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    Stephen Baxter • Wells Fargo

    Stephen Baxter's questions to Cardinal Health Inc (CAH) leadership

    Stephen Baxter's questions to Cardinal Health Inc (CAH) leadership • Q4 2025

    Question

    Stephen Baxter of Wells Fargo & Company asked for the specific dollar impact of the pharma items that caused the Q4 miss and for a breakdown of the elevated 'other income' line to isolate the revaluation impact.

    Answer

    CFO Aaron Alt confirmed the analyst's estimate that the pharma items were in a range that would have placed results above the guidance midpoint. For the 'other income' details, he referred the analyst to the forthcoming 10-K filing.

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    Stephen Baxter's questions to Cardinal Health Inc (CAH) leadership • Q3 2025

    Question

    Stephen Baxter sought clarity on the specific level of tariffs assumed in the company's guidance and asked about the process for reversing price increases if the tariff situation moderates.

    Answer

    CEO Jason Hollar stated the guidance is based on the tariff landscape as of 'literally today.' He explained that future sourcing and pricing decisions depend on relative tariff rates between countries, not just absolute levels. He highlighted that while North American production is now over 50% of value, the 10% of product from China remains a key driver of tariff costs and will continue to influence the financial impact.

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    Stephen Baxter's questions to Cardinal Health Inc (CAH) leadership • Q1 2025

    Question

    Stephen Baxter asked for clarification on the pharma guidance raise, questioning whether it reflects the annualization of Q1's underlying strength or is simply pulling forward the Q1 beat.

    Answer

    CEO Jason Hollar explained it was a combination of factors. He noted that the broad volume growth seen in Q1 is expected to return to more normalized levels for the rest of the year. The favorable product mix in Q1 is not assumed to continue, while ongoing cost reductions are a consistent but smaller factor. The guidance for Q2-Q4 reflects a more normalized performance, adjusted for the known COVID vaccine timing headwind in Q2.

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    Stephen Baxter's questions to Concentra Group Holdings Parent Inc (CON) leadership

    Stephen Baxter's questions to Concentra Group Holdings Parent Inc (CON) leadership • Q2 2025

    Question

    Stephen Baxter of Wells Fargo asked why the updated guidance reflected a larger percentage increase in revenue than in EBITDA. He also inquired about the timing of any potential benefit from the 'doc fix' legislation and whether rising employer health costs are increasing demand for Concentra's on-site model.

    Answer

    President & CFO Matthew DiCanio explained the conservative EBITDA guidance reflects ongoing, non-recurring M&A transition costs. CEO Keith Newton added that any 'doc fix' benefit would likely materialize in 2026, not 2025, due to state-specific timelines. He confirmed that while rising health costs are a factor, the primary driver of new on-site business is Concentra's new, competitive advanced primary care offering, which gives them a 'seat at the table' with employer benefits departments.

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    Stephen Baxter's questions to Concentra Group Holdings Parent Inc (CON) leadership • Q1 2025

    Question

    Stephen Baxter asked for details on the expected timing and revenue contribution of the Pivot acquisition within the updated guidance and inquired about how employer services rates have historically performed during uncertain economic cycles.

    Answer

    Executive Matthew DiCanio stated that the Pivot deal is expected to close late in Q2, contributing approximately half a year of its $60 million in annualized revenue to 2025 results. He explained the guidance raise was deliberately prudent, reflecting a strong Q1 but also accounting for macroeconomic uncertainty. Executive William Newton added that employer services pricing has historically trended with inflation. The company typically sets new rates late in the year, and these adjustments have been well-received by customers with minimal pushback, as evidenced by the 3.9% rate growth seen in the current quarter.

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    Stephen Baxter's questions to Concentra Group Holdings Parent Inc (CON) leadership • Q4 2024

    Question

    Stephen Baxter of Wells Fargo requested more context on the degree of improvement expected in the Employer Services business for 2025. He also asked about underlying rate trends for both workers' comp and employer services, excluding the significant Florida fee schedule update.

    Answer

    Executive Matthew DiCanio explained that after recent quarterly declines of 4-5% in Employer Services visits, early 2025 trends are 'a decent bit better,' with guidance assuming a progression to flat and then slightly positive growth by year-end. Regarding rates, both DiCanio and Executive William Newton confirmed that underlying rate growth, even excluding Florida, is expected to be 'slightly elevated' and 'stronger' than in the past year, influenced by inflationary pressures.

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    Stephen Baxter's questions to Concentra Group Holdings Parent Inc (CON) leadership • Q3 2024

    Question

    Stephen Baxter of Wells Fargo asked about the company's controllable growth levers, such as strategies to deepen relationships with employers, and how the economic sensitivity of the sales cycle affects these efforts.

    Answer

    Executive William Newton explained that the company's strategy to increase penetration is consistent across economic cycles. He detailed a multi-channel sales approach that targets not only employers directly but also key ecosystem partners like third-party claims administrators (e.g., Sedgwick), workers' comp insurers (e.g., Liberty Mutual), and employer services aggregators (e.g., eScreen) to drive patient volume.

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    Stephen Baxter's questions to Pennant Group Inc (PNTG) leadership

    Stephen Baxter's questions to Pennant Group Inc (PNTG) leadership • Q2 2025

    Question

    Stephen Baxter of Wells Fargo sought clarification on the updated guidance, asking for a breakdown of the revenue raise between organic and acquired sources, updated same-store growth expectations, and the key drivers behind the implied year-over-year margin improvement in the second half of the year.

    Answer

    CFO Lynette Walbom attributed approximately $6 million of the revenue raise to the GranCare acquisition and reiterated growth targets. CEO Brent Guerisoli outlined several drivers for second-half margin expansion, including operational improvements, a decline in the hospice cap impact, the positive hospice final rule rate update, growing contributions from recent acquisitions like Signature and GranCare, and continued momentum in the senior living segment.

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    Stephen Baxter's questions to Pennant Group Inc (PNTG) leadership • Q1 2025

    Question

    Stephen Baxter of Wells Fargo asked a series of questions covering several key areas. He inquired about the drivers of reaccelerated same-store growth in home health and hospice, the components of the updated annual guidance, the strategic rationale behind the potential UnitedHealth-Amedisys asset acquisition, the sustainability of strong rate growth in senior living amid macro uncertainty, and the current hiring and labor inflation environment.

    Answer

    President and COO John Gochnour and CEO Brent Guerisoli addressed the questions. Gochnour attributed the Q1 growth rebound to normal seasonality after a holiday-related Q4 dip and noted positive hiring trends with normalizing wage inflation (3.2% in home health/hospice, ~5% in senior living). Guerisoli confirmed strong performance in both segments is driving the company toward the high end of its guidance. Regarding M&A, he cited the successful Signature integration as a model for larger deals, emphasizing their focus on leadership capacity. He also explained that strong senior living rate growth was a result of a deliberate focus on revenue quality, which now allows for a dual focus on occupancy.

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    Stephen Baxter's questions to Pennant Group Inc (PNTG) leadership • Q4 2024

    Question

    Stephen Baxter asked about the drivers of the guided EBITDA margin improvement for 2025, seeking to understand the balance between recently acquired assets and same-store performance. He also requested more detail on the Q4 hospice cap issue, including operational remedies and its potential drag on 2025 results.

    Answer

    CFO Lynette Walbom stated that while recent acquisitions will create some noise, she expects the home health margin to be in the high 15% to low 16% range and the senior living margin to improve toward 10.5%. President and COO John Gochnour explained the $1.7 million Q4 hospice cap impact was primarily from California and that the company is adjusting referral patterns to mitigate it. He anticipates a reduced drag in 2025, potentially one-third of the 2024 impact, as they work to eliminate the issue.

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    Stephen Baxter's questions to Mckesson Corp (MCK) leadership

    Stephen Baxter's questions to Mckesson Corp (MCK) leadership • Q1 2026

    Question

    Stephen Baxter of Wells Fargo & Company asked about the potential impact of a rising uninsured rate on pharmaceutical demand, particularly for the U.S. Pharma segment in the second half of the year.

    Answer

    CEO & Director Brian Tyler downplayed the potential for a material impact, noting that proposed Medicaid cuts are spread over a long period and represent a small fraction of total healthcare spending. He argued that, historically, people who need care tend to find ways to receive it, even if it becomes uncompensated, suggesting that underlying demand for care remains relatively stable despite changes in coverage.

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    Stephen Baxter's questions to Mckesson Corp (MCK) leadership • Q3 2025

    Question

    Stephen Baxter of Wells Fargo asked management to identify any potential headwinds or significant swing factors that should be considered for the fiscal 2026 earnings baseline, beyond the positive drivers already mentioned.

    Answer

    CFO Britt Vitalone pointed to the onboarding of a large strategic customer during fiscal 2025 as a key item to consider when establishing a baseline for the next year. Otherwise, he reiterated the strong underlying performance of the business, particularly in pharmaceutical distribution and specialty areas like oncology.

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    Stephen Baxter's questions to Cencora Inc (COR) leadership

    Stephen Baxter's questions to Cencora Inc (COR) leadership • Q3 2025

    Question

    Stephen Baxter of Wells Fargo & Company requested an explanation for the acceleration in U.S. Healthcare operating income growth from 23% in the prior quarter to 29% in the current quarter, questioning if factors beyond the RCA acquisition's contribution were at play.

    Answer

    EVP & CFO James Cleary confirmed that while RCA contributed to the year-over-year growth rate, the outperformance was primarily driven by the fundamental strength of the core business. He highlighted exceptional execution and broad-based strength in the U.S. segment, particularly strong utilization trends and sales of specialty products to physician practices and health systems. He also noted a reduced headwind from COVID-19 compared to prior periods.

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    Stephen Baxter's questions to Cencora Inc (COR) leadership • Q1 2025

    Question

    Stephen Baxter from Wells Fargo & Company asked for the U.S. business's organic guidance revision, excluding RCA, and for more detail on the expected ramp-up of RCA's accretion during fiscal 2025.

    Answer

    CFO James Cleary stated that while an exact organic number isn't provided, the U.S. segment's performance ex-RCA is well above the initial 5-6.5% guidance range. He explained that RCA's expected $0.35 accretion will ramp up over the fiscal year, driven by business growth and the execution of strategic initiatives.

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    Stephen Baxter's questions to Oscar Health Inc (OSCR) leadership

    Stephen Baxter's questions to Oscar Health Inc (OSCR) leadership • Q2 2025

    Question

    Stephen Baxter of Wells Fargo inquired about the potential impact from CMS's scrubbing of duplicative enrollments, the magnitude of the provision for higher Q4 utilization, and Oscar's confidence that state regulators will approve its refiled, higher rates for 2026.

    Answer

    CFO Scott Blackley reiterated that the dual-eligible member impact is small and factored into guidance, and while a Q4 utilization increase is contemplated, it will be moderated by initiatives like FWA investments. CEO Mark Bertolini expressed high confidence in rate approvals, noting that regulators have been receptive and are focused on ensuring market stability.

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    Stephen Baxter's questions to Oscar Health Inc (OSCR) leadership • Q1 2025

    Question

    Stephen Baxter of Wells Fargo inquired about the proportion of grace period membership in the quarter, its effect on MLR seasonality, and the specific value of the 2024 risk adjustment true-up, as well as its influence on 2025 projections.

    Answer

    CFO Scott Blackley explained that the gap between effectuated and paid members was normalizing and would reach typical levels in Q2. He detailed that the net unfavorable prior period development (PPD) of $30 million was driven by a $92 million increase to the 2024 risk adjustment payable, which was partially offset by favorable claims runout. This PPD accounted for approximately 60 basis points of the year-over-year MLR increase.

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    Stephen Baxter's questions to Oscar Health Inc (OSCR) leadership • Q4 2024

    Question

    Stephen Baxter asked for a detailed discussion on payment integrity, effectuation rates, and assumptions for enrollment declines due to reverification programs.

    Answer

    CEO Mark Bertolini clarified that Oscar is now reporting 1.8 million paid members, a more conservative figure than the 1.98 million effectuated members, to account for a 9.1% non-payment assumption. CFO Scott Blackley added that the risks from broker restrictions and the 'file to reconcile' process have already been incorporated into the company's full-year revenue guidance, making the 1.8 million member count a de-risked starting point for 2025.

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    Stephen Baxter's questions to Oscar Health Inc (OSCR) leadership • Q3 2024

    Question

    Stephen Baxter from Wells Fargo Securities inquired about Oscar's competitive positioning for 2025, noting the company's 6% rate increase versus the market's 7%, and asked for clarification on the drivers of the higher-than-expected pressure from Special Enrollment Period (SEP) members.

    Answer

    CEO Mark Bertolini characterized the pricing market as largely rational and stable, dismissing competitors chasing market share as unsustainable. CFO Scott Blackley explained that the SEP pressure stems from a higher volume of new members than anticipated, not from poor performance, which has been in line with expectations. This volume impacts the in-year Medical Loss Ratio (MLR) due to partial-year risk adjustment dynamics.

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    Stephen Baxter's questions to CVS Health Corp (CVS) leadership

    Stephen Baxter's questions to CVS Health Corp (CVS) leadership • Q2 2025

    Question

    Stephen Baxter of Wells Fargo & Company asked about Group Medicare Advantage margins, specifically where the recent PDR places margins for 2025 and if the 2026 repricing effort is expected to restore target margins in a single cycle.

    Answer

    EVP & President - Aetna, Steve Nelson, explained that Group MA contracts are typically 3-5 years long and that the company is taking a disciplined approach to renewals to achieve target margins, acknowledging that it can sometimes take more than one cycle to reach that goal.

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    Stephen Baxter's questions to CVS Health Corp (CVS) leadership • Q1 2025

    Question

    Stephen Baxter requested clarification on the Health Care Benefits guidance, asking about the nature of the prior period revenue adjustments and which business lines they affected. He also asked if the projected variable loss from exiting the individual exchange business is the correct way to estimate the future earnings benefit.

    Answer

    CFO Tom Cowhey clarified that the favorable reserve development occurred across all business lines, with the majority from Q4 2024 dates of service, and the net impact on the bottom line was the $400 million guidance increase. He confirmed the year-over-year earnings improvement from exiting the individual exchange business should be viewed as the elimination of the variable loss, which is projected to be $350 million to $400 million for 2025, while noting uncertainty around reallocating fixed costs.

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    Stephen Baxter's questions to CVS Health Corp (CVS) leadership • Q3 2024

    Question

    Stephen Baxter asked to differentiate between utilization trends driven by benefits being restructured for 2025 versus more core trends, and questioned why a PDR might be needed for group MA but not individual MA or the exchanges.

    Answer

    CFO Tom Cowhey explained that PDR calculations differ by product; group MA contracts are often multi-year, limiting the ability to make swift improvements. For the individual exchange business, he noted that double-digit rate increases and an expected 20-25% membership reduction should improve 2025 performance, avoiding a PDR. He identified elevated supplemental benefits, inpatient/outpatient services, and medical pharmacy as key trend drivers. CEO J. Joyner added that the company is proactively addressing these known issues.

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    Stephen Baxter's questions to Humana Inc (HUM) leadership

    Stephen Baxter's questions to Humana Inc (HUM) leadership • Q2 2025

    Question

    Stephen Baxter from Wells Fargo asked for Humana's perspective on inpatient utilization trends in Medicare Advantage during the second quarter, noting a competitor had reported an acceleration.

    Answer

    CFO Celeste Mellet responded that Humana's inpatient trends are developing in line with, or on the better end of, their expectations when considering both admissions and cost per unit. She explicitly stated, 'we're not seeing an acceleration of anything.'

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    Stephen Baxter's questions to Humana Inc (HUM) leadership • Q1 2025

    Question

    Stephen Baxter inquired about Humana's visibility on risk adjustment following significant membership changes and asked for an update on Group MA performance in light of recent industry commentary.

    Answer

    George Renaudin, President of the Insurance Segment, reported a favorable shift toward higher lifetime value members and confirmed Group MA is performing as expected, with no unusual behavioral changes from repricing. CFO Celeste Mellet added that the V28 risk model impact is materializing as anticipated and was factored into guidance.

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    Stephen Baxter's questions to Humana Inc (HUM) leadership • Q3 2024

    Question

    Stephen Baxter inquired about the impact of the 2-midnight rule on Q3 results, given better-than-expected inpatient unit costs, and asked about the 2025 outlook's capacity to absorb potential cost volatility.

    Answer

    CFO Susan Diamond explained that the trend of lower inpatient unit costs has been durable throughout the year and that Q3 also benefited from lower-cost seasonality (flu/respiratory). She stated that these updated cost dynamics are fully embedded in the baseline for 2025 planning, and management feels confident in its unit cost trend assumptions for next year.

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    Stephen Baxter's questions to Centene Corp (CNC) leadership

    Stephen Baxter's questions to Centene Corp (CNC) leadership • Q2 2025

    Question

    Stephen Baxter of Wells Fargo followed up on the Medicaid outlook, asking for more detail on the cost assumptions underlying the guided 93.5% MLR for the second half, as it implies rate increases must drop through with minimal cost growth.

    Answer

    CEO Sarah London and CFO Drew Asher addressed the question. London emphasized that levers within their control, like utilization management, are key. Asher provided specifics, stating the forecast includes a greater than 4% lift in medical expense PMPMs for the second half versus the first. He also noted the forecast is prudent, as it does not include potential upside like a retroactive premium adjustment from Florida, and highlighted the power of the 5% rate increase coming in Q3.

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    Stephen Baxter's questions to Centene Corp (CNC) leadership • Q2 2025

    Question

    Stephen Baxter of Wells Fargo sought more detail on the assumptions underpinning the guided Medicaid MLR improvement to 93.5% in the second half, asking specifically about cost growth expectations and projected membership trends.

    Answer

    EVP & CFO Drew Asher provided specifics, stating that the forecast includes a 5% rate increase impacting 29% of revenue in Q3. Critically, he noted that the company has baked in a more than 4% lift in medical expense PMPMs for the second half versus the first, indicating they are not assuming flat cost trends. He added that potential tailwinds, like a retroactive payment in Florida, are not included in the forecast.

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    Stephen Baxter's questions to Centene Corp (CNC) leadership • Q1 2025

    Question

    Stephen Baxter asked for clarification on the expected progression of the Medicaid MLR throughout the year, noting that significant improvement is needed in the latter half to meet the full-year guidance after a high Q1 result.

    Answer

    CEO Sarah London explained the progression relies on two levers: securing adequate rates, supported by stronger data on member acuity, and internal clinical and operational initiatives to manage costs. EVP and CFO Andrew Asher added that the full-year rate goal is 4%+, implying a back-half rate assumption in the mid-3s, along with benefits from program changes like regaining pharmacy management in one state.

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    Stephen Baxter's questions to Centene Corp (CNC) leadership • Q4 2024

    Question

    Stephen Baxter questioned the conservatism of the Medicaid rate assumptions for the remainder of 2025, noting that the strong 1/1 rates suggest the placeholder for the rest of the year might be low.

    Answer

    CEO Sarah London reiterated the full-year 2025 composite rate expectation of 3% to 4%. She acknowledged that more robust data is improving rate conversations with state partners and noted that states are now more open to mid-year adjustments. However, she cautioned that the timing of achieving rate and acuity equilibrium may still play out over the course of the full year.

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    Stephen Baxter's questions to Centene Corp (CNC) leadership • Q3 2024

    Question

    Stephen Baxter inquired about the expected Medicaid Medical Loss Ratio (MLR) for the fourth quarter, any retroactive rate impacts in Q3, and the underlying cost growth trends in the Medicaid business.

    Answer

    CEO Sarah London highlighted that proactive state dialogues and data sharing led to a composite rate adjustment in the high 4% to 5% range. CFO Andrew Asher added that Q3 represents the 'high watermark' for the Medicaid HBR, with Q4 expected to improve due to new rates taking effect. He also noted typical seasonal HBR increases in Medicare and Commercial for Q4.

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    Stephen Baxter's questions to Molina Healthcare Inc (MOH) leadership

    Stephen Baxter's questions to Molina Healthcare Inc (MOH) leadership • Q2 2025

    Question

    Stephen Baxter from Wells Fargo inquired about Molina's forecast for the market-wide enrollment decline in the ACA exchanges for 2026, the magnitude of the acuity shift being priced in, and the company's planned response if states reject their requested rate hikes.

    Answer

    CFO Mark Keim stated that specific forecasts are competitive and vary significantly by state, so national averages are not as useful. CEO Joseph Zubretsky added that their pricing models are complex and that the risk of mispricing is mitigated because most states have confirmed they will allow a "second pass" rate filing, enabling the use of the most current data available.

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    Stephen Baxter's questions to Molina Healthcare Inc (MOH) leadership • Q1 2025

    Question

    Stephen Baxter asked for details on the Q1 Marketplace MCR increase, specifically the drivers behind the risk adjustment and member reconciliation items, and why they should be considered nonrecurring.

    Answer

    CEO Joseph Zubretsky and CFO Mark Keim explained that the 400 basis point MCR elevation was driven by three nonrecurring items: a final 2024 risk adjustment true-up, a one-time CMS member reconciliation scrub, and the initial higher MCR from the new ConnectiCare acquisition. Keim broke down the $40 million impact as roughly one-third from each factor, expressing confidence that the issues are contained to the prior year.

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    Stephen Baxter's questions to Molina Healthcare Inc (MOH) leadership • Q4 2024

    Question

    Stephen Baxter of Wells Fargo asked for a detailed breakdown of the fourth-quarter Medicaid MLR, seeking to identify any impacts from new stores, retroactivity, or prior period development to better understand the 2025 guidance jump-off point. He also requested the year-end IBNR balance.

    Answer

    CEO Joe Zubretsky characterized the Q4 Medicaid MCR as 'very, very clean,' stating it was driven purely by higher-than-forecasted medical trend (1.2% vs. 50 bps forecast) without any one-time items or retros. He cited pressure from LTSS, pharmacy, and behavioral health. CFO Mark Keim addressed reserves, reporting Days in Claims Payable (DCP) at 48, consistent with the prior quarter and within the historical average range of 47-51, affirming confidence in the $4.6 billion medical claims payable balance.

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    Stephen Baxter's questions to Tenet Healthcare Corp (THC) leadership

    Stephen Baxter's questions to Tenet Healthcare Corp (THC) leadership • Q2 2025

    Question

    Stephen Baxter of Wells Fargo asked about the appropriate EBITDA jump-off point for 2026, specifically questioning if it's as simple as removing the out-of-period Medicaid supplemental payments or if other one-time items should be considered.

    Answer

    Chairman & CEO Saum Sutaria directly stated that the company is not providing any comments on 2026 or discussing future headwinds and tailwinds at this time.

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    Stephen Baxter's questions to Tenet Healthcare Corp (THC) leadership • Q1 2025

    Question

    Stephen Baxter asked about Tenet's decision not to raise full-year guidance despite the Q1 beat and questioned the drivers of USPI's high revenue per case growth, noting that total joint case growth was lower than the prior year.

    Answer

    Saumya Sutaria, Chairman and CEO, stated that the company is not addressing guidance this early in the year but acknowledged the fundamental outperformance. He attributed USPI's revenue per case growth to the contracting platform, higher acuity, and a strategic shift away from lower acuity work, adding that as the platform grows, percentage growth rates for joints will naturally moderate.

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    Stephen Baxter's questions to Tenet Healthcare Corp (THC) leadership • Q4 2024

    Question

    Stephen Baxter requested a quantification of how much new hospital capacity will be online in 2025 to better understand the drivers of the 2-3% same-store volume guidance.

    Answer

    Dr. Saum Sutaria, Chairman and CEO, explained that the growth is driven by both market-level demand and selective capacity expansion, with market demand being the majority contributor. While he did not provide a specific quantification, he emphasized that service line choices and strong underlying demand patterns support the growth outlook.

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    Stephen Baxter's questions to Tenet Healthcare Corp (THC) leadership • Q3 2024

    Question

    Stephen Baxter questioned the hospital segment's Q4 earnings guidance, noting it implied a different seasonal cadence than usual. He also asked if any unusual positive or negative items impacted the hospital business in Q3.

    Answer

    Chairman and CEO Dr. Saum Sutaria attributed the Q4 guidance primarily to the impact of the Alabama hospital divestiture. EVP and CFO Sun Park added that the prior year's Q4 included a significant out-of-period payment, making comparisons less straightforward, and he confirmed there were no one-time items of note in the Q3 2024 hospital results.

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    Stephen Baxter's questions to agilon health inc (AGL) leadership

    Stephen Baxter's questions to agilon health inc (AGL) leadership • Q1 2025

    Question

    Stephen Baxter inquired about the impact of the V28 risk model transition on 2025 performance, how it compares to 2024, and the expected pacing for the remainder of the phase-in.

    Answer

    CEO Steven Sell stated that the 2025 risk adjustment impact is in line with expectations, reflecting a 2% net increase year-over-year which includes a 3% headwind from V28. He attributed this to the continuity of care from long-standing PCP-patient relationships and a stable member base, noting the preparatory work was completed in 2024.

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    Stephen Baxter's questions to agilon health inc (AGL) leadership • Q4 2024

    Question

    Stephen Baxter asked for details on the P&L impact of 2025 Part D contracting changes and inquired about the actual Part D medical margin for 2024.

    Answer

    CEO Steven Sell explained the strategy was to reduce exposure to uncontrollable Part D risk, successfully lowering it to under 30% of membership. CFO Jeffrey Schwaneke clarified that Part D is recorded net within revenue. For the remaining members with Part D risk in 2025, the company has doubled the projected per-member-per-month (PMPM) loss from 2024 to conservatively account for the Inflation Reduction Act's impact.

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    Stephen Baxter's questions to agilon health inc (AGL) leadership • Q3 2024

    Question

    Stephen Baxter inquired about the specific driver for the upward revision to the Q2 cost trend and asked for the reasoning behind not using Q4 as a trend baseline, seeking clarity on a more appropriate historical period for seasonality.

    Answer

    CFO Jeffrey Schwaneke attributed the Q2 trend revision to the receipt of more complete paid claims data, which indicated that costs in the month of May were higher than initially anticipated. He advised against using Q4 as a baseline due to the business's strong seasonality, where Q4 is historically the highest cost quarter and not representative of a full-year run rate. He noted Q1 is typically much lower.

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    Stephen Baxter's questions to HCA Healthcare Inc (HCA) leadership

    Stephen Baxter's questions to HCA Healthcare Inc (HCA) leadership • Q1 2025

    Question

    Stephen Baxter sought clarification on the 5.4% managed care volume growth figure, asking if it included exchange volumes and requesting the growth rate for commercial managed care excluding exchanges.

    Answer

    CFO Mike Marks confirmed that the 5.4% same-facility equivalent admission growth for total managed care was inclusive of exchange plans. He then provided a breakdown, stating that exchange volumes grew 22.4%, while traditional employer-sponsored insurance volumes grew by just under 0.5% year-over-year.

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    Stephen Baxter's questions to HCA Healthcare Inc (HCA) leadership • Q4 2024

    Question

    Steve Baxter sought to reconcile the moving parts in the quarter, noting that the full-year supplemental Medicaid benefit was higher than previously discussed while the hurricane impact was at the high end of the range, and asked if this implied core performance was softer than it appeared.

    Answer

    CFO Mike Marks framed the quarter's results by highlighting the hurricane impact, the fact that Q4 had the lowest supplemental payment benefit of the year, a tough comparison to a very strong Q4 2023, and admission growth of 3% that was lower than the year-to-date trend. He concluded that given these factors, it was a good quarter and a solid launching point for 2025 guidance.

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    Stephen Baxter's questions to HCA Healthcare Inc (HCA) leadership • Q3 2024

    Question

    Stephen Baxter of Wells Fargo questioned the 3% to 4% volume growth assumption for 2025, asking how management is thinking about the impact from unusual coverage dynamics, such as moderating exchange growth and the stabilization of Medicaid.

    Answer

    CFO Mike Marks explained that the 2025 forecast anticipates a moderation in exchange enrollment growth to around 8-10%, down from over 30% in 2024. He also expects Medicaid volumes to flatten out as the redetermination process concludes. The net effect of these dynamics is expected to result in a generally stable payer mix for 2025.

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    Stephen Baxter's questions to UnitedHealth Group Inc (UNH) leadership

    Stephen Baxter's questions to UnitedHealth Group Inc (UNH) leadership • Q1 2025

    Question

    Stephen Baxter inquired about Medicare Advantage margins, asking where they are expected to land in 2025, the timeline for recovering to target levels, and the company's confidence in improving margins in 2026 if high utilization trends persist.

    Answer

    Timothy Noel, CEO of UnitedHealthcare Medicare & Retirement, responded that the anticipated 2025 MA margins remain within the company's targeted range, even with the revised outlook. Looking to 2026, he stated that by incorporating the current higher care activity levels into bids and pricing, they expect to return to their historical target margin levels.

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    Stephen Baxter's questions to UnitedHealth Group Inc (UNH) leadership • Q4 2024

    Question

    Stephen Baxter of Wells Fargo & Company asked for perspective on the 2026 Medicare Advantage advanced notice, including any areas of encouragement or concern, and whether the proposed reimbursement reflects the elevated cost trends seen in 2024.

    Answer

    Executive Timothy Noel noted the rates are preliminary and it's too early to speculate, but the company looks forward to engaging with the administration. CEO Andrew Witty added that the key is for rate-setting to be 'rational' and reflect actual cost trends, a dynamic he hopes will return to the MA rate process as it has in Medicaid.

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    Stephen Baxter's questions to UnitedHealth Group Inc (UNH) leadership • Q3 2024

    Question

    Stephen Baxter questioned if the three factors causing Q3 MLR pressure were equally weighted and asked for details on operational progress in managing provider coding and utilization.

    Answer

    John Rex, President & CFO, confirmed that the three factors—provider coding intensity, Medicaid rate timing, and specialty Rx acceleration—were 'roughly in the same zone' in terms of their impact in the quarter. Brian Thompson, CEO of UnitedHealthcare, added that aggressive inpatient upcoding from a few large systems has persisted, and the company remains vigilant in managing this practice to control costs for consumers.

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    Stephen Baxter's questions to Brightspring Health Services Inc (BTSG) leadership

    Stephen Baxter's questions to Brightspring Health Services Inc (BTSG) leadership • Q4 2024

    Question

    Stephen Baxter asked about the expected pace of margin change in the pharmacy business for 2025, questioning if the recent step-down due to mix would continue or moderate. He also asked what drove the decision to increase the full-year guidance.

    Answer

    Executive Jon Rousseau stated that outside of the mix impact from specialty growth, he expects margins within the Infusion and Home & Community pharmacy businesses to be stable or improve, driven by lower OpEx per script as volume scales. Regarding the guidance increase, Rousseau attributed it not to a single factor but to 'continued momentum and breadth of progress across the entirety of the organization' observed during a productive start to the first quarter.

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    Stephen Baxter's questions to Universal Health Services Inc (UHS) leadership

    Stephen Baxter's questions to Universal Health Services Inc (UHS) leadership • Q4 2024

    Question

    Stephen Baxter of Wells Fargo & Company asked for the size of the 2024 medical malpractice expense overage and its expected tailwind for 2025. He also inquired about the portion of 2025 guided DPP revenue that still requires program renewal.

    Answer

    Executive Steve Filton stated that UHS recorded $79 million in malpractice reserves above its original 2024 plan, and the non-recurrence of this expense is a key driver of 2025 EBITDA growth. He estimated that roughly half of the Directed Payment Program (DPP) revenue included in the 2025 forecast is from programs that are still pending annual renewal.

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    Stephen Baxter's questions to Universal Health Services Inc (UHS) leadership • Q4 2024

    Question

    Stephen Baxter asked for the size of the 2024 medical malpractice expense that exceeded the initial plan and inquired what percentage of the 2025 DPP guidance is tied to programs that still require renewal.

    Answer

    Executive Steve Filton specified that UHS recorded $79 million in additional malpractice reserves in 2024 beyond its original guidance, which is not expected to recur and thus provides a tailwind for 2025. For DPP renewals, he estimated that roughly half of the DPP revenue included in the 2025 forecast is from programs where approval is still pending.

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    Stephen Baxter's questions to Cigna Group (CI) leadership

    Stephen Baxter's questions to Cigna Group (CI) leadership • Q4 2024

    Question

    Stephen Baxter of Wells Fargo asked about the historical impact of stop-loss repricing on client retention and membership, and questioned why the margin recovery from current pressures might extend as far as 2027.

    Answer

    Brian Evanko, CFO, explained that Cigna's stop-loss is an integrated product, not standalone, which strengthens client relationships. He noted that these multifaceted relationships, which provide budget certainty, lead to high persistency, with over half of stop-loss clients having a tenure of five years or more. This history gives them confidence in their ability to balance margin recovery with client retention over the 2025-2027 period.

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