Evolent Health Inc (EVH) 2024 Q2 法說會逐字稿

Welcome to the Evolent earnings conference call for the second quarter Ended June 30, 2024. As a reminder, this conference call is being recorded.

歡迎參加截至 2024 年 6 月 30 日的第二季 Evolent 收益電話會議。謹此提醒，本次電話會議正在錄音中。

Your hosts for the call today from Evolent are Seth Blackley, Chief Executive Officer and John Johnson, Chief Financial Officer. This call will be archived and available later this evening and for the next week via the webcast on the Company's website in the section titled Investor Relations.

今天 Evolent 電話會議的主持人是執行長 Seth Blackley 和財務長 John Johnson。該電話會議將被存檔，並在今晚晚些時候和下週透過公司網站上標題為「投資者關係」的部分的網路廣播提供。

I will now hand the call to Seth Frank, Evolent's Vice President of Investor Relations.

現在我將把電話轉給 Evolent 投資者關係副總裁 Seth Frank。

Thank you, and good evening. This conference call will contain forward-looking statements under the U. S. Federal laws. These statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations.

謝謝你，晚上好。本次電話會議將包含美國聯邦法律規定的前瞻性聲明。這些陳述存在風險和不確定性，可能導致實際結果與歷史經驗或當前預期有重大差異。

A description of some of the risks and uncertainties can be found in the Company's reports that are filed with the Securities and Exchange Commission, including cautionary statements included in our current and periodic filings. For additional information on the Company's results and outlook, please refer to our second quarter press release issued earlier today.

對一些風險和不確定性的描述可以在公司向美國證券交易委員會提交的報告中找到，包括我們目前和定期提交的文件中包含的警告聲明。有關公司業績和前景的更多信息，請參閱我們今天早些時候發布的第二季新聞稿。

Finally, as a reminder, reconciliations of non-GAAP measures discussed during today's call to the most direct comparable GAAP measures are available in the summary presentation available in the Investor Relations section of our website or in the Company's press release issued today and posted on the IR section of the Company's website, ir.evolent.com and the Form 8-K filed by the Company with the SEC earlier today. In addition to reconciliations, we provide details on the numbers and operating metrics for the quarter in both our press release and the supplemental investor presentation.

最後，提醒一下，今天電話會議中討論的最直接可比 GAAP 衡量標準的非 GAAP 衡量標準的調節可在我們網站的投資者關係部分或公司今天發布並發佈在網站上的新聞稿中找到。 ir.evolent.com 的IR 部分以及公司今天早些時候向SEC 提交的8-K 表格。除了對帳之外，我們還在新聞稿和補充投資者演示中提供了有關本季數據和營運指標的詳細資訊。

And now, I'd like to hand the call over to Evolent's CEO, Seth Blackley.

現在，我想將電話轉交給 Evolent 的執行長 Seth Blackley。

Good evening. Thanks for joining the call. Tonight, I'll go through the headline results for the quarter and update you on our three pillars of shareholder value creation before handing it to John to speak more about financials and outlook.

晚安.感謝您加入通話。今晚，我將回顧本季度的主要業績，並向您介紹我們創造股東價值的三大支柱的最新情況，然後交給約翰更多地談論財務和前景。

Evolent delivered revenue just above our anticipated range, while profitability came in within our expected range for the second quarter. Today, we're updating our full year 2024 adjusted EBITDA guidance. We're also reiterating our confidence in our $300 million 2024 year-end exit run rate target. To put the results and our outlook for the year in perspective, we have a number of important updates to share today.

Evolent 的營收略高於我們的預期範圍，而第二季的獲利能力則在我們的預期範圍內。今天，我們更新了 2024 年全年調整後 EBITDA 指引。我們也重申對 2024 年底 3 億美元退出運行率目標的信心。為了正確看待今年的結果和我們的展望，我們今天有一些重要的更新要分享。

First, recall in the quarter of this year, we noted a few performance suite markets with higher than expected medical costs due primarily to higher prevalence of disease. We also noted that our contracting model allows us to update our capitation rates to reflect these changes. Today, we're pleased to update you on our progress regarding rate increases from these Performance Suite customers.

首先，回顧今年第四季度，我們注意到一些性能套件市場的醫療成本高於預期，這主要是由於疾病盛行率較高。我們還注意到，我們的承包模式允許我們更新按人頭付費以反映這些變化。今天，我們很高興向您通報這些 Performance Suite 客戶費率上漲的最新進展。

Specifically, we have aligned with our partners on new rates, which we expect will contribute approximately $60 million in additional revenue on an annualized basis. We expect to capture approximately $35 million of this rate benefit in 2024. Based on the partnership dynamics with our payers in an environment where they are under pressure, we have prioritized setting the correct rates for the balance of 2024 and for 2025 over retrospective rate increases.

具體來說，我們已與合作夥伴就新費率達成一致，預計每年將貢獻約 6,000 萬美元的額外收入。我們預計到 2024 年將獲得約 3,500 萬美元的利率收益。根據與付款人在壓力環境下的合作動態，我們優先考慮為 2024 年和 2025 年設定正確的費率，而不是追溯費率上調。

Given that, we anticipate the majority of the economic benefit of these rate increases to begin in the third quarter of 2024 and not retrospectively. 2024 came in slightly lower than the midpoint, but we now have high confidence in reaching our target year end exit run-rate of $300 million in adjusted EBITDA as well as a strong setup for 2025. More importantly, we believe this outcome clearly underscores the fundamental value creation our solutions deliver to our customers.

有鑑於此，我們預計這些升息的大部分經濟利益將在 2024 年第三季開始，而不是追溯。 2024 年的數據略低於中點，但我們現在對實現 3 億美元調整後 EBITDA 的年終退出運行率目標充滿信心，並為 2025 年做好了強有力的準備。更重要的是，我們相信這一結果清楚地強調了我們的解決方案為客戶創造的基本價值。

With respect to overall utilization trends in our Performance Suite, expenses were in line with our expectations for Q2 and were consistent with elevated levels suggested by the leading indicators previously noted in March. We saw these same leading indicators decline in Q2, suggesting potential utilization improvement into Q3.

就我們性能套件的整體利用率趨勢而言，費用符合我們對第二季的預期，並且與 3 月之前提到的領先指標所建議的較高水平一致。我們在第二季看到這些相同的領先指標下降，顯示第三季利用率可能有所改善。

However, our full year guide assumes baseline third and fourth quarter utilization trend levels will remain consistent with Q2 levels. That is, we are assuming trend to be stable, neither improving nor deteriorating. And to achieve our $300 million adjusted EBITDA exit run rate, we are assuming normal margin maturation improvements consistent with our historical experience.

然而，我們的全年指南假設第​​三季和第四季的基準利用率趨勢水準將與第二季的水準保持一致。也就是說，我們假設趨勢穩定，既不改善也不惡化。為了實現 3 億美元的調整後 EBITDA 退出運行率，我們假設正常的利潤率改善與我們的歷史經驗一致。

As John will detail in a moment, at his normal course margin maturation, we expect to drive approximately $7 million in increased quarterly adjusted EBITDA by the end of the year. To achieve the top end of our range or higher, we need to slightly outperform our historical margin maturation pace or see utilization trends return to 2023 levels.

正如約翰稍後將詳細介紹的那樣，在正常利潤率成熟的情況下，我們預計到年底，季度調整後 EBITDA 將增加約 700 萬美元。為了達到我們範圍的上限或更高，我們需要稍微超過我們的歷史利潤率成熟速度，或看到利用率趨勢恢復到 2023 年的水平。

However, because the rate increases are fully in effect by December 31, 2024, we have high confidence in reaching the $300 million run rate exit EBITDA even if utilization trends remain at the 2024 average levels and don't return to 2023 levels.

然而，由於費率上調將於2024 年12 月31 日完全生效，因此即使利用率趨勢保持在2024 年的平均水平並且不會回到2023 年的水平，我們也對達到3 億美元的運行率退出EBITDA 充滿信心。

Regarding Medicaid redeterminations, we believe we have substantially captured the impact of this process in our revenue and earnings through the second quarter, and this issue is now in the rearview mirror.

關於醫療補助重新確定，我們相信我們已經充分認識到這個過程對我們第二季收入和收益的影響，這個問題現在已經成為過去。

Finally, I'm pleased to announce today four new revenue agreements from the second quarter, adding over $70 million in new annualized revenue bookings across Performance Suite and Technology and Services, with the latter closing out our Tech and Services new business EBITDA go get towards our $300 million run rate target.

最後，我今天很高興地宣布第二季度的四項新收入協議，在性能套件以及技術和服務方面增加了超過 7000 萬美元的新年度收入預訂，後者關閉了我們的技術和服務新業務 EBITDA我們3 億美元的運行率目標。

Taken together, as a result of these factors, we have confidence in our path to significantly improve the performance suite and enterprise margins and adjusted EBITDA for each of the remaining quarters of 2024 within the range provided today. Evaluating where the business stands today, I continue to feel excited about Evolent's future.

總而言之，由於這些因素，我們對在今天提供的範圍內顯著提高績效套件和企業利潤以及 2024 年剩餘每個季度的調整後 EBITDA 的道路充滿信心。評估目前的業務狀況，我仍然對 Evolent 的未來感到興奮。

We continue to see a strong pipeline, which we believe is reflective of high demand for our solutions from the leading payers around the country. We have $150 billion addressable market and over $50 billion in cross sell opportunity. We believe our portfolio consists of an attractive balance across different customer types and sizes and revenue models across fees and risk.

我們繼續看到強大的管道，我們相信這反映了全國領先的付款人對我們的解決方案的高需求。我們擁有 1500 億美元的潛在市場和超過 500 億美元的交叉銷售機會。我們相信，我們的投資組合在不同客戶類型和規模以及費用和風險的收入模式之間實現了有吸引力的平衡。

With that, let me turn to the results. Second quarter 2024 revenue was $647.1 million totaling year over year growth of 37.9%, all organically driven. We averaged 39.9 million unique members in the quarter with an average of two products deployed per unique number for a total of 79.9 million product members, a modest sequential decrease due to anticipated Medicaid redeterminations.

接下來，讓我談談結果。2024 年第二季營收為 6.471 億美元，年成長 37.9%，這一切都是有機驅動的。本季度，我們平均有 3,990 萬唯一會員，每個唯一會員數平均部署兩種產品，產品會員總數為 7,990 萬，由於預期的醫療補助重新確定，略有環比下降。

Given that we'll start to recognize the majority of our anticipated rate increase in Q3 and not Q2, adjusted EBITDA for the quarter was towards the lower part of the range totaling $52 million. We ended the quarter with a strong cash position of $101 million in cash and equivalents after the outflow of $89 million in cash for the earn out to the former owner of NIA.

鑑於我們將開始認識到我們預期的利率增長大部分是在第三季度而不是第二季度，因此該季度調整後的 EBITDA 接近該範圍的較低部分，總額為 5200 萬美元。在為 NIA 前所有者的盈利流出 8,900 萬美元現金後，本季末我們擁有 1.01 億美元現金及等價物的強勁現金頭寸。

Turning now to our three pillars of shareholder value creation. I want to update you first on our organic growth. We're announcing today over $70 million across four new revenue agreements that we anticipate will go live in the coming months.

現在轉向我們創造股東價值的三大支柱。我想先向您介紹我們有機成長的最新情況。我們今天宣布四項新收入協議的金額超過 7,000 萬美元，我們預計這些協議將在未來幾個月內生效。

Of the four new revenue agreements, two are Performance Suite and two are for Specialty Technology and Services. The two Performance Suite expansions are for Medicaid and commercial in Ohio and Wisconsin for an existing Performance Suite customer, and they're expected to add approximately $60 million in new annual revenue.

在四項新的收入協議中，兩項是性能套件，兩項是專業技術和服務。這兩個 Performance Suite 擴充功能適用於醫療補助計劃，以及在俄亥俄州和威斯康辛州為現有 Performance Suite 客戶提供的商業服務，預計將增加約 6000 萬美元的新年收入。

In Specialty Technology and Services, we are seeing exciting growth and growing traction among Blues plans around the country. In the quarter, we won an RFP to provide our comprehensive oncology, technology and services solution for one of the five largest Blue Cross Blue Shield plans in the country.

在專業技術和服務方面，我們看到全國各地 Blues 計劃的令人興奮的成長和日益增長的吸引力。本季度，我們贏得了 RFP，為該國五個最大的 Blue Cross Blue Shield 計劃之一提供全面的腫瘤學、技術和服務解決方案。

This plan was an existing NIA customer and has selected Evolent to provide medical and radiation oncology services as well as care navigation services across over 2 million of their members. We also expect this will be our first deployment under the Evolent umbrella of the Careology care navigation product announced in May.

該計劃是 NIA 的現有客戶，並選擇 Evolent 為超過 200 萬會員提供醫療和放射腫瘤學服務以及護理導航服務。我們也預計這將是我們在 5 月宣布的 Careology 護理導航產品 Evolent 範圍內的首次部署。

Secondly, we secured a significant line of business expansion with the Midwest Blue Cross Blue Shield plan for our MSK solutions within technology and services, expanding existing services to this client's Medicare membership beyond existing lines, including Medicaid and commercial.

其次，我們透過中西部Blue Cross Blue Shield 計劃為我們的MSK 解決方案在技術和服務方面實現了重大業務擴展，將向該客戶的Medicare 會員提供的現有服務擴展到現有業務之外，包括醫療補助和商業。

We expect these new agreements to contribute approximately $10 million in annual revenue when they go live, and these agreements close out the remaining revenue bookings towards our $300 million exit run rate. The four new revenue agreements announced today brings us to a total of 11 for 2024 sales cycle with one more quarter to go.

我們預計這些新協議生效後將貢獻約 1000 萬美元的年收入，並且這些協議將剩餘的收入預訂結算為我們 3 億美元的退出運行率。今天宣布的四項新收入協議使我們在 2024 年銷售週期中總共達成了 11 項收入協議，距離還剩一個季度。

Turning to operations. We completed a number of successful large scale go lives during the quarter. One example worth highlighting was implementation and deployment of our national radiation and surgical oncology solution to a large national health plan.

轉向營運。我們在本季完成了多次成功的大規模上線。一個值得強調的例子是在一項大型國家衛生計畫中實施和部署我們的國家放射和腫瘤外科解決方案。

This implementation marked the first time we rolled out our surgical oncology solution and the first time we implemented on a full 50 state basis in one go live. Recall, we announced this agreement back in February where we already provide national medical oncology technology and services across several dozen states.

這項實施標誌著我們第一次推出腫瘤外科解決方案，也是我們第一次在整個 50 個州一次性實施。回想一下，我們早在二月就宣布了這項協議，我們已經在幾十個州提供國家腫瘤醫學技術和服務。

In addition, we also had a successful rollout early in the quarter with our first cross sell of an existing Evolent client with Imaging Solutions. One other successful large-scale implementation to highlight was with one of our national partners for the specialty technology and services in the Midwest.

此外，我們也在本季初成功推出了現有 Evolent 客戶與影像解決方案的首次交叉銷售。另一個值得強調的成功大規模實施是與我們在中西部的專業技術和服務的國家合作夥伴之一合作。

New products included medical and radiation oncology as well as interventional cardiology for over 0.5 million members across all three major lines of business. We continue to be pleased with the progress that our services and solutions team has made in supporting higher scale and increasingly complex implementations.

新產品包括醫療和放射腫瘤學以及介入性心臟病學，為三大業務線的超過 50 萬名會員提供服務。我們對我們的服務和解決方案團隊在支援更大規模和日益複雜的實施方面所取得的進展仍然感到滿意。

Looking at the sales pipeline, we see significant demand that we can anticipate to continue to drive meaningful top line growth for Evolent. In speaking with payers across the country, it seems clear to us that health plans increasingly need effective strategies to manage high cost, complex and rapidly evolving medical specialties.

從銷售管道來看，我們看到了巨大的需求，預計這將繼續推動 Evolent 的營收顯著成長。在與全國各地的付款人交談時，我們似乎很清楚，健康計劃越來越需要有效的策略來管理高成本、複雜且快速發展的醫療專業。

We understand and align with where health care is headed, moving beyond the limitations of traditional utilization management to providing advanced condition management solutions. We believe these solutions lower abrasion with providers, improve satisfaction for patients and provide higher quality care.

我們了解並順應醫療保健的發展方向，超越傳統利用管理的局限性，提供先進的狀況管理解決方案。我們相信這些解決方案可以減少與提供者之間的摩擦，提高患者的滿意度並提供更高品質的護理。

Taken together, our positioning and competitive advantage remain highly differentiated, and we're optimistic regarding the setup for a strong growth year in 2025. Let's turn now to our second operating priority of expanding profitability. Our profitability and our value proposition are built on our ability to drive more clinical value than anyone else in the market.

總而言之，我們的定位和競爭優勢仍然高度差異化，我們對 2025 年的強勁成長感到樂觀。現在讓我們轉向我們的第二個營運重點：擴大獲利能力。我們的獲利能力和價值主張建立在我們比市場上任何其他公司都能帶來更多臨床價值的能力之上。

I'd like to share a few examples of what our clinical value creation looks like in real life for our customers. First, in our work with one of the largest community-based cancer specialists in the country located in the Southeast, we drove a 77% decline in designated low value regimens, which directly leads to higher quality and lower cost.

我想分享一些例子，說明我們在現實生活中為客戶創造的臨床價值。首先，在我們與位於東南部的全國最大的社區癌症專家之一的合作中，我們將指定的低價值治療方案減少了 77%，這直接導致了更高的品質和更低的成本。

We achieved this result using the full breadth of our performance suite model, alternative payment models, score carding and direct peer to peer engagement. Another example of clinical value creation can be found in our cardiology performance suite in another state in which we were able to drive a 20% decrease in the interventional cardiology costs in year one of an implementation using optimal medical management and guideline directed medical therapy.

我們透過全面的績效套件模型、替代支付模型、記分卡和直接點對點參與來實現這一結果。另一個創造臨床價值的例子可以在另一個州的心臟病學績效套件中找到，在該州，我們利用最佳醫療管理和指南指導的醫療治療，在實施的第一年就將介入心臟病學成本降低了20%。

Importantly, these financial results also improve quality of care for patients. These examples demonstrate the way our scalable approach can drive value far beyond what is achievable through traditional models. In fact, we believe our approach of implementing clinician engagement strategies such as peer to peer discussions and alternative payment models help reduce denials.

重要的是，這些財務表現也提高了患者的護理品質。這些例子展示了我們的可擴展方法如何推動價值遠遠超出傳統模型所能實現的價值。事實上，我們相信我們實施臨床醫生參與策略（例如同儕討論和替代支付模式）的方法有助於減少拒絕。

For example, in one Midwestern state, we recently demonstrated a denial avoidance rate of over 90% based on high quality peer to peer consultations. We believe this is how health care should work for complex care. Our world class experts having thoughtful, data driven conversations with the treating physicians about the right care for the patient. This model, we believe, improved the experience but also avoids delays, frustration and red tape associated with the traditional payer utilization management model.

例如，在中西部的一個州，我們最近展示了基於高品質點對點諮詢的拒絕避免率超過 90%。我們相信這就是醫療保健應如何進行複雜護理。我們的世界級專家與治療醫生進行深思熟慮的、數據驅動的對話，討論如何為患者提供正確的護理。我們相信，這種模式不僅改善了體驗，也避免了與傳統付款人使用管理模式相關的延遲、挫折和繁文縟節。

Let's turn to our third principle of disciplined capital allocation. It's a good time to talk about our operating efficiencies. We're pleased to announce the closing of the Machinify transaction we announced back in June and are rapidly ramping integration and implementation activities across our product portfolio.

讓我們轉向第三個原則：嚴格的資本配置。現在是談論我們的營運效率的好時機。我們很高興地宣布，我們在 6 月宣布的 Machinify 交易已經完成，並且正在迅速加強我們產品組合的整合和實施活動。

We acquired Machinify Technology and team after comprehensive search of competing AI technologies that were relevant to our products. We found the technology and platform deployed by Machinify to be the most advanced and the most consistent with our vision for AI and specialty condition management. As a reminder, we've described two immediate benefits of this technology to Evolent.

在全面搜尋與我們產品相關的競爭人工智慧技術後，我們收購了 Machinify Technology 和團隊。我們發現 Machinify 部署的技術和平台是最先進的，也最符合我們對人工智慧和特殊狀況管理的願景。提醒一下，我們已經向 Evolent 描述了該技術的兩個直接好處。

First, in scale deployments with a large payer, Machinify has demonstrated up to a 55% reduction in clinician review time. Evolent will spend about $150 million this year on clinical staff with continued rapid growth forecasted in years ahead. Using this technology to streamline the workflow of our expert clinical teams, we believe will enable them to work at the top of their license, deliver incremental value to our members and absorb our growth, which in turn should drive meaningful operating leverage for Evolent.

首先，在大型付款人的規模部署中，Machinify 已證明臨床醫生審查時間減少了 55%。Evolent 今年將在臨床人員上花費約 1.5 億美元，預計未來幾年將持續快速成長。我們相信，使用這項技術來簡化我們專家臨床團隊的工作流程，將使他們能夠在其許可的範圍內工作，為我們的會員提供增量價值並吸收我們的成長，這反過來又將為Evolent帶來有意義的營運槓桿。

The second benefit is an expansion of our product offering for clients and prospects. The Machinify product provides a holistic solution to payers for specialties and general authorizations where we do not focus, including inpatient admission reviews, long tail specialties and other areas that require conformity to health plan medical policy.

第二個好處是擴大了我們為客戶和潛在客戶提供的產品範圍。Machinify 產品為我們不關注的專科和一般授權的付款人提供了整體解決方案，包括住院審查、長尾專科和其他需要符合健康計劃醫療政策的領域。

Machinify can be sold to our health plan partners as a SaaS solution, enabling our partners to cover the long tail specialties with their in-house staff, while Evolent continues to manage the more complex specialties on an outsourced basis. This combination model, we believe, allows Evolent to serve our payer customers as a one stop partner for the first time.

Machinify 可以作為 SaaS 解決方案出售給我們的健康計劃合作夥伴，使我們的合作夥伴能夠利用其內部員工覆蓋長尾專業，而 Evolent 則繼續在外包的基礎上管理更複雜的專業。我們相信，這種組合模式使 Evolent 首次能夠作為一站式合作夥伴為我們的付款客戶提供服務。

At the moment, we're taking a measured approach to the implementation of this technology within our current development budget, though we do anticipate a lower capitalization rate of engineering resources as we start the integration. We continue to be excited about the potential of this technology and the impact we believe it will have as we target up to $50 million in annualized EBITDA improvement from the solution in the years to come.

目前，我們正在目前的開發預算內採取審慎的方法來實施該技術，儘管我們預計在開始整合時工程資源的資本化率會較低。我們仍然對這項技術的潛力以及我們相信它將產生的影響感到興奮，因為我們的目標是在未來幾年透過該解決方案實現高達 5000 萬美元的年化 EBITDA 改善。

Looking ahead, our capital priorities remain the same. We continue to reinvest in the business, seek out accretive assets that accelerate our platform and maintain a strong balance sheet and prudent leverage ratio to maximize financial flexibility and strategic growth.

展望未來，我們的資本優先事項保持不變。我們持續對業務進行再投資，尋找可加速我們平台發展的增值資產，並維持強勁的資產負債表和審慎的槓桿率，以最大限度地提高財務靈活性和策略成長。

Before I hand the call to John, I want to address a few issues on the policy front since we're in an election year and this topic will take on more oxygen as we get closer to November. In short, we're keeping our focus on the enduring theme of higher quality and lower cost, which is obviously has always enjoyed support by those on both sides of the aisle.

在我把電話交給約翰之前，我想先談談政策上的一些問題，因為我們正處於選舉年，隨著接近 11 月，這個話題將變得更加重要。簡而言之，我們將重點放在更高品質和更低成本這一持久主題上，這顯然一直受到兩黨人士的支持。

Further, we believe our condition management model drives more of our value from patient navigation and provider engagement and further reduces any burdens on providers from the utilization management model. In fact, based on the examples we gave earlier and other data, we estimate that in oncology, over 80% of our value creation comes from action outside of traditional utilization management and we believe that percentage will go up in the time ahead.

此外，我們相信我們的病情管理模式可以從病患導航和提供者參與中帶來更多價值，並進一步減輕利用管理模式給提供者帶來的負擔。事實上，根據我們先前提供的範例和其他數據，我們估計在腫瘤學領域，超過 80% 的價值創造來自傳統利用管理以外的行動，我們相信這一比例在未來一段時間內將會上升。

With that, I'll turn the call over to John.

這樣，我就把電話轉給約翰。

Thanks Seth. Let's unpack some of the key financial metrics for the quarter. Revenue of $647 million outperformed our internal expectations. This included the recognition of approximately $5 million in higher revenue in the quarter related to the rate increases driven by elevated prevalence and acuity we experienced in our performance suite. This $5 million per quarter improvement will persist, contributing $15 million for the year.

謝謝賽斯。讓我們來了解本季的一些關鍵財務指標。6.47 億美元的收入超出了我們的內部預期。這包括確認本季收入增加了約 500 萬美元，這與我們在性能套件中體驗到的普及率和敏銳度提高所驅動的費率增長有關。每季 500 萬美元的改進將持續下去，全年貢獻 1500 萬美元。

We anticipate new increases totaling $10 million per quarter starting in July for a total of $35 million for the year $60 million annualized. Specific line of business trends were consistent with our expectations, including specialty tech and services revenue of $81.5 million was down $7.5 million sequentially driven by a combination of Medicaid redetermination and lower onetime quarterly revenue compared to Q1 2024.

我們預計從 7 月開始每季新增總額為 1,000 萬美元，全年總額為 3,500 萬美元，年化總額為 6,000 萬美元。具體業務趨勢與我們的預期一致，包括專業技術和服務收入 8,150 萬美元，比 2024 年第一季下降 750 萬美元，原因是醫療補助重新確定和一次性季度收入下降。

As expected, we did not receive any new data for the Medicare shared savings program and so did not book any incremental revenue in the second quarter impacting comparison to Q1 '24. In cost of revenue, we recognized approximately $10 million in favorable claims development from 2023 that was not offset by revenue refunds. This claims development represents about 1% of specialty performance suite revenue in 2023 and was consistent with our expectations.

正如預期的那樣，我們沒有收到任何醫療保險共享儲蓄計劃的新數據，因此第二季度沒有記錄任何影響與 24 年第一季相比的增量收入。在收入成本方面，我們確認自 2023 年起約 1000 萬美元的有利索賠進展，該金額並未被收入退款所抵消。這項索賠進展約佔 2023 年特種性能套件收入的 1%，與我們的預期一致。

As a comparison, in Q2 of 2023, we recognized $6 million in favorable claims development from 2022, which was also about 1% of specialty performance suite revenue in 2022 for a $4 million net positive prior period developments relative to Q2 a year ago and $5 million more compared to Q1 of ‘24. This favorability was offset by continued elevated medical expenses during Q2 in certain of our performance suite markets, which I will discuss more [Technical Difficulty].

相較之下，在2023 年第二季度，我們確認自2022 年起有利索賠開發金額為600 萬美元，這也約佔2022 年專業性能套件收入的1%，相對於去年第二季度，前期開發淨額為400 萬美元，與去年同期相比為5 美元與 24 年第一季相比增加了 100 萬。這種優惠被我們某些性能套件市場第二季度持續上漲的醫療費用所抵消，我將對此進行更多討論[技術難度]。

Overall, adjusted gross margin in the quarter was 16.7%, an increase of about 30 basis points from the first quarter of 2024. This increase is attributable to favorable claims development offset in part by not recognizing shared savings from MSSP in the quarter as we mentioned would likely be the case.

整體而言，該季度調整後毛利率為16.7%，較2024年第一季成長約30個基點。這一增長歸因於有利的理賠進展，部分原因是由於我們沒有提到本季度 MSSP 的共享節省，我們可能會提到這種情況。

Adjusted SG&A of $56.1 million is down $13.7 million versus the same period last year, the result of strong execution of our One Evolent M&A integration program. Capitalized software development expense was $5.8 million about flat to the same period the prior year.

調整後的 SG&A 為 5,610 萬美元，與去年同期相比減少了 1,370 萬美元，這是我們大力執行 One Evolent 併購整合計畫的結果。資本化軟體開發費用為 580 萬美元，與去年同期持平。

Page 4 of the presentation posted on our IR website lays out the key drivers of change in adjusted EBITDA from Q2 of last year to Q2 of this year. First, we have overcome two-time bound headwinds totaling 10.5 in quarterly EBITDA impact. Recall in Q1, we completed the planned wind down of certain administrative services clients. Comparing versus Q2 of last year, this represented a $4 million headwind to adjusted EBITDA. Note that this represented a $7 million headwind to gross profits, which was offset by a $3 million reduction in SG&A.

我們的 IR 網站上發布的簡報第 4 頁列出了從去年第二季到今年第二季調整後 EBITDA 變化的主要驅動因素。首先，我們克服了兩次對季度 EBITDA 影響總計 10.5 倍的不利因素。回想一下，第一季度，我們完成了某些行政服務客戶的計畫縮減。與去年第二季相比，調整後的 EBITDA 面臨 400 萬美元的阻力。請注意，這意味著毛利減少了 700 萬美元，但 SG&A 減少了 300 萬美元。

On Medicaid redeterminations, we ended this quarter in line with our expectations for a total impact of $6.3 million since Q2 of last year. Gross Medicaid membership declines were approximately 15%, consistent with our expectations. Based on stable authorization trends across the second quarter and into July, we believe Evolent's risk business captures the impact of redeterminations within our Q2 results.

關於醫療補助重新確定，在本季結束時，我們預期自去年第二季以來總影響為 630 萬美元。醫療補助會員總數下降約 15%，與我們的預期一致。基於第二季到 7 月穩定的授權趨勢，我們相信 Evolent 的風險業務抓住了我們第二季業績中重新確定的影響。

Importantly, we believe these aforementioned headwinds to be complete as of the third quarter. The timing of revenue recognition for MFSP was a $7.6 million headwind comparing to the prior quarter. Though keep in mind, this is timing only and does not reflect the change in our outlook for that program.

重要的是，我們認為上述不利因素將於第三季結束。與上一季相比，MFSP 的收入確認時間出現了 760 萬美元的逆風。但請記住，這只是時間安排，並不反映我們對該計劃前景的變化。

Consistent with expectations, Q2 captured approximately $6.7 million of synergies from the NIA acquisition but the remainder on track to be in place by end of year. Additional SG&A reductions beyond what is included in the administrative services run out and NIA synergies categories contributed an additional $3.5 million.

與預期一致，第二季從 NIA 收購中獲得了約 670 萬美元的協同效應，但其餘部分預計將在年底前到位。除了行政服務所包含的費用外，額外的 SG&A 削減金額和 NIA 綜效類別額外貢獻了 350 萬美元。

Maturation of our performance suite added $5.5 million of EBITDA versus Q2 of last year and other net growth added $6.6 million. In other words, the core organic drivers of our business drove $12.1 million in adjusted EBITDA growth compared to the same period last year.

與去年第二季相比，我們的績效套件的成熟增加了 550 萬美元的 EBITDA，其他淨成長增加了 660 萬美元。換句話說，與去年同期相比，我們業務的核心有機驅動因素推動了調整後 EBITDA 成長 1,210 萬美元。

Now let's pivot to cost trend within Performance Suite year to date. Recall, in Q1, we recognized higher medical costs in some markets based on data from prior authorizations. Specifically, we saw increases in disease prevalence, acuity and estimated cost per encounter.

現在讓我們來看看今年迄今為止 Performance Suite 中的成本趨勢。回想一下，在第一季度，我們根據事先授權的數據認識到某些市場的醫療成本較高。具體來說，我們看到疾病盛行率、嚴重程度和每次就診的估計成本都有所增加。

Based on the most current data from our partners, these increases have translated into paid claims consistent with our reserves at the end of Q1 and overall utilization trend in Q2 was consistent with Q1 levels that's down from the March peak and higher than 2023 trend levels. Therefore, we continue to believe these increases were due to changes in the underlying populations and not caused by broader macro trends in our specialty areas.

根據我們合作夥伴的最新數據，這些增長已轉化為與我們第一季末的儲備金一致的已付索賠，第二季度的總體利用率趨勢與第一季的水平一致，低於3 月份的峰值，高於2023 年的趨勢水準。因此，我們仍然認為這些成長是由於基礎人群的變化造成的，而不是由我們專業領域更廣泛的宏觀趨勢引起的。

Fortunately, we have mechanisms in our contracts to increase our revenues if there are changes disease prevalence or acuity. During the quarter, we secured increased revenue for several of the impacted markets to cover the elevated costs we highlighted for March and into Q2.

幸運的是，我們的合約中有機制，可以在疾病流行率或嚴重程度變化時增加我們的收入。在本季度，我們確保了幾個受影響市場的收入增加，以彌補我們在 3 月和第二季度強調的增加的成本。

We have also reached alignment with our partners for higher revenue in the remaining affected markets that we expect to start to recognize in Q3. We are also enhancing the mechanisms by which we update these rates with our partners, giving us good line of sight for rate sufficiency into 2025 and beyond.

我們也與合作夥伴達成一致，以在剩餘受影響的市場中獲得更高的收入，我們預計將在第三季開始認識到這一點。我們也正在加強與合作夥伴一起更新這些費率的機制，為我們在 2025 年及以後實現費率充足提供良好的視野。

With these last rate increases coming into effect this quarter, we believe we will have fully covered the underlying changes in prevalence and acuity for the year. While the timing of this revenue beginning in Q3 impacts our original full year 2024 outlook, we believe our ability to rapidly capture these updates speaks to the value of the aligned partnership we have with our customers.

隨著最後一次升息於本季生效，我們相信我們將完全涵蓋今年患病率和敏銳度的根本變化。雖然這筆收入從第三季開始的時間影響了我們最初的 2024 年全年展望，但我們相信，我們快速捕捉這些更新的能力說明了我們與客戶保持一致的合作夥伴關係的價值。

Finally, as a part of our thoughtful approach to risk management, we have also agreed with certain partners to carve a select number of markets out of our scope for 2024, which will modestly reduce our full year revenue with no expected impact to adjusted EBITDA. This reduction in revenue is more than offset by the expected rate increases and new go live announcements we have discussed.

最後，作為我們深思熟慮的風險管理方法的一部分，我們還與某些合作夥伴達成一致，在2024 年的範圍之外開闢一些特定的市場，這將適度減少我們的全年收入，預計不會對調整後的EBITDA 產生影響。這種收入的減少被我們討論過的預期費率上漲和新的上線公告所抵消。

Turning to other key financial metrics, we completed our repositioning work on schedule during Q2 expensing the remaining $670,000 in the program. Overall, these repositioning investments have been the principal driver of the $13.7 million year on year decline in adjusted SG&A versus Q2 of last year.

談到其他關鍵財務指標，我們在第二季度按計劃完成了重新定位工作，支出了該計劃剩餘的 67 萬美元。總體而言，這些重新定位投資是調整後的 SG&A 與去年第二季相比同比下降 1,370 萬美元的主要推動因素。

Stock based compensation of $12.7 million in the quarter was consistent with our expectations. We paid $88.75 million in the quarter to close off the earn out for NIA, electing to fund that liability entirely in cash, which increased our net debt to 2.5 times adjusted EBITDA at the end of the quarter.

本季以股票為基礎的薪酬為 1,270 萬美元，符合我們的預期。我們在本季度支付了 8875 萬美元來結束 NIA 的盈利，選擇完全以現金為該負債提供資金，這使我們的淨債務在本季度末增加到調整後 EBITDA 的 2.5 倍。

Year-to-date cash flow from operations is $26.3 million which includes $22.2 million of the earn out payment. Excluding this classification item, year-to-date cash flow from operations would be $48.5 million. We remain on track towards our target of generating $150 million or more in cash flow from operations this year.

年初至今的營運現金流為 2,630 萬美元，其中包括 2,220 萬美元的獲利付款。排除這項分類項目，年初至今的營運現金流將為 4,850 萬美元。我們仍有望實現今年營運現金流達到 1.5 億美元或更多的目標。

As an organization, our financial North Star for almost two years has been achieving $300 million in adjusted EBITDA on a run rate basis exiting 2024. We believe securing the rate increases in the back half of the year and other factors lend confidence to our tracking to this target.

作為一個組織，我們的財務北極星近兩年來以 2024 年運行率計算調整後 EBITDA 已實現 3 億美元。我們認為，確保下半年升息和其他因素為我們實現這一目標提供了信心。

Let's go through the path from our Q2 results of $52 million to this target and I'll reference Page 5 in the presentation. Note that as we think about the starting point for this bridge, normalizing Q2 for a typical amount of prior year development is offset by also normalizing for an average quarter of MSSP revenue recognition.

讓我們回顧一下從第二季 5,200 萬美元的業績到這一目標的過程，我將在簡報中引用第 5 頁。請注意，當我們考慮這座橋樑的起點時，上一年典型開發量的第二季度標準化會被 MSSP 收入確認的平均季度標準化所抵消。

First, we expect to add an additional $10 million per quarter in revenue increases for performance suite markets beginning in Q3. Second, the remaining capture of NIA synergies adds $2 million. We have captured 6.75 of the original $8.75 million opportunity. Third, of the announced, but not yet live new business adds $4 million by the end of the year. We have captured $5 million of this original $9 million in our Q2 baseline and do not require any new business to reach the run rate target.

首先，我們預計從第三季開始，性能套件市場的收入每季將額外增加 1,000 萬美元。其次，NIA 剩餘的綜效增加了 200 萬美元。我們已經抓住了最初 875 萬美元機會中的 6.75 個機會。第三，已宣布但尚未實施的新業務到年底將增加 400 萬美元。我們已經在第二季基準中獲得了最初 900 萬美元中的 500 萬美元，並且不需要任何新業務即可達到運行率目標。

Finally, the continued maturation of our performance suite margin towards our target expectations at $7 million. We have captured $5.5 million of the initial $12.5 million target we had for the year. Overall, we are pleased with the consistency of our progress towards this run rate target.

最後，我們的性能套件利潤率持續成熟，朝著 700 萬美元的目標預期邁進。我們已經實現了今年最初 1,250 萬美元目標中的 550 萬美元。總體而言，我們對實現這一運行率目標的進展的一致性感到滿意。

Our outlook for the rest of the year also includes the following assumptions. First, stable disease prevalence and acuity at the elevated levels we have seen since Q1. Second, the capture of the anticipated rate increases going live this quarter. Third, continued strong execution in our performance suite driving quality up and medical expense down. Fourth, the go live of announced new business.

我們對今年剩餘時間的展望還包括以下假設。首先，疾病盛行率和病情嚴重程度穩定在第一季以來的較高水準。其次，捕捉本季生效的預期升息。第三，我們的績效套件持續強勁執行，提高了品質並降低了醫療費用。四是已公佈的新業務上線。

We do not require any additional new business to launch this year to hit this revenue or EBITDA range. And finally, we continue to expect similar economics from the Medicare shared savings programs we had last year.

我們不需要今年推出任何額外的新業務即可達到此收入或 EBITDA 範圍。最後，我們繼續期望去年的醫療保險共享儲蓄計畫能帶來類似的經濟效益。

For the third quarter of 2024, we are projecting revenues of $615 million to $635 million and adjusted EBITDA of $60 million to $68 million. This revenue outlook for Q3 is impacted by an expected one-time true down related to the narrower risk scope I mentioned earlier. For the full year, based on the anticipated rate increases and new go lives, we are raising our revenue range to $2.56 billion to $2.6 billion.

對於 2024 年第三季度，我們預計營收為 6.15 億美元至 6.35 億美元，調整後 EBITDA 為 6,000 萬美元至 6,800 萬美元。第三季的收入前景受到與我之前提到的較小風險範圍相關的預期一次性真正下降的影響。根據預期的利率上漲和新的上線，我們將全年收入範圍提高到 25.6 億美元至 26 億美元。

Beginning in August, as Seth noted, we are reallocating some engineering expenses towards the Machinify rollout. This will have a temporary effect of lowering our software capitalization rate and increasing our operating expenses by $5 million with most of the impact in Q4 and which we do not expect will continue past December and therefore will not impact our exit run rate adjusted EBITDA of $300 million.

正如 Seth 指出的那樣，從 8 月開始，我們將重新分配一些工程費用用於 Machinify 的推出。這將產生暫時的影響，即降低我們的軟體資本化率並使我們的營運費用增加500 萬美元，其中大部分影響將在第四季度產生，我們預計這種影響不會持續到12 月以後，因此不會影響我們300 美元的退出運行率調整後EBITDA百萬。

Our updated adjusted EBITDA range is $230 million to $245 million given the timing of revenue increases for our performance suites mentioned earlier and the $5 million based on a cash neutral basis shifted out of CapEx to OpEx as I just mentioned. Our revised expectation of cash for software development CapEx for the year is $25 million down from $30 million, and we continue to expect cash flow from operations to exceed $150 million for the year.

考慮到前面提到的性能套件收入成長的時機，以及我剛才提到的基於現金中性基礎的500 萬美元從資本支出轉移到營運支出，我們更新後的調整後EBITDA 範圍為2.3 億美元至2.45億美元。我們對今年軟體開發資本支出的現金預期從 3,000 萬美元下調至 2,500 萬美元，我們仍然預計今年營運現金流將超過 1.5 億美元。

With that, let's open it up for questions.

說到這裡，讓我們開始提問吧。

We will now begin the question-and-answer session. (Operator Instructions) Our first question will come from Ryan Daniels with William Blair. You may now go ahead.

我們現在開始問答環節。（操作員說明）我們的第一個問題將由瑞安·丹尼爾斯和威廉·布萊爾提出。現在你可以繼續了。

Congrats on the progress towards the re-contracting. Given I can only have one, I'll ask a multipart one, which you'll probably get a lot tonight. Can you speak to a few things there? Number one, it mentions in the release that guidance is predicated on the anticipated rate increases to go live. So, I'm curious how visible those are at this point that you'll actually get them, number one?

祝賀重新簽約取得進展。鑑於我只能擁有一個，我會要求一個多部分的，今晚你可能會得到很多。您能在那裡談談一些事情嗎？第一，它在新聞稿中提到，指導意見是基於預期的利率上漲而上線的。所以，我很好奇這些在這一點上有多明顯，你實際上會得到它們，第一？

And then number two, when you talk about updating the mechanisms to get these rate increases in the future, can you double click on that? I'm curious if it's something that makes it a little bit more formulaic, so that it'll just happen without having to go back to negotiations or what that really means. So just a little bit more color on all that. Thanks.

第二，當你談到更新機制以在未來提高利率時，你能雙擊它嗎？我很好奇這是否會讓事情變得更加公式化，這樣它就會發生，而不必回到談判或真正意味著什麼。所以只是在這一切上多一點顏色。謝謝。

Yes, thanks Ryan. It's Seth. I'm happy to take those. So, look on the first question, we've aligned with our partners. This is across several different health plans first of all and I've seen about the $35 million we noted for this year, about 30% of that is paper contractually, about 60% of that we've reached I'd say what I call alignment on what the business terms are and we expect to paper it over the next couple of weeks.

是的，謝謝瑞安。是賽斯。我很高興接受這些。所以，看第一個問題，我們已經與我們的合作夥伴保持一致。首先是幾個不同的健康計劃，我已經看到今年我們注意到的 3500 萬美元，其中大約 30% 是紙質合同，其中大約 60% 是我們已經達到的，我想說的是我所說的就業務條款達成一致，我們預計將在接下來的幾週內將其公佈。

So, it's in the final stages. We feel good about it. I think the thing that underlines the broader point and this is the most important point for Evolent more broadly is that we do feel Ryan like we create really unique clinical value and so when you get to this sort of moments in a relationship being able to know that clinically you feel like you're creating more value than the next best alternative is really important from our perspective.

所以，現在已經進入最後階段了。我們對此感覺很好。我認為強調更廣泛的一點，也是 Evolent 更廣泛的最重要的一點是，我們確實覺得 Ryan 創造了真正獨特的臨床價值，所以當你在一段關係中遇到這種時刻時，你能夠知道從我們的角度來看，臨床上你感覺自己比下一個最佳替代方案創造了更多價值，這一點非常重要。

So that's kind of where we are in that process in terms of the formulas. A lot of that is in most of our contracts. There are a few places where we're adding some additional detail as we noted on the call. And I don't think it's ever going to be fully formulaic, just how the world is. These customer relationships have lots of different facets to them and we at the end of the day are really dedicated to our customers succeeding Ryan. So, it's never going to be formulaic and we're all about partnering with them, but I do think it helps to have a framework set up.

這就是我們在公式方面所處的過程。我們的大多數合約中都有很多內容。正如我們在電話中指出的那樣，我們在一些地方添加了一些額外的細節。我認為世界本來就是這樣，永遠不會完全公式化。這些客戶關係有很多不同的方面，歸根結底，我們真的致力於幫助我們的客戶接替 Ryan。所以，它永遠不會是公式化的，我們都是為了與他們合作，但我確實認為建立一個框架是有幫助的。

Anne Samuel, JPMorgan.

安妮‧塞繆爾，摩根大通。

Congrats on the quarter. I was hoping maybe you could talk a little bit about the decision to exit certain markets, what went into that decision making process? And then, how to think about the revenue impact for next year realizing that there is no EBITDA impact?

恭喜本季。我希望您能談談退出某些市場的決定，這個決策過程是怎麼樣的？然後，在沒有 EBITDA 影響的情況下，如何考慮明年的收入影響？

So, this is a couple of markets with one payer that we're working on updating our risk profile given the elevated prevalence and acuity that we saw in some of these areas. And one of the tools that we have in addition to raising rates is to narrow our scope and we and payer decided collaboratively to do that here.

因此，考慮到我們在其中一些領域看到的盛行率和敏銳度的提高，我們正在努力更新我們的風險狀況，這是幾個只有一個付款人的市場。除了提高利率之外，我們擁有的工具之一就是縮小我們的範圍，我們和付款人決定在這裡合作做到這一點。

For this year, retro 1/1. I think in terms of scope, you sort of saw our raised revenue guide for the year. It feels quite swallowable to us and we don't think it impacts next year's growth either on the top or bottom-line opportunity in any particular meaningful way.

今年，復古1/1。我認為就範圍而言，您看到了我們今年增加的收入指南。這對我們來說是可以接受的，我們認為它不會以任何特別有意義的方式影響明年的成長，無論是在頂線還是底線機會上。

Jeff Garro, Stephens.

傑夫·加羅，史蒂芬斯。

I was hoping you could provide a little more context on the margin maturation for the Performance Suite. So, first of the $7 million remaining, maybe you could comment on visibility into contracts that have launched over roughly the last 12 months, hitting that kind of initial inflection point to in some cases I know from contributing zero EBITDA to contributing some once you hit that first initial milestone?

我希望您能提供更多關於性能套件的邊際成熟度的背景資訊。因此，首先，在剩下的700 萬美元中，也許您可以對大約過去12 個月內推出的合約的可見性發表評論，達到這種初始拐點，在某些情況下，我知道從貢獻零EBITDA 到一旦達到這種拐點就貢獻一些第一個初始里程碑？

And then, if you could also give some similar comments on the $5.5 million that you've already captured from the first time you provided that bridge. How much is from initial contracts hitting that initial milestone versus the more dated contracts performing better than expected or I guess better than in past years?

然後，您是否也可以對您第一次提供這座橋樑時已經獲得的 550 萬美元發表一些類似的評論。達到初始里程碑的初始合約與較過時的合約的表現比預期更好或我認為比過去幾年更好有多少？

Yes, good question, Jeff. It's a little of both and let me break it down a little bit. As you know, we sort of think about this margin maturation curve in two ways. One is the initial release of actuarial conservatism that we have right as we go live for the first few quarters of a partnership. And the second is driving the underlying clinical value through the network, which we've noted usually takes some time.

是的，好問題，傑夫。兩者兼而有之，讓我稍微分解一下。如您所知，我們以兩種方式思考這條利潤成熟曲線。一是精算保守主義的初步釋放，我們在合作關係的前幾季上線時就有權這樣做。第二是透過網路推動潛在的臨床價值，我們注意到這通常需要一些時間。

As you think about the progress that we've made this year that underlines that $5.5 billion that I noted, it is a combination of both of those factors. As we think about then what's in the $7 million, we still have a little bit of that initial actuarial conservatism from some of the most recent go lives that we would anticipate releasing in the coming quarters and the normal sort of everyday business of the Performance Suite in the market driving quality up and cost down continues and represents the rest of that $7 million.

當你想到我們今年的進展（強調了我提到的 55 億美元）時，你會發現這是這兩個因素的結合。當我們思考這 700 萬美元的內容時，我們仍然有一些最初的精算保守主義，來自我們預計在未來幾個季度發布的一些最新的上線以及性能套件的正常日常業務在市場上，質量的提高和成本的降低仍在繼續，這代表了這700 萬美元的其餘部分。

Charles Rhyee, TD Cowen.

查爾斯‧萊伊 (Charles Rhyee)，TD 考恩 (TD Cowen)。

Yes. Thanks for taking the question. John, I wanted to ask about sort of the timing impact of Medicare shared savings that didn't occur, that was last year but not this quarter. Should we anticipate, we could see that in the third quarter then? And is that in the guidance? Or would that be on top of guidance?

是的。感謝您提出問題。約翰，我想問醫療保險共享儲蓄的時間影響，但沒有發生，那是去年的事，但不是本季的事。我們是否應該預期，我們可以在第三季看到這一點？指南中有這樣的內容嗎？或者說這會是在指導之上的嗎？

And then secondly, when you talk about the higher rates, sort of $60 million on an annualized basis, is that right then we should see that benefit on a year-over-year basis as we go into the first half of next year?

其次，當你談到更高的利率時，按年計算約為 6000 萬美元，那麼當我們進入明年上半年時，我們是否應該看到同比的收益？

Yes, you got it. So, on MSSP you're exactly right. We would anticipate when we see the final settlement from CMS for PY 2023. We will expect to have a revenue true up there to the final settlement number. We also as we talked about before typically start accruing for the current performance year revenue, so that would be performance year ‘24 in Q3, but all of that is incorporated into our guide.

是的，你明白了。所以，在 MSSP 上，你是完全正確的。我們預計 CMS 將於 2023 年最終達成和解。我們預計收入將達到最終結算數字。正如我們之前談到的，我們通常開始提列目前績效年的收入，因此這將是第三季的績效年 - 24，但所有這些都已納入我們的指南中。

On your second question, yes, on a sort of like-for-like basis as we move into next year. The rate increases that we start to recognize here in the second half based on our expectations will be a bit of a tailwind for us going into next year.

關於你的第二個問題，是的，隨著我們進入明年，在類似的基礎上。根據我們的預期，我們在下半年開始認識到利率上漲，這對我們進入明年來說將是一個推動力。

Kevin Caliendo, UBS.

凱文‧卡里恩多，瑞銀集團。

You said that the rate increases are expected to offset anything that you see in terms of the elevated incidence and prevalence or in acuity. I guess what I want to understand is, what you’ve been seeing since 2Q, in terms of acuity and incidence. I know you have slightly more exposure to Medicare versus Medicaid, and recognizing that not all utilization is the same.

您說過，發病率的增加預計會抵消您在發病率和盛行率或敏銳度方面所看到的任何情況。我想我想了解的是，自第二季以來，您在敏銳度和發生率方面所看到的情況。我知道與醫療補助相比，您對醫療保險的了解稍多，並且認識到並非所有利用率都是相同的。

Can you maybe frame the relative exposure there versus the other? And if what you're saying implies that what you've seen since you've gotten these rate increases or negotiated these rate increases hasn't increased further, if that makes sense?

您能否框架那裡相對於其他地方的相對曝光度？如果你所說的話意味著自從你獲得這些加息或談判這些加息以來你所看到的並沒有進一步增加，這是否有道理？

It sure does Kevin. And the headline is exactly that, which is from a prevalence and acuity standpoint, we have seen consistent stats really since March. To dig a little bit deeper on the utilization question though, let me give a little bit more color.

凱文確實如此。標題正是如此，從盛行率和敏銳度的角度來看，自三月以來我們確實看到了一致的統計數據。為了更深入探討利用率問題，讓我提供更多的顏色。

If you think about our core leading indicator is an authorization and that authorization might be, let's take a cancer case, it might be for a checkpoint inhibitor where the authorization covers 12 weeks of treatments with infusion once every three to six weeks.

如果你認為我們的核心領先指標是授權，那麼授權可能是，讓我們以癌症為例，它可能是針對檢查點抑制劑，其中授權涵蓋 12 週的治療，每三到六週輸註一次。

And so said another way that authorization is translating into costs, i.e., utilization both in the current month and then often in the subsequent month or two. And so, what we saw first quarter was a ramp in those leading indicators to a peak in March, but then as we have now seen translated into sustained elevated claims into the second quarter.

換句話說，授權轉化為成本，即當月的使用率，以及隨後一兩個月的使用率。因此，我們在第一季看到的是這些領先指標在 3 月達到峰值，但隨後正如我們現在所看到的，轉化為第二季索賠持續上升。

The good news as Seth mentioned in his prepared remarks is that we've seen those leading indicators trend down since the peak in March. We're not assuming that that trend continues in our guide, that could be potential upside, but we have seen that trend down over the course of in particular the last couple of months.

正如 Seth 在他準備好的演講中提到的好消息是，我們已經看到這些領先指標自 3 月的高峰以來呈下降趨勢。我們並不假設這種趨勢在我們的指南中持續存在，這可能是潛在的上行空間，但我們已經看到這種趨勢在過去幾個月中有所下降。

Jailendra Singh, Truist Securities.

Jailendra Singh，Truist 證券公司。

Actually a follow up on Kevin's question. So it looks like the cost trends in Q2 are essentially the leading indicators are trending better than what you flagged better than what you flat from March last quarter. So maybe in March, you called out higher cardiology costs in Medicaid, higher oncology costs in Medicaid maybe clear in some of the markets. Maybe give some color on a particular category or payer type you're seeing that all those indicators are improving across the board. Like how do I reconcile this with the fact that for the March you called out $5 million headwind from higher cost, you're getting around a $5 million monthly rate adjustment which would imply the cost in $7 million range in the role of to of 70% cost really just I hope those numbers make sense? Just trying to reconcile that trends improving, but your rate update is actually reflecting higher cost trend.

實際上是凱文問題的後續。因此，看起來第二季的成本趨勢本質上是領先指標，其趨勢比您標記的要好於上個季度 3 月持平的水平。因此，也許在三月份，您指出醫療補助中的心臟病費用更高，醫療補助中的腫瘤費用更高，這在某些市場上可能是顯而易見的。也許可以對特定類別或付款人類型進行一些說明，您會發現所有這些指標都在全面改善。就像我如何調和這一事實，即3 月份，您因成本上升而面臨500 萬美元的逆風，您每月將獲得約500 萬美元的費率調整，這意味著成本在700 萬美元範圍內，相當於70 美元％成本真的只是我希望這些數字有意義嗎？只是試圖協調這種趨勢的改善，但您的費率更新實際上反映了更高的成本趨勢。

Yes. So, here's what I'd say on that, Jailendra. I'd go back to my point here that a leading indicator is just that right. It's a leading indicator of costs that we expect to incur in the coming weeks months. And so, while we have seen a decline in the leading indicators, in particular at the back part of the second quarter, the costs remained elevated and were only partially covered by the increase in rate $5 million in the quarter that we noted. Hopefully that makes sense.

是的。Jailendra，這就是我要說的。我想回到我的觀點，領先指標就是正確的。這是我們預計在未來幾週幾個月內產生的成本的領先指標。因此，雖然我們看到領先指標有所下降，特別是在第二季後期，但成本仍然很高，並且僅部分被我們注意到的該季度利率增加 500 萬美元所覆蓋。希望這是有道理的。

Anything you can call out on the type of payer, type of category you're seeing the improvement on those leading indicators? Sorry, that part was not answered.

您能談談您在這些領先指標上看到的付款人類型、類別類型的改進嗎？抱歉，該部分未得到答案。

Nothing in particular to call out there. It's pretty diverse, Jailendra.

那裡沒有什麼特別值得一提的。Jailendra，它非常多樣化。

Jessica Tassan, Piper Sandler.

傑西卡·塔桑，派珀·桑德勒。

I was just curious if you could maybe comment on any like any automatic triggers in your risk-based contracts that allow your rates to keep up with cost trend, just because we've heard about high single digit trend in Medicare Advantage. And I'm curious to know if your contracts just automatically recalibrate to accommodate that trend irrespective of kind of the acuity mix or how that works on an annual basis?

我只是好奇您是否可以對基於風險的合約中的任何自動觸發器發表評論，這些觸發器使您的費率能夠跟上成本趨勢，只是因為我們聽說過 Medicare Advantage 的高個位數趨勢。我很想知道您的合約是否會自動重新調整以適應這種趨勢，而不管敏銳度組合的類型或每年如何運作？

Yes, Jess. So, as I was mentioning earlier, it's not uniform across all clients. In certain cases, we do have negotiated provisions that do automatically adjust the rates. In certain other situations, it's more of a broad change event conversation and he didn't sit down with the client. So, it's yes in some cases, no in others.

是的，傑西。因此，正如我之前提到的，所有客戶的情況並不統一。在某些情況下，我們確實協商了自動調整費率的條款。在某些其他情況下，這更像是一次廣泛的變革事件對話，他沒有與客戶坐下來。所以，在某些情況下是的，在其他情況下則不是。

Again, I think the fundamental issue as we do sit down whether those exist or not it's always a broader conversation with these clients because there's usually opportunities to grow right into new markets to add different lines of business and the like. And so, these things do end up being broader conversations and some of them are more automatic and some of them are broader more integrated conversations.

再說一次，我認為，當我們坐下來討論這些是否存在時，最根本的問題始終是與這些客戶進行更廣泛的對話，因為通常有機會直接進入新市場，增加不同的業務線等。因此，這些事情最終確實會成為更廣泛的對話，其中一些是更加自動化的，其中一些是更廣泛、更全面的對話。

Richard Close, Canaccord Genuity.

理查德·克洛斯，Canaccord Genuity。

Seth, I think in your comments you talked a little bit about the rate increases and I think you said something with respect to 2025. Can you go over that again for us please?

Seth，我認為您在評論中談到了一些關於加息的問題，並且我認為您談到了 2025 年的情況。您能為我們再講一次嗎？

Yes, so the way we characterized it, Richard, was around the portion of the rate increase $35 million it affects this year. When you annualize that and go into a full run rate for $25 million it's about $60 million. And so, that's sort of the way we think about it. Some of those rate increases kick in kind of right at the end of the year going into January and some of them are across this fall.

是的，理查德，我們的描述方式是它影響今年升息 3500 萬美元的部分。如果按年計算並以 2500 萬美元的全額運行率計算，則約為 6000 萬美元。所以，這就是我們思考問題的方式。其中一些升息是在年底到一月開始的，有些是在今年秋天開始的。

Stephanie Davis, SVB Leerink.

史蒂芬妮戴維斯，SVB Leerink。

I see we have a throwback on the call, very excited. Guys, thank you for taking my question. Congrats on threading the needle this quarter. I have a bit of a multiparter, but in your prepared remarks, you talked with continuation of the environment.

我看到我們在電話會議上進行了回顧，非常興奮。夥計們，謝謝你們回答我的問題。恭喜本季成功。我有點多方，但在你準備好的發言中，你談到了環境的延續。

So, to the extent that utilization is higher for longer, how are you thinking about how this factor into your pipeline in conversations with payer clients around specialty care management? Is it more attractive on a relative basis or is there more distraction so there's just less conversations to be had? And in terms of how it could impact the forward model, is there anything left to do in a higher for longer environment beyond the re-contracting that's behind you?

那麼，就利用率在較長時間內較高的程度而言，您如何考慮在與付款人客戶圍繞專業護理管理進行對話時如何將此因素納入您的管道？相對而言，它更具吸引力，還是有更多的干擾，因此可以進行的對話更少？就它如何影響遠期模型而言，除了背後的重新簽約之外，在更高、更長期的環境中還有什麼事情要做嗎？

Yes. So, first of all on the pipeline, this has been a theme for a while multiple quarters I would say that the pressure on the payer side is a positive for us on the pipeline side. And I think when you think about the ways that payers manage costs, the specialty trend I'd say is very, very high number one. Number two on the list for many payers that we talk to Stephanie. So, we're seeing a lot of inbound demand for our products.

是的。因此，首先在管道方面，這已經成為多個季度的主題，我想說，付款人方面的壓力對我們管道方面來說是積極的。我認為，當你考慮付款人管理成本的方式時，我想說的專業趨勢是非常非常高的第一名。在我們與史蒂芬妮交談的許多付款人名單中排名第二。因此，我們看到對我們產品的大量入境需求。

Oncology has been an evergreen issue, the cardiology of late has been a pain point for a lot of payers in managing that one, but even MSK and down the line. So, I think that's certainly going to be part of the model going forward. I think to the extent that utilization ramp back up in some way. We obviously have the ability to go back to and have those conversations that we talked about. And I think we also have additional clinical levers that we continue to pull. In this current environment, we can continue to pull in that environment too Stephanie.

腫瘤學一直是個長期存在的問題，最近心臟病學一直是許多付款人管理這一問題的痛點，甚至包括 MSK 斯隆及其旗下的公司。所以，我認為這肯定會成為未來模型的一部分。我認為在某種程度上，利用率會以某種方式回升。顯然，我們有能力回去進行我們談論過的那些對話。我認為我們還有其他臨床槓桿可以繼續使用。在當前的環境下，我們也可以繼續將史蒂芬妮拉入該環境。

So, I think again our job from our perspective is to be able to help drive clinical value that's in excess of what our payer partners can do on their own. And I think our view is if we're able to do that which we think we can, the kind of balance between rate and fairly sharing that increased value creation sort of takes care of itself over time. And I think that kind of goes to both of your questions both on the pipe side but also how we'd address it if it ramped back up again.

因此，我再次認為，從我們的角度來看，我們的工作是能夠幫助推動臨床價值，這超出了我們的付款合作夥伴自己所能做到的。我認為我們的觀點是，如果我們能夠做到我們認為可以做到的事情，那麼隨著時間的推移，增加的價值創造就會自然而然地實現費率和公平分享之間的平衡。我認為這既涉及到您在管道方面的問題，也涉及到如果管道再次回升時我們將如何解決它。

Daniel Grosslight, Citi.

丹尼爾‧格羅斯萊特，花旗銀行。

Sorry about that. Hey, guys, thanks for taking the question. You mentioned that around 60% of the $35 billion of cap rate increase this year, you have alignment with the payer, but it hasn't yet been papered. I'm curious what's preventing, I guess that contractual obligation? And is there any risk that some of that either slips a little later or there is some disagreement or is it pretty much over the finish line at this point?

對此感到抱歉。嘿，夥計們，謝謝你提出問題。您提到，今年 350 億美元的資本化率成長中，大約有 60% 是您與付款人保持一致的，但尚未記錄在案。我很好奇是什麼阻礙了合約義務？是否有任何風險，其中一些可能會推遲一點，或者存在一些分歧，或者此時已經幾乎超出終點線了？

And then secondarily, are you all done with cap rate increases at this point in time? Or are there still some stragglers out there where you're still hoping to get a little more of a rate increase and that could potentially be some upside either this year or early next year?

其次，你們現在都完成了上限利率的提升嗎？或者是否還有一些落後者，您仍然希望獲得更多的升息，這可能會在今年或明年初帶來一些好處？

Yes, Daniel, on your first question the kind of 60% that's not yet papered. We feel good about the alignment that we've reached with our partners, and these things just take a little bit of time right to get formally contracted. And usually when you do an adjustment like this you might make a few other changes that need to be made at the same time, and these things just take a little while to paper, but we feel fundamentally good about the alignment that we have.

是的，丹尼爾，關於你的第一個問題，60% 還沒有寫下來。我們對與合作夥伴達成的一致感到滿意，這些事情只需要一點時間就可以正式簽訂合約。通常，當你進行這樣的調整時，你可能會同時進行一些其他需要進行的更改，而這些事情只需要一些時間來記錄，但我們對我們所擁有的一致性感到從根本上來說很好。

On your second question, no, there really aren't any stragglers. We've got our hands around the things that we need to have our hands around to drive towards the rest of the year guidance that we've provided.

關於你的第二個問題，不，確實沒有落後者。我們已經掌握了我們需要掌握的事情，以推動我們提供的今年剩餘時間的指導。

(Operator Instructions). Jack Wallace, Guggenheim.

（操作員說明）。傑克華萊士，古根漢。

Just a quick question on the third quarter revenue guide. It looks like it's down slightly over $20 million at the midpoint. Should be able to call it an 80-ish run rate, but you're getting a fee run rate back from the rate increases. At least in the press release you talked about the being mostly going to the onetime true down of risk scope. But is there also an element there of just kind of a lower jumping off point from the Medicare redeterminations, how should we just think about the bridge to the 3Q guide?

關於第三季營收指南的一個簡單問題。中間值看起來略低於 2000 萬美元。應該可以稱之為 80 左右的運行費率，但你會從費率增加中獲得費用運行費率。至少在新聞稿中，您談到了風險範圍的一次性真正下降。但是，是否還有一個因素是醫療保險重新確定的起點較低，我們應該如何考慮通往 3Q 指南的橋樑？

Yes, Jack the principal driver there down from 6.47 in Q2 to the guide for Q3 is three quarters of that retro true down for that risk scope narrowing.

是的，傑克是主要驅動力，從第二季度的 6.47 下降到第三季度的指導值，是風險範圍縮小的復古真實下降的四分之三。

Sean Dodge, RBC Capital Markets.

肖恩·道奇，加拿大皇家銀行資本市場部。

This is Thomas going on for Sean. Congrats on the positive update here and thanks for taking the question. Just going back to the performance fee margin ramp, you said 12% to 18% is possible there as those mature. How does some of those other capabilities acquired like palliative care and genetic testing play into that? As you build those into those engagements, does that help you get to the higher end of that range? And I guess maybe ask in more straightforward ways, is it possible to achieve and kind of stay at the 18% margin level there or do you kind of have to maintain a strict alignment around 15%?

這是托馬斯為肖恩發言。恭喜這裡的積極更新，並感謝您提出問題。回到績效費利潤率上升的問題，您曾說過隨著成熟度的提高，績效費率可能達到 12% 至 18%。安寧療護和基因檢測等其他獲得的能力如何發揮作用？當您將這些融入這些參與中時，這是否有助於您達到該範圍的高端？我想也許可以用更直接的方式問，是否有可能實現並保持在 18% 的利潤水平，還是必須嚴格保持在 15% 左右？

Yes, look I mean I think the mid-teens number that we've had on Performance Suite does require continued work. All these things require continued work to continue managing. That's our clinical innovation. That's the things that we're doing every year to improve our product. I think that also makes us better on the pipeline side.

是的，我的意思是，我認為我們在 Performance Suite 上擁有的十幾歲的數字確實需要繼續努力。所有這些事情都需要繼續工作來繼續管理。這就是我們的臨床創新。這就是我們每年為改進我們的產品所做的事情。我認為這也讓我們在管道方面做得更好。

And with respect to the in the life piece that sort of built into that range that we think about as we continue to manage towards those targets. And I don't think -- I would characterize that as a source of upside necessarily for the $7 million of this year, but it is part of our multiyear plan to continue to drive really strong clinical value back to our partners.

就生活中的部分而言，當我們繼續實現這些目標時，我們會考慮將其納入該範圍。我不認為——我認為這一定是今年 700 萬美元的上漲來源，但這是我們多年計劃的一部分，旨在繼續為我們的合作夥伴帶來真正強大的臨床價值。

Our next question will be a follow-up from Richard Close with Canaccord Genuity. You may now go ahead.

我們的下一個問題將由 Canaccord Genuity 的 Richard Close 提出。現在你可以繼續了。

Yes, thanks for letting me get back in. Seth, on the Machinify, you talked about, I guess, allowing customers to use the tool to do analyze like inpatient and some other items there. When is that like actually live? And I think with all the managed care talking about in higher inpatient trends that that would be significant demand there?

是的，謝謝你讓我回來。Seth，在 Machinify 上，我猜您談到了允許客戶使用該工具進行分析，例如住院病人和其他一些項目。什麼時候像真正的生活？我認為，隨著所有管理式醫療在住院病患成長趨勢的討論，這將是一個巨大的需求？

Yes, I agree Richard. That part of the tool is live today with Machinify customer that we are working across there that they have when we acquired the asset and it's available for us to bring out to the market. I just say in general a lot of demand around that platform, right now, Richard. There's a lot of payers that I think are looking for creative ways like this to manage the long tail specialties on a more innovative basis that are easier for the doctors to deal with and better for patients.

是的，我同意理查德。該工具的這一部分今天已與我們正在那裡工作的 Machinify 客戶一起使用，當我們購買該資產時他們就擁有了該工具，並且可供我們將其推向市場。我只是說，理查德，現在圍繞該平台的需求總體上很大。我認為有很多付款人正在尋找像這樣的創意方法，以更具創新性的方式管理長尾專業，讓醫生更容易處理，對病人也更好。

And so, I think that combined with our ability to kind of outsource and drive the really complicated specialties we think is going to be a pretty unique combination and we're out in the market pretty aggressively right now with that platform, that demo and having conversations right now.

因此，我認為，結合我們外包和驅動真正複雜的專業的能力，我們認為這將是一個非常獨特的組合，我們現在透過這個平台、演示和擁有非常積極的方式進入市場現在的對話。

It appears we have no further questions. This concludes our question-and-answer session. I would like to turn the conference back over to Seth Blackley for any closing remarks.

看來我們沒有其他問題了。我們的問答環節到此結束。我想將會議轉回塞思·布萊克利（Seth Blackley）發表閉幕詞。

All right. Thank you for joining us tonight. We'll look forward to connecting over the coming days. Thanks for the time.

好的。感謝您今晚加入我們。我們期待在未來幾天內建立聯繫。謝謝你的時間。

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

會議現已結束。感謝您參加今天的演講。您現在可以斷開連線。