Pediatrix Medical Group Inc (MD) 2024 Q4 法說會逐字稿

Thank you for standing by. My name is Tammy, and I will be your conference operator today. At this time, I would like to welcome everyone to the Pediatrix Medical Group, Inc., fourth-quarter 2024 earnings conference call. (Operator Instructions)

感謝您的支持。我叫 Tammy，今天我將擔任您的會議主持人。現在，我歡迎大家參加 Pediatrix Medical Group, Inc. 2024 年第四季財報電話會議。（操作員指示）

Thank you. I would now like to turn the conference over to Charles Lynch. Please go ahead, sir.

謝謝。現在我想將會議交給查爾斯·林奇。先生，請繼續。

Thank you, operator. Good morning, everyone. Welcome to our fourth quarter earnings call. I'll quickly read our forward-looking statements and then turn the call over to Mark. 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.

謝謝您，接線生。大家早安。歡迎參加我們的第四季財報電話會議。我會快速閱讀我們的前瞻性聲明，然後將電話轉給馬克。本次電話會議中的某些聲明和資訊可能被視為《1995 年聯邦私人證券訴訟改革法案》所定義的前瞻性聲明。

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

這些前瞻性陳述是基於 Pediatrix 管理層根據其經驗和對歷史趨勢、當前狀況、預期未來發展以及他們認為適當的其他因素的評估而做出的假設和評估。本次電話會議中所做的任何前瞻性陳述均截至今日為止，Pediatrix 不承擔更新或修改任何此類陳述的義務，無論其是否出現新資訊、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.

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已在公司向美國證券交易委員會提交的文件中進行了描述，其中包括題為“風險因素”的部分。

In today's remarks by management, we will be discussing non-GAAP financial metrics. A reconciliation of these non-GAAP financial measures for the most comparable GAAP measures can be found in this morning's earnings press release, our quarterly reports on Form10-Q, and our annual report on Form 10-K, and on our website at www.pediatrix.com.

在今天的管理階層演講中，我們將討論非公認會計準則財務指標。這些非 GAAP 財務指標與最具可比性的 GAAP 指標的對帳可以在今天早上的收益新聞稿、我們的 Form10-Q 季度報告、Form 10-K 年度報告以及我們的網站 www.pediatrix.com 上找到。

With that I'll turn the call over to our CEO, Mark Ordan.

說完這些，我將把電話轉給我們的執行長馬克·奧爾丹 (Mark Ordan)。

Thank you, Charlie, and good morning, everyone. Also with me today is Kasandra Rossi, our Chief Financial Officer.

謝謝你，查理，大家早安。今天和我一起的還有我們的財務長卡桑德拉‧羅西 (Kasandra Rossi)。

First, I want to thank Charlie, who will be departing at the end of this month. Charlie's contributions to our strategic goals and the communication of those goals to you will be missed. Please join me in wishing him well in his future endeavors.

首先，我要感謝查理，他將於本月底離職。我們會懷念查理對我們的策略目標所做的貢獻以及將這些目標傳達給您。請和我一起祝福他未來一切順利。

I want to begin by thanking our Board of Directors for reappointing me as Chief Executive Officer after serving as Executive Chair. I'm excited to return to this role and particularly at this point in time for the company following a period of such significant change. As I'll explain in a few minutes, I returned out of optimism about our prospects.

首先，我要感謝董事會在擔任執行主席後再次任命我為執行長。我很高興能夠重返這個職位，尤其是在公司經歷瞭如此重大的變革之後。正如我幾分鐘後將要解釋的那樣，我回來是因為對我們的前景感到樂觀。

I will begin with our fourth-quarter results and then spend time on our strategic priorities for 2025 and beyond. We finished 2024 with very strong fourth quarter and therefore year-end results. Our same-unit revenue growth was strong, driven by continued favorable payor mix and positive volume.

我將從我們第四季的業績開始，然後討論我們 2025 年及以後的策略重點。我們在 2024 年第四季取得了非常強勁的業績，因此年終業績也十分出色。受持續有利的付款人組合和積極的銷售量的推動，我們的同單位收入增長強勁。

Our same-unit cost trend continued down compared to the third quarter as well. As a result, adjusted EBITDA of $69 million was significantly above the expectations we provided in our updated guidance last year.

與第三季相比，我們的同單位成本趨勢也持續下降。因此，調整後的 EBITDA 為 6,900 萬美元，大大高於我們去年更新的指引中提供的預期。

From a strategic standpoint, we completed our portfolio restructuring on time, exiting practices that represented $200 million in annual revenue and a clear drag on earnings with their requisite overhead. I worked very closely with our operating teams who were incredibly focused on this goal. Their very hard work ensured that we were able to begin 2025 with a more focused portfolio and a more efficient operating team.

從戰略角度來看，我們按時完成了投資組合重組，退出了那些年收入高達 2 億美元、且因必要的管理費用而明顯拖累盈利的業務。我與我們的營運團隊密切合作，他們非常專注於此目標。他們的辛勤工作確保了我們能夠在 2025 年開始擁有更專注的投資組合和更有效率的營運團隊。

Similarly, the successful transition of our revenue cycle management function to a hybrid model enables us to focus this year first on ensuring the stability of our now very improved RCM process and then on continued improvement in our performance.

同樣，我們的收入週期管理功能成功過渡到混合模式，使我們能夠在今年首先集中精力確保現已得到極大改進的 RCM 流程的穩定性，然後再持續提高我們的績效。

Next, I'll add my thoughts on our strategic priorities following our portfolio restructuring and RCM transition. First, we start with a sector leading balance sheet with net debt of about 1.7 times. This affords us both flexibility and opportunities, which is most important in turbulent times. We now have a smaller footprint resulting in a more focused and more efficient organization and our priorities are quite clear.

接下來，我將補充我對我們的投資組合重組和 RCM 轉型後的策略重點的想法。首先，我們從業界領先的資產負債表開始，淨債務約為 1.7 倍。這為我們提供了靈活性和機遇，這在動盪時期至關重要。現在，我們的規模更小，組織更加專注、更有高效，我們的優先事項也更加明確。

We will first and foremost prioritize patient-centric care by providing optimal support to our clinicians and our practices. We will seek to strengthen our hospital and health system relationships. And we will look [good] stewards of our financial -- our improved financial positions and our cash flow. I also fully believe that the net result of following these priorities can be consistent, visible, and strong operating results.

我們將首先優先考慮以患者為中心的護理，為我們的臨床醫生和實踐提供最佳支援。我們將努力加強我們與醫院和衛生系統的關係。我們將會成為我們財務的好管家－我們改善的財務狀況和現金流。我也完全相信，遵循這些優先事項的最終結果可以帶來一致、可見和強勁的經營業績。

With that in mind and based on a robust budgeting process in which we focused on both the headwinds and opportunities we faced in 2025, this morning, we provided a preliminary expectation of adjusted EBITDA of between $215 million and $235 million. Kasandra will shortly provide some additional thoughts, but we believe that this represents a rigorous yet realistic and achievable outlook for our business this year, which we will obviously revisit an update as appropriate coming quarters.

考慮到這一點，並基於強有力的預算流程，我們重點關注 2025 年面臨的阻力和機遇，今天上午，我們初步預期調整後的 EBITDA 將在 2.15 億美元至 2.35 億美元之間。Kasandra 很快就會提供一些額外的想法，但我們相信這代表了我們今年業務的嚴謹而又現實且可實現的前景，我們顯然會在未來幾個季度內酌情重新審視更新。

I'd anticipate that some of you are wondering with the strength of our business and all that we accomplished, why not a guide to a higher number. Bear in mind that adjusted for the leap year 2024, adjusted EBITDA was roughly $220 million. So at midpoint of 2025 guidance of $225 million is of course an increase.

我預期你們中的一些人會感到疑惑，鑑於我們的業務實力和所取得的成就，為什麼不給出一個更高的數字呢？請記住，根據 2024 年閏年進行調整後，調整後的 EBITDA 約為 2.2 億美元。因此，到 2025 年中期，2.25 億美元的指導金額當然有所增加。

As I began with my remarks, I returned to Pediatrix as CEO, because I see a real opportunity to further transform the company through better hospital relationships, better recruiting which by the way, will report to me and growth and opportunities that both of these will afford. We are, of course, mindful that we are in a period of great uncertainty with headwinds in the healthcare provider space. These headwinds make us realistic about the year ahead, but in no way do they counter our optimists.

正如我在演講開始時所說，我回到 Pediatrix 擔任首席執行官，因為我看到了一個真正的機會，透過更好的醫院關係、更好的招聘（順便說一句，招聘將向我匯報）以及這兩者將帶來的增長和機會來進一步改變公司。當然，我們也意識到，我們正處於一個充滿不確定性的時期，醫療保健提供者領域面臨阻力。這些不利因素讓我們對未來一年抱持現實的態度，但絕不打擊我們的樂觀精神。

With that I'll turn the call over to Kasandra.

說完這些，我就把電話轉給卡桑德拉。

Thanks, Mark, and good morning, everyone. I'll provide some details of our fourth-quarter results and then I'll discuss some of the parameters of our preliminary 2025 outlook. Our consolidated revenue growth of just over 1% reflected strong same-unit growth of 8.7%, largely offset primarily by the impact of our portfolio restructuring activity.

謝謝，馬克，大家早安。我將提供我們第四季度業績的一些細節，然後討論我們對 2025 年初步展望的一些參數。我們的綜合收入成長略高於 1%，反映出 8.7% 的強勁同單位成長，但這在很大程度上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 $35 million reflecting a large share of the annualized $200 million in revenue that our restructuring represented based on 2023 financials. On the cost side, the decline in practice level SW&B expenses also reflected our portfolio restructuring.

總體而言，這一影響略高於 3,500 萬美元，占我們重組根據 2023 年財務狀況所代表的 2 億美元年化收入的很大一部分。在成本方面，實踐層面的 SW&B 費用的下降也反映了我們的投資組合重組。

On a same-unit basis, the growth in these expenses continued to decelerate as compared to both the prior year period and on a sequential basis. I'll note that while this trend is encouraging, same-unit salary expense growth continued to be above the average range of 2% to 3% that we saw pre-2022.

以同單位計算，這些費用的成長與去年同期和上一季相比持續放緩。我要指出的是，雖然這種趨勢令人鼓舞，但同單位薪資支出成長率仍高於 2022 年之前 2% 至 3% 的平均值。

The increase in our G&A expense on a year-over-year basis primarily reflected incentive compensation based on strong financial results. The additional staffing we added through most of 2024 as part of our hybrid RCM model was offset by efficiencies we have created through the year through staffing reductions across other shared services.

我們的一般及行政費用年增主要反映了基於​​強勁財務表現的激勵性薪酬。作為混合 RCM 模型的一部分，我們在 2024 年的大部分時間裡增加的額外人員被我們全年透過減少其他共享服務的人員而創造的效率所抵消。

Moving to cash flow. We generated $135 million in operating cash flow in the fourth quarter compared to $73 million in the prior year. Partially driving this strong cash flow was a sequential decline in our accounts receivable DSO, which ended the year at 47.5 days compared to 51.5 days at September 30, which as you may recall, we attributed to RCM transition related activities. Our capital expenditures were $3.5 million.

轉向現金流。我們第四季的經營現金流為 1.35 億美元，去年同期為 7,300 萬美元。推動這一強勁現金流的部分原因是我們的應收帳款 DSO 連續下降，年底為 47.5 天，而 9 月 30 日為 51.5 天，您可能還記得，我們​​將其歸因於 RCM 過渡相關活動。我們的資本支出為 350 萬美元。

As a result of this cash generation, we ended the year with cash of $230 million reducing our net debt to $386 million from $515 million at September 30. This reflects net leverage of just over 1.7 times based on our reported 2024 adjusted EBITDA.

由於產生了這些現金，我們在年底擁有 2.3 億美元的現金，將淨債務從 9 月 30 日的 5.15 億美元減少到 3.86 億美元。根據我們報告的 2024 年調整後 EBITDA，這反映出淨槓桿率略高於 1.7 倍。

With respect to the cash on our balance sheet, we expect to use a good portion of that cash to fund physician incentive compensation payments and other benefit payments, namely our 401(k) matching contributions that we always make during the first quarter of the year, and we will not have to draw on our revolver. As we move through 2025, we would expect to build cash again, and Mark and I will work with our Board of Directors to determine our best course.

就我們資產負債表上的現金而言，我們預計將使用其中很大一部分來支付醫生激勵薪酬和其他福利，即我們每年第一季始終進行的 401（k）匹配供款，這樣我們就不必動用循環信貸卡。隨著我們進入 2025 年，我們期望再次累積現金，馬克和我將與董事會合作，確定最佳方案。

Turning to our preliminary 2025 outlook. As Mark said, this outlook is the result of a robust budgeting process and also reflects the finalization of our 2024 portfolio restructuring plan. From a modeling perspective, this outlook contemplates full year revenue of approximately $1.8 billion. It also contemplates full year G&A expense in the range of $220 million to $230 million compared to our 2024 G&A of $238 million.

談談我們對 2025 年的初步展望。正如馬克所說，這一前景是穩健的預算過程的結果，也反映了我們 2024 年投資組合重組計劃的最終確定。從模型角度來看，該展望預計全年營收約 18 億美元。它還預計全年的 G&A 費用將在 2.2 億美元至 2.3 億美元之間，而 2024 年的 G&A 費用為 2.38 億美元。

Lastly, I'll note the normal seasonality of our quarterly results. Within our expectations of full year adjusted EBITDA of $215 million to $235 million, we anticipate that our first quarter, 2025 adjusted EBITDA will represent approximately 17% of that annual expected range.

最後，我要指出的是，我們的季度業績具有正常的季節性。在我們預期的全年調整後 EBITDA 為 2.15 億美元至 2.35 億美元的情況下，我們預計 2025 年第一季的調整後 EBITDA 將佔該年度預期範圍的約 17%。

There are a number of known factors we incorporated into our 2025 outlook. The first of these is the expected EBITDA benefit of our portfolio restructuring plan. Recall that our total expected benefit is approximately $30 million on an annualized basis, roughly a third of which we realized during 2024. In addition, as Mark referenced, 2024 was a leap year which contributed about $4 million in adjusted EBITDA last year, all else being equal.

我們在 2025 年展望中納入了許多已知因素。其中第一個是我們投資組合重組計劃預期的 EBITDA 收益。回想一下，我們預期的總收益以年率計算約為 3000 萬美元，其中約三分之一是在 2024 年實現的。此外，正如馬克所提到的，2024 年是閏年，在其他條件相同的情況下，去年的調整後 EBITDA 貢獻了約 400 萬美元。

Finally, we have not factored any contribution to our results from M&A activity in 2025. While we are always pursuing a pipeline of additions to our core business, the timing and magnitude of any contribution is not incorporated into this outlook.

最後，我們沒有將 2025 年併購活動對我們業績的任何貢獻納入考量。雖然我們一直在尋求為我們的核心業務增添新的內容，但任何貢獻的時間和規模都沒有被納入這項展望。

There are also other factors that we contemplated. First, while we are very pleased with the RCM transition that we completed in September of 2024, our focus for the first half of this year is in maintaining the stability of our performance under this hybrid model, while looking for additional improvements in that performance through process improvement and automation initiatives.

我們也考慮了其他因素。首先，雖然我們對 2024 年 9 月完成的 RCM 轉型感到非常滿意，但今年上半年我們的重點是保持這種混合模式下的績效穩定性，同時尋求透過流程改進和自動化計劃進一步提高績效。

Second, payor mix proved to be a strong positive factor in our 2024 operating results. This is not a business driver that we can control. And as a result, we are not contemplating any trend change in 2025 which could impact our results in either direction.

其次，付款人組合被證明是我們 2024 年經營績效的強大正面因素。這不是我們可以控制的業務驅動因素。因此，我們不會考慮 2025 年的任何趨勢變化，因為這可能會對我們的結果產生任何影響。

Finally, I noted that our underlying practice level cost trend improved throughout the second half of 2024, that trend remained above our historical range of 2% to 3%. This area is a key focus of our operating team, but it's premature at this point to presume continued deceleration, particularly given the still inflationary environment we're in and the significant amount of recruiting and retention activity required across our organization.

最後，我注意到，我們的基本實務水準成本趨勢在 2024 年下半年有所改善，趨勢仍高於我們 2% 至 3% 的歷史範圍。這一領域是我們營運團隊關注的重點，但目前預測其將持續減速還為時過早，尤其是考慮到我們仍處於通膨環境中，而且整個組織需要進行大量的招募和保留活動。

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

說完這些，現在我會把電話轉回給馬克。

Thank you, Kasandra. Operator, we will now open the call for questions.

謝謝你，卡桑德拉。接線員，我們現在開始提問。

(Operator Instructions)

（操作員指示）

A.J. Rice, UBS.

A.J.賴斯，瑞銀。

Hi everybody. Good luck, Charlie, and welcome back, Mark. First, maybe just to drill down a little bit more on the '25 outlook. There's a lot going on with the restructuring of the operations and some of the other things you've called out.

大家好。祝你好運，查理，歡迎回來，馬克。首先，也許我們只是想更深入地了解 25 年的前景。目前有很多工作正在進行，包括業務重組以及您提到的其他一些事情。

I wonder if you could just speak to what sort of level of embedded same-facility volume growth and pricing expectations are you baking in? And any other same store metrics to give us a little better sense of what the underlying trends are when you normalize for everything else that's going on?

我想知道您是否可以談談您所考慮的嵌入式同設施產量成長和定價預期水準？當您將正在發生的其他所有事情標準化時，還有其他同店指標可以讓我們更了解潛在的趨勢嗎？

Sure. So for volume -- I guess I'll take them one at a time. For volume, we did have a bit of acceleration of volume in the back half of '24 with NICU days coming in just under 3% and [births] were up about 30 basis points in Q4.

當然。因此，就數量而言——我想我會一次解決一個問題。就數量而言，2024 年下半年我們的數量確實有所加速，新生兒加護病房 (NICU) 的天數略微減少了 3%，第四季的出生率增加了約 30 個基點。

The other stats for neonatology, length of stay was flat, admin rate was slightly up. But we are takers of volume for the most part, so we did include flat volume in our outlook for 2025. Talking about MFM, we did see mid-single digit growth there all year and that was really based on a little bit of higher acuity resulting in some additional visits to our MFM clinics. But from a modeling perspective we did assume that volume would be flat.

新生兒科的其他統計數據顯示，住院時間持平，管理費率略有上升。但我們大部分都是交易量的接受者，因此我們在 2025 年的展望中確實包含了持平的交易量。談到 MFM，我們確實看到全年都出現了中等個位數的增長，這實際上是基於更高的敏銳度，從而增加了對我們 MFM 診所的訪問量。但從建模的角度來看，我們確實假設體積是平的。

Looking at pricing, we talked a little bit about payor mix and we know that payor mix was a massive tailwind for us in '24. But we do anticipate that that will level off and of course as we work our way through 2025, that comp will get a little bit tougher. So we do have that flat.

從定價的角度來看，我們談論了一些付款人組合，我們知道付款人組合對我們來說是 24 年的一大順風。但我們確實預期這一趨勢將會趨於平穩，當然，隨著我們進入 2025 年，這場競爭將會變得更加激烈。所以我們確實有那間公寓。

On the managed care side, we talked about the fact that we expect 2025 to be pretty stable, which actually will take as a win in the hard and tough environment that we're operating in where payors still are a bit immobile.

在管理式醫療方面，我們談到了我們預計 2025 年將會相當穩定的事實，這實際上將被視為我們在艱難的營運環境中取得的勝利，因為付款人仍然有點不願意。

And then on the RCM side, collections were really strong in the back half of '24 and the metrics are looking great. But we did build in some improvement in 2025 into our outlook, but we are really focused on stabilization and as we move through the year, we'll see if we can kick that up a bit with automation initiatives and process improvement.

然後在 RCM 方面，24 年下半年的收藏非常強勁，各項指標看起來都很棒。但我們確實在 2025 年的展望中做出了一些改進，但我們真正關注的是穩定性，隨著這一年的推進，我們將看看是否可以透過自動化計劃和流程改進來推動這一進程。

Of course, the biggest line in our cost trends are in the SW&B line. And as we mentioned, we did decelerate the clinical comp expense for the third quarter in a row, getting that just above 3%, although again not in line with our historical trends of 2% to 3%. So we do see that flattening out, but if we can make some additional headway there, we'll build that in as we move through the year.

當然，我們成本趨勢中最大的一條線是 SW&B 線。正如我們所提到的，我們確實連續第三個季度降低了臨床補償費用，使其略高於 3%，儘管這與我們 2% 至 3% 的歷史趨勢不符。因此，我們確實看到這一趨勢趨於平穩，但如果我們能夠取得一些額外的進展，我們將在今年內將其納入其中。

Okay, that's great. Let me -- maybe just on the follow-up question. We heard a lot -- we're hearing a lot from the hospital operators about professional fees and seeing demand for more subsidies, more support. And it seems like it's gone from ER to anesthesiology and more recently, we've heard hospitals talk about radiology. I wonder, in your NICU management relationships, are you seeing any opportunities for improved economics? Any comment on what those discussions are like?

好的，太好了。讓我——也許只是關於後續問題。我們聽到了很多——我們從醫院經營者那裡聽到了很多關於專業費用的呼聲，並看到了對更多補貼、更多支持的需求。似乎它已經從急診室擴展到麻醉科，最近，我們聽到醫院談論放射科。我想知道，在您的 NICU 管理關係中，您是否看到了改善經濟狀況的機會？對這些討論有何評論？

We have strong and continuous conversations with our hospital partners, and that's always been a part of what we do. So we would expect going forward that's going to continue to be part of what we do, but we're not baking in any -- into our broadcast any increase, so we'll report as we go along.

我們與醫院合作夥伴保持著密切而持續的對話，這一直是我們工作的一部分。因此，我們預計這將繼續成為我們工作的一部分，但我們不會在廣播中加入任何內容的成長，因此我們會隨時報告。

Okay, all right thanks a lot.

好的，好的，非常感謝。

Jack Slevin, Jefferies.

傑克·斯萊文，傑富瑞。

Hey, thanks. Good morning. Congrats on the quarter, and thanks to Charlie and congrats stepping back into Mark, hopefully that covers the pleasantries. I just want to touch on guidance. And I think you gave a lot of color. It's really helpful. I guess just backing out the leap year putting in the $20 million from the restructuring, you get to [$40 million] level, right?

嘿，謝謝。早安.恭喜本季取得的成績，感謝查理，恭喜馬克回歸，希望這些話能涵蓋寒暄。我只是想談談指導。我認為你賦予了很多色彩。這真的很有幫助。我想，只要去掉閏年，投入重組所得的 2000 萬美元，就能達到 [4000 萬美元] 的水平，對嗎？

And so taking all the rest of the commentary, I get the expectation is that wage inflation is going to outstrip kind of core rate trends assuming payor mix is flat in the guy like you said. Is that the right way to think about it? And sort of to get to that $5 million to $25 million hit versus (technical difficulty) a $40 million sort of starting point when you adjust for those first two items, am I thinking about that the right way?

因此，綜合所有其他評論，我預期薪資通膨將超過核心利率趨勢，假設付款人組合像您所說的那樣保持穩定。這是正確的思考方式嗎？當您針對前兩項進行調整時，要達到 500 萬美元到 2500 萬美元的損失，而不是（技術難度）4000 萬美元的起點，我這樣想對嗎？

Well, I think that when we thought about the appropriate range, I think about the comments that Kasandra made and then I made earlier, there are enough headwinds in the provider space that just make us cautious and obviously throughout the economy, this is a time of real uncertainty. So that tempered our thinking.

嗯，我認為，當我們考慮適當的範圍時，我會想到卡桑德拉和我之前發表的評論，供應商領域存在足夠多的阻力，這讓我們保持謹慎，顯然在整個經濟中，這是一個真正不確定的時期。這讓我們的想法變得溫和。

And importantly it's mid-February, that's why I say we'll update you. So there certainly is an opportunity to do better. We just wanted to be careful in our guidance. It wasn't because of a negative trend or something specific like that. It was just being mindful of the environment that we're in and the uncertainty.

重要的是，現在是二月中旬，這就是我說我們會向您更新資訊的原因。因此肯定還有機會做得更好。我們只是想在指導時謹慎一點。這並不是因為消極趨勢或類似的特定因素。這只是要注意我們所處的環境和不確定性。

Okay, got it. That makes sense and appreciate that given, I guess you know how much all of us are checking Twitter on a daily basis for sort of nebulous headwinds. That's really (technical difficulty)

好的，明白了。這是有道理的，我很感激，我想你知道我們每天都在檢查 Twitter 以尋找各種模糊的逆風。這真的（技術難度）

Yeah. One follow-up here. Maybe taking a step back to something that's perhaps positive that's coming out of that same sphere of influence. There's talk now that's a little more positive on IVF.

是的。這裡有一個後續行動。也許退一步來看一些可能具有正面意義的、來自同一影響範圍的事物。現在人們對 IVF 的討論變得更加積極了。

I think it's something that's pretty clearly could be a large tailwind for you on a multiyear basis. Maybe if there color in terms of -- are you seeing any sort of benefit there? How should we think about that opportunity for you? Is this something you've looked at or something you're contemplating as you look at a few?

我認為從長遠來看，這顯然會為你帶來巨大的推動力。也許如果從顏色方面來說——你看到任何好處了嗎？我們該如何看待您的這個機會？這是您已經看過的東西，還是您在看一些時正在思考的東西？

What I'd say is that we agree that it is a possible tailwind for us. We have not calculated that yet, and it's not incorporated in our numbers, but we do think that is a potential strong tail.

我想說的是，我們都同意這對我們來說可能是一個順風。我們還沒有計算出這一點，而且它也沒有納入我們的數字中，但我們確實認為這是一個潛在的強尾。

Got it. Thank you.

知道了。謝謝。

Thank you and for the pleasantry.

謝謝您，也謝謝您愉快的交談。

Whit Mayo, Leerink Partners.

惠特·梅奧 (Whit Mayo)，Leerink Partners。

Hey, thanks, good morning. First, a two-part question. One, Kasandra, what do you think the earnings tailwind was in 2024 from the improving payor mix?

嘿，謝謝，早安。首先，這個問題分為兩個部分。首先，卡桑德拉，您認為 2024 年付款人組合改善將為盈利帶來什麼推動力？

And two, I don't think that mix development was incorporated within the initial plan that you developed last year. So I'm curious when you isolate that one factor, Mark, how do you think about the overall performance of the business and all the other areas? Thanks.

其次，我認為混合開發並未納入您去年制定的初步計劃中。所以我很好奇，馬克，當你孤立出這個因素時，你如何看待業務和所有其他領域的整體表現？謝謝。

Sure. So on the payor mix tailwind, I think if you kind of take Q4 and you look at the same unit growth of about 9%, with about 6% of that coming from pricing, payor mix is about a third of that. So it's a meaningful number for 2024.

當然。因此，在付款人組合順風方面，我認為，如果您以第四季度為例，您會發現相同的單位增長率約為 9%，其中約 6% 來自定價，而付款人組合約佔其中的三分之一。所以對 2024 年來說這是一個有意義的數字。

And Mark (multiple speakers)

還有馬克（多位發言者）

Because of structural changes getting in the way -- I was just saying, because of the structural changes in the way, payors -- there's been a migration toward exchanges, we don't see this necessarily as stopping or reversing. But -- so this very well could hold, but we can't positively see that.

由於結構性變化的阻礙——我剛才說了，由於付款方式的結構性變化——出現了向交易所的遷移，我們認為這不一定會停止或逆轉。但是——這很有可能成立，但我們還不能肯定地看到這一點。

Yeah. This is about the fifth quarter in a row that we did see some tailwind and payor mix. And like Mark said, if it is a permanent shift, we would expect that to level off. But like we mentioned in our prepared remarks, it going either way can of course move our numbers in either direction.

是的。這是我們連續第五個季度看到順風和付款人組合。正如馬克所說，如果這是一個永久性的轉變，我們預期它會趨於平穩。但正如我們在準備好的發言中提到的那樣，無論哪種情況，都會對我們的數字產生影響。

Do you know what percent of your commercial revenues are coming from patients on the exchanges now?

您知道現在您的商業收入中有多少百分比來自交易所的患者嗎？

Yeah. We don't have that number.

是的。我們沒有這個號碼。

Yeah, we usually can't see that with any specificity. So it's a primary reason why we can't truly validate that the exchange migration is the key driver. We don't disagree with it, but we just can't validate it through our data.

是的，我們通常無法具體地看到這一點。所以這也是我們無法真正驗證交易所遷移是否是關鍵驅動因素的主要原因。我們並不反對這一點，但我們只是無法透過數據來驗證這一點。

Right. Okay. And maybe just one last one. Mark, just you referenced in your prepared comments some things about the business that give you -- you see great opportunity, I think, was your quote. Just what are some of the areas where you have the most optimism as you think about 2025? Thanks.

正確的。好的。也許這只是最後一個。馬克，剛才你在準備好的評論中提到了有關業務的一些事情，這些事情給你帶來了巨大的機遇，我想，這是你所說的話。那麼，當您展望 2025 年時，您對哪些領域最為樂觀呢？謝謝。

I'd say (multiple speakers) follow that. Yeah, well, I think it's short and long answer, and we're on it right now. There are two areas that I think are really key to our future success.

我想說（多位發言者）遵循這一點。是的，嗯，我認為這是一個簡短而又長的答案，我們現在正在討論這個問題。我認為有兩個領域對於我們未來的成功至關重要。

One is really, really systematic work on our hospital relationships. I mean, it's old fashioned, called it grinding or blocking and tackling, but that's what we're going to be very focused on. Really going hospital system by hospital system to make sure we have the strongest relationships and that's both with ones where we enjoy our relationship now and also where there're perspective opportunity.

一是真正有系統地進行與醫院關係的工作。我的意思是，這已經過時了，稱之為磨削或阻擋和鏟球，但這正是我們將要重點關注的。真正逐一檢視各個醫院系統，以確保我們與各個醫院系統建立最牢固的關係，這不僅包括我們現在享受的關係，也包括有遠景機會的關係。

The second is in recruiting. We are nothing but our people. And I think with another benefit of being more streamlined is we can really focus on how we do the best job possible in attracting and retaining amazing clinicians.

第二是在招募方面。我們只不過是我們的人民。我認為精簡流程的另一個好處是，我們可以真正專注於如何盡可能吸引和留住優秀的臨床醫生。

We have for a long time had a happy home for people. We want to make sure that we really maximize what that can provide. So that might seem amorphous, but it is the core of what we do and we're going to be all over it, we already are.

我們長期以來一直擁有一個幸福的人民家園。我們希望確保真正最大限度地發揮其所能提供的作用。這可能看起來不太明確，但這是我們工作的核心，我們會全力以赴，我們已經這樣做了。

Okay, thanks.

好的，謝謝。

(Operator Instructions)

（操作員指示）

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Hi guys, you got Benjamin Shaver on for Pito. Congrats on the nice quarter. I actually got a couple of questions on, I guess I'll hit pricing first. So obviously very strong in the fourth quarter. I was just wondering sort of how much of that 5.9% came from improvements in hospital contract admin fees?

大家好，本傑明·謝弗 (Benjamin Shaver) 取代了 Pito。恭喜本季取得良好成績。我實際上有幾個問題，我想我會先討論價格。因此第四季的表現顯然非常強勁。我只是想知道這 5.9% 中有多少來自醫院合約管理費的提高？

And then second part of that question is, price was very strong in the second half of this year, and I was wondering if that sort of comps into the first half of 2025? Thanks.

然後問題的第二部分是，今年下半年的價格非常強勁，我想知道這種走勢是否會延續到 2025 年上半年？謝謝。

So on the contract revenue, hospital admin fees for the pricing component, it was probably just under a third there as well. And then on the payor mix as how that flows into 2025, we're really just looking at flat pricing overall between payor mix, managed care, contract admin fees, and then a little bit of a bump up in RCM collections.

因此，就合約收入、定價部分的醫院管理費而言，可能也只佔三分之一左右。然後，關於付款人組合如何流入 2025 年，我們實際上只是關注付款人組合、管理式醫療、合約管理費之間的整體固定定價，然後是 RCM 收款的略微增加。

Got you. That makes sense. And then I just wanted to hit the -- on exiting the primary and urgent care clinics. You mentioned that was going to be roughly a $30 million tailwind, like favorable EBITDA tailwind.

明白了。這很有道理。然後我只想說——離開初級和緊急護理診所。您提到這將帶來約 3000 萬美元的順風，就像有利的 EBITDA 順風一樣。

And I was wondering if you could break out the split of how much you guys recognized of that in 2024 and how much of that tailwind is going to be a tailwind for 2025?

我想知道你們是否可以細分一下你們在 2024 年對此的認識程度以及這種順風在多大程度上會成為 2025 年的順風？

Yeah. So really, we considered the primary and urgent care exit as part of the entire portfolio restructuring. So that's included in that $30 million lift in EBITDA, of which we realized about a third of that in '24, and the rest will come through in '25, but it wasn't a discrete event. It was really an entire portfolio restructuring.

是的。因此，我們實際上將初級和緊急護理退出視為整個投資組合重組的一部分。因此，這包括在 EBITDA 的 3000 萬美元增長中，其中約三分之一是在 24 年實現的，其餘部分將在 25 年實現，但這並不是一個獨立事件。這其實是一次整個投資組合的重組。

Yeah. And most of it was not related to primary and urgent care. It was really broad array of ambulatory practices. And importantly, the overhead that accompanies that.

是的。其中大部分與初級和緊急護理無關。這確實是廣泛的門診實踐。更重要的是，隨之而來的開銷。

Got you. That makes sense. That's super helpful. And then I just had a last question on sort of your capital allocation. You mentioned that you obviously finished the quarter with a lot of cash on the balance sheet, you guys are generating cash as well. You mentioned you had no real plans for M&A and you're going to mainly be using that cash just support and continue to invest in your business.

明白了。這很有道理。這非常有幫助。然後我最後問一個關於你的資本配置的問題。您提到，本季結束時，你們的資產負債表上顯然有大量現金，你們也在產生現金。您提到您沒有真正的併購計劃，而主要使用現金來支持並繼續投資您的業務。

I assume that most of the stuff that you mentioned happens every year, right? So I was just wondering if you guys have any clarity on maybe any leverage targets that you're looking at and sort of how you're thinking about returning cash to shareholders?

我認為您提到的大多數事情每年都會發生，對嗎？所以我只是想知道你們是否清楚你們正在考慮的任何槓桿目標以及如何考慮向股東返還現金？

Well, as I mentioned in my prepared remarks and we all know it, in a period like this with a lot of turbulence, we think having an incredibly strong balance sheet is very, very helpful. It provides us with opportunities in a lot of areas and that can include M&A. But it's early in the year and we'll watch how the year progresses, how the sector progresses. And then as Kasandra said, we'll work with our Board of Directors to decide what our best course is.

嗯，正如我在準備好的發言中提到的，我們都知道，在這樣一個動盪的時期，我們認為擁有一個非常強勁的資產負債表是非常非常有幫助的。它為我們提供了許多領域的機會，其中包括併購。但現在才剛開始，我們將繼續關註今年的進展以及該行業的發展。然後，正如卡桑德拉所說，我們將與董事會合作，決定最佳方案。

Certainly, if you think we should do something paying down debt further or something else to return money to shareholders, we'll look at what the best use of our of our money is. But this has been a sector that has not rewarded people for having high leverage and we anticipated that and we also learned from it. So we're very pleased to be where we are.

當然，如果您認為我們應該採取一些措施來進一步償還債務或以其他方式將錢退還給股東，我們將考慮如何最好地利用我們的資金。但這個行業並沒有因為人們擁有高槓桿而給予獎勵，我們預料到了這一點，也從中吸取了教訓。我們很高興能取得現在的成績。

Yeah, that makes a lot of sense. I think that's super helpful. That's all I have. Congrats again on the nice quarter.

是的，這很有道理。我認為這非常有幫助。這就是我所擁有的一切。再次恭喜本季取得良好成績。

There are no questions at this time. I would now like to turn the call back over to Mark Ordan for closing remarks.

目前沒有問題。現在我想將電話轉回給馬克·奧爾丹，請他做最後發言。

Thank you all for tuning in today and for your support and your good questions. And again, Charlie, we wish you all the best along with our thanks. Have a great day.

感謝大家今天的收聽以及你們的支持和提出的好問題。查理，我們再次向你表示感謝，並祝你一切順利。祝你有美好的一天。

This concludes this conference call you may now disconnect.

本次電話會議到此結束，您可以掛斷電話了。