Akumin Inc (AKU) 2023 Q2 法說會逐字稿

(Operator Instructions) Good morning. My name is [Lara], and I will be your conference operator today. At this time, I would like to welcome everyone to Akumin Inc.'s 2023 second-quarter results research analyst call. (Operator Instructions)

（操作員指示）早上好。我的名字是[Lara]，今天我將擔任你們的會議操作員。此時，我歡迎大家參加 Akumin Inc. 2023 年第二季度業績研究分析師電話會議。 （操作員說明）

Mr. Zine, you may begin your conference.

Zine 先生，您可以開始會議了。

Good morning, and thank you for joining us for today's presentation. My name is Riadh Zine, and I'm the Chairman and CEO of Akumin. I'm joined today by David Kretschmer, our Chief Financial Officer. I want to thank all of you for taking the time to join us on this call.

早上好，感謝您參加我們今天的演講。我叫 Riadh Zine，是 Akumin 的董事長兼首席執行官。今天我們的首席財務官 David Kretschmer 也加入了我的行列。我要感謝大家抽出時間參加我們的這次電話會議。

In today's call, I will provide an overview of Akumin's Q2 results and discuss some of the factors that impacted our results in the quarter. I will also review the steps we're taking to overcome the challenges we have experienced in both of our business segments. David will go over some of our key operating and financial metrics and discuss our revised guidance for 2023. I will then conclude the presentation, and then we will proceed to Q&A.

在今天的電話會議中，我將概述 Akumin 第二季度的業績，並討論影響我們本季度業績的一些因素。我還將回顧我們為克服兩個業務部門所經歷的挑戰而採取的步驟。 David 將回顧我們的一些關鍵運營和財務指標，並討論我們修訂後的 2023 年指引。然後我將結束演示，然後我們將進行問答。

There is a slide deck that is meant to accompany our presentation today. A copy of it is available for download from the Investor Relations section of our website at akumin.com under Events and Presentations.

有一個幻燈片是為了配合我們今天的演示而準備的。您可以從我們網站 akumin.com 的“投資者關係”部分的“活動和演示”下下載該文件的副本。

Before we begin, let me remind you that certain matters discussed in today's conference call or answers that may be given to questions asked could constitute forward-looking statements or information that are subject to risks or uncertainties relating to Akumin's future financial and business performance. Actual results could differ materially from those anticipated in these forward-looking statements. Please refer to disclaimer slide, slide number 2 on our [follow-up] presentation, as well as the forward-looking statements section of our earnings press release.

在我們開始之前，讓我提醒您，今天電話會議中討論的某些事項或可能對提出的問題作出的回答可能構成前瞻性陳述或信息，這些陳述或信息受到與Akumin 未來財務和業務業績相關的風險或不確定性的影響。實際結果可能與這些前瞻性陳述中的預期存在重大差異。請參閱我們的[後續]演示文稿中的免責聲明幻燈片、第 2 號幻燈片，以及我們的收益新聞稿的前瞻性陳述部分。

The risk factors that may affect results in these forward-looking statements are detailed in Akumin's periodic results and public disclosure. These documents can be accessed under our public disclosure at sec.gov or sedar.com.

Akumin 的定期業績和公開披露中詳細介紹了可能影響這些前瞻性陳述中結果的風險因素。這些文件可通過我們在 sec.gov 或 sedar.com 上公開披露的內容獲取。

We may also refer to certain non-GAAP measures during this conference call, such as EBITDA and adjusted EBITDA and adjusted EBITDA margin. You can find the information regarding these non-GAAP measures, including definitions, again, on slide 2 of our presentation as well as the non-GAAP measures section of our earnings release.

我們還可能在本次電話會議期間提及某些非 GAAP 指標，例如 EBITDA 和調整後 EBITDA 以及調整後 EBITDA 利潤率。您可以在我們演示文稿的幻燈片 2 以及收益發布的非 GAAP 衡量標準部分找到有關這些非 GAAP 衡量標準的信息，包括定義。

The reconciliation of each EBITDA and adjusted EBITDA to net loss to the most comparable GAAP measure is included in the presentation as an appendix. We have not provided a reconciliation to any forward-looking non-GAAP measure referred to in this presentation, as we would not be able to produce such reconciliation without unreasonable effort.

每項 EBITDA 以及調整後的 EBITDA 與淨虧損與最具可比性的 GAAP 衡量標準的對賬均作為附錄包含在演示文稿中。我們尚未對本演示文稿中提到的任何前瞻性非公認會計原則措施進行調節，因為如果不付出不合理的努力，我們就無法進行此類調節。

Turning to our Q1 results. On slide 3, you can see the same-store consolidated volume growth in our key radiology service lines and our patient starts in our oncology division versus our results in Q2 of last year.

轉向我們第一季度的業績。在幻燈片 3 上，您可以看到我們的主要放射學服務線的同店綜合銷量增長，以及我們的患者在我們的腫瘤科開始與去年第二季度的結果相比。

Specifically, our same-store MRI volume were up 3.1%, which reflects ongoing strong demand for MRI procedures. Our same store PET/CT volumes were up an impressive 16.5%, a strong demand particularly from our hospital partners that continue to that modality. Total oncology patient starts were up 3.4%, as the market for oncology services remains robust.

具體來說，我們的同店 MRI 銷量增長了 3.1%，這反映出對 MRI 手術的持續強勁需求。我們的同店 PET/CT 數量增長了 16.5%，令人印象深刻，這是一個強勁的需求，尤其是來自我們繼續採用這種模式的醫院合作夥伴。由於腫瘤服務市場依然強勁，腫瘤科患者總起始人數增長了 3.4%。

Q1 revenue of $184.8 million was down 3.8% from $192.1 million in the second quarter of last year. Adjusted EBITDA of $26.5 million was down $11.7 million from $38.2 million in the first quarter (sic - see press release, "second quarter") of last year. And I will elaborate on some of the causes of this decline in later slides.

第一季度收入為 1.848 億美元，比去年第二季度的 1.921 億美元下降 3.8%。調整後 EBITDA 為 2650 萬美元，比去年第一季度的 3820 萬美元（原文如此 - 參見新聞稿，“第二季度”）下降了 1170 萬美元。我將在後面的幻燈片中詳細闡述這種下降的一些原因。

Adjusted EBITDA margins of 14.4% were down 5.5% from the second quarter of 2022 and down sequentially from 17.7% in Q1 2023. Our margins in Q2 were negatively impacted by a number of factors and, given our high operating leverage, resulted in a significant decline in margins in the quarter.

調整後EBITDA 利潤率為14.4%，較2022 年第二季度下降5.5%，較2023 年第一季度的17.7% 連續下降。我們第二季度的利潤率受到多種因素的負面影響，鑑於我們的運營槓桿較高，導致本季度利潤率下降。

On a consolidated basis, accounts receivable at quarter end were at $115.8 million versus $114.7 million at the end of Q1 2023. This equates to 57 days of sales outstanding, near record low levels.

綜合來看，季度末的應收賬款為 1.158 億美元，而 2023 年第一季度末的應收賬款為 1.147 億美元。這相當於未償還銷售天數為 57 天，接近歷史最低水平。

Turning to slide 4, we've begun to see same-store volume growth in our radiology segment in Q1, which continued in Q2, although not to the extent we anticipated and remains below our growth targets.

轉向幻燈片 4，我們開始看到第一季度放射科的同店銷量增長，這種情況在第二季度繼續增長，儘管沒有達到我們預期的程度，並且仍然低於我們的增長目標。

As highlighted on this slide, we experienced some challenges in Q2 that resulted in our radiology revenues to be down $4.6 million from the same period last year: the ongoing closure of our Port Charlotte facility in Florida, which has been closed for necessarily renovations after suffering significant hurricane-related damage last year. While we are working diligently with the local building authorities to secure permits to complete the necessary renovations, this process has proven to be more onerous and time consuming than originally anticipated.

正如本幻燈片所強調的，我們在第二季度遇到了一些挑戰，導致我們的放射學收入比去年同期下降了460 萬美元：我們位於佛羅里達州夏洛特港的設施正在關閉，該設施在遭受苦難後已關閉以進行必要的翻修去年遭受了與颶風相關的重大損失。雖然我們正在與當地建築當局努力合作，以獲得完成必要翻修的許可，但事實證明，這一過程比最初預期的更加繁重和耗時。

We also experienced some equipment delivery delays in the quarter, which negatively impacted our ability to bring new mobile customers online. We do anticipate that the situation will improve by year end such that we can satisfy commitments from new customers.

本季度我們還經歷了一些設備交付延遲，這對我們吸引新移動客戶上線的能力產生了負面影響。我們確實預計情況會在年底前有所改善，以便我們能夠滿足新客戶的承諾。

In addition to those items, which resulted in our year-over-year revenue decline, we also experienced some persistent labor shortages, particularly among clinic staff -- clinical staff, despite early signs of improvement of these fronts in Q1. The severity of this issue varies significantly across geographies. But in aggregate, our ability to perform additional procedures has been constrained.

除了這些導致我們收入同比下降的項目之外，我們還經歷了一些持續的勞動力短缺，特別是診所工作人員——儘管第一季度這些方面有改善的早期跡象。這個問題的嚴重程度因地區而異。但總的來說，我們執行額外程序的能力受到了限制。

In addition to clinical staff, we have also experienced above average number of vacancies amongst our account executive team responsible for the relationships with the referring physicians, which has compressed volume growth in certain specific regions.

除了臨床人員外，我們負責與轉診醫生關係的客戶執行團隊的職位空缺數量也高於平均水平，這壓縮了某些特定地區的數量增長。

Turning to oncology. While we saw growth in patient starts, this was more than offset by other factors that negatively impacted the segment, resulting in year-over-year revenue decline of approximately $2.7 million. Recall that under new leadership, our oncology segment underwent a repositioning in 2022, which included the re-examination of several of our partnerships.

轉向腫瘤學。雖然我們看到患者開始數量有所增長，但這被對該細分市場產生負面影響的其他因素所抵消，導致收入同比下降約 270 萬美元。回想一下，在新的領導下，我們的腫瘤學部門於 2022 年進行了重新定位，其中包括重新審查我們的幾個合作夥伴關係。

The result has been the discontinuation of certain operations. Unfortunately, certain Arizona contract discrepancies have led to reduction in revenues received from a specific customer. This obviously impacted our Q2 results and may continue to do so, pending resolution of this matter.

結果是某些業務被終止。不幸的是，某些亞利桑那州合同差異導致從特定客戶獲得的收入減少。這顯然影響了我們第二季度的業績，並且可能會繼續影響，直到此事得到解決。

We have also experienced some lengthy delays in receipt of payments from one of our oncology customers, in part due to the financial challenges and liquidity constraints they are facing. We have several tools at our disposal to either mitigate the financial impact or resolve this matter.

我們的一位腫瘤客戶的付款也經歷了一些長時間的延遲，部分原因是他們面臨的財務挑戰和流動性限制。我們可以使用多種工具來減輕財務影響或解決此問題。

On the expense side, we were also impacted by higher cost in the quarter, which were, in part, related to the increased use and cost of specialty tracers, particularly in our PET/CT modality. Although some of these costs can be passed through to customers, these and other cost inflation that we have experienced, including in medical supplies, has resulted in expenses being $3.9 million higher year over year.

在費用方面，我們還受到本季度成本上升的影響，這在一定程度上與特種示踪劑的使用和成本增加有關，特別是在我們的 PET/CT 模式中。儘管其中一些成本可以轉嫁給客戶，但我們經歷的這些成本和其他成本上漲（包括醫療用品）導致費用同比增加 390 萬美元。

Given our high operating leverage, the net aggregate EBITDA impact decline year over year was over $11 million in the quarter. That said, we remain very focused on implementing measures to address the operating challenges we are facing.

鑑於我們的運營槓桿較高，本季度 EBITDA 影響淨額同比下降超過 1100 萬美元。儘管如此，我們仍然非常注重採取措施來解決我們面臨的運營挑戰。

While we do expect these measures to benefit our results and performance over time, we do not foresee a material improvement prior to the end of 2023, which David will elaborate on in his discussion of our revised 2023 guidance.

雖然我們確實預計這些措施隨著時間的推移將有利於我們的業績和業績，但我們預計在2023 年底之前不會出現實質性改善，David 將在討論我們修訂後的2023 年指南時詳細闡述這一點。

On slide 5, we review our current outlook for the balance of 2023. As you can see, we expect the challenges we face in both our radiology and oncology segments to continue to a certain extent for the remainder of the year.

在幻燈片5 中，我們回顧了目前對2023 年剩餘時間的展望。正如您所看到的，我們預計我們在放射學和腫瘤學領域面臨的挑戰在今年剩餘時間內將在一定程度上持續下去。

We have also factored in some additional equipment delays in our budget and outlook. In our radiology segment, we are implementing measures to alleviate the impact of these challenges, including the ongoing digitization of our business and the continued deployment of our remote clinical capabilities, as described later on.

我們還在預算和展望中考慮了一些額外的設備延誤。在我們的放射科領域，我們正在採取措施減輕這些挑戰的影響，包括我們業務的持續數字化和遠程臨床能力的持續部署，如下文所述。

In oncology, we expect that based on business development initiatives we have underway and with the discontinuation of certain sub-optimal oncology partnerships, the contribution from this core business segment should improve materially in 2024.

在腫瘤學方面，我們預計，根據我們正在進行的業務發展計劃，以及隨著某些次優腫瘤學合作夥伴關係的終止，這一核心業務部門的貢獻應在 2024 年大幅改善。

Notwithstanding the challenges we face, we continue to see robust demand for our services. And the fundamentals of our industry remain very strong, which is why we are focused on taking measures to remedy these challenges.

儘管我們面臨挑戰，但我們的服務需求仍然強勁。我們行業的基本面仍然非常強勁，這就是為什麼我們專注於採取措施應對這些挑戰。

As you know, we embarked on a significant organizational transformation in 2022 to align and streamline all areas of our business. These initiatives resulted in the realization of approximately [$23 million] synergies last year, although they were somewhat offset by inflationary pressures and other cost increases during the year.

如您所知，我們於 2022 年開始進行重大組織轉型，以協調和簡化我們業務的所有領域。這些舉措去年實現了約[2,300萬美元]的協同效應，儘管這些舉措在一定程度上被年內的通脹壓力和其他成本增加所抵消。

In 2023, we had planned to implement initiatives related to rationalizing business processes, consolidating systems, and optimizing our procurement by leveraging our enhanced scale, which would result in additional $25 million in synergies on a run-rate basis by the end of 2023.

2023 年，我們計劃利用擴大的規模實施與業務流程合理化、整合系統和優化採購相關的舉措，到 2023 年底，按運行率計算將帶來 2500 萬美元的額外協同效應。

These initiatives have been delayed given the management focus on resolving our near-term challenges. As a result, we now do not anticipate any material financial benefit in 2023. However, we remain very confident that these synergies will be realized in 2024.

鑑於管理層專注於解決我們的近期挑戰，這些舉措已被推遲。因此，我們現在預計 2023 年不會產生任何實質性財務利益。但是，我們仍然非常有信心這些協同效應將在 2024 年實現。

As we have highlighted in the past, there is significant operating leverage in our business model. As such, we are very focused on increasing our capacity utilization and driving additional volumes through existing sites.

正如我們過去強調的那樣，我們的業務模式具有巨大的運營槓桿。因此，我們非常注重提高產能利用率並通過現有站點增加產量。

On that front, we continue to focus on improving scales and treatments per labor hour and enhancing our scheduling and call center capabilities. Another key element of our strategy is to digitize the business to streamline operations in order to enhance the patient experience and capture significant efficiencies. We are also deploying remote technology capabilities to help alleviate the labor constraints that our industry is facing and the healthcare sector generally (inaudible)

在這方面，我們繼續專注於改善每工時的規模和處理量，並增強我們的調度和呼叫中心能力。我們戰略的另一個關鍵要素是業務數字化以簡化運營，從而增強患者體驗並顯著提高效率。我們還部署遠程技術功能，以幫助緩解我們的行業和醫療保健行業普遍面臨的勞動力限制（聽不清）

On the business development front, we call that part of our strategic rationale for the Alliance acquisition in 2021 was to better position Akumin to service hospitals and health system partner in their ever-growing needs for outpatient service, delivery, and capacity.

在業務發展方面，我們稱 2021 年收購 Alliance 的部分戰略理由是為了更好地定位 Akumin，為醫院和衛生系統合作夥伴提供服務，滿足他們對門診服務、交付和容量不斷增長的需求。

With the extensive suite of services and facilities we have in place today, including network density in multiple markets, we are an attractive outpatient partners for hospitals and health systems. In fact, we have received significant partnership interest from hospitals and health systems, and we are now in the process of negotiating partnerships with these important customers.

憑藉我們今天擁有的廣泛的服務和設施，包括多個市場的網絡密度，我們成為醫院和衛生系統有吸引力的門診合作夥伴。事實上，我們已經收到了醫院和衛生系統的重大合作興趣，我們現在正在與這些重要客戶就合作夥伴關係進行談判。

We have also generated meaningful partnership interest from hospitals for our oncology services, given our unique capabilities in this business line. While formal relationships and partnerships will take time to finalize, we are confident that we'll be able to capitalize on opportunities to leverage our capabilities for the mutual benefit of Akumin and its hospital partners in the near future.

鑑於我們在該業務領域的獨特能力，醫院還對我們的腫瘤學服務產生了有意義的合作興趣。雖然正式的關係和夥伴關係需要時間才能最終確定，但我們相信，在不久的將來，我們將能夠利用機會發揮我們的能力，以實現 Akumin 及其醫院合作夥伴的共同利益。

Each of these initiatives are an important focus of Akumin. And together, we expect that they will deliver significant benefits to our platform in 2024 and beyond.

這些舉措中的每一項都是 Akumin 的重要關注點。我們預計它們將在 2024 年及以後為我們的平台帶來顯著的效益。

Turning to slide 7. As mentioned in our quarterly results press release, our Board of Directors has formed a special committee to explore strategic initiatives related to our capital structure. As you know, our current leverage is well above our management target levels. And given the operational challenges we have recently faced, the Board felt it was prudent to evaluate our alternatives at this time.

轉向幻燈片 7。正如我們在季度業績新聞稿中提到的，我們的董事會成立了一個特別委員會來探索與我們的資本結構相關的戰略舉措。如您所知，我們目前的槓桿率遠高於我們的管理目標水平。鑑於我們最近面臨的運營挑戰，董事會認為此時評估我們的替代方案是謹慎的。

As a reminder, interest on our subordinated debt held by our partner and sponsor, Stonepeak, has been paid in kind and is expected to become cash pay on September 1, 2023. The special committee is diligently evaluating alternatives, but that can be no assurance that this process will result in any transaction or other alternatives.

提醒一下，我們的合作夥伴和保薦人Stonepeak 持有的次級債務利息已以實物形式支付，預計將於2023 年9 月1 日變為現金支付。特別委員會正在認真評估替代方案，但這並不能保證該過程將導致任何交易或其他替代方案。

There's no set timetable to the completion of the strategic review process. And the company does not intend to provide updates unless or until the Board of Directors approves a specific action or otherwise determines that disclosure is appropriate or necessary.

完成戰略審查過程沒有設定時間表。除非或直到董事會批准具體行動或以其他方式確定披露是適當或必要的，否則公司不打算提供更新。

I will now turn the presentation over to David, who will walk you through some of our key operating and financial metrics.

我現在將演示文稿交給 David，他將向您介紹我們的一些關鍵運營和財務指標。

Thank you, Riadh. As Riadh mentioned at the outset, I will review some of the key operating and financial metrics in our business for the second quarter and provide an update to our 2023 guidance.

謝謝你，里亞德。正如 Riadh 一開始提到的，我將回顧第二季度我們業務的一些關鍵運營和財務指標，並提供 2023 年指導的更新。

Slide 8 illustrates that the Akumin platform continues to offer a diverse suite of services while remaining focused on areas of high growth and high value-added modalities. As you can see, 53% of our radiology revenues are derived from MRI procedures, making MRI buying a key driver to that segment.

幻燈片 8 表明，Akumin 平台繼續提供多樣化的服務，同時仍然專注於高增長和高附加值模式的領域。正如您所看到的，我們 53% 的放射學收入來自 MRI 程序，這使得 MRI 購買成為該細分市場的關鍵驅動力。

Second, it's also a significant player in cancer diagnosis and treatment, with 27% of our radiology revenues from PET/CT and 16% of our total revenues coming from the oncology division. These modalities are critical to delivering quality patient care and utilized by a variety of physician specialties across the care continuum from screening, to diagnosis, to treatment.

其次，它也是癌症診斷和治療領域的重要參與者，我們的放射學收入的 27% 來自 PET/CT，總收入的 16% 來自腫瘤部門。這些模式對於提供高質量的患者護理至關重要，並被各種專業醫生在從篩查、診斷到治療的整個護理過程中使用。

As we have previously highlighted, we have an ongoing initiative to consolidate our fixed site radiology footprint to eliminate underperforming sites. As of the end of Q2, we now operate 207 fixed site, comprised of 178 radiology and 29 in oncology.

正如我們之前強調的那樣，我們正在採取一項持續舉措來鞏固我們的固定站點放射學足跡，以消除表現不佳的站點。截至第二季度末，我們目前運營 207 個固定站點，其中 178 個放射科和 29 個腫瘤科。

We continue to evaluate off-site, so we can [edify] opportunities to improve the operation and contribution from our fixed site footprint, including exploring partnerships with hospitals to optimize the economics of these sites.

我們繼續進行場外評估，這樣我們就可以[創造]機會來改善我們固定站點足蹟的運營和貢獻，包括探索與醫院的合作夥伴關係，以優化這些站點的經濟效益。

As we previously stated, Akumin is well positioned to benefit from the ongoing shift to outpatient service delivery, as we partner with hospitals and hospital systems [to transition] care to lower-cost sites of delivery. We continue to generate over 95% of our revenues from outpatient procedures, as you can see on slide 9.

正如我們之前所說，Akumin 處於有利位置，可以從持續向門診服務提供的轉變中受益，因為我們與醫院和醫院系統合作，將護理轉移到成本較低的交付地點。正如您在幻燈片 9 中看到的那樣，我們 95% 以上的收入仍然來自門診手術。

We have a balanced revenue mix between third-party payers of outpatient services and hospitals. There's no one customer representing more than 4% of our consolidated pro forma revenue.

我們在門診服務的第三方付款人和醫院之間擁有平衡的收入結構。沒有任何一位客戶的收入占我們合併預計收入的 4% 以上。

As a preferred outpatient solution provider to hospitals, half of our revenues come from our hospital customers. The balance of revenues are derived from reimbursement for patient procedures paid by third party and government payers.

作為醫院首選的門診解決方案提供商，我們一半的收入來自醫院客戶。收入餘額來自第三方和政府付款人支付的患者手術費用的報銷。

We continue to expect a revenue share with hospitals to grow over time, as both existing and new hospital customers and partners search for outpatient solutions in both radiology and oncology.

隨著現有和新的醫院客戶和合作夥伴都在尋找放射學和腫瘤學方面的門診解決方案，我們繼續預計與醫院的收入份額將隨著時間的推移而增長。

Our financial performance is typically driven primarily by procedure volume. Although as we had previously mentioned, certain extraneous factors did impact our results this past quarter.

我們的財務業績通常主要由程序量驅動。儘管正如我們之前提到的，某些外部因素確實影響了我們上個季度的業績。

As you know, given that the current mix of our business include both hospitals and independent sites, we track actual scans by modality across our radiology platform. Previously noted, MRI and PET/CT scan procedure volumes are the biggest contributor to our performance in the radiology segment.

如您所知，鑑於我們目前的業務組合包括醫院和獨立站點，我們通過放射學平台按模式跟踪實際掃描。之前指出，MRI 和 PET/CT 掃描程序量是我們在放射學領域表現的最大貢獻者。

These volumes, together with the radiology procedures and the percent of revenue, as was illustrated on slide 8, are the key metrics we use to track our operating and financial performance in radiology.

這些數量以及放射學程序和收入百分比（如幻燈片 8 所示）是我們用來跟踪放射學業務和財務績效的關鍵指標。

On slide 10, we can see the MRI and PET/CT procedure volumes over the last four quarters and the percent same-store changes in both periods. As we had mentioned, equipment delivery delays, primarily in our mobile segment, together with an ongoing shortage of clinical staff, has been constraining our ability to grow procedure volumes. We're continuing to explore ways to alleviate this pressure and are optimistic that these efforts will begin to show tangible results by the end of 2023.

在幻燈片 10 上，我們可以看到過去四個季度的 MRI 和 PET/CT 手術量以及這兩個時期的同店變化百分比。正如我們所提到的，設備交付延遲（主要是在我們的移動領域）以及臨床人員的持續短缺一直限制了我們增加手術量的能力。我們正在繼續探索減輕這種壓力的方法，並樂觀地認為這些努力將在 2023 年底前開始顯現出切實的成果。

As we've previously highlighted, as the market leader and PET/CT, we have seen strong growth in that modality in recent years, as the pharmaceutical industry continues to develop improved tracers, which can allow for earlier detection of diseases.

正如我們之前強調的，作為市場領導者和 PET/CT，近年來，隨著製藥行業不斷開發改進的示踪劑，可以更早地發現疾病，我們看到這種模式的強勁增長。

Labor constraints are less of a factor to PET/CT, given the highly specialized skill sets of clinical personnel for this modality. We are better able to capitalize on the strong demand for these services.

鑑於臨床人員具備高度專業化的技能，勞動力限制對於 PET/CT 來說並不是一個因素。我們能夠更好地利用對這些服務的強勁需求。

In the oncology segment, we track activity level by patient start volume. As you can see, patient starts began to grow on Q4 2022, as we completed the review and repositioned that business in Q2 and Q3 of last year. That growth was less pronounced in the recent quarter, in part because of reduced collections for customer related to contract discrepancies and specific customer liquidity challenges that we had previously noted.

在腫瘤學領域，我們通過患者起始量來跟踪活動水平。正如您所看到的，隨著我們在去年第二季度和第三季度完成審查並重新定位該業務，患者開始數量在 2022 年第四季度開始增長。最近一個季度的增長不太明顯，部分原因是與合同差異相關的客戶收款減少以及我們之前註意到的特定客戶流動性挑戰。

We expect our oncology division to resume an improving growth trajectory over time, given business development initiatives we have underway.

鑑於我們正在進行的業務發展計劃，我們預計我們的腫瘤部門將隨著時間的推移恢復改善的增長軌跡。

We continue to believe we have compelling value proposition in radiation therapy that we bring to our hospital partners in this modality. This includes our mobile fleet, which enables oncology programs to continue treating patients or replace the equipment and our significant experience with Varian's Halcyon, a new treatment platform which can provide faster and more effective cost of treatment.

我們仍然相信，我們在放射治療方面擁有令人信服的價值主張，並以這種方式為我們的醫院合作夥伴帶來。這包括我們的移動車隊，它使腫瘤學項目能夠繼續治療患者或更換設備，以及我們在瓦里安Halcyon 方面的豐富經驗，這是一種新的治療平台，可以提供更快、更有效的治療成本。

On slide 11, we present the quarterly revenue and adjusted EBITDA trend for our radiology and oncology segments. As you can see, the contribution from our radiology and oncology segments were quite consistent over the past five quarters, with radiology ranging between 83% and 85% of total revenues, and oncology making it the balance of 15% to 17%.

在幻燈片 11 上，我們展示了放射學和腫瘤學領域的季度收入和調整後 EBITDA 趨勢。正如您所看到的，我們的放射科和腫瘤科部門的貢獻在過去五個季度中相當一致，放射科佔總收入的83% 至85%，腫瘤科則佔總收入的15% 至17% 。

In the radiology segment, our second-quarter adjusted EBITDA margin was 21.5% before allocation of corporate services. Our oncology segment has higher margin, with an adjusted EBITDA margin 33.4% before the allocation of corporate services. The chart on the right illustrates the quarterly adjusted EBITDA and EBITDA margin over the past five quarters.

在放射科領域，在分配企業服務之前，我們第二季度調整後的 EBITDA 利潤率為 21.5%。我們的腫瘤學部門的利潤率較高，在分配企業服務之前，調整後的 EBITDA 利潤率為 33.4%。右圖顯示了過去五個季度的季度調整後 EBITDA 和 EBITDA 利潤率。

Given the high operating leverage in our business, the modest volume growth in Q2, in large part because of the ongoing clinical labor shortage, together with delays and reopening of some facilities and some accounting of attrition, has put significant downward pressure on margins for the period. That said, we continue to believe we have a solid foundation on which to build and see strong demand for our services. To the extent that we are able to address these operational issues, we should see a return to growth in both revenue and adjusted EBITDA for the back half of 2023.

鑑於我們業務的運營槓桿較高，第二季度的銷量增長不大，這在很大程度上是由於持續的臨床勞動力短缺，加上一些設施的延遲和重新開放以及一些人員流失，給該公司的利潤率帶來了巨大的下行壓力。時期。儘管如此，我們仍然相信我們擁有堅實的基礎來建立服務並看到對我們服務的強勁需求。如果我們能夠解決這些運營問題，我們應該會在 2023 年下半年看到收入和調整後 EBITDA 恢復增長。

On slide 12, you'll see the annual and last 12 months' financial performance in our radiology and oncology segments and the consolidated adjusted EBITDA. Note that the 2020 results and pro forma, assuming the legacy Akumin-Alliance businesses, the acquisition of which was completed in September 2021, were combined for the entire period as well as adjusted for the fourth quarter of 2021 divestiture of Alliance Oncology of Arizona.

在幻燈片 12 上，您將看到我們放射學和腫瘤學部門的年度和過去 12 個月的財務業績以及綜合調整後 EBITDA。請注意，2020 年業績和備考假設是在整個期間合併了 Akumin-Alliance 遺留業務（收購於 2021 年 9 月完成），並根據 2021 年第四季度亞利桑那州 Alliance Oncology 剝離進行了調整。

As you will see in the chart in the left, the radiology segment contributed $622 million of revenue for the last 12 months, representing approximately 84% of total revenue. While the oncology segment contributed [$124 million] of revenue, approximately 16% of the total.

正如您在左圖中看到的那樣，放射科在過去 12 個月貢獻了 6.22 億美元的收入，約佔總收入的 84%。腫瘤學領域貢獻了 [1.24 億美元] 收入，約佔總收入的 16%。

As we mentioned on prior calls, growth in consolidated adjusted EBITDA [has been mute] in recent periods, as we are focused on internal integration and transformation (inaudible) and ongoing labor constraints.

正如我們在之前的電話會議中提到的，近期合併調整後 EBITDA 的增長[一直保持沉默]，因為我們專注於內部整合和轉型（聽不清）以及持續的勞動力限制。

As Riadh and I also mentioned, the oncology segment has been meaningfully impacted by the failure of two customers to meet their financial obligations to us, for which we are no longer recording revenue, and have increased reserves against the existing accounts receivable, also impacting revenue for the current period. As mentioned, we expect we will begin to see higher volume growth, driving revenue and adjusted EBITDA, as we exit 2023, assuming some of the issues negatively impacting our volume growth at the present abate in the back half of the year.+

正如Riadh 和​​我還提到的那樣，腫瘤學部門因兩個客戶未能履行對我們的財務義務而受到重大影響，我們不再記錄收入，並增加了現有應收賬款的準備金，這也影響了收入本期。如前所述，我們預計，當我們退出2023 年時，我們將開始看到更高的銷量增長，從而推動收入和調整後的EBITDA，假設目前對我們銷量增長產生負面影響的一些問題會在今年下半年減弱。+

Slide 13 is a bridge from our adjusted EBITDA to our free cash flow in the first half of 2023. As you can see from this slide, our cash position decreased by approximately $21.5 million so far in 2023. In the past quarters, debt service and finance lease payments continue to have a meaningful impact to free cash flow.

幻燈片13 是我們調整後的EBITDA 與2023 年上半年自由現金流之間的橋樑。正如您從這張幻燈片中看到的，2023 年迄今為止，我們的現金頭寸減少了約2150 萬美元。在過去的幾個季度中，償債和融資租賃付款繼續對自由現金流產生重大影響。

As you know, cash minority interest primarily relates oncology joint ventures and hospital partners and as a function of that performance of the centers, not a fixed obligation. As this partnership become more profitable and generate more cash, our cash distribution from minority partners increases as well. It should be noted that as at the end of Q2, we have incurred over $9.6 million of cash costs related to site repairs on our Port Charlotte facility and our ongoing restructuring efforts.

如您所知，現金少數股東權益主要與腫瘤合資企業和醫院合作夥伴有關，並且是中心績效的函數，而不是固定義務。隨著這種合作夥伴關係變得更加有利可圖並產生更多現金，我們從少數股東那里分配的現金也隨之增加。應該指出的是，截至第二季度末，我們因夏洛特港工廠的現場維修和正在進行的重組工作而產生了超過 960 萬美元的現金成本。

As we had mentioned, our Port Charlotte facility continue to be closed, as reopening measures are proving to be more onerous and lengthy than anticipated. We have received partial reimbursement for insurance and expect to recover more.

正如我們所提到的，我們的夏洛特港工廠繼續關閉，因為事實證明重新開放措施比預期更加繁重和漫長。我們已收到部分保險報銷，並預計能收回更多。

We do expect to reduce burn from restructuring charges in the latter part of 2023, together with a modest additional synergy capture to the benefit of our free cash flow. This will be offset by the additional cash interest payments related to Stonepeak subordinated notes, which are expected to (inaudible) cash pay on September 1 of this year.

我們確實預計將在 2023 年下半年減少重組費用的消耗，同時適度增加協同效應，以增強我們的自由現金流。這將被與 Stonepeak 次級票據相關的額外現金利息支付所抵消，這些利息預計將於今年 9 月 1 日（聽不清）現金支付。

Slide 14 is an update to our 2023 guidance, previously announced in the fourth-quarter 2022 earnings call. Given the challenges we have faced in the first half of the year and our expectation that some of these conditions will persist in the future quarters, we now expect 2023 consolidated revenue to be in the range of $740 million to $750 million and adjusted EBITDA to be in the range $120 million $130 million.

幻燈片 14 是我們之前在 2022 年第四季度財報電話會議上宣布的 2023 年指導的更新。考慮到我們上半年面臨的挑戰以及我們預計其中一些情況將在未來幾個季度持續存在，我們現在預計 2023 年合併收入將在 7.4 億至 7.5 億美元之間，調整後 EBITDA 為範圍為1.2 億美元1.3 億美元。

Turning to CapEx, we continue to refine our capital expenditure plans to ensure the most efficient deployment of equipment, better aligned with our strategic priorities. We continuously evaluate all markets and prioritize those that, based on our criteria, have the greatest near-term potential for growth.

談到資本支出，我們繼續完善資本支出計劃，以確保最有效地部署設備，更好地符合我們的戰略重點。我們不斷評估所有市場，並根據我們的標準優先考慮那些具有最大近期增長潛力的市場。

We're also cognizant of our ability to take delivery and install equipment in a timely manner and are currently experiencing some delays on that front. The result, we now expect total CapEx spend to be between $40 million and $50 million, with $10 million to $20 million allocated to growth CapEx for new customers and new sites, and the balance for maintenance CapEx.

我們還認識到我們有能力及時提貨和安裝設備，但目前在這方面遇到了一些延誤。結果，我們現在預計資本支出總額將在 4000 萬至 5000 萬美元之間，其中 1000 萬至 2000 萬美元分配給新客戶和新站點的增長資本支出，其餘用於維護資本支出。

Recall that we define maintenance CapEx as the spend for existing customers at existing sites, while growth CapEx is primarily oriented towards new hospital customer and partner acquisition as well as capacity expansion.

回想一下，我們將維護資本支出定義為現有站點現有客戶的支出，而增長資本支出主要面向新醫院客戶和合作夥伴的收購以及產能擴張。

Our investments in new customers and sites continues to be high return, typically with a four-year payback in growth capital. We anticipate total CapEx to be funded by approximately 20% in cash and the balance to be financed by combination of OEMs and equipment finance companies. Higher financing costs are a reality in all industries and maybe a headwind in coming quarters.

我們對新客戶和新地點的投資仍然具有高回報，通常在增長資本方面有四年的回報。我們預計總資本支出將由約 20% 的現金提供，其餘部分將由 OEM 和設備金融公司聯合提供資金。融資成本上升是所有行業的現實，並且可能是未來幾個季度的阻力。

Slide 15 illustrates our capital structure at the end of Q2 2023. As you can see, Akumin's leverage -- secured leverage is 7.0 times and our unsecured leverage is now 3.6 times.

幻燈片 15 展示了我們在 2023 年第二季度末的資本結構。如您所見，Akumin 的槓桿率——擔保槓桿率為 7.0 倍，而我們的無擔保槓桿率現在為 3.6 倍。

As an organization, we are very focused on reducing this leverage over time, although recent events have made that increasingly challenging. In the future, drivers of leverage reduction will come from increasing EBITDA as a result of the synergy capture, network rationalization, technology-driven standardization, and streamlining and service delivery, as we have outlined in previous calls.

作為一個組織，我們非常注重隨著時間的推移減少這種影響力，儘管最近發生的事件使這變得越來越具有挑戰性。未來，槓桿率降低的驅動因素將來自於協同效應捕獲、網絡合理化、技術驅動的標準化以及精簡和服務交付帶來的 EBITDA 的增加，正如我們在之前的電話會議中概述的那樣。

Note that as significant shareholders, we are highly incentivized to prudently optimize the capital structure. And we continue to evaluate options to do so as market conditions permit. As we had mentioned, the special committee of the Board is currently evaluating alternatives in the upfront.

請注意，作為重要股東，我們有很大動力謹慎優化資本結構。在市場條件允許的情況下，我們將繼續評估這樣做的選擇。正如我們所提到的，董事會特別委員會目前正在預先評估替代方案。

With that, I'll turn it back over to Riadh to wrap up before we take questions.

這樣，在我們回答問題之前，我會將其轉回給 Riadh 進行總結。

Thanks, David. That concludes the prepared remarks portion of the presentation. I hope we provided (inaudible) window to the results for the quarter. And we would now ask the operator to start the question-and-answer period.

謝謝，大衛。演講中準備好的評論部分就到此結束。我希望我們提供（聽不清）本季度結果的窗口。我們現在要求接線員開始問答環節。

Thank you, sir. Ladies and gentlemen, we will now begin the question-and-answer session. (Operator Instructions)

謝謝你，先生。女士們、先生們，我們現在開始問答環節。 （操作員說明）

Noel Atkinson, Clarus Securities.

諾埃爾·阿特金森，克拉魯斯證券。

Good morning, guys, and thanks for taking our questions this morning.

早上好，伙計們，感謝您今天早上提出我們的問題。

First off, just on the labor constraints. So are you seeing that across all your radiology segments? Or is it -- we're seeing this difference in PET/CT growth versus MRI growth. Is it more in the free-standing centers where you're seeing labor constraints? And then have you seen any easing of the hiring activity -- improvement of the hiring activity in Q3?

首先，只是關於勞動力限制。那麼您在所有放射科領域都看到了這一點嗎？或者是——我們看到了 PET/CT 生長與 MRI 生長的差異。在您看到勞動力限制的獨立中心中，這種情況是否更多？那麼，您是否看到第三季度招聘活動有所緩解——招聘活動有所改善？

Sure. Thanks, Noel, for the question. We're -- in specialized workforce like PET/CT, we're not seeing the same level of constraint. But for MRI and other procedures, yes, it's across the board.

當然。謝謝諾埃爾提出的問題。我們在 PET/CT 等專業勞動力中，沒有看到同樣程度的限制。但對於核磁共振和其他手術來說，是的，這是全面的。

The severity of the shortage depends market by market. It's not the exact same everywhere, but it's a tight labor. And it's not just new labor. Even when you compare pre-COVID to post-COVID, even from an overtime perspective, we don't have the same flexibility that we used to have.

短缺的嚴重程度取決於各個市場。各地的情況並不完全相同，但這是一項緊張的工作。這不僅僅是新勞動力。即使你將新冠疫情前和新冠疫情后進行比較，即使從加班的角度來看，我們也沒有以前那樣的靈活性。

They -- like we said before, David and I, there were signs of improvement. So it's actually -- the challenges are at a slower pace than it was at the end of last year or early next year, I think as you probably recall, Noel. And I think it's on the slide deck.

他們——就像我們之前說的，大衛和我，有改善的跡象。所以實際上，挑戰的速度比去年年底或明年初要慢，我想你可能還記得，諾埃爾。我認為它在幻燈片上。

When you look at year over year, we actually had no same-store growth in Q3 and Q4 of last year for MRI. It was 0%; it was flat. We started to see 4% and 3%, but that's not the growth levels that we've experienced in the past or we should experience based on the demand for our services.

當你逐年查看時，我們實際上在去年第三季度和第四季度的 MRI 上沒有同店增長。是 0%；它是平坦的。我們開始看到 4% 和 3%，但這不是我們過去經歷過的增長水平，或者我們應該根據對我們服務的需求來經歷。

So we're taking the steps. We've made some changes, where we started to see higher number of applicants in markets where we had challenges, where positions were open. And the long term solution, as you know, is also technology with our remote scanning capabilities. So we're working on both the short-term and long-term plans.

所以我們正在採取措施。我們做出了一些改變，在我們面臨挑戰、空缺職位的市場中，我們開始看到更多的申請人。如您所知，長期解決方案也是具有我們遠程掃描功能的技術。因此，我們正在製定短期和長期計劃。

And Riadh, if you don't mind, I'll jump in. And Noel, it's a great question. And as you appropriately noted, it's been less pronounced in our mobile division, where it's true for most of our PET/CTs.

Riadh，如果你不介意的話，我會插話。Noel，這是一個很好的問題。正如您恰當地指出的那樣，這種情況在我們的移動部門不太明顯，但對於我們的大多數 PET/CT 來說都是如此。

One thing that we don't put in -- discuss is what we kind of consider like other modalities. Because with -- as Riadh pointed out, there was a lower revenue and lower EBITDA with things like ultrasound, mammography. And we have seen a meaningful shortage in ability to backfill some of those tech positions as well.

我們沒有放入討論的一件事是我們像其他方式一樣考慮什麼。因為正如 Riadh 指出的那樣，超聲波、乳房 X 光檢查等業務的收入和 EBITDA 都較低。我們還發現，填補其中一些技術職位的能力嚴重短缺。

So while we don't talk about as much, it's not headline, that's impacted us also.

因此，雖然我們談論得不多，但這不是頭條新聞，但這也對我們產生了影響。

Okay. Thanks.

好的。謝謝。

Secondly -- so again, let's go back to this PET/CT, to just -- what you're seeing is continued acceleration of PET/CT volumes on a same-store basis. And you also mentioned that you're seeing some supply chain issues, getting new equipment.

其次，讓我們再次回到 PET/CT，您所看到的是同店 PET/CT 銷量的持續加速。您還提到您在購買新設備時遇到了一些供應鏈問題。

So first off, can you maybe give us a sense of -- how much is that impacting current revenue, this inability to get equipment to start -- I guess, start new contracts with hospitals? And then secondly, what are you seeing for demand in your pipeline for new contracts with hospitals?

首先，您能否讓我們了解一下，這種情況對當前收入的影響有多大，無法啟動設備，我猜是與醫院簽訂新合同？其次，您認為與醫院簽訂新合同的需求是什麼？

Are they kind of holding back on new initiatives, new partnerships, with folks like you because they're trying to save money? Or are they just saying, look, we need to increase this in light of, say, the new Alzheimer drug approvals and things like that?

他們是否因為想省錢而推遲與像你這樣的人的新計劃、新夥伴關係？或者他們只是說，看，我們需要根據新的阿爾茨海默病藥物批准之類的事情來增加這一點？

So again, thanks, Noel, the detailed question on the PET/CT. There were a couple of questions there. I'll try to answer each one of them.

再次感謝 Noel，關於 PET/CT 的詳細問題。有幾個問題。我會盡力回答每一個問題。

So on demand and on the new applications and new tracers, we expect this growth to continue into the next couple of years. This is not a phenomenon that will adjust the short term. We believe we're going to experience these levels, if not higher, of growth going forward.

因此，根據需求以及新應用程序和新跟踪器，我們預計這種增長將持續到未來幾年。這不是一個短期內會調整的現象。我們相信，未來我們將經歷這些水平（如果不是更高）的增長。

Having said that, as you pointed out, this is true not just for radiology, even for oncology. Post-COVID, there's a -- especially as we -- in PET/CT, we're signing up new customers. But the requirement on the mobile side is more soft with the new digital PET/CTs, which we have deployed already a number of them. And we're looking to deploy a lot more going forward.

話雖如此，正如您所指出的，這不僅適用於放射學，甚至適用於腫瘤學。新冠疫情過後，尤其是對我們來說，在 PET/CT 領域，我們正在簽約新客戶。但對於新的數字 PET/CT，移動端的要求更加寬鬆，我們已經部署了其中的一些。我們希望未來部署更多。

Those are -- that delay of equipment is impacting us. And just to give you an order of magnitude, which is why we're dealing with timing issues, in the mobile -- in the second quarter of 2023, the quarter that is in discussion right now, we booked or we signed up new customers that -- when you look at the book of business, we're signing up new customers versus what we booked as revenue in the second quarter because of delay in getting the equipment. It's a ratio of 3x.

這些是——設備的延誤正在影響我們。只是為了給您一個數量級，這就是我們在移動領域處理時間問題的原因 - 在 2023 年第二季度，即現在正在討論的季度，我們預訂或註冊了新客戶當你查看業務賬簿時，我們正在簽約新客戶，而我們在第二季度登記的收入是由於設備獲取延遲而造成的。其比例為 3 倍。

So you're signing up new customers at the rate of 3x to what you're booking. So it's a real issue, the delay in equipment delivery.

因此，您註冊新客戶的速度是預訂量的 3 倍。所以這是一個真正的問題，設備交付的延遲。

And I'll actually addresses at the same time because it's important for our investors to also understand that. The reason we are focusing and will focus more of the operations in the oncology repositioning and building a pipeline for the future -- because you really don't have access to equipment today. That's going to get resolved as we move into next year. But even if you signed up five new facilities today, you're going to have the same equipment delay we're experiencing on the mobile radiology side, for example. So it's a supply issue.

我實際上會同時發表講話，因為我們的投資者也必須理解這一點。我們之所以將重點放在腫瘤學重新定位和為未來建立管道上，並將更多地集中在腫瘤學業務上，是因為今天你確實無法獲得設備。當我們進入明年時，這個問題將會得到解決。但即使您今天註冊了五個新設施，您也會遇到與我們在移動放射學方面遇到的相同的設備延遲。所以這是一個供給問題。

That's -- so I think -- I hope that answers your question on -- but it's a really good question. We're not dealing with a change in fundamentals, we're just dealing with the reality of the supply side.

我認為，我希望這能回答你的問題，但這是一個非常好的問題。我們不是在應對基本面的變化，我們只是在應對供給側的現實。

Okay. And you feel comfortable that they're -- like you've been provided assurances from the manufacturer that the digital to PET/CT will come back, the availability will improve by the end of the year?

好的。您對它們感到滿意嗎？就像製造商向您保證數字化 PET/CT 將會回歸一樣，可用性將在年底前得到改善？

That's what we (inaudible) first of all, look, the GE has already a solution in the market. And as you know, for mobile, it's not just the equipment, like freestanding. It's also the unit that will house the equipment. And that's where the manufacturing also bottleneck is coming from.

這就是我們（聽不清）首先看到的，GE 已經在市場上提供了解決方案。如您所知，對於移動設備而言，不僅僅是設備，例如獨立式設備。它也是容納設備的單元。這就是製造瓶頸的來源。

So it's not the OEM in some cases. Because we have been able to secure to OEMs (inaudible) units. But the bottleneck is from the manufacturing side of the mobile unit itself that is hosting the PET/CT equipment.

所以在某些情況下它不是 OEM。因為我們已經能夠確保 OEM（聽不清）單位的安全。但瓶頸來自於承載 PET/CT 設備的移動單元本身的製造方面。

Got you. Okay. And then just maybe a couple of quick financial ones, if I can.

明白你了。好的。如果可以的話，也許還有一些快速的財務問題。

So you had accelerated amortization in Q2 from the oncology, closing one site lending, and off to the second. Does this amortization and depreciation go back to kind of Q1 levels or a bit below starting in Q3?

因此，您在第二季度加速了腫瘤學的攤銷，關閉了一個站點的貸款，然後轉到第二個站點。這種攤銷和折舊是否會回到第一季度的水平或略低於第三季度的水平？

It would be -- to your point, it would be slightly lower just because we accelerated the depreciation -- amortization in those couple of sites. So I think you're spot on.

就你而言，它會稍微低一些，只是因為我們加速了這幾個地點的折舊攤銷。所以我認為你說得對。

Okay. So instead of -- okay. So it would go down by like $10 million or something like that quarter over quarter?

好的。所以，而不是——好吧。那麼季度環比會下降 1000 萬美元左右嗎？

I'm not sure $10 million -- let me get you a better estimate for that as to what it could be.

我不確定 1000 萬美元——讓我給你一個更好的估計，看看它可能是多少。

Okay. And then finally, before I go back in the queue. You had all $55 million on your revolver available at the end of June. So does the company have full access to all of that $55 million at the present time, if it needed in the future?

好的。最後，在我回到隊列之前。到 6 月底，你的左輪手槍裡已經有 5500 萬美元可用了。那麼，如果將來需要的話，該公司目前是否可以完全使用這 5500 萬美元？

Well, the revolver availability is based on trailing 12 months and the ratio to EBITDA. So that will be probably slightly impaired. But the majority, the vast majority, of that will be available to us.

好吧，左輪手槍的可用性是基於過去 12 個月和 EBITDA 的比率。因此，這可能會受到輕微損害。但其中的大部分、絕大多數都將提供給我們。

Okay. All right. That's it for me. Thanks very much.

好的。好的。對我來說就是這樣。非常感謝。

Thank you, Noel.

謝謝你，諾埃爾。

Thank you. Rishi Parekh, JPM.

謝謝。里希·帕雷克 (Rishi Parekh)，JPM。

Excuse me. Commercial revenue was down, hospital revenue was flattish. Is this a sign that your legacy business is deteriorating and you're -- the Alliance healthcare side of the business is making up for that slack? And then with that, with hospital revenue being flat and volumes being so strong, are you granting of providing price concessions to your hospital customers?

打擾一下。商業收入下降，醫院收入持平。這是否表明您的傳統業務正在惡化，而聯盟醫療保健方面的業務正在彌補這一缺陷？那麼，在醫院收入持平且銷量如此強勁的情況下，您是否同意向醫院客戶提供價格優惠？

Because I'm just trying to understand why revenue was not up even more. I know you had a Port Charlotte issue. But more than what we're seeing, just given the volumes that you're producing.

因為我只是想了解為什麼收入沒有增加更多。我知道你有夏洛特港的問題。但不僅僅是我們所看到的，僅考慮到你們正在生產的數量。

Well, I'll jump in just real, real quickly before I let Riadh address the broader question. I did mention that particularly on the oncology side. We are no longer recording revenue to two customers and actually had to reverse previously accrued revenue due to lack of receiving payment. So that does distort Q2 a little bit just because of the reversal. And we have a slightly lower run rate (inaudible) until we resolve these issues with a couple of customers.

好吧，在讓 Riadh 解決更廣泛的問題之前，我會非常非常快地切入主題。我確實提到過這一點，特別是在腫瘤學方面。我們不再向兩個客戶記錄收入，並且由於未收到付款，實際上不得不沖銷之前的應計收入。因此，由於反轉，Q2 確實有點扭曲。在我們與幾個客戶解決這些問題之前，我們的運行率略低（聽不清）。

But does that explain the entire reason as to why revenue is down despite the volume increase?

但這是否可以解釋儘管銷量增加但收入卻下降的全部原因？

Well that was to, a large part, on the oncology side.

嗯，這很大程度上是在腫瘤學方面。

Yeah. And one the radiology side -- sorry, go ahead.

是的。放射學方面——抱歉，請繼續。

No. I'll let you address the radiology.

不，我會讓你談談放射學。

Yeah. So on the radiology side, Rishi, it's exactly what you've outlined. So the challenges that we have on -- as you know, whether it's hurricane related or it's the labor shortage, it's really on the commercial side. The only challenge we're having on the hospital side of the business is in the satisfying customer demands on the mobile side, not fast enough. But your observation is right on, where the commercial side is where we're having the pain points.

是的。因此，在放射學方面，Rishi，這正是您所概述的。因此，我們面臨的挑戰 - 如您所知，無論是與颶風有關還是勞動力短缺，實際上都是在商業方面。我們在醫院業務方面面臨的唯一挑戰是在移動端滿足客戶需求，但速度不夠快。但你的觀察是正確的，商業方面正是我們面臨的痛點。

And then if I -- just to kind of add onto that. With regards to the hospital side, are you losing contracts? I know this is -- before you look at the Alliance Healthcare business, CapEx was very high. And today, CapEx is very low relative to what we've seen before, which, to me, implies that you needed to keep spending money on the CapEx front to maintain those contracts. But because you're not, are you losing contracts on that side, which may also explain why hospital revenues are down?

然後如果我——只是想補充一下。醫院方面，你們有失去合同嗎？我知道，在你看聯盟醫療保健業務之前，資本支出非常高。如今，資本支出相對於我們之前所看到的非常低，對我來說，這意味著您需要繼續在資本支出方面花錢來維持這些合同。但因為你不是，你是否會失去那方面的合同，這也可以解釋為什麼醫院收入下降？

Yes. So as you know, it's the nature of the business on the mobile side. Or for the geology, there is a natural churn. And typically -- so you have contracts that expired in the past at the -- because you're very familiar with the legacy Alliance, I think as you probably recall, Rishi, they always talk about net renewal, like what -- is your book of business larger than what you are replacing?

是的。如您所知，這是移動端業務的本質。或者對於地質學來說，存在自然攪拌。通常 - 所以你的合同在過去已經到期 - 因為你非常熟悉遺留聯盟，我想你可能還記得，Rishi，他們總是談論淨更新，比如什麼 - 是你的業務簿比您要替換的業務簿大嗎？

Today, our book of business is actually in net position, but just from a signing perspective -- from commitments, but not from a revenue booking perspective. Because you're still -- the business is still turning or churning as historically. But to bring on new customers, you have the contract signed. But you have a timing issue in, basically, booking the revenue because you don't have the equipment yet.

今天，我們的業務賬簿實際上處於淨頭寸，但只是從簽約的角度來看——從承諾的角度來看，而不是從收入預訂的角度來看。因為你仍然——業務仍然像歷史一樣在轉變或攪動。但為了吸引新客戶，你必須簽署合同。但基本上，你在預訂收入時遇到了時間問題，因為你還沒有設備。

And that's also why the CapEx have came -- did come down. And we've revised it for the balance of the year because we're not getting the delivery of the equipment at the same pace that we expected it. And you're absolutely right when you said you have to continue to basically deploy CapEx, which -- really, what you're doing when you're deploying CapEx, you're signing new customers for longer terms. And that's just nature of the -- in the mobile side of radiology.

這也是資本支出確實下降的原因。我們已經對今年剩餘時間進行了修改，因為我們沒有按照預期的速度交付設備。當你說你必須繼續基本上部署資本支出時，你是絕對正確的，實際上，當你部署資本支出時，你正在簽署長期的新客戶。這就是放射學移動方面的本質。

And just a few other questions. On Port Charlotte, do you have insurance? So all this money that you're spending, do you expect to recoup it through reinsurance?

還有其他幾個問題。在夏洛特港，你有保險嗎？那麼您花費的所有這些錢，您希望通過再保險來收回嗎？

And with regards to the tracers, I know you said it as a pass through. But obviously, you took a loss in this quarter. Is there no way to recoup those losses in future periods with those same customers?

至於示踪劑，我知道你說的是穿越。但顯然，你在本季度虧損了。是否沒有辦法在未來期間彌補這些相同客戶的損失？

And then just lastly, I know you have partial access to your revolver. You have a $35 million or so of cash on balance sheet. You have this cash pay that might be coming up. So liquidity is going to be really tight. And it's not certain as to whether or not your guidance is maybe reflecting some of the challenges that you're seeing now.

最後，我知道你可以部分使用你的左輪手槍。您的資產負債表上有大約 3500 萬美元的現金。您可能會收到這筆現金工資。因此，流動性將會非常緊張。不確定您的指導是否反映了您現在看到的一些挑戰。

Do you believe that you have sufficient liquidity to get through this year? Is this restructuring something there you have to complete sooner than later?

您認為今年的流動性充足嗎？這次重組是不是必須盡快完成的事情？

And then with that, I believe you have $100 million or so of super secure capacity, maybe $100 million to $200 million of additional secured capacity. Can you just confirm what capacity -- what your capacity baskets are on the secure side and what your RP basket is today? Thank you.

然後，我相信您擁有 1 億美元左右的超級安全容量，也許還有 1 億到 2 億美元的額外安全容量。您能否確認一下您的容量籃子是安全的，以及您今天的 RP 籃子是多少？謝謝。

No problem. So I'll answer the first question on the Port Charlotte. We have received, like David mentioned earlier, a portion from the insurance companies that have pretty much covered most of the cost of or will cover most of the cost when we -- because there was a delay in getting the permits when we start the construction and the renovation.

沒問題。那麼我將回答關於夏洛特港的第一個問題。正如大衛之前提到的，我們已經從保險公司收到了一部分，這些保險公司幾乎承擔了我們的大部分成本，或者將承擔我們開始施工時的大部分成本——因為我們開始施工時獲得許可證的時間有所延遲。和裝修。

So that's going to -- that has been recovered, but we're still expecting more payments from the insurance company that relate to business interruption, which, as you would -- given that there was an [$8 million to $9 million] revenue facilities, that's obviously a large number. But we're still expecting more payments from the insurance companies.

因此，這已經恢復了，但我們仍然期望保險公司支付更多與業務中斷相關的付款，正如你所想的那樣，考慮到有 [800 萬至 900 萬美元] 的收入設施，這顯然是一個很大的數字。但我們仍然期望保險公司支付更多費用。

And that's really kind of what's going on with Port Charlotte. I think your -- before we go into liquidity, your second question again, Rishi, was on (multiple speakers)

這就是夏洛特港正在發生的事情。我認為，在我們討論流動性問題之前，Rishi，你的第二個問題再次出現（多個發言者）

On the tracer pass throughs? On the tracer pass throughs.

在示踪劑通道上？在示踪劑通道上。

On the tracer. So yes. So we -- historically, it has been -- what we're doing more is not just a simple cost recovery, given the cost of these specialty tracers and given the demands for the service and the growth we're seeing. So in new contracts, obviously, you cannot change existing contracts. But in new contracts, we're more successful in getting more than the cost of the company.

在示踪劑上。所以是的。因此，從歷史上看，我們所做的不僅僅是簡單的成本回收，考慮到這些專業追踪器的成本以及對服務的需求和我們所看到的增長。因此，在新合同中，顯然，您不能更改現有合同。但在新合同中，我們更成功地獲得了超出公司成本的收益。

And then on the liquidity and all those, David, if you want to address it. Or I'm happy to address it as well on the basket that we currently have.

然後是流動性和所有這些，大衛，如果你想解決這個問題的話。或者我也很高興在我們目前擁有的籃子上解決這個問題。

Yeah, I would -- yeah, a couple of high-level points. Number one, at the end of Q2 -- actually, I misspoke earlier. We actually had -- I said largely. No, it's entire -- the revolver's entirely available to us as of the end of Q2. So we do have that $55 million of liquidity available.

是的，我會——是的，一些高層次的觀點。第一，在第二季度末——實際上，我之前說錯了。我們實際上有——我說的是大部分。不，它是完整的——從第二季度末開始，我們就可以完全使用左輪手槍了。所以我們確實有 5500 萬美元的可用流動資金。

And while we do have to be cognizant of the fact the Stonepeak notes are going cash pay, we do have financial capacity to meet our obligations. So that's not an issue for us for -- through the year end and into next year. So we have some degree of line of sight.

雖然我們確實必須認識到 Stonepeak 票據將採用​​現金支付的事實，但我們確實有財務能力來履行我們的義務。因此，從年底到明年，這對我們來說都不是問題。所以我們有一定程度的視線。

Rishi, I think you did mention well that there is no insurances. Of course, there's a number of insurances. That, you're going to realize, would be in the range that we've outlined. And given our revised guidance, I understand some concern around that.

Rishi，我認為你確實提到了沒有保險。當然，還有很多保險。您將會意識到，這將在我們概述的範圍內。鑑於我們修訂後的指導意見，我理解對此的一些擔憂。

We think we've been appropriately conservative and putting that $120 million to $130 million EBITDA range together. And I think you've heard (inaudible) there are opportunities to go for additional liquidity events.

我們認為我們已經適當保守了，並將 1.2 億至 1.3 億美元的 EBITDA 範圍加在一起。我認為您已經聽說（聽不清）有機會進行額外的流動性活動。

We have recovered some of the payments from what we've spent on Port Charlotte. We expect to receive more. So that would be, again, a benefit over, above -- beyond the adjusted EBITDA.

我們已經收回了在夏洛特港花費的部分款項。我們期望收到更多。因此，這將是超出調整後 EBITDA 的收益。

And in terms of the basket, I want to -- probably, you two have a more precise number offline. You're right, we do have some of the capacity available to us. And while we hadn't reached the limit on the purchase money because of just on the buy that we've done for the equipment financing, every quarter, every month that goes by, we pay down some of those lease expenses. That does we recreate capacity in the purchase money.

就籃子而言，我想——也許你們兩個在線下有一個更準確的數字。你是對的，我們確實有一些可用的能力。雖然我們還沒有達到購買資金的上限，因為我們只是購買了設備融資，但每個季度、每個月，我們都會支付一些租賃費用。這就是我們重建購買資金的能力。

But we have been able to do a financing prior last couple of capital equipment purchases under operating leases. That also affects marginally, not usually. But it does impact the adjusted EBITDA because finance leases, that comes out of adjusted EBITDA. And the operating leases, it creates a little bit of a headwind in the adjusted EBITDA.

但我們已經能夠在最近幾次根據經營租賃購買資本設備之前進行融資。這也有輕微影響，但通常不會。但它確實會影響調整後的 EBITDA，因為融資租賃來自調整後的 EBITDA。經營租賃給調整後的 EBITDA 帶來了一些阻力。

Again, not significant, but we probably should start calling that out going forward, Riadh, about how had we continued prior -- previous practice of financing leases versus now starting to use some operating leases, how that impacts the adjusted EBITDA negatively.

同樣，這並不重要，但我們可能應該開始指出這一點，Riadh，關於我們如何繼續之前的融資租賃做法與現在開始使用一些經營租賃，這如何對調整後的 EBITDA 產生負面影響。

Good. Rishi, any additional questions?

好的。 Rishi，還有其他問題嗎？

I'll follow-up on the rest of it, but thank you.

我會跟進其餘部分，但謝謝你。

Thank you, Rishi.

謝謝你，里希。

Thank you. There are no further questions at this time. I would now like to turn the call back over to Mr. Zine for any closing remarks.

謝謝。目前沒有其他問題。我現在想將電話轉回 Zine 先生，請他發表結束語。

Okay. Thanks. Thank you, everyone, for your participation on today's call. I would like to take this opportunity to thank our staff, radiologists, and all of our stakeholders for their efforts and ongoing support, as we address our operating challenges and we address our capital structure as well.

好的。謝謝。感謝大家參加今天的電話會議。我想藉此機會感謝我們的員工、放射科醫生和所有利益相關者在我們解決運營挑戰和資本結構問題時所做的努力和持續支持。

This concludes our call, and thanks again to all participants for your interest in Akumin.

我們的電話會議到此結束，再次感謝所有參與者對 Akumin 的關注。

Thank you, sir. Ladies and gentlemen, this concludes your conference call for today. We thank you for participating and ask that you please disconnect your lines. Have a lovely day.

謝謝你，先生。女士們、先生們，今天的電話會議到此結束。我們感謝您的參與，並請您斷開線路。祝你愉快。