Yeah, yeah. Okay. Perfect. Great. Are my questions all updated? Got my mic live. I guess we can sit down. All right. Clock has started. So, welcome, everybody. Friday morning. Really appreciate that everybody who's here in the room. I imagine we have a bigger audience out there for the webcast, too. So, I'm Lance Wilkes, healthcare services analyst for Bernstein. Really excited to have Centene here again this year. And so, to kick things off, you know, what I'd like to do is let me just let both you guys introduce yourself. We'll probably, you know, as this conference has a lot of portfolio managers, I saw that Boeing canceled at the last minute, so we may have some extra portfolio managers in here. So maybe just a quick introduction of yourself and the company, and then we'll kind of walk through some questions. Obviously, you've got the 8-K out, so we can kind of turn right into that, and then build to, like, the longer strategic questions. Sure. Sounds good. Good morning. Thanks for joining us and for your interest. I'm Sarah London. I'm the CEO of Centene. Drew Asher, the CFO. So for folks who are newer to the Centene story, we are one of the largest managed care organizations in the country, so we provide health insurance to more than 28 million Americans, primarily focused on government-sponsored programs, so Medicaid, Medicare, and Marketplace. We take a very local approach to our work. We embed teammates in the states and in the communities that we serve, and really think about leveraging sort of the size and scale of the organization in delivering local care to our members. As you said, maybe just turn into the- Yeah ... 8-K, because hopefully, maybe you read it, but if there are some new folks, again, to the story, those who didn't, we put out a 8-K on Wednesday, and I'll hit some of the highlights of that and maybe give a little bit of color, but I know we'll dig into a lot of it in the questions. So a few points from the 8-K. First and foremost, we still feel good about our full year 2024 adjusted EPS guidance of greater than $6.80. We also still feel good about our consolidated HBR guidance range, which is 87.3%-87.9%. We are seeing pressure in our Medicaid book of business in April results, and that is largely due to the impact of this redeterminations process that we've been going through for more than a year now, and the shift in acuity of the underlying population that remains after the redeterminations process. So this is, the states were suspending the eligibility verification process for Medicaid members during the pandemic, and that restarted last April. We've been working through that over the last year plus now, and for context, we are about 95% of the way through the administrative part of that process, so redetermining the individual eligibility of Medicaid members state by state. And as of today, we have roughly two-thirds of our states completely done with that process. But there is a tail of a handful of states that will continue over the next couple of months for different reasons. But in other words, we're largely through the volume of membership that is shifting. The acuity starting to see pressure is largely a result of the timing. So think about the fact that the largest member shift took place in Q4 of 2023 and Q1 of 2024. But then what you have is the compounding effect of the denominator getting smaller as we think about the overall metrics. Add to that, this rejoiner dynamic that we've been talking about for a while, which is the fact that about 30% of members who rolled off in this redeterminations process or fell off fell off inappropriately, and it was partly due to administrative issues at the state level, system issues, things like that. We've been tracking that to be consistently now, coming out to around 30% of those members who come back to us. So that also creates a delay in seeing how the underlying member mix and acuity is gonna settle out. And so that is largely what we're seeing happening in the pressure in April. Good news about that is roughly 50% of our rates, which is really how you account for that acuity, is by matching the rates to the acuity of the population with your state partners. Roughly 50% of our rates are set between July 1 and October 1, so we have that data to be able to bring forward into our advocacy and our conversations with the states. The other good news is we know how to do this. So this dynamic of redeterminations is unprecedented right now because of the scale, but matching rates to acuity in Medicaid is normal course. It's the blocking and tackling that this company has been doing for 25 years now. So our teams have been totally organized around this for more than a year, having very productive conversations with our state partners. As we see this acuity settle out, we will be having those conversations with our, the other MCOs in our states, and so there's consistent messaging, consistent data, and that's really this dislocation that we've been talking about of timing that we're seeing, manifest largely in the April results. At the same time, our Marketplace business continues to perform very well, including, anticipated outperformance in risk adjustment. We're seeing strong investment income. Our Medicare business is in line with expectations, and that includes our PDP business. And then we didn't call this out in the 8-K, but as many of you know, who've been tracking this story, we've been very focused on driving a different level of operating discipline and efficiency in the company, so that continues to go really well. We're bringing in awesome talent and starting to see really good results there. And so when you put that all in, you know, having a diversified portfolio allows us to absorb pressure in one of our lines of business, navigate a dynamic landscape, and ultimately pleased to be able to reaffirm both the full year EPS guide and the consolidated HBR guide. Great. Well, let me just ask a couple follow-up questions on that. Mm-hmm. First one would be just to kind of frame, and I think you've hit this now, but to frame the concept, as I read the 8-K, the key question to me was, okay, are we seeing a spike in utilization in Medicaid, perhaps because utilization in Medicaid is finally getting back to sort of a normal pre-COVID level? Or is this the concept that, oh, you just estimated a certain MLR in the remainers, a certain MLR in the leavers, and as you're now observing what's really happening, yeah, that's, like, modestly different, and the remainers are at a slightly higher MLR, which then feeds into the rate thing. So you could just kind of comment on it, like, how much of it is any sort of utilization dynamic as opposed to, you know, just the acuity mix? Yeah, so it is largely the acuity mix. There are still some pockets of trend consistent with what we've called out over the last couple quarters that we're watching, like behavioral health, within Medicaid, and within other lines of business as well. So, so those are, you know, there are all sort of pockets that you wanna pay attention to. But it's largely the redeterminations, acuity shift, and then in some of our states where there's a similar, change, if they did a PBM carve-out or a PDL change, where, again, if you have a shift in, the underlying acuity and the rate isn't accounting for programmatic changes. But I don't know if there's anything else you wanna give color to. Yes, totally agree, 'cause we can track the stayers, the performance of the stayers. We know the performance of the leavers leading up to the point when they left. We can track the rejoiners, so those that left then came back, or referred to earlier. And then also we track the new members. And so because we've got visibility into the performance of each of those cohorts, we can sort of triangulate that and attribute most of this to effectively the underlying shift of membership base due to redeterminations. Okay, that's really helpful. Then, you know, that's obviously a really strong performance, both on keeping the EPS and keeping the MLR target. On the MLR target for the guide, is that... You know, should we be thinking of that as, well, you're being just conservative, and so you're able to, you know, withstand a little pressure here? Or is it, are there offsets in the other businesses that are, you know, offsetting some of the pressures with Medicaid? Yeah, first of all, it's a reasonably wide range. Yeah. We'll keep on looking at that as we get through the rest of the year. But, the Marketplace performance is effectively a partial offset to Medicaid. And then beyond that, as Sarah mentioned, you know, Medicare is on track. We were able to afford a $125 million premium deficiency reserve, which is attributable to the 2025 bids that we're just about to file. We've got investment income that's, you know, trucking along at a higher run rate than we were planning, and our premium and service revenue as a whole, which we'll update again on the Q2 call, is, stronger than we had previously guided to. Which is great, because that gives us long-term earnings power on a higher revenue base. So, company as a whole, diversified enterprise is performing well. Understandably, we're not pleased either with sort of the, let's call it the tightening or the worsening of the Medicaid HBR in the near term, but, we've just got to go get that fixed through rates largely. And as Sarah mentioned, we've got about half of our rates between 7/1 and 10/1, and we're averaging a composite rate around 3%, so call it 3%+. It's a little bit higher than the 2.5, over 2.5 that we've referred to on the Q1 call. But we still need to go get more than that. And this most recent data, we'll be making the case to the state. Thanks for the rate change, but look at the data, and we need to get topped off as we get into 2025. Yeah, they're real helpful. And then just a couple other, like, mechanics associated with this. From, you know, from your prior commentary on how earnings might flow in during the course of the year, yeah, how do you see that changing, if at all, with this? I think, previously you might have suggested, like, a 60/40 split with that. Does this have a change on that sort of impact? Yeah, we still feel good at that. No less than 60% in the first half of the year. So 60/40, hopefully do a little bit better in the first half so we can deliver earnings sooner in the year rather than later. Gotcha. Then, my last 8-K question in the strategic conversation, I'll then get to the longer term ones, would be, you know, how should we think about that PDR comment? And so, like, when I initially saw that, my reaction was, oh, what they're signaling is they're able to absorb $125 within guide, and they don't yet know what the PDR will be. But, you know, but is it in fact that maybe you have a... Given your bid, you have a clearer view as to what that PDR is gonna be at this point? Yeah, it's an actual calculation based upon the bids. I mean, literally, we're filing bids right now and all the way through Sunday. You don't wanna wait the last day- Yeah ... which is Monday. So we've got- My college career. Yeah, right. Right. Right. Well, when there's electronic submission involved, you're not completely in control. No way around that. Uh- You can't slip it under the professor's door. Yeah. Exactly. Yeah, it's time-stamped. But because we've done all the work, I mean, it's very complex, the culmination of the bid process across all of the different PBPs in Medicare Advantage, and then our PDP bids. But the PDR relating to Medicare Advantage is the culmination of all that detail buildup. It's our best estimate based upon the membership we expect to retain during the annual enrollment period. And really, it's, you know, thank you, investors, for allowing us to spend our collective money to preserve business we think will be very valuable in the long run. So we are gonna be, you know, very disciplined about exiting certain states, certain counties, certain products that we don't think will bear the long-term value, in conjunction with the sort of the Medicaid and Medicare coming together, supported by recent legislation, the strategic value of that business, and then business that's akin to, the low-income and dual business that we wanna serve in the long run. So that's sort of the nature of spending some money today, backfill it with Stars improvement over the next few years, and then have a really good Medicare business as we get to the back half of the decade. Cool. Well, let's walk through the three major businesses and talk a little bit about that. I think one of the top questions that I've had, and that's been out there, has been the kind of recent RFP activity. And so maybe if you can just, for the audience, comment on the activity that's taken place. And then what I'd be really interested in is kind of your postmortem, your assessment of scoring that's been taking place out there, where you feel you're strong, where you feel you have opportunities for improvement with that. And obviously, as part of that, any sort of updates on the Texas status and if you anything with respect to Georgia. Yeah. So we've had a number of major states go through the redeterminations or the RFP process, a loss of ours, in the last, call it 6-9 months, but some of the bigger states. So we just had great news in Florida, retaining our statewide presence there, given the recent ITN notification. Good results in Michigan, good results in Kansas, came in first in that RFP process. Still waiting on Georgia. We expect that sometime soon, sometime over the summer. A notable point there is that they've added complex populations to that bid, so that's an opportunity for not just retaining our market share in Georgia, but actually growing that program consistent with our long-term view of growth in Medicaid, which is at least partly driven by the addition of these complex populations, Aged, Blind, and Disabled, LTSS, foster care. We've had, so all told, some good results from an RFP standpoint. We did not have good results in Texas, but are protesting that and continue to be very concerned with what we saw there. There were a number of incumbents who got bounced out of regions in Texas, really sort of inconsistent with the data on the ground there. So they took out the top performing quality player in 9 of those regions as a result of the scoring, including a number of the children's hospitals. But even more concerning is the fact that the department apparently re-released all of the RFP submissions to one of the bidders in the middle of the process. So that protest is ongoing. I don't know if you all are tracking that closely, but there's been a lot of noise in Texas around that. And so we continue to push and believe that that should be reset. And it is the third time that the department has endeavored to secure that particular book of business. So some challenges there we continue to work through. But, to your point about postmortem, you know, we—since our results in California, really, which were a couple of months into our tenure, we've taken a real improvement approach and mentality to the BD process, 'cause I think we have—I still firmly believe that we have the best BD team in the business, but you can always do better. And what can we learn from the scoring? What's the feedback that we're getting? We consistently get positive feedback about the fact that we take a local approach. We are deeply tied into the community, which means we know who those community partners are, and that sort of nontraditional provider network that drives health outcomes for our members, continue to focus on innovation, care management. And I think the big opportunity for us, which is what, again, what we kind of put as our first priority starting two years ago, was operational excellence, and making sure that the underlying foundation, execution on the basics, is seamless and as strong as it can be, so you can really focus on having some of those exciting conversations with the department about how they wanna tackle health equity, how they wanna tackle some of these 1115 waiver opportunities that are coming. And so I think we've started to, you know, have the oxygen to really lean into those conversations because we're getting our arms around the operations of the company at the same time. That's great. And again, because we've got a broad audience, one of the things that we've been really excited about for the sector and for you guys for a number of years, but particularly right now, is the growth potential that remains in Medicaid. And our thesis in that is, you know, this more complex populations, which aren't yet outsourced, represents, like, 40-ish% of spend and still can get outsourced. And then I have a view that there's just a consistent eligibility expansion in this country that will continue, like, just like a demographic trend. That may not be right, but that's, like, my view. So I'd be interested in maybe if you could just spell out for folks, the backdrop's been redetermination. Everybody's been focused on redetermination, but underneath that, you've seen some expansions, you've seen the postpartum coverage. Could you just talk about, like, what it is you're seeing as far as expansion at a state level, maybe broadly? It doesn't have to be exactly like just to Georgia, but what you see and maybe how that links into your investor day long-term targets for growth in Medicaid. Yeah, well, we completely agree with you, both relative to the fact that Medicaid continues to grow, and there is sort of an underlying, call it 1%, just sort of growth of eligibility in the country. If you look at the demographics of the, you know, socioeconomic demographics of the country, we're heading even more in that direction, unfortunately, right? But that is a member base, and low-income and near low-income is, you know, who we focus on. So embedded in our belief that there is still significant growth in Medicaid are all the components you talked about, and that plays into the long-term algorithm, which is 7%-8% revenue growth, underneath that, 6%-7% Medicaid growth. If you break down where that's coming from, so there are still roughly 10 states that have not moved to Medicaid managed care, so they're managing their Medicaid business in a fee-for-service position. There are a roughly equal number of states that have moved into a managed Medicaid model that Centene does not operate in, so that is white space for us. There are 9 states, I think, that have not yet expanded Medicaid, but you just saw North Carolina do that. So proof point... So actually, let me take each one of these. So we said, roll back 2 years ago, we built our long-term algorithm. We said, "Okay, there are states that are not yet in managed Medicaid that are gonna flip." Oklahoma did that last year. We now serve Oklahoma. There are states that are in managed Medicaid that we are not in, that Delaware is an example of that. We entered Delaware last year. There are states that have not yet expanded Medicaid. North Carolina just did that starting last December. So as we've been clicking through, you know, sort of the operational turnaround of the business and clicking through redeterminations, we've put proof points on the board at the same time of each one of the growth areas. And then the last and the biggest one is those more complex populations. And there's a mix in there of, where the population is in a managed care model, so like Arizona LTSS, which we won in December, that Centene was not serving, now serving that. And then those populations that we've seen increasing momentum of states moving them into the managed care model because of the level of service, efficiency, and oversight, and then sort of, you know, cost management that we can do in partnership with the state. So again, the ABD bid in Georgia is an example of that. North Carolina added foster care in this most recent budget. And we are tracking each one of those opportunities state by state and also helping to influence that, because we have the ability to go to the department and go to the legislature and say, "You know, this is how we've managed LTSS in Texas and in a number of other states. These are the outcomes. We can show you the data, we can share references with you." It helps the states understand not just what the opportunity is, but what it feels like on the other side of that opportunity. That's really helpful. Okay, so let's turn to Marketplace. And if you can just give kind of a sense as to, you know, what it... How's the performance in that business? Obviously, growth has been great. And then, you know, as you look at 2025, what's your sense of, you know, the opportunities for growth and margin, kind of in either scenario, if there was some sort of impact to subsidies or if, you know, if there's a continuation, you know, kind of a trade on taxes and subsidies? Yeah. So the Marketplace business is performing incredibly well over the last couple of years, and there are a number of tailwinds that have driven that. Some of it is redetermination. So members who no longer eligible for Medicaid are eligible for an individual product on the Marketplace, and because of the enhanced subsidies that went into effect two years ago, there's no cost to many of those members to signing up for a Marketplace plan. So we have been very focused on helping members make that transition. But there have also been other interesting tailwinds that we can I'm sure get into later. But if you look at the growth in Marketplace, the biggest chunk of that has been from previously uninsured populations. So whether they are, you know, young gig workers or folks who didn't really trust sort of the stability of the Marketplace, I think we've seen a kind of stabilization of that chassis and a belief that kind of we're not gonna be subject to political whims, and that plus the subsidies, the, the awareness that CMS created through advertising dollars, the fact that brokers have now flooded that space and realized that it's an opportunity for them, we're seeing a lot more awareness, the, the feeling of affordability. So that's brought in the uninsured. And then we did a sample of our membership post OEP, of the new membership, and found that about 10% of those members were coming from their previous small group employer having offered insurance and no longer doing that. And so this dynamic that the small group market, and the smaller employers are actually, migrating, members into the Marketplace organically, we've now proven out in the data. We've been watching that dynamic quite a bit. But, overall, you know, we've seen tremendous growth. We continue to expect to be well into our target margins of 5%-7% this year. And then as we look to next year, you know, thinking about the enhanced APTC, so again, for folks who may not be as fluent in all this, this enhanced subsidy that the Biden administration passed, that is set to expire, coincident with the Trump tax cuts at the end of 2025, is a big question about what does that do to access affordability, and membership within, the Marketplace product. Obviously, something, something we care a lot about and have been paying a lot of attention to. And we are seeing, there's obviously, you know, Biden got up at State of the Union and said, if he's elected, he's going to make those permanent. What we are also seeing are a lot of interesting bipartisan data points, but, but also Republican data points around the idea that the Marketplace chassis is an important one as we think about ICHRA and the idea of individual coverage as an option as we go forward. And so, the even most recently, some of the conversations in the Ways and Means Committee has been about this sort of breakpoint of 400% FPL, and the idea that the subsidies, you know, go above that. And so our belief is that it's not a binary event, but that, you know, they may mitigate sort of the peanut butter effect of the subsidies and say, you know, maybe we'll cap them at 400%. You know, we have more than 90% of our membership is below 400% of the FPL. So that's sort of how we're looking at it. And again, a lot of positive data points, you know, if you just two things I'll put out, and some of you have heard me say this before, but one is, a significant portion of our members and sort of the broad members in the Marketplace are rural Americans who are Republican voters. So some of the loudest voices supportive of the ACA, perhaps ironically, perhaps not, are Republican voters who understand what it means to provide access to care and what the knock-on effects are of that, including reducing credit card debt, because a lot of that debt is driven by medical debt. The idea that you have, you know, job consistency and economic mobility as a result of that, there's a lot of amazing things that have come out of creating access. The other point that's notable is, you know, rough numbers. The total cost of the Trump tax cuts in one year are around $200 billion, and it would take $200 billion to make the enhanced APTCs permanent for it, right? The relativity is like $25 million per year versus $200, and they're set to expire at the same time, precisely so that if we have it, that divided government, there's a real opportunity to come to the table and discuss. Super helpful. I think that demographics of your population, in fact, 90% or below the 400 is really interesting data point. Thanks for that. You talked about ICHRA and just the concept of individual becoming sort of a vehicle for what I'd call kind of a siphoning out of employer. You know, for people who are less familiar with the space, employer health insurance hasn't grown since the year 2000. Obviously, employment has. There's safety net programs have grown tremendously over that time period. Like, someone like me, I would say, Oh, that's been siphoning over the expansion of safety net programs as a society for, like, 25 years now. But this is maybe more an opportunity to siphon away the core. What are you seeing as far as... Obviously, it's very early days with kind of ICHRA, but maybe if you could just spend a couple of minutes explaining kind of your experiences, what sort of uptake you're seeing in that sort of product. And this is kind of like a defined contribution edge product for anyone who's less familiar with that. Yeah. So think about the shift from pension to 401(k) analogy for health insurance. So instead of your employer providing your health insurance, they give you a stipend. You can then go choose a product on the exchange that, you know, better fits you. And so you think, you know, think about we have 66,000 employees. I think we have three or four health insurance options. For now. For now, right. We're probably, you know, we're probably not, like, nailing it out of the park in terms of customizing those options to 66,000 employees. If you think about the idea that you can sort of choose a level of coverage that you want, that that could be portable, it can travel with you. There's just a lot to like if you think about, you know, the generations of workers that are here and continuing to come, and the fact that that has been sort of the dynamic that has won in every other industry. This is why people, I think, are excited about what the growth would mean. It was sort of put into statute with, originally with the ACA, but then the tax law change that was needed in order to allow for the deduction from employer deduction, took effect in 2018, I think. And then we went into COVID. So there was like this moment that there could have been momentum, and then no one was going to touch health insurance in the middle of a pandemic. But people are now starting to come back and talk about this idea, particularly as, you know, premiums have gotten, you know, have increased, and employers are starting to think about their own desire for predictability in that line. Is there another way? And so our hypothesis is, we've seen, and there are lots of sources that you can go look at, in terms of how the market is growing. It continues to grow at a pretty significant clip, but again, denominator small. So big growth numbers, but it's still a nascent market. Lots of interesting conversations happening. We launched a pilot in Indiana this year that's allowed us to learn along with the market. Lots of, again, really interesting organic conversations coming out of the dynamic I mentioned of the organic small group migration that's already happening in Marketplace and what is driving that. And it is a combination of, you know, the CFO of an organization wanting to have predictability in what that spend is gonna be, and the pull from an employee standpoint of, I want choice, and I want a little bit more agency in making those decisions. Now, I think the rate-limiting factors to sort of the long-term adoption that you might hypothesize are some of those infrastructure pieces. So how do you make the administration easy? How do you make it feel like you're, as an employer, you're not throwing your employees to the wolves? Like, how do you create a navigation and buying experience? The brokers need to think a little differently because it's not really, you know, one shot to 60,000, but it's also not quite the one by one of Marketplace. And there are, you know, there's this in-between space that there's a lot of interesting activity stepping into, and we're part of all those conversations. We do have how many ICHRA members do we have? A couple thousand, right? That's pretty, like you said, it's a nascent market still. But we're able to sort of learn on, and that's not just the Indiana pilot. There's some actual sort of legacy, ICHRA membership that we've been testing and learning on. So this is important to note, you know, when we think about the long-term figure that we've put out until the 15%, ICHRA is not part of that. So there's still incredibly robust growth just in the line of businesses that we are in. But having a number one position in the individual Marketplace today, in a world where you ultimately believe that the, well, you know, group insurance is going to get into that space is really exciting. Yeah, we think it's a hell of a call option that you get for free when you buy us for 10x. Because there's 150 million people in that employer group space, and we are in the unique position, maybe the enviable position, of not having to protect a large commercial group business. In my prior lives, I've had to do a lot of protecting of national accounts, of small group, insured, mid-sized group. But given our government programs focus, we are in a, I think, a really good position to see this long-term opportunity. Yeah, I have a view that you're going to see a significant siphoning off over, like, a 15-20-year period of employer or orders of magnitude, like 25-40 million members moving over into either individual public options, things like that. Let's talk about Medicare Advantage. So Medicare Advantage, maybe just start off with, you know, kind of how that fits in with the rest of the business, and how you're evaluating progress on the strategy and, you know, what you think the ultimate vision of Medicare Advantage within Centene. Yeah. So, again, if you take a step back, our focus is government-sponsored programs and serving low-income, near or low-income Americans. And so just on paper, Medicare Advantage fits squarely into that. And I think that was the logic of the WellCare acquisition, originally. We are obviously in a turnaround on that business, because of historical Stars performance. But again, two years ago, when we set the long-term strategy, what we set was focusing on Medicare and specifically the more complex members, because of the synergy with our Medicaid business. And the belief that, you know, particularly dual-eligible members and again, to near low-income, complex Medicare members, services within the community that are critical to creating, a seamless and, supportive care environment for those members are very similar to the resources to support the Medicaid populations, and particularly more Medicaid populations, which again, we have the highest concentration of. And so there was a lot of synergy to, and logic to that view. We had also been tracking policy movement in that direction, which then landed formally with the Medicaid final rule. And this idea that as we head towards 2030, Medicare and Medicaid are going to be linked formally relative to serving dual special needs populations at the state level. And so having a strong leading Medicaid footprint in the country is actually a phenomenal place to be. Having our focus serving those more complex Medicare members, which we've continued to focus the book, both from a membership standpoint, investing in benefits, investing in the member experience internally, and even recalibrating our Stars target from a 4-point target to 3.5, which is more reasonable until we get the Health Equity Index in play, which, you know, when you're serving those complex members, is all about saying: This is the business we want to win. And it is not dissimilar to your point on Medicaid overall, that the fastest growing segment of Medicare and Medicare Advantage are the low-income, complex members, just because of the demographic and socioeconomic factors in the country. Just two follow-up questions on Medicare. One would be, I think you commented on this in your first quarter call, but what proportion of the book is sort of the duals or kind of complex populations today? And then what do you see as, like, long-term, you know, vision for the company as far as the mix between sort of that dual population and more traditional, like, individual MA population? So we grouped that in this AEP. I think we're in the- Mid-thirties. Mid-thirties. Pushing to the high 30s. Penetration. I think continuing to focus on that population, I mean, we still want to grow the overall MA book, but again, it's with a bias towards- ... those members that we can really deliver and differentiated value to. And then what will, I think, also be interesting is sort of the transition of, at the state level, some of these MMPs into HIDE and FIDE SNPs, which will be part of that sort of combined math of, you know, a real focused, dual population. So we'll continue to grow both, but again, you know, really believe that we should be a leader in that space. Great. And then the last question is, as you're, you know, obviously really focused on the Stars progress you're making, and, you know, get a scorecard later in the year, but from the way you look at it and the metrics you're looking at, you know, what, what's the state of progress and how is that moving forward? Yeah, I mean, I'm very pleased with the progress we're making, and that's everything from having, you know, a unified governance model, the level of focus across the entire company around quality. And, you know, we've talked about this before, but the benefit that we've had as we've invested in Stars is that, you know, quality is a central component of all three lines of business. So that when we make adjustments in closing gaps in care for our members and sending out to providers, we can have that conversation not just for their Medicare panel members, but also for Medicaid Marketplace. And so, you know, seeing the impact it's having on our Medicaid quality codes as well, and then Marketplace, which is recent. But great progress there. I think I'm really proud of the execution within the HEDIS season. If we think about this year, which is more for, you know, the 25 results, you know, just this is the—this, we're in the midst of, like, the third year of improvement, and at this time last year, we're, we're still seeing five times year-over-year improvement year-to-date in terms of reaching out and touching members and getting them in for provider visits. So, like, the machine is just clicking and improving. And I mentioned this in one of those recent calls, but a lot of good work done around digital data, which I get a little geeky about, but this idea that you can go and understand and get credit for the work that your care coordinators and your providers are doing to support members in a faster, better, cheaper way. We made a huge push on EMR connectivity and digital data in the last 12 months, and so we're really starting to see that flow through. And again, our goal has been not just sort of clicking through and hitting, you know, our goals for Stars, but making sure that we're building a sustainable engine that will produce high quality results in perpetuity for those lines of business. Let me hit a couple of quick pharmacy-related questions, and then we'll probably get to a point where we'll wrap up with some strategy broad question. But, obviously, nothing is more interesting to me than PBM and PBM migration. So if you could talk a little bit about- Sounds like you've been through a bad one back in your managed care days. Yeah, maybe. But could you just talk about, like, both how the migration is going, but also from an economic standpoint, maybe how we ought to be thinking about, is that coming in, where it came in, like, full force at the beginning and it's stable over the year, or is it something that scales up over time? Yeah. So as we've talked about, right after January first, the team did a phenomenal job on the industry's, what we believe is industry's largest ever big bang PBM conversion. And I've been through some good ones, going back, you know, back when you and I were in the nineties in managed care. There's been some rough ones as well. So you learn along the way, and because we had built that skill set, both at WellCare and then also at Centene, moving back and forth with some smaller PBMs, the team has had a really good partner at ESI in the process. And so operationally, not perfect, but really good. You know, macro, given the complexity of PBM conversion, because think about it, every single member is gonna access pharmacy, not like other benefits where you may or may not use them. Most members are accessing pharmacy. So operationally, well, we also learned along the way, going back to 2014 and all the way through the current, how to structure contracts, how to make sure that, you know, as a payer, you're overseeing the PBM and you're structuring contractual terms that are pretty tight. And we did that as well with our partner. And so the economics are being delivered. There is one thing I'm still negotiating, that I expect from my good friends at Express, that we talked about yesterday. But, very good collaboration with the team there, and the economics are coming in as expected. That was effective 1/1. Then as we move ahead, we are constantly looking on behalf of taxpayers, on behalf of the federal and state governments, doing our job to make sure we can provide affordable care. That, that's been a really good process. That's great to hear. And then you've become quite a large Part D player. So just interested in kind of the strategic vision. Is this an opportunistic thing with a great new PBM contract that you're in and out of? Or is this something that's like a core element that you see as being, you know, a durable element of kind of lines of business for you? Well, it's been durable since 2006- Yeah. with the MMA, and it's good that we've been in the business that long, because as payers through the IRA step into more and more of the risk, you know, managing the risk of that population, as opposed to the federal government underwriting it, there's a pretty big step from 2024 to 2025, with payers stepping into 60% of the core, you know, the risk corridor on the catastrophic phase versus 20% in 2024. So ... Macro, we view that product strategically, really for two purposes, though it's got to stand on its own and make money. It's not, you know, it's not being subsidized by other parts of the business. But number one is the strategic value that we get from that pharmacy spend, which is really heavy in Part D. I think it's over 6 million members in the PDP business. You may not realize that because it's only over $4.5 billion of revenue, 'cause it's just the pharmacy benefit this year. But that pharmacy spend helps us go negotiate and, you know, go to market and own the supply chain and get cost structure for the rest of our business. And then, two, longer term, as we improve the attractiveness of our Medicare product, focus, like Sarah laid out earlier, it's a great sort of hunting ground for conversions. Because really, economically, a senior should view the Medicare Advantage product more attractive than fee-for-service, plus a PDP on top of that. Well, as we're getting near the end, maybe just to wrap up, ordinarily, at the beginning, we'd like launch right into the story. We kinda launch right into the 8-K. So we'll flip it in this session. But could you just for especially for the portfolio managers, kinda lay out, okay, here's the case. I think, again, I think you did that really nicely at the end of yesterday, as you kind of provided very good long guidance and direction for folks. But, you know, what, what's sort of the vision for Centene, and where do you see it as attractive from an investor perspective? Yeah, so, long term, right, our goal is to provide affordable access to low-income and near low-income Americans, and we believe that is by focusing, today on the three core lines of business that we have, Medicaid, Medicare, Marketplace. Those are the fastest growing. They are the growth segments in our market overall. You heard Lance talk about what's happening in the group market. The growth segments are the segments we're in. We are purely focused on those, and within each one, there is tremendous embedded growth. So we talked about the organic growth that is out there within Medicaid. All of those dollars, that are not either not in managed care yet or that Centene is not yet managing, in Medicare, that is, that long term, we still believe that that's a great growth business. Medicare Advantage still has penetration opportunity, and within that, we think that the dual segment, again, is sort of a free option in terms of where the market is going. And our unique overlap between Medicaid and Medicare positions us beautifully for that. And then we've seen awesome growth in the Marketplace, but overall, macro, the belief that that is a stable chassis, that it will have partisan support, and that it will continue to grow organically in serving low-income Americans in individual products, but also start to be the vehicle by which large group-mid- to large group insurance starts to become an individual, customized, portable product in the United States. So we have a number one position in Medicaid, we have a number one position in Marketplace, and we have a focused Medicare book that is directly at the convergence of where policy is headed. And, you know, couldn't be more excited about the work that we're doing underneath to ensure that the company has the operating discipline, the execution, and the innovation. So think about, you know, our local model around health equity. Think about the power of the data that we have to drive insight, to drive automation. You ask me about AI, Lance, I'm just- I know. But, like, it is all there. That is a superpower, that will help us go after, I think, the fastest growing segment, within the market. That's great. Well, we've got three minutes left. AI couldn't take longer than that. So, why don't you talk about- Easy to answer the question. But, like, just maybe just to frame it for the audience, what do you perceive to be kind of the biggest AI opportunities in healthcare and in Centene? There are so many. Well, then the follow-up. Yeah. Okay, so AI is great. AI is useless if you don't have data, and health insurers have a lot of data. And so there's a tremendous opportunity to administrate healthcare better, faster, cheaper. Very quick example, today we have to take a lot of materials and translate it into 87 different languages. ChatGPT can do that, right? So all of that cost and, you know, all those intermediaries just goes away. Contract interpretation, you know, all that stuff, better, faster, cheaper. And then if you think about, you know, what works in healthcare, how do you actually drive health improvement, whether that's therapeutic, whether that's intervention, being able to crunch through a global set of data and then drive that down to an individual level of precision, we're only gonna be able to do that with AI. Big forms of data and then well trained in healthcare, and then focused on the individual. It fundamentally changes the level of quality that you get in the provider experience, and ultimately, the level of agency that you get in the individual navigating their own patient journey. Well, thank you so much. I appreciate our chat. Thank you all for attending, and we'll give a great rest of the day. I know you got a very full lineup. Thank you. Thanks. Thanks, everyone.