Premier Inc (PINC) 2023 Q3 法說會逐字稿

Good morning, and welcome to Premier's Fiscal 2023 Third Quarter Earnings Conference Call. [Please note, this event is being recorded.

早上好，歡迎來到 Premier 2023 財年第三季度收益電話會議。 [請注意，正在記錄此事件。

I would now like to turn the conference over to Angie McCabe, Vice President, Investor Relations. Please go ahead.

我現在想將會議轉交給投資者關係副總裁 Angie McCabe。請繼續。

Thank you. Welcome to Premier's Fiscal 2023 Third Quarter Conference Call.

謝謝。歡迎參加總理 2023 財年第三季度電話會議。

Our speakers this morning are Mike Alkire, Premier's President and CEO; and Craig McKasson, our Chief Administrative and Financial Officer.

今天上午我們的發言人是 Premier 總裁兼首席執行官 Mike Alkire；以及我們的首席行政和財務官 Craig McKasson。

Before we get started, I want to remind everyone that our earnings release and the supplemental slides accompanying this conference call are available in the Investors section of our website at investors.premier.com. Please be advised that management's remarks today contain certain forward-looking statements, and actual results could differ materially from those discussed today.

在我們開始之前，我想提醒大家，我們的收益發布和本次電話會議附帶的補充幻燈片可以在我們網站 investors.premier.com 的投資者部分找到。請注意，管理層今天的言論包含某些前瞻性陳述，實際結果可能與今天討論的結果大不相同。

These forward-looking statements speak as of today, and we undertake no obligation to update them. Factors that might affect future results are discussed in our filings with the SEC, including our most recent Form 10-K and our Form 10-Q for the quarter, which we expect to file soon.

這些前瞻性陳述截至今天，我們不承擔更新它們的義務。我們在提交給美國證券交易委員會的文件中討論了可能影響未來結果的因素，包括我們最近的 10-K 表格和本季度的 10-Q 表格，我們預計將很快提交。

We encourage you to review these detailed safe harbor and risk factor disclosures. Also, where appropriate, we will refer to adjusted or other non-GAAP financial measures, such as free cash flow to evaluate our business. Reconciliations of non-GAAP financial measures to GAAP financial measures are included in our earnings release in the appendix of the supplemental slides accompanying this presentation and in our earnings Form 8-K, which we expect to furnish to the SEC soon.

我們鼓勵您查看這些詳細的安全港和風險因素披露。此外，在適當的情況下，我們將參考調整後的或其他非 GAAP 財務指標，例如自由現金流來評估我們的業務。非 GAAP 財務指標與 GAAP 財務指標的對賬包含在本演示文稿附帶的補充幻燈片附錄中的收益發布以及我們預計將很快向 SEC 提供的收益表 8-K 中。

I will now turn the call over to Mike Alkire. Mike?

我現在將把電話轉給 Mike Alkire。麥克風？

Thank you, Angie. Good morning, everyone, and thank you for joining us today. Early this morning, we reported fiscal 2023 third quarter results and provided an update to our fiscal 2023 guidance.

謝謝你，安吉。大家早上好，感謝您今天加入我們。今天一大早，我們公佈了 2023 財年第三季度的業績，並更新了 2023 財年的指引。

Our third quarter results and revised full year guidance largely reflects three factors: one, our progress in advancing our longer-term strategy; two, an ongoing impact from macroeconomic headwinds; and three, health care market dynamics.

我們第三季度的業績和修訂後的全年指引主要反映了三個因素：一是我們在推進長期戰略方面取得的進展；二是宏觀經濟逆風的持續影響；三、醫療保健市場動態。

Today, I'll share some highlights from the third quarter, and then Craig will provide details on our financial and operational results and revised fiscal 2023 guidance. As a purpose-driven health care company, we remain steadfast in supporting our member health care providers and other customers as they continue to navigate the current environment, largely characterized by labor challenges, supply chain disruptions, inflation and rising interest rates.

今天，我將分享第三季度的一些亮點，然後 Craig 將提供我們的財務和運營結果以及修訂後的 2023 財年指導的詳細信息。作為一家以目標為導向的醫療保健公司，我們始終堅定不移地支持我們的成員醫療保健提供者和其他客戶，因為他們繼續應對當前環境，主要特點是勞動力挑戰、供應鏈中斷、通貨膨脹和利率上升。

We also continue to focus on advancing our longer-term strategy and reinforcing our competitive position in the market. Our business is built on a solid foundation, and we believe we are uniquely positioned in the market through: one, our ability to identify and predict innovation catalysts using our vast data set; two, our ability to deliver solutions to those catalysts in the market with AI-enabled technology, services and programs; and three, our ability to scale by leveraging the power of the Premier Alliance.

我們還繼續專注於推進我們的長期戰略並加強我們在市場上的競爭地位。我們的業務建立在堅實的基礎上，我們相信我們在市場上具有獨特的優勢，因為：第一，我們使用龐大的數據集識別和預測創新催化劑的能力；第二，我們有能力通過支持人工智能的技術、服務和項目為市場上的這些催化劑提供解決方案；第三，我們利用總理聯盟的力量進行擴展的能力。

In the third quarter, our Performance Services segment produced 9% quarter-over-quarter revenue growth. Within this segment, our AI-enabled technology and services platform is driving efficiency and scale for our health care provider members and other customers.

第三季度，我們的績效服務部門的收入環比增長了 9%。在這個細分市場中，我們的人工智能技術和服務平台正在為我們的醫療保健提供者成員和其他客戶提高效率和規模。

Top line growth in this segment reflects our progress in further diversifying our revenue mix and expanding into new customer bases by leveraging our unique combination of member relationships, integrated analytics and other wraparound services to further penetrate markets that are adjacent to our core health care provider business.

該細分市場的收入增長反映了我們通過利用我們獨特的會員關係組合、綜合分析和其他環繞服務進一步滲透與我們的核心醫療保健提供商業務相鄰的市場，在進一步多樣化我們的收入組合和擴展到新的客戶群方面取得的進展.

Through our adjacent markets businesses, we are also partnering with life sciences payers a self-insured employer customers and other health care products and service suppliers to deliver high quality, more effective health care.

通過我們鄰近的市場業務，我們還與生命科學付款人、自我保險的雇主客戶以及其他醫療保健產品和服務供應商合作，以提供高質量、更有效的醫療保健。

Collectively, our adjacent markets businesses produced strong quarter-over-quarter growth and remain on track to grow 30% to 40% this fiscal year. Contigo Health, our direct-to-provider and direct employer health plan benefits platform, which includes our provider network, centers of excellence, and third-party administrator and provider-sponsored health plan solutions, is making solid progress integrating our recently acquired provider network assets.

總體而言，我們的鄰近市場業務實現了強勁的季度環比增長，並有望在本財年實現 30% 至 40% 的增長。 Contigo Health 是我們直接面向提供者和直接雇主的健康計劃福利平台，其中包括我們的提供者網絡、卓越中心以及第三方管理員和提供者贊助的健康計劃解決方案，在整合我們最近收購的提供者網絡方面取得了穩步進展資產。

We recently formally launched ConfigureNet, our out-of-network wrap offering built from these acquired contracts with more than 900,000 providers across 4.1 million locations. While it's still early, ConfigureNet is beginning to gain traction in the market, and I'm pleased to report that we have signed several new ConfigureNet customers over the past several months.

我們最近正式推出了 ConfigureNet，我們的網絡外包裝產品是根據這些與 410 萬個地點的 900,000 多家供應商簽訂的合同構建的。雖然現在還早，但 ConfigureNet 已開始在市場上獲得關注，我很高興地向大家報告，在過去的幾個月裡，我們已經簽下了幾個新的 ConfigureNet 客戶。

Contigo Health customer base and pipeline of opportunities include provider-sponsored health plans and Fortune 50 and other large self-insured employers. We believe this business is well positioned to expand into self-funded employer health plans across the U.S. by offering a differentiated solution that better manages health care costs for employers and their health plan members.

Contigo Health 客戶群和機會管道包括供應商贊助的健康計劃和財富 50 強以及其他大型自保雇主。我們相信，通過提供差異化解決方案更好地管理雇主及其健康計劃成員的醫療保健成本，該業務已準備好擴展到美國各地的自籌資金雇主健康計劃。

Turning now to our Supply Chain Services business. In the third quarter, our group purchasing organization business performed in line with our expectations. With our non-acute or continuum of care GPO producing mid-single-digit growth.

現在轉向我們的供應鏈服務業務。第三季度，我們的團購組織業務表現符合我們的預期。我們的非急性或連續性護理 GPO 產生了中個位數的增長。

Our direct sourcing business continues to be impacted by excess market supply and high member inventory levels, which contribute to lower demand and pricing. We, along with our health care provider and supplier partners continue to focus on building a more resilient supply chain. As part of our ongoing effort to geographically diversify sources of production across a broader set of products, we recently announced a joint venture and the subsequent brand opening of a new domestic manufacturing facility to manufacturing and continence products in Virginia. We expect this and other partnerships to contribute more sustainable and secure production of vital, domestically produced health care products. We believe this will help drive less dependence on unpredictable markets and strengthen Premier's overall value proposition by further supporting our members, including the more than 4,400 U.S. hospitals and health systems and over 250,000 providers and other organizations.

我們的直接採購業務繼續受到市場供應過剩和會員庫存水平高的影響，這導致需求和定價下降。我們與我們的醫療保健提供者和供應商合作夥伴一起，繼續專注於建立更具彈性的供應鏈。作為我們在更廣泛的產品系列中實現地理多樣化生產來源的持續努力的一部分，我們最近宣布了一家合資企業，並隨後在弗吉尼亞州開設了一家新的國內製造工廠，用於製造和節制產品。我們期望這一合作夥伴關係和其他合作夥伴關係能夠促進更可持續、更安全地生產重要的國產醫療保健產品。我們相信，這將有助於減少對不可預測市場的依賴，並通過進一步支持我們的成員（包括 4,400 多家美國醫院和衛生系統以及超過 250,000 家提供商和其他組織）來加強 Premier 的整體價值主張。

Before I turn the call over to Craig and as we wrap up fiscal 2023, I want to acknowledge the continued dedication and efforts of our employees in advancing Premier's strategy and focusing on our mission to improve the health of our communities.

在我將電話轉給克雷格之前，在我們結束 2023 財年之際，我想感謝我們的員工在推進 Premier 的戰略和專注於我們改善社區健康的使命方面的持續奉獻和努力。

In summary, we remain focused on executing our longer-term strategy by partnering with our members and other customers to deliver innovative scalable solutions that we believe help solve some of healthcare's biggest challenges and create value for our stakeholders. We will continue to help providers and other customers navigate current macroeconomic headwinds and other market dynamics through novel technology-enabled solution designed to lower cost and improve health care and the quality of life for patients.

總之，我們通過與我們的成員和其他客戶合作提供創新的可擴展解決方案，繼續專注於執行我們的長期戰略，我們認為這些解決方案有助於解決醫療保健領域的一些最大挑戰並為我們的利益相關者創造價值。我們將繼續通過旨在降低成本並改善醫療保健和患者生活質量的新技術支持解決方案，幫助供應商和其他客戶駕馭當前的宏觀經濟逆風和其他市場動態。

I'll now turn the call over to Craig for a more detailed discussion of our third quarter results and revised fiscal 2023 financial guidance.

我現在將電話轉給克雷格，以更詳細地討論我們的第三季度業績和修訂後的 2023 財年財務指導。

Thanks, Mike. For the third quarter of 2023 and as compared with the same period a year ago, our results were total net revenue of $322.2 million, a decrease of 7%. Supply Chain Services segment revenue of $216.7 million, a decrease of 14% and Performance Services segment revenue of $105.6 million an increase of 9%.

謝謝，邁克。 2023 年第三季度與去年同期相比，我們的淨收入總額為 3.222 億美元，下降了 7%。供應鏈服務部門收入為 2.167 億美元，下降 14%，性能服務部門收入為 1.056 億美元，增長 9%。

In our Supply Chain Services segment, net administrative fees revenue was flat compared with the year ago quarter driven by mid-single-digit growth in our non-acute or continuum of care group purchasing business, where we continue to focus on technology enablement to create greater efficiencies for our members, while also channeling incremental member spend through our GPO portfolio.

在我們的供應鏈服務部門，淨行政費用收入與去年同期相比持平，這是由於我們的非急性或連續護理團體採購業務實現了中個位數增長，我們繼續專注於技術支持以創造為我們的會員提高效率，同時還通過我們的 GPO 產品組合引導會員增加支出。

The growth in our Continuum of Care GPO business was offset primarily by the following factors within our acute GPO business. First, the continued normalization of demand and pricing across certain categories, including pharmacy, diagnostics, staffing and personal protective equipment or PPE.

我們的 Continuum of Care GPO 業務的增長主要被我們急性 GPO 業務中的以下因素所抵消。首先，某些類別的需求和定價繼續正常化，包括藥房、診斷、人員配備和個人防護設備或 PPE。

Second, continued regional variation in patient utilization trends affecting member purchasing and third, a slight increase in aggregate blended member fee share due to current market dynamics, including the impact from consolidation of certain member health systems. Within both our acute and Continuum of Care GPO portfolios, the food category produced another consecutive quarter of strong growth, primarily driven by increases in volume and the impact of inflation, which was partially offset by the continued normalization of demand and pricing across the other categories previously mentioned.

其次，影響會員購買的患者使用趨勢持續存在區域差異，第三，由於當前市場動態，包括某些會員醫療系統整合的影響，混合會員費用份額總額略有增加。在我們的 Acute 和 Continuum of Care GPO 產品組合中，食品類別連續兩個季度實現強勁增長，這主要是由於銷量增加和通貨膨脹的影響，部分被其他類別的需求和定價持續正常化所抵消前面提到過。

Direct sourcing products revenue declined from the third quarter of fiscal 2022, which included the effect of higher prices and incremental purchases of PPE and other high-demand supplies as a result of the COVID-19 pandemic. This business continues to be impacted by excess market supply and member inventory levels of certain products, which resulted in lower demand and pricing.

直接採購產品收入從 2022 財年第三季度開始下降，其中包括因 COVID-19 大流行導致價格上漲和 PPE 及其他高需求供應品的增量採購的影響。該業務繼續受到市場供應過剩和某些產品的會員庫存水平的影響，導致需求和定價下降。

We continue to see ongoing demand for other products such as topical skin adhesives and IV safety catheters and are expanding our product portfolio and driving increased member adoption to mitigate current market conditions.

我們繼續看到對其他產品的持續需求，例如局部皮膚粘合劑和 IV 安全導管，並且正在擴大我們的產品組合併推動更多成員採用以緩解當前的市場狀況。

In our Performance Services segment, revenue increased 9% compared with last year's third quarter, primarily due to growth in our Consulting Services and certain of our adjacent markets businesses, including contributions from Contigo Health acquisition of TRPN assets in October 2022.

在我們的性能服務部門，收入與去年第三季度相比增長了 9%，這主要是由於我們的諮詢服務和我們的某些相鄰市場業務的增長，包括 Contigo Health 於 2022 年 10 月收購 TRPN 資產的貢獻。

As Mike stated earlier, we continue to expect revenue from our adjacent markets businesses to grow 30% to 40% on a combined basis in fiscal 2023 compared with fiscal 2022.

正如 Mike 之前所說，我們繼續預計 2023 財年我們鄰近市場業務的收入將比 2022 財年增長 30% 至 40%。

Turning to profitability. GAAP net income was $48.6 million for the quarter. Adjusted EBITDA increased 5% from the prior year period and primarily reflects two factors: first, an increase in Supply Chain Services adjusted EBITDA, which was mainly due to lower performance-related compensation expense, lower logistics costs in our direct sourcing business and higher equity earnings related to certain of our minority investments in domestic manufacturing. These items were partially offset by restructuring expenses from our previously announced cost savings plan that was implemented in the quarter.

轉向盈利能力。本季度 GAAP 淨收入為 4860 萬美元。調整後的 EBITDA 較上年同期增長 5%，主要反映了兩個因素：首先，供應鏈服務調整後的 EBITDA 增加，這主要是由於與績效相關的薪酬費用較低、直接採購業務的物流成本較低以及股權較高與我們在國內製造業的某些少數股權投資相關的收益。這些項目被我們先前宣布的本季度實施的成本節約計劃的重組費用部分抵消。

The increase in Supply Chain Services adjusted EBITDA was partially offset by a quarter-over-quarter decline in Performance Services adjusted EBITDA, which was mainly due to higher headcount-related expenses in some of our growing adjacent markets businesses compared with the prior year period as well as restructuring expenses associated with the cost savings plan.

供應鏈服務調整後 EBITDA 的增長部分被績效服務調整後 EBITDA 的環比下降所抵消，這主要是由於與去年同期相比，我們一些不斷增長的鄰近市場業務中與員工相關的費用增加以及與成本節約計劃相關的重組費用。

These items were partially offset by profitability associated with revenue growth in our PINC AI and Contigo Health businesses as well as lower performance-related compensation expense. Compared with the year ago quarter, adjusted net income and adjusted earnings per share each increased 2% primarily as a result of the same items that impacted adjusted EBITDA, partially offset by an increase in the effective tax rate in fiscal 2023 compared with fiscal 2022.

這些項目被與我們的 PINC AI 和 Contigo Health 業務收入增長相關的盈利能力以及較低的績效相關補償費用所部分抵消。與去年同期相比，調整後淨收入和調整後每股收益各增長 2%，這主要是由於影響調整後 EBITDA 的相同項目，部分被 2023 財年與 2022 財年相比的有效稅率增加所抵消。

From a liquidity and balance sheet perspective, cash flow from operations for the 9 months ended March 31, 2023, of $331.2 million decreased compared with the prior year period, primarily due to: one, a decrease in cash receipts from members and other customers compared with the prior year period, in which there was higher direct sourcing products revenue, as a result of the impact from the COVID-19 pandemic; and two, an increase in revenue share paid to members in the current year period.

從流動性和資產負債表的角度來看，截至 2023 年 3 月 31 日止 9 個月的運營現金流為 3.312 億美元，較上年同期減少，主要原因是：一、來自會員和其他客戶的現金收入較上年同期減少與去年同期相比，由於 COVID-19 大流行的影響，直接採購產品的收入更高；第二，本年度支付給會員的收入份額增加。

These items were partially offset by a decrease in inventory purchases compared with the year ago period as well as lower operating expenses driven by the company's cost savings plan implemented in the third quarter of fiscal 2023.

這些項目被庫存採購較上年同期減少以及公司在 2023 財年第三季度實施的成本節約計劃推動的運營支出減少所部分抵消。

In addition, net operating cash flows increased due to higher cash receipts, primarily due to dividends from one of our minority investments. Free cash flow for the 9 months year-to-date in fiscal 2023 was $199.5 million compared with $201.9 million for the same period a year ago.

此外，由於現金收入增加，淨經營現金流量增加，這主要是由於我們一項少數股權投資的股息。 2023 財年迄今 9 個月的自由現金流為 1.995 億美元，而去年同期為 2.019 億美元。

The decrease was primarily due to the same factors that impacted cash flow from operations, partially offset by lower purchases of property and equipment, namely our internally developed software and purchased hardware. Compared with the prior year period, due to the timing of projects and purchases.

減少的主要原因是影響運營現金流的相同因素，部分被財產和設備採購減少所抵消，即我們內部開發的軟件和購買的硬件。與上年同期相比，由於項目和採購的時間安排。

For fiscal 2023, we continue to expect free cash flow of approximately 45% to 55% of adjusted EBITDA. Cash and cash equivalents totaled $91.5 million as of March 31, 2023, compared with $86.1 million as of June 30, 2022.

對於 2023 財年，我們繼續預計自由現金流約佔調整後 EBITDA 的 45% 至 55%。截至 2023 年 3 月 31 日，現金和現金等價物總計 9150 萬美元，而截至 2022 年 6 月 30 日為 8610 萬美元。

We ended the quarter with an outstanding balance of $235 million on our 5-year $1 billion revolving credit facility, of which $60 million was repaid in April. During the first 9 months of fiscal 2023, we paid quarterly cash dividends to stockholders totaling $75.2 million.

本季度末，我們 5 年期 10 億美元的循環信貸額度的未償餘額為 2.35 億美元，其中 6000 萬美元已於 4 月償還。在 2023 財年的前 9 個月，我們向股東支付了總計 7520 萬美元的季度現金股息。

Recently, our Board of Directors declared a dividend of $0.21 per share payable on June 15, 2023, to stockholders of record as of June 1.

最近，我們的董事會宣布將於 2023 年 6 月 15 日向截至 6 月 1 日在冊的股東派發每股 0.21 美元的股息。

Now turning to our revised fiscal 2023 outlook and guidance. Based on our performance in the first 9 months of this fiscal year, our current visibility into the macro environment and market dynamics and our expectations for the remainder of the fiscal year, we are making the following updates to our fiscal 2023 guidance ranges.

現在轉向我們修訂後的 2023 財年展望和指導。根據我們在本財年前 9 個月的表現、我們目前對宏觀環境和市場動態的可見度以及我們對本財年剩餘時間的預期，我們對 2023 財年的指導範圍進行了以下更新。

We are lowering Supply Chain Services net revenue to a range of $895 million to $925 million. This decrease is due to our revised outlook for our direct sourcing products business of $250 million to $265 million, reflecting the ongoing impact of excess market supply and member inventory levels and lower revenues than we previously anticipated due to delays in new domestic manufacturing capabilities for isolation gowns and exam gloves.

我們將供應鏈服務淨收入下調至 8.95 億美元至 9.25 億美元。這一減少是由於我們將直接採購產品業務的前景修改為 2.5 億美元至 2.65 億美元，反映了市場供應過剩和成員庫存水平的持續影響，以及由於新的國內隔離製造能力的延遲導致收入低於我們之前的預期長袍和檢查手套。

Consistent with the guidance we provided last quarter, we continue to expect GPO net administrative fees revenue of $600 million to $620 million. We are lowering Performance Services net revenue to a range of $440 million to $460 million. While the overall business continues to have a strong pipeline of opportunities, we are seeing, to some degree, some softening in demand and delayed decision-making for some of our more comprehensive enterprise license and consulting services engagements largely due to the current macro environment.

與我們上個季度提供的指引一致，我們繼續預計 GPO 淨行政費用收入為 6 億至 6.2 億美元。我們將性能服務淨收入降低到 4.4 億至 4.6 億美元之間。雖然整體業務繼續擁有大量機會，但我們發現，在某種程度上，由於當前的宏觀環境，我們一些更全面的企業許可和諮詢服務業務的需求有所減弱和決策延遲。

While we believe there is a continued need for these innovative solutions in the longer term, we think it is prudent to take a more cautious view in the nearer term. As a result of the changes to segment level revenue guidance, we now expect total net revenue to be in the range of $1.34 billion to $1.39 billion in fiscal 2023.

雖然我們認為從長遠來看仍然需要這些創新解決方案，但我們認為在短期內採取更謹慎的態度是明智的。由於細分市場收入指引的變化，我們現在預計 2023 財年的總淨收入將在 13.4 億美元至 13.9 億美元之間。

We are revising our adjusted EBITDA guidance to a range of $490 million to $510 million and adjusted earnings per share to a range of $2.43 to $2.55. This is primarily due to the changes to our revenue guidance as well as the result of Premier entering into an amended agreement with FFF Enterprises where we received a preference on any future liquidation of that business.

我們將調整後的 EBITDA 指引修改為 4.9 億美元至 5.1 億美元，並將調整後的每股收益調整為 2.43 美元至 2.55 美元。這主要是由於我們的收入指引發生了變化，以及 Premier 與 FFF Enterprises 簽訂了修訂後的協議，我們在該協議中獲得了對該業務未來清算的優先權。

As a result of this new liquidation preference, our 49% ownership interest is now considered preferred equity rather than common stock interest, resulting in a change in the accounting methodology where we will no longer recognize our proportionate share of quarterly equity earnings, which we had historically included in adjusted EBITDA and adjusted earnings per share.

由於這一新的清算優先權，我們 49% 的所有權權益現在被視為優先股而非普通股權益，導致會計方法發生變化，我們將不再確認我們在季度股權收益中的比例份額，我們曾歷史上包括在調整後的 EBITDA 和調整後的每股收益中。

This change is expected to result in an approximate $0.02 to $0.04 per share impact on our fiscal 2023 earnings per share. Importantly, it will not have an impact on cash flow. While we're disappointed that we're bringing down our fiscal 2023 guidance, especially since we implemented the cost savings plan in the third quarter, to help mitigate some of the macro-related headwinds impacting our business, we remain focused on executing our long-term strategy to create value for our stakeholders.

這一變化預計將對我們 2023 財年的每股收益產生約 0.02 美元至 0.04 美元的影響。重要的是，它不會對現金流產生影響。儘管我們對下調 2023 財年指引感到失望，尤其是自從我們在第三季度實施成本節約計劃以來，以幫助減輕影響我們業務的一些與宏觀相關的逆風，我們仍然專注於執行我們的長期目標- 為我們的利益相關者創造價值的長期戰略。

Our business is stable and resilient, built on a solid foundation with significant cash flow generation and a strong flexible balance sheet, and importantly, supported by highly engaged employees dedicated to our mission to improve the health of communities.

我們的業務穩定而有彈性，建立在堅實的基礎上，產生大量現金流和強大靈活的資產負債表，重要的是，得到高度敬業的員工的支持，這些員工致力於我們改善社區健康的使命。

We appreciate your time today, and we'll now open the call to questions.

感謝您今天抽出寶貴時間，我們現在將開始提問。

(Operator Instructions) The first question comes from Kevin Caliendo with UBS.

（操作員說明）第一個問題來自瑞銀的 Kevin Caliendo。

I still believe you previously had said that the destocking trend would normalize in a couple of quarters, I think it was the actual language you used.

我仍然相信您之前曾說過去庫存趨勢將在幾個季度內正常化，我認為這是您使用的實際語言。

Is the expectation still the same? Has anything really changed much? Was this just like a magnitude issue that caused this?

期待還是一樣嗎？真的有什麼改變嗎？這是否只是一個造成這種情況的重大問題？

I think in general, what we're still seeing just excess inventory levels within the health systems, and they're continuing to bleed through this. So I still think obviously, we've got -- this has got to normalize at some point in time. We're still guessing that this probably is out a couple of quarters. But it -- we're just watching how these inventories are being utilized in the short term.

我認為總的來說，我們仍然看到衛生系統內的庫存水平過高，而且他們正在繼續為此流血。所以我仍然認為很明顯，我們已經 - 這必須在某個時間點正常化。我們仍然猜測這可能已經過了幾個季度。但它——我們只是在觀察這些庫存在短期內是如何被利用的。

Yes. And this is Craig. The only thing I'd add is that it is specific to some of the core commodity products, I think, gowns, gloves that were stocked up very heavily during the pandemic and which the direct sourcing business has its primary business in.

是的。這是克雷格。我唯一要補充的是，它特定於一些核心商品，我認為，在大流行期間大量庫存的禮服、手套，以及直接採購業務的主要業務。

So it does vary. But certainly, there -- we believe it will continue to take a couple of quarters to all the way out.

所以它確實有所不同。但可以肯定的是，我們相信它會繼續需要幾個季度才能完全消失。

I have a quick follow-up. Within SI&P, can -- maybe can you speak to the demand across categories? Is there excess supply within specific areas of PPE or supplies versus others?

我有一個快速跟進。在 SI&P 中，你能——也許你能談談跨類別的需求嗎？ PPE 的特定領域內是否存在供應過剩或與其他供應相比？

In general, I would just say that you still see excess supply in the gloves and the gowns, but you could generalize, Kevin and say that it's across all the categories.

總的來說，我只想說你仍然看到手套和禮服的供應過剩，但你可以概括一下，凱文，並說所有類別都是如此。

The next question comes from Michael Cherny with Bank of America.

下一個問題來自美國銀行的 Michael Cherny。

Maybe if I can just ask one on the GPO side. It seems like this quarter has been all about improving utilization. We've seen it from health systems you service. We've seen it from the very different medical device product manufacturers that you work with.

也許我可以在 GPO 方面問一個問題。似乎本季度一直都是關於提高利用率。我們已經從你們服務的衛生系統中看到了這一點。我們從與您合作的非常不同的醫療設備產品製造商那裡看到了這一點。

How do you think about that trajectory of what you're seeing, what your customer base is seeing on the utilization side, both inpatient and Continuum of Care, especially as it sets you up for the remainder of this calendar year and what may be or may not be included in some initial fiscal '24 jumping off points.

您如何看待您所看到的軌跡，您的客戶群在使用方面看到的情況，包括住院病人和連續護理，特別是因為它為您準備了本日曆年的剩餘時間以及可能或可能不包括在某些最初的 24 財年起點中。

Yes. So this is Mike. I'll start. So just consistent with what we saw last quarter, utilization varies by geography. And some have not seen the full return to pre-pandemic levels. I think it's incredibly geographically oriented.

是的。所以這是邁克。我會開始。因此，與我們上個季度看到的情況一致，利用率因地理位置而異。有些還沒有完全恢復到大流行前的水平。我認為這是難以置信的地理導向。

You see areas like Florida and Texas that, we're seeing great growth and they're doing very, very well. And then you see other areas that may be in the upper Midwest and those areas where the economy is not growing quite as fast that you see you don't see the growth.

你看到像佛羅里達州和得克薩斯州這樣的地區，我們看到了巨大的增長，他們做得非常非常好。然後你會看到其他可能位於中西部上游的地區，以及那些經濟增長速度不如你看到的那麼快的地區，你看不到增長。

And so again, I think it's lumpy. I also think when you have larger population areas versus more rural population areas, you're seeing a difference between how those parts of the country are coming back from a utilization standpoint. I was literally out with executives had some very, very large health systems that span geographies.

再一次，我認為它是塊狀的。我還認為，當你擁有更大的人口區域與更多的農村人口區域時，你會看到該國這些地區從利用率的角度來看是如何恢復的。我真的不同意高管們有一些非常非常大的跨越地域的衛生系統。

And even they are saying, look, across our entire business we're seeing exactly what you're seeing. We're seeing that in our higher-growth markets that from a population standpoint, we're seeing the recovery happening and then in those other areas we're not.

甚至他們說，看，在我們整個業務中，我們看到的正是您所看到的。我們看到，從人口的角度來看，在我們的高增長市場中，我們看到復蘇正在發生，而在其他地區則沒有。

And if I can just ask one just follow-up and just a tactical question. Can you remind us the Continuum of Care side of the net administrative fees, what is that as a percent of the total?

如果我可以只問一個跟進問題和戰術問題。您能否提醒我們淨行政費用的連續護理方面，它佔總額的百分比是多少？

The Continuum of Care represents approximately 40% of our total GPO today, Michael.

邁克爾，Continuum of Care 約占我們今天 GPO 總數的 40%。

The next question comes from Tiffany Yuan representing Steve Valiquette with Barclays.

下一個問題來自 Tiffany Yuan 代表 Steve Valiquette 與巴克萊銀行。

I think on PS last quarter, like in response to software dynamics you were seeing for Remitra, you announced a handful of new marketing efforts. I was wondering if you could give us an update on those efforts and maybe just any changes overall to the sales and marketing approach across all of PS in order to firm up sales type in response to what you're seeing in the market?

我認為在上個季度的 PS 上，就像響應您為 Remitra 看到的軟件動態一樣，您宣布了一些新的營銷活動。我想知道您是否可以向我們介紹這些工作的最新情況，以及是否可以對所有 PS 的銷售和營銷方法進行整體更改，以便根據您在市場上看到的情況來鞏固銷售類型？

Yes. So let me hit Remitra first, and then I'll talk in general about Performance Services. So in Remitra, obviously, we're continuing to build out our business-to-business infrastructure, which, as we've described in the past, really allows for both AR and AP payment automation.

是的。因此，讓我先點擊 Remitra，然後我將一般性地談論性能服務。因此，在 Remitra 中，很明顯，我們正在繼續構建我們的企業對企業基礎設施，正如我們過去所描述的那樣，它確實允許 AR 和 AP 支付自動化。

We think it is a very underserved part of the market. We think it's an opportunity to automate some functions within our Health Care Systems that need to be automated and drive significant efficiency.

我們認為這是市場中服務不足的部分。我們認為這是一個機會，可以使我們的醫療保健系統中的某些功能實現自動化，這些功能需要實現自動化並顯著提高效率。

So since our last call, we've been out having conversations with both suppliers as well as our members, talking about the value of the offering, getting their feedback and those kinds of things in terms of what it is from a product standpoint that will drive the most amount of value.

因此，自從我們上次通話以來，我們一直在與供應商和我們的成員進行對話，討論產品的價值，獲得他們的反饋以及從產品的角度來看，這將是什麼驅動最大的價值。

So we're going to continue to go down that path. We think that this is a program that is incredibly important for our business. And just as importantly, it's incredibly important for the health care systems as they're struggling in many cases with the headwinds associated with labor and other things.

所以我們將繼續沿著這條路走下去。我們認為這是一個對我們的業務非常重要的計劃。同樣重要的是，這對醫療保健系統來說非常重要，因為它們在許多情況下都在與分娩和其他事情相關的不利因素作鬥爭。

As it relates to Performance Services, a couple of different parts of Performance Services. If you look at our enterprise licenses, still see a very, very strong pipeline of enterprise licenses. As our Health Care Systems are continuing to need capabilities to help them managed through a very difficult environment so the technology and the wraparound services and those kinds of things, we see still a very, very strong pipeline.

因為它涉及性能服務，性能服務的幾個不同部分。如果您查看我們的企業許可證，仍然會看到非常非常強大的企業許可證管道。由於我們的醫療保健系統繼續需要能力來幫助他們在非常困難的環境中進行管理，因此技術和環繞服務以及諸如此類的東西，我們仍然看到一個非常非常強大的管道。

Our Life Science business, we're still seeing, again, great pipeline in the Life Sciences business, and we're really excited about some of the opportunities that we're embarking upon in that part of the business as well.

我們的生命科學業務，我們仍然再次看到生命科學業務的巨大管道，我們對我們在這部分業務中所面臨的一些機會感到非常興奮。

Yes. And the only color -- this is Craig, that I would add to that is I think part of your question was around sort of how are we approaching sales and marketing. And I think consistent with what we've said previously, given the extreme financial dress that a lot of these health care providers are under, we are continuing to try and articulate short-term value proposition to evidence why they should make the investment in certain performance improvement capabilities in order to try and get the sales in place so that they can actually improve their performance, and it can help us get the revenue growth that we're looking to achieve.

是的。唯一的顏色——這是克雷格，我要補充的是，我認為你的部分問題是關於我們如何進行銷售和營銷的。而且我認為與我們之前所說的一致，鑑於許多這些醫療保健提供者都身著極端的財務裝束，我們將繼續嘗試並闡明短期價值主張，以證明他們為什麼應該在某些方面進行投資績效改進能力，以便嘗試讓銷售到位，這樣他們才能真正提高績效，這可以幫助我們實現我們希望實現的收入增長。

The next question comes from Eric Coldwell with Baird.

下一個問題來自 Baird 的 Eric Coldwell。

On the GPO member fee share that was mentioned, I guess I can understand the impact of client consolidation on average fees. But I'm not as clear on why the macro environment was also cited as a reason for higher revenue share. What was the concept there?

關於提到的 GPO 會員費用份額，我想我可以理解客戶合併對平均費用的影響。但我不清楚為什麼宏觀環境也被列為更高收入份額的原因。那裡的概念是什麼？

Yes. I think the -- this is Craig. Thanks for the question, Eric. We're operating in a challenging environment, as you know, with labor challenges, supply chain disruptions, inflation, rising interest rates, et cetera, and that's putting unprecedented cost pressure on these health systems.

是的。我認為 - 這是克雷格。謝謝你的問題，埃里克。正如您所知，我們在充滿挑戰的環境中運營，面臨勞動力挑戰、供應鏈中斷、通貨膨脹、利率上升等，這給這些衛生系統帶來了前所未有的成本壓力。

So as we think about recruiting new ones, as we think about retention of ones that do have contracts coming up in the ordinary course. We are, in some cases, seeing more pressure for feature because they are looking to actually improve their financial performance in any possible way that they can in the short term. And so that is having a bearing on fee share in the current period.

因此，當我們考慮招聘新人時，我們考慮保留那些在普通課程中確實有合同的人。在某些情況下，我們看到更多的功能壓力，因為他們希望在短期內以任何可能的方式實際改善他們的財務業績。因此，這對當前期間的費用份額有影響。

And then on adjacent markets, is there any chance you could parse out the varying growth in the quarter between your legacy health care provider revenue and your adjacent markets? I'm trying to get a sense on what adjacent markets actually grew this quarter. I think last quarter was in the lower 20s, and you're citing 30% to 40% for the year. So assumption is that, that business had to do a little better on a growth rate this quarter, but I'd like to get your thoughts there.

然後在相鄰市場上，您是否有機會分析出本季度您的傳統醫療保健提供商收入與相鄰市場之間的不同增長情況？我試圖了解本季度哪些相鄰市場實際增長了。我認為上個季度是在 20 歲以下，而你引用的是全年 30% 到 40%。所以假設是，該業務必須在本季度的增長率上做得更好，但我想听聽你的想法。

Yes. So your assumption is correct. So for the third quarter, the business, we had really strong growth in Contigo Health and the Applied Sciences business in particular. But overall, we are -- as we said, validating to hit the 30% to 40% on a full year basis and did hit in, I'd say, the mid-20s in the adjacent markets with sort of mid-single-digit growth in the provider market.

是的。所以你的假設是正確的。因此，對於第三季度的業務，我們在 Contigo Health 和應用科學業務方面取得了非常強勁的增長。但總的來說，我們——正如我們所說的那樣，在全年的基礎上驗證了 30% 到 40% 的增長，並且確實進入了，我想說的是，相鄰市場的 20 年代中期，有點像中單-提供商市場的數字增長。

Okay. And then last one on the JVs, Honeywell and DeRoyal. I know last quarter, both of those were cited as running behind launch schedule. It sounds like that's still happening. What's the update on those facilities? Why are they delayed? And when do you expect them to, I guess, become, I don't know if the right word is productive, but functioning at the level you've anticipated?

好的。然後是關於 JVs、Honeywell 和 DeRoyal 的最後一個。我知道上個季度，這兩個都被認為落後於發布計劃。聽起來這種情況仍在發生。這些設施有什麼更新？他們為什麼延遲？我猜你希望他們什麼時候變得，我不知道正確的詞是否富有成效，但在你預期的水平上運作？

Yes. So I think as you can expect, when you're setting up new lines of production, particularly new facilities and for new complex manufacturing processes in the case of the DeRoyal gown manufacturing, that is a brand-new fully automated assembly line.

是的。所以我認為正如你所預料的那樣，當你建立新的生產線時，特別是新設施和新的複雜製造工藝，就 DeRoyal 禮服製造而言，這是一條全新的全自動裝配線。

It was being developed from scratch at a time when supply chain disruptions were affecting lots of organizations and people. So it did take longer than we'd anticipated initially to get the actual assembly line in place and operational.

它是在供應鏈中斷影響許多組織和人員的時候從頭開始開發的。因此，實際組裝線到位並投入運營所花的時間確實比我們最初預期的要長。

And then given the new automation, there were quality control checks to ensure that the products were actually meeting all the expectations as they were coming off the line. So there were delays by a number of months versus where we had originally anticipated as a result of that.

然後考慮到新的自動化，有質量控制檢查以確保產品在下線時確實滿足所有期望。因此，與我們最初預期的相比，延遲了幾個月。

They are now coming off the lines and so that part is moving forward. Relative to Honeywell, similarly, there have been delays in certain of the facilities that they were looking to manufacture. They have pivoted to other facilities to get production but it's not at the capacity and level that was originally anticipated and expected, according to the time lines and the plans that we had.

他們現在正在下線，所以這部分正在向前推進。同樣，相對於霍尼韋爾，他們希望製造的某些設施也出現了延誤。根據我們的時間表和計劃，他們已轉向其他設施進行生產，但未達到最初預期和預期的產能和水平。

And so they are operating now Eric, but not at the magnitude and level that was originally expected and then those delays. And we are also working a little bit through some of the excess inventory in those product categories that we've talked about as well impacting the level of growth in those businesses.

因此，埃里克，他們現在正在運作，但沒有達到最初預期的規模和水平，然後是那些延遲。我們也在努力解決我們所討論的那些產品類別中的一些過剩庫存，這些庫存也會影響這些業務的增長水平。

The next question comes from Richard Close with Canaccord Genuity.

下一個問題來自 Canaccord Genuity 的 Richard Close。

Craig, can you maybe just go into the softening demand on the consulting and license? Just a little bit more details there? What changed from the second quarter to this quarter?

克雷格，你能不能談談對諮詢和許可的需求疲軟？那裡有更多細節嗎？二季度到本季度有什麼變化？

And then you just mentioned a focus on, I guess, it was short-term ROI selling I guess, services and products focused on that. If you could just provide a little bit more detail specifically what you're talking about on that front from a services and product standpoint.

然後你剛剛提到了一個重點，我想，這是短期投資回報率的銷售，我想，服務和產品專注於此。如果您能從服務和產品的角度提供更多細節，具體說明您在這方面所談論的內容。

Sure. I'll start and then Mike can add any colors as he deems appropriate. Relative to changes in Performance Services, I think the financial pressures that the health care systems are facing are only continuing to increase longer term. They have the labor challenges and disruptions that are continuing to put pressure on them.

當然。我會開始，然後 Mike 可以添加他認為合適的任何顏色。相對於績效服務的變化，我認為醫療保健系統面臨的財務壓力只會在長期內持續增加。他們面臨著持續給他們施加壓力的勞動力挑戰和中斷。

So we are seeing some softening in terms of the willingness to close as quickly on some of the engagements as we had anticipated. We were going to see given some of the history we saw, for example, back in the second quarter when we had a very strong performance quarter with enterprise licenses.

因此，我們看到一些人願意像我們預期的那樣盡快結束一些合作。我們將看到我們所看到的一些歷史，例如，在第二季度，當我們有一個非常強勁的企業許可證季度表現時。

And so those engagements are taking longer to get through the funnel. As Mike indicated, we do still have a good pipeline, but it's just that they're not closing on the -- at the same pace as we had anticipated last quarter when we were providing our results.

因此，這些參與需要更長的時間才能通過漏斗。正如邁克所指出的那樣，我們仍然有一個很好的管道，但只是他們沒有以與我們上個季度提供結果時預期的速度相同的速度結束。

From a standpoint of what I was talking about with the short term, it's really about how can you quantify the return on investment quickly so that the investment in the consulting project or the technology can be quickly realized by the provider in terms of recognition.

從我所說的短期的角度來看，這實際上是關於如何快速量化投資回報，以便供應商在認可方面能夠快速實現對諮詢項目或技術的投資。

So it is really as opposed to making an investment today and seeing a return 18, 24 months from now, it's how do we position to really drive optimization from either a labor workforce standpoint or a service line standpoint, et cetera, so that they get those benefits more quickly. But Mike, I don't know if there's things you would add to that.

因此，與今天進行投資並在 18、24 個月後看到回報相反，我們如何定位以真正從勞動力的角度或服務線的角度等角度推動優化，以便他們獲得這些好處更快。但是邁克，我不知道你是否要添加一些東西。

No. You got it.

不，你明白了。

And then as a follow-up on the GPO side, you mentioned staffing improvements in staffing at the health system level was a headwind for you guys. Can you just go into that a little bit more, maybe the magnitude?

然後作為 GPO 方面的後續行動，你提到衛生系統層面人員配置的改進對你們來說是一個不利因素。你能不能再深入一點，也許是幅度？

Yes. I maybe reframe your question, the staffing for what now?

是的。我可能會重新定義你的問題，現在的人員配置是什麼？

I thought you had mentioned the category of staffing...

我以為你提到了人員配置類別...

Richard, this is Craig. I apologize. We have continued to see -- and I think I think you are aware of this. During the pandemic, with the labor shortages, there was a tremendous increase in temporary staffing. So we have a temporary staffing GPO relationship we saw substantial growth a year ago in that temporary staffing contract.

理查德，這是克雷格。我道歉。我們繼續看到——我想我想你已經意識到了這一點。疫情期間，勞動力短缺，臨時工大量增加。因此，我們有一個臨時人員 GPO 關係，我們在一年前看到該臨時人員合同的大幅增長。

Over time, health systems have begun to focus on how to reduce their dependency on those temporary staffing, and we've seen more normalization of that staffing category in our GPO. And so that has been pulling down the level of performance on a year-over-year basis. because they're not utilizing that contract at the pace and rate that they were in the prior year.

隨著時間的推移，衛生系統開始關注如何減少對這些臨時人員的依賴，我們已經在 GPO 中看到該人員類別更加規範化。因此，這一直在逐年拉低業績水平。因為他們沒有按照前一年的速度和速度使用該合同。

So would there be further deterioration? Or have we like bottomed out there?

那麼會不會進一步惡化呢？還是我們已經觸底了？

I think it's pretty hard to say. I would say that we're probably pretty close to the bottom. But there's still a ways to go. There's still excess costs associated with traveling temporary labor in some of our markets.

我認為這很難說。我會說我們可能非常接近底部。但是還有很長的路要走。在我們的一些市場中，臨時工的出差仍然存在超額成本。

And I will tell you, I think a lot of those health systems are looking at strategies to continue to get more full-time resources to support their patients.

我會告訴你，我認為很多衛生系統正在研究戰略，以繼續獲得更多的全職資源來支持他們的病人。

Yes. And I think it's important to note, temporary staffing is still an important of how a health care provider manages their labor. It just got to a point that the cost was extremely high. They couldn't justify it.

是的。而且我認為值得注意的是，臨時人員配置仍然是醫療保健提供者如何管理其勞動力的重要因素。只是到了成本極高的地步。他們無法證明這一點。

Some of them began to look at ways to in-source aspects of that capability. and still figuring out the right way to manage through the temporary staffing agency. So those agencies provide an important valuable service. It's just not sustainable at the levels it was when there was extreme labor shortages and challenges and the rate hikes that they were able to get over a period of time.

他們中的一些人開始尋找將該功能的各個方面內源化的方法。並且仍在尋找通過臨時人事代理機構進行管理的正確方法。因此，這些機構提供了重要的有價值的服務。在勞動力極度短缺和挑戰以及他們能夠在一段時間內獲得加息時的水平上，它是不可持續的。

The next question comes from Jessica Tassan with Piper Sandler.

下一個問題來自 Jessica Tassan 和 Piper Sandler。

Can you just talk a little bit about the product mix within the products revenue business? So is the vast majority still PPE? And then just what is kind of the long-term target mix of differentiated products versus PPE? And then the current versus long-term margin target for that business?

您能談談產品收入業務中的產品組合嗎？那麼絕大多數仍然是個人防護裝備嗎？那麼差異化產品與 PPE 的長期目標組合是什麼樣的？然後是該業務的當前與長期利潤率目標？

Sure, Jessica. This is Craig. I'll start, and then Mike can clarify or add any color. The vast majority of the products in our direct sourcing portfolio today are commodity products. That is where we started in the key areas of gloves, gowns, masks, things of that nature.

當然，傑西卡。這是克雷格。我會開始，然後 Mike 可以澄清或添加任何顏色。今天，我們直接採購組合中的絕大多數產品都是商品。這就是我們在手套、防護服、口罩等關鍵領域的起點。

We have continued to expand the product portfolio over time, and in some cases, have gone further up, I'll say, the clinical chain a bit when you think about things like surgeons gloves and IV catheters and different types of product categories that you've heard us talk about. But the vast majority does continue to be commodity products.

隨著時間的推移，我們繼續擴大產品組合，在某些情況下，我會說，當你考慮諸如外科醫生手套和 IV 導管以及你需要的不同類型的產品類別時，臨床鏈會更上一層樓聽我們說過。但絕大多數仍然是商品。

I think longer time -- we will longer term, excuse we will continue to think about the right product mix, and we'll look to where appropriate, source more clinical products that are more clinical in nature to the extent that there is a market that makes sense and we can reduce cost and bring transparency to what's happening from our product perspective in those areas.

我認為更長的時間——我們會更長期，請原諒我們將繼續考慮正確的產品組合，我們將在適當的時候尋找更多的臨床產品，這些產品在有市場的情況下本質上更具臨床意義這是有道理的，我們可以降低成本，並從我們的產品角度為這些領域的情況帶來透明度。

Longer term, I think that market lends itself and will continue to lend itself to having a majority of the products being commodity in nature. And the second part of your question from a standpoint of expected margins, we've always talked about that being sort of a low single-digit margin business more clinical products do have a higher margin, which helps you to actually improve that.

從長遠來看，我認為市場適合併將繼續適合大多數產品本質上是商品。從預期利潤率的角度來看，你問題的第二部分，我們一直在談論，作為一種低個位數利潤率的業務，更多的臨床產品確實有更高的利潤率，這有助於你實際改善這一點。

But it's not that, that is anticipated to become a high single-digit or double-digit type margin business overall because of the prevalence of commodity products that we will continue to expect to contract manufacture and source.

但這並不是說，由於我們將繼續期望合同製造和採購的大宗商品的流行，預計整體上將成為一個高個位數或兩位數類型的利潤率業務。

Yes. The only other variable that we consider is the healthiness of a market within a category. So if we've got categories that you have a single player or maybe a couple of players that there's not a lot of competitive friction. You will see us go into those markets. I think definitionally, those are also higher-margin areas just because of the way that market plays out.

是的。我們考慮的唯一其他變量是某個類別中市場的健康程度。所以如果我們有一個類別，你有一個玩家或者幾個玩家，那麼競爭摩擦就不大了。你會看到我們進入這些市場。我認為從定義上講，這些也是利潤率較高的領域，只是因為市場的運作方式。

Okay. that's very helpful. And then just my quick follow-up would be assuming it closes, what might be the impact of Kaiser's purchase of Geisinger. Is there a kind of a general rule for this and other consolidation activity like you recently renegotiated GPO contracts remain intact until they expire? Or are all kind of GPO contracts severed when deals close? Thanks.

好的。這很有幫助。然後我的快速跟進將假設它關閉，Kaiser 購買 Geisinger 的影響可能是什麼。對於此活動和其他合併活動，是否有某種通用規則，例如您最近重新談判的 GPO 合同在到期之前保持不變？還是在交易結束時所有類型的 GPO 合同都被切斷了？謝謝。

I can -- let me hit the macro question first, and then I think Craig has a comment. So at a higher level, from a macro standpoint, yes, I think we're going to continue to see consolidation across the industry. We've talked about it in the past, Health Systems are looking for additional scale to obviously absorb some of the costs associated with providing the services to their communities.

我可以——讓我先回答宏觀問題，然後我想 Craig 有意見。所以在更高的層面上，從宏觀的角度來看，是的，我認為我們將繼續看到整個行業的整合。我們過去曾討論過，衛生系統正在尋求更大的規模，以明顯吸收與向社區提供服務相關的一些成本。

I also think that you're seeing a significant movement to other revenue-generating areas, for example, health plans and getting more on the payment side of the business as well. So I think you're going to see Health Care System consolidation on both those fronts in the future as they continue to again, try to really create as much revenue as possible for the fixed costs that they have.

我還認為您正在看到其他創收領域的重大轉變，例如，健康計劃以及在業務的支付方面也越來越多。所以我認為你會在未來看到這兩個方面的醫療保健系統整合，因為它們會再次繼續，嘗試真正為他們擁有的固定成本創造盡可能多的收入。

Yes. And I think just a little more specificity relative to Kaiser and Geisinger specifically, they don't participate with us in our supply chain business. So that merger itself does not have an implication on our supply chain business today.

是的。而且我認為相對於 Kaiser 和 Geisinger 更具體一點，他們沒有參與我們的供應鏈業務。因此，合併本身不會對我們今天的供應鏈業務產生影響。

Relative to your question around contracts, the way that our GPO contracts work is that to the extent that there is a change of control on the health system side with a member that is not part of Premier what it provides for us an ability to terminate the agreement with 12 months' notice.

相對於您關於合同的問題，我們的 GPO 合同的運作方式是，在衛生系統方面與不屬於 Premier 的成員之間的控制權發生變化的情況下，它為我們提供了終止合同的能力同意提前 12 個月通知。

So it's not canceled immediately, but they do have the ability to go through a change of control process with 12 months' notice if there are two systems coming together, one of which is premier and one of which is not. In the event that two premier systems are merging together, it actually does not trigger that change of control provisions. So their contract would remain intact then it just becomes a question of market dynamics and what are they going to consider doing by virtue of coming together and what they're looking to accomplish.

所以它不會立即取消，但如果有兩個系統結合在一起，他們確實有能力在提前 12 個月通知的情況下完成控制流程的變更，其中一個是首要的，另一個不是。如果兩個主要係統合併在一起，它實際上不會觸發控制條款的變更。因此，他們的合同將保持不變，然後它就變成了市場動態的問題，以及他們將憑藉聚在一起考慮做什麼以及他們希望完成什麼。

And Craig and I have mentioned this in the past. I would be remiss if I didn't say when a health system that's part of us and a health system that's not part of us come together.

克雷格和我過去曾提到過這一點。如果我不說屬於我們一部分的衛生系統和不屬於我們一部分的衛生系統何時走到一起，那我就是失職了。

We've been very, very successful in retaining or winning that additional business. So we do think our overall value proposition is differentiated in the market.

我們在保留或贏得額外業務方面非常非常成功。所以我們確實認為我們的整體價值主張在市場上是與眾不同的。

The next question comes from Jack Wallace with Guggenheim Securities.

下一個問題來自古根海姆證券公司的傑克華萊士。

I've got a kind of a more philosophical question for you, particularly in the core Performance Services business. You have the consulting business, you have the technology business, but you're calling out your pressures with your member customers, particularly in labor.

我有一個更哲學的問題要問你，尤其是在核心性能服務業務方面。你有諮詢業務，你有技術業務，但你正在向你的會員客戶表達你的壓力，尤其是在勞動力方面。

We've seen a couple of other business models that sell technology solutions across different areas of the of the hospital system that also incorporate an outsourced labor component. Is an outsourced labor component, something you'd consider for that business? Does it make sense? And would that help reaccelerate your growth or provide a kind of a more visible and stable deal pipeline?

我們已經看到了一些其他商業模式，它們在醫院系統的不同領域銷售技術解決方案，其中還包含外包勞動力部分。是外包勞動力組成部分，您會為該業務考慮嗎？是否有意義？這會有助於重新加速您的增長或提供一種更明顯和穩定的交易渠道嗎？

It's a great question. So we are, in fact, exploring those opportunities as we speak. We have a whole business basically, we call co-management in the supply chain business, where we go in and we provide leadership to supply chain departments or will basically co-manage the entire department and then be held accountable this very, very specific results from a supply expense per adjusted discharge or operating costs or other models.

這是一個很好的問題。因此，事實上，我們正在探索這些機會。我們基本上有一個完整的業務，我們稱之為供應鏈業務中的共同管理，我們在那里為供應鏈部門提供領導，或者基本上共同管理整個部門，然後對這個非常非常具體的結果負責來自每調整排放或運營成本或其他模型的供應費用。

So that is something that we've got a pretty strong legacy doing, and we are continuing to see opportunities in that market. We also have capabilities and have launched capabilities to basically co-manage various parts of the technology that our Health Care Systems utilize to run their health systems.

因此，這是我們有相當強大的傳統所做的事情，我們將繼續在該市場中看到機會。我們也有能力並且已經啟動了基本上共同管理我們的醫療保健系統用來運行其醫療保健系統的技術的各個部分的能力。

And so we've got a couple of those deals that are either sold to be delivered or in process. Just as a reminder, we did create a company called LONG 80, where we actually can do more co-management leveraging what we think are some incredibly strong processes and some lower labor costs. So we're going to continue to look at that as an incredibly important area to help our -- help an important capability to help our health care systems control costs.

因此，我們有幾筆交易要么已售出交付，要么正在處理中。提醒一下，我們確實創建了一家名為 LONG 80 的公司，在那裡我們實際上可以利用我們認為非常強大的流程和較低的勞動力成本進行更多的共同管理。因此，我們將繼續將其視為一個非常重要的領域，以幫助我們——幫助我們的醫療保健系統控製成本的重要能力。

Great. That's helpful. And then on the GPO comments around the fee share pressure, I guess outside of consolidation, are you seeing these conversations pop up more with your customers that are not also Performance Services customers? Or is this pretty much across the board?

偉大的。這很有幫助。然後關於 GPO 關於費用共享壓力的評論，我想在合併之外，您是否看到這些對話更多地出現在您的客戶中，而這些客戶也不是 Performance Services 客戶？或者這幾乎是全面的？

I would say it's pretty much across the board. I'm trying to think -- but yes, I think just in general, it's pretty much across the board.

我會說這幾乎是全面的。我在努力思考——但是，是的，我認為一般來說，它幾乎是全面的。

The next question comes from A.J. Rice with Credit Suisse.

下一個問題來自 A.J.瑞士信貸的大米。

Hi, Everybody just to maybe go back to the GPO question. I think you called out mid-single-digit increase in your non-acute GPO business, but you left your overall GPO guidance unchanged.

大家好，也許回到 GPO 問題。我認為你在非急性 GPO 業務中提出了中個位數的增長，但你沒有改變你的整體 GPO 指導。

I know on the acute side, I guess that's where you're reflecting the changes in normalization demand and pricing for PPE products that you highlighted. But you also talked about utilization being strong and Florida, Texas for being less strong in the upper Midwest. If you isolate the -- what's going on with the PPE, what is happening when you can look at the overall of the acute side GPO? Is it flattish? Or is it up? Is it down?

我知道在尖銳的一面，我想這就是你反映你強調的 PPE 產品標準化需求和定價變化的地方。但是你也談到了中西部上游的利用率很高，佛羅里達州和德克薩斯州的利用率不那麼高。如果你隔離 - PPE 發生了什麼，當你可以看到急性側 GPO 的整體時會發生什麼？扁平化嗎？還是漲了？我坐下？

Yes. For the quarter itself, the acute was flat to slightly declining in terms of the third quarter performance.

是的。對於本季度本身，急性期在第三季度的表現方面持平或略有下降。

Normalizing for the PPE?

PPE 標準化？

Incorporating the implications of PPE, which are affecting pricing and demand, not just in direct sourcing, but we have GPO contracts for those products as well.

結合影響定價和需求的 PPE 的影響，不僅在直接採購方面，而且我們也有這些產品的 GPO 合同。

So I talked about the fact that food was a tailwind to our GPO performance, very strong growth across both acute and non-acute, but that was mitigated by the categories that I referenced in my prepared remarks.

所以我談到了這樣一個事實，即食品是我們 GPO 業績的順風，急性和非急性的增長都非常強勁，但我在準備好的發言中提到的類別減輕了這一點。

So when we look at diagnostics, when we look at PPE, when we look at the staffing that was asked about earlier, all those things are normalizing down from where they were 12, 24 months ago during the pandemic. You're not seeing the testing, you're not seeing the use of the supplies and you're not seeing the staffing. And so that is putting pressure more proportionately on the acute care part of the GPO because that's where a lot of those were actually taking place.

因此，當我們查看診斷時，當我們查看 PPE 時，當我們查看之前被問及的人員配置時，所有這些都比 12、24 個月前大流行期間的水平正常化。你沒有看到測試，沒有看到物資的使用，也沒有看到人員配備。因此，這對 GPO 的急症護理部分施加了更大的壓力，因為實際上很多事情都是在那裡發生的。

Okay. And then on the capital deployment, just I don't know if there's much to update there. But obviously, you continue to call out targeted acquisitions and investments to support strategic goals.

好的。然後在資本部署方面，我不知道那裡是否有很多更新。但很明顯，你繼續呼籲有針對性的收購和投資來支持戰略目標。

Any new or new things that you're looking at, things maybe that relative to the pipeline, how that looks? And then I guess you did tweak down very modestly $5 million. But is that anything there to note?

您正在關注的任何新事物，可能與管道相關的事物，它看起來如何？然後我猜你確實非常適度地削減了 500 萬美元。但這有什麼需要注意的嗎？

Yes. So on the CapEx, nothing to note. We're just continuing and noted in the commentary overall that some of that is the timing of when we do purchases and development.

是的。因此，在資本支出上，沒有什麼值得注意的。我們只是繼續，並在整體評論中指出，其中一些是我們進行採購和開發的時間。

But overall, we're going to continue to be focused on being good stewards of that and manage our capital expenditures as efficiently as we can, but nothing specific to note on that side.

但總的來說，我們將繼續專注於成為這方面的好管家，並儘可能有效地管理我們的資本支出，但在這方面沒有什麼特別需要注意的。

Relative to capital deployment overall, I would say no change to our philosophy in terms of balancing where appropriate M&A. We have done the acquisition this year that we -- the TRPN acquisition that we continue to integrate. And then our focus has been de-levering the credit facility that we did take up in order to facilitate that transaction.

相對於整體資本配置，我認為我們在平衡適當的併購方面的理念沒有改變。我們今年完成了收購——我們繼續整合的 TRPN 收購。然後我們的重點一直是去槓桿化我們確實接受的信貸安排，以促進該交易。

We have our ongoing quarterly dividend. From a pipeline standpoint, there are assets we do continue to look at. We continue to be focused in the supply chain on how to technology enable and look for solutions to help capture additional and more spend for providers particularly in the continuum of care as we move forward.

我們有持續的季度股息。從管道的角度來看，我們確實會繼續關註一些資產。我們將繼續關注供應鏈中的技術支持，並尋找解決方案來幫助供應商獲取額外和更多的支出，尤其是在我們向前推進的連續護理方面。

And so we'll continue to look for opportunities to do that. On the Performance Services side of the business, it is primarily focused on those growth businesses. So in Life Sciences, to the extent that there are things that are going to help us with data analytics and capabilities to help providers and life science companies with their analytics around the efficacy of products and the ability to source and identify patients for clinical trials.

因此，我們將繼續尋找機會來做到這一點。在業務的績效服務方面，它主要關注那些成長型業務。因此，在生命科學領域，有一些東西可以幫助我們進行數據分析和幫助供應商和生命科學公司分析產品功效以及為臨床試驗尋找和識別患者的能力。

We're continuing to advance strategically around the payer market with our clinical decision support capabilities, and so things that can help enhance that automation of prior authorization that we think is going to continue to be a significant development in the future.

我們將繼續憑藉我們的臨床決策支持能力圍繞支付市場進行戰略性推進，因此有助於增強我們認為在未來將繼續成為重大發展的事先授權自動化的事情。

And then Contigo Health, which we've talked about, we think there continue to be opportunities around enhancing the network that we've acquired and the capabilities to credential and things of that nature are areas of focus that we'll continue to take a look at.

然後是我們已經討論過的 Contigo Health，我們認為在增強我們已經獲得的網絡方面仍然存在機會，並且證書的能力和類似性質的東西是我們將繼續採取的重點領域看著。

So we will continue to look for opportunities to deploy capital to further differentiate our capabilities we will balance that with the dividend that we have in place and continue to have discussions with the Board of Directors about when it may be appropriate to implement an additional share repurchase authorization, which we do not have in place right now, but we'll continue to evaluate that with the Board on a go-forward basis.

因此，我們將繼續尋找機會來部署資本，以進一步區分我們的能力，我們將平衡這一點與我們現有的股息，並繼續與董事會討論何時適合實施額外的股票回購我們目前還沒有授權，但我們將繼續與董事會一起評估這一點。

The next question comes from Dolph Warburton on behalf of Eric Percher with Nephron.

下一個問題來自 Dolph Warburton 代表 Eric Percher with Nephron。

Just a quick question on the restructuring charges that are included within the adjusted EBITDA results for each segment. Can you -- is there a way to size the impact and the duration that these restructuring charges are going to have going forward?

關於每個部門調整後的 EBITDA 結果中包含的重組費用的快速問題。你能——有沒有辦法衡量這些重組費用將產生的影響和持續時間？

Like are we past them now? Just wanted to get some color on what you expect on EBITDA in the next few quarters.

就像我們現在過去了嗎？只是想了解您對未來幾個季度 EBITDA 的預期。

Thanks, Dolph. This is Craig. So first of all, yes, all of the restructuring charges took place and were implemented in the third quarter when we affected that transaction. So it was approximately $8 million of onetime cost across the two segments. I don't have the specific breakout amongst the various parts of the business at the tip of my fingers.

謝謝，多爾夫。這是克雷格。所以首先，是的，所有重組費用都發生了，並在我們影響該交易的第三季度實施。因此，這兩個部門的一次性成本約為 800 萬美元。我的指尖沒有業務各個部分之間的具體突破。

But in total, it was a onetime charge that we had to bear the burden of in Q3. And I think as you're aware, we did not adjust that out of our performance. So we are absorbing that in our financial performance that we our guidance for adjusted EBITDA that we've established.

但總的來說，這是我們在Q3不得不承擔的一次性費用。而且我認為正如您所知，我們沒有根據我們的表現進行調整。因此，我們在我們的財務業績中吸收了我們對我們已經建立的調整後 EBITDA 的指導。

The last question will come from Stephanie Davis with SVB Inc.

最後一個問題將來自 SVB Inc. 的 Stephanie Davis。

A lot of folks have asked about the macro. But Mike, Craig, you both at Premier for at least one economic cycle. Could you share if you saw anything like ordering and fee share pressure in the last recession? And thinking about the lessons learned from 2009 and beyond, how long did it take to rewrite the shift and see some of these pressures beats?

很多人都問過宏。但是邁克、克雷格，你們至少在一個經濟周期中都在 Premier。如果您在上一次經濟衰退中看到諸如訂單和費用分享壓力之類的事情，您能分享一下嗎？並考慮從 2009 年及以後吸取的教訓，重寫轉變並看到其中一些壓力被擊敗需要多長時間？

Yes. This is Mike. First of all, I think recoveries are different based on some -- to your point, some of the micro trends as well. I will tell you what's very unique about what's facing the health systems today is the just the labor issues that they're dealing with.

是的。這是邁克。首先，我認為複蘇是基於一些不同的——就你的觀點而言，一些微觀趨勢也是如此。我會告訴你，當今衛生系統所面臨的非常獨特之處在於他們正在處理的勞工問題。

First of all, some of the costs associated with it, but then also just access to the labor. I will tell you we have seen and we've continued to hear health care systems in some parts of the country struggling to provide the level of services that they want to provide as a result of that.

首先，與之相關的一些成本，但隨後也只是獲得勞動力。我會告訴你，我們已經看到並且我們繼續聽到該國某些地區的醫療保健系統因此而努力提供他們想要提供的服務水平。

So I just think it's -- we've got just from an industry standpoint, there's a headwind here. We've got an aging population that I think should be a tailwind. And so it depends how that all plays out. So we have enough resources actually to provide that care and when does that really provide the impetus for growth again?

所以我只是認為 - 我們只是從行業的角度來看，這裡有一個逆風。我們的人口老齡化，我認為這應該是一個順風。因此，這取決於一切如何進行。所以我們實際上有足夠的資源來提供這種護理，什麼時候才能真正為增長提供動力？

Yes. And the only color I would add to that is that I do think this cycle we're in now is unique and different from previous, I'll say, recessionary periods. I know the number of health care executives I've talked to for the reasons Mike just articulated, but I said that in 20, 30 years of leading health care systems.

是的。我要補充的唯一顏色是，我確實認為我們現在所處的這個週期是獨一無二的，不同於以前的，我會說，衰退期。我知道出於邁克剛才闡述的原因與我交談過的醫療保健高管的數量，但我說的是在領先的醫療保健系統 20、30 年中。

This is the worst dynamics that they have operated under in their entire careers. I think you have the whole supply chain disruption of the pandemic. And then the recessionary implications that are affecting labor and all those other dynamics. And so it is a perfect storm in terms of the pressure that it is putting on these health care systems to survive.

這是他們整個職業生涯中遇到的最糟糕的情況。我認為你有大流行的整個供應鏈中斷。然後是影響勞動力和所有其他動態的衰退影響。因此，就它給這些醫療保健系統施加的生存壓力而言，這是一場完美的風暴。

Coupling that with rising interest rates, which is creating cost of capital issues for them and things of that nature. And so just those dynamics, Stephanie, are different than being able to just rely on kind of historical episodic recessions because typically, I would say in the past, health systems were a bit more -- I don't want to say recession proof, but people need to care. They went and got it and they sort of manage through it. It might have affected their margin profile as they were going through it. But I think there are just more significant levers that are affecting their ability to perform through this cycle, given all of the things that are hitting them.

再加上利率上升，這給他們和類似性質的事情帶來了資本成本問題。因此，斯蒂芬妮，這些動態與僅僅依靠歷史上的偶發性衰退是不同的，因為通常情況下，我會說過去，衛生系統有點多——我不想說經濟衰退證明，但人們需要關心。他們去了並得到了它，並且他們設法解決了它。當他們經歷它時，它可能會影響他們的利潤率。但我認為，考慮到所有影響他們的因素，還有更重要的槓桿正在影響他們在這個週期中的表現能力。

Well, maybe let's try to point this a little bit of a different way because we have seen some of the labor challenges, what are still there as will ease a little bit. Is the read-through for Premier that your business model will see improvement with a lag or is there anything else to think about in how your contracts are structured that could expose you more to inflation or other macro or this COVID inventory issue?

好吧，也許讓我們嘗試以不同的方式指出這一點，因為我們已經看到了一些勞動力挑戰，但仍然存在的挑戰會有所緩解。 Premier 的通讀是否表明您的商業模式會出現滯後性改善，或者在您的合同結構方面是否還有其他需要考慮的地方，這可能會使您更容易受到通貨膨脹或其他宏觀或這個 COVID 庫存問題的影響？

Well, it's interesting. This is the reason that we have been so passionate around technology enablement and everything we do. We believe, obviously, the Remitra capability can extend resources and extend people's capability by automating e-payables and e-invoicing -- we believe that our natural language processing, machine learning capability and doing things around prior authorization.

好吧，這很有趣。這就是我們一直對技術支持和我們所做的一切充滿熱情的原因。我們相信，顯然，Remitra 功能可以通過自動化電子支付和電子發票來擴展資源和擴展人們的能力——我們相信我們的自然語言處理、機器學習能力和圍繞事先授權做事。

From a technological standpoint, reduces the amount of labor required to do the reviews, the chart reviews and those kinds of things from a prior authorization standpoint, same with documentation and coding. So that is the reason we are so passionate about the technology, Stephanie, as we want to be the driver behind this change regardless as whether or not these labor issues get resolved or not.

從技術的角度來看，從事先授權的角度來看，減少了進行審查、圖表審查和那些事情所需的勞動量，與文檔和編碼一樣。這就是我們對這項技術如此熱情的原因，斯蒂芬妮，因為無論這些勞工問題是否得到解決，我們都希望成為這一變化背後的驅動力。

This concludes our question-and-answer session and Premier's Fiscal 2023 Third Quarter Earnings Conference Call. Thank you for attending today's presentation. You may now disconnect.

我們的問答環節和 Premier 2023 財年第三季度收益電話會議到此結束。感謝您參加今天的演講。您現在可以斷開連接。