環球健康 (UHS) 2025 Q3 法說會逐字稿

Good day and thank you for standing by. Welcome to the third quarter of 2025 Universal Health Services earnings conference call. (Operator Instructions).

您好，感謝您的耐心等待。歡迎參加環球健康服務公司2025年第三季財報電話會議。（操作說明）

I'd now like to hand the conference over to Darren Lehrich, Vice President of Investor Relations. Please go ahead.

現在我將把會議交給投資者關係副總裁達倫·萊里奇。請繼續。

Good morning and welcome to Universal Health Services third quarter 2025 earnings conference call. I'm Darren Lehrich, Vice President of Investor Relations. With me this morning are our President and CEO, Marc Miller; and our Chief Financial Officer, Steve Filton. Marc and Steve will provide some prepared remarks, and then we'll open up to Q&A.

早安，歡迎參加環球健康服務公司2025年第三季財報電話會議。我是投資者關係副總裁達倫·萊里奇。今天早上陪同我的還有我們的總裁兼執行長馬克·米勒，以及我們的財務長史蒂夫·菲爾頓。馬克和史蒂夫將發表一些準備好的講話，然後我們將進入問答環節。

During today's conference call, we will be using words such as believes, expects, anticipates, estimates, and similar words that represent forecasts, projections, and forward-looking statements. For anyone not familiar with the risks and uncertainties inherent in these forward-looking statements. We recommend a careful reading of the section on risk factors and forward-looking statements and risk factors in our Form 10-K for the year ended December 31, 2024 and our Form 10-Q for the quarter ended June 30, 2025.

在今天的電話會議中，我們將使用諸如“相信”、“預期”、“預計”、“估計”等詞語以及代表預測、展望和前瞻性陳述的類似詞語。對於不熟悉這些前瞻性陳述中固有風險和不確定性的任何人。我們建議您仔細閱讀截至 2024 年 12 月 31 日止年度的 10-K 表格和截至 2025 年 6 月 30 日止季度的 10-Q 表格中關於風險因素和前瞻性陳述及風險因素的部分。

In addition, we may reference during today's call measures such as EBITDA, adjusted EBITDA net of MCI, and adjusted net income attributable to UHS, which are non-GAAP financial measures. Information and reconciliations of these non-GAAP financial measures to net income attributable to UHS can be found in today's press release. With that, let me now turn it over to Marc Miller for some introductory remarks.

此外，我們可能會在今天的電話會議中提及 EBITDA、扣除 MCI 後的調整後 EBITDA 以及歸屬於 UHS 的調整後淨收入等指標，這些都是非 GAAP 財務指標。有關這些非GAAP財務指標與歸屬於UHS的淨收入的相關資訊和調節表，請參閱今天的新聞稿。接下來，我將把發言權交給馬克·米勒，請他作一些開場白。

Thank you, Darren. Good morning, everybody. Thank you for your interest in UHS. I also want to take this opportunity to welcome down to the UHS team. We look forward to having him in a dedicated Investor Relations function for our company.

謝謝你，達倫。各位早安。感謝您對UHS的關注。我也想藉此機會歡迎大家加入UHS團隊。我們期待他能擔任公司專門的投資者關係職位。

Turning to our third quarter 2025 results, we reported adjusted net income attributable to UHS of $5.69 per share, representing a 53% increase from the third quarter of 2024. Revenue growth for the third quarter of 2025 was 13.4% year over year.

展望 2025 年第三季業績，我們報告稱，歸屬於 UHS 的調整後淨收入為每股 5.69 美元，比 2024 年第三季增長了 53%。2025年第三季營收年增13.4%。

Our third quarter performance reflects continued growth in our acute care operating environment, modest volume improvement in our behavioral health segment, and solid pricing across both segments. The third quarter included $90 million of net benefit from the recently approved supplemental Medicaid program in the District of Columbia.

第三季業績反映了我們急性護理營運環境的持續成長、行為健康部門的銷售小幅成長以及兩個部門的穩健定價。第三季包括來自哥倫比亞特區最近批准的補充醫療補助計劃的 9,000 萬美元淨收益。

Steve will cover the details of this approval and other supplemental Medicaid program updates. Based on our operational performance year-to-date and the increased supplemental reimbursement in the District of Columbia offset somewhat by additional professional and general liability reserves, we are increasing the midpoint of our 2025 adjusted EPS guidance by 6% to $21.80 per diluted share from $20.50 per diluted share previously.

史蒂夫將詳細介紹此次批准情況以及其他補充醫療補助計劃的最新進展。根據我們今年迄今的營運業績，以及哥倫比亞特區增加的補充報銷（部分被額外的專業和一般責任準備金所抵消），我們將 2025 年調整後每股收益預期中位數從之前的每股 20.50 美元上調 6% 至每股 21.80 美元。

During the quarter, we experienced progress in our two most recent acute care hospital openings, West Henderson Hospital in Henderson, Nevada and Cedar Hill Regional Medical Center in Washington DC. Specific to Cedar Hill, we achieved accreditation in early September.

本季度，我們兩家最新開業的急診醫院——位於內華達州亨德森市的西亨德森醫院和位於華盛頓特區的雪松山地區醫療中心——都取得了進展。其中，雪松山地區醫療中心已於9月初獲得認證。

As a result, the financial drag from our certification timing delay and startup issues began to subside during the third quarter, and we expect to exit this year at break even or better, putting us in a stronger position at this facility heading into 2026.

因此，由於認證時間延遲和啟動問題造成的財務拖累在第三季度開始緩解，我們預計今年將實現收支平衡或更好，這將使我們在進入 2026 年時在該工廠處於更有利的地位。

We believe the long-term outlook for Cedar Hill remains favorable due to demand for services and strong support within the community, as well as our long-standing presence in the District at the George Washington University Hospital.

我們相信，由於社區對服務的需求和強大的支持，以及我們在喬治華盛頓大學醫院在華盛頓特區的長期存在，Cedar Hill 的長期前景仍然良好。

Our next de novo acute care hospital opening will be the Alan B. Miller Medical Center in Palm Beach Gardens slated for 2026, slated for the spring of 2026. This project remains on track and we are encouraged by significant interest in the new medical campus by members of the community and the healthcare professionals that serve patients within this fast growing market. We have a long track record of expanding presence in core markets with new state of the art hospitals and are excited to build on our existing presence on the east coast of Florida.

我們下一家新建的急診醫院將是位於棕櫚灘花園的艾倫·B·米勒醫療中心，計劃於 2026 年春季開業。該計畫仍在按計劃進行，我們很高興看到社區成員和為這個快速增長的市場中的患者服務的醫療保健專業人員對新的醫療園區表現出濃厚的興趣。我們長期以來一直致力於透過新建最先進的醫院來擴大在核心市場的影響力，我們很高興能夠在佛羅裡達州東海岸鞏固我們現有的業務。

Separate from these new hospital projects, we've also been active on the outpatient side within our acute care segment where we operate 45 outpatient access points including free standing emergency departments, surgery centers, and other ambulatory services.

除了這些新的醫院計畫之外，我們在急性護理部門的門診方面也一直很活躍，我們經營著 45 個門診服務點，包括獨立的急診科、手術中心和其他流動服務。

On a year-to-date basis we've opened four free standing EDs, bringing our total to 34, and we believe our FED strategy is highly complementary to our acute care operations by allowing us to capture incremental higher acuity outpatient volume within our markets.

今年迄今為止，我們開設了四家獨立的急診科，使我們的急診室總數達到 34 家。我們相信，我們的 FED 策略與我們的急性護理業務高度互補，使我們能夠在市場中獲得更多高風險門診量。

Within our behavioral health segment, we've taken a disciplined approach to new bed capacity growth which has allowed us to focus on the highest potential expansion and de novo projects while we increasingly devote resources to accelerate our outpatient behavioral strategy.

在我們的行為健康領域，我們對新增床位容量採取了嚴謹的方法，這使我們能夠專注於最具潛力的擴張和全新項目，同時不斷投入資源來加速我們的門診行為策略。

On the outpatient side of our behavioral segment, we operate approximately 100 access points, including step down programs closely aligned with inpatient and residential operations, as well as step-in programs that allow us to reach patients in convenient community settings.

在行為健康門診方面，我們經營著大約 100 個服務點，包括與住院和住宿運營緊密相關的過渡項目，以及讓我們能夠在便利的社區環境中接觸患者的過渡項目。

We are on track to open 10 of these step-in programs this year under local brands as well as our new Thousand Branches Wellness brand in a model that supports outpatient services through both virtual and in-person settings.

我們今年將按計劃開設 10 個此類過渡性項目，這些項目將以本地品牌以及我們新的「千枝健康」品牌運營，該模式透過虛擬和麵對面的環境為門診服務提供支援。

Our strategies are designed to accelerate our outpatient growth rate, diversify our payer mix, and allow us to be the provider of choice within a behavioral marketplace that continues to have strong demand across the continuum. The behavioral healthcare we provide serves an important need within the healthcare system and our society more broadly. With that, I will now turn Steve Filton for a for a financial review of the third quarter.

我們的策略旨在加快門診業務成長速度，實現支付方組合多元化，並使我們成為行為健康市場中首選的醫療服務提供商，該市場在整個服務範圍內持續保持強勁的需求。我們提供的行為健康服務滿足了醫療保健系統乃至整個社會的重要需求。接下來，我將請史蒂夫·菲爾頓對第三季度的財務狀況進行回顧。

Thanks, Marc. I will highlight a few financial and operational trends before opening the call up to questions. The company reported net income attributable to UHS per diluted share of $5.86 for the third quarter of 2025.

謝謝你，馬克。在開放提問環節之前，我將重點介紹一些財務和營運趨勢。該公司公佈 2025 年第三季歸屬於 UHS 的每股攤薄淨收入為 5.86 美元。

After adjusting for the impact of the items reflected on the supplemental schedule as included with the press release, our adjusted net income attributable to UHS per diluted share was $5.69 for the quarter ended September 30, 2025.

在調整了新聞稿附表中所反映的項目的影響後，截至 2025 年 9 月 30 日的季度，歸屬於 UHS 的調整後每股攤薄淨收入為 5.69 美元。

We recognized approximately $90 million of net benefit during the third quarter of 2025 from the District of Columbia supplemental Medicaid program, which covers the time period from October 1, 2024 through September 30, 2025. Approximately 73 million of this benefit was recognized in our acute care results, while the remaining benefit was recognized in our behavioral results.

2025 年第三季度，我們從哥倫比亞特區補充醫療補助計劃中確認了約 9,000 萬美元的淨收益，該計劃涵蓋 2024 年 10 月 1 日至 2025 年 9 月 30 日期間。其中約 7,300 萬美元的收益在我們的​​急性護理結果中得到體現，其餘收益在我們的​​行為結果中得到體現。

During the third quarter of 2025 on the same facility basis, adjusted admissions at our acute care hospitals increased 2.0% over the third quarter of the prior year. Acute care volumes were consistent with trends in the first half of 2025, with solid growth in both inpatient medical admissions and outpatient services during the third quarter, and surgical volumes that increased slightly as compared to the prior year.

2025 年第三季度，以同一設施計算，我們急性護理醫院的調整入院人數比去年同期增加了 2.0%。2025 年上半年，急性照護量與趨勢一致，第三季住院醫療入院量及門診服務量均穩定成長，手術量與前一年相比略有增加。

Same facility net revenues in our acute hospital segment increased by 12.8% during the third quarter of 2025 on a reported basis as compared to last year's third quarter and increased 9.4% after excluding the impact of our insurance subsidiary and the prior period net benefit from the District of Columbia supplemental Medicaid program.

2025 年第三季度，我們急性醫院部門的同店淨收入按報告基準比去年同期增長了 12.8%，若不計入我們保險子公司的影響以及上一時期哥倫比亞特區補充醫療補助計劃的淨收益，則增長了 9.4%。

Acute care, same facility revenue per adjusted admission increased by 9.8% during the third quarter of 2025 on a reported basis and increased 7.3% after excluding the impact of our insurance subsidiary and the prior period impact of the District of Columbia supplemental Medicaid benefit.

2025 年第三季度，急性護理、同店調整入院收入按報告基準增長 9.8%，若不計入保險子公司的影響以及哥倫比亞特區補充醫療補助福利的前期影響，則增長 7.3%。

Operating expenses continued to be well managed across labor, supplies, and other expense categories. We have not experienced any noteworthy impact from tariff trade policies. Total operating expenses for adjusted admission increased by 4.0% on the same facility basis over last year's third quarter after excluding the impact of our insurance subsidiary.

營運費用在人工、物料和其他費用類別方面繼續得到良好控制。我們尚未感受到關稅貿易政策的任何顯著影響。剔除保險子公司的影響後，以同一設施計算，調整後的入院總營運費用比去年第三季增加了 4.0%。

For the third quarter of 2025, our solid acute care revenues combined with effective expense controls resulted in a 190basis points increase year over year in same facility EBITDA margin to 15.8% after excluding the prior period impact of the District of Columbia's supplemental benefit.

2025 年第三季度，我們穩健的急性照護收入加上有效的費用控制，使得同店 EBITDA 利潤率年增 190 個基點，達到 15.8%（不包括哥倫比亞特區補充福利對上期的影響）。

Turning to our behavioral health results during the third quarter of 2025, same facility net revenues increased 9.3% on a reported basis and we're up 8.5%, excluding the prior period impact of the District of Columbia supplemental Medicaid program.

回顧我們 2025 年第三季的行為健康業績，按報告基準計算，同店淨收入增長了 9.3%，若不計入哥倫比亞特區補充醫療補助計劃對前期的影響，則增長了 8.5%。

Same facility revenue growth was driven by a 7.9% increase in revenue per adjusted patient day as compared to the prior year. Excluding the prior period impact of the District of Columbia supplemental revenue, same facility revenue per adjusted patient day increased 7.1% during the third quarter of 2025.

與前一年相比，調整後每位患者每日收入成長了 7.9%，推動了同店收入的成長。剔除哥倫比亞特區補充收入對前期的影響，2025 年第三季度，每調整後病患日的同店營收成長了 7.1%。

Same facility adjusted patient days increased 1.3% as compared to the prior period's third quarter with volume growth modestly improving as compared to 1.2% in the second quarter and 0.4% during the first half of 2025.

與上一季第三季相比，同店調整後病患住院天數增加了 1.3%，而業務量成長略有改善，高於第二季的 1.2% 和 2025 年上半年的 0.4%。

We expect further volume improvements during the fourth quarter, although we now believe a reasonable expectation for same facility adjusted patient day growth should be in the 2% to 3% range with our near-term expectations at the lower end of this range.

我們預計第四季度業務量將進一步改善，儘管我們現在認為，經調整後的同店患者日增長率的合理預期應在 2% 至 3% 之間，而我們近期的預期則處於該範圍的下限。

Expenses in our behavioral health segment continued to be well managed with relatively stable margins during the third quarter, leading to a 7.6% increase in same facility EBITDA as compared to the third quarter of 2024 after excluding the prior period impact of the District of Columbia supplemental benefit.

第三季度，我們的行為健康部門的支出繼續得到良好控制，利潤率相對穩定，在不計入哥倫比亞特區補充福利的前期影響的情況下，與 2024 年第三季度相比，同店 EBITDA 增長了 7.6%。

We continue to experience labor tightness in some markets, although hiring trends have improved steadily throughout the year.

儘管今年以來招聘趨勢穩步改善，但我們仍然在一些市場面臨勞動力短缺的問題。

Our cash generated from operating activities was approximately $1.3 billion during the first nine months of 2025 as compared to approximately $1.4 billion during the same period in 2024. We expect to collect the $90 million of the District of Columbia supplemental payments during the fourth quarter of 2025.

2025 年前九個月，我們的經營活動產生的現金約為 13 億美元，而 2024 年同期約為 14 億美元。我們預計將在 2025 年第四季收到哥倫比亞特區的 9,000 萬美元補充付款。

During the first nine months of 2025, we spent $734 million on capital expenditures, close to 30% of which related to the new hospital in Florida and a replacement facility in California.

2025 年前九個月，我們在資本支出方面花費了 7.34 億美元，其中近 30% 與佛羅裡達州的新醫院和加州的替代設施有關。

During the nine months ended September 30, 2025, we also acquired 3.19 million of our own shares at a total cost of approximately $566 million. Including 1.315 million shares purchased during the third quarter of 2025.

截至 2025 年 9 月 30 日的九個月期間，我們也以約 5.66 億美元的總成本收購了 319 萬股本公司股份。包括 2025 年第三季購買的 131.5 萬股。

Today our board of directors authorized a new $1.5 billion increase to our stock repurchase program, bringing our total authorization to $1.759 billion including amounts remaining under the previous authorization.

今天，我們的董事會批准將股票回購計畫增加 15 億美元，使我們的總授權額達到 17.59 億美元，其中包括先前授權項下的剩餘金額。

Since 2019, we have repurchased approximately 36% of the company's outstanding shares and paid approximately $340 million in dividends to shareholders. In the absence of compelling acquisition opportunities over the near term, we expect to continue to prioritize our excess free cash flow for share buyback and dividends.

自 2019 年以來，我們已回購公司約 36% 的流通股，並向股東支付了約 3.4 億美元的股息。在短期內沒有令人信服的收購機會的情況下，我們預計將繼續優先把多餘的自由現金流用於股票回購和分紅。

As of September 30, 2025, we had approximately $965 million of aggregate available borrowing capacity pursuant to our $1.3 billion revolving credit facility. Turning to an update on Medicaid supplemental payment programs, our current projected 2025 full year net benefit from various previously approved programs is $1.3 billion.

截至 2025 年 9 月 30 日，根據我們 13 億美元的循環信貸額度，我們擁有約 9.65 億美元的可用借款總額。再來看醫療補助補充支付計劃的最新情況，我們目前預計 2025 年全年從各種先前批准的計劃中獲得的淨收益為 13 億美元。

This figure includes amounts recorded during the third quarter for the previously mentioned District of Columbia program and additional amounts related to this program that are expected to be recorded in the fourth quarter of 2025. But it does not include programs pending CMS approval.

該數字包括第三季度記錄的上述哥倫比亞特區計劃的金額，以及預計將在 2025 年第四季度記錄的與該計劃相關的其他金額。但這不包括正在等待CMS批准的專案。

As we discussed during our second quarter 2025 earnings call, the [OB3] legislation includes several significant changes in the Medicaid program, including changes to state directed payment programs and provider taxes.

正如我們在 2025 年第二季收益電話會議上所討論的那樣，[OB3] 立法對醫療補助計劃進行了多項重大改革，包括對州定向支付計劃和提供者稅收的改革。

At this time, assuming no changes to our Medicaid revenues or other changes to related state or federal programs, we estimate that commencing with the 2028 fiscal years, our aggregate net benefit will be reduced on an annually increasing and relatively pro rata basis by approximately $420 million to $470 million in 2032.

目前，假設我們的醫療補助收入或其他相關的州或聯邦項目沒有變化，我們估計，從 2028 財年開始，我們的淨收益總額將逐年減少，並且按比例相對減少，到 2032 年將減少約 4.2 億美元至 4.7 億美元。

This cumulative impact range has been increased to reflect recent supplemental program approvals. Given various uncertainties, including the evolving state by state interpretations and computations related to this legislation, our forecasted estimates are subject to change, potentially by material amounts. Operator, that concludes our prepared remarks, and we're pleased to answer questions at this time.

為反映近期補充計畫的批准，此累積影響範圍已擴大。鑑於存在各種不確定因素，包括各州對該立法的解釋和計算不斷變化，我們的預測估計可能會發生變化，而且變化幅度可能很大。接線員，我們的發言到此結束，現在我們很樂意回答大家的問題。

(Operator Instructions) Justin Lake, Wolfe Research.

（操作說明）賈斯汀·萊克，沃爾夫研究公司。

Thanks. Good morning, Steve. I appreciate all the details. I was hoping you could give us an update in terms of, I know there's a couple of states pending approval, Florida, and I believe Nevada. Maybe you can give us some color on. The potential DPP there that could benefit the company if those are approved and then maybe give us a quick rundown on or an update on where the exchange contribution looks like what's the kind of run rate on the exchange volume and revenue year-to-date and any updated thoughts on if those subsidies expire, what do you think that estimate is? Thanks.

謝謝。早安，史蒂夫。感謝您提供的所有細節。我希望您能為我們提供一些最新進展，我知道還有幾個州正在等待批准，例如佛羅裡達州，還有我相信的內華達州。或許您可以提供我們一些細節資訊。如果這些潛在的DPP獲得批准，可能會使公司受益。然後，能否簡要介紹交易所的貢獻情況，以及今年迄今為止交易所交易量和收入的運行速度，以及如果這些補貼到期，您認為預計會是多少？謝謝。

Sure, Justin, so as far as any new potential Medicaid supplemental benefits, we've been disclosing for I think several quarters that there's approval of a pending plan or expansion of the pending plan in Florida that we estimate would result in about a $47 million annual benefit to us. As I said, that program remains pending CMS approval of the state of Florida seems confident that it will be forthcoming at some point.

當然，賈斯汀，至於任何新的潛在醫療補助補充福利，我們已經披露了好幾個季度，佛羅裡達州正在批准一項待定計劃或擴大待定計劃，我們估計這將為我們帶來約 4700 萬美元的年度收益。正如我所說，該計劃仍待 CMS 批准，佛羅裡達州似乎很有信心該計劃會在某個時候獲得批准。

Additionally, I think we learned this quarter and we'll include this in our, to be filed 10Q for the quarter. That there's another maybe $30 million approximately of Nevada DPP increase again pending CMS approval. So on a combined basis, these two states would represent somewhere in the $75 to $80 million dollar range. To the best of our knowledge, there are no other material programs or approvals pending.

此外，我認為我們本季學到了一些東西，我們會把這些內容納入我們即將提交的本季 10Q 報告中。內華達州 DPP 計畫可能還會增加約 3,000 萬美元的資金，目前正在等待 CMS 的批准。因此，這兩個州加起來的價值大約在 7500 萬到 8000 萬美元之間。據我們所知，目前沒有其他實質項目或審批正在進行中。

As far as your second question about exchange contribution, the percentage of our total adjusted admissions, acute care admissions that are exchange patients is in the 6% to 6.5% range. That number has been ticking up.

關於您第二個關於交換貢獻的問題，我們調整後的總入院人數（急性護理入院人數）中，交換病人所佔的百分比在 6% 到 6.5% 之間。這個數字一直在上升。

Most of those patients are in two states in Texas and Florida, and so I think all the public companies have been reporting increases. And we have a smaller footprint in those states than some of our peers, but our numbers have been picking up as well. We have previously given an estimate, assuming that the exchange subsidies don't get extended about $50 to $100 million negative impact on us annually, given the increase in exchange volumes, we're probably trending towards the higher end of that range.

這些患者大多集中在德克薩斯州和佛羅裡達州，所以我認為所有上市公司都報告了業績成長。雖然我們在這些州的業務規模比一些同業要小，但我們的業務數量也在不斷增長。我們先前曾估計，如果外匯補貼不延長，每年將對我們造成約 5,000 萬至 1 億美元的負面影響；考慮到外匯交易量的增加，我們可能正朝著該範圍的較高端發展。

As far as I think sort of any prediction about how the exchange subsidy issue is to be resolved, I don't think we have any particularly pressing insight into that, and we're watching how this develops in congress along with everybody else. Thanks.

至於如何預測外匯補貼問題將如何解決，我認為我們目前還沒有特別緊迫的進展，我們和其他人一樣，都在關注國會的進展。謝謝。

Jason Cassorla, Guggenheim.

傑森·卡索拉，古根漢。

Great, thanks. Good morning. Just wanted to check in on '25 guidance. You increased the midpoint by a little over $90 million. Can you just walk through the bridge to the updated guidance, how that's split between the five quarters of DC DPP, the malpractice reserve increase, the legal settlement in the quarter, and outperformance, and then. You have about a $50 million guidance range at the low and high end, not significant range by any means, but just thoughts on what you need to see to trend towards the high end or the low end of guidance at this point. Thanks.

太好了，謝謝。早安.只是想確認一下25年的指導。你將中點提高了略高於 9000 萬美元。您能否簡要介紹一下更新後的指導意見，包括 DC DPP 五個季度的分配情況、醫療事故準備金增加、季度法律和解以及超額收益等，然後呢？你們給的指導範圍在 5000 萬美元左右，上下限相差不大，但這只是一個想法，看看目前需要看到哪些因素才能使業績趨向指導範圍的上限或下限。謝謝。

Yeah, so I, Jason, I think you largely captured the components of the guidance increase, as you said at the midpoint, it's in that $90 million to $95 million range that's made up of $140 million of increased DPP, the biggest chunk of that, of course, is the DC number. That's $90 million that we recorded in the third quarter and another $25 million that we expect to record in Q4.

是的，Jason，我認為你基本上抓住了指導增長的組成部分，正如你所說，中間值在 9000 萬美元到 9500 萬美元之間，其中包括 1.4 億美元的 DPP 增長，當然，其中最大的一部分是 DC 金額。第三季我們實現了 9,000 萬美元的收入，預計第四季也將實現 2,500 萬美元的收入。

So, that's $115 million of new DPP. There's another $25 million of miscellaneous increases across a variety of states, none of which are singularly materials to get us to the 140% increase in DPP. And then we deduct from that the $35 million malpractice increase that we described in our press release and another $18 million in a legal settlement that we described in an AK that we filed a few weeks ago and that gets you to that sort of, low to mid 90s number, effectively meaning that we're assuming from a core business perspective that the trends.

所以，新增的DPP金額為1.15億美元。此外，各州還有 2,500 萬美元的雜項成長，但這些成長都不是 DPP 成長 140% 的直接原因。然後，我們從中減去我們在新聞稿中提到的 3500 萬美元醫療事故增加額，以及我們在幾週前提交的 AK 文件中提到的 1800 萬美元法律和解金，這樣就得到了 90 美元左右的數字，這實際上意味著我們從核心業務角度假設這些趨勢。

That we expected when we increased guidance last quarter we'll continue, when you talk about sort of what it takes to get us to maybe the higher end of that, we're talking, about, I think the two businesses running. Same sort of revenue increases in the 5% to 7% range, and you know what gets us to the higher end is if we landed at the higher end of that range either through, volumes or pricing, so yeah, I think, all that is pretty consistent with what we've said previously.

正如我們在上個季度提高業績預期時所預期的那樣，我們將繼續提高業績預期。當談到要達到預期目標的較高水準需要做些什麼時，我認為我們指的是兩家公司都在正常運作。營收成長幅度大致在 5% 到 7% 之間，你知道，要達到更高的水平，要么是透過銷量，要么是透過定價，所以，是的，我認為，所有這些都與我們之前所說的相當一致。

Okay, thanks. Maybe just as a follow-up, just checking in on managed care activity and state budgets in relation to your behavioral health business. I mean, it looks like behavioral health length of stay continues to hold on, pricing remains favorable. I guess, are you seeing any different behavior as it relates to managed care at this juncture for behavioral?

好的，謝謝。或許只是想跟進一下，了解一下與您的行為健康業務相關的醫療管理活動和州預算情況。我的意思是，看起來心理健康治療的平均住院時間保持不變，價格也依然優惠。我想問的是，在目前這個階段，您在行為健康管理方面是否觀察到任何不同的行為？

And we're hearing multiple states enacting budgets that are reducing behavioral rates. Just any thoughts on the state budget situation across your markets stepping into 2026 would be helpful. Thanks.

我們聽說多個州正在實施預算，這些預算正在降低犯罪率。如果您能分享一下對您所在市場2026年州預算狀況的看法，那就太好了。謝謝。

Yeah, I mean, I think we have consistently found that, managed care players are aggressive in their utilization management in their management of length of stay, in their management of where patients are treated, meaning in inpatient or outpatient settings. I don't know that that's changed materially, as you point out. Our length of stay has remained fairly constant, a lot of that is.

是的，我的意思是，我認為我們一直發現，醫療管理機構在利用管理、住院時長管理、病患治療地點（即住院或門診）管理方面都非常積極。正如你所指出的，我不認為情況發生了實質的變化。我們的停留時間基本上保持不變，這在很大程度上是原因之一。

I think, a function of our aggressive behavior in terms of, documenting the medical needs of patients, etc. Which, we are, very much focused on, and so, we again have not seen, I think, significant changes in. Payer behavior, to date, we understand that that payers are under or any number of payers are under some pressure, but we also understand that their subscribers do need behavioral treatment. And I think given our market presence, given our clinical reputation, etc. We continue to be, I think, a preferred provider for many of those managed care companies.

我認為，這與我們積極主動地記錄患者的醫療需求等行為有關。我們非常重視這些方面，因此，我認為我們還沒有看到顯著的變化。到目前為止，我們了解到支付方或許多支付方都面臨著一定的壓力，但我們也了解到他們的訂戶確實需要行為治療。我認為，鑑於我們的市場地位、臨床聲譽等等，我們仍然是許多醫療管理公司的首選供應商。

As far as state budgets are concerned, the only state budget that I'm aware of where there have been actual Medicaid cuts is in North Carolina for behavioral. It's not a state that's material to us. I think about 2% of our behavioral beds are in the state of North Carolina. Other states have talked about state budget cuts for Medicaid, and we're sort of tracking that, but at the moment, I'm not seeing anything that affects us in any sort of material way.

就州預算而言，據我所知，唯一一個實際削減醫療補助的州預算是北卡羅來納州的行為健康預算。這對我們來說並非一個重要的狀態。我認為我們大約 2% 的行為矯正床位位於北卡羅來納州。其他州都討論過削減醫療補助的州預算，我們也在關注此事，但目前來看，還沒有看到任何實質的影響。

Okay, great. Thank you very much.

好的，太好了。非常感謝。

Whit Mayo, Leerink Partners.

Whit Mayo，Leerink Partners。

Hey, thanks. I'm just curious how Wes Henderson is performing now and any cannibalization of that on overall volumes within the quarter. And then my second question is just on Cedar Hills, whether or not you think it can offset the headwinds. So if it was, let's say a $50 million drag with startup losses this year, that $50 will reverse itself. But any thoughts on maybe the growth next year? Thanks.

嘿，謝謝。我只是好奇 Wes Henderson 目前的表現如何，以及這是否會對本季的整體銷售造成蠶食。我的第二個問題是關於雪松山的，您認為它能否抵消逆風的影響？所以，假設今年的啟動虧損造成了 5,000 萬美元的損失，那麼這 5,000 萬美元將會得到彌補。那麼，對於明年的成長前景，大家有什麼看法呢？謝謝。

Yeah, so I think as Mark commented in his remarks, Wes Henderson's been performing well. It's had positive EBITA really ever since it opened, which is really quite remarkable for a startup hospital. It does, I think, affect our same store numbers and particularly our same store volumes that we've talked in the past that there's probably, and again this is difficult to quantify precisely, but we would estimate maybe a 50 basis points or 60 basis points. Impact on our same store adjusted admissions, meaning without Henderson, West Henderson in the mix, our same store adjusted emissions might be 50 basis points or 60 basis points higher because of the cannibalization because some of their admissions or adjusted emissions are coming from our existing hospitals in the market.

是的，所以我覺得正如馬克在評論中所說，韋斯亨德森表現得很好。自開業以來，該醫院的息稅前利潤一直為正，這對於一家新創醫院來說確實非常了不起。我認為這確實會影響我們的同店銷售額，尤其是我們過去討論過的同店銷量，可能會受到影響，雖然很難精確量化，但我們估計可能會影響 50 到 60 個基點。對我們同店調整入院人數的影響，意味著如果將亨德森和西亨德森醫院排除在外，由於部分入院人數或調整後排放量來自我們市場上的現有醫院，我們的同店調整排放量可能會增加 50 或 60 個基點。

But West Henderson is doing well and we would expect we'll continue to improve into 2026. Cedar Hill, as we identified last quarter, lost $25 million in the second quarter. We projected they would lose $25 million in the back half of the year. They did lose that $25 million in the third quarter, and I think as Mark pointed out, we expect them to break even in Q4.

但西亨德森發展勢頭良好，我們預計到 2026 年將繼續進步。正如我們上個季度所指出的，Cedar Hill在第二季度虧損了2500萬美元。我們預測他們下半年將虧損 2,500 萬美元。他們在第三季度確實虧損了 2500 萬美元，我認為正如馬克指出的那樣，我們預計他們在第四季度將實現收支平衡。

And improve into next year. So obviously the $50 million loss that we incurred in 2025 should be a tailwind going into, 2026, assuming that worst case Cedar Hill breaks even. We assume they'll do better than that, and they will be, profitable in 2026, although I think our general sense and we'll get more detail on this when we give our guidance in February is that. Any incremental improvement over break even will largely help to offset any opening and startup losses from the ABM Medical Center in Florida.

爭取明年有所進步。因此，很顯然，假設雪松山在最壞的情況下能夠實現收支平衡，那麼我們在 2025 年遭受的 5000 萬美元損失應該會成為 2026 年的有利因素。我們預計他們會做得更好，並且會在 2026 年實現盈利，儘管我認為我們的總體感覺是，我們將在 2 月份發布業績指引時提供更多細節。任何超過盈虧平衡點的增量改進都將在很大程度上幫助抵消佛羅裡達州 ABM 醫療中心開業和啟動過程中的任何損失。

Okay thanks.

好的，謝謝。

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，加拿大皇家銀行資本市場。

Great, thank you very much. I appreciate your commentary on your outpatient, surgical initiatives. I was wondering if you could give us a little bit more color on what you're seeing in terms of surgical trends both inpatient and outpatient, and what case mix is looking like in the quarter and just how that's contributing overall to the volume growth for the care hospital segment. Thank you.

太好了，非常感謝。我非常感謝您對門診和外科手術計畫的評價。我想請您詳細介紹您觀察到的住院和門診手術趨勢，以及本季度的病例組合情況，以及這些因素如何促進護理醫院部門的整體業務量增長。謝謝。

Yes, so I think in our prepared remarks we made the comment that outpatient, surgical trends increased slightly over the prior year in the quarter and that actually was an improvement over the first half of the year when I think they were actually down, so we were encouraged by that and I think, we've noted that I think some of the call it surgical softness or softness in surgical volumes, I think have been difficult comparisons with prior years where we were seeing some bad from the catch up of deferred and postponed or procedures that had been deferred and postponed during COVID. I think we're starting to anniversary that and kind of get that behind us and it feels to us like surgical volumes are returning to sort of more normal levels.

是的，我認為我們在事先準備好的發言稿中提到，本季門診手術趨勢較上年同期略有增長，這實際上比上半年有所改善，因為上半年門診手術量實際上是下降的，所以我們對此感到鼓舞。我認為，我們注意到，有些人稱之為手術量疲軟或手術量下降，我認為這與往年相比比較困難，因為往年我們看到一些因疫情期間推遲或延期的手術而導致的不良情況。我認為我們正在開始紀念那件事，並逐漸將其拋在腦後，我們感覺手術量正在恢復到更正常的水平。

And then I'm sorry, was there a second part to your question? Oh, case, yeah, case mix was up slightly in the quarter, not a big driver of improvement, maybe 30 basis points.

然後，不好意思，您的問題還有第二部分嗎？哦，案例方面，是的，本季案例組合略有上升，但這並非改善的主要驅動因素，可能上升了 30 個基點。

Thank you. Raj Kumar, Stephens.

謝謝。Raj Kumar，史蒂芬斯。

Hi, just, on the [B8] side maybe just trying to kind of understand the overall supply demand dynamic, you've seen kind of like SWB growth of high single-digits on the same store basis where, while volumes of kind of. Been slightly negative, slightly positive throughout the year.

您好，關於[B8]方面，我只是想了解一下整體的供需動態，您已經看到SWB在同一門店的基礎上實現了接近兩位數的增長，而銷量卻…全年情緒時好時壞。

So maybe just trying to understand what the dynamics are in terms of, you're kind of increasing staffing and we should expect kind of better, volume growth kind of in subsequent quarters or just kind of more just, in order to maintain capacity that you're kind of pushing through these SWB trends.

所以，或許只是想了解其中的動態，你們正在增加人員配備，我們應該期待在接下來的幾個季度裡銷量會有更好的成長，或者只是為了維持產能，你們正在努力克服這些SWB趨勢。

Yeah, Raj, I mean, I think that we talked at some length in previous quarters, if there are two broad. Sort of overarching dynamics that I think have muted behavioral volumes. One, as I think we mentioned in our prepared remarks, has been a labor scarcity issue. It's not pervasive. I think it exists in maybe a 25% to 3% of our hospitals where we struggle to fill all of our vacancies, whether that's nurses, whether that's therapists, whether that's non-degree professionals, the people that we describe as mental health technicians.

是的，拉傑，我的意思是，我認為我們在前幾季已經詳細討論過，如果有兩個方面的話。我認為，某種整體動態因素抑制了行為量。其中一個問題，正如我們在準備好的演講稿中所提到的，是勞動力短缺問題。它並不普遍。我認為這種情況可能存在於我們醫院的 3% 到 25% 的醫院中，這些醫院難以填補所有空缺職位，無論是護士、治療師，還是沒有學位資質的專業人員，也就是我們所說的心理健康技術人員。

But I do think that in those specific facilities, volumes are often muted. I think as we said in our prepared remarks, our hiring numbers are increasing incrementally, albeit, and I think you see a little bit of that in the salary and wage data that you're referring to. I think the other piece of this is what we're finding, and I think you know we read through what a number of the managed care companies say is that behavioral utilization broadly and nationally is up across the Board.

但我認為在這些特定的場所，音量通常會被調低。我認為正如我們在準備好的演講稿中所說，我們的招聘人數正在逐步增加，儘管如此，而且我認為您在您提到的薪資數據中也能看到一些這一點。我認為這件事的另一部分是我們發現的，而且我認為你也知道，我們讀過一些醫療管理公司的說法，那就是行為健康利用率在全國範圍內普遍上升。

A lot of that seems to be on the outpatient side, and I think that's being delivered in a very, I'll describe in a sort of fragmented way, meaning those that outpatient care is being delivered in all sorts of settings, including hospital emergency rooms and urgent care centers and retail pharmacy clinics and [Mom and pop] operations, we think we can do a better job of capturing more of that outpatient activity through frankly better focus as well as, new and additional dedicated outpatient facilities.

許多門診服務似乎都集中在門診方面，我認為門診服務的提供方式非常分散，也就是說，門診服務在各種場所提供，包括醫院急診室、緊急護理中心、零售藥房診所和小型診所。我們認為，透過更精準的定位以及新建和增設專門的門診設施，我們可以更好地掌握更多的門診服務。

Obviously, that focus and those facilities require additional. Staff and we've been staffing up for that. So to some degree, I think, the increase that you're alluding to in salaries and wages is something that's preparing us to be able to treat and and and absorb more patient volume.

顯然，這種專注和這些設施需要額外的投入。我們已經為此增加了人手。所以在某種程度上，我認為你提到的薪資成長是為了讓我們能夠治療和吸收更多的病人。

Great, and maybe as a quick follow-up, you had to step up and kind of acquisition spend in the quarter and I, I'm assuming that's kind of more on the outpatient behavioral acceleration that you've kind of spoken to so maybe, what could we kind of expect forward from capital deployment on M&A on that front.

好的，也許可以快速跟進一下，您本季度不得不加大收購支出，我猜這更多是指您之前提到的門診行為加速發展，那麼，我們是否可以期待未來在這一領域的併購資本部署方面有什麼發展呢？

Yeah, so the acquisition spending that you refer to is actually mostly it's about $35 million or $40 million in the UK in the quarter, and that's mostly on H1stly on the inpatient side. I think we've talked about the fact on the outpatient side in the US, creating a greater presence in in the outpatient space really doesn't require a tremendous amount of new capitals. It's probably, $1million or $2 million on average to create one of these step in outpatient clinics. So again, I think the bigger challenge in those places is finding the appropriate number of therapists more than it is, a significant capital spend.

是的，你提到的收購支出實際上主要是在英國，本季約為 3,500 萬至 4,000 萬美元，而且主要是在上半年住院方面。我認為我們已經討論過，在美國的門診領域，擴大門診業務實際上並不需要大量的新資金。在門診診所建造這樣一個台階，平均成本可能在 100 萬美元到 200 萬美元之間。所以，我認為這些地方面臨的更大挑戰是找到足夠數量的治療師，而不是大量的資金投入。

Thank you. AJ Rice, UBS.

謝謝。AJ Rice，瑞銀集團。

Hi everybody, maybe a couple quick things here. I think your updated guidance there's about $25 million of sort of miscellaneous DPP payments and I'm it seemed like in the back half of the year that are incremental, is that more in the third quarter or was that something you'll be booked in the fourth quarter and on the litigation, settlement in Nevada, was that booked in the third quarter or is that going to be booked in the fourth quarter?

大家好，這裡有幾件事要簡單說一下。我認為您更新的指導意見中提到了大約 2500 萬美元的雜項 DPP 付款，而且看起來這些款項是在今年下半年新增的，這些款項主要是在第三季度入賬，還是會在第四季度入賬？關於內華達州的訴訟和解，這些款項是在第三季入賬，還是會在第四季入賬？

Yeah, so the litigation settlement was recorded in the third quarter, and it's reflected in our [non-sam] store acute results. The additional DPP, I think, is spread pretty rapidly between the third and fourth quarters.

是的，訴訟和解協議已在第三季結算，並反映在我們的（非山姆會員店）急性業績中。我認為，額外的 DPP 值會在第三節和第四節之間迅速分配。

Okay, I know you, your pricing on both businesses actually, even if you ex out the DPP payments, was pretty strong by historic standards. Anything to call out there, any, is that a sustainable level of, year to year pricing gains? Any thoughts on that?

好吧，我知道你，實際上，你對這兩家企業的定價，即使扣除 DPP 付款，以歷史標準來看也相當有競爭力。有什麼需要指出的嗎？例如，這種逐年上漲的物價水準是否可持續？對此有什麼看法？

So taking it, segment by segment, I think on the acute side we said that, our revenue per adjusted admission was was close to 10% increase, half of that I think is DPT related, which means, 5% is sort of from core results. That's on the high side for sure. I think we think that. Sustainable acute care pricing is more in the 3, maybe, 3 plus percent range. I think the excess in the quarter is a result of, some revenue cycle initiatives, that we've undertaken.

因此，我們逐一分析，我認為在急性病方面，我們說過，每次調整入院的收入增長了近 10%，其中一半我認為與 DPT 相關，這意味著 5% 來自核心績效。這價格確實偏高。我想我們都這麼認為。可持續的急性護理定價更可能在 3% 左右，甚至可能超過 3%。我認為本季的盈餘是我們採取的一些收入周期優化措施的結果。

To ensure that, our billing is clean and complete, that our, denial appeals are as appropriate and aggressive as they should be, dispute resolutions with a number of payers, all that sort of stuff. There's a few small one-time items in terms of an opioid settlement and we've disclosed our accountable care organization.

為了確保我們的帳單清晰完整，我們的拒付申訴能夠恰當且積極地進行，與多家付款方進行爭議解決，等等。關於阿片類藥物和解協議，有一些一次性的小項目，而且我們已經披露了我們的責任醫療組織。

Profits but yeah, I think our general sense is that acute to pricing in the 3% range is sort of that sustainable level. On the behavioral side, we've been in the 4% to 5% range when you adjust that, I think the DPP impacts.

在利潤方面，我認為我們的整體感覺是，3% 左右的價格波動幅度是比較可持續的水平。從行為來看，我們一直處於 4% 到 5% 的範圍內，當你調整這個範圍時，我認為 DPP 的影響。

We've been running that, and probably in the quarter we're again at the higher end of that range, because of, I think some of the things we've discussed already, some pressure for Medicaid state, reductions, I think we believe that the sustainable level of behavioral pricing is probably a notch below that, maybe 3.5% to 4.5%, but, still should continue to be quite positive and a good tailwind for that business.

我們一直在執行這項策略，而且本季度我們可能再次達到該範圍的較高水平，因為，我認為我們已經討論過的一些因素，例如醫療補助州面臨的一些壓力和削減，我們認為行為定價的可持續水平可能略低於這個水平，也許在 3.5% 到 4.5% 之間，但仍然應該繼續保持相當積極的地位，並對該業務構成良好的推動作用。

Okay, thanks a lot.

好的，非常感謝。

Craig Hettenbach, Morgan Stanley.

克雷格‧赫滕巴赫，摩根士丹利。

Yes, thank you. On the behavioral side you mentioned kind of a slight improvement in hiring. You just talk about more broadly how you think about capacity versus demand and behavioral and kind of what that means for volume growth.

是的，謝謝。在行為方面，你提到招募方面略有改善。你只是更廣泛地談論了你如何看待產能與需求和行為之間的關係，以及這對銷售成長意味著什麼。

Yeah, I mean, we've said that I think we think a reasonable level of volume growth in the behavioral business in the intermediate and long-term is sort of 2% to 3% in just the patient day growth. We're still a little shy of that, and feel like there's a chance. We can get there exiting this year, but if we don't, I think it's a reasonable target for next year, particularly at the lower end of that range.

是的，我的意思是，我們說過，我們認為在中長期內，行為健康業務合理的業務量增長水平應該是患者就診天數增長 2% 到 3%。我們離目標還差一點，但感覺還有機會。我們今年就能實現這個目標，但如果不能，我認為明年是一個合理的目標，尤其是在目標範圍的下限。

To get there, we need to continue to be able to fill our vacancies and reduce our turnover, things that have been happening and I think we can improve, but I think we can see that that process has been somewhat slower than we expected. But we continue to make incremental progress and expect that we'll continue to make incremental progress.

為了實現這一目標，我們需要繼續填補空缺職位並降低人員流動率，這些事情一直在發生，我認為我們可以做得更好，但我認為我們可以看到，這個過程比我們預期的要慢。但我們正在不斷取得漸進式進展，並期望能夠繼續取得漸進式進展。

Got it. And then just to follow-up on capital allocation on the back of the increased buyback authorization, your net leverage is that kind of the low end of history, just how you're thinking about that and any targets there and how that might influence capital deployment going forward.

知道了。然後，為了跟進增加回購授權後的資本配置問題，你們的淨槓桿率處於歷史低位，你們是如何看待這個問題的，以及任何目標，以及這可能會如何影響未來的資本部署。

Yeah, I mean, we've been an active acquire of our shares for a number of years now. We've said in our prepared remarks that since 2019 we've repurchased more than a third of our shares. We continue to view share repurchase, particularly at these current stock price levels as a compelling.

是的，我的意思是，這些年來我們一直在積極增持股份。我們在事先準備好的演講稿中提到，自 2019 年以來，我們已經回購了超過三分之一的股份。我們仍然認為股票回購，尤其是在目前的股價水準下，是一個極具吸引力的策略。

Use of our capital, we have seen an elevation in our activity and share repurchases, largely, I think tied to the increase in our free cash flow and, I think our expectation is that at a minimum we'll continue to devote most if not all, of our free cash flow to share repurchase absent. Any other compelling opportunities, might we choose to increase that and lever up, even more to do that, we might, it's, something that will make that judgment as we move along.

就我們的資本運用而言，我們看到我們的業務活動和股票回購有所增加，我認為這主要與自由現金流的增加有關，而且我認為，我們預計至少在沒有其他因素的情況下，我們將繼續把大部分（如果不是全部）自由現金流用於股票回購。如果還有其他令人信服的機會，我們可能會選擇增加投入並增加槓桿，甚至為了抓住這些機會而投入更多，這需要我們邊走邊判斷。

Helpful. Thank you.

很有幫助。謝謝。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Great, thanks. Maybe I'll ask the behavioral question again, maybe slightly differently, I guess, like, when we historically thought about this long-term supply, demand and balance within behavioral, you at least had a competitor who is growing very quickly now it seems like, they're slowing, they're closing down capacity in certain locations. Is there anything else that you're that you're seeing more broadly?

太好了，謝謝。也許我會再次提出行為方面的問題，也許會稍微換一種方式，比如，當我們過去思考行為方面的長期供需平衡時，至少會有一個增長非常迅速的競爭對手，但現在看來，他們的增長速度正在放緩，他們正在關閉某些地區的產能。您在更廣泛的範圍內還觀察到其他現象嗎？

Because 2% to 3% isn't their Herculean number, I don't think, but it also was easier to underwrite when someone else is growing much faster. Is there a competitive dynamic that's going on that's, maybe skewing things as part of the market that we don't see every day or anything else that you would kind of, point to that that might say that. The broader market is in fact growing faster than we think we can see from the outside.

因為 2% 到 3% 並不是他們難以企及的數字，我想，但當其他人增長速度更快時，承保也更容易一些。是否存在某種競爭動態，可能會扭曲市場，而這種動態是我們日常生活中看不到的，或者有其他什麼因素可以說明這一點？事實上，整體市場的成長速度比我們從外部看到的要快得多。

Yeah, I mean, so Kevin, the first thing is, it's difficult for us, I think, to comment on, operating trends in a competitor, we just don't have access to enough detail to really have, I think, useful insight in that regard. In terms of sort of what you know maybe I'm rephrasing a little bit the question you asked in terms of, what gives us confidence that there is increasing demand out there. I did reference before, I think, I'm not going to say every single managed care entity, but a great many of the managed care entities over the last several quarters in explaining an increase in their medical loss ratios and utilization.

是的，我的意思是，凱文，首先，我認為我們很難對競爭對手的營運趨勢發表評論，因為我們沒有足夠的細節資訊來真正獲得這方面的有用見解。就您所知，我或許可以稍微重新表達您提出的問題，那就是：是什麼讓我們確信市場上的需求正在不斷增長？我之前提到過，我不會說是每個醫療管理機構，但在過去幾個季度裡，許多醫療管理機構都出現了醫療損失率和使用率上升的情況。

Have cited behavioral care as, a significant chunk of that, and we obviously don't have access to their data, but we do have access to claims data and things. That we look at fairly carefully and what we see is, increased behavioral utilization, as I said earlier on the outpatient side in particular, being delivered in a lot of, I'm going to sort of call them non-traditional, some not necessarily in dedicated behavioral facilities, but in emergency rooms and urgent care centers and nursing homes, etc.

行為護理佔了很大一部分，我們顯然無法取得他們的數據，但我們確實可以獲得理賠數據等資訊。我們仔細觀察後發現，行為治療的使用率有所提高，正如我之前提到的，尤其是在門診方面，很多治療場所，我稱之為非傳統場所，有些不一定是在專門的行為治療機構，而是在急診室、緊急護理中心和療養院等。

And I think, given the clinical product that we can offer in our in and outpatient facilities, given our in-network position with many of these managed care companies, etc. We believe that there's an opportunity for us to capture, an incremental amount of that, and as you point out, it's not a Herculean effort, we're at 1.3% patient day, adjust the patient day growth in the quarter, we're sort of targeting 2%, that's obviously not, a huge GAAP to fill.

我認為，鑑於我們在門診和住院機構中提供的臨床產品，以及我們與許多醫療管理公司建立的合作關係等等，我們相信我們有機會從中分得一杯羹。正如您所指出的，這並非難事，我們目前的患者日增長率為 1.3%，如果調整本季度的患者日增長率，我們的目標是 2%，這顯然不是一個巨大的 GAAP 目標。

Let me just add also, Steve's made the point. I mean some of the limitations have been understaffing, and as that stabilizes, we do think that there are significant opportunities. That we can take advantage of we've been very responsible the last few years in our growth, and other competitors, multiple competitors have been a little bit more aggressive and now, probably didn't make sense.

我還要補充一點，史蒂夫已經表達清楚了。我的意思是，一些限制因素是人手不足，隨著人手短缺情況的穩定，我們認為將會出現很多機會。我們可以利用這一點，因為我們在過去幾年裡一直非常負責任地發展，而其他競爭對手，許多競爭對手則更加激進，現在看來，這可能並不明智。

Some of the moves that they've made and they're having to temper that and go backwards, so we're on the same path that we've been on. We've been responsible in the way we've looked at it. We've held on some supply increases, so adding beds because of maybe a lack of staffing in some of those markets. And if that stabilizes, we're going to have even more opportunities to grow going forward. So we feel really good about where we are with that.

他們採取的一些措施現在不得不加以調整，甚至倒退，所以我們又回到了原來的道路。我們一直以負責任的態度看待這個問題。我們一直沒有增加供應，所以增加床位可能是因為某些市場人手不足。如果這種情況能夠穩定下來，我們未來將擁有更多發展機會。所以我們對目前的情況感到非常滿意。

Okay, then maybe just to then follow-up on the outpatient side of the equation because, to your point you do have some advantages here as far as your in-network location, position and contracts and things like that, but it sounds like you're not capitalizing or you haven't capitalized on it, historically. Can you talk a little about the barriers of it just lack of focus?

好的，那麼接下來或許應該跟進一下門診方面的情況，因為正如你所說，你在網絡內的位置、地位、合同等方面確實有一些優勢，但聽起來你並沒有充分利用這些優勢，或者說，從歷史上看，你還沒有充分利用這些優勢。您能否談談其中的障礙，例如缺乏專注？

Are there markets where you are doing it well and there are blueprints? I mean how can we get confidence that You're going to get that if hiring's been the issue because hiring's been kind of an issue for a while now, why will you be able to kind of capture that that volume going forward. Thanks.

在某些市場，你們做得很好，並且有可以藉鏡的成功模式嗎？我的意思是，如果招募一直是個問題（因為招募問題已經持續了一段時間），我們如何才能確信你們能夠實現這個目標？你們怎麼保證未來能夠達到那個招募量呢？謝謝。

So what we've talked about, I think in the last couple of quarters, Kevin, is, I think two things, one is just an increased focus. We have conceded that for most of our decades-long history as a behavioral health provider, it has been a very inpatient centric business and while we have always had in most of our markets, outpatient programs.

所以，凱文，我認為在過去的幾個季度裡，我們討論的主要是兩件事，一是更專注。我們承認，在我們作為行為健康服務提供者的幾十年歷史中，我們的業務主要以住院治療為主，雖然我們在大多數市場一直都有門診計畫。

They just haven't been a focus and, what we've done, I think, that I think we'll wind up being quite effective if we've reorganized. Such that throughout the organization now there's really dedicated personnel or personnel that are dedicated to developing clinical programs, business development, referral sources, etc. That are, dedicated outpatient focused, and I think that's going to make a big difference because historically, when you have inpatient center facilities that have sort of, on the side outpatient programs, the outpatient programs just don't get the attention that they need.

他們一直不是我們的關注重點，而我們所做的，我認為，如果我們進行重組，最終會非常有效。因此，現在整個機構都有專門的人員負責開發臨床計畫、業務拓展、轉診管道等等。這些人員專注於門診服務，我認為這將帶來很大的改變，因為從歷史上看，當住院中心設施附帶一些門診計畫時，這些門診計畫往往得不到應有的重視。

So I think focus, reorganization of personnel, it's. Will be a big help in that regard. The second piece which we've talked about quite a bit in the last few calls is there's really two components of behavioral outpatient. One is what what we describe as step down business. These are folks who are generally discharged from our facilities but who require follow-up care, either partial hospitalization or intensive outpatient.

所以我認為重點在於人員重組。在這方面會有很大幫助。第二點，也是我們在最近幾次通話中經常談到的，是行為門診實際上包含兩個組成部分。其中之一是我們所謂的逐步退出業務。這些患者通常從我們的機構出院，但需要後續護理，包括部分住院或強化門診治療。

Therapy, we've always had that, and again I think that that business will benefit from increased focus, but where we haven't really had much of a presence historically is what we describe as step in business. These are patients who enter the behavioral system in an outpatient setting, and often are not comfortable doing that and entering the system on a hospital campus. They'd much prefer to get that care in a free standing outpatient setting.

我們一直都有心理治療業務，而且我認為這項業務會因更加重視而受益，但我們歷史上真正涉足的領域是我們所說的「步入式業務」。這些患者在門診環境中進入行為治療系統，他們通常不願意在醫院院區內進入系統。他們更願意在獨立的門診機構接受治療。

And I think that's where Mark was referring in his, prepared remarks to our Thousand Branches branded program. We branded that way because we don't want to necessarily associate it with, an existing inpatient hospital. But again, you said, and or repeating what I have said, we have advantages, we already have existing referral relationships, referral source relationships, we have existing managed care contracts, etc. That should help us, establish a footprint in that step in freestanding business a lot faster than a competitor might be able to do.

我認為這就是馬克在他準備好的發言中提到的我們「千枝」品牌項目。我們之所以這樣命名，是因為我們不想把它與現有的住院醫院連結起來。但是，正如您所說，或重複我之前所說，我們擁有優勢，我們已經建立了轉診關係、轉診來源關係，我們還有現有的醫療管理合約等等。這應該有助於我們比競爭對手更快地在獨立業務領域站穩腳跟。

Great, thanks.

太好了，謝謝。

Matthew Gillmor, KeyBank.

Matthew Gillmor，KeyBank。

Hey, thanks for the question. I want to ask about the acute performances as you think about the volume trends and the expense trends, that Steve discussed, is there any geographic variation to call out to highlight, particularly in some of your larger markets like Las Vegas?

嘿，謝謝你的提問。我想問一下，考慮到史蒂夫討論過的銷售趨勢和支出趨勢，您認為在哪些方面表現突出？是否存在一些值得特別指出的地域差異，尤其是在像拉斯維加斯這樣的一些較大的市場？

Yeah, I mean, obviously there's always, some variation in performance. We've been asked, I think, about, the Vegas economy in the last couple of calls. I think it's fair to say that our, Vegas or the results in the Vegas market are very similar to our overall results, and, as again, as we pointed out, I think Wes Henderson in particular is ramping up quite nicely.

是的，我的意思是，很明顯，表現總是會有一些差異。我想，在最近幾次通話中，我們都被問到了拉斯維加斯的經濟狀況。我認為可以公平地說，我們在拉斯維加斯或拉斯維加斯市場的業績與我們的整體業績非常相似，而且，正如我們再次指出的那樣，我認為韋斯·亨德森的業績尤其正在穩步提升。

We do acknowledge that, there's been a lot of data that suggests that tourist volume is down in Las Vegas. It's something we're watching, if that decline in tourist volume starts to have a ripple effect on the Vegas economy and unemployment rises, etc. You know that I think could be challenging in the future. At the moment we're not seeing those impacts. Unemployment honestly, I think is remaining relatively stable at the moment in Vegas.

我們承認，有許多數據顯示拉斯維加斯的遊客數量正在下降。我們正在密切關注，如果遊客數量的下降開始對拉斯維加斯的經濟產生連鎖反應，導致失業率上升等等，我認為這在未來可能會是一個挑戰。目前我們還沒有看到這些影響。說實話，我認為目前拉斯維加斯的失業率保持相對穩定。

And again, I think our performance in that market is remaining pretty stable and pretty consistent with our overall portfolio in the ET care business. Other than that, no, I don't think there's anything real significant from a, geographic perspective.

而且，我認為我們在該市場的表現相當穩定，與我們在 ET 護理業務的整體組合相當一致。除此之外，不，從地理角度來看，我認為沒有什麼真正重要的事。

Okay, fair enough. And then, a quick follow-up on the pending SDP approvals you mentioned Florida and Nevada. Is there a way for us to think about how that breaks down the net benefit between acute and behavioral?

好吧，這說得有道理。然後，我想快速跟進您提到的佛羅裡達州和內華達州待審批的 SDP 專案。我們能否思考一下，如何將急性獲益和行為效益區分開來？

Well, first of all, I would say that the Las Vegas number is predominantly acute. I don't have a breakout in front of me that for the Florida number, we can provide that in the future.

首先，我認為拉斯維加斯的數字主要是急性數字。我手頭上沒有佛羅裡達州的具體數據，我們將來可以提供。

Okay. Thank you.

好的。謝謝。

Benjamin Rossi, JP Morgan.

班傑明‧羅西，摩根大通。

Hey, good morning, thanks for taking my question. Just wanted to touch on operating cash flow development. You noted that some of the drag due to date has been coming from unfavorable changes in AR. I know you're expecting to get some of that back next quarter as you collect on the DC approval, but do you have any theories as to the drivers behind this unfavorable trend? And then is it fair to attribute some of this to broader payer utilization management trends?

嘿，早上好，謝謝你回答我的問題。只想簡單談談經營現金流發展。您指出，部分拖累是由於 AR 的不利變化造成的。我知道你預計下個季度會收到一部分DC批准款項，但你對造成這種不利趨勢的原因有什麼看法嗎？那麼，將其中一些歸因於更廣泛的支付方使用管理趨勢是否公平？

Yeah, I think our belief then is that the increase in RAR is almost exclusively a function of the 90 million of DC TPP that we intend to collect or expect to collect in the fourth quarter and then the new receivables both in DC, we didn't get our Medicare certification and ability to bill until early September, so you know there's virtually no, collections and. At Cedar Hill in the third quarter and even West Henderson, as its business continues to grow, its AR continues to grow. I think once we sort of factor in those dynamics, we're finding our days in receivables to be, quite consistent with historical levels.

是的，我認為我們當時的看法是，RAR 的成長幾乎完全取決於我們計劃或預計在第四季度收取的 9,000 萬美元 DC TPP，以及 DC 的新應收帳款。我們直到 9 月初才獲得 Medicare 認證和開票資格，所以你知道，幾乎沒有收款。在 Cedar Hill，第三季度，甚至在 West Henderson，隨著業務的持續成長，其應收帳款也持續成長。我認為，一旦我們將這些動態因素考慮在內，我們會發現我們的應收帳款週轉天數與歷史水準相當一致。

Okay, the confirmation. I guess just a follow-up on some of your ute volume commentary, specific to your self-pay category. How did volumes trend during 32 and then how have your self-pay volumes developed year-to-date relative to your expectations coming into the year? Thanks.

好的，確認完畢。我想就您之前關於皮卡車廂數量的評論做一些補充，特別是針對您自費車型的部分。2032 年的交易量趨勢如何？與年初的預期相比，今年迄今的自費交易量發展如何？謝謝。

I think as we said in a, in a previous comment, the one sort of identifiable change in Paix is we saw an increase in exchange volumes, that seemed to come at the expense or as a shift from Medicaid, so exchange volumes are up a little bit on an overall basis and Medicaid volumes are down in terms of our other. Payer classes, Medicare, commercial and self pay that you're ask me about specifically, we haven't seen any major changes in those other payer class. Got it, appreciate it.

我認為正如我們在先前的評論中所說，Paix 中一個可識別的變化是，我們看到交易量增加，這似乎是以犧牲或從 Medicaid 轉移為代價的，因此總體而言，交易量略有上升，而 Medicaid 的交易量則有所下降。您具體詢問的支付方類別，如醫療保險、商業保險和自費保險，我們尚未看到其他支付方類別發生任何重大變化。收到，謝謝。

Stephen Baxter, Wells Fargo.

史蒂芬‧巴克斯特，富國銀行。

Yeah, hi, thanks. I think you touched on this a little bit, so just hoping you could elaborate more on the change in surgical terms you saw in the quarter going from down slightly as of last quarter to up slightly this quarter, I guess where are you seeing that improvement come from? And I think this kind of been bounced around a little bit, but just wondering if you feel like there's been any kind of pull forward, evidence that we've seen of that, for maybe like exchanges, other populations for coverage loss is a bit of a concern going forward. Thank you.

嗨，謝謝。我想您剛才已經稍微提到過這一點，所以我希望您能更詳細地闡述一下您在本季度觀察到的手術術語的變化，即從上個季度的略微下降到本季度的略微上升，您認為這種改善來自哪裡？我覺得這個問題已經被反覆討論過幾次了，但我只是想知道你是否覺得有任何進展，或者我們看到了這方面的證據，比如對於交易所或其他人群來說，失去醫療保險保障是一個令人擔憂的問題。謝謝。

Yeah, I mean, I think we've seen the improvement in surgical volumes relatively across the board. I would say cardiology and cardiac services have been particularly strong, as far as sort of pull through, which I think the crux of that question is, does it seem like.

是的，我的意思是，我認為我們已經看到手術量總體上有所改善。我認為心臟病學和心臟科服務一直特別強勁，就目前的情況來看，我認為這個問題的關鍵在於，看起來是否如此。

Exchange patients are sort of accelerating care in anticipation of potentially losing their coverage. I don't think we're, I don't think that we're really seeing that. I think we've made the comment before that that exchange population seems to behave or their their utilization behavior sort of mirrors or is more closely tied to the Medicaid population, meaning it tends to be emergency room centric as opposed to a lot of elective cases, so. Yeah, I don't, we don't think, I think that there's this, significant pull through impact.

參加健保交換計畫的患者正在加速治療進程，以防失去健保。我不認為，我不認為我們真的看到了這一點。我認為我們之前已經評論過，交易所人群的行為或他們的使用行為似乎與醫療補助人群的行為或使用行為有些相似，或者聯繫更為緊密，這意味著它往往以急診室為中心，而不是以擇期手術為主。是的，我不認為，我們不認為，我認為不會有這種顯著的拉力影響。

Michael Ha, Baird.

Michael Ha，貝爾德。

Thank you. On behavioral volume, just wanted to confirm you're now expecting 2% to 3% growth in fourth quarter, but closer to the low end, and then should we expect next year to be consistently in that 2% to 3% range and then on acute pricing strength, even excluding the DCDDP 5% is pretty strong, especially off the tough prior year comp. I know Steve you mentioned case mix, revenue cycle initiatives, other one-timers, but how much did exchange volumes contribute to pricing?

謝謝。關於行為交易量，我只是想確認一下，您現在預計第四季度將增長 2% 到 3%，但更接近下限，那麼我們是否應該預期明年會持續保持在 2% 到 3% 的範圍內？至於急性定價的強勁程度，即使不包括 DCDDP，5% 的成長也相當強勁，尤其是在去年同期比較基數較高的情況下。我知道史蒂夫，你提到了案例組合、收入週期計劃和其他一次性因素，但是交易量對定價的影響有多大？

And I know you mentioned 2% to 3% is still a pretty good long-term target. Just to confirm, you're still confident on 2% to 3%, even in the face of exchange volume declines over the next couple of years. Thank you.

我知道你提到 2% 到 3% 仍然是一個相當不錯的長期目標。我想確認一下，即使未來幾年交易量下降，您仍然對 2% 到 3% 的成長率有信心嗎？謝謝。

Yeah, so you threw out a lot of numbers, Michael. I'm not sure that I follow all of them. Again, I'll repeat, I think that our view of the sustainable acute care model is, 5%, 6% revenue, same sort of revenue growth, pretty evenly between price and volume, so 2.5% to 3% price, 2.5% to 3% volume. I think on the behavioral side, maybe 6% or 7% same to revenue growth 2% to 3% volume, 3.5% to 4.5% price.

是的，邁克爾，你拋出了很多數字。我不確定我是否完全理解他們的意思。我再重申一遍，我認為我們對可持續急性護理模式的看法是，收入增長 5% 到 6%，收入增長大致相同，價格和銷量增長相當均衡，即價格增長 2.5% 到 3%，銷量增長 2.5% 到 3%。我認為從行為方面來看，收入成長可能達到 6% 或 7%，銷量成長 2% 至 3%，價格成長 3.5% 至 4.5%。

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

Great, thanks. Good morning. I appreciate the commentary on capital deployment, but the leverage ratios just keep coming down despite the share repurchase activity. I know you mentioned the new Florida Medical Center, but if you sort of contemplated any additional areas you could increase capital spending or sort of absent M&A and again additional spending, are you just kind of comfortable letting those ratios decline? Thanks.

太好了，謝謝。早安.我很欣賞您對資本部署的評論，但儘管進行了股票回購，槓桿率卻持續下降。我知道您提到了新的佛羅裡達醫療中心，但是如果您考慮過其他可以增加資本支出或進行併購並增加支出的領域，您是否樂於看到這些比率下降？謝謝。

Yeah, I don't think we anticipate our leverage ratios getting any lower than they currently are obviously we're not looking for ways to spend capital just to increase our leverage ratios, whether that's acquisition type opportunities or CapEx. We'll continue to invest where we think we can earn a compelling return.

是的，我認為我們預期槓桿率不會比現在更低了，顯然我們不會為了提高槓桿率而尋找花錢的方式，無論是收購機會還是資本支出。我們將繼續投資於我們認為能夠獲得可觀回報的領域。

I think we've intentionally kept our leverage ratios low in an environment where there has been some level of uncertainty at the sort of policy, regulatory legislative level. I think that's been a prudent approach, as I think we sort of start to experience and hopefully we do start to experience more certainty, we may be more comfortable increasing those leverage levels. Okay, thanks.

我認為，在政策、監管和立法層面存在一定程度不確定性的環境下，我們有意將槓桿率保持在較低水準。我認為這是一個謹慎的做法，因為隨著我們開始體驗到（希望我們真的會開始體驗到）更多的確定性，我們可能會更願意提高槓桿水平。好的，謝謝。

Joshua Raskin, Nephron Research.

Joshua Raskin，腎單位研究。

Yeah, I guess one that just left maybe an updated view on where you think margins can trend in the next few years, sort of think about pre-pandemic levels versus the progress you guys have made since the pandemic and maybe specific areas where you think there's opportunity to expand margin in each segment.

是的，我想請您更新一下您對未來幾年利潤率趨勢的看法，想想疫情前的水平與疫情以來你們取得的進展，以及您認為每個細分市場中哪些方面有機會擴大利潤率。

Yeah, I think just sort of mathematically, Josh, the general sense is if we can achieve the revenue targets that I just outlined in my last response, 5%,6% on the acute side, 6%, 7% on the behavioral side, clearly costs at the moment are not rising faster than that. They're rising to more at the 4% range. And so as I think has been the case with the historical model for these two businesses. For many years, there should be an opportunity for growth and margin expansion, and, again in an environment of relatively stable operating costs and I think relatively stable demand and pricing, we're looking at, margins in both businesses able to, continue to improve.

是的，Josh，我覺得從數學角度來看，總的來說，如果我們能夠實現我在上次回復中概述的收入目標，即急性疾病方面增長 5%、6%，行為疾病方面增長 6%、7%，那麼顯然目前的成本增長速度不會超過這個水平。它們正在上升到 4% 左右。我認為，這兩家企業的歷史模式一直都是如此。多年來，應該會有成長和利潤率擴張的機會，而且，在營運成本相對穩定、需求和價格相對穩定的環境下，我們認為這兩個業務的利潤率都能夠繼續提高。

And and maybe the follow-up and it's probably a silly question, but you know how do you go back? I know, let's exclude some of the government, segments that are paid, but you know when you're negotiating with managed care companies, if you're seeing that revenue number, I think the core acute number of 5% that you guys are throwing out, if you're seeing, numbers in that ballpark and costs are not going up this high, what sort of the conversation with the payers and, the justification around above average rate increases that we've been seeing lately?

而且，也許接下來的問題很傻，但你知道該如何回去嗎？我知道，我們可以排除一些政府付費的領域，但是你知道，當你和醫療管理公司談判時，如果你看到你們提到的5%的核心急性病支出增長數字，如果你們看到的數字在這個範圍內，而成本並沒有上漲到這麼高，那麼你們和支付方的溝通是怎樣的？最近我們看到的高於平均的費率成長又是如何解釋的呢？

So the the point that I would make on this is not exactly what you're pointing to, but when we sit down with these managed care companies, we've got much better information these days than maybe we had years ago. So even though we feel like we're doing well in a number of our areas, we still You'll see some of our price and lagging competitors in certain markets, and that's what we really point out and H1 in on, and that's where we're able to have a positive effect for ourselves because we're still behind what they're paying some of our competitors. So that's one big area that we bring up in our negotiations.

所以，我想表達的觀點可能和你指出的並不完全一樣，但如今我們與這些醫療管理公司坐下來交談時，我們掌握的資訊比幾年前要好得多。所以，儘管我們感覺自己在很多領域都做得不錯，但你仍然會看到我們在某些​​市場的價格和落後的競爭對手，而這正是我們真正要指出和關注的重點，也是我們能夠對自己產生積極影響的地方，因為我們仍然比一些競爭對手支付的價格要低。所以這是我們在談判中常提及的重要領域。

That's helpful, thank you.

這很有幫助，謝謝。

That concludes today's question-and-answer session. I'd like to turn the call back to Darren Lehrich for closing remarks.

今天的問答環節到此結束。我想把電話轉回給達倫·萊里奇，請他作總結發言。

Thank you everyone for participating in today's call and also for your interest in UHS. Hope you have a great rest of your day. Thanks.

感謝各位參加今天的電話會議，也感謝各位對UHS的關注。祝您今天餘下的時間過得愉快。謝謝。

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

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線了。