We have new offerings that are whole health full risk opportunities like oncology, assuming full risk in oncology, as well as in Medicaid with behavioral health with the seriously mental ill population. So, these are significant initiatives that are really propelling the trajectory of our business. I would also say that as it relates to external growth. We’re also seeing really nice improvements from that perspective and really nice momentum. Our pipeline in 2023 or 2024 growth was much more significant. In terms of our sales this time versus last year, we’ve seen a real nice trajectory in our growth. And we’ve had a couple of really nice notable wins with the Blues. I would say that as it relates to that and the opportunity with the Blues.
They are doing exactly, what we’ve talked about in the past, and looking closely at some of these full risk comprehensive offerings that, we’re delivering in Elevance Health and then very interested in that in terms of the opportunities to create predictable stable cost of care for them. So, very pleased with where we are in the trajectory of growth in Carelon.
Gail Boudreaux: Thank you. Next question please?
Operator: Next, we’ll go to the line of Stephen Baxter from Wells Fargo. Please go ahead.
Stephen Baxter: Yes. Hi. Thank you. I just want to come back to the Medicaid redetermination process. So entering 2023, we’re expecting some normalization of the Medicaid outperformance that you saw in years prior. Can you give us an update on where that landed in 2023, compared to your initial thinking? And then just a little bit more color on, what your guidance assumes for Medicaid in 2024. Does that put you back at historical norms for margins? Or should we think – should we be thinking about something else there? Thank you.
Mark Kaye: Stephen, thanks very much for the question. On Medicaid membership, our outlook reflects the footprint adjustments we spoke about on our third quarter earnings call and the continued attrition due to redetermination. We believe Medicaid redeterminations are approximately two-thirds complete across our Medicaid markets. And in general, we’ve seen more front-loaded disenrollment. Notably in a few large states that have elected to adopt accelerated processes. And then based on the trends that we’ve observed relative – or related to these market-wide coverage shifts. We have adjusted our Medicaid retention assumption, to be approximately 30% of our PHE related growth. We’re not planning to provide point estimates for coverage transitions generally.
We do, however, believe that ACA will pick up more than initially expected, while employer group coverage will gain a little bit less than initially expected. But most importantly, these updated projections are factored into our membership guidance that we provided this morning.
Gail Boudreaux: Thank you. Next question, please?
Operator: Next, we’ll go to the line of Lance Wilkes from Bernstein. Please go ahead.
Lance Wilkes: Yes. Thanks. Could you talk a little bit about your value-based care strategies? And what I would be interested in is, from a contracting standpoint, how are you approaching that for 2024 and like MA? Are you doing any sort of renegotiation to kind of hold those value-based care providers – more stable in that year given the risk adjustment changes? And then how is the priority for owning those sorts of assets in Carelon change? And what’s your current outlook there? Thanks.
Gail Boudreaux: Well, thanks for the question, Lance. It’s quite a bit there. But I think let me start with our value-based strategy, we’ve talked about on this call a number of times, and I think I would say it’s remained really consistent, but we’re making a lot of very good progress on that. Overall, more than 60% are in value-based care. And in Medicare, it’s even more. Specific to your question on renegotiation. We have multiple-year arrangements with our value-based providers, and we’re always looking at a couple of things. One, quite frankly, to make sure that it’s a win-win and we’re aligned, both on cost quality outcomes and Stars. So, we spend a lot of time focusing on some of the ways that, we can get data back and forth more simply.
We use our – we’ve integrated the way we share data back and forth. And that’s really around closing gaps in care and quite frankly, simplifying the process under which we work with those providers. Our goal is to make that ubiquitous across all of our value-based providers. And so, we made a lot of progress there, and dramatically improve sort of the time, to action with those providers. And I think that’s important because, honestly, that gives them data to act and that improves their outcomes. We have seen our value-based providers perform better in the circumstance, and we think that, that’s going to remain important. In terms of our strategy around ownership. We’ve talked about that. We – as you know, we do have assets inside of Carelon.
I guess where I would focus you more is around the specialty high-cost complex areas of specialty, because that’s where we think that there’s a huge differentiated focus between our technology, our clinical domain expertise and our ability to drive trend. Again, we don’t need to own the providers, but we do need to have a significant role in the enablement of those care providers, and we have spent time doing that. We launched a number of new products this year with oncology, serious mental illness, and we’re getting into other areas like musculoskeletal, renal and more. And I think – that’s where you see the significant spend area is accelerating and Carelon with its assets has a great opportunity. So, we expect Carelon’s care provider enablement platforms continue – to contribute pretty significantly Carelon’s revenue meaningfully over the longer-term, and we’re building those assets.
