2016-11-29 UnitedHealth.Investor Day
Unknown Executive
Ladies, and gentlemen, Senior Vice President, UnitedHealth Group, John Penshorn.
各位女士、先生们，联合健康集团高级副总裁约翰·彭斯霍恩。
John Penshorn Former Senior VP
Good morning. Good morning. Welcome to UnitedHealth Group's 2016 Investor Conference. It is great to be here and to see you all this morning.
早上好，早上好。欢迎大家参加联合健康集团2016年度投资者大会。今天早上能来到这里并见到大家，我感到非常高兴。
As it turns out, as is our tradition, we are going to make the forward-looking statements today. And so, I need to remind you that there are risks and uncertainties associated with any forward-looking statement. Actual results may differ materially, and those risks and uncertainties are articulated in cautionary statements in our SEC filings as well as posted on the Investor Relations section of the UnitedHealth Group website.
按照我们的惯例，今天的会议中将会包含前瞻性声明。因此，我需要提醒各位，任何前瞻性声明都伴随着风险和不确定性。实际结果可能与前瞻性声明存在重大差异，这些风险和不确定性在我们提交给美国证券交易委员会（SEC）的文件中已作出说明，并已发布在联合健康集团官网的投资者关系栏目中。
Our posted materials also contain a reconciliation of non-GAAP measures used this morning to the most comparable GAAP measures. Those non-GAAP measures are also at the back of your investor books, which you received on the way in this morning.
我们公布的材料中还包括了本次使用的非美国通用会计准则（non-GAAP）指标与最相近的美国通用会计准则（GAAP）指标的对账说明。这些非GAAP指标也在您今早入场时所领取的投资者手册的最后部分。
The investor books have the slides from today's presentations. And just a word about that, the UnitedHealth Group section this morning, which is Steve Hemsley; Dave Wichmann; and Larry Renfro, does not have slides in the book. The presentations are more illustrated than slide materials, so there'll be graphic illustration, but it isn't really the type of material that lends itself to slides.
投资者手册中包含了今天演讲的幻灯片内容。不过需要说明的是，今天上午联合健康集团部分的演讲者——史蒂夫·汉姆斯利、戴夫·维奇曼和拉里·伦弗罗——他们的部分没有配套的幻灯片。因为他们的演讲更偏向图文展示，而不是适合用幻灯片呈现的材料。
The Optum and UnitedHealthcare business presentations have their slide presentations, and then John Rex's UnitedHealth Group financial presentation has additional slide materials. So the materials that he covers in his speech, John also included additional financial reference materials in his section and you'll see that behind the UnitedHealth Group tab.
Optum和UnitedHealthcare的业务介绍则配有完整的幻灯片，此外，约翰·雷克斯所做的联合健康集团财务报告也配有更多的幻灯片材料。他演讲中涉及的内容在他所负责的章节中提供了额外的财务参考材料，您可以在投资者手册中“UnitedHealth Group”标签页之后找到。
With that overall orientation, it is my pleasure to introduce our Chief Executive Officer, Steve Hemsley.
以上是整体的说明介绍，现在我非常荣幸地介绍我们的首席执行官——史蒂夫·汉姆斯利。
Stephen Hemsley CEO & Non-Independent Non-Executive Chairman
Good morning, and thank you for joining us. We will do our best to make your participation today a good return on your time. In so many ways, this is an interesting moment to gather with you. We've just finished an important election cycle, and there is a temptation to view everything through the lens of what we'll call transitional undercurrents as a new administration is forming. That might lead to overlooking much of the good that has been going on in health care over the last few years, and consequently, misread what we might expect to continue both in the near future as well as in the longer term as natural market forces continued to advance as they have for many years now.
早上好，感谢大家的到来。我们将竭尽全力，让您今天的参与物有所值。从许多方面来看，现在正是一个非常值得我们相聚的时刻。我们刚刚经历了一次重要的选举周期，眼下正处于新政府组建的过渡阶段，人们很容易通过这种“过渡暗流”的视角来看待一切。但这可能会让我们忽视过去几年医疗行业中取得的诸多积极进展，进而误判接下来在短期及长期内可能延续的趋势——这些趋势源自多年来持续演进的自然市场力量。
Let's look back to the last change in administration in Washington and what has evolved over the last few years in health care. Today, there is clearly better and growing alignment among consumers, care providers, health plans and their engagement and accountability around affordability and value-based care funding. The way we design and pay for health care is steadily changing. There had been meaningful advances in technology, in basic connectivity and the effective use of information and how these are being applied across the health care system and we are in the very early stages of that effort. We are seeing steadily advancement in the adoption of modern approaches for coordinating and managing care and public and senior benefits. The health system is steadily embracing population health, quality and cost transparency, expanded ambulatory care, pharmacy care services, Telehealth, digital health and more and cost trends, while certainly still too high, had moderated to mid-single digits from annual double-digit levels a decade before. These are all part of natural and positive market progressions in health care, not politically or administratively driven substantive natural market trends such as these have been in motion for a long time, proving once again that because health care is, at its core, a social market, change takes place more slowly and to think more managed evolution than chaotic revolution.
让我们回顾一下上一次华盛顿政府更替以来，过去几年医疗行业的演变。如今，在消费者、医疗服务提供者、健康保险计划之间，围绕可负担性和基于价值的医疗资金安排，已经形成了更加完善且不断增强的协同关系。我们设计和支付医疗服务的方式正在稳步发生改变。技术、基础连接性以及信息的高效使用等方面都取得了实质性进展，而这些应用于整个医疗体系的努力仍处于起步阶段。我们还看到，在协调和管理医疗服务、公共福利和老年人福利方面，现代化方法正在被持续采用。整个医疗体系也在逐步拥抱群体健康管理、质量与成本透明、门诊服务的扩展、药品服务、远程医疗、数字医疗等新趋势。虽然成本水平仍然偏高，但与十年前的年均两位数增长相比，如今的成本增长趋势已降至中个位数水平。这些都是医疗行业中自然且积极的市场演进，并非由政治或行政力量推动。这类深层的自然市场趋势早已开始，并再次证明了一个道理：由于医疗本质上是一个社会性市场，变革往往较为缓慢，更像是一种有序管理的演化，而非混乱的革命。
Which brings us to the question about what will keep evolving over the next 10 years. We think the basic trends stay much the same, but the pace should accelerate. We have barely begun to create this more modern, more effective, more affordable and simpler health care system in the United States or globally. This natural health care evolution has a long way to go, driven by changing social expectations and dynamics and from within the private sector. And we're doing our best to enable a better system and drive that pace of change. There are some important things we feel will continue in the coming years and a few we don't yet know. Biggest unknown obviously concerns immediate legislative priorities, the ultimate reshaping of the more challenging aspects of the ACA and the evolutionary pace for the mainstay government programs of Medicare and Medicaid. What we expect to endure relates to society's ongoing health care needs and trends. As we've said for decades, access to quality care for all Americans should be a national social expectation and we believe it has become that. The question remaining is the ultimate approach as to how to best achieve and sustain it, but full market coverage will ultimately be achieved.
这引出了一个问题：未来十年医疗领域将如何继续演变？我们认为基本趋势将保持不变，但演进速度会加快。无论在美国还是全球，我们尚未真正构建起一个更加现代化、高效、可负担且简化的医疗体系。这场自然的医疗变革还有很长的路要走，它受到不断变化的社会预期、社会动态以及私营部门内部力量的驱动。而我们正在尽力推动这一体系的完善，加快变革的步伐。在未来几年中，有些重要趋势我们认为将会持续，也有一些我们仍无法确定。最大的不确定性，显然在于立法优先事项的走向、如何最终重塑《平价医疗法案》（ACA）中那些更具挑战性的部分，以及政府主导的医疗保险（Medicare）和医疗补助（Medicaid）项目的演进速度。我们预期会持续存在的是社会对医疗服务的基本需求和发展趋势。几十年来我们始终坚持认为，为所有美国人提供优质医疗服务应当成为一项国家层面的社会期望，而我们相信这一目标正在成为现实。剩下的问题是，如何以最佳方式实现并维持这一目标，但我们相信最终将实现全面市场覆盖。
Second, seniors and our most vulnerable citizens continue to need an effective and efficient health safety net and that need is growing both demographically and in its clinical and social aspects.
其次，老年人和最脆弱群体仍然需要一个高效、有效的健康保障网络，且这种需求正在从人口结构、临床需求和社会层面上持续增长。
The cost of care continues to rise, creating pressure across all markets, and we know those costs are better when managed and coordinated than when they are not by a factor of 20% to 30%. Clinical quality, consistency and accountable health outcomes must continue to advance. Governments and plan sponsors must ensure that health resources are spent optimally. There is less margin for error today than there was 20 or more years ago. And in light of these challenges, innovative solutions and old-fashioned perseverance remain critical to ultimately meeting society's health care needs for both health benefits and health services.
医疗成本仍在不断上升，给各个市场带来压力。我们也清楚，医疗支出若经过有效管理与协调，其成本可比未加管控时低20%至30%。临床质量、一致性及可问责的健康成果必须持续提升。政府和保险计划发起方必须确保医疗资源的最优配置。如今医疗体系的容错空间远小于20年前。在这些挑战面前，创新性的解决方案与传统意义上的坚韧毅力，依然是满足社会对医疗福利和医疗服务需求的关键所在。
We believe UnitedHealthcare, Optum and UnitedHealth Group are ideally positioned to continue helping those we serve address these issues. We have the right capabilities firmly in place. We are operating strongly and we have growing momentum. And we are more capable and engaged than we were when the last administration changed.
我们相信，联合健康保险公司（UnitedHealthcare）、奥普腾（Optum）以及联合健康集团（UnitedHealth Group）都处于理想位置，能够持续协助我们服务的对象解决上述问题。我们已具备所需的核心能力，运营状况稳健，发展势头持续增强。而且我们当前的能力和投入程度，已远胜于上一次政府更替时的水平。
UnitedHealthcare, our health benefits platform, is a leader in every major U.S. market: commercial, Medicaid and Medicare. We continue to emphasize the quality of our work, consumer engagement and experience and optimal care provider support, building closer relationships and trust with all those that we touch.
UnitedHealthcare，作为我们的健康福利平台，在美国各大主要市场（包括商业保险、医疗补助及医疗保险）均处于领先地位。我们始终重视服务质量、用户参与度与体验，以及对医疗服务提供者的最佳支持，从而不断与我们接触到的每一方建立更紧密的关系与信任。
Optum, our health services platform, has built a reputation for exceptional innovation and service based on distinctive analytic science applied to the deepest health data resources in the market today. We continue to better align resources to address enduring market trends, making the health system work better for everyone, strengthening relationships and unique collaborations across industry segments. Larry Renfro, who has been an exceptional leader for Optum, has been integral in developing these strategic relationships in his role as the Vice Chairman of UnitedHealth Group and that will only gain more profile and impact in the years to come. Under Larry's leadership, Optum is more integrated and connected than ever before and its growth momentum remains remarkably strong and robust.
我们的医疗服务平台 Optum 凭借对市场上最深层次健康数据资源的独特分析科学应用，赢得了卓越创新和服务的良好声誉。我们持续优化资源配置，以应对长期市场趋势，使医疗体系对所有人运作得更好，同时加强跨行业细分领域的关系与独特合作。拉里·伦弗罗（Larry Renfro）作为联合健康集团的副董事长，一直是 Optum 战略合作关系发展的关键人物，未来几年他的影响力只会进一步提升。在拉里的领导下，Optum 比以往任何时候都更加一体化和互联，其增长势头依然强劲有力。
Our global presence continues to deepen as health systems outside the United States learn better how capabilities can help with the similar problems they face and we learn how to apply these capabilities in different social settings. We continue to maintain our holistic -- our historic capital disciplines, built and stress-tested over many years. We applied private capital in a strong and sustainable fashion and we returned it in the form of growing dividends, share repurchases and share appreciation. We use this capital to help address acute social needs while achieving a 13% to 16% long-term earnings growth rate. We aspire to be a model of the modern, next-generation corporation in this private capital to social mission and market approach. And as I have said, we are even more engaged with health care policymakers and thought leaders at all levels, offering practical experience in dealing with complex health issues at a large scale across all social market segments, along with concrete insight on how to advance the care system both nationally and from within local markets where reality actually resides.
随着美国以外的医疗体系不断学习如何更好地运用能力来应对类似挑战，我们的全球影响力也在持续加深；同时我们也在学习如何将这些能力适配于不同的社会背景中。我们始终保持整体性的、历经多年构建并经受考验的资本纪律。在使用私人资本时，我们坚持强有力和可持续的方式，并通过不断增长的股息、股票回购和股价增值的方式回馈投资者。我们利用这些资本不仅满足社会紧迫需求，同时实现13%至16%的长期盈利增长。我们希望成为将私人资本投入社会使命与市场机制相结合的现代新一代企业典范。正如我所言，我们在各级政府政策制定者和医疗思想领袖中更为积极参与，提供应对大规模复杂医疗问题的实践经验，并为如何在国家和地方市场推进医疗体系提供具体见解——因为真正的现实恰恰存在于地方市场中。
Today, we advocate for a modern, high-performing, simpler health system: first, by reinvesting in health care to create a simpler, more diverse 21st century care infrastructure and workforce with modern and interoperable administrative support platforms and more agile and responsive health research and innovation that includes affordability as a priority.
如今，我们倡导构建一个现代化、高效、简化的医疗体系：首先，通过重新投资医疗体系，打造更简洁、多元化的21世纪医疗基础设施与劳动力，配备现代化且可互操作的行政支持平台，以及更灵活、高响应度的健康研究与创新体系，并将“可负担性”作为核心优先事项之一。
Second, to achieve full access to care by building on existing and proven flexible state-based coverage combined with employer-sponsored benefits and by continuing to support modernized Medicare and Medicaid coverage systems, moving them fully to proven managed-care approaches.
其次，通过在现有经验证的灵活州级覆盖基础上，结合雇主提供的福利，实现全民医疗服务可及性；并继续支持现代化的 Medicare 与 Medicaid 体系，使其全面转向成熟的管理式医疗模式。
And finally, to make health care more affordable by fully engaging consumer product designs while promoting a transparent value-based care payment system, a system where price increases and fees can be justified by the measurable value delivered and by eliminating taxes that simply make care less affordable to the consumer.
最后，通过充分引入以消费者为导向的产品设计，同时推动透明的基于价值的医疗支付体系，从而使医疗服务更具可负担性。该体系要求任何价格上涨与收费都需以可量化的服务价值作为支撑，并取消那些仅仅让医疗服务对消费者更不负担得起的税收。
We are focused on how our products and services line up with the challenges that face health care around the world, challenges that remain regardless of election outcomes. Today, we are positively engaged with consumers, care providers and our customers and all the constituents of health care around a higher quality NPS, Net Promoter Score, experience. And we are steadfast in our commitment to the interest of our shareholders in providing you a consistently strong return on your investment.
我们专注于确保我们的产品和服务能够应对全球医疗体系所面临的挑战，而这些挑战无论选举结果如何都将持续存在。如今，我们正与消费者、医疗服务提供者、客户及所有医疗体系相关方积极合作，围绕更高质量的NPS（净推荐值）体验展开深度参与。同时，我们坚定不移地致力于股东利益，持续为您带来稳定且强劲的投资回报。
The stability and the growth momentum of this enterprise are embedded in our character traits as a company, long-standing attributes that are core to UnitedHealth Group, to Optum and to UnitedHealthcare. These include being committed and guided by a single mission: helping people live healthier lives and making the health care system work better for everyone; adaptability in an ever-changing health care environment; dedication to consistent, fundamental execution, getting things right the first time and every time; a chronic institutional restlessness. We are far from performing to our natural potential, and we remain driven to constantly improve our businesses and thus our service to people and to markets. This restless drive is shared by well more than our 200,000 people who believe deeply in both our mission and our potential and work every day to see it fulfilled, led by some of the most talented health executives in the industry today. And importantly, a singular and enduring corporate culture centered around the values of integrity, compassion, innovation, relationships and performance. We are still growing in these values, which are becoming a vital part to our identity, our character, who we are and how we operate.
本企业的稳定性与增长动力，深深植根于我们的企业特质中——这些是联合健康集团、Optum 和 UnitedHealthcare 的核心长期特性。这些特性包括：坚守并以单一使命为引导——帮助人们过上更健康的生活，使医疗体系对所有人运作得更好；具备应对不断变化的医疗环境的适应力；坚持一贯的、基础性的执行力，每一次都要做到准确无误；以及一种持续的组织性“不安感”。我们距离自身的自然潜能仍有差距，这驱使我们不断提升业务，从而更好地服务于人群与市场。这种永不满足的进取精神已被我们超过20万名员工所共同拥有，他们对我们的使命和潜力深信不疑，每天都为实现它而努力。他们由当前业内最具才华的健康管理高管带领。此外，我们还拥有一个独特且持久的企业文化，以诚信、同理心、创新、关系与绩效为核心价值。我们仍在不断深化这些价值观，它们正逐步成为我们身份、特质、运营方式的核心部分。
We are moving into the future with strong forward momentum in our market growth and diversity; in our financial performance, our EPS performance and our steadily improving quality, our NPS performance; in developing trusting and deeper relationships with everyone we serve and in embracing the opportunity and the responsibility to drive our mission, and by doing so, experience remarkable growth and distinctive capital returns.
我们正以强劲的动能迈向未来，不仅体现在市场增长与多元化方面，也体现在财务表现、每股收益（EPS）、持续提升的服务质量和NPS成绩上；还包括与我们服务的每一位对象建立更深层、更具信任的关系，并勇于承担使命所带来的机遇与责任。通过这一切，我们实现了卓越的增长和独特的资本回报。
For all these reasons, we are looking forward to 2017 with renewed commitment and energy. When you consider the advances of the past decade in managed care penetration, in consumer participation, in value-based payment models, the applications of technology, the use of better -- the use of data to drive better performance and the introduction of first-generation digital services and the cumulative market effect of these changes that are -- these changes that are driving in the market, we see the next 10 years as holding even greater opportunity and growth than the last 10 years for this company.
正因为这些原因，我们怀着新的承诺和更大的热情展望2017年。回顾过去十年，管理式医疗的渗透、消费者的参与、基于价值的支付模式、技术的应用、数据在提升绩效中的使用、首代数字化服务的推出，以及这些变革在市场中所产生的累积效应——这些都在推动行业前行。因此，我们认为接下来的十年，对本公司而言将蕴含比过去十年更大的机遇与增长潜力。
I believe you'll find this enterprise continuing to grow and advance as we enable these forces for change and play an even more valuable role in the health care markets of the future. Our ultimate goal in the next decade is to reach that full potential. As we achieve that, we will be helping meet the health care needs of the consumers we serve and of society as well as any company on the globe and continuing to deliver exceptional performance to you, our shareholders.
我相信，随着我们不断释放变革的力量并在未来医疗市场中发挥更大价值，这家公司将持续成长与进步。未来十年，我们的终极目标是实现公司的全部潜能。随着这一目标的实现，我们将像全球最优秀的企业一样，满足我们所服务消费者和整个社会的医疗需求，同时持续为您——我们的股东——带来卓越的业绩表现。
Thank you, and I couldn't be more pleased now to put the conference into the exceptionally talented and capable hands of Dave Wichmann who has been my partner in every aspect of this enterprise for the nearly 20 years we've shared here and will now lead you through the day. Thank you.
谢谢大家。现在，我非常高兴将今天的会议交给戴夫·维奇曼（Dave Wichmann）——过去近二十年里，他是我在这家企业中每一项事务上的合作伙伴。他才华横溢、能力卓越，今天将由他带领大家继续深入会议内容。谢谢。
David Wichmann Former CEO & Director
Good morning. Thank you for being here with us today. We appreciate your investment of time to understand our business and the opportunities offered by the growing health care market. I hope you'll be able to join us for the clinical insights luncheon and the various seminars we have planned. They cover areas of both interests and complexity in health care as well as provide a deeper review of the opportunities we have for growth in 5 emerging market sub-segments: Medicaid long-term services and support, group Medicare Advantage, health care delivery, Specialty Pharmacy management and payer services.
大家早上好，感谢各位今天的到来。我们非常感激您愿意投入宝贵的时间来了解我们的业务，以及不断增长的医疗市场所带来的机遇。希望大家能够参加我们安排的临床洞察午餐会以及其他专题研讨会，这些内容涵盖了医疗领域中既关键又复杂的多个方面，也将更深入地探讨我们在五个新兴细分市场中的增长机会：医疗补助长期服务与支持（Medicaid LTSS）、团体医保优势计划（Group Medicare Advantage）、医疗服务提供、专科药房管理以及支付方服务。
As John Rex will describe, we have a very strong growth and financial outlook for 2017. Our business will achieve upwards of nearly \$200 billion in revenues, 20% growth in adjusted EPS and \$12 billion in cash flows from operations, virtually all organic, we believe a reasonable starting point for 2017 at this distance.
正如约翰·雷克斯稍后将详细介绍的那样，我们对2017年有着非常强劲的增长和财务预期。我们的业务预计将实现近2,000亿美元的收入，经调整每股收益（EPS）增长20%，经营现金流将达到120亿美元，几乎全部为内生增长。我们认为这是一个在当前阶段非常合理的起点。
This level of performance comes from our business model and from our people. The two are uniquely aligned around our single mission: to help people live healthier lives and to help make the health system work better for everyone. The alignment is also a cultural one. We have consciously been advancing our culture for 7 years now, supported by an intense focus on integrity, compassion, relationships, innovation and performance. Embedded in these values is a commitment to quality at the center of everything we do, quality defined by those we serve and measured outside-in through a Net Promoter Scoring system. This system drives continuous improvement in the level of trust we build and loyalty we achieve from those who access or support global health care. We want to be a better health care company and play a significant productive role in improving the health system, one we hope will provide more value to people than it does today.
这种业绩水平的取得，归功于我们的商业模式和团队。二者共同围绕一个明确的使命紧密结合：帮助人们拥有更健康的生活，并让整个医疗体系对所有人运行得更好。这种一致性同样体现在企业文化中。七年来，我们持续推动文化建设，始终专注于诚信、同理心、关系、创新与绩效五大核心价值。这些价值观的核心是一种对“质量”的坚定承诺——质量由我们所服务的对象来定义，并通过“净推荐值”（NPS）系统从外部视角进行衡量。该系统推动了我们在建立信任、赢得忠诚方面的持续改进。我们希望成为一家更出色的医疗企业，在改善整个医疗体系中发挥积极而有效的作用，为人们创造比今天更大的价值。
For us, health care is full of opportunity to help people more effectively, to unravel complex problems, to become simpler and to grow our business. It is a more than \$7 trillion growing global market and we are a mere 2.5% of it even with our relative size.
对我们而言，医疗行业充满了帮助他人、解决复杂问题、实现简化并推动业务增长的机会。全球医疗市场规模已超过7万亿美元，并仍在增长，而即使以我们目前的规模来看，我们的市场份额也仅占其中的2.5%。
Against the backdrop of some of the most challenging years in health care, we have built solid momentum in our mission and culture, in quality, in growth, in EPS and NPS, in benefits, in services and in the U.S. and increasingly abroad. There are still tough issues to be tackled. Millions in the United States still lack steady access to care and costs continue to climb. Whether existing public policies are refined or replaced, they need to be approached with a consumer mindset and then leverage the incredible capacities of the public and private domains to achieve the best possible outcome for people.
在经历了医疗领域中最具挑战性的几年背景下，我们在使命与文化、质量、增长、EPS 与 NPS、福利与服务、在美国及越来越多国际市场等方面都建立了坚实的增长动能。但困难依然存在：数百万美国人仍缺乏稳定的医疗服务可及性，医疗成本依旧持续上升。无论现有的公共政策是被优化还是被取代，都必须以“消费者思维”加以应对，并借助公共与私人领域强大的能力，以实现对人们最有利的结果。
These decisions are not unique to the United States. In just the last week, I was in South America and Europe, visiting 2 countries facing their own challenges and opportunities. Throughout the world, there are common themes: people don't find enough value in health care, there isn't enough access to high-quality care and the care that is needed costs more than people and governments can afford. That underscores the opportunity for a mission-minded health care company like UnitedHealth Group. We plan to be better at everything we do and deliver ever more distinctive value in 5 strategic growth areas we are particularly focused on serving: pharmacy care services, health care delivery, consumer-centric benefits, technology-enabled information and services and global opportunity.
这些决策并非美国独有。就在上周，我刚前往南美和欧洲，拜访了两个面临自身挑战和机遇的国家。放眼全球，存在一些共同的问题：人们在医疗服务中感受不到足够的价值；优质医疗资源获取不足；所需的医疗服务费用超出了个人和政府所能承受的范围。这进一步凸显了像联合健康集团这样以使命为导向的医疗企业的机遇。我们计划在所有业务中做到更好，并在五大战略增长领域提供日益突出的价值：药品护理服务、医疗服务提供、以消费者为中心的福利设计、技术驱动的信息与服务，以及全球化发展机会。
Our colleagues from UnitedHealthcare and Optum will discuss our engagement in these areas and our ambitions for 2017 in more depth, but let me give you some of the thinking behind the more recent extensions in our diverse offerings starting with our basic framework. We operate 1 company, 1 mission and 1 culture with 2 strategically aligned but distinct platforms, benefits and services, leveraging 3 core competencies, information, technology and clinical insights, all built on a core set of values that reflect recognition that we serve one of the most socially sensitive aspects of society: health care. We believe success for society and for us will be achieved when engaged consumers access a more modern, more intelligent and more aligned health system. This will provide high-quality consumer-responsive services, primarily in ambulatory care settings focused on better quality, lower cost and higher consumer satisfaction. These are the objectives that shape our business priorities and our growth investments.
来自 UnitedHealthcare 和 Optum 的同事将更深入地介绍我们在这些领域的布局以及对 2017 年的目标。但在此，我想先简要说明我们多元业务扩展背后的思路，先从基本框架讲起。我们是一家公司，一个使命，一种文化，运作着两个战略一致但定位不同的平台：福利与服务。我们依托三项核心能力——信息、技术与临床洞察——开展业务，这一切都建立在一套核心价值观之上，反映出我们所服务的领域——医疗——是社会中最为敏感、最需负责任的方面之一。我们相信，社会与企业的成功取决于：当积极参与的消费者能够接入一个更加现代化、智能化、协同化的医疗体系时。这一体系将主要通过门诊设置提供高质量、以消费者为导向的服务，聚焦更高质量、更低成本和更高满意度。这些目标共同引导着我们的业务重点与投资方向。
To that end, we are investing in pharmacy care services, not simply PBM capabilities. We are engaging consumers better at the point they access the health system with the highest frequency, the pharmacy transaction. Each encounter represents an opportunity to engage consumers in better managing their health care and closing gaps in care, many of which are caused by modifiable consumer behaviors or fragmented care. At the same time, pharmacy trends have elevated due to manufacturing pricing practices and the introduction of high-cost biologics. These drugs, while often effective, just as often carries substantial considerations related to patient safety and comparative effectiveness. Their introduction needs to be managed thoughtfully to ensure the right people receive the most clinically effective, safe therapies at the best possible value. This complexity and these emerging trends are why our pharmacy care services needed to be different. Our business takes a whole person integrated approach to manage all gaps in care, medical and pharmacy, using our vast data, technology and clinical knowhow. The approach is effective, saving consumers approximately \$1,300 per consumer per year in pharmacy spend while reducing medical costs by an additional \$130 to \$190 per consumer per year. This is an early emerging business for us, and Mark Thierer will discuss our considerable opportunity to better serve people and to grow our business.
为此，我们正在投资发展“药品护理服务”（而不仅仅是传统的药品福利管理PBM功能）。我们在消费者最频繁接触医疗体系的环节——药房交易时刻，与他们展开更深入的互动。每一次药房接触都是引导消费者更好管理健康、弥补护理缺口的机会——而这些护理差距往往源于可改善的消费行为或医疗碎片化。同时，由于制造商的定价行为和高价生物药物的引入，药品支出趋势明显上升。这类药物虽然通常疗效显著，但也涉及大量有关患者安全与治疗对比效益的重大考量。因此，它们的引入需要经过深思熟虑，以确保“适当人群”获得“最有效、安全、具有最佳价值”的治疗。这一复杂性以及新兴趋势正是我们必须打造差异化药品护理服务的原因所在。我们采取的是以“完整个体”为中心的整合式管理方法，借助我们庞大的数据、技术和临床知识，系统性地管理医疗和药品两方面的护理缺口。该方法十分有效，每位消费者每年可在药品支出上节省约1,300美元，同时在医疗支出上再减少130至190美元。这一领域对我们而言仍处于早期发展阶段，Mark Thierer 将进一步阐述我们在这一方向上服务人群与业务增长的巨大潜力。
Our health care delivery businesses are also designed to improve the value provided by the health system. You might recall a few years back we decided to pursue freestanding primary and ambulatory care in 75 markets constituting 2/3 of the U.S. population. Our experience so far in about 25 market shows we are reducing the use of emergency, acute and subacute services. We're providing consumers with more proactive health engagement and we're yielding higher-quality care and higher patient satisfaction at a lower cost. Today, in the more mature markets, we are seeing substantial positive impact on health system performance while achieving substantial investment returns. Eventually, each of these markets will consistently pursue a variety of aligned, value-based arrangements committing to achieve lower-cost, higher-quality health care for consumers. We aim to achieve a leading market position in this segment with returns on capital in the mid- to high teens. Amir Rubin will elaborate on this opportunity in just a moment.
我们的医疗服务业务同样旨在提升整个医疗体系所能带来的价值。大家可能还记得，几年前我们决定在75个市场（覆盖美国三分之二人口）发展独立设置的初级与门诊医疗服务。截至目前，在我们已投入运营的约25个市场中，数据显示我们已成功降低急诊、急性和亚急性服务的使用率。我们让消费者更积极参与健康管理，并在成本更低的前提下，带来更高质量的医疗服务与更高的患者满意度。如今，在那些发展更为成熟的市场中，我们已明显看到医疗体系运行效率的提升以及可观的投资回报。最终，这些市场都将持续推进各种一致的、以价值为导向的合作模式，致力于为消费者提供更低成本、更高质量的医疗服务。我们希望在这一细分领域中实现领先市场地位，并获得中到高十几个百分点的资本回报率。阿米尔·鲁宾（Amir Rubin）稍后将详细介绍这一机遇。
Consumer-centric benefits is a growth area we have pursued for decades yet we have just reached a point where shifts in the market have really come together with our product designs, clinical approaches, technology, information and service capacities. As they do, they are yielding distinctive value, which is producing sustained growth with 11 million domestic members added in the last 6 years, virtually all organically including striking growth momentum in Medicare. As access to care and coverage grows among all segments of the population, as it must, so, too, grows the need for private sector solutions. Our information-enabled clinical and social intervention services have made possible more clinically aligned, cost-effective approaches to serving a higher-risk patient base. These services also receive higher NPS scores from patients while saving states and the federal government billions of dollars annually.
以消费者为中心的福利服务是我们追求了数十年的增长领域，而现在市场的转变终于与我们的产品设计、临床方案、技术能力、信息系统及服务能力真正融合在一起。这种融合正在产生独特的价值，并带来持续增长——过去六年我们在美国本土新增了1100万名会员，几乎全部为内生增长，Medicare 业务尤其展现出强劲势头。随着全民对医疗服务与保障的可及性不断扩大——这是必然趋势——社会对私营部门解决方案的需求也随之增长。我们基于信息驱动的临床与社会干预服务，使我们能够以更具临床针对性、更具成本效益的方式服务于高风险患者群体。这些服务在患者中的NPS评分也更高，同时每年能为各州和联邦政府节省数十亿美元的支出。
We expect to grow at an above market rate for the foreseeable future. We will augment our organic growth in consumer-centric benefits by establishing and improving our market presence in select geographies. One recent example, our prospective new partnership with the Rocky Mountain Health Plan on the Western Slope of Colorado. This alignment provides continuity of coverage for the people of the Western Slope while extending our Colorado business statewide, leveraging a proven local market engagement model among the community, its doctors and the health plan.
我们预计在可预见的未来，将以高于行业平均水平的速度持续增长。我们将通过在特定区域建立和增强市场存在感，进一步推动以消费者为中心的福利业务的有机增长。例如，我们近期与科罗拉多州西坡地区的 Rocky Mountain Health Plan 正在洽谈新的合作关系。该合作不仅为西坡居民提供保障的连续性，还将我们的科罗拉多业务扩展至全州，并依托一个已被验证的本地市场参与模型，在社区、医生与健康计划之间建立协同。
Another example. We continue to advance a wider range of offerings enhancing health system's effectiveness in local communities, better serving the needs of lower-income consumers. We wrap the system and people with the services they need to make health care work better, services like more reliable transportation, housing, engagement tools and data, to name a few. We don't know exactly how large the addressable market potential is for us at this pilot stage. States spend as much on these services as they do on medical care for their Medicaid populations or around \$1.5 trillion. These services are proving essential to achieving health goals for people and budgetary goals for states. In all, we expect strong growth from our benefits businesses and expect each to sustain leading market positions across all 3 primary payer types: commercial, Medicare and Medicaid. Our UnitedHealthcare leaders will discuss with you how our support of consumers, health care providers and customers is leading to distinguished growth for our benefits businesses.
另一个例子是，我们持续拓展服务范围以提升本地社区医疗体系的有效性，更好地满足低收入群体的需求。我们围绕医疗体系与个人，提供所需的配套服务，让医疗真正发挥作用，例如更可靠的交通服务、住房支持、互动工具与数据服务等等。目前还处于试点阶段，我们尚无法准确评估该市场对我们而言的潜力规模。值得一提的是，各州在这类服务上的支出与其在 Medicaid 医疗服务上的支出相当，总额约达1.5万亿美元。这些服务被证明对于帮助人们实现健康目标、协助州政府实现财政目标都是至关重要的。总体而言，我们预计福利业务将保持强劲增长势头，并在商业保险、Medicare 和 Medicaid 三大主要支付类型中持续保持市场领先地位。UnitedHealthcare 的领导团队将向各位介绍我们是如何通过支持消费者、医疗服务提供者与客户，推动福利业务实现卓越增长的。
Underpinning the distinctive qualities of our business is a commitment to the use of information and technology to continuously improve individual health and the performance of health care. Here's one illustration: a few years back, we bought a small company, now called Rally Health. It was an innovative consumer wellness platform with about \$3 million in annualized revenues and around 50 people. Our vision was to evolve Rally into the world's most successful digital health care company, helping people select and enroll in their plan, assess individual health risk, administer health care more progressively and identify and engage in health improvement behaviors through missions, social networks and incentives. Today, Rally Health is well on its way to becoming the nation's leading digital health company with annualized revenues approaching \$400 million and employing 500 people in 2017. We're just getting started.
我们业务中之所以具备差异化特质，核心在于我们承诺始终利用信息与技术来不断改善个人健康状况和医疗体系绩效。举个例子：几年前我们收购了一家小公司，如今名为 Rally Health。当时它是一个创新的消费者健康管理平台，年收入仅约300万美元，员工也只有50人。我们的愿景是将 Rally 打造成为全球最成功的数字健康公司，帮助人们挑选并注册健康计划、评估个体健康风险、实现更进阶的健康管理，并通过任务系统、社交网络和激励机制，识别并促进健康行为。如今，Rally Health 正朝着全国领先的数字健康公司方向大步迈进，年化收入已接近4亿美元，预计到2017年员工规模将达500人。而这，仅仅是个开始。
Like Rally, other digital approaches such as Link, Real Appeal, Health Plan Manager and United In Motion reflect the progress we are making in digitizing health care and using information to help people and improve the performance of health systems. At substantially greater scale and impact through our OptumInsights efforts to meaningfully advance the performance of full health systems through its fast-emerging and growing technology-enabled information and service offerings. Bill Miller will show you how we are doing this in just a moment.
除了 Rally，我们还推出了 Link、Real Appeal、Health Plan Manager 和 United In Motion 等多项数字化产品，这些都体现了我们在推动医疗数字化、利用信息技术帮助人们、提升医疗体系表现方面所取得的进展。而通过 OptumInsights，我们正以更大规模、更深影响力加快这一进程，推出一系列技术驱动型的信息与服务产品，助力整个医疗体系效能的实质性提升。比尔·米勒（Bill Miller）将稍后向大家展示我们是如何实现这一目标的。
Last, but certainly not least is the global opportunity. Some people may not be aware we serve over 130 million people in 125 countries. Our offerings are small in most countries, but our nascent presence provides an avenue to develop relationships and gain market insights while providing substantive coverage, cross-border and assistant services to companies with a global footprint. Our most meaningful presence at this time is in Brazil, the second-largest private health care market in the world. Over the past 4 years, we have transformed Amil from a 2-city insurance company into a Brazilian health care enterprise with national scope and leading positions in health insurance, health care delivery and health care services. We operate Brazil's largest health insurance enterprise, serving 4 million people with full medical benefits and 2 million more in dental. We also operate the largest health care delivery company with 5,700 beds owned or affiliated. We have begun to pursue public-private partnerships through the use of data and information and have begun to support ambulatory services like oncology and surgical procedures in local communities. We plan to apply a similar model in priority development markets in the future with a focus on the larger, more developed markets where our services can be applied more broadly.
最后但同样重要的是全球发展机遇。可能并不是所有人都了解，我们目前在全球125个国家为超过1.3亿人提供服务。尽管我们在大多数国家的业务规模尚小，但这些早期布局为我们建立关系、获取市场洞察提供了渠道，同时也为拥有全球足迹的企业提供了实质性的保险覆盖、跨境服务与援助服务。目前，我们最具影响力的国际业务在巴西——全球第二大私营医疗市场。在过去四年中，我们将Amil从一家只在两座城市运营的保险公司，转型为一家覆盖全国、在健康保险、医疗服务提供及健康服务方面均处于领先地位的巴西医疗企业。我们运营着巴西最大的健康保险机构，为400万人提供全面医疗保障，另有200万人获得牙科保障。我们还运营着巴西最大的医疗服务交付机构，拥有或合作的病床数达到5,700张。我们已开始通过数据与信息推动公私合作项目，并已在当地社区支持包括肿瘤学与外科手术等门诊服务。未来我们计划在重点发展市场复制这一模式，特别是那些更大、更成熟、服务可广泛应用的市场。
We have a practical yet ambitious agenda for our company and for you here today. You'll get a broad view of our ever more diverse business and related growth ambitions, but what I hope will become most apparent is the energy and ambition of our team, the restless commitment we share to serve the evolving needs of the health care markets and for consumers and the grounding in our mission to help people live healthier lives and to help make the health system work better everyone. You'll see an intense focus on improving quality, not only what we do but how we do things and the impact on all those we serve and work with measured objectively through NPS. And you will see effort to advance our leadership in innovation, clinical insights, technology, information management, policymaking, consumerism, and importantly, consistent financial and capital disciplines with an emphasis on achieving total shareholder return.
我们为公司和在座各位制定了一个既务实又富有雄心的议程。今天您将看到我们日益多元化的业务布局及相关增长蓝图。但我更希望您能真切感受到我们团队所迸发的激情与雄心——我们对服务不断演变的医疗市场和消费者需求的执着承诺，以及我们所坚守的使命：帮助人们过上更健康的生活，让整个医疗体系为所有人运行得更好。您将看到我们高度专注于提升“质量”——不仅体现在我们做什么，还包括我们如何去做，以及这些行为对我们服务对象和合作伙伴所带来的影响，这一切都通过NPS系统客观衡量。同时，您也将看到我们致力于在创新、临床洞察、技术、信息管理、政策制定、消费者导向等领域保持行业领先，并持续秉持严格的财务和资本纪律，始终以实现股东的全面回报为核心目标。
Indeed, we have come a long way as a company, but we are not satisfied with our performance relative to our potential. Achieving our potential will be made possible only by the 225,000 people of UnitedHealth Group. We are grateful for their tireless contributions to this company and their compassionate approach to the more than 130 million people we are privileged to serve.
的确，我们作为一家企业已经走过了漫长的成长之路，但就潜力而言，我们对现有的表现还远未满足。实现潜力的关键，是联合健康集团22.5万名员工的共同努力。我们深知，没有他们不懈的付出与对我们所服务的1.3亿多人的关爱，这一切都无从谈起。
And few are as tireless in their pursuit of excellence as the Vice Chairman of UnitedHealth Group and Chief Executive Officer of Optum, Larry Renfro. Larry has a passion for growth, big and small. It's a discipline he brought to our company and you can see it play out across the entirety of our business, especially Optum, where he has architected growth performance like no other. So it is my pleasure to turn the stage over to Larry Renfro.
在追求卓越方面，鲜有人能像联合健康集团副董事长、Optum首席执行官拉里·伦弗罗那样执着。拉里对“增长”充满热情，无论是宏观还是微观。他将这一理念深植于公司的各个层面，尤其是在Optum业务中，他所构建的增长蓝图无可比拟。因此，我非常荣幸地将接下来的舞台交给拉里·伦弗罗。
Larry Renfro Former Vice Chairman
Thank you, Dave. Good morning, everyone. It is once again a privilege to speak with you about the evolution of our enterprise and the progress we are making on our mission to help improve global health systems and the health of the people these systems serve. UnitedHealth Group occupies a unique position in health care. Our customers use our innovative, uniquely effective capabilities across both health benefits and health services. Our resources and breadth position us to enable a progressive, better quality health care system for decades to come in the U.S. and across the globe. Our collective strengths are harnessed in an organizational design that respects our customer's interest, enables us to deliver greater performance and better value and allows us to establish broader strategic relationships. As a result, we can produce compelling improvements in health care for those we are privileged to serve.
谢谢你，戴夫。大家早上好。今天能再次与各位分享我们企业的发展历程，以及我们在实现使命——提升全球医疗体系和人群健康方面所取得的进展，是一种莫大的荣幸。联合健康集团在医疗行业中占据独特地位。我们的客户在健康福利和健康服务两大领域都能享受到我们富有创新性、独具成效的能力。我们的资源和业务广度使我们具备在美国及全球范围内推动医疗体系向更优质、更先进方向发展的条件。我们将这些集体优势汇聚于一套尊重客户利益的组织设计中，使我们能够交付更高的绩效、更优的价值，并建立更广泛的战略关系。因此，我们能够为有幸服务的人群带来令人信服的医疗改善。
There are many steps we take as an enterprise to move health care forward. We invest \$3 billion annually in technology. Participants across the health system benefit from the insights and innovations that emerge from this work each year. We build, we combine and deliver integrated care services and synchronize pharmacy care services for consumers across the U.S. and we are positioning these capabilities to serve international markets. We drive accuracy and accelerate the cycle time of revenue management and claims processing for health care payers, providers, and most importantly, patients.
为了推动医疗进步，我们在企业层面采取了多种举措。我们每年在技术方面投资30亿美元，医疗体系中的参与者每年都能从这些投入所带来的洞察与创新中受益。我们建设、整合并交付整合护理服务，并为全美消费者提供同步的药品护理服务，同时也在将这些能力拓展至国际市场。我们提升数据处理的精准性，加快收入管理和理赔流程的周转周期，从而为支付方、服务提供者，最重要的是为患者，带来实际价值。
We constantly evolve to meet the needs of the health care consumer by designing benefit plans informed by deeper levels of insight into the needs of specific populations. With these insights, we can accurately deploy advanced care support, wellness strategies and resources that improve the health of individuals and entire populations. These efforts reflect UnitedHealth Group system-wide focus, which is global in its ambitions.
我们不断进化，以满足医疗消费者的需求。通过深入了解特定人群的需求，我们能够设计出更加精准的福利计划。借助这些洞察，我们可以有针对性地部署先进的护理支持、健康管理策略和资源，从而改善个人乃至整个群体的健康。这些努力体现出联合健康集团在系统层面的战略重心——具备全球化的愿景。
In Brazil, we serve consumers through an integrated health plan and delivered care is centered in a market-leading hospital network. In line with our global strategy, we are developing these foundational assets as we build an integrated Health Care Services organization, one that can serve Brazil and ultimately the broader South American markets. We are investing to support the entire system market-wide with infrastructure, analytics, care delivery models and benefit designs.
在巴西，我们通过一体化的健康计划为消费者提供服务，并围绕领先的医院网络开展医疗服务。根据我们的全球战略，我们正以此为基础，打造一个整合式医疗服务组织，既可服务于巴西，也将服务于更广阔的南美市场。我们正持续投资于基础设施、数据分析、医疗服务模型与福利设计，以支持整个市场层级的医疗体系发展。
In England, we are supporting the National Health Service to achieve the vision set out in their Five Year Forward View, helping to make higher quality and lower cost a reality through the use of data, technology and new care models.
在英国，我们正协助国家医疗服务体系（NHS）实现其《五年远景规划》中提出的愿景，通过数据、技术和新型护理模型的应用，帮助其实现“更高质量、更低成本”的目标。
In the U.S., we support federal and state government agencies as they seek to fulfill their health care stewardship. You can see that in UnitedHealthcare where 5 new Medicaid markets are set to start in 2017 and in Optum's multibillion dollar veterans disability care awards, more specific examples of our work show that combining our businesses capabilities can generate value that far exceeds the sum of the parts. That is essentially true in applying our data
在美国，我们也积极支持联邦及州级政府机构履行其医疗服务监管职责。例如，UnitedHealthcare将在2017年开拓5个新的医疗补助（Medicaid）市场；Optum则获得了价值数十亿美元的退伍军人残障照护项目。这些具体案例都表明：当我们将多个业务能力加以整合时，所创造出的价值远远超出其部分之和。而在数据运用方面，这一点尤为明显。
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fundamental to innovation. Our ability to sustain this growth through continued innovation distinguishes the value we are able to deliver to the broader marketplace.
创新的根本在于数据。我们正是依靠持续的创新能力，才能维持当前的增长势头，并在更广泛的市场中展现出独特的价值。
We benefit from shared disciplines across UnitedHealth Group, principally, among them, a focus on continually elevating quality and customer satisfaction as measured by those we serve using tools like Net Promoter Score. We embed these principles into our culture. Every year at this conference, we share the mission and vision of our diverse organization.
我们受益于UnitedHealth Group内部所共享的各项原则和标准，最核心的其中之一，就是不断提升服务质量与客户满意度，而衡量这一点的标准，就是我们所服务对象的反馈，例如通过净推荐值（NPS）等工具。我们将这些原则深深植入企业文化之中。每年在本次大会上，我们都会分享这个多元化组织的使命与愿景。
Over the course of the day, I hope 2 things become clear: first, UnitedHealth Group has a distinct ability and inclination to build, nurture and sustain deep enterprise-wide relationships in an increasingly large scale. Because of the complex nature of health care, relationships that connect information, processes and accountability across the system are the only way to make transformative progress over time, and these relationships, yield growth. Over the past 5 years including 2016, UnitedHealth Group revenues will have grown by $82 billion and the majority of that growth is organic.
今天我希望大家能明确两点：第一，UnitedHealth Group拥有独特的能力与倾向，能够在不断扩大的规模中，建立、培育并维持企业范围内的深层关系。由于医疗本身的高度复杂性，唯有建立贯穿信息、流程与责任机制的系统性连接，才能实现持续的、根本性的转变，而这种关系，也会带来增长。包括2016年在内的过去五年中，UnitedHealth Group的营收增长了820亿美元，其中大部分来自内生增长。
Secondly, our goal is to make health care simpler and work better, most significantly on a human level. Examples from market leaders and other industries teach us that to make systems work more efficiently and simply, we cannot shy away from complexity. We must own it so that those we serve don't have to. We are restless about this and working with the urgency to harness the power of one of our greatest assets, which is firsthand insight into the processes underlying each level of the health system. Our people know health care and they operate in every corner of the system. We will not be satisfied until this complexity is simplified for all end users and we will be relentless in pursuing this goal.
第二，我们的目标是让医疗体系更简单、更有效，尤其是在“以人为本”的层面。市场领先者和其他行业的经验告诉我们，若要让系统更高效、更简洁地运行，我们不能回避复杂性，而是要主动承担，让服务对象不必为之操心。我们对此保持高度紧迫感，并致力于发挥我们最宝贵的资产之一：对医疗体系各个层级底层流程的第一手洞察。我们的人才了解医疗，他们遍布于系统的每一个角落。在我们能够将这份复杂性为终端用户全面简化之前，我们不会感到满足，并将为这一目标不懈努力。
Now let me talk specifically about Optum. Our people today, some 120,000-strong, serve organizations across the systems, care providers, employers, health plans, life sciences companies and governments, both here and abroad. Our service is designed to benefit the 115 million consumers we reach who deserve the best possible care, support and health outcomes. Our performance and the quality of our service can be attributed to an unwavering focus on the very same priorities we set for Optum at the start: simplifying our business, focusing on relationships, driving growth and strengthening leadership. Since 2011, Optum revenues have nearly tripled from just under $30 billion to more than $83 billion, and our earnings have grown at a 33% compounded annual growth rate.
接下来，我想具体谈谈 Optum。我们如今拥有约12万名员工，服务于各类组织，包括医疗服务提供者、雇主、健康保险计划、生命科学企业以及政府机构，遍布美国及海外市场。我们为1.15亿名消费者提供服务，致力于为他们带来最优质的照护、支持与健康结果。Optum 的业绩与服务质量，得益于自成立以来我们始终坚持的四大优先方向：简化业务、专注关系、推动增长和强化领导力。自2011年以来，Optum的营收几乎增长了三倍，从不到300亿美元上升至830多亿美元，盈利则以33%的年复合增长率持续提升。
In 2013, I made a commitment: to build strategic relationships that draw on the full breadth of Optum's capabilities. This year alone, we have established another 12 of these strategic long-term relationships and our strong momentum continues. Let me offer a few examples. In the first quarter, we announced the major relationship with Walgreens, focused on offering more choice to consumers and greater savings that benefit sponsors. This relationship has helped to drive OptumRx's strong performance this year. We also kicked off a broad technology partnership with leading health IT provider, Availity, to improve the claims process for payers, care providers and consumers. In the second quarter, OptumRx was privileged to be
2013年，我曾做出承诺：要建立能够充分发挥 Optum 全方位能力的战略合作关系。仅今年一年，我们就新建了12个长期战略合作关系，并持续保持强劲发展势头。让我举几个例子。第一季度，我们宣布与 Walgreens 建立重要合作关系，重点是为消费者提供更多选择，同时为计划发起人带来更大的成本节约。这一合作帮助 OptumRx 实现了今年的强劲表现。我们还与领先的健康科技公司 Availity 启动了广泛的技术合作，致力于改善支付方、服务提供者及消费者的理赔流程。第二季度，OptumRx 有幸参与到——
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then this past quarter, we reached agreement with Quest Diagnostics on a collaboration that spanned our enterprise starting with Optum360.
随后在上一季度，我们与 Quest Diagnostics 达成合作协议，合作将从 Optum360 开始，并扩展至整个企业范围。
Turning to the government market. Optum was honored to be awarded several multiyear, multibillion contracts by the Department of Veterans Affairs to provide disability exams for men and women of the military.
谈到政府市场，Optum 很荣幸获得美国退伍军人事务部（VA）授予的多个多年期、数十亿美元规模的合同，为现役及退役军人提供残疾鉴定服务。
An interrelationship that uniquely crosses OptumInsight and OptumHealth, we signed a long-term agreement with Allscripts to bring integrated technology and solutions to the market.
在横跨 OptumInsight 与 OptumHealth 的独特合作关系中，我们与 Allscripts 签署了长期协议，致力于向市场提供集成化的技术与解决方案。
And now today, we are pleased to announce a new relationship with CVS Health. It will provide access to medication for our members. The relationship will give consumers the ability to pick -- to really pick up 30- and 90-day prescriptions at CVS with preferred rates. We will continue to innovate with retailers like CVS to drive better outcomes from the pharmacy counter and greater efficiency from the back office, which is good for both our customers and for consumers.
今天，我们也很高兴宣布与 CVS Health 建立新的合作关系，为我们的会员提供用药服务。该合作将使消费者能够以优惠价格在 CVS 领取 30 天或 90 天的处方药。我们将继续与 CVS 这类零售商合作创新，不仅提升药房端的治疗结果，还提升后台运营效率，这对客户和消费者而言都是利好。
These new and diverse relationships are made possible by bringing together Optum's broad, unique capabilities to deliver value that sets us apart. In 2017, our job will be to serve our new partners with excellence and deliver consistent innovation as we continue to pursue a decades-long growth opportunity. We see that global market opportunity for Optum approaching $1.2 trillion including a U.S. market opportunity for health services of almost $700 billion and an international market that represents another $500 billion in potential.
这些新的多样化合作关系得以实现，正是因为我们整合了 Optum 广泛而独特的能力，从而交付出令我们与众不同的价值。2017年，我们的任务是在服务好新合作伙伴的同时，继续保持创新节奏，抓住这个我们已追求多年的长期增长机会。我们看到 Optum 面前的全球市场机会接近 1.2 万亿美元，其中美国健康服务市场的潜力约为 7,000 亿美元，国际市场则还有 5,000 亿美元的空间。
Today, a team of Optum leaders and experts will show you how we are addressing this opportunity. We do this by offering 5 core capabilities that match market and social needs: data and analytics, pharmacy care services, population health, care delivery and health care operations. You will note we start this list with data and analytics. It underpins everything we do. The same robust information powers all of our solutions. It brings deep, actionable insight to our customers and system partners, resulting in improved outcomes and lower cost every day. We serve a growing base of demanding, visionary customers and partners who are among the most advanced and courageous players in health care. They share our mission and are demanding more strategic, comprehensive data- and technology-powered solutions. They push us hard and we are better for it.
今天，Optum 的领导与专家团队将向各位展示我们是如何抓住这一机遇的。我们依托五项核心能力来匹配市场与社会的需求：数据与分析、药品护理服务、群体健康管理、医疗服务交付，以及医疗运营。请注意，我们首先强调的是“数据与分析”，因为它是我们所有业务的根基。这一强大的信息能力驱动着我们所有解决方案的实施，为客户和体系合作伙伴带来深刻、可执行的洞察，从而每天都能实现更好的健康成果与更低的成本。我们服务的客户与合作伙伴群体日益扩大，他们是医疗领域中最先进、最有远见、最有魄力的参与者。他们与我们拥有相同的使命，对我们提出更高的要求，要求我们提供更具战略性、更加全面的数据与技术驱动型解决方案。他们对我们的挑战也正促使我们变得更强。
Before I turn this over to the Optum team, I'll make a final and a central point. The people of Optum are our organization's greatest strength. Our team is dedicated to health care exclusively focused on the health system and will not deviate from the mission that has driven Optum from the start. I am grateful for their efforts. Optum leaders will demonstrate this morning how our people are bringing our capabilities together in new ways to take on the most critical challenges facing health care. We hope you come away with a deeper understanding of our commitment to a growing impact across the marketplace and appreciation for the tremendous opportunity in front of us.
在把话题交给 Optum 团队之前，我想强调最后一个也是最核心的观点：Optum 的员工是我们组织最宝贵的资产。我们的团队专注于医疗事业，专注于改善整个健康体系，并始终坚守自 Optum 创立以来的使命。我由衷感谢他们的付出。今天上午，Optum 的领导们将向大家展示，我们的员工如何以全新的方式将各种能力整合起来，直面医疗领域最严峻的挑战。我们希望您在今天能够更深刻地理解我们致力于在整个市场中发挥持续影响力的承诺，并感受到眼前这个巨大机遇所蕴藏的价值。
And there is no one better to keep this dialogue going than Bill Miller, CEO of OptumInsight.
接下来没有比 OptumInsight 首席执行官比尔·米勒更合适的人来继续这场对话了。
Bill Miller Former CEO
Thank you, Larry. Data and analytics have been a critical building block for our company for more than 40 years, delivering distinctive and actionable insights to our customers. Our industry-leading data set is the foundation. We start with nearly 180 million lives of claims data and 85 million lives of clinical data. Our data includes 5 billion medical procedures, 11 billion lab results and 4 billion diagnoses. We pair our data with thousands of dedicated people including data scientists and clinical experts, actuaries and programmers, just to name a few. On top of that foundation is a broad set of proprietary analytic solutions that unlock the value in our data. They help our customers translate data into actions that measurably improve health and cost outcomes.
谢谢你，拉里。数据与分析四十多年来一直是我们公司的关键基石，能够为客户提供独特且可执行的洞察。我们行业领先的数据集是整个体系的基础。我们起步于拥有近1.8亿人份的索赔数据和8,500万人份的临床数据。我们的数据涵盖了50亿次医疗操作、110亿条实验室结果和40亿条诊断记录。我们将这些数据与数千名专注的专家人才相结合，包括数据科学家、临床专家、精算师和程序员等。在这套基础之上，我们建立了一整套专有分析解决方案，从中释放出数据的真正价值。这些工具帮助我们的客户将数据转化为行动，从而在可量化的健康成果和成本效益上取得改善。
For example, Optum One is our analytics platform focused on predicting outcomes for populations and individuals, and today, is the nation's leading source of insights for physicians, hospitals and health systems. Nearly 700 hospitals have chosen Optum One, enabling almost 140,000 care providers to access its capabilities. In the last year alone, more than 100 additional hospitals have adopted Optum One. Top industry research firm, Frost & Sullivan, named Optum 2016 Company of the Year for population health management, citing our robust analytics as a unique strength.
例如，Optum One 是我们的分析平台，专注于预测群体与个体的健康结果。如今，它已成为全国范围内医生、医院及医疗系统获取洞察的领先来源。已有近700家医院选择了 Optum One，约14万名医疗服务提供者正在使用其功能。仅在过去一年，又新增超过100家医院采用该平台。顶尖行业研究机构 Frost & Sullivan 将 Optum 评为 2016 年度“群体健康管理公司”，并指出我们强大的分析能力是一项独特优势。
In payer analytics, our solutions are used by 20 of the top 25 U.S. health plans to improve claims processing and the quality of care. Our analytics drive real value by identifying the best actions to take at the right time such as when a doctor has the information she needs to guide a patient down the best care path and when the data alerts us to an at-risk health plan member who hasn't been following their treatment plan. The impact of analytics is also clear when we identify members of a population in greatest need and get them to the best care for their condition or when the benefit sponsor sees troubling health trends across their workforce and we help to reverse those trends.
在支付方分析领域，我们的解决方案已被美国排名前25位的健康保险计划中20家采用，用于提升理赔流程效率与医疗服务质量。我们的分析工具通过在关键时点提供最佳行动建议，从而创造真正的价值。例如，当医生获得了所需信息，能够引导患者选择最合适的治疗路径；或当数据系统提醒我们某位存在风险的会员未遵守治疗计划时。又如当我们识别出某一群体中最需要帮助的成员，并将其引导至最适合的治疗方案时；或当雇主发现员工健康趋势恶化，我们帮助他们逆转这一趋势时，这些都充分体现了数据分析的价值。
Those are just a few the examples. Analytics are hard at work across our business every day, driving innovation and value for every one we serve. Join me and now let's take a closer look.
以上只是其中一部分例子。分析技术每天都在我们业务的各个层面发挥作用，不断推动创新与价值，为我们服务的每一个人带来切实收益。请跟我一起深入了解。
[Presentation]
Mark Thierer Former CEO and Chairman
Good morning. I'm Mark Thierer, the CEO at OptumRx. Well, at OptumRx, we're using the most frequently utilized real-time consumer touch point in the entire health care system to fundamentally improve the care experience for over 64 million consumers. At the same time, we're bringing new levels of value to our benefit sponsors for whom we manage $80 billion in drug spend while processing more than 1 billion adjusted prescriptions per year.
大家早上好，我是 Mark Thierer，OptumRx 的首席执行官。在 OptumRx，我们正在利用整个医疗体系中最常被消费者使用的实时接触点——药房窗口——从根本上改善超过6,400万名消费者的用药体验。同时，我们也在为我们的福利计划发起人创造新的价值——我们每年管理800亿美元的药品支出，并处理超过10亿张经调整的处方订单。
So this year, we focused on advancing our strategic new business relationships to meet the changing needs of the marketplace. You heard Larry reference new partnerships we have with pharmacy leaders in this industry that give our
因此今年，我们重点推进了一些新的战略业务合作，以满足市场需求的持续变化。正如您从拉里的介绍中听到的，我们与业内领先的药房企业建立了新的合作伙伴关系，为我们带来了——
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at the right moment. We leverage Optum's clinical services and expertise to guide them to the highest quality care and support. Now this approach aligns the interests of both patients and payers and only Optum can do this.
在最关键的时刻，我们利用 Optum 的临床服务与专业知识，引导患者获得最高质量的护理和支持。这种方式能够让患者和支付方的利益保持一致，而只有 Optum 能够实现这一点。
Mark Thierer Former CEO and Chairman
Here to help me explain and illustrate exactly how we bring these capabilities together in pharmacy care services is Dr. Natasha Deckmann from OptumHealth. Hey, Natasha.
今天来帮我一起说明我们如何在药品护理服务中整合这些能力的是来自 OptumHealth 的 Natasha Deckmann 博士。嗨，Natasha。
Natasha Deckmann
Good morning, Mark.
早上好，Mark。
Mark Thierer
How are you?
你好吗？
Natasha Deckmann
I'm good.
很好。
Mark Thierer
Well, let's talk. Let's talk about Specialty Pharmacy in the biotech business. Obviously, one of the biggest problems our customers are facing today it's a very difficult challenge. We know that many specialty pharmacies fill prescriptions and occasionally will counsel a member but in our business at Optum. Our specialty pharmacists and our clinicians go much deeper. Now most of these patients, chronically ill patients with specialty conditions, have 3 and sometimes more co-morbidities, I mean, they're not well. So Natasha, maybe you can, for the group, share how Optum can help these folks.
那我们开始聊一聊吧。我们来说说生物科技行业中的专科药房服务。这显然是目前客户面临的最大难题之一，确实非常具有挑战性。我们知道，许多专科药房的主要职责是发药，偶尔也会向患者提供一些建议，但在 Optum，我们的专科药剂师和临床专家的介入要深入得多。这些病患，大多数是患有慢性病、罕见病或重症的患者，往往还伴有三种甚至更多的并发症，也就是说，他们的健康状况并不好。那么 Natasha，你能不能给大家举个例子，说明 Optum 是如何帮助这些人的？
Natasha Deckmann
Absolutely. Let's take a scenario, a patient of ours, Nancy. Nancy has multiple sclerosis and she called us to refill her prescription. And of course, our first goal was to do that, was to give her, her specialty medication. But once we did that, that was when our holistic approach really came to life. Because our nurses can see much more about Nancy than her pharmacy information, they can see her medical information, her clinical, her lab information. They're able to identify interventions that are appropriate for Nancy to better manage her health. Nurse explained to Nancy that she was eligible for such a program that would go far beyond medication adherence. It would help her manage her daily life living with diabetes. Nancy really appreciated this and enrolled immediately.
当然可以。我们就以 Nancy 为例，她是我们的患者之一，患有多发性硬化症。有一次她打电话来要求续配处方药，当然，我们的首要目标是及时为她提供所需的专科药物。但正是在完成这一步之后，我们的整体式护理模式真正发挥了作用。因为我们的护士不仅能看到她的用药记录，还能查看她的完整病历，包括医疗记录、临床数据和实验室检测结果。我们可以据此为 Nancy 识别出更适合她的干预措施，以便她更好地管理健康。护士告诉她，她符合参与某个项目的资格，而这个项目远不只是“用药依从性”那么简单，它可以帮助她更好地管理糖尿病带来的日常生活挑战。Nancy 对此非常认可，并立即加入了该项目。
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and hypertension. And again, like Nancy,
以及高血压。同样地，像 Nancy 一样……
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he called us to refill his prescription but while on the phone, and in so doing, she was actually screening him for depression because we know that's a risk for patients with multiple chronic conditions, but had to be a conversation not a checklist or Michael wasn't going to engage. So while on the phone with him, we used our integrated care system to check his benefits, identify eligible clinical programs and then get him to a behavioral health support team member. And in that moment, we were able to address the risk before it led to an issue. Michael can stay on his care plan, avoid sick days at work and stay healthier in the long run.
他打电话来续配处方药。在通话过程中，我们的护士实际上正在对他进行抑郁症筛查，因为我们知道，对于患有多种慢性病的患者来说，这是一项潜在风险。但这个筛查不能像填问卷一样，而必须通过自然的对话引导，否则像 Michael 这样的人是不会配合的。于是，在通话的同时，我们利用综合护理系统检查了他的福利状况，识别出他符合哪些临床项目的条件，并将他转介至我们的行为健康支持团队。就这样，我们在问题真正发生之前便及时干预，解决了风险。最终，Michael 能够继续坚持他的治疗计划，避免因病请假，更重要的是，从长远来看保持更好的健康状态。
这种的互动不解决根本性的问题，HIMS的方案更合理，问题是更好的互动=更多的需求，谁来支付费用？HIMS的策略看着非常好。
Mark Thierer Former CEO and Chairman
Well, I think you can tell from Natasha's comments that in both of these cases, Nancy and Michael, Optum went deeper and really addressed this whole-person approach and we supported these folks on their journey to better health and containing costs. And it is making an impact. We're seeing reductions in in-patient admissions, reductions in emergency room visits. We're seeing consumers participating at a whole new level in taking better care of themselves and their being more adherent to their medications. We're proving this. And importantly, for plan sponsors, we're seeing reductions in pharmacy and overall medical costs.
我想大家从 Natasha 的分享中可以明显感受到，不论是 Nancy 还是 Michael 的案例，Optum 都采用了更深入的“整体式护理”方法，全方位支持患者实现更好的健康结果并控制医疗成本。这种做法正在产生实际影响——我们看到住院率在下降，急诊访问次数在减少；我们也看到消费者开始以全新的方式参与自我健康管理，对药物治疗的依从性显著提高。我们已经证明了这一点。更重要的是，对于福利计划发起方而言，我们还观察到药品成本和总体医疗支出的双重下降。
So that's what pharmacy care services is really all about and it's all about going beyond the prescription. Thank you, Natasha.
这就是药品护理服务的真正意义所在——它远不止于发药，更是超越处方的整体健康管理。谢谢你，Natasha。
Natasha Deckmann
You're welcome.
不客气。
Mark Thierer
And I'd like to welcome John Prince.
接下来，让我们欢迎 John Prince。
John Prince Former President & COO
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It's about our core capabilities. Over my decade at Optum, population health management has grown to represent one of the best examples how we bring our expertise, people and capabilities together to help our clients, our partners and the consumers we serve. Together, through this approach, we actively meet the unique needs of a population driving value, high quality care and better outcomes to a consistently better consumer engagement.
我们要讲的是我们的核心能力。在我效力 Optum 的十年中，“群体健康管理”已经成长为最能体现我们如何将专业知识、人才和能力整合在一起，为客户、合作伙伴及服务对象创造价值的典范。通过这一方法，我们能够积极应对不同群体的独特需求，推动价值创造、优质医疗服务与更好的健康结果，同时也实现了持续优化的消费者参与度。
There are 3 key components to population health at Optum: consumer engagement, data and analytics, and clinical services. The most challenging and critical aspect of population health is effective and sustained consumer engagement. Our patented consumer analytics provide a more complete understanding of consumers' health needs and opportunities, enabling us to engaging with the best guidance and support when and where they're most receptive. Data and analytics are the core of our approach.
在 Optum 的群体健康管理中，有三大关键组成部分：消费者参与、数据与分析、以及临床服务。其中最具挑战性、也是最关键的，就是“有效且持续的消费者参与”。我们拥有专利的消费者分析技术，能够更全面地理解消费者的健康需求与干预契机，从而在最适当的时间与环境中，为他们提供最有指导意义的支持。而“数据与分析”正是我们整个方法的核心所在。
Care providers use Optum One to stratify their patient populations and identify those who need more support for interventions to close gaps in care. Benefit sponsors use our data visualization and reporting solutions to better understand the quality and true costs of the population health and strategies, insights they continually use to improve their programs.
医疗服务提供者利用 Optum One 对患者群体进行风险分层，并识别出最需要干预与支持的对象，以填补护理缺口。福利计划发起方则使用我们的数据可视化与报告工具，更深入地了解其群体健康管理项目的质量与真实成本，并借此不断优化自身计划。
Finally, our clinical services and expertise are best applied to support pilot population health, and pharmacy care services is a good example of that. There are many other examples you'll recognize [ph] in the Optum Health business, including leading wellness, care management and behavioral health programs.
最后，我们的临床服务与专业知识在群体健康管理试点项目中得到了充分应用，其中药品护理服务就是一个典型例子。在 Optum Health 的业务中还有许多类似的示范项目，例如领先的健康促进计划、护理管理服务，以及行为健康项目。
Our specialized care networks and growing care delivery organization focus on the right care at the right place at the right time with the right cost. And Optum Bank empowers its people to own their financial health, providing a range of services to help them save, invest and pay for health care. Together, these programs impact tens of millions of people.
我们的专科护理网络以及日益壮大的服务交付组织专注于在合适的时间、地点，以合理的成本，为患者提供恰当的医疗服务。而 Optum Bank 则在“金融健康”方面赋能用户，提供一系列服务帮助他们储蓄、投资并支付医疗费用。这些项目共同影响了数千万人的生活。
Population health is a core competency at Optum. It draws in a full spectrum of our core capabilities in people, and we do it at large scale. We have 10,000 people who spend their days directly engaged in supporting the population health needs of our customers. They answer important questions, identify gaps in care and guide them to resources in the care that they need, all with the human touch.
群体健康管理是 Optum 的核心能力之一。它汇聚了我们在人才方面的全部核心能力，并以大规模开展。目前，我们有约1万人每天专注于支持客户的群体健康需求。他们解答关键问题、识别护理缺口、并引导患者获取所需服务——始终保持“以人为本”的服务理念。
I'd like to welcome Sarah King and Jon Bunker, who'll provide 2 unique perspectives on how Optum helps improve and sustain population health for our customers. Thank you.
接下来，我要邀请 Sarah King 和 Jon Bunker，他们将分别从不同角度出发，分享 Optum 是如何帮助客户提升并维持群体健康管理绩效的。谢谢大家。
Sarah King
Thanks, John. My name is Sarah King, and I lead Optum's large employer team responsible for our relationship with companies like Best Buy.
谢谢你，John。我是 Sarah King，负责 Optum 大型雇主客户团队，管理我们与像 Best Buy 这样的企业客户之间的合作关系。
A few years ago, Best Buy came to us as they wanted to create a culture of health across their 125,000 employees. And core to that, they wanted more of their employees to access all of the services that they make available for them, but they wanted to do in a way where they would be able to achieve sustainable cost savings. So Optum partnered with Best Buy on a fully integrated population health model.
几年前，Best Buy 找到我们，他们希望在其 12.5 万名员工中建立起“健康文化”。关键在于，他们希望员工能够真正利用上公司为他们提供的所有健康服务，但同时实现可持续的成本节约。因此，Optum 与 Best Buy 合作，建立了一个全面整合的群体健康管理模型。
Now this model is comprehensive, including many of the services that John referenced. However, what sets it apart is our ability to motivate individuals to take action on their health. I'd like to share 3 examples of how we do that.
这个模型非常全面，涵盖了 John 刚才提到的许多服务。但它的独特之处在于，我们能够激发个体主动采取健康行动。让我分享三个具体例子：
First, we delivered personalized communications to Best Buy members, specific to a call, the action around their health needs. Next, we offered a personal advocate as a single point of contact for Best Buy employees and their family members. Now this advocate is available to answer any question they might have but also to redirect them to all the services that Best Buy offers. We also embedded a health specialist on-site at Best Buy. Now this specialist works like a wellness champion and really is an extension of the Best Buy HR team, helping identify new ways to engage the population and also bring that culture of health to life.
第一，我们向 Best Buy 员工提供了个性化的健康沟通信息，具体到与其健康需求相关的行动建议。第二，我们为 Best Buy 员工及其家属提供了专属健康顾问，作为唯一联络人。这个顾问不仅可以解答任何问题，还能引导员工使用 Best Buy 提供的各类服务。第三，我们还派驻了一位健康专家常驻 Best Buy，总部现场，担任类似“健康大使”的角色，作为 HR 团队的延伸，帮助发掘新的员工参与方式，并真正将“健康文化”落地。
When we deployed these strategies, we saw engagement rates rise dramatically. More than 50% of members are more engaged than they were previously, and employee use of wellness and coaching programs more than doubled. This means individuals are getting access to the care that they need. We saw 70% increase in the number of care guest result, and hospital admissions dropped by 15%. Now this increased engagement is more than just activity. It's translating into real cost savings for Best Buy.
当我们实施这些策略后，员工参与率大幅提升。超过一半的员工比以往更积极参与，员工使用健康与辅导项目的频率翻倍。这意味着员工真正得到了他们所需的健康服务。我们看到护理服务使用量增长了70%，住院率下降了15%。这种参与度的提升不仅仅是“活动量”的增长，它已经转化为 Best Buy 的实际成本节约。
Since our partnership on this population health model began over 4 years ago, Best Buy's total medical cost savings have nearly doubled. Our partnership with Best Buy continues to grow. Optum is serving Best Buy members, irrespective of the health plan that they have. And that culture of health is taking hold.
自从4年前我们合作建立这个群体健康模型以来，Best Buy 的整体医疗成本节省几乎翻倍。我们与 Best Buy 的合作持续深化，无论员工参与的是哪家健康保险计划，Optum 都为其提供服务。而“健康文化”已在这家公司真正扎根。
Jon?
Jonathon Bunker
Thank you, Sarah. Good morning, everybody. My name is Jon Bunker, and I have the privilege of leading Optum Care's West region. Best Buy is a great example of how we help benefit plan sponsors to engage members. But I'd like to pivot from the benefit plan sponsor and speak with you a little bit about how Optum Care's provider groups, and in this case Southwest Medical Associates, approaches population health from a direct health care delivery perspective.
谢谢你，Sarah。大家早上好，我是 Jon Bunker，负责 Optum Care 西部地区的业务。Best Buy 是一个很好的例子，说明我们如何协助福利计划发起方提升成员参与度。但接下来我想从另一个角度谈谈：Optum Care 的医疗服务提供者团队——以 Southwest Medical Associates 为例——是如何从“直接医疗服务交付”的角度开展群体健康管理工作的。
For context, Southwest Medical Associates is a wholly-owned subsidiary of Optum Care. It's located in Las Vegas, Nevada, and it employs nearly 400 primary and specialty care providers. In early 2016, Southwest Medical partnered with one of its largest and most important clients, that being the Station Casinos Group, with the overall objective to improve the employee health care of that population.
补充一下背景，Southwest Medical Associates 是 Optum Care 全资子公司，位于内华达州拉斯维加斯，雇用了近400名初级及专科护理人员。2016年初，Southwest Medical 与其最大且最重要的客户之一——Station Casinos 集团展开合作，目标是全面改善该企业员工的健康状况。
Using the Optum One analytical tool, Southwest Medical identified over 1,500 patients within the Station Casinos' population, who had diabetes, and developed a personalized experience for those who are at the highest risk of potentially meeting hospitalization or emergency room services in the future. Southwest Medical's care managers contacted each of these patients individually, and within 15 days, over 60% of them had an appointment with their physician. I want you just to imagine for a second that you might have been one of those employees and receive that telephone call. That emotional connection that is made at that point between a patient and a provider creates such a bond of confidence and trust.
Southwest Medical 借助 Optum One 分析工具，在 Station Casinos 员工中识别出超过1,500名糖尿病患者，并为其中未来有住院或急诊风险最高的一部分人制定了个性化的健康管理方案。护理经理逐一联系了这些患者，仅在15天内，超过60%的人就安排了与医生的面诊。我想请大家设想一下：如果你就是这名员工，在接到那通电话时，患者与医生之间所建立的情感联系会激发一种信任与安全感的纽带。
Well, within months, we saw significant improvements. Those patients who saw their provider and received a personalized care plan saw significant improvements in their cholesterol levels, their blood sugar levels, decreases in body mass index and were more compliant with their insulin usage and used it more appropriately and timely.
短短几个月内，我们就看到了显著的健康改善。那些按时就诊并获得个性化护理方案的患者，其胆固醇水平和血糖水平都有明显改善，体重指数（BMI）下降，胰岛素的使用依从性提升，使用频率也更加合理及时。
This engaged population of patients, together with this specialized care plan they received by their physician and the encouragement and follow-up for the physician, they were able to avoid emergency room usage and lower their overall health care spend by over 20%. For those individuals that didn't see a doctor received that personalized care plan, it's the complete opposite. All those same indicators that I mentioned, blood sugar, cholesterol, body mass index, all rose together with their corresponding increase in health care cost as opposed to a decrease. That's the difference an effective population health strategy can make.
在积极参与的这部分患者中，由于接受了医生制定的个性化护理方案以及后续的鼓励与跟进，他们避免了急诊使用，总体医疗支出也降低了超过20%。而那些未就诊、未接受护理方案的患者，情况正好相反：血糖、胆固醇、BMI 等指标全面上升，相应的医疗支出也随之上升。这正是有效的群体健康管理战略所能带来的巨大差异。
Optum Care's provider groups, in this instance Southwest Medical Associates, is able to engage members at a higher level, close gaps in care, lower medical costs, and not only identify but treat a health care condition before it becomes more serious and more costly.
Optum Care 的医疗服务团队——此次的 Southwest Medical Associates——展现出高水平的成员参与能力，能够有效填补医疗护理缺口、降低医疗成本，并在疾病变得更严重、治疗代价更高之前，及早识别并干预。
Thank you for allowing Sarah and I to share these important examples with you this morning. We'd now like to invite to the stage Amir Rubin, who joined us earlier this year after leading the Stanford University Health System. Amir?
感谢大家今天上午聆听我和 Sarah 分享这些重要案例。接下来请允许我邀请 Amir Rubin 上台发言，他在加入 Optum 之前曾担任斯坦福大学医疗系统的领导者。
Amir Dan Rubin Former EVP & Group CEO of Optumcare, PCS Group - Population Health Svcs & Optum360
Thank you, Jon. Care delivery gives Optum a primary access point to consumers, where we directly influence and improve their health, experiences and outcomes, and where we drive value and improvement from the center of the health care system. We carefully invest in leading providers in markets, where we can make meaningful impacts on the health of the community. These are progressive providers with a population, accountability and risk mindset. We bring the full capabilities of Optum to the table, clinical insights, best practices and consumer engagement models from OptumInsight, data and analytics, advanced technology and scaled operations, and expertise from across Optum on how to effectively manage risk.
谢谢你，Jon。医疗服务交付是 Optum 连接消费者的主要入口，在这个环节上，我们能够直接影响并改善人们的健康、体验和治疗结果，同时也从医疗体系的核心推动价值与绩效的提升。我们在目标市场中有选择地投资领先医疗服务提供者，以在社区健康方面产生实质性影响。这些合作方具备进步的理念，具备群体健康管理、问责机制和风险管理的思维。我们将 Optum 的全方位能力引入其中——包括来自 OptumInsight 的临床洞察、最佳实践与消费者参与模型，强大的数据分析能力、先进的技术平台和规模化运营经验，以及来自整个 Optum 团队在风险管理方面的专业知识。
Today, we are advancing care delivery in several ways, through primary care, urgent care and broader clinical services. Through 20,000 physicians, our clinical practices delivered care in 26 markets nationwide. Our growing leadership in urgent care includes one of the nation's largest neighborhood care center networks, MedExpress.
如今，我们正在通过多种方式推进医疗服务交付，包括初级护理、急诊护理以及更广泛的临床服务。我们拥有 20,000 名医生，在全美 26 个市场提供临床医疗服务。在急诊护理方面，我们日益展现出领导力，其中就包括 MedExpress——全美最大的邻里医疗中心网络之一。
By the end of the year, we'll have nearly 200 MedExpress locations in 15 states, with plans to meaningfully expand our footprint in 2017. Our clinical services extend and complement our clinical practices. We are one of the largest commercial employers of advanced practitioners in the United States, and many of these 6,500 professionals care for patients with complex needs in their homes or in long-term care facilities.
到今年年底，MedExpress 将在 15 个州开设近 200 家门店，并计划在 2017 年大幅拓展布局。我们的临床服务不仅延伸了临床业务，也与其形成互补。我们是美国最大的高级执业医师雇主之一，旗下约 6,500 名专业人士为需求复杂的患者提供上门或长期护理机构的医疗服务。
Through our HouseCalls business alone, they complete more than 1 million home visits per year, and we remained honored to support the health needs of military members and veterans through clinicians in our logistics health business.
仅通过我们的 HouseCalls 上门医疗服务，每年就完成超过 100 万次居家就诊。我们也非常荣幸，能通过后勤健康业务的临床医生团队，为军人和退伍军人提供健康支持。
Importantly, our model is multi-payer to ensure the broadest population possible can access higher-quality care in the communities we serve. Today, our physicians work with more than 80 health care payers across the country. Our care providers deliver notable improvements in quality and value for these payers and their populations.
重要的是，我们采用多支付方（multi-payer）模式，确保在我们服务的社区中，尽可能广泛的人群都能获得更高质量的护理。目前，我们的医生与全美超过 80 家医疗支付方合作，为其服务人群带来了显著的质量和价值提升。
For 2017 CMS Star Ratings, about 90% of Optum Care's Medicare Advantage patients will be in plans rated 4 stars or higher. And one of our plans in Texas is one of only 12 5-star plans in the nation. Our growth potential is significant on a national scale.
在 2017 年 CMS（联邦医疗保险服务中心）的星级评分中，约 90% Optum Care 的 Medicare Advantage（优选医保）患者参与的计划获得了 4 星或以上评级。在德州，我们的一项计划是全国仅有的 12 个 5 星计划之一。从全国视角来看，我们的增长潜力巨大。
With our care delivery practices alone, we plan to grow our physician base by 40%, in addition to entering new markets, attracting more patients and developing new payer relationships. Ultimately, we believe that full scale, primary care-driven, ambulatory care services can help improve the care and health of the people we're privileged to serve.
仅在医疗服务交付领域，我们计划将医生团队扩充 40%，同时进入新市场、吸引更多患者并建立新的支付方合作关系。我们坚信，由初级护理驱动的全面门诊护理服务将有效改善我们有幸服务人群的健康与治疗体验。
Now I am pleased to welcome Dr. Todd Staub, who has been a primary care physician for 32 years and helped build one of the largest primary care groups in the nation. Dr. Staub?
现在我很高兴邀请 Todd Staub 博士上台。他从事初级医疗服务已有 32 年，并参与创建了全美最大规模的初级医疗集团之一。Staub 博士，有请。
Todd Staub
Thank you, Amir, and good morning. My name is Todd Staub, and I served as Chairman of ProHealth Physicians for the last 16 years. Almost 2 decades ago, we founded ProHealth Physicians from 81 small primary care practices in the state of Connecticut. Over that next period of time, from those beginnings, we created one of the largest integrated primary care group practices in the country. And in December of 2015, we decided to join OptumCare and become part of Optum.
谢谢你，Amir，早上好。我是 Todd Staub，过去 16 年担任 ProHealth Physicians 的董事长。近二十年前，我们在康涅狄格州从 81 家小型初级医疗机构起步，创立了 ProHealth Physicians。随后，我们将这些资源整合，打造出全美最大型的综合初级医疗集团之一。2015 年 12 月，我们决定加入 OptumCare，成为 Optum 的一部分。
We made that decision because we needed a partner who could bring us the resources, capabilities and expertise to help us transition to a new value-based model of health care. We needed a partner who understood the importance of primary care in redesigning a health care system that works for people. And we needed to partner who honored, as much as we do, the core values in medicine that are based on trust and strong long-term relationships with the people that we serve. We found that partner in Optum.
我们之所以做出这个决定，是因为我们需要一个合作伙伴，能够为我们提供资源、能力与专业知识，帮助我们转型至一种全新的“以价值为基础”的医疗模式。我们需要的是一个真正理解初级医疗在重塑以人为本的医疗体系中所扮演核心角色的合作伙伴；也是一个像我们一样重视医学核心价值观——即建立在信任与长期关系之上的合作伙伴。我们在 Optum 找到了这样一个伙伴。
Since joining Optum, we have redesigned and refocused our population health strategy in important ways. One example is the field teams that we created to go right into the homes of the 62% of our elderly population. By bringing the right resources to the point of service, we're able to help people avoid the emergency room, avoid unnecessary hospitalizations, avoid days in the nursing home, all while keeping people where they most want to be, right in their own homes. Alone our physicians would not have been able to do this without the help of Optum.
自从加入 Optum 以来，我们从多个关键方面重新设计并聚焦了我们的群体健康战略。举个例子，我们建立了现场服务团队，走进我们老年患者中的 62% 的家庭中。通过将合适的资源直接带到服务现场，我们帮助人们避免进入急诊室，避免不必要的住院治疗，避免长期入住疗养院，同时让他们得以留在自己最想待的地方——他们的家中。仅凭我们自己的医生，是无法做到这些的，Optum 的支持使这一切成为可能。
Now we are part of building something greater. We are joining with some of the best medical groups from around the country to create a new kind of delivery system, one that is based on a strong foundation of primary care, one that is embedded in the communities and neighborhoods where our patients live, one that adapts to the regional variations in local markets that we find ourselves in, and one that meets people where they are and brings health care to them. We believe that this new delivery system that we're building together could lead the transformation of health care in our country. And so that is why in ProHealth Physicians, we feel that this decision to join Optum is one of the best decisions we have ever made. Thank you.
现在我们正在参与打造更伟大的事业。我们正与全国最优秀的一些医疗团队携手合作，建设一种全新的医疗服务交付系统：它以强大的初级医疗为基础，扎根于我们的患者所生活的社区与街区，能够灵活适应本地市场的区域差异，并且真正“走向人群”，将医疗服务送达他们所在之处。我们相信，这种我们共同建设的新型医疗服务交付体系，能够引领美国医疗体系的变革。因此，在 ProHealth Physicians，我们深信加入 Optum 是我们所做过最正确的决定之一。谢谢大家。
Norman Wright
Good morning. I'm Norman Wright. Today, I'm going to talk about some vital capabilities we put to work behind the scenes for having a profound and growing impact on the system. These capabilities are doing the unseen critical work of health care by targeting the processes, workflows and administrative functions needed to make the system work better.
大家早上好，我是 Norman Wright。今天我要谈谈一些我们“幕后”运作的关键能力，它们对整个医疗体系正产生深远且日益增强的影响。这些能力聚焦于流程、工作流以及管理功能，是那些虽不为人见却对提升系统运作至关重要的医疗支持力量。
As you've seen throughout our discussion today, all of our customers and system partners are seeking to use data and technology in new and transformative ways. Optum is accelerating that evolution by helping them put the data to work and essentially rewire and modernize our operations. We have improved the efficiency of critical administrative processes and workflows through technology, consulting, managed services as well as specialized IT and business process services. Diversity and scale of our offerings allows us to serve as a key partner in virtually every aspect of health care operations.
正如今天大家所看到的，我们的客户和体系合作伙伴都在努力通过全新方式运用数据和技术来实现转型。Optum 正在加速这一过程，帮助他们真正将数据转化为实际应用，从根本上“重构”并现代化运营体系。我们通过技术、咨询、托管服务以及专业 IT 与业务流程服务，大幅提升了关键管理流程与工作流的效率。我们服务的多样性与规模使我们几乎能成为医疗运营各个方面的核心合作伙伴。
We also provide modern technologies and expertise to make the interactions among health care payers, care providers and other industry stakeholders, smoother and more effective for everyone, including consumers. And we have thousands of people doing administrative work, ranging from field-based staff in hospitals, coders, clinicians and customer service staff. An example of how we're improving operations is payment integrity.
我们还提供先进的技术与专业知识，使医疗支付方、护理提供者与其他行业相关方之间的互动更顺畅、更高效——包括对消费者而言都是如此。我们拥有数千名从事管理工作的员工，涵盖医院现场人员、编码员、临床人员和客服人员等。我们在运营改进方面的一个重要案例是“支付准确性”（payment integrity）。
Reimbursement is one of the most of fragmented processes and one of the most complex processes in health care today, but it doesn't have to be that way. Our managed services, technology and consulting offerings are improving all aspects of the process. We help health plans ensure that they make the correct payment on a right claim at the right time and realize billions in annual savings as a result.
赔付流程是当前医疗系统中最碎片化、最复杂的流程之一，但并不必须如此。我们的托管服务、技术与咨询产品正改善这一流程的方方面面。我们帮助健康保险计划确保在正确的时间，为正确的索赔做出正确支付，从而每年实现数十亿美元的节省。
Optum360, our revenue management business, was founded just 4 years ago. And today, we have over 10,000 people dedicated to this business; and in 2017, we will manage $60 billion in billings for our partner organizations. 4 out of 5 U.S. hospitals rely on at least one Optum360 revenue management solution. And there is an opportunity to expand those relationships and deliver even more patient satisfaction.
Optum360 是我们的收入管理业务，成立仅四年。目前我们已有超过一万名员工专注于这项业务。2017年，我们将为合作机构管理 600 亿美元的账单。全美五分之四的医院至少使用过一种 Optum360 的收入管理解决方案。未来我们有巨大的机会扩大这些合作关系，进一步提升患者满意度。
Now let's take a closer look at Optum360 and how our team is innovating with health system leaders to modernize revenue management. I'd like to welcome Todd Gustin from the Optum360 team. Todd?
现在，让我们深入了解一下 Optum360 以及我们的团队如何与医疗体系领导者合作，推动收入管理现代化。有请 Optum360 团队的 Todd Gustin 上台。Todd？
Todd Gustin
Thank you, Norman. I'm Todd Gustin. I've had the privilege of working for Optum360 since its formation. Each year, Optum360 is making the coding and claims process more timely, more accurate and less labor-intensive in ways that only Optum360 can. One example. Coding and claims used to be done manually. Today, our clients can do it in real time using our proprietary natural language processing and computer-assisted coding technologies.
谢谢你，Norman。我是 Todd Gustin，自 Optum360 成立以来，我一直很荣幸在这里工作。每一年，Optum360 都在推动编码与理赔流程变得更加及时、准确、低人力投入——这正是我们 Optum360 独特的优势之一。举个例子：过去的编码和理赔处理都依赖人工操作，而如今，我们的客户可以借助我们自主研发的自然语言处理（NLP）与计算机辅助编码技术，实现实时自动处理。
Natural language processing reads physician documents, identifies gaps or inconsistencies, incorporates medical logic and ultimately maps it to an appropriate code. We're working with our provider clients in order to automate this coding process so that billing is more consistent and accurate.
我们的自然语言处理系统可以读取医生的文档，识别其中的缺漏与不一致之处，整合医疗逻辑，最终匹配到相应的医疗编码。我们正与医疗服务提供者客户合作，推动整个编码流程的自动化，使账单处理更加一致、更加精准。
Optum360 is also making it easier for payers and providers to collaborate. We're shifting the revenue cycle forward closer to the time, when services are rendered. That shift reduces costly errors upfront, eliminates rework that needs to happen, and ultimately minimizes the frustration between payers and providers.
Optum360 也在推动支付方与服务提供方之间的协作变得更顺畅。我们正在将收入周期前移，尽可能靠近实际服务发生的时间点。这种变化减少了前端成本高昂的错误，避免了重复返工，最终也降低了支付方与服务方之间的摩擦与不满。
Optum360 is growing because the value and the innovation it delivers is real. Clients see it in terms of improved efficiencies. They see it in a shortened cash collection cycle. And they see it in lower administrative costs. Every year, I've watched Optum360 add value in new ways, adding value by a more simplified financial experience for patients, and at the same time, a more accurate and consistent revenue cycle for providers. Thank you.
Optum360 之所以能够快速增长，是因为我们所带来的价值与创新是真实可见的。客户们看到我们帮助他们提升了运营效率，缩短了现金回收周期，降低了行政成本。每年我都看到 Optum360 以新的方式持续创造价值——既简化了患者的财务体验，也让医疗服务提供方拥有一个更加准确、一致的收入管理体系。谢谢大家。
Tami Reller Former CFO & Executive VP
Well, good morning. Everyone, I'm Tami Reller, and a few things stand out as one listens to the Optum's capabilities review.
大家早上好，我是 Tami Reller。当我们回顾 Optum 的各项能力时，有几个关键点非常值得强调。
Data and analytics are at the heart of Optum. Stakeholders across the health system are finding distinctive values in Optum's capabilities. And the market dynamics, when they're matched to Optum's unique assets, position us for growth for sustained years to come. I thought it might be help -- I thought it might help to connect the 5 core capabilities that we just reviewed, back to the reporting segments that you know best.
数据与分析是 Optum 的核心所在。医疗体系中的各类利益相关方都从 Optum 的能力中感受到独特的价值。当市场变化与 Optum 所拥有的独有资产相匹配时，这使我们具备了持续多年的增长潜力。我想现在我们可以将刚刚回顾的五大核心能力，与大家最熟悉的业务报告板块对应起来。
Data and analytics and health care operation of all forms, for payers, providers, sponsors, life science companies and governments, are all contained in OptumInsight. Pharmacy care services is our OptumRx business. And population health in the broadest sense as well as care delivery constitute the entirety of OptumHealth.
无论是为支付方、服务方、雇主、生命科学公司，还是为政府提供的数据分析与医疗运营服务，均属于 OptumInsight 业务板块。药品护理服务由 OptumRx 承担。而最广义的群体健康管理及服务交付，则构成了 OptumHealth 的整体。
In addition, Optum's capabilities are central in the 5 priorities of the UnitedHealth Group that Dave outlined earlier this morning.
此外，正如 Dave 今天早上所概述的，Optum 的能力也是 UnitedHealth Group 五大核心战略重点的基础。
So let's review our operational performance in 2016. Over the past year, we've strengthened in meaningful ways to fully serve customers and consumers.
接下来，我们来回顾一下 2016 年的运营表现。在过去一年中，我们在多个关键方面实现了实质性增强，更加全面地服务客户与消费者。
First. The integration of Catamaran delivered on our commitments to improve value and service. Customers benefited from our combined scale as the aligned our formulary approaches and management and consolidated the 2 companies purchasing contracts with drug manufacturers and others. In service delivery, we executed for consumers with the highest degree of accuracy to-date and with more improvements to come in 2017. In addition, we've now aligned our specialty pharmacy and our home delivery operations, driving direct value for customers, which will be more of a benefit in 2017. We streamlined operations at OptumRx fulfillment centers. And this move has reduced mail order delivery time for consumers by more than 10%, and importantly, increased the number of automated deliveries by 20%. We improved our competitive position by reducing fill cost per script another 5%, and that's on top of last year's 10% reduction. And we delivered on our synergy targets and still expect further benefits in 2017.
第一，我们对Catamaran的整合兑现了我们在提升价值与服务方面的承诺。客户从我们合并后的规模中获益，包括统一药品目录管理策略，以及整合两家公司与药品制造商及其他供应方的采购合同。在服务交付方面，我们为消费者提供了迄今为止最精确的服务执行，并将在2017年进一步提升。此外，我们已将专科药房和送药到家业务进行整合，为客户带来更直接的价值，这一优势将在2017年进一步显现。我们还优化了OptumRx的履约中心运营，此举让邮寄订单的配送时间缩短了10%以上，更重要的是自动化配送量增长了20%。在竞争力方面，我们将每张处方的填配成本再降5%，这还是继去年10%下降之后的进一步降低。我们实现了预期协同效益目标，并预计在2017年将持续获得更多益处。
Second. We delivered increasingly effective service for our clients and for consumers. We completed a record number of client implementations. Our customers benefited from readiness process improvements that resulted in simpler, more accurate, more consistent and predictable installations. We continued to elevate the quality that consumers experience through our call centers. We have further reduced the time it takes to resolve issues, which decreases appeals and it improves turnaround time. So in addition to the larger strategic relationships that Larry highlighted earlier this morning, more mid-market customers are seeking integrated solutions that help them solve complex problems. And the number of these customer wins grew around 15% this year, and we're looking to drive this even more intensely in 2017.
第二，我们为客户和消费者提供了更为高效的服务。今年，我们完成了创纪录数量的客户系统部署。客户从我们改进的准备流程中获益，使部署更简化、更准确、更一致，且可预测性更强。我们也持续通过呼叫中心提升消费者的服务体验，进一步缩短了问题解决时间，从而减少上诉率并加快响应周期。除了 Larry 今天早上提到的大型战略合作外，越来越多的中型客户也在寻求可帮助其解决复杂问题的集成式解决方案。这类客户的签约数量在今年增长了约15%，我们计划在2017年推动更强劲的增长。
Third. We continued to simplify our business and manage costs across Optum. We again met our cost savings targets in 2017 through productivity and by optimizing supply chain and vendor relationships. We achieved $200 million in cost savings, and that's above and beyond the gains in drug procurement. And it's on top of the $200 million in savings we achieved in 2015. In technology, we increased the productivity of our computing platforms by more than 10% year-over-year. And we're driving double-digit cost reduction through continued purchasing efficiencies. At our size, this progress delivers meaningful benefits to our customers, to consumers and our own businesses.
第三，我们继续简化Optum业务并优化成本管理。2017年，我们再次通过提升生产力、优化供应链与供应商关系，达成成本节约目标。我们实现了2亿美元的节省，这还不包括药品采购方面的效益，并是在2015年节省的2亿美元基础之上新增的。在技术方面，我们将计算平台的生产效率同比提升超过10%，并通过持续优化采购效率实现两位数的成本下降。以我们的业务体量而言，这些进展为客户、消费者乃至我们自身业务都带来了实质性利益。
Fourth. We strengthened care delivery to benefit patients and payers across the nation through Optum Care. We support value-based care for customers and physicians through our investments in technology and analytics. And by the end of 2016, we will have deepened our footprint in 4 of our major primary care markets through 35 new neighborhood urgent care centers opened in 2016.
第四，我们通过Optum Care加强了医疗服务交付，惠及全国的患者和支付方。我们通过在技术和数据分析方面的投资，支持客户和医生推动“基于价值”的医疗服务。到2016年底，我们已在四个主要初级护理市场新开设35家社区急诊中心，进一步扩大市场覆盖。
The fifth point. We are delivering higher levels of innovation to an even broader set of customers. In 2016, Optum customers experienced more than 80 new or significantly enhanced products across the Optum portfolio. Just one example. We enhanced our digital interactions with consumers by investing in new approaches that have made it simpler for them to access our services. These new approaches include telehealth for behavioral services and modern digital experiences for people needing support with diabetes, pregnancy, among others. In addition, we now have more than 200 new product development initiatives that are moving through our product innovation and lifecycle management process, representing significant opportunity for Optum, and importantly, value for customers.
第五，我们向更广泛的客户群体提供更高层次的创新。2016年，Optum 向客户推出了80多个全新或重大改进的产品。举个例子，我们通过投资新型方式提升了与消费者的数字化互动，使其更便捷地获取服务。这些方式包括为行为健康服务提供的远程医疗技术，以及针对糖尿病、孕产护理等人群的数字化支持体验。此外，我们目前还有200多个新产品开发项目正处于创新与生命周期管理流程之中，这不仅为Optum带来重大增长机会，更重要的是为客户创造了切实价值。
Okay, now on to the numbers. I'll provide an overview of our 2016 performance and then highlight our expectations for 2017. We expect to finish 2016 strong, with each business again delivering double-digit percentage revenue and earnings growth.
好了，现在我们来看看数据表现。我将先概述我们2016年的业绩表现，然后重点说明我们对2017年的预期。我们预计将在2016年强劲收官，每个业务板块再次实现营收和利润的双位数增长。
Optum revenues will reach $83 billion. That's growth of 23%. Revenues in 2016 are driven by strong organic growth, including contributions from behavioral solutions and population health, as well as from our technology-enabled products and services and OptumInsight. The pharmacy care services combination and our care delivery market expansion were also strong contributors to our top line growth.
Optum的收入将达到830亿美元，同比增长23%。2016年的营收增长主要来自强劲的内生增长，包括行为健康解决方案、群体健康管理、技术赋能的产品与服务，以及OptumInsight的贡献。同时，药品护理服务的整合与医疗服务市场的扩张也是推动营收增长的重要动力。
In 2016, we expect a 31% increase in operating earnings or growth of more than $1.3 billion to earnings of $5.6 billion. This is consistent with the range we provided a year ago. Performance within OptumRx supported incremental investments in key businesses within OptumHealth, including care delivery and MedExpress.
我们预计2016年的营业利润将增长31%，即增长超过13亿美元，达到56亿美元。这与我们一年前提供的预期区间一致。OptumRx的业务表现为OptumHealth旗下关键业务（如医疗服务交付与MedExpress）的追加投资提供了有力支撑。
Overall, 2016 operating margins will expand 40 basis points over last year from 6.3% to 6.7%. And we expect the momentum to continue. For 2017, we see revenues reaching $90 billion, up $7 billion. This growth, coupled with continued operational improvements, will further improve operating margins and drive double-digit earnings growth. We expect earnings will grow to a range of $6.2 billion to $6.4 billion, driven by pharmacy care services, expansion within care delivery as well as population health and continued strong growth from our tech-enabled businesses.
整体而言，2016年营业利润率将比去年提升40个基点，从6.3%上升至6.7%。我们预计这一增长势头将在2017年持续。2017年我们预期收入将达到900亿美元，增长70亿美元。配合持续的运营效率提升，这将进一步改善利润率并推动利润的双位数增长。我们预计2017年利润将增长至62亿至64亿美元之间，主要受药品护理服务、医疗服务交付、群体健康管理的扩张以及技术赋能业务的强劲增长所推动。
Let me now talk to the specific segments. Within OptumHealth, we expect revenue growth of 14% to 17%, with operating earnings growth in the 12% to 19% range, as we continue to expand our Optum Care footprint, and that includes MedExpress.
接下来我们来看各个细分板块的情况。对于OptumHealth，我们预计其收入将增长14%至17%，营业利润将增长12%至19%，这反映出我们在继续扩大Optum Care（包括MedExpress）市场覆盖的同时，保持了良好的增长态势。
We will end 2016 serving more than 81 million unique consumers. And in 2017, we anticipate growth in the 4% to 6% range to around 85 million consumers. The revenue and earnings contribution from increases in the number of consumers served is influenced by product mix. So over time, as we deepen relationships with our consumers, such as through Optum Care, we expect the financial contributions per consumer to grow.
到2016年底，我们将服务超过8100万名独立消费者。2017年，我们预计服务人数将增长4%至6%，达到约8500万名。每位消费者所带来的营收和利润增长受产品组合影响，因此，随着我们通过Optum Care等平台与消费者关系的深入，我们预计每位消费者的财务贡献也将不断增长。
For OptumInsight. We expect to end 2016 with backlog of $12.7 billion, and that's growth of more than 20%. Backlog is the key indicator, as is normally the case, for OptumInsight's future revenues. We project to grow revenues 10% to 14% in 2017, and we will have more than 80% of that already booked in backlog by the end of this year.
对于OptumInsight，我们预计2016年末的订单积压将达到127亿美元，同比增长超过20%。订单积压是OptumInsight未来营收的关键指标之一。我们预计2017年收入将增长10%至14%，其中超过80%的收入将在今年年底前已通过订单积压确认。
We expect to end 2017 with backlog in the range of $15 billion to $16 billion, growth of 18% to 26%. And this is going to be driven by large managed services awards as well as mid-market customers.
我们预计2017年年底的订单积压总额将在150亿至160亿美元之间，同比增长18%至26%。这一增长将主要由大型托管服务合同以及中型市场客户的持续推进所驱动。
We forecast OptumInsight earnings will grow 10% to 17%, and this earnings growth will be primarily driven by Optum360, payment integrity and our full portfolio of other payer and provider solutions. We will also continue to invest in developing and implementing end-to-end solutions for health-planned customers and the government markets.
我们预计OptumInsight的利润将增长10%至17%。此增长将主要由Optum360、支付准确性服务（payment integrity）以及我们完整的支付方与服务方解决方案组合所驱动。同时，我们将继续在开发与实施面向健康保险客户与政府市场的端到端解决方案方面加大投资。
Turning to OptumRx. We expect adjusted scripts will grow next year by 20 million to 50 million. This is the direct result of a successful 2016 selling season, including customer retention rates in the high 90s as well as membership growth from UnitedHealthcare. As a result, OptumRx's 2017 revenues will grow in the 6% to 7% range. And OptumRx operating earnings are expected to expand 8% to 12%. And this is based on serving more people, incremental synergies as well as specialty growth.
接下来看看OptumRx。我们预计明年的调整后处方量将增长2000万至5000万张。这直接得益于2016年销售季的成功，包括客户保留率维持在90%以上，以及来自UnitedHealthcare的会员增长。因此，OptumRx在2017年的收入将增长6%至7%，营业利润则预计增长8%至12%。这一增长基础包括服务人群的扩大、协同效益的释放以及专科药房业务的增长。
In summary, 2016 has been yet another strong year for Optum, and 2017 is setting up to build on that momentum. Next year, we expect our work for customers will produce revenues in the area of $90 billion and operating earnings nicely above $6 billion. At the midpoints of our outlooks, each of our now sizable core businesses is expected to grow operating earnings at double-digit percentages.
总的来说，2016年对Optum而言是又一个强劲增长之年，而2017年将延续并扩大这一增长势头。明年，我们预计所服务客户所带来的收入将达到约900亿美元，营业利润将超过60亿美元。按预测中值计算，我们现在的各大核心业务板块都将实现双位数的营业利润增长。
We are truly privileged to have this opportunity to help the people that we serve achieve their goals. It's an opportunity that I see our people embrace each and every day with both purpose and with determination. We are encouraged by our progress and yet we know much work remains to achieve our full potential.
我们非常荣幸有机会帮助我们所服务的人群实现他们的目标。我看到我们的员工每天都以坚定的信念和明确的使命投入到这项工作中。我们对当前的进展感到振奋，同时也深知要实现我们的全部潜力，还有大量工作要做。
Thank you once again for your time today and your continued interest in Optum. Now I'm very pleased to introduce Steve Nelson to start the conversation on UnitedHealthcare. Steve?
再次感谢各位今天的参与，以及大家对Optum的持续关注。接下来我很高兴邀请Steve Nelson上台，开启关于UnitedHealthcare的讨论。Steve，请。
Steve Nelson
Good morning. Thank you, Tami. My colleagues and I are grateful for this opportunity to update you on how UnitedHealthcare is making a difference for the 51 million people we are privileged to serve globally. Overall, UnitedHealthcare is performing well. We continued to improve the quality of our work, appropriately manage medical care and related medical costs, and strengthen the trust and loyalty with us.
早上好。谢谢你，Tami。我和我的同事们非常感激这次机会，能够向大家汇报 UnitedHealthcare 如何为全球我们有幸服务的5100万人带来积极影响。总体而言，UnitedHealthcare 表现良好。我们持续提升服务质量，妥善管理医疗服务及相关成本，并不断增强客户对我们的信任与忠诚。
We are really energized by the opportunities to help more people live healthier lives and make the health system work better for everyone. This mission leads us to directly improve the health care of the individuals we serve and advance the experience, affordability and success of the overall health systems. We do this by partnering with consumers, care providers and customers, to help create an even more integrated higher-quality health systems here in the United States and throughout the world.
我们因能帮助更多人实现健康生活、优化医疗体系而备受鼓舞。正是这一使命驱动我们直接改善所服务个体的医疗状况，同时提升整体医疗体系的体验、可负担性与成效。我们通过与消费者、护理提供者和客户的合作，致力于打造更加整合且高质量的美国及全球医疗体系。
Our approach is to surround the people we serve with a comprehensive coordinated system of support, including aligned incentives, personalized engagement and collaboration, relevant and actionable information and connectivity to others -- to each other and to us. With this system of support, UnitedHealthcare is driving distinguished value for customers leading to higher growth with lots of momentum.
我们的方式是为服务对象打造一个全面协调的支持系统，包括激励机制一致性、个性化互动与合作、相关且可操作的信息，以及与他人（包括彼此与我们）之间的连接。在这个支持系统的推动下，UnitedHealthcare 为客户创造了卓越价值，并推动业务持续高速增长。
First, let's take a look at how we support consumers. Consumers have an important and growing role in health care decision-making. Over the last 15 years, the portion of household income spent on health care has more than doubled. It should be no surprise people are becoming engaged health care shoppers. They expect a simple experience, and they expect it to be personalized, predictable and dependable. UnitedHealthcare is meeting that expectation in providing the needed and support one consumer at a time.
首先，让我们看看我们是如何支持消费者的。 消费者在医疗决策中的作用正变得越来越重要。过去15年，家庭收入中用于医疗的比例翻了一倍以上。人们开始主动参与医疗消费，这并不令人意外。他们希望体验简单、个性化、可预测且可靠。UnitedHealthcare 正在一对一地满足消费者的这些期望与支持需求。
We start by offering affordable product designs, using incentives aligned with healthy behaviors and lifestyles, guiding people along a more engaged and a healthier path. These modern benefit designs incent people to see that right doctors and pharmacists by rewarding them for making good and timely choices. Employers have seen improvements of 20% or more, when members see a higher-quality, more efficient provider. That leads to better health outcomes for the individual and greater health care savings, because these quality care providers are 12% more cost-effective.
我们首先从提供可负担的产品设计入手，运用与健康行为和生活方式相契合的激励机制，引导人们走向更积极、更健康的路径。这些现代化福利设计通过奖励机制鼓励人们及时做出正确的就医选择。数据显示，当成员选择高质量、高效率的服务提供者时，雇主能看到20%甚至更大的改善幅度。这不仅改善个体健康结果，也带来医疗成本的节省，因为高质量服务者的成本效益要高出12%。
So part of getting to better health and more efficient delivery of care is by personalizing the health care experience in new ways. The insights we've gathered from Net Promoter Scores across consumer segments help us focus on the key drivers of consumer and customer satisfaction and loyalty. NPS measures whether someone would recommend our products and services to others, and most importantly, why? We use this data and advanced analytics to track an individual across experience touch points and provide real-time information to our people who work on the phone or online.
因此，实现更健康的生活和更高效的医疗服务交付，关键在于通过新的方式实现医疗体验的个性化。我们通过对各类消费者群体的净推荐值（NPS）调研获得洞察，聚焦消费者和客户满意度与忠诚度的关键驱动因素。NPS 衡量人们是否愿意向他人推荐我们的产品与服务，更重要的是——“为什么”推荐。我们利用这些数据与高级分析工具，在整个体验流程中追踪个体，并将实时信息传递给我们在线或电话支持人员。
This helps create a personalized experience for each consumer, one that offers choices and solutions, they didn't even know to ask about. It allows us to engage with people as individuals with unique needs and preferences. We call this Advocate4Me, and it creates a personalized experience and circle of support around the consumer.
这样一来，我们便可为每一位消费者打造个性化体验，提供他们甚至未曾想到的选择与解决方案。这种方式让我们能以“独特需求者”的视角去理解和服务每一个人。我们称这一服务为 Advocate4Me —— 它围绕消费者构建起个性化体验与支持闭环。
Through it, we organize all aspects of care, clinical, financial and administrative. When a person calls, we're doing more than just reacting to a benefit question. We're recommending helpful services, like a house call or a wellness visit or scheduling medical appointments for them, all based on proprietary technology-enabled information and clinical insights into individual and their family needs.
通过这个平台，我们整合了医疗服务的各个方面：临床、财务和行政管理。当有人打电话进来时，我们不只是被动地回答保险福利问题，而是会主动推荐有帮助的服务，例如上门医疗、健康访问，或直接为他们安排医生预约，而这些服务都基于我们专有的技术信息和对个人及其家庭健康需求的临床洞察。
This results in fewer calls, more than to 200,000 appointments scheduled this year, higher Net Promoter Scores and an overall satisfaction rate of 95%, all contributing to improving retention to the highest rates in our history now for our third straight year. This personalized service experience was central to closing over 10 million gaps in care this year, providing better health for the people we serve.
这一做法使得用户来电量减少，同时我们在今年安排了超过20万个预约，净推荐值（NPS）得分更高，总体满意度达到95%。这一切都让我们的客户保持率连续第三年达到公司历史新高。正是这种个性化服务体验，使我们今年成功弥合了超过1,000万个护理缺口，为所服务人群带来了更好的健康结果。
Advocate4Me provides more help and more heart. Let me offer just one example of how we deliver compassion at scale, our initiative in our Medicare business. Last year, we've showed our advocates the direct correlation between the number of health screening they scheduled for members and lives saved. This really motivated them to take action.
Advocate4Me 不仅提供支持，更注入了人情温度。让我分享一个例子，说明我们如何在Medicare业务中大规模地传递同理心。去年，我们向客户服务代表展示了他们为会员安排的健康筛查次数与成功挽救生命之间的直接关系，这极大激发了他们的积极性和使命感。
Before the "Save a Life" effort, we scheduled about 200 screenings per month. That number has grown to over 20,000 per month in 2016. And not surprisingly, our employee engagement scores jumped 10 percentage points, and many of our advocates, like Mike Baker, now personally know people whose lives they've saved, people like Donna.
在开展“拯救生命”（Save a Life）计划前，我们每月仅安排约200次健康筛查，而在2016年，这一数字跃升至每月超过2万次。员工敬业度得分也提高了10个百分点。不少客户代表，比如 Mike Baker，如今都亲身认识到自己曾挽救生命的会员——像 Donna 那样的故事也因此不断发生。
Michael Baker
Donna is one of our Medicare members. Donna called one day ask a question about our benefits, and our systems immediately alerted the advocate she had not had a mammogram in over 18 months. Our advocate recommended she do so and then scheduled the appointment for her on the spot.
Donna 是我们 Medicare 计划的一位会员。有一天她打电话咨询福利问题，我们的系统立刻提醒服务代表：她已有超过18个月没有接受乳房X光检查。我们的代表建议她立即进行，并当场为她预约了检查。
Donna kept the appointment, went in for her mammogram and was diagnosed with stage 2 breast cancer. She went through many months of chemotherapy, but I'm pleased to report she is now in remission and doing fine. We encouraged our advocates to treat every member as if they were their own loved one.
Donna 如期前往检查，结果被诊断为二期乳腺癌。她经历了数月的化疗，而我很高兴地告诉大家，如今她已进入缓解期，身体状况良好。我们始终鼓励我们的服务代表，把每一位会员当作自己的亲人一样对待。
This inspiring story gets even more personal for us. As it turns out, Donna's granddaughter, Alexis, is a colleague of ours. She's an advocate too.
这个感人的故事对我们来说还不止于此。事实证明，Donna 的孙女 Alexis 正是我们的一名同事，她也是一名客户服务代表。
It's remarkable example, really, of how our mission help people live healthier lives is very real for our advocates and they're on the front lines of health care.
这的确是一个非凡的例子，展示了我们的使命——“帮助人们过上更健康的生活”——如何在一线员工中真正体现出来。他们正站在医疗服务的第一线。
Save a Life, it's the name of the program, but more importantly, it's a sense of purpose that guides our actions every day. And each month, we receive surveys and emails, handwritten notes, from members who tell us we played an important role in helping them discover a serious health condition early, that makes me very proud to be a member of UnitedHealthcare leadership team. Like my colleague, Alexis, UnitedHealthcare cares for someone important for me, my mom.
“拯救生命”不仅仅是一个项目的名称，更重要的是它代表一种使命感，每天引领我们的行动。每个月我们都会收到会员的反馈调查、电邮，甚至亲笔写的感谢信，告诉我们我们帮助他们及早发现严重健康问题，这让我为自己是 UnitedHealthcare 领导团队的一员感到由衷自豪。就像我的同事 Alexis 一样，UnitedHealthcare 也在照顾我生命中最重要的人——我的母亲。
Steve Nelson
I think Donna's story really bring homes the importance of using data to get health care right for consumers every time. But it's not just about using the data we have about them, it's also about the relevant information we give them and how we offer it at the point of decision-making.
我认为 Donna 的故事真正说明了在医疗保健中，每一次都为消费者做对决策的重要性——而数据正是关键。但这不仅仅是指我们利用手头已有的数据，更重要的是我们能否在消费者做出决策的关键时刻，向他们提供相关且可用的信息。
One example, a simple digital experience we created to help consumers make smart choices. When a consumer enrolls, a service we simply called Choice, helps them pick the best plan for their needs, taking into account age, family, status, health background and economics, then Connect another simple service, helps them find the highest performing doctors based on demonstrated performance on quality end cost as well as provider scoring based on other consumer experiences. And then our Engage service makes achieving health goals easier by providing digital tools, incentives and support groups to help people get healthy and stay healthy.
举个例子，我们开发了一个简单的数字化体验，帮助消费者做出明智选择。当消费者注册时，我们提供一项名为 Choice 的服务，根据其年龄、家庭状况、健康背景和经济条件等，帮助他们选择最适合的健康保险方案。之后是 Connect 服务，它基于医疗质量、成本表现以及其他消费者的评分，帮助用户寻找表现最佳的医生。而 Engage 服务则通过数字工具、激励机制和支持群体，帮助用户更轻松地实现健康目标，保持健康状态。
Unknown Executive
Jen makes the health decisions for her family and simply wants to ensure that she chooses the right benefits. We get to know Jen better through our intuitive digital enrollment process, where we make recommendations based on data that we already have, and we asked Jen a key set of questions, questions about her budget, her provider preference, her health needs and much more.
Jen 是家中负责健康决策的人，她只想确保自己选择的是最合适的福利方案。我们通过直观的数字注册流程深入了解 Jen，根据已有数据为她提出个性化建议，并向她询问一系列关键问题，比如预算、服务提供者偏好、健康需求等。
We package this information in a simple and clear easy manner so Jen can evaluate her options, make decisions and have no surprises. One of the key decisions that Jen needs to make in this process is in choosing an in-network doctor or care location. With Connect, we've transformed that experience for millions of consumers helping to make it easy to choose the right doctor, the right place at the right time.
我们将这些信息打包成简明易懂的方式，帮助 Jen 轻松评估选择、做出决策并避免任何意外。在这个过程中，她需要做出的一个关键决策是选择网络内的医生或医疗机构。通过 Connect，我们为数百万消费者彻底改善了这个体验，使他们能够在合适的时间选择合适的医生和合适的就医地点。
In this process, we've, as a fact, over 75% choose a Tier 1 PCP, leading for Jen higher-quality care at lower cost. In this process, finally, Jen indicates that she's interested in losing weight. So we offered her a personalized and intuitive weight loss management program, where over 80% lose 5% to 7% of the body weight, reducing risk of illness, and for Jen, helping her live a healthier life.
事实证明，在这个流程中，超过75%的用户选择了一级初级保健医生（Tier 1 PCP），这让 Jen 获得了更高质量、成本更低的医疗服务。最后，Jen 表示她希望减重，我们便向她提供了一个个性化、直观的减重管理项目，该项目中超过80%的参与者成功减去了5%至7%的体重，有效降低患病风险，也帮助 Jen 实现了更健康的生活目标。
Steve Nelson
We still have huge opportunities to simplify and personalize the experience for consumers, so we're stepping up our efforts on their behalf. And I can tell you we are passionate about getting it right for every consumer every time.
我们在简化与个性化消费者体验方面还有巨大的提升空间，因此我们正不断加快这方面的努力。我可以告诉大家，我们对每一次都为每位消费者提供准确、合适的服务充满热情。
Unknown Executive
Our relationships with care providers are critical to delivering better medical outcomes, improving the health care experience and lowering cost for consumers and customers. Hospitals and physicians are looking for trusted partners as the payment system continues to move to value-based care. They faced difficult changes in this complicated transition, increased demands for transparency, better coordination of care and greater accountability for improved outcomes.
我们与医疗服务提供者的关系，对于实现更好的医疗结果、提升医疗体验、降低消费者与客户的成本至关重要。随着支付体系持续向“以价值为基础的医疗”转型，医院与医生们都在寻找值得信赖的合作伙伴。在这个复杂过渡过程中，他们面临艰难的转变：更高的透明度要求、更强的护理协调能力，以及对医疗结果改进的更大责任。
UnitedHealthcare's relationship with care providers is evolving from a transactional experience, centered on what we expect from them to a collaborative relationship, where we work even more closely with them to help their patients and their practices, a framework in which all of our interests are aligned.
UnitedHealthcare 正在将与服务提供者的关系，从传统的“事务型”合作——仅关注我们对他们的要求，转向“协作型”合作，我们将与他们更紧密协作，共同支持患者与诊所的运营。这是一种利益一致的合作框架。
We're on a journey with providers, and it's up to us to become a better, more useful traveling partner. It began more than 40 years ago when our company first focused on using data and technology to help providers manage care.
我们正在与服务提供者共同踏上一段转型之旅，而我们自身也需要成为更好、更有价值的同行伙伴。这一旅程始于40多年前，当时我们首次专注于利用数据与技术，帮助服务提供者管理医疗服务。
We've evolved from simple disease management programs that only engaged after a patient become ill to a data-rich, proactive and predictive approaches. This enables us to help address a broad spectrum of medical needs as well as inpatient and outpatient and transitional care.
我们已从过去仅在患者生病后才介入的“简单疾病管理项目”，演变为数据丰富、主动预测的模式。这让我们能够帮助应对广泛的医疗需求，包括住院、门诊和过渡护理。
The data had pushed us deeper into the healthcare system and is responsible for significantly improving the quality of care for the people we serve, while generating meaningful medical cost savings each year. Just like with consumers, we have a system supporting care partners that provides aligned incentives, personalized engagement and collaboration, relevant and actionable information and connectivity with their patients and to us.
数据使我们更深入地参与到医疗体系中，不仅显著提升了服务质量，也为我们所服务人群带来了每年实质性的医疗成本节省。就像对待消费者一样，我们也为护理伙伴构建了支持系统，包括激励机制一致性、个性化互动与协作、可用且相关的信息，以及与患者和我们之间的紧密连接。
We sit down with individual care providers to understand their unique challenges and opportunities and together establish aligned goals and incentives for coordinating care, for consistently providing evidenced-based care and for improving health outcomes.
我们与每一个医疗服务提供者进行深入对话，了解他们面临的独特挑战与机会，并共同设定协调护理、持续提供循证医疗以及改善健康结果的共同目标和激励机制。
We're building multidimensional relationships with 100 strategic providers, who represent $35 billion in medical spend with us. These are among the largest health systems in the nation. They're sharing their strategies and their business objectives with us. We help them drive improvements in medical outcomes and simplify the administration of their practices, generating lower cost and shared revenue growth.
我们正在与100家战略性服务提供者建立多维合作关系，他们与我们相关的年度医疗支出总额达350亿美元。这些机构是全美最大的一批健康系统。他们与我们共享其战略和商业目标，而我们则帮助他们提升医疗结果、简化运营流程，从而实现成本降低与收益增长的共享。
UnitedHealthcare has nearly 15 million consumers receiving care from physicians and other care providers in value-based care arrangements. About 110,000 physicians and 1,100 hospitals now participate in some form of value-based care with us, already accounting for $52 billion in annual spending.
在UnitedHealthcare的“以价值为基础的医疗”体系中，已有近1500万名消费者正由医生与其他护理提供者提供服务。约有11万名医生和1100家医院正在与我们开展某种形式的价值导向型合作，这些合作关系所对应的年支出已达520亿美元。
Care providers are in different stages of maturity on this journey to value-based care. So we don't take a one-size-fits-all approach. We flex to their level of readiness to share in the risks and rewards that come with basing a larger portion of their revenues on performance-based measures and managing population health.
各家医疗提供者在“价值导向型医疗”转型之路上所处阶段不同。因此，我们并不采取“一刀切”的做法，而是根据他们对基于绩效的营收模式、风险与收益共担机制、群体健康管理等准备程度进行灵活适配与支持。
In clinically and financially integrated relationships, we provide information and analytics on patients' clinical interactions, including medical referrals, emergency room visits, hospital admissions and readmissions, discharge and follow-up care. We share analytical information identifying high-risk patients and whether certain individuals are predisposed to specific illnesses or conditions. Now armed with this information, care providers focus on what they're trained to do and are passionate about keeping patients healthier.
在临床与财务高度整合的合作关系中，我们向医疗提供者提供关于患者临床活动的信息与分析数据，包括转诊、急诊室就诊、住院与再入院、出院及后续护理等情况。我们还共享分析结果，识别高风险患者，并预测哪些人容易患某些疾病或健康状况。有了这些信息，护理提供者可以更专注于他们的专业所长与热情所在——帮助患者保持健康。
Our most mature relationships show the most improvements in care and quality, performing better on 83% of common quality metrics, including diabetes management, preventive screenings and prenatal care. And from those quality improvements, we're seeing reduction medical cost of up to 12%.
在我们最成熟的合作关系中，护理质量的提升最为显著，在83%的常见质量指标（如糖尿病管理、预防性筛查、产前护理）上表现更优。而这些质量的提升，也带来了高达12%的医疗成本下降。
Let's walk through how a more progressive value-based relationship actually works. So let me share with you how value-based relationship actually works. Meet Dr. Cleather [ph], our Market Medical Director, who also leads our ACL Activation Team. He partners with Central Ohio Primary Care, or COPC, to have discussions on how they can expand and focus on reducing ER visits as well as reducing admissions. Through expanding their office hours as well as focusing in on the high-risk members, he was able to partner with them to achieve that success.
接下来我们一起看看一个更前瞻性的“价值导向型合作关系”是如何运作的。让我介绍一下我们的市场医疗总监 Cleather 博士，他同时也是我们 ACL 启动小组的负责人。他与中俄亥俄州初级保健机构（Central Ohio Primary Care，简称COPC）合作，探讨如何扩大服务、重点降低急诊就诊率和住院率。通过延长门诊时间，并聚焦于高风险会员群体，他与COPC成功实现了这些目标。
Michelle, she's our clinical practice consultant. She partners with Central Ohio Primary Care almost on a daily basis. She partners with them by bringing her expertise, such as clinical practice workflow as well as helping them review their inpatient census data as well as identifying the action care for their physicians to intervene.
Michelle 是我们的临床实践顾问，她几乎每天都与COPC保持合作。她通过提供临床操作流程的专业指导，协助他们分析住院患者数据，识别需要医生介入的关键节点，从而与COPC建立了深度合作。
Tanya, she's our data analyst and shares with them reports that are actionable. A recent analysis show that Central Ohio Primary Care had higher radiology usage compared to their peers. This resulted in them intervening by changing their practice habits as well as tighter service, resulting in significant out-of-pocket cost reductions for their members.
Tanya 是我们的数据分析师，她会与COPC分享可执行的数据报告。近期一份分析显示，COPC 的影像学检查使用率高于同行，因此他们迅速调整了医疗操作习惯并加强服务把控，显著降低了会员的自付费用。
From this collaborative efforts, Central Ohio Primary Care was able to generate a 13% lower acute hospital admission rate for their Medicare members, a 22% lower ER visit rate and a 39% lower radiology utilization rate. To quote Central Ohio Primary Care, "We now see United Healthcare as a true partner who understands our business and our goals."
通过这些协作努力，COPC 成功地将其 Medicare 会员的急性住院率降低了13%，急诊就诊率降低了22%，影像学检查使用率下降了39%。用 COPC 的话来说：“我们现在将 UnitedHealthcare 视为真正理解我们业务和目标的合作伙伴。”
Unknown Executive
These relationships require continuing collaboration, empowering our partners with timely, relevant actionable information about their practices and the patients they manage. We're helping our network care providers move from siloed, closed systems to interoperability with shared data and analytics, which leads me to Link.
这种合作关系需要持续的协作，并通过及时、相关、可执行的信息赋能我们的合作伙伴，使其更好地了解自身诊所的运营状况及所服务的患者。我们正帮助我们的网络服务提供者从“孤岛式”、“封闭式”系统，转向数据与分析可共享的互操作体系。这也引出了我们要讲的 Link 系统。
Link is a single digital interface and it looks much like the collection of apps you have on your smartphone. Care providers and healthcare administrators use Link to access information they need across multiple networks and systems, efficiently, securely and in real time. This includes accessing patient data. It helps them improve outcomes and better collaborate with other care providers across the system.
Link 是一个统一的数字界面，外观看起来就像你智能手机上的应用集合。护理服务者与医疗管理人员可以通过 Link 快速、安全、实时地访问多个系统与网络中的所需信息，包括患者数据。这有助于他们提升治疗效果，并能更高效地与整个体系中的其他服务提供者协同合作。
And on the administrative side, Link supports verifying benefits and eligibility, e-prescribing, checking claims status and submitting prior authorizations. Care providers don't want multiple systems for multiple payers. They need a simple platform. The benefits for providers are numerous. Reductions in paperwork, improved accuracy, simplified claims processing and real-time provider data updates, leading to healthier patients.
在行政管理方面，Link 支持福利与资格验证、电子处方、查询理赔状态、提交事前授权等功能。服务提供者并不希望为多个付款方使用多个系统，他们需要的是一个简洁的平台。Link 为服务提供者带来诸多益处：减少纸质工作、提高准确率、简化理赔流程，以及提供实时的服务提供者数据更新，这一切最终都有助于提升患者健康水平。
Unknown Executive
Doctors consistently tell us 2 things. They want to know what happens with their patients after they leave their office and they want less administrative process, so that they can focus on patients care. Optum and United Healthcare have partnered to create Link, a web-based tool that supports both the clinical and the administrative side of care delivery.
医生们不断告诉我们两件事：第一，他们想知道患者离开诊室之后的情况；第二，他们希望减少行政流程，以便专注于患者护理。为此，Optum 与 UnitedHealthcare 合作开发了 Link——一个同时支持临床与行政功能的网页工具。
On the clinical side, Link provides basic, but important information. Has a patient seen another provider? Have they visited an ER? Have they been admitted to a hospital, transferred or discharged? Link provides daily notifications with just this type of data, arming providers with the information that they need to deliver the best care and the best patient outcomes.
在临床方面，Link 提供基础但重要的信息：患者是否就诊了其他机构？是否去过急诊？是否住院、转院或出院？Link 每日推送这类数据通知，为服务提供者提供所需信息，助力他们提供最佳的护理和健康成果。
On the administrative side, Link simplifies paperwork, improves accuracy and saves time. For example, through Link, providers can check member eligibility, they can update their directory information and let us know if they are accepting new patients and they can electronically submit claims, prior authorization, even medical records.
在行政管理方面，Link 简化了文书流程，提高准确率，并节省时间。举例来说，服务提供者可以通过 Link 查询会员资格，更新机构名录信息、告知是否接受新患者，并能在线提交理赔、事前授权，甚至是医疗记录。
Providers using Link have seen remarkable results. Over 1 million Medicare gaps in care reports have been delivered. We've seen a 20% reduction in the number of phone calls to check member eligibility and we've eliminated over 1 million paper submissions year-to-date.
使用 Link 的服务提供者取得了显著成效：已经交付了超过100万份 Medicare 护理缺口报告，电话查询会员资格的数量减少了20%，截至目前已减少超过100万份纸质文件提交。
Link is an important resource in our journey to connect with care providers on the things that matter most to them, to us and to their patients.
Link 是我们与服务提供者就最关键事务实现连接的重要工具——无论对他们、对我们，还是对患者而言，它都意义重大。
Unknown Executive
As we strengthen digital tools and data resources for care providers, we've improved our approach to patient-centered care. We now go beyond health to get closer to an individual's actual quality of life or their total well-being. This requires a healthcare system in which all care providers are connected as a team, aligned around patients' needs.
在为服务提供者强化数字工具与数据资源的同时，我们也在改善以患者为中心的护理模式。我们不再仅关注“健康”，而是更进一步贴近个人的实际生活质量和整体福祉。这就要求医疗体系中的所有服务者必须团队式连接，围绕患者需求实现协同。
Our whole person approach improves coordination among providers, identifying and engaging high-risk patients earlier and fully integrating patient care, especially for those with the most complex needs who make up roughly 5% of the population, but generate 50% of the cost.
我们采用“全人护理”模式来加强服务者之间的协作，更早识别并介入高风险患者，全面整合其护理服务。特别是对于那5%最复杂的患者群体——他们占人口比例虽小，却占据50%的医疗成本——这种模式尤为重要。
商业化是不是最终的出路？如果全面市场化，5%的人群一定会被保险公司剔除。
With better information and connectivity, care providers identify and act on behavioral and social barriers to physical health. This type of visibility takes on new importance, as providers reimbursements increasingly depend on improving quality and patient health outcomes.
凭借更优质的信息与连接能力，服务提供者得以识别并应对阻碍身体健康的行为和社会因素。这种“可见性”变得尤为关键，因为服务提供者的报酬越来越取决于其改善医疗质量与患者健康结果的能力。
Unknown Executive
David is one of those patients that could easily have had an important diagnosis slip through the cracks because of his complex needs. In today's fragmented health system, many patients just like David often have their health issues go undiagnosed or worse yet misdiagnosed, because they're seeing doctors who don't have a complete picture of their behavioral, social and medical needs. Thankfully for David, who is one of our patients, that didn't happen.
David 是那类极容易因为病情复杂而漏诊的重要患者之一。在当今碎片化的医疗体系中，像 David 这样的患者很容易出现健康问题未被发现，甚至被误诊的情况，因为他们接触的医生往往无法全面了解其行为、社会和医疗背景。幸运的是，作为我们的患者，David 避免了这一风险。
David does have a behavioral health condition that he lives with and he's being treated for that, but he also was suffering from severe headaches that were untreated, undiagnosed, debilitating and really having a negative impact on David's quality of life.
David 确实患有精神健康问题，正在接受相关治疗。但他还遭受严重的头痛困扰，这一问题未被诊断、未被治疗，已经严重影响了他的生活质量。
David's whole-person care coordinator didn't know about the headaches, but she did notice that he had missed his preventative visits and she encouraged him to make an appointment with Dr. Gencini [ph], David's primary care physician in rural New Mexico.
David 的“全人护理”协调员并不知道他的头痛问题，但她注意到他错过了预防性体检，并鼓励他与自己在新墨西哥乡村的初级保健医生 Gencini 医生预约。
Dr. Gencini quickly diagnosed David with high blood pressure, which was the main cause of his headaches. With proper treatment of the high blood pressure, David's headaches completely went away and his behavioral health condition improved.
Gencini 医生很快诊断出 David 患有高血压，这正是他头痛的主要原因。经过妥善治疗后，David 的头痛完全消失，连带其精神健康状况也得到了改善。
David's story is usually a great example of why treating the whole person is so important, why bringing together behavioral, social and medical information about a patient is critical.
David 的案例正是说明为何“全人护理”如此重要，为什么将患者的行为、社会及医疗信息整合在一起至关重要。
Dr. Gencini told us most of the time when his patients leave the office, he has no idea what's happening to them. Are they in the emergency room? Are they seeing other docs? Have they filled the prescription that he just wrote for at the pharmacy? He doesn't know.
Gencini 医生告诉我们，他的大多数患者离开诊室后发生什么，他都一无所知。他们是否去了急诊？是否又去看了其他医生？是否已经在药房取走他刚刚开的处方？他一概不知。
By providing Dr. Gencini line of sight to his patients' entire healthcare experience, Dr. Gencini is convinced that he can really now help his patients be healthier and the data suggests that's true.
我们为 Gencini 医生提供了患者完整的就医路径数据，他深信自己现在能真正改善患者健康。而数据也证明了这一点。
In New Mexico, where Dr. Gencini practices, our whole-person care results for the Medicaid population that we serve have been dramatic. We've seen a 39% reduction in hospitalizations and accompanied by that a 12% decrease in emergency room visits in 2015 compared to the prior year.
在 Gencini 医生执业的新墨西哥州，我们为 Medicaid 受益人提供的“全人护理”取得了显著成果：2015年住院率相比前一年下降了39%，急诊访问量下降了12%。
Unknown Executive
Clinical practice and healthcare delivery will continue evolving. We're actively working to become the partner of choice, supporting more care providers with our system of aligned incentives, engagement and collaboration, information and connectivity.
临床实践与医疗服务仍在持续演进。我们正积极努力成为服务提供者首选的合作伙伴，通过一致的激励机制、参与与协作、信息共享与系统连接为其提供支持。
The work we are pursuing with consumers and care providers directly benefits our customers creating value in both government programs and employer plans. Our customer needs and our mission are strongly aligned. We want the same things, better care and lower costs.
我们与消费者和服务提供者所做的工作，直接为客户带来了价值——无论是在政府医保项目还是雇主健康计划中。我们的客户需求与我们自身使命高度一致：我们共同追求的是更优质的护理与更低的成本。
We work closely with both government and commercial customers to align their plans and our services around what is most important to them and to help improve both the quality and affordability of care.
我们与政府客户和商业客户密切合作，围绕他们最重视的核心目标，协调其保险计划与我们的服务，并致力于提升医疗服务的质量与可负担性。
Our continuous improvement in star ratings for our Medicare Advantage plans is concrete evidence of this. For 2017, we expect 80% of United Healthcare's Medicare Advantage membership will be in plans rated 4 stars or higher by CMS. For 2018, we expect this metric to exceed 85%.
我们 Medicare Advantage 计划的星级评级持续改善，就是最有力的例证。2017年，我们预计 UnitedHealthcare 有 80% 的 Medicare Advantage 会员将参与获得 CMS 四星或以上评级的保险计划；到了2018年，这一比例预计将超过 85%。
We are using the knowledge we have gained through STARS to benefit all of our lines of business, improving HEDIS scores and employer health plans and for individuals and state-based qualities in ratings in Medicaid.
我们将从 STARS 评级体系中获得的经验应用于所有业务线，提升 HEDIS 指标成绩、雇主健康计划质量，并改善个人和州政府 Medicaid 项目的质量评级。
State governments are under increasing pressure to improve quality for beneficiaries, while ensuring the financial sustainability of their programs. We help state programs improve quality and outcomes for all types of Medicaid beneficiaries. Because of our long-standing experience and improving outcomes by directly managing care, states turn to us for help with their most difficult and expensive cases.
各州政府正面临提升医保受益人护理质量的压力，同时还需确保项目的财政可持续性。我们帮助州政府提升所有类型 Medicaid 受益人的服务质量和健康结果。凭借长期的经验和通过直接护理管理改善结果的能力，各州纷纷向我们寻求帮助，以处理最复杂、最昂贵的个案。
Our nearly 3,000 community-based clinical representatives work one-on-one with patients in collaboration with local care providers to personalize care management. People who need long-term services and support and dual eligible patients, those who qualify for both Medicare and Medicaid are perhaps the populations with the greatest health care need.
我们有近 3,000 名社区临床代表，与患者一对一合作，并与本地医疗服务提供者密切协作，开展个性化护理管理。需要长期服务支持者及双重医保受益人（同时符合 Medicare 与 Medicaid 条件者）通常是医疗需求最强烈的人群。
Today, United Healthcare is the largest provider of services for them, serving nearly 700,000 vulnerable individuals. And with the remaining market opportunity, sized at more than $200 billion, there is still plenty of room for continued growth.
目前，UnitedHealthcare 是该人群的最大服务提供商，为近 70 万名弱势群体提供服务。与此同时，该市场的剩余潜力超过 2000 亿美元，仍拥有巨大的增长空间。
Our employer clients look to us to help manage the health of their people, while keeping health care affordable. We set shared goals around quality and cost. And when we achieve those goals, everyone benefits.
我们的雇主客户希望我们既能帮助他们管理员工健康，又能控制医疗成本。我们与客户共同设定质量和成本方面的目标，一旦达成，各方皆受益。
We offer our commercial customers connectivity and real-time information on what's happening with their employees, so they can easily manage their health plan performance. We meet this need using data analytics capability called Health Plan Manager, provided integrating reporting for many of our national account clients.
我们为商业客户提供实时信息和连接能力，使其能够便捷地掌握员工的健康动态，并高效管理其健康保险计划绩效。我们通过名为 Health Plan Manager 的数据分析工具来满足这一需求，已被广泛应用于众多全国性账户客户的综合报告服务中。
Unknown Executive
Our clients tell us, it's not just data that's important, it's how the insights from the data can provide targeted actions. Health Plan Manager technology allows employers to use real-time data to take targeted actions on issues that are specific to their population.
我们的客户告诉我们，关键不只是“有数据”，而是“如何通过数据洞察采取有针对性的行动”。Health Plan Manager 技术使雇主能够基于实时数据，针对其特定人群的问题采取精准干预。
The end goal is to increase the quality of care for their employees, which improves health and supports the performance of their health care benefit strategy.
最终目标是提升员工的医疗服务质量，从而改善健康状况，并增强企业健康福利战略的执行效果。
Let me give you an example of 1 client. The Health Plan Manager data revealed that there was an increased utilization pattern on out-of-network spend. The data showed that the out-of-network costs were 22% higher in Florida, and more specifically 70% higher in South Florida. Further drill down on the data showed that the issue was specific to the Hispanic population in Miami, nearly double the national average.
让我举一个客户的例子。Health Plan Manager 的数据揭示出该客户的“网络外”支出存在使用率上升的趋势——在佛罗里达州，“网络外”成本比全国平均高出 22%，在南佛州更是高出 70%。进一步分析发现，这一现象集中发生在迈阿密的西班牙裔人群中，其使用率几乎是全美平均水平的两倍。
Our heat map analysis pinpointed that the out-of-network spend was located with outpatient surgeries with the concentration on back surgeries. From the information that the Health Plan Manager was able to provide and in partnership with our client, we developed an action plan to flex our dedicated clinical nurse team to include bilingual resources and provide an educational campaign.
我们的热力图分析精确指出，“网络外”支出主要集中在门诊手术中，尤其是背部手术项目。借助 Health Plan Manager 提供的信息，并与客户合作，我们制定了一项行动计划：调整专属临床护理团队的结构，引入双语护理资源，并开展健康教育宣传活动。
This allowed members to better understand their benefits and make more informed choices about where to get their care, resulting in a 4% reduction in trends and hospital admissions reduced by 10%. It's a matter of Health Plan Manager turning big data into practical data.
这些措施让会员更好地理解自身医保权益，并能在就医时做出更明智的选择。最终实现了医疗支出趋势下降 4%、住院率下降 10%。这正是 Health Plan Manager 将“大数据”转化为“实用数据”的价值所在。
Unknown Executive
Health Plan Manager is empowering to employers. It allows them to conduct their own analysis of clinical and economic performance to see employee participation levels and to measure how United Healthcare's programs and services are performing for them and their employees.
Health Plan Manager 为雇主赋能，让他们能够自主分析临床和经济绩效，了解员工参与程度，并衡量 UnitedHealthcare 各项计划和服务对企业及员工的实际效果。
In summary, we offer customers the value of the United Healthcare system of support we've described to you today, value-based care provider relationships, proactive clinical support, a higher level of consumer engagement with tools and information to help people make better decisions and capabilities to strongly manage health plan cost trends as well as population health.
总而言之，我们为客户提供的是 UnitedHealthcare 整套支持体系的价值：包括价值导向型服务提供者关系、主动的临床支持、更高水平的消费者参与，以及帮助人们做出更好决策的工具与信息；同时也具备强有力的成本趋势管理能力与人群健康管理能力。
We offer this support through a wide range of product solutions for active employees and retirees. Products including health savings accounts, ancillary services and risk fee and stop-loss arrangements.
我们通过多种产品方案为在职员工与退休人员提供支持，包括健康储蓄账户、附加服务、风险费用与止损安排等。
Through it all, our focus is on how we can better partner with our customers to maximize their health benefits, improve the quality of care for the people who depend on those benefits and reduce costs for individuals, for our customers and for the health system overall.
我们始终关注如何更好地与客户建立合作关系，从而最大化其健康福利的价值、提升依赖这些福利人员的护理质量，并降低个人、企业客户乃至整个医疗体系的成本。
Unknown Executive
This morning, my colleagues have shared what we are doing, to advance our service to consumers, to strengthen our partnerships with care providers and to deliver on our commitments to customers. You can see the results of this approach in our performance.
今天上午，我的同事们分享了我们在改善消费者服务、加强与服务提供者的合作、以及履行客户承诺方面所做的努力。从我们的业务表现中，您可以看到这些做法所带来的成果。
Today, we support over 51 million people. This includes 1 in every 5 seniors in Medicare, the employees and dependents of 200,000 employer clients, nearly 6 million Medicaid recipients, almost half of them children and 4 million people in Brazil.
目前，我们服务超过 5100 万人群，包括每五位 Medicare 老年人中的一位，20 万家企业客户的员工及其家属，近 600 万 Medicaid 受益人（其中近一半是儿童），以及巴西的 400 万居民。
As we close this year, we will have grown our domestic medical membership by almost 2 million people. This growth is balanced across our portfolio and frankly, in the offerings that drive the most value, employer group coverage, Medicare Advantage and people with more complex needs in Medicaid.
在即将结束的这一年里，我们在美国的医疗会员人数增加了近 200 万人。增长来自我们业务组合的各个方面，尤其集中在最具价值的服务项目上：雇主团体保险、Medicare Advantage，以及 Medicaid 中具有复杂需求的人群。
We continue to increase our share in each of our businesses, as the market responds to the value of our products and services. In 2017, we expect to add 1.6 million people at the midpoint of our range, excluding 2 items: the reduction of our individual exchange-related footprint and the transition out of the TRICARE West region contract. 2017 will mark the sixth year out of the last 7 years, where we will have grown organically by more than 1 million people.
随着市场对我们产品与服务价值的积极响应，我们在各业务领域的市场份额持续提升。预计 2017 年我们将在排除两个因素（即减少个人医保交换市场业务范围及退出 TRICARE 西部区域合同）后，净新增会员约 160 万人。这将是过去 7 年中第 6 个实现有机增长超过 100 万人的年度。
Turning to our commercial business. Our fully insured enrollment outlook includes a reduction in our exchange-related individual offerings of just under 1 million people. That estimate is based on a reduction of approximately 650,000 on exchanges, combined with net declines in our off exchange individual business.
转向商业保险业务。我们预计全额承保客户数量将因退出个人医保交换市场而减少近 100 万人，其中包括约 65 万的医保交易所会员减少，以及医保交易所以外个人业务的净流失。
We expect continued profitable growth of more than 200,000 consumers in full risk programs in the small business and middle market segments using the midpoint of our outlook.
预计我们在小型企业和中端市场的“全风险”计划中将实现盈利性增长，会员人数中值预计增加超过 20 万人。
The pricing environment for commercial risk remains consistent and we continue to find the market to be generally rationale. We expect a modest decline in self-funded enrollment. Growth in our middle market client segment will be more than offset by a contraction in our larger national accounts consumer base, in part due to our successful efforts supporting clients who choose to migrate their retirees to Medicare offerings.
商业风险定价环境保持稳定，市场整体较为理性。我们预计“自筹资金”类客户人数将小幅下降，中端市场客户增长将被大型全国性客户群体的缩减所抵消，这部分原因是我们帮助客户将其退休人员转移至 Medicare 计划取得了成功。
In our Medicare business, we are just wrapping up a successful open enrollment period. For the full year, we expect to add up to 800,000 seniors in our Medicare Advantage offerings, well balanced between individual and group-based offerings, another substantive growth here in Medicare Advantage.
在 Medicare 业务方面，我们刚刚结束了一个成功的年度开放注册期。全年预计将在 Medicare Advantage 计划中新增多达 80 万名老年会员，且增长在个人与团体 Medicare 计划之间分布均衡，再次实现 Medicare Advantage 的实质性增长。
Our consistent growth reflects the value seniors find in the stability and quality of our offerings and our retention levels are strong due to that value and the Medicare product experience our members receive. And we expect to continue strong steady growth in our Medicare supplement offerings and a return to growth in our stand-alone Part D offerings.
这一持续增长反映了老年客户对我们计划稳定性和质量的认可。凭借所提供的价值及优质的 Medicare 产品体验，我们的客户保留率表现强劲。预计我们在 Medicare 补充计划上的强劲增长将持续，并实现独立 Part D 药品计划的增长回归。
In our Medicaid business, we expect another meaningful growth here, adding 500,000 people at the midpoint of our range as we serve more people with more complex needs like in Virginia. Began additional new state awards in Missouri and California, expand with new awards in existing states like in Nebraska and grow organically in existing markets.
在 Medicaid 业务方面，预计将再次实现显著增长，以中值估算将新增 50 万会员，我们正在服务更多像弗吉尼亚州这样拥有更复杂需求的人群。我们已在密苏里和加州获得新合同，在内布拉斯加等现有州拓展新项目，同时在现有市场实现有机增长。
Finally, we expect our international business to return to modest growth on more stable unemployment rates in Brazil.
最后，随着巴西失业率趋稳，我们预计国际业务将恢复适度增长。
On to medical costs. We expect to close 2016 with the commercial net medical trend of approximately 6%, squarely in the range we provided you a year ago. We continue to see the effectiveness of our strong medical management disciplines, as 2016 marks the eighth consecutive year of absolute declines in hospital admissions on a per capita basis across all of our businesses.
接下来说说医疗成本。我们预计 2016 年商业保险的净医疗成本趋势约为 6%，正好落在我们一年前所提供的预期区间内。我们强有力的医疗管理纪律继续展现出成效——2016 年已经是我们连续第八年实现人均住院率的绝对下降，且涵盖所有业务线。
Looking ahead, we forecast a modest increase in utilization trend, offset by 1 fewer calendar day in 2017. The net of these factors results in a stable commercial net medical trend outlook in the range of 6% plus or minus 50 basis points. This outlook reflects consistent unit cost increases of around 4% and utilization of approximately 2%.
展望未来，我们预测 2017 年医疗服务使用趋势将小幅上升，但全年日历天数减少一天将在一定程度上抵消该影响。综合来看，商业保险的净医疗成本趋势展望将保持稳定，预计在 6% 上下 50 个基点的范围内。该预期反映出单位成本稳定上升约 4%，医疗服务使用率约为 2%。
We will continue to move our reimbursement arrangements towards value over volume and advance benefit offerings that motivate consumers to make better choices and play an active role in their health care. Today, we have $52 billion in annual spend under value-based arrangements and we are right on pace to deliver our long-standing goal of $65 billion by the end of 2018.
我们将继续推进从“按量付费”向“按价值付费”的报销模式转变，并推动激励消费者做出更优健康决策、积极参与护理的福利设计。目前我们已有 520 亿美元年度支出采用价值导向型安排，正按计划朝 2018 年底达成 650 亿美元的长期目标迈进。
As in past years, unit costs continue to be the largest cost trend driver, new specialty drugs and cost increases on existing therapies are the primary factors, partially offset by a reduction in the use of hepatitis C therapies.
如往年一样，单位成本仍是推动医疗成本趋势的最大因素。新推出的特殊药物及现有疗法成本上涨是主要原因，部分受到丙型肝炎治疗药物使用下降的抵消。
We are hosting a seminar this afternoon to discuss Specialty Pharmacy in greater detail. We are looking to physicians for greater and more consistent engagement to further improve quality. This will contribute to a modest increase in physician utilization. Meanwhile, our inpatient and outpatient trends remain fairly consistent year-over-year, supported by this engagement and effective medical cost management.
我们将在今天下午举办一个关于特殊药房业务的专题研讨会，进行更深入的探讨。我们也希望医生能够更加稳定、深入地参与，以进一步提升护理质量。这一趋势将推动医生服务使用率的温和上升。与此同时，住院和门诊趋势与去年基本持平，这得益于持续的合作与高效的医疗成本控制。
Turning to operating results. We expect to close 2016 with revenue of more than $148 billion, exceeding the high-end range we provided 1-year ago by nearly $5 billion.
关于运营结果，我们预计 2016 年全年营收将超过 1480 亿美元，比我们一年前提供的预期高区间高出近 50 亿美元。
We expect reported earnings of $7.6 billion, within the range we provided 1-year ago, despite the previously discussed $325 million in greater-than-expected losses in individual ACA offerings.
我们预计全年报告净利润为 76 亿美元，尽管 ACA 个人保险业务出现了 3.25 亿美元超出预期的损失，但整体仍在一年前提供的区间范围内。
In 2017, revenue will grow to as much as $160 billion, reflecting year-over-year advancement up to $12 billion or 8%. This includes a reduction year-over-year in individual revenue of nearly $5 billion and over $2 billion in gross health-insurance taxes, not billed to clients in 2017. When you exclude these 2 items, revenue was growing at a double-digit rate of 13%.
2017 年营收预计将增长至最多 1600 亿美元，较去年增长 120 亿或 8%。其中包括来自个人保险业务的近 50 亿美元营收减少，以及 20 多亿美元未向客户收取的医保税款。剔除这两项影响后，核心营收年增长率达到 13%。
Across UnitedHealth Group, we expect our reported consolidated medical care ratio in 2017 to be in the range of 82.5% plus or minus 50 basis points. This 120 basis point increase year-over-year is driven primarily by the insurers' fee deferral in 2017.
UnitedHealth Group 预计 2017 年合并医疗费用率为 82.5% 上下 50 个基点，年比上升 120 个基点，主要由于 2017 年医保费用递延所致。
Our exceptional organic growth and continued effective medical care management and operating cost disciplines will drive strong earnings in 2017. Next year, we expect after-tax operating profit in the range of $5.1 billion to $5.4 billion. This reflects growth of 19% to 25% year-over-year.
我们出色的有机增长、持续高效的医疗护理管理与运营成本控制，将支撑我们在 2017 年实现强劲盈利。预计明年税后运营利润将在 51 亿至 54 亿美元之间，同比增长 19% 至 25%。
John Rex will take you through the individual exchange-related business and the insurance tax deferral affect the company's financials at a consolidated level.
接下来由 John Rex 向大家详细介绍医保交易所相关业务及医保税递延对公司整体财务的影响。
These strong financial results are a direct outcome of our concentrated efforts across United Healthcare to better serve the needs of consumers, care providers and our customers.
这些亮眼的财务结果，正是我们在 UnitedHealthcare 内部持续努力、致力于更好服务消费者、服务提供者和客户的直接成果。
We surround them with a supportive system of incentive, engagement, information and connectivity that helps people of healthier lives and makes the health system work better for everyone.
我们围绕他们构建了一个由激励机制、参与模式、信息系统和互联平台组成的支持体系，帮助人们过上更健康的生活，让整个医疗体系更高效地为所有人服务。
We share how we think differently about our role in health care, with responsibilities well beyond a traditional payer. This unique position provides a platform to fulfill our mission and drive steady growth and profitability in 2017 and for many years to come.
我们也在重新定义自己在医疗体系中的角色，承担起远超传统付款方的责任。正是这种独特定位，使我们能够更好地实现使命，并在 2017 年及未来多年持续推动稳健增长与盈利。
Thank you. Now please welcome John Rex.
谢谢大家。现在请欢迎 John Rex 登场。
John Rex President & CFO
Well, good morning. Just have to take a moment to survey this crowd. It's so good to see all of you here. Thank you for taking time to spend a day with us. It's an honor to have you here and I know well how valuable your time is.
So this is my first opportunity to be before you in this role, but it's far from my first UnitedHealth Group Investor Conference. That would have been nearly 20 years ago sitting where you're sitting today. I just happen to take a look at the materials from that meeting the other day. Yes, CFOs can get nostalgic and we hold on to anything with numbers.
Back then, we talked about a company that would exceed $17 billion in revenue, serve 5 million Americans in health plans and have a workforce of nearly 30,000 people. We talked about expanding into new market such as Medicare with an aim to reach 300,000 members that year. Yes, there was even a discussion about that year's version of Medicare reform and what BBA 97, the balanced budget act for all of you that remember might actually mean. Bell Atlantic, Northwest Airlines, Continental Airlines, Washington Mutual were among our important commercial account wins that year, brand names that don't even exist today. And 1 exciting new client was America Online, blazing paths in the new world of the Internet. We talked about the emerging discreet benefits and services platforms within our enterprise. And yes, for all of you, even about medical cost trends and the commercial pricing environment, some things indeed never change.
There was even an Optum presentation. Yes, there was. It was actually titled that. It described a new services venture with ambition to build multiple, integrated, horizontal platforms to help manage the complexity of the health care system. Now the goal was to serve United Healthcare with distinctive capabilities and also take those capabilities into new external markets. That year, an entity called Optum would post just over $70 million in revenue.
Over the next 2 decades, we continue to evolve building and strengthening the foundation of the distinctive growing enterprise we're privileged to represent. Today, we have shared many numbers and measures with you, thousands, millions and billions. I'll have another batch for you in just a moment. And certainly, the numbers are important. We use them to manage our business, track our progress, set goals and report to our valued stakeholders, including all of you. But the numbers they don't measure us. They don't define us. That definition can be better found on our intense focus on the future, the next 10 to 20 years, much as when I sat in your chair 2 decades ago.
As they have in the past, our people are delivering through innovation, adaptability, performance and new levels of compassion and the global need to help people live healthier lives and to make health systems work better for everyone has never been more urgent, compelling or humbling.
This morning, you've heard about commitments and goals for the value UnitedHealth Group can deliver. We measure these in many ways: healthier lives, net promoter score, operating performance, growth and so much more. Over the next few minutes, I'm going to walk you through the financial results that are driven by that value delivery. You have our conference book with all the details, so I'll stick to the highlights.
In short, the 2016 headline story is strong and balanced growth and momentum heading into next year and beyond. The $27 billion revenue increase is driven by performance across the breadth of our company, steady double-digit gains in each of health benefits businesses and high-teens to mid-20s percentage growth in Optum's businesses.
Operating earnings are estimated to grow by 20% this year with Optum Rx leading the way at over 50%. Growth rates are in the mid-to-upper teens in the other Optum businesses and 13% at United Healthcare. We look for adjusted net earnings of about $8 per share, growth of 24%. Strength and consistency of cash flow continues and at $10 billion full year cash flow will approach 1.4x net earnings.
Turning to 2017. We expect continued strong financial performance. We look for revenues to approach $200 billion, growth of about 8% on our sizable base. As Dan described, our top line growth is moderated by the reduced footprint in the individual markets and the ACA tax moratorium. Combined, these have about 400 basis points of impact. Optum and the United Healthcare Public Sector and Senior businesses will be the prime drivers of revenue growth, as the commercial benefits business continue steady disciplined growth.
Like this year, revenue growth is paired with improved net margins at about 40 basis points. The net margin improvement stems from core business performance, reducing the exchange footprint and the ACA tax moratorium and we expect strong cash flow again. At $12 billion, cash flow will increase 20% and approach 1.4x net earnings. With the effects of both the reduced individual footprint and the tax moratorium, it might be helpful to roll forward adjusted earnings to illustrate the strength of the underlying business performance. All in, we project growth of 16% to 20% in net adjusted earnings to a range of $9.30 to $9.60 per share. Starting with this year's $8 per share base, we suggest you consider 2 tailwinds. First, we expect to gain about $0.25 per share from a reduced profile in the individual insurance business. This eliminates the losses incurred this year, but also assumes that some of the related fixed and semi-fixed cost remain. Second, removing the ACA tax next year creates a transitory tailwind, which we size at about $0.25 per share. You may recall, we discussed the headwinds impact when the tax was first implemented. You can also conclude that the tax will create a headwind in the year it returns.
As we stated before, these impacts essentially neutralize over the course of several years. Our ability to drive earnings per share growth through the use of cash is a modest headwind that may not be as readily apparent. As you recall, when we made the strategic decision to expand the pharmacy care services business, we also knew that we'd be allocating capital to delever. So while this has modest end-year EPS growth impact compared to long-term potential, it positions us for strategic growth, provides financial flexibility and creates long-term economic value. Consistent with our long-term 13% to 16% EPS growth outlook, we continue to view capital allocation activities, such as M&A and share repurchase, contributing up to 5 percentage points over time. At the top end, adjusting from the 2 tailwind factors results in 14% adjusted earnings per share growth from the underlying performance of the businesses.
Next, I'll take you through some of the key ratios. While the net effect the moratorium is a tailwind, it has opposing impacts on several metrics. Premiums are essentially grossed up for the nondeductible health insurance tax. So the removal lowers premiums having an unfavorable impact on both revenue and operating earnings growth, while raising the care ratio. Going in the other direction, the moratorium improves both the operating cost ratio and tax rate. Let me spend just a few moments on each of these. First, we expect the medical care ratio to be stable before considering the effects of the insurance tax and the individual business. The impact of the moratorium is partly offset by the absence of losses in the individual market, netting to just over 1 percentage point. We expect a slight increase due to the mix effect of public sector and senior growth. This leads to 82.5% care ratio plus or minus 50 basis points for next year.
The second effect of the moratorium is about an 80 basis points impact toward lowering the operating cost ratio. We expect to continue to achieve our target of 20 to 40 basis points of productivity and efficiency gains per year and balance this with increased investments in opportunities that have been described here this morning. These will drive improved outcomes for the people we serve and more effective use of resources across health systems. To name just a few, these include the care delivery businesses, Optum 360 growth, Rally Health innovation, network enhancements and incremental quality and STARS initiatives.
Third, the moratorium of the nondeductible health insurance tax reduces our reported tax rate, offsetting the impact to operating earnings. Removing the tax is positive for health care affordability as the taxes mostly passed on in higher premiums. This is worth about 5.5 percentage points to our effective tax rate. The approximately 34% rate we expect is closer to our pre-ACA fee rate. Whether considering this year or next, our tax rate remains comparatively high versus leading companies in other industries.
Turning to the balance sheet. We continue to operate from a position of strength. Our EBITDA interest coverage ratio is 15x and we plan to continue to reduce our leverage position to 40% over the course of the year.
Since 2013, the compounded annual growth rate of dividends is about 30%. Next year, based on existing dividend levels, we will return about $4 billion to shareholders through a combination of dividends and about $1.5 billion in share repurchase. We will invest $1.7 billion in CapEx, similar to this year's pacing.
UnitedHealth Group has a tradition of disciplined use of capital to create shareholder value, both by building businesses and by returning capital directly, over the last decade about $90 billion in total. And over that period, having close to a 50-50 split between the categories, while given the opportunities before us, showing an emphasis on building businesses. Looking ahead, we believe the combination of our capabilities, market presence and financial discipline positions us to continue the compound growth to serve more people, more effectively and produce advancing results for our shareholders.
Thank you, again, for joining us this morning. And now I'd like to invite some of my colleagues to the stage, so we can take your questions.
Unknown Executive
Thank you. Two things that I'm going to ask for your help with as we assemble for Q&A. The first is a survey. We're going to send a survey out tomorrow afternoon. You're going to get it from me. This is Net Promoter Score culture meets performance value. We'd like to hear your input on today, so that we can continue to make this conference the best possible use of your time. If you preregistered, you're going to get it tomorrow. If you came in kind of at the end of registration or just signed up today, it's going to come to you on Friday.
The second thing is lunch. Just a couple of words about that. I need your help in coming into the lunch in a very timely way. It's going to be a very full luncheon presentation and it's going to be a very full lunch room. As you can hear them setting in there, we're going to have a sitdown plated lunch and a clinical insight discussion over the course of the lunch and the room is very full. So if you are a board member of UnitedHealth Group, Dannette Smith has a table for you at the left side towards the back -- or towards the front of the room, the opposite side from here. If you are a UnitedHealth Group leader, whether you are presenting or whether you are here at the conference in another capacity, there are reserved table tent signs for you. They are not by name, just any reserved table tent sign. You'll recognize them because they are the seats with the backs to the stage. So thank you for your help with that.
And if you're an investor coming in, please as you come in, maybe if you're one of the early people into the room, move to the front, so that we can get everybody in. We would like to be sitting down and eating at 11:20 in order to keep things moving through the course of the day. Leading a company of this size is obviously a complex challenge. Steve Hemsley is going to start by introducing the concept to the office of the chief executive and how that works for us.
Stephen Hemsley CEO & Non-Independent Non-Executive Chairman
So what we just thought as we've kind of open this we would give you just a couple of themes about how we think about leadership, and we think about it very much in team dynamics. So what you have in front of you is the office of the CEO, which is the kind of at the top of the house, the first-line team that really leads the organization. If you think an enterprise like this is ever led by one person, that is a complete fantasy. You need a lot of really good people. And they have to have a good chemistry and they have to work together and there has to be a natural kind of engagement. And that's what I think we have in the office of the CEO in a very informal way. It's not Tuesday meetings at 9. It's calls at 10:00, calls at 6 in the morning. It's whatever needs to get done and what needs to be responded to while we continue to drive kind of a strategic agenda. So this is that team and just really functions extraordinarily well. But 2 of our team members haven't had a opportunity to kind of have formal comments this morning. So we thought -- I thought I would hijack a couple of minutes and ask them my own questions. And when I think about all the leaders that you saw today, and that's not an accident, that's purposeful, and we have about 70 or 80 of our emerging leaders that will be with us through the course of the day and so forth, so that they get an appreciation for what we're doing. Keeping that going, keeping that alive, I'm going to ask Ellen Wilson to kind of comment about how are we going to do this.
D. Wilson Former Executive VP
Good question. Well, we take leadership development and talent management incredibly seriously here especially with our growth plans. So I look at it in 3 different ways. One is the new talent we bring in, so talent acquisition. And we'll probably fill almost 40,000 jobs this year. So those are new jobs, those are replacement jobs. We look at every labor market. We look at every possible way to access these candidates. So that is a huge piece of what we do and then to assimilate them. Once they are here, development is a huge undertaking and we do both formal programs. But I would absolutely believe that 80% of development is on the job. And so we're fortunate that we're growing because we have access to new jobs almost every day. And then the third leg of that stool is talent mobility. So it's actually planning, helping people plan their careers and actually giving them access to different opportunities. So this year, we'll probably move almost 20,000 employees into different roles internally in the company and that's worldwide. So think of it as a 3-pronged approach, incredibly serious business. You never want to have a lack of talent for the growth of the business.
Stephen Hemsley CEO & Non-Independent Non-Executive Chairman
Thank you. And if you think about other themes that came across today hoping that you've got the sense of our commitment to quality and NPS, and a clear building block of that was making our regulatory compliance very strategic, very operational sense of accountability that if we want to be a trusted name in health care that compliance and real respect for regulatory needs was clearly a core element of what we talk about in terms of quality. So I'm going to ask Marianne to comment a little bit about those things.
Marianne Short Former Executive VP & Chief Legal Officer
Thanks, Steve. So as you've heard and as you've seen, hopefully, from the stage, we have a strong culture of compliance here at the company. It's actually, I think, woven into the fabric and it translates our company values in everyday actions that we take. Compliance, we say, and I think you've heard from the stage again, that we think it's a competitive advantage for us here at the company. It improves our relationships with the public sector as well as our commercial clients. And it improves, importantly, the measurements of our success as a business. We've talked a lot about NPS today but also star ratings and audit outcomes and really member retention. And of course, that all leads to success in the businesses as well. So when we deliver the highest quality of service, we're really doing that for our customers and our clients, and it gives us more opportunity, it gives us retention, it helps us to grow as well. So the other thing I think about compliance when I think about it, it is really the tone at the top. It is led by the most senior leaders, as you've seen here again from the stage. So it has the right degree of importance and it has the right degree of dialogue, and there is nowhere to hide from it because it comes from the top. So a couple just other little points that I'd make about it, obviously, it's what binds us, it makes us better. But compliance is dynamic. It's not static. We work on it regularly. We have the usual annual training programs that we run on all of our codes and all of our laws. But it is living, breathing. It shows up in almost every meeting that any of us attend, I think, and how we run our business. So I would just end by saying that -- I said it's our competitive advantage, but we are really true advocates than -- with state and federal regulators on how to break down some barriers and have better access for our customers and clients. And compliance helps us with that. And state and federal regulators recognize us for some of our best practices. A couple of just recent I will end with is the 2016 -- and I'm looking over at Steve Nelson, CMS Audit in which we were recognized for best practices. Another was the 2016 Connecticut Cybersecurity Review, and we were recognized again. So we take great pride. We hold each other individually and as a group responsible for attending and complying with all the compliance.
Stephen Hemsley CEO & Non-Independent Non-Executive Chairman
So thank you for that. Now we have our other team members warmed up a little bit, and we're going to incorporate some of our other management who are sitting -- I'm assuming in the frontline here, since I can't actually see any of them with these lights. But we're going to try to get the whole team in the act here. So John, do you want to...
John Penshorn Former Senior VP
Thank you, Steve. We've got mic runners in the back. Thank you, Teresa [ph].
Ralph Giacobbe Citigroup Inc.
Ralph Giacobbe, Citi. I just wanted to understand [indiscernible] a little bit better the $0.25, just help us understand. Is that direct bottom line impact of the amount that you essentially couldn't pass through? Or is there sort of some incremental amount that you're sort of plowing into benefits?
John Penshorn Former Senior VP
Mr. Rex.
John Rex President & CFO
Sure. And I will ask Dan Schumacher to elaborate also anything else, but -- so quick answer is yes, that is the direct bottom line effect, but it incorporates the offsetting impact of incrementally what we're, as you said, plowing into benefits also in order to create a real stable benefit environment for our members. So kind of net-net, after-tax bottom line, and you see we took pains to take everything to this after-tax level today. So the best way to understand it since the nondeductible nature of the tax gets confusing when you're sitting up at the operating earnings levels. That's why it down that way. Dan, any other comments on that, that you'd want to add?
Daniel Schumacher
Ralph, I just add that in the commercial business, right, you've got to account your tax balance against policy year cycle. So that's where you create a little bit of disconnect. So it's a bit of a damage here in 2016. It's a benefit in 2017. And over the 3 years it washes out, but that's what creates some of that dislocation.
John Penshorn Former Senior VP
Thank you. Janice [ph], please. And then, Fran [ph], we'll do you next. Anybody in this section with a question?
Unknown Analyst
I was hoping you could elaborate on the growth that you expect in the group commercial risk space. I think you are pointing to 150,000 to 300,000. How much do you think is going to come from the small group arena? And maybe more broadly, to what do you attribute your ability to make these market shares in the group insurance space. It historically has been very price-sensitive without seeing maybe the kind of margin degradation that we would -- we had seen from other companies when they've made market share gains of that sort in the past?
John Rex President & CFO
So I think we will have Dave respond to this and then you can maybe get Jeff and Dan in here.
David Wichmann Former CEO & Director
Yes, well, maybe I'll just say a few top-level remarks and, really, it's Jeff Alter who is -- a position of business for what I'll call consistent, steady, deliberate growth in this segment, something that I think has evaded the company up till the more recent past. So specifically to answer your question, the growth is pretty balanced, as it has been really between what we call small business and key accounts. So the middle market segments as well. We have -- and then inside those, there's subsegments as well, which we've been pretty deliberate around subsegmenting those markets and developing deliberate strategies to advance the growth of our business. Over time, and I know you've questioned this some as well and I think that's a fair request, but over time what we found is that we gave a lot of growth to the market, particularly, when co-ops and others came into the marketplace. What we saw was a level of pricing -- lack of disciplined pricing that caused us to lose some membership, call it, 3 years ago or so now. As time has gone on and those pricing strategies have failed, we've seen, particularly in this market, some of that come back to us. So that's what we've been talking about for last couple of years about the market returning back to us, which is in part what's fueling our growth. But I think what you saw today from UnitedHealthcare is kind of a broad-based agenda around advancing quality, listening better to the consumer, really an intense focus on managing medical costs and providing additional service capabilities and technologies to people so that they become more loyal and more trusting in us. And in turn, we're finding greater sense of persistency across our business. So that is what is not only helping us to grow in the past couple years, but also this year and hopefully we'll see for the foreseeable future. Jeff?
Jeff Alter Former CEO of UnitedHealthcare Employer & Individual Business
Thanks, Steve. Yes, I would reiterate some of the things that Dave said, but think of 3 categories. One, first and foremost, our persistency of existing accounts has reached record levels for us. And when you think of the size of the book that we have to manage, just a couple of percentage points in client retention is a huge headwind that we don't have to overcome on a year-to-year basis. I would reiterate, Dave, we were very disciplined going into the ACA in early 2014 and paid for it in a lot of -- in membership if you look back at that earnings call. We took it pretty hard on the chin in the number of markets. Those markets have come back to us as we remained disciplined. And the third area, which you may not see as evidence, but we started in 2012, 2013, really looking at our portfolio of products in the small business. And we were always known as a very large network, high-benefit, high-priced premium plan. And recognized as we move into the new world, we had to have a more broader price point. So we worked really hard in network design, product design to give us a much broader spectrum of products, particularly in the small end of our businesses, in the fully insured end of that business to be able to hit price points at appropriate margins and appropriate loss ratios, but to broaden our ability to gather growth at different price points than we had historically been able to.
John Penshorn Former Senior VP
Thank you. Good question. Fran [ph].
Unknown Analyst
I have a question about Medicare. Tremendous growth you're expecting in Medicare Advantage. How do I think about the trade-off with the EGWP and other issues offset by HIS [ph] in terms of the ex-HIF [ph] MLR for Medicare Advantage and also on Medicaid. Are you seeing rate cuts that could impact that loss ratio ex-HIF [ph]?
John Penshorn Former Senior VP
That's quite a combination question. Nice job of getting Medicaid into that. Maybe we should start with Steve in terms of the discussion around Medicare.
Steve Nelson
Sure. So just a few comments on the Medicare growth. Maybe just some high-level drivers. First, it is balanced with between group and individuals. So that's important component and context for -- in which to view the growth. And really excited about the fact that we do have strong momentum in both group Medicare Advantage and individual. Also, it's driven significantly by better retention, and so that's significant. Obviously, we have a lot of insight and experience with the members we already have. So that's important in the space. A couple of drivers, though, specifically that we've seen play out during this enrollment is the market is really reacting favorably to our stable benefits and the value that brings and when you add on to that progress we made in STARS, that's playing through and resonating really nicely in the market. Also, really have engaged our provider and distribution partners differently over the past couple of years and that has really been gaining momentum. Then last, I would just say, a lot of investment in -- and you've heard this throughout the morning -- in the member experience. And that is creating a different kind of dynamic as we talked to seniors about their health care choices, not just about benefits, but about health care experience. So those things are all kind of combining together and create some really strong growth. The -- and then maybe I'll just ask Dan to talk about the MLR impacts across Medicare and Medicaid for the health insurance tax. Sounds good?
Daniel Schumacher
Perfect. So with respect to the impact, obviously, in Medicare, we don't get any premium for it and is not a medical cost item. So from a Medicare perspective, no impact on the medical care ratio as it relates to the insurer's fee, either get in place [ph] or get in moratorium [ph]. As we thought about planning our benefits, we looked at it not as a windfall opportunity but as an opportunity to make meaningful investments in our product portfolio and the benefits that seniors get to realize, and as to Steve's point, certainly showing up nicely in our growth. On the Medicaid side, it's a pass-through. So obviously, it has the MLR impacts that John talked about in the Medicaid business, but when you strip that out, you should expect generally stable medical care ratios in our Medicaid business. And outside of the -- the only impact is obviously the insurer's fee and it's wearing off.
John Penshorn Former Senior VP
Austin, you want to comment on the rate environment in Medicaid?
Austin Pittman
Sure. Thanks. So really as we've kind of talked about over the quarters, there is not a real difference in the rate environment. States continue to really be challenged to provide more coverage, higher-quality care. We see it as stable, keeping pace with medical. And so the outlook is much like we've seen in this past year, continuing into this next year. We will see continuously, as we've talked about, the normalization of expansion rate to that 3% to 5% margin. So historically, as we've entered that expansion market, it's been a bit higher on the margin side. We've continued to see that steadily walk down back towards that what we've always expected it to be and perform in that 3% to 5% margin.
John Penshorn Former Senior VP
And that's in our outlook.
Austin Pittman
It's absolutely in our outlook.
John Penshorn Former Senior VP
Thank you. Let's come in the middle here. While we're handing the mic, I want to tell you this is a very professionally lit stage. And so you're wondering why is John not calling on me. It's because I can't see who individual people are. We are just going for hands.
Unknown Analyst
It's a question on the guidance here because, I guess, John, I've only been to 9 Investor Days, not 20 yet, but I'm used to you guys lowballing guidance and then slowly walking us up and even with this...
John Penshorn Former Senior VP
What kind of question is this, Kevin [ph]?
Unknown Analyst
Well, we'll get there. And even if you take out $0.25 from HIF [ph] and everything else, I mean, you're guiding to 10% to 15% kind of organic earnings growth, it sounds like, even though you're only getting 1% from share repurchase instead of the typical 5% you normally think of. So this seems like a pretty good guidance to start off with. Is this -- I haven't heard anything at all about headwinds in 2017. Is this a good guidance because you see things pretty straightforward? Or is this -- is there some level of conservatism in here the way that we're used to hearing you guys provide initial conservative guidance?
John Penshorn Former Senior VP
Well, I might start -- I will answer this one.
Unknown Analyst
Great idea.
John Penshorn Former Senior VP
Little offended on the notion that we -- I think we try to give you a balanced, measured view. And I think that we don't try to be conservative nor do we try to be unrealistic in terms of our outlook. There had been a rich market for headwinds over the last few years. And I would say that we have less of them. And I think we're being honest and balanced about that. I remain respectful of all the things and all the elements that you are profoundly aware of in the health care domain. It is a complex area. It is one that challenges your execution. There are a number of uncertainties that are so prevalent in the marketplace that they don't even feel like uncertainties anymore. They're just part of the landscape of health care. I think we've tried to put those into perspective and the momentum of our businesses we have had growth. And I think growth is the core element that you will see in here. We -- you've heard Jeff talked about it. You've heard Steve talked about it. You heard Larry and his colleagues talked about it, that we are growing across the board, nice diversified balance growth, not excessive in any one area, and there is an accumulative effect of that over time. So I think you're seeing some of that. We're also seeing hardening of our disciplines around operating costs. But maybe beyond some of the spending we've had to do for regulatory and compliance efforts. And so I think those things are coming together in something where we have a little bit more visibility, and I think that we've given you a balanced view. So I think, as we've said in the past, we'll always be focused on performing better than what we are offering. We're trying to give you something that you'd see as reasonably ambitious as well as realistic in terms of how we think we can perform. And then I will ask Dave and Larry to comment with respect to growth attributes and performance, because you're really talking about the performance of the enterprise.
Larry Renfro Former Vice Chairman
Want me to go first.
John Penshorn Former Senior VP
Yes.
Larry Renfro Former Vice Chairman
We kind of look across the enterprise and I'll focus on Optum for a minute and we look at certain attributes when we're looking at our growth. And one would be obviously our sales pipeline and how that's growing in, what's happening there. And that's up about 3x over last year. So we feel pretty good about the strength of that pipeline. Second attribute we look at would be what kind of TCV or total contract value we're getting when it comes to sales and how we're doing. That's up about 3x as well. So you've got a pipeline that's growing at 3 and you've got actual sales that's growing at 3. And then we have, and you've heard, I think, John and Tami talk about our backlog being $12.6 billion, that's up about 20%. A lot of these things that we're doing, it's all about relationships. I mean, we're building these relationships and we talked a bit about that in our approach. And I think you can see the statistics, you can see the numbers, you can see the outcomes, and we're feeling pretty good and pretty strong across the entity when you look at our development rate.
John Penshorn Former Senior VP
And we've actually tamped down Optum's growth rates a little bit more modest than last year. Obviously, different set of comparisons because of the acquisition dynamics of last year, but I think Optum reflects a really good balance measurement. Did that help? Dave, do you want to comment?
David Wichmann Former CEO & Director
Yes. So maybe the comment I'll make is if you look underneath the performance of the business, look underneath the impact of the headwinds have performed for the past few years, you'd find a comparable or strong rate of growth. It's just been that we've been balancing off against the headwinds for quite some time. The other thing you'll notice is that UnitedHealthcare's numbers are, at least on the revenue line, are understated in the fact that we've pulled out the HIF [ph] as we call it, the build HIF [ph], if you will. But in addition, we've had taken out the impact of the individual exchange and individual ACA membership as well, which is extensive. It's 1 million people. So underneath that, you actually have a business that's growing at a double-digit rate. So I have no explanation beyond the fact that both of the businesses are growing and growing strong, growing deliberately as well. You see it most pronounced in the government programs space where I think the opportunities are really afforded to those who can deal with the most complex circumstances the best. And that's what I think our Medicare business has been tuned to do. It dates all the way back to our Evercare roots of this business. We just continue to compound and build upon that over time. And now we've applied those same concepts as we look at the expansion populations and then also dealing with the long-term services and supports population, which are very challenged populations from a health perspective. So utilizing tools like the patient-centered care model, a house call, the intense focus on STARS and the quality that it brings to the marketplace, the alignment of the reimbursement systems, all the way from the consumer through the care provider. All that is coming together to establish a foundation for growth of this business like it has not seen before. And it just happens to be at the time where the market has been made available, and our team has done a fantastic job of deliberately pursuing that and achieving the kind of growth that you see here today. So it's -- we are balanced, we continue to view ourselves as prudent, and I think you're seeing -- the bottom line answer is broad-based growth.
John Penshorn Former Senior VP
Janice [ph], up here, please.
Hima Inguva BofA Securities
Hima Inguva, Bank of America. John, I attended 6 Investor Days, not 20. I thought that's a new trend you're required to disclose the number before asking a question. Two questions, if I may, please. One is, can you elaborate on your M&A outlook and long-standing criteria for acquiring growth? In the past, you indicated the focus to be mainly Optum and assets in international and unregulated markets, is that still the case? And then do Anthem, Cigna and Humana deals closing or not closing change the way you plan to approach M&A? And then the second question is...
John Penshorn Former Senior VP
Well, I'll deal with that one. We're really not going to comment on transactions of others or activities like that in the marketplace. So we'll just carve that piece of it out. And before you get to the third part of your single question, maybe we'll have John just comment a little bit about -- has anything changed in our basic outlooks and Dave should have something to offer on this, too, because he was really -- this is an area of real core strength with him.
John Rex President & CFO
Yes. And so quicker answer on that is, so you're correct, our focus over the past number of years has been on the services business and international in terms of what we're doing from an M&A perspective. Part of that has to do where we see the opportunity set. You saw a lot unfold on the stage here today to see where we're building our businesses. And those are in services, intensive businesses, and that will continue to be the case. And if you look at kind of our M&A track record, 10 years ago and the last 10 years, you'll see that shift to a services and international blend. I would expect that to continue. But it's driven in part much by opportunity set, much where we see the growth going forward, markets we're not even in right now, businesses that are where they may be multibillion-dollar businesses today for us are just barely getting started in terms of the opportunity we see.
John Penshorn Former Senior VP
And, Dave, maybe about broadly our capital allocation disciplines and perspectives?
David Wichmann Former CEO & Director
Yes. So this is pretty consistent. I think John had really nice slide, which shows the allocation of capital over time to be about 50% investment, if you will, in both M&A and CapEx, growth CapEx in our business and about 50% really focused on returning dollars to shareholders. And the only real shift that you've seen over time in the more recent past -- over the last 6 years or so is we have progressively moved our dividend forward what I characterize as a near market level, and market for us is where compete for capital, which is more in the Fortune 15 -- or Fortune 50, excuse me, zone -- Fortune 15, no, Fortune 50 zone and the Dow 30 and others. So that would put you in a zone of about 30% to 35% or so as a dividend payout ratio as a business. As we've extended that, and also because of the Catamaran transaction and our interest in moving our debt to total capital back to a 40% zone or lower, we have reduced our share repurchase and we're only doing enough to hold our share count level. So pretty consistent policies over time, they'll vary year-to-year. Couple of years ago, the extensive investment in Catamaran or, I guess, a year ago or so, that extensive investment and maybe a more modest approach this 2016 year.
John Penshorn Former Senior VP
Fundamentally, no change then. Do you remember the third part?
Hima Inguva BofA Securities
Yes.
Unknown Executive
I was hoping you'd forget.
Hima Inguva BofA Securities
This is easy. So if we do the math, $6 billion for growth capital and leverage reduction, if I can assume, if I back into 40% debt to cap, that leaves about $3 billion for cash use towards M&A. Is that fair to assume that for -- to the extent that there's a larger deal you'd be open to using equity capital. And then I'm obviously asking the question on behalf of bondholders here. Do you expect an uplift from current levels as you pay down debt and reach the 40% in '17?
John Rex President & CFO
Uplift in ratings?
Hima Inguva BofA Securities
Credit ratings, yes.
John Rex President & CFO
Thank you. Again, I don't think our philosophy has ever really changed. And the disciplines around making thoughtful investment in the right property that adds to the kind of the strategic framework that we have built here, we would engage very broadly in thinking around what could add value to the marketplace, added to the strategic framework of this enterprise. I don't think that changes and the mix of whether it is cash, equity and so forth. That has, again, has not changed. We've used equity in the past. We've used cash. So we would be open across the board. In terms of ratings, Dave, I would imagine that we would continue to -- I think we already have strong ratings.
John Penshorn Former Senior VP
Do you want to touch on that?
David Wichmann Former CEO & Director
Yes, well, let me touch on a couple of things, as you said. So your math is in the zone here in terms of what you are interpolating here in terms of that potential for -- in terms of debt paydown. In terms of ratings, I mean, certainly we've made -- we have laid out the framework under which we'd operate when we made the Catamaran acquisition and are really kind of sticking to that timetable and I think we're delivering on it in terms of getting back down to the debt capital ratios that we committed to. And so I think we've been very much in the zone of what the rating agencies would have expected us to do over this time frame for long.
John Penshorn Former Senior VP
We have a strongly rated balance sheet.
John Rex President & CFO
And then if I could add one thing, if you don't mind. So the one thing I'd add is if you look at the last 20 years of M&A, 175 transactions or so, about $60 billion of capital, it averages out to be about that level year by year. It just happens to be the case. I guess what I wanted to say is we're not intensely rigid. I mean, those are, in terms of the way in which we kind of manage those types of things. They don't necessarily fall into calendar years as perfectly as you might expect. So as a result, if we're able to maybe move some things forward or deferred some things back that things will move in and out in this 2017 calendar year as expected. Point being, though, is our intention is to move back to 40% debt-to-total capital ratio. We've been on that journey since the close of the Catamaran transaction. I think we're making very nice progress today and will continue to make progress towards that hopefully by the end of this coming year.
John Penshorn Former Senior VP
Yes, Fran [ph], I see your hand.
Peter Costa Wells Fargo Securities
Pete Costa, Wells Fargo. I think I have you all [indiscernible] on Investor Day for UnitedHealthcare. I won't talk about those. Those are the days. But my question goes back to Medicare Advantage and why your growth is so much there. The Medicare Advantage grew 5% this year. You're showing 20% less growth for next year. I understand it's balanced, so I guess, if I look at the group side, your commercial fee-based business would have grown if it wasn't for the conversions from commercial fee into Medicare Advantage. So I understand that. But of the retail, the individual side on the Medicare Advantage, can you explain to me where you got that membership from. Dan mentioned putting more of benefits of the HIF [ph] into benefits this year. So does that mean you're going to have to pull that back in 2018 if the HIF [ph] comes back and did you steal that business from other Medicare Advantage players? Or did you steal it from traditional Medicare?
Daniel Schumacher
I'd like to think of it as competing for and winning. But so I think you've got it right. On the group MA, I think we have a pretty unique value proposition because we have such a strong base of serving large accounts. And we understand that market segment very well. And I think that's fairly unique and distinctive for us among the other large players in this category. So that trend kind of follows the trend last year as well and the year before where we've won a lot of what the market made available to us. And again our team did a very nice job of executing against that opportunity. On the individual MA, we have to kind of look a little bit at the macro forces. So while the HIF [ph] is a component, it is a small component of the investment, if you will, invested in benefits. It's certainly there. It's overshadowed by the effects of things like the effectiveness of the House Calls program that Optum puts in place, which reduces ER visits and inpatient days and readmission rates and subacute days, as an example. So that's reduces our cost structure. But in addition, the advances on STARS and the reimbursement associated with that and then using that to stabilize your benefit and your premium base all give rise to this growth. So, assuming I didn't completely drain at the -- Steve, do you have any further...
David Wichmann Former CEO & Director
Yes, that's a good -- I might jump in because I actually think Steve's already kind of addressed this. But let's start a couple of years ago. I think we were very -- and I think we were very candid with you about being out of position and not pleased with our Medicare business. We took network actions. We were disruptive with respect to our benefit actions and Steve commented on the notion of really getting back to basics: The stability, the consumer experience, stability in networks, stability in benefits. To Dave's point, we had been stable in benefits. We have not overachieved by giving economics forward that we know could come back on us. So I think the approach to this in the NPS of that business, that is one of our highest NPS businesses, I think it speaks to retention, where we have had the best retention in that business and Jeff Alter has had in commercial and that we've had in the -- probably in our history in terms of duration. So much of this was, painful to say, getting our act back together in terms of Medicare and the elements that Dave talks about and the dynamics that Optum brings to it, we have more to offer in the space where the seniors see better, more modern, compelling offering than is available to the other places. Did I leave anything for you Steve?
John Penshorn Former Senior VP
We're going to take one last question. Currently, [indiscernible] come on up here. All right. We'll do 2. You 2 guys right here and then...
Unknown Analyst
It's interesting given the last couple of weeks that we spend so little time talking about the changing landscape in Washington. You mentioned it briefly in your comments, Steve. Doesn't sound like your growth outlook in the near to medium terms is contingent upon what happens in Washington. Just want to confirm that. And as you assess the landscape, what are the opportunities that you see potentially out there, challenges? And are you making any recommendations to the new administration?
Stephen Hemsley CEO & Non-Independent Non-Executive Chairman
Okay. So let's start by saying I think the commentary we started today with was really to respect the fact that policies may shift over time and that those policies can factor into your health care experience and then we have been thoughtful, respectful of those activities, very well engaged. Cory Alexander is going to be offering a seminar through the course of the afternoon. So I think you'll get a feel for it and some of our other seminars will also have themes in that we have to be attentive, engaged and value-added in the debate around changes in health care policy. That being said -- and then adjust, I think, the elements that came through should be adjusted and evolved to respond to that changing landscape. But the underlying themes, the underlying currents of health care around creating, as Larry said, a simpler, better consumer experience, taking the complexity out of the health care environment. The elements are around giving that consumer a more trusted and more consistent experience, getting cost under control and making the offerings more affordable to them, helping make the health system perform better by engaging more broadly in the spectrum of Optum's offerings. Those elements have durability. They're sustaining themselves in the marketplace. They were in motion before the last administration. They continue to be in greater motion, and I think those things will continue to play on. And those are the themes that we read. And then we will navigate with respect to policies that we value at. And I think to your question, we are very well engaged, again, facts, research, what works, insights about the marketplace, those elements. And we will adjust as the marketplace adjusts, and we have kind of an attitude of whatever comes. And so I would say that's kind of what's drives us.
John Penshorn Former Senior VP
All right. Thank you. Last question right here.
Unknown Analyst
So similar theme there and I understand the respect for legislation changes over time, but if I think about UnitedHealth Group, the last 8 years have admittedly been focused. John talked about service and international. The 8 years preceding that was a huge allocation of capital, the benefits business right? And that it's not really 10 years, it's really very specifically those 8 years. And so the market has set in the last couple of weeks there's a significant increase in the value of the benefits business. But I'm hearing from you that you are not really thinking that. So do you think the market has got it wrong? Or do you think it's just going to take time for United to digest what that potential change in legislation looks like and I guess based on the real question, is do we think benefit is going to be bigger driver over the next -- could maybe 4 years, potentially 8?
Stephen Hemsley CEO & Non-Independent Non-Executive Chairman
That's an interesting perspective because we have always loved the benefits business. It's the original business. And I don't think about them as being mutually exclusive, but think about that clearly as being better together and more dynamic together. They are good catalysts for each other. So I don't think about one versus the other or one being more favor than the other with respect to kind of legislative. When you think about the marketplace, they need all of this. They need a modern, progressive, consumer-centric, innovative benefits platform and they clearly need and a platform that brings a lot of those same elements to there to advance the health care environment system in total, and it's not just limited to the United States. Those elements play out powerfully in global markets. When you think about the NHS, you think about Brazil, you think about any of the social health care markets. They have all the same challenges and needs in terms of more modern, simpler, more consumer-friendly benefits and access and a system that works more effectively. So I don't think our perspective on that has changed or had been influenced by what's going on. We continue to think that we have really great growth prospects if we continue to work on our business and continued to invest in our competencies, our culture, our people and maintain the right perspective in terms of certainly social markets.
Unknown Executive
I would like to throw in on that. The context of your question may be around capital allocation and the bias towards services in international was not around what the potential future value of one versus the other might be. It was more commentary on the relative level of majority and development where benefits is well built today. Dave talked in his remarks about continuing to add geographically in areas that make sense. But it was not any comment on relative value between the various pieces.
John Penshorn Former Senior VP
So Steve, if you got some...
Stephen Hemsley CEO & Non-Independent Non-Executive Chairman
So thank you for joining us today. We realized it's been a long morning. I hope you will be joining us for lunch. I think you'll find the clinical session to be very provocative and very interesting. I think the takeaways from today are simply this: Kind of the coming of age of a strong, diverse, well-performing enterprise, as I said earlier, kind of driven by the right things, right mission, the right culture, strong leadership and a strong leadership team and a great workforce. We're very restless to take our performance to the next level and those being areas of service and innovation, value, and the quality of our work and then the growth that comes from that and then in shareholder return, kind of serving the growing needs of an enormous global health care marketplace. We're ready to adapt and to evolve to serve those market needs, helping people live healthier lives and making the system work for everyone. We'll be around for the course of the day. Thank you for joining us this morning. And we look forward to seeing you at lunch.
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