Astrana Health Inc (ASTH) 2023 Q1 法說會逐字稿

Greetings. Welcome to Apollo Medical Holdings First Quarter 2023 Financial Results. (Operator Instructions) Please note, this conference is being recorded. I will now turn the conference over to Carolyne Sohn, Vice President of Investor Relations. Thank you. You may begin.

問候。歡迎閱讀阿波羅醫療控股 2023 年第一季度財務業績。 （操作員說明）請注意，本次會議正在錄製中。我現在將會議交給投資者關係副總裁卡羅琳·索恩 (Carolyne Sohn)。謝謝。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 first quarter ended March 31, 2023, 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 a ApolloMed's website after the conclusion of this call.

謝謝接線員，大家好。感謝您加入我們。宣布 Apollo Medical Holdings, Inc. 截至 2023 年 3 月 31 日第一季度業績的新聞稿可在該公司網站 www.apollomed.net 的投資者部分獲取。為了提供有關其結果的一些額外背景，該公司在其網站上提供了補充資料。本次電話會議結束後，ApolloMed 的網站也將提供該廣播的重播。

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.

在開始之前，我想提醒大家，本次電話會議以及此處討論的任何附帶信息均包含 1995 年《私人證券訴訟改革法案》安全港條款含義內的某些前瞻性陳述。

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, 2023, continued growth, ability to decrease cost of care while improving quality and outcomes, ability to deliver sustainable revenue and EBITDA growth as well as long-term value, ability to respond to the changing environment, ability to offset anticipated losses in the Care Enablement segment, ability to successfully implement operational streamlining and successful implementation of strategic growth plans, acquisition strategy and merger integration efforts.

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，其中包括有關公司截至 2023 年 12 月 31 日的年度指導、持續增長、能力的陳述。降低護理成本，同時提高質量和結果，提供可持續收入和 EBITDA 增長以及長期價值的能力，應對不斷變化的環境的能力，抵消護理支持部門預期損失的能力，成功實施運營的能力簡化並成功實施戰略增長計劃、收購戰略和合併整合工作。

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.

儘管該公司認為其前瞻性陳述中反映的預期截至目前是合理的，但這些陳述存在風險和不確定性，可能導致實際結果與預測結果存在巨大差異。無法保證這些期望將被證明是正確的。有關投資 ApolloMed 相關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先查看這些文件。除法律要求外，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 Co-Chief Executive Officer, Brandon Sim, will discuss first quarter 2023 highlights and the latest operational development. Chief Financial Officer, Chan Basho, will follow with review of ApolloMed's results for the first quarter ended March 31, 2023. Brandon will conclude the remarks with an update on the company's outlook and long-term growth strategy before opening the floor for questions. With that, I'll turn the call over to ApolloMed's Co-Chief Executive Officer, Brandon Sim. Please go ahead, Brandon.

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 以獲取更多信息。對於那些關注隨附補充材料的人，幻燈片 3 上提供了該公司的概述。在今天的電話會議上，該公司聯合首席執行官 Brandon Sim 將討論 2023 年第一季度的亮點和最新的運營發展。首席財務官 Chan Basho 將隨後回顧 ApolloMed 截至 2023 年 3 月 31 日的第一季度業績。布蘭登將在發言結束時介紹公司的前景和長期增長戰略的最新情況，然後開始提問。接下來，我會將電話轉給 ApolloMed 的聯合首席執行官 Brandon Sim。請繼續，布蘭登。

Thank you, Carolyne, and good evening, everyone. Thank you for joining us today. We began 2023 with a strong first quarter as we continue to rapidly scale our leading value-based care enablement and delivery platform. While maintaining our long history of outstanding clinical outcomes, great health care experiences for our members and sustained profitability. I will first summarize our key quarterly financial results and reporting improvements, and then provide updates on operations. For the first quarter ended March 31, 2023, we reported total revenue of $337.2 million, a 28% increase from the prior year quarter and $29.8 million in adjusted EBITDA.

謝謝你，卡羅琳，大家晚上好。感謝您今天加入我們。 2023 年第一季度業績強勁，我們繼續快速擴展領先的基於價值的護理支持和交付平台。同時保持我們傑出的臨床結果的悠久歷史、為我們的會員提供良好的醫療保健體驗和持續的盈利能力。我將首先總結我們的關鍵季度財務業績和報告改進，然後提供運營方面的最新信息。截至 2023 年 3 月 31 日的第一季度，我們公佈的總收入為 3.372 億美元，較上年同期增長 28%，調整後 EBITDA 為 2,980 萬美元。

We are also introducing segment based reporting, details of which are included on Slide 7 of our earnings supplement. As our business continues to grow, we felt it was important for us to provide greater clarity into each segment's revenue, growth and operating profitability, which are the metrics by which we also evaluate our businesses, excluding nonoperator factors. We believe this information will allow investors to better evaluate changes in the operating results of our business segments, outside of nonoperational factors that affect net income. Thus providing insight into both operations and other factors impacting our results -- our reported results.

我們還引入了基於細分的報告，其詳細信息包含在我們收益補充材料的幻燈片 7 中。隨著我們業務的不斷增長，我們認為更清晰地了解每個部門的收入、增長和運營盈利能力非常重要，這些也是我們評估業務的指標，不包括非運營商因素。我們相信，這些信息將使投資者能夠更好地評估我們業務部門經營業績的變化，排除影響淨利潤的非經營因素。從而提供對運營和影響我們結果（我們報告的結果）的其他因素的深入了解。

Beginning with the first quarter ended March 31, 2023, we are reporting our financial results based on the following 3 business segments: Care Enablement, Care Partners and Care Delivery. Our Care Enablement segment is an integrated end-to-end clinical administrative platform, powered by our proprietary technology suite, which provides operational, clinical, financial, technology, management and strategic services to providers and payers. Revenue for this segment is primarily comprised of management and software fees charged as a percentage of gross revenue or on a per member per month basis.

從截至 2023 年 3 月 31 日的第一季度開始，我們將根據以下 3 個業務部門報告財務業績：護理支持、護理合作夥伴和護理交付。我們的護理支持部門是一個集成的端到端臨床管理平台，由我們的專有技術套件提供支持，為提供商和付款人提供運營、臨床、財務、技術、管理和戰略服務。該部門的收入主要包括按總收入的百分比或按每個會員每月收取的管理費和軟件費。

Our Care Partners segment is focused on building and managing high-quality and high-performance provider networks by partnering with empowering and investing in strong provider partners with a shared vision for coordinated care delivery. By leveraging our unique Care Enablement platform and ability to recruit, empower and incentivize physicians, we are able to organize partnered providers into successful risk-bearing organizations, which take on varying levels of risk based on total cost of care across membership in all lines of business, including Medicare, Medicaid, commercial and exchange.

我們的護理合作夥伴部門專注於通過與具有協調護理服務共同願景的強大提供商合作夥伴合作和投資來建立和管理高質量和高性能的提供商網絡。通過利用我們獨特的護理支持平台以及招聘、授權和激勵醫生的能力，我們能夠將合作提供者組織成成功的風險承擔組織，這些組織根據所有領域的會員的總護理成本承擔不同程度的風險。業務，包括醫療保險、醫療補助、商業和交換。

Revenue for this segment is primarily comprised of capitation and risk full settlements and incentives. Finally, our Care Delivery segment seeks to provide high-quality and accessible health care services through a patient-centric care delivery organization. It consists of outpatient clinics providing primary care, multi-specialty care, including cardiology and women's health, urgent care as well as ancillary services such as ambulatory surgical centers, diagnostic laboratory and imaging services and hospitals.

該部門的收入主要包括按人頭付費和風險全額結算和激勵。最後，我們的護理服務部門致力於通過以患者為中心的護理服務組織提供高質量且易於獲得的醫療保健服務。它由提供初級護理、多專科護理（包括心髒病學和婦女健康）、緊急護理以及輔助服務（例如門診手術中心、診斷實驗室和影像服務）和醫院的門診診所組成。

Revenue for this segment is primarily earned based on fee-for-service reimbursements, capitation and performance-based incentives. Moving next to operations. We continue to execute on our operational goals of: one, growing our membership in core and new geographies; two, moving members along the risk ladder towards global risk value-based contracts and three, enabling our providers to deliver excellent patient outcomes in order to manage that risk effectively. On the first goal, we've seen strong and steady progress.

該部門的收入主要通過服務費用報銷、按人頭付費和基於績效的激勵來賺取。接下來轉向運營。我們繼續執行我們的運營目標：第一，增加核心和新地區的會員數量；第二，讓會員沿著風險階梯走向基於全球風險價值的合同；第三，使我們的提供商能夠提供出色的患者治療結果，以便有效管理風險。在第一個目標上，我們看到了強勁而穩定的進展。

As Chan will detail later, we grew our Care Partners business by over 30% from the prior year quarter due to organic membership growth and a more favorable payer mix in our risk-bearing business. We also continue to make inroads in our newer Nevada and Texas geographies following our acquisition of Valley Oaks Medical Group last October.

正如 Chan 稍後將詳細介紹的那樣，由於會員的有機增長以及我們的風險承擔業務中更有利的付款人組合，我們的 Care Partners 業務比去年同期增長了 30% 以上。繼去年 10 月收購 Valley Oaks Medical Group 後，我們還繼續進軍內華達州和德克薩斯州的新地區。

Since that time, we have increased unique members seen by 120%, and we're very excited about the ongoing growth in those regions, as we continue to provide excellent care to members of those communities. We believe that this growth will be sustainable for the years to come, as we execute on our second operational target and moving towards taking global risk on total cost of care for our patients. Last week, we closed on the acquisition of For Your Benefit or FYB along with receiving regulatory approval for the change in control of FYB's full-service Restricted Knox-Keene licensed health plan, which will allow us to take global risk for the professional and institutional cost of care for members in the plan.

自那時起，我們的獨特會員數量增加了 120%，我們對這些地區的持續增長感到非常興奮，因為我們將繼續為這些社區的成員提供優質的護理。我們相信，隨著我們執行第二個運營目標，並努力承擔患者總護理成本的全球風險，這種增長在未來幾年將是可持續的。上週，我們完成了對 For Your Benefit 或 FYB 的收購，並獲得了監管機構對 FYB 全方位服務受限諾克斯基恩許可健康計劃控制權變更的批准，這將使我們能夠為專業和機構承擔全球風險。計劃中成員的護理費用。

This is a significant opportunity for us to deploy our care coordination and management capabilities more effectively and enhances our demonstrated ability to decrease total cost of care while improving quality and patient outcomes. We expect that this will drive both revenue and EBITDA growth over the next several years. As guided to you in the past, we plan to assume additional risk in a prudent, measured fashion over the next several years, but we strongly believe that the infrastructure, technology and operations we have developed position us strongly to succeed in this transition.

對於我們來說，這是一個重要的機會，可以更有效地部署我們的護理協調和管理能力，並增強我們降低總護理成本、同時提高質量和患者治療效果的能力。我們預計這將推動未來幾年收入和 EBITDA 的增長。正如過去向您提供的指導，我們計劃在未來幾年以審慎、謹慎的方式承擔額外風險，但我們堅信，我們開發的基礎設施、技術和運營使我們能夠在這一轉型中取得成功。

Finally, on our third goal, we continue to see MLR trends to be favorable versus both prior periods and in line quarter-over-quarter. This is the result of improvements we've made in medical costs in our existing markets as well as new ones we've added over the past year. In addition to executing on our 3 stated goals above, we also strongly believe in investing in the care delivery ecosystem at March. While we have built what we believe to be a world-class platform for managing global risk in a multi-payer setting across all patient types, we also know that there are others building innovative and exciting solutions in the value-based care delivery ecosystem.

最後，關於我們的第三個目標，我們繼續看到 MLR 趨勢比之前時期和季度環比都有利。這是我們在現有市場以及過去一年中增加的新市場中醫療費用方面取得的改善的結果。除了執行上述 3 個既定目標外，我們還堅信在 3 月份投資於護理服務生態系統。雖然我們已經建立了一個世界級的平台，用於管理所有患者類型的多支付者環境中的全球風險，但我們也知道還有其他人在基於價值的護理服務生態系統中構建創新和令人興奮的解決方案。

To that end, in recent months, we have made small venture investments in areas we feel will enhance our ability to empower providers in the delivery of value-based care. We led the pre-seed funding for Third Way Health, a company is looking to transform the front office for care delivery organizations. And also invested in 2 other companies: one focused on providing care to high-risk Medicare members and another focused on delivering technology-enabled services and infrastructure for value-based care providers and organizations.

為此，近幾個月來，我們在一些領域進行了小型風險投資，我們認為這些領域將增強我們增強服務提供者提供基於價值的護理的能力。我們主導了 Third Way Health 的種子前融資，該公司正在尋求改造護理服務組織的前台辦公室。還投資了另外兩家公司：一家專注於為高風險醫療保險成員提供護理，另一家專注於為基於價值的護理提供者和組織提供技術支持的服務和基礎設施。

We're excited by the progress we have made so far in working with these innovators and look forward to continuing those partnerships. I also have 2 more operational updates to share. Recently, we were unable to come to mutually agreeable terms for the renewal of a management services contract with LaSalle Medical Associates, 1 of our clients in our care enablement business with approximately 370,000 members.

我們對迄今為止與這些創新者合作所取得的進展感到興奮，並期待繼續保持這些合作夥伴關係。我還有 2 個操作更新要分享。最近，我們未能就與 LaSalle Medical Associates 續訂管理服務合同達成雙方同意的條款，LaSalle Medical Associates 是我們護理支持業務的客戶之一，擁有約 370,000 名會員。

That contract will thus terminate by the end of August of this year. In 2022, LaSalle contributed $21.4 million in net revenue on an annualized basis for the Care Enablement business. I want to emphasize that the impact of LaSalle only impacts our Care Enablement segment and that, that impact is under 2% of our total revenues for 2022. There will be no effect on our risk-bearing Care Partners segment. We expect to partially offset losses in revenue from this contract as we continually add new clients to our Care Enablement business. We are also taking this opportunity to streamline our operations and organizational structure, which have grown significantly over the course of the past several years.

該合同將於今年八月底終止。 2022 年，LaSalle 為護理支持業務貢獻了 2140 萬美元的年淨收入。我想強調的是，LaSalle 的影響僅影響我們的護理支持部門，而且這種影響占我們 2022 年總收入的 2% 以下。對我們承擔風險的護理合作夥伴部門不會產生影響。隨著我們不斷為我們的護理支持業務增加新客戶，我們預計將部分抵消該合同的收入損失。我們還藉此機會簡化我們的運營和組織結構，這些業務和組織結構在過去幾年中取得了顯著增長。

While this was necessary to support the growth of the company, we currently have over 1,500 employees across our organization. We will be focusing on performance management, especially within our operating departments in order to ensure that the profitability and margins in our Care Enablement segment remain on track against our expectations. We are confident that we will be able to continue delivering high-quality health care experiences and driving positive outcomes for our members with a leaner operating structure that will position the company for greater success. Given the strength of our first quarter and despite the recent development, we are reiterating our full year 2023 guidance on both the top and bottom line, which is listed in full on Slide 11 of our supplement.

雖然這是支持公司發展所必需的，但我們整個組織目前擁有 1,500 多名員工。我們將專注於績效管理，特別是在我們的運營部門內，以確保我們的護理支持部門的盈利能力和利潤率保持在符合我們預期的軌道上。我們相信，我們將能夠繼續提供高質量的醫療保健體驗，並通過更精簡的運營結構為我們的會員帶來積極的成果，這將使公司取得更大的成功。鑑於我們第一季度的強勁表現以及最近的發展，我們重申我們對 2023 年全年營收和利潤的指引，該指引完整列於我們補充材料的幻燈片 11 中。

We aim to continue growing membership in our core California markets while scaling rapidly in our newer markets, taking progress on moving patient cohorts towards global risk and managing towards excellent clinical and financial outcomes. We are excited by our progress so far on these fronts and believe we are well positioned going forward into the rest of 2023. Before I turn it over to Chan, I wanted to congratulate him on his official appointment as Chief Financial Officer of ApolloMed effective last Friday. He will continue in his role as Chief Strategy Officer, and we're very pleased to have his leadership in the areas of finance, operations, strategy and corporate development. Bringing his over 20 years of experience in these areas at various other health care companies, Chan has made invaluable contributions over the past year. And I'm thrilled to continue building with him in the years ahead. With that, I'll turn it over to Chan.

我們的目標是繼續增加加州核心市場的會員數量，同時在新市場中快速擴張，在將患者群體推向全球風險以及管理卓越的臨床和財務成果方面取得進展。我們對迄今為止在這些方面取得的進展感到興奮，並相信我們已經做好了進入 2023 年剩餘時間的準備。在我將其交給 Chan 之前，我想祝賀他被正式任命為 ApolloMed 首席財務官，該任命於去年生效星期五。他將繼續擔任首席戰略官，我們很高興由他在財務、運營、戰略和企業發展領域發揮領導作用。憑藉他在其他多家醫療保健公司在這些領域的 20 多年經驗，Chan 在過去的一年中做出了寶貴的貢獻。我很高興能在未來幾年繼續與他一起建設。有了這個，我就把它交給陳。

Thank you, Brandon. I want to thank you for the support and greatly value the opportunity. As we highlighted, we continue to deliver strong results, reporting total revenue of $337.2 million in the first quarter of 2023, a 28% increase from $263.3 million in the prior year quarter. This was primarily driven by increased revenue within our Care Partners segment. I'll quickly highlight our per segment results and offer a brief commentary on each. First, our Care Enablement segment reported revenue of $30.6 million for the quarter, an increase of 4% from $29.4 million in the prior year period.

謝謝你，布蘭登。我要感謝您的支持並非常珍惜這個機會。正如我們所強調的，我們繼續取得強勁的業績，2023 年第一季度的總收入為 3.372 億美元，比去年同期的 2.633 億美元增長 28%。這主要是由於我們的護理合作夥伴部門的收入增加所致。我將快速強調我們每個細分市場的結果，並對每個細分市場提供簡短的評論。首先，我們的護理支持部門報告本季度收入為 3060 萬美元，比去年同期的 2940 萬美元增長 4%。

Segment operating income decreased 49.3% to $5.7 million for the period, which was driven by our additional investments in infrastructure, technology and people to support our operational growth. We believe that these investments are necessary, as we prepare to take on management services contracts related to global risk, and we expect margin expansion once fees for managing these global risk contracts begin to offset some of the investments made over the past year. Membership under management within our Care Enablement business segment was approximately 1.3 million managed lives at the end of the first quarter ended March 31, 2023.

在此期間，該部門的營業收入下降了 49.3% 至 570 萬美元，這是由於我們為支持業務增長而對基礎設施、技術和人員進行了額外投資。我們認為這些投資是必要的，因為我們準備承擔與全球風險相關的管理服務合同，並且一旦管理這些全球風險合同的費用開始抵消過去一年的部分投資，我們預計利潤率會擴大。截至 2023 年 3 月 31 日的第一季度末，我們的護理支持業務部門管理的會員人數約為 130 萬。

Approximately 650,000 or half of these members were also within our Care Partners business and have capitated risk-bearing arrangements through our consolidated risk-bearing entities. Deep diving into our Care Partners segment. Revenue increased 30.4% to $314.7 million during the period, primarily driven by organic membership growth in our consolidated risk-bearing entities and a more favorable payer mix. Segment operating income increased 28.2% to $22.3 million, which was primarily driven by our ability to maintain a steady medical loss ratio and cost structure even with rising revenue. This is a result we're pleased with, and we will continue driving further growth in this segment by growing our membership base and moving forward to patients into global risk value-based arrangements. Finally, our Care Delivery segment revenue increased by 24.9% relative to the prior year period to $25.4 million.

其中大約 650,000 名或一半的成員也在我們的護理合作夥伴業務範圍內，並通過我們的合併風險承擔實體進行了資本化風險承擔安排。深入探討我們的護理合作夥伴部分。在此期間，收入增長了 30.4%，達到 3.147 億美元，這主要是由於我們合併的風險​​承擔實體的有機會員增長和更有利的付款人組合推動的。部門營業收入增長 28.2% 至 2230 萬美元，這主要是由於我們即使在收入增長的情況下也能保持穩定的醫療損失率和成本結構。這是我們感到滿意的結果，我們將通過擴大我們的會員基礎並推動患者加入基於全球風險價值的安排，繼續推動這一領域的進一步增長。最後，我們的護理服務部門收入較上年同期增長 24.9%，達到 2540 萬美元。

This was primarily driven by increased volume in patient visits to our primary multi-specialty and ancillary care delivery entities. The segment's operating loss was $1 million, relative to an operating income of $1.1 million in the prior year period. This was due to our continued investment in expanding our care delivery footprint in Nevada and Texas. We view the results in this segment, as in line to better than the guidance that we provided last quarter around investing in an incremental $5 million to $10 million in 2023 to scale new geographies. Net income attributable to ApolloMed was $14.6 million, up 3% relative to $14.3 million in the first quarter of 2022.

這主要是由於我們的主要多專業和輔助護理服務實體就診的患者數量增加所致。該部門的營業虧損為 100 萬美元，而去年同期的營業收入為 110 萬美元。這是由於我們持續投資擴大在內華達州和德克薩斯州的護理服務覆蓋範圍。我們認為該領域的業績優於我們上季度提供的關於 2023 年增加投資 500 萬至 1000 萬美元以擴展新地區的指導。 ApolloMed 的淨利潤為 1460 萬美元，較 2022 年第一季度的 1430 萬美元增長 3%。

Earnings per share on a diluted basis were $0.31, which is flat compared to $0.31 in the prior year period, mainly due to increased operating expenses that I referenced earlier. We reported EBITDA of $24 million in the first quarter of 2023, up 1.2% from $23.7 million in the prior year period. Adjusted EBITDA for this period was $29.8 million. We placed greater emphasis on the adjusted EBITDA figure, as these numbers back out the impact of excluded assets stock-based compensation, other income and income from equity method investments. Turning over to the balance sheet. We remain well capitalized and well positioned to execute on our growth initiatives. We ended the first quarter with $274.6 million in cash and cash equivalents compared to $288 million at the end of 2022.

攤薄每股收益為 0.31 美元，與去年同期的 0.31 美元持平，主要是由於我之前提到的運營費用增加。我們報告 2023 年第一季度 EBITDA 為 2400 萬美元，比上年同期的 2370 萬美元增長 1.2%。本期調整後 EBITDA 為 2980 萬美元。我們更加重視調整後的 EBITDA 數字，因為這些數字抵消了排除資產股票薪酬、其他收入和權益法投資收入的影響。轉到資產負債表。我們仍然擁有充足的資本和良好的條件來執行我們的增長計劃。第一季度結束時，我們的現金和現金等價物為 2.746 億美元，而 2022 年底為 2.88 億美元。

Our working capital was $292.7 million, compared to $287.8 million at the end of 2022. Total stockholders' equity increased to $563.2 million at the end of March 31, 2023, from $555 million as of December 31, 2022. Total debt at the end of the first quarter was $205.6 million. Lastly, this past December, our Board authorized the repurchase of up to $50 million of the company's shares of common stock from time to time in the open market as well as privately negotiated transactions. The company repurchased $9.5 million or approximately 270,000 shares during the first quarter.

我們的營運資本為 2.927 億美元，而 2022 年底為 2.878 億美元。截至 2023 年 3 月 31 日，股東權益總額從 2022 年 12 月 31 日的 5.55 億美元增至 5.632 億美元。第一季度營收為 2.056 億美元。最後，去年 12 月，我們的董事會授權不時在公開市場以及私下協商的交易中回購最多 5,000 萬美元的公司普通股。該公司在第一季度回購了 950 萬美元或約 270,000 股股票。

As a note, this share repurchase plan has no expiration date. In summary, we remain confident in the long-term prospects of our business and operational strategy and are looking forward to the year ahead. I'd now like to turn it back to Brandon for a discussion of our growth strategy and outlook for the remainder of 2023. Brandon?

需要說明的是，本次股票回購計劃沒有到期日。總而言之，我們對業務和運營戰略的長期前景仍然充滿信心，並對未來的一年充滿期待。現在我想請布蘭登來討論我們的增長戰略和 2023 年剩餘時間的前景。布蘭登？

Thanks, Chan. In closing, we have hit the ground running in 2023 and are very excited about our prospects for the remainder of the year. We are making notable progress on the key operational goals of organic growth in our core new markets, moving our risk-based membership towards global risk and empowering a growing network of providers to deliver superior outcomes for their patients in order to effectively manage our increasing book of risk-based business. With that, operator, let's open it up for Q&A.

謝謝，陳。最後，我們已在 2023 年開始工作，並對今年剩餘時間的前景感到非常興奮。我們在核心新市場的有機增長的關鍵運營目標上取得了顯著進展，將我們基於風險的會員資格轉向全球風險，並授權不斷增長的提供商網絡為患者提供卓越的結果，以便有效管理我們不斷增加的書籍基於風險的業務。那麼，操作員，讓我們開始問答吧。

(Operator Instructions) Our first question is from Ryan Daniels with William Blair.

（操作員說明）我們的第一個問題來自 Ryan Daniels 和 William Blair。

I'd love to get a little bit more color on some of the G&A investments you're making and how we should think about that going forward, given some of the streamlining you mentioned. And in particular, would love to hear more about what you're doing in Care Enablement. I know that nearly doubled year-over-year, even though it's only about 10% of your sales. So it's not the biggest G&A area. So maybe, one, talk about how we think about overall G&A going forward and number two, specifically in Care Enablement?

鑑於您提到的一些精簡工作，我很想進一步了解您正在進行的一些一般管理費用投資，以及我們應該如何考慮未來的發展。特別是，很想了解更多有關您在護理支持方面所做的工作。我知道這一數字同比幾乎翻了一番，儘管它只佔您銷售額的 10% 左右。所以這不是最大的一般管理費用領域。因此，也許，第一，談談我們如何看待未來的總體管理費用，第二，特別是在護理支持方面？

This is Brandon. Thanks for joining the call. Good to hear from you. So around Care Enablement and overall G&A, I think there have been a lot of areas where we've invested in starting last year, and that's where you're seeing the same quarter year-over-year increases in G&A. With particular respect to Care Enablement, we've made a lot of investment in our analytics and software engineering departments, for example, which are leading to -- causing some of the increased G&A.

這是布蘭登。感謝您加入通話。很高興聽到你的消息。因此，圍繞護理支持和總體管理費用，我認為從去年開始，我們在很多領域進行了投資，這就是您看到同季度管理費用同比增長的領域。例如，特別是在護理支持方面，我們在分析和軟件工程部門進行了大量投資，這導致了一些一般管理費用的增加。

We've also made investments into preparing for management services around institutional claims processing, authorization, case management, et cetera, which we've been doing in anticipation of 1 of our clients in the Care Enablement segment, signing on for additional institutional related services as well as our own Restricted Knox-Keene license going live this year.

我們還投資準備圍繞機構索賠處理、授權、案件管理等的管理服務，我們一直在這樣做，以期我們的護理支持部門的一位客戶簽約獲得其他機構相關服務以及我們自己的限制性諾克斯基恩許可證將於今年上線。

And so we'll start to see revenue come in to offset the increased G&A within the next quarter or 2 for the institutional investment. We do believe that G&A is going to slow down a bit for the rest of the year. Maybe Chan can talk a little bit about that.

因此，我們將開始看到收入在下一兩個季度內抵消機構投資增加的一般管理費用。我們確實相信，今年剩餘時間裡，一般行政費用將會有所放緩。也許陳可以談談這一點。

Yes. Thanks, Brandon. Kevin, thanks for the question. So as we previously mentioned, the G&A increase that we saw last year really kicked in and Q3 and Q4 is running at a steady state in Q1. And we expect '23 to be in line with full year 2022. And sorry about that, Ryan, in terms of the name.

是的。謝謝，布蘭登。凱文，謝謝你的提問。正如我們之前提到的，我們去年看到的一般費用增長確實開始顯現，第三季度和第四季度在第一季度處於穩定狀態。我們預計“23”將與 2022 年全年保持一致。瑞安，就名稱而言，對此感到抱歉。

No worries at all. And then maybe another big picture, one, just on Medicaid redetermination. I know that's down to 20% of sales now, but any thoughts on the potential impact given your exposure to California Medicaid? I know you're payer agnostic, but certainly, some of those lives are going to lose coverage. So is that contemplated in guidance? And then how big of an impact could that have?

完全不用擔心。然後也許還有另一幅大圖，一個是關於醫療補助重新確定的。我知道現在這已下降至銷售額的 20%，但考慮到您接受加州醫療補助，您對潛在影響有什麼想法嗎？我知道您對付款人不可知，但肯定的是，其中一些人將失去保險。那麼指導中是否考慮到了這一點？那麼這會產生多大的影響呢？

Yes. We're just starting to see redetermination kick in, in May, and we -- those numbers are built into our guidance. Give us about till next quarter to give you exactly the movement that we're seeing from Medicaid over to the exchange with the robust policies that are in place in California. We do expect to capture many of those members as they -- as the process happens.

是的。我們剛剛開始看到重新決定在五月份開始生效，而這些數字已納入我們的指導中。請讓我們在下個季度之前向您詳細介紹我們所看到的從醫療補助到與加利福尼亞州實施的強有力政策的交換的動態。我們確實希望在流程發生時捕獲其中許多成員。

Okay. Perfect. And then maybe last one, just any more color, I'm sure we'll get some questions on LaSalle Medical Group and the Care Enablement agreement there with the MSA being, I guess, discontinued as of August. Was it a pricing issue? Was it anything with dissatisfaction with the technology, just normal business? And then maybe you can remind us what the typical length of contract terms are in your historic retention rates?

好的。完美的。然後也許是最後一個，只是更多的顏色，我相信我們會收到一些關於 LaSalle Medical Group 的問題，以及那裡與 MSA 的護理支持協議，我猜，從 8 月份起就終止了。是定價問題嗎？是不是對技術不滿意，只是正常的生意？然後也許您可以提醒我們，您的歷史保留率中的典型合同期限長度是多少？

Sure thing, Ryan. I can take this one. Around the -- I would say that all of our MSO, our Care Enablement clients are important to us. We really do our best not to lose any, and this is actually pretty rare occurrence for us. I think our retention rate is well in the 90s and net retention from a revenue basis is probably over 100 to answer your other question. But I think in this particular instance, in those numbers I cited earlier, obviously, excluding LaSalle just to date, and that contract ends August 31 of this year.

當然可以，瑞安。這個我可以拿走我想說的是，我們所有的 MSO、我們的護理支持客戶對我們都很重要。我們真的盡力不丟失任何東西，這對我們來說實際上是非常罕見的情況。我認為我們的留存率在 90 年代就已經很不錯了，而以收入為基礎的淨留存率可能超過 100，可以回答您的其他問題。但我認為在這個特殊的例子中，在我之前引用的那些數字中，顯然不包括迄今為止的拉薩爾，而且該合同將於今年 8 月 31 日結束。

Unfortunately, with LaSalle, we were unable to come to terms with pricing that supported the long-term margins that we wanted in business, which are 20% to 30%. And there's a bit of a difference in kind of strategy that I probably won't go too deep in to you on this call, but unfortunately, these things happen. What I can say is that going forward, we do anticipate to build to ensure that the Care Enablement segment is still on track towards the 20% to 30% EBITDA margins that we've talked about. And there is a pipeline kind of folks, who are excited to get back on board or to get on board, sorry, in the Care Enablement segment.

不幸的是，我們無法與 LaSalle 達成能夠支持我們想要的業務長期利潤（20% 到 30%）的定價協議。策略上有一點不同，我可能不會在這次電話會議上向您深入介紹，但不幸的是，這些事情發生了。我能說的是，展望未來，我們確實預計將確保護理支持部門仍朝著我們談到的 20% 至 30% EBITDA 利潤率邁進。還有一種管道類型的人，他們很高興能重新加入或加入，抱歉，在護理支持領域。

Our next question is from Brooks O'Neil with Lake Street Capital Markets.

我們的下一個問題來自 Lake Street Capital Markets 的布魯克斯·奧尼爾 (Brooks O'Neil)。

Good afternoon, guys, and congratulations on the strong start to the year. Congratulations to Chan. I think it's fantastic. I look forward to continuing to work with you guys. So I have a couple of questions. I guess I'd like to start off, obviously, when you comment about trimming up the workforce, I've heard some other rumblings around from some other health plan organization that they're considering staffing reduction.

下午好，伙計們，祝賀今年的強勁開局。恭喜陳。我認為這太棒了。我期待著繼續與你們合作。所以我有幾個問題。我想我想首先，顯然，當您評論有關裁員的問題時，我聽到其他一些健康計劃組織正在考慮裁員。

Would you say that in response to reimbursement level in any parts of your business in particular, Ryan mentioned, the redetermination in Medicaid. But I've heard that there's some pressures in the Medicare Advantage business broadly defining, can you comment if you guys are seeing that or feeling that?

您是否會說，針對您業務的任何部分的報銷水平，瑞安提到了醫療補助的重新確定。但我聽說醫療保險優勢業務存在一些廣泛的壓力，如果你們看到或感覺到這一點，您能發表評論嗎？

Sure. Yes. Brooks, thanks for joining. Good to hear from you. I can certainly comment on that. I think around Medicare, we haven't seen as much pressure as perhaps the organization -- or perhaps the industry on average has seen. I think some of those -- some of the pressure that folks are anticipating are related to the RADV changes that will be phased in over the next 3 years, some risk adjustment changes from CMS.

當然。是的。布魯克斯，感謝您的加入。很高興聽到你的消息。我當然可以對此發表評論。我認為在醫療保險方面，我們沒有看到像該組織或行業平均所看到的那麼大的壓力。我認為其中一些——人們預期的一些壓力與將在未來 3 年內分階段實施的 RADV 變化以及 CMS 的一些風險調整變化有關。

I think as we've stated before and continue to believe the risk adjustment changes will not affect us as much as other organizations. We've run some analysis around the prevalence of certain codes or combinations of codes that will be eliminated or reduced in terms of risk adjustment contributions. And it's just not as high as we think. That combined with the rate of growth for us and the heightened base value score -- demographic score for risk adjustment should end up being a bit of a wash.

我認為正如我們之前所說的那樣，並仍然相信風險調整變化不會像其他組織那樣對我們造成那麼大的影響。我們對某些代碼或代碼組合的普遍性進行了一些分析，這些代碼或代碼組合將在風險調整貢獻方面被消除或減少。而且它只是沒有我們想像的那麼高。再加上我們的增長率和提高的基本價值分數——風險調整的人口統計分數最終應該會有點令人沮喪。

So I think we're feeling okay on the Medicare side of things. The main realignment or streamlining, so to speak, for the organization will really be, we grew very quickly. We grew at 1,500 -- more than 1,500 employees currently. We're talking about cuts of 5% or less. To be honest, it's not a large thing, but it is something we have to do to ensure that our margins in the Care Enablement business are going to be robust and on track for the 20% to 30% long-term margins that we've guided towards in the past. So that's really the scope and the rationale for the streamlining.

所以我認為我們在醫療保險方面感覺還不錯。可以說，對於組織來說，主要的調整或精簡實際上是，我們成長得非常快。我們的員工數量增加到了 1,500 人——目前已超過 1,500 名員工。我們正在談論 5% 或更少的削減。老實說，這不是一件大事，但這是我們必須做的事情，以確保我們在護理支持業務中的利潤率將保持強勁，並有望實現我們預期的 20% 至 30% 的長期利潤率。已經引導過去。這就是精簡的範圍和理由。

So second question I have or I guess, to make a quick comment that I'm wildly excited about your opportunity with the Restricted Knox-Keene license. I was hoping you might tell us a little bit about how you expect to take advantage of that. Obviously, San Francisco market is 1 opportunity, but since it applies in the whole state, it seems like just an enormous opportunity for you. And maybe you could share with all about sort of how you envision the financial effect of that and how you expect to take advantage over the next couple of years?

所以第二個問題我有或者我猜想快速發表評論，我對您獲得受限諾克斯基恩許可證的機會感到非常興奮。我希望您能告訴我們一些您希望如何利用這一點的信息。顯然，舊金山市場是一個機會，但由於它適用於整個州，這對您來說似乎是一個巨大的機會。也許您可以與大家分享一下您如何設想其財務影響以及您希望如何在未來幾年中利用這一優勢？

Sure Yes. Thanks for the question, Brooks. So we received regulatory approval from the state for the Restricted Knox-Keene license health plan. And as we mentioned, currently for 2 counties, so it's a fairly small group of members today, around 5,000 senior members, which were taking global risk on via the Restricted Knox-Keene license. Chan and myself are working hard to make sure that, that's operationalized across other counties in California, including ones in which we have the bulk of our risk-bearing care partners membership. And so you'll start seeing results of that show up in the Care Partners segment as we do that. Chan, do you want to talk a little more in depth about the impact to talk to bottom line?

當然可以。謝謝你的提問，布魯克斯。因此，我們獲得了州監管部門對諾克斯-基恩限制許可健康計劃的批准。正如我們所提到的，目前有 2 個縣，所以今天的會員群體相當小，大約有 5,000 名高級會員，他們通過受限的諾克斯-基恩許可證承擔全球風險。陳和我本人正在努力確保這一點在加州其他縣實施，包括我們擁有大部分風險護理合作夥伴會員的縣。因此，當我們這樣做時，您將開始在護理合作夥伴部分中看到結果。 Chan，您想更深入地談談對底線的影響嗎？

Sure. Brooks, thanks so much for the kind words. Great to hear from you. Yes. Short term, in terms of top line, we have about under 10,000 members that will initially be within FYB, and we're working to quickly expand it from the San Francisco Bay areas to other locales within California. In terms of bottom line, I would say for the initial 12 months, it's -- as we invest and build up, this is -- it's going to be breakeven. And we expect over time, the -- it will come in line with our overall long-term margins that we've guided to historically.

當然。布魯克斯，非常感謝你的客氣話。很高興聽到你的消息。是的。短期來看，就收入而言，我們最初將在 FYB 內擁有大約不到 10,000 名會員，並且我們正在努力將其從舊金山灣地區快速擴展到加利福尼亞州的其他地區。就底線而言，我想說，在最初的 12 個月裡，隨著我們的投資和建設，它將實現收支平衡。我們預計，隨著時間的推移，它將與我們歷史上指導的整體長期利潤率保持一致。

Great. Could I just ask 1 more follow-up on that. Obviously, FYB had some experience managing the global capitation, global risk. Would you stay your organization more broadly as significant experience with that? Or is that going to be a learning curve for the organization going forward?

偉大的。我可以再詢問 1 個後續問題嗎？顯然，FYB 在管理全球按人頭、全球風險方面有一些經驗。您會在更廣泛的範圍內保留您的組織作為重要的經驗嗎？或者這將成為組織未來的學習曲線？

Yes. We've been managing institutional risk via our dual risk arrangements -- full risk arrangements, as called California for some time, even in Southern California, a fairly large book of business. We've also hired most, if not all, the FYB related staff, which contributed partially to the increased G&A in the Care Enablement segment because the revenues haven't come in yet, but we've already hired the stuff. And so that's kind of a bit of what I was alluding to earlier with some of the fees related to institutional revenue coming in to offset the increased G&A that we had to invest in for and there's a bit of quarter timing issue there. So we expect those margins to kind of climb back up in line on the Care Enablement segment.

是的。我們一直通過雙重風險安排來管理機構風險——全風險安排，一段時間以來被稱為加州，甚至在南加州，這是一個相當大的業務範圍。我們還僱傭了大部分（如果不是全部）FYB 相關員工，這在一定程度上為護理支持部門的一般管理費用增加做出了貢獻，因為收入尚未到來，但我們已經僱傭了這些人員。這就是我之前提到的一些與機構收入相關的費用，以抵消我們必須投資的增加的一般管理費用，並且存在一些季度時間問題。因此，我們預計護理支持領域的利潤率將有所回升。

On the Care Partners segment where the actual risk will be born. As Chan mentioned earlier, we think we can get a 10% to 20% long-term margins even on the close to doubled revenue in that segment. So answer your question, yes, we're confident in our ability to do it. We've hired the folks and made the investments we need to and what's left is really operationalizing the contract across the California.

在護理合作夥伴部分，實際的風險將會產生。正如 Chan 之前提到的，我們認為即使該領域的收入接近翻倍，我們也可以獲得 10% 到 20% 的長期利潤率。所以回答你的問題，是的，我們對我們的能力充滿信心。我們已經聘請了人員並進行了所需的投資，剩下的就是在整個加州真正實施合同。

Let me just ask 1 more appreciate all the color. Can you just give us an update on what's going on, if anything, with regard to sort of the traditional Medicare programs you've been involved in. In the past, you've performed incredibly well. I'm just curious what you envision either this year or next year in those areas?

讓我再問1更欣賞所有的顏色。您能否向我們介紹一下您參與的傳統醫療保險計劃的最新情況（如果有的話）。過去，您的表現非常好。我只是好奇您今年或明年在這些領域有何設想？

Brooks, so last year, we were in the DCE program for our -- and that is now transitioned to the ACO REACH program. As we think about our -- as we think about 2022, we really viewed this as a breakeven business. In 2023, we continue to evaluate. And as we get further data, especially around the retroactive -- retrospective trend adjustment factor, which is a benchmark used by CMS around historical revenues versus current revenues, we'll be able to provide more insight probably by Q3.

Brooks，去年我們參加了 DCE 計劃，現在已過渡到 ACO REACH 計劃。當我們思考 2022 年時，我們確實認為這是一項盈虧平衡的業務。 2023年，我們繼續評估。隨著我們獲得更多數據，特別是關於追溯趨勢調整因子（這是 CMS 使用的歷史收入與當前收入的基準），我們可能能夠在第三季度提供更多見解。

(Operator Instructions) Our next question is from Adam Ron with Bank of America.

（操作員說明）我們的下一個問題來自美國銀行的 Adam Ron。

I have a couple of questions. So I guess following around the ACO REACH, are you saying last year was breakeven in this year, you're accruing for basically 100% MLR in the program? And if so, if that's how things end up playing out, like is that a program still worth being in? Like it adds scale and revenue and kind of breakeven introduces new provider relationships? Or is it not really playing out versus what expectations were and then would you seek out like an MSSP or what is the general thought process around that?

我有一些問題。所以我想，根據 ACO REACH，您是說去年今年實現了盈虧平衡，您在該計劃中基本上獲得了 100% 的 MLR 嗎？如果是這樣，如果事情最終就是這樣發展的，那麼這個項目還值得參加嗎？就像它增加了規模和收入，並且盈虧平衡引入了新的供應商關係？或者它並沒有真正實現與預期相反的效果，那麼您是否會像 MSSP 一樣尋求，或者圍繞它的一般思維過程是什麼？

Yes. I mean, long term, we would want to be in a business where we are able to achieve margins similar to other books of business. And you are right in your earlier statements, Adam, that for 2022 was breakeven, and we are -- in terms of 2023, that's where we're starting. I think we are -- we're being very conservative, and we're still learning about the program. And so as we see our -- and we've had so much fluctuations in the retrospective adjustment factor that it's hard -- it's really hard to get -- to move in any other way.

是的。我的意思是，從長遠來看，我們希望從事的業務能夠獲得與其他業務類似的利潤。亞當，你之前的說法是對的，2022 年是盈虧平衡的，而我們 - 就 2023 年而言，這就是我們的起點。我認為我們非常保守，而且我們仍在了解該計劃。因此，正如我們所看到的——我們的回顧性調整因素波動很大，很難——真的很難——以任何其他方式進行調整。

And so we will be getting our May -- in May, we'll be getting our summary for 2022 and then the final reconciliation happens in August. And so we'll be able to provide a lot more insight on '22 there. In terms of '23, as we start seeing that retrospective trend adjustment factor stabilize, we can also provide more insight. Around -- your third question around other programs, we're definitely evaluating other programs in terms of our long-term focus around help -- providing a full range of offerings and services for all members.

因此，我們將在 5 月獲得 2022 年的總結，然後在 8 月進行最終的核對。因此，我們將能夠提供有關 '22 的更多見解。就 23 年而言，當我們開始看到回顧性趨勢調整因素穩定時，我們也可以提供更多見解。關於您關於其他計劃的第三個問題，我們肯定會根據我們長期關注的幫助來評估其他計劃，即為所有會員提供全方位的產品和服務。

In terms of viewing the ACO program, in terms of a growth lever, it definitely is a growth lever. It's a way for us to build a relationship with new providers and further expand it over the years and -- as well as for our existing providers to make sure we have a program for all of their members.

從觀看ACO程序來看，從增長槓桿來看，它絕對是一個增長槓桿。這是我們與新提供商建立關係並多年來進一步擴大關係的一種方式，也是我們現有提供商確保我們為其所有成員提供計劃的一種方式。

All right. Appreciate that. And then going back to another question about the Knox-Keene conversion. If you could add some additional color around potential timing of converting it across your other capitated lives in California. Like what is it tied to? Is it tied to provider -- payer contracts and so those expire over the course of 2 to 3 years. And as you renegotiate those, you need to get full risk contracts from them.

好的。感謝。然後回到關於諾克斯-基恩轉換的另一個問題。如果您可以在將其轉換到您在加利福尼亞州的其他按人頭生活的潛在時機上添加一些額外的色彩。比如它與什麼相關？它是否與提供商-付款人合同掛鉤，因此這些合同將在 2 到 3 年內到期。當你重新談判這些時，你需要從他們那裡獲得全額風險合同。

And so we might -- it might take 2 to 3 years to get fully converted? And if that's the case, like what is the lumpiness associated with that? And then second, I didn't fully understand how the EBITDA conversion on that would work? Like would it be symmetrical if you're going from like 40% risk to 100% risk if EBITDA should convert that way? Or was your hospital partner already sharing through the risk pool incentives, some of what the upside would be of taking full risk and so it's somewhere in between the 40% and 100%.

所以我們可能需要 2 到 3 年才能完全轉變？如果是這樣的話，那麼與之相關的塊狀是什麼？其次，我沒有完全理解 EBITDA 轉換是如何進行的？如果 EBITDA 應該這樣轉換的話，如果你要從 40% 的風險變成 100% 的風險，它會是對稱的​​嗎？或者您的醫院合作夥伴是否已經通過風險池激勵措施分享了承擔全部風險的一些好處，因此介於 40% 和 100% 之間。

Adam, this is Brandon. Thank you for joining the call. Good to hear from you. I can take this one. So around the timing of the operationalization of the RKK license, you're right, there will be lumpiness to it because it depends on the specific health plan partner and county combination for that to be signed and then approved and moved into the global risk arrangements. We don't necessarily have to wait until the end of expiration of each contract. So it's not like we have to wait 2, 3 years that that's the end of the current contract. That's something we're negotiating on a plan-by-plan basis to ensure it gets done as soon as possible.

亞當，這是布蘭登。感謝您加入通話。很高興聽到你的消息。這個我可以拿走因此，圍繞 RKK 許可證的運營時間，你是對的，它會出現混亂，因為這取決於具體的健康計劃合作夥伴和縣組合，以便簽署、批准並納入全球風險安排。我們不一定要等到每份合同到期為止。因此，我們不必等待 2、3 年，當前合同就結束了。這是我們正在逐個計劃進行談判的事情，以確保盡快完成。

I would guide towards at least 1 -- I would say, at least 1 plan in Southern California. We expect to be within the Restricted Knox-Keene umbrella this year in 2023 and the next -- and the rest should be phased in over the next 18 to 24 months. The delay really is around contracting with each payer and we're very diversified in terms of our payer mix as well as contracting with the appropriate hospital systems (inaudible) members that are included in each plan such that we have met with the adequacy. So that's something we've been working on already. Some of the investments we've been making on the Care Enablement side. And like I said earlier, we should have some results to show sometime this year.

我會指導南加州至少制定 1 個計劃——我想說，至少 1 個計劃。我們預計今年、2023 年和明年都將受到諾克斯-基恩限制保護傘的保護，其餘的應在未來 18 至 24 個月內分階段實施。延遲實際上是與每個付款人簽訂合同有關，我們在付款人組合方面非常多樣化，以及與每個計劃中包含的適當醫院系統（聽不清）成員簽訂合同，以便我們滿足充分性。這就是我們一直在努力的事情。我們在護理支持方面進行了一些投資。正如我之前所說，我們應該在今年某個時候展示一些成果。

And then in terms of conversion to EBITDA of the increased revenue -- the risk revenue related to those numbers moving into global risk, we're conservatively saying that we should expect only a couple of percent of that to convert to EBITDA year 0 because we're going to try to maintain the existing hospital relationships that keep in pull from a financial perspective. Over time, we certainly expect to accrue more of -- that EBITDA to accrue such that in the long term, it's 10% to 20% EBITDA margin on the entire book of business, including the institutional part of the risk.

然後，就增加的收入轉換為 EBITDA 而言——與這些數字相關的風險收入進入全球風險，我們保守地說，我們應該預計只有百分之幾可以轉換為第 0 年的 EBITDA，因為我們我們將努力維持現有的醫院關係，從財務角度保持拉動。隨著時間的推移，我們當然預計會積累更多的 EBITDA，從長遠來看，整個業務（包括機構風險部分）的 EBITDA 利潤率將達到 10% 到 20%。

That's just not going to happen year 0 because it takes time to kind of move the hospital partners into the right economic arrangements. So I would guide for that to also happen over 18 to 36 months for the EBITDA contribution to get to the scaled margin contribution that we expect. I hope that helps, Adam.

這在第 0 年是不會發生的，因為讓醫院合作夥伴進入正確的經濟安排需要時間。因此，我建議 EBITDA 貢獻也發生在 18 至 36 個月內，以達到我們預期的按比例調整的利潤率貢獻。我希望這有幫助，亞當。

And you made an interesting comment about the new geography investments coming in better than you expect. So less dilutive than the $5 million to $10 million you initially guided to. What specifically is driving that? Is it like you're growing patients faster, and so there's more fixed cost coverage or MLR ramping better? And based on what you're seeing, I guess, just is there anything to call out? Or do you see opportunity to invest further? Or like what metrics are you seeing? And what do you need to see to expand, I guess, further into next year in these new markets?

您對新的地理投資的表現比您預期的要好發表了有趣的評論。稀釋程度低於您最初指導的 500 萬至 1000 萬美元。具體是什麼推動了這一點？是不是患者增長速度更快，因此固定成本覆蓋範圍更大，或者 MLR 增長得更好？根據你所看到的情況，我想，有什麼值得指出的嗎？或者您認為有進一步投資的機會嗎？或者你看到了什麼指標？我想，為了明年在這些新市場上進一步擴張，你需要看到什麼？

Yes, totally. So in Q1, you can see in our Care Delivery segment, which is most of the investments we're making in new geographies came in around [$2 million less] in terms of operating income relative to last year's Q1. And that's kind of the extent of the investments we've been making. So it's around $8 million on an annualized run rate basis. I think we guided towards [5% to 10%] in each of the new markets. So it's on track to slightly lower in terms of an operating income hit than guided towards.

是的，完全可以。因此，在第一季度，您可以看到我們的護理服務部門，我們在新地區進行的大部分投資的營業收入與去年第一季度相比大約[減少了 200 萬美元]。這就是我們一直在進行的投資的程度。因此，按年化運行率計算，約為 800 萬美元。我認為我們在每個新市場的目標都是 [5% 到 10%]。因此，就營業收入影響而言，其預計將略低於指導目標。

The progress has been good. We've been adding a lot of the investments include adding net new providers, for example, and it takes time to ramp those providers up in terms of their patient panels. We're moving the fee-for-service folks into partial risk arrangements over time as well. So there's some investment needed for the infrastructure on the ground to operationalize that. So I would say it's going better than expected. Membership, as I mentioned earlier in the prepared remarks, has been growing ahead of curve. We're monitoring a number of fee-for-service members, number of capitated members, Star scores, incentive reimbursements and so on and so forth, and things are tracking. So really, it's going to be small "J curve" as we add on new providers to ramp for our patients, but we expect it to be kind of in the 10,000 Medicare mark sooner than expected.

進展良好。例如，我們一直在增加大量投資，包括增加淨新的提供商，並且需要時間來擴大這些提供商的患者群體。隨著時間的推移，我們也會將按服務收費的人員轉移到部分風險安排中。因此，需要對當地的基礎設施進行一些投資才能實現這一目標。所以我想說，事情比預期的要好。正如我之前在準備好的發言中提到的，成員數量一直在超前增長。我們正在監控付費會員的數量、按人頭付費的會員數量、星級評分、獎勵報銷等等，一切都在跟踪中。因此，實際上，隨著我們增加新的提供者來為我們的患者提供服務，這將是一個很小的“J 曲線”，但我們預計它會比預期更早達到 10,000 名醫療保險大關。

Okay. Great. And then I guess my last question is broader. Basically, we covered a lot of the managed care companies, and it seems like trend broadly has been more controlled or tighter than maybe some expected possible companies and med tech companies talking about accelerating volumes. And so just curious what you're seeing in terms of your capitated risk business around trend and what you're assuming for the rest of the year, how things came in versus expectations?

好的。偉大的。然後我想我的最後一個問題更廣泛。基本上，我們涵蓋了許多管理式醫療公司，而且總體趨勢似乎比一些預期的可能公司和醫療科技公司談論的銷量加速受到更多控製或更嚴格。因此，我想知道您在圍繞趨勢的資本風險業務方面看到了什麼，以及您對今年剩餘時間的假設，情況與預期相比如何？

Yes. You can see our Care Partners business that operating income actually grew quite well in line with revenue growth. So if I'm -- please correct me if I'm misunderstanding your question, but we're seeing volumes moderate, and we're keeping our medical loss ratios in control. You mentioned it's favorable relative to Q1 last year. And approximately in line, I think, it was like a 30 basis point increase from Q4 of last year to this year, but let me know if I missed your question.

是的。你可以看到我們的護理合作夥伴業務，營業收入實際​​上與收入增長保持良好的增長。因此，如果我誤解了你的問題，請糾正我，但我們看到數量適中，並且我們正在控制醫療損失率。你提到它相對於去年第一季度是有利的。我認為，從去年第四季度到今年，大約增長了 30 個基點，但如果我錯過了你的問題，請告訴我。

Yes. No, I guess things came in better than expected. I'm just curious, like into April, if things are continuing as you accrued and built into guidance?

是的。不，我想事情的進展比預期的要好。我只是很好奇，就像進入四月一樣，事情是否會按照您積累和納入指導的方式繼續下去？

Yes, we're seeing margins in line with Q1 going into Q2, yes. I wouldn't say it's materially better. It's probably in line.

是的，我們看到第二季度的利潤率與第一季度一致，是的。我不會說它在物質上更好。應該是在排隊吧

We have reached the end of our question-and-answer session. I would like to turn the call back over to Brandon for closing comments.

我們的問答環節已經結束。我想將電話轉回布蘭登以徵求結束意見。

Great. Well, thank you all for your time today. We appreciate it. We thank you for joining the call. We're always open to a dialogue with investors and welcome visitors to our offices in Los Angeles. Please feel free to reach out to us or Investor Relations firm, the Equity Group, if you have any additional questions. And we look forward to speaking to you all again on our next quarterly call. Thank you.

偉大的。好的，謝謝大家今天抽出時間。我們很感激。我們感謝您加入此次通話。我們始終樂於與投資者對話，並歡迎訪客來到我們位於洛杉磯的辦公室。如果您有任何其他問題，請隨時聯繫我們或投資者關係公司 Equity Group。我們期待在下一次季度電話會議上再次與大家交談。謝謝。

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

謝謝。今天的會議到此結束。此時您可以斷開線路，感謝您的參與。