Astrana Health Inc (ASTH) 2025 Q1 法說會逐字稿

Good day everyone and welcome to today's Astrana Health first quarter 2025 earnings call. At this time, all participants are in a listen-only mode. Later you will have an opportunity to ask questions during the question and answer session, and instructions will be provided at that time.

大家好，歡迎參加今天的阿斯特拉納健康 2025 年第一季財報電話會議。此時，所有參與者都處於只聽模式。稍後您將有機會在問答環節中提問，屆時將提供說明。

Today's speakers will be Brandon Sim, President and Chief Executive Officer of Astrana Health, and Chan Basho, Chief Operating Financial Officer.

今天的演講者是阿斯特拉納健康公司總裁兼執行長布蘭登·西姆 (Brandon Sim) 和首席營運財務長陳·巴紹 (Chan Basho)。

The press release announcing Astrana Health, Inc.'s results for the first quarter ended March 31, 2025 is available at the investors section of the company's website at www.astranahealth.com. The company will discuss certain non-GAAP measures during this call. Reconciliations to the most comparable GAAP measures are included in the press release to provide some additional background on it results, the company has made a supplemental deck available on its website. A replay of the broadcast will also be available at Astrana Health's website after the conclusion of this call.

宣布 Astrana Health, Inc. 截至 2025 年 3 月 31 日的第一季業績的新聞稿可在公司網站 www.astranahealth.com 的投資者部分查閱。該公司將在本次電話會議中討論某些非公認會計準則指標。新聞稿中包含了與最具可比性的 GAAP 指標的對賬，以提供有關其業績的一些額外背景信息，該公司已在其網站上提供了補充資料。本次通話結束後，阿斯特拉納健康網站的廣播重播也將提供。

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附帶資訊包含 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, 2025, continued growth, acquisition strategy, ability to deliver sustainable long term value, ability to respond to the changing environment, liquidity, operational focus, strategic growth plans, and acquisition integration efforts.

這些前瞻性陳述可以透過預期、相信、期望、未來、計劃、展望和意願等術語來識別，包括但不限於有關公司對截至 2025 年 12 月 31 日的年度指導、持續增長、收購戰略、提供可持續長期價值的能力、應對不斷變化的環境的能力、流動性、運營重點、戰略增長計劃和收購整合努力的陳述。

Although the company believes that the expectations reflected in its statements are reasonable as of today, these statements are subject to risk and uncertainties that can cause the actual results to differ materially from those projected. There can be no assurance that these expectations will prove to be correct. Information about the risks associated with investing in Astrana Health 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.

儘管該公司認為其聲明中反映的預期截至今天是合理的，但這些聲明受風險和不確定性的影響，可能導致實際結果與預測有重大差異。沒有人能保證這些預期一定是對的。有關投資阿斯特拉納健康的相關風險的資訊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查看這些資訊。除法律要求外，本公司不承擔因新資訊、未來事件、市場條件變化或其他原因而更新任何前瞻性聲明的義務。

Regarding the disclaimer language, I would also like to refer you to slide two of the conference call presentation for further information.

關於免責聲明，我還想請您參閱電話會議簡報的第二張投影片以獲取更多資訊。

With that, I'll turn the call over to Astrana Health's, President and Chief Executive Officer, Brandon Sim. Please go ahead, Brandon.

說完這些，我將把電話轉給阿斯特拉納健康公司總裁兼執行長 Brandon Sim。請繼續，布蘭登。

Good afternoon and thank you all for joining us today.

下午好，感謝大家今天的參加。

We're pleased to report a strong start to the year. With first quarter results that reflect the continued momentum behind our strategy to build the nation's leading patient-centered healthcare platform.

我們很高興地報告今年開局強勁。第一季的業績反映了我們打造全國領先的以患者為中心的醫療保健平台策略的持續發展勢頭。

At Astrana, our progress is rooted in disciplined execution across four strategic pillars: first, we are sustainably growing our membership to expand access to high quality care for more Americans; second, we are strengthening alignment between patient outcomes and financial performance through thoughtful risk progression in our value-based arrangements; third, we are improving care quality and patient outcomes while managing costs effectively; and fourth, we are driving operational excellence through our proprietary care enablement platform, which supports clinical teams, enhances workflow efficiency, and scales our impact.

在阿斯特拉納，我們的進步植根於四大戰略支柱的嚴格執行：首先，我們正在持續增加我們的會員人數，以擴大更多美國人獲得高質量醫療服務的機會；第二，我們通過基於價值的安排中深思熟慮的風險進展，加強患者結果與財務績效之間的協調；第三，我們在有效管理成本的同時，提高護理質量和患者治療效果擴大臨床效率；

What continues to differentiate Astrana and what really drives our consistent performance across all market and policy environments is a combination of our physician-led clinical capabilities and our delegated model, which enables us to act as a single payer for our physicians.

阿斯特拉納 (Astrana) 的持續差異化以及真正推動我們在所有市場和政策環境中持續表現的是我們以醫生為主導的臨床能力和委託模式的結合，這使我們能夠作為醫生的單一付款人。

Our care delivery infrastructure integrates high performing provider networks with direct care delivery capabilities in our clinics and with our care management teams, enabling us to manage care more proactively and more consistently.

我們的醫療服務提供基礎設施將高效能提供者網路與我們診所和護理管理團隊的直接醫療服務提供能力相結合，使我們能夠更主動、更一致地管理護理。

In parallel, our delegated paraagnostic model allows us to build longitudinal patient relationships and gives us real-time visibility into utilization and claims, allowing for earlier interventions, more coordinated care over time rather than episodic interventions, and ultimately better outcomes.

同時，我們的委託副不可知論模型使我們能夠建立縱向的患者關係，並讓我們即時了解利用率和索賠情況，從而實現更早的干預，隨著時間的推移提供更協調的護理而不是偶發性幹預，並最終獲得更好的結果。

When paired with our proprietary technology platform, we're able to address regional differences in a consistent way, identify anomalies, and act on insights in real time. The result is greater stability and predictability in both medical cost trend and MLR performance regardless of geography, policy environment, or economic cycle.

與我們的專有技術平台結合，我們能夠以一致的方式解決區域差異，識別異常，並即時採取行動。結果是，無論地理位置、政策環境或經濟週期如何，醫療成本趨勢和 MLR 表現都具有更大的穩定性和可預測性。

With that, I'll share some financial highlights from the first quarter. In the quarter, Astrana generated total revenue of 620.4 million, a 53% increase compared to the prior year period and delivered adjusted EBITDA of 36.4 million. Revenue growth was driven by our care partner segment, which grew 57% year over year to 600 million. DHS contributed 95 million in the quarter, which was in line with our expectations.

我將分享第一季的一些財務亮點。本季度，阿斯特拉納的總營收為 6.204 億，比去年同期成長 53%，調整後 EBITDA 為 3,640 億。收入成長主要得益於我們的護理合作夥伴部門，該部門收入年增 57%，達到 6 億。DHS 本季貢獻了 9,500 萬美元，符合我們的預期。

Adjusted EBITDA in the first quarter reflected our continued success in growing membership and value-based arrangements while managing cost trend effectively. Margins were moderated by planned ongoing investments in growth, integration, and technology, as well as by revenue growth in areas with lower near-term margin profiles such as the CHS acquisition and newly converted full risk members, which was consistent with expectations. We expect this to improve in 2026 as previously guided as CHS moves towards break even this year and as our full risk cohorts further mature.

第一季調整後的 EBITDA 反映了我們在有效管理成本趨勢的同時，在增加會員數量和基於價值的安排方面取得的持續成功。利潤率受到計劃中對成長、整合和技術的持續投資以及近期利潤率較低領域的收入成長（如 CHS 收購和新轉變的全風險成員）的影響，但與預期一致。我們預計，隨著 CHS 今年實現收支平衡，且我們的全風險群體進一步成熟，這種情況將在 2026 年得到改善，正如先前的預測。

Medical cost trend in the quarter was in line with expectations in the mid single digits, blended across all lines of business. With Medicaid trend above and Medicare and commercial trend below that blended average.

本季的醫療成本趨勢與預期相符，處於中等個位數，涵蓋所有業務線。醫療補助趨勢高於此混合平均值，而醫療保險和商業趨勢低於該混合平均值。

Diving a little deeper here, despite a challenging flu season which drove higher than normal and lab utilization, we are pleased to be on track with our full year trend and profitability guidance.

深入一點，儘管流感季節充滿挑戰，導致實驗室利用率高於正常水平，但我們很高興全年趨勢和盈利預期能夠順利實現。

Turning to growth, our care partner segment continues to expand, reaching 910,000 members as of Q1 2025. We're also making disciplined progress in transitioning our membership into more strategically aligned full risk arrangements. As of this quarter, approximately 38% of our members are now in full risk contracts, up from 5.5% a year ago. And those members now account for 75% of our capitated revenue.

談到成長，我們的護理合作夥伴部門持續擴大，截至 2025 年第一季已達到 91 萬名會員。我們也正在穩步推進會員國向更具戰略一致性的全面風險安排的轉變。截至本季度，我們約有 38% 的會員簽訂了全風險合同，高於一年前的 5.5%。這些會員現在占我們人均收入的 75%。

Turning to our emerging markets, Nevada and Texas, we are seeing encouraging progress in both growth and operational execution in those markets. In Nevada, we achieved break even in both our risk bearing network and our Astrana care clinics during Q1, right on track with expectations. Membership in our risk bearing network grew 40% and clinic visit volume increased by 35% year over year, reflecting strong momentum in Nevada.

轉向我們的新興市場內華達州和德克薩斯州，我們看到這些市場在成長和營運執行方面都取得了令人鼓舞的進展。在內華達州，我們在第一季的風險承擔網絡和阿斯特拉納護理診所均實現了收支平衡，完全符合預期。我們的風險承擔網絡的會員人數增加了 40%，診所就診量年增了 35%，反映了內華達州的強勁發展勢頭。

In Texas, we continue to transform the market to align with our single payer delegated model over time, and we remain on track with reaching profitability in late 2025. These results reinforce the portability and scalability of the Astrana model and we're pleased to see performance in these markets tracking in line with our strategic plan.

在德州，我們將繼續改變市場，使其與我們的單一付款人委託模式保持一致，並且我們仍有望在 2025 年底實現盈利。這些結果強化了阿斯特拉納模型的可移植性和可擴展性，我們很高興看到這些市場的表現符合我們的策略計畫。

Now, turning to acquisitions. In 2024, our focus was on expanding our footprint and deepening our presence in key communities across the country. In 2025, our priority shifts to executing on that growth to unlock greater value across the platform.

現在，談談收購。2024 年，我們的重點是擴大我們的影響力並深化我們在全國主要社區的影響力。2025 年，我們的重點將轉向實現這一成長，以在整個平台上釋放更大的價值。

Starting with CHS, integration onto the Astrana platform for CHS is now complete. As expected, we've identified and executed on over $10 million in G and A efficiencies as CHS has onboarded to our proprietary technology platform.

從 CHS 開始，CHS 與 Astrana 平台的整合現已完成。正如預期的那樣，隨著 CHS 加入我們的專有技術平台，我們已經確定並執行了超過 1000 萬美元的 G 和 A 效率。

CHS's Q1 performance was in line with the expectations. And as we continue to implement our care model and scale it, we anticipate CHS will reach break even profitability in 2025 and achieve profitability in 2026. We're also making measured progress in expanding our delegated activities in 2026 and beyond.

CHS 第一季的業績符合預期。隨著我們繼續實施我們的護理模式並擴大其規模，我們預計 CHS 將在 2025 年實現收支平衡，並在 2026 年實現盈利。我們也在擴大 2026 年及以後的授權活動方面取得了穩步進展。

As for a planned acquisition of Prospect Health, we remain highly confident in the opportunity ahead. The transaction will significantly expand our provider network in Southern California and will position us to serve approximately 1.7 million members in value-based arrangements. We continue to expect prospect to contribute around 81 million in adjusted EBITDA and to deliver between 12 million to 15 million in synergies and we look forward to closing on the acquisition this summer.

至於計劃收購 Prospect Health，我們對未來的機會仍然充滿信心。這項交易將大大擴展我們在南加州的供應商網絡，並使我們能夠以價值為基礎的方式為約 170 萬會員提供服務。我們繼續預計該收購將為調整後的 EBITDA 貢獻約 8,100 萬英鎊，並帶來 1,200 萬至 1,500 萬英鎊的協同效應，我們期待今年夏天完成收購。

As we integrate and scale these acquisitions, it's equally important that we continue strengthening the foundation of our organization. To that end, we've made several exciting additions to our leadership team this quarter.

在我們整合和擴大這些收購的同時，持續加強我們組織的基礎也同樣重要。為此，本季我們為領導團隊增添了幾位令人興奮的新成員。

Georgie Sam has joined us as Chief Data and Analytics Officer to lead our enterprise-wide data, analytics and AI strategy. Glenn Sobotka has come on board as Chief Accounting Officer, bringing deep experience to support our continued financial discipline and scalability. And we're excited to have Rita Pew step up into the role of Chief People Officer, helping us further invest in the talent and culture that drives Astrana forward.

Georgie Sam 已加入我們，擔任首席數據和分析官，領導我們企業範圍的數據、分析和人工智慧策略。Glenn Sobotka 已加入公司擔任首席會計官，他擁有豐富的經驗，可以支持我們持續保持財務紀律和可擴展性。我們很高興麗塔·皮尤 (Rita Pew) 擔任首席人才官，幫助我們進一步投資於推動阿斯特拉納前進的人才和文化。

Now I'd like to touch on several recent industry-wide developments. Starting with Medicare Advantage rates, we're encouraged by the 2026 Medicare Advantage rate notice, which we believe signals continued federal support for both the MA program and value-based care more broadly.

現在我想談談最近整個行業發生的幾件大事。從醫療保險優勢計劃 (Medicare Advantage) 費率開始，我們對 2026 年醫療保險優勢計劃 (Medicare Advantage) 費率通知感到鼓舞，我們認為這表明聯邦政府將繼續更廣泛地支持 MA 計劃和基於價值的醫療服務。

The final rates reinforce a stable reimbursement outlook and should serve as a tailwind for Astrana's current business. And even more so for the performer business once the prospect acquisition is complete, given the combined scale of the of the performer platform.

最終費率鞏固了穩定的償還前景，並將成為阿斯特拉納當前業務的順風。考慮到表演者平台的綜合規模，一旦潛在客戶的收購完成，表演者業務就更加如此。

Turning to California's Proposition 35, this was not a headwind for Astrana in Q1. While we are still working through the broader implications of the legislation with our plan and provider partners, our current view is that the net impact will be neutral to EBITDA once resolved.

談到加州第 35 號提案，這對阿斯特拉納第一季來說並不是一個阻力。雖然我們仍在與我們的計劃和提供者合作夥伴一起研究該立法的更廣泛影響，但我們目前的觀點是，一旦解決，其淨影響將對 EBITDA 保持中性。

With regards to V28, we have not seen a negative impact on our business. We have always taken a principled approach to value-based care, finding success by driving better patient outcomes and higher quality of care, not by exploiting reimbursement mechanics. We believe that this is the only way to build a durable company and to deliver on a differentiated care experience improved outcomes for our patients.

就 V28 而言，我們尚未看到其對我們的業務產生負面影響。我們始終堅持以價值為基礎的原則性護理方法，透過推動更好的患者治療結果和更高的護理品質來獲得成功，而不是利用報銷機制。我們相信這是建立一家持久的公司並為患者提供差異化護理體驗、改善治療結果的唯一途徑。

Similarly, our exposure to part D risk remains de minimis with less than 2% of our members with any exposure. That is entirely by design. We have always remained disciplined about taking on risk where we believe we can have a meaningful impact. We have avoided exposure where that control is limited.

同樣，我們對 D 部分風險的暴露仍然很小，只有不到 2％ 的會員受到暴露。這完全是設計使然。我們始終堅持自律，勇於承擔我們認為能夠產生有意義影響的風險。我們避免在控制有限的情況下暴露。

To close my prepared remarks, we believe that our ability to grow rapidly while delivering consistent profitable results is a direct outcome of our proving care model, disciplined execution, the proprietary AI enabled technology infrastructure built to scale. We are proud to continue demonstrating that value-based care can be both scalable and effective, driving strong performance while improving patient outcomes.

最後，我相信，我們之所以能夠快速成長並持續獲利，直接得益於我們可靠的護理模式、嚴格的執行以及可擴展的專有人工智慧技術基礎設施。我們很自豪地繼續證明基於價值的護理既可擴展又有效，能夠在改善患者治療效果的同時帶來強勁的表現。

With that, I will now hand it over to Chan to discuss our financials in more detail.

現在，我將把話題交給陳先生，讓他更詳細地討論我們的財務狀況。

Thanks, Brandon, and thank you all for joining today.

謝謝，布蘭登，也謝謝大家今天的參加。

Turning to our first quarter results, I'm pleased to report that Astrana Health delivered a strong start to the year with performance in line with our expectations across all lines of business.

談到我們的第一季業績，我很高興地報告，阿斯特拉納健康今年取得了強勁的開局，所有業務線的業績都符合我們的預期。

Revenue for the quarter was 620.4 million, representing a year over year increase of 53%. This growth was driven primarily by strong organic growth in our core business and the acquisitions of CSC and CHS supplemented by our continued ramp in new geographies. Adjusted EBITDA came in at 36.4 million. Net income attributable to Astrana for the quarter was 6.7 million, and EPS was $0.14 per share.

本季營收為6.204億美元，年增53%。這一成長主要得益於我們核心業務的強勁有機成長、對 CSC 和 CHS 的收購以及我們在新地區的持續成長。調整後的 EBITDA 為 3,640 萬美元。本季歸屬於阿斯特拉納的淨收入為 670 萬美元，每股收益為 0.14 美元。

Looking at the balance sheet, we closed the quarter with 260.9 million in cash and short term investments. As we look ahead to closing the prospect acquisition this summer, our expected pro forma net leverage will be approximately 3.4 times, with the goal of delevering below three times within 12 months post close.

從資產負債表來看，本季末我們擁有 2.609 億美元的現金和短期投資。展望今年夏天完成潛在收購，我們預計的備考淨槓桿率將約為 3.4 倍，目標是在收購完成後 12 個月內將槓桿率降至 3 倍以下。

For the quarter we generated 13.6 million in free cash flow, which included a non-recurring debt issuance cost of 5 million related to the recent amendment of our credit agreement with trust. Excluding this one-time financing cost, free cash flow was 18.6 million, representing 51% of adjusted EBITDA for the quarter.

本季度，我們產生了 1,360 萬美元的自由現金流，其中包括與信託公司最近修訂信貸協議相關的 500 萬美元的非經常性債務發行成本。不包括這筆一次性融資成本，自由現金流為 1,860 萬美元，佔本季調整後 EBITDA 的 51%。

We remain confident in our ability to deliver within our previously stated full year guidance for revenue of 2.5 billion to 2.7 billion and adjusted EBITDA of 170 billion to 190 million.

我們仍然有信心能夠實現我們先前提出的全年預期，即收入 25 億至 27 億美元，調整後 EBITDA 1700 億至 1.9 億美元。

For second quarter 2025, we expect to generate between 615 million to 665 million of revenue with adjusted EBITDA ranging between 45 million to 50 million.

2025 年第二季度，我們預計營收在 6.15 億至 6.65 億之間，調整後的 EBITDA 在 4,500 萬至 5,000 萬之間。

Finally, we want to reiterate our previously stated medium-term adjusted guidance of at least 350 million in 2027. Despite the current environment, we remain confident in our ability to drive sustainable, profitable growth.

最後，我們要重申我們先前提出的中期調整指導，即到 2027 年至少達到 3.5 億。儘管當前環境如此，我們仍然對推動永續獲利成長的能力充滿信心。

With that, I'll turn it back to Brandon for closing remarks.

最後，我將把發言時間交還給布蘭登，請他做最後發言。

Thank you, Chan, and thank you everyone for your time today.

謝謝陳，也謝謝大家今天抽出時間。

In summary, we are proud of the progress we made in Q1, and we look forward to a strong rest of the year.

總而言之，我們對第一季的進展感到自豪，並期待今年剩餘時間的強勁表現。

We will now open it up for Q&A.

我們現在開始問答環節。

Thank you. We will now be conducting a question and answer session.

謝謝。我們現在將進行問答環節。

(Operator Instructions). One moment please while we pull for your questions.

（操作員指令）。請稍等片刻，我們正在回答您的問題。

Our first questions come from the line of Ryan Daniels with William Blair. Please proceed with your questions.

我們的第一個問題來自威廉布萊爾的瑞安丹尼爾斯。請繼續提問。

Yeah, thank you for taking the questions and congrats on the strong start to the year. Hoping you could go into a little bit more detail on the CHS integration. It sounds like that's progressed pretty smoothly, but I'm curious of any key integration activities or milestones that still remain, and just wanted to hear overall thoughts on how that's progressing. I know you indicated it's trending towards that breakeven level, but any more color there would be great to start.

是的，感謝您回答這些問題，並祝賀您今年取得了良好的開端。希望您能更詳細地介紹一下 CHS 整合。聽起來進展相當順利，但我很好奇是否還存在一些關鍵的整合活動或里程碑，只是想聽聽對進展的整體想法。我知道您指出它正趨向於盈虧平衡水平，但如果有更多的顏色，那將會是一個好的開始。

Hey Ryan, thank you for the question. I appreciate it.

嘿，Ryan，謝謝你的提問。我很感激。

On CHS, as I commented earlier, we're happy to say that integration is now complete. What that means is we have their staff onto our platform. We've deployed some of our technology platform into the provider groups.

關於 CHS，正如我之前評論的那樣，我們很高興地說整合現在已經完成。這意味著我們將他們的員工納入我們的平台。我們已經將部分技術平台部署到提供者群組。

We've identified opportunities over $10 million worth of G and A efficiencies by bringing on CHS, and we continue to expect improvements in care margins over the next several years as we fully implement the care model. So there's still opportunity to go and work to be done in terms of fully integrating and propagating the care model downstream, but we're very encouraged by the progress so far.

透過引入 CHS，我們發現了價值超過 1000 萬美元的 G 和 A 效率提升機會，隨著我們全面實施護理模式，我們預計未來幾年護理利潤率將繼續提高。因此，在全面整合和傳播下游護理模式方面仍有機會去做，但我們對迄今為止的進展感到非常鼓舞。

Okay, great. And then can you speak a little bit to the prospect deal? I know you've got the Hart-Scott-Rodino expected to close during the summer. Are you active in any integration activities yet, or do you have to wait till the close of that deal?

好的，太好了。然後您能稍微談談這項潛在交易嗎？我知道 Hart-Scott-Rodino 預計將於夏季關閉。您是否已經積極參與任何整合活動，還是必須等到交易結束？

And then secondarily, can you just remind us what your Medicare Advantage exposure will look like as a combined entity? Obviously you deployed capital before seeing the rate increases, so that looks even more strategic and profitable probably today than it was at the time of the announcement, so I want to get a feel for that too. Thanks.

其次，您能否提醒我們，作為一個合併實體，您的醫療保險優勢計劃 (Medicare Advantage) 風險敞口會是什麼樣的？顯然，您在看到利率上調之前就部署了資本，因此今天看起來可能比宣佈時更具戰略性和盈利能力，所以我也想感受一下這一點。謝謝。

Sure, yeah, so on prospects, as you mentioned, we have passed HSR approval. There are several regulatory approvals that we are still waiting for, primarily related to the State of California with the Department of Healthcare and the California Department of Public Health.

當然，是的，就前景而言，正如您所提到的，我們已經通過了 HSR 批准。我們仍在等待幾項監管部門的批准，主要涉及加州衛生部和加州公共衛生部。

So there are some items that we're still working on and until we have a full close we do don't want to be mindful and compliant. And so we haven't been able to dig as far under the hood as we will once the acquisition closes.

因此，有些項目我們仍在處理中，在專案完全結束之前，我們不想保持謹慎和順從。因此，我們無法在收購完成後深入挖掘其內部細節。

That being said, there are integration activities that we are doing in order to prepare for adding 600,000 members to our care enablement platform, so we're making the necessary upgrades to our data layers, to our technology platforms, and staffing up appropriately ahead of time. That's part of why we hired some of the individuals that we did and added to our leadership teams among many others at all levels of the company.

話雖如此，我們正在進行一些整合活動，為我們的護理支援平台增加 600,000 名會員做好準備，因此我們正在對我們的數據層、技術平台進行必要的升級，並提前適當配備人員。這就是為什麼我們聘用了一些人員，並將他們加入我們的領導團隊以及公司各個層級的許多其他人員的原因之一。

So that's something we're excited about in terms of the pro forma numbers for the combined entity. These are estimates, of course, but our anticipation today is that approximately 60% of the combined revenue of the businesses together will be related to Medicare. So and prospect as we had indicated before, will generate or generated $1.2 billion of revenue in 2024, a full year.

因此，就合併後實體的預測數字而言，我們感到非常興奮。當然，這些都是估計數，但我們今天的預期是，這些業務的總收入中約有 60% 將與醫療保險有關。因此，正如我們先前所指出的，預計 2024 年將全年產生 12 億美元的收入。

So we're excited again for the opportunity to continue onboarding or to start onboarding prospects into our platform and to serve those seniors once the deal closes.

因此，我們再次很高興有機會繼續引導或開始引導潛在客戶加入我們的平台，並在交易完成後為這些老年人提供服務。

Okay, great. And then one final one I'll hop off. You mentioned that Medicaid is trending above average trends, Medicare commercial below. On the Medicaid, is that solely due to the flu season and kind of more visits and lab, or is it primarily due to redetermination and kind of the mismatch between acuity and rates, which should settle out kind of mid-year or in October when all the states update their rates. Thanks guys.

好的，太好了。然後我要跳下最後一個。您提到醫療補助的趨勢高於平均趨勢，而商業醫療保險的趨勢低於平均趨勢。對於醫療補助，這僅僅是由於流感季節和更多的就診和實驗室檢查造成的，還是主要是由於重新確定以及敏銳度和費率之間的不匹配，這應該在年中或十月份所有州更新費率時得到解決。謝謝大家。

Sure, Ryan. That's right. Medicaid was above the blended average as we had expected.

當然，瑞安。這是正確的。正如我們預期的那樣，醫療補助高於混合平均水平。

There was a large spike in and lab utilization as you had pointed out, and that did contribute to the excess utilization. We're not seeing much. We're not seeing any impact really from a determination at this point. It's really around utilization and that trend even though above the blended average is still as expected for the year. So we're comfortable with that in Q1. We're going to continue monitoring in Q2, but at this time we're comfortable with the overall trend guidance we gave for the year, as well as what that translates into in terms of our adjusted EBITDA forecast for the year.

正如您所指出的，實驗室利用率大幅上升，這確實導致了過度利用。我們看到的並不多。目前我們還沒有看到這項決定真正產生任何影響。這實際上與利用率有關，儘管高於混合平均水平，但這一趨勢仍符合今年的預期。因此，我們對第一季的情況感到滿意。我們將在第二季度繼續監測，但目前我們對今年給出的總體趨勢指導以及這對我們今年調整後的 EBITDA 預測的影響感到滿意。

Great, thank you.

太好了，謝謝。

Sure, thanks.

當然，謝謝。

Thank you. Our next question comes from the line of Michael Ha with Baird. Please proceed with your questions.

謝謝。我們的下一個問題來自貝爾德的邁克爾·哈 (Michael Ha)。請繼續提問。

All right, thank you. So it looks like second quarter revenue guide 615, 655, a bit light versus the street and actually at the low end of your guide would imply a sequential decline, which is a bit surprising to me since I was expecting just continuing full risk member conversion, more organic and made growth to really help drive sequential improvement. I know exchange members maybe some attrition there still going through FTR checks, but I wouldn't think that would be a material enough to really fully offset the other positive drivers, so I'm curious, what's driving the low end of your guide range, what would have to happen for that to play out, and also what would have to happen for the high end to play out as well?

好的，謝謝。因此看起來第二季度的收入指南為 615,655，與華爾街的預測相比略低，實際上處於指南的低端意味著連續下降，這對我來說有點令人驚訝，因為我預計只是繼續進行完全風險成員轉換，更加有機和實現增長以真正幫助推動連續改善。我知道交易所會員中可能有一些仍在接受 FTR 檢查的人員流失，但我認為這不足以完全抵消其他積極因素，所以我很好奇，是什麼推動了您的指導範圍的低端，要實現這一點需要發生什麼，而且要實現高端也需要發生什麼？

Hey, Michael, thanks for the question. Some of these quarterly variances are simply just a seasonality thing. I'm, we're very confident in the overall guide for revenue.

嘿，邁克爾，謝謝你的提問。其中一些季度差異僅僅是季節性因素。我對整體收入指南非常有信心。

The guide is at the midpoint 2.6 billion is something we're very confident in. There's going to be additional, or probably more of the full conversion is weighted towards the back half of the year, especially as we try to get through some of the Medicaid renegotiations that we discussed before and the volatility in that sector right now. But again, we're very, I would say that we're very confident in the '25 to '27 guide that we put out for revenue at the beginning of the year.

指南中設定的中間值是 26 億，我們對此非常有信心。還會有更多，或者可能更多的全面轉換將集中在今年下半年，特別是當我們試圖完成之前討論過的一些醫療補助重新談判以及目前該領域的波動時。但我想說的是，我們對年初發布的 2025 年至 2027 年收入指南非常有信心。

Okay, thank you. And with the 26 month rate coming in so favorably, just curious what rate assumption was embedded in your 350 million adjusted EBITDA 2027 target. Just trying to figure out how much better the new final notices relative to that. And then when it comes, as it relates to the Medicaid, 70% of your contracts are locked rates. Just curious, what percentage of those contracts are up for renewal in '25, '26, '27, just trying to better visualize how the Medicaid economics can improve over the next three years and the magnitude of rate increases go through. Thank you.

好的，謝謝。而且 26 個月的利率如此有利，我只是好奇您的 3.5 億調整後 EBITDA 2027 目標包含了什麼利率假設。只是想弄清楚新的最終通知相對於那個有多好。然後，當涉及醫療補助時，70％的合約都是鎖定利率。只是好奇，這些合約中有多少百分比將在 25、26、27 年續簽，只是想更好地形象化地了解醫療補助經濟在未來三年內如何改善以及費率上漲的幅度。謝謝。

Hey Michael, I'm sorry you did. You were a little choppy in that question. I think I caught the gist of it, but if I didn't, please let me know. I apologize, but I think the question was how much of the rate increase did we assume in our 2027 medium term guide of at least 350 and you know the answer there is that we did assume some rate pick up.

嘿，邁克爾，我很抱歉你這麼做。你在這個問題上回答得有點不連貫。我想我抓住了它的要點，但如果沒有，請告訴我。我很抱歉，但我認為問題是我們在 2027 年中期指南（至少 350）中假設了多少利率增長，你知道答案是我們確實假設了利率有所上升。

I would say probably that the rate increase that we saw was favorable to our assumptions. At this moment, we're not ready to size exactly how many dollars that's worth in '27, given the dynamics of how the plans bid and how those dynamics play out in a couple of years, but we are encouraged by the administration's support for Medicare Advantage, and we continue to be confident in our both our '25 and '27 guides.

我想說，我們所看到的利率上升可能符合我們的假設。目前，考慮到計劃競標的動態以及這些動態在未來幾年內如何發揮作用，我們還沒有準備好準確估算出 27 年這筆錢的價值，但我們對政府對醫療保險優勢計劃的支持感到鼓舞，我們繼續對我們的 25 年和 27 年指南充滿信心。

I think the other question you asked was around the Medicaid contracts and what percentage of them are up for renewal. Is that right, Michael?

我認為您問的另一個問題是關於醫療補助合約以及其中有多少百分比需要續約。是這樣的嗎，麥可？

Yeah, sorry, I know 70% of your contracts are locked rates. Just trying to understand how many are up for renewal over the next three years. I want to better visualize as those renewals happen, how it can improve your Medicaid book over time?

是的，抱歉，我知道你們 70% 的合約都是鎖定利率。只是想了解未來三年內有多少需要續約。我想更清楚地了解這些更新如何隨著時間的推移改善您的醫療補助帳簿？

Got it.

知道了。

Thank you.

謝謝。

Right. Almost all of our, you're right, most of our Medicaid contracts are fixed rate, PMP today and to answer your question, almost all of our Medicaid contracts at some point in the next three years will be up for renewal. Those are typically staggered over time intentionally by plan, by county, even by state, I suppose, and by county. It will be a continuous, a fairly continuous set of renegotiations over the next two to three years.

正確的。您說得對，我們幾乎所有的醫療補助合約都是固定利率的，今天是 PMP，回答您的問題，我們幾乎所有的醫療補助合約在未來三年的某個時候都將續約。我認為，這些通常是按計劃、按縣、甚至按州和按縣有意地隨時間交錯的。在接下來的兩到三年裡，這將是一系列持續不斷的、相當持續不斷的重新談判。

Thank you. Our next questions come from the line of Jack Slevin with Jefferies. Please proceed with your questions.

謝謝。我們的下一個問題來自 Jefferies 的 Jack Slevin。請繼續提問。

Hey guys, thanks for taking the question and I work on the quarter. I think it's going to be quite similar to Michael's commentary or to his question, but really just want to maybe ask in a slightly different way. You gave the metrics on where utilization is trending right now. Your path has been quite different from many others in the industry and so to me the '26 rate update sort of flags is something that could be have an outsized impact relative to others that are undergoing different trends and so if it's trending below that 5% level right now, I guess I just want to think about sort of the confidence that we stay within that relevant range.

嘿夥計們，感謝你們回答這個問題，我正在處理本季的工作。我認為這與邁克爾的評論或問題非常相似，但實際上只是想以稍微不同的方式提問。您給出了當前利用率趨勢的指標。您的路徑與業內許多其他人截然不同，因此對我來說，'26 利率更新之類的標誌可能會對正在經歷不同趨勢的其他標誌產生巨大影響，因此，如果目前的趨勢低於 5% 的水平，我想我只是想想我們是否有足夠的信心保持在這個相關範圍內。

In which case we'd be looking at a '26 where at least on headline numbers and not assuming any mitigation of the '28, you'd still be able to see rev trend outstripping cost trend. Maybe just some thoughts generally on sort of how you see things progressing or what your confidence is in sort of the improvement of that MA market that you've done a lot of work to get to higher levels of risk on over the past couple of years. Thanks.

在這種情況下，我們會看到 26 年的情況，至少從總體數字來看，並且不假設 28 年的情況有任何緩解，你仍然能夠看到收入趨勢超過成本趨勢。也許只是一些關於您如何看待事情進展的想法，或者您對 MA 市場改善的信心，在過去幾年中，您為達到更高的風險水平做了很多工作。謝謝。

Thanks for the question. Yeah, I hear you and Michael on the question, I think.

謝謝你的提問。是的，我想我聽到了你和邁克爾的疑問。

At the moment we're not, it's still early on. We play an active role in how the plans bid, but we don't have ultimate control obviously over that process, so I don't want to be premature at this moment by sizing up the impact.

目前我們還沒有，一切還為時過早。我們在計劃競標過程中發揮積極作用，但顯然我們對這個過程沒有最終的控制權，所以我現在還不想過早評估其影響。

We are encouraged certainly very much so by the rate notice in 2026. It's something that we predicted and partially was part of our strategy to increase not only risk on the existing numbers that we have, but also to grow our senior membership via inorganic and organic means in 2024.

2026 年的利率通知確實讓我們深受鼓舞。這是我們預測到的事情，也是我們策略的一部分，不僅要增加現有會員數量的風險，還要在 2024 年透過無機和有機方式增加我們的高級會員數量。

So all of this is was partially expected by us and we're very encouraged by the fact that it happened. That being said, at the moment the guide is at least [215 2027]. We're very confident in that, given the prospect, the pending Prospect Health close. And I'm not sure that we have an exact EBITDA improvement number for you at this moment, but we are very encouraged by the rate update and we think that we will be able to take advantage of it given our renewed scope.

所以，這一切都是我們預料到的，而且它的發生也讓我們感到非常鼓舞。話雖如此，目前該指南至少[215 2027]。考慮到前景和即將完成的 Prospect Health 交易，我們對此非常有信心。我不確定我們目前是否有確切的 EBITDA 改善數字，但我們對利率更新感到非常鼓舞，我們認為，鑑於我們新的範圍，我們將能夠利用它。

Okay, got it. I appreciate that, Brandon. It's really helpful. And then just my follow up here, the commentary on Prop 35 was really helpful. I guess that to me adds a layer of complexity to a broader discussion on the California MCO tax. It sounds like OMB, like we don't have a lot of details, but it sounds like OMB may be taking a look at the MCO provider taxes and the structure of the one in California and New York.

好的，明白了。我很感激，布蘭登。這真的很有幫助。然後，我只是在這裡跟進一下，對第 35 號提案的評論確實很有幫助。我想，對我來說，這給加州 MCO 稅的更廣泛討論增加了一層複雜性。聽起來像是 OMB，好像我們沒有很多細節，但聽起來 OMB 可能正在研究 MCO 提供者稅以及加州和紐約州的稅結構。

I guess I just want to get a general sort of temperature check on what you're hearing or what you guys are trying to get smart on right now as it relates to that. I guess my understanding is not all the dollars have flowed through from the government yet on that provider tax and a lot of that was being sort of held to the side by California to push through it whether it be in rate increases or other things for a longer period of time. So maybe the immediate risk on that front would be lower, but we'd just love to get your thoughts either on that sort of moving piece specifically or sort of how you guys are thinking about attacking the problem.

我想我只是想對你們所聽到的內容或你們現在試圖了解的與此相關的內容進行一個總體了解。我想我的理解是，政府還沒有撥出全部資金用於支付服務提供者稅，其中很大一部分資金被加州擱置，以推動該稅的長期實施，無論是提高稅率還是採取其他措施。因此，也許這方面的直接風險會較低，但我們只是想聽聽您對這種移動部分的具體看法，或者您是如何考慮解決這個問題的。

Thanks. Yeah, this is still an ongoing situation, to be honest. As far as our best understanding of the situation, which I think you're very accurate on, those dollars have not flowed through to us.

謝謝。是的，說實話，這種情況仍在持續。據我們對情況的最佳了解，我認為您的了解非常準確，這些資金並沒有流向我們。

Almost all those dollars have not flowed through to us at this point in time, and there is an ongoing discussion at the state level as to when and how those funds will be used from the managed organization tax. There's obviously a federal policy portion of this as well, where depending on how the budget reconciliation goes. And by the way, there are promising signs that I don't want to be overly optimistic so early that Medicaid will be protected or at least somewhat protected in the budget reconciliation process in a bipartisan effort.

目前，幾乎所有這些資金都還沒有流向我們，而且州一級正在討論何時以及如何使用這些來自管理組織稅的資金。顯然，這也涉及聯邦政策部分，取決於預算協調的進展。順便說一句，有跡象表明，我不想過早過於樂觀，認為在兩黨共同努力的預算協調過程中，醫療補助將受到保護，或至少在一定程度上受到保護。

But that being said, There are a lot of variables, and our only certainty is that we believe the situation will be at the moment we're anticipating it to be net neutral to us in terms of adjusted EBITDA impact. If there are increased rates, that would be great. We would flow a lot of those through to our providers, and if not, we are prepared to absorb that without an adjusted EBITDA impact. So even with the lack of clarity, we continue to be confident in the '25 and '27 guides for Medicaid, and we'll keep you all updated certainly as we find out more.

但話雖如此，還有很多變數，我們唯一可以確定的是，我們相信目前的情況將是這樣的，我們預計就調整後的 EBITDA 影響而言，它對我們來說是淨中性的。如果利率上升，那就太好了。我們會將其中的大部分轉交給我們的供應商，如果沒有，我們準備好吸收這些費用，而不會對調整後的 EBITDA 產生影響。因此，即使缺乏明確的規定，我們仍然對 25 年和 27 年的醫療補助指南充滿信心，並且一旦發現更多信息，我們一定會及時向大家通報。

Got it. I appreciate all the color as always and nice work to again to you and the team.

知道了。我一如既往地欣賞所有的色彩，並再次向您和團隊表示感謝。

Thank you. Our next questions come from the line of Jailendra Singh with Truist Securities. Please proceed with your questions.

謝謝。我們的下一個問題來自 Truist Securities 的 Jailendra Singh。請繼續提問。

Thank you and thanks for taking my questions. Apologies if I missed this, but, one of your peers on the ACO reach site saw decent results in Q1. Just curious, how did the company perform from a profitability perspective there. We also saw there was some retro trend adjustment upgrade through March 31, which lowered the RTA likely creates a modest drag for the industry. Did you guys book that in Q1, or will that be in Q2, and it's in your outlook now?

謝謝您，也謝謝您回答我的問題。如果我錯過了這一點，請原諒，但是，ACO 覆蓋網站上的一位同行在第一季取得了不錯的成績。只是好奇，從獲利角度來看該公司的表現如何。我們也看到，截至 3 月 31 日，出現了一些逆勢調整升級，降低了 RTA，可能會對產業造成輕微拖累。你們是在第一季就預定了，還是會在第二季度預定，現在就在你的展望中？

Hey Jailendra, how are you? Thanks so much for the question. In terms of overall ACO, we did absorb the RTA and it was overall offset via stop loss and other puts and takes.

嘿，Jailendra，你好嗎？非常感謝您的提問。就整體 ACO 而言，我們確實吸收了 RTA，並且透過停損和其他看跌期權整體抵消了 RTA。

But you are seeing the slight drag on revenue still under especially due to the RTA coming in 1.097, just under the 1.01, which may be what you're alluding to.

但您會看到收入仍然受到輕微拖累，特別是由於 RTA 達到 1.097，略低於 1.01，這可能是您所暗示的。

Okay, and then, my follow up, congrats and best wishes to the new leadership team members. Can you share some thoughts on Georgie's role as Chief Data and Analytics Officer? What are some of the focus areas you guys have identified as near term and long term opportunities?

好的，然後，我要向新領導團隊成員表示祝賀和最良好的祝愿。您能否分享一些關於喬治擔任首席數據和分析官角色的看法？你們認為哪些重點領域是近期和長期機會？

Yeah, of course we're very excited to have him on board. He has a long and storied career helping healthcare organizations better utilize data to improve quality measures, to get to better stars, and to be proactive about insights for physicians and for our care teams. So very excited to have him.

是的，我們當然非常高興他能加入我們。他的職業生涯漫長而輝煌，致力於幫助醫療保健機構更好地利用數據來改善品質指標、獲得更好的評級，並積極主動地為醫生和護理團隊提供見解。我非常高興能擁有他。

In the near term, he's going to be ensuring that we have the data infrastructure or continuing to ensure rather that we have the data infrastructure set up to properly ingest over a billion dollars of revenue, 600,000 members across all lines of business, multiple counties, full risk members, partial risk members, the whole gamut from the from the pending Prospect Health acquisition. It is going to be a large lift to ensure that all the data pipelines are flowing appropriately into our data lake, into our unified data model, and then downstream into the applications that our care managers, clinicians, and ultimately the physicians use.

在短期內，他將確保我們擁有數據基礎設施，或繼續確保我們建立數據基礎設施，以正確吸收超過 10 億美元的收入、所有業務線的 600,000 名會員、多個縣、完全風險會員、部分風險會員以及即將進行的 Prospect Health 收購的全部範圍。這將是一個巨大的進步，以確保所有數據管道都能適當地流入我們的數據湖、統一的數據模型，然後流入我們的護理經理、臨床醫生以及最終醫生使用的應用程式中。

So. I think that's going to be very much a near term goal for the next six months as we head towards the close here and in the future, I think there are a lot of exciting opportunities that we've already been investing in that he will turbocharge in terms of AI applications, so summarizations of discharge notes, risk ratification, automation of workflow processes both for our delegated services as well as for physicians in the office, better integration.

所以。我認為這將是未來六個月的短期目標，因為我們即將結束這個項目，在未來，我認為我們已經投資了很多令人興奮的機會，他將在人工智慧應用方面提供動力，因此出院記錄的總結、風險批准、工作流程的自動化，無論是針對我們委託的服務還是辦公室的醫生，都能實現更好的整合。

With our data sources and real-time insights at the point of care and more, so Georgie's really excited, I think, to be joining us. We're excited to have him and it just continues to reflect the investments that we're making in data engineering and AI.

憑藉我們的數據來源和護理點的即時洞察等等，我認為喬治非常高興能加入我們。我們很高興能有他加盟，這也進一步體現了我們在數據工程和人工智慧領域的投資。

Great, thanks guys.

太好了，謝謝大家。

Thank you. Our next questions come from the line of Ryan Langston with TD Cowen. Please proceed with your questions.

謝謝。我們的下一個問題來自 TD Cowen 的 Ryan Langston。請繼續提問。

Hey, thanks. Kind of on top of the guidance questions, if I take the first quarter and the guided second quarter EBITDA, it looks like the full year, looks like it's slightly back half weighted, which is a little bit different than 2024, I believe. I guess is this from expected improvements in CHS as we move through the year or those kind of 15 million investments that you call about being more front loaded or maybe you just kind of walk us through the details of the cadence of those expectations?

嘿，謝謝。除了指導問題之外，如果我以第一季和第二季的指導 EBITDA 為例，它看起來就像全年一樣，看起來略微向後傾斜了一半，我認為這與 2024 年略有不同。我想這是因為我們預期 CHS 會在今年有所改善，或者是您所說的 1500 萬美元的投資會更加前期投入，或者您能不能向我們詳細介紹一下這些預期的節奏？

Hey Ryan, how are you? Thanks so much for the question.

嘿，瑞安，你好嗎？非常感謝您的提問。

Yeah, as we think about our guide for this year and what you saw last year. In 2024, you saw Q4 was skewed due to CHS, and there's other factors that contributed to the 2024 EBITDA. If you look at this year, flu impacted us.

是的，當我們思考今年的指南以及您去年看到的內容時。2024 年，您會看到第四季度因 CHS 而出現偏差，並且還有其他因素導致了 2024 年 EBITDA 的出現。回顧今年，流感對我們產生了影響。

As we think about the rest of the year, we're very confident in terms of our guide based on our expectations. Quarterly cadence for '25 is very much in line with what we're seeing. And what you'll really see is you'll see a larger percentage of our profitability coming in the back half of the year.

當我們考慮今年剩餘時間的情況時，我們對基於預期的指南非常有信心。25 年的季度節奏與我們所看到的非常一致。而您真正會看到的是，我們的獲利能力將在下半年大幅提升。

Got it. And then just finally, can you tell me what MSSP shared savings, if any, you booked this quarter? I think it was 5 million last quarter and I'm pretty sure it was 5 million embedded in this year's full year guide. So just looking if you booked anything in the first quarter. Thanks.

知道了。最後，您能告訴我本季您實現了哪些 MSSP 共享節省（如果有）嗎？我認為上個季度的數字是 500 萬，而且我確信今年全年指南中的數字也是 500 萬。所以只是看看您是否在第一季預訂了任何東西。謝謝。

Hey Ryan, so we booked zero in terms of MSSP in regards to the 2025 performance year. And as you will see in the latter half of the year as we gain more insight in terms of 2025 MSSP, we'll be booking something at that point. And yeah, you're correct. In 2020, in Q4 2025, we accrued 5 million for. For Q4 2024, we accrued 5 million for '24 dates of service and we guided to that 5 million to 6 million for '25 dates of service.

嘿，Ryan，所以我們在 2025 業績年度的 MSSP 方面預訂了零。正如您將在今年下半年看到的，隨著我們對 2025 年 MSSP 有了更多的了解，我們將在那時預訂一些東西。是的，你是對的。2020年，也就是2025年第四季度，我們累計了500萬。對於 2024 年第四季度，我們為 24 個服務日期累計了 500 萬美元，我們預計 25 個服務日期的累積金額為 500 萬至 600 萬美元。

That's great, thank you.

太好了，謝謝。

Thank you. Our next questions come from the line of Brooks O'Neil with Lake Street Capital Markets. Please proceed with your questions.

謝謝。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)。請繼續提問。

Thank you very much. Good evening, guys.

非常感謝。大家晚上好。

I'm just curious, realistically you've grown the organization at a far above average rate over the past couple of years. I give you tremendous credit for taking those opportunities, but could you give us a sort of a broad assessment of any stresses you feel for the organization right now and how you feel about the addition of prospect into any parts of the organization that are feeling stresses now?

我只是好奇，實際上，在過去幾年裡，你們的組織以遠高於平均的速度發展。我非常讚賞您抓住了這些機會，但您能否對我們目前對組織所感受到的壓力做一個廣泛的評估，以及您對將潛在客戶添加到組織中目前感受到壓力的任何部分有何感受？

Hey Brooks, good evening. Thanks for the question. I appreciate it.

嘿，布魯克斯，晚上好。謝謝你的提問。我很感激。

Yeah, as with any rapidly growing organization, over 50% growth year over year for this quarter. Last year was over, it was around 40% for the whole year in terms of growth.

是的，與任何快速發展的組織一樣，本季的成長率超過 50%。去年已經過去了，全年的成長大概是40%左右。

There are stresses, of course. There are, when I joined this organization we had fewer than 300 teammates and we're over 2000 today. We'll probably be close to 3,000 if not more, pending or accounting perform a pending acquisition, so I think there's certainly a lot of stress, in terms of ensuring that we're managing employees and many dozen states at this point in time.

當然，壓力是存在的。當我加入這個組織時，我們的隊友還不到 300 人，而今天我們的隊友已經超過 2000 人。我們可能有接近 3,000 人甚至更多，正在等待或會計執行待定收購，所以我認為在確保我們目前管理員工和數十個州方面肯定會有很大壓力。

Making sure that we're able to Integrate those employees into our cultural fabric, making sure that our systems are scalable, yet also customizable for each local market that we enter, over 15 markets at this point in time in many states relative to the one, when I joined this business many years ago.

確保我們能夠將這些員工融入我們的文化結構中，確保我們的系統可擴展，同時也能針對我們進入的每個本地市場進行定制，目前我們在許多州擁有超過 15 個市場，而我多年前加入這個公司時只有一個市場。

So certainly a lot of stresses due to that. It's a dynamic environment to use a kind word at the moment, so we are trying to navigate that and I'm really proud of the team for. Despite the rapid growth, being able to hold it together, continue to focus on our patients, which is the most important thing, and continue to deliver growth while being profitable at the same time.

因此肯定會帶來很多壓力。目前，這是一個充滿活力的環境，所以我們正在努力應對這種情況，我為這個團隊感到自豪。儘管成長迅速，我們仍能保持穩定，繼續關注我們的患者，這是最重要的事情，並在盈利的同時繼續實現增長。

We're really going to be focused, Brooks, this year on integration. We spent a lot of time integrating CHS, ensuring that the G and A synergies that we thought existed or came to fruition, and we're going to focus on much of the same thing for the next six to nine months as we get closer to the prospect closer.

布魯克斯，我們今年的重點將放在整合上。我們花了大量時間整合 CHS，確保我們認為存在或實現的 G 和 A 協同效應，並且隨著我們越來越接近這一前景，我們將在未來六到九個月內專注於同一件事。

Right. I appreciate all that color. Last thing I was curious about, obviously you're having a big growth in the amount of fully capitated lives or globally capitated lives, and I just love to hear any thoughts you have about the experience you've had as that number has gone up. It is the behavior consistent with your expectations or are you seeing anything different than that what you thought you'd see as the organization goes in that direction?

正確的。我很欣賞所有這些顏色。我最後好奇的是，顯然你們的完全人頭生活量或全球人頭生活量正在大幅增長，我很想聽聽你對這一數字增長過程中的經歷有何看法。這種行為是否與您的預期一致，或者當組織朝著這個方向發展時，您是否看到了與您想像的不同之處？

Thanks, Brooks. Yeah, we're seeing things in line. For the full risk cohorts, we're not going to see, as I guided before, we're not going to see the profitability pick up necessarily day one, but we are seeing those cohorts progress nicely as they move into full risk. We've invested in the infrastructure, most importantly to make that happen, so the inpatient case managers, the admin discharge transfer fees, all of that being piped into our care management applications that are a couple of 100, 400 clinical staff we're using to manage the populations in close to real time.

謝謝，布魯克斯。是的，我們看到一切都在正常進行。對於完全風險群體，正如我之前所指導的那樣，我們不會看到盈利能力在第一天就必然上升，但我們會看到這些群體在轉向完全風險時進展順利。我們已經在基礎設施上進行了投資，最重要的是實現這一點，因此住院病例管理員、行政出院轉院費用，所有這些都被輸入到我們的護理管理應用程序中，我們使用 100 到 400 名臨床工作人員來近乎實時地管理人群。

So those cohorts are progressing nicely, we believe, and we'll continue to be encouraged by that strategy of moving more members into full risk while growing prudently into other markets. I think the interesting thing is that prospect has been doing much of the same process in terms of moving members into these full risk arrangements and we think we're going to be able to turbocharge that when the two organizations are together in terms of the infrastructure we have to manage the total continuum of care for these patients.

因此，我們相信，這些群體正在順利發展，我們將繼續受到這項策略的鼓舞，讓更多成員承擔全部風險，同時謹慎地向其他市場發展。我認為有趣的是，前景在將成員轉移到這些全面風險安排方面一直在做相同的過程，我們認為，當兩個組織在基礎設施方面結合在一起時，我們將能夠增強這一點，我們必須管理這些患者的全程護理。

Great. Thank you very much. I'm looking forward to seeing that happen.

偉大的。非常感謝。我期待看到這一幕發生。

Thank you, Brooks.

謝謝你，布魯克斯。

Thanks.

謝謝。

Thank you. Our next questions come from David Larsen with BTIG. Please proceed with your questions.

謝謝。我們的下一個問題來自 BTIG 的 David Larsen。請繼續提問。

Hi, I've received a couple of questions about the prospect medical transaction, mainly from debt investors, and my sense from them is there may be some concern, I guess, about the transaction and the EBITDA in particular from Prospect Medical. I think you talked about 94 million of EBITDA from Prospect. Can you maybe just, I guess, give us a little more comfort around the earnings power of Prospect. How due diligence has that been? And then, how much EBITDA will Prospect add to your book when the deal actually closes. Thanks very much.

你好，我收到了一些關於 Prospect Medical 交易的問題，主要來自債務投資者，我的感覺是他們可能對這筆交易，特別是 Prospect Medical 的 EBITDA 有一些擔憂。我認為您談到了 Prospect 的 9,400 萬 EBITDA。我想，您能否讓我們對 Prospect 的獲利能力更加放心？這是多麼盡責啊？然後，當交易實際結束時，Prospect 會為您的帳簿增加多少 EBITDA。非常感謝。

Hey Dave, thanks for the question.

嘿，戴夫，謝謝你的提問。

So the audited financials for their fiscal year, which ends in Q3, plus the stub period that we had announced to the public last year was well above the 81 million of adjusted EBITDA that we anticipated to bring on that we announced at the close. We remain very confident in the 81 number and I'm not sure what the debtors are alluding to the creditors necessarily, but we have been looking at admin discharge transfer data. We've been looking at inpatient data. They also are in a delegated model, so we're looking at prior claims as well.

因此，他們財政年度（結束於第三季）的經審計財務狀況加上我們去年向公眾公佈的期末數據，遠高於我們在收盤時宣布的預計的 8,100 萬美元調整後 EBITDA。我們對 81 這個數字仍然非常有信心，我不確定債務人是否必然向債權人暗示什麼，但我們一直在查看行政解除轉移資料。我們一直在查看住院病人的數據。他們也處於委託模型中，所以我們也在考慮先前的索賠。

Of course, we can't see contractual details yet, to ensure that we stay compliant with, on a pre-closing basis. But all signs point to that 81 number being a solid number of which we can work with if and once we close the deal. So we look forward to, we genuinely look forward to showing you all the first quarter post close and helping dispel some of those concerns.

當然，我們還不能看到合約細節，以確保我們在交易完成前遵守合約規定。但所有跡像都表明，81 這個數字是一個可靠的數字，一旦我們達成交易，我們就可以利用這個數字。因此，我們期待，我們真誠地期待向大家展示第一季結束後的所有內容，並幫助消除其中的一些擔憂。

Great, thanks very much. And then, can you just please remind me what was the medical trend in the quarter? What is the projection for the year? And then, what is your visibility on that? One of your peers said that they typically have about 60% of claims by the end of each quarter, so there's a lot of IBNR that goes into any medical trend estimate for the quarter. Just thoughts around that and what sort of the key drivers are, in particular, oncology and oncology costs? Any thoughts that would be helpful. Thank you.

太好了，非常感謝。然後，您能否提醒我本季的醫療趨勢是什麼？今年的預測是什麼？那麼，您對此有何看法？您的一位同事表示，他們通常在每個季度末都會收到約 60% 的索賠，因此在該季度的任何醫療趨勢估計中都會包含大量的 IBNR。只是圍繞著這一點思考一下，特別是腫瘤學和腫瘤學成本的關鍵驅動因素是什麼？任何想法都會有幫助。謝謝。

Sure thing, we, as I mentioned in the prepared remarks, we remain confident in the full year trend which we had previously guided to 4.5% blended across all the lines of business. We came in slightly higher than that this quarter because of the flu that was entirely contemplated for in our 4.5% full year guidance, and we anticipate being able to meet that comfortably in the next three quarters to come.

當然，正如我在準備好的發言中提到的那樣，我們仍然對全年趨勢充滿信心，我們之前曾預測全年所有業務線的混合增長率為 4.5%。由於流感的影響，我們已將 4.5% 的全年預期完全考慮在內，因此本季度的業績略高於這一水平，我們預計未來三個季度我們能夠輕鬆實現這一目標。

We are not seeing any spikes necessarily in Oncology as you mentioned in Q1, the areas that we did see were mostly related to emergency room usage and especially laboratory usage. So that's something we're going to keep an eye on, but because of our ability to see claims and priors and inpatient data. The latter two on a more real-time basis, we feel confident in the 4.5% trend for the year at this moment.

正如您在第一季提到的那樣，我們並沒有看到腫瘤學領域出現任何峰值，我們看到的領域主要與急診室的使用，特別是實驗室的使用有關。所以這是我們要密切關注的事情，但由於我們能夠查看索賠、先前記錄和住院數據。後兩者基於更即時的數據，我們目前對今年 4.5% 的趨勢充滿信心。

Last quick one, tariffs, any impact potentially to your business, raising costs or from your customers, just any thoughts on tariffs, 25% on pharma potentially. Thanks.

最後一個問題，關稅，對您的業務有任何潛在的影響，增加成本或來自您的客戶，只是對關稅的任何看法，對製藥業的關稅可能為 25%。謝謝。

I think, as I mentioned in the prepared remarks, we're not taking much Part D risk at all. Less than 2% of our members have even a bit of Part D risk at all to them. The rest have zero exposure to that.

我認為，正如我在準備好的演講中提到的那樣，我們根本沒有承擔太多 D 部分的風險。我們的會員中只有不到 2% 的人面臨 D 部分風險。其餘的人對此毫無經驗。

Of course, there are minor secondary or maybe even tertiary type effects if there are increased costs on goods, medical equipment, etc., that our physicians would use. But for the most part of our 12,000 plus providers, these are partnered physicians that we are enabling and helping them earn far above the average primary care provider in their region. And so, we believe that our model is going to be very resilient and at least in the first, second, third, probably plus degree not impacted by potential tariffs at this time.

當然，如果我們的醫生使用的商品、醫療設備等的成本增加，那麼可能會產生輕微的二級甚至三級影響。但對於我們 12,000 多名醫療服務提供者中的大多數來說，這些都是合作醫生，我們正在為他們提供支持並幫助他們獲得遠高於其所在地區初級保健提供者平均水平的收入。因此，我們相信我們的模型將非常具有彈性，至少在第一、第二、第三，甚至更高程度上不會受到目前潛在關稅的影響。

Thanks very much. I'll hop back in the queue.

非常感謝。我會重新回到隊列中。

Thank you.

謝謝。

Thank you. Our next questions come from the line of Matthew Gilmore with Keybanc Capital Markets. Please proceed with your questions.

謝謝。我們的下一個問題來自 Keybanc Capital Markets 的 Matthew Gilmore。請繼續提問。

Hey, good afternoon, this is Zach. I'm from Matt. So like Payer talked about some unexpected variability with some new member risk adjustment coding. So, wanted to confirm you guys haven't seen any of these issues along those lines, and if you could maybe speak to your process as well. I'd appreciate it. Thank you.

嘿，下午好，我是札克。我來自馬特。因此，就像 Payer 談到一些新成員風險調整編碼的一些意外變化一樣。因此，我想確認一下你們是否沒有遇到類似這樣的問題，如果可以的話，是否可以談談你們的流程。我將非常感激。謝謝。

Hey, thanks for the question.

嘿，謝謝你的提問。

Typically new members absolutely do come in at a slightly lower rate depending on what was coded for them the prior year. So I can understand why someone would have that dynamic. I think we've been prudent to balance the new membership, ensuring that we're taking full risk on that membership once members are appropriately documented for in terms of their chronic conditions and once we're able to appropriately manage those chronic conditions from a cost perspective and a trend perspective.

通常，新成員的加入率確實會略低一些，這取決於前一年對他們的編碼。所以我能理解為什麼有人會有這種動力。我認為，我們一直謹慎地平衡新會員人數，確保在會員的慢性病得到適當記錄，並且我們能夠從成本角度和趨勢角度適當地管理這些慢性病後，我們會承擔該會員的全部風險。

So overall, yes, our newer cohorts, our net newer cohorts have slightly lower raft than our overall book. They do, but that's a normal dynamic that we've been dealing with for over 30 years. It's something that has already been contemplated in our guide for the year. From a go forward basis, we feel confident in our risk adjustment strategy. We've always, as I mentioned before, documented accurately, and the V-28 headwinds that I suspect some may be facing are we don't believe to apply to us as much or if at all.

所以總的來說，是的，我們的新客戶群，我們的淨新客戶群的筏子比我們的整體書籍略低。確實如此，但這是我們 30 多年來一直在處理的正常動態。這是我們今年的指南中已經考慮到的事情。從未來來看，我們對我們的風險調整策略充滿信心。正如我之前提到的，我們始終進行準確記錄，我懷疑有些人可能面臨的 V-28 逆風我們認為不會對我們產生太大影響，或者根本不會產生影響。

Great, thank you.

太好了，謝謝。

Thank you. Our next questions come from the line of Gene Mannheimer with Freedom Capital Markets. Please proceed with your questions.

謝謝。我們的下一個問題來自 Freedom Capital Markets 的 Gene Mannheimer。請繼續提問。

Oh thanks. Good afternoon. I thought you dropped me. Good job on the quarter. I just have one quick one. On CHS, you called out that you're tracking the break even exiting 2025. I'm just curious how long before you can get that asset, say back to your corporate margin. How long would that take? Thank you.

噢，謝謝。午安.我以為你把我丟下了。本季表現良好。我只有一個快速答案。在 CHS 上，您曾表示，您正在追蹤 2025 年的收支平衡點。我只是好奇你多久才能獲得該資產，比如說回到你的公司利潤。這需要多長時間？謝謝。

Hey Gene, thanks for the question. We would never drop you. We remember that you were there from the beginning, Gene. Thank you. Don't worry about that.

嘿，吉恩，謝謝你的提問。我們永遠不會拋棄你。我們記得你從一開始就在那裡，吉恩。謝謝。別擔心。

Yeah, no, we would never, thank you for the question, Gene. Thanks for hopping on. In terms of CHS, we will be, we're expecting to be break even this year, run rate break even this year as we previously guided. We expect that we'll be profitable in '26. I think we had guided, or yes, we had guided to at least 10 million of profitability in 2027, so at least in the near term till 2027.

是的，不，我們永遠不會，謝謝你的提問，吉恩。感謝您的參與。就 CHS 而言，我們預計今年將實現收支平衡，運行率也將實現收支平衡，正如我們之前所預測的那樣。我們預計26年我們將獲利。我認為我們已經預測到 2027 年盈利至少達到 1000 萬，或者是的，所以至少在短期內到 2027 年是這樣。

That is kind of the ramp up ramp up that we expect for CHS in terms of enterprise margins, over the long term we do believe that we can operate that business at enterprise margins, which would be in the high single digits EBITDA margin percent for Medicare Advantage and probably lower for Medicaid and ACO membership.

這是我們期望 CHS 在企業利潤率方面實現的成長，從長遠來看，我們確實相信我們可以以企業利潤率經營該業務，對於 Medicare Advantage 來說，EBITDA 利潤率將達到較高的個位數，而對於 Medicaid 和 ACO 會員來說，EBITDA 利潤率可能更低。

Okay, excellent. Thanks very much.

好的，非常好。非常感謝。

Thanks Gene.

謝謝吉恩。

Thank you. Our next questions come from the line of Andrew Mok with Barclays. Please proceed with your questions.

謝謝。我們的下一個問題來自巴克萊銀行的 Andrew Mok。請繼續提問。

Hi, this is Thomas Walsh for Andrew. Group Medicare Advantage has come under some pressure across the industry, and I was hoping you could share what your group MAX is and how it's performed relative to individual, and more generally, if you've seen any changes in patient behavior this quarter?

大家好，我是 Andrew 的 Thomas Walsh。團體醫療保險優勢計劃在整個行業都面臨著一些壓力，我希望您能分享一下您的團體 MAX 是什麼，以及它相對於個人的表現如何，更普遍地說，您是否發現本季度患者行為有任何變化？

Hey, how are you? In terms of our overall group versus individual mix, we're mostly individual and we haven't really seen any change in terms of mix shift.

嘿，你怎麼樣？就我們整個團體與個人組合而言，我們大多是個人，而且我們還沒有真正看到組合轉變方面的任何變化。

Got it. Okay, and I guess following up on the acceleration in and lab utilization in the Medicaid book, did you see a consistent acceleration through the end of the quarter or more of a spike which reverted?

知道了。好的，我想，根據醫療補助書中加速和實驗室利用率的情況，您是否看到了到本季末的持續加速，還是出現了回升的峰值？

Yeah, we did see a spike, particularly in January and a little bit into February, I would say that trends are as expected, especially now that we're here in May. And a lot of this spike was contemplated in our guidance when we first gave it back at the beginning of the year here.

是的，我們確實看到了峰值，特別是在一月份和二月份的一點時間，我想說趨勢是符合預期的，尤其是現在已經是五月了。當我們在今年年初首次給出指引時，我們已經在很大程度上考慮到了這種飆升。

Great, thanks for the call.

太好了，謝謝您的來電。

Thanks.

謝謝。

Thank you. We have reached the end of our question and answer session, and with that, I would like to bring the call to a close. We appreciate your participation today. You may disconnect your lines at this time. Enjoy the rest of your day.

謝謝。我們的問答環節已經結束，我想就此結束本次會議。我們感謝您今天的參與。現在您可以斷開線路。享受剩餘的一天。