ModivCare Inc (MODV) 2023 Q4 法說會逐字稿

Good morning, and welcome to ModivCare's Fourth Quarter and Full Year 2023 financial results conference call. At this time, all participants are in a listen only mode, a question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. Please note this conference call is being recorded.

早安，歡迎參加 ModivCare 2023 年第四季和全年財務業績電話會議。此時，所有參與者都處於僅聽模式，正式演示之後將進行問答環節。如果有人在會議期間需要接線員協助，請按下電話鍵盤上的星號零。請注意，本次電話會議正在錄音。

I will now like to turn the call over to Kevin Ellich, Head of Investor Relations. Mr. Ellich, you may begin.

我現在想把電話轉給投資人關係主管凱文‧埃里奇(Kevin Ellich)。埃利奇先生，您可以開始了。

Good morning, and thank you for joining ModivCare's Fourth Quarter and Full Year 2023 Earnings Conference Call and Webcast. Joining me today is Heath Sampson, ModivCare's President and Chief Executive Officer, and Barbara Gutierrez, ModivCare's Chief Financial Officer.

早安，感謝您參加 ModivCare 的 2023 年第四季和全年財報電話會議和網路廣播。今天與我一起出席的是 ModivCare 總裁兼執行長 Heath Sampson 和 ModivCare 財務長 Barbara Gutierrez。

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.

在我們開始之前，我想提醒大家，在今天的電話會議中，管理階層將根據《私人證券訴訟改革法案》做出前瞻性聲明。這些陳述涉及風險、不確定性和其他因素，可能導致實際結果或事件與預期有重大差異。有關這些因素的資訊包含在今天的新聞稿和公司向 SEC 提交的文件中。

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 their most directly comparable GAAP financial measures is included in our press release and Form eight K. A replay of this conference call will be available approximately one hour after today's call concludes and will be posted on our website motive Care.com. This morning, Hugh Sampson will begin with opening remarks by reviewed. Here's will review our financial results and guidance, then we'll open the call for your questions. With that, I'll turn the call over to Heath.

我們還將討論非GAAP 財務指標，以便向投資者提供更多信息，包括這些非GAAP 財務指標的定義，以及在適用的範圍內，我們的新聞稿和8 K 表格中包含與其最直接可比的GAAP財務指標的調節表。本次電話會議的重播將在今天的電話會議結束後約一小時提供，並將發佈在我們的網站 motive Care.com 上。今天上午，休‧桑普森將首先發表經審閱的開場白。我們將回顧我們的財務表現和指導，然後我們將開始電話詢問您的問題。這樣，我就把電話轉給 Heath。

Good morning, and thank you for joining our fourth quarter and full year 2023 earnings call. Today. I'll discuss our 2023 results reflect on our transformation journey and share our outlook for 2024.

早安，感謝您參加我們的 2023 年第四季和全年財報電話會議。今天。我將討論我們 2023 年的業績，反映我們的轉型之旅，並分享我們對 2024 年的展望。

Before handing the call over to Barb, who will further elaborate on our financial results.

在將電話轉交給巴布之前，巴布將進一步詳細說明我們的財務表現。

Let me begin by saying we are pleased to have delivered fourth quarter revenue and adjusted EBITDA in line with our expectations. Full year 2023 revenue grew 10% with adjusted EBITDA of $204 million.

首先我要說的是，我們很高興第四季的營收和調整後的 EBITDA 符合我們的預期。2023 年全年營收成長 10%，調整後 EBITDA 為 2.04 億美元。

Before addressing the transformation progress you've made, I'd like to address some of the challenges we've encountered primarily stemming from the recovery period following the pandemic. Firstly, our free cash flow for the fourth quarter was negative $37 million, which was below expectations, primarily due to delay in payment from an MCO client within a specific contract in Florida looking ahead and primarily to us managing redetermination and the increased health care utilization environment. We anticipate our free cash flow for the first half of the year will be constrained due to the ongoing build in contract receivables and the settlement of several large payables expected in the second quarter.

在談論你們所取得的轉型進展之前，我想先談談我們在疫情後的恢復期遇到的一些挑戰。首先，我們第四季的自由現金流為負 3,700 萬美元，低於預期，主要是由於佛羅裡達州特定合約中 MCO 客戶的付款延遲，以及我們管理重新確定和醫療保健利用率增加環境。我們預計，由於合約應收帳款持續增加以及預計第二季幾筆大額應付帳款的結算，今年上半年的自由現金流將受到限制。

It's important to note that our $144 million balance in contract receivables is an asset that we aim to collect in six to nine months, consistent with what we have been doing. The last several months, we are proactively working to renegotiate the prepayment terms on a number of our shared risk contracts. This realign the payments we eventually reconcile as redetermination unfolds and utilization and cost normalize higher post the pandemic. This will improve our working capital by securing more cash upfront for the second half of 2024, our free cash flow will begin to normalize as re-determination, $142 million of the 2023 new sales wins are onboarded and our cost saving measures continue to take hold.

值得注意的是，我們的 1.44 億美元合約應收帳款餘額是一項資產，我們的目標是在六到九個月內收回，這與我們一直在做的事情一致。過去幾個月，我們正在積極努力重新談判一些共擔風險合約的預付款條款。隨著重新確定的展開以及疫情後利用率和成本的正常化，我們最終會重新調整付款。這將透過在2024 年下半年獲得更多現金來改善我們的營運資金，隨著重新確定，我們的自由現金流將開始正常化，2023 年新銷售收入中的1.42 億美元已投入使用，我們的成本節約措施將繼續發揮作用。

Next, I want to share our 2024 adjusted EBITDA guidance, which we expect will be in a range of $190 million to $210 million. And our first quarter 2024 adjusted EBITDA guidance in a range of $28 million to $33 million. We are guiding first quarter EBITDA to help explain the ramp in the second half of the year. During the first quarter, we are addressing headwinds from a couple of contracts and membership losses prior to the 2023 contract wins starting implementation in the second quarter these front-loaded challenges are further impacted by the ongoing normalization of health care utilization and Medicaid redetermination. The root causes of these contract losses include a few MCO clients not securing their state contracts, state health departments decision to transition to a full broker model, favoring an incumbent competitor and a client's decision to diversify volume away from us due to legacy issues. However, it's important to note that these legacy issues have been addressed through our transformation, and I'm proud of my team for doing that. In fact, we remain the largest NEMT provider and a key strategic partner for this client, actively collaborating on several new initiatives.

接下來，我想分享我們的 2024 年調整後 EBITDA 指引，我們預計該指引將在 1.9 億至 2.1 億美元之間。我們的 2024 年第一季調整後 EBITDA 指引範圍為 2,800 萬美元至 3,300 萬美元。我們正在指導第一季 EBITDA，以幫助解釋下半年的成長。在第一季度，我們正在解決在第二季度開始實施 2023 年合約之前的一些合約和會員流失帶來的不利因素，這些前期挑戰受到醫療保健利用和醫療補助重新確定的持續正常化的進一步影響。這些合約損失的根本原因包括一些 MCO 客戶沒有獲得州合約、州衛生部門決定過渡到完整的經紀人模式、有利於現有的競爭對手，以及客戶由於遺留問題決定將交易量從我們這裡轉移出去。然而，值得注意的是，這些遺留問題已透過我們的轉型得到解決，我為我的團隊做到了這一點感到自豪。事實上，我們仍然是最大的 NEMT 提供者和該客戶的關鍵策略合作夥伴，在多項新措施上積極合作。

Also noteworthy to explaining our 2024 guidance. While we've achieved success in securing MCO contracts, anticipated state RFPs we expected to bid on in late 2023 and early 2024 continue to continue to be delayed or extended. In 2023, we went to $142 million in annual contract value and $11 million in our remote patient monitoring segment that will be onboarded starting in the second quarter and will ramp throughout the year. Even though state RFPs have been delayed, we did secure a new state contract and expanded and extended to other state Medicaid contracts from early RFPs in 2023. In addition, we've implemented initiatives to optimize our cost structure, which is expected to generate $30 million to $50 million of in-year cost savings.

同樣值得注意的是我們對 2024 年指引的解釋。雖然我們在獲得 MCO 合約方面取得了成功，但我們預計在 2023 年底和 2024 年初投標的預期州 RFP 繼續被推遲或延長。2023 年，我們的年度合約價值達到 1.42 億美元，遠距病患監護部門的合約價值達到 1,100 萬美元，該部門將從第二季開始投入使用，並將在全年不斷增加。儘管州 RFP 已被推遲，但我們確實獲得了一份新的州合同，並在 2023 年從早期 RFP 擴展到其他州醫療補助合同。此外，我們也實施了優化成本結構的舉措，預計年內可節省 3,000 萬至 5,000 萬美元的成本。

We've made significant strides digitally integrated with our clients a move we hadn't done the past, which will enhance our client relationships, leading to improved contract retention and reduced attrition. Additionally, our enhanced go-to-market capabilities contributed to a 90% win rate in new NCR bid throughout 2023. To capitalize on this momentum, we've recently augmented our sales team with additional talent for leveraging these enhanced capabilities to secure more wins from our pipeline valued at over $800 million today. These initiatives will mitigate the negative impact from legacy losses starting in the second quarter and will become more significant as the year progressed.

我們在與客戶的數位整合方面取得了重大進展，這是我們過去從未做過的舉措，這將增強我們的客戶關係，從而提高合約保留率並減少人員流失。此外，我們增強的上市能力使得 2023 年新 NCR 投標的得標率達到 90%。為了利用這一勢頭，我們最近為我們的銷售團隊增添了更多人才，以利用這些增強的功能從我們目前價值超過 8 億美元的管道中獲得更多勝利。這些舉措將減輕從第二季開始遺留損失的負面影響，並將隨著今年的進展變得更加重要。

Now I'd like to cover our balance sheet and capital structure. We have a deliberate plan and anticipate refinancing our 2025 unsecured notes in the coming months. Additionally, we are aligned with our partners to monetize our unconsolidated minority equity investment in Matrix Medical. While we are optimistic about achieving this within the year, as the company is performing very well. Our primary focus remains on supporting the management team and maximizing the return from this valuable assets. We have also successfully renegotiated our revolving credit facility covenants, enhancing our financial flexibility and addressing our liquidity requirements.

現在我想介紹一下我們的資產負債表和資本結構。我們有一個深思熟慮的計劃，預計在未來幾個月內為我們的 2025 年無擔保票據進行再融資。此外，我們與合作夥伴合作，將我們對 Matrix Medical 的未合併少數股權投資貨幣化。雖然我們對年內實現這一目標感到樂觀，因為該公司的表現非常好。我們的主要重點仍然是支持管理團隊並最大限度地提高這些寶貴資產的回報。我們也成功地重新協商了循環信貸便利條款，增強了我們的財務靈活性並滿足了我們的流動性要求。

Thanks to the backing of our banking partners. Although our current leverage is higher than our target, reducing debt levels continues to be a priority since assuming the role in November 2022, we have undergone a comprehensive transformation, which has been anchored by our core pillars people, operational excellence, growth and innovation, reflecting on the past year, we navigated challenges and achieved significant milestones. As for the people pillar, realigning our organization was crucial, notably strengthening our executive leadership team.

感謝我們銀行合作夥伴的支持。儘管我們目前的槓桿率高於我們的目標，但自2022 年11 月上任以來，降低債務水平仍然是我們的首要任務，我們已經經歷了全面轉型，這一轉型的基礎是我們的核心支柱：人員、卓越營運、成長和創新，回顧過去的一年，我們克服了挑戰，並取得了重要的里程碑。至於人員支柱，重組我們的組織至關重要，特別是加強我們的執行領導團隊。

We also realized approximately $65 million of savings through restructuring while reinvesting $30 million in key areas such as product technology, go-to-market and clinical expertise, operational excellence, we adjusted our business model to the post-pandemic environment and transition away from our legacy decentralized and manual processes to a more efficient functional structure. This shift improved our service quality, notably increasing on-time performance in NEMT by 6% and saving $27 million annually through our digital initiatives. These efforts have also resulted in improved satisfaction, solidifying our leading NEMT position.

我們還透過重組實現了約6500 萬美元的節省，同時在產品技術、上市和臨床專業知識、卓越營運等關鍵領域再投資了3000 萬美元，我們調整了我們的業務模式以適應大流行後的環境，並從我們的業務轉型傳統的分散式手動流程轉變為更有效率的功能結構。這一轉變提高了我們的服務質量，尤其是 NEMT 的準時率提高了 6%，並透過我們的數位計劃每年節省 2700 萬美元。這些努力也提高了滿意度，鞏固了我們領先的 NEMT 地位。

In the growth pillar, we improved our new business conversions in NEMT and focused on cross-selling our RPM services, leading to over $150 million in annual contract wins, driven by our improved proposal process, an enterprise engagement model innovation has been an important part of our journey. We advanced our leadership position, addressing the social determinants of health with new product development and technology, aligning closely with CMS's strategic pillars and expanding our service offers and offerings to proactively meet our clients' needs.

在成長支柱中，我們改進了NEMT 中的新業務轉換，並專注於交叉銷售我們的RPM 服務，每年贏得超過1.5 億美元的合同，在我們改進的提案流程的推動下，企業參與模式創新已成為重要組成部分我們的旅程。我們提升了我們的領導地位，透過新產品開發和技術解決健康的社會決定因素，與 CMS 的策略支柱緊密結合，並擴大我們的服務範圍和產品範圍，以主動滿足客戶的需求。

Turning to our 2024 outlook, we project our adjusted EBITDA will be in the range of $190 million to $210 million and revenue between $2.7 billion and $2.9 billion. Our guidance considers the headwinds previously mentioned with confidence in our initiatives as we continue to transform our cost structure and revenue model. We expect to exit 2024 with a run rate for adjusted EBITDA between $220 million and $230 million. Additionally, we expect to generate between $40 million to $60 million in free cash flow materially generated in the second half of 2024.

談到 2024 年的展望，我們預計調整後的 EBITDA 將在 1.9 億至 2.1 億美元之間，營收將在 27 億至 29 億美元之間。隨著我們繼續轉變成本結構和收入模式，我們的指導考慮了前面提到的不利因素，對我們的措施充滿信心。我們預計 2024 年調整後 EBITDA 運作率將在 2.2 億美元至 2.3 億美元之間。此外，我們預計 2024 年下半年將產生 4,000 萬至 6,000 萬美元的自由現金流。

Looking towards 2025, we will continue to see deleveraging benefits from our asset-light, high cash flow conversion business with normalized expectations of 40% to 50% EBITDA conversion to cash generation, we expect revenue growth rates for personal care and remote patient monitoring to be 8% to 10% and 10% to 12% respectively, with margins consistent with previous years at 10% to 12% for personal care and mid 30% for RPM.

展望2025 年，我們將繼續看到輕資產、高現金流轉換業務的去槓桿化效益，正常化預期40% 至50% 的EBITDA 轉換為現金生成，我們預期個人護理和遠距病患監護的收入成長率將達到分別為 8% 至 10% 和 10% 至 12%，個人護理品的利潤率為 10% 至 12%，RPM 的利潤率為 30% 左右，與往年一致。

We project modest growth for NEMT revenue with margin margins exiting 2024 at approximately 8% to 8.5%. In 2024, we are focused on positioning each of our business lines for long-term profitable growth while continuing the important work to fortify our platform. As we prepare for 2025 and beyond. As we look forward, we remain committed to being the trusted partner for integrated supportive care, combining digital and personal engagement to empower living at home.

我們預計 NEMT 收入將適度成長，到 2024 年利潤率約為 8% 至 8.5%。2024 年，我們的重點是定位我們的每條業務線以實現長期獲利成長，同時繼續加強我們平台的重要工作。當我們為 2025 年及以後做準備時。展望未來，我們仍然致力於成為值得信賴的全面支持性護理合作夥伴，將數位化和個人參與相結合，增強居家生活的能力。

Here's a concise overview of our 2024 strategic priorities across our segment. In NEMT, the focus is to leverage the momentum from the achievements of 2023, aiming to capture additional revenue from our $800 million plus pipeline. The key for growth this year is execution building on our comprehensive transformation and digital initiatives focused on enhancing omnichannel member engagement, expanding multimodal transportation solutions and achieving comprehensive integration with all stakeholders. These efforts are expected to drive significant cost savings targeting $60 million in 2025 with $30 million to $40 million anticipated this year.

以下是我們整個細分市場 2024 年策略重點的簡要概述。NEMT 的重點是利用 2023 年成就的勢頭，旨在從我們超過 8 億美元的管道中獲取額外收入。今年成長的關鍵是在我們全面轉型和數位化措施的基礎上執行，重點是增強全通路會員參與度、擴展多式聯運解決方案以及實現與所有利害關係人的全面整合。這些努力預計將在 2025 年大幅節省成本 6,000 萬美元，今年預計將節省 3,000 萬至 4,000 萬美元。

Building upon the centralization, standardization and technology platforms in 2023, our key to our continued transformation in Personal Care is now focused on leveraging automation and digital tools to improve caregiver efficiency and engagement. The key here is to free up our frontline members. This will enable us to outpace the inherent growth within the market. These market tailwinds should further be bolstered by regulatory clarity regarding CMS' rule known largely as it 80/20.

在 2023 年的集中化、標準化和技術平台的基礎上，我們個人護理領域持續轉型的關鍵現在集中在利用自動化和數位工具來提高護理人員的效率和參與度。這裡的關鍵是解放我們的第一線人員。這將使我們能夠超越市場的固有成長。CMS 規則（主要稱為 80/20）的監管明確性應該會進一步增強這些市場順風。

This spring, our strategy in remote patient monitoring is multifaceted and forward looking continue to grow our base in Personal Emergency device revenue and expand our product capabilities with enhanced digitally enabled clinical capabilities. This includes fostering member engagement through our innovative care center and virtual front door services and devices, integrating RPM and NEMT services has surpassed surpassed our expectations. We have addressed care gaps and reduce costs for our clients, which distinguishes us in the market. This integrated strategy has notably boosted our NEMT sales, especially in the managed Medicaid space as our services become crucial for customers aiming to address health determinants and reduce care costs.

今年春天，我們在遠距病患監護方面的策略是多方面且具有前瞻性的，繼續擴大我們在個人緊急設備收入方面的基礎，並透過增強的數位化臨床能力擴展我們的產品能力。這包括透過我們的創新護理中心和虛擬前門服務和設備促進會員參與，整合 RPM 和 NEMT 服務已經超出了我們的預期。我們解決了客戶的護理差距並降低了成本，這使我們在市場上脫穎而出。這項綜合策略顯著提高了我們的 NEMT 銷售，特別是在託管醫療補助領域，因為我們的服務對於旨在解決健康決定因素和降低護理成本的客戶至關重要。

Our journey through 2023 was marked by a comprehensive operational, organizational and cultural restructuring. And despite some of the challenges ahead, especially in the first half of this year, our margins and cash flow conversion will progress in the back half of the year. Our unique competitive advantages, coupled with our position in the expanding home centric healthcare market, sets us apart. I'd like to thank all our team members for their hard work and dedication for providing the highest quality of services to our clients and their members.

我們 2023 年的歷程以全面的營運、組織和文化重組為標誌。儘管未來面臨一些挑戰，特別是今年上半年，但我們的利潤率和現金流轉換將在今年下半年取得進展。我們獨特的競爭優勢，加上我們在不斷擴大的以家庭為中心的醫療保健市場中的地位，使我們與眾不同。我要感謝我們所有團隊成員的辛勤工作和奉獻精神，為我們的客戶及其會員提供最高品質的服務。

Now I'll hand the call call over to Bart, who will share additional details about our financial results and outlook for 2024 Barb.

現在我將把電話轉交給 Bart，他將分享有關我們的財務表現和 2024 年 Barb 展望的更多詳細資訊。

Thank you, Heath, and good morning, everyone. Fourth Quarter 2023 revenue increased 7.5% year over year to $703 million, while full year 2023 revenue increased 10% to $2.75 billion, driven by 10% NEMT growth, 7% growth in PCS, and 14% growth in our RPM segments. Fourth quarter net loss was $5 million, while adjusted net income was $18 million or $1.29 per diluted share. Fourth quarter adjusted EBITDA was approximately $51 million and adjusted EBITDA margin was 7.2%, a modest sequential decline due to higher G&A expenses related to investments to enhance our digital and data capabilities.

謝謝希斯，大家早安。2023 年第四季營收年增7.5%，達到7.03 億美元，而2023 年全年營收成長10%，達到27.5 億美元，這主要得益於NEMT 成長10%、PCS 成長7% 以及RPM 細分市場增長14%。第四季淨虧損為 500 萬美元，調整後淨利為 1,800 萬美元，即稀釋後每股收益 1.29 美元。第四季調整後 EBITDA 約為 5,100 萬美元，調整後 EBITDA 利潤率為 7.2%，由於與增強數位和資料能力的投資相關的一般管理費用增加，環比略有下降。

Fourth quarter gross margin improved 100 basis points sequentially to 16.8%, primarily attributable to our transformation initiatives in NEMT yielding early operational efficiencies to reduce costs. Full year 2023 adjusted EBITDA was $204 million and adjusted EBITDA margin was 7.4%. A 140-basis point year-over-year decline, primarily due to higher service expense, partially offset by lower G&A related to our cost saving initiatives. Full year gross margin decreased 270 basis points to 16.4%, primarily attributable to higher NEMT purchased services expense driven by higher utilization and then normalizing health care utilization environment.

第四季毛利率環比提高了 100 個基點，達到 16.8%，這主要歸功於我們在 NEMT 方面的轉型舉措，早期提高了營運效率，從而降低了成本。2023 年全年調整後 EBITDA 為 2.04 億美元，調整後 EBITDA 利潤率為 7.4%。年比下降 140 個基點，主要是由於服務費用增加，但部分被與我們的成本節約計劃相關的一般管理費用減少所抵消。全年毛利率下降 270 個基點至 16.4%，主要是由於利用率提高以及醫療保健利用環境正常化導致 NEMT 購買服務費用增加。

Turning to a review of our segment financials. NEMT fourth-quarter revenue increased 9% year over year to $499 million. Total membership decreased 5.5% year over year to 32.9 million members, and we averaged 33.6 million members for all of 2023. On a sequential basis, average monthly members decreased 2% during the fourth quarter, primarily due to Medicaid redeterminations, which was in line with our expectations. Trip volume increased 13% in the fourth quarter, while revenue per trip decreased 3.5% due to mix changes and an approximate 1% decrease in purchased services expense per trip, which drives the revenue in our shared risk contracts.

轉向對我們部門財務狀況的審查。NEMT第四季營收年增9%，達到4.99億美元。會員總數較去年同期下降 5.5%，至 3,290 萬名會員，2023 年全年平均會員人數為 3,360 萬名。第四季平均每月會員人數環比下降 2%，這主要是由於醫療補助計劃的重新確定，這符合我們的預期。第四季的出行量增加了13%，但由於組合變化，每次出行的收入下降了3.5%，而且每次出行購買的服務費用減少了約1%，這推動了我們共擔風險合約的收入。

Sequentially, NEMT gross margin increased 150 basis points. US payroll and other expense per trip decreased 6% to $6.89, while purchased services per trip increased 2.5% to $42.24. The reduction in payroll and other expense per trip is being driven by our cost saving initiatives that he's discussed, which are reduced using our calls per trip trip volume in the fourth quarter decreased 30 basis points sequentially, while monthly utilization increased about 20 basis points sequentially to 8.9% due to lower average monthly members and was in line with our expectations as a result of our strategic initiatives.

隨後，NEMT 毛利率增加了 150 個基點。美國每次行程的工資和其他費用下降 6% 至 6.89 美元，而每次行程購買的服務費用增加 2.5% 至 42.24 美元。每次旅行的工資和其他費用的減少是由他所討論的我們的成本節約計劃推動的，這些計劃是通過我們第四季度每次旅行的通話量連續下降30 個基點而減少的，而每月利用率連續增加約20 個基點由於每月平均會員人數較低，比例下降至 8.9%，符合我們策略措施的預期。

NEMT adjusted EBITDA for the fourth quarter was approximately $40 million or 8% of revenue, representing a 70-basis point sequential improvement from the third quarter. Gross profit per trip improved 16% sequentially, primarily due to improvement in payroll and other cost per trip during the fourth quarter Medicaid redeterminations reduced our Medicaid membership by approximately 450,000 members, bringing our Medicaid membership to 24.7 million members.

NEMT 第四季調整後的 EBITDA 約為 4,000 萬美元，佔營收的 8%，比第三季季增了 70 個基點。每次旅行的毛利環比增長16%，主要是由於第四季度醫療補助重新確定期間每次旅行的工資和其他成本的改善，使我們的醫療補助會員人數減少了約450,000 名，使我們的醫療補助會員人數達2,470 萬名。

Since redetermination started last April, we have seen an 8% reduction to our Medicaid membership, which is tracking in line with our original target of 10% to 15%. Based on our most updated projections, we estimate that as of December 31, 2023, redetermination was about 70% complete, and we expect that the process will conclude in the third quarter of 2024 redetermination impacted fourth quarter revenue by $10.5 million and adjusted EBITDA by approximately $3 million, which was in line with our expectations. In 2024, We expect re-determination to adversely impact revenue by approximately $60 million and adjusted EBITDA by approximately $30 million, which is in line with our original range of $20 million to $40 million, expected revenue and adjusted EBITDA impact for 2024 are embedded in our guidance.

自去年 4 月開始重新確定以來，我們的醫療補助會員人數減少了 8%，與我們最初 10% 至 15% 的目標一致。根據我們最新的預測，我們估計，截至2023 年12 月31 日，重新確定已完成約70%，我們預計該過程將在2024 年第三季結束，重新確定對第四季度收入造成1,050 萬美元影響，調整後EBITDA約300萬美元，符合我們的預期。到2024 年，我們預計重新確定將對收入產生約6000 萬美元的不利影響，調整後EBITDA 約3000 萬美元，這與我們最初2000 萬至4000 萬美元的範圍一致，2024 年的預期收入和調整後EBITDA 影響已納入我們的指導。

As a reminder, our margins are protected from increased utilization from redeterminations on our shared risk contracts. Our shared risk Medicaid contracts accounted for approximately 60% of our NEMT revenue in 2023. Even though we'll lose some Medicaid members in these contracts, we expect higher pass-through revenue under our shared risk contracts. Finally, the remainder of NEMT. revenue, approximately 20% is generated from Medicare Advantage and fee-for-service arrangements.

提醒一下，我們的利潤受到保護，不會因為重新確定我們的分擔風險合約而導致利用率增加。2023 年，我們的風險共擔醫療補助合約約佔 NEMT 收入的 60%。儘管我們將在這些合約中失去一些醫療補助成員，但我們預計在我們的風險共擔合約下會有更高的轉嫁收入。最後，NEMT 的剩餘部分。收入中，約 20% 來自 Medicare Advantage 和按服務收費安排。

Turning to our home division, fourth quarter personal care revenue increased 3% year over year to $181 million, driven by a 3% growth in hours and a modest decrease in revenue per hour. Personal Care growth was lower than the last few quarters, primarily due to the lapping of a large minimum wage related reimbursement rate increase in New York that went into effect on October 1, 2022. That said, in 2024, we received a reimbursement rate increase in New York tied to the increase in minimum wage, which should accelerate our PCS revenue growth in the first quarter.

轉向我們的家庭部門，第四季度個人護理收入年增 3%，達到 1.81 億美元，這得益於工作時間增長 3% 和每小時收入小幅下降。個人護理成長低於過去幾個季度，主要是由於紐約自 2022 年 10 月 1 日起大幅提高與最低工資相關的報銷率。也就是說，到 2024 年，我們在紐約的報銷率與最低工資的成長掛鉤，這應該會加速我們第一季 PCS 收入的成長。

Fourth quarter personal care adjusted EBITDA was $16 million or 8.7% of revenue, which was lower than expected, primarily due to slower than expected hours growth and higher direct labor, particularly overtime expense, which is used to temporarily staff new cases. Despite the softer margins in Q4, we still expect Personal Care margins to be in the 10% to 12% range in 2024, driven by operational efficiency gains and favorable reimbursement.

第四季個人照護調整後EBITDA 為1,600 萬美元，佔營收的8.7%，低於預期，主要是因為工作時間成長慢於預期以及直接勞動力增加，特別是用於臨時為新病例配備人員的加班費用。儘管第四季度利潤率有所下降，但在營運效率提升和優惠報銷的推動下，我們仍預計 2024 年個人護理利潤率將在 10% 至 12% 範圍內。

In our RPM segment, revenue increased 7% year over year to $20 million, driven by referral sales and new business wins. Our RPM team has been successful in winning new business, and we expect organic growth of 10% or more in 2024. Fourth quarter, RPM adjusted EBITDA was $7.2 million or a 35% margin. We continue to expect long-term RPM adjusted EBITDA margins will be in the 30% range.

在推薦銷售和新業務贏得的推動下，我們的 RPM 部門的營收年增 7%，達到 2,000 萬美元。我們的 RPM 團隊已成功贏得新業務，我們預計 2024 年有機成長將達到 10% 或更多。第四季度，RPM 調整後 EBITDA 為 720 萬美元，利潤率為 35%。我們繼續預計長期 RPM 調整後 EBITDA 利潤率將在 30% 的範圍內。

Our monitoring business continues to perform well and 2023 was one of the most productive years for winning new business and referrals, which we expect will continue in 2024.

我們的監控業務持續表現良好，2023 年是贏得新業務和推薦最有成效的年份之一，我們預計這種情況將在 2024 年繼續下去。

Turning to our cash flow and balance sheet. During the fourth quarter, net cash used in operating activities was approximately $26 million and free cash flow was negative $37 million as quarter over quarter, contract receivables increased approximately $15 million and contract payables decreased $16 million. Net cash provided from financing activities was $31 million with the amount drawn on our revolver of $113.8 million as of December 31, 2023.

轉向我們的現金流和資產負債表。第四季度，經營活動使用的現金淨額約為 2,600 萬美元，自由現金流環比為負 3,700 萬美元，合約應收帳款增加約 1,500 萬美元，合約應付帳款減少 1,600 萬美元。截至 2023 年 12 月 31 日，融資活動提供的現金淨額為 3,100 萬美元，循環動用金額為 1.138 億美元。

Our free cash flow for the fourth quarter of 2023 was less than we originally anticipated, primarily attributable to delayed payments under multiple contracts from one of our large MCO clients, which we expect to collect in the coming months. The net contract receivable and payable balance at the end of the fourth quarter was $27 million, which was in line with our previously stated range of $20 million to $30 million.

我們 2023 年第四季的自由現金流低於我們最初的預期，主要是由於我們的一位大型 MCO 客戶的多份合約延遲付款，我們預計將在未來幾個月內收回這些款項。第四季末的合約應收應付餘額為 2,700 萬美元，符合我們先前規定的 2,000 萬至 3,000 萬美元的範圍。

The primary fluctuations in our quarterly working capital are driven by the shared risk contracts with our NEMT clients with payments and reconciliations occurring over various time periods. We have improved the granularity of our data analytics and forecasting of our cash flow by contract and have increased our focus on timely client payments.

我們季度營運資金的主要波動是由與 NEMT 客戶簽訂的風險共擔合約所驅動的，其中付款和對帳發生在不同的時間段。我們透過合約提高了數據分析和現金流預測的粒度，並更加重視及時客戶付款。

Along with our account management teams. We expect to have more visibility into our free cash flow and contract receivables and payables in 2024 since our business has undergone a significant transformation, coupled with the impact of redetermination and a normalizing health care utilization backdrop, we expect continued variability in our quarterly cash flow with improvement occurring in the second half of 2024, while free cash flow is expected to improve meaningfully in 2024, going from negative $125 million in 2023 to a range of $40 million to $60 million in 2024.

以及我們的客戶管理團隊。由於我們的業務經歷了重大轉型，我們預計到2024 年我們的自由現金流和合約應收帳款和應付帳款將有更多的可見性，再加上重新確定的影響和醫療保健利用率正常化的背景，我們預期季度現金流將持續變化隨著2024 年下半年出現改善，預計自由現金流將在2024 年顯著改善，從2023 年的負1.25 億美元增至2024 年的4,000 萬至6,000萬美元。

We expect that free cash flow in the first half of 2024 will be negative with a positive exit rate into 2025. The confluence of increasing utilization, Medicaid redetermination and higher shared risk revenue is creating a temporary challenge in working capital as we work with clients to reset the contractual prepayments to more closely align with recent utilization trends, we are continuing to build contract receivables. We also expect to repay certain contract payables and second quarter of 2024. Attention on free cash flow will be partially offset by collections on contract receivables and improvements from resetting prepayment rates. However, we expect the full benefit of these items to be weighted in the second half of the year.

我們預計 2024 年上半年的自由現金流將為負，而 2025 年退出率為正。利用率的提高、醫療補助的重新確定和更高的分擔風險收入的結合正在對營運資金造成暫時的挑戰，因為我們與客戶合作重置合約預付款，以更緊密地符合最近的利用率趨勢，我們正在繼續建立合約應收帳款。我們也預計將在 2024 年第二季償還某些合約應付款項。對自由現金流的關注將被合約應收帳款的收回和重置預付款率的改善所部分抵消。然而，我們預計這些項目的全部效益將在今年下半年得到體現。

I also want to take a minute to remind you about some of the normal quarterly variabilities, specifically our semi-annual cash interest payments in the second and fourth quarters of $30 million to $35 million. Our senior unsecured notes have a principal balance of $1 billion with a weighted average interest rate of 5.4%. We have been actively evaluating proposed financing options with a goal of maintaining flexibility in our capital structure and expect to formalize a refinancing plan in the coming months.

我還想花一點時間提醒您一些正常的季度波動，特別是我們在第二和第四季度支付的半年度現金利息為 3000 萬至 3500 萬美元。我們的優先無抵押票據本金餘額為 10 億美元，加權平均利率為 5.4%。我們一直在積極評估擬議的融資方案，以保持資本結構的靈活性，並預計在未來幾個月內正式製定再融資計劃。

Our bank-defined net leverage ratio increased sequentially to 4.7 times as of December 31, 2023, compared to 4.6 times in the third quarter. We filed an 8-K announcing an amendment to our revolving credit facility, extending our covenant relief period and providing additional cushion in our covenants as we manage through the balance of redetermination and normalization of utilization. We appreciate the support and flexibility of our basis, primary use of free cash flow continues to be paying down our revolver and delevering.

截至 2023 年 12 月 31 日，我們的銀行定義淨槓桿率較上季增至 4.7 倍，而第三季為 4.6 倍。我們提交了 8-K，宣布對我們的循環信貸安排進行修訂，延長我們的契約救濟期，並在我們透過重新確定和使用正常化的平衡來管理時，為我們的契約提供額外的緩衝。我們感謝我們基礎的支持和靈活性，自由現金流的主要用途仍然是償還我們的左輪手槍和去槓桿化。

Turning to guidance, we issued 2024 revenue guidance in a range of $2.7 billion to $2.9 billion and adjusted EBITDA in a range of $190 million to $210 million. The midpoint of our revenue guidance calls for about 2% growth, which reflects the impact of Medicaid redeterminations healthcare utilization normalizing throughout the year. The timing of NEMT contract losses offset by the onboarding of new contracts and cost savings initiatives throughout the year. The midpoint of our adjusted EBITDA guidance range indicates relatively flat growth compared to 2023, primarily due to the respective timing of the changes in our business in 2024. We expect the second half of 2024 to be more normalized than the first half, primarily due to the timing mismatch for onboarding new contracts versus contract attrition, continued impact for Medicaid redeterminations and the impact from cost savings initiatives.

談到指導意見，我們發布了 2024 年收入指導意見，範圍為 27 億美元至 29 億美元，調整後的 EBITDA 範圍為 1.9 億美元至 2.1 億美元。我們的收入指引中位數要求成長約 2%，這反映了全年醫療補助重新確定醫療保健利用率正常化的影響。NEMT 合約損失的時間被全年新合約的加入和成本節約措施所抵消。我們調整後的 EBITDA 指導範圍的中點表明與 2023 年相比增長相對平穩，這主要是由於 2024 年我們業務變化的相應時間。我們預計 2024 年下半年將比上半年更加正常化，這主要是由於新合約與合約流失的時間不匹配、醫療補助重新確定的持續影響以及成本節約措施的影響。

We also issued guidance for the first quarter of 2024 with a revenue range of $650 million to $700 million and adjusted EBITDA in a range of $28 million to $33 million. Our first quarter will be impacted by a couple of contract losses as well as the loss of certain membership groups from another MCO. That said, our new contract wins will be implemented in the second quarter, and we'll ramp throughout the year.

我們也發布了 2024 年第一季的指導，營收範圍為 6.5 億美元至 7 億美元，調整後 EBITDA 範圍為 2,800 萬美元至 3,300 萬美元。我們的第一季將受到一些合約損失以及另一個 MCO 造成的某些會員群體損失的影響。也就是說，我們贏得的新合約將在第二季實施，我們將在全年不斷增加。

In summary, our fourth quarter revenue and adjusted EBITDA results were in line with our expectations. However, free cash flow was lower than we expected due to the timing of collections under multiple contracts from one of our MCO clients. To reiterate what he said, we expect to exit 2024 with a run rate for adjusted EBITDA between $220 million to $230 million, and free cash flow will improve materially in the second half of 2024 with a high cash flow conversion rate we have conviction around redetermination and utilization, stabilizing the traction we are achieving with our cost saving initiatives and the forward momentum from new business wins in 2023 and 2024. We know there's still a lot of work to be done, and we are taking the appropriate actions deliver on our plans for 2024 and beyond.

總而言之，我們第四季度的營收和調整後的 EBITDA 業績符合我們的預期。然而，由於我們的一位 MCO 客戶根據多份合約收取費用的時間安排，自由現金流低於我們的預期。重申他所說的，我們預計 2024 年調整後 EBITDA 的運行率為 2.2 億至 2.3 億美元之間，自由現金流將在 2024 年下半年大幅改善，現金流轉換率很高，我們對重新確定充滿信心和利用率，穩定我們透過成本節約措施所實現的牽引力以及2023 年和2024 年新業務勝利帶來的前進動力。我們知道還有很多工作要做，我們正在採取適當的行動來實現 2024 年及以後的計劃。

Before we open the call to questions. I'd like to thank all of our team members at MOTIVE care for their hard work and dedication. We've undergone a meaningful transformation over the last couple of years, and our team continues to be highly engaged while providing exceptional, supportive care services to our members.

在我們開始提問之前。我要感謝 MOTIVE care 的所有團隊成員的辛勤工作和奉獻精神。在過去的幾年裡，我們經歷了有意義的轉型，我們的團隊繼續高度參與，同時為我們的會員提供卓越的支持性護理服務。

This concludes our prepared remarks. Operator, please open the call for questions.

我們準備好的演講到此結束。接線員，請打開電話提問。

(Operator Instructions)

（操作員說明）

Brian Tanquilut, Jefferies.

布萊恩·坦奎魯特，傑弗里斯。

Hey, good morning, guys.

嘿，早上好，夥計們。

Maybe my first question, you know, as I think about Q1, obviously the guidance is probably lower than even you would have expected. So just trying to get a sense of what happened there, how do you feel confident about the bridge to the full year guidance? And maybe just any thoughts or anything you can share with us on contract losses and starts that obviously happened at the beginning of the year and losses and starts that you're expecting beginning in the second quarter?

也許是我的第一個問題，你知道，當我想到第一季時，顯然指導可能低於你的預期。因此，只是想了解那裡發生的事情，您對通往全年指導的橋樑有何信心？也許您可以與我們分享關於年初明顯發生的合約損失和開工以及您預計從第二季度開始的損失和開工的任何想法或任何事情？

Yes, yes. Thanks, lot. And a good reason why we guided to the first quarter is to provide the insight. And really, like I said, to talk about the performance that we're having and you start seeing that the second half, right of the first half of the year and what we've been talking about heavily impacted by redetermination and the recovery in COVID and utilization. However, the one item that we didn't talk about because it just happened was in the in the contract losses. And you can see that that's impacting us in Q1, the wonderful sales that we had in 2023 in mobility of $143 million and in home of $11 million, the bulk of that starts coming on in Q2, lots of success in winning deals, but with a few contracts that happened in last in Q1, that's the main reason that the down tick on on Q1 and then and then you can see the rest of the ramp. And this gets back to again, what we've been doing in this transformation and the success we're having in the cost-out in SALES new wins and just the broader growth across the home industry. So the detail is there to show it's factual, so you guys can bridge to where we are so but you're right, it is specific within those those contract losses that we talked about, and that's the main driver for the decrease in Q2 and Q1.

是的是的。謝謝，很多。我們指導第一季的一個很好的原因是提供洞察力。事實上，就像我說的，談論我們的表現，你會開始看到今年下半年、上半年以及我們一直在談論的內容受到重新決定和復甦的嚴重影響。 COVID 和利用。然而，我們沒有談論的一項是因為它剛剛發生，那就是合約損失。你可以看到，這對我們第一季產生了影響，2023 年，我們的流動性銷售額為1.43 億美元，家居銷售額為1100 萬美元，其中大部分從第二季度開始，在贏得交易方面取得了很大成功，但隨著第一季最後發生的一些合約，這是第一季下跌的主要原因，然後你可以看到其餘的上漲。這又回到了我們在這次轉型中所做的事情以及我們在銷售新勝利和整個家居行業更廣泛的成長方面所取得的成功。因此，細節是為了證明它是事實，所以你們可以了解我們現在的情況，但你們是對的，這是我們討論過的那些合約損失的具體內容，這是第二季度和第二季度下降的主要驅動因素。Q1.

Got it. And then, Bob, maybe just wondering how are you thinking about the 2025 maturities and just the ability to refinance what are the avenues to raise capital?

知道了。然後，鮑勃，也許只是想知道您如何看待 2025 年的到期日以及再融資的能力，籌集資金的途徑是什麼？

Yes.

是的。

Debt to fund operations and the refinancing?

債務來資助營運和再融資？

Yes.

是的。

Thanks.

謝謝。

Yes, yes. So in terms of the ability to refinance the 2025, as I say in the remarks, and we are actively pursuing some avenues. So we've got some proposals that we're evaluating. So no concerns about the options there. We have some some very good options in front of us. So we're going down a couple of different paths and to determine what's the right option for us, but definitely have some some proposals in front of us, so not concerned.

是的是的。因此，就 2025 年再融資的能力而言，正如我在演講中所說，我們正在積極尋求一些途徑。我們正在評估一些建議。所以不用擔心那裡的選擇。我們面前有一些非常好的選擇。因此，我們正在走幾條不同的道路，以確定什麼是適合我們的正確選擇，但我們面前肯定有一些建議，所以不用擔心。

And then second, we just kind of related to your question. You know, we as you all know as well, we amended our credit agreement so that we have some some breathing room and in our in our in our revolver going forward. And so really don't have any concerns about our ability to.

其次，我們只是與你的問題有關。你們知道，我們也知道，我們修改了我們的信貸協議，以便我們有一些喘息的空間，並在我們的左輪手槍中繼續前進。所以真的不用擔心我們的能力。

And yes, just a little bit more on that, Brian, right. We said this before, too we're asset-light business and our adjusted EBITDA that we're generating specifically, again, why we guided to the exit rate as well. And then also said a 40% to 50% cash conversion so we know this business, it generates cash flow. We know the transformation. We've done all the way from the operating metrics to customer set to sales and then our cost structure we're in a really good spot. We have the headwinds that we talked about early. But with that Kurt profile, we feel really good about our ability to refinance when and refinancing at the at the right time.

是的，布萊恩，再多說一點，對吧。我們之前說過，我們也是輕資產業務，我們正在專門產生調整後的 EBITDA，這也是為什麼我們也指導退出率。然後也說 40% 到 50% 的現金轉換，所以我們知道這項業務，它會產生現金流。我們知道這種轉變。我們已經完成了從營運指標到客戶群再到銷售的所有工作，然後是我們的成本結構，我們處於非常好的位置。我們面臨著我們之前談到的逆風。但憑藉庫爾特的個人資料，我們對自己在正確的時間進行再融資的能力感到非常滿意。

Yes, no, that makes them a. And maybe one last question for me, if I may. Just thinking about where we are now and the strategy right. We still have obviously three different business lines. How are you thinking about the fit of those different segments, the remaining opportunity there to synergize strategically or maybe maybe not right so just curious how you're thinking now about we are putting these and coupling these three assets, the other.

是的，不，這使他們成為。如果可以的話，也許還有最後一個問題想問我。只是想想我們現在所處的位置以及正確的策略。我們顯然仍然擁有三個不同的業務線。您如何考慮這些不同細分市場的契合度，剩餘的策略協同機會，或者可能不正確，所以只是好奇您現在如何考慮我們將這三個資產與其他資產結合。

Yes. So you think about what the market is doing and what our customers want right is that the pressures that they are having, whether that's in Medicare or Medicaid to really treat the patient outside of the clinical area, it's required to have access to the patient more fully all of our services, whether that's Personal Care, RPM or NEMT are critical to that. So we have the size and scale in each of those and then we've modernized and centralize and standardize. So we're in a really good position in each of the individual solutions as a stand-alone. So that's that's point number one point number two you think about how they come together. There's a lot of cross-selling opportunities, and we actually did specifically say this in the in the in the script. If you think about specifically the large payers, the integration that they are asking of us and seen of us is specifically in the RPM and the NEMT world, it's there. It's the same patient and they need both of those services so they can work standing alone, they can work together. So my job is to ensure that we continue to execute in accordance with our strategy and vision. At the same time, we look at the assets individually. So lots of value, whether you're looking at them standalone or some of the parts, but also value as a whole so we're sticking with the strategy, but you're right to point out the individual assets do have value as standalone as well.

是的。所以你想想市場正在做什麼以及我們的客戶想要的正確的是他們所面臨的壓力，無論是在醫療保險還是醫療補助中真正治療臨床領域之外的患者，需要更多地接觸患者我們所有的服務，無論是個人護理、RPM 或NEMT 對此都至關重要。因此，我們在每個方面都有規模和規模，然後我們進行了現代化、集中化和標準化。因此，我們在每個單獨的解決方案中都處於非常有利的位置。這就是第一點和第二點，你要考慮它們是如何結合在一起的。有很多交叉銷售的機會，我們實際上在腳本中特別說這一點。如果您特別考慮大型付款人，他們要求我們進行的整合以及我們看到的整合特別是在 RPM 和 NEMT 世界中，它就在那裡。這是同一個病人，他們需要這兩種服務，這樣他們就可以單獨工作，也可以一起工作。因此，我的工作是確保我們繼續按照我們的策略和願景執行。同時，我們單獨查看資產。因此，無論您是單獨查看它們還是其中的某些部分，都具有很大的價值，而且整體也具有價值，因此我們堅持該策略，但您指出單個資產確實具有獨立價值，這是正確的以及。

Awesome.

驚人的。

Thank you.

謝謝。

Thank you. Our next question is come from the line of Scott Fidel with Stephens. Please proceed with your question.

謝謝。我們的下一個問題來自斯科特·菲德爾和史蒂芬斯的對話。請繼續你的問題。

Hi, thanks. Good morning. First question really just wanted to wanted to just trying to summarize just on the shortfall on the on the NEMT outlook in particularly in the first quarter. And clearly, we know that there's there isn't a revenue, yes, the headwind here that you have called out in detail. Just want to understand on the cost side, whether there there's also sort of a cost issue here that's influencing the outlook relative to where you may have been thinking about it before in terms of costs coming in higher than expected or the savings that you're looking to target are not coming in as quickly or whether at least on the cost side, things are largely tracking as expected, and it sounds like redeterminations so far, it's very much playing out as you expected through the end of 2023. I do see in your in your deck that you do have around a 70 basis point step-up in utilization assumed in the first quarter or sequentially. So so maybe just sort of sort of level set us around the cost side of things in terms of, you know, are if anything playing out worse than expected here at this point or for is it largely tracking as expected?

你好謝謝。早安.第一個問題其實只是想總結一下 NEMT 前景的不足，特別是第一季的情況。顯然，我們知道沒有收入，是的，你已經詳細指出了這裡的逆風。只是想了解成本方面，這裡是否也存在某種成本問題，它會影響相對於您之前可能考慮的前景的前景，即成本高於預期或您節省的成本尋找目標的速度沒有那麼快，或者至少在成本方面，事情基本上按預期進行，而且到目前為止聽起來像是重新確定，到2023 年底，它的結果與您的預期非常一致。我確實在你的套牌中看到，假設第一季或隨後的利用率確實有大約 70 個基點的提升。因此，也許只是某種程度讓我們圍繞著成本方面的問題，你知道，目前是否有任何事情比預期更糟糕，或者基本上是否按預期進行？

Yes. Well, so the cost side, we couldn't be more proud of what we've been doing starting in 2023, which is what I said in my script, that were 27 to $30 million cost out. However, that was offset because of higher utilization and redetermination. So really the pressures on margin has to do with redetermination and utilization, the cost efforts I've been going very well, which is why I have a lot of conviction around those continuing. And you can see those in the decks when you look at it on a per trip basis, we're really showing strong progress there. So which gets Do I have a lot why we gave the guidance as an exit. A lot of it has to do with our conviction around the cost and we're seeing in the data. And I expect to continue.

是的。嗯，所以在成本方面，我們對從 2023 年開始所做的事情感到非常自豪，這就是我在腳本中所說的，成本為 27 至 3000 萬美元。然而，由於更高的利用率和重新確定，這一點被抵消了。因此，實際上，利潤率的壓力與重新確定和利用有關，我一直進展順利的成本努力，這就是為什麼我對那些繼續進行的工作充滿信心。當你在每次旅行的基礎上查看它時，你可以在甲板上看到這些，我們確實在這方面展示了巨大的進步。那麼我有很多為什麼我們給出指導作為退出嗎？這很大程度上與我們對成本的信念有關，我們在數據中看到了這一點。我希望繼續下去。

Just to summarize again that the headwinds are in the short term are to do with redetermination and utilization and then those those miss mismatching of the contract losses to the onboarding of the wins.

再次總結一下，短期內的不利因素與重新確定和利用以及那些錯過合約損失與勝利的啟動不匹配的人有關。

So with that clarity and with the cost structure that we're taking out. You put that to our scale. We're in a really good spot. And as we exit this year, we lose you guys and you have any other costs my last and hopefully get back in the queue. We'll talk to you.

因此，有了這樣的清晰度和我們正在製定的成本結構。你把它放在我們的尺度上。我們處於一個非常好的位置。當我們今年退出時，我們失去了你們，你們還有其他成本，我希望能回到隊列中。我們會和你談談。

Thanks for that question, Scott.

謝謝你提出這個問題，斯科特。

Thank you. Our next question is come from the line of Brooks O'Neil with Lake Street Capital Markets. Please proceed with your questions.

謝謝。我們的下一個問題來自 Lake Street Capital Markets 的布魯克斯·奧尼爾 (Brooks O'Neil)。請繼續回答您的問題。

Thank you. Good morning. Obviously, a redetermination involves, you know, member attrition and increased utilization is the exact opposite of what you might expect in light of falling membership. So can you talk to us a little bit about what you're seeing out there in the marketplace and what is they're actually driving that higher utilization?

謝謝。早安.顯然，重新確定涉及會員流失和利用率增加，這與您在會員人數下降的情況下所預期的完全相反。那麼您能否與我們談談您在市場上看到的情況以及它們實際上推動了更高利用率的原因是什麼？

Yes. Well, so you're right to point out, it's some the utilization has to do with two two items. The big driver just because of a denominator of membership coming away is redetermination. The good thing about that, like we are saying. And then also if you're listening to what the payers are doing, it about 70% through redetermination and most of it crescendo in April. There will be some some some redetermination that will happen in May and June. So there's a lot of conviction around that number.

是的。嗯，所以你指出的是正確的，有些利用率與兩個兩個項目有關。會員資格消失的最大推動因素是重新決定。正如我們所說，這樣做的好處是。另外，如果你聽聽付款人在做什麼，你會發現大約 70% 是透過重新決定，其中大部分在 4 月達到頂峰。五月和六月將會有一些重新決定。因此，人們對這個數字有很多信心。

And then the timing around redetermination, which is the biggest driver for utilization. However, the other part of utilization that's seen across the country and as seen with us, is this normalization of the usage of health care. So you can see that we actually have that utilization of health care also continuing to tick up. And we expect at the end of this year, considering all of those together, we'll exit at about 10 or $10.1 million of utilization. So it's two factors. And I do think at the end of 2024 and if you listen to the rest of it, the health care world, they probably agree that at the end of 2024, we should be back to this kind of post-COVID normalized environment.

然後是重新確定的時間，這是利用率的最大驅動因素。然而，在全國範圍內以及我們所看到的利用的另一部分是醫療保健使用的正常化。所以你可以看到，我們的醫療保健利用率實際上也持續上升。我們預計，到今年年底，綜合考慮所有這些因素，我們將以大約 1000 或 1010 萬美元的利用率退出。所以這是兩個因素。我確實認為到 2024 年底，如果你聽聽其他人的意見，即醫療保健界，他們可能會同意，到 2024 年底，我們應該回到這種後新冠疫情正常化的環境。

So just in summary around that, a lot of understanding now that we didn't have early in 2023 or mid 2023 around around all these factors and again, which is why we have conviction around both redetermination and normalization of health care utilization, but both effects.

總而言之，我們現在對所有這些因素在 2023 年初或 2023 年中期還沒有了解很多，這就是為什麼我們對醫療保健利用的重新確定和正常化抱有信念，但兩者影響。

Cool, that's helpful. So let's just talk briefly about the NYMT. really in particular the contract losses, which I think from relatively unexpected. Obviously some factors are beyond your control. But if you could highlight nicely and the factors you you see or have heard from from customers that are driving contract losses? And then just highlight quickly, what do you think you could do to fix those problems?

酷，很有幫助。那麼讓我們簡單談談 NYMT。確實特別是合約損失，我認為這是比較意外的。顯然有些因素是你無法控制的。但是，您是否可以很好地強調您看到或從客戶那裡聽到的導致合約損失的因素？然後快速強調一下，您認為可以採取哪些措施來解決這些問題？

Well, so since I took over in November of 2022. The focus quickly shifted to our customers and our customers, some that are specific to MA that are managed Medicaid. And of course, our state customers and actually a whole have different needs. And then you layer on what they're actually going through, whether that's because of the rad V rules that CMS came out with on Medicare or whether that's the increased focus of SDOH. within Medicaid and then even within the state related bids, the requirement of innovation to do more free members.

嗯，自從我 2022 年 11 月接任以來就是如此。焦點很快轉移到我們的客戶和我們的客戶上，其中一些是特定於由醫療補助管理的 MA 的客戶。當然，我們的國家客戶和實際上的整體都有不同的需求。然後你可以對他們實際經歷的情況進行分層，無論是因為 CMS 針對 Medicare 推出的 rad V 規則，還是因為 SDOH 更加關注。在醫療補助內部，甚至在州相關投標中，都要求創新以提供更多免費會員。

My my point on that is what was in the past is different now from a customer expectation for sure you need to have the right quality people up on time, have lower complaints, but you need to do more than that. And then you even need to start integrating with the customer to ensure that they can properly manage the member experience or integrate with a facility so they can book the trip on behalf of all those items has been part of our transformation. You look back a year ago, even two years ago, some of that we weren't we weren't where we needed to be, and that gets to and this is why I have a lot of conviction around what we've done because of what the team has done. Those issues that we had around quality are gone. In fact, we're back to best in class integrating with our customers so they can control the membership member experience is happening now. I've been having an understanding of that member. So you know that whether they made their dialysis trip three times, so we can communicate that we're doing that now. So all the stuff that we are in place there and now we didn't have before. And that's a big reason why some of our competitors were able to get in and it's a driver for for one of the reasons why we lost a part of that contract before. But I am going to say this again, and I say the wins that we had in 2023 of 101 hundred and 40 million plus that was scattered across many different, primarily managed Medicaid. And the reason why we were chosen is because all of these items that we have coupled with we can do more for that member. So we can give the trip, but we can also give insight to change to manage a gap or to improve customer satisfaction. Long story short, you need to have it all. I think some of our customer, our competitors have in some individual pieces we have them now, but we didn't have them before. So and we did lose I don't expect to win everything. But what we are where we're doing and what we're doing now will win and continue to win more than we lose three.

我的觀點是，過去的情況與現在客戶的期望不同，您肯定需要有合適的優質人員按時上班，減少投訴，但您需要做的不僅僅是這些。然後，您甚至需要開始與客戶集成，以確保他們能夠正確管理會員體驗或與設施集成，以便他們可以代表所有這些項目預訂行程，這是我們轉型的一部分。你回顧一年前，甚至兩年前，我們中的一些人並沒有達到我們需要達到的目標，這就是為什麼我對我們所做的事情充滿信心，因為團隊所做的事情。我們在品質方面遇到的那些問題都消失了。事實上，我們已經恢復了與客戶的最佳整合，以便他們可以控制現在正在發生的會員體驗。我一直對那位成員有所了解。所以你知道他們是否進行了三次透析旅行，這樣我們就可以傳達我們現在正在這樣做。所以我們現在擁有的所有東西都是以前沒有的。這是我們的一些競爭對手能夠進入的一個重要原因，也是我們之前失去部分合約的原因之一。但我要再說一遍，我說我們在 2023 年取得了 101 億 4000 萬以上的勝利，這些勝利分散在許多不同的、主要管理的醫療補助計劃中。我們被選中的原因是因為我們所提供的所有這些項目都可以為該成員做更多的事情。因此，我們可以提供旅行，但我們也可以提供洞察力以進行變革，以管理差距或提高客戶滿意度。長話短說，你需要擁有這一切。我認為我們的一些客戶、我們的競爭對手在一些單獨的產品中擁有它們，我們現在擁有它們，但我們以前沒有。所以我們確實輸了，我不指望能贏得一切。但我們正在做的事情以及我們現在正在做的事情將會贏得勝利，並且繼續贏得的勝利將超過我們失去的三場勝利。

That's helpful. And then just one more. One thing that I haven't heard a lot of conversation about is labor issues and and I'm considering that a good thing, but can you just give us an update on what you're seeing in the marketplace in terms of labor, labor availability and the cost of labor?

這很有幫助。然後還有一個。我沒有聽到很多討論的一件事是勞動力問題，我認為這是一件好事，但是您能否向我們介紹一下您在市場上看到的勞動力方面的最新情況？可用性和勞動力成本？

Yes. So so on, it was three quarters ago, and this is pretty consistent across our entire company. As you know, we have drivers that we have through our transportation providers and of course, close to 20,000 employees, a lot of those caregivers. And that's always a challenge, but it's really normalized over the last three quarters. So we feel we have a lot of opportunity to continue to hire and retain the differentiator now in this environment. So the external headwinds that that happened again, three quarters ago or last year, those have been flat. What we are doing now because of the efforts of centralization, standardization and even automation, we're able to free up resources to ensure we pay the right level and ensure that we can recruit and retain.

是的。依此類推，那是三個季度前的事了，這在我們整個公司都是相當一致的。如您所知，我們有透過運輸提供者提供的司機，當然還有近 20,000 名員工，其中有許多護理人員。這始終是一個挑戰，但在過去三個季度中它確實已經正常化。因此，我們認為，在這種環境下，我們有很多機會繼續僱用和留住差異化人才。因此，三季前或去年再次發生的外部阻力已經持平。我們現在所做的事情，由於集中化、標準化甚至自動化的努力，我們能夠釋放資源，以確保我們支付適當的水平，並確保我們能夠招募和留住人才。

So long story short, the environment stable and what we've done around this integration, centralization, standardization, we're able to outpace the market and retain and grow appropriately.

長話短說，穩定的環境以及我們圍繞整合、集中化、標準化所做的工作，我們能夠超越市場並維持和適當成長。

And on the labor side, sorry, thank you very much.

在勞工方面，抱歉，非常感謝。

Thank you. Our next question is come from the line of Pito Chickering with Deutsche Bank. Please proceed with your question.

謝謝。我們的下一個問題來自德意志銀行的 Pito Chickering。請繼續你的問題。

Good morning, guys, this morning. A couple of couple of from a year for the managed care contract and for as revenues you guys didn't like this quarter, I believe you collect them in the next few months. Can I ask why are they getting collected in the time period that you thought you would? Is there any issue on what they think they should pay versus what you guys have recognized OpEx?

早上好，夥計們，今天早上。一年中的一些用於管理式醫療合約以及您不喜歡本季的收入，我相信您會在接下來的幾個月內收到它們。我可以問一下為什麼他們會在您認為會的時間內被收集嗎？他們認為自己應該支付的費用與你們認可的營運支出相比是否有任何問題？

Yes, we what we wanted to be specific. It was one contract in one area because we have a lot of relationships with that payer that across the country on which we are in great standing. This specific issue has not been paid on at the same time. Why I said the next couple of months is because we will get it paid because it's contractually owed. So I wanted to make sure I said it because it was the main driver for the cash flow change in Q4, but I also wanted to be explicit about it and give the amount because it's contractually owed. There's and we'll get it paid within the next kind of 60 days.

是的，我們想要具體說明。這是一個領域的一份合同，因為我們與該付款人有很多關係，在全國各地我們都享有良好的信譽。該具體問題尚未同時支付。為什麼我說接下來的幾個月是因為我們會拿到報酬，因為這是合約規定的。所以我想確保我這麼說是因為它是第四季度現金流變化的主要驅動因素，但我也想明確說明這一點並給出金額，因為它是合約所欠的。已經有了，我們將在接下來的 60 天內付款。

All right, great. And then on the contract loss, I guess from for your sort of the large customer, um, you know, I guess, how do you guys feel about retaining the business you have with the customers for that customer. And I said that he's still we're still the largest NEMT broker. We have relationships from the top of the house down to procurement across all the countries. And we are doing things with them that are strategic and forward looking. So they may be appropriately diversified. I think we gave them a window a couple of years ago to do that. But we are still their number one NEMT broker, and we'll continue to grow with them. So unfortunate but going forward, I feel good about our relationship and our ability to continue to grow with them and of course others.

好吧，太好了。然後關於合約損失，我想是針對你們那種大客戶，嗯，我想，你們對於保留與該客戶的客戶的業務有何看法。我說他仍然是我們最大的 NEMT 經紀人。我們在所有國家都建立了從高層到採購的關係。我們正在與他們一起做一些具有策略性和前瞻性的事情。所以他們可以適當多元化。我認為幾年前我們給了他們一個這樣做的機會。但我們仍然是他們排名第一的 NEMT 經紀商，我們將繼續與他們一起成長。很不幸，但展望未來，我對我們的關係以及我們繼續與他們以及其他人一起成長的能力感到滿意。

Okay. From a from an interest expense perspective, how should we be modeling expense in the back half of the year after the refi. Just trying to tie that up with the 40 to $60 million of free cash flow guidance, just to get the model right?

好的。從利息支出的角度來看，我們應該如何對再融資後下半年的支出進行建模。只是想將其與 4000 至 6000 萬美元的自由現金流指導聯繫起來，只是為了使模型正確？

Yes.

是的。

Thanks for the questions, Mark.

謝謝你的提問，馬克。

Yes.

是的。

So I think naturally, you can see the disclosure on the on the new revolver, the new amendments, and you can see in there that the interest rate is a little bit higher and then the current rate. And so it's a complicated formula depending on how the borrowings go. But if you look in there it's a little bit higher than the current interest rate for refinancing.

所以我認為自然地，你可以看到關於新左輪手槍、新修正案的披露，你可以在那裡看到利率比當前利率高一點。因此，這是一個複雜的公式，取決於借款的情況。但如果你看一下，它比目前的再融資利率高一點。

The 20 fives is going to be higher interest rate. That's not in the numbers, but we feel like we're going to have a good interest rate. And then as we start delevering and paying down our line, you know that that higher end that you said of 30 35 or 70 for the year. That's there beyond the higher end, if you're modeling after the refi of the 20 fives and we'll update you more as we get closer. But it's not on the lower and it will be on the higher end after the refi.

二十五的利率將會更高。這不在數字中，但我們感覺我們將會有一個不錯的利率。然後，當我們開始去槓桿化並支付我們的額度時，你知道你所說的今年的較高端 30、35 或 70。如果您是在 20 世紀 50 年代的改裝之後進行建模，那麼這超出了高端，我們將在臨近時為您提供更多更新。但它不是在較低端，而是在改裝後會在較高端。

Got it.

知道了。

Sorry, could I clarify that you can look at the release and the interest rate on the revolver of 50 basis points higher flow that's in the release.

抱歉，我可以澄清一下，您可以查看該新聞稿以及該新聞稿中左輪手槍利率高出 50 個基點的流量。

Okay. And then last quick one here. As as you ramp up into 2Q EBITDA with the new contract wins coming online. Can you just remind us the process of onboarding new customers and how we should think about revenues and costs flowing through in those initial months?

好的。然後是最後一個快速的。隨著新合約的上線，您的第二季 EBITDA 也會增加。您能否提醒我們吸引新客戶的過程以及我們應該如何考慮最初幾個月的收入和成本流動？

That's it for me. Thank you.

對我來說就是這樣。謝謝。

Yes. So again, why we wanted to kind of separate out Q1 versus the rest of the year. And explicitly these contracts coming on are because our the sales that we had and closed in 2023. So why we feel good about the timing of those and the implementation from each of those is because we have a national platform in each of these states where we won. We already have other clients in there. If we didn't, there is a lot of work to get to stand up a network, but we don't have that issue because we're already concentrated in those specific states. So we feel good about the timing and the implementation. And again, we've already sold those. So it really is just execution for us. So I feel good about that.

是的。再說一遍，為什麼我們想將第一季與今年剩餘時間區分開來。顯然，這些合約的簽訂是因為我們在 2023 年完成的銷售。因此，為什麼我們對這些計劃的時機和每個計劃的實施感到滿意，是因為我們在我們獲勝的每個州都有一個國家平台。我們那裡已經有其他客戶了。如果我們不這樣做，那麼建立一個網路需要做很多工作，但我們不存在這個問題，因為我們已經集中在這些特定的州。因此，我們對時機和實施感到滿意。再說一次，我們已經賣掉這些了。所以這對我們來說實際上只是執行。所以我對此感覺很好。

Thanks.

謝謝。

Yes.

是的。

Thank you. Our next questions come from the line of Scott Fidel with Stephens. Please proceed with your question.

謝謝。我們的下一個問題來自斯科特·菲德爾和史蒂芬斯的對話。請繼續你的問題。

Hi, thanks. I'm back. I'm sorry, I was muted for my follow-up. So wanted to get those and on so on the next follow-up on just on the the NENT margins, I mean just given how important this metric is for all of us, can you just sort of tell us what is assumed for NENT margin inside of that 1Q 24 died and then Barb did give us that sort of exit rate of 88.5%. So I'm just just curious on sort of the sequencing of that between 1Q towards getting to that 8.5%?

你好謝謝。我回來了。抱歉，我的後續行動被靜音了。因此，我想在 NENT 利潤率的下一個後續行動中獲得這些信息，我的意思是，考慮到這個指標對我們所有人來說有多重要，您能否告訴我們 NENT 利潤率的假設是什麼？第一季24 人死亡，然後Barb 確實給了我們88.5% 的退出率。所以我只是好奇從第一季到達到 8.5% 的順序是怎麼樣的？

Yes. So So 1Q being down is driven from the items that we talked about, right? So it's re-determination. It's the recovery of utilization and also the mismatch, the loss that we had that hit us in Q1 and then the onboarding of our sales. And then you couple that with the continued ramp of our cost out that's already happening. So those items were at the low point in Q1 of that margin perspective for those reasons. But again, the sales are coming on. They already sold them right re-determination will be behind us, normalized utilization. We expect and we're in line with that. So it really gets down to the last component, which is those cost savings. And I talked about this in the script. I feel good about 60 as a total, right, but that's probably not going to not going to come until 2025. So really is what are we expecting to get in this year? So really, it's been getting 30 million that is about just execution. So which is why we gave that exit rate of 8% to 8.5%. So controllable in process and really down to that one item. So when you do have a number of in terms of what that computes forget and the MT. margin and one KOQ. one?

是的。那麼，第一季的下降是由我們討論的項目驅動的，對嗎？所以這是重新決定。這是利用率的恢復以及不匹配、我們在第一季遭受的損失以及隨後我們的銷售的啟動。然後你將其與我們已經發生的成本持續增加結合起來。因此，由於這些原因，這些項目在第一季處於利潤率的低點。但銷售又開始了。他們已經出售了他們的權利，重新確定將在我們身後，正常化利用。我們期望並符合這一點。因此，這實際上取決於最後一個組成部分，即節省成本。我在劇本中談到了這一點。我對總共 60 個感到滿意，對吧，但這可能要到 2025 年才會實現。那麼今年我們到底期望得到什麼呢？事實上，它已經獲得了 3000 萬美元，這只是執行。這就是為什麼我們給出 8% 到 8.5% 的退出率。流程如此可控，真正落實到那一項。因此，當您確實有一些計算內容和 MT 時，請忘記。保證金和 1 個 KOQ。一？

No, yes, that owns all of them. It will come down.

不，是的，它擁有所有這些。它會下來的。

Right.

正確的。

And then just to be in line with that, the margins will be lower in Q1 and Q2 and then start to ramp in Q3 and Q4 at So the ramp will be higher in Q3 and Q4 exiting at 8% to 8.5%.

然後為了與此保持一致，第一季和第二季的利潤率將較低，然後第三季和第四季的利潤率開始上升，因此第三季和第四季的利潤率將更高，達到8% 至8.5%。

Okay. We'll work through that in a model.

好的。我們將在模型中解決這個問題。

And then just the other follow-up question I want to ask about you did call out matrix on in the script. I was maybe hoping to get a little more more detail here in terms of I guess one, just you mentioned that performance has been good. Is there any any stats that you can share with us in terms of how that business performed, sort of exiting out of 23. And then that obviously, we're all interested in sort of the timing of the monetization opportunity here to announce like you think that's going to happen still in 24, but what's what would be the holdup here? Is it I know you want to be aligned with your partner? Are they not ready yet? Or maybe just walk us through sort of why just sort of getting to that monitorization catalyst opportunity?

然後我想問的另一個後續問題確實在腳本中調用了矩陣。我可能希望在這裡獲得更多細節，我猜，剛才你提到性能很好。您是否可以與我們分享有關該業務表現的任何統計資料（從 23 項中退出）。顯然，我們都對在這裡宣布的貨幣化機會的時機感興趣，就像你認為這將在 24 年內發生一樣，但是這裡會出現什麼阻礙？我知道你想與你的伴侶保持一致嗎？他們還沒準備好嗎？或者也許只是引導我們了解為什麼要獲得監控催化劑機會？

Yes. So first off, you're right, that the work that the team has done has been a tremendous ride that they've gone through a transformation ourselves from from Catherine, who's relatively new as CEO for the last couple years and you go through there, the management team that's new and across the board in all the metrics and of course, in the financials, it's showing up in any even strategically what they've done on the technology side. So the Company is very well oiled machine that has a very unique capability. They have a network of 5,000 nurses across the country that not only can do risk-adjustment, but they're in the home, which is why there's so much talk in value around that. But so I couldn't be more happy with what the team and successful. So we're not going to give you what happened out of 2023. We gave the broad range a number of times quarters ago and we're sticking with that of an EBITDA of 50 to 100 million. Again, why was that so broad because that was a long time ago. So I'd still use that as the right proxy for how you want to evaluate it.

是的。所以首先，你是對的，團隊所做的工作是一次巨大的旅程，他們經歷了凱瑟琳的轉變，凱瑟琳在過去幾年中擔任首席執行官相對較新，你經歷了那裡管理團隊在所有指標上都是全新且全面的，當然，在財務方面，它甚至體現在他們在技術方面所做的任何策略性工作中。因此，該公司是一家運作良好的機器，具有非常獨特的能力。他們在全國擁有一個由 5,000 名護士組成的網絡，不僅可以進行風險調整，而且他們可以在家中進行風險調整，這就是為什麼圍繞這一點的價值有如此多的討論。但我對團隊的成就和成功感到非常高興。因此，我們不會向您提供 2023 年之後發生的情況。我們在幾個季度前多次給出了廣泛的範圍，我們堅持 EBITDA 為 50 至 1 億。再說一次，為什麼這麼廣泛，因為那是很久以前的事了。所以我仍然會用它作為你想要如何評估它的正確代理。

So getting to the timing of modernization, we are completely aligned with our partners, their focus and our focus is, again to support the management team and at the right time to actually have it monetized and allow this team to really grow and do the great things about what I said in my script, it's within the next 12 months on and that aligns with what we are. But it gets back to again that it is performing and a very valuable asset in the marketplace. So hopefully that's helpful.

因此，談到現代化的時機，我們與我們的合作夥伴完全一致，他們的重點和我們的重點是，再次支持管理團隊，並在正確的時間將其真正貨幣化，並讓這個團隊真正成長並做出偉大的事情關於我在劇本中所說的內容，它是在接下來的 12 個月內進行的，並且與我們的現狀相符。但它又回到了它的表現，並且是市場上非常有價值的資產。希望這對您有所幫助。

Yes.

是的。

Okay. Thank you.

好的。謝謝。

Thank you. Our next question is come from the line of Bob Labick with CJS Securities. Please proceed with your question.

謝謝。我們的下一個問題來自 CJS 證券的 Bob Labick。請繼續你的問題。

Yes, hi, good morning. It's Pete Lukas for Bob. I just wanted to clarify your free cash flow targets for 24. Does that assume payment of those delayed payments that you called out and said you expect to get.

是的，嗨，早安。鮑伯是皮特·盧卡斯。我只是想澄清一下您 24 日的自由現金流目標。這是否假設您已經支付了您要求並表示希望收到的那些延遲付款。

Yes, it.

是的，它。

Great. And then I guess a lot has been covered. Just one more for me. How does the market for Matrix? How has it changed and for Matrix, how has it changed or evolved over time? And what are your current thoughts on the likelihood of Frasier monetizing the asset in 24?

偉大的。然後我想已經涵蓋了很多內容。只給我一個。Matrix的市場如何？它發生了怎樣的變化？對 Matrix 來說，它隨著時間的推移而發生了怎樣的變化或演變？您目前對 Frasier 在 24 小時內將資產貨幣化的可能性有何看法？

Yes. So similar to what I said before, I think we're aligned with our partners. The best thing is to support the management team and get the highest value. So my estimate of 12 months is what I expect, but it will be when it's the right time and and Frazier wants to also and monetize when that when the time is right, Tom. So consistent with what I said before, that's that's it from the value of matrixes, it's the nursing network, right? So it matches with what's happening in healthcare, though there is some pressures around risk adjustment, really though risk adjustment couldn't be more of a need than it has ever been because of what is necessary to do with that specific patient. So the value is we have a national platform across all the payers, risk adjustment demand remains. And then since you have those nurses and you're in the home, you can do a little bit more or a lot more whether that's giving a vaccine to closing another gap. So that's what we're enabling this management team to work on and build, and we will monetize at the right time.

是的。與我之前所說的類似，我認為我們與合作夥伴保持一致。最好的事情是支持管理團隊並獲得最高的價值。所以我對 12 個月的估計是我所期望的，但那會是在適當的時候，而且弗雷澤也希望在適當的時候實現貨幣化，湯姆。與我之前所說的一致，這就是矩陣的價值，這是護理網絡，對吧？因此，它與醫療保健領域正在發生的事情相匹配，儘管風險調整存在一些壓力，但實際上，由於需要對特定患者採取哪些措施，因此風險調整比以往任何時候都更加必要。因此，價值在於我們擁有一個涵蓋所有付款人的全國性平台，風險調整需求仍然存在。然後，既然你有這些護士，而且你在家裡，你可以做更多一點或更多，無論是注射疫苗還是縮小另一個差距。這就是我們讓管理團隊致力於和建構的目標，我們將在正確的時間實現盈利。

Great. Thanks, Bob.

偉大的。謝謝，鮑伯。

Did you have any further questions? It sounded like you were about to say something that's not NetSpend.

您還有其他問題嗎？聽起來你想說的不是 NetSpend 的話。

I'm good. Thanks.

我很好。謝謝。

Thank you.

謝謝。

Thank you. Our next question has come from the line of Mike Petusky with Barrington Research. Please proceed with your questions.

謝謝。我們的下一個問題來自 Barrington Research 的 Mike Petusky。請繼續回答您的問題。

Good morning. So I appreciate the commentary around your confidence in the collectibility of the delay and the possible timing. I didn't catch though, if you commented on it, is there a material disagreement between the parties in terms of what's actually out?

早安.因此，我很欣賞您對延遲的可回收性和可能的​​時間安排的信心的評論。但我沒明白，如果你對此發表評論，雙方在實際發布的內容方面是否存在重大分歧？

Well, so it's all of our contracts that are with shared risk. And this is why they they reconcile over many months. So that's complicated. But we've been we've been under this contract with this customer while one. They've been a long-time customer of ours, many, many years, and this contract structure started in late 2022. So we feel really good about the the math and the collection of the entire amount. It's in line with the requirements of the contracts up. We'll collect it within the next 60 days or so.

嗯，所以我們所有的合約都具有共同風險。這就是他們幾個月後才和解的原因。所以這很複雜。但我們已經與該客戶簽訂了這份合約。他們多年來一直是我們的長期客戶，這種合約結構於 2022 年底開始。因此，我們對整個金額的數學和收集感到非常滿意。符合合約的要求。我們將在接下來的 60 天內收集它。

And then And forgive me, I was off the call for about three minutes, and I may have missed this if you guys talked about this, but did you give or could you give sort of a sense of cadence of free cash between first half and second half. I see that the target is essentially sort of 50 million at the midpoint for 24. But just in terms of the cadence of first half versus second half?

然後請原諒我，我大約三分鐘沒接電話​​，如果你們談論這個，我可能會錯過這一點，但是你們是否給出了或者能否給出一種從上半場到上半場之間自由現金的節奏感下半場。我發現目標基本上是 24 月中點 5000 萬。但僅就上半場與下半場的節奏而言？

Yes.

是的。

Thanks for the question. As far as, yes, in the in the prepared remarks, we comment about the first half. We will we will have some tensions on our cash flow and we'll be generating the cash in the back half of the year.

謝謝你的提問。就目前而言，是的，在準備好的發言中，我們對上半場進行了評論。我們的現金流將會有些緊張，我們將在今年下半年產生現金。

So and yes, that's okay. So that's that part actually, comp but I was wondering if there might be at least some kind of range or quantification or range of exactly how much you are expecting within your guidance to have generate in the second half to get to that sort of 42?

所以，是的，沒關係。所以這實際上就是那部分，但我想知道是否至少有某種範圍或量化或範圍，您期望在您的指導下在下半年產生多少，以達到42？

It's really all of it in the second half, Mike. So again, the the amounts in the first half and then though Bob says tensions, but it really is redetermination and utilization and the contracts are working. So it's working capital. And the bulk of it is this increase in receivables because redeterminations bring down our membership. And that's just but the delta between that we throw in our balance sheet with the receivables. So it's arithmetic both in AR and then paying off the accounts of the contracts, payables, but the because we're going to be predetermination on any until April May. That's the main reason why we utilized so much in the first half of the year, but that's also done in the first half of the year, which is why we'll quickly ramp that rest of that kind of midpoint of 50.

這真的是下半場的全部，麥克。再說一次，上半年的金額，然後雖然鮑勃說緊張，但它確實是重新確定和利用，合約正在發揮作用。所以它是營運資金。其中大部分是應收帳款的增加，因為重新決定減少了我們的會員資格。這只是我們在資產負債表中與應收帳款之間的差額。因此，這都是 AR 中的算術，然後還清合約、應付帳款，但因為我們將在 4 月 5 月之前預先確定。這是我們在上半年使用如此多資金的主要原因，但這也是在今年上半年完成的，這就是為什麼我們將迅速增加 50 的中點的其餘部分。

Right.

正確的。

But I mean, it should be sorry for pressing on this, but I do think it's important. I mean, so are we looking at like sort of a negative 20, 25 a quarter in the first half and then and then sort of making making that up plus in the second half?

但我的意思是，對於堅持這一點應該感到抱歉，但我確實認為這很重要。我的意思是，我們是否會在上半場每季負20、25，然後在下半場彌補這一點？

Yes. So while we have a refinanced line and there'll be fluctuations that happen within the first the first couple of quarters. So we're not going to guide to what's actually going to happen in Q1 and Q2 around cash flow. But we have a lot of confidence in our exit rate around cash flow.

是的。因此，雖然我們有再融資額度，但在前幾個季度內會出現波動。因此，我們不會指導第一季和第二季現金流方面實際會發生什麼。但我們對現金流方面的退出率充滿信心。

Okay. And then I just wanted to So staying on this topic. In terms of free cash, the 40 to 60 odd target does not include that the any refi which you'll likely do in the first half, the refi of the 20 fives. And it also doesn't doesn't include the and the amendment to the revolver or is that not included in the 40 to 60 either?

好的。然後我只想繼續這個話題。就自由現金而言，40到60的目標不包括您可能在上半年進行的任何再融資，即20個五的再融資。而且它也不包括對左輪手槍的修改，或也不包括在40到60中？

Yes, the amendment to the revolvers in there.

是的，左輪手槍的修改就在那裡。

That's relatively small, right?

這是相對較小的，對吧？

Yes, but it doesn't include the additional interest on the 2025 and going?

是的，但是不包括2025年的額外利息，去哪？

I think it was Peter's question before we did give a range there. So I think it's going to be higher interest, but we'll also be bringing down as we start generating cash, we'll be able to bring down that line. So the right way to think about it right now, and we'll get more specific when we do refinance is in that higher end range, which was closer to 70 as a total annual number.

我認為這是彼得在我們給出範圍之前提出的問題。所以我認為利息會更高，但當我們開始產生現金時，我們也會降低利率，我們將能夠降低這條線。因此，現在考慮這個問題的正確方法是在較高的範圍內，當我們進行再融資時，我們會更具體，年度總數接近 70。

Okay. And then just last question, you sort of alluded to some some contract decisions being being being pushed out. Are you hopeful on obviously you've had great success in contract wins in 2020. Are you hopeful that in the second half of 20 for some of these decisions of these awards will be will be will be made and sort of setting up for 25 or can get a sense that a bunch of this may push into 25 and who knows beyond that?

好的。最後一個問題，您提到了一些合約決定被推遲。顯然，您對 2020 年在贏得合約方面取得的巨大成功充滿希望嗎？您是否希望在 20 世紀下半年做出這些獎項中的一些決定，並為 25 世紀做好準備，或者可以感覺到其中的一些可能會推進到 25 世紀，誰知道會超越那？

So what I was referring to was the state business with mobility. So and those a lot of those contracts especially in the second half of 23 and even in 24 have been pushed out. But I do expect RFPs to happen in 2024. But those will that when those awards happen. So that volume will come on until 2025. And then with the success rate that we had in our recent state bids that did come up and as we talked about, right, we won one and then extended one and then renewed. So I expect that we will win more than we lose. Therefore, that happens in 24. And we'll let you know when that happens in 24, but that and then we'll open it up and appropriately tell you what's going to happen in 25 and that new volume comes on. Any rough quantification of how much business is out there to sort of be bid on or not?

所以我指的是具有流動性的國營企業。因此，其中許多合同，尤其是 23 年下半年甚至 24 年的合約都被推遲了。但我確實預計 RFP 將在 2024 年進行。但當這些獎項頒發時，這些都會發生。因此該卷將持續到 2025 年。然後，隨著我們最近在州投標中的成功率確實出現了，正如我們所說，對，我們贏得了一項，然後延長了一項，然後續簽了。所以我預計我們贏的會比輸的多。因此，這發生在 24 日。我們會在 24 年發生這種情況時通知您，然後我們會打開它並適當地告訴您 25 年會發生什麼，並且新卷會出現。有多少業務可以競標或不可以競標的粗略量化數據嗎？

Yes. So so consistent will be, I think, a couple of quarters ago, we said this the TAM for ST is about 1.2 to 1.3 billion, and we have about half of that ourselves right now. So we have the ability to go after that other half, that entire 1.2 billion is not going to turn in 24 or even 25. But there will be meaningful opportunities for us to grow to retain that half as well as to grow above that.

是的。因此，我認為，幾個季度前，我們就說過 ST 的 TAM 約為 120 至 13 億，而我們現在自己擁有大約一半。所以我們有能力去追求另一半，這 12 億人不會變成 24 甚至 25。但我們將有有意義的機會來保持這一半並超越這一半。

All right. Very good. Thank you.

好的。非常好。謝謝。

Thank you.

謝謝。

Thank you. We have reached the end of our question and answer session. I would now like to turn the floor back over to Heath Sampson for any closing remarks.

謝謝。我們的問答環節已經結束。現在我想請希斯桑普森 (Heath Sampson) 發表結束語。

Thank you for participating in our call this morning. And for your interest in mode of care, our updated investor presentation is posted on our Investor Relations website. If you want to schedule a follow-up call, please contact Kevin Ellich, our Head of Investor Relations. Thanks, and have a great day.

感謝您今天早上參加我們的電話會議。為了滿足您對護理模式的興趣，我們更新的投資者介紹已發佈在我們的投資者關係網站上。如果您想安排後續電話會議，請聯絡我們的投資者關係主管 Kevin Ellich。謝謝，祝你有美好的一天。

Thank you. This does conclude today's teleconference. We appreciate your participation. You may disconnect at this time and enjoy the rest of your day, you all know.

謝謝。今天的電話會議到此結束。我們感謝您的參與。眾所周知，您此時可能會斷開連接並享受剩餘的一天。