ModivCare Inc (MODV) 2024 Q3 法說會逐字稿

Good morning, and welcome to ModivCare's third quarter 2024 financial results conference call. (Operator Instructions) Please note, this conference call is being recorded. I will now turn the call over to Kevin Ellich, Head of Investor Relations. Mr. Ellich, you may now begin.

早安，歡迎參加 ModivCare 2024 年第三季財務業績電話會議。（操作員指示）請注意，本次電話會議正在錄音。現在我將把電話轉給投資者關係主管 Kevin Ellich。埃利奇先生，現在您可以開始了。

Good morning and thank you for joining ModivCare's third quarter 2024 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. 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.

早安，感謝您參加 ModivCare 2024 年第三季財報電話會議和網路廣播。今天與我一起參加的是 ModivCare 總裁兼執行長 Heath Sampson；以及 ModivCare 的財務長 Barbara Gutierrez。在我們開始之前，我想提醒大家，在今天的電話會議上，管理階層將根據《私人證券訴訟改革法案》做出前瞻性陳述。這些聲明涉及風險、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美國證券交易委員會提交的文件中。

We will also discuss non-GAAP financial measures to provide additional information to investors. A definition of these non-GAAP financial measures and the applicable reconciliations to their 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. This morning, Heath Sampson will begin with opening remarks. Barbara Gutierrez will review our financial results and guidance.

我們還將討論非公認會計準則財務指標，以便向投資者提供更多資訊。這些非 GAAP 財務指標的定義以及與最直接可比較的 GAAP 財務指標的適用對帳包含在我們的新聞稿和 8-K 表中。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。今天上午，希斯桑普森將致開幕詞。芭芭拉古鐵雷斯 (Barbara Gutierrez) 將審查我們的財務結果和指導。

Then we'll open the call for questions. With that, I'll turn the call over to Heath.

然後我們將開始提問。說完這些，我會把電話轉給希思。

Good morning and thank you for joining our third quarter 2024 earnings call. This quarter has shown positive momentum, reflecting both operational enhancements and strengthened relationships even amid broad health care market shifts. Third quarter results were in line with our expectations with adjusted EBITDA of $43 million and revenue of $702 million. These results were driven by continued improvements in our Personal Care Services segment, higher margins in Remote Patient Monitoring and NEMT cost savings. We have made strides in optimizing technology to enhance processes, automating several contact center and back-office functions to improve our cost structure and reducing our NEMT unit costs through our multimodal network strategy initiative.

早安，感謝您參加我們的 2024 年第三季財報電話會議。本季度表現出積極的勢頭，即使在醫療保健市場發生廣泛變化的情況下，也反映出營運的改善和關係的加強。第三季業績符合我們的預期，調整後的 EBITDA 為 4,300 萬美元，營收為 7.02 億美元。這些結果得益於我們個人護理服務部門的持續改善、遠端病人監控的利潤率提高以及 NEMT 成本的節省。我們在優化技術以增強流程、自動化多個聯絡中心和後台功能以改善我們的成本結構以及透過多式聯運網路戰略計劃降低 NEMT 單位成本方面取得了長足進步。

During the quarter, we were successful in getting an amendment to our credit agreement, giving us temporary relief with our debt covenants. Our bank group continues to be constructive and supportive and we are working with them to finalize a long-term solution that provides us with the time needed to thoughtfully and strategically assess the best approach to optimize value for all stakeholders. Over the last several quarters, we have been actively working to reset several of our shared risk NEMT contracts through retrospective upfront prepayment increases. While these adjustments are a standard part of our annual resets, the impact of Medicaid redetermination and increased health care utilization created delays and increasing AR accruals. As a reminder, our contracts payables and our receivables accrue each quarter.

在本季度，我們成功修改了信用協議，從而暫時減輕了我們的債務負擔。我們的銀行集團繼續保持建設性和支持性，我們正在與他們合作，最終確定一個長期解決方案，為我們提供所需的時間，以便我們深思熟慮和策略性地評估為所有利益相關者優化價值的最佳方法。在過去的幾個季度中，我們一直在積極努力，透過追溯預付款增加來重置我們的幾份共享風險 NEMT 合約。雖然這些調整是我們年度重置的標準部分，但醫療補助重新確定的影響和醫療保健利用率的增加造成了延誤和應收帳款累積增加。提醒一下，我們的合約應付款項和應收款項每季都會累積。

They increase or decrease over 6- to 12-month reconciliation periods and subsequently settle over the next quarter. In the third quarter, we were able to collect gross contract receivable amounts of $105 million, including $42 million from retrospective prepayment resets, $39 million from an early settlement with our largest MCO client. Furthermore, our negotiations with clients to date have successfully reduced our contracts receivable build by 40% on a go-forward basis through increased upfront payments.

它們會在 6 到 12 個月的對帳期內增加或減少，然後在下一季穩定下來。第三季度，我們收回了 1.05 億美元的合約應收帳款總額，其中包括來自追溯預付款重置的 4,200 萬美元，以及與我們最大的 MCO 客戶的早期結算的 3,900 萬美元。此外，迄今為止，我們與客戶的談判已成功透過增加預付款將合約應收帳款減少了 40％。

We are working to address our remaining shared risk contracts through further prepayment updates and in many cases, shifting to fee-for-service arrangements, which will have monthly and quarterly payments. Our working capital and related free cash flow will continue to normalize over the next two to three quarters as these activities are completed and we work through the runoff from current payables and receivables.

我們正在努力透過進一步的預付款更新來解決我們剩餘的共享風險合同，並在許多情況下轉向按月和按季度付款的按服務收費安排。隨著這些活動的完成以及我們解決目前應付款項和應收款項的減少，我們的營運資金和相關自由現金流將在未來兩到三個季度繼續正常化。

We had a contract receivable balance of $110 million as of September 30, of which approximately 70% is contractually due to us by the end of the second quarter of 2025. This excludes any future receivable build. Regarding our contract payables, we expect to settle or repay substantially all of the existing payables balance, which was $47 million by the end of the second quarter of 2025. Additionally, we anticipate the build and receivables over the next two quarters will also be settled in mid-2025 as the contracts complete and we transition to new fee-for-service contracts. Shifting to our guidance.

截至 9 月 30 日，我們的合約應收帳款餘額為 1.1 億美元，其中約 70% 按合約規定應於 2025 年第二季末支付。這不包括任何未來的應收帳款。關於我們的合約應付款，我們預計將結清或償還大部分現有應付款餘額，到 2025 年第二季末為 4,700 萬美元。此外，我們預計，隨著合約完成以及我們過渡到新的按服務收費合同，未來兩個季度的建設和應收帳款也將在 2025 年中期結算。轉向我們的指導。

In mid-September, we lowered our 2024 adjusted EBITDA guidance to a range of $170 million to $180 million, primarily due to some repricing in our NEMT segment that were agreed to strategically retain or expand key customer relationships. We have ongoing discussions that could have a material positive or negative impact in 2024 financial results within the range we provided. Thus, we are not adjusting our guidance. We expect 2025 adjusted EBITDA to increase approximately 10%, driven by membership growth and new contract wins as well as cost savings and other strategic initiatives. Our transformation across all segments has created a foundation for stability with technology, clinical capabilities and customer engagement differentiations at scale.

9 月中旬，我們將 2024 年調整後 EBITDA 指引下調至 1.7 億美元至 1.8 億美元之間，這主要是因為我們對 NEMT 部門進行了一些重新定價，並同意在策略上保留或擴大關鍵客戶關係。我們正在進行的討論可能會對我們所提供的範圍內的 2024 年財務業績產生重大正面或負面影響。因此，我們不會調整我們的指導。我們預計 2025 年調整後 EBITDA 將成長約 10%，這主要得益於會員成長、新合約簽訂以及成本節約和其他策略舉措。我們在所有部門的轉型為技術、臨床能力和客戶參與差異化的穩定性奠定了基礎。

This positions us for sustainable growth, enhancing the near-term and long-term value for our business. We will provide more information regarding our 2025 outlook when we report fourth quarter and full year 2024 results, which is our normal cadence for providing more details. Over the past 18 months, the government-funded health care arena has faced several headwinds from material regulations, rising cost, a strained workforce and a growing chronic population. Our MCO clients, especially managed Medicaid, have been dealing with a number of issues, including Medicaid redetermination and the normalization of utilization. The Berkeley Research Group projects MA medical costs will increase 4% to 6% in 2025.

這使我們實現了永續成長，並提高了我們業務的短期和長期價值。我們將在報告 2024 年第四季度和全年業績時提供有關 2025 年展望的更多信息，這是我們提供更多詳細信息的正常節奏。在過去 18 個月中，政府資助的醫療保健領域面臨來自材料監管、成本上漲、勞動力緊張和慢性病患者人數增加等多重阻力。我們的 MCO 客戶，尤其是管理醫療補助的客戶，一直在處理許多問題，包括醫療補助重新確定和使用率正常化。柏克萊研究小組預測，2025 年麻州的醫療費用將上漲 4% 至 6%。

As a result of lower rates and higher costs, our MA, MCO clients have exited several unprofitable geographies and reduced supplemental benefit spend on transportation and other supportive care services. As a reminder, Medicare Advantage accounts for about 15% of our NEMT revenue and 25% of our RPM revenue.

由於費率降低和成本上升，我們的 MA、MCO 客戶已經退出了幾個無利可圖的地區，並減少了在交通和其他支持性護理服務方面的補充福利支出。提醒一下，Medicare Advantage 約占我們 NEMT 收入的 15% 和 RPM 收入的 25%。

We anticipate a shift of our MA mix to winners from losers as a result of potential changes. We are focusing on our sales and product strategy around these shifts, listening to our clients and developing MA products in response to the expected shifts in the market. In 2025, we do anticipate a contraction in Medicare Advantage business.

由於潛在的變化，我們預計我們的 MA 組合將從失敗者轉變為贏家。我們專注於圍繞這些變化製定銷售和產品策略，傾聽客戶的意見並開發 MA 產品以應對市場預期的變化。2025 年，我們確實預期醫療保險優勢計畫業務將會萎縮。

As our clients' MA membership firm up, this will be reflected in our 2025 budget with more details to follow on our next earnings call. Once we get beyond these changes, our supportive care services are well positioned to benefit from the tailwinds in MA and its focus in 2027 to integrating duly eligible members, health equity and SDOH measures. From an operational perspective, the NEMT segment continues to perform well with high on-time performance, low missed trips and historically low complaints.

隨著我們客戶的 MA 會員資格不斷鞏固，這將反映在我們的 2025 年預算中，更多詳細資訊將在下次收益電話會議上公佈。一旦我們克服這些變化，我們的支持性護理服務將受益於馬薩諸塞州的順風，並在 2027 年重點整合符合資格的會員、健康公平和 SDOH 措施。從營運角度來看，NEMT 部門持續表現良好，準時性高，誤班率低，投訴量也創歷史新低。

Our team has driven efficiencies through automation and optimizing the latest technologies, which has driven significant efficiencies and cost savings. In the third quarter, we realized $3 million of net cost savings driven primarily by our strategic initiatives in our NEMT segment.

我們的團隊透過自動化和優化最新技術來提高效率，從而顯著提高效率並節省成本。第三季度，我們實現了 300 萬美元的淨成本節約，這主要得益於我們 NEMT 部門的策略性舉措。

Since we started these initiatives in mid-2023, we have made major strides enhancing our technology capabilities by implementing new contact center technologies, enhancing the member experience and more capabilities to provide assistance while also driving cost savings, evident by lower payroll and other expense per trip, which is down approximately 25% over the last 18 months. Additionally, we have gained operating leverage through our multimodal strategy, reducing unit cost or purchase service expense per trip even in the face of rising utilization while ensuring members are aside the most medically appropriate level of service for their needs.

自 2023 年中期啟動這些計劃以來，我們透過實施新的聯絡中心技術、增強會員體驗和提供更多援助的能力，在增強技術能力方面取得了重大進展，同時也節省了成本，這體現在每次旅行的工資和其他費用降低，在過去 18 個月中下降了約 25%。此外，我們透過多式聯運策略獲得了營運槓桿，即使在利用率不斷上升的情況下也能降低每次行程的單位成本或購買服務費用，同時確保會員能夠享受到最適合其需求的醫療服務水平。

While we have made significant progress to optimize our cost structure, we believe there is more opportunity and expect additional cost savings will be realized over the next 12 months. During the third quarter, we won $12 million of NEMT annual contract value or ACV and have added $81 million year-to-date. We have successfully renewed or extended all the state NEMT contracts this year.

雖然我們在優化成本結構方面取得了重大進展，但我們相信還有更多機會，並預計未來 12 個月將實現額外的成本節約。第三季度，我們贏得了價值 1200 萬美元的 NEMT 年度合約（ACV），今年迄今已增加 8,100 萬美元。今年，我們成功續約或延長了所有國家 NEMT 合約。

Our NEMT pipeline remains strong with $1.5 billion of ACV. Our multipronged go-to-market strategy is positioning us for growth, not only with existing clients, but also with new clients who were previously disillusioned in 2019 to 2022. We've come a long way with tangible tech-enabled and when appropriate, high-touch performance. This year, we have successfully renewed, retained and extended state NEMT contracts and have a significant opportunity over the next five years as our new and expansion contract pipeline is valued at $1.7 billion. We are also seeing a shift in client retention as certain clients who previously moved to competitors focused on pricing or simplified solutions are now experiencing performance and cost issues.

我們的 NEMT 通路依然強勁，ACV 達到 15 億美元。我們多管齊下的行銷策略不僅讓我們與現有客戶實現了成長，也讓我們與 2019 年至 2022 年期間感到失望的新客戶實現了成長。我們憑藉切實的技術支援以及在適當的情況下提供高接觸性能已經取得了長足的進步。今年，我們成功續簽、保留和延長了國家 NEMT 合同，並且在未來五年內擁有巨大的機遇，因為我們的新合約和擴建合約管道價值 17 億美元。我們也看到客戶保留率的轉變，因為某些先前轉向專注於定價或簡化解決方案的競爭對手的客戶現在遇到了效能和成本問題。

Our commitment to sustainable partnership position us well and we are in close contact with these clients, expecting to win back their business in 2025 as they prioritize quality, member satisfaction and cost stability. In our Personal Care Services segment, we're making progress growing ours. We have successfully executed a transformation, building upon a unique platform with standardized technology, operational and compliance excellence. Our focus is to continuously optimize aligning our hiring with business development to accelerate the right referrals at the right time, therefore, improving top line growth. We anticipate further operational efficiencies and margin improvement over time, reinforcing the strength of our transform platform.

我們致力於建立可持續的合作夥伴關係，這使我們處於有利地位，並且我們與這些客戶保持著密切聯繫，期望在 2025 年重新贏得他們的業務，因為他們優先考慮品質、會員滿意度和成本穩定性。在我們的個人護理服務領域，我們正在取得進展並不斷發展。我們已成功實現轉型，建立在具有標準化技術、卓越營運和合規性的獨特平台之上。我們的重點是不斷優化招募與業務發展的結合，在正確的時間加速正確的推薦，從而提高營收成長。我們預計隨著時間的推移，營運效率和利潤率將進一步提高，從而增強我們轉型平台的實力。

Now I'd like to provide an update on New York's Consumer-Directed Personal Assistance Program, known as CDPAP. The state selected a single vendor as the exclusive administrator for New York CDPAP. PPL plans to have four large regional contractors and 30 subcontractors that will work with them in New York, and we have 1 of the 30. This is a dramatic shift from today's 700-plus fiscal intermediaries. While this change is slated to go in effect in April 1, 2025, many industry stakeholders, including legislators and one of the large regional subcontractors have voiced concern that the timeline is too aggressive and unviable.

現在我想介紹一下紐約消費者主導個人援助計劃（CDPAP）的最新情況。該州選擇了一家供應商作為紐約 CDPAP 的獨家管理者。PPL 計劃在紐約擁有 4 個大型區域承包商和 30 個分包商與其合作，而我們是這 30 個分包商中的 1 個。這與如今的700多家財政中介機構相比有著巨大的轉變。雖然這項變更定於 2025 年 4 月 1 日生效，但包括立法者和一家大型地區分包商在內的許多行業利益相關者都表示擔心，該時間表過於激進且不可行。

We expect this transition to be further delayed. There remains a lot of challenge with the state's new approach to CDPAP. However, we have been operating in the New York market for decades and in several counties and we expect to continue to be an experienced market leader. In 2024, reimbursement rates increased in two of our largest states, New York and New Jersey. Subsequent to the end of the third quarter, West Virginia saw a meaningful rate increase and we continue to advocate at the state and local level among our peers.

我們預計這一轉變將進一步推遲。國家對 CDPAP 的新方法仍有許多挑戰。然而，我們已經在紐約市場和多個縣運作了幾十年，我們希望繼續成為經驗豐富的市場領導者。2024 年，我們兩個最大的州紐約州和新澤西州的報銷率都有所增加。第三季結束後，西維吉尼亞州的稅率大幅上漲，我們將繼續在州和地方層級向同業發出倡議。

Our largest state, Pennsylvania, hasn't had a rate increase in over four years. Recently, the state requested public participation for a rate study, which could be a precursor to a potential rate increase that would be very meaningful for our PCS segment. Moving on to our RPM or monitoring segment. Revenue increased 2% sequentially and adjusted EBITDA margin was nearly 37% due to a concerted effort to manage costs. While top line growth is still lower than historical growth rates, primarily due to attrition within our MA portfolio, we expect growth will continue to improve over the coming quarters driven by new business wins and operating leverage.

我們最大的州賓州四年多來一直沒有升息。最近，州政府要求公眾參與費率研究，這可能是潛在費率上調的前兆，這對我們的 PCS 部門來說意義重大。繼續我們的 RPM 或監控部分。由於齊心協力控製成本，營收季增 2%，調整後 EBITDA 利潤率接近 37%。儘管營收成長仍低於歷史成長率，主要原因是 MA 投資組合內的人員流失，但我們預計，在未來幾個季度，在贏得新業務和經營槓桿的推動下，成長將繼續改善。

That being said, we expect the headwinds to continue in 2025 for MA supplemental benefits within [PERS]. As the premier PERS provider in the Medicaid long-term services market, our stable reoccurring revenue averages around five years per member, creating a stacking effect on long-term growth. Our unique technology-driven clinical monitoring solution is also gaining traction. We've effectively balanced low-cost continuous monitoring with targeted clinical oversight. Results from early pilot programs have been very encouraging, delivering significant value through innovation.

儘管如此，我們預計 2025 年 MA 補充福利仍將面臨阻力，[人員緊急應變系統]作為醫療補助長期服務市場中首屈一指的 PERS 提供者，我們每位會員平均五年左右的穩定經常性收入，對長期成長產生了累積效應。我們獨特的技術驅動的臨床監測解決方案也越來越受到關注。我們有效地平衡了低成本的持續監測和有針對性的臨床監督。早期試點計畫的結果非常令人鼓舞，透過創新提供了巨大的價值。

Combined with our Medicaid business, long-term growth and robust margins, this positions us for sustained success. In summary, we've clearly made meaningful strides in taking out costs and driving efficiency in all parts of our business, especially in EMT. The centralization and standardization in our Personal Care Services segment is nearly done and leading indicators are showing continued margin improvement over the next few quarters. We have gone through an unprecedented time with the impact of Medicaid redeterminations, which has created greater-than-expected volatility in the timing of our working capital normalization and cash flow generation. We believe there is considerable underlying value in our three segments.

結合我們的醫療補助業務、長期成長和強勁的利潤率，這使我們能夠持續取得成功。總而言之，我們在降低成本和提高業務各個環節效率方面都取得了顯著的進展，尤其是在 EMT 領域。我們的個人護理服務部門的集中化和標準化已接近完成，領先指標顯示未來幾季利潤率將繼續提高。我們經歷了前所未有的時期，受到了醫療補助重新確定的影響，這為我們的營運資本正常化和現金流產生的時間帶來了比預期更大的波動。我們相信，我們的三個部門具有相當大的潛在價值。

As previously stated, delevering our balance sheet is a top priority. Meantime, discussions with our bank group have been productive and we expect to have a long-term collaborative solution completed in the near term. Once this is done, we have a number of levers that we can pull to enhance stakeholder value. We are considering all options, but we will be strategic and thoughtful about which path we take to ensure we drive the best outcome for all our stakeholders. I'd like to thank all our teammates at ModivCare for their hard work and dedication, providing high-quality services to all our members and clients.

如前面所說，降低資產負債表中的槓桿率是當務之急。同時，我們與銀行集團的討論也很有成效，我們預計在短期內完成一個長期合作解決方案。一旦完成，我們就可以採取多種手段來提升利害關係人的價值。我們正在考慮所有的選擇，但我們將策略性地、深思熟慮地選擇採取哪條道路，以確保為所有利害關係人帶來最好的結果。我要感謝 ModivCare 所有隊友的辛勤工作和奉獻精神，為我們所有會員和客戶提供高品質的服務。

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

現在我將電話轉給 Barb，她將分享有關我們的財務表現和 2024 年展望的更多詳細資訊。巴布？

Thank you, Heath, and good morning, everyone. Third quarter 2024 revenue increased 2% year-over-year to $702 million, driven by 5% PCS growth and 1% NEMT growth. Third quarter net loss was approximately $27 million and adjusted net income was $6 million or $0.45 per diluted share. Third quarter adjusted EBITDA was $43 million or 6.2% of revenue, driven by solid performance in our RPM and PCS segments as well as continued operational improvements and cost savings in NEMT. Turning to review of our segment financials.

謝謝你，希斯，大家早安。2024 年第三季營收年增 2% 至 7.02 億美元，這得益於 PCS 成長 5% 和 NEMT 成長 1%。第三季淨虧損約 2,700 萬美元，調整後淨收入為 600 萬美元，即每股攤薄收入 0.45 美元。第三季調整後的 EBITDA 為 4,300 萬美元，佔營收的 6.2%，這得益於 RPM 和 PCS 部門的穩健表現以及 NEMT 持續的營運改善和成本節約。回顧我們分部的財務狀況。

NEMT third quarter revenue increased 1% year-over-year and was relatively flat sequentially at $492 million. NEMT revenue benefited from the onboarding of new contracts and contract reconciliations, offset by slightly lower revenue per member. Average monthly membership increased about 1% sequentially to $30 million due to the onboarding of previously announced contract wins, while trip volume increased 4%, leading to a 34 basis point increase in utilization to 10.48%, which was in line with our expectations. Revenue per trip decreased 3.8% sequentially due to trip mix. On a sequential basis, NEMT gross margin decreased approximately 150 basis points to 11.3%, primarily due to growth in trips as well as trip mix, which was partially offset by our cost-saving initiatives, resulting in reduced service expense per trip of 2%.

NEMT 第三季營收年增 1%，與上季持平，為 4.92 億美元。近端微電子顯微技術收入受益於新合約的簽訂和合約對賬，但會員人均收入略有下降。由於先前宣布的合約勝利，平均每月會員人數環比增長約 1%，達到 3000 萬美元，而出行量增長了 4%，導致利用率增加了 34 個基點，達到 10.48%，符合我們的預期。由於行程組合原因，每次行程收入季減 3.8%。與上一季相比，NEMT 毛利率下降約 150 個基點至 11.3%，主要原因是行程數量和行程組合增加，但我們的成本節約舉措部分抵消了這一影響，導致每次行程的服務費用減少 2%。

Purchased services expense per trip decreased 1% quarter-over-quarter to $3.75, driven by our multimodal initiatives. Payroll and other expense per trip decreased 9% sequentially to $5.60, which included a onetime benefit in salaries and wages. Payroll and other expense per trip, excluding the onetime benefit, remains lower sequentially and year-over-year and we expect the trend to continue in the right direction. NEMT adjusted EBITDA was approximately $31 million and NEMT margin decreased 99 basis points sequentially to 6.2%, driven by higher utilization, trip mix and higher G&A. During the third quarter, Medicaid redeterminations impacted our NEMT membership by approximately 220,000 members and adjusted EBITDA by less than $1 million, which was modestly higher than we anticipated as some of our larger states saw a greater-than-expected impact in the quarter.

受我們多式聯運計劃的推動，每次旅行的購買服務費用環比下降 1% 至 3.75 美元。每次出行的工資和其他費用環比下降 9% 至 5.60 美元，其中包括工資和薪水的一次性福利。每次出行的薪資和其他費用（不包括一次性福利）比上個季度和去年同期仍然較低，我們預計這一趨勢將繼續朝著正確的方向發展。NEMT 調整後的 EBITDA 約為 3,100 萬美元，NEMT 利潤率較上季下降 99 個基點至 6.2%，這得益於利用率提高、行程組合變動和 G&A 增加。在第三季度，醫療補助的重新確定對我們的 NEMT 會員產生了約 220,000 名影響，調整後的 EBITDA 減少了不到 100 萬美元，這略高於我們的預期，因為我們的一些較大的州在本季度受到的影響大於預期。

Overall, redeterminations have trended in line with our expectations, and we anticipate a minimal impact on our Medicaid membership for the remainder of the year. Turning to our Personal Care Services segment. Third quarter Personal Care revenue increased 5% year-over-year to approximately $189 million, driven by 3% growth in hours and 2% growth in revenue per hour. As a reminder, we received reimbursement rate increases from New York and New Jersey this year and we also received a meaningful rate increase from West Virginia subsequent to the end of the quarter. Personal Care adjusted EBITDA was approximately $16 million or 8.3% of revenue, which was a modest improvement from the second quarter, driven primarily by lower adjusted G&A expense and slightly lower service expense per hour.

總體而言，重新確定的趨勢符合我們的預期，我們預計今年剩餘時間對我們的醫療補助會員資格的影響將很小。轉向我們的個人護理服務部門。第三季個人護理收入年增 5% 至約 1.89 億美元，這得益於工作時間增長 3% 和每小時收入增長 2%。提醒一下，今年紐約和新澤西州的報銷率有所提高，而且在本季末，西維吉尼亞州的報銷率也有所提高。個人護理調整後的 EBITDA 約為 1,600 萬美元，佔收入的 8.3%，較第二季度略有改善，主要原因是調整後的 G&A 費用降低以及每小時服務費用略有下降。

We continue to expect additional margin improvement in the fourth quarter, driven by our efforts to drive operational efficiencies and reduce costs. RPM revenue decreased approximately 2% year-over-year and increased 2% sequentially to $19 million after higher-than-normal contract churn in the first half of the year. RPM adjusted EBITDA was $7.1 million or a 37% margin, driven by aligned service expense and mix compared to the previous quarter. We anticipate some headwinds from MA supplemental benefit changes going forward, but with expected new client onboarding and continued focus on cost management, RPM margins should remain in the mid-30% range going forward. Turning to our balance sheet and cash flow.

我們繼續預計第四季度利潤率將進一步提高，這得益於我們努力提高營運效率和降低成本。由於上半年合約流失率高於正常水平，RPM 收入年減約 2%，季增 2%，至 1,900 萬美元。RPM 調整後的 EBITDA 為 710 萬美元，利潤率為 37%，這得益於與上一季相比一致的服務費用和組合。我們預計未來 MA 補充福利變化會帶來一些阻力，但隨著預期的新客戶加入和對成本管理的持續關注，RPM 利潤率未來應能保持在 30% 左右的中間水平。轉向我們的資產負債表和現金流。

During the third quarter, free cash flow was $1.5 million, consisting of net cash provided by operating activities of approximately $9.3 million and capital expenditures of $7.7 million. We ended the quarter in a net contract receivables position of approximately $63 million, down from a net contract receivables position of $79 million at the end of Q2. On a net basis, contract receivables decreased by $55 million sequentially to $110 million, primarily due to successful collection of pricing resets and reconciliations during the quarter. Net contract payables decreased by $40 million quarter-over-quarter to $47 million. This decrease was due to reconciliation and settlement on certain contracts that were expected in the third quarter.

第三季度，自由現金流為 150 萬美元，其中包括經營活動提供的淨現金約 930 萬美元和資本支出 770 萬美元。截至本季末，我們的淨合約應收帳款狀況約為 6,300 萬美元，低於第二季末的 7,900 萬美元。以淨額計算，合約應收款環比減少 5,500 萬美元至 1.1 億美元，主要由於本季成功收取價格重置和對帳款項。淨合約應付款項季減 4,000 萬美元至 4,700 萬美元。這一下降是由於預計在第三季進行的某些合約的核對和結算所致。

Over the last several quarters, we have successfully renegotiated a number of our shared risk contracts to increase the upfront prepayment amounts and in some cases, accelerate contract receivable settlements otherwise due in subsequent quarters. As a result of the prepayment resets, we have been able to reduce our recent quarterly gross contract receivables build rate by 40% on a go-forward basis and improve our upfront cash flow conversion. In the third quarter, we collected $105 million of gross contract receivables, including $42 million from retrospective prepayment resets and $39 million from early settlements. While we had a net inflow of $16 million from our contract receivables and payables, other working capital fluctuations, including $25 million of debt refinancing costs led to a $45 million increase in our revolving credit facility, which had a balance of $228 million as of September 30. At the end of the third quarter, we proactively amended our credit agreement to increase the total net leverage ratio covenant for September 30, 2024, to 6.5x from 5.25x and reduced the minimum interest coverage ratio covenant to 2.0x from 2.5x.

在過去幾個季度中，我們成功地重新協商了若干共擔風險合同，以增加預付款金額，並且在某些情況下，加快了原本應在隨後幾個季度到期的合同應收賬款結算。由於預付款重置，我們能夠將最近季度的合約應收帳款總額累積率降低 40%，並改善前期現金流轉換。第三季度，我們收回了1.05億美元的總合約應收款，其中包括4,200萬美元來自追溯預付款重置以及3,900萬美元來自提前結算。雖然我們的合約應收款和應付款項淨流入 1,600 萬美元，但其他營運資金波動（包括 2,500 萬美元的債務再融資成本）導致我們的循環信貸額度增加 4,500 萬美元，截至 9 月 30 日的餘額為 2.28 億美元。第三季末，我們主動修改了信用協議，將2024年9月30日的總淨槓桿率承諾從5.25倍提高至6.5倍，並將最低利息覆蓋率承諾從2.5倍降低至2.0倍。

As of September 30, 2024, we had approximately $1.2 billion of debt and our bank-defined net leverage ratio was 5.6x. We are still in discussions with our bank group for a long-term relief amendment to ensure continued compliance and we'll provide an update once complete. We ended the third quarter with $48 million in cash. As a reminder, we make our semiannual interest payment on our 2029 senior unsecured notes in the second and fourth quarters. And the first interest payment on our new term loan facility was due on October 1, which will be due at each quarter end going forward.

截至 2024 年 9 月 30 日，我們的債務約為 12 億美元，銀行定義的淨槓桿率為 5.6 倍。我們仍在與銀行集團討論長期救濟修正案，以確保持續合規，完成後我們將提供最新消息。第三季結束時，我們的現金餘額為 4,800 萬美元。提醒一下，我們在第二季和第四季對 2029 年優先無擔保票據進行半年一次的利息支付。我們的新定期貸款的首筆利息將於 10 月 1 日到期，並且將從現在起在每個季度末到期。

Turning to 2024 guidance. We maintained our 2024 revenue guidance in a range of $2.7 billion to $2.9 billion and our adjusted EBITDA guidance in a range of $170 million to $180 million. Here are a few qualitative and quantitative items for you to consider for the remainder of 2024. Medicaid redetermination continues to track in line to slightly better than our original expectations and we anticipate a minimal impact for the remainder of the year. We expect a positive contribution from contract mix and utilization, which consists of, one, membership from net new contract wins; two, trip volume mix; and three, contract repricing.

轉向2024年指導。我們將 2024 年的營收預期維持在 27 億美元至 29 億美元之間，並將調整後的 EBITDA 預期維持在 1.7 億美元至 1.8 億美元之間。以下是您在 2024 年剩餘時間內需要考慮的一些定性和定量項目。醫療補助的重新確定繼續按照我們最初的預期進行，我們預計今年剩餘時間的影響將很小。我們預期合約組合和使用率將帶來正面貢獻，其中包括：一是來自淨新合約贏得的會員資格；二、出行量組合；三、合約重新定價。

We have achieved our cost savings target for the year with year-to-date savings of $40 million. For the remainder of the year, we expect to achieve further modest net cost savings driven by our strategic initiatives in NEMT. We anticipate continued contribution and growth from PCS and RPM as well as our business development activities, which is expected to have a positive impact on membership and trip volume mix. We will provide more details regarding our 2025 outlook when we report fourth quarter and full year 2024 results, which is our normal cadence for providing full year guidance. In summary, our third quarter financial results were in line with our expectations.

我們實現了今年的成本節約目標，今年迄今已節省 4,000 萬美元。在今年剩餘時間內，我們預計在 NEMT 策略措施的推動下，將進一步實現適度的淨成本節約。我們預計 PCS 和 RPM 以及我們的業務發展活動將繼續做出貢獻並實現成長，這有望對會員數量和旅行量組合產生積極影響。我們將在報告 2024 年第四季度和全年業績時提供有關 2025 年展望的更多詳細信息，這是我們提供全年指引的正常節奏。總的來說，我們第三季的財務表現符合我們的預期。

We were pleased with the significant collections of our contract receivables and continue efforts to work with our payers to tighten reconciliation periods on a go-forward basis. We continue to focus on maximizing value in each of our operating segments through growth and operating cost efficiencies. In the near term, we are concentrating on completing the long-term amendment on our credit facility to provide us flexibility and runway as we work on our top priority to delever our balance sheet. I would like to thank all of our teammates across the organization for their hard work and dedication. Your efforts are greatly appreciated as we continue serving our members and clients.

我們很高興收到大量合約應收帳款，並將繼續努力與付款人合作，縮短對帳期。我們將繼續致力於透過成長和營運成本效率來實現每個營運部門的價值最大化。短期內，我們正專注於完成信貸安排的長期修訂，從而為我們提供靈活性和跑道，因為我們的首要任務是降低資產負債表的槓桿率。我要感謝整個組織的所有隊友的辛勤工作和奉獻精神。我們非常感謝您的努力，我們將繼續為我們的會員和客戶提供服務。

Operator, please open the call for questions.

接線員，請打開電話詢問問題。

(Operator Instructions) And we'll take our first question from Brian Tanquilut from Jefferies.

(操作員指示)我們將回答 Jefferies 的 Brian Tanquilut 提出的第一個問題。

So first question, as I listen to your comments and prepared remarks on this fee-for-service shift that seems to be part of the new strategy. Maybe if you can just talk to us about, number one, the why? Is that reflective of expectation that utilization will remain [data]? And then two, maybe just the margin implications? And then three, is this something that you expect state plans to agree to as well?

所以第一個問題，當我聽取您對這種按服務收費轉變的評論和準備好的評論時，這似乎是新策略的一部分。也許您能跟我們談談，第一，為什麼？這是否反映了利用率將保持[數據]？其次，也許只是利潤影響？第三，您是否希望國家計畫也同意這一點？

Or is this limited to managed Medicaid?

還是這僅限於管理醫療補助？

Yes. I'll start from the -- your last question. So the state Medicaid, the contracts will likely remain full risk. We're seeing that. And so I don't expect those to move from where they are.

是的。我將從你的最後一個問題開始。因此，州醫療補助合約可能仍將存在全部風險。我們看到了這一點。所以我不希望它們從現在的位置移動。

And again, we've seen our renewals in that space and those continue to be at the full risk side of things, which is, again, 40%-ish of our revenue. And then the shared risk is definitely where you'll see the change. And this is a change that we are supportive of and pushing towards to ensure that we can get paid on a monthly basis or a quarterly basis. And you just do the math on the cost of capital, it makes a ton of sense to do that. And then -- because there is price compression that happens on that.

而且，我們已經看到我們在該領域的續約，而這些續約仍然處於完全風險之中，這又佔了我們收入的 40% 左右。那麼，您肯定會在共享風險方面看到變化。我們支持並推動這項變革，以確保我們能夠按月或按季度獲得報酬。只要你計算一下資本成本，就會發現這樣做非常有意義。然後——因為發生了價格壓縮。

So again, that far outweighs the price compression that we're seeing. In addition to the price compression, the efficiency that we're gaining in the system in the model, especially when we have scale is a really competitive advantage to ensure that we can compete on that price and not feel the compression that happens. So the math makes sense. The model and the initiatives that we did have -- acted on and continue to act on really give us a competitive advantage. So -- but you will see the price compression happen and again, as expected and we want that because of the timing of cash flow.

所以，這遠遠超過了我們看到的價格壓縮。除了價格壓縮之外，我們在模型系統中獲得的效率，特別是當我們擁有規模時，是一種真正的競爭優勢，以確保我們能夠在價格上競爭，而不會感受到價格壓縮。因此這數學計算是有道理的。我們已採取並將繼續採取的模式和措施確實為我們帶來了競爭優勢。所以 - 但你會看到價格壓縮再次發生，正如預期的那樣，我們希望這是因為現金流的時間表。

Got it. Okay. And then maybe since you mentioned cash flow, I appreciate all the detail on the moving pieces between AP and AR. But as I think about back half or mid-2025, how should we be thinking about we have a cash position or net AR versus AP position with you? What would that look like?

知道了。好的。既然您提到了現金流，那麼我很欣賞 AP 和 AR 之間移動部分的所有細節。但當我想到 2025 年下半年或中期時，我們應該如何考慮我們擁有的現金部位或淨應收帳款與應付帳款部位？那會是什麼樣子的呢？

And then what are you seeing in terms of new receivables coming in as you amend these contracts? We're hearing some delays in other areas of health care in terms of pay. So just curious what you're seeing there and what your expectations are?

那麼，當您修改這些合約時，您看到有什麼新的應收帳款產生？我們聽說醫療保健的其他領域在薪酬方面出現了一些延遲。所以只是好奇你在那裡看到了什麼以及你的期望是什麼？

Yes. So we couldn't be more proud of the team and actually the partnership with all our clients out there to get through this -- the health care industry and specifically our clients that we're managing on the shared risk side with redetermination coupled with higher utilization, the costs were higher than a lot of them expected. And that was painful, which is why these last couple of quarters, we've been disclosing these items. But it's -- and that was '23 cycle as well as '24 because, again, most of these contracts, especially in a weighted perspective are 12 months and then you have a quarter after that a reconciliation. So we're through that tough period, which is why we gave so much disclosure on how much we have collected and where we are.

是的。因此，我們對團隊以及與所有客戶的合作感到無比自豪，我們與醫療保健行業以及我們在共享風險方面管理的客戶一起度過了難關，重新確定加上更高的利用率，成本高於許多客戶的預期。這是令人痛苦的，這就是為什麼最近幾季我們一直在披露這些項目。但這是 23 年和 24 年的周期，因為大多數這些合同，特別是從加權角度來看，都是 12 個月，然後有一個季度，之後進行對帳。所以我們已經度過了那段艱難時期，這就是為什麼我們如此詳細地披露我們收集了多少資金以及我們目前所處的位置。

But we still have the '24 contracts to roll off. And that's why we've given that -- and why we've given the information around mid-2025, why we have a lot of clarity around the timing and the amount is because we're through that. But we do have to roll off these shared risk contracts through 2024 and that will take time through the middle of 2025. And a lot of those contracts as well in the middle part or early part of next year will be switched to that fee-for-service as well. But again, we've got to roll off the remaining 2024 contracts that are shared risk.

但我們還有 24 份合約要履行。這就是我們給出這個訊息的原因——為什麼我們在2025年中期左右給出訊息，為什麼我們對時間和金額有非常清晰的認識，因為我們已經度過了這個難關。但我們確實必須在 2024 年之前完成這些共擔風險合同，而這將需要到 2025 年中期的時間。許多合約在明年年中或年初也將轉為按服務收費。但是，我們必須完成剩餘的 2024 份共擔風險的合約。

Pito Chickering, Deutsche Bank.

德意志銀行的 Pito Chickering。

Can you start off with any interest on the sale of Matrix or divisions and how the timing of that looks like?

您是否有興趣了解 Matrix 或其部門的出售情況以及出售時間？

Yes. So Pito, consistent with what we've been talking about for the last couple of quarters. And again, that we are looking at each of our individual businesses to ensure that they are performing, operating at scale, have kind of consistent cash flows because they do all CapEx light. And the transformation that we've done is taking hold and you can go across the board to ensure that we have a long-term margin profile and consistent cash flow that come from each of these segments. So that's been a top priority for us, and we are deliberately talking about the three of them separately.

是的。所以 Pito，這與我們過去幾季談論的內容一致。再次強調，我們正在審視我們的每一個業務，以確保它們正常運作、規模化營運並且擁有穩定的現金流，因為它們的資本支出都很低。我們所做的轉型正在取得成效，您可以全面確保我們擁有長期的利潤狀況和來自各部門的穩定現金流。所以這對我們來說一直是首要任務，我們也特意分別討論這三個問題。

At the same time, we are evaluating those individually to see if they make sense to stay with us or they can be monetized and sold. So that dual path strategy preparing and doing is what we've been doing, and we continue to do that. And we'll give more information when the time is right because we know, and this is important that we delever the balance sheet. We know the cost that we have and the optionality to do that at the right time because we know where we are, we know where we're performing, and we understand if there was a sale what's the best timing and what's the best dollar amounts. And we're prepared for all those scenarios, and we understand it's a critical part of our strategy going forward.

同時，我們正在對它們進行單獨評估，看看它們是否適合繼續留在我們這裡，或者是否可以貨幣化並出售。因此，雙路徑策略的準備和實施是我們一直在做的事情，而且我們會繼續這樣做。我們會在適當的時候提供更多信息，因為我們知道，降低資產負債表的槓桿率非常重要。我們知道我們所擁有的成本以及在正確的時間做這件事的選擇，因為我們知道我們在哪裡，我們知道我們的表現如何，我們知道如果有銷售，什麼時候是最佳時機，最佳金額是多少。我們已經為所有這些情況做好了準備，我們知道這是我們未來策略的關鍵部分。

To do with Matrix, same. Matrix has done a wonderful job over the last 18 months to ensure they have a competitive advantage. Again, their main advantage is having these 2,000-plus nurse practitioners that can do more in the home and catch the tailwind of where health care is going into the home. So we've made significant -- or the team has made significant progress to have competitive advantages to ensure that we can match the nurse to the timing and the member, taking the friction out of that system and they've done a lot of that. So that timing on when we monetize that mainly to do with the MA tailwinds -- sorry, headwinds that have been in the marketplace.

與 Matrix 一樣。過去 18 個月，Matrix 做出了卓越貢獻，確保了其競爭優勢。再說一遍，他們的主要優勢是擁有超過 2,000 名執業護士，他們可以在家中做更多的事情，並抓住醫療保健進入家庭的順風。因此，我們取得了重大進展——或者說團隊取得了重大進展，獲得了競爭優勢，以確保我們能夠將護士與時間和會員相匹配，消除該系統中的摩擦，他們已經做了很多這方面工作。因此，我們將其貨幣化的時機主要與 MA 順風有關——抱歉，是市場上的逆風。

TBD, we're aligned with Fraser. The most important thing is to continue to execute, and we'll monetize when it makes the most sense.

有待確定，我們與弗雷澤保持一致。最重要的是繼續執行，我們會在最合理的時候將其貨幣化。

Great. And then following up on Brian's question around moving NEMT to fee-for-service. You sort of talked about price compression as managed care payers get quicker payments in return for lower prices. Historically, the PMPM model was remote. Like how do you defend against these sort of managed care payers using other ridesharing apps if you just move into fee-for-service?

偉大的。然後跟進 Brian 關於將 NEMT 轉為收費服務的問題。您談到了價格壓縮，因為管理式醫療付款人可以以更低的價格獲得更快的付款。從歷史上看，PMPM 模型是遙遠的。例如，如果您只是轉向按服務收費，那麼您如何利用其他共乘應用程式來抵禦這類管理式醫療付款人呢？

And are you seeing other competitors willing to keep the full risk model? And is there a risk for market share losses?

您是否看到其他競爭對手願意保留完全風險模型？是否存在市佔率損失的風險？

Yes. So the full risk model, primarily in the state business and those are large contracts, there really is only a couple of people now that can do that work and which is why you have seen the benefit of us continuing to extend that. So we feel really good about those and those are at full risk contracts, and they'll remain there, which are at the appropriate risk-adjusted margin, which is obviously higher. Where the margin compression is, again, is in that shared risk component. And really from a shared risk component, what we've been getting paid over the last couple of years anyway, has been lower.

是的。因此，完整的風險模型主要存在於國家業務中，而且都是大合同，現在實際上只有幾個人可以做這項工作，這就是為什麼你看到我們繼續擴展這項工作的好處。因此，我們對這些感到非常滿意，這些是完全風險合同，它們將保留在那裡，處於適當的風險調整保證金，這顯然更高。利潤率壓縮的地方再次在於共享風險成分。實際上，從共擔風險因素來看，過去幾年我們所獲得的報酬一直較低。

So moving to fee-for-service, again, the cost to capital far outweighs any additional margin compression that is happening. But where the competitors are and this has been consistent, is in that individual -- maybe there's a small part of a state plan -- I mean, sorry, in a state where there's an MCO, it's primarily MCO and it's primarily smaller sections that the competition has been. Rideshare is a critical component of our competition as well as us. And we have strong relationships and strong integration with them. However, that's only on a certain part of the population.

因此，轉向按服務收費，資本成本再次遠遠超過正在發生的任何額外利潤壓縮。但是競爭對手的處境是這樣的，而且這一點一直是一致的，那就是在那個單獨的——也許是一個州計劃的一小部分——我的意思是，抱歉，在實施行動管制令的州，主要是行動管制令，而且主要是競爭對手所處的較小部分。共乘對於我們和我們的競爭來說都是一個關鍵的組成部分。我們與他們保持著牢固的關係和強大的融合。然而，這僅僅針對一部分人口。

And there's a big difference between MA and [Cade] and even state business, but I'll just stick with because we're close to this and we're close to our payers. Managing the benefit is very complicated. Having a higher level of service as simple as being able to take somebody from door to door is critically important to health care, let alone needing a wheelchair, let alone needing a stretcher. So those higher level of service are really the most important components of ensuring cost is down and members get the appropriate medical care. That is complicated because people have different contracts, different payers have different ways.

馬薩諸塞州和 [Cade] 甚至州內業務之間存在很大差異，但我會堅持下去，因為我們接近這一點，並且我們接近我們的付款人。管理福利非常複雜。擁有更高水準的服務（例如能夠將某人從一家門送到另一家門）對於醫療保健至關重要，更不用說需要輪椅或擔架了。因此，更高水準的服務確實是確保降低成本和會員獲得適當醫療服務的最重要因素。這很複雜，因為人們有不同的合同，不同的付款人有不同的方式。

States are different. That managing the benefit is important. And the second other part, you need to have a high-touch model as well, high-touch to ensure members can reach out as well as if there's an issue to intervene on that. The second item is and this is what we do, you've got to be connected to the rest of the health care ecosystem, integrating one into transportation providers, but two, into the facilities, whether that's a dialysis facility is also critically important. And then secondly, as you can see things moving, if you look at the 2027 CMS requirements, which I think are really, really strong, ensuring that tools are managed more holistically.

各州情況不同。管理福利很重要。第二部分，您還需要有一個高接觸模型，高接觸以確保成員能夠聯繫到他們，並且在出現問題時能夠進行幹預。第二件事是我們所做的，你必須與醫療保健生態系統的其他部分相連，一方面將其融入運輸提供者，另一方面將其融入設施，無論是否是透析設施也至關重要。其次，正如您所看到的那樣，如果您查看 2027 年 CMS 要求，我認為這些要求非常非常強大，可確保工具得到更全面的管理。

Right now, it's very complicated. And that requirement is what actually payers are looking for us now. How do we manage that diversity that needs to happen around these very different plan designs? So anyway, I really like what we have been doing and the technology we've been implementing and it's a big part of our strength is to ensure that we manage the benefit and connect to the ecosystem. And we'll use rideshare appropriately for the right people at the right time, but there's many other modes.

目前情況非常複雜。而這個要求其實就是付款人現在要求我們的。我們如何管理這些截然不同的計劃設計所帶來的多樣性？所以無論如何，我真的很喜歡我們一直在做的事情和我們一直在實施的技術，我們的優勢很大一部分就是確保我們管理利益並與生態系統連結。我們會在合適的時間為合適的人適當地使用共乘服務，但還有許多其他方式。

So anyway, there's a lot there. You need to be able to do that at scale in order to manage through the cost and have a competitive margin relative to the rest of the competition.

無論如何，那裡有很多東西。您需要能夠大規模地做到這一點，以便管理成本並相對於其他競爭對手擁有競爭優勢。

Just a quick follow-up there. As you move directly into fee-for-service with the managed care partners, in some cases, you guys use rideshare. If you're going to trade fee-for-service, why don't they bypass you and just use rideshare themselves for some of the lower acuity patients?

只需快速跟進即可。當您與管理醫療夥伴直接進入按服務收費模式時，在某些情況下，您會使用共乘服務。如果您要按服務收費，為什麼他們不繞過您，自己為一些病情較輕的患者使用共乘服務呢？

Yes. So the benefit needs to be managed by a broker in NEMT for Medicaid. Medicare, absolutely. I think Medicare, you can start using a card as well. So I do believe in Medicare, you'll see -- there's a lot in Medicare that will continue to be transformed over these next couple of years.

是的。因此，該福利需要由 NEMT 的 Medicaid 經紀人來管理。絕對是醫療保險。我認為，您也可以開始使用醫療保險卡。所以我確實相信醫療保險，你會看到——未來幾年醫療保險的許多方面將繼續轉變。

We do believe we have a platform, and it is in partnership with rideshare to ensure we can deliver the best service, and it gets to again and this is critical and we're seeing this happen real time. It's easy for somebody when they are elderly, but not sick and in a metropolitan area, rideshare works like a charm. But if you need anything else, it doesn't. And that if you can't manage that friction, it's very expensive and you get a lot of issues. So I do think in MA, there'll be the right balance of rideshare and brokers.

我們確實相信我們有一個平台，並且它與 rideshare 合作以確保我們能夠提供最好的服務，而且它再次發揮作用，這是至關重要的，我們正在實時看到這種情況發生。對於年老但沒有生病且住在大都市的人來說，共乘很方便。但如果您需要其他任何東西，那就不需要了。如果你無法管理這種摩擦，那麼成本將會非常高昂，而且會出現很多問題。因此我確實認為在馬薩諸塞州，共乘和經紀人之間會取得適當的平衡。

Medicaid, it's required. Medicaid -- and I'm not going to repeat myself, it's really important to ensure that you're connected to this ecosystem and can manage the diversity of the benefit.

醫療補助，這是必要的。醫療補助－我不想重複，確保你與這個生態系統相連，並且能管理福利的多樣性真的很重要。

Bob Labick, CJS Securities.

鮑勃·拉比克（Bob Labick），CJS 證券公司。

So you talked on the call a lot about the kind of evolution of your contract structure and the potential to improve reconciliation be paid faster, all that kind of stuff. But can you set expectations? It sounds like that's -- we're still a few quarters away as we work through stuff. Maybe set expectations on working capital and free cash flow over the next three quarters? And then what free cash flow conversion should be once we get to the new structure you envision, please?

所以你在電話中談了很多關於合約結構的演變以及改善對帳和加快付款的潛力等等之類的事情。但你能設定期望嗎？聽起來好像是——我們還有幾個季度的時間來完成一些工作。也許可以設定未來三個季度的營運資本和自由現金流預期？那麼，一旦我們達到您所設想的新結構，自由現金流轉換應該是多少？

Yes, Bob. Hopefully, it was in the comments and I'll kind of double-down on, I think the thing that I'm most positive on is the clarity we have and what the amounts are going to be and the timing is going to be. As we didn't have that clarity two quarters ago or even a quarter ago because we were all -- the industry was kind of caught flat-footed. And we were making assumptions on what we could settle early on or what we could get changes on. That noise is through the system.

是的，鮑伯。希望這是在評論中，我會加倍努力，我認為我最積極的事情是我們所擁有的清晰度以及金額和時間。由於我們在兩個季度前甚至一個季度前都沒有明確的認識，因為我們都——整個行業都措手不及。我們正在假設哪些事情可以提前解決，哪些事情可以做出改變。那個噪音是透過系統發出的。

And every one of our clients, we understand where we are. And then we also understand where we are in the life cycle of these kind of last 2024 contracts. So the clarity around size and amounts is most important because that allows us to appropriately plan and which is why we're giving that guidance around mid-2025. So that's the number one most important point. But at the same time, because of that, we are not going to get to our free cash flow number until we're through this kind of change and settle up on the payables and receivables.

我們的每一位客戶都了解我們的處境。然後我們也了解了我們處於這類 2024 年合約的生命週期的哪個階段。因此，明確規模和數量至關重要，因為這使我們能夠進行適當的規劃，這也是我們在 2025 年中期左右給出該指導的原因。所以這是最重要的一點。但同時，正因為如此，在我們完成這種變更並結清應付款項和應收款項之前，我們不會有自由現金流數字。

So we should expect to be back in that in the latter half of 2025. And at this higher interest rate like we talked about, that cash conversion rate of 30% is the right mode. But at the same time to getting to Pito's question earlier, an important part of us is to ensure that we are delevering because that's a top priority for us. And then if we -- when we are able to delever, we know that cash conversion rate will be higher because of the big driver for that is the high interest expense we have. So clarity, consistency, alignment with our payers is something I'm proud of and we'll manage through that and get through that back to the right cash conversion rate in middle 2025.

因此，我們預計 2025 年下半年將恢復這一水準。在我們談到的較高利率下，30% 的現金轉換率是正確的模式。但同時，回到皮託之前的問題，我們的一個重要部分是確保我們正在去槓桿，因為這是我們的首要任務。然後，如果我們 - 當我們能夠去槓桿時，我們知道現金轉換率將會更高，因為最大的驅動力是我們的高利息支出。因此，我為我們的付款人的清晰度、一致性和一致性感到自豪，我們將努力實現這一點，並在 2025 年中期恢復到正確的現金轉換率。

Okay. Great. That's helpful. And then you've said for several quarters now, everything is on the table and shoring up the balance sheet. Is the long-term covenant relief contingent upon the sale of an asset?

好的。偉大的。這很有幫助。然後您已經說了好幾個季度了，一切都擺在桌面上，資產負債表也在加強。長期契約救濟是否取決於資產的出售？

Or what's the order of operations in terms of when we should learn more about long-term amendments and when we should learn about asset sales?

或者，我們什麼時候應該了解更多有關長期修正案的信息，什麼時候應該了解資產出售的信息，操作順序是什麼？

Yes. So the asset sales are going to be when the time is right at the right value. And of course, it's connected to delevering and the cost of that. So it's all understood. And of course, we have optionality in when we do that.

是的。因此，資產出售將在適當的時機和適當的價值進行。當然，這與去槓桿及其成本有關。所以一切都明白了。當然，我們可以選擇何時這樣做。

But it's an important part to do that at the right time. That's a critical part of our strategy to do that at the right time. And then to do with the covenant relief, we do want a long-term solution. So all the stuff that I just talked about now, that's the stuff that we're working with our banking partners to ensure we understand all the different scenarios that are out there. They see the value.

但在正確的時間做到這一點非常重要。這是我們的適時實施策略的關鍵部分。然後，關於契約救濟，我們確實想要一個長期的解決方案。所以，我剛才談到的所有事情，都是我們正在與銀行合作夥伴合作的事情，以確保我們了解存在的所有不同情況。他們看到了價值。

They see the eventual cash conversion. They see the benefits that we have in each of our assets at scale and our competitive advantages. We're just finalizing all that, getting the timing right, like truly the contract waterfall, which ones are fee-for-service, which ones aren't. So we're just working through the details to ensure that we have completeness on a long-term data gathering to ensure that we get this done at the right long-term level. So we're just -- that's -- we're in the middle of that, which is why we haven't given any more updates other than what we gave on the call.

他們看到了最終的現金轉換。他們看到了我們每項資產在規模上帶來的好處和競爭優勢。我們只是在完成所有這些，把握好時機，例如真正的合約瀑布，哪些是按服務收費的，哪些不是。因此，我們正在研究細節，以確保長期數據收集的完整性，從而確保我們在正確的長期水平上完成這項工作。所以我們只是 - 這就是 - 我們正處於其中，這就是為什麼除了我們在電話中提供的內容之外，我們沒有提供任何其他更新。

So we're really encouraged about it. They get to see a lot more than you all do and that's why I'm really optimistic about us getting something done.

因此我們對此感到非常鼓舞。他們比你們看到更多的東西，這就是為什麼我對我們能完成一些事情充滿樂觀。

Okay. Great. And last one for me. Obviously, you've discussed and intuitively, it makes sense to have the faster cash cycle even if you do give up a little pricing based on the cost of capital. But can you talk about kind of where you are in the NEMT infrastructure and the ability to manage your cost per ride and then still grow margins even under the kind of new contract structure?

好的。偉大的。對我來說這是最後一個。顯然，您已經討論過，並且直觀地看，即使您確實放棄一些基於資本成本的定價，更快的現金週期也是有意義的。但是，您能否談談您在 NEMT 基礎設施中處於什麼位置，以及管理每次乘車成本的能力，然後在新的合約結構下仍能增加利潤？

So when we started over 12 months ago, both on the purchase services, which is the different modes of transportation. And then with the, call it, back-office, which is the administration, which includes contact center as well as just the routing component. We have made a lot of progress across all those. You can see it in our data. We've never had purchase services margin come down since I've been and you've seen that consistently happening.

因此，當我們在 12 個月前開始提供採購服務時，我們就推出了不同的運輸方式。然後是所謂的後台，即管理部門，包括聯絡中心以及路由元件。我們在所有這些方面都取得了很大進展。您可以在我們的數據中看到它。自從我加入以來，我們的採購服務利潤率從未下降過，你已經看到這種情況一直在發生。

And I do believe there is a lot more in there and that will continue to happen with the initiatives that we have in place. Same with payroll and other really is this digital adoption that has been happening. And then kind of this -- part of that is taking the inefficiency out of change in transportation. And for us, at scale, that is a complicated thing because contracts are very different, but we are doing a really good job at that as well. So with the initiatives that we have put in place, we've seen that -- you've seen the improvements.

我確實相信，還有更多的事情要做，而且隨著我們採取的舉措，這些事情還會繼續發生。與工資單和其他確實正在發生的數位化應用相同。然後有點像這樣——其中一部分就是消除交通運輸變革中的低效率。對我們來說，從規模上來說，這是一件複雜的事情，因為合約非常不同，但我們在這方面也做得很好。因此，透過我們實施的舉措，我們已經看到了這一點——你們已經看到了進步。

I expect those improvements to continue throughout 2025. And then again, when we have scale and can manage the diversity of the benefit across all our payers, we'll be in a great place to have the lowest cost structure as well as being able to manage the complexity. So we do need to continue to execute, but that's why we're doing it and I feel good about our ability to get to the right margins because of all the cost out that we put in place.

我預計這些改進將持續到 2025 年。再說了，當我們擁有規模並能管理所有付款人的福利多樣性時，我們將能夠擁有最低的成本結構並能夠管理複雜性。因此，我們確實需要繼續執行，但這就是我們這樣做的原因，而且由於我們已經投入了所有成本，我對我們獲得正確利潤的能力感到滿意。

Scott Fidel, Stephens.

史考特菲德爾、史蒂芬斯。

First question, just hoping to get two numbers from you. The first would be what the -- what do you think the revenue headwind in RPM as a percentage of revs will be from the MA reductions in sub benefits that we're seeing for '25? Then the second numbers would be on the Personal Care margin exit rate. I know you had previously sort of called out targeting around a 10% targeted exit rate by the end of the year. Just curious on where you're standing at this point?

第一個問題，只是希望從您那裡得到兩個數字。第一個問題是—您認為由於我們看到的 25 年 MA 子福利減少，RPM 佔轉速的百分比將帶來多少收入阻力？那麼第二個數字就是個人護理利潤退出率。我知道您之前曾提出年底的目標退出率要達到 10% 左右。只是好奇現在站在哪裡？

Yes. So on the PCS side, that's where we're going to be falling out at the end of the year. I do think the investments that we have made to appropriately ensure that we will have growth and margin expansion into 2025 were the right things to do. So again, it will be close to that level of 10% as we exit the year. But I couldn't be more proud of what that team has done.

是的。所以就 PCS 方面而言，這就是我們年底將會陷入困境的地方。我確實認為，我們為適當確保我們在 2025 年實現成長和利潤擴大而進行的投資是正確的做法。因此，當我們結束今年時，它將再次接近 10% 的水平。但我對這個團隊所取得的成就感到無比自豪。

If I look at all the leading indicators across the -- where we maybe had some softness, they're all moving in the right direction. So I'm really encouraged about that business, one, as we exit the year, but really as we go into next year because really for us, we have a common platform. We have standardization, which is unusual in that market because it's primarily made up of many different acquisitions and many small mom-and-pop. So yes, that was a lot of effort, but we really have done a lot of good work and I feel good about the 2025. What was the first part? What was the first question?

如果我觀察所有領先指標——雖然可能有些疲軟，但它們都在朝著正確的方向發展。因此，我對這項業務感到非常鼓舞，一方面，我們即將結束這一年，另一方面，我們也將迎來新的一年，因為對我們來說，我們有一個共同的平台。我們擁有標準化，這在印度市場並不常見，因為印度市場主要由許多不同的收購企業和許多小型夫妻店組成。所以是的，我們付出了很多努力，但我們確實做了很多很好的工作，我對 2025 年充滿信心。第一部分是什麼？第一個問題是什麼？

MA headwinds RPM.

MA 逆風 RPM。

MA headwinds, yes. RPM. Yes. So yes, that is -- for us, for the RPM world, MA is a challenge. And for us, we were concentrated within one large MA plan.

是的，馬薩諸塞州有逆風。轉數。是的。是的，對我們、對 RPM 世界來說，MA 是個挑戰。對我們來說，我們集中在一個大型 MA 計劃中。

And I expect the big reason for the kind of flatness in growth this year is directly related to MA and I expect that to continue into 2025. However, because of what we've been doing both on the innovation side, but really, if you look at the Medicaid LTSS, that is going to continue to grow and we are the largest there and have scale across the entire country. So I expect that growth will offset the headwinds that we have in the MA market. So you shouldn't see big changes. But we'll give you really more specifics in detail, but that's the macro. Our LTSS growth will offset the MA headwinds.

我預計今年成長持平的主要原因與 MA 直接相關，而且我預計這種情況將持續到 2025 年。然而，由於我們在創新方面所做的努力，但實際上，如果你看看醫療補助長期支持服務 (Medicaid LTSS)，它將繼續增長，而且我們是該領域最大的機構，規模遍及全國。因此我預計成長將抵消我們在 MA 市場面臨的阻力。因此你不應該看到大的變化。但我們會向您提供更詳細的細節，但這就是宏觀。我們的 LTSS 成長將抵消 MA 的阻力。

Okay. Got it. And then my follow-up will be another two numbers questions. First would be if you can just size for us the CDPAP revs contribution in the PC business. I'm assuming there's probably not much EBITDA, but I don't want to make that assumption.

好的。知道了。然後我的後續問題將是另外兩個數字問題。首先，您能否為我們估算一下 CDPAP 對 PC 業務的貢獻。我假設 EBITDA 可能不會太多，但我不想做這樣的假設。

So -- and then on just sort of the -- and then on the fee-for-service, I know that you sort of framed like the 40% of the revenues relate to full risk state contracts in NEMT. I'm just curious if you could sort of, I guess, sort of just ring-fence for us how much revenue you expect in terms of the revenue mix in NEMT will sort of flow into fee-for-service. So first question, just remind what's CDPAP revs and EBITDA contribution in PCS. Second question was just around the fee-for-service mix of revenues in NEMT.

所以 — — 然後關於 — — 然後關於按服務收費，我知道您將 40% 的收入與 NEMT 中的全風險國家合約相關。我只是好奇，您是否可以為我們估算一下，就 NEMT 的收入組合而言，您預計有多少收入將流入按服務收費。所以第一個問題，只是提醒 PCS 中的 CDPAP 收入和 EBITDA 貢獻是多少。第二個問題是關於 NEMT 的收費服務收入組合。

Yes. So for New York CDPAP and we disclosed this, I think, last quarter. So the EBITDA impact, if it all went away, would be between $3 million and $5 million. So again -- but we don't expect that, which is what we talked about. There's going to be a lot that's going to play out there and we expect to participate in that.

是的。所以對於紐約 CDPAP，我想我們在上個季度就透露了這一點。因此，如果這些影響全部消失，EBITDA 的影響將在 300 萬至 500 萬美元之間。所以再說一次——但我們並不期待這一點，這正是我們所談論的。那裡將會發生很多事情，我們希望參與其中。

So higher than the EBITDA. But again, there's a lot to still unpack there on what happens in CDPAP. So again, the downside would be that it completely goes away and that's a $3 million to $5 million EBITDA. Again, we don't expect that. We expect that we will be a part of that, as we said there and if you look across we've been in the New York market for a while and there's a lot of business there.

因此高於 EBITDA。但是，關於 CDPAP 中發生的事情，仍有許多問題有待解開。所以，缺點是它會完全消失，EBITDA 為 300 萬到 500 萬美元。再說一次，我們並不期望這一點。我們希望成為其中的一部分，正如我們所說的那樣，如果你看一下，我們已經在紐約市場待了一段時間，那裡有很多生意。

There's a lot of people there. We are not spooked by the short-term noise. And I do believe in-home care and specific in-home personal care for New York is going to be a valuable part of the health care ecosystem and nobody is better to participate in that because of our large agency business as well as our ability to ensure that we can service anything around CDPAP as well. Again, that's a ways away when that all shakes out. And then with the fee-for-service component, again, that's where we're moving to in our shared risk contracts.

那裡有很多人。我們不會被短期的噪音所嚇倒。我確實相信，紐約的家庭護理和特定的家庭個人護理將成為醫療保健生態系統的重要組成部分，而且由於我們的大型代理業務以及我們確保能夠為 CDPAP 提供任何服務的能力，沒有人比我們更適合參與其中。再說了，當一切塵埃落定，這還有很長的路要走。然後，對於按服務收費的部分，我們再次強調，這是我們在共擔風險合約中要轉向的。

Eventually, as we get through this, I think most of it will be fee-for-service. There's a couple of components that within fee-for-service that we're doing and will likely have in place as well. So all of it, probably the right way to think about it is at the end of 2025. Again, a big chunk of that will be done before that and we'll be -- and this is why we have a lot of conviction around our cash flow coming out of the middle of 2025. But in general, all that will go to fee-for-service.

最終，當我們度過難關後，我認為大部分將會是收費服務。在收費服務中，我們正在實施一些組成部分，而且很可能也會實施。所以，所有這一切，可能正確的思考時間是在 2025 年底。再說一遍，其中很大一部分將在此之前完成，這就是為什麼我們對 2025 年中期的現金流充滿信心。但一般來說，所有這些都將用於收費服務。

So basically, just to simplify it, we should think about NEMT ultimately exiting '25 at sort of 60% fee-for-service relating to the -- basically the managed care business and then around 40% full risk relating to the state business. Is that a fair assumption?

因此，為了簡化起見，我們應該考慮 NEMT 最終在 25 年退出時，收取與管理式醫療業務相關的 60% 的服務費，然後承擔與國家業務相關的約 40% 的全部風險。這是一個合理的假設嗎？

Yes. Yes. But I want to give one clarity on fee-for-service. And it kind of also is to the point of Pito's question, are we kind of having a -- is there -- what's the competitive advantage? I think with some of our large payers, we're going to have, and this is what we want, kickers to do with cost and quality.

是的。是的。但我想就按服務收費問題作出一點澄清。這也正好回答了 Pito 的問題，我們是否有──有什麼競爭優勢？我認為，對於我們的一些大額付款人，我們將會有與成本和品質有關的額外費用，而這正是我們想要的。

So it's going to -- and I love that because we can perform on both of those. And then the second component and this is primarily going to be how the MA world is going to work, but it's happening right now in Cade. All members are not created equal. And having insight and ability to service those members differently are critical to our plans. And I expect and we're doing this right now in our contracts, we should get paid for that elevated service and quality.

所以這是會發生的 — — 我喜歡這樣，因為我們可以在這兩方面都表現出色。然後是第二個組成部分，這主要是 MA 世界將如何運作，但它現在正在 Cade 中發生。所有成員都不是天生平等的。而擁有洞察力和為這些會員提供不同服務的能力對於我們的計劃至關重要。我希望，我們現在就在合約中這樣做，我們應該為更高的服務和品質獲得報酬。

And so if I have it my way and I'm going to keep pushing for that, it will be fee-for-service with quality and cost kickers. And we'll give you more updates on that as we move through that, but that's likely how the fee-for-service contracts play out.

所以，如果我能按照自己的意願行事，並且繼續努力，我就會實行按服務收費，同時提高品質並降低成本。我們將在後續工作中為您提供更多更新信息，但這可能是按服務收費合約的具體實施方式。

Miles Highsmith, Deutsche Bank.

德意志銀行的邁爾斯·海史密斯 (Miles Highsmith)。

Just a couple for me. Just a follow-on to the conversation around fee-for-service, 60%, full risk 40% kind of as we look at the end of the year. Can you talk to us about like how much has already gone that way here in this recent quarter? And I guess I'm tying it back to the guidance revision back in September with some price concessions. Where are we in terms of incremental price concessions?

對我來說只有一對。這只是關於按服務收費 60%、完全風險 40% 的討論的後續，我們預計年底將會如此。您能否告訴我們最近這個季度的進展如何？我想我會將其與 9 月的指導修訂與一些價格優惠聯繫起來。就增量價格優惠而言，我們處於什麼位置？

Do you expect significant additional price concessions in connection with this moving to 60%? Or maybe you could frame that? And then my follow-up is on the receivables and contract receivables and payables, you've got $110 million receivable, $47 million payable at the end of the quarter. You made some comments around some of the moving parts there as we get into midyear. Are you willing to make any comments around whether those contract receivables will be a use or source of cash either through the first half of the year or for the full year '25?

您是否預期隨著降價幅度達到 60%，還會有大幅的額外價格折扣？或者也許你可以把它框起來？然後我要跟進的是應收帳款、合約應收帳款和應付帳款，本季末您的應收帳款為 1.1 億美元，應付帳款為 4,700 萬美元。當我們進入年中時，您對一些活動部分發表了一些評論。您是否願意對這些合約應收款是否會成為今年上半年或 25 年全年的現金用途或來源發表任何評論？

So the move to fee-for-service in our numbers right now and in the near term, you won't see the -- any material change in fee-for-service because we're still on the contracts that we have set for 2024. The fee-for-service revenue and related margin will start coming on in 2025 as we are renegotiating these contracts. But maybe underneath your question, we're in discussions with the majority of our revenue to move to fee-for-service. So that's why I have a lot of conviction around that in 2025, but it's not hitting our financial statements, it will hit in 2025. And then the -- to your question around compression and that's to -- I do expect that to be compression across the board.

因此，從我們現在的數據來看，在短期內轉向按服務收費，你不會看到按服務收費有任何重大變化，因為我們仍然遵守著 2024 年簽訂的合約。隨著我們重新談判這些合同，收費服務收入和相關利潤將於 2025 年開始出現。但也許在您的問題背後，我們正在討論將大部分收入轉向按服務收費。所以這就是為什麼我對 2025 年的情況充滿信心，但它不會影響我們的財務報表，而是在 2025 年影響到。然後——關於壓縮的問題，我確實希望這是全面的壓縮。

But again, it's the right thing to do. And again, we're able to manage that because of the quickness in getting the cash as well as the cost out. We're really competitively advantaged to win there. And then the specific items that we talked about last quarter had to do with the surprise that a lot of our payers had, really in some of in 2023 in their 2024 contracts. Those are where the price -- the lumpy price compressions have been given.

但我仍然認為這是正確的做法。而且，我們之所以能夠做到這一點，是因為我們能夠快速地獲得現金並支付成本。我們確實具有競爭優勢，能夠贏得勝利。然後，我們上個季度討論的具體項目與許多付款人的意外有關，實際上是在 2023 年和 2024 年的合約中。這些就是價格——給出的不均勻價格壓縮。

So -- and then for those specific companies that we've given that price compression in their 2024 contracts, the go-forward contracts after that are in line with the estimates that I talked about in the normal price compression again, which we'll be able to manage through at the right level. So if you're -- there's no need to kind of extrapolate or annualize these lumpy price compressions that we gave because those are isolated to the 2024 contracts. The go forward is as I articulated.

因此 — — 對於那些我們在 2024 年合約中給予價格壓縮的特定公司，此後的未來合約將與我在正常價格壓縮中談到的估計相符，我們將能夠在適當的水平上進行管理。因此，如果您 - 就沒有必要對我們給出的這些不規則價格壓縮進行推斷或年度化，因為這些是與 2024 年合約無關的。前進的方向正如我所闡述的。

Great. And any comments on the contract receivable, payables?

偉大的。對合約應收款、應付款還有什麼意見嗎？

Yes. Yes. So fully, we give a lot of disclosure around this. We gave a lot of information around our collections and the timing of those collections, both on the receivable and the payable side. So the right way -- we'll be through majority of that kind of lumpiness in the mid-part of 2025.

是的。是的。因此，我們對此進行了充分的揭露。我們提供了大量有關收款情況以及收款時間的信息，包括應收帳款和應付帳款。所以正確的做法是——我們將在 2025 年中期度過大部分此類困難時期。

So payables down and the AR is down and the related collections and settlements on that AR as we move to fee-for-service as well.

因此，隨著我們轉向按服務收費，應付帳款和應收帳款以及應收帳款的相關收款和結算也下降了。

Michael Petusky, Barrington Research.

巴林頓研究公司的麥可佩圖斯基 (Michael Petusky) 說。

(technical difficulty) I just want to clarify -- a lot going on here in terms of what you said. The 30% cash flow conversion, is that essentially what you're saying that is likely in terms of your EBITDA between now and mid-'25? Is that what was being communicated? Or can you just clarify that?

（技術難題）我只是想澄清一下——就你所說的內容而言，這裡有很多事情發生。30% 的現金流轉換率，這是否是您所說的從現在到 2025 年中期 EBITDA 的可能性？這就是要傳達的訊息嗎？或者您能澄清一下嗎？

No, it's post that.

不，那是之後的事了。

Post, okay.

發帖，好的。

It's post. So getting to the right conversion rate in -- after the midpoint of 2025 and underneath that. Yes, the fundamentals of our cost structure, the fundamentals of each of our businesses, we feel great about. It really is the timing of when we finish off the roll-off of all these contracts. And that's the driver for the continued need for capital.

這是帖子。因此，要在 2025 年中點之後及以下達到正確的轉換率。是的，我們對我們的成本結構基本面、我們每項業務的基本面都感到非常滿意。現在確實是我們完成所有這些合約的期限了。這就是持續需要資本的驅動因素。

The underperforming businesses are doing everything we wanted to and expected. So we've got to get through this contract roll-off and we have clarity now and alignment with our customers. So we feel good about that.

表現不佳的企業正在做我們想要和期望的一切。因此，我們必須完成這份合約的延期，現在我們已經明確了與客戶的關係，並與客戶保持一致。因此我們對此感到很高興。

Okay. Great. And then just sort of following up on that. And then it seems to -- you seem to say that then it can improve over time. I guess sort of what's the upside if we're looking at '26, '27 and beyond, I mean, can you get to a 50% cash flow conversion? Or can you just speak to where you think you can get to over time?

好的。偉大的。然後就這樣繼續跟進。然後似乎——你似乎說它可以隨著時間的推移而改善。我想，如果我們展望 26 年、27 年及以後，那麼好處是什麼？或者您能否談談您認為隨著時間的推移您可以達到的目標？

Yes. So delever, right, then we can get to that point. That's why it's such a priority. The businesses need to be competitively advantaged at scale and grow and we feel great about that. So that will continue to happen.

是的。所以去槓桿，對吧，然後我們就可以達到這一點。這就是為什麼它如此受重視。企業需要在規模上獲得競爭優勢並實現成長，我們對此感到非常高興。這種情況將會繼續發生。

So that's going to happen. So then really to get to that 50% amount, we need to have less debt. And that's why we are committed to that and that's why our dual strategy on ensuring that we can monetize one of these great assets to ensure that that happens is a top priority.

所以這會發生。所以為了真正達到那 50% 的金額，我們需要減少債務。這就是我們致力於此的原因，也是我們確保能夠將這些優秀資產貨幣化以確保這一點成為首要任務的雙重策略的原因。

Okay. And then in terms of what you guys talked about Pennsylvania rate study, I mean, to me, a state engaging in a rate study to me sounds like something that will take forever. But can you just comment on when you would guess action potentially could be taken? I mean, could that be in place by '26?

好的。然後就你們談到的賓州利率研究而言，對我來說，一個州進行利率研究聽起來像是永遠做不完的事。但您能否評論一下您猜測何時可能採取行動？我的意思是，這能在 26 年之前實現嗎？

Yes. So we were explicit about that because we're seeing lots of growth in the Pennsylvania market. And I do believe that the lower cost solution for Pennsylvania is to have Personal Care services. So it makes a lot of sense for them to continue to grow that. And that's us as well as the entire industry, how we're educating Pennsylvania.

是的。所以我們明確地說明了這一點，因為我們看到賓州市場出現了很大的成長。我確實相信，對於賓州來說，低成本的解決方案是提供個人護理服務。因此，對他們來說，繼續發展這項業務非常有意義。這就是我們以及整個產業對賓州的教育方式。

You can see all around Pennsylvania that these other states are having rate increases because of that. So I'm optimistic that Pennsylvania will do that. The industry as a whole is around that, predicting the timing, TBD, I do -- we're seeing engagement. We're seeing action. So we'll keep you up to date.

您可以看到，在賓州各地，其他州的費率也因這個原因而上漲。因此，我對賓州能夠做到這一點持樂觀態度。整個產業都圍繞著這一點，預測時機，有待確定，我確實看到了參與。我們看到了行動。我們會及時向您通報最新情況。

I do think it will happen, but I'm not going to guess on when that actual quarter is going to be.

我確實認為它會發生，但我不會猜測實際發生的時間是什麼時候。

Okay. And then just last quick question. The Matrix update you gave, obviously, it sounds like you feel good about what you guys are seeing in terms of the fundamentals, but it does seem like in terms of timing for monetization because of all that's going on in Medicare Advantage, that feels like it's been pushed out. I mean, is that a fair characterization of -- versus your prior thoughts?

好的。接下來是最後一個快速問題。您給出的 Matrix 更新，顯然，聽起來您對基本面的情況感覺很好，但就貨幣化時機而言，由於 Medicare Advantage 計劃中發生的一切，感覺它被推遲了。我的意思是，與您之前的想法相比，這是一個公平的描述嗎？

Yes, sir. Correct.

是的，先生。正確的。

Rishi Parekh, JPMorgan.

摩根大通的 Rishi Parekh。

There's a lot of (technical difficulty) and thank you for the free cash flow conversion post-second half. But I just want to go back to the EBITDA number that -- where you expect to be up 10%. And I know you're going to give us more information in fiscal '25, but I guess a tough time trying to bridge myself to that 10% growth. And I was hoping that you could help -- you talked about fee-for-service, which we know are lower margins. You talked (technical difficulty) cuts.

存在著許多（技術困難），感謝下半場後的自由現金流轉換。但我只想回到 EBITDA 數字上——您預計該數字將增長 10%。我知道您將在 25 財年向我們提供更多信息，但我想，實現 10% 的增長率將會很困難。我希望您能提供幫助——您談到了按服務收費的問題，我們知道這樣的利潤率較低。您談到了（技術難度）削減。

There might be some offsets with new wins. Some new revenue growth potential in 2025 could be in the low-single-digits and the rest of it is going to come through cost savings. Is that how we're supposed to think of it? Or can you just at least help us bridge from where we are today, at least from your guidance to that 10% growth and the puts and takes between revenue and expenses?

新的勝利可能會帶來一些補償。2025 年的一些新的收入成長潛力可能處於個位數的低位，其餘部分將透過成本節約實現。我們該這麼想嗎？或者您至少能幫助我們從目前的狀況過渡到 10% 的成長，以及收入和支出之間的利弊？

Yes. The first item, you're right, is the MA market and the headwinds that we have around that in membership reduction that's going to happen in NEMT and then the membership reduction that's also going to happen in the monitoring area. So that is the headwind. But when I get back to the fundamentals of each business because they're large at scale, the transformation that has happened ensures that we have the right peggings for the right cost structure across each of these and you're seeing that. And then the competitive advantages and leading indicators that show that we're going to have growth and operational efficiency.

是的。您說得對，第一點就是 MA 市場以及我們面臨的阻力，包括 NEMT 的會員數量減少以及監控領域的會員數量減少。這就是逆風。但當我回到每個業務的基本面時，因為它們的規模很大，已經發生的轉型確保我們在每個業務上都有正確的成本結構，而您也看到了這一點。競爭優勢和領先指標表明我們將實現成長和營運效率。

All that, I couldn't be more proud of the team and seeing that happen in the numbers. And that's going to be the under-pegging of ensuring that we have the right cost structure. So cost is going to be a continued component of that. But it's the right type of -- which is automation, efficiency, working out the right stuff at the right time. That's what's going to be the big driver for us and a lot of that -- those underpinnings have been put in place.

所有這些，我對這支球隊以及看到這些數字所帶來的變化感到無比自豪。這將是確保我們擁有正確成本結構的關鍵。因此，成本將繼續成為其中的一個組成部分。但它是正確的類型——即自動化、高效、在正確的時間做正確的事情。這將成為我們最大的驅動力，而且其中的許多基礎已經到位。

So that's a big part of what we will see contribute to our 10%. The other items are continued growth, right? The Personal Care and Monitoring business, stable, recurring, I feel really good about that. Personal Care, I really feel good about that with our new team that's there, but also our approach on business development, which hasn't been approached. So I feel good about that.

所以，這是我們看到的對我們的 10% 貢獻的很大一部分。其他項目都持續成長吧？個人護理和監測業務穩定、有經常性，我對此感覺非常好。個人護理，我對我們新的團隊感到非常滿意，而且我們的業務發展方法也是前所未有的。所以我對此感覺很好。

NEMT as well and this is why we were explicit in the script and I've been talking about a lot for us, it's to show this differentiation and to have high strong customer relationships. And in the Medicaid side, you're seeing continued wins, continued growth. I expect expansion to happen there. I am personally involved with our sales group on many of these customers and clients and we can show the differentiation. MA is where the challenge is and that's where we're going to need to overcome.

NEMT 也是如此，這就是為什麼我們在腳本中明確說明並且我已經談論了很多，這是為了展示這種差異化並建立高度牢固的客戶關係。在醫療補助方面，你會看到持續的成功和持續的成長。我預計那裡會發生擴張。我親自參與了我們許多此類顧客和客戶的銷售團隊，我們可以展示差異化。MA 是挑戰所在，也是我們需要克服的地方。

So that 10% growth is based on continued growth in offsetting the challenges on MA, continued growth both in the other segments and then the cost out. But again, those underpinnings of cost out are in place. We need to continue to execute, but we will and that's why we gave and reaffirmed that 10% gross margin.

因此，10% 的成長是基於持續成長以抵消 MA 上的挑戰、其他部分的持續成長以及成本。但再次強調，這些成本支出的基礎已經到位。我們需要繼續執行，但我們會繼續，這就是我們給出並重申 10% 毛利率的原因。

Okay. And on the follow-up, before you had a bolus of renewals, which I think you said earlier that you renewed all of them assuming at least a year. Just so we're aware, what should we expect from a full and RFP standpoint, whether it's a percentage of states for NEMT in 2025? I believe New Jersey is up for RFP. Timing, is this all within the summer? And just (inaudible) on a forward basis? And is that included in your 10%?

好的。關於後續行動，在您進行大量續約之前，我記得您之前說過，您將續約所有合同，並且合約期限至少為一年。我們知道，從完整和 RFP 的角度來看，我們應該期待什麼，2025 年 NEMT 的各州百分比是多少？我相信新澤西州已經準備好接受 RFP。時間問題，這一切都是在夏天嗎？並且只是（聽不清楚）向前發展嗎？這包含在你的 10% 中嗎？

Yes, it is included in our 10%. We do expect on the state side within mobility, RFPs to come out with the normal cycle. And when those come out, we feel really good about our ability to continue to win on those. As you know and I think the state side, especially in the state side, innovation is important, high-quality service is important. Consistency is important.

是的，它包含在我們的 10% 內。我們確實期望，在州一級的流動性方面，RFP 能夠按照正常週期出台。當這些出現時，我們對自己繼續獲勝的能力感到非常高興。如你所知，我認為在國家方面，特別是在美國方面，創新很重要，高品質的服務很重要。一致性很重要。

So we feel good about our ability to win those. And so even though they come out, any type of move if other -- and we expect this also next year that we will have net new opportunities in state wins. But even if we were to win one of those, they're not going to come on in '25. So in general, think about any kind of action on the RFPs within 2025, any change would not be impacted into 2026. That's in general.

所以我們對自己贏得這些勝利的能力感到很滿意。因此，即使他們出面，採取任何其他舉動——我們也預計明年我們將在州勝利中獲得新的淨機會。但即使我們贏得其中一場，他們也不會在25年上場。因此，一般來說，考慮 2025 年內對 RFP 採取的任何行動，任何變更都不會影響 2026 年。整體來說是這樣。

So that's what's happened on the state side. And again, on the Medicaid MCO side, I expect us to continue to win and grow there.

這就是州方面發生的事情。再次，在醫療補助 MCO 方面，我預計我們將繼續取得勝利並發展。

And if I could squeeze one more in on the covenants. I know you talked about it earlier. Is the timing more once we have audited financials going to wait until we actually have migrated over to fee-for-service before you and trying to figure out what the (inaudible)

如果我可以在契約中再擠一點時間的話。我知道你之前談過這個。時間是否更適合在我們審計財務狀況後，等到我們真正轉向按服務收費模式後再向您提出問題，並試圖弄清楚（聽不清楚）

No, it's not actually the financials at all. It really is us just ensuring that we have all the detail and information around what our forecasts are, and expectations are to get to them. So that's we're in the middle of showing the proof around everything I just talked about today and ensuring we get a long-term solution. This is not -- we just don't want a quarter solution or a two-quarter solution. We want a long-term solution and we're just in the middle of that planning process and sharing process, but it is not a requirement to get the audit done.

不，實際上這根本不是財務問題。我們實際上只是確保我們擁有有關我們的預測以及期望的所有細節和資訊。所以，我們正在展示我今天談到的所有內容的證據，並確保我們得到長期的解決方案。這並不是——我們只是不想要四分之一解決方案或四分之二解決方案。我們希望有一個長期的解決方案，目前我們正處於規劃過程和共享過程的中間，但這並不是完成審計的必要條件。

And that was our last question. I'd like to turn the floor back to Mr. Heath Sampson for closing remarks.

這是我們的最後一個問題。我想請希思‧桑普森先生作最後發言。

Yes. Thank you for participating in our call this morning and for your interest in ModivCare. Our updated investor presentation is posted on our website. If you want a follow-up call, please contact Kevin, our Head of Investor Relations. We look forward to speaking to many of you over the coming days, weeks, months before we report our fourth quarter and full year 2024 results in February of next year.

是的。感謝您參加我們今天早上的電話會議並關注 ModivCare。我們更新的投資者介紹已發佈在我們的網站上。如果您需要後續電話，請聯絡我們的投資者關係主管 Kevin。我們期待在明年 2 月報告我們的 2024 年第四季和全年業績之前的未來幾天、幾週、幾個月與你們中的許多人進行交談。

Thank you again. Have a great day. And operator, this concludes our call.

再次感謝您。祝你有美好的一天。接線員，我們的通話到此結束。