UNH Earnings Conference Call Second Quarter 2025 Remarks July 29, 2025

 

UNH Earnings Conference Call Second Quarter 2025 Remarks July 29, 2025
聯合健康集團 2025 年第二季財報電話會議發言稿 2025 年 7 月 29 日

 
Moderator:  
主持人：


Good morning, and welcome to the UnitedHealth Group Second Quarter 2025 Earnings Conference Call. A question and answer session will follow UnitedHealth Group’s prepared remarks. As a reminder, this call is being recorded.
早安，歡迎參加聯合健康集團 2025 年第二季財報電話會議。在聯合健康集團準備好的發言後將進行問答環節。提醒各位，本次通話正在錄音中。


Here is some important introductory information. This call contains “forward- looking” statements under U.S. federal securities laws. These statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations. A description of some of the risks and uncertainties can be found in the reports that we file with the Securities and Exchange Commission, including the cautionary statements included in our current and periodic filings.
以下是重要開場資訊。根據美國聯邦證券法規，本次電話會議包含「前瞻性」聲明。這些聲明涉及可能導致實際結果與歷史表現或當前預期產生重大差異的風險與不確定性。相關風險與不確定性的說明可於我們提交給證券交易委員會的報告中查閱，包括現行與定期申報文件中的警示聲明。


This call will also reference non-GAAP amounts. A reconciliation of the non- GAAP to GAAP amounts is available on the “Financial & Earnings Reports” section of the Company’s Investor Relations page at www.unitedhealthgroup.com.
本次會議亦將提及非公認會計原則（Non-GAAP）數據。非公認會計原則與公認會計原則（GAAP）數據間的調節表，可於聯合健康集團投資者關係網頁的「財務與盈餘報告」專區查詢，網址為 www.unitedhealthgroup.com。


Information presented on this call is contained in the Earnings Release we issued this morning and in our Form 8-K dated July 29, 2025, which may be accessed from the Investor Relations page of the Company’s website. I will now turn the conference over to the chairman and chief executive officer of UnitedHealth Group, Stephen Hemsley.
本次會議提供的資訊已包含於今早發布的盈餘報告，以及 2025 年 7 月 29 日提交的 8-K 表格中，皆可於公司官網投資者關係頁面取得。現在將會議交由聯合健康集團董事長兼執行長史蒂芬·漢斯利（Stephen Hemsley）主持。



Stephen Hemsley  
史蒂芬·漢斯利


Thank you. Good morning and thank you for joining. Today our prepared remarks will be a little longer than usual so we will be allowing more time for your questions.
謝謝。早安，感謝各位的參與。今天我們準備的發言內容會比平常稍長一些，因此我們會預留更多時間讓大家提問。

As we begin, I want to recognize our employees who have been so dedicated to serving our patients, consumers and customers during a prolonged, challenging period for our business. And I’d like to thank our leadership team, many of whom are new in their roles, for their willingness to join me in looking hard at our
在開始之前，我要特別表揚我們的員工，在業務面臨長期挑戰的這段期間，他們始終全心投入服務病患、消費者與客戶。同時也要感謝我們的管理團隊，當中有許多人是新任職位，感謝他們願意與我一同深入檢視我們的
 
businesses, getting a grounded assessment of our action plans, re-baselining our outlook and moving apace to advance the performance of each of our businesses.
各項業務，務實評估行動計畫，重新調整展望基準，並加速提升每個業務單位的表現。

This morning, I know you are eager to get into the underlying details of our revised financial outlook, which we will do. But at this moment, I believe it’s also important to convey the tone we are setting at this enterprise.
我知道各位今早都急於了解我們修正後財務展望的具體細節，這部分我們稍後會說明。但此刻，我認為傳達我們為企業定下的基調同樣重要。

More than anything, it is a tone of change and reform born out of a recommitment to our mission to help people live healthier lives and help make the health system work better for everyone. It’s a mission that requires a commitment to a culture of values, of service, responsibility, integrity and humility.
最重要的是，這是一種變革與改革的基調，源自於我們重新承諾的使命：幫助人們過上更健康的生活，並讓醫療體系為每個人發揮更好的作用。這項使命需要我們致力於建立一種價值觀文化，包括服務、責任、誠信與謙遜。

We pair that mission-driven ambition of reform with a keen sense of the opportunity and the expectation to perform better than we ever have. As we continue to assess the state of our businesses, it is very apparent that some require a fundamental reorientation, others require building and nurturing, and others must be reconsidered and redirected to original purpose. We also recognize the need and the opportunity to revisit and address critical processes and fundamental business practices, both internal and market-facing. We are acutely aware we have an enormous responsibility for providing care for millions of people and for protecting the government and private programs we partner in. As such we have embarked on a real cultural shift in our relationships with regulators and all external stakeholders. We intend to be proactively engaged, constructive and responsive to the concerns of all stakeholders and in our engagement with them.
我們將這份改革使命的雄心與對機會的敏銳感知相結合，期望能超越過往表現。在持續評估各業務現狀時，我們清楚認知到：有些需要根本性轉型，有些需要培育發展，另有些則必須重新審視並回歸初衷。我們也意識到必須把握機會，重新檢視並改善關鍵流程與基礎商業實務，無論是內部運作或市場面向。我們深刻理解自身肩負著為數百萬人提供照護、以及保護政府與民間合作計畫的重大責任。因此，我們已開始與監管機構及所有外部利害關係人建立真正的文化轉變。我們將主動參與、建設性回應所有利害關係人的關切，並在互動中保持積極態度。

We have the chance to reposition our enterprise as a far more modern, reliable, consumer and provider friendly enterprise using new technologies and approaches, and we are going to pursue that course.
我們有機會運用新科技與方法，將企業重新定位為更現代化、可靠且對消費者與供應者友善的組織，而我們正全力朝此方向邁進。

Pursuit of these opportunities aligns to and enables our reform and change mandate and allows us to better achieve our mission and to steadily perform better in doing so.
追求這些機會不僅符合並推動我們的改革與變革方針，更能讓我們更有效地達成使命，並在此過程中持續提升表現。
 
We are on this course against a challenging environment which includes:
我們正處於充滿挑戰的環境中推進這項進程，挑戰包括：

•    A generational pullback in Medicare funding, set in motion in 2023 and playing out through 2026.
• 聯邦醫療保險(Medicare)資金的世代性縮減，此政策自 2023 年啟動並將持續影響至 2026 年。
•    Unprecedented medical cost trend, measured in both intensity of services used as well as unit prices and more aggressive care provider coding and billing technologies.
• 前所未有的醫療成本上升趨勢，這既體現在服務使用強度的增加，也反映在單位價格上漲，以及醫療機構更為激進的診療編碼與帳務技術運用。
•    The prospects for further contraction of the Medicaid and Exchange markets.
• 醫療補助(Medicaid)與交易所市場進一步萎縮的前景。
•    The growing need to invest in the opportunities new technologies offer and the expectation of all health care entities to offer a better experience for consumers, customers, care providers and employees.
• 對新技術所帶來機會的投資需求日益增長，以及所有醫療保健實體都期望能為消費者、客戶、照護提供者和員工提供更好的體驗。
•    And finally, the continuing public controversy over long-standing practices and complexities across the entire health care sector, particularly managed care, which bears the critical roles for coverage, for care management and for pricing for the intensity and the cost of services used into the benefit products and programs for the entire health care market. As a leading provider of health services, we must help advance a better health system.
• 最後，針對整個醫療保健產業長期以來的做法與複雜性，尤其是管理式照護(managed care)所持續引發的公共爭議。管理式照護在承保範圍、照護管理，以及針對整個醫療保健市場福利產品與方案中所使用服務的強度與成本定價方面，扮演著關鍵角色。作為醫療服務的領先提供者，我們必須協助推動建立更完善的醫療體系。

We are committed to engaging in these pursuits with a sense of purpose and better partnership with all stakeholders, transparency in our business and reporting practices and continued integrity in all we do.
我們致力於以明確的目標感投入這些追求，與所有利害關係人建立更良好的合作夥伴關係，在業務與報告實務上保持透明，並在我們所做的一切中持續堅守誠信原則。

Beyond the environmental factors that are affecting the entire sector and more specifically to us, we have made pricing and operational mistakes as well as others. They are getting the needed attention. Our critical processes, including risk status, care management, pharmaceutical services and others are being reviewed by independent experts and they will be reviewed every year and reported on. And these processes can be reviewed at any time by outside stakeholders. While we believe in our oversight and the integrity of these processes, wherever they are determined to be at variance with prescribed practice, they will be promptly remediated and we’ll continue on this path.
除了影響整個產業的環境因素外，特別是對我們而言，我們在定價和營運方面也犯了一些錯誤。這些問題正受到應有的關注。我們的核心流程，包括風險評估、照護管理、藥事服務等，正由獨立專家進行審查，未來將每年定期審查並提交報告。這些流程隨時可接受外部利害關係人查核。雖然我們對這些流程的監管機制與完整性深具信心，但一旦發現與規範做法有所出入，我們將立即修正並持續改善。
 
All the foregoing is fully addressable. We can steadily restore our performance to levels consistent with our mission and stakeholder expectations – all as we strengthen an institutional culture aligned to that mission and accountable for performance
上述所有問題皆可完全解決。我們能逐步將營運表現恢復至符合企業使命與利害關係人期望的水準——同時強化與使命相符且對績效負責的企業文化。

Over the last 60 days or more, we have made extensive management and operational changes aligned to this agenda of reform and performance. Other such changes –
過去 60 多天以來，我們已針對這項改革與績效議題進行廣泛的管理與營運變革。其他相關調整包括——

•    to leadership,  • 領導階層變動
•    to our businesses, our culture, approaches and practices,
• 對我們的業務、企業文化、方法與實踐，
•    and to our board, governance and succession oversight, as appropriate,
• 以及適當時機對董事會、公司治理與接班監督，
•    will continue to be made as we proceed through this period.
• 我們將持續進行調整以因應這段過渡期。

With those thoughts in mind, Tim Noel and Patrick Conway, heads of UnitedHealthcare and Optum respectively, will walk through some of the specifics in their businesses. John Rex will discuss financial performance and the elements affecting our outlook. And I’ll come back with some closing thoughts, and then we will have ample time for questions and answers. Tim.
考量上述重點，聯合健康保險(UnitedHealthcare)負責人提姆·諾爾(Tim Noel)與 Optum 事業群負責人派崔克·康威(Patrick Conway)將分別說明其業務細節。約翰·雷克斯(John Rex)將分析財務表現及影響前景的各項因素。最後我會進行總結，並保留充足時間進行問答環節。有請提姆。

Tim Noel  提姆·諾爾


Thanks, Stephen.  謝謝你，史蒂芬。


I want to start by emphasizing that we are approaching our business with greater humility, greater transparency, and a renewed determination to meet your expectations and our standards.
首先我想強調，我們正以更謙遜的態度、更高的透明度，以及重新燃起的決心來經營業務，以符合各位的期待與我們的標準。

The primary driver of the UnitedHealthcare earnings shortfall for 2025 is that our pricing assumptions were well-short of actual medical costs. Our current view for 2025 reflects $6.5 billion more in medical costs than we anticipated in our initial outlook.
聯合健康保險 2025 年獲利未達預期的主要原因是，我們的定價假設遠低於實際醫療成本。根據目前評估，2025 年的醫療成本將比我們最初預期高出 65 億美元。
 
A little over half, or $3.6 billion, of this is in our broad-based Medicare portfolio. About one-third, or $2.3 billion, is in the commercial business, split evenly between ACA plans and our employer business. The remaining trend pressure is related to Medicaid, most notably due to elevated behavioral trend.
這筆金額中略超過半數，即 36 億美元，來自我們廣泛的聯邦醫療保險(Medicare)業務組合。約三分之一，約 23 億美元，來自商業保險業務，在平價醫療法案(ACA)計劃和雇主業務之間平均分配。其餘的趨勢壓力與醫療補助(Medicaid)相關，主要歸因於行為健康趨勢的上升。

In addition to trend-driven issues, the updated 2025 outlook removes about $1 billion from previously planned portfolio actions that we are no longer pursuing.
除了趨勢驅動的問題外，更新後的 2025 年展望中剔除了約 10 億美元，這些資金原本計劃用於我們已不再推進的業務組合調整行動。
It also reflects about $850 million of other items including unfavorable prior period items – primarily from 2024 – and recognition of several one-time settlements.
這還反映了約 8.5 億美元的其他項目，包括不利的前期項目（主要來自 2024 年）以及幾筆一次性和解款的確認。
We know these are serious challenges. We are humbled by them and will carry that sense of humility more deeply into our culture. But we also believe we can resolve our current issues and recapture our earnings growth potential.
我們深知這些都是嚴峻的挑戰。我們對此保持謙遜態度，並將把這種謙遜精神更深地融入我們的企業文化。但我們也相信，我們能夠解決當前的問題，並重新掌握盈利增長的潛力。

Let me now provide an update on where each business stands, starting with Medicare.
現在讓我從 Medicare 開始，為各位更新各項業務的現況。

When we prepared our 2025 Medicare Advantage offerings back in the first half of 2024, we significantly underestimated the accelerating medical trend and did not modify benefits or plan offerings sufficiently to offset the pressures we are now experiencing. This was compounded by the magnitude of plan exits across the sector and the extent to which we now see care providers placing further service intensity into the health system. The increasingly flexible orientation to which our Medicare networks and plan designs have evolved over recent years left us less able to address these trends in-year.
當我們在 2024 年上半年準備 2025 年 Medicare Advantage 產品時，嚴重低估了醫療成本加速上升的趨勢，未能充分調整福利或計劃方案來抵消目前面臨的壓力。這情況因業界大規模退出計劃，以及我們現在看到醫療服務提供者在醫療體系中進一步加強服務密集度而更加惡化。近年來我們 Medicare 網絡和計劃設計日益靈活的導向，使我們更難以在年度內應對這些趨勢。

On trend specifically, the increase in care activity across Individual and Group Medicare Advantage we saw earlier this year has now affected complex populations and our Medicare Supplement business as well.
具體就趨勢而言，今年稍早我們在個人和團體 Medicare Advantage 中看到的醫療活動增加，現在已影響到複雜族群和我們的 Medicare Supplement 業務。

Across Medicare Advantage, physician and outpatient care together represent 70% of the pressure year to date; however, inpatient utilization has accelerated through Q2 and we expect will comprise a relatively larger portion of the pressure over the full year.
在 Medicare Advantage 整體業務中，醫師門診和門診照護合計佔今年迄今 70%的壓力來源；然而，住院利用率在第二季度加速上升，我們預期這將在全年壓力中佔據相對更大的比重。
 
We continue to see utilization increases in ER and observation stays, and consistently see more services being offered and bundled as part of each ER visit and clinical encounter.
我們持續觀察到急診室和觀察住院的使用率上升，且每次急診就診和臨床診療中提供的服務項目與組合也持續增加。

In short: most encounters are intensifying in services and costing more. The higher trend is broad-based geographically and across our membership, including our large retained membership base.
簡而言之：多數診療服務的強度正在提升，成本也隨之增加。這股上升趨勢在地理分布和會員群體中普遍存在，包括我們龐大的既有會員基礎。

To put this into context, we had initially assumed Medicare Advantage medical cost trend of just over 5% when configuring our 2025 bids, in line with our normalized trend experience in 2024. We now expect full year 2025 trend to be approximately 7.5%.
具體來說，當我們制定 2025 年競標方案時，最初假設聯邦醫療優勢計劃的醫療成本增長率僅略高於 5%，與 2024 年的常態增長經驗相符。但現在我們預期 2025 全年增長率將達到約 7.5%。

Medicare Supplement, which typically is representative of overall care activity levels and cost trends in Medicare fee for service broadly, is up similarly in 2025 compared to historical levels. We expect that trend to be over 11% this year vs. 8 to 9% in recent years -- further confirming the broad-based nature of the care activity, and the coding and billing patterns trends we are seeing.
通常能反映聯邦醫療保險按服務收費整體照護活動水平與成本趨勢的醫療補助計劃，2025 年相較歷史水平同樣呈現上升。我們預期今年增長率將超過 11%，相較近年 8%至 9%的數據——這進一步證實了當前照護活動的普遍性，以及我們觀察到的編碼與帳單模式趨勢。

On Commercial: We are seeing higher-than-expected medical cost increases, particularly in outpatient care and, although to a lesser extent, inpatient care. Orthopedic spending and pharmacy infusions are notable factors here. In the ACA business, the revenue impact resulting from a difference between the morbidity that we priced for and what we experienced is the primary cause of our underperformance.
在商業保險方面：我們觀察到醫療成本增幅超出預期，特別是門診照護領域，住院照護雖程度較輕但也有所增加。其中骨科支出和藥劑輸注治療是顯著因素。在 ACA 業務中，我們定價時預估的發病率與實際經驗值之間的差異，是導致表現不如預期的主要原因。

One example of the elevated Commercial trend is group fully-insured. There, trend is approaching 11%, which is approximately 100bps higher than our initial expectations.
商業保險趨勢升溫的一個典型案例就是團體全額保險。該領域的成長率已接近 11%，比我們最初預期高出約 100 個基點。

Moving to Medicaid…Similar elevated trends are apparent and are further affected by increasing and unanticipated acceleration of costs in behavioral health, where trend is running at 20%, as well as in pharmacy and home health.
轉談醫療補助計劃...同樣明顯的上升趨勢在此也顯而易見，且進一步受到行為健康照護（該領域成長率達 20%）、藥劑及居家照護等成本意外加速攀升的影響。
 
We anticipate the existing rate and acuity mismatch will extend well into next year.
我們預期現行的費率與醫療需求強度之間的落差，將會持續延續至明年很長一段時間。

Beyond these segment-specific factors, there are other broad drivers of higher medical costs. There has been a marked increase in health care costs due in part to increases in service intensity per encounter. For example, in Medicare Advantage, higher frequency of physician rounding, testing and related services of specialists and in ER settings are contributing to elevated outpatient spend.
除了這些特定部門的因素外，還有其他廣泛推高醫療成本的驅動因素。醫療保健成本顯著上升，部分原因在於每次就診的服務強度增加。例如，在聯邦醫療保險優勢計劃中，醫師查房頻率提高、專科醫師檢測及相關服務增加，以及急診環境中的服務，都導致門診支出攀升。

In addition to strongly responsive pricing for 2026, which I will speak to in a moment, we are intensifying our remediation actions.
除了我稍後將談到的 2026 年強勁反應性定價外，我們正在加強補救措施。

We have stepped up our audit, clinical policy and payment integrity tools to protect customers and patients from unnecessary costs. These efforts ensure care is delivered in appropriate settings and grounded in safety and quality while also identifying waste and abuse in outlier coding and billing practices. We are shifting to narrower networks and focusing on more disciplined managed products, particularly in Medicare Advantage. And we have scaled our AI efforts across health plan operations, which improves the patient and provider service experiences while driving cost savings.
我們已加強審計、臨床政策和支付完整性工具，以保護客戶和患者免受不必要的成本影響。這些努力確保在適當的環境中提供照護，並以安全和品質為基礎，同時也能識別異常編碼和計費行為中的浪費和濫用。我們正轉向更狹窄的網絡，並專注於更有紀律的受管理產品，特別是在聯邦醫療保險優勢計劃中。此外，我們已擴大人工智慧在健康保險業務中的應用，這不僅改善了患者和醫療服務提供者的體驗，同時也實現了成本節約。

Lastly, in Medicaid, we continue to actively engage with state partners, using both past experience and data-driven insights to show the need for immediate and more regular rate updates.
最後，在醫療補助計畫方面，我們持續積極與各州夥伴合作，運用過往經驗與數據分析，展現立即且更定期調整費率的必要性。

Taken together, this work is helping restore our operational muscle and reclaiming executional rigor, helped by modern tools and driven by relentless focus on improvement.
整體而言，這項工作正協助我們重建營運實力並重拾執行紀律，這得益於現代化工具的輔助，以及對持續改善的不懈專注。

Turning now to 2026…Our pricing strategy is intensely focused on margin
現在談到 2026 年...我們的定價策略將全力聚焦於利潤
recovery and moving back toward our earnings growth targets.
回升，並逐步重返獲利成長目標。


In Medicare, we have historically targeted an operating margin range of 3 to 5% . Now, with the changes from the Inflation Reduction Act on the Part D program,
在聯邦醫療保險(Medicare)業務方面，我們歷來設定的營運利潤率目標區間為 3%至 5%。如今隨著《通膨削減法案》對 D 部分計畫的調整，
 
which resulted in higher revenue, but do not impact earnings, the equivalent target margin range is in the 2 to 4% range.
雖然帶來收入增長但未影響盈利，等同的目標利潤率區間已調整為 2%至 4%。

We are working intensively to remediate Medicare through pricing, product design and benefit changes that will enable us to be within the lower half of the targeted margin ranges in 2026, and advancing further in 2027.
我們正積極透過定價策略、產品設計與福利調整來改善 Medicare 業務，目標是在 2026 年達到利潤率目標區間的下半段，並於 2027 年進一步提升。

Our Medicare Advantage pricing strategy for 2026 assumes a trend approaching 10%, compared to our current 7.5% trend expectation. This accounts for trend acceleration and incorporates factors such as changes in fee schedules and the continuation of higher yields from provider coding and billing practices.
我們 2026 年 Medicare Advantage 的定價策略預估醫療成本趨勢將接近 10%，相較於目前 7.5%的趨勢預期。此預測考量了趨勢加速因素，並納入收費標準變更、醫療機構編碼與計費實務持續帶來較高收益等變數。
Considering the continued cost trend and funding pressures, and the need to support margin recovery, we have made significant adjustments to benefits.
考量到持續的成本趨勢與資金壓力，以及需要支持利潤恢復，我們已對福利進行重大調整。

Additionally – and unfortunately – given these pressures we have made the difficult decision to exit plans that currently serve over 600,000 members, primarily in less managed products such as PPO offerings. We have taken similar approaches for Medicare Supplement, Group MA, and standalone Part D pricing for next year. We will be watching the market closely as the 2026 Medicare offerings become public so we can better assess our market positioning and respond quickly.
此外——遺憾的是——基於這些壓力，我們做出了艱難決定，將退出目前服務超過 60 萬名會員的計劃，主要集中在管理較少的產品類別，例如 PPO 方案。我們在聯邦醫療保險補充計劃、團體 MA 以及明年獨立 Part D 定價方面也採取了類似做法。我們將密切關注市場動態，隨著 2026 年聯邦醫療保險方案公開，以便更準確評估我們的市場定位並迅速做出回應。

For Commercial, because renewals occur over the course of the year, we are able to price for changes more dynamically. Our pricing will anticipate higher trend continuing into 2026 and 2027. We expect increased membership decline, as well as shifts into both level-funded and self-funded product categories, because of higher medical cost trends.
至於商業保險部分，由於續約是全年陸續進行，我們能夠更靈活地因應變動調整價格。我們的定價將預期更高的成本趨勢持續至 2026 和 2027 年。由於醫療成本趨勢上升，我們預期會員人數將加速流失，同時會轉向定額資助和自籌資金產品類別。

In the individual exchange business, while we are prepared to continue to participate in the majority of the 30 markets we currently serve, we will approach them far more conservatively for 2026. We may need to make the difficult decision to exit select markets if we are unable to achieve the rates necessary for higher market-wide morbidity. Additionally, due to the projected expiration of premium subsidies across the ACA market our membership should decline
在個人保險交易所業務方面，雖然我們準備繼續參與目前服務的 30 個市場中的大多數，但我們將對 2026 年採取更為保守的態度。如果我們無法達到應對更高整體市場發病率所需的費率，我們可能不得不做出退出特定市場的艱難決定。此外，由於平價醫療法案市場的保費補貼預計將到期，我們的會員人數應該會下降
 
significantly and we are mindful of the potential for adverse selection dynamics as we re-price these offerings for next year.
顯著，並且我們意識到在為明年重新定價這些產品時可能出現逆向選擇的動態。

In Medicaid, there remains a lag between funding levels and member health risk and we expect this to continue into 2026, resulting in additional margin compression in the business including a loss within the non-dual segment of Medicaid in 2026. Membership losses from early adoption of recent legislation is also factored into our initial views for 2026. Wherever states support responsible funding for Medicaid, we remain committed to serving people through that program and view this as integral to our mission.
在醫療補助計劃方面，資金水平與會員健康風險之間仍然存在滯後，我們預計這種情況將持續到 2026 年，導致該業務的利潤進一步受到壓縮，包括 2026 年醫療補助非雙重資格人群部分的虧損。近期立法早期採納所導致的會員流失也被納入我們對 2026 年的初步預測中。只要各州支持對醫療補助計劃負責任的資金投入，我們仍致力於通過該計劃服務民眾，並將此視為我們使命的重要組成部分。

The American health system’s long-standing cost problem is accelerating. We are embracing our responsibility to continue to drive better health outcomes while trying to keep health care affordable for all Americans.
美國醫療體系長期存在的成本問題正在加速惡化。我們正承擔起責任，在努力讓所有美國人都能負擔醫療費用的同時，持續推動更好的健康成果。

The operational and pricing strategies I have described reflect our understanding of the challenges we face as a company and a society, and our dedication to responsibly navigating the current financial pressures so that we can set a stable course for the future.
我所描述的營運與定價策略，反映了我們對企業與社會面臨挑戰的理解，也展現我們致力以負責任的態度應對當前財務壓力，為未來奠定穩定基礎的決心。

I’ll now turn it over to Patrick Conway, CEO of Optum.
現在請 Optum 執行長派崔克·康威為各位說明。

Patrick Conway  派崔克·康威


Thanks, Tim.  謝謝你，提姆。


Clearly, Optum’s performance this year has also not met expectations – yours or ours. Echoing Tim and Steve, we are approaching this with humility and the need for deep analysis of key issues, and commitment to substantially improved execution. Serving our patients and customers is at the heart of our mission and business and we have the opportunity to truly help make the health system better for everyone.
顯然，Optum 今年的表現也未達預期——無論是你們還是我們的期望。如同提姆和史蒂夫所說，我們正以謙遜的態度面對這個問題，需要深入分析關鍵議題，並承諾大幅改善執行力。服務我們的病患與客戶是我們使命與業務的核心，我們有機會真正幫助改善醫療體系，讓每個人都能受益。
 
To do that, we need to refocus on our performance discipline with a bias for action and transparency for all stakeholders.
為此，我們需要重新聚焦於績效紀律，並以行動為導向，同時對所有利害關係人保持透明。

We have launched our agenda of change at Optum, starting with the evolution of our leadership team. Roger Connor brings tremendous experience in organizational execution as our chief financial officer. Krista Nelson is a deeply experienced health care operator now in the new role of chief operating officer of Optum Health. Dhivya Suryadevara is already reenergizing product development, marketing and service as the new CEO of Optum Insight. And Jon Mahrt brings his unmatched pharmacy services experience to bolster the already compelling offerings of Optum Rx.
我們已在 Optum 啟動變革議程，首先從領導團隊的調整開始。羅傑·康納作為我們的財務長，為組織執行力帶來豐富經驗。克莉絲塔·尼爾森作為 Optum Health 新任營運長，擁有深厚的醫療營運背景。迪維亞·蘇亞德瓦拉作為 Optum Insight 新任執行長，已為產品開發、行銷與服務注入新活力。而喬恩·馬赫特則以其無與倫比的藥學服務經驗，強化 Optum Rx 本已出色的服務內容。

These are not the only people in new roles and there will be more. We are taking these and many other steps swiftly to enable Optum to recapture its historic momentum.
這些並非唯一擔任新職位的人員，未來還會有更多變動。我們正迅速採取這些及其他多項措施，讓 Optum 能重拾過往的成長動能。

Let me turn now to a review of our businesses, starting with Optum Health – where improved execution is needed most and where we are experiencing the greatest pressures to our business.
現在讓我轉向業務回顧，首先從 Optum Health 開始——這裡是最需要改善執行力之處，也是我們業務面臨最大壓力的領域。

Our belief remains steadfast: value-based care has the potential to transform health care. Yet even as we struggle to align this model with new funding dynamics, it consistently delivers better outcomes. Tim highlighted the challenges of rising health care unit costs, accelerating service volumes and provider coding intensity, which further underscores that value-based care remains the most effective method for compensating providers to improve and sustain a patient’s health in contrast to simply increasing the volume and prices of services.
我們仍堅信不移：基於價值的照護模式具有改變醫療體系的潛力。即便我們仍在努力讓此模式與新的資金動態相契合，它始終能帶來更好的健康成果。Tim 已指出醫療單位成本上升、服務量加速增長及醫療機構編碼強度增加等挑戰，這更凸顯出相較於單純提高服務量與價格，基於價值的照護仍是補償醫療機構以改善並維持患者健康最有效的方法。

Research consistently supports this premise, showing Medicare Advantage patients in fully accountable arrangements are 20% less likely to be hospitalized and experience 11% fewer ER visits compared to those in fee-for-service. We are early in our value-based care journey. We know we have real and self-
研究數據持續支持這項前提，顯示在完全責任制安排下的聯邦醫療保險優勢計劃患者，與按服務收費模式相比，住院率降低 20%，急診室就診次數減少 11%。我們在價值導向醫療的旅程才剛起步。我們清楚認知到自身存在真實且...
 
inflicted executional challenges and we bear the responsibility to get this right, recognizing that urgent work lies ahead.
我們在執行面上遭遇挑戰，也承擔起改正的責任，深知眼前還有緊迫的工作待完成。

We have spent a decade assembling a care delivery model today serving nearly 20 million patients across three lines of business – value-based care, fee-for- service care delivery and services, the latter two of which help further enable value-based care.
我們花了十年時間打造一套醫療服務模式，目前透過三大業務線服務近 2,000 萬名患者——價值導向醫療、按服務計費醫療服務，後兩者更有助於進一步推動價值導向醫療的發展。

The first category, value-based care, has grown to account for approximately 65% of Optum Health’s revenues and serves 5 million patients in fully accountable arrangements. I’ll provide more details on this in a moment but first will detail the gap to our original Optum Health outlook.
第一類別，價值導向照護，已成長至佔 Optum Health 營收約 65%，並在完全責任制安排下服務 500 萬名病患。稍後我將提供更多細節，但首先會詳細說明與我們原先 Optum Health 展望之間的差距。

Overall, Optum Health earnings in 2025 are approximately $6.6 billion below our expectations. To break this down:
整體而言，Optum Health 在 2025 年的獲利較我們預期低約 66 億美元。具體分析如下：

•    Approximately $3.6 billion, or 55%, is concentrated in our value-based care business with three principal drivers of roughly equal weight:
• 約 36 億美元（佔 55%）集中在我們的價值導向照護業務，主要由三個權重相當的因素所驅動：
o    1: The mix of enrollment, including more complex and dually eligible members, and more new-to-Optum patients who were underserved;
o 1：投保成員的組成變化，包括更多病情複雜且具雙重資格（Medicare 與 Medicaid）的成員，以及更多過去未受完善照護的新加入 Optum 患者；
o    2: Accelerated medical trend, particularly physician and outpatient in Medicare and behavioral in Medicaid.
o 2：醫療費用趨勢加速攀升，特別是 Medicare 的醫師門診服務與 Medicaid 的行為健康照護領域。
o    And 3: Under-estimation of new members’ risk status as they come into our care and sub-optimal execution of the V28 risk model transition;
o 第三點：低估新加入會員在我們照護下的風險狀況，以及 V28 風險模型轉換的執行未達最佳化；

•    Second category - Another $2 billion, or 30%, relates to the decision to discontinue previously planned portfolio actions.
• 第二類別 - 另外 20 億美元（佔 30%）與中止先前規劃的投資組合行動決策有關。

•    And about $1 billion, or 15%, is from a combination of lower service volumes in our services businesses, some non-recurring prior period impacts and the slowing of tuck-in acquisitions. For example, on lower service volumes, in 2025 we planned for approximately 20 million fee-for-
• 約 10 億美元，即 15%，來自我們服務業務的服務量減少、一些非經常性的前期影響以及小型收購的放緩。舉例來說，在服務量減少方面，2025 年我們原計劃約有 2000 萬筆按服務收費的...
 
service visits in our care delivery clinics and we are tracking 19 million visits, or 5% below this expectationLet me dive a bit deeper specifically into factors affecting our value-based care business:
在我們的照護診所服務就診次數方面，目前追蹤到 1,900 萬次就診，比預期低 5%。讓我更深入探討影響我們價值導向照護業務的具體因素：

•    First, V28. This industry-wide shift is effectively a price reduction that we now estimate created an $11 billion headwind over three years for Optum Health, with ~$7 billion that will be realized through 2025. That is $2 billion and $1 billion, respectively, more than our initial estimates while we also overestimated the impact and mis-executed the planned efforts to offset the V28 funding cuts.
• 首先，關於 V28 政策。這項全行業性的調整實質上等同於降價，我們目前估計這將在三年內為 Optum Health 帶來 110 億美元的逆風，其中約 70 億美元將在 2025 年前實現。這比我們最初預估分別高出 20 億和 10 億美元，同時我們也高估了影響力，並未能有效執行原定抵消 V28 資金削減的應對措施。

•    Second, enrollment mix. Consistent with Q1, in 2025 we have an unanticipated number of new-to-Optum Health patients who were previously underserved. These new patients are largely in markets where numerous plan exits occurred. They include complex patients who require time to be managed effectively by us. This mix impact implies negative margins near double-digits for these new patients, which will improve meaningfully in 2026.
• 其次，參保結構問題。與第一季情況一致，2025 年我們意外接收了大量從未使用過 Optum Health 服務、過去醫療資源不足的新患者。這些新患者主要來自多個保險計劃退出的市場，其中包含需要時間讓我們有效管理的複雜病例。這種結構變化導致這些新患者的負利潤率接近兩位數，但預計 2026 年將顯著改善。

•    Lastly, the elevated medical trend we recognized in the second quarter was exacerbated by insufficient pricing within United Healthcare and other payer partners pulling through in the form of insufficient capitation rates for Optum.
• 最後，我們在第二季觀察到的高醫療成本趨勢，因 United Healthcare 及其他支付方合作夥伴的定價不足而加劇，這反映在提供給 Optum 的按人頭計費費率未能達到合理水平。
Despite these headwinds, Optum’s fully accountable value-based care business is delivering an operating margin of about 1% in 2025. This compares to full year operating margins of over 3% in 2024 and nearly 5% in 2023.
儘管面臨這些逆風，Optum 完全承擔價值的照護業務在 2025 年仍能實現約 1%的營業利潤率。相較之下，2024 年全年營業利潤率超過 3%，2023 年則接近 5%。

A large part of the mis-execution in addressing the V28 funding cuts was due to a non-standardized and overly localized management approach which we are addressing with urgency. We are driving to a consistent and much more concentrated regional operating model with four market leaders. We are evaluating our position in each market. We will shift risk back to the original underwriters until we have the hardened capacity to navigate it under value-
我們在應對 V28 資金削減時出現的重大執行失誤，主要歸因於非標準化且過度地方化的管理方式，目前我們正緊急處理此問題。我們正推動建立一個更一致且更集中的區域營運模式，由四位市場領導者負責。我們正在評估每個市場的定位，在具備足夠能力以價值為基礎的架構下應對風險前，我們將把風險轉回原始承保方。
 
based constructs.  為基礎的架構。


And Optum will be much more disciplined in taking risk arrangements in product designs and constructs that allow value-based care to have its intended impact.
此外，Optum 將在產品設計和架構上採取更嚴格的風險安排，讓基於價值的照護能發揮預期成效。

The margin compression reflects significant growth in new membership cohorts – with nearly 40% of the patients served today having come in since the beginning of 2024. It also reflects the pull-through from Medicare Advantage pricing dislocation Tim described, and the V28 payment cuts.
利潤壓縮反映了新會員群體的顯著增長——目前服務的患者中有近 40%是自 2024 年初以來加入的。這也反映了 Tim 所描述的 Medicare Advantage 定價錯位帶來的影響，以及 V28 支付削減的效應。

Regarding patient cohorts: in our value-based care practices, margins improve the longer patients remain. Our most mature value-based care cohorts – those from 2021 and prior – are operating at an estimated 8%+ margin in 2025. Those in 2022 and 2023 cohorts are operating at a 2% margin; the 2024 through 2025 groups are at negative margins.
關於患者群體：在我們的價值導向醫療實踐中，患者留存的時間越長，利潤就越好。我們最成熟的價值導向醫療群體——2021 年及之前的群體——在 2025 年的運營利潤率估計超過 8%。2022 年和 2023 年的群體運營利潤率為 2%；2024 年至 2025 年的群體則處於負利潤狀態。

Strong physician engagement, appropriate medical diagnosis, and improved, consistent quality of care continues to drive year over year improvement in a cohort’s financial performance and in their health. But it’s taking too long and there is too much variability in results among practices, and we are actively addressing those factors.
強勁的醫師參與度、適當的醫療診斷以及持續改善的照護品質，持續推動著群體財務表現和健康狀況的逐年改善。但這一過程耗時過長，且不同診所間的結果差異過大，我們正在積極解決這些問題。

That’s the overall picture of what is happening. I’ll turn now to remediation. Our
以上就是整體情況的概述。接下來我將轉向補救措施。我們的
plan for improvement has four key elements:
改善計畫包含四大關鍵要素：


First and foremost, we are improving the implementation and consistency of our clinical model, which is anchored in primary care and supported by wraparound services that continue to outperform on quality and cost.
首要之務，我們正強化臨床模式的執行力與一致性，該模式以基層醫療為核心，並輔以全方位支援服務，這些服務在品質與成本方面持續表現優異。

Second, we are committed to margin recovery in value-based care. We’ve aligned our 2026 benefits and product portfolio and footprint with our payor partners to address the final year of V28 headwinds. We plan to cease arrangements for about 200,000 patients largely in fully accountable PPO
其次，我們致力於恢復價值型醫療的利潤率。我們已針對 2026 年福利方案、產品組合及服務據點與保險合作夥伴達成共識，以因應 V28 計畫最後一年的挑戰。我們計劃終止約 20 萬名患者的服務合約，主要為完全責任制 PPO
 
products, representing approximately 40% of the PPO patients we serve today. We expect to keep narrowing our exposure beyond 2026.
產品類別的患者，約佔現有 PPO 服務患者的 40%。預計 2026 年後將持續縮減相關業務規模。

We are increasing rates to reflect the higher risk profiles and acuity we are seeing and expect to continue. We believe the combination of these activities will mitigate about half of the remaining $4 billion V28 headwind in 2026. The remainder of our offset will come from operating cost discipline and consistent execution of our care programs which enhance engagement, diagnosis accuracy and quality outcomes, and reduce overall cost of care.
我們正在調升費率以反映目前觀察到且預期將持續的高風險狀況與醫療需求。我們相信這些措施將能抵銷 2026 年剩餘 40 億美元 V28 衝擊中約半數的影響。其餘抵銷力道將來自營運成本控管，以及持續執行我們的照護計畫——這些計畫能提升參與度、診斷準確性與照護品質，同時降低整體醫療成本。

With 2026 being the final year of V28 phase-in, you should expect 2026 value- based care margins to remain relatively consistent with the 1% margin we are achieving this year, and then begin to advance again in 2027 and beyond.
隨著 2026 年成為 V28 逐步實施的最終年度，各位應預期 2026 年基於價值的照護利潤率將與我們今年達成的 1%利潤率保持相對一致，隨後於 2027 年及往後年度再次提升。

We are optimizing our portfolio of clinical practices. We are managing our fee-for- service and fully accountable risk practices to align with performance expectations, transitioning to partial risk or service arrangements where necessary, and exiting fully accountable products in certain markets.
我們正在優化臨床診療組合。針對按服務收費與完全承擔風險的診療模式，我們正進行管理以符合績效預期，必要時轉型為部分風險或服務協議模式，並在某些市場退出完全承擔風險的產品。

Third, we are aggressively advancing operational disciplines across our portfolio of businesses. The more concentrated operating model I mentioned earlier plays into more standardized approaches, predictable outcomes and lower operating costs. We will complete the final stages of our technology integration, which will enable meaningful advances with emerging technologies like AI to drive efficiency gains. For 2026 we expect to deliver almost $1 billion in cost reductions.
第三，我們正積極推動各業務組合的營運紀律。先前提到的更集中營運模式，將帶來更標準化的方法、可預測的成果與更低的營運成本。我們將完成技術整合的最終階段，這將使我們能運用 AI 等新興技術取得重大進展，從而提升效率。預計 2026 年將實現近 10 億美元的成本削減。

Finally, beyond value-based care, Optum Health also includes fee-for-service care delivery, including home care, ambulatory surgical care and medical practices that are not yet fully accountable but support value-based care. These together account for 15% of Optum Health’s revenues. Most of these businesses are performing well and operate at low double-digit margins. However, the primary care and multi-specialty medical practices that are not yet fully accountable are running at negative margins – generating hundreds of millions of
最後，除了基於價值的照護外，Optum Health 還包含按服務收費的照護服務，包括居家照護、門診手術照護以及尚未完全承擔績效責任但支持價值型照護的醫療業務。這些業務合計佔 Optum Health 營收的 15%。其中多數業務表現良好，營運利潤率維持在低雙位數。然而，尚未完全承擔績效責任的基層醫療與多專科醫療業務目前處於虧損狀態——光是今年就產生數億美元
 
losses this year alone – placing the overall fee-for-service care delivery business in the mid-single digit margin range.
虧損——使得整體按服務收費的照護業務利潤率落在中個位數區間。

So, we are actively working to improve payment yields and productivity while growing these high-value services and fee-for-service margins. We are targeting growth for these services which are projected to deliver strong year-over-year earnings growth in 2026.
因此，我們正積極致力於提升支付收益率與生產力，同時擴展這些高價值服務與按服務收費的利潤空間。我們鎖定這些服務的成長目標，預計將在 2026 年實現強勁的逐年收益增長。

The third component of Optum Health – services – is comprised of businesses including managed behavioral health, military and veterans and health financial services. These account for about 20% of Optum Health revenues and combined have an almost 10% operating margins.
Optum Health 的第三個組成部分——服務業務——包含管理式行為健康、軍人與退伍軍人服務，以及健康金融服務等業務。這些業務約佔 Optum Health 營收的 20%，綜合營業利潤率接近 10%。

Overall at Optum Health, while we expect continued pressure for the rest of this year, we anticipate meaningful improvement in our operations and with earnings growth in 2026, albeit with a longer path to recovery in our value-based care business. We now see Optum Health long-term margins in the 6-8% range, and at about 5% for value-based care specifically, as we see significant growth opportunity for the decade to come. The overall blended margin will reflect the early year investment losses generated by new cohorts. Optum Health is early in its development and mis-execution is a clear setback, but the long-term growth potential and expectations remain intact and significant.
整體而言，在 Optum Health 方面，雖然我們預期今年剩餘時間仍將面臨壓力，但我們預計營運將顯著改善，並在 2026 年實現收益增長，儘管我們的價值導向照護業務需要更長的復甦時間。我們現在預期 Optum Health 的長期利潤率將落在 6-8%的區間，而價值導向照護業務的利潤率約為 5%，因為我們看到未來十年具有顯著的成長機會。整體混合利潤率將反映新群組在初期產生的投資虧損。Optum Health 仍處於發展初期，執行失誤確實是個挫折，但長期成長潛力和預期仍然完整且相當可觀。

Moving to Optum Insight – there is a great need and appetite for technology and data products to help the health system perform more efficiently and effectively yet Optum Insight has not fully capitalized on this opportunity. That’s largely due to an unfocused suite of products, lagging innovation, and longer than expected impact from last year’s cyberattack, which, unfortunately, came at the expense of being able to drill down on business innovation, operations and growth.
轉談 Optum Insight——醫療體系對於能幫助其更高效運作的科技與數據產品存在巨大需求和渴望，但 Optum Insight 尚未充分把握這個機會。這主要是由於產品線缺乏聚焦、創新滯後，以及去年網路攻擊的影響比預期更長，不幸的是，這讓我們無法深入鑽研業務創新、營運和成長。

But as I mentioned earlier, we have a talented team in place now and continue to recruit talent to develop the next generation of products rooted in AI.
但正如我先前所提到的，我們現在擁有一支優秀的團隊，並持續招募人才來開發植基於 AI 的下一代產品。
 
As it relates specifically to 2025, we are adjusting our outlook downward by $1 billion. About half of this is due to a more gradual recovery than initially expected in some of our volume-based businesses due to Change Healthcare and one- time cyber-related expenses.
具體針對 2025 年，我們將展望下調 10 億美元。其中約半數是由於 Change Healthcare 事件及一次性網路安全相關支出，導致我們部分以量計價業務的復甦速度比最初預期更為緩慢。

The other half is due to pausing previously planned portfolio actions so that we can prioritize growth and innovation across our broader portfolio.
另外半數則是因為我們暫停了原先規劃的投資組合調整行動，以便能優先推動更廣泛投資組合的成長與創新。

At Optum Rx, client retention remains high and consistent with past years. We expect revenue growth of $18 billion, or 13%, and earnings growth of just over
在 Optum Rx 方面，客戶保留率仍維持高檔且與往年一致。我們預期營收將成長 180 億美元（增幅 13%），獲利成長幅度則略高於
$200 million, or nearly 4%, driven by low-margin specialty drugs.
2 億美元，或近 4%，主要受低利潤專科藥品影響。


Compared to the strong revenue growth rate, our earnings growth has been constrained by four main factors: the removal of portfolio actions from our plan is a roughly $150 million headwind; another $50 million is from a couple of ancillary businesses, where we are taking aggressive corrective actions and adjusting plans; and the impact of the initial launch phase of our private label business, Nuvaila, is a roughly $150 million headwind. As it matures, we see Nuvaila delivering affordability for clients and consumers and strong earnings for Optum Rx.
相較於強勁的營收成長率，我們的獲利成長受到四個主要因素限制：從計劃中移除投資組合行動造成約 1.5 億美元的阻力；另有 5,000 萬美元來自幾項附屬業務，我們正在採取積極糾正措施並調整計劃；而我們自有品牌業務 Nuvaila 在初期推出階段也造成約 1.5 億美元的影響。隨著業務成熟，我們預期 Nuvaila 將為客戶與消費者提供更實惠的選擇，並為 Optum Rx 帶來強勁收益。
Additionally, GLP1s, which can benefit appropriate patients, continue to impact earnings, representing a $160 million headwind for our pharmacy business.
此外，GLP1 類藥物雖能造福合適病患，但仍持續影響獲利表現，為我們的藥房業務帶來 1.6 億美元的阻力。

After three months in this role, I want to thank the thousands of people serving in Optum, and to let external stakeholders know that the problems are fixable, and that Optum will continue to drive long-term growth and make the most of our opportunity to serve people.
上任三個月以來，我要感謝 Optum 數千名同仁的付出，並向外部利害關係人說明這些問題都是可解決的，Optum 將持續推動長期成長，並把握服務大眾的契機。

I’ll turn it over to our president and chief financial officer, John Rex
我將交給我們的總裁兼財務長約翰·雷克斯
John?  約翰？

John Rex  約翰·雷克斯

Thanks, Patrick.  謝謝，派崔克。
 
I’ll first walk through second quarter results, then provide some color around the
首先我將回顧第二季度的業績表現，接著針對
underlying assumptions within our re-established `25 outlook.
我們重新確立的 2025 年展望中的基本假設。


Starting with the second quarter, UnitedHealth Group reported revenues of nearly $112 billion, a 13% increase over the prior year, which reflected growth across UnitedHealthcare and Optum.
第二季開始，聯合健康集團報告營收近 1,120 億美元，較去年同期成長 13%，這反映了聯合健康保險與 Optum 業務的全面增長。

Adjusted earnings per share of $4.08 was below the same period last year. This was due primarily to the pricing and medical cost trend factors at UnitedHealthcare and Optum Health. Included is about $1.2 billion in discrete items. A little over half reflects the recognition of unfavorable impacts to our ACA exchange offerings, which I will describe later in more detail. The remainder is the settlement of several outstanding items which have been in dispute or for which collection has recently become questionable. Most of these items arise from prior years. The full year ‘25 outlook we’ve offered today accommodates $1 billion in additional potential such items that we may seek to resolve in-year.
調整後每股盈餘為 4.08 美元，低於去年同期。這主要是由於聯合健康保險(UnitedHealthcare)和 Optum Health 的定價與醫療成本趨勢因素所致。其中包含約 12 億美元的個別項目影響，其中略超過半數反映我們對 ACA 交易所業務不利影響的認列，這部分我稍後會詳細說明。其餘部分則是針對數項爭議性項目或近期收款出現問題的款項達成和解，這些項目多數源自過往年度的帳務。我們今日提供的 2025 全年展望中，已預留 10 億美元額度來處理這類可能於當年度解決的潛在項目。
Now on to business overviews.
現在進入業務概覽部分。


At UnitedHealthcare, second quarter revenues grew by over $12 billion to $86.1 billion, while operating earnings declined by $1.9 billion to $2.1 billion primarily due to the medical trend factors Tim discussed.
在聯合健康保險方面，第二季營收增長超過 120 億美元，達到 861 億美元，但營業收益減少 19 億美元至 21 億美元，這主要是由於 Tim 所討論的醫療趨勢因素所致。

Within our Medicare businesses, year-to-date Medicare Advantage growth is 650,000 people, including those who are dually eligible for Medicaid and Medicare.
在我們的醫療保險業務中，截至目前的醫療優勢計劃（Medicare Advantage）增長人數達 65 萬人，其中包括同時符合醫療補助（Medicaid）和醫療保險（Medicare）資格的雙重資格者。

As noted, the second quarter results reflect just over $600 million of unfavorable impacts from our ACA exchange business, which includes acceleration of anticipated second half losses with the establishment of a premium deficiency reserve. This is due to the higher patient morbidity that is pervasive across the entire exchange market.
如前所述，第二季業績反映出我們的 ACA 交易所業務帶來超過 6 億美元的不利影響，這包括因設立保費不足準備金而加速預期的下半年虧損。這是由於普遍存在於整個交易所市場的較高患者發病率所致。
 
Given competitive market dynamics, we have less member growth within our commercial offerings than initially anticipated. ACA exchange drives about one- third of our reduced commercial risk member growth outlook for 2025, with group-insured comprising much of the rest.
由於市場競爭激烈，我們在商業保險產品中的會員成長幅度低於最初預期。ACA 交易所約佔我們 2025 年商業風險會員成長預期下調的三分之一原因，其餘大部分則來自團體保險業務。

As outlined earlier, our Medicaid offerings continue to experience pressure from the lag in state rate updates relative to the health status of the members being served. Our state partners remain highly engaged in ongoing rate conversations and we are closely attuned to the federal funding changes and the continued pace of medical cost trends, particularly in behavioral health.
如先前所述，我們的醫療補助計畫持續面臨壓力，主因是各州費率調整進度落後於被保險會員的健康狀況變化。我們與各州政府夥伴保持密切溝通，持續進行費率協商，同時密切關注聯邦資金變動及醫療成本趨勢（特別是行為健康領域）的持續發展。

Moving to Optum.  接下來談談 Optum 業務。


Optum Health revenues were $25.2 billion in the second quarter, a decline of
Optum Health 第二季營收為 252 億美元，呈現下滑趨勢。
$1.8 billion from last year. This was driven by the previously noted contract adjustments and the effects of the Medicare funding reductions. Optum Health now expects to add 300,000 new value-based care patients this year compared to the initial 650,000 outlook as it seeks to focus on improving operating performance. As noted, we‘ve updated our long-term target margin objective for Optum Health to the 6 to 8 % range.
較去年減少 18 億美元。這主要是由於先前提到的合約調整以及聯邦醫療保險(Medicare)資金削減的影響。Optum Health 現預計今年將新增 30 萬名價值導向照護患者，相較於最初預估的 65 萬名，此調整是為了專注於提升營運績效。如先前所述，我們已將 Optum Health 的長期目標利潤率調整至 6%至 8%的區間。

Optum Insight had revenues of $4.8 billion, an increase of $285 million or 6% year over year. We continue to progress on customer recovery following last year’s cyber event, albeit pacing more slowly than expected and this is a component of the reduced full year outlook. The contract revenue backlog at the end of the second quarter was $32.1 billion.
Optum Insight 營收達 48 億美元，較去年同期增加 2.85 億美元，成長 6%。儘管進展速度較預期緩慢，我們持續在去年網路安全事件後逐步恢復客戶關係，這也是全年展望下調的因素之一。第二季末的合約營收積壓訂單達 321 億美元。

Optum Rx second quarter revenues grew $6 billion, or 19%, over last year to
Optum Rx 第二季營收較去年同期成長 60 億美元，增幅達 19%，達到
$38.5 billion, driven by new customer adds as well as continued contribution from specialty products. Total adjusted scripts were 414 million compared to 399 million in the year ago quarter.
385 億美元，主要來自新增客戶以及專業藥品的持續貢獻。經調整後的總處方箋量為 4.14 億張，相較於去年同期的 3.99 億張有所增長。

Moving on to 2025 guidance.
接下來談談 2025 年的展望。
 
Our adjusted earnings outlook is at least $16 per share. Revenues will approach
我們調整後的每股盈餘預測至少為 16 美元。營收將接近
$448 billion, growth of 11% over ‘24.
4,480 億美元，較 2024 年成長 11%。


We now expect a full-year medical care ratio of 89.25%, plus or minus 25 basis points. This compares to the initial 86.5% mid-point we offered at the end of last year, with the increase driven by the factors discussed.
目前我們預期全年醫療照護比率為 89.25%，上下浮動 25 個基點。相較於去年底提出的初始中值 86.5%，此一調升係由先前討論的各項因素所驅動。

Within this, seasonal pacing compared to historical measures is impacted somewhat by the Part D coverage gap modifications due to the Inflation Reduction Act. With first half results, at the midpoint that places the second half at just under 91.5%, with the fourth quarter expected to be the highest and, at this distance, a relatively proportionate distribution on either side.
在這方面，與歷史數據相比的季節性步調受到《通膨削減法案》中 D 部分保障缺口修改的些微影響。根據上半年業績的中間值，下半年預計將略低於 91.5%，其中第四季度預計為最高峰，目前看來各季度分佈比例相對均衡。

The full year outlook contemplates a total of $1.6 billion of potential settlement items, an incremental $1 billion over the $600 million recognized in the second quarter.
全年展望中包含了總計 16 億美元的潛在和解項目，這比第二季度已認列的 6 億美元增加了 10 億美元。

Our tax rate for the year is now estimated at about 18.5%, affected by our revised earnings outlook as expected benefits remain steady, while earnings declined. The lower tax expense in the second quarter reflects the year-to-date recognition of the updated full year effective tax rate. We expect the second half rate to be just over 20%.
我們今年的稅率目前估計約為 18.5%，這受到修正後的盈利展望影響——雖然預期效益保持穩定，但盈利有所下降。第二季度較低的稅費支出反映了按更新後全年有效稅率計算的年初至今認列金額。我們預計下半年稅率將略高於 20%。

Full year ’25 cash flows from operations are expected to be about $16 billion or
2025 年全年營運現金流預計約為 160 億美元
1.1 times net income.  1.1 倍淨收入。


In June, we increased our dividend by 5% and we will strike a balance as to how we use capital over the near-term, being thoughtful about maintaining a strong balance sheet and credit rating and mindful of long-standing commitments, including the pending Amedisys transaction. Our updated share count of 912 to 914 million compares to the original outlook of 918 to 923 million and considers only share repurchases completed earlier this year.
六月份，我們將股息提高了 5%，並將在近期資金運用上取得平衡，謹慎維持強健的資產負債表與信用評等，同時顧及長期承諾事項，包括尚待完成的 Amedisys 收購案。更新後的流通股數預估為 9.12 至 9.14 億股，相較原先預測的 9.18 至 9.23 億股有所下調，此數據僅納入今年稍早完成的股票回購。
 
We will continue to balance and assess our capital priorities as we progress to returning to the performance levels we know we can achieve.
我們將持續權衡評估資金配置優先順序，逐步重返我們確信可達成的績效水準。

With that, I will hand it back over to Stephen before we head into Q&A.
接下來，在進入問答環節前，我將把時間交還給 Stephen。


Stephen Hemsley  史蒂芬·漢斯利
Thanks, John.  謝謝，約翰。


This is a challenging year for our enterprise. But I feel strongly we can overcome these challenges – as we have done before. I can see the depth of the commitment of our team. We are regaining the intensity, the precision, and the executional disciplines required to perform consistently and reliably. Our customers and our shareholders deserve it. And the health system expects us to function to our full potential.
對我們企業來說，這是充滿挑戰的一年。但我堅信我們能夠克服這些挑戰——就像我們過去所做的那樣。我能看到團隊成員展現出的深厚承諾。我們正在重拾所需的強度、精準度和執行紀律，以實現穩定可靠的表現。這是我們的客戶和股東應得的，而整個醫療體系也期待我們發揮最大潛能。

As we look toward 2026 and beyond, we expect the efforts we discussed throughout today’s call to steadily improve our performance. It begins with respecting pricing basics, advancing our foresight acumen and just better, more intense, more decisive overall management.
展望 2026 年及未來，我們預期今天電話會議中討論的各項努力將逐步提升我們的表現。這一切始於尊重定價基礎原則、提升前瞻洞察能力，以及實施更優質、更嚴謹、更果斷的整體管理。

We will be driving better business practices, better consumer and provider experience, and accelerating investments in key areas to both strengthen our foundations and modernize our businesses, anchored in practical innovations and scaled AI applications.
我們將推動更優質的商業實踐、提升消費者與供應商的體驗，並加速關鍵領域的投資，以強化基礎建設並實現業務現代化，這一切都將以務實創新與規模化 AI 應用為核心。

We are continuing to evaluate the investments we need to make in the near-term to meet our long-term growth potential while acknowledging the challenging environment in the year ahead.
我們持續評估近期必要的投資，以實現長期成長潛力，同時也認知到未來一年將面臨的挑戰環境。

As I mentioned at our shareholder meeting in June, we are rebuilding the trust through both change and through increased transparency. That includes work to ensure a wide range of stakeholders have confidence in the integrity of our Company and our business practices. This work is moving forward in our assessment of key policies, practices and associated processes by the end of
正如我在六月股東會上提到的，我們正透過變革與提升透明度來重建信任。這包括確保廣大利害關係人對本公司誠信與商業實踐的信心。相關工作正持續推進，我們將在
 
the third quarter and our first performance measures report in the fourth quarter. We have retained independent experts to oversee and assist in these reviews, including the Analysis Group and FTI Consulting. We will use this to continually strengthen and advance our strong compliance environment.
第三季末完成關鍵政策、實踐及相關流程的評估，並於第四季發布首份績效衡量報告。我們已聘請獨立專家團隊（包括 Analysis Group 和 FTI Consulting）監督協助這些審查工作。這些措施將持續強化並推進我們完善的合規環境。

Looking to 2026, at this distance I would expect solid but moderate earnings growth. As we look further ahead, we see our earnings growth outlook strengthening quickly in 2027 and pacing steadily upward over the succeeding years.
展望 2026 年，以目前情況來看，我預期將呈現穩健但溫和的獲利成長。當我們將目光放得更遠，可以看到 2027 年獲利成長前景將快速增強，並在後續幾年保持穩定上升的步調。