ATI Physical Therapy Inc (ATIP) 2023 Q4 法說會逐字稿

Good afternoon and welcome to the ATI Physical Therapy's Fourth Quarter and Full Year 2023 Earnings Conference Call and Webcast. All participants will be in a listen-only mode. After today's presentation, there will be an opportunity to ask questions. Please note this event is being recorded. On the call today is Sharon Beattie, Chief Executive Officer, JOSEPH Jordan, Chief Financial Officer, Chris Cox, Chief Operating Officer, and go on Bong, Senior Vice President, Treasurer and Head of Investor Relations. I will now turn the call over to Ms. Fong.

下午好，歡迎參加 ATI Physical Therapy 2023 年第四季和全年財報電話會議和網路廣播。所有參與者將處於僅聽模式。今天的演講結束後，將有機會提問。請注意此事件正在被記錄。今天參加電話會議的有執行長 Sharon Beattie、財務長 JOSEPH Jordan、營運長 Chris Cox，以及資深副總裁、財務主管兼投資者關係主管 Bong。我現在將電話轉給方女士。

Thank you, mandate. Good afternoon, everyone. Thank you for joining us today.

謝謝你，授權。大家下午好。感謝您今天加入我們。

Before we begin, I'd like to remind you that certain statements made during this call may be forward looking statements are subject to various risks and uncertainties, and if that's the current expectation based on our beliefs, assumptions and information currently available to us. Although we believe these 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.

在我們開始之前，我想提醒您，本次電話會議中做出的某些陳述可能是前瞻性陳述，會受到各種風險和不確定性的影響，如果這是基於我們的信念、假設和當前可獲得的資訊的當前預期。儘管我們認為這些期望是合理的，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 discussing certain non-GAAP financial measures that we believe are important in evaluating performance details and malicious 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 as posted ATS website and our SEC filings on that, I'd like to turn the call over to Sharon.

此外，請注意，公司正在討論某些非公認會計原則財務指標，我們認為這些指標對於評估業績細節非常重要，並且這些非公認會計原則指標與最具可比性的公認會計原則指標之間存在惡意，並且可以找到歷史非公認會計原則財務指標的調節表在 ATS 網站發布的收益新聞稿和我們向 SEC 提交的文件中，我想將電話轉給 Sharon。

Thank you, JoAnn, and welcome, everyone. In addition to Chris and Joe, we have the rest of our ELT on the call we have Emily Tansey, our Chief People Officer, Scott Ferguson, our Chief Growth Officer, best Oaks, our Chief Information Officer, and Erik cancer, key legal officer.

謝謝你，喬安，歡迎大家。除了 Chris 和 Joe 之外，我們還有 ELT 的其他成員參加電話會議，其中包括我們的人力長 Emily Tansey、我們的首席成長長 Scott Ferguson、我們的資訊長 best Oaks 和關鍵法律長 Erik cancer 。

As you may know earlier, today, we reported our fourth quarter and full year 2023 results. 2023 was a reset year, and I'm very proud of our achievements. ATI. staff exhibited strong teamwork across our national single-branded Flint single brand platform to bring our purpose to life in our local communities, expanding access to care and helping people live their healthiest life. Our team implemented deliberate strategies to deliver meaningful quarter-over-quarter growth, allowing us to exceed our revenue targets and our 2023 guidance. 2023 was it was a year when we implemented many winning strategies, including strengthening the ATI. culture, growing the provider base, elevating talent and creating development opportunities for our employees, expanding access for patients, advancing clinic operations and enhancing the patient experience, all resulting in improved financial and key KPI performance.

如您所知，今天我們報告了 2023 年第四季度和全年業績。 2023 年是重置的一年，我對我們的成就感到非常自豪。ATI。員工在我們的全國單一品牌弗林特單一品牌平台上展現了強大的團隊合作精神，將我們的目標在當地社區變為現實，擴大獲得護理的機會並幫助人們過上最健康的生活。我們的團隊實施了深思熟慮的策略，以實現有意義的季度環比成長，使我們能夠超越我們的收入目標和 2023 年指導。 2023 年是我們實施許多致勝策略的一年，包括加強 ATI。文化、擴大提供者基礎、提升人才並為員工創造發展機會、擴大患者就診機會、推進診所營運並增強患者體驗，所有這些都有助於改善財務和關鍵 KPI 績效。

I'm going to double down on a few areas that are highlights of 2023, starting with the demand for ATI. services. It was exceptionally strong in 2023, and we saw an all-time high in ATS history of referrals per day and referrals continue to be robust into 2024 time frame into 2023, the rate per visit increased by $3.30 over the previous year. So as we look at this, there are two contributing factors. One here are rate increases, coupled with operational improvements in our revenue cycle management, the HR and ops teams work together to allow us to see 390,000 more patient visits in 2023 compared to 2022. The labor market continues to remain tight. And in 2023, Emily Tansey, our Chief People Officer, lead our HR teams to successfully grow the number of clinical FTEs year over year end, significantly reduced turnover to a more normalized level, creating stability in our clinics. Chris Koch, our COO, led the teams focused on reducing administrative burdens and improving processes in the clinic, allowing our providers to see more visits per day per clinical FTE in 2023, achieving a historic high watermark on our clinic footprint. We opened 13 de novo clinics and closed or divested 40 clinics for performance reasons. 2024 will be a year of investing in our current fleet with necessary upgrades, expansion and consolidation, coupled with and without opening a limited number of new clinics.

我將重點放在 2023 年的幾個亮點領域，首先是對 ATI 的需求。服務。2023 年的表現異常強勁，我們看到ATS 每日推薦歷史記錄創下歷史新高，並且從2024 年到2023 年的時間範圍內，推薦繼續保持強勁勢頭，每次訪問的費用比上一年增加了3.30美元。因此，當我們看待這個問題時，有兩個因素。其中之一是費率上調，再加上我們收入週期管理的營運改進，人力資源和營運團隊共同努力，使我們在 2023 年的就診人數比 2022 年增加了 39 萬人次。勞動市場持續緊張。2023 年，我們的人力長 Emily Tansey 帶領我們的人力資源團隊成功地逐年增加了臨床 FTE 的數量，將營業額顯著降低到更正常的水平，從而為我們的診所創造了穩定性。我們的營運長Chris Koch 領導的團隊專注於減少診所的行政負擔和改善流程，讓我們的服務提供者在2023 年每個臨床FTE 每天的就診次數增加，從而在我們的診所足跡上實現了歷史性的高水位。我們新開設了 13 家診所，並因績效原因關閉或剝離了 40 家診所。 2024 年將是對我們現有車隊進行必要的升級、擴張和整合進行投資的一年，同時開設或不開設數量有限的新診所。

Now our long-term goal is to grow the footprint while continuously monitoring, local markets and Clinique performance. Overall, we are focused on capitalizing on the momentum achieved in 2023 with people in operations to continue growing ATI.'s capacity in 2024. Our people are what set us apart from our competitors through all the changes in the market and within the company. In the past few years, our team's commitment to our care excellence has grown hearing from our patients as a critical part of C-BASS in 2023. We refined our patient survey processes during the year to gain additional insights in our patient experiences. We anticipate sharing this new improved customer satisfaction, KPKPI. later this year in 2024. Our clinical quality remains exceptional as previously reported in 2023 ATI. achieved an exceptional rating in patient quality from the Center for Medicare and Medicaid services mix program for the fourth consecutive year, basically every year since the program's inception for physical therapy providers in 2024 HE, I will again receive a bonus payments to help offset the CMS fee schedule cuts in 2024.

現在，我們的長期目標是擴大足跡，同時持續監控當地市場和倩碧的表現。總體而言，我們的重點是利用營運人員在 2023 年取得的勢頭，在 2024 年繼續提高 ATI 的產能。在市場和公司內部發生的所有變化中，我們的員工使我們從競爭對手中脫穎而出。在過去幾年中，我們團隊對卓越護理的承諾得到了患者的認可，成為 2023 年 C-BASS 的重要組成部分。我們在這一年中完善了患者調查流程，以獲得有關患者體驗的更多見解。我們期待分享這項新的改進的客戶滿意度 KPKPI。今年晚些時候，即 2024 年。正如 2023 年 ATI 先前報導的那樣，我們的臨床品質仍然非常出色。連續第四年在醫療保險和醫療補助服務組合計劃中心獲得了患者質量的特殊評級，自該計劃於2024 年針對物理治療提供者啟動以來基本上每年都是HE，我將再次收到獎金以幫助抵銷CMS 2024 年費用表削減。

Another area of excellence is the launch earlier this month of the Institute for musculoskeletal advancement. The purpose of the institute is to advance scientific research and to enhance the quality of musculoskeletal clinical care. The Institute for musculoskeletal advancement will create new opportunities for our colleagues to get involved with teaching research and influencing policy is a top priority in 2024 in 2023, the operations team completed numerous process improvements and technology implementations. Chris will provide a detailed discussion of those operational initiatives and performance later during the call. I do want to call out two areas. The operations team drove increased clinic utilization every quarter over quarter during the year and in the fourth quarter drove the highest visits per clinic since the start of COVID in 2022, our clinicians were highly productive throughout 2023, spending more time treating patients than the prior year with each clinical ST. in 2023, seeing a historically high visits per day at 9.4. Strong demand for ATI. services, combined with the progress we made in the business resulted in the Company, beating our 2023 revenue and adjusted EBITDA guidance shortly, Joe will provide a detailed walk-through of Q4 and full 2023 financial results and sure Q1 2024 expectations. Worth noting is our continuous progress in 2023 to increase revenue every quarter, four from the prior sequential quarter with a TISQ. for 2023 revenue back to levels when the pandemic started in 2020. In 2024, we have kicked off the year implementing numerous strategies to extend the progress we made in 2023. It goes without saying we have incredible teams at ATI that are making a difference in the lives of our patients and communities every day I have tremendous gratitude for our talented teams, dedicated clinicians and leaders, promotionally invest and are passionate about enriching the lives of our colleagues, patients and communities.

另一個卓越領域是本月稍早成立的肌肉骨骼進步研究所。該研究所的宗旨是推進科學研究並提高肌肉骨骼臨床護理的品質。肌肉骨骼進步研究所將為我們的同事創造新的機會參與教學研究和影響政策是2024年的首要任務，2023年營運團隊完成了大量的流程改善和技術實施。克里斯將在稍後的電話會議中詳細討論這些營運計劃和績效。我確實想指出兩個領域。營運團隊在年內每個季度都推動了診所利用率的提高，第四季度每個診所的就診量達到了2022 年新冠疫情爆發以來的最高水平，我們的臨床醫生在2023 年全年的工作效率很高，比前一年花了更多的時間來治療患者每個臨床 ST。 2023 年，每日造訪量將達到 9.4 次，創歷史新高。對ATI的需求旺盛。服務，結合我們在業務方面取得的進展，使公司很快超過了2023 年的收入和調整後的EBITDA 指導，喬將提供第四季度和2023 年完整財務業績的詳細介紹，以及2024 年第一季度的預期。值得注意的是，我們在 2023 年每季的營收都在增加，比上一季的 TISQ 收入增加了四個季度。 2023 年收入恢復到 2020 年疫情爆發時的水準。2024 年，我們開啟了實施多項策略的一年，以延續我們在 2023 年的進展。不用說，我們ATI 擁有令人難以置信的團隊，他們每天都在改變我們患者和社區的生活，我對我們才華橫溢的團隊、敬業的臨床醫生和領導者深表感謝，他們大力投資，並熱衷於豐富我們患者的生活。同事、病人和社區。

Big congratulations to the entire ATI. team for showing everyone the real ATI. With that, I will turn the call over to Chris to discuss operations.

衷心祝賀整個 ATI。團隊向大家展示真正的 ATI。這樣，我會將電話轉給克里斯討論營運事宜。

All right.

好的。

Thank you, Sharon, and proud to share an update on our transformation efforts during the fourth quarter and the full year of 2023, as well as the outstanding operational results that we achieved in January. I was able to attend our national leadership event for the second time, we brought together every clinic, DIRECTOR from across our national footprint, along with our field and corporate leaders as well as Board members to focus on leadership development as well as our 2024 critical path. This meeting sets the stage for our year ahead and affords us the opportunity to continue to develop the core competencies and skill sets that our clinicians need to enable continued operational and clinical progress. I'm inspired by our providers and their passion for achieving exceptional outcomes for our patients. Our operational progress furthers our ability to deliver continued excellence in health health outcomes. And I want to thank the ATI colleagues who bring our purpose to life every day in 2023, our field, a clinic team has continued to deliver exceptional patient care. While our central operations team has diligently refined workflows and processes together, we remain focused on enhancing our capacity for care and on continuing to elevate the patient experience.

謝謝 Sharon，我很自豪地分享我們第四季度和 2023 年全年轉型工作的最新情況，以及我們 1 月份的出色營運成果。我能夠第二次參加我們的全國領導力活動，我們將全國範圍內的每家診所、主任、我們的領域和企業領導者以及董事會成員聚集在一起，重點關注領導力發展以及我們2024 年的關鍵目標小路。這次會議為我們未來的一年奠定了基礎，並為我們提供了繼續發展臨床醫生所需的核心能力和技能的機會，以實現持續的營運和臨床進展。我們的醫療服務提供者以及他們為患者取得卓越成果的熱情讓我深受啟發。我們的營運進展進一步增強了我們持續提供卓越健康成果的能力。我要感謝 ATI 的同事，他們在 2023 年每天都將我們的目標變為現實，我們的領域、診所團隊繼續提供卓越的患者護理。雖然我們的中央營運團隊一起努力完善工作流程和流程，但我們仍然專注於提高護理能力並繼續提升患者體驗。

As Sharon mentioned, our clinic teams again earned an exceptional rating by CMS mix for delivering quality patient care that will be awarded a bonus for many Medicare services rendered. The clinic teams also expanded patient access with each clinical FTE. seeing an additional 0.6 visits each day in 2023 over 2022. And in fact, we increased the visits per day and visits per day per clinic every single quarter in 2023 over the prior quarter as we made continued progress with our operations team at the beginning of 2023, I spoke about how we would leverage process innovation and enhancements in technology to reduce administrative burdens and support for four-wall performance fast-forward to the end of the year, and we can see that we realized greater efficiencies and higher customer satisfaction with our centralized intake initiative and clinic process innovation efforts. In Q4, we completed the centralization of our intake, registration and scheduling functions, completing the rollout across all our clinics. This effort has removed over 3.8 million annual phone calls from our clinics and helped drive consistency in our referral management, safeguarding referrals from slipping through the cracks. This effort, combined with enhancements to make our ATI. EMR system, even easier for physicians to use in addition to other operational initiatives, enabled our providers to spend more time operating at the top of their license focusing on patients and delivering high-quality evidence-based care, but it doesn't stop. There are initiatives to augment our clinical operations will continue in 2024 by further streamlining administrative processes in our clinics, we expect to unlock even greater value for our organization. We have ongoing efforts to reduce paperwork and digitize registration for new patients, which will save both clinicians and providers time and now that we have a single centralized intake model, we will begin experimenting with new patient engagement strategies to drive higher referral conversion and appointment attendance with reduced administrative burden and a more predictable operating rhythm. We expect our clinics to continue to experience improved employee satisfaction with more time to focus on delivering exceptional care in equally impactful. Despite the ongoing imbalance in the physical therapy labor market. We successfully grew our clinical FTE. base throughout 2023 and ended in Q4 at nearly 26,000 FTEs. We remain committed to prioritizing strategies that bolster both retention and recruitment efforts, recognizing the pivotal role our clinicians play in our continued growth and success submission turnover ended the year in the fourth quarter at 21%, which is on par with our pre-COVID levels, considering the challenging labor market we are in this notable retention speaks volumes about the culture we are building FOSTER community where providers are engaged to stay and grow.

正如 Sharon 所提到的，我們的診所團隊再次獲得 CMS mix 的卓越評級，因為他們提供優質的患者護理，並將因提供的許多醫療保險服務而獲得獎金。診所團隊也透過每次臨床 FTE 擴大了患者的就診範圍。與 2022 年相比，2023 年每天的訪問量將增加 0.6 次。事實上，隨著我們的營運團隊在2023 年初不斷取得進展，我們在2023 年每個季度的每日就診次數和每個診所的每日就診次數都比上一季度有所增加，我談到了我們將如何利用流程創新和技術的增強，以減輕行政負擔，並支持四牆性能，快進到今年年底，我們可以看到，透過我們的集中接收計劃和臨床流程創新工作，我們實現了更高的效率和更高的客戶滿意度。第四季度，我們完成了收治、掛號和排班功能的集中化，完成了在所有診所的推廣。這項工作每年為我們的診所減少了超過 380 萬通電話，並幫助提高了轉診管理的一致性，防止轉診漏掉。這項努力與我們的 ATI 的增強功能相結合。除了其他營運措施之外，EMR 系統甚至更容易讓醫生使用，使我們的提供者能夠花更多時間在其許可範圍內運營，專注於患者並提供高品質的循證護理，但它並沒有停止。透過進一步簡化診所的行政流程，我們將在 2024 年繼續採取一些增強臨床業務的舉措，我們期望為我們的組織釋放更大的價值。我們不斷努力減少新患者的文書工作和數位化註冊，這將節省臨床醫生和提供者的時間，現在我們有了單一的集中接收模式，我們將開始試驗新的患者參與策略，以提高轉診轉換率和預約出勤率減少管理負擔並提高營運節奏。我們期望我們的診所能夠持續提高員工滿意度，讓他們有更多的時間專注於提供同樣有影響力的卓越照護。儘管物理治療勞動市場持續不平衡。我們成功地提高了臨床 FTE。 2023 年全年 FTE 人數接近 26,000 人，截至第四季。我們仍然致力於優先考慮加強保留和招聘工作的策略，認識到我們的臨床醫生在我們的持續增長和成功提交營業額中發揮的關鍵作用，截至第四季度的營業額為21%，與新冠疫情爆發前的水平持平，考慮到我們所處的充滿挑戰的勞動力市場，這種顯著的保留充分說明了我們正在建立的 FOSTER 社區文化，在這個社區中，供應商致力於留下來並成長。

Finally, our rate in 2023 was positively impacted by revenue cycle enhancements and ongoing negotiations with payers for reimbursement and during the year, we also standardized our Workers' Compensation offering to ensure that we are providing a provider of choice in that area.

最後，我們2023 年的費率受到收入週期增強以及與付款人正在進行的報銷談判的積極影響，在這一年中，我們還標準化了我們的工人賠償服務，以確保我們在該領域提供首選的提供者。

I previously talked about transforming our revenue cycle management function to achieve best-in-class performance. In 2023, we made significant improvement in almost every KPI that measures revenue cycle efficiency from denial rate, the cost to collect the POS. collection rate for net collection rate. With our decision to consolidate our relationships and work more closely with the preferred vendor partner to drive collection rates, we were able to reduce costs and employ more automation in our efforts. We have also seen a reduction in bad debt expense throughout the year as reflected in the financials, driven by technology and process enhancements and to conclude, I want to emphasize that my priority remains driving innovative improvements to our processes to better support our teams and to stand out among the competition. We still have work to do, and I am energized by the progress we achieved in 2023. I look forward to providing updates as we continue to build on our momentum. I want to again express my heartfelt gratitude to our clinicians, field leaders, health services teams and central teams for their steadfast commitment and passion. It is through their collective efforts that we can make meaningful strides in improving the health and outcomes of our patients. Their dedication is the cornerstone of our success, and I am deeply appreciative of their continued focus on driving positive change. As we move forward. I am excited by the abundant opportunities that lie ahead.

我之前談到要轉變我們的收入週期管理職能，以實現一流的績效。2023 年，我們在幾乎所有衡量收入週期效率（從拒絕率、收取 POS 的成本）的 KPI 上都取得了重大改進。收集率即淨收集率。透過我們決定鞏固我們的關係並與首選供應商合作夥伴更密切地合作以提高收款率，我們能夠降低成本並在我們的工作中採用更多的自動化。在技​​術和流程增強的推動下，我們還看到全年壞帳費用有所減少，這反映在財務方面。最後，我想強調，我的首要任務仍然是推動我們流程的創新改進，以更好地支持我們的團隊並在競爭中脫穎而出。我們仍有工作要做，我對 2023 年的進展感到鼓舞。我期待著在我們繼續發展勢頭的過程中提供最新資訊。我想再次對我們的臨床醫生、現場領導、衛生服務團隊和中央團隊的堅定承諾和熱情表示衷心感謝。透過他們的集體努力，我們可以在改善患者的健康和治療結果方面取得有意義的進展。他們的奉獻精神是我們成功的基石，我非常感謝他們持續專注於推動正向改變。當我們前進時。我對未來的豐富機會感到興奮。

Now I'd like to turn the call over to Joe provide an in-depth review of our financial results.

現在我想把電話轉給喬，他對我們的財務表現進行了深入的審查。

Thank you, Chris, and thanks to everyone for joining the call today. I'll talk about our fourth quarter and full year 2023 financial results. And then later on, I'll discuss, as Sharon mentioned, early trends for 2024, as well as our expectations for the first quarter. Starting out with Q4, our net revenue in the fourth quarter was $182 million, which is a 12.7% increase year over year from $162 million in Q4 of the prior year. And as we go a layer deeper net patient revenue was $166 million, which is a 13.6% increase year over year. All other revenue for the fourth quarter was $16 million, which is a 3.7% increase year over year. And it's mostly due to higher revenue from MX from RMSAC. our visits per day per clinic, as Chris talked about a little bit earlier was 27 for the quarter, which is a sequential increase of 1.1 visits from the third quarter, which sat at 25.9. And since we began the execution of our clinic optimization and our operational improvement plans last year, the result continues to be stronger more vibrant clinics and improved unit economics. And also, as Chris mentioned, we've seen a sequential increase every quarter in visits per day per clinic visits per day per clinic of 27 in the fourth quarter compares to 24.1 in the fourth quarter of the prior year. Rate per visit was $108.81 in the third quarter, a decrease of 1% from $109.90 in the third quarter, but an increase of 4.6% from $103.99 in the fourth quarter of the prior year. Looking over the sequential quarters, the slight decrease in rate was mostly due to a more more significant discrete rate adjustments occurring in Q three related to prior period favorable collection experience. And when we look year over year, the increase in rate is primarily driven by favorable rate rate realization due to operational enhancements and revenue cycle management and increased contracted rates, with which Sharon and Chris both touched upon salaries and related costs in the fourth quarter 2023 were $99 million and that's a 9.5% increase year over year from $91 million in Q4 of the prior year was primarily driven by more clinical staff supporting higher revenue and higher wage wage rates due to inflation. PT. salaries and related costs per visit during the quarter were $56.56. That decreased 1.6% from $57.47 in the third quarter of 2023 and an increased 3% year over year from $54.92 in the fourth quarter of the prior year quarter over quarter. Decrease from Q3 is primarily due to higher labor productivity, while the year-over-year increase was primarily due to higher compensation and wage inflation, which was partially offset by higher labor productivity, Rent, clinic supplies, contract labor and other in the fourth quarter was $53 million, which is a 7% increase year over year from $49 million in Q4 of the prior year. It's primarily due to increased spend on contract labor and outside services. On a per clinic basis, those same costs were approximately $57,000 which is essentially flat from the third quarter and increasing 11% year over year from $51,000. For the same previously noted reasons, contractor spend and outside service, our provision for doubtful accounts during the quarter was approximately $1 million, which is 0.9% of PT revenue, and that compares favorably to 2.1% of (technical difficulty) this year. And 1.7% in Q4 of last year. And on a full year basis, the provision was 1.8% of PT revenue compared to 2.4% in the prior year. Now these improvements are the result of deliberate process improvements and collection efforts by our teams. Chris talked a lot about the rev cycle management improvements that have happened year over year, and those improvements in those processes remain ongoing as we move into 2024.

謝謝克里斯，也謝謝大家今天加入電話會議。我將談論我們第四季度和 2023 年全年的財務表現。然後，正如 Sharon 所提到的，我將討論 2024 年的早期趨勢，以及我們對第一季的預期。從第四季開始，我們第四季的淨收入為 1.82 億美元，比去年第四季的 1.62 億美元年增 12.7%。隨著我們進一步深入，患者淨收入為 1.66 億美元，年增 13.6%。第四季所有其他收入為 1,600 萬美元，年增 3.7%。這主要是由於 RMSAC 的 MX 收入增加。正如 Chris 之前提到的，本季每個診所每天的就診次數為 27 次，比第三季的 25.9 次增加了 1.1 次。自從我們去年開始執行診所優化和營運改善計畫以來，結果是診所變得更強大、更有活力，單位經濟效益也得到改善。而且，正如 Chris 所提到的，我們發現每個季度每個診所的每日就診次數連續增加，第四季度每個診所每天的就診次數為 27 次，而去年第四季為 24.1 次。第三季每次造訪費用為 108.81 美元，比第三季的 109.90 美元下降 1%，但比去年第四季的 103.99 美元增加 4.6%。縱觀連續幾個季度，費率略有下降，主要是由於第三季度發生了與前期有利的收款體驗相關的更顯著的離散費率調整。當我們逐年查看時，費率的增長主要是由於營運增強和收入周期管理以及合約費率增加而實現的有利費率推動的，莎倫和克里斯都談到了2023 年第四季度的工資和相關成本為 9,900 萬美元，較去年第四季的 9,100 萬美元年增 9.5%，這主要是由於更多的臨床人員支持更高的收入和通貨膨脹導致的更高的工資水準。PT。本季每次就診的工資和相關費用為 56.56 美元。較 2023 年第三季的 57.47 美元下降 1.6%，較去年第四季的 54.92 美元年增 3%。較第三季的下降主要是由於勞動生產力的提高，而同比增長主要是由於薪酬和工資上漲的增加，這部分被第四季度勞動生產力、租金、診所用品、合約工和其他方面的提高所抵消。該季度營收為5,300 萬美元，較上年第四季的4,900 萬美元年增7%。這主要是由於合約工和外部服務支出的增加。以每個診所計算，這些成本約為 57,000 美元，與第三季度基本持平，較去年同期的 51,000 美元增長 11%。出於與先前提到的相同的原因，承包商支出和外部服務，我們在本季的呆帳準備金約為100 萬美元，佔PT 收入的0.9%，與今年（技術難度）的2.1% 相比，情況良好。去年第四季為 1.7%。就全年而言，撥備佔 PT 收入的 1.8%，而前一年為 2.4%。現在，這些改進是我們團隊精心改進流程和收集工作的結果。Chris 談論了很多關於逐年發生的轉速週期管理改進的內容，並且隨著我們進入 2024 年，這些流程的改進仍在繼續。

Sg&a during the quarter was approximately $26 million, which is a 4.2% decrease year over year from $28 million in Q4 of the prior year, primarily driven by lower severance and lower non-ordinary legal costs, partially offset by higher outside services and contract labor, non-cash goodwill, intangible and other asset impairment charges in the fourth quarter were $6 million. It's due to long-lived asset impairments related to primarily subleasing a portion of our corporate office space.

本季的銷售及管理費用約為 2,600 萬美元，較上年第四季的 2,800 萬美元年減 4.2%，主要是由於遣散費和非普通法律費用減少，部分被外部服務和合約工增加所抵銷第第四季的非現金商譽、無形資產和其他資產減損費用為600 萬美元。這是由於主要與轉租部分公司辦公空間相關的長期資產減損所致。

Operating income, excluding impairment charges in the fourth quarter was $3 million, which increased from an operating loss of $8 million in the prior year, which reflects the higher revenue we earned in 2023 and the associated earnings that come along with that notable below-the-line items during the quarter included income resulting from a decrease in the fair value of our second-lien PIC notes, our contingent common shares and warrants, which totaled $16 million. Those are mark-to-market at fair value every quarter. So as of year end, December 31 valuation analysis that resulted in $16 million. Our interest expense during the quarter was $15 million, which compares to $13 million in the fourth quarter of the prior year. And the increase is primarily due to lower interest rate hedge benefits.

第四季的營業收入（不包括減損費用）為300 萬美元，比上一年的營業虧損800 萬美元有所增加，這反映了我們在2023 年獲得的更高收入以及隨之而來的相關收益 -本季度的項目包括因我們的第二留置權 PIC 票據、或有普通股和認股權證的公允價值下降而產生的收入，總計 1600 萬美元。這些價格每季以公允價值以市價計價。截至年底，即 12 月 31 日，估值分析結果為 1,600 萬美元。本季我們的利息支出為 1,500 萬美元，而去年第四季為 1,300 萬美元。這一增長主要是由於利率對沖收益降低。

Income tax expense for the quarter was $2 million, which compares to a benefit of $5 million in the fourth quarter of the prior year. And our net loss during the quarter was $5 million compared to a net loss of $102 million in the fourth quarter of the prior year.

本季的所得稅費用為 200 萬美元，而去年第四季的所得稅費用為 500 萬美元。我們本季的淨虧損為 500 萬美元，而去年第四季的淨虧損為 1.02 億美元。

Looking at the full year, revenue for 2023 was $699 million. That's a 10% increase year over year from $636 million and outperformed revenue guidance of [$680 million to $695 million]. The primary drivers were an increase in visits per day, which increased 7.5% year over year and rate per visit, which grew 3.2%. And on the adjusted EBITDA line, the full year was $36.2 million, which increased from $7 million in the prior year, also outperforming our adjusted EBITDA guidance range of $30 million to $36 million. Cash used during 2023 was approximately $46 million compared to cash generated in the prior year of $35 million as we break that down further, operating cash use was $12 million in 2023 compared to $66 million in 2022 and the improvement reflects improved earnings.

從全年來看，2023 年的收入為 6.99 億美元。這比去年同期的 6.36 億美元增長了 10%，超出了 2019 年的收入指導[6.8 億至 6.95 億美元]。主要驅動因素是每日造訪量的增加（年成長 7.5%）和每次造訪率的成長（年成長 3.2%）。在調整後的 EBITDA 專案中，全年為 3,620 萬美元，比上一年的 700 萬美元有所增加，也超出了我們調整後的 EBITDA 指導範圍 3,000 萬美元至 3,600 萬美元。2023 年使用的現金約為4,600 萬美元，而前一年產生的現金為3,500 萬美元，我們進一步細分，2023 年的營運現金使用為1,200 萬美元，而2022 年為6,600 萬美元，這項改善反映了收益的改善。

In addition to that conclusion of CARES Act, investing cash use was $17 million compared to $28 million in 2022, with the decrease mostly due to fewer clinic openings and financing cash use was $17 million compared to cash generated of $128 million in 2022. With the decrease driven primarily by the issuance of preferred stock that happened in 2022 as well as higher revolver repayments in 2023 as we had significant borrowings at the end of 2022 and then repaid some of it in '23. As of December 31, 2023, our available liquidity was approximately $42 million, and that consisted of cash and cash equivalents of $37 million and then available revolver capacity of $5 million. And in addition to that availability, we had access to a $25 million delayed draw term loan, which was fully drawn in January of 2024.

除了CARES 法案的結論之外，投資現金使用量為1,700 萬美元，而2022 年為2,800 萬美元，減少的主要原因是診所開業數量減少，融資現金使用量為1,700 萬美元，而2022 年產生的現金為1.28 億美元。下降的主要原因是 2022 年發行優先股以及 2023 年循環償還額增加，因為我們在 2022 年底有大量借款，然後在 23 年償還了部分借款。截至 2023 年 12 月 31 日，我們可用的流動資金約為 4,200 萬美元，其中包括 3,700 萬美元的現金和現金等價物，以及 500 萬美元的可用循環能力。除此之外，我們還獲得了 2500 萬美元的延遲提取定期貸款，該貸款已於 2024 年 1 月全額提取。

Finally, as Sharon and Chris discussed the people and the operational advances that we achieved in 2023 led to volume and led to capacity utilization increases throughout the year. And we're pleased with the progress that we made during 2023, and we're excited to continue these advancements into 2024 despite the severe weather in January that negatively impacted patient visits. We currently expect Q1 revenue to be between $175 million and $185 million and adjusted EBITDA to be between $5 million and $10 million, demonstrating growth over the prior year. Of course, this will depend upon continued success of our current initiatives and the risks outlined in our press release and other filings. Overall, we continue to see plenty of demand for ATA services, and Sharon talked about that early on in 2024, we'll be working to see if we can achieve the full potential of the process improvements and technology solutions that we implemented throughout last year and with the changes made to date and others still in process, we plan to achieve productivity levels exceeding 2023, and we expect to provide full year guidance during our next early earnings call.

最後，正如 Sharon 和 Chris 所討論的那樣，我們在 2023 年實現的人員和營運進步導致了全年產量和產能利用率的增加。我們對 2023 年的進展感到滿意，並且很高興能夠在 2024 年繼續取得這些進展，儘管 1 月份的惡劣天氣對患者就診產生了負面影響。我們目前預計第一季營收將在 1.75 億美元至 1.85 億美元之間，調整後的 EBITDA 將在 500 萬美元至 1,000 萬美元之間，顯示出較前一年的成長。當然，這將取決於我們當前舉措的持續成功以及我們的新聞稿和其他文件中概述的風險。總體而言，我們繼續看到對 ATA 服務的大量需求，Sharon 在 2024 年初談到，我們將努力看看我們是否能夠充分發揮我們去年實施的流程改進和技術解決方案的潛力鑑於迄今為止所做的變革以及其他仍在進行中的變革，我們計劃實現2023 年以上的生產力水平，並且我們預計將在下一次早期財報電話會議期間提供全年指導。

In the spring.

在春天。

With that, I'll turn the call back over to Sharon for closing remarks.

接下來，我將把電話轉回給莎倫，讓她作結束語。

Thank you, Joe. As I said before, 2023 was a reset year and we succeeded in setting up ATI. for continued growth. Success has accomplished during the year demonstrate that we have the right team in place. We are aggressively aggressively executing our operations improvements while continuing to make notable strides toward our strategic vision. I am very confident in our people, strategy and ongoing initiatives and that we will continue to advance our national practice improve performance and lead in the musculoskeletal space. We will capitalize on the 2023 momentum and execute on known growth to XL in 2024.

謝謝你，喬。正如我之前所說，2023年是重置年，我們成功地成立了ATI。持續增長。這一年所取得的成功顯示我們擁有合適的團隊。我們正在積極主動地實施營運改進，同時繼續朝著我們的策略願景取得顯著進展。我對我們的人員、策略和正在進行的舉措非常有信心，我們將繼續推進我們的國家實踐，提高績效並在肌肉骨骼領域處於領先地位。我們將利用 2023 年的勢頭，並在 2024 年實現已知的 XL 成長。

I'll now hand the call back to the operator to open up for questions and answers.

現在，我將把電話轉交給接線員，以供提問和解答。

The floor is now open for your questions.

現在請大家提問。

To ask a question at this time, simply press star followed by the number one on your telephone keypad. We'll now take a moment to compile our roster.

此時要提問，只需按星號，然後按電話鍵盤上的數字 1 即可。我們現在需要一些時間來編制我們的名單。

No.

不。

Our first question comes from the line of Brian Tanquilut with Jefferies.

我們的第一個問題來自 Brian Tanquilut 和 Jefferies 的對話。

Please go ahead.

請繼續。

Mandeep, would you like to open up for questions and answers now?

Mandeep，您現在願意開放提問和回答嗎？

Hi, good evening. You have Toshi Philips on for Brian, and thank you for taking my question. So first, my first question is going to be on how we should think about the cadence of earnings power throughout the year. I mean, obviously, you had provided some guidance for Q1. Just curious if qualitatively you can provide some commentary on how we should be thinking about revenue generally --

嗨，晚上好。請托什·飛利浦 (Toshi Philips) 代為布萊恩，感謝您回答我的問題。首先，我的第一個問題是我們應該如何思考全年獲利能力的節奏。我的意思是，顯然，您為第一季提供了一些指導。只是好奇您能否從定性上提供一些評論，說明我們應該如何普遍考慮收入--

I'm sorry, I'll jump in and assist when.

抱歉，我會及時介入並提供協助。

Ryan, would you like to go first, right?

瑞安，你想先走嗎？

Hey, Todd, this is Chris. I'm not in the room with them, but there must be some sort of audio connection issue.

嘿，托德，這是克里斯。我不在他們的房間裡，但肯定存在某種音訊連接問題。

Hello?

你好？

Hello?

你好？

Can you all hear me?

你們都能聽到我說話嗎？

Yes.

是的。

Can you hear me.

你聽得到我嗎。

Yes. Can you hear me now?

是的。你聽得到我嗎？

Apologies if this Toshi Philips on for Brian.

抱歉，如果這個 Toshi Philips 為 Brian 服務。

This is Fred, and I'm not in the room with them, but they must be having some sort of issue?

這是弗雷德，我不在房間裡，但他們一定有什麼問題吧？

Hang on second because I don't want.

堅持第二個，因為我不想。

Okay, no problem.

好的沒問題。

Is the operator available?

運營商有空嗎？

Asking questions? We can't hear.

問問題？我們聽不到。

This operator, are you able to hear me.

這位接線員，您聽得到我說話嗎？

So I can hear you, Chris.

這樣我就能聽到你的聲音，克里斯。

And then our technology from Jefferies Can hear you. The room with Sharon go and Joanne cannot hear us.

然後我們 Jefferies 的技術就可以聽到您的聲音。莎倫去的房間，喬安妮聽不到我們的聲音。

I'm going to attempt to home dialysis, which could contact them One moment, please. (technical difficulty)

我打算嘗試居家透析，可以聯絡他們，請稍等。（技術難度）

But Darren, can you hear me now?

但是達倫，你現在聽得到我說話嗎？

(technical difficulty) On a higher term loan are experiencing technical issues in Brazil resume momentarily.

（技術困難） 較高期限的貸款在巴西遇到技術問題，暫時恢復。

Hello.

你好。

Can you hear us now it, Joanne, can you hear me?

你現在聽得到我們說話嗎，喬安妮，你聽得到我嗎？

We can hear you now, Dan, I don't know. (multiple speakers)

我們現在可以聽到你的聲音了，丹，我不知道。（多個發言者）

Okay.

好的。

Satoshi Tachi from Jefferies was asking a question.

Jefferies 的 Satoshi Tachi 正在提問。

Hi, all. Can you all hear me.

大家好。你們都能聽到我說話嗎？

(multiple speakers) Yes, I think as you say that, that rate would.

（多個發言者）是的，我認為正如您所說，這個比率會。

Hi. Thank you for taking my question and no worries. And so I now that you have got you have provided some commentary around Q1 and what we should be expecting in terms of revenue and EBITDA. Just curious even qualitatively, can you provide some commentary around what we should be expecting in terms of the cadence of earnings power throughout the rest of the year?

你好。感謝您提出我的問題，不用擔心。現在，您已經提供了有關第一季的一些評論以及我們在收入和 EBITDA 方面的預期。只是好奇，即使是定性的，您能否就我們對今年剩餘時間盈利能力的節奏的預期提供一些評論？

I think Tazeen, it's Joe. I could I could start out. I think I think we expect to follow seasonality trends like we have in past years and you obviously understand the seasonality of the business at this point out of Q2, Q4 being a strong quarter. And as I mentioned in my comments, and Chris and churn both touched on as well. We'd expect to continue to experience growth and see the positive trends that we developed in 2023 expand in 2024. So that's how you can think about it directionally. And then as I mentioned, when we get to Q one earnings in the spring in May, we would we would come out with more definitive guidelines around what that revenue and adjusted EBITDA and probably the clinic count looks like as well.

我認為是塔津恩，是喬。我可以，我可以開始。我認為我們希望像過去幾年一樣遵循季節性趨勢，並且您顯然了解第二季、第四季是強勁季度中業務的季節性。正如我在評論中提到的，克里斯和流失也都談到了。我們預計將繼續實現成長，並看到我們在 2023 年形成的積極趨勢將在 2024 年擴展。這樣你就可以有方向性地去思考。然後，正如我所提到的，當我們在 5 月春季公佈第一季收益時，我們會就收入和調整後 EBITDA 以及診所數量得出更明確的指導方針。

Yes. And we're very proud of that 2023 accomplishment. Many of those initiatives have a Phase two or we have some new initiatives in place and for 2024 related to leveraging technology, streamlining our front end and intake process control continuing to standardize roles and team-based care and so and then the revenue cycle management sophistication. So those are there are we have a portfolio of initiatives, initiatives, Toshi that we are putting in place for 2024 that we will, I think, start seeing some of the traction when we get to Q2.

是的。我們對 2023 年所取得的成就感到非常自豪。其中許多舉措都有第二階段，或者我們在2024 年制定了一些新舉措，涉及利用技術、簡化我們的前端和接收流程控制、繼續標準化角色和基於團隊的護理等等，然後是收入週期管理的複雜性。因此，我們正在為 2024 年實施一系列舉措、舉措和 Toshi，我認為，當我們進入第二季度時，我們將開始看到一些吸引力。

Great. Appreciate that and then a slightly different topic. Just curious around your thoughts on the near term leverage target and the actions you'll take to you hit that target?

偉大的。欣賞這一點，然後是一個稍微不同的話題。只是好奇您對近期槓桿目標的想法以及您為實現該目標將採取的行動嗎？

Well, I think the leverage target we haven't put out there. I would say for us, the focal point has been driving back towards cash flow breakeven. And one of the things I talked about in our last earnings call is I didn't expect 2024 to be a breakeven year, but I think it's a continued building block to getting towards cash flow breakeven in 2025. And if you look back at 2023 and you strip out the noise of our refinancing, we were cash use of somewhere around $35 million, $36 million and $36million of EBITDA. So we need to obviously dependent on interest rates and borrowings, which could move around. We need to continue to grow into our capital structure, which is what we'll look to do in 2024 and continue to build on the momentum that we had last year. But target leverage isn't really our focus just at this point it's really driving more towards cash flow breakeven.

嗯，我認為我們還沒有提出槓桿目標。我想說，對我們來說，焦點一直是恢復現金流損益平衡。我在上次財報電話會議中談到的一件事是，我預計 2024 年不會是損益兩平的一年，但我認為這是 2025 年現金流損益平衡的持續基石。如果你回顧 2023 年，剔除我們再融資的噪音，我們的現金使用額約為 3,500 萬美元、3,600 萬美元和 3,600 萬美元的 EBITDA。因此，我們顯然需要依賴可能變動的利率和借款。我們需要繼續發展我們的資本結構，這是我們 2024 年的目標，並繼續鞏固去年的勢頭。但目標槓桿率並不是我們目前真正關注的焦點，它實際上正在推動現金流損益平衡。

Great. And then just last question for me. Obviously, a lot of improvement this year versus last year and the comps are definitely unfavorable for this year. As you think about the sustainable growth path moving forward, I guess what actions do you need to take to bring back that sustainable growth even on top of tougher comps like we would see in 2023.

偉大的。然後是我的最後一個問題。顯然，今年與去年相比有了很大的進步，而且今年的比較肯定對今年不利。當您思考未來的永續成長之路時，我想您需要採取哪些行動才能恢復永續成長，即使是在 2023 年面臨更嚴峻的競爭的情況下。

I think the growth will follow two paths. One is the traditional areas that we have thought out growth before and that relates to some referrals, emerging referrals, increasing capacity and productivity within the clinics. I also think that we are looking at other less traditional ways to grow the business in parallel, which may relate to our new strategic partners, getting further upstream in the referral process and also looking at different types of reimbursement models.

我認為增長將遵循兩條路徑。一是我們之前考慮過成長的傳統領域，涉及一些轉診、新興轉診、提高診所內的能力和生產力。我還認為，我們正在尋找其他不太傳統的並行方式來發展業務，這可能與我們的新策略合作夥伴有關，在推薦流程中進一步上游，並研究不同類型的報銷模式。

Great. Thank you so much.

偉大的。太感謝了。

Thank you, sir.

謝謝你，先生。

Our next question comes from the line of Bill Sutherland with The Benchmark Company. Please go ahead.

我們的下一個問題來自 Benchmark Company 的 Bill Sutherland。請繼續。

Thank you and everybody. Nice Nice work from here to where are you at this point with the office kind of rationalization process.

謝謝你和大家。很好，從這裡到現在你在辦公室類型的合理化過程中，工作做得很好。

up clinics health?

診所健康嗎？

Clinic. Sorry, Yes.

診所。抱歉，是的。

So we have we are actively on a quarterly basis looking at our clinics and what the performance is and how that performance relates to what's happening within those communities. And so we have a list of clinics that we watch on a regular basis. And as I talked about in my in my call, we will we will continue to prune clinics that don't make sense in this window anymore. And that said, in 2024, we are also looking at how do we maximize our current fleet through consolidations, expansions and upgrades. And we are we similar. We look at where we have more demand than we have capacity. We look at the market and the community to determine if there's an action we can take that makes sense to allow us to improve not only access, but the financial performance of it and then into that, our main focus for this year, we will do a small number of denovos and I would anticipate that we would be looking at more de novos in the future.

因此，我們每季都會積極關注我們的診所，了解其績效如何，以及該績效與這些社區內發生的事情有何關係。因此，我們有一份定期觀察的診所清單。正如我在電話中所說，我們將繼續修剪在此視窗中不再有意義的診所。也就是說，到 2024 年，我們還將研究如何透過整合、擴張和升級來最大限度地利用現有機隊。我們是相似的。我們著眼於哪裡的需求大於我們的能力。我們關注市場和社區，以確定我們是否可以採取一項有意義的行動，不僅可以改善准入，還可以改善其財務績效，然後進入這一點，這是我們今年的主要重點，我們將這樣做少量的從頭開始，我預計我們將來會考慮更多的從頭開始。

So it sounds like maybe you just hold steady with office count between now absent and closures and you're just looking to increase productivity again for client base.

因此，聽起來也許您只是在現在缺席和關閉之間保持辦公室數量穩定，並且您只是希望再次提高客戶群的生產力。

Yes, I think go in the clinics that would fall into our quote-unquote watch list. That list has been getting smaller as we've closed some clinics last year, but then also performance improved throughout the year, referrals have been going up. Number of clinicians have been going up, both of those contribute to clinics coming off the watch list. And so we are in process of and we're constantly in process of reevaluating our watch list and determining what, if any, clinics might close in in 2024. So it's hard to say exactly what that number looks like right now. But I think as we move towards the first quarter, we'll probably have a pretty decent view that we can share.

是的，我認為去那些屬於我們的報價觀察名單的診所。由於我們去年關閉了一些診所，名單變得越來越小，但全年業績也有所改善，轉診量一直在增加。臨床醫生的數量一直在增加，這兩者都有助於診所脫離觀察名單。因此，我們正在不斷地重新評估我們的觀察名單，並確定哪些診所（如果有的話）可能會在 2024 年關閉。所以現在很難確切地說出這個數字是什麼樣的。但我認為，隨著我們進入第一季度，我們可能會有一個可以分享的相當不錯的觀點。

Yes.

是的。

And our goal is to continue to grow the footprint, but it also is important to make sure we're maximizing what we've already built.

我們的目標是繼續擴大足跡，但確保我們最大限度地利用我們已經建立的東西也很重要。

Sure. On the hiring and productivity front churn has improved. Do you expect to further improve it? And where are you contract utilization versus where you'd like to be?

當然。在招募和生產力方面，客戶流失率有所改善。您期望進一步改進嗎？您的合約利用率與您想要的情況相比如何？

So three parts to that question, I would say one, we are continuing to hire and we we had put a lot of energy into rebuilding our structure around our talent acquisition and our retention. So both of those are key factors that I think will continue to produce for us in 2024.

對於這個問題，我想說的三個部分是：第一，我們正在繼續招聘，我們投入了大量精力圍繞人才獲取和保留來重建我們的結構。因此，我認為這兩個因素將在 2024 年繼續為我們帶來影響。

I'm going to I'm going to let Chris answer the productivity question because he's very close to it. And then I would just say the other is we're sitting on about 7% of our total commission headcount to our contractors. And we continue in certain geographies to be dependent upon contractors where we have more supply than we have to miss the back, but the other way around where we have more demand than we have supply and the team is very cognizant of that. And we I don't I actually don't see 2024 being a year where we move fully back to a lower level of contractors similar to what we had prior to COVID. I think it's going to well, I think we're going to have continue to have a reliance on contractors for the year with the eye toward I'm trying to where we can and beef up the FT.s and not so not not have to rely on those contractors.

我會讓克里斯回答生產力問題，因為他非常接近這個問題。然後我只想說另一個是我們向承包商收取的佣金佔總佣金的約 7%。在某些地區，我們繼續依賴承包商，在這些地區，我們的供應量比我們必須錯過的供應量要多，但相反，在我們的需求量大於供應量的地方，我們的團隊非常清楚這一點。事實上，我不認為 2024 年我們會完全回歸到與新冠疫情之前類似的較低級別承包商。我認為一切都會順利，我認為今年我們將繼續依賴承包商，專注於我正在盡我們所能並加強《金融時報》，而不是沒有依賴那些承包商。

And Chris, why don't you take the productivity question for Bill?

克里斯，你為什麼不回答比爾的生產力問題呢？

What I would say is that we do see room for continued productivity growth. As we look out across the country we serve, we see certain geographies performing. Some of that is due to some legacy targets that were set at different levels by different geographic P&L owners. Some of that is due to referral demand within particular geographies, and some of it is just pure execution. So those are all levers that we are going after this year. We've standardized our expectations and across all of our geographies to kind of the higher levels of what we had previously had some were managing outliers in a very robust way. And then we do see some of the pockets where we've historically had some referral needs growing with referrals, which is helping us to improve productivity.

我想說的是，我們確實看到了生產力持續成長的空間。當我們放眼所服務的國家時，我們發現某些地區表現出色。其中部分原因是不同地區的損益所有者在不同層級設定了一些遺留目標。其中一些是由於特定地區的推薦需求，還有一些只是純粹的執行。這些都是我們今年要追求的槓桿。我們已經在所有地區標準化了我們的期望，以達到我們之前以非常穩健的方式管理異常值的更高水平。然後我們確實看到一些我們歷來有推薦需求的領域隨著推薦而成長，這有助於我們提高生產力。

And then finally, I'd take you to my prepared comments. The continued process innovation, removal of administrative burden should open up the ceiling to be even higher there.

最後，我將帶您閱讀我準備好的評論。持續的流程創新、行政負擔的消除應該會打開更高的上限。

Got you hit a big hit on three things build that are that are going to continue to be important in 2024. And like I said, we're kind of Chapter two. We made some improvements and had great progress in '23. And we've lined up what next to continue to push on those pieces.

讓您在 2024 年仍將繼續重要的三件事上取得巨大成功。就像我說的，我們已經進入了第二章。我們在 23 年做了一些改進並取得了很大的進步。我們已經安排了下一步繼續推動這些工作的計劃。

Thank you, so much for all the color guys.

謝謝你們，非常感謝所有顏色的傢伙。

There are no further questions at this time. I would now like to turn the call over to Sharon BD for closing remarks.

目前沒有其他問題。我現在想將會議轉交給 Sharon BD 進行總結發言。

So first of all, apologies for those technical difficulties. I guess everyone could hear each other except for us. So apologies there, and thank you for joining us. Thank you for the questions and participation, and we look forward to sharing our progress at our next earnings call, which will be early May of 2024.

首先，對這些技術困難表示歉意。我想除了我們之外每個人都能聽到彼此的聲音。在此深表歉意，並感謝您加入我們。感謝您的提問和參與，我們期待在 2024 年 5 月初舉行的下一次財報電話會議上分享我們的進度。

This concludes today's call. You may now disconnect.

今天的電話會議到此結束。您現在可以斷開連線。