LifeStance Health Group Inc (LFST) 2023 Q4 法說會逐字稿

Good morning. My name is Audra, and I will be your conference operator today. At this time, I would like to welcome everyone to the lifestyle Health fourth quarter 2023 earnings call. Today's conference is being recorded. (Operator Instructions) At this time, I would like to turn the conference over to Monica precaution, Vice President of Investor Relations.

早安.我叫奧德拉，今天我將擔任你們的會議操作員。現在，我歡迎大家參加生活風格健康 2023 年第四季財報電話會議。今天的會議正在錄製中。（操作員指示） 現在，我想將會議交給投資者關係副總裁莫妮卡預防。

Thank you, operator. Good morning, everyone, and welcome to the lifestyles Health Fourth Quarter 2023 earnings conference call and Monica for Koski Vice President of Investor Relations. Joining me today are Ken Burdick, Chief Executive Officer, Dave Barton, Chief Financial Officer, and Donna Karan, Shea, Chief Operating Officer. 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 dot stamps.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 earnings press release and SEC filings.

謝謝你，接線生。大家早安，歡迎參加生活風格健康 2023 年第四季收益電話會議，歡迎莫妮卡·科斯基 (Monica for Koski) 投資者關係副總裁參加。今天與我一起出席的有首席執行官肯·伯迪克 (Ken Burdick)、首席財務官戴夫·巴頓 (Dave Barton) 和首席營運官謝伊唐娜·卡蘭 (Donna Karan)。我們在今天早上開盤前發布了收益報告和簡報。兩者均可在我們網站 Investordot stamps.com 的投資者關係部分取得。此外，在將電話會議轉交給管理層以聽取他們準備好的講話之前，將在電話會議結束後重播本次電話會議，請注意收益新聞稿和 SEC 文件中包含的有關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 comparisons of current and past performance. 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.

今天的言論包含前瞻性陳述，包括有關我們的財務表現展望、業務模式和策略的陳述。正如我們在向 SEC 定期提交的文件中所指出的，這些陳述涉及風險、不確定性和其他因素，可能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。收益新聞稿表和演示附錄中包含了與最直接可比較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。

At this time, I'll turn the call over to Ken Burdick, CEO. of Lightspan's. ken?

此時，我會將電話轉給執行長肯·伯迪克 (Ken Burdick)。的 Lightspan 的。肯？

Thanks, Monica, and thank you all for joining us today. I'd like to begin by highlighting what we stand for purifies fans. Every day, we are focused on three foundational pillars the patient experience, clinical quality and developing an inclusive purpose-driven culture. First, we are committed to putting the patient experience at the forefront of everything we do since the start of the pandemic, the country has experienced an alarming increase in the rates of anxiety and depression as well as guests resulting from overdose and suicide, more than 150 million people. We live in an area with a shortage of mental health professionals and only 56% of psychiatrists except commercial insurance, tens of millions of Americans are unable to access mental health care treats with devastating effects on families and communities.

謝謝莫妮卡，也謝謝大家今天加入我們。首先我想強調一下我們對淨化粉絲的立場。我們每天都專注於三個基本支柱：患者體驗、臨床品質和發展包容性的目標驅動文化。首先，我們致力於將患者體驗放在我們所做的一切工作的最前沿，自大流行開始以來，該國的焦慮和抑鬱發生率以及因服藥過量和自殺而導致的客人數量急劇增加，超過1.5億人。我們生活在一個心理健康專業人員短缺的地區，除了商業保險之外，只有56% 的精神科醫生，數以千萬計的美國人無法獲得心理健康護理，這對家庭和社區造成了毀滅性影響。

In 2023 life sciences team of over 6,600 clinicians helped address these access challenges by providing mental health services to over 880,000 patients who depend on our care with our differentiated hybrid model of in-person and virtual visits. We meet patients where they are by accepting insurance. We provide patients with affordable access to mental health care, whereas much of the market is cash pay and therefore, out of reach for the majority of Americans. The exceptional care provided by our clinicians is reflected in the feedback we receive from our patients in 2023. Lifespans received a patient Net Promoter Score of 82. And our average Google review score across all lifestyle centers stood at 4.5 out of five stars.

2023 年，由 6,600 多名臨床醫生組成的生命科學團隊透過我們的面對面和虛擬就診的差異化混合模式，為超過 880,000 名依賴我們護理的患者提供心理健康服務，幫助解決了這些獲取挑戰。我們透過接受保險來滿足患者的需求。我們為患者提供負擔得起的精神健康保健服務，而市場上的大部分都是現金支付，因此對大多數美國人來說是遙不可及的。我們的臨床醫生提供的卓越護理反映在我們 2023 年從患者收到的回饋中。Lifespans 的患者淨建議值為 82。我們所有生活中心的 Google 平均評分為 4.5 分（滿分五顆星）。

As you will hear in our prepared remarks, we continue to focus on enhancing the end to end experience for our patients. Second, we are dedicated to clinical quality life stance and our team of multidisciplinary clinicians are committed to providing patients with personalized, high-quality care with clinical integrity. We provide training programs for our clinicians and conduct clinical audits to conform with best practice guidelines, which also afford an opportunity for our clinical leaders to collaborate with and measure our clinicians. Our focus is on delivering the most appropriate treatment for each patient's individual needs based on informed clinical judgment as we enhanced our capabilities around clinical quality. I am excited to announce the appointment of Dr. LeWinn's while rent-a-car as Chief Medical Officer. He joined live stance in January and is off to a great start. Well, he's board-certified in pediatric and adult psychiatry, and he's held multiple senior clinical leadership roles in our industry.

正如您將在我們準備好的演講中聽到的那樣，我們將繼續致力於增強患者的端到端體驗。其次，我們致力於臨床品質的生活態度，我們的多學科臨床醫生團隊致力於為患者提供個人化、高品質的臨床誠信照護。我們為臨床醫生提供培訓計劃並進行臨床審核，以符合最佳實踐指南，這也為我們的臨床領導者提供了與臨床醫生合作和衡量臨床醫生的機會。我們的重點是在提高臨床品質能力的同時，根據明智的臨床判斷，為每位患者的個人需求提供最合適的治療。我很高興地宣布任命 LeWinn 醫師為首席醫療官。他在一月份加入了現場立場，並有了一個良好的開始。嗯，他獲得了兒科和成人精神病學的委員會認證，並在我們的行業中擔任過多個高級臨床領導職務。

Last but not least, we are evolving from an entrepreneurial company focused almost exclusively on growth to one that is more balanced and disciplined when it comes to prioritization and execution. While we continue to grow as a company, we are also growing us to ensure that as a company, we have the people, systems, processes and culture to deliver on our mission at scale. As a leadership team, we are committed to developing a sustainable, inclusive and purpose-driven culture that keeps our organization aligned with our vision mission and values.

最後但並非最不重要的一點是，我們正在從一家幾乎完全專注於成長的創業公司發展成為一家在優先順序和執行方面更加平衡和紀律嚴明的公司。在我們作為一家公司不斷發展的同時，我們也在不斷發展，以確保作為一家公司，我們擁有能夠大規模實現我們使命的人員、系統、流程和文化。作為一個領導團隊，我們致力於發展可持續、包容和目標驅動的文化，使我們的組織與我們的願景使命和價值觀保持一致。

2024 represents the 2nd year of our two year plan to invest in the business, fortify our foundation and standardize our operations at the one year, Mark, we'll begin to see some tangible benefits. First, we beat on all guided metrics for the full year 2023. This quarter represents the fifth consecutive quarter that Lightspan's has met or exceeded expectations across all financial metrics.

2024 年是我們投資業務、鞏固基礎和標準化營運的兩年計畫的第二年，馬克，我們將開始看到一些實際的好處。首先，我們超越了 2023 年全年的所有指導指標。本季是 Lightspan 的所有財務指標連續第五個季度達到或超出預期。

Second, we are making solid progress on our three strategic investments. We remain on track to launch both our human resource information system and our new credentialing and clinician onboarding system by this summer.

二是三大戰略投資紮實推進。我們仍有望在今年夏天推出人力資源資訊系統以及新的認證和臨床醫生入職系統。

For the third initiative, the electronic health record. We completed the initial discovery process where we identified incremental opportunities for improvement with our existing platform for 2024, we are focused on those improvements and enhancing related processes as a result, we will further evaluate our long-term EHR solution in 2020 price.

第三項措施是電子健康紀錄。我們完成了初步發現過程，確定了 2024 年現有平台的漸進式改善機會，我們專注於這些改進並增強相關流程，因此我們將在 2020 年價格中進一步評估我們的長期 EHR 解決方案。

One example of the improvements we are making is a digital patient check-in tool that we believe will enhance the patient clinician and front office staff experience while reducing our administrative costs. While it is still early, we have seen encouraging results in our initial launch. And third, we become much more strategic when it comes to our payer strategy.

我們正在做出的改進的一個例子是數位病患登記工具，我們相信它將增強病患臨床醫生和前台工作人員的體驗，同時降低我們的管理成本。雖然現在還為時過早，但我們在最初的發布中已經看到了令人鼓舞的結果。第三，在付款人策略方面，我們變得更具策略性。

In 2023, we terminated roughly 30% of our 440 payer contracts in 2024 we will continue to evaluate our payer relationships and focus on aligning with payer partners who share our vision of expanding access to mental health care. And finally, we continue to remain laser focused on profitability while making the near-term investments needed for the long-term success of the business. This was the first time in recent quarters where our revenue grew faster than our adjusted G&A. Going forward, we expect operating leverage and margin expansion to be the norm a nice stand this year.

2023 年，我們終止了440 份付款人合約中的大約30%，到2024 年，我們將繼續評估我們的付款人關係，並重點與那些與我們有著共同願景的付款合作夥伴保持一致，即擴大心理健康護理的覆蓋範圍。最後，我們持續高度關注獲利能力，同時進行業務長期成功所需的短期投資。這是近幾季我們的營收成長首次超過調整後的一般管理費用。展望未來，我們預期營運槓桿和利潤率擴張將成為今年的常態。

We will continue to strengthen our operational processes by streamlining, standardizing and automating end to end workflows. While we have made meaningful progress, there is plenty of work remaining to improve our operational and financial performance. Said differently, we have steadied the ship, but we have not yet come close to optimizing the potential of harvest.

我們將繼續透過簡化、標準化和自動化端到端工作流程來加強我們的營運流程。儘管我們取得了有意義的進展，但在改善我們的營運和財務表現方面仍有大量工作要做。換句話說，我們已經穩住了船，但我們還沒有接近優化收穫潛力。

With that, I'll turn it over to Dave to provide additional commentary on our fourth quarter and full year financial performance as well as our 2024 guidance.

接下來，我將把它交給戴夫，對我們第四季度和全年的財務業績以及 2024 年的指導提供更多評論。

Dave?

戴夫？

Thanks, Ken. Slide 10. I'm pleased with the team's operational and financial performance in 2023, exceeding our expectations for the full year.

謝謝，肯。幻燈片 10。我對團隊 2023 年的營運和財務表現感到滿意，超出了我們全年的預期。

In the fourth quarter, we achieved strong top line results with revenue of $281 million, representing growth of 22% year over year with outperformance in the quarter driven primarily by positive visit volumes as our clinicians delivered more visits during the holiday season than expected. Visit volumes of 1.8 million increased 20% year over year, primarily driven by organic condition growth and modest productivity improvements.

第四季度，我們取得了強勁的營收成果，營收為2.81 億美元，年增22%，該季度的出色表現主要得益於積極的就診量，因為我們的臨床醫生在假期期間的就診量超出了預期。遊客量達 180 萬人次，年增 20%，這主要是由於有機條件的增長和生產率的適度提高所推動的。

Total revenue per visit increased by 2% year over year to $157, primarily driven by payer rate increases. For the full year, we delivered revenue of $1,056 million, up 23% year over year. Regarding profitability, the better-than-expected top line results flowed through to center margin. Center margin of $83 million in linked-quarter increased by 33% year over year. Full year center margin of $302 million grew 27% year over year.

每次造訪的總收入年增 2%，達到 157 美元，這主要是由於付費費率上漲所致。全年我們營收 10.56 億美元，年增 23%。就獲利能力而言，好於預期的營收業績影響了中心利潤率。關聯季度的中心利潤率為 8,300 萬美元，年增 33%。全年中心利潤率為 3.02 億美元，較去年同期成長 27%。

Adjusted EBITDA of $20 million in the quarter was strong and consistent with our expectations. Our fourth quarter adjusted EBITDA increased 99% year over year. For the full year, adjusted EBITDA was $59 million, representing 5.6% of revenue.

本季調整後 EBITDA 為 2,000 萬美元，表現強勁，符合我們的預期。我們在第四季調整後的 EBITDA 年成長 99%。全年調整後 EBITDA 為 5,900 萬美元，佔營收的 5.6%。

Turning to liquidity, in the fourth quarter, we generated positive free cash flow of $5 million and $17 million in cash from operating activities. These improvements in cash flow were driven by higher collections with DSO improvement of 11 days from 52 in Q3 to 41 in Q4. Each one of these days represents approximately $3 million in cash.

談到流動性，第四季我們產生了 500 萬美元的正自由現金流和 1700 萬美元的營運活動現金。現金流量的這些改善是由於收款增加推動的，DSO 縮短了 11 天，從第三季的 52 天縮短到第四季的 41 天。這些天中的每一天都代表著大約 300 萬美元的現金。

As expected, DSO improved in Q4 as we released claims that we had intentionally held in Q three due to positive updates from rate negotiations with several large payers. Free cash flow and cash from operating activities were negatively impacted in the quarter due to the shareholder litigation settlement. As disclosed in an eight K filing earlier this month, we have now fulfilled our obligations related to this settlement, which we discussed in our last earnings call.

正如預期的那樣，DSO 在第四季度有所改善，因為我們發布了由於與幾家大型付款人的費率談判取得的積極進展而在第三季度有意持有的聲明。由於股東訴訟和解，本季自由現金流和經營活動現金流受到負面影響。正如本月稍早提交的 8K 文件中所揭露的，我們現已履行了與此和解相關的義務，我們在上次財報電話會議中對此進行了討論。

This included intentionally accelerating into Q4 for a final $25 million payment that was due in Q1. For the full year 2023, free cash flow was negative $57 million, which includes shareholder litigation expenses of approximately $50 million. We exited the quarter with $79 million in cash and net long-term debt of $280 million.

其中包括有意加速到第四季支付第一季到期的 2,500 萬美元最終付款。2023 年全年，自由現金流為負 5,700 萬美元，其中包括約 5,000 萬美元的股東訴訟費用。本季結束時，我們擁有 7,900 萬美元的現金和 2.8 億美元的淨長期債務。

We have additional debt capacity from a delayed draw term loan of $8 million as well as a $50 million revolving debt facility, providing us with sufficient financial flexibility. In terms of our outlook for 2024, we expect full year revenue of $1,190 million to $1,240 million center margin of $345 milliln to $365 million and adjusted EBITDA of $80 million to $90 million.

我們透過 800 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。就 2024 年的前景而言，我們預計全年營收為 11.9 億美元至 12.4 億美元，中心利潤率而言，我們預計全年營收為 11.9 億美元至 12.4 億美元，中心利潤率為 3.45 億美元至 3.65 億美元，調整後 EBITDA 為 8,000 萬美元至 9,000 萬美元。

Our annual guidance assumes year-over-year revenue growth, driven primarily by higher visits from clinician growth combined with a low single digit increase in the total revenue per visit. Otherwise, we're assuming generally consistent operational performance year over year.

我們的年度指導假設收入同比增長，這主要是由臨床醫生增長帶來的就診次數增加以及每次就診總收入的低個位數增長推動的。否則，我們假設營運績效逐年基本一致。

Our guidance also contemplates a revenue split of roughly 50-50 in the first and second half of the year due to seasonality. Regarding earnings as compared to 2023, where they were weighted to the second half. We expect this year's earnings to be more balanced throughout the year. This is due to the timing of investments and variation in rates, which are the result of payer rate changes and other mix components like geography and services.

由於季節性原因，我們的指導還考慮到今年上半年和下半年的收入分配約為 50-50。與 2023 年相比，收益已加權至下半年。我們預計今年全年獲利將更加平衡。這是由於投資時機和利率變化造成的，而投資時間和利率變化是由付款人利率變化以及地理位置和服務等其他組合因素造成的。

For the first quarter, we expect revenue of $287 million to $307 million. Center margin of $81 million to $93 million and adjusted EBITDA of $17 million to $23 million. Additionally, we expect stock-based compensation of approximately $80 million to $95 million in 2024, including approximately $20 million to $25 million from new 2024 grants.

我們預計第一季營收為 2.87 億美元至 3.07 億美元。中心利潤率為 8,100 萬美元至 9,300 萬美元，調整後 EBITDA 為 1,700 萬美元至 2,300 萬美元。此外，我們預計 2024 年的股票薪酬約為 8,000 萬至 9,500 萬美元，其中包括來自 2024 年新撥款的約 2,000 萬至 2,500 萬美元。

Consistent with our prior messaging on pausing M&A, we are not planning to pursue any acquisitions in 2024. I am excited to announce, and we expect to achieve a company milestone by generating positive free cash flow for full year 2024. This will be driven by improved profitability and lower capital expenditures as we continue to strategically moderate the opening of de novo centers. We expect leverage to come down significantly this year and anticipate net leverage to be below 2.5 times by the end of the year. We continue to have sufficient financial capacity to run the business and we do not intend to raise additional debt or equity in 2024 related to strategic initiatives. In 2023, we recognized a total of approximately $5.5 million of costs for the HRIS and credentialing and onboarding platform. Of this, $3 million were recognized as G&A expenses with the remainder in CapEx.

與我們先前關於暫停併購的消息一致，我們不打算在 2024 年進行任何收購。我很高興地宣布，我們預計透過在 2024 年全年產生正的自由現金流來實現公司的里程碑。隨著我們繼續策略性地控制新中心的開設，獲利能力的提高和資本支出的降低將推動這一趨勢。我們預計今年槓桿率將大幅下降，並預計到年底淨槓桿率將低於2.5倍。我們仍然有足夠的財務能力來經營業務，我們不打算在 2024 年籌集與策略性舉措相關的額外債務或股本。2023 年，我們確認 HRIS 以及認證和入職平台的成本總計約為 550 萬美元。其中，300 萬美元被確認為一般管理費用，其餘部分計入資本支出。

As Ken stated for the EHR, we are focused on improving our existing platform and related processes in 2024 and therefore will not incur any costs in the current year.

正如 Ken 在 EHR 中所說，我們的重點是在 2024 年改進現有平台和相關流程，因此今年不會產生任何費用。

In closing, we are pleased with the progress we made in 2023, and we are confident as we look ahead to 2024.

最後，我們對 2023 年的進展感到滿意，對 2024 年充滿信心。

Now I will turn it over to Dennis to share the work done in 2023 and the priority areas for 2024 that will position us to achieve our commitments.

現在我將把它交給丹尼斯，分享 2023 年所做的工作以及 2024 年的優先領域，這將使我們能夠實現我們的承諾。

Thanks, Dave. We continue to align our teams around two growth priorities, net clinician adds and clinician productivity. We grew by 227 net clinician adds in the fourth quarter and 1,014 for the full year, bringing our total clinicians to 6,645, an increase of 18% year over year. Importantly, our growth in Q4 remains 100% organic for the third consecutive quarter, our clinician value proposition remains strong and we are proud of our clinician recruiting and operations teams, great work in delivering clinician growth in 2023.

謝謝，戴夫。我們繼續圍繞兩個成長重點調整我們的團隊：臨床醫生淨增加和臨床醫生生產力。第四季臨床醫師淨增加 227 名，全年淨增加 1,014 名，臨床醫師總數達 6,645 名，年增 18%。重要的是，我們第四季的成長連​​續第三個季度保持100% 有機成長，我們的臨床醫生價值主張仍然強勁，我們為我們的臨床醫生招募和營運團隊感到自豪，他們在2023 年實現臨床醫生成長方面做出了出色的工作。

Turning to clinician productivity for 2023 on a visits per average clinician basis, we saw productivity increased by 2%, driven by many of the operational actions we saw throughout the year. As a reminder, productivity is a function of two components, clinician capacity or the time clinicians give us and utilization our ability to fill clinician time with patients.

談到 2023 年臨床醫生的生產力，以臨床醫生平均就診次數為基礎，我們發現，在我們全年看到的許多營運行動的推動下，生產力提高了 2%。提醒一下，生產力取決於兩個組成部分：臨床醫生的能力或臨床醫生給予我們的時間以及利用我們的能力來填補臨床醫生與患者的時間。

In 2023, we put our focus towards utilization, delivering on our core commitments to our clinicians to fill their schedules by driving operational discipline throughout the patient funnel. At the top of the funnel, we made enhancements to our primary care referral team organic search traffic, internal clinician referrals and enterprise referral partnerships. These actions delivered improvements in attracting new patients above the growth of our physician base, demonstrated by our growing waitlist for services I will note that our cost per new patient acquisition continued to decline year over year, and we spend a de minimus amount on paid advertising as part of our top of funnel strategy.

2023 年，我們將重點放在利用率上，兌現我們對臨床醫生的核心承諾，透過在整個患者管道中推動操作紀律來滿足他們的日程安排。在管道的頂部，我們增強了初級保健轉診團隊的自然搜尋流量、內部臨床醫生轉診和企業轉診合作關係。這些行動在吸引新患者方面的改善超過了我們醫生群體的增長，這從我們不斷增長的服務候補名單中可以看出。我要指出的是，我們獲得新患者的成本逐年持續下降，而且我們在付費廣告上的支出微乎其微。作為我們漏斗頂部策略的一部分。

Second, at the middle of the funnel in terms of converting patients to scheduled appointments, we continue to leverage our digital capabilities to improve patient matching via our online booking experience OB, which we rolled out nationwide. Additionally, we enhanced the patient experience with better online condition profiles, reduced scheduled complexity and enhancements. Our phone intake processes, which is a key area for 2024.

其次，在將患者轉化為預定預約的漏斗中間，我們繼續利用我們的數位能力，透過我們在全國推出的線上預約體驗 OB 來改善患者配對。此外，我們還透過更好的線上病情概況、降低的計劃複雜性和增強功能來增強患者體驗。我們的電話接收流程是 2024 年的關鍵領域。

Finally, at the bottom of the funnel, in terms of scheduled appointments converting to completed visits, our cancellation and no-show rates have now stabilized in the 9% to 10% range, which is a significant improvement from the previous 15% level when we set this as the focus area for improvement.

最後，在漏斗的底部，就已安排的預約轉化為已完成的訪問而言，我們的取消率和缺席率現已穩定在9% 至10% 的範圍內，這比之前的15% 水平有了顯著改善。我們將此作為重點改進領域。

As we head into 2024, we are shifting our attention to the other side of the productivity equation, clinician capacity. We have early initiatives in place to grow overall clinician capacity with the goal to reward and incentivize those clinicians offering full-time hours. For example, we are using tiered benefits to provide incentives such as medical coverage and for one K match to full-time clinicians. Additionally, our recruiting team is focused on attracting clinicians who desire full-time employment. And finally, we offer equity ownership through our long-term incentive program to attract and retain our highest contributing clinicians.

進入 2024 年，我們正在將注意力轉向生產力等式的另一面，即臨床醫生能力。我們已經採取了早期措施來提高臨床醫生的整體能力，目的是獎勵和激勵那些提供全職工作的臨床醫生。例如，我們使用分級福利來提供醫療保險等激勵措施，以及為全職臨床醫生提供 1K 匹配。此外，我們的招募團隊致力於吸引希望全職工作的臨床醫生。最後，我們透過長期激勵計畫提供股權，以吸引和留住貢獻最高的臨床醫生。

In addition to improving clinician productivity. We made notable strides in other areas during the past year. First, in terms of leadership, we reorganized and upgraded our practice operations, senior leadership team. We made significant changes, streamlining the number of senior leaders promoting top performers and bringing in new external talent with the appropriate skill sets to guide an organization of Life Sciences current and future scale.

除了提高臨床醫師的工作效率之外。過去一年，我們在其他領域取得了顯著進步。首先，在領導方面，我們對實踐業務、高階領導團隊進行了重組和升級。我們做出了重大改變，精簡了高層領導的數量，提拔了頂尖人才，並引進了具有適當技能的外部新人才，以指導當前和未來規模的生命科學組織。

Second, in terms of KPI.s, we reoriented our operations teams around the metrics-driven approach to managing the business and instituted a new reporting suite of KPI.s to bring focus prioritization and data-driven decision making to the organization while continuing to emphasize the patient and clinician experience serve in terms of culture, we restructured the Company around supporting local operations and clinician needs while emphasizing belonging and connection. For example, we prioritized increased teammate engagement, the social gatherings recognition and appreciation and participation in community volunteer events.

其次，在 KPI 方面，我們圍繞指標驅動的業務管理方法重新調整了我們的營運團隊，並製定了新的 KPI 報告套件，為組織帶來焦點優先級和數據驅動的決策，同時繼續為了強調患者和臨床醫生的文化服務體驗，我們圍繞著支持當地營運和臨床醫生的需求對公司進行了重組，同時強調歸屬感和聯繫。例如，我們優先考慮增加隊友的參與度、社交聚會的認可和讚賞以及社區志工活動的參與。

Fourth, in terms of cost efficiency, we completed our real estate optimization projects. In total, we consolidated 82 centers in 2023 with little to no disruption to our patients and clinicians. We opened 35 de novo centers, and we'll continue to intentionally moderate our pace of openings with an expectation of no more than 20 denovos in 2024.

四是在成本效益方面，完成了房地產優化項目。到 2023 年，我們總共整合了 82 個中心，對患者和臨床醫生幾乎沒有造成乾擾。我們開設了 35 個 de novo 中心，並且我們將繼續有意放慢開業速度，預計 2024 年 de novo 中心數量不會超過 20 個。

Finally, we made tangible progress in standardizing and streamlining the business, including moving to a single EHR phone system, KPI. suite, an online booking tool as well as creating a single operating model for our regional support teams. Looking ahead to 2024, there is no shortage of opportunities for improvement with many new initiatives unlocked by the work done in 2023, delivering an amazing patient and clinician experience remains a top priority for us. I'd like to take a moment to discuss three tangible examples of how we are going to do this while also generating operating leverage First, we are continuing to invest in the front office of our centers, focusing our resources on those areas of support that most directly impact the experience of our patients and clinicians we are increasing our center staffing levels over 25% by year end and redesigning our processes to better support our patients, clinicians and administrative support teams.

最後，我們在標準化和簡化業務方面取得了實際進展，包括轉向單一 EHR 電話系統 KPI。 suite、線上預訂工具以及為我們的區域支援團隊創建單一營運模式。展望 2024 年，不乏改進的機會，2023 年所做的工作開啟了許多新舉措，提供令人驚嘆的患者和臨床醫生體驗仍然是我們的首要任務。我想花點時間討論三個具體的例子，說明我們將如何做到這一點，同時也產生營運槓桿首先，我們將繼續投資於我們中心的前台部門，將我們的資源集中在那些支持的領域最直接影響我們的患者和臨床醫生的體驗，我們將在年底前將中心人員配備水準增加25% 以上，並重新設計我們的流程，以更好地支持我們的患者、臨床醫生和行政支援團隊。

Second, we are making improvements for new patients booking by the phone. We are rolling out the new phone booking tool that leverages the matching capabilities of OBI, our online booking tool. This will further enhance the patient matching experience while significantly reducing complexity and increasing the speed of scheduling over the phone for our in-state team.

其次，我們正在改進新患者透過電話預約的方式。我們正在推出新的電話預訂工具，該工具利用我們的線上預訂工具 OBI 的配對功能。這將進一步增強患者配對體驗，同時顯著降低複雜性並提高我們州內團隊透過電話安排的速度。

Third, we are piloting a new digital patient check-in tool that will allow us to collect and verify patient information upfront as well as allow patients to pay their balances more easily. This will reduce stress for patients and manual complexity for our operations and billing teams. We are doing all three of these things while also meeting our commitments to margin expansion in 2024, demonstrating that delivering improved patient and clinician experiences while also delivering improved operating leverage can be accomplished simultaneously.

第三，我們正在試行一種新的數位患者登記工具，該工具將使我們能夠預先收集和驗證患者信息，並讓患者更輕鬆地支付餘額。這將減輕患者的壓力以及我們的營運和計費團隊的手動複雜性。我們正在做所有這三件事，同時也履行我們對 2024 年利潤擴張的承諾，這表明可以同時實現改善患者和臨床醫生體驗的同時改善營運槓桿。

I'm proud of what our teams have accomplished over the past year, and I'm equally excited about the opportunities in front of us in 2024 and beyond. I'm also particularly proud of the strength of the leadership bench that we have built. We've delivered on our commitments for the full year 2023 and will be instrumental in leading the long-term profitable growth of the business.

我為我們的團隊在過去一年所取得的成就感到自豪，我同樣對 2024 年及以後我們面前的機會感到興奮。我也對我們所建立的領導班子的實力感到特別自豪。我們已經兌現了 2023 年全年的承諾，並將有助於引領業務的長期獲利成長。

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

說到這裡，我將把它轉回給肯，讓他作結束語。

Thanks, Dennis. In closing, I am encouraged by the progress made in 2023. We remain focused on operational improvements, profitable growth and disciplined capital deployment. Our 2024 guidance reflects the strong positive momentum of the organization. And we look forward to continuing to invest in the patient and clinician experience while at the same time delivering margin expansion. In particular, I am thrilled that we expect to achieve the important milestone of positive free cash flow for 2024.

謝謝，丹尼斯。最後，我對 2023 年的進展感到鼓舞。我們仍然專注於營運改善、獲利成長和嚴格的資本部署。我們的 2024 年指導反映了該組織強勁的積極勢頭。我們期待繼續投資於患者和臨床醫生的體驗，同時實現利潤率的擴張。我特別感到興奮的是，我們預計將在 2024 年實現正自由現金流這一重要里程碑。

Along with Dave and Dennis, I offer my thanks and appreciation to our 9,500 colleagues who demonstrate their dedication to our vision, mission and values in the work they do every day. It is due to their collective efforts that we have made significant strides toward realizing life-sciences potential. Operator, please open up the line for Q&A.

我與 Dave 和 Dennis 一起向我們的 9,500 名同事表示感謝和讚賞，他們在每天的工作中展現了對我們願景、使命和價值觀的奉獻精神。正是由於他們的集體努力，我們在實現生命科學潛力方面取得了重大進展。接線員，請開通問答線。

(Operator Instructions) Craig Hettenbach, Morgan Stanley.

（操作員說明）Craig Hettenbach，摩根士丹利。

Thank you, Ken, despite the comments of improved track record that you've seen in the last five quarters, so there's still some noise out there in terms of physician turnover and growth. So I'd love to get your take in terms of things you've done to kind of steadied the ship and expectations going forward on those metrics.

謝謝你，肯，儘管你在過去五個季度看到了改善記錄的評論，所以在醫生流動和增長方面仍然存在一些噪音。因此，我很想了解您為穩定局勢所做的事情以及對這些指標的未來期望的看法。

Sure. I'm going to let Danish respond to the clinician turnover. Generally, what I would say is on well, obviously, we've posted a strong fourth quarter. And as Dan, it's Dave and I have all said in our prepared remarks, it is plenty of work that remains to do. And Doug, I'll let Don perhaps elaborate on some of his comments as it relates to clinician growth and retention?

當然。我將讓丹麥人對臨床醫生的流動做出回應。總的來說，我想說的是，顯然，我們第四季的業績表現強勁。丹、戴夫和我在準備好的發言中都說過，還有大量工作要做。道格，我會讓唐詳細闡述他的一些評論，因為這與臨床醫生的成長和保留有關？

Sure, Greg. So in terms of clinician retention, it continues to remain stable. We have witnessed that throughout 2023 and feel really good about what we've been able to accomplish there. But as I indicated in my prepared remarks, we are continuing to focus on enhancing our value proposition to our clinicians and through the way that we are investing in the practice group, things like I mentioned, around increasing our front office staffing to have a very tangible and direct feeling of support for our clinicians across the country. Is one specific example, but as indicated by our net clinician adds of over 1,000, which we're very proud of, our ability to both attract and retain clinicians remains strong and we continue to be able to deliver that despite moving to what has essentially been for the last three quarters, 100% organic, and delivered net clinician adds above 2022 while moving towards a 100% organic strategy. So all in all, we feel great about where we're on. We're at today.

當然，格雷格。因此，就臨床醫生保留率而言，它繼續保持穩定。我們在 2023 年見證了這一點，並對我們所取得的成就感到非常滿意。但正如我在準備好的發言中指出的那樣，我們將繼續專注於增強我們對臨床醫生的價值主張，並透過我們對實踐小組的投資方式，就像我提到的那樣，圍繞著增加我們的前台人員配置，以擁有一個非常好的團隊。對全國各地臨床醫生的支持有形而直接的感覺。這是一個具體的例子，但正如我們的淨臨床醫生數量超過1,000 所表明的那樣，我們對此感到非常自豪，我們吸引和留住臨床醫生的能力仍然很強，並且我們繼續能夠實現這一目標，儘管我們已經轉向了本質上已經達到的水平。過去三個季度，100% 有機，交付的淨臨床醫生數量將超過 2022 年，同時朝著 100% 有機戰略邁進。總而言之，我們對目前的處境感覺很好。我們今天到了。

It is a question for Dave. Just on operating leverage. I know whether it's the footprint, consolidation, payer consolidation and a number of things at play. But this year, particularly you (technical difficulty) think single out expenses is going to be in Q2 to deliver operating leverage. And in APAC building to 2025 that look to Facebook, there's different things that come into the fold.

這是戴夫的問題。僅就經營槓桿而言。我知道這是否是足跡、整合、付款人整合以及許多因素在起作用。但今年，特別是您（技術困難）認為第二季將單獨支出以提供營運槓桿。在 Facebook 到 2025 年的亞太地區建設中，有不同的事情需要考慮。

Craig, it's Dave. I think I got the gist of your question, which was focused on operating leverage where you were cutting out pretty bad. As far as the operating leverage, yeah, we're guiding to improvements and operating leverage in 2024. I mean, one of the ways we're doing that is if you look at our Q1 guide and our full year guide on G&A, it's pretty flat throughout the year and we explained that is in the first quarter, you're going to get a pop up in G&A as a result of the resumption of the payroll taxes. And then as that goes away in subsequent quarters, it's being replaced by some of the investments that Donna talked about, digital check-in tool and things like that. But having said that, we're able to keep G&A spend relatively flat because of the efficiencies that we've been we've been working on as we've been strengthening and fortifying the business. So we feel feel really good about the margin expansion that we're seeing, both in the bottom line as well as incentive margin for 2024.

克雷格，我是戴夫。我想我明白了你問題的要點，問題的重點是營運槓桿，而你在這方面的表現非常糟糕。就營運槓桿而言，是的，我們正在指導 2024 年的改進和營運槓桿。我的意思是，我們這樣做的方法之一是，如果您查看我們的第一季指南和全年一般行政費用指南，您會發現全年的情況非常平穩，我們解釋說這是在第一季度，您將獲得由於恢復工資稅而在一般管理費用中彈出。然後，隨著這種情況在接下來的幾個季度中消失，它會被唐娜談到的一些投資、數字簽到工具之類的東西所取代。但話雖如此，我們能夠保持一般管理費用相對平穩，因為我們在加強和強化業務的過程中一直在努力提高效率。因此，我們對所看到的利潤率擴張感到非常滿意，無論是在利潤方面還是在 2024 年的激勵利潤率方面。

Lisa Gill, JPMorgan.

麗莎·吉爾，摩根大通。

Thank you, Matt, and good morning. Ken, I was wondering if you could give us an update on where you are in the managed care payer contracting strategy and how much is left to be done here in 2024? And then when I look at the revenue per clinician, I think you talked about rates getting better in the fourth quarter and holding some claims until the fourth quarter. How do you think about that progression of revenue per clinician going into 2024?

謝謝你，馬特，早安。Ken，我想知道您能否向我們介紹一下您在管理式醫療付款人合約策略中的最新進展以及 2024 年還需要做多少工作？然後，當我查看每位臨床醫生的收入時，我認為您談到了第四季度的費率有所改善，並將一些索賠保留到第四季度。您如何看待 2024 年每位臨床醫師的收入成長？

Sure, Lisa, I'll take the first part of that and let Danish speak to the revenue per clinician. Our payer strategy really is going to continue on the work that we started in 2023, which is, but I was very surprised to see the number of payer contracts we had. It was well in excess of 400. We reduced that by about 30% last year. We will do an additional reduction this year, probably not quite as large. But then I think what's most important is sharing the underlying rationale of why we're doing it. So when we think about our payer contracts, first and foremost, we found that we had many, many where there was such little volume.

當然，麗莎，我將討論第一部分，讓丹麥人談談每位臨床醫生的收入。我們的付款人策略確實將繼續我們在 2023 年開始的工作，但我很驚訝地看到我們擁有的付款人合約數量。遠遠超過了400。去年我們將這一數字減少了約 30%。今年我們將進一步削減，但幅度可能不會那麼大。但我認為最重要的是分享我們這樣做的根本原因。因此，當我們考慮我們的付款人合約時，首先也是最重要的是，我們發現我們有很多很多，但數量卻很少。

It just didn't make sense, contact administratively to maintain the work to reload the rates to do the credentialing, et cetera. So that's important beyond volume. We look at the administrative terms that we have with a payer and look to trying to make them and simple and straightforward and not overly complex and onerous. We also look at whether or not we have delegated credentialing because we have found there's a dramatic reduction and the time it takes to onboard a clinician when they grant us delegation.

這是沒有意義的，聯繫行政人員以維持工作，重新加載費率以進行認證，等等。所以這比數量更重要。我們會研究與付款人簽訂的管理條款，並努力使它們簡單明了，而不是過於複雜和繁瑣。我們也會檢查是否已委託認證，因為我們發現當臨床醫生授予我們委託時，臨床醫生入職所需的時間和時間都會大幅減少。

And then the last two things are we certainly look at the reimbursements that were paid and their desire and willingness to partner with us with strategic initiatives such as value-based care and integrated care between physical and mental health.

最後兩件事是我們當然會關注所支付的報銷情況以及他們與我們合作實施戰略舉措的願望和意願，例如基於價值的護理和身心健康之間的綜合護理。

Elyse, this is Dave. I'll take your the kind of the TRPV. growth question. So in the fourth quarter, as you noted, we had a material step up in our in our rates or the revenue. We were collecting per clinician. The primary drivers of ITRPV. improvement in the fourth quarter were driven by the higher increase in the higher margin, higher revenue services we've talked about for neuroscience testing and services like that. And in addition, we did get some nice increases in payer payer rates in the fourth quarter. I'd have you think about that as largely, we were getting increases for 2020 for just a few months a few months earlier.

伊麗絲，這是戴夫。我會選擇你的那種TRPV。成長問題。因此，正如您所指出的，在第四季度，我們的費率或收入有了實質的提高。我們正在收集每個臨床醫生的資訊。ITRPV 的主要驅動因素。第四季度的改善是由我們談到的神經科學測試和類似服務的更高利潤、更高收入服務的更高成長所推動的。此外，我們在第四季度的付款人付款率確實取得了一些不錯的成長。我想讓你考慮一下，在幾個月前，我們在 2020 年僅幾個月就獲得了加價。

So that's what drove the increase in the total rate per visit in the fourth quarter, but you mentioned the holding of claims that was more of a cash phenomenon, something that impacted our cash. We were still booking until appropriate levels of revenue. So that didn't impact our TRPV. It was really more an impact on DSO. And as you noted, we did release those claims and you saw our TRPR., you saw DSO come down significantly in the fourth quarter as we expected.

這就是第四季度每次訪問總費用增加的原因，但您提到持有索賠更多的是現金現象，這影響了我們的現金。我們仍在預訂，直到收入達到適當水平。所以這並沒有影響我們的 TRPV。這對 DSO 的影響更大。正如您所指出的，我們確實發布了這些聲明，並且您看到了我們的 TRPR。您看到 DSO 在第四季度顯著下降，正如我們預期的那樣。

And if I can just squeeze in a quick follow-up. Just you talked about full-time employees and the capacity opportunity that you talk about how many of your clinicians are full-time today and what the ultimate goal would be?

如果我能快速跟進一下的話。剛才您談到了全職員工和產能機會，您談到了今天有多少臨床醫生是全職的，最終目標是什麼？

Yes, this is Danish. So our long-term goal is to always make sure that we're creating an environment where clinicians feel like they can dedicate, they are full caseload and time to lifespan. And we continue to enhance our benefits, create incentives and rewards for clinicians to do that. However, on we do have both clinicians that are providing, would you consider a full time in the higher end of ours and we have ones that are more part time and our value propositions are different city, which continue to resonate for both.

是的，這是丹麥語。因此，我們的長期目標是始終確保我們創造一個環境，​​讓臨床醫生感覺他們可以奉獻，他們可以處理完整的病例並有足夠的時間完成生命週期。我們將繼續提高我們的福利，為臨床醫生這樣做提供激勵和獎勵。然而，我們確實有兩位臨床醫生提供服務，您是否會考慮在我們的高端提供全職服務，而我們有更多的兼職臨床醫生，而且我們的價值主張是不同的城市，這將繼續引起雙方的共鳴。

The point in our prepared remarks was that we continue to focus our energies around incentivizing and rewarding clinicians to really build their careers here and have those be their on their primary or only source in Carm-Ann.

我們準備好的演講中的要點是，我們繼續將精力集中在激勵和獎勵臨床醫生在這裡真正建立自己的職業生涯，並使這些成為他們在卡姆安的主要或唯一來源。

Ryan Daniels, William Blair.

瑞恩·丹尼爾斯、威廉·布萊爾。

Hey, guys, this is [Jack Senft] on for Ryan Daniels. Congrats on the quarter and thanks for taking the questions. Just for a clarification for 2024 I know you aren't expecting to open more than 20 clinics. And I guess just what is your expectation for consolidating clinics this year? Are you completely passed that hurdle now? Or Is kind of an ongoing situation?

嘿，夥計們，這是瑞恩·丹尼爾斯的[傑克·森夫特]。恭喜本季度，感謝您提出問題。澄清一下，我知道您預計 2024 年不會開設超過 20 家診所。我想您對今年整合診所的期望是什麼？現在你已經完全跨過這個坎了嗎？還是一種持續存在的情況？

Hey, this is Danish. It's like can you talk about that. So again, as we mentioned in the prepared remarks, we consolidated 82 centers in 2023 at this point, kind of a broad scale consolidation like that, we would consider complete and behind us on a go forward basis as leases come up for renewal every year. We will continue to evaluate each and renew or close as it makes sense, but it will not be a large scale effort like what we saw in 2023.

嘿，這是丹麥語。就像你能談談這個嗎？因此，正如我們在準備好的演講中提到的那樣，我們在2023 年整合了82 個中心，這是一種大規模的整合，我們會考慮在未來的基礎上完成並支持我們，因為每年都會更新租賃。我們將繼續評估每一項，並在有意義時更新或關閉，但這不會是我們在 2023 年看到的大規模努力。

We will now drive further optimization, primarily through monitoring the pace of our denovos and take placing bills in markets where in-person demand continues to increase beyond the footprint, we have in any of those markets as well as building further clinician density within the existing 575 centers that we have today. I would note that in-person continues to be a very important part of our overall hybrid strategy and is a significant differentiator for us versus others that are out there. And we continue to, I believe, firmly in the hybrid model and that we have done them and the large lifts and optimizing our footprints in 2023.

我們現在將推動進一步的優化，主要是透過監控我們的devos 的速度，並在現場需求持續增加超出我們在任何這些市場中的足跡的市場中開具賬單，以及在現有的市場範圍內進一步建立臨床醫生密度。我們今天擁有 575 個中心。我要指出的是，面對面仍然是我們整體混合策略中非常重要的一部分，也是我們與其他人相比的一個顯著差異化因素。我相信，我們將繼續堅定地採用混合模式，我們已經在 2023 年完成了這些任務、大型升降機並優化了我們的足跡。

Okay, perfect. Thanks. As a quick follow-up to Lisa's question. In the prepared remarks, you did mention the shifting your focus towards clinician capacity and you want to reward and incentivize clinicians offering full time off our hours. Can you just dive a bit deeper on this a little bit more clinicians coming from private practices or, you know, competitors desiring these type of benefits more? Or is there anything you've learned with incoming hires that you kind of talk about with that with these incentives?

好的，完美。謝謝。作為麗莎問題的快速跟進。在準備好的演講中，您確實提到將重點轉向臨床醫生的能力，並且您希望獎勵和激勵全職休假的臨床醫生。您能否更深入地了解更多來自私人診所的臨床醫生，或者您知道，競爭對手更希望獲得此類福利？或者您從新員工身上學到了什麼，可以透過這些激勵措施來談論？

Sure. This is Danish. I can cover that. So yes, as we look at where we attract clinicians, it tends to fall into three areas. One is conditions that are looking for improved lifestyle and are moving away from, but typically inpatient physicians or hospital-based physicians with heavy caseloads and they are looking to have benefits as part of that transition because that's typically what they're receiving at the other environments.

當然。這是丹麥語。我可以涵蓋這一點。所以，是的，當我們看看吸引臨床醫生的地方時，它往往分為三個領域。一種是尋求改善生活方式並正在遠離的情況，但通常是住院醫生或處理大量病例的醫院醫生，他們希望在這一轉變中獲得好處，因為這通常是他們在其他地方獲得的好處。

The other areas you see is new grads coming out of training that are looking for to start their careers. And we're looking for someone that can provide overall employee moves inclusive of benefits as they begin to start operating as a practice and commission and then the third is conditions that are coming either out of solo practice or other small group practices that are typically 1099 in nature and do not offer benefits and so particularly for that group, though, across all three, it resonates, but particularly for that group of clinicians and being able to incentivize and reward them through benefits like health care from k match, et cetera, is something that is unique and that we offer and continues to be a differentiator for our value proposition.

您看到的其他領域是剛結束培訓、正在尋求開始職業生涯的新畢業生。第 1099 章本質上並且不提供福利，因此特別是對於該群體而言，儘管在所有三個方面，它都會引起共鳴，但特別是對於該群體的臨床醫生來說，並且能夠通過k match 等的醫療保健等福利來激勵和獎勵他們，是我們提供的獨特產品，並將繼續成為我們價值主張的差異化因素。

Kevin Caliendo, UBS.

凱文‧卡里恩多，瑞銀集團。

This is actually Dylan Finley on for Kevin Caliendo on as the volumes are approaching 25 and your prior comments on exiting that year with double digit margins. I guess first of all, there's still a reasonable objective and as of today. And then secondly, based on the improvements indicated in '24, it seems like [$25 million] year with a little more of a heavier lift on. And just wondering if you could break out on the sources of that margin expansion on, does that contemplate further center margin improvement versus a reduction in certain operating expenses?

這實際上是 Dylan Finley 為 Kevin Caliendo 所做的，因為銷量已接近 25 份，而您之前對當年以兩位數利潤率退出的評論。我想首先，到目前為止，仍然有一個合理的目標。其次，根據 24 年指出的改進，似乎每年 [2500 萬美元]，還有更多的提升。只是想知道您是否可以突破利潤率擴張的來源，是否考慮進一步提高中心利潤率而不是減少某些營運費用？

Yes, we looked at the guidance for 24 in our previous comments relative to exiting 25 with double digit margins. I would describe this is right on track. We've said in the past, it wouldn't necessarily be completely linear and on. We're really pleased that as compared to our sort of long-term comments on where we were you're projecting and committing to free cash flow for full year 2025 in this call this morning, we're announcing that a year earlier such that 2024. We are now expecting a full year that will generate free cash.

是的，我們在先前的評論中查看了 24 的指導，相對於以兩位數利潤率退出的 25。我想說這是正確的軌道。我們過去說過，它不一定是完全線性的。我們非常高興的是，與我們在今天早上的電話會議中對我們的預測和承諾的 2025 年全年自由現金流的長期評論相比，我們一年前就宣布了這一點，以便2024 年。我們現在預計全年將產生自由現金。

Brian Tanquilut, Jefferies.

布萊恩·坦奎魯特，傑弗里斯。

Hey, good morning, guys. Maybe just to Dan, just point on increasing incentive offers new clinicians, how should we be thinking about the impact of that unnecessarily be as you roll that out?

嘿，早上好，夥計們。也許對 Dan 來說，只要提到增加新臨床醫生的激勵措施，當你推出這項措施時，我們該如何考慮這種不必要的影響？

And it absolutely be part of what we did, but it's our last part of your question.

這絕對是我們所做工作的一部分，但這是我們問題的最後一部分。

Yes, just on the impact of rolling out a new incentive program on the salaries, wages, and benefits line.

是的，只是關於推出新的激勵計劃對工資、工資和福利線的影響。

So this will be a new benefits program. This is just simply shaping the overall benefits program that we administer to health lean, heavier towards incentivizing clinicians that are offering full-time hours versus those that remain a part-time or on very part time. So there's not a growth in the overall cost structure as it relates to the benefits just again, is shaping of how we are aligning that between part-time and full-time clinicians.

所以這將是一個新的福利計劃。這只是簡單地塑造我們管理的整體福利計劃，以實現健康精簡，更注重激勵那些提供全職工作時間的臨床醫生，而不是那些仍然兼職或非常兼職的臨床醫生。因此，整體成本結構沒有成長，因為它再次與效益相關，正在塑造我們如何調整兼職和全職臨床醫生之間的關係。

And then maybe, Ken, just any thoughts that you could share with us on your view on the fundamental trends within behavioral health in your patient population because as we looked at your growth rate, right, I mean, you've seen it in the high teens to low 20% range. Just your thoughts on the sustainability of that level of volume growth, especially given the backdrop that we see in the mental health space.

然後，肯，也許您可以與我們分享您對患者群體行為健康基本趨勢的看法，因為當我們觀察您的增長率時，對，我的意思是，您已經在從高10% 到低20% 的範圍。只是您對這種數量增長水平的可持續性的看法，特別是考慮到我們在心理健康領域看到的背景。

Yes. Certainly on a macro basis, the demand for outpatient mental health services has not subsided at all. So we have a very significant long term tailwind there on specifically to light stance, obviously, as we continue to go larger and larger, the days of 75%, 100% year over year growth are behind us.

是的。當然，從宏觀來看，門診心理健康服務的需求並沒有絲毫減弱。因此，我們有一個非常重要的長期順風，特別是在輕型立場上，顯然，隨著我們繼續做得越來越大，75%、100%的同比增長的日子已經過去了。

We continue to build strong conviction around our and our estimates around mid-teen organic growth that obviously when we go back to pursuing some acquisitions that will drive it beyond the mid 10s. So we think there's plenty of opportunity for continued growth in the business, even as we sort of double down and focus on margin expansion and profitability and efficient capital deployment also.

我們繼續對 10 多歲左右的有機成長抱持堅定的信念，顯然，當我們回去進行一些收購時，這將推動有機成長超過 10 多歲。因此，我們認為，即使我們加倍努力並專注於利潤率擴張和盈利能力以及高效的資本部署，業務仍有大量持續增長的機會。

Thank you.

謝謝。

Stephanie Davis, Barclays.

史蒂芬妮戴維斯，巴克萊銀行。

Thanks taking my questions. First, Danish, we've seen some pretty rapidly changing trend over the past few years around patient acquisition, efficiency and cost. Does hoping we could dig in a little more to that patient acquisition strategy, touch on your comments, talk to me about top of funnel versus middle funnel, bottom of funnel and kind of how much mindshare is taking and maybe what areas you could be focusing less on versus the prior year?

謝謝回答我的問題。首先，丹麥人，我們在過去幾年中看到了圍繞患者獲取、效率和成本的一些快速變化的趨勢。是否希望我們能進一步深入了解患者獲取策略，談談您的評論，與我討論漏斗頂部與漏斗中部、漏斗底部以及需要多少注意力以及您可能會關注哪些領域與上一年相比減少了嗎？

Well, sure, Stephanie. Thanks for the question. So as I mentioned in our prepared remarks, we continue to be focused on all three, top, middle and bottom of the funnel. However, as I think back to 2023, a considerable amount of our effort went into improvements in the bottom of the funnel, which we talked about each quarter in the improvements we saw at our no-show and cancellation rates by approximately five to six points over that, the kind of the year plus that we've been talking about that

嗯，當然，史蒂芬妮。謝謝你的提問。正如我在準備好的演講中提到的，我們繼續關注漏斗的頂部、中間和底部這三個部分。然而，回想 2023 年，我們投入了大量精力來改進漏斗底部，我們每個季度都會談論我們在缺席率和取消率方面看到的改進大約五到六個點除此之外，我們一直在談論的這一年

. And so though there remains some additional opportunity there over time. I largely view the work in optimizing the bottom of the funnel as complete and stable. And so we will continue to shift our attention towards particularly the middle of the funnel where we are improving our matching capabilities, both online through the rollout of OB and through improving our phone intake and matching experience by leveraging a lot of the capabilities first developed for OB. And then top of the funnel, it will always be a focus. We have been able to demonstrate not just a patient acquisition in terms of volume above the pace of growth of our clinician base. But we've also been able to deliver that while bringing down the cost of acquisition for each new visits over time. And so it will, by the nature of the business requirements remain focused there. But over the last year and what we would view at least for 2024 and Vietnam likely beyond this, patient demand will continue to outstrip supply. So an area of focus but middle of the funnel between the three is going to be the most focus on area for 2024.

。因此，隨著時間的推移，仍然存在一些額外的機會。我在很大程度上認為優化漏斗底部的工作是完整且穩定的。因此，我們將繼續將注意力轉向漏斗的中間部分，我們正在提高我們的匹配能力，無論是通過推出 OB 進行在線匹配，還是通過利用最初開發的許多功能來改善我們的電話接收和匹配體驗。OB 。然後在漏斗的頂部，它將永遠是一個焦點。我們不僅能夠證明患者獲取量超過了我們臨床醫生基礎的成長速度。但隨著時間的推移，我們也能夠實現這一目標，同時降低每次新訪問的獲取成本。因此，根據業務需求的性質，它仍然會集中在那裡。但在過去的一年裡，我們預計至少在 2024 年以及之後的越南，患者需求將繼續超過供應。因此，位於三者之間的漏斗中間的一個重點領域將成為 2024 年最受關注的領域。

And when I think about the forward for kind of your patient acquisition strategy is this something where it's being tweaked and you're making some of these last year was bottom of funnel narrowed in middle top of funnel more. And then it's kind of a more stable process in the out years? Or is this something that has to be continuing to improve?

當我想到你的患者獲取策略的前景時，它正在被調整，去年你所做的一些事情是漏斗底部在漏斗中間頂部進一步縮小。那麼在接下來的幾年裡這是一個更穩定的過程嗎？或者這是必須繼續改進的事情嗎？

I mean, I view anything as you continue to scale as the business that you're forever, optimizing it. And so and whether there are significant, whether there's significant room for improvement over a longer trajectory will remain to be seen. But I mean, we will always be optimizing around the edges for both top middle and bottom of the funnel, but at least as it pertains to the part of the heavy lifting done, I think 24 will be a middle of the funnel focus. And then at that point, just optimization of the business continues to scale over the coming years.

我的意思是，當你繼續擴大業務規模並對其進行最佳化時，我認為一切都是如此。因此，在較長的發展軌跡上是否有顯著的改進，是否有顯著的改進空間，仍有待觀察。但我的意思是，我們將始終圍繞漏斗頂部中間和底部的邊緣進行優化，但至少與完成的繁重工作相關，我認為 24 將是漏斗焦點的中間。到那時，業務優化將在未來幾年繼續擴大規模。

I'll just add, I think one of the most powerful things that Dan has shared in his remarks is the extent to which we are able to overlay on referrals from physicians and such that our paid advertising to acquire new patients is quite tiny, frankly, compared to some others in our space.

我只想補充一點，我認為丹在他的演講中分享的最有力的事情之一是我們能夠在多大程度上覆蓋醫生的推薦，坦率地說，我們用於獲取新患者的付費廣告非常小，與我們空間中的其他一些相比。

And there are no further questions at this. I would like to turn the conference over to Ken Burdick for closing remarks.

這沒有其他問題了。我想請肯‧伯迪克 (Ken Burdick) 致閉幕詞。

Thank you. I've shared previously the founders of life-science designed a great model, achieved exceptional growth and has given new commerce like myself and Dave, an opportunity to evolve and scale a great business. I want to remind everyone, we are still in the early stages. We are a young business. We have grown through both acquisition, approximately 100 acquired independent practices and thousands of clinicians hired one by one. And as we continue to emphasize these phrases like operational improvement and plenty of work to do. I wanted to just understand that it's not false utility. That is a realistic acknowledgment of where we are in our multiyear journey. We have more work to do. We continue to improve our focus on execution, prioritization, standardization so that we can run a more efficient business, recognizing that there's more work to do.

謝謝。我之前曾分享過，生命科學的創始人設計了一個偉大的模型，實現了非凡的成長，並為像我和戴夫這樣的新商業提供了發展和擴展偉大企業的機會。我想提醒大家，我們還處於早期階段。我們是一家年輕的企業。我們透過這兩次收購不斷成長，大約收購了 100 家獨立診所，並一一聘請了數千名臨床醫生。我們繼續強調營運改進和大量工作要做等這些短語。我只是想明白這不是虛假的效用。這是對我們多年歷程中所處位置的現實承認。我們還有更多工作要做。我們繼續加強對執行、優先順序和標準化的關注，以便我們能夠更有效率地經營業務，並認識到還有更多工作要做。

I do want to be sure to call out that I could not be more proud of my teammates across wise because the passion that they demonstrate the work ethic that they display is not only the key to our past accomplishments, but it's going to be the source of our future achievements as we continue to realize the potential of our business.

我確實想指出，我為我的隊友們感到無比自豪，因為他們所表現出的職業道德不僅是我們過去成就的關鍵，而且將成為我們的源泉隨著我們不斷發揮業務潛力，我們將取得未來的成就。

Thank you for your interest in live stance, and thanks for joining us today.

感謝您對即時立場的興趣，並感謝您今天加入我們。

And if this does conclude today's conference call, thank you for your participation. You may now disconnect.

如果今天的電話會議到此結束，感謝您的參與。您現在可以斷開連線。