Acadia Healthcare Company Inc (ACHC) 2023 Q1 法說會逐字稿

Good morning, and welcome to Acadia Healthcare's First Quarter 2023 Earnings Conference Call. (Operator Instructions) Please also note that this event is being recorded today. I would now like to turn the conference over to Gretchen Hommrich. Please go ahead.

早上好，歡迎來到 Acadia Healthcare 2023 年第一季度收益電話會議。 （操作員說明）另請注意，今天正在記錄此事件。我現在想將會議轉交給 Gretchen Hommrich。請繼續。

Good morning, and welcome to Acadia's First Quarter 2023 Conference Call. I'm Gretchen Hommrich, Vice President of Investor Relations for Acadia. First, provide you with our safe harbor before turning the call over to our Chief Executive Officer, Chris Hunter. To the extent any non-GAAP financial measure is discussed in today's call, you'll also find a reconciliation of that measure to the most directly comparable financial measure calculated according to GAAP on our website by viewing yesterday's news release under the Investors link.

早上好，歡迎來到阿卡迪亞 2023 年第一季度電話會議。我是 Acadia 投資者關係副總裁 Gretchen Hommrich。首先，在將電話轉交給我們的首席執行官克里斯亨特之前，為您提供我們的安全港。如果在今天的電話會議中討論了任何非 GAAP 財務指標，您還可以通過在投資者鏈接下查看昨天的新聞稿，在我們的網站上找到該指標與根據 GAAP 計算的最直接可比財務指標的對賬。

This conference call may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including statements, among others, regarding Acadia's expected quarterly and annual financial performance for 2023 and beyond. You are hereby cautioned that these statements may be affected by the important factors, among others, set forth in Acadia's filings with the Securities and Exchange Commission and in the company's first quarter news release. And consequently, actual operations and results may differ materially from the results discussed in the forward-looking statements.

本次電話會議可能包含 1995 年《私人證券訴訟改革法案》含義內的前瞻性陳述，其中包括關於 Acadia 2023 年及以後預期季度和年度財務業績的陳述。特此提醒您，這些聲明可能會受到 Acadia 向美國證券交易委員會提交的文件和公司第一季度新聞稿中規定的重要因素的影響。因此，實際運營和結果可能與前瞻性陳述中討論的結果存在重大差異。

At this time, for opening remarks, I would like to turn the conference call over to our Chief Executive Officer, Chris Hunter.

此時，為了開場白，我想將電話會議轉交給我們的首席執行官克里斯亨特。

Thank you, Gretch, and good morning, everyone, and thank you for being with us today for our first quarter 2023 conference call. I'm here today with our Chief Financial Officer, David Duckworth, and other members of our executive management team. David and I will provide some remarks about our financial and operating performance for the first quarter of 2023. And following our comments, we'll open the line for your questions.

謝謝你，Gretch，大家早上好，感謝你今天和我們一起參加我們 2023 年第一季度的電話會議。今天，我和我們的首席財務官戴維·達克沃斯 (David Duckworth) 以及我們執行管理團隊的其他成員一起來到這裡。大衛和我將就我們 2023 年第一季度的財務和運營業績發表一些評論。在我們發表評論之後，我們將開通您的問題熱線。

Today, I'm pleased to share that our first quarter results mark a strong start to 2023 as we continue to execute our strategy with favorable results. We reported year-over-year revenue growth of 14.2%, adjusted EBITDA growth of 11.6% and adjusted EPS growth of 11.9%, driven by robust demand for our behavioral health care services.

今天，我很高興地分享我們的第一季度業績標誌著 2023 年的良好開端，因為我們繼續執行我們的戰略並取得了良好的成果。我們報告收入同比增長 14.2%，調整後的 EBITDA 增長 11.6%，調整後的每股收益增長 11.9%，這得益於對我們行為保健服務的強勁需求。

Stepping back, our ability at Acadia to address complex behavioral health needs in our country has never been more urgent. According to the National Alliance on Mental illness, suicide is now the second leading cause of death among Americans aged 15 to 24. Nearly 20% of high school students report serious thoughts of suicide.

退一步說，我們在 Acadia 解決我國複雜行為健康需求的能力從未如此緊迫。根據全國精神疾病聯盟的數據，自殺現在是 15 至 24 歲美國人的第二大死因。近 20% 的高中生表示有嚴重的自殺念頭。

In a recent study by the Institute of Mental Health estimated that 1 in 5 American adults is living with some type of mental illness. These are discouraging statistics, and that is why we remain so proud of the role Acadia is playing to help lead the way in not only how we deliver outstanding care for those in need, but also how we work to reduce the stigma around mental illness.

心理健康研究所最近的一項研究估計，五分之一的美國成年人患有某種類型的精神疾病。這些都是令人沮喪的統計數據，這就是為什麼我們仍然為阿卡迪亞所扮演的角色感到自豪，因為它不僅在我們如何為有需要的人提供出色的護理方面，而且在我們如何努力減少精神疾病的恥辱感方面發揮引領作用。

Earlier this month, the New York Times detailed the growing need for access to quality behavioral health care services and highlighted our Acadia Maple Heights Behavioral Health Facility in Indiana is one that is helping to make stand-alone behavioral health treatment more accessible.

本月早些時候，《紐約時報》詳細介紹了對獲得優質行為健康護理服務的日益增長的需求，並強調了我們位於印第安納州的 Acadia Maple Heights 行為健康設施正在幫助人們更容易獲得獨立的行為健康治療。

Today, Acadia is uniquely positioned to help support, shape and deliver care across the full behavioral health spectrum. Each day, our 23,000 employees across our network of 250 facilities in diversified service lines worked tirelessly to care for patients and advance behavioral health care across the country. Our team working more effectively together as we expand our care strategy to meet the growing demand, has helped to deliver continued strong results in the first quarter. To start, our same-facility revenue increased 13.3% compared with the first quarter of 2022. As we shared in February and demonstrated in our results released last night, we saw record patient volumes during the first quarter.

如今，Acadia 具有獨特的優勢，可以幫助支持、塑造和提供整個行為健康領域的護理。每天，我們 250 家設施網絡中的 23,000 名員工在多元化服務領域孜孜不倦地工作，以照顧患者並在全國推進行為健康護理。在我們擴展護理策略以滿足不斷增長的需求時，我們的團隊更有效地合作，幫助我們在第一季度取得了持續強勁的業績。首先，與 2022 年第一季度相比，我們的同設施收入增長了 13.3%。正如我們在 2 月份分享的那樣，並在昨晚發布的結果中證明，我們在第一季度看到了創紀錄的患者數量。

The 6.5% year-over-year patient day growth for the first quarter was above the high end of our outlook range. We are also very pleased with our revenue per day growth of 6.4%, which was driven by favorable rate increases across our service lines, markets and payers.

第一季度患者日同比增長 6.5%，高於我們預期範圍的上限。我們對每天 6.4% 的收入增長也感到非常滿意，這是由於我們的服務線、市場和付款人的費率增長有利。

Like other health care providers, we're continuing to manage through a tight labor market. Our team has done an excellent job navigating this environment while maintaining our high standards of patient care. We were pleased with our labor metrics for the first quarter of 2023 and believe the labor environment continues to show signs of improvement, positioning the company for further stability and an easing of wage growth over the remainder of the year.

與其他醫療保健提供者一樣，我們將繼續應對緊張的勞動力市場。我們的團隊在維持我們高標準的患者護理的同時，在應對這種環境方面做得非常出色。我們對 2023 年第一季度的勞動力指標感到滿意，並相信勞動力環境繼續顯示出改善的跡象，使公司在今年剩餘時間裡進一步穩定和緩和工資增長。

For the first quarter, our labor costs were in line with our expectations, and our base wage inflation of 7.5% in premium pay showed sequential improvement as compared with the fourth quarter of 2022. Even as we saw record census that required increased staffing to support our patients, we were able to manage our labor cost with incremental improvement. As we have previously shared with you, our growth strategy is centered around our 5 distinct pathways, and we continue to make the necessary investments to support our growth objectives.

第一季度，我們的勞動力成本符合我們的預期，與 2022 年第四季度相比，我們的保費基本工資上漲 7.5% 顯示環比有所改善。儘管我們看到創紀錄的人口普查需要增加人員來支持我們的患者，我們能夠通過漸進式改進來管理我們的勞動力成本。正如我們之前與您分享的那樣，我們的增長戰略以 5 條不同的途徑為中心，我們將繼續進行必要的投資以支持我們的增長目標。

I will briefly update you on our continued work related to these 5 pathways during the first quarter. Our first pathway facility expansions remains our primary and most efficient driver of growth. We added 106 beds to our existing facilities during the first quarter, well on our way to our expected total bed additions of approximately 300 in 2023.

我將簡要介紹我們在第一季度與這 5 條途徑相關的持續工作。我們的第一個通路設施擴建仍然是我們增長的主要和最有效的驅動力。第一季度，我們在現有設施中增加了 106 張床位，預計 2023 年床位總數將增加約 300 張。

Importantly, as we indicated on the fourth quarter call, we continue to expect that many of the bed additions in 2023 will open in the first half of the year and are expected to contribute to an accelerating volume growth outlook for the company.

重要的是，正如我們在第四季度電話會議上指出的那樣，我們繼續預計 2023 年新增的許多床位將在今年上半年開放，並有望為公司的銷量增長前景做出加速貢獻。

Our second growth pathway is to develop wholly owned de novo facilities in underserved markets for behavioral health care services. We look forward to increasing the pace of our de novos from opening 1 per year to 2 per year in 2023, and we are on track to meet that goal with the opening of a 101-bed adult hospital in Chicago and a new 80-bed facility in Indio, California.

我們的第二個增長途徑是在服務不足的行為保健服務市場開發全資的從頭設施。我們期待在 2023 年加快從頭開始的步伐，從每年 1 家增加到每年 2 家，我們有望實現這一目標，在芝加哥開設一家擁有 101 個床位的成人醫院和一家擁有 80 個床位的新醫院位於加利福尼亞州印第奧的工廠。

During the first quarter, we commenced construction on a new 100-bed acute care behavioral health hospital Agave Ridge Behavioral Hospital that will serve the residents of Mesa, Arizona and surrounding communities. Opening additional de novo acute and specialty facilities remains a high priority for Acadia as we focus on supporting more communities.

在第一季度，我們開始建設一家擁有 100 個床位的新急症護理行為健康醫院 Agave Ridge 行為健康醫院，該醫院將為亞利桑那州梅薩和周邊社區的居民提供服務。隨著我們專注於支持更多社區，開設更多新的急性和專業設施仍然是 Acadia 的重中之重。

Expanding our network of comprehensive treatment centers or CTCs, is another important priority for Acadia. We will continue to expand our network of 151 CTCs in 32 states with the goal of adding at least 6 CTCs in 2023.

擴大我們的綜合治療中心或 CTC 網絡是 Acadia 的另一個重要優先事項。我們將繼續擴大我們在 32 個州的 151 個 CTC 網絡，目標是在 2023 年至少增加 6 個 CTC。

Our third attractive growth pathway is through forming strategic partnerships with leading health systems across the country. Acadia has joint venture partnerships for 19 facilities in various stages of development with 9 facilities in operation and 10 facilities expected to open over the next several years. We expect to open 2 facilities with our JV partners, Geisinger Health in Pennsylvania and Bronson Healthcare in Michigan in the third quarter.

我們的第三個有吸引力的增長途徑是通過與全國領先的衛生系統建立戰略夥伴關係。 Acadia 擁有 19 個處於不同開發階段的設施的合資夥伴關係，其中 9 個設施正在運營，10 個設施預計將在未來幾年開放。我們預計在第三季度與我們的合資夥伴、賓夕法尼亞州的 Geisinger Health 和密歇根州的 Bronson Healthcare 開設 2 家設施。

We remain encouraged by the growing interest from potential JV partners and continue to strengthen our JV pipeline, and we expect additional announcements later in 2023.

我們對潛在合資夥伴日益增長的興趣感到鼓舞，並繼續加強我們的合資管道，我們預計將在 2023 年晚些時候發布更多公告。

With respect to our fourth growth pathway, we continue to look for selective acquisitions that complement our growth objectives and meet the criteria of our capital allocation strategy. We're fortunate to have a strong balance sheet that provides the flexibility to pursue M&A opportunities as well as make the necessary investments to support our other strategic growth pathways.

關於我們的第四條增長途徑，我們繼續尋找有選擇性的收購，以補充我們的增長目標並符合我們的資本配置戰略標準。我們很幸運擁有強大的資產負債表，可以靈活地尋求併購機會，並進行必要的投資以支持我們的其他戰略增長途徑。

For our fifth and final growth pathway, we continue to identify additional ways to support the patients who come to Acadia for treatment by extending our continuum of care. For example, we strengthened our mid-level acuity programming with 9 additional PHP IOPs to assist our patients after residential treatment and provided greater access to virtual care offerings.

對於我們的第五個也是最後一個成長途徑，我們繼續確定其他方法，通過延長我們的連續護理來支持前來阿卡迪亞接受治療的患者。例如，我們通過 9 個額外的 PHP IOP 加強了我們的中級敏銳度編程，以在住院治療後為我們的患者提供幫助，並提供更多的虛擬護理服務。

We have also improved our cross referral program through enhanced systems that allow nurses and clinicians to more easily identify cross-referral opportunities across our Acadia network and identify the appropriate level of patient care. Through each of these distinct pathways, we are well positioned to maintain our strong growth trajectory and meet our development targets for calendar 2023, which are summarized as follows: adding approximately 670 beds through approximately 300 bed additions to existing facilities, opening 2 inpatient de novo facilities, opening 2 facilities with JV partners and opening at least 6 CTC locations.

我們還通過增強系統改進了我們的交叉轉診計劃，使護士和臨床醫生能夠更輕鬆地識別我們 Acadia 網絡中的交叉轉診機會，並確定適當的患者護理水平。通過這些不同的途徑，我們有能力保持我們強勁的增長軌跡並實現我們 2023 年的發展目標，這些目標總結如下：通過在現有設施中增加約 300 張床位增加約 670 張床位，從頭開設 2 個住院病人設施，與合資夥伴開設 2 個設施，並開設至少 6 個 CTC 地點。

Looking ahead, we are focused on expanding access and availability of our services across new and existing markets, we will also look for ways to improve upon the delivery of care we provide and strengthen our capabilities with the right technology investments and differentiated services that continue to drive favorable clinical outcomes. As a leader in our industry, we also recognize our corporate responsibility to promote sustainability throughout our operations. Earlier this month, we published our inaugural sustainability report, which outlines our focus and ongoing progress towards environmental, social and governance initiatives across Acadia.

展望未來，我們專注於擴大我們服務在新市場和現有市場的可及性和可用性，我們還將尋找方法來改進我們提供的護理服務，並通過正確的技術投資和差異化服務加強我們的能力，這些服務將繼續推動良好的臨床結果。作為我們行業的領導者，我們也認識到我們在整個運營過程中促進可持續發展的企業責任。本月早些時候，我們發布了首份可持續發展報告，其中概述了我們在 Acadia 的環境、社會和治理舉措方面的重點和持續進展。

Our report, which is posted to our corporate website highlights our dedication to quality service and care for patients or drive to foster employee empowerment, engagement and excellence and our focus on environmental responsibility. Across our network of 250 facilities, we have a shared mission to provide high-quality behavioral health care services, and we look forward to the opportunities ahead for Acadia in 2023 and beyond.

我們發佈在公司網站上的報告強調了我們致力於為患者提供優質服務和護理，或致力於促進員工賦權、敬業度和卓越表現，以及我們對環境責任的關注。在我們的 250 家設施網絡中，我們的共同使命是提供高質量的行為保健服務，我們期待著 Acadia 在 2023 年及以後的機遇。

At this time, I will now turn the call over to David Duckworth to discuss our financial results for the quarter and 2023 guidance.

此時，我將把電話轉給大衛達克沃斯，討論我們本季度的財務業績和 2023 年的指導意見。

Thanks, Chris, and good morning. Our first quarter financial performance marked a great start to 2023 with 14.2% year-over-year revenue growth.

謝謝，克里斯，早上好。我們第一季度的財務業績標誌著 2023 年的良好開端，收入同比增長 14.2%。

Revenue for the first quarter of 2023 was $704.3 million compared with $616.7 million for the first quarter of 2022, reflecting the robust demand for our services with favorable volume trends. For the first quarter, adjusted EBITDA increased 11.6% to $151.3 million compared with $135.5 million for the first quarter of 2022. Adjusted income attributable to Acadia stockholders per diluted share was $0.75, up 11.9% for the first quarter of 2023 compared with $0.67 for the first quarter of 2022.

2023 年第一季度的收入為 7.043 億美元，而 2022 年第一季度的收入為 6.167 億美元，這反映出對我們服務的強勁需求以及有利的銷量趨勢。第一季度，調整後的 EBITDA 增長 11.6% 至 1.513 億美元，而 2022 年第一季度為 1.355 億美元。調整後歸屬於 Acadia 股東的每股攤薄收益為 0.75 美元，與 2023 年第一季度的 0.67 美元相比增長 11.9% 2022 年第一季度。

Adjustments to income for the first quarter of 2023 include transaction-related expenses and the related income tax effect. Maintaining a strong financial position will continue to be a top priority for 2023, providing us the flexibility and capital to support our growth strategy and future investments. As of March 31, 2023, we had $63.8 million in cash and cash equivalents and $485 million available under our $600 million revolving credit facility with a net leverage ratio of approximately 2.2.

2023 年第一季度收入調整包括交易相關費用和相關所得稅影響。保持強勁的財務狀況將繼續成為 2023 年的首要任務，為我們提供靈活性和資本來支持我們的增長戰略和未來投資。截至 2023 年 3 月 31 日，我們擁有 6380 萬美元的現金和現金等價物，我們的 6 億美元循環信貸額度下有 4.85 億美元可用，淨槓桿率約為 2.2。

We remain focused on disciplined cost management across our operations and we will continue to pursue a disciplined capital allocation strategy that supports organic growth as well as opportunistic acquisitions.

我們仍然專注於我們運營中嚴格的成本管理，我們將繼續奉行嚴格的資本配置戰略，以支持有機增長和機會性收購。

Now turning to our guidance. As noted in our press release, we are affirming our previously stated guidance for 2023, which includes revenue in a range of $2.82 billion to $2.88 billion, adjusted EBITDA in a range of $635 million to $675 million and adjusted earnings per diluted share in a range of $3.10 to $3.40.

現在轉向我們的指導。正如我們在新聞稿中指出的那樣，我們確認我們之前公佈的 2023 年指導方針，其中包括 28.2 億美元至 28.8 億美元的收入、6.35 億美元至 6.75 億美元的調整後 EBITDA 以及 6.35 億美元至 6.75 億美元的調整後每股攤薄收益3.10 美元至 3.40 美元。

As a reminder, the company's guidance does not include the impact of future acquisitions, divestitures, transaction-related expenses or the recognition of any additional provider relief fund income.

提醒一下，公司的指引不包括未來收購、資產剝離、交易相關費用或確認任何額外供應商救濟基金收入的影響。

With that, Joe, we are ready to open the call for questions.

有了這個，喬，我們準備好開始提問了。

(Operator Instructions) At this time, we will take our first question, which will come from Whit Mayo with SVB Securities.

（操作員說明）此時，我們將提出第一個問題，該問題將來自 SVB 證券公司的 Whit Mayo。

Maybe just to start with the topic around labor. Just anything additional that you can unpack that you learned within the quarter that gives you some confidence that we've hit the high water market. And really more specifically, my question is, when you marry together sort of the labor and the demand and volume agenda and the strategy you have with this hypothesis that I have that there's probably a deliberate strategy to let labor creep in an effort to perhaps secure volume with referral sources in an effort to play the long game. It might just be helpful to kind of marry those 2 together.

也許只是從關於勞動的話題開始。您在本季度內學到的任何其他可以打開包裝的東西都可以讓您相信我們已經進入了高水位市場。更具體地說，我的問題是，當你將某種勞動力、需求和數量議程以及你所擁有的戰略與我所擁有的這個假設結合在一起時，我的假設可能是一種深思熟慮的戰略，讓勞動力悄悄地努力，以確保安全具有引薦來源的數量，以努力進行長期比賽。將這兩個結合在一起可能會有所幫助。

Okay. Whit, this is Chris. I'll start. Thanks for the question. I would say, just to start, we're really pleased with the improvement overall in our base wage inflation from 8% in Q4 to 7.5% in Q1. And I think to your point, I mean, the 2 are closely linked in terms of our ability to increase our staffing requirements has led to the record census that we've seen in the quarter and that we continue to see.

好的。惠特，這是克里斯。我會開始。謝謝你的問題。我想說，首先，我們對基本工資通脹從第四季度的 8% 整體改善到第一季度的 7.5% 感到非常高興。我認為就你的觀點而言，我的意思是，就我們增加人員配置要求的能力而言，這兩者密切相關，這導致了我們在本季度看到的創紀錄的人口普查，而且我們將繼續看到。

I would say an additional data point is that our wage inflation on a total basis, so when we're combining our premium pay, it was 7.1%, which is actually below 7.5% on our premium pay relative to last year, where the metric was 8%. So overall, I mean, I think the pay adjustments that we put in place in the back half of 2022, got us to a point where we're at market and I think really set us up for the rest of the year. I do think that we have also seen some real improvement in recruiting and retention trends, which has also enabled our labor cost to be a little bit more stable.

我想說的另一個數據點是我們的工資總體上漲，所以當我們合併我們的保費時，它是 7.1%，這實際上低於我們保費相對於去年的 7.5%，其中指標為 8%。所以總的來說，我的意思是，我認為我們在 2022 年下半年進行的薪酬調整使我們達到了市場水平，我認為這確實為今年餘下的時間做好了準備。我確實認為我們在招聘和保留趨勢方面也看到了一些真正的改善，這也使我們的勞動力成本更加穩定。

We've had a real focus on improving our net new hires, and we had another strong quarter around net new hires overall in really all classes, but particularly all classes of employees, but particularly RNs and BHAs. And so we think that, that improvement in net new hires is also going to benefit us with reducing premium labor over time and also any of the temporary staffing challenges we had.

我們真正專注於提高我們的新員工淨額，而且我們在所有類別的整體新員工淨額方面有另一個強勁的季度，尤其是所有類別的員工，尤其是 RN 和 BHA。因此，我們認為，淨新員工的改善也將使我們受益，因為隨著時間的推移會減少優質勞動力，以及我們遇到的任何臨時人員配置挑戰。

The only other thing that I would just say on recruiting and retention, we just put a number of strategies in place that we think are really helping us on the labor front. I mean one has been developing several partnerships with nursing schools where we're trying to attract nursing students into behavioral health, while in school, offering internships and rotations, that's been beneficial. We've also put some strategies in place around centralizing support of RN recruiting to all of our facilities.

關於招聘和保留，我只想說的另一件事是，我們只是實施了一些我們認為真正在勞動力方面幫助我們的戰略。我的意思是，有人一直在與護士學校建立多種合作夥伴關係，我們試圖在這些學校吸引護理專業的學生學習行為健康，而在學校提供實習和輪崗，這是有益的。我們還制定了一些策略，將對 RN 招聘的支持集中到我們所有的設施。

We've heard some real demand for tuition reimbursement. And so we've invested, particularly in clinical roles and degree programs to help our employees advance their careers. And we've also had some real variation in the way that we've done clinical training that we've shored up. And I think the final thing we've mentioned in the past around employee engagement, we did our first-ever employee engagement survey in the fall of last year, and we put action plans in place across the board to improve engagement in all of our facilities and our CEOs are now measured on their action plans and their annual incentives. And we think that, that also is improving our engagement, helping us with our net new hires and I think setting us up for the future. But David, anything you want to add?

我們聽到了一些對學費報銷的真實需求。因此，我們進行了投資，特別是在臨床角色和學位課程方面，以幫助我們的員工提升他們的職業生涯。而且我們在進行臨床培訓的方式上也有一些真正的變化，我們得到了支持。我認為我們過去提到的關於員工敬業度的最後一件事是，我們在去年秋天進行了有史以來的第一次員工敬業度調查，我們制定了全面的行動計劃以提高我們所有部門的敬業度設施和我們的首席執行官現在根據他們的行動計劃和年度激勵措施進行衡量。我們認為，這也在提高我們的參與度，幫助我們招聘新員工，我認為這為我們的未來做好了準備。但是大衛，你想補充什麼？

No, I don't think so. I mean we were pleased to be seeing record census throughout the quarter, and at the same time, have the success that we had in recruiting and retention to properly staff for that growth. And at the same time, see some improvement in our premium pay and base wage inflation. So it's really nice to see the positive labor trends, especially during a period of time where our demand and census has been as strong as it's been.

不，我不這麼認為。我的意思是，我們很高興在整個季度看到創紀錄的人口普查，與此同時，我們在招聘和留住合適的員工以實現增長方面取得了成功。與此同時，我們的保費和基本工資通脹有所改善。因此，很高興看到積極的勞動力趨勢，尤其是在我們的需求和人口普查一直如此強勁的時期。

Yes. Maybe my second question, just any fresh thoughts around Medicaid redeterminations. And it may just be also helpful just to remind us, looking at Medicaid, how much is managed Medicaid as a percent of that revenue. And also looking at all of the Medicaid revenue, how much of that is RTC versus the CTC business?

是的。也許我的第二個問題是關於醫療補助重新確定的任何新想法。提醒我們，看看醫療補助計劃，管理醫療補助計劃佔該收入的百分比可能也有幫助。還要看看所有的醫療補助收入，其中有多少是 RTC 與 CTC 業務？

Okay. Great. This is Chris again. I'll start with. I would say redetermination overall is still in very early stages. And I think most know that it launched in April. So we only have 5 states right now that have started the process, and Acadia has facilities in 4 of those 5 states, Arkansas, Arizona, New Hampshire and South Dakota. There are other states that are almost all expected to begin the process between now and mid-summer. So as an example, we have 5 today that will ramp to 14 states in May and will continue to escalate from there. So we've done some pretty extensive analysis on redetermination overall.

好的。偉大的。這又是克里斯。我先說。我想說重新確定總體上仍處於非常早期的階段。我想大多數人都知道它是在四月份推出的。所以我們現在只有 5 個州已經開始了這個過程，而 Acadia 在這 5 個州中的 4 個州、阿肯色州、亞利桑那州、新罕布什爾州和南達科他州都有設施。幾乎所有其他州都有望在現在和仲夏之間開始這一進程。因此，舉個例子，我們今天有 5 個州，5 月份將增加到 14 個州，並將繼續從那裡升級。所以我們對整體重新確定做了一些相當廣泛的分析。

I mean there's some pretty good third-party research that we've reviewed. And estimates show that for the overall Medicaid population, there's about 15 million individuals or 17% of total enrollees that are expected to lose coverage and no longer meet their eligibility requirements. But within that 75%, which is about 13% of total enrollees are expected to still be able to get commercial insurance through either an employer plan or by moving to one of the health insurance exchanges. So the remaining 25%, which is about 4% of total enrollees are expected to become uninsured. And so within this 4%, we -- when we look at our book of business, to your question, we really believe our volume is further risk mitigated because of the coverage continuity that's available for that -- for our patient population and then just some of the actions that we're taking.

我的意思是我們已經審查了一些非常好的第三方研究。估計顯示，對於整個 Medicaid 人口，大約有 1500 萬人或總參保者的 17% 預計將失去覆蓋範圍並且不再符合他們的資格要求。但在這 75% 的人中，約佔總參保人數的 13% 預計仍然能夠通過雇主計劃或轉至其中一家健康保險交易所獲得商業保險。因此，剩下的 25%，即總參保人數的 4% 左右，預計將沒有保險。因此，在這 4% 內，我們 - 當我們查看我們的業務簿時，對於您的問題，我們真的相信我們的數量會進一步降低風險，因為覆蓋連續性可用於我們的患者群體，然後只是我們正在採取的一些行動。

So just a couple of quick thoughts on that. On our RTC service line, the majority of our children now lessons that are treated in RTC, we do expect to maintain their Medicaid coverage. So we do not expect the RTC service line to see a significant impact.

所以只是一些快速的想法。在我們的 RTC 服務熱線上，我們的大多數孩子現在都在 RTC 接受治療，我們確實希望維持他們的 Medicaid 保險。因此，我們預計 RTC 服務線不會受到重大影響。

On our specialty business, in most cases, our Medicaid volume there is in a state that has fall back coverage for substance use treatment that is available. And so because that's available from other governmental agencies within those states, we don't expect that specialty will see a significant impact on redetermination either.

在我們的專業業務中，在大多數情況下，我們的 Medicaid 數量處於一種狀態，可以為可用的物質使用治療提供後備保險。因此，因為可以從這些州內的其他政府機構獲得，我們預計該專業也不會對重新確定產生重大影響。

And then finally, we have over 50% of our CTC patients that are actually in states that have some form of either uninsured or underinsured funding for opioids disorder that we think also benefits us. So that's kind of the overall protections that we're seeing. And then just really quickly, tactically, there are a number of strategies that we've continued to put in place to further limit the impact.

最後，我們有超過 50% 的 CTC 患者實際上處於對阿片類藥物障礙提供某種形式的未保險或保險不足資金的州，我們認為這對我們也有好處。這就是我們所看到的整體保護。然後很快，從戰術上講，我們繼續實施許多策略來進一步限制影響。

I mean it starts with patient education. We have been working with our patients for many months now going back to last year. We have QR codes in our facilities. We have digital materials. We're talking to them about the risks around Medicaid redetermination. What that means for them is individual patients. We set up a dedicated hotline that we found that is getting a lot of uptake, and we're helping navigate these patients through some of the challenges they're coming up with when they do arise and we're trying to help them be proactive. And we're obviously training our staff and doing everything that we can to make sure that we have resources that are on the ground in addition to the hot line. So when you put all that together, we feel like 5 states have started in April, 14 more are coming, and we're just going to continue to closely monitor and provide updates throughout the year. David, anything you want to add on the mix?

我的意思是它從耐心教育開始。我們已經與我們的患者一起工作了好幾個月，現在可以追溯到去年。我們的設施中有二維碼。我們有數字資料。我們正在與他們討論重新確定醫療補助計劃的風險。這對他們來說意味著個體患者。我們設立了一條專門的熱線電話，我們發現它得到了很多人的關注，我們正在幫助這些患者應對他們在出現時遇到的一些挑戰，我們正在努力幫助他們積極主動.很明顯，我們正在培訓我們的員工，並儘我們所能確保我們擁有除了熱線之外的實地資源。所以當你把所有這些放在一起時，我們覺得 5 個州已經在 4 月開始，還有 14 個州即將到來，我們將繼續密切監測並提供全年的更新。大衛，你想添加什麼？

Yes. I'll just respond to a couple of your other questions around the residential business and the managed Medicaid. We do see for our Medicaid, we, of course, combine managed Medicaid into what we report as Medicaid. But in our acute markets, around 90% of the Medicaid revenue we see is with a managed Medicaid payer. And then as we think about, Chris mentioned some of our protections in place within Medicaid for our RTC business as well as our specialty and CTC business, as we look at the RTC business, which is 11% of our revenue, that's a 90% of Medicaid business, and we do have some commercial pay within that service line as well.

是的。我只會回答您關於住宅業務和管理醫療補助的其他幾個問題。我們確實看到我們的醫療補助計劃，當然，我們將管理的醫療補助計劃合併到我們報告的醫療補助計劃中。但在我們敏銳的市場中，我們看到大約 90% 的醫療補助收入來自受管理的醫療補助付款人。然後，正如我們所想，Chris 提到了我們在醫療補助計劃中為我們的 RTC 業務以及我們的專業和 CTC 業務提供的一些保護，當我們查看 RTC 業務時，它占我們收入的 11%，即 90%醫療補助業務，我們在該服務範圍內也有一些商業報酬。

But it's good from our perspective that there's appropriate continuation of coverage for that business in those adolescents. And that is a heavy mix of our RTC business. Specialty also has Medicaid. It's -- in total, that service line has 22% of our business. And within that, Medicaid is almost a 30% portion of our revenue there.

但從我們的角度來看，在這些青少年中繼續適當地覆蓋該業務是件好事。這是我們 RTC 業務的重要組成部分。專業也有醫療補助。總的來說，該服務線占我們業務的 22%。其中，醫療補助幾乎占我們收入的 30%。

So we do see not only for residential and specialty, but for the CTC business as we move into the redetermination process that really gets going, started in just very select markets in April, but we'll get going over the second half of the year. We hope with the actions we're taking as well as some of these protections in place across our service lines that the volume risk that we had previously identified will really be mitigated.

因此，我們不僅看到住宅和專業，而且看到 CTC 業務，因為我們進入真正開始的重新確定過程，從 4 月份在非常精選的市場開始，但我們將在今年下半年開始.我們希望通過我們正在採取的行動以及我們服務線中的一些保護措施，我們之前確定的數量風險將真正得到緩解。

And our next question will come from Andrew Mok with UBS.

我們的下一個問題將來自瑞銀集團的 Andrew Mok。

First, I just wanted to clarify the labor trends. You mentioned base wage inflation and premium pay trending better sequentially, but it wasn't entirely clear to me what the offsets are that are flowing through the SWB line, that resulted in SWB per patient day remaining elevated up 9% year-over-year. So can you help us understand that better and how start-up losses maybe specifically are impacting that line?

首先，我只想澄清勞動力趨勢。你提到基本工資通脹和保費支付的連續趨勢更好，但我並不完全清楚流經 SWB 線的抵消是什麼，這導致每個病人每天的 SWB 同比增長 9% .那麼，您能否幫助我們更好地了解這一點，以及初創企業虧損可能具體如何影響這條生產線？

Yes, Andrew, we do look at that SWB per patient day, understand that's what investors and analysts have access to as we report just directly from our financial statements. And it is a useful metric that can be used as a measure of our wage increases, but of course, also incorporates our volume and it's a view into our consolidated level results, not just our facility results and incorporates benefits expense as well.

是的，安德魯，我們確實會查看每個病人每天的 SWB，了解這是投資者和分析師可以訪問的內容，因為我們直接從財務報表中報告。這是一個有用的指標，可以用來衡量我們的工資增長，但當然也包括我們的數量，它是我們綜合水平結果的一個視圖，而不僅僅是我們的設施結果，也包括福利費用。

So the 9.5% this quarter was in line with our expectations is higher than our wage inflation that was 7.5%. And the start-ups were a part of that. We opened a number of new facilities in the second half of 2022, and they are making good progress in their start-up. But the level of SWB relative to revenue that we saw in those facilities was much higher than what we saw in the first quarter of 2022. And so those start-ups in our view, account for several percentage points within the SWB per patient day actually about 0.5%.

因此本季度的 9.5% 符合我們的預期，高於我們 7.5% 的工資通脹率。初創企業是其中的一部分。我們在 2022 年下半年開設了一些新設施，它們的啟動進展順利。但是我們在這些設施中看到的 SWB 相對於收入的水平遠高於我們在 2022 年第一季度看到的水平。因此，在我們看來，這些初創企業實際上在每個患者日的 SWB 中佔了幾個百分點約 0.5%。

The other piece of that would be investments that we have made in our corporate office and in our benefits program, which the benefit to investment would have taken effect at the beginning of the year. But -- and then the corporate office is also part of that. We've made a number of enhancements in additions to our corporate office, some of which, of course, we reported and described over the course of 2022, but that's what's sort of causing that higher level of SWB per patient day relative to base wage inflation.

另一部分是我們在公司辦公室和福利計劃中進行的投資，投資收益將在今年年初生效。但是——然後公司辦公室也是其中的一部分。我們對公司辦公室進行了一些改進，當然，我們在 2022 年期間報告和描述了其中一些改進，但這就是導致相對於基本工資，每個病人每天的 SWB 水平更高的原因通貨膨脹。

The timing of our merit increase is, of course, part of that, where we do expect for this year a higher level of wage inflation and SWB per patient day in the beginning part of the year and continue to have an expectation that, that moderates over the course of the year.

當然，我們加薪的時機是其中的一部分，我們確實預計今年年初的工資通脹和每位患者每天的 SWB 水平會更高，並且繼續期望這會緩和在這一年的過程中。

Great. Maybe as a follow-up, just curious to hear whether you're seeing any impact from the recent deregulation of buprenorphine as it relates to demand for methadone and your CPC business line.

偉大的。也許作為後續行動，只是想知道您是否看到最近解除對丁丙諾啡管制的影響，因為它與美沙酮需求和您的 CPC 業務線有關。

Yes, Andrew, we're familiar with the legislation that's been a topic among investors and was passed by legislators in March around what's referred to as the ex waiver, which allows physicians to write prescriptions of buprenorphine also known as Suboxone. And as we look back, physicians have had this flexibility to write these prescriptions over the course of the public health emergency. So over the last 3 years, physicians have had that ability to write these prescriptions. Of course, we are supportive of any initiative that improves access for people that need treatment. And we do use buprenorphine in our CTC locations.

是的，安德魯，我們熟悉該立法，該立法一直是投資者的話題，立法者於 3 月通過了所謂的豁免，該豁免允許醫生開丁丙諾啡（也稱為 Suboxone）的處方。當我們回顧過去時，醫生可以靈活地在公共衛生緊急情況下開出這些處方。所以在過去的 3 年裡，醫生們有能力開出這些處方。當然，我們支持任何改善需要治療的人獲得治療機會的舉措。我們確實在 CTC 地點使用丁丙諾啡。

For us, we look back at the 3 years where physicians had that ability and really didn't see an increase in physicians really increasing their treatment of the OUD patient. And for our business, as we think about it specifically, we have 90% of our business where methadone is the medication that's used to treat our patients. And we would attribute that to just the clinical effectiveness of methadone combined with the comprehensive view that we take into the treatment around counseling and other services that we provide, but methadone does have an ability relative to buprenorphine to treat a higher level of addiction in a more complex OUD patient, which we believe we're seeing more of in the industry because of things like (inaudible) and other advances that have made addiction stronger.

對我們來說，我們回顧了過去 3 年的醫生擁有這種能力，但實際上並沒有看到更多的醫生真正增加了對 OUD 患者的治療。對於我們的業務，正如我們具體考慮的那樣，我們 90% 的業務中美沙酮是用於治療患者的藥物。我們將其歸因於美沙酮的臨床有效性以及我們對諮詢和我們提供的其他服務進行治療的綜合觀點，但美沙酮相對於丁丙諾啡確實具有治療更高水平成癮的能力更複雜的 OUD 患者，我們相信我們在行業中看到更多，因為（聽不清）和其他使成癮性更強的進步。

So we do not see a significant impact given how we're positioned and the treatment that we have of the higher acuity, more complex patient and the 90% that we have within the methadone business, but we will maintain the Suboxone treatment, and there are patients where that is appropriate. But just given the limited growth in that over the last several years, we do not think that, that ex waiver will materially impact our business.

因此，考慮到我們的定位以及我們對更高敏銳度、更複雜患者的治療以及我們在美沙酮業務中擁有的 90%，我們看不到重大影響，但我們將維持 Suboxone 治療，並且有是適當的患者。但鑑於過去幾年增長有限，我們認為豁免不會對我們的業務產生重大影響。

And we'll just add, we are seeing -- we talk about our inpatient business and the record census that we're seeing. We are also seeing record census levels in our CTC business right now, which is a credit to the tremendous job our leadership team is doing, our operators across our 32 states and the strong demand that we're seeing within that service line.

我們只是補充說，我們正在看到——我們談論我們的住院業務和我們正在看到的創紀錄的人口普查。我們現在還看到我們的 CTC 業務的人口普查水平創歷史新高，這歸功於我們的領導團隊所做的巨大工作、我們在 32 個州的運營商以及我們在該服務線中看到的強勁需求。

And our next question will come from Kevin Fischbeck with Bank of America.

我們的下一個問題將來自美國銀行的 Kevin Fischbeck。

Appreciate the comment about redeterminations. So maybe you can just put a little bit finer point to it. You're talking about volume offsets and headwinds being mitigated. I mean, do you guys have a net impact that you're thinking about either from a revenue or an EBITDA perspective over the next couple of years from that?

感謝有關重新確定的評論。所以也許你可以更細化一點。你說的是體積抵消和逆風正在減輕。我的意思是，在接下來的幾年裡，你們是否有從收入或 EBITDA 的角度考慮的淨影響？

Yes. I mean, Kevin, I think it's too early for us to say exactly what the impact could be right now. Of course, we could -- we do the math internally and provide a variety of estimates. And we mentioned some third-party data earlier just to hopefully help investors do any kind of sizing and sensitivity that you'd like to do, but we think it's too early for us as a company to put out a number. I will say we think there's a limited impact this year just given that it's, fortunately, a lot of the states are thoughtful around working with providers and phasing that in, which we think helps patients and helps this be orderly.

是的。我的意思是，凱文，我認為我們現在確切地說出影響可能還為時過早。當然，我們可以——我們在內部進行數學計算並提供各種估計值。我們之前提到了一些第三方數據，只是希望能幫助投資者做任何你想做的規模和敏感性，但我們認為作為一家公司，現在公佈數字還為時過早。我要說的是，我們認為今年的影響有限，因為幸運的是，許多州都在考慮與提供者合作並逐步實施，我們認為這有助於患者並有助於有序進行。

And then 2024, there's estimated to be more of a full year impact. I think as we think about it today, relative to the increased confidence that we have that more patients will continue to have access to coverage within our service lines and just the strong demand that we're seeing and our ability to admit patients that have appropriate coverage and work with our referral sources as we do that, we think there's not a significant volume headwind at this point going into next year. But we're paying very close attention to it, and we'll have to provide an update as we see more and experience more over the second half of this year.

然後到 2024 年，估計會有更多的全年影響。我認為，正如我們今天所考慮的那樣，相對於我們越來越有信心更多的患者將繼續獲得我們服務範圍內的覆蓋範圍，以及我們看到的強勁需求和我們接納具有適當患者的能力的能力在我們這樣做的時候，覆蓋範圍和與我們的推薦來源一起工作，我們認為在進入明年的這一點上沒有明顯的逆風。但我們非常密切地關注它，我們將不得不提供更新，因為我們在今年下半年看到了更多，體驗了更多。

Okay. I mean, that's fair. I guess, I mean, you guys -- obviously, so your guidance includes whatever impact, if it's 1/3 of the impact you're growing this way this year through that in the back half of the year. And I guess, maybe you can -- in there, there's an offset, right, that the commercial rates are higher than Medicaid rate. Can you just remind us like what the rate differential is? I know it's quite wide and acute, I think, it's a little bit narrower for psych if you lose some Medicaid to pick on commercial, that feels like another mitigant, I guess, from an economic perspective that you didn't highlight before. Just trying to understand how important that might be.

好的。我的意思是，這很公平。我想，我的意思是，你們 - 顯然，所以你的指導包括任何影響，如果它是你今年通過今年下半年以這種方式增長的影響的 1/3。而且我想，也許你可以 - 在那裡，有一個抵消，對，商業費率高於醫療補助費率。你能提醒我們一下差價是多少嗎？我知道它非常廣泛和尖銳，我認為，如果你失去一些醫療補助來選擇商業廣告，它對心理來說有點窄，我想，從你之前沒有強調的經濟角度來看，這感覺就像是另一種緩和劑。只是想了解這可能有多重要。

Yes. We thought about that payer mix shift and how that might impact the company and provide an offset. And our difference between our Medicaid and commercial rates can vary by market. And so while there could be that benefit that we see in certain markets. Overall, our Medicaid rates and commercial rates don't have the differential that you may see in a lot of other parts of health care. So I don't think that payer mix shift will provide a significant benefit, although we could see a benefit from that in certain markets. And I'll be clear, you mentioned the impact in 2023.

是的。我們考慮了付款人組合的轉變以及這可能如何影響公司並提供抵消。我們的 Medicaid 費率和商業費率之間的差異可能因市場而異。因此，雖然我們在某些市場上可能會看到這種好處。總的來說，我們的醫療補助費率和商業費率沒有您在醫療保健的許多其他部分看到的差異。因此，我認為付款人組合的轉變不會帶來顯著的好處，儘管我們可以在某些市場看到它帶來的好處。我會很清楚，你提到了 2023 年的影響。

We do think, and obviously, we're affirming our guidance. We do think that what we had built in to our initial guidance for the second half of the year, which is just some kind of high-level moderate impact was already reflected in our guidance. We still think that our 2023 guidance holds as we think about our ability to navigate through this over the second half of the year.

我們確實認為，而且很明顯，我們正在確認我們的指導。我們確實認為，我們在下半年的初步指導中內置的只是某種高水平的適度影響，已經反映在我們的指導中。我們仍然認為我們的 2023 年指導方針是有效的，因為我們考慮了我們在今年下半年完成這項工作的能力。

And our next question will come from A.J. Rice with Credit Suisse.

我們的下一個問題將來自 A.J.瑞士信貸的大米。

Just wanted to maybe go back to the CTC business and flesh that out a little more. I think you're expecting to open this year. I know one of the topics at the Investor Day was that as some of this opioid money comes in, states are looking for ways to support this population in a couple of cases and turn to you for partnerships. I wonder if there's any update, any discussions along those lines. And then alternatively, there's been some discussion about the relative profitability of that business. I know you don't break out profitability by law of the business, but and whether the amount of earnings in the CTC business might attract attention down the road from the Medicaid payers. Can you comment on your discussions around that? And maybe to the extent you're willing to say it, talk a little bit about the relative profitability of that business compared to your overall mix?

只是想回到 CTC 業務並充實它。我想你預計今年開業。我知道投資者日的主題之一是，隨著一些阿片類藥物資金的流入，各州正在尋找在某些情況下支持這一人群的方法，並向你們尋求合作夥伴關係。我想知道是否有任何更新，是否有任何類似的討論。然後，還有一些關於該業務的相對盈利能力的討論。我知道你不會根據業務法來突破盈利能力，但 CTC 業務的收入金額是否會引起醫療補助付款人的注意。你能評論一下你對此的討論嗎？也許在您願意說的範圍內，談談該業務與您的整體組合相比的相對盈利能力？

Yes, A.J., this is Chris. Why don't I start? I mean I would say, overall, David alluded to the fact that we've really attracted a very strong leadership team on CTC. And so we now have 151 locations in 32 states overall. And I think it just really set up well to grow that business. I think one stat that we saw recently is that now 7% of all hospital spend in the U.S. is actually directed towards the care of patients with OUD. So we just see this continuing to become a strong -- a real problem for the -- from the broader industry.

是的，A.J.，這是克里斯。我為什麼不開始？我的意思是，總的來說，大衛提到了一個事實，即我們確實在 CTC 上吸引了一支非常強大的領導團隊。因此，我們現在在 32 個州共有 151 個地點。而且我認為它真的很適合發展該業務。我認為我們最近看到的一個統計數據是，現在美國所有醫院支出中有 7% 實際上是針對 OUD 患者的護理。因此，我們只是看到這繼續成為一個強大的——一個真正的問題——來自更廣泛的行業。

You're right that we are focused on opening at least these 6 CTCs in 2023. We're going to accelerate that to 14 in 2024. And we do think we're going to see some benefit from the opioid settlement dollars that are really just beginning to flow in. Again, it's $54 billion, the total expected funding. It's going to be dispersed over an 18-year schedule. And we're just beginning to see that happen now. So only $2 billion to $3 billion of the $54 billion has actually been dispersed 2 states to date.

你是對的，我們的重點是在 2023 年至少開設這 6 個 CTC。我們將在 2024 年將其加速到 14 個。我們確實認為我們會從阿片類藥物結算美元中看到一些好處，這確實是才剛剛開始流入。同樣，它是 540 億美元，是預期的總資金。它將分散在 18 年的時間表中。我們現在才剛剛開始看到這種情況發生。因此，迄今為止，540 億美元中只有 20 億至 30 億美元實際上分散了 2 個州。

Most are kind of setting up bodies to oversee the disbursement of the funds at the individual county levels. And some are a little bit more aggressive and progressive than others. I mean we see Rhode Island, North Carolina and Ohio as an example, probably being a little bit further along than some of the other states. But I think our team is doing a really good job of tracking the settlement opportunities.

大多數是建立機構來監督各個縣級的資金支付。有些人比其他人更具侵略性和進步性。我的意思是我們以羅德島、北卡羅來納州和俄亥俄州為例，可能比其他一些州走得更遠一些。但我認為我們的團隊在跟踪定居機會方面做得非常好。

We actually were awarded our very first opioid settlement in February, which was $200,000 for some wraparound services in North Carolina. So our team is just very focused on tracking this. We're partnering in many instances with community sponsors like the Jason Foundation on a grant to support youth outreach related to OUD and we're doing everything that we can to continue to make sure that we're well positioned with these individual counties within the states that are going to disperse the dollars.

實際上，我們在 2 月份獲得了第一份阿片類藥物和解金，為北卡羅來納州的一些綜合服務支付了 200,000 美元。所以我們的團隊非常專注於跟踪這一點。在許多情況下，我們與 Jason Foundation 等社區贊助商合作，提供一筆贈款，以支持與 OUD 相關的青年外展活動，我們正在盡一切努力繼續確保我們在這些單獨的縣中處於有利地位將分散美元的國家。

And with respect to just the margin for that business, we've always said as we look at our service line margins, the factors that we really see driving our margin across our service line is really more market specific and facility-specific as we think about the strength of a local operation, their occupancy and number of patients that are treated and maturity of many of our locations, especially those locations that have been in place for a really long time with a strong presence in the community and a significant population of patients that are treated. So saying that, we've always said those are the factors that can impact our margins.

就該業務的利潤率而言，我們總是說，當我們查看我們的服務線利潤率時，我們真正看到的推動我們整個服務線利潤率的因素實際上更像我們認為的市場特定和設施特定關於當地手術的實力、他們的入住率和接受治療的患者數量以及我們許多地點的成熟度，尤其是那些已經存在很長時間、在社區中有很強影響力和大量人口的地點接受治療的患者。所以說，我們一直說這些是會影響我們利潤率的因素。

And across our service lines, the average for the company continues to be in the upper 20% range, and we see that for each of our service lines, we can see many of our CTC locations be above that 28% or so, same facility margin and those facilities are usually demonstrate the factors that I mentioned around the presence that they have and the number of patients that they treat. And so I'm glad to clarify, I guess there's always been and recently has been some questions around our margins for that business. And while we can see some facilities with strong margins across our service lines, the average continues to be very close to the company average.

在我們的服務線中，公司的平均值繼續保持在 20% 以上的範圍內，我們看到對於我們的每條服務線，我們可以看到我們的許多 CTC 地點都高於 28% 左右，相同的設施保證金和這些設施通常證明了我提到的關於他們的存在和他們治療的患者數量的因素。因此，我很高興澄清，我想一直以來並且最近一直存在關於我們該業務利潤率的一些問題。雖然我們可以看到一些設施在我們的服務線中有很高的利潤率，但平均水平仍然非常接近公司平均水平。

Okay. And if I could just slip in one other follow-up. The -- I think in your guidance for this year, and maybe you talked around this a little in one of the earlier questions. But you've assumed a moderation in the update, I think, mainly, as you describe it, the Medicaid states that sort of do midyear updates in their resets and their rates, you had assumed more return to normal. Is that what you're actually seeing as you get a little closer to discussing what that July 1 rate update on Medicaid might look like? Any further thoughts on whether that assumption was a little conserved? Or is that what you're actually seeing?

好的。如果我可以再進行一次跟進。 - 我認為在你今年的指導中，也許你在之前的一個問題中談到了這一點。但是你已經假設更新會有所緩和，我認為，主要是，正如你所描述的，醫療補助計劃聲明在他們的重置和利率方面進行年中更新，你假設更多的恢復正常。當您越來越接近討論 7 月 1 日的醫療補助費率更新可能是什麼樣子時，這就是您實際看到的嗎？關於該假設是否有點保守的任何進一步想法？或者這就是你實際看到的？

Yes, A.J., I'll take that. I mean, clearly, as we've said, we've got very good visibility in the first half of the year, kind of trending in mid-single digits on a weighted average basis. But because 75% of all of our Medicaid revenue, at least in our acute service line has new contracting years that start in the second half of the year, we just really don't have a significant update relative to April for the commentary that we gave last quarter.

是的，A.J.，我會接受的。我的意思是，很明顯，正如我們所說，我們在今年上半年的能見度非常好，在加權平均數的基礎上呈中等個位數的趨勢。但是因為我們 75% 的醫療補助收入，至少在我們的急性服務線有新的合同年從今年下半年開始，我們真的沒有相對於 4 月份的評論有重大更新，我們的評論給了上個季度。

I would just say that we continue to engage very deliberately in all of our rate strategies throughout Q1. I think we continue to feel like we have -- we're getting better visibility in the second half of the year, but so many of these negotiations are still yet to be had.

我只想說，我們在整個第一季度繼續非常有意識地參與我們所有的利率策略。我認為我們繼續感覺我們已經 - 我們在今年下半年獲得更好的知名度，但仍有許多此類談判尚未進行。

I would say our outlook maybe does reflect a little bit of conservatism because we continue to have a very positive view on our ability to achieve these rates, but I think we're still just in the early stage activities in many of these states, we're doing all the work that we usually do in anticipation of these discussions that we have with various payers and continue to be confident in our ability to execute on those.

我想說我們的前景可能確實反映了一點點保守主義，因為我們繼續對我們實現這些比率的能力持非常積極的看法，但我認為我們仍處於許多這些州的早期活動中，我們我們正在做我們通常做的所有工作，以期與各種付款人進行這些討論，並繼續對我們執行這些討論的能力充滿信心。

And our next question will come from John Ransom with Raymond James.

我們的下一個問題將來自 John Ransom 和 Raymond James。

Just a couple of outlook detailed questions. As you move through the year, when do you -- what's your forecast for kind of the exit rate of labor inflation in 4Q? And also, just in your model, when do you see labor to revenue improving year-over-year?

只是幾個前景詳細的問題。隨著這一年的推移，你什麼時候——你對第四季度勞動力通脹退出率的預測是什麼？而且，僅在您的模型中，您什麼時候會看到勞動力收入同比增長？

Yes, John, we -- because over the second half of 2023, we would reach the anniversary date of many of our pay adjustments that we made in 2022. We do believe at the end of the year, we would see that our year-over-year wage inflation at that point would just reflect any adjustments we have made in 2023, which would largely be comprised of merit increases for our employees this year. So as we have talked about before, the target for that would be less than 5%, could be in a range of 3% to 5%, but that's where we would expect to exit the year. And we continue to have in our minds, more positive indicators that the market is improving and that we should see that wage inflation improvement over the course of the year.

是的，約翰，我們——因為在 2023 年下半年，我們將迎來我們在 2022 年進行的許多薪酬調整的周年紀念日。我們確實相信，到年底，我們會看到我們的一年——屆時的年度工資通脹只會反映我們在 2023 年所做的任何調整，其中主要包括今年員工的績效增長。因此，正如我們之前談到的那樣，該目標將低於 5%，可能在 3% 至 5% 的範圍內，但這是我們預計今年結束的水平。我們的腦海中繼續有更多積極的指標表明市場正在改善，我們應該看到工資通脹在這一年中有所改善。

As we look at our year-over-year benefit, I do think we'll see higher wage inflation on a year-over-year basis and growth in SWB as a percentage of revenue on a year-over-year basis. That reflects not only the fact that our wages are growing more so than our nonlabor costs, but also just some of the investments we've made in our benefit programs and at the corporate level. So we may see the gap narrow a little bit, the year-over-year growth in SWB as a percentage of revenue, but as we look at that, the stability that we've seen and the ability to manage our nonlabor costs, supports margin growth as we look at the second half of the year.

當我們查看我們的同比收益時，我確實認為我們會看到同比更高的工資通脹和同比增長 SWB 佔收入的百分比。這不僅反映了我們的工資增長快於我們的非勞動力成本這一事實，還反映了我們在福利計劃和公司層面所做的一些投資。因此，我們可能會看到差距略有縮小，SWB 佔收入的百分比同比增長，但正如我們所看到的那樣，我們所看到的穩定性和管理非勞動力成本的能力支持我們看今年下半年的利潤率增長。

And so while wages may still be higher, even though the gap narrows, we do look at the second half of the year and project margin growth despite wages being up even in the second half of this year as wages moderate.

因此，儘管工資可能仍然更高，即使差距縮小，但我們確實著眼於今年下半年和預測利潤率增長，儘管工資在今年下半年上漲，因為工資溫和。

Yes. And just as a follow-up, corporate overhead, how do we think about, it did jump a little bit in the first quarter sequentially. How do we think about -- are we done with the big investments in corporate overhead? Or is that going to continue to grow at an [outside] space?

是的。作為後續行動，公司間接費用，我們如何看待，它確實在第一季度連續增長了一點。我們如何考慮——我們是否已經完成了對公司間接費用的大量投資？還是會在[外部]空間繼續增長？

Yes, John, let me take that one. This is Chris. I would say we've made a number of investments that are going to help us advance the business and really deliver on all the commitments that we have laid out at the Investor Day that we did back in December. I think there's a number of areas where, historically, we've underinvested a little bit, and we need to position ourselves to continue to grow and meet the commitments that we've laid out. I think there are several key areas. I mean, from IT, which we've discussed at length, HR and recruiting, marketing, even managed care and strategy that we needed to make some investments that I think will begin to see some benefit over time.

是的，約翰，讓我拿那個。這是克里斯。我想說我們已經進行了一些投資，這些投資將幫助我們推進業務，並真正兌現我們在去年 12 月所做的投資者日做出的所有承諾。我認為，從歷史上看，我們在許多領域投資不足，我們需要定位自己以繼續發展並履行我們做出的承諾。我認為有幾個關鍵領域。我的意思是，從我們已經詳細討論過的 IT、人力資源和招聘、營銷，甚至是管理式醫療和戰略，我們需要進行一些投資，我認為隨著時間的推移，這些投資將開始看到一些好處。

I would say that we are already beginning to see some benefits from some of these investments. I mean, just in the short term, we're already seeing it with the higher level of expected volume growth in the range of 4% to 6% compared to the historical average of 3 to 4. And then I just think we're going to see benefit over time from kind of 3 different categories. I think first is just enhancing our overall facility performance. We're seeing volumes that are already being supported by optimized marketing and some really good work that our team has done there and also on the managed care front.

我想說的是，我們已經開始從其中一些投資中看到一些好處。我的意思是，就短期而言，與歷史平均水平 3 到 4 相比，我們已經看到 4% 到 6% 的預期銷量增長水平更高。然後我認為我們是隨著時間的推移，會從 3 種不同的類別中看到好處。我認為首先只是提高我們的整體設施性能。我們看到已經得到優化營銷支持的數量，以及我們的團隊在那里以及在管理式醫療方面所做的一些非常好的工作。

I think secondly, and I'll come back to this. I think driving further efficiencies and optimization is clearly going to provide value overall. And then I think overall, just strengthening the company's foundation for the long-term execution of all these growth pathways that I covered in the opening, I think, is important.

我認為其次，我會回到這個問題上。我認為進一步提高效率和優化顯然會提供整體價值。然後我認為總的來說，只是加強公司的基礎，以長期執行我在開幕式中涵蓋的所有這些增長途徑，我認為很重要。

I think the last thing I would say, though, is that I'm been here for a little bit over a year. One of the things that we clearly recognize as a leadership team, is that we still have pretty significant variation across the company, across our 250 facilities.

不過，我想我最後要說的是，我來這裡已經一年多了。作為一個領導團隊，我們清楚地認識到的一件事是，在我們的 250 個工廠中，我們在整個公司仍然存在相當大的差異。

So our company really has grown by M&A, particularly in the early years. And when you look at that variation, it's not limited to any one area. It can include admissions and marketing and even certain HR processes. So we have a really good business transformation team that is helping us look at that. And I think over time here, we're putting together a number of initiatives as we speak, that we think are going to help us optimize our performance, continue to drive really strong volumes, but also achieve better efficiencies and specific cost savings in certain functions in the back half of the year. So a lot of these investments that we are making now, we think will continue to benefit us beginning in the second half of the year and into next year. And we haven't quite evaluated the financial impact. We'll clearly be coming back to share that, but we do expect value over time, and we recognize the need for continued operating leverage.

所以我們公司確實是通過併購發展壯大的，尤其是在早期。當您查看該變化時，它不僅限於任何一個區域。它可以包括招生和營銷，甚至某些人力資源流程。因此，我們有一個非常優秀的業務轉型團隊，可以幫助我們審視這一點。而且我認為隨著時間的推移，我們正在整合一些舉措，我們認為這些舉措將幫助我們優化績效，繼續推動真正強勁的銷量，同時在某些領域實現更高的效率和特定的成本節約下半年發揮作用。因此，我們現在正在進行的很多投資，我們認為將從今年下半年開始到明年繼續使我們受益。我們還沒有完全評估財務影響。我們顯然會回來分享這一點，但我們確實期望隨著時間的推移會產生價值，並且我們認識到需要持續的經營槓桿。

And our next question will come from Brian Tanquilut with Jefferies.

我們的下一個問題將來自 Jefferies 的 Brian Tanquilut。

Chris, maybe just to follow up on those comments you made to John's last question. I know during Investor Day, you talked about some of the IT initiatives that you feel are [necessary for the] business. Anything you can share with us in terms of (inaudible) the EHR rollout and where do you stand on that?

克里斯，也許只是想跟進你對約翰最後一個問題的評論。我知道在投資者日期間，您談到了您認為對業務 [必要] 的一些 IT 計劃。在（聽不清）EHR 推出方面，您可以與我們分享任何內容，您對此有何看法？

Yes, sure. A few things that I would say just on the IT front. I mean, again, we're early days here. We have done a pilot where we have onboarded half a dozen hospitals around implementing an EHR. And we're still in the early phases of evaluating it. But I would say we're already beginning to see benefit. The engagement survey that I referenced earlier, we -- for those facilities that actually have the new EMR, we're seeing that those employees are scoring significantly higher pretty much on every indices when there is an EMR versus not having one.

是的，當然。我只想在 IT 方面說幾句話。我的意思是，我們還處於早期階段。我們已經完成了一個試點，我們已經在實施 EHR 的過程中加入了六家醫院。我們仍處於評估它的早期階段。但我想說我們已經開始看到好處了。我之前提到的敬業度調查，我們 - 對於那些實際上擁有新 EMR 的設施，我們看到當有 EMR 與沒有 EMR 時，這些員工在每個指數上的得分都高得多。

And I think overall, there's going to be 5 kind of categories of benefit from these IT investments. I mean we're already seeing benefit on the safety and compliance side. We had a survey just a few weeks ago, where we got extremely high marks and the surveyor specifically referenced the EMR that was in place as well as some of the remote monitoring software that we put in place. So we're already seeing some of the benefit there with respect to reducing our compliance risk and just overall driving a more standardized compliance program and just overall patient safety.

我認為總體而言，這些 IT 投資將帶來 5 類收益。我的意思是我們已經在安全和合規方面看到了好處。幾週前我們進行了一次調查，我們得到了極高的分數，調查員特別提到了現有的 EMR 以及我們部署的一些遠程監控軟件。因此，我們已經看到了降低我們的合規風險以及整體推動更標準化的合規計劃和整體患者安全方面的一些好處。

I think there's going to be benefit secondly, just around overall patient experience. We're already seeing on the employee satisfaction front. I've spoken in the past about nurses that are trained today on EMRs. And when they come to a behavioral health company, they don't expect to work in paper. That can be a real job to satisfy and that can hurt us on the recruitment and the retention front. So having this technology in place, we think, is going to have real benefit in the near term.

我認為其次會有好處，就在整體患者體驗方面。我們已經在員工滿意度方面看到了。我過去曾談到今天接受過 EMR 培訓的護士。當他們來到一家行為健康公司時，他們不希望在紙上工作。這可能是一份真正令人滿意的工作，但可能會在招聘和留住人才方面對我們造成傷害。因此，我們認為，擁有這項技術將在短期內帶來真正的好處。

And then ultimately, data and analytics. I mean we want to get to a point where we compete on the strength of our clinical health outcomes, which we think we will be able to do once we have the data that we can sit down with [payers] and have, but we need to implement the EMR to be in a position to do that.

最後是數據和分析。我的意思是，我們希望達到這樣一個地步，即我們在臨床健康結果的實力上展開競爭，我們認為一旦我們擁有可以與 [付款人] 坐下來並擁有的數據，我們就能夠做到這一點，但我們需要實施 EMR 才能做到這一點。

And then finally, just efficiencies that I was just referring to. I mean, we think that there are real opportunities just given the amount of paper that we and others and behavioral health have, I mean extensive paper, paper storage, but just reducing paper overall. And there's a number of just improvements in back office functions as well. So we continue to be just very optimistic about these investments that we're making. We don't think we're going to have to wait several years to see the benefit. We're really seeing the benefit now in several different categories, and we'll continue to provide updates as we go.

最後，就是我剛才提到的效率。我的意思是，我們認為，考慮到我們和其他人擁有的紙張數量以及行為健康，我們認為存在真正的機會，我的意思是大量紙張，紙張存儲，但只是減少了紙張總量。後台功能也有一些改進。因此，我們繼續對我們正在進行的這些投資非常樂觀。我們不認為我們將不得不等待幾年才能看到好處。我們現在確實在幾個不同的類別中看到了好處，我們將繼續提供更新。

Got it. And then, David, I guess, my question for you, my follow-up would be, as I think about the rest of the year, I know you obviously don't give quarterly guidance here, but anything you would call out from a modeling perspective as we think about the cadence for the year? And maybe focus on labor as well. Just -- I know you gave, for example, a merit increase to some employees on April 1. So how should we be thinking about just the progression of some of these moving parts in your opinion?

知道了。然後，大衛，我想，我想問你的問題是，我想在今年餘下的時間裡，我知道你顯然不會在這裡給出季度指導，但你會從當我們考慮今年的節奏時建模的角度？也許也關注勞動力。只是——我知道你在 4 月 1 日給了一些員工加薪。那麼在你看來，我們應該如何考慮其中一些活動部分的進展？

Yes. As you think about the quarterly earnings spread, I think -- the Street generally has it ride and understands the company's seasonality. The second and third quarter usually looked pretty similar. Of course, the first quarter is when we see the greatest impact of seasonality. So we're optimistic on moving into the second and third quarter. And we see a little bit more seasonality in the fourth quarter around the holidays, but it's typically $4 million or $5 million lower than the second and third quarter. So I think the -- hopefully, that's a helpful guide in terms of how the year typically plays out with our seasonality.

是的。當你考慮季度收益差時，我認為 - 華爾街通常會順其自然並了解公司的季節性。第二和第三季度通常看起來非常相似。當然，第一季度是我們看到季節性影響最大的時候。因此，我們對進入第二和第三季度持樂觀態度。而且我們在假期前後的第四季度看到了更多的季節性，但通常比第二和第三季度低 400 萬或 500 萬美元。因此，我認為 - 希望這對了解一年通常如何與我們的季節性有關方面有幫助。

From a labor cost perspective, we've talked about the moderating wage inflation but that some of the benefits in the corporate office investments will, of course, be reflected in those numbers over the course of the year. And so hopefully, that's helpful from a labor perspective. But we think the underlying core labor trends are really improving. And in the second half of the year, we'll see some of that year-over-year growth really moderate. So we believe we're in a good position from both a labor perspective and to deliver on our guidance for the year, Brian.

從勞動力成本的角度來看，我們已經談到了緩和的工資通脹，但公司辦公室投資的一些好處當然會反映在全年的這些數字中。希望從勞動力的角度來看，這會有所幫助。但我們認為潛在的核心勞動力趨勢確實在改善。而在今年下半年，我們將看到一些同比增長非常溫和。因此，布賴恩，我們相信從勞動力的角度和實現我們今年的指導意見我們都處於有利地位。

Our next question will come from Pito Chickering with Deutsche Bank.

我們的下一個問題將來自德意志銀行的 Pito Chickering。

And I appreciate, I do want to ask a question here. So I didn't get asked about the ex waivers and there is proposed elective changes that allow for taking on methadone being prescribed by physicians. So I guess the question is, with the number of changes to the law, or potential changes to the law around treating patients for methadone for a medication assistant treatment patients. I guess why are methadone clinics the best site of care from the perspective of patient burden and cost of care?

我很感激，我確實想在這裡問一個問題。所以我沒有被問到關於豁免的問題，並且有提議的選擇性改變允許服用醫生開的美沙酮。所以我想問題是，隨著法律的改變，或者對美沙酮治療患者的法律的潛在改變，作為藥物輔助治療的患者。我想從患者負擔和護理成本的角度來看，為什麼美沙酮診所是最佳護理場所？

Yes, Pito, there have been a number of bills introduced to address access. And of course, the situation in the industry is less than 10% of those OUD patients actually get treatment. And so that's what I know everyone, including us in the industry as the industry leader wants to improve access and drive that percentage higher. And there is a bill that's out there that I know you've referenced around just some attempt to improve that access by more flexibility in how methadone is dispensed, whether that's unsupervised 30-day doses or whether that's pharmacies being permitted to dispense methadone. We and others have been vocal about the initiatives already in place to improve access that we think will be a positive. And our view continues to be that this is a highly complex patient population.

是的，皮托，已經出台了許多法案來解決訪問問題。當然，該行業的情況是只有不到 10% 的 OUD 患者真正得到治療。這就是我所知道的每個人，包括我們作為行業領導者的行業希望改善訪問並提高該百分比。那裡有一項法案，我知道你已經參考了一些嘗試，通過更靈活地分配美沙酮來改善這種訪問，無論是無人監督的 30 天劑量還是允許藥店分配美沙酮。我們和其他人一直在直言不諱地談論我們認為將產生積極影響的改善准入的舉措。我們的觀點仍然是，這是一個高度複雜的患者群體。

There is a risk of diversion associated with any other setting of care. And it takes a highly trained clinician that works very closely on a daily basis and weekly counseling sessions, and you really have to have the full treatment of that patient that has a complex disease. And so that's why not only do we believe methadone will stay in the CTC OTP setting, but also while we believe there will continue to be just an importance of counseling and other wraparound services that we provide to our patients. We have not heard there's a bill out there, the modernizing opioid treatment Access Act. We've not heard that it's expected to really gain a lot of support. It's been out there in other forms over the last couple of years. So we -- our expectation is that, that bill would not pass in its current form, and we believe we have the right model in terms of treating that highly complex patient that honestly has a stronger addiction now than even in the services we were providing several years ago.

存在與任何其他護理環境相關的轉移風險。它需要一位訓練有素的臨床醫生，每天和每週的諮詢會議都非常密切地合作，而且你真的必須對患有復雜疾病的患者進行全面治療。因此，這就是為什麼我們不僅相信美沙酮將留在 CTC OTP 環境中，而且我們相信我們為患者提供的諮詢和其他綜合服務將繼續發揮重要作用。我們還沒有聽說有一項法案，即現代化的阿片類藥物治療准入法案。我們還沒有聽說它有望真正獲得大量支持。在過去的幾年裡，它以其他形式出現了。所以我們 - 我們的期望是，該法案不會以目前的形式獲得通過，我們相信我們有正確的模式來治療這個高度複雜的患者，這些患者現在誠實地比我們提供的服務更容易上癮幾年前。

And Pito, this is Chris. Maybe just one thing I would add. I just think the potency of fentanyl which is 50x relative to heroin. We see that when someone comes in that is -- has an advanced diagnosis of OUD, they really need significant treatment in the early weeks and days and months in terms of regulating that medication. And Suboxone and buprenorphine is just not the same clinical efficacy as what our clinicians see with methadone, which really continues to be the gold standard for medication and improving these OUD patients over time.

皮托，這是克里斯。也許我只想補充一件事。我只是認為芬太尼的效力是海洛因的 50 倍。我們看到，當有人進來時——對 OUD 進行了晚期診斷，他們確實需要在最初幾週、幾天和幾個月內就調節該藥物進行重大治療。 Suboxone 和丁丙諾啡的臨床療效與我們的臨床醫生使用美沙酮看到的臨床療效不同，美沙酮確實繼續成為藥物治療的金標準，並隨著時間的推移改善這些 OUD 患者。

So we just continue to think that, that is the better model particularly given the counseling and the significant in-person treatment that's required for these patients that are extremely sick and we think that will continue into the future.

因此，我們只是繼續認為，這是更好的模式，特別是考慮到這些重病患者所需的諮詢和重要的面對面治療，我們認為這種模式將持續到未來。

We have time for one more question here, and that will come from Gary Taylor with Cowen.

我們還有時間再問一個問題，這個問題將來自 Gary Taylor 和 Cowen。

Most of my thematic questions answered. So I just want to shoot you a technical one, financial one. Cash flow from ops a little lighter than our model and down year-over-year a little lighter than typical 1Q seasonality. It looks like the biggest part of that was just accrued SWB dropped about $30 million sequentially, which looked a little unseasonal as well. So just wondered if there was any particular explanation for that? Or how 1Q has any implications for how you see cash from ops developing this year?

我的大部分主題問題都得到了回答。所以我只想給你拍一張技術片，金融片。來自運營的現金流略低於我們的模型，同比下降略低於典型的第一季度季節性。看起來其中最大的部分是剛剛應計的 SWB 連續下降了大約 3000 萬美元，這看起來也有點不合時宜。所以只是想知道是否有任何特別的解釋？或者 1Q 對您如何看待今年運營現金的發展有何影響？

Yes, Gary, thanks for your question. No, it does not impact how we see the year playing out. The $44 million of operating cash flows was actually in line with our expectations. We do expect in the first quarter, we will have seasonal items related to working capital, not only some of the accrued compensation items and timing of our payroll. But also as you just think about accounts receivable building up during a period of significant revenue growth. Our team continues to do an incredible job with our cash collections with AR days of [44], but you're going to see just with the lag in the revenue growth that, that does drive some accounts receivable buildup. So it's just timing of working capital and we're expecting a strong year from here from an operating cash flow perspective.

是的，加里，謝謝你的提問。不，這不會影響我們對這一年的看法。 4400 萬美元的運營現金流實際上符合我們的預期。我們確實預計在第一季度，我們將有與營運資金相關的季節性項目，而不僅僅是一些應計薪酬項目和我們的工資發放時間。但也正如您只是考慮在收入顯著增長期間積累的應收賬款一樣。我們的團隊繼續以 [44] 的 AR 天數處理我們的現金收款，但你會看到收入增長滯後，這確實推動了一些應收賬款的積累。所以這只是營運資金的時機，我們預計從經營現金流的角度來看，今年將是強勁的一年。

And that concludes our question-and-answer session. I'd like to turn the conference back over to Chris Hunter for any closing remarks.

我們的問答環節到此結束。我想將會議轉回給 Chris Hunter，聽取任何閉幕詞。

Okay. Before we end the call, I just want to again thank our committed facility leaders, clinicians and 23,000 dedicated employees across the country. We just continue to work tirelessly to meet the needs of our patients in a safe and effective manner. I want to thank you all for being with us this morning and for your interest in Acadia. And if you have any additional questions today, please don't hesitate to contact us directly. Have a great day, everyone.

好的。在我們結束電話會議之前，我只想再次感謝我們敬業的設施領導、臨床醫生和全國 23,000 名敬業的員工。我們只是繼續孜孜不倦地工作，以安全有效的方式滿足患者的需求。我要感謝大家今天早上和我們在一起，感謝你們對阿卡迪亞的關注。如果您今天有任何其他問題，請隨時直接與我們聯繫。祝大家有個美好的一天。

The conference has now concluded. Thank you very much for attending today's presentation. You may now disconnect your lines.

會議現已結束。非常感謝您參加今天的演講。您現在可以斷開線路。