Astrana Health Inc (ASTH) 2021 Q3 法說會逐字稿

Greetings. Welcome to Apollo Medical Holdings Third Quarter 2021 Financial Results Call. (Operator Instructions) Please note, this conference is being recorded. At this time, I'll turn the conference over to Carolyne Sohn with Investor Relations. Carolyne, you may begin.

問候。歡迎參加 Apollo Medical Holdings 2021 年第三季度財務業績電話會議。（操作員說明）請注意，正在錄製此會議。此時，我會將會議轉交給投資者關係部的卡羅琳·索恩 (Carolyne Sohn)。卡羅琳，你可以開始了。

Thank you, operator, and hello, everyone. Thank you for joining us. The press release announcing Apollo Medical Holdings, Inc.'s results for the third quarter ended September 30, 2021, is available at the Investors section of the company's website at www.apollomed.net. To provide some additional background on its results, the company has made a supplemental deck available on its website. A replay of this broadcast will also be made available at ApolloMed's website after the conclusion of this call.

謝謝接線員，大家好。感謝您加入我們。公佈 Apollo Medical Holdings, Inc. 截至 2021 年 9 月 30 日的第三季度業績的新聞稿可在公司網站 www.apollomed.net 的投資者部分查閱。為了提供一些關於其結果的額外背景，該公司在其網站上提供了一個補充平台。本次電話會議結束後，還將在 ApolloMed 的網站上提供該廣播的重播。

Before we get started, I would like to remind everyone that this conference call and any accompanying information discussed herein contains certain forward-looking statements within the meaning of the safe harbor provision of the Private Securities Litigation Reform Act of 1995. These forward-looking statements can be identified by terms such as anticipate, believe, expect, future, plan, outlook and will and include, among other things, statements regarding the company's guidance for the year ending December 31, 2021, continued growth, acquisition strategy, ability to deliver sustainable long-term value, ability to respond to the changing environment, operational focus, strategic growth plans and merger integration efforts as well as the impact of the 2020 novel coronavirus or COVID-19 pandemic and the Delta variant on the company's business, operations and financial results.

在我們開始之前，我想提醒大家，本次電話會議和此處討論的任何隨附信息包含某些前瞻性陳述，這些陳述符合 1995 年《私人證券訴訟改革法案》安全港條款的含義。這些前瞻性陳述可以通過預期、相信、期望、未來、計劃、展望和意願等術語來識別，其中包括關於公司截至 2021 年 12 月 31 日的年度指導、持續增長、收購等的陳述戰略、提供可持續長期價值的能力、應對不斷變化的環境的能力、運營重點、戰略增長計劃和合併整合工作以及 2020 年新型冠狀病毒或 COVID-19 大流行和 Delta 變種對公司的影響公司的業務、運營和財務業績。

Additionally, certain financial measures we will discuss on this call are non-GAAP financial measures. We believe that providing these measures helps investors gain a better and more complete understanding of our financial results and is consistent with how management views our financial results. A reconciliation of these non-GAAP measures to the most comparable GAAP measure is available in the earnings press release and Form 8-K filed with the SEC. Although the company believes that the expectations reflected in its forward-looking statements are reasonable as of today, those statements are subject to risks and uncertainties that could cause the actual results to differ dramatically from those projected.

此外，我們將在本次電話會議上討論的某些財務指標是非 GAAP 財務指標。我們相信，提供這些衡量標準有助於投資者更好、更全面地了解我們的財務業績，並且與管理層對我們財務業績的看法一致。這些非 GAAP 措施與最具可比性的 GAAP 措施的對賬可在收益新聞稿和向美國證券交易委員會提交的 8-K 表格中找到。儘管公司認為其前瞻性陳述中反映的預期在今天是合理的，但這些陳述存在風險和不確定性，可能導致實際結果與預期結果大相徑庭。

There can be no assurance that those expectations will prove to be correct. Information about the risks associated with investing in ApolloMed is included in its filings with the Securities and Exchange Commission, which we encourage you to review before making an investment decision. The company does not assume any obligation to update any forward-looking statements as a result of new information, future events, changes in market conditions or otherwise, except as required by law.

無法保證這些期望將被證明是正確的。有關與投資 ApolloMed 相關的風險的信息包含在其向美國證券交易委員會提交的文件中，我們鼓勵您在做出投資決定之前進行審查。除非法律要求，否則公司不承擔因新信息、未來事件、市場條件變化或其他原因而更新任何前瞻性陳述的義務。

Regarding the disclaimer language, I would also like to refer you to Slide 2 of the conference call presentation for further information. For those of you following along with the accompanying supplement, there is an overview of the company on Slide 3. On today's call, the company's Executive Chairman, Dr. Kenneth Sim, will make some opening remarks and then turn the call over to Brandon Sim, the company's Co-CEO, who will discuss the third quarter and year-to-date 2021 highlights and the latest operational developments. Chief Financial Officer, Eric Chin, will follow with a review of ApolloMed's results for the third quarter and first 9 months of 2021. Brandon will conclude the remarks with an update on the company's outlook and long-term growth strategy before opening the floor for questions.

關於免責聲明語言，我還想請您參閱電話會議演示文稿的幻燈片 2 以了解更多信息。對於那些跟隨隨附補充的人，幻燈片 3 上有公司的概述。在今天的電話會議上，公司執行主席 Kenneth Sim 博士將發表一些開場白，然後將電話轉給 Brandon Sim ，該公司的聯合首席執行官，他將討論第三季度和 2021 年年初至今的亮點和最新的運營發展。首席財務官 Eric Chin 隨後將審查 ApolloMed 2021 年第三季度和前 9 個月的業績。在開始提問之前，布蘭登將以公司前景和長期增長戰略的最新情況結束髮言。

With that, I'll turn the call over to ApolloMed's Executive Chairman, Dr. Kenneth Sim. Please go ahead, Dr. Sim.

有了這個，我將把電話轉給 ApolloMed 的執行主席 Kenneth Sim 博士。請繼續，Sim 博士。

Good afternoon to all of you, and thank you for joining us to discuss ApolloMed's third quarter 2021 results. I would like to begin this call by addressing the leadership changes we announced in conjunction with our earnings report this afternoon. We are very pleased to appoint Brandon Sim as ApolloMed's Co-CEO, effective November 2. Since joining the company, Brandon has led key efforts in creating and executing ApolloMed's new growth model, navigating the COVID-19 global pandemic and transforming ApolloMed into the technology-powered health care company that it is today.

大家下午好，感謝您加入我們討論 ApolloMed 2021 年第三季度的業績。我想通過解決我們今天下午在收益報告中宣布的領導層變動來開始本次電話會議。我們很高興任命 Brandon Sim 為 ApolloMed 的聯席首席執行官，自 11 月 2 日起生效。自加入公司以來，Brandon 在創建和執行 ApolloMed 的新增長模式、應對 COVID-19 全球大流行以及將 ApolloMed 轉化為技術方面發揮了重要作用今天的強大醫療保健公司。

As Chief Technology Officer, Brandon built our team of engineers and data scientists from the ground up over the last 2.5 years, leading the development of ApolloMed's proprietary technology platform. This platform that serves as an operating system for value-based care has allowed the company to scale effectively across local health care delivery systems, greatly reducing operating expenses and leading to notable financial performance improvements. More importantly, this platform is helping us drive improved clinical outcomes and patient satisfaction by streamlining care and utilization management workflows. The platform also algorithmically surfaces actionable data and insights so that our providers can take on and succeed in value-based care arrangements.

作為首席技術官，布蘭登在過去 2.5 年裡從頭開始組建了我們的工程師和數據科學家團隊，領導了 ApolloMed 專有技術平台的開發。這個平台作為基於價值的護理的操作系統，使公司能夠在當地的醫療保健服務系統中有效地擴展，大大降低了運營費用，並顯著提高了財務業績。更重要的是，該平台通過簡化護理和使用管理工作流程，幫助我們提高臨床結果和患者滿意度。該平台還通過算法呈現可操作的數據和見解，以便我們的提供者能夠承擔並成功進行基於價值的護理安排。

As Chief Operating Officer, Brandon has spearheaded ApolloMed's corporate strategy, business development, operations and engineering efforts for over a year now, and he will continue to lead those efforts as Co-CEO. I will continue to serve as Executive Chairman of the Board, working closely with the Board of Directors and executive management team.

作為首席運營官，布蘭登 (Brandon) 一年多來一直領導 ApolloMed 的企業戰略、業務發展、運營和工程工作，他將繼續作為聯席首席執行官領導這些工作。我將繼續擔任董事會執行主席，與董事會和執行管理團隊密切合作。

ApolloMed has been evolving towards becoming a technology-powered integrated health care delivery company for the last few years. And this leadership transition marks a major milestone in our continued efforts to provide patients with best-in-class valued-based care. Having witnessed the incredible results built by Brandon's passion and drive, the Board of Directors and I are confident that Brandon is the right person to lead ApolloMed into its next chapter. It is truly an incredibly exciting time at our company, and we look forward to continuing our success and rapid growth under Brandon's leadership.

在過去的幾年裡，ApolloMed 一直在朝著成為一家技術驅動的綜合醫療服務公司的方向發展。這一領導層交接標誌著我們繼續努力為患者提供一流的基於價值的護理的一個重要里程碑。在見證了布蘭登的熱情和乾勁所取得的令人難以置信的成果後，董事會和我相信布蘭登是帶領 ApolloMed 進入下一章的合適人選。這對我們公司來說確實是一個令人難以置信的激動人心的時刻，我們期待在 Brandon 的領導下繼續我們的成功和快速發展。

With that, I would like to turn it over to Brandon, who will go over highlights for the third quarter and year-to-date 2021 as well as recent operational developments. Brandon?

有了這個，我想把它交給布蘭登，他將回顧第三季度和 2021 年年初至今的亮點以及最近的運營發展。布蘭登？

Thank you, Dr. Sim. I'm so glad to have this opportunity to speak with you all on my first earnings call as ApolloMed's Co-CEO. It has been an exciting few years of building tirelessly, growing rapidly and serving our providers and patients proudly here at ApolloMed. I am incredibly optimistic about our company's future and our ability to execute on our mission of transforming the way health care is delivered in our country. I pledge to not only continue and even amplify our steadfast commitment to health care equity and physician empowerment as we continue on this journey, but to also align all stakeholders to continue driving sustainable long-term value for our shareholders. And of course, I very much look forward to continuing to work closely with Dr. Thomas Lam, my Co-CEO, and the rest of our talented and passionate team here at ApolloMed.

謝謝您，辛醫生。我很高興有這個機會在我作為 ApolloMed 的聯席首席執行官的第一次財報電話會議上與大家交談。在 ApolloMed 不知疲倦地建設、快速發展並自豪地為我們的提供者和患者服務的幾年裡，這是令人興奮的幾年。我對我們公司的未來以及我們執行改變我們國家提供醫療保健方式的使命的能力非常樂觀。我承諾，在我們繼續這一旅程的過程中，不僅會繼續甚至擴大我們對醫療保健公平和醫生賦權的堅定承諾，而且還會與所有利益相關者保持一致，繼續為我們的股東創造可持續的長期價值。當然，我非常期待繼續與我的聯合首席執行官 Thomas Lam 博士以及我們在 ApolloMed 的其他才華橫溢、充滿激情的團隊密切合作。

ApolloMed is in a truly unique position to bring about and lead this change in health care delivery for several reasons. The first differentiating advantage for ApolloMed is our long history of physician leadership and our dedication to physician empowerment and partnerships. The roots of ApolloMed were planted by physicians and our continued partnership and deep alignment with independent physicians and groups have led to an understanding of integrated health care delivery in a value-based care setting that is hard to match.

由於多種原因，ApolloMed 處於真正獨特的地位，可以帶來並引領醫療保健服務的變革。ApolloMed 的第一個差異化優勢是我們在醫師領導方面的悠久歷史以及我們對醫師賦權和合作夥伴關係的奉獻。ApolloMed 的根源是由醫生種下的，我們與獨立醫生和團體的持續合作和深入合作使我們了解了在難以匹敵的基於價值的護理環境中提供綜合醫療保健服務。

This advantage is a natural segue into the second powerful differentiator for ApolloMed, our expertise in value-based care and taking risk successfully. We have been operating profitably in risk-bearing value-based arrangements in Southern California for more than 2 decades. And we have used this experience to create a platform that empowers independent physicians and groups all over the country to not only participate in but also succeed in such risk-bearing value-based care arrangements.

這一優勢是 ApolloMed 的第二個強大差異化因素的自然延伸，我們在基於價值的護理和成功承擔風險方面的專業知識。2 多年來，我們一直在南加州以基於風險的價值為基礎的安排中盈利。我們利用這一經驗創建了一個平台，使全國各地的獨立醫生和團體不僅能夠參與這種基於風險的基於價值的護理安排，而且還能取得成功。

Third, we couple our decades of value-based care expertise with technology and engineering advances, where I've had a lot of experience in both academic and practical settings. As Dr. Sim mentioned earlier, we are committed to continuing to invest in and build a world-class health care delivery operating system, marrying clinical and operational proficiency with advances in machine learning, Bayesian decision-making, modern software engineering. This allows us to create systems that are not only tailored to each independent physician group and local community but also flexible enough to handle and make sense of extremely large-scale data as we scale and build integrated health care delivery systems nationwide. It also allows us to reduce operating expenses and helps to improve clinical outcomes, quality of care delivered and patient satisfaction. This last piece of the puzzle is what allows us to take what has worked in the local communities we already serve and bring that expertise into other geographies across the country.

第三，我們將數十年基於價值的護理專業知識與技術和工程進步相結合，我在學術和實踐環境中都有很多經驗。正如 Sim 博士之前提到的，我們致力於繼續投資和構建世界一流的醫療保健服務操作系統，將臨床和操作熟練程度與機器學習、貝葉斯決策、現代軟件工程的進步相結合。這使我們能夠創建不僅為每個獨立的醫生團體和當地社區量身定制的系統，而且在我們在全國范圍內擴展和構建綜合醫療保健服務系統時，還具有足夠的靈活性來處理和理解極其大規模的數據。它還使我們能夠減少運營費用，並有助於改善臨床結果、提供的護理質量和患者滿意度。最後一塊拼圖是什麼讓我們能夠利用我們已經服務的當地社區的成功經驗，並將這些專業知識帶到全國其他地區。

Finally, these 3 unique elements snowball into our final competitive advantage, a strong financial position with consistent profitability that we will use to invest in future growth and deliver sustained shareholder returns. The record third quarter earnings that we are reporting today as well as our confidence in raising full year guidance are evidence of this. We once again achieved solid growth on the top line and more than doubled our bottom line. This quarter represents the highest quarterly revenue, net income attributable to ApolloMed shareholders and earnings per share that we have delivered thus far in our company's history. And I am proud to say that these results were driven by growth across nearly all of our businesses, particularly in our risk pool settlements and incentives.

最後，這 3 個獨特的元素滾雪球般地成為我們最終的競爭優勢，強大的財務狀況和持續的盈利能力，我們將利用它來投資於未來的增長並提供持續的股東回報。我們今天公佈的創紀錄的第三季度收益以及我們對提高全年業績指引的信心都證明了這一點。我們再次實現了收入的穩健增長，利潤翻了一番多。本季度代表了我們公司歷史上迄今為止實現的最高季度收入、歸屬於 ApolloMed 股東的淨收入和每股收益。我很自豪地說，這些結果是由我們幾乎所有業務的增長推動的，尤其是在我們的風險池結算和激勵措施方面。

Based on the positive trends that we are seeing, our continued organic growth, contributions from our technology platform and phenomenal results in the first 9 months of the year, we are once again raising our guidance for full year 2021. We now anticipate at least 9% growth year-over-year on the top line to between $751.5 million and $758.5 million and at least 89% growth year-over-year in net income attributable to ApolloMed to between $71.5 million and $73.5 million. We also anticipate diluted EPS for the year to be between $1.58 and $1.62, which would represent at least 56% earnings growth year-over-year. I will go over the full set of updated guidance later on in the call during our discussion of outlook and growth strategy.

基於我們看到的積極趨勢、我們持續的有機增長、我們技術平台的貢獻以及今年前 9 個月的顯著成果，我們再次提高了 2021 年全年的預期。我們現在預計收入至少同比增長 9%，達到 7.515 億美元至 7.585 億美元之間，歸屬於 ApolloMed 的淨收入同比增長至少 89%，達到 7150 萬美元至 7350 萬美元之間。我們還預計今年攤薄後的每股收益將在 1.58 美元至 1.62 美元之間，這意味著收益同比至少增長 56%。在我們討論前景和增長戰略期間，我將在稍後的電話會議中回顧整套更新指南。

During the third quarter of 2021, we continue to see solid organic membership growth in our existing IPAs during the period, which drove the increase in capitation revenue. We nearly doubled risk pool and incentive revenues year-over-year as a result of decreased utilization at our partner hospitals as well as an increase in the shared savings settlement from our participation in an ACO for performance year 2020. Fee-for-service revenues also saw a year-over-year increase in the third quarter as a result of increased utilization at our surgery and heart centers following their reopening this year and $2 million of contributions from Sun Labs following the closing of that transaction during the period.

在 2021 年第三季度，我們繼續看到我們現有 IPA 的會員有機增長穩健，這推動了人均收入的增長。由於我們合作醫院的利用率下降，以及我們參與 2020 年績效年度 ACO 的共享儲蓄結算增加，我們的風險池和激勵收入同比增長了近一倍。由於我們的手術和心臟中心在今年重新開放後利用率提高，以及交易結束後 Sun Labs 提供的 200 萬美元捐款，第三季度的按服務收費收入也出現了同比增長期間。

We did incur higher OpEx in Q3 as a result of increased cost of services from greater utilization, increased provider bonus payments related to the increased ACO shared savings settlement and increased payroll due to our continued investment in an all-star operational and technical team. Despite this, we were able to still achieve 105% growth in net income attributable to ApolloMed, recording $34.3 million during the period compared to $16.7 million in the prior year period. Diluted EPS was up 64% to $0.74 for the quarter. For the 9 months ended September 30, 2021, we achieved a 13% increase in total revenue, reporting $578.8 million for the period and achieved 116% growth in net income attributable to a ApolloMed of $60.1 million. Diluted EPS increased 77% to $1.33 for the first 9 months of 2021.

由於更高的利用率導致服務成本增加，與增加的 ACO 共享儲蓄結算相關的供應商獎金支付增加，以及由於我們對全明星運營和技術團隊的持續投資而增加的工資，我們在第三季度確實產生了更高的運營支出。儘管如此，我們仍然能夠實現歸屬於 ApolloMed 的淨收入 105% 的增長，在此期間錄得 3,430 萬美元，而去年同期為 1,670 萬美元。本季度稀釋每股收益增長 64% 至 0.74 美元。在截至 2021 年 9 月 30 日的 9 個月裡，我們的總收入增長了 13%，報告期內收入為 5.788 億美元，歸屬於 ApolloMed 的淨收入增長了 116%，為 6010 萬美元。2021 年前 9 個月，稀釋後每股收益增長 77% 至 1.33 美元。

In terms of the utilization trends we are observing as a result of the ongoing COVID-19 pandemic, we continue to see utilization increase during the third quarter of 2021, and our current projection is a return to pre-COVID utilization rates for the remainder of this year. As utilization does return to normal levels, we remain confident in our ability to execute on our model, delivering consistently impressive results as we have in prior periods.

就我們觀察到的由於持續的 COVID-19 大流行而導致的利用率趨勢而言，我們繼續看到 2021 年第三季度的利用率增加，我們目前的預測是在剩餘時間裡恢復到 COVID 之前的利用率今年。隨著利用率確實恢復到正常水平，我們仍然對我們執行模型的能力充滿信心，與前幾個時期一樣始終如一地取得令人印象深刻的結果。

From an operational standpoint, we've also had a very productive third quarter. We closed the strategic alliance and investment in New York-based CAIPA MSO and now own 30% of the postclosing total interest on a fully diluted basis. We continue working to onboard CAIPA physicians onto our technology platform so that they may benefit from the additional clinical and administrative support that will drive improved outcomes for their patients. Value-based care has not yet become commonplace in New York, and we look forward to expanding upon this partnership and introducing our risk-bearing, value-based care model to local communities in that state.

從運營的角度來看，我們的第三季度也非常富有成效。我們結束了對總部位於紐約的 CAIPA MSO 的戰略聯盟和投資，現在在完全攤薄的基礎上擁有收盤後總權益的 30%。我們繼續努力讓 CAIPA 醫生加入我們的技術平台，以便他們可以從額外的臨床和行政支持中受益，從而為他們的患者帶來更好的結果。基於價值的護理在紐約尚未普及，我們期待擴大這種夥伴關係，並將我們的風險承擔、基於價值的護理模式引入該州的當地社區。

We also closed on the purchase of controlling interest in Sun Clinical Laboratories, a CLIA-certified full-service lab operating in 19 locations across Southern California. We continue working to integrate Sun Lab's operations into our comprehensive care delivery platform and are exploring expansion opportunities where we can bring Sun Lab's high-quality lab services to more patients across the nation. Lastly, we closed on the acquisition of Access Primary Care Medical Group, an IPA that primarily serves senior patients in the Northern California counties of San Mateo and San Francisco. Access Primary Care is a risk-bearing organization that has successfully provided professional services to senior members under capitated arrangements with its contracted payer partners since 2016, which is also the year we began working with them as their MSO. We are pleased to welcome Access Primary Care's over 120 primary and specialty care providers and approximately 1,000 Medicare Advantage members as part of the ApolloMed network.

我們還完成了對 Sun Clinical Laboratories 控股權的收購，Sun Clinical Laboratories 是一家通過 CLIA 認證的全方位服務實驗室，在南加州的 19 個地點運營。我們繼續努力將 Sun Lab 的運營整合到我們的綜合護理提供平台中，並正在探索擴展機會，我們可以將 Sun Lab 的高質量實驗室服務帶給全國更多的患者。最後，我們完成了對 Access Primary Care Medical Group 的收購，這是一家 IPA，主要為北加州聖馬特奧縣和舊金山縣的老年患者提供服務。Access Primary Care 是一家承擔風險的組織，自 2016 年以來，它與簽約的付款合作夥伴成功地根據人頭安排為高級會員提供專業服務，這也是我們開始與他們合作作為他們的 MSO 的一年。我們很高興地歡迎 Access Primary Care 的 120 多家初級和專科保健提供者以及大約 1,000 名 Medicare Advantage 成員加入 ApolloMed 網絡。

I would also like to share that Anthem, one of the largest health plans in the country, is partnering with us and several of our affiliated IPAs in a collaboration to provide high-quality, affordable and culturally competent care to local communities. Our partnership, through which our affiliate network of contracted physicians will be offered to consumers through the Covered California program, will stay in both Southern and Northern California. Anthem has been a payer partner of ours for some time, and we look forward to continuing this partnership and finding similar ways to expand upon it in the years to come.

我還想分享一下，Anthem 是該國最大的健康計劃之一，它正在與我們和我們的幾個附屬 IPA 合作，共同為當地社區提供高質量、負擔得起和具有文化競爭力的護理。我們的合作夥伴關係將留在南加州和北加州，我們的簽約醫生附屬網絡將通過 Covered California 計劃向消費者提供。一段時間以來，Anthem 一直是我們的付款合作夥伴，我們期待繼續這種合作關係，並在未來幾年尋找類似的方式來擴展它。

Finally, I know we've referenced our impressive performance for the 2019 year on several occasions, and I am thrilled to report that we have once again delivered phenomenal results. Our ACO generated $57.7 million in gross savings in the 2020 performance year, which ranked the highest out of all 37 analogous ACOs for that performance year. Gross savings is defined as the total benchmark expenditures minus total aligned beneficiary expenditures, and we achieved the highest result in that measure by a margin of over $18 million or 48% more in gross savings than the next best analogous ACO's results. We are incredibly pleased by this performance, which had a notable impact on our financial results for Q3, contributing $21.8 million to our top line and $13.1 million to our bottom line. Keep in mind that our ACO serves approximately 29,000 aligned beneficiaries out of the over 1.1 million members that we manage.

最後，我知道我們已經多次提及 2019 年令人印象深刻的表現，我很高興地報告我們再次取得了驚人的成績。我們的 ACO 在 2020 年績效年產生了 5770 萬美元的總節省，在該績效年的所有 37 個類似 ACO 中排名最高。總儲蓄被定義為總基準支出減去總受益人支出，我們在該衡量標準中取得了最高的結果，利潤超過 1800 萬美元，即總儲蓄比次佳的類似 ACO 結果高出 48%。我們對這一表現感到非常高興，這對我們第三季度的財務業績產生了顯著影響，為我們的收入貢獻了 2180 萬美元，為我們的利潤貢獻了 1310 萬美元。請記住，在我們管理的超過 110 萬名成員中，我們的 ACO 為大約 29,000 名一致的受益人提供服務。

All of these accomplishments I've covered so far are thanks to the amazing people throughout our organization, from the doctors, nurses and other frontline providers to our administrative staff, all of whom benefit from utilizing our tech-powered health care platform. Our leading performance validates ApolloMed's superior clinical care coordination and our expertise in transitioning providers from traditional fee-for-service models to value-based care arrangements. This is why doctors join ApolloMed, and this is why they stay with us. In summary, I am incredibly excited by the strength of our platform and the many opportunities we have ahead of us, and we will continue to invest in our people and our technology as we execute on those opportunities and take a ApolloMed to the next level.

到目前為止，我所取得的所有這些成就都歸功於我們整個組織中令人驚嘆的人們，從醫生、護士和其他一線提供者到我們的行政人員，他們都受益於利用我們的技術支持的醫療保健平台。我們領先的表現證明了 ApolloMed 卓越的臨床護理協調能力以及我們在將供應商從傳統的按服務收費模式轉變為基於價值的護理安排方面的專業知識。這就是醫生加入 ApolloMed 的原因，也是他們留在我們身邊的原因。總而言之，我對我們平台的實力和我們面前的許多機會感到非常興奮，我們將繼續投資於我們的人員和技術，因為我們會抓住這些機會並將 ApolloMed 提升到一個新的水平。

With that, I'll turn it over to Eric, our CFO, to review our financial results.

有了這個，我將把它交給我們的首席財務官埃里克來審查我們的財務業績。

Thank you, Brandon. We achieved strong results in the third quarter of 2021 primarily driven by the organic growth and increased risk pool and incentives revenue, reporting total revenue of $227.1 million, a 26% increase from the $180.1 million in the prior year quarter. As in the second quarter, the increased risk pool settlements and incentives revenue was primarily related to decreased utilization at our hospice partner hospitals when the pandemic first began in 2020 as these revenues from our partner hospitals reflect a 15- to 18-month lag. We also saw a $2 million year-over-year increase in the shared savings settlement from our notable ACO results in the performance year 2020.

謝謝你，布蘭登。我們在 2021 年第三季度取得了強勁的業績，主要受有機增長以及風險池和激勵收入增加的推動，報告的總收入為 2.271 億美元，比去年同期的 1.801 億美元增長了 26%。與第二季度一樣，風險池結算和激勵收入的增加主要與 2020 年大流行首次開始時我們臨終關懷合作醫院的利用率下降有關，因為我們合作醫院的這些收入反映了 15 至 18 個月的滯後。我們還看到，在 2020 績效年度，我們顯著的 ACO 結果使共享儲蓄結算同比增加了 200 萬美元。

Total operating expenses increased about 22% to $174.0 million in the third quarter of 2021 from $142.8 million in the prior year period. This was primarily a result of increased cost of services due to higher claims expense at our consolidated IPAs as utilization increased compared to the prior year period as well as increased claims expense at APA ACO. We also incurred increased general and administrative expenses related to provider bonus payments as a result of the increased shared savings settlement from our ACO as well as increased investments in our staff, which Brandon touched on earlier. As a result of the increased net revenue, net income attributable to ApolloMed was $34.3 million, an increase of 105% from the $16.7 million in the third quarter of 2020. Our earnings per share on a diluted basis were $0.74 per share, up 64% from the $0.45 per share in the prior year period.

2021 年第三季度的總運營費用從去年同期的 1.428 億美元增長了約 22% 至 1.74 億美元。這主要是由於我們綜合 IPA 的索賠費用增加導致服務成本增加，因為與去年同期相比利用率增加，以及 APA ACO 的索賠費用增加。由於我們的 ACO 的共享儲蓄結算增加以及對我們員工的投資增加，我們還增加了與供應商獎金支付相關的一般和管理費用，布蘭登早些時候提到了這一點。由於淨收入增加，歸屬於 ApolloMed 的淨收入為 3430 萬美元，較 2020 年第三季度的 1670 萬美元增長了 105%。我們的攤薄後每股收益為每股 0.74 美元，比上年同期的每股 0.45 美元增長 64%。

We reported EBITDA of negative $0.3 million in the third quarter of 2021, which compares to a positive $42.6 million in the prior year period. Adjusted EBITDA was $74.5 million, which is a 40% increase from the $53.4 million in the prior year period. We placed greater emphasis on the adjusted EBITDA figures, which are calculated consistently quarter-over-quarter as it is a more meaningful representation of the company's performance and consistent with how management views the results. Adjusted EBITDA backed out the impact of recently acquired IPA, other income and income from equity method investments. It also backed out the impact of excluded assets, which for Q3 2021 included a noncash unrealized loss of $63 million as a result of a decrease in fair value related to the passive investment in a payer partner. These losses are in the excluded assets bucket that we've described in the past as they are solely for the benefit of our affiliate, APC, and its shareholders.

我們報告 2021 年第三季度的 EBITDA 為負 30 萬美元，而去年同期為正 4260 萬美元。調整後的 EBITDA 為 7450 萬美元，比去年同期的 5340 萬美元增長了 40%。我們更加重視調整後的 EBITDA 數據，這些數據是按季度連續計算的，因為它更能代表公司的業績，並且與管理層對結果的看法一致。調整後的 EBITDA 抵消了最近收購的 IPA、其他收入和權益法投資收入的影響。它還抵消了排除資產的影響，2021 年第三季度，由於與支付合作夥伴的被動投資相關的公允價值下降，其中包括 6300 萬美元的非現金未實現損失。這些損失在我們過去描述的排除資產範圍內，因為它們完全是為了我們的附屬公司、APC 及其股東的利益。

I'll quickly go over a few financial highlights for the first 9 months of 2021. Total revenue was $578.8 million, up 13% from $510.4 million in the prior year period. Total OpEx increased to $482.9 million from $455.8 million in the prior period primarily as a result of increased claims expenses due to utilization returning closer to pre-COVID level and increased payroll costs as discussed by Brandon earlier. G&A expense also increased due to costs incurred for the debt refinancing and provider bonus payments. These were partially offset by a reduction in G&A expenses due to our technology platform. Net income attributable to ApolloMed increased to $60.1 million for the 9 months ended September 30, 2021, from $27.8 million for the 9 months ended September 30, 2020. The increase from the prior year quarter was primarily due to the increased revenues across nearly all our lines of business.

我將快速回顧 2021 年前 9 個月的一些財務亮點。總收入為 5.788 億美元，比去年同期的 5.104 億美元增長 13%。總運營支出從上一期間的 4.558 億美元增加到 4.829 億美元，這主要是由於利用率恢復到更接近 COVID 之前的水平導致索賠費用增加，以及布蘭登早些時候討論的工資成本增加。由於債務再融資和供應商獎金支付產生的成本，G&A 費用也有所增加。由於我們的技術平台，G&A 費用的減少部分抵消了這些。截至2021年9月30日止9個月，歸屬於ApolloMed的淨收入從截至2020年9月30日止9個月的2780萬美元增加至6010萬美元。與去年同期相比的增長主要是由於我們幾乎所有業務線的收入增加。

Turning over to the balance sheet. We remain well-capitalized and well positioned to execute on our growth initiatives. We ended the third quarter with $204.8 million in cash and cash equivalents compared to $193.5 million at the end of 2020. Our working capital increased to $310.5 million from $223.6 million at the end of 2020 and total stockholders' equity increased to $440.3 million at September 30, 2021, from $330.9 million at December 31, 2020. Moving further down the balance sheet. Total debt at the end of the third quarter was $182.8 million. We are also safely in compliance with our debt covenants with a total consolidated net leverage ratio of 1.06x compared to the maximum permitted 3.75x and consolidated interest coverage ratio of 25.55x compared to the minimum permitted 3.25x.

轉向資產負債表。我們仍然擁有充足的資本和有利的條件來執行我們的增長計劃。我們在第三季度末擁有 2.048 億美元的現金和現金等價物，而 2020 年底為 1.935 億美元。我們的營運資金從 2020 年底的 2.236 億美元增加到 3.105 億美元，股東權益總額從 2020 年 12 月 31 日的 3.309 億美元增加到 2021 年 9 月 30 日的 4.403 億美元。進一步向下移動資產負債表。第三季度末的總債務為 1.828 億美元。我們還安全地遵守了我們的債務契約，總綜合淨槓桿率為 1.06 倍，而最高允許為 3.75 倍，綜合利息覆蓋率為 25.55 倍，而最低允許為 3.25 倍。

I'd now like to turn it back over to Brandon for a discussion of our growth strategy and outlook for the remainder of 2021. Brandon?

我現在想把它轉回給布蘭登，討論我們 2021 年剩餘時間的增長戰略和前景。布蘭登？

Thanks, Eric. We were pleased to close several of the transactions we had announced in the first half of the year and anticipate the final months of 2021 to have plenty of activity as well. We continue working towards reaching our previously stated goal of growing our member population to approximately 2 million lives by the end of the year, and we believe we will reach the 2-million-member mark in the near-term future. However, we do want to act responsibly when it comes to what we invest in, especially in the backdrop of [property] valuations.

謝謝，埃里克。我們很高興完成我們在今年上半年宣布的幾項交易，並預計 2021 年的最後幾個月也將有大量活動。我們繼續努力實現我們之前提出的目標，即到今年年底將我們的會員人數增加到大約 200 萬，我們相信我們將在不久的將來達到 200 萬會員的大關。但是，我們確實希望在投資方面採取負責任的行動，尤其是在 [property] 估值的背景下。

We have certain valuations and qualities in mind when it comes to whether we believe an organization might be a good fit for ApolloMed. And this leads to a differentiated pipeline, which we found has translated into potentially longer transaction time lines. However, we remain confident that we will be able to identify and execute on the right deals to maximize long-term shareholder value while working with like-minded physicians. We are also optimistic about organic growth in the near term, where we are seeing positive tailwinds due to several partnerships with payers as well as the pipeline of new clients.

當談到我們是否認為一個組織可能適合 ApolloMed 時，我們會考慮某些估值和品質。這導致了差異化的管道，我們發現它已經轉化為可能更長的交易時間線。然而，我們仍然相信，在與志同道合的醫生合作的同時，我們將能夠確定並執行正確的交易，以最大限度地提高長期股東價值。我們也對短期內的有機增長持樂觀態度，由於與付款人的多個合作夥伴關係以及新客戶的渠道，我們看到了積極的順風。

As it relates to our current business, we are pleased to be once again raising our guidance projections for full year 2021 due to the positive trends we are seeing across the business and the strong organic growth and outstanding financial results we have achieved in the first 9 months of the year. As listed on Slide 11 of our supplement, we now anticipate for the year ending December 31, 2021, the following: revenues of between $751.5 million to $758.5 million, net income of $81 million to $83.5 million, net income attributable to a ApolloMed of $71.5 million to $73.5 million, diluted EPS of $1.58 to $1.62, EBITDA of $139 million to $143 million and adjusted EBITDA of $168.5 million to $170.5 million.

就我們當前的業務而言，由於我們在整個業務中看到的積極趨勢以及我們在前 9 年取得的強勁有機增長和出色的財務業績，我們很高興再次提高我們對 2021 年全年的指導預測一年中的幾個月。正如我們補充的幻燈片 11 所列，我們現在預計截至 2021 年 12 月 31 日的年度如下：收入在 7.515 億美元至 7.585 億美元之間，淨收入在 8100 萬至 8350 萬美元之間，歸屬於 ApolloMed 的淨收入為 71.5 美元億美元至 7350 萬美元，攤薄後每股收益為 1.58 美元至 1.62 美元，EBITDA 為 1.39 億美元至 1.43 億美元，調整後的 EBITDA 為 1.685 億美元至 1.705 億美元。

Please keep in mind that the updated net income and EBITDA guidance do not take into account any potential impacts of APC's passive investment in a publicly traded payer partner, which Eric noted earlier in his comments. For this reason, we place greater emphasis on the net income attributable to ApolloMed shareholders and adjusted EBITDA metrics. These guidance metrics also do not consider any potential acquisitions or other major business transactions we may complete in the remainder of 2021. As any material developments arise, we will be sure to update the markets and reevaluate guidance as appropriate.

請記住，更新後的淨收入和 EBITDA 指南沒有考慮 APC 對公開交易的支付合作夥伴的被動投資的任何潛在影響，埃里克早些時候在評論中指出了這一點。因此，我們更加重視歸屬於 ApolloMed 股東的淨收入和調整後的 EBITDA 指標。這些指導指標也不考慮我們可能在 2021 年剩餘時間內完成的任何潛在收購或其他主要業務交易。當出現任何重大進展時，我們一定會更新市場並酌情重新評估指南。

I'll also take a brief moment here to mention that we will be at the Virtual Credit Suisse Global Healthcare Conference next week, and we look forward to speaking with investors during that event. To close, 2021 has been a very productive year so far for ApolloMed. With our physician-centric model, our expertise in value-based care and taking risk successfully, our technology and engineering expertise and our strong financial position as tailwinds, I am excited and energized by the opportunities we see before us to truly make a difference on health care delivery nationwide. We look forward to closing out the year on a strong note.

我還要在這里花點時間提一下，我們將參加下週的虛擬瑞士信貸全球醫療保健會議，我們期待在該活動期間與投資者交談。總而言之，2021 年對 ApolloMed 來說是收穫頗豐的一年。憑藉我們以醫生為中心的模式、我們在基於價值的護理和成功承擔風險方面的專業知識、我們的技術和工程專業知識以及我們強大的財務狀況作為順風，我對我們面前看到的機會真正有所作為感到興奮和鼓舞全國范圍內的醫療保健服務。我們期待以強勁的勢頭結束這一年。

With that, operator, let's open it up for Q&A.

有了這個，運營商，讓我們打開它進行問答。

(Operator Instructions) Thank you. At this time, I'll turn the floor back to management for further remarks.

（操作員說明）謝謝。此時，我將把發言權轉回管理層，聽取進一步的評論。

Thank you all for your time today. We are always open to a dialogue with investors and welcome visitors to our offices in Alhambra, California, should any of you be in the Los Angeles area. Please feel free to reach out to us or our Investor Relations firm, Equity Group, with any additional questions. We look forward to speaking to you all again on our next quarterly call. Thank you.

謝謝大家今天的時間。我們始終樂於與投資者進行對話，並歡迎來訪者訪問我們位於加利福尼亞州阿罕布拉的辦公室，如果你們中的任何人在洛杉磯地區。如有任何其他問題，請隨時與我們或我們的投資者關係公司 Equity Group 聯繫。我們期待在下一個季度電話會議上再次與大家交談。謝謝。

Thank you. This concludes today's conference. You may disconnect your lines at this time, and we thank you for your participation.

謝謝。今天的會議到此結束。您此時可以斷開線路，我們感謝您的參與。