Q3 2023 UnitedHealth Group Inc Earnings Call

Good morning, and welcome to the Unitedhealth Group third quarter 2023 earnings Conference call. A question and answer session will follow Unitedhealth group's prepared remarks as well.

Speaker 1: UnitedHealth Group Third Quarter 2023 Earnings Conference call. A question and answer session will follow UnitedHealth Group's prepared remarks. As a reminder, this call is being recorded. Here are some important introductions for

This call is being recorded.

Here's some important introductory information.

Speaker 1: This call contains forward-looking statements under U.S. federal security laws.

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.

Speaker 1: statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations.

Speaker 1: A description of some of the risks and uncertainties can be found in the reports that we file with the Securities and Exchange Commission, including the cautionary statements included in our current and periodic filing.

A description of some of the risks and uncertainties can be found in the reports that we file with the Securities and Exchange Commission, including the cautionary statements included in our current M periodically filings.

Speaker 1: This call will also reference non-GAAP amounts. A reconciliation of the non-GAAP to GAAP amounts is available on the Financial and Earnings Reports section of the Companies Investor Relations page at www.unitedhealthgroup.com.

This call will also reference non-GAAP amounts a reconciliation of the non-GAAP to GAAP amounts is available on the financial and earnings reports section of the company's Investor Relations page at Www Dot Unitedhealth group Dotcom.

Information presented on this call is contained in the earnings release, we issued this morning and in our form 8-K dated October 13th at 'twenty, two 'twenty, three which may be accessed from the Investor Relations page of the company's website.

Speaker 1: Information presented on this call is contained in the earnings release we issued this morning and in our form 8K dated October 13, 2023.

Unknown Executive: Good morning and welcome to the UnitedHealth Group third quarter 2023 earnings conference call. A question and answer session will follow UnitedHealth Group's prepared remarks. As a reminder, this call is being recorded.

Speaker 1: may be accessed from the investor relations page of the company's website.

Speaker 1: I will now turn the conference over to the Chief Executive Officer of United Health Group, Andrew Whitty.

I will now turn the conference over to the Chief Executive Officer of Unitedhealth Group Andrew witty.

Unknown Executive: Here is some important introductory information. This call contains forward-looking statements under US Federal Security Laws. These statements are subject to risk and uncertainties that could cause actual results to differ materially from historical experience or present expectations. A description of some of the risk and uncertainties can be found in the reports that we file with the Securities and Exchange Commission, including the cautionary statements included in our current and periodic filings. This call will also reference non-gap amounts. A reconciliation of the non-gap to gap amount is available on the financial and earnings report section of the company's investor relations page at www.unithelpgroup.com.

Good morning, and thank you for joining us.

Speaker 2: Good morning and thank you for joining us. The third quarter results we reported today reflect well-balanced and durable growth supported by disciplined execution.

Third quarter results, we reported today reflect well balanced and durable growth supported by disciplined execution.

Speaker 2: and the steadfast commitment to ensure high quality comprehensive care is well within reach for every person we're privileged to serve.

The steadfast commitment to ensure high quality comprehensive care is well within reach for every person we are privileged to serve.

Evolution in our marketplace, including regulatory changes means agility and adaptability must continue to be defining characteristics of our company.

Speaker 2: Evolution in our marketplace, including regulatory changes, means agility and adaptability must continue to be defining characteristics of our company.

Speaker 2: People of Optum and UnitedHealthcare continuously strive to find new ways to innovate, serve and grow.

The people of Optum, and United Health care continuously strive to find new ways to innovate and grow.

As a direct result of the mission driven focus this year will serve even more people more comprehensively than anticipated in the outlook. We offered at the end of 2022.

Speaker 2: As a direct result of their mission-driven focus, this year we'll serve even more people more comprehensively than anticipated in the outlook we offered at the end of 2022.

Unknown Executive: Information presented on this call is contained in the earnings release we issued this morning and in our form 8K dated October 13th 2023, which may be accessed from the investor relations page of the company's website.

Speaker 2: By the close of this year, we will serve nearly 900,000 additional patients under value-based care arrangements at Optum Health.

By the close of this year, we will serve nearly 900000 additional patients under value based care arrangements of Optum health.

Andrew Witty: I will now turn the conference over to the Chief Executive Officer of UnitedHealth Group Andrew Whittie. Good morning, and thank you for joining us. The third quarter results we reported today reflect well-balanced and durable growth, supported by disciplined execution, and the steadfast commitment to ensure high quality, comprehensive care is well within reach for every person we're privileged to serve.

Almost 1 million new consumers across Unitedhealth, guys Medicare advantage offerings.

Total more than $1 5 billion scripts to the people who rely on optimal racks.

Based on this performance, we're strengthening our 2023 adjusted earnings outlook to a range of $24.85 to <unk> $25 per share.

Speaker 2: Based on this performance, we're strengthening our 2023 adjusted earnings outlook to a range of $24.85 to $25 per share.

The confidence we have enough sustained long term growth outlook is exemplified by the 14% third quarter revenue increase we reported this morning more than $11 billion above last year.

Speaker 2: The confidence we have in our sustained long-term growth outlook is exemplified by the 14% third quarter revenue increase we reported this morning, more than $11 billion above last year.

Andrew Witty: Evolution in our marketplace, including regulatory changes, means agility and adaptability must continue to be defining characteristics of our company. The people of Optum and UnitedHealth Care continuously strive to find new ways to innovate, serve, and grow. As a direct result of their mission-driven focus, this year we'll serve even more people more comprehensively than anticipated in the outlook we offered at the end of 2022. By the close of this year, we will serve nearly 900,000 additional patients under value-based care arrangements at Optum Health.

The sources of this growth will drive many more years of strong performance.

Value based care is the centerpiece of our long term strategy precisely because it delivers on the promise of high quality clinical outcomes and experiences at lower cost than traditional models.

Speaker 2: Value-based care is the centerpiece of our long-term strategy, precisely because it delivers on the promise of high-quality clinical outcomes and experiences at lower cost than traditional models.

This year, we expect Optum health will serve more than 4 million people and fully accountable relationships.

Speaker 2: This year, we expect optimum health will serve more than 4 million people in fully accountable relationships.

Speaker 2: Almost twice as many people as we served just two years ago.

Andrew Witty: Almost 1 million new consumers across UnitedHealth Care's Medicare Advantage offerings, and a total more than 1.5 billion scripts to the people who rely on Optum Rx. Based on this performance, we're strengthening our 2023 adjusted earnings outlook to a range of $24.85 to $25 per share. The confidence we have in our sustained long-term growth outlook is exemplified by the 14% third quarter revenue increase we reported this morning, more than $11 billion above last year. The sources of this growth will drive many more years of strong performance.

Almost twice as many people as we serve just two years ago.

Many of these patients have serious health challenges few economic resources and until now often had limited access to care or the type of care they truly need.

Speaker 2: Many of these patients have serious health challenges, few economic resources, and until now, often had limited access to care, or the type of care they truly need.

Ramping up to engage these patients require significant upfront investment and high touch reach these early efforts ensure we can address patients unique needs and design personalized care plans that drive better health outcomes increase quality of life and deliver cost savings throughout the health system.

Speaker 2: Ramping up to engage these patients requires significant upfront investment and high-touch reach. These early efforts ensure we can address patients unique needs and design personalized care plans that drive better health outcomes, increase quality of life and deliver cost savings throughout the health.

Making the investments to serve people who have endured far too many barriers to care is an easy choice first of all.

Speaker 2: Making investments to serve people who have endured far too many barriers to care is an easy choice for us all.

Andrew Witty: Value-based care is the centerpiece of our long-term strategy, precisely because it delivers on the promise of high-quality clinical outcomes and experiences at lower cost than traditional models. This year, we expect Optum Health will serve more than 4 million people in fully accountable relationships. Championships, almost twice as many people as we served just two years ago. Many of these patients have serious health challenges, few economic resources, and until now, often had limited access to care, or the type of care they truly need.

Speaker 2: In 2023, you have seen both our commitment and financial capacity to invest, to further enable our ability to serve and to grow far into the future.

In 2023, you've seen both our commitment and financial capacity to invest to further enable our ability to serve and to grow far into the future.

Speaker 2: In recent years, we've invested significant resources in building our capabilities to care for people most effectively. For the life or health stage, they find themselves in. Whether they need preventative or palliative care, or are best served in a clinic at home or virtually.

In recent years, we've invested significant resources in building our capabilities to care for people most effectively for the life or health states. They find themselves in whether they need preventative or palliative care or are best served in a clinic at home all virtually and.

In particular, we're advanced in our ability to care for people in their homes and integrating that physical care with our pharmacy and behavioral offerings.

Speaker 2: in particular. We're advancing our ability to care for people in their homes and integrating that physical care with our pharmacy and behavioral office.

Andrew Witty: Ramping up to engage these patients requires significant upfront investment and high touch reach. These early efforts ensure we can address patient's unique needs and design personalised care plans that drive better health outcomes, increase quality of life, and deliver cost savings throughout the health system. Making investments to serve people who have endured far too many barriers to care is an easy choice for us all.

Speaker 2: This work means developing an even more versatile clinical workforce to serve consumers in more ways through clinic-based, optum-care delivery capabilities and extending our reach to consumers who may not have ready access to physical clinics.

This work means developing an even more versatile clinical workforce to serve consumers in more ways through clinic based optum care delivery capabilities and extending our reach to consumers, who may not have ready access to physical clinics.

Medicare advantage continues to be a powerful force in driving superior health outcomes for consumers.

Speaker 2: Medicare Advantage continues to be a powerful force in driving superior health outcomes for consumers and in helping to lower costs at the system level.

And in helping to lower costs at the system level.

Speaker 2: Today, about half of all seniors in the US have chosen Medicare Advantage over traditional Medicare, and that number will continue to expand for very good reason.

Andrew Witty: In 2023, you have seen both our commitment and financial capacity to invest to further enable our ability to serve and to grow far into the future. In recent years, we've invested significant resources in building our capabilities to care for people most effectively, for the life or health stage they find themselves in, whether they need preventative or palliative care or are best served in a clinic at home or virtually. In particular, we're advancing our ability to care for people in their homes and integrate in that physical care with our pharmacy and behavioural offerings. This work means developing an even more versatile clinical workforce to serve consumers in more ways through clinic-based optum care delivery capabilities and extending our reach to consumers who may not have ready access to physical clinics.

Today about half of all seniors in the U S have chosen Medicare advantage over traditional Medicare.

That number will continue to expand for very good reasons.

The results are well documented Medicare advantage outperformance traditional fee for service with seniors on many measures, including lower rates of hospitalization.

Speaker 2: The results are well documented. Medicare Advantage outperforms traditional fee-for-service for seniors on many measures, including lower rates of hospitalisation.

And they spend up to 45% less out of pocket compared to those in Medicare fee for service.

Speaker 2: and they spend up to 45% less out of pocket compared to those in Medicare FIFA service.

Importantly, this high value for consumers is delivered at a lower cost to the health system.

Speaker 2: This high value for consumers is delivered at a lower cost to the health.

United Healthcare, so there's more people and high quality full star and higher Medicare advantage plans than any other organization.

Speaker 2: United Health Care serves more people in high quality four-star and higher Medicare Advantage plans than any other organization.

Speaker 2: Look into the 2024 enrollment period, which begins Sunday, we're confident our offerings will again resonate with consumers as they prioritize high quality care and stable benefits.

Looking to the 2024 enrollment period, which begins Sunday, we're confident our offerings will again resonate with consumers as they prioritize high quality care and stable benefits.

Andrew Witty: Medicare Advantage continues to be a powerful force in driving superior health outcomes for consumers and in helping to lower costs at the system level. Today, about half of all seniors in the US have chosen Medicare Advantage over traditional Medicare and that number will continue to expand for very good reasons. The results are well documented. Medicare Advantage outperforms traditional fee-for-service for seniors on many measures, including lower rates of hospitalisation and they spend up to 45% less out-of-pocket compared to those in Medicare fee-for-service.

And the reduced funding environment health plans face I credit our teams for investing in the areas consumers value most including zero dollars premium plans no co pays for primary virtual and preventative care and no co pays for hundreds of the most commonly prescribed drugs.

Speaker 2: In the reduced funding environment, health plans face, I credit our teams for investing in the areas consumers value most, including zero dollar premium plans, no copays for primary, virtual and preventative care, and no copays for hundreds of the most commonly prescribed drugs.

I want to highlight one more aspect of our growth story.

Speaker 2: I want to highlight one more aspect of our growth story that consistently strong performance of our pharmacy business.

Our consistently strong performance of our pharmacy businesses.

Speaker 2: Pharmacy, as you know, is the most common consumer touch point in healthcare.

Pharmacy as you know is the most common consumer touch points in health care.

Speaker 2: What consumers and employers want more than anything is access to the most effective treatments in the moment they need them for the lowest possible cost.

What consumers and employers more than anything is access to the most effective treatments in the moment they need them for the lowest possible cost.

Andrew Witty: Importantly, this high value for consumers is delivered at a lower cost to the health system. United health care serves more people in high quality four-star and higher Medicare Advantage plans than any other organisation. Look into the 2024 enrollment period which begins Sunday, we're confident our offerings will again resonate with consumers as they prioritize high quality care and stable benefits. In the reduced funding environment health plans face, I credit our teams for investing in the areas consumers value most, including zero dollar premium plans, no copays for primary, virtual and preventative care, and no copays for hundreds of the most commonly prescribed drugs.

<unk> is delivering on those expectations. This most recent selling season is on track to be among our strongest reflecting a combination of new clients and retention rates in the very high nineties.

Speaker 2: This most recent selling season is on track to be among our strongest. Reflecting a combination of new clients and retention rates in the very high nine.

And as the coming season for 2025 develops we're expecting another year of robust growth.

Speaker 2: And as the coming season for 2025 develops, we're expecting another year of robust growth.

Our clients tell us they value the enhancements, we are making to our pharmacy offerings, providing them transparency and choice, while also integrating new tools and capabilities.

Speaker 2: Our clients tell us they value the enhancements we are making to our pharmacy offerings, providing them transparency and choice while also integrating new tools and capabilities.

Notably our pharmacy service offerings go far beyond the foundational benefit management capabilities and now account for about half of all Optum Rx revenues.

Speaker 2: Notably, our pharmacy service offerings go far beyond the foundational benefit management capabilities and now account for about half of all Optamar X revenue.

Andrew Witty: I want to highlight one more aspect of our growth story that consistently strong performance of our pharmacy businesses. Pharmacy, as you know, is the most common consumer touch point in health care. What consumers and employers want more than anything is access to the most effective treatments in the moment they need them for the lowest possible cost. OptimaRX is delivering on those expectations. This most recent selling season is on track to be among our strongest, reflecting a combination of new clients and retention rates in the very high 90s.

Speaker 2: We continue to expand the reach of our community pharmacies and our diverse specialty and infusion offerings are growing double-did.

We continue to expand the reach of our community pharmacies, and our diverse specialty and infusion offerings are growing double digits.

Speaker 2: Driving this expanding market demand is the enormous pressure facing employers, health plans, governments and others to manage and respond to manufacturer list price.

Driving this expanding market demand is the enormous pressure facing employers health plans governments and others to manage and respond to manufacturer list pricing.

The service is offered by up Tomorrow, and others are the only came to balance to drug company pricing. The foundational business objectives for Pbms is to lower costs and make medicines more affordable and accessible for individuals and families.

Speaker 2: The services offered by Optamrx and others are the only counterbalance to drug company price.

Speaker 2: The foundational business objectives for PBMs is to lower costs and make medicines more affordable and accessible for individuals and family.

Andrew Witty: And as the coming season for 2025 develops we're expecting another year of robust growth. Our clients tell us they value the enhancements we are making to our pharmacy offerings, providing them transparency and choice while also integrating new tools and capabilities. Notably our pharmacy service offerings go far beyond the foundational benefit management capabilities and now account for about half of all OptimaRX revenues. We continue to expand the reach of our community pharmacies and our diverse specialty and infusion offerings are growing double digits.

Speaker 2: CBMs are the only entities in the drug supply chain with that exclusive focus and incentive. And we're honored to play this critical role.

Pbms are the only entities in the drug supply chain with our exclusive focus and incentive.

And we're honored to play this critical role.

Speaker 2: These pillars of our growth, value-based care, pharmacy and our innovative benefits business.

These pillars of outgrowth value based care pharmacy, and our innovative benefits businesses.

Speaker 2: Alongside our health technology and financial service capability.

Alongside our health technology, and financial service capabilities, underpin, our ability to develop ever stronger value propositions for the people, who receive and those who pay for care.

Speaker 2: underpin our ability to develop ever stronger value propositions for the people who receive and those who pay for care.

Speaker 2: and support our confidence in a future of growth.

And support our confidence in our future of growth.

Speaker 2: And with that, I'll pass it to Dirk McMahon, our President and COO.

And with that I'll pass it to Dirk Mcmahon, our president and COO.

Thanks, Andrew I recently hosted United Healthcare's National accounts Forum, where we bring together client leaders twice a year to share ideas and gather feedback. These are some of the biggest and most sophisticated companies in America that collectively employ and sponsor coverage for millions of people.

Speaker 3: Thanks Andrew. I recently hosted United to Healthcare's National Accounts Forum. We'll be bringing together client leaders twice a year to share ideas and gather

Andrew Witty: Driving this expanding market demand is the enormous pressure facing employers, health plans, governments and others to manage and respond to manufacturer list pricing. The services offered by OptimaRX and others are the only counterbalance to drug company pricing. The foundational business objectives for PBMs is to lower costs and make medicines more affordable and accessible for individuals and families. PBMs are the only entities in the drug supply chain with that exclusive focus and incentive and we're honored to play this critical role.

Speaker 3: These are some of the biggest and most sophisticated companies in America. They collectively employ and sponsor coverage for millions of...

Speaker 3: And to no surprise, healthcare costs top their list of concerns, especially the rising cost of...

It's no surprise healthcare cost pop their list of concerns, especially the rising cost of drugs.

In addition, they want innovation new tools to help their employees take full advantage of their benefits achieve better health outcomes and save money.

Speaker 3: In addition, they want innovation, new tools to help their employees take full advantage of their benefits, achieve better health outcomes, and save money. And of course,

And of course, it has to be digital.

Andrew Witty: These pillars of our growth value-based care pharmacy and our innovative benefits businesses. Alongside our health technology and financial service capabilities, underpin our ability to develop ever stronger value propositions for the people who receive and those who pay for care and support our confidence in a future of growth.

Speaker 3: Let me offer a few examples of innovation that have fueled our growth outlook. Starting with our mobile platform, the primary access point for millions of UHC men.

Let me offer a few examples of innovation that have fueled our growth outlook, starting with our mobile platform. The primary access point for millions of UHC members. Each year, we add new capabilities to provide consumers with increased on demand care access highly personalized information about their benefits real time.

Speaker 3: Each year, we have new capabilities to provide consumers with increased on-demand care access, highly personalized information about their benefits, real-time support, cost estimation tools, integrated pharmacy capabilities, and enhanced rewards.

Support cost estimation tools integrated pharmacy capabilities and enhanced rewards.

Dirk Mcmahon: And with that, our passage to Dirk McMahon, our president and COO. Thanks Andrew. I recently hosted United to Healthcare's National Accounts Forum where we bring together client leaders twice a year to share ideas and gather feedback. These are some of the biggest and most sophisticated companies in America that collectively employ and sponsor coverage for millions of people. And to no surprise, healthcare costs pop their list of concerns, especially the rising cost of drugs. In addition, they want innovation, new tools to help their employees take full advantage of their benefits, achieve better health outcomes and save money. And of course, it has to be digital.

Another example.

Speaker 3: Our newest and fastest growing commercial offerings, which featured no annual deductibles and incentivized people to make good healthcare choices by offering an unprecedented view into quality and cost.

Our newest and fastest growing commercial offerings, which featured no annual deductibles and incentivize people to make good health care choices by offering an unprecedented view into quality and cost.

Speaker 3: When seeking care options, consumers see potential care providers latest reviews and quality designations. And they see what they will actually pay for their care, which will help them make the most informed to-

When seeking care options consumers see potential care providers latest reviews and quality designations and they see what they will actually pay for their care, which will help them make the most informed decisions.

Unitedhealthcare members and these offerings are receiving more preventative care, while paying about 50% less out of pocket compared to people enrolled in traditional offerings.

Speaker 3: United Health Care members and these offerings are receiving more preventative care while paying about 50% less out of pocket compared to people enrolled in traditional office.

Dirk Mcmahon: Let me offer a few examples of innovation that have fueled our growth outlook. Starting with our mobile platform, the primary access point for millions of UHC members. Each year, we had new capabilities to provide consumers with increased on-demand care access, highly personalized information about their benefits, real-time support, cost estimation tools, integrated pharmacy capabilities, and enhanced rewards.

Speaker 3: And their employers can reduce the total cost of care with an average savings of 11%

And their employers can reduce the total cost of care with an average savings of 11%.

Speaker 3: These results are why such new offerings are among our fastest growing.

These results are why such new offerings are among our fastest growing.

Speaker 3: Beyond these consumer facing innovations, we're leveraging the latest technologies to create greater operational capacity and productivity so we can better serve consumers and focus on the highest value.

Beyond these consumer facing innovations, we're leveraging the latest technologies to create greater operational capacity and productivity. So we can better serve consumers and focus on the highest value work.

Speaker 3: Our teams are significantly improving. How quickly we respond to the millions of benefit questions we receive each.

Our teams are significantly improving how quickly we respond to the millions of benefit questions we receive each year.

Dirk Mcmahon: Another example. Our newest and fastest growing commercial offerings, which featured no annual deductibles and incentivized people to make good healthcare choices by offering an unprecedented view into quality and cost. West. When seeking care options, consumers see potential care providers' latest reviews and quality designations, and they see what they will actually pay for their care, which will help them make the most informed decisions. The UnitedHealth Care members and these offerings are receiving more preventative care while paying about 50% less out of pocket compared to people enrolled in traditional offerings. And their employers can reduce the total cost of care, with an average shade of savings of 11%. These results are why such new offerings are among our fastest growing.

Speaker 3: We are using AI and natural language processing to expedite call documentation.

We are using AI and natural language processing to expedite call documentation to rapidly generate accurate summaries of consumer interactions with our contact centers.

Speaker 3: to rapidly generate accurate summaries of consumer interactions with our contacts.

Saving millions of dollars in administrative work and freeing up capacity for our people to prioritize engagement.

Speaker 3: Saving millions of dollars in administrative work and freeing up capacity for our people to prioritize engagement.

We're also utilizing these technologies to translate and interpret unstructured data such as physician notes, which will help for example provide deeper insights for life sciences customers. So they can better assess the efficacy of their treatments.

Speaker 3: We're also utilizing these technologies to translate and interpret unstructured data such as physician notes, which will help, for example, provide deeper insights for life sciences customers so they can better assess the efficacy of their...

Speaker 3: Of course, these are just a few of the hundreds of AI applications powered by Optimizite we are actively developing, testing and deploying today to further elevate the consumer and care provider experience while driving increased quality and lower cost.

Of course. These are just a few of the hundreds of AI applications powered by optimistic we are actively developing testing and.

And deploying today to further elevate the consumer and care provider experience, while driving increased quality and lower costs.

Dirk Mcmahon: Beyond these consumer facing innovations, we're leveraging the latest technologies to create greater operational capacity and productivity so we can better serve consumers and focus on the highest value work. Our teams are significantly improving how quickly we respond to the millions of benefit questions we receive each year. We are using AI and natural language processing to expedite call documentation to rapidly generate accurate summaries of consumer interactions with our contact centers, saving millions of dollars in administrative work and freeing up capacity for our people to prioritize engagement.

Speaker 3: And with that, I'll turn it over to our CFO John Rex.

And with that I'll turn it over to our CFO John Rex.

Speaker 4: Thank you, Derk. The growth we reported today is a direct result of investments made over many years to develop and connect the diverse health capabilities needed to serve the people who rely on us each day, while also creating the foundational capacity to serve millions more in the years ahead.

Thank you Derek.

Growth we reported today is a direct result of investments made over many years to develop and connect the diverse health capabilities needed to serve the people who rely on us each day, while also creating the foundational capacity to serve millions more in the years ahead.

Speaker 4: This capability development has long been in the making and is still very much underway as the opportunities to serve more people more deeply continue to expand.

This capability development has long been in the making and it's still very much underway and the opportunities to serve more people more deeply continue to expand.

Dirk Mcmahon: We're also utilizing these technologies to translate and interpret unstructured data such as physician notes, which will help, for example, provide deeper insights for life sciences customers so they can better assess the efficacy of their treatments. Of course, these are just a few of the hundreds of AI applications powered by optimum site. We are actively developing testing and deploying today to further elevate the consumer and care provider experience while driving increased quality and lower costs.

Before reviewing our business results I'll offer a few brief comments on cure activity.

Speaker 4: Before reviewing our business results, I'll offer a few brief comments on care activities.

Speaker 4: Care patterns remain consistent with the view we shared during the second quarter, with activity levels still led by outpatient care for seniors, and still most notably in the orthopedic and cardiac procedure category.

Care patterns remain consistent with the view, we shared during the second quarter with activity levels still led by outpatient care for seniors and still most notably in the orthopedic and cardiac procedure categories.

Speaker 4: These transraming stable at the levels we previously described.

These trends remained stable at the levels. We previously described.

As we've noted our outlook assumes these activity levels persist throughout next year.

Speaker 4: As we've noted, our outlook assumes these activity levels persist throughout Well, powderstruckals

Speaker 4: We continuously monitor a broad spectrum of patient acuity levels and have yet to see any other notable change.

We continuously monitor a broad spectrum of patient acuity levels and have yet to see any other notable changes for.

John Rex: And with that, I'll turn it over to our CFO, John Rex. Thank you, Derk. The growth we reported today is a direct result of investments made over many years to develop and connect the diverse health capabilities needed to serve the people who rely on us each day while also creating the foundational capacity to serve millions more in the years ahead. This capability development has long been in the making and is still very much underway as the opportunities to serve more people more deeply continue to expand.

For example, within oncology the average stage at which we are first seen cancer diagnosis remains consistent with historical patterns.

Speaker 4: For example, within oncology, the average stage at which we are first seen cancer diagnosis remains consistent with historical pattern.

Speaker 4: As always, we remain diligent in looking for changes to the underlying health of patients.

As always we remain diligent in looking for changes to the underlying health of patients.

With that let's turn to our third quarter results.

Speaker 4: Revenues of 92.4 billion grew by 14% over the prior year with double digit growth again at both Optum and United Healthcare.

Revenues up $92 4 billion grew by 14% over the prior year with double digit growth again at both Optum and Unitedhealthcare.

John Rex: Before reviewing our business results, I'll offer a few brief comments on care activity. Care patterns remain consistent with the view we shared during the second quarter, with activity levels still led by outpatient care for seniors and still most notably in the orthopedic and cardiac procedure categories. These trends remain stable at the levels we previously described. As we've noted, our outlook assumes these activity levels persist throughout next year. We continuously monitor a broad spectrum of patient acuity levels and have yet to see any other notable changes. For example, within oncology, the average stage at which we are first seen cancer diagnoses remains consistent with historical patterns. As always, we remain diligent in looking for changes to the underlying health of patients.

Often health revenues grew by 29% approaching 24 billion driven by an increase in the number of care services, we offer and patients we serve especially for those with complex care needs.

Speaker 4: Often health revenues grew by 29% approaching 24 billion, driven by an increase in the number of care services we offer, and patients we serve, especially for those with complex care needs.

Operating margins continue to reflect the initial clinical engagement activities that support the strong growth in patients we have realized this year as.

Speaker 4: Operating margins continue to reflect the initial clinical engagement activities that support the strong growth in patients we have realized this year.

As well as the higher cure activity patterns, we have discussed.

Speaker 4: as well as the higher care activity patterns we have discussed.

<unk> revenues grew by 14% approaching 29 billion driven.

Speaker 4: OptomRx revenues grew by 14%. Approaching 29 billion driven by the strength in our pharmacy care services offerings, as well as new customer wins.

Driven by the strength in our pharmacy care services offerings, as well as new customer wins.

Script growth up nearly 7% reflects customer response to our innovative solutions, which focus on choice and lowest net cost.

Speaker 4: Script growth of nearly 7%, reflects customer response to our innovative solutions, which focus on choice and lowest net cost.

Optum insight revenues grew by 35% to $5 billion.

Speaker 4: Optimize revenues grew by 35% to 5 billion.

John Rex: With that, let's turn to our third quarter results. Revenues of 92.4 billion grew by 14% over the prior year, with double-digit growth again at both Optum and United Health Care. Often Health revenues grew by 29% approaching $24 billion driven by an increase in the number of care services we offer and patients we serve, especially for those with complex care needs. Operating margins continue to reflect the initial clinical engagement activities that support the strong growth in patients we have realized this year, as well as the higher care activity patterns we have discussed.

Speaker 4: Revenue backlog of over 31 billion increased by more than 7 billion. In part due to the change healthcare company.

Revenue backlog of over 31 billion increased by more than $7 billion in part due to the change healthcare combination.

In addition, we recently announced a partnership to provide revenue cycle analytics and information technology services to a health system, serving more than 400000 people in the Midwest.

Speaker 4: In addition, we recently announced a partnership to provide revenue cycle, analytics, and information technology services to a health system serving more than 400,000 people in the Midwest. This gear is in the next region, including Bend simulate the control becomes collections and

Turning to United Healthcare.

Speaker 4: Our commercial business added nearly 700,000 people through the third court.

Our commercial business added nearly 700000 people through the third quarter.

Speaker 4: Further, selling season indications are tracking favorably, particularly in national accounts.

Further selling season indications are tracking favorably, particularly in national accounts.

Speaker 4: So as 24 begins, we expect to grow to serve an additional 1 million people with commercial benefit.

That's 24 begins.

We expect to grow to serve an additional 1 million people with commercial benefits.

John Rex: OptimRx revenues grew by 14%, approaching $29 billion driven by the strength in our pharmacy care services offerings, as well as new customer wins, script growth of nearly 7% reflects customer response to our innovative solutions which focus on choice and lowest net cost. OptimInsight revenues grew by 35% to 5 billion revenue backlog of over 31 billion increased by more than 7 billion in part due to the change healthcare combination. In addition, we recently announced a partnership to provide revenue cycle analytics and information technology services to a help system serving more than 400,000 people in the Midwest.

Speaker 4: Within our public sector programs, we expect growth of nearly one million Medicare advantage members this year.

Within our public sector programs, we expect growth of nearly 1 million Medicare advantage members this year.

Speaker 4: And looking to the year ahead, we're encouraged by the consumer value, stability, and breadth of our office.

And looking to the year ahead, we are encouraged by the consumer value stability and breadth of our offerings.

Speaker 4: And as always, we start with an expectation that we will outpace overall market growth.

And as always we start with an expectation that we will outpace overall market growth.

Speaker 4: Our Medicaid performance remains strong as we support people and families through the redeterminations process.

Our Medicaid performance remained strong as we support people and families through the Redetermination process. Our teams are really leaning in and speaking with thousands of consumers each day.

Speaker 4: Our teams are really leaning in, speaking with thousands of consumers each day.

Speaker 4: Through a comprehensive outreach program, we are helping people navigate the process

Through a comprehensive outreach program, we are helping people navigate the process and connecting them with the resources they need to retain or reinstate their health benefits.

John Rex: Turning to United Health Care, our commercial business added nearly 700,000 people through the third quarter. Further, selling season indications are tracking favorably, particularly in national accounts. So as 24 begins, we expect to grow to serve an additional 1 million people with commercial benefits. Within our public sector programs, we expect growth of nearly 1 million Medicare Advantage members this year. And looking to the year ahead, we're encouraged by the consumer value, stability and breadth of our offerings.

Or to help them find other affordable coverages.

Speaker 4: A significant majority of the people we engage with are able to retain or reinstate their cover.

A significant majority of the people, we engage with are able to retain or reinstate their coverage.

Our capital capacity has remained strong.

Speaker 4: Our capital capacity remains strong for the first nine months of the year adjusted cash flows from operations. We're at 22.4 billion or 1.3 times net income.

For the first nine months of the year adjusted cash flows from operations were at $22 4 billion or one three times net income.

Speaker 4: And in that same timeframe, we returned over 11.5 billion to shareholders through dividends and share repurchase-

And in that same timeframe, we returned over 11 5 billion to shareholders through dividends and share repurchases.

Speaker 4: As noted, given the strength of our business performance, this morning we have updated our 23 outlook for adjusted earnings to $24.85 to $25 per share.

As noted given the strength of our business performance. This morning, we have updated our 'twenty three outlook for adjusted earnings to $24 85 to $25 per share.

John Rex: And as always, we start with an expectation that we will outpace overall market growth. Our Medicaid performance remains strong as we support people and families through the re-determinations process. Our teams are really leaning in, speaking with thousands of consumers each day. Through a comprehensive outreach program, we are helping people navigate the process and connecting them with the resources they need to retain or reinstate their health benefits, or to help them find other affordable coverages.

And as we finished strongly in 'twenty, three and look forward to 'twenty four.

Speaker 4: And as we finish strongly in 23 and look forward to 24, we're intensely focused on execution, while further expanding our capacity to serve more people, more deeply.

We're intensely focused on execution, while further expanding our capacity to serve more people more deeply.

Speaker 4: and building the foundations to support our growth objective for years to come.

And building the foundation to support our growth objectives for years to come.

Now I'll turn it back to Andrew.

Speaker 2: Now I'll turn it back to Andrew. Thanks John . Before opening up for questions, I'll offer some preliminary observations about next.

Thanks, John before opening up for questions I'll offer some preliminary observations about next year.

John Rex: A significant majority of the people we engage with are able to retain or reinstate their coverage. Our capital capacities remain strong for the first nine months of the year, adjusted cash flows from operations were at 22.4 billion or 1.3 times net income. And in that same timeframe, we returned over 11.5 billion to shareholders through dividends and sharey purchases. As noted, given the strength of our business performance, this morning we have updated our 23 outlook for adjusted earnings to $24.85 to $25 per share.

Speaker 2: I reserve in most of this conversation for our investor conference on November 29th.

Serving most of this conversation for our Investor Conference on November 29.

Our businesses continue to build momentum, while maintaining flexibility and adaptability for an ever changing landscape, even as we invest for the future.

Speaker 2: Our businesses continue to build momentum while maintaining flexibility and adaptability for an ever-changing landscape, even as we invest for the future.

We're focused on our strategic growth pillars, and driving efficiencies throughout the enterprise at an accelerated pace.

Speaker 2: We're focused on our strategic growth pillars and driving efficiencies throughout the enterprise and accelerated pace.

Speaker 2: At this distance, analyst earnings estimates for 2024 reasonably reflect the performance view we expect to offer in November , with consensus near the upper end of our likely initial outlook range. Importantly, the growth we're realising today and our expanding capacity serve to further reinforce the confidence we have in our long-term 13-16% growth object.

At this distance.

Earnings estimates for 2020 full reasonably reflect the performance view, we expect to offer in November with consensus near the upper end of our likely initial outlook range importantly, the growth. We are realizing today and are expanding capacity serve to further reinforce the confidence we have.

John Rex: And as we finish strongly in 23 and look forward to 24, we are intensely focused on execution, while further expanding our capacity to serve more people, more deeply, and building the foundations to support our growth objectives for years to come.

Long term, 13% to 16% growth objective.

Speaker 2: And with that, I'll now have the operator to open up the question.

And with that I'll now ask the operator to open up for questions.

The floor is now open for questions. At this time, if you have a question or comment. Please press star one on your Touchtone phone.

Speaker 1: The floor is now open for questions. At this time, if you have a question or a comment, please press star one under touch tone zone. You may remove yourself from the queue by pressing star two under touch tone zone. We ask you to...

Andrew Witty: Now, I'll turn it back to Andrew. Thanks, John.

Andrew Witty: Before opening up for questions, I'll offer some preliminary observations about next year, while I reserve in most of this conversation for our investor conference on November 29th. Our businesses continue to build momentum while maintaining flexibility and adaptability for an ever-changing landscape, even as we invest for the future. We're focused on our strategic growth pillars and driving efficiencies throughout the enterprise and accelerated pace. At this distance, analyst earning estimates for 2024 reasonably reflect the performance view we expect to offer in November, with consensus near the upper end of our likely initial outlook range. Importantly, the growth we're realising today and our expanding capacity serve to further reinforce the confidence we have. In our long-term 13-16% growth objective.

They remove yourself from the queue by pressing star two on your Touchtone phone.

We ask you to limit yourself to one question.

Speaker 1: If you ask multiple questions, we will only be answering the first question, so we can respond to everyone in the queue this morning.

If you ask multiple questions will only be answering the first question. So we can respond to everyone in the queue. This morning.

We'll go first to Lisa Gill with JP Morgan.

Hi, good morning, and thanks for the comments I wanted to start with <unk> and really understand from two sides. One when we think about our rates for 2024 can you talk about what you've incorporated in rates around DLP wines, especially around weight loss as we have new products coming to the market and how do we think about that.

Speaker 5: Good morning and thanks for the comments. I wanted to start with CLP ones and really understand from two sides. One, when we think about rates for 2024, can you talk about what you've incorporated in rates around CLP ones, especially around weight loss as we have new products coming to the market? And how do I think about that from the PBM side when we think about the services that you can wrap around that and sell from a PBM perspective?

The Pbms side, when we think about the services that you can wrap around that and sell from a PJM perspective.

Speaker 2: Lisa, thanks so much for the question. Now, in a second, I'll ask Brian Thompson from UAC and Dr. Patrick Conway to respond to your comments in a little more detail. But...

Lisa Thanks, so much for the question in a second I'll ask Brian Thompson from UHC and Dr. Patrick Homeaway to respond to your comments in little more detail, but let me just preface all of that.

Unknown Executive: And with that, I'll now ask the operator to open up for questions. The floor is now open for questions. At this time, if you have a question or a comment, please press star one under touch tone phone. You may remove yourself from the queue by pressing star two under touch tone phone. We ask you to limit yourself to one question. If you ask multiple questions, we will only be answering the first question, so we can respond to everyone in the queue this morning.

Speaker 2: Let me just preface all of that. You know, the thing we're most overall focused on on GLP1 spaces, honestly, the pricing. And later on, you'd avoid options.

Thing, where most overall focused on the <unk> spaces honestly the pricing.

Speaker 2: You know, we're very positive about the potential for another tool in the toolbox to help folks manage their weight. We recognise that has potential benefits, but...

We're very positive.

The potential for another tool in the toolbox to help folks manage their weight, we recognize that has potential benefits but.

Speaker 2: We're struggling and frankly our clients are struggling with the list prices which have been demanded of these products in the US Which are running at about ten times the level of price which have been paid in Western Europe

We're struggling and frankly, our clients are struggling with the list prices, which are being demanded of these products in the U S, which are running at about 10 times the level of price, which are being paid in western Europe .

Andrew Witty: We'll go first to Lisa Gill with JP Morgan. Good morning and thanks for the comments. I wanted to start with GLP1s and really understand from two sides. One, when we think about rates for 2024. Can you talk about what you've incorporated in rates around GLP1s, especially around weight loss as we have new products coming to the market? And how do I think about that from the PBM side when we think about the services that you can wrap around that and sell from a PBM perspective?

Speaker 3: So overall I'd say that is our focus is to try and find a way to make this sustainable and affordable space for our clients to support With that said let me ask Brian to give you a perspective from UHC and how they've incorporated this in their forward view Sure, thanks for the question, they're lethal first-of-putting context GLP1's over 80% on the diabetic side so as we think about weight loss

So overall I'd say that is our focus is to try and find a way to make this a sustainable on a full tubal space.

Space for our clients to support.

With that said, let me ask Brian to give you a perspective from UHC and how they've incorporated this and that for sure.

Sure. Thanks for the question there lease up first to put in context <unk> with over 80% on the diabetic side. So as we think about weight loss up to maybe 20% of our total spend in it.

Speaker 3: up to maybe 20% of our total spend. And it's largely performing in line with what we had planned as we went into 23 and we feel very confident and comfortable about how we're looking at that going forward into 24. As you think about it, keep in mind, the vast majority of the coverage here is in our fee-based business. That's our self-employed customers. And that's still at less than a third or on 30% of our book.

Andrew Witty: Lisa, thanks so much for the question. In a second, I'll ask Brian Thompson from UAC and Dr Patrick Conway to respond to your comments in a little more detail. But let me just preface all of that. You know, the thing we're most overall focused on and GLP1 spaces, honestly, the pricing. You know, we're very positive about the potential for another tool in the toolbox to help folks manage their weight. We recognize that has potential benefits, but we're struggling and frankly our clients are struggling with the list prices, which have been demanded of these products in the US, which are running at about 10 times the level of price, which have been paid in Western Europe. So overall, I'd say that is our focus is to try and find a way to make this sustainable and affordable space for our clients to support.

It is largely performing in line with what we had planned as we went into 'twenty three and we feel very confident and comfortable about how we're looking at that going forward into 'twenty four as you think about it keep in mind. The vast majority of the coverage areas in our fee based business Thats, our self employed customers and thats still at less than a third around 30% of our book.

Speaker 3: As we look forward, our customers are considering to cover more or less. I would say it's a mixed bag summer seeking coverage. I'll be dissatisfied with the price points, summer backing off given the cost. But I wouldn't really be directional one way or the other on whether or not we're seeing more or less coverage on the weightless side as we look forward. But again, to Andrew's point, beyond just getting to the obvious lower price points, we're really trying to work with manufacturers to get to some aligned value-based constructs.

As we look forward our customers considering to cover more or less I would say, it's a mixed bag. Some are seeking coverage, albeit dissatisfied with the price points. Some are backing off given the costs, but I wouldn't really be directional one way or the other on whether or not we're seeing more or less coverage on the waitlist side as we look forward, but again to Andrew's point.

And just getting to the obvious lower price points, we're really trying to work with manufacturers to get to some aligned value based constructs getting pricing to a point, where it's based on outcomes and adherence levels all the way to outright risk on utilization levels and pairing those with therapies in programs that can put less reliance on lifelong adherence requirements. Like these drugs currently have were not there.

Speaker 3: getting pricing to a point where it's based on outcomes and adherence levels all the way to outright risk on utilization levels and pairing those with therapies and programs that can put less reliance on lifelong adherence requirements like these drugs currently have. We're not there yet. We're optimistic that we can get there but clearly price point is a key barrier.

Brian Thompson: With that said, let me ask Brian to give you a perspective from UAC and on how they've incorporated this in their full view. Sure. Thanks for the question, Lisa. The first to put in context, GLP1 is over 80% on the diabetic side. So as we think about weight loss, you know, up to maybe 20% of our total spend. It's largely performing in line with what we had planned as we went into 23 and we feel very confident and comfortable about how we're looking at that going forward into 24.

We're optimistic that we can get there, but clearly price point as a key barrier alright. Thanks, so much and packaging maybe from the from Optum Rx perspective gets a little bit about the broader approaches we've taken.

Speaker 2: Thanks so much and pack it maybe from the from up to my ex-perspect you could talk a little bit about the broader approaches

Speaker 4: Thank you. As Andrew said, our customers, payers, employers, people we serve are concerned about the prices of GLP1s as set by manufacturers. You know, OptamRx will continue to negotiate lower prices through discounts over time, be transparent with our customers and implement clinical evidence-based guidelines so the right people get appropriate medicine.

Thank you as Andrew said, our customers payers employers people. We serve are concerned about the prices of GOP ones is set by manufacturers optimize <unk> will continue to negotiate lower prices through discounts over time be transparent with our customers and implement clinical evidence based guidelines. So the right people get appropriate medicine.

Brian Thompson: As you think about it, keep in mind the vast majority of the coverage here is in our fee-based business. That's our self-employed customers. And that's still at less than a third or on 30% of our book. As we look forward, our customers considering to cover more or less, I would say it's a mixed bag, summer seeking coverage. I'll be dissatisfied with the price points, summer backing off given the cost, but I wouldn't really be directional one way or the other on whether or not we're seeing more or less coverage on the weight less side as we look forward.

And as you alluded to Liza obesity in cardio metabolic disease is a major publication issue health issue in the U S and across all of Optum, we are developing and implementing comprehensive solutions of which medicines. There are only a part of on behalf of our clients and people we serve to drive better health outcomes for all and value to the health.

Speaker 6: And as you alluded to, Lisa, obesity and cardiometabolic disease is a major public issue, health issue in the U.S. And across all of us, we are developing and implementing comprehensive solutions, of which medicines are only a part of on behalf of our clients and people we serve to drive better health outcomes for all and value to the health.

Brian Thompson: But again, to Andrew's point beyond just getting to the obvious lower price points, we're really trying to work with manufacturers to get to some aligned value-based constructs. Getting pricing to a point where it's based on outcomes and adherence levels, all the way to outright risk on utilization levels and pairing those with therapies and programs that can put less reliance on lifelong adherence requirements like these drugs currently have. We're not there yet. We're optimistic that we can get there, but clearly price point is a key barrier. Brian, thanks so much.

Thanks, Patrick and Lisa Thanks, So much for the question next question. Please Jennifer yes.

Speaker 7: Thanks, Patrick, and Lisa, thanks so much for the question. And next question, please, Jennifer. Yes, we'll go next to AJ Rice.

Yes, we'll go next to a J rice with UBS.

Speaker 8: Hi everybody, thanks for the question.

Hi, everybody. Thanks for the question.

Speaker 8: You know, it's similar to last quarter, the trend in margin and often health and optimum site has been down year to year. You know, you've called out change, particularly with optimum site, but I wonder if there's any ability to discuss unusual items, non-recurring items. I know you said you had some cost reduction programs you were implementing this quarter and often health. Did those impact the results? And is there any change? Because you look ahead to 24 in your margin expectations or targets for those two business.

Yes.

Similar to last quarter, the trend in margin and Optum health in Optum insight.

Patrick Conway: And Patrick, maybe from the from up to our exp respect, you could talk a little bit about the broader approaches. Thank you. As Andrew said, our customers, payers, employers, people we serve are concerned about the prices of GLP1s as set by manufacturers. You know, often our acts will continue to negotiate lower prices through discounts over time, be transparent with our customers and implement clinical evidence-based guidelines so the right people get appropriate medicines.

It's been down year to year, and I know, you've called out change, particularly with Optum insight, but I'm wondering if there's any ability to discuss unusual items.

Nonrecurring items I know you said you had some cost reduction programs, you're implementing this quarter and Optum health did those impact the results and is there any change as you look ahead to 'twenty, four and your margin expectations or targets for those two businesses.

Patrick Conway: And as you alluded to, Lisa, obesity and cardiometabolic disease is a major public issue, health issue in the U.S. And across all of us, we are developing and implementing comprehensive solutions of which medicines are only a part of on behalf of our clients and people we serve to drive better health outcomes for all and value to the health system. Thanks, Patrick. And Lisa, thanks so much for the question.

Hey, Jay Thanks, so much for the question appreciate it so let me just make a few comments, particularly as it speaks to the Optum health part of the question that you raised.

Speaker 2: AJ, thanks so much for the question, I appreciate it. So let me just make a few comments, particularly as it speaks to the optimal health part of the question that you raised.

Unknown Executive: Next question, please, Jennifer.

Speaker 2: So as you look at 2023, essentially what we've seen and we refer to this in Q2.

So as you look at 2023, essentially what we've seen and we referred to this in Q2.

Speaker 2: Greater growth in the number of people, patients that we've been privileged to serve this year, particularly the more complex patients. So very strong, and you heard in our opening commentary, very strong, growth in the number of fully accountable lives running about 900,000 substantial fraction of that coming in the more complex cases. As I said back in the last call, we're very, very pleased to have that growth. That we believe that is really foundational, or a key foundation for future long-term growth of the business.

Great to growth in the number of people patients that we've been privileged to serve the ship, particularly the more complex patients. So very strong and you heard in our opening commentary very strong growth in the number of fully accountable lives running about 900 times and substantial fraction of that coming in the more complex cases, as I said back in the last call.

AJ Rice: Yes, we'll go next to AJ Rice with UBS. Hi, everybody. Thanks for the question. You know, it's similar to last quarter of the trend in margin. And often health and optimum site has been down year to year. You know, you've called out change, particularly with optimum site, but I wonder if there's any ability to discuss unusual items, non-recurring items. I know you said you had some cost reduction programs, you were implementing this quarter and often health. Did those impact the results? And is there any change? As you look ahead to 24 in your margin, expectations or targets for those two businesses? AJ, thanks so much for the question. Appreciate it.

We're very very pleased to have that growth that we believe that as really foundational key foundation for future long term growth of the business.

Speaker 2: However, within that, the mix of that population a little different to what we expected. That takes time to then build the engagement capabilities that we need to be able to work with those people and their care providers to ensure the very best care is delivered.

However, within that the mix of that population a little different to what we expected that takes time to then build the engagement capabilities that we need to be able to work with those people and that can provide us to ensure the very best care is delivered at the most efficient and effective way and Thats really the bulk of the investment that we're talking about it's really taking the.

Speaker 2: the most efficient and effective way and that's really the bulk of the investment that we're talking about. It's really taking the time, looking after those folks in the way they need to be looked after right now in advance of us being able to engage with them fully and deliver then the various interventions and advices that we can provide that we're really building throughout Optum to ensure that not just in one year but over multiple years those folks get increasingly better care delivery and better outcomes.

Time looking after those folks and the way they need to be looked after right now in advance of us being able to engage with them fully and deliver than the various interventions and advises that we can provide that we're really building through our optum to ensure that not just in one year, but over multiple years those folks get increasingly better.

John Rex: So let me just make a few comments, particularly as it speaks to the optimum health part of the question that you raised. So as you look at 2023, essentially what we've seen and we refer to this in Q2, greater growth in the number of people, patients that we've been privileged to serve this year, particularly the more complex patients. So very strong and you heard in our opening commentary, very strong growth in the number of fully accountable lives running about 900,000 substantial fraction of that coming in the more complex cases.

Delivery and better outcomes and recall that these patients in many cases have really being somewhat.

Speaker 2: and recall that these patients in many cases have really been somewhat, you know, not necessarily looked after as well as it could have been by the system because of their very complexity, in some cases they're not able to get to clinic.

Not necessarily looked after as well as it could have been by the system because of their very complexity in some cases, they are not able to get to clinics, which is why we feel we've been building up our homecare capabilities and other wraparound services to the classic clinic approach, that's really the driving force now as that speaks to the future two things really a J.

John Rex: As I said back in the last call, we're very, very pleased to have that growth that we believe that is really foundational or a key foundation for future long term growth of the business. However, within that, the mix of that population little different to what we expected. That takes time to then build the engagement capabilities that we need to be able to work with those people and their care providers to ensure the very best care is delivered at the most efficient and effective way.

Speaker 2: is why we've been building up our home care capabilities and other wraparound services to the classic clinic approach. That's really the driving force now. As that speaks to the future, two things really AJ, one is...

One is.

Speaker 2: We're super confident around our ability to continue to grow the number of patients who were able to look after. Number two, as those capabilities that have been accelerated during this year begin to affect the quality positively and the cost of how these patients care is delivered, you're going to see that shine through an improved economic performance of optimum health. And as we look forward, we're very confident continue to strengthen and adapt this.

We're super confident around our ability to continue to grow the number of patients who were able to look after number two as those capabilities that have been.

Accelerated during this year begin to affect the.

John Rex: And that's really the bulk of the investment that we're talking about. It's really taking the time looking after those folks in the way they need to be looked after right now in advance of us being able to engage with them fully and deliver them the various interventions and advices that we can provide that we're really building throughout optimum to ensure that not just in one year, but over multiple years, those folks get increasingly better care delivery and better outcomes.

The quality positively and the cost of these patients care is delivered youre going to see that shine through an improved economic performance of Optum health and as we look forward. We're very confident about continued strengthening of that business make no mistake Optum health is having a very strong growth year and we're taking the opportunity.

Speaker 2: At Make No Mistake, Optum Health is having a very strong growth year and we're taking the opportunity this year to really ready ourselves and build strength for the next many years of that.

Unity this year to really ready ourselves and build strength for the next many years of that business a J. Thanks. So much for the question next question.

John Rex: And recall that these patients in many cases have really been somewhat, you know, not necessarily looked after as well as they could have been by the system because of their very complexity. In some cases, they're not able to get to clinics, which is why we've been building up our home care capabilities and other wraparound services to the classic clinic approach. That's really the driving force now as that speaks to the future two things really AJ one is we're super confident around our ability to continue to grow the number of patients who were able to look after number two as those capabilities that have been accelerated during this year begin to affect the both the quality positively and the cost of how these patients care is delivered.

Speaker 9: AJ, thanks so much for the question. Next question. Yes, we'll go next to Josh Ruskin with

Yes, we'll go next to Josh Raskin with Nephron research.

Hi, Thanks, Good morning, understanding that you expect Medicare advantage to grow at a healthy pace I think you said above market again in 2024 could you speak to that progress expected in Optum health I know, we'll get details at the Investor day, but how are you thinking about the transition of patients from sort of fee for service to these full fully risk engagements.

Speaker 10: Hi, thanks. Good morning. Understanding that you expect Medicare advantage to grow at a healthy pace. I think you said above market again in 2024. Could you speak to that progress expected at Optum Health? I know we'll get details at the investor day, but how are you thinking about the transition of patients from sort of fee for service to these fully risk engagements? And then maybe general levels of investment for growth and light of the risk model and reimbursement model changes?

And then maybe general levels of investment for growth in light of the risk model and reimbursement model changes.

So Josh thanks, so much for the question I mean, obviously, we'll leave will leave very much the detail of.

Speaker 2: So Josh, thanks so much for the question. I mean, obviously we'll leave very much the detail of the elements of the growth model for when we meet with you all in November . I mean, having said that, we would no reason not to expect a continued healthy momentum in our move toward value-based care next year with continued high expectations for our ability to deliver that. That.

The elements of the growth model for when we meet with you all in November I mean, having said that we would no reason not to expect a continued healthy momentum in our move toward value based care next year with continued high expectations for our ability to deliver that.

John Rex: But you're going to see that shine through an improved economic performance of optimum health. And as we look forward, we're very confident about continued strengthening in about business. Make no mistake, optimum health is having a very strong growth year and we're taking the opportunity this year to really ready ourselves and build strength for the next many years of that. Business, AJ, thanks so much for the question.

Speaker 2: So you're broader question, maybe just reflect a little bit again on 2023. So this has been a year which essentially has been obviously very heavily influenced by the change in the funding environment that was announced earlier in the year for Medicare at BAN.

To your broader question, maybe just reflect a little bit again on 2023. So so this has been a.

A year, which essentially has been obviously very heavily influenced by the change in the funding environment that was announced earlier in the year for Medicare advantage.

Josh Raskin: Next question. Yes, we'll go next to Josh Raskin with Neffron Research. Hi, thanks.

Josh Raskin: Good morning. Understanding that you expect Medicare Advantage to grow at a healthy pace. I think you said above market again in 2024. Could you speak to that progress expected at Optum Health? I know we'll get details at the investor day, but how are you thinking about the transition of patients from sort of fee for service to these fully risk engagements? And then maybe general levels of investment for growth and light of the risk model and reimbursement model changes? So Josh, thanks so much for the question.

Speaker 2: And we're very appreciative of the three year phase in of the changes which CMS ultimately decided to make. But obviously those changes are essentially the equivalent to a price cut phase in over three years for the Medicare Advantage program.

We're very appreciative of the three year phase in of the changes, which CMS ultimately decided to make.

Obviously.

Those changes are essentially the equivalent to a price cut phased in over three years for the Medicare advantage program.

Speaker 2: We're appreciative of the fact that we've had essentially seven, eight, nine months warning of that in terms of when that was announced before we go into the 24 year.

We are appreciative of the fact that we've had essentially 789 months warning of that in terms of when that was announced before we go into the 24 year.

Speaker 2: And that's the louder than we've taken full advantage of it to really focus on how we ready ourselves. Not just for 2024 but for the next 36 months. So 2023 has all been all for us, been about ensuring.

And that's allowed us and we've taken full advantage of it to really focus on how we ready ourselves not just for 2024, but for the next 36 months. So 2023 is all be all for us been about ensuring that we reengineer our cost base that we refocused all benefit strategies to those things that matter most to patients that we strength.

Andrew Witty: I mean, obviously we'll leave we'll leave very much the detail of the elements of the growth model for when we meet with you all in November. I mean, having said that, you know, we would no reason not to expect a continued healthy momentum in our move toward value based care next year with continued high expectations for our ability. To deliver that to your broader question, maybe just reflect a little bit again on 2023.

Speaker 2: that we re-engineer our cost-base, that we refocus our benefit strategies to those things that matter most to patients, that we strengthen and invest in our abilities to manage affordability of care, going forward into the system, and that we're taking full advantage of building the capabilities. We have already begun to construct around our consumer engagement, our technology digital first capabilities.

And then invest in our abilities to manage affordability of care going forward into into the system and we're taking full advantage of building the capabilities. We have already begun to construct around our consumer engagement, our technology digital first capabilities and ultimately doubling down on our commitment to value based care that has really.

Andrew Witty: So so this has been a year which essentially has been obviously very heavily influenced by the change in the funding environment that was announced earlier in the year for Medicare Advantage. And we're very appreciative of the three year phase in of the changes, which CMS ultimately decided to make, but obviously those changes are essentially the equivalent to a price cut phase in over three years for the Medicare Advantage program. We're appreciative of the fact that we've had essentially seven, eight, nine months warning of that in terms of when that was announced before we go into the 24 year.

Speaker 2: and ultimately doubling down on our commitment to value-based care. That has really been the story behind the investments of 2023 in response to the changes that have been signaled by CMS, so that we go into 24, 25, 26, 27, feeling strong, feeling that we've taken advantage of these last several months.

The story behind the investments of 2023 in response to the changes that are being signaled by CMS. So that we go into 'twenty four 'twenty five 'twenty six 'twenty seven feeling strong feeling that we've taken advantage of these last several months to ensure that we've adjusted and adapted our strategy and business.

Speaker 2: to ensure that we've adjusted and adapted our strategy and business in readiness for the change in the funding environment which gives us strong confidence for next year and underpins our commitment to the signal I just gave you in terms of our potential for 2024. Next question please. ????? push it!

In readiness for the change in the funding environment, which gives us strong confidence for next year and underpins our commitment to the signal I. Just gave you in terms of our potential for 2024.

Andrew Witty: And that's allowed us and we've taken full advantage of it to really focus on how we ready ourselves not just for 2024, but for the next 36 months. So 2023 has all for us been about ensuring that we re-engineer our cost base, that we refocused our benefit strategies to those things that matter most to patients, that we strengthen and invest in our abilities to manage affordability of care going forward into into the system.

Next question please.

We'll go next to Justin Lake with Wolfe Research.

Thanks. Good morning wanted to ask you about UHC performance first shrimp Youre MLR was better than our expectation for curious how it compared to your internal estimates and maybe you could share how that might have come across.

Speaker 11: Thanks, good morning. Wanted to ask about UHC performance. First, your MLR was better than our expectations, but curious how it compared to your internal estimates. And maybe you could share how that might have come across.

Andrew Witty: And that we're taking full advantage of building the capabilities we have already begun to construct around our consumer engagement, our technology digital first capabilities, and ultimately doubling down on our commitment to value base care. That has really been the story behind the investments of 2023 in response to the changes that have been signal by CMS so that we go into 24, 25, 26, 27 feeling strong feeling that we've taken advantage of these last several years.

Speaker 11: come in across the three main business segments and then quickly on the third quarter UAC margins. I found it interesting that while the MLR deteriorated by 50 basis points year over year in the quarter overall UAC margin actually improved by 50 basis points. So, curious what might have drove that. Thanks.

And across the three main business segments, and then quickly on the third quarter UHC margins I found it interesting that while the MLR detour deteriorated by 50 basis points year over year in the quarter overall UHC margins actually improved by 50 basis points. So curious what might have drove that thanks.

Speaker 2: Justin, thanks so much for the question. Let me ask John Rex to respond to the first part and then Brian Thompson the second.

Justin Thanks, so much for the question, let me ask John Rex to respond to the first part and then Brian Thompson the second.

Andrew Witty: We've been able to ensure that we've adjusted and adapted our strategy and business in readiness for the change in the funding environment, which gives us strong confidence for next year and underpins our commitment to the signal I just gave you in terms of our potential for 2024.

Speaker 4: Good morning, Justin. So overall, I call it broadly consistent with our expectations in terms of the third quarter. So a few things I'd like to highlight though. So care patterns were as we discussed. Focused again on outpatients, outpatient activity with seniors, those continue at the levels we described during the second quarter.

Morning, Justin So overall call it broadly consistent with our expectations and in terms of the third quarter. So a few things I'd like to highlight though so care patterns were as we discussed our.

Focused again on outpatient outpatient activity with seniors those continue at the levels. We described during the second quarter and Thats, what really drove a lot of kind of the activity.

Justin Lake: Next question please. For the next two, Justin Lake with Wolf Research. Thanks.

Speaker 4: And that's what really drove a lot of kind of activity throughout the quarter. It's still in those categories that we have been focused on. The sequential move.

Justin Lake: Good morning. I wanted to ask about UHC performance. First, your MLR was better than our expectations, but curious how it compared to your internal estimates. And maybe you could share how that might have come across, come in across the three main business segments. And then quickly on the third quarter, UHC margins. I found that interesting that while the MLR deteriorated by 50 basis points year over year in the quarter, overall, UHC margin actually improved by 50 basis points.

Throughout throughout the quarter, it's still in those categories that we have been focused on.

The sequential move that you see.

Speaker 4: From second quarter to third quarter is largely a seasonal factor. As you know well, there's always less care activity in a third quarter that has to do just with vacations, a lot of the elements that go in there in terms of certain types of discretionary care. Seasonal illnesses, so typical patterns, and also part D patterns that you see on a regular basis. In fact, if you go back to the years prior to 2020,

Second quarter to third quarter is largely a seasonal factor.

As you know well, there's always less care activity in a third quarter that has to do just with.

Vacations, a lot of the elements that go in there in terms of certain types of discretionary care.

No illnesses. So typical patterns and also part D pattern that you see on a regular basis. In fact, if you go back to the years prior to 2023.

Justin Lake: And so curious what might have drove that. Thanks. Justin, thanks so much for the question. Let me ask John Rex to respond to the first part, and then Brian Thompson the second. Good morning, Justin. So overall, I call it broadly consistent with our expectations in terms of the third quarter. So a few things I'd like to highlight though. So care patterns were as we discussed, focused again on outpatients, outpatient activity with seniors.

Speaker 4: 3Q would typically be the lowest caratial quarter. So I'd say it's probably more typical than not. Just getting back to periods that were more normalized in terms of the activities that we saw going on there.

<unk> would typically be the lowest care ratio quarter. So I'd say, it's probably more typical than not just getting back to periods that were more normalized in terms of the activity that we saw going on there.

Speaker 4: We continue to expect our full year medical care ratio to be the toward the upper end of our initial 82.6 plus minus 50 basis point range. So very consistent with the level that we set out there back again in the two-court of the upper end of that outlook.

We continue to expect our full year medical care ratio to be that towards the upper end of our initial $82 six plus minus 50 basis point range. So very consistent with the level that we set out there back again in the <unk> towards the upper upper end of that.

Justin Lake: Those continue at the levels we described during the second quarter. And that's what really drove a lot of kind of a activity throughout throughout the quarter. It's still in those categories that we have been focused on. The sequential move that you see from second quarter to third quarter is largely a seasonal factor. As you know, well, there's always less care activity in a third quarter that has to do just with vacations.

Of that outlook.

Speaker 4: So, and then the seasonal factors in the three cues that some of those things influencing where you'd expect to be in a fourth quarter, the final quarter of the calendar year, certainly utilization.

So and then the seasonal factors and the <unk> that some of those things influencing where you would expect to be in the fourth quarter. The final quarter of the calendar year certainly utilization part.

Speaker 4: Part D impacts, they move the other direction in a fourth quarter. So typical in that, that's amplified, of course, very much by the deductible where-off features that you see in a fourth quarter.

Part D impacts they move the other direction.

In the fourth quarter. So typical in that that's amplified of course very much by the deductible warehouse features that you see in the fourth quarter.

Justin Lake: A lot of the elements that go in there in terms of certain types of discretionary care, seasonal illnesses, so typical patterns, and also part D patterns that you see on a regular basis. In fact, if you go back to the years prior to 2020, 3Q would typically be the lowest care ratio quarter. So I'd say it's probably more typical than not. Just getting back to periods that were more normalized in terms of the activities that we saw going on there.

Speaker 3: Influenza RSV all those patterns are command so we'd expect that to move to move the other direction here as we go into the 4Q Thanks John and broad yeah, I John I think you did a good job of explaining sort of the sequencing of the

Influenza RSV all those patterns that come in so we would expect that to move to move the other direction here as we go into the <unk> right. Thanks, John and Brian Yes, John I think you did a good job of explaining sort of the sequencing of the medical cost ratio, what I don't want to lose sight of is I think the key point is all of our businesses and United Health care right now are really.

Speaker 3: Medical cost ratio, what I don't want to lose sight of is I think the key point is all of our businesses in the United Healthcare right now are really demonstrating innovation and market success at the same time.

Demonstrating innovation and market success at the same time and Youre seeing that come through in these margins, whether that's our complex care and health equity strategy in Medicaid, how we're showing up with broader service offerings and conveniences like <unk>, new ride in M&A to complement strong stable core benefits or some of the innovations you heard around the commercial benefits in <unk> opening remarks.

Justin Lake: We continue to expect our full year medical care ratio to be the toward the upper end of our initial 82.6 plus minus 50 basis point range. So very consistent with the level that we set out there back again in the two quarter that would be toward the upper end of that outlook. So, and then the seasonal factors in the 3Q, some of those things influencing where you'd expect to be in a fourth quarter, the final quarter of the calendar year, certainly utilization, part D impacts, they move the other direction in a fourth quarter.

Speaker 3: And you're seeing that come through in these margins. Whether that's our complex care and health equity strategy and Medicaid, how we're showing up with broader service offerings and conveniences like you, Cardin, you, ride.

Speaker 7: NMA to complement strong stable core benefits or some of the innovations you heard around the commercial benefits and DERC's opening remarks. This is really translating the type of growth and performance that I think you've come to expect from United Health Care and I think it sets up a really nice baseline that I remain optimistic about as we look forward to 2024. Thanks so much, Brian , John . And next question, please. Thank you.

It is really translating the type of growth and performance that I think you've come to expect from United Healthcare and I think it sets up a really nice baseline that I remain optimistic about as we look forward to 2024.

Thanks, So much Brian John next question. Please.

We'll go next to Stephen Baxter with Wells Fargo.

Justin Lake: So typical in that, that's amplified, of course, very much by the deductible warehouse features that you see in a fourth quarter. Influenza, RSV, all those patterns that come in. So we'd expect that to move to move the other direction here as we go into the 4Q. Thanks John. Yeah, John, I think you did a good job of explaining sort of the sequencing of the medical cost ratio. What I don't want to lose sight of is I think the key point is all of our businesses in the United Health Care right now are really demonstrating innovation and market success at the same time.

Speaker 10: Yeah, hi, thanks. I wanted to ask about the PBM business, obviously interest in alternative or maybe even experimental models has been a big area of the day, the past quarter or so. I guess we're doing hearing from your health plan and employer clients on their degree of interest in doing something totally transformational in terms of how they manage those benefits. Thanks.

Yeah, Hi, Thanks, I wanted to ask about the Pbms business, obviously interest in alternative or it may be then experimental models has been a big area of debate in the past quarter. So I guess what are you hearing from your health plan employer clients on their degree of interest in doing something totally transformational in terms of how they manage those benefits. Thanks.

Speaker 2: So Stephen, thanks so much. Let me ask Patrick on way to respond to that.

Steven Thanks, So much let me ask Patrick Homeaway to respond to that.

Justin Lake: And you're seeing that come through in these margins, whether that's our complex care and health equity strategy and Medicaid, how we're showing up with broader service offerings and conveniences like you card and you ride in MA to compliment strong stable core benefits or some of the innovations you heard around a commercial benefits and dorks opening remarks. This is really translating the type of growth and performance that I think you've come to expect from United Health Care.

Speaker 6: Yes, so as we interact with our clients, employers, payers and others, on this first all-nove recent survey came out, approximately 90% of those clients are satisfied with their PBM. They're also satisfied with the level of...

Yes, so as we interact with our clients employers payers and others on this first I'll note. Recent survey came out approximately 90% of those clients are satisfied with their pbms. They're also satisfied with the level of transparency specifically for Optum Rx, we will continue to innovate.

Speaker 6: Specifically for Optamar X, we will continue to innovate and provide additional solutions to our clients that are comprehensive, integrated, and transparent. I'll call out one other area of transparency to the consumer. This has been a journey for us that we continue to drive transparency to the consumer to call out one example with Price Edge, a product regional.

And provide additional solutions to our clients that our comprehensive integrated and transparent I'll call out one other area transparency to the consumer this has been a journey for us that we continue to drive transparency to the consumer to call out. One example, with price edge product recently launched that's providing consumers the most affordable.

Brian Thompson: And I think it sets up a really nice baseline that I remain optimistic about as we look forward to 2024.

John Rex: Thanks so much, Brian, John.

Stephen Baxter: Next question, please. The next two Stephen Baxter with Wells Fargo. Yeah, hi, thanks.

Speaker 7: That's providing consumers the most affordable medicine at the point of care. We're seeing millions of consumers access, use this tool as we provide it to them. And so you'll continue to see us to drive consumer transparency and innovative solutions to our clients. Right, Patrick, thanks so much. Next question. Next.

<unk> at the point of care, we are seeing millions of consumers.

Stephen Baxter: I wanted to ask about the PVM business, obviously interest in alternative or maybe the experimental models has been a big area of the base, you know, the past quarter or so. I guess what are you hearing from your health plan employer clients on their degree of interest and doing something totally transformational in terms of how they manage those benefits. Thanks. Thanks, Stephen. Thanks so much.

Access use this tool as we provided to them and so youll continue to see us to drive consumer transparency and innovative solutions to our clients.

Right Patrick Thanks, so much nice question.

We'll go next to Nathan Rich with Goldman Sachs.

Patrick Conway: Let me ask Patrick Conway to respond to that. Yeah, so as we interact with our clients, employers, payers and others. On this, first I'll note, recent survey came out approximately 90% of those clients are satisfied with their PBM. They're also satisfied with the level of transparency. Specifically for OptumRX, we will continue to innovate and provide additional solutions to our clients that are comprehensive. Integrated and transparent, I'll call out one other area of transparency to the consumer.

Great. Good morning, Thanks for the question.

Speaker 12: Great good morning. Thanks for the question.

I wanted to go back to the <unk>, one class and I guess.

Speaker 12: I wanted to go back to the GOP1 class. And I guess as we're starting to see more outcomes data for these drugs, do you see that changing employers' willingness to cover this class given the potential long-term benefits? And how are you helping them think about potential ways to design the benefit to be able to manage that cost, which you guys talked about earlier, being so much in focus for employers?

Starting to see more outcomes data for these drugs do you see that changing employers willingness to cover this class given the potential long term benefits.

How are you, helping them think about potential ways to design the benefit.

To be able to manage that cost, which you guys talked about earlier being so much in focus for employers.

Patrick Conway: This has been a journey for us that we continue to drive transparency to the consumer to call out one example with price edge. A product recently launched. That's providing consumers the most affordable medicine at the point of care. We're seeing millions of consumers. Access use this tool as we provide it to them. And so you'll continue to see us to drive consumer transparency and innovative. We'll give solutions to our clients.

Speaker 2: Nathan, thanks so much for the question. I mean, there's an old adage which I quite like in this context, which is the innovation that is not affordable is nice.

Yes, Nathan Thanks, so much for the question I mean, there is an old there's an old adage, which I quite like in this context, which is the innovation that is not affordable is innovative.

Patrick Conway: Patrick, thanks so much.

Speaker 2: And that's really the key to all of this. Though I have no argument, I don't think anybody United Health Group has any argument with...

And that's really the key to all of this though I have no argument I don't think anybody Unitedhealth group has any argument with the prospects and possibility for the future of this drug class.

Speaker 2: The prospects and possibility for the future of this drug class, and we recognize the need and nothing would make us happier honestly to be able to lean forward and see more and more folks take advantage of these sorts of opportunities. But ultimately it has to be affordable.

We recognize the need.

Nothing would make us happier honestly to be able to lean forward and see more and more folks take advantage of these sorts of opportunities, but ultimately it has to be affordable and what we're hearing from our clients as they just they are really struggling to see how they embark on that journey of what they regard as a kind of open ended.

Nathan Rich: Next question. We'll go next to Nathan Rich with Goldman Sachs. Great, good morning. Thanks for the question. I wanted to go back to the GLP1 class. And I guess as we're starting to see more outcomes data for these drugs, do you see that changing employers' willingness to cover this class? Yes, given the potential long-term benefits. How are you helping them think about potential ways to design the benefit to manage that cost, which you guys talked about earlier, being so much in focus for employers?

Speaker 2: And what we're hearing from our clients is they are really struggling to see how they embark on that journey of what they regard as a kind of open-ended financial risk.

Financial risk.

Speaker 2: Now that's exactly why Brian earlier made the comments he did about we're trying to put forward two various manufacturers a variety of different options but we need the manufacturers to move, it's as simple as that.

It's exactly why Brian earlier I made the comments you did about we're trying to put forward to various manufacturers' a variety of different options, but we need to manufacturers to move its as simple as that.

Speaker 7: And, you know, we remain extremely open-minded to any model that works. We're working with our clients to ensure that they understand the various options, but they are given us very, very, very clear signals. They need our help to make this a more affordable proposition for their employees and their members, and we'll continue to lean into that. Thanks for the question, Nathan. Next question. Hey!

And.

We remain extremely open minded to any model. It works, we're working with our clients to ensure that they understand the various options, but they all given us very very very clear signals. They need our help to make this a more affordable proposition for their employees and their members.

Andrew Witty: Nathan, thanks so much for the question. There's an old adage which I quite like in this context, which is the innovation that is not affordable is not innovative. And that's really the key to all of this. Though I have no argument. I don't think anybody United Health Group has any argument with the prospects and possibility for the future of this drug class. And we recognize the need and nothing would make us happier, honestly, to be able to lean forward and see more and more folks take advantage of these sorts of opportunities.

We will continue to lean into that thanks for the question Nathan next question.

We'll go next to Scott Fidel with Stephens.

Hi, Thanks, good morning.

Speaker 10: Hi, thanks. Good morning. Terious, if you can give us your updated thoughts on from this vantage point, what you're thinking about the trajectory of just overall wage inflation.

If you can give us your updated thoughts on from this vantage point, what you're thinking about the trajectory of just overall wage inflation.

Speaker 10: in healthcare and how you're sort of planning for that. You know, we had been seeing sort of moderation from the COVID peaks, but there certainly seems to be some pro inflationary risks out there when thinking about some of the federal policy proposals, state proposals, and then obviously some of these union actions too. So just curious on how you're thinking about, you know, wage inflation and healthcare moving forward and risks, you know, to that and reflecting back upwards. e???ch.

Healthcare, it and the and how you're sort of planning for that.

Andrew Witty: But ultimately it has to be affordable. And what we're hearing from our clients is they are really struggling to see how they embark on that journey of what they regard as a kind of open-ended financial risk. Now that's exactly why Brian earlier made a comment he did about we're trying to put forward two various manufacturers a variety of different options, but we need the manufacturers to move. It's as simple as that.

We had been seeing sort of moderation from the Covid peak spot there certainly seems to be some pro inflationary risks out there when thinking about some of the federal rollout policy proposals state proposals and then obviously some of these union actions to show. So just curious on how you're thinking about wage inflation and healthcare moving forward.

And and risks to that and reflecting back back upwards.

Andrew Witty: And we remain extremely open-minded to any model of works we're working with our clients to ensure that they understand the various options, but they are giving us very, very clear signals. They need our help to make this a more affordable proposition for their employees and their members and we'll continue to lean into that. Thanks for the question, Nathan.

Speaker 3: Yeah, absolutely. Thanks so much for the question. Let me ask Dirk to give you a few comments on that. Yeah, well to start, you know, what I would say is as we go out and we negotiate with your clip.

Yes, absolutely. Thanks, so much for the question, let me ask <unk> to give you a few comments on that yes, well to start what I would say is as we are as we go out and we negotiate with various health systems for prices as we move forward one of the key things involved in those discussions is what wage inflation, what wage inflation is and how it's impacting your cost.

Unknown Executive: Next question.

Speaker 3: For prices as we move forward, you know one of the key things involved in those discussions is you know What wage and phrase what wage inflation is and how it's impacting their cost, you know as we sit here today It's lucky that we sort of have three-year contracts. So it's muted a little bit But what I would also say is you know I we see a little bit of upward pressure on unit costs related to wages But as I sit here today it's not something that we haven't planned for him priced about

So as we sit here today, it's it's lucky that we sort of have three year contracts. So it's muted a little bit but why would also say as you know.

Scott Fidel: Next to Scott, the Dow with demons.

Doug: Hi, thanks so good morning, curious if you can give us your updated thoughts on on from this vantage point what you're thinking about the trajectory of just overall wage inflation in healthcare and the and how you're sort of planning for that. We have been seeing sort of moderation from the COVID peaks, but there certainly seems to be some pro inflationary risks out there when thinking about some of the federal policy proposals, state proposals, and then obviously some of these union actions too. So just curious on how you're thinking about wage inflation and healthcare moving forward and risks to that and reflecting back upwards. Thanks. Yeah, absolutely. Thanks so much for the question.

We see a little bit of upward pressure on unit costs related to wages, but as I sit here today, it's not something that we have in play form priced about as I think about our own business. We haven't had trouble recruiting people such as nurses clinicians, we've actually people really want to work for us and from a capacity perspective, one of the things as we've talked about our <unk>.

Speaker 3: As I think about our own business, we haven't had trouble recruiting people, such as nurses, clinicians. We've actually, you know, people really want to work for us and from a capacity perspective, one of the things as we've talked about our road so far, we have to make sure we have the appropriate labor capacity to manage all the risk that we take.

So far we have to make sure we have the appropriate labor capacity to manage all of the risk that we take.

Speaker 7: And as a consequence, we do spend a lot of time looking at the market. And as I said, people want to come to work for us. They like the mission. They like the ability to transform healthcare. And we're pretty pleased with our ability to hire and manage our operations going forward. Thanks, Doug. Thank you very much for the question. Next question, please. So the next two, Kevin, this...

As a consequence, we do spend a lot of time looking at the market and as I said people want to come to work to work for us they like the mission they like the ability to transform healthcare.

We're pretty pleased with our ability to hire and manage our operations going forward. Thanks, Doug. Thank you very much for the question next question. Please.

Doug: Let me ask Doug to give you a few comments on that. Yeah, well, to start, you know, what I would say is as we're, as we go out and we negotiate with various health systems for prices as we move forward, you know, one of the key things involved in those discussions is, you know, what wage inflation, what wage inflation is, and how it's impacting their cost. You know, as we sit here today, it's lucky that we sort of have three-year contracts, so it's muted a little bit.

We will go next to Kevin Fischbeck with Bank of America.

Great. Thanks.

Speaker 11: Great, thanks. I wanted to ask about Optum Health. I understand the commentary about membership coming in better, which creates a margin drag, but it feels like a couple hundred thousand people, maybe low to mid-single digit, more membership than you expected, causing margins to drop.

Wanted to ask about Optum health I understand the commentary about membership coming in better which creates a margin drag but it feels like a couple of hundred thousand people, maybe low to mid single digit more membership and your expected, causing margins to drop from $8 seven or 12% essentially it seems.

Doug: But what I would also say is, you know, we see a little bit of upward pressure on you. We're not going to cost related to wages, but as I sit here today, it's not something that we haven't planned for and priced about. As I think about our own business, we haven't had trouble recruiting people, such as nurses, clinicians, we've actually, you know, people really want to work for us and from a capacity perspective, one of the things as we've talked about our growth so far, we have to make sure we have the appropriate labor capacity to manage all the risk that we take.

Speaker 11: or 12% essentially seems like a pretty big delta. I assume there's other things going on in there beyond just digesting new membership growth, if not, and I guess we would know what the margin is on those new members. But is there anything else you would do?

A pretty big Delta So I assume there's other things going on in there beyond just digesting new membership growth. If not then I guess, we would know what the margin is on those new members, but is there anything else you would.

Speaker 7: spike out there and how do we think about building back from where we are today to the age of 12, for 8 to 10 percent margin target? Is it simply about getting today's membership to target margins or is there a cost size seems like you're adjusting the labor force to some degree? Is there an MLR side? Is there a rate side? Any of the color to kind of help us give us a billy and be at the 10 over time? Thanks.

Spike out there and how do we think about building back from where we are today to that eight to 12, 8% to 10% margin target is it simply about <unk>.

Doug: And as a consequence, we do spend a lot of time looking at the market. And as I said, people want to come to work to work for us. They like the mission. They like the ability to transform health care. And we're pretty pleased with our ability to hire and manage our operations going forward. Thanks, Doug. Thank you very much for the question.

Today's membership to target margins or are there.

The cost side it seems like Youre adjusting the labor force to some degree is there an MLR side is there a right side any color to kind of help us give us ability into the eight to 10 over time. Thanks.

Kevin Fischbeck: Next question, please. Well, the next two, Kevin, the spec was Bank of America. Great. Thanks.

Speaker 2: Kevin, thanks so much for the question. So, um, for listen.

Kevin Thanks, so much for the question so by far and away. The most important phenomena here are the things we've talked about two already so just to reiterate a little bit what we said to you back in Q2.

Speaker 2: By far and away, the most important phenomena here are the things we've talked about too already. So just to reiterate a little bit, what we said to you back in Q2. So we've seen obviously the elevation in MLR, which has stabilized, hasn't really come down, isn't accelerating up, but definitely is a phenomena year over year. Number one, number two, increased behavioral care. I'll remember that within Optum Health, our behavioral businesses, that's where our behavioral business sits and that.

Kevin Fischbeck: I wanted to ask about Optum Health. I understand the commentary about membership coming in better, which creates a margin drag. But it feels like, you know, a couple hundred thousand people, you know, maybe low to mid-single digit, more membership than you expected causing margins to drop, you know, from eight to seven or, you know, 12% essentially seems like a pretty big delta. I assume there's other things going on in there beyond just digesting new membership growth.

So we've seen obviously the elevation in MLR.

As stabilized hasn't really come down isn't accelerating up but definitely is a phenomenal year over year number one number two increase behavioral care costs remember within Optum health behavioral businesses, that's where our behavioral business sits and that has also seen significant increase year over year, we're very positive about that because it's a signal.

Speaker 2: has also seen significant increase year over year. We're very positive about that, because it's a signal that people are engaging in seeking help for their behavioral conditions. And we know that that in twines very importantly with their ongoing medical costs.

Kevin Fischbeck: If not, then I guess we would know what the margin is on those new members. But is there anything else you would spike out there? And how do we think about building back from where we are today to that eight to 12% to 10% margin target? Is it simply about getting today's membership to target margins? Or is there a cost sizing? Like you're adjusting the labor force to some degree? Is there an MLR side? Is there a rate side? Any of the color to kind of help us give us a billy into the 10 over time? Thanks.

People are engaging in seeking help for that behavioral conditions, and we know that that <unk> very importantly, with their ongoing medical cost, but nonetheless, it's an element of elevation and then as you.

Speaker 2: but nonetheless it's an element of elevation and then as you rightly reiterate, a piece of it is the growth in all value-based lives and the mix of those lives.

You rightly reiterate.

Or is the growth in our value based lives on the mix of those lives and by mix that means complexity mix as well as geographic mix and it takes as I said already today. It takes a little bit of time to build up the capabilities to allow us to engage properly with those folks at the level, we want to and we've really we have not held back on doing that Kevin.

Speaker 2: And by mix that means complexity mix as well as geographic mix and it takes as I said already today.

Speaker 2: take a little bit of time to build up the capabilities to allow us to engage properly with those folks at the level we want to and we've really we have not held back on doing that Kevin and that's really the bulk of the of the investment during this cycle where we've really lent into building those capabilities and readiness for the next we hope many years of serving these individuals higher and higher capability

Kevin Fischbeck: Kevin, thanks so much for the question. So listen, by far and away, the most important phenomena here are the things we've talked about too already. So just to reiterate a little bit what we said to you back in Q2. So we've seen obviously the elevation in MLR, which has stabilized, hasn't really come down isn't accelerating up, but definitely is a phenomena year over year. Number one, number two, increased behavioral care cost.

And that's really the bulk of the of the investment during this cycle, where we've really learned into building those capabilities and readiness for the next we hope many years of serving these individuals are higher and higher capability.

Speaker 2: Of course, and I made a comment earlier about re-engineering our cost base. Of course, there are changes going on in our cost base across the whole organisation, including optimum health in response to the changing price in signals from CMS. But I would put those very much secondary to the core elements I've just described.

Of course, and I made a comment earlier about reengineering our cost base of course, there are changes going on in our cost base across the whole organization, including Optum health and responds to the changing pricing signals from CMS, but I.

Kevin Fischbeck: Remember that within Optum Health, our behavioral businesses, that's where our behavioral business sits and that has also seen significant increase year over year. We're very positive about that because it's a signal that people are engaging in seeking help for their behavioral conditions. And we know that that in twines very importantly with their ongoing medical costs. But nonetheless, it's an element of elevation. And then as you rightly reiterate a piece of it is the growth in our value based lives and the mix of those lives.

I would put those very much kind of secondary to the core relevance I've just described.

Speaker 2: We're in a position obviously where we know exactly what these populations are, that we're now looking after. That's been very much the basis of our forward views in terms of how we're starting to lay out for 24, 25, 26. And we feel very confident about our ability, not only to grow as an organisation, but to continue to strengthen margins back into the zone that you've historically been used to. Thanks so much, Kevin, for that and next question.

We're in a position, obviously, where we know exactly what these populations all of that we're now looking after that.

That's been very much the basis of our forward views in terms of highway started to lay out for $2025 26.

Feel very confident about our ability not only to grow as an organization, but to continue to strengthen margins back into the zone that you've historically been used to.

Kevin Fischbeck: And by mix, that means complexity mix as well as geographic mix. And it takes, as I said already today, take a little bit of time to build up the capabilities to allow us to engage properly with those folks at the level we want to. And we've really we have not held back on doing that Kevin and that's really the bulk of the of the investment during this cycle where we've really led into building those capabilities in readiness for the next we hope many years of serving these individuals higher and higher capability.

Thanks, so much Kevin for that and the next question.

We'll go next to Sarah James with Cantor Fitzgerald.

Speaker 13: Thank you. I wanted to circle back to your comments on the strengths in commercial growth and national accounts for next year. Can you give us a little bit of color on the pricing environment, giving all the comments you've made on the moving pieces and cost trends and then help us put into context that and that broader economy with how your clients are thinking about product selection, either in breast or the type of products that they're purchasing from you in 24.

Thank you I wanted to circle back to your comments on the strength in commercial growth in National accounts for next year can you give us a little bit of color on the pricing environment given all the comments you've made.

The moving pieces and cost trends and then help us put into context.

Kevin Fischbeck: You know, of course, and I made a comment earlier about reengineering our cost base, of course, there are changes going on in our cost base across the whole organization, including Optum Health in response to the change in pricing signals from CMS. But I would put those very much kind of secondary to the core elements I've just described. We We're in a position, obviously, where we know exactly what these populations are that we're now looking after.

Matt.

And the broader economy with how your clients are thinking about product selection, either in breath or where the type of products that they're purchasing from you in 'twenty four.

Thanks, So much for the question, let me ask Don Keto, who looks after our commercial insurance business to answer them.

Speaker 2: Thanks so much for the question. Let me ask Edankito who looks after our commercial insurance business.

Yeah, Thanks, Andrew Hi, Sarah Thanks for the question the growth that John mentioned in his comments is settled business in our national accounts fee based segment. So we're very happy with how thats completed where pricing and negotiating our fully insured business for January right now and we're comfortable with how that's materializing as well.

Speaker 3: Yeah, thanks Andrew Heissera. Thanks for the question. The growth that John mentioned in his comments is settled business.

Kevin Fischbeck: That's been very much the basis of our forward views in terms of how we're starting to lay out for 24, 25, 26, and we feel very confident about our ability not only to grow as an organization, but to continue to strengthen margins back into the zone that you've historically been used to.

Speaker 3: international accounts fee-based segments. So we're very happy with that, how that's completed.

Speaker 3: We're pricing and negotiating our fully insured business for January right now and we're comfortable with how that's materializing as well.

Employers continue to focus on both affordability and innovation and our innovative products continue to resonate significantly in the market as Derek highlighted in his comments. Thanks, Sir thanks, So much Don next question. Please.

Speaker 7: Employers continue to focus on both affordability and innovation and our innovative products continue to resonate significantly in the market as they're highlighting his comments. Thanks, Sarah. Thanks so much, Tom. Next question, please.

Kevin Fischbeck: Thanks so much, Kevin, for that, and next question.

Sarah James: Hold on to Sarah James with Cantor Fitzgerald. Thank you. I wanted to circle back to your comments on the strengths in commercial growth and national accounts for next year.

We'll go next to David Windley with Jefferies.

Dan Kueter: Can you give us a little bit of color on the pricing environment, give it all the comments you've made on the moving pieces and cost trends, and then help us put into context that and that broader economy with how your clients are thinking about product selection, either in breadth, or where the type of products that they're purchasing from you in 24. Sarah, thanks so much for the question. Let me ask a Dan Kueter who looks after all our commercial insurance business to Angela.

Speaker 14: Hi, good morning. Thanks for taking my question. I wanted to pivot to Optum Insight. You had commented in previous calls about a fairly heavy level of spending to integrate change and invest in that platform. I wondered if you could update us on any ongoing spend in that regard, what we should expect in terms of implementation on pro-health and kind of trajectory of margin and Optum Insight. Thanks.

Hi, Good morning, Thanks for taking my question I wanted to pivot to Optum insight you had commented in previous calls about a fairly heavily heavy level of spending to integrate change and invest in that platform I wondered if you could update us on any ongoing spend in that regard.

Dan Kueter: Thanks, Andrew. Hi, Sarah. Thanks for the question. The growth that John mentioned in his comments is settled business in our national accounts fee-based segments, so we're very happy with how that's completed. We're pricing and negotiating our fully-insured business for January right now, and we're comfortable with how that's materializing as well. Employers continue to focus on both affordability and innovation, and our innovative products continue to resonate significantly in the market as they're highlighting his comments. Thanks, Sarah. Thanks so much, Tom.

What we should expect in terms of implementation on pro health.

And kind of trajectory of margin in Optum insight. Thank you.

Hi, David Thanks, So much for the question, let me ask Roger Krone, who is our new CEO of Optum insight to respond and Roger Thank you and David. Thank you for the question first of all just to say I'm delighted to be taking over the leadership of insight. This is a pretty unique and special business.

Speaker 15: David, thanks so much for the question. Let me ask Roger Kona, who's our new CEO of Otter Insight to respond, Roger. Thank you, and David. Thank you for the question. First of all, this is the same, the latter to be taken over the leadership of Insight. This is a pretty unique and special business.

Speaker 15: And getting to know the people of products and the offerings, I think we're going to make a real difference to the health care. So excited about that future.

On getting to know the people the products and the offerings I think we're going to make a real difference to the health care. So excited about the future.

Speaker 15: Specifically David on your question, the change in integration has gone really well, to be honest. You'll see in the Q3 margin that we had the TLN of some of that span.

Pacifically David on your on your question the <unk> integration is going really well to be honest.

Youll see in the Q3 margin that we had the <unk> of some of that spend.

David Windley: Next question, please. Well, the next two, David Wendley with Jeffries. Hi, good morning. Thanks for taking my question. I wanted to pivot to Optum Insight. You had commented in previous calls about a fairly heavy level of spending to integrate change and invest in that platform. I wondered if you could update us on any ongoing spend in that regard. What we should expect in terms of implementation on pro-health and kind of trajectory of margin and optimum insight. Thank you.

Roger Connor: Hi, David. Thanks so much for the question.

Speaker 15: to integrate, but the Q3 margin is in line with our expectations. I think this worth understanding the longer term outlook for off-dem insight margin, we still believe that in the region of 18 to 22%. That's really driven by the mix of the businesses. As you know, we're a business that has software, we have services, there are different margins in there.

Integrated but the Q3 margin is in line with our expectations I think thats worth understanding the longer term outlook for Optum insight margin, we still believe that in the region of <unk>.

<unk> to 22%, that's really driven by the mix of the businesses as you know we're a business that has software we have services different margins in there, but when you take what we've created with change and you look out the overall portfolio that we have we helped us incredible portfolio of those addressing everything.

Speaker 15: But when you take what we've created with change and you look at the overall portfolio that we have, we have this incredible portfolio that is addressing.

Speaker 15: Everything from clinical decision support, we've got products for admin efficiency, we've got other products for payment optimization. You have that group engine plus our innovation plus that margin profile, we're very confident about the future performance.

<unk> from clinical decision support with the products for admin efficiency, we've got other products for payment optimization you are.

Roger Connor: Let me ask Roger Connor, who's our new CEO of Optum Insight to respond Roger. Thank you, David. Thank you for the question.

Growth engine, plus our innovation profile margin profile, we're very confident about the future performance of insight.

Roger Connor: First of all, this is Sam, delighted to be taking over the leadership of Insight. This is a pretty unique and special business. I'm getting to know the people, the products, and the offerings. I think we're going to make a real difference to help her. So excited about that future. Just specifically, David, on your question, the change integration is going really well, to be honest. You'll see in the Q3 margin that we had the TLN of some of that span to integrate, but the Q3 margin is in line with our expectations.

Speaker 2: That's great and I wonder whether Dan Schumacher who's been very heavily involved in our various health systems Partnerships might just want to reflect you know a little bit on on

That's great.

Dan Shoemaker, who has been very heavily involved in our various health systems partnerships might just wanted to reflect a little bit on.

The question, obviously, it was around pro health, but rather than talking specifically, maybe just share a few thoughts about the overall evolution of those health system profiles and how they play out over the first couple of years sure. Thanks Andrew.

Speaker 16: The question obviously was around pro-health, but rather than talking specifically, maybe just share a few thoughts about the overall evolution of those health system profiles and how they play out over the first couple of years. Sure, thanks Andrew. David, appreciate the question. Certainly our health system partnerships, you mentioned one that we've announced recently. It's a growing portfolio for us. Obviously, at the health system level, there's a lot of pressures.

Roger Connor: I think this worth understanding the longer term outlook for Optum Insight margin. We still believe that in the region of 18 to 22%. That's really driven by the mix of the businesses. As you know, we're a business that has software, we have services, there are different margins in there. But when you take what we've created with change and you look at the overall portfolio that we have, we have this incredible portfolio that is addressing everything from clinical decisions to port. We've got products for ads and inefficiency. We've got other products for payment optimization. You have that group engine plus our innovation plus that margin profile. We're very confident about the future performance.

David I appreciate the question.

Certainly our health system partnerships, you mentioned, one that we've announced recently.

Our growing portfolio for us obviously at the health system level, there's a lot of pressures we've talked in earlier questions about wage inflation and so forth and we have a unique opportunity to really be able to address some of those near term challenges.

Speaker 16: We've talked in earlier questions about wage inflation and so forth. And we have a unique opportunity.

Speaker 16: to really be able to address some of those near term challenges while at the same time provide some capacity for future evolution.

At the same time provide some capacity for future evolution.

Speaker 16: of the system as they think about more digital capacities, greater outpatient catchment, as well as further engagement. So those are some of the things that we can help unlock for them and their migration to value-based care. So we're encouraged by the portfolio, it continues to grow.

Our system as they think about more digital capacities greater outpatient catchment.

As well as further engagement. So those are some of the things that we can help unlock for them and their migration to value based care. So we're encouraged by the portfolio continues to grow.

Daniel Schumacher: That's great and I wonder whether Dan Schumacher who's been very heavily involved in our various health systems partnerships might just want to reflect you know a little bit on the question obviously with their own pro health but rather than talking specifically maybe just share a few thoughts about the overall evolution of those health system profiles and how they play out over the first couple of years. Sure thanks Andrew. David appreciate the question.

Actually from the initial scope nine out of 10 have expanded from their initial scope. So continuing to grow we're in the early days and we see a lot of opportunity ahead of us I appreciate it and thanks. So much for the question next question. Please.

Speaker 7: actually from the initial scope, 9 out of 10 have expanded from their initial scope. So continuing to grow, we're in the early days and we see a lot of opportunity ahead of us. And appreciate it and thanks so much for the question. Next question please.

We'll go next to Ann Hynes with Mizuho Securities.

Hi, Good morning, I would like to ask the G. L. P question more on the medical side it sounds like right now price.

Speaker 9: Hagen Morning, I would like to ask a GLP question more on the medical side. It sounds like right now price appears to be the greatest barrier for widespread adoption. Assumingly, outcome data continues to be positive.

Daniel Schumacher: Certainly our health system partnerships you mentioned. One that we've announced recently it's a growing portfolio for us obviously at the health system level there's a lot of pressures we've talked in earlier questions about wage inflation and so forth and we have a unique opportunity to really be able to address some of those near term challenges while at the same time provide some capacity for future evolution of the system as they think about more digital capacities greater outpatient catchment as well as further engagement.

To me the greatest barrier to widespread adoption, assuming the outcome data continues to be positive.

Speaker 17: That price and guess to a point that you view and you're client view is affordable. What do you think would be the long-term impact on care on the medical side? Are you seeing any near-term effects right now on MLR? I should say an MLR benefit. And do you think it would be reasonable to assume overall MLRs should decline with greater adoption of these drugs? And maybe what categories are health spend? Do you think a do you view would be the biggest opportunity going forward? Thanks.

Pricing gets to a point that you're viewing your clients view.

What do you think would be the long term impact on care on the medical side are you seeing any near term effects right now on MLR I should say in our benefit and do you think it would be reasonable to assume overall MRO MLR should decline with greater adoption of these drugs and maybe luck cat.

Daniel Schumacher: So those are some of the things that we can help unlock for them and their migration to value-based care so we're encouraged by the portfolio continues to grow actually from the initial scope 9 out of 10 have expanded from their initial scope so continuing to grow we're in the early days and we see a lot of opportunity ahead of us. I appreciate it and thanks so much for the question.

He has a house spend do you think it would be.

The biggest opportunity going forward. Thanks.

Speaker 2: And thanks so much for the question. I mean, I think honestly it's just way too early for us to be able to see anything like that, just in terms of, you know.

Thanks, So much for the question I mean, I think honestly, it's just way too early for us to be able to see any anything like that.

Just in terms of.

Obviously, the weight loss indications are only just really coming into play we haven't really been able to see I'd say anything from that perspective yet.

Speaker 2: Obviously the weight loss indications are only just really coming into play. We haven't really been able to see, I'd say, anything from that perspective yet. And as I said earlier, the real focus for us right now is to try and figure out a way in which we can get to a position where the affordability of this class puts it in as own where the people who need it can get it and can afford it. Not in more to say on that, honestly. Next question, please.

Anne Hines: Next question please.

Andrew Witty: We'll go next to Anne Hines with Mizzouho securities. Hi and morning I would like to ask a GLP question more on the medical side. It sounds like right now price appears to be the greatest barrier for widespread adoption. Assume the outcome data continues to be positive. If price against a real point that you view and you climb to you as affordable what do you think would be the long term impact on care on the medical side.

And as I said earlier, the real focus for US right now is to try and figure out a way in which we can get to a position where the affordability of this class puts in a zone where.

The people, who need it can get it and kind of afford it.

Nothing more to say on that honestly.

Next question please.

We'll go next to John Ransom with Raymond James.

Hey, good morning on.

Speaker 15: Hey, good morning. On your fully accountable lives, what's the expectation where you'll end up in the year with a number of Medicare fully abandoned lives? And just looking at the eliminations, is it fair to assume that a lot of those fully accountable lives are coming out of the UHT book? Thanks.

On your fully accountable lives.

Andrew Witty: Are you seeing any near term effects right now on MLR I should say an MLR benefit and do you think it would be reasonable to assume overall MLRs should decline with greater adoption of these drugs. And maybe what categories of health spend do you think do you think would be the biggest opportunity going forward. Thanks.

Spectation, where you'll end up the year with a number of.

And I think carefully about our lives and just looking at the eliminations.

Fair to assume that a lot of those fully accountable lives are coming out of the UHC book. Thanks.

Speaker 2: So thanks very much for the question. I'll ask Dr. Amar Desai who leads our Optum Health Organization just to come a little bit on the kind of shape of the folks we look after there, and the degree to which they come from both UAC. And obviously, many of our external partners are...

So thanks very much for the question I'll ask Doctor amount Desai, who leads our Optum health organization, just to comment a little bit on the the kind of shape of.

Andrew Witty: And thanks so much for the question. I mean I think honestly it's just way too early for us to be able to see anything like that. Just in terms of you know obviously the weight loss indications are only just really coming into play. We haven't really been able to see I'd say anything from that perspective yet. Another said earlier the real focus for us right now is to try and figure out a way in which we can get to a position where the affordability of this class puts it in a zone where you know the people who need it can get it and kind of afford it. Nothing more to say on that honestly.

John Ransom: Next question please.

<unk>.

The folks we look after that.

And the degree to which.

They come from both UHC and obviously many of our external partners AMA.

John Thanks, very much for the question.

Speaker 3: John , thanks very much for the question. We've had great growth in fully accountable membership as we mentioned earlier, adding over 900,000 patients for the year.

Had great growth and fully accountable membership as we mentioned earlier, adding over 900000 patients for the year that growth is diverse across a number of pairs. We have over 100 payer partners spanning both national and reader regional payers and as we think about that growth of course, unitedhealthcare as a core partner to us.

Speaker 18: That growth is diverse across a number of pairs. We have over 100 pair partners spanning both national and regional pairs. And...

Speaker 18: As we think about that growth, of course, United Healthcare is a core partner to us, but we continue to have the strength of our medical groups and physician networks being incredibly attractive to other pairs, regionally and nationally, to be able to grow in their own value-based arrangements to drive.

John Ransom: The next two John ransom with Raymond James.

We continue to have the strength of our medical groups and physician network being incredibly attractive to other payers regionally and nationally to be able to grow in their own value based arrangements to drive outcomes and total cost of care. So we look forward to continued growth in our broad based diverse way. Thank you very much.

Amar Desai: Hey good morning on your fully accountable lives. What's the expectation where you'll end up the year with a number of medical fully abandoned lives and just looking at the eliminations is it fair to assume that a lot of this fully accountable lives are coming out of the UHC book. Thanks. So thanks very much for the question. I'll ask Dr. Amar Desai who leads our optimum health organization just to comment a little bit on the you know the kind of shape of the folks we look after there.

Amar Desai: And the degree to which they come from both UHC and obviously many of our external partners. John, thanks very much for the question. We've had great growth and fully accountable membership as we mentioned earlier, adding over 900,000 patients for the year. That growth is diverse across a number of pairs. We have over 100 pair partners spanning both national and regional pairs. And as we think about that growth, of course, UnitedHealth Care is a core partner to us.

Speaker 18: outcomes and total cost of care. So we look forward to continued growth in a broad, base, diverse way. Thank you very much.

Speaker 7: Thank you. Thank you for the question. Jennifer, Jennifer, would you take the last question now, please? Okay. We'll go last.

Thank you and thank you for your question, Jennifer Jennifer will take the last question now please.

Okay, We'll go last to Lance Wilkes with Bernstein.

Great. Thanks for taking the question.

Speaker 11: Great. Thanks for taking the question. On Medicaid and Medicaid re-determination, could you comment a little bit on the margin implications of the members that are getting re-determined off? We already seen a lot of double coverage or zero MOR on that. And then just in general, our enrollment trends kind of consistent with your expectations. And do you see where those members are going to as far as individual employer are uninsured? Thanks.

On Medicaid and Medicaid Redetermination could you comment a little bit on the margin.

Implications of the members that are getting re determined off or you're seeing a lot of double coverage or zero MLR on that and then just in general our enrollment just enrollment trends kind of consistent with your expectations and do you see where those members are going to as far as individual employer or uninsured.

Thanks, So much for the question I'm going to ask Tim spoke of who leads our community and state business to respond to that and yeah. Thank you Lance for the question and maybe I'll start with just the enrolment trends because I think that really informs.

Speaker 19: Hey Lance, thanks so much for the question. I'm gonna ask Tim Spilker, who leads our community and state business to respond to that. Yeah, thank you, Lance, for the question. And maybe I'll start with just the enrollment trends, because I think they really informs a whole number of facts.

Amar Desai: But we continue to have the strength of our medical groups and physician networks being incredibly attractive. Active to other pairs regionally and nationally to be able to grow in their own value based arrangements to drive outcomes and total cost of care. So we look forward to continued growth in a broad based, diverse way. Thank you very much. Thank you. I'm thank you for the question.

A number of factors.

Speaker 19: So first off, what we're seeing, I think, consistent with what states have reported in significant disenrollment for procedural reasons. And what's more, a lot of variability, frankly, across states in terms of the pacing and reenrollment. And even states now that are suspending terminations or reenrolling members based on guidance.

So first off what we're seeing I think consistent with what <unk> reported significant dis enrollment for procedural reasons.

And what's more a lot of variability frankly across states in terms of the pacing and re enrollment and even states now that are suspending terminations or re enrolling members based on guidance.

Jennifer: Jennifer, Jennifer, would say the last question now, please.

Lance Wilkes: Okay, we'll go last two lands. We'll go with Bernstein. Great. Thanks for taking the question. On Medicaid and Medicaid re-determination, could you comment a little bit on the margin and implications of the members that are getting re-determined off? We already seen a lot of double coverage or zero MLR on that. And then just in general or enrollment, disenrollment trends kind of consistent with your expectations. And do you see where those members are going to as far as individual employer are uninsured? Thanks. Thanks so much for the question.

Speaker 19: So those stops and starts certainly have an impact, you know, on our membership as well as membership mech.

<unk> stops and starts certainly have an impact.

On our membership as well as membership mix.

Speaker 19: But frankly, that's why we continue to develop even more ways to engage members and support our states. Our goal really is to help individuals find coverage. And so a couple of points on that are retrait for the programs that we've implemented. We've seen that of our traditional programs. And we're seeing strong re-enrollment rates between 15 and 20% depending on the state. And so as a result, as John mentioned in his comments, we're retaining a significant majority of the members we engage with. that are v?i, after, and later in

But frankly, that's why we continue to develop even more ways to engage members and support our states and our goal really is to help individuals find coverage and so a couple of points on that are re trade for the programs that we've implemented.

Is that of our traditional programs and we're seeing strong re enrollment rates between 15 and 20% depending on the state and so as a result as John mentioned in his comments, we're retaining a significant majority of the members we engage with certainly more to do and then second in terms of your.

Timothy Spilker: I'm going to ask Tim Spilker who leads our community and state business to respond to that. Yeah, thank you. Lance, for the question. And maybe I'll start with just the enrollment trends because I think that really informs a whole number of factors. So first off, what we're seeing, I think, consistent with what states have reported is significant disenrollment for procedural reasons. And what's more, a lot of variability, frankly, across states in terms of the pacing and re-enrollment and even states now that are suspending terminations or re-enrolling members based on guidance.

Speaker 19: So in second, in terms of your question around just kind of outlook, again, I think the factors around the re-enrollment has an impact on just how we think about MEX. But I think it's also important that to consider the rate environment, you know, states are taking into account a thoughtful, taking a thoughtful and data-driven approach to rate setting and with visibility now into around 45% of our revenue for 24, really appreciative of the approach that state.

Question around just kind of outlook again, I think the factors around the re enrollment has an impact on just how we think about mix, but I think it's also important to.

To consider the rate environment stays or taking into account a thoughtful taking a thoughtful and data driven approach to rate setting and with visibility now at around 45% of our revenue for 24 really appreciative of the approach that states are taking so all in all I would say both membership as well as our outlook is in line with what we expected at this point with <unk>.

Speaker 19: So all in all I would say both membership as well as our outlook is in line with what we expected at this point with a lot of variability. I think our membership looks good in terms of the outlook that we set at the beginning of the year and at this point, still.

Timothy Spilker: So those stops and starts certainly have an impact on our membership as well as membership next. But frankly, that's why we continue to develop even more ways to engage members and support our states. You know, our goal really is to help individuals find coverage. And so a couple of points on that are retreat for the programs that we've implemented exceeds that of our traditional programs. And we're seeing strong re-enrollment rates between 15 and 20% depending on the state.

A lot of variability I.

I think our membership looks good in terms of the outlook that we set at the beginning of the year and at this point until all of this is manageable.

Speaker 7: Thank you so much. And thank all of you for your time this morning. I hope what you heard during today's call only reinforces what you've come to expect from United Health Group. An organization that's just as nimble and agile as it is focused and disciplined, always growing, always innovating, ceaselessly committed to our mission and deeply devoted to those we share. Thank you for your attention today, and we appreciate it. Just done.

Thanks, so much and.

Thank all of you for your time this morning I.

I hope what you heard during today's call only reinforces what you've come to expect from United Health Group.

The organization is just as nimble and agile as it is focused on disciplined always growing always innovating ceaselessly committed to our mission and deeply devoted to those we sure. Thank you for your attention today and we appreciate it.

Timothy Spilker: And so as a result, as John mentioned in his comments, we're retaining a significant majority of the members we engage with, certainly more to do. So in second, in terms of your question around just kind of outlook, again, I think the factors around the re-enrollment has an impact on just how we think about MIX. But I think it's also important that to consider the rate environment, you know, states are taking into account a thoughtful, taking a thoughtful and data-driven approach to rate setting and with visibility now into around 45% of our revenue for 24, really appreciative of the approach that states are taking.

This does conclude today's conference we thank you for your participation.

Timothy Spilker: So all in all, I would say both membership as well as our outlook is in line with what we expected at this point with a lot of variability. I think our membership looks good in terms of the outlook that we set at the beginning of the year. And at this point, Phil, all this is manageable.

Unknown Executive: Then, thanks so much.

Andrew Witty: And thank all of you for your time this morning. I hope what you heard during today's call only reinforces what you've come to expect from United Health Group. An organization that's just as nimble and agile as it is focused and disciplined, always growing, always innovating, ceaselessly committed to our mission and deeply devoted to those we share.

Unknown Executive: Thank you for your attention today and we appreciate it. This does conclude today's conference. We thank you for your participation.

Unknown Executive: Thank you very much.