2022-11-29 UnitedHealth.Investor Day
Andrew Witty Non-Independent Director
Good morning, and welcome to UnitedHealth Group. Thank you so much for joining us here today, and we look forward to spending the next couple of hours with you taking you through our story here at the company. It's about 45 years since UnitedHealth Group was first incorporated. And as many of you recognize, it's almost unrecognizable today from what it was back in the late 1970s. It's evolved from being a company initiating to look for coverage for folks grew through an year of figuring out how to develop policies to help influence best care delivery, extend it into care delivery itself.
Andrew Witty 非独立董事
早上好，欢迎来到UnitedHealth Group。非常感谢大家今天来到这里，我们期待接下来的几个小时与您分享公司一路走来的历程。UnitedHealth Group成立至今已有大约45年了，正如许多人所注意到的，公司与上世纪70年代末的模样几乎已经面目全非。最初，它只是一个寻求为人们提供保险覆盖的公司，随后不断摸索，制定有助于推动优质医疗服务的政策，最终更是拓展至医疗服务本身。
Those years of evolution have really been a response to market dynamics to the needs of the environment to the needs of consumers and the needs of payers. And the company has responded repeatedly with an agility and an energy to grow and change. And yet after 45 years, the team you're going to meet today, our team stands fairly more optimistic that our greatest potential still sits in front of us. We still feel complete commitment to our long-term adjusted earnings growth rate of 13% to 16%. We believe that despite all of the achievements of the last 45 years, the scope for further impact is larger going forward than it has been even behind us. And today, we look forward to sharing the reasons why we believe that, why we think those opportunities are real and within our grasp. We're going to do that through the lens we laid out last year, the growth strategy of UnitedHealth Group built on our 5 growth pillars.
这些年来的演变，其实正是公司对市场动态、环境变化、消费者需求以及付款方需求的持续回应。公司一次又一次地展现出敏捷与活力，实现了不断的成长与变革。如今45年过去了，您即将见到的这个团队——我们的团队——比以往任何时候都更加充满信心地认为，公司最伟大的潜力仍在未来。我们依然坚守长期调整后每股收益增长13%至16%的目标。我们相信，尽管过去45年取得了丰硕成果，未来所能产生的影响将更加深远。今天，我们将与大家分享我们为何如此相信这些机会真实存在且触手可及。我们将以去年提出的UnitedHealth Group增长战略为主线展开介绍，这一战略建立在五大增长支柱之上。
Those growth pillars are guiding us. They how we run the company, they how we keep score within our own organization. And you're going to hear over the next couple of hours, how we feel that's going, the progress we're making and you're going to -- we're going to share with you some of our scorecard in terms of how we think things are playing out. To recap those 5 growth pillars really quickly, value-based care, how we can build an ambulatory value-based care system comprehensively looking after patients, figuring out a way to deliver more quality at lower cost, better medical outcome.
这五大增长支柱为我们指明方向，指导我们如何运营公司，也决定了我们内部如何衡量成绩。接下来的几个小时里，您将听到我们对各项工作的进展评估，并分享我们的“成绩单”，看看事情的发展是否如我们所愿。快速回顾一下这五大增长支柱：第一是价值导向的医疗服务，我们致力于建设一个以门诊为基础的价值型医疗体系，全面照顾患者健康，在控制成本的同时提供更高质量的服务，实现更好的医疗效果。
Benefits, how we can continue to develop affordable, high-quality accessible health coverage for people regardless of their status across our country. Health technology, how we can bring the benefits of health technology to payers and providers across the country to be the greatest supporter of the general development and innovation of the health care system. How we can bring to life the opportunity of financial services within health care, a key strand which drives much of the system and represents great opportunity for simplification and streamlining. And last but not least, the relentless modernization of the most common touch point in health care, pharmacy services, how we can develop a pharmacy services platform for the future and 1 which can really respond to technology and innovation, which is coming from the pharmaceutical industry.
第二，保险福利——我们要持续开发负担得起、高质量且易于获取的健康保险产品，不论个人的社会或经济背景如何。第三，健康科技——我们将健康科技的优势带给全国各地的付款方与医疗服务提供者，力争成为整个医疗系统发展与创新最有力的推动者。第四，医疗金融服务——金融服务是医疗体系的关键组成部分，我们希望能把这个机会变为现实，推动医疗金融的简化与优化。最后但同样重要的是，持续推进药房服务的现代化，这一环节是医疗服务中最常见的接触点。我们致力于打造面向未来的药房服务平台，使其真正能够响应制药行业日新月异的技术与创新。
Those are our 5 core growth pillars for this organization. Each one of those individually represents tremendous scope of opportunity. Each one of the 5 are already very big businesses within UnitedHealth Group. They all represent engines of this organization. You'll see all 5 of those represented to you this morning. You'll see the progress they're making and the growth they're achieving. They all exist within large addressable marketplaces. And in most cases, we're really now, despite our size, only scratching the surface of the opportunity that lay ahead. And you'll see some of that described to you. But in addition, and importantly, in addition to those significant focused engines, they have something else very special. They all help each other. They all play together in ways which make each one stronger than they could possibly be standing alone.
这就是我们组织的五大核心增长支柱。每一个支柱单独来看都蕴含巨大的发展潜力。它们在UnitedHealth Group内部已经发展成各自规模庞大的业务板块，成为公司增长引擎的重要组成部分。今天上午您将会看到这五大支柱的全面展现，了解它们所取得的进展与实现的增长。它们所在的市场空间都极为广阔，即使在我们已经具备如此体量的基础上，也依然只是触及了这些机会的冰山一角。除此之外，更重要的是，这些强劲引擎之间并非孤立存在，它们之间相互促进、彼此协同，这种协作效应让每一个板块的实力远胜于单打独斗。
That ability to connect the system to find ways in which financial services can support value-based care, find ways in which pharmacy can help our benefits business. Our benefits business can inspire our delivery business. That's where the true energy of this organization lay. Let me bring that to life a little bit by diving into value-based care. Think about what we're building within OptumHealth. Of course, the clinics, the focus on building out clinics, but as you look at the way in which that has grown step back, where did it come from? The inspiration for that entire strategy comes from our benefits business. The benefits business conceived the notion of how we could develop value-based approach, Optum began to build in response to that.
这种系统连接能力正是本组织真正的动能所在——我们探索如何让金融服务支持价值导向医疗，如何让药房服务提升保险福利业务，如何通过福利业务反过来激发医疗服务业务的灵感。这种协同才是我们真正的力量源泉。让我通过价值导向医疗举例说明。看看我们在OptumHealth内部所构建的体系——当然，建设诊所始终是重点之一。但当我们回顾其增长历程时，会发现这一切最初的灵感其实源于我们的保险福利业务。正是福利业务最早提出了发展价值导向医疗的构想，Optum才开始据此搭建相应体系。
That build begins around clinics. It then assembles other capabilities, different types of specialists. About half of our physicians are primary care, about half of specialists. We work with employed and contracting and affiliated clinicians many different models being deployed. You see the pace at which that business is developing. This year already, we've transferred or grown 1 million more lives looked after within our OptumCare value-based platform. Next year, we're expecting to add at least 750,000 more. That pace of growth is becoming -- is coming through because of that growth of capabilities that's been established. But it's not about the clinics. It's now about home and community.
这一体系最初从诊所建设入手，随后逐步汇集多种能力，涵盖不同类型的专业医生。我们约一半的医生是初级保健医，另一半为专科医生。我们通过雇佣、合同制、合作制等多种模式与临床人员合作。这项业务的增长速度令人瞩目。今年，我们在OptumCare价值导向平台上新增或转入了100万名被照护人群。预计明年还将新增至少75万人。这一增长势头正是因为我们已建立起的能力体系所驱动。但这不仅仅关乎诊所，更是关于家庭与社区的照护。
And as you think about next year, of the very substantial number of lives, which will be looked after by the home and community risk-bearing entity platform complementary to the clinic platform. About half of those lives looked after by home and community are in geographies where we have no clinics. And so the home and community platform itself gives us yet another opportunity to extend the notion, the idea that we believe in that comprehensive value-based care delivers better medical outcome, better quality for patients, a better role for providers and crucially better value for money for payers. We think it's a truly sustainable way to modernize the health care system for all of the key participants.
明年我们将在家庭与社区风险承担平台上照护大量人群，这一平台与诊所平台互为补充。而其中大约一半的被照护者所在地区，我们并没有诊所。这意味着家庭与社区平台本身为我们提供了又一个拓展机会，使我们所坚持的理念得以延伸——即全面的价值导向医疗不仅能够带来更优的治疗结果与患者体验，也能为医疗提供者赋能，为付款方带来更高的资金使用效率。我们认为这是一种真正可持续的方式，能够为整个医疗系统的所有关键参与方带来现代化变革。
And as you think about that value-based environment, not only was it originated conceptually from the Benefits business, not only has it assembled these capabilities, it's powered by our data. It's powered by our understanding of the system. It's helped by the way in which our pharmacy capabilities, home infusion can complement our clinical capabilities in OptumHealth. It's a good example of how all 5 of the engines start to work together to help that particular engine continue to work strongly. As we work those ideas, the key then is to figure out how to grow them. And as you look at value-based care, you'll see 2 dimensions on which you could easily imagine that continuing to grow substantively. One is already within sight, and we've [ cloud ] that for well, and we will continue to do so geographic expansion.
在这一价值导向医疗生态中，最初源于福利业务的构想如今已集成多种能力，并由我们的数据和对系统的深刻理解所驱动。同时，我们在药房服务、居家输液等方面的能力也有效补充了OptumHealth的临床服务能力。这正是五大引擎协同发力的典范，彼此互促、共同发展。接下来我们思考的核心问题是：如何实现这些理念的进一步增长。就价值导向医疗而言，我们看到它在两个方向上仍有广阔增长空间。其中之一已经清晰可见，我们已经在着手推进——那就是地理扩张。
Not just through M\&A, not just through organic expansion of our clinics, but for example, through home and community where we find a new way to bring the good idea to people's homes without necessarily having to wait for the build out of the clinic strategy. It's a great way for us to accelerate the delivery of what we believe to be a highly effective, extremely sustainable approach to more people more quickly. The second area is to conceptualize the way in which we take a great idea, comprehensive value-based care, which, of course, has been pioneered within the senior marketplace and take it to a different part of the marketplace. Commercial, 170 million Americans in the commercial insurance environment, the opportunity to innovate in that space feels right, the timing feels right.
不仅仅通过并购，也不仅仅依赖诊所的自然扩张，我们还通过家庭与社区服务，开辟了一条将优秀理念带入人们家中的新路径，而无需等待诊所网络的逐步建设。这是一种加速普及我们认为高度有效、极具可持续性的医疗模式的方式，让更多人更快受益。第二个重要方向，是重新构思如何将“全面价值导向医疗”这一在老年人市场中率先实践的成功模式，推广至另一个巨大的市场——商业医疗保险。美国约有1.7亿人处于商业医保体系中，这正是一个创新的巨大机遇，我们认为时机已经成熟。
The rails that we're build in within OptumHealth creates a set of capabilities and instinct a muscle memory within our health system, which we know works for seniors and we are confident can be developed and built further for the commercial environment. Those 2 dimensions, geographic and moving across into different classes of business represent enormous future potential growth for the organization and are high on our list to move forward. You will hear about all of that in the next couple of hours.
我们在OptumHealth内部构建的基础设施和能力已经在老年医疗中得到了验证，形成了一套系统性的本能反应和运营机制。我们有信心，这些能力可以进一步扩展到商业医保领域。这两个维度——地理拓展与业务类型跨越——代表着公司未来极为可观的增长潜力，也将是我们接下来重点推进的方向。接下来的几个小时中，您将听到更多关于这方面的内容。
What we try and do across the organization is relatively simple, and it repeats and repeats across the company. We try and understand the complex environment. And then we try and translate it and make it simpler for the people who live in it. We want people in America who need health care to be able to access it without needing a PhD in health care to do it. We need people to feel confident that when they come for care, they're going to get great care and they're not going to be bankrupted in the process. Our job is to translate that complexity and make the extraordinary capacity of the U.S. health care environment available for everybody who needs it. We're incredibly focused on making sure that that's true across the spectrum of people in the country, whether they are poor, whether they're rural, whether they're urban, whether they're veterans or whether they're conscientious objectives.
我们在整个组织中的工作理念其实很简单，并在各个业务层面不断重复实践：理解复杂的医疗环境，然后将其简化，让普通人也能轻松应对。我们希望美国所有需要医疗的人，不需要有博士学位，也能轻松获得服务；他们应该有信心，在寻求治疗时不仅能够获得优质照护，也不会因此破产。我们的职责就是将复杂的医疗体系“翻译”成所有人都能用得上的服务，让美国庞大的医疗能力真正惠及所有需要它的人。无论他们是贫困人群、生活在偏远地区、城市居民、退伍军人，还是出于个人信念不参与某些制度的人群，我们都致力于确保他们都能从系统中获益。
We want to create a system which works for everybody, and we're working hard to make that happen. We believe that within that agenda, that commitment to the mission that there is tremendous ongoing growth in this organization. You will see that reflected, and I hope you saw that reflected last night in our confidence for next year. Now to do all of that, we also need to do 2 other really important things to bring some high-octane energy to the future growth of the organization.
我们希望打造一个对所有人都适用的医疗体系，并正为实现这一目标不懈努力。我们坚信，这一使命所承载的价值，也将持续带动本组织的强劲增长。您应该已经在昨晚的展望中看到我们对明年的高度信心。要达成这一切，我们还需在两个关键方面注入强大动力，以驱动未来的增长。
The first is to become and learn how to be a preeminent consumer organization. The future of health care in no scenario is a future where the American consumer has less influence than they have today. In every scenario, the American consumer, the American patient has more influence in the future than today. We need to build and respond to that. That's why you've seen in the last 12 months, enormous steps forward in the company's stance towards the consumer at every level, our agreements with Walmart, our partnership with Red Ventures Health are both designed to engage us at a level with the American consumer, where we've been nowhere close to before.
第一项，就是成为、并持续学习如何成为一家卓越的以消费者为中心的组织。无论未来医疗体系走向何方，都不会是消费者影响力减弱的局面。相反，在每一种情境中，美国消费者和患者的影响力都会比现在更大。我们必须为此做好准备并积极响应。这也是为何过去12个月里，我们在面向消费者方面做出了巨大推进——与Walmart的合作，与Red Ventures Health的合作，正是为了与美国消费者建立起前所未有的深入联系。
Whether people want to meet us on their shopping visits to Walmart, whether they meet us through health grades or health lines, those hundreds of millions of people a month who are trafficking through those digital environments or through those stores, those are our customers. They are the customers of the future. Theirs are the voices we have to build and respond to. You will see more and more emphasis in the organization as we lean into that consumer agenda. It's important we do that. Those consumers are, of course, our customers. They either are or they will be our patients. They are or will be the decision makers on how care evolves. And there are scenarios, as you imagine, things like commercial, health insurance, maybe 1 day evolving for being a defined benefit to a defined contribution environment, where you can anticipate the consumer's role becoming even more critical.
无论人们是在Walmart购物时与我们接触，还是通过Healthgrades或Healthline等平台接触我们——每月有数以亿计的用户访问这些线上和线下渠道——这些人都是我们的客户，更是我们未来的客户。他们的声音，是我们必须聆听并积极回应的。公司将持续强化在消费者战略方面的投入，这是至关重要的。因为这些消费者，要么已经是我们的客户或患者，要么未来将会成为。他们也将成为医疗服务如何演进的关键决策者。设想一下未来的商业医保场景，例如由“确定福利”向“确定供款”转变时，消费者所扮演的角色只会更加关键。
Building the capabilities ready for those scenarios are no regret moves and help future-proof our long-term growth over the next decades. Second area that we need to make sure that we accelerate at pace is technological capabilities. Our ability to bring value from all of the data and the connectivity that we have across the system is crucial for us to make sure that we bring to customers, consumers, patients and providers and to payers exquisite right first-time advice, exquisite understanding of opportunities to take cost out of the system and figure out where are the no regret places that we can stop care without necessarily impacting outcome and where we should increase care because we know it maximizes benefits to the patient.
为这些未来场景打造相应能力，是“无悔之举”，不仅如此，它还能让我们的长期增长具备更强的抗风险能力。第二个我们必须快速推进的领域是技术能力。我们如何利用整个系统中积累的数据和连接性，将价值真正传递给客户、消费者、患者、医疗服务提供者和付款方，这一点至关重要。我们要提供精准、一次到位的建议；深入洞察哪些地方可以安全地压缩成本，不影响治疗效果；又有哪些领域应该增加投入以最大化患者受益——这是一项数据挑战。
That's a data challenge. How we bring that data to life again, we're just scratching the surface. But we're at a moment in time where technology and the availability of talent is an extraordinary fertile opportunity for this company to leap forward, both in technology and its application and in the way in which we drive a consumer orientation in the business. None of that takes away from being a hard core organization focused on medicine, health care and, of course, fiscal thoughtfulness.
这是一个数据带来的挑战，而我们目前仅仅触及了表层。如今正值技术进步和人才充沛的时代，对我们公司而言，这是一个实现飞跃的绝佳时机——无论是在技术本身、在应用方面，还是在推动企业转向以消费者为中心的进程上。这一切并不会削弱我们作为一家专注于医学、医疗保健以及财务审慎运营的核心组织本质。
But in addition to all of those things, making sure that we are a strong consumer-led and strongly technologically empowered organization are areas for us to continue to build on. You will hear a lot more about that over the next few hours and I encourage you to engage in the seminars also as we get into that. Now to achieve all of that, we really need to have an extraordinary organization of people. And I'm incredibly privileged to stand here representing 380,000 people across the world who support UnitedHealth Group every day.
在此基础上，我们还必须持续建设一家既以消费者为核心，又具备强大技术能力的组织。这将是我们接下来持续深化的关键方向。接下来的几个小时中，您将听到更多相关内容。我也鼓励大家积极参与我们的专题研讨。要实现这一切，我们必须拥有一支卓越的员工队伍。此刻我非常荣幸能够代表遍布全球、每天为UnitedHealth Group努力工作的38万名员工站在这里。
Those people do an incredible job, whether they are answering calls, whether they're going into a seniors home to help understand that person's health needs, whether they're making sure that our financial strength is there for us to make the next move in our strategy, whether they are simply making sure that the machine of the company turns every day the way it needs to. We depend on all of them. The diversity of that skill set is proliferating fantastically well. You have to have that diversity in every sense because we now need strong consumer capabilities. We now need much more advanced, more modern technology capabilities.
这些人每天都在各自岗位上做出卓越贡献——无论是接听电话、走访老人住所以了解其健康需求，还是保障公司的财务稳健以支持战略推进，抑或是确保公司运转机制每日如常。我们仰赖于他们每一个人。他们带来的技能多样性正在迅速壮大，这种多样性在当前尤为重要——因为我们不仅需要强大的消费者运营能力，也需要更先进、更现代化的技术能力。
We need more physicians, more clinicians, more people who've got empathy with the system. It's an extraordinary statistic for me the most extraordinary statistic of today. So far this year, 3.9 million people have applied to join UnitedHealth Group as an employee. That is an extraordinary signal of how people want to be part of this journey. Why do they want to be part of this journey? Because they can see in this company, an ambition to grow, yes, they see in this company a deep commitment to quality, yes, they see in this company an extraordinary commitment to putting the patient first, yes. A culture which values performance, yes, a culture which holds ourselves accountable for doing the right thing every single day when people are watching and when they're not watching and delivering performance for all of our stakeholders.
我们需要更多医生、更多临床人员、更多对医疗体系充满同理心的人。今天最令我震撼的一项数据是：今年迄今为止，已有390万人申请加入UnitedHealth Group。这是一个极其强烈的信号，说明人们渴望参与这段旅程。他们为何想成为这旅程的一部分？因为他们在这家公司看到了增长的雄心，是的；看到了对医疗质量的深度承诺，是的；看到了以患者为先的坚定理念，是的。他们还看到了一种重视绩效的文化，以及一种无论是否有人监督都坚持做正确之事、为所有利益相关者持续创造价值的文化。
You're going to see over the next couple of hours and in the seminars later today, 60 of my colleagues. A 1/3 of those 60 have joined us in the last 2 or 3 years from other Fortune 100 companies. There is a mix of experience there. People have been here for decades, people have been here for a much shorter time. People have come from the biggest tech companies in America to the biggest consumer companies from pharmaceutical industry and from government. It's that diversity reflected in the 60 folks you're about to meet reflected down through 380,000 people across this organization, which gives us the confidence to be able to commit to the growth that we're laying out for you today.
在接下来的几个小时以及今天稍后的研讨会上，您将见到我60位同事中的部分代表。其中三分之一是在过去两三年间从其他《财富》百强公司加入我们的。这支团队背景多元，有些人已在公司工作数十年，也有刚刚加入不久的新人。他们来自美国最顶尖的科技公司、消费品公司、制药企业以及政府机构。这种多样性不仅体现在您即将见到的这60人身上，也贯穿于我们这支38万人的全球团队，这正是我们有信心向您展示未来增长路径的根本所在。
We believe it's built behind a great mission. We believe it's built on the shoulders of values. It's built on a culture of quality and performance, and it's built on a culture of holding ourselves accountable for delivery. We're going to take you through that. We're going to share that with you, and I hope very much you see at the end of the day why we're so confident our potential is stronger in front of us than it even has been already.
我们坚信，这一切是建立在伟大使命之上的，是建立在价值观之上的，是建立在追求质量与绩效的文化之上的，是建立在对结果负责、勇于担当的文化之上的。接下来我们将带您深入了解这一切，全面与您分享我们的愿景。我衷心希望，等到今天结束时，您能明白为什么我们如此笃信：UnitedHealth Group的最大潜力仍在未来，而非过去。
Final reason why these 60 people are coming to this company, why these 3.9 million people are applying to this company? Why the 380,000 people turn up every morning to work hard for this company is because they know in this company, they can make an impact on health care and not just in a small pilot example, not just in an experiment, but when their idea works, it can affect millions of people. It can change the lives of millions of families. It's the impact that people are seeking is the opportunity they have to do that at this company that brings them to UnitedHealth Group.
这些人——无论是那60位来自各行各业的精英，还是那390万名申请者，抑或每天清晨准时上班的38万名同仁——他们选择UnitedHealth Group，是因为他们知道，在这里，他们可以真正改变医疗行业。他们的影响不仅限于某个小型试点，也不仅是实验室里的理论，一旦他们的想法奏效，它将影响到数百万人的生命，改善数百万个家庭的生活。正是这种“影响力的机会”，吸引他们来到UnitedHealth Group。
It's what brought me to this company. It's what brought the 60 you're about to see from this to this company. I welcome you to this conference today. Please engage. We look forward to sharing everything we have with you. And with that, I'm delighted to hand over to Dirk McMahon, our President and Chief Operating Officer.
这也是我选择加入这家公司的原因，也是您即将见到的这60位同仁加入的原因。欢迎各位莅临今天的会议，请积极参与互动。我们期待与您全面分享我们的成就与规划。现在，我非常荣幸地将话筒交给我们公司的总裁兼首席运营官，Dirk McMahon。
Dirk McMahon Former President & COO
Thanks, Andrew. That's certainly true for me and the reason I've stayed with the company for nearly 20 years. During the next hour, we're going to dig deeper into the growth strategy, powering that mission, introducing you to the people bringing it to life, leaders who've grown up in the company and others who've recently joined us.
谢谢你，Andrew。对我个人而言也完全如此——正是这些原因让我在这家公司坚守了近二十年。接下来的一个小时，我们将深入探讨推动使命实现的增长战略，向您介绍正在将其付诸实践的团队成员——既有在公司中成长起来的领导者，也有最近加入我们的新同仁。
You'll also meet some of our colleagues in the front lines who are carrying out that mission each and every day. 1 patient, 1 member, 1 customer at a time. As you just heard, we're making real progress staying laser-focused in our execution and always looking for ways to innovate, drive better value and serve more people. You'll see over the course of the morning, how each pillar of our growth strategy is delivering results on their own as well as how the interconnectivity between them spurs innovation, creating value that extends well beyond our walls. Each one is an enterprise effort where Optum and UnitedHealthcare leaders are operating across individual lines of business and P\&L responsibilities to drive enterprise value and to deliver specific performance and financial targets year-over-year, quarter-by-quarter.
您还将见到一些在一线践行这一使命的同事——他们每天都在为每一位患者、每一位会员、每一位客户提供服务。正如刚才所提到的，我们的执行始终保持高度专注，持续取得实质性进展，并不断寻求创新、提升价值、服务更多人。今天上午，您将看到我们增长战略的各大支柱如何分别产生成果，也将看到它们之间如何通过互联互通激发创新，创造出超越公司边界的价值。每一项战略都是Optum与UnitedHealthcare高管跨越业务线和盈亏责任所共同推动的企业级协作，致力于持续提升企业价值，实现年复一年、季度接季度的绩效与财务目标。
So as the session unfolds, I hope you'll hear a few key themes pulling through. One, durability. We're a company whose model is built to perform, respond. And if I have a thing to say about it, relentlessly improve over time. What we're really talking about here is building a consistent, well-balanced growth on the strength of our core market positions. The 46 million Americans enrolled in UnitedHealthcare benefit plans, the 129 million consumers we serve through Optum. Our 200-plus payer relationships, 4 have every 5 in the marketplace and the more than 1.4 billion adjusted scripts we manage each year.
在接下来的环节中，我希望您能注意到几个核心主题。第一，韧性。我们的业务模型设计本身就是为了持续执行、灵活应变，更重要的是，不断改进。如果由我来定义，那就是要“永不止步的优化”。我们要在核心市场地位的基础上，实现稳定且均衡的长期增长。我们为4600万UnitedHealthcare会员提供福利服务，通过Optum服务1.29亿消费者，拥有200多个付款方合作关系，占据市场80%的覆盖率，同时每年管理超过14亿张调整后处方。
Next thing, innovation. Building and refining new capabilities on top of these market positions and strengthening the connectivity between each of them. You saw from Andrew how we're working to expand the number of people benefiting from value-based care, but we're going to show you how we're taking that model to a whole new level. For health benefits, you'll see how we're continuing to elevate our value proposition across our commercial businesses and government programs by further integrating our care delivery, technology, financial services, pharmacy and consumer capabilities and all that we do.
第二，创新。我们在已有市场基础上不断构建和优化新能力，同时加强各个业务模块之间的连接协同。刚才Andrew提到我们如何扩大受益于价值导向医疗服务的人群，而我们还将进一步展示如何将这一模式提升至全新高度。在健康福利方面，您将看到我们如何通过进一步整合医疗服务、科技、金融服务、药房以及消费者能力，全面提升我们在商业与政府计划中的价值主张。
How we're moving beyond the traditional PBM model to provide pharmacy services, coordinating care for those with the most complex needs and how we're continuing to commercialize health technology and health financial services to support other payers, care providers and consumers across the system. Finally, a laser focus on the consumer. Today, people are more informed and empowered than ever before, able to get most anything with the touch of a button, the American consumer is in the driver's seat. And it's not a leap to think about how those expectations are carried over to health care, better access to their own data. Simpler means of transiting a system, they once accepted as too complicated to do on their own.
我们正突破传统的药品福利管理（PBM）模式，提供更广泛的药房服务，为复杂病患协调治疗。同时，我们也在持续将健康科技与健康金融服务商业化，支持整个系统中的付款方、医疗服务提供者及消费者。最后，是对消费者的聚焦。如今，人们掌握的信息和自主权比以往任何时候都更强大，只需轻点按钮就能获取几乎一切服务，美国消费者已经成为真正的主导者。这种趋势自然也延伸至医疗领域——他们期待更便捷地获取自身健康数据，更轻松地导航原本复杂的医疗系统。
There is a recalibration of the expectations people have for health care. And today, you'll see how we're working to bring the system in line with those expectations. Now I promised Andrew and John, I'd stay away from the sports metaphors. So I'll take 1 from my days in the airline industry. Each growth opportunity is at a different level of maturity. Health benefits is the furthest in flight. Health financial services is just getting pushed back from the Jet Bridge, but they all have tremendous potential for future growth.
人们对医疗的期望正在重构。而今天，您将看到我们如何努力使整个体系与这些新期待对齐。我答应Andrew和John不再用体育比喻了，因此这次我用我从航空业学到的一个比方来说明：不同的增长机会正处于不同的发展阶段——健康福利业务已经进入“飞行状态”，而健康金融服务则刚刚从登机桥推离，即将启程。但它们都拥有巨大的未来增长潜力。
Okay. Throughout the day, I'll come back at the end of each section, and we'll hit on a few important numbers and themes together. So with that, I'd like to bring up Dr. Wyatt Decker to take you through our value-based care delivery strategy. Wyatt?
好的，在今天的议程中，我会在每一节结束时回到台上，和大家一起回顾关键数字和主题。现在，我很高兴邀请Wyatt Decker博士上台，为大家详细介绍我们的价值导向医疗服务战略。Wyatt，请。
Wyatt Decker Executive VP and Chief Physician of Value-Based Care & Innovation
Good morning. As a practicing emergency physician, I've seen the best and the worst of the health care system. In my 20 years at the Mayo Clinic, I witnessed life-saving interventions by some of the world's best medical teams and I've seen far too many instances or a small gap in care, something as simple as a missed prescription refill, led to a life-threatening condition that could have been easily avoided. That's why UnitedHealth Group's long-held ambition is very inspiring to me to provide high-quality, comprehensive care through a value-based system to millions more people.
早上好。作为一名从业的急诊医生，我亲眼见证了医疗体系中最优秀和最糟糕的一面。在梅奥诊所工作的20年中，我曾目睹世界顶尖医疗团队的救命干预，也看到太多因为医疗照护中的一个小漏洞——例如一次漏开的处方——演变成本可避免的致命状况。正因为如此，UnitedHealth Group长期以来的愿景令我深受鼓舞——通过价值导向体系，为更多人提供高质量、全面的医疗服务。
Connecting every part of a person's health, delivering better outcomes at lower costs. We started this journey well over a decade ago. Today, our physician-led network encompasses more than 2,200 sites of care across 44 states, serving more than 20 million people. As we look to serve even more people more comprehensively, we are further integrating and expanding our capabilities in many ways.
我们致力于将个人健康的各个方面相互连接，以更低成本实现更优治疗效果。我们在这一旅程上已经前行了十多年。如今，我们由医生主导的网络已覆盖全美44个州，拥有2200多个医疗服务点，服务超过2000万人。为了为更多人提供更全面的服务，我们正通过多种方式进一步整合并扩展我们的能力。
First, growing our clinics, reaching more people within the communities we already serve, while growing our presence in other regions. Second, continuing to bring other modalities of care, including virtual and behavioral health, we're integrating behavioral and medical benefits and care, delivering outpatient mental health services in 37 states and offering a growing set of virtual and digital capabilities to patients across the country. We're also expanding our ability to deliver high-quality care in \[ norm ], helping more people manage multiple chronic conditions, providing a broader spectrum of clinical services and supporting more people as they manage post-acute transitions. As they manage those transitions into skilled nursing facilities and we're helping them return home even sooner.
首先，我们在原有服务社区内扩展诊所覆盖，同时拓展其他地区的布局；其次，我们持续引入多种服务形式，包括虚拟医疗和行为健康服务。我们正在整合行为与医疗福利及服务，在37个州提供门诊心理健康服务，并向全国患者提供日益丰富的虚拟与数字化能力。我们也在拓展高质量慢性病照护能力，帮助更多患者管理多种慢病，提供更广泛的临床服务，并在急性治疗后期过渡阶段给予支持，例如协助他们进入专业护理机构并更快回到家中。
As we expand how and where we reach more patients, what sets us apart is the growing connectivity within our capabilities that deliver truly differentiated, comprehensive experiences. And while there are different models to align incentives, our experience shows us the most impactful our fully accountable arrangements. Today, our care teams are managing the complete health of more than 3.2 million individuals through these relationships. That's 1 million more people than last year and more than double the number of people just 3 years ago. And in 2023, we expect the total number of people we serve in these relationships to grow to 4 million. One of the most compelling reasons for this continued growth is the outcomes we deliver and the quality of care we provide. Primary care providers working in value-based clinics have more touch points with their patients and offer more coordinated care than fee-for-service.
随着服务方式与覆盖范围的不断扩展，我们真正的差异化在于内部能力的日益连接，从而提供全方位、一体化的医疗体验。尽管激励机制的设计可以有多种模式，但我们的经验表明，效果最显著的是“全面责任制”安排。如今，我们的护理团队通过这种模式全面管理320多万人的健康状况——比去年增加100万人，是三年前的两倍以上。预计到2023年底，这一数字将增至400万人。促使持续增长的最关键原因之一是我们带来的结果与服务质量。相比按服务计费（fee-for-service）模式，价值导向诊所中的初级保健医生与患者有更多互动，提供更协调的照护。
Care teams have more time to focus on addressing their patients complete health needs. Under our value-based care, patients complete annual wellness visits at a 24% higher rate than people in fee-for-service, allowing care teams to address issues earlier. These more frequent touch points and incentives around whole health, paired with advanced clinical technology show up in the quality of our clinical outcomes.
护理团队有更多时间专注于解决患者的全面健康需求。在我们的价值导向体系中，患者进行年度健康检查的完成率比按服务计费模式高出24%，这使护理团队能更早发现问题。这些更频繁的接触点，辅以针对“整体健康”的激励机制和先进的临床技术，最终体现在更高的临床质量上。
Let me give you 4 examples of how Optum's Medicare Advantage patients are experiencing better outcomes than people in MA plans receiving care from other providers. Our patients achieved hypertension control 14% and diabetes control 7% more often. Our patients also have comprehensive medication reviews 7% more often. And after hospital discharge, medication reconciliation occurs 39% more often, which is an incredibly important step in avoiding adverse drug reactions.
让我举4个例子说明Optum的Medicare Advantage（联邦医疗保险优势计划）患者比其他医疗服务提供者的MA患者获得更好结果：我们患者的高血压控制率高出14%，糖尿病控制率高出7%；进行全面药物审查的比例也高出7%；在出院后进行药物核对的比例高出39%——这对于避免药物不良反应极为关键。
Now I'm going to turn it over to Caitlin Zulla, who's going to talk about the opportunity we have to drive quality and affordability by optimizing the site of care.
现在，我将把时间交给Caitlin Zulla，她将为大家讲解我们如何通过优化照护地点来推动质量与可负担性的提升。
Caitlin Zulla;SCA Health;CEO
Thank you so much, Dr. Decker. The site of care has a powerful impact on both patient outcomes and costs. Our ambulatory surgery centers deliver better patient outcomes at half the cost of hospitals. And we know effective home-based medical care, can reduce hospital admissions, ER visits and time spent in skilled nursing facilities by 15% to 25%. The ability to guide patients to the right level of care in the right setting and at the right time and bringing together all the right pieces to offer a comprehensive experience that empowers both the care provider and the patient are critical elements to effective value-based care.
非常感谢你，Decker医生。照护地点对患者的治疗效果和医疗成本有着显著影响。我们的门诊手术中心提供的治疗效果更佳，成本却仅为医院的一半。同时，我们也清楚地知道，有效的居家医疗服务可以将住院、急诊就医和入住专业护理机构的时间减少15%至25%。能否在合适的时间、以正确的方式、在恰当的地点引导患者接受所需的照护，并整合各项资源，为患者与照护者共同提供全面体验，是实现高效价值导向医疗的关键所在。
For us, this usually starts with the primary care physician. Building our physician-led network over the past decade has been anything but a one-size-fits-all approach. But there is a common thread from large-scale local care delivery organizations to individual physician groups. They all share a desire to elevate patient care and deliver better outcomes in the communities they serve. And as we grow our ability to serve more Medicare Advantage patients more effectively, we're continuing to invest in capabilities to expand our value-based care opportunities in new and interesting ways, like exploring other types of strategic partnerships. Similar to the one we recently formed with Walmart and further accelerating the adoption of value-based care to the 170 million people who have coverage in the commercial market to serve far more people than we do today.
对我们来说，这一切通常始于初级保健医生。过去十年里，我们建立了由医生主导的照护网络，这绝不是千篇一律的模式。从大型本地照护机构到独立医生集团，有一个共同点始终贯穿其中：他们都希望提升患者照护水平，并在其所服务的社区中实现更优的医疗结果。随着我们为更多Medicare Advantage患者提供服务的能力不断增强，我们也在持续投资，探索扩大价值导向医疗的新方式，例如建立更多类型的战略合作伙伴关系，比如我们最近与Walmart达成的合作协议，并进一步推动这套体系在1.7亿商业保险覆盖人群中的普及，从而服务更多人群。
And that brings me to Kelsey-Seybold Clinic, who's been serving the Houston area for over 70 years from pediatrics to senior care, they deliver high-quality compassionate care in 35 locations, supported by nearly 700 care providers in more than 65 specialties. And they're 1 of only a few organizations in the country with deep experience serving Medicare Advantage and commercial patients through value-based arrangements. Joining me now is Dr. Tony Lin, CEO of Kelsey-Seybold. Tony thanks so much for joining us.
这让我想介绍Kelsey-Seybold诊所。该诊所已在休斯敦地区服务超过70年，覆盖从儿科到老年医疗的全生命周期照护，在35个地点提供高质量、有温度的医疗服务，拥有近700名医疗人员，涵盖65个以上的专业领域。他们也是全美少数几家在价值导向架构下，深度服务Medicare Advantage和商业医保患者的机构之一。现在请允许我邀请Kelsey-Seybold的首席执行官Tony Lin博士加入我们。Tony，非常感谢你的到来。
Tony Lin
Good morning, Caitlin. Thank you for allowing me to be here. I'm honored to be with all of you today to talk about our future with Optum.
早上好，Caitlin。感谢您邀请我来参加今天的会议。能够与大家一起探讨我们与Optum未来的合作，我深感荣幸。
Caitlin Zulla;SCA Health;CEO
Well, thank you for being here. It's amazing to see you I have so enjoyed going to Houston and getting to learn more about Kelsey-Seybold, I'm sure there's many here who don't know as much. Can you share a little bit about Kelsey?
非常感谢你亲临现场。见到你真的很高兴。我非常享受去休斯敦实地了解Kelsey-Seybold的过程。我想在场还有不少人对Kelsey不太了解，你能简单介绍一下吗？
Tony Lin
Of course Caitlin, value-based accountable care, it's the core to our mission at Kelsey. We introduced our first commercial risk plan in 2008. And 15 years later, we're now serving large and small employers, nonprofits as well as municipalities and school districts.
当然可以，Caitlin。价值导向的责任制医疗是Kelsey的核心使命。我们早在2008年就推出了首个商业风险型计划。15年后的今天，我们已经在为大型与小型雇主、非营利机构，以及市政单位和学区等多元客户提供服务。
Caitlin Zulla;SCA Health;CEO
So 15 years' experience in commercial risk. That is truly unheard of. Can you talk a little bit more about what your experience has been?
拥有15年商业风险型医疗的经验，确实非常罕见。你能分享一些这方面的具体经验吗？
Tony Lin
Yes, patients in our Kelsey care plan are thriving. And the outcomes are measurably better compared to the fee-for-service patients, starting at the very top, Kelsey care plan members comply with their preventive care plans at 13 percentage points higher than their counterparts. About 73% of our diabetic patients are compared to their counterparts at much higher percentages, 73% compared to 51% in better control.
当然。我们Kelsey照护计划下的患者整体状况非常良好，医疗结果也明显优于按服务计费的患者。首先，在遵循预防性医疗计划方面，Kelsey计划的成员比其他患者高出13个百分点。以糖尿病患者为例，血糖控制良好的比例为73%，而同期其他患者仅为51%。
It's actually a very similar story for hypertension. Blood pressures are in good control for 73% of those patients compared to a national average of around 49%. So all good.
高血压方面也类似，73%的Kelsey患者血压控制良好，而全国平均水平约为49%。整体情况非常不错。
Caitlin Zulla;SCA Health;CEO
Those clinical outcomes are incredible, and I know you care as much about cost. Can you talk a little bit about impact on total cost of care?
这些临床结果令人印象深刻，我知道你们也非常关注成本。你能谈谈你们对整体医疗成本的影响吗？
Tony Lin
Yes. We have seen great results on costs as well. Our care coordination on complex patients has allowed us to achieve about 15% to 20% lower total medical costs. And that includes 40% fewer bed days and 30% lower emergency utilization. As the quality goes up, the cost comes down. Caitlin, that's our textbook definition of what we've been all searching for in value-based care.
当然。在成本控制方面，我们也取得了非常好的成果。通过为复杂病患提供协调照护，我们将总医疗成本降低了约15%到20%。这其中包括住院天数减少了40%，急诊使用率降低了30%。当质量提升时，成本也在下降。Caitlin，这正是我们一直以来在价值导向医疗中所追求的“教科书式”成果。
Caitlin Zulla;SCA Health;CEO
I could not agree more. That truly is incredible. And one of the many reasons we're so excited to have you part of Optum. Can you talk a little bit about what joining Optum has meant for you in your Kelsey-Seybold team?
我完全赞同，真的是非常了不起的成就。这也是我们非常高兴你们能加入Optum的重要原因之一。你能谈谈加入Optum对你和Kelsey-Seybold团队意味着什么吗？
Tony Lin
Definitely. We know Optum is here for the long-term, helping us to continue to build on our strong foundation. Optum will help physician now to serve even more patients, more seniors and even our diverse communities in our regions. Being part of this organization, Caitlin, means that we could start tapping into the full scope of the UnitedHealth Group capabilities that we'll talk about this morning. Pharmacy services, advanced technologies, and Caitlin, I'm going to tell you that we -- I am especially excited to be able to share what we are learning in Houston, especially on the commercial part of the business.
当然可以。我们知道Optum是一个致力于长期发展的合作伙伴，它将帮助我们在已有坚实基础上继续成长。Optum将协助我们的医生服务更多患者、更多老年人，也更好地覆盖我们地区中多元化的群体。Caitlin，成为这个组织的一部分，意味着我们能够开始全面接入UnitedHealth Group的整体能力，这其中包括药房服务、先进技术等。我特别期待的是能够分享我们在休斯敦的经验，尤其是在商业医疗领域的实践成果。
Caitlin Zulla;SCA Health;CEO
Well, I know that we cannot wait to learn alongside you. Thank you so much, Tony. We really appreciate you. And with that, I will turn it over to Kristy Duffey to explain how we're expanding our in-home capabilities.
太棒了，我们也迫不及待地想与你们共同学习。非常感谢你，Tony。我们由衷感激你们的参与。接下来，我将时间交给Kristy Duffey，请她讲讲我们如何扩展居家服务能力。
Unknown Attendee
Thank you, Caitlin. And good morning, everyone. As a geriatric nurse practitioner in the ER and ICU, I learned quickly if basic needs aren't met, everything else becomes nearly impossible. I saw so many missed opportunities to prevent our most vulnerable patients from ending up in the hospital because they didn't have access to the care that they needed. So we are expanding the ways we reach people, caring for them and the comfort of their homes to address their medical, behavioral and their social needs, which is especially important for the growing number of Medicare \[ dual ] and chronic special needs patients who require a far more individualized approach to care considering the compounding challenges they face in their daily lives.
谢谢你，Caitlin。大家早上好。作为一名在急诊和重症监护室工作的老年科执业护士，我很快意识到，如果患者最基本的需求得不到满足，其他一切都将难以推进。我看到太多本可以避免的住院案例——我们最脆弱的患者因为无法获得所需照护而最终被送进医院。因此，我们正在拓展服务方式，在患者舒适的家中照护他们，满足他们的医疗、心理和社会需求。这一点对于日益增长的Medicare双重资格和慢性特殊需求患者尤为关键，他们日常面临多重挑战，必须依赖更个性化的照护方式。
On average, they're managing 9 different chronic conditions. Many are disabled. They lack transportation and they live in remote areas. They're trying to manage multiple medications and about 40% struggle with mental health issues. That's where our team steps in, thousands of dedicated Optum clinicians delivering value-based care in their home, bringing together physicians, nurse practitioners, social workers, pharmacists and other experts.
这些患者平均要应对9种慢性疾病，许多人存在残疾，缺乏交通工具，居住在偏远地区。他们还需要管理多种药物，并且约40%的患者面临心理健康问题。这正是我们团队介入的地方——成千上万名敬业的Optum临床人员将价值导向医疗服务带入患者家中，由医生、执业护士、社工、药剂师及其他专家组成协作团队。
We are bridging home and clinic and coordinating care for the most complex patients. If a patient doesn't have a primary care physician, we connect them with one. And we serve as an extension of that physician helping to coordinate care. Our clinicians and care teams, they get to know their patients, building relationships and earning their trust. Our home care model is centered around our patients' needs. As their health status changes, we adapt our visits and can spend over an hour with them depending on the complexity of their needs.
我们正在弥合家庭与诊所之间的照护差距，为最复杂的患者群体协调治疗。如果某位患者没有初级保健医生，我们会为他们联系，并作为该医生的延伸，协助其进行全程照护。我们的医护团队会真正了解患者，与他们建立关系、赢得信任。我们的居家照护模式完全以患者需求为中心，随着他们健康状况的变化，我们灵活调整服务频次，必要时可在家中陪伴超过一个小时，视其需求复杂程度而定。
We might see a patient several times a week, a few times a month or multiple times a year. And if a patient has an urgent need, we will see that patient the same day. With this level of support, our patients are highly engaged in their care. More than 90% have a primary care physician and are 8% more likely to visit their doctor each year than patients who are not in our program.
我们可能每周看望一位患者数次、每月几次，或每年多次。如果患者有紧急需求，我们当天就会安排访问。在这种支持力度下，患者在自身照护中积极参与。超过90%的患者拥有自己的初级保健医生，而且他们每年就诊的可能性比未参与我们计划的患者高出8%。
不产生重大影响的做法。
This is leading to better outcomes, including a 12% reduction in hospitalizations, high patient satisfaction with an NPS of nearly 80 and 99% of our patients are in a 4-star or higher plan. This is only possible because of our access to the broader capabilities of UnitedHealth Group. This past year, we doubled the number of people we serve with this approach to home-based care across both existing and new payer relationships. Dirk?
这直接带来了更好的结果，包括住院率降低12%，患者满意度极高，净推荐值（NPS）接近80，且我们99%的患者参与的保险计划评级为4星或更高。这一切都得益于我们接入了UnitedHealth Group更广泛的综合能力。过去一年，通过现有及新增付款方合作关系，我们采用这种居家照护模式所服务的人数实现了翻倍增长。Dirk？
Dirk McMahon Former President & COO
Expanding value-based care requires long-term planning and investments in both people and capabilities in each of our markets. For people, we've added 10,000 more physicians to our team this year. For capabilities, we're putting the right building blocks together and taking the traditional model to a whole new level, seamless coordination across all sites of care, integrated pharmacy and behavioral care, delivered increasingly in the home. In fact, you can expect at-home capabilities you just heard Kristy talk about, will generate a significant portion of our value-based care growth next year. So just a couple of numbers to punch this up. In 2022, we added 1 million new patients in these arrangements, 700,000 through organic growth and we hope to add another 750,000 through organic growth in 2023.
扩展价值导向医疗体系需要在各个市场进行长期规划和持续投入，不仅在人力资源方面，也包括能力建设。今年，我们新增了1万名医生加入团队。在能力方面，我们正在整合各项关键要素，将传统模式提升到全新层次，实现所有照护场所的无缝协同，以及将药房服务和行为健康服务整合后，日益多地在居家场景下交付。事实上，正如Kristy刚才所讲的居家服务能力，预计将为我们明年价值导向医疗增长贡献显著部分。举两个数据来说明：2022年，我们通过此类安排新增了100万名患者，其中70万来自自然增长；而我们希望在2023年再通过自然增长新增75万人。
And as we continue to expand the number of payers we support, there's still a ton of runway ahead. By 2025, 70 million seniors will be eligible for Medicare. Then think about what Dr. Lin and the team at Kelsey-Seybold, think about the 170 million people who have commercial insurance in America. We're not even scratching the surface in terms of what's possible.
随着我们支持的付款方数量不断扩大，未来还有巨大增长空间。到2025年，将有7000万老年人符合Medicare资格。再联想到Lin博士和Kelsey-Seybold团队的案例，再想到美国那1.7亿拥有商业保险的人群，我们目前所覆盖的范围仍只是冰山一角。
So with that, let's jump into our health benefit strategy with Brian Thompson.
接下来，我们来听听Brian Thompson分享我们的健康福利战略。
Brian Thompson Former CEO of UnitedHealthcare
The health benefits business continues to perform at a high level by delivering value to the diverse customers we serve. And as Andrew noted, we are preparing for an even more consumer-centric future, fueling innovations that better meet the needs of people, communities and employers who rely on this marketplace.
健康福利业务始终保持着高水平表现，为我们服务的多元客户群体持续创造价值。正如Andrew所说，我们正为一个更加以消费者为中心的未来做准备，推动创新，以更好地满足个人、社区和雇主对这一市场的依赖与期待。
In Medicare, we're leading the way, focused on addressing the broad health needs of seniors with more value-added benefits at low or no cost to them. In Medicaid, we continue to win and expand into new states with record growth over the past 18 months and an RFP win rate of over 90%. And in commercial, we're off to a strong start to 2023.
在Medicare方面，我们走在行业前列，聚焦老年人广泛的健康需求，提供低成本甚至零成本的增值服务。在Medicaid方面，过去18个月我们实现了创纪录的增长，持续赢得RFP投标并扩展至更多州，中标率超过90%。在商业保险领域，我们在2023年开局强劲。
Increasing innovation in our consumer offerings while preparing for a future where consumers have more choice in how they get and pay for health care. The diversity of our businesses, products and solutions position us well, well to succeed in the evolving marketplace, including in the near-term, the redeterminations process, and that will require many people to seek new coverage over the next couple of years, and we're ready. We've grown our exchange footprint significantly with plans now available to nearly half the U.S. population, and we have significant distribution capabilities.
我们不断在消费者产品与服务中推动创新，同时为一个未来——消费者在如何获取和支付医疗服务上拥有更多选择——做好准备。我们的业务、产品与解决方案高度多样化，这让我们有能力在不断演变的市场中立于不败之地。短期内，我们也正积极应对资格重审流程（redetermination process），该流程将在未来几年中推动大量人群重新寻求保险覆盖，我们已充分准备好应对。目前，我们在保险交易所的覆盖范围已大幅扩展，现可覆盖美国近一半人口，同时我们具备强大的分销能力。
So we can help individuals find the UnitedHealthcare plan that's right for them. We're confident our vision will enable us to serve even more people as we focus our work in 3 key areas: first, making care more affordable; the second is simplifying and personalizing the consumer experience; and third, providing quality care in the home virtually and the community. And all this work is powered by our ability to bring consumer-centric tech forward Optum-enabled solutions to the market.
因此，我们能够帮助个人找到最适合他们的UnitedHealthcare保险计划。我们有信心，我们的愿景将使我们能够服务更多人，当前我们的工作聚焦在三个关键领域：第一，使医疗照护更加负担得起；第二，简化并个性化消费者体验；第三，在家庭、虚拟平台和社区中提供高质量照护。所有这些工作，都是基于我们将以消费者为中心的技术与Optum解决方案推向市场的能力所实现的。
This year, you've seen us take some steps to lead the industry in novel directions. We're making it easier for customers and consumers to get the most out of their benefits and making it easier for providers to do business with us, from our move to provide access to insulin and other life-saving drugs at no cost to the member to meaningfully reducing prior authorization requirements.
今年，您已经看到我们迈出了一些引领行业的新步伐。我们正让客户和消费者更容易获得最大化的福利，同时让医疗服务提供者与我们开展业务变得更加便捷。例如，我们为成员免费提供胰岛素和其他救命药物，同时大幅减少事前授权的要求。
So providers can focus on delivering care. We're hungry for change and we are ready to lead. All right, let's get to it. I'd like to welcome Brandon Cuevas to explain how we're making care more affordable and driving growth across our benefits businesses.
这样医疗提供者就能更专注于提供照护。我们渴望变革，并已准备好引领方向。好的，接下来我们有请Brandon Cuevas为大家介绍我们如何使医疗照护更加负担得起，并推动整个福利业务的增长。
Brandon Cuevas CEO of California Health Plan
Thanks, Brian. Affordability remains the single biggest issue for consumers and customers. We've talked to you in the past about our efforts to bring down total cost of care, and we've made excellent progress improving our network competitiveness over the last few years, but it's more than that. We're investing to drive real value for our clients and our members. We're adding new tools and capabilities as well as innovative benefit and network designs like accountable care organization based health plans, self-funded solutions for small employers and consumer cost estimators.
谢谢你，Brian。医疗可负担性仍然是消费者和客户面临的最大问题。我们过去曾向大家介绍过我们在降低整体医疗成本方面所做的努力，过去几年我们在提升网络竞争力方面取得了显著进展，但这还远远不够。我们正进行持续投资，为客户和会员创造真正的价值。我们增加了新工具与新功能，推出了多种创新福利与网络设计，如基于责任照护组织（ACO）的健康计划、为小型雇主提供的自筹资解决方案，以及消费者费用估算工具等。
All of these innovations are designed to help people make more informed choices and save money. This is especially important in today's economic environment, where we are helping people maximize their health care benefits and get the most for their health care dollar. Brian mentioned our move to eliminate out-of-pocket cost for life-saving drugs and we are continuing to explore new ways to offer rewards and incentives that enable people to access care without paying out of their pocket. This type of first dollar coverage removes consumer costs while improving access to preventative and chronic care. Take our Surest product, which is unlike anything else in the industry. It provides first dollar coverage by eliminating deductibles.
所有这些创新，都是为了帮助人们做出更明智的选择并节省开支。在当前的经济环境下，这一点尤其重要——我们正在帮助人们最大化其医保福利，真正实现每一分钱的价值。Brian提到我们已取消救命药物的自付费用，我们还在持续探索更多方式，如通过奖励和激励机制，帮助人们无需自费也能获得医疗服务。这种“首美元保障”模式一方面消除了患者负担，另一方面也改善了对预防性和慢性病照护的可及性。以我们推出的Surest产品为例，它在业内独树一帜，通过取消免赔额来实现首美元保障。
Surest provides cost transparency for consumers, giving them clarity and certainty with a premium designated provider network, allowing us to eliminate high deductibles, coinsurance and other financial barriers to care leading to high satisfaction for members and reducing cost by up to 46% for members and up to fifth percent for employers and customers and their employees are taking notice.
Surest为消费者提供清晰的成本透明度，借助优质指定医疗网络，使他们拥有明确且确定的就医路径，从而免除高额免赔额、共同保险和其他财务障碍。这不仅带来了极高的会员满意度，还帮助会员节省高达46%的成本，雇主和客户最多也能节省50%。越来越多的雇主和员工正注意到这一点。
In 2021, about 1 in 25 of our national accounts offered Surest in 2023, 1 in 9 will offer it, making sure it's one of the fastest-growing commercial offerings. Now affordability is the first thing customers and members consider when picking a plan, but experience is essential. Qian Qian Tang will discuss how we are making care more personal and easier to use.
2021年，我们的全国客户中大约每25个才有1个提供Surest计划，而到了2023年，这一比例已升至每9个客户中就有1个提供，使其成为增长最快的商业保险产品之一。尽管医疗可负担性是客户和会员在选择计划时最优先考虑的因素，但用户体验也至关重要。接下来，请Qian Qian Tang为大家讲讲我们如何让医疗服务更加个性化、更易使用。
Unknown Executive
Thanks, Brandon. After cost, the next biggest pain point for our customers and consumers is how difficult it is to navigate the entire health care system, including benefits. Our job is to make it simpler. We're doing this through digital and personal solutions designed to anticipate people's needs and provide next best actions.
谢谢你，Brandon。继医疗成本之后，客户和消费者面临的最大痛点就是整个医疗系统（包括福利）难以理解和操作。我们的任务就是让它变得更简单。我们通过数字化与个性化的解决方案来实现这一点，旨在预判人们的需求，并提供“下一步最佳行动”建议。
Using a multichannel platform, chat digital text and call, we're engaging people at every step of the way. In Medicare, we are engaging seniors even before their benefits take effect, allowing them to start taking advantage of services like scheduling an appointment or earning an incentive. We're also simplifying their experience with innovative products like our integrated card powered by Optum Financial, consolidating separate member benefits and incentives into a single, easy-to-use card that can be used at tens of thousands of retail locations to buy groceries and OTC products.
我们利用多渠道平台——包括聊天、数字短信和电话沟通——在每一个环节与用户互动。在Medicare方面，我们在福利生效前就与老年人进行接触，使他们可以提前预约就诊、获取奖励等服务。我们还通过创新产品简化他们的体验，比如由Optum Financial提供支持的整合卡，将多个独立的会员福利和奖励合并为一张便捷易用的卡，用户可以在数万个零售点使用，购买食品杂货和非处方药品。
This integrated card was available to 180,000 people this year. In 2023, we're bringing it to more than 7 million people. This is a great example of how we can quickly test, scale and deliver innovation to market. Once members are signed up and have access to their benefits, they can use provider search and online scheduling to see the right doctor. User cost transparency tools to understand what they will pay and tap a digital wallet to cover the cost of the visit. For example, NPS scores for members who use our cost estimate tools were 20 points higher than those who haven't. We see a huge opportunity to help address fragmentation in the marketplace, addressing the point solutions Andrew referenced earlier, so we can simplify the consumer experience.
今年，这张整合卡已覆盖18万人。到2023年，我们将把它推广到超过700万人。这是我们如何快速测试、扩展并推向市场的创新典范。会员注册后，可以使用医生搜索与在线预约工具找到合适的医生，利用费用透明工具了解自己将要支付的金额，再通过数字钱包支付相关费用。例如，使用我们费用估算工具的会员，其净推荐值（NPS）比未使用者高出20分。我们认为，这是一个巨大的机会，有助于解决市场上的碎片化问题，也回应了Andrew此前提到的“点解决方案”现象，从而简化消费者的整体体验。
One way we're doing this is through our programs that advocate for our members. Our advocacy work started by helping members and care providers understand their next best actions. We then developed personalized service solutions for those with special or complex care needs. Our advocacy service solutions help members achieve better health. For example, our solutions led to a 42% increase in closing gaps in care, up to 15% lower ER visits and an over 10% increase in clinical program enrollment compared to customers who utilize our standard service offerings.
我们通过会员倡导项目来推进这一目标。这项工作起初是帮助会员和医疗服务提供者了解“下一步最佳行动”，随后我们为有特殊或复杂照护需求的人群开发了个性化服务方案。我们的倡导型服务方案能帮助会员获得更好的健康结果。例如，与使用标准服务的客户相比，我们的方案使护理缺口填补率提高了42%，急诊就诊率降低高达15%，临床项目的参与率也提升了超过10%。
And our advocacy service solutions also support the affordability work Brandon discussed. Leveraging data points and signals such as diagnosis codes and claims data, our advocates can help people navigate to higher-value options either before they seek care or in real time while they're in the doctor's office potentially saving hundreds or even thousands of dollars in out-of-pocket costs.
我们的倡导型服务也支持Brandon提到的成本控制目标。通过利用诊断编码和理赔数据等数据点与信号，我们的倡导人员可以在患者就医前，或在他们到达诊所时的实时过程中，引导他们选择更具性价比的医疗方案，帮助他们节省数百甚至数千美元的自付费用。
For employers, these programs mean better health outcomes and a more productive workforce as well as total cost of care savings of up to 4% each year. And we're able to provide a single integrated platform to manage the experience and health of their employees versus a portfolio of disconnected third-party point solutions. Through the combination of digitization and a human touch, we are anticipating people's needs, meeting them at the right time, right place and with the right experiences to guide them on their health care journey.
对雇主而言，这些项目意味着员工将拥有更好的健康结果和更高的工作效率，同时每年可节省高达4%的总体医疗成本。我们能够提供一个统一、整合的平台来管理员工的健康和体验，而非依赖多个彼此割裂的第三方点解决方案。通过数字化手段与人工服务相结合，我们能够预测人们的需求，在正确的时间、地点，以合适的方式陪伴他们踏上医疗旅程。
With that, Bobby Hunter will share how we are meeting customer needs in their homes and communities.
接下来请Bobby Hunter为大家介绍，我们如何在家庭与社区中满足客户的需求。
用别人的钱给自己看病，要简化流程是非常困难的。
Robert Hunter
Thanks, Qian Qian. Convenient access to health care, whether it's virtual, digital or physical, not only improves health but also helps ensure more equitable care for the people we serve. HealthEquity is built into everything we do and care in the home is no exception. House calls has been the centerpiece of our home care model for government programs for years.
谢谢你，倩倩。无论是虚拟、数字化，还是线下的实体服务，便捷获取医疗照护不仅能提升健康水平，也有助于我们为服务对象提供更加公平的照护。健康公平（Health Equity）已融入我们所做的一切，居家医疗服务亦不例外。上门问诊（HouseCalls）多年来一直是我们在政府医保项目中的居家照护核心模式。
We expect to complete 2.2 million house calls this year, bringing personalized care into the home to address both immediate and preventive medical care needs in addition to social needs, including access to healthy food, safe housing, transportation and medical appointments and more. We have been testing people for underdiagnosed conditions such as diabetes, prediabetes, hep C and colon cancer. And what we found is nearly 1 out of every 4 people we screened had a condition, they didn't realize they had and the hep C positivity rates for dual special needs members are nearly double the national average.
今年我们预计完成220万次上门问诊，将个性化照护带入患者家中，不仅满足他们的即时和预防性医疗需求，也覆盖了诸如获取健康食物、安全住房、交通与医疗预约等社会需求。我们还对人群进行筛查，检测一些常被忽视的疾病，比如糖尿病、糖尿病前期、丙型肝炎和结肠癌。结果显示，被筛查人群中，几乎每四人中就有一人患有自己未曾察觉的疾病，而双重特殊需求成员（D-SNP）的丙肝阳性率几乎是全美平均水平的两倍。
Based on the program's continued effectiveness, we are expanding house calls to deliver even more clinical services. For example, this year, we began providing flu vaccines and we are adding COVID-19 vaccines and boosters. Additionally, we are committed to identifying even more ways for house calls to make high-quality clinical care more convenient for our members further solidifying the home as a primary setting for clinical care. And while many of our visits represent an opportunity to provide routine care, it's not unusual that we find someone with a dire need. Let's take a look at Margaret's story.
鉴于项目持续展现出显著效果，我们正在拓展上门问诊服务，提供更多临床服务。例如今年我们开始提供流感疫苗，并计划加入COVID-19疫苗及加强针。此外，我们还在积极探索更多方式，让上门问诊成为会员获取高质量临床照护的便捷渠道，从而进一步巩固“家庭”作为临床照护首选场所的定位。虽然我们许多访问是为提供常规照护，但也时常遇到紧急情况。下面让我们一起看看Margaret的故事。
\[Presentation]
【播放展示片段】
Robert Hunter
Margaret's story is an incredible testament to how we are bringing clinical care right into the home to help manage it even avoid critical health issues. And while the HouseCalls program is key to addressing social determinants of health, we are also tackling disparities in the communities where our members live and work in other ways. This year, we expect to screen more than 5 million members for social needs, barriers to wellness and other risks that significantly impact health and quality of life with approximately 1 in 4 members wanting help.
Margaret的故事生动印证了我们如何将临床照护真正带入家庭，帮助人们管理甚至避免严重的健康问题。HouseCalls项目虽然是解决健康社会决定因素的关键举措之一，但我们还通过其他方式，在会员生活与工作所在社区着手，积极应对健康不平等问题。今年我们预计将为超过500万名会员进行筛查，识别其社会需求、健康障碍及其他影响健康与生活质量的重要风险，其中大约每四人中就有一人表示需要帮助。
In addition to member screenings, we are also partnering with federally qualified health centers and community-based organizations to address needs on a larger scale targeting our efforts at what matters most in each community. In Kansas City, we've increased behavioral health and dental care visits for expecting mothers, supporting improvement in full-term birth rates. And we've also increased postnatal care appointment attendance by 90%, helping moms and babies stay healthy and thrive.
除了会员筛查，我们还与联邦认证的健康中心（FQHC）及社区组织合作，在更大范围内解决问题，聚焦各地社区的关键需求。在堪萨斯城，我们提高了准妈妈们对行为健康和牙科服务的就诊率，从而支持足月分娩率的提升；我们还将产后护理预约出席率提升了90%，帮助母婴保持健康、蓬勃成长。
Given the success of these programs, we are doubling the number of federally qualified health centers implementing these interventions and bringing private sector employers to the table to help accelerate these efforts. For example, we are working with the University of Tennessee, local employers and community organizations to create a health hub where health coaches will provide support for weight loss, blood pressure control, medication adherence and more. The goal is to provide a holistic approach to improving health outcomes and do it at no cost for neighborhood residents. So from the doctor's office to the living room, we are bringing high quality care to people wherever and whenever they need it.
鉴于这些项目的成功，我们正在将实施这些干预措施的联邦认证健康中心数量翻倍，并引入私营企业参与，共同加速推动这些努力。例如，我们正在与田纳西大学、本地雇主和社区组织合作，建立一个健康枢纽，由健康教练提供体重管理、血压控制、用药依从性等方面的支持。我们的目标是以全面方式改善健康结果，而且对所在社区居民免费。无论是在诊所还是在客厅，我们都在将高质量照护带到人们身边，在他们最需要的时间和地点。
Sometimes, even before they know they do. Now let me turn it back to Dirk to wrap things up.
有时，我们甚至在他们意识到自己需要照护之前，就已为其做好准备。现在，我将时间交还给Dirk，做最后总结。
Dirk McMahon Former President & COO
So 2 things I want to put a button on. First, Medicaid. As Brian mentioned, we've seen a record growth rate in the last 18 months. We're expecting the public health emergency to end next year, but there's no chance we're going to get a whole bunch of people lose coverage regardless of where they get it. The other big one, Medicare Advantage, seniors love it.
我想特别强调两件事。第一，Medicaid。正如Brian所提到的，在过去18个月中，我们在Medicaid业务上实现了创纪录的增长。虽然我们预计公共卫生紧急状态将于明年结束，但无论人们通过什么途径获得医保，我们都不会让大量人群失去保障。第二个重点是Medicare Advantage——老年人非常喜欢它。
Today, nearly half of seniors are making the choice to join the program, more than double what it was in 2007. There is real tangible value in these offerings, value people experience every day. Seniors who choose Medicare Advantage save 40% on out-of-pocket cost. That's over \$2,000 a year on average, which is particularly meaningful when close to half of all Medicare Advantage seniors live on less than \$25,000 a year. And the program continues to deliver better outcomes than traditional Medicare, with members experiencing a 43% lower rate of avoidable hospitalizations for any condition. 23% fewer inpatient hospital stays for those clinically complex members, nearly 12% in combined savings for the government and seniors.
如今，几乎一半的老年人选择加入Medicare Advantage，这一比例是2007年的两倍多。这些计划带来了切实可感的价值，是人们每天都能体验到的好处。选择Medicare Advantage的老年人自付医疗费用平均可节省40%，也就是每年节省超过2,000美元——对那些年收入不足25,000美元的老人而言，这一数字尤其重要。此外，该项目相较传统Medicare还能带来更好的健康结果，其会员在可避免住院方面的发生率降低了43%，临床复杂患者的住院次数减少了23%，而政府与患者合计节省的成本接近12%。
So with that, I want to invite Dan Schumacher to talk tech. Dan, you're up.
接下来，我想邀请Dan Schumacher来分享技术相关的内容。Dan，请。
Dan Schumacher President
Thank you, Dirk. Every day, millions of people engage with the health system in millions of interactions. And every day, we are working to make those interactions simple, intuitive and connected. We're bringing together processes, people and information to eliminate moments of friction and frustration delivering actionable data to drive insights and create a more connected health system. With the right technology and the best people, we are getting information into the right hands, improving care quality, building trust and preventing mistakes. In our recent combination with Change Healthcare strongly positions Optum to continue to lead the industry in health care technology and services.
谢谢你，Dirk。每天，数百万人与医疗体系进行着数百万次互动。每天，我们都在努力让这些互动变得更加简单、直观、互联互通。我们正在整合流程、人员与信息，消除摩擦与障碍，传递可操作的数据，推动洞察的形成，建设一个更加紧密互联的医疗体系。借助正确的技术与优秀的人才，我们正将关键信息交到合适的人手中，从而提升医疗质量、建立信任、预防错误。我们最近与Change Healthcare的合并，使Optum在医疗科技与服务领域继续保持行业领先地位。
It means growth in our capabilities, growth in our customer base, and ultimately, growth in our impact, our impact in driving administrative efficiency and reducing friction across billing, claims, eligibility, to make these transactions seamless, accurate and automated.
这将带来能力的提升、客户群的扩大，最终实现影响力的增长——这种影响体现在提升行政效率、降低账单处理、理赔与资格验证等各环节的摩擦，使交易更加无缝、准确、自动化。
It's about our growing ability to make health care payments faster and more accurate. And it's about expanding our opportunities to give providers critical information at the point of care, so they can make better decisions and ultimately improve the health of patients. So now our team is here to share how we're deploying the most advanced technologies in health care to drive real improvements across administrative transactions, clinical support and payment processing.
我们正逐步具备更高效、更精准处理医疗支付的能力。同时，我们也在拓展向医生及时提供关键信息的能力，让他们在护理过程中作出更明智的决策，最终提升患者健康水平。现在，我们的团队将介绍我们如何在医疗领域部署最先进的技术，从行政事务、临床支持到支付流程，推动真正的系统改进。
Let's start with Neil de Cosenza. Neil?
首先，有请Neil de Cosenza。Neil？
Unknown Executive
Thanks, Dan. As we expand our efforts to make administrative task simpler and more efficient, we are making platforms truly interoperable. We're providing a multi-payer multi-provider experience, which is creating greater alignment and ultimately reducing rework. A new solution we developed enables faster payment of claims by ensuring these claims get submitted correctly, which, of course, is a big source of friction in the system.
谢谢你，Dan。随着我们不断推进简化行政任务、提升效率的努力，我们正在构建真正具备互操作性的技术平台。我们提供的是一种多付款方、多服务提供者的体验，这种模式能够带来更高的一致性，从根本上减少重复劳动。我们开发的一项新解决方案能够确保理赔申请在提交时就正确无误，从而加快理赔支付速度——而错误提交正是医疗系统中最大的摩擦点之一。
When we move payer payment rules into the providers' revenue cycle workflow, the volume of rework drastically declined. Our technology incorporates machine learning and offers recommendations to care providers right at the time they're completing the documentation required for billing. And this gives them the opportunity to correct these claims that would wind up stuck in the system and helps them get it right the first time.
当我们将付款方的支付规则嵌入到医疗服务提供方的收入周期工作流程中时，重复返工的情况大幅减少。我们的技术集成了机器学习功能，在医生填写账单所需文件的同时，系统就会给出建议，使他们有机会在第一时间修正可能被系统卡住的理赔申请，做到“一次就对”。
The results of this innovation are strong. We're tracking to a 25% improvement in accuracy, which is great as it saves time and reduces costs for providers. And when modeling these savings at scale we can impact the hundreds of billions of dollars, care providers and payers pay each year. And for consumers, like all of us, the value of eliminating one of the biggest pain points is enormous. And this is just 1 example of what we're doing to improve the administrative side of health care. And now Todd Walthall will share what we are doing to improve the patient experience through our revenue cycle management solutions. Todd?
这一创新带来了显著成果。我们测得理赔准确率提高了25%，这对于医疗服务提供方来说意味着节省大量时间和成本。当这种节省效应在全行业规模下进行建模时，将影响到每年支付数千亿美元的医疗服务商与付款方。而对像我们这样的消费者来说，消除医疗流程中最令人头疼的环节之一，其价值不言而喻。这只是我们在改善医疗行政管理方面的一个例子。接下来请Todd Walthall介绍我们如何通过收入周期管理方案提升患者体验。Todd？
Todd Walthall
Thanks, Neil. We rely on technology to maximize the power of our revenue cycle management tools. Today, across all customers, we manage over \$120 billion in annual billings and around 4,000 facilities, hospitals and health plans covering over 180 million members use our solutions today. One of our partners, Boulder Community Health in Colorado is using our solutions to reimagine how the revenue cycle can raise performance and they're seeing strong results, including double-digit improvement in cash collections as a percentage of revenue build as well as clinical documentation and coding which is key to ensuring appropriate reimbursements for services.
谢谢你，Neil。我们依靠技术充分释放收入周期管理工具的效力。目前，我们为客户管理的年账单总额超过1200亿美元，我们的解决方案已被大约4,000家机构、医院和健康保险计划采用，覆盖超过1.8亿名会员。我们的合作伙伴之一——科罗拉多州的博尔德社区医疗中心（Boulder Community Health）正使用我们的方案重新构想收入周期如何提升绩效，并取得了显著成果，例如现金收入占比提升了两位数，临床文件记录和编码质量也有大幅改善，这是确保服务获得合理报销的关键。
这是一个自产大量噪音的领域，软件有显而易见的价值。
These tools, technology and process improvements are also helping reduce employee burnout. Since forming our partnership last year, employee retention has improved significantly. In addition to our work with Boulder Community Health, we're also helping clients improve the patient experience within the revenue cycle. For example, when it comes to digital, consumers expect ease and simplicity. They also want their health care digital experiences to work the same way.
这些工具、技术和流程优化同样有助于缓解员工倦怠。自去年与我们合作以来，该机构的员工留存率显著提升。除了与Boulder Community Health的合作之外，我们还在帮助其他客户改善患者在收入周期中的体验。比如在数字化方面，消费者期待简单易用的一致体验，他们也希望医疗数字体验能像其他数字产品一样顺畅无阻。
Combining the revenue cycle capabilities of Optum and \[ Change ] Healthcare enables us to provide real-time digital cost estimates. So patients know what their financial obligation will be for a medical procedure. We can determine eligibility and automate the prior authorization process, so there's no delay. Patients can pay online or through an app. We even offer financial assistance tools.
通过整合Optum与Change Healthcare的收入周期能力，我们可以为患者提供实时数字费用估算，让他们在接受医疗服务前就清楚自己的经济负担。我们可以进行资格验证，并自动处理事前授权流程，避免任何延误。患者可以通过线上或App进行支付，我们甚至还提供经济援助工具。
All of this simplifies the patient's financial experience and offers them a peace of mind of knowing what to expect. Now I'm going to turn it over to my colleague, Dr. Dom King, who's going to show us how we are helping enable physicians to achieve better health outcomes.
这些努力共同简化了患者的财务体验，也让他们在就医过程中心中有数、安心无忧。现在，我将话筒交给我的同事Dom King博士，他将为大家介绍我们如何帮助医生实现更优的健康结果。
Dominic King
Thanks, Todd, and good morning. An important component of our value-based care is making sure that clinicians have access to the right technology and tools they need to deliver best practice care. As a doctor, I've experienced how technology can often frustrate us in trying to deliver great care. And as a technologist, leading research and development teams at organizations like DeepMind and Google, I understand how challenging it is to bring innovation into complex health care environments.
谢谢你，Todd，大家早上好。我们价值导向医疗的重要组成部分之一，是确保临床医生拥有合适的技术与工具，以便他们能够提供最佳实践的医疗服务。作为一名医生，我深知在临床工作中，技术常常让我们倍感挫败。而作为一位曾在DeepMind和Google领导研发团队的技术专家，我也了解将创新引入复杂医疗环境的挑战有多大。
At UnitedHealth Group, we have an unparalleled opportunity to successfully take cutting-edge technology from the lab right into the clinic and helping our patients. An area we're investing heavily in is clinical decision support. These tools are rigorously researched importantly built hand-in-hand with users and reliably updated as peer-reviewed evidence emerges. Dr. Casey Humanas and his colleagues are using Optum's clinical decision support system in Florida to help him deliver better care for patients with chronic conditions like diabetes and high blood pressure. Let's take a look.
在UnitedHealth Group，我们拥有独一无二的机会——能够将实验室中的尖端科技直接带入临床、造福患者。其中一个我们重点投资的领域是“临床决策支持系统（CDSS）”。这些工具经过严格研究，关键在于与用户共同开发，并且会随着同行评审新证据的出现持续更新。以佛罗里达的Casey Humanas医生及其团队为例，他们正使用Optum的临床决策支持系统来更好地照护患有糖尿病和高血压等慢性病的患者。我们来看一段短片。
\[Presentation]
【播放展示片段】
Dominic King
Today, 40% of Americans are managing multiple chronic conditions requiring challenging merging of guidance. As you heard from Dr. Jimenez, this is all about the complexity of health care with the goal of making it easier. Clinicians using the tools that you've just seen followed best practice guidance, 98% of the time compared to 72% without access to this support.
如今，40%的美国人正在应对多种慢性病，这需要将不同的治疗指南整合起来，非常复杂。正如Jimenez医生所说，这一切的核心就是简化复杂的医疗过程。使用刚才提到的工具后，医生遵循最佳实践指南的比率达到了98%，而未使用这些支持系统的医生仅为72%。
There was also a nearly 20% reduction in time spent arriving at those decisions, better decisions leading to better care and better experiences. As we look to the future, we're excited to begin incorporating trusted artificial intelligence insights into our clinical decision support tools, giving them more predictive capabilities and allowing clinicians to make the shift from detecting a problem to preventing it happening in the first place. Take for example, chronic kidney disease, which affects 1 in 7 adults in the U.S. We're building artificial intelligence models that can identify patients that require more proactive support, aiming to head off the need for intensive and costly future interventions, such as dialysis or a kidney transplant.
此外，医生在做出决策所需的时间也减少了近20%。更快的决策、更优的医疗照护和更好的患者体验三者相辅相成。展望未来，我们非常期待将可信的人工智能洞察集成进我们的临床决策支持系统，让它们具备更强的预测能力，从而让医生的角色从“发现问题”转向“预防问题”。以慢性肾病为例，这种病影响着每7位美国成年人中的1位。我们正在构建AI模型，识别出需要更积极干预的患者，从而避免未来必须进行代价高昂的治疗，如透析或肾脏移植。
This is just 1 focus of our applied research programs. Other areas we're exploring include how AI can help to identify those patients at greater risk of a hospital admission. Similar approaches are being taken to help clinicians complete administrative tasks faster and smarter. Doug?
这只是我们应用研究项目中的一个重点方向。我们还在探索其他领域，比如如何用AI识别住院风险较高的患者。类似的方法也被应用于帮助医生更快速、更智能地完成行政任务。Doug？
Dirk McMahon Former President & COO
Thanks, team. Getting things right the first time, that's what stuck with me. You heard the team discuss how we're really leaning into 3 key areas: expanding point-of-care insights aligned to evidence-based standards inside the physician workflow, making health care payments faster and more accurate, driving administrative efficiency and reducing friction, less rework, faster speed to payment, putting minutes back on the provider schedule. All signs of a health technology and data strategy that's durable and scalable, a strategy that enables high-quality care for everyone.
谢谢团队。“一次就做对”，这是让我印象最深的一点。刚才大家听到了，我们的重点聚焦在三个关键领域：一是扩展临床现场的洞察力，将其嵌入医生工作流程，并与循证标准对齐；二是让医疗支付更快速、更准确；三是推动行政效率提升、减少流程摩擦，降低返工，提高支付速度，为医疗提供者“挤”出宝贵时间。这些都是我们持久、可扩展的健康科技与数据战略的体现，一个能够为所有人提供高质量医疗服务的战略。
病能不能看好首先不是技术，而是付钱。
In the benefit of this work and Optum's enhanced capabilities will be exciting. This year, we'll execute 10 billion electronic transactions and with Change, will do more than 22 billion. Together, we will manage provider billings of more than 120 billion which is a 30% increase when Change is added. Altogether, faster speed, better accuracy, greater volume will ultimately drive more standardization and simplicity in the system. With that, I'd like to invite Kurt Adams to take you through our financial services strategy. Kurt?
我们在这个方向上的努力与Optum的能力提升，将带来令人兴奋的成果。今年，我们将执行100亿笔电子交易，而与Change合并后，将达到220亿笔。我们将共同管理超过1200亿美元的医疗机构账单，这比合并前增长了30%。更快的速度、更高的准确率、更大的交易量，最终将推动整个体系更高的标准化与简化。接下来，我想邀请Kurt Adams来介绍我们的金融服务战略。Kurt？
Kurt Adams;Optum Financial;CEO
Thanks, Dirk. Nearly 20 years ago, we formed a bank to offer a seamless solution to help people better manage their health care expenses. It turns out, we created a business that generates steady growth and provides health care financial services to more than 17 million people and 58,000 employers. We also saw another opportunity this time to streamline claims payments for care providers. They were growing increasingly frustrated not only by how long it took to get paid for their services, but the friction created by disparate platforms and workflow applications required to reconcile and settle these claims payments.
谢谢你，Dirk。大约二十年前，我们成立了一家银行，旨在为人们提供一体化解决方案，帮助他们更好地管理医疗支出。事实证明，我们不仅创造了一个持续增长的业务，也为超过1700万人和58,000家雇主提供了医疗金融服务。后来我们又发现了一个新机遇——帮助医疗服务提供方简化理赔支付流程。他们越来越不满：不仅等待付款时间太长，还要面对各个平台与系统之间难以衔接的工作流程所带来的摩擦。
These challenges ultimately inspired the development of a highly efficient and robust payment platform and network that today delivers payments digitally into the accounts of more than 2 million providers on behalf of more than 150 payers, security, accuracy and scale are cornerstones of our platform and vital to the day-to-day transaction flow of the entire health system.
这些挑战促使我们开发出一个高效且强大的支付平台与网络，如今它已可为超过150家付款方代表进行支付操作，将资金直接汇入200多万名医疗服务提供者的账户。安全性、准确性与可扩展性是这一平台的基石，也是维系整个医疗系统日常交易运转的关键。
The value of our network was made even more clear at the onset of the pandemic when clinics were closed, cash flows dried up and thousands of practices were worried they might never reopen again. Given the crisis, Congress authorized the distribution of billions and payments to care providers, but the agency didn't have the connected network or the platform to deliver the payments as fast as they were needed. So on Saturday morning in early April of 2020, we got a call. And within days, we began what would become \$150 billion of payments over 440,000 care providers, a large percentage of the health system, but well within our capabilities.
我们支付网络的价值，在疫情初期体现得尤为明显。那时，众多诊所关闭，现金流断裂，成千上万的医疗机构担心自己再也无法重新营业。面对危机，国会授权向医疗服务提供者发放数百亿美元的援助资金，但相关机构并不具备能迅速执行这一任务的互联网络和平台。于是，在2020年4月初的一个周六早上，我们接到了一个电话。几天之内，我们开始执行这项任务——向超过44万家医疗机构发放总额达1500亿美元的款项，占据整个医疗系统的很大一部分，但这完全在我们的能力范围之内。
This infrastructure 2 decades in the making serves as the foundation for our strategy in shaping and transforming the next 2 decades in health financial services. And while there are many payments companies with strong network capabilities and many health care companies with broad-reaching relationships throughout the system no one else brings both capability sets together to create value for consumers, payers and providers quite like we do. My colleague Takumi will now share with you some of the areas where we're driving innovation.
这套历经二十年打造的基础设施，也正是我们制定未来二十年医疗金融服务战略的根基。虽然市面上有不少支付公司具备强大的网络能力，也有很多医疗公司拥有广泛系统关系，但没有任何一家能够像我们这样将这两类能力整合起来，为消费者、付款方和服务提供者同时创造价值。接下来，我将请我的同事Takumi为大家介绍我们在推动创新的一些核心领域。
Unknown Executive
Thanks, Kurt. I lead innovation at Optum Financial. Prior to Optum, I was a part of successful initiatives at PayPal and Apple Pay, where I help build and scale solutions that reach millions of merchants and users because the solutions were intuitive and reliable. I learned the importance of building platforms that could integrate with networks at scale and build trust. The ability for a simple app like Venmo to connect to bank accounts and debit cards turn that solution into a verb, where 83 million people are now \[Venmoing] one another for everything from concert tickets to piano lessons, a trusted alternative to cash.
谢谢你，Kurt。我负责Optum Financial的创新业务。在加入Optum之前，我曾参与PayPal和Apple Pay的一些成功项目，帮助构建并扩展了直达数百万商户和用户的解决方案，这些方案之所以成功，是因为它们直观且值得信赖。我在过程中深刻理解到：构建能够大规模集成到网络的平台，并赢得用户信任，是多么关键。像Venmo这样一个简单App之所以能连接银行账户和借记卡，并演化为一个动词——如今已有8300万人通过Venmo支付音乐会门票或钢琴课学费，它成为了现金的可信替代品。
It's how a platform connected to over 40 global payment networks connected to thousands of card issuers facilitated the safe and secure provisioning of millions of cards on to millions of iPhones every day. I was drawn to Optum because of the same potential for impact and scale with a unique collection of assets and capabilities, a financial services business moving hundreds of billions of dollars between payers, providers and consumers. These building blocks are enabling us to bring scalable innovation to health care payments and to bring new solutions to market. One example is the card technology my colleagues talked about earlier today.
类似的，一个平台若能接入40多个全球支付网络、成千上万的发卡机构，就可以每天安全、可靠地将数百万张卡片加载到数百万台iPhone上。我之所以被Optum吸引，是因为它同样具备这种影响力与规模潜力。我们拥有独特的资产和能力组合，是一家每年在付款方、服务提供方与消费者之间流转数千亿美元的金融服务企业。这些“基础构件”使我们能够在医疗支付领域实现可扩展的创新，并将新解决方案推向市场。其中一个例子就是我们同事今天早些时候提到的卡片技术。
Not only are we creating a more convenient experience for seniors in Medicare Advantage and dual special needs plans, linking their health plan information, pharmacy benefits, rewards gym membership to a single ID card, our payments capabilities allow members to easily pay for items covered by their health benefits, like groceries, over-the-counter medications and even utility bills without using cash or worrying about saving a receipt to be reimbursed. We can identify qualified items at the SKU or product level and execute payment at the point of service.
我们不仅为Medicare Advantage及双重特殊需求计划（D-SNP）下的老年人创造了更便捷的体验，将健康保险信息、药房福利、奖励项目和健身房会员资格整合到一张ID卡上；同时，我们的支付能力也让会员能够轻松支付由健康保险覆盖的项目，如食品杂货、非处方药，甚至水电账单，完全无需使用现金或保留小票报销。我们能够在SKU或产品级别识别符合条件的商品，并在服务点完成支付。
The integration with our retail network and ability to adjudicate at single item level precision is what makes this possible. By early next year, this technology will be available to almost 12 million people across multiple health plans. Our retail acceptance network already includes 6 of the 10 largest grocers in America, including Walmart and Kroger as well as leading pharmacies like Walgreens and CVS. Convenience is key as 92% of Americans live no more than 5 miles from a participating store. And our retail network will only continue to grow. But more importantly, what we're uniquely able to do is to offer a service that connects with -- from within the health care system.
我们能实现这一切，关键在于我们与零售网络的深度整合，以及我们具备对每一件商品进行精确支付判断的能力。到明年初，这项技术将覆盖多个健康保险计划，服务近1200万人。目前，我们的零售网络已覆盖全美十大连锁超市中的六家，包括Walmart和Kroger，也包括像Walgreens和CVS这样的主要药房。便利性至关重要——92%的美国人住在距离参与商店不超过5英里的范围内。我们的零售网络还在持续扩展。但更重要的是，我们独有的能力，是提供一项来自医疗体系“内部”的连接服务。
What's different in our approach is not just connecting the consumer to the retailer, but connecting their health plan as well whomever the payer or plan might be. So the capability and potential impact extends well beyond the core transactional functionality of the retail network. It amplifies the utility.
我们的方式不同之处在于，我们不仅仅是将消费者与零售商连接起来，更是将他们的健康保险计划也纳入其中——无论付款方是谁、计划是哪种。这种能力及其潜在影响，远远超越了传统零售网络的交易功能，极大地放大了整体使用价值。
When we connect and integrate to the care providers in our ACH network that Kurt just talked about, we are similarly creating opportunities to amplify and play a deeper role in payments and financing to deliver on the promise of real-time payments in health care. Platforms that connect to networks to deliver better experiences and embedded financial services at scale. Back to you, Kurt.
当我们将这些能力与Kurt刚才提到的ACH（自动清算中心）网络中的医疗服务提供者进行连接与整合时，我们同样创造了加深支付与金融参与的新机会，从而真正实现医疗服务中的“实时支付”承诺。这些连接型平台让大规模嵌入式金融服务成为现实，并极大改善整体体验。Kurt，交回给你。
Kurt Adams; Optum Financial; CEO
Thanks, Takumi. We are working on a future where retail purchases and medical claims are processed instantly at the point of service, where payments happen with the same ease and convenience consumers have come to expect in so many other aspects of their daily lives. And with our growing consumer capabilities, enhances our scale and value of our payment networks, and provides an opportunity to improve consumer experiences throughout our combined efforts. This is hard work, no doubt. And while we are still early in our journey, the addressable market revenue opportunity is well north of \$100 billion across the health care industry. This type of opportunity isn't available to everyone. We are unique because of our payment platform, network capabilities and the broad relationships we have embedded within the health care industry.
谢谢你，Takumi。我们正在努力打造一个未来，在这个未来中，无论是零售购物还是医疗理赔，都能在服务现场实现即时处理，支付体验也将像人们在日常生活中所习惯的那样便捷与顺畅。随着我们消费者服务能力的提升，我们的支付网络规模和价值也在不断扩大，这为提升消费者整体体验带来了更大机会。这当然是一项艰巨的任务。虽然我们仍处于旅程的早期阶段，但整个医疗行业中可触达的市场营收机会已远超千亿美元。并非每家公司都能抓住这样的机会。我们的独特之处在于，我们拥有支付平台、网络能力，以及深嵌于医疗行业中的广泛关系网络。
We have just the right mix of expertise, innovation and ambition to deliver the next generation of solutions that are easy to use and take out the unnecessary friction that exists in the market today. Thank you.
我们拥有正确的组合——专业知识、创新能力和远大抱负，能够交付新一代解决方案，使其易于使用，并消除当今市场中不必要的摩擦。谢谢大家。
Dirk McMahon; Former President & COO
Thanks, Kurt. Like I mentioned at the top, our financial service capabilities still in the early stages. With the kind of innovation that Kurt and Takumi are talking about is so elemental to our DNA, building products and services for the people we serve that go on to transform the industry. Those seeds we planned in nearly 20 years ago, blossomed into a significant and growing consumer accounts business, the largest provider payment network, 2 million plus and growing and a nationwide retail network that includes 6 of Americas 10 largest grocers and much of the transaction's infrastructure for the health system.
谢谢你，Kurt。正如我在一开始所说，我们的金融服务能力仍处于初期阶段。但Kurt和Takumi所谈到的这些创新，早已深植于我们的基因中——我们为所服务的人群打造产品和服务，并最终推动整个行业的转型。二十年前我们播下的种子，现已成长为一个重要且持续扩张的消费者账户业务、一个拥有超过200万医疗提供者的最大支付网络，以及一个涵盖全美十大超市中六家的全国性零售网络，也构成了整个医疗交易系统的关键基础设施。
Now our story wouldn't be complete without a look at our pharmacy services business. I want to ask Heather Cianfrocco to come up and take us home.
现在，让我们聚焦我们的药房服务业务，否则今天的故事将不完整。我邀请Heather Cianfrocco上台，为我们做最后总结。
Heather Cianfrocco; EVP of Governance, Compliance & Information Security
1 million each day. That's how many people we reach through our pharmacy offerings, helping people manage multiple medications and chronic diseases, helping people access and afford the drugs they need and giving them every assurance they're not on their own and navigating the complexities of the health system.
每天100万人。这是我们通过药房服务所触达的人数。我们帮助人们管理多种药物和慢性疾病，帮助他们获取和承担得起所需药物，并让他们知道，在面对复杂的医疗体系时，他们并不孤单。
We have more than 12,000 clinicians, pharmacists and pharmacy technicians connecting the dots with health care and advocating to make it easier for people to access the medical, pharmacy and behavioral health therapies that they need. We're driving affordability and transparency for our clients, always guiding them towards the lowest net cost approach while remaining grounded in our strong clinical foundation.
我们拥有超过12,000名临床医生、药剂师和药房技术人员，他们与医疗服务紧密协作，努力为人们争取更便捷的获取方式，让大家更容易获得所需的医疗、药品和心理健康治疗。我们坚持为客户推动可负担性和透明度，在坚实的临床基础上，始终引导他们选择净成本最低的方式。
We're taking a holistic approach to managing specialty drugs and complex cases, and we're providing solutions that reduce drug costs for uninsured patients. We're simplifying access to care through direct-to-consumer digital solutions, home delivery, infusion services and integrated pharmacies and community mental health centers, all while providing full service, personalized pharmacy care and multichannel digital engagement. Let's start with the ongoing evolution of our pharmacy benefits capabilities, our PBM. And the more than 61 million people it serves. And I'd like Tricia Purdy to share more about how we're expanding on this foundation and going so much further.
我们以整体视角来管理特殊药品和复杂病例，并为无保险患者提供降低药品费用的解决方案。我们通过直面消费者的数字化方案、送药上门、注射服务、整合药房及社区心理健康中心等方式简化照护获取流程，同时提供全方位、个性化的药房服务和多渠道数字互动。接下来让我们从我们的药房福利管理（PBM）能力说起——目前已为6100多万人提供服务。现在请Tricia Purdy为我们介绍我们如何在这一基础上持续扩展、迈向更远。
Unknown Executive
Our differentiated PBM has long been the engine, powering our consistent durable growth, enabling us to innovate and scale to reduce pharmacy costs whether consumers receive their benefits from UnitedHealthcare or they are the 50% of people we serve who don't. We are building on our cost-based drug pricing model, an alternative to traditional pricing by creating configurability for our clients, allowing even more transparency in how we deliver value and savings to our clients.
我们差异化的药房福利管理（PBM）长期以来一直是推动我们持续、稳定增长的核心引擎，使我们能够不断创新与扩展，从而降低药品成本——无论消费者是否通过UnitedHealthcare获取福利，还是属于我们服务对象中那50%的非UnitedHealthcare人群。我们正在基于“成本定价药品模式”持续推进，这是对传统定价机制的替代方案，具备可配置性，让客户更清晰了解我们如何为他们创造价值并带来节省。
Our suite of tools gives both people and their doctors real-time information, including if the drug is covered and how best to receive the lowest price. This kind of innovation is leading to client retention of over 98% and material growth. This year, we expect to process more than 1.4 billion adjusted scripts up 5% year-over-year.
我们的一整套工具可以为患者和医生提供实时信息，包括药品是否被覆盖以及如何以最低价格获取。这种创新促使客户保留率超过98%，并带来了实质性增长。今年我们预计将处理超过14亿份调整后的处方，同比增长5%。
As we continue serving more clients and more patients, we are focused on the future where care services cap capabilities are increasingly integrated with pharmacy, medical and behavioral health as you've heard throughout the morning, enabling us to care for the whole person. Today, we'd like to highlight 2 examples of where we are bringing this to life. Our community pharmacies and our rare disease pharmacy. Tasha Hennessy is a pharmacist and she's the Chief Operating Officer for our community pharmacies, and she is joining us live from Dallas today. Good morning, Tasha, -- great to see you.
随着我们服务的客户与患者数量不断增长，我们更加聚焦未来的发展方向——正如今天上午你们多次听到的那样，照护服务的核心能力将日益整合药房、医疗和心理健康，从而实现对人的“整体照护”。今天我们想重点分享两个实践案例：社区药房和罕见病药房。Tasha Hennessy 是一名药剂师，同时也是我们社区药房业务的首席运营官。她今天从达拉斯现场直播加入我们。早上好，Tasha，很高兴见到你。
Unknown Executive
Thanks, Trish, and good morning as well.
谢谢你，Trish，大家早上好。
Unknown Executive
Nice to be with you. I would love to jump right in. Speaking of our community pharmacy model, one of the key attributes is the clinical value and how we deliver care. Could you spend just a couple of minutes talking about that and maybe a window into some of the results you and the team are achieving.
很高兴你能加入我们。我想我们就直接切入正题。谈到我们的社区药房模式，其中一个关键特点是它所带来的临床价值以及我们交付照护的方式。你能否简单谈一下这个模式的特点，并介绍一些你和你的团队取得的成果？
Unknown Executive
Yes, absolutely. So our team takes a really hands-on approach. The connection between our pharmacy and clinical care teams is key. Our community pharmacies serve as a critical bridge helping care providers deliver more complete care and better outcomes, including a 90% adherence rate for medications compared to that of about 50% in the U.S. broadly. And speaking as a pharmacist, that's a total game changer, especially for people with really challenging situations, who need a lot of extra support. Because this model has been so successful, we've expanded the number of community pharmacies by 50% in the last 4 years, including more than 400,000 new patients this year alone, helping to deliver an increase of 2.5 million more prescriptions than we filled in 2021.
当然可以。我们团队采取的是高度参与、亲自介入的方式。我们药房与临床照护团队之间的紧密协作至关重要。社区药房是关键桥梁，帮助医疗提供方实现更全面的照护与更优的治疗效果。例如，我们的药物依从率高达90%，而全美平均水平仅约50%。作为一名药剂师，我可以说，这是一个改变行业格局的成果，尤其对那些处于困难境地、需要大量额外支持的患者而言至关重要。由于该模式取得了显著成功，我们在过去四年中已将社区药房数量扩大了50%，仅今年新增患者就超过40万人，开药量比2021年多出了250万份。
As a result of this growth, we've identified other areas where we can expand the model to people who need a higher level of support for specific conditions. So compelling. And one of those conditions is HIV. And maybe Tasha, if you could spend a little bit of time just describing how we're evolving the model, tailoring the model to meet the needs of this unique population.
随着这一模式的发展，我们也发现了可以将其扩展至更多特定高需求人群的领域。这一前景令人振奋。其中一个重点疾病就是HIV。Tasha，或许你可以简单介绍一下，我们是如何根据这类独特人群的需求来优化和定制我们的社区药房模式的？
Unknown Executive
Yes, Tricia, I'd love to. So there are more than 1 million people living with HIV in the U.S. today. As you know, there's been huge advances in treatment over the years. A person diagnosed with this disease can really enjoy a long and healthy life if they get the right treatment and, of course, adhere to that treatment plan. But about 1/3 of people living with HIV struggle with their medication regimen. And not following treatment plans leads to increased morbidity, mortality and risk for HIV transmission.
是的，Tricia，我很乐意分享。目前，美国有超过100万人生活在HIV感染状态中。正如你所知，多年来在HIV治疗方面取得了巨大进展。如果患者接受了正确治疗，并且坚持治疗方案，就有机会享有长期且健康的生活。但问题在于，大约三分之一的HIV患者在遵守用药方案方面存在困难。一旦不遵循治疗计划，就会导致更高的发病率和死亡率，也会增加HIV传播的风险。
Our pharmacists who are clinically trained in providing HIV pharmacy care really take the time to get to know each patient and their unique treatment plan to provide counseling on those complex medications, help work through side effects they may be experiencing, partnering with their doctors to adjust treatment plans and overall supporting their medication management and this is all to help people with HIV stay on their medication. And most importantly, stay healthy. So that 90% adherence rate I mentioned earlier, we're achieving that same result for patients with HIV.
我们的药剂师接受过HIV药事照护的专业临床培训，他们会花时间真正了解每位患者及其独特的治疗方案，为患者提供复杂药物的用药指导，协助他们缓解不良反应，与医生合作调整治疗方案，全面支持患者的用药管理。所有这些努力，都是为了帮助HIV患者坚持服药，并最重要的是——保持健康。我们在HIV人群中也实现了90%的用药依从率，这与我们在其他领域的表现相当。
Unknown Executive
It's so helpful to hear how you're guiding to specific populations. Also would love to click down into the human side, which you were -- you're starting to talk about Tasha. What are some of the ways in which you and your team are supporting each individual?
很高兴听到你们如何为特定人群提供指导。我也想深入了解你刚刚提到的“人文层面”，Tasha，你能否具体谈谈你和你的团队是如何支持每一位患者的？
Unknown Executive
Yes, this is a great call out. The human aspect of our model is so important. The culturally competent care is an essential part of building trust in health care, especially for our patients. It means ensuring our pharmacists know how important it is to put a premium on privacy, provide free discrete delivery and make sure we have personal hygiene kits, food and water on hand to help patients who are also struggling with Life's basic needs.
这是个非常重要的关注点。我们这一模式中的“人文因素”至关重要。提供具有文化敏感性的照护，是建立医疗信任的核心组成部分，尤其对我们的患者而言。这意味着我们的药剂师要充分认识到隐私的重要性，提供免费且私密的送药服务，并确保我们随时备有个人卫生包、食物和饮用水，以帮助那些连基本生活都面临困难的患者。
Unknown Executive
Tasha, thank you so much for being here this morning. Thanks for all you do and your team do to have a big impact. Clearly, we are seeing positive results from this model and so much promise. It's all part of a broader community pharmacy expansion strategy. You may recall last year, we opened our 600th pharmacy, and we will finish this year with our 700th pharmacy, some of which are co-located with OptumCare delivery organizations. So you've heard directly from Tasha how our community pharmacies are delivering outstanding care to our patients. Now [Aaron Satellite] will share how our new rare disease pharmacy is helping patients, their families, their providers and payers navigate the world of multimillion dollar therapies.
Tasha，非常感谢你今天的分享，也感谢你和你的团队所做的一切，对患者生活产生了巨大影响。很明显，我们已经从这一模式中看到了积极成效和广阔前景。这一切都是我们更大规模社区药房扩张战略的一部分。你或许记得，我们在去年开设了第600家药房，到今年年底，我们将迎来第700家，其中部分门店与OptumCare照护机构共享同一地点。刚才你们直接听到了Tasha的分享，了解了我们如何通过社区药房为患者提供卓越照护。现在，请[Aaron Satellite]来介绍我们的“罕见病药房”如何帮助患者、其家属、医生与付款方应对高达数百万美元的治疗挑战。
Unknown Executive
Thank you, Tricia. In 2021, about half of all new drug approvals had orphan designation. Next year, the rare disease and orphan drug market in the United States will surpass $100 billion. Only one part of the more than $400 million in total direct medical cost to the system attributed to rare disease. While these dynamic therapies are transforming patients' lives, they come with a high price tag and with a number of challenges that the health care system isn't prepared for. Patients and providers not only need a reliable resource to secure medication. They also need our expertise because most providers will see a rare disease only a few times at most in their entire career. Drug procurement, logistics, dosing selection, insurance navigation, drug administration, lifestyle changes and overall medication management are only a handful of examples where rare diseases challenge the system.
谢谢你，Tricia。2021年，所有新获批药物中约有一半获得了孤儿药（orphan drug）指定。明年，美国的罕见病与孤儿药市场将突破1000亿美元。而整个医疗体系中，罕见病所导致的直接医疗成本已超过4000亿美元。这些突破性的疗法正在改变患者的生活，但它们的价格极高，也带来了许多当前医疗体系尚未准备好的挑战。患者与医生不仅需要可靠的药品获取渠道，更需要我们的专业知识——因为大多数医生在其职业生涯中仅会遇到几次罕见病病例。药物采购、物流、剂量选择、保险协调、药物管理、生活方式调整等，仅是罕见病对体系挑战的一小部分。
Many of these patients see multiple doctors over years before they get a diagnosis. And once someone with a rare disease finally has a prescription, they need help with the lifestyle changes that sometimes come with a new medicine so that it works optimally. That is why we built our rare disease pharmacy, which specializes in providing access to therapy, education and support for the whole person.
许多罕见病患者在确诊前会辗转于多个医生之间，历时多年。一旦最终确诊获得处方，他们还常常需要在生活方式上做出调整，以确保药物能够发挥最佳疗效。这正是我们创立“罕见病药房”的初衷——专注于为患者提供全方位的治疗获取、教育辅导与身心支持。
After we opened our doors in 2021, we quickly started winning with pharma, securing access to manage ultra-limited distribution drugs and support the patients who take them. And in 2022, we doubled our win rate, including several exclusive agreements, a testament to the trust pharma manufacturers have in our service and our clinical expertise. We provide value to patients, providers, payers and pharma to support these complex conditions. But what's important about this is that we are creating the foundation for our overall specialty model with expert holistic support. That's why the pharma is coming to us.
自2021年成立以来，我们迅速赢得了制药企业的信任，获得了高度限制分销药物的管理权限，并为使用这些药物的患者提供支持。到了2022年，我们的合作成功率翻倍，签下了数个独家协议，这证明了药企对我们服务与临床专业能力的认可。我们正在为患者、医疗提供者、付款方与药企在这些复杂病症上创造真正的价值。而更重要的是，我们正以专业化、整体化的支持体系，为整个“专科药品业务模式”打下坚实基础。这也是为何药企主动找上门来。
Key to our success has been going deep in each therapeutic area, including extensive research, training and engagement with patient advocacy organizations. This is how we create custom models that give patients one-on-one support on a first name basis, supported by technology platforms with condition-specific data collection and reporting. A focus on a differentiated clinical model with the pharmacist life care team is central to our strategy across our specialty businesses. And this is really important because sometimes the medication alone is not enough.
我们成功的关键之一，是在每个治疗领域都深耕细作，开展深入研究、培训并与患者倡导组织紧密合作。正因如此，我们得以打造出高度定制的照护模型，让患者获得一对一、直呼其名的支持，并由具备疾病特异性数据收集与报告功能的技术平台加以支撑。我们的战略重心是一种差异化的临床照护模型，以药剂师主导的生命照护团队为核心——因为在很多情况下，仅靠药物远远不够。
Let's look at how our distinctive care model made all the difference for the Jamieson family. Two of Marcy Jameson's children Quinn and Rye have a rare condition that affects a person's ability to digest certain sugars. Jameson are among those living with 7,000 classified rare diseases. They saw doctors they even had a prescription, but the children weren't improving. -- until Optum took over support for their drug and our expert pharmacists TAM, help them understand for the first time that in order for the drug to work well, they also needed to make changes to what they eat. Here is their story.
让我们看看我们独特的照护模式如何彻底改变了Jamieson一家的生活。Marcy Jameson的两个孩子——Quinn与Rye——患有一种罕见病，这种病会影响人体消化某些糖类的能力。Jameson一家是罕见病患者中——全球已分类的7000种疾病之一的代表。他们曾看过许多医生，也拿到了处方，但孩子的病情始终未见改善——直到Optum接手了药物支持，我们的专家药剂师TAM首次帮助他们明白，要让药物真正发挥作用，孩子们的饮食结构也必须随之调整。以下是他们的故事。
[Presentation]
【播放故事展示片段】
Dirk McMahon – Former President & COO
There are a lot of families like the Jamieson who need our health and one-on-one support our pharmacists provide. Erin talked about how we more than doubled the win rates of rare disease drugs in 2022. Next year, we expect to secure even more. And remember, the average rare disease drug is 3 to 4x the cost of other specialty drugs and 25x the cost of traditional drugs, which means growth in this area brings an outsized impact. Pharmacy services like these are the clear future of the pharmacy business. A future we expect will grow substantially over the next several years. In fact, our non-PBM revenue now accounts for about half of our overall pharmacy revenue and will continue to grow. And you should also expect significant growth in our core PBM business with a 98% retention rate. We're deepening relationships with consumers.
像Jamieson一家这样的家庭还有很多，他们需要我们的健康照护服务，也需要我们药剂师所提供的一对一支持。Erin提到，在2022年，我们罕见病药物合作项目的中标率提高了一倍以上。明年，我们预期会获得更多机会。别忘了，平均而言，一款罕见病药物的费用是其他专科药物的3到4倍，是传统药物的25倍，这也意味着该领域的增长带来了成倍放大的影响力。像这些药房服务，正代表着药房业务的未来——一个我们预计将在未来几年大幅增长的未来。事实上，我们PBM以外的业务收入已占药房总收入的约一半，并仍在持续增长。而我们的核心PBM业务也将保持强劲增长，目前客户保留率高达98%。我们与消费者的关系正在不断加深。
We're growing our annual adjusted scripts, adding another $50 million in 2023. Okay. But before I pass it on to John Rex, I hope what came through during these sessions is our dual focus, our relentless drive for operational excellence and our long-term vision for what health care can be for people. And now -- and how, we are doing it on behalf of everyone in the health system.
我们每年的调整处方总量也在持续增长，2023年将新增5000万张。好，在我将时间交给John Rex之前，我希望你们在这次会议中能够清楚看到我们的“双重聚焦”：一方面是我们对卓越运营的不懈追求，另一方面是我们对未来医疗体系愿景的长期承诺——一个为所有人带来真实价值的医疗体系。而我们，正是在整个医疗系统的名义下推动这一转型。
Now I'll hand the stage over to John. John?
现在，我把舞台交给John。John？
John Rex – President & CFO
Good morning, and let me add my thanks to you for joining us today. We know it's a considerable time commitment, and we're grateful you chose to make it. Along with that gratitude, I have to offer an apology at the outset here, a preemptive apology, let's call it, in the event these comments make you feel like you're back in your high school science class. That's because I want to talk about physics for a moment.
大家早上好，我也想对大家的到来表示感谢。我们知道你们投入了大量宝贵时间，感谢你们的参与。在表达感谢的同时，我得提前道个歉——或者说是“预先致歉”，因为我接下来的发言可能会让你们有种仿佛回到了高中物理课堂的感觉。因为我想先谈一谈“物理学”。
In particular, 2 basic concepts, velocity and systems. Speed, if I recall correctly, is the rate at which something covers a distance, literally how fast the thing is moving. Velocity, however, is both the rate of change and the direction of change, the velocity with which a baseball travels from a pitcher's hand to the catcher's mitt, for example. It's an important distinction, and you'll see where I'm going with this in a moment.
特别是两个基础概念：速度（speed）和“速率+方向”（velocity）。如果我没记错的话，速度指的是某物在一段时间内移动的距离，也就是“移动有多快”。而velocity不仅指移动的速度，还包含“方向”。就像棒球从投手手中投出，到达接手手套的过程，就是velocity。这个区分非常重要，待会儿你们就会明白我想表达什么。
The body can be fast but not go anywhere. So speed alone doesn't say nearly enough to put it in terms more relevant to today, simply stating health care is changing rapidly doesn't tell us much at all about where we are or where we're going.
一个系统可以很“快”，但可能根本没有向前推进。因此，仅仅强调速度并不足以说明问题。换句话说，“医疗体系正在迅速变化”这句话并不能告诉我们，我们现在身处何处，也无法说明我们究竟要去哪里。
Contrast that to velocity, which is pace with direction. That's what we think is important, not simply how fast we are changing but in what direction of travel we are seeking to shape those changes. We believe there's increasing velocity of opportunity for UnitedHealth Group to create greater value. And this velocity is accelerating towards systems and, importantly, a certain kind of system.
而如果我们换一个角度来看——velocity，是“带方向的速度”。这才是我们认为真正重要的：不仅要看变化的速度，更要看变化的方向。我们认为，UnitedHealth Group创造更大价值的“velocity”正在加速，而且这种加速正指向一个核心概念——系统，确切地说，是某种特定的系统。
To explain, back we go to high school physics. Isolated systems, you'll recall, are collections of objects that do not exchange matter or energy with their surroundings, but only among the objects. To some extent, that's how health care often functions. Point solutions engaging singly with other dedicated point solutions. And it's not that they don't accomplish anything at all. It's more that there's a limit to the ultimate benefit for people and the broader health care system effects.
我们再回到高中物理。你们或许记得，“孤立系统”是指这样一种系统：它的组成部分只在系统内部相互作用，不与外部交换能量或物质。在某种程度上，这其实也是当前医疗体系运作的方式：一个个“点式解决方案”，彼此孤立地运作，有时仅与其他“点”交互。这并不是说这些解决方案没有成效，而是它们对人群与整个医疗体系的终极影响存在结构性的局限。
In contrast, what we're aiming for is a connected system where matter and energy are exchanged among the pieces and with the more encompassing external environment. This is how we believe better outcomes and experiences can result both within and from UnitedHealth Group. It is the clearest path to creating more value for our many partners and customers and the health care system as a whole.
与之相对，我们的目标是构建一个“互联的系统”，其中各组成部分之间以及与更广阔的外部环境之间可以交换“物质和能量”。我们相信，正是这种连接性，能在UnitedHealth Group内部以及外部实现更好的结果与体验。这是为我们众多合作伙伴、客户以及整个医疗体系创造更多价值的最清晰路径。
We set out intentionally with speed in this direction, primarily from a foundation of employer-sponsored benefits. We built upon this foundation, extending and expanding our health benefit capabilities to serve people in Medicare and Medicaid and then connecting the 2 to serve those with dual special needs. Then we brought out our services, pharmacy, for example, and technology and management systems. And we added care delivery, starting first with primary care practices.
我们有意识地、迅速地朝这个方向前进，最初是从“雇主赞助的健康福利”打下的基础出发。在这个基础上，我们扩展了健康福利服务的覆盖人群，拓展至Medicare和Medicaid群体，并进一步连接两者，服务于“双重特殊需求人群”。随后我们引入了其他服务能力，例如药房、技术平台与管理系统，并逐步将照护服务纳入其中，从初级医疗开始，拓展照护交付能力。
As we gained experience in each area, we found we could go both deeper within each capability and broader to the adjacent ones. Building systems, which became increasingly more connected, no longer isolated points in nature but helping those within our company and more broadly. Our intention has never been to be the most successful vendor of single-point solutions. The goal has always been to build strong connections across those capabilities because that delivers the better outcomes, experiences and quality of a high-performing health system.
随着我们在每个领域的积累不断加深，我们发现自己不仅能在每项能力中走得更深，也能扩展至相邻领域，实现横向协同。于是，我们所构建的系统逐渐走向高度互联，已不再是一个个孤立的“点”，而是互通互助，既服务于公司内部，也惠及更广泛的生态体系。我们的初衷从来不是要成为最成功的“点式方案供应商”，而是致力于在各项能力之间建立强有力的连接，因为正是这种连接，才能带来优异的医疗成果、更佳的体验与高质量的系统表现。
It takes substantial time and substantial capital to assemble some of these capabilities. In some respects, that's the easy part. Only when the pieces are assembled does the hard work begin, building the system characteristics and the system effects, the connections that make all this work. A prime example, comprehensive value-based care provided by Optum Health, working with over 100 health plan partners, including UnitedHealthcare, the overall system benefits from the health outcome improvements discussed earlier here.
组建这些能力模块本身需要大量时间与资金投入。在某种意义上，这还只是“相对容易”的部分。真正困难的是：当所有模块组合在一起之后，我们才开始做更艰巨的工作——打造“系统属性”与“系统效应”，也就是通过“连接”让整个系统真正运转起来。一个典型案例是Optum Health所提供的“综合价值导向医疗”，它与100多家健康保险计划合作伙伴（包括UnitedHealthcare）共同协作，使整个系统受益于我们之前所提到的健康结果改善。
Consider our advances in bringing care to people at home. We started with in-home preventive care assessments for Medicare Advantage patients. We served about 250,000 people that first year. Today, our nurse practitioners engage in an expanding range of highly effective clinical activity such as vaccines and disease screening. In 2022, about 5 million people will benefit from these capabilities.
再以“家庭照护”为例，我们的进展同样显著。最初我们为Medicare Advantage患者提供上门的预防性健康评估，第一年服务约25万人。如今，我们的执业护士已参与开展种类更多、效果显著的临床服务，如疫苗接种、疾病筛查等。在2022年，已有约500万人受益于这一体系。
Importantly, what's also different today is that this once isolated point capability complements other capabilities across our organization. And what's also different today is that we can use the expertise and capabilities we have developed in home services to see how else we build greater value for people. Compared to a decade ago, when we look at partnering with an organization like home health care company, LHC, there are many more points across our company to which they can connect.
尤其重要的是，这项原本“点状”的能力，如今已能与我们组织内的其他能力形成协同互补。而且，我们也能够利用在居家服务中积累的专业知识和实践经验，探索如何为人们带来更大的价值。与十年前相比，当我们今天与像LHC这样的居家护理公司开展合作时，它们能接入的公司节点更多、联系更紧密，合作空间更广。
As such, we can expand the impact we can create for patients and for payer customers. Today, when we look at potential strategic partners, it's through a much wider lens than just 5 or 10 years ago. We look for not just one but multiple sets of connection points that solve problems, smooth out experiences and drive better outcomes. It's part of why we are highly energized about both our near and our long-term prospects. It's the connected system concept come to life, the sharing of energy and value, increasing the velocity of opportunity toward achieving the mission of UnitedHealth Group.
正因如此，我们现在可以为患者与付款方客户带来更广泛的影响。当我们评估潜在战略合作伙伴时，视角已远非五年前、十年前那样局限。我们现在寻找的是能够形成多个连接点、解决多个问题、优化体验、提升结果的协作机会。这正是我们对公司中短期与长期前景充满信心的重要原因。一个真正“互联”的系统正在实现：能量与价值得以共享，机会的velocity不断加速，推动我们实现UnitedHealth Group的使命。
All right. That's probably enough about science. Let's head over to math class and see how this translates into the numbers.
好了，关于“科学”的部分我们就讲到这里。现在让我们一起“走进数学课堂”，看看这些理念如何转化为实际的数字成果。
I'll start with a brief recap of 2022. As we updated with our third quarter earnings report 6 weeks ago, we expect '22 adjusted earnings per share to be in the $21.85 to $22.05 range. The growth comes from across the enterprise with particular strength from Optum Health by serving more people in value-based care arrangements and from UnitedHealthcare by adding more people to its benefit offerings. There's a lot to point to from this year. But we also know it's the end of November, and what you really want to hear about is '23. So that's where I'll turn.
我先简要回顾一下2022年。截至6周前我们发布的第三季度财报，我们预计2022年全年调整后每股收益将在21.85至22.05美元之间。本年度的增长来自整个集团，尤其是Optum Health在价值导向医疗（value-based care）方面服务了更多人群，以及UnitedHealthcare通过扩展福利覆盖人群所带来的增长。今年的亮点很多，但我们也知道现在已经是11月底，大家最想听的，其实是2023年的展望。下面我就说说这部分。
Our initial '23 adjusted earnings per share outlook is $24.40 to $24.90, again, with balanced growth from across the enterprise. We expect total revenues to approach $360 billion with double-digit growth at both Optum and UnitedHealthcare. This growth is driven primarily by serving more people and by serving them more comprehensively.
我们对2023年最初的调整后每股收益预期为24.40至24.90美元，依然反映了整个集团各业务板块的均衡增长。我们预计全年总营收将接近3600亿美元，其中Optum与UnitedHealthcare都将实现双位数的增长。这一增长主要得益于我们服务了更多的人群，而且服务也更加全面深入。
Turning to the specific businesses. UnitedHealthcare revenues will approach $276 billion, growth of $27 billion or 11% over 2022. This is driven by ongoing strength from our Medicare Advantage offerings and innovative commercial products, partially offset by the potential that Medicaid members may be affected by eligibility redeterminations.
具体来看，UnitedHealthcare的营收预计将接近2760亿美元，较2022年增长270亿美元，增幅为11%。这主要来自Medicare Advantage产品的持续强劲增长和创新型商业产品的推进，部分被Medicaid成员因资格重审而可能流失的因素所抵消。
Our Medicaid team is highly engaged in detailed planning for the potential resumption with a strong focus on assisting our members and others who may be impacted. The growth outlook presented today incorporates a view that redeterminations will begin in the first half of the year. We will be working with our state partners and community organizations to ensure that people have continuous access to benefits.
我们的Medicaid团队已积极投入到相关规划中，特别关注那些可能受到影响的成员，并为此做了细致准备。今天所呈现的增长预期已将资格重审可能在上半年启动的情形纳入考量。我们将与各州合作伙伴及社区组织紧密合作，确保人们能持续获得医疗福利保障。
And by the time redetermination activities are completed, we expect that between helping people reinstate existing coverage and offering them other options, including commercial and exchange based, we will serve even more people across coverages than we do today. The proportion of people in the United States with health benefits is at the strongest levels we've ever seen. We should not move backwards now.
等资格重审程序全部完成后，我们预期在帮助人们恢复现有保障的同时，也将为他们提供其他方案，包括商业保险和医保交易所产品，从而使我们的整体覆盖人群比当前更多。如今，美国拥有健康福利的人口比例达到了历史最高水平，我们不能也不应出现倒退。
For our Medicare Advantage offerings, the open enrollment season now underway leads us to expect an eighth consecutive year of above-market growth. We do this by listening to seniors, maintaining benefit stability and introducing product innovations, delivering real value to both customers and taxpayers. As a result, in '23, we will serve more people in high-quality, 4- and 5-star plans than any other company. You heard earlier about our new and innovative commercial products gain traction among employer customers and their employees.
对于我们的Medicare Advantage业务，目前正处于开放注册季，我们预计这将带来连续第八年的超越市场平均水平的增长。我们之所以能实现这一点，是因为我们倾听老年群体的需求、保持福利稳定性、推出创新产品，从而为客户和纳税人都带来了切实价值。因此，到2023年，我们在高质量的4星和5星计划中所服务的人数将超过任何其他公司。正如你们之前听到的，我们面向企业客户及员工的新型创新型商业产品，也正在迅速获得市场认可。
Our aim is to continue to develop new approaches that meet their ever-evolving needs. You should expect to see this lead to increasing growth rates in this important market over the next several years. We're highly energized about the prospects for Optum, both in '23 and well beyond. Optum's capabilities and connected system orientation make it an invaluable innovator, one that's uniquely positioned at the center of the health system.
我们的目标是不断开发新的解决方案，以满足客户持续变化的需求。你们将看到这一策略在未来几年推动这一重要市场实现更快的增长。我们对Optum在2023年以及更长远的前景充满信心。Optum的能力组合与其系统互联的战略方向，使其成为医疗体系中不可替代的创新者，处于行业核心的独特位置。
That's why Optum's revenues will grow upwards of 17% next year. This growth will come from all segments. Optum Health revenues will approach $92 billion, an increase of about $20 billion or 29% driven by continued growth in the number of patients served under value-based care arrangements.
这就是为什么Optum在明年将实现超过17%的收入增长。此次增长将来自所有业务板块。其中，Optum Health的收入预计将接近920亿美元，同比增长约200亿美元，增幅达29%，主要推动力是价值导向医疗（value-based care）服务人群的持续扩张。
You heard the Optum team describe the 4 million value-based patients we expect to serve in '23, an increase of more than 2 million over the past 3 years. It's a start, but still early stage when we consider the potential. For example, when we look at just the regions where OptumCare delivers care today, we currently serve only about 10% of the seniors in those areas with value-based offerings. And that's just seniors. We're also laying the foundations from which we will serve people in commercial and Medicaid plans.
你们刚才听到Optum团队提到，我们预计在2023年将服务400万名参与价值导向医疗的患者，这一数字比三年前增长了超过200万。这只是一个起点，若考虑到整体潜力，这仍处于早期阶段。举例而言，仅在OptumCare当前提供服务的地区，我们的价值导向医疗产品目前只覆盖了大约10%的老年人口——而这还只是老年群体。我们也正在为商业医保和Medicaid人群服务奠定基础。
Revenue per Optum Health consumer served is expected to grow by more than 25%, driven by the increasing number of people under value-based care arrangements. This growth, though, is also due to the advancing levels of care we offer. For example, in '22, our ambulatory surgical centers [ perform ] 3 times as many complex procedures such as orthopedic and cardiac than just 3 years ago. Moreover, our patients have high-quality clinical outcomes and strong experiences reflected in NPS scores, which consistently run at 90% or higher. Importantly, this is provided at a 50% savings for the health system compared to traditional settings, delivering critical value in a world of scarce health resources.
Optum Health的每位客户带来的收入预计将增长超过25%，这既是由于接受价值导向医疗服务人群数量的上升，也得益于我们提供的照护水平持续提升。比如，2022年，我们的日间手术中心完成的复杂手术（如骨科和心脏类）数量是三年前的3倍。此外，我们患者的临床效果优异，体验良好，净推荐值（NPS）持续维持在90%以上。更重要的是，与传统场所相比，我们的服务为医疗系统节省了50%的成本，在资源稀缺的时代，这种价值至关重要。
OptumInsight revenues will grow 30%. The revenue backlog will approach $33 billion in '23, growth of $4 billion. The OptumInsight team is sharply focused on the opportunity with Change Healthcare to improve system performance and experiences for patients and providers. With the combination having been completed only recently, the '23 earnings outlook accommodates a view that we will accelerate integration activities and investments so we can more quickly expand upon these capabilities, especially in the first half of the year.
OptumInsight的收入将增长30%，其在手订单预计在2023年将达到330亿美元，较前一年增长40亿美元。OptumInsight团队正专注于与Change Healthcare的协同效应，通过整合改善系统效率以及提升患者和医疗服务提供者的体验。由于此次合并刚刚完成，2023年的业绩展望已纳入我们将加快整合进程和相关投资的假设，特别是在上半年，以便更快发挥新能力。
Optum Rx continues to evolve its business to extend clinical value beyond medications. These newer services build upon the strong foundation of the PBM whose purpose is to deliver more value for the people we serve. The breadth and value of these offerings lead us to expect Optum Rx revenues for '23 of $106 billion, organic growth of about $6 billion and with multiple pathways to continue this growth for years to come.
Optum Rx正在持续拓展其服务边界，将临床价值延伸至药物以外的领域。这些新兴服务建立在我们PBM（药房福利管理）业务坚实的基础之上，PBM的使命就是为所服务人群创造更多价值。正是由于其服务的广度与深度，我们预计Optum Rx在2023年将实现1060亿美元的收入，实现60亿美元的自然增长，并具备多年持续增长的多种路径。
These growing businesses support and are supported by substantial financial capacity and a strong balance sheet. Cash flow from operations in '23 will approach $28 billion or 1.2x net income.
这些增长中的业务不仅受益于我们强劲的财务能力与资产负债表，同时也为集团提供反哺与支撑。2023年，我们的经营现金流预计将接近280亿美元，约为净利润的1.2倍。
Returning capital to you, our shareholders, remains an enduring commitment. In '22, we will return $13 billion through dividends and share repurchases, about a 25% increase over last year. We will continue to grow the amount of capital we return in '23 and beyond.
持续回馈股东资本始终是我们不变的承诺。2022年，我们将通过分红和股票回购向股东返还130亿美元，较去年增长约25%。在2023年及未来，我们还将继续扩大资本回馈规模。
And even with this level of activity, our growth capital capacities remain strong. For example, in '22, we will deploy over $20 billion in growth capital. Our commitment to building long-term value through strategic combinations into the future. Further accelerating system velocity remains steadfast as well.
即使在如此高强度的资本回馈活动下，我们的增长资本实力依然强劲。例如，2022年我们将投入超过200亿美元用于增长型资本配置。这体现了我们通过战略整合持续打造长期价值的承诺。同时，我们也将继续坚定不移地加速系统“velocity”的提升。
One of the areas from physics I did not touch on earlier was the idea of limits, the idea that there are various technical or physical law imposed limits on what can be done. As it pertains to advanced physics, I'm not the guy to ask. But as it pertains to UnitedHealth Group, given the markets and the people we serve and the expanding nature of their needs, we are a long way from such theoretical limits.
我之前在讲物理的时候，有一个领域没谈到——那就是“极限”的概念，即各种技术或自然法则所设定的边界。关于高等物理学的极限，我不是专家；但就UnitedHealth Group而言，考虑到我们所服务的市场、人群及其需求的不断扩展，我们距离所谓的“理论极限”还有很长的距离。
From where we sit, we see substantial opportunities to bring even more value to more people and organizations across the health care system far into the distance and to continue delivering growth at our 13% to 16% long-term rate as we do so. And you have the commitment from all 60 of us gathered with you today and our 380,000 colleagues to deliver that growth to you and to deliver ever-increasing value to the people we are privileged to serve every day.
从我们的角度来看，我们看到的是面向未来的巨大机会——为更多人群与组织带来更大价值，并继续实现13%至16%的长期增长目标。我们在场的60位高管，以及我们38万名同事，都承诺将持续为股东实现这一增长，也不断为我们有幸服务的每一个人提供日益提升的价值。
Thank you very much. And now we're going to take a minute to set up the stage for our Q&A session.
非常感谢大家。现在我们稍作准备，马上开始问答环节。
Andrew Witty – Non-Independent Director
Well, hello again, and thank you so much for your attention so far this morning. I'm delighted that we're going to start the Q&A now. So thank you for listening, and we look forward to your engagement. Let me ask my team to come up here and join me on the stage real quick, and we'll get the Q&A underway -- straightaway.
大家好，欢迎再次加入，非常感谢你们整个上午的关注。我很高兴我们现在正式进入问答环节。感谢你们的聆听，我们非常期待与各位的交流。现在请我的同事们上台，我们马上开始答问。
We have folks in the room with mics and paddles. So if you do have a question, just raise your hand. One of the team will come to you, and we'll try and get around just as many as we possibly can. In the center, there's Zack. I think I'll see you first.
现场有同事举着麦克风与指示牌，如果你有问题，请举手，我们的团队成员会把麦克风递给你。我们会尽可能多地回答大家的问题。中间那位是Zack，我想你是第一个吧。
Zachary Sopcak – Senior VP of Capital Markets Communications & Investor Relations
We're going to start off with Justin Lake from Wolfe Research.
我们首先请Wolfe Research的Justin Lake提问。
Justin Lake – Wolfe Research
My question is on the financial services opportunity. Post the acquisition of Change, certainly seems like one of the more significant opportunities down the road. Can you flesh that out for us in terms of what are 1, 2, 3 of the bigger opportunities you see in the near term over the next 3 to 5 years to drive growth in that segment?
Justin Lake – Wolfe Research
我想问一下金融服务业务的机会。在收购Change之后，这无疑成为未来最具潜力的增长领域之一。你们能否具体说明在接下来3到5年内，这一板块有哪些最具增长潜力的1至3个主要机会？
Andrew Witty – Non-Independent Director
Yes, it's great. So I'll ask John Rex to make a couple of comments and then Kurt Adams, who I think -- can we get a mic to Kurt in the audience. You heard from him already. I'd like him to comment on this as well. John, why don't you kick off? And then Kurt.
Andrew Witty – 非独立董事
这个问题非常好。我先请John Rex来谈几点，然后再请Kurt Adams补充——请把麦克风递给Kurt，你们早前也听过他的发言。我希望他也对此发表意见。John，你先来？
John Rex – President & CFO
And maybe pitch it up. First and foremost, the opportunity to remove friction from the system. So much of the friction in the system today exists in the -- between the patient and the provider and that relationship. So much of that friction results from something to do with a payment or a collection. And so how do we bring those capabilities together to make that seamless, perhaps even instantaneous? So take out that piece where the friction results.
John Rex – 总裁兼首席财务官
我可以从系统“减摩”这个角度来谈。当前系统中很多阻力都发生在患者与医疗服务提供者之间，这些摩擦大多源于支付或结算环节。那么我们如何整合相关能力，让这些过程变得无缝，甚至做到“即刻完成”？核心目标就是把这些摩擦消除。
The other opportunity that we see also in this, so there's an enormous opportunity there. You heard opportunities described about the consumer experience that we've developed and are rolling out quite broadly this year in terms of integrated card capabilities. And then our ability to help providers, to help providers expand their practices, make better decisions, quicker decisions and much more efficiently and economically than they're able today.
另一个非常重大的机会，是我们能改进消费者体验。你们之前也听到我们提到了“集成卡”功能，这项能力今年正快速推进并广泛落地。同时，我们也能通过这些工具支持医疗提供者，帮助他们扩大业务、更快地做出决策、以更高效和经济的方式运作。
Kurt Adams – CEO, Optum Financial
Yes. Thank you. And just to add to that, as we were talking about earlier on the stage, platforms connected to networks to deliver experiences. Really, as we think about the platform capabilities now between Optum and Change Healthcare, they're massive. It brings us to a true multi-payer capability that allows us to connect to our retail and provider care networks to deliver payments more efficiently, more effectively and drive a lot more value for both providers and consumers in that value chain and for us to really be able to build experiences on top of all this infrastructure that's been established over the course of the past 20 years or so.
Kurt Adams – Optum Financial首席执行官
是的，谢谢你。我来补充一下，正如我们之前在台上讲到的，平台通过连接网络来交付用户体验。而从Optum和Change Healthcare合并之后所形成的平台能力来看，规模是巨大的。它让我们真正具备了多付款方（multi-payer）对接能力，可以连接到我们的零售网络和医疗提供网络，从而更高效、更有价值地完成支付流程，为整个价值链中的医疗提供者和消费者创造更多价值，也让我们能在这过去20年所建立的基础设施上持续构建出丰富的用户体验。
And finally, the amount of paper in the system that Change brings. We are talking a lot of paper that is still in the system that we have the opportunity to digitize and make a far more efficient process for all -- for both payers and providers in the system.
最后一点是Change Healthcare仍带来了系统中大量的“纸质流程”。现在体系内还有很多依赖纸张的环节，而我们有机会将其数字化，从而让整个支付流程对付款方和服务提供者来说都变得更加高效。
Andrew Witty – Non-Independent Director
Great. Thanks, Kurt. And Justin, I really appreciate the question. And I think if you just boil it into 2 segments, there's a huge provider set of opportunities in terms of taking friction out, taking paper out, waste, speeding things up, accelerating payments to providers, helping their cash flow situation, that kind of thing. That's, I'd say, kind of super imminent, super close, slightly longer term, but not much. Really project forward what a true consumer health care marketplace could look like.
Andrew Witty – 非独立董事
太好了，谢谢你，Kurt。Justin，也非常感谢你提出这个问题。我认为如果把它分成两个层面来概括，会更清晰。一方面，是医疗服务提供者端的巨大机会，比如消除系统摩擦、减少纸质流程、降低浪费、加快流程速度、让服务商更快收到付款、改善他们的现金流状况等——这是非常迫近的、眼前就能实现的机会。另一方面，稍微长远一点（但其实也不远），我们可以设想一个真正以消费者为中心的医疗健康市场的未来形态。
So as Optum starts to build a multi-payer marketplace environment, a lot of the work we'll be doing this year is laying the ground for that, having a sophisticated financial service capability able to run through the back of that, recognizing that $1 and $5 spent in the U.S. is spent in health care, super important opportunity for us in terms of the consumer agenda as well. So those 2 areas, I'd say, Justin, and you heard some of the detail beneath that.
因此，随着Optum开始构建一个“多付款方”的市场环境，我们今年会花大量时间来夯实基础，打造一个能够承载这一体系的成熟金融服务能力。毕竟，美国每五美元的消费中就有一美元用于医疗，这是我们布局消费者战略的重要机会。所以Justin，我会说，以上这两个方向就是重点，你也听到了背后的一些细节。
Okay. Next one, yes, please, in the center there. Julie?
好的，下一位，就中间那边。Julie？
Julie Murphy – Vice President of Investor Relations
Yes. We have A.J. Rice from Crédit Suisse.
Julie Murphy – 投资者关系副总裁
是的，我们现在请Crédit Suisse的A.J. Rice提问。
Albert Rice – Crédit Suisse AG
Maybe to just flesh out a little more of the commercial value-based care opportunity. I know Kelsey is a big part of that. But over time, how will that start to contribute? And does that model look differently than the risk model that you have with MA and how that's developed?
Albert Rice – 瑞士信贷
我想进一步了解一下商业医保领域的价值导向医疗机会。我知道Kelsey在这方面发挥了重要作用，但从长期看，这块业务将如何贡献？它的运行模式和你们在Medicare Advantage里的风险模型相比，有哪些不同？
Andrew Witty – Non-Independent Director
A.J., thanks so much. I'm going to ask Brian Thompson to comment in a second. As I mentioned, you heard 2 or 3 times from the stage today, we definitely feel that the skills and the rails we've been developing, particularly in the senior market, has applicability across much broader segments of the marketplace. Clearly, as you think about a clinic in the real world, of course, they see seniors. They see MA seniors. They see Medicaid. Of course, they see commercial lives as well.
Andrew Witty – 非独立董事
A.J.，非常感谢你的问题。我会请Brian Thompson来补充一下我的回答。正如今天我们在台上多次强调的，我们在老年人市场所开发的能力和基础设施（rails），是完全可以应用到更广泛市场的。现实中的诊所并不是只接待Medicare Advantage的老年人患者，他们同时也服务Medicaid和商业医保的客户。
So once those clinics have developed a way of working, it's not a huge leap to imagine how that can be practically delivered. The question then becomes how you start to evolve the incentives and make sure that the system itself sees the benefit from it.
因此，一旦这些诊所建立起一套成熟的运作方式，向商业医保客户推广其实是很自然的延伸。接下来的关键在于：如何设计好激励机制，让整个系统都能从中获益。
And maybe Brian, you could talk a little bit about how you envision that.
Brian，也许你可以谈一谈你对这个问题的看法？
Brian Thompson – Former CEO of UnitedHealthcare
Yes. Thanks for the question, A.J. Having spent so many years in Medicare, I'm perhaps most excited about the opportunity that I do see in commercial. And it's not new to us. We've done value-based care in commercial for some time in California, in Nevada, in particular. But what I think I'm most excited about is what I haven't known in the past and what I've learned from Dr. Lin and others. I think the breadth and scale of what we can do in commercial, we're just scratching at the surface of it.
Brian Thompson – UnitedHealthcare前首席执行官
谢谢你的提问，A.J。我在Medicare领域工作多年，但现在我对商业医保中的机会感到尤为兴奋。其实这对我们来说并不新鲜，我们在加州和内华达州已经开展商业医保的价值导向医疗一段时间了。但让我感到最振奋的是，以前我所不了解、而现在从Lin医生和其他同事那里学到的新东西。我意识到，我们在商业医保领域的潜力和可拓展性非常大，而我们目前不过刚刚触及表层。
So I absolutely believe that this is the future of commercial care, and driving the same sort of alignment is the same sort of incentive that we see between providers and payers. That's no different. How do we make sure that we get that excess and inefficiency out of the system that we see in fee-for-service is probably what we're most excited about in the business. So yes, I think we're only scratching the surface, and Kelsey-Seybold is certainly helping us understand what perhaps we haven't known in the past.
因此，我坚信这就是商业医保发展的未来方向，其核心依然是我们在Medicare中看到的那种“提供者与付款方之间的激励一致性”。我们最期待的，是能够将按服务付费（fee-for-service）体系中那些过度和低效的部分从系统中剔除。所以是的，我们才刚刚开始，Kelsey-Seybold确实帮助我们深入理解了过去我们尚未掌握的内容。
Andrew Witty – Non-Independent Director
And I think -- I'd just add to that, A.J. As you think about it, a lot of the progress that's been made so far, even in -- honestly, even in the MA sector, as you think about how we make sure the right resources get allocated to patient. And then we're very focused on things like site of service and increasingly now beginning to address the efficiency of the core medical spend and Dom King when he was talking today about making sure everybody is on that best practice, that cutting-edge evidence-based medicine.
Andrew Witty – 非独立董事
A.J.，我也补充一点。你想想看，即使是在Medicare Advantage领域，我们现在取得的许多进展也都集中在如何确保资源正确分配到患者身上。我们非常重视就诊地点（site of service）的问题，现在也开始更深入地关注核心医疗支出的效率。今天Dom King也提到了，我们致力于让所有人都遵循最佳实践和最前沿的循证医学。
But that's really just beginning. The opportunity to take savings out of unnecessary care, not site of service, just care that wasn't necessarily in the first place, that opportunity exists both in the current value-based space, unmined fundamentally and is a huge opportunity in commercial. So in a sense, both the current value-based platform and the potential opportunity in commercial benefit from that focus on that piece of the space.
但这其实只是开始。从“非必要治疗”中节约成本的机会非常大，这不是指场所的转移，而是指那些根本就不该发生的治疗。这种机会在当前的价值导向医疗领域尚未被充分挖掘，在商业医保中更是一个巨大的空间。因此，从这个角度看，当前平台的提升以及商业领域的拓展都会从对“医疗必要性”的聚焦中获益。
社会矛盾的中心，不可能调和的冲突。
And that's where you're going to see a lot of attention. That's why the systems, the bringing together of clinical expertise with technical expertise, being able to automate this at a level we haven't really seen before becomes a key enabler to both of these. How can we do more for seniors in the classic space? How do we unlock the commercial space?
这也正是我们未来会重点投入的领域。把临床专业能力和技术能力结合起来，并将之自动化到前所未有的水平，是我们推进这些工作的关键支点。我们要思考的是：如何在原有老年医保领域做得更好？又如何真正释放商业医保的潜力？
Zack, you have Kevin, I think.
Zack，我想你那边有Kevin的问题。
Operator
Yes, I've got Kevin from Bank of America.
主持人
是的，下一位是来自美国银行的Kevin。
Kevin Fischbeck – BofA Securities
You've talked a lot about home and value-based care a lot more than, I guess, I'm familiar with you talking about it. You said that that's going to be a big part of the value-based care growth. Is that in the 750,000 that you're talking about growing this year? And if so, can you talk a little bit about the economics? Is that similar to a physician economics where it's 85% of premium? Or is it some component of that? And how do we think about margins?
Kevin Fischbeck – 美国银行证券
你们今天谈到居家医疗与价值导向医疗的比重比我以往听到的都多。你们说这是今年价值导向医疗增长中的一个重要组成部分。那么这个增长是否包含在你们提到的新增75万人口中？如果是，能否谈一下其经济模型？它是否与传统医生服务的模型相似，比如大约占保费的85%？还是只是其中一部分？以及我们该如何理解它的利润率情况？
Andrew Witty – Non-Independent Director
Yes, great. Kevin, I'm going to ask Dr. Decker to respond to that, please.
Andrew Witty – 非独立董事
好的，Kevin，我请Decker医生来回答你的问题。
Wyatt Decker – Executive VP and Chief Physician of Value-Based Care & Innovation
Yes. Thanks for the question. And absolutely, I think what you'll see us building out is our care delivery capabilities in the home, and that is included in fully capitated lives in our 750,000 risk life number. So point one.
第一点，谢谢你的问题。确实如此，我们正在重点拓展“居家照护”的服务能力，而这部分内容已经包含在我们今年新增的75万名“风险人群”（fully capitated lives）当中。
Point two is where we can really unlock value and create remarkable patient experiences with better outcomes at lower cost is when we combine the primary care physician, in particular, but the physician practices with the home care.
第二点，我们真正能释放价值、提升患者体验、实现更好健康结果并降低成本的地方，是将初级保健医生（尤其是家庭医生）与居家照护服务进行整合。
And so increasingly, you'll see us across Optum Health bringing together our home care capabilities and partnering with both our own primary care physicians as well as community physicians to create a holistic solution for health care. And that's really where we see unlocking the greatest value and the greatest accelerant for growth.
因此，未来你将看到Optum Health会越来越多地将居家服务与我们的初级医疗体系深度整合——既包括我们自有的医生，也包括社区医生——共同构建一个“整体医疗解决方案”。在我们看来，这正是价值释放和增长加速的最大潜力所在。
Andrew Witty – Non-Independent Director
And of course, as you'd expect, in that home and community capability, it really speaks very nicely to the D-SNP population. So one of the areas you know well is a lot of the D-SNP patients actually need to be managed much more in the home. It's much -- it creates a much more accessible health care opportunity for them. You get better outcomes. People get better care.
Andrew Witty – 非独立董事
另外毫不意外地，这类居家和社区照护服务特别适用于D-SNP（双重特殊需求）人群。你很清楚，这部分人群很多都需要在家中进行更频繁、更系统的管理。这种模式为他们提供了更易获取的医疗服务，也带来了更好的健康结果和照护体验。
So it allows us to strengthen our capability to be effective for those people with the most complex situations who, in many cases, don't find it so easy to engage with the classic infrastructure of the health care system. Thanks for the question.
这也让我们有能力更好地服务那些最复杂、最难接触传统医疗体系的人群。谢谢你的提问。
Julie, you got Josh?
Julie，接下来是Josh的问题，对吧？
Operator
Josh Raskin from Nephron.
主持人
来自Nephron的Josh Raskin。
Joshua Raskin – Nephron Research
All right. I think I'll stick on the same topic. I guess just on the value-based care model, one question I would have is, where are you seeing the most success or most effectiveness in terms of actual care management, setting-wise, through the primary care? Is it sort of MSO based, center based, et cetera? How do you manage the specialist as part of that? And sort of interested in lessons learned.
Joshua Raskin – Nephron Research
好的，我想继续讨论价值导向医疗这个话题。我的问题是：在照护管理的实际执行层面，尤其是在初级保健（primary care）中，你们在哪些具体设置中看到最显著的成效？比如是MSO模式（管理服务组织）、中心模式，还是其他？另外，专科医生如何整合到这一模型中？你们有哪些经验教训可以分享？
And then on the commercial, just to go back to that. My understanding is value-based care is most effective for chronic care management. I know that's a portion of the commercial population, but probably not to the same extent as Medicare. So how does the care model change relative to what you're doing for seniors?
再回到商业医保这个话题，我的理解是，价值导向医疗在慢性病管理方面最为有效。而我知道慢性病群体在商业医保中的占比不像Medicare那样高。那么相较于你们为老年人所设计的模型，你们在商业群体中会采取哪些不同的策略或变化？
Andrew Witty – Non-Independent Director
So maybe I'll ask Brian to address the second part of your question, Josh, and then go back to Wyatt to comment on the first part.
Andrew Witty – 非独立董事
Josh，你的问题我们来分两部分回答。我请Brian先回应你关于商业医保的那部分，然后再请Wyatt回应你关于照护模式设置方面的问题。
Brian Thompson – Former CEO of UnitedHealthcare
Sure. I'll be brief on the first. I think it's as simple as when you can get engagement and you can get coordination, there's opportunity. And clearly, I think we see that in chronic populations most notably. But I don't think that limits the opportunity to manage care better when you have that primary care engagement model where they're accountable for all the downstream care. And I see that with similar upside in our commercial market as well.
Brian Thompson – UnitedHealthcare前首席执行官
好的，我先简单回应一下。我认为，关键就在于“能否实现参与度”和“能否实现协调”。在慢性病人群中，这一点尤为明显。但我并不认为这就限制了我们在其他人群中改善照护管理的机会——只要你建立了一个由初级保健医生主导、对全流程照护负责的模式。这种模式同样在我们的商业医保市场中具有巨大的增长潜力。
Wyatt Decker – Executive VP and Chief Physician of Value-Based Care & Innovation
I would say the magic happens, Josh, with the primary care provider and the wraparound solutions, the team and the technology. But as you know well, with chronic disease and with many conditions, specialty input is necessary. So what you'll see us doing is thoughtfully employing, and this -- and Kelsey is a great example of this. It's a multi-specialty practice. Many of our practices – Atrius, [indiscernible], etc. – are multi-specialty.
Wyatt Decker – 价值导向医疗与创新首席医生
Josh，我想说，整个模型的“魔力”在于将初级保健医生与配套支持资源（团队和技术）结合起来。当然，如你所知，在慢性病和很多其他疾病的治疗中，专科医生的介入是不可或缺的。所以你会看到我们在用非常审慎的方式进行专科整合。Kelsey-Seybold就是一个很好的例子，它是一个多专科整合的实践机构。我们旗下许多机构，比如Atrius等，也都是多专科机构。
So we thoughtfully employ the right number of specialists who then engage into that value-based specialty consultation, providing just the right expertise, not too much, not too little. And in markets like Colorado, where we have largely an affiliated specialty network, we actually work with SCA again, Caitlin Zulla, to say who are the highest-quality orthopedic providers in that market. And we use data and analytics to identify them and preferentially leverage their expertise.
因此，我们非常有策略地配置适量的专科医生，以参与到“价值导向的专科会诊”中来，提供“恰到好处”的专业判断，不多也不少。在像科罗拉多这种主要依赖外部专科网络的市场中，我们会与SCA（由Caitlin Zulla领导）合作，识别该地区最优秀的骨科提供者。我们借助数据与分析来筛选，并优先使用这些高质量资源。
So if you're practicing high-quality, evidence-based medicine, you're going to get Optum Health referrals. If you're not, you're going to see that number dwindle. And so for us, that's a very powerful motivator for our physician specialty networks who are a critical part of the team.
因此，如果你坚持高质量、循证的医疗实践，你就会获得来自Optum Health的大量转诊；反之，你的转诊量会明显减少。对我们来说，这也是驱动我们专科网络医生持续提高质量的强大激励机制——他们是照护团队不可或缺的一部分。
Andrew Witty – Non-Independent Director
And it's fascinating, Josh, when you spend time with the advanced value-based care clinics. What they really start to do is they look at their overall population on a very dynamic rolling basis, so every few days a week, and really fixate on literally a handful of patients. I mean -- so if you think about 80-20, when you're really thinking about where the value-based opportunities and risks are in a population, it's probably more like 97-3.
Andrew Witty – 非独立董事
Josh，还有一点很有意思。如果你去到那些成熟的价值导向医疗诊所观察，你会发现他们会以非常动态、持续更新的方式来看待自己的患者群体——可能每几天就会重新评估一次。他们真正关注的，往往就是那极少数几个“关键患者”。如果我们通常说医疗支出遵循80/20法则，那么在价值导向医疗中，这个比例可能更像97/3。
I mean it's -- a very, very small number of folks in a given time period are going to be the people that you need to really be focused on, making sure that you have this kind of pooling of expertise. So pivots around the primary care physician. But pools around them and wraps around them all the kind of insights you need to be able to spot people who might be about to go out of control, who maybe just came back from the hospital, you don't want them to ping back again, maybe is at risk of being a repeat visitor to the ER.
也就是说，在任何给定的时间段内，你真正需要集中资源关注的只是极少数患者。要确保你的临床团队、技术系统与数据洞察都能围绕初级保健医生构建，并配套足够的支持体系，能够精准识别哪些人可能即将病情恶化、刚刚出院、有急诊复发风险等。这正是整个价值导向模型发挥最大作用的地方。
All of those things which are going to really drive bad performance clinically as well as cost-wise, that's really how this comes to life. So as you see this, it becomes a team sport. Primary care physician is very much the center of it, but it becomes a team sport. And the more competency you can put in that team aligned with the right incentive, the best outcome you get.
这些不良的临床表现和成本问题，正是价值导向医疗努力解决的核心。当你深入了解这一模型，它其实更像是一项“团队运动”。初级保健医生固然是核心，但真正发挥作用的是一个整体协作的照护团队。这个团队越专业，激励机制越一致，最终的患者结果和成本控制就越理想。
And then of course, as we start to power that with more and more data, which I'd say is still early days, the work that Dom King shared with you today, the progress we're making in terms of being able to deliver evidence-based care advice to physicians in real time, that's beginning. We have a long way to go with that. But the potential there to really raise the standard across the board is phenomenal. So when you think about how that team can strengthen, that's where we think we can head. Okay. Zack?
当然，随着我们将更多数据引入这一模型——现在还处于早期阶段——Dom King今天分享的那些内容就展示了我们的进展：我们已开始向医生提供实时的循证医疗建议。这项工作仍有很长的路要走，但其对医疗质量整体提升的潜力是巨大的。所以，当你思考如何进一步强化照护团队时，这正是我们要走的方向。好，Zack？
Zachary Sopcak – Senior VP of Capital Markets Communications & Investor Relations
I have Ann Hynes from Mizuho.
Zachary Sopcak – 资本市场沟通与投资者关系高级副总裁
我们请Mizuho的Ann Hynes提问。
Ann Hynes – Mizuho Securities USA
This is a follow-on to A.J.'s question about commercial opportunity in value-based care. Can you put some numbers around that, maybe timing of goals, how many lives you expect and when? And what do you think the biggest barriers to entry, to penetration for that is? And then secondly, for 2023 guidance, can you just talk about what type of recessionary risk you have in that guidance? That would be great.
Ann Hynes – 瑞穗证券（美国）
我想接着A.J.的问题，继续谈商业医保中的价值导向医疗机会。你们能否给出一些具体数字，比如目标时点、预期覆盖的人群数量？目前最大进入壁垒和渗透障碍是什么？此外，关于2023年的业绩指引，能否谈谈你们考虑了哪些“经济衰退风险”因素？谢谢。
Andrew Witty – Non-Independent Director
So John, why don't you tackle the second part, and then I'll come back on the first.
Andrew Witty – 非独立董事
John，你先回应第二个关于衰退风险的问题，然后我再回答商业医保那部分。
John Rex – President & CFO
Yes. In terms of '23 outlook and the potential for recessionary impacts and such, so for a company like ours and such in terms of different impacts we would consider, certainly, what's happening with interest rates broadly. As we've discussed in prior settings here, we are fairly managed in that regard. However, with interest income and interest expense and how we manage that component of our balance sheet, dramatically reducing the volatility that's created by that, typically in a position where we are modestly biased to being net investment income positively biased, however, in terms of any of those types of situations.
John Rex – 总裁兼首席财务官
关于2023年业绩展望及可能的衰退影响，我们考虑了多个层面。首先是整体利率环境的变化，这对我们这类公司来说非常重要。正如我们之前也讨论过的，我们对利率相关的资产和负债管理得比较稳健。通过合理的资产负债结构，我们显著降低了利率波动对公司的影响。通常情况下，我们对净投资收益持“略偏积极”的预期。
The other impacts that we see in recession in terms of what impact they can have in other businesses often have to do with business cycles, not so much in our core health plan businesses, but in other businesses such as OptumInsight, what we'd be thinking about business activity all over broadly in terms of relationships that we're entering into.
至于衰退对我们其他业务的影响，更多体现在商业周期上。比如，核心医保业务受影响相对较小，但OptumInsight这类业务可能会受到一定冲击，主要体现在与合作方达成的新业务关系及相关活动的节奏上。我们对此保持关注，并进行了情景假设建模。
Now I say that realizing that health systems, particularly as they work with OptumInsight and the many offerings they have in their rev cycle business, as they come into periods which are challenging, are often attracted to the ability to do business with a partner like OptumInsight. But checking a view of that and how would that impact elements such as we discussed, what would happen to our revenue backlog growth as we look at that. Considering all those elements is really how we looked at putting together the business in terms of the business plan for '23 and what kind of offsets we might see.
当然我们也意识到，在经济面临挑战时期，很多医疗系统，尤其是那些与OptumInsight合作、使用我们营收周期服务的机构，反而会倾向于与我们这样的平台合作伙伴加深合作关系。我们在制定2023年业务计划时，就已充分考虑了这类因素，以及它们对比如营收积压订单增长等关键指标的潜在影响，并思考可以有哪些对冲措施。因此我们对整体抗风险能力是有信心的。
Andrew Witty – Non-Independent Director
Thanks, John. And to your first question, so already underway. So pockets of commercial risk capitation already in the business. You heard from Tony Lin and Kelsey, several other areas of Optum Health, we already have that. I think in terms of pacing, I think this is something which we'd see accelerate over the next 3, 4, 5 years. It's going to be very much a kind of geographic employer kind of mix.
Andrew Witty – 非独立董事
谢谢你，John。Ann，回到你第一个问题——商业医保中的价值导向医疗机会，其实已经在进行中。目前在我们的业务中，确实已经存在一些“商业风险全额支付”（commercial risk capitation）的实践案例，比如Tony Lin提到的Kelsey，以及Optum Health的多个区域团队。至于扩张节奏，我认为这项业务会在未来3到5年内逐步加速推进，并将呈现出“地域+雇主导向”的混合发展特征。
So I think you'll see it pop up in different locations across the country. And one of the things we're working very closely with is how to do that. And we're in a very interesting opportunity in that regard. So if you think about historically, we've tended to meet -- we tended to meet our patients through the insurance business first, and then we've connected them to care in Optum.
因此你会看到这一模式在美国不同地区陆续展开。目前我们正积极推进实施路径。过去我们的路径通常是“先从保险端接触客户，再引导至Optum的照护体系”；但现在，我们看到了一种更具潜力的逆向路径。
I think as you think about this model of moving toward commercial value-based care, the model can work both ways. We can, of course, continue to do that. And we have a high probability of meeting people through Optum and then arranging their financing through the health -- through the insurance business. That creates a super interesting way in which you can bring this whole concept to life.
随着商业医保价值导向医疗的发展，这一模型将会是“双向驱动”的。我们既可以继续从保险切入，也可以先通过Optum照护网络接触到雇主或员工，然后再由保险产品“支持融资”进行覆盖。这种模式极具吸引力，也将帮助我们更好地将这一战略落地。
So being a little bit more plural about the way in which we evolve this model is something you're going to see. Sometimes, it will be very much UHC-led and, in fact, other payers, and we're in engagement with other payers around this agenda right now. And it can also work the other way. So the clinic sits in the city. It's already looking after lots of people in that employer group. Maybe they want to change the way in which it operates. It's actually a conversation which begins with Optum and then becomes backed up by UHC. So you'll see all of that start to play out. I'd guide you over 3 to 5 years in terms of substantive growth.
因此你会看到我们在发展模式上保持更多样性。有时由UnitedHealthcare主导；有时我们甚至和其他保险公司（payers）合作，Optum启动、UHC支持，已经有多个这类对话在进行中。比如一个城市中的诊所可能已经服务某个大型雇主团体，他们可能希望切换运营模式，那这类对话可能先从Optum开始，然后由UHC补充保险支持。这一模式的规模化，你可以预期将在3到5年内显现。
Dirk McMahon – Former President & COO
Yes. Andrew, let me add. There's -- Andrew hit on the 2 things. You asked about the rate limiting factor. The first one is markets, right? If you go back even to the original days of PacifiCare, they had a fairly big commercially capitated book of business in Southern California. So very market-specific in addition, as we talked about today with Kelsey.
Dirk McMahon – 前总裁兼首席运营官
Andrew说得很对。我也补充一下关于你提到的“发展瓶颈因素”（rate limiting factor）。第一个显而易见的限制是“地域市场特性”。举个例子，PacifiCare当年在南加州就有相当规模的商业医保全额支付客户群，这种发展历来是“市场因地而异”的，就像今天我们提到的Kelsey一样。
But also, as I've sort of been in the national account space, we're hearing more and more are sort of willing to sort of go to OptumCare and say, hey, let's go to OptumCare. Can we take -- can we dedicate part of our population in this ZIP code to OptumCare? I think with -- and there's a little bit more of a lean into some of them being willing to accept a little bit of a narrowing of a network. So those type of things are sort of, what I would say, you could look at market-wise and employer-wise, are 2 things that you would logically look at as the rate limiting factor.
此外，从我目前接触的大型雇主账户来看，我们越来越多地听到雇主主动表示：我们能否将某个邮政编码区域的一部分员工群体交给OptumCare来照护？并愿意接受略微收窄的医疗网络。在我看来，这就从“市场接受度”和“雇主意愿”两个维度体现了未来发展的限制因素。整体来看，这两个维度将是我们判断商业医保价值导向医疗渗透路径的关键。
Andrew Witty – Non-Independent Director
Absolutely. Julie?
Andrew Witty – 非独立董事
当然可以。Julie，请继续。
Julie Murphy – Vice President of Investor Relations
I have Lance Wilkes from Bernstein.
Julie Murphy – 投资者关系副总裁
我们请Bernstein的Lance Wilkes提问。
Lance Wilkes – Sanford C. Bernstein & Co.
So you're [forecasting] some really strong growth in the employer membership in UHC, in particular, in ASO. Just interested in what sort of products are driving that and what particular segments that that's expected to come in.
Lance Wilkes – 伯恩斯坦公司
你们对UHC的雇主团体会员数预期了非常强劲的增长，特别是在ASO（行政服务型自保）方面。能否分享一下是哪些具体产品在驱动这种增长？你们预期主要会来自哪些细分客户群体？
Andrew Witty – Non-Independent Director
I think Brian has been hoping you would ask that question. I'm going to just let him answer that.
Andrew Witty – 非独立董事
我想Brian一直希望你问这个问题，我就直接交给他回答吧。
Brian Thompson – Former CEO of UnitedHealthcare
We're really excited about our growth, as you might expect, for 2023. And I'd say it's really balanced. A couple of things that I might point out. Our Surest offering is really resonating in the market, both fully insured and in our ASO. Level Funded products continue to be an alternative for small group plans. As I look forward to 2023, I think this is our strongest growth year that we've seen in almost a decade for our national account. So our value prop of how we organize across our enterprise with Optum is resonating.
Brian Thompson – UnitedHealthcare前首席执行官
2023年的增长情况确实让我们非常振奋，尤其是它呈现出良好的平衡性。我想强调几点：首先，我们的Surest产品目前在市场上非常受欢迎，无论是全险（Fully Insured）还是ASO结构。其次，Level Funded产品持续成为小团体客户的一个有吸引力的替代方案。展望2023年，我们在全国大客户（National Account）领域的增长可能是近十年来最强劲的一年。我们和Optum跨业务协同的价值主张在这一群体中产生了明显共鸣。
But you're just seeing strength and balance across [the] business. And clearly, that's also benefiting from the expectation that we see redetermination start up here again in 2023. But really pleased with that balance, not only in ASO, as you said, but also growth in our fully insured business.
此外，从整体业务来看也体现出强劲和平衡的势头。当然，这也部分受益于2023年“Medicaid资格重新认证”（Redetermination）重新启动的预期。但无论是ASO业务，还是你提到的全险业务，我们都对目前的发展势头感到非常满意。
Andrew Witty – Non-Independent Director
Great. Thanks so much. Zack?
Andrew Witty – 非独立董事
很好，谢谢你，Zack请继续。
Zachary Sopcak – SVP of Capital Markets Communications & Investor Relations
I've got Lisa Gill from JPMorgan.
Zachary Sopcak – 资本市场沟通与投资者关系高级副总裁
我们请JPMorgan的Lisa Gill提问。
Lisa Gill – JPMorgan Chase & Co.
So I have 2 questions on the pharmacy side. First, Andrew, I think last year, we talked about value-based programs and shift towards value-based care when we think about the pharmacy. I can understand that for UnitedHealthcare, but how do I think about difference and payment mechanisms for non-UnitedHealthcare when I think about your PBM would maybe be the first question. And then secondly, I look at the margin improvement for 2023, is that biosimilars? And how do I think about the biosimilar opportunity?
Lisa Gill – 摩根大通
我有两个关于药房业务的问题：
第一个问题是，Andrew，去年我们谈到药房业务正在向价值导向支付机制转型。我理解这在UnitedHealthcare体系内是怎么运作的，但请问如果是非-UHC客户，你们PBM（药品福利管理机构）的支付机制是否有不同？
第二个问题是，我注意到2023年你们预期药房业务利润率提升，这是否是由生物类似药（biosimilars）带动的？你们如何看待这个机会？
Andrew Witty – Non-Independent Director
Yes. No, 2 great questions, Lisa. Thanks so much.
Andrew Witty – 非独立董事
谢谢你，Lisa，两个非常好的问题。
Make a couple of comments, and I'm going to ask Heather to go into more detail on both of those. So just on the biosimilar piece and Heather can describe a little bit more to you on that. From our perspective, we see the PBM as a key mechanism to drive as much cost advantage in the system as possible. So to drive down those prices as fast as possible, driven by the catalyst of the biosimilar. But then we're passing that through to the payers.
我先简单回答一下，然后请Heather再详细说明这两个问题。关于生物类似药，我们的看法是，PBM的核心作用就是帮助整个系统降低成本，而生物类似药是一个非常重要的催化剂，能快速推动价格下降。而这些节省下来的成本，我们是直接传导给客户——也就是付款方（payers）的。
So the short answer to that question is really no. We see this very much as a moment where the PBM demonstrates its effectiveness as a procurement vehicle on behalf of the clients, the beneficiaries of the savings.
所以简而言之，生物类似药带来的价值，我们并不是用来改善PBM自身利润率的，而是让PBM成为客户（包括非UHC客户）节省成本的有力工具，真正体现PBM在采购端的效率和价值。
Give a little more detail on biosimilars, Heather, and then into the first part as well.
Heather，你来详细讲讲生物类似药的问题，然后也一起谈谈第一个关于支付机制的问题。
Heather Cianfrocco – EVP of Governance, Compliance & Information Security
Yes, sure. And so maybe let me take the biosimilar and how to think about '23, and then we can do the value-based care.
Heather Cianfrocco – 治理、合规与信息安全执行副总裁
好的。我先谈谈生物类似药和2023年相关增长的因素，然后再说价值导向医疗。
So when you think about '23, '23 and the strength in '23 is really going to come from a couple of things. I've said it before. But the PBM is really well positioned from just a value proposition standpoint and how we're serving clients. And we've seen really strong growth there. So that's one element.
2023年的增长主要来自几个关键方面。第一，我们PBM的价值主张非常清晰，我们在服务客户方面的定位非常扎实。这一块的业务本身就增长得很强劲。
The other element of it is the breadth of the pharmacy services. You saw -- we highlighted a few of those today, but you can fill pharmacies that are integrated into communities. They're integrated into care models. They're integrated into patients' lives. We're leading with pharmacists first, 24/7 access, and we've seen material growth year-over-year as a result of that.
第二个因素是我们药房服务的广度。今天我们其实展示了一些例子，比如我们的社区药房，与照护模型深度整合，真正融入患者的日常生活。我们以“药师主导”的服务为核心，全天候提供服务，这一模式带来了持续强劲的年增长。
In fact, we've seen double-digit growth in the pharmacy segment of our business. And a lot of that growth comes from non-UHC sources, a lot of that volume and growth. So I think that's the strength you're going to see in '23.
实际上，我们药房业务板块已经连续实现了两位数增长，而这其中有相当大一部分来自非UnitedHealthcare（UHC）的客户。这就是你在2023年所看到的“增长基础”的关键所在。
Biosimilar, to Andrew's point, that's all about the client. And this is the event that offers the opportunity to drive affordability beginning with adalimumab in specialty drugs for clients who use the competition, the selection.
至于生物类似药，就像Andrew说的，这是“以客户为核心”的一项重要机会。从用于自身免疫疾病的阿达木单抗（adalimumab）开始，它为客户在特殊药物领域带来了可比竞争性，促进成本降低。
And I think when I think about biosimilar, the thing I would take away for what Optum Rx is doing is we're really set on ensuring that we provide affordability with choice. We're not limiting to provide client, patient and prescriber choice.
从Optum Rx的角度出发，我们的核心目标是“在保障可负担性的同时，提供多样选择”。我们不强制限定客户、医生或患者的用药选项。
We wanted to provide both, and we're driving affordability with year 1 material savings for our clients while allowing our patients, their prescribers and our clients to make the choice between continuity or new options. And so that's how I think about biosimilar.
我们追求“二者兼得”——既实现首年就为客户带来实质性成本节约，又允许患者、开药医生、和客户在“维持原药”与“使用类似药”之间自主选择。这就是我们对生物类似药的战略定位。
Heather Cianfrocco – EVP of Governance, Compliance & Information Security
Value-based constructs. So we're not going to actually impact total cost of care until we get pharmacy into the perimeter. And so those models, you'll see us driving 2 really important aspects. One is those clinical models where we're doing more than just dispensing. We're getting closer to the prescriber. We're getting closer to the pharmacist. We're getting closer to those that bear risk, and we're making sure they have the tools and the supports. We're wrapping around them with the clinical models. We're co-locating with them with OptumCare practices.
Heather Cianfrocco – 治理、合规与信息安全执行副总裁
价值导向的医疗体系必须把“药房”纳入整体范围，才能真正影响总医疗成本。因此，我们主要在两个关键层面推动这类模型：第一，是“临床层面”模型，我们不再只是负责发药，而是更贴近开药医生、药师以及承担风险的照护方。我们为他们提供工具和支持，同时用临床模型形成协作包围，甚至直接与OptumCare的诊所实现共址整合。
And so that's how I think when you think about value-based care, think of us as the enabler. We provide the data and the tools on the PBM side. We provide the holistic pharmacy. And then we'll talk about this a little bit more in Optum Rx seminar, but we are building capabilities with our [pharmaceutical] manufacturer partners to give them better tools, better data so that they can ensure that they're enabling the value-based care as well. That's how I think about it going into '23.
所以，当你谈到价值导向医疗，请把我们看作是“赋能者”：我们在PBM端提供数据和工具，在药房层面提供全面服务；此外我们还与制药厂合作，为他们打造更先进的数据和技术能力，从而让他们也能参与到支持价值导向照护的体系中。这是我们对2023年及之后的布局。
Andrew Witty – Non-Independent Director
Great. Thanks so much, Heather. And just going back to biosimilars, just real quick. The work that Heather and her team have done in terms of creating this platform where we believe we get great opportunity to leverage down cost and maintain increased choice so the consumer has choice, we're really laying a template down to how we think future biosimilars need to be managed.
Andrew Witty – 非独立董事
谢谢你，Heather。回到“生物类似药”这个话题，我再补充一点：Heather和团队构建的这套平台，不但有效降低成本，还保留了患者的选择权，为未来管理生物类似药奠定了清晰模板。
So this is very much pro biosimilar. It's pro competition. It's pro bringing cost down. And it's a model we're going to apply on future -- and as you know, there's many more coming after this one. So this is an important step, and a ton of work has gone on this year to lay the ground, and we're feeling very good about how we sit as we roll into the new year. Julie?
我们的立场非常明确：我们支持生物类似药、支持竞争、支持压低成本。这套管理模型我们会复制到未来更多即将上市的类似药上。今年我们已经做了大量铺垫，对目前的准备状态很有信心。Julie？
Julie Murphy – Vice President of Investor Relations
Gary Taylor from Cowen.
Julie Murphy – 投资者关系副总裁
我们请Cowen的Gary Taylor提问。
Gary Taylor – TD Cowen
I want to go back to value-based care for a minute. And what I'm thinking about when we look historically at entities that have assembled large groups of physicians, either employed or affiliated, and have quickly ramped the risk taking, the actuarial risk taking that those groups have had, so many have struggled or outright failed. So all we get to see when you guys acquire something or build something is we see it going into that Optum Health line, and we get to see the OI, and that's kind of all we're getting to see out of it.
Gary Taylor – TD Cowen
我想回到价值导向医疗这个话题。从历史经验来看，那些快速整合大批医生群体（不论是雇佣的还是合作的）并迅速推进风险承担（actuarial risk-taking）的机构，很多都遇到了困难，甚至失败。而对于你们，外界能看到的只是当你们进行并购或自建时，这些资产被归入Optum Health，最终看到的是运营利润（OI），仅此而已。
So I was hoping maybe you could talk about 2 or 3 things that you're tracking or looking at as CEO to give us comfort that the clinical technology, financial integration is happening and that the risk taking and the ramp of risk-taking is prudent and not getting ahead of yourself, so to speak.
所以我想请你们分享一下，作为CEO，你们内部都在关注哪些关键指标或机制，让我们能相信你们在“临床-技术-财务”整合方面确实做到了扎实推进，而且你们对于承担风险的节奏是审慎推进的，并没有冒进？
Andrew Witty – Non-Independent Director
No, that's a very fair question. So we spent a lot of time focused on this. And as Wyatt will confirm; Selemon, who's here, who's our finance leader for OptumCare; Travis Winkey, who's here, who many of you know well, John, Dirk and I, I think, monthly sit with the whole team. And we go through how all the vintages of our various clinics are doing each year, who's joined the organization, where are they in terms of risk transference, what's the performance of those groups, how are they doing in community MA, how are they doing in D-SNP and then a whole piece around our alignment and integration.
Andrew Witty – 非独立董事
这个问题非常合理。我们确实花了大量时间在这方面。Wyatt 可以作证，还有我们OptumCare的财务负责人Selemon也在场，Travis Winkey也在，很多人都认识他。我、John、Dirk每月都会与整个团队开会，系统地回顾我们旗下各家诊所的运营“历程”（vintages）：每年的新成员情况、他们的风险转移进度、业绩表现、他们在社区医保（MA）和D-SNP的表现如何，以及和我们整体系统的整合程度。
So what -- and I'd say -- I give Wyatt enormous credit for this over the last 3 or 4 years. The transformation in the way in which Optum Health is integrating to a national system, a national approach is completely different to where it was 4 or 5 years ago. And that's critical because it's given us really clear insight, early warning in terms of where things aren't quite performing the way you'd like them to do.
我必须特别肯定Wyatt在过去3、4年中的努力。Optum Health如今实现了真正的全国化整合，这与4、5年前是完全不同的水平。这种转变非常关键，因为它让我们获得了清晰的洞察力，也能在早期就识别出那些没有达到预期效果的地方，从而及时调整。
And then the final -- I think final thing I would say, Gary, is that we're a beneficiary of the portfolio. So because the scale of Optum Health is significant and because we have multiple vintages of risk transference going through, we learn as we go through. So when things go wrong, we're able to course correct and avoid it the next time.
最后一点也很重要，Gary。我们现在的“组合效应”对我们极为有利。Optum Health的规模庞大，风险转移的“历程批次”（vintages）也非常多样，因此我们能够从过程中不断学习，一旦发现问题，可以迅速纠偏，避免未来重蹈覆辙。
But we're also able to accommodate within the portfolio a mix of performance. So we're not exposed to any given trend typically. So if you have one part of the country or one clinic which for whatever reason stubs its toe, the overall portfolio is able to manage within it. And that's important because it -- there's no way that you can take this to perfection in 1 or 2 time cycles. It takes time for us to really get to that level. But we are running, I think, a very -- exactly what I expect from UHG. We're running a very, very focused operational excellence oversight over what is a very substantial development.
同时，整个组合内部可以容纳一定程度的“业绩差异”，我们不会被某一个地区或诊所的短期波动所拖累。如果某家诊所暂时“踩了个坑”，整个系统依然可以保持稳定。这很关键，因为这种模式不可能在一两个周期内就做到完美，它是长期积累的结果。而UHG对此的运营管理和审慎程度，正是我所期望的那种高标准、高密度的管控体系。
I might just ask Sandeep, who is at the end here, Sandeep is our new CTO. And one of the key pieces here is how we're building out the technology backbone to support everything I've just described because a ton of that is really reenvisioning what a clinical risk-bearing entity tech back bone needs to be to deliver exactly the certainty that you're looking for? And maybe Sandeep, make a couple of comments on how you see that? And then Dirk to finish off on this.
我也想请我们新任CTO Sandeep补充一下。他领导的工作是我们在技术基建层面如何构建支持上述所有整合和风控的系统，这其中需要重新定义“临床风险承担实体”的核心技术架构。Sandeep，你来谈一谈？然后请Dirk做个总结。
Sandeep Dadlani – Executive VP and Chief Digital & Technology Officer
Thank you, Andrew. And first of all, let me tell you what a privilege it is to join this leadership team just a couple of months ago to drive purpose at this scale with such impact. My early impressions here is that UHG has made fantastic investments in technology, in talent and in all the programs that we're running. But to Andrew's point, the opportunity here is immense in trying to make all of this technology, first, more consumer-friendly, frictionless, and there's just infinite opportunity there; second, make it more connected, as our beloved physics professor taught us today how a connected system would work much, much better.
Sandeep Dadlani – 执行副总裁兼首席数字与技术官
谢谢Andrew。首先我想说，能加入这个团队、推动如此有意义的工作，我感到非常荣幸。我刚加入几个月，目前最深的感受是：UHG已经在技术、人才和系统建设方面投入巨大。正如Andrew所说，我们现在面临的机会也非常巨大。第一个机会是让这些技术变得更加“面向消费者”、无摩擦地嵌入体验，这方面有无限可能。第二个是实现更强的“互联互通”，正如今天讲到的“物理系统连接”那样，只有连接起来，系统运行才能最优。
And then finally, the data that we collect, we use responsibly to continuously improve those systems so that our consumers get the best of all worlds. So I think those 3 things, consumer-friendly, frictionless, connected and always improving is the big opportunity in front of us.
最后，我们还致力于负责任地使用收集到的数据，持续改进我们的系统，从而让消费者真正受益。我认为，这三个方向——以消费者为中心、消除摩擦、互联互通，并持续进化，是我们当前面临的最大机会。
Dirk McMahon – Former President & COO
Let me give you 2 specifics. Thanks, Sandeep. Let me give you 2 specifics, Gary, on how we manage and measure. So one of the key things you have to do is get the systems aligned, right? So you have things like utilization management systems. You have patient portals. You have EMRs. We track really explicitly for each of our local care delivery organizations where they are with respect to end state. What you want to ultimately do is have a model which is very consistent or as consistent it can be systems-wise across. In order to do all the efficient data that we've all talked about today, you got to be as common as you can with system-wide. That's one real KPI that we track.
Dirk McMahon – 前总裁兼首席运营官
让我具体举两个例子，谢谢Sandeep。Gary，你刚才的问题，我们在管理和衡量时非常关注两点：第一，我们必须让系统“对齐”。比如说你有利用管理系统（UM）、患者门户（Patient Portal）、电子病历系统（EMR）等。我们对旗下每一个地方性照护机构的“系统整合状态”都有明确追踪，目标是尽可能让全系统在技术架构上达到一致性。因为要实现今天我们谈到的所有数据效率，前提就是底层系统要一致。这是我们非常明确追踪的关键KPI之一。
The other thing I would say that's a little bit under the covers is there's a big people piece of this, too. So you have to move -- we've moved some real actuarial talent from UnitedHealthcare. Now they're working in OptumCare. Network talent from UHN, UnitedHealth Networks, we move them. Now they're now Optum employees, right? So sort of the talent to be able to take that risk, there's a lot of that talent in our organization, and we deploy it across the enterprise, and that's really benefited us.
第二点，表面上不容易看到，但至关重要的是“人才结构”的重构。我们把UnitedHealthcare的一些核心精算人才调到OptumCare，把UnitedHealth Networks的网络布局专家也转过去了。也就是说，我们把能够承担风险的人才整合进Optum体系，这种跨体系的部署，在支持我们迈向风险承担型（risk-bearing）照护模式上起到了非常重要的作用。
Andrew Witty – Non-Independent Director
Thanks, Dirk. I'm afraid we only have time for one more question. So Zack?
Andrew Witty – 非独立董事
谢谢你，Dirk。我们时间只够再回答一个问题。Zack？
Zachary Sopcak – Senior VP of Capital Markets Communications & Investor Relations
Steve Valiquette from Barclays.
Zachary Sopcak – 资本市场沟通与投资者关系高级副总裁
Barclays的Steve Valiquette提问。
Steven J. Valiquette – Barclays Bank
With the MLR guidance for '23 expected to be up 60 basis points at the midpoint versus the '22 estimate, can you just remind us and reiterate what the biggest variables are in your initial assumptions for the MLR to be a little higher year-over-year? And also, how are you thinking about the flu impact on MLR in early '23?
Steven J. Valiquette – 巴克莱银行
2023年的MLR指引相比2022年中位数提高了60个基点。能否重申一下你们预测中导致MLR同比上升的主要变量？另外，2023年初流感的影响，你们怎么看？
Andrew Witty – Non-Independent Director
Yes. Great. John, why don't you start there? And maybe, Brian, you maybe add a little bit more depth.
Andrew Witty – 非独立董事
好的问题。John，你先来谈谈，然后请Brian做进一步补充。
John Rex – President & CFO
So the outlook for '23 accommodates the view that we've been anticipating for some time now. Do we see people start to present with more acute conditions because of deferred care that occurred during the height of the pandemic? And does that present itself in the way we just see an average higher acuity level and return to pre-pandemic levels of consumption [ plus that ]? So that's a key component there.
John Rex – 总裁兼首席财务官
2023年的预测中，我们考虑到了早已预见的一些趋势。比如：由于疫情高峰期推迟就诊，是否会出现更多“病情加重”的患者？是否会因此看到总体“疾病严重程度”（acuity level）上升，并叠加回归疫情前的就医使用率？这是推动MLR上升的关键因素之一。
Also accommodating a view that there is a moderately higher flu incidence level than normal years. Something that we haven't actually experienced yet as we look at kind of current trending in month of November, but an anticipation that, that could occur.
此外，我们也在模型中考虑了一个假设——流感发生率可能略高于正常年份。虽然截至11月的数据尚未看到明显上升，但我们预计这种可能性在未来几个月内是存在的。
Andrew Witty – Non-Independent Director
And Brian, do you want to add?
Andrew Witty – 非独立董事
Brian，你要补充一下吗？
Brian Thompson – Former CEO of UnitedHealthcare
The only thing I would say is really pleased with how we're stepping out for our [ BCR ] next year, particularly as you think about continued greater mix in our government programs, really stepping out at what I consider to be a real sustainable and durable position.
Brian Thompson – UnitedHealthcare前首席执行官
我只想补充一点：对于我们明年在 [BCR]（注：可能指Benefit Cost Ratio）方面的展望，我感到很满意。特别是在政府项目业务持续占比提升的情况下，我们正在以一个我认为“可持续且稳健”的姿态迈出步伐。
And on the flu, we probably all experienced it as we gathered for Thanksgiving holidays, certainly seeing it a little bit higher, but that's really resonating in the Rx scripts, TAMIFLU, physician, not seeing it on our inpatient level. So I would suggest less intense but moderately higher than normal, and both rest of '22 and how we thought about '23 is instructed with what we've seen here early.
至于流感，我想我们大多数人在感恩节期间应该已经亲身体会到，发病率确实稍微高一点。这主要体现在处方药数量上，例如TAMIFLU的使用，以及门诊量的上升；但住院层面并没有显著增加。所以我认为这轮流感“强度不高但略高于正常年份”，我们对2022年末和2023年的预测也正是基于这种初步观察得出的。
Andrew Witty – Non-Independent Director
Thanks. So unfortunately, that's -- we're pretty much out of time in terms of the questions. Just to introduce -- make sure you know 3 people here you haven't heard speak already today but are going to be here for the rest of the -- Patricia Lewis, who leads our sustainability effort; Erin McSweeney, who's our Chief People Officer; and Dr. Margaret-Mary Wilson, who's our Chief Medical Officer. All 3 are going to be here, obviously. So although the questions didn't come up in that topic here, please do take advantage if you're interested in what we're doing in terms of people strategy, what we're doing in terms of our quality, patient safety strategies and what we're doing, of course, in our core ESG strategies where a ton of progress has been made this year.
Andrew Witty – 非独立董事
谢谢。很遗憾我们问答环节时间差不多了。我想在结束前介绍一下今天还没有发言、但接下来整天都会在场的三位重要同事：Patricia Lewis，她负责我们的可持续发展战略；Erin McSweeney，我们的首席人力资源官；还有Margaret-Mary Wilson医生，我们的首席医疗官。这三位都在现场，虽然今天问答中没有涉及她们的领域，但如果你对我们的“人才战略”、医疗质量与病患安全策略，以及今年在ESG方面取得的重大进展感兴趣，请在接下来的走廊或专题研讨环节与她们交流。
So please do take advantage in the corridors or in the seminars to catch up with everybody you want to. We've tried to put some time in the day for you to catch up with folks in the corridors. Please do, do that. You've seen about half of our team who are here. There are another half ready to go, ready to answer your questions. Please do avail yourself of that.
请务必在走廊或研讨会上多交流。我们今天专门安排了时间方便大家与团队成员面对面交流。你们今天已经见到了我们团队中的一半，另外还有一半同事已经准备好，随时回答你们的问题。请大家积极提问。
I want to thank the team, but most importantly, thank you very much for the questions, and thank you for your attention today. Seminars are going to start after a short break. Please take advantage of all of that. We look forward to spending the rest of the day with you all. We appreciate your attention. Thank you so much.
我想感谢今天发言的团队成员，但最重要的是，感谢在座各位的提问和关注。我们将在稍作休息后进入专题研讨阶段，请大家多多参与。我们非常期待与大家共度接下来的时光。谢谢你们的关注与支持！
热门主题
Related Articles
2015-12-01 UnitedHealth.Investor Day
Operator Welcome to the UnitedHealth Group Investor Conference. Introducing UnitedHealth Group Chief Executive Officer, Stephen Hemsley. 主持人 欢迎来到联合健康集团投资者大会。现在请出联合健康集团首席执行官斯蒂芬·汉姆斯利。 Stephen Hemsley CEO & Non-Independent Non-Executive Chairman Good ...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 ...2017-07-18 UnitedHealth Group Incorporated (UNH) Q2 2017 Earnings Call Transcript
UnitedHealth Group Inc. (NYSE:UNH) Q2 2017 Earnings Conference Call July 18, 2017 8:45 AM ET Executives Stephen J. Hemsley - CEO David S. Wichmann - President Larry C. Renfro - VC, UnitedHealth Group and CEO, Optum John Rex - EVP and CFO Andrew Hayek ...2025-01-16 UnitedHealth Group Incorporated (UNH) Q4 2024 Earnings Call Transcript
Call Start: 08:45 January 1, 0000 9:50 AM ET UnitedHealth Group Incorporated (NYSE:UNH) Q4 2024 Earnings Conference Call January 16, 2025, 08:45 AM ET Company Participants Andrew Witty - Chief Executive Officer John Rex - Chief Financial Officer Amar ...2025-04-17 UnitedHealth Group Incorporated (UNH) Q1 2025 Earnings Call Transcript
UnitedHealth Group Incorporated (NYSE:UNH) Q1 2025 Results Conference Call April 17, 2025 8:45 AM ET Company Participants Andrew Witty - Chief Executive Officer John Rex - Chief Financial Officer Tim Noel - Chief Executive Officer, UnitedHealthcare ...