Operator: Thank you. Our next question today comes from Scott Fidel with Stephens. Please go ahead.
Scott Fidel: Hi, thanks. Good morning. Just wanted to pivot back to Medicare. Interested if you could sort of talk through for us just on the inpatient side, it doesn’t seem like you saw anything unusual in the fourth quarter, but do want to confirm whether or not you did see any type of mix shift towards more short stay inpatient visits, a reduction in observation visits as mentioned by a large peer in Medicare. Then just sort of sticking on this potential theme, would love just your feedback and thoughts around the implementation of the two midnight rule for MA and how you’re factoring that into your 2024 outlook. Thanks.
Drew Asher: Yes, thanks Scott. As Sarah said, at a high level, inpatient was pretty steady throughout 2023, and you go a couple clicks below that, we looked at case mix, admits per thousand, obs per thousand, we didn’t see a Q4 uptick in inpatient. If you look at observation days, we saw no meaningful shift in observation days. We all know the two midnight rule doesn’t start until 1/1/24, but we’ve been on top of that, preparing for that, thinking through that as we formulated our forecasts for 2024, and we think we’ve got that captured. Obviously the industry, we can still do medical necessity on that, but yes, we’ll be observing that two midnight rule beginning in January.
Operator: Thank you. Our next question today comes from Lance Wilkes with Bernstein. Please go ahead.
Lance Wilkes: Great. Could you talk a little bit about the pipeline and the upcoming bids with respect to Medicaid, some of the upcoming RFP awards? Then more broadly, Sarah, if you could talk a little bit to as you’ve gone through some of the recent wins and as you’re looking at satisfaction scores within states, what are areas of strength that are helping you with either retention or new wins, and are there particular areas of opportunity and what are some of the plans to address some of those areas? Thanks.
Sarah London: Yes, thanks Lance for the question. As you pointed out, we’ve had some great positive momentum of late with New Hampshire, Arizona, North Carolina expansion, as well as Oklahoma, and that makes us feel good as we roll into what’s an active RFP season. We obviously have Florida in flight, and really proud of the sunshine team and the work they’re doing, as well as Georgia, and then Texas for later this year and 2025 go-live, so we continue to track that. We continue to have, I believe, the best BD team in the business, incredibly strong local teams that are being really thoughtful and incrementally forward looking in terms of, as we said at investor day, making sure that we’re competing on promises kept, not just promises made.
That, I think goes to the second part of your question, which is really what are we seeing in the market in terms of the investments we’ve made over the last two years around customer satisfaction and that local community partnership, and we’re really starting to see improvement in terms of partner satisfaction, provider relationships, as well as quality. If you look at our Medicaid quality scores year-over-year, you’re seeing really nice improvement there. Those have been things at the top of our list in terms of focus over the last two years, and I think starting to see those bear fruit, those are really important drivers as states think about who they want as partners relative to the managed Medicaid business. I would say the other major theme that we continue to hear and we continue to be focused on pretty organically, frankly, is health equity, and so the emergence of the 11/15 waivers and thinking about how to put dollars into things like housing, food, jobs, childcare that ultimately drive pretty significant healthcare outcomes, and that’s something that states are increasingly interested in partnering over.
Again, it’s something that Centene has been naturally focused on as a by-product of being local in our approach and having the strengths of those longstanding incumbent relationships. I think really good improvement in the places that we’ve focused and really good core strength in the areas that are going to matter going forward.
Operator: Thank you. Our next question today comes from Cal Sternick with JP Morgan. Please go ahead.
Cal Sternick: Yes, thanks for the question. I wanted to ask two on the marketplace. First, could you talk about the demographic trends of the incremental membership you got, so any insight on the acuity and metal mix of the extra members you added compared to what you initially anticipated? Then on ICRA [ph] and the Indiana pilot, how many members did you enroll in that product and what are some of the key milestones you’re looking to evaluate the pilot as you move through this year? Thanks.
Sarah London: Thanks Cal for the question. As you’ve heard, the demographics for the population that came in during OEP for us were pretty consistent with our expectations, and the distribution of tiers between silver, gold and bronze, also pretty consistent. We still have the majority of our members in that silver tier, so the demographics have not shifted materially. One of the things that I think is interesting – this may just be the data geek in me – but if you look at what we’re seeing, not just in our book but overall in the market, there are some interesting small shifts in the demographics overall that I think tell us a lot about what’s actually driving the underlying growth, above and beyond just what we know in terms of affordability and awareness from the enhanced [indiscernible] and the additional marketing dollars going into navigators and the broker channel.
