Operator

运营商

Good morning. And I'll be your conference operator today. Welcome to the UnitedHealth Group Second Quarter 2017 Earnings Conference Call. A question-and-answer session will follow UnitedHealth Group's prepared remarks. As a reminder, this call is being recorded. Here is some important introductory information.

大家早上好，我是今天的电话会议主持人。欢迎参加联合健康集团（UnitedHealth Group）2017年第二季度财报电话会议。在公司准备发言结束后，我们将进入问答环节。请注意，本次电话会议正在录音。以下是一些重要的介绍信息。

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

本次电话会议包含根据美国联邦证券法规定的前瞻性声明。这些声明涉及可能导致实际结果与历史经验或当前预期产生重大差异的风险与不确定性。相关风险和不确定性的说明可以在我们提交给美国证券交易委员会的报告中找到，包括我们定期发布的风险提示内容。

This call will also reference non-GAAP amounts. A reconciliation of the non-GAAP to GAAP amounts is available on the financial reports and SEC filings section of the Company's Investor page, at www.unitedhealthgroup.com.

本次会议还将提及非GAAP财务数据。非GAAP与GAAP财务数据的对账信息可在公司投资者网站 www.unitedhealthgroup.com 的财务报告和SEC文件板块中查阅。

Information presented on this call is contained in the earnings release we issued this morning and in our Form 8-K dated July 18, 2017, which may be accessed from the investors’ page of the Company's website.

本次会议中提及的信息包含在我们今天早上发布的财报公告和2017年7月18日提交的8-K表格中，投资者可通过公司网站的投资者页面获取。

I would now like to turn the conference over to the Chief Executive Officer of UnitedHealth Group, Mr. Stephen Hemsley.

接下来，我将电话交给联合健康集团首席执行官 Stephen Hemsley 先生。

Stephen J. Hemsley

Good morning and thank you for joining us today. As we reach the halfway point of 2017, UnitedHealth Group, Optum, and UnitedHealthcare continued to grow and perform strongly and we expect our performance momentum to carry forward through the balance of this year into 2018 and beyond.

大家早上好，感谢您今天的参与。2017年过半之际，联合健康集团及其旗下的Optum和UnitedHealthcare依然保持强劲的增长与表现。我们预计这种增长势头将在今年下半年延续，并贯穿至2018年及更远的未来。

UnitedHealthcare has been a distinctive organic growth leader over the last seven years. During that same time Optum has emerged as the leading force for broadly enabling the healthcare industry with market leading data analytics and practical and innovative approaches to longstanding market challenges.

过去七年里，UnitedHealthcare 一直是有机增长方面的引领者。同时，Optum也迅速发展为推动整个医疗行业进步的核心力量，依托领先的数据分析能力以及在解决行业长期挑战方面的创新务实方法。

These businesses are strong, stable, and exceptionally complementary to each other, growing and operating effectively while continuing to diversify naturally into adjacent healthcare markets.

这两大业务板块都非常强劲、稳定，彼此之间高度互补，在高效运作和持续成长的同时，也自然地向相邻的医疗市场延伸。

With a socially sensitive global healthcare market constantly challenged and changing we see UnitedHealth Group, Optum, and UnitedHealthcare built for that environment. Adaptable and creative, focused on the people and customers we serve, working with others and playing our role in leading and supporting progressive change across health systems.

面对一个社会高度关注、不断变化且充满挑战的全球医疗市场，我们认为UnitedHealth Group、Optum和UnitedHealthcare正是为这一环境而构建的：灵活应变、富有创造力、以人为本、以客户为中心，积极与各方协作，引领并推动医疗体系的持续进化。

One important constant is our commitment to mission and the quality of our work, the positive experience and value we drive on behalf of consumers and customers, and their cultural bonds of integrity, compassion, relationships, innovation, and accountable performance we seek to bring to everything we do.

我们始终如一地坚守使命、追求卓越工作质量，为消费者和客户持续创造积极体验与价值，并以诚信、同理心、关系建设、创新和责任绩效为文化核心，融入到我们开展的每一项工作中。

We are at home in the current environment. UnitedHealth Group is a different organization than we were just 10 years ago and you should expect us to be different still a decade from now. Society will continue to need and drive change in healthcare, we will continue to adapt and evolve with it and on behalf of it.

我们在当前环境中如鱼得水。联合健康集团已经与十年前大不相同，十年后的我们也将持续演进。医疗行业的变革仍将持续，并将由社会各界共同推动；我们也将不断适应并引领这种变化。

We are committed to reaching the full potential that UnitedHealth Group has to offer, knowing the next 10 years hold more opportunity than the last 10, those who are committed to keep evolving, perform consistently, and deliver value.

我们致力于释放联合健康集团的全部潜力，因为我们知道，未来十年的机会将远超过去十年。唯有持续进化、稳定履责、持续创造价值，才能赢得未来。

To guide our progress we have a strong, deep, and restless leadership team in place which will continue to positively evolve and change as well. I'll turn to three of those leaders Dave Wichmann, Larry Renfro, and John Rex to take us through our second quarter earnings report. Dave?

为推动我们的持续进步，我们拥有一支强大、资深且不断进取的管理团队，并将在未来继续演进与成长。接下来，我将请出我们三位核心管理者——Dave Wichmann、Larry Renfro 和 John Rex，为大家详细解读第二季度财务业绩。Dave，请开始。

David S. Wichmann

大卫·S·威奇曼

Thank you, Steve. We enter the second half of 2017 in a strong position. UnitedHealth Group is serving more people more consistently with greater levels of measurable satisfaction than ever. We are reaching, helping, and staying connected to the people we are privileged to serve in more ways and through more channels both digitally and physically in the communities where we work. We are caring for more people, closing more gaps in care, and producing more savings and value for consumers and sponsors.

谢谢你，Steve。我们以强劲的势头进入2017年下半年。联合健康集团目前服务的人数更多，服务的一致性更强，客户满意度也创下新高。我们通过线上线下多渠道、以更多样的方式触达、帮助并持续联结我们所服务的人群，在我们所扎根的社区中深入运营。我们正在为更多人提供照护，弥合更多的健康服务差距，并为消费者和保险出资方带来更多节省和价值。

We are partnering more deeply and impactfully with care providers in part because our nearly 25,000 OptumCare doctors are dedicated to serving patients affiliated with more than 80 payers across the nation including UnitedHealthcare. That experience helps us to think more broadly than most about topics like the application of technology to enhance the consumer experience, the use of data, analytics and data exchange, effective management of healthcare resources and evidence based protocols, and healthcare quality, consistency and payment models that better serve people and plan sponsors.

我们与医疗服务提供方的合作日益深入且更具成效，这得益于我们拥有近25,000名OptumCare医生，他们为包括UnitedHealthcare在内的全国80多家医保出资方的患者提供服务。这种多元化的实践经验，使我们在技术提升消费者体验、数据应用与交换、资源管理、循证医学路径制定、医疗服务质量与一致性、以及创新支付模式等方面具有更广阔的视野和更高效的行动力。

Today we serve 139 million people globally including 126 million people in the United States. And we see UnitedHealth Group's U.S. and global market potential as with all practical limit at this early stage in the evolution of our company.

目前我们在全球服务约1.39亿人，其中在美国服务约1.26亿人。我们认为，在公司发展早期阶段，联合健康集团在美国乃至全球市场的发展潜力几乎不设限。

Second quarter results followed things from our first quarter performance. In the second quarter the company produced strong and balanced revenue growth pacing to exceed the $200 billion mark this year. Medical costs were in line with expectations. Operating costs continued to be well contained. The company generated strong cash flows up 29% year-over-year as adjusted net earnings grew 26% over last year's second quarter to $2.46 per share.

第二季度的业绩延续了第一季度的良好态势。本季度公司实现了强劲且均衡的收入增长，预计全年收入将突破2000亿美元。医疗费用与预期一致，运营成本依然控制良好。公司产生了强劲的现金流，同比增长29%；调整后每股收益为2.46美元，同比增长26%。

For the first half of 2017 adjusted net earnings grew 28% year-over-year to $4.83 per share. UnitedHealthCare continued to deliver exceptional results in the second quarter. Excluding the individual market, UnitedHealthCare grew to serve 2.5 million more people year-over-year including 1.7 million more in the first half of 2017. This continues our consistent, multiyear organic growth performance across all three major businesses.

2017年上半年，调整后每股收益同比增长28%，达到4.83美元。UnitedHealthcare在第二季度继续取得优异成绩。剔除个人市场后，UnitedHealthcare在过去一年中新增服务人群250万人，其中170万人是在今年上半年增长的。这延续了我们三个主要业务板块连续多年的有机增长势头。

This growth has been fueled by a long history of restless products and service innovation responding to and even sometimes driving market evolution. This focus towards innovation has advanced the data, information, and tools to support both individual efforts to achieve better health and system wide efforts to deliver better healthcare.

这种增长得益于我们长期以来在产品和服务创新方面的不断投入，这些创新不仅顺应了市场变化，有时甚至引领了市场演进。这一创新导向推动了数据、信息和工具的发展，既支持了个人实现更好健康的目标，也推动了整体医疗体系服务能力的提升。

A business model increasingly centered on serving the unique healthcare needs of consumers, we are performing in serving new populations such as group Medicare Advantage, people with complex conditions served by Medicaid programs in emerging markets like Brazil as well as in longstanding well established markets.

我们正围绕满足消费者差异化健康需求构建商业模式，并已开始在新兴人群中取得成效，例如团体Medicare Advantage、巴西等新兴市场中通过Medicaid照护的复杂病患，以及一些成熟市场中的新需求人群。

Healthcare is essential to everyone, individually and to the quality and productivity of societies and we aim to serve it all in one way or another, one person at a time to the best of our abilities.

医疗健康对每个人都至关重要，也关系到整个社会的质量和生产力。我们致力于通过各种方式、一对一地服务每一位需要帮助的人，尽我们所能。

A dedicated compassionate workforce of 260,000 people serving in local communities built on UnitedHealth Group values and singularly aimed at helping people live healthier lives and helping make our health system work better for everyone. They are led by a deep and stable UnitedHealthcare leadership team that has worked together for more than a decade.

我们拥有26万名富有同理心、深耕社区的一线员工，他们秉承联合健康集团的价值观，致力于帮助人们过上更健康的生活，推动整个医疗系统为所有人更好地运转。这支队伍由一支稳定的UnitedHealthcare领导团队带领，他们在一起共事已有十余年。

And finally our commitment to quality in everything we do, in advancing net promoter scores both strengthening customer and consumer retention and care provider relationships across all of our businesses.

最后，我们在一切工作中始终坚持对“质量”的承诺——不断提升净推荐值（NPS），加强客户和消费者黏性，巩固与医疗服务提供商的关系，这些都贯穿在我们全部业务当中。

In many ways we are still just getting started but you can see the momentum in our results. In the employer market our local group commercial business continues to grow organically month in and month out, virtually every month for almost three years.

从很多方面来说，我们还只是刚刚起步，但你们已经能从我们的业绩中看到强劲的势头。在雇主市场中，我们的本地团体商业保险业务已连续近三年实现月度有机增长，几乎每月都在增长。

In the past 12 months we have grown to serve nearly 600,000 more people through full risk products in the employer group market. We are growing by consistently serving the health needs of this population at more affordable levels and with greater consistency in the quality of their experiences and the cost of their coverages.

在过去12个月中，我们在雇主团险市场中通过全风险型产品新增服务人群近60万。我们之所以能实现持续增长，是因为我们以更可负担的方式持续满足这类人群的健康需求，同时在保障质量和费用控制方面做到更加一致。

Across Medicare Advantage and Supplement UnitedHealthcare has grown to serve 935,000 more people in the past year with balanced growth in the individual senior market and the corporate retiree market.

在Medicare Advantage和补充险业务中，过去一年我们新增服务人群93.5万，在个人老年市场和企业退休人群市场实现均衡增长。

Our Medicare Advantage business continues to benefit from strong consumer retention reflecting senior's positive experience and the clear economic value of our offerings. In 2018 our distinctive product value and consumer experience should allow us to continue to grow as we expect to increase our overall Medicare Advantage market share in a growing Medicare Advantage market again next year.

Medicare Advantage业务保持良好的客户留存，反映出老年人对我们服务体验的满意度以及产品的经济价值。我们预计，2018年凭借我们差异化的产品价值与客户体验，将在整体持续扩大的Medicare Advantage市场中进一步提升份额。

States continued to turn to the private sector to strengthen and modernize their Medicaid programs. We are implementing four new State awards this year in California, Missouri, Nebraska, and Virginia. We discussed dual special needs plans with you in our first quarter call and our revenues serving people through these plans grew 33% year-over-year in the second quarter. In total our community and state business served over 700,000 more people at June 30.

各州继续依赖私营部门以加强并现代化其Medicaid项目。今年我们将在加州、密苏里州、内布拉斯加州和弗吉尼亚州实施四个新的州级合同。在第一季度电话会上我们曾提到“双重特殊需求计划”（D-SNP），第二季度该项服务收入同比增长33%。截至6月30日，我们的社区和州政府业务共新增服务人群超过70万。

Taken as a whole the UnitedHealthcare businesses grew revenues this quarter by $3.2 billion or nearly 9% to $40.8 billion despite forgoing over $1.8 billion in revenues from the ACA individual insurance market withdrawals and the health insurance tax moratorium.

整体来看，尽管由于退出《平价医疗法案》（ACA）个人险市场以及健康保险税暂缓执行导致公司少收18亿美元收入，UnitedHealthcare板块本季度仍实现收入同比增长32亿美元，约增长9%，达到408亿美元。

Earnings from operations exceeded $2.2 billion in the quarter growing 13.9% consistent with our top line growth rate in the quarter after considering the ACA items.

考虑到ACA影响后，运营利润为22亿美元，同比增长13.9%，与营收增长保持一致。

Let me now turn it to Larry for his perspective on UnitedHealth Group's enterprise growth and an update on Optum. Larry?

接下来请Larry分享他对联合健康集团整体增长的看法，并介绍Optum业务的最新进展。Larry，请。

Larry C. Renfro

拉里·C·伦弗罗

Thank you, Dave. Yesterday evening UnitedHealth Group was honored to announce the early renewal and extension of our distinctive and longstanding relationship serving seniors together with AARP. Our two organizations have a 20 year history of working together to serve seniors greatest needs and to advance health and healthcare in practical ways. Each of us believes there is no better collaborator for the work we do on behalf of those we serve. We expect the value of this relationship to grow further in the years ahead as we continue to implement shared ideas and innovations, to better serve Americans over age 50 as the growth of that population accelerates meaningfully.

谢谢你，Dave。昨晚，联合健康集团很荣幸地宣布，我们已提前续签并延长与AARP长期且独特的合作关系。我们与AARP已携手服务老年群体达20年之久，致力于以务实方式推进健康服务的发展。双方一致认为，在为服务对象谋福祉的工作中，彼此是最佳合作伙伴。未来，随着50岁以上美国人群加速增长，我们将继续共同推进理念和创新的落地，进一步提升这段合作关系的价值。

The AARP relationship is a good example of our leaders working at the enterprise level to develop broader, deeper relationships, strengthen customer experience through NPS disciplines, and drive strong sustained multi-year growth.

AARP的合作是我们管理层在集团层面拓展更广更深合作关系的典范，同时通过NPS体系提升客户体验，推动企业实现多年持续增长。

Other examples abound: receiving new awards as well as contract renewals and expansions serving State Medicaid programs, corporate Medicare Advantage awards, new and renewing pharmacy care services awards, and the Department of Defense engaging us to provide NurseLine and digital clinical support services to military health system beneficiaries. Or the work we are now doing for Merck and others in the life sciences domain to help understand the impact of their medicines in a value based contracting world.

类似例子还有很多，例如：获得并续签了多州的Medicaid项目合同；拓展企业 Medicare Advantage 合作；签订新药品管理服务合同；美国国防部也邀请我们为军人健康系统用户提供远程护理热线与数字化临床支持服务；此外我们也与默克等生命科学企业合作，在价值导向型合同环境下评估药品的真实效果。

The breadth of that list should give you a sense of why this team shows a high level of optimism as we look ahead to the next decade.

从这些广泛的合作可见，我们团队对未来十年充满信心。

We serve deep end markets with significant unmet needs and we are working to better serve these customers by improving the economic value of our services consistently raising quality and innovating in ways that solve problems. These efforts are steadily driving net promoter scores higher.

我们服务的是深层次、需求未被充分满足的市场，我们正通过提升服务的经济价值、持续改善质量并推出切实可行的创新解决方案，来更好地满足这些客户需求。这些努力正在稳步提升我们的净推荐值（NPS）。

Turning specifically to Optum, second quarter revenues increased by $2 billion or 10% to $22.7 billion driven by strong organic growth even as OptumRx revenue growth rate was affected by its delivery of significant channel savings to customers and consumers.

具体来看Optum业务，第二季度营收同比增长20亿美元，达227亿美元，同比增长10%。尽管OptumRx为客户和消费者带来了大量渠道节省，从而拉低了其营收增速，但整体仍实现了强劲的有机增长。

Optum’s earnings from operations grew 20.5% to $1.5 billion as operating margins expanded 60 basis points over last year to 6.7%. All segments grew earnings by double-digit percentage rates in the second quarter.

Optum运营利润增长20.5%，达到15亿美元，运营利润率同比提升60个基点至6.7%。第二季度，所有业务板块均实现两位数利润增长。

At OptumHealth we grew to serve 9 million more people in the past 12 months with per capita revenues growing about 13%. This is an important metric as we look towards future deepening our relationships with the consumer.

在OptumHealth板块，过去12个月我们新增服务人群达900万，人均收入增长约13%。这项指标对于未来深化客户关系具有重要意义。

Growth continues to be led by OptumCare business which grew revenues by more than 40% through the combination of strong organic growth and strategic business expansion.

OptumCare仍是增长主引擎，依靠强劲的有机增长和战略性扩张，营收同比增长超40%。

At OptumCare our goal is to create and operate the leading high value ambulatory care delivery system in the nation offering high quality, cost effective care to a full spectrum of payers and patients.

OptumCare的目标是打造并运营全国领先的高价值门诊照护体系，为各类医保支付方和患者提供高质量、具成本效益的照护服务。

We do this by empowering clinicians with data, insight, and workflow protocols that bring the best of Optum analytics to bear in settings where strong analytics directly impact people's lives for the better.

我们通过数据、洞察和工作流赋能医生，将Optum最强分析能力直接应用于影响人们生活的实际医疗场景。

By improving patient value and satisfaction at the best sites of service for care delivery, helping people access care that is convenient, high quality and affordable…

我们致力于在最合适的场所提升患者价值与满意度，帮助人们获取便捷、优质、可负担的医疗服务……

…and by serving physician employees and partners, giving them the tools and support they need to be great medical practitioners focused on the clinical needs of their patients and on growing their practices to serve more health plans and people.

同时服务好我们的医生员工和合作伙伴，为他们提供必要的工具与支持，使其更专注于患者的临床需求，并拓展服务规模，覆盖更多医保计划与人群。

The second quarter was our first full quarter with Surgical Care Affiliates (SCA) included in OptumCare's results. SCA’s performance is slightly ahead of our expectations. The team has already established six new outpatient surgical centers this year and is progressing well on aligning expansion plans with our geographic strategy and payer needs.

本季度是Surgical Care Affiliates（SCA）并入OptumCare后的首个完整季度。 SCA的业绩略好于预期。今年已新建6家门诊手术中心，并正积极将扩张规划与OptumCare的市场布局和健康计划客户需求对齐。

Like SCA, the MedExpress portion of OptumCare continues to grow steadily. MedExpress opened 20 new neighborhood care centers in the first half of 2017 and is on pace to produce record growth while experimenting with alternative formats and approaches that could deliver even greater convenience and value to consumers.

与SCA类似，OptumCare旗下的MedExpress业务也稳步增长。2017年上半年新开设20家社区护理中心，并正尝试新模式和服务形式，探索为消费者提供更大便利与价值的路径，有望实现历史最快增长。

In the local market primary care business we were privileged this past quarter to expand with two exceptional market leading group practices in Indianapolis and Denver.

在本地初级诊疗市场，我们在本季度有幸与印第安纳波利斯和丹佛的两家头部医疗集团达成合作，进一步拓展覆盖范围。

We continue to align with the leading local medical groups who are committed to the idea that patients benefit significantly from deeper investment in proactive primary care services.

我们将持续与这些致力于深化主动初级照护服务的本地优秀医疗集团合作，共同推动患者获益。

Our doctors help patients achieve a healthier state and to do so with a favorable cost profile. We are more than five years into the OptumCare build out but we are still in the early stages.

我们的医生通过具有成本效益的方式帮助患者实现更健康的状态。OptumCare发展至今已有五年，但仍处于早期阶段。

We remain focused on its steady development and see this business as a significant source of growth for the next 10 years and more.

我们将继续稳步推进OptumCare，将其视为未来十年及更长期的关键增长引擎。

At OptumRx the revenue growth rate of 5% was well in line with expectations for 2017. Revenue yield per script was flat as we effectively passed supply chain improvements on to our customers.

OptumRx板块营收同比增长5%，符合全年预期。每张处方的营收持平，我们将供应链优化带来的收益有效转让给客户。

We continued to experience strong customer retention as large sophisticated buyers who value transparency are attracted to our data driven clinically integrated approach.

大型成熟客户偏好透明度高、数据驱动、临床一体化的管理模式，因此我们的客户保持率依然强劲。

These organizations are represented in a strong pipeline stemming from our healthcare transformation alliance relationship discussed in our last earnings call…

这些客户正来自我们在上季度财报电话会议中提到的“医疗转型联盟”合作渠道……

…and our recent award to provide pharmacy care services to the State of New Jersey beginning next year. OptumRx fulfilled 322 million adjusted scripts in the second quarter, an increase of 5% over the last year.

我们也刚获得新泽西州明年起的药品管理服务合同。OptumRx本季度完成调整后处方量达3.22亿，同比增长5%。

In 2018 we again expect to grow our adjusted script volume above the industry growth rate.

我们预计2018年调整后处方量仍将保持高于行业平均水平的增长。

OptumInsight continues its strong growth pace, particularly in the payer and care provider markets with recent awards or late stage RFPs in the areas of data analytics, payment integrity, business services, revenue management, and clinical best practices.

OptumInsight继续保持强劲增长势头，尤其在支付方与医疗服务商市场，近期获得了多个合同或进入后期竞标阶段，涵盖数据分析、支付准确性、业务服务、收入管理及临床最佳实践等领域。

OptumInsight's revenue backlog grew 18.6% or $2.1 billion in the past 12 months with $800 million added in the first half of 2017 including $300 million in the second quarter.

过去12个月，OptumInsight未履行收入储备增长18.6%，达21亿美元；2017年上半年新增储备8亿美元，其中第二季度新增3亿美元。

Stepping back, Optum is positioned on the front edge of the major growth trends in the market helping the health system perform better for everyone.

总体而言，Optum正站在市场关键增长趋势的前沿，助力整个医疗体系为所有人群提供更优服务。

We use advanced technology, market leading health analytics, modern care delivery, data driven population health approaches, and distinctive pharmacy care services as a portfolio of capabilities that help our clients reduce cost and solve complex operational challenges on behalf of the people they serve.

我们整合了先进技术、领先健康分析能力、现代化照护交付体系、数据驱动的群体健康管理方法和特色药品服务，帮助客户为其服务人群降低成本、解决复杂运营挑战。

This unique position gives Optum a long runway for continued growth and we are further focusing our growth efforts to take advantage of the opportunities.

这一独特定位为Optum带来了长期成长空间，我们正进一步聚焦资源把握这一战略机遇。

Now let me turn it over to John Rex.

现在我将话筒交给John Rex。

John Rex

约翰·雷克斯

Thank you Larry. The strength of our two business platforms drove strong, consistent, well balanced results in the quarter. Five of the seven reporting businesses had revenue growth rates above 10% as consolidated revenues grew 7.7% surpassing 50 billion in a single quarter for the first time.

谢谢你，Larry。本季度，我们的两大业务平台表现强劲，为公司带来了持续稳健且结构均衡的业绩表现。在七个业务板块中，有五个实现了超过10%的收入增长，公司合并营收同比增长7.7%，首次单季突破500亿美元大关。

Our consolidated earnings from operations exceeded 3.7 billion and our net earnings to shareholders grew 30% year-over-year to 2.3 billion in the quarter. Second quarter adjusted EPS rose 26% to $2.46 per share.

The second quarter medical care ratio of 82.2% brought our year-to-date care ratios to 82.3% putting us on track to be at or below the midpoint of our full year 2017 outlook of 82.5% plus or minus 50 basis points.

Medical costs have been well managed and continue within our established outlook and market pricing across segments and products remains disciplined and rational.

整体医疗成本控制良好，仍处于我们预设的区间内；各业务和产品线的市场定价也保持纪律性与理性。

The operating cost ratio was 14.6% in the second quarter and 14.5% through the first six months.

本季度运营成本率为14.6%，上半年累计为14.5%。

For the full year we expect to be at or slightly above the midpoint of our 2017 full year outlook of 14.5% plus or minus 30 basis points. Due to the mixed impact of care provider expansions which carry disproportionately higher operating costs and which added about 80 basis points year-over-year to our consolidated operating cost ratio in the quarter.

全年来看，我们预计将达到或略高于全年运营成本率展望中14.5% ± 30个基点的中值。这一变化主要来自医疗服务提供商扩张的结构性影响，这些新业务运营成本较高，使本季度合并运营成本率同比上升了约80个基点。

These mix changes signaled the continuing diversification of our revenues.

这些结构变化表明我们收入来源的持续多元化趋势。

Touching on capital for a moment, our Board increased our dividend payment rate by 20% to $3 per share annually at our June Board meet. And we expect to achieve a debt to total capital ratio of approximately 40% by the end of this current quarter, three months sooner than our previous outlook.

关于资本管理，今年6月董事会已批准将年度股息提高20%，至每股3美元。我们预计将在本季度末将负债占总资本比降至约40%，较此前预期提前三个月达成。

Cash flows from operations through the first half of 2017 are solidly in line with our outlook and we continue to expect approximately 12 billion for the full year, an increase of 22.5% over last year.

2017年上半年的经营现金流表现稳健，符合预期。我们仍预计全年经营现金流约为120亿美元，同比增长22.5%。

This morning we've increased our outlook for 2017 adjusted net earnings to a more narrow and higher range of $9.75 to $9.90 per share, prudently recognizing the strength in this quarter.

基于本季度的强劲表现，我们今日将2017年全年调整后净收益预期上调至9.75至9.90美元/股的更高、更收窄区间。

We remain comfortable with the existing Street consensus view of third quarter adjusted net earnings per share. With full year 2017 adjusted EPS now expected to grow in the area of 22% of the midpoint we feel this is an appropriate stance at this point of the year.

对于第三季度的每股调整后净利润，我们仍对市场一致预期保持信心。全年预计调整后EPS同比增长约22%，我们认为目前的立场是审慎且合理的。

Steve.

交还给Steve。

Stephen J. Hemsley

Thank you, John. We recognize at this point in the year thoughts begin to shift to the year ahead. Consistent with our past practices we are not going to discuss 2018 in any depth this morning, it's simply too soon, and there is too much unknown at this point. But we can offer directionally suggests the fundamentals of our businesses remain strong and we feel positively about our ability to perform and grow in 2018.

谢谢你，John。我们认识到，每年这个时候，人们的关注点开始转向来年。按照我们一贯的做法，我们今天早上不会深入讨论2018年，因为现在谈论它还为时过早，很多情况仍不明朗。但我们可以大致提供一个方向，那就是我们业务的基本面依然稳健，我们对2018年的执行能力和增长前景持积极态度。

Like any year 2018 will have its share of headwinds and tailwinds. The tailwinds are largely organic and company specific. Among them we would include continuing growth momentum and performance particularly with customer retention as our focus on NPS improves, increasingly effective capabilities to manage and contain medical costs, the improving leverage of our operating infrastructure, and our continuing efforts to optimizing capital management, investment income, tax cost, and other areas.

和往年一样，2018年也将面临顺风与逆风并存的局面。顺风因素主要来自内生增长和公司自身特点。其中包括我们持续的增长势头和业绩表现，尤其是在专注提升净推荐值（NPS）过程中实现的客户保留率的提高；管理和控制医疗成本的能力日益增强；运营基础设施的杠杆效应不断改善；以及我们在优化资本管理、投资收益、税务成本等方面的持续努力。

The headwinds are largely around externalities. National and state healthcare policies, funding trends, and taxes which we and you are all following closely. We respect the complexity of the social, economic, and political matters that are intertwined here and certainly at this stage in the national conversation speculation about any outcome here would just be that. So we approach each year determined to overcome headwinds and grow to our best potential given the diverse and complementary portfolio of businesses and capabilities we can deploy.

逆风主要来自外部因素，如国家和州层面的医疗政策、资金趋势以及税收问题，这些都是我们和各位正在密切关注的领域。我们尊重其中错综复杂的社会、经济和政治因素，目前在国家层面的讨论阶段，对任何结果的猜测都只是猜测。因此，我们每年都以坚定的决心面对逆风，力求凭借我们多元且互补的业务组合和能力，充分实现增长潜力。

For 2018 and beyond themes for us will center around continued broad based and diverse organic growth across our portfolio. Steady substantive advances in quality and NPS that will gain further momentum in 2018 and position us well for the future. But first focus on costs, to drive better product price points continued evolution of our products and services toward more consumer centric and market response of designs particularly in healthcare delivery and pharmacy care services, deeper larger relationships, market alliances, and other channel partnerships.

对于2018年及未来，我们的主题将围绕在整个业务组合中实现广泛而多样的内生增长。我们将在质量和NPS方面实现稳定且实质性的进展，这些将在2018年进一步加速，并为未来奠定良好基础。但首先要专注于成本控制，以推动更具竞争力的产品定价；我们的产品和服务将持续朝着更加以消费者为中心、更加响应市场需求的方向演进，特别是在医疗服务和药品护理服务领域；我们还将建立更深入、更广泛的客户关系、市场联盟及其他渠道合作关系。

Advancements in the application of next generation technologies to drive better health outcomes, value and consumer experience at lower cost. And with capital capacities at full strength continued focus on thoughtful deployment of capital including expansion and diversification both domestically and globally and return of capital to shareholders through market rate dividends and measured levels of share repurchase. We will give you some initial direction on 2018 in our third quarter earnings call and the full review at our November 28th Investor Conference.

我们还将推进下一代技术的应用，以在降低成本的同时实现更好的健康成果、更高的价值和更优的客户体验。随着资本能力处于充足状态，我们将继续专注于资本的审慎部署，包括在国内外实现扩张与多元化，并通过具有市场水平的股息和适度的股份回购向股东返还资本。我们将在第三季度财报电话会议上提供2018年的初步指引，并在11月28日的投资者大会上进行全面回顾。

We remain positive and constructive with respect to our organizations potential to better serve the health and well being of individuals and improve the health system overall. As we respond to these needs we will realize the remarkable growth potential of this enterprise and we thank you today for your interest. Our executive team is here in the room with us to answer your questions and please only one question per person, thank you.

我们始终以积极和建设性的态度看待公司在更好地服务于个人健康和福祉、提升整体医疗系统方面的潜力。我们将持续响应这些需求，从而释放本企业令人瞩目的增长潜力。感谢大家今天的关注，我们的管理团队也在现场，欢迎提问，请每人只提一个问题，谢谢。

Question-and-Answer Session

问答环节

Operator

[Operator Instructions]. We'll take our first question from Justin Lake with Wolfe Research. Please go ahead.

[操作指令说明]。我们将接听来自Wolfe Research的Justin Lake的第一个提问。请开始。

Justin Lake

Thanks, good morning. I wanted to ask about the OptumCare business but first let me congratulate Andrew on the new role and then given the optimism on future growth here that was discussed, hoping you could put some numbers around the opportunity, maybe share with us the current revenue profile for 2017 that’s expected here? And then where do you see the ultimate business opportunity in terms of the TAM as you continue to roll out your 75 target MSAs and then maybe share where you think is the sustainable growth rate for this segment of the business going forward? Thanks.

谢谢，早上好。我想问一下关于OptumCare业务的问题，但首先恭喜Andrew担任新职务。考虑到刚才提到的对未来增长的乐观态度，希望你们能具体量化一下这个增长机会，比如分享一下2017年OptumCare预计的收入结构？然后在你们继续推进目标为75个的都会统计区（MSAs）时，你们如何看待这一业务板块的总体市场机会（TAM）？此外，你们认为这个业务板块未来的可持续增长率是多少？谢谢。

Stephen J. Hemsley

Justin you seem to have captured all the appropriate themes maybe we'll have Larry start and then Andrew pick that up.

Justin，你似乎已经把关键话题都涵盖了，也许我们可以让Larry先回答，然后让Andrew接着补充。

Larry C. Renfro

Sure. Justin that's a good question and it’s an appropriate question but I thought I might since we're going to talk about growth and maybe give you kind of a general view of growth across Optum for a second and then we’ll get to Andrew but I'm going to ask some other people to talk about growth as well. I'm probably going to bring in Tim Wicks from a financial standpoint. And John Prince from a PBM standpoint and Eric from Optum360. But we’ll lead off with Andrew in a second. There's really just some three areas of what I'd call metrics that we pay attention to when we are looking at our growth across Optum. Number one is are our sales pipeline and I think you hit that and again I'm talking about Optum in general. And our pipeline today is greater than $40 billion and it's a strong, strong pipeline and that's not including what I would call mega deals. This is excluding them but we have a very robust pipeline of about $40 billion.

我们的年初至今销售额约为230亿美元，这与2016年全年约300亿美元的销售额相比，表现良好。而2015年仅为约100亿美元，你可以看到从整体销售角度来看增长有多显著。第三个我们关注的指标是订单积压量，Eric Murphy稍后会谈到这一点，目前同比增长了19%，大约为21亿美元。综上所述，从今年年初以来，我们在这三个方面的表现都非常强劲。那么现在我来转交给Andrew，让他具体回答你的问题，之后我们还会谈到其他增长领域。Andrew？

Andrew Hayek

Thanks Larry, good morning Justin. So as you know we have a belief that there's a significant opportunity to improve the quality, the experience, and the cost of healthcare on a national basis creating value for patients and the marketplace. And the experience over the past several years has been that physicians can achieve outstanding results when empowered with the right analytics, tools, and support. And the market is asking for these kinds of models to improve the cost, quality of care. So our approach is to tailor our market presence based on the local factors in each market that we serve, leveraging primary care, urgent care, surgery centers, and house calls, leveraging technology and tools from across Optum to create value for our patients and for our care providers. We are building this in a multi payer manner serving all payers in the markets that we serve and we believe your question that the market potential is very significant, the depth of the issues resolving, the value we can create for patients into the marketplace is very significant, and we look forward to creating a business multiples of our current size.

谢谢Larry，早上好，Justin。正如你所知，我们认为在全国范围内提升医疗服务的质量、体验和成本控制方面存在巨大的机会，这能为患者和整个市场创造价值。过去几年的经验表明，当医生获得合适的分析工具、技术和支持时，能够实现卓越的成果。市场正在呼唤此类模式来优化医疗成本和质量。因此，我们的策略是根据各地市场的具体因素调整我们的布局，利用初级护理、急诊服务、外科中心和上门服务，结合Optum全平台的技术和工具，为患者和医疗服务提供者创造价值。我们采用多支付方模式，在各市场为所有支付方提供服务。正如你问题中提到的，我们认为市场潜力非常巨大，所要解决的问题深度也非常高，我们为患者和市场能够创造的价值非常可观，我们有信心将这一业务发展为当前规模的数倍。

Tim Wicks

Justin, it is Tim Wicks, let me jump in as well and talk about overall Optum revenues. So, overall total revenue and unaffiliated revenue growth were both in line with our expectations on the quarter. OptumHealth and OptumInsight together had double-digit unaffiliated revenue growth for the quarter as well. I would point also then to OptumRx and just want to clarify this work in the supply chain that we've been doing is translating into lower drug costs for consumers and customers and that really would translate then into lower external revenue for this quarter even though external scripts were up year-over-year. As you know we never apologized UHC's growth and UHC grew faster in the quarter which is obviously a positive impact to our revenue as well. So as we look at the quarter our revenue and product mix are on plan for yield. Total revenue and external revenue both in line with our expectations.

Justin，我是Tim Wicks，我也来补充一下，谈谈Optum的整体营收情况。本季度，我们的总营收和非关联方营收增长都符合预期。OptumHealth和OptumInsight两者的非关联方营收都实现了双位数的同比增长。我还想特别提一下OptumRx，我们在供应链方面开展的工作，已经转化为消费者和客户的更低药品成本，因此本季度的外部营收有所下降，尽管外部处方量同比上升。正如你所知，我们从不对UHC（联合健康保险公司）的增长感到抱歉，而UHC本季度增长更快，这显然对我们的营收也是正面影响。因此总体来看，我们的营收和产品结构符合计划，整体营收和外部营收都在预期范围内。

John Prince

Justin, this is John Prince, CEO of OptumRx. I just wanted to talk a little about OptumRx and how we are doing. We're halfway through the year. We are hitting our new business targets and we remain very confident about hitting our full year target. Our retention is very strong, we have renewal rates in the high 90's. As Larry mentioned in the script we're very honored about the award from the State of New Jersey. That deal actually brings us more than 700,000 new members. We see a broad trend that large, sophisticated buyers are very attracted to our pharmacy care services model, it is very differentiated in the market. We've had some other normal wins and we have a health plan wins and also we have renewed our health plan clients who are out too this year. We have several new wins through the healthcare transformation alliance which we announced last quarter. I would say overall we are very optimistic about OptumRx's compelling buyer proposition in the market, it is resonating well and we are seeing very good results.

Justin，我是John Prince，OptumRx的首席执行官。我想简单谈一下OptumRx的表现。今年已经过去一半，我们已经达成了新的业务目标，并对完成全年目标充满信心。我们的客户保持率非常高，续约率达到90%以上。正如Larry在讲话中提到的，我们很荣幸获得新泽西州授予的合同，该交易为我们带来了超过70万名新成员。我们看到一个广泛的趋势，即大型、成熟的客户对我们的药品护理服务模式非常感兴趣，这种模式在市场上具有高度差异化。我们还取得了一些常规的业务胜利，包括健康保险计划方面的胜出，并且我们也成功续签了今年到期的健康计划客户。我们还通过上季度宣布的医疗保健转型联盟赢得了几项新业务。总体来说，我们对OptumRx在市场上的吸引力持非常乐观态度，它的价值主张得到了很好的共鸣，成效显著。

Eric Murphy

Thanks John. Justin, Eric Murphy with OptumInsight. To Larry's point around regarding Optum360 as well as our backlog, regarding Optum360 we are in late stage assessments with four major delivery systems. Our qualified pipeline for Optum360 is up 60% year-over-year. The sales cycles in this side of the market as we've shared in the past are elongated and we're working diligently right now to improve the assessments that we do with our clients and prospects in this area to be able to get to value proposition discovery in the shorter period of time to generate results for these delivery systems. And then finally I would share we’re bullish on where we land for the year regarding backlog of between $15 billion and $16 billion for 2017.

谢谢John。Justin，我是Eric Murphy，来自OptumInsight。关于Larry提到的Optum360及我们的订单积压情况，Optum360目前正处于与四家大型医疗服务系统的评估后期阶段。我们的Optum360有效销售线索同比增长了60%。正如我们以往所分享的，这一领域的销售周期较长，我们目前正努力优化与客户和潜在客户的评估流程，以便更快明确价值主张，从而为这些医疗系统带来成果。最后我还想补充，我们对今年的订单积压持乐观态度，预计2017年将达到150亿至160亿美元之间。

Stephen J. Hemsley

So that was more than you asked for Justin but a very fulsome answer so the next question please.

Justin，我们给出的信息比你问的还多，但这是一个非常全面的回答。请下一位提问。

Operator

We'll go next to David Windley with Jefferies. Please go ahead.

下一位提问来自Jefferies的David Windley，请开始。

David Windley

Hi, thanks for taking my question. I will switch over to OptumRx, some recent comments that you made quantified the channel savings that you're making reference to this morning at savings I think on a PMP wide basis of about $1300. I also quantified $200 of medical, what I might call mock on savings or what I believe to be your evidence of the value of synchronization and I wondered if you could maybe elaborate on that and talk about where you think that $200 can go?

你好，谢谢你回答我的问题。我想转向OptumRx。你们最近的一些评论量化了你们今天早上提到的渠道节省，我记得在每会员每年（PMPY）基础上的节省大约为1300美元。同时我也看到有200美元的医疗节省，我姑且称之为“mock on savings”，我理解这是你们在同步化（synchronization）方面价值的证明。我想请你详细说明一下，并谈谈你们认为这200美元的节省空间还能走到哪里？

Stephen J. Hemsley

Sure. John, do you want to respond to that.

当然。John，你来回答一下好吗？

John Prince

Sure. David, this is John Prince. I am not sure I followed all the math that you're doing but let me take it at a high level. I think you know I see at the high level happening and if you just look at our external client market is that our number of clients we serve is up, our number of scripts is up but actually the revenue is sort of flat on a per script basis and I think that is really what you see is that the value that we're doing really looking at net best cost for clients as we are delivering that. And I think that is also why our story is resonating in the market in terms of the value that we bring to our clients. What we're also seeing is that even though we're delivering that value our external product gross margin actually is up year-over-year.

好的，David，我是John Prince。我不确定完全理解你计算的方式，但我可以从高层次上解释一下。在我们的外部客户市场中，我们服务的客户数量在上升，处方数量也在增加，但每张处方的收入基本持平。我认为这反映出我们正致力于为客户提供净最佳成本的价值传递。这也是为什么我们的价值主张在市场上产生共鸣的原因。同时我们也观察到，虽然我们在为客户提供价值，我们的外部产品的毛利率实际上同比上升了。

So actually we're getting the margin online business was driven by that more volume. So we're actually getting greater margin on it but we're actually delivering that value back to the client. When we're going out into the market we're actually talking about not just the pharmacy cost but we're talking about total cost of care. So what you are seeing in the revenue here that’s our story of the market around pharmacy cost but our real value story as you go to market is people looking at total cost of care. And so we actually have a story in the market which we're talking to that actually talks about how we save a client $11 to $16 per month as they talk about our full synchronized solution. And that is what our clients are receiving. In our UHC book about 30% of the clients have that synchronized value. We also do that on a direct basis and also with other partners in terms of other health plans that we served in the market. So, clearly we are seeing a very differentiated value that our clients are seeing in their trend.

实际上我们获取了更多在线业务的利润，原因是规模更大。我们确实在获得更高的利润，但我们同时把这些价值回馈给客户。当我们进入市场时，我们谈的不只是药品成本，而是总体医疗成本。因此你在营收中看到的是关于药品成本的故事，但我们在市场上传递的真正价值主张是帮助客户降低整体医疗支出。我们当前的市场主张是，通过我们完整的同步解决方案，每位会员每月可节省11到16美元。这就是我们的客户正在获得的价值。在我们UHC（联合健康保险）内部，大约30%的客户正在享受这种同步化带来的价值。我们也以直连方式和通过与其他健康保险计划的合作伙伴一起向市场提供该服务。因此，客户在他们的趋势中明显感受到我们的差异化价值。

David Windley

So if I could just clarify so the point to the question was where can the $11 to $16 per member per month go?

我能否确认一下，我的问题核心是，这每位会员每月11到16美元的节省会流向哪里？

John Prince

Well the $11 to $16 goes back in terms of their total cost of healthcare, so it actually went forward to our number, actually the client would see that and the return it would give to them.

这个11到16美元会反映在他们的总医疗支出中，也就是说它最终体现为客户可以实际看到并获得的节省回报。

Stephen J. Hemsley

It was to the benefit of the client, our benefit is the retention of customers and the growth that we get.

这笔节省对客户是直接受益，而我们的回报则体现在客户的留存和业务增长上。

David Windley

Thank you.

谢谢。

Stephen J. Hemsley

Next question please.

请下一位提问。

Operator

We’ll go next to Kevin Fischbeck with Bank of America Merrill Lynch.

下一位提问是来自美国银行美林证券的Kevin Fischbeck，请开始。

Kevin Fischbeck

Hey great, thanks. I wanted to ask a question on MA actually, maybe a two part question. First, given all the growth that you have there just want to make sure that the performance from margin across expectation is coming in line with how you had expected it this year? And I guess secondly you mentioned that you expect to gain share again next year, wanted to get a little more color on the purpose behind that because group MA went so far, is there anything you don't have that your competitors bids up for next year so I just want to know what gave you confidence in saying that you are going to gain share this early in the process?

好的，谢谢。我想问一个关于Medicare Advantage（联邦医疗保险优势计划，简称MA）的问题，实际上是两个部分。第一，鉴于你们在这方面的增长，我想确认一下利润表现是否符合你们今年的预期？第二，你们提到明年有望继续提升市场份额，能否进一步说明这背后的原因？尤其是团体MA已经发展得很快了，是不是还有什么是你们目前没有但竞争对手会在明年加码竞标的内容？我想了解你们为何如此早就有信心表示会继续抢占份额？

Stephen J. Hemsley

Why don’t we ask Steve Nelson kind of give you the broader themes and then Brian Thompson will fill in the rest.

我们不妨请Steve Nelson先就整体主题做一个概括，然后由Brian Thompson来补充细节。

Steve Nelson

Thanks, Steve. Hey Kevin, this is Steve Nelson. Let me just talk a little bit about how we're thinking about growth and the positioning of UnitedHealthcare overall and because I think the themes are pretty consistent as we move to a specific Medicare Advantage conversation. But we've been very focused on a specific agenda trying to drive value, improve our quality, very focused on costs both medical and administrative that are really driving an agenda of what we call distinction, trying to innovate around our both our clinical experience and our service experience, driving improved NPS. We see that actually across our businesses but particularly in our MAPD business as well, driving more attention which I think is significantly contributing to the growth and also the inline performance we've seen this year on that growth. But also you just heard the Optum team talk about their robust capabilities as we bring those things into UnitedHealthcare. We continue to see that really resonating in the market across all of our businesses. And so we're really bringing this agenda of distinction to new populations whether we are talking about bringing populations into more populations with complex care, complex conditions into managed Medicaid or some of the emerging populations that we continue to see grow whether it's a D-SNP or group Medicare Advantages as you referenced. So really well positioned across all of these businesses but MA is a tremendous story so with that maybe just have Brian give some color about what we are seeing there early in this year.

谢谢，Steve。你好，Kevin，我是Steve Nelson。我想先谈谈我们整体上对UnitedHealthcare增长和定位的看法，因为即便专注到Medicare Advantage（MA）上，这些主题依然是一致的。我们一直专注于一套明确的议程，致力于提升价值、改善服务质量，特别关注医疗和行政成本，这是我们所谓“差异化战略”的核心，围绕临床体验和服务体验进行创新，并提升NPS（净推荐值）。我们在各业务线都看到了这种改进，尤其在MAPD（Medicare Advantage Prescription Drug）业务中尤为明显，这也在很大程度上推动了增长以及增长过程中的一致性表现。此外，正如你刚才听到Optum团队提到的强大能力，我们也在将这些能力整合到UnitedHealthcare中，这在所有业务中都引起了市场的共鸣。因此我们正在将这种“差异化”的战略引入新的群体中——无论是更复杂病况的人群加入管理式Medicaid，还是你提到的像D-SNP（双重资格特需计划）或团体MA这类不断增长的新兴人群，我们在这些业务上都处于良好位置。而MA则是其中非常成功的一部分，下面请Brian补充下今年初我们在这方面看到的情况。

Brian Thompson

Steve, thank you. Kevin, good morning, this is Brian Thompson. For 2017 we are off to a very strong first half of the year on both service and support as well as our engagement with our new seniors that have chosen UnitedHealthcare. What we are seeing is aligning to our expectations, so we are not only pleased with what we're seeing in 2017 year-to-date but also our positioning as we look forward to 2018 and we have a very positive long-term outlook for the industry and for us specifically. We expect as you heard to continue to outperform the market in 2018 overall on MA balanced both in group and individual just as we did this year and the two years prior.

谢谢你，Steve。你好，Kevin，早上好，我是Brian Thompson。2017年上半年我们在服务和支持方面的表现都非常强劲，与新加入UnitedHealthcare的老年人群体之间的互动也非常良好。从目前的情况看，我们的表现符合预期，因此我们不仅对2017年迄今为止的结果感到满意，也对2018年的市场定位充满信心。我们对整个行业以及我们自身的长期前景都非常乐观。正如你听到的，我们预计在2018年将继续在MA领域整体跑赢市场，无论是团体还是个体业务，这与我们今年以及过去两年的表现一致。

The return of the insurance fee will be the single largest headwind in 2018, it's return was assumed that our 2018 bid submissions but despite the return of the tax and program funding pressure there, we do intend to keep our benefit offerings as stable as possible and we intend to compliment our 2018 growth and product stability with advances in both quality and satisfaction. So our products will again be designed for high levels of retention. So on balance we are very optimistic, we are optimistic about our positioning both group and individual against the backdrop of an advancing very positive industry growth outlook for 2018.

2018年最大的不利因素将是保险税费的恢复，这在我们2018年的投标中已经考虑在内。尽管面临税收和计划资金方面的压力，我们仍打算尽可能保持福利产品的稳定，并通过在质量和满意度方面的提升来进一步支持2018年的增长和产品稳定性。因此我们的产品依然会以高留存率为设计目标。总体而言，我们对整体前景感到非常乐观，无论是团体业务还是个体业务，我们在2018年积极向好的行业增长背景下都具备有利的市场定位。

Stephen J. Hemsley

Thank you next question.

谢谢，请下一位提问。

Operator

The next question is from Chris Rigg with Deutsche Bank, please go ahead.

下一位提问来自德意志银行的Chris Rigg，请开始。

Chris Rigg

Good morning. I just wanted to ask or get a little more color on the operating cost ratio and just to better understand the mix dynamics there and I guess most importantly I'm trying to determine whether is there an incremental investment spending in the number related to the provider side or is that all just mix at this point? Thanks.

早上好。我想问一下关于运营成本率（Operating Cost Ratio，OCR）的问题，能否提供更多细节，帮助理解其中的业务结构变化？我最关心的是，这一数字中是否包含了与医疗提供方（provider side）相关的新增投资支出？还是说这完全是由业务结构变化所致？谢谢。

Stephen J. Hemsley

John?

John，你来回答吗？

John Rex

Yes, thanks. John Rex here, so when I talked about the 80 basis points of impact, that was truly just the mix impact, a higher proportion of really care delivery businesses in our revenue base and that's the impact that we're seeing in the business. So that is straight up the care delivery business expanding and growing and care delivery business somewhere now in kind of two thirds of the range of all of OptumHealth. There are always investments we're making across the businesses and certainly within our OCR this quarter there were plenty but our commitment to you is to always balance those and as we deliver our results by that point of segment the 80 basis points does not include investments that we make.

好的，谢谢，我是John Rex。当我提到影响为80个基点时，这完全是由业务结构变化引起的，主要是我们收入中“医疗服务提供”类业务占比上升带来的影响。这就是我们在业务中所看到的变化。本质上是医疗服务业务在扩张和增长，这类业务现在大概占OptumHealth总业务的三分之二。当然，我们始终在各业务领域持续进行投资，在本季度的OCR中也确实包含了不少投资内容，但我们承诺会始终在投资与财务表现之间保持平衡。而我所提到的那80个基点的影响，并不包括这些投资行为。

Stephen J. Hemsley

Excellent, next question please.

很好，请下一位提问。

Operator

We will go next to Peter Costa with Wells Fargo.

下一位提问是来自富国银行的Peter Costa，请开始。

Peter Costa

Hi, thanks. You mentioned the impact of the health insurance will be coming back next year, if it does come back next year that turns into quite a price increase for the commercial planned staff to pay, more than most businesses are growing these days. So can you talk about what you're seeing employers do right now that counteract that rising cost in terms of what cost cutting measures are they putting in place and what cost cutting measures are you putting in place to help ameliorate the rate increase?

你好，谢谢你们的分享。你们提到明年健康保险税将恢复，如果真是这样的话，那会对商业计划的保费造成显著上涨——超过大多数企业当前的增长水平。那么你们现在看到雇主在采取哪些措施来对冲这一成本上升？他们采取了哪些削减成本的措施？你们公司又在采取哪些成本控制手段来缓解这一涨价压力？

Stephen J. Hemsley

So, maybe Jeff Alter and Dan Schumacher can you kind of combine on that.

那我们请Jeff Alter和Dan Schumacher一起来回应这个问题。

Jeff Alter

Sure, thanks Peter. It's Jeff Alter. You know a few years ago we put forth a very purposeful initiative to expand our portfolio of fully insured products which included broadening that portfolio to reach many different price points and then connecting those products with varying network structures. So we have a very robust product portfolio that allows our clients to adjust to increasing medical costs whether that’s driven by pharmacy or driven by medical costs or driven by legislative and regulatory actions. So our clients have the ability to create five down opportunities or to change in complimenting their benefit strategies without having to change their carrier because of the proactive work we've done in our product portfolio particularly in our fully insured product portfolio.

当然可以，谢谢你Peter，我是Jeff Alter。几年前我们有意识地推动了一个重要举措，那就是扩大我们全额投保类产品（fully insured products）的组合，这包括拓展产品线以覆盖更多价格区间，并将这些产品与多样化的网络结构相结合。因此我们现在拥有一个非常强健的产品组合，能够帮助客户应对因药品成本、医疗支出，或是立法和监管变化带来的成本上升压力。客户可以在不更换保险提供商的前提下，通过我们已有的全额投保产品组合主动调整他们的福利策略，从而实现降本优化或结构性调整。

Dan Schumacher

So I think variety of products and offerings and really focus on broad range of price points.

我认为我们的产品和服务种类多样，而且专注于涵盖广泛的价格区间。

Peter Costa

Is there anything in particular that's being picked up more than not.

有没有哪一类产品比其他类型更受欢迎？

Jeff Alter

You know I would say that there's far more interest in varying network constructs. One of the more popular choice has been the leveraging of our more than a decade old premium designation program where we use lot of the OptumInsight in analytics to determine the best providers, those that practice both first and foremost always quality but then efficiency. And so we've created network and product structures that drive people to those top tier doctors using either co-pay or co-insurance variations. It has become very popular because it helps our clients achieve the price points that are affordable for them but also given the comfort that people are getting better outcomes at a lower cost. And I think that's a real story of the integration of the UnitedHealthcare and in Optum to deliver meaningful value to a marketplace that first and foremost drives people to the best performing physicians. But overall achieves a price point for their sponsors.

我想说，目前雇主对不同网络结构的兴趣正在显著增加。一个特别受欢迎的选择是我们已经运营十多年、名为“Premium Designation”的优质提供商项目，我们利用OptumInsight的分析能力，识别出既具高质量又具效率的医生。我们通过共付额（co-pay）或共同保险（co-insurance）机制，引导患者前往这些优质医生处就诊，从而构建了相应的网络和产品结构。这种模式非常受欢迎，因为它既帮助客户实现可承受的价格，又让员工安心：他们在更低成本下获得了更好的健康结果。我认为这正是UnitedHealthcare与Optum整合带来的实质性价值，既能把人引导到表现最好的医生那里，又能帮助雇主控制整体成本。

Peter Costa

Thanks, that’s helpful. Thank you.

谢谢，很有帮助。

Stephen J. Hemsley

Next question please.

请下一位提问。

Operator

We’ll go next to Scott Fidel with Credit Suisse. Please go ahead.

下一位提问是来自瑞信的Scott Fidel，请开始。

Scott Fidel

Thanks, just had a question just on the tax rate. I know there's been a few discrete items this year so first, just if you have just an updated guidance for the tax rate this year and then what you would view as sort of a good sort of run rate, tax rate, looking out that we should be modeling for next year excluding obviously the return of the industry?

谢谢。我想问一下关于税率的问题。我知道今年有一些一次性事项，所以首先，请问你们是否有对今年税率的最新指引？其次，从更长期来看（当然不包括保险税的恢复），你们认为我们在建模明年财务时可以采用的常态税率水平大概是多少？

Stephen J. Hemsley

We're so we're going to not actually get into 2018 too much but John, do you want to respond?

我们不会深入谈论2018年的情况，但John你能回应一下吗？

John Rex

Thanks Scott, John Rex here. I will speak to this year. So we're not updating our tax rate outlook for the year here. Let me just talk a little bit about within the quarter because we did speak about it last quarter also. So there is nothing unusual that I would spike out in the 2Q effective tax rate beyond normal exercise activity. So typically with the share purchase -- with stock based compensation accounting we're going to see more impact in the first half and the second half in terms of lowering that tax rate. So we’d expect that to increase in the second half. In the first quarter we had really talked about half of the impact that we expected to be nonrecurring and that was really due to just an unusually large amount of stock option exercises. It was related in part to an older acquisition and so that was the piece we spiked out there. But I wouldn't spike out anything as unusual in this quarter's rate and we'd be at the still in that 32.5% zone. We’d always try to do a little bit better than we can and that would be my aspiration but that’s what it would be.

谢谢你，Scott。我是John Rex。我来谈谈今年的情况。我们目前不会更新全年税率预期，但我可以讲讲本季度的一些情况，也是在上季度我们谈到过的。第二季度的有效税率没有什么特别异常的项目，除了一些正常的期权行权活动。根据股票薪酬会计的处理方式，通常在上半年会对税率有更明显的下调影响，而下半年这一影响会减弱，因此我们预计下半年税率会上升。第一季度我们指出过有一半的税率影响是一次性的，那主要是由于当时有一笔异常大的股票期权行权，部分与早期的一项收购有关，这是我们当时特别说明的内容。但本季度我认为没有任何需要特别剔除的异常因素，整体税率仍维持在大约32.5%左右。我们总是希望能做得比这更好，这是我们的目标，但目前就是这个水平。

Scott Fidel

Okay, thanks.

好的，谢谢。

Stephen J. Hemsley

Next question please.

请下一位提问。

Operator

Next to A.J. Rice with UBS. Please go ahead.

下一位提问是来自瑞银的A.J. Rice，请开始。

A.J. Rice

Hello everybody, I just maybe ask about capital deployment. John, I think in your prepared remarks you’re saying that you guys will hit your yearend target by the end of the third quarter for where you were hoping debt to cap would be. There’s been a lot of discussion in the press about your potentially being involved in various M&A type of transactions supporting Optum, Reliant, Advisory Board, etc. I guess conceptually as you guys get to your debt to cap target do you — is the M&A environment just so robust what you’re seeing out there that your capital is going to continue to be mainly focus there, do you see an opportunity to maybe reestablish more actively the buyback program, give us some flavor for where you guys are thinking on capital deployment?

大家好，我想问一下关于资本部署的问题。John，我记得你在事先准备的发言中提到，你们将在第三季度末实现全年目标，即达到你们期望的债务与资本比率目标。近期媒体上有很多关于你们可能参与并购交易的讨论，比如支持Optum、Reliant、Advisory Board等。我的问题是，从战略角度来看，当你们达到债务/资本比率目标后，是不是因为当前的并购环境非常活跃，所以你们仍会主要把资本投向M&A？还是说你们会考虑更积极地恢复股票回购计划？能否请你们谈一谈当前资本部署的优先方向？

Stephen J. Hemsley

I think maybe Dave Wichmann would respond.

我觉得这个问题可以请Dave Wichmann来回答。

David S. Wichmann

Sure A.J. Thank you for the question. Very thoughtful. So you’re right that our ambitions are to achieve our 40% leverage ratio by the end of the third quarter and we think we stand a really good shot at getting there which should be one quarter early. John has done a very nice job in managing our capital structure and getting us into that position along with our team. As you know we don’t discuss rumors and speculation about our M&A activity and we’re certainly not going to start today. But I think as you know A.J. that M&A has been a critical part of the way in which this organization has identified new opportunities to serve more people and more market broadly. And those ambitions continue as Steve lined out in his concluding remarks in the opening remarks around those ambitions being both domestic as well as global. And really focused in the services category really continuing to support Optum’s growth and diversification, establishing platforms like you saw with OptumCare which we believe will be strong growth performers for us for the next decade. And I could go on and list many more but I think you get the idea. So it is a core part of our emphasis.

当然可以，A.J.，感谢你提出这个非常有思考的问题。你说得对，我们的目标是在第三季度末达到40%的杠杆率，我们认为很有可能提前一个季度实现这个目标。John和他的团队在资本结构管理方面做得非常出色，让我们有机会达到这一目标。正如你所知道的，我们不会对有关并购活动的传言和猜测发表评论，今天也不会例外。但你也了解，A.J.，并购一直是本公司发现服务更多人群、拓展更广阔市场机会的关键路径。这些目标仍在持续，正如Steve在开场和总结发言中所描述的，我们的野心既包括国内也包括国际市场，尤其聚焦于服务领域，支持Optum的增长与多元化，打造类似OptumCare这样的业务平台，我们相信它们将在未来十年持续为我们带来强劲增长。我可以列举更多例子，但我想你已经理解我们在这方面的核心战略重点。

As relates to share repurchase we continue with a consistent policy at this time whereby we are just trying to keep our share count level. And as I believe you saw in June we increased our dividend again to a rate of $3 per share which is a 20% increase in continuing with our ambitions of advancing our dividend to a market rate level. Thank you.

关于股票回购，我们目前依然维持一贯的政策，即努力保持股份总数基本稳定。同时，正如你在6月看到的，我们再次提高了股息，每股达到3美元，同比增长20%，这是我们将股息提升至市场水平目标的一部分。谢谢。

Stephen J. Hemsley

Next question please.

请下一位提问。

Operator

We will go next to Josh Raskin with Barclays. Please go ahead.

下一位提问是来自巴克莱银行的Josh Raskin，请开始。

Joshua Raskin

Hi, thanks and good morning. I wanted to ask about potential changes in tax rate and I understand it's very premature, we don't even have necessarily a real proposal from the Republicans but to the extent that you guys have thought about it, I'm curious what the impact on your tax rate is from the non-deductibility of the excess compensation, how you would think about the introduction add back? And then as I look about your tax rate sort of before the ACA, your tax rate today is running 400 to 500 basis points below where you were so, just trying to sort of level set the opportunity were there to be changes and maybe specifically on those two items that we know have the potential to change?

你好，谢谢，早上好。我想问一下关于税率可能变化的问题。我知道现在谈这个还为时过早，目前共和党甚至还没有拿出真正的提案。但就你们目前的考虑而言，我想知道像“高管超额薪酬不再可抵扣”这种规定会如何影响你们的税率？你们又是如何看待“加回项”（add-back）的引入？另外从历史角度看，在ACA（奥巴马医改）实施之前，你们的税率比现在高出约400到500个基点。所以我只是想了解一下，如果政策真的有所变化，你们内部是否已经开始预估这些潜在变化带来的影响，尤其是针对我们已经知道可能会调整的这两个点？

Stephen J. Hemsley

You know Josh we are really not going to try to get into themes that could affect 2018 outlook but we would really prefer to do that not in a peaceful way but in a more fulsome way when we can really talk about all the elements. The insurance tax is clearly if it has sustained a headwind influencing 2018 and its progress of data really effects the cost for consumers in both -- across the commercial Medicare and Medicaid markets, etc. And it's a factor in terms of market -- it is stabilizing factor in the marketplace both in its cost. So the return of the tax making would further destabilize the market which is already fragile. And make that market less affordable.

Josh，我们现在不会深入讨论可能影响2018年展望的主题。我们更倾向于在未来能更完整地、一揽子地讨论所有因素时再来谈这个问题。关于保险税，它若持续存在将是2018年的一大阻力，而且它的具体进展实际上影响到消费者在商业保险、Medicare和Medicaid市场中的成本水平。它在市场中起到一定的稳定作用，但从成本角度看，它也是一项负担。如果该项税收恢复，将进一步加剧本已脆弱的市场的不稳定性，使得市场的可负担性更差。

So we are we would clearly think that either repealing or deferring that would be a positive thing but as it relates to our actual workings with our 2018 outlook or tax rate and so forth we're just going to save those so that we can actually go through them with you in a more thoughtful way, in a more complete way, maybe to some extent in the third quarter but for sure at our Investor Conference.

因此我们显然认为，废除或推迟这一税项将是一件积极的事情。但关于我们2018年展望、税率变化等更具体的内容，我们会留到之后以更全面、更严谨的方式与你们讨论，也许部分会在第三季度提到，但肯定会在我们的投资者大会上详细说明。

Joshua Raskin

Do I get a mulligan then Steve.

那我这个问题可以算作“无效”提问吗，Steve？

Stephen J. Hemsley

You do. Alright do you want another.

可以，当然。你想再问一个吗？

Joshua Raskin

I will pretend that didn’t happen. So my next question would just be, we're talking about OptumHealth and OptumCare specifically. We're seeing a lot of discussion among competitors around growth in urgent care in ASC's, how would you describe the competitive landscape, are you seeing more and more supply of like services in the market and is that impacting OptumCare at all.

我就当刚才那个问题没发生过。那我接着问一个关于OptumHealth和OptumCare的具体问题。我们看到竞争对手现在在紧急护理（Urgent Care）和门诊手术中心（ASC）方面的布局在快速增长。你们怎么看当前的竞争格局？你们是否注意到市场上此类服务供应量的增加？这对OptumCare的业务是否构成了影响？

Stephen J. Hemsley

You know, I think we are but I think others are better qualified to respond to that. So, maybe Larry to begin and then Andrew.

我认为我们确实注意到了这种情况，但我认为让其他人来回应会更合适。那么，我们请Larry先说，然后再由Andrew补充。

Larry C. Renfro

Okay, Josh — as you know, when we put our program together, when we started OptumCare, it was probably about 2012 when we brought the Optum business plan, and so I would say we got out early in terms of how we were going to approach the market and how we were going to look at it from an investing standpoint — we would partner, we would contract, buy, build. So we had a lot of different strategies in terms of how we were going to really attack and put together our OptumCare program. So urgent care, care delivery, the surgery care, house calls, behavioral — we have all of those programs in place and they are actually functioning extremely well. And I'm going to let Andrew talk about it but, the one thing I would say is we are early but we have an established platform. We didn't miss any boat here. We are out and we understand the marketplace and we are in the process of evaluating many different organizations on how we say that they fit with us and we have a very robust opportunity that we are seeing in the marketplace. So with that I will turn it over to Andrew.

好的，Josh。你知道，当我们启动OptumCare计划是在2012年左右，那时我们正式提出Optum的业务规划。可以说我们很早就进入市场，提前布局了我们的策略，无论是投资角度上的合作、签约、收购、还是自主建设，我们都有完整的策略。因此在紧急护理、基础医疗服务、外科手术、上门问诊、心理行为健康等方面，我们的项目早已就绪，并且运作良好。我会让Andrew来详细说明，但我想强调的是，我们虽然布局早，但平台已经非常成熟。我们并没有错过任何机会，我们了解市场，也正在评估许多潜在合作的组织，看它们是否适合与我们整合。从目前来看，市场中蕴藏的机会非常可观。下面我把时间交给Andrew。

Andrew Hayek

Thanks Larry and good morning Josh. So I would say the local markets remain competitive in different ways, in unique ways depending on the market structure. But as we look across our OptumCare platforms — in physician groups, the SCA, MedExpress, house calls — the distinctive capabilities that we have really created demand for what we have to offer in improving the quality, the cost, the experience, the care and improving the provider experience. And so I'd say as the market forces continue to push towards higher quality at more cost-effective price points, the demand for a distinctive platform that can enable physicians and care providers to achieve better results, leveraging tools, insight, and other components of our platform — the need for what we have to offer is growing. And we remain very bullish and optimistic around the opportunity to expand across the 75 markets, to deepen our presence in the markets we currently serve. As Larry referenced, we believe we’re in the very early stages of this opportunity and again, in many respects the increasing competition increases the demand for a distinctive platform — which we have.

谢谢Larry，早上好，Josh。我认为各地市场的竞争情况各不相同，会根据本地的市场结构而呈现出不同的形式。但从我们的OptumCare平台来看——包括医生集团、SCA、MedExpress、上门问诊等服务线——我们所具备的独特能力已经在市场上创造出明确的需求，我们能够提升医疗质量、降低成本、优化患者体验和服务体验，同时改善医务人员的工作体验。我想说的是，随着市场继续向着“更高质量、性价比更高”的方向发展，对能够赋能医生和医疗提供者、帮助他们实现更好结果的平台的需求也在不断增长，而我们的平台正好具备这一能力。我们对在75个目标市场中持续扩张、并进一步加深在现有市场中的渗透非常有信心。如Larry所说，我们相信目前还处于机会的早期阶段，而竞争的加剧，反而进一步强化了市场对我们这样差异化平台的需求。

Stephen J. Hemsley

So maybe we could then give it to Dan because that really kind of the voice of demand in there.

我们或许可以请Dan来继续，因为他正代表了“需求端”的声音。

Dan Schumacher

Sure, so Josh one thing I would just highlight is obviously when you look at our spend and the composition of it and how much of it orients to the acute setting. We've got so many surgical procedures and so forth that are happening in inpatient and outpatient hospital settings and the reality is we've seen for a long time an opportunity to really focus on the site of service, get them into places where we can drive better quality, frankly a better patient experience at a lower cost as Andrew has been talking about. And we do it in a couple of ways. Certainly we do it in terms of our approach to medical management, so looking at prior authorization and making sure that we're getting it into the right site of service on the front end before procedures are happening. We are also building it into the product designs as well so that we're putting incentives in there to make some of the transition from acute to ambulatory to really drive the kind of outcomes that we're looking for.

好的，Josh。我想特别指出的是，当你观察我们的医疗支出构成时，会发现其中很大一部分与急性治疗环境相关。我们有大量的手术是在住院和门诊医院中进行的。实际上我们早就看到了一个机会：聚焦服务场所（site of service），将治疗转移到可以提供更高质量、更优患者体验、同时成本更低的场所，正如Andrew刚才所讲的那样。我们通过几种方式来实现这一点。一方面是在医疗管理上进行前置干预，比如通过事前授权（prior authorization），确保在手术进行前就将其安排在最合适的服务场所。另一方面是在产品设计中也嵌入了这样的机制，我们设置激励措施，促使医疗从高成本的急性场所向门诊场所（ambulatory settings）转移，以实现我们预期的治疗效果。

And more recently with the acquisition of SCA and our partnership there we are really leaning into that and investing in quality incentives for surgeons so that we can drive greater volumes into these less intensive settings and we're able to do frankly more acute procedures and more complicated procedures in that setting as well. So we see a lot of opportunity in it. We've got it in place in select markets today and we will be looking to expand that meaningfully over the course of this year and into next. So those are some of the things that we're doing around both the plan design, the medical management, as well as the incentives to put those three things together in alignment to drive those transitions from acute settings to ambulatory settings to drive better cost, value, and experience. Larry.

此外，近期通过收购SCA（Surgical Care Affiliates）并与其建立合作关系，我们在这一领域更加积极，并为外科医生设立了质量激励，推动更多手术量转移到这些低强度的环境中。事实上我们现在甚至能够在这些场所开展更多急性和复杂程度更高的手术，因此我们在这方面看到了巨大的机会。目前我们已经在部分市场部署了这一模式，并计划在今年和明年大力扩展。以上是在保险产品设计、医疗管理以及激励机制三方面，我们如何协同推进从急性医疗场所向门诊医疗场所转变，以实现更优成本、更高价值和更佳体验的策略。Larry？

Larry C. Renfro

I’d just like to add one other aspect of the Optum business and that would be Optum360. Sometimes we forget that on the primary care side, the urgent care, and now what we're doing with surgery care across the board we have strategic relationships with a lot of the Optum360 clients that are actually involved with us in using those programs. And so we get caught up in terms of talking about how we're looking at our different programs in OptumCare mainly from a health plan standpoint when the Optum360 organizations are actively engaged with how we tie into them as well. So that's a whole other avenue of our business there.

我还想补充一点关于Optum业务的内容，那就是Optum360。我们有时会忽视这一点，其实在初级医疗、紧急护理乃至我们正在推进的外科手术服务领域，我们与众多Optum360的客户建立了战略合作关系，他们已经在实际参与并使用这些项目。所以当我们讨论OptumCare各类项目时，往往从医保计划的角度出发，但实际上Optum360客户也在积极参与、与我们整合，这其实是我们业务的另一个重要维度。

Stephen J. Hemsley

Thank you. Next question please.

谢谢，请下一位提问。

Operator

We’ll go next to Ralph Giacobbe with Citigroup. Please go ahead.

下一位提问是来自花旗集团的Ralph Giacobbe，请开始。

Ralph Giacobbe

Thanks, good morning. You know, there has been headlines around States potentially tying Medicaid contracts to exchange participation. So just want to get your thoughts on that and then with procurements coming up, how concerned are you that States consider exchange participation even if not explicitly and how could that influence your views around reentering the exchange? Thanks.

谢谢，早上好。最近有新闻称一些州可能会将Medicaid（医疗补助）合同与联邦医保交易所（exchange）的参与挂钩。我想请问你们对此怎么看？另外，随着一些新的招标即将进行，你们是否担心即便没有明说，某些州也会在评估中考虑保险公司是否参与交易所？这是否会影响你们是否重新进入交易所市场的判断？谢谢。

Stephen J. Hemsley

Maybe, we'll have Austin begin to comment with respect to safe base to dead end.

我们请Austin先回应一下这个问题。

Austin Pittman

So I guess first and foremost these are really State by State discussions and not something that we're really going to comment broadly here and not going to speculate about that. I would say with regard to your second question we are constantly in conversations with our States on how to expand coverage for more people, particularly those with complex needs. A lot of the activity that we see both in renewal activity as well as new business certainly surrounds that which as we talked about before is a real area of distinction for the combination of Optum and UnitedHealthcare. So we're very positive, we look forward to continue to serve our States and find solutions, particularly get around these populations with very complex needs.

首先，我想强调这是一个因州而异的问题，不太适合在此作出广泛评论，我们也不会对这种可能性做任何猜测。关于你第二个问题，我们确实持续与各州政府保持沟通，探讨如何扩大覆盖人群，尤其是那些有复杂需求的群体。从我们目前看到的续约情况和新增业务来看，这些人群正是Optum与UnitedHealthcare协同服务的差异化优势所在。因此我们对此非常积极，也希望继续服务各州，特别是为复杂人群找到解决方案。

Stephen J. Hemsley

So we'll continue to work with States and so forth but I don't see anything that establishes what might be a trend with respect to tying these kinds of programs together. States have been I think very thoughtful about this to date so I think that's the best response we can offer at the moment. Next question.

我们将继续与各州政府合作，但我目前还没有看到任何明确迹象表明这类项目会被系统性地绑定在一起。到目前为止，我认为各州在这方面都比较谨慎而理性。所以目前我们能给出的答复大概就是这样。请下一位提问。

Operator

Our next question is from Sarah James with Piper Jaffray. Please go ahead.

下一位提问是来自Piper Jaffray的Sarah James，请开始。

Sarah James

Thank you. Stephen, what we know now about the Medicare market [indiscernible] — could the market see a continuation of the 2% penetration increase that we saw in 2017? And long-term, given the inherent value proposition of Medicare Advantage, where do you think penetration is heading — with the potential market that is 50% MA?

谢谢你，Stephen。基于我们目前对Medicare市场的了解，您认为我们是否可能在2017年看到的2个百分点渗透率提升基础上继续上行？从长期来看，考虑到Medicare Advantage本身的价值主张，你认为它的市场渗透率最终可能达到多少？我们是否正在走向一个“50% Medicare Advantage”的市场？

Stephen J. Hemsley

Maybe I will have Steve respond to that but I think we've been pretty consistent in the past that we do expect that penetration to go forward and we do expect the MA market to mature and grow.

我想请Steve来回答这个问题。但总体来说我们过去的观点一直很明确，我们确实预计Medicare Advantage的渗透率将继续上升，并且这个市场会不断走向成熟和增长。

Steve Nelson

Good morning Sarah, Steve Nelson. I agree with Steve's high-level comments there. I have seen clearly in our experience we have seen tremendous growth in our Medicare Advantage and while that clearly we think is driven by some of the things that we uniquely bring to the market — whether it's the stability of benefits, the product designs, the service, or the clinical models. But also in addition to that there's just a real strong overall value proposition with Medicare Advantage and we're seeing that not only just with the folks that we serve but as we talk to policymakers too, there's really strong support for it. So you see a population that needs it, it serves them well. It drives down cost, the satisfaction is up, it's definitely growing, and so we think that's going to continue. And so we do think there's an opportunity to further advance the penetration of the Medicare Advantage. Where it can go is hard to tell, but I don't think it's unreasonable to think about something north of — considerably north of — where we are, about 40% approaching 50%. It doesn't seem like an unreasonable idea to us, no. I would think that we would think that it could go 50% or better.

早上好，Sarah，我是Steve Nelson。我非常赞同Stephen刚才的整体观点。从我们的经验来看，Medicare Advantage确实取得了显著增长。我们认为这部分增长归因于我们在市场中提供的独特价值，比如福利的稳定性、产品设计、服务体验以及临床模式等。此外，从整体上看，Medicare Advantage具备非常强的价值主张，这不仅体现在我们服务的群体反馈中，也在我们与政策制定者的交流中得到了强有力的支持。需求人群确实存在，而且该计划确实对他们有益，既降低了成本，又提高了满意度，并且还在持续增长中。因此我们认为其渗透率仍有进一步提升的空间。它最终会达到什么水平很难说，但我们不认为达到目前大约40%水平以上、甚至接近50%是一个不合理的预期。我们认为，Medicare Advantage渗透率达到甚至超过50%是完全可能的。

Stephen J. Hemsley

Next question please.

请下一位提问。

Operator

We go next to Matthew Borsch with BMO Capital Markets.

下一位提问是来自BMO资本市场的Matthew Borsch，请开始。

Matthew Borsch

Yes, thank you and I'm going to ask a question that sort of asked before but just as you know had started with your comment but you've added 600,000 group commercial risk lives year-over-year. I just wanted to understand — I mean, you're obviously doing better than almost all your competitors, most of whom are seeing attrition on the group commercial risks. And I guess the question — you described your pricing, I think John did — as disciplined and rational, which I'm not disputing. My question is, is this really just that you are producing a better medical cost outcome and so you can price lower than the market? Because a lot of this business — you can correct me if I’m wrong — it moves unpriced. Sorry for the long question.

谢谢你。我想问一个之前稍微涉及过的问题，你们在过去一年中新增了60万名团体商业风险客户（group commercial risk lives），而你们的大多数竞争对手在这方面都在流失客户，显然你们表现更好。我记得你们提到过定价是“有纪律且理性”的，我并不质疑这一点。我的问题是：你们是不是因为医疗成本控制更好，所以可以在不牺牲利润的前提下提供比市场更低的价格？因为我理解这一部分业务很多时候并不是完全通过定价实现增长的，如果我理解有误还请指正。抱歉问题比较长。

Stephen J. Hemsley

So I think that we started to get into this a little bit before when Jeff Alter was commenting, it is I think a function of many things of which cost structure is clearly part of it but its spectrum of products, the design, etc. So Jeff do you want to respond?

这个问题我们之前在Jeff Alter发言时其实已经涉及到一些。我认为这背后有多种因素，其中当然包括成本结构，但也包括产品范围、设计等。Jeff，你来回答一下吧？

Jeff Alter

Sure, hey Matt. I guess I would try in my response to kind of elevate the discussion a bit. So I would say the market moves on value — it doesn't necessarily move on price. And we have been very purposeful across our product, our services. The focus on NPS has, I think, brought a much stronger value proposition to particularly the fully insured small group market. Long-term disciplined pricing is a good thing and I think you're seeing the discipline that we had in the early stages of the ACA now coming back to us as a value play. Couple that with a very purposeful decision a number of years ago to broaden our product portfolio and to offer a much broader spectrum of network opportunities or choice for particularly our fully insured small group clients.

好的，Matt。我会尽量从更高的层面来回应你的问题。我认为市场是基于“价值”而非“价格”在运作的。我们在产品和服务方面一直非常有目的地进行布局，特别是在提升NPS（净推荐值）上的专注，让我们在全额投保的小型团体市场上具备了更强的价值主张。从长期看，有纪律的定价是件好事，我认为你现在看到的增长，实际上是我们在ACA（奥巴马医改）早期阶段坚持纪律性定价所带来的价值回报。此外，几年前我们就做出有意识的决策，拓展产品组合，提供更广泛的网络选择，尤其是面向我们的小型团体全险客户。

We also have undertaken a different view with our distribution community — our brokers and consultants — a more disciplined approach with them, narrowing some of that distribution network to more favored partners and giving them some added services. So one of the things that we've learned over the years is that our brokers and consultants in that marketplace seek to do business with those that make it easier for them to do business with. We've created — again with the assistance of Rally and our Optum partners — a much easier way for our small business brokers to onboard clients with us, to make plan changes, to recommend using some of the OptumInsight analytics. The next logical moves for buy-down. So you really have to look at the value we bring as opposed to the price of our product. I think it maps to the answer why our small group fully insured business has done well over the last few years.

我们在与经纪人和顾问的合作方面也采取了新的思路，采取了更有纪律的策略，缩小部分销售网络，聚焦于我们更信赖的合作伙伴，并为他们提供额外服务。我们这些年学到的一点是，市场上的经纪人和顾问更愿意与那些“合作流程简单、支持更到位”的公司合作。在Rally和Optum合作伙伴的帮助下，我们打造了一套简化流程，使小型企业的经纪人更容易为客户完成开户、修改方案，并使用OptumInsight的分析工具提出降本建议。因此，你真正应该看的是我们所提供的“整体价值”，而不仅仅是产品的价格。我认为这就是我们过去几年中小型团体全险业务表现突出的关键原因。

Matthew Borsch

Thank you.

谢谢。

Stephen J. Hemsley

Thank you, next question please?

谢谢，请下一位提问。

Operator

We go next to Ana Gupte with Leerink Partners. Please go ahead.

下一位提问是来自Leerink Partners的Ana Gupte，请开始。

Ana Gupte

Yes, thanks, good morning. On Optum — you saw some really nice margin expansion on OptumHealth and OptumRx despite the mix shifting pressures you talked about on providers. I was just wondering if this is an area of focus for the organization or this is one-off and where could the margins shake out by business line and overall?

谢谢，早上好。关于Optum，我看到你们在OptumHealth和OptumRx上实现了非常可观的利润率扩张，尽管你们之前也提到在provider业务方面存在结构性压力。我想了解一下，这是你们组织当前的重点战略方向，还是一次性的表现？你们预计未来按业务线和整体来看，利润率可能会处于什么水平？

Stephen J. Hemsley

Larry, maybe you want to respond to that, clearly an area of focus right.

Larry，你要不要来回答这个问题？这显然是我们的一个重点方向。

Larry C. Renfro

It is an area of focus and Ana we’re obviously — you're looking at both from a financial perspective as well from a margin perspective — and all that is in line with our expectations. I am going to ask Tim Wicks to comment on this.

是的，Ana，这确实是我们的重点方向。你提到从财务和利润率角度来看这部分业务的表现，这些确实都符合我们的预期。我请Tim Wicks来详细补充一下。

Tim Wicks

Sure, thanks Ana. First, as we think about the margin growth that we're seeing since we had — we’re pleased to start a very strong start to the year 2017. The earnings are in line with our expectations June year-to-date and comprise about 40% of the full year expectations and so right in line with both our prior several years of experience in the first half of the year as well as our 2017 guidance.

当然可以，Ana，谢谢你的问题。首先，从2017年初的表现来看，我们的利润率增长情况令人满意，年初至今的收益表现符合我们的预期，已实现全年目标的约40%。这不仅与我们过去几年上半年的表现一致，也符合我们对2017年的整体指引。

I think it's also important to understand that there's seasonality in our businesses and maybe I'll just point to two examples where there's some seasonality. One, is in OptumInsight — as you know, the second half of the year is typically pretty strong in terms of the relative distribution of earnings growth in the year and it's really driven by several other businesses in OptumInsight: quality and the risk businesses, the Optum360 content sales, as well as technology data and software sales.

我认为还要理解的一点是，我们的业务存在季节性波动。我举两个例子说明这一点。首先是OptumInsight——你知道，下半年通常是收益增长的强势期，这主要由几个方面推动，包括质量和风险业务、Optum360内容销售，以及技术、数据和软件的销售。

The second example I would use is in OptumHealth as well — when we look at OptumHealth, SCA (Surgical Care Affiliates) volume is characteristically also stronger in the second half of the year. And then typically we expect fourth quarter overall for Optum to be stronger than the third quarter as well as we go through the year.

第二个例子是OptumHealth。我们看到OptumHealth中，SCA（外科护理联盟）的手术量在下半年往往更高。通常来说，我们预计Optum整体在第四季度的表现会强于第三季度。

Stephen J. Hemsley

Thank you. We’ll do two more questions and then we'll have to close it. So, we will do two more questions first.

谢谢。我们再接两个问题，然后就要结束本次会议。请继续提问。

Operator

We'll go to Sheryl Skolnick with Mizuho. Please go ahead.

下一位提问是来自瑞穗证券的Sheryl Skolnick，请开始。

Sheryl Skolnick

Thank you very much for keeping me in. So I'll just observe that if this is early stage growth — for a $200 billion revenue run rate company to produce what you're producing — I’d like to see what late stage looks like. So thank you for that. But the real question I have here is that I’ve learned over time to pay close attention to what is said on this call. And one of the things that you mentioned, Steve, early on in your remarks was that — words to the effect of — “it is now time to turn our attention to cost.” In the past, when you’ve turned the organization’s attention to something, it’s resulted in significant advances for the business enterprise as a whole. And I’m wondering if this is one of those things that we should be paying attention to. And if so, can you quantify it in any way or qualify it in any way to give us a sense of where the opportunities are? I know we’ve discussed it from the OptumCare perspective, but more broadly across the enterprise would be helpful. Thank you.

非常感谢你们让我参与发言。我想先说一句：如果这还只是“早期增长阶段”：哪一家年营收达到2000亿美元的公司能取得这样的成绩，我真想看看“后期阶段”会是什么样子。所以谢谢你们的精彩表现。但我真正的问题是：长期以来，我一直很重视你们在财报电话会中讲的话。而Steve，你在开场发言中提到一句话，大意是“现在是时候把注意力转向成本了”。过去每当你们全力聚焦某个方向，通常都会给整个企业带来重大进展。所以我想问的是：这次是否也是类似的重要信号？如果是，你们能否定量或定性地说明一下这些成本机会大概在哪里？我知道我们已经从OptumCare角度讨论了一些内容，但如果能从整个集团层面给出更广泛的视角就更有帮助了。谢谢。

Stephen J. Hemsley

I'm not sure I can offer you too much specifics, but that was intentional. I think that in general, if you take a look at our organization, we have grown well over the last couple of years. We've been able to add some and introduce some strong companies into our portfolio. And I think that if you see the growth and, in essence, the net productivity out of that, you’d sit back and say there's an opportunity to strengthen the enterprise — continue to lead the enterprise — focused on the things that are most important.

我不确定能为你提供非常具体的数字，但我要说，那句话的确是有意强调的。总体来看，我们过去几年取得了良好增长，也成功并入了一些实力强劲的公司。你如果观察我们增长背后的“净生产力”表现，就会意识到，我们确实有机会进一步强化整个集团运营，保持领先地位，并聚焦于那些最核心、最关键的工作。

And if you recognize the value equation as it’s played out in the marketplace, many of today’s themes were around retention of customers, value to customers, and so forth. As one of the questioners pointed out, the price point is a very important part of this. We have to challenge ourselves to deliver value all the time. We're in a very strong position — this is a great time to be taking that challenge up — and that is what we're focused on.

再看当前市场中价值传递的路径，今天我们反复强调的主题其实就是：客户留存、客户价值等等。就像之前有位提问者提到的，“价格”是这个等式中很关键的一环。我们要不断挑战自己，在每一个阶段都提升我们的价值交付能力。我们现在处于非常强劲的市场地位，这正是我们主动迎战、聚焦成本优化的大好时机，而这正是我们当前正在专注推进的重点。

We think we can deliver more value. We think we can drive more innovation, fresh approaches, and I think this enterprise is full of people who are ready to do that. The alignment of new technologies to that effort — use of more advanced data analytics — produces a lot of opportunity for us, particularly just given the setup of our businesses. So those are the themes around that and we are focused on a marketplace that’s going to be looking for value and think that we can anticipate that. I think NPS is a big part of that effort as well. Thank you for the question.

我们相信，我们可以交付更多的价值，可以推动更多创新，采用更具前瞻性的策略。我相信我们整个团队已经准备好迎接这一挑战。我们正将新技术应用于这项工作，利用更先进的数据分析方法，这将为我们带来非常多的机会，特别是考虑到我们目前的业务布局。这就是我们这项“关注成本”背后的战略主线——市场会持续要求价值提升，而我们有能力预判并满足这些需求。同时，NPS的持续提升也是这一战略的重要组成部分。谢谢你的问题。

Stephen J. Hemsley

Next, last question please.

最后一个问题，请开始。

Operator

And we'll go to Zack Sopcak with Morgan Stanley. Please go ahead.

接下来是来自摩根士丹利的Zack Sopcak，请开始。

Zack Sopcak

Hey good morning, thank you. I wanted to ask about CMS’s proposal to remove knee arthroplasty from the in-patient only list. Was that something that you considered happening in the near term when you were in the stages of acquiring SCA and how do you think about the impact of that business over a longer term — is it meaningful and does that have any impact on your MA strategy going forward?

早上好，谢谢你们。我想问一下CMS（美国医疗保险和医疗补助服务中心）提议将膝关节置换术从住院治疗（in-patient only）列表中移除的问题。当你们在收购SCA（Surgical Care Affiliates）时，是否已经预见到这种政策变动在近期会发生？从更长期来看，这项业务的影响是否重要？它会对你们未来的Medicare Advantage（MA）策略产生影响吗？

Andrew Hayek

It’s Andrew. I'd offer a couple comments here. From an SCA perspective the team there has been focusing on higher acuity procedures for several years — in orthopedics, in spine, in cardiovascular — and that includes total joint replacements, which the SCA team has been performing on a commercial basis for a number of years with outstanding results. Very consistent with the AAA in terms of the quality outcomes, the patient experience, and of course material cost savings.

我是Andrew，我来回应一下。从SCA的角度看，他们团队多年来一直专注于更高复杂度的手术，包括骨科、脊柱手术和心血管治疗，其中也包括全关节置换手术。SCA团队已经在商业市场中开展此类手术多年，取得了非常出色的成果。在质量结果、患者体验以及显著成本节省方面，都与AAA（门诊手术卓越标准）高度一致。

So we've been applying that in the commercial environment and there's been discussion for a number of years at the CMS level around the potential to allow total joint replacement in the surgery center setting, which we of course would embrace — allowing us to extend the benefits of that platform in terms of quality, experience, and obviously reducing total cost — and extend that to the Medicare population. So in many ways we have been anticipating this. This is something on a commercial basis we've been doing. We can obviously speculate as to how — what the outcome will be — but this is a positive and consistent with the strategy we've been pursuing.

我们已经将这些能力应用于商业环境中。事实上，CMS层面早已讨论过是否允许在门诊手术中心开展全关节置换术的可能性。我们当然欢迎这一提议，因为它将使我们能够将高质量体验和整体成本控制的优势，进一步扩展至Medicare人群。从多个角度来说，我们是预期到这一政策趋势的。我们早就在商业市场中开展这项服务，现在只是可能扩展到Medicare领域。虽然我们目前无法完全预测最终结果如何，但这项变动对我们来说是利好，也与我们一贯的战略高度一致。

Stephen J. Hemsley

So thank you. Thank you once again for your interest in our progress today. Kind of midway through the year our performance and momentum remain strong. We expect to continue to deliver higher quality and value in healthcare and sustainable growth throughout 2017, 2018 and the years to come. Our thanks to our people who through their commitment to our mission and culture are helping to drive our enterprise to reach its full potential. Thank you and that concludes our call today.

谢谢大家。再次感谢你们对我们公司发展的关注。我们目前已进入年中的阶段，业务表现和增长势头依然强劲。我们预计将在2017年、2018年以及更长远的未来，持续为医疗服务带来更高质量、更高价值的成果，同时实现可持续增长。我们也要感谢我们的团队，正是他们对使命和企业文化的坚定承诺，推动着公司向着全部潜力迈进。谢谢大家，本次电话会议到此结束。

Operator

This will conclude today's program. Thanks for your participation. You may now disconnect and have a great day.

本次会议到此结束。感谢各位的参与。您现在可以断开连接，祝您有美好的一天。