2024-12-04 UnitedHealth.Investor Day

Andrew Witty – CEO & Non-Independent Director

[Presentation]

Good morning, everybody, and welcome to the 2024 UnitedHealth Group Investor Conference. We're delighted that you're all here, and I'm very personally grateful of your willingness to give up some time today to meet with us and listen to me, my colleagues and everybody who's involved in UnitedHealth Group to update you on how things are going at the company. So thank you for being here, first and foremost.

大家早上好，欢迎出席2024年联合健康集团投资者大会。我们非常高兴大家的到来，我本人也非常感激各位愿意抽出宝贵时间，和我、我的同事以及联合健康集团的所有成员见面，并听我们介绍公司的最新进展。首先，衷心感谢大家的到来。

The last 2 years has been a dynamic 2 years, to say the very least. And last year, I stood here and talked about an impending price cut coming in the form of a funding reduction through the V28 adjustments that CMS had announced in February of '23. And as we've gone through '23 and '24, we've seen a sequence of unprecedented changes, really, in the funding environment of the business in which we operate on behalf of the government.

过去两年无疑是非常动荡的两年。去年我在这里提到，医保和医疗补助服务中心（CMS）在2023年2月宣布的V28调整，将以资金削减的形式带来价格压力。到了2023和2024年，我们确实经历了一连串前所未有的变化，特别是在我们代表政府运营的业务领域的资金环境方面。

Whether that was through V28, whether it was through underfunded growth rate on a year-on-year basis, or through the reform of the Part D model which hasn't fully compensated for the increase in benefits which have been committed to, all of that has added up to a significant amount of dynamic for our sector to deal with. Maybe more than we've seen ever before, and certainly more than we've seen in the last several years.

无论是V28带来的调整、年度增长率被系统性低估，还是D部分（处方药福利）的改革未能完全覆盖已承诺的福利增长，这些都为我们的行业带来了巨大的挑战。可以说，这是我们前所未见的复杂局势，远远超过过去几年的任何时刻。

Combine that with the hangover effects of the COVID pandemic and the return to accelerated MEDEX trend that we saw during the last year, those 2 pressure points have unmistakably created a tougher situation for everybody who competes in this marketplace that's so important to people across the country.

再加上新冠疫情的持续影响，以及去年我们观察到的Medicare Advantage（老年医疗保险优势计划，MEDEX）支出趋势的加速反弹，这两个压力源无疑令所有在这个对全美民众都至关重要的市场中竞争的企业处境更加严峻。

What I hope you've seen from UnitedHealth Group though is, during that period, we have really dug deep into our resilience and our tenacity. That notwithstanding changes to what we expected to happen or changes to the external environment, we continued to stay focused on our core mission to improve the system for everybody and our ability to deliver for our shareholders.

不过我希望大家看到的是，联合健康集团在这段时间展现出了深厚的韧性和坚毅精神。无论是原计划的变化还是外部环境的剧变，我们始终坚持我们的核心使命——改善整个医疗体系，同时为股东持续创造价值。

We continue to make sure that we don't buckle under the pressure to say, "Well, why don't we just take an easier path? Why don't we just accept that things are different and change our goals?" We don't do that.

我们从不在压力面前退缩，从不轻易放弃，不会因为情况变了就选择“走捷径”或“降低目标”。

We figure out ways to solve problems. We figure out ways to respond differently to different situations that come up in front of us. And we believe that, that serves us well, not just in the short run, but in the longer term as well. And I hope you've seen that during the last couple of years. But I'd be the first to say that the plan that we executed over the last couple of years is not the plan that we exactly planned to execute because of the changes that we had to deal with.

我们致力于寻找解决问题的新路径，应对每一种新情况的新方法。我们坚信，这种方式不仅适用于短期，也会在长期中证明其价值。我希望你们过去两年已经感受到了这一点。但我也必须坦率地说，过去几年我们所执行的计划，并不完全是我们最初设想的路径，而是对不断变化的现实做出的主动调整。

We haven't been afraid to start to refocus our organization. We haven't been afraid to embrace technology at a much faster rate. We haven't been afraid to look at ways in which we can address our cost base even more aggressively than we'd originally anticipated. We will continue to do that.

我们不惧于重塑组织重点，不惧于加速拥抱新技术，也不惧于比最初预期更激进地优化我们的成本结构。未来我们还将继续这样做。

We're not afraid to divest ourselves of businesses which are no longer performing as well in our organization as needed, or maybe those which have been obsoleted by changes in the way in which the funding environment has been developed. All of those things are simply reflections of a deeply pragmatic organization which is committed to its mission, it's committed to its product delivery, and it's committed to doing the right thing for people every single day.

我们也不惧于剥离那些在我们组织中表现不佳，或因政策环境变化而逐渐失去价值的业务。这一切，都体现了我们作为一家高度务实、坚定使命、致力于产品交付与客户福祉的组织文化。

Running through the whole organization is a culture of restlessness, of performance orientation, but most importantly, a culture of compassion, a culture of compassion which focuses not just on what we do but how we do it. Making sure the quality of what we do is tip-top, making sure that quality is something that we individually, that our families, that your families, that everybody's families, would want to be exposed to. It's why this company is the only and the first company to try to build a national ambulatory quality patient management system, akin a little bit to what you expect to see in hospital systems.

贯穿整个组织的是一种不满足现状的精神、一种以绩效为导向的文化，但更重要的是，一种“同理心”的文化。这种文化不仅关注我们“做了什么”，更关注我们“是怎么做的”。我们致力于确保服务质量达到最高标准，让我们的员工、家庭、您的家庭，乃至所有人的家庭都愿意信赖我们。正因为如此，我们是美国第一家、也是唯一一家尝试建立全国性门诊质量管理系统的企业，类似于你们在大型医院系统中所期待的那种标准。

How can we be confident of the quality of care that's being delivered across the ambulatory networks? Really, you can't today, because those systems don't exist. But we're building the first version of that. And we're building the first version of that quality system at the very moment where we're all under the most funding pressure we've had for the last decade or more.

我们如何能够确信整个门诊网络所提供的护理质量？事实上，目前我们并不能真正确信，因为这样的系统根本还不存在。但我们正在打造行业首个此类系统。而且，我们正是在过去十多年来资金压力最大的时刻构建这套质量系统。

It's a good example of how we will never make a short-term decision simply for quarter which might put at risk the future. We're committed to making sure that we're always playing chess and never playing checkers. We will never put short term ahead of quality outcome, and we will never put the short term ahead of the strategic value opportunity of this company.

这正是我们绝不为短期季度结果而牺牲长期发展的一个鲜明例证。我们始终坚持下的是“国际象棋”而不是“跳棋”——也就是说，我们追求的是远见和布局，而非短期得失。我们永远不会将短期利润置于护理质量之上，也不会把短期成绩凌驾于公司战略价值和机会之上。

Next year is a good example of that proof. You can see our guidance for next year is a little lower than we would normally like to step out with at the beginning of a year. It's a little lower for all of the reasons I just alluded to, those pressures accumulating as we transition through those pressures. In particular next year, the second wave of V28 and in particular the consequential impacts of the Part D reform.

2025年就是这种长期主义原则的一个很好的例证。你们会看到我们明年的业绩指引比我们通常希望在年初公布的要略低一些。造成这个情况的正是我刚才提到的一系列累积性压力——尤其是V28政策的第二轮影响，以及Part D（处方药保险）改革所带来的连锁反应。

But as we cycle through that, we are continuing to commit to our long-term 13% to 16% adjusted earnings per share growth. Our ambition inside UnitedHealth Group is undiminished by the pressures we deal with on the outside of this company. We continue to see many opportunities to return to that growth rate, and that is clearly our goal.

但随着我们穿越这一阶段，我们仍坚定致力于实现长期每股收益（EPS）13%到16%的调整后增长目标。尽管外部环境充满压力，我们在联合健康集团内部的目标和雄心从未动摇。我们依然看到众多恢复这一增长轨道的机会，而这正是我们的明确目标。

But the important thing to do for 2025 was not to fall into the trap of overly cutting and underinvesting in the future to accelerate '25 and undermine the potential of delivery in '26, '27, '28 and beyond.

2025年真正重要的是避免陷入“削减过度、投资不足”的陷阱，不为了冲刺2025年的短期数字，而破坏2026、2027、2028乃至更长远的增长潜力。

The future opportunity is enormous for this organization. Not least because despite who we are and because despite of what we're able to do, we still occupy a tiny fraction of this enormous environment called the U.S. health care marketplace. Still less than double digits of this marketplace do we occupy. In most of our competitive positions, we're very often not the leader, we're often second or third. We are often the insurgent. We like being the insurgent. We like to be the company that wants to try and change and innovate.

对我们而言，未来的机会是巨大的。因为尽管我们有现在的规模、能力和地位，我们在庞大的美国医疗健康市场中所占份额仍然是个位数。在多数竞争领域，我们往往不是老大，而是第二、第三，甚至是“挑战者”。我们喜欢做挑战者，我们希望成为那个愿意尝试、不断创新的公司。

And we see our opportunities to grow across all of our various spectrum of the company, whether that be in our value-based care businesses, in Optum, whether that be in our benefits business, whether that be in our pharmacy business, whether that be in our growing financial services businesses, or in our technology-led businesses. Those 5 growth pillars remain the engines of the organization. And they're the engines because that's where the need is and that's where the scope for growth exists. In almost all of those categories, we have enormous opportunity to continue to grow.

我们在公司旗下的各条业务线上都看到了强劲的增长机会：无论是以价值为导向的医疗服务（value-based care），还是Optum业务板块；无论是福利服务、药房业务，还是我们正在壮大的金融服务与科技驱动型业务。这五大增长支柱仍是联合健康集团的核心驱动力。正因为这些领域存在现实需求、具备扩张空间，我们才有机会在这些领域持续增长。

What we have to do over the next year is adjust to the reality of the new funding environments. And we're ready to do that. We've got through this year. We've got through this year well, although differently. We will get through next year and into a very, very different environment, we believe, for the long-term future of the company.

接下来一年，我们要做的是适应新的资金环境。这一点我们已有充分准备。今年我们已经顺利渡过，虽然方式不同，但成果实在。我们也有信心穿越2025，迎来公司更长远发展的全新环境。

Those external signals that we've absorbed as a sector over the last 2 years really send a couple of unmistakable messages. Number one, people want lower prices. Why would you reduce funding? You want to send a message you want more efficiency, you want more efficiency. You want more simplicity. You listen to the narrative, people complain about complexity. You listen to the policy, they want to spend less money. We need to respond to both of those things.

过去两年，我们这个行业所吸收到的外部信号，其实传达了两个非常清晰的信息：第一，人们希望价格更低。为什么要削减资金？是为了传达“效率更高”的诉求。同时也希望更简洁——人们在表达中抱怨的是系统的复杂性，政策的方向是要花更少的钱。我们必须对这两点都作出回应。

The good news is that's exactly why UnitedHealth Group exists. We exist to try and help improve the health system for everybody. We want to make it work more easily, more smoothly, more intuitively, more transparently. That's exactly what working to do day in and day out.

好消息是，这正是联合健康集团存在的意义：我们致力于改善全民健康体系，让它更高效、更流畅、更直观、更透明。这就是我们每天都在做的事。

We're living in the era of AI, if you haven't noticed. And if we took the greatest AI machine that could possibly exist, and maybe we're 10 years away from that day where that machine exists, and you asked it to design the American Health system, even AI wouldn't design the health system we have today.

我们已经进入人工智能时代，如果你还没注意到的话。而即便我们假设有一台终极AI机器存在——也许再过十年我们就能拥有它——让它来设计美国的医疗体系，恐怕它也不会设计出我们今天所拥有的这套系统。

In no way you would design something as complicated and as contradictory and as difficult to navigate as the system we all find ourselves in today. Because nobody designed it, it simply evolved.

绝不可能有人会主动设计出像我们今天所处的这套医疗体系那样复杂、矛盾重重、难以理解的结构。因为它根本不是设计出来的，而是在历史演变中自然形成的。

And we're now in a situation where we're all trying to strive to deliver better patient experience, higher-quality outcomes, lower cost outcomes, greater transparency, greater predictability, from within a thicket of a system of regulation and complexity which none of us designed, we all have to figure out how to decode. And that's what we're doing at UnitedHealth Group.

而现在，我们却必须在这样一套错综复杂、规则繁多、并非人为规划的系统中努力追求：更好的患者体验、更高质量的医疗结果、更低的成本、更强的透明度和更高的可预测性。我们所有人都需要“破译”这套系统。而这，正是联合健康集团正在做的事情。

这个行业的冲突是天生的。

Now to do that, in reality, you have to have access to a lot of different capabilities. If you are in the business of trying to improve health care for everybody, not just for a small subset, not just for the people in your town or village, but for everybody, then the need to have access to broad sets of capabilities, where you are able to start to rethink that thicket of complexity, where you're able to rethink alignment of incentives:

而要实现这一点，实际上你必须掌握多种能力。如果你的目标是改善全民医疗服务，而不仅仅是服务一小部分人、某个城镇或某个社区的人群，那么你就必须具备广泛的系统性能力，能够重新审视这套复杂机制，并重新构建激励结构：

How you get payers and providers in step through value-based care, how you think about how you might use data to understand how to manage pharmaceutical price negotiation so you can bring down those drug prices for patients across the country.

比如，如何通过“价值导向医疗”（value-based care）让支付方和医疗提供方步调一致；如何利用数据来优化药品价格谈判，从而真正为全美患者降低药价。

How you can use data and digital technologies to create new apps and new access, so on a phone, any consumer is able to know immediately where the very best place to go get their medicine or their treatment is, whether on or off benefit.

又比如，如何用数据和数字技术开发新的应用和入口，让消费者通过手机就能立刻知道，无论是否在保险福利范围内，哪里是获取所需药品或治疗的最佳地点。

Those things, you don't just do on a Friday afternoon in the shed in the garden, those are significant industrial innovation environments that we are able to develop.

这些事可不是“周五下午在花园棚子里”就能随便想出来的，它们需要的是高度专业化的产业级创新能力。而我们正在打造的，正是这样的能力平台。

The future of U.S. health care requires that simplification, that consumerization. It requires us to find ways to take cost out.

美国医疗体系的未来，亟需“简化”和“以消费者为中心”的转型。它需要我们找到真正有效的方式，把不必要的成本从系统中剔除。

It can only be done by bringing together many different elements of the system to think differently, to think in a more aligned way, to put the patient at the center of every decision; to make sure we're focused on the outcome, the clinical outcome, the experiential outcome and the financial outcome.

要实现这一点，必须整合系统内的各个要素，用一种全新的思维方式、更协同的视角来重新出发。把“患者”放在每一个决策的中心，关注三重结果：临床效果、患者体验和经济负担。

That's what we're driving towards in this organization. And it's why we believe those 5 growth pillars: value-based care, benefits business, the pharmacy business, financial services and technology-led businesses, are so critical to all of this. Within all of those businesses are the componentry to reimagine American health care.

这就是我们组织正在全力以赴推动的方向。也正因为如此，我们认为那“五大增长支柱”——价值导向医疗、福利业务、药房业务、金融服务业务和科技驱动业务——对于实现这一目标至关重要。在这些板块中，蕴藏着重塑美国医疗体系的全部“关键部件”。

And people need and they want that. You only have to walk into a room with 5 people to hear 4 stories of frustration. I couldn't find a doctor. I didn't know where to go. It's too difficult to understand.

而人们确实“需要”并“渴望”这些改变。你只要走进一个房间，里面有五个人，可能就会听到四个关于医疗系统的抱怨：我找不到医生、不知道该去哪儿、流程太复杂难懂。

And of course, we hear it from policymakers through the various decisions we've seen over the last couple of years.

当然，这些声音我们也在过去几年各种政策调整中，从政策制定者那里听到了。

During today, you're going to hear in the seminars a lot more about those 5 growth pillars. And I really encourage you, those of you who are able to attend those seminars, to take advantage of the Q&A sessions where you'll get the chance to meet about 50 or 60 on of our senior executives and physicians and clinicians from across UnitedHealth Group. Please take advantage of the opportunity to get to know them and to ask them questions about how they see the journey and the mission that we're on.

今天的专题研讨会将会深入介绍那五大增长支柱。我诚挚鼓励大家，特别是有机会亲自参加研讨会的朋友们，充分利用问答环节。你们将有机会与我们来自UnitedHealth Group的五六十位高管、医生和临床专家面对面交流。请珍惜这个机会，向他们了解我们这段旅程、我们肩负的使命。

But for the next couple of hours, here on this stage, you're going to hear from a smaller group, maybe 14 or 15 people. And we're going to take you a little deeper into progress we're making and where we are on just 3 of the key areas that I've already referred to, but for me, really sit centrally and probably most differentially within our strategy of going forward in this business.

而接下来的几个小时，在这个主舞台上，你们将听到我们更小规模的核心团队的分享，约有14到15人。他们将深入讲解我们在三大重点领域的最新进展。这三个领域我之前已经提过，它们不仅是我们战略的核心，也是我们未来业务差异化的关键所在。

The first is value-based care. The second is our progress in consumer. And the third is how we're leveraging technology and AI to bring to life all of the opportunity that we see in front of us. That's what you're going to see on this stage.

这三个关键领域分别是：第一，价值导向医疗；第二，我们在消费者服务方面的进展；第三，我们如何利用科技和人工智能，将面前的机遇变为现实。接下来你们将在这个舞台上详细了解这三方面内容。

And then we'll have a session of Q&A at the end for all of you have asked -- all of your questions as you wish.

最后，我们还将安排问答环节，欢迎大家尽情提问。

As we go into this next couple of hours. Value-based care, you know that's a key priority for us. It's been an area of great dynamic over the last 2 years. Many companies who have begun to put their toe in the water of value-based care, particularly provider organizations, have been very significantly burned by the rapid and sudden shift in funding dynamic in the marketplace. What we've done is continue to double down on our strategy. You're seeing today another 650,000 lives will transit to Optum Health in fully capitated manner over the next 12 months.

接下来几个小时，我们会深入探讨“价值导向医疗”（Value-based Care）——这是我们最核心的优先事项之一。过去两年，这一领域经历了极大的波动。许多刚开始涉足价值导向医疗的公司，尤其是医疗服务提供方，在市场资金动态的快速、突变式变化中受到了严重冲击。而我们选择的，是继续坚定投入我们的战略。就在今天，你们会看到，又有65万名患者将在未来12个月内以“全额预付”（fully capitated）的方式转入Optum Health的服务体系。

We continue to build out our networks of clinics across the country. We're continuing to refine that model. We continue to refine and modernize our at-home platform. And within those 2 statements, there's a really good insight into how United operates.

我们持续在全国扩展诊所网络，同时不断优化这一模型。我们也在不断改进和现代化我们“居家护理”平台。光是这两句话，就已经能很好地反映出UnitedHealth的运营逻辑。

We introduced models of care or models of work or models of alignment: Value-based care in the clinic; how we might utilize home and community alongside that; how we might meet patients where they really want to be, which is not really in the clinic, but in their home.

我们不仅推出新的诊疗模式、工作模式或协作模式：比如在诊所中实施价值导向医疗；又比如如何将“居家”和“社区”资源与诊所服务协同起来——因为患者真正希望被照护的地方，不是诊所，而是他们自己的家。

But we know at the very beginning, we'll get things wrong. And so those models have to be constantly reiterated and reiterated. You saw in the clinics. We've been doing that for over a decade, and you can see that, that model is now beginning to be truly replicable at scale, at speed, which is why we can absorb this 650,000 patients per year into that new model.

我们也很清楚，在起步阶段我们一定会犯错。所以这些模式必须不断打磨、反复迭代。就像我们的诊所模式——我们已经实践了十多年，现在它终于实现了可复制、可扩展的成熟化。这也正是我们今天能每年容纳65万新患者进入该模式的原因。

And we know those patients love it. They want to be in that environment. They like the focus on prevention. And it's an important way in which they believe and they know they are getting more care and attention. You're going to hear more about that today.

我们也知道患者非常喜欢这种模式。他们希望在这种环境中接受照护，他们喜欢这种强调“预防优先”的服务理念。这种方式让他们真切感受到“被关照、被重视”。今天你们还会听到更多这样的内容。

But as you think about what we do in the home, we're at the beginning of that journey. It's a little bit like the clinics 10 or 12 years ago. We're at the year 1 or 2 of the home journey. We're constantly revising and reforming how we develop that model.

至于“居家医疗”，我们仍处于旅程初期。这有点像我们十几年前刚开始建设诊所网络的时候。居家平台现在相当于是第1到第2年，我们仍在不断调整、打磨、塑造这套模型。

It's almost impossible to reimagine how to intervene in U.S. health care in theory on a piece of paper and then just launch it as a finished product. You have to get in, you have to start working with patients and provider networks and you start to figure out what works and what doesn't work.

你几乎不可能在一张纸上就凭空构思出如何在美国医疗系统中开展干预，然后把它直接推向市场。你必须深入系统，和患者、医疗服务网络一起工作，一点点试出来，什么行得通、什么行不通。

And what you'll see and what you'll hear is the momentum within this organization to relentlessly improve and develop and refine our approach to value-based care.

你们将看到、听到的是我们这个组织内部持续不懈地改进、拓展、优化我们价值导向医疗策略的决心和行动。

Now despite the occasional critics, if you step back, the super strong alignment of opinion leaders, administration and policymakers across the U.S. for the last 20 years says, "Do more value-based care." Four administrations, every CMS over the last 20 years have said the same thing. They argue about how much they should pay for it, but the direction of travel is completely uncontroversial.

尽管偶尔会有一些批评声音，但如果你从宏观上回看，美国过去20年间，舆论领袖、政府行政机构、政策制定者之间，在“推进价值导向医疗”这件事上的共识是非常强的。四届总统任期、历届CMS都在说同一件事。他们可能会就支付金额争论不休，但战略方向是没有任何争议的。

When you think about it from a logic point of view, it's uncontroversial. When you think about it from a medical point of view: Put prevention first, make sure you get ahead of things, make sure you're thinking about the whole person not just a slice of that person, it's uncontroversially sensible. That's why we're so focused on it. You're going to hear a lot more of that. You're going to hear from our physicians. You're going to hear patients. You're going to hear from people who really are part of that world.

从逻辑上看，这没有争议；从医学角度看：“预防优先、提前干预、关注整个人而非某一器官”——这都是显而易见的合理方向。这也正是我们如此专注这一领域的原因。你们将会听到更多这方面的信息：来自我们医生、患者，以及正在实践这一理念的一线人员的声音。

But make no mistake. Again, our ambition in value-based care is undiminished. This is, we believe, the best way to start to address the complexity and the thicket of the environment in which we all find ourselves. It's what gives us that aligning focus.

但请不要误解——我们在“价值导向医疗”方面的雄心从未削弱。我们坚信，这是应对当前复杂医疗生态的最佳方式，也是我们全公司保持聚焦和一致性的关键所在。

Consumer. You'll see a lot of examples of the progress we've been making in consumer, and I couldn't be happier about that. 4 years ago, we marked out that consumer would be a key area of focus for this organization. And I think a lot of people looked a little bit sideways around whether or not UnitedHealth Group could really become more of a consumer organization.

接下来是“消费者”板块。你们会看到我们在消费者端取得的众多成果，这让我感到非常欣慰。四年前，我们就明确提出“消费者将成为公司重点关注领域”。当时还有不少人对此表示怀疑，质疑UnitedHealth Group是否真的能转型为一个以消费者为导向的组织。

We're on the march in that journey. We're not done by any stretch. And maybe we're only just in the first 15% or 20% of that journey. We probably are. But compared to where we were 4 years ago, our responsiveness, our ability to have, to give access to individuals where they want it, typically mobile, in a format where they're able to understand it, we're seeing that reflected in every possible metric.

我们仍在这条旅程上不断前进，绝没有完成。现在可能也只是走到了整个路程的前15%或20%，差不多就是这个水平。但与四年前相比，我们的响应能力、让用户在他们想要的时间和地点——通常是手机端——以他们能理解的方式获取服务的能力，已经显著提升。这种进步已经反映在各种指标上。

We're seeing it in our NPS scores. We're seeing it in our retention scores. We're seeing it in a reduction in the number of people who feel the need to call us because they need to speak to us to understand something. All of that is reflective of significant effective progress in our consumer journey.

我们从客户净推荐值（NPS）中看到了这点，从客户留存率中看到了这点，也从客户“因为不理解而打电话”的需求显著减少中看到了这点。这些都说明，我们在“消费者转型”这条路上取得了实质性成果。

And we will continue to drive very hard on that. That, again, is a forcing influence on simplifying our environment. Even something as trite and as simple as saying we should reduce or eliminate paper in the system forces you to simplify.

我们还会在这个方向上持续推进。这种以消费者为中心的转型，本身也在倒逼我们简化整个系统。哪怕只是提出“减少纸张使用、取消纸质文件”这样看似简单的事情，也在促使我们进行系统性简化。

When you all get your 6-page explanation of benefits document, how many times do you read it? How many of you really understand it? How many of the people out in the real world really take the time to read and understand it? How useful is it versus how complicated is it?

比如你收到那份6页长的《福利说明书》（Explanation of Benefits）时，有多少人真的会仔细读它？有多少人真的看得懂？现实中，又有多少普通人真的有时间和精力去读懂它？它的实用性和复杂性相比，哪个更大？

It's time for us to start to challenge all of that in the world in which we now live, where people expect information to be much more readily available when they want it, where they want it, exactly what we're aiming to do.

是时候对这一切提出质疑了。我们现在生活在一个全新的时代，人们希望信息在他们想要的时候、在他们想要的地方、以他们想要的形式轻松获取——而这正是我们努力实现的目标。

Much of what we're trying to do in value-based care and consumer and, of course, elsewhere in our core benefits business and in our financial service business and in our pharmacy business, is being facilitated by the era in which we happen to live.

我们在价值导向医疗、消费者业务，当然还有核心福利业务、金融服务业务、药房业务等方面所做的很多努力，恰恰是因为我们正处于这样一个时代，它为这一切提供了可能。

So we happen to live in a time where we inherit a complex health system. We happen to live in a moment in time where governments want to reduce funding levels. On the other hand, we happen to live in a moment of extraordinary technological innovation, a moment in time where our ability to do things has never been greater than it is today.

我们身处这样一个时代：一方面，我们继承了一套极其复杂的医疗体系；另一方面，政府又正希望削减资金。但与此同时，我们也刚好处于一个技术飞跃、创新空前的时代，我们能做的事情，比历史上任何时候都更多、更强。

Our ability to actually understand what we have in our hands has never been higher than it is today through technology and, of course, through AI. And we were a very early adopter of AI. We've been working in this space for a long time, and we've been ramping it up very aggressively over the last couple of years.

我们现在对自身所掌握的信息和能力的理解能力，借助技术，尤其是人工智能，达到了前所未有的高度。我们是AI的早期使用者，在这个领域已经耕耘多年，过去两年更是大力加速投入。

It's an area where we are relentlessly investing, and we will continue to do so as we go through the next several years.

我们会在这个领域持续投资，在未来几年也不会停止。

Already, 16,000 engineers at UnitedHealth Group are equipped with generative AI capabilities. 16,000 engineers. In the last 30 days, we've accepted 8.4 million lines of code generated by AI. 24 million lines so far this year, 8.4 million in the last 30 days, it's completely exponential. That is transforming everything we do inside this company.

目前，联合健康集团已有16,000名工程师具备生成式AI能力。仅过去30天，我们就采纳了由AI生成的840万行代码。今年以来总计已达2400万行。这个数字是指数级的增长。AI正在彻底改变公司内部的所有流程。

I would say almost every use case -- and we are now well in excess of 500 deployed use cases, every use case is delivering at least double-digit rate, percentage rates of efficiency in terms of our activity. We're seeing core volumes drop. We're seeing numbers of people needed to undertake basic menial tasks drop. We're seeing our ability to deliver response faster go up.

目前我们部署的AI应用场景已超过500个，几乎每一个都实现了至少两位数的效率提升。我们看到核心处理量在下降、完成重复性工作的人员数量在减少，同时我们的响应速度显著提升。

I'll give you one example, pharmacy prior -- PA, automated PAs for pharmacy. Typical turnaround time 7.5 days. So this is a pharmacy claim comes in, requires a PA, it starts to ping back and forward between the various participants, provider, pharmacy, payer, to get that done. On average, 7.5 days to get that approved. We're now deploying, with health systems, automated PA to do exactly the same thing. 7.5 days, 29 seconds. That is transformational.

举个例子：处方药审批（PA, Prior Authorization）。过去一个药品索赔提交后，需要来回在服务提供方、药房、支付方之间沟通确认，平均耗时7.5天。我们现在和医疗系统合作，使用自动化PA系统来完成同样的流程。审批时间从7.5天缩短到29秒。这是颠覆性的效率飞跃。

That kind of shift we're seeing in business field after business field across our organization. Technology is -- you're going to hear a lot more about this from Sandeep and the team today. Technology is allowing us to streamline administrative efficiency. It's allowing us to bring to consumers information in a format which they can understand and digest, which you could only have dreamed about 2 years ago.

这种改变正持续发生在我们组织的一个又一个业务板块。你们今天还会从Sandeep和他的团队那里听到更多关于这方面的分享。技术正在帮助我们大幅提升行政效率，也让我们能以前所未有的方式、以消费者可理解的形式向他们传递关键信息——两年前这还只是梦想。

It's allowing us to take speed as a real advantage into this marketplace. And it's allowing us for the very, very first time to start to be able to understand the enormous amount of information we have as a company.

技术赋予我们“速度”作为竞争优势。更重要的是，它首次真正让我们有能力理解公司掌握的大量信息。

What does that mean, for the very first time? Well, let me unpack that a little bit. So think about data, and I'll give you a few very simple examples. Think about data. The vast majority of all the data that we deal with is unstructured data. It's free text. It's contracts. It's endless pages of information. It's not just tables of numbers. Tables of numbers are easier, they've been easy for years. The free text is where all the value really sits.

“首次真正理解信息”是什么意思？让我解释一下。我们处理的数据，大部分是“非结构化”的数据，比如自由文本、合同文件、无数页的文字信息，而不仅仅是数字表格。数字表格早就可以轻松处理了，但真正有价值的内容往往藏在自由文本中。

对技术有准确的理解。

It's almost impossible, up until now, to be able to really systematize your access to that information. What that means is you don't really know what's in there, or you have to hire a lot of people with very high levels of training to interrogate dense information to try and get the truth out. What that leads to is mistakes, because you pull information out of dense text, it's not quite right, it's maybe transcribed wrong, it creates an appeal. Boom, off we go down the little journey of appeals and all of the cost that, that associates.

直到最近，我们几乎无法真正系统性地访问这些信息。这意味着我们其实并不知道数据中到底包含什么，或者必须雇佣大量高素质人员，深入分析繁杂文本，试图提取出准确的信息。但这样容易出错——从复杂文档中提取的信息可能并不准确，甚至在转录过程中就发生了错误，最终导致申诉流程被触发，然后是伴随而来的大量额外成本。

AI allows us to access all of that information. Even as simple as, what are your contractual rights to the information that you are looking at? What can you or can't you do with that information? That's all buried in thousands of pages of contracts which were written years ago when those data sets were brought into the company. AI can access that information instantly. What does that do? It unlocks your capacity to make your data labeled, to be able to move it to be able to access it and to work it.

而人工智能可以帮助我们访问所有这些信息。哪怕是最基本的问题，比如你对某份信息是否拥有合同上的使用权、你能不能使用这些数据——这些都埋藏在公司多年前签署的上千页合同中。AI可以立刻访问这些内容。这就解锁了我们对数据的“标注、迁移、调用与处理”能力。

So AI has utility far beyond the administrative efficiency, it unlocks data across the organization, and it does 2 other things. It allows us to fundamentally start to think about how we can help every clinician have the best possible advice and information every time they make a decision or a choice. Not for them, simply to advise them. And then secondarily, AI allows us to make sure that across the organization, we are able to see information and be able to connect dots faster than we could possibly have imagined in the past. All of that allows us to move at speed and pace across the business.

所以，AI的作用远远不止提升行政效率。它还让整个组织的数据资源真正“活”了起来，同时还实现了两项关键突破：第一，我们可以开始思考，如何让每一位临床医生在每一次决策时，都获得最优质的信息和建议（不是替代，而是辅助）；第二，AI让我们全组织能更快地获取信息、关联信息——远超以往。这一切都极大提升了业务的推进速度。

So what you'll see over the next couple of hours is that value-based care agenda, that consumer agenda and the way in which technology and AI is being used to bring that forward. We think that the combination of all of that, alongside our other elements of the growth pillars, are truly differentiating in this marketplace.

接下来的几小时里，你们将看到我们的“价值导向医疗”战略、“消费者战略”，以及我们如何通过技术和AI推动这些战略落地。我们相信，这三者与我们其他增长支柱的结合，是我们在市场中真正的差异化所在。

And one of the great attributes of UnitedHealth Group for the last 40 years has been, when it figures out a way to do something well, it is unparalleled in its ability to bring it to the marketplace. It's unparalleled in its ability to scale a good idea.

UnitedHealth Group过去40年来的一大优势就在于：一旦我们找到了行之有效的做法，我们的市场化能力、规模化推广能力是无与伦比的。

Just look at the UCard from 2 or 3 years ago. Look at Surest right now in terms of the pace of adoption of that new benefits product. Think about how we can implement things like that automated PA idea that I just talked to you about. Think about what we can do as we get access to information in a more productive way than we've ever done before. That scaling dynamic allows us to truly contribute to improving the system across the whole environment.

看看两三年前我们推出的UCard，再看看现在Surest这款新型福利产品的采用速度；想想我们如何落地刚才提到的处方审批自动化（PA）；想想我们如何以前所未有的方式提升数据访问效率——这种“快速规模化”的能力让我们真正有机会改善整个系统。

Culture of this organization is really at the heart of everything. It's restless. It's compassionate. It's performance-driven. And over the last couple of years, we've proven that we're tenacious and we're resilient. And we demonstrate that our ambition is undimmed.

我们组织的文化才是一切的核心：不安于现状、有同理心、注重绩效。过去几年，我们证明了我们的坚韧与韧性，也证明了我们的雄心从未减退。

A lot of people say about companies like United Health Group: "they can't innovate." People have written papers saying that the established health care companies will never be able to be a consumer company in the way that maybe start-up consumer companies can be. People write that successful companies will never self-change their business models, it will always be up to somebody else to change it for them.

很多人曾经说，像UnitedHealth Group这样的公司“不能创新”。有人写论文说，大型医疗机构永远无法像初创企业那样转型为真正的消费者公司。也有人说，成功的大企业永远不会自己变革商业模式，总是得靠外部力量来逼迫他们改变。

People see things like that about this company. But when you talk to the 400,000 people who work in this company, they say words like can't and won't are not in the dictionary. Words like will and can are in the dictionary.

人们对这家公司也说过类似的评判。但当你真正与这家公司40万名员工接触时，你会发现：“不能”、“不会”从不出现在他们的字典里。他们的字典里只有“可以”、“我们会”。

And what you're going to see today is an organization that, even in environments where funding levels change, policy can be a little unpredictable. We have a clear North Star around what we're trying to do. We are going to improve health care for every individual who wants it, and we're going to improve the health system.

今天你们将看到的，是这样一个组织：即使面对资金压力、政策波动，我们依然拥有清晰的“北极星”——我们致力于改善每一个需要帮助的人的医疗体验，也致力于改善整个健康系统。

And we're going to do it through the deployment of the capabilities we are fortunate enough to be custodians of, with the skills of the most brilliant people in health care, some of whom you're going to see today.

我们会依靠手中所掌握的强大能力，以及我们有幸拥有的一流医疗人才来实现这一点——其中有些人你今天就会见到。

And we're going to demonstrate once again that when the going gets tough, the tough get going. Thank you very much.

我们将再次证明：越是艰难时刻，越显英雄本色。谢谢大家！

Heather Cianfrocco – EVP of Governance, Compliance & Information Security

We believe everyone deserves a health care experience like Mirna, and that's why UnitedHealth Group is committed to making value-based care a reality for every patient and provider in this country. We believe in value-based care because it works. We surround patients with a personalized primary care team that helps them stay on top of their screenings, ensures they're taking their medication and coordinates and consults with high-quality specialists to better manage chronic disease.

Heather Cianfrocco – 治理、合规与信息安全执行副总裁

我们相信每个人都应该享有像Mirna那样的医疗体验，这正是为什么UnitedHealth Group致力于将“价值导向医疗”（Value-based Care）推广到全美每一位患者和医疗服务者的原因。我们坚信价值导向医疗的有效性：我们为患者配备个性化的初级保健团队，帮助他们按时筛查、规范服药，并协调高水平专家参与慢性病的管理。

Our teams detect symptoms early, intervene before problems arise, engage through the care transitions and help people stay out of the hospital and live healthier lives. You'll hear many examples today from the team of how this approach leads to better experiences and outcomes for patients with more accessible coordinated primary care, a more rewarding experience for providers with better tools and information to treat their patients and ultimately a higher-performing health system.

我们的团队能够更早发现症状，在问题发生前就进行干预，并贯穿整个治疗过程进行陪护，帮助人们避免住院、过上更健康的生活。今天你们将听到我们团队带来的许多例子，这些例子表明：这种模式能带来更便捷、协调性更强的初级照护，让患者拥有更好的体验和结果；也能为医疗提供者带来更有价值的职业回报，因为他们拥有更好的工具和信息来治疗病人；最终，这一切都促成了一个绩效更强的健康系统。

The benefits of value-based care are real, and this is why it remains the centerpiece of America's long-time health policy. The seeds were planted more than 20 years ago. At the time, access to primary care was limited. Rates of chronic disease were on the rise. The first wave of Baby Boomers were about to begin aging into Medicare. Health care costs were outpacing inflation. And the prevailing fee-for-service system left providers with little choice but to do more tests, schedule more visits and administer more care just to stay afloat.

价值导向医疗的好处是真实的，这也是为什么它始终是美国长期医疗政策的核心。早在20多年前，这一理念就已开始萌芽。当时，初级医疗资源有限，慢性病发病率不断攀升，第一批“婴儿潮一代”正进入Medicare体系，医疗成本远远高于通胀速度。而按服务计费（Fee-for-Service）的主流模式迫使医生不得不增加检查、安排更多门诊、实施更多治疗来维持运营。

It was clear to everyone that health care was headed in the wrong direction. Health care policy experts agreed that value, not volume; and quality, not quantity, was the answer. And they set in motion a decades-long bipartisan effort to realign incentives to encourage and reward physicians for delivering higher-quality care at lower cost. And at the same time, CMS began creating programs and incentives to spur innovation. And this has been reinforced multiple times over multiple administrations.

当时大家都意识到，医疗体系正朝着错误的方向前进。政策专家一致认为：关键不在于服务“量”的多少，而是“质”的优劣；追求的是“价值”，而不是“数量”。于是，他们推动了一个历时数十年、跨党派支持的变革进程：重塑激励机制，鼓励并奖励医生以更低成本提供更高质量的治疗。同时，CMS也开始设立各种项目和激励机制，推动创新——历届政府多次重申并加强了这一方向。

Policymakers have tested dozens of value-based models, all in service of their ambitious goal to have every person served by Medicare and the vast majority of Medicaid patients participating in accountable care models by 2030. That's more than 150 million people, yet we think the opportunity is so much greater.

政策制定者已经测试了数十种不同的价值导向医疗模型，目标是在2030年前让所有Medicare患者和绝大多数Medicaid患者纳入“责任医疗”（Accountable Care）模式。这涉及超过1.5亿人，但我们认为这个机会还远不止于此。

Because of the success of Medicare Advantage, value-based care continues to gain substantial traction among seniors and people with complex care needs, delivering far superior patient outcomes at a significantly lower cost than what it costs taxpayers to provide fee-for-service Medicare.

得益于Medicare Advantage计划的成功，价值导向医疗在老年人和高复杂度患者群体中越来越被认可。相较于按服务计费的传统Medicare，这一模式以显著更低的成本，带来了远远更优的患者健康结果，对纳税人而言也是巨大利好。

When I talk to employers, pick a sector, any size, they all want the same thing: Increased access to high-quality primary, behavioral, and pharmacy care for their employees, but at a lower cost to both the employer and the employee. That's why the number of people we serve in commercial value-based plans has grown nearly 50% over the past 2 years.

无论我与哪个行业、任何规模的雇主交流，他们都提出同一个需求：希望员工能更容易获得高质量的初级医疗、心理健康服务和药房支持，但前提是这对雇主和员工来说都是更低的成本。正因如此，过去两年中，我们在商业价值导向医疗计划中服务的人数增长了近50%。

Value-based care's promise appeals to what all people want from health care: Patients who are seeking more information, coordination and high-quality care teams; providers who are striving for a rewarding culture and team-based approach to practicing medicine; and payers, including taxpayers, who are demanding improved outcomes and value. And we will feel the difference as more and more of our health system transitions to value-based care.

价值导向医疗的愿景正好契合了人们对医疗的根本期待：患者希望获得更多信息、更好的协作和更高素质的照护团队；医生期盼的是更有价值、更具协作文化的行医环境；而支付方——包括纳税人——则希望看到更好的医疗结果与性价比。随着我们整个系统越来越多地向价值导向医疗过渡，所有人都将切实感受到这一变化。

As you've seen from this stage before, our premier care delivery organizations are delivering value-based care at scale in the commercial market. We've expanded our commercial value-based offerings in Texas, Southern California, Nevada and markets in the Northeast, too. Over the next decade, you will see our value-based care efforts accelerate and help this enterprise grow.

正如各位此前在这个舞台上所看到的，我们顶尖的医疗服务组织正在商业市场上大规模推进价值导向医疗。我们已将商业价值导向医疗产品拓展至德州、南加州、内华达州以及美国东北部多个市场。未来十年，我们在该领域的努力将进一步加速，并助力整个企业持续增长。

Today, Optum works with more than 100 health plans. We serve more than 100 million consumers, offering integrated care and increasingly care delivered in the home. While seniors in Medicare constitute the largest proportion of people in our most comprehensive models, Optum also serves hundreds of thousands of people across our commercial, Medicaid, exchange and special needs plans. And these numbers will continue to rise as our capabilities and resulting impact grows and as we continue to share our expertise with partners across the system.

目前，Optum已与逾100家健康保险计划合作，服务超过1亿名消费者，提供整合式医疗服务，并日益扩展至“居家照护”领域。在我们最全面的医疗模式中，Medicare老年患者占据最大比例，但Optum也为数十万商业医保、Medicaid、医保交易所计划及特殊需求人群提供服务。随着我们的能力和影响力不断提升，并持续与系统内合作伙伴分享专业经验，这一服务规模还将继续扩大。

Value-based care is an enterprise priority. It's a UnitedHealth Group ambition grounded in our ability to create connections across care delivery, technology, pharmacy, benefits and financial services, wrapping it all around the patient and the provider.

价值导向医疗是整个企业的核心战略优先事项。这是UnitedHealth Group的共同愿景，基于我们在医疗服务、技术、药房、福利及金融服务等多个环节的协同整合能力，能够真正实现以患者和医生为中心的全方位支持。

Having these capabilities under one roof with the ability to tackle the complexities of the health system at scale is essential to improving health care in this country.

将所有这些能力集中在一个组织体系之下，并具备应对大规模复杂医疗系统挑战的能力，这是提升全美医疗质量的关键所在。

This morning, we're going to update you on our journey and demonstrate why we are confident in our ability to deliver on the growth commitments that we have made to you. And we will begin with our care providers: Primary care physicians, specialists, surgeons, who practice value-based care everyday in cities across the U.S., from Boston and L.A. to Seattle and Houston.

今天上午我们将向大家汇报我们的进展，并展示我们为何有信心兑现此前对你们作出的增长承诺。我们将从前线医疗人员开始讲起——从波士顿到洛杉矶，从西雅图到休斯顿，无数初级保健医生、专科医生和外科医生每天都在全国各地践行价值导向医疗理念。

Amar Desai – CEO of Optum Health

Those are just a few of my colleagues who, together, are serving 4.7 million people in value-based models, more than twice as many as we did 3 years ago, yet this is just a fraction of the nearly 340 million Americans today. We're intent on serving more people in our integrated care models by consistently delivering differentiated clinical quality through evidence-based medicine, proactive patient engagement and deeply coordinated care, and unifying our operating infrastructure and systems to serve more patients across more geographies and plan partners.

Amar Desai – Optum Health 首席执行官

刚才提到的只是我部分同事的例子，他们正为470万人提供价值导向医疗服务，这个数字是三年前的两倍多，但在美国3.4亿人口中仍只是极小一部分。我们决心通过循证医学、积极的患者参与、深度协同的照护体系，不断提升差异化临床质量，并统一运营架构和系统，扩展我们的整合医疗模式，从而服务更多患者，覆盖更多地区和合作保险计划。

As a physician, I've seen firsthand how value-based care leads to better patient outcomes through a team-based approach, led by primary care doctors and supported by multidisciplinary care teams. Together, they keep patients healthy and deliver high clinical quality as reflected through benchmarks like Star ratings.

作为一名医生，我亲眼见证了价值导向医疗如何通过“以初级保健医生为主导、多学科团队协作”的方式，带来更优的患者健康结果。这些团队共同致力于帮助患者维持健康，并提供高质量的临床照护，具体体现在诸如Star评级等关键指标上。

Our model starts with early engagement to deliver the right preventive care, quickly detect conditions and delay disease progression. In fact, nearly 3/4 of our in-home visits result in a primary care visit within 90 days. Additionally, nearly 3/4 of Medicare Advantage patients in our value-based models were screened for breast cancer and colorectal cancer. And more than 90% of our Medicare Advantage patients with hypertension adhere to medication recommendations.

我们的模式从“早期接触”开始，提供精准的预防照护，快速发现疾病，延缓病程发展。事实上，我们近四分之三的居家拜访在90天内促成了一次初级保健就诊；同时，在我们的价值导向模型中，近四分之三的Medicare Advantage患者接受了乳腺癌与结直肠癌筛查；而90%以上的高血压患者遵循了用药建议。

Our care programs are tailored to unique patient needs and result in better chronic disease management. For patients with diabetes, uncontrolled hemoglobin A1C levels can lead to severe complications. But with a dedicated care team to help manage diet, lifestyle and medications, 70% of diabetic patients under our control -- under our care have control of their A1C levels, an 11-point increase year-over-year.

我们的照护计划因人而异，定制化设计，显著提升慢性病管理效果。以糖尿病为例，若血糖水平（A1C）控制不当，极易诱发严重并发症。但在我们团队提供饮食、生活方式和药物管理支持下，70%的糖尿病患者实现了A1C控制水平，同比增长11个百分点。

Our longitudinal data empowers care teams to deliver timely, targeted care, improving patient outcomes and experiences and reducing costly and unnecessary treatments that arise when those conditions are not addressed. As a result, Medicare Advantage patients in Optum Health are 10% less likely to be hospitalized for stroke or heart attack. Over the past 2 years alone, our early engagement, timely clinical interventions and affordability programs have reduced unnecessary medical cost by more than $1 billion, and we see significantly more opportunity ahead.

我们的“纵向数据”使照护团队能及时、精准地提供干预，提高健康结果与体验，同时避免因延误治疗而产生的高昂成本与不必要程序。以此成果为例，Optum Health的Medicare Advantage患者因中风或心脏病住院的几率降低了10%。仅过去两年，我们通过早期干预、及时诊疗和成本管控项目，已经减少了超10亿美元的不必要医疗支出，未来还有巨大的潜力等待挖掘。

寿命拉长后整个生命周期的医疗费用是不是更多？

Now to deliver exceptional care and further enhance clinician collaboration, like you saw in the video, we're advancing our infrastructure, systems and data supporting care delivery. For example, our unified care data systems will include 100% of our value-based care patients by the end of the year. This is up from just 18% in 2023. This gives us a comprehensive view of every patient, unifying data from multiple sources that allow for earlier signaling and actionable insights at the point of care.

为了提供卓越照护、进一步提升临床协作（正如你们在视频中看到的），我们正在升级支持照护交付的基础设施、系统和数据平台。例如，我们的统一照护数据系统将在今年年底覆盖100%的价值导向医疗患者，而这一比例在2023年还仅为18%。这样，我们可以整合来自多源的信息，实现对每位患者的全面洞察，从而在照护现场更早地识别问题并提供可执行的临床洞见。

And our practice management systems are delivering a more cohesive, consistent experience for our care teams and patients. Just one example of this effort is with our electronic medical records. By the end of the year, more than 80% of our employed providers will be using 1 of 3 preferred EMRs, down from 18 less than 3 years ago.

我们的运营管理系统也正在为照护团队和患者提供更连贯一致的体验。以电子病历（EMR）系统为例：到今年底，超过80%的签约医疗提供者将使用我们指定的3套首选EMR之一，而三年前这一数字还是18套系统。

We're also taking this integrated approach across claims, provider and patient services and referral management, enhancing the scalability and flexibility to support a broad range of value-based relationships across Medicare, Medicaid and commercial plans.

我们还将这种整合模式推广至理赔管理、医疗服务、患者服务和转诊管理等领域，进一步提升可扩展性和灵活性，以支撑覆盖Medicare、Medicaid和商业保险的广泛价值导向关系。

In just 2 years, this work has already generated efficiencies, resulting in nearly $1 billion. And importantly, it uniquely positions Optum to serve more value-based care patients well into the future. And this is just the beginning. These focus areas, our relentless pursuit of clinical quality and a more unified infrastructure, are foundational to our future growth, strongly position us to expand value-based care to more people and gives us confidence to deliver on our long-term margin target of 8% to 10%.

短短两年内，这些举措已带来接近10亿美元的效率提升成果。更重要的是，它为Optum未来服务更多价值导向医疗患者打下了独一无二的基础。而这只是起点。我们在上述关键领域的投入、对临床质量的执着追求以及基础设施的一体化，构成了未来增长的基石，让我们有信心将价值导向医疗拓展至更广泛人群，并实现长期8%至10%的利润率目标。

Our physicians and care teams are doing this work every day, providing care to millions of people in local communities across America. And more than ever, that care is occurring in the home.

我们的医生与照护团队每天都在全国各地社区中践行这一工作，为数百万人提供服务。而且比以往任何时候都更多，这些服务正发生在患者的家中。

Alexander Billioux

Today, there are nearly 13 million people who are dually eligible for Medicare and Medicaid. As an internist and Chief Medical Officer for UnitedHealthcare's Government Programs, I can tell you this is a group struggling with some extraordinary challenges. Nearly half of this population are not in good health by any clinical standard, about half needs support with mental health and about 1 in 4 have been diagnosed with at least 5 or more chronic diseases.

Alexander Billioux

如今，全美大约有1300万人同时符合Medicare与Medicaid双重资格。作为UnitedHealthcare政府项目的首席医疗官，也是一名内科医生，我可以说这是一个面临极大挑战的群体。按临床标准来看，近一半的人身体状况不佳；约一半的人需要心理健康支持；每四人中就有一人患有至少五种或更多慢性病。

最不缺需求、问题、冲突的领域。

Exacerbating these challenges are widespread disparities in access: Access to traditional primary care, access to mental health, access to pharmacy care; and those other critical but less obvious elements for a healthy life, nutritious foods, stable housing, reliable transportation. Given the depth of the needs and historically high rates of hospitalization, the average cost of caring for people in these vulnerable populations is more than twice what is spent to care for people on average.

这些挑战因“医疗服务可及性的巨大差异”而更加严峻：基础医疗、心理健康服务、药房照护的可得性都存在严重问题。除此之外，还有一些看似不那么显眼但同样关键的健康因素，比如营养食物、稳定住房、可靠交通等。这一人群的需求深度，加之住院率长期偏高，使得照护他们的平均成本是普通人群的两倍以上。

Nationally, participation in special needs plans has more than doubled during the last 5 years, and we expect it will only continue to grow. Less than half of those eligible for a special need plan are currently enrolled in one. And these are just a few of the many reasons where our partners in government, at CMS and across state Medicaid agencies, are hungry for innovation.

全国范围内，在过去5年中，特殊需求计划（Special Needs Plans，SNP）的参保人数翻了一倍还多，我们预计这个趋势将持续增长。目前，符合SNP资格的人群中，只有不到一半真正参与了这类计划。这只是我们看到的许多问题之一，也正是为什么CMS及各州Medicaid机构等政府合作方如此渴望推动创新。

And home is becoming an optimal setting for delivering value-based care, engaging people who are most in need and otherwise have limited access to care in the comfort and safety of their homes. Optum's home care models are designed to do just that, keeping patients healthy and out of the hospital, and surrounded by a team of physicians, nurse practitioners, social workers, pharmacists and others who are all working to ensure no one slips through the cracks.

而“居家环境”正日益成为价值导向医疗的理想场景——在舒适、安全的家中接触并照护那些最有需要、但通常无法获得传统医疗资源的人群。Optum的居家医疗模式正是为此而设，目标是帮助患者维持健康、避免住院，同时由医生、执业护士、社工、药剂师等组成的专业团队全方位守护，确保没有一个人被系统遗漏。

Let's take a look at how our colleagues are bringing this model to life for those in special needs plans in Georgia.

现在，让我们看看我们的同事是如何在乔治亚州将这一模式落实到特殊需求计划中的具体实践。

Joshua Proffitt – CEO & President

This year, clinicians like Stacy and Daphne will visit millions of people like Antonio. As a result of our team-based care model, our most challenged patients, people contending with multiple chronic conditions and in need of comprehensive support, are 18% less likely to be admitted to the hospital and 14% less likely to make an avoidable visit to the ER.

Joshua Proffitt – 首席执行官兼总裁

今年，像Stacy和Daphne这样的临床医生将走进成百万像Antonio这样的患者家中。在我们的团队式照护模式下，最困难的患者——那些面临多种慢性病、亟需综合支持的人群——住院风险降低了18%，而避免前往急诊室的比例提升了14%。

Increasingly, we're helping people manage their urgent care needs from home. Clinicians and our always-on call center filled nearly 7,500 of these calls each month. And in the cases that can't be resolved over the phone, a clinician will go to the patient's home to address acute issues and administer medications. Nearly 80% of these cases avoid hospitalization. And we expect to expand this capability to a broader mix of patients in the years ahead.

我们正越来越多地帮助人们在家中处理紧急医疗需求。临床医生与全天候运营的呼叫中心每月接听这类电话近7,500次。如遇电话难以解决的问题，我们会派出医生亲自上门处理急性症状并提供用药服务。近80%的此类情况都成功避免了住院。未来几年，我们预计将把这一服务能力拓展至更多类型的患者。

For patients who need hospital care, our care transitions program has referred approximately 124,000 patients in 2024 to home and community programs for further post-discharge support. This ability to smoothly and effectively coordinate care across different settings while minimizing disruption for patients and providers, truly does set us apart.

对于需要住院治疗的患者，我们的“照护过渡项目”在2024年已将约124,000名患者转介至居家及社区项目，提供出院后的后续支持。我们能在不同照护场景之间平稳、有效地协调资源，同时最大程度减少患者与医护人员的干扰，这正是我们的独特之处。

But what is unique and essential to this value-based care model is that no interaction occurs in isolation. Primary care physicians and their care teams are situated in the center of it all. They have visibility to what's going on in their patients' lives, which enables them to develop care plans for a person's comprehensive needs, physical, mental and social, regardless of the care setting.

而这一价值导向医疗模式真正独特且核心的地方在于——没有任何一次医患接触是孤立发生的。初级保健医生及其照护团队始终处于整个系统的中心位置，全面了解患者生活的实际情况，从而能够无论照护发生在哪个场景，都制定涵盖身体、心理与社会需求的综合照护方案。

Without question, there is still so much work to be done. Home care remains deeply fragmented, disconnected and too difficult to navigate. It accounts for about $150 billion of the health sector today, and we expect this figure to climb substantially by the end of the decade. By then, 20% of the U.S. population will be 65 or older. More than 9 million will be over the age of 85.

毫无疑问，我们还有很多工作要做。目前的居家照护领域依然高度碎片化、缺乏衔接，且难以高效协调。如今它在医疗支出中已占据约1500亿美元，我们预计到本十年末，这一数字将大幅上升。届时，美国将有20%的人口年满65岁以上，超过900万人将超过85岁。

People are living longer. They have a lot of needs, yet they all want the same thing: To stay in their homes with their loved ones and enjoy their lives. And that's why we're determined to get this right, connecting the services, experiences and support people need and staying right there at their side every step of the way.

人们活得更长，需求也更多，但他们都渴望同一件事：留在家中，与所爱之人一起，享受生活。正因如此，我们决心把这件事做好——将所有所需服务、体验与支持真正连接起来，在他们人生的每一步都守在身边。

Heather Cianfrocco – EVP of Governance, Compliance & Information Security

Whether it's care delivered in the home or in a clinic, providers are looking for a partner to help them adopt their own value-based care models. Increasingly, they're turning to UnitedHealth Group's provider solutions, including our advanced clinical decision support tools. These tools help providers follow the most up-to-date standard of care and quickly identify at-risk patients, offering data-driven insights and personalized treatment plans.

Heather Cianfrocco – 治理、合规与信息安全执行副总裁

无论是居家照护还是诊所治疗，医疗服务提供者都在寻求合作伙伴，以推进自身的价值导向医疗模式。现在，越来越多的他们选择UnitedHealth Group的“提供者解决方案”，其中包括我们的先进临床决策支持工具。这些工具帮助医生依据最新治疗标准快速识别高风险患者，提供数据驱动的洞察和个性化治疗方案。

Our suite of technology and clinical solutions is helping improve quality at the point of care. It's managing risk and population health and more easily tracking outcomes. And all in, our clinical decision support tools will help close approximately 25 million gaps in care just this year.

我们的一整套技术与临床解决方案正在帮助提升“照护现场”的服务质量，实现风险控制与群体健康管理，并更轻松地追踪治疗成效。仅在今年，我们的临床决策支持工具就将帮助弥合大约2,500万个医疗服务缺口。

While much of this work is in early stages, our tools are positively impacting people right at the point of care. Dr. McKinley Glover is a physician on our innovation team, and he's here with us to show how our clinical support tools are helping providers prioritize patient engagement and improve outcomes. So Dr. Glover, welcome.

虽然这项工作仍处于早期阶段，但我们的工具已在照护现场产生了积极影响。McKinley Glover医生是我们创新团队的一员，今天他也在现场，将向大家展示我们的临床支持工具是如何帮助医疗提供者提升患者参与度、改善治疗效果的。欢迎你，Glover医生。

McKinley Glover

Thanks, Heather.

谢谢你，Heather。

Heather Cianfrocco – EVP of Governance, Compliance & Information Security

Okay. So I want to start with some background. Trained radiologist, tell us a little bit about your path to Optum.

Heather Cianfrocco – 治理、合规与信息安全执行副总裁

好，我们先从你的背景谈起。你是一位受过专业训练的放射科医生，可以简单介绍一下你是如何来到Optum的吗？

McKinley Glover

Thanks. So radiologists, we love using cool and innovative technology like MRIs and CAT scans to make diagnoses, to help our physician colleagues make the best treatment decisions for their patients.

McKinley Glover

谢谢。作为放射科医生，我们非常喜欢使用诸如MRI（核磁共振）和CT扫描等酷炫而创新的技术来做出诊断，协助临床医生同仁为他们的患者制定最佳治疗决策。

Throughout my career, I've had the privilege of working with physicians across specialties, geographies and practice types. And one unifying theme is that we all need better tools to do what we are ultimately called to do in medicine, which is take better care of our patients.

在我的职业生涯中，我有幸与来自不同专科、地域及执业模式的医生合作过。有一点是大家的共识——我们都需要更好的工具来完成医学赋予我们的根本使命：更好地照顾我们的病人。

Heather Cianfrocco

So speaking of cool tools, talk a little bit about Optum's clinical decision support tools and how they can help support physician practices.

Heather Cianfrocco

说到“酷工具”，请你谈谈Optum的临床决策支持工具，这些工具是如何帮助医生执业的？

McKinley Glover

So first, what is clinical decision support? It's tools that provide the right information and knowledge at the right time via the right channel, that enable our care teams to make the best evidence-based and personalized decisions for their patients.

McKinley Glover

首先，什么是“临床决策支持”？它是通过恰当的渠道，在正确的时间为医护团队提供正确的信息与知识，使其能为患者做出最佳的、基于循证医学和个性化的决策的工具。

So regardless of where practices are on their VBC journey, there are a couple of challenges that are facing all of us. So the first is patients are increasingly clinically complex with multiple comorbid conditions. Next, the amount of clinical information and knowledge is increasing at an exponential pace. And third is the number of therapeutic options has expanded significantly. For example, the FDA has approved over 500 new drugs in the last 10 years and the total drugs available now is over 20,000.

无论一家机构目前在价值导向医疗（VBC）路径上处于哪个阶段，大家都面临几个共同挑战：第一，患者的临床状况日益复杂，往往合并多种疾病；第二，医学知识量正以指数级增长；第三，治疗选择显著增加——例如，FDA在过去十年内已批准了超过500种新药，目前市场上可用药物已超过2万种。

So our tools allow providers to stay on top of it all while reducing the time spent in the electronic health record by up to 20%, allowing meaningful time for conversations with patients.

我们的工具帮助医生驾驭这些信息洪流，同时还能将他们在电子病历系统上花费的时间减少多达20%，从而为他们留出更多宝贵时间与患者进行有意义的交流。

Heather Cianfrocco – EVP of Governance, Compliance & Information Security

So bring that to life for us in a practice.

Heather Cianfrocco – 治理、合规与信息安全执行副总裁

那能不能用具体例子讲讲，在临床实践中这些工具是怎么发挥作用的？

McKinley Glover

Yes. So I've had the privilege of actually working with one of our practices recently and seeing them use our tools in real time, and it was extremely gratifying. As soon as I walked in, the provider said, "Thank you so much for building these tools. They've made my job so much easier."

McKinley Glover

当然可以。我最近有幸与我们某家合作诊所的医护人员一同工作，亲眼见到他们实时使用我们的工具，真的非常令人欣慰。刚走进诊室，医生就说：“太感谢你们开发了这些工具，让我的工作轻松了许多。”

And at the start of a busy clinic day watching her use our tools to identify opportunities for enhancing care delivery and supported by the evidence that providers know and trust, and then most importantly, in the exam room with the patient. The patient and provider having a meaningful conversation about optimizing the therapy and using our tools to personalize those recommendations based on what's important to the patient, including side effects as well as out-of-pocket drug costs.

我见证了她在忙碌门诊日开始时，如何借助这些工具识别提升照护质量的机会，结合临床证据（医生们熟悉并信任的）进行支持。最重要的是，在与患者面对面时，她和患者围绕如何优化治疗方案进行了深入交谈，还利用工具根据患者最关心的事项（包括药物副作用和自付费用）个性化地调整推荐方案。

Heather Cianfrocco

Absolutely. So let's spend a minute on chronic disease. Dr. Desai talked about the challenge in managing heart failure. How do our clinical decision support tools help physicians and patients manage chronic disease?

Heather Cianfrocco

没错。那我们花点时间讲讲慢性病管理。Desai医生提到过心力衰竭的管理挑战，我们的临床决策支持工具是如何帮助医生和患者应对这类慢病的？

McKinley Glover

Yes. So heart failure is a great example. So nearly 1 in 4 Americans will be diagnosed with heart failure at some point in their life. And research has shown that over 90% of patients are not on the optimal therapy for heart failure currently. And so there's significant morbidity and mortality associated with this. Fortunately, our tools are enabling, at scale, identifying and supporting providers on making the best treatment decisions. And we believe, over the next 5 years, we're able to reduce the total cost of care by up to $4 billion.

McKinley Glover

当然。心力衰竭就是个很典型的例子——大约每四位美国人中就有一位一生中会被诊断出心衰。而研究表明，目前有超过90%的患者并未接受最佳治疗，因此带来了显著的发病率与死亡风险。幸运的是，我们的工具可以大规模地帮助医生识别这些患者，并支持他们做出最佳治疗决策。我们相信，在未来五年内，我们有望将这一疾病相关的总体医疗成本降低最多达40亿美元。

Heather Cianfrocco

So there is incredible need here, but great momentum. So I know you're just getting started, but you're making great progress. Dr. Glover, thank you for the work and also for being here today.

Heather Cianfrocco

可见这方面的需求非常大，同时也蕴藏着巨大的推动力。我知道你才刚起步，但已经取得了令人瞩目的进展。Glover医生，感谢你的付出，也感谢你今天的到来。

McKinley Glover

Thanks, Heather.

谢谢你，Heather。

Heather Cianfrocco – EVP of Governance, Compliance & Information Security

Thank you. So the next 10 years hold incredible opportunity to further build out our capabilities, connect more of the health system and serve even more people. When you look at the country today, less than 5% of all patients are cared for in the most comprehensive value-based care relationships. But that is changing. Industry studies believe that patients in these types of arrangements will grow by double digits annually for the next several years.

Heather Cianfrocco – 治理、合规与信息安全执行副总裁

谢谢。接下来的十年，我们将迎来巨大的机遇，进一步拓展我们的能力，连接更广泛的医疗系统，服务更多人群。放眼全美，目前仅有不到5%的患者享受到最全面的价值导向医疗服务。但这一现状正在改变。行业研究预测，在未来几年内，这类患者群体将以每年两位数的速度增长。

Today, we're successfully managing Medicare Advantage, commercial Medicaid and exchange patients, and we do expect to continue to expand our offerings. And we will continue to realize the full potential of our diverse care modalities, the home, behavioral and surgical care, by deploying and connecting them across value-based infrastructure to drive growth in new ways. With a flexible risk platform serving patients across value-based models, by integrating our systems to fully support accountable care at scale and partnering with providers across health care, we are well positioned to grow.

如今，我们已成功管理Medicare Advantage、商业医保、Medicaid与医保交易所的患者群体，并预计将持续拓展我们的服务组合。我们也将进一步释放多元照护模式的潜力——包括居家医疗、心理健康照护和外科服务——将它们整合到价值导向医疗的基础架构之中，从而以全新方式推动增长。凭借灵活的风险平台服务各类价值导向模型的患者，再通过系统整合支持大规模“责任医疗”，并与全行业提供者建立合作，我们具备良好的增长优势。

As we prove out the value of value-based care, we will deliver even more consistent performance with more comprehensive services. Clinical quality and outcomes will continue to improve. We're already seeing the benefits of integrated services in the home, increasing access to primary care and reducing hospitalizations. Cost savings will accelerate. In our care delivery business alone, our early clinical interventions, operating efficiencies and affordability initiatives are meaningfully reducing costs. And the entire health care experience will feel different.

随着价值导向医疗的价值不断被验证，我们将实现更稳定的绩效输出与更全面的服务。临床质量与健康结果将持续改善。我们已经看到居家整合服务的好处——提升了初级照护的可及性，减少了住院发生。成本节约也在加速。在我们的医疗服务业务中，早期临床干预、运营效率提升及成本控制举措，已切实降低了支出。整个医疗体验也将随之发生根本性的变化。

As more providers seek out value-based care, as more consumers are engaged in benefits from the value-based care system, and has more come to expect a more integrated experience, years from now, as we look back, serving 4.7 million patients will feel very small.

随着越来越多的医疗提供者转向价值导向医疗，越来越多的消费者也参与进来并从中受益，而人们对整合式体验的期待也日益提升——若干年后当我们回首今天，470万患者的服务规模将显得微不足道。

An important enabler of value-based care is the continued advancement of technology. So now we'd like to update you on our efforts to drive intelligence and productivity across health care.

而价值导向医疗的重要推动力之一，正是技术的持续进步。接下来，我们原计划向大家介绍我们在推动医疗智能化与生产力提升方面所做的努力。

Andrew Witty – CEO & Non-Independent Director

Thanks, Heather. I'm afraid that we -- as some of you may know, we're dealing with a very serious medical situation with one of our team members. And as a result, I'm afraid we're going to have to bring to a close the event today, which I apologize for. I'm sure you'll understand.

Andrew Witty – 首席执行官兼非独立董事

谢谢你，Heather。很遗憾地告诉大家，如部分人所知，我们团队中有成员正面临一场严重的健康紧急状况。因此，我们不得不提前结束今天的会议，对此我深感抱歉，也希望大家能够理解。

We were going to go offline now from the broadcast. And we'll share with you an alternate mechanism to update you all with the information we were going to share with you with the rest of the day.

我们将马上中止直播。稍后我们会通过其他方式，向大家传达原定今天剩余时间要分享的信息。

I apologize for bringing things to close, but I hope you'll understand. And I appreciate again you joining us today. Thank you.

再次为此次提前结束表示歉意，感谢大家的理解，也感谢你们今天的参与。谢谢。

2024-12-04 UnitedHealth.Investor Day

2024-12-04 UnitedHealth.Investor Day

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