Adapthealth Corp (AHCO) 2024 Q4 法說會逐字稿

Good day, everyone, and welcome to today's AdaptHealth fourth quarter 2024 earnings release. Today's speakers will be Suzanne Foster, Chief Executive Officer of AdaptHealth; and Jason Clemens, Chief Financial Officer of AdaptHealth.

大家好，歡迎參加今天的 AdaptHealth 2024 年第四季財報。今天的演講者是 AdaptHealth 執行長 Suzanne Foster；以及 AdaptHealth 財務長 Jason Clemens。

Before we begin, I would like to remind everyone that statements included in this conference call and in the press release issued today may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act. These statements include, but are not limited to, comments regarding financial results for 2025 and beyond. Actual results could differ materially from those projected in forward-looking statements because of a number of risk factors and uncertainties, which are discussed at length in the company's annual and quarterly SEC filings.

在我們開始之前，我想提醒大家，本次電話會議和今天發布的新聞稿中包含的聲明可能構成《私人證券訴訟改革法案》所定義的前瞻性聲明。這些聲明包括但不限於 2025 年及以後財務表現的評論。由於多種風險因素和不確定因素，實際結果可能與前瞻性陳述中的預測存在重大差異，這些因素在公司年度和季度 SEC 文件中進行了詳細討論。

AdaptHealth Corp has no obligation to update the information provided on this call to reflect such subsequent events. Additionally, on this morning's call, the company will reference certain financial measures such as EBITDA, adjusted EBITDA, adjusted EBITDA margin and free cash flow, all of which are non-GAAP financial measures. You can find more information about these non-GAAP measures in the presentation materials accompanying today's call, which are posted on the company's website. This morning's call is being recorded and a replay of the call will be available later today.

AdaptHealth Corp 沒有義務更新本次通話中提供的資訊以反映此類後續事件。此外，在今天早上的電話會議上，公司將參考某些財務指標，如 EBITDA、調整後的 EBITDA、調整後的 EBITDA 利潤率和自由現金流，所有這些都是非 GAAP 財務指標。您可以在今天電話會議的演示材料中找到有關這些非公認會計準則指標的更多信息，這些材料已發佈在公司的網站上。今天上午的通話正在錄音，今天晚些時候將提供通話重播。

It is now my pleasure to introduce the Chief Executive Officer of AdaptHealth, Suzanne Foster.

現在我很高興介紹 AdaptHealth 的執行長 Suzanne Foster。

Good morning, everyone, and thank you for joining the call. As we close out 2024, I'm encouraged by the progress we've made towards strengthening our foundation and positioning the company for long-term success and growth.

大家早安，感謝大家參加電話會議。隨著 2024 年即將結束，我們在鞏固基礎和為公司實現長期成功和成長做好準備方面所取得的進展令我感到鼓舞。

Before I get into that, I'd like to take a moment to review our fourth quarter results. We are pleased that revenue, adjusted EBITDA and free cash flow each exceeded the high end of our guidance ranges for the fourth quarter of 2024, acknowledging that this follows on the reduced expectations we shared in early November.

在開始之前，我想花點時間回顧一下我們第四季的業績。我們很高興看到，2024 年第四季的營收、調整後 EBITDA 和自由現金流都超過了我們預期範圍的高端，我們也承認，這是在我們 11 月初降低預期之後的結果。

Fourth quarter revenue was effectively flat versus the prior year quarter, but beat the midpoint of our Q4 guidance range by 3% as our Sleep Health and Respiratory Health segments delivered year-over-year growth, offsetting contraction in our Diabetes Health segment.

第四季營收與去年同期相比基本持平，但由於我們的睡眠健康和呼吸健康部門實現同比增長，抵消了糖尿病健康部門的萎縮，因此比我們第四季度預期範圍的中點高出 3%。

Compared to prior year quarter by segment, fourth quarter Sleep Health revenue increased 3.4%, Respiratory Health increased 1%, Wellness at Home declined 0.8% and Diabetes Health declined 7.3%. Fourth quarter adjusted EBITDA contracted 2% from the prior year quarter, but was well above the high end of our guidance range, while our adjusted EBITDA margin was 23.4%, modestly narrower than the 23.8% reported in prior year quarter.

與去年同期相比，各部門第四季睡眠健康收入成長 3.4%，呼吸健康收入成長 1%，家庭健康收入下降 0.8%，糖尿病健康收入下降 7.3%。第四季調整後的 EBITDA 較去年同期收縮 2%，但遠高於我們預期範圍的高位，而我們的調整後 EBITDA 利潤率為 23.4%，略低於去年同期的 23.8%。

Free cash flow was strong in the fourth quarter at $73 million, up 10% from prior year quarter and well above the high end of our guidance range. As you know, last August, we identified five areas of focus, which included our One Adapt initiative, accelerating the application of AI and automation, increasing our clinical relevance, delivering organic growth and strengthening our balance sheet. And I'm pleased that we are already making progress on all fronts.

第四季自由現金流強勁，達到 7,300 萬美元，較去年同期成長 10%，遠高於我們預期範圍的高點。如您所知，去年八月，我們確定了五個重點領域，其中包括我們的 One Adapt 計劃、加速人工智慧和自動化的應用、提高我們的臨床相關性、實現有機成長和加強我們的資產負債表。我很高興我們在各方面都取得了進展。

Starting with One Adapt, we're taking action to standardize work and cultivate a mindset of continuous improvement to ensure that we deliver exceptional service and quality of care to patients. We began by assembling a team of talented and experienced leaders, recruiting several senior professionals to the company over the last seven months. This includes new leaders for operations and strategy, who both joined in the second quarter. It also includes the appointment of a Chief Commercial Officer, a new Chief Legal Officer and an SVP of Supply Chain this past quarter. And this coming month, we are looking forward to welcoming our newly appointed senior leader to build out our Adapt Operating System or AOS.

從 One Adapt 開始，我們採取行動標準化工作並培養持續改進的心態，以確保我們為患者提供卓越的服務和護理品質。我們首先組建了一支才華橫溢、經驗豐富的領導團隊，並在過去七個月內為公司招募了幾位高級專業人員。其中包括第二季度加入的營運和戰略新領導人。它還包括上個季度任命一位首席商務官、一位新的首席法律官和一位供應鏈高級副總裁。下個月，我們期待歡迎新任命的高級領導人來建立我們的 Adapt 作業系統或 AOS。

We made all of these additions while holding the line on our adjusted EBITDA margin. Just as important, we are empowering these individuals and the teams they lead through an organizational structure that prioritizes accountability, coordination and trust.

我們在保持調整後 EBITDA 利潤率不變的情況下進行了所有這些增加。同樣重要的是，我們透過優先考慮責任、協調和信任的組織結構賦予這些個人和他們領導的團隊權力。

Among other changes, starting in the fourth quarter, we moved to a segment structure for managing the company with general managers appointed to each of these four segments. This new structure provides visibility into the needs of our customers, coordinates our efforts around service excellence, drives accountability throughout our organization and allows us to measure and improve our business performance.

除其他變化外，從第四季度開始，我們轉向分部結構來管理公司，並為四個分部分別任命總經理。這種新結構使我們能清楚地了解客戶的需求，協調我們為追求卓越服務所做的努力，推動整個組織的責任制，並使我們能夠衡量和提高業務績效。

Further, we are harnessing the abundance of talent and experience in our workforce by enlisting employees across all levels of the organization to participate in training on problem-solving methods, by challenging them to proactively identify opportunities for improvement in our processes and operations and by inviting them to work with their colleagues to implement changes that will increase the quality of the work we perform.

此外，我們也充分利用員工隊伍中的豐富才華和經驗，邀請組織各個層級的員工參加解決問題的方法培訓，鼓勵他們積極主動地尋找改善流程和營運的機會，並邀請他們與同事一起實施變革，以提高我們工作的品質。

One Adapt is about superior execution. It is about being the best operator in the industry and building an unrivaled reputation for patient service excellence. In short, it's about being the best version of what we already are. And at the same time, we recognize we must evolve how we do what we do today. And that means leading the home health industry in innovation and expanding the value we deliver for patients.

One Adapt 致力於卓越的執行。其目標是成為業界最好的營運商，並建立無與倫比的卓越患者服務聲譽。簡而言之，這就是我們要成為現有的最好的版本。同時，我們認識到我們必須改進我們目前的做事方式。這意味著引領家庭保健產業的創新並擴大我們為患者提供的價值。

A prime example is our focus on harnessing the power of automation and AI. We have several initiatives underway that will simplify the patient experience, streamline the work we do for them and free up resources that could be reinvested in creating additional patient value. To name just two, in October, we introduced a self-pay feature in our mobile application called myAPP. And following through on an initiative I mentioned last quarter, in December, we launched a CPAP self-scheduling feature in myAPP. Our self-scheduling feature eliminates the need for patients to interact with a customer service representative to schedule a CPAP setup.

一個典型的例子就是我們專注於利用自動化和人工智慧的力量。我們正在進行多項舉措，旨在簡化患者體驗、精簡我們為他們所做的工作並釋放可重新投資於創造額外患者價值的資源。僅舉兩個例子，十月份，我們在名為 myAPP 的行動應用程式中推出了一項自付費功能。為了貫徹我上個季度提到的一項計劃，我們在 12 月在 myAPP 中推出了 CPAP 自我安排功能。我們的自我安排功能消除了病人與客戶服務代表互動來安排 CPAP 設定的需要。

These new features provide additional convenience and simplicity. Similarly, we see an immense opportunity to increase clinical relevance. We are already investing heavily in our adherence programs, helping more patients stay on critical therapies for longer and reducing the incidence of costly rehospitalization.

這些新功能提供了額外的便利和簡單。同樣，我們看到了提高臨床相關性的巨大機會。我們已經在依從性計劃上投入了大量資金，幫助更多患者更長時間地接受關鍵治療，並減少昂貴的再入院發生率。

The next phase in our evolution is harnessing the massive quantities of physiological, behavioral and environmental patient-generated data from our in-home equipment and using that data to deliver actionable insights to patients, physicians and payers. This is the direction we will follow to build a best-in-class health services business that drives improved health outcomes and reduced costs to benefit all of the stakeholders in the US healthcare system.

我們發展的下一個階段是利用來自家用設備的患者產生的大量生理、行為和環境數據，並利用這些數據向患者、醫生和付款人提供可操作的見解。這是我們建立一流醫療服務業務的方向，旨在改善健康結果、降低成本，使美國醫療保健系統的所有利益相關者受益。

While we are in the early stages of realizing this ambition, we view our recent success with capitated arrangements as a strong vote of confidence in our ability to appropriately manage patient care and a solid indication that we have a path to an expanded role, which brings me to the next area of focus, delivering organic growth.

雖然我們正處於實現這一目標的早期階段，但我們認為，我們最近在按人頭計費安排方面取得的成功，是對我們適當管理患者護理的能力的強烈信心，也是我們能夠發揮更大作用的有力跡象，這也將我帶到了下一個重點領域，即實現有機增長。

In the fourth quarter, we realigned our sales organization under our new Chief Commercial Officer, Russ Schuster, who brings a wealth of experience and proven track record of growing large businesses and who will oversee our commercial strategy and revenue generation. Under Russ' leadership, we also implemented sales quotas for the first time in many years. These quotas will provide clear performance benchmarks and inject the proper incentives needed for driving sales effectiveness.

在第四季度，我們在新的商務長拉斯舒斯特（Russ Schuster）的領導下重組了我們的銷售組織，他擁有豐富的經驗和發展大型企業的成功經驗，並將監督我們的商業策略和創收。在拉斯的領導下，我們也多年來首次實施了銷售配額。這些配額將提供明確的績效基準，並注入提高銷售效率所需的適當誘因。

Further, we are strengthening the connective tissue between our commercial and operations teams who are partnering to improve workflow around order intake and conversion of orders to revenue. We are also focused on resuming organic growth in our Diabetes Health segment. To this end, we commenced a diagnostic review of the causes of our underperformance. Notwithstanding structural reimbursement pressures that have weighed on all operators in the medical benefit channel, we simply weren't keeping pace with the competition. Among other causes, our review determined that we had lost focus on how we manage patient interactions.

此外，我們正在加強商業和營運團隊之間的聯繫，他們正在合作改善圍繞訂單接收和訂單轉化為收入的工作流程。我們也致力於恢復糖尿病健康部門的有機成長。為此，我們開始對業績不佳的原因進行診斷性審查。儘管結構性的報銷壓力對醫療福利管道的所有運營商都構成壓力，但我們根本無法跟上競爭的步伐。除其他原因外，我們的審查發現我們失去了對如何管理患者互動的關注。

Excessive patient outreach elevated our attrition rates with existing resupply patients and depressed diabetes new starts by damaging our standing with referring physicians. As I mentioned last quarter, we made swift moves to course correct our Diabetes business. We installed a new leadership team for the segment, aligned under an experienced general manager, and we integrated diabetes resupply into our sleep resupply operations to leverage the experience and leadership that have made sleep resupply our center of excellence.

過度的患者外展增加了我們現有補給患者的流失率，並損害了我們在轉診醫生中的聲譽，從而抑制了糖尿病的新起點。正如我上個季度提到的，我們迅速採取行動，糾正糖尿病業務的方針。我們為該部門組建了一個新的領導團隊，由一位經驗豐富的總經理領導，並將糖尿病補給整合到我們的睡眠補給業務中，以利用經驗和領導力，使睡眠補給成為我們的卓越中心。

In the fourth quarter, we remodeled our diabetes patient outreach program using best practices from our sleep resupply operations to deliver an experience that makes sense for patients. I am pleased to report that we are beginning to see promising signs that these actions are working.

在第四季度，我們利用睡眠補給營運的最佳實踐重塑了我們的糖尿病患者外展計劃，為患者提供有意義的體驗。我很高興地報告，我們開始看到這些行動正在發揮作用的良好跡象。

On the resupply side, we grew orders year-over-year in December. Our Q4 2024 attrition rate was the lowest we have seen in two years and we exceeded our Q4 2024 diabetes resupply revenue forecast, albeit off of our reduced expectations.

在補給方面，我們12月的訂單年增。我們的 2024 年第四季員工流失率是兩年來最低的，我們超越了 2024 年第四季糖尿病補給收入預測，儘管低於我們降低的預期。

On new starts, we are working hard to rebuild trust with our referral sources and we were encouraged to see a sequential increase in new diabetes patients during Q4 2024, which contrasts with the sequential contraction we saw in the prior year quarter. One quarter does not make a trend and it's going to take some time to improve performance, but I have confidence that the team is executing well on its plan to shore up the processes and we are cautiously optimistic that diabetes will become less of a drag on our overall organic growth rate over time.

在新病例方面，我們正在努力重建與轉診來源的信任，我們很高興看到 2024 年第四季度新糖尿病患者數量環比增加，這與去年同期的環比收縮形成了鮮明對比。一個季度並不能形成一種趨勢，而且需要一段時間來提高業績，但我相信團隊正在很好地執行其計劃以鞏固流程，我們謹慎樂觀地認為，隨著時間的推移，糖尿病對我們整體有機增長率的拖累將逐漸減小。

Also related to delivering organic growth, we continue to see opportunities to grow our business through capitated fee arrangements with payers and we are encouraged by how our existing arrangements are performing in terms of outcomes, costs and satisfaction for both payers and patients.

此外，與實現有機成長相關的是，我們繼續看到透過與付款人達成的按人頭收費協議來成長業務的機會，並且我們對現有協議在結果、成本以及付款人和患者的滿意度方面的表現感到鼓舞。

In fact, I am pleased to announce that this past week, we agreed to a multi-year extension of our capitated contract with Humana. Finally, turning to our objective of strengthening our balance sheet. In the last year, we reduced debt outstanding by $170 million, including another $50 million in the fourth quarter. And at year-end 2024, our net leverage ratio stood at 2.8 times. Also during 2024, we refinanced our senior secured credit facility to extend our maturity and reduce our interest expense.

事實上，我很高興地宣布，上週我們同意與 Humana 延長一份多年的按人頭計費合約。最後，談談我們加強資產負債表的目標。去年，我們減少了 1.7 億美元的未償還債務，其中第四季又減少了 5,000 萬美元。截至2024年底，我們的淨槓桿率為2.8倍。此外，在 2024 年，我們對高級擔保信貸工具進行了再融資，以延長期限並降低利息支出。

Further, we have continued to exit non-strategic product lines. In the third quarter, we completed a transaction to sell certain custom rehab assets. In the fourth quarter, we reached a definitive agreement to sell certain incontinent assets to a third-party. And in 2025, we will continue to explore the potential divestiture of an additional non-core product line. We expect these divestitures in aggregate to be accretive to our adjusted EBITDA margin and to generate proceeds for further debt reduction.

此外，我們繼續退出非策略性產品線。第三季度，我們完成了出售某些客製化復健資產的交易。第四季度，我們達成了最終協議，將某些失禁資產出售給第三方。2025年，我們將繼續探索剝離更多非核心產品線的可能性。我們預計，這些資產剝離總體上將增加我們的調整後 EBITDA 利潤率，並產生進一步減債的收益。

In closing, our five areas of focus are just the first steps along our journey to realize our full potential as a healthcare services company. In many respects, it is an execution road map designed to help our new leadership team lock arms to keep us focused on what we need to accomplish in the near-term.

最後，我們關注的五個領域只是我們作為醫療服務公司充分發揮潛力的第一步。從許多方面來看，它都是執行路線圖，旨在幫助我們的新領導團隊齊心協力，讓我們專注於近期需要完成的任務。

Undoubtedly, all of you are keenly interested in understanding more about the strategic direction of the company, and I can assure you that is forthcoming. Our strategy team is already sharpening our vision for how best to create value from our opportunities and establishing a plan for resourcing and executing that vision over the next several years. I look forward to sharing more about that as 2025 progresses.

毫無疑問，大家都非常有興趣進一步了解公司的策略方向，我可以向你們保證，這一切即將實現。我們的策略團隊正在完善我們的願景，即如何最好地利用我們的機會創造價值，並製定未來幾年為該願景提供資源和執行的計劃。我期待在 2025 年到來之際分享更多相關資訊。

With that, I will turn it over to Jason.

說完這些，我將把麥克風交給傑森。

Thank you, Suzanne, and thanks to everyone for joining our call. Today, I'm going to review full year and fourth quarter 2024 results. I'll follow that with a review of our balance sheet and our plans for capital allocation before finishing with our outlook for 2025.

謝謝你，蘇珊娜，也謝謝大家參加我們的電話會議。今天，我將回顧 2024 年全年和第四季的業績。接下來，我將檢視我們的資產負債表和資本配置計劃，然後結束我們對 2025 年的展望。

Starting with the fourth quarter, we moved to a multiple segment structure for reporting our results to align with how we are now managing the company. We believe this reporting change will increase transparency into our business performance, and I look forward to sharing our segment results for the first time today.

從第四季開始，我們轉向採用多分部結構來報告業績，以符合我們現在的公司管理方式。我們相信，這項報告變化將提高我們業務績效的透明度，我期待今天首次分享我們的分部表現。

For full year 2024, net revenue of $3.26 billion grew 1.9% versus the prior year. Notably, our 2024 revenue growth overcame pressure from the divestiture of certain custom rehab assets and the termination of the public health emergency 75/25 blended reimbursement rates originally introduced in response to the COVID pandemic.

2024 年全年淨收入為 32.6 億美元，較上年增長 1.9%。值得注意的是，我們 2024 年的收入成長克服了剝離某些客製化康復資產以及終止最初為應對 COVID 大流行而推出的公共衛生緊急 75/25 混合報銷率帶來的壓力。

Underneath these headwinds, we produced growth from new capitated revenue and strong sleep resupply volumes, partially offset by weakness in the Diabetes Health segment, which reflected payer shifts to the pharmacy reimbursement channel for diabetes, and as Suzanne discussed earlier, operational missteps that we are in the process of correcting.

在這些不利因素之下，我們仍然透過新的人均收入和強勁的睡眠補給量實現了增長，但糖尿病健康部門的疲軟部分抵消了這一增長，這反映了付款人轉向糖尿病藥房報銷渠道，正如蘇珊娜之前所討論的，我們正在糾正運營失誤。

By segment, net revenue growth for full year 2024 was 4.5% in Sleep Health, 6.0% in Respiratory Health and 1.9% in Wellness at Home, offset by a revenue decline of 6.9% in Diabetes Health. Our fourth quarter revenue was roughly flat versus the prior year quarter, but landed just above the high end of the guidance range we provided in November.

依部門劃分，2024 年全年淨收入成長如下：睡眠健康部門成長 4.5%、呼吸健康部門成長 6.0%、家庭健康部門成長 1.9%，但糖尿病健康部門收入下降 6.9%。我們第四季的營收與去年同期基本持平，但略高於我們 11 月提供的指導範圍的高端。

Our Sleep Health business continues to be an area of strength. Sleep Health net revenue increased 3.4% year-over-year to $356.5 million. Sleep Health new starts surpassed 120,000 for the third consecutive quarter. And our Sleep Health census now stands at 1.66 million, up another 23,000 sequentially and up 6.5% from year-end 2023. Our CPAP survey now indicates that 15.3% of respondents are using GLP-1s to manage diabetes or weight loss.

我們的睡眠健康業務繼續成為我們的強項。睡眠健康淨收入年增 3.4% 至 3.565 億美元。睡眠健康新開辦機構連續第三個季度超過 12 萬家。我們的睡眠健康普查人數目前為 166 萬，比上一季增加 23,000 人，比 2023 年底增加 6.5%。我們的 CPAP 調查現在表明，15.3% 的受訪者正在使用 GLP-1 來控製糖尿病或減肥。

We are still seeing a modest increase in CPAP adherence for GLP-1 patients versus non-GLP-1 patients and we continue to see an immaterial difference in resupply order patterns between the two cohorts. Respiratory Health net revenue was $165.3 million in the fourth quarter, up 1% compared to the prior year quarter.

我們仍然看到 GLP-1 患者與非 GLP-1 患者的 CPAP 依從性略有增加，並且我們繼續看到兩組之間的補給訂單模式存在無關緊要的差異。第四季呼吸健康淨收入為 1.653 億美元，較去年同期成長 1%。

Despite a slower than normal start to flu season, our oxygen census set another record, now surpassing 330,000 patients actively on service. We continue to help patients reduce time spent reordering tank refills by providing tools that eliminate the need to interact with an Adapt customer service representative, including new technology launched in the AdaptHealth myAPP. Fourth quarter Diabetes Health revenue of $171.3 million decreased 7.3% from the prior year quarter.

儘管流感季節的開始速度比平常慢，但我們的氧氣普查數據卻創下了另一項紀錄，目前活躍在服務中的患者已超過 33 萬人。我們將繼續透過提供無需與 Adapt 客戶服務代表互動的工具（包括在 AdaptHealth myAPP 中推出的新技術）來幫助患者減少重新訂購藥罐補充的時間。第四季糖尿病健康收入為 1.713 億美元，較去年同期下降 7.3%。

However, sequential growth of $30.2 million over the third quarter was the most produced in the last three years. While we are not satisfied with that performance, results were better than we anticipated due partly to some early results from the operational changes Suzanne mentioned earlier and characterized by better than anticipated starts and patient retention.

然而，第三季季增 3,020 萬美元，是近三年來的最高增幅。雖然我們對這一表現並不滿意，但結果比我們預期的要好，部分原因是 Suzanne 之前提到的營運變化的一些早期成果，其特點是開局和患者保留率比預期的要好。

For Wellness at Home, which includes all other product categories, fourth quarter net revenue was $163.5 million, down 0.8% from the prior year quarter, driven by revenue disposed with the sale of certain custom rehab assets. The remaining products in this segment grew as expected. Turning to profitability and starting with our full year results.

對於包括所有其他產品類別在內的家庭健康業務而言，第四季淨收入為 1.635 億美元，較去年同期下降 0.8%，這主要得益於出售某些客製化康復資產所獲得的收入。該部門其餘產品均如預期成長。轉向盈利能力並從我們的全年業績開始。

Adjusted EBITDA was $688.7 million for 2024, up 2.7% from full year 2023 and about 2% above the high end of the guidance range we provided in November. We held the line on adjusted EBITDA margin, which was 21.1% for 2024 versus 21.0% for 2023 even as we made investments in leadership, technology and processes that we expect to support our long-term growth.

2024 年調整後 EBITDA 為 6.887 億美元，較 2023 年全年增長 2.7%，比我們 11 月提供的指引範圍高端高出約 2%。儘管我們在領導力、技術和流程方面進行了投資，預計這些投資將支持我們的長期成長，但我們仍保持了調整後 EBITDA 利潤率不變，2024 年為 21.1%，而 2023 年為 21.0%。

By segment, adjusted EBITDA margin for full year 2024 was 25.8% in Sleep Health, 30.7% in Respiratory Health, 9.9% in Diabetes Health and 12.3% in Wellness at Home. Our Sleep Health adjusted EBITDA margin contracted 120 basis points, driven predominantly by product and payer mix. Our Respiratory Health adjusted EBITDA margin expanded 190 basis points as a result of a full year of key capitated contracts.

按部門劃分，2024 年全年調整後 EBITDA 利潤率為：睡眠健康部門為 25.8%、呼吸健康部門為 30.7%、糖尿病健康部門為 9.9%、家庭健康部門為 12.3%。我們的睡眠健康調整後 EBITDA 利潤率收縮了 120 個基點，主要原因是產品和付款人組合。由於全年的關鍵人頭合同，我們的呼吸健康調整後 EBITDA 利潤率擴大了 190 個基點。

Our Diabetes Health adjusted EBITDA margin contracted 220 basis points on lower revenue as we maintained sales and operations capacity in anticipation of resuming revenue growth. Wellness at Home adjusted EBITDA margin expanded 200 basis points, also benefiting from a full year of key capitated contracts as well as the disposition of certain custom rehab assets with lower margins.

由於我們預期恢復收入成長，保持銷售和營運能力，我們的糖尿病健康調整後 EBITDA 利潤率因收入下降而收縮了 220 個基點。Wellness at Home 調整後的 EBITDA 利潤率擴大了 200 個基點，這也受益於全年的關鍵人頭合約以及某些利潤率較低的客製化康復資產的處置。

For the fourth quarter, adjusted EBITDA was $200.6 million. Adjusted EBITDA margin of 23.4% contracted 40 basis points from Q4 2023, primarily driven by increased labor costs, reflecting the aforementioned investments we are making to support growth. Moving to cash flow, balance sheet and capital allocation.

第四季度，調整後的 EBITDA 為 2.006 億美元。調整後的 EBITDA 利潤率為 23.4%，較 2023 年第四季收縮 40 個基點，主要原因是勞動成本增加，反映了我們為支持成長而進行的上述投資。轉向現金流、資產負債表和資本配置。

For full year 2024, cash flow from operations was $541.8 million, up 12.7% against full year 2023. CapEx was $306.1 million or 9.4% of revenue, down from 10.5% of revenue in 2023. And free cash flow was $235.8 million compared to $143.2 million a year ago. For Q4 2024, cash flow from operations was $150.4 million. CapEx of $77.3 million was 9.0% of revenue, down from 10.3% in the fourth quarter of 2023 and slightly below the full run rate for 2024.

2024 年全年營運現金流為 5.418 億美元，較 2023 年全年成長 12.7%。資本支出為 3.061 億美元，佔營收的 9.4%，低於 2023 年的 10.5%。自由現金流為 2.358 億美元，去年同期為 1.432 億美元。2024 年第四季，經營現金流為 1.504 億美元。7,730 萬美元的資本支出佔收入的 9.0%，低於 2023 年第四季的 10.3%，略低於 2024 年的全部運行率。

Free cash flow was $73.1 million, $41.1 million above the high end of our guidance range provided in November. Of the $73.1 million in free cash flow, we deployed $9.5 million to a tuck-in acquisition in the Southeast and we used $50 million to reduce the balance on the Term Loan A. The remainder went to unrestricted cash, which stood at $109.7 million at year-end.

自由現金流為 7,310 萬美元，比我們 11 月提供的指導範圍上限高出 4,110 萬美元。在 7,310 萬美元的自由現金流中，我們用 950 萬美元進行了東南部的臨時收購，用 5,000 萬美元減少了定期貸款 A 的餘額。剩餘部分用作非限制性現金，年底時為 1.097 億美元。

Days sales outstanding for Q4 2024 was 43.8, down from the previous quarter as accounts receivable continued to normalize following the Change Healthcare situation earlier in 2024. We are working on opportunities to improve our revenue cycle management, streamline financial operations, improving inventory management and capturing cost efficiencies, all of which are increasing the level of our cash flow.

2024 年第四季的應收帳款週轉天數為 43.8，低於上一季度，因為在 2024 年初發生 Change Healthcare 事件之後，應收帳款繼續正常化。我們正在尋找機會改善我們的收入週期管理，簡化財務運作，改善庫存管理和提高成本效率，所有這些都在提高我們的現金流量水準。

As of year-end 2024, net debt stood at $1.93 billion and our net leverage ratio was 2.79 times, down from 2.87 times at the end of last quarter and down from 3.16 times at the end of 2023. As Suzanne mentioned, we've been using free cash to reduce debt, resulting in a $170 million reduction in our TLA balance over the last year.

截至 2024 年底，淨負債為 19.3 億美元，我們的淨槓桿率為 2.79 倍，低於上一季末的 2.87 倍，也低於 2023 年底的 3.16 倍。正如蘇珊娜所提到的，我們一直在使用自由現金來減少債務，導致去年我們的 TLA 餘額減少了 1.7 億美元。

Recall that last quarter, we introduced a target of 2.5 times net leverage. Between the progress we made in 2024, our expectations for free cash flow generation in 2025 and our near-term capital allocation priorities, we are already well along the path toward achieving this target. In terms of capital allocation, our current priorities are investing to accelerate organic growth and reducing our debt to further strengthen our balance sheet.

回想一下上個季度，我們引入了 2.5 倍淨槓桿的目標。從我們在 2024 年取得的進展、對 2025 年自由現金流產生的預期以及我們近期的資本配置重點來看，我們已經在實現這一目標的道路上取得了很大進展。在資本配置方面，我們目前的重點是投資以加速有機成長並減少債務以進一步加強我們的資產負債表。

As noted earlier, last quarter we completed a transaction to sell certain custom rehab assets. And in the fourth quarter, we reached a definitive agreement to sell certain incontinent assets to a third-party. In 2025, we will explore the divestiture of one additional similarly sized non-core product line. In aggregate, these non-core assets represent approximately $100 million in revenue. For now, we expect M&A activity to be modest.

如前所述，上個季度我們完成了出售某些客製化康復資產的交易。並且在第四季度，我們達成了最終協議，將某些不可抗力資產出售給第三方。2025年，我們將探討剝離另外一條規模相似的非核心產品線。整體而言，這些非核心資產約帶來 1 億美元的收入。目前，我們預期併購活動將會比較溫和。

Further on the horizon, we will continue to look for strategic acquisitions of home medical equipment providers to round out our geographic footprint and increase patient access. Turning to guidance. For full year 2025, we expect revenue of $3.22 billion to $3.36 billion or negative-1% to positive-3% growth. This assumes approximately 0 to 450 basis points in underlying growth, partially offset by a 40 basis points drag related to the disposition of certain custom rehab assets and a 90 basis points non-cash drag from changes in the mix of purchase revenue versus rental revenue.

未來，我們將繼續尋求對家用醫療設備供應商的策略性收購，以完善我們的地理覆蓋範圍並增加患者的就醫機會。轉向指導。我們預計 2025 年全年營收為 32.2 億美元至 33.6 億美元，或成長 -1% 至 -3%。假設基礎成長率約為 0 至 450 個基點，部分被與處置某些客製化復原資產相關的 40 個基點拖累以及購買收入與租賃收入組合變化帶來的 90 個基點非現金拖累所抵銷。

Rental revenue requires amortizing assets over their useful life, effectively deferring revenue to future periods. We expect this to disproportionately affect the first quarter and be smaller in the remaining quarters of 2025. We expect the shape of quarterly revenue to look similar to that of 2024. And as a reminder, our guidance does not include any impact from acquisitions or dispositions not yet closed. We expect full year 2025 adjusted EBITDA of $670 million to $710 million. We expect and adjusted EBITDA margin of approximately 21%, in line with full year 2024.

租金收入需要在資產使用壽命內攤銷，從而有效地將收入延後到未來期間。我們預計這將對第一季產生最大影響，對 2025 年剩餘幾季的影響會較小。我們預計季度收入的狀況將與 2024 年相似。提醒一下，我們的指引不包括尚未完成的收購或處置的影響。我們預計 2025 年全年調整後 EBITDA 為 6.7 億美元至 7.1 億美元。我們預計調整後的 EBITDA 利潤率約為 21%，與 2024 年全年持平。

We expect to see the aforementioned 90 basis points impact to flow entirely to the bottom-line in 2025. Finally, we expect full year 2025 free cash flow in the range of $180 million to $220 million. Similar to our results in 2024, we expect approximately 1/3 of that estimate in the first half of the year and the remainder in the second half of the year. For the first quarter of 2025, we expect revenue to be down between 3% and 4% versus Q1 2024. We expect an adjusted EBITDA margin of 16% to 17% for Q1 2025.

我們預計上述 90 個基點的影響將在 2025 年完全影響利潤。最後，我們預計 2025 年全年自由現金流將在 1.8 億美元至 2.2 億美元之間。與我們 2024 年的結果類似，我們預計該估計的約 1/3 將出現在上半年，剩餘部分將出現在下半年。對於 2025 年第一季度，我們預計營收將較 2024 年第一季下降 3% 至 4%。我們預計 2025 年第一季的調整後 EBITDA 利潤率為 16% 至 17%。

These expectations reflect ongoing weakness in our Diabetes Health performance as well as the drag from the mix of purchase versus rental revenue, which as noted, will proportionately affect the first quarter and drops entirely to the bottom-line.

這些預期反映了我們糖尿病健康表現的持續疲軟，以及購買收入與租賃收入組合的拖累，如前所述，這將對第一季產生一定影響，並完全下降到底線。

As usual, we expect Q1 2025 free cash flow to be modest. In summary, our fourth quarter results exceeded our expectations. We expect 2025 to be another strong year for free cash flow generation and are making good progress on our balance sheet. While we expect 2025 to be somewhat of a transition year for growth, we are executing on our five areas of focus to strengthen our foundation and are confident that we're on a path to accelerated growth in 2026 and beyond.

與往常一樣，我們預計 2025 年第一季的自由現金流將會適中。總而言之，我們第四季的業績超出了我們的預期。我們預計 2025 年將是自由現金流產生強勁的另一年，我們的資產負債表也正在取得良好進展。雖然我們預計 2025 年在某種程度上將是成長的過渡年，但我們正在執行五個重點領域來加強我們的基礎，並相信我們將在 2026 年及以後走上加速成長的道路。

That brings me to the end of my remarks. Operator, would you kindly open up the call for questions?

我的發言到此結束。接線生，請您打開電話詢問功能好嗎？

(Operator Instructions) Ben Hendrix, RBC Capital Markets.

（操作員指示） Ben Hendrix，RBC 資本市場。

Can you talk more about the conversations you've been having with carriers over additional capitated arrangements? Specifically, are we at a point yet with the Humana arrangement that you can kind of demonstrate to payers, clinical outperformance, reduction in admissions or other data to support more incremental adoption of those capitated programs?

能否詳細談談您與業者就額外人頭費安排的對話？具體來說，我們是否已經達到了 Humana 協議的某個階段，您可以向付款人展示臨床表現優異、入院人數減少或其他數據，以支持更逐步地採用這些按人頭計費的計劃？

Yes. Thanks for the question. I'll start with that. So two parts. We have ongoing conversations going with a variety of proposed capitated arrangements in our pipeline that are progressing well.

是的。謝謝你的提問。我先從那裡開始。所以是兩個部分。我們目前正在就各種擬議的按人頭付費安排進行討論，這些安排進展順利。

In terms of the data and conversations with Humana, that relationship remains very strong. We meet regularly and review our performance, including some of the data about how we're managing their patients and they've been very complementary about the performance that we're having.

從數據和與 Humana 的對話來看，這種關係仍然非常牢固。我們定期開會審查我們的表現，包括我們如何管理患者的一些數據，他們對我們的表現給予了高度評價。

Ben, I'd add that since the last quarter, we have, in fact, signed additional capitated arrangements. Now these are nowhere near the size and scale of the Humana arrangement, but we are making progress. I think in terms of kind of voting, if you will, I mean, Humana has been pretty clear. I mean, in signing a contract extension, I think both parties have said that things are going quite well and we'd like to continue the relationship over multiple years.

本，我想補充一點，自上個季度以來，我們實際上已經簽署了額外的按人頭計費的安排。目前這些還遠未達到 Humana 協議的規模，但我們正在取得進展。我認為，就投票而言，如果你願意的話，我的意思是，Humana 已經非常清楚了。我的意思是，在簽署續約合約時，我認為雙方都表示事情進展順利，我們希望在未來幾年繼續保持這種合作關係。

Great. And if I could just squeeze one more in real quick. You noted revenue cycle and inventory measures as well as normalization in DSO following the change outage. Can you talk more about your kind of working capital outlook? How much cash flow improvement we can expect from your various efficiency initiatives and timing to reach those targets?

偉大的。如果我可以再快速擠一點的話。您注意到，變更中斷後，收入週期和庫存措施以及 DSO 中的正常化。能否詳細談談您對營運資本的展望？從您提出的各種效率措施以及達到這些目標的時間表來看，我們可以預期現金流改善多少？

Sure, Ben. Well, first, I'd say, we're incredibly pleased with our free cash flow performance in 2024. Really, all levers of working capital have made progress. Now on the DSO front, certainly, we were handicapped by the change outage earlier in the year, but revenue cycle and AR is starting to normalize following that impact. So we expect same or better DSOs over the course of 2025.

當然，本。首先，我想說，我們對 2024 年的自由現金流表現感到非常滿意。確實，營運資本的所有槓桿都取得了進展。現在在 DSO 方面，當然，我們在今年早些時候受到了變更中斷的阻礙，但在受到該影響之後，收入週期和 AR 開始正常化。因此，我們預計 2025 年的 DSO 將保持相同或更好。

On the payables front, we had some significant move in payment terms throughout the course of the year. Now certainly, we're not expecting all of that to recur in '25, which is why you'll notice that at the midpoint, we're committing to $200 million of free cash flow. And then on inventory and CapEx, as Suzanne talked about, our new Chief Operating Officer that joined us very recently. We're thrilled to have him and the team that he's brought with him as well as the rest of the folks that are here at Adapt that he leads every day. And we're making a demonstrable improvement in inventory management and in CapEx management.

在應付款項方面，我們全年在付款條件方面做出了一些重大調整。當然，我們並不期望所有這些都會在25年重現，這就是為什麼你會注意到，在中期，我們承諾提供2億美元的自由現金流。然後是關於庫存和資本支出，正如蘇珊娜所談到的，我們最近加入的新營運長。我們很高興有他和他帶來的團隊以及他每天領導的 Adapt 的其他員工。我們在庫存管理和資本支出管理方面取得了明顯的進展。

Mathew Blackman, Stifel.

馬修·布萊克曼（Mathew Blackman），Stifel。

I wanted to do a quick confirmation question upfront before I get to my follow-up. On the guidance for this year, you talked about the 40 bps drag due to the disposal of assets. That's just the assets in the fourth quarter and not the planned disposal of one additional line in 2025, correct?

在進行後續跟進之前，我想先快速確認一下問題。關於今年的指引，您談到了資產處置造成的 40 個基點的拖累。這只是第四季的資產，而不是 2025 年計畫處置的一條額外生產線，對嗎？

Yes, you got it.

是的，你明白了。

Okay. And then on the Diabetes business, I'm curious what you're thinking about for the contribution to 2025 guidance. You've got somewhat improving trends in pumps the last several quarters. I'm curious how that progressed during the fourth quarter? And then also very obvious improvement in CGM. Curious what you're baking in to the guidance this year.

好的。然後關於糖尿病業務，我很好奇您對 2025 年指導貢獻有何看法。過去幾個季度，泵浦的銷售趨勢有所改善。我很好奇第四季進展如何？而且 CGM 也有非常明顯的改善。好奇您今年的指導方針是什麼。

Sure. So for pump and pump supplies, in the third quarter, we reported some modest growth for the first time over the prior year by the tune of about $1 million, it might have been $2 million. In the fourth quarter, it was about the same. We were down $1 million, but effectively flat. So I think as it relates to pump and pump supplies, we're at a stable revenue jump-off point and we do expect to start showing some modest growth in pump and pump supplies.

當然。因此，對於泵浦和泵浦供應而言，在第三季度，我們首次報告與去年同期相比出現了小幅增長，增長幅度約為 100 萬美元，甚至可能是 200 萬美元。第四季的情況也大致相同。我們損失了 100 萬美元，但實際上持平。因此，我認為就泵浦和泵浦供應而言，我們正處於穩定的收入起點，並且我們確實預計泵浦和泵浦供應將開始適度成長。

As it relates to CGM, which is the largest part of the Diabetes segment, we said last quarter that we're not going to commit to growth in that segment, frankly, until we've proven it. We don't want to get too ahead of ourselves. There are a lot of moving pieces. It's a big business. We are making progress and we intend to do that for the balance of 2025.

至於 CGM，它是糖尿病領域中最大的部分，我們上個季度就曾表示，坦白說，在我們證明這一點之前，我們不會致力於該領域的成長。我們不想太超越自己。有很多活動的部分。這是一筆大生意。我們正在取得進展，並打算在 2025 年之前完成這一目標。

But we're not getting ahead of ourselves. We're not committing yet to growth in the Diabetes segment until we're able to prove it.

但我們不會超越自己。在我們能夠證明這一點之前，我們不會致力於糖尿病領域的成長。

And you did see a minor uptick in capitated revenue arrangement revenues during the fourth quarter. Should we expect that 4Q to be a reasonable quarterly run rate for 2025?

您確實看到第四季度按人頭計算的收入安排收入略有上升。我們是否應預期第四季將是 2025 年合理的季度運行率？

Yes. We signed those agreements in the fourth quarter. They will actually start in early 2025. I think a very modest increase in capitated revenue over the course of the year is the right way to think about it.

是的。我們在第四季度簽署了這些協議。他們實際上將於 2025 年初開始。我認為全年人均收入略有增加是正確的思考方式。

Brian Tanquilut, Jefferies.

傑富瑞 (Jefferies) 的 Brian Tanquilut。

Congrats on the quarter. Suzanne, maybe a follow-up to Jason's last comment, not committing to growing the Diabetes business yet. So from where you sit today, I mean, you've been here to digest the whole enterprise. And do you still see synergies and strategic value to owning diabetes at this point?

恭喜本季取得佳績。蘇珊娜，也許是對傑森最後一條評論的後續，尚未承諾發展糖尿病業務。所以從你今天所處的位置來看，我的意思是，你在這裡已經消化了整個企業。現在您還看到擁有糖尿病的綜效和策略價值嗎？

Yes. Thanks for the question. At this point, I do. It's a hypothesis we're proving out, but there are two reasons. One is, we see the potential for growth coming from two areas.

是的。謝謝你的提問。就這一點而言，我同意。這是我們正在證明的假設，但有兩個原因。一是，我們看到兩個領域的成長潛力。

One is with our hospital customers and the value proposition of the one-stop shop in the broad portfolio is playing out for us well. So that continues to be a good feedback that we're receiving from our bigger hospital systems where we seem to be winning and we'll continue to track that to see if the full breadth of the portfolio is of value. But at this point, we believe it is.

一是與我們的醫院客戶合作，廣泛產品組合中的一站式服務的價值主張對我們來說效果很好。因此，我們從大型醫院系統獲得的回饋仍然很好，我們似乎正在獲勝，我們將繼續追蹤這一點，以了解整個投資組合是否有價值。但就目前而言，我們相信確實如此。

And the second reason for that is on future capitated arrangements. We think that there's an opportunity here as well where payers are intrigued by the breadth of our portfolio and our geographic reach. That seems to be the value proposition. And that value prop is holding up well, as I mentioned earlier, with a strong pipeline there. So at this point, if we can get diabetes performing well and the breadth of our portfolio, we think that's a winning combination.

第二個原因與未來的人頭安排有關。我們認為這裡也存在機會，付款人對我們的產品組合廣度和地理覆蓋範圍很感興趣。這似乎就是價值主張。而且正如我之前提到的，這個價值主張保持得很好，並且擁有強大的管道。因此，從目前的情況來看，如果我們能夠讓糖尿病領域表現良好並且擴大我們的產品組合範圍，我們認為這是一個成功的組合。

I appreciate that. And then maybe, Jason, my follow-up, as I think about your guidance ranges. So first, free cash flow, the midpoint of 2025 guide is below last year's. And then you mentioned you're expecting margins to be flat. I know you mentioned some of that is just the business that you've sold.

我很感激。然後也許，傑森，我的後續行動，當我考慮你的指導範圍時。首先，自由現金流，2025 年指引的中點低於去年的水準。然後您提到您預計利潤率將保持穩定。我知道您提到其中一些只是您已出售的業務。

But any other things we need to think about as puts and takes in terms of the cash flow guidance and EBITDA? And is it just conservatism or is there anything else we need to be considering there?

但是，就現金流指引和 EBITDA 而言，我們還需要考慮其他什麼因素嗎？這只是保守主義嗎，還是還有其他我們需要考慮的因素？

Sure, Brian. So regarding free cash flow, yes, at the mid, we are showing about a $35 million less free cash flow in 2025. I mean, really, that's a result of the payment extensions, payment term extensions that we talked about in 2024. We did a lot. We really moved the needle in important ways there.

當然，布萊恩。因此，就自由現金流而言，是的，在中期，我們顯示 2025 年的自由現金流將減少約 3500 萬美元。我的意思是，這確實是我們在 2024 年談論的付款延期、付款期限延長的結果。我們做了很多。我們確實在重要方面取得了進展。

But to do that a second year in a row, it's just not possible, frankly. And so we've adjusted that free cash flow expectation for that reason. I mean, I think to the ups on free cash flow, look, we're going to have considerably less interest in 2025. I mean, we're making significant progress there. And this is the first quarter and the fourth quarter in a long time.

但坦白說，連續第二年做到這一點是不可能的。因此，我們出於這個原因調整了自由現金流預期。我的意思是，我認為對於自由現金流的增加，到 2025 年我們的利息將會大大減少。我的意思是，我們在那裡取得了重大進展。這是很長一段時間以來的第一個季度和第四季度。

I mean, interest expense was under $30 million. And we intend to keep going and we intend to continue to fuel the cash flow machine that we're building here. I'd say, in terms of margins, look, we feel that we put out a very appropriate guide. I mean, certainly, if we can get revenue going and growth going in some of these areas of the company and that will help contribute and should flow through at higher margins.

我的意思是，利息支出低於 3,000 萬美元。我們打算繼續前進，我們打算繼續為我們在這裡建造的現金流機器提供動力。我想說，就利潤而言，我們覺得我們已經給了非常合適的指導。我的意思是，當然，如果我們能夠在公司的某些領域實現收入成長和成長，這將有助於貢獻並帶來更高的利潤。

But it's early in the year. We've made some key investments. There's a lot of new people here in the company and we think they're all incredibly talented and they're going to do great things, but we just got to let that play out a little bit.

但現在還只是年初。我們進行了一些重要投資。公司裡有很多新人，我們認為他們都非常有才華，會做出偉大的事情，但我們只需要讓他們稍微發揮一點。

Richard Close, Canaccord.

理查德·克洛斯（Richard Close），Canaccord。

Good news on the diabetes progress. Can you, Suzanne, just talk a little bit about the changes you've made there, the reworking of the resupply outreach program and then process of rebuilding that trust from the referral standpoint?

糖尿病進展方面的好消息。蘇珊娜，你能否稍微談談你在那裡所做的改變，補給外展計劃的重新制定，以及從轉介的角度重建信任的過程？

Sure. Thanks for the question. So we started with the new leadership team. We put in a very experienced operator, Gary Sheehan, who was the CEO of his own company and then did some remarkable work here at Adapt. So he brought that HME thinking, if you will, and structure and organization to the business.

當然。謝謝你的提問。因此，我們從新的領導團隊開始。我們聘請了一位非常有經驗的運營者，加里·希恩 (Gary Sheehan)，他曾是自己公司的首席執行官，然後在 Adapt 做出了一些出色的工作。因此，他將 HME 思維（如果你願意的話）以及結構和組織帶入了企業。

So there was a lot of just great blocking and tackling and getting back to the basics of how you run a business that he brought on early in Q4. In addition, at that same time, shifting the resupply business over to Matt Cox in Nashville with our sleep resupply. That engine was well -- had a good foundation for us to put in the Diabetes business.

因此，有很多出色的阻擋和解決，並回到了他在第四季度初提出的經營業務的基本原則。此外，與此同時，我們將睡眠補給業務轉移給納許維爾的馬特·考克斯（Matt Cox）。這個引擎為我們開展糖尿病業務奠定了良好的基礎。

And what I mean by that is that team understands that patients like a variety of different outreaches. And we had in the former diabetes resupply business allowed our processes to get out of control where we were excessively contacting patients and not providing the right loop back, if you will, information to how to reach us back, but rather just continuing to reach out, which caused frustration on their end and there was a lot of attrition that has stopped.

我的意思是，團隊知道患者喜歡各種不同的外展治療。在以前的糖尿病補給業務中，我們曾讓流程失控，我們過度聯繫患者，卻沒有提供正確的反饋信息，也就是如何联系我們，而是繼續聯繫，這讓他們很沮喪，大量的人員流失已經停止了。

And it was remarkable to see how quickly that bleeding stopped. But more importantly, with the right outreach program, how we were able to win back patients fairly quickly within the quarter. So I'm incredibly pleased with the expertise that that team down in Nashville has been able to do. On the -- so that's around attrition and retention.

令人驚訝的是，血止住了得如此之快。但更重要的是，透過正確的外展計劃，我們能夠在本季內相當快速地贏回患者。因此，我對納許維爾團隊的專業素養感到非常滿意。這是關於人員流失和保留的問題。

On the new starts, our new sales leader, Graham Ward, came in, has focused the team on better selling techniques, but more importantly, has partnered with our very large HME team and has taken a One Adapt approach where they're going in and selling our value prop to hospitals, improving the way that we communicate about what we need for a good referral.

在新的開始中，我們的新銷售主管 Graham Ward 加入了我們，他帶領團隊專注於更好的銷售技巧，但更重要的是，他與我們非常龐大的 HME 團隊合作，並採取了「一個適應」的方法，他們進入醫院並銷售我們的價值主張，改善我們溝通良好轉診所需內容的方式。

Sometimes we were getting information that we just couldn't process. And so that team has been retrained on how to get the appropriate information so that we can move that referral and get that patient the product that they need.

有時我們得到的資訊只是我們無法處理。因此，我們對團隊進行了重新培訓，讓他們知道如何獲得適當的信息，以便我們能夠轉移轉診並為患者提供他們需要的產品。

So that team is partnering the 50 or 70 or so salespeople with our several hundred HME team and they're now out there in force together. So on all fronts, both on the new starts, the resupply and then the leadership under Gary, I'm pleased with the progress of just basic blocking and tackling and strong execution.

因此，該團隊將 50 或 70 名左右的銷售人員與我們數百人的 HME 團隊合作，現在他們已經齊心協力。因此，在各個方面，包括新的開始、補給以及加里領導下的領導，我對基本阻擋、鏟球和強有力的執行所取得的進展感到滿意。

That's very helpful. And then as a follow-up, you talked about implementing the sales quota first time for that. Can you talk a little bit how that was received? Did that create any changes in the sales force? Anything along those lines?

這非常有幫助。然後作為後續問題，您談到首次實施銷售配額。能稍微談談大家對此有何反應嗎？這會為銷售團隊帶來什麼改變嗎？有什麼類似的事情嗎？

Yes. Really excited by this initiative. So back in -- really right after I got here, that was one of the first projects we started. Originally, our sales force at that time was just paid on volume and no quota setting. And so we kicked off a very deep analysis, did the work upfront through 2024 to make sure that this rollout would be done with as close to perfection as possible because we all know that that can be a delicate situation.

是的。我對這個舉措感到非常興奮。所以回到——實際上我剛到這裡後，這是我們開始的第一批項目之一。原來，我們當時的銷售人員都是按量付費，沒有設定配額。因此，我們進行了非常深入的分析，並提前做好了 2024 年的工作，以確保這次推出盡可能接近完美，因為我們都知道這可能是一個微妙的情況。

The team rolled that out January 1 and it has been -- the sales force has responded very favorably. They understand it's a fair program. We did it in a way that it really over the next two years gets us to really where we want to be. And so you always know when these go well where there's pretty much silence from the sales force. And that's what we've experienced is everyone understands it, they've rallied around it, it's allowed us to set quotas that will make our forecasting more predictable.

該團隊於 1 月 1 日推出了這項計劃，並且銷售人員的反應非常積極。他們明白這是一個公平的計劃。我們這樣做的目的是在接下來的兩年裡讓我們真正達到我們想要的目標。因此，當銷售人員幾乎沒有任何回應時，您總是知道這些進展順利。我們的體驗是每個人都理解它，他們團結一致，這使我們能夠設定配額，從而使我們的預測更加可預測。

So all in all, this has been very successful and it really came through good leadership of our new sales leadership team and it also was supported heavily by our operations team who were managing the sales force. We're very supportive in the transition. So this is one of the highlights from a performance perspective of the team this past year.

總而言之，這是非常成功的，它確實得益於我們新銷售領導團隊的良好領導，同時也得到了管理銷售團隊的營運團隊的大力支持。我們非常支持這項過渡。從表現角度來看，這是過去一年球隊的亮點之一。

Eric Coldwell, Baird.

埃里克·科爾德威爾，貝爾德。

Congrats on the nice progress so far, Suzanne. So on this purchase versus rental situation, I'd like to dig in a little bit. Why is it happening? What is happening? What segment? It looks like, if I understood the commentary correctly, you've got something in the ballpark of, I don't know, maybe $25 million, $30 million impact in Q1 revenue. And then I assume that revenue starts coming back in Q2 and beyond. But just hoping you could dig in on that one a little bit.

蘇珊娜，祝賀你迄今為止的良好進展。因此，關於購買與租賃的情況，我想深入探討。為什麼會發生這種情況？怎麼了？什麼片段？如果我理解正確的話，看起來您對第一季收入的影響大概是 2500 萬美元、3000 萬美元。然後我假設收入將在第二季及以後開始回升。我只是希望您能夠深入了解這一點。

Sure, Eric. This is Jason. Well, firstly, it is really focused in our Sleep business. I mean, all components across all product lines, I mean, they're reimbursed differently for different reasons. I would say that as technology has evolved over time, components that in the past might have been separatable, but as tech improves, they're really now core to the pieces of equipment.

當然，埃里克。這是傑森。首先，我們確實專注於睡眠業務。我的意思是，所有產品線上的所有組件，由於不同的原因，它們的報銷方式也不同。我想說的是，隨著技術不斷發展，過去一些組件可能是可分離的，但隨著技術的進步，它們現在實際上已成為設備的核心。

That's changed the way -- not the way that we get reimbursed, but it does change the way that we account for that revenue. And so in sleep, as an example, as you know, most products are appreciated over about a 13-month cycle. And so that's what we're looking at here is really a change in that mix. And so the revenue, you've got that calculated correctly at about $25 million to $30 million top-line. We really expect that to be delayed.

這改變了我們獲得報銷的方式，但確實改變了我們計算收入的方式。以睡眠為例，如您所知，大多數產品的升值週期約為 13 個月。所以我們現在看到的是這種組合的真正改變。所以，您正確計算了收入，約 2500 萬至 3000 萬美元。我們確實希望這會被推遲。

So it will be a bigger impact in the first quarter. It will wane in the second and the third and over the course of the year until we pass the 13-month cycle.

因此，這對第一季的影響會更大。它會在第二年、第三年以及全年逐漸減弱，直到我們度過 13 個月的週期。

All right. My next topic, I was hoping we could get a final tally on the impact of 75/25 for the year and the fourth quarter and just confirming that or checking that there's no other reimbursement or regulatory changes, things out of DC post-PHE impacts that are material to 2025 and beyond or if there are, what might those be?

好的。我的下一個主題是，我希望我們能夠對今年和第四季度 75/25 的影響進行最終統計，並確認或檢查沒有其他報銷或監管變化，PHE 之後 DC 之外的影響對 2025 年及以後有重大影響，或者如果有，這些影響可能是什麼？

Sure, Eric. So we previously discussed about a $25 million top-line and bottom-line pressure in 2024. We came right in that area. For the fourth quarter, frankly, just due to more revenue activity than the other quarters of the year, that represented close to 30% of that pressure in the fourth quarter. And so as we look at '25, we would frame the reimbursement environment as stable.

當然，埃里克。我們之前討論過 2024 年 2500 萬美元的營收和淨利潤壓力。我們正好來到了那個區域。坦白說，就第四季而言，僅僅由於收入活動比一年中其他季度更多，這相當於第四季度壓力的近 30％。因此，當我們展望25年時，我們會將報銷環境設定為穩定的。

There was a post fee schedule increase awarded in early December that went effective in January of this year. That's accounted for entirely in our full year guidance. And then across the payer landscape, just normal course operations, we're working on contract-by-contract to get reimbursed what we think deserves reimbursement. But overall, we view it as very, very stable.

去年 12 月初，郵資標準有所上調，並於今年 1 月生效。這已完全體現在我們的全年預期中。然後在整個付款人環境中，只是正常的課程操作，我們正在逐個合約地努力獲得我們認為值得報銷的費用。但總體而言，我們認為它非常非常穩定。

And if I could do just one more. You had a competitor that recently alluded to a change in one of their capitated contracts and expected change that seems like a bit of a headwind to them. You've just extended the Humana deal and have announced some other wins. You sound very happy with them.

如果我可以再做一件事就好了。您的一個競爭對手最近暗示他們的一項按人頭計費的合約將發生變更，並且預計這一變更對他們來說似乎有點不利。您剛剛延長了與 Humana 的交易，並宣布了其他一些勝利。聽起來你對他們很滿意。

I'm curious, are there any -- is there any color you could provide on the renewal here in terms of pricing concessions, term changes, limitations, expansions of products or states? Is there any update or was it pretty much a we like what we're doing, we're going to keep doing it for longer agreement?

我很好奇，您能提供有關續約的詳細信息，包括價格優惠、期限變更、限制、產品或狀態擴展嗎？有任何更新嗎，或者我們非常喜歡我們正在做的事情，我們是否會繼續做更長的協議？

Yes, Eric, I don't know that we have comments on any of our competitors in their contracts. I will say, for us, the pipeline continues to be robust. We've got a full dedicated team that focuses on selling the value proposition of these arrangements every day, of pricing them, of tracking utilization management. I mean, we have built a real core capability here at AdaptHealth and we're not accounting for any new wins for capitated arrangements in our '25 guidance. However, we are hard at work at it.

是的，埃里克，我不知道我們對任何競爭對手的合約有何評論。我想說的是，對我們來說，通路仍然十分強勁。我們擁有一支專門的團隊，每天專注於推銷這些安排的價值主張、定價以及追蹤利用率管理。我的意思是，我們在 AdaptHealth 已經建立了真正的核心能力，並且我們並沒有在我們的 25 年指導中考慮任何新的按人頭計費安排的勝利。然而，我們正在努力工作。

And any changes or updates on the big contract that was extended? Anything you would -- nuanced?

延長的大合約有什麼變化或更新嗎？您想說什麼？細微的差別？

I mean, you can really think of this as just an extension of terms that I think both sides view very favorably today. So it has no relationship, I think you're talking about competitors and other things. I mean, for us and for Humana, I think that the original deal makes a lot of sense, we're all very pleased with it and we're extending it for multiple years.

我的意思是，你真的可以把這看作是雙方今天都非常贊同的條款的延伸。所以這沒有關係，我想你談論的是競爭對手和其他事情。我的意思是，對於我們和 Humana 來說，我認為最初的交易非常有意義，我們都對此非常滿意，而且我們會將其延長多年。

(Operator Instructions) Pito Chickering, Deutsche Bank.

（操作員指示） 德意志銀行 Pito Chickering。

This is Kieran Ryan on for Pito. Just wanted to start on diabetes. I think you've commented on kind of the new starts and resupply sales dynamics already. Can you just talk a little bit about that other factor you called out in 3Q around pricing pressure from the shift to all pharmacy for certain payers? Just wanted to know like if that was in line with your expectations for the quarter and if we should see that continue at a stable rate into 2025 absent any other expansion there?

這是 Kieran Ryan，代替 Pito 上場。只是想開始討論糖尿病。我想您已經對新的開始和補給銷售動態發表了評論。您能否稍微談談您在第三季度提到的其他因素，即針對特定付款人轉向所有藥房而產生的定價壓力？只是想知道這是否符合您對本季度的預期，以及在沒有任何其他擴張的情況下，我們是否應該看到這一速度以穩定的速度持續到 2025 年？

Sure, Kieran. I mean, if we look at 2024 as a whole, payer reimbursement for diabetes went largely as we expected. We spoke about a couple of key states that within their Medicaid agencies made determinations on reimbursement and that again played out as expected. I think as we stand here today, we believe that any shift to -- any kind of shift to pharmacy reimbursement will be muted versus what happened last year. But certainly, as we hear policy change, if and when it occurs, we'll be sure to update that in our guidance. But as we stand here today, we feel very good. It seems like a stable partner.

當然，基蘭。我的意思是，如果我們從整體上看 2024 年，糖尿病的付款人報銷基本上符合我們的預期。我們談到了幾個關鍵州，這些州的醫療補助機構就報銷問題做出了決定，結果也符合預期。我認為，當我們今天站在這裡時，我們相信，與去年的情況相比，任何對藥房報銷的轉變都會受到抑制。但可以肯定的是，當我們聽到政策變化時，如果發生這種情況，我們一定會在我們的指導中更新它。但今天我們站在這裡，感覺非常好。它看起來像一個穩定的合作夥伴。

And then just on Sleep, just outside of that sales versus rental dynamic, if there's any color or puts and takes you can provide around how we should think about 2025 growth there coming off of some -- a few quarters in a row of really strong underlying demand. Just want to understand how you're thinking about kind of the range and outcomes in Sleep for 2025?

然後就睡眠問題而言，除了銷售與租賃動態之外，如果您能提供任何細節或利弊，說明我們應該如何看待 2025 年的成長，這些成長將來自連續幾季的強勁潛在需求。只是想了解您對 2025 年睡眠的範圍和結果有何看法？

Sure, Kieran. I mean, we've just introduced our segments. I mean, we're not in a position to guide on segments in any way. I mean, what we can offer for perspective, when you look at the enterprise growth for 2025, we do expect compression in diabetes. We intend to do better, but that is what we have modeled in our assumptions.

當然，基蘭。我的意思是，我們剛剛介紹了我們的片段。我的意思是，我們無法以任何方式指導各個部分。我的意思是，當你展望 2025 年的企業成長時，我們可以提供以下觀點：我們確實預期糖尿病會受到擠壓。我們旨在做得更好，但這就是我們在假設中所建模的。

We do expect Respiratory and Wellness at Home to produce some modest but compounding and consistent revenue growth each quarter over the prior year. And we do expect Sleep to make up the difference from diabetes to the enterprise. So that's what we can offer. We're looking forward to a solid year in Sleep and the other segments.

我們確實預計，呼吸和家庭健康部門每季的收入將比去年同期實現適度但複合且持續的成長。我們確實希望睡眠能彌補糖尿病為企業帶來的差異。這就是我們能提供的。我們期待睡眠和其他領域能夠迎來豐碩的一年。

It appears we have no further questions at this time. I'll now turn the program back over to Suzanne Foster for any additional remarks.

目前看來我們沒有其他問題了。現在我將把節目交還給蘇珊娜福斯特 (Suzanne Foster)，以便他發表其他評論。

Thank you, everyone, for participating in our call today. Just to wrap up, the key takeaways is that we've made a lot of progress on our five areas of focus in a relatively short time. And we have a lot to accomplish still, but the team is invigorated and I'm confident that we are on the path to realizing our full potential as a health services company. So we look forward to meeting with you as many of you in person in the coming weeks. Thanks again.

感謝大家參加我們今天的電話會議。總而言之，關鍵的收穫是我們在相對較短的時間內對五個重點領域取得了巨大進展。我們還有很多事情要做，但團隊充滿活力，我相信我們正在充分發揮作為健康服務公司的潛力。因此，我們期待在未來幾週內與盡可能多的你們見面。再次感謝。

Thank you. Ladies and gentlemen, this concludes today's event. You may now disconnect.

謝謝。女士們、先生們，今天的活動到此結束。您現在可以斷開連線。