Surgery Partners, Inc. (SGRY) 2026 Q1 法說會逐字稿

Ladies and gentlemen, greetings and welcome to the Surgery Partners First Quarter 2026 Earnings Conference Call. (Operator Instructions) As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Dave Doherty, Surgery Partners' Chief Financial Officer. Please go ahead.

各位女士、先生，大家好，歡迎參加 Surgery Partners 2026 年第一季財報電話會議。(接線員指示) 提醒各位，本次會議將被錄音。現在很榮幸為各位介紹本次會議主持人，Surgery Partners 財務長 Dave Doherty。請開始。

Good morning and thank you for joining Surgery Partners First Quarter 2026 Earnings Call. I am joined today by Eric Evans, our Chief Executive Officer; as well as Justin Oppenheimer, our Chief Operating Officer, who joined the company in January.

各位早安，感謝您參加 Surgery Partners 2026 年第一季財報電話會議。今天與我一同出席的有我們的執行長 Eric Evans；以及今年 1 月加入公司的營運長 Justin Oppenheimer。

During this call, we will make forward-looking statements. There are risk factors that could cause future results to be materially different from these statements as described in this morning's press release and the reports we file with the SEC. Company does not undertake any duty to update these forward-looking statements.

在本次電話會議中，我們將作出前瞻性陳述。如同今早新聞稿以及我們向美國證券交易委員會（SEC）提交的報告所述，存在可能導致未來結果與這些陳述有重大差異的風險因素。本公司不承擔更新這些前瞻性陳述的任何義務。

In addition, we reference certain non-GAAP financial measures, which we believe can be useful in evaluating our performance. we reconcile these measures to the most applicable GAAP measure in this morning's press release.

此外，我們也會提及若干非 GAAP 財務衡量指標，我們認為這些指標有助於評估我們的表現。我們已在今早的新聞稿中，將這些指標與最適用的 GAAP 指標進行調節（對帳）。

With that, I will turn the call over to Eric. Eric?

那麼，我將把電話會議交給 Eric。Eric？

Thank you, Dave, and good morning, everyone. Before we get started, I'd like to introduce Justin Oppenheimer on the call this morning. Justin joined the company as our Chief Operating Officer in January and has made an immediate positive impact on the organization.

謝謝你，Dave，各位早安。在開始之前，我想先在今天早上的電話會議中介紹 Justin Oppenheimer。Justin 於 1 月加入公司擔任營運長，並已立即對組織帶來正面的影響。

By way of background, Justin was previously an executive at Hospital for Special Surgery, the world's leading academic system focused on musculoskeletal care, where he held several roles overseeing operations and strategy. Justin will be available to answer questions during the Q&A portion of our call, and we look forward to using to know him better in the months ahead.

就背景而言，Justin 先前任職於 Hospital for Special Surgery，這是全球領先、專注於肌肉骨骼照護的學術體系；他曾擔任多個職務，負責營運與策略。Justin 將在問答環節中回答問題，我們也期待在接下來幾個月能更深入認識他。

Now moving to our first quarter operational and financial performance. I'll start with a brief overview of our first quarter results, followed by additional color on our progress across the three pillars of our growth algorithm, organic growth, margin improvement and capital deployment.

接著談我們第一季的營運與財務表現。我將先簡要概述第一季結果，接著補充我們在成長演算法三大支柱上的進展：有機成長、利潤率改善與資本配置。

Let's start with the highlights. We are encouraged by our start to the year. First quarter performance broadly in line with our internal expectations, reflecting improved stability across the portfolio and initial signs of recovery in areas that were pressured towards the end of 2025.

先從重點摘要開始。我們對今年的開局感到鼓舞。第一季表現大致符合我們內部預期，反映投資組合整體穩定性提升，並在 2025 年底承壓的部分領域出現初步復甦跡象。

As a reminder, we ended last year with a select number of clearly identified addressable headwinds, particularly within a small subset of our surgical hospital portfolio. Entering 2026, our focus has been on restoring operating consistency and predictability, better supporting physician transitions and positioning the business for sustainable growth.

提醒各位，我們在去年年底面臨少數幾項明確可辨識且可處理的逆風，特別是在我們外科醫院投資組合中的一小部分。進入 2026 年，我們的重點在於恢復營運的一致性與可預測性、更好地支持醫師轉換，並讓業務定位於可持續成長。

We believe our first quarter results reflect early progress we have made and position us well to meet or exceed our 2026 objectives. At a high level, during the quarter, we delivered approximately $811 million of net revenue, same-facility revenue growth of 4.4% and adjusted EBITDA of approximately $102 million, as we continue to execute against the foundational drivers of our long-term growth strategy.

我們認為第一季結果反映了我們已取得的初步進展，並使我們處於有利位置，以達成或超越 2026 年目標。整體而言，本季我們實現約 8.11 億美元的淨營收、同院（同設施）營收成長 4.4%，以及約 1.02 億美元的調整後 EBITDA；我們持續落實長期成長策略的基礎驅動因素。

Dave will walk through the financial details shortly. Tracking our first pillar, organic growth. Same-facility case growth of 0.6% in the first quarter was modest and below our long-term growth algorithm driven by primarily by temporary weather-related disruptions early in the quarter that led to case losses or deferrals in several higher volume but lower acuity markets.

Dave 稍後將說明財務細節。就第一支柱「有機成長」而言：第一季同院病例量成長 0.6% 屬溫和，低於我們長期成長演算法，主要原因是季初短期的天候相關干擾，導致數個病例量較高但病情嚴重度較低的市場出現病例流失或延後。

Importantly, these impacts were not broad-based and did not materially affect the higher acuity portion of our portfolio. We would also note that this performance is relative to a strong prior year comparison where we delivered approximately 6.5% same-facility case growth in the first quarter of 2025.

重要的是，這些影響並非全面性，且未對我們投資組合中病情嚴重度較高的部分造成重大影響。我們也要指出，這項表現是相對於去年同期的強勁比較基期；我們在 2025 年第一季同院病例量成長約 6.5%。

As we have noted in the past, and given the continued acuity shift in our space, we believe the total same-facility net revenue metric remains the best to assess our growth as it reflects both total cases, acuity and rate improvements. At 4.4%, our same-facility revenue growth was in line with our first quarter and long-term expectations.

如同我們過去所提及，且考量我們產業持續出現病情嚴重度上移的趨勢，我們認為「同院淨營收」仍是評估成長的最佳指標，因其同時反映總病例量、病情嚴重度與費率改善。同院營收成長 4.4% 符合我們對第一季及長期的預期。

We remain focused on executing our organic growth strategy centered on expanding surgical case volumes while strategically shifting towards higher acuity procedures. To this end, we continue to see favorable trends in our musculoskeletal service line with total joints performed in our ASCs growing 14.6% year-over-year. Our investment in surgical robotics continues to support this momentum.

我們仍專注於執行有機成長策略：在擴大手術病例量的同時，策略性地轉向更高病情嚴重度的手術。為此，我們在肌肉骨骼（MSK）服務線持續看到有利趨勢，我們在門診手術中心（ASC）執行的全關節置換手術量年增 14.6%。我們在手術機器人方面的投資持續支撐這股動能。

Our portfolio consists of 73 surgical robots, further supporting higher acuity procedures, we can perform safely and efficiently across the platform. We remain focused on thoughtfully deploying this technology to enhance our capabilities where it drives clinical value and enables us to earn more complex, higher acuity cases. Physician recruiting remains another key driver of long-term growth.

我們的投資組合包含 73 台手術機器人，進一步支援我們在平台內安全且高效率地執行更高病情嚴重度的手術。我們仍專注於審慎部署此技術，在能帶來臨床價值之處強化能力，並使我們能承接更複雜、病情嚴重度更高的病例。醫師招募仍是長期成長的另一項關鍵驅動因素。

During the quarter, we recruited approximately 140 physicians with a strong concentration in orthopedics, ophthalmology, GI and other priority specialties. While new recruits take time to ramp, these additions position us well for accelerating volume and acuity as the year progresses. De novo development continues to provide one of the highest returns on capital across our portfolio.

本季我們招募約 140 位醫師，主要集中於骨科、眼科、腸胃科（GI）及其他優先專科。雖然新招募醫師需要時間爬坡，但這些新增人力使我們在今年後續期間更有利於加速提升量能與病情嚴重度。新設（de novo）開發仍是我們投資組合中資本報酬率最高的來源之一。

During the first quarter, we opened one de novo, bringing our total openings to nine over the trailing 12 months. Our de novo ASCs are heavily weighted towards MSK, aligning closely with our long-term strategy to expand higher acuity capabilities in attractive markets.

第一季我們新開設 1 家 de novo，使過去 12 個月的總開設數達到 9 家。我們的 de novo 門診手術中心（ASC）高度偏重於 MSK，與我們在具吸引力市場擴大高病情嚴重度能力的長期策略高度一致。

Turning to margin expansion. Our adjusted EBITDA margin was 12.6%, in line with our expectations for the seasonally lower margin first quarter. Overall, cost management was solid in the quarter, with both labor and supply costs showing sequential improvements as a percentage of net revenue relative to the first quarter of 2025, which Dave will provide greater detail on in his comments.

接著談利潤率擴張。我們的調整後 EBITDA 利潤率為 12.6%，符合我們對季節性利潤率較低的第一季之預期。整體而言，本季成本管理表現穩健；相較於 2025 年第一季，勞動成本與耗材成本占淨營收比重皆呈現環比改善，Dave 將在他的說明中提供更多細節。

Our proactive efforts allowed us to partially offset the onetime pressures related to re establishing incentive compensation, increased provider taxes and tariff pressures that are detailed in our posted slides.

我們的主動作為使我們得以部分抵銷一次性壓力，包括重新建立獎酬激勵、供應商稅增加，以及關稅壓力；相關內容已在我們發布的簡報中詳述。

Regarding payer mix, while we did see modest payer mix pressure in the first quarter, the trend is moderating from the second half of 2025, and we are continuing to take action to both recover and grow our commercial market share as well as to reduce our expenses to improve our Medicare case profitability.

就付款方組合而言，雖然第一季確實出現輕微的付款方組合壓力，但相較於 2025 年下半年，趨勢正在趨緩；我們也持續採取行動，一方面恢復並提升商業保險市占，另一方面降低費用以改善 Medicare 病例的獲利能力。

Importantly, regarding the three surgical hospital markets we discussed on our fourth quarter call, they are executing their plan through the first quarter, and I am confident that our new leadership teams that are in place will continue to drive progress. Moving into -- on to our third pillar, capital deployment towards M&A.

重要的是，關於我們在第四季電話會議中討論的三個外科醫院市場，它們在第一季持續按計畫執行；我有信心，已到位的新領導團隊將持續推動進展。接著進入第三支柱：將資本配置用於併購（M&A）。

During the first quarter, we deployed approximately $4 million of capital. Our pipeline remains active, and we continue to target deploying approximately $200 million in capital annually. While first quarter deployment was modest, we continue to have a healthy pipeline and remain optimistic about our long-term opportunity to be an accretive consolidator in the very fragmented ASC landscape.

第一季我們配置約 400 萬美元資本。我們的案源管線仍然活躍，並持續以每年約 2 億美元的資本配置為目標。雖然第一季配置金額不大，但我們仍有健康的案源管線，並對我們在高度分散的 ASC 市場中成為具增益（accretive）的整合者之長期機會保持樂觀。

As a reminder, our full year 2026 guidance does not factor in any potential impact of M&A. In parallel to continued execution of disciplined M&A, we have made progress on our portfolio optimization initiative. Our efforts remain focused on a small number of larger surgical hospital markets that have broader services than our core short-stay surgical focus.

提醒各位，我們 2026 年全年財測並未納入任何併購（M&A）可能帶來的影響。在持續執行嚴謹併購的同時，我們在投資組合優化計畫上也取得進展。我們的工作仍聚焦於少數幾個規模較大的外科醫院市場，這些市場提供的服務範圍較我們核心的短住院外科重點更廣。

We are in advanced discussions on one key opportunity in a larger surgical hospital market and are working through customary diligence and transaction considerations. Our Board is actively engaged in this process, and we continue to target an announcement in mid-2026.

我們正就一項位於更大型外科醫院市場的關鍵機會進行深入洽談，並正處理慣常的盡職調查與交易相關考量。我們的董事會正積極參與此流程，且我們仍以於 2026 年年中發布公告為目標。

As we continue to advance our portfolio optimization efforts, our focus remains on unlocking financial benefit to the company through reduced leverage and improved free cash flow conversion. Before turning the call back to Dave, I want to thank our teams across the organization as well as our physician partners for their focus and execution, particularly in navigating a dynamic operating environment.

隨著我們持續推進投資組合優化工作，我們的重點仍是透過降低槓桿並提升自由現金流轉換率，為公司釋放財務效益。在把電話交回給 Dave 之前，我想感謝全組織各團隊以及我們的醫師合作夥伴在專注與執行上的努力，特別是在因應多變的營運環境方面。

We remain confident in the durability and value of our model, the strength of our physician partnerships and our ability to execute against our strategy as we move through the remainder of the year.

隨著我們走過今年剩餘時間，我們仍對我們模式的韌性與價值、醫師合作關係的強度，以及我們依策略執行的能力充滿信心。

With that said, I will turn the call back to Dave. Dave?

話說到這裡，我把電話交回給 Dave。Dave？

Thanks, Eric. Adjusted EBITDA for the quarter was $102 million. Compared to last year, results reflected the planned impact of payer mix and provider tax items discussed on our fourth quarter call and embedded in our 2026 outlook. Against that backdrop, overall performance came in modestly ahead of expectations and in line with our underlying assumptions for the year.

謝謝你，Eric。本季調整後 EBITDA 為 1.02 億美元。與去年相比，結果反映了我們在第四季電話會議中討論、且已納入 2026 年展望的付款方組合與提供者稅項目的既定影響。在此背景下，整體表現略優於預期，並與我們對全年基本假設一致。

Supply expense represented approximately 27.2% of net revenue during the quarter, while SWB expense was approximately 30.5% of revenue, both showing modest improvement year-over-year. Both professional and medical fees and G&A expenses were broadly in line with the prior year. Other operating expenses were 7.3% of revenue, higher year-over-year, reflecting the provider taxes we have previously discussed.

本季供應費用約占淨營收的 27.2%，而薪資、工資與福利（SWB）費用約占營收的 30.5%，兩者皆較去年同期小幅改善。專業費與醫療費以及一般與行政（G&A）費用整體上與去年同期大致一致。其他營運費用占營收的 7.3%，較去年同期提高，反映了我們先前討論過的提供者稅。

While these items contributed to margin pressure during the quarter, they were fully contemplated in our internal expectations and full year outlook. Collectively, expense ratios were generally consistent with the prior year and our expectations. Same-facility case growth was 0.6%, with several specialties contributing above 2% growth, including vascular and orthopedics.

雖然這些項目在本季對利潤率造成壓力，但已完全納入我們的內部預期與全年展望。整體而言，各項費用比率大致與去年同期及我們的預期一致。同店病例量成長為 0.6%，其中多個專科貢獻了超過 2% 的成長，包括血管與骨科。

These trends helped offset case deferrals driven by weather-related disruption in higher volume, low acuity markets early in the quarter, which we estimated affected growth by approximately 40 basis points. Working capital performance remained solid. Days sales outstanding were approximately 66 days, consistent with both the fourth quarter of 2025 and the first quarter of 2025.

這些趨勢有助於抵銷本季初在高量、低急性市場因天候相關干擾所導致的病例延後；我們估計其對成長的影響約為 40 個基點。營運資金表現仍然穩健。應收帳款週轉天數（DSO）約為 66 天，與 2025 年第四季及 2025 年第一季一致。

Interest expense increased year-over-year by approximately $7 million, reflecting higher rates following the expiration of our interest rate swap. This increase represented a meaningful cash headwind during the quarter, though it was partially offset by base rate reductions we executed on our credit facility in 2025, and by improved working capital performance.

利息費用較去年同期增加約 700 萬美元，反映在我們利率交換到期後利率較高。此增加在本季形成顯著的現金逆風，但部分被我們於 2025 年在信貸融資安排上執行的基準利率下調，以及營運資金表現改善所抵銷。

Operating cash flow for the quarter was approximately $12 million, an increase from $6 million from the prior year period, reflecting improved underlying performance consistent with typical first quarter seasonality and timing-related movements in working capital.

本季營運現金流約為 1,200 萬美元，較去年同期的 600 萬美元增加，反映了在典型第一季季節性與營運資金時點變動下，基本面表現的改善。

Capital expenditures during the quarter included $9 million of maintenance-related spend, largely associated with equipment refreshes, information technology and routine facility investments necessary to support ongoing operations. In addition, we made $58 million of distributions to our physician partners, consistent with the historical patterns and our partnership-based model.

本季資本支出包含 900 萬美元的維護性支出，主要與設備汰換、資訊科技以及支持持續營運所需的例行設施投資相關。此外，我們向醫師合作夥伴支付了 5,800 萬美元的分配，符合歷史模式以及我們以合作夥伴為基礎的商業模式。

Net leverage under our credit agreement was approximately 4.3 times, which is consistent with the fourth quarter. GAAP net debt to adjusted EBITDA was approximately 5.1 times. We remain focused on disciplined capital allocation and expect to continue to drive gradual deleveraging over time, supported by earnings growth and ongoing portfolio optimization.

依據我們的信貸協議，淨槓桿約為 4.3 倍，與第四季一致。依 GAAP 計算之淨負債對調整後 EBITDA 約為 5.1 倍。我們仍專注於嚴謹的資本配置，並預期在獲利成長與持續的投資組合優化支持下，隨時間推進逐步去槓桿。

During the quarter, we deployed approximately $4 million on acquisitions. Based on internal development reporting, we estimate these acquisitions will contribute approximately $7 million of revenue in 2026. Regarding our share repurchase authorization, we did not repurchase shares during the quarter.

本季我們在併購上投入約 400 萬美元。根據內部開發報告，我們估計這些併購將於 2026 年貢獻約 700 萬美元營收。關於我們的庫藏股回購授權，本季我們未回購股份。

As discussed previously, we will remain disciplined in the use of this program, and we'll evaluate repurchases opportunistically based on valuation, liquidity and alternative uses of capital. We are reiterating our full year 2026 revenue guidance of $3.35 billion to $3.45 billion and adjusted EBITDA guidance of at least $530 million.

如先前所述，我們將在使用此計畫上保持紀律，並將基於估值、流動性與資本的其他用途，伺機評估回購。我們重申 2026 全年營收指引為 33.5 億至 34.5 億美元，調整後 EBITDA 指引為至少 5.30 億美元。

For the second quarter, we expect revenue to represent 24% to 24.5% of the annual target and adjusted EBITDA to be 23% to 23.5%. We -- as you've heard from us today, we continue to manage the business prudently with a focus on enhancing execution and protecting and growing margins.

就第二季而言，我們預期營收將占全年目標的 24% 至 24.5%，調整後 EBITDA 將為 23% 至 23.5%。我們——如同各位今天所聽到的——將持續以審慎方式管理業務，聚焦於提升執行力並保護與擴大利潤率。

While we know there is still work to be done as we continue to navigate near-term market dynamics, we believe our early efforts have laid solid groundwork for continued improvements in 2026. In addition to disciplined execution of our organic growth strategy and continuing to drive operational efficiencies, progress on M&A and our portfolio optimization initiative represents additional potential levers to accelerate our return to our long-term growth algorithm.

雖然我們知道在因應短期市場動態的過程中仍有工作要做，但我們相信早期的努力已為 2026 年的持續改善奠定了穩固基礎。除了嚴謹執行我們的內生成長策略並持續推動營運效率外，併購（M&A）與投資組合優化計畫的進展，也代表可加速我們回到長期成長算法的額外潛在槓桿。

We remain confident in our full year outlook and more broadly, our ability to return to consistent and sustainable growth, fueled by the strength of our unique short-stay surgical platform.

我們對全年展望仍具信心；更廣泛而言，我們也有信心能在我們獨特的短住院外科平台實力帶動下，回到一致且可持續的成長。

With that, I will turn the call back over to the operator for questions. Operator?

接下來，我將把電話交回給接線員以進行提問。接線員？

(Operator Instructions)

（接線員指示）

Brian Tanquilut, Jefferies LLC.

Brian Tanquilut，Jefferies LLC。

Hey. Good morning, guys. Congrats on the quarter. I know it was tough. So maybe I'll start with Justin, since you're new to the earnings call, just curious, I mean, you've been here about four months now. Anything you can share with us in terms of what you see -- what you've learned about the company, the operations and then what areas of opportunity you see in terms of like blocking and tackling or areas of further productivity and efficiency gains where you can make a difference in the operations.

嗨。各位早安。恭喜本季表現。我知道這很不容易。那我可能先從 Justin 開始，因為你是第一次參加法說會；只是好奇，你到任大概四個月了。你能否分享一下你所看到的——你對公司與營運的了解，以及你認為有哪些機會領域，例如在基本功與執行面，或在生產力與效率提升方面，你可以在營運上帶來改變？

Thank you for the very first question. Maybe what I'll do is just highlight three categories of early observations just to stay organized, maybe one around people second around our organization's positioning and three, our operational priorities. So the first, our people, I've spent nearly every week on the ground in our markets, spending time with our people and physician partners.

謝謝你的第一個問題。為了有條理，我先用三個面向來分享一些初步觀察：第一是人員，第二是我們組織的市場定位，第三是我們的營運優先事項。先談第一點，人員：我幾乎每週都在各市場第一線，與我們的同仁及醫師合作夥伴相處交流。

And very impressed with the positive culture of Surgery Partners. It's palpable. Everyone is committed to their patients, to their physician partners to each other. We have talented people who want to have an impact and create value for our physician partners and our shareholders.

我對 Surgery Partners 的正向文化印象非常深刻。這是可以真切感受到的。每個人都致力於病患、致力於醫師合作夥伴，也致力於彼此。我們有才華洋溢的人才，渴望產生影響力，並為醫師合作夥伴與股東創造價值。

And so I think just a level set summary on our people, and I think our culture is very strong. Initial talent assessment as our core operators are strong. There's always places to shore up, but that's to be expected. The second category just around our organization's positioning. One of the reasons I joined Surgery Partners is its positioning in the market.

因此，先就人員做個總結：我認為我們的文化非常強。初步的人才盤點顯示，我們的核心營運團隊很強。當然總有需要補強之處，但這是可以預期的。第二個面向是我們組織的市場定位。我加入 Surgery Partners 的原因之一，就是它在市場中的定位。

The tailwinds in this sector are real, and you can really see them on the ground. Patients want and appreciate the convenient high-value care that we're producing. Physicians want to bring their patients to our efficient facilities and partnered facilities and payers want the procedures done in the right setting.

這個產業的順風因素是真實存在的，而且你在第一線確實看得到。病患希望並重視我們所提供的便利且高價值的照護。醫師希望把病患帶到我們高效率的設施與合作設施，而付款方也希望手術在合適的場域完成。

And so you can really see this on the ground. And what's more positive from my mindset is Surgery Partners is the only company at scale focused solely on the management of surgical facilities into the future. So this has been all confirming. To get to your question about operational priorities, with the cultural foundation and these industry tailwinds, the priority is really on execution.

所以你確實可以在第一線看到這一點。而從我的心態來看，更正面的地方是，Surgery Partners 是唯一一家具規模、且專注於未來僅以手術設施管理為核心的公司。因此，這一切都再次得到印證。回到你關於營運優先事項的問題，在文化基礎與這些產業順風之下，優先事項其實就是把執行做好。

And I do believe there are a lot of embedded earnings with better execution, a real focus for our teams coming out of the first quarter is on organic growth and operational excellence. And those have been the central themes coming out of my first 100 days.

而我確實相信，只要執行得更好，還有很多內含的獲利空間；我們團隊在第一季結束後的重點，是真正聚焦於有機成長與營運卓越。而這些一直是我上任前 100 天以來的核心主題。

Growth means physician recruiting and physician relationships, operational excellence means hardwiring cost management and really pulling the key levers that make surgical facilities. And so both our teams and you all hear this drumbeat of growth and operational excellence from me throughout the year. So maybe I'll end with that.

成長代表醫師招募與醫師關係；營運卓越代表把成本管理制度化，並真正拉動那些讓手術設施運作的關鍵槓桿。因此，無論是我們的團隊或各位，今年都會一直從我這裡聽到「成長」與「營運卓越」這個主旋律。所以我大概就以此作結。

That's very helpful. Maybe, Dave, just shifting gears quickly. As I look at the P&L, a lot of progress here on SWB, supplies cost and even profits. So just curious, I mean, how do we think about, number one, what those levers were pulled during the quarter? And second, the sustainability of these levels of cost essentially its operations level.

這非常有幫助。Dave，或許我們快速換個話題。我看損益表（P&L），在 SWB、耗材成本甚至獲利方面都有很大進展。所以我想了解的是，第一，這一季主要拉動了哪些槓桿？第二，這些成本水準的可持續性如何——基本上是在營運層面的成本。

Yeah. Thanks, Brian. I may jump in here, and then I'll let Dave add a little color if he wants to. First of all, thank you for the comments on the quarter. Glad to have a solid start to the year. I think when we look at the cost controls and Justin has been jumping in with this; our team has been focused on cost management for a long time.

是的。謝謝，Brian。我先補充一下，然後再讓 Dave 看他是否要再加一些說明。首先，謝謝你對本季的評論。很高興今年有個穩健的開局。我想當我們看成本控管時，Justin 也一直有參與；我們團隊長期以來都很專注在成本管理。

But we came out of last fourth quarter with a real focus on driving some cost out of the business to improve margins on the Medicare business. You're seeing that show up in SWB and supply management. We do think there's still opportunities there. We've talked about -- if you look across the business the last five years, we have consistently improve margin over time.

但我們在去年第四季結束後，特別聚焦於把部分成本從業務中移除，以改善 Medicare 業務的利潤率。你現在看到的就是反映在 SWB 與耗材管理上。我們確實認為那裡仍有機會。我們也談過——如果你回顧過去五年整體業務，我們的利潤率一直隨時間穩定改善。

We do have some near-term headwinds. We've outlined in our slides, but we still feel really good about the team's ability to continue to take advantage of our scale in efficiency to drive those costs down as a percent of net revenue.

我們確實有一些短期逆風。我們在簡報中已經說明，但我們仍然非常看好團隊能持續運用規模帶來的效率，將這些成本占淨營收的比重進一步降低。

So I don't know, Dave, if you have anything to add to that. But I mean I would say we believe Q1 with a lot of confidence in our ability to manage those costs and to find ways to drive improvement around margins.

所以我不確定 Dave 是否要補充。但我的意思是，我們對第一季以及我們管理這些成本、並找出提升利潤率的方法的能力，抱持很高的信心。

Yeah. I'd just supplement that with a couple of things maybe to highlight where we're going to see some of this pressure coming through on those headwinds that we've cited. And we experienced a little bit inside the first quarter. So those are legitimate headwinds that we're seeing.

是的。我再補充幾點，或許可以強調我們提到的那些逆風，壓力會從哪些地方逐步反映出來。而我們在第一季內也已經感受到一些。所以這些確實是我們正在面對的、合理的逆風。

Re establishing the bonus is a big one that will start to show up in the second quarter, and you'll really start to see that more significant in the third quarter. So you'll see a little bit of pressure really more of a return to normal on that SWB line as a result of that. The provider’s tax pressure that we'll see will pop up in our other expenses, and that's a net new item for us.

重新設立獎金是一個很大的因素，會從第二季開始反映出來，而在第三季你會更明顯看到其影響。因此，SWB 那一行會出現一些壓力，基本上更像是回到正常水準。我們將面臨的提供者稅（provider’s tax）壓力，會反映在其他費用中，這對我們而言是全新的項目。

I think historically, that number has been around $200 million for the year. That number will be a little bit elevated this year as we overcome those new -- those new pressures that we've talked about before. Offsetting all of that is exactly what Eric was talking about and what we alluded to in our fourth quarter call as we adjust to the payer mix that we've talked about, cost containment is the other way that we're doing that in a strong partnership.

我想歷史上，那個數字全年大約在 2 億美元左右。今年這個數字會略高一些，因為我們要消化先前談到的那些新——那些新的壓力。而抵銷這些影響的，正如 Eric 所說、以及我們在第四季電話會議中提到的：當我們因應先前談到的付款方組合（payer mix）調整時，成本控管是我們在強力合作關係下採取的另一種方式。

That's what we're really excited about the early work that Justin has done. That we'll see kind of across the board supplies G&A and SWB improvement accelerating more in the second half of the year.

這也是我們對 Justin 早期所做的工作感到非常興奮的原因。我們預期在今年下半年，耗材、G&A 與 SWB 的改善會在各方面加速。

Matthew Gillmor, KeyBanc Capital Markets Inc.

Matthew Gillmor，KeyBanc Capital Markets Inc.

Hey, thanks for the question. I appreciate the comments on the three markets showing some recovery. I just wanted to see if there's any additional details to share, especially with respect to some of the payer mix dynamics that you called out last quarter.

嗨，謝謝讓我提問。我很感謝你提到那三個市場出現一些復甦。我想看看是否能分享更多細節，特別是關於你們上季提到的一些付款方組合（payer mix）變化。

Yeah. Thanks for the question, Matt. And Justin has actually been on the ground a lot as have I in those markets. What I would say is, look, the pressures have moderated, although there are certainly -- it sounds like we've bounced back completely. We've talked about a little bit.

是的。謝謝你的問題，Matt。其實 Justin 和我都經常在那些市場第一線走訪。我會說，壓力已經趨緩，雖然當然——聽起來好像我們已經完全反彈，但我們之前也稍微談過。我們確實有提到一些。

We've got new leadership teams in those markets. We've also got a just -- we've had a lot of time to sit down with our physician partners and focus on the fact that despite all their hard work and growth efforts, they didn't necessarily see it flow through.

我們在那些市場有新的領導團隊。另外，我們也——我們花了很多時間與醫師合作夥伴坐下來，聚焦在一點：儘管他們非常努力、也推動成長，但他們不一定看到成果反映到最終表現上。

And so the focus on really, really coordinating closer and tighter to make sure we're competing appropriately for each and every commercial patient to maintain and grow that market share has been there. We've also done a lot of work around just timing of physician transitions, and that continues to be a focus area for us. I would say pretty pleased with the first quarter.

因此，我們的重點是更緊密、更嚴密地協同，確保我們在每一位商業保險病患（commercial patient）上都能適當競爭，以維持並擴大市占率。我們也在醫師轉換時點（transition timing）方面做了很多工作，而這仍然是我們的重點領域。我會說，我們對第一季的表現相當滿意。

Those three markets are in line with where we expected them to be making progress. And again, I will reiterate, while those three markets had pressure, they are really great markets for us overall. They continue to have really strong payer mix in general, despite the pressure.

那三個市場的進展符合我們的預期。而且我再重申一次，雖然那三個市場曾承受壓力，但整體而言它們對我們來說都是非常好的市場。儘管有壓力，它們整體仍維持非常強勁的付款方組合。

They also have really, really strong market positions. But yes, no, it's encouraging to see those get back online. Obviously, the fourth quarter was an unexpected kind of challenge in those three markets, and we're excited to kind of see the early progress.

它們也擁有非常、非常強的市場地位。所以，是的，看到它們重新回到正軌是令人鼓舞的。顯然，第四季在那三個市場出現了意料之外的挑戰，而我們也很期待看到早期的進展。

Great. And then following up on the comment you made about surgical robots and the contribution to total joints. Can you maybe just sort of paint the picture in terms of the growth in surgical robots over the past maybe a year or two? And how many you think you can add to the portfolio over the next couple of years?

很好。接著追問你提到手術機器人以及其對全膝／全髖關節（total joints）的貢獻。你能否大致描繪一下，過去大概一到兩年手術機器人的成長情況？以及你認為未來幾年你們的組合中還能新增多少台？

Yeah. Great question. I mean surgical robots really over the last four or five years have been an unlock for us and largely with physicians that might have already been partners are using our facility. And we did not feel comfortable bringing those higher acuity cases until they had the matching technology.

是的。好問題。我的意思是，手術機器人在過去四、五年確實為我們帶來突破，主要是那些可能原本就已是合作夥伴、也在使用我們設施的醫師。在他們具備相匹配的技術之前，我們並不覺得適合引進那些更高病情複雜度（higher acuity）的病例。

We continue to see technology in general robotics, whether it be orthopedic robots in some cases, some of the new soft tissue robots that are coming out. The ability for us to make it easy for physicians to move patients safely and have the same level of technology they get in the traditional acute care setting has been a big unlock.

我們持續看到整體技術、尤其是機器人領域的發展——不論是某些情況下的骨科機器人，或是一些新推出的軟組織手術機器人。對我們而言，能讓醫師更容易把病患安全地轉移過來，並提供與傳統急性照護環境相同等級的技術，是一個很大的突破。

And we still see opportunity there. Again, roughly 70% of our total facilities have the ability to do MSK. And a lot of those over time have added robots. We still have a ways to go there. I mean you see that even -- we're still seeing strong double-digit growth in total joints. I don't see that changing in the near future. There's still a lot of cases to transition.

我們在那裡仍然看到機會。再說一次，我們大約 70% 的總設施具備進行 MSK（肌肉骨骼）業務的能力。而且其中很多設施隨著時間推移也新增了機器人設備。我們在這方面還有一段路要走。我的意思是，你也看到——我們的全關節置換仍然維持強勁的兩位數成長。我不認為短期內會有改變。仍然有很多病例需要轉換。

When you think about -- we talked a little bit in the opening comments about our de novo pipeline, again, very, very MSK heavy. I think you can expect to see robotic expansion there as well. So we think we're in the early innings. Over the last several years, I mean, we've added double-digit robots on average most every year, continue to find opportunities for that.

當你想到——我們在開場評論中也稍微談到我們的 de novo（新設）管線，同樣是非常、非常偏重 MSK。我想你也可以預期那裡會有機器人擴張。所以我們認為我們還在早期階段。過去幾年，我的意思是，我們幾乎每年平均都新增兩位數的機器人設備，並持續找到相關機會。

And in some cases, as we're out recruiting, one of the things we have to be very focused on is how do we match up technology and capacity in a way that's attracted to physicians. And I think our team does that very, very well.

而在某些情況下，當我們在外招募時，我們必須非常專注的一件事是：如何以能吸引醫師的方式，將技術與產能做出匹配。我認為我們的團隊在這方面做得非常、非常好。

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，RBC Capital Markets。

Great. Thank you very much. I just wanted to talk a little bit about the lower acuity deferrals weather-related that you saw in the first quarter, just how you're thinking about those getting back on the schedule. Should we expect some skewness in the second quarter in terms of the case growth versus rate balance? And how do you expect that mix to kind of track through the rest of the year?

很好。非常感謝。我想稍微談一下你們第一季看到的、與天氣相關的低急性（低嚴重度）延後案件，你們如何看待這些案件回到排程上。我們是否應該預期第二季在病例量成長與費率平衡之間會有一些偏斜？以及你們預期這個組合在今年剩餘時間會如何走？

Hey, Ben. Thanks for the question. So as far as the weather-related deferrals, obviously, I think you've heard all of our peers and everyone talk about January and February, certainly had some weather where it hit us tended to be in markets where we had a lot of kind of high volume, lower acuity procedures, think GI and eyes. About -- Dave mentioned in the script, about 40 basis points of impact on our growth.

嗨，Ben。謝謝你的問題。就天氣相關的延後而言，顯然我想你已經聽到我們所有同業以及大家都在談一月和二月；確實有一些天氣因素影響到我們，而且往往發生在我們有大量高量、低急性手術的市場，像是腸胃科（GI）和眼科。大約——Dave 在講稿裡提到，對我們成長的影響約 40 個基點。

So instead of 60 basis points, we would have been at 1%, still not where we expect to be long term. As far as getting those cases back, some of them will probably come back over the course of the year. The reality of it is when you lose those cases for weather, you lose a day, it's hard. A lot of those really busy facilities.

所以如果不是 60 個基點，我們本來會是 1%，但仍然不是我們長期預期的水準。至於把那些病例排回來，其中一些可能會在今年的過程中回來。但現實是，因天氣而少了那些病例、少了一天，這很難補回來。因為很多都是非常忙碌的設施。

They're full most of the time. And so yes, we'll capture some of that, but I wouldn't think it's going to lead to any kind of real skewing. The good news is we've seen really strong growth within high acuity. So I don't know, Dave, if you would add anything to that.

它們大多數時間都是滿載的。所以是的，我們會回收其中一部分，但我不認為這會導致任何實質的偏斜。好消息是，我們在高急性業務方面看到非常強勁的成長。所以我不知道，Dave，你是否要補充什麼。

Yeah. Maybe just one thing, just a reminder on the calculation for same-store rate, particularly on a business that has high-acuity business and lower acuity business. And it's not a return of those cases, but a return to normalcy sequentially between the first quarter and second quarter, we'll put a little bit of pressure on that rate just sequentially, if you're looking at net revenue per case.

是的。也許補充一點：提醒一下同店費率（same-store rate）的計算方式，特別是對於同時有高急性與低急性業務的企業。這不是那些病例回流，而是第一季到第二季按季回到常態，若你看的是每例淨營收（net revenue per case），會在按季比較上對該費率造成一些壓力。

And just to follow up. We're getting some incomings on the cash flow from operations print. Just any more detail you can provide on the working capital dynamics you're expecting? And how should we about timing of cash flow realization through the year?

再追問一下。我們收到一些關於營運現金流（cash flow from operations）數字的詢問。你們能否提供更多關於你們預期的營運資金（working capital）動態的細節？以及我們應該如何看待今年現金流實現的時間點？

I'll let Dave dive into the details. I'd just say high level on free cash flow, we're very, very focused on driving improvement there. First quarter was an improvement over last year. We -- this business produces a lot of cash. We've got to make sure we continue to convert that and grow with our business along the way we see lots of opportunities in working capital.

我讓 Dave 來深入說明細節。我只想在高層次上說，自由現金流（free cash flow）方面，我們非常、非常專注於推動改善。第一季較去年有所改善。我們——這個業務能產生大量現金。我們必須確保持續把它轉化出來，並隨著業務成長而同步提升；我們在營運資金方面看到很多機會。

I'll let Dave talk about a few of those that he's working on this year.

我讓 Dave 談談他今年正在推動的其中幾項。

Yeah. So first off, just dissecting the first quarter cash flow from operations. We did have some benefit from working capital relatively marginal. I'll talk about that in just a quick second. But other factors that you can kind of look at lower below-the-line spend year-over-year as that number comes back down as we've been guiding to more in line with long-term historical perspective.

好的。首先，拆解第一季的營運現金流。我們確實從營運資金得到一些好處，但相對而言幅度不大。我很快會提一下。但你也可以看到其他因素，例如年對年較低的線下支出（below-the-line spend），因為該數字如我們所指引的，回落到更符合長期歷史水準的區間。

And interest cost is interesting. There's two components of our corporate debt. As you might recall, last year, we did refinance our term loan and the revolver, bringing that down to very good interest rates of SOFR plus 250 basis points. That generated a net positive for us in the quarter of about $9 million.

而利息成本也很有意思。我們公司債務有兩個組成部分。如你可能記得，去年我們為定期貸款與循環信貸（revolver）進行再融資，把利率降到非常好的水準：SOFR 加 250 個基點。這在本季為我們帶來約 900 萬美元的淨正面影響。

However, in the quarter, that was offset by pressure from unwinding the last quarter's benefit of the interest rate swap that we had last year and then marginally higher debt that we hold related to our refinancing of last year. So working capital, we will now kind of overcome that. Starting in the second quarter, you won't see that interest pressure from the interest rate swap termination.

不過在本季，這被一些壓力所抵銷：包括去年我們持有的利率交換（interest rate swap）在上一季帶來的好處於本季回沖（unwinding），以及與去年再融資相關、我們持有的債務略為增加。所以營運資金方面，我們接下來會逐步克服這些。從第二季開始，你就不會再看到因終止利率交換而產生的利息壓力。

So that unlock should start to happen there. On a working capital basis, again, something I'm super excited about working with Justin and his team on is embedding greater working capital discipline at the facility level. Our days’ sales outstanding was 66 days in the quarter. That's the same as it was in the fourth quarter.

因此那個釋放（unlock）應該會從那時開始出現。在營運資金方面，我非常期待與 Justin 及其團隊合作的一件事，是在設施層級嵌入更強的營運資金紀律。我們本季的應收帳款週轉天數（DSO）是 66 天。這與第四季相同。

We need to make that better as we progress throughout the course of the year, and we've got plans in place. That's the single largest lever that we have at the facility level in order to unlock that cash flow. Our physician partners are aligned with that because they get better distributions when that happens. So we do expect that, that unlock should happen over the course of the year.

我們需要在今年的進程中把它做得更好，而且我們已經有計畫。這是在設施層級、用來釋放現金流的最大單一槓桿。我們的醫師合作夥伴也與此目標一致，因為當這發生時，他們會獲得更好的分配（distributions）。所以我們確實預期，這個釋放會在今年的過程中逐步發生。

Whit Mayo, Leerink Partners LLC.

Whit Mayo，Leerink Partners LLC。

Hey, thanks. I may have missed this, but how much were the provider taxes in the quarter, both revenue and other operating expenses?

嗨，謝謝。我可能漏聽了，但本季的提供者稅（provider taxes）是多少，分別在營收與其他營運費用上？

Yeah. Thanks for the question. Yeah. So as a reminder for the large group, we did talk about new headwinds that we're facing this year that fall into kind of two categories. In one state, the -- pretty much the only state where we have any exposure to Medicaid that was in across the Board, 4% rate reduction that started to impact us in the fourth quarter of last year and did impact this year.

是的。謝謝你的問題。是的。提醒一下各位，我們確實談到今年面臨的新逆風，大致分成兩類。在某一個州——基本上也是我們唯一有 Medicaid（醫療補助）曝險的州——全州實施 4% 的費率下調，從去年第四季開始影響我們，今年也持續影響。

That had a very small impact on revenue, almost inconsequential, but of course, that flows all the way down to the bottom line. And we also had provider taxes introduced in two new states, for which we have virtually no Medicaid business just for the fact that we carry the title hospital in those two markets.

那對營收的影響非常小，幾乎可忽略，但當然會一路反映到最終損益。另外，我們在兩個新州被引入提供者稅；在那兩個市場我們幾乎沒有 Medicaid 業務，原因只是我們在那兩個市場掛的是醫院（hospital）的名義。

The combined pressure on the adjusted earnings line for those two things is estimated to be around $8 million for the full year, a little bit more front loaded because of that Medicaid rate pressure only affects three quarters of the year. So we're a little bit more than 25% of that number impacting our results, split between revenue and other operating expenses.

這兩項因素對調整後盈餘線的合併壓力，估計全年約為800萬美元；由於Medicaid費率壓力只影響全年中的三個季度，因此影響會稍微偏向前期。因此，對我們業績的影響略高於該數字的25%，並在營收與其他營運費用之間分攤。

Okay. So divide it by four, so more than two in the quarter year-over-year was the pressure...

好的。所以除以四，也就是說按年比較，單季的壓力超過200萬美元……

Yeah. Okay. And my other question is just around like what we're seeing with a lot of the payers that continue to push this campaign around prior authorization. And I'm just wondering if you're seeing any changes with the plan's behavior? And then just also any comments you have around CMS' prior of demo with the Wiser model, whether or not that's having any impact one way or the other.

對。好的。我另一個問題是，關於我們看到許多支付方持續推動這項「事前授權」的行動。我想請問你們是否看到保險計畫行為有任何改變？另外也想請你們評論一下CMS以Wiser模型進行的事前授權示範計畫，是否在任何方面帶來影響。

Yeah. Thanks, Whit. Appreciate the question. Look, we are certainly all on board and in favor of all the work the payers are talking about when all of the prior authorizations. We do see in markets one of the great things about our model is we are aligned with payers and saving the system money.

是的。謝謝你，Whit。感謝這個問題。你看，我們當然都支持、也贊成支付方在事前授權方面所談到的各項工作。我們確實在市場上看到一些情況；而我們模式的一大優勢是，我們與支付方目標一致，能為整個體系節省成本。

So this idea of payers making it harder to get approval in the wrong setting of care is a great thing for us. We obviously fully supportive this push to reduce prior authorization burden going back to that 66 DSO days and all the other complexities we face, obviously, would be a welcome headwind -- or a welcome tailwind for cash flow.

因此，支付方讓在不適當的照護場域取得核准變得更困難，這個方向對我們非常有利。我們顯然完全支持這股降低事前授權負擔的推動，回到先前提到的66天DSO以及我們面臨的其他複雜性；這些若能改善，對現金流而言將是令人樂見的順風。

So we do see payers making real efforts there, and I do think that benefits our business moving forward just because of our cost position. With regard to the Wiser program, that has gone in place the Medicare demo. We have seen -- early on, there were some learnings there just to make sure, as you know, it add some more administrative, unfortunately, work on our side. But we feel like we're through understanding the program.

所以我們確實看到支付方在這方面做出實質努力，我也認為這會因為我們的成本定位而在未來有利於我們的業務。至於Wiser計畫，它已在Medicare示範中上路。我們看到——在初期確實有一些需要學習之處，以確保如你所知，它不幸地在我們這邊增加了一些行政作業。但我們覺得我們已經理解並掌握這個計畫。

We don't see any material impact. And we understand the goals of that program, which, again, I want to make sure patients are getting the care they need the right care in the right place. All of those efforts align perfectly with our mission, which is really to provide high-value care at the right setting, right care, right place, right price.

我們沒有看到任何重大影響。我們也理解該計畫的目標；也就是再次強調，要確保病人獲得他們需要的照護、在正確的地方接受正確的照護。所有這些努力都與我們的使命完全一致，也就是在正確的照護場域提供高價值照護：正確的照護、正確的地點、正確的價格。

And so we think those are going to be long-term tailwinds. We haven't seen tremendous impact there yet, although there are certainly markets where we are hearing that it's harder for physicians to get their patients into a hospital when there's an ASC option, and that's great.

因此我們認為這些將是長期的順風。我們目前還沒有看到非常顯著的影響，不過確實在某些市場，我們聽到當有ASC（門診手術中心）選項時，醫師要把病人送進醫院變得更困難，而這很好。

Joanna Gajuk, Bofa.

Joanna Gajuk，Bofa。

Hi, good morning. Thanks for taking the question. So can you give us an update on the portfolio optimization and selling or, I guess, reducing exposure to your surgical hospitals?

嗨，早安。謝謝讓我提問。你們能否更新一下投資組合優化的進度，以及出售——或我想是降低你們對外科醫院曝險的情況？

Sure, Joanna. Thanks for the question. Obviously, it's something we've talked about for last several quarters is portfolio optimization. We remain committed to reviewing those opportunities within our portfolio to do several things. I just want to remind everyone what we're looking to accomplish with this. One is to make -- to actually de lever faster, so finding a way to help us delever improving free cash flow conversion.

當然可以，Joanna。謝謝你的問題。很明顯，投資組合優化是我們過去幾個季度一直在談的事情。我們仍致力於檢視投資組合中的這些機會，以達成幾件事。我想提醒大家我們希望透過這件事達成什麼。第一，是讓我們能更快去槓桿化（delever），也就是找到方法協助我們去槓桿，提升自由現金流轉換率。

Some of those places are a little bit more capital intensive than our core business. The third is really to improve our growth rate going forward. And then lastly, just simplify the business to our core short-stay strategy. So we do see opportunities there. It has been -- as you bring up here, the timing of this, it's been hard to predict.

其中有些據點相較於我們的核心業務更偏資本密集。第三，是在未來提升我們的成長率。最後，是把業務簡化並聚焦在我們核心的短住院策略。因此我們確實看到機會。正如你提到的，時點方面一直——很難預測。

We do have a large market, we mentioned in my comments earlier that we are in the final stages of, we are still targeting midyear. But I'd be clear on that, that we're going to be very disciplined on making sure these are good assets, making sure we get the right value while we're committed to portfolio optimization. We want to do it in a way that's accretive to shareholders and make sure we accomplish those things that I talked about earlier.

我們有一個大型市場——我在先前的評論中提到——目前已進入最後階段，我們仍以年中為目標。但我也要說清楚，我們會非常自律，確保這些是優質資產、確保取得合理價值；雖然我們致力於投資組合優化，但我們希望以能為股東帶來增益（accretive）的方式來進行，並確保達成我剛才提到的那些目標。

So, there's one market that's in the very advanced stages there. We're targeting midyear. We'll see. Obviously, nothing is done until it's signed. And then there are a couple of other markets that we're going to be exploring, and we'll give you the right -- we'll give you the updates as those are appropriate.

所以，有一個市場在那方面已進入非常後期的階段。我們以年中為目標。我們再看看。顯然，在簽署之前一切都還不算完成。另外還有幾個市場我們會去探索，並在適當時機向各位提供更新。

And I guess with that, if I can, any update on your Investor Day that you were planning? I guess, is it still in the works? So are you waiting to complete more of these before you have this meeting?

另外如果可以的話，關於你們原本規劃的投資人日（Investor Day）有沒有更新？我想問，是否仍在規劃中？你們是否在等完成更多這類交易後才舉辦這場會議？

Yeah. No, we're definitely still committed to doing an Investor Day. As we've said before, we are tying that to having something meaningful done within our portfolio optimization. We do plan to do that later this year. And so we're staying very closely tied to that timing. And as we have something to update you on there, we'll obviously do it quickly.

是的。不，我們絕對仍承諾會舉辦投資人日。如同我們之前說過的，我們會把它與投資組合優化中完成一件有意義的事項連結在一起。我們計畫在今年稍晚舉辦。因此我們會與該時程保持非常緊密的連動。一旦有可更新的內容，我們當然會很快對外說明。

Andrew Mok, Barclays.

Andrew Mok，Barclays。

Good morning. This is Thomas Walsh on for Andrew. You shared some of the deliberate actions taken to address payer mix pressures from the back half of 2025. How did commercial mix come in, in the quarter? And could you comment more broadly on the view of the strength of the consumer wallet and employment trends in your markets?

早安。我是代替Andrew的Thomas Walsh。你們分享了一些為因應2025年下半年支付方組合壓力而採取的審慎措施。本季商業保險占比表現如何？另外，能否更廣泛地談談你們市場中消費者荷包力道與就業趨勢的看法？

Sure. So commercial came in about 50% for the first quarter, which was -- had a little pressure. If you look at sequentially, and we always have a little bit of pressure. Obviously, our population is aging. We've got to take commercial market share to stay even. But I feel pretty good about the moderation of that. We are seeing some -- again, some improvement signs there.

當然。第一季商業保險約占50%，這——有一些壓力。如果看季比，我們一向會有些許壓力。顯然，我們的服務族群正在老化。我們必須取得商業保險的市占才能維持持平。但我對這種壓力的趨緩感覺還不錯。我們確實看到一些——再次強調——改善的跡象。

It was not nearly the same pressure we saw in the fourth quarter but also did not totally abate. So we're very, very focused on that. I think from your question around just the consumer wallet, it's interesting, the pressure we saw in cases in the first quarter relative to kind of lower acuity, higher volume rates was mainly around weather.

這並不像第四季看到的壓力那麼大，但也沒有完全消失。因此我們非常、非常專注在這件事上。至於你問到消費者荷包的問題，這很有意思：我們第一季在病例量上看到的壓力，相較於那種低病情嚴重度、高量的比率，主要是與天氣有關。

I think it's a little early to say. I mean the economy still seems to be holding up relatively well. I'm not ready to say that we're seeing consumers make different decisions. But again, one of the hardest things in health care is to determine why patients don't walk into your doors. But we feel good about the start year for growth.

我覺得現在下結論還有點早。我的意思是，整體經濟看起來仍維持得相對不錯。我還不準備說我們看到消費者做出不同的決策。但再說一次，醫療照護中最難的一件事之一，就是判斷為什麼病人沒有走進你的大門。不過我們對今年成長的開局感到樂觀。

When it comes to -- I think you're kind of alluding to some of the pressure, too, that's been on exchange -- the exchanges and kind of patients transitions there. We've mentioned before because of the nature of our business. We don't really have ERs. It's purely elective. We have not historically in most markets, seen a lot of those HIX patients.

談到——我想你也多少在暗示一些壓力，這些壓力一直在交易所——也就是交易所端，以及那邊病患轉換的情況。我們之前提過，因為我們業務的性質。我們其實沒有急診室（ER）。完全是選擇性（非急迫）的。在大多數市場，我們過去並沒有看到很多這類 HIX 病患。

And so we haven't really felt a material pressure there, but we continue to watch that. The good news is we're not exposed to kind of payer mix weakening. The only thing that we would have to watch closely is there some kind of dampening or postponing of procedures. And I think it's too early to say we've seen any of that. We continue to believe have great confidence in our outlook for cases this year, which admittedly is a bit below our kind of long-term algorithm of 2% to 3%.

所以我們在那方面並沒有真正感受到實質性的壓力，但我們會持續觀察。好消息是，我們並未暴露在付款方組合（payer mix）走弱的風險之下。我們唯一需要密切留意的是，是否會出現某種手術量被抑制或延後的情況。而我認為現在說我們已經看到任何這種情況還太早。我們仍然相信，並對今年的病例量展望非常有信心；坦白說，這確實略低於我們長期 2% 到 3% 的既定成長算法（algorithm）。

And following up, you provided second quarter revenue and EBITDA outlook, that appears slightly below your normal revenue seasonality and some below consensus estimates. Are there any timing elements in the second quarter to consider or for the remaining of the year?

接著追問，你們提供了第二季營收與 EBITDA 的展望，看起來略低於你們一般的營收季節性水準，也低於部分市場一致預期。第二季是否有任何時點因素需要考量，或是對今年剩餘期間有什麼影響？

Yeah. Thanks for the question. I mean there's always some timing elements. I would say -- let me start off by saying we were very confident in our full year’s guidance. The second quarter guide is just a prudent guide from where we sit today. We feel it's -- actually, if you look at the longer-term seasonality, it's relatively in line with what we've said historically.

是的。謝謝你的問題。我的意思是，時點因素總是會有一些。我想——先說，我們對全年指引非常有信心。第二季的指引只是基於我們目前所處位置所做的審慎指引。我們覺得——其實如果你看更長期的季節性，它相對符合我們過去一貫的說法。

Certainly, we're entering Q2 with confidence in how the business is progressing this year. We feel good about our ability to meet or exceed our outlook. And I think you should just say that -- I should say it's early in the year. It's a prudent guidance for Q2. I don't know, Dave, if you would add anything.

當然，我們帶著信心進入第二季，因為今年業務進展良好。我們對達成或超越展望的能力感到樂觀。而我想你應該也要理解——我應該說，現在仍是年初。這是對第二季的審慎指引。我不知道，Dave，你是否要補充？

Yeah. Perhaps just a point of emphasis when you're doing a comparison year-over-year. In the second quarter of last year, we -- I'm sorry, in the third quarter of last year, we announced one of our initial portfolio optimization efforts that took a surgical hospital from a consolidated position down to a deconsolidated position.

是的。也許只是強調一點，當你做年對年比較時。去年第二季我們——抱歉，是去年第三季，我們宣布了初期的投資組合最佳化（portfolio optimization）措施之一，將一家外科醫院從合併報表（consolidated）狀態調整為不再合併（deconsolidated）狀態。

So that revenue would have been in the second quarter last year, not in the revenue for this year. Any other factor that's going to affect your year-over-year performance inside the second quarter are those headwinds that we've highlighted in our financial supplement.

因此，那部分營收會出現在去年第二季，但今年的營收中就不會包含。另外，任何會影響你第二季年對年表現的因素，就是我們在財務補充資料中已強調的那些逆風。

Sarah James, Cantor Fitzgerald.

Sarah James，Cantor Fitzgerald。

Thanks. I want to continue that topic a little bit more. Can you help us bridge the first half to the second half, the EBITDA ramp there? How much of that depends on payer mix recovery versus your cost actions?

謝謝。我想把這個主題再延伸一點。你們能否協助我們把上半年到下半年的 EBITDA 提升（ramp）做個銜接說明？其中有多少取決於付款方組合的回升，多少取決於你們的成本措施？

Yeah. Thanks for the question, Sarah. I think look, if you want to -- if you're thinking about bridging the first half performance second half performance, we are not -- there's nothing embedded in there that's some dramatic improvement in our payer mix.

好的。謝謝你的問題，Sarah。我想，若你要——如果你在思考如何銜接上半年表現與下半年表現，我們並沒有——裡面沒有任何假設付款方組合會出現戲劇性的改善。

So we do have -- again, we're seeing moderation so that is contemplated, but it's -- the second half does not depend on that. From a cost standpoint, we're always working on ways to more efficiently run the business. We do expect to continue to drive improvement on that throughout the year.

所以我們確實有——再次強調，我們看到的是趨勢趨緩（moderation），這已納入考量，但——下半年並不依賴這件事。在成本方面，我們一直在尋找更有效率營運的方法。我們確實預期全年會持續推動這方面的改善。

But I think what I would say is from a seasonal adjustment standpoint that this is a relatively normal spread. And we feel really confident in our ability to deliver not only on Q2, but on the full year.

但我想我會說，從季節性調整的角度來看，這是一個相對正常的差距。而且我們對不僅能達成第二季、也能達成全年目標非常有信心。

Maybe if I just add just to that fair -- for your benefit. As a reminder, I mentioned this a little bit earlier on the call, but some of those headwinds that we've noted are more front-end loaded and the biggest one being that Medicaid cut, which will not affect our year-over-year performance in the fourth quarter.

也許我再補充一點，供你參考。提醒一下，我在電話會議稍早有提到一些我們指出的逆風較偏向前期集中（front-end loaded），其中最大的一項是 Medicaid 的削減，而這在第四季不會影響我們的年對年表現。

And the other thing is -- the other two things, Eric did mention the focus on cost containment in the industry as those pick up, and we kind of mature into those, those will have an impact inside the second half of the year. And then finally, that portfolio optimization work that we talked about a little bit earlier in my last question, the increase that comes from an earnings perspective, as we talked about last year, is mostly back half of the year weighted.

另外還有——另外兩件事，Eric 確實提到產業對成本控管的關注；隨著這些措施逐步加強、我們也逐步成熟到位，它們會在下半年帶來影響。最後，我們稍早在我上一個問題中提到的投資組合最佳化工作，從獲利角度帶來的提升，如同我們去年所說，主要是偏向下半年（back half）加權。

So those are the key components that would drive better performance in the second half of the year, all relatively marginal. But when you add them together, that's how you get north of 50% of the earnings in the second half of the year, which is normally the case. It's normal, yes.

所以，這些是推動下半年表現更好的關鍵組成，單項影響都相對有限。但把它們加總起來，就能解釋為什麼下半年會貢獻超過 50% 的獲利——這通常就是如此。是的，這很正常。

A.J. Rice, UBS.

A.J. Rice，UBS。

First question around the deal activity, you did $4 million in the quarter, you're saying you're still reiterating the $200 million spend. That's been an area of volatility the last two years, two years ago above expectations last year, well below. Can you comment on visibility on that deal spend, what the pipeline looks like, what the competitive landscape looks like?

第一個問題關於交易活動（deal activity），你們本季做了 400 萬美元，但你們仍重申 2 億美元的投入（spend）。這在過去兩年是波動較大的領域：兩年前高於預期，去年則遠低於預期。你能否談談這筆交易投入的能見度、案源管線（pipeline）看起來如何、競爭態勢如何？

Sure, A.J. And it's a great question. Actually, the point you're bringing up is exactly why we don't have it in guidance this year, right? I think we've struggled the last several years with kind of over and under and the timing of M&A is fickle. We'll say, look, we feel good about our pipeline.

當然可以，A.J.，這是個很好的問題。其實你提出的點，正是我們今年沒有把它納入指引的原因，對吧？我想過去幾年我們在高估與低估之間掙扎，而併購（M&A）的時點確實很難捉摸（fickle）。我們會說，整體來看，我們對案源管線感覺良好。

We continue to see new things coming in. And certainly, it's a very fragmented industry. So big picture that $200 annual number is one that we are continuing to talk about long term. Obviously, off to a little bit of a modest start this year, but we do feel good about the pipeline. It's always a little bit fickle. I would remind everyone that anything we do on the M&A pipeline is pure upside to guidance.

我們持續看到新的案子進來。而且，這確實是一個高度分散的產業。所以從大方向來看，每年 2 億美元這個數字，是我們長期仍持續在談的目標。顯然，今年開局稍微保守一些，但我們確實對管線有信心。只是時點總是有點難以捉摸。我也要提醒大家，我們在併購管線上做的任何事情，對指引而言都是純粹的上行空間（pure upside）。

And so we do -- look, I expect we're going to make progress. I think last year, we ended up finishing not too far off A.J. I think we had up spending about $180 million had some great deals. We finished up with a big one in the fourth quarter. it was back-end weighted, obviously. And this year, it looks like we're going to end up being a little back-end weighted to given the first quarter.

所以我們確實——你看，我預期我們會有所進展。我想去年我們最後的結果離目標不算太遠，A.J.；我記得我們投入大約 1.8 億美元，做了一些很棒的交易。我們在第四季完成了一筆大的交易；顯然是偏向後段加權（back-end weighted）。而今年，考量第一季的情況，看起來我們最後也會比較偏向後段加權。

But look, I would say we're were the last kind of only stand-alone short-stay surgical operator. We're well positioned in the market that need -- that is going to continue to consolidate. We think we're well positioned to be one of those consolidators. And so like I don't -- long term, nothing's changed, but the timing is fickle and admittedly, it's been a slow start.

但你看，我會說我們是最後一家、算是唯一的獨立短期住院外科營運商（stand-alone short-stay surgical operator）。我們在一個將持續整併（consolidate）的市場中具備良好定位。我們認為自己很有條件成為其中的整併者之一（consolidator）。所以，長期來看，我不——沒有任何改變；只是時點難以捉摸，而且坦白說，今年起步確實偏慢。

Okay. The other thing I was going to ask you about, you mentioned that you recruited roughly 140 physicians in the quarter. I usually think of the heavy recruiting periods more in the second half of the year, the back half of the year, but maybe not in your case.

好的。我還想再問你另一件事，你提到本季大約招募了140位醫師。我通常會把招募高峰期視為在下半年、也就是年後半段，但也許你們的情況不是這樣。

But just give us a perspective on that. Is that sort of normal course? Or are you -- is that a step up? And anything to call out on where their focus is in terms of any kind of surgical specialty or anything?

不過請給我們一些觀點。這算是正常節奏嗎？還是你們——這是加速了？另外，他們的重點是否集中在某些外科專科或其他領域，有沒有什麼值得特別指出的？

Yeah. Great question. I would say the 140 is kind of -- is basically in line with where we would expect in the first quarter. You're right, we are back-end loaded when it comes to recruitment. That's always the case. And so our physicians that we recruited in August through December of last year, obviously contributing into this year, that will be where you'll see that number raised in the back part of the year.

是的。好問題。我會說這140位大致——基本上符合我們對第一季的預期。你說得對，我們在招募方面通常是後段加重。一直都是如此。因此，我們在去年8月到12月招募的醫師，顯然會在今年持續貢獻；你會在年後半段看到那個數字上升。

Very focused still on MSK. We spend a lot of time on those higher acuity services and so the team is focused on driving growth there. I would say as a kind of a positive of those 140 doctors this year, they are, by doctor, higher net revenue in total than last year's recruiting class. So again, we very much closely watch kind of that performance.

仍然非常聚焦在MSK（肌肉骨骼）。我們在那些更高急重症（higher acuity）的服務上投入很多時間，因此團隊的重點是推動那裡的成長。我會說，今年這140位醫師的一個正面之處是：以單一醫師來看，他們帶來的總淨營收高於去年的招募班底。所以我們確實會非常密切地追蹤這類表現。

And we've got a very targeted list we're going after. The good news is with technology and with the inpatient only list coming off, that eligible list of proceduralists who can bring all their cases continues to grow. We continue to stay focused on going after the right docs. But definitely back-end loaded, I feel good about the early start.

而且我們有一份非常精準的目標名單正在追蹤。好消息是，隨著科技進步以及「僅住院（inpatient only）」清單取消，符合資格、能把所有病例都帶進來的手術醫師名單持續擴大。我們會持續專注於鎖定正確的醫師。但確實是後段加重；我對於早期就有良好起步感到很有信心。

William Spivack, TD Cowen.

William Spivack，TD Cowen。

Hey, guys. Thanks for taking my question. Can you just talk about your expectations for the split between case growth and revenue per case growth as the year progresses?

嗨，各位。謝謝讓我提問。你們能談談隨著今年推進，你們對「病例量成長」與「每例營收成長」之間分拆的預期嗎？

Yeah. Thanks, William, for the question. So what we have implied in our guidance for the year continues to be approximately 3-plus percent same facility revenue growth, which is how we prefer to look at this. As you saw in the first quarter, we had just under 1% same-facility case growth. I think you'll skew more positively on the rate side as the year progresses.

好的。謝謝你，William，這個問題。我們在全年指引中所隱含的，仍大約是3%以上的同院（same facility）營收成長，這也是我們偏好用來觀察的方式。如你在第一季看到的，我們同院病例量成長略低於1%。我認為隨著年度推進，你會看到費率（rate）端的貢獻更偏正向。

Of course, as I mentioned earlier, with the return to normalcy in the second quarter, that may be pressured a little bit. But -- so that -- I would consider that to be normal fluctuations. But you'll roughly get an equal contribution between both of those, perhaps skewing a little bit more towards the rate side.

當然，如我先前提到的，第二季回歸常態可能會帶來一些壓力。但——所以——我會把那視為正常的波動。不過整體而言，兩者的貢獻大致會相當，可能會稍微偏向費率端。

Okay. Just as a follow-up, just to clarify a question from earlier on the other OpEx and provider taxes. So I think you said that was about a $2 million headwind maybe a little bit more to EBITDA in the quarter. So I think other OpEx was up about $15 million. Can you break out how much of that other OpEx increase was the provider tax side so we can kind of back into the revenue as well?

好的。再追問一下，想釐清先前關於其他營業費用（OpEx）與提供者稅（provider taxes）的問題。我想你說本季對EBITDA大約有200萬美元的逆風，可能略多一些。所以我看到其他OpEx大約增加了1,500萬美元。你能拆解一下這個其他OpEx增加中，有多少是提供者稅的部分，讓我們也能大致回推到營收端嗎？

Yeah. So there's a lot of moving parts there because of all the different states and how they flow through. If you think about in total at a gross level, that OpEx expense related to provider taxes is about $11 million, with the biggest part of that being the new states that we've added. But we'll certainly -- we're happy to go through those details.

好的。那裡面有很多變動因素，因為牽涉到不同州以及它們在報表上的流轉方式。如果你從總額（gross）層面來看，與提供者稅相關的OpEx費用大約是1,100萬美元，其中最大的一部分來自我們新增的州。不過我們當然——也很樂意把這些細節再逐一說明。

Then I would also say that other operating expense, if you look at it over time, it does fluctuate quite a bit. This year, though, that change is driven by those provider tax changes, not only in existing states, but importantly and the biggest contributor this year as the new states that added those.

另外我也想說，其他營業費用如果拉長時間來看，確實會有相當大的波動。但今年這個變動是由提供者稅的變化所驅動，不僅是在既有州，且更重要、也是今年最大貢獻來源的是新增那些採行提供者稅的州。

And unfortunately, added those without any Medicaid benefit for us. We're obviously still going to be very active in advocacy on some of those areas. So I don't think those things are necessarily forever, if we can work on them, but that's where that's showing up, and that's roughly the numbers.

而且不幸的是，新增了這些稅，卻沒有帶給我們任何Medicaid（醫療補助）方面的利益。我們顯然仍會在其中一些領域非常積極地進行倡議（advocacy）。所以如果我們能推動改善，我不認為這些狀況一定會永遠如此；但目前就是反映在這裡，數字大致如此。

Yeah. I would say a large majority of that year-over-year increase is related to provider taxes, roughly a little bit less than half of that relates to the new provider taxes associated with those programs from which we get no benefit. The good news is those -- even though there may be a big number on provider or other operating expenses, they are in facilities that we don't have a significant ownership interest in some cases, they're relatively small.

是的。我會說，年對年增加的很大一部分與提供者稅有關；其中大約略低於一半，來自那些我們無法獲得任何利益的計畫所新增的提供者稅。好消息是——即便提供者稅或其他營業費用看起來數字很大——在某些情況下，這些發生在我們持股比例不高的機構，而且規模相對較小。

So that does move down to -- in line with kind of what our long-term growth algorithm, the way I answered with question earlier. So the adjusted earnings piece of that is going to be a little bit lower -- a lot lower, I should say.

因此，這會往下反映到——與我們長期成長演算法一致，也就是我先前回答那個問題時所提到的方式。所以在調整後盈餘（adjusted earnings）層面，影響會稍微小一些——我應該說會小很多。

Bill Sutherland, The Benchmark Company.

Bill Sutherland，The Benchmark Company。

Thank you. Good morning, everybody. Just want to think about the de novos for a second. Can you give us a sense of kind of what's in the pipeline and maybe how they're sort of moving towards consolidation as a group?

謝謝。各位早安。我想先談一下de novos（新設據點）。你能讓我們了解一下目前管線裡大概有哪些，以及它們作為一個群組是如何朝向整合（consolidation）推進的嗎？

Hey, Bill. I appreciate the question. We are excited about the de novo pipeline. We have five expected to open later this year, seven more in the pipeline, and we continue to see interest in that area. It is a place where we see the opportunity for accretive growth. Unfortunately, it takes a while to show up.

嗨，Bill。謝謝你的問題。我們對de novo管線感到很興奮。我們預期今年稍晚會有5家開業，管線中還有另外7家，而且我們持續看到這個領域的興趣。這是我們看到具有增益性（accretive）成長機會的地方。不過不幸的是，它需要一段時間才會反映出來。

As we've talked about, it takes 12 to 18 months to syndicate and 12 to 18 months to build, a year to get to cash flow breakeven, but the return on these is quite good. And so we're getting into that point where we've been doing this now for a couple of years, it will start becoming run rate.

如我們談過的，聯合投資（syndicate）需要12到18個月，建置也需要12到18個月，再花一年左右才能達到現金流損益兩平，但這些專案的報酬相當不錯。因此我們正進入一個階段：我們已經做了幾年，接下來它會開始成為常態化的運行水準（run rate）。

We are not yet to the point, Bill, where we're doing buy-ups in those facilities. We've got about half of those that are with health systems, about half that are independent although that independent number, I think, is going to go up over time. In those independent centers, there will be an opportunity as they ramp, we expect to buy up and consolidate those centers.

Bill，我們目前還沒到在那些機構進行買增持股（buy-ups）的階段。其中大約一半是與醫療體系（health systems）合作，約一半是獨立機構；不過我認為獨立機構的比例會隨時間上升。在那些獨立中心，隨著它們爬坡成長，我們預期會有機會買增並整合那些中心。

But we're not to that level of maturation, but we're super excited about where those are heading. And feel good about the opportunity to continue to have that be a nice lever to help meet our growth. Thank you, Bill.

但我們還沒到那樣的成熟度，不過我們對它們的發展方向非常興奮。也對於持續把這當作一個很好的槓桿、協助達成我們成長目標的機會感到樂觀。謝謝你，Bill。

Benjamin Rossi, JPMorgan.

Benjamin Rossi，摩根大通。

Hi, all. Thanks for squeezing me in here. Just following up on your physician recruitment comment, in the language from the final OPPS rule, much of the logic stream from CMS' discussion about removing the inpatient-only list come from this concept of greater physician autonomy over where they treat their patient case load.

大家好。感謝讓我插進來提問。我想延續你們關於醫師招募的評論，依據最終版 OPPS 規則的文字，CMS 在討論移除「僅限住院（inpatient-only）」清單時，其許多邏輯脈絡都源自於這個概念：讓醫師對於在哪裡治療其病患個案量擁有更大的自主權。

Just taking a step back, when thinking about the changes that allow physicians to take a greater portion of their book of business into the outpatient setting, what do you consider to be some of the remaining obstacle they're paying points for doctors that prevent them from treating their entire caseload of Medicare and commercial patients in the outpatient setting at this point?

先退一步來看，當我們思考這些變更讓醫師能把其業務量中更大一部分帶到門診場域時，你們認為目前仍有哪些障礙（他們為此付出代價的痛點）在阻止醫師把其全部的 Medicare 與商業保險病患個案量都放在門診場域治療？

Yeah. . Great question, Benjamin. I appreciate the question. So the inpatient only [indiscernible], we are very excited about the fact that the government has decided to put the decision back in the physician's hands. As you probably know, over the last 10 years, the government has spent a lot more money than it needed to because they were behind on getting Medicare caught up with what was happening with commercial patients.

是的。。很好的問題，Benjamin。謝謝你的提問。關於僅限住院清單（inpatient only）[聽不清]，我們非常興奮政府決定把決策權交回醫師手上。如你可能知道的，過去 10 年，政府花了比必要更多的錢，因為他們在讓 Medicare 追上商業保險病患端的變化方面落後了。

It happened with total joints. It certainly happened in vascular procedures. And so you I think you look at some of these things, and the government has seen repeatedly where commercial has moved faster and doctors that move patients safely based on technology in front of their list on the Medicare side.

這在全關節置換上發生過。在血管手術上當然也發生過。所以我想你看這些事情，政府一再看到商業保險端推進更快，而醫師也能基於技術進步，讓病患在 Medicare 端的清單上更早、且安全地轉移治療場域。

So we're always excited when the government leans in to prefer our setting because we know we create great value. We've got great outcomes. So continue to see that as a nice tailwind for the business going forward. Some of the obstacles that still remain. There are some states that haven't caught up with CMS in certain areas of vascular and EP.

因此，當政府更積極地傾向支持我們這種場域時，我們總是很興奮，因為我們知道我們能創造很高的價值。我們有很好的臨床結果。所以我們會持續把這視為未來業務發展的一股有利順風。至於仍然存在的一些障礙。有些州在血管與電生理（EP）某些領域，尚未在規範上追上 CMS。

There are -- in cardiovascular. There are -- I think there's obviously always different parts of the country that physicians have. It's a little bit sometimes going to be a little bit of gill mentality. They have their own reasons they think patients can't be safely treated and certain side of care that we have to go through.

在心血管方面也是。我想，顯然全國各地醫師的情況也不盡相同。有時候會有點像「羊群心態」。他們各自有一些理由，認為病患無法被安全地治療，或是對於我們所提供的照護端仍有一些流程與觀念需要克服。

Technology is sometimes a barrier. There are certain specialties where the technology, the robotics technology, for instance, is sometimes a limiting factor for ASCs to be able to afford the capital. We think there's real opportunity with payers and with some of the new technologies coming out to fix that issue. So, there are some minor things left.

技術有時也是一道門檻。在某些專科領域，例如機器人技術，有時會因為 ASC 難以負擔資本支出而成為限制因素。我們認為，透過支付方以及一些新技術的推出，確實有機會解決這個問題。所以，還剩下一些小問題。

I do think that a lot of those things continue to melt away as physicians experience our side of care, continue to have great outcomes with patients and higher acuity. And we're thrilled that no matter which administration has been in democratic, republic and they've supported the ASC space.

我確實認為，隨著醫師體驗我們這一端的照護、並持續在更高病情複雜度的病患上取得很好的結果，很多這類問題會逐步消退。而且我們很高興，無論哪一屆政府執政，不論民主黨或共和黨，都一直支持 ASC 領域。

But in particular, this administration with the removement of the inpatient-only list, that plays perfectly into our thesis, perfectly into what we're trying to deliver for the health care system, and we expect that, that's going to be a nice tailwind for us in the coming years.

但特別是本屆政府移除僅限住院清單，這完全契合我們的論點，也完全契合我們想為醫療體系交付的價值；我們預期這將在未來幾年成為我們的一股有利順風。

With that, I appreciate -- go ahead, sorry.

說到這裡，我很感謝——你請說，不好意思。

I just wanted to say appreciate the color there. Just real quick then. Now 140 new additions on physician recruiting. Any comments on if these are replacing retirees and departures versus being truly additive? Thanks.

我只是想說，謝謝你提供這些補充說明。再很快問一下。現在醫師招募新增了 140 位。你們能否評論一下，這些是用來替補退休與離職的人員，還是真正的淨新增？謝謝。

Yeah. So I think in the first quarter, we feel really good about the additions we have had. Some of those would be replacing retiring some of them are pure net adds. I don't have that net number. We haven't released that. But I would say we're pretty happy with our start around this recruiting.

好的。我想在第一季，我們對新增的人數感到非常滿意。其中一部分是替補退休人員，另一部分則是純粹的淨新增。我手上沒有那個淨新增數字。我們也尚未對外發布。但我會說，我們對今年招募的開局相當滿意。

We do see it as additive to the -- to our growth profile going forward. We're going to be closely watching that this year. Obviously, last year, we had a bit higher retirement rate than we've seen in the past, and we are adjusting to that to make sure we manage that very, very carefully. But super excited about kind of the early reads on recruitment this year.

我們確實認為這會對——對我們未來的成長輪廓帶來增量貢獻。我們今年會密切觀察這件事。顯然，去年我們的退休率比過去看到的略高一些，我們正在調整以確保能非常、非常謹慎地管理。但對於今年招募的早期回饋，我們非常振奮。

And again, I think as technology and as government regulation allows us to target additional procedures, it certainly continues to open up that world of recruits for us, and we're being very focused on that. So -- appreciate the question. I think that was our last question. I appreciate everyone's time today. And look, I'll let you enjoy the rest of the day. Thanks so much for your time. See you.

再者，我認為隨著技術進步以及政府法規讓我們能鎖定更多手術項目，確實也會持續為我們打開更大的招募人才池，而我們也會非常聚焦在這上面。所以——謝謝你的提問。我想這是我們最後一個問題了。感謝大家今天撥冗參與。那麼，我就不打擾各位，祝各位接下來一天愉快。非常感謝各位的時間。再見。

Thank you. Ladies and gentlemen, with that, we conclude today's conference call of Surgery Partners. Thank you for your participation. You may now disconnect your lines.

謝謝。各位女士、先生，今天 Surgery Partners 的電話會議到此結束。感謝各位的參與。您現在可以掛斷電話。