Astrana Health Inc (ASTH) 2021 Q4 法說會逐字稿

Greetings. Welcome to the Apollo Medical Holdings Fourth Quarter and Year-end 2021 Financial Results Conference Call. (Operator Instructions) Please note this conference is being recorded.

問候。歡迎參加 Apollo Medical Holdings 2021 年第四季度和年終財務業績電話會議。 （操作員說明）請注意正在錄製此會議。

I will now turn the conference over to your host, Carolyne Sohn. You may begin.

我現在將會議轉交給主持人 Carolyne Sohn。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 fourth quarter and year ended December 31, 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 12 月 31 日的第四季度和年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, 2022, 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 pandemic on the company's business, operations and financial results.

在我們開始之前，我想提醒大家，本次電話會議和本文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諸如預期、相信、期望、未來、計劃、展望和意願等術語來識別，並包括，除其他外，關於公司對截至 2022 年 12 月 31 日的年度的指導、持續增長、收購戰略、交付能力的陳述可持續的長期價值、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 年新型冠狀病毒大流行對公司業務、運營和財務業績的影響。

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. 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.

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。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.

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。

On today's call, the company's Co-Chief Executive Officer, Brandon Sim, will discuss fourth quarter and year-end 2021 highlights and the latest operational developments. Chief Financial Officer, Eric Chin, will follow with a review of ApolloMed's results for the year ended December 31, 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.

在今天的電話會議上，公司聯席首席執行官 Brandon Sim 將討論 2021 年第四季度和年底的亮點以及最新的運營發展。隨後，首席財務官 Eric Chin 將回顧 ApolloMed 截至2021年12月31日止年度的業績。布蘭登將在發言結束時介紹公司的前景和長期增長戰略，然後再開始提問。

With that, I'll turn the call over to ApolloMed's Co-Chief Executive Officer, Brandon Sim. Please go ahead, Brandon.

有了這個，我將把電話轉給 ApolloMed 的聯席首席執行官 Brandon Sim。請繼續，布蘭登。

Thank you, Carolyne. Good afternoon, everyone, and thank you for joining us to discuss ApolloMed's fourth quarter and year-end 2021 results.

謝謝你，卡羅琳。大家下午好，感謝您加入我們討論 ApolloMed 2021 年第四季度和年底的業績。

I'm excited to discuss another milestone year for our company in 2021, during which we made great strides across the business, continued to enable thousands of physicians and health care providers through our technology-powered platform and set the stage for significant growth in 2022. We continue to execute on our mission of making it seamless for all health care providers, from primary care to specialists, to hospitalists, from independent practices to staff model clinics, to engage in and excel at delivering value-based care to all populations, especially those which are traditionally underserved. And we're proud of the work we have done to enable all health care providers with the flexibility to deliver high-quality care in a way that is tailored to each local community.

我很高興討論 2021 年對我們公司來說又一個具有里程碑意義的一年，在此期間，我們在業務上取得了長足進步，繼續通過我們的技術驅動平台為成千上萬的醫生和醫療保健提供者提供支持，並為 2022 年的顯著增長奠定了基礎. 我們繼續履行我們的使命，使所有醫療保健提供者，從初級保健到專家，再到住院醫生，從獨立實踐到員工示範診所，參與並擅長為所有人群提供基於價值的護理，特別是那些傳統上服務不足的地方。我們為我們所做的工作感到自豪，這些工作使所有醫療保健提供者能夠靈活地以適合每個當地社區的方式提供高質量的醫療服務。

Reflecting on 2021, the company achieved total revenues of $773.9 million, an increase of 13% from $687.2 million in 2020. We nearly doubled net income attributable to ApolloMed which came in at $73.9 million for 2021 compared to $37.9 million in the prior year. Diluted EPS for the year was $1.63 per share for the year ended December 31, 2021, which was up 61% from $1.01 per share for 2020.

回顧 2021 年，公司實現總收入 7.739 億美元，比 2020 年的 6.872 億美元增長 13%。歸屬於 ApolloMed 的淨收入幾乎翻了一番，2021 年的淨收入為 7390 萬美元，而上年為 3790 萬美元。截至 2021 年 12 月 31 日止年度，稀釋後每股收益為每股 1.63 美元，較 2020 年的每股 1.01 美元增長 61%。

I'll quickly note that these results exceeded our own projections for each of these metrics, once again delivering record numbers for the company. This was primarily driven by organic growth in our existing consolidated IPAs, increased risk pool settlement and incentives revenue and our continued superior performance in an ACO model for the performance year of 2020.

我很快注意到，這些結果超出了我們對每個指標的預測，再次為公司創造了創紀錄的數字。這主要是由於我們現有綜合 IPA 的有機增長、風險池結算和激勵收入的增加以及我們在 2020 年績效年度的 ACO 模型中的持續卓越表現所推動的。

Like some of our peers, we've benefited from tailwinds due to decreased utilization during the pandemic, which we do expect to normalize back to pre-COVID levels in 2022. However, we believe the gains we have made through the use of our technology platform will continue to create efficiencies and improve patient experience, access to care and staff productivity, dampening the impact of normalized utilization levels. To support our growth plans for 2022 and beyond, we have made several strategic appointments in recent months.

與我們的一些同行一樣，由於大流行期間利用率下降，我們受益於順風，我們確實希望在 2022 年恢復到 COVID 之前的水平。但是，我們相信我們通過使用我們的技術取得的收益該平台將繼續提高效率並改善患者體驗、獲得護理的機會和員工的工作效率，從而抑制標準化利用率水平的影響。為了支持我們 2022 年及以後的增長計劃，我們在最近幾個月進行了多項戰略任命。

We have hired key personnel in strategy, operations, business development and more to help us bring greater focus to these areas as we aim to grow aggressively over the next few years. It wasn't until a couple of months ago, for example, that we made our first business development team hire, which will enable us to allocate more resources, identifying and evaluating business development opportunities. Our entire management team is fully on board to invest heavily in our current team members and to expand our clinical operations and administrative teams as we move into new regions and continue to recruit mission-driven individuals to create the nation's leading value-based care platform.

我們聘請了戰略、運營、業務發展等方面的關鍵人員，以幫助我們更加關注這些領域，因為我們的目標是在未來幾年積極發展。例如，直到幾個月前，我們才聘用了第一個業務開發團隊，這將使我們能夠分配更多資源，識別和評估業務發展機會。我們的整個管理團隊都全力投入到現有團隊成員中，並在我們進入新地區時擴大我們的臨床運營和行政團隊，並繼續招募有使命感的個人來創建全國領先的基於價值的護理平台。

As a result of this, we do expect our operating expenses to increase in the near term as part of this org-wide investment, but we are confident that this will strengthen our culture, capabilities and ability to scale rapidly in 2022 and beyond.

因此，作為這項全組織投資的一部分，我們確實預計我們的運營費用在短期內會增加，但我們相信這將加強我們的文化、能力和在 2022 年及以後迅速擴展的能力。

To that point, I'm excited to announce that we recently appointed Allen Hsu as Chief Growth Officer of ApolloMed. Allen brings over 15 years of finance and operations experience within the health care industry to this newly created role and will be responsible for driving physician recruitment, strategy and revenue growth for ApolloMed. He most recently served as Vice President of Operations at Optum, where he led managed care operations, IPA strategy and network development for Southern California. Prior to Optum, he held various health care leadership roles such as VP of M&A and integration as well as international new market development for DaVita. We are excited to welcome Allen to our leadership team, and I'm looking forward to working very closely with him to drive growth onto the ApolloMed platform.

就此而言，我很高興地宣布，我們最近任命 Allen Hsu 為 ApolloMed 的首席增長官。 Allen 為這個新設立的職位帶來了超過 15 年的醫療保健行業財務和運營經驗，並將負責推動 ApolloMed 的醫生招聘、戰略和收入增長。他最近擔任 Optum 的運營副總裁，領導南加州的管理式醫療運營、IPA 戰略和網絡開發。在加入 Optum 之前，他擔任過各種醫療保健領導職務，例如併購和整合副總裁以及 DaVita 的國際新市場開發。我們很高興歡迎 Allen 加入我們的領導團隊，我期待著與他密切合作，推動 ApolloMed 平台的發展。

In addition, we strengthened our Board of Directors with the addition of 2 new Board members: Weili Dai and J. Lorraine Estadas. Weili brings over 25 years of experience in the tech industry as a founder, executive, venture capitalist and Board member in the technology and digital health industries. We believe that her expertise will be valuable as we continue to grow our technology platform and AI capabilities while executing on our growth strategy. Lorraine brings decades of leadership and experience within the Los Angeles health care industry. She currently serves as Chief Executive Officer of Arroyo Vista Family Health Center, a nonprofit network of community health centers serving Greater Northeast Los Angeles area since 1981. She helped grow Arroyo Vista from a small storefront clinic to a health care delivery network of 4 health centers and a mobile medical clinic serving the health care needs of medically underserved families within its local communities as a federally qualified health center.

此外，我們還加強了董事會，增加了 2 名新董事會成員：Weili Dai 和 J. Lorraine Estadas。 Weili 作為技術和數字健康行業的創始人、高管、風險投資家和董事會成員，在技術行業擁有超過 25 年的經驗。我們相信，隨著我們在執行增長戰略的同時繼續發展我們的技術平台和人工智能能力，她的專業知識將很有價值。 Lorraine 在洛杉磯醫療保健行業擁有數十年的領導才能和經驗。她目前擔任 Arroyo Vista 家庭健康中心的首席執行官，這是一個自 1981 年以來服務於洛杉磯大東北地區的非營利性社區健康中心網絡。她幫助 Arroyo Vista 從一個小型店面診所發展成為一個由 4 個健康中心組成的醫療保健提供網絡和一家流動醫療診所，作為符合聯邦資格的醫療中心，滿足當地社區醫療服務不足家庭的醫療保健需求。

In other operating news, over the course of 2021, we entered into a few strategic partnerships and made several small tuck-in acquisitions that enhance the ApolloMed health care delivery network, either by growing the number of members under capitated arrangements or by bringing ancillary services such as lab and diagnostics work in network for our contracted physicians and for our members.

在其他運營新聞中，在 2021 年期間，我們建立了一些戰略合作夥伴關係並進行了幾項小規模收購，通過增加按人頭安排的成員數量或通過提供輔助服務來增強 ApolloMed 醫療保健服務網絡例如，為我們的簽約醫生和我們的會員在網絡中開展實驗室和診斷工作。

In December 2021, we announced that our affiliate entered into a definitive agreement to acquire 100% of the fully diluted capitalization of Jade Health Care Medical Group, a primary and specialty care physicians group of over 350 providers serving Medicaid, Medicare and commercial members in the San Francisco Bay Area. Jade Health is a risk-bearing organization that has successfully provided culturally competent, linguistically appropriate professional services to members and its local communities since 2016. The transaction will add approximately 13,000 members primarily located in the city and county of San Francisco and San Mateo County to ApolloMed membership under capitated arrangements. We are working to onboard Jade Health and its providers onto our technology and operations platform by the close of the transaction, which is expected to take place by the end of the second quarter of this year. Following the acquisition of Access Primary Care Medical Group in 2021, Jade Health will continue to strengthen ApolloMed's presence in Northern California.

2021 年 12 月，我們宣布我們的附屬公司達成最終協議，收購 Jade Health Care Medical Group 100% 的完全攤薄資本，Jade Health Care Medical Group 是一個由 350 多家提供醫療補助、醫療保險和商業會員的初級和專科醫師組成的集團舊金山灣區。 Jade Health 是一家承擔風險的組織，自 2016 年以來已成功地為成員及其當地社區提供具有文化競爭力、語言適用的專業服務。該交易將增加約 13,000 名主要位於舊金山市和縣以及聖馬特奧縣的成員ApolloMed 會員資格按人頭安排。我們正努力在交易結束前將 Jade Health 及其供應商納入我們的技術和運營平台，預計將於今年第二季度末完成。在2021年收購 Access Primary Care Medical Group 之後， Jade Health 將繼續加強 ApolloMed 在北加州的業務。

Just last month, we also closed on the acquisition of Orma Health, a provider of AI-driven solutions that enables physician groups to transition to and succeed in the delivery of value-based care. We are very excited to have made significant progress in integrating Orma Health's technology platform into that of ApolloMed. As a reminder, Orma's real-time clinical AI platform takes data from multiple sources and utilizes advanced risk stratification models to identify patients for various clinical programs, including RPM, remote patient monitoring, mental health support, chronic disease management and more. Its clinical platform is also deeply integrated with its proprietary RPM ecosystem, which consists of smart health devices and a suite of technology tools to help manage patients' health.

就在上個月，我們還完成了對 Orma Health 的收購，Orma Health 是一家提供人工智能驅動解決方案的供應商，它使醫生團體能夠過渡到並成功提供基於價值的護理。我們很高興在將 Orma Health 的技術平台整合到 ApolloMed 的技術平台方面取得了重大進展。提醒一下，Orma 的實時臨床 AI 平台從多個來源獲取數據，並利用先進的風險分層模型來識別各種臨床項目的患者，包括 RPM、遠程患者監測、心理健康支持、慢性病管理等。其臨床平台還與其專有的 RPM 生態系統深度集成，該生態系統由智能健康設備和一套幫助管理患者健康的技術工具組成。

Prior to the acquisition, Orma Health served over 4,000 aligned Medicare beneficiaries in the CMS innovation model and over 2,500 patients in California, Nevada, Arizona and Texas through its remote patient monitoring platform. I'm excited to share that shortly after joining ApolloMed, Orma Health has seen a significant increase in demand for its products and today serves over 40,000 Medicare fee-for-service patients on its analytics platform and over 2,700 active members on its RPM platform, which is growing at approximately 10% month-over-month. We continue to see Orma as a key growth lever within our Medicare fee-for-service business in this coming year and beyond driven by its ability to further augment our existing technology, boost organic growth and deliver deeper, more actionable insights to enable our providers to succeed at value-based care and all CMMI programs.

在收購之前，Orma Health 通過其遠程患者監控平台為加利福尼亞州、內華達州、亞利桑那州和德克薩斯州的 4,000 多名 CMS 創新模式中的 Medicare 受益人和 2,500 多名患者提供服務。我很高興與大家分享，在加入 ApolloMed 後不久，Orma Health 發現對其產品的需求顯著增加，如今在其分析平台上為超過 40,000 名 Medicare 按服務收費的患者提供服務，並在其 RPM 平台上為超過 2,700 名活躍成員提供服務，環比增長約 10%。我們繼續將 Orma 視為來年及以後我們 Medicare 按服務收費業務的關鍵增長槓桿，因為它有能力進一步增強我們現有的技術，促進有機增長並提供更深入、更可行的見解，使我們的供應商能夠在基於價值的護理和所有 CMMI 計劃中取得成功。

Lastly, we have seen an acceleration of organic growth over the last few months in core new regions. Our team has been working extremely hard to ensure that our patients receive the highest quality care, and we're seeing the word spread within our core markets as we saw more than 9% growth during the latest annual enrollment period in those regions. In conjunction, we continue to integrate our management platform with our recently acquired businesses, for which we're seeing early indications of success through the normalization of margins towards what we see in our core markets.

最後，我們在過去幾個月中看到核心新地區的有機增長加速。我們的團隊一直在非常努力地工作，以確保我們的患者獲得最高質量的護理，並且我們看到這個詞在我們的核心市場中傳播開來，因為我們在這些地區的最新年度註冊期間看到了超過 9% 的增長。與此同時，我們繼續將我們的管理平台與我們最近收購的業務相結合，我們通過利潤率正常化看到了我們在核心市場看到的成功的早期跡象。

Additionally, due to our strong track record in managed care and success participating in CMMI programs, we have received a lot of inbound interest from provider groups and health care organizations in new regions looking to join the ApolloMed platform, citing a robust suite of tech-enabled solutions as a key differentiator among other value-based care platforms. Within the last few months, we've already added over 200 providers and 4,500 members in new regions and have a strong pipeline of groups in late-stage discussions eager to join the platform.

此外，由於我們在管理式醫療方面的良好記錄和成功參與 CMMI 計劃，我們收到了來自希望加入 ApolloMed 平台的新地區的提供者團體和醫療保健組織的大量入境興趣，並引用了一套強大的技術-使解決方案成為其他基於價值的護理平台的關鍵區別。在過去的幾個月裡，我們已經在新地區增加了 200 多家提供商和 4,500 名成員，並且在後期討論中擁有大量渴望加入該平台的團體。

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 reported record total revenue of $773.9 million for 2021, an increase of 13% from $687.2 million in 2020. Our top line growth was primarily driven by the following: one, increased capitation revenue from organic membership growth at APC and Alpha Care Medical Group as well as higher average capitation rates at APC during the year; #2, increased risk pool settlements and incentives revenue driven by increased incentive payments received from our payer partners as well as reduced utilization at ApolloMed's partner hospital during COVID-19 pandemic.

謝謝你，布蘭登。我們報告 2021 年的總收入達到創紀錄的 7.739 億美元，比 2020 年的 6.872 億美元增長 13%。我們的收入增長主要由以下因素推動：第一，APC 和 Alpha Care Medical Group 的有機會員增長帶來的人均收入增加以及年內 APC 更高的平均人頭率； #2，在 COVID-19大流行期間，從我們的付款合作夥伴收到的獎勵付款增加以及 ApolloMed 合作醫院的利用率降低推動了風險池結算和獎勵收入的增加。

Please keep in mind that these revenues from ApolloMed partner hospitals reflect a 15- to 18-month lag. And lastly, an increase in the shared savings settlement earned from ApolloMed participation in an ACO related to performance year 2020; and #3, our increase in fee-for-service revenue as a result of more patient visits with the reopening of ApolloMed surgery and heart centers and the company's consolidation of Sun Clinical Laboratories and Diagnostic Medical Group, which contributed an additional $7 million during the year. Capitation revenue of $593.2 million represented 77% of our total revenue in 2021.

請記住，這些來自 ApolloMed 合作醫院的收入反映了 15 到 18 個月的滯後。最後，ApolloMed 參與與 2020 年績效相關的 ACO 所獲得的共享儲蓄結算有所增加；第三，由於 ApolloMed 手術和心臟中心的重新開放以及公司對 Sun Clinical Laboratories 和 Diagnostic Medical Group 的整合，更多患者就診，我們的按服務收費收入增加，這在年。 5.932 億美元的人均收入占我們 2021 年總收入的 77%。

We ended 2021 with our membership at approximately 1.2 million managed lives. Taking a closer look at our membership, approximately half of our members were fully capitated through our consolidated IPA.

到 2021 年底，我們的會員人數約為 120 萬。仔細查看我們的會員，大約一半的會員通過我們的合併 IPA 完全資本化。

Total OpEx increased to $675.7 million in 2021, an increase of 11% from $606.7 million. This increase was primarily due to the increased cost of services from higher medical claims, capitation and other health services expenses due to the greater utilization throughout the year as well as increased G&A expense related to increased share-based compensation, higher bonuses paid to certain physicians driven by the increase in shared savings earned related to the settlement of the 2020 ACO performance year and costs incurred for the debt refinancing. These were partially offset by a reduction in G&A expenses due to our technology platform.

2021 年總運營支出增至 6.757 億美元，比 6.067 億美元增長 11%。這一增長主要是由於更高的醫療索賠、人頭費和其他醫療服務費用導致服務成本增加，原因是全年利用率更高，以及與股份補償增加、支付給某些醫生的獎金增加相關的 G&A 費用增加受與 2020 年 ACO 績效年度結算相關的共享儲蓄增加以及債務再融資產生的成本推動。由於我們的技術平台，G&A 費用的減少部分抵消了這些。

Net income attributable to ApolloMed increased to a record $73.9 million, up 95% from $37.9 million for 2020. Earnings per share on a diluted basis were $1.63 per share compared to $1.01 per share for the prior year. We reported EBITDA of $99.1 million compared to $203.5 million for the year ended December 31, 2020. Adjusted EBITDA increased 34% to $174.2 million for the year ended December 31, 2021, from $129.9 million for the year ended December 31, 2020.

歸屬於 ApolloMed 的淨收入增加到創紀錄的 7390 萬美元，比 2020 年的 3790 萬美元增長了 95%。攤薄後每股收益為每股 1.63 美元，而去年同期為每股 1.01 美元。我們報告的 EBITDA 為 9910 萬美元，而截至 2020 年 12 月 31 日止年度為 2.035 億美元。經調整的 EBITDA 增長 34%，截至 2021 年 12 月 31 日止年度為 1.742 億美元，而截至 2020 年 12 月 31 日止年度為 1.299 億美元。

We placed greater emphasis on the adjusted EBITDA figures as these numbers back out the impact of recently acquired IPA, provider bonus payments, other income and income from equity method investments. It also backs out the impact of excluded assets, which for 2021 included a onetime noncash unrealized loss of $10.7 million as a result of a decrease in fair value related to passive investment in the payer partner as well as unrealized losses on investments. These losses are in the excluded asset bucket that we've described in the past as they are solely for the benefit of our affiliate APC and its shareholders.

我們更加重視調整後的 EBITDA 數據，因為這些數據反映了最近收購的 IPA、供應商獎金支付、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，其中包括 2021 年因與付款方合作夥伴的被動投資相關的公允價值下降以及投資的未實現損失而導致的 1070 萬美元的一次性非現金未實現損失。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關聯公司 APC 及其股東的利益。

Turning over to the balance sheet. We remain well capitalized and well positioned to execute on our growth initiatives. We ended the fourth quarter with $233.1 million in cash and cash equivalents compared to $193.5 million at the end of 2020. Our working capital increased to $283.4 million from $223.6 million at the end of 2020. And total stockholders' equity increased to $460.5 million at December 31, 2020, from $330.9 million at December 31, 2020.

轉向資產負債表。我們仍然擁有充足的資本並處於有利地位，可以執行我們的增長計劃。第四季度結束時，我們的現金和現金等價物為 2.331 億美元，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 2.834 億美元。12 月份股東權益總額增加到 4.605 億美元2020 年 12 月 31 日，2020 年 12 月 31 日為 3.309 億美元。

Moving further down the balance sheet. Total debt at the end of the fourth quarter was $182.9 million. We are safely in compliance with our debt covenants, with our consolidated total net leverage ratio at 1.16x compared to the maximum permitted 3.75x and our consolidated interest coverage ratio of 25.44x and compared to the minimum permitted 3.25x.

進一步向下移動資產負債表。第四季度末的總債務為 1.829 億美元。我們安全地遵守了我們的債務契約，我們的合併總淨槓桿率為 1.16 倍，而允許的最大值為 3.75 倍，合併利息覆蓋率為 25.44 倍，而允許的最小值為 3.25 倍。

As Brandon mentioned earlier, the impact of COVID provided some temporary tailwinds that had a positive impact on our results in 2021. We anticipate these tailwinds will subside as we have returned to pre-COVID utilization levels in 2022. We are seeing a return to the more normal visit patterns for routine non-COVID-related care impacting our medical claims cost and patient visits to the hospital for nonemergency procedures affecting our risk pool settlements with our hospital partners.

正如 Brandon 之前提到的，COVID 的影響提供了一些暫時的順風，對我們 2021 年的業績產生了積極影響。我們預計，隨著我們在 2022 年恢復到 COVID 之前的利用率水平，這些順風將會消退。我們正在看到回歸常規非 COVID 相關護理的更正常就診模式會影響我們的醫療索賠成本，而患者因非緊急程序到醫院就診會影響我們與醫院合作夥伴的風險池結算。

With respect to the Omicron surge in early 2022 and the overall employment macro environment, similar to many employers across the country, we have also experienced higher employee-related costs as we expand our team to support our continued growth as well as retain our existing team members. We believe we will be able to manage these additional costs effectively as we grow our business.

關於 2022 年初 Omicron 的激增和整體就業宏觀環境，與全國許多雇主類似，我們也經歷了更高的員工相關成本，因為我們擴大了我們的團隊以支持我們的持續增長並保留我們現有的團隊成員。我們相信，隨著業務的發展，我們將能夠有效地管理這些額外成本。

I'd now like to turn it back over to Brandon for a discussion of our growth strategy and outlook for 2022. Brandon?

我現在想把它轉回給布蘭登，討論我們的增長戰略和 2022 年的展望。布蘭登？

Thanks, Eric. We believe that ApolloMed is well positioned to execute on our growth strategy, particularly given the recent appointments to our leadership, operations and business development teams. We are very excited about the additional talent that has joined our company and remain optimistic about our prospects as we continue to work through our robust pipeline of potential targets in new regions.

謝謝，埃里克。我們相信 ApolloMed 能夠很好地執行我們的增長戰略，特別是考慮到最近對我們的領導、運營和業務開發團隊的任命。我們對加入我們公司的更多人才感到非常興奮，並對我們的前景保持樂觀，因為我們將繼續通過我們在新地區的強大潛在目標渠道開展工作。

As shown on Slide 11 of our supplement, we are also excited to be providing total revenue guidance projections for 2022 of between $1.03 billion and $1.08 billion, which would translate into between 33% and 39% year-over-year growth on the top line. This revenue growth is being driven by strong organic growth in core markets, expansion into new markets and participation in the CMMI innovation model.

如我們增刊的幻燈片 11 所示，我們也很高興能夠提供 2022 年 10.3 億美元至 10.8 億美元的總收入指導預測，這將轉化為收入同比增長 33% 至 39% .這一收入增長是由核心市場的強勁有機增長、向新市場的擴張以及參與 CMMI 創新模型推動的。

The company is providing projections for total revenue only at this time due to uncertainties related to its participation in the previously mentioned model, ongoing investments in our staff to support future growth and certain investments that depend on unpredictable macroeconomic factors. Please also note that these guidance metrics do not consider any potential acquisitions or any other major business transactions that we may complete in 2022. As any material developments arise, we will be sure to update the markets and reevaluate guidance as appropriate.

由於參與上述模式的不確定性、為支持未來增長而對員工的持續投資以及依賴於不可預測的宏觀經濟因素的某些投資，公司目前僅提供總收入預測。另請注意，這些指導指標並未考慮我們可能在 2022 年完成的任何潛在收購或任何其他主要業務交易。隨著任何重大進展的出現，我們一定會及時更新市場並重新評估指導。

I also want to briefly mention that we are excited about and support the new ACO REACH program. The vision represented by the REACH model of high-quality affordable care with a focus on health equity, access and community health align exactly with our guiding principles and our core values here at ApolloMed. I'll also mention that I will be attending the Barclays Global Healthcare Conference in Miami next month, and I look forward to seeing some of you there.

我還想簡單地提一下，我們很高興並支持新的 ACO REACH 計劃。以健康公平、可及性和社區健康為重點的高質量負擔得起的護理 REACH 模型所代表的願景與我們在 ApolloMed 的指導原則和核心價值觀完全一致。我還要提一下，我將參加下個月在邁阿密舉行的巴克萊全球醫療保健會議，我期待在那裡見到你們中的一些人。

To close, 2021 was another milestone year for ApolloMed. We believe that we are differentiated by our physician-centric model, our expertise in value-based care and taking risks successfully and our technology and engineering expertise. We truly understand that there is no one-size-fits-all methodology when we engage with doctors who operate their own practices. We want to work with doctors who want to participate in value-based arrangements and possess the mindset that it requires. We believe that our platform offers providers a practical and flexible way of engaging in risk-bearing arrangements successfully. Our goal is to provide individuals and families in all local communities with quality, cost-effective health care. And that by empowering doctors to successfully engage in value-based care, we can make that change happen. The results we've achieved thus far are the best testament, we believe, to what we can achieve in further parts of the country as we expand.

總而言之，2021 年是 ApolloMed 又一個具有里程碑意義的一年。我們相信，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以及我們的技術和工程專業知識脫穎而出。當我們與自己執業的醫生打交道時，我們真正了解到沒有一種放之四海而皆準的方法。我們希望與想要參與基於價值的安排並擁有所需心態的醫生合作。我們相信，我們的平台為供應商提供了一種實用且靈活的方式來成功參與風險承擔安排。我們的目標是為所有當地社區的個人和家庭提供優質、具有成本效益的醫療保健。通過授權醫生成功參與基於價值的護理，我們可以實現這種改變。我們相信，我們迄今為止取得的成果最好地證明了隨著我們的擴張，我們可以在該國的其他地區取得成就。

Thank you, everyone. And with that, operator, let's open it up for Q&A.

謝謝大家。有了這個，運營商，讓我們打開它進行問答。

(Operator Instructions) Our first question is from Sarah James with Barclays.

（操作員說明）我們的第一個問題來自巴克萊銀行的 Sarah James。

I'm hoping you guys can unpack a little bit how you get to the 30% to 45% long-term growth. So that implies about 20% on M&A and 10% to 25% on organic, so it would be helpful if you had any context around the product mix of that. And then on the M&A side, how you think about your pipeline development?

我希望你們能解釋一下如何實現 30% 到 45% 的長期增長。所以這意味著大約 20% 的併購和 10% 到 25% 的有機，所以如果你對產品組合有任何背景，那將會很有幫助。然後在併購方面，您如何看待您的管道開發？

Sarah, thanks for calling in today. Appreciate you joining. Yes, happy to talk about the 30% to 45% number, which I believe you're referencing from our latest investor presentation. As you mentioned, that's a mix of both organic growth as well as M&A. On the organic side of things, we are -- as I mentioned in our earnings call, we're seeing really strong growth in our core markets after AEP. We're excited to say that a lot of members have chosen to join the plans and aligned with doctors that are currently in our affiliated IPAs. And that led to really strong organic growth in our existing markets.

莎拉，感謝您今天的來電。感謝您的加入。是的，很高興談論 30% 到 45% 的數字，我相信你在我們最新的投資者介紹中提到了這一點。正如您所提到的，這是有機增長和併購的結合。在有機方面，正如我在財報電話會議上提到的那樣，我們在 AEP 之後看到核心市場的強勁增長。我們很高興地說，許多成員已選擇加入該計劃，並與目前在我們附屬 IPA 中的醫生保持一致。這導致我們現有市場真正強勁的有機增長。

We're also seeing great results as we expand into new markets. As I mentioned in the earnings call, we recently signed on another couple of hundred providers, a couple of thousand senior members and have a lot of items in the pipeline organically as well. We believe that all these efforts combined can conservatively reach those numbers that we talked about in the investor presentation.

隨著我們擴展到新市場，我們也看到了很好的結果。正如我在財報電話會議上提到的那樣，我們最近與另外幾百家供應商、幾千名高級會員簽約，並且還有很多項目正在有機地進行中。我們相信，所有這些努力的結合可以保守地達到我們在投資者介紹中談到的那些數字。

As for M&A, with the hiring of Allen and our existing corporate development team, we believe we still have a strong pipeline of exciting opportunities, and we expect some of those to be announced in the first half of this year.

至於併購，隨著艾倫和我們現有企業發展團隊的聘用，我們相信我們仍然擁有大量令人興奮的機會，我們預計其中一些將在今年上半年公佈。

Hopefully, that helps answer your question, Sarah.

希望這有助於回答您的問題，Sarah。

It does. And to follow up on the M&A, I was looking at Slide 32, the map going from 1.2 million to 2 million. The wording on that seems to imply that they're maybe capitated. So I just wanted to make sure I understood, is that membership growth on the capitated side, MSO or unclear at this point?

確實如此。為了跟進併購，我正在看幻燈片 32，地圖從 120 萬增加到 200 萬。上面的措辭似乎暗示他們可能是大寫的。所以我只是想確保我明白，會員增長是按人頭計算的，MSO 還是目前還不清楚？

Yes, happy to clarify. The growth from 1.2 million to 2 million in our slide deck does not specify the breakdown between fully capitated membership growth versus, let's say, managed services membership. We've -- we're currently unable to kind of provide the breakdown at this time. But as soon as we have further information, we'll let you and other investors know.

是的，很高興澄清。我們的幻燈片中從 120 萬增長到 200 萬並沒有具體說明完全資本化的會員增長與管理服務會員之間的細分。我們 - 我們目前無法提供細分。但是，一旦我們獲得更多信息，我們就會通知您和其他投資者。

And then on the DCE front, I know you guys can't talk about how that's going so far, but I'm wondering if you can talk about any accounting aspects of it. So with the next-gen ACO, there's a lag in when you get paid out because of the benchmark aspect. And just wondering if the DCE program would work the same with you guys or if there would be a year where if you were in the DCE program, you would get paid from that program and then a double-up from the lagging next-gen ACO.

然後在 DCE 方面，我知道你們不能談論到目前為止的進展情況，但我想知道你們是否可以談論它的任何會計方面。因此，對於下一代 ACO，由於基準方面的原因，您在獲得報酬時會出現滯後。只是想知道 DCE 計劃是否對你們有同樣的效果，或者是否會有一年如果你參加 DCE 計劃，你會從該計劃中獲得報酬，然後從落後的下一代 ACO 中獲得雙倍報酬.

Right. That's a great question. As you know, the next-gen ACO program had ended at sunset at the end of 2021. And as you stated, there is a lag in terms of when that impact is realized in our accounting due to the 12- to 18-month lag on the shared savings settlement for the next-gen ACO. Therefore, as you noted, the 2021 performance year shared, savings will be most likely realized sometime this year in 2022.

正確的。這是一個很好的問題。如您所知，下一代 ACO 計劃已於 2021 年底日落時結束。正如您所說，由於 12 到 18 個月的滯後，在我們的會計中實現這種影響的時間存在滯後關於下一代 ACO 的共享儲蓄結算。因此，正如您所指出的，共享的 2021 年績效年很可能會在今年 2022 年的某個時候實現節省。

As for the DCE or, as it's now called, the ACO realizing equity access and community health REACH model, you also correctly noted that we're unfortunately able to confirm -- unable, sorry, to confirm our participation in REACH, which is a successor to the GPDC model. However, if we were to participate, we would be realizing part of the benchmark as top line revenue, if not all.

至於 DCE，或者現在稱為 ACO 實現公平准入和社區健康 REACH 模型，您也正確地指出我們很遺憾能夠確認——抱歉，無法確認我們參與 REACH，這是一個GPDC 模型的繼承者。然而，如果我們參與，我們將實現部分基準作為頂線收入，如果不是全部的話。

Okay. And then last question here is on this unrealized loss of $33.5 million in the quarter on previous investments. Just any color that you can give us on what asset that was and any kind of detail would be helpful.

好的。然後這裡的最後一個問題是關於本季度之前投資的 3350 萬美元的未實現損失。您可以為我們提供有關資產的任何顏色以及任何類型的細節都會有所幫助。

Sarah, it's Eric Chin here. Thanks for the question. In terms of that investment, it was shares that our excluded assets bucket of APC had taken from a payer partner. And so at the end of the day, those are not impacting the bottom line net income attributable to ApolloMed shareholders. And it just reflects the change in the market value of those shares.

莎拉，我是 Eric Chin。謝謝你的問題。就該投資而言，我們排除的 APC 資產桶是從付款合作夥伴那裡獲得的股份。因此，歸根結底，這些並沒有影響歸屬於 ApolloMed 股東的淨利潤底線。它只是反映了這些股票市值的變化。

I believe that the identity of the payer partner is disclosed or has been disclosed in the past.

我相信付款合作夥伴的身份已被披露或過去已被披露。

(Operator Instructions) Our next question is from Kyle Bauser with Colliers.

（操作員說明）我們的下一個問題來自 Colliers 的 Kyle Bauser。

Brandon and Eric, congratulations on the great results. So with the newly formed BD team in place, can you talk a little bit more about how you're sourcing new M&A opportunities and how you're prioritizing them as it relates to geography and clinical specialties, et cetera?

布蘭登和埃里克，祝賀你們取得了很好的成績。因此，在新成立的 BD 團隊就位後，您能否多談談您如何尋找新的併購機會以及如何在與地理和臨床專業等相關的情況下對它們進行優先排序？

Kyle, thanks for joining the call. Good to hear from you. Yes, absolutely happy to talk about that. So for the new BD and growth team led by Allen, we have an existing pipeline of both inbound interest as well as groups that align very well with our mission and with the demographics that we currently serve. We will be executing on some of the inbound opportunities as well as our current pipeline, and Allen is building a team of other BD folks to create new opportunities as well.

凱爾，感謝您加入電話會議。很高興聽到你的消息。是的，非常高興談論這個。因此，對於由 Allen 領導的新 BD 和增長團隊，我們擁有既有入站興趣的現有渠道，也有與我們的使命和我們目前服務的人口統計數據非常吻合的群體。我們將執行一些入站機會以及我們當前的管道，Allen 正在組建一個由其他 BD 人員組成的團隊，以創造新的機會。

As for how we're prioritizing, we're prioritizing acquisitions in new regions and then using those as springboards for us to continue growing in those new regions organically. Hopefully, that helps.

至於我們如何確定優先次序，我們正在優先考慮在新地區的收購，然後將這些作為我們繼續在這些新地區有機增長的跳板。希望這會有所幫助。

Got it. Yes, it does. And you've mentioned, and it's still in the presentation, the goal of getting to the 2 million patients for coordinating the care of -- I think Eric said the number is at 1.2 million now. And sorry if I missed this, but can you talk a little bit about timing, how you anticipate getting to that goal this year?

知道了。是的，它確實。你已經提到，並且仍在演示中，目標是讓 200 萬患者協調護理——我想埃里克說現在這個數字是 120 萬。很抱歉，如果我錯過了這個，但你能談談時間安排嗎？你預計今年將如何實現這個目標？

Sure, yes. So for that membership number, I'd like to point out that -- or clarify that, that includes both managed -- lives under management as well as consolidated IPA fully capitated lives. The mix, as I mentioned to Sarah, we're not sure of exactly at the moment and we'll disclose more details as it comes along. That being said, given the number of the 2 million, a lot of that will be in M&A. Some of it will be in continued organic growth in our core and existing markets.

當然，是的。因此，對於該會員編號，我想指出——或澄清一下，這包括管理的——管理下的生活以及綜合 IPA 完全按人頭計算的生活。混合，正如我對莎拉提到的，我們目前還不確定，我們會在它出現時披露更多細節。話雖這麼說，考慮到 200 萬的數量，其中很多將用於併購。其中一些將在我們的核心和現有市場中持續有機增長。

As for timing, we think that it will probably be in the first half of this year. But with the markets as they are, we're being vigilant around kind of what the opportunities -- which opportunities we'd like to take and which ones we wouldn't. And so we'll continue to be prudent and ensure that we're maximizing shareholder value.

至於時間點，我們認為可能會在今年上半年。但隨著市場的現狀，我們對什麼樣的機會保持警惕——我們想抓住哪些機會，不想抓住哪些機會。因此，我們將繼續保持謹慎，並確保我們最大化股東價值。

Got you. Appreciate that. And then lastly, so regarding the Orma Health acquisition, you mentioned the AI and RPM capabilities. I'm just curious, is Orma focusing on services that relate to the new CMS reimbursement codes for remote therapeutic monitoring? Those codes kind of allow for patient self-reported outcomes. Just kind of curious how they're thinking about that.

明白了感謝。最後，關於收購 Orma Health，你提到了 AI 和 RPM 功能。我很好奇，Orma 是否專注於與用於遠程治療監測的新 CMS 報銷代碼相關的服務？這些代碼允許患者自我報告結果。只是有點好奇他們是怎麼想的。

Yes. Kyle, some of the codes they're working on do include the RPM and RTM reimbursement codes. If you want more detail on them, I'm happy to connect with you as well in that. The other part of their offering is primarily around serving analytics to Medicare fee-for-service beneficiaries were aligned with a CMMI innovation model. And that's that 40,000 aligned Medicare fee-for-service beneficiary number that I referenced in the earnings call. So it's kind of a two-pronged approach, both helping providers with analytics on those fee-for-service populations and also helping them with RPM chronic care management, so on and so forth.

是的。凱爾，他們正在研究的一些代碼確實包括 RPM 和 RTM 報銷代碼。如果您想了解更多有關它們的詳細信息，我也很樂意與您聯繫。他們提供的另一部分主要是圍繞為醫療保險按服務收費的受益人提供分析服務，並與 CMMI 創新模型保持一致。這就是我在財報電話會議中提到的 40,000 個一致的 Medicare 按服務收費的受益人號碼。所以這是一種雙管齊下的方法，既幫助提供者分析這些按服務收費的人群，也幫助他們進行 RPM 慢性護理管理，等等。

We have reached the end of the question-and-answer session, and I will now turn the call over to Brandon Sim for closing remarks.

問答環節已經結束，我現在將把電話轉給 Brandon Sim 作結束語。

Thank you all for your time today. We are always open to dialogue with investors and welcome visitors to our offices in Alhambra should any of you be in the Los Angeles area. Please feel free to reach out to us or our Investor Relations firm, The 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對話，如果你們中的任何人在洛杉磯地區，歡迎來訪我們在阿罕布拉的辦公室。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 The 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。

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

今天的會議到此結束，此時您可以斷開您的線路。感謝您的參與。