Aveanna Healthcare Holdings Inc (AVAH) 2023 Q4 法說會逐字稿

Good morning, and welcome to the Aveanna Healthcare Holdings Fourth Quarter 2023 earnings conference call. Today's call is being recorded, and we have allocated one hour for prepared remarks and Q&A. At this time, I'd like to turn the call over to Debbie Stewart Aveanna, Chief Accounting Officer. Thank you. You may begin.

早安，歡迎參加 Aveanna Healthcare Holdings 2023 年第四季財報電話會議。今天的電話會議正在錄音，我們分配了一小時準備發言和問答。現在，我想將電話轉給首席會計官 Debbie Stewart Aveanna。謝謝。你可以開始了。

Good morning, and welcome to Aveanna Fourth Quarter 2023 earnings call. I am Debbie Stewart, the Company's Chief Accounting Officer. With me today is Jeffrey Shaner, our Chief Executive Officer, and Matt Buckhalter, our Chief Financial Officer.

早上好，歡迎參加 Aveanna 2023 年第四季財報電話會議。我是黛比·斯圖爾特，公司首席會計官。今天與我在一起的有我們的執行長 Jeffrey Shaner 和我們的財務長 Matt Buckhalter。

During this call, we will make forward-looking statements. Risk factors that may impact those statements and could cause actual future results to differ materially from currently projected results are described in this morning's press release and the reports we file with the SEC. The Company does not undertake any duty to update such forward-looking statements.

在本次電話會議中，我們將做出前瞻性陳述。今天上午的新聞稿和我們向 SEC 提交的報告中描述了可能影響這些陳述並可能導致未來實際結果與當前預測結果有重大差異的風險因素。本公司不承擔更新此類前瞻性陳述的任何責任。

Additionally, during today's call, we will discuss certain non-GAAP measures, which we believe can be useful in evaluating our performance. The presentation of this additional information information should not be considered in isolation or as a substitute for results prepared in accordance with GAAP. A reconciliation of these measures can be found in this morning's press release, which is posted on our website at Aveanna.com and in our most recent annual report on. Form 10-K, which will be filed with the SEC this afternoon. With that, I will turn the call over to our Aveanna, Chief Executive Officer, Jeffrey Shaner.

此外，在今天的電話會議中，我們將討論某些非公認會計準則衡量標準，我們認為這些衡量標準有助於評估我們的績效。不應孤立地考慮此附加資訊的呈現，也不應將其視為根據 GAAP 準備的結果的替代品。這些措施的協調可以在今天上午的新聞稿中找到，該新聞稿發佈在我們的網站 Aveanna.com 和我們最近的年度報告中。10-K 表，將於今天下午向 SEC 提交。接下來，我將把電話轉給我們的執行長 Jeffrey Shaner。

Jeff you, Debbie. Good morning and thank you for joining us today. We appreciate each of you investing your time this morning to better understand our Q4 and full year 2023 results and how we are moving our Aveanna forward in 2024 and beyond. My initial comments will briefly highlight our fourth quarter and full year 2023 results, along with the steps we are taking to address the labor markets and our ongoing efforts with government and preferred payers to create additional capacity.

傑夫，你，黛比。早安，感謝您今天加入我們。我們感謝大家今天早上投入時間來更好地了解我們的第四季度和 2023 年全年業績，以及我們如何在 2024 年及以後推動 Aveanna 的發展。我的初步評論將簡要強調我們第四季和 2023 年全年的業績，以及我們為解決勞動力市場問題而採取的措施，以及我們與政府和首選付款人持續努力創造額外產能的努力。

I will then provide insight on how we are thinking about year two of our strategic transformation and overall outlook for 2024 prior to turning the call over to Matt to provide further details into the quarter and our 2024 outlook.

然後，我將介紹我們如何思考第二年的策略轉型和 2024 年的整體前景，然後將電話轉交給 Matt，以提供有關本季和 2024 年前景的更多詳細資訊。

Starting with some highlights for the fourth quarter and full year 2023 revenue for the fourth quarter was approximately $479 million, representing a 6.1% increase over the prior year period. Fourth quarter adjusted EBITDA was$38.7 million, representing a 30.4% increase over the prior year period, primarily due to the improved payer rate environment as well as cost reduction efforts taking hold.

從第四季的一些亮點開始，2023 年第四季的全年營收約為 4.79 億美元，比去年同期成長 6.1%。第四季調整後 EBITDA 為 3,870 萬美元，比上年同期成長 30.4%，這主要是由於付款人費率環境的改善以及成本削減措施的落實。

Finally, full year 2023 revenue and adjusted EBITDA was approximately $1.895 billion and, $139.2 million representing a 6% and 7.6% restrict respective increase over the prior year. As we have previously discussed, the labor environment represented the primary challenge that we needed to address in 2023 to see the on resume the growth trajectory that we believe our company could achieve.

最後，2023 年全年營收和調整後 EBITDA 約為 18.95 億美元，其中 1.392 億美元分別較上年增長 6% 和 7.6%。正如我們之前討論的那樣，勞動力環境是我們在 2023 年需要解決的主要挑戰，以確保我們的公司能夠恢復成長軌跡。

It is important to note that our industry does not have a demand problem. The demand for home and community-based care continues to be strong with both state and federal governments and managed care organizations asking for solutions that can create more capacity.

需要注意的是，我們這個行業不存在需求問題。對家庭和社區護理的需求持續強勁，州和聯邦政府以及管理式護理組織都在尋求能夠創造更多能力的解決方案。

I am proud of our focus and execution in 2023 as we aligned our objectives with those of our preferred payers and government partners by focusing our clinical capacity on our preferred payers, we achieved year-over-year growth in revenue and adjusted EBITDA. We also experienced improvement in our caregiver hiring and retention trends by aligning our efforts to those payers willing to engage with us on enhanced reimbursement rates and value-based agreements.

我對2023 年的重點和執行力感到自豪，因為我們將我們的臨床能力集中在我們的首選付款人身上，從而將我們的目標與我們的首選付款人和政府合作夥伴的目標保持一致，我們實現了營收和調整後EBITDA 的年成長。透過將我們的努力與那些願意與我們合作提高報銷率和基於價值的協議的付款人結合起來，我們的護理人員招聘和保留趨勢也得到了改善。

While we continue to operate in a challenging labor and inflationary environment, our preferred payer strategy allows us to return to a more normalized growth rate in our business segments since our third quarter earnings call, I am pleased with the continued progress we have made on several of our rate improvement initiatives with both government and preferred payers as well as the continued signs of improvement in the caregiver labor market.

雖然我們繼續在充滿挑戰的勞動力和通貨膨脹環境中運營，但自第三季度財報電話會議以來，我們的首選付款人策略使我們的業務部門能夠恢復到更加正常化的增長率，我對我們在幾個方面取得的持續進展感到高興我們與政府和首選付款人的費率改善舉措以及護理人員勞動力市場持續改善的跡象。

Specifically, as it relates to our Private Duty Services business, our goal for 2023 was to execute a legislative strategy that would increase rates by double digit percentages across our various states, with particular emphasis on California, Texas and Oklahoma, which represented approximately 25% of our total PDS revenue.

具體來說，由於與我們的私人值班服務業務相關，我們2023 年的目標是執行一項立法策略，將各州的費率提高兩位數百分比，特別是加州、德州和俄克拉荷馬荷馬州，佔約25%我們的 PDS 總收入。

At year end 2023, we had successfully obtained double digit PDS rate increases in eight key states, including Oklahoma. We have also achieved rate wins in the additional 11 states that were either in line or slightly better than our expectations. These combined 19 states represent approximately 55% of our PDS footprint, and we expect to see positive progress into 2024 as we focus on the remaining states. As a point of reference, the majority of the rate increases were effective in the second half of 2023, which will result in a full year benefit in 2024.

到 2023 年底，我們在包括俄克拉荷馬州在內的八個關鍵州成功實現了兩位數的 PDS 費率成長。我們還在另外 11 個州取得了利率勝利，這些州的利率符合或略好於我們的預期。這 19 個州合計約占我們 PDS 足跡的 55%，隨著我們專注於其餘州，我們預計到 2024 年將取得積極進展。作為參考，大部分升息在 2023 年下半年生效，這將在 2024 年帶來全年效益。

While we are pleased that our PDS. legislative messaging has been well received by state legislatures. We still have much work to do. As an example of the work ahead. Our PDN rate request was not included in the California governor's proposed budget. We believe that we made significant strides with the governor medical department leadership and California Legislature, demonstrating the importance of PDN rate increases and how they support an overall lower health care cost improve patient satisfaction and quality outcomes. However, it is clear that we need to further accelerate our preferred payer strategy and government affairs efforts to continue to advocate for children with complex medical conditions.

雖然我們很高興我們的 PDS。立法資訊受到州立法機構的好評。我們還有很多工作要做。作為未來工作的一個例子。我們的 PDN 費率請求未包含在加州州長的擬議預算中。我們相信，我們與州長醫療部門領導層和加州立法機構取得了重大進展，證明了 PDN 費率提高的重要性，以及它們如何支持整體降低醫療保健成本，提高患者滿意度和品質結果。然而，很明顯，我們需要進一步加快我們的首選付款人策略和政府事務工作，以繼續為患有複雜疾病的兒童提供支援。

This strategy allows us to become a solution for overcrowded children's hospitals and distraught parents who want their children to be cared for in the comfort of their home. We have a proven track record of expanding our preferred payer programs and will enhance our efforts in California similar to our approach in other states.

這項策略使我們能夠成為人滿為患的兒童醫院和那些希望孩子在舒適的家中得到照顧的心煩意亂的父母的解決方案。我們在擴大首選付款人計劃方面擁有良好的記錄，並將加強我們在加州的努力，類似於我們在其他州的做法。

As we look at our preferred payer initiatives, in other states. Our goal for 2023 was to double our PDS. preferred payers from 7 to 14. In the fourth quarter, we added two additional preferred payer agreements achieving our goal of 14. Our PDS. preferred payer volumes remain consistent at 17% of total PDS. volumes. We are optimistic that we will continue to execute this strategic initiative into 2024.

當我們審視其他州的首選付款人計劃時。我們 2023 年的目標是將 PDS 增加一倍。 7 至 14 歲的首選付款人。在第四季度，我們增加了兩項額外的首選付款人協議，實現了 14 項的目標。我們的PDS。首選付款人數量維持在 PDS 總量的 17%。卷。我們樂觀地認為，我們將在 2024 年繼續執行這項策略性舉措。

While we are taking a national approach to our PDS. preferred payer strategy, where we are placing particular focus in 2024 on the state of California and continuing our positive traction in the state of Texas using Texas. As a point of reference, as of year-end, we are approaching 60% of our Texas PDN volumes with a preferred payer and still believe we have an opportunity to further improve this trend to approximately 70% in 2024.

我們正在對 PDS 採取全國性的方法。首選付款人策略，我們將在 2024 年特別關注加利福尼亞州，並利用德克薩斯州繼續在德克薩斯州發揮積極作用。作為參考，截至年底，我們的德州 PDN 交易量中首選付款人的比例已接近 60%，並且仍然相信我們有機會在 2024 年將這一趨勢進一步改善至約 70%。

We plan to execute a similar playbook in California over the next 18 to 24 months and are optimistic we can achieve positive results. Moving to our preferred payor progress in home health our goal for 2023 was to improve our episodic payer mix by 10% from approximately 60% to above 70% by year-end 2023. We signed a total of eight episodic agreements in 2023 and improved our episodic mix from approximately 60% at the end of 2022 to 74% in Q4. We continue to remain focused on aligning our. Home Health caregiver capacity with those payers willing to reimburse us on an episodic basis and focus on improved clinical and financial outcomes. We are encouraged by our 2023 rate increases, preferred payer agreements and subsequent recruiting results.

我們計劃在未來 18 至 24 個月內在加州執行類似的方案，並對能夠取得積極成果持樂觀態度。轉向我們在家庭健康方面的首選付款人進展，我們 2023 年的目標是到 2023 年年底將我們的間歇性付款人組合提高 10%，從大約 60% 提高到 70% 以上。2023 年，我們總共簽署了八項情境協議，並將我們的情境組合從 2022 年底的約 60% 提高到第四季的 74%。我們繼續專注於調整我們的。家庭健康照護人員的能力，那些願意定期向我們報銷並專注於改善臨床和財務結果的付款人。我們對 2023 年的升息、首選付款人協議和隨後的招聘結果感到鼓舞。

Our business is demonstrating signs of recovery as we achieve our rate goals previously discussed home and community-based care will continue to grow, and Vienna is a comprehensive platform with a diverse payer base, providing a cost-effective, high-quality alternative to higher cost care settings. And most importantly, we provide this care in the most desirable setting, the comfort of the patient's home.

隨著我們實現先前討論的費率目標，我們的業務正在顯示復甦的跡象。基於家庭和社區的護理將繼續增長，維也納是一個擁有多元化付款人基礎的綜合平台，為更高的醫療服務提供了一種經濟高效、高品質的替代方案。成本護理設定。最重要的是，我們在最理想的環境——患者舒適的家中提供這種護理。

Before I turn the call over to Matt, let me comment on our strategic plan and our initial outlook for 2024. As we enter year two of our strategic transformation, we remain highly focused on those initiatives that created positive momentum in 2023.

在我把電話轉給 Matt 之前，讓我先談談我們的策略計畫和 2024 年的初步展望。隨著我們進入策略轉型的第二年，我們仍然高度關注那些在 2023 年創造積極勢頭的舉措。

We will continue to focus our efforts on four primary strategies. First, enhancing partnerships with government and preferred payers to create additional caregiver capacity, second, identifying cost efficiencies and synergies that allow us to leverage our growth, third, managing our capital structure and collecting our cash while producing positive free cash flow and forward engaging our leaders and employees and delivering our Aveanna mission.

我們將繼續集中精力實施四項主要策略。首先，加強與政府和首選付款人的合作夥伴關係，以創造額外的護理能力，其次，確定成本效率和協同效應，使我們能夠利用我們的成長，第三，管理我們的資本結構並收集現金，同時產生正的自由現金流並向前參與我們的業務。領導者和員工，並實現我們的 Aveanna 使命。

While executing the above key strategies. We still believe it is important to set expectations that acknowledge the environment that we are operating in and the time it will take to fully transform our company to sustain growth. Accordingly, we expect we currently expect full year 2024 revenue to be in a range of $1.96 billion to $1.98 billion and adjusted EBITDA to be in a range of $146 million to $150 million. We believe our outlook provides a prudent view considering the challenges we face with the evolving labor market and hopefully it proves to be conservative as we execute throughout the year.

在執行上述關鍵策略的同時。我們仍然認為，設定預期非常重要，要考慮到我們所處的營運環境以及全面轉型公司以維持成長所需的時間。因此，我們目前預計 2024 年全年營收將在 19.6 億美元至 19.8 億美元之間，調整後 EBITDA 將在 1.46 億美元至 1.5 億美元之間。我們相信，考慮到我們在不斷變化的勞動力市場中面臨的挑戰，我們的前景提供了審慎的觀點，並希望在我們全年執行時它被證明是保守的。

In closing, I am very proud of our Aveanna team. We offer a cost-effective patient preferred and clinically sophisticated solution for our patients and families. Furthermore, we are the right solution for our payers, referral sources and government partners by partnering with preferred payers, we can and will move rate and wage metrics in meaningful ways that support our growth.

最後，我為我們的 Aveanna 團隊感到非常自豪。我們為患者和家屬提供經濟高效、患者首選且臨床複雜的解決方案。此外，透過與首選付款人合作，我們是付款人、推薦來源和政府合作夥伴的正確解決方案，我們可以並將以有意義的方式調整費率和工資指標，以支持我們的成長。

This strategy allows us to hire, retain and engage more caregivers in providing the mission of Aveanna every day. With that, let me turn the call over to Matt to provide further details on the quarter and our 2024 outlook. Matt?

這項策略使我們能夠僱用、保留和吸引更多的護理人員來每天履行 Aveanna 的使命。接下來，讓我將電話轉給 Matt，以提供有關本季和 2024 年展望的更多詳細資訊。馬特？

Thanks, Jeff, and good morning. I'll first talk about our fourth quarter financial results and liquidity before providing additional details on our initial outlook for 2024. Starting with the top line, we saw revenues rise 6.1% over the prior year period to $479 million. We experienced revenue growth in two of our operating divisions, led by our. Private Duty Services and Medical Solutions segments, which grew by 6.1% and 17.5% compared to the prior year quarter.

謝謝，傑夫，早安。我將首先討論我們第四季度的財務表現和流動性，然後提供有關 2024 年初步展望的更多詳細資訊。從營收開始，我們看到營收比去年同期成長 6.1%，達到 4.79 億美元。在我們的帶領下，我們的兩個營運部門的收入實現了成長。私人值班服務和醫療解決方案領域，與去年同期相比分別成長 6.1% 和 17.5%。

Consolidated gross margin was $148.4 million or 31%, representing a 15.3% increase over the prior year period. Consolidated adjusted EBITDA was $38.7 million, a 30.4% increase as compared to the prior year, reflecting the improved payer rate environment as well as cost reduction efforts taking hold.

綜合毛利率為 1.484 億美元，即 31%，比上年同期成長 15.3%。綜合調整後 EBITDA 為 3,870 萬美元，比上年增長 30.4%，反映出付款人利率環境的改善以及成本削減措施的落實。

Now taking a deeper look at each of our segments, starting with Private Duty Services. Revenue for the quarter was approximately $383 million, a 6.1% increase and was driven by approximately $10.1 million hours of care, a volume increase of 5.1% over the prior year. Our volumes have improved over the prior year. We continue to be constrained in our top-line growth due to the shortage of available caregivers.

現在，從私人值班服務開始，更深入地研究我們的每個細分市場。該季度的營收約為 3.83 億美元，成長 6.1%，主要得益於約 1,010 萬美元的護理小時數，比上一年增長 5.1%。我們的銷量比前一年有所改善。由於護理人員短缺，我們的收入成長繼續受到限制。

Although we are continuing to see signs of improvement and the labor market, Q4 revenue per hour of $38.4 was up $0.38 or 1% as compared to the prior year quarter. We remain optimistic about our ability to attract caregivers and address market demands for our services when we obtain acceptable reimbursement rates.

儘管我們繼續看到勞動力市場改善的跡象，但第四季度每小時收入為 38.4 美元，比去年同期增長了 0.38 美元，即 1%。當我們獲得可接受的報銷率時，我們對吸引護理人員並滿足市場對我們服務的需求的能力保持樂觀。

Turning to our cost of labor and gross margin metrics, we achieved $103.6 million of gross margin or 27%, a 12.7% increase from the prior year quarter. Our cost of revenue rate of $27.76 was sequentially flat from Q3. While we continue to experience wage pressures in the labor markets, we did improve our Q4 spread per hour to $10.28, representing a 7.6% increase over the prior year.

就我們的勞動成本和毛利率指標而言，我們實現了 1.036 億美元的毛利率，即 27%，比去年同期增長了 12.7%。我們的營收成本率為 27.76 美元，與第三季持平。雖然我們繼續面臨勞動力市場的工資壓力，但我們確實將第四季度的每小時工資提高至 10.28 美元，比前一年增長了 7.6%。

Moving on to our Home Health & Hospice segment. Revenue for the quarter was approximately $54 million, a 1.1% decrease over the prior year. Revenue was driven by 9,200 total admissions with approximately 74% being episodic and 11,300 total episodes of care up sequentially from Q3, Medicare revenue per episode for the quarter was $3,064, up 1.8% as compared to the prior year.

繼續我們的家庭健康和臨終關懷部分。該季度營收約為 5,400 萬美元，比去年同期下降 1.1%。收入由 9,200 起總入院人數推動，其中約 74% 為偶發性護理，從第三季度開始，總共有 11,300 起護理事件，本季度每起醫療保險收入為 3,064 美元，比上一年增長 1.8%。

We continue to focus on rightsizing our approach to growth in the near term by focusing on preferred payers that reimburse us on an episodic basis. This episodic focus has accelerated our margin expansion and improved our clinical outcomes with episodic admissions over 70%. We have achieved our goals of rightsizing our margin profile and enhancing our clinical offerings.

我們繼續專注於短期內調整我們的成長方式，並專注於定期向我們償還費用的首選付款人。這種偶發性重點加速了我們的利潤擴張，並改善了我們的臨床結果，偶發性入院率超過 70%。我們已經實現了調整利潤狀況和增強臨床產品的目標。

As we enter 2024, we believe our admission growth will normalize in the 3% to 5% range. We are committed to a disciplined approach to growth while shifting our capacity to those payers who value our clinical resources. We're pleased with our gross margin of 50.9% in Q4, demonstrating our continued focus on cost initiatives to achieve our targeted margin profile. We believe this is the right long-term growth strategy, and we hold a strong belief in this business and its lasting value proposition.

進入 2024 年，我們相信入學人數成長將正常化在 3% 至 5% 的範圍內。我們致力於採取嚴格的成長方式，同時將我們的能力轉移給那些重視我們臨床資源的付款人。我們對第四季度 50.9% 的毛利率感到滿意，這表明我們繼續專注於成本計劃，以實現我們的目標利潤率。我們相信這是正確的長期成長策略，並且我們對這項業務及其持久的價值主張抱持堅定的信念。

Our home health and hospice platform is dedicated to creating value through effective operational management and the delivery of exceptional patient care now your Medical Solutions segment results for Q4. During the quarter, we produced revenue of $41.3 million, a 17.5% increase over the prior year. Revenue was driven by approximately 90,000 unique patients served an 8.4% increase to the prior year period and revenue per UPS of $458.80.

我們的家庭健康和臨終關懷平台致力於透過有效的營運管理和提供卓越的患者護理來創造價值，現在您的醫療解決方案部門第四季度的業績。本季度，我們實現營收 4,130 萬美元，比上年增長 17.5%。收入由大約 90,000 名獨特患者提供的服務推動，比去年同期增長 8.4%，每個 UPS 的收入為 458.80 美元。

Gross margins were 42% for the quarter, up 2.3% over the prior year period. And in line with our targeted margin profile for Medical Solutions, we continue to implement initiatives to be more effective and efficient in our operations to leverage overhead as we continue to grow. While other essential providers have decided to exit the market, we see this as an opportunity to expand our national interest presence and to further our payer partnerships.

該季度毛利率為 42%，比去年同期成長 2.3%。根據我們醫療解決方案的目標利潤狀況，我們繼續實施舉措，以提高我們的營運效率和效率，以在我們不斷發展的同時利用管理費用。雖然其他重要提供者已決定退出市場，但我們認為這是擴大我們的國家利益影響力並進一步加強我們的付款人夥伴關係的機會。

In summary, we continue to fight through a difficult labor environment while keeping our patients care at the center of everything we do, it is clear to us shifting caregiver capacity to those preferred payers who value our partnership is the path forward at Aveanna.

總而言之，我們繼續在艱難的勞動環境中奮鬥，同時將患者護理置於我們所做一切的中心，很明顯，我們將護理能力轉移給那些重視我們合作夥伴關係的首選付款人是 Aveanna 的前進道路。

As Jeff stated, our primary challenge continues to be reimbursement rates with the positive momentum we experienced in 2023. We are optimistic that such trends will continue into 2024 as we continue to make progress with the rate environment will pass through wage improvements and other benefits to our caregivers and the ongoing effort to better improve volumes.

正如傑夫所說，我們的主要挑戰仍然是報銷率，以及我們在 2023 年經歷的積極勢頭。我們樂觀地認為，這種趨勢將持續到 2024 年，因為我們將透過提高護理人員的薪資和其他福利以及不斷努力更好地提高數量來繼續在費率環境方面取得進展。

Now moving to our balance sheet and liquidity. At the end of the fourth quarter, we had liquidity in excess of $232 million, representing cash on hand of approximately $43.9 million, $20 million of availability under our securitization facility and approximately $168 million of availability on our revolver, which was undrawn as of the end of the quarter. Lastly, we have $32 million and outstanding letters of credit at the end of Q4. I'm proud of the progress we've made in enhancing our overall liquidity throughout the year.

現在轉向我們的資產負債表和流動性。截至第四季末，我們的流動性超過2.32 億美元，其中手頭現金約為4,390 萬美元，證券化工具下的可用資金為2,000 萬美元，左輪手槍的可用資金約為1.68 億美元，截至2019 年尚未提取。季度末。最後，截至第四季末，我們有 3,200 萬美元的未償信用證。我對我們全年在增強整體流動性方面取得的進展感到自豪。

On the debt services front, we had approximately $1.47 billion of variable-rate debt at the end of Q4. Of this amount, $520 million is hedged with fixed rate swaps and $880 million, subject to an interest rate cap, which limits further exposure to increases. And so far above 3%. Accordingly, substantially all of our variable rate debt is hedged. Our interest rate swaps extend through June 2026, and our interest rate caps extend through February 2027. One last item I will mention related to our debt is that we have no material term loan maturities until July 2028.

在債務服務方面，截至第四季末，我們的可變利率債務約為 14.7 億美元。其中，5.2 億美元透過固定利率互換進行對沖，8.8 億美元受到利率上限的限制，從而限制了進一步上漲的風險。到目前為止，這一比例已超過 3%。因此，我們幾乎所有的浮動利率債務都進行了對沖。我們的利率掉期有效期至 2026 年 6 月，利率上限有效期至 2027 年 2 月。我要提到的與我們的債務相關的最後一項是，我們在 2028 年 7 月之前沒有重大定期貸款到期。

Looking at cash flow, cash provided by operating activities was positive $22.7 million for the quarter, and free cash flow was positive approximately $12.5 billion, while Q4 benefited from some timing related items, which we expect to be moderate headwinds into Q1 cash flows. We continue to believe we'll be a positive operating cash flow company in 2024, and we also expect to see continued cash flow benefits as our top line and cost management initiatives come to fruition.

從現金流來看，本季經營活動提供的現金為正2,270 萬美元，自由現金流為正約125 億美元，而第四季受益於一些與時間相關的項目，我們預計這將對第一季度現金流產生溫和的阻力。我們仍然相信，到 2024 年，我們將成為一家正營運現金流的公司，隨著我們的營收和成本管理計畫取得成果，我們也預計將看到持續的現金流效益。

Before I hand the call over to the operator for Q&A, let me take a moment to address our initial outlook for 2024. As Jeff mentioned, we currently expect full year revenue to be in the range of $1.96 billion to 1.98 billion an adjusted EBITDA range of $146 million to $150 million. As we think about seasonality, we expect our revenue to grow as rate increases are implemented throughout the year and our volumes grow.

在我將電話轉交給接線員進行問答之前，讓我花點時間談談我們對 2024 年的初步展望。正如傑夫所提到的，我們目前預計全年營收在 19.6 億美元至 19.8 億美元之間，調整後的 EBITDA 範圍在 1.46 億美元至 1.5 億美元之間。當我們考慮季節性時，我們預計隨著全年費率的提高和銷售量的成長，我們的收入將會成長。

Accordingly we expect approximately 20% of our full year adjusted EBITDA guidance to be recognized in the first quarter and approximately 44% of our full year guided adjusted EBITDA to be recognized in the first half of 2024, as most of our annual rate increases typically become effective in the second half of the year, we expect our adjusted EBITDA to ramp as we use dose increases to attract and retain more caregivers and drive volumes.

因此，我們預計全年調整後EBITDA 指引的約20% 將在第一季度得到確認，全年調整後EBITDA 指引的約44% 將在2024 年上半年得到確認，因為我們的大部分年利率成長通常將成為從今年下半年開始，我們預計調整後的 EBITDA 將大幅增加，因為我們利用劑量增加來吸引和留住更多的護理人員並推動銷售。

Our EBITDA will also ramp as we realize the benefits of our continued cost savings initiatives and closing. I'm proud of all of our Aveanna team members and our hard work in achieving our 2023 results. I look forward to the continued execution of our 2024 strategic plan and updating you further at the end of Q1 with debt, let me turn the call over to the operator, thank queue.

隨著我們意識到持續的成本節約計劃和關閉的好處，我們的 EBITDA 也將大幅成長。我為我們所有 Aveanna 團隊成員以及我們為實現 2023 年業績所做的辛勤工作感到自豪。我期待繼續執行我們的 2024 年戰略計劃，並在第一季末進一步向您通報債務情況，讓我將電話轉給接線員，謝謝隊列。

At this time, we'll be conducting a question-and-answer session. (Operator Instructions).

此時，我們將進行問答環節。（操作員說明）。

Brian Tanquilut from Jefferies

傑富瑞 (Jefferies) 的布萊恩坦奎魯特 (Brian Tanquilut)

Good morning. You have Taji Phillips on for Brian. Thank you for taking my question. So maybe to start, the midpoint of your guidance implies that margins will be roughly 7.5% for 2024. Maybe can you talk to the building blocks that are or key assumptions that are built into your margins for 2024? And what would need to happen to see the business outperform your implied guidance? And then lastly, if you can provide much detail, break down the margin expectations across all three segments?

早安.塔吉·菲利普斯 (Taji Phillips) 替補布萊恩 (Brian)。感謝您回答我的問題。因此，也許首先，你們指導的中點意味著 2024 年的利潤率將約為 7.5%。也許您能談談 2024 年利潤中的建置模組或關鍵假設嗎？需要做什麼才能看到該業務超越您的隱含指導？最後，如果您可以提供更多細節，細分所有三個細分市場的利潤預期？

Hi, Taji. Good morning, guys. Thanks for your question. I think I'll it all started, and I'll turn it over to Matt. But I think as we think of our 2024 guidance, you know, we have we have very good visibility into rate coming out of 2023. So, I think first, and that story is we've got solid momentum from our 19 rate increases. I think five or six, those rate increases were effective 1/1 of '24. So we've got nice momentum rolling into the year. We know our Home Health & Hospice final rule.

嗨，塔吉。早上好傢伙。謝謝你的提問。我想我會開始一切，然後把它交給馬特。但我認為，當我們考慮 2024 年的指引時，我們對 2023 年的利率有很好的了解。所以，我認為首先，我們從 19 次升息中獲得了堅實的動力。我認為有五到六個，這些利率上調於 24 年 1 月 1 日生效。因此，今年我們的勢頭良好。我們知道我們的家庭健康和臨終關懷最終規則。

So really good visibility into this year. Obviously, we're now working on a legislative plan for 2024 which most of those come due mid to late year. So, our heads are down on the year in Matt's prepared remarks, he talked about 20% of the implied guide we think will be in Q1. We would remind everyone, Q1 is our from a seasonal standpoint, is our low point.

今年的能見度非​​常好。顯然，我們現在正在製定 2024 年的立法計劃，其中大部分計劃將於今年中後期完成。因此，在馬特準備好的演講中，我們對這一年的情況感到沮喪，他談到了我們認為將在第一季度出現的隱含指南的 20%。我們要提醒大家，從季節角度來看，第一季是我們的低點。

We've got a lot of payroll tax headwinds in Q1 coming out of the holidays, but we're off sitting here in early March. We're off to a really nice start to the year. We're very pleased on where we are today. So I think you'd see it from our standpoint building throughout the year, Q1 being our low point, but pleased to have levers to pull up.

假期過後，我們在第一季遇到了許多工資稅的阻力，但我們將在三月初坐在這裡。今年我們有一個非常好的開始。我們對今天的處境感到非常高興。因此，我認為您會從我們全年的立場來看，第一季是我們的低點，但很高興有槓桿拉升。

I think big picture, you know, we we remain prudent. I'll use the word prudent in our in our guidance that we continue to execute against our strategic plan to rebuild the company. Our ultimate goal target is still to get back to 10% adjusted EBITDA, and we're still a year or so from that point.

我認為從大局來看，我們仍然保持謹慎。我將在我們的指導中使用謹慎這個詞，我們將繼續執行重建公司的策略計畫。我們的最終目標仍然是恢復到 10% 的調整後 EBITDA，距離這一目標還需要一年左右的時間。

But we see it, we know the plan or I think it's a plan to get us back to that 10% target. And I think you'll see it build throughout the year. And I think the most important part is, as we said in our comments around our four strategic initiatives for this year, we know exactly what to do. We know how to do it. And it's just about us executing. And I think as we showed in 2023, that this team knows how to execute against our business plan.

但我們看到了，我們知道這個計劃，或者我認為這是一個讓我們回到 10% 目標的計劃。我想你會看到它全年都在建設。我認為最重要的是，正如我們在圍繞今年四項戰略舉措的評論中所說，我們確切地知道該做什麼。我們知道該怎麼做。這只是我們執行的問題。我認為正如我們在 2023 年所展示的那樣，這個團隊知道如何執行我們的業務計劃。

So, with that, Matt, let me talk to you on more of a guidance.

那麼，馬特，讓我和你談談更多的指導。

Yes. I think that's really well said, Jeff. I mean, I think you nailed it in our 2024 guidance. I think is a prudent con concept and consistent with how we have been performing and leading the broader markets on margin expansion there, Taji, I don't think you really think anything on gross margin to be different than what you've come to expect with our current business platforms, you know, that will be consistently in line potential for outperform associated with it.

是的。我認為這句話說得很好，傑夫。我的意思是，我認為您在我們的 2024 年指南中明確了這一點。我認為這是一個審慎的騙局概念，與我們在利潤率擴張方面的表現和領先更廣泛市場的方式一致，塔吉，我認為你真的認為毛利率上的任何事情都與你的預期不同您知道，透過我們目前的業務平台，這將始終符合與之相關的跑贏大盤的潛力。

Could be continued on overachieving of our preferred payers and overachieving of our state rate increases. Once again, that doesn't necessarily increase your margin gross margin profile because what we're doing is taking those dollars and reinvesting them back into our caregivers and back into our workforce to really drive those volumes with those volumes driving or leveraging overhead with it. And we're continue to have cost savings initiatives throughout the organization. We did a really nice job of in 2023.

可以繼續超額完成我們的首選付款人以及超額完成我們的州加息。再說一遍，這並不一定會增加您的毛利率，因為我們正在做的是將這些美元重新投資到我們的護理人員和我們的勞動力中，以真正推動這些數量，並通過這些數量驅動或利用管理費用。我們將繼續在整個組織內採取成本節約措施。2023 年我們做得非常好。

We're continuing to do it in 2024. We'll nip and tuck where we can, but we're also going to invest in the right areas that will demonstrate better clinical outcomes and really overachieve for our preferred payor initiatives through value-based care, to. So, in line with where we expect, see that build and EBITDA build throughout the year. And I think that's the way you should think about it.

我們將在 2024 年繼續這樣做。我們將盡我們所能，但我們也將投資於正確的領域，這些領域將展示更好的臨床結果，並透過基於價值的護理真正超額實現我們首選的付款人計劃。因此，根據我們的預期，全年的建設和 EBITDA 都會不斷增加。我認為這就是你應該考慮的方式。

Well said. Anything else, Taji?

說得好。還有什麼嗎，塔吉？

Yes, just one more question for me. Jeff, last question on we thinking about on the labor environment. I really appreciate the commentary in your prepared remarks, but how should we be thinking about wage inflation in 2024?

是的，還有一個問題想問我。傑夫，最後一個問題是關於我們對勞動環境的思考。我真的很欣賞你準備好的發言中的評論，但我們應該如何考慮 2024 年的薪資通膨？

Yes, I think Matt just said it really well, Taji, we still focus our focus is on rate, which then drives incremental rate. So, I think as you think about our margin profile met, Matt said it well, and. I will point out in our home health business, home health and hospice business, you saw 50.9% gross margins for Q4. It's taken us about two years to get that back to the 50%. That was our target. I'm really proud of the home health and hospice team for how hard they work to get it there.

是的，我認為馬特剛才說得很好，塔吉，我們仍然把重點放在速率上，然後推動增量速率。所以，我認為當你考慮我們的利潤狀況時，馬特說得很好，而且。我要指出的是，在我們的家庭健康業務、家庭健康和臨終關懷業務中，第四季的毛利率為 50.9%。我們花了大約兩年的時間才恢復到 50%。這就是我們的目標。我為家庭健康和臨終關懷團隊感到​​自豪，他們為實現這一目標付出了巨大的努力。

But I think as we think of margins, gross margins amounts that it will still be consistent in 2024 as we saw it kind of Q3, Q4 run rate, every rate increase. We are whether it's a preferred payer or a government of state or federal agency. We're going to pass that that rate or a large portion of that right through to the caregivers. That is our that is our value proposition to our paid preferred payers.

但我認為，當我們考慮利潤率時，毛利率金額在 2024 年仍將保持一致，因為我們看到第三季、第四季的運行率以及每次利率的成長。無論是首選付款人還是州政府或聯邦機構，我們都是如此。我們將把這個比例或其中的很大一部分直接傳遞給護理人員。這就是我們對付費首選付款人的價值主張。

It's our value proposition to our government partners. So, I think you'll think of gross margins being consistent in the course of the year. And as Matt said, well, we're really trying to drive the growth levers both in PDS, home health and hospice and IMS. So we're real excited to get the top line and also bottom line growth and '24 where we expected. Thanks, Taji.

這是我們對政府合作夥伴的價值主張。因此，我認為您會認為全年毛利率保持穩定。正如馬特所說，我們確實在努力推動 PDS、家庭健康和臨終關懷以及 IMS 領域的成長。因此，我們非常高興能夠實現 24 年的營收和利潤成長，達到我們的預期。謝謝，塔吉。

Thank you.

謝謝。

Thank you.

謝謝。

Ben Hendrix from RBC Capital Markets

加拿大皇家銀行資本市場部的本‧亨德里克斯

Okay, great. Thanks, guys. I'm just I appreciate all the commentary about the preferred payer progress in Texas and expectations to go seven, 70% this year. I was wondering if you could remind us kind of where we are in California and where that could go in the near term in terms of preferred payer relationships on the CDN side and then on separately in areas where we're not yet seeing that double digit rate increase in budgets? And how much how much how do we think about how much of the PDN. preferred payer penetration to make up for that shortfall more about that?

好的，太好了。多謝你們。我只是感謝所有關於德州首選付款人進展的評論以及今年將達到 7%、70% 的預期。我想知道您是否可以提醒我們在加州的情況以及近期在 CDN 方面的首選付款人關係方面可能會走向何方，然後分別在我們尚未看到兩位數的地區預算增加率？以及我們如何看待PDN的多寡。首選付款人滲透率可以彌補這一不足嗎？

Thanks so much and good, great question. I think California, we've been heads down. Okay. I'll start big broad picture, California and then drill into your question. On kind of how we think about California. We've been at the government affairs legislative process in California now for over two years. I think it's no surprise anyone that California is staring down somewhere between $50 billion and $80 billion. I know it's a pretty broad, but area deficit this coming year.

非常感謝，很好，很好的問題。我想加州，我們一直低著頭。好的。我將從加州的大局開始，然後深入探討你的問題。關於我們如何看待加州。我們參與加州政府事務立法程序已有兩年多了。我認為加州的投資額在 500 億至 800 億美元之間並不奇怪。我知道明年的赤字範圍相當廣泛，但面積很大。

So big, big, issues and opportunities in California for them to tackle their budget. We've made meaningful progress, significant progress with both the governor, his staff leadership staff, the head of HHH, which is Medi-Cal, Dr. Ghaly as well as the legislature. I think as we think of this moving forward, we think of accelerating our preferred payer strategy.

加州的問題和機會如此之大，讓他們能夠解決預算問題。我們與州長、他的幕僚領導團隊、HHH（即 Medi-Cal）負責人、Ghaly 博士以及立法機構取得了有意義的進展。我認為，當我們考慮這項進展時，我們會考慮加快我們的首選付款人策略。

To your question, Ben, in California, unlike Pennsylvania or Texas, that is predominantly 90 plus percent Medicaid MCO for our business, California is still the majority. More than 50% of the PDN population in California still is on Medicare still is a we are paid by Medicare.

對於你的問題，Ben，在加州，與賓州或德州不同，我們的業務主要有 90% 以上的醫療補助 MCO，但加州仍然佔大多數。加州超過 50% 的 PDN 人口仍然享有 Medicare，我們仍然由 Medicare 支付費用。

They are overseen by Medicare families. What we have seen, though, in the last two years as California wage and hyperinflation have played through is that families have found their ways to either what's called a whole child model program, which is a specific California as well as some of the commercial plans in California and some of the Medicaid MCO plans that are established in California.

他們由醫療保險家庭監督。然而，我們在過去兩年中看到，隨著加州工資和惡性通貨膨脹的影響，家庭已經找到了所謂的「整體兒童模式計畫」（這是一個特定的加州）以及一些商業計畫的方法。以及在加州制定的一些醫療補助MCO 計劃。

So we are seeing families find their ways, and I think it's nothing more specific than they just realized to get their children coverage, both acute care coverage and home, they need to get to AMCO. up a plan or a whole child model plan.

因此，我們看到許多家庭找到了自己的方法，我認為這只不過是他們剛剛意識到要為孩子提供保險（包括急診保險和家庭保險），他們需要去 AMCO。制定計劃或整個兒童模型計劃。

So, we are seeing a shift in our population in '23. And as we enter '24 now, it is still less than 50% of the population. So, we're pleased that we get to accelerate our preferred payer strategy in California. We are not going to give up on our legislative strategy. We're going to continue to double down a legislative strategy because at the end of the day at $44.12 is what we're reimbursing California for Medicare. That's not enough. It's not competitive to hire wages on the Medicaid program. So, we're going to continue to do both then you asked for a specific metric. We have not shared that publicly yet.

因此，我們在 23 年看到了人口的變化。當我們現在進入 24 世紀時，它仍然不到總人口的 50%。因此，我們很高興能夠加快在加州的首選付款人策略。我們不會放棄我們的立法策略。我們將繼續加倍立法策略，因為最終我們將向加州償還 44.12 美元的醫療保險費用。這還不夠。透過醫療補助計劃僱用工資沒有競爭力。因此，我們將繼續執行您要求的特定指標。我們尚未公開分享這一點。

And I think over the course of 2024, we'll reevaluate that. But we're excited that we have two levers to pull in California, not just a government affairs strategy, but we're going to use our Texas strategy or Pennsylvania strategy may estates and accelerated in California, and I will say of the 14 preferred payers we have today, I think it's two or three of them today are based in California. So, a couple of our preferred payers today are already in the state of California and work, and they pay us well above the Medicaid PDN, right. So hopefully that's helpful.

我認為在 2024 年，我們將重新評估這一點。但我們很高興我們在加州有兩個槓桿可以拉動，而不僅僅是政府事務戰略，但我們將使用我們的德克薩斯州戰略或賓夕法尼亞州戰略可能會在加利福尼亞州加速，我會說14個首選我們今天擁有的付款人，我認為其中有兩三個位於加州。因此，我們今天的一些首選付款人已經在加州工作，他們向我們支付的費用遠高於醫療補助 PDN，對吧。希望這對您有所幫助。

Yes, thank you very much.

是的謝謝你。

Anything else then?

那還有什麼嗎？

I think that's it for me for now. Thank you.

我想我現在就這樣了。謝謝。

Thanks.

謝謝。

Thank you, Raj Kumar with Stephens, Inc.,

謝謝史蒂芬斯公司的 Raj Kumar，

As Raj on for Scott Bardo. A quick question on just when we think about '23 and all the momentum game across the three business lines, where do you see the most upside in 2024 among three business line?

拉吉（Raj）代替斯科特·巴多（Scott Bardo）。一個簡單的問題是，當我們思考 23 年以及三個業務線的所有動力遊戲時，您認為 2024 年三個業務線中最大的上行空間在哪裡？

Raj, good morning, and thanks. Great question. I think all three of our business lines have the ability to grow materially and produce great great results. As Matt mentioned, we've really been focused the last 18 months on on your cost efficiencies, cost synergies. So we've got a corporate overhead in place where we think we are in a really nice place to oversee a business, but to do it at good leverage. I think the business that you will hear us be probably most proud of is the is the rebound of our Home Health and Hospice business.

拉吉，早上好，謝謝。很好的問題。我認為我們的三個業務線都有能力實現實質成長並產生巨大的成果。正如 Matt 所提到的，過去 18 個月我們一直非常關注您的成本效率和成本協同效應。因此，我們已經制定了公司管理費用，我們認為我們處於一個非常好的地方來監督業務，但要以良好的槓桿作用來做到這一點。我認為您會聽到我們最引以為傲的業務可能是我們的家庭健康和臨終關懷業務的反彈。

You know, I think everyone saw a year and a half ago, we were we were at a difficult spot in our Home Health and Hospice business. And we are still still finishing the integration of four companies still transitioning to Homecare Homebase, getting our arms around clinical outcomes and financial outcomes where we sit today entering 2024.

你知道，我想每個人一年半前都看到，我們的家庭健康和臨終關懷業務正處於困境。我們仍在完成四家公司的整合，這些公司仍在向 Homecare Homebase 過渡，在進入 2024 年時，我們將重點放在我們今天所處的臨床結果和財務結果。

We are just focused on growing the business and producing great clinical outcomes. And but both not either but both and really proud of Shane and Mary and the entire team to lead our home health and hospice team. They have absolutely turned that business around for us, have got us in a great place as we enter 2024. We have great momentum in our PDS business.

我們只專注於發展業務並產生出色的臨床成果。但兩者都不是，而是兩者都對肖恩和瑪麗以及整個團隊領導我們的家庭健康和臨終關懷團隊感到​​非常自豪。他們絕對為我們扭轉了業務局面，讓我們在進入 2024 年時處於有利地位。我們的 PDS 業務發展勢頭強勁。

We have great momentum in our AMS business in '23, but turning around our Home Health and Hospice business was one of our top five priorities in the Company and just incredibly proud and that team and the discipline that we have instilled to not trying to be a solution for everyone home health hospice, but to be a solution for those payers that are willing to reimburse on an episodic basis.

23 年，我們的AMS 業務發展勢頭強勁，但扭轉我們的家庭健康和臨終關懷業務是我們公司的五個優先事項之一，對此我們感到非常自豪，我們的團隊和我們灌輸的紀律，不試圖成為一個適合每個人家庭健康臨終關懷的解決方案，但也適合那些願意定期報銷的付款人。

And I I think you heard Matt talk about north of 70% is where we want to be. We ended the year at 74% episodic. That's exactly where we want to be in that business. And so really proud of that team as we as we run into 2024 for us.

我想你聽到 Matt 談到 70% 以上就是我們想要達到的目標。到了年底，我們的偶發性率為 74%。這正是我們想要從事這項業務的地方。當我們邁向 2024 年時，我們為這個團隊感到非常自豪。

Great. And as my follow-up, just kind of thinking about just cash flow and with the framing of being or operating cash flow positive, how would you kind of frame the working capital dynamics in 2024 and the ability to further expand upon the EBITDA conversion rate to operating cash flow?

偉大的。作為我的後續行動，我想談談現金流，以及在現金流為正或經營現金流為正的框架下，您將如何框架 2024 年的營運資本動態以及進一步擴大 EBITDA 轉換率的能力到經營現金流？

Yes, great question. And kind of combining that idea of cash flow and liquidity here in Oman, and I think we'll experience, I know will experience moderate headwinds in Q1. We addressed that in the script as well, but we also have just normal seasonality that occurs for us in Q1 in the business itself with just EBITDA with headwinds of state taxes, just a little bit of reengagement with the workforce right out of the holidays as well.

是的，很好的問題。在阿曼，將現金流和流動性的想法結合起來，我認為我們將在第一季經歷適度的阻力。我們也在劇本中解決了這個問題，但我們在第一季度的業務本身也遇到了正常的季節性，只有 EBITDA 以及州稅收的不利因素，只是在假期結束後與勞動力進行了一些重新接觸，出色地。

And then just third-party liability seasons, EPL season, which extends the DSL out a few days on Q1, that kind of rebalance back into Q2 and Q3 as that cash starts coming in. And so you'll see a dip in Q1 a little bit as it starts to then added back in Q2 and Q3, we look forward to increasing our overall liquidity and 2024. It's a great opportunity for us to do.

然後是第三方責任賽季，EPL 賽季，將 DSL 在第一季延長幾天，隨著現金開始流入，這種重新平衡回到第二季和第三季。因此，您會看到第一季略有下降，然後在第二季和第三季增加，我們期待在 2024 年增加整體流動性。這對我們來說是一個很好的機會。

So what we'll do is that we'll see how that kind of for now plays out. We are interested in the idea of small M&A tuck-ins where appropriate when appropriate, in the market. We continue to look at deals when they come up, but that's probably more in the back half of this year or into 2025. Right now, we're going to focus on operating our business effectively efficiently converting that EBITDA into cash and on growing our overall liquidity position as well.

所以我們要做的是看看目前情況如何。我們對在適當的時候在市場上進行小型併購的想法感興趣。我們會繼續關注出現的交易，但這可能更多發生在今年下半年或 2025 年。目前，我們將專注於有效經營我們的業務，將 EBITDA 轉化為現金，並提高我們的整體流動性狀況。

Said, Matt, Andrew, as early as it is as you know, there's been a tremendous amount of conversation nationally over the last 22 days on change, healthcare and UnitedHealthcare. I couldn't be more proud of that. Our team, our billing leadership team all the lobbying. It doesn't build claims directly through Change Healthcare directly.

馬特、安德魯，正如你們所知，過去 22 天全國範圍內就變革、醫療保健和聯合醫療保健進行了大量討論。我對此感到非常自豪。我們的團隊、我們的計費領導團隊都在進行遊說。它不會直接透過 Change Healthcare 直接提出索賠。

Some of our vendor partners do and our team has done an amazing job of getting bills out the doors, ensuring that that obviously continues to be paid for the great work that we've done. And it's been a lot of hours and spent a lot of overtime that's been a lot of work and workarounds, but it's a relatively low impact to our beyond that specific change issue. But our team has worked incredibly hard the last three weeks to ensure that our liquidity, our cash flow is solid, and I'm proud to say that it is. And so, kudos to kudos to our RCM billing teams who've really just work to make that make that a reality for Aveanna.

我們的一些供應商合作夥伴這樣做了，我們的團隊在處理帳單方面做得非常出色，確保我們所做的出色工作繼續得到報酬。我們花了很多時間，花了很多加班時間，做了很多工作和解決方法，但除了特定的變更問題之外，這對我們的影響相對較小。但我們的團隊在過去三週非常努力地工作，以確保我們的流動性和現金流穩定，我很自豪地說確實如此。因此，我們的 RCM 計費團隊非常努力，讓 Aveanna 實現這一目標。

Thank you, Raj.

謝謝你，拉吉。

Pito Chickering from Deutsche Bank.

德意志銀行的皮托‧奇克林 (Pito Chickering)。

Hi there. You've got Kieran Ryan on for Pito. Thanks for taking the questions. Apologies if you've touched on a few of these things, I just wanted to confirm a couple of points. First off, on the margin expansion for 2024 guidance implies 20 basis points. Is it fair to say from your commentary that we should expect that to come through the SG&A line with maybe some potential for outperformance on gross margin. But as far as what's guided, that's most likely to come in SG&A, correct?

你好呀。基蘭瑞安 (Kieran Ryan) 代替皮托 (Pito)。感謝您提出問題。如果您觸及其中一些內容，我深表歉意，我只是想確認幾點。首先，2024 年利潤率擴張指引意味著 20 個基點。從您的評論中可以公平地說，我們應該期望透過 SG&A 線實現這一目標，並可能在毛利率方面表現出色。但就指導內容而言，最有可能出現在 SG&A 中，對嗎？

Yes. Good morning, Kieran. Yes, I think the answer is that, yes, we have set up our infrastructure to allow us to be able to grow and leverage our growth. And I think if you take the Q3, Q4 performance of the company and transform that into 2024, probably gives you a better idea of where our gross margins would be specifically because the comments are on Home Health & Hospice and their improvement.

是的。早上好，基蘭。是的，我認為答案是，是的，我們已經建立了基礎設施，使我們能夠發展並利用我們的成長。我認為，如果您將公司第三季、第四季的業績轉化為2024 年，可能會讓您更了解我們的毛利率具體在哪裡，因為這些評論是關於家庭健康和臨終關懷及其改善的。

But yes, Kieran, I think our feedback would be that there's moderate -- minimal to moderate improvement and opportunity in gross margin where we think we'll be able to overperform in the year is really growth, our ultimate revenue growth rate, volume growth rates, rate improvements that we win within the course of the year and driving that through the EBITDA adjusted EBITDA line. Matt, anything you would add to that?

但是，基蘭，我認為我們的反饋是，毛利率有適度的——最小到適度的改善和機會，我們認為我們今年能夠表現出色的是真正的增長，我們的最終收入增長率、銷量增長利率，我們在一年內贏得的利率改進，並透過EBITDA 調整後的EBITDA 線推動這一進步。馬特，你還有什麼要補充的嗎？

I think you nailed it. Gross margins kind of flat on our H2 results from 2023, kind of reengaging that through 2024. Obviously, a little bit of seasonality in here in the front half of the year, specifically Q1, which is some state tax implications that occur. But then from there, just good old fashion leveraging overhead, nipping and tucking where appropriate, taking some costs out where appropriate. But I think that's where you'll see that 20-basis point margin expansion on the bottom line.

我想你已經成功了。從 2023 年開始，我們的下半年業績毛利率基本上持平，到 2024 年，這種情況會有所恢復。顯然，今年上半年，特別是第一季度，存在一些季節性因素，這是發生的一些州稅收影響。但從那裡開始，只是很好的老式方式利用開銷，在適當的情況下進行壓縮和折疊，在適當的情況下削減一些成本。但我認為這就是你會看到利潤率擴大 20 個基點的地方。

Got it. Thank you. And then lastly, just as we think about where revenues and PDS grow in 2024, wherever that shakes out, say, somewhere in like the 4% to 5% range, maybe how should we think about the contribution from volumes versus rate, '24? Thank you.

知道了。謝謝。最後，正如我們思考 2024 年收入和 PDS 的成長情況一樣，無論在什麼地方，比如說，在 4% 到 5% 的範圍內，也許我們應該如何考慮銷售與成長率的貢獻，'24 ？謝謝。

Yes. Historically, we would have told you that rate would have been 1% for an entire year out there. I think you can look at 2023 and see that we grew 3.8% on the rate, and 3.5% on the volume to be just north of 7%. I think you kind of nailed it in that 4% to 5% range is a good range for us. We had a very successful year with 19 state rate increases, 8 of them being double-digits as well as our preferred payors being 17% of our total PDS volume. We're going to continue that engagement into 2024. But I think it's.

是的。從歷史上看，我們會告訴您全年的利率為 1%。我認為你可以看看 2023 年，我們的成長率為 3.8%，交易量成長了 3.5%，略高於 7%。我認為你把它固定在 4% 到 5% 的範圍內，這對我們來說是一個很好的範圍。我們度過了非常成功的一年，有 19 個州加息，其中 8 個是兩位數，而且我們的首選付款人占我們 PDS 總量的 17%。我們將繼續這種合作直至 2024 年。但我認為是的。

I would take it and draw it right down the middle and say half of it will be rate, half of it will be volume. There's a chance to outperform, of course, if we're able to lean in pulling additional preferred payors through it but splitting it kind of 50-50 is where I would model it out.

我會把它畫在中間，一半是利率，一半是成交量。當然，如果我們能夠透過它吸引更多的優先付款人，那麼我們就有機會跑贏大市，但我將把它分成 50-50 的比例。

Thanks a lot.

多謝。

Thanks, Kieran.

謝謝，基蘭。

Thank you. Ladies and gentlemen, there are no other questions at this time. I'll turn the floor back, Mr. Jeffrey Shaner.

謝謝。女士們、先生們，目前沒有其他問題。我將請發言，傑弗瑞‧沙納先生。

Thank you, Melissa, and thank you, everyone for your interest in our Vienna story. We look forward to updating you on our continued progress at the end of Q1. Thank you and have a great day.

謝謝梅麗莎，也謝謝大家對我們維也納故事的興趣。我們期待在第一季末向您通報我們的持續進展。謝謝您，祝您有美好的一天。

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

謝謝。今天的會議到此結束。此時您可以斷開線路。謝謝你，請。