(MPLN) 2022 Q3 法說會逐字稿

Hello, everyone, and thank you for joining the MultiPlan Corporation Third Quarter 2022 Earnings Conference. My name is Taris and I'll be the operator for today. (Operator Instructions)

大家好，感謝您參加 MultiPlan Corporation 2022 年第三季度財報會議。我叫 Taris，今天我是接線員。 （操作員說明）

I now have the pleasure of handing you over to your host, Shawna Gasik, AVP, Investor Relations. Please go ahead.

我現在很高興將你交給你的東道主，Shawna Gasik，AVP，投資者關係。請繼續。

Thank you. Good morning, and welcome to MultiPlan's Third Quarter 2022 Earnings Call. Joining me today is Dale White, Chief Executive Officer; and Jim Head, Chief Financial Officer. The call is being webcast and can be accessed through the Investor Relations section of our website at www.multiplan.com.

謝謝你。早上好，歡迎來到 MultiPlan 的 2022 年第三季度收益電話會議。今天加入我的是首席執行官 Dale White；和首席財務官 Jim Head。該電話會議正在進行網絡直播，可通過我們網站 www.multiplan.com 的投資者關係部分收聽。

During our call, we will refer to the supplemental slide deck that is available on the Investor Relations portion of our website, along with the third quarter 2022 earnings press release issued earlier this morning. Before we begin, a couple of reminders. Our remarks and responses to questions today may include forward-looking statements. These forward-looking statements represent management's beliefs and expectations only as of the date of this call. Actual results may differ materially from those forward-looking statements due to a number of risks. A summary of these risks can be found on the second page of the supplemental slide deck and a more complete description on our annual report on Form 10-K and other documents we file with the SEC.

在我們的通話中，我們將參考我們網站投資者關係部分提供的補充幻燈片，以及今天上午早些時候發布的 2022 年第三季度收益新聞稿。在我們開始之前，有幾點提醒。我們今天的評論和對問題的回答可能包括前瞻性陳述。這些前瞻性陳述僅代表管理層截至本次電話會議之日的信念和預期。由於存在多種風險，實際結果可能與這些前瞻性陳述存在重大差異。這些風險的摘要可以在補充幻燈片的第二頁找到，更完整的描述可以在我們的 10-K 表格年度報告和我們向美國證券交易委員會提交的其他文件中找到。

We will also be referring to several non-GAAP measures, which we believe provide investors with a more complete understanding of MultiPlan's underlying operating results. An explanation of these non-GAAP measures and reconciliations to the most comparable GAAP measures can be found in the earnings press release and the supplemental slide deck.

我們還將提到一些非 GAAP 措施，我們認為這些措施可以讓投資者更全面地了解 MultiPlan 的基本經營業績。這些非 GAAP 措施的解釋以及與最具可比性的 GAAP 措施的對賬可以在收益新聞稿和補充幻燈片中找到。

With that, I would now like to turn the call over to our Chief Executive Officer, Dale White. Dale?

有了這個，我現在想把電話轉給我們的首席執行官戴爾懷特。戴爾？

Thank you, Shawna. Good morning, everyone, and welcome to the call. By now, many of you have had an opportunity to review our third quarter results. I'll say at the outset that these results were disappointing. And while the predominant driver of the shortfall was the decline in patient utilization of health care services, I would be remiss if I didn't acknowledge our results, nevertheless, fell short of our third quarter expectations.

謝謝你，肖娜。大家早上好，歡迎來電。到目前為止，你們中的許多人都有機會回顧我們第三季度的業績。我首先要說這些結果令人失望。雖然造成短缺的主要原因是患者對醫療保健服務的使用率下降，但如果我不承認我們的結果，我將是失職，但仍未達到我們第三季度的預期。

I'm going to cover 3 topics this morning. I'll provide some context around the market conditions and moving pieces that drove our third quarter results, I'm going to reinforce that we continue to see strong underlying demand for our services, are highly engaged with our customers and remain focused on investing in our business to drive growth, and then I'll review the action plan our leadership is implementing to manage the business through these more challenging market conditions. Let's jump into our third quarter results.

今天早上我將討論 3 個主題。我將提供一些有關市場狀況和推動我們第三季度業績的因素的背景，我將強調我們繼續看到對我們服務的強勁潛在需求，與我們的客戶高度互動並繼續專注於投資我們的業務推動增長，然後我將回顧我們的領導層正在實施的行動計劃，以通過這些更具挑戰性的市場條件來管理業務。讓我們來看看我們的第三季度業績。

As shown on Page 4 of the supplemental deck, third quarter revenues of $250.5 million declined about $40 million from the prior quarter, and fell about $30 million short of our third quarter guidance provided in August. Adjusted EBITDA of $172.2 million declined about $37 million from the prior quarter and fell about $28 million short of our third quarter guidance. Despite this quarter's results, we remain highly profitable, maintain best-in-class adjusted EBITDA margins and continue to generate significant cash flow.

如補充資料第 4 頁所示，第三季度收入為 2.505 億美元，比上一季度下降約 4000 萬美元，比我們 8 月份提供的第三季度指導低約 3000 萬美元。調整後的 EBITDA 為 1.722 億美元，比上一季度下降約 3700 萬美元，比我們第三季度的指引低約 2800 萬美元。儘管本季度取得了業績，但我們仍保持高利潤，保持一流的調整後 EBITDA 利潤率，並繼續產生可觀的現金流。

In the third quarter, our adjusted EBITDA margin was nearly 69%. We generated $109 million in free -- in cash flow from operations, and we ended the quarter with $439 million of cash on the balance sheet. Our profitability provides us with significant flexibility to navigate a challenging environment while pursuing our strategic initiatives and to thoughtfully allocate our capital.

第三季度，我們調整後的 EBITDA 利潤率接近 69%。我們從運營中產生了 1.09 億美元的自由現金流，本季度末資產負債表上的現金為 4.39 億美元。我們的盈利能力為我們提供了極大的靈活性，使我們能夠在充滿挑戰的環境中度過難關，同時追求我們的戰略舉措並周到地分配我們的資本。

Third quarter results exhibited an unusual, although not unprecedented level of volatility for a business that has typically displayed ability and visibility. As shown on Page 6 of the supplemental deck, that volatility was caused by a confluence of factors. The single largest factor was external market conditions which were characterized by a decline in health care utilization among health plan members. This drove lower savings volumes and mix shift that was unfavorable to revenues. Separately, we had an anticipated shift away from us of a portion of an overall program at one of our customers. And then there were several smaller components that cumulatively impacted revenues yielded from our identified savings in the quarter.

對於通常顯示能力和知名度的企業而言，第三季度業績表現出異常但並非前所未有的波動。如補充套牌第 6 頁所示，這種波動是由多種因素共同造成的。最大的單一因素是外部市場條件，其特點是健康計劃成員的醫療保健利用率下降。這導致儲蓄量減少和不利於收入的組合轉變。另外，我們有一個預期的轉變，我們的一個客戶的整體計劃的一部分會從我們這裡轉移。然後有幾個較小的組成部分累積影響了我們在本季度確定的節省產生的收入。

On our second quarter call, we noted that volumes reported by a number of hospital and health services groups as well as lower medical loss ratios at some major health insurers were pointing to a sluggish patient utilization during the second quarter, and we noted that these trends were beginning to be reflected in our claim and charge volumes. Given our typical lag, the full extent of that sluggishness became evident in our third quarter results.

在我們第二季度的電話會議上，我們注意到許多醫院和醫療服務集團報告的數量以及一些主要醫療保險公司較低的醫療損失率表明第二季度患者利用率低迷，我們注意到這些趨勢開始反映在我們的索賠和收費量中。鑑於我們典型的滯後，這種低迷的全部程度在我們第三季度的業績中變得顯而易見。

As shown on Page 7, charges processed declined approximately 2% sequentially to $31.4 billion. And while that may seem like a modest decline at the top of our claims funnel, it masks a mix shift in claim types that drove a larger 4% sequential decline in identified savings to $5.3 billion and a 7% decline in identified savings at the core of our revenue model, as Jim will discuss momentarily. In particular, at the planned member level, we observed swift changes in demand for discretionary care, starting with medical services rendered in May and June. This supports a growing consensus that health plan members are postponing or forgoing non-emerging care and are slightly more hesitant to spend out-of-network given the environment.

如第 7 頁所示，處理的費用環比下降約 2% 至 314 億美元。雖然這在我們的理賠漏斗頂部看起來似乎略有下降，但它掩蓋了理賠類型的混合轉變，導致確定的儲蓄額連續下降 4% 至 53 億美元，以及核心的已確認儲蓄額下降 7%我們的收入模式，吉姆稍後會討論。特別是，在計劃會員級別，我們觀察到自 5 月和 6 月提供的醫療服務開始，全權委託護理的需求發生了迅速變化。這支持了越來越多的共識，即健康計劃成員正在推遲或放棄非緊急護理，並且在考慮到環境的情況下對網絡外支出略有猶豫。

Together, these identified savings volume and mix factors explain about $19 million or roughly half of the revenue decline between this quarter and last quarter. As I mentioned, also affecting our revenues this quarter was the anticipated impact of a partial program loss as a customer decided to shift the component of its overall out-of-network savings program away from us. The impact of that decision accounted for about $7 million to $8 million of the decline in revenue relative to the prior quarter. Such shifts happen from time to time in the normal course. As much as I'd love to say we win 100% of the time that simply isn't the reality of any business.

這些確定的節省量和混合因素共同解釋了本季度與上一季度之間約 1900 萬美元或大約一半的收入下降。正如我所提到的，影響我們本季度收入的還有部分計劃損失的預期影響，因為客戶決定將其整體網絡外儲蓄計劃的組成部分從我們這裡轉移出去。與上一季度相比，該決定的影響導致收入下降約 700 萬至 800 萬美元。這種轉變在正常過程中時有發生。就像我想說的那樣，我們 100% 的時間都贏了，這根本不是任何企業的現實。

Importantly, though, our relationship with this key customer, which is not our larger customer that recently renewed its contract with us remains healthy. They continue to use the same breadth of our solutions in the larger portion of the program that remains with us.

但重要的是，我們與這個主要客戶的關係仍然健康，這不是我們最近與我們續簽合同的大客戶。在我們保留的大部分計劃中，他們繼續使用我們相同範圍的解決方案。

Finally, we had a number of customer-related adjustments during the third quarter. As shown on Page 6 and as Jim will discuss momentarily, these accounted for about $13 million of decline in total revenues. It's typical for us to experience various puts and takes in any given quarter, but our third quarter had an abnormal number of puts and few takes. Despite the third quarter results, I am confident that our business remains robust as evidenced by our strong margins and cash flow. We do not believe the third quarter is indicative of MultiPlan's long-term earnings power. Importantly, all of our payer customer relationships remain healthy. The vast group of over 100,000 employers and other plan sponsors we serve through these customers is essentially unchanged. We continue to be highly engaged with our customers to help drive deeper medical cost savings for the employers and plan members they serve.

最後，我們在第三季度進行了一些與客戶相關的調整。如第 6 頁所示以及 Jim 稍後將討論的那樣，這些導致總收入下降約 1300 萬美元。我們通常會在任何給定的季度中經歷各種不同的投入和投入，但我們第三季度的投入和投入數量異常。儘管取得了第三季度的業績，但我相信我們的業務依然強勁，我們強勁的利潤率和現金流就證明了這一點。我們認為第三季度並不代表 MultiPlan 的長期盈利能力。重要的是，我們所有的付款人客戶關係都保持健康。我們通過這些客戶服務的超過 100,000 名雇主和其他計劃發起人的龐大群體基本上沒有變化。我們將繼續與客戶保持高度互動，以幫助為他們所服務的雇主和計劃成員節省更多的醫療費用。

While patient utilization is soft, demand for our cost management services is strong, and we expect it to remain so given the widely reported decline in affordability of health benefits that employers and plan sponsors presently face. We believe it is unlikely that patient utilization will remain suppressed indefinitely. And while it is difficult to predict when it will rebound, we expect it to benefit -- we expect to benefit when it does, just as we have in the past. In the meantime, we continue to sell new business, and we expect these efforts to drive additional revenues in future periods. We are adjusting to prevailing market conditions, while maintaining our focus on growing the business and keeping our platform in a position to benefit from higher volumes when utilization recovers.

儘管患者使用率疲軟，但對我們的成本管理服務的需求強勁，鑑於廣泛報導的雇主和計劃贊助商目前面臨的健康福利負擔能力下降，我們預計這種情況將保持下去。我們認為不太可能無限期地抑制患者的使用。雖然很難預測它何時會反彈，但我們預計它會受益——我們預計它會在反彈時受益，就像我們過去所做的那樣。與此同時，我們繼續銷售新業務，我們預計這些努力將在未來推動額外收入。我們正在根據當前的市場狀況進行調整，同時繼續專注於發展業務，並使我們的平台能夠在利用率恢復時從更高的交易量中受益。

With these objectives in mind, our leadership team is implementing an action plan for managing through uncertain market conditions as shown on Page 9. First, we are aggressively implementing new initiatives with our customers to help them cope with accelerating health care costs. This includes reviewing all of our solution configurations with our customers and intensifying efforts around enhancements to optimize their medical cost savings. We expect these initiatives to drive meaningful incremental identified savings for our customers and revenue for MultiPlan. In fact, we are already seeing results in this area.

考慮到這些目標，我們的領導團隊正在實施一項行動計劃，以管理不確定的市場條件，如第 9 頁所示。首先，我們正在與客戶一起積極實施新舉措，以幫助他們應對不斷增加的醫療保健成本。這包括與我們的客戶一起審查我們所有的解決方案配置，並加強圍繞增強功能的努力，以優化他們的醫療成本節約。我們希望這些舉措能夠為我們的客戶和 MultiPlan 帶來有意義的增量確定儲蓄和收入。事實上，我們已經在這方面看到了成果。

For example, this quarter, we implemented enhancements to our data eyesight pricing service that are expected to add approximately $6 million in annual revenue, which will begin to ramp in Q4. During the quarter, we implemented or scheduled implementation of several solution hierarchy changes for payers to help them quickly pivot in response to changing market dynamics. Combined, these will generate additional savings worth about $14 million to $16 million in annual revenues to MultiPlan.

例如，本季度，我們對數據視力定價服務實施了改進，預計年收入將增加約 600 萬美元，並將在第四季度開始增長。在本季度，我們為付款人實施或計劃實施多項解決方案層次結構變更，以幫助他們快速調整以響應不斷變化的市場動態。綜合起來，這些將為 MultiPlan 帶來價值約 1400 萬至 1600 萬美元的額外節省，年收入。

Second, we have been fully immersed in product development, and that effort has already yielded plans to launch several promising products in 2023. This includes one product focused on protecting members against balanced bills on non-NSA related claims and another that leverages machine learning to optimize claim routing between our solutions. We're also working with our partner, Abacus Insights to bring our solution set to their customers on their data interoperability platform.

其次，我們已經完全專注於產品開發，這項努力已經產生了在 2023 年推出幾款有前途的產品的計劃。這包括一款專注於保護會員免受非 NSA 相關索賠的平衡賬單的產品，以及另一款利用機器學習來優化我們的解決方案之間的理賠路徑。我們還與我們的合作夥伴 Abacus Insights 合作，在他們的數據互操作性平台上將我們的解決方案集帶給他們的客戶。

Third, we are undertaking a review of MultiPlan's long-term growth strategy to ensure we are prioritizing our most attractive opportunities to more deeply penetrate our existing markets and to diversify into adjacent markets. The goal of the review is to amplify the progress already made against our strategy. Among other sides of this progress, we've enhanced our solutions with advanced analytics and data to drive savings and service performance. To this end, today, we have a team of about 15 data scientists implementing machine learning and advanced technology initiatives with a focus on surprise bill negotiation and arbitration strategies, data mining and prepayment negotiation services.

第三，我們正在對 MultiPlan 的長期增長戰略進行審查，以確保我們優先考慮最具吸引力的機會，以更深入地滲透我們現有的市場並多元化進入鄰近市場。審查的目標是擴大我們的戰略已經取得的進展。在這一進步的其他方面，我們通過高級分析和數據增強了我們的解決方案，以推動節省和服務性能。為此，今天，我們有一個由大約 15 名數據科學家組成的團隊，他們正在實施機器學習和先進技術計劃，重點是意外賬單談判和仲裁策略、數據挖掘和預付款談判服務。

We have also extended our service penetration in adjacent markets with organic initiatives and the acquisitions of HST and Discovery Health Partners, both of which target health plans in-network claims and one of which also delivered significant business that we've continued to grow in the Medicare Advantage market segment. I look forward to communicating the refinements to MultiPlan's growth strategy over the coming months.

我們還通過有機舉措和收購 HST 和 Discovery Health Partners 擴大了我們在鄰近市場的服務滲透率，這兩家公司都以網絡索賠中的健康計劃為目標，其中之一還提供了我們在Medicare Advantage 細分市場。我期待在未來幾個月內傳達 MultiPlan 增長戰略的改進。

Fourth and lastly, as Jim will discuss in greater detail, we have identified internal cost-saving initiatives, some of which have -- some of which already have been implemented. These will help offset inflationary pressures on our cost and provide capacity for the investments in our talent and platform that are critical to executing on the numerous projects underway and to capturing our growth opportunities.

第四也是最後一點，正如 Jim 將更詳細地討論的那樣，我們已經確定了內部成本節約計劃，其中一些已經 - 其中一些已經實施。這些將有助於抵消我們成本的通貨膨脹壓力，並為我們的人才和平台投資提供能力，這對於執行正在進行的眾多項目和抓住我們的增長機會至關重要。

Now I'd like to turn to some other highlights that occurred during the third quarter. MultiPlan closed 148 opportunities during Q3 that we expect to contribute approximately $13 million in annual revenues to the business with some of these starting to contribute as early as Q4. Value-driven health plan services continued to grow above our expectations. By January 1, we will have added 39 new employer groups with nearly 15,000 members. This would bring total members under these plans -- these types of plans to over 1 million.

現在我想談談第三季度發生的其他一些亮點。 MultiPlan 在第三季度關閉了 148 個機會，我們預計將為該業務貢獻約 1300 萬美元的年收入，其中一些最早在第四季度就開始貢獻。價值驅動的健康計劃服務繼續增長超出我們的預期。到 1 月 1 日，我們將新增 39 個雇主群組，擁有近 15,000 名成員。這將使這些計劃下的成員總數超過 100 萬。

MultiPlan's itemized bill review service, which was announced just last quarter, added 2 new customers in Q3 and there are an additional 40 opportunities progressing through the pipeline. There is strong interest in our subrogation service. During the quarter, we submitted several proposals to regional health plans, which could contribute up to $20 million in annual revenues. And finally, we added new network business during the quarter, including 1 commercial and 2 Medicare Advantage payers.

MultiPlan 的逐項賬單審查服務剛剛在上個季度宣布，在第三季度增加了 2 個新客戶，另外還有 40 個機會正在籌備中。人們對我們的代位求償服務很感興趣。在本季度，我們向區域健康計劃提交了幾項提案，這些提案可能會貢獻高達 2000 萬美元的年收入。最後，我們在本季度增加了新的網絡業務，包括 1 個商業和 2 個 Medicare Advantage 付款人。

Moving on to the No Surprises Act, I'm pleased to report that our claim activity is trending as expected, this softening, somewhat, over the quarter given overall utilization. A number of our customers continue to use our core cost management solutions, while others use our new QPA-based pricing service. QPA is a benchmark established by the act. While QPA isn't mandated as a reimbursement amount, it does play a role in determining the members' cost share, an independent dispute resolution or IDR. The IDR process is still in its early stages and continues to be somewhat chaotic for payers and providers.

繼續《無意外法案》，我很高興地報告，我們的索賠活動趨勢如預期，考慮到整體利用率，這一季度有所軟化。我們的許多客戶繼續使用我們的核心成本管理解決方案，而其他客戶則使用我們新的基於 QPA 的定價服務。 QPA 是該法案建立的基準。雖然 QPA 不是強制要求的報銷金額，但它確實在確定成員的費用分攤、獨立爭議解決或 IDR 方面發揮作用。 IDR 流程仍處於早期階段，對於付款人和提供者而言仍然有些混亂。

As you may recall, when NSA's interim final rules for the process were published last September, provider organization successfully sued in federal court. As a result, the government struck the portions of the NSA's interim final rule that had given primacy to the QPA and the IDR process. These changes were included in the final rules released this August. However, provider groups have sued again citing additional aspects of the implementation guidance that they say still prioritize the QPA over other factors considered in arbitration. There remains to be seen how this continued push back from the provider community will play out.

您可能還記得，去年 9 月 NSA 發布流程的臨時最終規則時，提供商組織在聯邦法院成功起訴。因此，政府取消了 NSA 臨時最終規則中給予 QPA 和 IDR 程序優先權的部分。這些更改包含在今年 8 月發布的最終規則中。然而，供應商團體再次提起訴訟，理由是實施指南的其他方面仍然優先考慮 QPA，而不是仲裁中考慮的其他因素。提供商社區的持續反擊將如何發揮作用還有待觀察。

In the meantime, we have closed 1,240 IDR cases and have another nearly 18,000 in process. With IDR likely to remain a changing and complicated process, we are confident, our data, our analytics, and our operational expertise in this area will continue to deliver value to our customers.

與此同時，我們已結案 1,240 起 IDR 案件，另有近 18,000 起正在處理中。由於 IDR 可能仍然是一個不斷變化和復雜的過程，我們相信，我們在這一領域的數據、分析和運營專業知識將繼續為我們的客戶創造價值。

I would like to turn now to our outlook on the market environment and what that means for our fourth quarter expectations and the starting base for 2023. The third quarter results reported by a number of hospital and health services groups and the continued lower medical loss ratios at several major health insurers suggest that patient utilization remained soft in Q3, which due to our typical claims lag impacts our Q4 revenues.

我現在想談談我們對市場環境的展望，以及這對我們第四季度的預期和 2023 年的起始基數意味著什麼。許多醫院和醫療服務集團報告的第三季度業績以及持續下降的醫療損失率幾家主要健康保險公司的研究表明，第三季度患者利用率仍然疲軟，這是由於我們典型的索賠滯後影響了我們第四季度的收入。

Utilization tends to be seasonally higher in Q4, but at this point, we have little reason to expect that our fourth quarter results will look better than those in the third quarter. As such, we are guiding to fourth quarter revenues between $235 million and $250 million and fourth quarter adjusted EBITDA of between $155 million and $170 million. Changes to our full year 2022 guidance are detailed on Page 12 of the supplemental deck.

第 4 季度的利用率往往季節性較高，但在這一點上，我們沒有理由預期我們的第 4 季度業績會比第 3 季度好。因此，我們指導第四季度收入在 2.35 億美元至 2.5 億美元之間，第四季度調整後的 EBITDA 在 1.55 億美元至 1.7 億美元之間。我們對 2022 年全年指南的更改詳見補充資料的第 12 頁。

While we are not providing guidance for 2023, clearly, our Q4 guidance implies we are exiting the year at a lower run rate than where we were -- than where we started. And next year, we will have the impact of the contract renewal with our -- with a major customer as announced previously. We are cautiously optimistic that patient utilization could begin to recover more broadly. As I noted, we do not believe it can remain suppressed indefinitely. Further, we've seen periods like this before, COVID lockdowns being the most recent episode, and utilization can return swiftly with an associated lift in our revenues.

雖然我們沒有提供 2023 年的指導，但很明顯，我們的第四季度指導暗示我們今年結束時的運行率低於我們過去的水平——低於我們開始時的水平。明年，我們將與我們的 - 與先前宣布的主要客戶續簽合同產生影響。我們對患者利用率可能開始更廣泛地恢復持謹慎樂觀態度。正如我所指出的，我們不相信它可以無限期地受到壓制。此外，我們以前也見過這樣的時期，最近一次是 COVID 封鎖，隨著我們收入的相關提升，利用率會迅速恢復。

We're also optimistic that our planned product launches and other growth initiatives will provide some offset if the market softness persists into 2023. That said, visibility on when external pressures might abate is low. And as such, we feel it's prudent to recalibrate expectations for the time being. Consistent with our historical practice, we'll provide full year 2023 guidance on our fourth quarter call this coming February.

我們還樂觀地認為，如果市場疲軟持續到 2023 年，我們計劃推出的產品和其他增長舉措將提供一些抵消。也就是說，外部壓力何時可能減弱的能見度很低。因此，我們認為暫時重新調整預期是明智的。根據我們的歷史慣例，我們將在今年 2 月的第四季度電話會議上提供 2023 年全年指導。

In summary, while third quarter results missed the mark and visibility on the road ahead has become more challenging, we will stay focused on controlling what we can control. That means driving meaningful progress on all fronts by executing on our long-term priorities, selling new business, building our pipeline, investing in our people and solutions to drive growth, managing our cost and delivering high levels of value and service to our payer customers.

總而言之，雖然第三季度的業績沒有達到預期目標，未來道路的可見性也變得更具挑戰性，但我們將繼續專注於控制我們能控制的事情。這意味著通過執行我們的長期優先事項、銷售新業務、建立我們的管道、投資於我們的人員和解決方案以推動增長、管理我們的成本以及為我們的付款客戶提供高水平的價值和服務，在各個方面推動有意義的進展.

Before I turn the call over to Jim, I want to say that I'm extremely proud of how our team is responding to these market conditions on their front seat, managing actively and focused on growing the business, all the while maintaining their dedication to our mission to deliver affordability, efficiency and fairness to the U.S. health care system and to deliver operational excellence and outstanding customer service. Thank you.

在我把電話轉給吉姆之前，我想說，我為我們的團隊如何在他們的前排座位上應對這些市場條件、積極管理並專注於發展業務，同時始終保持他們的奉獻精神感到非常自豪我們的使命是為美國醫療保健系統提供可負擔性、效率和公平性，並提供卓越的運營和出色的客戶服務。謝謝你。

With that, I'll turn the call over to Jim to discuss our financial results in more detail. Jim?

有了這個，我會把電話轉給吉姆，更詳細地討論我們的財務結果。吉姆？

Thank you, Dale, and good morning, everyone. I will echo Dale in acknowledging that while we remain confident about the strength of our business and our ability to grow it long term, our third quarter was challenging and our results fell short. I'll start today with my usual walk through the financial details and then provide some additional commentary about our outlook for Q4 and the action plan our leadership team is implementing to manage through the more challenging conditions for revenue, and I'll close with balance sheet, cash flow and capital allocation.

謝謝戴爾，大家早上好。我將回應 Dale，承認雖然我們對我們的業務實力和長期增長的能力充滿信心，但我們的第三季度充滿挑戰，我們的業績不盡如人意。今天，我將按照通常的財務細節開始，然後對我們對第四季度的展望以及我們的領導團隊正在實施的行動計劃進行一些額外的評論，以管理更具挑戰性的收入條件，我將以平衡結束表、現金流和資本配置。

As shown on Page 4 of the supplemental deck, Q3 revenue was $250.5 million, down 13.1% from Q3 '21 and down 13.7% from the prior quarter. Dale discussed the major components of the sequential decline, which are again detailed in the revenue bridge on Page 6 of the supplemental deck. I'd like to touch on some of these components in more detail and relate them to the decline in our revenues as a percentage of identified savings or what we call share of savings.

如補充資料第 4 頁所示，第三季度收入為 2.505 億美元，比 21 年第三季度下降 13.1%，比上一季度下降 13.7%。 Dale 討論了連續下降的主要組成部分，補充甲板第 6 頁的收入橋中再次詳細說明了這些組成部分。我想更詳細地談談其中的一些組成部分，並將它們與我們的收入下降聯繫起來，作為已確定儲蓄的百分比或我們所說的儲蓄份額。

Lower patient utilization of the health care system accounted for about $19 million of the change in revenues in the quarter. While total identified savings declined 4% sequentially, we experienced a much deeper decline in the savings categories that comprise most of our revenue. Specifically, as indicated on Page 8, identified savings related to our percentage of savings revenue model, which represents about 3/4 of our savings volumes and over 90% of our revenues, that declined 7%, while our per member per month savings volumes actually grew 5%.

本季度收入變化中約有 1900 萬美元因醫療保健系統的患者使用率下降而下降。雖然確定的儲蓄總額環比下降了 4%，但占我們收入大部分的儲蓄類別下降幅度更大。具體而言，如第 8 頁所示，確定的節省與我們的儲蓄收入模型百分比相關，占我們儲蓄量的大約 3/4 和我們收入的 90% 以上，下降了 7%，而我們每個會員每月的儲蓄量實際上增長了5%。

The net volume effect accounted for about half of the $19 million impact from lower patient utilization. As our identified savings volumes declined, we experienced mix shift between service lines and products, which unfavorably affected our revenues. This mix shift comprises the other half of the $19 million impact from lower patient utilization.

淨數量效應約佔因患者利用率降低而產生的 1900 萬美元影響的一半。隨著我們確定的儲蓄量下降，我們經歷了服務線和產品之間的混合轉變，這對我們的收入產生了不利影響。這種混合轉變包括因患者利用率降低而產生的 1900 萬美元影響的另一半。

Page 8 of the supplemental deck also presents identified savings as a percentage of our revenues. The share of savings declined about 50 basis points from prior quarter from 5.05% to 4.51%. This was driven in roughly equal parts by the identified savings volume mix shift I just discussed and the cumulative impact of the 3 other components that are each itemized on the revenue bridge on Page 6.

補充資料的第 8 頁還顯示了確定的節省占我們收入的百分比。儲蓄份額比上一季度下降約 50 個基點，從 5.05% 降至 4.51%。這是由我剛剛討論的已確定的儲蓄量組合轉變和其他 3 個組件的累積影響大致相等的部分驅動的，每個組件都在第 6 頁的收入橋上逐項列出。

These consisted of: a $6 million impact from above-trend revenue yield in analytics-based services during the first half of 2022, which subsided in Q3 and created a negative comparison; a $4 million impact related to customer contract adjustments and approximately $3 million of nonrecurring onetime customer credits that were true-up from prior periods. As Dale mentioned, our third quarter had an abnormal number of puts and few takes.

其中包括： 2022 年上半年基於分析的服務的高於趨勢的收入收益帶來 600 萬美元的影響，該影響在第三季度消退並形成負面比較；與客戶合同調整相關的 400 萬美元影響以及與前期調整一致的約 300 萬美元非經常性一次性客戶信貸。正如 Dale 所提到的，我們的第三季度出現了異常數量的 put 和很少的 take。

Neither the NSA or COVID were significant contributors to the sequential change in revenues. In fact, savings volumes and revenues related to our NSA services were a relative bright spot during the third quarter. NSA related claims volumes were not as soft as overall claim volume as relatively lower level of discretionary and elected health services are included in the mix of NSA claims, and as the conversion of in-scope claims to our NSA solutions otherwise continue to track to our expectations. Also notable, the change in revenues attributable to the COVID testing and treatment claims was not a material component of the sequential change in our total revenues.

NSA 或 COVID 都不是收入連續變化的重要貢獻者。事實上，與我們的 NSA 服務相關的儲蓄量和收入是第三季度的一個相對亮點。 NSA 相關索賠量並不像整體索賠量那麼疲軟，因為 NSA 索賠組合中包含相對較低水平的自由裁量和選擇的健康服務，並且由於範圍內索賠轉換為我們的 NSA 解決方案，否則繼續跟踪我們的期望。同樣值得注意的是，COVID 測試和治療索賠引起的收入變化並不是我們總收入連續變化的重要組成部分。

Our net COVID-related impact in the quarter was approximately $4 million to $6 million, a small percentage of revenues similar to last quarter and down from approximately $8 million to $10 million in the prior year quarter as detailed on Page 17 of the supplemental deck. We have mentioned that the net COVID-related impact is becoming less relevant with more distance from the initial lockdowns 2.5 years ago. We plan to assess the ongoing utility of providing this metric at the end of the year.

我們在本季度與 COVID 相關的淨影響約為 400 萬至 600 萬美元，佔收入的一小部分與上一季度相似，低於去年同期的約 800 萬至 1000 萬美元，詳見補充資料第 17 頁。我們已經提到，與 2.5 年前的初始封鎖距離越來越遠，與 COVID 相關的淨影響變得越來越不重要。我們計劃在年底評估提供該指標的持續效用。

Turning to Page 5 of the supplemental deck. Revenues were down in each of our service lines in Q3 2022. Network-based services declined 12.1% year-over-year, driven by lower patient utilization, lower COVID-related volumes, substitution of analytics-based services and some attrition of smaller clients that we had called out with our second quarter results. The network-based services declined -- based services revenues declined 7.2% sequentially, driven predominantly by lower patient utilization and lower savings volumes.

翻到補充卡組的第 5 頁。 2022 年第三季度，我們每條服務線的收入均有所下降。基於網絡的服務同比下降 12.1%，原因是患者利用率降低、與 COVID 相關的數量減少、基於分析的服務被替代以及小客戶的一些流失我們在第二季度的業績中提到了這一點。基於網絡的服務下降——基於網絡的服務收入環比下降 7.2%，這主要是由於較低的患者利用率和較低的儲蓄量。

Analytics-based services declined about 11.8% versus the prior quarter and 15% sequentially, driven by lower patient utilization, the aforementioned partial program loss at one of our customers, and the customer revenue adjustments, all of which were recognized in the service line. Payment Integrity revenues declined 21.9% year-over-year and 17.2% sequentially. The decline is attributable to our prepayment clinical negotiation business versus our Discovery business, which actually grew modestly. Our clinical negotiation business was softer from the lower volumes but also programmatic shift to customers and the substitution of clinical negotiation with NSA services, which are part of our analytics reporting line.

基於分析的服務較上一季度下降約 11.8%，環比下降 15%，原因是患者利用率較低、我們的一個客戶上述部分項目損失以及客戶收入調整，所有這些都在服務線中確認。 Payment Integrity 收入同比下降 21.9%，環比下降 17.2%。下降歸因於我們的預付款臨床談判業務與我們的發現業務相比，後者實際上增長緩慢。我們的臨床談判業務因交易量減少而變得疲軟，但也有計劃地向客戶轉移以及用 NSA 服務替代臨床談判，這是我們分析報告線的一部分。

Turning to expenses. The third quarter 2022 adjusted EBITDA expenses were $78.3 million, up from $69.9 million in the prior year quarter and down slightly from $80.5 million in Q2 '22. The increase versus the prior year quarter was caused predominantly by higher personnel costs due to increases in employee headcount and year-over-year wage increases. The sequential decline in Q3 represents tightening on hiring and the initial impact of several targeted cost initiatives we have undertaken in response to more difficult market conditions. The bulk of the actions will be implemented in the fourth quarter and first quarter and will impact our 2023 base.

談到開支。 2022 年第三季度調整後的 EBITDA 支出為 7830 萬美元，高於去年同期的 6990 萬美元，略低於 2022 年第二季度的 8050 萬美元。與去年同期相比增加的主要原因是員工人數增加和工資同比增長導致人事成本增加。第三季度的環比下降代表著招聘收緊以及我們為應對更加困難的市場條件而採取的幾項有針對性的成本舉措的初步影響。大部分行動將在第四季度和第一季度實施，並將影響我們 2023 年的基地。

Adjusted EBITDA was $172.2 million in Q3 '22, down about 21.2% from $218.4 million in the prior year quarter and down about 17.9% sequentially. Adjusted EBITDA margin came in at 68.7% in Q3 2022, down from 75.8% in Q3 '21 and down from 72.3% in the prior quarter, reflecting the revenue and adjusted EBITDA expense trends discussed previously. While we remain best-in-class with our adjusted EBITDA margins, our expense base is relatively fixed, and therefore, our margins are often driven by the trajectory of our revenues in any given quarter. In the third quarter, net cash provided by operating activity was $109 million and free cash flow was $88 million. As a reminder, our cash flow tends to be higher in the first and third quarters given the timing of our debt, interest and tax payments.

22 年第三季度調整後的 EBITDA 為 1.722 億美元，比去年同期的 2.184 億美元下降約 21.2%，環比下降約 17.9%。調整後的 EBITDA 利潤率在 2022 年第三季度為 68.7%，低於 21 年第三季度的 75.8% 和上一季度的 72.3%，反映了之前討論的收入和調整後的 EBITDA 費用趨勢。雖然我們在調整後的 EBITDA 利潤率方面保持一流，但我們的費用基數相對固定，因此，我們的利潤率通常受任何給定季度的收入軌跡驅動。第三季度，經營活動提供的現金淨額為 1.09 億美元，自由現金流為 8800 萬美元。提醒一下，考慮到我們的債務、利息和稅收支付的時間，我們的現金流在第一季度和第三季度往往更高。

Turning to our outlook on Page 11 of the supplemental deck. We are projecting Q4 '22 revenue of $235 million to $250 million. As Dale mentioned, our fourth quarter guidance embeds an expectation that patient utilization of the health care system remains sluggish in the third quarter. Even if utilization recovers in the fourth quarter, given our typical claim lag, it would be unlikely to materially lift our Q4 '22 revenues. We are projecting Q4 '22 adjusted EBITDA of $155 million to $170 million. That guidance implies an adjusted EBITDA expenses of about $80 million, slightly above the Q3 run rate of $78.3 million. Our guidance implies an adjusted EBITDA margin of 66% to 68% for the fourth quarter.

轉向我們對補充甲板第 11 頁的展望。我們預計 22 年第四季度的收入為 2.35 億美元至 2.5 億美元。正如 Dale 所提到的，我們第四季度的指導意見包含了對第三季度患者對醫療保健系統的利用仍然低迷的預期。即使利用率在第四季度恢復，考慮到我們典型的索賠滯後，也不太可能大幅提升我們的 Q4 '22 收入。我們預計 22 年第四季度調整後的 EBITDA 為 1.55 億美元至 1.7 億美元。該指引意味著調整後的 EBITDA 支出約為 8000 萬美元，略高於第三季度 7830 萬美元的運行率。我們的指引意味著第四季度調整後的 EBITDA 利潤率為 66% 至 68%。

As part of the action plan, our leadership team is implementing, we are addressing costs proactively. We've always been a very cost-conscious organization, and we are tightening our belt to help fund investments that we are making in the business and to also preempt inflationary pressures on cost. The goal is to contain expense growth in 2023 while keeping our platform in a position to benefit from higher volumes when utilization recovers and maintaining our focus on delivering for customers and growing the business.

作為行動計劃的一部分，我們的領導團隊正在實施，我們正在積極解決成本問題。我們一直是一個非常注重成本的組織，我們正在勒緊褲腰帶以幫助為我們在業務中進行的投資提供資金，並預防成本的通脹壓力。目標是在 2023 年控制費用增長，同時使我們的平台在利用率恢復時能夠從更高的交易量中受益，並繼續專注於為客戶提供服務和發展業務。

Turning to the balance sheet and capital. Our total and operating leverage ratios, net of cash were 5.4x and 3.9x, respectively, effectively unchanged from the prior quarter. We ended the third quarter with $439 million of cash on the balance sheet. And combined with the maturity schedule of our debt instruments, we have significant financial flexibility. Our business continues to generate substantial cash flow, which allows us to balance investing in growth of the business and reducing our leverage. As we have discussed previously, we will continue to take an opportunistic but balanced and disciplined approach to deploying our cash and are considering all options given these unique market conditions.

轉向資產負債表和資本。我們的總槓桿率和運營槓桿率（扣除現金）分別為 5.4 倍和 3.9 倍，與上一季度基本持平。我們在第三季度結束時資產負債表上有 4.39 億美元的現金。結合我們債務工具的到期時間表，我們擁有顯著的財務靈活性。我們的業務繼續產生大量現金流，這使我們能夠平衡投資於業務增長和降低杠桿率。正如我們之前所討論的那樣，我們將繼續採取機會主義但平衡和有紀律的方式來部署我們的現金，並考慮到這些獨特的市場條件下的所有選擇。

That brings me to the end of my comments. I'd like to turn it back over to Dale.

我的評論到此結束。我想把它轉回給戴爾。

Thank you, Jim. Before we open it up for Q&A, I want to acknowledge again that it was a tough quarter for MultiPlan, and for companies inside and outside of the health care sector, many of them household names. By no means am I sugarcoating, these results are in a disappointment, no question. And as any company does, MultiPlan has had its highs and lows. In my 20 years with the company, I've had a courtside seat to most of them. We always capitalize on the highs to become an even stronger partner to our customers, and we always come through the lows with renewed focus and energy. I believe this time will be no different because in our view, MultiPlan has the best fundamentals in our space.

謝謝你，吉姆。在我們開放問答環節之前，我想再次承認，對於 MultiPlan 以及醫療保健行業內外的公司來說，這是一個艱難的季度，其中許多公司都是家喻戶曉的公司。我絕不是糖衣，毫無疑問，這些結果令人失望。和任何公司一樣，MultiPlan 也有過高潮和低谷。在我為公司工作的 20 年裡，我對他們中的大多數人都有一個場邊的座位。我們總是利用高潮來成為客戶更強大的合作夥伴，並且我們總是以新的專注和活力度過低谷。我相信這一次也不會有什麼不同，因為在我們看來，MultiPlan 擁有我們所在領域最好的基礎。

Operator, would you please open it up -- would you kindly open it up for Q&A?

接線員，你能打開它嗎——你能打開它進行問答嗎？

(Operator Instructions) First question comes from Joshua Raskin from Nephron Research LLC.

（操作員說明）第一個問題來自 Nephron Research LLC 的 Joshua Raskin。

So I'll ask both questions kind of sequentially here. So the first thing I just want to make sure I understood your commentary, Dale, around 2023. It sounds like you expect the 4Q run rate to sort of continue or at least now what you're seeing in 3Q to continue. So should we assume that 2023 is expected to be down relative to the 4Q run rate because the customer -- the big customer (inaudible) or were you [including] that with the run rate?

所以我會在這裡按順序問這兩個問題。因此，首先我只想確保我理解你的評論，Dale，大約在 2023 年。聽起來你希望第四季度的運行率在某種程度上繼續下去，或者至少現在你在第三季度看到的情況會繼續下去。那麼我們是否應該假設 2023 年預計相對於 4Q 運行率會下降，因為客戶 - 大客戶（聽不清）或者你是否[包括]運行率？

Yes, Josh, this is Jim. I think -- well, I'll offer a couple of observations in a couple of dimensions. Number one, we're not providing 2023 guidance, and I think we're going to have a lot more visibility on run rate at the turn of the year than we have right now. So I would say, on one hand, we are acknowledging that the run rate of the business today is -- third and fourth quarter look a lot alike. But I don't think we're ready to kind of make a prediction as to what next year is going to look like. I do think that, as we've said in the second quarter earnings call, we do have this customer contract adjustment, which is going to be a headwind to growth.

是的，喬希，這是吉姆。我認為 - 好吧，我將在幾個方面提供一些觀察結果。第一，我們沒有提供 2023 年的指導，我認為我們將在今年年初對運行率有比現在更多的可見性。所以我想說，一方面，我們承認今天的業務運行率——第三季度和第四季度看起來很相似。但我認為我們還沒有準備好對明年的情況做出預測。我確實認為，正如我們在第二季度財報電話會議上所說的那樣，我們確實進行了客戶合同調整，這將成為增長的阻力。

We've talked about that being muted, flattish in terms of the impact because it will being offset to other initiatives in other growth areas as well as it could be all things being equal, is kind of a flat environment. So I think it's too early to say, Josh. There's a little bit of ambiguity on Q3 and Q4 because of utilization. But as we've seen in prior cycles, that can change relatively soon, and I think we'll have a better handle on that after our -- with our fourth quarter announcement.

我們已經談到了在影響方面被靜音，持平，因為它會被其他增長領域的其他舉措所抵消，而且它可能是所有事情都是平等的，這是一種扁平的環境。所以我認為現在說還為時過早，Josh。由於利用率，Q3 和 Q4 有點含糊不清。但正如我們在之前的周期中看到的那樣，這種情況可能會很快發生變化，而且我認為在我們發布第四季度公告之後我們會更好地處理這個問題。

Okay. So it sounds like if 4Q utilization were to be the run rate, right now is this customer adjustment will be a headwind, right? So -- but to your point, there's new growth and that sort of thing. The other question is the slide, looking at the sequential change of $39 million decline in revenue, only $3 million was kind of termed as nonrecurring. It seems like just a huge drop in utilization and then you kind of went through the litany of issues. But -- can you confirm that, that was the only catch up in that -- there was no other sort of retroactive adjustments or anything that was maybe overstated in the first half of the year? And then what specifically was the $3 million customer adjustment for?

好的。所以聽起來如果第四季度的利用率是運行率，那麼現在這種客戶調整將是一個逆風，對吧？所以 - 但就你的觀點而言，有新的增長和類似的事情。另一個問題是幻燈片，看看收入下降 3900 萬美元的連續變化，只有 300 萬美元被稱為非經常性收入。這似乎只是利用率的大幅下降，然後你就會遇到一連串的問題。但是——你能否證實，這是唯一的趕上——今年上半年沒有其他類型的追溯調整或任何可能被誇大的事情？那麼 300 萬美元的客戶調整具體是為了什麼？

Yes. So Josh, I want to make sure I understood -- let's talk about the -- let's maybe go and refer to Page 6 and just to kind of provide some specificity. The onetime customer adjustment that $3 million that's just true-ups from, frankly, some 2021 claims, et cetera. It's not -- it is not unusual given our revenue accounting that we could have some retroactive true-ups, but it is -- it doesn't happen very often. So those are onetime kind of true-ups against the past. I guess I would call -- and I'll just walk across this, the contract adjustments -- those are kind of modifications with customers along the way that are -- I wouldn't say normal course, but they happen and there are about $4 million of adjustments in this quarter.

是的。喬希，我想確保我理解了——讓我們談談——讓我們參考第 6 頁，只是為了提供一些具體信息。坦率地說，300 萬美元的一次性客戶調整隻是來自 2021 年的一些索賠等。考慮到我們的收入核算，我們可以進行一些追溯調整，這並不罕見，但它並不經常發生。所以這些都是對過去的一次調整。我想我會打電話——我會簡單介紹一下合同調整——這些是與客戶一起進行的某種修改——我不會說正常的過程，但它們確實發生了，而且大約有本季度有 400 萬美元的調整。

And then last but not least, I want to call out the yield normalization because that is less about -- that's a lot more about performance than history, so to speak, in the sense that the yield normalization, we have utilization of savings that we present to our customers. And we accrue to historical yields. And what happened in Q1 and Q2, and it took a little bit of digging, we were just performing above our accrual levels historically. And that's because whether it was COVID or some other classes of claims, where our clients were just accepting an abnormally high level.

最後但並非最不重要的一點是，我想提出收益率標準化，因為這與其說是關於性能，不如說是關於歷史，可以說，在收益率標準化的意義上，我們利用了我們節省的資金呈現給我們的客戶。我們積累了歷史收益率。而在第一季度和第二季度發生的事情，需要一點挖掘，我們的表現只是高於歷史上的應計水平。那是因為無論是 COVID 還是其他一些類別的索賠，我們的客戶只是接受了異常高的水平。

In Q3, largely because of some of the volume shifts, et cetera, it normalizes. So what that means is we have a comparison issue. It's less about business walking out of the door. It's more like the yields have come down a little bit in some of those areas, particularly in our analytics business, and it just creates a tough compare against last quarter. So we wanted to call that out, so you understood where we are today. So I hope that helps in terms of the [compulsory].

在第三季度，主要是由於一些交易量的變化，等等，它恢復正常。所以這意味著我們有一個比較問題。這與走出門外的業務無關。這更像是其中一些領域的收益率有所下降，尤其是在我們的分析業務中，這與上一季度相比形成了一個艱難的對比。所以我們想把它說出來，這樣你就會明白我們今天的處境。所以我希望在 [強制性] 方面有所幫助。

Yes, yes. So it sounds like it's not necessarily run rate and environmental totally, but I understand you're resetting to a lower, right? That the recurring is that it continues in the future and not that you're expecting these sorts of headwinds every quarter?

是的是的。所以聽起來它不一定完全是運行率和環境，但我知道你正在重置為較低的，對吧？反復出現的是它會在未來繼續，而不是你預計每個季度都會出現這種逆風？

Exactly. And listen, we see kind of the benefits of volume when things come in a little bit hot, our yields are a little bit higher, elective surgeries, which are oftentimes big tickets, the orthos, et cetera, can enhance our yields. And when volumes recede, and I think you kind of parse through the detail here, but our volumes came down about 7% in our percentage of savings categories, you could argue that they were even higher in some of the discretionary categories because our NSA claims were steadier. And so we get -- we can kind of get the benefit when it swings up and we get the decrement when it swings down.

確切地。聽著，當事情變得有點熱時，我們看到了體積的好處，我們的產量有點高，擇期手術，通常是大票，矯形器等等，可以提高我們的產量。當交易量下降時，我想你在這里分析了一些細節，但我們的儲蓄類別的交易量下降了大約 7%，你可以爭辯說，在某些可自由支配的類別中，交易量甚至更高，因為我們的國家安全局聲稱更穩定。所以我們得到 - 當它向上擺動時我們可以得到好處，當它向下擺動時我們可以得到減少。

The next question comes from Daniel Grosslight from Citigroup.

下一個問題來自花旗集團的 Daniel Grosslight。

I want to stick with Slide 6 for a little bit and really focus in on the $8 million program-related attrition. Curious if you have any color on where that client wins. What was the issue with that program specifically if there is pricing pressure, competition, et cetera. Just a little more color on the $8 million program-related decline.

我想稍微堅持使用 Slide 6，並真正關注與項目相關的 800 萬美元的人員流失。好奇您是否對客戶獲勝的地方有任何顏色。如果存在定價壓力、競爭等，該計劃的問題是什麼？與計劃相關的 800 萬美元下降只是多了一點色彩。

Right. Thanks, Daniel. It is a -- look, as I said and I've said it repeatedly, we always like to win 100% of the time. In this case, the customer made a decision to shift a part of its business and part of its work to a competitor, and not have all the takes in one basket. And so from that perspective, it didn't -- as the client customer didn't change its service portfolio with us, how it utilizes us, all the same services that the client -- the customer utilized prior to the change is the same array of services they use us -- use through us today for the lion's share of the business.

正確的。謝謝，丹尼爾。這是——看，就像我說過的，而且我已經反复說過，我們總是喜歡在 100% 的時間裡獲勝。在這種情況下，客戶決定將其部分業務和部分工作轉移給競爭對手，而不是將所有收入放在一個籃子裡。所以從這個角度來看，它並沒有——因為客戶沒有改變我們的服務組合，它如何利用我們，所有與客戶相同的服務——客戶在改變之前使用的是相同的他們使用我們的一系列服務——今天通過我們使用的大部分業務。

Okay. Makes sense. And then it seems like you're generating more of your revenue from PEPM versus shared savings. Is that just a 3Q, maybe 4Q issue and you expect that to normalize back in 2023? Or should we think about more savings coming through PEPM, which will continue to weigh on your revenue yield in '23 and beyond?

好的。說得通。然後，與共享儲蓄相比，您似乎從 PEPM 中獲得了更多的收入。這只是第 3 季度，也許是第 4 季度的問題，您預計它會在 2023 年恢復正常嗎？或者我們是否應該考慮通過 PEPM 節省更多費用，這將繼續影響您在 23 世紀及以後的收入收益？

Yes. And the -- we're being a little bit more transparent on that mix because the PEPM weighting, so to speak, and that savings is getting -- if it continues to grow, it's going to be a bigger component of it. So it does speak to a little bit of yield degradation by just virtue of volume, right? In our 10-Q, we call out the revenues on a percentage of savings versus PEPM. So I think that you will have the tools, I think, between our schedule on Page 8 versus the 10-Q to kind of think through some of those yield implications. But you're absolutely right. As we grow our PEPM business, the savings that are going to be attached to that or associated with that will continue to grow. That's our network side and it's also our HST.

是的。而且 - 我們在這種組合上變得更加透明，因為 PEPM 權重，可以這麼說，而且這種節省正在增加 - 如果它繼續增長，它將成為其中更大的組成部分。所以它確實說明了產量會因數量而有所下降，對吧？在我們的 10-Q 中，我們根據節省百分比與 PEPM 計算收入。因此，我認為在我們第 8 頁的時間表與 10-Q 之間，您將擁有工具來思考其中的一些收益影響。但你是絕對正確的。隨著我們 PEPM 業務的發展，與之相關或與之相關的節省將繼續增長。那是我們的網絡端，也是我們的 HST。

Right. And as I noted in my comments, Daniel, the value-driven health plan business grew substantially coming to just January 1, right? Where I think we're adding 39 groups, almost 15,000 new lives, and we've already exceeded 1 million total lives. So if that continues to grow, and that business, in particular, is based on a PEPM model, it will take a bigger piece of our revenue.

正確的。正如我在評論中指出的那樣，丹尼爾，價值驅動的健康計劃業務在 1 月 1 日大幅增長，對嗎？我認為我們正在增加 39 個組，將近 15,000 條新生命，並且我們已經超過 100 萬條總生命。因此，如果它繼續增長，尤其是該業務基於 PEPM 模型，它將佔用我們更大的收入。

Okay. And last one for me just on EBITDA. You guys mentioned you have really good incremental margins, but on the way down, you have high decremental margins. So I'm just curious for '23, if we don't see a nice rebound in utilization. Are we going to be kind of at the same run rate of EBITDA margin as you are in Q3 and Q4? How much cost can you actually take out of the business if you don't see that return to utilization? And then just one kind of accounting thing, I guess, for EBITDA this quarter. There was a $20.5 million add back in EBITDA for expenses, where did that come from?

好的。最後一個是關於 EBITDA 的。你們提到你們的增量利潤率非常好，但在下降的過程中，你們的遞減利潤率很高。所以我只是對 23 年感到好奇，如果我們沒有看到利用率有很好的反彈。我們是否會像您在第三季度和第四季度那樣以相同的 EBITDA 利潤率運行？如果看不到利用率的恢復，您實際上可以從業務中扣除多少成本？然後我猜，本季度的 EBITDA 只是一種會計事項。 EBITDA 中有 2050 萬美元的費用增加，這是從哪裡來的？

Okay. Why don't we take the margin question first, and then we'll hit the transaction expenses. The margin -- and what I can do is give you a little bit of context on the expense side because the margin will be, as we said, is going to be a function of what kind of revenue assumptions you're going to make. But the one thing that we can control is our expenses. Now having said that, it's relatively fixed. We've got $78 million of EBITDA expenses in Q3. We've got -- we're predicting $80 million in our guidance. So just kind of think of that as a run rate. What we're trying to do here is identify cost to mitigate the inflation of that base for next year.

好的。我們為什麼不先解決保證金問題，然後再解決交易費用問題。利潤率——我能做的就是在費用方面給你一些背景信息，因為正如我們所說，利潤率將取決於你將做出什麼樣的收入假設。但我們可以控制的一件事是我們的開支。現在話說回來，還是比較固定的。我們在第三季度的 EBITDA 支出為 7800 萬美元。我們已經 - 我們預測我們的指導價值為 8000 萬美元。因此，只需將其視為運行率即可。我們在這裡要做的是確定成本，以減輕明年該基地的通貨膨脹。

So you can imagine that we're probably the most cost-conscious company out there, given the margin profile we have today. We still have some opportunity to sharpen our pencil on the cost, but it is relatively fixed. And we don't want to be in a position where we miss out on our customer commitments and our revenue opportunities by cutting our costs too thinly. So we're taking a very disciplined approach to this, but you should not expect that our costs are going to take a shift down, so to speak, in 2023.

所以你可以想像，鑑於我們今天的利潤率，我們可能是最注重成本的公司。我們仍然有機會在成本上削尖我們的鉛筆，但它是相對固定的。而且我們不想因為過於削減成本而錯失我們對客戶的承諾和我們的收入機會。所以我們對此採取了非常有紀律的方法，但你不應該期望我們的成本會在 2023 年下降，可以這麼說。

I think what we're trying to do is mitigate what you could call an inflationary rate against that cost base and then find some areas of investment, and we'll call out those investment areas in our guidance in 2023. So that gives you some context on how we're thinking about it. And then as you -- as we talked about the 2023 revenue it's going to be a little bit of a function of where we kind of enter the new year, and that will drive the margin on whether it's 68 or otherwise.

我認為我們正在努力做的是減輕你可以稱之為成本基礎的通貨膨脹率，然後找到一些投資領域，我們將在 2023 年的指導中指出這些投資領域。這樣可以給你一些關於我們如何思考它的背景。然後就像你一樣——當我們談到 2023 年的收入時，它會有點影響我們進入新的一年的地方，這將推動它是 68 還是其他方面的利潤率。

And then secondly, Daniel, you asked about transaction expenses in the -- in our adjusted -- the non-GAAP EBITDA. And you're correct, there was an increase of transaction-related expenses in Q3 of about -- you see about $27 million in the schedule. This is noncash. The vast majority of that figure relates to reserves that we accrued this quarter for litigation of prior transactions. Now as the policy, we're just not going to comment on any pending litigation. But I would just say that you can look at our 10-Q, our public disclosure, and we call out what that means essentially in our filings.

其次，丹尼爾，你問過我們調整後的非公認會計原則 EBITDA 中的交易費用。你是對的，第三季度與交易相關的費用增加了大約——你在時間表中看到了大約 2700 萬美元。這是非現金。該數字的絕大部分與我們本季度為先前交易的訴訟累積的準備金有關。現在作為政策，我們只是不打算對任何未決訴訟發表評論。但我只想說，你可以看看我們的 10-Q，我們的公開披露，我們會在我們的文件中說明這基本上意味著什麼。

The next question comes from Cindy Motz from Goldman Sachs.

下一個問題來自高盛的 Cindy Motz。

I just had a couple, but just following up on that last thing you said, Jim, about the litigation reserve. So yes, because just in looking at the G&A that was reported and then obviously, there was an add-back of about $28.5 million or so. So that litigation expense, I mean, is that going to continue -- it's noncash and it's not going to continue, correct? Or how does that work?

我只有幾個，但只是跟進你最後說的，吉姆，關於訴訟儲備金。所以是的，因為僅查看報告的 G&A，很明顯，增加了大約 2850 萬美元左右。所以訴訟費用，我的意思是，會繼續下去——它是非現金的，不會繼續下去，對嗎？或者它是如何工作的？

We can't comment on whether it will continue or not. But I think the right way to describe it is, if we're putting a reserve on the balance sheet, it's because there's an estimate. And I think I would just go to our public disclosure in the 10-Q, and it explains our call is how we -- our philosophy on that.

我們無法評論它是否會繼續。但我認為正確的描述方式是，如果我們在資產負債表上放置準備金，那是因為有一個估計。我想我會在 10-Q 中公開披露，它解釋了我們的呼籲是我們如何 - 我們的理念。

Okay. And then just some housekeeping with the expenses. So the gross profit margin is about 78% -- 79%. Is that correct? Am I getting that right?

好的。然後只是一些家務管理費用。所以毛利率約為78%——79%。那是對的嗎？我說得對嗎？

Yes. I -- if you're calculating it off the press release, it's fine. We typically look at our EBITDA margins versus our gross. But in the 10-K to 10-Q, we'll have the -- yes, in the 10-Q, we'll have the breakout of the gross margin, personnel expenses, et cetera, and then the G&A side of things that should be able to bridge any questions you have.

是的。我 - 如果您根據新聞稿計算它，那很好。我們通常會比較我們的 EBITDA 利潤率與我們的毛利率。但是在 10-K 到 10-Q 中，我們將有——是的，在 10-Q 中，我們將有毛利率、人事費用等方面的突破，然後是 G&A 方面的事情那應該能夠解決您的任何問題。

All right. Okay. And just one -- just going back to the revenue bridge because there's great detail on Page 6 with the revenue bridge. So obviously, you explained the utilization, it looks like the yield is related to this. Just with the customer loss as well, you said it's partial, do you expect potentially maybe other losses with this customer or others? I know it's hard to predict, but are you -- I understand by utilization and everything, but do you feel like the competition is increasing? Like is it coming down to price? Or just any other color? I know you've already talked a lot about the macro, but just anything on the competitive situation around pricing would be helpful.

好的。好的。只有一個 - 回到收入橋樑，因為第 6 頁上有收入橋樑的詳細信息。很明顯，你解釋了利用率，看起來產量與此有關。就客戶流失而言，您說這是部分損失，您是否預計該客戶或其他客戶可能會造成其他損失？我知道這很難預測，但你是——我從利用率和一切方面理解，但你覺得競爭在加劇嗎？就像它降價了嗎？或者只是任何其他顏色？我知道你已經談了很多關於宏觀的問題，但任何關於定價競爭情況的內容都會有所幫助。

Yes, Cindy, we always have competitors as every business does, right? And so we like our chances. We always have a right to win. And -- but we never win -- we'll never bat 1,000%. And so from our perspective, we have a -- we have a great set of services. We have a great client roster. Our services are broad. They're sticky. They provide flexibility for every market shift and including the one we're facing now. And we've -- I think we have a proven track record to grow both organically and through acquisitions. And we clearly excel at integrating and cultivating those businesses we acquire. And so we'll -- yes, we have competitors, and -- but we compete every day, and I like our chances.

是的，辛迪，我們總是有競爭對手，就像每個企業一樣，對吧？所以我們喜歡我們的機會。我們總是有獲勝的權利。而且——但我們永遠不會贏——我們永遠不會達到 1,000%。因此，從我們的角度來看，我們有——我們有一套很棒的服務。我們有一個很棒的客戶名冊。我們的服務範圍很廣。它們很粘。它們為每一次市場轉變提供了靈活性，包括我們現在面臨的市場轉變。而且我們 - 我認為我們在有機增長和通過收購方面都有良好的記錄。我們顯然擅長整合和培育我們收購的那些業務。所以我們會——是的，我們有競爭對手，而且——但我們每天都在競爭，我喜歡我們的機會。

The next question comes from Steven J. Valiquette from Barclays.

下一個問題來自巴克萊銀行的 Steven J. Valiquette。

So a couple of questions here. Again, the revenue bridge down on Slide 6 is definitely useful. I guess just to simplify things, thinking about going from Q3 to Q4, you're sequentially guiding for both revenues and EBITDA to be down sequentially in 4Q versus 3Q. But what's the single biggest factor that drives that downward trend sequentially because you have to point out one from all the moving parts? .

所以這裡有幾個問題。同樣，幻燈片 6 上的收入橋樑絕對有用。我想只是為了簡化事情，考慮從第三季度到第四季度，您正在引導收入和 EBITDA 在第四季度與第三季度連續下降。但是，由於您必須從所有移動部件中指出一個，導致順序下降趨勢的最大因素是什麼？ .

The second question is, I didn't really have time to go look up all the various debt covenants before the earnings call this morning. But with a downward trend in EBITDA, let's call it, $650 million annualized run rate if you just take the fourth quarter guidance times that by 4, does that put the company in jeopardy of tripping any debt covenants in the next year? I mean you show the current leverage ratios on Page 14 in the slide deck but it was obviously going to come down into next year? And also, is your credit definition EBITDA comparable to what you're showing for equity EBITDA in the slide decks today?

第二個問題是，在今天早上的財報電話會議之前，我真的沒有時間去查看所有各種債務契約。但隨著 EBITDA 的下降趨勢，讓我們稱之為 6.5 億美元的年化運行率，如果你只是將第四季度的指導值乘以 4，這是否會使公司在明年有可能違反任何債務契約？我的意思是你在第 14 頁的幻燈片中顯示了當前的槓桿率，但它顯然會下降到明年？而且，您的信用定義 EBITDA 是否與您今天在幻燈片中顯示的股權 EBITDA 相當？

Why don't we -- make sure I got this, I'll answer the covenant and the debt EBITDA. The debt EBITDA and what we put in our press release are the same, so just -- just so you understand -- they're consistent. We -- our covenants are largely incurrence versus maintenance. So I don't think we have any material covenant issues coming up, and we obviously monitor that pretty closely.

我們為什麼不 - 確保我得到這個，我會回答契約和債務 EBITDA 。債務 EBITDA 和我們在新聞稿中的內容是相同的，所以只是 - 就像你理解的那樣 - 它們是一致的。我們——我們的契約主要是發生與維護。所以我不認為我們有任何實質性的契約問題出現，我們顯然會非常密切地監控它。

I'd also just point out that our maturity schedule, which you'll see in the supplemental deck, we've got -- we're not up against any looming maturities. The convertibles are -- end of 2027 and the rest of our capital to 2028. Our term -- our revolver is a little bit sooner than that, but the major components of our debt structure are turned out. So we've got some -- we've got flexibility here as we navigate through a little bit of a soft patch. So I hope that answers your -- call it, your debt questions.

我還要指出我們的成熟度時間表，你會在補充甲板上看到，我們已經有了——我們沒有面對任何迫在眉睫的成熟期。可轉換債券——到 2027 年底，我們的其餘資本到 2028 年。我們的期限——我們的左輪手槍比那早一點，但我們債務結構的主要組成部分已經出來了。所以我們有一些 - 我們在這裡有一些靈活性，因為我們瀏覽了一些軟補丁。所以我希望這能回答你的——稱之為你的債務問題。

And then Q4, I think the simplest way to describe it, Steve, and it's a good question is -- listen, our July run rate, revenues, et cetera, which reflects April, May time frame, but was included in our Q3 was higher. And as we went through the quarter, we get to September, which is reflecting kind of June, July environment, it was down. And so we're kind of managing through that downturn with a run rate beginning in the quarter, that's just lower than the run rate beginning last quarter. And so we're -- that's the major rationale for why we're a little bit lower.

然後是第四季度，我認為描述它的最簡單方法，史蒂夫，這是一個很好的問題——聽著，我們 7 月的運行率、收入等等，反映了 4 月、5 月的時間框架，但包含在我們的第 3 季度中是更高。當我們經歷這個季度時，我們到了 9 月，這反映了 6 月、7 月的環境，它下降了。因此，我們正在以本季度開始的運行率來應對經濟低迷，這僅低於上個季度開始的運行率。所以我們 - 這就是為什麼我們稍微低一點的主要原因。

The next question comes from Rishi Parekh from JPMorgan.

下一個問題來自摩根大通的 Rishi Parekh。

I apologize, I've been hopping around on calls. So if you've already answered these questions, I apologize for that. One, on the customer loss, is it reflective of the -- is that loss for the entire quarter? Or is it just a portion of the quarter? And if you were to -- if it's just a portion, what's the loss of the entire quarter? And as it relates to that customer, was that loss, as it relates to a competitor, did it move in-house? Or did -- was it to, I think, you had noted as a competitor? I just want to make sure it did not move in-house. And what area did it impact? Was it eyesight? Was it the network business? Was it Payment Integrity? And was that loss mostly due to price service? I was hoping that you could provide some more details as to how -- what led to that loss? And I have a follow-up.

抱歉，我一直在打電話。因此，如果您已經回答了這些問題，我深表歉意。第一，關於客戶流失，它是否反映了整個季度的損失？或者它只是該季度的一部分？如果你要 - 如果它只是一部分，那麼整個季度的損失是多少？就該客戶而言，與競爭對手相關的損失是否在內部轉移？還是——我想，你是作為競爭對手注意到的嗎？我只是想確保它沒有在內部移動。它影響了哪些領域？是視力嗎？是網絡業務嗎？是支付完整性嗎？這種損失主要是由於價格服務造成的嗎？我希望您能提供更多細節，說明是什麼導致了這種損失？我有一個後續行動。

Okay. Let's break that down. The $8 million is the full quarter. The shift occurred at -- literally on July 1.

好的。讓我們分解一下。 800 萬美元是整個季度。轉變發生在——確切地說是 7 月 1 日。

July 1.

7 月 1 日。

July 1. And it affected mostly our analytics side, but...

7 月 1 日。它主要影響了我們的分析方面，但是......

And negotiations.

和談判。

And negotiations. But again, I think, as Dale mentioned, it's a little bit more of the customer spreading the eggs around in their basket versus going in-house.

和談判。但是，我再次認為，正如 Dale 提到的那樣，與去內部相比，更多的是客戶將雞蛋散佈在他們的籃子裡。

Okay. And then on the utilization, can you maybe just break down what areas were impacted? Was it mostly elective surgeries? Was it related to the NSA related claims, behavioral health? I was hoping that maybe you could rank or bucket what areas were impacted in that utilization?

好的。然後關於利用率，您能否分解哪些區域受到影響？主要是擇期手術嗎？它與 NSA 相關的聲明、行為健康有關嗎？我希望您可以對哪些領域在該利用率中受到影響進行排名或分類？

Yes. It's interesting. It is not -- NSA was, as we said, was a bright spot. And...

是的。這真有趣。它不是——正如我們所說，NSA 是一個亮點。和...

It was mostly -- I think it was mostly in the areas you would expect, Daniel, -- you're not Daniel, I'm sorry, Rishi, it's in the elective category. So facilities like ambulatory surgical centers, general surgery, orthopedics, PT evaluations, chiro, muscular, skeletal those were the types of services that were largely impacted.

它主要是 - 我認為它主要是在你期望的領域，Daniel， - 你不是 Daniel，對不起，Rishi，它屬於選修類別。因此，門診手術中心、普通外科、骨科、PT 評估、脊椎、肌肉、骨骼等設施是受到很大影響的服務類型。

Yes. And we can see that in the claims data that we're processing, i.e. savings category. So some of these less severe and more -- non-emergent and more elective categories were down even more than the average 7% rate that we saw. And it affects our business a lot of that is processed through data eyesight where there's really attractive savings. And so that's part of that product mix shift in that $19 million we're talking about, Rishi.

是的。我們可以在我們正在處理的索賠數據中看到這一點，即儲蓄類別。因此，其中一些不那麼嚴重和更多——非緊急和更多選修類別的下降幅度甚至超過了我們看到的平均 7% 的下降率。它影響了我們的業務，其中很多是通過數據洞察力處理的，而這確實有吸引力的節省。因此，這是我們正在談論的 1900 萬美元產品組合轉變的一部分，Rishi。

It appears we have no questions at this moment. So I'm going to conclude today's call. Thank you, everyone, for joining and have a lovely day.

看來我們現在沒有問題了。所以我要結束今天的電話會議。謝謝大家的加入，祝你有美好的一天。