RadNet Inc (RDNT) 2024 Q1 法說會逐字稿

Good morning, everyone, and welcome to the RadNet, Inc. first-quarter 2024 financial results conference call. (Operator Instructions) Please also note, today's event is being recorded.

大家早安，歡迎參加 RadNet, Inc. 2024 年第一季財務業績電話會議。（操作員說明）也請注意，今天的活動正在錄製中。

At this time, I'd like to turn the floor over to Mark Stolper, Executive Vice President and Chief Financial Officer. Sir, please go ahead.

現在，我想請執行副總裁兼財務長馬克‧斯托爾珀 (Mark Stolper) 發言。先生，請繼續。

Thank you. Good morning, ladies and gentlemen, and thank you for joining Dr. Howard Berger and me today to discuss RadNet's first-quarter 2024 financial results.

謝謝。早安，女士們、先生們，感謝您今天與 Howard Berger 博士和我一起討論 RadNet 2024 年第一季的財務表現。

Before we begin today, we'd like to remind everyone of the Safe Harbor statement under the Private Securities Litigation Reform Act of 1995. This presentation contains forward-looking statements within the meaning of the US Private Securities Litigation Reform Act of 1995. Specifically, statements concerning anticipated future financial and operating performance, RadNet's ability to continue to grow the business by generating patient referrals and contracts with radiology practices, recruiting and retaining technologists, receiving third-party reimbursement for diagnostic imaging services, successfully integrating acquired operations, generating revenue and adjusted EBITDA for the acquired operations as estimated, among others, are forward-looking statements within the meaning of the Safe Harbor.

在今天開始之前，我們想提醒大家注意 1995 年《私人證券訴訟改革法案》中的安全港聲明。本簡報包含 1995 年美國私人證券訴訟改革法案意義內的前瞻性陳述。具體而言，有關預期未來財務和營運績效的陳述、RadNet 透過產生病患轉診和與放射科診所簽訂合約、招募和留住技術人員、接受診斷影像服務的第三方報銷、成功整合收購的業務、產生除其他外，所估計的收購業務的收入和調整後的 EBITDA 均為安全港含義內的前瞻性陳述。

Forward-looking statements are based on management's current preliminary expectations and are subject to risks and uncertainties which may cause RadNet's actual results to differ materially from the statements contained herein. These risks and uncertainties include those risks set forth in RadNet's reports filed with the SEC from time to time, including RadNet's annual report on Form 10-K for the year ended December 31, 2023. Undue reliance should not be placed on forward-looking statements, especially guidance on future financial performance, which speaks only as of the date it is made. RadNet undertakes no obligation to update publicly any forward-looking statements to reflect new information, events, or circumstances after the date they were made or to reflect the occurrence of unanticipated events.

前瞻性陳述是基於管理層目前的初步預期，並受到風險和不確定性的影響，這些風險和不確定性可能導致 RadNet 的實際結果與本文中包含的陳述有重大差異。這些風險和不確定性包括 RadNet 不時向 SEC 提交的報告中列出的風險，包括 RadNet 截至 2023 年 12 月 31 日的年度 10-K 表格年度報告。不應過度依賴前瞻性陳述，尤其是對未來財務表現的指導，該指導僅代表截至發布之日的情況。RadNet 沒有義務公開更新任何前瞻性陳述，以反映其作出後的新資訊、事件或情況，或反映意外事件的發生。

And with that, I'd like to turn the call over to Dr. Berger.

說到這裡，我想把電話轉給伯傑醫生。

Thank you, Mark. Good morning, everyone, and thank you for joining us today. On today's call, Mark and I plan to provide you with highlights from our first-quarter 2024 results, give you more insight into factors which affected this performance, and discuss our future strategy. After our prepared remarks, we will open the call to your questions. I'd like to thank all of you for your interest in our company and for dedicating a portion of your day to participate in our conference this morning.

謝謝你，馬克。大家早安，感謝您今天加入我們。在今天的電話會議上，馬克和我計劃向您提供 2024 年第一季業績的亮點，讓您更深入地了解影響這一業績的因素，並討論我們的未來策略。在我們準備好發言後，我們將開始電話詢問您的問題。我要感謝大家對我們公司的興趣，並感謝你們抽出一天的時間來參加我們今天早上的會議。

Let's begin. I am very pleased with our performance in the first quarter. It was the strongest first quarter in our company's history with record revenue, adjusted EBITDA, and adjusted earnings. Relative to last year's first quarter, total company revenue increased 10.5%, Imaging Center revenue increased 9.9%, and the new Digital Health revenue segment increased 32.3%. Imaging Center revenue was driven by heavy demand in virtually all of our markets despite being adversely impacted in the quarter on the East Coast by several snowstorms and in California by unusual rainstorms and flooding.

讓我們開始。我對我們第一季的表現非常滿意。這是我們公司史上最強勁的第一季度，營收、調整後 EBITDA 和調整後收益均創歷史新高。相較於去年第一季，公司總營收成長10.5%，影像中心營收成長9.9%，新的數位健康部門營收成長32.3%。儘管本季度東海岸受到幾次暴風雪以及加州不尋常的暴雨和洪水的不利影響，但幾乎所有市場的強勁需求都推動了成像中心的收入。

Nevertheless, we continue to benefit from the increasing utilization of diagnostic imaging within healthcare as well as the shift of procedural volumes away from the more expensive hospital alternatives to ambulatory freestanding centers like the ones we operate. Also contributing to the strong revenue performance was the positive impact of improved reimbursement from commercial and capitated payors who recognize the important role we are playing as a lower-priced alternative to hospital-based imaging.

儘管如此，我們繼續受益於醫療保健中診斷成像的使用不斷增加，以及程序量從更昂貴的醫院替代方案轉向像我們經營的那樣的流動獨立中心。商業和按人頭付款人的報銷改善也帶來了積極影響，這也促成了強勁的收入表現，他們認識到我們作為醫院成像的低價替代品所發揮的重要作用。

Lastly, our top line is benefiting from a continuing shift in modality mix towards advanced imaging, MRI, CT and PET CT, where the revenue per scan is substantially higher than the routine imaging. This is both a function of an overall industry trend as well as the significant capital investment we have made in the last few years in advanced imaging equipment for growth and upgrades.

最後，我們的收入受益於模式組合向先進影像、MRI、CT 和 PET CT 的持續轉變，其中每次掃描的收入大大高於常規影像。這既是整體行業趨勢的結果，也是我們過去幾年在先進成像設備上進行的用於成長和升級的大量資本投資的結果。

Driving the revenue growth within the digital health was the AI business including our EBCD, Enhanced Breast Care Detection, breast cancer screening AI-powered initiative which grew 118.8% quarter over last year's same quarter.

推動數位健康領域營收成長的是人工智慧業務，包括我們的 EBCD、增強型乳房護理檢測、乳癌篩檢人工智慧驅動的計劃，該計劃比去年同期成長了 118.8%。

Adjusted EBITDA was also a first-quarter record. In conjunction with the strong revenue results, which I just discussed, our focus on operational efficiency, improved management, and utilization of labor, investments in information technology, and effective cost control contributed to a total company adjusted EBITDA, which increased 21.4% from last year's first quarter.

調整後 EBITDA 也創下第一季紀錄。結合我剛才討論的強勁的收入業績，我們對營運效率、改進管理和勞動力利用、資訊技術投資和有效成本控制的關注為公司調整後的 EBITDA 總額做出了貢獻，比去年增長了 21.4%今年第一季。

Another contributing factor to adjusted EBITDA growth was a disproportionate growth in the higher profit margin digital health segment businesses. Cumulatively, these factors drove a 120-basis-point increase in our adjusted EBITDA margin as compared with last year's first quarter. While we are pleased with this margin expansion, I remain convinced we have further opportunity to improve margins.

調整後 EBITDA 成長的另一個影響因素是利潤率較高的數位醫療細分業務的不成比例成長。總的來說，這些因素推動我們調整後的 EBITDA 利潤率比去年第一季成長了 120 個基點。雖然我們對利潤率的擴大感到滿意，但我仍然相信我們還有進一步提高利潤率的機會。

The strong operating results in the first quarter relative to our internal budget, combined with ongoing operating trends that have continued into the second quarter, resulted in our decision to increase 2024 full year guidance ranges for revenue adjusted EBITDA and free cash flow. Mark will discuss this in more detail in his prepared remarks.

第一季相對於我們內部預算的強勁營運業績，加上持續到第二季​​的持續營運趨勢，導致我們決定提高 2024 年全年收入調整後 EBITDA 和自由現金流的指導範圍。馬克將在他準備好的發言中更詳細地討論這一點。

We continue our multifaceted approach to accelerate our growth. With respect to acquisitions, some of you may have seen our two recent announcements regarding our entry into the Houston, Texas market. Upon quarter end, we completed the acquisition of the seven imaging centers of Houston Medical Imaging. In addition, we announced the second acquisition in April of six American Health imaging centers to be completed in June. Texas is the first new state we have entered since 2020.

我們繼續採取多方面的方法來加速我們的成長。關於收購，你們中的一些人可能已經看到了我們最近關於進入德克薩斯州休斯頓市場的兩則公告。季度末，我們完成了休士頓醫學影像公司七個影像中心的收購。此外，我們在 4 月宣布第二次收購 6 個美國健康影像中心，將於 6 月完成。德克薩斯州是我們自 2020 年以來進入的第一個新州。

The Houston metropolitan marketplace encompassing about 7.3 million people is the fourth most populous city and the second fastest-growing metropolitan area in the United States. We are confident of the opportunity for our further acquisitions, de novo buildouts as desirable, health system partnerships, and other means of expansion which include bringing our artificial intelligence and leading-edge clinical and operating digital health solutions to the patients and referring communities of Greater Houston.

休士頓大都會市場約有 730 萬人口，是美國人口第四大城市和發展第二快的大都會區。We are confident of the opportunity for our further acquisitions, de novo buildouts as desirable, health system partnerships, and other means of expansion which include bringing our artificial intelligence and leading-edge clinical and operating digital health solutions to the patients and referring communities of Greater休士頓.

Also during the first quarter, we completed a tuck-in acquisition of four centers in the Antelope Valley north of Los Angeles. New market acquisitions like Houston and the in-market tuck-in acquisitions like that in Antelope Valley will be a continuing part of our growth strategy.

同樣在第一季度，我們完成了洛杉磯北部羚羊谷四個中心的收購。像休士頓這樣的新市場收購以及像羚羊谷這樣的市場內收購將是我們成長策略的持續組成部分。

2024 will be a year of reinvestment in our business to accelerate future growth. We currently have 12 de novo facilities in various stages of development which will open for operations throughout the remainder of the year. These are on top of the two de novos which opened in the first quarter.

2024 年將是我們業務再投資以加速未來成長的一年。目前，我們擁有 12 個處於不同開發階段的 de novo 設施，這些設施將在今年剩餘時間內投入營運。這些是在第一季開業的兩個新項目之上的。

These facilities are located in markets where we have patient backlogs, require additional capacity, or where we currently lack access points to serve particular patient populations. While these projects are requiring us to make capital investments above our normal spending, we are confident that these centers will be material contributors to our long-term performance and growth.

這些設施位於我們有患者積壓、需要額外容量或我們目前缺乏服務特定患者群體的接入點的市場。雖然這些項目要求我們進行高於正常支出的資本投資，但我們相信這些中心將為我們的長期績效和成長做出重大貢獻。

We continue to grow our hospital and health system joint venture businesses. Currently, 137 of our 375 centers, or 36.5%, are held within health system partnerships. Our partners are some of the largest and most successful systems in our geographies. Partners include RWJBarnabas in New Jersey, MemorialCare, Dignity Health, Lifebridge, University of Maryland, Adventist, Cedars-Sinai, and others.

我們繼續發展我們的醫院和衛生系統合資業務。目前，我們 375 個中心中有 137 個（佔 36.5%）屬於衛生系統合作夥伴。我們的合作夥伴是我們所在地區一些最大、最成功的系統。合作夥伴包括新澤西州的 RWJBarnabas、MemorialCare、Dignity Health、Lifebridge、馬裡蘭大學、Adventist、Cedars-Sinai 等。

These and other systems are seeking solutions for long-term strategy around outpatient imaging and have recognized that cost-effective and efficient freestanding centers will continue to capture share from hospitals as payors and patients alter their site of care towards lower-cost, high-quality facilities. Our hospital and health system partners have been instrumental in increasing our procedural volumes with their physician relationships.

這些系統和其他系統正在尋求圍繞門診成像的長期策略的解決方案，並認識到，隨著付款人和患者將其護理地點轉向低成本、高質量，具有成本效益和高效的獨立中心將繼續從醫院奪取份額設施。我們的醫院和衛生系統合作夥伴透過他們的醫生關係在增加我們的手術量方面發揮了重要作用。

During the first quarter, we added seven additional centers to our joint venture with Dignity Health in Arizona through the acquisition of facilities which were previously owned by Cigna's Evernorth Care Group. And upon quarter close, we formed a new seven-center joint venture with Providence Health System in the northern and eastern San Fernando Valley of Los Angeles. Furthermore, our Dignity joint venture in Ventura County recently acquired four imaging centers in Oxnard and Ventura.

在第一季度，我們透過收購以前由 Cigna 的 Evernorth Care Group 擁有的設施，為我們與亞利桑那州 Dignity Health 的合資企業增加了七個中心。季度結束後，我們與普羅維登斯醫療系統在洛杉磯聖費爾南多谷北部和東部組建了一家新的七中心合資企業。此外，我們在文圖拉縣的 Dignity 合資企業最近收購了位於奧克斯納德和文圖拉的四個成像中心。

Including these joint venture expansion and others, upon which we are working, we expect to have close to 40% of our centers held within health system partnerships by year-end 2024. We continue to make progress in the Digital Health segment. As some of you remember, we announced earlier this year the formation of the RadNet Digital Health financial reporting segment effective January 1, 2024, which combines the eRAD and DeepHealth operating system software businesses into what was our clinical AI reporting segment in 2023.

包括這些合資企業擴張和我們正在努力的其他項目，我們預計到 2024 年底，我們將有近 40% 的中心屬於衛生系統合作夥伴關係。我們繼續在數位健康領域取得進展。你們有些人還記得，我們​​今年稍早宣布成立RadNet 數位健康財務報告部門，於2024 年1 月1 日生效，該部門將eRAD 和DeepHealth 作業系統軟體業務合併到我們2023 年的臨床人工智慧報告部門中。

The financial impact of these digital health businesses has great potential for RadNet both as a customer of the DeepHealth OS and AI solutions, and of course, as the owner of these businesses would sell their solutions to customers outside of RadNet. Software businesses and in particular SaaS-based models can operate at significantly higher margin than RadNet's core imaging center segment and will require less capital investment.

這些數位健康業務的財務影響對於 RadNet 具有巨大潛力，無論是作為 DeepHealth 作業系統和人工智慧解決方案的客戶，還是因為這些業務的所有者將其解決方案出售給 RadNet 以外的客戶。軟體業務，特別是基於 SaaS 的模型的營運利潤率明顯高於 RadNet 的核心成像中心部門，並且需要更少的資本投資。

Within Dignity Health, we continue to sell service -- excuse me, within digital health, we continue to sell, service, and support eRAD solutions to new and existing customers while we focus on the ongoing developments of the next-generation DeepHealth OS cloud-based operating system and generative AI modules.

在 Dignity Health 內部，我們繼續銷售服務 - 對不起，在數位健康內部，我們繼續向新客戶和現有客戶銷售、服務和支援 eRAD 解決方案，同時我們專注於下一代 DeepHealth 作業系統雲端的持續開發 -基於作業系統和生成式人工智慧模組。

We continue to believe that DeepHealth OS can have a major impact in lowering costs and increasing efficiency in the areas of patient scheduling, pre-authorization, insurance verification, reporting, revenue cycle management, and analytics. We will begin testing some of the AI-enabled automation tools of the DeepHealth OS in the third and fourth quarters of this year and aim to have commercially available solutions in the first half of 2025. Our Enhanced Breast Cancer diagnostic mammography offering continues its rollout in Central and Northern California. We expect implementation to be substantially complete as early as the end of the second quarter.

我們仍然相信 DeepHealth OS 可以在患者安排、預先授權、保險驗證、報告、收入週期管理和分析等領域對降低成本和提高效率產生重大影響。我們將於今年第三季和第四季開始測試 DeepHealth OS 的一些支援人工智慧的自動化工具，並計劃在 2025 年上半年推出商用解決方案。我們的增強型乳癌診斷乳房 X 光檢查產品繼續在加州中部和北部推出。我們預計實施最早將在第二季末基本完成。

Adoption rates continue to rise on the East Coast and are now approaching 40%. While the implementation in Southern California is more recent, we are encouraged from initial adoption rates which are significantly higher than those experienced at the beginning of the East Coast rollout.

東海岸的收養率持續上升，現已接近 40%。雖然南加州的實施是最近的事，但我們對最初的採用率感到鼓舞，該採用率明顯高於東海岸推出之初的採用率。

Aidence's lung and Quantib prostate and neuro AI solutions are also expanding their customer base predominantly in Europe. This has been highlighted in the United Kingdom, where Aidence is the partner of choice for the four-country rollout of the NHS targeted lung health check lung cancer screening program.

Aidence 的肺部、Quantib 前列腺和神經人工智慧解決方案也在擴大其主要在歐洲的客戶群。這一點在英國得到了強調，Aidence 是在四個國家推出 NHS 針對性肺部健康檢查肺癌篩檢計畫的首選合作夥伴。

Finally, we continue to improve liquidity and financial leverage. We ended the first quarter with a cash balance of $527 million and a net debt to adjusted ratio of slightly more than one time. Included in the net cash balance were approximately $219 million of net proceeds from a successful stock offering we completed in March.

最後，我們持續提高流動性和財務槓桿。第一季結束時，我們的現金餘額為 5.27 億美元，淨債務與調整後的比率略高於一倍。淨現金餘額包括我們 3 月成功完成股票發行的約 2.19 億美元淨收益。

Additionally, subsequent to the end of the first quarter and completed on April 18, we opportunistically refinanced our debt facilities. With this financing, we were able to reduce our cost of capital, extend maturities, and add an additional approximately $168 million to RadNet's cash balance.

此外，在第一季末並於 4 月 18 日完成後，我們機會主義地為債務融資進行了再融資。透過這筆融資，我們得以降低資本成本、延長期限，並為 RadNet 的現金餘額增加約 1.68 億美元。

With all of this, RadNet is in the best financial condition in its history and is poised for accelerated growth.

憑藉所有這些，RadNet 處於歷史上最好的財務狀況，並準備好加速成長。

At this time, I'd like to turn the call back over to Mark to discuss some of the highlights of our first quarter 2024 performance. When he is finished, I will make some closing remarks.

這次，我想將電話轉回給 Mark，討論我們 2024 年第一季業績的一些亮點。當他講完後，我將做一些總結發言。

Thank you, Howard. I'm now going to briefly review our first-quarter 2024 performance and attempt to highlight what I believe to be some material items. I will also give some further explanation of certain items in our financial statements as well as provide some insights into some of the metrics that drove our first-quarter performance. I will also provide an update to 2024 financial guidance levels, which were released in conjunction with our 2023 year-end results in March.

謝謝你，霍華德。我現在將簡要回顧我們 2024 年第一季的業績，並嘗試強調我認為的一些重要項目。我也會對我們財務報表中的某些項目進行進一步解釋，並對推動我們第一季業績的一些指標提供一些見解。我還將提供 2024 年財務指導水準的更新，該水準與我們 3 月份的 2023 年年終業績一起發布。

In my discussion, I will use the term adjusted EBITDA which is a non-GAAP financial measure. The company defines adjusted EBITDA as earnings before interest, taxes, depreciation, and amortization and excludes losses or gains on the disposal of equipment, other income or loss, loss on debt extinguishments, and noncash equity compensation.

在我的討論中，我將使用調整後 EBITDA，這是一種非 GAAP 財務指標。該公司將調整後的 EBITDA 定義為息稅折舊攤銷前利潤，不包括設備處置損失或收益、其他收入或損失、債務清償損失以及非現金股權補償。

Adjusted EBITDA includes earnings, equity earnings, and unconsolidated operations, and subtracts allocations of earnings to noncontrolling interest in subsidiaries and is adjusted for noncash or extraordinary and onetime events taking place during the period. A full quantitative reconciliation of adjusted EBITDA to net income or loss attributable to RadNet, Inc. common stockholders is included in our earnings release. With that said, I'd now like to review our first-quarter 2024 results.

調整後的 EBITDA 包括收益、股本收益和未合併業務，並減去分配給子公司非控制權益的收益，並根據期間發生的非現金或非常規和一次性事件進行調整。我們的收益發布中包含調整後 EBITDA 與歸屬於 RadNet, Inc. 普通股股東的淨利潤或虧損的完整定量調節表。話雖如此，我現在想回顧一下我們 2024 年第一季的業績。

For the first quarter of 2024, RadNet reported total company revenue of $431.7 million and adjusted EBITDA of $58.5 million. Revenue increased $41.1 million or 10.5% and adjusted EBITDA increased $10.3 million or 21.4% as compared with the first quarter of 2023. Breaking this performance down to the individual operating segments, our imaging centers segment reported revenue of $417 million and adjusted EBITDA of $54.9 million. This was an increase of $37.6 million or 9.9% in revenue and an increase of $6.8 million or 14.1% in adjusted EBITDA as compared with last year's first quarter.

RadNet 公佈的 2024 年第一季公司總營收為 4.317 億美元，調整後 EBITDA 為 5,850 萬美元。與 2023 年第一季相比，營收增加了 4,110 萬美元，即 10.5%，調整後的 EBITDA 增加了 1,030 萬美元，即 21.4%。將這項績效細分到各個營運部門，我們的影像中心部門報告營收為 4.17 億美元，調整後 EBITDA 為 5,490 萬美元。與去年第一季相比，營收增加了 3,760 萬美元，即 9.9%，調整後 EBITDA 增加了 680 萬美元，即 14.1%。

Driving this performance were strong aggregate and same-center procedure volumes, the impact of higher reimbursement we are receiving from commercial and capitated payors, the gradual movement towards advanced imaging and tight expense control.

推動這一業績的因素包括強勁的總體和同中心手術量、我們從商業和按人頭付款人獲得的更高報銷的影響、逐步向先進成像方向發展和嚴格的費用控制。

The digital health segment reported revenue of $14.7 million and adjusted EBITDA of $3.5 million during the quarter. Revenue increased $3.6 million or 32.3%, and adjusted EBITDA increased $3.5 million or 17,500% as compared with the first quarter of 2023. Digital health's significant growth was due in part from a $2.5 million or a 118.8% increase in AI revenue which climbed to $4.7 million during the first quarter of 2024.

數位健康部門報告本季營收為 1,470 萬美元，調整後 EBITDA 為 350 萬美元。與 2023 年第一季相比，營收增加了 360 萬美元，即 32.3%，調整後的 EBITDA 增加了 350 萬美元，即 17,500%。數位健康的顯著成長部分歸因於人工智慧收入成長 250 萬美元，即 118.8%，在 2024 年第一季攀升至 470 萬美元。

Total company net loss for the first quarter of 2024 was $2.8 million as compared with a total company net loss of $21 million for the first quarter of 2023. Net loss per share for the first quarter of 2024 was negative $0.04 compared with a net loss per share of negative $0.36 in the first quarter of 2023, based upon a weighted average number of diluted shares outstanding of 69.3 million shares in 2024 and 57.7 million shares in 2023.

2024 年第一季公司淨虧損總額為 280 萬美元，而 2023 年第一季公司淨虧損總額為 2,100 萬美元。2024 年第一季每股淨虧損為負 0.04 美元，而 2023 年第一季每股淨虧損為負 0.36 美元，基於 2024 年稀釋後流通股的加權平均數為 6,930 萬股和 5,770 萬股2023年。

There were a number of unusual or one-time items impacting the first quarter including the following: $1.2 million of noncash gain from interest rate swaps, $1 million expense related to leases for our de novo facilities under construction that have not yet opened for operations, $2 million noncash increase to contingent consideration related to completed acquisitions, and $3.3 million of noncapitalized research and development expenses with respect to our new DeepHealth cloud OS and generative AI.

有許多不尋常或一次性的項目影響第一季度，包括以下內容：利率掉期帶來的120 萬美元非現金收益、與我們在建但尚未投入運營的de novo 設施的租賃相關的100 萬美元費用，與已完成的收購相關的或有對價非現金增加 200 萬美元，以及與我們新的 DeepHealth 雲端作業系統和生成人工智慧相關的非資本化研發費用 330 萬美元。

Adjusting for the above items, total company adjusted earnings was $5 million for the quarter, and diluted adjusted earnings per share was $0.07 per share during the first quarter of 2024. This compares with total company adjusted loss of $13 million and diluted adjusted loss per share of negative $0.22 during the first quarter of 2023.

在上述項目進行調整後，該季度公司調整後總收益為 500 萬美元，2024 年第一季稀釋調整後每股收益為 0.07 美元。相較之下，2023 年第一季公司調整後總虧損為 1,300 萬美元，攤薄調整後每股虧損為負 0.22 美元。

For the first quarter of 2024, as compared with the prior year's first quarter, MRI volume increased 11.7%, CT volume increased 9.1%, and PET CT volume increased 17.5%. Overall volume, taking into account routine imaging exams inclusive of x-ray, ultrasound, mammography, and all other exams increased 5.7% over the prior year's first quarter.

2024年第一季，與去年第一季相比，MRI檢查量增加了11.7%，CT檢查量增加了9.1%，PET CT檢查量增加了17.5%。考慮到包括 X 光、超音波、乳房 X 光檢查和所有其他檢查在內的常規影像檢查，總體數量比去年第一季增加了 5.7%。

On a same-center basis, including only those centers which were part of RadNet for both the first quarters of 2024 and 2023, MRI volume increased 9.9%, CT volume increased 6.5%, and PET CT volume increased 15.3%. Overall, same-center volume, taking into account all routine imaging exams, increased 3.8% over the prior year same quarter. In the first quarter of 2024, we performed 2,646,951 total procedures. The procedures were consistent with our multi-modality approach whereby 74.3% of all the work we did by volume was from routine imaging.

在同一中心基礎上，僅包括 2024 年第一季和 2023 年第一季 RadNet 的中心，MRI 體積增加了 9.9%，CT 體積增加了 6.5%，PET CT 體積增加了 15.3%。總體而言，考慮到所有常規影像檢查，同中心數量比去年同期增加了 3.8%。2024 年第一季度，我們總共執行了 2,646,951 例手術。這些程序與我們的多模態方法一致，我們所做的所有工作中有 74.3% 來自常規成像。

Since we now have a table of our aggregate procedure volumes broken down by modality in our earnings release, I won't go through the numbers but want to make the following points. In his remarks, Dr. Berger mentioned that we are experiencing a slow shift to higher-acuity procedures or what we call advanced imaging.

由於我們現在在收益報告中列出了按方式細分的總手術量表，因此我不會詳細介紹這些數字，但想提出以下幾點。伯傑博士在演講中提到，我們正在經歷向更高敏銳度手術或我們所說的高級影像的緩慢轉變。

In the first quarter of this year, 25.7% of our procedures were from MRI, CT, and PET CT. In last year's first quarter, this metric was 24.5%, a shift of 1.2% of our procedure volumes towards advanced imaging. With higher pricing and better margins, more advanced imaging improves our financial results, including our operating margins.

今年第一季度，我們 25.7% 的手術來自 MRI、CT 和 PET CT。去年第一季度，這項指標為 24.5%，意味著我們的手術量有 1.2% 轉向了先進影像。憑藉更高的定價和更好的利潤，更先進的成像技術改善了我們的財務業績，包括我們的營業利潤。

Overall GAAP interest expense for the first quarter of 2024 was $16.3 million as compared with $15.7 million during last year's first quarter. In the first quarter of 2024, cash interest expense, which includes payments to and from counterparties on our interest rate swaps and net interest income from our cash balance, was $10.5 million. This compares with $17.5 million in the first quarter of 2023. The lower cash interest expense this quarter is primarily the result of more interest income on larger cash balances as well as the timing of cash interest paid on our term loan.

2024 年第一季的整體 GAAP 利息支出為 1,630 萬美元，而去年第一季為 1,570 萬美元。2024 年第一季度，現金利息支出為 1,050 萬美元，其中包括我們的利率掉期交易對手的付款以及現金餘額的淨利息收入。相比之下，2023 年第一季的銷售額為 1,750 萬美元。本季現金利息支出較低，主要是由於現金餘額較多而利息收入增加以及定期貸款支付現金利息的時間安排所致。

With regards to our balance sheet, as of March 31, 2024, unadjusted for bond and term loan discounts, we had $317.1 million of net debt, which is our total debt at par value less our cash balance. This compares with $789.2 million of net debt at March 31, 2023. Note that this debt balance includes New Jersey Imaging Network's debt of $142.5 million for which RadNet is neither a borrower nor a guarantor.

就我們的資產負債表而言，截至 2024 年 3 月 31 日，未經債券和定期貸款折扣調整，我們的淨債務為 3.171 億美元，這是我們按面值計算的總債務減去現金餘額。相比之下，截至 2023 年 3 月 31 日的淨債務為 7.892 億美元。請注意，此債務餘額包括新澤西成像網路 1.425 億美元的債務，而 RadNet 既不是藉款人也不是擔保人。

As of March 31, 2024, we were undrawn on our $195 million line of credit and had a cash balance of $527 million. At March 31, 2024, our accounts receivable balance was $189.6 million, an increase of $25.9 million from year-end 2023. The increase in accounts receivable is primarily the result of some collection delays resulting from the cyberattack on Change Healthcare and the normal first quarter effect of cash collections from the resetting of patient deductibles each year in January.

截至 2024 年 3 月 31 日，我們尚未提領 1.95 億美元的信貸額度，現金餘額為 5.27 億美元。截至2024年3月31日，我們的應收帳款餘額為1.896億美元，比2023年底增加2,590萬美元。應收帳款的增加主要是由於 Change Healthcare 受到網路攻擊而導致收款延遲，以及每年 1 月重置患者免賠額導致現金收款對第一季的正常影響。

Despite the impact from the Change Healthcare breach, our DSOs, or day sales outstanding, was 34.9 days at March 31, 2024, near our historic low. Through March 31, 2024, we had total capital expenditures net of proceeds from the sale of imaging equipment of $64.4 million. This total includes $6.9 million spent under equipment notes and the remainder spent in cash.

儘管受到 Change Healthcare 資料外洩的影響，截至 2024 年 3 月 31 日，我們的 DSO（即未償還日銷售額）為 34.9 天，接近歷史低點。截至 2024 年 3 月 31 日，扣除銷售影像設備收益後的總資本支出為 6,440 萬美元。該總額包括 690 萬美元的設備票據支出和其餘的現金支出。

Note that each year, we front-load the majority of our capital decisions into the first part of the year and have been spending extraordinarily on growth CapEx to fund the 12 de novo facilities in construction, which are scheduled to open before year end.

請注意，每年，我們都會將大部分資本決策提前到今年上半年，並在成長資本支出上投入大量資金，為正在建設中的 12 個從頭設施提供資金，這些設施計劃在年底前投入使用。

At this time, I'd like to update and revise our 2024 financial year guidance levels, which we released in conjunction with our fourth quarter and year-end 2023 results. Given the positive trends we are experiencing in virtually all aspects of our business and the strong financial performance of the first quarter, which is continuing into the second quarter, we are revising upwards certain guidance levels in anticipation of financial results that we believe will exceed our original expectations for 2024.

目前，我想更新和修改我們與 2023 年第四季和年底業績一起發布的 2024 財年指導水準。鑑於我們幾乎在業務的各個方面都經歷了積極的趨勢，以及第一季持續到第二季​​度的強勁財務業績，我們正在上調某些指導水平，因為我們預計財務業績將超過我們的預期2024 年的最初預期。

For revenue, we increased our guidance level for the imaging center segment by $25 million, both at the low end and the top end of the range. Also, for the imaging center segment, we've increased our EBITDA guidance by $5 million at the low end and the high end of our range. Our guidance level is now $255 million to $265 million.

就收入而言，我們將成像中心細分市場的指導水準提高了 2500 萬美元，無論是低端還是高端。此外，對於成像中心細分市場，我們將低端和高端的 EBITDA 指導提高了 500 萬美元。我們目前的指導水準為 2.55 億至 2.65 億美元。

For capital expenditures for the imaging center segment, we increased our guidance both at the low end and the high end of the range by $5 million. For cash paid for interest, due to the refinancing transaction and our much larger cash balance, we've decreased our cash paid for interest this year by $3 million, both at the low end and high end of the range and anticipate our cash interest expense to be $37 million to $42 million, and we increased our free cash flow generation guidance level by $3 million to $68 million to $78 million.

對於成像中心部分的資本支出，我們將低端和高端範圍的指導增加了 500 萬美元。對於支付利息的現金，由於再融資交易和我們更大的現金餘額，我們今年將支付利息的現金減少了 300 萬美元，包括範圍的低端和高端，並預計我們的現金利息支出我們將自由現金流生成指導水準提高了300 萬美元，達到6,800 萬美元到7,800 萬美元。

For the digital health segment, we increased our EBITDA guidance by $1 million, both at the low end and the high end of the range to $13 million to $15 million. We increased our noncapitalized R&D expenditures by $1 million to $12 million to $14 million, and all other guidance ranges remain the same for the digital health platform.

對於數位健康領域，我們將 EBITDA 指導值提高了 100 萬美元，範圍的低端和高端均達到 1300 萬美元至 1500 萬美元。我們將非資本化研發支出增加了 100 萬美元至 1,200 萬美元至 1,400 萬美元，數位健康平台的所有其他指導範圍保持不變。

I'll now discuss reimbursement with respect to Medicare. With respect to Medicare reimbursement for 2025, there's nothing to report at this time. As is typical each year, we are expecting CMS to release a preliminary rate schedule sometime in June or July, at which time, we will analyze CMS' proposal and our industry's lobbying groups will provide CMS our industry's feedback.

我現在將討論有關醫療保險的報銷。關於 2025 年的醫療保險報銷，目前沒有什麼可報告的。與每年的慣例一樣，我們預計 CMS 將在 6 月或 7 月的某個時間發布初步費率表，屆時我們將分析 CMS 的提案，我們行業的遊說團體將向 CMS 提供我們行業的反饋。

At the time of our second quarter financial results call, we will be in a position to comment on CMS' proposal and its impact, if any, upon RadNet's future results. However, we did receive some good news in March regarding 2024 Medicare rates. Effective March 9 of this year, as part of the Consolidated Appropriations Act, 1.72% of the 3.4% scheduled reduction in the conversion factor of the 2024 Medicare fee schedule was eliminated on a prospective basis.

在召開第二季財務業績電話會議時，我們將能夠評論 CMS 的提議及其對 RadNet 未來業績的影響（如果有）。然而，我們在 3 月確實收到了一些關於 2024 年 Medicare 費率的好消息。自今年 3 月 9 日起生效，作為《綜合撥款法》的一部分，2024 年醫療保險費用表轉換係數計劃削減 3.4% 中的 1.72% 被預期取消。

The reduction of the cut applies to all of our Medicare billings from March 9 through the end of this year. As some of you may remember, the original proposed cut was going to reduce our 2024 revenue by an estimated $7 million to $8 million. Thus, the mitigation gives back almost half of this amount, thereby increasing our 2024 revenue by $3.4 million relative to our original expectations and budget.

削減幅度的減少適用於我們從 3 月 9 日到今年年底的所有 Medicare 帳單。你們有些人可能還記得，最初提出的削減計畫將使我們 2024 年的收入減少約 700 萬至 800 萬美元。因此，緩解措施將返還近一半的金額，從而使我們 2024 年的收入比我們最初的預期和預算增加 340 萬美元。

At this point, I'd like to turn the call back to Dr. Berger, who will make some closing remarks.

現在，我想將電話轉回伯傑博士，他將做一些總結演講。

Thank you, Mark. As we move towards the half year point of 2024, we are excited about the initiatives we have for the remainder of the year. We are particularly encouraged by the progress we are making in digital health. As we continue to improve and accelerate growth in the core imaging center business, our digital health initiatives are poised to help us drive more revenue, reduce costs, and increase margins.

謝謝你，馬克。隨著 2024 年半年的到來，我們對今年剩餘時間內的舉措感到興奮。我們在數位醫療領域的進展尤其令我們感到鼓舞。隨著我們不斷改善和加速核心影像中心業務的成長，我們的數位健康計畫將幫助我們增加收入、降低成本並提高利潤。

We remain convinced that the successful future of any imaging business will be heavily dependent upon the automation and efficiency by which patients and clinical data is managed, analyzed, and processed. This is the driver for our development of the new DeepHealth OS, which will be the delivery platform for solutions which automate business processes and more effectively manage patient and clinical data.

我們仍然堅信，任何影像業務的成功未來將在很大程度上取決於管理、分析和處理患者和臨床數據的自動化和效率。這是我們開發新 DeepHealth 作業系統的驅動力，它將成為自動化業務流程並更有效管理患者和臨床數據的解決方案的交付平台。

We expect DeepHealth OS to further automate processes that today principally rely on human labor in the areas of patient scheduling, clinical reporting, medical coding, sales and marketing, workflow improvement and analytics. In this vein, we are currently making investments in foundation generative AI models.

我們期望 DeepHealth OS 能夠進一步實現目前在患者調度、臨床報告、醫療編碼、銷售和行銷、工作流程改進和分析等領域主要依賴人力的流程自動化。本著這項精神，我們目前正在對基礎生成人工智慧模型進行投資。

It is faster and less expensive for data sciences to use pretrained foundation models to develop new machine learning applications rather than train unique machine learning models from the ground up. When trained on broad data sets, these models can support a diverse range of use cases. Tests that foundation models can perform, including language processing, visual comprehension, code generation and human decision-making.

對於資料科學來說，使用預先訓練的基礎模型來開發新的機器學習應用程式比從頭開始訓練獨特的機器學習模型更快、更便宜。當在廣泛的資料集上進行訓練時，這些模型可以支援各種用例。基礎模型可以執行的測試，包括語言處理、視覺理解、程式碼生成和人類決策。

Advances in available foundation models will enable us to design and test AI solutions more quickly and at a lower cost, giving us a distinct advantage when applied to the enormous database of clinical and business information we own. While we develop DeepHealth OS, we continue to grow revenue from our clinical AI solutions for breast, lung, and prostate cancer screening. Our objective is to design and deploy these tools and others that lower the cost and increase the accuracy of cancer diagnosis in a form that can be packaged to create widespread population health initiatives and screening.

可用基礎模型的進步將使我們能夠更快、以更低的成本設計和測試人工智慧解決方案，這在應用於我們擁有的龐大的臨床和商業資訊資料庫時為我們帶來明顯的優勢。在開發 DeepHealth OS 的同時，我們繼續透過乳癌、肺癌和攝護腺癌篩檢的臨床人工智慧解決方案來增加收入。我們的目標是設計和部署這些工具和其他工具，以一種可以打包的形式降低成本並提高癌症診斷的準確性，以創建廣泛的人口健康措施和篩檢。

Our breast cancer AI and the EBCD program exemplifies this opportunity. Our breast AI is improving the productivity and accuracy of our radiologists while providing a valuable benefit to our patients for which they are willing to self-pay.

我們的乳癌 AI 和 EBCD 計畫就是這個機會的例證。我們的乳房人工智慧正在提高放射科醫生的工作效率和準確性，同時為我們願意自費的患者提供有價值的好處。

We are formulating similar screening programs for prostate, lung, and other chronic diseases for both domestic and international markets, as we firmly believe that healthcare needs to shift towards prevention and early detection and not just focus on treating patients who are already sick.

我們正在為國內和國際市場制定類似的前列腺、肺部和其他慢性疾病篩檢計劃，因為我們堅信醫療保健需要轉向預防和早期發現，而不僅僅是專注於治療已經患病的患者。

We look forward to updating you further on the progress of our digital health initiatives in the coming quarters. Operator, we are now ready for the question-and-answer portion of the call.

我們期待在未來幾季向您進一步通報我們數位健康計畫的進展。接線員，我們現在已準備好進行通話的問答部分。

(Operator Instructions) Brian Tanquilut, Jefferies.

（操作員說明）Brian Tanquilut，Jefferies。

Maybe my first question just given the strength that we're seeing here, curious, Mark or Howard, what you can or what you are seeing in terms of the continued strength maybe into the quarter? I know, Mark, you alluded to that a little bit, but also pricing seems strong. So maybe if you can share with us any color on the pricing strength as well.

也許我的第一個問題只是考慮到我們在這裡看到的實力，好奇，馬克或霍華德，您可以或您看到的可能是本季度的持續強勢？我知道，馬克，你提到了一點，但定價似乎也很強勁。因此，也許您也可以與我們分享任何有關定價優勢的顏色。

In regards to pricing, we have, over the past several years, tried to transform at least RadNet from being what we have traditionally called ourselves price takers to at least the opportunity to sit down and negotiate pricing with the various payers other than Medicare, of course, and Medicaid. But this past year and starting out in 2024, we've taken a position, particularly given the enormous demand that we have in backlogs, that contracts, as they come up for renewal, need to be at pricing levels that we think are appropriate, not only for maintaining and sustaining the health of our company and for the benefit of our patients and referring physicians but take into account increasing costs primarily for labor that we have been incurring now for the past couple of years.

在定價方面，在過去的幾年裡，我們至少嘗試將 RadNet 從我們傳統上稱為價格接受者的角色轉變為至少有機會坐下來與醫療保險以外的各種付款人協商定價。醫療補助。但從去年到 2024 年，我們採取了立場，特別是考慮到我們積壓的巨大需求，合約在續約時需要處於我們認為合適的定價水平，不僅是為了維持和維持我們公司的健康以及我們的患者和轉診醫生的利益，而且還考慮到過去幾年我們主要承擔的勞動力成本的增加。

When we're not able to reach an agreement as to what we believe are fair and sustainable rates with a particular example that I can give you with our capitation contracts, we're prepared to go to fee-for-service and which effectively did happen over the latter part of last year and beginning of this year, where at least two of our contracts have moved to fee-for-service at rates substantially higher than what we were able to agree for renewing the contracts if we stayed with capitation.

當我們無法就我們認為公平且可持續的費率達成協議時，我可以透過我們的按人頭付費合約向您提供一個具體示例，我們準備採取按服務付費的方式，這實際上做到了這種情況發生在去年下半年和今年年初，我們至少有兩份合約已改為按服務付費，其費率遠高於我們在繼續按人頭付費的情況下能夠同意續約合約的費率。

So I think this is really a function of finally being in a position where we're not just going to accept pricing from any payor that isn't consistent with the appropriate business models and need for us not only to cover increasing costs, but as you can see from our investment through our CapEx and building of de novo centers, a significant commitment that we have to improving access and improving the state-of-the-art technology by which we pride ourselves as being top of the industry.

因此，我認為這實際上是我們最終處於這樣一個位置：我們不僅要接受任何付款人與適當的商業模式不符的定價，而且我們不僅需要承擔不斷增加的成本，而且還需要您可以從我們通過資本支出和建設從頭中心進行的投資中看到，這是我們必須改善准入和改進最先進技術的重大承諾，我們以此作為行業頂尖而自豪。

So I think both of those have resonated well. We are successful virtually in all of our negotiations, and I think that has contributed in part to the improved margins that Mark discussed in his remarks. I think this will be a continuing effort on our part to continually monitor not only what the appropriate rates are but also the tools by which we and everybody else in healthcare are burdened by once we do a procedure collecting those procedures.

所以我認為這兩點都引起了很好的共鳴。我們幾乎在所有談判中都取得了成功，我認為這在一定程度上促成了馬克在演講中討論的利潤率的提高。我認為這將是我們持續不斷的努力，不僅要持續監控適當的費率，還要持續監控我們和醫療保健領域的其他人在執行收集這些程序的程序後所承受的負擔。

So our revenue cycle management group as well as the contracting groups working hand-in-hand as we come up with these contract renewals to make certain that we get paid for every procedure that we do and at rates that we think are not only consistent with our needs but still remain far lower than the alternative in many of our markets for hospital-based work.

因此，我們的收入週期管理小組以及合約小組在我們提出這些合約續約時攜手合作，以確保我們為我們所做的每項程序獲得報酬，並且我們認為不僅符合我們的需求，但仍然遠低於我們許多醫院工作市場的替代方案。

And then, Howard, maybe just on the volume, just your expectation for the continuation of the strength you're seeing there.

然後，霍華德，也許只是在數量上，只是你對你所看到的力量持續存在的期望。

Yeah. Well, I think that's perhaps one of the hidden milestones in our reporting here, Brian. There is clearly a trend towards using more advanced imaging as both the technology improves and as the marketplace realizes the benefits and begins to adopt these. A 1.2% increase in our overall procedural volume shifting from routine imaging to advanced imaging has been a remarkable achievement to demonstrate this.

是的。好吧，我認為這可能是我們在此報導中隱藏的里程碑之一，布萊恩。隨著技術的進步以及市場意識到其優勢並開始採用，顯然存在使用更先進成像的趨勢。從常規成像轉向高級成像，我們的整體程序量增加了 1.2%，這是一項了不起的成就，證明了這一點。

In particular, I would like to point out the enormous increase that we've seen in which we will continue to accelerate is PET CT. As I've discussed on previous remarks and closed calls, we are the largest providers now of what they call PSMA PET CT scanning which has been transformative for the diagnosis and treatment of prostate cancer and is a substantial component of the almost I believe it was 15% same-store increase in PET CT scanning between 2023 and our first quarter of 2024.

我想特別指出的是，我們已經看到了 PET CT 的巨大成長，我們將繼續加速這一成長。正如我在之前的評論和閉門會議中所討論的那樣，我們現在是他們所謂的PSMA PET CT 掃描的最大提供商，該掃描對前列腺癌的診斷和治療具有革命性意義，並且幾乎是我相信的重要組成部分。

So that, we think, will continue to accelerate as this becomes more and more adopted by not only the urologic community but others who oversee the treatment of prostate cancer. I also think that we may eventually, in the latter part of this year, see similar increase in PET CT scanning as well as MR scanning from the new Alzheimer's drugs that have now been approved but which require both PET CT scanning and ongoing MRI scanning for monitoring.

因此，我們認為，隨著泌尿外科界和其他監督前列腺癌治療的其他人越來越多地採用，這一趨勢將繼續加速。我還認為，我們最終可能會在今年下半年看到 PET CT 掃描以及 MR 掃描的類似增長，這些藥物現在已獲得批准，但需要 PET CT 掃描和持續的 MRI 掃描來治療阿茲海默症。 。

At this point, I think in the first quarter, we've done about 300 of these exams on national scale with backlogs and demand for far more than that as more and more people not only become aware of this, but as the criteria for doing these become more adopted and accessible to make certain that the patients get reimbursed adequately or appropriately, I should say, from the various payors. So the trends that I think we're seeing in imaging, particularly advanced imaging, will continue.

到目前為止，我認為在第一季度，我們已經在全國範圍內完成了大約300 場此類考試，但積壓的考試和需求遠不止於此，因為越來越多的人不僅意識到這一點，而且將其作為考試的標準我應該說，這些措施變得更容易被採用和使用，以確保患者從各個付款人那裡得到充分或適當的補償。因此，我認為我們在成像領域，特別是先進成像領域看到的趨勢將持續下去。

We hope to also continue a shift into cardiac imaging and preventative cardiovascular disease that we will be investing more time and human resources in to building up for a procedure for screening for cardiac disease, which I believe will be a standard as far as population health and cardiovascular screening, probably in the very near future and for which imaging is the poster child to managing good care and good outcomes.

我們也希望繼續轉向心臟影像和預防性心血管疾病，我們將投入更多時間和人力資源來建立心臟病篩檢程序，我相信這將成為人口健康和預防性心血管疾病的標準。查，可能在不久的將來，影像學是管理良好護理和良好結果的典範。

So I expect advanced imaging to also benefit from the technology improvements, which are allowing us to do better throughput on our existing systems, which we can upgrade or new systems where the processing time or scanning time has been reduced significantly and which allows us to facilitate and handle some of our backlog, which is another reason why we're increasing our advanced imaging business. So I think we'll be very happy to update you on our progress in all these regards in our second and the subsequent quarters of this year.

因此，我預計高級成像也將受益於技術改進，這使我們能夠在現有系統上實現更好的吞吐量，我們可以升級這些系統，或者在新系統上處理時間或掃描時間已顯著減少，這使我們能夠促進並處理一些積壓的訂單，這是我們增加先進成像業務的另一個原因。因此，我認為我們將非常樂意在今年第二季和隨後的季度向您通報我們在所有這些方面取得的最新進展。

Awesome. And then maybe just a follow-up question for Mark. How are you thinking about balancing the spend on CapEx between maintenance CapEx and growth CapEx? Just curious what your philosophy is there at this point.

驚人的。然後也許只是馬克的一個後續問題。您如何考慮在維護資本支出和成長資本支出之間平衡資本支出？只是好奇你此時的哲學是什麼。

That philosophy changes year by year depending upon what's on our plate, but what I would tell you is that this year, we're projecting upwards of about $130 million worth of CapEx spend. More than half of that is going to be earmarked for the construction and development of the de novo facilities. As Dr. Berger mentioned, we opened up two facilities in the first quarter, one in Maryland, one in California, and we've got 12 other facilities that are in various stages of construction and completion that should open up by year end.

這種理念每年都會發生變化，具體取決於我們的工作內容，但我要告訴您的是，今年，我們預計資本支出將高達約 1.3 億美元。其中一半以上將專門用於新建設施的建設和開發。正如伯傑博士所提到的，我們在第一季開設了兩個設施，一個在馬裡蘭州，一個在加州，我們還有其他12 個設施處於不同的建設和竣工階段，應該會在年底前開放。

Most of these centers cost, on average, $5 million to $6 million to build. So if you're talking about 12 centers at $6 million, we're talking about $70 million of CapEx spend just on those de novo facilities, which is more than half of our spend this year. So we have shifted a fair bit of our CapEx, and we are spending extraordinarily right now to accelerate growth, which we expect to start seeing some contribution from these centers in the latter half of this year and into 2025.

大多數這些中心的建造成本平均為 500 萬至 600 萬美元。因此，如果您談論的是價值 600 萬美元的 12 個中心，那麼我們談論的是這些 de novo 設施的資本支出就達到 7000 萬美元，這是我們今年支出的一半以上。因此，我們已經轉移了相當一部分資本支出，現在正在投入大量資金來加速成長，我們預計這些中心將在今年下半年和 2025 年開始做出一些貢獻。

So it has been a strategic (multiple speakers) So we have had a strategic change or a strategic shift in our thinking around CapEx because of the opportunity that exists to accelerate growth due to the fact that there's just significant volumes out there, heavy volumes that today we're not able to avail ourselves either because we've got capacity constraints in some of these markets or we just simply don't have access points that can service patient populations that currently today we're not servicing.

所以這是一個戰略性的（多個發言者）所以我們對資本支出的思維進行了戰略性的改變或戰略性的轉變，因為存在加速增長的機會，因為事實上存在大量的交易量，大量的交易量今天，我們無法利用自己，要么是因為我們在其中一些市場中存在容量限制，要么我們只是沒有可以為目前我們尚未服務的患者群體提供服務的接入點。

John Ransom, Raymond James.

約翰·蘭塞姆，雷蒙德·詹姆斯。

Just kind of an obvious question. But when you guys have a 100-basis-point mix shift to higher cost scans, is that pretty much dropped to the bottom line?

只是一個顯而易見的問題。但是，當你們將 100 個基點的混合轉向更高成本的掃描時，這是否已經下降到底線了？

Yes, it does, John. Are you talking about our margin improvement, John?

是的，確實如此，約翰。約翰，你是在談論我們的利潤率改善嗎？

Yes.

是的。

Yeah, yeah. It was 120 basis points, but okay. Yes, but --

是啊是啊。雖然是 120 個基點，但還好。對，但是--

Well, so hypothetically, every 100 bps -- I am saying hypothetically, every 100 bps is 100 bps of this as well?

好吧，所以假設，每 100 bps——我是說假設，每 100 bps 也是這個的 100 bps？

Yes. I think a substantial portion of that, probably 80% of it in that range drops down to the bottom line, which is one of the reasons why we're very focused on reporting that this year more so than prior years.

是的。我認為其中很大一部分，可能是該範圍內的 80%，都下降到了底線，這就是為什麼我們非常專注於報告今年比往年更多的原因之一。

And is that -- I know you've kind of talked about this, but I mean, it seems like that's just sort of a structural trend that will go out into the future, this mix shift given all --

我知道你已經談到過這一點，但我的意思是，這似乎只是一種結構性趨勢，將持續到未來，考慮到所有因素，這種混合轉變--

I believe so. Yeah. I think last year, I think it was contributed by the improvement in reimbursement and shift of higher profit margin business, the advanced imaging. I think in subsequent quarters and years, it will be impacted by the implementation of our new DeepHealth operating system and automation of what have been up to this point largely manual processes.

我相信是這樣。是的。我認為去年，我認為這是由於報銷的改善和利潤率較高的業務（先進成像）的轉移而做出的貢獻。我認為在接下來的幾個季度和幾年裡，它將受到我們新的 DeepHealth 作業系統的實施以及迄今為止主要是手動流程的自動化的影響。

Great. And just two others for me. As we think about the cadence of the year for AI, eRAD, is that still on track to be -- is there any acceleration in that profitability curve? Or is it still on -- is that part of your $5 million? Or is it still kind of -- is mostly the $5 million in the core imaging sector?

偉大的。我只需要另外兩個。當我們思考今年人工智慧（eRAD）的節奏時，它是否仍在正常軌道上——獲利曲線是否有任何加速？或者它還在——這是你的 500 萬美元的一部分嗎？還是說，500 萬美元主要集中在核心影像領域？

Yeah. I think we expect some acceleration on two fronts. One is further implementation and adoption of our EBCD program, which we're very pleased with and I think has provided some outstanding results, one of which I'll mention and that was released interestingly this morning from the Cancer Moonshot White House program is that we have detected 450 cancers so far with the use of this breast screening tool that might have otherwise gone undetected so that the notion of enhanced or earlier breast cancer detection is a reality.

是的。我認為我們預計在兩個方面會有所加速。一是進一步實施和採用我們的 EBCD 計劃，我們對此感到非常滿意，我認為它提供了一些出色的成果，其中我要提到的一項是今天早上癌症登月白宮計劃有趣地發布的：到到目前為止，我們已經使用這種乳癌篩檢工具檢測到了450 種癌症，否則這些癌症可能不會被發現，因此增強或早期乳癌檢測的概念已成為現實。

As we get further implementation on the West Coast, which is continuing to ramp up, and as we continue to improve, I think, the patient adoption of this, we could alter our guidance on that perhaps later or in subsequent quarters. Also, some other initiatives that we're starting, one of which is what we're calling EPS, or enhanced prostate screening, is something that we're now rolling out as a self-pay opportunity for men to come in at a fairly nominal price, get an MRI scan with artificial intelligence even if they're asymptomatic and are just looking for greater confidence than routine blood tests that are used primarily for prostate screening.

隨著我們在西海岸得到進一步的實施（該計劃正在繼續加強），並且隨著我們繼續改進，我認為，耐心地採用這一點，我們可能會在稍後或隨後的幾個季度改變我們對此的指導。此外，我們正在啟動的其他一些舉措，其中之一就是我們所說的 EPS，即增強前列腺篩檢，我們現在正在推出這種自付費用機會，讓男性能夠以公平的價格參與其中。症狀，並且只是尋求比主要用於攝護腺篩檢的常規血液檢查更大的信心，也可以以名義價格進行人工智慧MRI 掃描。

We expect that to be something that probably will become more apparent in our financial results towards the end of the year. But we've had some very good results and some test sampling that we've done on much like in breast screening, finding early cancers that are certainly going to lead to better outcomes for men who choose this pathway.

我們預計這一點可能會在年底的財務表現中變得更加明顯。但我們已經取得了一些非常好的結果，並且進行了一些測試採樣，就像乳房篩檢一樣，發現早期癌症肯定會為選擇這條途徑的男性帶來更好的結果。

Great. And then the last one for me just on M&A. I know you don't put future M&A in your guide. But if we're spit balling and we're six months down the road, should we expect the probability of just more tuck-in deals in existing markets? Or what are the odds do you think you'll wrestle one of these elephants in the ground?

偉大的。最後一篇是關於併購的。我知道您不會將未來的併購納入您的指南中。但如果我們正在吐口水，而且還有六個月的時間，我們是否應該期望現有市場上出現更多交易的可能性？或者你認為你能在地上與這些大象摔角的幾率有多大？

Okay. I think tuck-ins will be a continual part of our acquisition and growth opportunity. We find those to be very targeted in our existing markets, if you will, and both on the East Coast and West Coast, there's a constant pipeline of requests that we're getting for further opportunities in our existing markets, much like we demonstrated in Houston when we entered that market just this quarter, April 1.

好的。我認為，折騰將成為我們收購和成長機會的持續組成部分。我們發現這些在我們現有的市場中非常有針對性，如果你願意的話，在東海岸和西海岸，我們不斷收到在現有市場中尋求更多機會的請求，就像我們在休斯頓，我們本季度（4 月1 日）剛進入該市場。

If there's other markets where we can find a good platform company to build a longer-term presence in a market, we would look at those. Those may become a little bit more expensive than the tuck-in acquisitions, but they do represent a longer-term platform to expand our reach. So I think you can continue to see those along with the de novos as being a very important component of this year's growth.

如果我們可以在其他市場找到一家優秀的平台公司來在市場上建立長期存在，我們會考慮這些。這些可能會比內部收購貴一點，但它們確實代表了擴大我們影響力的長期平台。因此，我認為您可以繼續將這些與從頭開始視為今年成長的非常重要的組成部分。

Andrew Mok, Barclays.

安德魯·莫克，巴克萊銀行。

Wanted to follow up on the digital health segment and the DeepHealth capability. One, can you help us understand what the adoption rate is for the EBCD AI option? And then I would love to hear more on the cost savings and throughput efficiencies that this could drive in imaging centers.

希望跟進數位健康領域和 DeepHealth 功能。第一，您能否幫助我們了解 EBCD AI 選項的採用率是多少？然後我很想聽到更多關於這可以在成像中心帶來的成本節約和吞吐量效率的資訊。

Sure. Well, as I mentioned, I think, in my remarks, on the East Coast, where we've had the longest experience with EBCD, our current adoption is about 40% of all of the patients that are offered EBCD that actually enroll and pay $40 for that procedure. We have found that to be consistent with our expectations and believe, though, that we can drive that number higher.

當然。嗯，正如我所提到的，我認為，在我的發言中，在東海岸，我們在EBCD 方面擁有最長的經驗，我們目前採用的患者佔所有接受EBCD 治療並實際註冊並付費的患者中約有40%該手術費用為 40 美元。我們發現這與我們的預期一致，但我們相信我們可以推動這個數字更高。

We're hoping at least on the East Coast, perhaps, even by the second half of this year, that number could approach 50%. On the West Coast, the adoption rate is in the 32%, 33% range. But that is also very comforting to us because that's higher than what we started off with on the West Coast -- I'm sorry, on the East Coast. And the West Coast has learned some of the tools.

我們希望至少在東岸，甚至到今年下半年，這個數字也能接近 50%。在西海岸，採用率在 32% 至 33% 之間。但這也讓我們感到非常欣慰，因為這比我們在西海岸開始時的水平要高——對不起，在東海岸。西海岸已經學會了一些工具。

But I have to caution everybody that this is an educational process. It's not something that we simply ask somebody to sign up for without giving them a lot of the background and benefits of these tools. So as we learn more and more about what the issues are that and questions that our patients have for these procedures, the more, I think, effective we are in communicating that benefit and the more receptive our patients are.

但我必須提醒大家，這是一個教育過程。我們不是簡單地要求某人註冊而不向他們提供這些工具的大量背景和好處。因此，隨著我們越來越了解患者對這些手術的問題和疑問，我認為我們在傳達這種好處方面就越有效，我們的患者就越容易接受。

I would tell you it is my firm belief that artificial intelligence, as it relates to breast screening and mammography, is state of the art and will be the routine sometime in the future, and we expect there to be some form of reimbursement for it. But during this period, we want our patients to benefit from the investments that we've made and the opportunities.

我想告訴你，我堅信，與乳房篩檢和乳房X光檢查相關的人工智慧是最先進的，並且將在未來的某個時候成為常規，我們希望能夠得到某種形式的補償。但在此期間，我們希望我們的患者能夠從我們所做的投資和機會中受益。

I would also like to include that not only do we detect the breast cancers more accurately and earlier, we're also having an impact on recall rates so that fewer of our patients, when some sort of further diagnostic work is necessary, is being determined, artificial intelligence is giving greater confidence that some of these callbacks, in fact, just need to be watched and don't need to go through further diagnostic workups such as biopsies and other procedures. So the benefit here is substantial in both regards.

我還想補充一點，我們不僅能夠更準確、更早地檢測出乳癌，而且還對召回率產生影響，以便在需要進行某種進一步診斷工作時，可以確定更少的患者人工智慧讓人們更有信心相信，其中一些回調實際上只需要觀察，不需要進一步的診斷檢查，例如活檢和其他程序。因此，在這兩方面，這裡的好處都是巨大的。

In terms of our radiologists, I think we're comfortable feeling that our radiologists are more accurate and confident now as they get more and more use of artificial intelligence, and we think we can get perhaps as much as a 15% to 20% improvement in their productivity simply because the majority of the breast screening that we do are normal scans, and they have a greater confidence level when the artificial intelligence confirms their initial impression of the mammogram being normal.

就我們的放射科醫生而言，我認為我們很高興感覺到我們的放射科醫生現在更加準確和自信，因為他們越來越多地使用人工智慧，我們認為我們可能可以獲得多達15% 到20 % 的改善提高他們的工作效率只是因為我們所做的大多數乳房篩檢都是正常掃描，當人工智慧確認他們對乳房 X 光檢查的初步印像是正常時，他們就有了更大的信心。

So I think there's a win-win win for everybody in this remarkable new achievement for which we are continuing to evolve further tools, not only in breast, but as we mentioned, in lung and prostate, where we expect similar results and benefits. I'd also like to again mention the fact that we're going to embark on an accelerated program for cardiovascular screening for which artificial intelligence tools have now been approved for reimbursement that give further benefit to our patients rather than just doing the CT scan itself.

因此，我認為這項非凡的新成就對每個人來說都是雙贏的，為此我們將繼續發展進一步的工具，不僅在乳房方面，而且正如我們所提到的，在肺部和前列腺方面，我們期望獲得類似的結果和益處。我還想再次提及這樣一個事實，即我們將啟動一項心血管篩檢加速計劃，該計劃的人工智慧工具現已獲得報銷，這將為我們的患者帶來更多好處，而不僅僅是進行CT 掃描本身。

So I think all of this will be part of our DeepHealth operating platform. And I think you can look forward to us talking about other AI tools that we will expand into to help improve both diagnostic accuracy and productivity for our radiologists.

所以我認為所有這些都將成為我們 DeepHealth 營運平台的一部分。我認為您可以期待我們談論其他人工智慧工具，我們將擴展這些工具，以幫助提高放射科醫生的診斷準確性和工作效率。

Great. And then secondly, I think your other category in your payer mix ticked up about 100 basis points sequentially. Just want to clarify what that other category is and what's behind that uptick. Is that tied to the higher EBCD volumes as well?

偉大的。其次，我認為您的付款人組合中的其他類別連續上漲了約 100 個基點。只是想澄清一下其他類別是什麼以及這種增長背後的原因。這是否也與更高的 EBCD 銷售有關？

Yeah. It's everything that isn't just patient scanning. So it's management fees, it's the category that doesn't fit into MRI, CT, x-ray, or mammography procedures such as certain interventional procedures. And part of it had to do with when we -- the reason why it shifted, I think, of about 1% quarter over quarter had to do with when we rejiggered our operating segments between the imaging center and the digital health segment and moving that eRAD business out of the imaging center segment changed the proportions of those exams. But nothing fundamentally has changed with our business.

是的。這不僅僅是患者掃描之外的一切。所以這是管理費，它不屬於 MRI、CT、X 光或乳房 X 光檢查程序（例如某些介入程序）的類別。部分原因與我們的情況有關——我認為，季度環比變化約 1% 的原因與我們重新調整成像中心和數位健康部門之間的營運部門並將其轉移有關。檢查的比例。但我們的業務並沒有發生根本性的變化。

I was actually talking about the other category, the payer mix, not the procedure mix.

我實際上談論的是另一個類別，即付款人組合，而不是程序組合。

Oh, I'm sorry, I thought you talked about the procedure mix.

哦，抱歉，我以為你談到了程式組合。

Yeah, that would be from EBCD because it's -- that's self-pay, so it's in the other category.

是的，這將來自 EBCD，因為它是自費的，所以它屬於另一個類別。

Yes, that's likely the case, Andrew. I'll double check the reports and follow up with you.

是的，情況很可能是這樣，安德魯。我會仔細檢查報告並與您聯繫。

Yeah, that makes sense. And then are there any metrics you can share to give us a sense of the backlog or unmet demand? I think it's clear that there's strong demand backdrop and you have this patient backlog, but just curious if there's anything you can share with us to give us a sense of that unmet demand.

是的，這是有道理的。那麼您是否可以分享任何指標，讓我們了解積壓或未滿足的需求？我認為很明顯存在強勁的需求背景，並且您有耐心的積壓，但只是好奇您是否可以與我們分享任何內容，讓我們了解這種未滿足的需求。

I think that the backlogs are a function of, number one, more use of imaging and greater adoption of it, aging population, growing population, all of which require more and more imaging. And I think greater than previously determined shift away from hospitals. I think there is more effort on the part of payors to direct the business away from hospitals, again, by education and giving the patients an alternative that they might not have previously realized were available to them.

我認為，積壓的原因是，第一，成像的更多使用和採用，人口老化，人口增長，所有這些都需要越來越多的成像。我認為，從醫院轉移的程度比之前確定的要大。我認為付款人需要付出更多努力，透過教育和為患者提供他們以前可能沒有意識到的替代方案來引導業務遠離醫院。

And I think this is important and has become more important as deductibles have risen with some of the newer products. When you stop to think about how much if a patient goes to a hospital, they have to pay for their co-pay segment of the scan. These numbers are rather substantial, and yeah, eat through their deductible very quickly. And their effective use of that cash could go further for more health services if they elect to go to an outpatient facility where, as we've talked about in the past, scanning differential can be three to five or even more times in a hospital.

我認為這一點很重要，並且隨著一些新產品的免賠額增加而變得更加重要。當你停下來思考如果病人去醫院要花多少錢時，他們必須支付掃描的自付部分。這些數字相當可觀，是的，很快就耗盡了他們的免賠額。如果他們選擇去門診機構，他們有效利用這些現金可以獲得更多的醫療服務，正如我們過去談到的那樣，掃描差異可能是醫院的三到五倍甚至更多。

So, I think all of these are coming together. And I think perhaps the other reason is that things that were more esoteric in the past are now becoming more familiar and patients more comfortable with things like PET CT scanning that maybe in the past people thought were only done at veterinary clinics. But particularly as things like prostate screening and now for Alzheimer's screening as well as the general use of it in cancer for diagnostic staging are now just being recognized by everybody of the enormous value that these tools are. So there's greater adoption and greater demand for this coming from all sectors. I would say that also our experience for increased demand is not unique to RadNet.

所以，我認為所有這些都會結合在一起。我認為也許另一個原因是，過去那些深奧的事情現在變得越來越熟悉，患者對 PET CT 掃描等可能過去人們認為只能在獸醫診所完成的事情也更加適應。但特別是像前列腺篩檢和現在的阿茲海默症篩檢以及它在癌症診斷分期中的一般用途現在剛剛被每個人認識到這些工具的巨大價值。因此，各行業對此的採用率和需求量都更大。我想說的是，我們對需求增加的經驗並不是 RadNet 所獨有的。

I think almost all of the people that we talk to in the industry, other large chain operators as well as acquisitions when we talk to our various opportunities here, are all experiencing increase in demand. So what makes RadNet a little bit different is that our ability to take advantage of this by deploying capital either by doing acquisitions or building de novo centers allows us to address these kind of opportunities, which benefit not only our patients and referring physicians, but our communities as a whole. So I just think that right now, imaging is enjoying a very important role in delivery of healthcare. And as I've said previously, I believe it is the gateway for population health. And I believe more and more people are coming to agree with that statement.

我認為幾乎所有與我們交談的業內人士、其他大型連鎖運營商以及當我們談論這裡的各種機會時的收購，都在經歷需求的增長。因此，RadNet 的與眾不同之處在於，我們能夠透過收購或建立 de novo 中心來部署資本，從而抓住這些機會，這不僅有利於我們的患者和轉診醫生，也有利於我們的客戶。作為一個整體。所以我認為目前影像在醫療保健領域扮演著非常重要的角色。正如我之前所說，我相信這是人口健康的門戶。我相信越來越多的人會同意這個說法。

Yeah. And specifically, to your question, Andrew, from the standpoint of what KPIs we look at in order to determine how big our backlogs are and whether we have to invest in those centers to expand them or build new centers, we particularly look at advanced imaging and how long it takes when a patient calls into our scheduling department, how long it takes them to actually come in and get their exam performed. And for advanced imaging, if someone's calling up for an MRI or a PET CT and is concerned that they have a serious injury or serious disease process, if we can't get that patient in in a matter of three or four days, we're going to end up losing some of that business because the patient is not going to wait around a week or two to figure out if he or she has cancer.

是的。具體來說，對於你的問題，安德魯，從我們考慮哪些關鍵績效指標來確定我們的積壓量有多大以及我們是否必須投資這些中心來擴大它們或建立新中心的角度來看，我們特別關注先進成像患者致電我們的預約部門需要多長時間，他們實際進來並進行檢查需要多長時間。對於高級影像，如果有人要求進行 MRI 或 PET CT 檢查，並擔心他們受了嚴重傷害或患有嚴重疾病，如果我們無法在三四天內讓該患者接受檢查，我們就會『我們最終會失去部分業務，因為患者不會等待一兩週左右才能確定自己是否患有癌症。

So we manage the scheduling. We try to, as much as we can, load balance with our scheduling departments that are centralized in that region, and we'll try to direct that patient to another center that might have a scanning spot that's open with less waiting time. But unfortunately, what we're facing right now are some real scheduling difficulties, which is why we've determined that we need to build new centers and increase capacity. The newer equipment, particularly in the areas of MRI, have faster throughput these days, better post processing software. So we are able to do more scanning in the same amount of work hours.

所以我們管理調度。我們會盡力與集中在該地區的調度部門進行負載平衡，並且我們會嘗試將患者引導至另一個中心，該中心可能有開放的掃描點，且等待時間較短。但不幸的是，我們現在面臨的是一些真正的調度困難，這就是為什麼我們決定需要建造新的中心並增加容量。如今，較新的設備，尤其是 MRI 領域的設備，具有更快的吞吐量和更好的後處理軟體。因此，我們能夠在相同的工作時間內進行更多的掃描。

And we've been, as much as we can over the last couple of years, trying to upgrade our MRI scanners to the newer technologies. But this is the highest-class problem we can have, but it's still a problem nonetheless because we don't want to lose this patient volume to our competitors. And referral patterns, physician relationships tend to be sticky, and so once you lose business to someone else, it's hard to get that business back, which is why we're trying to expand our capacity so quickly.

在過去的幾年裡，我們一直在盡我們所能，嘗試將我們的 MRI 掃描器升級到更新的技術。但這是我們可以遇到的最高級別的問題，但它仍然是一個問題，因為我們不想讓我們的競爭對手失去這些患者數量。轉診模式、醫生關係往往是黏性的，因此一旦你的業務輸給了其他人，就很難收回業務，這就是為什麼我們要如此迅速地擴大我們的產能。

Yuan Zhi, B. Riley Securities.

袁志，B.萊利證券。

Congrats on the great quarter. And thank you for the corrections. I have a couple of them. So first, if we take a step back, you have different market shares in different states. I'm curious what was the reason to have higher market share in some states and the lower market share in the others?

恭喜這個偉大的季度。並感謝您的指正。我有幾個。首先，如果我們退一步，你會發現不同州有不同的市場份額。我很好奇在某些州擁有較高市場份額而在其他州擁有較低市場價值的原因是什麼？

In other way, was it because of lack of good acquisition targets? Or do you think you've reached certain critical mass in that stage? I think that here in Texas or even new state, if you are expanding further, what would be the criteria or goal there?

或者說，是因為沒有好的收購標的嗎？或者你認為你在那個階段已經達到了一定的臨界質量嗎？我認為在德克薩斯州甚至新州，如果你要進一步擴張，那裡的標準或目標是什麼？

So when we look at a market, we don't necessarily have a market share in mind. We have found in our operating history that there are tremendous benefits to operating at scale in local markets, most of which are around centralizing a lot of the business processes that we perform on behalf of our centers.

因此，當我們審視市場時，我們並不一定考慮市場份額。我們在營運歷史中發現，在當地市場大規模營運可以帶來巨大的好處，其中大部分好處是集中我們代表中心執行的許多業務流程。

For instance, we have the centralization of scheduling, pre-authorization, insurance verification, revenue cycle among other -- marketing among other things. And so when we think about building scale in a regional market, it's not necessarily driving towards a particular market share, it is really the result of how we can grow the business profitably using the benefits of scale.

例如，我們集中了調度、預先授權、保險驗證、收入週期等——行銷等。因此，當我們考慮在區域市場建立規模時，它不一定會推動特定的市場份額，而實際上是我們如何利用規模優勢來實現業務獲利成長的結果。

And so when we look at all of our markets, we want to have that benefit where we want to be able to achieve those benefits of scale. And there isn't necessarily a magic market share where we can do that. When you look at where our sites are today, we certainly don't have a lot of scale in the state of Florida. All four of our centers are in one particular market there in the Treasure Coast, Port St. Lucie, Stuart area of Florida. But that's a state where we would love to expand given the right opportunities.

因此，當我們審視所有市場時，我們希望在能夠實現規模效益的地方獲得這種效益。我們不一定有神奇的市場份額才能做到這一點。當您查看我們今天的站點時，您會發現我們在佛羅裡達州的規模當然不大。我們的所有四個中心都位於佛羅裡達州斯圖爾特地區聖露西港寶藏海岸的一個特定市場。但只要有合適的機會，我們就願意在這種情況下擴張。

Arizona, we feel like we're not yet getting the benefits of the scale that we could possibly have in the Phoenix area. And we did make an acquisition there with our partner, Dignity Health, where we acquired seven additional centers this quarter as Dr. Berger mentioned in his prepared remarks.

在亞利桑那州，我們覺得我們尚未獲得菲尼克斯地區可能擁有的規模效益。我們確實與我們的合作夥伴 Dignity Health 在那裡進行了收購，正如伯傑博士在他準備好的演講中提到的那樣，我們本季度又收購了七個中心。

So, I think the short answer to your question is we'd like scale in all of the markets that we have because of the ability to manage these business processes more efficiently and get better profitability from our assets.

因此，我認為對你的問題的簡短回答是，我們希望在我們擁有的所有市場中擴大規模，因為我們有能力更有效地管理這些業務流程並從我們的資產中獲得更好的盈利能力。

Got it. That's very helpful. And maybe one additional housekeeping questions here. Great to see the increase of PET CT volumes related to PSMA. I'm curious did you guys see any update on Alzheimer-related procedures, both the PET CT part as well as the MRI part in 1Q or recently in April?

知道了。這非常有幫助。也許還有一個額外的內務問題。很高興看到與 PSMA 相關的 PET CT 數量的增加。我很好奇你們是否在第一季或最近四月份看到了有關阿茲海默症相關手術的任何更新，無論是 PET CT 部分還是 MRI 部分？

Yeah. We are starting to see more volume come in, in the Alzheimer's area, both on the initial PET/CT screen for the presence of these amyloid plaques as well as some ongoing MRI monitoring once these patients are on these therapies, although we're not seeing a lot of that because these patients are just starting to go on to these therapies.

是的。我們開始看到更多的病例出現在阿茲海默症領域，無論是在最初的PET/CT 篩檢中發現這些澱粉樣斑塊的存在，還是在這些患者接受這些治療後進行一些持續的MRI監測，儘管我們並沒有這樣做。

There has been a delay in qualifying a lot of these patients on to some of the newer drug therapies and getting the initial diagnostic imaging approved to qualify these patients. The decision for this was passed down to the individual regional Medicare administrators or what we call the MACs and that has caused a delay. But we are starting to see some uptick.

這些患者中的許多人都被推遲了一些新的藥物療法的資格，並獲得了批准這些患者資格的初始診斷成像。此項決定已下達至各個地區醫療保險管理員或我們所說的 MAC，這導致了延誤。但我們開始看到一些上升。

But we're talking about patients in the hundreds of patients, not the thousands or tens of thousands of patients that we would have expected to see by now. We still remain optimistic that this is going to happen. I think these therapies prove to be efficacious in their clinical trials.

但我們談論的是數百名患者，而不是我們現在預計會看到的數千或數萬名患者。我們仍然對這將會發生保持樂觀。我認為這些療法在臨床試驗中被證明是有效的。

It's going to lean heavily on advanced imaging, both on the initial PET CT screen to determine whether these patients are eligible for these therapies as well as the ongoing MRIs that are indicated every three to four months for at least 18 months when these patients go on these therapies.

它將在很大程度上依賴先進的成像技術，既透過最初的PET CT 篩檢來確定這些患者是否有資格接受這些治療，又透過持續的MRI 進行檢查，這些檢查在這些患者繼續治療時每三到四個月進行一次，持續至少18 個月。

So I think this is just another example that gives us encouragement and optimism about the continued use of advanced imaging. I mean, Dr. Berger mentioned cardiac imaging which is growing in popularity, the PSMA test on the PET CT side, Alzheimer's, and there's others that are coming down the road particularly in the area of PET CT where there is a lot of development of some of these new radioactive tracers that are targeting very specific solid tumors, cancer tumors in the body. So I think it's going to be an ongoing process that unfolds here.

所以我認為這只是另一個例子，它給了我們對繼續使用先進成像技術的鼓勵和樂觀。我的意思是，Berger 博士提到了越來越受歡迎的心臟成像、PET CT 方面的 PSMA 測試、阿茲海默症以及其他正在出現的技術，特別是在 PET CT 領域，該領域在其中一些新的放射性追蹤劑針對的是非常特定的實體腫瘤，即體內的癌症腫瘤。所以我認為這將是一個持續的過程。

Jim Sidoti, Sidoti & Company.

吉姆‧西多蒂 (Jim Sidoti)，西多蒂公司。

Just two quick ones for me. Can you update us on how things are going in Texas? It has been a while since you entered a new market. How do you find this market? Is it easy to get paid? And is it easy to do business there?

對我來說只有兩個快速的。您能為我們介紹一下德州的最新情況嗎？您進入新市場已經有一段時間了。你如何找到這個市場？收錢容易嗎？還有那裡做生意容易嗎？

Yeah. Well, I mean it's a little hard to say now. So we completed the first acquisition of seven centers. We completed that on April 1. So we don't have a whole lot of operating experience there as of yet. I think the integration of that business and what we call the RadNetization is just at the very beginning stages.

是的。嗯，我的意思是現在有點難說。這樣我們就完成了第一個七個中心的收購。我們在 4 月 1 日完成了這項工作。因此，我們目前還沒有豐富的營運經驗。我認為該業務與我們所謂的 RadNetization 的整合還處於起步階段。

The other acquisition that we've announced of the American Health Imaging centers in Houston, that's scheduled to close kind of in the June, July timeframe. And we anticipate some further integration of those two operations to create a platform from which we can grow at that point. So I think we'll have a lot better feeling of -- and a better way of answering your questions in the coming quarters.

我們宣布的另一項收購是對休士頓美國健康影像中心的收購，計劃在六月、七月的時間範圍內完成。我們預計這兩項業務將進一步整合，以創建一個我們可以在此基礎上發展的平台。因此，我認為在接下來的幾個季度中，我們將有更好的感覺，並有更好的方式來回答您的問題。

But early indication is that this is a very attractive market, good demographics, good payor relationships. We think that we've identified and partnered with an excellent group of radiologists. And they're motivated as our lead to really grow that platform through further acquisitions, de novo centers. There's a number of hospital relationships in that market that could be interesting to us as we continue to grow there. So I think we're highly encouraged from what we see so far.

但早期跡象表明，這是一個非常有吸引力的市場，良好的人口統計數據，良好的付款人關係。我們認為我們已經找到了一群優秀的放射科醫生並與之合作。作為我們的領導者，他們有動力透過進一步的收購和從頭中心來真正發展該平台。隨著我們繼續在那裡發展，我們可能會對這個市場上的許多醫院關係感興趣。所以我認為我們對目前所看到的情況感到非常鼓舞。

Okay. All right. And second one, can you just give us updated share count what we need to be using for Q2 and Q3 this year?

好的。好的。第二個問題，您能給我們更新今年第二季和第三季需要使用的股票數量嗎？

Could you repeat that? Sorry, it's a little bit difficult to hear you.

你能再說一次嗎？抱歉，聽你說話有點困難。

Sorry, it is a question on what's the right share count for the rest of the year?

抱歉，問題是今年剩餘時間的正確股票數量是多少？

Sure. So I think we have somewhere in the 73 million to 74 million outstanding shares. We typically wouldn't -- unless we're doing any acquisitions using our stock for the remainder of the year, we don't expect that share count to go up significantly. Generally speaking, it's the first quarter where we issue equity to our existing employee base as part of their annual compensation. So that was already completed in the first quarter. So I wouldn't expect anything to increase our shares materially between now and the end of the year unless there's some acquisition where we choose to use stock.

當然。所以我認為我們有 7300 萬到 7400 萬股流通股。我們通常不會——除非我們在今年剩餘時間內使用我們的股票進行任何收購，否則我們預計股票數量不會大幅增加。一般來說，我們在第一季向現有員工發放股權，作為他們年度薪資的一部分。所以第一季就已經完成了。因此，我預計從現在到今年年底，我們的股票不會大幅增加，除非我們選擇使用股票進行某些收購。

And ladies and gentlemen, at this time, I'm showing no additional questions. I'd like to turn the floor back over to management for any closing remarks.

女士們先生們，此時我沒有提出其他問題。我想將發言權交還給管理階層，讓他們發表結束語。

All right. Thank you, operator. Again, I would like to take this opportunity to thank all of our shareholders for their continued support and the employees of RadNet for their dedication and hard work. Management will continue its endeavor to be a market leader that provides great services with an appropriate return on investment for all stakeholders.

好的。謝謝你，接線生。我想藉此機會再次感謝我們所有股東的持續支持以及 RadNet 員工的奉獻和辛勤工作。管理層將繼續努力成為市場領導者，為所有利害關係人提供優質服務和適當的投資回報。

Thank you for your time today, and I look forward to our next call.

感謝您今天抽出寶貴的時間，期待我們的下次通話。

Ladies and gentlemen, with that, we'll be concluding today's conference call and presentation. We thank you for joining. You may now disconnect your lines.

女士們、先生們，我們今天的電話會議和演示就到此結束。我們感謝您的加入。現在您可以斷開線路。