coming to you.

John Penshorn；高级副总裁

好的，Fran \[音]？是的，Scott 正在走向你这边。

Scott Fidel   Deutsche Bank AG

Just wanted to get some more details on the acceleration you're expecting in Medicare Advantage growth for next year. Maybe talk about the split between group and individual growth, how that's driving that? And then, in the individual market, maybe talk about some of the factors that are allowing you to accelerate share gains for 2016 relative to 2015?

Scott Fidel 德意志银行

我想请你们进一步谈谈明年Medicare Advantage业务增长加速的预期。能不能具体说明团体客户和个人客户的增长分布，以及这种分布是如何推动整体增长的？另外，在个人市场方面，是否能说明一下2016年相较于2015年，你们是通过哪些因素加快了市场份额的增长？

John Penshorn;Senior Vice President

Dan, you want to start that, and then we'll go to Steve?

John Penshorn；高级副总裁

Dan，你先来回答这个问题，然后我们再请Steve补充？

Daniel Schumacher   Former CEO of OptumInsight

Sure. So as I mentioned, I think at the high end of the range, we're expecting growth in our Medicare Advantage offering next year of about 400,000 lives. If you look at the composition of that in terms of group and individual, we would expect a greater orientation to the individual side than we saw in 2015, as an example. So think of it in terms of somewhere around 100,000 thereabouts in the group side, and the balance really coming in the individual MA space. And I think, with regard to our positioning, obviously, the Medicare business has been through several rounds of funding implications that have impacted product positioning, network composition, introduction of premium and so forth. So this year, we were able to bring more stable benefits to the market, more stable premiums and so forth. And it's really driving a strong result for us.

Daniel Schumacher 前OptumInsight首席执行官

当然可以。如我之前提到的，在我们对明年Medicare Advantage业务增长的预期中，上限是新增约40万名会员。若按团体与个人划分，我们预计个人市场的增长占比将高于2015年。例如，团体市场的增长大概在10万人左右，其余主要来自个人MA市场。至于我们的市场定位，众所周知，Medicare业务过去几轮的资金政策变动对产品配置、网络结构、保费设定等都带来了影响。而今年我们得以向市场提供更为稳定的福利和保费结构，这确实为我们带来了良好的业绩表现。

Steven Nelson   Former Executive VP & Office of the Chief Executive

Sure. Thanks. I'll just add to that. It's actually kind of easy to say stable benefits, because at the end of the day, that is what drives growth in this business. But if you think about the foundation that was laid over the past couple of years to get to the point where we could offer stable benefits year-over-year, which is a big driver. Then within those stable benefits, we've actually evolved the benefit portfolio to allow more choice, for example, where we do add premiums, we have side-by-side 0 premium opportunities, and so we've evolved that.

Steven Nelson 前执行副总裁兼集团执行办公室成员

当然，谢谢你。我来补充一下。虽然说“福利稳定”听起来很简单，但实际上这确实是推动这项业务增长的核心因素。但要达到能够年复一年提供稳定福利的水平，是过去几年持续打基础的结果。这种稳定本身就是一个强大推动力。在稳定福利结构的基础上，我们还对福利组合进行了优化，使其提供了更多选择。例如，在我们设定了部分保费的同时，也提供了并列的零保费选项，因此我们的产品组合是在不断演进的。

And then, in addition to that, some of the foundational items, improving STARS, creating more engaged network, a better member experience and those kinds of things or -- and then, how we think about just partnering with our distribution system and channel and brokers to actually be able to tell that story and help potential and existing consumers understand the value in the UnitedHealthcare benefit offering has been really powerful, and that's -- we see that playing out. So really excited about the momentum as we kind of head through the AEP. And we think that will carry on not only in 2016, but beyond in 2017 and for several years to come. So foundation is the key. That's, I think, laid the groundwork for us to have growth this year and beyond.

此外，我们还在一些基础性方面做了很多工作，比如提升STARS评级、打造更有参与度的网络、更好的会员体验等。再加上我们与分销体系、销售渠道和代理商的紧密协作，能够清晰传达我们的价值主张，帮助潜在客户和现有客户理解UnitedHealthcare福利方案的价值，这也发挥了很大作用。我们已经看到这些努力的成果显现。对我们来说，AEP（Annual Enrollment Period，年度登记期）期间的动能令人振奋，我们相信这种势头不仅会持续到2016年，还将延伸至2017年甚至更远的未来。基础建设是关键，我认为这正是我们实现今年以及未来增长的根基所在。

John Penshorn;Senior Vice President

Diane \[ph], where are you? All right. I'm still figuring out how my room works here. Anybody over on this side? Teresa \[ph], to your right here, please.

John Penshorn；高级副总裁

Diane \[音]，你在哪里？好的。我还在摸清楚这个房间的布局。右边这边有人吗？Teresa \[音]，请你右边这位。

Unknown Attendee

I was wondering if Dan could comment -- you gave us a commercial cost trend view, some commentary around Medicare, Medicaid as we look into '16, and as well as commenting specifically on ICD-10 and whether or not you're seeing any impacts or expect to see any impacts from that?

不知名与会者

我想请Dan评论一下——你之前提到了商业保险成本趋势，对2016年Medicare和Medicaid也有所提及。你是否可以进一步评论一下ICD-10的问题？你们是否已经看到或预期会有影响？

Daniel Schumacher   Former CEO of OptumInsight

Sure. So I'd say, across the UnitedHealthcare portfolio overall, so government programs, as well as commercial, we're taking a very similar posture as we think about our expectations for 2016. We do expect a modest increase in underlying utilization, I'd say broadly, across both government as well as commercial. As I had mentioned in my prepared remarks, obviously, the biggest drivers that we see, certainly around pharmacy and outpatient spend will be key categories within that. And as we look back on our experience here in 2015, we came into this year with an expectation of some increase. And the places that we had expected it, outpatient, pharmacy, we did see that increase. But we also worked hard to offset that, and balanced against it was really nice progress on the inpatient side, again, this year in 2015. We would expect to be able to replicate that again in 2016. So that's kind of how we're thinking about the overall trend environment. Certainly, we take a prudent posture as we think about the coming year, as how we position our benefits in Medicare, how we price our offerings in the commercial business and so on. And so we have put in an expectation of an increase.

Daniel Schumacher 前OptumInsight首席执行官

当然可以。从UnitedHealthcare的整体业务组合来看，包括政府项目和商业保险，我们对2016年的预期采取的是非常一致的立场。我们确实预计基础医疗服务的使用率会有小幅增长，无论是在政府项目还是商业保险方面。如我在之前的发言中提到，推动这一趋势的最大因素之一显然是药房支出和门诊支出这两个关键领域。回顾我们在2015年的经验，我们当时就预期这些方面会有增长，而最终我们确实在门诊和药房上看到了增长。但与此同时，我们也努力通过其他方式来抵消这部分增长，尤其是在住院方面今年取得了不错的进展。我们预期在2016年能再次实现类似的平衡。这就是我们对整体趋势环境的看法。面对即将到来的2016年，我们在Medicare福利配置、商业业务定价等方面都采取了相对谨慎的策略，因此也在模型中设定了成本增长的预期。

With regard to your question on ICD-10, I will tell you, at this point, we have the overwhelming majority of our claims are coming in on ICD-10 format, and our actual rejection rate is lower in November this year than it was last year. And at this point, we have paid literally tens of millions of claims. So at this point, it looks to be going well. And for those folks that are struggling with it, we have a process to identify that early on. And we've been doing proactive outreach with providers to help ensure that they're getting through any challenges they may be having. But I will tell you that at this point, we've got tens of millions of claims, and it's been running smoothly.

关于你提到的ICD-10问题，我可以告诉你，目前我们绝大多数的理赔都是通过ICD-10编码格式提交的，而且我们的拒赔率在今年11月相比去年同期还要更低。到目前为止，我们已经处理并支付了数千万笔理赔。从现阶段来看，这一切进展得很顺利。对于在转换过程中遇到困难的服务提供者，我们也建立了早期识别机制，并主动与他们沟通协作，确保他们能够顺利应对挑战。但总体来看，我们已经处理了数以千万计的理赔请求，整个系统运行得相当平稳。

John Penshorn;Senior Vice President

Diane \[ph], could you bring up the microphone to Bill? And ICD-10's an interesting topic, because it's both an operating issue on the benefits side and a growth driver on the Optum side. So Larry or John, could you start a little bit? And Bill, could you give some color on ICD-10 and how that relates to rev cycle and all that?

John Penshorn；高级副总裁

Diane \[音]，你能把麦克风递给Bill吗？ICD-10是一个很有趣的话题，因为它既是福利业务运营层面的一个问题，同时又是Optum业务的增长驱动力之一。Larry 或 John，你们能先谈一点吗？然后Bill你再具体说说ICD-10如何与收入周期管理等方面相关？

Larry Renfro   Former Vice Chairman

So obviously, Bill Miller runs OptumInsight, and he's had some pretty good success as we talk about some of the numbers and so forth and the remarks in terms of cost reduction and how it's kind of played out. But Bill, you might just -- can you talk a little bit about the product, talk a little bit about some of the customers and kind of what's happening?

Larry Renfro 前副董事长

显然，OptumInsight是由Bill Miller领导的，他在成本控制方面取得了不错的成绩，刚才我们也谈到了一些数字和成效。那么Bill，你能不能谈一谈这个产品，介绍一下部分客户，以及目前的情况发展？

Bill Miller; Chief Executive Officer

Yes. We've spent a lot of the last 3 years getting ready for the eventual switch over to ICD-10, and it happened this year. And in spite of a lot of fair warning, there are a handful of providers that were not necessarily prepared, which is a good thing for Optum because we get to benefit from that lack of preparedness on one way or another. A lot of what we've seen in the growth of Optum360 is a handful of the large providers asking us to basically take over all their coding on their behalf, using our own technology and tools, which we've automated and built over the last couple of years. A lot of the clients that are ready and some of the success that I would argue UnitedHealthcare is seeing, is the benefit of our computer-assisted coding tools that we've sold remarkably well in the marketplace for the last 3 years, getting a lot of our core providers ready. And those that weren't ready, we're seeing a pretty pronounced uptick in outsourced activities, where they would rather just have us take it over, maybe indefinitely or maybe for a temporary time, while they are getting ready and dealing with the changes.

Bill Miller 首席执行官

当然。过去三年里我们投入了大量精力，为ICD-10的最终切换做准备，这一切在今年正式落地。尽管之前有很多充分的预警，仍有部分服务提供者准备不足——这对Optum来说其实是好事，因为我们能在一定程度上从这种准备不足中获得机会。我们在Optum360业务中看到的很多增长都来自一些大型医疗机构，它们要求我们接手所有的编码工作，使用的是我们这几年自主开发并自动化的技术和工具。对于那些已做好准备的客户，甚至UnitedHealthcare本身所取得的成果，我认为很大程度上也得益于我们在过去三年中在市场上非常成功销售的计算机辅助编码工具，帮助我们的核心客户实现了就绪。而对于尚未准备好的客户，我们看到外包服务需求显著上升——他们宁愿让我们全权接管这些工作，无论是长期还是短期，直到他们自己准备好、能适应新变化为止。

But it is certainly a great on ramp to build, as Larry said, those core relationships. Because what has happened, more times than not, is as we performed well with big sea changes in industry like that, your confidence level grows in one another where we could take on other revenue cycle capabilities like we had in some of the names that Larry talked about in his remarks. So it's just another good growth area for us, one that we've invested in and have been ready for, literally, for the last 3 and 4 years. It's been a big investment for us, and we're getting paid back for it handsomely circa 2015, '16 and beyond.

这正如Larry所说，是我们建立核心客户关系的绝佳切入口。因为在面对这种行业性重大变革时，只要我们表现出色，客户对我们的信任也会提升，我们就有机会接手其他收入周期管理方面的职能，正如Larry之前提到的那些案例所示。所以，这确实是我们又一个良好的增长领域。我们为此已经投入了3到4年的准备，这是一项巨大的投资，现在来看，从2015年、2016年开始，这项投资已经获得了丰厚的回报，而且前景仍在持续。

Larry Renfro   Former Vice Chairman

I think what Bill's showing and just starting to see develop on the Optum side is we do talk about these large, deeper, more comprehensive relationships. I mean, we have a lot. And every product that we come out with, we are able to get that positioned in a lot of these organizations. And Bill's team have done a great job of doing it.

Larry Renfro 前副董事长

我认为Bill所展示的，以及我们在Optum端开始看到的发展趋势，是我们正在与客户建立更大规模、更深入、更全面的关系。我们确实与很多客户建立了这样的联系，我们每推出一款新产品，几乎都能进入这些机构的体系。Bill的团队在这方面做得非常出色。

John Penshorn;Senior Vice President

Right here, Janice \[ph]. Thank you.

John Penshorn；高级副总裁

就在这里，Janice \[音]，谢谢。

Unknown Attendee

The question is about the space \[ph] Contracting. It sounds like you're seeing more success in providers taking on health risk. Can you just comment and give us some more color on the difference and the appetite between doc practices, integrated health systems versus hospitals? And to what degree the capital that UHC is bringing to bear has an impact on their willingness to do this?

不知名与会者

我的问题是关于“基于价值的合约模式（risk contracting）”。听起来你们在推动服务提供者承担健康风险方面取得了更多进展。你能否具体谈一谈医生执业团体、综合性健康系统和医院之间的差异，以及他们对这种模式的接受程度？另外，UHC所提供的资本投入在多大程度上影响了他们的意愿？

John Penshorn;Senior Vice President

Can you help me with the end of the question, the degree to which the capital impacts their interest?

John Penshorn；高级副总裁

你能帮我再重复一下最后那个问题吗？关于资本投入在多大程度上影响他们兴趣的那部分。

Unknown Attendee

Yes, I guess, what we hear from advisory board and other firms of that nature is that, that health systems may eventually dis-intermediate the plans. I mean, literally, that is one of the thesis out there in the long run. And so I'm just kind of wondering, is this more of a shared risk model? Where that would be the end state? Or would Northwell and those types of health systems eventually come in head-to-head with managed care, if you will?

不知名与会者

是的，我的意思是，从Advisory Board等类似机构听到的一些观点认为，从长期看，健康系统可能最终会绕过保险计划商，直接向消费者提供服务。这是市场上的一种假设。所以我想问的是，现在的模式更像是一种“共享风险”吗？这会是最终形态吗？还是说，像Northwell这样的健康系统最终会与管理式医疗（managed care）正面交锋？

John Penshorn;Senior Vice President

Do you want to give some perspective on that spectrum of risk-taking? And maybe that will help clarify that.

John Penshorn；高级副总裁

你要不要谈谈关于承担风险这一整条路径的情况？或许这能帮助我们澄清这个问题。

Daniel Schumacher   Former CEO of OptumInsight

Yes, absolutely. So I think Jeff Alter, Dan Rosenthal did well this morning to talk a little bit about the journey that we've been on about orienting a greater share of our reimbursement towards value from volume. And the progression that we have been on, right? Working up that stair step from first, orienting around those particular outcomes that drive quality and then ultimately, realizing relationships where we're really taking on the full population health management responsibility in a very different way. And so we've made very strong progress in that. Today, as Jeff mentioned, we've got about \$43 billion in value-based reimbursements. And we made some great progress actually inside of that, around our ACOs and other accountable relationships we have. We added about 250 of those in 2015. So we brought it from 500 to about 750. We're still -- have a greater orientation to the lower end of the continuum, where you're orienting towards and incenting particular quality measures, and less so on the upper end of the continuum, where we're -- where we expect and want to drive to over time.

Daniel Schumacher 前OptumInsight首席执行官

当然可以。我想今天上午Jeff Alter和Dan Rosenthal已经很好地讲述了我们在推进从“按量计酬”向“按价值计酬”转变的路径。这是一个逐步推进的过程，一步步从注重某些具体的质量成果开始，最终发展到一种我们承担全面人群健康管理责任的全新关系形式。在这方面我们已经取得了显著的进展。正如Jeff所说，我们目前已有约430亿美元的支付是按价值计酬的。在这些关系中，我们在ACO（责任医疗组织）和其他可问责的合作关系方面也取得了进展，仅2015年我们就新增了大约250个此类合作，从500个增长到约750个。尽管目前我们的合作关系仍以价值计酬路径的初级阶段为主，比如聚焦特定的质量指标并给予激励，但我们确实有意愿也有计划向更高层次推进——也就是建立深度价值共享和风险共担的合作关系。

But I would tell you that our engagement with care partners and delivery partners has been very strong. And their willingness and openness to engage, I mean, from days past, where we sat on opposite sides of the table, the orientation is changing, where we're sitting on the same side of the table, thinking about how do we create greater value and then how do we share in it. And so those conversations are progressing nicely.

但我必须说，我们与医疗服务伙伴和交付合作方的互动非常积极。他们的合作意愿和开放性也显著提升。过去我们常常是坐在谈判桌两侧，而现在越来越多的是并肩而坐，共同思考如何创造更大价值，以及如何实现价值的共享。这些对话进展非常顺利。

And importantly, inside of UnitedHealthcare, we've got to change our skill set, too. I mean, we have 2,000 people that are expert negotiators in our company. And the reality is, over time, we don't need people that can negotiate fee schedule to fee schedule. We need people that can reshape the relationship in a very different way. In terms of receptivity and -- I would tell you that certainly, the more progressive delivery systems have more interest to it, it's coming later to less progressive delivery systems, less integrated delivery systems and things like that. But nonetheless, great take up. And I think, we'll -- we're well on our way to achieve our goal of \$65 billion of spend oriented in value-based reimbursements over the coming couple of years.

此外，UnitedHealthcare内部的能力结构也需要随之转变。我们公司有2000名擅长谈判的专家，以前我们依靠这些人来一项一项地谈判费率，但未来我们需要的是能以全新方式重塑合作关系的人才。在接受度方面，更具前瞻性、更为一体化的交付体系表现出更高的兴趣，而那些整合程度较低的系统会更晚进入这个阶段。但整体来看，市场反响良好。我相信我们将在未来几年顺利实现按价值计酬支出达到650亿美元的目标。

John Penshorn;Senior Vice President

Larry, like ICD-10, there's 2 sides to this. How about the care provider hospital system side?

John Penshorn；高级副总裁

Larry，就像ICD-10那样，这件事也有两面性。那在医疗服务提供者、医院系统这一侧呢？

Larry Renfro   Former Vice Chairman

Most things around right now, there are 2 sides. I'll start a little bit here and talk about Optum. I might ask Jack Larsen to be ready to help out here. We started with our plan, about 5 years ago, where we look at the marketplace, and we came out with this \$500 billion market. We've kind of broke it down into the marketplace, that was about 75 markets we wanted to be in. About 1/3 of them were hospital dominated, about 1/3 were physician dominated and the other 1/3 is kind of combination of both. So we have, on the physician side, we're probably, today, pretty strong in terms of having about 17,000 PCPs as part of Optum, where we're managing care. We probably have about 24 or so, what I'll call multi-payer contracts, where we're actually taking on risk in probably in about half of those, and the other half are Fee-for-Service. But as we continue to grow this, we come, I guess, from a different perspective of managing those populations, taking risk and working with other carriers to do that.

Larry Renfro 前副董事长

现在大多数事情确实都有两面。我先谈一点Optum这边的情况，然后可能会请Jack Larsen来补充。我们大约五年前开始制定这项计划，当时我们看到这是一个5000亿美元的市场。我们将它细分成大约75个目标市场，其中大约三分之一是医院主导的，三分之一是医生主导的，还有三分之一是两者结合的。在医生这一侧，我们现在的布局相当强大，大约有1.7万名初级保健医生（PCP）隶属于Optum，由我们负责管理他们的医疗服务。我们现在大概有24个所谓的多支付方合同（multi-payer contracts），其中大约一半是承担风险型合同，另一半则是按服务收费（Fee-for-Service）。随着我们不断拓展业务，我们在管理人群健康、承担风险、与其他保险公司合作方面，采取的是一种与传统不同的视角。

Jack Larsen runs that business. He's been growing that business. And the other side of that, one with the hospitals, would be Bill Miller, who is actually putting those same kind of programs together, but we're going into the hospital systems and actually taking physician management right on site with a lot of the hospital systems as well. But from a direct care delivery standpoint, when you hear us talk about that today, that is us. We're not talking about or necessarily working with someone else. It's a little bit on the hospital side, but not on what I would call the consumer side, where we have about 7 million or so that we're actually servicing. So Jack, maybe a comment?

这部分业务由Jack Larsen负责，他一直在推动这项业务的增长。而在医院那一侧，则是Bill Miller在主导类似的项目，我们也进入了不少医院系统，并直接在医院现场接管了医生管理。从直接医疗服务的角度讲，当你听到我们今天谈“我们在做这件事”时，这就是指我们自己在做，而不是通过或依赖其他机构。在医院系统方面我们会合作一些，但在面向消费者这一侧，也就是我们目前服务的约700万人群，我们是直接运营的。Jack，你来补充一下？

Jack Larsen   Executive VP of Optumcare

Thank you, Larry. I think -- I'm not quite sure I would be willing to speculate who displaces who going forward. Bill is working with a lot of hospitals as they plot their way forward. But there's a fair number of physician groups around the country in those 75-or-so markets who are really bound and determined to remain independent in some way. And I would say, the receptivity for value-based contracting is very high. What I would say, though, is that there is a gulf between that receptivity and actually how to get it done. And I think that's where Optum Care and our care delivery business really steps in and begins to work with those physicians, help them get the tools, the access to the kinds of things they need to move their way up that value-based contracting continuum. And let me give you a shameless plug from my ambulatory care seminar, little later this afternoon, we'll talk a little bit more about that.

Jack Larsen OptumCare执行副总裁

谢谢你，Larry。我想说，我不太愿意去预测未来谁会取代谁。Bill目前确实在与很多医院合作，帮助他们规划未来的发展路径。但在我们所提到的那75个左右的市场中，有相当数量的医生集团坚定地希望以某种方式保持独立。就“按价值计酬”的合同模式而言，医生们的接受度非常高。但我要指出的是，从“愿意接受”到“真正实施”，中间存在一条明显的鸿沟。而这正是Optum Care和我们医疗服务交付业务介入的地方——我们与这些医生合作，帮助他们获得必要的工具和资源，推动他们在“价值合同”这条路径上不断迈进。顺便打个广告，今天下午我在门诊医疗专题会上会讲得更详细一些，欢迎大家来听。

John Penshorn;Senior Vice President

Yes, up here. Thank you, Janice \[ph].

John Penshorn；高级副总裁

好的，这边请。谢谢你，Janice \[音]。

Unknown Attendee

I have a question just around broader health care M\&A, not just even in services, but you've seen a real significant, I think, acceleration in consolidation across everything in health care. You guys have obviously been participants, so has the industry. So I guess 2 questions. One, is there something in the environment that's changed that's become a catalyst for that? And then, two, how do we think about the boundaries at which UnitedHealth Group would operate?

不知名与会者

我有个关于整个医疗行业并购（M\&A）的更广泛问题，不仅仅是服务领域。近年来我们看到整个医疗行业的整合速度明显加快，你们显然也参与其中，整个行业也是如此。所以我有两个问题：第一，是不是外部环境出现了什么变化，成为这种并购浪潮的催化剂？第二，我们该如何理解UnitedHealth Group的业务边界？你们会拓展到什么程度？

Stephen Hemsley   CEO & Non-Independent Non-Executive Chairman

I'll offer a reaction to that, and then I'll kind of react on the last one too. I think it's health care, and so there'll be as many versions of this as one can think of. And it's a great area to experiment. And then, we'll participate and have the capacity to participate in all of them and see what plays out.

Stephen Hemsley 首席执行官兼非独立非执行董事长

我先回应一下这个问题，也顺带回应刚才那个问题。我认为这毕竟是医疗行业，所以会有无数种模式可以设想，也是一个非常适合尝试和创新的领域。我们会参与其中，也具备参与各种模式的能力，看看最终哪些模式会发展起来。

In terms of the M\&A marketplace in total, based upon what I've read, \$400 billion or so, \$200 billion plus in pharma, \$20 billion in retail, \$120 billion in the benefits domain, probably as much capital and as much activity as seen in decades in a single sector. I think it's coming of age of health care in some respects, where greater capabilities are being demanded, the marketplace is demanding more. They're demanding more performance, and they are expecting better economics from it, which are not all that different than other sectors the economy have had to live up to. And by its nature, it has been a fragmented marketplace, and I think it is just going through an iteration where it is kind of stepping up into a more mature economic sector. It is a very strong, as we've shown through the course of the day, a lot going on, a tremendous amount of opportunity. And I think that has been driving the interest and the confidence in the capital. That'd be the best I could react to it.

就整体医疗行业的并购市场而言，据我了解，现在大约有4000亿美元的交易活动，其中制药领域超过2000亿，零售约200亿，福利服务领域约1200亿。这在单一行业中是几十年来罕见的资本投入与活跃度。我认为这在某种意义上标志着医疗行业的“成熟期”已经到来——市场对能力提出了更高要求，对绩效的要求也更高，同时也期望从中看到更好的经济效益，这些要求其实与其他成熟行业所面临的并无不同。而医疗本身一直是一个高度碎片化的市场，现在正处在从碎片向成熟经济体过渡的阶段。正如我们今天一整天所展示的，这是一个充满活力、机会巨大的行业。我认为，正是这些前景吸引了资本，也增强了投资者的信心。这是我对这个问题最真实的看法。

Unknown Attendee

And the boundaries for UnitedHealthcare Group.

不知名与会者

那UnitedHealth Group的业务边界又在哪里呢？

Stephen Hemsley   CEO & Non-Independent Non-Executive Chairman

For United, again, as we've talked about some of these conversations earlier, one lens to think about, it is to -- I know we've put this model in front of you, and you may think it's a nice graphic but benefits and services and the complementary nature of them, regulated and nonregulated, and then the core competencies underneath, areas that we feel we have invested in and can bring something to bear. So there is a model in our mind where those competencies are brought to bear, both in the benefits domain and in the services domain, kind of demand and supply. And we have -- we are in areas today that I would have sworn to you we would not be in 10 years ago. So I would never do the never commentary.

Stephen Hemsley 首席执行官兼非独立非执行董事长

关于United的边界问题，我们之前其实谈过一些。从一个角度来看——我知道我们曾经向你们展示过那个模型，也许你们觉得那只是个漂亮图表，但它实际上表达了福利和服务之间的互补性，无论是在监管领域还是非监管领域，以及其背后的核心能力——这些是我们真正投入过、具备能力的领域。我们在头脑中构建了一个模型，这些能力可以应用于福利和服务两个领域，分别代表需求和供给。我们目前涉足的一些领域，十年前我可能还会坚定地说我们不会进入。所以我不会轻易给出“我们绝不会做某件事”这种评论。

But we have a very good platform going right now in services. I think to what Dave said before, we have made good investments in benefits and that benefits platform is continuing to innovate and grow organically unto itself. There are some opportunities there, but the build-out in Optum is probably center right now. And we are looking for opportunities on the international front, but we're going to be thoughtful and selective there. Because that's a marketplace where I think our capabilities clearly come to bear, but then getting them positioned there and in the right timing is going to be key. So I wouldn't put a lot of boundaries around that. I would look at where the capabilities around technology, around data and how it's applied and around care insights go, and that's where those work, that's where I think we'll explore.

目前我们在服务业务方面拥有一个非常强大的平台。正如Dave之前提到的，我们在福利领域也进行了良好的投资，该平台本身仍在持续创新并实现有机增长。尽管其中存在一些新机会，但我们现在的建设重点显然是Optum。同时我们也在寻找国际市场的机会，但会采取非常审慎和有选择性的方式。因为那是一个我们能力可以发挥作用的市场，但要在合适的时间点和方式进入是关键。所以我不会为我们的业务设定太多边界。我会关注技术、数据、数据应用以及医疗洞察方面的能力，这些是我们擅长的领域，也将是我们未来将进一步探索的方向。

John Penshorn;Senior Vice President

In the center here. We got 2, you guys can hand the mic to each other when you're done.

John Penshorn；高级副总裁

这边中间有两位，请你们回答完后把麦克风传给对方。

Unknown Attendee

That's easy. You guys did a good job talking about the capabilities at Optum, but I still feel very much like Optum is a black box financially. With the issues in the individual business, it's not something that we expected to happen, but if you had asked me, it would have been among the handful of risks that I could have told you were a risk. On the Optum side, you've laid out this opportunity to grow double digits for years and expand margins, and it all sounds good. I see the opportunity there. But how do you think about the risks in that business? I mean, across the 3 business lines, what are the risks of growing the top line double-digits for the next several years? What are the risks to the margins potentially over time? I don't feel like I've got a good handle on those risks to that growth.

不知名与会者

这个问题不难。你们刚才确实很好地介绍了Optum的能力，但我仍然觉得从财务角度看，Optum有点像一个“黑箱”。比如你们在个人业务上的问题，我们事前并没有预料到——虽然如果有人问我，这本来也可以列入可能风险之一。Optum这边，你们描绘了一个多年持续实现两位数增长、扩大利润率的愿景，这听上去确实很有吸引力，我也看到这里有机会。但你们如何看待这项业务的风险？具体来说，在这三个业务线中，未来几年保持两位数营收增长面临哪些风险？利润率方面又面临什么潜在威胁？我觉得目前我还无法很好地判断这种增长背后的风险。

John Penshorn;Senior Vice President

Do you want to start?

John Penshorn；高级副总裁

你要不要先来回答？

John Rex   President & CFO

Yes, sure. So a couple of things that we hope to accomplish. One is, every year, when we come here trying to increase the visibility into the businesses. So very purposeful in trying to orient towards those 3 main platform businesses that we talk to here: OptumHealth, OptumInsight and OptumRx. And how one approaches those if you were approaching a standalone company you might cover in that area. So for example, within the OptumInsight world, take a look into how the investment community approaches ACIT \[ph] companies. How do they approach them? They approach them often, one of the measures we used here, thinking about things like revenue backlog, right? Very important metric for all of these -- all of you that are in that space and are constantly modeling those companies, that's typically how you're driving your models actually. And it's a visibility perspective. So we talk about 80%. So we essentially booked 80% of the revenue in OptumInsight. That's in the books that will come out, trying to provide some visibility into the duration of that and the sales pipelines and such. So important in that area. And then some of the other metrics that we try to focus on today, when you look at comparative companies, if you can find them, comparative companies that may have kind of similar businesses, so whether that's consumers served within OptumHealth or adjusted scripts in OptumRx. So kind of from a visibility perspective, trying to give you something similar.

John Rex 总裁兼首席财务官

当然可以。我们每年出席这个会议的一个核心目的，就是希望能逐步提升业务的透明度。我们一直在努力明确聚焦于Optum的三大核心平台业务：OptumHealth、OptumInsight和OptumRx。我们希望你们在分析这些业务时，能够像分析一个独立公司那样去看待它们。举例来说，在OptumInsight这块，可以参考投资界看待ACIT（医疗科技与信息公司）企业的方式。他们通常会使用一些关键指标，比如我们今天提到的“收入积压”（revenue backlog）——这是一个非常重要的指标，对所有在这个领域建模的投资者来说都是常用的参数。我们提到OptumInsight大概已经“锁定”了约80%的未来收入，这就是我们在努力提升收入可见性的一个例子。我们还尝试提供关于这些收入持续性的视角，比如销售管道等内容。

再比如其他业务线，我们也尝试提供一些类比指标：OptumHealth服务的消费者数量、OptumRx的调整后处方量（adjusted scripts）等——我们希望在这些方面给你们提供更多参照，从而提升你们对我们业务的可见度和理解。

I think the other piece then, so let's go now -- that's kind of the media modeling piece and kind of how you get a little more granularity in understanding the businesses -- and how about the forward view. And that's where we've tried to narrow it down, in thinking about the businesses that will be among the most significant in terms of driving our growth. So narrowing it down to -- in areas within OptumHealth and OptumInsight, in particular, the care delivery businesses, Jack Larsen runs here and that we spent a lot of time with today, and the revenue management businesses, such as Optum360, that we focused on. So when we focused it down, we've -- what we're attempting to do is try to like really show you where the majority of our growth will come from as we think about it over the next 5 years. To help you also -- and it's a great question, as you think about assessing risk, so you can better understand the kind of businesses that we're counting on, that we're focusing on, that we're putting our capital into to, to drive this. And giving you some visibility into helping you kind of look at other sectors, the industries that we are in, that we're competing in, as you think about our margins and our growth rates. But Larry will...

接下来谈谈未来展望。除了建模层面的透明度，我们还在努力明确聚焦那些未来五年将成为主要增长引擎的业务板块。尤其是在OptumHealth和OptumInsight内部，像是Jack Larsen负责的“医疗服务交付”业务，以及我们今天特别强调的“收入管理”业务，比如Optum360。这些是我们资本投入、战略关注的重点领域。我们想要帮助你了解，我们真正依赖于哪些业务来推动增长，这样你在评估风险时，就能抓住我们在下重注的方向。我们也希望通过这些信息，帮助你类比其他行业中类似企业的利润率水平和增长轨迹，从而更好地评估Optum的成长性。

Larry Renfro   Former Vice Chairman

So I'll come at it from a business perspective. And John is explaining is that we're coming out with more metrics, we're coming out with more ways to look at the business, so that it will fit, I think, into a model that you'll get comfortable with. But the way I kind of look at it is pretty simple. We've kept 6 basic, what I'll call priorities. And we look at those priorities every year, and we don't change them. And one is business integration and alignment. And we kind of know if we don't do those things, we're going to have failures. And those failures are going to be, if we acquire an organization like Catamaran, and we don't integrate them, we don't align them with the businesses, and we don't get the synergies that we plan, we've got a problem. So we kind of know how to attack that approach.

Larry Renfro 前副董事长

我来从业务角度谈谈这个问题。John刚才讲得很好，我们确实正在提供更多指标、更多观察业务的方式，目的是让你们的分析模型能更自如地对接Optum。但对我来说，我看问题的方式其实很简单：我们始终坚持6项基本优先事项，每年都会检视这些优先级，从不更改。第一项就是“业务整合与协同”。我们非常清楚，如果这件事做不好，问题就会出现。比如我们收购了Catamaran，如果我们不能很好地整合它，不能让它与我们其他业务对齐，不能兑现我们当初设想的协同效应，那就是失败。所以我们知道该怎么制定路径、避免这种风险。

Larry Renfro   Former Vice Chairman

We have a second priority of simplification and execution. So I would just say, execution, execution, execution. That's what it's going to be all about. Steve talked about quality, and quality goes along with that execution. So we have all types of measures and metrics that John Prince, who runs all of our shared services, put in place. And that will continue to really go down the road in terms of how we measure it ourselves.

Larry Renfro 前副董事长

我们的第二个优先事项是“简化与执行”。我会说，最关键的就是“执行、执行、再执行”。Steve提到过质量，而质量其实正是执行的一部分。我们现在有各种各样的度量标准和绩效指标，由负责所有共享服务的John Prince所推动设立。我们会沿着这条路径持续推进，用这些机制来衡量我们自己的表现。

When John talks about the backlog, the backlog is over \$10 billion. I would tell you, we didn't really talk about the qualified sales pipeline, that's probably over \$20 billion at this point in time. So we got a lot of -- a line of sight into a lot when it comes to the businesses that we're trying to bring forward. But one key area that's one of our priorities is strengthening leadership, and it will take that. Because we are on that type of growth that we constantly are having to bring in stronger leaders really as fast as we can find them in order to not only continue the growth, but to really do the things that we're talking about and the execution and the quality and so forth.

当John刚才提到“积压订单（backlog）”时，那部分的规模已经超过100亿美元。实际上我们并没有详细谈“合格销售机会管道（qualified sales pipeline）”，但目前那个数字可能已超过200亿美元。所以我们在未来业务推进方面是有很强可视性的。我们的另一个核心优先事项是“加强领导力”，这是必不可少的。因为我们正处于快速增长阶段，这意味着我们必须以最快速度引入更强的领导者，这样不仅可以支撑增长，还能真正落实我们前面说的各项计划，包括执行力、质量等。

So we haven't changed these things. These has been constant for the last 5 years. They'll remain constant. And what we'll do a better job of is coming up with these metrics and so forth that will give you more line of sight into this.

这些优先事项五年来都没有变过，将来也不会变。我们接下来会做得更好的一点，是不断完善各种度量体系，让你们对我们的业务前景看得更加清晰。

Unknown Attendee

Maybe just a quick follow-up on that. When you think about where you are -- 5 years from now, you come back and look and say, for whatever reason, we didn't have what we thought in Optum, would you say it would be because of the top line opportunity or because of the margin opportunity?

不知名与会者

我就这个话题补充个简单的问题。如果说五年后你们回过头来看，发现Optum没有实现你们原本的期望，你觉得更可能是因为营收端机会没有兑现，还是利润端的机会没有兑现？

Larry Renfro   Former Vice Chairman

Well, I would say that it would be more the top line, but I don't think we'll have to say that.

Larry Renfro 前副董事长

我会说，更可能是营收端的原因。但坦白讲，我并不认为我们会落到那种情况。

John Penshorn;Senior Vice President

It's a very hypothetical question. Ralph?

John Penshorn；高级副总裁

这是个非常假设性的问题。Ralph？

Ralph Giacobbe   Citigroup Inc.

Can you maybe talk about the recent hospital purchase in Brazil, sort of how that fits and whether we should expect more of that going forward in that market? And then maybe, even more importantly, why it works there and not domestically?

Ralph Giacobbe 花旗集团

你们能不能谈一下最近在巴西收购医院的交易？这项收购是如何融入你们的战略的？未来在巴西市场是否会有更多类似交易？另外更关键的是，为什么这样的模式在巴西可行，而在美国国内却不可行？

John Penshorn;Senior Vice President

Yes, thank you.

John Penshorn；高级副总裁

好的，谢谢你的问题。

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

So I'll take that. So the primary health-care delivery vehicle in Brazil is through the hospital institution, if you will. So a lot of the initial access to care is through the emergency room, and then it's facilitated from there, if you will. So at least for now, until that health-care system is made more efficient, which we think we can do over time, that's the kind of the centerpiece of health-care delivery. Specifically, to the hospital that we acquired, it's Hospital Samaritano. We're in process of acquiring it. It is, I'd say, a top 5 health care -- top 5 hospital -- top 4 hospital in Sao Paulo, and probably one of the best in the country, if you will.

Stephen Hemsley 首席执行官兼非独立非执行董事长

我来回答这个问题。在巴西，医院机构仍然是主要的医疗服务提供渠道。很多患者初次就医是通过急诊室进入系统，然后才有后续的治疗流程。至少目前来说，在整体医疗系统尚未实现效率提升前，这仍然是核心的交付模式。我们刚刚收购的医院是Samaritano医院，目前正在收购流程中。我会说，它是圣保罗排名前五、甚至前四的医院，也可能是全国最好的医院之一。

It is complementary to the -- what we did in Rio de Janeiro where we built organically Americas Medical City, where we have a hospital there called Samaritano as well. So our interests here were to continue to establish a reputation of clinical excellence in that marketplace, serving a specific product type, if you will, broadly and building very specifically, in Sao Paulo and Rio and then also up in the northeast. We've been pretty actively acquiring hospital and care delivery assets. So they're not just all hospitals.

这家医院与我们在里约热内卢的有机发展项目“美洲医疗城”形成互补，那里我们也有一家名为Samaritano的医院。我们此举的意图，是在该市场持续建立临床卓越的声誉，服务于某一类特定但广泛的产品线，并重点打造圣保罗、里约以及东北部地区的布局。我们一直在积极收购医院和其他医疗服务交付资产，并不局限于医院本身。

We do so to create verticalized systems, which means they're bundled with insurance products. And virtually every patient that is served in that hospital setting is an Amil patient. Those are what we refer to as our next product line in hospitals. And then we have what we call market-rate hospitals, which is what Samaritano, Americas Medical City, Procardio, others that we have in Rio, Sao Paulo and in the northeast as well, which serve all, meaning they're not verticalized systems. They serve Amil members but they also serve Bradesco, Sul America and other members there as well.

我们这么做，是为了建立“垂直化体系”，也就是这些医院与保险产品进行绑定。在这些医院中服务的几乎所有病人，都是Amil保险的会员。我们将这些医院称作“下一代医院产品线”。与此同时，我们也拥有所谓“市场定价医院”，比如Samaritano、美洲医疗城、Procardio等，这些医院分布在里约、圣保罗和东北部地区，服务面向全市场，不限于Amil会员，也包括Bradesco、Sul America等其他保险公司的客户。

We have become much more of a health care delivery business in Brazil with kind of an insurance arm, if you will -- or I should say. We're becoming more of a healthcare delivery business in Brazil with an insurance arm, whereas what we bought in Amil was an insurance company with health care delivery assets. So we're going to continue to build that infrastructure because it's unique to that market, we think that's where the priority is in the market. We think there's a lot of demand for services, and we think we can meet that demand and grow our business nicely.

在巴西，我们正在转型为“以医疗服务交付为主、附带保险功能”的企业，而不是像过去那样只是“保险公司+少量医疗资产”的组合。我们之所以持续投资于这套基础设施，是因为这是巴西市场的独特性所在，也是我们认为的核心优先发展领域。我们看到服务需求巨大，相信我们有能力满足这些需求，并实现业务的可持续增长。

John Penshorn; Senior Vice President

Just to emphasize a point that you made, so local is important wherever you are, so Dave talked about Sao Paulo and Rio de Janeiro. Brazil is a big country, think of this as bigger cities, Chicago and Los Angeles, it's about being very strong and very effective at a local level, and that's an orientation that's been part of this.

John Penshorn；高级副总裁

我想强调你刚才说的一个重点：无论在哪个国家，本地化都是关键。Dave也提到了圣保罗和里约。巴西是一个大国，我们可以把它想象成像芝加哥、洛杉矶这样的大城市组合。重点是在“本地层面”建立强大且高效的运营能力，而这是我们战略的一部分。

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

That's right. The other thing I just want to say is Optum Brasil, which is an organically developed company, has been instrumental in improving Amil but also as well will be instrumental in forging this health care delivery system, this efficient system, if you will, where we think we'll have a -- end with the competitive advantage. So we are organically developing that.

Stephen Hemsley 首席执行官兼非独立非执行董事长

完全正确。我还想补充一点，Optum Brasil 是我们在巴西本土有机发展出来的公司，它不仅在改善Amil业务方面发挥了重要作用，也将在我们打造一个高效、系统化的医疗服务网络中起到关键作用。我们认为这将最终成为我们的竞争优势之一。我们正在有计划、有步骤地推动这一本地化发展。

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

They started with an analytic framework for Amil. That framework was then used to price product, to develop affordability programs, to drive network negotiations, all in a very different way than has been -- than has happened in Brazil in the past. And moving on now to developing out in-region services, so around assisting with calls and care management and claims adjudication and whatnot, versus while developing an organic site in Curitiba, which is just in the southern part of Sao Paulo. So -- and they will continue to build technology-based services, Data Services and whatnot, similar to what you might find in the United States. They just have to be configured differently, because Brazil's demands and needs and their ability to actually absorb the intelligence, if you will, is different than you find here in the United States.

Stephen Hemsley 首席执行官兼非独立非执行董事长

我们最初是从为Amil建立一个分析框架开始的。这个框架随后被用于产品定价、制定可负担性计划、推动网络谈判等环节——这种方式与巴西过去的做法非常不同。接下来我们又开始发展区域内的服务，例如客户来电协助、健康管理、理赔审核等。同时我们也在圣保罗南部的库里提巴建设一个有机发展的运营中心。未来我们还将继续建设以技术为基础的服务和数据服务等，类似于你在美国所见的模式，但配置方式会有所不同，因为巴西市场的需求、吸收能力与美国存在差异。

John Penshorn; Senior Vice President

Let's go here and then back over there, Fran [ph]. Chris.

John Penshorn；高级副总裁

我们先请这边发问，然后回到那边，Fran [音]。Chris，请。

Christian Rigg Susquehanna Financial Group

Just on the PDP repositioning, I mean the type of volatility you guys are seeing in a membership is not something that's unique to that business. When you say reposition, does that mean once you get through 2016, you've sort of done something fundamental to it, that it will begin to stabilize in terms of membership and you should be able to grow over the long term?

Christian Rigg Susquehanna金融集团

关于PDP（处方药计划）重新定位的问题，你们目前在会员人数上的波动，其实在这个领域并不罕见。但当你们提到“重新定位”时，这是否意味着到了2016年底，业务会经历某种根本性的调整，从而使会员人数趋于稳定，并在长期实现增长？

John Penshorn; Senior Vice President

A question about the outlook for prescription drug plans, Dan?

John Penshorn；高级副总裁

这个是关于处方药计划（Part D）的前景问题，Dan？

Daniel Schumacher Former CEO of OptumInsight

Sure, the comments about Part D, obviously, as you mentioned there is a cyclical nature to that, and every 3 to 4 years there seems to be some cycling inside of it. And I'll tell you this year we were very deliberate, and we made a decision with regard to profit over enrollment, sustainable program, sustainable margins. And so we made that choice. So we knew that today we, in '15, we serve 32 out of 34 of the region for the low-income subsidy members. And in 2016, we'll serve about 1/2 of them, and that was very much in keeping with what we had expected the outcome to be, based on how we position our product.

Daniel Schumacher 前OptumInsight首席执行官

当然。关于Part D（联邦医疗保险处方药部分），正如你提到的，它确实具有周期性，大约每三到四年就会经历一次波动。我可以坦率地说，今年我们做出了一个非常明确的战略选择：我们更关注利润，而不是参保人数，目标是打造可持续的计划和利润率。因此我们有意识地做出了取舍。2015年我们为低收入补助群体服务的地区覆盖了全国34个区域中的32个；而在2016年，我们将只覆盖其中一半左右，这与我们产品定位所预期的结果完全一致。

And then I think I'll tell you, I would share -- with not sharing too much -- we're going to be doing some things in the first half of 2016 and as we plan for our benefits for 2017 that will be different. That will lead us to growth in 2017 and beyond.

另外我可以透露一些（虽然还不能说太多）：我们将在2016年上半年推出一些新的举措，并在规划2017年福利设计时做出不同的策略调整。这将帮助我们在2017年及之后重新实现增长。

John Penshorn; Senior Vice President

Over here.

John Penshorn；高级副总裁

这边请。

Matthew Borsch Goldman Sachs Group, Inc.

Back over there, here. My question is on the buildup of your healthcare delivery assets within OptumHealth. And that's been an area that you've really been focused on growing in the last few years. Can you give us some figures to think about the relative size of that? I don't know what the right way to size it relative to the total medical spending at UnitedHealthcare or the touch points relative to the total touch points you have across your network. I'm just trying to figure out when -- I know it's moving the needle, but how much is it moving the needle, and how can we think about that from a size perspective?

Matthew Borsch 高盛集团

我这边的问题是关于你们在OptumHealth中不断扩展的医疗服务交付资产。这几年来你们明显在这个方向上加大了力度。能不能提供一些数据，帮助我们判断这个部分相对的规模？比如它在UnitedHealthcare总医疗支出中所占比例，或是在你们整个网络中的触点占比？我知道这确实在“推动指针”（即产生实质性影响），但想更具体地了解它的实际体量，以及我们该如何衡量它的规模？

Larry Renfro Former Vice Chairman

Okay. I'll take that. So I'm going to ask a couple of people to talk about this a bit. I'll ask Jack Larsen. And Jack runs our Optum Care business and that would be our local care delivery as well as our complex conditions. And I'm going to ask Mike Weissel, who runs our consumer side of this. And I'll have him comment on this as well.

Larry Renfro 前副董事长

好的，我来回答这个问题，并请几位同事补充说明。我会请Jack Larsen来谈一下，他负责我们的Optum Care业务，也就是本地医疗服务交付和复杂病情管理部分。我还会请Mike Weissel发言，他负责的是我们这一块的消费者端业务，让他也来谈谈他的看法。

I will just make a comment about that business and kind of where it's cycling right now. A few years ago, I think you guys realize that we got into the PBM business a little bit different. We had, had the Medicare and Medicaid business, and we needed to get into commercial. And so we had to bring in technology platforms and build these out over a couple of years. And it took some time, and then that business kicked in. And now we see the rewards of that. Then right behind that, we did the same thing with Optum360, where we decided to ground that business, put that business together, build it up and take a year or so to do that. Then we had to deal with these are big, big deals, multibillion-dollar, multi-year contracts, and the conversions take a long time. This year was OptumHealth's turn. And so we're in the process for both what Jack's doing as well as what Mike's doing to be in that cycle for them, and we'll cycle next year probably with somebody else. But Jack, you might take it from that perspective.

我先简单评论一下当前这个业务的周期发展状况。几年前，我们进入药品福利管理（PBM）业务的方式和其他人有点不同。当时我们已有Medicare和Medicaid业务，但还需要进入商业险市场。为此，我们必须引入技术平台，并在几年时间里搭建起整个系统。这是一个渐进过程，但现在我们已经开始看到成果。随后我们又用同样方式推进Optum360，先构建基础，组建业务，花一年左右时间打好底子。这些业务都涉及规模庞大的交易，是数十亿美元、跨多年的合同，转化周期很长。今年轮到的是OptumHealth，所以Jack和Mike现在正处于这个建设周期中，而明年可能会轮到其他业务线来接棒。Jack，你从你的视角说说吧。

Jack Larsen Executive VP of Optumcare

Sure, I think, Matt, that we shared 7 million-or-so consumer touches throughout all of Optum Care. About 3 million of those are in the MedExpress urgent care business that Dr. Alderman spoke to. About 1 million of those are HouseCall visits, home visits that we do in the Optum Care business. So that leaves about 3 million or so patients in the healthcare delivery system. And I'd say how much is associated with UnitedHealthcare versus the industry-wide, I think like everything in healthcare, it depends. Some of our healthcare practices are exclusive to UnitedHealthcare, based on their origins, Southwest Medical for example, in Las Vegas is, for the most part, dedicated to UnitedHealthcare, both Medicare and commercial.

Jack Larsen OptumCare执行副总裁

好的，Matt，我们目前整个Optum Care体系下大约有700万次“消费者接触”。其中大约300万来自MedExpress的急诊护理业务（Dr. Alderman之前提到过），大约100万是HouseCall项目中的上门问诊，剩下约300万是我们医疗服务交付体系中的患者。至于这些服务中有多少与UnitedHealthcare有关，这和整个行业一样，答案是“视情况而定”。我们有一些医疗实践项目是专门服务UnitedHealthcare的，比如我们在拉斯维加斯的Southwest Medical，主要面向UnitedHealthcare的Medicare和商业险客户。

But I would say the majority of our other practices are multi-payer. We serve lots of payers around the country. Southern California, we certainly support UnitedHealthcare as well as most of the other payers. So I'd say that it is a mix, but over time, we're working very closely with our UnitedHealthcare colleagues to make sure that we can deliver on the integrated delivery part of the 4-plank strategy that Jeff talked about and become more of that integrated provider that's important for the success of UnitedHealthcare.

但大多数其他实践项目都是多支付方模式，我们服务全国范围内的多个保险商。在南加州，我们既支持UnitedHealthcare，也支持其他多数支付方。因此整体是一个混合结构。长期来看，我们会与UnitedHealthcare的同事密切合作，确保我们在Jeff所提到的“四大支柱战略”中履行“整合式交付”这一部分，并逐步成为UnitedHealthcare成功所依赖的重要整合型服务提供者。

Daniel Schumacher Former CEO of OptumInsight

And Matt, I might add from a UnitedHealthcare perspective, obviously, Jack broke down 7 million folks or so, 3 million of them UnitedHealthcare in the context of 46 million domestic members we have here in the U.S. So a relatively small proportion of our overall enrollment base. But what I will tell you is that where we are partnered with Optum, we really like the outcomes. And so we are endeavoring as they look to grow that business to grow right alongside them. So it is -- we are trying to orient a greater share through our Optum delivery partners over time.

Daniel Schumacher 前OptumInsight首席执行官

Matt，我也从UnitedHealthcare的角度补充一下。Jack提到的700万人中，大约300万是UnitedHealthcare的成员，而我们在美国的整体会员规模大约是4600万，因此这仍然是一个相对较小的比例。但我要说的是，凡是我们与Optum合作的地方，结果都非常好。所以我们也希望随着他们的发展同步成长。我们正努力在长期内将更大比例的服务转移至Optum的交付网络中。

Michael Weissel

I'll just comment. This is Mike Weissel with the Consumer Solutions Group, so when they talked earlier about the 77 million customers that Optum interacts with in some way or another, a lot of those are related to our population health management services that we have and as well as our financial services. And so we have a large number of touch points, and a large number of those are actually multicarrier in nature. So while we work extremely closely with all of our colleagues at UnitedHealthcare across all of their sectors, we work with many of the largest plans in the United States today, a number of Blues plans, regional plans, where they are also taking advantage of our care management services for their own populations. And so we're really not restricted in any way in terms of how we do that, but we're able to take all these learnings and kind of drive them out throughout the entire marketplace.

Michael Weissel 消费者解决方案集团负责人

我补充几点。我是来自消费者解决方案集团的Mike Weissel。刚才提到Optum在某种程度上接触到约7700万名客户，其中很多都与我们的人口健康管理服务和金融服务有关。我们有非常广泛的接触点，而且其中相当一部分是多支付方（multicarrier）性质的。虽然我们与UnitedHealthcare各业务板块的同事密切合作，但我们同时也与美国许多最大的健康保险公司合作，包括多个“蓝十字蓝盾”计划（Blues plans）和地区性保险计划，这些保险商同样使用我们的健康管理服务来服务他们自己的客户群体。因此我们的运营模式并不受限，反而可以将我们的经验推广到整个市场中。

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

So I just want to, if I can, just maybe take a moment to clarify one thing, because I want to make sure Dan's comment wasn't misinterpreted. The 7 million people that are served are served through multiple payers, multiple payers. So we're the minority. UnitedHealthcare is the minority of payer that is served by MedExpress, as an example. And the same thing, the local care delivered practices serve a very diversified payer base, as well as what Mike Weissel just said as well. So it's a small percentage of the total overall practice, but a critical and very important one, really around where we target our growth in our respective markets.

Stephen Hemsley 首席执行官兼非独立非执行董事长

我想借此机会澄清一点，避免Dan的评论被误解。那700万服务人群是来自多个支付方的，也就是说，我们服务的对象涵盖众多保险计划。以MedExpress为例，UnitedHealthcare其实只是其中较小的一部分。同样地，我们本地医疗实践项目也服务于非常多元化的支付方，就像刚才Mike Weissel所说的一样。UnitedHealthcare虽然只占其中一小部分，但它是一个关键且非常重要的组成部分，也是我们在特定市场中实现增长的重点目标对象。

John Rex President & CFO

And Matt, I'd just add just to get to your question on size -- how do I think about the size of this business, right. So all of Optum Care is within OptumHealth, it's more than 1/2 of revenues.

John Rex 总裁兼首席财务官

Matt，为了回应你关于规模的问题——你问如何评估这块业务的规模。整个Optum Care业务是包含在OptumHealth之下的，它现在占到了OptumHealth总营收的一半以上。

John Penshorn; Senior Vice President

And the local thing plays out again here. So Optum care is very locally developed, it's not a random spread. It's in targeted markets that have got attributes and characteristics that are fruitful for the development of these types of platforms.

John Penshorn；高级副总裁

本地化因素在这里再次体现得很明显。Optum Care是高度本地化建设的，它不是随机扩展，而是在那些具有有利特征和发展潜力的市场中精心布局的。这些市场适合发展这种平台型医疗服务体系。

There are questions over here. Diane [ph], if you could come around or Teresa [ph], come on up. Thank you. Any of these guys, yes.

这边还有提问。Diane [音]，你可以过来一下，或者Teresa [音]，请上前。谢谢。你们几位谁都可以接着回答。

Unknown Attendee

Thanks, good morning. On the slide about the international business, the $5 trillion opportunity, can we think about that -- it seems like most of that was on the benefit side. But to break that out a little bit further on the benefits side, is that more care delivery, such as Brazil, or is it insurance-based? How to think about how you think that dynamic will play out over time?

不知名与会者

谢谢，早上好。在你们展示的关于国际业务的幻灯片中，提到了5万亿美元的市场机会。我们能否理解为这个机会主要集中在“福利”端？如果进一步细分这个福利部分，是更偏向医疗服务交付（比如巴西那种模式），还是更偏向保险业务？你们如何看待这类动态在未来的演进路径？

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

Sure, it was my slide, so let me take a crack at it and then maybe turn to Larry, because I think the vast majority of the opportunity we're going to see globally is going to be through our services business from Optum. But that slide was mainly to give you kind of an impressionistic feel for the opportunity that's in front of us. And as Steve indicated, international represents 3% of our $180 billion forecasted business. So it's a relatively modest piece. And inside the totality of the international opportunity, it's very, very small. So basically, to just give you a sense that the opportunity is big and rich.

Stephen Hemsley 首席执行官兼非独立非执行董事长

好的，那张幻灯片是我准备的，我先来回答，然后也许请Larry补充。我们认为，未来在全球市场上我们看到的绝大多数机会，将来自Optum的服务型业务。但那张幻灯片更多是为了让大家对我们面前的机会有一个“印象派”式的感知。而正如Steve之前提到的，目前我们的国际业务仅占预计1800亿美元营收中的3%，也就是一个相对较小的部分。放在整个国际市场的机会池中，我们目前的规模是非常微小的。重点在于，那张图想表达的是：国际市场的机会规模既庞大又充满潜力。

I think what you'll find -- I'll maybe just touch on the health care delivery and the health insurance, I think generally what you'll find is that they're probably more health care delivery and public-private partnership opportunities globally than there are insurance opportunities -- viable insurance opportunities. There are a lot of markets that operate as private insurance markets, but they are so heavily regulated that they really don't provide you the degrees of freedom in order to be successful in those markets. So generally speaking, unless the market takes on characteristics like we find in Brazil -- not so much the economy per se or the current political environment, if you will, but rather the growing middle class, a fair amount of dependency on the private sector to be able to serve the citizens more fully. When you find characteristics like that, like you find in other countries in South America, and like you find in countries in Southeast Asia and elsewhere, if you will, those are kind of the places where I could see us investing more in care delivery practices and then possibly offering insurance products alongside. But I think the real opportunity -- and I think we collectively would say the real opportunity probably really is $0.5 trillion -- our initial opportunity is in the $0.5 trillion global market that Optum could pursue.

在全球范围内，我们看到的可行机会，大多来自医疗服务交付和公私合作（PPP）模式，而不是传统保险市场。虽然很多国家表面上有私人保险市场，但监管高度严格，实际上并没有为外部参与者提供足够的灵活空间。因此除非这个市场具备某些特征，比如巴西那样：不是说宏观经济或政治环境，而是拥有不断扩大的中产阶级群体，并且对私营部门有相当依赖，以满足公众服务需求。如果市场具备这种特性——比如南美其他国家、东南亚某些国家——我们会更倾向于在这些地方投资医疗服务体系，并可能搭配推出保险产品。我们一致认为，真正的可行机会是Optum可以进入的那5,000亿美元级别的全球服务市场。

Larry Renfro Former Vice Chairman

I'll make a couple comments. I mean, Dave already talked about Amil and Optum bringing in services on the affordability side, the technology side, really from an efficiency and productivity standpoint and how that kind of works with Amil. But we've been in certain markets, certain countries for a while. What I would say is, that we're now starting to understand those markets better. And what we're trying to do is to look at the needs. And a lot of these markets, as we look at the needs, it's just like being here. It's not really a disconnect in terms of the same needs, the same problems, the same issues, are the same as they are in the United States.

Larry Renfro 前副董事长

我也补充几点。Dave刚才讲过Amil和Optum如何通过引入负担能力管理服务、技术服务，在提升效率和生产力方面推动了Amil的发展。而我们其实已经在一些市场、一些国家耕耘了一段时间。现在我们开始对这些市场有了更深刻的理解，我们真正做的是去识别和满足他们的“实际需求”。在很多市场上，我们看到的“需求”其实和美国是一样的，并没有太大差别——同样的问题、同样的挑战，也需要同样的解决方案。

I think a couple of years ago, we punched a ticket. And that ticket was called healthcare.gov. And the fact that we did that we did, I believe that other governments know that. And they understand how Optum played a role with the government. And so I think the governments that we're starting to work with are pretty open and honest with us in terms of what we might be able to develop. And I think if we can punch 1 more ticket with another of those countries, it will kind of open up the world to us. And that's where we're at right now, trying to get ourselves established pretty much in the U.K., to be honest with you, at this point.

我认为我们几年前“打通了一张入场券”，那张票就是 healthcare.gov（美国联邦医保市场）。我们完成了那项任务，我相信各国政府都知道这一点，他们也清楚Optum在其中扮演了怎样的角色。所以我们目前接触到的很多政府对我们持开放和坦诚的态度，愿意探索我们可以共同开发的服务模式。我认为如果我们再在某个国家“打通另一张票”，这可能会真正为我们打开全球市场。目前我们正在积极推进在英国的布局，老实说，这就是我们现在正努力实现的目标。

David Wichmann Former CEO & Director

I think in the simplest way to think about that, rough numbers, $7 billion to $8 billion of earnings coming out of the benefits platform, $5 billion to $6 billion coming out of the services platform. In a few years, we will like to be sitting here and talking about a couple billion dollars coming out of the international platform. That's -- to me, that's the bottom line of the discussion around international. We have compelling capabilities that are clear market needs, we've got to connect those and execute, and we're looking for the third leg of the stool.

David Wichmann 前首席执行官兼董事

我认为最简单的理解方式是：大致来看，来自福利平台的利润约为70亿到80亿美元，服务平台贡献约为50亿到60亿美元。我们希望几年之后，可以在这里谈论国际业务平台也能带来几十亿美元的利润。对我而言，这正是整个国际业务讨论的核心。我们拥有具吸引力的能力，也确实对应着明确的市场需求，关键在于如何将两者高效连接并执行到位。我们正在寻找这张三脚凳的“第三条腿”。

John Penshorn; Senior Vice President

Okay. I will take a couple more, back here in the center please. Thank you, Janice [ph].

John Penshorn；高级副总裁

好的，我再接几个问题。中间这边请。谢谢你，Janice [音]。

Unknown Attendee

The more you guys talk over time, the more it seems that Optum and UnitedHealthcare are very much integrated. Are we still thinking better together? It seems like that's kind of the direction, but we do get a lot of questions about potential for a spin-out. And then Dan, you talked about the MLR improvement overall and the public exchange contribution, could you go through some other business lines like Medicaid, Medicare, PDP and directionally where you think those MLRs might go?

不知名与会者

听你们讲得越多，感觉Optum和UnitedHealthcare的整合性就越强。你们还在坚持“Better Together”（更好地一起）这一理念吗？虽然听上去确实是这个方向，但我们仍然经常会被问到有关Optum是否会被拆分的可能性。另外，Dan你刚才提到了整体MLR（医疗损失率）的改善和公共交易市场的贡献，能否也谈谈其他业务板块，比如Medicaid、Medicare、PDP等，这些业务的MLR趋势如何？

David Wichmann Former CEO & Director

I'll take the first one. We never stopped talking about better together. So we have been pretty faithful to that theme all the way through and believe that it is playing out and strengthening both of those platforms. And while they work very well and are very effective together, Optum has the capacity to serve the broad marketplace and from its very beginning was built for that purpose. So I think there are a lot of synergies around innovation and adoption. The UnitedHealthcare is a strong adopter and user of Optum Care capability -- or Optum capabilities broadly. And as those grow, I think it strengthens UnitedHealthcare and as UnitedHealthcare grows, it strengthens Optum. So I think that it's as good as it gets from that point of view. We'll continue to be objective and continue to evaluate and so forth, but we've never really stopped talking about better together, and I think as years go by, we're just proving how it's playing out. And the second part?

David Wichmann 前首席执行官兼董事

我先回答第一个问题。我们从未停止谈论“Better Together”（更好地一起），我们一直忠实于这一理念，并且我们相信，这种协同的模式确实正在逐步显现成效，强化着两个平台的能力。虽然Optum和UnitedHealthcare协作良好、运行高效，但Optum本身就具备服务整个市场的能力，而且从一开始就是为了这个目的而建立的。因此，我认为在创新与落地应用方面，它们之间有很多协同机会。UnitedHealthcare一直是Optum能力，尤其是Optum Care服务的积极采纳者和使用者。随着Optum的发展，它在不断强化UnitedHealthcare；同样地，UnitedHealthcare的成长也反过来增强了Optum的实力。从这个角度来说，这种协作是非常成功的。我们会继续保持客观，持续评估各种可能性，但我们从未真正停止过“Better Together”的理念，而随着时间推移，我们也在不断证明这种模式确实奏效。你刚才提到的第二个问题是？

John Penshorn; Senior Vice President

Care ratio, color commentary, Dan.

John Penshorn；高级副总裁

关于MLR的趋势，Dan你来具体说一下吧。

Daniel Schumacher Former CEO of OptumInsight

Sure. So as you look at, as I mentioned, in aggregate, right, it's declining in 2016 compared to 2015. And as you look at the pieces inside that, the commercial business is declining the most on a reported basis. And if you adjusted out some of the individual exchange elements of it, it would be flattish to a little bit up as you look at the commercial business. So keeping in line year-over-year when you recalibrate for that item, I would likewise say the same is true in Medicaid, a decline year-over-year. Part of that is a pull-forward of the loss. If you're adjusting for that, it's more flat comparable year-over-year. And then we're seeing very nice improvement in our care ratio year-over-year in our Medicare business. And as you look underneath it, obviously we've made some very strong progress in our STARS performance, and we're going to get off to a great start from an enrollment standpoint. All those things, we think, are going to contribute to what will be a very strong performance in our Medicare business, and that will improve the care ratio the most inside the portfolio on a year-over-year basis.

Daniel Schumacher 前OptumInsight首席执行官

当然。如我之前提到的，整体来看，2016年的MLR（医疗损失率）相比2015年是下降的。具体来看，商业保险业务的下降幅度最大——这是按报告数据而言。如果把其中的个人交易所部分调整出去，那么商业险的MLR大致持平或略有上升。也就是说，经调整后是基本一致的。对于Medicaid来说，我们也看到MLR同比下降，其中部分下降其实是“损失前置”的结果，如果把这一因素剔除，MLR大致是持平的。而在Medicare业务中，我们的MLR同比改善非常明显。深入来看，这主要归功于我们在STARS评级上的显著进步，同时我们的投保季开局也非常强劲。这些因素都将在今年为Medicare业务带来强劲表现，从而使其成为整个业务组合中MLR同比改善幅度最大的部分。

Unknown Attendee

A question on operating cost ratio. You, I think are looking for an improvement in '16, but you've already shown a very sharp improvement versus your expectations a year ago, from 17% then to 15.4% for 2015 now. As you think about what drove that, presumably mix was a piece of that, can you disaggregate that? And then looking over the next few years, talk about how much farther down those CR can go.

不知名与会者

我有一个关于运营成本率（Operating Cost Ratio）的问题。我记得你们预计2016年还会有所改善，但实际上你们2015年的表现已经远好于一年前的预期，从17%降到了15.4%。你们认为是什么推动了这种改善？我猜业务组合变化是其中一个因素，但能否拆解一下各部分影响？另外，未来几年，这项成本率还有多少进一步下降的空间？

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

So the leading contributor to the sharp improvement in the operating cost ratio was the bringing Catamaran on board. So it was -- it had a pretty substantive impact. I'd say beyond that, you get various mix considerations, depending upon whether or not you've got a strong bias towards government programs-based growth versus commercial-based business growth. But beyond mix, generally speaking, you have about 20 to up to 40 basis points of improvement every year, based upon actions that we've taken to improve the productivity of our business. So in very good years, like last year's was, you end up at the higher end of that range. But I'd say on a more normalized basis, you end up falling somewhere in between.

Stephen Hemsley 首席执行官兼非独立非执行董事长

这项运营成本率的大幅改善，最主要的驱动因素是我们收购了Catamaran，这一并购对成本率产生了实质性影响。除此之外，确实还有业务结构（mix）的影响，比如你是更偏重政府项目增长，还是商业业务增长。不过，撇除业务结构的因素，一般来说我们每年可以通过提升业务生产力来实现20到40个基点的改善。在表现特别好的年份（比如去年），可以达到这个区间的上限。而在更“常态”的年份，通常就在中间值附近。

So generally 20 to 40 basis points is what we're looking for, for improvement each and every year. Some years we turn, and we invest some of that so that we can build the capabilities, as Dan described earlier in his comments here in response to the another question, but for the most part you can count on somewhere in the 20 to 40 basis points improvement range.

因此我们对每年运营成本率的预期改善值通常在20到40个基点之间。有些年份我们会将部分节省下来的成本再投资，用于构建新的能力，这一点正如Dan之前提到的。但总体而言，你可以预期我们每年通过提高生产效率带来的改善大致就在这个范围内。

John Penshorn; Senior Vice President

Well, there's also an aspect relative to the reclassification item that Dan mentioned. So there's operating losses [ph] that are moving to the medical line related to the fulfillment of pharmaceuticals through our pharmacy care services business. And in the fourth quarter earnings release, we'll give you historical restated data, so that you've got apples and oranges on the way we're going to report on a go-forward basis.

John Penshorn；高级副总裁

还有一点补充，是关于Dan提到的一个分类调整问题。我们有部分与药品配送有关的运营成本，原本计入运营成本项，现在会重新归类到医疗支出项下（因为它本质上是与药品交付直接相关）。在第四季度财报中，我们会提供历史数据的重分类版本，以便你们在后续的报告口径下能够“对齐口径”（即确保比较维度一致）。

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

I just want to make sure -- we continue to expect pressure on that metric over time. I mean, getting it to be reduced over time is a real challenge given the strong growth that we experience out of Optum, which carries a higher operating cost ratio, of course, than the benefits based business. So you'll see pressure on that, don't be alarmed by it. Just recognize that across the expanse of our business, we generally will deliver somewhere in the 20 to 40 basis points improvement range related to just productivity. Otherwise it's mix.

Stephen Hemsley 首席执行官兼非独立非执行董事长

我还想特别提醒一下：尽管我们一直在改善这项指标，但长期来看这项指标还是会受到压力。因为我们在Optum业务上的强劲增长会带来更高的运营成本率，相比之下，福利业务的运营成本率要低得多。所以你未来可能会看到一些上行压力，但这并不需要担心。你只需要知道，整体来看，我们通过提升生产力，每年仍有望带来20到40个基点的改善，除非是业务组合结构变化带来的波动。

John Penshorn; Senior Vice President

Okay. Last 2 questions you guys have now taken the microphones yourselves, so I know they're going to get in, Peter and Andy and we'll be done.

John Penshorn；高级副总裁

好的，最后两个问题，现在你们已经把麦克风拿在手上了。Peter和Andy，请开始提问，结束之后我们就收尾。

Peter Costa Wells Fargo Securities

I wanted to drill down on a couple of specifics on some of the guidance that you gave on UnitedHealthcare, Steve you mentioned the strong open enrollment in Medicare already this year, we're about coming to the close. And Dan, when you rattled through the enrollment growth numbers of each of the different business units, you gave the midpoint of all the numbers except in Medicare Advantage, where you pointed to the high number. Is that to say that you guys are already at the high number Medicare Advantage of your guidance at this point in time?

And then in terms of the medical cost trend numbers that you gave, you showed about 100 basis points of improvement on both physician and outpatient trend relative to the growth that you showed last year. Can you tell us why those trend numbers are a little bit lower on physician and outpatient?

另一个问题是关于医疗成本趋势。你们提供的数据显示，在医生服务和门诊服务的成本趋势方面，相较去年有大约100个基点的改善。能否解释一下，为何这两个类别的成本趋势有所放缓？

Daniel Schumacher Former CEO of OptumInsight

Sure. So on your observation about Medicare Advantage, we like where we're positioned. And we like how we're performing through the open enrollment period. So I'll let you read through, but it is still open. It's still open, but we're off to a good start. And so we did orient towards the higher on that.

Daniel Schumacher 前OptumInsight首席执行官

当然可以。关于你提到的Medicare Advantage，我们对自己的市场定位和在整个公开投保期中的表现都非常满意。虽然投保期尚未正式结束，但目前进展良好，所以我们确实在指引中更倾向于区间的高端部分。这方面你可以自行解读。

And then your second question was with regard to the trend categories. So as you look at it year-over-year, I mean, I guess the one thing I'd point out is, year-over-year inpatient up a little bit, outpatient down a little bit. And there's a little bit of trade going on in there. So historically, the last couple, 3 years I would say, we've done an incredible focus on 1-day observation stays and converting those to the outpatient setting. So over time, we've been having greater declines in inpatient and having some offsetting rise in outpatient, as we take those 1-day length of stays, and we convert them from an inpatient stay to an outpatient stay, pay less for it and things like that. So what you're seeing in the relationship year-over-year for 2016 is some moderation in the progress we've made in that, because we've been so strong in that the last couple of years. That's what I would highlight.

关于你提到的成本趋势问题，具体来看，2016年与2015年相比，住院服务的成本略有上升，而门诊服务则略有下降，二者之间存在一定“迁移效应”。在过去两三年中，我们非常关注“一日观察住院”这一类项目，并主动将其转化为门诊形式。通过这种方式，我们逐步实现了住院服务的成本下降，同时门诊服务的相应上升，但总体更经济。你现在看到的2016年趋势，其实是在这个转化过程中节奏趋缓的体现——因为过去几年我们已经取得了非常强劲的成果，现在的改善幅度自然会有所减弱。

Physician? Physician is a blend of both. So it's a little bit about our unit cost progress as we've been orienting more towards value and some of the outcomes we've been able to drive there. And then a little bit less in terms of underlying volume of visits.

至于医生服务方面，这是两方面因素的综合体现：一是单位成本上的持续优化，我们越来越多地转向按价值计酬的模式，也取得了实际成效；二是医生就诊量的自然下降，整体使用量略有减少。

John Penshorn; Senior Vice President

Okay, last question.

John Penshorn；高级副总裁

好的，最后一个问题。

Andrew Schenker Morgan Stanley

Great. So maybe following up on that a little bit. You spent a lot of time today talking about Medical management. I mean, any way to really talk about or quantify that at the aggregate level, its impact on trend each year and is this giving you a competitive advantage versus your peers? Or it's just what you need to do to stand still and face a rising utilization and rising costs?

Andrew Schenker 摩根士丹利

很好，我想就这个话题稍作延伸。你们今天在会议上花了不少时间讲医疗管理（Medical Management）。那么你们是否能在整体层面谈一谈它对每年成本趋势的实际影响？它是否为你们带来了相对竞争优势？还是说，这只是一种“必要防御”，用来应对不断上升的使用率和医疗成本？

John Penshorn; Senior Vice President

I want to start that with the observation that was made earlier, that UnitedHealthcare is growing organically by nearly 10 million people over the last 6 years. And so there is some version of value proposition that's coming into the market. It's probably got multiple dimensions to it, but, you want to talk about the effective managing costs Dan?

John Penshorn；高级副总裁

我想从之前提到的一个事实开始：过去六年里，UnitedHealthcare通过有机增长增加了近1000万名会员。这说明我们确实在向市场提供某种形式的“价值主张”。这种价值主张可能是多维度的。那么，Dan，你要不要具体讲讲成本控制的成效？

Daniel Schumacher Former CEO of OptumInsight

Yes, Andy, I would add to it, just to say that we enter every year with an affordability outcome, an expectation in each of our businesses. In an aggregate that is north of $3 billion, is what our expectation is for 2016. And we look to increment that year after year after year after year. And 2016 will be no exception for us and as you would expect it is a multifaceted agenda. It has a large concentration, certainly, in our management and control of pharmacy spend in partnership with our friends in OptumRx. It certainly has elements of payment integrity in part of it. And again, we partner very closely with Optum on that as well.

Daniel Schumacher 前OptumInsight首席执行官

当然，Andy，我补充一下。我们每年都会为各业务单元设定“可负担性目标”，2016年的整体目标是超过30亿美元的成本改善，而且我们年年都力求在此基础上持续提升。这项计划并不例外地涉及多个维度，特别是在药品支出控制方面，我们与OptumRx密切合作。此外，还包括付款准确性管理（payment integrity）等环节，在这方面我们也与Optum紧密配合。

And then as you can imagine, on the inpatient side, outpatient side, site of service and so forth, we have an agenda that spans every cost category. And in 2016, we expect that to be north of $3 billion. So that gives you some context of the contribution to reduction in medical cost.

你可以想象，在住院、门诊、服务场所等各个维度，我们都有一套完整的成本控制计划。2016年我们预计这些措施将带来超过30亿美元的医疗支出削减，这可以让你对我们在控制医疗成本方面的贡献有一个大致的了解。

And to John's point, I think overtime, if you look at our trend outcomes in relation to others, I think we've fared reasonably well. And obviously, the true indicator of whether or not you're delivering differentiated value in the marketplace is whether or not people want to buy your stuff. And the reality is we've had success selling and renewing customers over the last 6 years at a pace greater than some of the folks we compete against.

呼应John刚才的观点，从长期趋势看，我们在医疗成本控制上的表现相较同行是相当不错的。而是否在市场中提供了差异化价值，最真实的衡量标准是：有没有人愿意买你的产品。现实是，过去六年来我们在新客户获取和续保客户上的增长速度都优于部分竞争对手，这也印证了我们所提供的价值。

Stephen Hemsley CEO & Non-Independent Non-Executive Chairman

It's a key attribute in improving the value people receive out of healthcare. And so what we tried to describe here today, particularly -- on both Optum and UnitedHealthcare, was to really give you a strong sense of how we're really improving health care quality and reducing health care costs at the same time.

Stephen Hemsley 首席执行官兼非独立非执行董事长

这确实是提升医疗价值的一项关键属性。我们今天在这里所展示的内容，特别是关于Optum和UnitedHealthcare的部分，目的就是让大家切实感受到我们是如何同时提升医疗质量并降低医疗成本的。

And very specifically to your question, does that create a competitive advantage for your business, we think it does. Not only in terms of our ability to improve health care quality and outcomes, as well as improve health care costs, but also the consumer-facing elements of that and the loyalty that we develop, the relationships that get developed, all leads to trust and growth. And so that's what we're trying to accomplish as a company here.

针对你刚才的问题：“这是否构成了竞争优势？”——我们的回答是肯定的。不仅体现在我们改善医疗质量和控制成本的能力上，也体现在我们面向消费者的服务体验、客户忠诚度以及由此建立的关系和信任上。所有这一切最终推动了增长，这正是我们作为一家公司正在努力实现的目标。

John Penshorn; Senior Vice President

So let me close off with some orientation to what's next. We've got a couple things here. We have lunch that should be available fairly soon. I think we're finishing a little sooner that I had thought we might. But they should have lunch very quickly in the back. And that will be through the other side of the innovation product showcase.

John Penshorn；高级副总裁

最后我做个收尾，介绍一下接下来的安排。我们这边准备的午餐应该很快就会提供。我们的会议比预期稍微提前结束，后面在“创新产品展示区”的另一侧就可以取餐了。欢迎大家继续交流。

This is set up a little bit differently this year. We actually have 26 different products and capabilities spread between 6 themes arranged blue and orange, 3 themes on each side. And we don't have subject matter experts stationed there. We've got business leaders. And so rather than taking you down into the weeds on the umpteenth detail, where they're conversant is how these products make a difference for our customers and for our businesses. They can provide you context on that. And they're set up to do this at a 2-level fashion. So it's a summary conversation that's very short, what is this, why does it matter, what's the value proposition? If you're curious and think that's interesting, I'd like to know a little bit more about how that works, they can take you through a fairly brief demonstration that really illustrates what that value proposition is. It's not structured, this is a buffet. And so you'll be able to shop among these various booths and talk to the people about the subjects that you find interesting.

今年的展示安排略有不同。我们准备了26个不同的产品和能力展示，分布在6个主题下，按蓝色和橙色两组布局，每边3个主题。今年不再是配备主题专家，而是由各业务线的领导者亲自坐镇。他们不会带你深入到每一个技术细节，而是重点介绍这些产品如何为客户和公司业务带来实际价值，提供宏观背景与上下文。展示分为两个层级：第一层是非常简短的概览性交流——这是什么、为什么重要、它的价值主张是什么；如果你觉得有意思，想深入了解具体怎么实现，他们也可以为你提供一个简洁的演示，直观展现产品的核心价值。这不是按流程安排的讲解，更像是一个“自助餐”，你可以自由选择感兴趣的展台，与相关负责人进行互动交流。

It's part of this theme of trying to pull you in closer to the real business underneath the model. We'll continue that after lunch. We've got seminars again this year. They are shorter than last year. 30-minute sessions, they begin at 1:15. Those seminars are on the LL level, so you have to go down 2 levels. There are staircases. You have to go down 2 sets of stairs and even a little sub-stair after that, or an elevator and hit LL. And then there's all kinds of signs. And those sessions will fire off on the schedule that you've got. I want to just profile those for you.

这也是我们希望大家更深入了解业务本质的一部分安排。午餐过后，我们还将继续进行专题研讨会。今年的研讨会时间比去年短，每场30分钟，从下午1:15开始。会场在LL层，需要下两层楼，可以走楼梯（有两个主要台阶，还有一个小平台）或乘电梯按LL键。现场会有标识引导。各场会议将按你们手上的时间表进行。以下是研讨会的主题概览：

Social Services Growth Market is hosted by Austin Pittman and Sue Schick — focused on coordinating social determinants that impact 10%-20% of healthcare costs for high-need populations.

社会服务增长市场：由Austin Pittman和Sue Schick主持，探讨如何协同管理社会决定因素，这些因素对高需求人群的医疗成本影响达10%-20%。

Public Exchanges by Jeff Lucht, Heather Kane, Dan Schumacher — expands on the earlier topic Steve opened with.

公共交易所：由Jeff Lucht、Heather Kane 和 Dan Schumacher主持，深入讨论Steve早前提到的相关话题。

Clinical Engagement with Dr. Sam Ho and Bill Hagan — addressing how clinical cost management has changed over 5 years, including new tools and methodologies.

临床参与度提升：由Dr. Sam Ho 和 Bill Hagan主讲，聚焦过去五年中我们如何在医疗成本管理方面发生变革，介绍关键工具和方法。

Specialty Pharmacy with Mark Thierer and Mike Zeglinski — focused on our PBM-side strategy and approach to specialty pharmaceuticals.

特药服务：由Mark Thierer和Mike Zeglinski讲解，围绕我们从PBM（药品福利管理）角度开展的特药战略和实践。

Ambulatory Care with Dr. Frank Alderman and Jack Larsen — continuing the discussion from the morning Q&A session.

门诊护理：由Dr. Frank Alderman和Jack Larsen继续上午交流环节的探讨。

Optum Analytics with A.G. Breitenstein and Michael Weintraub — sharing the analytics power used by care providers and its growing integration with payers.

Optum数据分析：由A.G. Breitenstein和Michael Weintraub共同主持，他们是Optum Analytics的联合创始人，将介绍该系统如何赋能医疗服务提供者，并逐步与支付方打通，实现基于人群健康和价值导向的合同管理。

I missed a point on product showcase. I meant to pull this out. In the back of your hard copy book is a brochure that outlines the various products that we're showing here in the back. And this are more product-oriented. We've showed you a lot of innovation in the past. These are innovative products but, by and large, they're products which are out in use in the marketplace. Not a coming soon, but a here-and-now today kind of proposition.

我还漏提了产品展示部分，请允许我补充。在你们资料册的最后，有一份产品手册，列出了我们今天在展示区展示的各个产品。这些展示以产品为核心，不再只是过去那种“概念式创新”，而是已经在市场上实际应用的创新型产品，不是‘即将上线’，而是‘现已投入使用’的解决方案。

So I thank you for your attention and interest. I hope you've taken a way that we're well-diversified. That we're hungry. That we're focused on growth, quality, driving performance, execution and that we believe that we're going to continue to increase shareholder value by further living the mission of this company. Thank you.

非常感谢大家的关注与参与。我们希望你们能感受到，我们是一家业务多元、充满渴望、聚焦于增长、质量、绩效与执行的公司。我们坚信，继续践行公司使命，将进一步提升股东价值。谢谢大家！