Privia Health Group Inc (PRVA) 2025 Q1 法說會逐字稿

Thank you for standing by. My name is Dee, and I will be your conference operator. At this time. I would like to welcome everyone to the Privia Health first quarter conference call. (Operator Instructions) I would like to turn the call over to Robert Borchert, SVP of Investor and Corporate Communications. Please go ahead, sir.

感謝您的支持。我叫 Dee，我將擔任您的會議接線生。此時。歡迎大家參加 Privia Health 第一季電話會議。（操作員指示）我想將電話轉給投資者和企業傳播高級副總裁羅伯特·博切特 (Robert Borchert)。先生，請繼續。

Thank you, Dee and good morning, everyone. Joining me are Parth Mehrotra, our Chief Executive Officer; and David Mountcastle, our Chief Financial Officer. This call is being webcast and can be accessed in the Investor Relations section of priviahealth.com, along with today's financial press release and slide presentation. (Operator Instructions)

謝謝你，迪，大家早安。與我一起的還有我們的執行長 Parth Mehrotra 和我們的財務長 David Mountcastle。本次電話會議正在進行網路直播，您可以透過 priviahealth.com 的投資者關係部分訪問，同時還可以查看今天的財務新聞稿和幻燈片演示。（操作員指示）

The financial results reported today are preliminary and are not final until our Form 10-K for the year ended December 31, 2024, is filed with the Securities and Exchange Commission. Some of the statements we'll make today are forward-looking in nature based on our current expectations and view of our business as of May 8, 2025. 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.

今天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 2024 年 12 月 31 日的 10-K 表格之前，這些結果並非最終結果。我們今天所做的一些聲明本質上是前瞻性的，基於我們目前的預期以及對截至 2025 年 5 月 8 日的業務的看法。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，都受到風險和不確定性的影響，可能導致實際結果大不相同。

As a result, these statements should be considered along 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 reconciliation of these measures to comparable GAAP measures are included in our press release and the accompanying slide presentation posted on our website. So now, I'd like to hand the call over to our CEO, Parth Mehrotra.

因此，這些聲明應與今天的新聞稿中的警告聲明以及我們公司最近向美國證券交易委員會提交的文件中所述的風險因素一起考慮。最後，我們可能會在電話會議上參考某些非公認會計準則財務指標。我們的新聞稿和網站上發布的幻燈片簡報中包含了這些指標與可比較 GAAP 指標的對帳情況。現在，我想將電話交給我們的執行長 Parth Mehrotra。

Thank you, Robert, and good morning, everyone. Privia Health started 2025 with strong growth and momentum as we continue to execute very well across all aspects of our business. This morning, I’ll cover our first quarter performance and recent business highlights. Then David will discuss our market presence, financial results, and our 2025 guidance update before we take your questions.

謝謝你，羅伯特，大家早安。Privia Health 在 2025 年開始展現強勁的成長勢頭，我們在業務的各個方面繼續表現優異。今天上午，我將介紹我們第一季的業績和近期的業務亮點。然後，在我們回答您的問題之前，David 將討論我們的市場地位、財務表現以及 2025 年指導更新。

Privia’s growth team has continued to deliver strong new provider signings across all of our markets, which underpins our visibility through 2025. Implemented Provider growth of 11.7% and value-based attribution growth of 11.1% year-over-year helped drive total Practice Collections growth of 12.8%.

Privia 的成長團隊繼續在我們所有的市場中簽下強勁的新供應商，這鞏固了我們到 2025 年的知名度。實施提供者成長 11.7%，基於價值的歸因成長 11.1%，推動整體實務收集成長 12.8%。

Adjusted EBITDA increased 35.1%, with EBITDA margin expanding 460 basis points year over year while we continue to invest in growth and expansion. This highlights the scale and strength of our business model. In early April, we announced our entry into the state of Arizona as we pursue disciplined growth to complement our organic sales engine. Following this outstanding overall performance in the first quarter, we are raising our 2025 outlook to the mid to high end of our initial guidance.

調整後的 EBITDA 成長了 35.1%，EBITDA 利潤率年增 460 個基點，同時我們繼續投資於成長和擴張。這凸顯了我們商業模式的規模和實力。四月初，我們宣布進入亞利桑那州，以追求有紀律的成長來補充我們的有機銷售引擎。由於第一季整體表現優異，我們將 2025 年的展望上調至初步指引的中高端。

Attributed Lives guidance remains unchanged. This guidance raise early in the year is being driven by our excellent 2 operating execution and the continued exceptional performance by all of our provider partners in the current healthcare services environment.

歸因生命指導維持不變。今年年初上調指引得益於我們出色的營運執行力以及所有提供者合作夥伴在當前醫療服務環境下持續的卓越表現。

We announced our partnership in early April with IMS as our anchor practice to enter the state of Arizona. IMS is one of the largest, independent, multi-specialty practices in Arizona with approximately 70 providers. This is a very strategic market entry for Privia, as the demographics of Arizona offer a compelling value-based care opportunity.

我們在 4 月初宣布與 IMS 建立合作夥伴關係，作為我們進入亞利桑那州的支柱機構。IMS 是亞利桑那州最大的獨立多專業醫療機構之一，擁有約 70 家醫療服務提供者。對於 Privia 來說，這是一個非常具有戰略意義的市場切入點，因為亞利桑那州的人口結構提供了一個極具吸引力的基於價值的護理機會。

IMS has more than 28,000 value-based care attributed lives across Commercial, Medicare and Medicaid programs. The transaction value was $95 million at closing. Privia Health owns the medical group entity and the management services organization in Arizona.

IMS 在商業、醫療保險和醫療補助計劃中擁有超過 28,000 個基於價值的護理生命。交易結束時價值為 9500 萬美元。Privia Health 在亞利桑那州擁有醫療集團實體和管理服務機構。

IMS remains physician owned and will operate with significant clinical autonomy. We expect the Arizona market to be EBITDA positive in the fourth quarter this year following IMS’s implementation on the Privia Platform. We also expect it to meaningfully contribute to adjusted EBITDA in 2026, giving us confidence in our ability to continue to target 20% EBITDA growth.

IMS 仍由醫生擁有，並將擁有很大的臨床自主權。我們預計，隨著 IMS 在 Privia 平台上實施，亞利桑那州市場今年第四季的 EBITDA 將為正值。我們也預計它將對 2026 年的調整後 EBITDA 做出有意義的貢獻，使我們有信心繼續實現 20% 的 EBITDA 成長目標。

We look forward to building on the IMS culture of delivering high-quality community care as we continue to align with like-minded providers across the United States. Now, I’ll ask David to review our market position, recent financial results, balance sheet, and discuss our 2025 guidance outlook in more detail.

我們期待在繼續與美國各地志同道合的供應商合作的同時，繼續發揚 IMS 提供高品質社區護理的文化。現在，我將請大衛回顧我們的市場地位、近期財務表現、資產負債表，並更詳細地討論我們 2025 年的指導前景。

Thank you, Parth. With the addition of Arizona, Privia Health now operates across 15 states and the District of Columbia. Our footprint of high-quality, community-based medical groups and risk entities comprises 4,871 implemented providers caring for over 5.2 million patients in more than 1,200 care center locations.

謝謝你，Parth。隨著亞利桑那州的加入，Privia Health 目前已涵蓋 15 個州和哥倫比亞特區。我們的高品質社區醫療團體和風險實體涵蓋 4,871 個實施服務提供者，在 1,200 多個護理中心為超過 520 萬名患者提供護理。

Privia now serves 1.27 million attributed lives across more than 100 commercial and government value-based care programs. This breadth and geographic reach positions us as a highly diversified and balanced value-based care organization.

Privia 目前為 100 多個商業和政府價值型護理計劃中的 127 萬人提供服務。這種廣度和地理覆蓋範圍使我們成為一個高度多元化和均衡的基於價值的護理組織。

Total attributed lives at March 31 increased 11.1% from a year ago. This was driven by new provider growth as well as new value-based care contracts in certain programs. Commercial attributed lives increased 13.6% from last year to reach 779,000.

截至 3 月 31 日的總歸因生命比去年同期增加了 11.1%。這是由新供應商的成長以及某些項目中新的基於價值的護理合約所推動的。商業歸因生命比去年增加了 13.6%，達到 779,000。

Lives attributed to the Medicare Shared Savings Program were up almost 5%. Medicare Advantage and Medicaid attribution increased more than 8% and 11%, respectively, from a year ago. The diversification of Privia’s value-based care contracts gives us confidence in our ability, to build scale and profitability, across the business, despite challenges in any one particular program or contract.

受益於醫療保險共享儲蓄計劃的人數增加了近 5%。與一年前相比，醫療保險優勢計劃和醫療補助計劃的歸屬分別增加了 8% 和 11% 以上。Privia 以價值為基礎的護理合約的多樣化使我們對自己在整個業務中建立規模和盈利能力的能力充滿信心，儘管任何特定的計劃或合約都面臨挑戰。

We remain highly focused on generating positive contribution margin in our value-based contracts as we pursue attribution growth, manage risk, and implement clinical and operational enhancements in our partner practices. We continue to evaluate moving to greater downside risk when we believe contract economics appropriately compensate our four physician partners for the level of risk incurred. Ultimately, our goal is to achieve consistent and sustainable earnings growth for our medical groups and shareholders.

在我們追求歸因成長、管理風險並在合作夥伴實踐中實施臨床和營運改善的同時，我們仍然高度重視在基於價值的合約中產生積極的貢獻利潤率。當我們認為合約經濟學能夠適當補償我們的四位醫生合作夥伴所承擔的風險水平時，我們將繼續評估轉向更大的下行風險。最終，我們的目標是為我們的醫療集團和股東實現持續、可持續的獲利成長。

Privia Health executed very well to start 2025 with strong growth and momentum across all our markets. Implemented providers grew 82 sequentially from Q4 to reach 4,871 at March 31 , an increase of 11.7% year-over-year. The growth in implemented providers along with strong ambulatory utilization trends and value-based performance led to Practice Collections increasing 12.8% from Q1 a year ago to reach $798.6 million.

Privia Health 在 2025 年開局表現非常出色，所有市場都實現了強勁成長和發展勢頭。已實施的提供者數量較第四季環比增加 82 家，截至 3 月 31 日達到 4,871 家，年增 11.7%。實施提供者的成長、強勁的門診利用趨勢和基於價值的績效導致實踐收集較去年第一季增長 12.8%，達到 7.986 億美元。

Adjusted EBITDA, which is reconciled to GAAP Net Income in the Appendix, increased 35.1% over the first quarter last year to reach $26.9 million, representing 25.6% of Care Margin. This is a 460 basis-point improvement from a year ago as we generated operating leverage across both cost of platform and G&A, while investing across all markets.

調整後的 EBITDA（與附錄的 GAAP 淨收入相協調）較去年第一季成長 35.1%，達到 2,690 萬美元，佔 Care Margin 的 25.6%。這比一年前提高了 460 個基點，因為我們在平台成本和一般及行政費用方面都產生了營運槓桿，同時在所有市場進行了投資。

We ended the first quarter of 2025 with $469 million in cash and no debt following typical quarterly cash outflows early in the year related to employee bonuses and value-based care payments to providers. This does not reflect the $95 million deployed in April for the Arizona acquisition. Our healthy balance sheet continues to position us with significant financial flexibility to deploy capital for business development and take advantage of opportunities in the current market environment.

在年初出現與員工獎金和向醫療服務提供者支付的基於價值的護理費用相關的典型季度現金流出之後，我們在 2025 年第一季結束時擁有 4.69 億美元現金且沒有債務。這還不包括 4 月為收購亞利桑那州而投入的 9,500 萬美元。我們健康的資產負債表繼續使我們擁有極大的財務靈活性，可以部署資本用於業務發展並利用當前市場環境中的機會。

We are raising our full-year 2025 guidance to the mid-to-high end of the initial ranges due to the strength of our first quarter performance and visibility through the remainder of the year. Guidance for Attributed Lives remains unchanged.

由於第一季的強勁表現以及今年剩餘時間的可預見性，我們將 2025 年全年業績指引上調至初始範圍的中高階。歸因生命的指導保持不變。

We are maintaining a robust pipeline of existing market expansion and potential new market opportunities. However, our 2025 guidance does not assume any additional business development activity beyond Arizona.

我們正在保持強大的現有市場擴張和潛在新市場機會的管道。然而，我們的 2025 年指導方針並不假設亞利桑那州以外還有任何額外的業務發展活動。

Capital expenditures are expected to be de minimis again this year as part of our capital-light operating model. We continue to expect at least 80% of our full year Adjusted EBITDA to convert to free cash flow.

作為我們輕資本營運模式的一部分，預計今年的資本支出將再次降至最低。我們繼續預計全年調整後 EBITDA 中至少 80% 將轉化為自由現金流。

Privia has delivered consistent growth and profitability across economic, healthcare, and regulatory cycles over the past seven years. The power of our business model and consistent execution is evident in how we have compounded all key metrics over time.

過去七年來，Privia 在經濟、醫療保健和監管週期中實現了持續成長和獲利。我們的商業模式和持續執行的強大力量體現在我們如何隨著時間的推移不斷增強所有關鍵指標。

Our 2025 guidance demonstrates our expectation for another year of strong EBITDA growth and free cash flow conversion. We look forward to continuing to serve our physicians, providers, and health system partners and, in turn, creating value for our shareholders as Privia Health builds large scale, primary care-centric care delivery networks across the nation. Operator, we are now ready to take questions.

我們對 2025 年的預期表明，EBITDA 將再度強勁成長，自由現金流也將持續轉換。我們期待繼續為我們的醫生、服務提供者和醫療系統合作夥伴提供服務，並在 Privia Health 在全國範圍內建立大規模、以初級保健為中心的醫療服務網絡時為我們的股東創造價值。接線員，我們現在可以回答問題了。

(Operator Instructions) Jailendra Singh.

（操作員指示） Jailendra Singh。

Yeah, this is Jailendra Singh from Truist. So congratulations on the strong quarter and of course on the Arizona market entry. Can you take some time to talk about the IMS transaction and prospects you see in that market? What differentiated this as from ones you have done in the past? And how much practice collection and EB benefit you, including in your guidance right now? Thank you.

是的，我是 Truist 的 Jailendra Singh。因此，恭喜本季業績強勁成長，當然也祝賀我們成功進入亞利桑那州市場。您能否花點時間談談 IMS 交易以及您在該市場看到的前景？這與您過去所做的事情有何不同？實踐收集和 EB 對您有多大幫助，包括您現在的指導？謝謝。

Yeah, thanks for the question, Jailendra. Look, IMS, as we said, Arizona's a pretty important healthcare state, big dam, good demographic trends. IMS has been operating for many years and came out of a health system a few years ago and established itself as an independent practice. A lot of cultural alignment with what we are trying to do.

是的，謝謝你的提問，Jailendra。你看，IMS，正如我們所說，亞利桑那州是一個非常重要的醫療保健州，擁有大壩和良好的人口趨勢。IMS 已運作多年，幾年前脫離醫療系統，成為獨立的醫療機構。我們正在嘗試做的事情與許多文化一致。

Very large practice, good size, many locations, really well established patient panels. So overall, really good partner to have and pursue the Privia mission in that state. Pretty important transaction relative to the value, pretty significant EBITDA contribution given the nature of the deal.

診所規模大，規模合適，地點眾多，患者小組也十分完善。因此，總的來說，在那個州擁有並執行 Privia 使命確實是一個不錯的合作夥伴。就價值而言，這是一筆非常重要的交易，考慮到交易的性質，EBITDA 貢獻也相當可觀。

We're not disclosing specifics on the deal or specifically the EBITDA contribution specifically allocated to Arizona or to IMS. It's all embedded in our guidance. But as we've noted in our prepared remarks, this will be EBITDA positive from the first day that they implemented. Pretty significant contribution next year, and that gives us a lot of confidence to keep going even at 20% into next year. Thank you.

我們不會透露有關該交易的具體細節，或具體分配給亞利桑那州或 IMS 的 EBITDA 貢獻。這一切都已融入我們的指導中。但正如我們在準備好的評論中所指出的，從實施的第一天起，這將對 EBITDA 產生積極影響。明年的貢獻相當可觀，這給了我們很大的信心，甚至在明年繼續保持 20% 的增幅。謝謝。

Josh Raskin, Nephron Research.

Josh Raskin，Nephron Research。

Hi, thanks. I'm going to follow up on Arizona as well. I guess I'm specifically interested in sort of that PCP versus specialist mix that IMS has maybe relative to your existing provider base. Anything we should be thinking in terms of differences in collections per positions and maybe how IMS is positioned with the larger payers in the market.

你好，謝謝。我也會關注亞利桑那州的情況。我想我特別感興趣的是 IMS 相對於您現有的提供者基礎的 PCP 與專家組合。我們應該考慮每個職位的收款差異，以及 IMS 如何定位於市場上較大的付款人。

And then finally, did that strong value-based care opportunity that you guys talk about, did that make the transaction more attractive, less attractive? How were you thinking about that in the context of the broader preview?

最後，你們談到的強大的基於價值的護理機會是否使交易變得更有吸引力，還是更沒有吸引力？在更廣泛的預覽背景下，您是如何考慮這一點的？

Yeah, thanks for the question, Josh. So they're multi-specialty practice. You can go on their website and they've listed every single specialty and providers, so it's all public info. Slightly more skewed towards specialist versus primary care, but pretty healthy mix.

是的，謝謝你的提問，喬希。所以他們是多專業的實踐。您可以訪問他們的網站，他們列出了每個專業和提供商，因此都是公開資訊。稍微偏向專科護理而非初級護理，但結構相當健康。

You see, we disclose the attributed lives of 28,000, so that that's all attributed to the PCPs. But again, it's very similar to some of our other states. It's not skewed one way or the other in one direction, and it's a multi-specialty practice, covering all specialties. So slightly higher practice collections per provider, as you would expect from that perspective.

您瞧，我們揭露了 28,000 條生命記錄，這些都歸功於 PCP。但同樣，它與我們其他一些州的情況非常相似。它不會偏向某一方向，而且它是一種多專業實踐，涵蓋所有專業。因此，正如您從這個角度所期望的那樣，每個提供者的實踐收集量會略高一些。

And then I think from the -- from an opportunity perspective, there's a day one opportunity with the group with 28,000 lives. But then more importantly, I think Arizona is a pretty important state as far as EMEA is concerned, the demographic trends are concerned, the availability of independent providers.

然後我認為從機會的角度來看，對於擁有 28,000 名生命的群體來說，第一天就有機會。但更重要的是，我認為就歐洲、中東和非洲地區、人口趨勢和獨立供應商的可用性而言，亞利桑那州是一個非常重要的州。

So I think we can have a pretty good presence over the next 4, 5, 10 years. That's always a playbook. As we enter these states, it's not a 1, 2 year play. We're looking to establish a pretty large medical group over time. And I think the TAM opportunity is there for us to go get in Arizona, so we're pretty excited about that.

所以我認為我們在未來 4 年、5 年、10 年內能夠有相當好的表現。這始終是一個劇本。當我們進入這些州時，這不是一兩年就能完成的事。我們希望隨著時間的推移建立一個相當大的醫療集團。我認為 TAM 有機會讓我們進入亞利桑那州，所以我們對此感到非常興奮。

Richard Close, Canaccord Genuity.

Canaccord Genuity 的 Richard Close。

Yes, congratulations. Thanks for the questions.

是的，恭喜你。感謝您的提問。

When you guys are calling out strong ambulatory utilization, can you provide some perspective in terms of how it came in versus maybe what was baked into your guidance and and your thoughts on utilization throughout the rest of the year and maybe how that factored into the updated commentary on guidance?

當你們呼籲強勁的門診利用率時，您能否提供一些觀點，說明它是如何產生的，以及可能包含在您的指導中的內容，以及您對今年剩餘時間利用率的看法，以及這對更新後的指導評論有何影響？

Yeah, thanks for the question, Richard. So I think it's been pretty strong. The flu season varies every year. We have a pretty significant portion of our providers as pediatricians, as PCPs, as family medicine, as you know. So given which month the flu season hits, in that call it November through March time frame or April time frame, some years it's earlier, some years it's later. So we kind of normalize for that in our guidance over the years.

是的，謝謝你的提問，理查德。所以我認為它非常強大。每年的流感季節都有所不同。如您所知，我們的醫療服務提供者中，有相當一部分是兒科醫生、初級保健醫生和家庭醫生。因此，如果確定流感季節發生在哪個月份，那麼就稱之為 11 月到 3 月的時間範圍或 4 月的時間範圍，有些年份會更早，有些年份會更晚。因此，我們在多年來的指導中對此進行了規範化。

But you know, we've expected and experienced pretty strong trends continuing. And that's reflected in practice collections. I think we're going to continue to see those trends going forward. I mean, we've said that pretty consistently. Utilization continues to be at this elevated level. And I think that bodes well for our fee-for-service business.

但你知道，我們已經預期並經歷了相當強勁的趨勢持續下去。這在實踐收藏中有所體現。我認為我們將繼續看到這些趨勢向前發展。我的意思是，我們一直都這麼說。利用率繼續維持在這一較高水準。我認為這對我們的收費服務業務來說是個好兆頭。

It's also great for the value-based business because we are seeing the patients much more frequently. So our guidance fully reflects those trends continuing.

這對於基於價值的業務來說也是一件好事，因為我們可以更頻繁地見到病人。因此，我們的指導充分反映了這些趨勢的持續。

Matthew Gillmor, KeyBanc.

馬修·吉爾摩（Matthew Gillmor），KeyBanc。

Hey, thanks for the question. I just wanted to ask a clarification on IMS and the guide. Are you absorbing any new market entry costs as it relates to Arizona within the guide? And then also, can you just remind us in terms of how the accounting works? Do you recognize any revenue prior to them being implemented on the on the Privia platform? Thanks.

嘿，謝謝你的提問。我只是想澄清一下 IMS 和指南。您是否在指南中吸收了與亞利桑那州相關的任何新市場進入成本？另外，您能否提醒我們一下會計工作是如何進行的？在 Privia 平台上實施之前，您是否確認有任何收入？謝謝。

Yeah, thanks for the question, Matt. I'll start, and then David will take the accounting question. So, we always have new market entry costs because as you know the model, we enter a state and we establish our sales team, implementation teams.

是的，謝謝你的提問，馬特。我先開始，然後大衛將回答會計問題。因此，我們總是有新市場進入成本，因為正如你所知的模型，我們進入一個州並建立我們的銷售團隊和實施團隊。

Our operations to go to get other providers in the state to join our platform in addition to the anchor practice. So our guidance assumes absorbing those costs starting this year and then going into next year.

除了主力業務之外，我們的營運還將吸引該州的其他供應商加入我們的平台。因此，我們的指導假設是從今年開始吸收這些成本，然後持續到明年。

Obviously, that highlights the merits of this transaction that despite absorbing those costs, we expect the transaction to be positive EBITDA this year upon implementation and pretty significantly next year. And that was really attractive to us. I'll let David handle the accounting question.

顯然，這凸顯了這筆交易的優點，儘管吸收了這些成本，我們預計該交易在實施後今年的 EBITDA 將為正，明年的 EBITDA 將相當可觀。這對我們來說確實很有吸引力。我會讓大衛處理會計問題。

Yeah, and so from an accounting perspective, because we acquired the medical group, as soon as we acquired the medical group, we get revenue and practice collections from that entity. However, the deal works where we don't get care margin and adjusted EBITDA until we implement them on the Athena platform, which we expect to happen in Q4 this year.

是的，從會計角度來看，因為我們收購了醫療集團，所以一旦我們收購了醫療集團，我們就會從該實體獲得收入和實務收益。然而，根據該交易的規定，我們只有在 Athena 平台上實施這些措施後才能獲得護理利潤和調整後的 EBITDA，我們預計這將在今年第四季度實現。

Jessica Tassan, Piper Sandler.

傑西卡·塔桑、派珀·桑德勒。

Hi guys, and thanks so much for taking the question and congrats on Arizona and the strong quarter. I was hoping maybe you could talk a little bit about the growth in capitated lives quarter over quarter. Was the growth just population growth within existing contracts?

大家好，非常感謝你們回答這個問題，並祝賀亞利桑那州取得如此強勁的季度業績。我希望您能稍微談談按人頭計算的壽命的季度環比增長情況。這種成長僅僅是現有合約範圍內的人口成長嗎？

And then any perspective on Medicare Advantage. In 2026, just whether you're interested in expanding with new health plans or expanding the scope of your MA capitated contracts? Any color on just how you're thinking about '26 in light of the rate announcement. Thanks.

然後是關於醫療保險優勢的任何觀點。到 2026 年，您是否有興趣擴展新的健康計劃或擴大 MA 按人頭計算的合約範圍？從利率公告來看，您對 26 年有何看法？謝謝。

Yeah, thanks for the question, Jess. So yeah, the growth was pretty much organic in the cap book either existing -- in the same existing contracts. So existing providers participating seeing a few more patients and expanding the panels, and then some new providers joining the same contracts in those geographies and patients coming with those new providers.

是的，謝謝你的提問，傑西。所以，是的，無論是現有的還是現有的合同，成長基本上都是有機的。因此，現有的提供者參與看診更多的患者並擴大小組，然後一些新的提供者加入這些地區的相同合同，患者也隨之而來。

So, it was a few thousand lives. And that's our objective. Once we enter these contracts, we want to improve performance, we want to add attributed lives and continue to expand that book of business if we think we're going to do well.

因此，這關係到幾千人的生命。這就是我們的目標。一旦我們簽訂了這些合同，我們就想提高績效，增加歸因生命，並繼續擴大業務範圍，如果我們認為我們會做得很好的話。

And then on your second question, our view on MA remains pretty much the same as we discussed at length on the last earnings call. I think we're in this 3, 4 year period, which is going to be pretty challenging for MA, for all the factors that you all know pretty well, and we've articulated in the past calls.

關於您的第二個問題，我們對 MA 的看法與我們在上次收益電話會議上詳細討論的大致相同。我認為我們正處於這 3、4 年時期，這對 MA 來說將是一個相當大的挑戰，因為所有因素你們都非常了解，而且我們在過去的電話會議中也已經闡明了這一點。

We will continue to pursue our strategy of sharing risk with the payers in MA contracts. So we would look to grow our book, grow our attributed lives in MA. I would not expect us to get into full cap or 100% risk deals. Our preference is to continue to enter into shared risk arrangements with the payer just given the environment. And we actually think that's the best long-term sustainable model.

我們將繼續推行與併購合約付款人共擔風險的策略。因此，我們希望擴大我們的書籍，擴大我們在 MA 的歸屬生活。我不指望我們會達成全額上限或 100% 風險的交易。我們傾向於在既定環境下繼續與付款人達成共擔風險的協議。我們確實認為這是最好的長期可持續模式。

If we are able to underwrite any deals where we think we're going to get significantly compensated for the level of risk in a full cap kind of contract, we look to add those. But at this moment you should not expect us to enter fresh new fully 100% capitated contracts. But we'll continue to grow the book with both existing payers and look for new payers in existing or new states in growing that MA book.

如果我們能夠承保任何交易，並且我們認為我們將在全額合約的風險水平上獲得顯著的補償，我們就會考慮增加這些交易。但目前您不應期望我們簽訂全新的完全 100% 人頭合約。但我們將繼續與現有的付款人一起擴大該書，並在現有或新的州尋找新的付款人來擴大該 MA 書。

Whit Mayo, Leerink Partners.

惠特·梅奧 (Whit Mayo)，Leerink Partners。

Hi, this is Alberta Massey on for Whit. Thanks for taking the question. We're about halfway through V28 now. Are there any surprises with the implementation versus expectations in MSSP? I would be curious to hear about any changes in practice care management strategies. Thanks.

大家好，我是 Whit 的 Alberta Massey。感謝您回答這個問題。現在我們已經完成了 V28 的一半了。與 MSSP 的預期相比，實施情況有什麼意外嗎？我很想知道實踐護理管理策略方面有任何變化。謝謝。

Yeah, thanks for the question, Alberta. So, V28 doesn't impact MSSP. As much per se, it's mainly related to MA. I mean, the average risk code in MSSP is, around 1, and risk coding well plays some role. It's not a big factor in our performance.

是的，謝謝你的提問，艾伯塔。因此，V28 不會影響 MSSP。就其本身而言，它主要與 MA 有關。我的意思是，MSSP 中的平均風險代碼約為 1，風險編碼發揮了一定的作用。這對我們的表現來說不是一個很大的因素。

As far as the MA book is concerned, it's playing out as we expected. We took a very conservative view since the beginning of last year when we exited two capitation contracts. We think it's a pretty significant headwind to the industry, to the MA business, both for the payers and providers downstream.

就 MA 書而言，它的發展正如我們所預期的那樣。自從去年年初我們退出兩份人頭稅合約以來，我們採取了非常保守的觀點。我們認為，對於該行業、對於 MA 業務，無論是對於下游的付款人還是提供者來說，這都是一個相當大的阻力。

And it's playing out as we expected. You've seen pressures on different payers at different points in time, either last year or this year. You've seen pressures on the provider group. So I think we continue to be cautious and see how it plays out. And again, fundamentally, we've got to get paid to take additional risk in MA, and we'll keep looking for those opportunities as we just said.

一切正如我們預期的那樣。無論是去年還是今年，在不同時間點，您都會看到不同付款人所面臨的壓力。您已經看到了提供者群體面臨的壓力。因此我認為我們會繼續保持謹慎並觀察事態如何發展。再說一次，從根本上來說，我們必須獲得報酬才能在 MA 中承擔額外的風險，而且正如我們剛才所說的那樣，我們會繼續尋找這些機會。

AJ Rice, UBS.

瑞銀的 AJ Rice。

Hi everybody, maybe just broaden out this discussion. There has been some speculation some of the trade press that the Trump administration might look at some changes to MSSP program. They were largely supported in the first term if you heard anything along those lines and maybe more broadly with all the discussions about Medicaid changes.

大家好，也許只是擴大這個討論。一些行業媒體猜測川普政府可能會考慮對 MSSP 計劃進行一些改變。如果您聽到類似的言論，您就會知道他們在第一任期內得到了大力支持，而且在有關醫療補助改革的討論中，他們的支持範圍可能更為廣泛。

I know that's about 50% of your government loss, but it sounds like you've only got upside arrangements. Any thoughts about any of that and whether it will present opportunities? And maybe just last on the government stuff. They haven't been able to get the docs do fix legislation this year. Does that have any impact on you? I assume some of your providers are impacted by that, but any comment on that?

我知道這大約佔政府損失的 50%，但聽起來你只有上行安排。您對此有何看法？是否會帶來機會？最後再談談政府事務。他們今年還未能獲得修復立法的文件。這對你有什麼影響嗎？我認為你們的一些供應商受到了影響，對此有什麼評論嗎？

I'll take them in order. We haven't heard anything new since last quarter. I think we covered it pretty extensively. MSSP continues to be pretty well established program, one of the most well established programs out of CMS.

我會按順序處理它們。自上個季度以來，我們沒有聽到任何新消息。我認為我們已經討論得相當廣泛了。MSSP 繼續是一個非常成熟的項目，也是 CMS 中最成熟的項目之一。

I think they understand it. The folks in the administration understand it. And we continue to expect it to stay at the level that it is today. If we hear anything differently, they'll make an announcement, and obviously we'll comment on it. But we haven't heard anything on any potential changes to MSSP.

我想他們明白這一點。政府裡的人們明白這一點。我們仍然預計它將保持在今天的水平。如果我們聽到任何不同的消息，他們會發佈公告，顯然我們也會對此發表評論。但我們還沒有聽到有關 MSSP 任何潛在變化的消息。

To your second question, I mean, it's all fully baked in our guidance like on the Medicaid side. It's -- we don't take any risk. As you mentioned, it's about 100,000 lives. It's upside only. We get some care management fees. We're trying to manage those lives without taking risk.

對於您的第二個問題，我的意思是，這一切都完全融入了我們的指導中，例如在醫療補助方面。這是——我們不承擔任何風險。正如你所提到的，大約有10萬人喪生。這只是好處。我們收取一些護理管理費。我們試圖在不冒險的情況下管理這些人的生活。

It's not a big part of our fee-for-service business. And I think what's important to recognize is we have an ambulatory care delivery network with community-based providers. That's the front line of healthcare with some of these Medicaid patients, doctors in the communities taking care of children, mothers, family members. And I think that's a pretty important aspect of the level of care in that population.

這不是我們收費服務業務的重要組成部分。我認為重要的是要認識到我們擁有一個由社區提供者組成的門診護理服務網絡。這是醫療保健的第一線，其中一些醫療補助患者、社區醫生負責照顧兒童、母親和家庭成員。我認為這是該人群護理水平的一個非常重要的方面。

So we don't expect that we will be impacted that significantly from costs. If anything, folks will hopefully see that level of frontline care versus some of the more acute care that could be impacted downstream from some potential costs.

因此，我們預計成本不會受到太大影響。無論如何，人們希望看到這種級別的一線護理，而不是一些可能受到潛在成本影響的更急性的護理。

But again, we'll see how it plays out. On your last question, there may be some impact, but again, we have a pretty big diversified book. It's all factored in our guidance, and nothing material to call out on that particular legislation.

但我們會再看看結果如何。關於你的最後一個問題，可能會有一些影響，但是，我們擁有相當龐大的多元化資產。這些都已納入我們的指導範圍，對於該項具體立法並沒有什麼實質要求。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Hi, this is Thomas Walsh on for Andrew. Hoping you could comment on if you've seen any behavioral change in patients using their coverage this year, whether that's induced by premium increases or changes in patient cost responsibility.

大家好，我是 Thomas Walsh，代表 Andrew。希望您能評論一下，您是否發現今年患者使用保險的行為發生了任何變化，無論是由於保費上漲還是患者費用責任的變化引起的。

No, nothing out of the ordinary, that's worth calling out. We have a pretty diversified book, 5-plus million patients, so we haven't seen any fundamental -- fundamentally different, levels of Activity.

不，沒有什麼不尋常的，值得一提。我們擁有相當多樣化的患者群體，超過 500 萬名患者，因此我們尚未發現任何根本性——根本上不同的活動水平。

Ryan Langston, TD Cowen.

瑞安·蘭斯頓（Ryan Langston），TD Cowen。

Hey, thanks. Just go back to the guidance. Obviously, updated it this quarter. Last couple of years in the first quarter you simply just reiterated the guide. Most other companies this quarter maintain guide as well. So it sounds like you're a little bit more confident than some of your peers based on your prepared comments. Is this mostly just the IMS pick up in the guide or is really just what you're seeing in the underlying business performance driving that guidance?

嘿，謝謝。只需返回指導即可。顯然，本季度對其進行了更新。過去幾年第一季你只是重申了該指南。本季大多數其他公司也維持指導價。因此，從您準備好的評論來看，您似乎比一些同行更自信一些。這主要是 IMS 在指南中的拾取，還是實際上只是您在推動該指南的基礎業務績效中看到的內容？

Yeah, I appreciate the question. I think it's a combination of both. I mean, there was no IMS impact and you're seeing the outperformance across the Board on all our metrics all the way down to EBITDA.

是的，我很感謝你提出這個問題。我認為這是兩者的結合。我的意思是，沒有受到 IMS 的影響，而且您會看到我們的所有指標（一直到 EBITDA）都表現出色。

So that has no impact from Arizona. And then as we noted in our prepared remarks, all that impact starts in Q4, at least their margin downwards on our P&L.

所以這不會受到亞利桑那州的影響。然後，正如我們在準備好的評論中所指出的那樣，所有這些影響都始於第四季度，至少他們的利潤率會下降。

So I think it's a combination of both. We saw pretty good results this quarter. You're right, we haven't -- it's still early in the year. But given the strong performance, given the impact of the transaction, we feel pretty confident for the rest of the year. We'll see how the year plays out and then update guidance further. But at this point, we felt pretty comfortable going and given a strong start to the year.

所以我認為這是兩者的結合。本季我們看到了相當不錯的業績。你說得對，我們還沒有──現在還只是年初。但鑑於強勁的表現，考慮到交易的影響，我們對今年剩餘時間的表現充滿信心。我們將觀察今年的進展情況，然後進一步更新指導。但此時，我們感覺非常安心，並為今年開了個好頭。

Elizabeth Anderson, Evercore ISI.

伊麗莎白·安德森，Evercore ISI。

Hi, guys, thanks for the question. A slight two part for me. One, not to beat a dead horse, but so the attributed lives for IMS come in in which quarter? So I just want to make sure I have that down correctly. And then two, you had a nice, obviously, organic improvement in G&A in the quarter. Is that we just think of that as continuing to run like to sort of be smoothly across the year or anything sort of one time you to call out that would impact the cadence for the rest of the year? Thanks.

大家好，謝謝你們的提問。對我來說，這分為兩個部分。第一，不想再重複老生常談，但 IMS 的貢獻來自於哪個季度？所以我只是想確保我正確地記下了這一點。其次，本季的 G&A 明顯有了顯著的有機改善。我們是否認為這可以繼續順利運行，或者像您所說的那樣，一次性地影響今年剩餘時間的節奏？謝謝。

Yeah, thanks, Elizabeth. The attributed lives will flow through in the following quarter, so that's not yet reflected in the March 31 number for IMS. That's why you're seeing, while we've kept that piece of the guidance unchanged, we're still below the low end of the guidance, which is very typical for Q1.

是的，謝謝，伊麗莎白。歸因生命將在下一季流入，因此這尚未反映在 3 月 31 日的 IMS 數字中。這就是為什麼你會看到，雖然我們保持了指導方針不變，但我們仍然低於指導方針的低端，這對於第一季來說非常典型。

Some of the lives or some of the employers change their carriers on the commercial book. MA members change plans. And so if you look at past years, it's very difficult for us to have that churn. The patient is not going anywhere. The doctor is not going anywhere. But it's just the movement of different health plans. And so we'll pick up all that attribution going forward. Could you repeat your second question again?

一些生命或一些雇主在商業書籍上改變了他們的載體。MA 成員改變計劃。所以，如果你回顧過去幾年，你會發現我們很難實現這樣的轉變。病人哪裡也不去。醫生哪兒也不去。但這只是不同健康計畫的變動而已。因此，我們將繼續追究所有這些責任。您能再重複一下您的第二個問題嗎？

The G&A question.

一般及行政事務 (G&A) 問題。

I think the second question was around G&A, and I'll take that part. From a G&A perspective, we saw a sequential decline in G&A from the fourth quarter, mainly attributed to what we accrue for bonuses and our contractor expenses. Early in the year, we pretty much stayed consistent on bonus accruals and don't look to increase that until we get further into the year.

我認為第二個問題是關於 G&A 的，我會回答這部分。從一般及行政費用的角度來看，我們發現一般及行政費用從第四季度開始連續下降，這主要歸因於我們累積的獎金和承包商費用。今年年初，我們的獎金累積基本上保持一致，並且不打算在年底前增加獎金累積。

So, it's just those two things. I think you were asking about throughout the rest of the year. I would say, follow similar trends to previous years, is what we're expecting.

所以，只有這兩件事。我想您問的是今年剩餘時間的情況。我想說，我們所期待的是遵循與前幾年類似的趨勢。

Constantine Davides, Citizens JMP.

康斯坦丁·戴維茲，公民 JMP。

Just following up on Arizona, what made them move to partner with you in this type of transaction and what was important to them with respect to what Privia checked the boxes on maybe relative to some other platforms or options they may have evaluated and then just given their higher sort of mix of value-based lives relative to the number of PCPs they have? Are they moving away from a prior enablement partner? Thanks.

只是想跟進亞利桑那州的情況，是什麼促使他們與您在這種交易中進行合作？相對於他們可能評估過的其他平台或選項，Privia 所勾選的選項對他們來說重要嗎？然後考慮到他們相對於所擁有的 PCP 數量而言更高價值的生活組合？他們是否會放棄先前的支持夥伴？謝謝。

Yeah, I appreciate the question, Constantine. So I think it's a pretty important question that highlights the strength of our platform. Any practice that size, as we stated in previous calls, has been approached by everybody you can imagine, health systems, private equity, bigger payers, other consolidators, so on and so forth, other enablement companies.

是的，我很感謝你提出這個問題，康斯坦丁。所以我認為這是一個非常重要的問題，它凸顯了我們平台的優勢。正如我們在之前的電話會議中提到的那樣，任何這種規模的機構都已經被所有你能想到的機構所接觸過，包括醫療系統、私募股權、更大的付款人、其他整合者等等，以及其他支持公司。

I think what was key to them partnering with us is, number one, we just have a unique model that can cater to the entirety of the practice, all specialties, every single patient, every single line of business, every payer, comprehensive tech services platform. That coupled with an ability to maintain clinical autonomy in a model like Privia, where you're not getting employed by another entity from your compensation perspective, you are able to make decisions in day-to-day working at the clinic operations and how they practice medicine. I think that was immensely important to the physician leadership there.

我認為他們與我們合作的關鍵在於，首先，我們有一個獨特的模式，可以滿足整個實踐、所有專業、每位患者、每一條業務線、每一位付款人的需求，並提供全面的技術服務平台。再加上在像 Privia 這樣的模型中保持臨床自主權的能力，從薪酬角度來看，您不會被其他實體僱用，因此您可以就診所的日常運營工作以及如何行醫做出決策。我認為這對那裡的醫生領導者來說非常重要。

They came out of a health system, and so obviously, the group is fiercely independent and believes in the autonomy of private practice, which leads to a strong cultural alignment. I think we can have a great business in Arizona with their help, and grow that business, grow their clinics as well as build around them. So I think it's a combination of all of those.

他們來自醫療體系，因此顯然，這個群體非常獨立，並且相信私人診所的自主權，這導致了強烈的文化一致性。我認為，在他們的幫助下，我們可以在亞利桑那州開展偉大的事業，發展壯大這項事業，擴大他們的診所，並圍繞他們進行建設。所以我認為這是所有這些因素的結合。

They did partner with other enablement companies. and I think we just evaluate those contracts over time. But we fully own the medical group, risk entity, MSO entities, and so we'll just evaluate how we move some of those contracts over time.

他們確實與其他支援公司合作。我認為我們只是隨著時間的推移評估這些合約。但我們完全擁有醫療集團、風險實體、MSO實體，因此我們只會評估如何隨著時間的推移轉移其中一些合約。

And that again highlights the importance where even though some of these practices can partner with other entities once we come in with a comprehensive solution, that overweighs any prior decisions. So we'll just see how those play out and what the contractual terms are and how they're performing and take it from there.

這再次凸顯了其重要性，儘管一旦我們提出全面的解決方案，其中一些實踐可以與其他實體合作，但這比任何先前的決定都更重要。因此，我們只需觀察這些情況如何發展、合約條款是什麼、它們的表現如何，然後從那裡開始。

Jack Slevin, Jefferies.

傑克·斯萊文，傑富瑞。

Thanks for taking the question and congrats on a really strong quarter. Two parter. One, just to clear this out, IMS, are they participants in MSSP or ACO REACH currently? And when you say that they've got other enablement agreements, presently is that what you're referring to?

感謝您回答這個問題，並祝賀本季業績表現強勁。兩人一起。首先，為了澄清這一點，IMS，他們目前是 MSSP 或 ACO REACH 的參與者嗎？當您說他們有其他支援協議時，您目前指的是這個嗎？

And then the second one really just thinking more about how we look at fee-for-service utilization in 2025. The United callout was that AWV ran really, really hot. I would think you would benefit from similar trends in the first quarter, but I'm trying to get a sense of what we've seen year-to-date in terms of PCP or primary care provider, utilization versus specialists in our book. And is there an expectation that the front-running of AWV might bring some upside throughout the year as we trend downwards toward the -- downstream toward the rest of the specialists in the ecosystem?

第二個問題其實只是更思考我們如何看待 2025 年的按服務收費利用率。美聯航表示，AWV 運作確實非常糟糕。我認為您將從第一季度的類似趨勢中受益，但我試圖了解我們今年迄今為止在 PCP 或初級保健提供者、利用率與專家方面所看到的情況。隨著我們向下游生態系統中其他專家的趨勢發展，是否有人預期 AWV 的領先優勢會在全年帶來一些好處？

Yes, on the first question, the short answer is yes, they do participate in MSSP/ ACO REACH or one of those programs. We're not going to comment on which one and how many lives, but they do participate currently. And so we'll inherit that book.

是的，關於第一個問題，簡短的回答是肯定的，他們確實參與了 MSSP/ACO REACH 或其中一個項目。我們不會評論哪一個以及有多少生命，但他們目前確實參與了。所以我們將繼承那本書。

On the second one, yeah, I think as we said previously, I won't categorize it just AWV's per se, but, we've experienced pretty strong ambulatory utilization that our PCP pediatricians, OBGYNs, even some of the specialists. So we've seen in office community-based physician utilization to be pretty strong.

關於第二個問題，是的，我想正如我們之前所說的那樣，我不會將其僅僅歸類為 AW​​V 本身，但是，我們的 PCP 兒科醫生、婦產科醫生，甚至一些專家都經歷了相當強大的門診利用率。因此，我們發現，辦公室社區醫生的使用率相當高。

That's reflected in our practice collections. And you know we don't see any reason to believe that that would not continue for the rest of this year. We'll just see how it plays out, but that's reflected in our guidance. We'll update that as we go forward.

這反映在我們的實踐收藏中。你知道，我們沒有理由相信這種情況在今年剩餘時間不會持續下去。我們只會觀察其如何發展，但這反映在我們的指導上。我們將隨時更新。

Jeff Garro, Stephens.

傑夫加羅、史蒂芬斯。

Yeah, good morning. Thanks for taking my question. I want to go back to the follow of 2023 you had announced an AI partnership that targeted physician productivity. So I was hoping for an update on how adoption has been of that solution by your providers and what kind of productivity gains you've realized. Thanks.

是的，早安。感謝您回答我的問題。我想回顧 2023 年，當時您宣布了一項旨在提高醫生工作效率的人工智慧合作關係。因此，我希望了解您的供應商對該解決方案的採用情況以及您實現了哪些生產力提升。謝謝。

Yeah, I appreciate the question. So, the utilization has been great. I mean, we've adopted that pretty significantly across our provider base. We continue to innovate with the partner, Navina, and, we think it's a great solution.

是的，我很感謝你提出這個問題。因此，利用率很高。我的意思是，我們已經在整個供應商群體中廣泛採用了這種方法。我們繼續與合作夥伴 Navina 一起創新，我們認為這是一個很好的解決方案。

That streamlines clinical documentation, prevents errors, highlights care gaps at the point of care to the PCP, right when they're seeing the patient. So I think it's another way where we are continuously evaluating where AI and other tools can improve the workflow, reduce the time that is spent.

這簡化了臨床文檔，防止了錯誤，並在 PCP 看病時向其強調了護理方面的差距。所以我認為這是我們不斷評估人工智慧和其他工具可以改善工作流程、減少花費時間的另一種方式。

We have a case study out that I think is public on our website, so we can send it to you after the call that highlights all the stats on this particular partnership. I think they also showcased that at HIMSS recently. So, we're all pretty happy, and we continue to improve this in other areas with the adoption of AI.

我們有一個案例研究，我認為它是在我們的網站上公開的，所以我們可以在通話後將其發送給您，其中重點介紹了有關此特定合作關係的所有統計數據。我認為他們最近也在 HIMSS 上展示了這一點。所以，我們都很高興，並且我們將繼續透過採用人工智慧在其他領域進行改進。

Ryan Daniels, William Blair.

瑞安丹尼爾斯、威廉布萊爾。

Yeah, thanks for taking the question, guys. I guess most of the big ones have been answered. I wanted to do a follow up there and just ask any other big IT initiatives or initiatives that Privia is looking at for the next 6 to 12 months. We've heard a lot on AI, but also more on specialty referrals and things like healthcare. So curious kind of what's on the agenda for the team. Thanks.

是的，謝謝大家回答這個問題。我想大多數重要問題都已經得到解答了。我想進行跟進，並詢問 Privia 在未來 6 到 12 個月內正在考慮的任何其他大型 IT 計劃或舉措。我們聽到了很多關於人工智慧的消息，但也聽到了更多關於專業轉診和醫療保健等方面的消息。所以我很好奇團隊的議程是什麼。謝謝。

Yeah, I appreciate the question, Ryan. So as you know, we have a very comprehensive full-tech service platform across all lines of business, both people service, web cycle, value-based care. And so we are continuously looking to improve. The value-based care is a big area obviously both on improving the clinical workflow, decision making, how the data comes in from different payers, different contracts.

是的，我很感謝你的提問，瑞安。如您所知，我們擁有一個涵蓋所有業務線的非常全面的全技術服務平台，包括人員服務、網路週期和基於價值的護理。因此我們不斷尋求進步。基於價值的照護顯然是一個很大的領域，它涉及改善臨床工作流程、決策，以及數據如何從不同的付款人和不同的合約中獲得。

We have 100-plus value-based contracts and to take a risk you want to make sure you're getting real-time data as much as possible or with minimal lag, we have a lot of visibility into it. So there's a lot of effort just to keep improving those. I think we've had -- our good performance is reflective of the stack. We have currently that you need to have in place, but there's always scope for improvement. So that's a big area for us to focus.

我們有 100 多份基於價值的合同，為了承擔風險，您要確保盡可能多地獲取實時數據或以最少的延遲獲取數據，我們對此具有很高的可見性。因此，我們付出了很多努力來不斷改進這些。我認為我們已經有了——我們的良好表現反映了這一點。我們目前已經滿足了您需要的條件，但總是有改進的空間。所以這是我們需要重點關注的領域。

And then on the regular workflow as a patient comes in and through their life cycle with the doctor during the year or over many years. I think we've continuously looked at different solutions that are improved -- getting improved now, whether it's on scribing, on RCM workflows, on just improving again accuracy, timelines, speed.

然後，隨著患者入院，醫生會按照常規工作流程，在一年或多年的時間內完成他們的生命週期。我認為我們一直在不斷研究改進的不同解決方案——現在正在改進，無論是在抄寫方面，在 RCM 工作流程方面，還是在再次提高準確性、時間表和速度方面。

And so you know we have a bunch of things that are in the works that get implemented on the platform on a continuous basis with our clinical IT committee, which is chaired by a lot of the providers that we practice with.

所以你知道，我們正在與我們的臨床 IT 委員會一起持續在平台上實施一系列工作，該委員會由許多與我們合作的供應商擔任主席。

I think the interesting thing is we eat our own cooking. We are the medical group and the service provider all in one, so there's a very good feedback loop. And I think that's the strength of our platform where we can implement things that can be really used by our providers if they want.

我認為有趣的事情是我們吃自己做的飯。我們既是醫療集團，也是服務提供者，因此有一個非常好的回饋循環。我認為這是我們平台的優勢，如果我們的供應商需要的話，我們可以實現他們真正需要的東西。

David Larsen, BTIG.

BTIG 的 David Larsen。

Hey, congratulations on the good quarter. And Parth, I always like how you're very careful around which risk contracts you get into. I did see capitated revenue increased pretty significantly sequentially. And then also, I think, your medical loss ratio contracted by about 150 basis points sequentially. Can you maybe just talk about the growth in cap revenue? I think you said it's organic.

嘿，恭喜這個季度取得好成績。Parth，我一直很喜歡你在簽訂風險合約時非常謹慎。我確實看到人頭收入連續大幅增加。而且我認為，您的醫療損失率連續下降了約 150 個基點。能談談資本收入的成長嗎？我認為你說它是有機的。

How much visibility do you have into those physicians and those members? Are these groups that have been on your platform for a couple of years, so you're very comfortable with them bearing risk with those new members? And then just any thoughts on the cap? EBITDA would be very helpful. Some of your peers have had some pressures on the side of the thing, side of the house, which is why I'm asking. Thanks a lot.

您對這些醫生和會員的了解有多少？這些團體是否已在您的平台上存在了幾年，所以您是否放心讓他們與這些新成員一起承擔風險？那麼對於上限有什麼想法嗎？EBITDA 將會非常有幫助。你們的一些同儕在事情方面、家庭方面面臨一些壓力，這就是我問這個問題的原因。多謝。

Yeah, I appreciate the question. So yes, we did see some -- I think there's a question asked before. Like, we saw a few 1,000 lives increase in the in the cab book, pretty much all organic, either existing doctors seeing more patients or a few more doctors joining with new panels in that contract. So that's reflected in the cab book.

是的，我很感謝你提出這個問題。是的，我們確實看到了一些——我認為之前有人問過一個問題。例如，我們看到計程車司機人數增加了幾千人，這幾乎都是自然而然的，要么是現有的醫生接診了更多的病人，要么是更多的醫生加入了合約中的新小組。這反映在出租車手冊中。

I mean, you can see from the disclosure in the press release, it's still early days in the year. And you know it's not like we're making many significant EBITDA yet. But our hope is that -- I mean, it's still a positive contribution pretty slightly. But as the year progresses, our expectation is we continue to hopefully do well, and this will be part of the margin. Otherwise, there's no point doing capitation to lose money.

我的意思是，您可以從新聞稿中披露的內容中看到，現在還處於年初階段。你知道，我們還沒有實現顯著的 EBITDA。但我們的希望是——我的意思是，它仍然會做出相當積極的貢獻。但隨著時間的推移，我們期望我們能夠繼續表現良好，這將成為利潤的一部分。否則，按人頭付費就沒有任何意義，而且還會虧錢。

And I think that's going to be our strategy. We've articulated it pretty carefully. We want to take risks when we're getting paid to take risks, especially in this environment with all the pressures in MA. And I think we'll continue to do that. Otherwise, we're just happy to have a pathway to risk 50/50 risk sharing with the players and keep expanding our MA book from that perspective. But I think the growth was in that one particular contract that we have, pretty much organically.

我認為這將是我們的策略。我們已經非常謹慎地表達了這一點。當我們獲得報酬去冒險時，我們願意去冒險，特別是在馬薩諸塞州這種充滿壓力的環境下。我認為我們會繼續這樣做。否則，我們很高興能與玩家以 50/50 的比例分擔風險，並從這個角度繼續擴展我們的 MA 書。但我認為成長是源自於我們所簽訂的一份特定合同，而且幾乎是自然成長。

Matt Shea, Needham.

馬特謝伊，尼德姆。

Hey, good morning. Thanks for taking the question and congrats on the Arizona expansion. In the past, you've commented on new markets requiring $2 million to $3 million in investment, and you tend to break even on that in 18 months.

嘿，早安。感謝您回答這個問題，並祝賀亞利桑那州的擴張。過去，您曾評論新市場需要 200 萬至 300 萬美元的投資，而且您往往能在 18 個月內實現收支平衡。

So with Arizona break even expected in the fourth quarter, it appears you guys are ahead of schedule. So curious what the dynamic is there. Are you starting to break even faster in new markets or just requiring less initial investment? Maybe something specific about IMS or Arizona, any color there would be helpful.

因此，預計亞利桑那州將在第四季度實現收支平衡，看來你們已經提前完成了計劃。非常好奇那裡的動態是什麼樣的。您是否開始在新市場中更快地實現盈利，或者只是需要較少的初始投資？也許是關於 IMS 或亞利桑那州的具體信息，任何顏色都會有幫助。

Yeah, I appreciate the question. So I think Matt Gilmor asked the same one or similar question earlier. We will have new market entry costs. I think this transaction is unique in that it comes with pretty significant EBITDA contribution which offsets some of that cost this year into next year. So while we continue to spend that, again, every anchor transaction that we do is different in nature, size of the practice, nature of our relationship, management fees, so on and so forth. And so I think that's reflected in the purchase price which we've disclosed.

是的，我很感謝你提出這個問題。所以我認為 Matt Gilmor 之前問過同樣或類似的問題。我們將會有新的市場進入成本。我認為這筆交易的獨特之處在於它帶來了相當可觀的 EBITDA 貢獻，可以抵消今年到明年的部分成本。因此，雖然我們繼續花費這些資金，但我們所做的每筆主力交易在性質、業務規模、關係性質、管理費等方面都是不同的。所以我認為這反映在我們披露的購買價格中。

And so I think again, future markets may or may not look like this. We've entered all kinds of markets in our past if you look at that slide 11 and see all the different markets that we've entered each of the years. Some may not come with a pretty significant practice or significant EBITDA contribution.

所以我再次認為，未來的市場可能會或可能不會是這個樣子。如果您看第 11 張投影片並看到我們每年進入的所有不同市場，您會發現我們過去已經進入了各種各樣的市場。有些可能沒有相當顯著的實踐或顯著的 EBITDA 貢獻。

In fact, we burned some cash in the first few years given the new market entry costs, and then the market turns profitable. And in other cases the market comes with a pretty significant book of business that can be a positive.

事實上，考慮到新市場的進入成本，我們在最初幾年燒了一些現金，然後市場就開始獲利。而在其他情況下，市場會出現相當重要的業務記錄，這可能是件好事。

So I think it just depends on the nature of the transaction, which market. There's no other new markets in our guidance for this year other than Arizona. So if we end up deploying more capital and enter any new states, we'll update guidance accordingly. And like we've said previously, if you're putting significant capital to work, we're going to be pretty disciplined and make sure we're focused on EBITDA and free cash flow. So I think we'll just continue to do that the way we've done and keep compounding EBITDA here.

所以我認為這取決於交易的性質、哪個市場。除了亞利桑那州以外，我們今年的指導中沒有其他新市場。因此，如果我們最終部署更多資本並進入任何新州，我們將相應地更新指導。正如我們之前所說的那樣，如果您投入大量資金，我們將非常自律，並確保我們專注於 EBITDA 和自由現金流。所以我認為我們將繼續按照我們的做法，並繼續增加 EBITDA。

Jamie Perse, Goldman Sachs.

高盛的傑米·珀斯 (Jamie Perse)。

Hey, thanks. Good morning. A question on operating leverage you showed here in the first quarter. So cost of platform has been up mid-teens the last two years. I think that reflects some of the infrastructure build out you've done in new markets that you've entered over that period.

嘿，謝謝。早安.您在第一季提出了一個關於經營槓桿的問題。因此，過去兩年平台成本已經上漲了十幾倍。我認為這反映了您在那段時期內進入的新市場中所做的一些基礎設施建設。

Here in the first quarter, cost the platform was up 10% versus 13% practice collections growth. So you're getting operating leverage there. So the broad question is just how to think about cost of platform investments in 2025.

今年第一季度，平台成本上漲了 10%，而實踐收入成長了 13%。因此，您就獲得了經營槓桿。所以整體問題是如何考慮 2025 年平台投資的成本。

And then more specifically, are some of these new markets you've entered over the last couple of years now at a point where the infrastructure is in place and as you grow you'll see a lot of operating leverage there?

更具體地說，過去幾年你們進入的一些新市場現在是否已經具備了基礎設施，隨著你們的發展，你們是否會看到很多經營槓桿？

Yeah, it's a great question, Jamie. I appreciate you asking it. I think it's more to go back to slide 11. And if you see our EBITDA margin as a percentage of care margin, we've just grown that significantly over the past 4, 5, 6 years despite entering some of the new markets.

是的，這是一個很好的問題，傑米。感謝您提出這個問題。我認為最好回到第 11 張投影片。如果你將我們的 EBITDA 利潤率視為護理利潤率的百分比，那麼儘管我們進入了一些新市場，但我們在過去 4、5、6 年中仍然實現了顯著增長。

So, some years we get some leverage, some years we're investing. You saw that '22 to '23, it was pretty flattish, EBITDA as a percent of the care margin, and then you see the operating leverage in the subsequent years.

所以，有些年份我們會獲得一些槓桿，有些年份我們會進行投資。您會看到，22 年到 23 年，EBITDA 佔護理利潤率的百分比相當平穩，然後您會看到隨後幾年的經營槓桿。

I think, our long-term margins, that we've guided to, previously is around 30% to 35%. We're sitting at very close to 25% with our guidance. We were over 25% in this quarter and if you look at our midpoint of our guidance, it's kind of a 24.6%. So we are pretty significantly there. And this is fully expensing all of G&A, public company costs, full sales and marketing, all of our technology development.

我認為，我們先前預測的長期利潤率約為 30% 至 35%。我們的預期非常接近 25%。本季我們的成長率超過了 25%，如果你看一下我們的預期中位數，那大概是 24.6%。因此，我們已經取得了相當大的進展。這完全涵蓋了所有 G&A 費用、上市公司成本、全部銷售和行銷費用以及我們所有的技術開發費用。

As we don't capitalize much at all. And I think you're seeing the strength of the business model that as we've scaled and grown our medical groups, gotten some of these markets to even come out of that initial 1- or 2-year initial ramp up phase. We start to see operating leverage all the way down to down to EBITDA and then 80%-plus conversion to free cash flow.

因為我們根本沒有利用太多資本。我認為，隨著我們醫療集團規模的擴大和發展，您已經看到了這種商業模式的優勢，一些市場甚至已經走出了最初一兩年的初始成長階段。我們開始看到經營槓桿一路下降至 EBITDA，然後 80% 以上轉化為自由現金流。

So I think we continue to be pretty excited in how we've delivered this. Our guidance reflects for the rest of the year, what we expect. But again if we perform better, at the high end, it could be better than what we have. We'll just see how the year plays out.

所以我認為我們對我們實現這一目標的方式仍然感到非常興奮。我們的指導反映了我們對今年剩餘時間的預期。但如果我們表現得更好，在高端，它可能會比我們現在的更好。我們只需看看今年的情況如何。

And I think it's also important to understand like we're delivering this despite pretty significant headwinds in the value-based space. I mean, as you know, our management fee structure is pretty significantly skewed towards moving lives into risk arrangements of all shapes and sizes. And that's where we earn 40% of the shared savings.

我認為，同樣重要的是要理解，儘管價值型領域面臨相當大的阻力，我們仍能實現這一目標。我的意思是，如你所知，我們的管理費結構明顯偏向將生命轉移到各種形式和規模的風險安排。這就是我們賺取 40% 共享節省的地方。

So despite having a period where value-based care, shared savings is flat year over year, we're still delivering on operating leverage. So I think we feel really good about the progress of the business, progress of the cost structure as we add more lives, more providers. I think the existing infrastructure scales really well. And I don't -- I mean, once we get to close to 30%, I think you'll see some stability. But our endeavor is to continue to keep expanding that EBITDA margin over time.

因此，儘管在一段時間內基於價值的護理、共享節省與去年同期持平，但我們仍在實現營運槓桿。因此，我認為，隨著我們增加更多生命、更多供應商，我們對業務的進展、成本結構的進展感到非常滿意。我認為現有的基礎設施擴展性非常好。我不這麼認為——我的意思是，一旦我們接近 30%，我認為你就會看到一些穩定性。但我們的努力是隨著時間的推移繼續擴大 EBITDA 利潤率。

Daniel Grosslight, Citi.

花旗銀行的丹尼爾‧格羅斯萊特（Daniel Grosslight）。

Hi, thanks for taking the question and congrats on the strong start to the year. I'm just curious how your conversations with providers have changed, if at all, this year. Are they more or less receptive to joining the Privia platform, particularly as it relates to potentially moving into some of these value-based care arrangements?

你好，感謝您的提問，並祝賀您今年取得了良好的開端。我只是好奇今年您與供應商的對話有何變化，如果有的話。他們是否更願意加入 Privia 平台，特別是因為它可能涉及一些基於價值的護理安排？

But you mentioned that at least an IMF, they had been approached by everyone under the sun, just given their size. I'm curious, with other smaller providers, is it a similar dynamic where most folks now have been approached by someone to do something like what Privia is doing, or are you still really kind of chatting with folks where this is more new to them?

但您提到，至少國際貨幣基金組織，鑑於其規模，全世界所有人都曾與它接觸。我很好奇，對於其他較小的供應商來說，是否有類似的動態，即現在大多數人都被聯繫去做類似 Privia 所做的事情，或者您是否仍然真的在與那些對他們來說更新鮮的人聊天？

Yeah, I appreciate the question, Daniel. I think it's a pretty important question. I think the comprehensiveness of our platform across all specialties, all lines of business, all pairs joining a medical group versus just partnering with a company on one particular risk contract, I think, it's very attractive to a lot of small providers.

是的，我很感謝你的提問，丹尼爾。我認為這是一個非常重要的問題。我認為，我們的平台涵蓋所有專業、所有業務線、所有加入醫療集團的配對的全面性，而不是僅僅與一家公司就特定的風險合約進行合作，我認為這對許多小型供應商來說非常有吸引力。

They've been approached by someone or the other, so it's very rare that even a small practice is just totally independent and did everything themselves and has never spoken to anybody in either the physician enablement space or some hospital or private equity or whatever have you, depending on their size.

他們已經被某個人或其他人聯繫過，因此，即使是小型診所也很少能夠完全獨立，自己做所有事情，並且從未與醫生支持領域或醫院或私募股權或任何其他機構的任何人交談過，這取決於他們的規模。

Our sales team is performing really well, as we said in our prepared remarks. Last two or three years, we've seen a lot of great momentum. I think we're one of the survivors in this industry, given all the shakeout that's happening. I think we are operating from a position of strength. The results are there for everybody to see. And so I think our performance speaks for itself, and ultimately our existing physician base is our best sales team.

正如我們在準備好的演講中所說的那樣，我們的銷售團隊表現非常出色。過去兩三年，我們看到了許多強勁的發展動能。我認為，考慮到正在發生的所有動盪，我們是這個行業的倖存者之一。我認為我們正以強勢地位開展行動。結果是大家都有目共睹的。所以我認為我們的業績是不言而喻的，最終我們現有的醫師群就是我們最好的銷售團隊。

As we enter a state, the flywheel just snowballs and runs where existing practices that have been live for 2, 3, 4, 5 years act as a great referral to new practices. And doctors speak with doctors as you know. So, I think even in some of our mature markets, we are seeing where a lot of the top-of-the-funnel activity is referral from our existing providers.

當我們進入一種狀態時，飛輪就會像滾雪球一樣快速運轉，已經運行了 2、3、4、5 年的現有實踐可以作為新實踐的良好參考。如你所知，醫生與醫生之間是可以交談的。因此，我認為即使在一些成熟的市場中，我們也看到許多頂級活動都是來自我們現有供應商的推薦。

And that comes with a very high conversion rate. So I think the fact that we have really performed well in this model, this model works. Physicians are able to stay independent, autonomous, and yet be part of something bigger. I think it really resonates for the totality of the practice.

並且其轉換率非常高。所以我認為事實上我們在這個模型中表現得很好，這個模型是有效的。醫生能夠保持獨立、自主，同時又能成為更大團體的一部分。我認為這確實對整個實踐產生了共鳴。

We're not going in doing anything artificial, giving them money, protecting downside risk, giving them equity. Like all those things run their course over some period of time. And so I think from a sustainability perspective, this is the right long-term partnership model that we think. Obviously, I'm biased, but I think all those things over time just help you continue to grow this business. So I think we're seeing some of that across all our states.

我們不會做任何人為的事情，給他們錢，保護下行風險，給他們股權。就像所有這些事情都會在一段時間內自然發生一樣。因此，我認為從永續發展的角度來看，這是我們認為的正確的長期合作模式。顯然，我有偏見，但我認為隨著時間的推移，所有這些事情都會幫助你繼續發展這項業務。所以我認為我們在所有州都看到了這種情況。

Michael Ha, Baird.

麥可·哈，貝爾德。

Thank you. Quickly, first, I'm not sure if you'll comment on this, but how many of the 28,000 IMS lives are for capitation? Then, in terms of earning seasonality for this year, just given how first quarter is quite meaningful outperformance and historically. Looks like 1Q is generally softer in terms of full-year earnings contribution,

謝謝。首先，我不確定您是否會對此發表評論，但是 28,000 名 IMS 人員的生命中有多少人是為了人頭稅而犧牲的？那麼，就今年的獲利季節性而言，考慮到第一季的表現相當出色，而且從歷史上看。就全年獲利貢獻而言，第一季似乎整體上較為疲軟，

I'm curious how we should think about the remainder of the year. Do we expect anything different versus historical? Any different from these new Arizona costs?

我很好奇我們應該如何看待今年剩下的時間。我們期望的與歷史相比有什麼不同嗎？與亞利桑那州的新費用有何不同？

And last question. And with some of your larger value-based care for risk providers in the market facing some pretty meaningful issues this year. When you see all this, plus you're consistently scanning the country for profitable capitated providers, we'd love to hear if you've seen anything noticeable in terms of a V28 impact it's had. Maybe more specifically, in your view, if you think the economics over the past 5 years for these provider models might now be structurally impaired?

最後一個問題。今年，市場上一些較大的基於價值的風險護理提供者面臨著一些相當嚴重的問題。當您看到這一切，再加上您一直在全國範圍內尋找盈利的按人頭計費的供應商時，我們很想知道您是否看到了它對 V28 產生的任何明顯影響。也許更具體地說，在您看來，您是否認為過去 5 年這些提供者模式的經濟效益現在可能受到結構性損害？

Yeah, thanks for the question, Michael. So, three in one, I'll try and take them in order. On IMS, we don't usually disclose, but none of the lives are capitated. So, that's the short answer of the 28,000. On the second one, again, it's early in the year. You shouldn't expect anything different from a seasonality perspective. So we've entered the year pretty strong.

是的，謝謝你的提問，麥可。因此，三者合一，我會嘗試按順序進行。在 IMS 上，我們通常不會披露，但沒有一條生命是按人頭計算的。所以，這就是 28,000 的簡短答案。第二次，同樣，是在年初。從季節性的角度來看，你不應該期待任何不同的事情。因此，我們以相當強勁的勢頭進入了新的一年。

And we'll update guidance as the quarters go by, but we don't expect any anomaly this year versus previous years from a quarterly cadence perspective on how the P&L should run its course. We'll see. Again, the biggest variable is the value-based book. And as we get more data, we'll update our accruals and see how it all plays out. But we feel pretty comfortable updating our guidance the way we did.

隨著季度的推移，我們會更新指導意見，但從季度節奏的角度來看，我們預計今年的損益表與前幾年相比不會出現任何異常。我們將拭目以待。再次強調，最大的變數是基於價值的書。隨著我們獲得更多數據，我們將更新我們的應計數據並觀察其結果如何。但我們對於以我們的方式更新指導感到非常滿意。

On the third one, I think that's a pretty interesting question. There have been many models, public and private that try to get these providers, in some way, shape or form, into contracts of certain tenure. They haven't performed, as is pretty obvious in full risk.

關於第三個問題，我認為這是一個非常有趣的問題。有許多公共和私人模式試圖以某種方式、形式讓這些提供者簽訂一定期限的合約。他們沒有表現出來，這在完全風險的情況下是相當明顯的。

And I think over time, these provider practices will make the decision on whether to stick with their existing partner or look for a switch. We've again said we're not out there hunting for capitated lies. I mean that's just the nature of a financial contract between the payer and an entity like us. I think it's important to do value-based care and MA risk thoughtfully in a manner where all three entities, the payer, an enablement company like Trivia and the doctor or the physician group all have skin in the game.

我認為隨著時間的推移，這些提供者將決定是否繼續與現有合作夥伴合作或尋求轉換。我們再次表示，我們並不是在尋找人頭謊言。我的意思是，這只是付款人和我們這樣的實體之間的金融合約的本質。我認為，以三方實體（付款人、Trivia 等支持公司以及醫生或醫師團體）都參與其中的方式，認真對待基於價值的護理和 MA 風險非常重要。

It's long term sustainable. You're not doing anything artificial just for the sake of doing capitation. And people are getting paid to take their risk and paid to do the piece of job that they're supposed to do. And I think a lot of these companies entered into some contracts that didn't validate that thesis.

這是長期可持續的。你並沒有為了實行人頭稅而做任何人為的事情。人們得到報酬來承擔風險，做他們該做的工作。我認為許多公司簽訂的一些合約並未證實這一論點。

And financially now, some of these contracts or structures might be impaired, just unsustainable from a payer enablement company perspective or unsustainable from the relationship that they have with the provider group that they signed in terms of economic sharing, overall opportunity to earn shared savings, so on and so forth, as all these impacts happen on the MA book from V28 and star scores, utilization, so on and so forth.

現在從財務角度來看，其中一些合約或結構可能受到損害，從付款人支持公司的角度來看是不可持續的，或者從他們與供應商集團在經濟共享、獲得共享節省的整體機會等方面簽署的關係來看是不可持續的，因為所有這些影響都會發生在 V28 的 MA 賬簿和星級評分、利用率等方面。

So I think all that should bode well for us. I think we'll continue to see some disruption. We've said previously, we look to take advantage of that and get these groups in, hopefully, which is a model that is much more sustainable like ours. So organically and then also in organically.

所以我認為這一切對我們來說都是好兆頭。我認為我們將繼續看到一些混亂。我們之前說過，我們希望利用這一點，並讓這些團體加入進來，希望這是一個像我們一樣更具可持續性的模式。所以有機地，然後也是有機地。

Joanna Gajuk, Bank of America.

美國銀行的喬安娜‧加朱克 (Joanna Gajuk)。

Hey, good morning. Thanks for squeezing me in. So actually, I want to ask about the M&A pipeline. So with all the cash that you have now on the balance sheet, would you look to do more deals immediately, or is it more like, first to kind of digest the Arizona before you move on? Because also, what I'm getting at -- just curious, because -- somewhat related to the prior question around, are there a lot of interest from practices? Is there activity there in terms of deals just floating around?

嘿，早安。謝謝你把我擠進來。所以實際上，我想問一下有關併購管道的問題。那麼，考慮到您現在資產負債表上的所有現金，您是否會考慮立即進行更多交易，還是更像先消化亞利桑那州，然後再繼續前進？因為同樣，我所得到的只是好奇，因為──有點與先前的問題相關，實踐中是否有很多興趣？那裡有正在進行的交易活動嗎？

But the other part of the question is around valuations. How should we think about what you typically pay in terms of multiples for deals of that size?

但問題的另一部分是關於估值。我們應該如何考慮對於這種規模的交易，您通常需要支付多少倍數的費用？

Yeah, thanks for the question, Joanna. So the pipeline remains really strong. Again, you can see slide 11. We've entered 1, 2 or more states every year, pretty consistently. Some years it's more states, some years it's less. It just depends on when we do the deal.

是的，謝謝你的提問，喬安娜。因此，管道仍然非常強勁。再次，您可以看到幻燈片 11。我們每年都會進入 1 個、2 個或更多州，而且相當穩定。有些年份州數較多，有些年份則較少。這取決於我們何時達成交易。

We are still in 15 states; 35 to go. And so our view is we keep looking for opportunities to enter different states, also increase density in existing states. We've done all kinds of deals. As you know, we bought medical group entities, risk entities, MSO entities, combinations of them. And so it just depends on what kind of deal we find where, given our unique model where it's a pretty comprehensive platform, again, catering to all specialties, all payers, all patients, all lines of business.

我們目前仍在 15 個州；還需到達 35 個州。因此，我們的觀點是，我們將繼續尋找進入不同州的機會，同時增加現有州的密度。我們做過各種各樣的交易。如您所知，我們收購了醫療集團實體、風險實體、MSO實體以及它們的組合。因此，這取決於我們在哪裡找到什麼樣的交易，鑑於我們獨特的模式，這是一個相當全面的平台，再次滿足所有專業、所有付款人、所有患者、所有業務線的需求。

So the valuation then is reflective of the entities we buy, the earning stream from that. We have pretty disciplined buyers focused on EBITDA free cash flow. So, if you are putting significant capital to work, like we did in the Arizona deal, you should expect pretty significant EBITDA contribution.

因此，估值反映了我們購買的實體及其獲利流。我們擁有非常自律的買家，專注於 EBITDA 自由現金流。因此，如果您投入大量資本，就像我們在亞利桑那州的交易中所做的那樣，您應該期待相當可觀的 EBITDA 貢獻。

If it's a smaller deal, we may be just entering a state, buying a tax ID, buying a risk entity, so on and so forth, and playing the long game there. It just depends on the nature of the transaction, but we'll continue to be pretty disciplined. If you're putting significant capital, you should expect that it will come with hopefully good earnings contribution.

如果交易規模較小，我們可能只是進入一個州，購買稅號，購買風險實體等等，並在那裡進行長期博弈。這取決於交易的性質，但我們將繼續保持嚴格的紀律。如果您投入大量資本，您應該期望它會帶來良好的獲利貢獻。

And lastly, I would say again, in this environment, we are in a position of strength with our balance sheet and our free cash flow generation to take advantage of as many opportunities that arise. Obviously, we don't have billions of dollars, but I think we are hopefully a partner of choice, both given our business model, ability to partner with different kinds of provider groups as they make a decision whether to join us or private equity group or any other payer. So I think it's a pretty unique time to be in this space, and we're glad to be operating from a position of strength.

最後，我想再說一遍，在這種環境下，我們憑藉著資產負債表和自由現金流的產生處於優勢地位，可以利用出現的盡可能多的機會。顯然，我們沒有數十億美元的資金，但我認為，我們希望成為首選合作夥伴，因為我們擁有商業模式，有能力與不同類型的供應商集團合作，因為他們可以決定是否加入我們、私募股權集團或任何其他付款人。所以我認為現在是進入這個領域非常獨特的時機，我們很高興能夠以實力為基礎開展營運。

We have no further questions. Management, please continue.

我們沒有其他問題了。管理層，請繼續。

Thank you for listening to our call today. We appreciate your continued interest and look forward to speaking with you again in the near future. Have a great day.

感謝您今天收聽我們的電話。我們感謝您的持續關注，並期待在不久的將來再次與您交談。祝你有美好的一天。

This concludes today's conference call. You may now disconnect.

今天的電話會議到此結束。您現在可以斷開連線。