Aveanna Healthcare Holdings Inc (AVAH) 2025 Q2 法說會逐字稿

Good morning, and welcome to Aveanna Healthcare Holdings second-quarter 2025 earnings conference call. Today's call is being recorded, and we have allocated one hour for prepared remarks and Q&A.

早安，歡迎參加 Aveanna Healthcare Holdings 2025 年第二季財報電話會議。今天的電話會議正在錄音，我們預留了一個小時的時間來準備好的發言和問答。

At this time, I'd like to turn the call over to Debbie Stewart, Aveanna's Chief Accounting Officer. Thank you. You may begin.

現在，我想將電話轉給 Aveanna 的首席會計官 Debbie Stewart。謝謝。你可以開始了。

Good morning, and welcome to Aveanna's second-quarter 2025 earnings call. I am Debbie Stewart, the company's Chief Accounting Officer. With me today is Jeff Shaner, our Chief Executive Officer; and Matt Buckhalter, our Chief Financial Officer.

早上好，歡迎參加 Aveanna 2025 年第二季財報電話會議。我是黛比‧史都華 (Debbie Stewart)，公司的首席會計官。今天和我一起的有我們的執行長 Jeff 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美國證券交易委員會提交的報告中描述了可能影響這些聲明並可能導致實際未來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義務。

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 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, aveanna.com; and in our most recent quarterly report on Form 10-Q when filed.

此外，在今天的電話會議中，我們將討論某些我們認為有助於評估我們績效的非公認會計準則指標。不應孤立地考慮這些附加資訊的呈現，也不應將其視為根據 GAAP 編制的結果的替代方案。這些措施的協調可以在今天早上發佈在我們的網站 aveanna.com 上的新聞稿中找到；也可以在我們提交的最新 10-Q 表季度報告中找到。

With that, I will turn the call over to Aveanna's Chief Executive Officer, Jeff Shaner. Jeff?

說完這些，我將把電話轉給 Aveanna 的執行長 Jeff Shaner。傑夫？

Thank 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 Q2 results and how we are moving Aveanna forward in 2025.

謝謝你，黛比。早安，感謝您今天加入我們。我們感謝你們每個人今天上午抽出時間來更好地了解我們的第二季度業績以及我們如何在 2025 年推動 Aveanna 向前發展。

My initial comments will briefly highlight our second quarter 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. I will then provide updates on the Thrive Skilled Pediatrics integration, the current regulatory environment, and year three of our strategic plan. Lastly, I will comment on our enhanced outlook for 2025 before turning the call over to Matt to provide further details into the quarter.

我最初的評論將簡要介紹我們的第二季業績，以及我們為應對勞動力市場而採取的措施，以及我們與政府和優先付款人正在共同努力創造額外產能。然後，我將提供有關 Thrive Skilled Pediatrics 整合、當前監管環境以及我們策略計劃第三年的最新情況。最後，我將對我們對 2025 年的展望進行評論，然後將電話轉給 Matt，讓他提供有關本季度的更多詳細資訊。

Moving to highlights for the second quarter. Revenue for the second quarter was approximately $590 million representing a 16.8% increase over the prior year period. Second-quarter adjusted EBITDA was $88.3 million representing a 93.6% increase over the prior year period, primarily due to the improved rate environment and continued cost savings initiatives.

轉到第二季的亮點。第二季營收約 5.9 億美元，比去年同期成長 16.8%。第二季調整後的 EBITDA 為 8,830 萬美元，較去年同期成長 93.6%，主要得益於利率環境的改善和持續的成本節約措施。

We continue to execute our transformation strategic transformation strategy, focusing on obtaining adequate rates from our payer and government partners for the services we provide, which is clearly evidenced in our second-quarter results.

我們繼續執行我們的轉型策略，重點是從我們的付款人和政府合作夥伴那裡獲得我們提供的服務的足夠費率，這在我們的第二季度業績中得到了明顯證明。

Our second-quarter performance benefited from some timing-related revenue items including an uptick in value-based payments which had a favorable revenue and EBITDA impact of approximately $9 million in the quarter. Matt will provide further details on the positive impact in his prepared remarks.

我們第二季的業績受益於一些與時間相關的收入項目，包括基於價值的支付的增加，這對本季度產生了約 900 萬美元的收入和 EBITDA 影響。馬特將在準備好的演講中進一步詳細說明其積極影響。

As we have previously discussed, the labor environment represented the primary challenge that we needed to address to see Aveanna resume the growth trajectory that we believed our company could achieve. It is important to note that our industry does not have a demand problem.

正如我們之前所討論的，勞動力環境是我們需要解決的主要挑戰，以使 Aveanna 恢復我們認為公司能夠實現的成長軌跡。值得注意的是，我們的產業不存在需求問題。

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 create more capacity while reducing the total cost of care.

家庭和社區照護的需求持續強勁，州和聯邦政府以及管理式醫療組織都要求提供能夠創造更多能力同時降低總照護成本的解決方案。

Our Q2 results highlight that we continue to align 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.

我們第二季的業績表明，我們繼續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。透過將我們的臨床能力集中在我們的優先付款人身上，我們實現了收入和調整後 EBITDA 的同比增長。

We also experienced improvement in our caregiver hiring and retention trends by aligning our efforts with those payers willing to engage with us on enhanced reimbursement rates and value-based agreements. While we continue to operate in a challenging environment, our preferred payer strategy supports our ability to achieve normalized growth rates in all three of our business segments.

透過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保持一致的努力，我們的護理人員招聘和保留趨勢也得到了改善。雖然我們繼續在充滿挑戰的環境中運營，但我們的優先付款人策略支持我們在所有三個業務部門實現正常化成長率的能力。

Since our first-quarter earnings call, I am pleased with the continued progress we have made on several of our rate improvement initiatives with both government and payer partners, as well as continued signs of improvement in the caregiver labor markets. Specifically, as it relates to our private duty services business, our government affairs strategy for 2025 is twofold.

自從第一季財報電話會議以來，我很高興看到我們與政府和付款方合作夥伴在多項費率改進措施上取得了持續進展，並且護理人員勞動力市場也持續出現改善的跡象。具體來說，就我們的私人服務業務而言，我們 2025 年的政府事務策略具有雙重性。

First, we plan to execute on our legislative agenda to improve reimbursement rates in at least 10 states. And second, we continue to advocate for Medicaid rate integrity on behalf of children with complex medical conditions.

首先，我們計劃執行立法議程，提高至少 10 個州的報銷率。其次，我們繼續為患有複雜疾病的兒童倡導醫療補助費率的完整性。

We have a strong advocacy presence with both federal and state legislatures, as well as solid support from our governors across our national footprint. Legislatures have recognized how meaningful private duty nursing is to the overall cost savings and improved outcomes of our nation's most vulnerable children.

我們在聯邦和州立法機構都有強大的倡議力量，並且得到了全國各地州長的大力支持。立法機構已經認識到私人護理對於我國最弱勢兒童的整體成本節約和改善結果具有多麼重要的意義。

As it relates to rate updates, we have achieved 10 rate enhancements year to date in our private duty services segment and are well on our way to achieving our legislative goals for 2025. I am proud of our government affairs and advocacy teams for their commitment to protecting children with complex medical conditions.

就費率更新而言，今年迄今為止，我們在私人稅務服務領域已實現了 10 次費率上調，並且正在順利實現 2025 年的立法目標。我為我們的政府事務和宣傳團隊致力於保護患有複雜疾病的兒童而感到自豪。

Now moving on to our preferred payer initiatives. Our goal for 2025 is to increase the number of private duty services preferred payer agreements from 22 to 30.

現在轉向我們的首選付款人計劃。我們的目標是到 2025 年將私人服務優先付款人協議的數量從 22 個增加到 30 個。

We added one additional preferred payer agreement in Q2 and are currently positioned at 25 agreements in total. Aveanna's preferred payer strategy is gaining momentum and allowing us to invest in caregiver wages and recruitment efforts to accelerate hiring and staffing of nurses for our patients.

我們在第二季增加了優先付款人協議，目前總共達成了 25 項協議。Aveanna 的優先付款人策略正在獲得發展動力，使我們能夠投資於護理人員的薪資和招募工作，以加快為我們的病患招募和配備護理人員。

Additionally, our Q2 preferred payer agreements account for approximately 55% of our total private duty services MCO volumes. This positive momentum and preferred payer volumes continues to highlight the shift in our caregiver capacity and recruitment efforts towards our private duty services preferred payer partners.

此外，我們的第二季優先付款人協議約占我們私人服務 MCO 總量的 55%。這種積極的勢頭和優先付款人數量繼續凸顯了我們的護理人員能力和招聘工作轉向私人服務優先付款人合作夥伴的轉變。

Now moving to our preferred payer progress in home health. Our goal for 2025 was to maintain our episodic payer mix above 70% while returning to a more normalized growth rate.

現在轉向我們在家庭保健方面的首選付款人進展。我們 2025 年的目標是將分期付款人比例維持在 70% 以上，同時恢復更正常的成長率。

In Q2, our episodic mix was 74.5%, and our total episodic volume growth was positive 6.9% compared with the prior year period. The continued investments in clinical outcomes, sales resources, and a focused approach to growth is now paying dividends with Q2 total admissions of 9,800 or a positive 4.3% growth over the prior year period.

在第二季度，我們的情境劇組合為 74.5%，與去年同期相比，我們的情境劇總量增加了 6.9%。對臨床結果、銷售資源和重點成長方法的持續投資現已獲得回報，第二季度總入院人數達到 9,800 人次，比去年同期增長 4.3%。

We currently have 47 preferred payer agreements in home health. Our focus on aligning our home health caregiver capacity with those payers willing to reimburse us on an episodic basis has led to positive momentum in our clinical and financial outcomes.

目前，我們在家庭保健領域有 47 項優先付款人協議。我們致力於將家庭保健護理人員的能力與願意偶爾向我們報銷的付款人結合起來，這為我們的臨床和財務結果帶來了積極的勢頭。

Finally, as we have achieved our desired preferred payer model in private duty services and home health and hospice, we have embarked on a similar strategy in our medical solutions business. We are in the mid stages of implementing our preferred payer strategy in medical solutions and believe it will be fully realized by the end of this year.

最後，由於我們在私人服務和家庭保健及臨終關懷領域實現了我們期望的優先付款人模式，我們也在醫療解決方案業務中採取了類似的策略。我們正處於醫療解決方案優先付款人戰略實施的中期階段，相信該戰略將在今年年底全面實現。

To date, we have 18 preferred payers in medical solutions, and we expect that number to grow as we achieve our desired preferred payer model. Our gross margins are stabilizing in the 42% to 44% range as we align our clinical capacity with those payers that value our services and pay us in a timely fashion.

到目前為止，我們在醫療解決方案方面擁有 18 個首選付款人，隨著我們實現理想的首選付款人模式，我們預計這個數字將會成長。由於我們將臨床能力與重視我們服務並及時付款的付款人相結合，我們的毛利率穩定在 42% 至 44% 的範圍內。

I am pleased with our Q2 growth of approximately 91,000 unique patients served as we continue -- as we work to achieve our target operating model. While we expect our volume growth to be relatively muted this year, we are experiencing improvement in our clinical outcomes, customer satisfaction, and financial outcomes.

我很高興看到我們第二季度服務的患者數量增長了約 91,000 名，我們將繼續努力實現我們的目標營運模式。雖然我們預計今年的銷售成長相對溫和，但我們的臨床結果、客戶滿意度和財務結果正在改善。

Our medical solutions business is well on its way to achieving its target operating model, and I look forward to updating you on its continued progress throughout the year. We are encouraged by our rate increases, preferred payer agreements, and subsequent recruiting results. Our business has demonstrated solid signs of recovery as we achieve our rate goals previously discussed.

我們的醫療解決方案業務正在順利實現其目標營運模式，我期待全年向您通報其持續進展。我們的費率上漲、優先付款人協議以及隨後的招聘結果令我們感到鼓舞。隨著我們實現先前討論的利率目標，我們的業務已顯示出強勁復甦的跡象。

Home and community-based care will continue to grow, and Aveanna 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.

家庭和社區護理將繼續增長，Aveanna 是一個綜合平台，擁有多元化的付款人群體，為高成本的護理環境提供具有成本效益的高品質替代方案。最重要的是，我們在最理想的環境中——患者舒適的家中提供這種護理。

As it relates to our recent acquisition of Thrive Skilled Pediatrics, I am pleased to report that we are on target with our integration efforts. Our combined leadership teams are collaborating on effective and efficient operations and strategies to optimize care delivery for our patients and families.

就我們最近收購 Thrive Skilled Pediatrics 而言，我很高興地報告，我們的整合工作正在按計劃進行。我們的共同領導團隊正在合作制定有效、有效率的營運和策略，以優化對病人和家屬的照護服務。

As a reminder, the Thrive acquisition expanded our PDS offerings in five current states while adding two new states in Kansas and New Mexico. We expect the Thrive acquisition to be accretive to our 2025 results and a really nice addition to our Aveanna family.

提醒一下，Thrive 的收購擴大了我們在五個現有州的 PDS 產品範圍，同時增加了堪薩斯州和新墨西哥州兩個新州。我們預計，對 Thrive 的收購將對我們 2025 年的業績產生增值作用，並對我們的 Aveanna 家族產生真正好的補充。

Now turning to the current regulatory environment with Medicaid and Medicare. We have been quite busy since our last earnings call with our advocacy efforts primarily based in Washington DC. We focused our efforts on two fronts: first, supporting overall Medicaid policy; and second, defending the Medicare home health benefit for American seniors.

現在來談談醫療補助和醫療保險的當前監管環境。自從上次財報電話會議以來，我們一直非常忙碌，主要在華盛頓特區開展倡議工作。我們的工作重點集中在兩個方面：第一，支持整體醫療補助政策；第二，維護美國老年人的醫療保險家庭健康福利。

On the Medicaid front, we believe our patient population fared relatively well in the One Big Beautiful Bill legislation. Pediatric and adult patients with complex medical conditions were not directly targeted in the bill, and the initial view is that PDN was mostly insulated in the almost $1 trillion cut to Medicaid.

在醫療補助方面，我們相信我們的患者群體在「一項偉大的美麗法案」立法中表現相對較好。該法案並未直接針對患有複雜疾病的兒科和成人患者，最初的觀點是，PDN 在近 1 兆美元的醫療補助削減中基本上沒有受到影響。

With that said, we are experiencing general headwinds with state Medicaid directors and governors as they plan for less overall Medicaid funding and the possibility of shouldering more of their Medicaid costs in the future.

話雖如此，我們正經歷州醫療補助主管和州長們的普遍阻力，因為他們計劃減少整體醫療補助資金，並有可能在未來承擔更多的醫療補助費用。

As it relates to the proposed home health rule for calendar year 2026, frankly, we were disappointed by the significance of the proposed cuts totaling 6.4%. We are totally aligned with the National Alliance for Care at Home and our home health peers in our opposition to the proposed rule.

由於它與 2026 年曆年擬議的家庭健康規則有關，坦白說，我們對擬議的總計 6.4% 的削減幅度感到失望。我們完全同意全國家庭護理聯盟和我們的家庭保健同行對該擬議規則的反對。

This proposed rule would be a direct cut to Medicare and seniors receiving and expecting to receive health care at home. Although not overly material to Aveanna's 2026 results, this proposed rule is very challenging for the home health industry.

這項擬議規則將直接削減醫療保險以及老年人在家中接受和期望接受的醫療保健的費用。儘管這項擬議規則對 Aveanna 2026 年的業績影響不大，但對於家庭保健行業來說卻極具挑戰性。

Ensuring adequate access to care for seniors is paramount in especially in America's rural communities where there is a dire need for more, not less, access to care. We strongly object to the proposed rule, are commenting during CMS's open comment period, and will continue to advocate in all 38 Aveanna states for CMS and Congress to halt any cuts to the home health benefit.

確保老年人獲得足夠的照護至關重要，尤其是在美國農村社區，迫切需要更多的而不是更少的照護服務。我們強烈反對擬議的規則，正在 CMS 的公開評論期內發表評論，並將繼續在所有 38 個 Aveanna 州倡導 CMS 和國會停止對家庭健康福利的任何削減。

Before I turn the call over to Matt, let me comment on our strategic plan and enhanced outlook for 2025. We will continue to focus our efforts on five primary strategic initiatives: first, enhancing partnerships with government partners and preferred payers to create additional capacity and growth; second, identifying cost efficiencies and synergies that allow us to leverage our growth; third, modernizing our medical solutions business to achieve our target operating model; fourth, managing our capital structure and collecting our cash while producing positive free cash flow; and finally, engaging our leaders and employees in delivering our Aveanna mission.

在我將電話轉給馬特之前，請允許我評論我們的戰略計劃和 2025 年的展望。我們將繼續專注於實施五個主要戰略舉措：第一，加強與政府合作夥伴和優先付款人的合作，以創造更多產能和增長；第二，確定成本效益和協同效應，以促進增長；第三，實現醫療解決方案業務的現代化，以實現目標運營模式；第四，管理資本結構，收集到 Aveanna 任務；最後，讓我們的領導使命參與 Aveanna 員工。

Based on the strength of our second-quarter and year-to-date results, we now anticipate 2025 revenue to be greater than $2.3 billion and adjusted EBITDA to be greater than $270 million. We believe this enhanced 2025 outlook provides a prudent view considering the challenges we still face with the evolving regulatory environment.

根據我們第二季和年初至今的強勁業績，我們現在預計 2025 年的營收將超過 23 億美元，調整後的 EBITDA 將超過 2.7 億美元。我們相信，考慮到我們在不斷變化的監管環境中仍然面臨的挑戰，這項增強的 2025 年展望提供了一種審慎的觀點。

In closing, I am incredibly proud of our Aveanna team and their dedication to executing our strategic transformation while holding our mission at the core of everything we do. 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.

最後，我為我們的 Aveanna 團隊感到無比自豪，他們致力於執行我們的策略轉型，同時將我們的使命置於我們所做的一切的核心。我們為患者和家屬提供經濟高效、患者首選且臨床先進的解決方案。此外，我們為付款人、轉診來源和政府合作夥伴提供正確的解決方案。

With that, let me turn the call over to Matt to provide further details on the quarter and our 2025 outlook. Matt?

說完這些，讓我把電話轉給馬特，讓他提供有關本季和 2025 年展望的更多詳細資訊。馬特？

Thank you, Jeff, and good morning. I'll first talk about our second-quarter financial results and liquidity before providing additional details on our improved outlook for 2025.

謝謝你，傑夫，早安。我將首先談談我們第二季度的財務表現和流動性，然後再提供有關我們對 2025 年改善的前景的更多細節。

Starting with the top line, we saw revenues rise 16.8% over the prior year period to $589.6 million. We achieved year-over-year revenue growth in all three of our operating divisions led by our private duty services, home health and hospice, and medical solution segments which grew by 19.2%, 10.0%, and 2.2% compared to the prior year quarter.

從營業收入來看，我們發現營收較上年同期成長 16.8%，達到 5.896 億美元。我們的三個營運部門的收入均同比增長，其中私人服務、家庭健康和臨終關懷以及醫療解決方案部門的收入分別比去年同期增長了 19.2%、10.0% 和 2.2%。

Consolidated gross margin was $210.8 million or 35.8%. Consolidated adjusted EBITDA was $88.3 million or 93.6% increase as compared to the prior year. This growth reflects an improved rate environment, increased volumes, as well as enhanced operational efficiencies.

合併毛利率為 2.108 億美元，即 35.8%。合併調整後 EBITDA 為 8,830 萬美元，較上年增長 93.6%。這一增長反映了利率環境的改善、交易量的增加以及營運效率的提高。

Additionally, second-quarter results were positively impacted by timing-related rate enhancement, improved revenue reserves, and annual value-based payments in our PDS segment, which contributed approximately $9 million to revenue and EBITDA in the quarter.

此外，第二季的業績受到與時間相關的利率提高、收入儲備增加以及 PDS 部門的年度價值支付的積極影響，這為本季的收入和 EBITDA 貢獻了約 900 萬美元。

Now taking a deeper look into each of our segments, starting with private duty services. Revenue for the quarter was approximately $486 million, a 19.2% increase, and was driven by approximately 11.1 million hours of care, a volume increase of 6.9% over the prior year.

現在讓我們深入了解我們的每個部分，從私人服務開始。本季營收約 4.86 億美元，成長 19.2%，主要得益於約 1,110 萬小時的護理，比上年增長 6.9%。

Q2 revenue per hour of $43.97 was up 12.3% as compared to the prior year quarter, primarily driven by our preferred payer volume growth and the rate enhancements previously discussed. We remain optimistic about our ability to attract caregivers and address market demands for our services when we obtain acceptable reimbursement rates.

第二季每小時收入為 43.97 美元，與去年同期相比增長 12.3%，主要得益於我們優先付款人數量的增長以及之前討論過的費率提高。當我們獲得可接受的報銷率時，我們仍然對我們吸引護理人員和滿足市場對我們服務的需求的能力持樂觀態度。

Turning to our cost of labor and gross margin metrics. We achieved $157.9 million of gross margin, or 32.5%. Cost of revenue rate of $29.68 in Q2 was up $0.95 or 3.6% from the prior year period. Despite continued wage pressures in the labor market, our Q2 spread per hour was $14.29.

轉向我們的勞動成本和毛利率指標。我們的毛利率達到 1.579 億美元，即 32.5%。第二季的營收成本率為 29.68 美元，比去年同期上漲 0.95 美元，成長 3.6%。儘管勞動市場持續面臨工資壓力，但我們第二季的每小時工資差價為 14.29 美元。

This figure was influenced by the previously discussed $9 million timing-related items as well as the reversal of a $6 million legal settlement that was previously accrued and resolved during the quarter. We expect this metric to normalize over time as we make ongoing adjustments to caregiver wages to support higher volumes and improve clinical outcomes.

這一數字受到先前討論的 900 萬美元時間相關項目以及本季累積並解決的 600 萬美元法律和解金的逆轉的影響。隨著我們不斷調整護理人員的薪資以支持更高的照護量並改善臨床結果，我們預計這項指標將隨著時間的推移而正常化。

Moving on to our home health and hospice segment. Revenue for the quarter was approximately $60.1 million, a 10% increase over the prior year. Revenue was driven by 9,800 total admissions, with approximately 74.5% being episodic and 12,400 total episodes of care, up 6.9% from the prior year quarter.

接下來是我們的居家保健和臨終關懷部分。本季營收約 6,010 萬美元，較上年成長 10%。收入主要來自總入院人數 9,800 人次，其中約 74.5% 為偶發性入院，總護理次數為 12,400 次，比去年同期增長 6.9%。

Medicare revenue per episode was $3,231, up 4.5% from the prior year quarter. We continue to focus on right sizing our approach to growth in the near term by focusing on preferred payers that reimburse us on an episodic basis.

每集醫療保險收入為 3,231 美元，比去年同期成長 4.5%。我們將繼續專注於在短期內正確調整我們的成長方式，並專注於按階段性向我們償還費用的優先付款人。

This episodic focus has accelerated our margin expansion and improved our clinical outcomes. With episodic admissions well over 70%, we have achieved our goal of right sizing our margin profile and enhancing our clinical offerings.

這種偶發性關注加速了我們的利潤擴張並改善了我們的臨床結果。由於偶發性入院率遠超過 70%，我們實現了調整利潤率和增強臨床服務的目標。

We are pleased with our Q2 gross margin of 55%, up 1.2% over the prior year period and representing our continued focus on cost initiatives to achieve our targeted margin profile. Our home health and hospice platform is dedicated to creating value through effective operational management and the delivery of exceptional patient care.

我們對第二季 55% 的毛利率感到滿意，比去年同期成長了 1.2%，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。我們的家庭保健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。

Now to our medical solutions segment results for Q2. During the quarter, we produced revenue of $43.4 million, a 2.2% increase over the prior year. Revenue was driven by approximately 91,000 unique patients served, up 2.2% sequentially, and revenue per UPS of approximately $477, up 5.4% over the prior year period.

現在來看看我們第二季醫療解決方案部門的表現。本季度，我們的營收為 4,340 萬美元，比上年增長 2.2%。收入主要來自服務的約 91,000 名獨立患者，比上一季增長 2.2%，每 UPS 的收入約為 477 美元，比去年同期增長 5.4%。

Gross margins were approximately $19.8 million or 45.6% for the quarter, up 3.2% over the prior year period. As Jeff mentioned, we continue to implement initiatives to be more effective and efficient in our operations to achieve our targeted operating model. We are accelerating our preferred payer strategy and medical solutions by aligning our capacity with those payers that value our resources and appropriately reimburse us for the services we provide.

本季毛利率約 1,980 萬美元，或 45.6%，比去年同期成長 3.2%。正如傑夫所提到的，我們將繼續實施舉措，提高營運的有效性和效率，以實現我們的目標營運模式。我們正在透過將我們的能力與那些重視我們的資源並為我們提供的服務提供適當補償的付款人相結合，來加速我們的優先付款人策略和醫療解決方案。

We expect gross margins to normalize in the 42 to 44% range and UPS to continue its growth as we implement our targeted operating model. We will update you on our progress as we execute on this initiative.

我們預計毛利率將恢復正常，在 42% 至 44% 的範圍內，隨著我們實施目標營運模式，UPS 將繼續成長。我們將在執行此措施的過程中向您通報進度。

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

總而言之，我們將繼續在艱難的環境中奮鬥，同時將患者的照護放在我們所做的一切的中心。我們很清楚，將護理人員的能力轉移給那些重視我們合作關係的優先付款人是 Aveanna 前進的道路。

With the positive momentum we experienced in Q2, we remain optimistic that such trends will extend throughout 2025. We will continue to pass through wage improvements and other benefits to our caregivers in the ongoing effort to better improve volumes.

鑑於我們在第二季度經歷的積極勢頭，我們仍然樂觀地認為這種趨勢將延續到 2025 年。我們將繼續為護理人員提供薪資提高和其他福利，以持續努力提高護理品質。

Now moving to our balance sheet and liquidity. At the end of the second quarter, we have liquidity of approximately $354 million, representing cash on hand of approximately $101 million, $106 million of availability under our securitization facility, and approximately $147 million of availability on our revolver, which was undrawn as of the end of the quarter.

現在轉到我們的資產負債表和流動性。截至第二季末，我們的流動資金約為 3.54 億美元，其中包括庫存現金約 1.01 億美元、證券化工具下可用資金 1.06 億美元以及循環信貸額度可用資金約 1.47 億美元（截至本季末尚未提取）。

We had $23 million in outstanding letters of credit at the end of Q2. During the quarter, we extended our securitization facility to 2028, increased its availability by $50 million, and achieved more favorable pricing. These enhancements further strengthened our overall liquidity position, providing flexibility to operate the business and invest in continued growth and future M&A.

截至第二季末，我們有 2,300 萬美元的未償信用證。本季度，我們將證券化工具的期限延長至 2028 年，將其可用金額增加了 5,000 萬美元，並實現了更優惠的定價。這些改進進一步增強了我們的整體流動性狀況，為業務營運和投資持續成長及未來併購提供了靈活性。

On the debt service front, we had approximately $1.47 billion of variable rate debt at the end of Q2. Of this amount, $520 million is hedged with fixed rate swaps and $880 million is subject to interest rate caps, which limits further exposure to increases in SOFR above 3%.

在債務償還方面，截至第二季末，我們的浮動利率債務約為 14.7 億美元。其中，5.2 億美元透過固定利率掉期進行對沖，8.8 億美元受到利率上限的限制，從而限制了 SOFR 利率超過 3% 的進一步風險敞口。

Accordingly, substantially all of our variable rate debt is hedged. Our interest rate swaps extend through June 2026. And our interest rate caps extend in February 2027. As a reminder, we have no material term loan maturities until July 2028.

因此，我們幾乎所有的浮動利率債務都得到了對沖。我們的利率互換有效期至 2026 年 6 月。我們的利率上限將於 2027 年 2 月延長。提醒一下，我們在 2028 年 7 月之前沒有重大定期貸款到期。

Looking at year-to-date cash flow. Cash generated by operating activities was $42.9 million, and free cash flow was positive $36.9 million. We are encouraged by the strong cash collections and expect to generate additional free cash flow throughout the remainder of the year.

查看年初至今的現金流。經營活動產生的現金為 4,290 萬美元，自由現金流為正 3,690 萬美元。強勁的現金回款讓我們感到鼓舞，並預計在今年剩餘時間內將產生額外的自由現金流。

Before I hand the call over to the operator for Q&A, let me take a moment to address our improved outlook for 2025. As Jeff mentioned, we now expect full-year revenue to be greater than $2.3 billion and adjusted EBITDA to be greater than $270 million. This enhanced guidance is inclusive of our Thrive acquisition.

在我將電話交給接線員進行問答之前，請容許我花點時間來談談我們對 2025 年的展望。正如傑夫所提到的，我們現在預計全年收入將超過 23 億美元，調整後的 EBITDA 將超過 2.7 億美元。這項增強的指導包括我們對 Thrive 的收購。

As we reflect on the Q2 results, I'd like to take a moment to express my sincere gratitude to all of our Aveanna teammates. These strong results would not have been possible without your hard work and dedication. Looking ahead, I'm excited for the execution of our 2025 strategic plan and look forward to providing you with further updates at the end of Q3.

當我們回顧第二季度的業績時，我想花點時間向我們所有的 Aveanna 隊友表達誠摯的感謝。如果沒有你們的辛勤工作和奉獻，這些出色的成績是不可能實現的。展望未來，我對我們 2025 年策略計畫的執行感到興奮，並期待在第三季末為您提供進一步的更新。

With that, let me turn the call over to the operator.

說完這些，讓我把電話轉給接線生。

Thank you. We will now be conducting a question-and-answer session. (Operator Instructions) Benjamin Rossi, JPMorgan.

謝謝。我們現在將進行問答環節。（操作員指示）摩根大通的本傑明·羅西 (Benjamin Rossi)。

Just first glance at 2025 guidance, so projected EBITDA now up to 50% year over year. Could you just talk us through what is being contemplated in that $63 million increase in guidance in terms of aggregate improvements and either clients and pricing across two segments?

乍看之下 2025 年的指導方針，預計 EBITDA 將年增 50%。您能否向我們介紹一下，在整體改善以及兩個部門的客戶和定價方面，6,300 萬美元的指導增加中考慮了什麼？

And then for cadence, we have the $26 million in one-time items during 1Q and 2Q that you described. Is there any other year-over-year dynamics to consider or expected M&A within the skies for the back half of the year?

然後就節奏而言，正如您所描述的，我們在第一季和第二季有 2600 萬美元的一次性項目。還有其他需要考慮的同比動態嗎？或是下半年天空中預計會發生哪些併購？

I guess I'll start with -- at this point, I think as we said, at the end of Q1, we had really good rate outlook and certainty in 2025.

我想首先從這一點開始——正如我們在第一季末所說的那樣，我們對 2025 年的利率前景和確定性有非常好的判斷。

And I think this guidance now shows that playing through our mid-year state legislative efforts -- we talked about 10 PDS rate wins year to date. So we've got really good visibility into 2025 and really from the Medicaid side of business, good outlook into '26 from rate as well.

我認為，現在的指導表明，透過我們年中州立法的努力——我們今年迄今為止已經討論了 10 個 PDS 利率勝利。因此，我們對 2025 年以及醫療補助業務方面有很好的預見性，對 2026 年的利率前景也很好。

Clearly, the volume of our PDS business has picked up. We've talked about that being in the 3% to 5% range over the last two years. I think the last three quarters, that number has been in the 6%, 6.5% now almost touching 7%.

顯然，我們的PDS業務量已經回升。過去兩年，我們一直認為這一比例在 3% 到 5% 之間。我認為過去三個季度，這個數字一直在 6%、6.5% 之間，現在幾乎達到 7%。

And remember, our payers want us to staff more hours. So more volume is good for our payers, good for the state Medicaid systems, because we're keeping patients in the right cost setting at home. But good rate certainty. We now know the hospice rules, so we set the hospice rules. So really the one still hanging rate conversation for us is the home health proposed rule for 2026.

請記住，我們的付款人希望我們增加員工的工作時間。因此，更大的治療量對於我們的付款人有利，對於州醫療補助系統也有利，因為我們可以讓患者在家中享受合適的成本設定。但利率確定性較好。我們現在知道了臨終關懷規則，所以我們制定了臨終關懷規則。因此，對於我們來說，真正懸而未決的利率討論是 2026 年的家庭健康擬議規則。

Obviously, we've aligned with our peer group, working incredibly hard on getting that overturned between now and the final rule so that there's not a decrease in rate in home health for '26,. But with that said, I think at this point in the year, we clearly have very solid rate certainty. All three of our business segments are just performing at a really high level right now.

顯然，我們與同行保持一致，從現在到最終規則出台期間，我們非常努力地推翻這項規定，以確保 26 年家庭保健率不會下降。但話雖如此，我認為在今年的這個時候，我們顯然對利率有非常穩固的確定性。我們所有三個業務部門目前的表現都處於非常高的水平。

I do want to point out medical solutions. Matt and I are really proud. We're all proud of a medical solutions team that's going through their modernization efforts, and yet are executing on growth and great outcomes and good profitability. So really nice shout out to all three of our businesses, and I think that's contemplated in the idea of greater than [270].

我確實想指出醫學解決方案。馬特和我都感到非常自豪。我們都為醫療解決方案團隊感到自豪，他們正在進行現代化努力，但仍在實現成長、取得優異成果和良好盈利。所以，我們三家公司都很高興，我認為這是「大於」理念的一部分。[270]。

Matt, you want to --

馬特，你想--

Just to add to it, Jeff, we're really proud of the teams. I mean, everybody's executing at a very high level. We're delivering exceptional patient care out there.

傑夫，我還要補充一點，我們真的為這些團隊感到驕傲。我的意思是，每個人的表現都很高。我們正在為患者提供卓越的護理。

At the same time, we recognize there's still a lot of work to do. And so we're going to focus on getting back to work and doing what we do best, and that's providing the best care possible to all of our patients.

同時，我們也意識到還有很多工作要做。因此，我們將專注於恢復工作並做我們最擅長的事情，那就是為我們所有的患者提供最好的護理。

Matt, I think you said it. Ben you mentioned it, but Thrive is included in this uptick in our guidance both in revenue and EBITDA. And we're really pleased with the Thrive acquisition integration, and the Thrive team has been amazing.

馬特，我想你說過。正如 Ben 您所提到的，但在我們的收入和 EBITDA 預測中，Thrive 都包含在此成長之中。我們對 Thrive 的收購整合感到非常高興，Thrive 團隊非常出色。

Our teams are working well, incredibly well together, as I said in my prepared remarks. And we really think Thrive will be a great part of our story as we move into '26.

正如我在準備好的演講中所說，我們的團隊合作得非常好。我們確實認為，當我們邁入 26 年時，Thrive 將成為我們故事的重要組成部分。

I mentioned we're really excited about Kansas and New Mexico. There's two new Medicaid states for us. So just excited on how the business is operating. I think Matt said it well. We're humbled by the opportunity to get back to work every day and just do the right thing for our patients, our payers, and our government partners.

我提到我們對堪薩斯州和新墨西哥州感到非常興奮。我們有兩個新的醫療補助州。所以我對業務的運作感到非常興奮。我認為馬特說得很好。我們很榮幸有機會每天重返工作崗位，為我們的患者、付款人和政府合作夥伴做正確的事情。

Understood. So just I guess tying on the rates. So last quarter you mentioned an expectation of the spread rate in PDS normalizing in the sub-11 range during 3Q.

明白了。所以我猜只是在利率上打了折扣。上個季度您提到，預計 PDS 的利差率將在第三季正常化至 11 以下。

Obviously, with the $15 million combined favorable one-times and maybe some of that M&A in there, seeing the rates stay elevated during 2Q, is there any way to think about where your core spread rate currently sits excluding those items? Just trying to understand the lift you're getting purely from your previous payer contracting efforts there.

顯然，考慮到其中有 1500 萬美元的一次性優惠以及其中的一些併購，看到利率在第二季度保持高位，有沒有辦法考慮一下排除這些項目後，您的核心利差率目前處於什麼位置？只是想了解您從之前的付款人簽約努力中獲得的提升。

Let's talk about the spread rates for a second because I think it's a great question. I really want to clarify that last $6 million that we talked about from the reversal.

讓我們來討論一下價差率，因為我認為這是一個很好的問題。我真的想澄清一下我們談到的逆轉的最後 600 萬美元。

So Q2, we had some elevated one-time benefits in there. One time in nature is probably more timing-related items than anything else than one time, but that was a $9 million benefit. That was the increased value based payments we discussed, some rate enhancements in there as well, as continued phenomenal cash collections from previously aged accounts that the team has done a great job on.

因此，第二季度，我們獲得了一些一次性福利的增加。從本質上講，一次可能比一次其他任何事情都更多地與時間有關，但那是一筆 900 萬美元的收益。這就是我們討論過的基於價值的增加的付款，其中也包括一些利率的提高，以及團隊在之前的陳舊帳戶中繼續進行的大量現金收集。

Additionally, there was that $6 million legal settlement in there. That did not benefit EBITDA. If you go look at our adjustments, it actually comes out of EBITDA as well. And so though it impacted or influenced spread rates or our wage rate was compressed because of it, it did not impact our EBITDA at all for that $88 billion.

此外，其中還有 600 萬美元的法律和解金。這對 EBITDA 沒有好處。如果你看一下我們的調整，它實際上也來自 EBITDA。因此，儘管它影響了利差率，或者我們的工資率因此受到壓縮，但它根本沒有影響我們 880 億美元的 EBITDA。

So you've got to pull that out of your one-time benefit in there as well. Looking ahead, we're obviously going to continue to pass through additional wages and benefits to achieve that full wage pass through. That's continuing in Q3, but we expect a full wage pass through to be accomplished by the end of this year.

所以你也必須從你的一次性福利中拿出這筆錢。展望未來，我們顯然將繼續透過增加薪資和福利來實現全額薪資轉移。這一情況將在第三季繼續，但我們預計今年年底前將實現薪資全額轉嫁。

Probably not fully baked in Q4, but exiting the year in December, we expect to be on that run rate basis. We're doing that because we want to align our caregivers with what our preferred payers want to do, and that's helping to fill more shifts and to support our patients.

第四季可能還沒有完全成熟，但到了 12 月年底，我們預計會達到這一運行率。我們這樣做是因為我們希望我們的護理人員與我們首選的付款人所做的事情保持一致，這有助於填補更多的輪班並為我們的患者提供支持。

And I think it's well said that underlying in all this is wage pass through has been happening every week of every month of this year, including 2024. So it's not like we're waiting for specific dates to pass through wages. We have been continuing to be methodical.

我認為，所有這一切的根本原因在於薪資轉嫁在今年每個月每週都在發生，包括 2024 年。因此，我們並不是等待具體日期來發放薪水。我們一直堅持有條不紊地工作。

But I think after three years of our strategy playing through, what we're seeing is it's not across the board wage increases in every market. It's very targeted areas, specific geography, specific shifts on specific days and nights and weekends and holidays.

但我認為，經過三年的策略實施，我們看到的是，並不是每個市場的薪資都全面上漲。它針對的是特定的區域、特定的地理位置、特定的日子、夜晚、週末和假日的特定輪班。

So our teams are just being very methodical in how they think about it. But I think the most important thing is our payers continue to lean into us, Ben, and ask for more nursing coverage, more home coverage at home, and really more hours being filled for their patients, which is a great outcome.

所以我們的團隊在思考這個問題時非常有條理。但我認為最重要的是我們的付款人繼續向我們靠攏，本，並要求提供更多的護理覆蓋、更多的家庭家庭覆蓋，以及為他們的病人提供更多的時間，這是一個很好的結果。

Brian Tanquilut, Jefferies.

傑富瑞的布萊恩‧坦奎魯特 (Brian Tanquilut)。

And congrats on another solid quarter. Maybe Jeff, just to follow up on that comment you made there. So are you seeing like a notable increase in the number of caregivers as these wage rate increases are coming through? And I know you pass it through, but is that already translating into increased capacity? And what does the labor market look like right now for your caregivers?

恭喜您又一個季度取得穩健業績。也許傑夫，只是為了跟進你在那裡發表的評論。那麼，隨著薪資水準的提高，您是否看到護理人員的數量明顯增加？我知道你已經通過了，但這是否已經轉化為容量的增加？目前，您的護理人員的勞動市場狀況如何？

Yeah, great question, Brian. Yeah, and I'll lean back to Q1, that the momentum coming out of '24 was probably greater than we expected it or knew at the time, those rate wins through '24, the enhanced wages that we had put through, and really what we've done in the first half of the year.

是的，布萊恩，這個問題問得很好。是的，我會回顧第一季度，24 年的發展勢頭可能比我們當時預期或知道的要大，24 年的利率優勢、我們提高的工資，以及我們在上半年所做的事情。

We had 11 million hours for the first time as an organization in Q2 in our BDS segment. Every one of those hours is a caregiver that's in the home. So yes, I think we're seeing, both from a Medicaid standpoint, the investments we've seen in Medicaid states, as well as the preferred payer model, picking up momentum, hiring more nurses, more caregivers.

作為一個組織，我們在第二季首次在 BDS 部門投入了 1100 萬小時。每天的每個小時都有護理人員在家。所以是的，我認為從醫療補助的角度來看，我們看到醫療補助州的投資以及優先付款人模式正在加速發展，並僱用了更多的護士和護理人員。

And I wouldn't say it happened at one specific date or one specific month. It's been just a continued uplift. But I do want to remind us, there's not one preferred payer who has enough nurses from Aveanna.

我不會說它發生在某個特定的日期或特定的月份。這只是一種持續的提升。但我確實想提醒我們，沒有一個優先付款人擁有足夠的來自 Aveanna 的護士。

So our top preferred payers, every time I talk to them, which is often, they want more. They just want more coverage. They want more of our patients, more of their patients to be seen by our caregivers, which means we just got to keep hiring more and more.

因此，每次我和我們最優先的付款人交談時，他們通常都會想要更多。他們只是想要更多的報道。他們希望我們的護理人員能接待更多我們的患者、更多他們的患者，這意味著我們必須繼續招募更多的護理人員。

So it's a continued evolution of the strategy. But I think as we've settled in year three here, it finally has settled institutionally into both the Medicaid state systems and our preferred payers that the uplift in rate has equated to uplift in wage and uplift in number of caregivers providing care.

所以這是戰略的持續演變。但我認為，隨著我們在這裡度過第三年，它最終在醫療補助州系統和我們的首選付款人中得到了製度上的認可，費率的提高相當於工資的提高和提供護理的護理人員數量的提高。

That's awesome. And then maybe my follow up since we talked about payers. We're all aware that some of these Medicaid MCOs are facing struggles right now. I mean, are you hearing anything from them in terms of their interest in driving more patients to you guys or rate negotiations? Anything you can share with us as we think about the manage Medicaid MCOs?

太棒了。自從我們討論付款人以來，也許我會繼續跟進。我們都知道，其中一些醫療補助 MCO 目前正面臨困境。我的意思是，您是否聽到他們有意為您帶來更多患者或進行費用談判的消息？當我們考慮管理醫療補助 MCO 時，您能與我們分享什麼嗎？

I would say it's been positive. I mean, we are very sensitive to their success is also our success. And so we're very attuned, like you are, to the health and well-being of both the Medicaid and the Medicare MCOs. We consider them partners and -- because they are our partners.

我想說這是正面的。我的意思是，我們非常敏感，他們的成功也是我們的成功。因此，我們和您一樣，非常關注醫療補助和醫療保險 MCO 的健康和福祉。我們將他們視為合作夥伴——因為他們就是我們的合作夥伴。

So their success ultimately is our success. And I think the answer that we would give you is even in these turbulent times that they are working through, they continue to lean deeper and deeper in us. And their plan presidents continue to expect more of us. They expect more -- not only more hours, but better quality.

所以他們的成功最終就是我們的成功。我認為我們能給出的答案是，即使在他們正在經歷的這些動盪時期，他們仍然會越來越深入地依賴我們。他們的計劃主席繼續對我們抱持更高的期望。他們期望更多——不僅是更多的工作時間，而且還有更好的品質。

And we talked about our value-based payments was part of the lift that was in Q2, just like Q2 of '24 as well, but that's the annual base payments from our previous year coming through and being adjudicated and now paid.

我們談到了基於價值的支付是第二季度成長的一部分，就像 2024 年第二季一樣，但這是我們上一年的年度基本支付，已經通過審核並支付。

And so none of our payers balked at paying us their value-based bonuses from '24, even in quarters where they had a turbulent quarter, which just tells me that they need us. They need more from us. They expect more from us.

因此，從 24 年開始，我們的付款人毫不猶豫地向我們支付基於價值的獎金，即使是在他們經歷動盪的季度，這也告訴我，他們需要我們。他們需要我們提供更多幫助。他們對我們期望更高。

I will say they have raised the bar for us. So the better we do, the more they expect, which I think is a good thing. They just expect us to become more sophisticated; not only more hours, but better at managing costs, better at managing quality.

我想說他們為我們提高了標準。因此，我們做得越好，他們的期望就越高，我認為這是一件好事。他們只是希望我們變得更老練；不僅要花更多的時間，還要更好地管理成本，更好地管理品質。

And I think that's one of the reasons that they really like Aveanna is that we're comfortable being held accountable for great outcomes and cost effective care. So it's a win-win related to the MCOs.

我認為這是他們真正喜歡 Aveanna 的原因之一，因為我們樂於承擔提供出色結果和具有成本效益的護理的責任。因此，這對 MCO 而言是雙贏的。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

As we think about the right jump off point for EBITDA for next year, is $270 million less, I think, $20 million items that you've called out year-to-date, that gets you to $250 million. Is that the right number to think about as we contemplate kind of growth for next year?

當我們考慮明年 EBITDA 的正確起點時，我認為應該減去您今年迄今提到的 2000 萬美元項目，即 2.7 億美元，這樣就達到了 2.5 億美元。當我們考慮明年的成長方式時，這個數字是否正確？

I think I'd say that there's still more to play out this year. I think as you as you think about Q3 and Q4 and as these volumes settle in all three of our businesses in our second half of the year, I think you'll see that it's probably -- we've underpinned a little bit higher number than $250 million.

我想說今年還會有更多的事情要做。我認為，當您考慮第三季度和第四季度，並且隨著我們下半年所有三個業務的銷量穩定下來時，您會發現這個數字可能 - 我們已經支撐了略高於 2.5 億美元的水平。

I will say to Matt's points earlier, the timing-related events in Q1 and Q2 are all revenue and EBITDA. They're not one-time adjustments to lawsuits that we've taken credit for or -- it's revenue. It's cash collections. It's improved rates.

我要回應馬特之前提出的觀點，第一季和第二季與時間相關的事件都是收入和 EBITDA。它們不是針對我們所承擔的訴訟的一次性調整，也不是收入。這是現金收款。它的利率提高了。

So even though we might move them into the corners in which they belong, it is good quality business. And so I think Matt and I and Debbie, we would all be careful to not try to underpin an $88 million quarter moving forward.

因此，儘管我們可能將它們移到它們所屬的角落，但這仍然是高品質的業務。因此我認為，馬特、我和黛比都會小心謹慎，不要試圖支撐未來 8,800 萬美元的季度業績。

We would absolutely hedge against that we don't believe Aveanna is a 15% EBITDA company at this point. And we certainly would not try to have anyone underpin that. I do think we've been striving for a long time to be north of a 10% EBITDA company. And I think at this point, clearly, we can underpin the fact that we're north of 10%.

我們絕對會規避風險，因為我們認為 Aveanna 目前不是 EBITDA 為 15% 的公司。我們當然不會試圖讓任何人支持這一點。我確實認為我們長期以來一直在努力使公司的 EBITDA 達到 10% 以上。我認為，目前我們可以清楚證明我們的成長率已經超過 10%。

Matt, additional thoughts?

馬特，還有其他想法嗎？

Yeah. I would also just like to add, Jeff, we're halfway through the year right now and there's a lot of wood to chop out there with our teams. Our teams know that there's a lot of patients that still need our care. There's patients stuck in the hospital. There's nurses that need to be hired.

是的。傑夫，我還想補充一點，今年已經過去一半了，我們的團隊還有很多工作要做。我們的團隊知道還有很多病人需要我們的照護。有病人被困在醫院。需要雇用護士。

And so we're going to continue to focus on doing that and driving volume and driving results. We think that the way to do so is providing the best care possible, and everything will work its way out in the end.

因此，我們將繼續專注於此，推動銷售和成果。我們認為，做到這一點的方法是提供盡可能最好的護理，最終一切都會好起來的。

Got it. And maybe related to that point, you mentioned passing through the caregiver wages. Do you expect to get back to the $10 to $10.50 spread this year? Just curious at like timing and progression of what that looks like from here.

知道了。也許與這一點相關，您提到了護理人員的薪水。您預計今年價差會回到 10 美元至 10.50 美元之間嗎？只是好奇從現在開始它的時間和進展是什麼樣子。

Back to the exiting the year, it will take time for us to get back to that number itself, Andrew. And we talked about in Q3, it will continue to come down. In Q4, it'll continue to go down.

回到過去的一年，我們需要時間才能回到那個數字本身，安德魯。我們在第三季討論過，它將繼續下降。第四季度，它將繼續下降。

We expect to be exiting -- I'm saying exiting December in the idea of being in our go-forward range. But it'll still be a little bit elevated of that throughout the remainder of the year. There's still thoughtfulness on this wage pass through.

我們預計——我是說在 12 月退出，這樣我們就處於前進的範圍內。但在今年剩餘時間內，這一數字仍將略有上升。這次的薪資轉嫁還是需要深思熟慮。

How do we feel that next shift? How do we feel that night? How do we feel that weekend? How do we feel that holiday? And so we just want to make sure we're getting the best coverage for our patients.

我們對下一次轉變有何感受？那天晚上我們感覺如何？那個週末我們感覺如何？我們對這個假期有何感受？因此，我們只是想確保我們為患者提供最好的保障。

Ben Hendrix, RBC Capital Markets.

加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Ben Hendrix。

Just wanted to talk a little bit more about your Medicaid policy comments. Appreciate that HCBS dodged most of the headwinds from the OBBBA.

只是想再多談談您對醫療補助政策的評論。感謝 HCBS 避免了 OBBBA 的大部分阻力。

But as the states and their budgets start to address these Medicaid cuts and their impact on other providers, how do you characterize HCBS positioning amid some broader headwinds, budgetary headwinds? And how are you thinking about that impacts your efforts to achieve those 10 rate updates or those rate updates in at least 10 states this year?

但是，隨著各州及其預算開始解決醫療補助削減及其對其他提供者的影響，您如何在一些更廣泛的阻力、預算阻力中描述 HCBS 的定位？您認為這會對今年實現這 10 個稅率更新或至少 10 個州的稅率更新的努力產生什麼影響？

Yeah, I think we've already seen this year just the feedback I think we shared in the Q1 call. We've had great conversations with our state governors and the Medicaid directors. And obviously, they were anxious all -- the whole first half of the year and probably are still anxious today, being -- that they're probably still anxious today on the settling in of the OBBBA over the course of the next decade.

是的，我想我們已經看到了今年在第一季電話會議上分享的回饋。我們與各州長和醫療補助主管進行了很好的對話。顯然，他們整個上半年都很焦慮，而且可能今天仍然焦慮，因為他們今天可能仍然焦慮於 OBBBA 在未來十年的穩定。

I will say, the rate enhancements we've got mid-year are more muted, right? So they're in the single digit, low single-digit percentages where over the last three years, we were probably receiving double-digit rate improvements in many states. So -- and we're hearing from our state partners just the need to be fiscally -- incredibly fiscally responsible, which we expected.

我想說的是，我們在年中實施的利率上調幅度比較小，對嗎？因此，他們的成長率處於個位數，低個位數百分比，而在過去三年中，我們在許多州可能都獲得了兩位數的成長率。所以——我們從州合作夥伴那裡聽說，我們需要在財務上——極其負責任，這是我們所預料到的。

At the end of the day, I do believe the 3.5 years of work post COVID or during COVID has settled in nicely within our state legislatures. And it's the same work that we're trying to get done on the federal side with CMS and Congress related to home health, that you need home-based care, both in Medicaid and Medicare.

總而言之，我確實相信，在新冠疫情之後或疫情期間的 3.5 年的工作已經在我們的州立法機構中順利完成。我們在聯邦政府方面與醫療保險和醫療補助服務中心 (CMS) 和國會合作完成的有關家庭保健的工作也是同樣的，無論是在醫療補助計劃 (Medicaid) 還是醫療保險計劃 (Medicare) 中，都需要家庭護理。

You need the most cost-effective, patient-preferred healthcare setting, at home. And I think in the Medicaid system, maybe not in every one of the 50 states, AKA California, we still -- that message has resonated incredibly well.

您需要在家中獲得最具成本效益、患者最喜歡且最受患者歡迎的醫療保健環境。我認為在醫療補助制度中，也許不是在美國 50 個州（也就是加州）的所有州，我們仍然 — — 這一訊息引起了非常好的共鳴。

So I don't think at this point we have to start over with our state governors and -- hey, let us tell you the value of home here. I think they get it. I think they absolutely get it. It's really now about partnering with them that as their Medicaid budgets inevitably have gotten tighter and are going to get tighter, that we are a partner with them and a solution with them.

所以我認為現在我們不必重新與州長們開始——嘿，讓我們來告訴你這裡的家的價值。我想他們明白了。我想他們肯定明白這一點。現在我們真正要與他們合作的是，隨著他們的醫療補助預算不可避免地變得越來越緊縮，並且還會越來越緊縮，我們是他們的合作夥伴，為他們提供解決方案。

So I think as we've said over the course of the last few quarters, three years ago we had 30 states that we needed to get major rate improvements. As of the end of last year we were down to one. And as we sit here today, it's still the same one.

所以我認為，正如我們在過去幾季所說的那樣，三年前我們有 30 個州需要大幅提高利率。截至去年年底，我們只剩下一個了。今天當我們坐在這裡時，它依然如故。

So we're not going to give up in California. We're going to continue to advocate and partner with California to move the PDN rate. But effectively, that is the only state at this point that we don't have a rate that we can be successful in.

所以我們不會放棄加州。我們將繼續倡導並與加州合作提高 PDN 費率。但實際上，這是目前我們唯一沒有成功率的州。

So Matt, anything to add?

那麼馬特，還有什麼要補充的嗎？

So just add on there, we're going to continue to advocate for our patients and their families. In the meantime, we're going to continue to do what we do best. We're going to provide the best quality care with great operational efficiency in the most cost-efficient setting in that patient's home, to Jeff's Point.

所以補充一點，我們將繼續為我們的患者及其家人爭取權益。同時，我們將繼續做我們最擅長的事情。我們將在患者家中，也就是傑夫角，以最具成本效益的環境，提供最優質、最高效的營運護理。

Regardless of whatever policy ends up coming out of it, that's going to be our focus. We do believe that we're positioned to partner with these payers who really want to take care -- cost out of healthcare, and we believe that's in the patient's home.

無論最終出台什麼政策，這都將是我們的重點。我們確實相信，我們有能力與那些真正想要承擔醫療費用的付款人合作，我們相信這些費用是在患者家中支付的。

Appreciate that commentary. Just shift over to the home health side real quick. Assuming we do see a clawback in the 6%-plus range get finalized, what is the potential for that level of cut to trickle into some of your episodic rates that are embedded in the preferred -- home health preferred payer relationships?

感謝您的評論。只需快速轉到家庭保健方面即可。假設我們確實看到 6% 以上的回扣最終確定，那麼這種削減水準對嵌入優先（家庭健康優先付款人關係）中的部分分期費率的影響有多大？

First of all, I don't think I can speak strongly enough about how disappointed we are in the proposed rule. It makes absolutely no sense in today's environment to use a statistic from the Alliance from Care at Home.

首先，我認為我無法充分錶達我們對擬議規則的失望程度。在當今環境下，使用家庭護理聯盟的統計數據是毫無意義的。

Since 2015, the cumulative impact of the rate increase to home health, including 2026 proposed rule, is 1.1%. Over an 11-year period, CMS has invested 1.1% rate increases into home health.

自 2015 年以來，包括 2026 年擬議規則在內的費率上漲對家庭保健的累積影響為 1.1%。在 11 年的時間裡，CMS 對家庭保健的投資費率增加了 1.1%。

Our peers have received over 30% rate increase. And that includes COVID, that includes inflation, hyperinflation. Labor is up. As you know Ben, over 40% wage increase in that 11-year period.

我們的同行已獲得超過 30% 的利率成長。其中包括 COVID，包括通貨膨脹、惡性通貨膨脹。勞動力上漲。如你所知，本，在這 11 年間，薪資成長了 40% 以上。

So it just doesn't make sense. It makes absolutely zero sense, if I'm being blunt. And it's not the right thing to do. It's not helping control costs.

所以這根本說不通。坦白說，這完全沒有意義。這不是正確的做法。這無助於控製成本。

We know the lower that you utilize home health, the more that hospital and care ends up being utilized, so higher cost care settings. So yeah, I just can't speak loud enough.

我們知道，居家照護的使用率越低，醫院和照護的使用率就越高，因此照護環境的成本就越高。是的，我只是說得不夠大聲。

I'm proud of my peers. We have been working together with the Alliance for Care at Home for the last 45 days. I will tell you, Ben. The government has awoken the home care industry, and we are united in our response that not only is it the wrong thing to do, it's harmful to seniors.

我為我的同齡人感到驕傲。在過去 45 天裡，我們一直與家庭護理聯盟合作。我會告訴你的，本。政府已經喚醒了家庭護理行業，我們一致認為這不僅是錯誤的做法，而且對老年人有害。

It damages rural home care, rural healthcare. Home care is a great recipient for that. So it's just bad policy throughout, and we really want to work with CMS to overturn that policy between now and the final rule.

它損害了農村家庭護理和農村醫療保健。居家照護是實現這一目標的絕佳途徑。所以這始終是一項糟糕的政策，我們真的希望與 CMS 合作，從現在到最終規則出台期間推翻這項政策。

With that said, let me come back to Aveanna for a second. 70%, almost 80% of our revenues are driven through Medicaid, Medicaid MCOs. So Aveanna is going to be fine regardless of the outcome of the home health rule.

話雖如此，讓我再回到 Aveanna 的話題上。我們 70% 甚至幾乎 80% 的收入都來自醫療補助 (Medicaid)、醫療補助 MCO。因此，無論家庭健康規則的結果如何，Aveanna 都會沒事。

Aveanna is going to be strong. We've got a lot of momentum. One of the things I'm most proud of with Matt and the team, Debbie, is our cash flow results and our liquidity. It is -- compared to when we started three years ago, our positive operating cash flow, free cash flow, the improvement in liquidity, the improvement in our balance sheet, the deleveraging that we have accomplished at Aveanna, it truly is phenomenal.

Aveanna 將會變得強大。我們擁有很大的發展動能。黛比，我對馬特和團隊最自豪的事情之一是我們的現金流結果和流動性。與三年前剛開始時相比，我們的正營運現金流、自由現金流、流動性的改善、資產負債表的改善以及我們在 Aveanna 實現的去槓桿化，確實是驚人的。

So Aveanna is going to be fine, but we can't sit down and allow home health to be, effectively, eliminated as a benefit. That's not okay for American seniors. So you're going to hear us be incredibly passionate. You're going to hear our peers being incredibly focused on overturning this.

因此 Aveanna 不會有問題，但我們不能坐視家庭保健作為一項福利被取消。對美國老年人來說，這是不行的。所以你會聽到我們無比熱情的聲音。你會聽到我們的同行們非常專注於推翻這個決定。

And one of the great things about home care is we're in every community of all 50 states, and we represent seniors throughout the entire United States of America. And I truly believe the government through our Congress, through our administration, and CMS will hear from home health in every single county in all 50 states; and it will be crystal clear in the messaging.

居家照護的一大優點是，我們遍布全美 50 個州的每個社區，代表整個美國的老年人。我堅信，政府將透過國會、行政部門和醫療保險和醫療補助服務中心 (CMS) 聽取全美 50 個州每個縣的家庭保健意見；而且，訊息傳遞也將十分清晰。

So anyways, you can tell I'm passionate on this subject.

無論如何，你可以看出我對這個主題很感興趣。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Nice job this quarter. I guess sitting back here, looking at the rate increases, looking at the preferred providers that you've been doing, how much demand remains left there? I mean, what ending are we in for getting patients out of the hospitals? Are we in the early innings, the latter inning? How much more demand is there going to be as these rates are coming up into levels that you guys are able to staff better?

本季做得很好。我想，坐在這裡，看看費率的上漲，看看您一直在選擇的供應商，那裡還剩下多少需求？我的意思是，我們要怎麼讓病人離開醫院呢？我們正處於早期階段，還是後期階段？隨著這些費率上升到你們能夠更好地配備人員的水平，需求還會有多少？

I like to think of this year's All-Star game which was hosted right here in Atlanta, that we're probably in inning four or five. And we're going to go into extra innings, and we might even need to get the best batter from both the American League and the National League up to bat to bring this home.

我喜歡回憶今年在亞特蘭大舉辦的全明星賽，我們可能已經進入了第四局或第五局。我們將進入加時賽，我們甚至可能需要派出美國聯盟和國家聯盟的最佳擊球手上場擊球才能獲勝。

But all kidding aside, I don't know that we can ever fully solve the demand. And that's why we say it in every script that we don't have a demand problem. There's not one preferred payer that would say, yes, Aveanna has solved all of our home care issues or all of our PDN issues because we just -- we can't.

但玩笑歸玩笑，我不知道我們是否能夠完全解決這項需求。這就是為什麼我們在每個腳本中都說我們沒有需求問題。沒有一個優先付款人會說，是的，Aveanna 已經解決了我們所有的家庭護理問題或所有的 PDN 問題，因為我們只是——我們不能。

We, at best, would have, 50%-ish market share with a single preferred payer at best. So there is a tremendous still upside in these relationships. And so we're not in the first or second inning year plan.

我們最多只能擁有 50% 左右的市場份額，並且最多只有一個優先付款人。因此，這些關係仍有巨大的優勢。因此我們還沒有進入第一年或第二年的計劃。

I mean, we are now in year three with many of our relationships, certainly year two with the majority of our relationships. So they are maturing in nature, but there's not one plan president from one MCO plan who would say, yes, Aveanna has solved all of my PDN issues.

我的意思是，我們現在與許多關係已經處於第三年，當然，我們的大多數關係已經處於第二年。因此，它們本質上正在成熟，但沒有一位 MCO 計劃的計劃總裁會說，是的，Aveanna 解決了我所有的 PDN 問題。

They say anything about that, but we need more from Aveanna. So I just think -- I think, all joking aside, that that this will play out for the next three to five years. And then ultimately, we probably never will be able to fully solve all the issues of our MCO partners. We certainly can make a significant impact as we're making today.

他們對此有所評論，但我們需要 Aveanna 提供更多資訊。所以我只是認為——我認為，拋開所有玩笑不談，這將在未來三到五年內發生。最終，我們可能永遠無法完全解決 MCO 合作夥伴的所有問題。我們當然能夠像今天這樣產生重大影響。

Okay, great. Then a follow up here this is asked a couple of different ways. I'll go differently. In the script, you talked about discussions with state medical directors as they look for changes next year with lower dollars.

好的，太好了。然後這裡的後續問題可以用幾種不同的方式來提出。我會採取不同的做法。在劇本中，您談到了與州醫療主任的討論，他們希望明年以更低的花費做出改變。

I mean, what areas could they do to impact you guys? Would it go back to lower rates? Would they put different screening mechanisms? I mean, what could the state medical directors do next year as the Medicaid dollar pool gets smaller that could negatively impact you guys?

我的意思是，他們可以在哪些方面影響你們？利率會恢復到較低水準嗎？他們會採用不同的篩選機制嗎？我的意思是，隨著醫療補助資金池變得越來越小，州醫療主任明年可以做什麼來對你們產生負面影響？

Yeah, I don't think -- first of all, thoughtful question. I don't think there's one -- a silver bullet answer to that. I think every state is different.

是的，我不認為——首先，這是一個深思熟慮的問題。我認為，沒有一個萬能的答案可以解決這個問題。我認為每個州都不同。

And you can ask the question, why did 10 states this year give us rate increases if they knew that the bill -- they knew there was going to be a headwind. They knew there's going to be cuts to Medicaid, right? They did it because they still value the services.

你可以問這樣一個問題，如果他們知道這項法案會帶來阻力，為什麼今年有 10 個州還要提高我們的稅率？他們知道醫療補助將會被削減，對吧？他們這樣做是因為他們仍然重視這些服務。

Those 10 states didn't give rate increases to all healthcare, right? They gave increases specifically to at least PDNs. So I think the key is for us to be incredibly thoughtful partners with our states.

這 10 個州並沒有提高所有醫療保健的費用，對嗎？他們至少特別增加了 PDN 的數量。因此我認為關鍵在於我們要與各州成為非常體貼的合作夥伴。

And it would be foolish for us to go to -- I'll use Georgia as an example, which -- I think we talked about Georgia last year this time had just given us the largest investment in home-based nursing in the history of Georgia, according to Governor Kemp.

如果我們去——我將以佐治亞州為例——我想我們去年討論過佐治亞州，根據州長坎普的說法，佐治亞州剛剛給予我們佐治亞州歷史上最大的家庭護理投資。

It'd be foolish for us to go to the Governor Kemp this year and say, okay, we need another 30% rate increases. It just wouldn't land well. It wouldn't show that we understand the environment.

如果我們今年去找坎普行長說，好吧，我們需要再加息 30%，那就太愚蠢了。它只是無法順利著陸。這並不能表示我們了解環境。

But with that said, we are going back to those same state directors and legislators. And we're showing, you gave us this investment two years ago. Here's what we've done with it. Here's where we spent that money. Here's how we've hired more nurses. Here's how we've taken more children home.

但話雖如此，我們還是要回到同樣的州長和立法者。我們要表明的是，您兩年前給了我們這項投資。以下是我們所做的。這就是我們花錢的地方。以下是我們僱用更多護士的方法。以下是我們如何將更多孩子帶回家。

So part of our job is to go back and retell the story to the people who've already invested money in us and show them what we've done, including Medicaid systems and governors. So I think being a thoughtful partner has been our -- has been our goal for the last three years, will continue to be our goal.

因此，我們的工作之一就是回顧過去，向那些已經在我們身上投資的人重述我們的故事，並向他們展示我們所做的事情，包括醫療補助系統和州長。所以我認為成為一個體貼的合作夥伴一直是我們的目標——這是我們過去三年的目標，並將繼續是我們的目標。

I keep coming back to California. We can solve so many problems for California with a thoughtful rate increase. And so we are still at the table with California. We are still with our peers and the state association, pounding on Governor Newsom's door and pounding on the director of Medicaid's door, really focusing on like, you're the one state that's not invested in this clearly $6,000 a day to $600 a day change in settings.

我經常回到加州。透過深思熟慮的提高利率，我們可以解決加州的許多問題。因此我們仍然與加州進行談判。我們仍然與我們的同行和州協會一起，敲著紐瑟姆州長和醫療補助計劃主管的門，真正關注的是，你們是唯一一個沒有在這個從每天 6,000 美元到每天 600 美元的設置變化上投資的州。

So again, we're not going to give up. We're going to keep advocating for these families. We are thoughtful enough to know that there are general headwinds in Medicaid that we're going to have to navigate through over the next, 12, 18, 24 months. I think the company is well prepared to do so.

所以，我們再說一遍，我們不會放棄。我們將繼續為這些家庭爭取權益。我們深思熟慮後才知道，醫療補助計劃中存在一些整體阻力，我們必須在未來 12、18、24 個月內克服這些阻力。我認為公司已經做好了充分的準備。

Raj Kumar, Stephens.

拉吉·庫馬爾，史蒂芬斯。

Just appreciate the color on the medical solutions business and the preferred payer strategy there. Maybe -- you talked about 18 preferred payer contracts in place. Maybe just framing that, what that means in terms of a percent revenue contribution or from a volume perspective.

只是欣賞醫療解決方案業務的色彩和那裡的首選付款人策略。也許——您談到了 18 份優先付款人合約。也許只是框架性地解釋一下，從百分比收入貢獻或數量角度來看這意味著什麼。

And then thinking about the margins in that business, it's towards the -- at least here today, it's looking at towards being the high end of that 42% to 44%. So how should we think about the back half progression of margins relative to that framework?

然後考慮該業務的利潤率，它朝著——至少在今天，它朝著 42% 到 44% 的高端發展。那麼，我們該如何看待相對於該框架的後半部利潤成長呢？

Yeah. Great question, Raj. I mean, we're really excited about the implementation of the preferred payer strategy and honestly the targeted operating model that the team's putting in place in medical solutions.

是的。問得好，拉吉。我的意思是，我們對優先付款人策略的實施以及團隊在醫療解決方案中實施的目標營運模式感到非常興奮。

We added one preferred payer in Q2 of this year to get us up to 18 preferred payers to date. We'll continue to expand that through the back half this year and continue to add to it as well.

我們在今年第二季增加了一個優先付款人，目前我們的優先付款人總數已達 18 個。我們將在今年下半年繼續擴大這一範圍，並繼續增加這一範圍。

To your point, gross margins were a little high at 45.6%. We think that will settle back into that 42% to 44% range in H2 of this year and then live there indefinitely.

正如您所說，毛利率 45.6% 有點高。我們認為，今年下半年這一數字將回落至 42% 至 44% 的區間，並保持在該水平。

We are really proud of this team's expansion now in growth while going through this modernization effort and this transformational effort. To go sequentially 2.2% growth as they're going and reshaping this division is unheard of, and hats off to that team what they've been able to accomplish.

我們為這個團隊在經歷現代化努力和轉型努力的同時不斷成長感到非常自豪。在他們重塑這個部門的過程中，連續實現 2.2% 的成長率是聞所未聞的，我們向這個團隊所取得的成就表示敬意。

But you should see that gross margins start to come down a little bit. But reciprocally, you will continue to see that growth continuing there.

但你應該會看到毛利率開始稍微下降。但反過來，你將繼續看到那裡的成長持續。

I think you said it, Matt, well, which is 18 is just the beginning. We expect 18 to grow to north of 20 and one day be north of 30 and potentially 40 preferred payers. Matt sets it up well with the TSA pre-check line.

我想你說過，馬特，嗯，18 歲只是一個開始。我們預計優先付款人數將從 18 家增加到 20 家以上，有朝一日將達到 30 家以上，甚至可能達到 40 家。馬特 (Matt) 很好地安排了 TSA 預檢線。

Like think of this like TSA pre-check. We're trying to get payers into a mode where we know that they're going to pay us appropriately. We're going to allow us to provide a great clinical service with great customer satisfaction, and we're going to get paid for those services in a timely manner. That's what a preferred payer medical solutions looks like.

就像把它想像成 TSA 預檢查一樣。我們正試圖讓付款人進入一種模式，讓我們知道他們會向我們支付適當的費用。我們將提供優質的臨床服務，讓客戶非常滿意，並且我們將及時獲得這些服務的報酬。這就是優先付款人醫療解決方案的樣子。

Not to say the highest payer, but someone that we can count on to get paid for the services that we provide. And so Matt said it well. We're really proud of this team. The fact that they hit 91,000 UPS in the middle of the modernization is fantastic.

並不是說付款最高的人，而是我們可以依靠他來獲得我們提供的服務的報酬的人。馬特說得很好。我們真的為這支球隊感到驕傲。在現代化過程中，他們的 UPS 數量達到了 91,000 台，這真是太棒了。

And our leader there is doing a fantastic job, and we're so proud of her and her team. So I'm really excited about what this business looks like in '26 and '27 because it should not have the constraints that we've been talking about related to PDS and Medicaid.

我們的領導做得非常出色，我們為她和她的團隊感到驕傲。因此，我對這項業務在 26 年和 27 年的前景感到非常興奮，因為它不應該受到我們一直在談論的與 PDS 和醫療補助相關的限制。

Got it. And then thinking about free cash flow and even accounting for the one-time items, it seems like the year-to-date contributions from free cash flow are higher versus last year. So maybe helping us frame a bogey for this year, I know you called out higher tax payments this year just given the earnings growth.

知道了。然後考慮自由現金流，甚至考慮一次性項目，似乎今年迄今為止的自由現金流貢獻比去年更高。因此，也許這有助於我們為今年設定一個目標，我知道，考慮到獲利成長，您要求今年繳納更高的稅金。

But maybe anything else to think about in the second half? You think about free cash flow. And then any prioritization towards debt pay down as well, that would be helpful.

但下半場也許還有其他需要考慮的事情嗎？你考慮自由現金流。然後，任何優先償還債務的措施都會有所幫助。

Yeah, Raj. Great question. We're really pleased with the team's progress on positioning Aveanna as a free cash flow generating company.

是的，拉傑。好問題。我們對團隊將 Aveanna 定位為一家自由現金流產生公司所取得的進展感到非常高興。

$37 million of free cash flow year to date really reflects that dedication to that patient care, but also our team's dedication on collecting that cash on a timely manner as well. It's coming through. Our revenue cycle team has done a great job, teamed up with our payer relations team and our entire operations and clinical team to make this happen as well.

今年迄今為止 3700 萬美元的自由現金流確實反映了我們對患者護理的奉獻精神，也反映了我們團隊及時收取現金的奉獻精神。它正在通過。我們的收入週期團隊做得非常出色，並與我們的付款人關係團隊以及我們的整個營運和臨床團隊合作實現了這一目標。

We'll continue to add additional free cash flow throughout the remainder of the year. Q2 was a great quarter for us. Q3, we'll continue to add to it and into Q4. So we're going to keep that liquidity at this time, keep our liquidity position up just for any potential M&A in the future; and the way we're going to be able to do it is through this free cash flow generation.

我們將在今年剩餘時間內繼續增加額外的自由現金流。第二季度對我們來說是一個很棒的季度。Q3，我們將繼續加入內容並進入Q4。因此，我們現在要保持流動性，保持流動性狀況，以應對未來任何潛在的併購；而我們能夠做到這一點的方法是透過這種自由現金流的產生。

And I'll go on top of Matt. Just he said it, and I'm going to say it again. I mean, three years ago, we were in a very tight cash position and tight liquidity. We've worked incredibly hard as a combined team -- and I echo Matt's comments.

我會去馬特上面。他已經這麼說了，我還要再說一次。我的意思是，三年前，我們的現金狀況和流動性都非常緊張。作為一個團隊，我們付出了令人難以置信的努力——我同意馬特的評論。

Just so proud of our team on making -- not being a positive free cash flow company, but really controlling costs, collecting cash, and providing great outcomes and I think, to your point, stronger than where we thought we would be this time of year, but also nice -- a nice horizon for the rest of the year.

我為我們的團隊感到驕傲——雖然我們不是一家自由現金流為正的公司，但我們可以真正控製成本、收集現金，並提供出色的成果。我認為，正如你所說，我們的業績比我們預想的今年這個時候的水平要好，而且對今年剩餘的時間也有著美好的前景。

And I think on all fronts, cash flow is going to be a really good story for Aveanna this year and certainly much stronger than we had expected coming into this year. So nice job to the entire team who's made that happen.

我認為從各方面來看，Aveanna 今年的現金流都會表現得非常好，而且肯定比我們今年預期的要強勁得多。整個團隊都做得很好，讓這一切成為現實。

David MacDonald, Truist.

大衛麥克唐納，Truist。

Just one question left. Wanted to come back to labor for a quick minute. And just see -- can you guys give us some sense, just some framing, in terms of whether it's number of hires, percentage of demand you're able to service, retention you mentioned during the prepared remarks?

只剩下一個問題了。想要快速回來工作一會兒。看看——你們能否給我們一些概念，一些框架，就招聘人數、能夠滿足的需求百分比以及您在準備好的評論中提到的保留率而言？

Just -- can you give us a sense of where you were, let's say, 12 to 18 months ago and where you are now, given all the success that you've had on the rate side?

只是——您能否讓我們了解一下，比如說，12 到 18 個月前您的情況，以及考慮到您在利率方面取得的所有成功，您現在的狀況？

Yeah, I'm going to focus on home health and hospice for a minute. Because I think it's a similar story to that of PDS, which is just as we focus on our preferred payer model and really focused on aligning our caregiver capacity with those partners that are willing to partner with us so that we can provide great clinical outcomes and have an appropriate growth margin and an appropriate financial outcome, I think that showed us that labor was there, but you had to, A, provide the right service at the right pace at the right time.

是的，我將暫時關注家庭保健和臨終關懷。因為我認為這與 PDS 的情況類似，就像我們專注於我們的首選付款人模式並真正專注於將我們的護理人員能力與願意與我們合作的合作夥伴相結合，以便我們可以提供出色的臨床結果並獲得適當的增長利潤和適當的財務結果，我認為這向我們表明勞動力是存在的，但你必須在正確的時間以正確的速度提供正確的服務。

But you got to be very disciplined on who you allocated that labor to. And I just think that's been our story. It's not been go be everything to everyone. It's been being very targeted in each business model.

但你必須非常自律地選擇將勞動力分配給誰。我想這就是我們的故事。它並不是對每個人都適用的。它在每種商業模式中都具有很強的針對性。

I know labor is not how we think of med solutions, but it's what we're doing to med solutions right now, right? It's aligning our capacity with those payers that value us.

我知道勞動不是我們對醫療解決方案的看法，但這是我們現在對醫療解決方案所做的事情，對嗎？它使我們的能力與重視我們的付款人保持一致。

So it's less about inflation. It's less about is the labor market good, bad, or indifferent. If we continue to stay focused on the right partners in each of our businesses, we can produce sustained growth.

所以這跟通貨膨脹關係不大。這與勞動市場好、壞或無所謂關係不大。如果我們繼續專注於每個業務中的正確合作夥伴，我們就能實現持續成長。

And I do think we were very specific on home health and hospice. Everything else has been working, including clinical outcomes, except for positive year over year growth. We were break even, I think, last quarter, just north of 0%.

我確實認為我們對家庭保健和臨終關懷非常具體。除了同比增長以外，其他一切都進展順利，包括臨床結果。我認為，上個季度我們實現了收支平衡，略高於 0%。

This quarter, we turned the corner. And I don't think we'll look back for the foreseeable future in home health or hospice. Generating almost 10% volume growth in home health or hospice every year is phenomenal.

本季度，我們迎來了轉機。我認為在可預見的未來我們不會回顧家庭保健或臨終關懷。每年家庭保健或臨終關懷的數量增加近 10% 是驚人的。

It isn't like we hired 10% more nurses to do that. It's that we've aligned our business with the right payers, and now we can grow because those payers pay us in a timely manner and an appropriate manner to go hire caregivers.

我們並沒有多僱用 10% 的護士來做這件事。這是因為我們已將我們的業務與合適的付款人對齊，現在我們可以發展，因為這些付款人及時且以適當的方式向我們付款以僱用護理人員。

And so I just think that's the way we think of it. It's less about labor and inflation and availability. It's more about us managing to our playbook, getting things hones just right, driving great outcomes. And great outcomes do drive growth.

所以我認為這就是我們的想法。這與勞動力、通貨膨脹和可用性關係不大。這更多的是關於我們按照劇本進行管理，讓事情變得正確，從而取得偉大的成果。而偉大的成果確實推動了成長。

And then guys, just one quick follow up just with regards to Thrive and the M&A environment. Look, you obviously improved financial flexibility. Can you just talk a little bit about just how you're thinking about -- if you were to see another unique opportunity like a Thrive -- I mean, obviously, in home health with some of the challenge visibility in the near term, I assume nothing to think about there. But just when you think about PDS and potentially incremental M&A, just any high level thoughts there?

然後夥計們，我們再快速跟進一下有關 Thrive 和併購環境的問題。看，你明顯提高了財務靈活性。您能否簡單談談您是如何考慮的——如果您看到另一個像 Thrive 這樣的獨特機會——我的意思是，顯然，在家庭保健領域，短期內會面臨一些挑戰，我認為沒有什麼可考慮的。但是當您考慮 PDS 和潛在的增量式併購時，您有什麼高層次的想法嗎？

One, we have the liquidity to now be meaningful in M&A and continue to lean deeper and deeper in it. Our teams are doing a great job with Thrive, but our teams are heading down and integrating Thrive as we speak right now this week, next week, last week. But we'll wrap up Thrive integration here in the next few months.

首先，我們現在擁有在併購中發揮意義的流動性，並將繼續深入地進行併購。我們的團隊在 Thrive 方面做得非常出色，但就在本週、下週、上週，我們的團隊正著手整合 Thrive。但我們將在接下來的幾個月內完成 Thrive 整合。

We would like to target something for the later half of this year, first of next year. I would have told you, most likely home health oriented, David. But to your point, we're a little bit more muted at the moment to really see where home health lands.

我們希望在今年下半年和明年年初制定一些目標。我會告訴你，最有可能的是家庭健康導向，大衛。但正如您所說，我們目前還不太清楚家庭保健的真正發展方向。

We are a big believer in home health over the period of a decade, two decades. So I do think you'll see us continue to lean into home health and hospice from an acquisitive standpoint, just not at the current moment until things settle up.

十年、二十年來，我們一直堅信家庭保健的重要性。因此，我確實認為，你會看到我們從獲取的角度繼續傾向於家庭保健和臨終關懷，只是目前還不是時候，直到事情安定下來。

But yeah, I think you should expect us to -- we're not a debt pay down shop. That's not what we do, right? We focus on growing M&A and growing revenue.

但是的，我認為你應該期待我們——我們不是一家債務償還商店。那不是我們做的事，對吧？我們專注於增加併購和增加收入。

So I think as Matt will talk about, I think you'll see us continue to lean in both PDS and HHH. And then as we get into '26, we'll start to lean back into med solutions and look at tuck-ins in med solutions. But Matt, anything you add to that?

所以我認為，正如馬特所說的，你會看到我們繼續傾向於 PDS 和 HHH。然後，當我們進入 26 年時，我們將開始重新依賴醫療解決方案並研究醫療解決方案中的附加功能。但馬特，你還有什麼補充嗎？

David, I think the way to think about it is thoughtful. We will be very thoughtful on any M&A in here. We've done a great job of generating free cash flow, being mindful about our expenditures out there, and bringing in really good companies with really good clinical outcomes as well.

大衛，我認為思考這個問題的方式是經過深思熟慮的。我們會非常認真地考慮這裡的任何併購。我們在創造自由現金流、專注支出以及引進具有良好臨床結果的優秀公司方面做得非常出色。

That's what we're going to continue to target and continue to look for. We've done a phenomenal job of deleveraging this organization, total team effort to do so. So anything that we go out and look to acquire, we're just going to keep all those things in mind: make sure it's a great clinical outcome, it's a deleveraging story for Aveanna, and that it will continue to generate free cash flow for us.

這就是我們將繼續努力和尋找的目標。我們在降低組織的槓桿率方面做得非常出色，整個團隊都為此做出了努力。因此，無論我們出去尋求收購什麼，我們都會牢記以下幾點：確保它有良好的臨床結果，對 Aveanna 來說是一個去槓桿的故事，並且它將繼續為我們產生自由現金流。

Thank you. We have reached the end of our question-and-answer session. I would now like to turn the floor back over to Jeff Shaner for closing comments.

謝謝。我們的問答環節已經結束。現在我想把發言權交還給 Jeff Shaner 來做最後評論。

Thank you so much. And thank you for your attention and your focus on our company and your interest in Aveanna. We look forward to connecting at the end of Q3. Thank you.

太感謝了。感謝您對我們公司的關注和重視以及對 Aveanna 的興趣。我們期待在第三季末建立聯繫。謝謝。

Thank you. This does conclude today's teleconference. We appreciate your participation. You may disconnect your lines at this time. Enjoy the rest of your day.

謝謝。今天的電話會議到此結束。感謝您的參與。現在您可以斷開線路。享受剩餘的一天。