Pediatrix Medical Group Inc (MD) 2024 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by and welcome to the 2024 third quarter's earnings conference.

女士們、先生們，感謝你們的支持並歡迎參加 2024 年第三季財報會議。

(Operator Instructions) And as a reminder, this conference is being recorded.

（操作員說明）謹此提醒，本次會議正在錄製中。

I would now like to turn the conference over to our host, Charles Lynch.

我現在想把會議交給我們的東道主查爾斯·林奇。

Please go ahead.

請繼續。

Thank you, operator and good morning, everyone.

謝謝接線員，大家早安。

I'll quickly read our forward-looking statements and then we'll get into the call.

我將快速閱讀我們的前瞻性聲明，然後我們將開始通話。

Certain statements and information during this conference call may be deemed to be forward-looking statements within the meaning of the Federal Private Securities Litigation Reform Act of 1995.

本次電話會議期間的某些陳述和資訊可能被視為 1995 年聯邦私人證券訴訟改革法案意義內的前瞻性陳述。

These forward-looking statements are based on assumptions and assessments made by Pediatrix Management in light of their experience and assessment of historical trends, current conditions, expected future developments and other factors they believe to be appropriate.

這些前瞻性陳述是基於 Pediatrix Management 根據其經驗以及對歷史趨勢、當前狀況、預期未來發展和他們認為適當的其他因素的評估而做出的假設和評估。

Any forward-looking statements made during this call are made as of today and Pediatrix undertakes no duty to update or revise any such statements, whether as a result of new information, future events, or otherwise.

本次電話會議期間所做的任何前瞻性陳述均截至今日，Pediatrix 不承擔更新或修改任何此類陳述的義務，無論是由於新資訊、未來事件或其他原因。

Important factors that could cause actual results, developments and business decisions to differ materially from forward-looking statements are described in the company's filings with the SEC, including the sections entitled Risk Factors.

該公司向美國證券交易委員會提交的文件中描述了可能導致實際結果、發展和業務決策與前瞻性陳述存在重大差異的重要因素，包括標題為「風險因素」的部分。

In today's remarks by management, we will be discussing non-GAAP financial measures.

在今天管理階層​​的演講中，我們將討論非公認會計準則財務指標。

A reconciliation of these non-GAAP financial measures to the most comparable GAAP measures can be found in this morning's earnings press release, our quarterly reports on Form 10-Q and our annual report on Form 10-K and our website at www.pediatrix.com.

這些非 GAAP 財務指標與最具可比性 GAAP 指標的調整表可在今天早上的收益新聞稿、我們的 10-Q 表格季度報告和 10-K 表格年度報告以及我們的網站 www.pediatrix 中找到。 .

Now, I'll turn the call over to our CEO, Dr. Jim Swift.

現在，我將把電話轉給我們的執行長吉姆·斯威夫特博士。

Thank you, Charlie and good morning, everyone.

謝謝你，查理，大家早安。

Also with me today is Kasandra Rossi, our Chief Financial Officer.

今天與我在一起的還有我們的財務長卡桑德拉·羅西 (Kasandra Rossi)。

Our third quarter operating results were modestly ahead of expectations, driven primarily by same unit revenue growth.

我們第三季的經營業績略高於預期，這主要是由於單位收入成長所致。

Similar to second quarter, payer mix provided a tailwind to our top line, although this did moderate toward the end of the quarter.

與第二季類似，付款人組合為我們的營收提供了推動力，儘管這種情況在本季末有所放緩。

Patient volumes were stable to positive across all of our core service lines compared to the third quarter of last year.

與去年第三季相比，我們所有核心服務線的患者數量穩定至正值。

On the hospital-based side, our NICU days rose modestly, reflecting slightly positive total births and we saw positive comparisons across newborn nursery, pediatric intensive care, and peds hospitalist services.

在醫院方面，我們的新生兒加護病房天數略有增加，反映出總出生率略有上升，我們看到新生兒托兒所、兒科重症監護和急診住院服務之間的積極比較。

On the office-based side, maternal-fetal medicine volume growth remained strong as we have experienced throughout 2024.

在辦公室方面，母胎藥品銷售成長依然強勁，正如我們在 2024 年所經歷的那樣。

Looking at our exposure to hurricanes Helene and Milton during the end of September and early October, while we did experience some office closures, those were quite brief and we did not see any material disruptions to our hospital-based services.

看看我們在 9 月底和 10 月初遭遇的颶風海倫和米爾頓，雖然我們確實經歷了一些辦公室關閉，但這些時間相當短暫，我們沒有看到我們醫院的服務受到任何重大干擾。

More importantly, all of our team members who were in harm's way are safe.

更重要的是，我們所有受傷的團隊成員都很安全。

Many of our affiliated hospital-based clinicians in affected areas remained in their facilities to care for their patients during storms, and those in office-based settings undertook great efforts both to prepare for the storms and reopen as quickly as possible on behalf of their patients.

我們在受影響地區的許多附屬醫院的臨床醫生在風暴期間仍留在自己的設施中照顧患者，而辦公室的臨床醫生則做出了巨大努力，既為風暴做好準備，又代表患者盡快重新開放。

I want to thank our teams for their dedication to patient care and similarly our hospital partners for their own such dedication.

我要感謝我們的團隊對病人照護的奉獻精神，同樣感謝我們的醫院夥伴的奉獻精神。

During the quarter, we successfully completed the final wave of our transition to a hybrid revenue cycle management structure, and I am pleased that not only is the transition behind us, but we were able to complete it without any meaningful disruptions to our operating results.

在本季度，我們成功完成了向混合收入周期管理結構過渡的最後一波，我很高興不僅我們已經完成了過渡，而且我們能夠在不對我們的經營業績造成任何有意義的干擾的情況下完成過渡。

Our internal team has worked in full collaboration with our new vendor Guidehouse and we will now shift our focus from transition to driving improved performance.

我們的內部團隊與我們的新供應商 Guidehouse 充分合作，我們現在將把重點從轉型轉向推動績效改進。

We also remain focused on completing our portfolio restructuring plan by the end of the fourth quarter.

我們也繼續致力於在第四季末完成我們的投資組合重組計劃。

Under this plan, we are exiting businesses totaling $200 million in revenue with an expectation of approximately $30 million in annualized improvement in adjusted EBITDA based on 2023 results.

根據該計劃，我們將退出總收入為 2 億美元的業務，預計根據 2023 年業績，調整後 EBITDA 的年度改善約為 3,000 萬美元。

We expect to realize a portion of this in 2024 and the remainder in 2025 and beyond.

我們預計將在 2024 年實現其中一部分，並在 2025 年及以後實現剩餘部分。

As I discussed last quarter, our operating teams have moved quickly, but thoughtfully to ensure that patient services are not disrupted during these transitions and we have identified appropriate pathways for these exits, including transitions to private practice, new ownership or hospital partnerships.

正如我上季度所討論的，我們的營運團隊行動迅速，但經過深思熟慮，以確保患者服務在這些過渡期間不會受到干擾，並且我們已經確定了這些退出的適當途徑，包括過渡到私人診所、新所有權或醫院合作夥伴關係。

Based on our third quarter results and the progress of our operating plans, we have narrowed our outlook of full year adjusted EBITDA to $205 million and $215 million.

根據我們第三季的業績和營運計畫的進展，我們將全年調整後 EBITDA 的預期縮小至 2.05 億美元和 2.15 億美元。

2024 has been and continues to be a period of significant change for Pediatrix.

2024 年對 Pediatrix 來說一直是並將繼續是一個發生重大變化的時期。

Our goals, however, are unchanged to focus our attention on those service lines with solid financial underpinnings, solidify our margin profile, and create meaningful operating efficiencies for Pediatrix.

然而，我們的目標並沒有改變，將我們的注意力集中在那些具有堅實財務基礎的服務線上，鞏固我們的利潤狀況，並為 Pediatrix 創造有意義的營運效率。

In turn, we believe that executing on our plans will enable us to support highly collaborative and critical patient services and continued investments in clinical research and education.

反過來，我們相信，執行我們的計劃將使我們能夠支持高度協作和關鍵的患者服務以及對臨床研究和教育的持續投資。

I'd like now to formally introduce Kasandra Rossi, our Executive Vice President, Chief Financial Officer and Treasurer.

現在我想正式介紹我們的執行副總裁、財務長兼財務主管卡桑德拉·羅西 (Kasandra Rossi)。

Kasandra has been with the company for more than 15 years, taking on increasing and more senior roles within our finance organization.

Kasandra 在公司工作超過 15 年，在我們的財務組織中擔任越來越多的高階職位。

I've had the pleasure of working with her throughout my own tenure here, and over the past several months we have spent significant time ensuring that this leadership transition will be a smooth one.

我很高興在我的任期內與她一起工作，在過去的幾個月裡，我們花了大量時間確保這個領導層過渡順利進行。

Kasandra leads a very experienced and dedicated finance organization and all of us on the leadership team look forward to her continued contributions to the company.

Kasandra 領導著一個經驗豐富且敬業的財務組織，領導團隊中的所有人都期待她繼續為公司做出貢獻。

And with that, I'll turn the call over to Kasandra.

然後，我會將電話轉給 Kasandra。

Thanks, Jim, and good morning, everyone.

謝謝吉姆，大家早安。

First, I'd like to thank Jim, our Board, and the Pediatrix team for the opportunity to serve as Chief Financial Officer.

首先，我要感謝 Jim、我們的董事會和 Pediatrix 團隊給我擔任財務長的機會。

As Jim noted, I've spent a considerable part of my career here, and it's an honor to continue to support such a valuable organization, particularly at such an important time in our evolution.

正如吉姆所指出的那樣，我職業生涯的很大一部分都是在這裡度過的，我很榮幸能夠繼續支持這樣一個有價值的組織，特別是在我們發展的如此重要時刻。

I'm a true believer that our finance organization should play an important role not only in strategic decision-making, but in decisions across our entire organization, all of which have financial implications.

我堅信，我們的財務組織不僅應該在策略決策中發揮重要作用，而且應該在整個組織的決策中發揮重要作用，所有這些都具有財務影響力。

We have a talented group of dedicated employees that are part of the CFO organization, accounting, finance, enterprise data analytics, information technology, and revenue cycle management.

我們擁有一群才華洋溢、敬業的員工，他們是財務長組織、會計、財務、企業資料分析、資訊科技和收入週期管理的一部分。

These functions overlap with every single part of the business, and I consider it my responsibility to ensure that we bring a full suite of financial data and analytics to the table, as well as identify innovation and automation opportunities so that our operators and shared services partners can make timely and informed decisions and ultimately work toward our shared goal of operating more efficiently.

這些職能與業務的每個部分重疊，我認為我有責任確保我們提供全套財務數據和分析，並識別創新和自動化機會，以便我們的營運商和共享服務合作夥伴能夠做出及時、明智的決策，並最終實現我們更有效率營運的共同目標。

With that said, I'll provide some additional details on the quarter.

話雖如此，我將提供有關本季度的一些其他詳細資訊。

Our consolidated revenue growth of just under 1% reflected strong same unit growth, offset primarily by the impact of our portfolio restructuring activity.

我們的綜合收入成長略低於 1%，反映了強勁的同單位成長，但主要被我們的投資組合重組活動的影響所抵消。

In total, this impact was just over $20 million during the quarter, reflecting both practice dispositions completed and the divestitures of our former primary and urgent care clinics.

總的來說，本季的影響剛剛超過 2000 萬美元，反映了已完成的診所處置以及我們以前的初級和緊急護理診所的剝離。

On the cost side, practice level, S&B expenses declined year-over-year, also reflecting our portfolio restructuring.

在成本方面，實務水準、S&B費用年減，也反映了我們的投資組合重組。

On a same unit basis, these expenses did increase year-over-year, but at a slower pace than same unit revenue, and we did see a year-over-year deceleration in underlying salary growth, not only as compared to the prior year period, but on a sequential basis as compared to the first and second quarters of '24.

在相同單位的基礎上，這些費用確實同比增加，但增速低於相同單位收入，而且我們確實看到基本工資增長同比減速，不僅與上一年相比期間，但與2024 年第一季和第二季相比是連續的。

Our G&A expense increased modestly year-over-year, primarily reflecting the additional staffing we have put in place as part of our hybrid revenue cycle management structure and incentive compensation based on financial results.

我們的一般管理費用同比小幅增長，主要反映了我們作為混合收入周期管理結構和基於財務業績的激勵薪酬的一部分而增加的人員配置。

This was partially offset by efficiencies we've created through the year through staffing reductions across shared services as a result of our smaller footprint across fewer service lines.

這部分被我們全年透過減少共享服務人員數量所創造的效率所抵消，因為我們在較少的服務線中佔地面積較小。

We continue to anticipate that full year 2024 G&A expense will be comparable to 2023 G&A on a dollar basis.

我們繼續預計，以美元計算，2024 年全年一般管理費用將與 2023 年一般管理費用相當。

For those of you keeping models, I'll note that our depreciation and amortization expense declined to $6.3 million compared to $9.2 million in the prior year.

對於那些保留模型的人，我要指出的是，我們的折舊和攤銷費用從上一年的 920 萬美元下降到了 630 萬美元。

This decline primarily reflects lower depreciation expense related to our practice dispositions and our third quarter level of G&A should be fairly consistent going forward, all else being equal.

這一下降主要反映了與我們的業務處置相關的折舊費用降低，並且在其他條件相同的情況下，我們第三季度的一般管理費用水平未來應該相當一致。

Moving to cash flow.

轉向現金流。

We generated $96 million in operating cash flow during the third quarter compared to $81 million in the prior year.

第三季我們產生了 9,600 萬美元的營運現金流，而去年同期為 8,100 萬美元。

As Jim noted, we completed the final wave of our transition to a hybrid revenue cycle management structure during the quarter with no disruptions to cash generation.

正如吉姆指出的那樣，我們在本季度完成了向混合收入周期管理結構過渡的最後一波，沒有中斷現金產生。

We ended the quarter with cash just over $100 million, reducing our net debt to $515 million from $600 million at June 30th.

本季結束時，我們的現金略高於 1 億美元，淨債務從 6 月 30 日的 6 億美元減少到 5.15 億美元。

This reflects net leverage of just under 2.5 times based on the midpoint of our outlook of adjusted EBITDA for the year.

根據我們今年調整後 EBITDA 展望的中位數，這反映出淨槓桿率略低於 2.5 倍。

With respect to the cash on our balance sheet, we are currently investing that cash in very attractive time deposit accounts at interest rates that are substantially similar to our debt service costs.

就我們資產負債表上的現金而言，我們目前將這些現金投資於非常有吸引力的定期存款帳戶，利率基本上與我們的償債成本相似。

We expect to use this cash and any cash accumulated during the fourth quarter of '24, early in 2025 to make physician incentive compensation payments and other benefit payments, namely our 401(k) matching contributions.

我們預計將在 2025 年初使用這筆現金以及 2024 年第四季度累積的任何現金來支付醫生激勵補償金和其他福利付款，即我們的 401(k) 配套繳款。

Our intent is to reduce any potential borrowing needs in Q1 2025 before we turn to expected free cash flow generation in Q2 '25 and beyond.

我們的目的是在 2025 年第二季及以後轉向預期的自由現金流產生之前，減少 2025 年第一季的任何潛在藉貸需求。

Finally, I'll reiterate that based on our results for the first nine months of the year, we have narrowed our expectation of full year 2024 adjusted EBITDA to a range of $205 million to $215 million.

最後，我要重申，根據今年前 9 個月的業績，我們已將 2024 年全年調整後 EBITDA 的預期縮小至 2.05 億美元至 2.15 億美元之間。

With that, now I will turn the call back over to Jim.

現在我將把電話轉回給吉姆。

Thank you, Kasandra.

謝謝你，卡桑德拉。

Operator, let's now open up the call for questions.

接線員，現在讓我們開始提問。

Ryan Daniels, William Blair.

瑞恩·丹尼爾斯、威廉·布萊爾。

Please go ahead.

請繼續。

Yeah.

是的。

Hi, everyone.

大家好。

This is Jack Senft for Ryan.

我是瑞安的傑克·森夫特。

Thanks for taking the questions.

感謝您提出問題。

You mentioned that you increased internal staffing, I believe, as part of the RCM transition.

我相信，您提到您增加了內部人員配置，作為 RCM 過渡的一部分。

Are you at okay levels now, like as we look into fourth quarter and into 2025, or is this still going to be an area that you'll want to bolster up, kind of throughout the next year or so?

你們現在的水平還好嗎，就像我們展望第四季和 2025 年一樣，還是說這仍然是你們想要加強的領域，在明年左右？

Yeah.

是的。

So, we actually believe we are fully staffed.

所以，我們實際上相信我們的人員配備齊全。

I know when we initially moved to this hybrid revenue cycle management structure, we noted that we should add approximately 150 heads.

我知道當我們最初轉向這種混合收入周期管理結構時，我們注意到我們應該增加約 150 名負責人。

We have actually been able to fully staff our teams up and we are in the mid-130s, and we feel that that is appropriate moving forward.

事實上，我們已經能夠為我們的團隊配備足夠的人員，而且我們已經有 130 多歲了，我們認為這是適當的前進。

And, of course, we will keep an eye on that as we gain additional efficiency as we move into 2025.

當然，隨著我們進入 2025 年，我們將獲得更高的效率，我們將密切關注這一點。

Okay, perfect.

好的，完美。

Thank you.

謝謝。

And then just a quick follow-up.

然後進行快速跟進。

I know like in the release you noted the same unit revenue from net reimbursement related factors increased just from the improved payer mix and then modest improvements in hospital contract admin fees.

我知道，就像在新聞稿中您指出的那樣，來自淨報銷相關因素的相同單位收入的增加只是由於付款人組合的改善以及醫院合約管理費的適度改善。

On both of these fronts, are these two dynamics something we should expect going forward?

在這兩個方面，這兩種動態是我們未來該期待的嗎？

I think the favorable payer mix was evident last quarter as well.

我認為有利的付款人組合在上個季度也很明顯。

So maybe just to clarify that.

所以也許只是為了澄清這一點。

And then, is the contract administration fees, is that improvement mainly from renegotiations, or is there something additional underlying there?

然後，是合約管理費，這種改善主要來自於重新談判，還是還有其他潛在因素？

Thanks.

謝謝。

We'll split this up a little bit.

我們將把它分開一點。

This is Jim.

這是吉姆。

I'll handle the contract revenue with our hospital partners.

我將處理與我們醫院合作夥伴的合約收入。

We spent a fair amount of time, end of '22, end of '23, renegotiating some of those contracts and feel that we're at levels that are appropriate for the services we provide.

我們在 22 年底和 23 年底花了相當多的時間重新談判其中一些合同，並認為我們處於適合我們提供的服務的水平。

On a go-forward basis, obviously, what we see is pretty stable pricing.

顯然，在未來的基礎上，我們看到的是相當穩定的定價。

And remember, we're not an organization that relies on a lot of contract revenue.

請記住，我們不是一個依賴大量合約收入的組織。

However, if a hospital wants to increase a service or looks for additional services, that's always in place.

然而，如果醫院想要增加服務或尋求額外的服務，那總是可以的。

So, again, we can look at those judiciously as we move forward, which will be the same pace in 2025.

因此，我們在前進時可以再次明智地看待這些問題，2025 年也將保持同樣的步伐。

And I can take the payer mix question.

我可以回答付款人組合問題。

I think you could say we've pretty much seen about a four-quarter reset of sorts for payer mix.

我想你可以說我們幾乎已經看到了第四季度付款人組合的重置。

I know that we've been very transparent in the past that we know what is happening.

我知道我們過去一直非常透明，我們知道正在發生什麼。

It's a little bit tougher for us to put our fingers on the why.

對我們來說，要找出原因有點困難。

I think we're going to need to watch this and see how it plays out over the next couple of quarters.

我認為我們需要關注這一情況，看看它在接下來的幾個季度中會如何發展。

We think it's probably some type of a reset that will level off.

我們認為這可能是某種類型的重置，最終會趨於平穩。

Okay, understood.

好的，明白了。

Thanks for the color.

謝謝你的顏色。

And then if I can just flip one final question in there.

然後我能否提出最後一個問題。

The same unit revenue increased again at a pretty decent clip this quarter.

本季同樣的單位收入再次以相當不錯的速度成長。

I think it was up a little over 5%.

我認為上漲了 5% 多一點。

Can you just maybe talk about what is in your control to keep the same unit revenue steady and kind of stabilize going forward?

您能否談談您可以控制什麼來保持相同的單位收入穩定並在未來保持穩定？

Or is this kind of more like a function of just market growth and what's happening in terms of volume?

或者這更像是市場成長和數量變化的函數？

Thanks.

謝謝。

Yeah.

是的。

So, I mean, of course, on our volumes, for our neonatology business, we are pretty much takers of volume.

所以，我的意思是，當然，就我們的數量而言，對於我們的新生兒業務來說，我們幾乎是數量的接受者。

So, it is really what's happening, happening in the market.

所以，這確實是市場上正在發生的事情。

I think in the one area we have had some strength is MFM.

我認為我們在 MFM 領域擁有一定的優勢。

We have seen a little bit acuity is a bit higher there.

我們看到那裡的敏銳度有點高。

So, we have had some additional visits, and we do expect that that will hold as we head into 2025.

因此，我們進行了一些額外的訪問，我們確實預計在進入 2025 年時這種情況將會持續下去。

Okay, perfect.

好的，完美。

Thank you again, guys.

再次感謝你們，夥伴們。

Jack Slevin, Jefferies

傑克·斯萊文，杰弗里斯

Hey, good morning.

嘿，早安。

Welcome to Kasandra and congrats to everyone on the quarter.

歡迎來到 Kasandra，恭喜本季的所有人。

A couple things I want to touch on here.

我想在這裡談幾件事。

Probably just the two biggest moving pieces I think that are in folks' minds on the restructuring plan and then on the RCM front.

我認為人們心中最感人的兩個因素可能是重組計劃和 RCM 方面的問題。

On the restructuring plan, the commentary pretty clear, I guess two things on that.

關於重組計劃，評論很清楚，我想有兩點。

How do you think about modeling that into the fourth quarter on the revenue line?

您如何看待將其建模到第四季度的收入線上？

Are we approaching that sort of run rate around the $200 million that you think on a quarterly basis, or is it still a little below that trend like it was in the third quarter?

我們是否正在接近您所認為的每季 2 億美元左右的運行率，還是仍略低於第三季的趨勢？

And then in terms of EBITDA contribution, can you confirm if there was any benefit in the third quarter or if you'd expect any benefit in the fourth quarter?

然後就 EBITDA 貢獻而言，您能否確認第三季是否有任何好處，或者您預計第四季度是否有任何好處？

That's embedded in the guidance on that front.

這已包含在這方面的指南中。

So, I think on the practice dispositions and on the revenue topic, you will see that the impact of the practice dispositions in our non-same unit activity, we mentioned that during the quarter that was about $20 million and if you look at the year-to-date on that it's about $50 million.

因此，我認為在實踐處置和收入主題上，您會看到實踐處置對我們非同一單位活動的影響，我們提到在本季度約為 2000 萬美元，如果您看看這一年- 迄今為止，該金額約為5000 萬美元。

We did last quarter let you know that most of that activity is slated toward the end of the year, and it is really back loaded mostly in the fourth quarter.

我們上季度確實讓您知道，大部分活動都計劃在今年年底進行，而且實際上主要是在第四季度進行的。

So, while we do anticipate getting to that $200 million of revenue, it will be by the end of the year with the most of that to come in the fourth quarter.

因此，雖然我們確實預計將實現 2 億美元的收入，但到今年年底，其中大部分將在第四季度實現。

And on the EBITDA contribution, we had put out a number in May about $30 million is our expectation of what would flow through from the full suite of our portfolio restructuring.

關於 EBITDA 貢獻，我們在 5 月公佈了大約 3000 萬美元的數字，這是我們對全套投資組合重組的預期。

We do expect that we will see about a third of that in '24, but the rest of that will roll into '25.

我們確實預計在 24 年我們會看到其中的三分之一，但其餘的將在 25 年出現。

Okay, got it.

好的，明白了。

That's really helpful.

這真的很有幫助。

And then maybe on the RCM front, I mean, it sounds like everything is going according to plan there.

然後也許在 RCM 方面，我的意思是，聽起來一切都按計劃進行。

Obviously, '22 and '23 were both years where that was a pretty material headwind to revenues and earnings.

顯然，22 年和 23 年這兩個年份都對收入和收益造成了相當大的阻力。

How should you think about the opportunity on a, call it, 12 to 24-month basis if everything continues to go according to plan in rev cycle?

如果一切都繼續按計劃進行，您應該如何看待 12 至 24 個月的機會？

What sort of -- is there any framework you can build out for how we should think about what that could mean on either a revenue or an EBITDA front.

您可以建立什麼樣的框架來幫助我們思考這對收入或 EBITDA 意味著什麼。

Yeah.

是的。

So, we're a little early on being able to kind of quantify what we expect we will have in terms of improved performance as we move out of '24.

因此，我們還為時過早，能夠量化 24 世紀之後我們對效能改進的預期。

One thing we were clear about is 2024 was just going to be all about stabilization.

我們清楚的一件事是 2024 年將完全穩定。

The fact that between March of 2024 and September of 2024 that we moved $1.6 billion of revenue and $800 million of AR with no material disruptions is a feat.

事實上，在 2024 年 3 月至 2024 年 9 月期間，我們在沒有重大中斷的情況下轉移了 16 億美元的收入和 8 億美元的 AR，這是一項壯舉。

So, we're very pleased about the collaboration.

所以，我們對這次合作感到非常高興。

And now we're going to move to automation, looking for ways we can improve performance.

現在我們將轉向自動化，尋找提高效能的方法。

While the Guidehouse, our vendor staffing gets up to speed and fully trained and our teams are up to speed, we're looking to the future.

在 Guidehouse、我們的供應商人員配備和接受全面培訓、我們的團隊也跟上腳步的同時，我們也在展望未來。

We absolutely expect there will be improved performance, but we're really not ready to quantify what that may be and when.

我們絕對期望性能會得到改善，但我們確實還沒有準備好量化可能會發生什麼以及何時發生。

Awesome.

驚人的。

Thanks very much.

非常感謝。

(Operator Instructions) Pito Chickering, Deutsche Bank

（操作員指示）Pito Chickering，德意志銀行

Hi, there.

你好呀。

This is Kieran [ph] on for Pito.

我是 Pito 的 Kieran [ph]。

Thanks for taking the question.

感謝您提出問題。

I just wanted to ask if you've seen any improvement in maybe your ability to secure additional funding from hospitals, whether that be in the form of subsidies or something else.

我只是想問一下，您從醫院獲得額外資金的能力是否有所改善，無論是補貼還是其他形式。

I know you've commented before that you don't get subsidies from the majority of your hospitals, but still sounds like to us there's still a lot of specialty groups out there that are kind of asking for these and getting them in a lot of cases.

我知道您之前曾評論過，大多數醫院都沒有提供補貼，但對我們來說，仍然有很多專業團體在要求這些補貼，並將它們納入到很多醫院中。

So, just wondering if you think that might be an opportunity in 2025.

所以，我想知道您是否認為 2025 年這可能是一個機會。

Yeah.

是的。

Kieran, it's Jim.

基蘭，我是吉姆。

We know there's a lot of noise out there on other specialties, particularly on the adult side for some of that contract revenue from the hospitals.

我們知道其他專業有很多噪音，特別是在成人方面，醫院的部分合約收入。

Our relationship with our hospital partners has been very stable and where we have needed, again, because of inflation in wages or inflation in the needs of staffing, we've been successful in negotiating increases to those.

我們與醫院合作夥伴的關係一直非常穩定，並且在我們需要的地方，由於工資上漲或人員配置需求膨脹，我們已經成功地透過談判增加了這些費用。

And again, as I said earlier on the call, we largely got a number of those done in late '22 and through the beginning of 2023.

正如我之前在電話會議上所說，我們在 22 世紀末和 2023 年初完成了其中的大部分工作。

And again, if we believe we need those associated with increased costs, we will approach our hospital partners.

同樣，如果我們認為我們需要那些與成本增加相關的費用，我們將與我們的醫院合作夥伴聯繫。

If it's a new service line that would require us to have contract revenue, we always negotiate those fully at the beginning of the contract.

如果這是一條新的服務線，需要我們有合約收入，我們總是在合約開始時就這些內容進行充分協商。

So, there's an opportunity there.

所以，那裡有一個機會。

But I don't think that we have the same requirements that some of the adult service lines have.

但我不認為我們的要求與某些成人服務熱線相同。

Got it.

知道了。

That's helpful.

這很有幫助。

Thank you.

謝謝。

And then second, just one -- another good cash flow quarter.

其次，只有一個——另一個現金流良好的季度。

It seems like the cash flow generation should benefit from RCM and the divestitures.

看來現金流的產生應該受益於 RCM 和資產剝離。

So just wanted to see how you're thinking about getting back into M&A in the near term now that you're at under two times leverage.

因此，我只是想看看，既然您的槓桿率低於兩倍，您如何考慮在短期內重新進行併購。

And any commentary you can provide on the pipeline would be great.

如果您能對管道提供任何評論，那就太好了。

Thank you.

謝謝。

Yeah.

是的。

We're pretty happy with the pipeline we have on the core services.

我們對核心服務的管道非常滿意。

And so, we think there's a real opportunity there coming up tail end of the year here and then into '25.

因此，我們認為今年年底以及 25 年將有真正的機會。

So, our focus is really looking at both our inorganic and organic pipeline. We think there's a meaningful number of acquisitions that we can start down the path on now that we've rided [ph] the ship in terms of some of these other headwinds we are facing.

因此，我們的重點實際上是專注於我們的無機和有機管道。我們認為，既然我們已經克服了我們面臨的其他一些不利因素，我們就可以開始進行大量的收購。

Got it. That's helpful. Thank you. And then second, just one -- another good cash flow quarter. It seems like the cash flow generation should benefit from RCM and the divestitures. So just wanted to see how you're thinking about getting back into M&A in the near term now that you're at under two times leverage. And any commentary you can provide on the pipeline would be great. Thank you.

知道了。這很有幫助。謝謝。其次，只有一個——另一個現金流良好的季度。看來現金流的產生應該受益於 RCM 和資產剝離。因此，我只是想看看，既然您的槓桿率低於兩倍，您如何考慮在短期內重新進行併購。如果您能對管道提供任何評論，那就太好了。謝謝。

Yeah. We're pretty happy with the pipeline we have on the core services.

是的。我們對核心服務的管道非常滿意。

And so, we think there's a real opportunity there coming up tail end of the year here and then into '25.

因此，我們認為今年年底以及 25 年將有真正的機會。

So, our focus is really looking at both our inorganic and organic pipeline.

因此，我們的重點實際上是專注於我們的無機和有機管道。

We think there's a meaningful number of acquisitions that we can start down the path on now that we've rided [ph] the ship in terms of some of these other headwinds we are facing.

我們認為，既然我們已經克服了我們面臨的其他一些不利因素，我們就可以開始進行大量的收購。

And does that answer your question?

這能回答你的問題嗎？

Yes, I'm all set.

是的，我已經準備好了。

Thank you.

謝謝。

Thank you.

謝謝。

Operator, do we have a question?

接線員，我們有問題嗎？

A.J. Rice, UBS

A.J.賴斯、瑞銀

Thanks.

謝謝。

Seems to be a little echo there, but anyway.

那裡似乎有一點迴聲，但無論如何。

Can you maybe just more broadly on the cash flow question, Obviously, there's the revenue cycle management that you've reworked, there's the portfolio restructuring.

您能否更廣泛地討論現金流問題？

Have a sense of what a normalized cash flow, either from operations or even free cash flow, run rate is that you're generating at this point?

了解您此時產生的正常化現金流（無論是來自營運還是自由現金流）的運作率是多少？

Hey, A.J. it's Charlie.

嘿，A.J.是查理。

I can give some historical reference, which is that our experience, in general, has been our conversion of EBITDA to operating GAAP, operating cash flow has typically been in kind of 60% to two-thirds range.

我可以提供一些歷史參考，那就是我們的經驗，一般來說，我們將 EBITDA 轉換為營運 GAAP，營運現金流通常在 60% 到三分之二的範圍內。

That's probably a good baseline to think about.

這可能是值得思考的良好基準。

Clearly, this year we've had a lot of moving parts, but I think looking forward, that's probably a good kind of set of guardrails to think about.

顯然，今年我們有很多變動的部分，但我認為展望未來，這可能是值得考慮的一套很好的護欄。

Okay.

好的。

And then as you said, you got a couple things that are committed.

然後正如你所說，你已經承諾了幾件事。

The cash flow is committed to through the first quarter of '25.

現金流承諾持續到 25 年第一季。

You just asked about M&A, but I wonder broadly share repurchases, other things, capital deployment.

你剛剛問了併購，但我想知道廣泛的股票回購、其他事情、資本部署。

Maybe just give a little update on your thinking about capital deployment strategy from here.

也許只是從這裡提供一些關於您對資本部署策略的想法的最新資訊。

Yeah.

是的。

So, as we actually head into '25, we, of course, expect to use all that cash on our balance sheet early in the year.

因此，當我們實際進入 25 世紀時，我們當然希望在年初使用資產負債表上的所有現金。

But as we move into '25 and we get our budgets finalized and we see if we're in a place where we may have excess cash, we, of course, will look at all of the options available to us to deploy capital.

但隨著我們進入 25 年，我們最終確定了預算，我們看看我們是否處於可能擁有多餘現金的境地，我們當然會考慮所有可用於部署資本的選項。

We were talking a bit about M&A, we would look always at share repurchases, potentially paying down debt or some combination of those.

我們談論了一些關於併購的問題，我們總是會關注股票回購、可能償還債務或這些的某種組合。

But I think the message there is that we have optimal flexibility as to what we should do with our excess cash.

但我認為，這裡傳達的訊息是，我們對於如何處理多餘的現金擁有最佳的靈活性。

Okay.

好的。

Maybe just one final point of clarification.

也許只是最後一點需要澄清。

On the $30 million from the portfolio restructuring, is there any stranded overhead that or does that incorporate getting rid of any corporate expense that doesn't need to continue because of the downsizing of those practices?

投資組合重組帶來的 3000 萬美元中，是否存在任何擱置的管理費用，或者是否包括消除因這些業務規模縮減而不需要繼續的公司費用？

I guess, I would -- yeah, just see if the $30 million is a hard number, or is there maybe other opportunities over the next year or two.

我想，是的，我會看看 3000 萬美元是否是一個硬性數字，或者在未來一兩年內是否有其他機會。

I know the $30 million was our estimate.

我知道 3000 萬美元是我們的估計。

I wouldn't call it a hard number.

我不會稱之為硬數字。

There is -- we have the potential for that to actually come out a little bit better when we get through all of this activity.

當我們完成所有這些活動時，我們實際上有可能做得更好一些。

But it is intended to be the full suite of costs that supported the practices that are exiting the organization.

但它旨在成為支持正在退出組織的實踐的全套成本。

We will always look for opportunities for additional efficiency as we move into '25, and that's really part of what we're doing right now with our '25 budget planning.

當我們進入 25 世紀時，我們將始終尋找提高效率的機會，這確實是我們現在正在做的 25 預算規劃的一部分。

Okay, thanks a lot.

好的，非常感謝。

(Operator Instructions) And we have no further questions at this time.

（操作員說明）目前我們沒有其他問題。

Please continue.

請繼續。

Thank you, operator.

謝謝你，接線生。

And thank all of you for joining the call this morning.

感謝大家今天早上參加電話會議。

Have a great day.

祝你有美好的一天。

Thank you.

謝謝。

That does conclude our conference for today.

我們今天的會議到此結束。

Thank you for your participation and for using AT&T Executive Teleconference.

感謝您的參與和使用 AT&T 高階主管電話會議。

You may now disconnect.

您現在可以斷開連線。