InnovAge Holding Corp (INNV) 2024 Q3 法說會逐字稿

Good day and thank you for standing by, and welcome to the innovation Third Quarter 2024 earnings conference call. At this time, all participants are in a listen only mode after the speakers' presentation, there will be a question and answer session to ask a question. During the session, you'll need to press star one one on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star one again. Please be advised that today's conference is being recorded. I would now like to turn the conference over to your speaker for today, ryan Covanta, Director of Investor Relations. Please go ahead.

美好的一天，感謝您的支持，歡迎參加創新 2024 年第三季財報電話會議。此時，所有參與者都處於只聽模式，在演講者演講後，將有一個問答環節來提問。在會議期間，您需要在電話上一一按星號。然後您將聽到一條自動訊息，建議您舉手。若要撤回您的問題，請再次按星號一。請注意，今天的會議正在錄製中。現在我想將會議交給今天的發言人，投資者關係總監瑞安·卡萬塔 (ryan Covanta)。請繼續。

Thank you, operator. Good afternoon, and thank you all for joining the innovation fiscal 2024 third quarter earnings call. With me today is Patrick Blair, President and CEO, and Ben Adams, CFO, Dr. Rich Pfeiffer, Chief Medical Officer, will also be Joining in the Q&A portion of the call today after the market closed, we issued a press release containing detailed information on our quarter results for our fiscal third quarter 2024. You may access the release on the Investor Relations section of our company website, Inivata.com. For those listening to the rebroadcast of this call, we remind you that the remarks made herein are as of today, Tuesday, May 7, 2024, and have not been updated subsequent to this call.

謝謝你，接線生。下午好，感謝大家參加創新 2024 財年第三季財報電話會議。今天與我在一起的還有總裁兼首席執行官帕特里克·布萊爾(Patrick Blair)、首席財務官本·亞當斯(Ben Adams)、首席醫療官Rich Pfeiffer 博士，他們也將在今天收市後參加電話會議的在問答部分，我們發布了一份新聞稿，其中包含詳細資訊有關 2024 年第三財季季度業績的資訊。您可以在我們公司網站 Inivata.com 的投資者關係部分存取新聞稿。對於那些收聽本次電話會議重播的人，我們提醒您，本文中的言論截至今天（2024 年 5 月 7 日星期二），並且在本次電話會議之後尚未更新。

During our call, we will refer to certain non-GAAP measures. A reconciliation of these measures to the most directly comparable GAAP measures can be found in our earnings press release posted on our web. We will also be making forward-looking statements, including statements related to our full fiscal year projections, future growth prospects for the de novo centers, our acquisition of Concerto care pace, our payer capabilities and clinical value initiatives, the status of current and future regulatory actions and other expectations. Listeners are cautioned that all of our forward-looking statements involve certain assumptions that are inherently subject to risks and uncertainties that can cause our actual results to differ materially from our current expectations. We advise listeners to review the risk factors discussed in our Form 10-K annual report for fiscal year 2023, and our subsequent reports filed with the SEC, including our most recent quarterly report Form 10-Q . After the completion of our prepared remarks, we will open the call for questions.

在我們的電話會議中，我們將參考某些非公認會計原則措施。這些指標與最直接可比較的 GAAP 指標的調整可以在我們網站上發布的收益新聞稿中找到。我們還將做出前瞻性聲明，包括與我們的整個財年預測、de novo 中心的未來成長前景、我們對Concerto carepace 的收購、我們的付款人能力和臨床價值計劃、當前和未來的狀況相關的聲明。請聽眾注意，我們所有的前瞻性陳述都涉及某些假設，這些假設本質上會受到風險和不確定性的影響，這些風險和不確定性可能導致我們的實際結果與我們目前的預期有重大差異。我們建議聽眾查看我們 2023 財年 10-K 表格年度報告以及我們向 SEC 提交的後續報告（包括我們最新的 10-Q 表格季度報告）中討論的風險因素。在完成我們準備好的發言後，我們將開始提問。

I will now turn the call over to our President and CEO, Patrick Blake. Patrick?

我現在將把電話轉給我們的總裁兼執行長帕特里克·布萊克。派崔克？

Thank you, Ryan, and good afternoon to everyone. I want to begin by expressing my gratitude to our colleagues, participants, government partners in the investor community who supported of age.

謝謝你，瑞安，祝大家下午好。首先，我要向支持年齡的投資人界同事、參與者、政府合作夥伴表示感謝。

I'd also like to thank those of you who attended our first Investor Day in late February. We believe it effectively reintroduced the Company including the investment thesis, how we're different than other value-based care models and this unique inflection point in the company's history, given the internal transformation over the last two years, the company's third quarter results were largely consistent with our expectations. We continue to see ongoing performance improvement in every facet of our operations, which is driving greater stability in our financial results and increased confidence in our ability to deliver high-quality care and a great participant experience while also growing our top and bottom line.

我還要感謝參加二月下旬首屆投資者日活動的人們。我們相信，它有效地重新介紹了公司，包括投資主題、我們與其他基於價值的護理模式的不同之處以及公司歷史上的這一獨特拐點，考慮到過去兩年的內部轉型，公司第三季度業績為與我們的預期基本一致。我們繼續看到我們營運各個方面的績效不斷提高，這推動了我們財務表現的穩定性，增強了我們對提供高品質護理和良好參與者體驗的能力的信心，同時也提高了我們的收入和利潤。

As discussed on prior earnings calls, we normally experience seasonality in the third quarter this year, it was exacerbated because of what we believe to be a few moment in time drivers, which I'll cover in a moment. Critically, when we look at the momentum of our business. Just from the top down, we're pleased to see the steady growth in the demand for pay services. We're confident in the industry tailwinds and the unique benefits to the stakeholders that pays off.

正如之前的財報電話會議中所討論的那樣，我們通常會在今年第三季度經歷季節性因素，但由於我們認為存在一些臨時驅動因素，這種情況會加劇，我稍後會介紹這一點。至關重要的是，當我們審視我們業務的勢頭時。從上到下，我們很高興看到付費服務需求的穩定成長。我們對產業的順風和利害關係人獲得回報的獨特利益充滿信心。

With respect to quarterly financials, we reported revenue of $193 million for the quarter, an increase of approximately 2% compared to the second quarter and center level contribution margin of $34 million, which represents a 17.6% margin and is generally consistent with the second quarter adjusted EBITDA was $3.6 million for the quarter.

就季度財務數據而言，我們報告本季營收為 1.93 億美元，較第二季成長約 2%，中心級貢獻利潤率為 3,400 萬美元，利潤率為 17.6%，與第二季基本一致本季度調整後EBITDA 為360 萬美元。

Importantly, in the quarter, we incurred increased denovo losses as we are now open in Tampa and Orlando. And you'll recall last quarter's results included a one-time risk adjustment true-up benefit, making this sequential progression less comparable. On a year-over-year basis, quarterly revenue has increased by approximately 12% and adjusted EBITDA was up $5.6 million from a quarterly loss of approximately $2 million in the third quarter of fiscal year '23.

重要的是，在本季度，由於我們現在在坦帕和奧蘭多開業，我們的新損失增加了。您會記得上一季的結果包括一次性風險調整調整收益，使得這項連續進展的可比性降低。與去年同期相比，季度營收成長了約 12%，調整後的 EBITDA 比 2023 財年第三季約 200 萬美元的季度虧損增加了 560 萬美元。

Census increased to 6,820, which represents a quarter-over-quarter improvement of approximately 1%. Overall, our results reflect solid performance in the areas of top line growth, medical cost management center level staffing costs in SG&A. We remain focused on day-to-day execution and exiting fiscal year '24 with solid earnings momentum. The portfolio of initiatives that we've launched over the past two years are creating tangible impact that we're seeing translate into earnings.

人口普查人數增加至 6,820 人，較上季增加約 1%。整體而言，我們的績效反映出在營收成長、SG&A 醫療成本管理中心級人員成本等領域的穩健表現。我們仍專注於日常執行和以穩健的獲利動能結束 24 財年。我們在過去兩年中推出的一系列舉措正在產生切實的影響，我們看到這些影響已轉化為收益。

As we discussed at our Investor Day, we continue to challenge ourselves to continuously identify new value creation opportunities at the center level with the goal of achieving an overall central level contribution margin of 20% or more over time. While we now operate 20 centers across 6 states, including the opening of Orlando sooner, which occurred on April 1, health care is delivered locally and their differentiated opportunities and challenges to address it.

正如我們在投資者日討論的那樣，我們將繼續挑戰自我，不斷在中心層面尋找新的價值創造機會，目標是隨著時間的推移實現中心層面整體貢獻率達到 20% 或更高。雖然我們現在在 6 個州經營 20 個中心，包括 4 月 1 日早些時候開設的奧蘭多中心，但醫療保健是在當地提供的，解決這個問題的機會和挑戰也各不相同。

We are bringing best practices to centers into departments with incentives that we believe can be improved. We are pleased with our recent work in this area. We are starting to see the contribution margin impact, and we have confidence that we will achieve our future goals.

我們正在將最佳實踐引入各個部門，並提供我們認為可以改進的激勵措施。我們對最近在該領域的工作感到滿意。我們開始看到邊際貢獻的影響，我們有信心實現未來的目標。

We also remain focused on our five pillar performance management framework, which uses a balanced scorecard to assess our delivery of high-quality compliant care in a financially responsible way. We used the five pillar metrics to track operational performance at the center and enterprise level, and we link our management incentive program to the results.

我們也繼續關注我們的五支柱績效管理框架，該框架使用平衡計分卡來評估我們以對財務負責的方式提供的高品質合規護理。我們使用五個支柱指標來追蹤中心和企業層面的營運績效，並將我們的管理激勵計畫與結果連結起來。

Our strong performance against our target metrics continued this quarter as a couple of examples, our participant experience, which is measured by Net Promoter Score, was 46 in fiscal year '24 against a target of 35. Our proprietary quality composite score was 4.2, which is slightly above our target level of 4 out of 5 stars. We believe the continued strong performance in the pillars of employee engagement, participant satisfaction care quality and compliance are an excellent leading indicator for future growth and financial performance.

舉幾個例子，本季我們的目標指標持續保持強勁表現，我們的參與者體驗（以淨推薦值衡量）在 24 財年為 46 分，而目標為 35 分。我們專有的品質綜合得分為 4.2，略高於我們的 4 顆星（滿分為 5 顆星）的目標水準。我們相信，員工敬業度、參與者滿意度、護理品質和合規性等支柱的持續強勁表現是未來成長和財務表現的出色領先指標。

Now turning to the details on the quarter, you'll recall last quarter and during our Investor Day, we touched on anticipated third quarter seasonality this quarter. Seasonality was exacerbated by several moment in time factors. We continue to experience ongoing enrollment processing delays in Colorado in part due to the competing priorities of Medicaid redeterminations.

現在轉向本季度的詳細信息，您會記得上個季度和在我們的投資者日期間，我們談到了本季度預期的第三季度季節性。幾個時刻因素加劇了季節性。我們在科羅拉多州繼續經歷持續的註冊處理延遲，部分原因是醫療補助重新確定的優先事項相互競爭。

As a reminder, the barriers we are experiencing include state enrollment, resource constraints post public health emergency policy changes that now require in-person level of care assessments versus telephonic and new state vendors who are still ramping up to targeted services. While these delays do not affect the eligibility of potential participants, the protracted nature of the enrollment process and delays have resulted in some prospects opting to pursue other service options.

提醒一下，我們遇到的障礙包括州註冊、公共衛生緊急政策變化後的資源限制，現在需要面對面的護理評估，而不是電話和新的州供應商仍在增加有針對性的服務。雖然這些延遲不會影響潛在參與者的資格，但註冊過程和延遲的長期性導致一些潛在參與者選擇尋求其他服務選項。

We continue to work with the state to resolve these issues as quickly as possible. Additionally, due to physician and nurse practitioner staffing, vacancies and recruitment challenges in our Sacramento and San Bernardino centers, we made the proactive decision to temporarily slow the rate of enrollment despite market demand that surpassed expectations to ensure the workload of onboarding new enrollment matched our primary care staffing well, certainly more seniors remains a top priority.

我們將繼續與國家合作，盡快解決這些問題。此外，由於薩克拉門托和聖貝納迪諾中心的醫生和護士執業人員配備、職位空缺和招聘挑戰，儘管市場需求超出預期，但我們仍主動決定暫時放慢註冊率，以確保新註冊的工作量與我們的工作量相符。

Ensuring we deliver a high quality participant experience is Bedrock to our responsible growth strategy. We have now filled the open positions and have resumed normal enrollment tempo this year. We also experienced an unusually competitive environment due to the richness of the Medicare Advantage supplemental benefits when compared to past annual enrollment periods.

確保提供高品質的參與者體驗是我們負責任的成長策略的基石。我們現已填補了空缺職位，並在今年恢復了正常招生節奏。與過去的年度投保期相比，由於 Medicare Advantage 補充福利的豐富性，我們也經歷了異常競爭的環境。

The amount has increased materially from years past and a breadth of where cash benefits can be spent has expanded as well. As a result, we believe this had a marginal impact on both our ability to enroll new participants and a higher number of existing participants who did enroll for an alternative plan. We have strong conviction that the integrated and personalized nature of the PACE model offers a superior value proposition.

與過去幾年相比，金額大幅增加，現金福利的支出範圍也擴大了。因此，我們認為這對我們招募新參與者的能力以及更多已註冊替代計劃的現有參與者的能力產生了邊際影響。我們堅信，PACE 模型的整合和個人化本質提供了卓越的價值主張。

Frail seniors are struggling to maintain their independence when compared to other Medicare Advantage options in our enrollment and operation teams are working to educate our participants potential participants on the benefits of pets. We also believe that margin pressure, which is recently materialized across the MA industry will result in a reduction of MA value-added benefits in 2025, which will only enhance our relative content.

與其他 Medicare Advantage 選項相比，體弱的老年人正在努力保持獨立性，我們的註冊和營運團隊正在努力向我們的參與者提供有關寵物好處的潛在參與者的教育。我們也認為，最近整個 MA 產業出現的利潤率壓力將導致 2025 年 MA 增值效益減少，這只會提高我們的相對含量。

Despite these temporary headwinds, the overall demand for our services has continued to grow, as evidenced by a sequential increase in sales, qualified leads of 10% with the total number, reaching over 1,600 leads in the third quarter. This underpins our ongoing confidence that far more individuals are interested in pace, and we are enrolling on the de novo front. We're excited to announce that were operational at our new Orlando Center like Tampa.

儘管存在這些暫時的不利因素，但對我們服務的整體需求仍在持續增長，銷售額連續增長就證明了這一點，合格的潛在客戶佔總數的10%，在第三季度達到了1,600 多個潛在客戶。這支撐了我們持續的信心，即越來越多的人對速度感興趣，我們正在從頭開始。我們很高興地宣布，我們的新奧蘭多中心（如坦帕中心）已投入營運。

This new state-of-the-art facility has the capacity to serve approximately 1,300 participants at maturity. Enrollment efforts are underway and job number one is to begin expanding access to the many deserving eligible participants in the communities. We're hosting a grand opening on May 29 to bring awareness to celebrate this important milestone in Orlando in our recently acquired crucial California center. We're encouraged to see momentum build under our ownership as Q3 enrollment began to ramp in line with our expectations.

這個最先進的新設施成熟後能夠為大約 1,300 名參與者提供服務。報名工作正在進行中，首要任務是開始擴大社區中許多值得參加的合格參與者的參與。我們將於 5 月 29 日在我們最近收購的加州重要中心舉辦盛大的開幕典禮，以慶祝奧蘭多這一重要的里程碑。隨著第三季入學人數開始按照我們的預期增加，我們很高興看到我們所有權下的勢頭不斷增強。

On the regulatory front, we're pleased to report that our post sanction monitoring in Colorado, which was initiated in January of 2023, has been closed out by CMS. We continue to engage with the state of Colorado to finalize the outstanding process.

在監管方面，我們很高興地報告，我們於 2023 年 1 月啟動的科羅拉多州制裁後監控已被 CMS 終止。我們將繼續與科羅拉多州合作，以完成未完成的流程。

Our last call, we touched on the ongoing activities in our San Bernardino center with the California Department of Healthcare Services. DHCS. conducted their targeted medical review in March, and we await notification on a date for the exit interview.

我們的最後一次電話會議涉及了我們的聖貝納迪諾中心與加州醫療服務部正在進行的活動。DHCS。三月進行了有針對性的醫療審查，我們正在等待離職面談日期的通知。

Regarding Sacramento, we submitted proposed corrective actions to DHCS. in March and at the beginning of this month, CMS officially closed its portion of the <unk>. We are awaiting feedback from DH following resolution of the audits and corrective actions in California. We expect to resume discussions with the state regarding their downing and Bakersfield expansion plans.

關於薩克拉門托，我們向 DHCS 提交了擬議的糾正措施。在3月和本月初，CMS正式關閉了其的部分。在加州的審計和糾正措施得到解決後，我們正在等待衛生署的回饋。我們預計將恢復與州政府就其擊落和貝克斯菲爾德擴張計劃進行討論。

Turning to operating performance, we continue to see improvement in our management of external medical costs as evidenced by a sequential decrease in participant expense PMPM from $3,903 last quarter to $3,823 this quarter, which represents an approximately 2% improved. The largest driver of our sequential improvement was the decrease of permanent placement nurses.

就營運績效而言，我們繼續看到我們對外部醫療成本的管理有所改善，參與者費用 PMPM 連續下降，從上季度的 3,903 美元降至本季度的 3,823 美元，相當於提高了約 2%。我們連續改善的最大驅動力是永久安置護理人員的減少。

As discussed on previous calls, our goal is to have our population reflect the population of the communities we serve. And these communities are made up of a mix of people that are living independently, those that are receiving some type of support of housing and those in an institutional setting. As we continue to enroll new participants who are living independently in the community, we're seeing a decrease in the percentage of our participants permanently residing in nursing homes we believe this change in the composition of living situation demonstrates a modest improvement in risk mix relative to where we were while under enrollment restrictions.

正如先前電話會議中所討論的，我們的目標是讓我們的人口反映我們所服務的社區的人口。這些社區由獨立生活的人、接受某種類型住房支持的人以及生活在機構環境中的人組成。隨著我們繼續招募在社區中獨立生活的新參與者，我們發現永久居住在療養院的參與者的比例有所下降，我們相信生活狀況構成的這種變化表明風險組合相對的適度改善到我們在入學限制期間所處的位置。

Said differently, our mix is migrating back in line with the underlying assumptions used to derive our rates over time. Improved mix should help offset external medical cost trends while supporting independent living goals. Cms or state parts additionally, we piloted an end-of-life Comfort Care program in Denver, which supports our participants with palliative care expertise and 24/7 access to our own team of nurses. As a means of improving participant experience while also reducing lower-value external hospice costs.

換句話說，隨著時間的推移，我們的組合正在重新符合用於得出利率的基本假設。改善組合應有助於抵消外部醫療成本趨勢，同時支持獨立生活目標。此外，Cms 或州部分，我們在丹佛試行了一項臨終舒適護理計劃，該計劃為我們的參與者提供安寧療護專業知識和 24/7 與我們自己的護理團隊聯繫的機會。作為改善參與者體驗的一種手段，同時也減少低價值的外部臨終關懷成本。

In addition to better coordination with our interdisciplinary care team and participant and family satisfaction program reduced external spend by 43% from the baseline in November, while improving overall quality of care, we're currently developing the business case to scale this program to other markets.

除了與我們的跨學科護理團隊和參與者進行更好的協調外，家庭滿意度計劃還使外部支出較11 月份的基線減少了43%，同時提高了整體護理質量，我們目前正在開發業務案例，將該計劃擴展到其他市場。

Our portfolio of clinical value initiatives or CDI.s, as we refer to them internally are performing in line with our expectations. As you would expect, some are ahead of plan and there are a few which were delayed, and we don't anticipate seeing the run rate benefits until fiscal year 2025.

我們內部所稱的臨床價值措施或 CDI.s 組合的表現符合我們的預期。正如您所料，有些項目提前於計劃，有些項目則被推遲，我們預計要到 2025 財年才能看到運行率的改善。

Further, we're seeing improvement in our center level staffing ratios, which has improved approximately by 5% relative to where we started the fiscal year, while holding our quality and compliance resources constant during a period with the same level of CMS and state auditing activity. Recall senior-level staffing ratios were negatively impacted by the effect sanctions had on our census and because of the additional internal and external resources required to meet the demands of the.

此外，我們看到我們的中心級人員配備比例有所改善，與本財年開始時相比，提高了約5%，同時在CMS 和國家審計水平相同的時期內保持我們的品質和合規資源不變活動。回想一下，制裁對我們的人口普查的影響以及由於滿足人口普查的要求所需的額外內部和外部資源，對高級人員配置比例產生了負面影響。

In summary, we believe we are continuing to improve the business every quarter, the combined effect of our broad set of initiatives in the areas of top line growth, cost management, quality and compliance over the course of the past two years is accelerating as evidenced by our improving results. We will continue our tireless efforts to make each central better every day at the centers of the heart of our business.

總而言之，我們相信我們每個季度的業務都在持續改善，過去兩年我們在營收成長、成本管理、品質和合規性領域採取的一系列舉措的綜合效應正在加速，這一點有證據表明透過我們不斷改進的成果。我們將繼續不懈努力，使我們業務核心的每個中心每天都變得更好。

And with that, I'll turn it over to Bill to walk through our quarterly financial performance.

接下來，我將把它交給比爾，讓他詳細介紹我們的季度財務表現。

Thank you, Badree. Have today. I'll provide some highlights from our third quarter fiscal year 2024 financial performance and insight into some of the trends we are seeing in the quarter. While it is still early in our margin improvement initiatives, we continue to track to our internal targets, and we are pleased with our progress and with the opportunity for additional margin recapture.

謝謝你，巴德里。有今天。我將提供 2024 財年第三季財務業績的一些亮點，以及我們在本季看到的一些趨勢的見解。雖然我們的利潤率改善計劃仍處於早期階段，但我們將繼續追蹤我們的內部目標，我們對我們的進展和重新獲得額外利潤的機會感到滿意。

Starting with census, we served approximately 6,820 participants across 19 centers as of March 31, 2024, which represents quarter-over-quarter growth of 0.7%. We reported 20,360 member months in the third quarter, 1.2% increase over the second quarter.

從人口普查開始，截至 2024 年 3 月 31 日，我們為 19 個中心的約 6,820 名參與者提供了服務，環比增長了 0.7%。我們報告第三季會員月數為 20,360 人，比第二季成長 1.2%。

This reflects the anticipated third quarter enrollment softness. As Patrick discussed, total revenue of $193.1 million increased 2.2% compared to the second quarter, due primarily to an increase in member months, coupled with an increase in Medicare capitation rates this was partially offset by a California rate decrease of approximately 2.5% effective January 1, 2024, and the one-time Medicare true up outside the regular payment cycle that was recorded in the second quarter. We incurred $100 million of external provider costs during the third quarter of fiscal 2024 a 1% decrease compared to the second quarter. The sequential decrease was primarily driven by lower permanent nursing facility utilization, resulting in a decrease in cost per participant, partially offset why an increase in member wants cost of care, excluding depreciation and amortization of $59.1 million increased 8.8% compared to the second quarter.

這反映了預期的第三季招生疲軟。正如帕特里克所討論的，總收入為1.931 億美元，與第二季度相比增長了2.2%，這主要是由於會員月數的增加，加上Medicare 人頭費率的增加，部分被加州費率從1月起下降約2.5% 所抵銷。2024 財年第三季度，我們產生了 1 億美元的外部供應商成本，比第二季度下降了 1%。環比下降主要是由於永久性護理設施利用率較低，導致每位參與者的成本下降，部分抵消了會員想要護理成本增加的原因，不包括折舊和攤銷，5910萬美元與第二季度相比增長了8.8%。

The increase was due to higher cost per participant coupled with an increase in member months. The cost per participant increase was driven by an increase in salaries, wages and benefits due to higher headcount and increased wage rates associated with the annual reset of employee benefits and tax, an increase in software license fees associated with a new pharmacy software program that we rolled out in January. You know, occupancy and administrative costs associated with our new Crenshaw and Bakersfield centers acquired in the Concerto care piece acquisition and third party expenses associated with the annual Part D bid creation and the retrospective coding review central level contribution margin, which we define as total revenue, less external provider costs and cost of care, excluding depreciation and amortization, was $34 million for the quarter compared to $33.6 million in the second quarter.

增加的原因是每位參與者的成本增加以及會員月數的增加。每位參與者的成本增加是由於員工人數增加以及與員工福利和稅收年度重置相關的工資率增加導致薪水、工資和福利的增加，以及與我們新的藥房軟體程式相關的軟體許可費的增加。您知道，與我們在Concerto 護理件收購中收購的新克倫肖和貝克斯菲爾德中心相關的佔用和管理成本，以及與年度D 部分投標創建和回顧性編碼審查中央級貢獻邊際相關的第三方費用，我們將其定義為總收入扣除外部提供者成本和護理成本（不包括折舊和攤提），該季度為 3,400 萬美元，而第二季為 3,360 萬美元。

As a percentage of revenue, central level contribution margin of 17.6% was relatively unchanged compared to 17.8% in the second quarter, sales and marketing expense was $7.2 million, an increase of approximately $1.3 million compared to the prior quarter. The increase was primarily due to increased headcount, coupled with increased marketing spend for our newly opened Tampa center and recently acquired Crenshaw. Corporate, general and administrative expense increased to $27.5 million, a $2.3 million increase compared to the second quarter. The increase was primarily due to an increase in benefits expense due to an annual reset of employee benefits and taxes, an increase in bad debt, an increase in software license and maintenance costs, including user licensing costs associated with Epic and an increase in third-party legal expense. The increase was partially offset by a decrease in costs associated with the Epic conversion that we completed in the second quarter.

從佔收入的百分比來看，中央層級的貢獻率為17.6%，與第二季的17.8% 相比，保持不變；銷售和行銷費用為720 萬美元，比上一季增加了約130 萬美元。這一增長主要是由於員工人數的增加，以及我們新開設的坦帕中心和最近收購的克倫肖的營銷支出的增加。公司、一般和管理費用增加至 2,750 萬美元，比第二季增加 230 萬美元。這一增長主要是由於員工福利和稅收的年度重置導致福利費用增加、壞帳增加、軟體許可和維護成本增加（包括與 Epic 相關的用戶許可成本以及第三方費用增加）。這一增長被我們在第二季度完成的 Epic 轉換相關的成本下降所部分抵消。

Net loss was $5.9 million compared to a net loss of $3.8 million in the second quarter, we reported a net loss per share of $0.04 on both the basic and diluted basis, and our weighted average share count was approximately 135.9 million shares for the quarter on both a basic and fully diluted base. Adjusted EBITDA, which we calculate by adding net interest expense, taxes, depreciation and amortization, M&A and denovo center development expenses and other nonrecurring or exceptional costs to net loss was $3.6 million for the quarter compared to $7.8 million in the second quarter the decrease was due to the one-time Medicare true-up payment in the second quarter, as well as the increase in denovo costs associated with Tampa, Orlando and Crenshaw in the third quarter our adjusted EBITDA margin was 1.9% for the third quarter compared to 4.1% in the second quarter. Denovo losses, which we define as net losses related to preopening and start-up ran through the first 24 months of denovo operation for the third quarter were $4.1 million and primarily related to the recently acquired bakers field and Crenshaw centers and our centers in Florida. This compares to $2.2 million of de novo losses in the second quarter.

淨虧損為 590 萬美元，而第二季的淨虧損為 380 萬美元，我們公佈的基本和稀釋基礎上每股淨虧損為 0.04 美元，本季我們的加權平均股數約為 1.359 億股。和完全稀釋的基礎。調整後EBITDA（我們透過將淨利息費用、稅金、折舊和攤銷、併購和新中心開發費用以及其他非經常性或特殊成本與淨虧損相加計算得出）為360 萬美元，而第二季度為780 萬美元，下降幅度為由於第二季度一次性醫療保險調整付款，以及第三季度與坦帕、奧蘭多和克倫肖相關的從頭成本增加，我們第三季度調整後的EBITDA 利潤率為1.9 %，而第三季為4.1%在第二季。Denovo 虧損（我們將其定義為與開業前和啟動相關的淨虧損）貫穿第三季度denovo 運營的前24 個月，為410 萬美元，主要與最近收購的Bakers Field 和Crenshaw 中心以及我們在佛羅裡達州的中心有關。相比之下，第二季的新損失為 220 萬美元。

Turning to our balance sheet, we ended the quarter with $54.1 million in cash and cash equivalents plus $45.2 million in short-term investments. We had $81.3 million in total debt on the balance sheet, representing debt under our senior secured term loan plus finance, lease obligations and other commitments.

談到我們的資產負債表，本季末我們的現金和現金等價物為 5,410 萬美元，加上短期投資為 4,520 萬美元。我們的資產負債表上的債務總額為 8,130 萬美元，包括我們的優先擔保定期貸款下的債務加上融資、租賃義務和其他承諾。

For the third quarter, we reported cash flow from operations of $3.5 million, and we had $450,000 of capital expenditures. We are reaffirming our fiscal 2024 guidance, which, as we said last quarter, includes the Concerto care Pace acquisition. Based on the information as of today, we expect our ending census for the year 2024 to be between 6,807 and 7,400 participants and member months to be in the range of 79,000 to 83,000.

第三季度，我們的營運現金流為 350 萬美元，資本支出為 45 萬美元。我們重申我們的 2024 財年指導，正如我們上季度所說，其中包括收購 Concerto care Pace。根據今天的信息，我們預計 2024 年最終人口普查參與者人數將在 6,807 至 7,400 人之間，會員月數將在 79,000 至 83,000 人之間。

We are projecting total revenue in the range of $725 million to $775 million and adjusted EBITDA in the range of $12 million to $18 million. Finally, we anticipate that de novo losses for fiscal 2024 will be in the $10 million to $12 million range, which again is inclusive of our recently acquired Bakersfield and trenchers.

我們預計總營收將在 7.25 億美元至 7.75 億美元之間，調整後的 EBITDA 將在 1,200 萬美元至 1,800 萬美元之間。最後，我們預計 2024 財年的從頭損失將在 1,000 萬至 1,200 萬美元範圍內，其中也包括我們最近收購的貝克斯菲爾德和挖溝機。

In closing, I want to reiterate Patrick's comments as we believe we are continuing to make improvements to the business every quarter. We remain focused on the day-to-day operational execution and exiting fiscal 2024 with solid earnings momentum.

最後，我想重申帕特里克的評論，因為我們相信我們每季都會繼續改進業務。我們仍專注於日常營運執行，並以穩健的獲利動能結束 2024 財年。

Operator, that concludes our prepared remarks, please open the call for questions from the banking, which as a reminder, if you would like to ask a question, please press star one one on your telephone. We ask that you wait for your name and company to be announced before you proceed with your question one moment while we compile the Q&A roster. Sorry, our first question today will be coming from Jason Pennsylvania of Citi. Your line is open.

接線員，我們準備好的發言結束了，請打開銀行提問電話，謹此提醒，如果您想提問，請在電話上按星號一一。我們要求您先等待您的姓名和公司公佈，然後再繼續您的問題，同時我們會編制問答名冊。抱歉，我們今天的第一個問題將來自花旗銀行的傑森賓州。您的線路已開通。

Great, thanks. Good afternoon. Yes, I just saw you guys maintained our '24 guidance given year to date trend are you considering Q4 would shake out at least towards the higher end of the range on just given where you're at or are there offsets that we should be thinking about for the fourth quarter.

萬分感謝。午安.是的，我剛剛看到你們維持了我們的24 年指導方針，考慮到今年迄今為止的趨勢，你們是否考慮到第四季度至少會在考慮到你們所處的位置或是否存在我們應該考慮的偏移量的情況下向範圍的高端移動大約是第四季。

And then just as a follow-up, as you have that 7% to 9% kind of a margin target over the next two to four years, I know recognizing you're not providing fiscal '25 guidance yet, but can you maybe give us a sense on the puts and takes some margin progression for next year?

然後，作為後續行動，由於您在未來兩到四年內設定了 7% 到 9% 的利潤率目標，我知道您還沒有提供 25 年財政指導，但您能否給出我們對看跌期權有感覺並為明年採取一些保證金增長嗎？

Hey, this is Patrick Kelly. Could you hear from Jason, I'll get started and then maybe kick it over to Ben. Just to know what has been said. We remain focused on exiting fiscal year '24 with as much momentum as possible as we head into fiscal '25. And I think we're trending that direction. We're pleased with where we are. If you recall, we did intentionally set a larger range for guidance, and we're still comfortable that we're going to fall within that range on at the same time, we're also awaiting some outcomes on a few risk adjustment payments, which also underpins our current expanded range given the lack of uncertainty at the moment, we we are always a turnaround story and there's still a lot of unknowns in the business when I think about it is we're taking premium from both the federal government and the state government were small business. And so building in some conservatism for the one-timers that kind of naturally flow through our business at this sort of profile. I think for those reasons, we feel comfortable maintaining our guidance and being a little extra color here who may be on the range?

嘿，這是派崔克凱利。你能收到傑森的來信嗎？只是為了知道都說了什麼。我們仍然專注於在進入 25 財年時以盡可能多的動力結束 24 財年。我認為我們正在朝這個方向發展。我們對自己所處的位置感到滿意。如果您還記得，我們​​確實有意設定了一個更大的指導範圍，並且我們仍然對我們將落在該範圍內感到滿意，同時我們也在等待一些風險調整付款的一些結果，鑑於目前缺乏不確定性，這也支撐了我們目前擴大的範圍，我們始終是一個扭虧為盈的故事，當我想到我們從聯邦政府和政府那裡獲取溢價時，業務中仍然存在很多未知因素州政府都是小企業。因此，為一次性者建立一些保守主義，這種保守主義自然會以這種方式貫穿我們的業務。我認為出於這些原因，我們願意維持我們的指導，並在這裡提供一點額外的色彩，誰可能在範圍內？

Yes. Look, I think, Patrick, actually pretty much nailed it for you because we our businesses have no sort of a complex history over the last year. Or so. There are a number of items that can roll in any one particular quarter. Some of them are related to prior periods. Some of them are related to current periods and so there is that kind of natural variability in the business still. I think as we continue to involve evolve and look at and move into the future, we'll have greater and greater precision around our estimates. But we've started this year with what we thought was a pretty straight down the middle of the fairway on guidance range. We kept a little bit, why do count pretty variability?

是的。聽著，我想，派崔克，實際上已經為你做好了準備，因為我們的企業在過去的一年裡沒有任何複雜的歷史。或者。有許多項目可以在任何一個特定季度滾動。其中一些與之前的時期有關。其中一些與當前時期有關，因此業務中仍然存在這種自然變化。我認為，隨著我們繼續發展、展望未來並走向未來，我們的估計將會越來越精確。但我們今年一開始就認為在指導範圍內的球道中間相當筆直。我們保留了一點，為什麼要計算相當多的變異性？

We think we're tracking nicely against that guidance range. And as Patrick said, our real goal here is to make sure that we're operating as well as possible by the end of this fiscal year. So we can move into '25 with a lot of positive momentum.

我們認為我們正在很好地追蹤該指導範圍。正如帕特里克所說，我們的真正目標是確保我們在本財年結束前盡可能良好地運作。因此，我們可以帶著很多積極的勢頭進入 25 年。

You know, obviously, we haven't put out '25 guidance yet. We'll reserve that until we get to our year-end earnings release. But I think if you were to look at our business, we would expect so a lot of the progress you've seen over the course of this year to sort of continue going into 2025 and beyond, we put out those margin targets both for the intermediate term and for the longer term with the Investor Day presentation, you know, in a thoughtful way based on what we think the business is really going to do over time. So I think if you look at what we've done this year, sort of extend that forward, look at those guidance ranges and for margin down the road, that should give you a pretty good sense of the trajectory of the business.

顯然，我們還沒有發布 '25 指南。我們將保留這一點，直到我們發布年終收益。但我認為，如果你看看我們的業務，我們預計今年你所看到的很多進展將持續到 2025 年及以後，我們為中期和長期的投資者日演示，你知道，基於我們認為業務隨著時間的推移真正要做的事情，以深思熟慮的方式。因此，我認為，如果你看看我們今年所做的事情，並將其向前延伸，看看這些指導範圍和未來的利潤率，這應該會讓你對業務的發展軌跡有一個很好的了解。

I might maybe make one final punctuation to that that we think about rate of margin improvement. And we think about the drivers of that we're very focused right now on enrollment growth. Obviously, Q3 came in a bit below what we had hoped due to some seasonality that was exacerbated medical cost trends have been looking for a number of drivers for that. And we've talked about just the ongoing improvements in our staffing ratios as we grow. And that's one aspect of our business that we anticipate getting some leverage from. And so how we sort of in the year, you know, in each of those is really going to play a big role in sort of what we're expecting for fiscal year '25.

我可能會最後加上一個標點符號，表示我們考慮的是利潤率改善率。我們思考其驅動因素，我們現在非常關注入學人數的成長。顯然，第三季的業績略低於我們的預期，因為一些季節性因素加劇了醫療成本趨勢，我們一直在尋找一些驅動因素。我們已經討論了隨著我們的發展，我們的人員配置比例的持續改善。這是我們業務的一個方面，我們預計可以從中獲得一些影響力。所以我們今年的表現，你知道，在每一個方面都將在我們對 25 財年的預期中發揮重要作用。

Great. That's all. That's super helpful. And maybe just to your point around the census side of the fence, I know you called out MA plan development switching, it sounds like census came in a little bit below your expectations on either Colorado, specifically on the processing delays. I guess with the bottleneck being there, I mean, would you expect a bolus of members kind of coming online as those issues are resolved? Or and I guess in the meantime, how should we think about kind of the impacts of the Colorado dynamics against, you know, the fourth quarter census development as you see it? Just any risks there. Other ways to think about.

偉大的。就這樣。這非常有幫助。也許就您在人口普查方面的觀點而言，我知道您提出了 MA 計劃開發切換，聽起來科羅拉多州的人口普查結果有點低於您的預期，特別是在處理延遲方面。我想隨著瓶頸的存在，我的意思是，隨著這些問題的解決，您是否會期望大量會員上線？或者我想與此同時，我們應該如何考慮科羅拉多州動態對您所看到的第四季度人口普查發展的影響？那裡有任何風險。其他的思考方式。

What I would say, Jason, is we are working through it on with the state. And there are some good examples of where we are. The constraints we've experienced no into degree in the second quarter and third quarter are starting to be resolved. It's going to take some time before it sort of flows through, but there were system elements of this, and I know there's already some system changes going in that are going to relieve some of the constraints on, you know, there's two case management organizations that are enrollments flow through, and one of those is showing steady improvement, but it was still an impact, you know, in this quarter. And so the Q4 is going to be a nice predictor of some of the kind of the rate of change on that situation, but we don't change overnight, but I think we're doing a nice job, certainly are generating strong demand in Colorado and both innovation and the state are very focused on making sure those people get that services they need as quickly as possible. So I think we're going to we're going to get through it.

傑森，我想說的是，我們正在與政府一起解決這個問題。有一些很好的例子可以說明我們的處境。我們在第二季和第三季經歷的限制正在開始解決。需要一些時間才能順利通過，但是其中存在系統元素，而且我知道已經進行了一些系統更改，這將減輕對兩個案例管理組織的一些限制這是入學人數的流動，其中之一正在穩步改善，但你知道，在本季度這仍然是一個影響。因此，第四季度將成為這種情況變化率的一個很好的預測指標，但我們不會在一夜之間發生變化，但我認為我們做得很好，肯定會產生強勁的需求科羅拉多州以及創新和州都非常注重確保這些人盡快獲得他們需要的服務。所以我認為我們會度過難關。

Okay, great. And if I could just ask one more on on the census acuity mix, it sounds like you're seeing improvement there, which is.

好的，太好了。如果我能再問一個關於人口普查敏銳度組合的問題，聽起來你看到了那裡的改善，確實如此。

Yes, certainly encouraging. Can you maybe give us a sense on where that your current acuity mix kind of stands today again, where it needs to be to reflect underlying reimbursement. Do you think this is something it's going to take kind of multiple quarters to come to fruition? Or maybe how would you frame the lead time there to balance assuming kind of like a normalized census growth going forward? Just any color around that would be very helpful.

是的，當然令人鼓舞。您能否讓我們了解您目前的敏銳度組合今天又處於什麼位置，需要在什麼位置才能反映潛在的報銷。您認為這需要幾個季度才能實現嗎？或者，也許您將如何規劃那裡的準備時間，以平衡假設未來人口普查正常化成長的情況？只要周圍的任何顏色都會非常有幫助。

Yes. I think if you look at our incoming participants, our freshmen who come into the program, they've got a good mix between of folks that are sort of higher acuity lower acuity and good mix by living situation and they are gradually as they flow into the system, slowly changing the mix of our patients and changing our acuity mix.

是的。我認為，如果你看看我們即將加入的參與者，我們進入該計劃的新生，他們在不同的人之間有很好的混合，這些人的敏銳度較高，較低的敏銳度，並且根據生活狀況進行了良好的混合，並且隨著他們逐漸融入系統，慢慢地改變我們的患者組合併改變我們的敏銳度組合。

As you would expect it to happen. I think one of the tricks is if you look at the number of people that are role with us every single month and compare to the overall census, you get a sense for it takes a little time for this to wash through the system. So we're seeing what we would expect to see, which is a gradual improvement on those metrics, and it will take a little time before it goes through. But as we come into the right kind of mix, we're kind of coming into alignment with the assumptions that underlying base rates in the first place. So we're kind of moving in the right direction. It takes a little bit time.

正如您所期望的那樣。我認為其中一個技巧是，如果你查看每個月與我們一起工作的人數，並與總體人口普查進行比較，你會感覺到，這需要一點時間才能透過系統進行清洗。因此，我們看到了我們所期望看到的，即這些指標的逐步改進，並且需要一些時間才能完成。但當我們採用正確的組合時，我們首先就會與基本利率的假設一致。所以我們正在朝著正確的方向前進。這需要一點時間。

Okay. Thank you for all the color.

好的。謝謝你所有的顏色。

Thank you. And now we turn the call back over to Patrick Blair, President and CEO for closing remarks. Please go ahead.

謝謝。現在我們將電話轉回給總裁兼執行長 Patrick Blair 致閉幕詞。請繼續。

Just like to say again how much we appreciate your interest in the organization, and we're excited about the progress of the momentum that we have and are getting back with you next quarter, hopefully talk about additional progress we're making have a terrific evening.

我想再說一遍，我們非常感謝您對本組織的興趣，我們對我們所擁有的勢頭的進展感到興奮，並將在下個季度與您聯繫，希望能談談我們正在取得的額外進展晚上。

This does conclude today's conference call. You may all disconnect.

今天的電話會議到此結束。你們都可以斷開連線。