ATI Physical Therapy Inc (ATIP) 2023 Q3 法說會逐字稿

Good afternoon, and welcome to ATI Physical Therapy's third quarter 2023 earnings conference call and webcast. All participants have been placed in the listen-only mode. After today's presentation, there will be an opportunity to ask questions. (Operator Instructions) Please note this event is being recorded.

下午好，歡迎參加 ATI Physical Therapy 2023 年第三季財報電話會議和網路廣播。所有參與者均已置於僅聽模式。今天的演講結束後，將有機會提問。 （操作員說明）請注意此事件正在被記錄。

On the call today is Sharon Vitti, Chief Executive Officer; Eimile Tansey, Chief People Officer; Joseph Jordan, Chief Financial Officer; and Joanne Fong, Senior Vice President, Treasurer, and Head of Investor Relations.

今天的電話會議由執行長莎朗維蒂 (Sharon Vitti) 主持。 Eimile Tansey，首席人力官；約瑟夫‧喬丹，財務長；以及資深副總裁、財務主管兼投資者關係主管 Joanne Fong。

I'll now turn the call over to Ms. Fong.

我現在將電話轉給方女士。

Thank you, Lisa. Good afternoon, everyone. Thank you for joining us today. To cover, we'd like to remind you that certain financial statements made during this call will be forward-looking statements which are subject to various risks and uncertainties and reflect our current expectations based on beliefs, assumptions, and information currently available to us.

謝謝你，麗莎。大家下午好。感謝您今天加入我們。為此，我們想提醒您，本次電話會議期間所做的某些財務報表將是前瞻性報表，這些報表會受到各種風險和不確定性的影響，並反映我們基於信念、假設和當前可所獲得的資訊的當前預期。

Although we believe that such expectations are reasonable, we undertake no obligation to revise any statements to reflect changes that occur after this call. Descriptions of some of the factors that cause actual results to differ materially from these forward-looking statements can be found in the Risk Factors section in the company's filings with the Securities and Exchange Commission.

儘管我們認為這種預期是合理的，但我們沒有義務修改任何聲明以反映本次電話會議後所發生的變更。導致實際結果與這些前瞻性陳述有重大差異的一些因素的描述可以在該公司向美國證券交易委員會提交的文件的風險因素部分中找到。

In addition, please note that the company will be discussing certain non-GAAP financial measures that we believe are important and evaluate performance. Details on relationship between these non-GAAP measures to the most comparable GAAP measures and reconciliation of historical non-GAAP financial measures can be found in the earnings press release that's posted on ATI's website and filed with the SEC.

此外，請注意，本公司將討論我們認為重要的某些非公認會計準則財務指標並評估績效。有關這些非 GAAP 衡量標準與最具可比性 GAAP 衡量標準之間的關係以及歷史非 GAAP 財務衡量標準調節的詳細信息，請參閱 ATI 網站上發布並提交給 SEC 的收益新聞稿。

And with that, I'd like to turn the call over to Sharon.

說到這裡，我想把電話轉給莎倫。

Thank you, Joanne. Welcome everyone to the ATI Q3 2023 earnings call. I wanted to let folks know that in addition to the EL team members Joanne mentioned, we also have Chris Cox, our COO, on the call; Scott Gregerson, our Chief Growth Officer, on the call; Gus Oakes, our Chief Information Officer; and Erik Kantz, our Chief Legal Officer. And they'll be available to participate in the Q&A.

謝謝你，喬安妮。歡迎大家參加 ATI 2023 年第三季財報電話會議。我想讓大家知道，除了 Joanne 提到的 EL 團隊成員之外，我們的營運長 Chris Cox 也參加了電話會議；我們的首席成長長 Scott Gregerson 在電話會議上； Gus Oakes，我們的資訊長；以及我們的首席法務官埃里克·坎茨 (Erik Kantz)。他們將可以參加問答。

So earlier today, we reported our third quarter 2023 results, and we delivered strong people, operating, and financial gains in the quarter. We have seen continued advancement in many areas within the ATI organization driven by our strong teamwork across the national platform and the continued passion around our mission to expand access to care and help people live their healthiest life.

今天早些時候，我們報告了 2023 年第三季業績，我們在本季度實現了強勁的人員、營運和財務收益。我們看到 ATI 組織內的許多領域不斷取得進步，這得益於我們在全國平台上強大的團隊合作以及對我們擴大護理機會和幫助人們過上最健康生活的使命的持續熱情。

So I'm going to go through some highlights of the third quarter and I'll start with growth. The demand for ATI services remained strong and was escalated in Q3. Our providers are committed to ensuring all new patients get started with their care at ATI as soon as possible as we know that is the best for the patients and their clinical outcomes.

因此，我將回顧第三季的一些亮點，我將從成長開始。對 ATI 服務的需求依然強勁，並在第三季有所升級。我們的提供者致力於確保所有新患者盡快開始在 ATI 接受護理，因為我們知道這對患者及其臨床結果是最好的。

So as our referrals convert to visit, it creates a vibrant and busy atmosphere that is palpable to our patients and our providers. In particular, in the quarter, our sales team outperformed expectations in generating physician referrals to our clinics. Q3 visits per day were the highest since the start of COVID. In September 2023, our referrals per day were greater than 3,000, which is an all-time high for us. Our visits per day per clinic was also the highest since the start of COVID.

因此，當我們的轉診轉化為就診時，它會營造出一種充滿活力和忙碌的氛圍，這對我們的患者和我們的服務提供者來說是顯而易見的。特別是，在本季度，我們的銷售團隊在向我們的診所推薦醫生方面超出了預期。第三季的每日訪問量是新冠疫情爆發以來最高的。 2023 年 9 月，我們每天的建議量超過 3,000，這是我們的歷史最高水準。我們每個診所的日均就診量也是新冠疫情爆發以來最高的。

Contributing to that favorable performance was the meaningful progress we've made in the quarter optimizing our clinical footprint -- clinic footprint. We closed 14 underperforming clinics in the quarter, bringing the year-to-date total of closures to 36. We also selectively opened three de novo clinics in the quarter, bringing the year-to-date total of openings to 13.

我們在本季在優化我們的臨床足跡（診所足跡）方面取得了有意義的進展，為這一良好的業績做出了貢獻。我們在本季關閉了14 家表現不佳的診所，使年初至今關閉的診所總數達到36 家。我們還在本季度選擇性地開設了3 家新開設的診所，使年初至今新開設的診所總數達到13 家。

Lastly, we've completed a strategic review of the market and our business capabilities. Under Scott Gregerson's leadership, we've identified several opportunities for growth beyond clinic footprint expansion. We look forward to discussing the areas of growth that position ATI to lead in the musculoskeletal sector as we make progress in the quarters ahead.

最後，我們完成了對市場和我們業務能力的策略審查。在 Scott Gregerson 的領導下，我們發現了診所規模擴張之外的一些成長機會。隨著我們在未來幾季取得進展，我們期待討論使 ATI 在肌肉骨骼領域處於領先地位的成長領域。

(technical difficulty) some key area for us, our people are what differentiate us from the competition. Eimile Tansey, who you'll hear from later, has done an outstanding job since joining the company just over a year ago. While her accomplishments are numerous, I want to call out two key areas.

（技術難度）對我們來說，在某些關鍵領域，我們的員工是我們在競爭中脫穎而出的關鍵。您稍後會聽到 Eimile Tansey 的講話，自從一年多前加入公司以來，他的工作表現非常出色。雖然她的成就眾多，但我想指出兩個關鍵領域。

Under Eimile's leadership, she's reorganized the talent acquisition team and positioned them as strategic business partners to our field leaders. She has also reestablished ATI's culture as people focused and is extending our refreshed ATI brands to the candidate pools.

在 Eimile 的領導下，她重組了人才招募團隊，並將他們定位為我們領域領導者的策略業務夥伴。她還重建了 ATI 以人為本的文化，並將更新的 ATI 品牌擴展到候選人庫。

As our people teams and programs gain traction, our base of clinical FTEs is growing and increasing our ability to provide more patients with access to high-quality care. Growing clinician headcount is an important unlock for our business. In the third quarter, the clinician headcount increased by an astounding 134 people, an all-time high growth number. This was achieved through a combination of targeted hiring and strong retentions. Eimile will go into details on our approach to provider acquisition and retention later in the call.

隨著我們的人員團隊和計畫獲得關注，我們的臨床 FTE 基礎正在不斷擴大，並增強了我們為更多患者提供高品質照護的能力。不斷增加的臨床醫生人數是我們業務的重要解鎖點。第三季度，臨床醫師人數增加了 134 人，創下歷史新高。這是透過有針對性的招募和強有力的保留相結合實現的。 Eimile 將在稍後的電話會議中詳細介紹我們取得和保留提供者的方法。

From an operations lens, we're continuously working to improve operations to positively impact the patient experience -- the patient journey -- clinician experience and our financials. In this quarter, the team notably drove rate per visit improvement and clinician productivity to favorably impact Q3 results.

從營運角度來看，我們不斷努力改善運營，以對患者體驗、患者旅程、臨床醫生經驗和我們的財務狀況產生積極影響。在本季度，該團隊顯著提高了每次就診率和臨床醫生的工作效率，對第三季度的業績產生了有利的影響。

So as we dig into rate, our rate per visit in Q3 was $109.90. That increased by more than $5 from the second quarter. Primary drivers include increases in contracted rates and operational improvements in revenue cycle management, both driving stronger revenue per visit in current and prior periods. While the improvement related to prior periods is onetime, the enhancements in revenue cycle management and contract rates should carry forward into 2024.

因此，當我們深入研究費率時，我們在第三季度的每次訪問費率為 109.90 美元。比第二季增加了 5 美元以上。主要驅動因素包括合約費率的增加和收入週期管理的營運改進，兩者都推動了當期和前期的每次訪問收入的成長。雖然與前期相關的改善是一次性的，但收入週期管理和合約費率的增強應該會延續到 2024 年。

Speaking of rates, the Medicare fee schedule final rules were just published. We're disappointed in the continuing Medicare fee schedule rate cuts for physical therapy. It makes no sense given the value and effectiveness of high-quality PT to our country's physical health.

說到費率，醫療保險費用表最終規則剛剛發布。我們對物理治療的醫療保險費用表費率持續下調感到失望。考慮到高品質PT對我國身體健康的價值和有效性，這是沒有意義的。

There is a bright spot on the CMS front for ATI. This is the fourth year that ATI has received an exceptional provider rating from the MIPS program, which is a Merit-Based Incentive Payment System, which is one of the CMS quality payment programs.

ATI 的 CMS 方面有一個亮點。這是 ATI 第四年獲得 MIPS 計劃的傑出提供者評級，該計劃是基於績效的激勵支付系統，也是 CMS 品質支付計劃之一。

The exceptional provider rating earned by our clinical team for high quality performance will again qualify the provider for a bonus percentage on top of the Medicare reimbursement rate and will be helpful to our 2024 financials once finalized.

我們的臨床團隊因高品質表現而獲得的卓越提供者評級將再次使提供者有資格獲得除醫療保險報銷率之外的獎金百分比，一旦最終確定，將對我們的 2024 年財務狀況有所幫助。

Onto provider productivity, our providers continue to perform at a high level sequential quarter over quarter. While Q3 showed up with a modest 0.2 visits per day per clinical FTE decline from Q2 to Q3, each established provider on average had slightly higher visits per day quarter over quarter on those days when in the clinic, basically accounting for higher vacation days taken during the summer months and the ramp time for all our new providers.

在提供者生產力方面，我們的提供者繼續按季度保持高水準表現。雖然從第二季度到第三季度，每個臨床FTE 每天的就診次數小幅下降0.2 次，但每個已建立的醫療服務提供者在診所期間平均每天的就診次數比季度略高，這基本上是因為在第三季期間休假天數較多。我們所有新供應商的夏季月份和斜坡時間。

Financials show consistent progress. In 2023, revenue increased every quarter from the prior sequential quarter. Q3 2023 marked ATI's highest revenue since the impact started, since the pandemic started in early 2020. Joe will provide detailed financial walk-through of Q3 results later in the call.

財務狀況顯示持續的進展。 2023 年，每季的營收都較上一季有所成長。 2023 年第三季是 ATI 自 2020 年初大流行開始以來的最高收入。喬將在稍後的電話會議中提供第三季業績的詳細財務概覽。

We have incredible teams at ATI that are making a difference in the lives of our patients in our communities every day. Today starts our ATI Employee Appreciation Week. I want to thank our talented and dedicated clinicians and leaders that emotionally invest and are passionate about enriching the lives of our colleagues, patients, and communities. You are what fuels ATI and makes us special.

ATI 擁有令人難以置信的團隊，他們每天都在改變我們社區患者的生活。今天就開始我們的 ATI 員工答謝週。我要感謝我們才華橫溢、敬業的臨床醫生和領導者，他們投入了情感，並熱衷於豐富我們同事、患者和社區的生活。你們是 ATI 的動力，讓我們與眾不同。

With that, I'll turn the call over to Eimile for a discussion of our people and performance during the quarter.

接下來，我會將電話轉給 Eimile，討論我們的人員和本季的業績。

Thanks, Sharon. I'd like to share what we're seeing in the current labor market and review the traction we've gained from our initiatives to hire and retain skilled providers and our programs to develop future leaders in the industry. The current labor market remains challenging, and we anticipate the headwinds we are facing to continue for some time.

謝謝，莎倫。我想分享我們在當前勞動力市場中看到的情況，並回顧我們從僱用和留住熟練供應商的舉措以及培養行業未來領導者的計劃中獲得的動力。目前的勞動力市場仍然充滿挑戰，我們預計我們面臨的阻力將持續一段時間。

While each local market has its unique nuances, the national imbalance between the supply of physical therapists and the demand for PT services will take several years to reach equilibrium. However, we've made good progress year to date with growing the clinical team, and I'm confident that we can continue to grow by working on the things we can control, specifically staying on top of the market trends, listening to our employees, and cultivating our culture.

雖然每個當地市場都有其獨特的細微差別，但全國物理治療師的供應與物理治療服務的需求之間的不平衡需要幾年時間才能達到平衡。然而，今年迄今為止，我們在臨床團隊的發展方面取得了良好的進展，我相信我們可以透過致力於我們可以控制的事情來繼續發展，特別是掌握市場趨勢，傾聽我們員工的意見，並培養我們的文化。

Last year, I discussed that I would be focused on increasing clinical candidates at the top of the funnel and on developing programs that would further advance ATI as an outstanding place for providers to start, build, and accelerate their careers.

去年，我討論過，我將專注於增加漏斗頂部的臨床候選者，並開發能夠進一步推動 ATI 成為服務提供者開始、建立和加速職業生涯的傑出場所的計畫。

This year, we are beginning to witness returns from these programs as we continue to forge a culture characterized by high level provider experience, clinical excellence, and outstanding customer service. This is reflected in the results of this year's employee engagement survey, where we received positive feedback, most notably around rewarding roles, respectful direct leaders, and an inclusive culture. We also identified areas of opportunity and are motivated to take the valuable feedback to continue improving our employees' experience and make ATI the employer of choice.

今年，我們開始見證這些計劃的回報，因為我們繼續創造一種以高水準的提供者經驗、卓越的臨床和出色的客戶服務為特徵的文化。這反映在今年員工敬業度調查的結果中，我們收到了正面的回饋，尤其是在獎勵角色、尊重的直接領導和包容性文化方面。我們也確定了機會領域，並積極收集寶貴的回饋，以繼續改善員工的體驗，並使 ATI 成為首選雇主。

As a result of the work we are doing around our people strategy, we have seen significant growth in our provider base. In the third quarter, as Sharon mentioned, clinician headcount grew 5% sequentially quarter over quarter. Furthermore, our retention metric has remained at pre-COVID levels now for two consecutive quarters. These improvements are evidence that we are doing the right things for our providers and our patients, enabling us to achieve our mission and expanding patient access to high-quality care.

由於我們圍繞人員策略所做的工作，我們看到我們的供應商基礎顯著成長。正如 Sharon 所提到的，第三季臨床醫師人數較上季成長 5%。此外，我們的保留指標已連續兩季維持在新冠疫情爆發前的水準。這些改進證明我們正在為我們的提供者和患者做正確的事情，使我們能夠實現我們的使命並擴大患者獲得高品質護理的機會。

I wanted to thank the entire HR team for all the hard work this year to get us to where we are now. We have many opportunities in front of us and have a focus on making sure we implement improvements and refinements that allow our providers to operate at the top of their license.

我要感謝整個人力資源團隊今年的辛勤工作，讓我們取得了現在的成績。我們面前有很多機會，我們的重點是確保我們實施改進和完善，使我們的提供者能夠在其許可範圍內運作。

I'm proud of ATI's outstanding brand, an amazing culture, and the progress we have made this year to further augment that culture. ATI is defined by our people, and I'm excited to continue the work we are doing to ensure ATI remains a great place to learn and grow.

我為 ATI 的傑出品牌、令人驚嘆的文化以及我們今年在進一步增強這種文化方面取得的進步感到自豪。 ATI 是由我們的員工定義的，我很高興能夠繼續我們正在做的工作，以確保 ATI 仍然是一個學習和成長的好地方。

Now, I'd like to turn it over to Joe for a financial review.

現在，我想將其交給喬進行財務審查。

Thank you, Eimile, and thank you to everyone for joining the call. I will cover our third quarter financial results, and I'll start out with net revenue, which was $177 million for the quarter. That's a 13% increase over the prior year, which reported net revenue of $157 million. And if we break that down a little bit further, net patient revenue was $162 million, which increased 14% year over year. And other revenue was $15 million, which is a 5% increase over the prior year.

謝謝你，艾米爾，也謝謝大家加入電話會議。我將介紹我們第三季的財務業績，並首先介紹該季度的淨收入，即 1.77 億美元。比前一年增長 13%，淨收入為 1.57 億美元。如果我們進一步細分，患者淨收入為 1.62 億美元，年增 14%。其他收入為1500萬美元，比上年增長5%。

As Sharon mentioned earlier, visits per day per clinic were up during the quarter at 25.9, and that's an increase of 0.2 versus the second quarter of 2023. And if we compare to the third quarter of the prior year, we increased our visits per day per clinic by 2.7. Now, these improvements in the visits per day per clinic metric reflect our continued efforts to fully utilize our clinics and ultimately, to optimize profit through leveraging our fixed costs.

正如Sharon 先前提到的，本季每個診所的每日就診次數增加了25.9 次，與2023 年第二季相比增加了0.2 次。如果我們與去年第三季相比，我們每天的就診次數有所增加每個診所 2.7。現在，每個診所每日就診量指標的這些改善反映了我們不斷努力充分利用我們的診所，並最終透過利用我們的固定成本來優化利潤。

Our rate per visit during the quarter, as Sharon said, was $109.90, which sequentially increased from $104.74 in the second quarter of 2023, which is about 4.9%, and from $103.46 or 6.2% from the third quarter of the prior year.

正如 Sharon 所說，我們本季的每次造訪費用為 109.90 美元，較 2023 年第二季的 104.74 美元（約 4.9%）和去年第三季的 103.46 美元（約 6.2%）有所增加。

And then focus on the sequential increase, the primary drivers were improvement in contracted rates, both new and existing contracts, and process improvements within the revenue cycle management function, which drove higher rate realization. A portion of which is related to prior claims, but as Sharon talked about earlier, portion that will continue into the fourth quarter and really beyond into next year.

然後專注於環比成長，主要驅動因素是合約費率（新合約和現有合約）的改善，以及收入週期管理功能內的流程改進，這推動了更高的費率實現。其中一部分與先前的索賠有關，但正如莎倫早些時候談到的那樣，部分將持續到第四季度，甚至持續到明年。

Salaries and related costs in the third quarter of 2023 was $97 million, which is a 7.5% increase over $90 million in the third quarter of the prior year. And the primary driver there is more clinicians and increased support staff supporting the higher revenue, and then a little bit of wage inflation and higher incentive payments as well.

2023年第三季的薪資及相關成本為9,700萬美元，較上年第三季的9,000萬美元成長7.5%。主要驅動因素是更多的臨床醫生和更多的支援人員支持更高的收入，然後是一點點工資上漲和更高的獎勵金。

Our PT salaries and related cost per visit during the quarter were $57.47, which sequentially increased from $54.81 in the second quarter of 2023, about 4.8%, and from $56.20 or 2.3% from the third quarter of the prior year. The quarter over quarter increase was primarily due to lower labor productivity with visits per day per clinical FTE declining by 0.2. But that's driven by seasonality when you move from Q2 to Q3, as well as onboarding new providers, and Eimile talked about all the new providers that were added in the third quarter.

本季我們的 PT 薪資和每次就診的相關費用為 57.47 美元，較 2023 年第二季的 54.81 美元環比增加約 4.8%，較去年第三季的 56.20 美元環比增加約 2.3%。環比成長主要是由於勞動生產力下降，每個臨床 FTE 每天的就診次數下降了 0.2。但這是由季節性因素驅動的，當你從第二季度轉向第三季度時，以及新提供者的加入，Eimile 談到了第三季度添加的所有新提供者。

When looking at year over year, the increase was primarily due to increased support staff and higher compensation per clinical FTE, which is partially offset by higher labor productivity when looking year over year of 0.6.

與去年同期相比，這一增長主要是由於支援人員的增加和臨床 FTE 薪酬的提高，而與去年同期相比，勞動生產力提高了 0.6，這部分抵消了這一影響。

Rent, clinic supplies, contract labor and other was $53 million or a 2.5% increase year over year from $51 million in Q3 of the prior year, and it's driven by increased spend on contract labor and outside services. And on a per clinic basis, these costs were approximately $57,000, which increased from $54,000 in both the second quarter of 2023 as well as the third quarter of 2022.

租金、診所用品、合約工及其他費用為 5,300 萬美元，較去年第三季的 5,100 萬美元同比增長 2.5%，這是由合約工和外部服務支出增加推動的。以每個診所計算，這些成本約為 57,000 美元，高於 2023 年第二季和 2022 年第三季的 54,000 美元。

Our provision for doubtful accounts for the quarter was $3 million, which is 2.1% of net patient revenue, compared to the third quarter prior year of $3 million and 2% of net patient revenue.

我們本季的呆帳準備金為 300 萬美元，佔病患淨收入的 2.1%，而去年第三季的呆帳準備金為 300 萬美元，佔病患淨收入的 2%。

And then SG&A during the quarter was approximately $25 million, which is essentially flat with the prior year. Our operating loss excluding impairment charges was $1 million, which improved year over year from $13 million loss in the prior year, reflecting the higher revenue generated in the current year.

該季度的 SG&A 約為 2500 萬美元，與去年基本持平。扣除減損費用後，我們的營業虧損為 100 萬美元，比前一年的虧損 1,300 萬美元有所改善，反映出本年度產生的收入較高。

Interest expense during the quarter was $15 million compared to $12 million in the third quarter of 2022 with the increase primarily driven by a higher interest rate environment and a lower hedge benefit. Income tax expense for the quarter was $100,000, compared to an income tax benefit of $7 million in the third quarter of the prior year. And net loss was $15 million, compared to $117 million in the third quarter of the prior year, which included $107 million in goodwill impairment charges in the prior year.

本季利息支出為 1,500 萬美元，而 2022 年第三季為 1,200 萬美元，成長主要是由於利率環境較高和對沖收益較低。本季的所得稅費用為 10 萬美元，而去年第三季的所得稅收益為 700 萬美元。淨虧損為 1,500 萬美元，而上年第三季的淨虧損為 1.17 億美元，其中包括去年 1.07 億美元的商譽減損費用。

Adjusted EBITDA during the third quarter was $9 million, and that's a 5.3% margin. It increased over the prior year when we had an adjusted EBITDA loss in the third quarter of $400,000. The year-over-year increase in adjusted EBITDA was primarily driven by higher revenue and the associated earnings that come along with that higher revenue.

第三季調整後 EBITDA 為 900 萬美元，利潤率為 5.3%。與去年同期相比有所增加，當時我們第三季調整後的 EBITDA 虧損為 40 萬美元。調整後 EBITDA 的年成長主要是由收入增加以及收入增加帶來的相關收益所推動的。

We're pleased with the progress that we made during the third quarter due to the hard work of our dedicated team. And with the momentum that we carried into the third quarter and through the third quarter and really even into the beginning of the fourth quarter, we remain confident with our adjusted EBITDA guidance and project to hit the high end of the guidance for revenue, which, as a reminder, was $680 million to $695 million, and the high end of the guidance of adjusted EBITDA, which was $30 million to $36 million range.

由於我們敬業的團隊的辛勤工作，我們對第三季的進展感到高興。憑藉我們進入第三季度、整個第三季度甚至第四季度初的勢頭，我們對調整後的 EBITDA 指導和達到收入指導上限的項目仍然充滿信心，其中，提醒一下，調整後EBITDA 指導的上限為6.8億美元至6.95 億美元，調整後的EBITDA 指引上限為3,000 萬美元至3,600 萬美元。

Our cash flow use year to date was $63 million with $18 million used to fund operations, $15 million used to fund investing activities, and $31 million used to fund financing activities. (technical difficulty) [An important to note] as part of the financing activities was $25 million in repayments on the revolving line of credit.

今年迄今，我們的現金流使用量為 6,300 萬美元，其中 1,800 萬美元用於為營運提供資金，1,500 萬美元用於為投資活動提供資金，3,100 萬美元用於為融資活動提供資金。 （技術困難） [值得注意的重要一點] 作為融資活動的一部分，循環信貸額度還款額為 2,500 萬美元。

And then as of September 30, 2023, our liquidity is approximately $40 million, and that $40 million consists of cash and cash equivalents of $20 million and available revolver capacity of $20 million. In addition to the $40 million of liquidity, we do have access to $25 million in a delayed draw term loan subject to certain restrictions.

截至 2023 年 9 月 30 日，我們的流動性約為 4000 萬美元，這 4000 萬美元包括 2000 萬美元的現金和現金等價物以及 2000 萬美元的可用左輪手槍容量。除了 4000 萬美元的流動資金外，我們還可以獲得 2500 萬美元的延遲提取定期貸款，但須遵守某些限制。

That wraps up the financial update. And now, I'd like to turn the call back over to Sharon for closing remarks.

財務更新到此結束。現在，我想將電話轉回給莎倫，讓她致閉幕詞。

Thanks, Joe. Thanks, Eimile, and Joanne, and everyone participating. We have momentum and are poised to lead in the musculoskeletal landscape. We've clearly demonstrated momentum year to date in 2023. We have the right team in place to deliver results and generate value for our patients, employees, communities, and shareholders.

謝謝，喬。謝謝艾米爾、喬安妮以及所有參與的人。我們勢頭強勁，準備在肌肉骨骼領域處於領先地位。 2023 年迄今為止，我們已經清楚地展現了強勁的勢頭。我們擁有合適的團隊來交付成果，為我們的患者、員工、社區和股東創造價值。

We have a positive trajectory that should deliver significant growth in 2024. I remain excited for the opportunities ahead and look forward to sharing more about our growth expectations on our year-end call.

我們的發展軌跡積極向上，應該會在 2024 年實現顯著增長。我對未來的機會仍然感到興奮，並期待在年終電話會議上分享更多有關我們成長預期的資訊。

Thank you again for joining. We'll now open the line for Q&A. (Operator Instructions) Brian Tanquilut, Jefferies.

再次感謝您的加入。我們現在將開通問答熱線。 （操作員說明）Brian Tanquilut，Jefferies。

Congrats on the quarter. I guess, Sharon, my first question is, as we think about year-to-date openings and closings, just as we net that out, looking into 2024, how should investors be thinking about the footprint and how that affects the revenue base for next year?

恭喜本季。莎倫，我想，我的第一個問題是，當我們考慮今年迄今的開業和關閉時，正如我們在展望 2024 年時那樣，投資者應該如何考慮足跡以及這如何影響收入基礎明年？

Thanks, Brian. So a few, things, I did mention -- I think there are two ways to look at it. So one is, there's the expansion of the footprint, and it's a little too early for us to say what we're going to do in 2024 around the expansion of footprint only because there's a lot of moving pieces. So I would say, that's one piece.

謝謝，布萊恩。我確實提到了一些事情——我認為有兩種方式來看待它。其一，足跡的擴大，現在就說 2024 年我們將圍繞足蹟的擴張做什麼還為時過早，因為還有很多變化。所以我想說，那是一件。

But I'd say the other is, we are looking at other opportunities to grow top line beyond the expansion of footprint. So as I see this, it's a combination of the two that is going to get us the top line. And I think we've got to look at this as a multiyear journey.

但我想說的是，我們正在尋找擴大足跡之外的其他機會來增加收入。因此，在我看來，這兩者的結合將使我們獲得最高收入。我認為我們必須將其視為一個多年的旅程。

'24 is almost upon us and we will -- we have some de novos in the pipeline and we're looking at should we increase that number. But I would say, the other piece is around growth and working with different new channels for referrals, et cetera. It's also going to be impactful in our '24, '25 growth of top line.

'24 即將到來，我們將會——我們正在醞釀一些新的計劃，我們正在考慮是否應該增加這個數字。但我想說，另一部分是圍繞成長以及與不同的新管道合作進行推薦等。這也將對我們 '24、'25 的收入成長產生影響。

And then Brian, it's Joe. Maybe just to add to that, as Sharon said, we'll talk more about 2024 when we do our year end. But even if we're closing a handful of clinics to optimize our fleet, we're still looking at adding clinicians.

然後布萊恩，是喬。也許只是補充一點，正如莎倫所說，我們將在年底時更多地討論 2024 年。但即使我們關閉一些診所以優化我們的車隊，我們仍在考慮增加臨床醫生。

And so I think, on an overall basis, we expect momentum that we carried through the third quarter and expect to carry into the fourth quarter will continue into 2025, where, on an overall basis, we're looking to drive improvements in revenue, not a decline in revenue even if there is a minor negative impact to the fleet, which, we'll talk more about that as we get into the guidance for next year.

因此，我認為，總體而言，我們預計第三季和第四季的勢頭將持續到 2025 年，總體而言，我們希望推動收入的改善，即使對機隊有輕微的負面影響，收入也不會下降，我們將在進入明年的指導時更多地討論這一點。

I mean we need both.

我的意思是我們兩者都需要。

Okay. That's helpful.

好的。這很有幫助。

Yeah, we need both, Brian, but I do think we have opportunities right in front of us that we're harvesting right now that don't require the heavy lift of a footprint expansion.

是的，我們兩者都需要，布萊恩，但我確實認為我們現在正在收穫的機會就在我們面前，不需要繁重的佔地面積擴張。

No, that makes a lot of sense. Joe, revenue per visit, just -- I know there's a one-timer there, but how should we be thinking about the growth rate given the contracts that you guys are signing right now on that rev per visit KPI going forward?

不，這很有意義。喬，每次訪問收入，只是 - 我知道那裡有一個一次性的，但是考慮到你們現在簽署的合同，我們應該如何考慮未來每次訪問收入 KPI 的增長率？

Yeah. And really -- absolutely. And really, like I said and like Sharon said, Brian, there's two components. It's new and existing contracts and getting some improvements in rates with those contracts. But some of the improvements in RCM that we've seen go back to prior claims. But certainly, a lot of the changes also impacted the current Q3 claims, and we'd expect those impacts to carry forward into future quarters.

是的。真的——絕對。事實上，就像我說的和莎倫說的，布萊恩，有兩個組成部分。這是新的和現有的合同，並且這些合同的費率得到了一些改進。但我們所看到的 RCM 的一些改進可以追溯到先前的聲明。但當然，許多變化也影響了目前第三季的索賠，我們預計這些影響將延續到未來幾季。

So we're pleased with not only the payer contracting rate improvements that we've seen, but also the improvements in RCM which will allow us to realize higher revenue rates moving forward.

因此，我們不僅對付款人簽約率的改善感到滿意，而且對 RCM 的改善也感到滿意，這將使我們能夠實現更高的收入率。

As far as breaking out the onetime piece versus the recurring, I'd say, roughly 30% to 40% of what we saw in Q3 relative to Q2, that improvement carries forward. So that puts us somewhere in the, call it, mid-106s. Obviously, when you're bifurcating, now, one-time versus recurring, it's not going to be 100% precise, but I think that's a good spot to anchor to.

至於一次性片段與重複片段的對比，我想說，相對於第二季度，我們在第三季度看到的情況大約有 30% 到 40%，這種改進會繼續下去。所以這讓我們處於 106 年代中期。顯然，當你現在分叉時，一次性與重複性，它不會是 100% 精確的，但我認為這是一個很好的定位點。

But probably important to note that we'll continue to focus on driving improvements in RCM, we'll continue to focus on driving improvements in payer contracting, and so the goal would be not to stop at those mid-106s to see where we can get to beyond that.

但可能需要注意的是，我們將繼續專注於推動 RCM 的改進，我們將繼續專注於推動付款人合約的改進，因此我們的目標不會停留在 106 中期，看看我們可以在哪裡超越那個。

All right. Last question for me, Joe. As I think about interest expense, $15.5 million here, is that sort of the right baseline we should be thinking about that? And then maybe just looking at the cash flow as well, obviously, there's cash burn during the quarter. So splitting those together, how should we be thinking about cash generation and then what your interest coverage looks like going forward?

好的。我的最後一個問題，喬。當我考慮利息支出時，這裡是 1550 萬美元，這是我們應該考慮的正確基準嗎？然後也許只看現金流，顯然，本季存在現金消耗。因此，將它們分開，我們應該如何考慮現金生成，然後您的利息覆蓋率會是什麼樣子？

Yes, the cash -- and just, I'm going to break out interest expense from cash interest because I'm guessing you care a little bit more about cash interest piece of that. The cash interest, probably somewhere around $14 million a quarter in cash interest based on the debt structure, assuming the current interest rate environment and other recent improvements in the interest rate environment which could drive it down because our interest does have a variable component to it.

是的，現金——只是，我將從現金利息中扣除利息費用，因為我猜你更關心其中的現金利息部分。現金利息，根據債務結構，現金利息可能約為每季 1400 萬美元，假設當前的利率環境和利率環境的其他近期改善可能會壓低利率，因為我們的利息確實有可變成分。

But I think $14 million is a good place to earmark it. And so to your point, that's $56 million of cash interest. So we will be a user of cash in 2023, although we think Q4 will be generating single digit millions of cash in 2024. We'll come out and talk more about that, obviously, when we're in 2024. But you could do the math on the cash interest plus some amount of CapEx and realize that to be cash flow positive. It's probably somewhere in the $70 million-plus of adjusted EBITDA range.

但我認為 1400 萬美元是指定用途的好地方。就您而言，這是 5,600 萬美元的現金利息。因此，我們將在2023 年成為現金用戶，儘管我們認為2024 年第四季度將產生數百萬美元的現金。顯然，當我們到2024 年時，我們會出來更多地討論這個問題。但你可以這樣做計算現金利息加上一定數量的資本支出，並意識到現金流為正。調整後的 EBITDA 範圍可能超過 7000 萬美元。

And we like the momentum that we've been able to gain throughout 2023 and through Q3. And as I mentioned, we think we'll continue to gain momentum in 2024. I don't foresee being cash flow positive in 2024 yet, but it's an important step towards cash flow positive. And with the $40 million of liquidity and the availability that we have on the delayed draw term loan, I think we feel that it gives us the runway to continue to grow into our capital structure.

我們喜歡我們在 2023 年全年和第三季所獲得的勢頭。正如我所提到的，我們認為我們將在 2024 年繼續獲得動力。我預計 2024 年現金流不會為正，但這是邁向正現金流的重要一步。憑藉 4000 萬美元的流動性和延遲提取定期貸款的可用性，我認為這為我們提供了繼續發展資本結構的跑道。

(Operator Instructions) All right. And there are no further questions at this time, I'd like to turn the call back over to Sharon Vitti for any additional or closing remarks.

（操作員指示）好的。目前沒有其他問題，我想將電話轉回給 Sharon Vitti，以徵求任何補充或結束語。

This ends the Q&A portion of our call. Thank you to our investors, analysts, and all the ATI team members for joining the ATI Q3 quarterly earnings call, and we will look forward to seeing you in the New Year. Thank you.

我們通話的問答部分到此結束。感謝我們的投資者、分析師和所有 ATI 團隊成員參加 ATI 第三季財報電話會議，我們期待在新年見到您。謝謝。

Thank you. And that does conclude today's presentation. Thank you for your participation. You may now disconnect.

謝謝。今天的演講到此結束。感謝您的參與。您現在可以斷開連線。