Chemed Corp (CHE) 2025 Q1 法說會逐字稿

Good day, and thank you for standing by. Welcome to the Chemed Corporation first quarter 2025 earnings conference call. (Operator Instructions) Please be advised that today's conference is being recorded.

您好，感謝您的支持。歡迎參加 Chemed Corporation 2025 年第一季財報電話會議。 （操作員指示）請注意，今天的會議正在錄音。

I would now like to hand the conference over to your host today, Holley Schmidt, Assistant Controller. Please go ahead.

現在我想將會議交給今天的主持人、助理財務主管霍莉·施密特 (Holley Schmidt)。請繼續。

Good morning. Our conference call this morning will review the financial results for the first quarter of 2025 ended March 31, 2025. Before we begin, let me remind you that the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 apply to this conference call. During the course of this call, the company will make various remarks concerning management's expectations, predictions, plans and prospects that constitute forward-looking statements.

早安.我們今天早上的電話會議將審查截至 2025 年 3 月 31 日的 2025 年第一季的財務表現。在開始之前，請容我提醒您，1995 年《私人證券訴訟改革法案》的安全港條款適用於本次電話會議。在本次電話會議期間，本公司將就管理層的期望、預測、計劃和前景發表各種評論，這些評論構成前瞻性陳述。

Actual results may differ materially from those projected by these forward-looking statements as a result of a variety of factors, including those identified in the company's news release of April 23 and in various other filings with the SEC.

由於多種因素，包括公司 4 月 23 日的新聞稿和向美國證券交易委員會提交的其他各種文件中確定的因素，實際結果可能與這些前瞻性陳述預測的結果有重大差異。

You are cautioned that any forward-looking statements reflect management's current view only and that the company undertakes no obligation to revise or update such statements in the future. In addition, management may also discuss non-GAAP operating performance results during today's call, including earnings before interest, taxes, depreciation and amortization or EBITDA and adjusted EBITDA. A reconciliation of these non-GAAP results is provided in the company's press release dated April 23, which is available on the company's website at chemed.com.

請注意，任何前瞻性陳述僅反映管理層目前的觀點，本公司不承擔將來修改或更新此類陳述的義務。此外，管理階層也可能在今天的電話會議上討論非公認會計準則經營績效結果，包括息稅折舊攤提前利潤或 EBITDA 和調整後 EBITDA。這些非 GAAP 結果的對帳表已在公司 4 月 23 日發布的新聞稿中提供，可在公司網站 chemed.com 上查閱。

I would now like to introduce our speakers for today, Kevin McNamara, President and Chief Executive Officer of Chemed Corporation; Mike Witzeman, Chief Financial Officer of Chemed; and Nick Westfall, Chairman and Chief Executive Officer of Chemed's VITAS Healthcare Corporation subsidiary. I will now turn the call over to Kevin McNamara.

現在，我想介紹我們今天的演講者，Chemed Corporation 總裁兼執行長 Kevin McNamara； Chemed 財務長 Mike Witzeman；以及 Chemed 旗下 VITAS Healthcare Corporation 子公司的董事長兼執行長 Nick Westfall。現在我將電話轉給凱文·麥克納馬拉。

Thank you, Holley. Good morning. Welcome to Chemed Corporation's first quarter 2025 conference call. I will begin with highlights for the quarter, then Mike and Nick will follow up with additional details. I will then open up the call for questions.

謝謝你，霍莉。早安.歡迎參加 Chemed Corporation 2025 年第一季電話會議。我將首先介紹本季度的亮點，然後 Mike 和 Nick 將跟進更多細節。然後我將開始提問。

VITAS continued its strong operating performance during the first quarter of 2025. Admissions during the quarter totaled 18,139, which equates to a 7.3% improvement from the same period of 2024. Our average daily census or ADC, expanded to 22,244, an increase of 13.1% when compared to the prior year quarter.

VITAS 在 2025 年第一季持續維持強勁的營運表現。本季入院總人數為 18,139 人次，比 2024 年同期增加了 7.3%。我們平均每日入院人數或 ADC 擴大至 22,244 人次，與去年同期相比成長了 13.1%。

These historically good metrics were positively impacted by the $85 million acquisition of Covenant Health, which was closed on April 17, 2024. Through the end of the first quarter, the Covenant Health acquisition is meeting all of our internal financial projections developed at the time of the acquisition.

這些歷史上良好的指標受到了 2024 年 4 月 17 日完成的 8,500 萬美元收購 Covenant Health 的正面影響。到第一季末，Covenant Health 收購符合我們在收購時所製定的所有內部財務預測。

As Nick will discuss further, VITAS management continues to successfully execute the strategies required to navigate the Medicare Cap at certain of our locations. A major part of that strategy is to increase our hospital-based admissions. Admissions from hospitals generally come to us later in their disease trajectory. These short-stay patients put a limiting factor on our ability to grow revenue and EBITDA margin, but do provide additional Medicare Cap cushion. Despite this headwind, VITAS continues to achieve above-average growth in revenue and EBITDA.

正如尼克將進一步討論的那樣，VITAS 管理層繼續成功執行在我們的某些地點應對醫療保險上限所需的策略。該策略的主要部分是增加醫院的入院人數。醫院的病人一般都是在病情發展較晚的時候才來找我們。這些短期住院患者限制了我們增加收入和 EBITDA 利潤的能力，但確實提供了額外的 Medicare Cap 緩衝。儘管面臨這種不利因素，VITAS 的收入和 EBITDA 仍保持高於平均水準的成長。

Our new programs in the Florida counties of Pasco and Marion counties are also a key part of mitigating Medicare Cap issues in 2025 and beyond. We continue to grow ambitions in Pasco County. We anticipate taking our first submission in Marion County in mid-May.

我們在佛羅裡達州帕斯科縣和馬里恩縣實施的新計畫也是緩解 2025 年及以後醫療保險上限問題的關鍵部分。我們在帕斯科縣的雄心壯志將繼續增長。我們預計五月中旬在馬里恩縣接受第一份提交。

Now let's turn to Roto-Rooter. We are happy to report that Roto-Rooter generated a total revenue increase of 1.8% in the first quarter of 2025 when compared to the prior year quarter. Gross branch revenue increased 3.1%, consisting of branch residential revenue increasing 1.7% and branch commercial revenue increasing 7.3%.

現在讓我們轉向 Roto-Rooter。我們很高興地報告，與去年同期相比，Roto-Rooter 在 2025 年第一季的總營收成長了 1.8%。總分行收入成長 3.1%，其中住宅分行收入成長 1.7%，商業分行收入成長 7.3%。

Total leads were down 7.8% in the first quarter of 2025 compared to the same period of 2024. The revenue improvements during the first quarter of 2025 are the consequence of the variety of initiatives undertaken during 2024. As we discussed throughout the course of 2024, those initiatives include a more focused sales approach for our commercial business, maximizing opportunities from the leads we do receive and an emphasis on quicker response times to residences with possible water restoration opportunities.

2025 年第一季的總銷售線索數量與 2024 年同期相比下降了 7.8%。 2025 年第一季營收的成長是 2024 年採取的各種措施的結果。正如我們在整個 2024 年所討論的那樣，這些舉措包括針對商業業務採取更有針對性的銷售方式，最大限度地利用我們收到的銷售線索中的機會，並強調對可能有水修復機會的住宅更快地做出響應。

To summarize, the strong results at VITAS continue. VITAS management has consistently demonstrated the ability to hire and retain licensed health care professionals at an appropriate pace. This has translated into an extended period of strong growth. Two new locations in the state of Florida provided a nice growth opportunity for the next few years.

總而言之，VITAS 的強勁業績仍在持續。 VITAS 管理階層始終展現出以適當的速度聘用和留住持證醫療保健專業人員的能力。這意味著一段較長的強勁增長期。佛羅裡達州的兩個新地點為未來幾年提供了良好的成長機會。

We continue to work diligently to expand our operating scope within Florida as well as the other states that have some form of certificate of need restrictions. We are pleased with Roto-Rooter's turn towards our revenue growth trajectory. We are confident that Roto-Rooter maintains its core competitive advantages in terms of excellent brand awareness, customer response time, 24/7 call centers and aggressive internet presence.

我們將繼續努力擴大我們在佛羅裡達州以及其他有某種形式的需要證明限制的州的經營範圍。我們很高興看到 Roto-Rooter 的營收呈現成長趨勢。我們相信，Roto-Rooter 憑藉著卓越的品牌知名度、客戶回應時間、全天候呼叫中心和積極的網路影響力，將保持其核心競爭優勢。

With that, I would like to turn this teleconference over to Mike.

說完這些，我想把這場電話會議交給麥克。

Thanks, Kevin. VITAS net revenue was $407.4 million in the first quarter of 2025, which is an increase of 15.1% when compared to the prior year period. This revenue increase is comprised primarily of an 11.9% increase in days of care and a geographically weighted average Medicare reimbursement rate increase of approximately 3.2%.

謝謝，凱文。 2025 年第一季度，VITAS 淨收入為 4.074 億美元，年增 15.1%。收入成長主要包括照護天數增加 11.9% 以及按地區加權的平均醫療保險報銷率增加約 3.2%。

The acuity mix shift negatively impacted revenue growth, 112 basis points in the quarter. The combination of Medicare Cap and other contra revenue changes increased revenue growth by approximately 112 basis points.

敏銳度組合的轉變對本季的營收成長產生了負面影響，下降了 112 個基點。醫療保險上限和其他反向收入變化的結合使收入增長了約 112 個基點。

Average revenue per patient day in the first quarter of 2025 and was $207.58, which is 221 basis points above the prior year period. During the quarter, high acuity days of care were 2.6% of total days of care, a decline of 22 basis points when compared to the prior year quarter. Adjusted EBITDA, excluding Medicare Cap, totaled $70.3 million in the quarter, an increase of 15.9%.

2025 年第一季每位病人每天的平均收入為 207.58 美元，比去年同期高出 221 個基點。本季度，高危險症狀照護天數佔總照護天數的 2.6%，與去年同期相比下降了 22 個基點。本季調整後的 EBITDA（不包括 Medicare Cap）總計 7,030 萬美元，成長 15.9%。

Adjusted EBITDA margin in the quarter, excluding Medicare Cap, was 17.2%, which is 13 basis points above the prior year period. The financial results just discussed include the impact of the Covenant Health acquisition, which positively impacted revenue, adjusted net income and EBITDA by 3% to 4%.

本季調整後的 EBITDA 利潤率（不包括 Medicare Cap）為 17.2%，比去年同期高出 13 個基點。剛剛討論的財務結果包括收購 Covenant Health 的影響，該收購對收入、調整後淨收入和 EBITDA 產生了 3% 至 4% 的正面影響。

Now let's turn to Roto-Rooter. Gross branch revenue increased 3.1% in the first quarter of 2025 versus the first quarter of 2024. Roto-Rooter branch residential revenue in the quarter totaled $167.2 million, an increase of 1.7% from the prior year period. The residential revenue increase was driven by a 3% increase in excavation revenue and a 12.5% increase in water restoration.

現在讓我們轉向 Roto-Rooter。 2025 年第一季度，分行總收入與 2024 年第一季相比成長了 3.1%。 Roto-Rooter 分行本季住宅收入總計 1.672 億美元，比去年同期成長 1.7%。住宅收入的成長得益於挖掘收入增加 3% 和水資源恢復收入增加 12.5%。

Roto-Rooter branch commercial revenue in the quarter totaled $57.7 million, an increase of 7.3% from the prior year. The commercial revenue increase was driven by a 38% increase in excavation and a 14% increase in water restoration. Offsetting the 3.1% gross branch revenue increase, revenue from our independent contractors declined 6.4% in the first quarter of 2025 as compared to the same period of 2024.

Roto-Rooter 分行本季商業收入總計 5,770 萬美元，較上年增長 7.3%。商業收入的成長得益於挖掘量增加 38% 和水資源恢復量增加 14%。抵銷了 3.1% 的分行總營收成長，2025 年第一季我們獨立承包商的營收與 2024 年同期相比下降了 6.4%。

Our independent contractors are generally smaller operations in middle-market cities. In most instances, they do not have the capability to perform the add-on business that is currently the primary driver of revenue growth at Roto-Rooter branches.

我們的獨立承包商一般都是中型城市規模較小的企業。在大多數情況下，他們沒有能力開展目前是 Roto-Rooter 分公司收入成長的主要驅動力的附加業務。

Adjusted EBITDA at Roto-Rooter in the fourth quarter -- first quarter of 2025 totaled $59.2 million, a decrease of 2.4% compared to the prior year quarter. The adjusted EBITDA margin in the quarter was 24.7%. The first quarter adjusted EBITDA margin represents a 108 basis points decline from the first quarter of 2024.

Roto-Rooter 2025 年第四季（第一季）的調整後 EBITDA 總計 5,920 萬美元，與去年同期相比下降 2.4%。本季調整後的 EBITDA 利潤率為 24.7%。第一季調整後的 EBITDA 利潤率較 2024 年第一季下降 108 個基點。

The 7.3% increase in commercial revenue and the slight decline in EBITDA margin during the first quarter of 2025 were driven by the same factors. Overall, commercial business has generally performed at a slightly lower margin than residential business. Additionally, Roto-Rooter management received feedback from our commercial sales force that we could potentially drive additional excavation work if we priced that work less aggressively.

2025年第一季商業營收成長7.3%和EBITDA利潤率略有下降都是受相同因素推動。整體而言，商業業務的利潤率通常略低於住宅業務。此外，Roto-Rooter 管理層從我們的商業銷售團隊那裡得到回饋，如果我們對挖掘工作進行不那麼激進的定價，我們可能會推動更多的挖掘工作。

Commercial excavation is one of the most price-sensitive aspects of our business, as they are some of our largest jobs frequently exceeding $50,000 per job. Due to the size of the job, it is more likely that a commercial customer will get quotes from multiple vendors.

商業挖掘是我們業務中對價格最敏感的方面之一，因為它們是我們最大的工作，每項工作的費用通常超過 50,000 美元。由於工作規模較大，商業客戶更有可能從多個供應商獲得報價。

In the first quarter, Roto-Rooter management reduced the price structure for selected large commercial excavation jobs. This is a key factor that led to the 38% increase in commercial excavation revenue. However, due to the reduced pricing, those jobs were done at a slightly lower margin than our other business.

第一季度，Roto-Rooter 管理階層降低了部分大型商業挖掘作業的價格結構。這是導致商業開採收入成長38%的關鍵因素。然而，由於價格降低，這些工作的利潤率比我們的其他業務略低。

Roto-Rooter management intends to refine its excavation pricing model during the second quarter until a balance between revenue growth and EBITDA margin is achieved. The financial results in the first quarter of 2025 are well within our expectations and related guidance for both VITAS and Roto-Rooter. We anticipate providing updated earnings guidance as a part of the June 30, 2025, earnings press release.

Roto-Rooter 管理層打算在第二季度完善其挖掘定價模型，直到實現收入成長和 EBITDA 利潤率之間的平衡。 2025 年第一季的財務表現完全符合我們對 VITAS 和 Roto-Rooter 的預期和相關指引。我們預計在 2025 年 6 月 30 日的收益新聞稿中提供更新的收益指引。

I will now turn this call over to Nick.

現在我將把這通電話轉給尼克。

Thanks, Mike. I'm pleased with our start to 2025, which is in line with our guidance and on the heels of the strong operating performance over the past few years. In the first quarter of 2025, our average daily census was 22,244 patients, an increase of 13.1% when compared to the prior year period. VITAS has generated quarterly sequential ADC growth over the last 10 quarters.

謝謝，麥克。我對我們 2025 年的開局感到滿意，這符合我們的指導方針，並延續了過去幾年強勁的營運表現。 2025 年第一季度，我們平均每天接診 22,244 名患者，與去年同期相比增加了 13.1%。在過去 10 個季度中，VITAS 的 ADC 逐季實現連續成長。

In the first quarter of 2025, total VITAS admissions were 18,139. This is a 7.3% increase when compared to the first quarter of 2024. In the quarter, admissions increased in all four of our preadmit location types. Our nursing home admissions increased 3.9%, hospital-directed admissions increased 12%, home-based patient admissions expanded 4.2% and the assisted living facilities admissions increased 5.2% when compared to the prior year period.

2025 年第一季度，VITAS 入院總人數為 18,139 人次。與 2024 年第一季相比，這一數字成長了 7.3%。本季度，我們所有四種預入院地點類型的入院人數均有所增加。與去年同期相比，我們的療養院入院人數增加了 3.9%，醫院入院人數增加了 12%，家庭病患入院人數增加了 4.2%，輔助生活設施入院人數增加了 5.2%。

Our average length of stay in the quarter was 118.7 days. This compares to 103.9 days in the first quarter of 2024. It's important to remember that length of stay statistics for the industry are calculated based on discharge patients, not active patients.

本季我們的平均停留時間為 118.7 天。相比之下，2024 年第一季為 103.9 天。重要的是要記住，該行業的住院時間統計數據是根據出院患者而不是活躍患者計算的。

The increase in average length of stay between quarters represents the effect of the patients admitted during our community access initiative, which was designed to identify appropriate patients earlier in their disease trajectory being discharged.

季度間平均住院日數的增加反映了我們在社區就診計劃中接收患者的影響，該計劃旨在在患者病情發展早期識別出適合出院的患者。

I believe we continue to successfully manage our exposure to Medicare Cap in 2025. Our median length of stay was 16 days in the first quarter of both 2025 and 2024. Additionally, our median length of stay in the quarter decreased sequentially from 16 days -- from 18 days in the fourth quarter of 2024, which illustrates the intended impact of increased hospital admissions.

我相信，到 2025 年，我們將繼續成功管理 Medicare Cap 的風險敞口。 2025 年和 2024 年第一季度，我們的平均住院日數均為 16 天。此外，本季我們的平均住院日數從 2024 年第四季的 18 天（16 天）連續下降，這說明了住院人數增加的預期影響。

As Kevin mentioned, the primary Medicare Cap management strategy is to increase hospital-based admissions in select locations. Hospital referrals traditionally come later in a patient's disease trajectory and, therefore, result in shorter length of stay. This has the overall effect of moderating both revenue growth and margin growth, but also provides additional cap cushion in those key locations.

正如凱文所提到的，主要的醫療保險上限管理策略是增加特定地區的住院人數。醫院轉診通常在病患病情發展後期出現，因此住院時間較短。這對整體而言會起到緩和收入成長和利潤率成長的作用，但也為這些關鍵地區提供了額外的資本緩衝。

In the first quarter of 2025, hospital-based admissions represented 49% of our overall admissions, which is our highest level since the pandemic. Hospital-based admissions increased 12% compared to the first quarter of 2024. With the current Medicare Cap rules, this is the right thing to do for the company to ensure long-term sustainable growth.

2025 年第一季度，醫院入院人數占我們總入院人數的 49%，這是自疫情爆發以來的最高水準。與 2024 年第一季相比，醫院入院人數增加了 12%。根據現行的醫療保險上限規則，這是公司確保長期可持續成長的正確做法。

As Kevin also mentioned, we're excited to be providing services in Pasco County and soon in Marion County, Florida. We believe our entry into these two territories is a win both for the people we will serve and for the future growth potential of VITAS. These new locations also provide Medicare Cap cushion in the near term.

正如凱文所提到的，我們很高興能夠在佛羅裡達州帕斯科縣提供服務，並且很快就會在馬里恩縣提供服務。我們相信，進入這兩個地區對於我們服務的人們和 VITAS 未來的成長潛力來說都是一個勝利。這些新地點還可在短期內提供醫療保險上限緩衝。

To quickly recap what our team has accomplished, we've now generated 11 quarters of sequential net growth in licensed health care workers and 10 quarters of sequential growth in ADC. Last year, we demonstrated the ability to partner with and successfully integrate other providers through acquisitions to ensure communities continue to receive the best possible care.

快速回顧我們團隊所取得的成就，我們現在已經在持照醫療保健工作者方面實現了 11 個季度的連續淨增長，在 ADC 方面實現了 10 個季度的連續增長。去年，我們展示了透過收購與其他供應商合作並成功整合的能力，以確保社區繼續獲得最佳的照護。

As a result of these efforts, VITAS continues to achieve higher than historical averages in ADC growth, revenue growth, EBITDA growth and EBITDA margin. We are optimistic about the ability for VITAS to maintain above-average growth, both organically and through accretive acquisitions in 2025 and beyond.

由於這些努力，VITAS 在 ADC 成長、收入成長、EBITDA 成長和 EBITDA 利潤率方面繼續取得高於歷史平均水平的成績。我們對 VITAS 在 2025 年及以後透過有機成長和增值收購保持高於平均水準的成長的能力持樂觀態度。

With that, I'd like to turn the call back over to Kevin.

說完這些，我想把電話轉回給凱文。

Thank you, Nick. I will now open this teleconference to questions.

謝謝你，尼克。現在我將開始本次電話會議並回答大家的提問。

(Operator Instructions)

（操作員指示）

Ben Hendrix, RBC Capital Markets.

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

Hey, thank you very much. I just wanted to ask a little bit more -- go into a little more detail about the longer-term cap management strategy. I know that you have rate updates that are wage index, the cap is not and it makes sense that you're focusing selectively on the shorter-stay patients. But just wondering how that plays out over time? And how we would expect that to evolve as we kind of go in through different rate setting cycles and how that resets every year?

嘿，非常感謝。我只是想多問一點——更詳細地介紹長期上限管理策略。我知道你們的費率更新是工資指數，上限不是，而且你有選擇地關注短期住院患者是有道理的。但只是想知道隨著時間的推移情況會如何發展？當我們進入不同的利率制定週期以及每年如何重置時，我們預計這種情況將如何發展？

And if this is something that's just going to continue to accelerate and then we're going to see continued cap pressure for the intermediate term or if we're going to see a reset in the near term? Thanks.

如果這種情況繼續加速，那麼我們將看到中期持續的上限壓力，還是我們將在短期內看到重置？謝謝。

I'm going to have Nick answer this question, but let me just start by giving very generally. I mean, ideally, you would like cap cushion to be zero. You want to take advantage of all the opportunities available by your level of admits. And there are a couple of things that I going to talk about that keep in mind, during the pandemic when our staff was short, the -- our emphasis from hospital admissions was necessarily changed a little bit just because of the acuity levels that a lot of the hospital-based admissions -- the acuity levels that the patients come with. And it has the effect of increasing our real average length of stay, just -- it was just out of necessity just based on the staffing levels we were able to maintain.

我將讓尼克回答這個問題，但讓我先從非常籠統的回答開始。我的意思是，理想情況下，您希望上限緩衝為零。您希望充分利用您所在等級所能提供的所有機會。我要談的幾件事是，請記住，在疫情期間，當我們的人手短缺時，我們對醫院入院的重點必然會有所改變，這是因為很多醫院入院的病人的病情都很危急。而且它確實增加了我們實際的平均住院時間，這只是出於必要，基於我們能夠維持的人員配備水準。

Nick knew that was going to be -- was going to cause some mid-course corrections as the -- as we expanded into the coming years. And he's in the quarters been doing that, okay? The second thing is if you look at the reimbursement that you made reference to for Florida for this year -- for this government plan year. In Florida, it was a little bit higher than we anticipated, okay? So that used -- that's good.

尼克知道，隨著我們未來幾年的擴張，這將會——將會導致一些中途的修正。他一直在做這些事，好嗎？第二件事是，如果你看一下你提到的佛羅裡達州今年的報銷金額——也就是本政府計劃年度的報銷金額。在佛羅裡達州，這個數字比我們預期的要高一點，好嗎？所以用起來很好。

There's more profitability, used a little bit more of a cushion. We're talking about it a little bit more. But I'm just saying very generally speaking, it's a good thing. If you ask me what is -- it's a good thing to have no cushion at the end of the year. It's a bit of a high-wire act.

獲利能力更強，緩衝作用更大。我們正在進一步討論這個問題。但我只是從總體上來說，這是一件好事。如果你問我什麼是——年底沒有緩衝是件好事。這有點像高難度動作。

But that's how you take best advantage of the opportunities provided to the business. But Nick, why don't you talk -- I just want to give that overview and just say, in a sense, we meant to do this. But Nick, why don't you just talk about the kind of programs that -- things you are doing and you will be talking about over the next 6 to 12 months?

但這就是您如何充分利用為企業提供的機會。但是尼克，你為什麼不談談——我只是想給出一個概述，並且從某種意義上說，我們打算這樣做。但是尼克，為什麼你不只談論你正在做的事情以及你將在未來 6 到 12 個月內談論的事情？

Yeah, I mean I think then the most important piece is that this is all part of normal business and has been for the last decade plus of running and operating VITAS in any hospice provider. So yes, from a year-to-year basis with five, six years ago, a regulatory change that dislocated the annualized rate impact compared to the individual market rate adjustments.

是的，我認為最重要的一點是，這都是正常業務的一部分，在過去十多年裡，任何臨終關懷機構運作和經營 VITAS 都是如此。是的，與五、六年前相比，監理變化導致年化利率影響與個別市場利率調整相差甚遠。

You may see an acceleration or a reduction over a 12-year window based on the differential between that national wage rate and the local market components. But all it ultimately means at the end of the day is a mature hospice provider that's looking at it, evaluating it and monitoring it on a month-to-month basis, has a fiduciary responsibility just to manage and think out about the future trend.

根據全國工資率和當地市場成分之間的差異，您可能會看到 12 年內工資率的加速或下降。但最終這意味著一個成熟的臨終關懷提供者會逐月審視、評估和監控它，並負有管理責任和思考未來趨勢。

So it's not anything that materially changes anything in the near term or the long term. And quite frankly, one of the reasons I think we've been talking about a little bit more over the last six to nine months is answering some of the questions when we have outsized top line and bottom line growth as to why our guidance, which was above historical average, didn't have marginal expansion necessarily inside of it.

因此，它不會在短期或長期內產生任何實質的改變。坦白說，我認為我們在過去六到九個月裡討論得更多的一個原因是，當我們的營收和利潤都大幅增長時，為什麼我們的預期（高於歷史平均水平）中沒有包含邊際擴張？

And it really -- that's sort of the underlying factor. And so while you have a huge queue of active existing patients and constantly emitting new patients with the median length of stay at 16 days, there's a long tail to all these things. And I think we just tried to be more proactive of talking about those different factors, all of which should have minimal to no P&L impact in the near term, as you can see from '25 guidance or in the mid and long term.

這確實是一個潛在因素。因此，雖然您有大量活躍的現有患者，並且不斷有新患者出院，平均住院時間為 16 天，但所有這些事情都有很長的尾巴。我認為我們只是試圖更積極地談論這些不同的因素，所有這些因素在短期內對損益的影響都應該很小甚至沒有，正如你從 25 年指導或中長期所看到的那樣。

It's just -- it's a function of the industry from a rule that got put in place when the benefit was enacted in 1983 when almost every patient was a cancer patient with a very predictable prognostication and outlook.

這只是——這是該行業的一種功能，源於 1983 年頒布該福利時制定的一項規則，當時幾乎每個患者都是癌症患者，並且其預後和前景都非常可預測。

Ben, the only thing -- this is Mike. The only thing I would add is, as sort of as Kevin mentioned, we knew that the growth path at '23 and '24 looked like was probably higher than what was sustainable for the midterm and long term only because of the Medicare Cap. So I think that if you're looking '26 and beyond, the operating metrics that we're showing in the first quarter and have sort of guided to for '25 is probably the more sustainable growth trajectory versus what we saw in '23 and '24, again, only because of the Medicare Cap.

本，唯一的事——這是麥克。我唯一想補充的是，正如凱文所提到的那樣，我們知道，僅僅因為醫療保險上限，23 年和 24 年的成長路徑看起來可能高於中期和長期可持續的成長路徑。因此，我認為，如果展望 26 年及以後，我們在第一季展示的營運指標以及對 25 年的指導可能是比 23 年和 24 年更可持續的成長軌跡，同樣，這僅僅是因為醫療保險上限。

Great. That makes perfect sense. Thank you for that color. And I guess, Mike, staying with you for a second. Just wondered, if we could get a little bit more color, any details you can offer on cash flow dynamics, particularly working capital, looks like we had a step-up in AR. Just wanted to get your thoughts there. Thanks.

偉大的。這很有道理。謝謝你的那個顏色。我想，麥克，請再跟你聊一會兒。只是想知道，如果我們可以獲得更多細節，您可以提供有關現金流動態（特別是營運資本）的任何細節，看起來我們在 AR 方面有所提升。只是想了解你的想法。謝謝。

Sure. There's two things that really affected cash flow and working capital at the end of the first quarter, '25. First one is, and Nick can talk in great detail about it, if you want, but we've disclosed in the past, we had a strange case with the OAS, where they did an audit of a very select few patients, extrapolated it across some crazy three year window and said that we needed to refund $48 million. We had refunded the $48 million, I think, two years ago. We found out at the -- in the first quarter this year, we were getting it all back that --

當然。 2025 年第一季末，有兩件事確實影響了現金流和營運資本。第一個問題是，如果你願意的話，尼克可以詳細地談論它，但我們過去曾披露過，我們與 OAS 有過一個奇怪的案例，他們對極少數患者進行了審計，將其推斷為三年內某個瘋狂的時間窗口，然後說我們需要退還 4800 萬美元。我想，兩年前我們已經退還了 4,800 萬美元。我們發現——在今年第一季度，我們收回了所有資金——

Except $8.

除了 8 美元。

Yes. Except for $8 that we had to pay. But otherwise, we were getting it all back. So over the last two years, that $48 million has been sitting as a long-term receivable because we actually got the cash back, I believe, on April 1. It got moved to a short-term receivable in the first quarter.

是的。除了我們必須支付 8 美元之外。但除此之外，我們已經恢復了一切。因此，在過去兩年裡，這 4800 萬美元一直作為長期應收款，因為我相信我們實際上是在 4 月 1 日收到了現金回饋。它在第一季被轉為短期應收款。

And so receivables are $48 million higher because of that. The other thing is always that affects our cash flow is the timing of the PIP. And so we got a PIP three days into the quarter this year -- into the second quarter. So the PIP payment that we got at the end of the first quarter in '24 didn't come to the beginning of the second quarter in '25. And that's $57 million. And so those are the two things that are affecting both the receivable balance as well as the cash flow during the quarter.

因此應收帳款增加了 4800 萬美元。影響我們現金流的另一件事是 PIP 的時間。因此，我們在今年第二季的第三天就獲得了 PIP。因此，我們在 24 年第一季末收到的 PIP 付款並沒有在 25 年第二季初到帳。這筆金額是 5700 萬美元。因此，這兩個因素都會影響本季的應收帳款餘額和現金流量。

But we have the cash now.

但我們現在有現金。

We have the cash now. And neither of those are any indication of cash flow collection problems or anything like that. It's just timing.

我們現在有現金了。這些都不是現金流收集問題或類似問題的跡象。這只是時間問題。

Great. Thank you very much, guys.

偉大的。非常感謝你們，夥伴們。

R. Prakash, Bloomberg.

R. Prakash，彭博。

Bloomberg, your line may be on mute.

彭博社，您的線路可能處於靜音狀態。

I'm showing no further questions in queue at this time. I'd like to turn the call back to Kevin McNamara for closing remarks.

目前隊列中沒有其他問題。我想請凱文·麥克納馬拉 (Kevin McNamara) 作最後發言。

Thank you. Thank you for your attention. I thought I just want to congratulate both our operating units for exceeding our internal projections from which we provided guidance. We maintain that guidance. And again, looking at the stock price, it seems to be a bit of a dislocation in the market for our stock for some reason.

謝謝。感謝您的關注。我想我只是想祝賀我們的兩個營運單位超出了我們提供指導的內部預測。我們堅持這一指導方針。再一次，從股價來看，由於某種原因，我們的股票市場似乎出現了一些混亂。

But in any event, I want to thank everyone for their attention, and we'll renew these discussions three months ahead. Thank you.

但無論如何，我要感謝大家的關注，我們將在三個月後重新開始這些討論。謝謝。

This concludes today's conference call. Thank you for participating. You may now disconnect.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。