Acadia Healthcare Company, Inc. (ACHC) 2024 Q2 法說會逐字稿

Good day and welcome to Acadia Healthcare second quarter of 2024 earnings call. (Operator Instructions) Also, please be aware that today's call is being recorded.

大家好，歡迎參加 Acadia Healthcare 2024 年第二季財報電話會議。(接線員指示) 另外，請注意今天的電話會議將被錄音。

I would now like to turn the call over to Patrick Feeley, Head of Investor Relations. Please go ahead.

現在我想把電話會議交給投資人關係主管 Patrick Feeley。請開始。

Thank you and good morning. Yesterday after the market closed, we issued a press release announcing our second quarter 2024 financial results. This press release can be found in the Investor Relations section of the acadiahealthcare.com website. Here with me today to discuss the results are Chris Hunter, Chief Executive Officer, and Heather Dixon, Chief Financial Officer.

謝謝，大家早安。昨天收盤後，我們發布新聞稿，公布 2024 年第二季財務結果。該新聞稿可在 acadiahealthcare.com 網站的投資人關係專區查閱。今天與我一同討論結果的有執行長 Chris Hunter 與財務長 Heather Dixon。

To the extent any non-GAAP financial measure is discussed in today's call, you will also find a reconciliation of that measure to the most directly comparable financial measure calculated according to GAAP in the press release that is posted on our website.

若今天電話會議中討論任何非 GAAP 財務衡量指標，您也可在我們網站上發布的新聞稿中，找到該指標與依 GAAP 計算之最直接可比財務衡量指標之調節表。

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 2024 and beyond. These statements may be affected by the important factors, among others set forth in Acadia's filings with the Securities and Exchange Commission and the company's second quarter news release.

本電話會議可能包含《1995 年私人證券訴訟改革法》所定義的前瞻性陳述，其中包括但不限於關於 Acadia 對 2024 年及其後之預期季度與年度財務表現的陳述。這些陳述可能受到多項重要因素影響，包括但不限於 Acadia 向美國證券交易委員會提交之文件以及公司第二季新聞稿中所列因素。

And consequently, actual operations and results may differ materially from the results discussed in the forward-looking statements.

因此，實際營運與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, I'd like to turn the conference call over to Chris.

此刻，我想把電話會議交給 Chris。

Thank you, Patrick, and good morning, everyone. Thank you for being with us for Acadia's second quarter 2024 conference call. For the second quarter, we reported strong results, reflecting continued momentum in our business.

謝謝你，Patrick，大家早安。感謝各位參加 Acadia 2024 年第二季電話會議。第二季我們繳出強勁成果，反映公司業務動能持續。

Total revenue increased 8.8% over the prior year second quarter to $796 million, driven by both rate improvement and patient day growth. Our top line growth combined with solid operating leverage, led to adjusted EBITDA growth of 7.6% over the same quarter last year. Underlying labor trends remained stable into the second quarter. In addition to a more favorable overall labor market, our initiatives centered around recruitment, retention, and employee engagement have helped attract talent and maintain a more stable labor force.

總營收較去年第二季成長 8.8% 至 7.96 億美元，主要受惠於費率提升與病人日數成長。營收成長搭配穩健的營運槓桿，使調整後 EBITDA 較去年同期成長 7.6%。第二季的基礎人力趨勢仍維持穩定。除整體勞動市場更為有利外，我們聚焦於招募、留任與員工參與的各項措施，也有助於吸引人才並維持更穩定的人力結構。

On a same-store basis, revenue increased 8.3% compared with the second quarter of last year. Overall demand for our services remains strong, and we believe we are well positioned within our markets for continued growth, especially as new beds continue to ramp over the course of the year. We also remain on track for adding approximately 1,200 beds this year, including the addition of over 400 beds to existing facilities, which we believe will set us up for strong sustained growth in 2025 and beyond.

以同店基礎計算，營收較去年第二季成長 8.3%。整體而言，市場對我們服務的需求仍然強勁；我們相信在各個市場中已具備持續成長的良好定位，尤其是隨著新床位在今年內持續爬坡。我們也仍按計畫在今年新增約 1,200 張床位，其中包括在既有院所新增超過 400 張床位；我們相信這將為 2025 年及其後的強勁且可持續成長奠定基礎。

Now, I'd like to provide an update on our progress against our growth strategy. During the second quarter, we added 37 beds to existing facilities, bringing the year-to-date total to 64 beds. Bed expansions continue to be one of our best uses of capital, and we remain on track to add more than 400 beds to existing facilities for the full year.

接下來，我想更新我們在成長策略上的進展。第二季我們在既有院所新增 37 張床位，使今年迄今累計新增達 64 張。床位擴建仍是我們資本運用的最佳選項之一，我們也仍按計畫在全年於既有院所新增超過 400 張床位。

We also remain focused on developing new facilities in underserved markets for behavioral health care services, including wholly owned De Novos and strategic joint ventures. During the second quarter, we opened again, a rich Behavioral Hospital, a 100 bed De Novo acute care hospital in Mesa, Arizona. We also continue to make progress in creating new opportunities through our strategic joint ventures.

我們也持續聚焦於在行為健康照護服務不足的市場開發新院所，包括全資 De Novo 新設院所與策略性合資案。第二季我們開設了 Agave Ridge Behavioral Hospital，這是一家位於亞利桑那州梅薩（Mesa）的 100 床 De Novo 急性照護醫院。我們也持續透過策略性合資案推進並創造新的機會。

We're extremely proud to partner with premier health system healthcare systems in strategic markets with a shared mission to integrate physical and behavioral healthcare. These partners provide strong market recognition as well as established relationships that are advantageous to Acadia as we enter into these joint ventures. Including our joint ventures and wholly owned De Novos, over the past four quarters, we have now opened five new facilities.

我們非常自豪能在策略性市場與頂尖醫療體系合作，共同肩負整合身體與行為健康照護的使命。這些合作夥伴具備強大的市場知名度以及既有關係網絡，對 Acadia 進入這些合資案具有優勢。包含合資案與全資 De Novo 新設院所，在過去四個季度中，我們已開設五家新院所。

During the second quarter, we broke ground on a new 96 bed behavioral health hospital in partnership with Geisinger Health in Danville, Pennsylvania, which is their headquarters. This is our second joint venture facility with Geisinger, and follows the successful opening of our 96-bed facility in Moosic, Pennsylvania, in the third quarter of last year.

第二季我們與 Geisinger Health 在賓夕法尼亞州丹維爾（Danville）（其總部所在地）合作，為一座新的 96 床行為健康醫院動土。這是我們與 Geisinger 的第二個合資院所，延續去年第三季在賓夕法尼亞州穆西克（Moosic）成功開設的 96 床院所。

Looking forward, we have strong visibility into the new bed growth opportunities with nearly 2,000 new beds currently under construction, including both new facilities and bed expansions to existing facilities. In the second half of 2024, we expect to open four new facilities, including two new joint venture facilities, a 192 bed joint venture hospital in partnership with Henry Ford Health System in Detroit, and a 144 bed joint venture hospital in partnership with Intermountain Health in Denver, Colorado.

展望未來，我們對新增床位的成長機會具有高度能見度，目前約有近 2,000 張新床位正在施工中，包含新院所與既有院所的床位擴建。在 2024 年下半年，我們預期將開設四家新院所，其中包括兩家新的合資院所：一是與 Henry Ford Health System 合作、位於底特律的 192 床合資醫院；二是與 Intermountain Health 合作、位於科羅拉多州丹佛的 144 床合資醫院。

We are also on track to open up to 14 new CTCs in 2024, with three facilities already added to date via acquisition. Our CTC service line offers comprehensive care for patients who are affected by opioid use disorder or OUD. As the opioid epidemic escalates across the country, we are seeing record demand for our CTC services. It is estimated that 9 million Americans are suffering from OUD with a record 110,000 overdose deaths reported last year.

我們也按計畫在 2024 年最多開設 14 家新的 CTC，目前已透過併購新增 3 個據點。我們的 CTC 服務線為受鴉片類藥物使用障礙（OUD）影響的病人提供全方位照護。隨著鴉片類藥物疫情在全國惡化，我們看到對 CTC 服務的需求創下新高。據估計，有 900 萬名美國人正受 OUD 所苦，而去年通報的藥物過量死亡人數創紀錄達 11 萬人。

As we have previously discussed, the increasing prevalence of fentanyl mixed with other potent drugs has heightened the complexity and severity of OUD. Improved access to medication-assisted therapy is essential to helping address this crisis. We remain focused on meeting the critical demand for this treatment and delivering an exceptional and convenient patient experience, including adding mobile vans and reducing dosing wait times.

如我們先前所討論，芬太尼與其他強效藥物混用的盛行，提升了 OUD 的複雜度與嚴重性。提升藥物輔助治療（medication-assisted therapy）的可近性，對於協助因應此危機至關重要。我們仍專注於滿足此治療的關鍵需求，並提供卓越且便利的病人體驗，包括增設行動車與縮短給藥等候時間。

Importantly, we have maintained the highest-level standards of care in our CTCs, as evidenced by achieving scores of 99% across all 13 dimensions measured by the international regulatory body, [Carv]. Acadia now operates 160 CTC locations in 32 states across the country.

重要的是，我們在 CTC 中始終維持最高等級的照護標準；這可由我們在國際監管機構[Carv].所衡量的 13 個面向中取得 99% 的評分得到證明。

Extending the continuum of care is also important to our clinical strategy. One of our focus areas is expanding our partial hospitalization programs or PHP, and intensive outpatient programs, IOP that can provide four to six hours of care per day. These programs are advantageous for patients stepping down from an acute or specialty facility into a PHP or IOP program as they transition back into the community.

延伸照護連續性也是我們臨床策略的重要一環。我們的重點之一是擴大部分住院計畫（PHP）與密集門診計畫（IOP），這些計畫每天可提供 4 至 6 小時的照護。對於從急性或專科機構轉銜至 PHP 或 IOP、並逐步回歸社區的病人而言，這些計畫具有優勢。

Overall, with both PHP and IOP, we have established a strong track record of improved clinical outcomes post discharge. And from a return on capital perspective, PHPs and IOPs are attractive growth opportunities for Acadia due to the relatively low capital requirements.

整體而言，透過 PHP 與 IOP，我們在出院後改善臨床結果方面已建立強勁的實績。從資本報酬的角度來看，PHP 與 IOP 因資本需求相對較低，對 Acadia 而言是具吸引力的成長機會。

We added 15 outpatient programs during the second quarter of 2024 for a total of 30 added through the first half of the year. And we will continue to focus on this important clinical service. Quality remains foundational to every aspect of the work we do at Acadia and is key to driving outcomes and operational effectiveness. Our quality initiatives are designed to support our clinical teams with enhanced training and development, and we continue to refine our processes to ensure consistency across our operations.

我們在2024年第二季新增了15個門診方案，使上半年累計新增總數達到30個。我們將持續聚焦於這項重要的臨床服務。品質仍是我們在 Acadia 所做一切工作的基石，也是推動療效成果與營運效能的關鍵。我們的品質倡議旨在透過強化訓練與發展來支持臨床團隊，並持續精進流程，以確保各項營運的一致性。

We are making investments in programs that drive greater efficiency, including electronic medical records and patient monitoring technology. And we remain focused on investments that support the clinical side for both patient and staff safety. We recognize the importance of having quality measures and the right technology in place to make sure we are providing data that aligns with what our payer partners want to measure.

我們正在投資於可提升效率的方案，包括電子病歷與病患監測技術。我們也持續聚焦於支持臨床端的投資，以確保病患與員工的安全。我們了解建立品質衡量指標並配置適當技術的重要性，以確保我們所提供的數據符合保險支付方合作夥伴希望衡量的內容。

We expect to compete on the strength of our clinical outcomes and the ability to measure and demonstrate these outcomes is important to our payer collaborations. We are proud of our role as a leading pure play behavioral health care provider as the demand for behavioral health care services in our nation has never been greater. Whether serious mental illness, substance use disorder, suicide deaths, overdoses each of these issues have been on the rise in the past year alone.

我們預期將以臨床成果的優勢來競爭，而衡量並展示這些成果的能力，對我們與支付方的合作至關重要。隨著我國對行為健康照護服務的需求達到前所未有的高點，我們以作為領先的純行為健康照護提供者而自豪。無論是嚴重精神疾病、物質使用障礙、自殺死亡或藥物過量，僅在過去一年中，這些問題都呈上升趨勢。

The trends in our business through the first half of the year reflect this demand and we look forward to the significant opportunities ahead for Acadia to extend our market reach and serve even more patients in 2024. Our strategic priorities remain focused on accelerating facility growth, expanding services across the care continuum, strengthening our core capabilities, and strategically leveraging technology to enhance patient care and improve clinical outcomes, all with a focus on delivering the highest quality patient care.

我們在上半年業務表現的趨勢反映了這股需求，我們也期待 Acadia 在2024年能把握前方的重大機會，擴大市場觸及並服務更多病患。我們的策略重點仍聚焦於加速設施成長、在照護連續體中擴展服務、強化核心能力，以及策略性運用科技以提升病患照護並改善臨床成果，並以提供最高品質的病患照護為核心。

With our results to date, we remain confident in our ability to meet our growth objectives in 2024. We have the ability to leverage our proven operating model across our network of 258 facilities with service lines across the continuum of care. Importantly, we have the financial strength to support our continued growth. And finally, we're extremely fortunate to have over 23,500 committed employees and clinicians who work hard every day to address the nation's critical need for safe quality treatment for mental health and substance use issues.

以目前為止的成果來看，我們仍對在2024年達成成長目標充滿信心。我們有能力在由258家設施組成的網絡中，運用我們經驗證的營運模式，並涵蓋照護連續體各服務線。重要的是，我們具備支持持續成長的財務實力。最後，我們非常幸運擁有超過23,500名投入的員工與臨床人員，他們每天努力回應全國對安全且高品質的精神健康與物質使用問題治療的迫切需求。

At this time, I will now turn the call over to Heather to discuss our financial results for the quarter.

此時，我將把電話會議交給 Heather，請她說明本季的財務結果。

Thanks, Chris, and good morning, everyone. Our second quarter financial performance reflects continued growth across our business. We reported $796 million in revenue for the quarter, representing an increase of 8.8% over the second quarter of last year. Same-facility revenue grew 8.3% compared with the second quarter of 2023, which included an increase in revenue per patient day of 5.6% and patient day growth of 2.6%. We were also pleased to see volume growth accelerate throughout the course of the second quarter, in line with our expectations.

謝謝你，Chris，各位早安。我們第二季的財務表現反映出業務持續成長。本季我們營收為7.96億美元，較去年第二季成長8.8%。同店營收較2023年第二季成長8.3%，其中每位病患日營收增加5.6%，病患日成長2.6%。我們也很高興看到第二季期間量能成長逐步加速，符合我們的預期。

Adjusted EBITDA for the second quarter of 2024 increased 7.6% over the prior year to $187.6 million. Adjusted EBITDA margin was 23.6% compared with 23.9% for the same quarter last year. The year-over-year change in margin was primarily driven by the accelerated pace of recently opened De Novo facilities. As Chris mentioned, we've now opened five new facilities in the past four quarters. These facilities are ramping up nicely and remain on pace to deliver strong incremental volume growth and margin expansion in the back half of the year.

2024年第二季調整後 EBITDA 較去年同期成長7.6%，達1.876億美元。調整後 EBITDA 利潤率為23.6%，去年同季為23.9%。利潤率的年對年變動主要是由近期新開設的 De Novo 設施加速開辦所驅動。如 Chris 所提，我們在過去四個季度已開設五家新設施。這些設施的爬坡進展良好，並仍按計畫在下半年帶來強勁的增量量能成長與利潤率擴張。

On a same facility basis, adjusted EBITDA margins were flat in both the second quarter of this year and the prior year's second quarter. Adjusted income attributable to Acadia stockholders per diluted share was $0.91 compared to $0.92 for the prior-year period. Consistent with previous periods adjustments to income for the second quarter of 2024 include transaction, legal and other costs, loss on impairment, and the related income tax effects of all items.

以同店基礎來看，今年第二季與去年第二季的調整後 EBITDA 利潤率持平。歸屬於 Acadia 股東的每股稀釋調整後盈餘為0.91美元，去年同期為0.92美元。與以往期間一致，2024年第二季對盈餘的調整項目包括交易、法律及其他成本、減損損失，以及所有項目相關的所得稅影響。

We continue to focus on maintaining a strong financial position, providing the flexibility to make strategic investments that support our growth and fit our capital allocation framework. As of June 30, 2024, we had 77.2 million in cash and cash equivalents and $371.5 million available under our $600 million revolving credit facility with a net leverage ratio of approximately 2.5 times.

我們持續專注於維持強健的財務狀況，以提供彈性進行支持成長且符合資本配置框架的策略性投資。截至2024年6月30日，我們持有7,720萬美元的現金及約當現金，並在6億美元的循環信用額度下尚有3.715億美元可用，淨槓桿比率約為2.5倍。

Moving on to our outlook for 2024. As noted in our press release, we have adjusted our previously announced 2024 guidance, which includes revenue in the range of $3.18 billion to $3.225 billion, adjusted EBITDA in the range of $735 million to $765 million, adjusted earnings per diluted share in the range of $3.45 to $3.55 (sic - see press release, "$3.65") and total bed additions of approximately 1,200 beds.

接著談我們對2024年的展望。如我們新聞稿所述，我們已調整先前公布的2024年財測指引，包括營收區間為31.8億至32.25億美元、調整後 EBITDA 區間為7.35億至7.65億美元、每股稀釋調整後盈餘區間為3.45至3.55美元（原文如此—請參閱新聞稿，「3.65美元」），以及總床位新增約1,200床。

Please note that our updated guidance reflects the closure of two underperforming facilities during the second quarter. Prior guidance contemplated approximately $25 million of revenue contribution and breakeven EBITDA from these facilities for the full year. As a reminder, the company's guidance does not include the potential benefit of state supplemental payments that have not yet been fully approved, nor does it include the impact of any future acquisitions, divestitures, transaction, legal and other costs or nonrecurring legal settlements expense.

請注意，我們更新後的指引反映了第二季關閉兩家表現不佳的設施。先前指引原本預期這些設施全年可貢獻約2,500萬美元營收，且 EBITDA 損益兩平。提醒各位，公司指引不包含尚未完全核准的州政府補充付款之潛在效益，也不包含任何未來併購、處分、交易、法律及其他成本或一次性法律和解費用的影響。

With that, operator, we're ready to open the call for questions.

以上，接線員，我們準備開始開放提問。

We will now begin the question-and-answer session. (Operator Instructions) Whit Mayo, Leerink.

我們現在開始問答環節。（接線員指示）Whit Mayo，Leerink。

Hi. Thanks. Good morning. I think you mentioned in your remarks that the volumes accelerated throughout the quarter. Can you maybe elaborate a little bit more on the month-over-month trends and improvement that you saw comment on the exit rate and any insight into July and the second half target space?

嗨。謝謝。早安。我想你在談話中提到，本季量能在整個季度期間加速。你能否再多說一些你們看到的逐月趨勢與改善情況，並評論一下期末退出率（exit rate），以及對7月與下半年目標區間的任何看法？

Sure. And Thanks, Whit. Yeah, I'd be happy to. Volume growth actually accelerated over the course of the quarter. Same-store patient day growth improved month over month sequentially throughout the quarter, and volume remained strong into July, with July census in line with where we would have expected it to be at the beginning of the year.

當然可以。謝謝你，Whit。是的，我很樂意。量能成長確實在本季期間逐步加速。同店病患日成長在整個季度逐月依序改善，而量能在7月仍維持強勁，7月的住院人數（census）與我們在年初所預期的水準一致。

We saw that sequential improvement throughout the quarter across the lines of business, including acute and specialty. And we continue to see same-store patient day growth comfortably in the mid-single digits for the second half of the year.

我們在整個季度看到各業務線（包括急性與專科）都有這種連續性的改善。我們也持續預期下半年同店病患日成長可穩健維持在中個位數百分比。

Maybe just a reminder, we have added over 1,000 new beds in the past 18 months, 400 of those in the second half of last year alone. And those are continuing to ramp nicely. And that includes two of our joint venture De Novos that we will roll into the same store calculation count during the third quarter. And those are two of the most successful De Novos that we had to date. They're already running at 60% or more occupancy less than a year after opening.

也許提醒一下，我們在過去18個月新增了超過1,000張新床位，其中光是去年下半年就新增了400張。而這些床位的爬坡進展仍然相當順利。其中也包括我們兩個合資的新設院所（De Novo），我們會在第三季把它們納入同店（same-store）計算的口徑。而這兩個是我們迄今最成功的De Novo之一。它們在開業不到一年後，入住率就已達到60%或更高。

So just to reiterate, we feel really good about being comfortably in that mid-single digit range for the second half.

所以再重申一次，我們對於下半年能夠穩健落在中個位數區間感到非常有信心。

Okay. And maybe just on the closures, there has been a pattern. This year, you've closed more facilities than prior years. And I'm not sure if there's a theme here, anything to read into it, maybe there is just an internal focus more to manage the portfolio more aggressively. But if you could just share what you guys are doing and why you're moving a little bit more aggressively with closures?

好的。另外關於關閉院所這件事，似乎有一個模式。今年你們關閉的機構比以往年度更多。我不確定這背後是否有什麼主題或可解讀之處，也許只是內部更聚焦於更積極地管理投資組合。但你們能否分享一下你們在做什麼，以及為什麼在關閉方面採取更積極的作法？

Sure. Whit, this is Chris. I'll take that one. We have made the decision to close two underperforming facilities during the second quarter, and we've closed five in the last 12 months. I would simply say this is just a process of just continuously evaluating the portfolio. If we're seeing facilities that are underperforming and don't see a path to improvement, we're going to take action. But I wouldn't read anything into it more than just now constant evaluation and optimization that we'll continue to monitor going forward.

當然。Whit，我是Chris。這題我來回答。我們已決定在第二季關閉兩家表現不佳的院所，而在過去12個月我們總共關閉了五家。我想說，這只是持續評估投資組合的一個流程。如果我們看到某些院所表現不佳，且看不到改善的路徑，我們就會採取行動。但我不會把它解讀成除此之外的任何事情；這就是持續性的評估與優化，我們未來也會繼續監控。

Okay. Thanks, guys.

好的。謝謝各位。

A.J. Rice, UBS.

UBS 的 A.J. Rice。

Hi, everybody. I know part of the dynamic of seeing the improved EBITDA from first half to second half this year. I think you've characterized it as about $10 million. Part of that was going to be the bed additions, which you just addressed. But part of it, I think was also the timing of Medicaid rate updates coming into the back half of the year. Can you comment of how those are tracking relative to your expectations? I assume you got some July and there's probably another batch that come in in October. How are those seeming to trend?

各位好。我知道今年上半年到下半年EBITDA改善的動能之一，我想你們把它描述為大約1,000萬美元。其中一部分來自新增床位，你們剛剛已經談到。但我認為另一部分也與Medicaid費率更新在下半年生效的時點有關。你們能否評論一下，這些更新的進度相較於你們的預期如何？我猜7月你們已經拿到一些，10月可能還會有另一批。這些趨勢看起來如何？

Yeah. Thanks, AJ. I'll take that one, I'll start just on the sequencing of EBITDA second half versus first half. And then I'll talk about the rate specifically. Three things really, I would point to. The first is volume. We just talked about how volume is trending and what we're seeing just to reiterate coming into the second half, we're going to -- we feel really good about where the underlying volume trends are as they stepped up month-over-month and then stayed strong in July.

是的。謝謝你，AJ。這題我來回答。我先談一下下半年相對上半年EBITDA的排序/節奏，然後再具體談費率。我主要會指出三件事。第一是量（volume）。我們剛剛談到量的走勢以及我們看到的情況；再重申一次，進入下半年，我們對於基本面量的趨勢感到非常樂觀，因為它逐月上升，且在7月仍維持強勁。

And then we see that incremental volume coming in to the second half of the year from all the new beds that we've added that I just talked about. And specifically with those joint ventures coming into the same-store calculations. From all of that, we had previously said and we still continue to believe that that specific cohort of beds will is on pace and will contribute at least $10 million of incremental EBITDA in the second half of the year. So the underlying volume plus specifically, the EBITDA from the new beds is coming in strong for the second half versus the first half.

接著，我們也看到因為新增床位（我剛剛提到的）而在下半年帶來的增量量能。尤其是那些合資案將納入同店（same-store）計算。基於上述因素，我們先前已表示、且現在仍然相信，這一特定床位群組正按計畫推進，並將在下半年貢獻至少1,000萬美元的增量EBITDA。因此，基本面量的提升，加上新增床位帶來的EBITDA，讓下半年相較上半年表現強勁。

And then finally, rate updates as you mentioned, a majority of our Medicaid revenue has contract years that start in the second half versus the first half. And I think about EBITDA sequentially second half versus first half. That's certainly a benefit that we would see that would improve EBITDA sequentially.

最後，如你所提到的費率更新，我們大部分的Medicaid收入其合約年度是在下半年開始，而不是上半年。因此，若以EBITDA的序列來看下半年相對上半年，這確實會帶來一個有利因素，使EBITDA在序列上改善。

For Medicaid, you're right. We do see most of those updates in the second half of the year. We continue to think that our mid-single digit rate updates for the full year, where would land. And we don't have complete visibility yet, AJ, into those rate updates. October 1 is our biggest contract reset date, and a lot of those rate updates tend to go into place retroactively. So we don't get rate notifications until after the period starts in some cases. So we get more details on that. We'll keep you guys updated.

就Medicaid而言，你說得沒錯。我們確實在一年下半年看到大多數的更新。我們仍然認為全年中個位數的費率更新會落在我們預期的區間。但目前我們對這些費率更新還沒有完全的能見度，AJ。10月1日是我們最大的合約重設日期，而許多費率更新往往會追溯生效。因此在某些情況下，我們要到期間開始後才會收到費率通知。等我們掌握更多細節，我們會持續向各位更新。

But in terms of what's built into our outlook, our outlook continues to include mid-single digit rate for the year, and we expect underlying rates to be similar to recent trends. And that's what we've seen to date so far. We just don't have to complete visibility yet.

但就我們展望中所納入的假設而言，我們的展望仍包含全年中個位數的費率水準，且我們預期基本費率將與近期趨勢相近。到目前為止，我們看到的也確實如此。只是我們還沒有完全的能見度。

Okay. And maybe one follow up on the supplemental payment comment. Lot of focus on that these days on the acute side, but it obviously benefits you as well. Can you comment on whether there was any material change in supplemental payment, either on the revenue line or the expense line that impacted the results in this quarter? And I know it's early on the Tennessee, but I think there's been some reporting out there that suggests that could be as much as 5% boost to your consolidated EBITDA if that program gets approved as submitted?

好的。另外針對你提到的補充支付（supplemental payment）再追問一題。最近市場對急性照護端（acute side）非常關注，但顯然這也會讓你們受益。你們能否評論一下，本季是否有任何補充支付的重大變動——不論是在營收端或費用端——影響了本季結果？另外我知道田納西州（Tennessee）的部分還很早，但我想外界有一些報導指出，如果該計畫按提交內容獲批，可能會讓你們合併EBITDA提高多達5%？

And then is there any other programs should we keep an eye on that are under discussion?

此外，還有沒有其他正在討論中的計畫，是我們應該留意的？

Yeah, AJ, this is Chris. Thanks for the question. Let me start on just the Tennessee supplemental program. Just a few comments here at the outset. I mean, I think first of all, Tennessee is obviously our home state. Has been working with the state for a number of years on this program. And we just continue to be really pleased that they're moving with it.

是的，AJ，我是Chris。謝謝你的問題。我先從田納西州的補充計畫談起。一開始先補充幾點。首先，田納西州顯然是我們的總部所在州。我們與州政府就這個計畫合作推動已經有好幾年。我們也持續對他們推進此事感到非常欣慰。

I think as everyone is aware, it's been approved by the governor, it's now with CMS for their review and approval. And we continue to think that the most likely scenario is that the program gets approved near the end of the year or early next year. And this would obviously, for us, apply to our acute hospitals across the state, which is 950 beds for us in Tennessee. And we think that that would apply to have roughly 70% or 75% of those 950 beds.

我想大家都知道，該計畫已獲州長批准，目前已送交CMS進行審查與核准。我們仍然認為最可能的情境是該計畫在今年年底附近或明年年初獲批。而這對我們而言，顯然會適用於我們在全州的急性醫院（acute hospitals），也就是我們在田納西州的950張床位。我們認為其中大約70%或75%的這950張床位會適用。

So we're not yet in a position to size it until the program is fully approved, but we would expect the benefit, of course, to be material once it is implemented and it's still working its way through the process. So we're going to just have to wait and see. But once it is approved, our understanding is that the program will be retroactive to (technical difficulty) 1, but we haven't assumed anything in guidance for the program until we have more clarity there.

因此，在該計畫完全獲批之前，我們還無法評估其規模，但我們預期一旦實施，效益當然會相當可觀，而目前它仍在流程中推進。所以我們只能再觀察看看。但一旦獲批，據我們了解，該計畫將追溯至（技術問題）1，但在我們對該計畫有更清楚的資訊之前，我們在指引中尚未對此作任何假設。

And in terms of your question on other states, I mean, there definitely are other states that have the potential to expand these programs over the next few years. There aren't any that I would specifically call out, but we continue with our teams to be monitoring that very closely.

至於你關於其他州的問題，我的意思是，未來幾年確實還有其他州有可能擴大這些計畫。我不會特別點名任何一個州，但我們會持續與團隊密切監控相關動態。

Yeah, I'll pick up on your question about what we've seen to date, what's in the numbers and what we would expect. If we look at the first quarter and where we started the guidance, we had $10 million in the guidance for the full year from one-time payments that we would call out. $7 million of that we received in the first quarter and called out that we still have $3 million of that $10 million to come in the second half of the year. So we still haven't received that.

是的，我來接續你關於截至目前我們看到什麼、數字裡反映了什麼，以及我們預期會如何的問題。如果我們看第一季以及我們起始的全年指引，我們在指引中納入了1,000萬美元的全年一次性付款收入。我們在第一季已收到其中的700萬美元，並指出剩餘的300萬美元（在這1,000萬美元之中）將於下半年入帳。所以我們仍尚未收到那筆款項。

During the quarter -- you asked if there were any unusual movements to point out it? Yes, in other operating expenses, we did see some provider tax payments associated with some supplemental revenue in the period. Those were, I would say, materially the same. So there's no real material impact to EBITDA. They were roughly in line with each other just due to timing. And those show up in other operating expenses, the provider taxes do. And so those tend to jump out on that line. But if you exclude those provider taxes, that are effectively taxes on a path to repayments, other OpEx would have been in line with the first quarter as a percentage of revenue.

在本季期間——你問是否有任何不尋常的變動值得指出？有的，在其他營運費用方面，我們確實看到一些與本期部分補充性收入相關的提供者稅（provider tax）支付。我會說，兩者在金額上大致相當。因此對EBITDA沒有實質性的影響。它們大致彼此一致，主要只是時間點的差異。而這些提供者稅會列在其他營運費用中。所以在那一行通常會特別顯眼。但如果你排除這些提供者稅——它們本質上是通往償付（repayments）路徑上的稅負——其他營運費用占營收比重將會與第一季一致。

Okay, thanks a lot.

好的，非常感謝。

Brian Tanquilut, Jefferies.

Jefferies 的 Brian Tanquilut。

Hey, good morning, guys, and congrats on the quarter. Maybe Heather, just to follow up on AJ's question, anything we need to think about just as we model for Q3? Just any sequential considerations that we need to factor in, that you want to call out?

嘿，早安，各位，恭喜本季表現。也許 Heather，接續 AJ 的問題，我們在為第三季建模時，有沒有什麼需要特別留意的？有沒有任何連續性（sequential）的考量需要納入、你想特別提醒的？

No, I think that covered it, thinking about volume and EBITDA and then the rate increases. So there's nothing else I would call out on that.

沒有，我認為已經涵蓋了，主要就是量（volume）與EBITDA，以及費率上調。所以沒有其他我會特別提出的。

Okay. Got it. And maybe, Chris, as you think about redeterminations, obviously, the process is potentially done, but just curious, I'm guessing there was some impact still in Q2. So how are you or how should we be thinking about any residual impact for redeterminations back half of the year?

好的。了解。另外，Chris，談到資格重新認定（redeterminations），顯然流程可能已接近完成，但我好奇，我猜第二季仍有一些影響。那麼對於今年下半年重新認定可能帶來的任何殘餘影響，你們是如何看待、或我們應該如何思考？

Yeah. Thanks, Brian. I would say that we just continue to see no material impact from redetermination at all. At this point, we feel like we have almost no exposure left. Well over 90% of our populations have already gone through the process. And we obviously spent -- as we've talked about before extensive time planning on well over a year ago, in advance of redetermination. And I think that planning and that execution has really served us well overall.

是的。謝謝，Brian。我會說，我們持續看到重新認定幾乎完全沒有任何實質性影響。目前我們覺得幾乎已沒有曝險。我們超過90%的族群已經走完該流程。而且我們顯然——如同先前談過的——在重新認定開始之前就花了非常多時間做規劃，早在一年多以前就開始準備。我認為那樣的規劃與執行整體上確實讓我們受益良多。

So I would just say I'm really pleased with the work our team has done. Our patients experienced very little to no disruption, and we're really pleased to have that behind us overall. So I'll just leave it at that.

所以我只能說，我對團隊所做的工作非常滿意。我們的病患幾乎沒有受到影響或中斷，我們也很高興整體而言這件事已經告一段落。我就說到這裡。

Awesome. Thank you.

太棒了。謝謝你。

Kevin Fischbeck, Bank of America.

美國銀行（Bank of America）的 Kevin Fischbeck。

Thanks. Can you just add a little more color on the volume commentary as far as ramping through the quarter? Is it largely just the issues you mentioned at the end of last quarter being in the base and normalizing off of that as the new beds coming on ramping up faster? Is there anything that you spike out as to why we start to see that acceleration as the quarter went on?

謝謝。你能否就本季量（volume）的評論再多補充一些細節，特別是關於在季度內逐步爬升（ramping）的情況？這主要只是你提到的上季末那些問題已反映在基期中，然後隨著新床位啟用更快爬升而回歸正常嗎？是否有任何你會特別指出的因素，能解釋為何我們在本季進行中開始看到加速？

I would say it's the former. So if you think about what we talked about on the last call, we expected for those underlying volumes to pick back up throughout the quarter. And that's exactly what we saw. We saw sequential improvement throughout the quarter, across lines of business, and we saw that each month quarter over quarter. And then we saw July really strong as well. I said it before, but I'll just repeat it. We are back at census levels for July that were in line with where we would have expected them to be at the beginning of the year.

我會說是前者。所以如果你回想我們在上一通電話中談到的，我們預期那些基本量（underlying volumes）會在本季期間逐步回升。而我們看到的正是如此。我們在本季期間、跨各業務線都看到逐月的連續改善，而且每個月相較前一季也都有改善。另外我們也看到7月表現非常強勁。我之前說過，但我再重申一次。我們7月的在院人數（census）已回到與我們年初預期一致的水準。

Okay. And then maybe just a follow-up again on the commentary about the closures because it is a bit of a change over the last 12 months. And since it sounds like demand, broadly speaking, is incredibly strong. Trying to understand what is it that actually causes the facility to underperform? Can you give some examples of what was going out of these facilities that would have made them ones where you just didn't see an opportunity for improvement?

好的。接著再追問一下關於關閉據點（closures）的評論，因為相較過去12個月這確實有些變化。而且聽起來整體需求非常強勁。我想了解的是，究竟是什麼原因會導致某個機構表現不佳？你能否舉一些例子，說明這些機構出了什麼狀況，使得你們認為看不到改善的機會？

Sure, Kevin, I'll take that. A few things, I would say. We had one facility as an example. That was a wilderness program in western North Carolina, where we were having a real challenges, finding staff and counselors that could take adolescence into the woods for (technical difficulty) days. We had no other programs like that. And it was really a one-off type facility where we were struggling with staffing.

當然，Kevin，我來回答。我會說有幾個因素。例如我們有一個機構。那是一個位於北卡羅來納州西部的荒野計畫（wilderness program），我們在招募人員與諮商師方面遇到很大挑戰，因為需要有人能帶青少年進入野外（技術問題）天。我們沒有其他類似的計畫。而那確實是一個一次性的特殊據點，我們在人力配置上一直很吃力。

So that's an example of something that we would look at in the context of optimization. I would say if you look back historically over the last few years, the year-over-year revenue drag from the closed facilities has typically been in the ballpark of around $5 million per quarter. And so we have closed more than typical over the last few quarters. And I would say on a year over year from a revenue standpoint, it's been a drag of about $12 million to $15 million per quarter in the first half of the year.

所以這就是我們在最佳化（optimization）脈絡下會評估的一個例子。我會說，如果你回顧過去幾年的歷史，已關閉機構對年對年營收造成的拖累，通常大約落在每季500萬美元左右。而在過去幾季，我們關閉的數量高於一般水準。我會說，從營收的年對年角度來看，今年上半年每季大約拖累1,200萬到1,500萬美元。

And you can clearly see that in the same-store revenue comps that we report relative to the prior year. So I would just say we have 258 facilities. This is normal portfolio optimization, as I mentioned before, and just --we'll continue to monitor it going forward.

而且你可以在我們相對於前一年的同店營收比較（comps）中清楚看到這一點。所以我只想說，我們有 258 家機構。如我先前提到的，這是正常的投資組合優化，我們也會在未來持續監控。

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，RBC Capital Markets。

Great. Thank you very much. Just following up on that prior question, I wonder if you can contrast the backdrop for some of the new areas that you expect to expand into in underserved markets, how the staffing backdrop is in those markets, physician availability, payer mix, et cetera. What are the key points that give you confidence that you're going to see good strong performance in those facilities as they ramp up? Thank you.

很好。非常感謝。延續剛才那個問題，我想請你對比一下你們預期在服務不足市場中將擴張進入的一些新區域的整體背景，例如這些市場的人力配置情況、醫師供給、付款方組合等。有哪些關鍵因素讓你有信心，這些機構在爬坡期會看到良好且強勁的表現？謝謝。

Sure. I would just say that one of the things that we would look at closely as we consider deploying capital, our geographies that we think are attractive across a number of different dimensions. It could be the competitive environment, certainly the labor environment, payer reimbursement, there are all sorts of various factors there.

當然。我想說的是，當我們考慮資本投放時，會非常仔細地評估我們認為在多個面向都具吸引力的地理區域。這可能包括競爭環境，當然也包括勞動力環境、付款方給付（reimbursement），以及各式各樣的因素。

And I think those are always considered, I would say from a labor standpoint, we've seen market as everyone else has that has been challenged, but stable over the last year. And we've put a number of initiatives in place that have really helped us on that front continue to bring turnover down. I think we've chosen geographies just very carefully that have less challenge.

而我認為這些因素一直都會被納入考量。就勞動力而言，我們和其他人一樣也看到市場曾面臨挑戰，但過去一年相對穩定。我們也推動了多項措施，確實在這方面幫助我們持續降低離職率。我認為我們非常謹慎地選擇了挑戰較少的地區。

I'd say therapists remain hard to recruit overall, there are certain clinicians in various markets that can be challenging by service line and geography.

我會說，整體而言治療師仍然難以招募；在不同市場中，某些臨床人員會因服務線與地理位置而更具挑戰。

Rural areas are certainly tougher, but we continue to do a really good job of managing through that and have felt like we have been able to take real strides given many of the initiatives that we have put in place, particularly around the employee engagement surveys that we put in place that we haven't looked at historically, the training of our clinical staff that is new and just a number of other things that we've just been very deliberate about ensuring that there's consistency across all of our facilities, and that we're providing training to new employees in the same way.

鄉村地區確實更困難，但我們仍持續把這件事管理得很好，也覺得在我們推動的多項措施下已取得實質進展，特別是我們導入的員工敬業度調查（過去我們並未歷來採用）、對臨床人員的新訓練，以及其他一些事項；我們一直非常有意識地確保所有機構之間的一致性，並以相同方式為新進員工提供訓練。

And then maybe the last thing I would add is just really helps to have new technology and newer facilities. I think our JV partners do a tremendous job of helping attract talent to these new facilities that we're opening together. We obviously start that process many months, if not a year in advance of the facility opening. And I think that is one of the real advantages to these JVs that we're doing. They're really helping us on the labor front as well.

另外我想補充的最後一點是，擁有新技術與較新的設施確實很有幫助。我認為我們的合資（JV）夥伴在協助吸引人才到我們共同開設的新機構方面做得非常出色。顯然，我們在機構開業前好幾個月、甚至提前一年就開始這個流程。我認為這也是我們進行這些合資的一項真正優勢。他們也確實在勞動力方面幫了我們很大的忙。

Thanks. And just if I could ask one on the legislative and regulatory backdrop, your peer UHS noted little fallout to date regarding the Senator Wyden investigation into RTCs. I was just wondering what you're preparing for or expecting could come down the line from a legislative perspective, whether it be transparency, oversight, minimum staffing, et cetera. Thank you.

謝謝。另外我想問一個關於立法與監管環境的問題，你們同業 UHS 提到，截至目前針對 Wyden 參議員對 RTC 的調查，影響不大。我想請問你們在立法面可能會為哪些事情做準備或預期未來可能出現哪些變化，例如透明度、監督、最低人力配置等。謝謝。

Yeah, I would say I'm we just haven't seen any real impact from the Senate hearing in the report. I think we believe that the people that deal with this patient population every day, and that certainly includes our referral sources as well as the various regulatory oversight bodies that are routinely in these facilities understand that this is just a really difficult population.

是的，我會說我們確實還沒有看到參議院聽證會與報告帶來任何實質影響。我想我們相信，每天都在處理這類病患族群的人——這當然包括我們的轉介來源以及各種監管監督機構——都明白這是一個非常難處理的族群。

I think they also understand our facilities are providing high-quality care to this population, and we demonstrate that routinely with the outcomes that we're able to achieve. And so we just haven't seen impact.

我想他們也了解，我們的機構正在為這個族群提供高品質照護，而我們也能透過我們所達成的治療結果（outcomes）持續證明這一點。因此我們確實沒有看到影響。

I'd also point out that our RTC business is small. We only operate nine facilities, it's about 11% of our revenue. And so it's also not overly material from a financial standpoint to begin with.

我也要指出，我們的 RTC 業務規模不大。我們只營運 9 家機構，約占我們營收的 11%。因此從財務角度來看，一開始也不是特別重大。

John Ransom, Raymond James.

John Ransom，Raymond James。

Hey, good morning. Kind of an in the weeds question here. Just looking at your salaries and wages per patient day, it bounces around as we move through the year. [$532] in the first quarter, [$519] in the second quarter. How are you thinking about that metric if you happen to know that? Zooming out, how should we think about the underlying inflation rate on a same facility basis for labor? Is it still running like you saw it a quarter ago? Thanks.

嗨，早安。這是一個比較細節的問題。我在看你們每病患日（patient day）的薪資與工資，隨著年度推進會上下波動：第一季是 [$532]，第二季是 [$519]。如果你剛好知道的話，你們怎麼看這個指標？拉遠一點看，在同一機構基礎上，勞動力的底層通膨率我們應該怎麼理解？它是否仍像你們一季前看到的那樣運行？謝謝。

Hi, John, yeah, thanks for the question. Our underlying wage inflation continues to translate favorably, just below that 5% level. As you recall, the high watermark was really in the fourth quarter of 2022, and we have been very focused on the efforts around that in terms of employee engagement, retention, working with the local market operators. And we were able to bring that down successfully during the course of 2023. And we finished 2023 under 5% from a wage inflation perspective.

嗨，John，是的，謝謝你的問題。我們的底層薪資通膨持續呈現有利走勢，略低於 5% 的水準。如你所記得的，高點其實是在 2022 年第四季；我們一直非常專注於相關工作，包括員工敬業度、留任，以及與當地市場營運團隊合作。我們在 2023 年期間成功把它降下來。從薪資通膨角度來看，我們在 2023 年底已降到 5% 以下。

As with any company that operates in many markets, there's always going to be some pockets of challenge, but through the first half of this year, we've been able to successfully maintain that sub-5% range, and we would continue to expect that our base wage inflation will remain stable for the rest of the year and same with the SWB per patient day, same story we would expect there. So really tracking in line with our expectations, and we continue to expect that to be stable for the balance of the year.

就像任何在多個市場營運的公司一樣，總會有一些較具挑戰的區域，但在今年上半年，我們已成功維持在 5% 以下的區間；我們也預期今年剩餘時間底層薪資通膨將維持穩定，而每病患日的薪資與工資（SWB）也是同樣的情況，我們也預期會是同樣的走勢。因此整體上都符合我們的預期，我們也持續預期在今年餘下期間會保持穩定。

If I could just follow up, maybe for Chris. I'm just looking at the MAT business. I mean, the growth rate in the De Novos it picked up. If we just disaggregate that business, I know it was reported in your consolidated numbers. But how should we think about the growth rate of that business? What are you targeting over the intermediate term? And yeah, relative to the growth rate in your core facility business?

如果我可以再追問一下，可能是問 Chris。我在看 MAT 業務。我的意思是，De Novos 的成長率有加快。如果我們把那個業務拆開來看，我知道它是併在你們的合併數字裡報告的。但我們應該怎麼看那個業務的成長率？你們在中期目標是什麼？以及相對於你們核心機構業務的成長率而言呢？

Yeah. Thanks, John, for the question. I would say that this is a business that we continue to feel great about, particularly given the demographic trends with over 9 million people that are suffering from OUD. We're up right now to 160 locations in 32 states. I don't want to put a specific target on a growth rate, but we've seen -- particularly since Nasser came in two years ago to run that business, just substantial growth.

是的。謝謝你，John，這個問題。我會說，這是一項我們仍然非常看好的業務，特別是考量到人口結構趨勢——有超過 900 萬人正受 OUD 所苦。我們目前已成長到在 32 個州有 160 個據點。我不想對成長率給出一個特定目標，但我們看到——尤其是自從 Nasser 兩年前接手經營這項業務以來——成長非常顯著。

And not only have we seen growth, we've seen incredibly strong clinical outcomes, which I think have been beneficial in helping us with opioid settlement dollars, our best in class [Carv] scores, in addition to the fact that our turnover in that business has been really strong as well.

而且我們不僅看到了成長，還看到了極為強勁的臨床結果；我認為這有助於我們取得阿片類藥物和解金、我們同業最佳的 [Carv] 評分，此外，我們在該業務的員工流動率表現也一直非常強勁。

Over 80% of our CTC patients are also opioid-free within six months of initiating treatment, which we also think is best in class. So we just feel really good about the prospects of that business and our ability to grow it going forward.

我們的 CTC 病患中有超過 80% 在開始治療後六個月內也能達到無阿片狀態，我們也認為這是同業最佳。因此，我們對該業務的前景以及未來持續擴張的能力感到非常樂觀。

And is that business -- what's the -- I don't know, average length of stay is the wrong term, but just the median course of treatment when patients enter and leave, what is that number?

那這項業務——平均住院天數這個說法可能不太對，但就病患進入與離開時的治療中位數療程而言，那個數字是多少？

Yeah, John, we don't have it off hand in terms of the exact specifics. It can obviously really vary. But I think the key metric is that those that are coming in, we are able to get to opioid-free within six months. And after that, it can really vary. But I mean, that is a best-in-class measure right there.

是的，John，我們手邊沒有確切的細節數據。這當然可能差異很大。但我認為關鍵指標是：對於進來的病患，我們能在六個月內讓他們達到無阿片狀態。而在那之後，情況就會有很大差異。不過我的意思是，這本身就是一個同業最佳的衡量指標。

Scott Fidel, Stephens.

Scott Fidel，Stephens。

Hi, thanks. Good morning. I just was hoping to get your initial assessment. You've had all the way since last night, I guess to review this, but just with the final Medicare IPF rates coming out on for FY 2025, just your view on the adequacy of the final rate at around 2.5%?

嗨，謝謝。早安。我希望先聽聽你們的初步評估。你們從昨晚到現在應該有時間檢視了；關於 2025 會計年度（FY 2025）最終版 Medicare IPF 費率出爐，你們如何看待約 2.5% 的最終調幅是否足夠？

And then any call-outs on any of the policy items included in it -- either positive or negative or did everything so far seems to be pretty much in line?

另外，裡面包含的政策項目有沒有什麼值得特別點出的——不論正面或負面？還是目前看起來都大致符合預期？

Thanks for the question. We're obviously still digesting it as it came out last night. But I would say early read, it's in line with our expectations. That's what we had expected and projected into our guide for the year and no surprises there.

謝謝你的問題。這是昨晚才公布的，我們顯然還在消化中。但就初步解讀而言，與我們的預期一致。這正是我們所預期的，也已納入我們今年的財測指引中，沒有任何意外。

As far as other things that we're tracking, there's nothing really material on the horizon that we're tracking. Of course, we're following all the developments, but nothing I would point to, specifically.

至於其他我們在追蹤的事項，目前沒有什麼在可預見的範圍內會造成重大影響。當然，我們會持續關注所有進展，但沒有什麼我會特別點名的。

Okay. And then just a follow-up, just on operating cash flow and CapEx. Saw the updated reaffirmed guidance. I'm just curious if there are any call-outs that you wanted to give us on modeling that for 3Q versus 4Q on cash flow? Any working capital or timing items that you would highlight? And same thing on CapEx, any tempo that you would call out between the 3Q and 4Q?

好的。再追問一下，關於營運現金流與資本支出（CapEx）。我看到你們更新並重申了指引。我想了解在建模第三季（3Q）相對第四季（4Q）的現金流時，有沒有任何你們想提醒我們的重點？例如營運資金或時點上的因素，有沒有需要特別注意的？同樣地，CapEx 在 3Q 與 4Q 之間的節奏，有沒有什麼你們會特別提示的？

No, nothing really to call out. We continue to have a significant number of beds under construction. Certainly this year, and that will go into next year as well as we add those beds. But nothing specifically, I would call that in the cadence because we're sort of in the midst of those incremental bed adds.

沒有，沒有什麼特別需要點出的。我們仍有相當多的床位正在施工中。當然今年如此，明年也會延續，因為我們會持續新增這些床位。但就節奏而言沒有特別要說的，因為我們正處於這些增量床位新增的進行當中。

Okay. Thank you.

好的。謝謝。

Pito Chickering, Deutsche Bank.

Pito Chickering，德意志銀行（Deutsche Bank）。

Good morning. We saw some pressure on Q-to-Q -- for the Veterans Association, opening up new beds. I guess can you talk about how specialty started and ended the quarter in any a lasting impact from VA?

早安。我們看到退伍軍人事務部（VA）開放新床位，對季度環比（Q-to-Q）造成了一些壓力。可否談談專科業務在本季初與季末的情況，以及 VA 是否帶來任何持續性的影響？

Hi Pito. Yeah. We saw, as I mentioned, we saw the sequential improvement each month in the quarter in volumes, and that included specialty volumes as well as acute volumes. So I've really seen that come back nicely in line with our expectations and then I mentioned that that remained strong in July as well. And so feel good about those coming in line with where we thought that they would be. As far as looking through the rest of the year, we think that's going to continue to be in line with our expectations and see that volume improvements.

嗨，Pito。是的。如我提到的，我們在本季每個月的量能都有環比改善，這也包含專科量能以及急性照護量能。所以我確實看到它回升得很好，符合我們的預期；我也提到 7 月仍然維持強勁。因此，我們對其回到我們原先預期的水準感到樂觀。至於今年剩餘時間，我們認為會持續符合預期，並看到量能持續改善。

Okay. And one quickly on CTC. What was the organic growth rate of that business? And what's the split between volume and pricing? Thanks so much.

好的。再快速問一個關於 CTC。該業務的有機成長率是多少？量與價（volume 與 pricing）的拆分各是多少？非常感謝。

Yeah, sure. I'll take that as well. CTC you'll see, when it comes out in the Q that the CTC business grew about 9% from a revenue perspective and the top line throughout the quarter. We don't split the EBITDA or anything else by division or by line of business. But that's what you'll see in terms of top line growth.

好的，當然。我也來回答。CTC 方面，你會看到在季度資料公布時，CTC 業務從營收角度來看，本季營收與整體營收（top line）約成長 9%。我們不會按事業部或業務線別拆分 EBITDA 或其他指標。但就營收成長而言，你會看到的是這個數字。

Andrew Mok, Barclays.

Andrew Mok，巴克萊（Barclays）。

Hi, good morning. I wanted to ask about the bed cadence. I think you've done 300 today. So can you help us with just the cadence of the significant bed adds for the balance of the year? And it sounds like most of those would be in the fourth quarter just given how late those new and JV facilities are coming online, would you expect that group to be a net headwind or tailwind to 2025 earnings? Thanks.

嗨，早安。我想問一下床位新增的節奏。我想你們目前已新增 300 床。能否協助我們了解今年剩餘期間重大床位新增的節奏？而且聽起來由於新設與合資（JV）設施較晚才上線，多數會落在第四季；你們是否預期這一批對 2025 年獲利會是淨逆風還是淨順風？謝謝。

Yeah, thanks, for the question, Andrew. There's no material impact from that. It's continuing the us -- headwinds tailwinds are the impact of those new beds. It's continuing to track in line with what we had expected at the beginning of the year. But you're right on the cadence of those beds coming in towards the second half and weighted towards the end of the second half

好的，謝謝你的問題，Andrew。這方面沒有重大影響。這些新床位帶來的影響——不論是逆風或順風——目前的進度持續符合我們年初的預期。但你說得對，床位導入的節奏會落在下半年，且更偏向下半年末端。

Yeah. And Andrew, thanks for the question. Why don't I just give you a little bit of additional color. I think clearly the JVs I mentioned in the prepared remarks, both Henry Ford, which is 192 bed JV, acute hospital on Metro Detroit are coming on board later this year, as well as Intermountain, which is 144 beds in Denver. So it's 336 beds on the JV front by year end.

是的。Andrew，謝謝你的問題。我再補充一些背景說明。我想很明顯地，我在事先準備的講稿中提到的合資案（JV），包括 Henry Ford——位於底特律都會區的 192 床合資急性照護醫院——將在今年稍晚加入；以及 Intermountain——丹佛 144 床——也會在今年稍晚加入。因此到年底，合資案方面合計是 336 床。

And then we've got a number of de Novos. I mean, we I've already opened our Agave Ridge facility in Arizona. We've opened another one Sable Palms in Brooksville, Florida. We've got another in Madison, Wisconsin, that will be opening later this year. And then you also need to take into account the fact that we have significantly ramped up our historical average of 300 bed additions to over 400. It was really evaluating markets that we think are attractive.

另外我們還有多個新設（de Novo）案。也就是說，我們已在亞利桑那州開設 Agave Ridge 設施。我們也在佛羅里達州 Brooksville 開設了另一家 Sable Palms。我們在威斯康辛州 Madison 還有一家將於今年稍晚開幕。此外你也需要考量，我們已將過去歷史平均每年新增 300 床的速度，大幅提升到超過 400 床。這主要是因為我們在評估我們認為具吸引力的市場。

And then I would just also note that on the CTC side, we're seeing continued demand there and we've stepped up the number of CTC De Novos from 6 last year to 14 this year. So a lot of construction going on, but we have a very strong team that is maniacally focused on execution right now. And we continue to feel very good about our ability to deliver on the 1,200 that we've committed to.

另外我也想補充，在 CTC 方面，我們看到需求持續存在，今年我們將 CTC De Novos 的數量從去年的 6 家提升到今年的 14 家。因此目前有大量建設在進行中，但我們有一支非常強的團隊，現在正以近乎偏執的專注力聚焦於執行。而且我們仍然對達成我們承諾的 1,200（床位）交付能力感到非常有信心。

Got it. And then if I could, I just want to follow up on the other OpEx. I understand provider taxes flow through that line. So the trends can do difficult to parse, but it seems like those costs might be creeping up even beyond that. Can you comment on underlying OpEx trends beyond provider taxes. I would think you'd be able to generate better leverage on that line with the double-digit revenue growth. Thanks.

了解。另外如果可以的話，我想追問一下其他營運費用（OpEx）。我理解提供者稅（provider taxes）會流經那一行。所以趨勢可能很難拆解，但看起來這些成本可能甚至在此之外也在緩步上升。你能否評論一下扣除提供者稅之後的底層 OpEx 趨勢？我原本以為在營收雙位數成長的情況下，你們應該能在那一行產生更好的營運槓桿。謝謝。

Yeah, sure. I'll take that. So just to reiterate, the provider taxes that came through in Q2 were about $3 million or $4 million higher sequentially. And that's really the taxes effectively on some pass-through payments that came through as well.

好的，當然。我來回答。先重申一下，第二季流入的提供者稅，較前一季約增加了 300 萬到 400 萬美元。而那其實是對一些同樣流入的轉付（pass-through）款項所課徵的稅。

But the provider taxes come through in the other OpEx line. So it distorts it. If you pull that out, excluding the step-up in those provider taxes, then operating expenses as a percentage of revenue are really right in line with what we saw in first quarter. So I wouldn't -- there's nothing I would call out there other than that, that is that's what's distorting it a bit.

但提供者稅是計入其他 OpEx 這一行。所以會把該項目扭曲。如果把它剔除，也就是排除提供者稅的上升因素，那麼營運費用占營收比重其實與第一季看到的水準非常一致。所以我不會——除了這點之外，沒有其他我會特別指出的；就是這個因素讓它看起來有些被扭曲。

Sarah James, Cantor Fitzgerald.

Sarah James，Cantor Fitzgerald。

Thank you. Some clinical worker employers on the acute side have started talking about coming to what they think will be at the end of the recovery cycle or reaching run rate on the recruiting retention, premium labor recovery path. Can you talk about where you think you are on that journey? And then on a broader sense, where do you think the behavioral sector is? How much room there is left for improvement?

謝謝。急性照護端的一些臨床人力雇主已開始談到，他們認為招募留任與高價人力（premium labor）回落的復甦路徑，可能正接近復甦週期尾聲或達到常態化運行水準（run rate）。你能談談你們認為自己在這段旅程中的位置嗎？另外更廣泛來看，你認為行為健康（behavioral）產業目前處於什麼位置？還有多少改善空間？

Thanks, Sarah. We continue to see just really strong progress. Our turnover continues to be flat to down across the company. And we put a number of initiatives in place that have helped drive that. I referenced earlier, just the consistent training programs, onboarding that we have put in place across our 248 facilities, our improved employee engagement. We had not done surveys before two years ago. We're getting ready to do another survey here shortly and then obviously putting all of this technology in place as well.

謝謝你，Sarah。我們持續看到非常強勁的進展。我們的離職率在全公司範圍內持平到下降。而我們也推出了多項措施來推動這個結果。我先前提到過，我們在 248 家機構全面導入一致性的訓練計畫與到職培訓（onboarding），並提升員工敬業度。在兩年前之前我們並沒有做過員工調查。我們很快會再進行一次調查，當然也同時在導入所有這些技術。

So we can, we're always going to see some fluctuation by job category service line geography. But I think in totality, we've done a really good job of addressing this, and it continues to be just a major focus. Obviously, our ability to staff these facilities is going to continue to be crucial to our ability to fill these beds that we're constructing and to continue to grow. So we're very focused on it and feel good about the progress that we continue to make year to date.

因此，我們在不同職類、服務線與地理區域之間，仍然會看到一些波動。但整體而言，我認為我們在解決這個問題上做得非常好，而且這仍然是我們的重大重點。顯然，我們能否為這些機構配置足夠人力，將持續是我們能否填滿正在建設的床位並持續成長的關鍵。所以我們非常專注於此，也對今年迄今持續取得的進展感到樂觀。

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

Hi, good morning. Maybe just a broader bigger picture question. I guess, how are you thinking about the election dynamics? We're getting a lot more questions these days from clients on? And I guess if the Republicans do retake the White House, I would still think there's broad support for behavioral services. But curious maybe just what you're hearing from state partners or just any other broader thoughts you have on that topic? Thank you.

嗨，早安。也許是一個更宏觀的大方向問題。你們如何看待選舉的動態？我們最近從客戶那邊收到更多相關問題。我想即使共和黨重新奪回白宮，我仍然認為行為健康服務應該有廣泛支持。但也想請教你們從州政府合作夥伴那邊聽到什麼，或你們對這個議題是否有其他更宏觀的看法？謝謝。

Yeah, thank you for the question, Ryan. I mean, I think we feel that there's still broad bipartisan support for behavioral health across the country. And I think that's especially been true over the last few years. The importance of mental health, particularly coming out of the pandemic, has been increasingly recognized just year over year. And we just don't see that changing.

好的，謝謝你的問題，Ryan。我的意思是，我們認為全國對行為健康仍然有廣泛的跨黨派支持。而且我認為過去幾年尤其如此。心理健康的重要性，特別是在疫情之後，逐年愈來愈受到重視。我們不認為這會改變。

So I think it's a little premature for us to speculate beyond that. But I think overall just what we're seeing on the federal and state side, there just continues to be tremendous support for the services that we're providing and we'll continue to work with our partners in the state and in DC to continue to monitor this.

所以我認為現在就此做進一步推測還有點太早。但整體而言，從聯邦與州層級我們所看到的，是對我們所提供服務仍然有非常強勁的支持；我們也會持續與州政府以及華府（DC）的合作夥伴合作，持續追蹤與監測這些情況。

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

問答環節到此結束。我想把電話會議交回給 Chris Hunter，請他做結語。

Thank you. In closing, I just want to again thank our committed facility leaders, our clinicians, and approximately 23,500 dedicated employees across the country who just continue to work tirelessly to meet the needs of patients in a safe and effective manner. We have such a strong foundation and a proven strategy for driving growth and delivering greater value to both the patients we serve and our shareholders.

謝謝。最後，我想再次感謝我們盡責投入的機構領導團隊、臨床人員，以及全國約 23,500 名敬業的員工；你們持續不懈地以安全且有效的方式滿足病患需求。我們擁有非常堅實的基礎，以及一套經驗證的策略，能推動成長並為我們服務的病患與股東帶來更大的價值。

So thank you all for being with us this morning, and thank you for your interest in Acadia.

因此，謝謝各位今天早上與會，也謝謝各位對 Acadia 的關注。

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

本次電話會議已結束。感謝各位參加今天的簡報。您現在可以掛斷電話線。