A UnitedHealthcare Briefing on health care cost trends

[Text On Screen – Welcome to Jan. 31 UnitedHealthcare Briefing! Today’s meeting is a video webcast. There is no dial-in for this meeting. [Barcode] While waiting for the webcast to begin, please share what topics you’d like covered in future Briefings by scanning the code or visiting www.menti.com and using the code 8569 0682. Disclaimer: UnitedHealthcare presentation materials and responses to your questions are intended to provide general information and assistance and do not constitute legal or tax advice. Please contact your legal and tax advisors on how to respond to this situation. The materials and discussion topics do not constitute a binding obligation of UnitedHealthcare with respect to any matter discussed herein. Some of our products and networks have different features and as a result different guidelines and protocols are applicable to them.]

BRANDON CUEVAS VOICEOVER:  Hi, everyone. Thank you for joining us today. I’m Brandon Cuevas, the Chief Growth Officer for the commercial business, and it’s great to be with you here today.

[VIDEO OF BRANDON CUEVAS SPEAKING]

BRANDON CUEVAS: We have a lot of great information to share with you, so let’s go ahead and get started. As a quick reminder, as you’ll see on the screen, this webinar is being recorded, and the materials presented today are meant to be informational and should not be seen as legal business advice.

[Text On Screen – Agenda: Trends within UnitedHealthcare data, Unpacking the economic challenges ahead, Cost management that meets the moment, Regulatory updates, Q&A. Today’s Speakers: Mallory Kirby Director Health Plan Research Advisory Board, Vidal Seegobin Director Health System Research Advisory Board, Beth Soberg Regional CEO Employer & Individual UnitedHealthcare, Brandan Cuevas Chief Growth Officer Employer & Individual UnitedHealthcare]

In today’s briefing, we are going to cover the initial trends and cost drivers we’re seeing within UnitedHealthcare data for 2023. Craig Kurtzweil’s going to take you through that. Then the advisory board will join us to unpack the economic and market challenges impacting not only health systems but also employers and health plans specifically, and then, following that, we’re going to have Beth Soberg, our regional president for the west region, will highlight some of the cost management strategies employers can implement to help combat those economic pressures. And, at the end, I’ll come back, and we’ll finish up with our normal regulatory updates, as well as leave some time, as we typically do, for Q&A. So, with that, I’m going to hand it over to Craig Kurtzweil to dive into the data.

[Text On Screen –Trends to watch according to UnitedHealthcare data, Craig Kurtzweil, Vice President, Center for Advanced Craig Kurtzweil VP, Data Analytics Employer & Individual UnitedHealthcare, Analytics, Employer & Individual, UnitedHealthcare, Slide 3]

CRAIG KURTZWEIL VOICEVER: Thank you, Brandon. Happy to be back presenting to you all. We thought it would be good to cover a few different topics for you today, really focused on going forward what are the trends, what are the drivers, what do we need to focus in on in 2023 and beyond.

[Text On Screen – Cost drivers for employers to consider in 2023, 1) Trends around COVID-19 and care utilization, 2) Workforce generational shifts related to health needs and care preferences, 3) Clinical cost drivers based on generations]

To do that, I’ll focus on a few main areas. We will do a little bit of status check on where we are with COVID and what are the ripple effects that we’re going to see associated with that. But we’re going to more focus on what do we do next, what’s happening now. As the workforces change, we’re going to focus in on some of those generational shifts and what we’re seeing in the population and what that’s going to mean for you, as an employer. And then, finally, we know there’s going to be a different mix of clinical cost drivers. As the generational shift and the ripple effect of COVID is felt, we’ll make sure that we’re prepared for what that data is telling us there as well.

[VIDEO OF CRAIG KURTZWEIL SPEAKING]

CRAIG KURTZWEIL: So let’s dive in.

[Text On Screen – COVID-19 continues to slow down, UnitedHealthcare Commercial COVID Admissions per 1,0000 and Mortality]

CRAIG KURTZWEIL VOICEOVER: A quick review of where we are with COVID-19, and, note, there is some late breaking news with it looks like the PHE, the Public Health Emergency is going to be lifted on May 11^th. And just note that there is a team of individuals at United that’s rapidly working on what that’s going to mean, and we will be covering that in detail at a future call, but, if you look at the stats, you can see that COVID’s in a very different place than it’s been during our discussion throughout the pandemic. We’re at the lowest rates for cases, for admissions, and for mortality at this point, and the trends keep on going down from here, so it looks to be in a good spot for everything. Looks to be in a good spot from a COVID analytics perspective.

[Text On Screen – … as flu admissions trend downward]

And on the next slide you can see, when we take a look at how does this compare against the flu, because we all know flu basically disappeared during the pandemic, you can see from an admission perspective, we’re now at the point where flu is overtaking COVID. So for the first time over the last couple years, flu’s back, and COVID is being outpaced by far by what we’re seeing from admission data for when we compare COVID-19 against the flu, so obviously we’re in a very different spot with the COVID pandemic.

[Text On Screen – Now what?[Employers] 2022 Tailwinds: Telehealth, Personal Hygiene, Infectious Disease Protocols, 2023 Headwinds: Long COVID & Return to Health, Preventative Care Gap, Generational Shifts, Behavioral Health.]

But we know on the next slide we want to focus in on where do we go from here. So there’s a lot that we learned during the pandemic. There were a lot of tailwinds that came out of that, as far as what we learned, and some adjustments that the health system has made, but there’s also some headwinds in what we’re going to face as employers and plan sponsors around what is this going to mean for our population and what do we need to plan for as we move forward. And just know, as I walk through each one of these, just know there’s teams of individuals at United that we are responding to this data as well.

[VIDEO OF CRAIG KURTZWEIL SPEAKING]

CRAIG KURTZWEIL: We’re developing the right policies, procedures, and products to make sure that we can meet the new demands that are going to happen based on some of the data that I’m going to show you next.

[Text On Screen – Debunking long COVID, UHC Long COVID Claimants per 1,000]

So the first data point we wanted to make sure you were all well aware of is long COVID. It’s making headlines. There’s lots of different studies that are out there. But the data’s really interesting. On the left hand side, you can see some survey data around the percent of the population that feels like they’re struggling with post-COVID related issues, so roughly 30% of those COVID patients feel like they have post-COVID, long COVID sort of issues, but, when you look in the claims data in the middle of the screen, you can see that less than 1% of our commercial population is coming and seeking therapy and having claims associated with long COVID, so there’s a big disconnect between people that are struggling with long COVID or perceived struggling with long COVID, versus those that are actually coming in from a claims perspective, so, as you think about what’s 2023 and beyond going to look like, so far it doesn’t look like long COVID’s going to be a huge budget item from a healthcare population perspective. That could change, but, at this point, it’s pretty rare. Next slide.

[Text On Screen – A return to pre-pandemic care utilization patterns]

We know that there’s been abatement of care. During the pandemic, the health system shut down, and people weren’t able to get wellness screens and cancer screens and so on. Just note, as you see on this slide, that almost every one of those preventive care measures has bounced back and bounced back rapidly. We are back to quote on quote normal for wellness visits, cancer screenings, and so on. The only areas where we remain low is on the far right with childhood vaccinations, particularly measles, mumps, rubella, where we are well below our 2019 levels.

[Text On Screen – … with the exception of MMR vaccination rates January – December (1 Month of Runout) for 2019 October 2021- September 2022 (1 Month of Runout) for Rolling 12]]

And, as we drill into that on the next slide, it’s not a one size fits all. It’s not across the US a similar sort of trend, but it’s interesting to look to see those states that have seen the biggest reduction in childhood vaccinations. On the far right, lots of numbers on the slide, but on the far right is look at those states that saw the most significant reductions from a pre-pandemic basis to a post-pandemic basis of measles vaccinations, so the states with the largest declines are Hawaii, California, Washington, and New York. Maybe not what you would have expected, but definitely make every states dropping, but some states dropping much more dramatically. So keep that in mind as you’re looking at your populations. Return to health is important, but especially return to health for our kids is going to be really important. Next slide.

[Text On Screen – Employees by industry and generation, Generational make-up varies greatly by industry .However, the workforce is predominantly Millennial and Generation X currently.]]

We also know that during the pandemic there’s been a rapid populations shift, right? The generations have shifted. Baby boomers have retired out of the workforce, and millennials are now the dominant workforce in our book of business and across almost every one of our industries. So what does that mean for you as a plan sponsor? What does it mean for us as a payer, to make sure that we are responding to the unique needs of that millennial population.

[Text On Screen – Outpatient services by generation, Millennials lead all other generations in ER, Urgent Care, Telemedicine and Virtual Visits. Baby Boomer outpatient surgical procedures are driven by GI and orthopedic procedures]

Well, on the next slide, you can see that we know that millennials use care in a very different way. They’re the yellow bar in this illustration. You can see that they use the ER at the highest rate, the urgent care at the highest rate, virtual care, telemedicine, across the board use care, this kind of quick care at a much higher rate than we’ve ever seen with other generations. So what does that mean? Is that a problem? Is that an opportunity?

[VIDEO OF CRAIG KURTZWEIL SPEAKING]

CRAIG KURTZWEIL: Well, it wouldn’t have been if we were to look at this five, 10 years ago, when the millennials were young and invincible and didn’t really have a dramatic need to seek care, but, on the next slide, you can see why this is a problem.

[Text On Screen – Health continuum by generation, Members classified as “Well” decrease with age. The most “At Risk” groups are Millennials and Generation X]

As you look at our book of business and look at that millennial population, we can see that now over half of that population now has a chronic disease or is at risk of developing a chronic disease. So we now have our dominant workforce and most of your populations that now has—50% of them having chronic disease, but does not want to use brick and mortar PCPs and wants to use urgent care, quick care, ER, virtual care. So it really makes it more impactful and important for the health system to adjust and meet the unique needs of that millennial population, where virtual care or quick care can’t just be treating cough and cold. It really has to start to treat some of these chronic diseases in that generation. Next page.

[Text On Screen – Behavioral health utilization is on the rise, +22.6% from Q1 2020 to Q3 2022, Behavioral Health Claimants per 1,000]

And we know that one of the other things that’s changed during the pandemic is behavioral health has started to escalate. This honestly was happening before COVID, but COVID kind of rapidly escalated it, so we are seeing that just the general prevalence or I should say diagnosis of behavioral health claims has increased substantially,

CRAIG KURTZWEIL VOICEOVER: almost to 20%, over 20% increase from pre-pandemic to post-pandemic, with a rapid increase during the lockdown phases, but a consistent trend over these last three years. And what’s driving that? Some of that is due to the pandemic, right, it was stressful, it was hard, it was lockdowns.

[Text On Screen – Clinical cost drivers by generation, Only Infectious Disease, driven by COVID-10, and Wellness, affect spend for every generation. However, multi-generational themes can be found in the data.]

There was lots of stress on the population, but, again, also part of this is just the generational shift. As we see baby boomers retire and millennials take over and Gen Z start to rise, there’s not as much stigma in those populations, so you’re going to start to see in your population mental disorders is going to become a top five condition. As millennials start to dominate your workforce and dominate the populations, mental health is going to rise. That’s not due to the fact that there’s more mental health, to be honest. It’s more due to the fact that they’re a population that is much more open to be treated with that condition, and so you’re going to start to see it come up much more rapidly within your claims data.

[Text On Screen – What does all this mean for employers? 1) As concerns around COVID-19 subside and care utilization returns to pre-pandemic levels, employers may see a rise in their medical costs. 2) Generational shifts will require employees to think differently about the benefits they offer to better meet the health needs of their employees. 3) Understanding the clinical cost drivers based on the generational make-up of an employee population may be key to controlling costs for employers. *Yet other pressures remain that are making cost an even bigger priority for employers and for the health system at-large.]]

So, if you look back at some of things we just rapidly covered, we know that COVID had an impact. It’s going to have a ripple effect going forward with abatement of care and long COVID potentially, and we know that that shift of the generations is going to make a big difference within the populations. They’re going to use care very differently, and we need to make sure we can meet them where they’re at,

[VIDEO OF CRAIG KURTZWEIL SPEAKING]

CRAIG KURTZWEIL: and that mix of services and clinical drivers is going to change pretty rapidly going forward, and we all need to make sure we can adjust and account for those needs. But we also know that there are other pressures outside of just what I’m showing you in the claims data that are going to drive some of the system-wide sort of issues, that are going to drive cost and concerns for the employee population, so, with that, I’m going to hand the baton over to Mallory to walk through what she’s seen from an advisory board perspective.

[Text On Screen – Now, let’s broaden the perspective… Mallory Kirby Director Health Plan Research Advisory Board, Vidal Seegobin Director Health System Research Advisory Board]

MALLORY KIRBY VOICEOVER:  Thanks, Craig. And thanks so much to everyone on the line for joining us today.

[VIDEO OF MALLORY KIRBY SPEAKING]

MALLORY KIRBY: My name is Mallory Kirby, and I’m here with my colleague Vidal representing Advisory Board, which, for those unfamiliar, is a healthcare best practice research company serving thousands of cross industry members across the provider, health system, health plan, and life sciences space. We are also an editorially independent subsidiary of UHC, and we were invited here today to share with you the biggest economic pressures impacting our cross industry members and of course the employers on the line and our perspective on the response.

[Text On Screen –  Advisory Board, Unpacking the economic challenges ahead, Health plan and employer implications]

So just to introduce myself, I am the Director of Health Plan Research at Advisory Board. I work most closely with our plan members of all different sizes, and I’ll dig a bit more into the plan and employer response, but, to start, I’ll turn things over to Vidal to introduce himself and go through some of the broader market forces impacting health systems.

VIDAL SEEGOBIN VOICEOVER:  Great. Thanks, Mallory.

[VIDEO OF VIDAL SEEGOBIN SPEAKING]

VIDAL SEEGOBIN: As we noted a moment ago, the longer term kind of research that I work on is focused on hospitals and health systems.

[Text On Screen –  Hospital expenses tempering, remain elevated into 2023]

So I won’t spend too much time on this slide, but I do want to orient you to the broader provider landscape,

VIDAL SEEGOBIN VOICEOVER: particularly the finances and the implications and priorities and what it means for the consequences of these hospitals and health systems as your partner. The topline message from this data is pretty straightforward. It’s that health systems expenses have risen across all categories, considering labor, supply chain, prescription drugs, and capital expenses. And I don’t want to be entirely doom and gloom here, as these numbers have improved over the last six months, but it is worth noting that hospitals and health systems have been responsive to these pressure. Many have succeeded in moving the labor cost from agency spend to fulltime equivalents, and, while that has not been fully impactful in terms of mitigating the margin pressures, it has been improving, and we are continuing to see this trend moving forward.

[Text On Screen – Burden of inflation pushed on to payers, employers Stakeholders feel different but interconnected drivers of financial strain]

Now, I don’t want to imply that health systems are somehow alone in this challenge. Across the wider ecosystem, we are all battling inflation and seeing the trickle down effects from the economic forces that are impacting all types of providers. The financial strain to providers that they are experiencing right now, now make it more difficult for health plans to meet their mandate of affordability and for their employer partners. The financial stressors that we see compounding will have myriad impacts, so providers and payers are dealing with a more competitive labor market, and employers are dealing with all the above plus demands from their employees. Now release strategies, which often mean passing costs further down the value chain, are also compounding. So how can we think about solving these problems without pushing the potato downstream or handing it off to someone else? So, for providers, we think that they all need to start to lay a foundation of thinking about operational efficiencies. They cannot be blind to the need to align medical and drug spending with overall goals. For plans, we will see an acceleration, we think, towards value-based care and more targeted investments to underpin that, and, for employers, we might see, considering a limiting of benefits coverage, direct contracting, narrower networks, all as potential options. But these decisions may not have these limited consequences. They, in fact, probably have longer term consequences worth consideration.

[Text On Screen –  Hospital performance is stratifying]

I’ll go through the next slides really quickly, but I think it’s important to determine a little level of signal when it comes to hospitals and health systems vis-à-vis which ones are stronger or in a weaker position heading into 2023.

[VIDEO OF VIDAL SEEGOBIN SPEAKING]

VIDAL SEEGOBIN: With 2022 in our rearview mirror, we’re seeing a split in the performance between for profit hospitals and their not for profit peers. Obviously the devil is always in the detail, but what I think this data illustrates is that for select for profit hospitals, they’ve been better at navigating the workforce shortage that all vex hospitals and health systems, in addition to being able to treat their patients in a more quickly and timely fashion. Underpinning the numbers here as well, at least on the side on the right that’s green, I think we also have seen on the for profit side a faster pivot towards outpatient orientation that allows for them to treat patients more quickly and allow for them to recover at home faster.

[Text On Screen –  Look for savings opportunities – avoid “haircuts”]

Now, I did want to spend a few moments unpacking the overall economics of the hospital business, because it does inform why a lot of hospitals are experiencing negative margins, and that was the case across 2022. As you’ll see on the pie chart on the right, very little of what makes up the hospital’s cost structure is, in fact, variable.

VIDAL SEEGOBIN VOICEOVER: The lion’s share of hospital staff is salaried, largely tied up within nurses, and so it doesn’t really fluctuate with patient volume. Purchase services also tend to be on multi-year contracts, and so they are oftentimes less variable than one would expect.

[VIDEO OF VIDAL SEEGOBIN SPEAKING]

VIDAL SEEGOBIN: Now, that doesn’t mean that there are zero opportunities for efficiencies. We’ve spoken to hospitals in majority markets with a growing share of the total urban market share that are finding that they are in the lower percentile when it comes to their supply contract, so that’s both in terms of total spend as well as price per purchased services, and we think there’s also a sizable opportunity around care variation reduction, which can happen in provider settings. The thing I do want to underpin here is that none of this work is easy. In fact, I think for most hospitals, a lot of the low hanging fruit has already been plucked, and what’s left are the more challenging clinician-related activities that are frequently met with skepticism or opposition. And, of course, many will tell you at this point in time that they’re not even staffed up across their units to be considering revising their care models.

[Text On Screen –  Staffing cycle difficult for systems to escape]

Which brings me to the most critical challenge that any hospital is going to be trying to solve right now, and that’s workforce stability. We have two important elements that I want to call out here.

VIDAL SEEGOBIN VOICEOVER: So, first, consumers index on their clinician much more powerfully than any other clinical variable. A solid bedside manner and someone who makes the patient feel heard and provides timely clinical decisions creates a loyal patient who will come back again and again, which means that when that clinician departs, the relationship between the provider and the patient can be severed, and that’s not only disruptive to the care experience but also starts to create capacity shortages, which impedes the provider’s ability to see more patients.

[VIDEO OF VIDAL SEEGOBIN SPEAKING]

VIDAL SEEGOBIN: And therefore, for cost and quality partner selection, I think the variable that you want to index on is on staffing stability. Those providers who can retain a full complement of teammates and clinicians are the ones most likely to provide predictable, high quality care that will satisfy the patient’s needs and expectations. These pressures are not only being felt by health systems, but also by employers and health plans. Now I’d like to transition over to Mallory to talk a little bit about how carriers are responding to these wider economic forces and what it means for employers in turn.

[Text On Screen – Market forces are changing the traditional health insurance landscape, Motivations driving health insurers to diversify revenue streams 1) Higher medical costs and capped margins. Supply chain disruptions, workforce shortages, inflation, and utilization uncertainty have all contributed to higher costs and declining margins 2) Shifting purchaser expectations, Cost remains the greatest factor, but purchases are increasingly asking for advanced services ranging from tele-behavioral health to maternal health 3) Increased competition, Large nationals expanding in breadth and depth: competing with non-traditional competitors, like health systems, and newer entrants, such as Amazon and Walmart]

MALLORY KIRBY VOICEOVER:  Thanks Vidal. And I think that that is the perfect transition point, right, the fact that these financial stressors and the staffing stressors that health systems and providers are seeing are really having a downstream impact on health plans and their support of employers.

[VIDEO OF MALLORY KIRBY SPEAKING]

MALLORY KIRBY: We know that there are several economic and market drivers influencing health plan behavior and responses, and really the largest response that we’re seeing is some degree of revenue and service diversification from health plans, really an evolution in terms of what they are offering and what they are becoming to their employer partners, so that action from health plans is taken in response to some of those financial and market forces that you’ve talked through. We know that health plans currently are motivated to evolve primarily because of financial factors, but also face increasing competition and heightened expectations from purchasers, so their solutions that they’re coming with are aiming to address all three of the drivers that we see here. The top financial pressures that health plans are feeling are really motivated by two things. First, the medical loss ratio requirements that are capping the percentage of profits that they can generate from premiums, and, second, those dramatically increasing medical and drug costs, really forcing them to look for alternate revenue streams. Beyond that, we know that purchasers, including individual members, but more often employers, are both expecting more from plans and allowing for greater plan influence to help them meet their own priorities. So this growing importance or shifting role that the health plan plays to employers is going to make sense, given that employers and benefit leaders, like many of you on the call, are also dealing with new levels of financial and social pressures.

[Text On Screen – Employers, benefits leaders facing pressure from all angles]

Getting that into a little bit more detail, we know that employers shouldered an enormous burden of additional healthcare responsibility across the last three years when compared to historic norms, and that a large part of that was directly the part of the pandemic in terms of increased medical costs or absenteeism. But also part of that is a result of demographic and social shifts in terms of what employees are expecting from their employers and how that employer employee contract is evolving. We also have legacy cost challenges to address, which are depicted on the right hand side of that slide. So it’s top of mind right now in terms of what we’re hearing from our members, what we’re hearing from employers is both spiking healthcare costs from 2022 and potentially heading into 2023 as a result of recovered patient volumes and potentially more costly healthcare needs, as a result of avoided or unmet care during the pandemic. So all of these pressures, both historic pressures and new dynamics between employees, employers, and health plans coalesce to three big trends that we see shaping employer demands and employee benefits, so we’re going to address those three trends in a little bit of detail and consider how carriers, how health plans are attempting to meet the moment and respond.

[Text On Screen – Three trends shaping employee benefits: Affordable care & coverage: Employer health care cost anticipated to increase by 5% or more in 2023, Behavioral health & virtual care:87% of employers accelerated initiatives to expand mental health access and services, Holistic & inclusive benefits: 63% of North American businesses say DEI initiatives are a priority]

Now, the three trends that you see here were important before the pandemic, but have dramatically accelerated in the last couple of years, and there’s a growing recognition among plans and employers that these three areas are critical to support the resiliency of your workforce, to differentiate your benefits strategy, and to effectively compete for talent in this challenging labor market. And these drivers are affecting both employee benefits but also plans as they anticipate their response.

[Text On Screen – Employers balancing savings potential with perception, Employer options for reducing health benefits spending]

So I want to double click first on providing affordable care and coverage. Now, the challenge from employers is typically balancing cost reduction with employee satisfaction, and normally or pre-pandemic we saw that employee’s happiness tend to carry a little bit less weight. The dollars at stake, the money almost always wins out, but, in this labor market, employee happiness has proven much more valuable. Even before the pandemic, we know that employers were hitting the breaks on cost shifting to employees, and we think that it’s unlikely that there’ll be a resurgence in that approach in the wake of the pandemic, both because we’d kind of hit a barrier of you can’t really transfer that many more costs onto employees, and I think due to some questioning about the impact of those results overall or of that strategy overall. What we’re seeing from employers, and this may sound familiar to those of you on the line, is instead finding that ways to manage drug spending is an urgent priority. Almost every single employer that we talk to mentions it, but we know that this space is complex and that many employers are still in the learning phase. And we know that meeting employer demands here is a priority for plans, and some of the plans or some of the strategies that we’ve seen from plans to support employers in lowering drug costs are listed on the lower right of this slide. Other tactics that we’ve heard from plans themselves include entering the PBM space or the pharmacy specialty space to try to negotiate better deals and stuff like thinking about formulary exclusions. Beyond managing drug spend, we think that the most likely area of focus for affordability in the coming years is going to be steerage in all of its forms. You were hearing that employers and employees have more appetite for this member navigation through both hard steerage, like narrow networks, and softer steerage, like centers of excellence, high value primary care networks, and navigation services, and we also know that plan executives across the board continue to cite these strategies as a priority for mitigating cost. Now, what I’m hearing more of is that the role of employers, like you on the call, needs to be more proactive at the negotiation table, both when it comes to network contracts and negotiating with providers, and also when advocating to PBMs. And I want to leave you with some strategies that we’ve heard plans are using to help employers help themselves in the affordability space. We know that employers have a lot of options for partnerships, when it comes to addressing affordability from vendors to smaller disruptor organizations, but also that plans are trying to solidify their unique partnership through proactively sharing data, providing clinical expertise, and advocating for employer voices in the pharmacy market.

[Text On Screen – Helping employers help themselves]

MALLORY KIRBY VOICEOVER: When it comes to being a partner, we’re really pushing plans to ask themselves about how they’re building trust with employers and where they’re demonstrating their commitment to helping them manage drug and other costs. Looking ahead, we anticipate that employers will need to lean on plans to help them navigate the coverage and management of things like new ultra high cost drugs and provider contracts that are coming to market. Now, the next big factor influencing employee benefits is behavioral health needs, which I know that Craig addressed in the opening here, but I think deserves a little bit more attention.

[Text On Screen – BH system facing a long-term spike in demand]

COVID has understandably had a huge impact on our mental health, from social isolation to a loss of child care and this impending uncertainty over the future. Those are just a few ways that our collective mental health has been impacted by the pandemic.

[VIDEO OF MALLORY KIRBY SPEAKING]

MALLORY KIRBY: In addition to that, we know that both mental health issues and substance abuse are up since the pandemic and that employers are taking action accordingly, experimenting with a number of benefit offerings to support employee behavioral health. I want to give you a few examples of what employers and payers are doing in this space. So while we know that employer’s healthcare costs are increasing, we also know that they recognize that cutting services across the board is not always the right answer. And that, in fact, increasing utilization of certain services and the costs that are associated with them will have improved benefits and cost savings downstream. That explains why we’re seeing continued investment from payers and employers in the behavioral health space. Some of the strategies that we’ve seen from payers include pursuing teletherapy partnerships or offering their own programs internally through more of that service diversification, increasing employee education programs to help employees recognize and address a range of mental health conditions and investing in more of an omnichannel approach to increase access points to behavioral healthcare throughout the community.

[Text On Screen – Payers target predictive analytics to identify social needs]

Now, the final market force that we wanted to discuss impacting both plans and employer’s responses is the need for holistic and inclusive benefits to meet social determinants of health, and I think that this has gained importance, again, as we revisit that shifting employee employer contract really and what they expect. We know that social determinants of health are hugely impactful on healthcare costs, around 320 billion today, and could increase to 1 trillion by 2040 if inequities go unaddressed. Now, this, of course, has a direct impact on employers who experience 93 billion in medical costs and 42 billion lost from on the job productivity annually. We’re seeing many carriers introduce holistic analytics programs that help connect members to more holistic, inclusive benefits to address these needs and these costs. Now, a sample program might de-analyze claims or, excuse me, analyze de-identified claims data, census information, and member assessments, to generate a personalized health risk score for each of their members. When members dial into their call center, representatives are going to see this score and then can refer them to local social organizations. So one way that plans are attempting to address some of those challenges that employers are facing that are having very real impacts on your workforce. Plans of course hope that connecting members to these holistic programs and solutions will improve health outcomes and result in lower downstream costs.

[Text On Screen – Key Takeaways: Network management still stands as the primary mechanism to reduce cost, and employers are open to experimenting over the long term, including... … exploring traditional gatekeeping models, member navigation, COEs, or site of care shifts, Employers are looking to double down on investments made during the pandemic such as behavioral health and virtual care, The health equity discussions of the past 2+ years have pushed employers to expand inclusiveness and address inequities in their health plan offerings]

Now, with the costs of deferred care from throughout the pandemic coming home to roost, we know that employers are revisiting their long term ambitions of making healthcare spending sustainable.

MALLORY KIRBY VOICEOVER: And, despite some hesitation to limit employee choice, we’re seeing employers more open to experimenting with innovative network management strategies, including harder steerage for members. Especially when it comes to reducing drug costs, we hear employers looking for trusted partners to help them reach their goals and plans open for input and increased collaboration when it comes to the plan employer table.

[VIDEO OF MALLORY KIRBY SPEAKING]

MALLORY KIRBY: Plans have an opportunity to really evaluate where their goals align with those of employer partners, but are also up against enormous economic pressures trickling down from all areas of the healthcare industry, which makes solving for those three goals we discussed very difficult. However, we think that with increased alignment in those three areas we discussed, in those goals, employers and plans are on the path forward to meeting the top needs of their employee members and realizing their long term ambitions of making healthcare more affordable for everyone.

[Text On Screen – Cost management that meets the moment, Beth Soberg Regional CEO Employer & Individual UnitedHealthcare]

Now, advisory board has a lot more on these materials, if you are interested in connecting with us in follow up, but I will now turn things over to Beth for her discussion on cost management that is meeting the moment.

BETH SOBERG VOICEOVER:  Thank you to Mallory and Vidal and Craig. In light of the data that was just shared, and it’s pretty clear that cost is top of mind for employers, and, frankly, for the whole industry.

[VIDEO OF BETH SOBERG SPEAKING]

BETH SOBERG: At UnitedHealthcare, we’re actively working with brokers, consultants, and employers, like all of you, to help bring forward the strategies and solutions that can help mitigate those pressures. I’m going to go into some of those today and share with you some of the implementation of strategies that help get after some of those market issues.

[Text On Screen – Working to make health care simpler, more affordable and supportive, With one of the largest datasets in the industry and a quality health care ecosystem under one roof, we’re working to help drive more informed decisions, better health outcomes, lower costs and healthier communities.]

Really at the foundational level, UnitedHealthcare’s working to make healthcare simpler, more affordable, and supportive.

BETH SOBERG VOICEOVER:  Now, we have boiled those down into five major commitments. Those include leveraging data and insights, curating solutions that drive more informed health decisions, helping people navigate what we know is a fragmented system, enhancing benefits through collaboration across medical, pharmacy, and behavioral for better outcomes, reducing the total cost of care, and also, as you heard, building healthier communities, such as addressing social determinants of health. Today we’re going to focus on that fourth commitment, that total cost of care.

[Text On Screen – Health care spending in the U.S. keeps trending higher as economic pressures grow]

[VIDEO OF BETH SOBERG SPEAKING]

BETH SOBERG: So, as you’ve heard through our presenters, the cost of care continues to rise at unsustainable rates, and it has for some time. The economy’s only making matters worse. It reinforces the need for a strategic approach to cost management that goes well beyond network discounts.

[Text On Screen – Current cost landscape demands a strategic approach beyond network discounts]

BETH SOBERG VOICEOVER:  As you know, it can be easy to look at things like upfront network discounts and other short term cost cutting actions to achieve immediate savings. In fact, that’s really what a lot of employers and brokers and consultants will look at in terms of the discount that we’re able to negotiate, but gone are the days where it’s only about discounts. We shouldn’t be satisfied with looking at costs from only a unit cost measure, because that only provides half the financial picture. It’s taking unit cost plus the potential savings from clinical programs,

[VIDEO OF BETH SOBERG SPEAKING]

BETH SOBERG: payment integrity programs, site of care redirection, and effective utilization management, among others, that provide a more holistic picture and solutions to drive that total cost of care value. So we’re committed to working with you to build benefit strategies that help you meet the moment through a total cost of care approach. We understand though that it’s not enough just coming from us, which is why we have and continue to engage third party firms like Wakely Consulting Group to prove to you our total cost of care methodology and our savings.

[Text On Screen – The right blend of cost-management strategies may help combat financial pressures, Network and plan design, clinical and care management, Employee engagement]

On top of understanding the potential total cost of care savings, we’re focused on finding the right solutions that meet an employer’s needs and fit within your budgets. How do we do that? We do it by helping ensure employers have the right blend of network and plan design, clinical and care management programs, through targeted clinical strategies, and effective employee engagement programs, to not only reduce the cost but also to drive better health outcomes and a simpler and more satisfying patient experience. So let’s start with network and plan design strategies.

[Text On Screen – Network and plan design strategies]

Without a solid network strategy that keeps quality of care and cost in mind, employers and their employees may not get the best value out of their health plan.

[Text On Screen – Designing networks and plans around quality care, greater value]

BETH SOBERG VOICEOVER:  You heard Mallory talk about perhaps solutions that are more curated network plans. Networks that promote quality providers and systems cannot only lead to better health outcomes, but also lower the costs for the employee and for the employer. Meeting employees where they are is also critical to our network strategy. There is no one size fits all. Craig spoke earlier about millennials that now make up the majority of today’s workforce, and the way that the millennial generation and future generations prefer to engage with the health system is different. You know, I see it within my own family. I have a Gen Z who just graduated from college, and the way that he prefers to access the healthcare system on his time and his moment where he is, is different than others.

[VIDEO OF BETH SOBERG SPEAKING]

BETH SOBERG: That’s why we continue to invest in the expansion of our virtual health solutions. Virtual health solutions not only provide employees with a more convenient and simple experience, but they can also reduce the number of costlier and often unnecessary visits to urgent care and the ER, and virtual care is becoming much more holistic than what it had been as just an acute care or just in time to chronic care management, primary care access, and behavioral. Pairing network strategies and plan designs that also work to promote the provider patient relationship really is key. For example, health plans that require employees to select a PCP can ensure that they’re getting the right care in the right place at the right time. And these primary care physicians can act as the quarterback in making sure that care happens when it should. It’s especially true in the markets that I serve in the west.

[Text On Screen – Reimagining health plan design to simply care, lower costs]

One health plan that’s gaining traction across the nation is Surest, a UnitedHealthcare Company. Now, Surest allows members to check costs, compare options to doctors, treatment, and drugs before making an appointment, and you do that through an app, a very easy to use app. Employees will know what they owe in advance, and they’ll receive a single bill for the services that are delivered in that one visit. You’re accessing a broad network, so the price transparent quality-driven plan design is unlocking the better health outcomes and lower costs for both employers and members, while preserving choice. In fact, this January 1, I enrolled my family in Surest this year, after many years on a Choice Plus program. And just last weekend before my Gen Z went off to his new city to start his life, we downloaded the app, and he was amazed by the simplicity and the cost transparency that that offered. For a 24 year old, I consider that a home run. Those are the types of plan designs and user tools that will make an impact.

[Text On Screen – Clinical and care management strategies]

BETH SOBERG VOICEOVER:  Then our clinical and care management strategies help meet employees wherever they are on their healthcare journey through personalized care plans and advocacy to help them get there.

[Text On Screen – Putting employees on a healthier plan]

Lower healthcare spending is dependent on employees making smart, informed healthcare choices from the start. We’re using data and analytics to anticipate employee needs, to personalize and proactively identify and engage those who are at risk of certain conditions.

[VIDEO OF BETH SOBERG SPEAKING]

BETH SOBERG: You heard Craig talk about millennials and that 50% now have a chronic condition. These are important programs that are personalized to their care. Our clinical advocacy solutions are helping connect those dots across the health system, so employees receive personalized care that results in better health outcomes and lower costs.

[Text On Screen – Supporting the right care, in the right place, at the right cost]

Where an employee receives care could also contribute to high costs and suboptimal health. It’s why it’s important to invest in programs and strategies that help employees navigate and incent them in getting the right care in the right place and at the right cost. We do this by working with providers to direct employees to less costly sights of care as appropriate. An example is redirecting or incenting an employee from receiving an outpatient procedure at a hospital to a less costly ambulatory surgery center.

[Text On Screen – Supporting communities and members holistically]

Now, we heard Mallory talk about this, identifying and addressing social determinants of health, disparities employees may be facing really is becoming foundational to our clinical strategy. Today health disparities cost the health system approximately $320 billion annually. That number could exceed a trillion dollars by 2040. That’s why we’re committed to supporting communities and employees more holistically. We do this by training our advocates, clinicians, and care teams to listen for key words or social cues, such as I’m hungry or I’m having a hard time making ends meet. With that training, they can then connect members to helpful community resources that lead to better health and lower costs.

[Text On Screen – Employee engagement strategies]

Engagement strategies. An engaging employee in effective engagement strategies along their health journey can also be an effective cost management strategy.

[Text On Screen – Guiding employees to care at lower costs]

BETH SOBERG VOICEOVER: Through my UHC.com and our UnitedHealthcare app, along with personal health records, wearables, we’re using digital tools and technology to help make it easier for employers to take an active, more informed role in their care. Delivering a simple personalized healthcare experience is leading to improved decision making, less wasteful or unnecessary spending, and a better overall experience.

[Text On Screen – Incentives built to increase engagement]

Incentives can also lead employees to make healthier choices, lifestyle decisions, reinforcing employee ownership over their health and related healthcare costs, really empowering them with data and incentives that will offer those rewards.

 [VIDEO OF BETH SOBERG SPEAKING]

BETH SOBERG: It goes a long way towards fulfilling the idea of first dollar coverage. So, for example, helping employees recoup costs from a high deductible health plan through those rewards. The combinations of the employee engagement strategies, the clinical and care management programs, and the health plan and network designs will be critical in reducing costs for employees and employers during these challenging times.

[Text On Screen – Cost management that meets the moment, Contact your broker, consultant or UnitedHealthcare representative to learn more about the ways you may be able to manage costs]

So, again, it’s not really just about unit cost. It’s an important component, but it’s about wrapping that unit cost with programs that really focus on total cost of care.

BETH SOBERG VOICEOVER:  We understand that every employer’s needs and budgets are unique, so reach out to your broker consultant or UnitedHealthcare representatives, learn more about the cost management strategies that may be available to you to meet your needs. You can also learn more about this topic at our broker consultant and employer websites on UHC.com. So thank you for your time. Now I’ll let Brandon share some regulatory updates, key initiatives that are impacting employers in addition to the economic pressures covered today. Brandon?

[Text On Screen – Regulatory updates, Brandan Cuevas Chief Growth Officer Employer & Individual UnitedHealthcare]

BRANDON CUEVAS VOICEOVER:  Awesome, thanks, Beth. That was fantastic. Both presentations were great. Thank you very, very much to advisory board and to Beth for jumping in.

[VIDEO OF BRANDON CUEVAS SPEAKING]

BRANDON CUEVAS: I’m going to go ahead and get started with some regulatory updates, but just as a side note, there’s quite a few of you out there today, so about 3300 of your closest friends are joining us today online, so thank you for joining and participating with us. We hope you find these meetings valuable, and we’ll have some time at the end to kind of continue to solicit feedback on topics you want to hear from us on. But, with that, in addition to rising costs, we know that you’re dealing with an ever-changing regulatory environment that surrounds healthcare. And now with the end of the PHE on May 11^th, there’s going to be even more going on, and so there are updates we want to get to you today, want to talk about some of the Omnibus bill changes that we touched on last time a little bit, but then we’re going to actually also make sure that we give you some opportunity to go deeper into that coming up, and then we’ll also make sure that we get some communication out with you on, like we said earlier, the transition with what’s happening around the May 11^th PHE expiration. So, with that, I want to give you a couple of other quick updates. For 2024, just to hit the maximum out of pocket levels are going to be going up, so the max out of pocket for 2024 is $9.450 for self only coverage and 18,900 for other than self only coverage, representing about a 4%, 3.9%, to be exact, increase above the 2023 parameters. The out of pocket max applies to most fully ensured and ASO grandfather group health plans, but it does not apply to grandfathered or transitional relief or retiree only plans, so it’s a lot of information, but it’s more to make you aware of these changes that are coming. This audience will receive information about the 2024 out of pocket max via your respective communication channels going out later this week. Before I move onto the impacts of the Omnibus bill, I do want to make a quick public service announcement that your UnitedHealthcare and UMR representatives are ready to help you understand what plan changes are underway and upcoming, effective dates of changes and actions you may need to consider, so please connect with them, and they will help you out. This is going to be very critical as we begin to move forward through the 511 timeframe and with a lot of the changes that we’re going to be talking about coming up here in a second.

[Text On Screen – What to know about the latest Omnibus Bill and redeterminations, The Omnibus Bill decoupled redeterminants from the public health emergency. States will be required to resume annual Medicaid eligibility verification beginning April 201223. States can begin reaching out to beneficiaries on February 1, 2023, to inform them of the change.]

So I only have a few minutes today, but I want to share some critical updates on the Omnibus bill. Now this bill, like we talked about, was 4,000 pages short, but the key area I want to highlight is around the topic we briefly covered in our last briefing, which was around Medicaid eligibility and redeterminations, as we call it. And, as we discussed, this has the potential to have a pretty significant impact on employers and on some of their employees. As a quick refresher, this is the process that states use to evaluate and roll these continued eligibility for Medicaid coverage. Medicaid eligibility has income and resource limits, and the Medicaid agency is required to ensure that individuals and families continue to fall under those financial limits. If household income is not reported or if income is above the federal poverty level for the state’s—for that specific state, Medicaid benefits will be terminated. These redeterminations were paused during the COVID-19 public health emergency, due to the Families First Coronavirus Act and the additional federal Medicaid funding that states were receiving during the public health emergency was also predicated on stopping redeterminations. In exchange for enhanced funding, states had to maintain continuous enrollment in Medicaid, meaning an individual could not have their Medicaid coverage terminated. Exceptions including somebody moving out of state and a beneficiary request to terminate their coverage. Up until the Omnibus bill, we were waiting, because the states were going to start redeterminations after the end of the public health emergency. Now, with the bill, the Medicaid redeterminations will begin on April 1^st. It separated the PHE ending from the start of redeterminations. So now we kick off with states have to re-determine coverage for all Medicare beneficiaries over a 14 month period. Technically, they have 12 months to get it done, but they have a notification requirement that will go two months past, so the 60 day notification requirement. So just to give you some context on the magnitude, according to CMS data, since the COVID-19 PHE was first issued in March of 2020, Medicaid enrollment grew up 18 million people. Now 100% of individuals currently enrolled in Medicaid will need to have their eligibility checked within the short timeframe I just mentioned. So imagine almost 80 million people will have to be evaluated for continued eligibility in the Medicaid program. This is going to be challenging, no question, to the states and to their infrastructure, but we expect states to start at different times, because of different resourcing. But, ultimately, no matter when states start, they have to end by that timeframe of 4/1 of next year. So they have 12 months to really go all the way through and make sure that those timeframes are hit within the 12 month period starting on 4/1 and ending 12 months later. So it’s expected that some people remain on Medicaid. Some people will be re-determined. They’ll still be eligible from Medicaid. Some people may be eligible for employer coverage, and some people may be eligible for low cost individual and family plans offered on the marketplace or the exchange marketplace, as we call it. This is where we all have a role to play. Empowering members to take action and providing the information they need to get proper coverage is critical to ensure that your employees are not left uncovered and at financial risk if they have a health event. To make it easy, we’re developing employee resources that can be leveraged by you. We want to make sure that you are prepared to actively distribute information about coverage options for employees who may not have employer or exchange coverage today and could be losing Medicaid coverage throughout the redetermination period. We expect the redetermination process will go well into 2024, taking about 12 to 14 months. Remember, states have to re-evaluate all of the beneficiaries, giving them notice, and then the beneficiaries have 60 days to enroll in coverage. This will not be a big bang event, just with when the state starts it, that it’s all going to happen, and then it’s going to be 60 days from there. They have to churn through all of their membership, so even if a state starts right away, it will continue to pour through its membership, and that will just take time as they move through cohorts of membership all the way through, knowing that there’s many notification periods that will be happening, giving members the 60 day notification before they’ll be losing coverage, so it’s going to be happening all around us for the next 12 to 14 months. UnitedHealthcare will work with our state and commercial customers, retailers, and providers to share our capabilities and solutions once members are re-determined.

[Text On Screen – Save the Date, UnitedHealthcare Briefing: All about redeterminations, Feb. 23 12 p.m. CT]

So we’re going to cover this in much more detail on our February 23^rd meeting at the next UHC briefing. And, with that, I’m going to go ahead and open up to Alyssa, who’s going to talk—or open up for questions for Q&A.

[Text On Screen – Q&A and Poll [Barcode] Scan code or visit www.menti.com Enter code: 856 0682]

ALYSSA VOICEOVER:  Awesome, thanks, Brandon. And so many great questions coming in. A few things I’d like to cover off logistically. Yes, we will have a recording of today’s events, as we always do. You’ll receive that via email in the way that you were actually invited, or you can always access the link that you used today to join the call. So actually one other logistical thing here, if you will just take a moment to take the survey that we’re putting up on the screen, you can link over to Menti and enter the number, that would be great. And then there were some questions coming in on Surest as Beth was talking about that, and availability does vary by state, so work with your account management team or your salesperson, broker, consultant, and see if that is an option for you. With that, Brandon, I’m going to start off with you. We had very early in the call a lot of questions coming in around markets that have limited doctors. I think someone even said forget about a PCP, just limit it doctors in general in certain markets, with very long wait times, if you’re even able to get into one. Can you talk a little bit about how we as a company and your team are looking at this situation that’s very real for many?

BRANDON CUEVAS VOICEOVER: Yeah, that’s a great question.

[VIDEO OF BRANDON CUEVAS SPEAKING]

BRANDON CUEVAS: Prior to the pandemic, we’d been investing quite a bit of time and energy and resources into virtual care. I think we had spent quite a bit of our time really building out things like virtual 24/7 care and creating access to afterhours care and any time care through a variety of digital and virtual solutions with those providers that could offer that, and that actually ended up turning out to be pretty amazing, as we all know as we went through the pandemic, with the adoption rates going up significantly. As a result of that and seeing kind of the adoption rates and just kind of our long term vision of what we wanted to do with virtual, we began investing pretty heavily in that capability, in embedding that capability into our mobile experiences and being able to give members access to that. So your members in almost all situations will have access to that 24/7 virtual care-ish capability, the 24/7 care. Then we also started to invest pretty heavily in virtual primary care. And so last year we launched virtual PCP solutions on all of our products, and we put them out there available in the preferred tier, so, if you’re in a premium designated tier or a Nexus product, we have them in a preferred tier, so they are available as a virtual PCP provider in our network, and then we’ve also begun to realize that people needed care beyond just primary care. They also wanted obviously behavioral health, and I’ll touch base on that in a second, but behavioral health was a natural fit for just people that can’t get to the physician, they couldn’t get access, couldn’t get an appointment fast enough, so we spent a lot of time in the behavioral space not only helping members navigate on the way through, so, if you go to our website or you go through MyUHC.com and you go through, you actually can get navigated to digital solutions, coaching, to virtual care. And so that capability has been fantastic at getting people, and, in fact, the adoption rates are very high. 53% of our visits today in behavioral health are done virtually, and we’ve expanded that now into things like last year we launched a virtual migraine program. We’re launching virtual dermatology this quarter, so we continue to invest heavily in everything from I need care now with our virtual care solutions to I want a PCP relationship that’s available virtually. We have that available. And now we’re moving more into specialty care. And, again, with a lot of investments in particular in the behavioral space. So we know it’s a need. We know that the demands on providers are heavy. We know that there has been through the post-pandemic with hiring and staffing shortages that wait times can be long, so we hope these solutions are meaningful and actually can get people speed to care, so work with your account management teams, and we’ll make sure that you’re aware of all the solutions that we have available to you.

ALYSSA VOICEOVER:  Great, thanks for that, Brandon. A lot of questions coming in around Omnibus, surprise billing, all topics we’re going to cover when we meet together on the 23^rd, so stay tuned and look for that invite coming through. Beth, a question coming through, and maybe it’s Beth or Brandon. How can employers, whether it’s small business to larger organizations, encourage their employees to use their benefits most cost effectively, whether that’s provider selection, employee engagement programs? Any thoughts around that?

[VIDEO OF BETH SOBERG SPEAKING]

BETH SOBERG:  Well, I’ll start. You know, I think that is a challenge, right? Is actually the activation and engagement of employees, even with the best program that’s been put in front of them. You know, I will tell you that—and I talked a little bit about incentives, not just incentives on reward programs, which are very, very effective and can align the incentive to empower members and their family members, but also to—and send them to gain access to information, but also to build benefit plans that will reward and financially incent first dollar coverage by offering easy to use resources and transparency around what something’s going to cost. And so, you know, I use Surest as an example, because, to me, it’s just such a clear example where, you know, for years we’ve been trying to get employees to use urgent care instead of ERs or to use physicians instead of urgent or to use virtual care when it’s appropriate, but the ability that we bring through our Surest programs to have easily on an app, based on a broad network, so maintaining choice, the ability to enter in a service that you need or a physician type that you need, I need, you know, I need migraine treatment, I need lab tests, I need an MRI, and then to have those options come up, based upon quality and cost, and the differentiation being my copayment, that is really the purest form of empowerment, so I think how we do it is we continue to bring forth innovations, leverage digital, leverage transparency information, and tie those financial incentives to those programs, so that employees can continue to engage in that empowerment. What we find is that, if we can align the right incentives to the right outcome, then employees and their family members will begin to use those. So, again, I use Surest is what I consider one of the best examples I’ve ever seen of that activation. Brandon, anything that you would add?

[VIDEO OF BRANDON CUEVAS SPEAKING]

BRANDON CUEVAS: No, I think it’s great. I think that’s exactly right, Beth. I think one of the things that makes Surest special is engagement right up front, and so one of the things I would think is a tip for all of us is getting your employees engaged upfront, get them to register, get them to go online and become aware of the tools so that they can begin to get digitally engaged. I know that’s not the panacea for everything, but it’s definitely—I always liken it to you don’t ever really think about the phone number for the plumber until your toilet backs up, and then now, okay, now I’m scrambling. Well, healthcare’s way more complicated, and so it’s not always easy to know in the moment where I need to go to find the right place of care, so you’ve got to get engaged upfront. Our marketing teams and our engagement teams are very focused on making sure we try to have those connection points all throughout the year with letting you know, but I think it’s digital engagement upfront, getting people aware of the tools that we have, like treatment cost estimators, how they can maximize their plans, and we have some programs that we’re going to be rolling out on how to help your members maximize their benefits, but moreover, it’s about getting them aware of the tools and then making them see that there’s real value to them financially in using those tools. And I think, as you see, Surest is a very strong example of how that’s all lined up, and we’re bringing many of those experiences into all of our products with our new find and price care journey that we’re taking, and you’ll start to see that enhancement to our transparency and pricing tools come out, so that’s all the work that we believe that if you can get people engaged upfront, you can make a difference when they need it, because they just need to know this is where I go upfront before I’m actually in that health moment, and where they’re scrambling to try to get it altogether, if you will, and then try to make the best financial decision in the middle of trying to get their health managed. Great question.

ALYSSA VOICEOVER:  Thank you for that. Yeah, that takes us right up to time. If you haven’t already scanned that QR code, please provide feedback, so we know how you’re feeling about this call. Brandon, any last words to wrap us up before we go today?

[VIDEO OF BRANDON CUEVAS SPEAKING]

BRANDON CUEVAS: No, just thank you for your participation and joining. We want to bring value to you. We want to be your partner in this journey of making, you know, helping people live healthier lives and helping the health system work better for everyone, so it really does require us getting feedback from you, so we know how to hit the target on the things you want. Please give us feedback. We want this to be about getting benefit to you, so thank you for your partnership. Thank you for your trust in us and for your business, and we just hope that you have a safe February.

[Text On Screen – Q&A and Poll [Barcode] Scan code or visit www.menti.com Enter code: 856 0682]