UnitedHealth Group Incorporated (UNH) Q3 2025 Earnings Call October 28, 2025 8:00 AM EDT
Company Participants
Stephen Hemsley - CEO & Non-Independent Non-Executive Chairman
Timothy Noel - Chief Executive Officer of UnitedHealthcare Business
Patrick Conway - Chief Executive Officer of Optum Rx
Wayne DeVeydt - Chief Financial Officer
Krista Nelson - Chief Executive Officer of UnitedHealthcare Community & State
Sandeep Dadlani - Executive VP and Chief Digital & Technology Officer
Bobby Hunter - CEO of Government Programs & Head of Medicare Insurance
Mike Cotton
Daniel Schumacher - Chief Strategy & Growth Officer
Conference Call Participants
Joshua Raskin - Nephron Research LLC
Albert Rice - UBS Investment Bank, Research Division
Justin Lake - Wolfe Research, LLC
Stephen Baxter - Wells Fargo Securities, LLC, Research Division
Kevin Fischbeck - BofA Securities, Research Division
George Hill - Deutsche Bank AG, Research Division
Lisa Gill - JPMorgan Chase & Co, Research Division
Andrew Mok - Barclays Bank PLC, Research Division
Ann Hynes - Mizuho Securities USA LLC, Research Division
Lance Wilkes - Sanford C. Bernstein & Co., LLC., Research Division
Scott Fidel - Goldman Sachs Group, Inc., Research Division
Erin Wilson Wright - Morgan Stanley, Research Division
David Windley - Jefferies LLC, Research Division
Jessica Tassan - Piper Sandler & Co., Research Division
Benjamin Mayo - Leerink Partners LLC, Research Division
Presentation
Operator
Good morning, and welcome to the UnitedHealth Group's Third Quarter 2025 Earnings Conference Call. [Operator Instructions]. As a reminder, this call is being recorded. Here are some important introductory information. This call contains forward-looking statements under U.S. federal securities laws. These statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations.
各位早上好，欢迎参加 UnitedHealth Group 2025 年第三季度财报电话会议。[运营方指引]。提醒一下，本次电话会议会被录音。以下是一些重要的说明信息。本次电话会议包含受美国联邦证券法约束的前瞻性陈述。这些陈述面临风险与不确定性，可能导致实际结果与历史经验或当前预期存在重大差异。
A description of some of the risks and uncertainties can be found in the reports we file with the Securities and Exchange Commission, including the cautionary statements included in our current and periodic filings. This call will also reference non-GAAP amounts. A reconciliation of the non-GAAP to GAAP amount is available on the financial and earnings reports section of the company's Investor Relations page at [
www.unitedhealthgroup.com](http://www.unitedhealthgroup.com).
Information presented on this call is contained in the earnings release we issued this morning and in our Form 8-K dated October 28, 2025, which may be accessed from the Investor Relations page of the company's website.
本次电话会议所述信息包含在我们今早发布的业绩公告及 2025 年 10 月 28 日提交的 8-K 文件中，均可通过公司官网投资者关系页面获取。
I will now turn the conference over to the Chairman and Chief Executive Officer of UnitedHealth Group, Stephen Hemsley.
下面我将把会议交给 UnitedHealth Group 董事长兼首席执行官 Stephen Hemsley。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Good morning. Thank you for joining us today. Our enterprise continues to advance on the improvement paths first discussed with you in July. We've been introducing new leaders, strengthening underperforming businesses, identifying both opportunities and inefficiencies and importantly, recommitting to the mission and culture of this company. We're getting at the core of the underperformance issues with fresh perspectives, intent on positioning our organization as a positive and innovative leader helping to advance next era of health care. A keen sense of urgency in this effort is consistent throughout the enterprise.
早上好。感谢各位今天的参加。自 7 月与各位沟通以来，我们的企业持续沿着既定改进路径推进。我们引入了新的领导者，强化表现欠佳的业务，识别机会与低效环节，并且更重要的是，重新承诺公司的使命与文化。我们以全新的视角直击业绩不佳的根源，致力于将公司定位为积极且富有创新的行业领导者，推动医疗保健的下一时代发展。在整个企业内，这项工作的紧迫感高度一致。
At the same time, recognizing the pace of progress varies across our businesses, depending upon their challenges and opportunities. Some efforts will require more time and investment. Others will show more immediate progress. Repricing within UnitedHealthcare is on track to drive solid operating earnings growth from margin improvement within that business in 2026. In our less mature businesses such as Optum Health and Optum Insight, our efforts to improve operations and make needed investments will show more measured progress in 2026 and will take more time to fully bear fruit.
同时，我们也认识到不同业务受挑战与机遇所限，推进速度会有所差异。部分举措需要更长时间与投入，另一些则会更快见效。UnitedHealthcare 的重新定价工作按计划推进，预计将通过该业务的利润率改善，于 2026 年带动稳健的经营收益增长。对于 Optum Health 与 Optum Insight 等相对不成熟的业务，我们在运营改进与必要投资方面的努力，将在 2026 年呈现更为稳健的进展，并需要更长时间才能完全显现成效。
As Patrick Conway will discuss, our belief in the need for an impact of value-based care remains intact, as is our confidence in returning to expected performance standards. And throughout the company, we will ensure we are focused on activities that align with our long-term future and be very disciplined about moving on from those that do not. We're committed to returning to the consistent enterprise-wide performance levels you should expect of us.
正如 Patrick Conway 稍后将讨论的，我们对价值导向医疗所需产生影响的信念不变，我们也有信心恢复到预期的业绩水准。在公司层面，我们将确保聚焦与长期未来相契合的活动，并严格而有纪律地剥离不相契合的事项。我们致力于回到各位对我们应有期待的一贯的全公司层面的业绩水平。
Within Optum Health, the team has taken concrete steps that will refocus the business back to its original mission, actions that will narrow networks with more emphasis on appropriately aligned physicians, geographies, the right clinical services and the right benefit offerings for the members we serve. We are also keeping sharp focus on the continued competitiveness of UnitedHealthcare as evidenced by our recent Medicare STARS scores showing improvement year-over-year, and [ that work ] remains intense now for payment year 2028 STARS performance.
在 Optum Health，团队已采取具体措施，使业务重新聚焦其初衷，通过收窄网络、更加重视医师匹配度、区域布局、合适的临床服务以及为我们服务对象提供合适的福利方案等行动来实现。我们同样高度关注 UnitedHealthcare 的持续竞争力，最近的 Medicare STARS 评分已同比提升，而针对 2028 支付年度 STARS 表现的相关工作当前仍在紧张推进中。
As we look ahead to the next few years, we will consistently emphasize the fundamental execution discipline that has long been a key trade of this company, and I'm gratified to see the quick and enthusiastic response to this enterprise -- to this emphasis from our leadership team. External challenges will remain, including continued headwinds in 2026 from the third year of nearly $50 billion in industry-wide Medicare cuts by the previous administration as well as Medicaid funding and program pressures.
展望未来几年，我们将持续强调公司长期以来的关键特质——基本的执行纪律。我也很高兴地看到领导团队对这一强调作出了迅速而积极的响应。外部挑战仍将存在，包括 2026 年将面临上一届政府在行业范围内连续第三年、累计近 500 亿美元的 Medicare 削减所带来的逆风，以及 Medicaid 资金与项目方面的压力。
Even so, I'm confident we will return to solid earnings growth next year given the operational rigor and more prudent pricing. While we are still finalizing 2026 plans and intend to share full guidance with you in January, current analyst consensus captures a likely stepping off point for next year. We intend to balance our earnings growth ambitions in 2026 with investments and actions that will drive higher and sustainable double-digit growth beginning in 2027 and advancing from there.
即便如此，基于更严格的运营与更审慎的定价，我有信心我们将在明年重回稳健的盈利增长。我们仍在敲定 2026 年的计划，并计划于 1 月向各位提供完整指引；目前分析师一致预期所反映的水平，大致体现了我们对明年的起步点。我们计划在 2026 年兼顾盈利增长目标与投资及行动布局，以推动自 2027 年起实现更高且可持续的两位数增长，并在此基础上继续推进。
That is the perspective we're keeping front of mind. Our longer-term outlook will be refreshed as we continue to execute over the next year. As we've been doing these last few months, we will continue to engage actively with both investors and the broader stakeholder community and plan to convene our investor conference in the back half of 2026.
这是我们始终坚持的视角。随着未来一年的执行推进，我们将刷新长期展望。正如过去几个月所做的那样，我们将继续与投资者及更广泛的利益相关方保持积极互动，并计划于 2026 年下半年召开投资者大会。
This morning, Tim Noel and Patrick Conway will provide details on the progress of UnitedHealthcare and Optum, respectively. Our Chief Financial Officer, Wayne DeVeydt; will review third quarter results. I'm pleased to welcome Wayne to our leadership team. He has the right experience, values and expertise to help guide UnitedHealth Group at this moment in our development, and he's off to a fast start.
今天早上，Tim Noel 与 Patrick Conway 将分别介绍 UnitedHealthcare 与 Optum 的进展情况。我们的首席财务官 Wayne DeVeydt 将回顾第三季度业绩。我很高兴欢迎 Wayne 加入我们的领导团队。他具备恰当的经验、价值观与专业能力，能够在公司当前发展的关键阶段引领 UnitedHealth Group，他也已经迅速进入状态。
So with that, Tim, you want to take it?
说到这里，Tim，请你开始吧。
Timothy Noel
Chief Executive Officer of UnitedHealthcare Business
Thanks, Steve. For the current year, overall UnitedHealthcare performance remains in line with the expectations we offered in the second quarter. Medical cost trends remained historically high but consistent with our second quarter guidance, and we expect that to continue throughout the remainder of 2025.
谢谢你，Steve。就本年度而言，UnitedHealthcare 的整体表现与我们在第二季度给出的预期一致。医疗成本趋势依然处于历史高位，但与我们第二季度的指引一致，我们预计这种情况将在 2025 年剩余时间里持续。
Turning to our efforts for 2026, a vital element has been our pricing. Since our last update with you, we've repriced the vast majority of our UHC risk businesses, including Medicare Advantage and, to varying degrees, our commercial fully insured and residual ACA offerings. Trend experience for the third quarter continues to validate the actuarial forecasts underpinning our 2026 pricing actions. Taken together, these actions position each of our businesses on a clear path towards margin growth in 2026 with the exception of Medicaid, which I will discuss in a moment.
谈到我们面向 2026 年的工作，定价是关键要素。自上次与各位沟通以来，我们已对 UHC 大部分承担风险的业务重新定价，其中包括 Medicare Advantage，并在不同程度上覆盖我们的商业全额承保和残余 ACA 产品。第三季度的趋势经历持续验证了支撑我们 2026 年定价行动的精算预测。总体来看，除 Medicaid（我稍后将讨论）外，这些行动为我们各项业务在 2026 年实现利润率增长铺设了清晰路径。
Our Medicare business continues to perform in line with the expectations we shared last quarter. That's true for care activity and medical cost trends, and importantly, for the mix of clinical activity and utilization across physician, outpatient and inpatient. We forecast a full year 2025 trend of approximately 7.5% in Medicare Advantage, consistent with our previous expectations. As we shared with you last quarter, trend remains elevated across Medicare overall with our [ Med Supp ] offerings still seeing medical cost trends in excess of 11%.
我们的 Medicare 业务继续与上季度分享的预期一致。这一点体现在护理活动与医疗成本趋势上，更重要的是体现在门诊医师、门诊与住院的临床活动与利用率组合上。我们预计 2025 年 Medicare Advantage 全年趋势约为 7.5%，与此前预期一致。正如上季度所分享的，Medicare 整体趋势仍处于高位，我们的 [Med Supp] 产品的医疗成本趋势仍超过 11%。
In individual Medicare Advantage, we continue to believe an expected 10% medical cost trend for 2026 has us positioned appropriately. This trend assumes -- assumption reflects a continuation of the elevated care activity levels observed in 2025, known impacts from fee schedule changes and continued expansion of aggressive provider coding and billing practices. We have taken a similarly prudent view across all our Medicare product offerings for 2026, including Medicare Supplement, Group MA and stand-alone Part D.
在个人 Medicare Advantage 方面，我们依然认为对 2026 年 10% 的医疗成本趋势预期使我们处于合适的位置。该趋势假设反映了 2025 年观察到的较高护理活动水平的延续、已知收费表调整的影响，以及供应商更为激进的编码与计费做法的持续扩张。对于 2026 年，我们对全部 Medicare 产品（包括 Medicare Supplement、Group MA 和独立 Part D）也采取了类似审慎的观点。
For Medicare Advantage, we're now about 2 weeks into the annual enrollment period and early results are in line with our strategic positioning for 2026. Our plan for next year reflects a conservative path focused on margin growth. We made significant adjustments to benefits and executed targeted plan exits and network reductions to offset elevated medical trends and government funding decreases. As a result of our planned actions as well as competitive market dynamics, we expect membership contraction of approximately 1 million members in total Medicare Advantage, including individual and group markets. We expect these actions will drive margin improvements in 2026 with potential for further advancements in 2027 that will position us to reach the upper half of our 2% to 4% targeted margin range, all of which is supported by strong STARS results. As Steve mentioned earlier, we already have shifted focus to the next STARS performance period including incremental investments made in the fourth quarter.
对于 Medicare Advantage，目前年度投保期已进行约两周，早期结果与我们针对 2026 年的战略定位一致。我们对明年的计划反映出一条以利润率增长为导向的保守路径。我们对福利进行了显著调整，并实施了有针对性的计划退出与网络收缩，以抵消抬升的医疗趋势与政府资金减少。受计划行动及市场竞争态势影响，我们预计 Medicare Advantage 总会员（涵盖个人与团体市场）将收缩约 100 万人。我们预计这些举措将在 2026 年推动利润率改善，并在 2027 年进一步提升，使我们达到 2%—4% 目标利润率区间的上半段，且上述判断得到了强劲的 STARS 结果支持。正如 Steve 先前所述，我们已将重心转向下一考核期的 STARS 表现，包括在第四季度进行的增量投入。
Turning to commercial. We are focused on pricing and cost management efforts to support 2026 margin recovery. At this point, approximately 60% of our group commercial insured offerings have been priced for next year. Our commercial pricing reflects the elevated cost levels we've seen this year, which we expect to persist in 2026. While we expect our group fully insured business to contract in line with the broader market, we continue to see strong traction for our self-funded offerings. We expect the vast majority of our employer insurance businesses to be repriced for 2026 and to return to our normal margin range in 2027.
转到商业险。我们正聚焦定价与成本管理，以支撑 2026 年利润率修复。目前，约 60% 的团体商业承保产品已完成明年的定价。我们的商业定价反映了今年所见的较高成本水平，且我们预计该水平将延续至 2026 年。尽管我们预计团体全额承保业务将随大盘收缩，但自筹资金方案仍保持强劲势头。我们预计绝大多数雇主保险业务将完成 2026 年的重新定价，并于 2027 年回归正常利润率区间。
Moving to ACA markets. We have submitted rate filings in nearly all of the 30 states where we participate that reflect 2025 morbidity and experience. These include average rate increases of over 25%. Where we are unable to reach agreement on sustainable rates, we are enacting targeted service area reductions. We believe these actions will establish a sustainable premium base while likely reducing our ACA enrollment by approximately 2/3. These actions should drive margin improvement in our employer and individual segment in 2026, though still below our targeted 7% to 9% range.
谈到 ACA 市场。我们已在几乎全部 30 个参保州提交了费率申请，反映 2025 年的发病率与经验数据。其中包含平均超过 25% 的费率上调。对于无法就可持续费率达成一致的地区，我们正在实施有针对性的服务区域缩减。我们认为这些举措将建立可持续的保费基准，同时可能使我们的 ACA 参保规模减少约 2/3。这些举措应当在 2026 年推动雇主与个人板块的利润率改善，但仍低于我们 7%—9% 的目标区间。
In Medicaid, the path to recovery will be more challenging. States have not funded in line with actual cost trends. So funding levels are not sufficient to cover the health needs of state enrollees. While we're making steady progress in bridging this gap with states, the mismatch between rate adequacy and member acuity will likely extend through 2026. To date, we have received 2026 draft rates on almost half of our contracts, which have a January 1 rate cycle, and we continue to advocate for rate updates to better reflect our ongoing experience with elevated trends. Our team is focused on addressing drivers unique to these markets, especially behavioral health and will continue to push for appropriate funds.
在 Medicaid 方面，复苏路径将更具挑战。各州的资金投入未能与实际成本趋势相匹配，因此当前资金水平不足以覆盖州内参保人的健康需求。尽管我们在与各州弥合缺口方面稳步推进，但费率充足性与会员病情严重程度之间的不匹配很可能会延续至 2026 年。迄今，我们已收到近半数按 1 月 1 日计价周期的合同对应的 2026 年费率草案，并将继续倡导费率更新，以更好反映我们在高位趋势下的持续经验。我们的团队正聚焦这些市场的特有驱动因素，尤其是行为健康，并将持续推动获得适当资金。
As I said last quarter, wherever states support responsible funding for Medicaid, we remain committed to serving people through that program and view this as integral to our mission. As we indicated in July, we anticipate Medicare margins will be breakeven for 2025. As we look to 2026, we expect margins to decline further if the existing cost trends continue and the current rate environment does not change.
正如我在上季度所说，只要各州对 Medicaid 提供负责任的资金支持，我们就将持续通过该项目服务民众，并将其视为我们使命不可或缺的一部分。正如我们在 7 月所指出的，我们预计 2025 年 Medicare 的利润率将持平。展望 2026 年，若现有成本趋势延续且当前费率环境不变，我们预计利润率将进一步下滑。
Looking at UnitedHealthcare overall, the underlying business continues to perform well in serving consumers, plans and program sponsors. To give you some examples of how we're enhancing the experience for these cohorts, nearly 85% of member inquiries are served digitally. When members call us, 90% of calls are answered within 30 seconds and 95% of members' questions are resolved in the first interaction. Some 95% of our claims are automatically processed immediately. We're delivering more value, ease, simplicity and guidance throughout the UHC member experience. We're also aggressively scaling AI and machine learning capabilities to enhance these experiences and optimize core performance.
总体来看，UnitedHealthcare 的基本业务在服务消费者、健康计划与项目赞助方方面持续表现良好。以体验提升为例，近 85% 的会员咨询通过数字化渠道得到服务。会员致电我们时，90% 的来电在 30 秒内接通，95% 的问题在首次互动即获解决。约 95% 的理赔实现了即时自动处理。我们在 UHC 会员全流程中提供了更多价值、更高便捷性、更强简洁性与指引能力。我们也在积极扩展 AI 与机器学习能力，以增强这些体验并优化核心绩效。
While 2025 remains a transition year, the pressure we experience is largely a result of mispricing and suboptimal market positioning. We remain humbled by the challenges of this environment and the lessons we've had to learn once again, but confident that we are in solid footing to recapture our performance potential.
尽管 2025 年仍是过渡之年，我们所承受的压力主要源于定价失当与次优的市场定位。我们对这一环境带来的挑战与再次汲取的教训保持敬畏，但有信心我们已站稳脚跟，能够重拾业绩潜力。
With that, I'll turn it over to Patrick Conway, CEO of Optum.
说到这里，我把时间交给 Optum 的首席执行官 Patrick Conway。
Patrick Conway
Chief Executive Officer of Optum Rx
Thanks, Tim. I will spend the majority of my time today updating you on our efforts to restore Optum Health to its original intent around value-based care, which experience continues to shows us is the optimal model to deliver the right care at the right time in the right setting for the best outcomes at the lowest cost to the people we serve, particularly in light of current cost trends and the market dominance of the large health systems. Over the last few years, through a period of rapid expansion, Optum Health's strategy around value-based care strayed from the initial intent of the model. Three critical issues emerged.
谢谢你，Tim。今天我将主要向各位更新我们把 Optum Health 恢复到以价值导向医疗为初衷的努力。实践持续表明，这一模式是在合适的时间、合适的场景提供合适的医疗，从而以最低成本为我们服务的人群带来最佳结果的最优解，尤其是在当前成本趋势与大型医疗体系市场支配地位的背景下。过去几年，在快速扩张期内，Optum Health 围绕价值导向医疗的战略偏离了该模式的最初意图，出现了三项关键问题。
First, the provider network grew too large. Second, the rapid pace of expansion and slower pace of integration resulted in operating inconsistencies, exacerbated by relying too much on affiliated physicians who are less aligned with core VBC policies. And lastly, Optum Health was accepting risk in products and services less suited for a clinically oriented value-based model. Understanding these issues has helped us better pursue the steps needed to get back to the original intent of Optum Health and value-based care.
第一，提供者网络增长过大。第二，扩张过快而整合较慢，导致运营不一致性，并因过度依赖与核心 VBC 政策契合度较低的附属医师而被加剧。最后，Optum Health 在某些不太适合以临床为导向的价值导向模式的产品与服务上承担了风险。认识到这些问题，有助于我们更好地采取步骤，回归 Optum Health 与价值导向医疗的最初意图。
Over the past 6 months, we have made significant leadership changes to better drive an integrated VBC provider model. Under the leadership of Krista Nelson, our Chief Operating Officer, we are focusing our efforts on 3 key connected areas to drive better performance. First, returning to the original intended clinical framework that best supports VBC. Second, moving towards narrower, more integrated and dedicated value-based care provider model and network. And third, focusing on the appropriate managed benefit product and patient base.
在过去 6 个月里，我们进行了重要的人事调整，以更好地推动一体化的 VBC 提供者模型。在首席运营官 Krista Nelson 的领导下，我们将精力聚焦于三个相互关联的关键领域，以推动更好表现：第一，回归最能支撑 VBC 的原始临床框架；第二，迈向更为精干、整合度更高且专注的价值导向医疗提供者模型与网络；第三，聚焦于合适的管理式福利产品与患者群体。
Within this framework, our team has made solid progress, especially in bringing greater discipline to how we approach risk arrangements, which will benefit the business in 2026. This includes partnering with payers on benefit adjustments and appropriate rates to match the risk and mix of the populations we serve. At this point, we are close to completion in over 90% of our value-based payer contracts for next year and are on track to reach our goal of offsetting approximately half of the 2026 V28 headwind through payer contracting.
在该框架下，我们取得了扎实进展，尤其是在风险合约的把控上更为严谨，这将有利于 2026 年的业务表现。其中包括与付费方合作进行福利调整与合理定价，以匹配我们所服务人群的风险与构成。截至目前，我们已基本完成明年超过 90% 的价值导向付费合同，并有望通过与付费方的签约抵消约一半 2026 年的 V28 逆风。
We are also pursuing market and product exits, including from lower-performing PPO contracts. As indicated last quarter, we have finalized exits for 200,000 lives in 2026, the majority of which are PPO. While still early in the Medicare annual enrollment period, we expect total Optum Health value-based care membership to shrink by approximately 10% in 2026 before returning to growth in 2027. We also continue to intentionally shape our care provider network to prioritize high-performing partners who demonstrate strong patient engagement and consistently positive outcomes. We are moving to employed or contractually dedicated physicians wherever possible.
我们也在推进市场与产品的退出，包括业绩较差的 PPO 合同。正如上季度所述，我们已确定在 2026 年退出覆盖 20 万人的业务，且多数为 PPO。尽管目前仍处于 Medicare 年度投保期的早期阶段，我们预计 Optum Health 价值导向医疗的总会员将在 2026 年收缩约 10%，并于 2027 年重返增长。我们还将有意识地重塑医疗服务提供网络，优先与在患者参与度与持续性积极结果方面表现突出的高绩效伙伴合作；在可行的情况下，向自有或合同专属医师转型。
We are separating from providers who are less aligned with the VBC model. The targeted network actions we've taken over the last 60 days will result in fewer providers in our networks starting in 2026. Within our markets and their related networks, we are working to more fully integrate our clinical practices to ensure greater performance consistency. The team is refining our portfolio and accelerating a consistent national operating model for regionally led, high-performing Optum Health practices that reduces fixed cost, drives purchasing economies, align technology and most importantly, ensures continued high-quality care.
对于与 VBC 模式契合度较低的提供者，我们正在与其分离。过去 60 天采取的有针对性的网络行动将使自 2026 年起我们的网络内提供者数量减少。在各市场及其关联网络内，我们正更充分地整合临床实践，以确保更高的一致性表现。团队正在优化我们的业务组合，并加速建立一个由地区牵头、表现优异的 Optum Health 实践所采用的全国一致运营模式，以降低固定成本、实现采购规模经济、对齐技术，并且最重要的是，确保持续的高质量医疗。
These actions increase our confidence in our ability to meet our V28 cost reduction targets in 2026 and strengthen our operating foundations for the long term. Lastly, our engagements and clinical work at Optum continue to track with our expectations for meaningfully reducing medical cost trends, engaging with over 85% of our high-risk members in 2025, which accounts for the remaining V28 pressure offsets in 2026.
这些举措增强了我们实现 2026 年 V28 成本降低目标的信心，并夯实了我们的长期运营基础。最后，Optum 的干预与临床工作仍符合我们对显著降低医疗成本趋势的预期：在 2025 年触达超过 85% 的高风险会员，这将构成 2026 年剩余 V28 压力的对冲。
Bottom line, getting back to the basics of our VBC model will be good for the people we serve and for our business. As a point of reference, our 2026 CMS Star Rating projections show 80% of Optum at home members in 4+ star plans and nearly 100% of our I-SNP members in 4+ star plans. Evidence of our quality of care is underscored by a strong NPS of 90 at our highest performing facilities.
归根到底，回归 VBC 模式的基本面将有利于我们服务的人群与我们的业务。作为参考，我们对 2026 年 CMS Star Rating 的预测显示，80% 的 Optum at home 会员处于 4 星及以上的计划，几乎 100% 的 I-SNP 会员处于 4 星及以上的计划。我们的护理质量还体现在最高绩效机构的 NPS 高达 90 分。
For the third quarter, Optum Health performance was in line with our expectations, reflecting the natural seasonality in our business and the pull forward of some investments. Within this, we expect to end 2025 with margins of just under 3%, which includes value-based care margins under 1%. We expect margin improvement across all of Optum Health in 2026, even in the face of the third year of the Medicare funding cuts. We believe these efforts will drive further acceleration in 2027 towards our long-term margin targets of 6% to 8%.
第三季度，Optum Health 的表现与我们的预期一致，反映了业务的自然季节性以及部分投资的前置。在此背景下，我们预计 2025 年结束时的利润率略低于 3%，其中价值导向医疗的利润率低于 1%。即便在 Medicare 连续第三年资金削减的情况下，我们仍预计 2026 年 Optum Health 全盘利润率将改善。我们相信这些努力将在 2027 年进一步加速，朝着我们 6%—8% 的长期利润率目标迈进。
Turning to Optum Health's fee-based care services. As we discussed last time, these were not performing to their potential. We are adopting more consistent and rigorous processes to better manage these practices for growth and appropriate profitability. We are seeing early results in our East region, which serves nearly 5 million patients, where we have generated a 3% per visit productivity increase quarter-over-quarter, driven by targeted improvements in scheduling, workflow efficiency and patient acquisition. We have similar undertakings in motion in our South and West regions.
谈到 Optum Health 的按次收费医疗服务。正如上次所讨论的，这些业务未能发挥其潜力。我们正在采用更一致、更严格的流程，以更好地管理这些实践，实现增长与合理盈利。在覆盖近 500 万名患者的东部区域，我们已看到初步成效：通过在排班、流程效率与患者获取方面的有针对性改进，实现了单次就诊生产率环比提高 3%。我们在南部与西部区域也在推进类似举措。
As for Optum Insight, we continue to perform solidly but not at the level of the potential for these services. Under the leadership of Sandeep Dadlani, we now see the alignment of our end-to-end technology and AI innovation efforts coming into formation. We will make the investments needed to accelerate the advancement of this distinctive platform that serves the expanse of the health system. We are confident in our plan will ignite top line revenue and operating earnings in line with our long-term growth targets.
至于 Optum Insight，我们的表现依然稳健，但尚未达到这些服务的潜在水平。在 Sandeep Dadlani 的领导下，我们端到端技术与 AI 创新工作的对齐正逐步成形。我们将进行必要投资，加速这一服务于广泛医疗体系的差异化平台的推进。我们对该计划有信心，认为其将点燃营收与经营利润的增长，符合我们的长期增长目标。
At Optum Rx, we continue to perform well with double-digit revenue growth in our pharmacies and a strong selling season for our pharmacy offerings. Our products are resonating in the market with stronger customer retention and new customer growth. At this stage, we expect new membership growth in 2026 will be more than offset by expected membership attrition from the UnitedHealthcare business. Importantly, our team remains disciplined around pricing, transparency and quality outcomes for our customers at a time when the pharmaceutical industry continues to drive cost ever higher.
在 Optum Rx，我们继续表现良好：药房业务实现两位数收入增长，药房产品迎来强劲销售季。我们的产品在市场上反响良好，客户留存与新客户增长更强。在这一阶段，我们预计 2026 年的新会员增长将被 UnitedHealthcare 业务预期的会员流失所抵消。重要的是，在医药行业持续推高成本的背景下，我们的团队在定价、透明度与客户质量结果方面依然保持自律。
Today, we offer full rebate pass-through arrangements to all of our customers with nearly 85% of them participating. We were the first in our industry to announce this arrangement back in the beginning of the year and we expect 95% of our customers will be in these arrangements in 2027 with the remainder in full rebate pass-through by 2028. And we have increased payments on branded drugs to over 14,000 independent retail pharmacies as part of our commitment to a balanced pricing approach.
目前，我们向所有客户提供全额回扣直通（full rebate pass-through）安排，参与比例接近 85%。我们在年初成为业内首家宣布该安排的公司，并预计到 2027 年将有 95% 的客户采用该安排，剩余客户将在 2028 年实现全额回扣直通。作为我们对均衡定价方式承诺的一部分，我们还提高了对超过 14,000 家独立零售药店的品牌药支付水平。
Thanks for your time today. I'll now turn it over to Wayne DeVeydt.
感谢各位今天的时间。下面我把话筒交给 Wayne DeVeydt。
Wayne DeVeydt
Chief Financial Officer
Good morning, everyone. I'd like to begin by expressing my sincere appreciation to Steve, Tim, Patrick and all of my colleagues at UnitedHealth Group for the warm welcome. It's truly an honor to be part of this team and to contribute to our shared mission.
大家早上好。首先，我想向 Steve、Tim、Patrick 以及 UnitedHealth Group 的所有同事表达诚挚的感谢，感谢你们的热情欢迎。能够成为这个团队的一员并为我们共同的使命作出贡献，我深感荣幸。
Today, I'd like to cover 3 important topics. First, I'll provide an overview of our quarterly performance and how it informs our outlook for the rest of the year. I will then discuss our capital and liquidity framework as we look ahead to 2026, particularly in terms of resuming share buybacks and strategic acquisition activities. And finally, I'll offer some insights into our expectations for 2026.
今天，我将讨论三个重要主题。首先，我会概述本季度的业绩表现，以及这些结果如何影响我们对全年剩余时间的展望。随后，我将讨论面向 2026 年的资本与流动性框架，特别是关于恢复回购与战略性并购活动的考量。最后，我会分享我们对 2026 年的一些预期看法。
Moving to the quarter. Today, we reported adjusted earnings per share of $2.92, which was slightly ahead of our expectations. These results reflect steady execution while we work through our longer-term improvement plans. We've balanced immediate performance with strategic investments that will support our future growth and natural diversification.
先说本季度。今天我们公布的调整后每股收益为 2.92 美元，略好于我们的预期。这些结果反映出在推进长期改进计划的同时，我们实现了稳健执行。我们在当期业绩与战略性投资之间取得平衡，以支撑未来增长与自然多元化。
Some details for the quarter. We delivered revenues of over $113 billion, reflecting 12% year-over-year growth, driven by domestic membership expansion of over 780,000 lives year-to-date. We ended the third quarter with total domestic membership of more than 50 million. Our medical care ratio of 89.9% in the quarter compares to 85.2% in the same quarter last year, with the full year trending towards the lower end of the projections we offered last quarter.
关于本季度的若干细节：我们的收入超过 1130 亿美元，同比增长 12%，主要受益于年初至今国内会员新增超过 78 万人。第三季度末，我们的美国本土总会员数超过 5000 万。本季度医疗费用率（MCR）为 89.9%，而去年同期为 85.2%；全年走向将趋近于我们上季度给出的预测区间的低端。
As Tim stated, medical cost trends, while historically high, remain consistent with our outlook for 2025 and align with our pricing actions for 2026. The operating cost ratio of 13.5% in the quarter reflects larger investments in technology and people than originally contemplated when guidance was set in 2Q. Specifically, we invested more than $450 million in broad-based employee incentives and in contributions to the UnitedHealth Foundation, both critically important for strengthening our relationships with our workforce and with local communities in the health system at large. And investments were proportionately greater in Optum Health and Optum Insight.
正如 Tim 所述，尽管医疗成本趋势处于历史高位，但仍与我们对 2025 年的展望一致，并与我们针对 2026 年的定价行动相匹配。本季度运营成本率为 13.5%，反映出我们在技术与人才方面的投入高于二季度设定指引时的原始假设。具体而言，我们在广泛的员工激励以及对 UnitedHealth Foundation 的捐助方面投入超过 4.5 亿美元，这两者对于强化我们与员工、与更广泛卫生体系中的地方社区的关系至关重要；其中在 Optum Health 与 Optum Insight 的投入占比更高。
Finally, our earnings were supported by strong cash flows of 2.3x net income and an overall increase in days claims payable of 1.7 days sequentially.
最后，我们的盈利得到强劲现金流的支撑，经营现金流量约为净利润的 2.3 倍；同时，应付赔款天数环比增加了 1.7 天。
Turning to our capital and liquidity framework. As previously communicated, we have paused our strategic acquisitions and share buyback while we dedicate our cash to returning to a long-term debt-to-capital ratio around 40% and interest coverage ratios in line with historic levels. In the third quarter, our debt-to-capital ratio remained stable at 44.1%, reflecting continued actions to improve cash efficiency, offset by the completion of the Amedisys transaction late in the third quarter, which represented a net cash disbursement of $3.4 billion.
转向资本与流动性框架。正如先前所沟通的，我们已暂停战略并购与回购，并将现金优先用于将长期债务占资本比降至约 40%，以及将利息保障倍数恢复到历史水平。第三季度，我们的债务占资本比维持在 44.1% 的稳定水平，这反映了我们持续提升现金效率的举措，但也被三季度末完成的 Amedisys 交易所部分抵消，该交易净现金支出为 34 亿美元。
We expect our debt-to-capital ratio to trend closer to 40% in the second half of 2026. Accordingly, while we have not finalized plans for 2026, we anticipate we may be in a position to reinstate our historical capital deployment practices later in the year. Finally, we generated operating cash flow from operations of $5.9 billion. We still expect to close this year with $16 billion in operating cash flow or 1.1x net income.
我们预计 2026 年下半年债务占资本比将趋近 40%。因此，尽管我们尚未最终确定 2026 年的计划，但预计在当年较晚时候，我们有望恢复历史上的资本配置做法。最后，我们本季度实现经营活动现金流 59 亿美元。我们仍预计全年经营活动现金流约为 160 亿美元，约为净利润的 1.1 倍。
Looking ahead to 2026. As Steve mentioned, we will provide formal guidance with our fourth quarter results in January. We are comfortable with current consensus and within that, we are making the requisite investments needed to accelerate our returns in 2026 and to position our company for meaningfully stronger growth in 2027 and beyond. We are optimistic in our ability to execute on our 2026 plans, but there are remaining headwinds we will have to overcome. Items to keep in mind include, we're entering the final year of V28, which represents a more than $6 billion headwind to the overall enterprise. As you heard from Tim and Patrick, we've taken numerous actions around benefit design, cost control and member engagement to substantially offset this impact.
展望 2026 年。正如 Steve 所提及的，我们将于 1 月随第四季度业绩一同提供正式指引。我们对当前一致预期感到满意；在此框架内，我们正在进行必要投资，以在 2026 年加速回报，并为 2027 年及以后实现更强劲的增长奠定基础。我们对执行 2026 年计划的能力持乐观态度，但仍有一些逆风需要克服。需要注意的是，我们正进入 V28 的最后一年，这将为整个企业带来逾 60 亿美元的逆风。正如各位从 Tim 与 Patrick 的发言中听到的，我们已在福利设计、成本控制与会员互动方面采取了众多举措，以大幅对冲该影响。
Further investment in Optum Health and Optum Insight is needed and we are accelerating some of those investments as noted in our third quarter results. We are also accelerating our pace of AI applications to fundamentally advance a vast spectrum of processes and capabilities we expect will structurally improve our enterprise performance.
我们需要在 Optum Health 与 Optum Insight 继续加大投入，且正如第三季度结果中所述，我们正在加速推进其中部分投资。我们也在加快 AI 应用的步伐，从根本上提升广泛流程与能力，期望以结构性方式改善企业绩效。
Our effective tax rate is expected to return to a more normalized level in 2026 as compared to 2025. And finally, investment income should continue to move lower as interest rates decline. From a tailwind perspective, our repricing efforts will be a catalyst for earnings growth as we begin returning to our long-term target margins with particularly solid year-over-year results expected in our commercial and Medicare businesses.
与 2025 年相比，我们的有效税率预计在 2026 年回归更为正常的水平。最后，随着利率下行，投资收益预计将继续下降。就顺风因素而言，随着我们开始回归长期目标利润率，重新定价工作将成为推动盈利增长的催化剂，其中商业险与 Medicare 业务预计将表现出尤其稳健的同比改善。
We also expect stability and a measured return to growth in our Optum entities, with aspects of that growth being reinvested in the business, specifically Optum Health and Optum Insight. These investments may slow 2026 growth, but should accelerate growth in 2027, more in line with historical expectations. We will be paying down debt and identifying opportunities to further reduce our interest expense as a result of the declining rate environment.
我们同样预计 Optum 各实体将趋于稳定并逐步恢复增长，其中部分增长将再投资于业务，尤其是 Optum Health 与 Optum Insight。这些投资可能放缓 2026 年的增长，但应在 2027 年加速，更符合历史期望。我们将利用利率下行环境偿还债务，并寻求进一步降低利息支出的机会。
And finally, we're taking an aggressive step on affordability initiatives that should improve overall medical trend relative to our pricing. While we have a number of moving parts to manage for the remainder of this year, we also have concrete plans to execute on all the items we discussed this morning that will position us for the type of growth you've come to expect from UnitedHealth Group.
最后，我们正在积极推进“可负担性”举措，使总体医疗趋势相对于我们的定价得到改善。尽管今年剩余时间仍有诸多要素需要管理，但我们也已有切实可行的计划去执行今天上午讨论的各项举措，从而使我们达到各位一贯对 UnitedHealth Group 的增长期待。
Thanks for your time this morning. I'll now turn it back to Steve.
感谢各位今天上午的时间。现在我把话筒交还给 Steve。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Thanks, Wayne. As I hope you clearly -- you heard clearly, this team and our 400,000 colleagues are focused on delivering on all fronts for the people we're privileged to serve and for our shareholders. As I said in the outset, we're being very disciplined. This plays out day to day as this management team recognizes the need to manage our costs, both in the short term as well as structurally. And through another lens, throughout the quarter, we have continued to evaluate the company's businesses with fresh perspectives and with continued confidence in our progress and our overall direction. We expect to complete that assessment in the fourth quarter as we position for 2026 and the years ahead.
谢谢你，Wayne。希望你们都能清楚地听到：这个团队和我们 40 万名同事，正全方位为我们有幸服务的人群以及股东创造价值。正如我在一开始所说，我们正在以高度的纪律性推进工作。这体现在日常运营中：管理团队既关注短期也关注结构性的成本管理。从另一个角度看，在整个季度里，我们以全新的视角持续评估公司的各项业务，并对我们的进展与总体方向保持信心。我们预计将在第四季度完成这项评估，以为 2026 年及其后数年做好布局。
A few themes emerge from these efforts. We are dedicating our energies to serving U.S. health care needs and we'll be reducing our footprint in international markets that do not support these needs. We will be finalizing our initiatives for recovery of the remaining outstanding loan balances from the care provider support programs associated with the 2024 Change Health cyberattack.
从这些工作中浮现出若干主题。我们将把精力集中于满足 U.S. 医疗保健需求，并将在无法支撑这些需求的国际市场缩减布局。我们将敲定与 2024 年 Change Health 网络攻击相关的 care provider support programs 中剩余未偿贷款余额的追回举措。
For Optum Health, we are consolidating locations and completing plans addressing the geographic markets in which we will serve patients, all intended to operationally advance and scale the leading value-based clinical care business of Optum Health. And we are realigning Optum Financial Services within our Optum Insight Services platform. While we have not yet finalized these plans, many of these actions are underway, and we believe they will improve both our focus and long-term performance. We are in the process of quantifying the accounting, tax and cash implications of our plans.
对于 Optum Health，我们正在整合网点，并完成对未来服务患者的地理市场规划，旨在运营上推进并规模化 Optum Health 领先的价值导向临床护理业务。同时，我们将把 Optum Financial Services 重新整合进 Optum Insight Services 平台。尽管这些计划尚未全部最终确定，但许多举措已经在推进中，我们相信它们将提升我们的聚焦度与长期业绩表现。我们也在量化这些计划在会计、税务与现金层面的影响。
At this stage, our preliminary work would imply a non-GAAP, substantially noncash, low single-digit billion-dollar charge. We will provide further details on our fourth quarter call as we conclude these efforts. Simply put, we will end 2025 well positioned for a return to solid growth in 2026, acceleration in 2027 and a clear focus on our long-standing mission and strategy.
在当前阶段，我们的初步测算显示将产生一项 non-GAAP、基本为非现金、金额在低单位数十亿美元范围内的费用。待这些工作完成后，我们将在第四季度电话会上提供更多细节。简而言之，我们将在 2025 年收官时处于良好位置：2026 年重返稳健增长，2027 年实现加速，并持续聚焦我们长期坚持的使命与战略。
An important reason for my confidence in our outlook is the way I see our people embracing a renewed focus on the mission, culture and values of our company. How we go about things in the sensitive area of health care is as essential as what we do, and we are bringing new energy to that imperative each day.
我对前景充满信心的一个重要原因，是我看到我们的员工重新聚焦公司的使命、文化与价值观。对于医疗保健这一敏感领域，我们“如何去做”和“做什么”同等重要，而我们正在每天为这一要务注入新的活力。
Now operator, let's open it up for questions.
现在由运营方开始进入问答环节。
Question-and-Answer Session
Operator
[Operator Instructions] Our first question comes from Josh Raskin with Nephron Research.
【运营方指引】我们的第一个问题来自 Nephron Research 的 Josh Raskin。
Joshua Raskin
Nephron Research LLC
I appreciate all that detail this morning. I was wondering if you could just give us a more updated view or a more specific view on the sub businesses in Optum Health. I'm specifically looking to understand how much of the revenue base is coming from capitated premiums from health plans and within that, how much from your biggest customer, UHC. And then how much of the remainder is fee-for-service billings from your employed physicians and then maybe some of the moving parts, I heard a little bit of the membership details as you think about stepping into 2026, at least directionally.
感谢你们今早提供的详尽信息。我想请你们更新、更具体地说明一下 Optum Health 各子业务的情况。具体来说，我想了解收入基盘中有多少来自健康计划的定额预付（capitated premium），其中来自你们最大客户 UHC 的占比又有多少？此外，其余收入中有多少来自自有（受雇）医师的按次收费（fee-for-service）？以及一些动态因素——我听到了一些关于会员规模的细节，能否在你们迈向 2026 年的背景下，至少给出方向性的说明？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Sure. Why don't we just start with Patrick and then finish with Krista?
好的。不如先请 Patrick 回答，然后由 Krista 做补充？
Patrick Conway
Chief Executive Officer of Optum Rx
That's great. So thanks, Josh, for the question. High level, the breakdown on revenue is as we described last quarter, 65% VBC, 15% care delivery fee-for-service and 20% are payer, employer services. Within VBC, it's about 2/3 of our book of business is serving UnitedHealthcare, the rest is diverse array of payers. Within -- the growth potential, as we close out this year, as you heard, we plan to close 2025 just under that 3% margin with VBC margins under 1%. And then we're taking the actions this year to set us up for '26, and I'll let Krista cover that portion.
好的。谢谢你，Josh。概览来看，收入结构与上季度披露一致：65% 来自 VBC，15% 来自护理交付的按次收费，20% 来自付费方与雇主服务。在 VBC 内，大约 2/3 的业务服务于 UnitedHealthcare，其余来自多元的付费方。关于增长潜力，正如你所听到的，我们计划在 2025 年收官时总体利润率略低于 3%，其中 VBC 的利润率低于 1%。我们今年已采取一系列举措，为 2026 年做好铺垫，接下来这部分我交给 Krista。
Krista Nelson
Chief Executive Officer of UnitedHealthcare Community & State
Yes. Thanks for the question, Josh. So I think as we are pacing into 2026, we remain anchored and committed to the long-term potential of this business, the 6% to 8% margin that we outlined in the second quarter, and within that, the 5% commitment to our value-based care agenda. We continue to work a robust set of actions and opportunities with clear line of sight and frankly, a lot of the ambition to the work ahead. And, again, just remain optimistic on our positioning for the long term. Thanks for the question.
是的。谢谢你的提问，Josh。进入 2026 年的节奏中，我们依然锚定并承诺于这项业务的长期潜力，即二季度所阐述的 6%—8% 的利润率目标，其中包含对价值导向医疗议程 5% 的承诺。我们持续推进一整套扎实的行动与机会，路径清晰、目标进取。再次强调，我们对自身的长期定位保持乐观。谢谢你的提问。
Operator
And we'll take our next question from A.J. Rice with UBS.
接下来请 UBS 的 A.J. Rice 提问。
Albert Rice
UBS Investment Bank, Research Division
Maybe just I'll stick on the Optum theme. I appreciate the comments on Optum Insight and the comment about need for investment. Can you just sort of comment a little more deeply on your view of where Optum Insight sits competitively at this point? Where are those investments need to go and the time frame for seeing a reacceleration of growth there?
我继续围绕 Optum 提问。我认同你们对 Optum Insight 的表述以及对投资需求的说明。能否更深入地谈谈你们对 Optum Insight 当前竞争地位的看法？这些投资将主要投向哪些方向？何时能够看到那里的增长重新加速？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Sure. I actually think that Optum's competitive position is actually pretty strong. We have a really nice base of business and continue to grow that. But I think the potential is much greater. So Sandeep, do you want to offer some views?
好的。我认为 Optum 的竞争地位实际上相当强。我们拥有很不错的业务基础，并在持续扩大。但我认为潜力远不止于此。Sandeep，你来谈谈看法？
Sandeep Dadlani
Executive VP and Chief Digital & Technology Officer
Sure. Thanks, A.J. Look, 4 weeks into the role, I'm super impressed with the talent, the domain knowledge, the customer franchise and the mission. I'm particularly excited by the momentum of some of our AI first new products in the portfolio. I mean just last week, you must have seen we launched Optum Real, which was inspired by innovation at UnitedHealthcare. This is the first real-time platform for claims and reimbursements anywhere in the industry. And just our early pilots are showing dramatic results in streamlining what I think is one of the most complex pain points for payers and providers.
好的。谢谢你，A.J.。上任 4 周，我对这里的人才、行业知识、客户基础与使命都印象深刻。让我尤为兴奋的是我们一些 AI first 新产品的动能。比如上周你或许已看到，我们发布了 Optum Real，它受 UnitedHealthcare 的创新启发。这是业内首个用于理赔与报销的实时平台。仅在早期试点中，它就在简化我认为是付费方与服务方最复杂痛点之一的流程上，取得了显著成效。
I'll give you another example. We recently launched Optum Integrity One. This is the most advanced AI auto coding tool in the market, and it's driving demand among health systems and hospitals looking to improve middle revenue cycle automation and performance. Just some metrics. For ambulatory outpatient claims coding, this showed 73% productivity over prevailing solutions. And for hospital inpatient coding, it showed 23% increase in productivity.
再举一个例子。我们最近推出了 Optum Integrity One，这是市场上最先进的 AI 自动编码工具，正在受到寻求提升中段收入周期自动化与绩效的医疗体系与医院的青睐。给出一些指标：在门诊理赔编码方面，其生产率较主流方案提升 73%；在住院编码方面，生产率提升 23%。
A third one is Crimson AI. This is an AI first clinical analytics platform that has created 6 wins in the last 90 days itself. This helps providers with their surgical costs and operating room optimization. Just the average return on investment for any provider system investing in Crimson AI has been 13:1. So look, in my first few interactions with our top clients, they've expressed tremendous excitement and anticipation for our new AI-based offerings. They've also provided feedback on where we can do better.
第三个是 Crimson AI，这是一个 AI first 的临床分析平台，在过去 90 天里单独就斩获了 6 个新签。它帮助医疗服务方优化手术成本与手术室效率。对于投资 Crimson AI 的任何医疗体系而言，其平均投资回报为 13:1。总体来看，我与头部客户的几次交流中，他们对我们的 AI 新产品充满期待与兴奋，同时也给出了我们可以进一步改进的反馈。
But it's clear that our traditional services in Optum Insight have to evolve to AI-first services, then to products and eventually to platforms. We are well on our way with this journey. We're beginning to build powerful AI products like the ones I mentioned. We are rationalizing and modernizing some of the existing legacy products that have great market presence. And then finally, we're investing in an AI-first workforce. Remember, I come from the tech role where we built 10,000 AI builders and we're building AI-first sales teams.
但很明确，Optum Insight 的传统服务必须演进为 AI-first 的服务，进而成为产品，最终成为平台。我们已在这条路上稳步前行：一方面构建我刚才提到的这类强力 AI 产品；另一方面对具备广泛市场覆盖的既有遗留产品进行梳理与现代化改造；最后，我们还在打造 AI-first 的人才队伍。请记得，我来自技术领域，曾经打造过 1 万名 AI 构建者，我们也在建设 AI-first 的销售团队。
So we are investing, as earlier noted, in building, growing new products and offerings, and I'm incredibly excited about the possibilities. We want to simplify health care with AI and Optum Insight is the best company to do it. Thank you for the question.
因此，正如先前所述，我们正在投入力量以构建并壮大新产品与新方案，对其潜力我无比期待。我们希望用 AI 简化医疗，而 Optum Insight 是实现这一目标的最佳公司。谢谢你的提问。
Operator
Our next question comes from Justin Lake with Wolfe Research.
接下来是 Wolfe Research 的 Justin Lake 提问。
Justin Lake
Wolfe Research, LLC
First, let me congratulate and welcome Wayne back to the sector. Good to have you back. My question here is for Tim. Wanted to confirm, you talked about getting your commercial margins back to the 7% to 9% target range for 2027. Just wanted to make sure I heard that right. And then in terms of the current baseline for '25, I'm kind of backing into a margin in the 3% to 5% range for commercial, Tim. Is that in the right ballpark?
首先，恭喜并欢迎 Wayne 回归这个行业。很高兴你回来。我的问题是给 Tim 的。想确认一下，你提到在 2027 年让商业险利润率回到 7%—9% 的目标区间。我想确保我听对了。然后关于 2025 年的当前基线，我大致测算商业险的利润率在 3%—5% 区间，Tim，这个量级是否大致正确？
Timothy Noel
Chief Executive Officer of UnitedHealthcare Business
Yes. Thanks, Justin, for the question. So the commercial business, as we've talked about, for 2026 and as a result of our pricing actions, we'll make meaningful progress as you think about the work being done across the ACA and the other commercial products to chip away at a return to that 7.9% long-term margin. We view 2026 as a year where we're probably still 150 basis points below that low end of the margin. But again, given how the pricing is being received in the marketplace, some of the opportunities that we see around controlling our costs in the future, we still feel as though that longer-term margin range of 7% to 9% is attainable.
是的。谢谢你的提问，Justin。关于商业险，正如我们所讨论的，受益于 2026 年的定价举措，我们会取得实质性进展。考虑到在 ACA 以及其他商业产品上推进的工作，我们正在一点点向 7%—9% 的长期利润率靠拢。我们认为 2026 年可能仍较该区间下限低约 150 个基点。但鉴于市场对我们定价的接受程度，以及我们在未来成本控制方面看到的一些机会，我们仍然认为 7%—9% 的长期利润率区间是可以实现的。
Operator
Our next question comes from Stephen Baxter with Wells Fargo.
下一个问题来自 Wells Fargo 的 Stephen Baxter。
Stephen Baxter
Wells Fargo Securities, LLC, Research Division
Just wanted to ask for some additional color on the membership declines you're expecting in Medicare Advantage in 2026. Can you help us think about the breakout between individual duals and group? And then at the industry level, CMS is expecting enrollment growth to be pretty flat in 2025. I guess, first, does the company agree with that assessment? And second, how are you thinking about the type of industry growth you might see as we move into 2027 and beyond?
想请你们进一步解释一下你们预计 2026 年 Medicare Advantage 会员下滑的情况。能否帮助我们理解在个人、双重资格（duals）以及团体之间的拆分？另外，从行业层面看，CMS 预计 2025 年参保增长基本持平。首先，公司是否认同这一判断？其次，展望 2027 年及以后，你们如何看待行业增长的态势？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
I think Bobby Hunter is best for this [indiscernible].
我认为这个问题由 Bobby Hunter 来回答最合适。
Bobby Hunter
CEO of Government Programs & Head of Medicare Insurance
Yes. Great. Thanks, Stephen. So I'll hit the membership item first. Tim mentioned in the prepared remarks, approximately 1 million membership contraction for 2026 across MA. That does include both group and individual. Obviously, we've been pretty clear about the fact that we're exiting products impacting about 600,000 members. So think about that as kind of your first core element of how you build to that 1 million. And then I would say the balance of the bridge to the full 1 million is pretty evenly split between pressure inside of our group MA business as a result of taking a really disciplined approach to pricing there and some dislocation that will exist in the group customers as a result of some other more aggressive competitor actions.
好的。谢谢你，Stephen。先说会员这块。正如 Tim 在准备稿中提到的，2026 年我们预计 MA 的会员将收缩约 100 万人，这既包括团体也包括个人。显然，我们已相当明确地表示将退出一些产品，影响约 60 万名会员——这是达到 100 万这一数字的第一块核心拼图。其余部分，大致在我们的团体 MA 业务与个人业务之间平均分配：团体端一方面源自我们在定价上采取了非常有纪律性的策略所带来的压力，另一方面也有来自竞争对手更为激进举措导致的客户错配与流失。
And then the other kind of 50% of that bridge from the 600,000 to the 1 million representing a pretty even split across our individual MA business. Obviously, really early in AEP at this point, but that's kind of the way I see it from this distance. When you think about growth overall, I would expect 2026 to be probably more in line with the general progression and growth that we're seeing in 2025. And that's largely a result of continued benefit cuts in the marketplace, continued plan closures and then some disruption in the broker community related to pretty broad commission changes. I absolutely believe in the long-term growth potential of MA, and I think we can grow above those levels as you step out further.
而从 60 万到 100 万之间的“桥”的另一半，大体就是分布在我们的个人 MA 业务中。显然，目前 AEP 还处于很早的阶段，但从现在这个视角看大致如此。就整体增长而言，我预计 2026 年大致与 2025 年的进程与增速相仿，这主要是因为市场上福利继续削减、计划持续关闭，以及经纪人群体因较大范围的佣金调整而出现一定扰动。我对 MA 的长期增长潜力完全有信心，并认为在更长的时间维度上，我们能够实现高于这些水平的增长。
Ultimately, right now, though, medical trend pressure is increasing the cost of health care and the funding cuts of the program are degrading choice, access and value to the consumer. And that's a real impact on the 35 million Medicare eligibles who rely on MA right now to make health care affordable. So still absolutely believe in the differentiated value proposition of MA, but cannot underscore the importance of stability in the program as we look to the longer-term growth rate and opportunity for MA. Thanks for the question.
但归根到底，当前医疗趋势压力在抬升医疗成本，而项目资金的削减在损害消费者的选择、可及性与价值。这对当下依赖 MA 以维持医疗可负担性的 3500 万 Medicare 合格人群而言，影响是真实存在的。因此，我们依然坚信 MA 的差异化价值主张，但在展望 MA 的长期增长率与机遇时，也必须强调项目稳定性的重要性。谢谢你的提问。
Operator
Next question comes from Kevin Fischbeck with Bank of America.
下一个问题来自 Bank of America 的 Kevin Fischbeck。
Kevin Fischbeck
BofA Securities, Research Division
I was wondering if you could talk a little bit more about Optum Health. The pullback in retrenchment and the refocus on certain types of plans, if we went back a number of years, who would have thought that value-based care could potentially serve the majority of MA lives. I mean is there a TAM that you're thinking about? Like what -- if you look at the markets today and the markets you want to focus on, what percentage of MA really lends itself to a successful value-based care model? And how penetrated is that today?
我想请你们再多谈一点关于 Optum Health 的情况。你们在收缩、整顿，以及重新聚焦某些类型的计划——如果我们把时间倒回若干年前，谁会想到价值导向医疗（value-based care）可能有能力覆盖 MA 群体的大多数？我的意思是，你们心里是否有一个可服务市场（TAM）的量级？比如说，站在今天、以及你们想要聚焦的市场来看，MA 中到底有多大比例适合于成功的价值导向医疗模型？而当下这一模型的渗透率又是多少？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
I'll have Krista respond to this, but I think we remain very positive and actually think MA should move more to value-based care and those themes just picking up exactly what Bobby said. So Krista, maybe you want to talk a little bit about the future of value-based care.
我请 Krista 来回答这个问题。不过我们的看法依然非常积极，我们实际上认为 MA 应该进一步向价值导向医疗转型，这也正好呼应了 Bobby 刚才的观点。那么，Krista，你或许可以谈谈价值导向医疗的未来。
Krista Nelson
Chief Executive Officer of UnitedHealthcare Community & State
Yes, absolutely. Kevin, thanks so much for the question. As we mentioned in our opening remarks, we are deeply committed to value-based care and research continues to validate the impact that it can have. We know fee-for-service rewards volume. We know that value-based care aligns incentives. And when you look across Optum Health, we've got an incredible set of assets that really enable an integrated delivery system to create value in the markets that we are focused in.
当然。Kevin，非常感谢你的提问。正如我们在开场白中所说，我们对价值导向医疗有着深度承诺，而研究也在持续验证其影响力。我们知道按次收费（fee-for-service）奖励的是服务量；我们也知道价值导向医疗能够实现激励对齐。从 Optum Health 的全局来看，我们拥有一套极具实力的资产，确实能够支撑一个整合式交付体系在我们聚焦的市场中创造价值。
And so I just think about the potential. It really is limitless. I think what you're seeing from us is a focus and operating discipline and really kind of getting back to some of our core so that we are able to expand and grow in the future. And we're really deepening our presence in the markets. We're focused on the appropriate network, on the appropriate providers, on the appropriate risk, footprint portfolio so that we are positioned for long-term success inside value-based care.
因此，就潜力而言，我认为几乎是“无上限”的。你从我们身上看到的是聚焦与运营纪律，实质上是回到一些核心要素，从而能够在未来实现扩张与增长。我们正在实实在在地加深在各个市场的布局，聚焦于合适的网络、合适的提供者、合适的风险与地域组合配置，以便在价值导向医疗领域获得长期成功的定位。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Which implies you have to have it aligned to the right products, you have to have it aligned to the right processes and disciplines, and that alignment is literally what we're returning to. So good question.
这意味着你必须让它与合适的产品对齐、与合适的流程与纪律对齐，而这种对齐正是我们正在回归的方向。问题问得很好。
Operator
Our next question comes from George Hill with Deutsche Bank.
下一个问题来自 Deutsche Bank 的 George Hill。
George Hill
Deutsche Bank AG, Research Division
We saw a pretty significant step up in what I would call discretionary expenses in the quarter compared to Q2. You talked a lot about the need for investment in a lot of the business lines. I guess as you think about those numbers, can you talk about -- can you quantify the step-up in investments that were incurred in Q3? And how much of those should we think of as run rate investments versus onetime investments where we'll see leverage going forward?
与第二季度相比，本季度我们看到你们所谓“可自由支配费用”有明显上升。你们也多次谈到许多业务线需要投入。从这些数字出发，你们能否说明——也就是量化一下——第三季度发生的投资增量？其中有多少应被视为经常性投入（run rate），有多少是一次性投入、未来会带来经营杠杆的？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Sure. Wayne, just take it.
好的。Wayne，请你回答。
Wayne DeVeydt
Chief Financial Officer
Yes. Thanks, George. I would say of the $450 million plus that we discussed, about 1/3 of that is a commitment to our foundation, which had not been funded at the levels that it should have been in the past and clearly puts us on a runway for multiple years of activities around the foundation. So view it as not necessarily run rate into next year, but nonetheless, something that we believe is part of our encore and core, and we'll continue to do it in the outer years.
好的。谢谢你，George。在我们提到的 4.5 亿美元以上的投入里，大约三分之一是对我们基金会的承诺。过去该基金会的资金并未达到应有水平，这次投入显然为未来多年的基金会活动提供了“跑道”。因此，这部分不一定会形成下一年的经常性（run rate），但它属于我们持续与核心的一部分，后续年份我们仍会继续做。
The delta of that then is all investments in our people. You heard Sandeep talk a bit about Optum Insight, and that cultivated with the number of resources we have there and aligning incentives around the execution that we expect. So I would view much of that as being recurring in nature, part of our core business and the investments we'll continue to make in the expansion that we see both in Optum Health and in AI specifically.
剩余的部分全部是对我们员工的投入。你们听到 Sandeep 谈到 Optum Insight——这与我们在那里的资源配置相配合，也围绕我们期望的执行对激励进行对齐。因此，我认为相当一部分具备经常性特征，属于我们核心业务的一部分；针对 Optum Health 以及尤其在 AI 方面的扩张，这类投入我们将会持续进行。
Operator
Our next question comes from Lisa Gill with JPMorgan.
下一个问题来自 JPMorgan 的 Lisa Gill。
Lisa Gill
JPMorgan Chase & Co, Research Division
I just had a question around utilization and how to think about it here in the back half of the year. Clearly, this quarter came in a little bit better than what we were expecting, but we're looking at what's happening with the exchanges, looking at the step-up in Part D. So can you maybe just talk about your expectation going into the fourth quarter? And specific to Part D, are you expecting a big step-up as we think about the fourth quarter?
我想问一下关于利用率，以及如何看待今年下半年的走势。显然，本季度结果略好于我们的预期，但我们也在观察交易所（exchanges）的情况，以及 Part D 的上升。那么你们能否谈谈进入第四季度的预期？尤其关于 Part D，在我们思考第四季度时，你们是否预计会有显著的抬升？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Tim, do you want to take this?
Tim，你来回答好吗？
Timothy Noel
Chief Executive Officer of UnitedHealthcare Business
Yes. Thanks, Lisa, for the question. So as I think about utilization, really tracking in line with the expectations that we called out in last quarter's call, really across all of the product lines, the general commercial business, including the ACA, as well as Medicare and Medicaid. And also on the Part D portion of the business, also tracking in line with expectations. Clearly, there is quite a bit of seasonality that's always at play in the health insurance business. I think you can think of normal seasonality, first half to second half, as 60% in the first half in terms of earnings contribution, 40% in the second half.
好的。谢谢你的提问，Lisa。关于利用率，我认为基本与我们上季度电话会中的预期一致，涵盖所有产品线：一般商业险（包括 ACA）、以及 Medicare 和 Medicaid。Part D 业务部分也与预期一致。显然，健康保险业务一直存在显著季节性。我认为从盈利贡献看，正常季节性通常是上半年约 60%，下半年约 40%。
This year, given some of the trends that we've seen, a little bit more of a bias towards earnings in the first half of the year versus the second half of the year, but really kind of trends tracking with how we expected them to track, consistent with what we guided in the second quarter and the seasonality really just kind of a byproduct of the business. And also some of the additional spend that we have on things like a seasonal ramp in AEP with respect to Medicare.
今年，基于我们所观察到的一些趋势，盈利更偏向上半年而非下半年，但总体走势仍按我们的预期运行，与二季度提供的指引一致；而季节性更多只是这门业务的“副产品”。此外，我们在 Medicare 的年度投保期（AEP）等季节性事项上也会有一些额外支出。
Operator
Our next question comes from Andrew Mok with Barclays.
下一个问题来自 Barclays 的 Andrew Mok。
Andrew Mok
Barclays Bank PLC, Research Division
I wanted to follow up on the Medicare Part D drug benefit for next year. It looks like the benefit for Tier 3 branded drugs changed from a co-pay to co-insurance across most of your MAPD and stand-alone Part D plans. Can you elaborate on your experience with the co-pay structure in 2025? And what drove that decision to change the benefit structure in 2026?
我想追问一下明年的 Medicare Part D 药品福利。看起来你们的大多数 MAPD 和独立 Part D 计划中，Tier 3 品牌药的福利从固定共付额（co-pay）改成了按比例共保（co-insurance）。你们能否详细说明一下 2025 年采用共付额结构的经验？是什么因素促使你们在 2026 年改变福利结构？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Bobby?
Bobby Hunter
CEO of Government Programs & Head of Medicare Insurance
Andrew, thanks for the question. So I would say just kind of big picture, we take a multiyear metered approach to our benefit planning that includes, as you can appreciate, managing and balancing many different variables, and that's particularly important given the dynamics around V28 and the phased approach there. The other element, perhaps, just to kind of call out, as you think about how we decided the modifications to make the benefit design for Part D in particular, for 2026, with some uncertainty around the demo program and how that would continue to persist or not into 2026. So we took what we felt was an appropriately kind of cautious approach there, pulling all the levers available to us to ensure that we would be well positioned on the overall benefit design regardless of how the demo came into 2026.
Andrew，感谢你的提问。总体而言，我们对福利规划采取多年、节奏化（metered）的策略，需要管理和平衡许多变量——在 V28 的动态及其分阶段实施背景下，这一点尤为重要。另一个需要指出的因素是，在决定 2026 年尤其是 Part D 的福利设计调整时，关于 demo program 在 2026 年是否以何种形式延续仍存在不确定性。因此，我们采取了我们认为合适的谨慎做法，动用所有可用的调节手段，以确保无论 demo 在 2026 年如何落地，我们在整体福利设计上都能占据有利位置。
So as I look now kind of where we sit from a benefit design standpoint with the co-insurance we have on Tier 3, the deductibles that we have kind of broadly across MAPD and PDP, I feel pretty aligned to industry there. And I would expect us to have continued good performance as we step then into 2026. And as it relates to '25, really on the MAPD side, no concerns around selection, mix or outlook given the prevalence of deductibles that we put on our MAPD offerings. And on PDP, really kind of no material contributor or risk to rest of your outlook on that one either. So overall, feel pretty good about how we're stepping into '26 on PDP.
就当前的福利设计而言，Tier 3 采用共保、且在 MAPD 与 PDP 广泛设置免赔额，我认为我们的做法与行业相当一致。我预期进入 2026 年我们仍将保持良好表现。至于 2025 年，MAPD 方面由于我们普遍设置了免赔额，在选择效应、结构或前景上并无顾虑；PDP 方面同样没有对全年展望构成实质性正负面的因素或风险。总体而言，我们对 PDP 迈入 2026 年的态势感觉良好。
Operator
Our next question comes from Ann Hynes with Mizuho Securities.
下一个问题来自 Mizuho Securities 的 Ann Hynes。
Ann Hynes
Mizuho Securities USA LLC, Research Division
My question is focused on Medicaid. At the last call, I believe, you said margins should be in the negative 1% to negative 1.5% range. Is that still a good bogey? And just like looking, with the One Big Beautiful Bill, is there anything that would prevent like a path to Medicaid margin recovery in 2007 (sic) [ 2027 ] and 2028?
我的问题聚焦在 Medicaid。上次电话会上，我记得你们说利润率应在 -1% 到 -1.5% 的区间。这个目标现在仍然适用吗？另外，结合 One Big Beautiful Bill 来看，有没有什么因素会阻碍 Medicaid 在 2027 年和 2028 年走上利润率修复路径？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Mike, do you want to take that?
Mike，你来回答好吗？
Mike Cotton
Yes. Ann, thanks for the question. As Tim indicated, our view for Medicaid has not changed from last quarter. We expect breakeven in 2026 -- in 2025. As we think about 2026, we expect some margin degradation due to the continued dislocation of premium funding and what we're seeing in terms of elevated medical cost trends. But we do see 2026 as the trough for that performance. Our elevated trends are driven, as the industry has, by specialty pharmacy, behavioral health and also as we look at home health services. We think, over time, the One Big Beautiful Bill, there will be some transformation and work as we collaborate with states. But we see, over time, about an 18- to 24-month period, we will be able to return to a rate of margins of around 2%. Thank you very much for the question.
好的。Ann，感谢你的提问。正如 Tim 所述，我们对 Medicaid 的看法与上季度一致。我们预计 2025 年实现盈亏平衡。展望 2026 年，由于保费资金持续错配以及我们所见的医疗成本高企，利润率会有一定下滑，但我们认为 2026 年将是该表现的谷底。推动高位趋势的因素，与行业一致，主要来自 specialty pharmacy、行为健康以及居家医疗服务。我们认为，随着与各州协作推进，One Big Beautiful Bill 将在一段时间内带来一定的转型与改进。整体来看，约 18—24 个月后，我们有望将利润率恢复到约 2% 的水平。非常感谢你的提问。
Operator
Our next question comes from Lance Wilkes with Bernstein.
下一个问题来自 Bernstein 的 Lance Wilkes。
Lance Wilkes
Sanford C. Bernstein & Co., LLC., Research Division
Could you talk a little bit about the employer market? And specifically, what's the medical cost trends you're seeing this year and next? And given the pressures on employers, what are some of the strategies they're looking at for the '26 and looking out to '27 on the selling seasons? In particular, any interest in adoption of value-based care? Are they using more Surest, things like that?
你们能否谈谈雇主市场？具体来说，你们今年和明年的医疗成本趋势如何？在雇主面临压力的情况下，他们在 2026 年以及展望 2027 年的销售季会采用哪些策略？特别是，他们是否对价值导向医疗有兴趣？是否更多采用 Surest 等产品？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Dan?
Daniel Schumacher
Chief Strategy & Growth Officer
Yes. Thanks, Lance, for the question. Trends for 2025 and our outlook for 2026 remain in line with what we shared in the guidance last quarter. Trends are approximately 11%, and that is how we have priced into 2026, and I'll just share that. With 50% of our January insured business resolved at this point, encouraged by both the yield on persistency and rate to deliver the margin expansion that Tim spoke about in light of that trend of approximately 11%.
好的。谢谢你的提问，Lance。2025 年的趋势以及我们对 2026 年的展望与上季度指引一致，趋势约为 11%，我们也据此为 2026 年定价。截至目前，明年 1 月起生效的承保业务已有约 50% 落地；考虑到约 11% 的趋势，我们在续保稳定性与费率带来的收益方面都看到积极信号，这将支撑 Tim 所提到的利润率扩张。
You're right, health care affordability is top of mind for all employers and we hear that this selling and renewal season, as we always do, but even a little bit louder given the trends and the pricing associated with it. Employers are evaluating a host of considerations. You referenced Surest, and Surest continues to be a leading product for us, continuing to capture share. And that has continued to grow and has a robust pipeline already as we look toward the jumbo selling season of 2027.
没错，医疗可负担性是所有雇主的首要关切。本轮销售与续约季我们听到的声音依旧强烈，鉴于当前趋势与相应定价，这种关切甚至更甚。雇主在评估多项举措。你提到的 Surest 依然是我们的拳头产品，市场份额持续提升，增长态势良好；面向 2027 年的大型销售季，我们已拥有强劲的在手储备。
I might highlight some additional things that employers are looking at as well. Integrated advanced advocacy solutions that we sell in our product portfolio continue to capture employer attention as they help us bring together more synergistic approaches to care.
我再强调几项雇主关注的方向：我们产品组合中的一体化高级“advocacy”（引导/倡导式）解决方案持续获得关注，因为它们有助于将更多协同式护理方式整合在一起。
That includes value-based care, as you referenced, tighter coordination between medical benefits and Rx benefits, which employers are continuing to do on an increasing basis, as we see more and more employers moving to combining medical and Rx benefits and satisfied very much so with how we're advancing in that way with Optum Rx. So those are a couple of highlights that I would offer that are on top of mind for employers, certainly, for 2026 and already as we look forward into 2027. Thanks for the question, Lance.
其中包括你提到的价值导向医疗，以及医疗福利与处方药（Rx）福利之间更紧密的协同。我们看到越来越多的雇主把医疗与 Rx 福利打包配置，并对我们与 Optum Rx 在这方面的推进表示满意。以上就是我想强调的、当前及 2026 年最受雇主关注的要点，并且已经延伸到 2027 年的规划。谢谢你的提问，Lance。
Operator
Next question comes from Scott Fidel with Goldman Sachs.
下一个问题来自 Goldman Sachs 的 Scott Fidel。
Scott Fidel
Goldman Sachs Group, Inc., Research Division
I appreciate the update on the capital deployment timing returning to the normal plan. Can you also just update us on sort of the dividend and what your view is on the dividend and that looking forward? And then curious just around -- I know that there's going to need to be possibly some portfolio rationalizations occurring in Optum Health and other businesses as you pursue the new approach. Is there a way that you can sort of frame that for us in terms of, I don't know, whether it's sort of revenue or just more philosophically, how you're thinking about the asset base in OH and maybe more broadly around where -- and around potential rationalizations that could occur?
感谢你们关于资本部署时点回归常态计划的更新。能否也更新一下股息的情况，以及你们对股息的看法与前瞻？另外，我也好奇——我知道在你们推进新方法时，Optum Health 以及其他业务可能会进行一些资产组合的优化调整。能否为我们勾勒一个框架？比如从收入维度，或者更偏理念层面，你们如何看待 OH 的资产基础，以及更广泛地，哪些地方可能会发生这些优化调整？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Sure. The dividend, we'll start with Wayne and then I'll start with Optum and give it to Krista and to Patrick. So Wayne?
好的。关于股息，先请 Wayne 回答；随后我来谈 Optum，再交给 Krista 和 Patrick。Wayne？
Wayne DeVeydt
Chief Financial Officer
Thanks, Steve. Scott, there are no changes in our historical dividend practices nor do we expect those to change going forward. We will maintain the dividend as we've done. The next prioritization, as we're paying down debt, will then revert back to the buyback program and then our strategic acquisition. So view it as no changes and then hopefully back into our normal capital deployment activities back half of next year.
谢谢你，Steve。Scott，我们在历史股息做法上没有变化，且预计未来也不会改变。我们将继续维持既有股息政策。接下来的优先顺序是在降债的同时，恢复回购计划，其后是战略并购。所以可以理解为：股息无变化，并且我们希望在明年下半年回到常态的资本部署节奏。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
And then just broadly, related to Optum Health, helping people understand, we are very much committed to this. We are just reshaping it back to the way we had originally conceived it and believe that it has the most impact on value and we're really just taking the right steps to bring that back into form so that we can really move and grow and advance it in the construct of that disciplined model we had going forward. So Krista, do you want to talk a little bit about that?
再从更宏观的角度谈 Optum Health，让各方明白：我们对这项业务的承诺非常坚定。我们正在把它重塑回最初构想的样子——我们相信那样的形态对价值创造的影响最大。我们正在采取正确步骤，将其带回到那种有纪律的模型中，以便继续推进、发展与壮大。Krista，你来补充一下？
Krista Nelson
Chief Executive Officer of UnitedHealthcare Community & State
Yes, I can just add to that. Thanks for the question. So yes -- so Scott, as Steve mentioned, we are really kind of taking a look at the whole like integrated delivery system. We have a combination of value-based care assets, some assets that are focused more on fee-for-service, but truly enable that value-based care agenda. And it's really important to ensure that kind of integrated model can deliver the best outcomes. And so as we're thinking about the portfolio rationalization, we taking into account a combination of things like where we have the right clinical quality, where we have the best operating cost performance, where we have the right engagement and where that model can really be brought to life for both value-based and those kind of fee-for-service service lines as well.
好的，我来补充。谢谢你的问题。Scott，正如 Steve 所说，我们在审视的是整个一体化交付体系。我们既有价值导向医疗（VBC）资产，也有更偏向按次收费（fee-for-service）的资产，但这些资产同样能够支撑 VBC 议程。确保这种一体化模型能够交付最佳结果至关重要。因此，在考虑资产组合优化时，我们会综合评估多项因素：临床质量是否达标、运营成本表现是否最佳、患者与提供者的参与度是否到位，以及该模型能否在 VBC 与按次收费两类服务线上真正落地。
And so I think those are the ways in which we're kind of looking at the model. So it's a market focus. We are looking at rooftops. We are again looking at the populations, the risk, the products, and I think through all of that, there will be an output of some actions that we'll take in the near term to position us for long-term success of that integrated model.
以上就是我们审视该模型的方式。我们以市场为核心，看具体网点（rooftops），再看服务人群、风险与产品结构。综合这些维度，我们将在近期采取一系列行动，为这一一体化模型的长期成功奠定基础。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Likely withdraw from a few geographic markets, likely reshape the practices within certain markets where we remain, likely shape, let's say, the primary delivery system along line with the complementary services, things along those -- that nature. All very logical, all actually more constructive, but to be constructive, sometimes you have to take some things away.
我们很可能会从少数地理市场撤出；在保留的部分市场，重塑当地的医疗实践；并按照互补服务来重塑核心交付体系。类似这样的举措，逻辑上都是成立且更具建设性的——但要实现建设性，有时也需要做“减法”。
Patrick Conway
Chief Executive Officer of Optum Rx
In the -- to add one point across Optum and connect a couple of questions. In the face of escalating cost trends, what we hear from our payer partners, from employers and from patients and providers is they want a value-based care system that delivers better quality, better experience and lower cost of care. And that's what Optum is delivering to our various customers.
补充一点，串联一下前面几个问题：在成本趋势不断上行的背景下，我们从付费方合作伙伴、雇主、患者与提供者那里听到的诉求是一致的——他们希望有一个能够带来更高质量、更佳体验、且更低医疗成本的价值导向医疗体系。这正是 Optum 正在为各类客户交付的东西。
Operator
Our next question comes from Erin Wright with Morgan Stanley.
下一个问题来自 Morgan Stanley 的 Erin Wright。
Erin Wilson Wright
Morgan Stanley, Research Division
So I have a follow-up on that front. Is there anything you can quantify or break down for us in terms of those steps to turn around Optum Health? Like how much is just walking away from risk? How much is fixing the fee-for-service business? And presumably, that could be addressed a little bit quicker, right? And how much is just integrating into a consolidated operating model? And then what sort of incremental investments that you can quantify at this point that needs to go into that business as well? Presumably, does this all get you to 6% to 8% margin in 2028 and that's just back end weighted? Is that the right way to think about it?
我就此再追问一下。关于扭转 Optum Health，你们是否能量化或拆解相关举措？比如，有多少是“退出风险承担”？有多少是修复按次收费（fee-for-service）业务——按理说这块应当更快见效，对吗？又有多少是整合进统一的运营模型？此外，目前可量化的、需要投入到该业务的增量投资规模大致是多少？按推测，这一切是否将把你们在 2028 年带到 6%—8% 的利润率，而且是“后半段权重更高”？这样理解是否正确？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
I think directionally, I don't think we can achieve the level of precision you might be looking for something like that just because this does blend together. But Krista, do you want to respond?
我认为在方向上大体如此，但要达到你所期望的那种精确度并不现实，因为这些举措彼此交织。Krista，你来回应一下？
Krista Nelso
Chief Executive Officer of UnitedHealthcare Community & State
Yes. Yes, thanks for the question, Erin. So let me just kind of start where you ended, which is likely more back half weighted, but you should expect progress throughout here. And while we might see faster progress in some fee-for-service improvement, Patrick highlighted whether that's kind of productivity or scheduling or improving access or collection rate, you will also start to see some progress on our value-based portfolio as well.
好的。谢谢你的问题，Erin。我先从你问题的结尾处说起：结果大概率会是“后半段权重更高”，但整个期间都会有进展。尽管在按次收费的改进上（如 Patrick 提到的生产率、排班、就医可及性或回款率）可能更快见效，你也会开始在我们的价值导向组合上看到进展。
So think of things like medical management, the work we're doing with our payers, the work we're doing to curate our networks, also the work we're doing to manage operating cost discipline. So these things really all come together in this integrated model, but maybe some faster progress in certain areas while you'll still continue to see kind of progress against the holistic model.
例如医疗管理、与付费方的协作、我们对网络的精细化梳理，以及我们对运营成本纪律的管控。这些要素都汇入同一个一体化模型：有些领域会更快推进，但你也会持续看到整体模型的稳步进展。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
For example, you kind of -- a little bit of further ahead in the Eastern region on this and seeing some impact on that, and that's a good example of how this will progress, right? So a pickup in terms of volume there, greater capture, greater reach.
举个例子，东部区域在这方面推进得更靠前，已经能看到一些效果——这很好地说明了这一进程会如何展开：那里的量在回升，获取能力更强，覆盖范围更广。
Operator
Our next question comes from Dave Windley with Jefferies.
下一个问题来自 Jefferies 的 Dave Windley。
David Windley
Jefferies LLC, Research Division
My question is related somewhat. But I think earlier in the call, you quantified that half of your headwind, I think the V28 headwind for 2026, you plan to mitigate through recontracting. And I wanted to make sure I understood, is that across the portfolio of payers? Are you mostly harvesting that from the UHC portion? The non-UHC portion? And then is the -- did I hear correctly that VBC lives you expect to decline by 10%? Is that interwoven in that at all?
我的问题与此相关。我记得你们在本次电话会较早时提到，2026 年 V28 的逆风中有一半计划通过重新签约来对冲。我想确认这是否涵盖你们全部付费方组合？主要来自 UHC 端，还是非 UHC 端？另外，我是否听对了：你们预计 VBC 会员人数将下降 10%？这与重新签约之间是否相互交织？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
So Krista, do you want to respond?
Krista，你来回答好吗？
Krista Nelson
Chief Executive Officer of UnitedHealthcare Community & State
Yes, absolutely. So yes, so -- like Patrick mentioned, so we sought to overcome half of the V28 headwind through our payer contracting efforts, which would include all payers. And we have completed that, and we're about 90% complete with our contracting with line of sight to the rest by the end of the year. So I feel good about that. That encompasses rates as well as product and benefits. And we've talked a little bit about some market exits inside of that. So exiting more than 40% of our PPO footprint was also kind of part of that exercise, but again, across all of our payers.
当然可以。正如 Patrick 提到的，我们希望通过与付费方的签约工作来对冲 V28 逆风的一半，覆盖所有付费方。相关工作已基本完成：目前约 90% 的合约已到位，其余部分预计在年内可见落地路径。内容包括费率、产品与福利设计。我们也提到会有部分市场退出，其中退出超过 40% 的 PPO 足迹也是该项工作的组成部分，但同样是覆盖我们所有付费方的组合。
And then you asked about membership as well with the approximately 10% reduction as we pace into next year. Again, we probably will see even some additional PPO exit as part of the work we continue to do with all of our payers and the work that we're going to do to finish that work. But then that would be just really a direct result of actions we're taking to optimize our portfolio. So again, products, market, footprint and the risk that is appropriate for this model.
至于你问到的会员规模，我们预计明年整体约下降 10%。随着我们与各类付费方继续推进相关工作，PPO 侧可能还会有进一步的退出。这主要是我们为优化资产组合所采取行动的直接结果——再次强调，围绕产品、市场、网点足迹以及与该模型相匹配的风险配置来进行优化。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Leaning into products that lend themselves to management.
更加倾向于便于管理的产品。
Krista Nelson
Chief Executive Officer of UnitedHealthcare Community & State
Exactly.
正是如此。
Operator
Our next question comes from Jessica Tassan with Piper Sandler.
下一个问题来自 Piper Sandler 的 Jessica Tassan。
Jessica Tassan
Piper Sandler & Co., Research Division
Can you describe just the tone of any recent conversations you may have had with CMS, their receptivity and posture towards MA? What do you think CMS is focused on from a STARS risk adjustment and MA rate perspective? And what is UHC lobbying for?
你们能否描述一下近期与 CMS 对话的基调、他们对 MA 的接受度与姿态？从 STARS、风险调整与 MA 费率角度看，你们认为 CMS 当前关注什么？UHC 又在游说什么？
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
You guys can decide which -- want to respond to that. We're not lobbying for anything in particular. So, please?
你们看谁来回答这个问题。我们并没有就某件特定事情进行游说。请？
Timothy Noel
Chief Executive Officer of UnitedHealthcare Business
Yes. Thanks, Jess, for the question. As I think about CMS receptivity, we've been encouraged and continue to be very encouraged of the receptivity of this administration to have conversations with industry about ways to modernize and ways to improve this already very popular program. This is in direct contrast to what we experienced over the previous administration. And we always enjoy and appreciate the efforts to be able to have these fact-based conversations around how to modernize the program and feel like that's the best way to get to a constructive answer and a constructive way to move forward.
好的。谢谢你的提问，Jess。谈到 CMS 的开放度，我们对本届政府愿意与行业就如何实现现代化、如何改进这一已经非常受欢迎的项目展开对话感到鼓舞，并持续感到鼓舞。这与我们在上一届政府中的经历形成鲜明对比。我们始终欢迎并感激围绕项目现代化开展基于事实的对话，并认为这是达成建设性答案、以建设性方式向前推进的最佳路径。
So encouraged, again, on just the level of activity and the level of conversation that we have with the administration, and we'll continue to do that and continue to bring to them ideas that we think are ideas that are the best path forward that provides some level of stability for beneficiaries and also modernize the program in the process.
总体而言，我们对与政府当前的互动频次与对话水平持乐观态度；我们将继续这样做，并持续向其提出我们认为最有利于前进的方案，在推进项目现代化的同时，也能为受益人提供一定程度的稳定性。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Yes, absolutely. So we have time for one question remaining.
好的，当然。我们还剩最后一个提问时间。
Operator
Our last question comes from Whit Mayo with Leerink Partners.
最后一个问题来自 Leerink Partners 的 Whit Mayo。
Benjamin Mayo
Leerink Partners LLC, Research Division
All right. Tim, I was just hoping that you could comment more on the provider coding stuff that you were talking about. We hear pushback on that from many health systems. And then maybe any observations that you could share on the independent dispute resolution process and actions you're taking there or the impact on trend.
好的。Tim，我想请你进一步评论一下你之前提到的关于医疗提供者编码的问题。我们从很多医疗系统那里听到对此的反对意见。然后，你能否分享一下对独立争议解决（IDR）流程的观察、你们在那方面采取的行动，以及对趋势的影响？
Timothy Noel
Chief Executive Officer of UnitedHealthcare Business
Yes. Thanks for the question, Whit. So when I think about some of what we're seeing in trend, there certainly is a meaningful portion of it that is related to more service intensity per encounter being billed by health systems and by providers. Some of the ways that's coming through are higher-cost sites of service where lower costs are available. Think lab, think ER and surgery. I'm also seeing more services being attached to ER visits and hospital visits, an increase in the number of specialists that are rounding per inpatient stays and then a bias towards some higher DRG weighting than we've seen in the past. And it is happening fairly consistently across the country, but then also have some fairly -- very significant outliers.
好的。谢谢你的提问，Whit。就我们看到的趋势而言，其中确实有相当一部分与医疗系统和提供者在每次就诊中计费的“服务强度”提高有关。具体体现包括：在存在更低成本选项的情况下，更多采用成本更高的医疗场所（比如检验、急诊（ER）和外科手术）。我还看到，急诊与住院就诊附加更多服务；每次住院查房的专科医生人数增加；以及相较过去出现更高 DRG 权重的倾向。这些情况在全国范围内相当一致，但也存在一些非常显著的极端值。
And one part of what we're doing is we are addressing these outliers, we have to. We have to keep medical costs and health care affordable for consumers, affordable for states, the federal government. So we will be taking some network actions where we need you to keep health care affordable. We're also using -- making more use of AI in our payment integrity programs, increasing some of our payment policy efforts as well as our clinical affordability programs to address some of what we're seeing.
我们正在做的一部分工作，就是处理这些极端值——这是必须的。我们必须让医疗成本与医疗服务对消费者、各州以及联邦政府保持可负担。因此，在需要维持医疗可负担性的领域，我们将采取一些网络层面的举措。我们也在支付完整性（payment integrity）项目中更多地使用 AI，强化部分支付政策工作，以及临床可负担性项目，以应对我们所观察到的现象。
As I think about the IDR process, it's not something that would spike out in terms of a material trend driver from this distance, but certainly something that we're keeping an eye on pretty carefully.
就 IDR 流程而言，从当前视角看，它并非显著的趋势驱动因素，但我们肯定会持续密切关注。
Stephen Hemsley
CEO & Non-Independent Non-Executive Chairman
Great. So thanks, great conversation today. That's all we really have time for. I want to thank you all for joining us, and we look forward to talking with you again and engaging with you before we get to January. And in January, we will provide both our year-end results as well as guidance for 2026. So thank you all for joining us this morning.
很好。感谢大家，今天的交流非常精彩。我们的时间就到这里。感谢各位参与，我们期待在 1 月之前与大家继续交流。到 1 月时，我们将发布全年业绩以及 2026 年指引。再次感谢各位今天上午的参与。