Daniel J. Schumacher - Chief Operating Officer and Chief Financial Officer, UnitedHealthcare, UnitedHealth Group, Inc.
Management
Good morning, Chris. Dan Schumacher. So, first and foremost, just as a reminder, coming into the year, our expectation was for a moderate increase in underlying utilization trend. That's what informed our pricing, our entire benefit planning as well as the guidance we've provided. And that's what we were able to manage to in the second quarter, very consistent with our conversation in the first quarter and very much in line with our expectation. It's kind of looking at how trends progress through the year. Typically, we talk in annual terms. But as we look to the quarters, we certainly don't view Q2 use as having accelerated beyond the Q1 rate. If anything, I'd probably tell you that Q2 is perhaps a little bit lower. To your questions about the categories themselves, the bigger drivers of our trend are certainly in pharmacy and outpatient, as Dave mentioned, and then working against that is more moderate levels of trend, as we drive down per capita use on an inpatient basis. The pharmacy piece, I will tell you that's largely driven by Hepatitis C. So, we changed our coverage criteria effective 1/1 of 2016 in our commercial business, so we expanded coverage. And that's what's really driving that 8% to 9% pharmacy trend on a commercial basis that we talked about back at the investor conference. And then if you look to the outpatient side, inside there, we see elevated levels of emergency room. Surgical procedures are contributing, also facility-based – facility-dispensed prescriptions, so that's kind of oriented more around the oncology space. So, those are some of the bigger contributors, and not surprisingly, that is absolutely where our medical management efforts are focused to work down those costs. All of those categories, I will tell you, are within the ranges that we expressed at the investor conference, probably a little bit higher on the outpatient side, in line in the pharmacy space, a little bit better on the inpatient side, but net-net, we still expect, on a commercial basis, our full year medical trend to be in the range of 6% plus or minus 50 basis points.