ModivCare Inc (MODV) 2022 Q4 法說會逐字稿

Good morning and welcome to ModivCare's Fourth Quarter and Full Year 2022 Financial Results Conference Call. (Operator Instructions) Please note that this conference is being recorded. I will now turn the call over to Kevin Ellich, Head of Investor Relations. Thank you, please go ahead.

早上好，歡迎來到 ModivCare 的第四季度和 2022 年全年財務業績電話會議。 （操作員說明）請注意，正在錄製此會議。我現在將把電話轉給投資者關係主管 Kevin Ellich。謝謝，請繼續。

Good morning and thank you for joining ModivCare's fourth quarter and full year 2022 earnings conference call and webcast. Joining me today is Heath Sampson, ModivCare's President, Chief Executive Officer, and Chief Financial Officer; Ken Shepard, CFO of Mobility and Scott Kern, CFO of Home.

早上好，感謝您加入 ModivCare 的第四季度和 2022 年全年收益電話會議和網絡廣播。今天和我一起的是 ModivCare 總裁、首席執行官兼首席財務官 Heath Sampson； Mobility 首席財務官 Ken Shepard 和 Home 首席財務官 Scott Kern。

Before we get started, I want to remind everyone that during today's call, management will make forward-looking statements under the Private Securities Litigation Reform Act. These statements involve risks, uncertainties and other factors that may cause actual results or events to differ materially from expectations. Information regarding these factors is contained in today's press release and in the company's filings with the SEC. We will also discuss non-GAAP financial measures to provide additional information to investors. A definition of these non-GAAP financial measures and to the extent applicable a reconciliation to the most directly comparable GAAP financial measures is included in our press release and Form 8-K. A replay of this conference call will be available approximately 1 hour after today's call concludes and will be posted on our website, modivcare.com.

在我們開始之前，我想提醒大家，在今天的電話會議上，管理層將根據《私人證券訴訟改革法》做出前瞻性陳述。這些陳述涉及可能導致實際結果或事件與預期存在重大差異的風險、不確定性和其他因素。有關這些因素的信息包含在今天的新聞稿和公司提交給美國證券交易委員會的文件中。我們還將討論非 GAAP 財務措施，以向投資者提供更多信息。我們的新聞稿和 8-K 表中包含這些非 GAAP 財務指標的定義以及在適用範圍內與最直接可比的 GAAP 財務指標的對賬。本次電話會議的重播將在今天的電話會議結束後約 1 小時提供，並將發佈在我們的網站 modivcare.com 上。

This morning, Heath Sampson will begin with opening remarks. Then he will provide an update on our business strategy and review highlights of fourth quarter and full year 2022 results. Ken Shepard will review our financial results and outlook for 2023. Then we will open the call for questions.

今天早上，希思·桑普森 (Heath Sampson) 將首先致開幕詞。然後，他將提供我們業務戰略的最新情況，並回顧第四季度和 2022 年全年業績的亮點。 Ken Shepard 將回顧我們 2023 年的財務業績和展望。然後我們將公開提問。

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

有了這個，我會把電話轉給希思。

Hello everyone and a warm welcome to our fourth quarter and full year 2022 earnings call. Today we reported strong full year 2022 results with revenue and adjusted EBITDA exceeding the high end of our guidance ranges. These results were driven by solid growth in our mobility business and a double digit growth from our Home division, which includes personal care services and remote patient monitoring.

大家好，熱烈歡迎參加我們的第四季度和 2022 年全年財報電話會議。今天，我們公佈了強勁的 2022 年全年業績，收入和調整後的 EBITDA 超過了我們指導範圍的高端。這些結果是由我們的移動業務的穩健增長和我們的家庭部門的兩位數增長推動的，其中包括個人護理服務和遠程患者監控。

I want to take a moment to acknowledge and express my appreciation for the hard work and dedication of the entire team at ModivCare. It's because of them that we are able to provide high quality care and the best experience for approximately 35 million members. We ended the year with solid momentum heading into 2023. To this point, we issued 2023 revenue guidance of $2.575 to $2.6 billion and adjusted EBITDA guidance of $225 to $235 million, indicating our confidence in continued growth.

我想花點時間感謝 ModivCare 整個團隊的辛勤工作和奉獻精神，並對此表示感謝。正是因為他們，我們才能夠為大約 3500 萬會員提供高質量的護理和最佳體驗。我們以穩健的勢頭結束了這一年，進入了 2023 年。至此，我們發布了 25.75 美元至 26 億美元的 2023 年收入指引，並將 EBITDA 指引調整為 225 美元至 2.35 億美元，表明我們對持續增長充滿信心。

In the past two quarters we have taken significant steps to realign and reallocate resources to drive efficiencies and operating leverage. Our One ModivCare strategy, which is defined as alignment across all of our supportive care services will help us share best practices, drive scale and efficiencies and standardize processes to ensure the best experience for our members and customer's within each point solution and more holistically across all our solutions.

在過去的兩個季度中，我們採取了重大步驟來重新調整和重新分配資源，以提高效率和運營槓桿。我們的 One ModivCare 戰略被定義為我們所有支持性護理服務的一致性，這將幫助我們分享最佳實踐、推動規模和效率以及標準化流程，以確保我們的會員和客戶在每個點解決方案中以及更全面地跨所有方面獲得最佳體驗我們的解決方案。

Our goal for 2023 is twofold, build for scale and grow our business. To build for scale. We will strive for operational excellence, integrate as One ModivCare and use technology to enable our solutions. To grow we will sell our point solutions more effectively, leverage our relationships to cross sell and continue to deliberately develop and grow our value based care solutions. Our approach to value based care is about driving performance based payments into each of our points solutions and eventually moving into more shared risk arrangements across our entire platform.

我們 2023 年的目標是雙重的，擴大規模並發展我們的業務。建立規模。我們將努力實現卓越運營，整合為 One ModivCare，並使用技術來實現我們的解決方案。為了發展，我們將更有效地銷售我們的單點解決方案，利用我們的關係進行交叉銷售，並繼續有意識地開發和發展我們基於價值的護理解決方案。我們基於價值的護理方法是將基於績效的支付驅動到我們的每個積分解決方案中，並最終在我們的整個平台上進行更多的風險共擔安排。

I'd like to discuss some exciting advancements from our innovation efforts. Our remote patient monitoring solutions like E3 are the tip of our spear for value based care and we are seeing increased activity from payers who want to sign up new arrangements with us. We recently began an innovative value based care program for E3 with a leading national managed care organization. This program is essentially the next evolution of E3 as it utilizes greater data sharing and partnership with the health plan for gap closures and assessments, allowing us to have a more meaningful impact on improving health outcomes and using our supportive care services.

我想討論一下我們在創新工作中取得的一些激動人心的進步。我們的遠程患者監控解決方案（如 E3）是我們基於價值的護理的矛尖，我們看到希望與我們簽訂新安排的付款人的活動越來越多。我們最近與一家領先的全國管理式醫療機構合作，為 E3 啟動了一項基於價值的創新醫療計劃。該計劃本質上是 E3 的下一個演變，因為它利用更大的數據共享和與健康計劃的伙伴關係來縮小差距和評估，使我們能夠對改善健康結果和使用我們的支持性護理服務產生更有意義的影響。

We are in discussions with several other national payers for similar programs and we continue to look for ways to build off our innovative programs and point solutions shifting from standard benefits to Medicare Advantage supplemental benefits. We are confident about adding more value based care arrangements to our portfolio and using valuable member data, insight and analytics to drive meaningful long term value for all of our stakeholders.

我們正在與其他幾個國家付款人就類似計劃進行討論，我們將繼續尋找方法來建立我們的創新計劃和點解決方案，從標準福利轉變為 Medicare Advantage 補充福利。我們有信心在我們的產品組合中增加更多基於價值的護理安排，並使用有價值的會員數據、洞察力和分析來為我們所有的利益相關者帶來有意義的長期價值。

Our new sales organization has made very good progress and we have a lot of exciting plans for the year to accelerate our growth. Although most of the sales success will increase revenue in 2024 and beyond. Our sales pipeline has increased by over 1/3 and we are close to signing contracts with new customers that we historically did not pursue.

我們新的銷售組織取得了很好的進展，我們今年有很多令人興奮的計劃來加速我們的增長。儘管大部分銷售成功將在 2024 年及以後增加收入。我們的銷售渠道增加了 1/3 以上，我們即將與新客戶簽訂我們過去沒有追求的合同。

Before I dive into our segment highlights for the quarter, I wanted to update you on some of the changes we made to our leadership team. We've hired some great people, including an SVP of Strategic Execution, Matt Snyder, and an SVP of Innovation and Growth, Seth Ravine and we have even more exciting announcements soon to come. But as you can imagine it takes time to find the right people for the job. As we have adjusted our operating model and priorities that had been necessary to make some personnel changes. I want to thank those who are leaving us for their hard work. But I'm confident that we're putting together the best team to take ModivCare to the next level.

在我深入探討本季度的細分市場亮點之前，我想向您介紹我們對領導團隊所做的一些改變。我們聘請了一些優秀的人才，包括戰略執行高級副總裁 Matt Snyder 和創新與增長高級副總裁 Seth Ravine，我們即將發布更多令人興奮的公告。但正如您所想像的那樣，找到合適的人選需要時間。由於我們調整了我們的運營模式和優先事項，因此有必要進行一些人事變動。我要感謝那些離開我們的人，感謝他們的辛勤工作。但我相信我們正在組建最好的團隊，將 ModivCare 提升到一個新的水平。

Moving on to our Mobility or NEMT segment. I'm pleased to report that we experienced a 14% year over year increase in NEMT revenue during the fourth quarter. This growth was driven by increased trip growth as membership grew to approximately 35 million members, which is consistent with our commentary from the third quarter earnings call. Our focus on discipline execution and team alignment is working. For example, our fourth quarter on time performance was at its highest level in two years. We also exceeded service level expectations in our contact centers and reduce missed trips by about a third. We continue to transform our Mobility operating model through three main initiatives, provide a partnership, multimodal network and omnichannel member engagement.

繼續我們的移動或 NEMT 部分。我很高興地報告，我們在第四季度的 NEMT 收入同比增長了 14%。隨著會員人數增加到約 3500 萬，這一增長是由旅行增長推動的，這與我們在第三季度財報電話會議上的評論一致。我們對紀律執行和團隊協調的關注正在發揮作用。例如，我們第四季度的準點率達到了兩年來的最高水平。我們還超出了聯絡中心的服務水平預期，將錯過的行程減少了大約三分之一。我們繼續通過三個主要舉措轉變我們的移動運營模式，提供合作夥伴關係、多模式網絡和全渠道成員參與。

Our provide a partnership initiative involved narrowing our transportation network in creating win-win relationships with only the best providers. Our multimodal network initiative, medically tailored the member's ride via the traditional sedan, rideshare, public transit or a family member. And our omnichannel member engagement initiative, meets the members where they are by providing telephonic, IVA, IVR, texting, chat, web portal or app engagement. Today, our primary engagement channel is telephonic as such, we have a lot of opportunity ahead of us. All three of these initiatives will further improve the member experience while also driving down operating and trip costs.

我們提供一項合作計劃，涉及縮小我們的運輸網絡，只與最好的供應商建立雙贏關係。我們的多式聯運網絡計劃通過傳統轎車、拼車、公共交通或家庭成員為會員量身定制了醫療行程。我們的全渠道會員參與計劃通過提供電話、IVA、IVR、短信、聊天、門戶網站或應用程序參與與會員會面。今天，我們的主要參與渠道是電話，我們面前有很多機會。所有這三項舉措都將進一步改善會員體驗，同時降低運營和旅行成本。

We had significant improvement in our operating performance in the fourth quarter, and we expect the initiatives we have implemented to have meaningful impact throughout 2023 on both our member experience and cost structure. Regarding redetermination, we acknowledge that Medicaid members can be reviewed by states starting April 1. However, states are obligated to fulfill various reporting and outreach obligations, which could cause delays in the process, especially in the states where we have significant presence. We expect the impact of this process in 2023 to be insignificant. And we have outlined strategies such as contract repricing, business wins and operational enhancements as discussed earlier. And at our Investor Day in June, which we believe will enable us to overcome any long term impacts.

我們在第四季度的經營業績有了顯著改善，我們預計我們實施的舉措將在整個 2023 年對我們的會員體驗和成本結構產生有意義的影響。關於重新確定，我們承認各州可以從 4 月 1 日開始對 Medicaid 成員進行審查。但是，各州有義務履行各種報告和外展義務，這可能會導致流程延遲，尤其是在我們有大量業務的州。我們預計這一過程在 2023 年的影響微乎其微。如前所述，我們概述了合同重新定價、業務成功和運營改進等戰略。在 6 月的投資者日，我們相信這將使我們能夠克服任何長期影響。

Moving on to the Home division, which is comprised of our personal care and remote patient monitoring segments. In the fourth quarter, our personal care revenue grew 12% year over year, as we continue to see strong improvement in caregiver hiring trends. We recently implemented a caregiver satisfaction score across our organization, similar to a net promoter score. We improved our caregiver satisfaction by over 50 points in 2022 to the great level by capturing feedback through our caregiver advisory council, and by providing additional benefits such as 401(k), health benefit and an employee assistance program.

轉到家庭部門，該部門由我們的個人護理和遠程患者監控部門組成。在第四季度，我們的個人護理收入同比增長 12%，因為我們繼續看到護理人員招聘趨勢的強勁改善。我們最近在整個組織實施了護理人員滿意度評分，類似於淨推薦評分。通過我們的護理人員諮詢委員會收集反饋，並提供額外的福利，例如 401(k)、健康福利和員工援助計劃，我們在 2022 年將我們的護理人員滿意度提高了 50 多分，達到了很高的水平。

While we improved our score last year, we know that we can even do better and we aim to achieve the excellent mark in 2023. All these investments in our team members experience has helped us maintain an industry leading retention rate of 65%. Our main goal is to achieve growth in the personal care sector. To achieve this, we are continuing the heavy lift to standardize and centralize non-caregiver functions in certain operational processes. By doing this, we aim to create a more efficient and scalable platform for growth.

雖然我們去年提高了分數，但我們知道我們可以做得更好，我們的目標是在 2023 年取得優異成績。所有這些對團隊成員體驗的投資幫助我們保持了 65% 的行業領先保留率。我們的主要目標是實現個人護理行業的增長。為實現這一目標，我們正在繼續努力，以標準化和集中某些運營流程中的非護理人員職能。通過這樣做，我們的目標是創建一個更高效和可擴展的增長平台。

Our strategy also involves focusing our efforts on developing standard tools and techniques that can be deployed locally to accelerate caregiver recruitment and retention. In addition, we plan to expand our personal care locations through de novo openings and position ourselves to easily integrate any future acquisitions. We expect the reimbursement environment to remain favorable for personal care services and we plan to add more value based care arrangements similar to our current value based care arrangements in Pennsylvania focused on gap closure. We have also added new arrangements focused on changes condition escalation, as well as Electronic Visit Verification or EVV.

我們的戰略還包括集中精力開發可在當地部署的標準工具和技術，以加速護理人員的招募和保留。此外，我們計劃通過重新開業來擴大我們的個人護理地點，並將自己定位為輕鬆整合未來的任何收購。我們預計報銷環境將繼續有利於個人護理服務，我們計劃增加更多基於價值的護理安排，類似於我們目前在賓夕法尼亞州的基於價值的護理安排，重點是縮小差距。我們還添加了新的安排，重點關注變更條件升級，以及電子訪問驗證或 EVV。

Moving to our remote patient monitoring segment, which is a particularly innovative and important part of our business. We saw strong growth during the fourth quarter with monitoring revenue increasing 18% year-over-year and adjusted EBITDA margin of 35.8%. We saw 36% year over year increase in total active clients in the fourth quarter which includes the contribution from the integrated Guardian Medical Monitoring acquisition. Our monitoring team performed exceptionally well last quarter with a couple of new state Medicaid wins and our strong pipeline for additional business that we can execute on this year.

轉到我們的遠程患者監控部分，這是我們業務中特別創新和重要的部分。我們在第四季度實現了強勁增長，監測收入同比增長 18%，調整後的 EBITDA 利潤率為 35.8%。我們看到第四季度活躍客戶總數同比增長 36%，其中包括收購 Guardian Medical Monitoring 的貢獻。我們的監控團隊在上個季度表現非常出色，贏得了幾個新的州醫療補助計劃，並且我們為今年可以執行的其他業務提供了強大的渠道。

Our net promoter score also remained at an industry leading 88. As we move into 2023 our priorities are to accelerate Medicaid and Medicare Advantage sales and continue to innovate our monitoring offerings and value based care capabilities. We expect growth in line with our long term target of mid-teens revenue growth, and a mid-30% adjusted EBITDA margin. Before I turn the call over to Ken Shepard, our CFO of Mobility to review the fourth quarter and full year 2022 financial results, I want to remind everyone that the biggest fundamental challenges facing the US healthcare systems today are its elevated cost, the inequities and access to care for the most vulnerable patients and too little focus on care prevention by addressing the social determinants of health. We are uniquely positioned to address these challenges. Our supportive care solutions provide the highest quality, best in class member experience in the most cost effective manner for our customers in the healthcare system as a whole. Ken, please walk us through our financial results.

我們的淨推薦值也保持在行業領先的 88 分。進入 2023 年，我們的首要任務是加快 Medicaid 和 Medicare Advantage 的銷售，並繼續創新我們的監測產品和基於價值的護理能力。我們預計增長符合我們中期收入增長的長期目標，以及 30% 的調整後 EBITDA 利潤率。在我將電話轉給我們的移動首席財務官 Ken Shepard 審查第四季度和 2022 年全年財務業績之前，我想提醒大家，當今美國醫療保健系統面臨的最大基本挑戰是成本上升、不公平和為最弱勢的患者提供護理，並且很少關注通過解決健康的社會決定因素來預防護理。我們具有獨特的優勢來應對這些挑戰。我們的支持性護理解決方案以最具成本效益的方式為整個醫療保健系統的客戶提供最高質量、一流的會員體驗。肯，請向我們介紹我們的財務結果。

Thanks Heath, and good morning, everyone. We had a strong year in 2022 with consolidated revenue of $2.5 billion up 25% year-over-year driven by double digit growth across each of our segments. Net loss from continuing operations and 2022 was approximately $32 million or $2.26 per share. Adjusted net income for the year was approximately $103 million or $7.32 per diluted share and adjusted EBITDA was approximately $222 million or 8.9% of revenue.

謝謝希思，大家早上好。我們在 2022 年表現強勁，綜合收入達到 25 億美元，同比增長 25%，這得益於我們每個部門的兩位數增長。持續經營和 2022 年的淨虧損約為 3200 萬美元或每股 2.26 美元。調整後的年度淨收入約為 1.03 億美元或每股攤薄收益 7.32 美元，調整後的 EBITDA 約為 2.22 億美元或收入的 8.9%。

For the fourth quarter revenue increased 14% year over year to $654 million. Net loss from continuing operations was $7 million or $0.49 cents per share. Adjusted net income for the fourth quarter of 2022 was approximately $30 million or $2.11 per diluted share. Fourth quarter adjusted EBITDA was approximately $60 million or 9.1% of revenue. Fourth quarter adjusted EBITDA included approximately $7 million of onetime benefit about half of which was related to our year end accrual adjustments, and the other half related to a onetime revenue recapture in our NEMT contracts. Excluding this benefit adjusted EBITDA for the full year would have been near the midpoint of our guidance range which we think is a good baseline when thinking about growth in 2023.

第四季度收入同比增長 14% 至 6.54 億美元。持續經營淨虧損為 700 萬美元或每股 0.49 美分。 2022 年第四季度的調整後淨收入約為 3000 萬美元或每股攤薄收益 2.11 美元。第四季度調整後的 EBITDA 約為 6000 萬美元，佔收入的 9.1%。第四季度調整後的 EBITDA 包括大約 700 萬美元的一次性收益，其中大約一半與我們的年終應計調整有關，另一半與我們 NEMT 合同中的一次性收入收回有關。如果不計入這一調整後的全年 EBITDA，則接近我們指導範圍的中點，我們認為這是考慮 2023 年增長時的一個很好的基線。

Transitioning to the financial results of our segments starting with Mobility or NEMT, fourth quarter 2022 revenue increased 14% year-over-year to $459 million, driven by a 16% increase in average monthly members. For the full year NEMT revenue increased 19% year over year to $1.77 billion driven by a 14% increase in average monthly members and a 4% increase in revenue per member per month. Service expense for the NEMT segment, which includes all direct costs increased approximately 22% year over year in the fourth quarter of 2022 to $387 million.

從 Mobility 或 NEMT 開始過渡到我們細分市場的財務業績，2022 年第四季度的收入同比增長 14% 至 4.59 億美元，這主要得益於平均每月會員增長 16%。 NEMT 全年收入同比增長 19% 至 17.7 億美元，這得益於平均每月會員增長 14% 和每個會員每月收入增長 4%。 NEMT 部門的服務費用（包括所有直接費用）在 2022 年第四季度同比增長約 22% 至 3.87 億美元。

The increase was driven by higher service expense costs associated with higher trip volume related to increased monthly membership and a 13% increase in transportation cost per trip due to the general inflationary environment. On a sequential basis, purchase services per trip were flat at $42 per trip. utilization, which is defined as monthly paid member -- paid trips per member was quarter-over-quarter at 7.5%. That said, we expect utilization to gradually increase throughout 2023. NEMT net income was $17 million in the fourth quarter of 2022 and approximately $79 million for the full year. NEMT adjusted EBITDA was approximately $46 million in the fourth quarter of 2022 or 10.1% of NEMT revenue. Full year NEMT adjusted EBITDA was approximately $169 million or 9.6% of any NEMT revenue.

增加的原因是與每月會員增加相關的旅行量增加相關的服務費用成本增加，以及由於普遍的通貨膨脹環境，每次旅行的運輸成本增加了 13%。按順序計算，每次旅行的購買服務持平於每次旅行 42 美元。利用率，定義為每月付費會員——每個會員的付費旅行環比為 7.5%。也就是說，我們預計整個 2023 年的利用率將逐漸增加。2022 年第四季度 NEMT 淨收入為 1700 萬美元，全年約為 7900 萬美元。 2022 年第四季度，NEMT 調整後的 EBITDA 約為 4600 萬美元，佔 NEMT 收入的 10.1%。全年經 NEMT 調整後的 EBITDA 約為 1.69 億美元，佔任何 NEMT 收入的 9.6%。

NEMT margins for the fourth quarter and full year were lower primarily due to higher transportation costs. partially offset by G&A cost leverage. While we experienced higher transportation costs throughout the first three quarters of 2022 we expect cost per trip to stabilize and gradually improve in 2023.

第四季度和全年的 NEMT 利潤率較低主要是由於運輸成本較高。部分被 G&A 成本槓桿所抵消。雖然我們在 2022 年前三個季度經歷了更高的運輸成本，但我們預計每次旅行的成本將在 2023 年穩定並逐漸改善。

Turning to our Personal Care segment, revenue in the fourth quarter of 2022 was $176 million, which was a 12% increase year over year. We saw increases in caregiver hiring throughout the quarter. However, we typically see a seasonal slowdown in hours in December around the holidays. This resulted in fourth quarter hours remaining flat sequentially at $6.8 million, which was still an improvement from typical Q4 seasonality as we typically see hours decline in the low single-digit range from Q3 to Q4.

談到我們的個人護理部門，2022 年第四季度的收入為 1.76 億美元，同比增長 12%。我們看到整個季度的看護人招聘有所增加。但是，我們通常會在 12 月假期前後看到季節性的小時數放緩。這導致第四季度的小時數環比持平，為 680 萬美元，這仍然比典型的第四季度季節性有所改善，因為我們通常會看到從第三季度到第四季度的小時數下降幅度處於較低的個位數範圍內。

Full year 2022 Personal Care revenue increased 35% year-over-year to approximately $668 million, driven by the full year contribution from our CareFinders acquisition, which annualized in September as well as improvements in recruiting, retention and a 6% revenue per hour increase during the year. Personal Care service expense per hour, primarily representing caregiver wage expense increased approximately 6% sequentially from the third quarter of 2022 due to increased wage expenses, particularly in New York, where there was an increase in caregiver minimum wages and a corresponding reimbursement rate increase during the fourth quarter.

2022 年全年個人護理收入同比增長 35% 至約 6.68 億美元，這得益於我們收購 CareFinders 的全年貢獻（該收購於 9 月進行了年度化）以及招聘和保留方面的改善以及每小時收入增長 6%年內。每小時的個人護理服務費用，主要代表看護人的工資支出，自 2022 年第三季度以來環比增長約 6%，原因是工資支出增加，特別是在紐約，那裡的看護人最低工資有所增加，相應的報銷率也有所增加第四季。

Going forward, we expect caregiver wage inflation to continue to be offset by reimbursement rate increases. Personal Care segment net income was $2.3 million, while segment adjusted EBITDA was $16.6 million in the fourth quarter of 2022 or 9.4% of revenue. For the full year, Personal Care adjusted EBITDA increased 67% year-over-year to approximately $70 million, which was 10.5% of Personal Care revenue. While we were able to drive some G&A leverage during the fourth quarter, higher service expense led to a 160 basis point sequential decrease in adjusted EBITDA margin.

展望未來，我們預計看護人的工資上漲將繼續被報銷率的上漲所抵消。個人護理部門淨收入為 230 萬美元，而 2022 年第四季度的部門調整後 EBITDA 為 1660 萬美元，佔收入的 9.4%。全年，個人護理調整後的 EBITDA 同比增長 67% 至約 7000 萬美元，佔個人護理收入的 10.5%。雖然我們能夠在第四季度推動一些 G&A 槓桿，但更高的服務費用導致調整後的 EBITDA 利潤率連續下降 160 個基點。

Moving on to our Remote Patient Monitoring. Revenue in the fourth quarter of 2022 increased 18% year-over-year to approximately $19 million, which included approximately $4.6 million of contribution from our Guardian Medical Monitoring acquisition. For the full year, Remote Patient Monitoring revenue was $68 million, which included approximately $12 million of contribution from Guardian.

繼續我們的遠程患者監控。 2022 年第四季度的收入同比增長 18% 至約 1,900 萬美元，其中包括約 460 萬美元來自我們收購 Guardian Medical Monitoring 的貢獻。全年，遠程患者監控收入為 6800 萬美元，其中包括 Guardian 貢獻的約 1200 萬美元。

On a sequential basis, average monthly members increased approximately 3%, driven by consistent growth in referrals across the legacy and recently acquired RPM business. RPM segment net income was $0.7 million in the fourth quarter, while adjusted EBITDA was approximately $6.8 million and adjusted EBITDA margins improved 50 basis points sequentially to 35.8%. We remain confident in our long-term targets for RPM revenue growth in the mid-teens and margins in the mid-30% range.

在連續的基礎上，平均每月會員增加約 3%，這得益於傳統和最近收購的 RPM 業務的推薦持續增長。第四季度 RPM 部門淨收入為 70 萬美元，而調整後的 EBITDA 約為 680 萬美元，調整後的 EBITDA 利潤率環比提高 50 個基點至 35.8%。我們對我們的長期目標充滿信心，即 RPM 收入增長在十幾歲左右，利潤率在 30% 左右。

Turning to our cash flow and balance sheet. Consolidated cash flow from operations in the fourth quarter of 2022 was the use of $56 million due to payments on contract payables, partially offset by solid cash flow from our core operations. During the fourth quarter, we reduced our contract payables balance, net of our contract receivables by $61 million to a net balance of $123 million. For all of 2022, we reduced our net contract payables by $134 million, which primarily relates to overpayments and liability reserves on certain NEMT contracts.

轉向我們的現金流量和資產負債表。 2022 年第四季度來自運營的綜合現金流是由於支付合同應付款項而使用的 5600 萬美元，部分被我們核心業務的穩健現金流所抵消。在第四季度，我們減少了我們的合同應付餘額，扣除我們的合同應收賬款 6100 萬美元，達到 1.23 億美元的淨餘額。在 2022 年全年，我們將合同應付淨額減少了 1.34 億美元，這主要與某些 NEMT 合同的超額付款和責任準備金有關。

Excluding the combined negative impact of $61 million from these items during the fourth quarter, cash flow from our core business remains solid. As a reminder, we expect a more normalized level of activity for these contracts payable moving forward and, therefore, a more normalized environment for our free cash flow in 2023. We ended the fourth quarter of 2022 with approximately $14.5 million in cash and had no amounts drawn on our $325 million revolving credit facility. Our principal debt balance was sequentially flat at $1 billion, and our consolidated pro forma net leverage was 4.3x as of December 31, 2022.

排除第四季度這些項目帶來的 6100 萬美元的綜合負面影響，我們核心業務的現金流仍然穩健。提醒一下，我們預計這些應付合同的活動水平將在未來更加正常化，因此我們的自由現金流在 2023 年的環境更加正常化。我們在 2022 年第四季度結束時擁有大約 1,450 萬美元的現金，並且沒有從我們 3.25 億美元的循環信貸額度中提取的金額。我們的本金債務餘額環比持平於 10 億美元，截至 2022 年 12 月 31 日，我們的綜合備考淨槓桿率為 4.3 倍。

We remain committed to delevering over time, and our target net leverage ratio of 3x remains unchanged. In 2023, we expect net leverage will be gradually reduced to the high 3x range through debt reduction and EBITDA growth. As a reminder, 100% of our current debt structure is at fixed rates. Our capital allocation strategy remains unchanged as we are committed to a disciplined and balanced approach towards capital deployment with the primary focus on delevering our balance sheet. This morning, we provide 2023 guidance that included revenue in a range of $2.575 billion to $2.6 billion and adjusted EBITDA of $225 million to $235 million.

我們仍然致力於隨著時間的推移去槓桿化，我們的 3 倍目標淨槓桿率保持不變。到 2023 年，我們預計通過債務減少和 EBITDA 增長，淨槓桿率將逐漸降至 3 倍的高位。提醒一下，我們目前 100% 的債務結構都是固定利率的。我們的資本配置策略保持不變，因為我們致力於以一種有紀律和平衡的方式進行資本配置，主要側重於去槓桿化我們的資產負債表。今天早上，我們提供了 2023 年的指導，其中包括 25.75 億美元至 26 億美元的收入和 2.25 億美元至 2.35 億美元的調整後 EBITDA。

Here are some of the puts and takes to consider as you think about the year ahead. Within our Home division, which includes Personal Care and Remote Patient Monitoring, we expect revenue and adjusted EBITDA to increase double digits on a combined basis in 2023. For Personal Care, we expect high single-digit to low double-digit revenue growth, driven by continued improvement in the caregiver hiring, leading to growth in hours, along with reimbursement rate increases. For Remote Patient Monitoring, we expect revenue growth in the mid- to high teens, driven by new client growth. We also expect to see increased utilization of our suite of monitoring services led by our E3 engagement solution.

以下是您在考慮來年時要考慮的一些看跌期權和期權。在我們的家庭部門（包括個人護理和遠程患者監控）中，我們預計 2023 年收入和調整後的 EBITDA 將綜合增長兩位數。對於個人護理，我們預計收入將實現高個位數到低兩位數的增長，推動通過持續改進看護人的招聘，導致工作時間增加，以及報銷率增加。對於遠程患者監控，我們預計在新客戶增長的推動下，中高端收入將增長。我們還希望看到以我們的 E3 參與解決方案為主導的我們的監控服務套件的利用率有所提高。

In our Mobility segment, we expect revenue and adjusted EBITDA could approximately be flat in 2023. While we have had several new NEMT wins in 2022, the timing of our larger opportunities has been pushed out to the extent that we don't expect a meaningful impact in 2023. Our contract pipeline is as strong as ever, and we are confident that we will continue to win our fair share of competitive contracts going forward. We also believe that the impact from redetermination in the second half of the year and normal attrition could be a headwind, which could offset potential wins, contract expansions and repricings that are expected in 2023.

在我們的移動部門，我們預計收入和調整後的 EBITDA 到 2023 年可能會大致持平。雖然我們在 2022 年獲得了幾項新的 NEMT 勝利，但我們更大機會的時間已經推遲到我們預計不會有意義的程度2023 年的影響。我們的合同管道一如既往地強大，我們有信心在未來繼續贏得競爭性合同的公平份額。我們還認為，下半年重新確定和正常減員的影響可能是不利因素，這可能抵消 2023 年預期的潛在勝利、合同擴展和重新定價。

As we suggested last quarter, we expect our full year 2023 adjusted EBITDA to be more back half weighted due to our ongoing operating initiatives, investments we are making during the first half of the year as well as normal seasonality impact on profitability. We expect these initiatives to drive lower cost and improved margins in the second half of the year. Overall, we think current consensus estimates capture the quarterly cadence fairly well for 2023. Again, we also expect to generate solid free cash flow in 2023 and remain committed to delevering and expect to achieve our net leverage target of 3x over time.

正如我們上個季度所建議的那樣，由於我們正在進行的運營計劃、我們在今年上半年進行的投資以及正常的季節性對盈利能力的影響，我們預計 2023 年全年調整後的 EBITDA 的權重將增加一半。我們預計這些舉措將在今年下半年推動成本降低和利潤率提高。總體而言，我們認為當前的共識估計很好地捕捉了 2023 年的季度節奏。同樣，我們還預計 2023 年將產生穩定的自由現金流，並繼續致力於去槓桿化，並預計隨著時間的推移實現我們 3 倍的淨槓桿率目標。

Lastly, we remain confident in our long-term targets for $3 billion of revenue and $300 million of adjusted EBITDA in 2025. To wrap things up, we are pleased with our strong fourth quarter and full year 2022 financial results. We are confident that 2023 will build upon the progress that we have made in 2022, and we look forward to reporting meaningful progress on our operational and strategic initiatives over the next several quarters. I would also like to take this opportunity to thank the entire team at ModivCare for the hard work and dedication throughout the year to generate these results while providing high-quality care, improving health outcomes for our members. This concludes our prepared remarks.

最後，我們對 2025 年 30 億美元的收入和 3 億美元的調整後 EBITDA 的長期目標仍然充滿信心。總而言之，我們對我們強勁的第四季度和 2022 年全年財務業績感到滿意。我們相信 2023 年將在我們 2022 年取得的進展的基礎上再接再厲，我們期待在未來幾個季度報告我們的運營和戰略計劃取得有意義的進展。我還想藉此機會感謝 ModivCare 的整個團隊一年來的辛勤工作和奉獻精神，以取得這些成果，同時提供高質量的護理，改善我們會員的健康結果。我們準備好的發言到此結束。

Operator, please open the call for questions.

接線員，請打開電話提問。

The floor is now open for questions. (Operator Instructions) The first question today is coming from Brian Tanquilut of Jefferies.

現在可以提問了。 （操作員說明）今天的第一個問題來自 Jefferies 的 Brian Tanquilut。

Congrats on a solid quarter. As I think about cash flow, obviously, you -- there was cash burn in Q4 that was expected. But how should we be thinking about cash generation going forward and the rebates? Is that an issue that's behind us at this point?

祝賀一個穩定的季度。當我考慮現金流時，很明顯，你 - 預計第四季度會出現現金消耗。但是我們應該如何考慮未來的現金產生和回扣？在這一點上，這是我們背後的問題嗎？

Yes. Yes. So just -- so consistent with what we've been saying for the last 4 quarters, 2022 involves us paying off the cash that we accumulated on our balance sheet through COVID in 2020 and 2021 and the bulk of accumulation -- or a disproportional amount of that accumulation was all paid off in 2022. So the COVID payoff was finished in 2022. And that was the main driver, as you can see in our $50 million decrease quarter-over-quarter that we paid above and beyond our kind of normal working capital fluctuations.

是的。是的。所以——與我們過去 4 個季度所說的一致，2022 年涉及我們還清我們在 2020 年和 2021 年通過 COVID 在資產負債表上積累的現金以及大部分積累——或者不成比例的數額的積累在 2022 年全部付清。因此 COVID 的回報在 2022 年完成。這是主要的驅動因素，正如您在我們支付的季度環比減少 5000 萬美元中看到的那樣，我們支付的費用超出了我們的正常水平營運資金波動。

Another item that just to note for everybody, when we pay our debt as well, we pay semiannually. So that also happened in this quarter. So those 2 reasons are the main reasons of why we are for cash. And then again, for your question going forward, now we're at normal levels of working capital, and we expect to be generating free cash flow each quarter going forward.

另一點要提醒大家，當我們還債時，我們每半年還一次。所以這也發生在這個季度。所以這兩個原因是我們要現金的主要原因。再一次，對於你未來的問題，現在我們的營運資金處於正常水平，我們預計未來每個季度都會產生自由現金流。

Awesome. And then Heath, as I think about the NEMT business, obviously, it was pretty strong in Q4. I know in the past, you've talked about redeterminations being a headwind for this year and you've even quantified that. But how should we be thinking about margins for NEMT over the course of the year and also as we normalize post redeterminations?

驚人的。然後希思，當我想到 NEMT 業務時，顯然，它在第四季度非常強勁。我知道在過去，你曾談到重新確定是今年的逆風，你甚至已經量化了這一點。但是，我們應該如何考慮 NEMT 在這一年中的利潤率，以及我們如何規範重新確定後的利潤率？

Yes. So margins for 2023 going forward will be on the lower end of our range as we work through the transition. There's mainly 2 reasons for that and it has primarily to do with costs. Last Q3 and Q4 really hit the high mark on our unit cost within the Mobility segment, primarily driven by the pressures that everybody is feeling and we've been feeling around inflation, fuel that in general. However, we expect that to start coming down in the latter half, primarily because of the initiatives we have in place, which is mainly involving narrowing our network to the key providers, therefore, assuring that we can pay them the right level of unit cost at a higher level. So hit the high watermark, that will come down, but that will be the latter part of this year.

是的。因此，隨著我們努力過渡，2023 年的利潤率將處於我們範圍的低端。這主要有兩個原因，主要與成本有關。去年第三季度和第四季度我們在移動領域的單位成本確實達到了高點，這主要是受到每個人都感受到的壓力的推動，而我們一直感受到通貨膨脹，總體上助長了這種壓力。然而，我們預計這一數字將在下半年開始下降，這主要是因為我們已經採取了一些舉措，主要涉及將我們的網絡縮小到主要供應商，因此，確保我們能夠向他們支付適當水平的單位成本在更高的層次上。所以達到高水位線，那將會下降，但這將是今年下半年。

In addition to that, in our kind of operating expense, which a big chunk of that has to do with the calls we take, the majority of the interactions we have with our members still are telephone. And we are doing kind of common practices around call avoidance, whether that's text messages, apps, -- those 2 things will allow us to reduce the cost, increase member experience, and I expect us to start moving to the middle part of the range of our expectations in 2023.

除此之外，在我們的運營費用中，很大一部分與我們接聽的電話有關，我們與會員的大部分互動仍然是電話。我們正在圍繞避免呼叫進行一些常見的做法，無論是短信、應用程序——這兩件事將使我們能夠降低成本，增加會員體驗，我希望我們開始轉向范圍的中間部分我們對 2023 年的期望。

The next question is coming from Bob Labick of CJS Securities.

下一個問題來自 CJS Securities 的 Bob Labick。

It's Peter Lukas for Bob. You guys covered a lot answer to most of my questions here. Just if you could give a quick update on labor conditions and staffing levels in Personal Care, what are the expectations for the year? And how much closer do you think you can get to pre-pandemic levels? And in terms of any improvement you're seeing in hiring and are making to achieve those goals?

這是鮑勃的彼得盧卡斯。你們在這裡回答了我的大部分問題。如果您能快速更新個人護理部門的勞動條件和人員配置水平，您對今年的期望是什麼？您認為您可以接近大流行前的水平多少？就您在招聘方面看到的以及為實現這些目標所做的任何改進而言？

Yes. So the amount of work that we've done in the Personal Care segment led by me and Haney there has been tremendous. And it really is transforming that organization where we have these 100-plus locations that are really used to doing everything from the beginning to the end on how you deliver the service and how you can account for it. We've made a lot of progress in centralizing and standardizing a lot of those kind of halfway through that journey, 2023 is a big part of that.

是的。因此，在我和 Haney 的領導下，我們在個人護理部門所做的工作量巨大。它確實正在改變我們擁有 100 多個地點的組織，這些地點真正習慣於從頭到尾做所有關於如何提供服務以及如何解釋服務的事情。在這段旅程的中途，我們在集中化和標準化許多此類方面取得了很大進展，2023 年是其中的重要組成部分。

Those efforts, we had some investments that we needed to make at that corporate level, and we'll start to see those investments pay off as we finish with that integration. But the point around that is that frees up the resources, whether that's the bodies or even capital to ensure that we are properly investing in our caregivers with increased pay or as importantly and in some cases, more importantly, giving additional benefits that ensure that we can recruit and retain. So that is showing up in the -- in our recruitment and retention numbers. We have grown relatively consistent with the high-performing players within personal care.

這些努力，我們需要在公司層面進行一些投資，我們將在完成整合後開始看到這些投資得到回報。但關鍵是要釋放資源，無論是身體還是資本，以確保我們適當地投資於我們的護理人員，增加工資，或者同樣重要的是，在某些情況下，更重要的是，提供額外的福利，確保我們可以招募和保留。所以這顯示在 - 在我們的招聘和保留數字中。我們的發展與個人護理領域的高績效參與者相對一致。

So very successful, made a lot of progress. So the labor challenges have stabilized, and we expect it to stay at that stabilized level. And then the initiatives that I just articulated before is going to allow us to really accelerate beyond the market in retention. As we noted as well earlier, our retention rates are high, higher than normal. So labor is in a good spot, always going to be challenging, hiring hourly people in specific caregivers -- but we feel good about where we're going.

所以非常成功，取得了很大的進步。因此，勞動力挑戰已經穩定下來，我們預計它會保持在穩定的水平。然後我剛才闡述的舉措將使我們能夠真正加速超越市場的保留。正如我們之前指出的那樣，我們的保留率很高，高於正常水平。因此，勞動力處於一個有利的位置，總是充滿挑戰，在特定的護理人員中僱用小時工——但我們對我們要去的地方感覺很好。

Pre-pandemic levels, we're not there yet from a standpoint of meeting that demand. I think that's related to your question. And that will, we won't get all the way back to that even at the end of this year, but we will have significant growth. So the point of that is, I think we have a reasonable plan. And then after that, I do think we'll continue to accelerate beyond that. But -- so that's kind of the update on the labor market and what we're doing to push beyond that.

從滿足這種需求的角度來看，我們還沒有達到大流行前的水平。我認為這與你的問題有關。即使在今年年底，我們也不會完全恢復到那種狀態，但我們將會有顯著的增長。所以重點是，我認為我們有一個合理的計劃。然後在那之後，我認為我們會繼續加速超越。但是 - 這就是勞動力市場的最新情況以及我們正在做的超越這一點的事情。

The next question is coming from Brooks O'Neil of Lake Street Capital Partners.

下一個問題來自 Lake Street Capital Partners 的 Brooks O'Neil。

I have a couple of questions. I guess, first, I'd love to hear a little bit more about the response of state governments and managed care companies to the One ModivCare initiative that you discussed in your prepared remarks.

我有一些問題。我想，首先，我想听聽更多關於州政府和管理式醫療公司對您在準備好的發言中討論的 One ModivCare 倡議的反應。

Yes. So yes, the One ModivCare vision is resonating well with all our payers and even internally for us, it's allowing us to work cross-functionally across all of our divisions. So it's really resonating with the senior C-level people within each of these specific payers or states. And why is that? Because they're having the same challenges and struggles within their patient population.

是的。所以，是的，One ModivCare 願景與我們所有的付款人產生了很好的共鳴，甚至在我們內部，它使我們能夠跨所有部門跨職能工作。因此，它確實引起了每個特定付款人或州內高級 C 級人員的共鳴。為什麼是這樣？因為他們在患者群體中面臨著同樣的挑戰和鬥爭。

It's all about how do they identify the higher risk people and get ahead of that, the one they can help them and also kind of lower that cost of care. And almost every week or every month, there is some study that comes out around the benefits of supportive care services and the direct impact that has on changing outcomes. So that acceleration, that data is really resonating with executives. And we are in front of a lot of clients either doing pilots right now, doing contract work where we are actually helping them change outcomes and then even in broader discussions on how we bring them all together to help their population.

這完全是關於他們如何識別高風險人群並領先於此，他們可以幫助他們並降低護理成本。幾乎每週或每個月，都會有一些研究圍繞支持性護理服務的好處及其對改變結果的直接影響展開。所以這種加速，那種數據真的引起了高管們的共鳴。我們面對很多客戶，要么現在就在做試點，要么在我們實際幫助他們改變結果的地方做合同工作，然後甚至在更廣泛的討論中討論我們如何將他們聚集在一起以幫助他們的人口。

So long story short, resonating very well, and we expect our contracts to increase this year around that and then do a lot of work to ensure that, that continues to happen.

長話短說，共鳴很好，我們預計今年我們的合同將圍繞這一點增加，然後做大量工作以確保這種情況繼續發生。

Fantastic. I think it's a great initiative. So let me just ask one more. I see some activity in the personal care arena. I guess I might call it consolidation activity, but it's really more just various corporate stages happening. Do you guys see that as opportunity or threat to you in the personal care arena?

極好的。我認為這是一個偉大的創舉。所以讓我再問一個。我在個人護理領域看到了一些活動。我想我可以稱之為整合活動，但它實際上更像是發生在各個公司階段。你們認為這是個人護理領域對你們的機遇還是威脅？

So the personal care industry as a whole continues to mature. And then it's still made up of primarily mom-and-pop organizations 150,000 plus. So it's a normal cycle of almost every industry that goes through that consolidation. But more so in personal care, this gets back to your -- even your previous question, the value of these services for people's members are valuable. And that is -- that shows up in our increased reimbursement rates. It shows up in the increased regulation, by the way, which is -- sounds like a bad thing, but it's actually a good thing.

因此，個人護理行業作為一個整體不斷走向成熟。然後它仍然主要由 150,000 多個夫妻組織組成。因此，幾乎每個行業都經歷過這種整合，這是一個正常的周期。但在個人護理方面更是如此，這又回到了你——甚至是你之前的問題，這些服務對人們會員的價值是有價值的。那就是 - 這體現在我們增加的報銷率中。順便說一句，它體現在加強監管中，這聽起來像是一件壞事，但實際上是一件好事。

So you're seeing more sophisticated people realize that and continue to roll that up and consolidate. So I view the -- what's happening in the marketplace as a positive thing for the industry as a whole. And there's plenty of hours up there, and I expect and hope that, that continues. So not a threat. I think good for the industry, and I expect that to continue.

所以你會看到更老練的人意識到這一點，並繼續將其整合起來。所以我認為——市場上正在發生的事情對整個行業來說是一件積極的事情。那裡有很多時間，我期待並希望這種情況繼續下去。所以不是威脅。我認為這對行業有利，我希望這種情況會繼續下去。

The next question is coming from Scott Fidel of Stephens.

下一個問題來自 Stephens 的 Scott Fidel。

First question, just interested if you've got any insights into just how Matrix has been doing with their operational turnaround. And then I know that you've talked about potentially seeing an opportunity looking out to the back half of '23 for a monetization opportunity. Just interested in your updated thoughts around that potential catalyst.

第一個問題，如果您對 Matrix 在運營周轉方面的表現有任何見解，我只是感興趣。然後我知道你已經談到可能會看到一個機會，期待 23 年後半年的貨幣化機會。只是對您圍繞該潛在催化劑的最新想法感興趣。

Yes. We're really proud of what Matrix has done over the last 6 to 9 months, completely new management team, restructuring divestiture of businesses that really pops in COVID, but the thesis of them continuing post COVID was not there. So a lot of heavy lifting to get those away and not be a distraction and then even take out the costs that are related to that, pretty much done with all that restructuring and costs. And then more importantly, this gets to the team that they brought in, the levels of performance within the risk adjustment business, they're back to the way it was pre-COVID.

是的。我們真的為 Matrix 在過去 6 到 9 個月裡所做的一切感到自豪，全新的管理團隊，重組剝離在 COVID 中真正流行的業務，但他們在 COVID 後繼續的論點並不存在。因此，要完成大量繁重的工作，而不是分散注意力，然後甚至消除與之相關的成本，所有重組和成本都已完成。然後更重要的是，這影響到他們引入的團隊，風險調整業務中的績效水平，他們回到了 COVID 之前的狀態。

Unfortunately, we kind of lost our focus on that in those kind of 2020, 2021 and even kind of early part of 2022. But they're back and increasing beyond that, that's tech, process new people. So I'm really encouraged about what they've been doing there, showing up in the numbers, and I expect that to accelerate in the related financial performance to continue to improve each quarter.

不幸的是，在 2020 年、2021 年甚至 2022 年初的那種情況下，我們有點失去了對這一點的關注。但他們又回來了，並且超越了這一點，那就是技術，流程新人。因此，我對他們在那裡所做的事情感到非常鼓舞，在數字中顯示出來，我預計相關財務業績將加速增長，每個季度都會繼續改善。

I know I've said that potentially, there's something in 2023. And that could happen really for us and what we're seeing now is watching them perform and helping them perform. And again, the monetization will be there. I still think that's early is would be in 2023. But yes, so we look forward to watching them do it and at the right point in time, there will be an exit for us.

我知道我已經說過，2023 年可能會有一些事情發生。這對我們來說真的可能發生，我們現在看到的是看著他們表演並幫助他們表演。再一次，貨幣化將在那裡。我仍然認為那是 2023 年的早期。但是，是的，所以我們期待看到他們這樣做，並且在正確的時間點，我們會有一個出口。

Understood. And then just my follow-up question, just getting back to redeterminations and obviously, that's a trickier sort of modeling exercise for all of us until we just see the tempo start to kick in. It does sound like you're building in some mix impact, right, in terms of assuming some higher utilization in 2023, which I think seems prudent. I would be interested in sort of how you're modeling in average membership just as we sort of play out over the course of the quarters just as we factor and think about redeterminations?

明白了。然後是我的後續問題，回到重新確定，顯然，這對我們所有人來說都是一種更棘手的建模練習，直到我們看到節奏開始發揮作用。聽起來確實像是在構建某種混音影響，對，就假設 2023 年的利用率有所提高而言，我認為這似乎是謹慎的。我會對您如何在平均會員中建模感興趣，就像我們在整個季度中發揮作用一樣，就像我們考慮並考慮重新確定一樣？

Yes. So you're right. We expect that to -- what we have modeled into our numbers that coming down, membership coming down in Q3 and Q4. But we also do have offsets with other new wins that we're doing, expansion of certain portfolios that we do have. So that's why we're saying we think it's something we'll be able to manage through. And I also do think if it does start happening in redetermination, our model is probably a little conservative for what's likely going to happen.

是的。所以你是對的。我們預計 - 我們已經模擬到我們的數字下降，第三季度和第四季度的會員人數下降。但我們也確實抵消了我們正在做的其他新勝利，我們確實擁有的某些投資組合的擴展。所以這就是為什麼我們說我們認為這是我們能夠管理的事情。而且我也確實認為，如果它確實開始發生在重新確定中，我們的模型對於可能發生的事情可能有點保守。

If you talk to -- and I know, Scott, you talked to everybody a lot around this. The requirement and the appropriate requirements for states and what they have to do before they roll people off are a laborious and detailed. And I do think that's going to take some time. And I do think we'll figure out that a lot of people price. So again, I think it's -- we're modeling it. I think it's conservative, but the way it is in our model, we're offsetting a good chunk of that with new volume and new business in the latter half of this year.

如果你和——我知道，斯科特，你就這個問題和每個人談了很多。各州的要求和適當的要求以及他們在將人員撤離之前必須做的事情是一項艱鉅而詳細的工作。我確實認為這需要一些時間。而且我確實認為我們會發現很多人都在定價。所以，我認為它是——我們正在對其進行建模。我認為這是保守的，但在我們的模型中，我們將在今年下半年用新的銷量和新業務抵消其中的很大一部分。

The next question is coming from Peter Chickering of Deutsche Bank.

下一個問題來自德意志銀行的 Peter Chickering。

This is Kieran Ryan on for Peter. Can I just start off with guidance. It looks like the margin assumptions within guidance are about 8.6% to 9.1% versus 8.9% in 2022. And you have given us some good color on the top line growth across the businesses. But is there any key expense swing factors that you can call out between the low and high end of the range, whether it's wage growth, turnover, transportation costs like is there anything that sticks out more than the others?

這是彼得的基蘭瑞安。我可以從指導開始嗎？看起來指導範圍內的利潤率假設約為 8.6% 至 9.1%，而 2022 年為 8.9%。您為我們提供了一些有關業務收入增長的良好色彩。但是，是否有任何關鍵的支出波動因素可以在範圍的低端和高端之間調出，無論是工資增長、營業額、運輸成本，比如有什麼比其他因素更突出？

Yes. So a couple of things. Getting back to Mobility and where we are in the life cycle of the initiatives that we are doing. The cost structure with Mobility is at the high point right now, both on the unit costs or in our COGS as well as in that operating expense side, and we expect those to start coming down in the latter part of this year. So that cost structure is high. And again, it's not rolling off to the end of the year, for the full year, it still remained elevated to how we'd be exiting. So that's one explanation for the margin that we have.

是的。所以有幾件事。回到移動性以及我們在我們正在執行的計劃的生命週期中所處的位置。 Mobility 的成本結構目前處於高點，無論是單位成本還是我們的 COGS 以及運營費用方面，我們預計這些將在今年下半年開始下降。所以成本結構很高。再說一次，它不會滾到今年年底，全年，它仍然保持在我們退出的方式。所以這是對我們的保證金的一種解釋。

In the Personal Care business and deliberate and absolutely the right thing to do, and I said this a little bit earlier, is we're moving into this new model where we have back office centralized as well as other processes in the operations actually centralized, we're investing in that now. And the reason why we're doing that now because we need to catch the changes that we're making with those people. And that cost shift basically getting the other cost out will also start happening in the latter part of this year and it makes a lot of sense.

在個人護理業務中，經過深思熟慮並且絕對正確的做法，我之前說過，我們正在進入這種新模式，在這種模式中，我們將後台辦公室集中化，而運營中的其他流程實際上也集中化了，我們現在正在投資。我們現在這樣做的原因是因為我們需要了解我們正在與這些人一起做出的改變。這種成本轉移基本上將其他成本轉移出去，也將在今年下半年開始發生，這很有意義。

We're building it up centrally. But as we finish with the integration in the right deliberate way with people, process and tech, we'll be able to lower that operating cost in the field in the latter part of this year. So again, we're probably at the high point from a cost perspective in the Personal Care segment aside, and I expect that to improve and exit and be on the higher end of our range from a margin perspective exiting 2023.

我們正在集中構建它。但是，當我們以正確的方式完成與人員、流程和技術的整合時，我們將能夠在今年下半年降低該領域的運營成本。因此，從個人護理領域的成本角度來看，我們可能再次處於高點，我預計到 2023 年，從利潤率的角度來看，這種情況會有所改善並退出並處於我們範圍的高端。

Really the same with monitoring as well. We're in that we're -- for us, the focus and the opportunity is all about selling. Margins are very strong. We are getting minimal leverage on the G&A side. I expect that to improve nominally this year and then 2024 and beyond. So the other thing that we are doing, and you can see this if you look at our add-backs, we are ensuring that we have the right people in the right seats. And a part of that with what I talked about earlier around how we're investing in different parts of the business, we're also releasing people and we did that and we did that in Q4. And I expect that to happen as well going forward to ensure, again, that we have the right people in the right seat.

監控也是如此。我們就是這樣——對我們來說，重點和機會都是關於銷售的。利潤率非常高。我們在 G&A 方面的影響力很小。我預計今年和 2024 年及以後名義上會有所改善。所以我們正在做的另一件事，如果你看一下我們的附加功能，你就會看到這一點，我們正在確保我們有合適的人在合適的位置。其中一部分是我之前談到的關於我們如何投資於業務的不同部分，我們也在釋放人員，我們做到了，我們在第四季度做到了。我希望這種情況也能在未來發生，以再次確保我們有合適的人坐在合適的位置上。

All that putting aside, we feel really comfortable with the margin ranges that we have in 2023 and feel really comfortable about our cost structure and leverage from the people we get going beyond that.

撇開所有這些不談，我們對 2023 年的利潤率範圍感到非常滿意，並且對我們的成本結構和我們超越該範圍的人員的影響力感到非常滿意。

The other comment that I would add is if you take out what we mentioned on the call, the $7 million of onetime benefit that we experienced in the fourth quarter. The margins will be right at that low end of the 8.6% to 9.1% for 2022. And so really, we feel like the jumping-off point is appropriate. And so we feel like we have upside opportunity in 2023.

我要補充的另一條評論是，如果你去掉我們在電話會議上提到的內容，即我們在第四季度經歷的 700 萬美元的一次性收益。到 2022 年，利潤率將恰好處於 8.6% 至 9.1% 的低端。因此，我們確實認為起點是合適的。因此，我們覺得我們在 2023 年有上行機會。

That's very helpful. And then just a quick follow-up. You touched on RPM there. Top line, that it's holding up well, but not as quite as much G&A leverage there. Would you attribute most of that just kind of to these contract repricings that you talked about last quarter? And then I know there's some negative pricing impact from the Guardian acquisition and to get back to a point where you are generating operating leverage and EBITDA is growing faster than revenue. Is that kind of just -- do those dynamics just need to annualize out or is there some other factor there that we should look for that?

這很有幫助。然後只是快速跟進。您在那裡談到了 RPM。最重要的是，它表現良好，但 G&A 的槓桿率不高。您是否會將其中大部分歸因於您上個季度談到的這些合同重新定價？然後我知道收購 Guardian 會對定價產生一些負面影響，並回到您產生運營槓桿和 EBITDA 增長快於收入增長的地步。那種只是 - 這些動態是否只需要年化，或者是否還有其他一些我們應該尋找的因素？

Yes. Yes. The Guardian actually has the pricing is right in line with the rest of it. So it hasn't been a -- it's not a drag. The Guardian acquisition is really successful integrated, we are getting leverage off of that from a -- just within the RPM group. So congratulations to the team that's really successful, and it's good for us.

是的。是的。衛報的定價實際上與其他內容一致。所以這不是——這不是拖累。對 Guardian 的收購是真正成功的整合，我們正在從 RPM 集團內部獲得影響力。因此，祝賀真正成功的團隊，這對我們有好處。

On the pricing side, and definitely related to the margin that we had coming into even in 2022, is the MA pricing that we had for a large payer deliberately doing that because we're getting a national license to hunt. So I'll do that every day, all day for MA business, but that's the main reason for the delta and the decrease in margin is because of the MA business that we brought on. But that -- again, that will help grow the dollar amount going forward.

在定價方面，與我們甚至在 2022 年獲得的利潤肯定相關的是我們為大型付款人故意這樣做的 MA 定價，因為我們獲得了國家狩獵許可證。所以我每天都會為 MA 業務做這件事，但這是三角洲的主要原因，而利潤率下降是因為我們帶來了 MA 業務。但是，這將再次有助於增加未來的美元金額。

So that -- we're really excited about that. For us, it's really about growth and ensuring we are growing that business as a whole. Margins are still strong, but those lower levels are on purpose and as expected, and I'll continue to do that if necessary on the MA side. And then the leverage on the G&A side. I don't want to overplay that because they are still performing well. I'm just -- the point there is I do think there's an opportunity to get more leverage around the one ModivCare G&A platform as well. But we're just we're prioritizing stuff. And right now, that we're fine with where we are now. So long story short, great margin, on purpose based on the MA business, and I expect that to continue for 2023 and beyond.

所以——我們對此感到非常興奮。對我們來說，這真的是關於增長和確保我們作為一個整體發展該業務。利潤率仍然很高，但那些較低的水平是有意且符合預期的，如果有必要，我將繼續在 MA 方面這樣做。然後是 G&A 方面的槓桿作用。我不想誇大其詞，因為他們仍然表現良好。我只是——關鍵是我確實認為有機會在一個 ModivCare G&A 平台上獲得更多的影響力。但我們只是在優先考慮事情。而現在，我們對現在的狀況很好。長話短說，利潤豐厚，有意基於 MA 業務，我預計這種情況將持續到 2023 年及以後。

The next question is coming from Brian Tanquilut of Jefferies.

下一個問題來自 Jefferies 的 Brian Tanquilut。

Thanks for letting me do a follow-up here. As I think about the longer-term guidance ranges you had previously provided, say, for 2025, both in revenue and EBITDA. I think about where you are for '23, it implies a little bit of acceleration in '24 and '25 or either that or conservatism in 23, right? So anything you should -- you want to call out for us or we should be thinking about that would drive some growth acceleration next year in valid years?

感謝您讓我在這裡進行跟進。當我想到你之前提供的長期指導範圍時，比如 2025 年，包括收入和 EBITDA。我想一想你對 23 年的看法，這意味著 24 年和 25 年的加速或 23 年的保守主義，對吧？所以你應該做的任何事情——你想為我們呼籲，或者我們應該考慮這會在有效年份推動明年的一些增長加速？

So the growth within the Home division is very reasonable. If you look at where we are and what we expect to have, and those are really in line with what we talked about last June, in line with the market, in line with just kind of steady performance. Where the most -- where the additional growth really needs to happen for us, and I'm comfortable with this is in the NEMT business. And primarily, that has to do with selling. So there's 2 dynamics around what has happened in the NEMT business and why I feel comfortable with that accelerated bump going into '24 and '25.

所以家庭部門的增長是非常合理的。如果你看看我們所處的位置和我們期望擁有的東西，那麼這些確實與我們去年 6 月談到的內容一致，與市場一致，與穩定的表現一致。最多——我們真正需要額外增長的地方，我對此感到滿意的是 NEMT 業務。這主要與銷售有關。因此，圍繞 NEMT 業務中發生的事情有兩種動態，以及為什麼我對進入 24 和 25 年的加速沖擊感到滿意。

One is the -- really the pushback of many large RFPs -- and I think we're talking about these RFPs for 12-plus months. And every month, I'd say they keep getting pushed out. Many of them have been pushed out for a year. And so this year, the latter part of this year, a lot of these larger RFPs will come up, and we expect to win more than our fair share of those. But that volume will come on until 2024.

一個是——實際上是許多大型 RFP 的推遲——我認為我們討論這些 RFP 已經 12 個多月了。每個月，我都會說他們不斷被排擠。他們中的許多人已經被推遲了一年。所以今年，今年下半年，將會出現很多這樣的大型 RFP，我們希望贏得比我們公平份額更多的 RFP。但這一數量將持續到 2024 年。

So the other half of that is selling. So our focus -- we've hired some hunters, right. We have great account management people, but we've also hired hunters. And our focus in the past hasn't been on growth beyond really our current big clients. That is our focus. And there's a lot of other -- we focus on the big 6. We know there's many more big payers out there. And we are really close to signing a large deal with a large payer that we haven't even talked to before, we didn't talk to before. So -- and the pipeline, as we articulated, is significantly up since kind of the August-September time frame.

所以另一半是銷售。所以我們的重點——我們僱傭了一些獵人，對吧。我們有優秀的客戶管理人員，但我們也聘請了獵人。我們過去的重點並不是真正超越我們目前的大客戶。這是我們的重點。還有很多其他的——我們專注於六大巨頭。我們知道還有更多的大支付者。而且我們真的很接近與我們之前從未談過的大型付款人簽署大筆交易，我們之前沒有談過。所以——正如我們所闡述的那樣，自 8 月至 9 月的時間框架以來，管道明顯增加。

So those 2 together, our hunting coupled with the timing of large RFPs, winning our fair share will allow us to hit those growth targets in Mobility and therefore, the growth targets across the company to hold through 2025.

因此，將這兩者結合起來，我們的狩獵加上大型 RFP 的時機，贏得我們的公平份額將使我們能夠實現移動性的增長目標，因此，整個公司的增長目標將保持到 2025 年。

The next question is coming from Mike Petusky of Barrington Research.

下一個問題來自 Barrington Research 的 Mike Petusky。

Just one real quick one and then maybe possibly 1 or 2 others. On the payables issue, I just want to make sure you're essentially saying the impact is sort of completely -- not way reduced, but the impact on cash flows in '23 is essentially axed out. Is that a fair characterization of what you're saying?

只是一個真正快速的，然後可能還有 1 或 2 個。在應付賬款問題上，我只想確保你基本上是在說影響是完全的——而不是減少的方式，但對 23 年現金流的影響基本上被消除了。這是對你所說內容的公平描述嗎？

Well, so yes, so there's a couple of things. There's a little -- like always, there's a little bit more I should explain. Consistent with what I said before, anywhere kind of that kind of $40 million to $60 million paid out that is unusual that happened in 2022, that happens and you see that happen in -- you see that happen in the fourth quarter. We are still seeing in certain contracts that still that increase a little bit. So there is going to be some -- a little bit of lumpiness in our contracts payable for a few contracts.

好吧，是的，所以有幾件事。有一點 - 像往常一樣，我應該解釋更多一點。與我之前所說的一致，在 2022 年發生的 4000 萬至 6000 萬美元的支付是不尋常的，這種情況發生了，你看到它發生在——你看到它發生在第四季度。我們仍然看到某些合同仍略有增加。因此，我們的合同中會有一些 - 一些合同的應付金額有點大。

I don't want that to distract from the message that I've been consistently saying. I said earlier is that we're back to normal working capital and that kind of big COVID bump is behind us. But there is a little bit that we will still be working through increases and then, therefore, some lumpy decreases in the next couple of quarters, but not to the extent of the $40 million to $60 million each quarter.

我不希望這會分散我一直在說的信息。我之前說過，我們已經恢復正常的營運資金，而 COVID 的那種大衝擊已經過去了。但有一點我們仍將通過增加來努力，因此，在接下來的幾個季度中會出現一些塊狀下降，但不會達到每個季度 4000 萬至 6000 萬美元的程度。

Okay. So I mean -- and I'm not trying to put words in your mouth, but just in terms of magnitude, I mean, it could be maybe sort of $10 million or $20 million, something like that over the course of the year in terms of drag, possibly or?

好的。所以我的意思是——我不是想把話放在你的嘴裡，而是就規模而言，我的意思是，它可能是 1000 萬美元或 2000 萬美元，在這一年中大概是這樣的阻力方面，可能還是？

Yes, that's the right way to box it in.

是的，這是裝箱的正確方法。

Okay. Perfect. And then on the contract pushout and then you sort of seem to allude that there could be some attrition in the second half, which I'm assuming is around existing obviously, attrition existing relationships. I guess can you sort of size up, I mean, in any way, the contract size that in aggregate that have sort of been pushed out in your mind and also sort of the potential attrition risk in the second half associated with transportation?

好的。完美的。然後在合同推出時，你似乎暗示下半年可能會有一些消耗，我假設這顯然是圍繞現有的，消耗現有的關係。我想你能不能估計一下，我的意思是，總的來說，合同規模已經在你的腦海中被推出了，還有下半年與運輸相關的潛在減員風險？

Yes. So I don't see the second half having incremental attrition. I think within our current numbers right now has the -- we continue to win well beyond what we've won and so we are continuing to get new volumes, but we haven't got the increased volume we that we expected. That's the main message. And again, I don't expect any more attrition happening in Q2, Q3, Q4. What's in our numbers right now is in our numbers. I expect to actually win in the latter part of this year, but you're right, that wouldn't come on until 2024.

是的。所以我不認為下半場有增量減員。我認為在我們目前的數字中 - 我們繼續贏得遠遠超過我們所贏得的勝利，因此我們將繼續獲得新的數量，但我們沒有達到我們預期的增加量。這是主要信息。再說一遍，我預計第二季度、第三季度、第四季度不會再出現任何人員流失。我們現在的數字就是我們的數字。我希望在今年下半年真正獲勝，但你是對的，這要到 2024 年才會發生。

So I don't want to -- I'm glad you asked that question because I don't expect additional attrition happening. But we're -- so then from a size perspective, the good thing was that there's nothing that is material as a stand-alone, right, because we don't want to have the risk or on the other side, we don't have the opportunity either for us to really get one contract and it's going to have a material impact. That being said, there are large contracts that can have an annual EBITDA range of kind of $5 million to $10 million, which is very good.

所以我不想——很高興你問了這個問題，因為我不希望發生額外的人員流失。但是我們 - 所以從規模的角度來看，好消息是沒有什麼是獨立的物質，對吧，因為我們不想承擔風險，或者在另一方面，我們不我們也沒有機會真正獲得一份合同，這將產生重大影響。話雖這麼說，但有些大型合同的年度 EBITDA 範圍可能在 500 萬至 1000 萬美元之間，這非常好。

But at the same time, from a risk perspective, we can manage through some of that. So I don't expect anything this year from a risk perspective to come off. I expect all the opportunities to come on going forward. But the right range of that, there's probably 4 to 5 contracts like that, that will be coming up over the next 12 months in that range.

但與此同時，從風險的角度來看，我們可以應對其中的一些風險。因此，從風險的角度來看，我預計今年不會出現任何結果。我希望所有的機會都能繼續前進。但在正確的範圍內，可能有 4 到 5 份這樣的合約，將在未來 12 個月內出現在該範圍內。

Got you. All right. Let me sneak last one in. And I've asked about this a couple of times, and it seems like maybe this is more of a back burner long term, but any update on meal delivery and how you guys are thinking about that? Or should we just sort of back burner that for '23 and think about it more realistically down the road as something you guys might really go all in on?

明白了好的。讓我偷偷溜進最後一個。我已經問過幾次這個問題，從長遠來看，這似乎更像是一個次要的問題，但是關於送餐的任何更新以及你們是如何考慮的？或者我們應該把它放在 23 年的後面，更現實地考慮一下你們可能真的會全力以赴嗎？

No. So I feel really good about our plan for what we want to do in meals. We have great -- new people that have taken that over, and it's actually the platform that it's on is the platform that we have in our Home division, which makes a lot of sense because it's a referral-based business. So they have that -- the tools, the people have that skill set. And we've appropriately -- we have the right partner, and we have the right states picked to start to grow.

不，所以我對我們在用餐時想做的事情的計劃感到非常滿意。我們有很棒的新人接管了它，實際上它所在的平台是我們在家庭部門擁有的平台，這很有意義，因為它是一個基於推薦的業務。所以他們擁有 - 工具，人們擁有那種技能。而且我們已經適當地 - 我們有合適的合作夥伴，並且我們選擇了合適的州來開始發展。

We have clear objectives, OKRs that we have in 2023, and I expect that we will achieve that. The revenue and EBITDA contribution will be nominal as designed because we want to make sure that we continue to prove out this model and have the right mousetrap in place before we really accelerate it. But this year, and I do -- I look for each quarter updating you on how we're doing it mainly to show, yes, we're getting it, it's the right thing. Here's my conviction around what it's going to do in 2024 and beyond. So it's going to be a good year for meals.

我們有明確的目標，即 2023 年的 OKR，我希望我們能夠實現這一目標。收入和 EBITDA 貢獻將按設計名義進行，因為我們希望確保在真正加速之前繼續證明該模型並準備好正確的捕鼠器。但今年，我確實 - 我希望每個季度都向您介紹我們的工作方式，主要是為了表明，是的，我們正在接受它，這是正確的事情。這是我對 2024 年及以後將要做什麼的信念。因此，今年將是用餐的好年頭。

So it actually could get to a point in '24 where you actually start talking about it as a?

所以它實際上可能會在 24 年達到你真正開始談論它的地步？

Better, right? Well, it's better. I say that, I don't mean that from a hope perspective. I mean that from the team that's working on this and the disciplined actions that we have in place, the customer commitments we have, we've got to execute on that, and I expect that we will.

更好，對吧？好吧，這樣更好。我這麼說，並不是從希望的角度說的。我的意思是，從致力於此的團隊和我們已經採取的紀律行動，我們對客戶的承諾，我們必須執行，我希望我們會。

At this time, I'd like to turn the floor back over to Mr. Sampson for additional or closing comments.

現在，我想將發言權轉回給 Sampson 先生，徵求他的補充意見或結束意見。

I want to thank you for participating on our call this morning and your interest in ModivCare. Our updated investor presentation and quarterly supplemental deck are posted on the Investor Relations website. If you are interested in scheduling any follow-up calls, please contact Kevin Ellich, our Head of Investor Relations. We look forward to speaking with many of you over the next number of days, weeks, months before we report our quarter results in May. So thank you again for all the support. Have a great day.

我要感謝您今天早上參加我們的電話會議以及您對 ModivCare 的關注。我們更新的投資者介紹和季度補充資料發佈在投資者關係網站上。如果您有興趣安排任何跟進電話，請聯繫我們的投資者關係主管 Kevin Ellich。在我們 5 月份報告季度業績之前，我們期待在接下來的幾天、幾週、幾個月內與你們中的許多人交談。再次感謝大家的支持。祝你有美好的一天。

Ladies and gentlemen, thank you for your participation. This concludes today's event. You may disconnect your lines or log off the webcast at this time, and enjoy the rest of your day.

女士們，先生們，感謝你們的參與。今天的活動到此結束。此時您可以斷開線路或退出網絡廣播，然後享受接下來的一天。