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Operator
Good day, ladies and gentlemen, and welcome to the LHC Group Q2 2015 earnings conference call. At this time all participants are in listen-only mode. Later, we will conduct a question-and-answer session and instructions will follow at that time. (Operator Instructions) As a reminder, today's conference call is being recorded.
I would now like to turn the conference over to Mr. Eric Elliott, Senior Vice President of Finance. Please go ahead, sir.
Eric Elliott - SVP of Finance
Thank you, Candace. And welcome, everyone, to LHC Group's earnings conference call for the second quarter, ended June 30, 2015. Hopefully everyone has received a copy of our earnings release. If not, you may obtain a copy along with other key information about LHC Group and the industry on our website. In a moment, we will hear from Keith Myers, Chief Executive Officer; Don Stelly, President and Chief Operating Officer; and Dionne Viator, Chief Financial Officer of LHC Group.
Before that, I would much remind everyone that statements included in this conference call and our press release may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act. These statements include but are not limited to comments regarding our financial results for 2015 and beyond. Actual results could differ materially from those projected in forward-looking statements because of a number of risk factors and uncertainties which are discussed in our annual and quarterly SEC filings. LHC Group shall have no obligation to update the information provided on this call to reflect subsequent events.
Now I am pleased to introduce the CEO of LHC Group, Keith Myers.
Keith Myers - Chairman and CEO
Thank you, Eric. Good morning, everyone. As always, I want to begin by congratulating and thanking our nearly 10,000 team members for their unwavering commitment to excellence and for consistently delivering high-quality care to the growing number of patients, families and communities we serve.
I am extremely proud of the well-balanced overall performance of our team thus far in 2015. I am particularly pleased with our solid organic growth rate in home health admissions of 4.4% in the first half of 2015 compared to the same period last year, and our ability to control and further reduce G&A costs as a percentage of revenue.
The 2016 home health proposed rule released in early July, if implemented as proposed, would have an overall negative impact of negative 1.8% on home health agencies in 2016, according to CMS. The main components of the proposed rule, in addition to rebasing, are a negative 0.6% cut for productivity, a negative 1.72% case mix increase cut in each of calendar year 2016 and 2017, and a 2.9% market basket update. In its draft regulations, CMS is also proposing to file a home health value-based purchasing program in nine states, which Don will touch on in more detail in his section.
We are actively working in conjunction with the National Association for Home Care and Hospice and the Partnership for Quality Home Healthcare in preparing comments in response to this proposal. VNA is also collaborating with NAHC and the partnership in this effort. These groups have commissioned several analytical studies to counter CMS's position on nominal case mix growth. In addition, these groups are joined together to initiate a congressional sign-on letter in the House last week, led by Representatives Walden, Price, Blumenauer and McGovern, and expect a companion letter to be circulated in the Senate in the near term.
The 2016 hospice reimbursement final rule was issued last Friday. Hospice agencies will see an estimated 1.1% increase in their payments for fiscal year 2016. Beginning January 1, 2016, CMS is implementing two routine home care rates to provide separate payment rates for the first 60 days of care and care beyond 60 days. In addition to the two routine home care rates, CMS has included a service intensity add-on payment that would help to promote and compensate for the provision of skilled visits at end-of-life. With approximately 70% of our hospice patients falling inside the zero-to-60-day timeframe, we feel this new payment structure will benefit LHC.
Moving on now to our pipeline, with regard to external growth we continue to focus on corporate development efforts on our three in-home service lines of home health, hospice and community-based services, with a more intense focus than ever before on adding hospice to our service offering in every market we serve, and home- and community-based services in every market in states where reimbursement is sufficient.
Year to date, we have reviewed more than 150 acquisition or hospital joint venture opportunities, including more than 50 since our last earnings call. For the same period last year, that total number reviewed was less than 75. From these numbers, you can see that activity has increased significantly, and we expect this trend to continue.
Of the opportunities we reviewed thus far this year, more than 30 remain active, four of which we have exclusivity on while performing confirmatory due diligence and negotiating purchase agreements.
In addition to our traditional core pipeline activity, our executive team has continued to meet more regularly with investment bankers to evaluate larger strategic opportunities. I am happy to address any of these further during Q&A.
Now I would like to turn the call over to Dionne.
Dionne Viator - EVP, CFO and Treasurer
Thank you, Keith, and good morning, everyone. The net service revenue for the second quarter of 2015 was $200.2 million, an increase of 6% compared with net service revenue of $188.9 million in the same period of 2014. And for the six months ended June 30, 2015, net service revenue was $393.3 million, an increase of 11.6% compared with net service revenue of $352.5 million in the same period of 2014.
Same-store revenue grew 2.7% for the second quarter and 4.1% year to date compared to the same period last year. This growth in same-store revenue is due to our growth in same-store admissions, changes in patient acuity and the increase in the Medicare episodic rate from 2014 to 2015.
Net income for the second quarter of 2015 was $2.6 million, or $0.51 per diluted share, an increase of 47.7%, compared with net income of $6.1 million, or $0.35 per diluted share, in the same period of 2014. And for the six months ended June 30, 2015, net income was $15.8 million, or $0.90 per diluted share, an increase of 55.5%, compared with net income of $10.1 million, or $0.59 per diluted share, in the same period of 2014.
On a consolidated basis, our gross margin was 41.7% of revenue in the second quarter of 2015 and 41.2% of revenue for the six months ended June 30, 2015. This is compared to 40.9% and 40.7% in the same periods of 2014.
Our general and administrative expense was 30.2% of revenue in the second quarter of 2015 and 30.4% of revenue for the six months ended June 30, 2015. This was less than the 31.6% and 31.9% in the same periods of 2014, an indication of successfully controlling costs while growing revenue.
Our bad debt expense represented 2.4% of revenue in the second quarter as compared to 2.7% of revenue in the first quarter of 2015 and 2.3% in the second quarter of 2014.
During the first half of 2015, we performed a reengineering of our revenue cycle department. We are now seeing the benefits from that as our cash collections in July are 11% higher than the monthly average January through June of this year. As of today, the balance on our line of credit is down to $30 million and our leverage ratio stands at 0.58.
Our effective tax rate in the second quarter and for the six months ended June 30, 2015 was 41.0%, compared to 41.8% in the second quarter of 2014.
Regarding 2015 full-year guidance, we are raising full-year 2015 guidance for net service revenue to a new range of $780 million to $795 million from the previous range of $765 million to $780 million. In addition, we are raising our fully diluted earnings per share to a new range of $1.70 to $1.80 from the previous range of $1.55 to $1.70. The guidance does not take into account the impact of future reimbursement changes, future acquisitions or shares repurchased, if any, de novo locations if opened, or future legal expenses if necessary.
For the full year of 2015 we expect gross margin to be in the range of 40.5% to 41.5%, G&A as a percentage of revenue to be in the range of 30.5% to 31.5%, bad debt expense as a percentage of revenue to be in the range of 2% to 2.5%, our effective tax rate in 2015 to be in the range of 40.5% to 41.5%.
Included in our new guidance is our estimates of the impact in the fourth quarter of 2015 of the proposed 2016 home health rule on straddle episodes; the final hospice and LTAC rules for the 2016, which go into effect October 1, 2015; and the estimated effect from ICD 10.
The primary factors behind our raise and guidance this quarter are a few things. First, organic growth. We are trending at 4.4%, as Keith mentioned, compared to our 2% to 3% growth expectation previously. Our acquisitions of Deaconess, Addus, AseraCare and Lifecare operating margins are trending better than expected. Strong cost management. And, lastly, a benefit in pricing from the 2015 CMS home health reimbursement role. The 2015 rule included an increase in the standard episodic base rates to offset the case mix re-weighting in an effort for it to be budget-neutral for the industry. This neutrality was built into our previously issued guidance. However, due to our patient population, we are actually experiencing a 3% increase in our episodic rate in the first half of 2015 over the same period last year.
That concludes my prepared remarks, and I'm now pleased to turn the call over to Don Stelly.
Don Stelly - President and COO
Thank you, Dionne. Good morning, everyone, and thanks to all for listening in. I'll begin my prepared comments by touching on a few things that's ahead of us. First, and as Keith mentioned, 2016 home health (technical difficulty) rule looks to establish a value-based purchasing pilot program. The proposed pilot program would withhold between 5% and 8% of participating home health agencies' Medicare payments, which would then be redistributed, depending on participants' performance related to certain and specified quality measures.
Beginning on January 1 of next year, nine states will be participating in the program, and we have 29 providers located in these nine states, which represents about $103 million of our net service revenue. In addition to fully supporting these efforts with point of care now in arrears with us and a new relationship with SHP, we are excited to fully maximize this opportunity and those that will follow, at least we think, this pay-for-performance lead.
Next, I will touch on comprehensive care for joint replacement. Under this proposed model, the hospital in which a hip or knee replacement takes place would be accountable for the cost and the quality of care from the time of the surgery through 90 days afterwards, what's called an episode of care.
Depending on the hospital's quality and cost performance during the episode, the hospital would either earn a financial reward or be required to repay Medicare for a portion of the costs. This payment would give hospitals an incentive to work with physicians, home health agencies and other providers to make sure the beneficiaries receive the coordinated care that goes along with the goal of reducing avoidable hospitalizations and subsequent complications. Hospitals would have additional tools such as spending and utilization data as well as the sharing of best practices to improve the effectiveness of that care coordination.
By bundling these payments, hospitals and physicians have an incentive to work together to deliver more effective and efficient care. This model would be in 75 geographic areas throughout the country, and most hospitals in those regions would be required to participate. LHC Group has 24 agencies located in these 75 geographic areas, 11 of which are joint ventures with hospitals.
Interestingly, even before this model was introduced, we began working on a very similar orthopedic program with one of our major hospital partners, a program that has demonstrated a less than 1% rehospitalization rate and a savings of nearly $750,000 on the inpatient side for the hospital as well. So obviously, we are excited with this program. We are excited to expand it to our other JVs and certainly plan to do it in these 75 markets.
Thirdly, the Medicare Choice model is designed to evaluate whether eligible Medicare and dually eligible beneficiaries would like to receive supportive care services typically provided by hospice if they could also continue to receive curative services, and whether providing both palliative and curative care concurrently impacts overall quality as well as satisfaction. Services under this model will be available to Medicare beneficiaries that elect to participate in the model around the clock, 365 calendar days per year. And CMS will pay a per-beneficiary, per-month fee ranging from $200 to $400 to participating hospices when delivering these services under the model.
We have 2 hospice agencies that will be participating in this model as of today's call: one beginning in phase 1; and the other, of course, in phase 2.
Next, the rule to update fiscal year 2016 payment policies and rates under the inpatient PPS and LTAC PPS, which affects discharges occurring on or after October 1 of this 2015, would decrease projected LTAC PPS rates by 4.6%. This estimate decrease is primarily attributable to the statutory decrease in payment rates from site neutrality cases that do not meet the clinical criteria to qualify for higher LTAC rates in cost reporting years beginning on or after October 1 of 2015. Cases that do not qualify for the higher LTAC PPS rate will actually see a payment increase of 1.7%. -- Cases that do qualify, sorry, for that LTAC PPS rate will actually see a payment rate increase of 1.7%.
CMS is also finalizing its proposal to implement a transitional blended rate -- 50% of site neutrality, 50% of the LTAC PPS rate -- for site-neutral discharges occurring in fiscal years 2016 and 2017.
So certainly there are a lot of moving parts. And I think the cut to the chase for us is that, of our 8 locations, this rule will become effective for 2 of them beginning June 1 of 2016 and the remaining 6 locations beginning September 1 of 2016. So we have time to mitigate, and we will have all scored plans factored into our 2016 guidance.
My last rule update is in regard to CMS's proposed change to the Medicare physician fee schedule for calendar year 2016, which includes payments to physicians for advanced-care planning sessions that they have with patients and with family members. CMS proposed coverage of advance care planning is a vital step toward improving quality of care and ensuring patient involvement in self-determination in the healthcare decision-making process. This proposal fits nicely with what we are doing to enhance care coordination and better leverage in-home interventions by physicians, nurse practitioners and physician assistants.
Turning briefly to growth, growth in new home health admissions in the quarter was 4.9% for the six-month period ending June 30, 2015, 11%, as compared to the same periods prior year. Organic growth in home health admissions was 1.7%, and for the six-month period ending June 30, 2015 was 4.4% as compared to the same periods last year.
Also, during these months the Company deployed and trained upon a new CRM platform for the entire sales force. While admittedly this did interrupt call routes and stunted some productivity during this past quarter, we were still pleased with our growth initiatives, its results, and see the CRM platform as imperative to growing our market share in the future.
We still do have about 20% of our sales force below our expectations for their event management inside of this PlayMaker, but we see that momentum is getting better each and every day that closes and thus still hold to what Keith and Dionne both alluded to, that 4.5% run rate on organic growth.
Before I hand the call over to Candace for Q&A, I want to thank our entire LHC Group family for doing a job well done in the first half of the year thus far. Specifically, however, I want to acknowledge our hospice leadership team and all who were involved in transferring 99 patients from a competitor hospice provider in South Carolina to our team at South Carolina HBC in the last few weeks. You are all instrumental in transferring those lives to us and the employees that came aboard as well. Nice work and truly way to live out our purpose. It's all about helping people.
So Candace, we are now ready to open the call up for Q&A.
Operator
(Operator Instructions) Kevin Ellich, Piper Jaffray.
Kevin Ellich - Analyst
Nice quarter, guys. Keith, maybe could we start off with the comments on external growth with the deals that you are evaluating? And could we get some more color on the four that you have exclusivity on and what you are talking about with the larger deals you are meeting with bankers on?
Keith Myers - Chairman and CEO
I'll tell you as much as I can. So the four that we have in confirmatory diligence at this point are a combination of home health and hospice. And I guess I could say this. As far as -- I don't want to get into specifics, but let's just say this. I think the four combined are less than $100 million in revenue. And obviously that, because we are talking about conversations with bigger deals, and I don't want to leave out there that there's some really big deal in confirmatory diligence.
And then on the larger deals, our traditional core pipeline that has been very accretive for us and that we built the Company with -- I don't think it's a secret to anyone that follows us -- has been highly accretive and bread-and-butter for us. It's where the hospital joint ventures come, and all of the tuck-in, freestanding locations. And we are not -- if anything, we're accelerating that effort.
But in addition to that now, we want to be opportunistic. And therefore the executive team is meeting in a separate effort with banks on a regular basis to evaluate these larger opportunities very seriously. In fact, we were on the road last week doing some of that. And I'm very involved in that. The timing is right for us on all of our work on the fundamentals over the last four or five years. Our balance sheet is strong. We have some reimbursement clarity now that just makes it the right time for us. I hope that -- does that help?
Kevin Ellich - Analyst
That does help. With these deals -- with these larger yields that you are evaluating -- are they still in the core home health/hospice categories? Are you looking at something -- are you evaluating other specialties as well? And then how willing are you guys to put on debt on the balance sheet? I don't know if Dionne can chime in on what you are willing to take your leverage ratio up to.
Keith Myers - Chairman and CEO
Yes. So we will tag-team that. So that was a really good question. You also know that we're not huge risk takers. So these larger deals are all in our sweet spot of home health/hospice or home and community-based services. We are constantly piloting and testing other bolt-on service lines. But we do that on a really small scale; it wouldn't hit the radar here. And -- you know, where we test those out. And some of that would be on advanced practitioner services that bolt in to our model and things like that. But we would go out and do a big acquisition on that before testing it for some period of time.
And with regard to leverage, I'll let Dionne talk about what we can do. But in conversation, if the right larger opportunity came along we would be comfortable levering the Company up to in the mid-3s, maybe even a little bit higher than that for a short period of time if we had to because we're generating enough cash flow to pay that down very quickly. And then you also have the option of going back to the market. And if we have the need to do that and we have already leveraged the balance sheet, that's something we are talking about in the boardroom and that we are prepared to do if it makes sense.
Dionne?
Dionne Viator - EVP, CFO and Treasurer
I think that's exactly right. With the stable earnings of the Company, the clean balance sheet, there's a variety of financing options including, today, our current commercial banks. We have options with institutional investors and then getting back to the market. So at this point I feel like if the opportunity is the right opportunity, we have a variety of ways to finance that and are not limiting ourselves to one particular structure there.
Kevin Ellich - Analyst
Right. And Dionne, since I got you, could you maybe talk about the expense management? You guys have done a great job of controlling G&A. Just wondering how much lower that can go and is all the low-hanging fruit taken at this point?
Dionne Viator - EVP, CFO and Treasurer
Well, I think you continue to look at that with a fresh pair of eyes, constantly. So I think that a lot of the low-hanging fruit and some not so low, has Don has alluded to, over the last four or five years has done a lot to look at the cost side. I think one of the primary opportunities here is with the anticipated growth, continuing to hold and reduce, where possible, our G&A costs but really just taking advantage, moving forwards, of the combined size and leverings of the infrastructure in place at this time.
Don Stelly - President and COO
I'll add just a little bit of color to that. Obviously, we were really clear that the cessation of point of care and finalizing all of that allowed us to cut over $8 million out six months ago. So while we may not have that kind of chunk in G&A specifically, I can assure you that operationally we have $500,000 a month that we can go find and we're working through. But most of that in newer acquisition improvement and letting some of that growth offset some of the cost infrastructure that we don't have because of the low volumes, and we're really starting to see that right now.
So all in all, obviously, there's room for improvement in pocketed areas. But I don't want to mislead you and think that we've got another huge chunk like we just did at the beginning of this year.
Kevin Ellich - Analyst
Got you. And then, Don, if I could sneak one last quick one in, you gave some good detail on the joint care comprehensive bundling initiative and also what you guys are seeing with your hospitals in terms of cost savings and readmissions -- very impressive data. Just wondering where you think everything is going here. And maybe Keith can also add some color. But with BPCI, ACOs, everything going on towards value-based reimbursement models, how do you think that is going to play out for you, and how big of an opportunity is it?
Keith Myers - Chairman and CEO
We think it's going to be a huge opportunity. And listen, I don't think anyone that loves this industry like we do discounts the fact that this is where it needs to go. We need to be in a pay-for-performance environment. I've said all along, Kevin, that this point-of-care conversion -- I've said those words so many times you are probably are tired of hearing that. It was a huge distraction for us. And it's a distraction that has moved away, and it's going to allow us to capture that opportunity.
What we have proven to ourselves is when we truly coordinate care, not in words but in processes every day, that 1% was huge in this pilot program. And that $750,000 was real money both in length of stay and cost issues when it came to supplies, services and things that we did on the bundled side. And so if we can replicate that throughout the country, it obviously is going to put us in a great position for all of these. But this is going to be here to stay. So we need to live within those confines, and honestly we need to use it as a competitive advantage for us.
Don Stelly - President and COO
I would just add, Kevin, that it has been a great experience for us to work with hospital partners in risk-based arrangements in a managed care setting. We are seeing everything we have learned there will be applicable to a bundle of value-based purchasing environment because, in effect, it's the closest thing we've seen to value-based purchasing. It removes the reimbursement barriers that are embedded in a fee-for-service environment that restrict home health from being fully leveraged. And so we are quite excited about that.
Kevin Ellich - Analyst
Great. Thanks, guys.
Operator
(Operator Instructions) Toby Wann, Obsidian Research Group.
Toby Wann - Analyst
Just a couple of quick things. With regards to the CRM implementation during the quarter and its impact, can you maybe tease that out a little bit in terms of how much better could the quarter actually have been had that not been a bit of a drag?
Keith Myers - Chairman and CEO
I'll be honest with you, I had to eat a little bit of crow, Toby, because when I sat with the earnings call last time, at that time I thought I was sitting on a 5% number just on Medicare home health. But when we had to infiltrate this training of PlayMaker, it took about, on average, 10 hours of productive time away per PCR per sales rep, and we have 352 of them. So it started us pretty hard in a three-week period. And although we've ramped up, obviously we didn't ramp up enough to get to the number that I thought we would get. But I still hold true that that 3% to 5% is going to bake in for the year.
So it really did bump it off. And then the last thing is I was very honest; we still have about 20% of that team -- because the way this works, you have first got to get really accustomed to the methodology in the screenshots to route plan. Then there's some embedded data based on decile rankings on statistically what referral sources are better to call upon than others on their utilization of home health services. And it has just taken us a little bit more time than I personally thought to see that ramp up. It has affected us a little bit in July as well, but we are really coming out of it right now on a better end of the learning curve.
Did that help you?
Toby Wann - Analyst
Yes, absolutely. Quarter could have been a little bit better, obviously, but it was still a fantastic quarter. So not to -- I just wanted to get that fleshed out a little bit more.
And then just in a general sense at a higher level, as we've seen Medicare advantage continue to grow, more managed Medicaid because of the ACA expansion and the expanded Medicaid, can you guys talk about your experience with bad debts, high-deductible health plans, those sorts of things, and how that may be impacting, if at all, your all's business as the patients now have a little more skin in the game financially than they typically did?
Don Stelly - President and COO
Well, that's a real complex question. There is no doubt that diversification of payer sources require us to do different things both on the front end and the back end, from authorization and the nuances that come with that to the pre-off running out and still the patient needing services and yet not having that. So that's very complex.
The state specificity on the Medicaid-manage issues that you're talking about seem to change daily. And we have done a much better job as our community-based services has grown from $6 million to going to the $50 million mark of dealing with that. Has it affected our bad debt? Dionne can talk to that a little bit more. The answer is yes. But she has also alluded to some of the revenue cycle issues that we've tackled are addressing this issue through our pod program.
So I guess that's a rambling way to say it is much more complex. But I think the processes and the undertow of what we are doing from pre-admit all the way through collections are addressing that. And I don't think -- and Dionne, step on my toe if you disagree -- that that bad-debt percentage that she disclosed will at all run up because of what you just addressed.
Dionne Viator - EVP, CFO and Treasurer
Great. Just to add a little bit to what Don has said, part of the restructuring I alluded to earlier is really more about putting different processes in place on the front end rather than having the impact be on the back end there. So still working through some of those issues, but not an area of high concern at this point.
Toby Wann - Analyst
Okay, fair enough. And then just in general with regard to managed care, as it becomes a bigger payer source, how do you guys approach that relative to traditional Medicare pay type patients, those sorts of things? Some providers shy away from managed care, don't think they can make a decent-enough margin. Just wanted to get your all's thoughts with regards to that.
Don Stelly - President and COO
That's a really good question and one that I think it's fair to say that our position is changing. I think you said it best. I think that it's been obvious we have run away from it. And I think now what we're looking at is intuitive and different ways inside of our agencies to deal with that.
So I'll give you one specific example is that six months ago we didn't have anyone truly looking at the utilization by visit under commercial business. Now not only do we -- are we piloting that but we are piloting it in several different managed-care environments to make sure that we have a pretty good handle on the G&A inside of that team and also the actual service provisions that can be done differently in that visit.
And so all of that is to say that I think that -- and maybe Keith can chime in -- instead of looking at this as something that we have to do to get to the Medicare, I think our thought is beginning to go into the thought of, let's do it and minimize any disruption because it's here and we are forced to take some of that. So don't necessarily run at it, but quit running away from it.
Keith Myers - Chairman and CEO
Yes. I think I will probably come at that at a different angle. Every managed-care company that we deal with seems to have their own twist on how they want to run their programs around everything but really on home care. And they will have centralized oversight and care management of different functions, and it's not consistent across all.
In our standard model, we of course provide all of the basics and requirements of a Medicare provider. But we do a lot of things in addition to that to drive quality metrics and things that are important to us on what gets reported on Medicare patients. And historically we've done that same thing for everyone. And we've done it for the managed-care patients, too, even though they didn't want it, weren't willing to pay for it and we weren't required to do it for them.
So we have, I think -- Don, is that right?
Don Stelly - President and COO
That's absolutely right.
Keith Myers - Chairman and CEO
So we have separated that out. So for those patients, we have more patient-specific model. Of course, for those payers where we have an adequate volume and the market to justify that, if it was just a managed-care company and we have a handful of patients, well, we of course don't do that.
Keith Myers - Chairman and CEO
Toby, let me -- they pay us per visit, in many cases. And most times we are still doing things as if it was an episodic patient paying us for a period of time. So we are really looking at -- we're really trying to tailor to the need of the payer and still be a partner with them.
So I think that's what we are trying to say is that two years ago we probably wouldn't have answered this question that long because we didn't look at it that hard. That's the bigger point that I'm trying to make is that it's part of our life and we need to do a better job. Granted, by specificity of payer; but we need to do a better job of managing that business.
Toby Wann - Analyst
Okay. No, that's helpful. And then just one last one, more for Dionne. On the revenue cycle management stuff you guys have been doing -- and congrats on the results of that -- is there further leverage to go? In other words, is there further room for improvement beyond what you guys have already started to realize? Not that I'm going to bake that into my model, but just let me put that qualifier out there.
Keith Myers - Chairman and CEO
Really, thank you for doing that. You have a champion (multiple speakers).
Dionne Viator - EVP, CFO and Treasurer
Don, I'm going to answer you as absolutely. To score it at this point, I'm not prepared to do that. And if you are not baking it in, you don't need me to anyway. But no; absolutely I think that we have got a nice amount of opportunity. Part of what we've done is in our restructuring. Instead of our billers and collectors working across the board with all of our payers, we've put the billers and collectors in pods, we call that, so that they can develop relationships back to the point of refocus on how we work with a lot of our managed-care plans and commercial business. Having billers and collectors in pods where they develop relationships with each of the payers, understand what they need from that payer from the front end doing the authorization all the way to the end of collecting is really proving beneficial now and into the future with, like I said, understanding each payer and their nuances, relationships and what we can do from there.
Toby Wann - Analyst
Okay. Thank you. Thanks for the questions.
Operator
And I am showing no further questions at this time. I'd like to turn the conference back over to Mr. Keith Myers for closing remarks.
Keith Myers - Chairman and CEO
Thank you, operator. Thank you, everyone, for listening in this morning. Thank you for your support of LHC Group. As always, if you have any questions or would like to discuss anything with us between these regularly scheduled earnings calls, please feel free to reach out to us -- Eric and Elliott -- and we will be glad to schedule time with management if that's something you'd like to have. Thanks so much. Talk to you next quarter.
Operator
Ladies and gentlemen, and thank you for participating in today's conference. This does conclude the program and you may all disconnect.