LifeStance Health Group Inc (LFST) 2024 Q1 法說會逐字稿

Thank you for standing by. My name is Alex, and I will be your conference operator today. At this time, I would like to welcome everyone to the Lifestance Health first quarter 2024 earnings conference call. (Operator Instructions)

謝謝你的支持。我叫亞歷克斯，今天我將擔任你們的會議操作員。現在，我歡迎大家參加 Lifestance Health 2024 年第一季財報電話會議。（操作員說明）

I would now like to turn the call over to Monica Prokocki, Vice President of Investor Relations. Blease. Go ahead.

我現在想將電話轉給投資者關係副總裁 Monica Prokocki。拜託。前進。

Thank you, operator. Good morning, everyone, and welcome to Life Science Health first quarter 2024 earnings conference call. I'm 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.

謝謝你，接線生。大家早安，歡迎參加生命科學健康 2024 年第一季財報電話會議。我是莫妮卡‧普羅科基 (Monica Prokocki)，投資人關係副總裁。今天加入我的是執行長肯·伯迪克 (Ken Burdick)；戴夫波登，財務長；營運長丹麥庫雷希 (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.

我們在今天早上開盤前發布了收益報告和簡報。兩者皆可在我們網站 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。

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.

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.

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。

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. 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.

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 LifeStance. Ken?

此時，我會將電話轉給 LifeStance 執行長 Ken Burdick。肯？

Thanks, Monica, and thank you all for joining us today. In the first quarter, we once again beat on all our guided metrics making this the sixth consecutive quarter that LifeStance has met or exceeded expectations.

謝謝莫妮卡，也謝謝大家今天加入我們。在第一季度，我們再次超越了所有指導指標，這使得 LifeStance 連續第六個季度達到或超出預期。

We delivered strong financial performance with revenue growth of 19% to $300 million and adjusted EBITDA up 174% to $28 million. We are also raising full year adjusted EBITDA guidance based on the strength of the quarter.

我們實現了強勁的財務業績，營收成長 19%，達到 3 億美元，調整後的 EBITDA 成長 174%，達到 2,800 萬美元。我們也根據本季的實力提高了全年調整後 EBITDA 指引。

Our clinician value proposition continues to resonate with 221 net clinician adds in the quarter, representing 15% entirely organic growth in our clinician base. Our patient experience continues to receive outstanding scores for the patient Net Promoter Score of 84 and average Google reviews across LifeStance centers at 4.5 out of 5 stars.

我們的臨床醫生價值主張繼續與本季度淨增加的 221 名臨床醫生產生共鳴，占我們臨床醫生基礎的 15% 的完全有機增長。我們的患者體驗持續獲得出色的評分，患者淨推薦值高達 84 分，LifeStance 中心的 Google 平均評價為 4.5 顆星（滿分為 5 顆星）。

Before covering our strategic and operational highlights, I would like to share the news that Danish has reached the difficult decision to leave LifeStance. Knowing this was not an easy decision, I'd like to give Danish the opportunity to directly share his thoughts with all of you.

在介紹我們的策略和營運亮點之前，我想先分享一下丹麥人做出離開 LifeStance 的艱難決定的消息。我知道這不是一個容易的決定，我想給丹麥人一個直接與大家分享他的想法的機會。

Thank you, Ken. In March we celebrated the seven year anniversary of the founding of LifeStance. That's giving me the chance to reflect on all that we have achieved over the years in service of our mission of increasing access to affordable mental health care as one of the founders of LifeStance, it's been a remarkable journey as we've grown the company from our first practice group of approximately 100 clinicians in Ohio to almost 7,000 clinicians across 33 states touching the lives of millions of patients for the better all along the way. It's been one of the great joys of my life have contributed to those achievements.

謝謝你，肯。三月份，我們慶祝了 LifeStance 成立七週年。作為 LifeStance 的創始人之一，這讓我有機會反思我們多年來為實現增加人們獲得負擔得起的精神健康保健服務的使命而取得的所有成就，這是一段非凡的旅程，我們將公司從我們的第一個實踐小組由俄亥俄州約100 名臨床醫生和遍布33 個州的近7,000 名臨床醫生組成，一路走來，讓數百萬患者的生活變得更好。這些成就是我一生中最大的快樂之一。

Two years ago, it became clear that we needed to make the shift from a high growth startup to a scaled public company. At that time, I stepped into the role of President and COO with the goal of solidifying the foundation of the business, rebuilding, and upskilling our operations leadership team and moving us to a performance-driven organization. I am so proud of all that we've accomplished since then and I'm particularly proud of the strength of the operations leadership team we've built. No better demonstrated than by our delivering six sequential quarters of meeting and exceeding our financial commitments.

兩年前，我們很明顯需要從一家高成長的新創公司轉變為規模化的上市公司。當時，我擔任總裁兼營運長，目標是鞏固業務基礎，重建和提高我們的營運領導團隊的技能，並將我們轉變為績效驅動型組織。我對自那時起我們所取得的成就感到非常自豪，尤其對我們建立的營運領導團隊的實力感到自豪。我們連續六個季度的會議並超越了我們的財務承諾就是最好的證明。

Having enjoyed the privilege of building LifeStance since its founding and having spent the last 2 years turning LifeStance into a high-performing and stable public company, for me, now is the right time to step away and take on my next challenge. As an entrepreneur and builder at heart, I have the desire and drive to make a similar impact on other parts of the health care ecosystem as I've had the privilege of doing so here at LifeStance.

自從 LifeStance 成立以來，我一直享有創建 LifeStance 的榮幸，並在過去兩年中將 LifeStance 轉變為一家高性能且穩定的上市公司，對我來說，現在是離開並接受下一個挑戰的最佳時機。作為一名本質上的企業家和建設者，我有願望和動力對醫療保健生態系統的其他部分產生類似的影響，就像我有幸在 LifeStance 這樣做一樣。

This has not been an easy decision, and I want to thank all of those who have helped me as I thought this through over the previous months. I will continue to operate in my current role through the end of June. However, many of the changes needed to ensure a smooth transition have been put into place over the course of the last 2 years as we have built out our leadership bench strength and worked together to solidify our foundation.

這不是一個容易的決定，我要感謝所有在我過去幾個月思考這個問題時幫助我的人。我將繼續擔任目前的職位直至六月底。然而，在過去兩年中，隨著我們增強了領導力並共同努力鞏固了我們的基礎，確保平穩過渡所需的許多變革已經落實到位。

While I'm excited about my next chapter, I have never felt more confident in the future of LifeStance, and I look forward to seeing all that the team achieves over the coming years.

雖然我對我的下一個篇章感到興奮，但我對 LifeStance 的未來充滿信心，我期待看到球隊在未來幾年取得的一切成就。

With that I'll pass it back to Ken.

我會把它傳回給肯。

Thank you, Danish. I've appreciated Danish's contributions and have enjoyed the partnership that we've developed. He has made an extraordinary impact on the organization over the past 7 years. I am grateful that he has engaged in these conversations with myself and the Board to ensure a smooth transition through his final day. I know that I speak for the entire leadership team when I express profound appreciation for his contribution to LifeStance and a genuine desire for his continued success in the next chapter of his career.

謝謝你，丹麥人。我感謝丹麥人的貢獻，並享受我們建立的夥伴關係。在過去 7 年裡，他對本組織產生了非凡的影響。我很感激他與我本人和董事會進行了這些對話，以確保在他的最後一天順利過渡。我知道，當我對他對 LifeStance 的貢獻表示深切讚賞，並衷心希望他在職業生涯的下一個篇章中繼續取得成功時，我代表整個領導團隊。

As Danish referenced, LifeStance is well positioned to continue our exciting journey of expanding access to high-quality, affordable mental health care. We have made strong progress on improving our operations and strengthening our team. To ensure a smooth transition, several of our leaders have already stepped into increased responsibility for which they are well prepared and most deserving.

正如丹麥所提到的，LifeStance 處於有利地位，可以繼續我們令人興奮的旅程，擴大獲得高品質、負擔得起的精神衛生保健的機會。我們在改善營運和加強團隊方面取得了巨大進展。為了確保平穩過渡，我們的幾位領導人已經承擔了更多的責任，他們已做好充分準備，也是理應承擔的責任。

My conviction is stronger than ever regarding the ability of LifeStance's unique business model to address the challenges that have long existed within the industry. We see the benefits of our model play out through an exceptional patient experience, continued clinician growth and our ability to navigate industry challenges in ways that positively differentiate us from other mental health companies.

我比以往任何時候都更堅信 LifeStance 獨特的商業模式有能力應對業界長期存在的挑戰。我們看到我們的模式的好處透過卓越的患者體驗、持續的臨床醫生成長以及我們以積極區別於其他心理健康公司的方式應對行業挑戰的能力而發揮出來。

The recent cyber cyber-attack on Change Healthcare offers a tangible proof point of LifeStance's differentiation and resilience. While Change Healthcare Systems were down, many mental health provider groups experienced unprecedented financial distress due to their inability to process claims and receive reimbursement, which in many cases affected their ability to pay their clinicians for the services they provide.

最近針對 Change Healthcare 的網路攻擊為 LifeStance 的差異化和彈性提供了切實的證據。在變革醫療系統癱瘓的同時，許多精神健康服務提供者團體由於無法處理索賠和獲得報銷而經歷了前所未有的財務困境，這在許多情況下影響了他們向臨床醫生提供的服務付費的能力。

Our clinicians are W-2 employed and paid on a fee-for-service basis with guaranteed rate schedules. Thanks to our scale and flexibility. We have been able to absorb 100% of the impact of reimbursement delays without financial disruption to our clinicians.

我們的臨床醫生是 W-2 僱員，並按服務收費和有保證的費率表支付報酬。感謝我們的規模和靈活性。我們已經能夠 100% 吸收報銷延遲的影響，而不會對我們的臨床醫生造成財務中斷。

Additionally, we have been able to achieve this without the need to raise debt or equity capital. And as Dave will touch on shortly, we remain on track to be free cash flow positive for the full year of 2024.

此外，我們無需籌集債務或股本就能實現這一目標。正如 Dave 稍後將談到的，我們仍有望在 2024 年全年實現正自由現金流。

Shifting to payer strategy. We have previously stated that we are becoming more assertive in demanding appropriate reimbursement and terms for our services. Overall, we've been successful in these efforts as evidenced by the 4% year-over-year increase we saw in total revenue per visit in the first quarter. This was driven by the positive outcomes of several contract negotiations in late 2023 and early 2024.

轉向付款人策略。我們之前曾表示，我們在要求適當的報銷和服務條款方面變得更加自信。總體而言，我們在這些努力上取得了成功，第一季每次造訪總收入年增 4% 就證明了這一點。這是由 2023 年底和 2024 年初多項合約談判的積極成果所推動的。

Our increased engagement has translated into improved reimbursement from payers. However, we had a single outlier with historically above-market rates who negotiated reimbursement that will now bring them in line with our overall book of business. This will create short-term downward pressure on total revenue per visit for the back half of 2024 and the first part of 2025. Importantly, this both derisks our overall portfolio and has already been contemplated in our 2024 guidance raise.

我們參與度的提高已轉化為付款人報銷的改善。然而，我們有一個異常值，歷史上的利率高於市場水平，他們協商了報銷，現在這將使他們與我們的整體業務保持一致。這將對 2024 年下半年和 2025 年上半年的每次訪問總收入造成短期下行壓力。重要的是，這不僅降低了我們整體投資組合的風險，也已經在我們 2024 年的指導上調中考慮到了。

This is another demonstration of our resilience and ability to deliver on our commitments. We continue to expect total revenue per visit to increase by low single digits for the year. And in the medium and longer term, we continue to see meaningful upside opportunity to increase the level of reimbursement with payers. With our unique outpatient and in-network business model, we provide both patients and our payer partners with an affordable option for increasing access to much-needed mental health care services.

這再次證明了我們履行承諾的韌性和能力。我們仍然預計今年每次訪問的總收入將以較低的個位數成長。從中長期來看，我們繼續看到提高付款人報銷水準的有意義的上昇機會。憑藉我們獨特的門診和網路內業務模式，我們為患者和付款合作夥伴提供負擔得起的選擇，以增加獲得急需的精神健康保健服務的機會。

Before closing, I am pleased to announce that we welcomed Dr. Teresa DeLuca to our Board of Directors. She is a psychiatrist and accomplished physician executive with over 20 years of leadership experience in health care operations and clinical management. I am confident that Teresa will be a great addition to the LifeStance Board.

在結束之前，我很高興地宣布，我們歡迎 Teresa DeLuca 博士加入我們的董事會。她是一位精神科醫生和卓有成效的醫師主管，在醫療保健運營和臨床管理方面擁有 20 多年的領導經驗。我相信特蕾莎將成為 LifeStance 委員會的重要補充。

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

接下來，我會將其交給戴夫，以對我們的財務表現和前景提供更多評論。戴夫？

Thanks, Ken. Like Ken, I'm pleased with the team's operational and financial performance in the first quarter. We delivered solid top line results with revenue of $300 million, representing growth of 19% year over year. The outperformance was primarily driven by higher total revenue per visit and increased visit volumes, both were modestly above our expectations.

謝謝，肯。和 Ken 一樣，我對團隊第一季的營運和財務表現感到滿意。我們實現了穩健的營收業績，營收達 3 億美元，年增 19%。表現優異主要是由於每次訪問總收入的增加和訪問量的增加，兩者均略高於我們的預期。

Visit volumes of $1.9 million increased 15% year over year, primarily driven by higher organic clinician growth. In the first quarter, we added 221 net clinicians, which was above our expectations. This brings our total clinician base to 6,866 clinicians, representing growth a 15% year over year. While we do not guide on clinician count, I want to highlight that we expect net clinician adds in the second quarter to be meaningfully lower than the first quarter, which is similar to the dynamic we saw last year with the trend reversing later in the year.

就診量為 190 萬美元，年增 15%，這主要是由於臨床醫生的有機成長所致。第一季度，我們淨新增 221 位臨床醫生，超出了我們的預期。這使得我們的臨床醫生總數達到 6,866 名，年增 15%。雖然我們沒有對臨床醫生數量進行指導，但我想強調的是，我們預計第二季度的臨床醫生淨增加量將顯著低於第一季度，這與我們去年看到的動態類似，趨勢將在今年晚些時候逆轉。

Clinician productivity was in line with our expectations in the first quarter with the timing of holidays and spring breaks impacting clinician capacity. Total revenue per visit increased by 4% year over year to $157, primarily driven by payer rate increases.

第一季臨床醫師的生產力符合我們的預期，假期和春假的時間影響了臨床醫師的能力。每次訪問的總收入年增 4% 至 157 美元，這主要是由於付費費率上漲所致。

Regarding profitability, the better than expected top line results flowed through to center margin. Center margin of $95 million in the quarter increased by 36% year over year, and center margin as a percentage of revenue grew nearly 4 point to 31.5%. The year-over-year improvement was primarily due to higher total revenue per visit and operating leverage in center costs, mainly driven by real estate optimization.

就獲利能力而言，好於預期的營收業績影響了中心利潤率。本季中心利潤率為 9,500 萬美元，年增 36%，中心利潤佔收入的百分比增長了近 4 個百分點，達到 31.5%。同比改善主要是由於每次訪問總收入增加以及中心成本的營運槓桿增加，這主要是由房地產優化推動的。

Outperformance in the quarter was driven by favorable spending and to a lesser extent, higher total revenue per visit.

本季的優異表現是由有利的支出以及較小程度上的每次訪問總收入的增加所推動的。

Adjusted EBITDA of $28 million in the quarter was very strong and outperformed our expectations, increasing 174% year over year. Adjusted EBITDA as a percentage of revenue grew over 5 point to 9.2%. The outperformance in adjusted EBITDA is attributable to the improvement in center margin.

本季調整後 EBITDA 為 2800 萬美元，非常強勁，超出了我們的預期，年增 174%。調整後 EBITDA 佔營收的百分比成長超過 5 個百分點，達到 9.2%。調整後 EBITDA 的優異表現歸因於中心利潤率的改善。

Turning to liquidity. In the first quarter, free cash flow was negative $27 million. We exited the quarter with $49 million in cash and net long-term debt of $280 million. As Ken touched on, we did see a temporary disruption to our cash collections from the cyberattack on Change Healthcare. This resulted in a net impact of approximately $18 million, comprised of delayed cash collections, partially offset by stronger cash management.

轉向流動性。第一季自由現金流為負 2,700 萬美元。本季結束時，我們擁有 4,900 萬美元的現金和 2.8 億美元的淨長期債務。正如 Ken 所說，我們確實看到 Change Healthcare 的網路攻擊導致我們的現金收款暫時中斷。這導致約 1,800 萬美元的淨影響，其中包括現金收款延遲，但部分被更強的現金管理所抵消。

DSO increased to 53 days in the quarter with the impact from change being approximately nine days. The impact from Change is expected to be a timing issue that will largely resolve itself in the second quarter. We are already seeing progress with improved DSO in April and anticipate that DSO will revert back to normal later this year. As a result of this, we remain confident in our commitment to deliver positive free cash flow in 2024.

本季 DSO 增加到 53 天，變化的影響約為 9 天。變革的影響預計將是一個時間問題，將在第二季基本解決。我們已經在 4 月看到 DSO 的改進取得了進展，並預計 DSO 將在今年稍後恢復正常。因此，我們對 2024 年實現正自由現金流的承諾仍然充滿信心。

We also 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 and have no intention of raising additional debt or equity. We continue to see improvement in our leverage ratios with net leverage improving sequentially over 40 basis points to 3.1 times. We remain confident that we will finish the year with net leverage below 2.5 times.

我們還透過 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，並且無意籌集額外的債務或股本。我們的槓桿率持續改善，淨槓桿率連續改善 40 個基點至 3.1 倍。我們仍有信心今年年底淨槓桿率將低於 2.5 倍。

In terms of our outlook for 2024. We are maintaining our full year revenue range of $1,190 million to $1,240 million. We feel good about the improved margin performance of the business and are raising the center margin range by $8 million at the midpoint at $353 million to $373 million. And the adjusted EBITDA range by $8 million at the midpoint to $88 million to $98 million.

就我們對 2024 年的展望而言。我們將全年收入維持在 11.9 億美元至 12.4 億美元之間。我們對業務利潤率表現的改善感到滿意，並將中間利潤率範圍提高 800 萬美元，達到 3.53 億美元至 3.73 億美元。調整後的 EBITDA 範圍為 800 萬美元至 8,800 萬至 9,800 萬美元。

We continue to expect the earnings to have a different quarterly progression compared to 2023, which was more weighted to the back half. Whereas this year we will be more weighted in the front half of the year.

我們仍然預計，與 2023 年相比，季度獲利將有所不同，2023 年的比重更集中在下半年。而今年我們將在上半年給予更多的權重。

As Ken noted, we will see a negative impact on total revenue per visit in the second half as a result of a rate decrease from one payer, partially offset by increases from others.

正如肯所指出的那樣，由於一個付款人的費率下降，我們將看到下半年每次訪問的總收入受到負面影響，而其他付款人的費率增加部分抵消了這一影響。

We continue to expect total revenue per visit to increase by low single digits for the year. In the medium and longer term, we continue to see meaningful upside opportunity to increase the level of reimbursement with payers and remain confident in our commitment to exit 2025 at double digit margins. For the second quarter, we expect revenue of $297 million to $315 million, center Margin of $85 million to $97 million, and adjusted EBITDA of $20 million to $26 million.

我們仍然預計今年每次訪問的總收入將以較低的個位數成長。從中長期來看，我們繼續看到有意義的上升機會，可以提高付款人的報銷水平，並對我們以兩位數利潤率退出的承諾充滿信心。我們預計第二季營收為 2.97 億美元至 3.15 億美元，中間利潤為 8,500 萬美元至 9,700 萬美元，調整後 EBITDA 為 2,000 萬美元至 2,600 萬美元。

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。

Thank you, Dave. In closing, I'm proud of the results achieved by our clinicians and team members this quarter. We delivered strong organic revenue growth while executing on our commitment to deliver year over year operating leverage and margin expansion.

謝謝你，戴夫。最後，我對我們的臨床醫生和團隊成員本季的成果感到自豪。我們實現了強勁的有機收入成長，同時履行了逐年實現營運槓桿和利潤擴張的承諾。

I'd like to once again thank Danish for his contributions to LifeStance, and wish him well on his career journey. While we are sad to see him go, we are well positioned to continue delivering on our mission of expanding access to high-quality, affordable mental health care.

我要再次感謝丹麥人對 LifeStance 的貢獻，並祝福他的職業生涯一切順利。雖然我們對他的離開感到悲傷，但我們有能力繼續履行我們的使命，擴大獲得高品質、負擔得起的精神健康保健的機會。

While I recognize that we still have a great deal of work ahead in 2024 and beyond, I am encouraged by the momentum we are building toward our stated commitments of positive free cash flow in 2024, growing revenue at mid-teens through 2025, and exiting 2025 with double-digit margins.

雖然我意識到我們在2024 年及以後仍有大量工作要做，但我對我們正在為實現2024 年正自由現金流、到2025 年收入增長到10% 左右以及退出的既定承諾而建立的勢頭感到鼓舞。

As a country, we have underfunded mental health care and underserved millions of individuals for far too long. Our team at LifeStance will continue to work tirelessly to address these challenges until mental health parity is a reality.

作為一個國家，我們的精神健康保健資金不足，並且長期以來為數百萬人提供的服務不足。我們 LifeStance 的團隊將繼續不懈地努力應對這些挑戰，直到心理健康平等成為現實。

Operator, we're now ready for questions.

接線員，我們現在準備好提問了。

(Operator Instructions) Craig Hettenbach, Morgan Stanley.

（操作員說明）Craig Hettenbach，摩根士丹利。

Yeah, thank you. I wanted to touch on the better-than-expected center margin EBITDA. Ken, when you joined, there was a focus, an increased emphasis on kind of building a foundation, increased investments in the business. And it looks like that's starting to translate. So would love to get your take on just operating leverage in the model as you see it and kind of how you see that path to 10% margins exiting next year.

是的，謝謝。我想談談好於預期的 EBITDA 中心利潤率。肯，當你加入時，有一個重點，更強調建立基礎，增加對業務的投資。看起來這已經開始轉變了。因此，我很想知道您對模型中營運槓桿的看法，以及您如何看待明年實現 10% 利潤率的路徑。

Sure. Thanks for the question, Craig. You're right. I think we are encouraged by the operating leverage that we're beginning to experience. I would also highlight that we had some delayed expense that contributed to an outperformance and also that, as I've shared before, this is sort of a two year journey of rebuilding and strengthening the foundation, improving the processes. So I would view this as initial progress and some demonstration of the benefit. But my view is we're sort of five quarters into what's likely going to be an eight or nine quarter improvement in our operating efficiency and, therefore, operating leverage.

當然。謝謝你的提問，克雷格。你說得對。我認為我們對我們開始體驗到的營運槓桿感到鼓舞。我還要強調的是，我們有一些延遲的費用，這導致了我們的優異表現，而且正如我之前所分享的，這是一個為期兩年的重建和加強基礎、改進流程的旅程。所以我認為這是初步進展和一些好處的證明。但我的觀點是，我們的營運效率以及營運槓桿率可能會在五個季度內有所改善，因此營運槓桿率可能會提高八個或九個季度。

Got it. And then just as a follow-up, I wanted to touch on just capacity and just any update. There's efforts to improve capacity by moving clinicians more towards full-time arrangements. So kind of where things stand there and what that could mean the next 12 to 18 months?

知道了。然後，作為後續行動，我想談談容量和任何更新。人們正在努力透過讓臨床醫生更多地轉向全職安排來提高能力。目前的情況如何？

Hey, Craig, this is Danish. I can answer that. So like we discussed on last quarter's earnings call, because of all the work that we put into -- on the utilization side of the productivity equation, we have begun our shift towards the capacity side. A lot of those plans have just started to get underway in Q1, so it's early days.

嘿，克雷格，這是丹麥人。我可以回答這個問題。正如我們在上個季度的財報電話會議上討論的那樣，由於我們在生產力等式的利用率方面投入的所有工作，我們已經開始向產能方面轉變。其中許多計劃在第一季才剛開始實施，所以現在還處於早期階段。

And we're hoping that, that will start to play out in a more meaningful way throughout the course of the year. But as a reminder, we have not, in our guidance, included any assumptions around improvements in productivity. So again, early days around capacity, and we'll continue to provide updates as they make sense.

我們希望，這將在今年開始以更有意義的方式發揮作用。但提醒一下，我們的指導中沒有包含任何關於生產力提高的假設。再說一次，關於容量的早期階段，我們將繼續提供有意義的更新。

Thank you.

謝謝。

(Operator Instructions) Lisa Gill, JP Morgan.

（操作員指示）Lisa Gill，摩根大通。

Thanks very much. Good morning. First off, Danish, I wanted to say I wish you the best in your next endeavor. It was nice getting to know you. And for my question, Ken, I want to understand, when we think about the payer strategy, you talked about the single outlier that's now in line. Can you maybe just talk about was that a really unusual contract that was signed? Like I just want to better understand why it was an outlier.

非常感謝。早安.首先，丹麥人，我想說我祝你在接下來的努力中一切順利。很高興認識你。對於我的問題，肯，我想了解，當我們考慮付款人策略時，您談到了現在符合的單一異常值。您能否談談所簽署的合約是否非常不尋常？就像我只是想更好地理解為什麼它是異常值。

And then secondly, when we think about the new contracts that are being signed, is there anything that's changing in the contracting? I agree with you how important mental health is and the lack of mental health providers we have. So I was just a little surprised to hear that there is this one outlier. I just want to better understand that. Thanks so much.

其次，當我們考慮正在簽署的新合約時，合約中是否有任何變更？我同意你的觀點，心理健康是多麼重要，而且我們缺乏心理健康提供者。所以當我聽到這個異常值時，我有點驚訝。我只是想更好地理解這一點。非常感謝。

Sure. Thanks for the question. It really was. It was a historic outlier and meaningfully higher than sort of the portfolio of contracts that we had. And it goes back several years. We would have loved for it to continue. But we always knew that there was a possibility that through negotiations, it would come back to sort of where the overall market is for us. So it truly was unique. And we are being paid, as I say, consistent with the rest of our payer community. We will continue to look for upgrades because it's not identical. One of the things that we feel is that everyone should pay their fair share. And so we continue to work on that.

當然。謝謝你的提問。確實如此。這是一個歷史性的異常值，明顯高於我們擁有的合約組合。這可以追溯到幾年前。我們希望它能繼續下去。但我們一直知道，透過談判，有可能回到整體市場對我們來說的位置。所以它確實是獨一無二的。正如我所說，我們的報酬與我們付款人社群的其他成員一致。我們將繼續尋找升級，因為它不完全相同。我們認為的一件事是每個人都應該支付公平的份額。因此我們將繼續致力於此。

As it relates to sort of the demand/supply, what's really important to remember is that employers are really demanding better access for their employees and their employees' dependents. And because of that fact, we have constructive discussions and negotiations with payers. And while I would love to see us move into more value-based contracting, I would say right now, we're in the very, very early stages of that. And you'll see and hear more about that in the years to come. But there's really no major change other than the drumbeat from employers for greater access.

由於它涉及某種需求/供應，真正重要的是要記住，雇主確實要求為其僱員及其僱員的家屬提供更好的訪問權限。正因為如此，我們與付款人進行了建設性的討論和談判。雖然我希望看到我們轉向更多基於價值的合同，但我想說，現在我們正處於非常非常早期的階段。在未來的幾年裡，您將會看到和聽到更多相關內容。但除了雇主要求提供更多機會之外，實際上沒有什麼重大變化。

Great. Thank you.

偉大的。謝謝。

Ryan Daniels, William Blair.

瑞恩·丹尼爾斯、威廉·布萊爾。

Hey, guys, this is Jack Senft for I Daniel. Thanks for taking the question. Congrats on the quarter. I just want to go back to basically the same line of questions. For the payer outlier that had the above-market rate, can you just talk just a little bit more about it? I'm assuming that this is the payer that had significant volume, given the near-term impact. So is there any way to kind of quantify the impact or, I guess, how we should think about the impact? I understand the downward pressure, but just curious if you can dive a little bit deeper into that.

嘿，夥計們，這是《丹尼爾》的傑克森夫特。感謝您提出問題。恭喜本季。我只想回到基本上相同的問題。對於高於市場利率的付款人異常值，您能多談談嗎？考慮到近期的影響，我假設這是擁有大量交易量的付款人。那麼有沒有什麼方法可以量化影響，或者我想我們該如何考慮影響？我理解下行壓力，但只是好奇你是否能更深入地了解這一點。

Yes. We're going to resist the temptation to get very specific about any one single payer negotiation. As you can appreciate, whether it's, in this case, going down or in many -- in most other cases, going up, it doesn't behoove us to get into the specific details of any one single negotiation.

是的。我們將抵制住對任何單一付款人談判進行非常具體的誘惑。正如你所理解的，無論是在這種情況下下降，還是在許多其他情況下上升，我們都沒有必要深入了解任何一項談判的具體細節。

So I can confirm that, yes, it's a national payer with significant volume, which is why we thought it was important in this call to share that while we had an outstanding first quarter, we want to be sure people, as they do their modeling, don't just extrapolate from the first quarter, multiply it by 4 and say, "Okay, you're on your way to an unbelievable beat."

因此，我可以確認，是的，它是一個擁有大量交易量的國家支付者，這就是為什麼我們認為在這次電話會議中分享這一點很重要，雖然我們第一季表現出色，但我們希望在人們進行建模時確保他們，不要只是從第一季推斷，將其乘以 4 並說：“好吧，你正在走向令人難以置信的節奏。”

We had a great beat in the first quarter. And what we're trying to project in both our prepared remarks and during the Q&A is we expect that the rest of the year will play out and consistent with our original commitments and the budget that we have committed to.

我們在第一節表現出色。我們在準備好的演講和問答中試圖表達的是，我們預計今年剩餘時間將按照我們最初的承諾和我們承諾的預算進行。

Okay, understood. And just a quick follow-up, too, I think it was an answer to a previous question. But you mentioned the delayed expense that led to an outperformance this quarter. So can you just talk a little bit more about this as well? Maybe I missed it in the prepared remarks. But what exactly was that and maybe how much? And then two, will this be delayed then to kind of feeding into the second quarter? Or kind of how we should think about that?

好的，明白了。我也只是快速跟進，我認為這是對之前問題的答案。但您提到了導致本季表現優異的延遲費用。那你能再多談談這個嗎？也許我在準備好的發言中漏掉了這一點。但那到底是什麼？然後第二個問題，這會被推遲到第二季嗎？或者我們該如何思考這個問題？

Yeah, good morning. Jack, it's Dave. I'll take that one. So the beat in the first quarter primarily came through performance in center margin. And it was spend within that center margin bucket. And a lot of that was -- it's delayed in the sense of we expected it to happen in the first quarter and a lot of it is pushing into the second quarter. And it's things like the investment we're making in the patient -- the digital patient check-in tool as well as investments that we're making in our front office of our centers.

是的，早安。傑克，這是戴夫。我會接受那個。因此，第一季的表現主要來自中心利潤率的表現。它是在中間利潤桶內支出的。其中很多是——從我們預計它會在第一季發生的意義上來說，它被推遲了，而其中許多都被推遲到了第二季度。這就像我們對患者的投資一樣——數位患者登記工具以及我們對中心前台辦公室的投資。

We've talked about it in our last earnings call. So those were all investments that we are planning on making throughout the year. They're just getting off the ramp a little bit slower than we thought. And that's what primarily contributed to the Q1 beat and why that's not flowing through to the remaining quarters.

我們在上次財報電話會議中討論過這個問題。這些都是我們計劃全年進行的投資。他們只是從坡道上下來的速度比我們想像的慢一點。這就是第一季業績成長的主要原因，也是為什麼這不會影響到其餘季度的原因。

Kevin Caliendo, UBS. Please go ahead.

凱文‧卡里恩多，瑞銀集團。請繼續。

Thank you, and thanks for taking my question. Danish, congrats on all your achievements at LifeStance, and best of luck going forward. It was a pleasure getting to know you. I just want to go back to the payer stuff again. I just want to understand that a little bit better. Does this -- does the new sort of rates kick in on July 1? Is that why the cadence is -- in the second half is not as great or not the normal seasonality?

謝謝你，也謝謝你提出我的問題。丹麥人，恭喜您在 LifeStance 所取得的所有成就，祝福您未來一切順利。很高興認識你。我只想再次回到付款人的話題。我只是想更好地理解這一點。新的利率是否會在 7 月 1 日生效？這就是為什麼下半年的節奏不那麼快或不符合正常的季節性嗎？

And two, maybe just to provide a little bit of comfort around this more, how often are these payer rates negotiated? And can you talk about any negotiations that would have started 1/1 on a same-store basis? Like typically, what do you normally see when you redo or renew a payer relationship?

第二，也許只是為了提供一點安慰，這些付款人費率多久要協商一次？您能談談在同店基礎上以 1/1 開始的任何談判嗎？像往常一樣，當您重做或續訂付款人關係時，您通常會看到什麼？

Yes. It's not quite as structured and organized as January 1 of every year, we renegotiate all of our contracts. This is really as we engage in a much more wholesome comprehensive fashion, we're talking about rates. We're talking about sort of the terms. We're talking about delegated credentialing, et cetera. So these are pretty comprehensive discussions. Historically, it's been sort of a nonevent that maybe there was a 1% add-on for future years, and we've changed that. So now we're having these deeper, more strategic discussions about what the relationship is going to look like.

是的。它不像每年 1 月 1 日那樣有條理和有組織，我們會重新談判所有合約。這實際上是當我們從事一種更健康的綜合時尚時，我們正在談論價格。我們正在談論一些術語。我們談論的是委託認證等。所以這些都是非常全面的討論。從歷史上看，未來幾年可能會有 1% 的附加費，這在某種程度上是一件小事，但我們已經改變了這一點。因此，現在我們正在就兩國關係的走向進行更深入、更具戰略性的討論。

And in some cases, they are multiyear contracts. And in others, they are annual. But they happen throughout the year. And so it's -- I would describe it as lumpy. Even this particular contract renegotiation, there's different lines of business that come into effect at different times. So I can't even tell you that everything happens on July 1. There's sort of a phase in. And it's a little bit more nuanced than just sort of one single change in rate on one given date.

在某些情況下，它們是多年期合約。而在其他國家，它們是一年一度的。但它們全年都會發生。所以它——我會把它描述為塊狀的。即使是這個特定的合約重新談判，也有不同的業務範圍在不同的時間生效。所以我甚至不能告訴你一切都發生在 7 月 1 日。有一個階段。它比某一特定日期的單一匯率變動更加微妙。

And maybe just, Kevin, just to pile on to Ken's comments. For your -- from a modeling perspective, if you're thinking about TRPV, what you're saying is generally accurate, which is we would expect TRPV in the first half of the year to be higher than the back half of the year so that -- so to answer that specific question.

凱文，也許只是為了補充肯的評論。對你來說——從建模的角度來看，如果你正在考慮 TRPV，你所說的通常是準確的，也就是說我們預計上半年的 TRPV 會高於下半年，所以那就回答這個具體問題吧。

Okay, thank you.

好的謝謝。

Brian Tanquilut, Jefferies.

布萊恩·坦奎魯特，傑弗里斯。

Thank you for taking my question. YYou have Taji Phillips on for Brian. So first off, Danish, I want to say congratulations to you. It was wonderful working with you. And so my first question is going to be on clinician adds in the quarter. I know that you guys have mentioned that they had exceeded your expectations. So maybe if you can just provide an update on several different KPIs, retention, recruitment, turnover, right, within your clinician base. And then I have a follow-up from there.

感謝您回答我的問題。塔吉·菲利普斯 (Taji Phillips) 替補布萊恩 (Brian)。首先，丹麥人，我想向你們表示祝賀。和你一起工作真是太棒了。因此，我的第一個問題將是關於本季臨床醫生的補充。我知道你們已經提到他們超出了你們的預期。因此，也許您可以在您的臨床醫生群體中提供幾個不同 KPI（保留率、招聘率、營業額等）的最新資訊。然後我會從那裡進行後續行動。

Yes. Taji, this is Danish. Thanks for the comments. And I can address the question around net clinician adds and some of the drivers. So yes, we're very pleased with our net clinician adds in Q1. That exceeded our expectations. Again, that was 100% organic, which is something that we remain very proud of.

是的。塔吉，這是丹麥文。感謝您的評論。我可以解決有關網路臨床醫生添加和一些驅動程式的問題。所以，是的，我們對第一季臨床醫生淨增加感到非常滿意。這超出了我們的預期。同樣，這是 100% 有機的，這是我們仍然感到非常自豪的事情。

Retention continues to remain stable. Our recruiting engine continues to be what we characterize as best-in-class. Our value proposition to our clinicians, both those that are here as well as new ones that we're trying to attract, continues to remain strong. And so we feel good about our ability to continue to deliver strong net clinician adds throughout the year.

留存率持續保持穩定。我們的招募引擎仍然是我們所認為的同類最佳的引擎。我們對臨床醫生（無論是現有的臨床醫生還是我們試圖吸引的新臨床醫生）的價值主張仍然保持強勁。因此，我們對全年繼續提供強勁的臨床醫生淨增長的能力感到滿意。

Dave did mention in the prepared remarks, the dynamic that we see around Q2, where you typically see a lower number that reverses later in the year just due to seasonality and the fact that because we are delivering this on a 100% organic basis now, the seasonality is more visible than in previous years, where we had M&A as a component on top of organic. So hopefully, that provides some additional color on what we're seeing there.

戴夫確實在準備好的發言中提到了我們在第二季度看到的動態，您通常會看到較低的數字，但由於季節性因素以及我們現在在100% 有機基礎上提供這一事實，這一數字會在今年稍後逆轉，季節性比前幾年更加明顯，當時我們將併購作為有機業務的一部分。希望這能為我們所看到的內容提供一些額外的色彩。

That was great. And then another follow-up there, I know this is more recent news and obviously still preliminary, and there's been some pushback on this. But thinking about the FTC's potential noncompete ban, how are you thinking about the impact to your business, right, and just the general recruiting environment for clinicians in behavioral health space?

那很棒。然後是另一個後續消息，我知道這是最近的消息，顯然仍處於初步階段，對此存在一些阻力。但考慮到聯邦貿易委員會潛在的競業禁止禁令，您如何考慮對您的業務的影響，對吧，以及行為健康領域臨床醫生的一般招聘環境？

Yeah, I can take that as well. So for us, we do in states that, at least today, allow for noncompetes have that in our contracts. But not all states even today allow for it. And in those states, we do not. Though we have included that in contracts, we have never built the value proposition around noncompetes.

是的，我也可以接受。因此，對我們來說，至少在今天，我們在允許非競爭的州在我們的合約中包含了這一點。但即使在今天，也並非所有州都允許這樣做。在這些州，我們不這樣做。儘管我們已將其納入合約中，但我們從未圍繞非競爭建立價值主張。

For us, it's about what are we providing to our clinicians to both not subtract but retain them and making sure that we're constantly solidifying and bolstering that value proposition. So for us, this is not something where it's a particular worry. If anything, we'd be hopeful that it creates more movement on the recruiting side and our ability to attract clinicians from other practice groups, where they currently may feel restricted to explore other opportunities.

對我們來說，重要的是我們向臨床醫生提供什麼，而不是減少而是保留它們，並確保我們不斷鞏固和支持這一價值主張。所以對我們來說，這並不是特別值得擔心的事。如果有什麼不同的話，我們希望它能在招募方面帶來更多的動力，並有能力吸引來自其他實踐團體的臨床醫生，因為他們目前在探索其他機會時可能感到受到限制。

Thank you.

謝謝。

Stephanie Davis, Barclays.

史蒂芬妮戴維斯，巴克萊銀行。

Hey, guys. And Danish, congrats on the accomplishments to date, best of luck in your next thing. I want to ask a little bit about the COO transition. Is there any sort of succession plan? Is this the role you're expecting to keep? And then I guess, the follow-up related to that would be, is there a read-through, considering there's been a bit of a turnaround in the back end for the past year that maybe a lot of this is already accomplished?

大家好。丹麥人，恭喜迄今為止所取得的成就，祝你接下來的事情好運。我想問一些關於首席營運長過渡的問題。有任何繼任計畫嗎？這是您希望保留的角色嗎？然後我想，與此相關的後續行動是，考慮到過去一年後端發生了一些轉變，也許其中許多已經完成，是否有通讀？

I'll speak to the first part. You might have to elaborate on the second part. I wasn't sure about the second half of the year comment. But one of the things that Danish has done so well over the past couple of years is recruit great talent to the organization. And so I do not have an immediate plan to replace Danish. As he mentioned in his prepared remarks, we've already elevated our leader of shared services and our leader of practice ops to the executive team.

我先講第一部分。您可能需要詳細說明第二部分。我不確定下半年的評論。但丹麥在過去幾年中做得非常好的事情之一就是為該組織招募了優秀的人才。所以我沒有立即計劃取代丹麥語。正如他在準備好的演講中所提到的，我們已經將共享服務領導者和實踐營運領導者提升為執行團隊。

And my initial thinking is that they are ready to step up. And the rest of us on the ELT will step up. So at this juncture, I'm not in a position to communicate that we're going to do an external search or we're going to promote somebody from within to replace Danish in kind. And I think it really is a tribute to the strength of the team that we've all built over the last couple of years. We're in a dramatically different place.

我最初的想法是他們已經準備好挺身而出。我們 ELT 的其他人也會挺身而出。因此，在這個節骨眼上，我無法傳達我們將進行外部搜尋或我們將從內部提拔某人以取代丹麥人的情況。我認為這確實是對我們過去幾年建立的團隊力量的致敬。我們處在一個截然不同的地方。

And one of the things that encourages me that I didn't say in my prepared remarks, I think whether we're talking about Change Healthcare, we're talking about the departure of a founder, this hard work, which I've told you before, is not sexy and it doesn't show up immediately. It's created a resilience, a stability and a predictability that we simply didn't have a couple of years ago. And so while I know we will have other surprises thrown at us from time to time, I continue to gain more and more conviction that we are more than prepared to navigate through it. Do you want to elaborate the second part of your question?

我在準備好的發言中沒有說的鼓勵我的事情之一，我認為我們是否在談論變革醫療保健，我們正在談論創始人的離開，這種艱苦的工作，我已經告訴過以前的你，並不性感，也不會立即顯現出來。它創造了我們幾年前所沒有的韌性、穩定性和可預測性。因此，雖然我知道我們會不時遇到其他驚喜，但我越來越相信，我們已經做好了渡過難關的準備。您想詳細說明問題的第二部分嗎？

Exactly. As I think about how much back-end turnaround has been going on and how that's probably often in the COO's purview, so is the readthrough that a lot of the groundwork has already been laid for the back-end operations update and there's less going forward? Or is it more just that you feel that there's a lot of talent that can handle it and deliver the needs?

確切地。當我想到後端週轉已經進行了多少以及這可能經常在首席營運官的職權範圍內時，我讀到的內容是，已經為後端營運更新奠定了很多基礎工作，而未來的工作卻很少？或者更只是你覺得有很多人才可以處理它並滿足需求？

Yes, no, thank you. Now I get it. And I'm happy to speak to that. There is a lot of talent, but the -- one of the things that we have done, and I would say Danish leading the way, we've created a great deal of clarity around expectations and KPIs and building a culture of accountability.

是的，不，謝謝。現在我懂了。我很高興談論這一點。這裡有很多人才，但我們所做的事情之一，我想說丹麥人在這方面處於領先地位，我們已經圍繞著期望和 KPI 建立了很大的清晰度，並建立了一種問責文化。

So both the processes and the culture are very different now than they were a couple of years ago. And so that's part of what I consider Danish's legacy as a COO. And so I'm just so appreciative that he hung in. Many founders would depart when the company went public. And this will be Danish's second very successful startup.

因此，現在的流程和文化都與幾年前大不相同。因此，這就是我認為丹麥人作為首席營運長的遺產的一部分。所以我非常感激他堅持了下來。許多創辦人會在公司上市後離開。這將是丹麥第二家非常成功的新創公司。

So I look at this as, thank goodness, he hung with us for a couple of years because the work that he did as he transitioned from Head of Business Development and Chief Growth Officer to COO, has been incredibly powerful and sets us up for success.

所以我認為，謝天謝地，他在我們身邊待了幾年，因為他從業務開發主管和首席成長長過渡到營運長期間所做的工作非常強大，為我們的成功奠定了基礎。

To your point, while there's still way more work to be done, we have made a major pivot. And I think I won't speak for Danish, but based on all of our one-on-one conversations, it is a big part of the reason why he feels like now is the right time.

就你的觀點而言，雖然還有很多工作要做，但我們已經實現了重大轉變。我想我不會代表丹麥人發言，但根據我們所有的一對一談話，這是他覺得現在是正確時機的重要原因。

Helpful. Thank you.

有幫助。謝謝。

That concludes our Q&A session. I will now turn the conference back over to Ken Burdick, Chief Executive Officer, for closing remarks.

我們的問答環節到此結束。現在我將把會議轉回執行長 Ken Burdick 致閉幕詞。

Thank you, operator. I want to thank everybody for participating on today's call. I want to also thank our approximately 9,500 employees, who have such a deep sense of purpose and commitment to what we are doing, which is trying to increase access to high-quality, affordable mental health care. And you've heard me say multiple times that this is an underserved population. And I just want to put a couple of statistics around that.

謝謝你，接線生。我要感謝大家參加今天的電話會議。我還要感謝我們約 9,500 名員工，他們對我們正在做的事情抱持如此深刻的使命感和承諾，我們正在努力增加獲得高品質、負擔得起的精神健康保健的機會。你已經聽我多次說過，這是一個服務不足的人群。我只想提供一些統計數據。

Mental health clinicians currently are reimbursed 22% less than their counterparts on the med-surg side of the business. And patients go out of network 3.5 times more often. So in addition to the struggles that folks have even developing and coming up with the courage to seek care, there is a financial burden when they have to go out of network and incur those out-of-pocket costs, which I just don't think is the country that we want to live in.

目前，心理健康臨床醫生的報銷比醫療外科領域的同行少 22%。患者離開網路的頻率增加了 3.5 倍。因此，除了人們所經歷的掙扎以及鼓起勇氣尋求護理之外，當他們不得不離開網絡並承擔那些自付費用時，還會產生經濟負擔，而我只是不這樣做認為是我們想要居住的國家。

So we have tens of millions of individuals across this country who do not have access to services that they need. And as I said in my closing, I couldn't be more proud and more committed to the mission of LifeStance, which is to address that. And because of our size and scale, we think we can have a meaningful impact on the trajectory for years to come. So I want to thank all of our employees, and I want to thank all of you for your interest in LifeStance.

因此，全國有數以千萬計的人無法獲得所需的服務。正如我在結語中所說，我感到無比自豪，也更致力於 LifeStance 的使命，即解決這個問題。由於我們的規模和規模，我們認為我們可以對未來幾年的發展軌跡產生有意義的影響。因此，我要感謝我們所有的員工，也感謝你們所有人對 LifeStance 的興趣。

Gentlemen, that concludes today's call. Thank you all for joining. You may now disconnect.

先生們，今天的電話會議到此結束。感謝大家的加入。您現在可以斷開連線。