Privia Health Group Inc (PRVA) 2023 Q1 法說會逐字稿

Good day, and thank you for standing by. Welcome to the Privia Health Q1 2023 Conference Call. (Operator Instructions) Please be advised that today's conference is being recorded.

美好的一天，謝謝你的支持。歡迎來到 Privia Health 2023 年第一季度電話會議。 （操作員說明）請注意，今天的會議正在錄製中。

I would now like to hand the conference over to your speaker today, Robert Borchert. Robert, please go ahead.

我現在想把會議交給今天的發言人 Robert Borchert。羅伯特，請繼續。

Thank you, Kyle, and good morning, everyone. Joining me today are Shawn Morris, our Chief Executive Officer; Parth Mehrotra, President and Chief Operating Officer; and David Mountcastle, our Chief Financial Officer. This call is being webcast and be accessed from the Investor Relations section of priviahealth.com. Today's press release highlighting our financial and operating performance and the slide presentation accompanying our formal remarks are posted on the Investor Relations pages of priviahealth.com.

謝謝你，凱爾，大家早上好。今天加入我的是我們的首席執行官肖恩·莫里斯 (Shawn Morris)； Parth Mehrotra，總裁兼首席運營官；和我們的首席財務官 David Mountcastle。此電話會議正在網絡直播，可從 priviahealth.com 的投資者關係部分訪問。今天強調我們的財務和運營業績的新聞稿以及伴隨我們正式評論的幻燈片演示發佈在 priviahealth.com 的投資者關係頁面上。

Following our prepared remarks, we will open the line for questions. Please limit yourself to one question only and return to the queue if you have a follow-up, so we can get to as many questions as possible. The financial results reported today and in the press release are preliminary and are not final until our Form 10-Q for the first quarter ended March 1, 2023 is filed with the Securities and Exchange Commission, which was filed earlier today.

在我們準備好的評論之後，我們將打開問題熱線。請將自己限制在一個問題上，如果您有後續問題，請返回隊列，以便我們盡可能多地回答問題。今天和新聞稿中報告的財務結果是初步的，在我們向美國證券交易委員會提交截至 2023 年 3 月 1 日的第一季度 10-Q 表格之前不是最終的，該表格於今天早些時候提交給美國證券交易委員會。

Some of the statements we will make today are forward-looking in nature based on our current expectations and view of our business as of May 4, 2023. Such statements, including those related to our future financial and operating performance and future business plans and objectives are subject to risks and uncertainties that may cause actual results to differ materially. As a result, these statements should be considered in conjunction with the cautionary statements in today's press release and the risk factors described in our company's most recent SEC filings. Finally, we may refer to certain non-GAAP financial measures on the call and reconciliations of these measures to comparable GAAP measures are included in our press release and the accompanying slide presentation posted on our website. Now I'll turn the call over to Shawn.

根據我們目前對截至 2023 年 5 月 4 日的業務的預期和看法，我們今天將發表的一些聲明具有前瞻性。此類聲明包括與我們未來財務和經營業績以及未來業務計劃和目標相關的聲明受可能導致實際結果大不相同的風險和不確定性的影響。因此，這些聲明應與今天新聞稿中的警告聲明以及我們公司最近提交給美國證券交易委員會的文件中描述的風險因素一起考慮。最後，我們可能會參考某些非 GAAP 財務措施，並將這些措施與可比的 GAAP 措施進行對賬，這些措施包含在我們的新聞稿和我們網站上發布的隨附幻燈片演示中。現在我會把電話轉給肖恩。

Thank you, Robert. Good morning, everyone. Privia Health delivered solid first quarter results to start 2023 as we continue to execute in each of our markets. We remain focused on driving towards our long-term vision to build Privia Health into one of the largest ambulatory care delivery networks in the nation. Our market momentum and highly aligned partnership model continue to drive growth on multiple fronts and support our high-level confidence in our 2023 outlook. This morning, I'll review a few business highlights, Parth will offer a market and operational update, and then David will discuss our recent financial performance and our 2023 guidance outlook before we take your questions.

謝謝你，羅伯特。大家，早安。隨著我們繼續在我們的每個市場執行，Privia Health 在 2023 年開始的第一季度取得了穩健的業績。我們仍然專注於推動我們的長期願景，將 Privia Health 建設成為全國最大的門診醫療服務網絡之一。我們的市場勢頭和高度一致的合作夥伴模式繼續推動多方面的增長，並支持我們對 2023 年前景的高度信心。今天早上，我將回顧一些業務亮點，Parth 將提供市場和運營更新，然後 David 將在我們回答您的問題之前討論我們最近的財務業績和我們 2023 年的指導展望。

During the first quarter, Privia Health continued to execute at a very high level with Practice Collections increasing more than 17% year-over-year. Adjusted EBITDA was up almost 14% as we continue to increase our number of provider partners and invest in our recent new market entries. This performance was again driven by continued same-store growth as well as our new provider additions in existing markets. In the last few months, we've entered 4 new states and have already signed new providers in our medical group platforms in Connecticut, North Carolina and Ohio.

在第一季度，Privia Health 繼續以非常高的水平執行，Practice Collections 同比增長超過 17%。調整後的 EBITDA 增長了近 14%，因為我們繼續增加供應商合作夥伴的數量並投資於我們最近的新市場准入。這一業績再次受到同店持續增長以及我們在現有市場增加新供應商的推動。在過去的幾個月裡，我們進入了 4 個新州，並且已經在我們位於康涅狄格州、北卡羅來納州和俄亥俄州的醫療集團平台上簽署了新的供應商。

We continue to see a very strong sales funnel with potential new providers across our markets and are maintaining a healthy business development pipeline as we look to enter additional states over the next few years. Separately, we are very excited and have launched and priced this morning a large secondary offering of the company's total diluted shares outstanding. This transaction substantially reduces or eliminates Goldman Sachs and Pamplona Capital's ownership. We are also very excited to welcome a number of new long-term oriented investors, including Durable Capital Partners and Rubicon Founders among others who purchased shares in this transaction. The entire Privia team looks forward to executing on our strategy, continue to create value for our shareholders in years to come.

我們繼續看到一個非常強大的銷售渠道，在我們的市場上有潛在的新供應商，並且在我們希望在未來幾年進入更多州時保持健康的業務發展渠道。另外，我們非常興奮，並於今天上午啟動並定價了公司全部已發行稀釋股票的大規模二次發行。該交易大大減少或消除了高盛和潘普洛納資本的所有權。我們也非常高興地歡迎一些新的長期投資者，包括 Durable Capital Partners 和 Rubicon Founders 等，他們在此次交易中購買了股票。整個 Privia 團隊期待著執行我們的戰略，在未來幾年繼續為我們的股東創造價值。

In other news, we recently announced that I plan to retire at the end of June and our Board of Directors named Parth Mehrotra to succeed me as Chief Executive Officer of Privia Health. I decided that now it was an opportune time to step away from my operating role, to spend more time focused on my personal interest. I will remain on the Privia Board, and I look forward to continuing to track Privia's future success. Parth and I have worked very closely together over the last 5 years. As many of you know, Parth has been an integral part of establishing Privia's presence in many new states, taking our company public in 2021 and directing Privia's growth. We expect a very smooth transition, and it will be exciting to watch Parth and our leadership team drive Privia's next phase of growth. It's been a privilege to interact with many of you and more than 900 Privians dedicated to improving health. Now I ask Parth to provide a market and operational update.

在其他新聞中，我們最近宣布我計劃在 6 月底退休，我們的董事會任命 Parth Mehrotra 接替我擔任 Privia Health 的首席執行官。我決定現在是時候離開我的運營角色，花更多時間專注於我的個人興趣。我將留在 Privia 董事會，我期待著繼續追踪 Privia 未來的成功。在過去的 5 年裡，Parth 和我密切合作。正如你們中的許多人所知，Parth 一直是 Privia 在許多新州建立業務不可或缺的一部分，使我們的公司在 2021 年上市並指導 Privia 的發展。我們期待一個非常平穩的過渡，看到 Parth 和我們的領導團隊推動 Privia 的下一階段增長將是令人興奮的。很榮幸能與你們中的許多人以及 900 多名致力於改善健康的 Privians 互動。現在我請 Parth 提供市場和運營更新。

Thank you, Shawn. It has been an absolute pleasure to work with you and our privilege to succeed you as CEO. We continue to expand Privia's national footprint, which now includes more than 3,700 implemented providers in our medical groups, caring for over 4.4 million patients in 970 locations. We believe our scale and diverse provider and payer partnerships offer a true differentiator as we build one of the largest multi-specialty medical groups and ambulatory care delivery networks in the country that can improve patient outcomes and reduce costs.

謝謝你，肖恩。與您共事是我的榮幸，我們有幸接替您成為 CEO。我們繼續擴大 Privia 的全國足跡，現在我們的醫療集團中包括 3,700 多家已實施的供應商，在 970 個地點為超過 440 萬名患者提供護理。我們相信，我們的規模和多樣化的供應商和付款人合作夥伴關係提供了一個真正的差異化因素，因為我們建立了該國最大的多專業醫療集團和門診醫療服務網絡之一，可以改善患者的治療效果並降低成本。

We are ahead of our growth plan in each of our new markets and expect to add new implemented providers in Connecticut, North Carolina and Ohio before the end of this calendar year. Privia's value-based care platform continues to be one of the broadest, most balanced and diversified in the industry. We cover more than 1 million attributed lives across more than 100 at-risk payer contracts in commercial and government programs. Total attributed lives increased more than 22% from a year ago, driven by our new ACOs in 2023, including our partnerships with Community Medical Group in Connecticut and Beebe Healthcare in Delaware.

我們在每個新市場都領先於我們的增長計劃，並希望在本日曆年結束之前在康涅狄格州、北卡羅來納州和俄亥俄州增加新的實施供應商。 Privia 的基於價值的護理平台仍然是業內最廣泛、最平衡和多樣化的平台之一。我們在商業和政府項目中的 100 多個風險付款人合同中覆蓋了超過 100 萬條生命。在我們 2023 年新的 ACO 的推動下，包括我們與康涅狄格州的 Community Medical Group 和特拉華州的 Beebe Healthcare 的合作夥伴關係，總歸屬生命比一年前增加了 22% 以上。

Our quarter end attributed lives includes the impact of a joint decision with a health plan partner to pause one capitated MA risk arrangement for performance year 2023. The health plan terminated its relationship with the technology services provider earlier this year. And as a result, given the health plan's near-term operating challenges, we both decided to pause the capitated arrangement. We will continue to serve these MA patients as before with a focus on improving patient outcomes and reducing total cost of care, and we'll jointly reevaluate the downside risk arrangement for performance year 2024.

我們的季度末歸因生命包括與健康計劃合作夥伴共同決定暫停 2023 年績效年的一項按人頭計算的 MA 風險安排的影響。該健康計劃今年早些時候終止了與技術服務提供商的關係。因此，鑑於健康計劃的近期運營挑戰，我們都決定暫停按人頭計算的安排。我們將一如既往地繼續為這些 MA 患者提供服務，重點是改善患者預後和降低總護理成本，我們將共同重新評估 2024 年績效的下行風險安排。

Overall, our value-based book of business performed very well in 2022 and in the first quarter of 2023. And there remains a significant embedded opportunity for us to thoughtfully move MA lives into capitated arrangements over the next few years. Now I'll ask David to review our recent financial results and 2023 outlook.

總的來說，我們基於價值的業務在 2022 年和 2023 年第一季度表現非常好。我們仍然有一個重要的嵌入式機會，可以在未來幾年內將 MA 生命周到地轉移到資本化安排中。現在，我將請大衛回顧一下我們最近的財務業績和 2023 年展望。

Thank you, Parth. Privia Health delivered another solid quarter of performance in the first 3 months of 2023. Our implemented provider count of 3,716 was up 10.3% year-over-year. Solid ambulatory utilization trends, new implemented providers and additional attributed lives led to practice collections increasing 17.3% from Q1 a year ago to reach $658.9 million. We continue to generate operating leverage with adjusted EBITDA up 13.9% over Q1 last year to $16.9 million. Total value-based care comprised 33.8% of total GAAP revenue in the first quarter of 2023 compared to 27.1% in Q1 a year ago, which highlights our thoughtful move to at-risk contracts over time.

謝謝你，帕特。 Privia Health 在 2023 年前 3 個月又實現了一個穩定的季度業績。我們實施的供應商數量為 3,716 家，同比增長 10.3%。穩固的門診使用趨勢、新實施的提供者和額外的歸因生命導致實踐收入比一年前的第一季度增長 17.3%，達到 6.589 億美元。我們繼續產生經營槓桿，調整後的 EBITDA 比去年第一季度增長 13.9%，達到 1690 萬美元。基於價值的護理總額佔 2023 年第一季度 GAAP 總收入的 33.8%，而一年前第一季度為 27.1%，這突顯了我們隨著時間的推移對風險合同的深思熟慮。

The strength and resiliency of our operating model is highlighted by our solid Q1 performance, diversified book of business and strong aggregate performance in our value-based and capitated arrangements. With this continued business momentum, we are reiterating our full year 2023 guidance. We expect practice collections to grow 14.5% to more than $2.7 billion and adjusted EBITDA to increase 18.3%, both at the midpoint of our guidance. With 4 new states and 3 new ACOs in 2023, we plan to continue to invest across our business enterprise to support our significant expansion. Our balance sheet and capital position continue to be very strong with cash of more than $311 million and no debt. Our 2023 adjusted EBITDA guidance absorbs approximately $8 million to $10 million in new market entry and expansion investments.

我們運營模式的實力和彈性體現在我們穩健的第一季度業績、多元化的業務以及我們基於價值和資本化安排的強勁總體業績。憑藉這種持續的業務勢頭，我們重申了 2023 年全年的指導方針。我們預計實踐收入將增長 14.5% 至超過 27 億美元，調整後的 EBITDA 將增長 18.3%，均處於我們指引的中點。 2023 年將有 4 個新州和 3 個新 ACO，我們計劃繼續投資於我們的企業以支持我們的重大擴張。我們的資產負債表和資本狀況繼續非常強勁，現金超過 3.11 億美元且沒有債務。我們 2023 年調整後的 EBITDA 指引吸收了大約 800 萬至 1000 萬美元的新市場進入和擴張投資。

We expect our new markets to scale significantly in the coming years as we grow our provider base and attributed lives in these new states. Given our capital efficient partnership model with annual capital expenditures of less than $1 million, we expect 80% to 90% of our adjusted EBITDA to convert to free cash flow. We remain focused on growing and expanding our business for many years to come and investing to support this growth as we build our national footprint. We are now ready to take your questions.

隨著我們在這些新州擴大我們的供應商基礎並歸因於生活，我們預計我們的新市場在未來幾年將顯著擴大。鑑於我們每年資本支出低於 100 萬美元的資本高效合作模式，我們預計調整後 EBITDA 的 80% 至 90% 將轉化為自由現金流。在未來的許多年裡，我們將繼續專注於發展和擴大我們的業務，並在我們建立我們的國家足跡時投資以支持這種增長。我們現在準備好回答您的問題。

(Operator Instructions) Your first question comes from the line of Lisa Gill from JPMorgan.

（操作員說明）您的第一個問題來自摩根大通的 Lisa Gill。

Great. First, congrats to you, Parth. And Shawn it has been great working with you. I know you'll continue to be on the Board, but I think this is a great transition. I just really want to understand a little bit better the timing of physician implementation. As I look at your guidance, it appears to be fairly conservative to us as you move throughout the year and just want to understand kind of the timing of things.

偉大的。首先，恭喜你，Parth。肖恩，和你一起工作很愉快。我知道你會繼續留在董事會，但我認為這是一個很好的過渡。我真的很想更好地了解醫生實施的時機。當我看你的指導時，它對我們來說似乎相當保守，因為你全年都在移動，只是想了解事情發生的時間。

I heard you talk about the health plan pause, but any incremental color you can give into the new markets would be really helpful. And then just as a quick follow-up, Parth, I thought it was very interesting, your new compensation package. And we've had a number of questions just around who that peer group is. And maybe if you can talk about some of the metrics that you're going to be measured against over the next year?

我聽說你談到了健康計劃的暫停，但你可以為新市場提供的任何增量色彩都會非常有幫助。然後作為快速跟進，Parth，我認為這非常有趣，你的新薪酬方案。我們有很多關於這個對等群體是誰的問題。也許你能談談明年你將要衡量的一些指標嗎？

Thank you, Lisa, I really appreciate it. So just take them in order. So #1, as we stated, we are ahead of our plan on implemented providers in the new states, Connecticut, North Carolina and Ohio, and we expect to implement some providers in those states before the end of the year. As you know, that's a 5- to 6-month process, but the visibility we have through the sales pipeline gives us that confidence. And again, from a guidance perspective, it's still Q1. We have pretty good visibility, and we'll update the guidance as we go through the rest of the year. And I'd also like to mention, this obviously does not include any new states, and we are pursuing business development throughout the course of the year as we've done in past years. And if we have -- as and when we have updates, we'll obviously update the guidance.

謝謝你，麗莎，我真的很感激。因此，請按順序處理它們。所以#1，正如我們所說，我們領先於我們在新州、康涅狄格州、北卡羅來納州和俄亥俄州實施供應商的計劃，我們希望在今年年底之前在這些州實施一些供應商。如您所知，這是一個 5 到 6 個月的過程，但我們通過銷售渠道獲得的可見性給了我們信心。再一次，從指導的角度來看，它仍然是第一季度。我們有很好的知名度，我們將在今年剩餘時間更新指南。我還想提一下，這顯然不包括任何新的州，我們在全年都在追求業務發展，就像我們過去幾年所做的那樣。如果我們有——當我們有更新時，我們顯然會更新指南。

And then on your follow-up questions, on #1, again, our focus has been to get fully aligned with our shareholders from a value creation perspective that happened prior to the company being public and the details which were filed with the SEC suggests that the entire initial grant for my request to the comp committee was to tie it to a relative total shareholder return metric, which will be the Health Care Services Index. And it will be -- it vests on a cliff basis in 4 years. So that just aligns from a true long-term perspective, and that's the mindset we have in running the business and creating value for shareholders.

然後關於你的後續問題，關於#1，我們的重點再次是從公司上市之前發生的價值創造的角度與我們的股東完全一致，提交給美國證券交易委員會的詳細信息表明我向薪酬委員會提出的請求的全部初始撥款是將其與相對的股東總回報指標掛鉤，這將是醫療保健服務指數。它將是——它將在 4 年內以懸崖的形式歸屬。因此，從真正的長期角度來看，這才是一致的，這就是我們在經營業務和為股東創造價值時的心態。

Lisa, thank you for the (inaudible). Obviously, I've enjoyed being here for over 5 years and have a lot of confidence in Parth and the team and excited to stay on the Board of Directors. And as I noted in the prepared remarks, just see the company grow and hit this next phase.

麗莎，謝謝你（聽不清）。顯然，我很享受在這裡待了 5 年多，對 Parth 和團隊充滿信心，很高興能留在董事會。正如我在準備好的評論中指出的那樣，只要看到公司成長並進入下一階段。

Your next question comes from the line of A.J. Rice from Crédit Suisse.

你的下一個問題來自 A.J.來自 Crédit Suisse 的大米。

Best wishes, Shawn and congratulations Parth well. Maybe just because it's the topic du jour, the Medicare final rate notice has been out there. Obviously, the bids for next year get submitted in June. Can you just comment on your discussions? I know your model in taking on the risk in MA tends to be very specific to different relationships. But what kind of discussions are you having? Is it making people think they want to accelerate the path to risk on the physician's side? Is it saying, hey, we need to pause here. How do we think about the final rate notice and how that's changing the push to take on more risk in your MA book?

最良好的祝愿，Shawn 並祝賀 Parth 一切順利。也許只是因為它是熱門話題，Medicare 最終費率通知已經發布。顯然，明年的投標書是在 6 月提交的。你能評論一下你的討論嗎？我知道您在 MA 中承擔風險的模型往往針對不同的關係。但是你們正在進行什麼樣的討論呢？它是否讓人們認為他們想要加快醫生一方的風險路徑？是不是在說，嘿，我們需要在這裡暫停一下。我們如何看待最終利率通知，以及這如何改變推動您在 MA 書中承擔更多風險的努力？

Yes. Thanks, A.J. It's Parth. I appreciate your comments. And then to your question directly, it kind of validates our model more so than jumping into full risk 100%. We've not really seen any change in our discussion with both our payer partners as well as provider groups. And this model that we have are thoughtfully moving up the risk spectrum. As and when the providers are ready, the payers are ready, I think in this kind of an environment where you really have to go geography by geography, look at the density, look at the panels, look at the health plan partner and make that decision and do it thoughtfully so that neither entity is burned in the process. So I think that's validating our strategy more so as folks are being much more thoughtful as to how they construct this. But we are seeing a lot of momentum across those discussions, both with payers and then obviously, our medical groups.

是的。謝謝，A.J.是帕特。感謝您的評論。然後直接回答你的問題，它比跳入 100% 的全風險更能驗證我們的模型。在我們與支付合作夥伴和供應商團體的討論中，我們並沒有真正看到任何變化。我們擁有的這個模型正在深思熟慮地提升風險範圍。當提供者準備就緒時，付款人也準備就緒，我認為在這種環境中，您真的必須逐個地理區域，查看密度，查看面板，查看健康計劃合作夥伴並做出做出決定並深思熟慮地做出決定，以免在此過程中燒毀任何實體。所以我認為這更多地驗證了我們的戰略，因為人們對他們如何構建這個戰略更加深思熟慮。但我們在這些討論中看到了很大的動力，既有付款人，也有我們的醫療團體。

Thanks A.J.

謝謝 A.J.

Your next question comes from the line of Andrew Mok from UBS.

你的下一個問題來自瑞銀的 Andrew Mok。

Looking at the equity alignment agreement with Novant, should we be thinking of this deal as a template for your strategy going forward when it comes to implementing providers alongside large health system partners? And can you explain the thought process and rationale restructuring the deal in this way?

看看與 Novant 的股權調整協議，在與大型衛生系統合作夥伴一起實施供應商時，我們是否應該將這筆交易視為您未來戰略的模板？你能解釋一下以這種方式重組交易的思維過程和理由嗎？

Yes. Thanks, Andrew. I appreciate the question. Look, I think when it comes to big large health systems, especially of that size, it's a very significant commitment on their part. We are talking about thousands of providers, and that significantly changes the dynamic of the relationship and the depth of the partnership, as you can imagine, and those decisions are never made lightly. And those are also very long term in nature. You cannot reverse them overnight, if you will.

是的。謝謝，安德魯。我很欣賞這個問題。聽著，我認為當涉及到大型醫療系統時，尤其是那種規模的醫療系統，這是他們的一項非常重要的承諾。我們談論的是數以千計的提供商，正如您可以想像的那樣，這極大地改變了關係的動態和夥伴關係的深度，而且這些決定從來都不是輕易做出的。這些在本質上也是非常長期的。如果你願意，你不可能在一夜之間扭轉它們。

So I think we are very comfortable in having a structure that aligns our partnership and the depth of that relationship, if that includes a certain amount of equity if they make that kind of commitment. And again, the decision will be health system by health system. It just depends on the nature of the strategic objectives of that particular health system and our strategy in that particular geography. But it is an incentive arrangement and the reason for that is that sometime in the future, we can get that kind of book of business.

因此，我認為我們很樂意擁有一種結構，使我們的伙伴關係和這種關係的深度保持一致，如果他們做出這種承諾的話，如果這包括一定數量的股權。同樣，決定將由衛生系統決定。這僅取決於該特定衛生系統的戰略目標的性質以及我們在該特定地區的戰略。但這是一種激勵安排，原因是在未來的某個時候，我們可以獲得那種業務簿。

Your next question comes from the line of Sean Dodge from RBC Capital Markets.

你的下一個問題來自 RBC 資本市場的 Sean Dodge。

This is Philip Keller on for Sean. And also congratulations to Shawn and Parth on the transition. So I wanted to check back in on the Surgery Partner's partnership. I mean, even more comfortable in the first year, can you give us an update maybe on the status of that implementation, Montana? And anything you can share in terms of performance metrics tied to that partnership? I guess more specifically, I'm looking to understand how you're measuring success there and what you need to see before potentially kind of expand that relationship to the other states?

這是肖恩的菲利普·凱勒。還要祝賀 Shawn 和 Parth 的過渡。所以我想重新檢查手術合作夥伴的合作夥伴關係。我的意思是，第一年會更舒服，蒙大拿州，您能否向我們提供有關該實施狀態的最新信息？在與該合作夥伴關係相關的績效指標方面，您可以分享什麼？我想更具體地說，我希望了解您如何衡量那裡的成功以及在可能將這種關係擴展到其他州之前您需要看到什麼？

Yes. Thank you. So the relationship is going really well. The Montana Group has been live now for some time, for many months, and that's going well. And then both companies obviously are evaluating relationship in other states and that was the genesis of the partnership. We have certain other groups in some other states that are implemented. So again, we've proven that out -- are going to be implemented. So we've proven that out in more than just one state. And then, obviously, there's a broader strategic alignment on their value oriented in what they do. You've seen some of their recent announcements, including with a health system, where we also partnered with in Ohio.

是的。謝謝。所以這段關係發展得非常好。 Montana Group 已經上線了一段時間，已經好幾個月了，而且進展順利。然後兩家公司顯然都在評估與其他州的關係，這就是合作夥伴關係的起源。我們在其他一些州實施了某些其他團體。因此，我們再次證明了這一點——將要實施。所以我們已經在不止一個州證明了這一點。然後，很明顯，在他們所做的事情中，他們以價值為導向存在更廣泛的戰略一致性。你已經看到了他們最近的一些公告，包括衛生系統，我們也在俄亥俄州與之合作。

So I think we're going to look forward to as we both develop and grow those relationships, try and work together and bring a very unique offering to our payer partners from a value perspective and how we construct these networks in a multi-specialty medical group with an outpatient facility attached to it. And you can -- as you know, you can reduce total cost of care in a pretty meaningful way with those strategies. So we'll continue to work. This is going to be a multiyear discussion and strategy with them. So we look forward to executing on it.

因此，我認為我們將期待隨著我們雙方發展和發展這些關係，嘗試共同努力，從價值角度以及我們如何在多專業醫療領域構建這些網絡，為我們的付款合作夥伴提供非常獨特的服務附有門診設施的小組。你可以——正如你所知，你可以通過這些策略以一種非常有意義的方式降低總護理成本。所以我們會繼續工作。這將是與他們的多年討論和戰略。所以我們期待著執行它。

For our next question, it comes from the line of Gary Taylor from Cowen.

對於我們的下一個問題，它來自 Cowen 的 Gary Taylor。

I wanted to ask about a couple of things. One, the $3.3 million of negative prior-year development, I think that's just new disclosure on the roll forward table. But given those contracts are obviously pretty new, was curious on what was driving that and how it's influenced your reserving this year, if at all?

我想問幾件事。第一，330 萬美元的前一年負發展，我認為這只是滾動表上的新披露。但考慮到這些合同顯然很新，想知道是什麼推動了它，以及它如何影響你今年的預訂，如果有的話？

And then also, there were about $3.5 million of add-backs to EBITDA beyond just the stock comp add back. That amounts a little larger than we typically see from you. And I know you pride on not adding a lot of stuff back. So just wanted to see if there was any more detail on that $3.5 million?

然後，除了股票補償之外，EBITDA 還增加了大約 350 萬美元。這比我們通常從您那裡看到的要大一些。而且我知道你為沒有添加很多東西而感到自豪。所以只是想看看是否有關於那 350 萬美元的更多細節？

Thanks, Gary. So on the first one, again, it's related to the capitated book. A large part of that was due to on this one book that we highlighted in the prepared remarks around the pausing of the capitated arrangement with the health plan, in particular, given the operating challenges they faced as they went through that change.

謝謝，加里。所以在第一個上，它又與大寫的書有關。其中很大一部分是由於在這本書中，我們在準備好的評論中強調了暫停與健康計劃的按人頭安排，特別是考慮到他們在經歷這一變化時面臨的運營挑戰。

All of that is recognized in Q1, so we don't see any further downside from that. So I don't think you should expect that to continue through the rest of the course of this year. So that was pretty much it from that (inaudible) perspective. And then on the adjusted EBITDA add back, it was onetime costs, legal-related, some deal related. Obviously, we've had a very busy business development activity over the last few months. And so some of that is purely onetime in nature in addition to certain severance costs.

所有這些都在第一季度得到認可，因此我們看不到任何進一步的不利因素。所以我認為你不應該期望這種情況會持續到今年餘下的時間。所以從那個（聽不清）的角度來看，這幾乎就是它。然後在調整後的 EBITDA 上加回來，這是一次性成本，與法律相關，與一些交易相關。顯然，過去幾個月我們的業務開發活動非常繁忙。因此，除了某些遣散費之外，其中一些純粹是一次性的。

Appreciate it. Is there any management participation in the sector offering that got priced?

欣賞它。是否有管理層參與已定價的行業發行？

No, it was totally secondary by pre-IPO investors, largely Goldman Sachs and Pamplona. There was no management participation.

不，它完全被 pre-IPO 投資者排在第二位，主要是高盛和潘普洛納。沒有管理層參與。

And your next question comes from the line of Whit Mayo from SVB.

你的下一個問題來自 SVB 的 Whit Mayo。

Just looking at AR days in the quarter, they were up a lot, and I recognize there's a lot that influences that. But maybe, Parth, if you could help us understand some of those factors influencing that number, maybe MSSP, maybe some of the capitated stuff. And maybe just comment broadly on MSSP performance versus expectations in the quarter?

只看本季度的 AR 天數，它們增加了很多，我認識到有很多影響因素。但是，Parth，如果你能幫助我們了解影響該數字的一些因素，也許是 MSSP，也許是一些人頭的東西。也許只是對本季度的 MSSP 績效與預期進行廣泛評論？

Yes. Thanks, Whit. So the AR is mainly related to the capitated book as that's grown over the last 18 months or so as we've gone from 0 to 30,000-plus lives. So obviously, they'll normalize year-over-year once that book becomes a little stabilized. It's not related to MSSP. That's been fairly normal as we get paid sometime in Q3, as you know. And overall, our value-based book, as we said in our prepared remarks, overall has performed really well. We're very pleased with the results from all the data we see. Our accruals are updated this quarter. So the results for the quarter and the guidance reflects where we are today. And obviously, we'll update those as we move forward. But so far, everything we've seen, we're very pleased with.

是的。謝謝，惠特。所以 AR 主要與人頭化的書有關，因為它在過去 18 個月左右的時間裡增長，因為我們已經從 0 到 30,000 多條生命。很明顯，一旦這本書變得有點穩定，他們就會逐年正常化。它與 MSSP 無關。如您所知，這很正常，因為我們會在第三季度的某個時候獲得報酬。總的來說，正如我們在準備好的評論中所說，我們基於價值的書總體上表現非常好。我們對所看到的所有數據的結果感到非常滿意。我們的應計費用在本季度更新。因此，本季度的結果和指導反映了我們今天的情況。顯然，我們會在前進的過程中更新這些內容。但到目前為止，我們所看到的一切，我們都非常滿意。

For the next question, it comes from the line of Jessica Tassan from Piper Sandler.

對於下一個問題，它來自 Piper Sandler 的 Jessica Tassan 的台詞。

Congratulations to Parth and Shawn. It was great getting to know you and working with you. Can you guys just clarify when was the capitated contract terminated? And then just what the impact is on the 40,600 capitated lives as of 1/1/123? And I guess just kind of what is the headwind that the reiterated guidance is absorbing related to the pause of that capitated contract? And should we expect a sequential step down in capitated revenue in 2Q?

祝賀 Parth 和 Shawn。很高興認識你並與你一起工作。你們能澄清一下人頭合同是什麼時候終止的嗎？那麼截至 2012 年 1 月 1 日，這對 40,600 條按人頭計算的生命有何影響？而且我想，與暫停按人頭計算的合同相關的重申指南吸收的逆風是什麼？我們是否應該期望第二季度的人均收入連續下降？

Thank you, Jess. So I'll take those in order, just a few points. So number one, the situation involved our partner and as you -- many of you have written another public company, so we're going to be respectful of their disclosure on this matter. But overall, as far as we are concerned -- again, this was an example of a risk that was not in our control and it validates our decision to share the risk with the health plan partner in such arrangements, especially as we are starting out in these arrangements for the first year. And we're looking for a lot of consistency.

謝謝你，傑斯。所以我會按順序進行，只有幾點。所以第一，這種情況涉及我們的合作夥伴和你們——你們中的許多人已經寫過另一家上市公司，所以我們將尊重他們在此事上的披露。但總的來說，就我們而言——再一次，這是一個我們無法控制的風險的例子，它證實了我們在這種安排中與健康計劃合作夥伴分擔風險的決定，尤其是在我們剛開始的時候在這些安排中的第一年。我們正在尋找很多一致性。

So all prior period impact is fully reflected in our Q1 results, and there will be no further downside impact to 2023, and that was the reason for us to pause. And again, it demonstrates the strength and diversification of our book and how well we performed in the rest of the value-based book, given our results this morning for Q1 and our confidence for the rest of the year. So we don't see any further downside impact from this book.

因此，所有前期影響都充分反映在我們的第一季度業績中，到 2023 年不會有進一步的下行影響，這就是我們暫停的原因。鑑於我們今天早上第一季度的結果以及我們對今年剩餘時間的信心，它再次證明了我們賬簿的實力和多元化，以及我們在基於價值的賬簿的其餘部分中的表現如何。所以我們看不到這本書有任何進一步的負面影響。

And then more importantly, as we reevaluate the decision in future years, in these lives, there will be upside. So the one change you'll notice from the last quarter when we reported, if you look at the bubble chart under MA, the downside risk lives are now 23%, and that's down. So we have about 30 -- a little over 31,000 lives that are currently in capitated arrangements, and that's down from the prior report.

然後更重要的是，當我們在未來幾年重新評估這個決定時，在這些生活中，會有好的一面。因此，當我們報告上一季度時，您會注意到一個變化，如果您查看 MA 下的氣泡圖，下行風險壽命現在為 23%，而且下降了。所以我們有大約 30 - 超過 31,000 條生命目前處於人頭安排中，這比之前的報告有所下降。

For your next question, it comes from the line of David Larsen from BTIG.

對於您的下一個問題，它來自 BTIG 的 David Larsen。

Congrats on a good quarter. Can you talk about the difference in expected margin between MSSP deals and also capitated deals? It's kind of my understanding that the capitated deals can actually be much higher risk, obviously, and leaner margin long term. And Parth, I like how you take -- your bear risk responsibly. And then also, over what period of time should we see EBITDA increase for new market that you enter into? Any color around that would be great.

祝賀一個好的季度。您能談談 MSSP 交易和資本化交易之間的預期利潤率差異嗎？我的理解是，按人頭計算的交易實際上風險更高，顯然，長期利潤率更低。 Parth，我喜歡你如何承擔——負責任地承擔風險。然後，我們應該在多長時間內看到您進入的新市場的 EBITDA 增加？周圍的任何顏色都會很棒。

Yes. Thanks, David. So broadly speaking, Privia's take rate on shared savings is effectively the same on the 2 books of business. We shared at 60-40 with our doctors, how we split the pie with the health plan defers. So for MSSP in the enhanced track, it's a 75-25 split with CMS. And then in a capitated arrangement, that can vary differently by geography, by health plan. So that's the first difference. But our take rate overall is the same.

是的。謝謝，大衛。所以從廣義上講，Privia 的共享儲蓄率在 2 個業務簿上實際上是相同的。我們在 60-40 時與我們的醫生分享了我們如何通過推遲健康計劃來分蛋糕。因此，對於增強軌道中的 MSSP，它與 CMS 的比例為 75-25。然後在按人頭計算的安排中，這可能因地理位置、健康計劃而異。這是第一個區別。但我們的整體採用率是相同的。

And then the way we like to think about margin is given the revenue recognition on the top line, just a percentage margin is really not apples-to-apples comparison, MSSP versus MA given you start to recognize pretty significant top line in a fully capitated MA deal. But from a shared savings percentage basis, as you see in our largest ACO in mid-Atlantic, we are saving close to 10% theoretically, and that's an open access kind of product with CMS theoretically in a GAAP book of business with MA, you should expect over time to go at or higher than that number from a savings percentage perspective because you're managing the lives much more closely, you're taking more risk. So from that perspective, hopefully, the opportunity is bigger, and that's how we like to characterize the difference.

然後，我們喜歡考慮利潤率的方式是在頂線確認收入，只是一個百分比的利潤率真的不是蘋果對蘋果的比較，MSSP 與 MA 鑑於你開始認識到完全資本化的相當重要的頂線MA交易。但是從共享儲蓄百分比的基礎上，正如你在我們大西洋中部最大的 ACO 中看到的那樣，我們理論上節省了近 10%，這是一種開放式訪問類型的產品，理論上在與 MA 的 GAAP 業務簿中，你從儲蓄百分比的角度來看，應該期望隨著時間的推移達到或高於該數字，因為您正在更密切地管理生活，承擔更多風險。因此，從這個角度來看，希望機會更大，這就是我們想要描述差異的方式。

And for your next question, it comes from the line of Richard Close from Canaccord.

對於您的下一個問題，它來自 Canaccord 的理查德·克洛斯 (Richard Close)。

Congratulations, Shawn and Parth on the changes there. With respect to the new markets that you called out, Ohio, North Carolina and Connecticut. Can you just tell us -- they're running ahead of expectations, but can you tell us in terms of what you were expecting previously in terms of contribution on 2023?

祝賀 Shawn 和 Parth 那裡發生了變化。關於您提到的新市場，俄亥俄州、北卡羅來納州和康涅狄格州。你能告訴我們——他們的表現超出了預期，但你能告訴我們你之前對 2023 年貢獻的預期嗎？

Yes. So thanks, Richard. Overall, we thought we would be implementing providers sometime next year. I think that time line accelerated a little bit. From a top line and platform contribution perspective and EBITDA perspective, it will still be fairly muted this year, given when the providers get implemented later this year and the in-year contribution from them.

是的。所以謝謝，理查德。總的來說，我們認為我們會在明年的某個時候實施供應商。我認為時間線加快了一點。從頂線和平台貢獻的角度以及 EBITDA 的角度來看，考慮到提供商在今年晚些時候實施以及他們的年內貢獻，今年它仍然相當低迷。

But I think it gives us good runway into starting 2024 in a pretty strong footing. And again, we are planning this journey in each of those states over a 4-, 5-year period to try and get to 400 or 500 providers. I mean, that's always our target. All these states have very significant TAM. Our -- we have a pretty large partnership model in each of those 3 states and the opportunity for us to partner with many providers. So that gives us the confidence to build these medical groups to that size over that period of time. So it will not be linear. And so -- but I think we're off to a good start, and we'll see how we execute.

但我認為它為我們在 2024 年打下堅實的基礎提供了良好的跑道。再一次，我們計劃在 4 年、5 年的時間內在這些州中的每一個州進行這一旅程，以嘗試獲得 400 或 500 個提供者。我的意思是，這始終是我們的目標。所有這些州都有非常重要的 TAM。我們——我們在這 3 個州中的每一個州都有相當大的合作夥伴關係模型，我們有機會與許多供應商合作。因此，這使我們有信心在這段時間內將這些醫療集團建設到如此規模。所以它不會是線性的。所以——但我認為我們有了一個良好的開端，我們將看看我們如何執行。

And for the next question, it comes from the line of Jamie Perse from Goldman Sachs.

對於下一個問題，它來自高盛的 Jamie Perse。

I just wanted to go back to the capitated arrangements you have, I think contribution last year was just over 260,000. Can you give us a sense of what you're seeing so far this year and how you're accruing costs relative to collections on that book of business so far this year?

我只想回到你的人頭安排，我認為去年的貢獻剛剛超過 260,000。你能告訴我們今年到目前為止你看到了什麼，以及今年到目前為止你是如何計算與該業務簿上的收藏相關的成本的嗎？

Yes. Thanks, Jamie. So obviously, we're not going to go contract by contract, but generally speaking, on the remaining book, we obviously paused one arrangement as we outlined. But on the remaining book, it's better than last year, that's how we would expect. So obviously, all the prior period stuff is flushed out. But for 2023, if you can look at our disclosure both on the revenue that is disaggregated and the medical margin, you'll see that we are performing pretty well. If you compare the capitated revenue number of $78.2 million relative to the in-year health care costs incurred on that book. So you'll see, obviously, we are accruing at a much better clip for the in-year performance on those deals.

是的。謝謝，傑米。很明顯，我們不會按合同簽訂合同，但總的來說，在剩下的書上，我們顯然暫停了我們概述的安排。但就剩下的書而言，它比去年好，這就是我們所期望的。很明顯，所有前期的東西都被沖掉了。但是對於 2023 年，如果您可以查看我們對分類收入和醫療利潤率的披露，您會發現我們的表現相當不錯。如果您將 7820 萬美元的人均收入數字與該賬簿發生的年內醫療保健費用進行比較。所以你會看到，很明顯，我們在這些交易的年內表現上取得了更好的成績。

And for your next question, it comes from the line of Joshua Raskin from Nephron Research.

對於你的下一個問題，它來自 Nephron Research 的 Joshua Raskin。

I'll add my congrats to both Shawn and Parth as well. Just focus on the VBC lives that change sequentially. So is that all MSSP or were you seeing some growth in the MA contract? And then getting back to this health plan pause, I just wanted to better understand, it sounds like there was a technology partner that changed at the health plan side. It sounds like that must have impacted performance, right, because the negative development, a couple of million bucks there. Is it fair to assume that you guys had been accruing last year, maybe even just very modestly positive savings or results or maybe nothing? And now in hindsight, it sounds like the performance on that contract in total was negative. Is that the right way to think about it?

我還要向 Shawn 和 Parth 表示祝賀。只關注順序變化的 VBC 生活。那麼是所有 MSSP 還是您看到 MA 合同有所增長？然後回到這個健康計劃暫停，我只是想更好地理解，聽起來好像有一個技術合作夥伴在健康計劃方面發生了變化。聽起來這一定會影響性能，對吧，因為負面的發展，那裡有幾百萬美元。假設你們去年一直在積累，甚至可能只是非常適度的積極儲蓄或結果，或者可能什麼都沒有，這是否公平？現在回想起來，這份合同的總體表現似乎是負面的。這是正確的思考方式嗎？

Yes. Thanks, Josh. I'll take those in order. So #1, there's always movement at the beginning of the year on the overall attribution. It happens in commercial the most, if you will, as employers change sometimes their TPA or their health plan partners. So obviously, you see that and then the lives get reattributed to us. So you'll see some movement in commercial in Q1 and as the year progresses, that normalizes.

是的。謝謝，喬希。我會按順序處理的。所以#1，年初的整體歸因總是有變化。如果您願意的話，這種情況在商業廣告中發生得最多，因為雇主有時會改變他們的 TPA 或他們的健康計劃合作夥伴。很明顯，你看到了，然後生命被重新歸因於我們。所以你會在第一季度看到一些商業活動，隨著時間的推移，這種情況會正常化。

There could be some in MSSP as well if some of the beneficiaries used to go into MA. So we do see some of that movement, but we capture that back in the MA book because they're obviously not changing their PCP in most cases. But again, hopefully, that attribution normalizes in Q3, Q4 and -- sorry, by Q2, Q3, and that's what gives us confidence on our overall guidance range for that metric. And then on the health plan side, again, it was a pretty significant disruption that a health plan can face. Obviously, we were aware of this last year. We expect a lot of consistency in how we get the data, claims data and so forth.

如果某些受益人曾經進入 MA，MSSP 中也可能會有一些。所以我們確實看到了其中的一些變化，但我們在 MA 書中捕捉到了這一點，因為在大多數情況下他們顯然沒有改變他們的 PCP。但同樣，希望這種歸因在第三季度、第四季度和——抱歉，到第二季度、第三季度標準化，這讓我們對該指標的總體指導範圍充滿信心。然後在健康計劃方面，再次，這是健康計劃可能面臨的一個非常重大的中斷。顯然，我們去年就意識到了這一點。我們希望在獲取數據、索賠數據等方面保持一致。

And when you have some kind of disruption like this, there can be substantial delays in getting the data. Our accruals reflect what we see at the end of each quarter when we close it, and that's what's reflected in what we accrue and the results. And so obviously, there was some prior period noise with that. And that was obviously part of the reason why we decided to pause the arrangement jointly with the health plan. They shared some of the risk, some of the downside risk in this particular contract, and that validates our strategy to have them have some skin in the game so that when some kind of a disruption like this happens, you're making a much more thoughtful decision jointly. So I think hopefully, we'll reevaluate it for 2024.

當你遇到像這樣的中斷時，獲取數據可能會有很大的延遲。我們的應計利潤反映了我們在每個季度末關閉時看到的情況，這也反映在我們的應計收入和結果中。很明顯，這其中有一些前期噪音。這顯然是我們決定暫停與健康計劃聯合安排的部分原因。他們分擔了一些風險，一些在這個特定合同中的下行風險，這驗證了我們的策略，讓他們在遊戲中有一些皮膚，這樣當發生這樣的某種中斷時，你正在做更多共同深思熟慮的決定。所以我希望我們會在 2024 年重新評估它。

Thank you. And for your next question, it comes from the line of Sandy Draper from Guggenheim.

謝謝。對於你的下一個問題，它來自古根海姆的 Sandy Draper。

This is Mitch on for Sandy. And actually, all of our questions have been asked and answered. So I just wanted to share my and Sandy's congrats to both Shawn and Parth.

這是桑迪的米奇。實際上，我們所有的問題都已被提出並得到解答。所以我只想分享我和桑迪對肖恩和帕斯的祝賀。

Thank you.

謝謝。

Thank you...

謝謝...

And for the next question, it comes from the line of Brian Tanquilut from Jefferies.

對於下一個問題，它來自 Jefferies 的 Brian Tanquilut。

Congrats again to both of you guys and hopefully, Shawn, I'll see you around here (inaudible). I guess just one question for Parth, as I think about the 100-plus stocks that you added during the quarter, maybe any color you can give in terms of the breakdown between organic recruitment and conversions from Privia Care Partners and what we're seeing in terms of the pipeline for both of those buckets of organic growth?

再次祝賀你們兩個，希望肖恩，我會在這裡見到你（聽不清）。我想只有一個問題要問 Parth，因為我想到您在本季度添加的 100 多隻股票，也許您可以根據 Privia Care Partners 的自然招聘和轉化之間的細分以及我們所看到的情況給出任何顏色就這兩桶有機增長的管道而言？

Yes. Thanks, Brian. Largely organic for this quarter, there were some care partners. And again, that's a longer-term strategy, and that will be in big chunks. All of Connecticut effectively, you could argue with care partners as we're starting that market with 1,100 provider, largest clinically integrated network. So converting as many of those will largely be care partners, and that's a big part of the strategy. But this was again very -- as expected, most of these were sold last year. There was also some good organic same-store growth, which is becoming meaningful for us. We are in 970 physical sites with a very large installed base, and that's a very good organic growth for us. So we're really excited to see that happen too.

是的。謝謝，布萊恩。本季度主要是有機的，有一些護理合作夥伴。再一次，這是一個長期戰略，而且將是大塊的。實際上，在康涅狄格州的所有地方，您都可以與護理合作夥伴爭論，因為我們正在以 1,100 家提供者、最大的臨床綜合網絡啟動該市場。因此，轉換其中許多人將主要是護理合作夥伴，這是該戰略的重要組成部分。但這又是非常——正如預期的那樣，其中大部分是去年售出的。還有一些良好的有機同店增長，這對我們來說變得有意義。我們擁有 970 個物理站點，擁有非常龐大的安裝基礎，這對我們來說是一個非常好的有機增長。所以我們也很高興看到這種情況發生。

And for your next question, it comes from the line of Adam Ron from Bank of America.

對於你的下一個問題，它來自美國銀行的 Adam Ron。

So you did allude to the large embedded value-based opportunity within Privia's patient panels. But if you divide the number of attributed lives in the quarter by the number of patients across the patient panels that you report, I think it's like $4.4 million and you come up with that the percentage is around 130 basis points year-over-year the penetration rate, and it's actually down versus 2021. So is this the kind of rate penetration expansion that you expect or the penetration and value-based care should be relatively steady and that all new growth in value-based care lines have to come from new doctors? Or is there some expectation around increasing penetration? And if so, what is the timing of that? And what specifically are you looking for before you move more patients into risk?

所以你確實提到了 Privia 患者面板中基於內在價值的巨大機會。但是，如果您將本季度的歸因生命數除以您報告的患者小組中的患者數量，我認為這大約是 440 萬美元，您得出的百分比約為 130 個基點，同比增長滲透率，實際上與 2021 年相比有所下降。因此，這是您期望的那種滲透率擴張，還是滲透率和基於價值的護理應該相對穩定，並且基於價值的護理線的所有新增長都必須來自新的醫生？還是對提高滲透率有一些期望？如果是這樣，時間是什麼時候？在將更多患者轉移到風險中之前，您具體在尋找什麼？

Yes. Thanks, Adam. Great question. The uniqueness of our business is, we do value-based in all books, commercial, MSSP, MA and Medicaid. And there's a lot of opportunity, especially in the commercial book and then also sometimes in the Medicaid book, where you could have a lot of the existing lives move into value-based arrangements with a particular payer in that -- in specific geographies. The MA lives obviously have a much more well-understood pathway where we can have lives participate in MSSP or Medicare Advantage.

是的。謝謝，亞當。很好的問題。我們業務的獨特之處在於，我們在所有書籍、商業、MSSP、MA 和 Medicaid 中都以價值為基礎。並且有很多機會，特別是在商業書籍中，然後有時在醫療補助書籍中，在那裡你可以讓很多現有的生活進入與特定付款人的基於價值的安排 - 在特定地區。 MA 生活顯然有一個更容易理解的途徑，我們可以讓生活參與 MSSP 或 Medicare Advantage。

So I think there's a massive opportunity for us to move a lot of those 4.4 million patients in some form of value-based arrangements. It will not happen overnight. It's a -- we try and move these in big chunks. And you'll see them spread across all our books of business. And then the second part of that strategy is obviously to increase the level of performance, increase the level of risk and hopefully, that goes in tandem with increased level of performance and then, therefore, our ability to generate shared savings for our health plan partners, for the doctors and for us, and then our take rate is 40%.

因此，我認為我們有很大的機會以某種形式的基於價值的安排來轉移這 440 萬患者中的很多人。這不會在一夜之間發生。這是一個 - 我們嘗試將它們大塊移動。你會看到它們遍布我們所有的業務書籍。然後該策略的第二部分顯然是提高績效水平，增加風險水平，並希望這與提高績效水平同步進行，因此，我們有能力為我們的健康計劃合作夥伴創造共享儲蓄，對於醫生和我們，然後我們的採納率為 40%。

So the operating leverage even on the existing book is pretty substantial. And then obviously, on top of that, as you're seeing with deals like Connecticut, that's a new geography, new clinically integrated network. We did not have close to 200,000 lives and 1,100 providers 2 quarters ago, and you can see the amount of opportunity we have in just expanding into new geographies with new doctors. And then also with new doctors in existing geographies that we can layer on top of that. So I think it's both same-store, same book of business and then new providers and new lives that come with them.

因此，即使對現有賬簿的經營槓桿也相當可觀。然後很明顯，最重要的是，正如你在康涅狄格州這樣的交易中看到的那樣，這是一個新的地理區域，新的臨床整合網絡。 2 個季度前，我們還沒有將近 200,000 條生命和 1,100 家提供者，您可以看到我們有多少機會通過新醫生擴展到新的地區。然後還有我們可以在現有地區的新醫生。所以我認為這既是同一家商店，同一本業務簿，然後是新的供應商和隨之而來的新生活。

And for our next question, it comes from the line of Jailendra Singh from Truist.

對於我們的下一個問題，它來自 Truist 的 Jailendra Singh。

Shawn and Parth, congrats and best wishes to both of you. Just a quick clarification, just going back to Jeff's question about what was the revenue impact of these 16,000 full-risk lives decline? I mean, I'm assuming that's captured in the guidance now and kind of incremental headwind. And then my main question, and I joined a little late, so apologies if you already covered this, it has seen that some strong utilization trends highlighted by some providers. I was wondering if you could talk about how were trends for you guys across the business line, anything meaningfully different to call out in terms of utilization between your payer class? And what are you assuming in terms of utilizing for rest of '23?

Shawn 和 Parth，向你們倆表示祝賀和良好祝愿。只是快速澄清一下，回到 Jeff 的問題，即這 16,000 名全風險生命下降對收入的影響是什麼？我的意思是，我假設現在的指南中已經包含了這一點，並且是一種漸進的逆風。然後是我的主要問題，我加入的時間有點晚，如果您已經討論過這個問題，我們深表歉意，它已經看到一些供應商強調了一些強勁的利用趨勢。我想知道您是否可以談談你們整個業務線的趨勢如何，在您的付款人類別之間的利用率方面有什麼有意義的不同之處？在 23 年剩下的時間裡，你有什麼假設？

Yes. Thank you, Jailendra. So I'll just take them in order. So on the first one, as we noted, we recognized all prior period impact on that book in Q1. And despite that, our results are really strong. So that was largely more than offset by our good performance in the rest of the value-based book. On the top line side, again, both the fee-for-service and value-based book is performing very well. So there's a lot of offsetting. So we don't see any net impact, which gives us the confidence to maintain our guidance as we have. Obviously, if we eliminate capitated arrangement, you will add back the fee-for-service revenue because these lives are still with us. The doctors are still seeing these patients.

是的。謝謝你，杰倫德拉。所以我會按順序處理它們。因此，正如我們指出的那樣，在第一個方面，我們認識到第一季度對該書的所有前期影響。儘管如此，我們的結果確實很強勁。因此，這在很大程度上被我們在基於價值的賬簿的其餘部分中的良好表現所抵消。同樣，在收入方面，按服務收費和基於價值的圖書表現都非常好。所以有很多抵消。因此，我們沒有看到任何淨影響，這讓我們有信心維持我們現有的指導。顯然，如果我們取消按人頭計算的安排，您將加回按服務收費的收入，因為這些生命仍然與我們同在。醫生們仍在看望這些病人。

And so the net impact is much lower from that perspective, again, that bodes well for us having the confidence to maintain the guidance. So both from a top line or a bottom line perspective, we should not see any further net impact. There's some movement and there's some offsetting, and that's what gives us confidence at this point of the year to just maintain our guidance. And then we are seeing pretty good utilization trends. That has continued as we've gone through the stale end of the COVID period that is very consistent with last year. And again, our strategy is to be prudent when we plan for utilization and guide. And if there's a surprise, hopefully, is to the upside. So you're seeing some of that strength play out in our book even now. Ambulatory utilization has been much more stable as we've talked about previously versus surgery-oriented or specialty utilization, which can be lumpy, but we are seeing pretty good strong trends to continue across our book.

因此，從這個角度來看，淨影響要低得多，這再次預示著我們有信心維持指導。因此，無論是從頂線還是底線的角度來看，我們都不應該看到任何進一步的淨影響。有一些變動，也有一些抵消，這讓我們在今年的這個時候有信心維持我們的指導。然後我們看到了很好的利用率趨勢。隨著我們經歷了與去年非常一致的 COVID 時期的陳舊結束，這種情況一直在持續。同樣，我們的策略是在計劃使用和指導時要謹慎。如果有驚喜，希望是好的。因此，即使是現在，您也會在我們的書中看到一些力量在發揮作用。正如我們之前討論過的那樣，門診利用率比面向手術或專業的利用率要穩定得多，後者可能是不穩定的，但我們看到相當不錯的強勁趨勢將在我們的書中繼續。

And for your next question, it comes from the line of Jeff Garro from Stephens.

對於你的下一個問題，它來自 Stephens 的 Jeff Garro。

I'll echo the congrats to Shawn and Parth. Just a bookkeeping question from me. Maybe I missed it, I jumped on late, but I want to see if you gave the care partners, number of providers at the end of period? And then my larger question is, seeing the cost of platform showing good leverage in the quarter, I'm just curious if there are any investments that you think you need the rest of the year for the platform and how to think of timing of any incremental spend there?

我將對 Shawn 和 Parth 表示祝賀。只是我的簿記問題。也許我錯過了，我遲到了，但我想看看你是否給了護理夥伴，期末提供者的數量？然後我更大的問題是，看到平台的成本在本季度顯示出良好的槓桿作用，我很好奇您是否認為今年剩餘時間需要對平台進行任何投資，以及如何考慮任何投資的時機增量消費在那裡？

Yes. Thanks for the question. Just take them in order. So we're not breaking out care partners live separately, but they are all included in the 1 million-plus attribution. As we've said before, the Connecticut lives, about 200,000 thereabouts are all care partners, Beebe Healthcare in Delaware is all care partners as we outlined at the last quarter. So you can see some of the numbers there. But -- and again, those will grow in chunks over as we do these deals, and it's better than what we expected. So we're pretty excited about that.

是的。謝謝你的問題。把它們整理好。所以我們並沒有把護理夥伴分開住，但他們都包含在 100 萬以上的歸因中。正如我們之前所說，康涅狄格州大約有 200,000 人都是護理夥伴，特拉華州的 Beebe Healthcare 都是我們在上個季度概述的護理夥伴。所以你可以在那裡看到一些數字。但是——再一次，當我們進行這些交易時，這些將成塊增長，而且比我們預期的要好。所以我們對此感到非常興奮。

And then from a platform contribution perspective, again, the level of spend is fairly consistent during the course of the year because we are setting up these new states with sales implementation leadership teams and that spend is pretty standard and equally spread throughout the course of the year. But then obviously, as top line impact comes in, you start to see some more operating leverage. So again, from a modeling perspective, quarter-over-quarter, you should see similar trends to last year given all the MSSP results and payments happen in Q3. So you'll see the same trends pretty much, but the spend is pretty consistent.

然後從平台貢獻的角度來看，在這一年中，支出水平相當穩定，因為我們正在與銷售實施領導團隊建立這些新狀態，並且支出非常標準，並且在整個過程中均勻分佈年。但很明顯，隨著頂線影響的出現，你開始看到更多的運營槓桿。因此，再次從建模的角度來看，考慮到所有 MSSP 結果和付款都發生在第三季度，您應該會看到與去年類似的趨勢。所以你會看到幾乎相同的趨勢，但支出非常一致。

Great. And then just following up on the care partners side of things. I wanted to see if you could give any detail on the number of providers just knowing that I believe that's not included in the implemented provider count?

偉大的。然後只是跟進護理合作夥伴方面的事情。我想看看您是否可以提供有關提供商數量的任何詳細信息，只是知道我相信這不包括在已實施的提供商數量中？

Yes. We're not breaking that out. I mean, it's -- again, there are some -- obviously, like I said, the Connecticut providers, that's about 1,100, Beebe Healthcare was about 100 PCPs. We've disclosed that before. So it's similar to what we said last quarter.

是的。我們沒有打破這一點。我的意思是，它是——再次，有一些——很明顯，就像我說的，康涅狄格州的供應商，大約有 1,100 家，Beebe Healthcare 大約有 100 家 PCP。我們之前已經披露過。所以這與我們上個季度所說的相似。

Yes, we expect to update the care partners number on an annual basis.

是的，我們希望每年更新一次護理夥伴編號。

And for the last question, it comes from the line of Ryan Daniels from William Blair.

對於最後一個問題，它來自威廉布萊爾的瑞安丹尼爾斯。

I'll add my congrats to both Parth and Shawn, it's been great working with you guys. My question revolves around more of the Specialty Care business. I know you're involved with ASCs, you do a lot in pediatrics, but we're hearing a lot of buzz in the industry about things like nephrology and CKD, oncology, et cetera. So I'm curious what your purview is there? If you look at going out more aggressively with some of the specialty groups and participating in some of those accountable care type organizations or risk-based contracting?

我要向 Parth 和 Shawn 表示祝賀，與你們合作非常愉快。我的問題更多地圍繞著專業護理業務。我知道你參與了 ASCs，你在兒科做了很多工作，但我們在這個行業聽到了很多關於腎髒病學和 CKD、腫瘤學等方面的議論。所以我很好奇你的權限是什麼？如果您考慮更積極地與一些專業團體一起出去並參與其中一些負責任的護理類型組織或基於風險的合同？

Yes. Thanks, Ryan. Really appreciate it. Look, we are consciously from day 1 have been building multi-specialty groups for this particular reason. 80% of the cost is downstream from the PCP. We have 52 specialties today in our platform. And I think it's a great opportunity for us going forward. We already participate in some programs in a pretty minor way, bundles and so forth. But I think going forward, as we both organically internally as well as through partnerships, you should expect us to look at some of these specialty specific strategies.

是的。謝謝，瑞安。真的很感激。看，我們從第一天起就出於這個特殊原因有意識地建立了多專業小組。 80% 的成本來自 PCP 的下游。今天，我們的平台上有 52 個專業。我認為這對我們前進來說是一個很好的機會。我們已經以非常小的方式參與了一些計劃，捆綁等等。但我認為展望未來，因為我們在內部有機地以及通過合作夥伴關係，你應該期望我們研究其中一些特定於專業的策略。

It will be, again, very disease-specific or specialty specific as you outlined, so -- and then geography specific where we have density in lives, and we can make a big impact. But I think it's a big part of our strategy going forward.

正如您所概述的那樣，它將再次針對特定疾病或特定專業，因此 - 然後是我們生活密度高的特定地理區域，我們可以產生重大影響。但我認為這是我們未來戰略的重要組成部分。

So if we have no further questions, Kyle, I'll ask Shawn Morris to just make a quick closing statement.

因此，如果我們沒有其他問題，凱爾，我將請肖恩莫里斯做一個簡短的結束語。

Sure. Thank you, everybody, for listening to our call today. I really have enjoyed getting to know you, and I look forward to talking to you more. We appreciate your continued interest and support for our company. Enjoy the rest of the day.

當然。謝謝大家今天聽我們的電話。我真的很高興認識你，我期待著與你更多地交談。感謝您一直以來對我們公司的關注和支持。享受剩下的一天。

Thank you. And this concludes today's conference call. Thank you for participating. You may now disconnect.

謝謝。今天的電話會議到此結束。感謝您的參與。您現在可以斷開連接。