LifeStance Health Group Inc (LFST) 2023 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by. My name is Negre, and I will be your conference operator today. At this time, I would like to welcome everyone to the LifeStance Health Second Quarter 2023 Earnings Call. (Operator Instructions) I would now like to turn the conference over to Monica Prokocki, Vice President of Investor Relations. Please go ahead.

女士們先生們，感謝你們的支持。我叫 Negre，今天我將擔任你們的會議操作員。此時，我謹歡迎大家參加 LifeStance Health 2023 年第二季度收益電話會議。 （操作員指示）我現在想將會議轉交給投資者關係副總裁 Monica Prokocki。請繼續。

Good morning, everyone, and welcome to LifeStance Health Second Quarter 2023 Earnings Conference Call. I am Monica Prokocki, Vice President of Investor Relations. Joining me today are Ken Burdick, Chief Executive Officer; Dave Bourdon, Chief Financial Officer; and Danish Qureshi, Chief Operating Officer.

大家早上好，歡迎參加 LifeStance Health 2023 年第二季度收益電話會議。我是莫妮卡·普羅科基 (Monica Prokocki)，投資者關係副總裁。今天加入我的是首席執行官肯·伯迪克 (Ken Burdick)；戴夫·波登，首席財務官；首席運營官丹麥庫雷希 (Danish Qureshi)。

We issued the earnings release and presentation before the market opened this morning. Both are available on the Investor Relations section of our website, investor.lifestance.com. In addition, a replay of this conference call will be available following the call. Before turning the call over to management for their prepared remarks, please direct your attention to the disclaimers about forward-looking statements included in the earnings press release and SEC filings.

我們在今天早上開盤前發布了收益報告和演示文稿。兩者均可在我們網站 Investor.lifestance.com 的投資者關係部分找到。此外，電話會議結束後將提供該電話會議的重播。在將電話轉交給管理層以聽取他們準備好的言論之前，請注意收益新聞稿和美國證券交易委員會文件中包含的前瞻性聲明的免責聲明。

Today's remarks contain forward-looking statements, including statements about our financial performance outlook, business model and strategy. Those statements involve risks, uncertainties and other factors. As noted in our periodic filings with the SEC that could cause actual results to differ materially. In addition, please note that we report results using non-GAAP financial measures, which we believe provide additional information for investors to help facilitate comparison of current and past performance.

今天的言論包含前瞻性陳述，包括有關我們的財務業績展望、業務模式和戰略的陳述。這些陳述涉及風險、不確定性和其他因素。正如我們在向美國證券交易委員會提交的定期文件中指出的，這可能會導致實際結果出現重大差異。此外，請注意，我們使用非公認會計準則財務指標報告結果，我們認為這為投資者提供了更多信息，有助於比較當前和過去的業績。

A reconciliation to the most directly comparable GAAP measures is included in the earnings press release tables and presentation appendix. Unless otherwise noted, all results are compared to the comparable period in the prior year. At this time, I'll turn the call over to Ken Burdick, CEO of LifeStance. Ken?

收益新聞稿表和演示附錄中包含了與最直接可比的公認會計準則衡量標準的調節。除非另有說明，所有結果均與上一年可比期間進行比較。此時，我會將電話轉給 LifeStance 首席執行官肯·伯迪克 (Ken Burdick)。肯？

Thanks, Monica, and thank you all for joining us today. Halfway through the year, we are continuing to steadily strengthen our operational performance. In addition, we continue to see strong visit volume and clinician growth. Importantly, this is the first quarter where 100% of our growth was organic.

謝謝莫妮卡，也謝謝大家今天加入我們。今年過半，我們繼續穩步增強我們的運營業績。此外，我們繼續看到強勁的就診量和臨床醫生的增長。重要的是，這是我們 100% 有機增長的第一季度。

Nearly 90% of the U.S. population has access to our multidisciplinary team of clinicians through a hybrid model of virtual and in-person care covered by commercial insurance. These dedicated clinicians deliver every day on LifeStance's mission to provide access to trusted, affordable and personalized mental health care.

近 90% 的美國人可以通過商業保險承保的虛擬和麵對面護理的混合模式獲得我們的多學科臨床醫生團隊的幫助。這些敬業的臨床醫生每天都履行 LifeStance 的使命，即提供值得信賴、負擔得起和個性化的心理健康護理。

Our team is passionate about optimizing patient outcomes. I want to begin by highlighting recent advances on this front to better support our clinicians in measuring how their patient's care is progressing. We launched a new outcomes-informed care program. As part of this program, outcomes assessments will be sent to all new patients and after follow-up appointments as deemed clinically appropriate.

我們的團隊熱衷於優化患者治療結果。首先，我想強調這方面的最新進展，以更好地支持我們的臨床醫生衡量患者護理的進展情況。我們啟動了一項新的以結果為導向的護理計劃。作為該計劃的一部分，結果評估將發送給所有新患者，並在臨床上認為適當的後續預約後發送。

Over time, this new capability will allow us to develop an unprecedented level of clinical efficacy data. This data will be invaluable for improving patient care at LifeStance and will highlight our differentiated ability to deliver quality outcomes. It will also support our continued advancement toward value-based care arrangements with our payer partners.

隨著時間的推移，這種新功能將使我們能夠開發出前所未有的臨床療效數據水平。這些數據對於改善 LifeStance 的患者護理至關重要，並將凸顯我們提供優質結果的差異化能力。它還將支持我們與付款合作夥伴繼續推進基於價值的護理安排。

We are uniquely positioned to leverage LifeStance's size and scale to measure quality and outcomes in a disciplined way that we believe can help drive improvements in mental health care across the country. We are excited about this step on our path to using data and analytics to better inform care and enhance mental health treatment.

我們擁有獨特的優勢，可以利用 LifeStance 的規模和規模，以規範的方式衡量質量和結果，我們相信這有助於推動全國精神衛生保健的改善。我們對利用數據和分析更好地為護理提供信息並加強心理健康治療的道路上邁出的這一步感到興奮。

While we are still early in rolling out our new outcomes initiatives, we are very pleased with the results of other patient experience data that we have been tracking over time. We currently earn a patient Net Promoter Score of over 80%, and our average reviews for LifeStance centers across Google searches are currently at 4.6 out of 5 stars. The ratings represent the tremendous experience and care that our patients receive from LifeStance clinicians.

雖然我們仍處於推出新成果計劃的早期階段，但我們對我們長期以來跟踪的其他患者體驗數據的結果感到非常滿意。目前，我們的耐心淨推薦值超過 80%，Google 搜索結果中 LifeStance 中心的平均評價目前為 4.6 星（滿分 5 星）。這些評級代表了我們的患者從 LifeStance 臨床醫生那裡獲得的豐富經驗和護理。

We are proud of the compassionate and customized care that we deliver every day, but recognize that we have opportunities to enhance the patient experience. As we constantly strive for continuous improvement, we're proud of the team's progress and commitment as we move closer to serving nearly 1 million patients annually.

我們為每天提供的富有同情心和定制的護理感到自豪，但我們也認識到我們有機會改善患者的體驗。隨著我們不斷努力持續改進，我們為團隊的進步和承諾感到自豪，因為我們越來越接近每年為近 100 萬患者提供服務。

Regarding operational execution, we continue to make progress on initiatives to streamline the business and improve our performance. We announced on our last earnings call that we were in the process of sending termination notifications for approximately 30% of our payer contracts, which we completed as of July 1.

在運營執行方面，我們繼續在簡化業務和提高績效的舉措上取得進展。我們在上次財報電話會議上宣布，我們正在向約 30% 的付款人合同發送終止通知，該通知已於 7 月 1 日完成。

These will have little to no impact on visit volume, but will allow our internal teams to operate more efficiently. While this initial phase is complete, we will continue to evaluate our payer contracts and focus on aligning with payer partners who share our vision of expanding access to mental health care and invest in that vision with rates and terms commensurate with the value that LifeStance clinicians provide.

這些對訪問量幾乎沒有影響，但將使我們的內部團隊更有效地運作。雖然這一初始階段已經完成，但我們將繼續評估我們的付款人合同，並重點與與我們有共同願景的付款合作夥伴保持一致，即擴大獲得精神衛生保健的機會，並以與LifeStance 臨床醫生提供的價值相稱的費率和條款來投資於這一願景。

Additionally, as of July 1, we now have all of our centers aligned on one single EHR system, one phone system and one e-mail system. This is a truly significant step forward towards simplifying the complexity created from nearly 100 acquisitions during the past 6 years as the administrative burden of multiple systems will be significantly reduced. Streamlining our processes and systems will also enable us to swiftly and effectively implement new company-wide initiatives.

此外，截至 7 月 1 日，我們所有的中心現在都使用一套 EHR 系統、一套電話系統和一套電子郵件系統。這是朝著簡化過去 6 年來近 100 次收購所產生的複雜性邁出的真正重要的一步，因為多個系統的管理負擔將顯著減輕。簡化我們的流程和系統還將使我們能夠快速有效地實施新的全公司計劃。

Turning to our financial results in the second quarter. We delivered revenue of $260 million, center margin of $73 million and adjusted EBITDA of $14 million, all of which met or exceeded our expectations. This is the third consecutive quarter that our team has met or exceeded expectations and with continued disciplined execution, we feel well positioned to achieve our full year commitments.

轉向我們第二季度的財務業績。我們實現了 2.6 億美元的收入、7300 萬美元的中心利潤和 1400 萬美元的調整後 EBITDA，所有這些都達到或超出了我們的預期。這是我們的團隊連續第三個季度達到或超出預期，通過持續嚴格的執行，我們感覺自己有能力實現全年承諾。

With that, I will turn it over to Dave to provide additional commentary on our financial performance and outlook. Dave?

至此，我將把它交給戴夫，以對我們的財務業績和前景提供更多評論。戴夫？

Thank you, Ken. I would like to echo Ken's comments regarding the team's solid performance through the first half of this year, both operationally and in our financial results. In the second quarter, we produced strong top line results with revenue of $260 million, representing growth of 24% year-over-year.

謝謝你，肯。我想贊同 Ken 對今年上半年團隊在運營和財務業績方面的穩健表現的評論。第二季度，我們實現了強勁的營收業績，收入達 2.6 億美元，同比增長 24%。

This outperformance was primarily driven by increased visit volumes that were the result of higher-than-expected productivity. Visit volumes of 1,705 million increased 21% year-over-year, primarily driven by higher clinician count and higher productivity. Total revenue per visit increased 3% year-over-year to $152, primarily driven by modest payer rate increases. The outperformance on revenue flowed through to center margin. Center margin of $73 million in the quarter increased by 22% year-over-year. Adjusted EBITDA of $14 million was consistent with our expectations.

這一出色表現主要是由於生產力高於預期而導致訪問量增加。就診量達 17.05 億人次，同比增長 21%，這主要是由於臨床醫生人數增加和工作效率提高所致。每次訪問的總收入同比增長 3% 至 152 美元，這主要是由於付費費率小幅上漲所致。收入的優異表現也體現在中心利潤率上。本季度中心利潤率為 7300 萬美元，同比增長 22%。調整後 EBITDA 為 1400 萬美元，符合我們的預期。

Turning to liquidity. In the second quarter, free cash flow was negative $12 million, a $6 million improvement year-over-year, which was in line with our expectations. As we stated previously, we expected to improve cash flow from the first quarter, which was impacted by compensation costs such as bonus payments and higher payroll taxes.

轉向流動性。第二季度自由現金流為負1200萬美元，同比改善600萬美元，符合我們的預期。正如我們之前所說，我們預計第一季度的現金流將有所改善，這受到獎金支付和更高的工資稅等補償成本的影響。

In the second quarter, DSO increased sequentially from 42 days to 43 days. This was above our prior expectations as we made the decision to hold claims for a large payer due to a retroactive rate increase. We expect a similar dynamic in the third quarter as we hold claims for several other payers due to updates from rate negotiations. DSO should meaningfully improve during the fourth quarter.

第二季度，DSO 環比從 42 天增加到 43 天。這超出了我們之前的預期，因為我們因追溯加息而決定為大付款人保留索賠。我們預計第三季度也會出現類似的情況，因為我們根據費率談判的最新情況對其他幾家付款人提出了索賠。 DSO 在第四季度應該會顯著改善。

We exited the quarter with cash of $80 million and net long-term debt of $249 million. As of the end of Q2, we had additional debt capacity from a delayed draw term loan of $41 million as well as a $50 million revolving debt facility providing us with sufficient financial flexibility to run the business as we head towards positive free cash flow for the full year 2025.

本季度結束時，我們擁有 8000 萬美元的現金和 2.49 億美元的淨長期債務。截至第二季度末，我們通過4100 萬美元的延遲提取定期貸款以及5000 萬美元的循環債務融資獲得了額外的債務能力，為我們提供了足夠的財務靈活性來經營業務，因為我們正朝著積極的自由現金流邁進2025 年全年。

In terms of our outlook for 2023, we are raising our full year revenue range by $20 million to $1.010 billion to $1.040 billion and raising our full year center margin range to $280 million to $300 million. We are reiterating the adjusted EBITDA guidance range of $50 million to $62 million to maintain flexibility for further investing in the business. We expect the higher productivity that we experienced in Q1 and Q2 to continue into the second half of the year, which is driving the increase in our revenue guidance.

就 2023 年的前景而言，我們將全年收入範圍提高 2000 萬美元至 10.1 億美元至 10.4 億美元，並將全年中心利潤率範圍提高至 2.8 億美元至 3 億美元。我們重申調整後的 EBITDA 指導範圍為 5000 萬美元至 6200 萬美元，以保持進一步投資業務的靈活性。我們預計第一季度和第二季度的生產率提高將持續到今年下半年，這將推動我們收入指引的增加。

For the third quarter, we expect revenue of $250 million to $260 million, center margin of $69 million to $76 million and adjusted EBITDA of $11 million to $17 million. As a reminder, there is seasonality reflected in our third quarter guidance as a result of the summer vacation season, which results in lower clinician capacity.

我們預計第三季度收入為 2.5 億至 2.6 億美元，中心利潤率為 6,900 萬至 7,600 萬美元，調整後 EBITDA 為 1,100 萬至 1,700 萬美元。提醒一下，由於暑假季節，我們的第三季度指導反映了季節性，這導致臨床醫生的能力下降。

Before I transition to Danish, I'd like to make it clear that as we drive revenue favorability, we are continuing to accelerate investments in 2023. As stated previously, we expect to exit 2025 with double-digit margins. However, our progression from 2023 to 2025 will not be linear. We fully expect to see margin expansion in 2024, but anticipate greater margin expansion in 2025 as we will have the benefit of a full year of returns on our foundational investments.

在我轉向丹麥語之前，我想明確表示，隨著我們提高收入優勢，我們將在 2023 年繼續加快投資。如前所述，我們預計到 2025 年將以兩位數的利潤率退出。然而，我們從 2023 年到 2025 年的進展不會是線性的。我們完全預計 2024 年利潤率會擴大，但預計 2025 年利潤率會更大，因為我們將受益於基礎投資的全年回報。

With that, I'll turn it over to Danish for additional color with respect to operations.

有了這個，我將把它交給丹麥人以獲取有關操作的更多信息。

Thank you, Dave. We continue to align our teams around 2 growth priorities. Net clinician adds and clinician productivity. In terms of net clinician adds, we grew by 171 in the second quarter, bringing our total to 6,132 clinicians, an increase of 17% year-over-year. Importantly, and consistent with our prior messaging, this quarter's growth was 100% organic.

謝謝你，戴夫。我們繼續圍繞兩個增長優先事項調整我們的團隊。臨床醫生淨增加和臨床醫生生產力。就淨臨床醫生數量而言，第二季度我們增加了 171 名臨床醫生，使臨床醫生總數達到 6,132 名，同比增長 17%。重要的是，與我們之前發布的消息一致，本季度的增長是 100% 的有機增長。

Turning to clinician productivity, capacity or the time clinicians make available to see patients trended in line with our expectations. In terms of utilization or our ability to appropriately fill our clinician schedules, we continue to deliver improvement, which has been sustained for 3 quarters. We believe it is now appropriate to increase our go-forward productivity assumptions to reflect the performance in the first half of the year, which is factored into our higher revenue expectations for the second half of the year.

轉向臨床醫生的生產力、能力或臨床醫生為查看患者而提供的時間，趨勢符合我們的預期。在利用率或我們適當填補臨床醫生日程的能力方面，我們繼續提供改進，這種改進已經持續了三個季度。我們認為，現在適當提高我們的未來生產率假設，以反映上半年的業績，這已納入我們對下半年更高的收入預期中。

We are driving these improvements in utilization through operational discipline at the top, middle and bottom of the patient funnel. At the top of the funnel, we continue to attract new patients in line with the overall growth of our clinicians and their related capacity. Our boots on the ground primary care referral team is doing a tremendous job expanding and solidifying local relationships and delivering growth in referrals, which is a key contributor to ramping new clinicians.

我們正在通過患者漏斗頂部、中部和底部的操作紀律來推動利用率的提高。在漏斗的頂部，我們根據臨床醫生及其相關能力的整體增長繼續吸引新患者。我們腳踏實地的初級保健轉診團隊正在做大量工作，擴大和鞏固當地關係，並實現轉診數量的增長，這是增加新臨床醫生的關鍵因素。

Additionally, our marketing team's ability to drive continued growth in online organic patient traffic in combination with increasing levels of brand awareness, continue to have a positive effect at the top of the funnel.

此外，我們的營銷團隊有能力推動在線有機患者流量的持續增長，並結合不斷提高的品牌知名度，繼續對漏斗頂部產生積極影響。

Second, at the middle of the funnel, we are improving our scheduling of patients. Our intake teams are focused on enhancing the overall conversion and matching experience for patients who prefer to schedule their appointments over the phone. We also continue to leverage our digital capabilities to optimize patient matching via our online booking and intake experience, OBIE.

其次，在漏斗的中間，我們正在改進患者的安排。我們的接待團隊致力於增強喜歡通過電話安排預約的患者的整體轉換和匹配體驗。我們還繼續利用我們的數字能力，通過我們的在線預約和入院體驗 OBIE 來優化患者匹配。

We are excited to announce that OBIE has been fully implemented nationwide as of the second quarter completing an 18-month project. These online and offline efforts have led to further progress at the middle of the funnel.

我們很高興地宣布，OBIE 已於第二季度在全國范圍內全面實施，完成了為期 18 個月的項目。這些線上和線下的努力導致了漏斗中間的進一步進展。

Finally, at the bottom of the funnel, in terms of scheduled appointments converting to completed visits, our cancellation rates improved by another 2 points this quarter, down to 10% that represents a 4-point improvement since the end of 2022 and has had a significant impact on utilization and the ability of our clinicians to use their patient-facing time productively. Our strong execution at the top, middle and bottom funnel contributed to better-than-expected productivity in the second quarter.

最後，在漏斗底部，就預定預約轉化為已完成訪問而言，我們的取消率本季度又提高了 2 個百分點，降至 10%，自 2022 年底以來提高了 4 個百分點，並且已經實現了對臨床醫生有效利用其面對患者的時間的利用率和能力產生重大影響。我們在頂部、中部和底部漏斗的強勁執行力導致第二季度的生產力好於預期。

Turning to real estate. We are making good progress on the real estate optimization project that we initially announced on our Q4 earnings call. As a reminder, we were planning to consolidate 30 to 40 centers this year. By the end of the second quarter, we consolidated 36 centers with little to no disruption to our patients and clinicians. As we work through this review of our real estate, we identified additional centers that we are targeting for consolidation late in 2023, and we will provide an update by next quarter's earnings call.

轉向房地產。我們最初在第四季度財報電話會議上宣布的房地產優化項目正在取得良好進展。提醒一下，我們計劃今年整合 30 到 40 個中心。到第二季度末，我們整合了 36 個中心，幾乎沒有對患者和臨床醫生造成乾擾。在我們對房地產進行審查時，我們確定了計劃在 2023 年末整合的其他中心，我們將在下季度的財報電話會議之前提供最新信息。

Additionally, we are continuing to intentionally moderate our pace of de novo openings. We are now expecting to open no more than 36 in 2023, down from our original guidance of 40 to 45. Going forward, we will continue to regularly evaluate our real estate footprint to ensure it meets the needs of our hybrid model while supporting our goals of efficiency and operating leverage and we expect fewer de novo openings in 2024 as we continue to optimize the use of our existing space.

此外，我們將繼續有意放慢重新開業的步伐。我們目前預計2023 年開設的門店不超過36 家，低於我們最初指導的40 到45 家。展望未來，我們將繼續定期評估我們的房地產足跡，以確保其滿足我們混合模式的需求，同時支持我們的目標效率和運營槓桿的提高，隨著我們繼續優化現有空間的利用，我們預計 2024 年新的空缺職位將會減少。

In closing, I'm proud of the team's continued dedication to driving operational improvements across the foundation of our business. We have dramatically reduced complexity and streamlined many areas of the company. We've gone from 100 phone systems to 1, dozens of EHRs to 1 and rolled out a national online booking system. We've also aligned the teams around a single set of KPIs that move us forward in a common direction. While we still have a lot of work to do and are just 2 quarters into a 2-year transformation process, the energy and enthusiasm of the team are palpable and inspiring.

最後，我為團隊持續致力於推動整個業務基礎的運營改進感到自豪。我們極大地降低了複雜性並簡化了公司的許多領域。我們已經從 100 個電話系統減少到 1 個，數十個 EHR 減少到 1 個，並推出了全國性在線預約系統。我們還圍繞一組 KPI 協調團隊，推動我們朝著共同的方向前進。雖然我們還有很多工作要做，而且為期 2 年的轉型過程才剛剛過去 2 個季度，但團隊的活力和熱情是顯而易見且鼓舞人心的。

With that, I'll turn it back over to Ken for his closing remarks.

至此，我將把它轉回給肯，讓他作結束語。

Thank you, Danish. I would like to thank all of our dedicated clinicians and team members for their continued outstanding work in the first half of 2023. It has been nearly one year since I joined LifeStance. And at that time, we have focused on standardizing and simplifying our processes, systems, payer contracts, real estate and other areas of the business as referenced by Danish.

謝謝你，丹麥人。我要感謝我們所有敬業的臨床醫生和團隊成員在 2023 年上半年繼續出色的工作。我加入 LifeStance 已經快一年了。當時，我們專注於標準化和簡化我們的流程、系統、付款人合同、房地產和丹麥提到的其他業務領域。

As leaders in the outpatient mental health care space, we are also beginning to leverage our unique scale to use data and analytics to better inform care and enhance mental health treatment. While I recognize that there is a great deal of work ahead of us, I am more confident than ever as we continue to focus on our top priorities, execute with discipline and make the necessary investments to strengthen our foundation, we will achieve both our short and long-term commitments.

作為門診心理健康護理領域的領導者，我們也開始利用我們獨特的規模來使用數據和分析來更好地為護理提供信息並加強心理健康治療。雖然我認識到我們面前還有大量工作要做，但我比以往任何時候都更有信心，因為我們將繼續專注於我們的首要任務，嚴格執行並進行必要的投資來鞏固我們的基礎，我們將實現我們的短期目標和長期承諾。

(Operator Instructions) Your first question comes from Craig Hettenbach with Morgan Stanley.

（操作員說明）您的第一個問題來自摩根士丹利的 Craig Hettenbach。

Ken, based on the clinician growth and productivity gains, it seems you're firmly on track for kind of the mid-teens revenue growth over the next couple of years. Can you just talk about what do you think about some puts and takes around some things that could drive revenue growth higher or any potential risks to that mid-teens as you see it?

肯，根據臨床醫生的增長和生產力的提高，看來您在未來幾年內將堅定地實現十幾歲左右的收入增長。您能否談談您對一些看跌期權和看跌期權的看法，這些看跌期權和看跌期權可能會推動收入增長更高，或者您認為對十幾歲左右的人有任何潛在風險？

Craig. I'll give you my 2 cents and then let Danish weigh in and add his comments. The first thing that occurs to me is that, as we've mentioned in the script, the growth that we've had most recently is 100% organic. So one of the upsides is that at a point where we can fund acquisitions from our free cash, we will be back into more of an acquisitive mode. So that represents sort of pure upside. And in terms of the downside, we have to stay vigilant in focusing on the things that Danish talks about in each earnings call. And frankly, he focuses on every day, which is around productivity and utilization, conversion rates, cancellation rates, et cetera. So I'm overall optimistic, but we've got to stay on top of it.

克雷格.我會給你 2 美分，然後讓丹麥人參與進來並添加他的評論。我首先想到的是，正如我們在劇本中提到的，我們最近的增長是 100% 有機增長。因此，好處之一是，當我們可以用自由現金為收購提供資金時，我們將回到更多的收購模式。所以這代表了某種純粹的上行空間。就不利方面而言，我們必須保持警惕，關注丹麥人在每次財報電話會議上談論的事情。坦率地說，他每天都關註生產力和利用率、轉化率、取消率等等。所以我總體上很樂觀，但我們必須保持領先。

Yes, I'd concur with that answer. As we really look out to the future, whether it's being an organic-focused approach now, our ability to continue to deliver on net clinician adds or recruiting engine, which we continue to view as best-in-class, and we continue to be able to scale in conjunction with our improvements that we've already delivered on the utilization front as it affects productivity with the new lever being how do we start to turn our attention to the other side of the productivity equation, which is capacity.

是的，我同意這個答案。當我們真正展望未來時，無論是現在以有機為中心的方法，還是我們繼續提供網絡臨床醫生補充或招聘引擎的能力，我們仍然認為這是一流的，並且我們繼續能夠與我們在利用率方面已經實現的改進結合起來進行擴展，因為它會影響生產力，新的槓桿是我們如何開始將注意力轉向生產力等式的另一面，即容量。

Historically, that has been an area that we have very purposely not put our attention to with our primary focus being driving the improvements on utilization and delivering on our commitments to our clinicians that when they make time available to us, we are going to fill that appropriately. Now that we have made so many strides on that front, we will start to turn our attention again to the other side of the equation, which is capacity and see how we affect that going forward.

從歷史上看，這是一個我們故意不關注的領域，我們的主要重點是推動利用率的提高，並兌現我們對臨床醫生的承諾，即當他們為我們提供時間時，我們將填補這一空白適當地。既然我們在這方面已經取得瞭如此大的進步，我們將開始再次將注意力轉向等式的另一邊，即容量，並看看我們如何影響未來的發展。

Got it. And then I have a follow-up for Dave. It's nice to have revenue upside that you can reinvest more into the business. On those investments, is it just things that you are already doing and you're able to spend a little bit more? Or are there any other initiatives? Like how would you frame some of the investments you're making this year?

知道了。然後我有一個關於戴夫的後續行動。收入上升是件好事，您可以將更多資金再投資到業務中。在這些投資上，是否只是您已經在做並且可以多花一點錢的事情？或者還有其他舉措嗎？比如你會如何規劃今年的一些投資？

Yes. As far as the investments themselves, I would say more of the same, I would not point to any new particular initiatives. We continue to invest in areas across many aspects of the business that allow us to drive performance as well as scale effectively so that we can drive margin improvement in '24 and exit '25 with double-digit margins.

是的。就投資本身而言，我想說的更多是相同的，我不會指出任何新的具體舉措。我們繼續在業務的許多方面進行投資，使我們能夠有效地提高業績和規模，以便我們能夠在 24 年推動利潤率提高，並在 25 年以兩位數的利潤率退出。

Our next question comes from Lisa Gill with JPMorgan.

我們的下一個問題來自摩根大通的麗莎·吉爾。

I just want to start with the current environment around managed care contracting. And I noted, Dave, you made the comment that your DSOs were up because you're holding claims due to rate increases. One, is it an annual negotiation with managed care when we think about rate; two, can you give us any color around what you're seeing in the rate environment with managed care? And then thirdly, around that, is managed care looking to do any type of contracting around either value-based care initiatives or capitation, et cetera? Like is there any changes when we think about those contracts that you have with managed care?

我只想從管理式醫療承包的當前環境開始。我注意到，戴夫，您評論說您的 DSO 上升是因為您因利率上漲而持有索賠。第一，當我們考慮費率時，是否與管理式醫療進行年度談判？第二，您能給我們介紹一下您在管理式醫療的費率環境中所看到的情況嗎？第三，圍繞這一點，管理式醫療是否尋求圍繞基於價值的醫療計劃或按人頭付費等簽訂任何類型的合同？當我們考慮您與管理式醫療簽訂的合同時，是否有任何變化？

Lisa, it's Dave. I'll take that one. So there was a few pieces there. So first of all, as far as negotiations that go with the payers, we are doing them -- we are having regular interactions with our payers from an engagement perspective. Some of them are annual contracts, some of them are an annual plus 1 from an escalator perspective. So it depends on the situation. But more than anything else, we want to have frequent interactions with our payers and be engaging with them.

麗莎，是戴夫。我會接受那個。所以那裡有幾塊。因此，首先，就與付款人進行的談判而言，我們正在進行——我們從參與的角度與付款人進行定期互動。有的是年度合同，有的是從自動扶梯的角度來說是年度加1。所以這要看情況。但最重要的是，我們希望與付款人經常互動並與他們互動。

As far as the value-based care, we do have some value-based care arrangements already. I would point you to more of them being around access and quality rather than capitation or risk-bearing things like that. And I would also say it's early stages in mental health around value-based care. That is not prevalent across our entire book.

就基於價值的護理而言，我們確實已經有了一些基於價值的護理安排。我想向您指出，其中更多的是圍繞准入和質量，而不是按人頭付費或承擔風險之類的事情。我還想說，這是圍繞基於價值的護理的心理健康的早期階段。這在我們整本書中並不普遍。

Okay. Great. And then just a quick follow-up on virtual versus in-person. Can you maybe just give us what the percentage is this quarter and your expectation for the rest of the year?

好的。偉大的。然後快速跟進虛擬與面對面的情況。您能否告訴我們本季度的百分比以及您對今年剩餘時間的預期？

Sure. This is Danish. I can answer that. So from a virtual perspective, virtual business represented about 73% of our total visits in Q2 as compared with 75% in Q1. So we continue to see an increased trends in patient demand for in-person visits and a slow return to in that direction.

當然。這是丹麥語。我可以回答這個問題。因此，從虛擬角度來看，虛擬業務約佔第二季度總訪問量的 73%，而第一季度為 75%。因此，我們繼續看到患者對親自就診的需求呈增加趨勢，並且朝著這個方向緩慢回歸。

That being said, because of our hybrid model and the way that we deliver care, we remain agnostic as to where it trends, how fast it trends and ultimately where it settles out, which is a key differentiator for us. What it affects more than anything is how we continue to think about our optimization strategy around real estate and the footprint that we want to maintain.

話雖這麼說，由於我們的混合模式和提供護理的方式，我們仍然不知道它的趨勢、趨勢的速度以及最終的結果，這對我們來說是一個關鍵的差異化因素。它對我們影響最大的是我們如何繼續思考圍繞房地產和我們想要維持的足蹟的優化策略。

Next question comes from Ryan Daniels with William Blair.

下一個問題來自瑞安·丹尼爾斯和威廉·布萊爾。

This is Jack Senft for Ryan Daniels. So I appreciate the comments on the launch of the new outcomes-informed care program for clinicians. But can you dive just a little deeper into this program on the clinician front, specifically, maybe like what measures are included or how it differs from the older process for clinicians. And then as the second part with this, too, is this rolled out nationwide already? Or is this only rolled out to a select group?

我是瑞恩·丹尼爾斯的傑克·森夫特。因此，我感謝針對臨床醫生啟動新的結果知情護理計劃的評論。但是，您能否在臨床醫生方面更深入地了解該計劃，具體來說，可能包括哪些措施，或者它與臨床醫生的舊流程有何不同。那麼作為第二部分，這也已經在全國范圍內推廣了嗎？或者這只是向選定的群體推出？

Jack. Actually, it is rolled out nationwide, and that's the power of this program. It's not as if we haven't been doing assessments. But as we transition from lots of acquisitions doing things the way they had always done them to a single approach at LifeStance that's nationally consistent, it's going to allow us to harness that data more effectively. And to date, we have already done 180,000 of these patient assessments, and we're still in the very early stages. But it's just a more structured disciplined way of making sure that we are analyzing the clinical efficacy of the work and then helping to inform our clinicians and hopefully helping to inform the industry about best practices and protocols.

傑克。事實上，它是在全國范圍內推廣的，這就是這個計劃的力量。我們並不是沒有進行評估。但是，當我們從大量收購的一貫方式轉變為 LifeStance 全國一致的單一方法時，這將使我們能夠更有效地利用這些數據。迄今為止，我們已經完成了 180,000 名患者評估，但仍處於非常早期的階段。但這只是一種更加結構化、規範的方式，以確保我們分析工作的臨床療效，然後幫助告知我們的臨床醫生，並希望幫助告知行業有關最佳實踐和協議的信息。

Understood. And as a quick follow-up, too, on the center consolidation front, you noted the additional centers that are good consolidation candidates. I'm curious if those are within the same markets as others that you're consolidating or if those are new markets that you identified.

明白了。作為快速跟進，在中心整合方面，您注意到其他中心是很好的整合候選者。我很好奇這些是否與您正在整合的其他市場位於同一市場，或者這些是否是您確定的新市場。

This is Danish. I'll take that. So some of them are within the same states or markets that the initial 36 may have had. We may have had closures and others are in new markets. The way that we looked at this was with the initial 36, that was sort of what I'd characterize as the obvious closures. They were all acquired locations that were suboptimal in either the footprint, the layout, the quality of the build and most importantly, the in-person utilization of the space.

這是丹麥語。我會接受的。因此，其中一些與最初的 36 個可能位於相同的州或市場。我們可能已經關閉了，而其他人則進入了新市場。我們看待這個問題的方式是使用最初的 36，這就是我所說的明顯的閉包。它們都是被收購的地點，無論是佔地面積、佈局、建築質量，還是最重要的是，空間的實際利用率都不是最佳的。

With this next go-round, it's looking more broadly to say these centers may not check every single box, but there's a compelling reason, the largest one being in-person utilization and proximity to other centers where we can consolidate some of that visit volume and both patient traffic and clinician workspace. So it's a mixed bag to answer your specific question, which is, in some cases, they may be brand-new markets that were not part of the initial 36, in other cases that may occur in the same market.

在下一輪中，更廣泛地說這些中心可能不會檢查每一個方框，但有一個令人信服的理由，最大的一個是面對面的利用以及靠近其他中心，我們可以在那裡整合一些訪問量以及患者流量和臨床醫生工作空間。因此，回答您的具體問題是一個複雜的問題，即在某些情況下，它們可能是不屬於最初 36 個市場的全新市場，而在其他情況下可能會出現在同一市場中。

Next question comes from Kevin Caliendo with UBS.

下一個問題來自瑞銀集團的 Kevin Caliendo。

You mentioned you're sort of 2 quarters into a 2-year plan here in terms of updating, improving operations. I know a lot of the heavy lifting is done, but maybe can you talk about some of the initiatives you have going forward? And are those, again, to be margin enhancements, operational enhancements, revenue enhancements, all of the above. Just love to hear a little bit more detail on what you could share at least with sort of the next 18 months of this plan.

您提到，在更新、改進運營方面，您的兩年計劃已經進入了兩個季度。我知道很多繁重的工作已經完成，但也許您能談談您未來的一些舉措嗎？再次強調的是，利潤率提高、運營提高、收入提高等等。只是很想听聽您至少可以在該計劃的未來 18 個月中分享的更多細節。

Sure, Kevin. This is Ken. I want to be really clear while we are pleased with the progress, we literally are only 1/4 of the way through this 2-year investment phase where we have every intention of fortifying the foundation so that we can continue to build and grow a strong company. So none of us at LifeStance would decide -- would declare that the heavy lifting is done. We are -- there's plenty of heavy lifting that remains over the next 18 months. Having said that, I view the progress as solid and steady, but we are far from declaring victory.

當然，凱文。這是肯.我想澄清的是，雖然我們對進展感到滿意，但我們實際上只完成了這個為期 2 年的投資階段的 1/4，我們完全打算鞏固基礎，以便我們能夠繼續建立和發展一個實力雄厚的公司。因此，LifeStance 的任何人都不會決定——會宣布繁重的工作已經完成。我們——未來 18 個月還有大量繁重的工作要做。話雖如此，我認為進展是堅實和穩定的，但我們還遠未宣布勝利。

To the second part of your question, it really is all of the above. The work that we're doing is going to improve our operational performance that will drive improved administrative costs, operating leverage, if you will. But we're also doing things that will improve revenue. So it's across the board, and that's why we talk about it as transformational, because we're taking an incredibly high-growth business and we're taking just a bit of a pause to invest for 2 years so that we have a rock solid foundation upon which to grow going forward.

對於你問題的第二部分，確實是以上所有內容。我們正在做的工作將提高我們的運營績效，從而提高管理成本和運營槓桿（如果你願意的話）。但我們也在做一些可以提高收入的事情。所以這是全面的，這就是為什麼我們將其稱為變革性的，因為我們正在開展一項令人難以置信的高增長業務，並且我們只是暫停了兩年的投資，以便我們擁有堅如磐石的基礎為今後的發展奠定了基礎。

Appreciate that. A quick follow-up, if I might. Are you -- in terms of demand for services or patient traffic or the like, are you finding that just being in network is enough to fill your schedules? Or is there any additional outreach that needs to be done advertising and the like? Just sort of trying to understand the dynamics of where demand is currently and where you think it's heading.

感謝。如果可以的話，快速跟進。您是否——就服務需求或患者流量等而言，是否發現僅僅在網絡中就足以滿足您的日程安排？或者是否有任何額外的外展活動需要進行廣告等？只是試圖了解當前需求的動態以及您認為需求的走向。

Yes. Kevin, this is Danish. I can take that. So in general, as a starting point, from an industry perspective, patient demand outstrips supply. So irregardless of LifeStance, in general, we are all positioned well just based on the overwhelming demand for mental health services across the country.

是的。凱文，這是丹麥人。我可以接受。所以總的來說，作為一個起點，從行業角度來看，患者的需求超過了供應。因此，無論 LifeStance 是什麼，總的來說，基於全國對心理健康服務的巨大需求，我們都處於有利地位。

Now that being said, making sure that enough of that demand is appropriately coming our direction to fill the top of the funnel. And then obviously, all the operational execution that takes place to convert that to completed visit through the middle and the bottom of the funnel. That's where we're really focused.

話雖如此，確保有足夠的需求適當地來自我們的方向，以填補漏斗的頂部。顯然，所有的操作執行都是通過漏斗的中間和底部將其轉換為完成的訪問。這就是我們真正關注的地方。

But right now, with our marketing and business development efforts, which include our local relationships with primary care offices as well as our increasing levels of organic online presence and brand awareness, we feel that our top of the funnel or the overall patient demand as compared to the clinicians capacity we have to fill is appropriately right-sized.

但目前，通過我們的營銷和業務發展努力，包括我們與初級保健辦公室的本地關係以及我們不斷提高的有機在線形象和品牌知名度，我們認為我們的漏斗頂部或整體患者需求與我們必須填補的臨床醫生的容量是適當的。

I know you guys don't ever talk about your CAC. It's a number that others in the industry talk about a lot. But when you think about it, where do you expect the trends on that to go for you going forward, meaning where we are now, I understand the demand supply setup is favorable. Do you think it remains that way? Do you think it gets easier as your brand awareness gets better as your market penetration gets better. I'd just love to think about how you guys think about allocating resources in that direction going forward.

我知道你們從不談論你們的 CAC。這是業內其他人經常談論的一個數字。但是，當您考慮一下，您預計未來的趨勢將走向何方，即我們現在所處的位置，我知道需求供應設置是有利的。您認為情況仍然如此嗎？您是否認為隨著您的品牌知名度提高以及您的市場滲透率提高，事情會變得更容易？我只是想了解一下你們如何考慮在這個方向上分配資源。

We have always been, from the beginning of the company, very organic focus as it pertains to patient acquisition. So CAC or CPA is not something that we regularly discuss only because it is such a minimal amount of our total spend. So if you look at it in aggregate, like we've discussed on kind of previous -- in previous public statements. In totality, we spend less than 2% of revenue on everything related to "marketing." And so that is not just paid, which is a fraction of that 2%, that is the actual teams, the headcount, the related activities that they have.

從公司成立之初起，我們就一直非常注重患者獲取。因此，CAC 或 CPA 並不是我們經常討論的話題，因為它只占我們總支出的極小部分。因此，如果你從總體上看，就像我們在之前的公開聲明中討論過的那樣。總的來說，我們在與“營銷”相關的所有事情上的支出不到收入的 2%。因此，這不僅僅是報酬（這只是那 2％ 的一小部分），還包括實際的團隊、員工人數以及他們所進行的相關活動。

So we have an extremely efficient model as it pertains to patient acquisition because of the demand and that continues to move in a favorable direction as we focus on both organic and increasing levels of brand awareness as the primary drivers of filling our top of the funnel.

因此，我們有一個非常有效的模型，因為它與患者獲取有關，因為需求，並且隨著我們專注於有機和不斷提高的品牌知名度作為填充漏斗頂部的主要驅動力，該模型繼續朝著有利的方向發展。

Next question comes from Jamie Perse with Goldman Sachs.

下一個問題來自高盛的 Jamie Perse。

Danish, sticking with you here to start, just on the productivity front and your ability to fill capacity, that's obviously been a key driver of the outperformance in the first half. How much more room is there to improve that first piece, the ability to fill time through conversions and lower cancellations? And then you mentioned the other piece, which is maybe incentivizing clinicians to give you more of their time. What levers do you have to pull to accomplish that? And any thoughts on just the wage environment or compensation packages, changes you're making for clinicians?

丹麥人，從這裡開始，就生產力方面和填補產能的能力而言，這顯然是上半年表現出色的關鍵驅動力。第一個部分還有多少空間可以改進，即通過轉化和降低取消來填補時間的能力？然後你提到了另一件事，這可能會激勵臨床醫生給你更多的時間。為了實現這一目標，你必須拉動什麼槓桿？對於工資環境或薪酬方案以及您為臨床醫生所做的改變有什麼想法嗎？

You're right in -- when I started as COO, the very first focus for us was making sure that we're delivering on our commitments to our clinicians by filling the time that they were giving us appropriately with a full case load of patients. And so that cuts to the heart of everything we've talked about on the utilization side of the productivity equation.

你是對的——當我開始擔任首席運營官時，我們的首要關注點是確保我們兌現對臨床醫生的承諾，充分利用他們給我們的時間來處理滿負荷的患者。因此，這切入了我們在生產力等式的利用率方面所討論的一切的核心。

We've made very significant strides in that front with the specific example that we have given being cutting our cancellation rates down by about 1/3 since we've put a concerted effort against it. So though we continue to have further areas for improvement on the utilization front, we feel like we're in a spot where now is the right time to start to turn our attention to the other side of the equation, which is capacity.

我們在這方面取得了非常重大的進展，我們舉了一個具體例子，自從我們共同努力後，我們將取消率降低了約 1/3。因此，儘管我們在利用率方面仍然有進一步改進的地方，但我們覺得現在是開始將注意力轉向等式的另一面的正確時機，即容量。

There are a number of levers and incentives that we can pull there that we are starting to discuss with our leadership teams and the clinicians themselves to understand what we could do. But it's early enough in that -- in our kind of thought process there that will come back later once we've made more of a -- developed more of a concerted strategy around it.

我們可以採取許多槓桿和激勵措施，我們正在開始與我們的領導團隊和臨床醫生本身討論，以了解我們可以做什麼。但現在還很早——在我們的思維過程中，一旦我們制定了更多——圍繞它制定了更多協調一致的戰略，就會回來。

Things like our LTIP program was an initial path that starting to create long-term incentives around those clinicians that want to give us more of their capacity and more of their time and want to focus on filling that productively. And so we'll continue to evaluate other similar opportunities as we go forward, and we'll come back to you all when we have clarity there.

像我們的 LTIP 計劃這樣的事情是一條初始路徑，它開始為那些希望為我們提供更多能力和更多時間並希望專注於有效地填補這些空白的臨床醫生創建長期激勵措施。因此，我們將繼續評估其他類似的機會，當我們弄清楚之後，我們會再與大家聯繫。

Okay. And then maybe just a financial philosophy question. You're increasing revenue guidance EBITDA is being maintained. It sounds like there's not specific investments you're contemplating that are incremental. You mentioned just maintaining flexibility. So is the philosophy just that when you have a stronger top line, you'll reallocate that or invest incrementally in accelerating the operations? Or is there a potential to kind of let that flow through? Just any thoughts on how you think about that would be great.

好的。然後也許只是一個金融哲學問題。您正在增加收入指導，EBITDA 保持不變。聽起來您沒有考慮增量的具體投資。你提到只是保持靈活性。那麼，這個理念是否只是當你擁有更強大的收入時，你會重新分配它或增量投資以加速運營？或者是否有可能讓它流通？如果你有任何關於你如何看待這一點的想法那就太好了。

Jamie, it's Dave. I'll take that one. Basically, it's what you just described, which is for 2023, as we generate flexibility we are investing. We have an investment list that we're working through. There's not any new big initiatives there. It's more smaller investments in multiple areas. And I expect that to continue through 2023 if and when we generate financial flexibility. As we move into 2024, we will see operating leverage and margin improvement, but we still will be also making investments in '24, as Ken has stated, '23 and '24 are foundational and investment years.

傑米，我是戴夫。我會接受那個。基本上，這就是您剛才所描述的，即 2023 年，因為我們正在投資產生靈活性。我們正在製定一份投資清單。那裡沒有任何新的重大舉措。它是在多個領域進行更小的投資。如果我們實現財務靈活性，我預計這種情況將持續到 2023 年。當我們進入 2024 年時，我們將看到運營槓桿和利潤率的改善，但我們仍然會在 24 年進行投資，正如 Ken 所說，23 年和 24 年是基礎年和投資年。

We do have our last question comes from Brian Tanquilut with Jefferies.

最後一個問題確實來自 Jefferies 的 Brian Tanquilut。

Ken, maybe just a question on how you're thinking about the Biden's administration push to force more in-network coverage for behavioral health? I mean how do you think that affects LifeStance? Whether it's an opportunity or does that open the door for increased competition?

肯，也許只是一個問題，您如何看待拜登政府推動加強網絡內行為健康覆蓋？我的意思是，你認為這會如何影響 LifeStance？這是否是一個機會，或者是否為加劇競爭打開了大門？

Well, I'm entirely supportive. I think what President Biden is doing, he's highlighting what we've all observed, it existed before the pandemic, but the pandemic sort of elevated it and exacerbated the disconnect between the demand for mental health treatment and the supply.

嗯，我完全支持。我認為拜登總統正在做的事情，他強調了我們都觀察到的事情，它在大流行之前就存在了，但大流行在某種程度上加劇了這種情況，並加劇了心理健康治療的需求與供應之間的脫節。

So whether we're talking about fully realizing parity, or we're talking about responding to the changing condition, frankly, of the American Society, I think it will be positive as we sort of try to translate and navigate through a period where we're seeing unprecedented demand, and there's no indication that, that demand is going to subside.

因此，無論我們是在談論完全實現平等，還是在談論應對美國社會不斷變化的狀況，坦率地說，我認為這將是積極的，因為我們試圖翻譯和引導我們度過一個時期。我們看到了前所未有的需求，而且沒有跡象表明這種需求會消退。

So if it brings on more competition and people continue to find better ways to expand access to mental health, that's a positive. We don't think we are a good company because we lack competition. We think we're a good company because of the model that we've built and the way that we execute.

因此，如果它帶來更多競爭，並且人們繼續尋找更好的方法來擴大獲得心理健康的機會，那是積極的。我們認為我們不是一家好公司，因為我們缺乏競爭。我們認為我們是一家優秀的公司，因為我們建立的模型和執行的方式。

And then maybe as we think about the fact that you're calling contracting, I think you called out 30% have been eliminated. Are you seeing any flow through to the other side of the remaining clients or contracts with payers who are willing to give you the rate increases that you need to justify keeping them on the panel.

然後，也許當我們考慮您所說的承包這一事實時，我認為您稱 30% 已被淘汰。您是否看到任何流量流向剩餘客戶或與付款人簽訂的合同，這些付款人願意為您提供您需要增加的費率，以證明將他們保留在面板上是合理的。

Yes, that's an ongoing discussion and ongoing initiative. As we said in our prepared remarks, increasing our level of engagement with payers is really important. Certainly, the rates are important, but it's also the terms and it's the way in which we partner for mutual benefit. So we want to be a good partner. We want to be able to minimize the stress and strain for our patients and their members as they access mental health treatment, which is a courageous decision in and of itself.

是的，這是一個持續的討論和持續的倡議。正如我們在準備好的發言中所說，提高我們與付款人的接觸程度非常重要。當然，費率很重要，但它也是條款，也是我們為了互惠互利而合作的方式。所以我們想成為一個好的合作夥伴。我們希望能夠最大程度地減少患者及其成員在接受心理健康治療時的壓力和壓力，這本身就是一個勇敢的決定。

So removing barriers and everything from the credentialing process to the payment process, including reimbursement, it's just going to be an ongoing dialogue with our payer partners. The reduction in payer contracts was done for many reasons. The first reason is because we were looking to simplify our administrative burden and so this first tranche, as Danish said in his remarks, literally had a deminimis impact on patient visits and revenue because these were contracts where we're seeing very, very little visit activity.

因此，要消除從認證流程到支付流程（包括報銷）的所有障礙，我們將與付款合作夥伴進行持續對話。減少付款人合同的原因有很多。第一個原因是因為我們希望簡化我們的行政負擔，因此正如丹麥人在他的講話中所說，第一筆付款實際上對患者就診和收入產生了微乎其微的影響，因為在這些合同中，我們看到的就診量非常非常少活動。

As we go further, we'll continue to review this and make sure that the payer relationships that we have going forward fit our -- sort of our best interest and the best interest of our patients. So we'll be looking at rates. We'll be looking at volume. We'll be looking at the terms of the relationship.

隨著我們的進一步發展，我們將繼續審查這一點，並確保我們未來的付款人關係符合我們的最大利益和患者的最大利益。所以我們將關注費率。我們將關注數量。我們將研究這種關係的條款。

Understand. Maybe Dave, just one quick follow-up. You drew $25 million of the credit facility. Is that just a timing thing? How should we be thinking about that?

理解。也許戴夫，只是一個快速跟進。您提取了 2500 萬美元的信貸額度。這只是一個時間問題嗎？我們應該如何思考這個問題？

Yes, that was a timing thing. That was related to funding our acquisitions that were early in the year. We accessed our DDTL, the delayed draw term loan facility. And that was, again, just to maximize flexibility so we put more cash on the balance sheet.

是的，那是一個時機問題。這與我們年初的收購融資有關。我們使用了 DDTL，即延遲提取定期貸款工具。這又是為了最大限度地提高靈活性，以便我們在資產負債表上投入更多現金。

There are no further questions at this time. This concludes the question-and-answer session. Gentlemen, this concludes today's conference call. You may now disconnect.

目前沒有其他問題。問答環節到此結束。先生們，今天的電話會議到此結束。您現在可以斷開連接。