So that these patients will be supported and managed really positively going through ’24. That’s what then underpins and unlocks the whole opportunity of value based care for Optum Health. Lisa, thank you for your question. And I’ll move on to the next question.
Operator: We’ll go next to Stephen Baxter with Wells Fargo.
Stephen Baxter: Yes, hi. Thank you. I was hoping you could talk a little about what you’re seeing for cost performance in the group commercial or exchange or Medicaid businesses? As you step back, is this still appropriate to attribute all the pressure really, you’ve seen in 2023 to seniors or should we be mindful of anything else there? Thank you.
Andrew Witty: Stephen, thanks so much. Maybe I ask Brian just to give you a kind of overarching summary of what UHC has seen in its different books of business, Brian?
Brian Thompson: Yes, I appreciate that. Thanks, Stephen, for the question. And I think I’ll just lead with, I feel really good not only about how we finished the year in UnitedHealth Care 2023, growth at the top end of our ranges, performance run in positions across the board, but also as we step into the businesses for 2024, feel very good about the key assumptions that underpin our plan and very optimistic. And you mentioned a couple of areas. You’re right, as we’ve discussed some of these elements with respect to cost trend, they are centered in our senior community. And I think the message around those other businesses, nothing to see here and really aligned with our expectations, some good stability and durability in the underlying elements, both utilization and unit cost of our trend outlook and obviously feel very confident in how we’re showing up competitively when you look at our growth outlook.
So very optimistic about UnitedHealthcare, durability in those other lines that you’re suggesting and a lot to look forward to here in the year.
Andrew Witty: Right. Thanks, Brian. Next question, please.
Operator: We’ll go next to Lance Wilkes with Bernstein.
Lance Wilkes: Great, thanks. Can you talk a little bit about Optum Rx, the drivers of growth in the quarter, in particular topline? And then if you could comment a little on revenue per Rx? And do you have any programs that either in the fourth quarter or in ’24 that you’ve been rolling out that are capturing some of the increased demand on topics like GLP-1s that might be contributors to some of the strong performance? Thanks.
Andrew Witty: Hey, Lance, thanks so much for the question. Before I ask Patrick to start the response on Optum Rx. First off, I just want to note a super strong selling year for us in Optum Rx, probably our best ever. Extraordinary and across a wide range of categories, plans, public service states, as well as obviously commercial. And really, really pleased with the differentiated product offering, really built on transparency, choice, and of course cost. And so we feel we’ve built a strong momentum in ‘23, rolling into ‘24. Patrick, you may want to go a little deeper, maybe share a little detail on weight engaged, specifically around the question that Lance raised around GLPs?
Patrick Conway: Yes, thanks, Lance, for the question. So, as Andrew said, really diverse growth, both new business and high retention rates. So one of our best-selling years ever. I’d also call out the pharmacy services expansion, the organic growth there across the diverse set of pharmacy services, cost management. And then last, as you mentioned, new products and services, just to call out one weight engaged. So comprehensive management, medication, provider support, client support, lifestyle modification, digital, so a comprehensive solution across Optum, not just Optum Rx, partnering with Optum Health and Optum Insights. Already live with clients and robust interest in the marketplace, because patients, members, employers want comprehensive solutions that demonstrate better health outcomes at lower total cost of care.
Andrew Witty: Thanks so much, Patrick. And Lance, thanks for the question. Next question, please.
Operator: We’ll go next to Kevin Fischbeck with Bank of America.
Kevin Fischbeck: Great, thanks. I guess, I’m still just struggling with the concept of 2023 coming in worse, but this having no impact on the 2024 outlook. I mean, are you saying that the incremental pressure is really just like flu RSV and therefore unlikely to replicate at these levels next year, because the negative development speaks to costs earlier in the year also coming in worse, which implies that the baseline is — the core baseline is also higher. So can you just help me reconcile, you know, why this isn’t raising the base for next year and I guess within that you may feel confident with the guidance range for MLR, but is there reason to be at the higher end of the range to start the year or is the midpoint still where you’re orienting? Thanks.
Andrew Witty: So I’ll ask John to go a little deeper. Obviously, as you know, Kevin, we’ve set an MLR target next year, which is in fact higher than the actual closeout for this year in any case, which takes into consideration some of that kind of elevation, which we’ve seen throughout the year. So I’m going to call it the core elevation associated with the outpatient senior behaviors that we’ve been talking about now for several quarters. And then as we’ve talked a little bit already, this end of Q4 type of a small seasonality variation, we don’t think is really durable or relevant to the rest of the year. But John, maybe go a little deeper on that.
