美國醫院公司 (HCA) 2025 Q2 法說會逐字稿

Ladies and gentlemen, welcome to HCA Healthcare second-quarter 2025 earnings conference call. Today's call is being recorded. At this time, for opening remarks and introductions, I would like to turn the call over to Vice President of Investor Relations, Mr. Frank Morgan. Please go ahead, sir.

女士們，先生們，歡迎參加 HCA Healthcare 2025 年第二季財報電話會議。今天的通話正在錄音。現在，為了致開幕詞和介紹，我想將電話轉給投資者關係副總裁弗蘭克·摩根先生。先生，請繼續。

Good morning and welcome to everyone on today's call. With me this morning is our CEO, Sam Hazen; and our CFO, Mike Marks. Sam and Mike will provide some prepared remarks, and then we'll take questions.

早安，歡迎大家參加今天的電話會議。今天早上和我一起的有我們的執行長 Sam Hazen 和我們的財務長 Mike Marks。山姆和麥克將發表一些準備好的講話，然後我們將回答問題。

Before I turn the call over to Sam, let me remind everyone that should today's call contain any forward-looking statements, they're based on management's current expectations. Numerous risks, uncertainties, and other factors may cause actual results to differ materially from those that might be expressed today. More information on forward-looking statements and these factors are listed in today's press release and in our various SEC filings.

在我將電話轉給 Sam 之前，請允許我提醒大家，如果今天的電話會議包含任何前瞻性陳述，那麼它們都是基於管理層當前的預期。許多風險、不確定性和其他因素可能導致實際結果與今天表達的結果大不相同。有關前瞻性陳述和這些因素的更多資訊列在今天的新聞稿和我們向美國證券交易委員會提交的各種文件中。

On this morning's call, we may reference measures such as adjusted EBITDA, which is a non-GAAP financial measure. A table providing supplemental information on adjusted EBITDA and reconciling net income attributable to HCA Healthcare Inc. is included in today's release.

在今天早上的電話會議上，我們可能會參考調整後的 EBITDA 等指標，這是非 GAAP 財務指標。今天的新聞稿中包含一個表格，提供有關調整後 EBITDA 的補充資訊以及歸屬於 HCA Healthcare Inc. 的淨收入調節表。

This morning's call is being recorded and a replay of the call will be available later today.

今天上午的通話正在錄音，今天晚些時候將提供通話重播。

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

說完這些，我現在將電話轉給 Sam。

All right. Thank you, Frank. Good morning to everybody and thank you for joining the call.

好的。謝謝你，弗蘭克。大家早安，感謝大家參加電話會議。

The company's financial results for the second quarter were strong, with a 24% increase in diluted earnings per share as adjusted to $6.84. The results reflected solid revenue growth of 6.4%, which was driven by greater demand for our services, improved payer mix, and consistent patient acuity levels.

公司第二季財務業績強勁，經調整後每股攤薄收益成長24%至6.84美元。績效反映出營收穩健成長6.4%，這得益於我們服務需求的增加、付款人組合的改善以及病患診療水準的持續穩定。

In the quarter, we also experienced a stable operating environment which allowed us to produce better margins. Because of the team's great start to the year, we increased our guidance for 2025 as reflected in our earnings release this morning. This updated outlook also reflects the positive demand environment we expect in our markets, the effectiveness of our strategic initiatives, and the momentum we see in our business.

本季度，我們還經歷了穩定的營運環境，這使我們能夠獲得更好的利潤率。由於球隊今年開局良好，我們提高了 2025 年的預期，這反映在了我們今天早上發布的收益報告中。這項更新的展望也反映了我們預期的市場積極需求環境、我們的策略舉措的有效性以及我們在業務中看到的勢頭。

During the quarter, we also improved quality outcomes, throughput measures in our emergency rooms, and patient satisfaction. We believe the HCA way of combining our high quality local health networks with the capabilities of a national system will continue to reinforce our competitive position, help us respond effectively to evolving market dynamics, and meet the needs of our patients.

本季度，我們也改善了品質結果、急診室的吞吐量指標以及病患滿意度。我們相信，HCA 將我們高品質的本地醫療網絡與國家系統的能力相結合的方式將繼續加強我們的競爭地位，幫助我們有效應對不斷變化的市場動態，並滿足患者的需求。

As a team, we remain relentless in our pursuits to innovate using technology, find new ways to increase efficiencies, and hold ourselves accountable for delivering results for our stakeholders. I want to thank our colleagues again for their outstanding work and their ongoing pursuits to deliver on our mission.

作為一個團隊，我們堅持不懈地追求利用技術進行創新，尋找提高效率的新方法，並承擔起為利害關係人提供成果的責任。我要再次感謝我們的同事們的出色工作以及他們為完成我們的使命所付出的不懈努力。

Now let me transition to the federal policy environment and the recent passage of the One Big Beautiful Bill Act. With respect to the Medicaid component in this Act, we believe the adverse impacts over the next few years are manageable. This belief is based on the grandfathering provisions for supplemental programs which include a number of previously submitted applications for state directed payments and the timelines for phasing in work requirements and supplemental payment program changes.

現在讓我轉入聯邦政策環境和最近通過的《一項大美麗法案》。關於該法案中的醫療補助部分，我們認為未來幾年的不利影響是可以控制的。這種信念是基於補充計劃的祖父條款，其中包括許多先前提交的國家指示支付申請以及分階段實施工作要求和補充支付計劃變更的時間表。

I will also note that the bifurcation of the policy between expansion and non-expansion states lessens the expected impact to HCA Healthcare. Approximately 60% of our Medicaid volumes and revenue are in non-expansion states.

我還要指出的是，擴張州和非擴張州之間的政策分歧減輕了對 HCA 醫療保健的預期影響。我們的醫療補助額度和收入的約 60% 來自非擴張州。

With respect to the exchange provisions in the Act, we do anticipate that some people will lose insurance coverage over the next few years, but we believe our financial resiliency program should offset these effects.

關於該法案中的交換條款，我們確實預計未來幾年有些人將失去保險，但我們相信我們的財務彈性計劃應該可以抵消這些影響。

We are also mindful of the scheduled expiration of the enhanced premium tax credits at the end of this year. We continue to advocate strongly for their extension, but at this point, we do not know what the outcome will be.

我們也注意到，增強保費稅收抵免將於今年底到期。我們將繼續大力倡導延長該期限，但目前我們還不知道結果會如何。

Recent polling indicates that many Americans want them extended. Many believe they need them for their families, and many say their voting patterns could hinge on their ultimate fate. We are working to develop and execute resiliency programs to offset as much as possible any adverse impact should they expire.

最近的民調顯示，許多美國人希望延長這項期限。許多人認為他們需要這些投票來保護他們的家庭，許多人表示他們的投票方式可能決定他們的最終命運。我們正在努力製定和執行彈性計劃，以盡可能抵消其到期時產生的任何不利影響。

Let me close with this. Regardless of the outcome with these federal policies, we are optimistic about the future of HCA Healthcare. Our balance sheet is strong. We have an experienced, capable, and disciplined team, and where appropriate, we will adjust as we can as we can and continue delivering on our mission.

讓我以此作為結束。無論這些聯邦政策的結果如何，我們都對 HCA 醫療保健的未來持樂觀態度。我們的資產負債表強勁。我們擁有一支經驗豐富、能力強、紀律嚴明的團隊，在適當的情況下，我們會盡可能地進行調整，繼續履行我們的使命。

With that, I'll turn the call to Mike for more details.

說完這些，我將把電話轉給麥克以了解更多詳細資訊。

Thank you, Sam. Good morning, everyone. We are pleased with our second quarter earnings. Equivalent admissions increased 1.7% for the quarter and 2.3% for the year. Year-to-date managed care equivalent admissions, including the exchanges, grew 4%, which is in line with our expectations.

謝謝你，山姆。大家早安。我們對第二季的收益感到滿意。本季等效入場人數增加了 1.7%，全年增加了 2.3%。年初至今，包括交易所在內的管理式醫療等效入院人數增加了 4%，符合我們的預期。

Medicare grew 3%, which is slightly below our expectation. Medicaid was down slightly and self-pay was up slightly. Both were below our expectations and represent our lowest reimbursing payers. However, given the payer mix and acuity of our patients, we have a revenue growth of 6.4%, slightly above the top end of our long term 4% to 6% guidance.

醫療保險成長了 3%，略低於我們的預期。醫療補助略有下降，自付費用略為上升。兩者都低於我們的預期，並且是我們的最低報銷付款人。然而，考慮到付款人結構和患者的敏銳度，我們的收入成長率為 6.4%，略高於我們長期 4% 至 6% 指導的最高值。

Adjusted EBITDA margin and improved 30 basis points compared to the prior-year quarter. Salary and benefits along with other operating expenses both improved as a percentage of revenue when compared to the prior-year. Same facility contract labor improved 1% from the prior-year quarter and represented 4.3% of total labor costs in the second quarter of 2025 versus 4.6% in the second quarter of 2024. Supply expenses increased slightly as a percentage of revenue due primarily to increased spending on cardiac-related devices.

調整後的EBITDA利潤率較去年同期提高30個基點。與前一年相比，薪資和福利以及其他營運費用佔收入的百分比都有所提高。同一設施合約勞動力比去年同期改善了 1%，佔 2025 年第二季總勞動力成本的 4.3%，而 2024 年第二季為 4.6%。供應費用佔收入的百分比略有增加，主要原因是心臟相關設備的支出增加。

Adjusted EBITDA in the second quarter grew 8.4% over the prior-year quarter, and we were pleased that a substantial portion came from core operations.

第二季調整後的 EBITDA 較去年同期成長 8.4%，我們很高興看到其中很大一部分來自核心業務。

Regarding Medicaid supplemental payment programs, as we've said in the past, these programs are complex, variable in common, and do not fully cover our costs to treat Medicaid patients.

關於醫療補助補充支付計劃，正如我們過去所說，這些計劃很複雜，共同點各不相同，並且不能完全涵蓋我們治療醫療補助患者的費用。

Considering Medicaid state supplemental payments and related provider taxes in isolation, we saw an approximate $100 million increase in net benefit in the second quarter of 2025 compared to the prior-year quarter due to prior period reconciliation payments and program accrual times.

單獨考慮醫療補助州補充支付和相關提供者稅，我們發現 2025 年第二季的淨收益與去年同期相比增加了約 1 億美元，這是由於前期對帳支付和計畫累積時間造成的。

The new Tennessee directed payment program was approved in late June. As this is a newly approved program, we did not accrue any benefit from this program in second quarter of 2025 and we'll record as we receive cash.

田納西州新的定向支付計劃於六月下旬獲得批准。由於這是一個新批准的計劃，我們在 2025 年第二季度沒有從該計劃中獲得任何收益，我們將在收到現金時進行記錄。

Moving to capital allocation, we continue to deploy a balanced strategy of allocating capital for long-term value creation. Cash flow from operations was $4.2 billion in the quarter. Capital allocation in the second quarter of 2025 was $1.2 billion in capital expenditures, $2.5 billion in share repurchases, and $171 million in dividends.

在資本配置方面，我們持續部署平衡的資本配置策略，以實現長期價值創造。本季經營現金流為 42 億美元。2025 年第二季的資本配置為 12 億美元的資本支出、25 億美元的股票回購和 1.71 億美元的股利。

We were able to defer approximately $850 million tax payments to the fourth quarter due to the IRS providing relief to Tennessee taxpayers in the aftermath of severe weather in early April. Our debt-to-adjusted our leverage remains in the lower half of our stated guidance range, and we believe our balance sheet is strong and well positioned for the future.

由於美國國稅局在四月初惡劣天氣後向田納西州納稅人提供救濟，我們得以將約 8.5 億美元的稅款推遲到第四季度繳納。我們的債務與調整後槓桿率仍處於既定指導範圍的下半部分，我們相信我們的資產負債表強勁，為未來做好了準備。

Sam discussed the health policy implications of the One Big Beautiful Bill Act. I will provide a few more detailed notes. As it relates to tax policy, this Act was positive for HCA, making 100% bonus appreciation permanent and effective back to Inauguration Day, which is helpful given our capital investment program. The Act did not include policies that would have materially increased our tax liability.

山姆討論了「一項大美麗法案」對健康政策的影響。我將提供一些更詳細的註釋。就稅收政策而言，該法案對 HCA 來說是有利的，它使 100% 的獎金增值永久有效，可追溯至就職日，這對我們的資本投資計劃很有幫助。該法案並未包括會大幅增加我們納稅義務的政策。

We continue our work to develop and execute resiliency plans to offset as much of any adverse impact as possible from the Act the potential expiration of the EPTCs and other administrative actions such as tariffs. We will provide more information on our resiliency efforts during our fourth quarter in 2025 ranks call when we issue our 2026 guidance.

我們將繼續努力製定和執行彈性計劃，以盡可能抵消該法案、EPTC 可能到期以及關稅等其他行政措施的不利影響。當我們發布 2026 年指導意見時，我們將在 2025 年第四季排名電話會議上提供更多有關我們的彈性努力的資訊。

So with that, let me speak to our 2025 guidance. As noted in our release this morning, we are updating the full-year 2025 guidance as follows. We expect revenues to range between $74 billion and $76 billion. We expect net income attributable to HCA Healthcare to range between $6.11 billion and $6.48 billion. We expect adjusted EBITDA to range between $14.7 billion and $15.3 billion. We expect diluted earnings per share to range between $25.50 and $27. We expect capital spending to be approximately $5 billion.

因此，讓我來談談我們 2025 年的指引。正如我們今天早上發布的新聞稿中所述，我們將更新 2025 年全年指引如下。我們預計營收將在 740 億美元至 760 億美元之間。我們預計HCA Healthcare的淨收入將在61.1億美元至64.8億美元之間。我們預計調整後的 EBITDA 將在 147 億美元至 153 億美元之間。我們預計每股攤薄收益將在 25.50 美元至 27 美元之間。我們預計資本支出約為 50 億美元。

We are updating our guidance to project growth and equivalent emissions to be between 2% and 3% for the full-year 2025. With the approval of the Tennessee program and with updated information from across our programs, we now anticipate our supplemental payment full year net benefit to be between flat and $100 million favorable year-over-year. This projection does not include any potential impact in 2025 from the grandfathering of applications under the Act.

我們正在更新專案成長和等效排放量指導，預計 2025 年全年成長率在 2% 至 3% 之間。隨著田納西州計劃的批准以及我們各個計劃的最新信息，我們現在預計補充支付全年淨收益將與去年同期持平至 1 億美元。該預測並未包括 2025 年該法案下的祖父條款適用所帶來的任何潛在影響。

We believe one of the underlying strengths of HCA is our diversified portfolio of (inaudible). The recovery in our facilities impacted by Hurricane Celine and Milton in third and fourth quarter of 2024 is going better than anticipated. However, we have a couple of markets below our expectations that are offsetting some of the better performance in the hurricane affected markets.

我們相信 HCA 的根本優勢之一是我們多元化的投資組合（聽不清楚）。2024 年第三季和第四季，受颶風席琳和米爾頓影響的設施的恢復情況好於預期。然而，有幾個市場的表現低於我們的預期，抵消了受颶風影響的市場的一些較好表現。

We understand the challenges in these markets and have confidence in the plans in place to address them. Ultimately, the increase in our earnings guidance is equally weighted between the updated net benefit from the state supplemental payment programs and the improvement in our overall portfolio operational performance, including the hurricane impacted markets. With that, I will turn the call over to Frank for questions.

我們了解這些市場面臨的挑戰，並對解決這些挑戰的計畫充滿信心。最終，我們的獲利預期的成長是在國家補充支付計畫的最新淨收益和我們整體投資組合營運表現的改善（包括受颶風影響的市場）之間平等加權的。說完這些，我將把電話轉給弗蘭克來回答問題。

Thank you, Mike. As a reminder, please limit yourself to one question so we might give as many as possible in the queue an opportunity to ask a question. Abby, you may now give instructions to those who would like to ask a question.

謝謝你，麥克。提醒一下，請將自己的問題限制在一個範圍內，以便我們盡可能為隊列中的人提供提問的機會。艾比，現在你可以向那些想要提問的人發出指示了。

(Operator Instructions)

（操作員指示）

AJ Rice, UBS.

瑞銀的 AJ Rice。

Hi everybody, just maybe just asking around the guidance update. So, you raised your EBITDA guidance adjusted down by about $300 million at the midpoint. I think that's roughly the amount of outperformance that you saw in the scene so far here date in the first half, just a couple questions around that. Obviously, you now have the Tennessee DPP program. Should we think of that as reflected in this updated outlook? And then second, I know you're making a modest tweak on the admissions number, down, you're not alone in that. Some of your peers have already reported have done that. Any commentary on what you're seeing in terms of underlying demand on the volume front?

大家好，我只是想詢問一下指導更新。因此，您提高了 EBITDA 指導值，並在中間值下上調了約 3 億美元。我認為這大致就是您在上半年迄今為止的場景中看到的優異表現，我只想問幾個有關這個問題的問題。顯然，現在有了田納西州 DPP 計劃。我們是否應該認為這一點已經反映在更新後的展望中？其次，我知道你們正在對招生人數進行適度調整，你們並不是唯一這樣做的人。您的一些同事已經報告說他們已經這樣做了。您對數量方面的潛在需求有何評論？

Hey, AJ. Good morning. Let's talk about guidance first. So if I think about the $300 million increase in guidance, at this point, as I noted in my comments, about half of that is from state supplemental payment programs, and that does reflect the approval of the new Tennessee program. We expect to receive, start to receiving cash in that here in the back half of the year and probably a material chunk of that in the third quarter likely. It also reflects some just better visibility as we always have here at midyear about the rest of our programs. So that's about half of the increase.

嘿，AJ。早安.我們先來談談指引。因此，如果我考慮指導金額增加 3 億美元，那麼正如我在評論中指出的那樣，其中約有一半來自州補充支付計劃，這確實反映了對田納西州新計劃的批准。我們預計將在今年下半年開始收到現金，並可能在第三季收到其中的大部分現金。這也反映出我們在年中對其餘項目的了解更加深入。這大約是增幅的一半。

If I think about the other half of our guidance increase, it really relates to our portfolio, and again, as I mentioned in my opening statement, about $150 million of that increase is related to the portfolio and I would size that for you as follows. It's about a $100 million better in our hurricane-related markets, and you'll recall that we originally got that to be flat to the prior-year. So that's that's $100 million off, but we have a couple of markets that are underperforming roughly in the $50 million range of impact. So those two markets are offsetting some of the hurricane market improvements.

如果我考慮我們指導成長的另一半，它實際上與我們的投資組合有關，而且，正如我在開場白中提到的那樣，其中約 1.5 億美元的增長與投資組合有關，我將按如下方式為您估算。我們的颶風相關市場收入增加了約 1 億美元，您可能還記得，我們最初的目標是與前一年持平。因此，這意味著 1 億美元的損失，但我們有幾個市場的表現不佳，影響範圍大約在 5,000 萬美元左右。因此，這兩個市場抵消了颶風市場的部分改善。

And then really the rest of our portfolio is performing better than anticipated, so the net combined effect of our combined portfolio, including the hurricane markets, really results in the other half.

然後，我們投資組合的其餘部分的表現實際上好於預期，因此，包括颶風市場在內的組合投資組合的淨綜合效應確實對另一半產生了影響。

I might mention though just so that you guys can think through this as you prepare your comments, but I think third quarter, the guide the earnings growth will be a little bit lower, and fourth quarter is likely going to be a little bit higher in terms of growth rate compared to that midpoint of the guidance and that that's largely related to both the timing of supplemental payment program, payments and. Specifically the fourth quarter, you may recall that we received one-time payments fourth quarter of last year that do not repeat, and then we believe our hurricane markets, the recovery that we're that we're showing is largely going to be in the fourth quarter, if not entirely. So a couple of notes on that.

我之所以要提一下，只是為了讓你們在準備評論時仔細考慮這一點，但我認為第三季度的盈利增長預期會略低一些，而第四季度的增長率可能會比預期的中點高一些，這在很大程度上與補充支付計劃、付款的時間有關。具體來說是第四季度，您可能還記得，我們去年第四季度收到了一次性付款，這些付款不會重複，然後我們相信，我們的颶風市場，我們所展示的復甦將主要發生在第四季度，即使不是完全復甦。關於這一點，有幾點要注意。

So on volume, let me start and then Sam, please feel free to jump in. I know you will, the bit when I think about our volume, year-to-date through June of 2.3% equivalent emission growth, and I compare that to our original 3% to 4% guidance coming into the year. There are a couple of moving parts that that I would mention.

那麼關於音量，請讓我先開始，然後 Sam，請隨意加入。我知道你會的，當我想到我們的產量時，截至今年 6 月，當量排放量增長了 2.3%，而我將其與我們今年最初的 3% 至 4% 的指導方針進行了比較。我想提到幾個活動部件。

The first is that Medicaid, for June year-to-date, Medicaid's down 1.2% to prior-year, and we originally believed and built into our guidance the notion that Medicaid would flatten out this year, if not even show a bit of growth coming off of the Medicaid radio determination program.

首先，從今年 6 月至今的醫療補助來看，醫療補助較上年同期下降了 1.2%，我們最初相信並在我們的指導意見中認為，醫療補助今年將趨於平穩，甚至不會因醫療補助無線電測定計劃而出現一點增長。

And then our self-paid charity volumes are only up 1.5% June year-to-date, and we had believed originally that they would at least grow at the overall rate of volume growth. And, just for context, our self-pay volumes were up on the 7% and 24% over '23. So the combined of Medicaid and self-pay being below our expectations explained about half of the difference of our current year-to-date volume growth.

而今年 6 月至今，我們的自付慈善捐款金額僅成長了 1.5%，而我們原本相信，它們至少會以整體捐款金額的成長率成長。僅就背景而言，我們的自付費用量比 23 年分別成長了 7% 和 24%。因此，醫療補助和自付費用總額低於我們的預期，解釋了我們今年迄今為止銷售成長差異的一半左右。

Versus our 3% to 4% original guidance and really the other half is Medicare. We originally expected Medicare to grow a bit faster than it is, although I would note that a 3% growth in Medicare year-to-date through June is still a premium. So those are the two main categories of our volume that are trailing our original expectation of 3% to 4%. And Sam, I don't want to --

與我們最初的 3% 到 4% 的指導相比，另一半實際上是醫療保險。我們最初預期醫療保險的成長速度會比現在快一點，不過我要指出的是，截至 6 月份，醫療保險年初至今 3% 的成長率仍然是一個溢價。因此，這兩個主要類別的銷售量低於我們最初預期的 3% 至 4%。Sam，我不想--

Let me just add a couple of comments here, Mike, because I think context is always important. You look at the headlines on volume metrics as Mike just suggested, there's one metric where everybody looks at and we get it, but when you start reading through the full story and not just focus on the headlines, you start to see the productive aspects. And the qualitative value of the underlying business, for example, we had 14 out of 15 divisions that grew their admissions. 14 out of 15 domestic divisions grew their adjusted admissions. Our cardiac procedure volume was up 5%. Our obstetrics volumes were up 3%, neonatal volume up 13%.

麥克，讓我在這裡補充幾點評論，因為我認為背景始終很重要。正如麥克剛才建議的那樣，你可以查看有關數量指標的標題，有一個指標是每個人都會看的，我們也明白了，但是當你開始閱讀整個故事而不是只關注標題時，你就會開始看到富有成效的方面。以基礎業務的定性價值為例，我們 15 個分部中有 14 個的入場人數有所增加。 15 個國內分部中有 14 個的調整後入場人數增加。我們的心臟手術量增加了5%。我們的產科數量增加了 3%，新生兒數量增加了 13%。

So the details, in many respects reflect the power of a diversified portfolio of markets and services. I think another point for us, and this is how we look at it, we've had 16 consecutive quarters volume growth. And so that consistency tells us that the network model that we're investing in very heavily and we're focused around execution on it allows us to compete effectively. It's allowed us to sustain market share gains, and we think it adds value for our patients. Adds value for our physicians and we think it adds value for our shareholders. So yeah, the number is 1.7%, but when you look underneath it, the productive and qualitative aspects of it are more impactful than maybe first understood.

因此，細節在許多方面反映了多元化市場和服務組合的力量。我認為我們的另一點是，我們的看法是，我們已經連續 16 個季度實現了銷售成長。這種一致性告訴我們，我們投入大量資金的網路模型以及我們專注於執行該模型使我們能夠有效競爭。它使我們能夠維持市場份額的成長，並且我們認為它為我們的患者增加了價值。為我們的醫生增加了價值，我們認為這也為我們的股東增加了價值。是的，這個數字是 1.7%，但是當你深入研究它時，它的生產和品質方面的影響可能比最初理解的更大。

Okay. Thanks a lot.

好的。多謝。

Ann Hynes, Mizuho.

安‧海因斯 (Ann Hynes)，瑞穗。

Good morning. Thank you. Can you just provide more details on your resiliency programs? I think the street really at this point don't, doesn't believe that the subsidies will be extended. How much of a headwind do you think you can offset in 2026? Is any of this benefit embedded in your 2025 guidance, or will it all be incremental to 2026? And any other incremental details about what type of cost savings you'll be doing, that'd be great. Thank you.

早安.謝謝。您能否提供有關您的彈性計劃的更多詳細資訊？我認為街道在這一點上確實不相信，不相信補貼會延長。您認為到 2026 年您能抵銷多大的逆風？這些好處是否包含在您的 2025 年指導方針中，還是會逐漸增加到 2026 年？另外，如果您能提供關於您將採取哪些類型的成本節約措施的其他詳細信息，那就太好了。謝謝。

So let me kind of summarize our thinking about the one Big Beautiful Bill Act, the EPTCs, and how we're thinking about a resiliency program, and then, and as I mentioned in my comments, we will comment further and provide more details related to this in our fourth-quarter '25 earnings call when we get guidance for 2026.

因此，讓我總結一下我們對「美麗大法案」、EPTC 的想法，以及我們對彈性計畫的看法，然後，正如我在評論中提到的那樣，當我們獲得 2026 年的指導時，我們將在 2025 年第四季度收益電話會議上進一步評論並提供更多與此相關的細節。

First, let me start with the Act itself. I do believe in the near term. That our financial resiliency program should offset the exchange provisions in the Act. In the longer term, as it relates to the Act specifically with both the delayed start and the phased in nature of these provider tax and state directed payment reimbursement reforms, along with the potential for the approval of the submitted supplemental payment applications, we believe HCA will be able to generally manage these impacts with our resiliency efforts without material impact to our long term guidance.

首先，讓我先從法案本身說起。我確實相信在短期內。我們的金融彈性計畫應該抵銷法案中的兌換條款。從長遠來看，由於該法案與提供者稅和國家指導的支付報銷改革的延遲啟動和分階段實施有關，加上提交的補充支付申請有可能獲得批准，我們相信 HCA 將能夠透過我們的彈性努力總體上管理這些影響，而不會對我們的長期指導產生重大影響。

Specific to EPTCs, at this point, we do not know what the outcome will be. As noted, we are working to develop our resiliency programs to offset as much as possible any adverse impacts should they expire. And again, the potential approval of the grandfathered applications would certainly help.

具體到 EPTC，目前我們還不知道結果會如何。如上所述，我們正在努力開發我們的彈性計劃，以盡可能抵消它們到期時產生的任何不利影響。再次強調，祖父條款申請的潛在批准肯定會有所幫助。

We will comment further as noted when we do our 2026 guidance. Suffice it to say our resiliency efforts as we continue to work through them, and we've been working on them as you, as we've talked about over the last year, in a very diligent way, address both benchmarking our corporate departments and shared service organizations against best practices and finding operational improvement opportunities.

我們將在製定 2026 年指導時進一步發表評論。可以說，隨著我們繼續努力提高彈性，我們一直在努力，正如我們在過去一年中談到的那樣，我們以非常勤奮的方式，既要針對最佳實踐對我們的公司部門和共享服務組織進行基準測試，又要尋找運營改進機會。

We are deep in the middle of our field-based resiliency efforts, many of which we commented on before, from a length of stay and improvement opportunities with our case management operations through significant opportunities around both our automation and our digital transformation agendas and our labor and supply related resiliency plans are also very developed and mature.

我們正深入開展基於現場的復原力工作，其中許多工作我們之前都曾評論過，從我們的案例管理運營的停留時間和改進機會，到圍繞我們的自動化和數位化轉型議程的重大機遇，以及我們的勞動力和供應相關的復原力計劃也非常發達和成熟。

We will get more updates on that and when we get to the fourth quarter call, but hopefully that helps.

當我們進入第四季度電話會議時，我們將獲得有關該問題的更多更新，但希望這會有所幫助。

Ben Hendrix, RBC Capital Markets.

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

Great, thank you very much. I appreciate all the color about, trends in the various peer classes. I was wondering if you could comment a little bit on a commercial volume you're seeing one of your peers talked about waning consumer confidence, driving some weakness in their book, but to see what you're seeing and kind of that weighed against any expectation for a pickup in activity, assuming people are trying to get procedures done toward the end of the year in anticipation of losing the enhanced premium subsidies. Any thoughts there on what we can expect through 4Q and commercial? Thanks.

太好了，非常感謝。我欣賞各個同儕階層的各種色彩和趨勢。我想知道您是否可以就商業交易量發表一些評論，您看到一位同行談到消費者信心減弱，導致他們的賬簿出現一些疲軟，但看看您所看到的情況，以及這與任何活動回升的預期相權衡，假設人們預計會失去增強的保費補貼，試圖在年底前完成程序。您對於第四季和商業廣告有何期待？謝謝。

So I'll give you, then June year-to-date our maintenance care in hicks equivalent emissions are up 4% over a prior-year. If you think about how that compares to our expectations coming into the year, it's right there. I mean that that's about what we expected for as part of our original 3% to 4% guide. I would say that healthcare exchanges, which are up 15.8% through June year-to-date are a little better than our original expectation.

因此，我可以告訴您，今年 6 月迄今為止，我們的維護保養中希克斯當量排放量比前一年增加了 4%。如果您想想這與我們對今年的期望相比如何，它就在那裡。我的意思是，這大約是我們最初 3% 到 4% 指導方針所預期的。我想說的是，醫療保健交易所今年截至 6 月已上漲 15.8%，比我們最初的預期要好一些。

And our commercial managed care book, excluding the exchanges, which is up just short of a point to prior-year, maybe a little below our original guidance, but that, that's how we read it. We're pleased with the payer mix through second quarter. Sam, I don't know if you have any comments about consumers.

我們的商業管理式醫療保健帳簿（不包括交易所）比去年同期僅上漲了不到一個百分點，可能略低於我們最初的指導，但這就是我們的解讀。我們對第二季的付款人組合感到滿意。山姆，我不知道您對消費者有什麼評論。

No, I don't think we can make any. Comments yet about consumer confidence. I think again the demand for health care largely over time appears to have been inelastic. I don't know that anything is necessarily changing that and so it's it's difficult for us to point to consumer confidence. At least across our portfolio as a driver of activity.

不，我認為我們做不到。關於消費者信心的評論尚未公佈。我再次認為，隨著時間的推移，對醫療保健的需求似乎變得缺乏彈性。我不知道有什麼必然會改變這種狀況，因此我們很難指出消費者信心。至少在我們的投資組合中，它是活動的驅動力。

Again, we had good commercial growth in a lot of categories.

再次，我們在許多類別中都取得了良好的商業成長。

We had declines in areas as Mike mentioned that were government or no payer payer sponsored business. We saw declines in pediatrics. We can point to a respiratory, environment last year that we didn't have this year that influenced our overall statistics, behavioral health admissions were down in our company.

正如麥克所提到的，我們在政府或無付款人贊助的業務領域出現了下滑。我們看到兒科的衰落。我們可以指出，去年的呼吸環境今年沒有出現，這影響了我們的整體統計數據，我們公司的行為健康入院人數有所下降。

Some of that was because we shrunk supply in certain facilities.

部分原因是我們減少了某些設施的供應。

Again, that doesn't have as good a payer mix as the rest of our business.

再說了，它的付款人組合不如我們其他業務那麼好。

So I think from that standpoint we're still pretty, confident as we mentioned in the demand for health care across our markets, and we don't see that being disrupted too much in the in the short run.

因此，我認為從這個角度來看，我們仍然非常有信心，正如我們所提到的那樣，我們整個市場對醫療保健的需求，我們認為短期內不會受到太大的干擾。

Here, the only thing I might mention is that it's a pretty tough prior-year cost of prior-year, and I think everyone realizes that.

在這裡，我唯一想提的是，這是一個相當艱難的上一年成本，我想每個人都意識到了這一點。

The prior-year had really robust volume growth, just a couple of notes here when you think about this, the first half of this year compared to the first half of last year, we had, we still have a bit of a leap here impact, that's about 50 basis points, of volume impact. Medicaid redeterminations last year were fueling, big exchange growth last year. You may recall that our exchange. Volume growth last year was robust over 40%. Kind of an interesting statistic. From first quarter to second quarter of '24, our exchange equivalent emissions increased 14%.

去年的銷售成長確實非常強勁，當你想到這一點時，這裡有幾點需要注意，今年上半年與去年上半年相比，我們仍然有一點飛躍的影響，銷量影響約為 50 個基點。去年醫療補助的重新確定推動了去年交易所的大幅成長。您可能還記得我們的交流。去年銷量成長強勁，超過 40%。這是一個有趣的統計數據。從2024年第一季到第二季度，我們的交換當量排放量增加了14%。

This year from first quarter to second quarter of 25%, they're up about 3%. So we still saw growth sequentially from first quarter to second quarter, but I think prior-year just had robust exchange. Volume growth and then just the other thing just to keep in mind when you're thinking about the prior-year comp is that the Medicare Advantage to be not rule did impact admissions in '24, and that has sunset into the '25. So I think the prior-year comparison is also a bit of a story here.

今年從第一季到第二季成長了25%，上漲了約3%。因此，我們仍然看到第一季到第二季的連續成長，但我認為去年同期的匯率非常強勁。除了數量增長之外，當您考慮上一年同期的業績時，需要記住的另一件事是，醫療保險優勢計劃不規則確實影響了 24 年的入院人數，並且該政策將在 25 年失效。因此，我認為與去年同期的比較也有一定的道理。

Great, thank you.

太好了，謝謝。

Brian Tanquilut, Jefferies.

傑富瑞的布萊恩‧坦奎魯特 (Brian Tanquilut)。

Hey, good morning, guys. Hey, Sam, just to follow up on some of these discussions on, I appreciate your comments on the growth rates that you saw with the different regions, but how are we thinking about market share that you're seeing in the local market, maybe also in the context of, the payers are talking about high utilization rates and, that's translating to the volume trends that you're reporting. So just curious if you're seeing any dynamics at the local level you could share with us. Thank you.

嘿，大家早安。嘿，薩姆，只是為了跟進這些討論中的一些，我很欣賞你對不同地區增長率的評論，但是我們如何看待你在當地市場看到的市場份額，也許在付款人談論高利用率的背景下，這轉化為你報告的數量趨勢。我只是好奇，如果您看到任何可以與我們分享的地方層面的動態。謝謝。

Yeah, Brian, thank you. As I mentioned. We've had sustained market share gains, and we think we've continued to Accomplished that with the most recent data that we've seen in our market share if you really sort of, exclude behavioral health given that we put some pressure ourselves, we're above 28% and we're showing signs of broad-based market share growth across service lines as well as across many of our markets. We do have a few markets as we always do. We have 43 US markets that we focus our share on and some are doing better than others. But we're fairly agile in responding to those dynamics.

是的，布萊恩，謝謝你。正如我所提到的。我們的市佔率持續成長，我們認為我們已經繼續實現了這一目標。根據我們在市場份額方面看到的最新數據，如果排除行為健康（考慮到我們自己施加了一些壓力），我們的市場份額已經超過 28%，並且我們顯示出在各個服務線以及許多市場中廣泛增長的跡象。像往常一樣，我們確實有幾個市場。我們的重點市場為 43 個美國市場，其中一些市場的表現優於其他市場。但我們對這些動態的反應相當敏捷。

I mean there's a lot of investments that we're making in our business. We still have about $5.5 billion worth of capital that is in flight that will add to our networks both with outpatient facilities as well as inpatient capacity where appropriate. We think that will continue to produce the necessary overall capacity to meet the demand as well as the share gains that we anticipate with our initiatives.

我的意思是我們對我們的業務進行了大量投資。我們仍有價值約 55 億美元的流動資金，這些資金將用於擴充我們的網絡，包括適當的門診設施和住院容量。我們認為，這將繼續產生必要的整體產能來滿足需求以及我們預期透過我們的措施獲得的份額成長。

So we continue to find ways to improve what we call the integrity of our network and keep patients inside the system where appropriate for them, and that's an area of focus for us also. So I'm pretty pleased with how our teams are executing on the ground, so to speak, to deliver value for our patients, grow their business and so forth.

因此，我們將繼續尋找方法來改善我們所謂的網路完整性，並將患者留在適合他們的系統內，這也是我們關注的領域。因此，我對我們團隊的實際執行情況感到非常滿意，可以說，我們為患者提供了價值，並發展了他們的業務等等。

We recently finished our midyear reviews with all of our divisions. And we're optimistic that their assessments of the markets are continually favorable and will allow us to achieve our objectives as we push forward.

我們最近完成了所有部門的年中評估。我們樂觀地認為，他們對市場的評價將持續良好，並將幫助我們在前進的道路上實現目標。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

One quick clarification and then a real question. Clarification on supplemental payments, I believe you raised the annual guidance by about $170 million at the midpoint. I believe the first quarter is $80 million ahead. Second quarter was $100 million ahead. So it's confirming that you are not changing payment guidance for the back half of the year.

快速澄清一下，然後提出一個真正的問題。關於補充付款的澄清，我相信您在中期將年度指導金額提高了約 1.7 億美元。我相信第一季的獲利將達到 8,000 萬美元。第二季獲利 1 億美元。因此，這確認您不會改變下半年的付款指南。

And then the real question is, do you have any color on how your HICS patients have access to employer-sponsored health care, but have chosen due to lower cost I'm just struggling as a look at the millions of jobs created in your states and yet the employer sponsor growth is tracking below job growth.

那麼真正的問題是，您是否了解您的 HICS 患者如何獲得雇主贊助的醫療保健，但由於成本較低而選擇這樣做，我只是在努力看看你們各州創造的數百萬個就業機會，但雇主贊助的增長速度卻低於就業增長。

Thanks, Peter. Let me start with guidance. As I noted in my comments, about half of our increased guidance at midpoint is coming from state supplemental payments. So $150 million increase in our guidance is coming from state supplemental payments that reflects not only the fact that the Tennessee program has improved, it has been approved, but that we expect to start receiving cash here in the back half of the year.

謝謝，彼得。讓我先從指導開始。正如我在評論中指出的那樣，我們中期增加的指導金額中約有一半來自國家補充支付。因此，我們指導金額中增加的 1.5 億美元來自州政府的補充支付，這不僅反映了田納西州的計劃已經得到改善、已經獲得批准，而且我們預計將在今年下半年開始收到現金。

I would think about it this way, as you think about kind of the second half of the year versus the first half of the year. In terms of the first half of the year, we've had $180 million of supplemental payment net benefit to year-over-year earnings in the first half.

我會這樣想，就像你思考下半年與上半年的情況一樣。就上半年而言，我們的補充支付淨收益為 1.8 億美元，與去年同期相比有所成長。

In the second half of the year, we anticipate a $130 million decline in net benefits compared to the second half of 2024 and really entirely in the fourth quarter. And so just as you think about the implied guidance rate in our revised guidance, the second half after considering the hurricane market improvement in fourth quarter and the state supplemental payment decline in the back half of the year.

我們預計，今年下半年的淨利潤將比 2024 年下半年減少 1.3 億美元，而第四季的淨利潤將完全減少。因此，正如您所想到的，我們修訂後的指引中的隱含指導率，在考慮到第四季度颶風市場的改善和下半年國家補充支付的下降之後，下半年的情況是這樣的。

We think that the second half of the year's growth rate is roughly comparable to the first half after considering those factors. We do not, at this point, have a good enough insights relative to what percentage of the people who potentially would lead the exchanges if the APTCs expire that would go back to employee-sponsored insurance. Other than to say that we believe that there would be a component of those people who lose EPTCs would go back to employee-sponsored insurance.

我們認為，綜合考慮這些因素，下半年的成長速度與上半年大致相當。目前，我們還不清楚，如果 APTC 到期，有多少比例的人可能會領導交易所，而這些人又會回到員工贊助的保險。除此之外，我們相信失去 EPTC 的人員中會有一部分人重新獲得員工贊助的保險。

And as you noted in our key states, especially our non-expansion states, given the job growth that we've seen over the last several years in places like Florida and Texas, we believe it would be a component of the stores. A little early to probably get insight yet until we know what happens with APT seats.

正如您在我們的關鍵州，特別是非擴張州所指出的，鑑於過去幾年我們在佛羅裡達州和德克薩斯州等地看到的就業增長，我們相信它將成為商店的一個組成部分。在我們知道 APT 席位的情況之前，現在獲取資訊可能還為時過早。

Whit Mayo, Leerink Partners.

惠特·梅奧 (Whit Mayo)，Leerink Partners。

Just wondering if there are any changes that you guys are seeing in MA behavior denials, anything to call out that's maybe changed versus last year? And any investments maybe that you've made around documentation or revenue cycle that's also changed.

只是想知道你們是否看到 MA 行為拒絕方面有任何變化，與去年相比有什麼變化嗎？您可能在文件或收入週期方面進行的任何投資也發生了變化。

So just on Medicare a couple of numbers here. So Medicare Vantage now represents 58% of our total Medicare admissions. Just one note on the two midnight rule that seems to be fully implemented in 2020 where we're really not seeing any additional movement from observation to inpatient there. As it relates to the payers with -- we are not seeing any significant impact on our results from denial activities.

這裡僅介紹一下醫療保險的幾個數字。因此，Medicare Vantage 目前占我們 Medicare 總入院人數的 58%。關於午夜兩點規則，需要注意的是，該規則似乎將在 2020 年全面實施，我們實際上並沒有看到任何從觀察到住院的額外流動。就付款人而言，我們沒有看到拒絕活動對我們的結果產生任何重大影響。

But I think that does reflect the significant work that we have put into our revenue cycle over the last couple of years to strengthen our organization's management deals. I'll mention that we have -- over the last year or so, we have initiated several partnership activities with our key partners in our key managed care payer partners.

但我認為這確實反映了我們在過去幾年中為加強我們組織的管理交易而在收入週期中投入的大量工作。我要說的是，在過去一年左右的時間裡，我們與主要管理醫療支付合作夥伴中的關鍵合作夥伴發起了許多合作活動。

These partnership activities focus on things like digital integration, administrative simplification and better management of disputes. I think there's a lot of good work in flight between us and our payer partners and hopeful that we can continue to manage through these things and as we have been in a really meaningful way. We need them. They need us. And I think we have a good relationship in flying to work through these areas.

這些合作活動的重點是數位整合、行政簡化和更好地管理糾紛等面向。我認為我們和我們的付款合作夥伴之間正在進行許多良好的工作，並希望我們能夠繼續以真正有意義的方式管理這些事情。我們需要他們。他們需要我們。我認為我們在這些地區的飛行工作中有著良好的關係。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Maybe just one quick info request and then a question. Can you give us the latest quote on HCA revenue and admissions. And maybe just a question on the hurricane performance. Appreciate all the color there. But I think the headwind, at least the start of the year was $250 million versus last year now you're attributing $100 million of the guidance raise that hurricane.

也許只是一個快速的資訊請求，然後是一個問題。您能否向我們提供有關 HCA 收入和招生的最新報價？也許只是關於颶風表現的問題。欣賞那裡的所有色彩。但我認為，至少今年年初的逆風是 2.5 億美元，而去年現在你把指導價上漲的 1 億美元歸因於這場颶風。

So does that mean there's still $150 million of continuing headwinds embedded in the guidance for the back half?

那麼，這是否意味著下半年的業績預期中仍將存在 1.5 億美元的持續不利因素？

And can you give us a sense for how occupancy, payer mix and profitability stand in that mission, North Carolina market versus pre-hurricane.

您能否向我們介紹一下與颶風前相比，北卡羅來納州市場的入住率、付款人結構和獲利能力如何？

Let me start with the exchanges. About 8% equivalent admissions and just a smidge over 10% on net revenues for the exchanges as a percent of total.

我先從交流開始。約佔入場費的 8%，交易所淨收入佔總收入的 10% 多一點。

So on the hurricane markets, remember, if you think about last year for the third quarter and fourth quarter of last year, a piece of that $250 million were lost revenues and a piece of that was additional expenses. And roughly 60-40 additional expenses, 40% loss revenue. So you don't get the lost revenue back, Andrew. And clearly, you do get to go year-over-year on the additional expenses for prior-year.

因此，在颶風市場上，請記住，如果您考慮去年第三和第四季度，那麼這 2.5 億美元中的一部分是收入損失，一部分是額外費用。大約有60%-40%的額外支出，40%的收入損失。所以你無法收回損失的收入，安德魯。顯然，您確實可以逐年增加上一年的額外支出。

So when we were constructing our original guidance, the hurricane markets, we have pretty good confidence and insight that the large hospital would have year-over-year growth in earnings because it reopened on December 1. And a lot of the impact there was repairs and maintenance expenses to reopen that facility.

因此，當我們制定最初的指導意見，即颶風市場時，我們非常有信心和洞察力，認為大型醫院的利潤將同比增長，因為它在 12 月 1 日重新開放。而重新開放該設施的維修和維護費用則產生了很大的影響。

And then in our North Carolina division, you may recall, we were concerned we didn't -- we never closed operations, but we were concerned about the lingering effects of the hurricane in that market. because of the broad impact to the population in Western North Carolina. And so our best estimate at the time when we issued our original guidance was that we thought that when combined, the hurricane markets would be flat year-over-year, '25 compared to '24.

然後，在我們的北卡羅來納州分部，您可能還記得，我們擔心我們沒有——我們從未關閉過業務，但我們擔心颶風對該市場的持續影響。因為這對北卡羅來納州西部的人口產生了廣泛的影響。因此，我們在發布原始指引時的最佳估計是，我們認為綜合起來，25 年颶風市場與 24 年相比將持平。

As we've gone through the first two quarters, what we've seen is a little better recovery than our original anticipation. You may recall that -- in first quarter, the year-over-year impact of those two markets was relatively flat. The second quarter was a bit negative. I mean there was a decline in earnings year-over-year. It wasn't material at the company level, but it was certainly a bit negative.

我們已經經歷了前兩個季度，我們看到的復甦比我們最初的預期要好一些。您可能還記得—在第一季度，這兩個市場的年比影響相對穩定。第二季的情況有些糟糕。我的意思是收入比去年同期有所下降。雖然這對公司層面來說並不重要，但肯定有點負面影響。

We think third quarter could be a bit negative as well, and then we see a recovery year-over-year in fourth quarter. But for the full year, we believe that the hurricane-related markets will come in at about $100 million better year-over-year, which is, again, as compared to our original total hopefully, that helps on the -- Yes. And Mike, let me add one thing. I mean what we've seen in North Carolina is greater demand than we anticipated.

我們認為第三季可能也會有些負面，但第四季將出現年比復甦。但就全年而言，我們相信颶風相關市場的收入將比去年同期增加約 1 億美元，與我們最初的總額相比，希望這會有所幫助——是的。麥克，請容許我補充一點。我的意思是，我們在北卡羅來納州看到的需求比我們預期的要大。

Unfortunately, we've seen the labor market get more tight. And that required us to use more contract labor in North Carolina to service that demand.

不幸的是，我們看到勞動市場變得更加緊張。這就要求我們在北卡羅來納州使用更多的合約工人來滿足這一需求。

And so those are really the two big items there. Again, this is still a very short period after the storm. We don't know the long-term effects on Ashville, North Carolina, in particular, in what it means to economic development and tourism and so forth, but we're really pleased with how our teams have dealt with the operational requirements, the patient requirements with the situation there, and they continue to push on in a very effective way.

所以這確實是兩個大問題。再次，這仍然是風暴過後很短的一段時間。我們不知道這會對北卡羅來納州阿什維爾的經濟發展、旅遊業等產生什麼長期影響，但我們對我們的團隊如何處理營運要求、如何處理那裡的情況的耐心要求感到非常滿意，他們繼續以非常有效的方式繼續前進。

And we remain a very bullish about our system in North Carolina, and we continue to add where we can underneath the rules in that state. We continue to improve the quality and we continue to engage with our stakeholders in a very effective way. So we're excited about the position of Mission Hospital in particular and where it stands, and we'll continue to execute on the plan that's in front of us.

我們仍然對北卡羅來納州的體系非常看好，我們將繼續在該州的規則下盡可能地增加內容。我們不斷提高質量，並繼續以非常有效的方式與我們的利益相關者合作。因此，我們對 Mission Hospital 的地位和現狀感到非常興奮，我們將繼續執行我們面前的計劃。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

Going to try to get at this resiliency stuff and maybe another way without trying to pin you down on it. As the world looks that you're at what's coming, right? There's going to be a loss revenue. And when we think about exchanges and the provider taxes, there's certainly very high margin revenue, right? So as that goes away, there's the potential for a big impact, right?

試著獲得這種彈性的東西，也許還有另一種方法，而不是試圖將你束縛住。正如全世界所期待的，你正在經歷即將發生的一切，對嗎？收入將會損失。當我們考慮交易所和提供者稅時，肯定會有非常高的利潤收入，對嗎？因此，當這種情況消失時，可能會產生很大的影響，對嗎？

I don't think I'm telling you anything you don't know.

我想我沒有告訴你任何你不知道的事。

The I think the main question I'd love to get from you guys here is just you've done an incredible job over time in different operating environment staying around a 19% to 20% margin. And is that a reasonable framework like, look, we're going to lose revenue, but we're going to say that we think with the resiliency efforts, we can keep within that typical margin target. Is that a reasonable framework to think about the next few years?

我認為我最想從你們這裡得到的主要問題是，你們在不同的營運環境中一直做得非常出色，利潤率保持在 19% 到 20% 左右。這是一個合理的框架嗎？看，我們將會損失收入，但我們會說，我們認為透過彈性努力，我們可以保持在典型的利潤目標範圍內。這是思考未來幾年的合理框架嗎？

Josh, this is Sam. I don't know if I'm going to put a frame of reference on any of that at this particular juncture -- we need to get through the last half of the year to understand exactly where the premium tax credits land we will score that. We are actively developing our cost plan in order to respond to that.

喬希，這是山姆。我不知道在這個特定時刻我是否要對其中任何一個提出一個參考框架——我們需要度過下半年才能確切了解保費稅收抵免的具體落地情況，我們才能獲得這一分數。為了應對這個問題，我們正在積極制定成本計劃。

I will tell you this, we have a pattern of owning our realities, whatever they happen to be, in finding pathways forward to accomplish our financial objectives our growth objectives, our return on capital objective, our quality objectives. And I'm confident that we will do that in an appropriate fashion as we push forward. And so we're not ready to give you a margin range. We're not ready to give you a revenue implication just yet because it would be inappropriate for us to do that until we have greater clarity on exactly how this lands where some of these people go if they do, in fact, lose coverage.

我會告訴你，我們有一個掌握現實的模式，無論它們是什麼，我們都會找到前進的道路來實現我們的財務目標、成長目標、資本回報目標和品質目標。我相信，隨著我們不斷前進，我們將以適當的方式做到這一點。因此我們還沒有準備好為您提供保證金範圍。我們還沒有準備好告訴您收入影響，因為在我們更清楚地了解如果這些人真的失去保險，他們將會去哪裡之前，這樣做是不合適的。

And we understand everybody's concern and desire to want to try to score it. But you got to give us some sense of time here and the ability to sort of process it. But when I pull up and I think about who this organization is, the people we have on our team, the position we have in the markets that we serve, I'm pretty confident that we'll get to where we need to be.

我們理解每個人的擔憂以及想要嘗試進球的願望。但你必須讓我們對時間有一些認識，並且有能力處理它。但當我停下來思考這個組織是誰、我們團隊中的人員、我們在所服務市場中的地位時，我非常有信心我們會達到我們需要的目標。

Matthew Gilmore, KeyBanc.

馬修·吉爾摩（Matthew Gilmore），KeyBanc。

Going back to the guidance discussion, there was a comment about a handful of markets that were underperforming. Can you give us some sense for the drivers of that underperformance and then the actions that are underway to improve results?

回顧指導討論，有一則評論提到了少數表現不佳的市場。您能否向我們解釋一下導致業績不佳的原因以及正在採取哪些措施來改善業績？

Yes, this is Sam. We have 16 geographic divisions in HCA when you include the U.K. We have 15 obviously, in the US every year, we have one or two of them that aren't accomplishing what we hope to accomplish for a variety of reasons. Certain volumes don't materialize as we anticipate competitors do something that we didn't expect.

是的，這是山姆。如果算上英國，HCA 共有 16 個地理分部。顯然，我們有 15 個，而在美國，每年都有一兩個分部因為各種原因未能實現我們的預期目標。由於我們預期競爭對手會做出一些我們意想不到的事情，因此某些數量並未實現。

Physicians have dynamics that create flow of business it's so variable. So we have two divisions. I'm not going to call them out on this call, other than to say we're confident in our overall positioning in both of them and what they're doing in order to respond. These are seasoned leaders in these hospitals and in these divisions. There's been some competitive dynamics in one division that dislocated some of our business, but we're responding to that appropriately.

醫生具有創造業務流程的動力，它是如此多變。所以我們有兩個部門。我不會在這次電話會議上對他們進行批評，只是想說，我們對我們在這兩家公司中的整體定位以及他們為應對這些公司所採取的措施充滿信心。這些都是這些醫院和部門的經驗豐富的領導者。某個部門的競爭態勢已經擾亂了我們的部分業務，但我們正在採取適當的應對措施。

In the other division, there was a bit of service mix change, nothing structural, but it hit us pretty hard in the second quarter, and we're reacting to that appropriately with our cost but we expect fully that will recover in the second half of the year. And so this is sort of the normal give and take with what's uniquely, I think, our diversified portfolio.

在其他部門，服務組合有一些變化，不是結構性變化，但在第二季度對我們造成了相當大的打擊，我們正在透過成本調整對此做出適當的反應，但我們預計下半年將完全恢復。所以我認為這是對我們的獨特多元化投資組合的正常付出和收穫。

And again, having geography differences across the company allows us to absorb two divisions that didn't have the performance that we anticipated. And that's what happened last year. We had a couple of divisions that did not accomplish their objectives in '24. And we overcame it last year, and we're doing it again this year.

而且，由於公司存在地域差異，我們可以吸收兩個業績未達預期的部門。這就是去年發生的事情。我們有幾個部門在 1924 年沒有完成他們的目標。去年我們克服了這個困難，今年我們又將再次克服它。

Josh Raskin, Nephron Research.

Josh Raskin，Nephron Research。

Could you provide just a little bit more color on maybe surgery volumes, both on the inpatient and outpatient side and maybe any changes in trends you're seeing around site of care?

您能否提供更多關於住院和門診手術量的信息，以及您在護理地點看到的趨勢變化？

So outpatient surgery is a continuation of kind of our past stories here, Josh. I mean, I would note that on the pure case count standpoint, we were down 0.6% for the quarter, which better than our most recent trends and still almost entirely driven by Medicaid self-pay and a bit of a drop in lower acuity cases.

因此，門診手術是我們過去故事的延續，喬希。我的意思是，我要指出的是，從純病例數的角度來看，本季度我們下降了 0.6%，這比我們最近的趨勢要好，而且仍然幾乎完全受到醫療補助自付和低危險病例略有下降的影響。

I would note, as we've noted before, that we are seeing good revenue growth in our outpatient surgery book of business call it, 7.5%, 8% growth here that we're seeing on the revenue side. So that's good. And really, if I pull up outside this outpatient surgery and look at outpatient in total, we had a good quarter. I mean our total outpatient revenue grew almost 8%.

我想指出的是，正如我們之前提到的，我們的門診手術業務收入成長良好，收入方面我們看到的成長率為 7.5% 至 8%。這很好。事實上，如果我在這家門診部外面停下來，看看門診部的整體情況，就會發現我們這個季度的業績不錯。我的意思是我們的門診總收入增加了近8％。

So all four categories of our outpatient book that we track performed well. The inpatient surgery is very similar story in payer mix. And the biggest impact was a drop in Medicaid cases on the inpatient side. So inpatient surgeries on the same facility basis were relatively flat in the quarter, and it's pretty much payer mix on Medicaid drip.

因此，我們追蹤的所有四個門診病人類別都表現良好。住院手術在付款人組成方面的情況非常相似。最大的影響是住院醫療補助病例的下降。因此，同一設施的住院手術在本季度相對平穩，幾乎是醫療補助滴灌的付款人組合。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，費茲傑拉領唱者。

Can you talk about how commercial exchange and self-pay compare historically on fee schedule and revenue collection rate? And to the degree we see some shifting in volume to self-pay in the future. Is there anything that your team can do on the revenue collection strategy side to improve collection rates on Self-pay?

您能否談談商業交易和自付費用在費用表和收入收取率的歷史比較？在某種程度上，我們看到未來自付費用的數量會有所轉變。您的團隊在收入收集策略方面可以做些什麼來提高自付收入的收集率？

Yes, Sarah. So let me kind of double-click on patient collections a bit here. When I think about the patient portion or the patient balance that's owed under our commercial contracts, the first thing that we track is this idea of what do we typically see on an annual basis in terms of the increase in the average patient balance over many years, we've seen kind of mid-single-digit increases annually on the amount patients owed as part of their kind of overall commercial increase -- and then in recent quarters, we've seen that a little higher, and that's been influenced by the health care exchanges where patients do tend to have a little bit higher patient responsibilities compared to traditional commercial.

是的，莎拉。因此，請允許我在這裡雙擊一下患者集合。當我考慮根據我們的商業合約欠下的患者部分或患者餘額時，我們跟踪的第一件事就是我們通常看到的年度平均患者餘額的增長情況，多年來，我們看到患者欠款金額每年以中等個位數增長，這是他們整體商業增長的一部分 - 然後在最近幾個季度，我們看到這一數字略高，這是受到醫療保健交易所的影響，與傳統商業相比，患者責任。

Regarding collectability of those amounts owed, we've generally maintained our historical levels of collection on patient balances on our traditional commercial population. The health care exchange population, the rate collection is a bit lower than on the traditional side, the traditional commercial side.

關於欠款的可收回性，我們通常維持傳統商業人群患者餘額的歷史收取水準。醫療保健交換人口的費率比傳統的、傳統的商業費率低一些。

But overall, we have not seen yet any significant impact on the collectability of our patient receivables in the aggregate. So that's kind of an update on what we're seeing relative to patient collection.

但總體而言，我們尚未看到對患者應收帳款的可收回性產生任何重大影響。這是我們觀察到的與患者收集相關的最新情況。

But are you able to give us a comparison to what that looks like versus self-pay so for the uninsured population that's self pace? How much of a delta is there on collection rates or the fee schedule chart?

但是，您能否為我們做一個與自付相比的比較，以便對於沒有保險的人群來說，可以自行決定支付的進度？收費率或費用表的差異有多大？

We collect very little cash from the truly uninsured populations there really, what you see with truly unsure is you get a little bit of a pickup on DISH. But there is not any material collections that would fall into a material zone for the company on the uninsured population most uninsured patients in our company qualify for either our charity programs or significantly reduced amounts due to our patient protection policy. So there's not a lot of revenue produced for uninsured patients.

我們實際上從那些真正沒有保險的人群那裡收取的現金非常少，你會看到，從那些真正沒有保險的人群那裡，你只能從 DISH 上獲得一點點收益。但是，對於沒有保險的人群來說，沒有任何實質性的收集會落入公司的實質區域，我們公司的大多數沒有保險的患者都有資格享受我們的慈善計劃，或者由於我們的患者保護政策而大幅減少的金額。因此，沒有保險的患者無法獲得太多收入。

Ryan Langston, TD Cowen.

瑞安·蘭斯頓（Ryan Langston），TD Cowen。

Can you give us an update on the commercial contracting percentages over the next couple of years, I guess, in terms of what's already negotiated and what's still kind of hanging out there. And then CapEx, we heard from several larger nonprofits that the outlook is very uncertain they're taking a pretty cautious approach, maybe in some cases, cutting budgets. I guess is there a scenario where you see that in your markets and actually ramp up capital spending to try to capture some of that market share maybe longer term?

我想，您能否向我們介紹一下未來幾年商業承包百分比的最新情況，包括已經談判的內容和仍懸而未決的內容。然後是資本支出，我們從幾個較大的非營利組織那裡聽說，前景非常不確定，他們採取了相當謹慎的態度，在某些情況下可能會削減預算。我想，是否存在這樣一種情況，即您在市場中看到了這種情況，並實際上增加了資本支出，試圖在長期內佔領部分市場份額？

So our managed care contracting to date, we're largely done for '25. For 26, we're about 80% contracted, again, achieving the targets that we had established for each of those contracts. And we're about 1/3 of the way through '27, again, achieving the targets that we had assigned to those specific contracts.

因此，到目前為止，我們的管理式醫療承包在 25 年內基本完成。對於 26 份合同，我們已經簽訂了約 80% 的合同，再次實現了我們為每份合約設定的目標。我們已經完成了 27 年計畫的三分之一，再次實現了我們為這些特定合約設定的目標。

So we're pleased with where we are in our contracting cycle. We continue to try to work with the payers to create value for them, easy access for their beneficiaries. And then as Mike alluded to, eliminating some of the administrative friction and cost for both them and us creating a better experience for our patients and a better experience for their members and even our physicians who participate in the process.

因此，我們對目前的承包週期感到滿意。我們將繼續努力與付款人合作，為他們創造價值，為受益者提供便利的醫療服務。然後，正如麥克所提到的，消除他們和我們的一些行政摩擦和成本，為我們的患者創造更好的體驗，為他們的成員甚至參與過程的醫生創造更好的體驗。

So that's where we are on the managed care side, and I'm pleased with our position at this particular juncture. With respect to capital expenditures, the company is continuing to operate on the inpatient side at north of 70% occupancy, maybe 73%, 74% occupancy year-to-date. We have, as I mentioned, $5.5 billion worth of capital that has been approved that is in the pipeline under construction and should come online later this year, next year and on into '27.

這就是我們在管理式醫療方面的現狀，我對我們目前所處的地位感到滿意。就資本支出而言，該公司繼續在住院方面運營，今年迄今的入住率在 70% 以上，可能為 73% 或 74%。正如我所提到的，我們已經批准了價值 55 億美元的資本，這些資本正在建設中，預計將在今年稍後、明年以及 2027 年投入使用。

And we continue to see opportunities for us to add to our networks, as I mentioned. I think we're today, I don't know, close to 2,700 facilities in our company. We continue to add facilities both through greenfield projects as well as acquisitions where we can and we will look for those as well. As it relates to competitive dynamics, we do think there are opportunities for us to accelerate investments in certain situations and put ourselves in a better position to achieve our objectives, and we will sort through those in the normal course. But I don't see anything necessarily positioning a rapid acceleration in our spending to accomplish that.

正如我所提到的，我們繼續看到擴大我們網路的機會。我認為我們今天公司有近 2,700 個設施。我們將繼續透過綠地項目和收購來增加設施，我們也會尋找這些。就競爭動態而言，我們確實認為，在某些情況下，我們有機會加快投資，使自己處於更有利的位置來實現我們的目標，我們將在正常過程中對這些進行分類。但我認為沒有必要透過快速增加支出來實現這一目標。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Okay. Great. I just wanted to go back to kind of think about the exchange subsidy exploration. There's a few dynamics in there. I guess, one is, can you just remind us what your exchange revenue was a percent total back in 2019 before these enhanced subsidies were in place?

好的。偉大的。我只是想回過頭來思考交易所補貼的探索。其中有一些動態。我想，首先，您能否提醒我們，在實施這些增強補貼之前，2019 年您的外匯收入佔總收入的百分比是多少？

And I guess is there any reason to think that, that wouldn't drop back down to that level? And you mentioned that there was the potential that, that might drop many of those people might show up on commercial. Can you -- is there any way to kind of go back and look and see historically, if there was a shift out of commercial when exchange grew and maybe help quantify what that looks like.

我想，有什麼理由認為它不會回落到那個水平嗎？您提到，這可能會導致許多出現在商業廣告中的人減少。你能不能——有沒有什麼方法可以回顧歷史，看看當交易成長時是否出現了商業轉移，並可能幫助量化這種情況。

Kevin, as we noted in the call, we're going to be we're not going to really give that kind of detail right now. It's pretty difficult to size that at this point. So as we get through the balance of this year, and we have a better understanding of what happens to And a little better understanding of how we think the population will react to what happens.

凱文，正如我們在電話中提到的，我們現在不會透露這類細節。目前很難確定其大小。因此，當我們度過今年的平衡時，我們會更好地了解將會發生什麼，並且更了解我們認為人民將如何應對所發生的事情。

We'll be in a better position on our fourth quarter call to address those more detailed questions at this point. I'll just note again that we're at 8% of volume now with a little bit over 10% of revenues at this.

我們將在第四季度的電話會議上更好地解答這些更詳細的問題。我再強調一下，我們現在的銷售量佔比為 8%，營收佔比略高於 10%。

Okay. And then maybe you can just clarify, did I hear you say earlier that you think that between the bill and the exploration of the subsidies over the longer term, you still expect to grow EBITDA 4% to 6%, so like a 5-year plus time horizon. Even with the impacts of all these things, you'll still grow EBITDA in that range, that's the expectation?

好的。然後也許您可以澄清一下，我是否聽到您之前說過，您認為在法案和長期補貼探索之間，您仍然預計 EBITDA 將增長 4% 至 6%，因此時間跨度為 5 年以上。即使受到所有這些因素的影響，您的 EBITDA 仍將在該範圍內成長，這是預期嗎？

No, it's good. Let me go back through that just so that it's clear on what we said. So as it relates to the active in the near term, we believe that our financial resiliency program should offset the exchange provisions in the app. In the longer term, as it relates to the Act specifically with both the delayed start and the phased-in nature of these provider tax and STP reforms, along with the potential of the approval of the submitted supplemental payment applications.

不，很好。讓我再重複一遍，以便更清楚地了解我們所說的內容。因此，就其與短期活動相關而言，我們認為我們的財務彈性計劃應該可以抵消應用程式中的兌換規定。從長遠來看，它與該法案有關，特別是這些提供者稅和 STP 改革的延遲啟動和分階段實施，以及提交的補充支付申請獲得批准的可能性。

We believe ACA will be able to generally manage these impacts with our resiliency efforts without material impacts to our long-term guidance. And then regarding the EPDC as you know, we do not know what the outcome will be at this point. But we are working to develop resiliency programs to offset as much as possible any adverse impact should they expire. And so we will roll all that together, Kevin, has noted when we comment further when we issued our 2016 guidance on our fourth quarter 2025 earnings call.

我們相信，ACA 將能夠透過我們的彈性努力整體上管理這些影響，而不會對我們的長期指導產生重大影響。關於 EPDC，如您所知，我們目前還不知道結果會是什麼。但我們正在努力開發彈性計劃，以盡可能抵消它們到期時產生的任何不利影響。因此，我們將把所有這些結合起來，凱文在我們在 2025 年第四季財報電話會議上發布 2016 年指引時進一步評論時指出。

Okay. That's helpful. So the mitigation is both the -- your actions and the additional SDP approvals combined. That's what is your confidence in the.

好的。這很有幫助。因此，緩解措施是您的行動和額外的 SDP 批准的組合。這就是你的信心所在。

Yes, I'll say.

是的，我會這麼說。

Raj Kumar, Stephens.

拉吉·庫馬爾，史蒂芬斯。

I just have one on kind of framed the $600 million to $800 million of targeted savings that you had over the years when you did that during the Investor Day. Just kind of bogey where we're kind of at from those cost entities standpoint, given that we're kind of like 1.5 years into that five-year outlook -- and maybe if you've identified any additional opportunities to bolster the financial resilience initiatives kind of given the policy and knowns that we have over the next couple of years?

我只是大致估算了一下，您在投資者日期間所做的這些年來所實現的 6 億到 8 億美元的目標儲蓄。從成本實體的角度來看，我們目前所處的狀況有點令人擔憂，因為我們已經進入了五年期展望的 1.5 年了——也許您是否已經發現了任何其他機會，可以根據我們未來幾年的政策和已知信息來加強金融彈性舉措？

So we -- as we noted in our Investor Day conference at the end of '23, we've been hard at work developing our resiliency program really across three main categories where you may recall from the presentation. The first one is around benchmarking. And and really getting to ground and benchmarking both our corporate and shared service functions against the rest of the 400 and then helping our facilities benchmark their performance cost a series of both operational and cost metrics to help them find their biggest opportunities for improvement.

因此，正如我們在 23 年底的投資者日會議上所指出的那樣，我們一直在努力開發我們的彈性計劃，實際上涉及三個主要類別，您可能還記得我們在演示中提到過這些類別。第一個是關於基準測試。並真正深入研究並將我們的企業和共享服務功能與其他 400 個功能進行對比，然後幫助我們的設施根據一系列營運和成本指標對其績效成本進行對比，以幫助他們找到最大的改善機會。

And then we leverage our best practices to help them identify those opportunities and take action. And so that's benchmarking. The significant efforts in flight around both automation and digital transformation that we commented on this before. but our digital transformation agenda includes a series of focused areas in our administrative platforms and in our operational platforms that we believe holds significant promise as we move forward.

然後我們利用我們的最佳實踐來幫助他們識別這些機會並採取行動。這就是基準測試。我們之前評論過圍繞自動化和數位轉型所做的重大努力。但我們的數位轉型議程包括管理平台和營運平台中的一系列重點領域，我們相信這些領域在我們前進的過程中具有巨大的前景。

And really third is just continuing to better leverage our shared service platforms. And we're adding additional functions over time. to our shared service platforms to really drive that benefit of scale of standardization and best practice as we move forward. Really, since the Investor Day meeting, and as we've gone through the last 12 to 18 months, in light of these potential challenges, we have both accelerated and enhanced these efforts.

第三就是繼續更好地利用我們的共享服務平台。並且，我們會隨著時間的推移為我們的共享服務平台添加更多功能，以便在我們前進的過程中真正推動標準化和最佳實踐的規模效益。確實，自投資者日會議以來，以及過去 12 到 18 個月以來，鑑於這些潛在的挑戰，我們已經加快並加強了這些努力。

And so as we have gone through this year, we've been working very carefully with all of our teammates and colleagues across the company to ensure that we're identifying our best opportunities and then take action as we go through the balance of this year and into 2016 and beyond. And so that's a quick update of where we are on our resiliency program -- and again, as we noted, earn the call, we'll give a more fulsome update on that when we give guidance on our fourth quarter call.

因此，在這一年中，我們一直與公司所有團隊成員和同事密切合作，以確保我們能夠找到最佳機會，並在今年餘下的時間以及 2016 年及以後採取行動。這就是我們彈性計畫進度的快速更新——同樣，正如我們所提到的，在第四季度電話會議上提供指導時，我們將對此進行更全面的更新。

Andy, I think we have time for just one more question.

安迪，我想我們還有時間再問一個問題。

Lance Wilkes, Bernstein.

蘭斯威爾克斯、伯恩斯坦。

Could you talk a little bit about compensation ratio and labor supply? And talk a little on overall, how you're managing that so well if there are outlooks as far as how you're changing the number of employees relative to were you seeing with wage inflation? And if there are any expectations that you could give us for contracts and wage inflation for the second half of the year?

能否談一下薪資比例和勞動力供應問題？請您整體談談，您是如何管理得這麼好的，如果您看到員工人數隨薪資上漲而變化，您對此有何看法？您對下半年的合約和薪資通膨有什麼預期嗎？

As we noted and even on the first quarter call, we're seeing a pretty stable labor environment, Lance and our wage inflations are coming in about where we expected them to be. I think we've noted before, we've seen a pretty significant improvement in our contract labor as a percent of SWB here over the last several quarters as we kind of worked off of the pandemic and moved through that in a productive way.

正如我們在第一季電話會議上所指出的，我們看到勞動力環境相當穩定，蘭斯，我們的薪資通膨也達到了我們預期的水平。我想我們之前已經注意到，在過去幾個季度中，隨著我們擺脫疫情並以富有成效的方式度過難關，我們的合約工佔 SWB 的百分比有了相當顯著的改善。

We're down now to 4.3%. Contract labor is 4.3% of SPB. And if you go back to the for the pending, I think it was like $1 million at 4.1%, 4.2% in that range. So we're -- I still think there's some room for improvement, and we're working hard on that, both in terms of better retention and better recruiting -- but I do think that just at a macro level, the clinical labor side is pretty stable. I mean I would note, we've talked about this before that -- the one area of our workforce is still a bit elevated in cost pressures as our physician cost.

現在已降至 4.3%。合約工佔 SPB 的 4.3%。如果你回顧一下未決事項，我認為它大約是 100 萬美元，利率在 4.1% 到 4.2% 之間。所以，我認為我們仍有改進的空間，我們正在為此努力，無論是在更好地保留員工還是更好地招募員工方面，但我確實認為，從宏觀層面來看，臨床勞動力方面是相當穩定的。我的意思是，我想指出，我們之前已經討論過這個問題——我們勞動力的一個領域仍然面臨一些成本壓力，因為我們的醫生成本。

Our same facility professional fees did increase about 10% over the prior-year, which is about what we expected. So that component of the business, we're still dealing with some greater than inflationary levels, cost pressure. But -- on the pure labor side, I think we're in good shape.

我們相同的設施專業費用確實比前一年增加了約 10%，這與我們的預期差不多。因此，對於該業務部分，我們仍然面臨著高於通膨水準的成本壓力。但是——就純勞動力方面而言，我認為我們狀況良好。

That concludes our question-and-answer session. I will now turn the conference back over to Mr. Frank Morgan for closing remarks.

我們的問答環節到此結束。現在我將會議交還給弗蘭克·摩根先生，請他致閉幕詞。

Amy, thank you for your help today, and thanks, everyone, for joining us on the call. We hope you have a great weekend and we're certainly around to answer follow-up questions if you think an thanks.

艾米，謝謝你今天的幫助，也謝謝大家參加我們的電話會議。我們希望您度過一個愉快的週末，如果您願意的話，我們一定會回答您的後續問題。

And ladies and gentlemen, this concludes today's call, and we thank you for your participation. You may now disconnect.

女士們、先生們，今天的電話會議到此結束，感謝你們的參與。您現在可以斷開連線。