US Physical Therapy Inc (USPH) 2024 Q2 法說會逐字稿

Good day and thank you for standing by. Welcome to the U.S. Physical Therapy second-quarter 2024 earnings conference call. (Operator Instructions)

美好的一天，感謝您的支持。歡迎參加美國物理治療 2024 年第二季財報電話會議。（操作員說明）

I'd now like to turn the call over to Chris Reading, President and CEO. Please go ahead, sir.

我現在想將電話轉給總裁兼執行長克里斯·雷丁 (Chris Reading)。請繼續，先生。

Thanks, Jamie. Good morning. And welcome everyone to our second-quarter 2024 U.S. Physical Therapy earnings call. With me on the line this morning, I've got Carey Hendrickson, our Chief Financial Officer; Eric Williams, our President and COO, East; Graham Reeve, our Chief Operating Officer, West; Rick Binstein, our Executive Vice President and General Counsel.

謝謝，傑米。早安.歡迎大家參加我們 2024 年第二季美國物理治療財報電話會議。今天早上打電話給我的是我們的財務長凱裡‧亨德里克森 (Carey Hendrickson)； Eric Williams，我們東部地區的總裁兼營運長； Graham Reeve，West 營運長；賓斯坦 (Rick Binstein)，我們的執行副總裁兼總法律顧問。

Before I make some prepared remarks relating to our quarter and year, I'll ask Jake Martinez to cover a brief disclosure.

在我對我們的季度和年度發表一些準備好的評論之前，我將請傑克·馬丁內斯（Jake Martinez）做一個簡短的披露。

Thank you, Chris. This presentation includes forward-looking statements which involve certain risks and uncertainties. These forward-looking statements are based on the company's current views and assumptions. The company's actual results may vary materially from those anticipated. Please see the company's filings with the Securities and Exchange Commission for more information.

謝謝你，克里斯。本簡報包含涉及某些風險和不確定性的前瞻性陳述。這些前瞻性陳述是基於公司目前的觀點和假設。公司的實際結果可能與預期有重大差異。請參閱該公司向美國證券交易委員會提交的文件以了解更多資訊。

This presentation also contains certain non-GAAP measures as defined in Regulation G. The related reconciliations can be found in the company's earnings release and the company presentations on our website. Chris?

本簡報還包含法規 G 中定義的某些非 GAAP 衡量標準。克里斯？

Thanks, Jake. So let's get started. My discussion this morning will cover a variety of highlights. We've definitely made some progress in some key areas. It will also touch on one of our primary challenges as well.

謝謝，傑克。那麼就讓我們開始吧。我今天上午的討論將涵蓋各種要點。我們確實在一些關鍵領域取得了一些進展。它還將涉及我們的主要挑戰之一。

Let's start with the fact that this was a very solid quarter from a volume perspective, the best visit per clinic per day quarter in our history. April was our high month at 31.2, marking a high also for the year, followed by May nicely over 30. June, just under 30 at 29.8. And all of this follows our normal seasonal progression with school finishing and summer vacations kicking off for a bit before things get back to normal that they've begun to do with school starting up here in Texas this week in many places.

讓我們先了解一個事實：從數量角度來看，這是一個非常穩定的季度，也是我們歷史上每個診所每天就診次數最多的季度。4 月是我們的最高月份，為 31.2，也是今年的最高點，其次是 5 月，遠遠超過 30。6 月，29.8，略低於 30。所有這一切都遵循我們正常的季節性進程，學校放學和暑假開始一段時間，然後一切恢復正常，本週德克薩斯州許多地方都開始開學。

Speaking a minute to our expectations, our total visits are ahead of where we budgeted them to be at the midpoint this year, better by approximately 6,600 visits and ahead of last year's same period by over 108,000 visits. Our partnerships are doing a great job addressing demand and doing a terrific job with patients and what seems to be a rather tight labor market. More on that in a minute.

談談我們的預期，我們的總訪問量比我們今年預算中點的訪問量提前了大約 6,600 次，比去年同期增加了 108,000 多次。我們的合作夥伴在解決需求方面做得很好，在患者和似乎相當緊張的勞動力市場方面也做得很好。稍後會詳細介紹。

And kudos are due to our contracting team. We're starting to see their hard work over the past 18 months really beginning to bear fruit. Net rate for the quarter progressed nicely and finished at $105.05 per visit, up a little bit more than $3 per visit over the same quarter in 2023.

榮譽要歸功於我們的承包團隊。我們開始看到他們過去 18 個月的辛勤工作真正開始結出碩果。本季淨利率進展順利，最終達到每次訪問 105.05 美元，比 2023 年同一季度每次訪問上漲 3 美元多一點。

As you might remember, last year, we renegotiated a large volume of commercial and more complicated contracts. While those adjustments took a little time to phase in and show up, they're doing so now in really nice progression that we are seeing and expect to continue as the year goes forward.

您可能還記得，去年我們重新談判了大量商業合約和更複雜的合約。雖然這些調整需要一些時間來逐步實施和顯現，但它們現在正在以非常好的進展進行，我們看到並期望在未來的一年中繼續下去。

We have also seen a work comp volume move up, and while the aggregate percentage has changed a little, it really shows up when you see the number and rate of year-over-year change in work comp visits, which I'll have Eric cover as we open it up for discussion after these prepared remarks.

我們還看到工作補償量有所上升，雖然總百分比發生了一些變化，但當您看到工作補償訪問的數量和同比變化率時，它確實會顯現出來，我會讓埃里克（Eric）了解這一點在這些準備好的發言之後，我們將進行討論。

The culmination of rate for commercial plans and our faster-than-average work comp growth is resulting in a very nice uptick in our net rate so far for the year and actually we expect that to continue as we go forward.

商業計劃費率的頂峰和我們高於平均水平的工作薪酬增長導致我們今年迄今為止的淨費率出現非常好的上升，實際上我們預計這種情況將在我們前進的過程中持續下去。

In the injury prevention side of things, we had a very good quarter. Revenues grew by more than 23%. We also saw a nice margin improvement of about 70 basis points to 21.4%, with an increased profitability of more than 27%.

在傷害預防方面，我們度過了一個非常好的季度。收入成長超過23%。我們也看到利潤率大幅提高約 70 個基點，達到 21.4%，獲利能力增加超過 27%。

And I was just out in Denver, spent a few days with [WREX] partners. They're working to integrate our recent Atlas acquisition. That opportunity is going very well and the integration of our teams is progressing nicely with what I think will be some enhancements that will be beneficial to us in the long run once this combination is fully complete. Both of our injury prevention partnerships, East and West, are doing well and gaining new customers and have a better-than-expected, better-than-budget trajectory on the year so far.

我剛剛在丹佛，與 [WREX] 合作夥伴一起度過了幾天。他們正在努力整合我們最近收購的 Atlas。這個機會進展順利，我們團隊的整合進展順利，我認為一旦合併完全完成，長遠來看將有一些增強功能對我們有利。我們在東部和西部的傷害預防夥伴關係都表現良好，贏得了新客戶，今年迄今的發展軌跡好於預期、好於預算。

Where we had more work, and frankly, we are behind where we expected to be at this point, and really our primary point of struggle was around our PT-related costs for labor. Carey will cover the per visit and percent of revenue costs in detail, but the sum of it all is that the people we have hired this last year, and likely in that period slightly preceding that, are at a higher rate given inflation and employee scarcity than we've experienced in the past. Therapists overall are about 4% more on average for incentives. Front office personnel are about 5% more.

我們還有更多的工作要做，坦白說，我們目前落後於我們的預期，而我們的主要鬥爭點實際上是與 PT 相關的勞動力成本。凱裡將詳細介紹每次訪問和收入成本的百分比，但總而言之，考慮到通貨膨脹和員工稀缺，我們去年僱用的人員以及可能在此之前的那個時期僱用的人員的比率較高比我們過去經歷過的。整體而言，治療師的獎勵平均高出 4% 左右。前台人員大約增加了5%。

Additionally, in a handful of markets, we have greater-than-expected use of contract and travel-based labor. That obviously has hurt us and impacting our performance and our margin, despite the strong gains in net rate that we've made.

此外，在少數市場中，我們對合約工和出差勞工的使用量超出了預期。儘管我們的淨利率取得了強勁增長，但這顯然對我們造成了傷害，並影響了我們的業績和利潤。

It's a little bit of a two-edged sword in that we have good demand in and across most of our partnerships and addressing that immediate demand in the current environment has necessitated that we bring on more contract labor than we initially envisioned.

這有點像一把雙面刃，因為我們在大多數合作關係中都有良好的需求，而要滿足當前環境下的直接需求，我們需要雇用比最初預想更多的合約工。

Our ops teams are very aware of where we are and where we would like to be and are working hard to ensure that we have the staffing balanced appropriately for the season. And we have sufficient resources to meet the demand, but remain highly efficient at the same time.

我們的營運團隊非常清楚我們現在的處境以及我們想要達到的目標，並且正在努力確保我們在本賽季的人員配置上保持適當的平衡。我們有足夠的資源來滿足需求，同時保持高效率。

Additionally, we've made numerous investments in the areas of recruiting that we expect to bear fruit and some longer-term initiatives with respect to school relationships, partnerships, and affiliations. These are all things you should expect us to be doing over the coming months and quarters as we look to readjust to the market factors that are currently influencing our outlook for the remainder of the year.

此外，我們在招聘領域進行了大量投資，希望能夠取得成果，並在學校關係、合作夥伴關係和隸屬關係方面採取了一些長期舉措。這些都是您應該期望我們在未來幾個月和幾季要做的事情，因為我們希望重新調整目前影響我們今年剩餘時間前景的市場因素。

Let me say this: while I know our cost issue is an unfavorable development we have to overcome, when you look at our key focus areas over time, we have a very good history of overcoming obstacles. We have a dedicated and capable group of partners, a great ops team, all of whom are working to get this dialed in over the coming period.

讓我這樣說：雖然我知道我們的成本問題是我們必須克服的不利發展問題，但當你隨著時間的推移審視我們的重點關注領域時，我們有克服障礙的良好歷史。我們擁有一支敬業且有能力的合作夥伴團隊，一支出色的營運團隊，所有人都在努力在未來一段時間內實現這一目標。

One final note. We're busy and remain committed on the development side of things. A few of our deals have pushed out a little bit due to factors that we don't control on the seller side of the equation. But rest assured, we're working hard and we expect a strong finish to the year for our development efforts with some exciting markets and partners who we are anxious to make part of our family as we look ahead.

最後一點。我們很忙，並繼續致力於開發方面。由於我們在賣方方面無法控制的因素，我們的一些交易已經推遲了一些。但請放心，我們正在努力工作，我們希望與一些令人興奮的市場和合作夥伴一起，在今年的開發工作中取得良好的成果，展望未來，我們渴望讓他們成為我們大家庭的一部分。

That concludes my overview and prepared remarks. Carey, as he always does so well, will cover the detail behind these themes. Go ahead, Carey.

我的概述和準備好的演講就到此結束。凱裡（Carey）一如既往地做得很好，他將介紹這些主題背後的細節。繼續吧，凱裡。

Great. Thank you, Chris, and good morning, everyone. We saw some really good things inside of our numbers for the second quarter, things that we expect to continue to benefit us through the remainder of the year and beyond.

偉大的。謝謝你，克里斯，大家早安。我們在第二季的數據中看到了一些非常好的事情，我們預計這些事情將在今年剩餘時間及以後繼續使我們受益。

Chris mentioned some of them in his remarks, but they're particularly notable and worth repeating a few of them. Our hard work on rate negotiations and our focus on increasing workers' comp as a percentage of our overall business continued to take root in the second quarter, resulting in a substantial year-over-year increase in our net rate.

克里斯在演講中提到了其中一些，但其中一些特別值得注意，值得重複。我們在費率談判方面的努力以及對提高工人報酬佔整體業務的百分比的關注在第二季度繼續紮根，導致我們的淨費率同比大幅增長。

Also, our average visits per day in the second quarter are a record high for the company and our IIP business grew at a mid-teens rate in the second quarter, even before adding the acquisition that we made on April 30. Our salaries and contract labor were higher than we would have liked in the quarter, but the business itself is strong as we continue to see meaningful growth in these key indicators.

此外，我們第二季度的日均訪問量創下了該公司的歷史新高，我們的國際投資頭寸業務在第二季度以中位數的速度增長，甚至在加上我們4 月30 日進行的收購之前也是如此。本季我們的薪資和合約工高於我們的預期，但業務本身很強勁，因為我們繼續看到這些關鍵指標的有意義的成長。

We reported adjusted EBITDA for the second quarter of 2024 of $22.1 million, compared to $23.6 million in the prior year. Our adjusted EBITDA margin was 16.4% in the second quarter of this year, compared to 17.7% in the second quarter of the prior year.

我們報告 2024 年第二季調整後 EBITDA 為 2,210 萬美元，而前一年為 2,360 萬美元。今年第二季我們調整後的 EBITDA 利潤率為 16.4%，而去年第二季為 17.7%。

Traditionally, most calculate our EBITDA margin without the benefit of knowing what our adjusted revenue for minority interest is, which makes it appear that our margin is lower than it actually is. This adjusted EBITDA margin that I just quoted is 16.4% in the second quarter. It's calculated on an apples-to-apples basis with both revenue and EBITDA adjusted for minority interest.

傳統上，大多數人在計算我們的 EBITDA 利潤率時並不知道我們調整後的少數股東權益收入是多少，這使得我們的利潤率看起來比實際情況要低。我剛才引用的第二季調整後 EBITDA 利潤率為 16.4%。它是按照同等比例計算的，收入和 EBITDA 均根據少數股東權益進行了調整。

Our operating results were $11 million in the second quarter of 2024, which is an increase of $600,000 over the second quarter of 2023. On a per share basis, operating results were slightly lower than 2024 than 2023 at $0.73 this quarter, and $0.76 in the second quarter of last year. That small decrease is related to the increase in shares that were associated with the secondary offering that we completed in May of last year.

2024 年第二季我們的營運表現為 1,100 萬美元，比 2023 年第二季增加了 60 萬美元。以每股計算，本季營運業績略低於 2024 年和 2023 年，為 0.73 美元，去年第二季為 0.76 美元。這一小幅下降與我們去年 5 月完成的二次發行相關的股票增加有關。

Our average visits per clinic per day in the first quarter was 30.6, which is the highest volume per quarter in the company's history. Chris noted what the progression was throughout the month. The lower number in June, as he mentioned, is our typical seasonal pattern, as both patients and our clinicians take vacations, and the schedule just changes a little bit in the summer there for families. In July, our average visits per day was 29.8, which is consistent with July of last year, and it's in sync with our seasonal expectations.

第一季每個診所每天的平均就診量為 30.6 次，這是該公司歷史上單季最高的就診量。克里斯指出了整個月的進展。正如他所提到的，六月的數字較低，是我們典型的季節性模式，因為患者和我們的臨床醫生都在休假，而且夏季家庭的日程安排略有變化。7 月份，我們的每日平均造訪量為 29.8 次，與去年 7 月份一致，也與我們的季節性預期一致。

Our net rate was $105.05 in the second quarter of 2024, which was $3.02 per visit, or 3% higher than the second quarter of last year, even with another 1.8% Medicare reduction by CMS that was in effect in the second quarter of 2024. This was the highest quarterly net rate we've had since 2020, while enduring four Medicare rate reductions by CMS since that time.

2024 年第二季我們的淨費率為 105.05 美元，即每次就診 3.02 美元，比去年第二季高出 3%，即使 CMS 在 2024 年第二季又削減了 1.8% 的醫療保險費用。這是我們自 2020 年以來最高的季度淨費率，同時自那時起 CMS 已四次降低醫療保險費率。

Excluding Medicare, our rate was up $4.80 per visit, or 4.5% over the second quarter of last year. The increase was largely related to our strategic priority of increasing reimbursement rates through contract negotiations with commercial and other payers, and our focus on growing our workers' comp business. We're also focused on maximizing our cash collections through improvements in our revenue cycle management.

不包括 Medicare，我們每次就診的費率上漲了 4.80 美元，比去年第二季上漲了 4.5%。這一增長很大程度上與我們透過與商業和其他付款人進行合約談判來提高報銷率的策略優先事項以及我們對發展工人補償業務的關注有關。我們也致力於透過改進收入周期管理來最大化我們的現金回收。

Each of our major category of payers increased year over year. Workers' comp, which is one of our highest rate categories, increased from 9.6% of our revenue mix in the second quarter of 2023 to 10.1% in the second quarter of 2024. These rate-enhancing initiatives will remain high priorities throughout 2024 and beyond.

我們每個主要類別的付款人逐年增加。工人補償是我們費率最高的類別之一，占我們收入組合的比例從 2023 年第二季的 9.6% 增加到 2024 年第二季的 10.1%。這些提高利率的措施在 2024 年及以後仍將是高度優先事項。

Physical therapy revenues were $143.5 million in the second quarter of 2024, which was an increase of $11.2 million or 8.5% from the second quarter of 2023. This increase was driven by having 25 more clinics on average in the second quarter of 2024 than in the second quarter of last year, as well as an increase in our visits at mature clinics, and of course, the increase in that rate.

2024年第二季物理治療收入為1.435億美元，較2023年第二季增加1,120萬美元，成長8.5%。這一成長的推動因素是，2024 年第二季診所數量比去年第二季平均增加了 25 家，以及成熟診所就診次數的增加，當然還有該比率的增加。

Physical therapy operating costs were $114.7 million, which was an increase of 10.3% over the second quarter of last year, due in part, again, to having 25 more clinics on average in the second quarter of last year, as well as the increases in salaries and wages and contract labor costs that we've mentioned.

物理治療營運成本為 1.147 億美元，比去年第二季成長 10.3%，部分原因同樣是去年第二季平均新增 25 家診所，以及我們提到的工資和合約勞動成本。

On a per visit basis, our total operating costs were $84.46 in the second quarter, which compares to $80.61 in the second quarter of 2023. Our salaries and related costs per visit were $59.66 in the second quarter of 2024, compared to $57.59 in the second quarter of 2023. And our physical therapy margin was 20.1% in the second quarter of 2024.

按每次訪問計算，我們第二季的總營運成本為 84.46 美元，而 2023 年第二季為 80.61 美元。2024 年第二季我們每次就診的薪資和相關費用為 59.66 美元，而 2023 年第二季為 57.59 美元。2024 年第二季我們的物理治療利潤率為 20.1%。

As Chris noted, our IIP team produced excellent growth in the first quarter. IIP net revenues were up $4.5 million or 23.2% over the second quarter of 2023, with IIP income up $1.1 million or 27.4%. Excluding the acquisition that we closed on March 31, 2024, our net revenues were still up 13.5%, with our gross profit up 15.7%. Our IIP margin increased from 20.7% in the second quarter of 2023 to 21.4% in the second quarter of 2024.

正如克里斯指出的，我們的 IIP 團隊在第一季取得了出色的成長。與 2023 年第二季相比，IIP 淨收入成長 450 萬美元，即 23.2%，其中 IIP 營收成長 110 萬美元，成長 27.4%。不包括我們於 2024 年 3 月 31 日完成的收購，我們的淨收入仍成長 13.5%，毛利成長 15.7%。我們的國際投資部位利潤率從 2023 年第二季的 20.7% 增至 2024 年第二季的 21.4%。

Our corporate office costs were $14.2 million, which is 8.5% of revenue, right in line with expectations in the second quarter of 2024. That compared to $12.1 million or 8% of revenue in the second quarter of 2023. The second quarter of 2023 included a downward revision in our bonus accrual, causing it to look a little bit better as a percent of revenue than in the second quarter of this year. Our corporate costs in the second quarter of this year were actually lower than our budget by about $400,000.

我們的公司辦公成本為 1,420 萬美元，佔營收的 8.5%，與 2024 年第二季的預期相符。相比之下，2023 年第二季的營收為 1,210 萬美元，佔營收的 8%。2023 年第二季度我們對應計獎金進行了向下修正，使其佔收入的百分比看起來比今年第二季度要好一些。今年第二季我們的企業成本實際上比預算低了約 40 萬美元。

Quickly turning to our balance sheet, it continues to be in excellent position. We have $142.5 million of debt on our term loan, with a swap agreement in place that places the rate on our debt at 4.7%, which you know is a very favorable rate in today's market and well below the current Fed funds rate even. In the first half of 2024 alone, the swap agreement saved us $1.8 million in interest expense, with cumulative savings of $5.1 million since the third quarter of 2022 in interest expense.

快速轉向我們的資產負債表，它仍然處於良好狀態。我們的定期貸款債務為 1.425 億美元，互換協議將我們的債務利率定為 4.7%，您知道，這在當今市場上是一個非常優惠的利率，甚至遠低於當前的聯邦基金利率。光是2024年上半年，互換協議就節省了180萬美元的利息費用，自2022年第三季以來累計節省了510萬美元的利息費用。

In addition to the term loan, we also have a $175 million revolving credit facility that had nothing drawn on it during the second quarter, so that's all available capacity. And we have approximately $90 million of excess cash over and above what we need for working capital ready for deployment into growth initiatives. We deployed $40 million of cash in acquisitions so far this year and expect to deploy more before the end of the year.

除了定期貸款外，我們還有 1.75 億美元的循環信貸額度，第二季沒有動用任何資金，因此這就是所有可用能力。除了我們所需的營運資金之外，我們還有大約 9,000 萬美元的多餘現金，可以部署到成長計畫。今年到目前為止，我們在收購中部署了 4000 萬美元現金，並預計在年底前部署更多現金。

As we noted in our release, we're updating our EBITDA guidance for full-year 2024, returning to our original range of $80 million to $85 million. The change in guidance reflects our updated expectations for salaries and related costs and contract labor through the remainder of the year related to the continuing challenging employment environment, particularly for our clinicians and our front office staff. We expect our patient volumes to continue to be strong during 2024 and we expect to make additional progress on net rate throughout the year.

正如我們在新聞稿中指出的，我們正在更新 2024 年全年 EBITDA 指引，恢復到 8000 萬美元至 8500 萬美元的原始範圍。指導意見的變化反映了我們對今年剩餘時間的工資和相關成本以及合約工的最新預期，這些預期與持續充滿挑戰的就業環境有關，特別是對我們的臨床醫生和前台工作人員而言。我們預計 2024 年患者數量將繼續保持強勁，並預計全年淨率將取得進一步進展。

With those details, Chris, I'll turn it back to you. We'll take questions.

克里斯，有了這些細節，我會把它轉回給你。我們將接受提問。

Okay, Carey. Great job. Thank you. Jamie, let's go ahead and open it up for questions.

好的，凱裡。幹得好。謝謝。傑米，讓我們繼續提問。

(Operator Instructions)

（操作員說明）

Brian Tanquilutit, Jefferies.

布萊恩·坦奎魯蒂特，傑弗里斯。

Hey. Good morning, guys.

嘿。早安，夥計們。

Good morning.

早安.

Chris, maybe I'll start with you. So the labor challenges that we're seeing here, I guess two questions. It doesn't seem like it's impacting your ability to drive volume growth. So is this just a matter of basically a reset in the baseline for what your therapists are making?

克里斯，也許我會從你開始。因此，我們在這裡看到的勞動力挑戰，我想有兩個問題。它似乎並沒有影響您推動銷售成長的能力。那麼，這基本上只是重置治療師所做的基線的問題嗎？

And then maybe the second part of the question would just be, how are you thinking about strategies and initiatives to drive and improve that labor situation?

那麼問題的第二部分可能只是，您如何考慮推動和改善勞動力狀況的策略和措施？

Yeah. It's a good question. So, first part is the perspective that it hasn't impacted our volume because the volume's been pretty good. I think it has impacted our volume in a negative way. We've beefed up our recruiting teams; we're doing better. But we still have markets where if somebody does leave us and turnover's been good, if somebody does leave us, they relocate their family to another state or another place. It takes a while to fill that spot and we do feel it. And so I think if the labor market eases, I think it reciprocally will have a further uplift on volume, but demand's good.

是的。這是一個好問題。因此，第一部分是它沒有影響我們的銷量，因為銷量非常好。我認為這對我們的銷量產生了負面影響。我們加強了招募團隊；我們做得更好。但我們仍然有這樣的市場：如果有人離開我們，而且人員流動情況良好，如果有人離開我們，他們就會把家人搬到另一個州或另一個地方。填補這個位置需要一段時間，我們確實感覺到了。因此，我認為，如果勞動市場放緩，我認為數量將會進一步增加，但需求良好。

Look, the operations team, it's a tough balance, particularly as we have gone into and through now vacation season with our staff working hard to deal with the volume that they have and the necessity to bring in some other or ancillary staff to fill those gaps, to keep volume up. Ops team's very aware of it. Eric and Graham and our regional presidents. And it's tough, but we've got to just keep everything very dialed in.

看，營運團隊，這是一個艱難的平衡，特別是因為我們已經進入並度過了現在的假期，我們的員工正在努力處理他們擁有的工作量，並且有必要引入一些其他或輔助人員來填補這些空白，保持音量增大。營運團隊非常清楚這一點。艾瑞克和格雷厄姆以及我們的地區總裁。這很困難，但我們必須保持一切正常。

We had a greater number of techs hired in the period than I kind of expected, so they're digging into that a bit. That may just be a seasonal thing. And we're coming out of that season now that school's back in.

在此期間，我們僱用的技術人員數量比我預期的要多，因此他們正在對此進行深入研究。這可能只是季節性的事情。現在學校已經開學了，我們即將結束那個季節。

And then just on the demand side, any time that there's pressure around hiring, the tendency is to pay more, to just block it down. And so we need to do a better longer-term job on widening the funnel. And so we're making some adjustments and some investments in the part of our business that really interfaces most closely with the PT schools around the country and offering, I think, a wider complement of things that we can do for those programs to help them and reciprocally help us as well. And so it's a little bit of a longer-term program and project. But all those things are in the works right now.

然後就需求方面而言，每當招聘面臨壓力時，人們都會傾向於支付更高的工資，從而阻止招聘。因此，我們需要在擴大通路方面做得更好、更長期。因此，我們正在對與全國各地的 PT 學校聯繫最密切的業務部分進行一些調整和投資，我認為，我們可以為這些項目提供更廣泛的補充，以幫助他們並相互幫助我們。所以這是一個有點長期的計劃和項目。但所有這些事情現在都在進行中。

Okay. That makes sense. And then maybe just my follow-up question would just be on the turnover, are you seeing any change there? And is that something that's just stable and then what we're seeing is just kind of like a replacement cycle that's consistent with the normal trend?

好的。這是有道理的。也許我的後續問題只是關於營業額，您看到那裡有什麼變化嗎？這是不是一種穩定的東西，然後我們所看到的只是一種與正常趨勢一致的更換週期？

Yeah. I think turnover's actually been pretty steady, steady meaning it's been good for the last year and a half, two years. I think the group's done a good job on that. Where we've seen pressure is, this year, we gave probably larger-than-average raises just because people were pressed and the market's tight and it's very competitive. And then the newer people coming in, we know we're paying a bit more than we were a couple years ago and so I think it's that combination.

是的。我認為營業額實際上相當穩定，穩定意味著過去一年半、兩年一直很好。我認為該小組在這方面做得很好。今年我們看到的壓力是，我們的加薪可能高於平均水平，只是因為人們受到壓力，而且市場緊張且競爭非常激烈。然後新人加入，我們知道我們支付的費用比幾年前要高一些，所以我認為這就是這種結合。

Where I think we're going to have to retest and I don't know that it'll be on the clinician side of the market, but on our hourly wage area in our front desk and looking maybe for some more efficiencies there or retesting the numbers that we've been paying this last year to see if we can balance inflation. I've debated a bit to see if we can get those back down a little.

我認為我們將不得不重新測試，我不知道它會在市場的臨床醫生方面，但會在我們前台的小時工資區域，並尋求更高的效率或重新測試我們去年支付的數字是為了看看我們是否能夠平衡通貨膨脹。我已經爭論了一會兒，看看我們是否可以把這些降低一點。

And so all those factors, along with making sure our cash flow's been fantastic, our collections have been really good. And our executive who handles that area's doing a great job, and just making sure we're as efficient as we need to be and can be on the backside of our operations as well.

因此，所有這些因素，再加上確保我們的現金流非常好，我們的收藏非常好。我們負責該領域的高階主管做得很好，確保我們達到所需的效率，並且也能支援我們的營運。

And so that in combination with the fact that I expect that we'll still see some more rate growth, I'm really pleased with all of the reports and how that is lining up. And Carey and I both expect to see that to continue to progress over the coming period. And so it's going to have to be that combination of operational focus seeing what we can do in terms of rate at the front desk and some efficiencies in some other areas, and hopefully we can get it down a bit.

因此，結合我預計我們仍會看到更多利率增長這一事實，我對所有報告及其進展感到非常滿意。凱里和我都希望看到這一點在未來一段時間內繼續取得進展。因此，這必須是營運重點的結合，看看我們在前台的費率和其他一些領域的效率方面可以做些什麼，希望我們能把它降低一點。

Thank you.

謝謝。

Thanks, Brian.

謝謝，布萊恩。

Larry Solow, CJS Securities.

拉里·索洛，CJS 證券。

Great. Thanks and --

偉大的。謝謝和--

Good morning.

早安.

Good morning, Chris. Good morning, Carey. It's fun to ask you the question on the volumes, maybe a little bit of a follow-up to Brian's question just on the staffing constraints. So volumes are -- as you pointed out, at record levels in a seasonal and strong quarter. Just curious, though, if we look year-to-date, we're pretty much flat, right, on a same-store basis. I know Q1 was maybe a little unfair because there was some weather, but you've grown 2% to 3% volume in the last 10 years.

早上好，克里斯。早上好，凱裡。問你關於卷的問題很有趣，也許是布萊恩關於人員限制的問題的後續行動。因此，正如您所指出的，在季節性強勁的季度中，成交量達到了創紀錄的水平。不過，只是好奇，如果我們看看今年迄今為止，我們在同店基礎上幾乎持平，對吧。我知道第一季可能有點不公平，因為有一些天氣因素，但過去 10 年銷量增長了 2% 到 3%。

So is there -- if we get above this 30 per visit per day and I've asked this question before, are there constraints? I mean, clearly it sounds like, I would guess, staffing is one of them. Just -- and you did mention that volumes are sort of in line with your expectations. So do you kind of bake in a little bit of a slower volume year this year? Or just any color around that would be great.

那麼，如果我們每天每次訪問的次數超過 30 次，而我之前曾問過這個問題，是否有限制？我的意思是，顯然，我猜，人員配備就是其中之一。只是——你確實提到銷量有點符合你的預期。那麼，今年的烘焙量是否會稍微放緩一些呢？或者任何周圍的顏色都會很棒。

Yeah. I don't think 30 is the threshold for anything. I mean, a lot of our workforce are part-time, regular committed part-time, but part-time moms that are working, part-time with kids still at home, other things. And so we do have the ability to flex staffing, assuming that staffing is available and people are available and I think that's been the biggest limiting factor so far this year.

是的。我不認為30歲是任何事情的門檻。我的意思是，我們的許多勞動力都是兼職的，定期致力於兼職，但兼職媽媽正在工作，兼職照顧仍在家裡的孩子，等等。因此，我們確實有能力靈活調整人員配置，假設人員配置可用且人員可用，我認為這是今年迄今為止最大的限制因素。

And you're right, we're flat on the year after having a lighter than expected first quarter. Second quarter came in about where we expected. It was a little bit lighter in June than I think we had modeled, particularly after a strong April.

你是對的，在第一季的業績低於預期之後，我們今年的業績持平。第二季的業績符合我們的預期。六月的天氣比我想像的要淡一些，特別是在經歷了強勁的四月之後。

But volume, generally speaking, demand for new patients is there. We just have to be able to assess it from a staff perspective. And so I don't think this is a ceiling for us. We certainly don't have a ceiling from a facility standpoint, a physical plant and things like that, and it's all about creating incremental staffing so that we can continue to grow.

但整體來說，新患者的需求量是存在的。我們只需要能夠從員工的角度進行評估。所以我認為這不是我們的上限。從設施的角度來看，我們當然沒有上限，實體工廠和類似的東西，這都是為了增加人員配置，以便我們可以繼續發展。

Right. And on pricing, you've done a great job. Obviously, made some good strides. It feels to me like hopefully, you continue to negotiate and renegotiate, right? Because physical therapy, as we know, is a cost saver, right? And with these inflationary pressures, you should be able to go back and some industries are getting so much more price, right? So I feel like you got that, right?

正確的。在定價方面，你們做得很好。顯然，取得了一些良好的進步。我覺得希望你們能夠繼續談判並重新談判，對嗎？因為眾所周知，物理治療可以節省成本，對嗎？有了這些通膨壓力，你應該能夠回到過去，一些行業的價格要高得多，對嗎？所以我覺得你明白了，對吧？

Yeah.

是的。

Right. And just on the Medicare side, any update there? I think they came out with their proposals. Maybe this is the last year of proposed cuts. Any thoughts, longer term, maybe go into a CPI-based index pricing on the government side --

正確的。就醫療保險而言，有什麼更新嗎？我認為他們提出了自己的建議。也許這是擬議削減的最後一年。從長遠來看，任何想法都可能會進入政府方面基於 CPI 的指數定價--

Yeah. Yeah.

是的。是的。

-- or anything there?

——或者那裡有東西嗎？

Yeah. That's what's supposed to happen now in the interim period, this comment period following the July release. We're pressing hard. Having five years' worth of cuts in a row, in succession, it just makes making operational adjustments very, very difficult.

是的。這就是在 7 月發布之後的過渡期（即評論期）中應該發生的情況。我們正在努力施壓。連續五年的削減，使得營運調整變得非常非常困難。

And I think we've squeezed and maneuvered and managed, not perfectly by any stretch, but I think pretty well. And yet, I don't know that I can name another industry that's had maybe home health and some stretches, this kind of punishment unnecessarily.

我認為我們已經進行了擠壓、操縱和管理，儘管無論如何都不是完美的，但我認為相當不錯。然而，我不知道我能說出另一個可能有家庭健康和一些延伸的行業，這種懲罰是不必要的。

And it all, frankly, comes from a mistake that MedPAC made when this all began. Or they didn't realize that physical therapy was part of the code set that they were impacting. They thought they were impacting interventional pain management specialists, PM&R doctors and orthopedic surgeons, the guys at the top of the food chain. And it's unfortunate, but we're in it.

坦白說，這一切都源自於 MedPAC 在這一切開始時所犯的錯誤。或者他們沒有意識到物理治療是他們正在影響的代碼集的一部分。他們認為自己正在影響介入性疼痛管理專家、PM&R 醫生和骨科醫生，這些處於食物鏈頂端的人。這很不幸，但我們身在其中。

We're almost out the other side. I can't imagine that this is going to continue without some reversal. And we're spending a lot more time in DC with the lobby group, our industry group, APTQI, with the APTA, with our congressmen and women. And hopefully, once this election cycle is through and we get some daylight on the other side and people can focus on governing, we can make some progress.

我們快要走出另一邊了。我無法想像這種情況會繼續下去而不發生一些逆轉。我們在華盛頓特區與遊說團體、我們的行業團體 APTQI、APTA、與我們的國會議員和女議員一起度過了更多的時間。希望一旦這個選舉週期結束，我們在另一邊得到一些曙光，人們可以專注於治理，我們就可以取得一些進展。

Got it. And the proposed cut, I guess, for 2025, I believe, is just similar to the initial proposal for 2024, just under 3%. Is that right?

知道了。我認為，我認為 2025 年擬議的削減與 2024 年的最初提議相似，略低於 3%。是這樣嗎？

Yeah. I think that.

是的。我認為。

3.5%.

3.5%。

Okay.

好的。

Yeah. All right. Okay.

是的。好的。好的。

Yeah. Yeah.

是的。是的。

And just --

只是——

Our --

我們的--

Yeah. Yeah.

是的。是的。

Go ahead, Larry. Go ahead.

來吧，拉里。前進。

No, no. Go ahead. Your comment, I just had a question, a random one. Just go ahead. What was your thought there?

不，不。前進。你的評論，我只是有一個問題，一個隨機的問題。繼續吧。當時的想法是什麼？

I was just saying, in the meantime, we're working. We can't control what Medicare does, what CMS does, unfortunately. But in the meantime, we're trying to control what we can control. And that's putting a lot of effort towards contract and rate negotiations for commercial, for workers' comp, for all those things. We're seeing really good progress there.

我只是說，與此同時，我們正在工作。不幸的是，我們無法控制 Medicare 和 CMS 的角色。但同時，我們正在努力控制我們能控制的事情。這為商業、工人補償等所有方面的合約和費率談判投入了大量精力。我們在那裡看到了非常好的進展。

And you'll remember, when we did these negotiations, many of them, we built in three-year step increases. So they continue to produce fruit each year to have continual step increases in our rates. So that's good, and that's going to benefit us going forward. It's already benefited us.

你會記得，當我們進行這些談判時，我們在其中許多談判中都制定了三年的逐步成長計畫。因此，他們每年繼續生產水果，使我們的價格不斷提高。所以這很好，這將有利於我們未來的發展。已經讓我們受益匪淺了。

We're seeing -- really starting to see the impact of it now. And I'm pleased with our team that's been, that's done a really good job on that, as well as the increase in workers' comp that, the number of visits in particular. And as a percent of our mix, it's a really good thing, because that's one of our highest rate categories. So we're working hard to move that rate, even with the pressure from CMS.

我們現在確實開始看到它的影響。我對我們的團隊非常滿意，他們在這方面做得非常好，而且工人報酬的增加，特別是訪問次數的增加。作為我們組合的百分比，這確實是一件好事，因為這是我們費率最高的類別之一。因此，即使面臨 CMS 的壓力，我們也正在努力提高這一速度。

Great. I was just going to ask you to start off, but just with the Hurricane Beryl, I know it caused a little bit of a lateness in your results and some shutdowns around in the Houston area. I know you guys have a decent amount of facilities down there. Was there any volume impact we should expect in Q3? Thanks.

偉大的。我只是想請您開始，但就颶風貝裡爾而言，我知道它導致您的結果有點延遲，並導致休士頓地區周圍出現一些停工。我知道你們那裡有相當多的設施。我們應該預期第三季會對銷售產生什麼影響嗎？謝謝。

We lost about 2,600 visits as a result of that. But I noted in my comments that our average visits per day in July was 29.8. So it's still right in line with what June was and right in line with our expectations and right about the same place it was last year in July of 2023.

我們因此損失了大約 2,600 次訪問量。但我在評論中指出，7 月份我們的日均訪問量為 29.8 次。因此，它仍然與 6 月的情況相符，也符合我們的預期，並且與去年 2023 年 7 月的情況大致相同。

Great. I appreciate all the comments. Thank you.

偉大的。我感謝所有的評論。謝謝。

Thanks, Larry.

謝謝，拉里。

Joanna Gajuk, Bank of America.

喬安娜·加尤克，美國銀行。

Hi. Good morning.

你好。早安.

Good morning, Joanna.

早安，喬安娜。

Thanks so much. Hey. Thanks so much for taking the question here. So I guess on the labor, since very tough here, but my question is, to your point, you've been hiring these workers for a year or maybe even longer at this higher rate.

非常感謝。嘿。非常感謝您在這裡提出問題。所以我想在勞動力方面，因為這裡非常艱難，但我的問題是，就你而言，你已經以這種更高的速度僱用這些工人一年甚至更長的時間。

So my question is, like, why such a surprise on labor during this quarter? I mean, you've been talking about, like, staffing improving and turnover below the industry, which I guess that still holds. But I guess, why were you so surprised with this quarter? Why, I guess, it didn't transpire in Q1?

所以我的問題是，為什麼本季的勞動力狀況如此令人驚訝？我的意思是，您一直在談論人員配備的改善和低於行業的營業額，我想這仍然成立。但我想，為什麼你對這個季度如此驚訝？我猜為什麼它沒有在第一季發生？

Yeah.

是的。

Yeah.

是的。

It's a -- go ahead, Carey.

這是——繼續吧，凱裡。

Yeah. I was just going to say, one of the things that played into it, I think, was we expected to be able to transition from contract labor to permanent employees in some of these markets that we're really challenged with. And so that would have helped us, but we had higher contract labor and that was part of the equation. But, Chris, go ahead.

是的。我只是想說，我認為其中發揮作用的一件事是，我們希望能夠在我們真正面臨挑戰的一些市場中從合約工過渡到長期員工。所以這對我們有幫助，但我們有更高的合約工，這是等式的一部分。但是，克里斯，繼續吧。

No. I think part of it was we had a really strong April, really, really strong April. And spring quarter is usually a very strong volume quarter for us. And I think the combination of starting the quarter, with a lot of demand resulted maybe in us having slight increments here and there of staff beyond where we needed as the quarter progressed.

不。我認為部分原因是我們度過了一個非常強烈的四月，非常非常強烈的四月。對我們來說，春季季度通常是銷量非常強勁的季度。我認為，從本季度開始，大量的需求可能導致我們隨著季度的進展，員工數量略有增加，超出了我們的需要。

We're still peeling this onion a bit. As Carey said, we have a handful of markets that kind of stand out as markets where at least I believe that we shouldn't have as much contract labor as we do. We should be able to find long-term employees that are committed and part of our staff. We have good teams there. But for whatever reason, we're struggling in those handful of markets.

我們還在剝洋蔥皮。正如凱裡所說，我們有一些突出的市場，至少我認為我們不應該擁有那麼多的合約工。我們應該能夠找到忠誠的長期員工並成為我們員工的一部分。我們那裡有很好的團隊。但無論出於何種原因，我們在這少數市場中都舉步維艱。

And so Eric and Graham and the rest of the team, meeting with partners, working on that, we're trying to look at some of the underlying factors. But as Carey mentioned, we didn't expect to be carrying as much of contract labor as we have.

因此，埃里克和格雷厄姆以及團隊的其他成員與合作夥伴會面，致力於解決這個問題，我們正在嘗試研究一些潛在因素。但正如凱裡所提到的，我們沒想到會承擔這麼多的合約工。

Then, honestly, I thought as inflation began to subside a bit, we could get our offered hourly rates down. I don't know that we've seen that transpire yet, but we're going to have to test it. Because I think, particularly at our front desk, we're too high. And we're going to have to see what we can do there. And so combination of factors, I wish it was perfect. It's not, of course. And we're going to have to make some adjustments.

然後，老實說，我認為隨著通貨膨脹開始稍微消退，我們可以降低我們提供的每小時費率。我不知道我們是否已經看到這種情況發生，但我們必須對其進行測試。因為我認為，特別是在我們的前台，我們太高了。我們必須看看我們能在那裡做什麼。綜合各種因素，我希望它是完美的。當然不是。我們將不得不做出一些調整。

So when it comes --

所以當它到來的時候--

And Chris, this is Eric.

克里斯，這是艾瑞克。

Oh, go ahead.

哦，繼續吧。

The only other comment I want to add to that is while the turnover rate is low and we are backfilling clinical and non-clinical positions at a higher rate, there's also an impact on the existing staff within the business. I mean, when you start bringing in newer people, potentially less experienced, it does have an impact in terms of doing market adjustments to hang on to existing staff.

我想補充的唯一一點是，雖然人員流動率很低，而且我們正在以更高的速度填補臨床和非臨床職位，但這也會對企業內的現有員工產生影響。我的意思是，當你開始引進可能經驗不足的新人時，它確實會對進行市場調整以留住現有員工產生影響。

So it's something that we're battling right now. There's no question. I think there's a couple of things that we're in the process of doing now that will have an impact for us. We're certainly going to Chris's point where we saw labor adds in the business, taking a hard look at ensuring that the productivity that we have within that clinic is consistent with our staffing ratios for clinical and nonclinical staff. So the people that added staff, did we get the volume to leverage those additional expenses.

所以這是我們現在正在努力解決的問題。毫無疑問。我認為我們現在正在做的一些事情將對我們產生影響。我們當然會談到克里斯的觀點，即我們看到業務中的勞動力增加，並認真考慮確保我們在該診所內的生產力與我們的臨床和非臨床人員的人員配置比例一致。因此，那些增加員工的人，我們是否獲得了足夠的資金來利用這些額外費用。

I will say that looking a little bit deeper in this, and to Chris's point, we still are peeling the onion a little bit. The 23 de novos that we had in place didn't lever costs as effectively as they should. So we're in the process of evaluating those businesses to see what we can do in terms of changing their trajectory. We did expect them to contribute a little bit more than they did from a net income perspective. So that's a place we're going to have to revisit.

我想說的是，從更深入的角度來看，就克里斯的觀點而言，我們仍然在剝洋蔥皮。我們實施的 23 項從頭計劃並沒有像應有的那樣有效地控製成本。因此，我們正在評估這些企業，看看我們能做些什麼來改變他們的發展軌跡。我們確實期望他們的貢獻比從淨收入角度來看多一點。所以這是我們必須重新審視的地方。

There's no doubt that the additional resources that we're putting in here will help us, particularly in recruiting, are going to help us. I think we've added roughly a 40% increase in recruiting staff to help us in those problem markets where we've over-relied on contract labor. So I think those additional resources will help us there.

毫無疑問，我們在這裡投入的額外資源將會幫助我們，特別是在招募方面，將會幫助我們。我認為我們在招募員工方面增加了約 40%，以幫助我們解決過度依賴合約工的問題市場。所以我認為這些額外的資源將對我們有所幫助。

And my hope is the additional resources will also decrease fill times to bring PTs on board where we do have turnover. Because to Chris's point, there is a volume impact associated with turnover that's reflected in these first two quarters of numbers for us. So it's an area that we're just going to continue to have to focus and invest in going forward here over the balance of the year.

我希望額外的資源也能減少在我們確實有營業額的地方吸引 PT 的填補時間。因為就克里斯的觀點而言，與營業額相關的數量影響反映在我們前兩個季度的數據中。因此，這是我們在今年餘下時間必須繼續關注和投資的領域。

Eric, thank you so much. And if I may, it sounds like there are a handful of markets that stand out. And I guess the question there is like, did something change competitively? Are you seeing more competition from other therapy providers, physical therapy? Or is it nursing homes, or is there anybody else that I guess changed their behavior that made it more competitive?

埃里克，非常感謝你。如果可以的話，聽起來好像有些市場很突出。我想問題是，競爭是否改變了？您是否看到其他治療提供者（物理治療）的更多競爭？或者是療養院，或者我認為是否有其他人改變了他們的行為，從而使其更具競爭力？

Yeah. Let me take that, I think. We're seeing young people come out of school right now. Now that some years ago, everybody moved to mandatory doctorate program, seeing younger people come out of school with higher and higher levels of debt. I mean, those of us who have kids in college, we know that the progression for just general college, let alone graduate level programs has increased every year.

是的。讓我接受吧，我想。我們現在看到年輕人走出學校。幾年前，每個人都轉向了強制性的博士學位課程，看到年輕人在畢業時背負越來越高的債務。我的意思是，我們這些有孩子上大學的人都知道，普通大學的升學率每年都在增加，更不用說研究生程度的課程了。

And so what we're also seeing, which differs from years and years ago, is we're seeing people with debt levels that are so high that while when I came out of school, I knew the only thing I wanted to do was orthopedic outpatient physical therapy. And while some of these kids would like to be in the settings that we offer because they're fantastic settings, they have to go where the money's the highest.

因此，我們也看到，與幾年前不同的是，我們看到人們的債務水平如此之高，以至於當我走出學校時，我知道我唯一想做的事情就是整形外科門診物理治療。雖然其中一些孩子希望進入我們提供的環境，因為它們非常棒，但他們必須去錢最高的地方。

And so in some cases, it may mean a hospital, it may mean a physician home practice, it may mean home health nights and weekends. And so while the competitive market hasn't necessarily seismically shifted, what has shifted is the amount of debt that these kids have and the necessity to make choices that are purely based on how many dollars they can put in the bank at any given time.

因此，在某些情況下，這可能意味著醫院，可能意味著醫生家庭診所，可能意味著家庭健康之夜和週末。因此，雖然競爭市場不一定會發生翻天覆地的變化，但發生變化的是這些孩子所欠的債務數額，以及他們做出選擇的必要性，而這些選擇完全取決於他們在任何特定時間可以存入銀行的金額。

And we haven't been a profession that's been driven that way, but we're seeing more and more people that are faced with those realities and we've got to -- as an industry, we've got to adjust.

我們並不是一個受這種方式驅動的職業，但我們看到越來越多的人面臨這些現實，我們必須——作為一個行業，我們必須進行調整。

Thanks for that call. If I may, a last one on the topic, and I guess, my last question. So you also mentioned that you look to obviously try to manage down the costs, but you also mentioned some efficiencies.

謝謝你的來電。如果可以的話，這是關於這個主題的最後一個問題，我想，這是我的最後一個問題。所以您也提到，您顯然希望嘗試降低成本，但您也提到了一些效率。

So can you maybe elaborate a little bit, maybe Eric can chime in in terms of what exactly you can do to kind of improve, I guess, efficiencies which would result in improved labor? Thank you.

那麼你能否詳細說明一下，也許艾瑞克可以插話一下你到底可以做些什麼來提高效率，我猜，這將導致勞動力的改善？謝謝。

Well, that's definitely volume. I mean, volume is our best way to lever our costs. But the point that I was referencing earlier is, going back and taking a look at where we had headcount adds, particularly in the tech and front office space, which is where a lot of our headcount adds did take place, and making sure that those clinics with those additional adds are really at the threshold that we would expect from a visit perspective to support that kind of staffing.

嗯，這絕對是音量。我的意思是，數量是我們槓桿成本的最佳方式。但我之前提到的一點是，回過頭來看看我們在哪些方面增加了員工數量，特別是在技術和前台辦公領域，這是我們確實增加了很多員工數量的地方，並確保這些員工數量增加了。

So that's a clinic-by-clinic analysis that's going to result in, if we're overstaffed, shuffling people around and putting them in the right place or taking labor out in the event that they don't have the volume to support it.

因此，這是一個逐個診所的分析，如果我們人手過多，就會對人員進行重新安排，並將他們安排在正確的位置，或者在沒有足夠的數量來支持的情況下取消勞動力。

Great. Thank you so much.

偉大的。太感謝了。

Thank you.

謝謝。

Jared Haase, William Blair.

賈里德·哈斯，威廉·布萊爾。

Good morning, Jared.

早上好，賈里德。

Hey. Good morning. Thanks for taking the questions. Carey, maybe for you, I just want to make sure I understood kind of the -- going back to the original guidance range for adjusted EBITDA for the year, some of the assumptions in the second half of the year, just want to understand kind of the puts and takes there.

嘿。早安.感謝您提出問題。Carey，也許對你來說，我只是想確保我理解了——回到今年調整後 EBITDA 的原始指導範圍，下半年的一些假設，只是想理解一下那裡的看跌期權和賣出期權。

Is that largely reflecting swing factors in the labor environment in the second half of the year? Or anything else that you call out in terms of assumptions for the guidance? And are you assuming further increases in labor costs for here? Or is that largely kind of based on current trends?

這是否很大程度反映了下半年勞動力環境的波動因素？或者您在指導假設方面提出了什麼其他要求？您是否假設這裡的勞動成本進一步增加？或者這很大程度上是基於當前的趨勢？

Yeah. The guidance, it includes -- it's based on current trends in our labor and that really is, there's really no impact on the revenue side. We're doing what we thought we'd do from our previous guidance and forecast on that side. It's just on the cost side, we had sort of to bump it up a little bit to kind of reflect what we've seen so far this year.

是的。該指南包括——它是基於我們當前的勞動力趨勢，而且確實對收入方面沒有任何影響。我們正在按照先前的指導和預測去做我們認為應該做的事情。只是在成本方面，我們不得不稍微提高一點，以反映我們今年迄今為止所看到的情況。

Carey, if I may, I want to add one thing.

凱裡，如果可以的話，我想補充一件事。

Yeah.

是的。

When we originally did guidance, we had a pretty good-sized deal that we had close to done and we had baked in. And unfortunately, as life happens sometimes, one of the owners went and probably is still going through a difficult divorce that put the kibosh on that opportunity. And so that in combination with some of the other factors that we've discussed at length here, but that was a pretty good chunk of both revenue and EBITDA that was, we expected to be in the door by the end of June. But we had to adjust that.

當我們最初做指導時，我們有一筆規模相當大的交易，我們即將完成並且已經完成。不幸的是，正如生活中有時會發生的那樣，其中一位業主離開了，而且可能仍在經歷一場艱難的離婚，這讓這個機會被放棄了。因此，結合我們在這裡詳細討論的一些其他因素，但這是收入和 EBITDA 的相當大一部分，我們預計將在 6 月底之前實現。但我們必須對此進行調整。

Understood. That makes sense and that's helpful. And then I guess just as a follow-up, maybe taking a step back, this is a bit more of a strategic question, but I'm curious how you think about the balance between growth and profitability going forward.

明白了。這是有道理的，也是有幫助的。然後我想，作為一個後續行動，也許退一步，這更像是一個策略問題，但我很好奇你如何看待未來成長和獲利能力之間的平衡。

Obviously, you're seeing strong demand and very nice volume trends that of course is leading to some of the incremental contract labor utilization to help support that. Do you start to consider at all kind of pivoting this strategy a bit and maybe capture a little less volume growth but have a little bit more stability on the expense side?

顯然，您看到了強勁的需求和非常好的銷售趨勢，這當然會導致一些增量的合約勞動力利用率來幫助支持這一點。您是否開始考慮稍微調整這項策略，也許會減少銷售成長，但在費用方面增加一點穩定性？

Yeah. It's tough. I mean, it's a fair question. It's a good question. We're in the service business to take care of people. And so when somebody's at your door and they've had surgery and they want to be seen, we just -- as caregivers at heart, we have a hard time saying no to that. And so generally speaking, most of our facilities, probably with a few exceptions, we don't have waiting lists. They don't have a lot of patients that they turn away.

是的。它太硬。我的意思是，這是一個公平的問題。這是一個好問題。我們從事服務業是為了照顧人們。因此，當有人來到您家門口並且他們已經接受了手術並且希望被看到時，我們只是——作為內心的護理人員，我們很難拒絕這一點。一般來說，我們的大多數設施（可能除了少數例外）都沒有等候名單。他們不會拒絕太多病人。

It's not to say that we shouldn't look at our mix of patients and how we prioritize based on acuity and maybe even based on, in some cases, payer dynamics, who gets to the front of the line. And we're having to look at all those things, quite honestly, to make sure that the next 10 patients come in aren't patients that are just barely above our cost to deliver care. We've got to be focused. That's why the focus on work comp has been so important.

這並不是說我們不應該考慮我們的患者組合以及我們如何根據敏銳度來確定優先順序，甚至在某些情況下還可以根據付款人的動態來確定優先順序。老實說，我們必須考慮所有這些事情，以確保接下來的 10 名患者不是僅僅超出我們提供護理費用的患者。我們必須集中註意力。這就是為什麼關注工作補償如此重要。

And I guess on that, just to create some perspective, I'd like Eric to talk a little bit about the growth in that comp area. Because I do think it relates to your question and how we prioritize what we do and when we make step adjustments and other things. Eric, you want to touch on that?

我想，為了創造一些觀點，我想讓艾瑞克談談該比較領域的成長。因為我確實認為這與你的問題以及我們如何優先考慮我們所做的事情以及何時進行步驟調整和其他事情有關。艾瑞克，你想談談這個嗎？

Sure. Yeah. Sure. I'm happy to talk about that. I know it's been a focus of our quarterly calls here for a little while. There was a lot of work that was done to really properly position the organization to grow work comp; Carey referenced it.

當然。是的。當然。我很高興談論這個。我知道這段時間以來一直是我們季度電話會議的焦點。為了真正正確地定位組織以提高工作薪酬，我們做了很多工作；凱裡引用了它。

Work comp went from 9.6% of revenues Q2 last year to 10.1% this year. And while that may seem relatively slow or light when compared to what work comp percentages looked like in the past, we're making substantial strides in terms of visit growth. Our visit growth in Q2 on work comp was 12.6%. We're running about 9.3% year to date.

工作補償從去年第二季營收的 9.6% 上升到今年的 10.1%。雖然與過去的工作報酬百分比相比，這似乎相對緩慢或輕微，但我們在訪問量增長方面正在取得重大進展。第二季工作補償的訪問量增加了 12.6%。今年迄今為止，我們的運行率為 9.3%。

So this category is growing really, really well. I think it's directly tied to the efforts we've had in terms of substantially increasing network participation. And we have another nine work comp contracts that are going to be coming online here in Q3 and Q4 that I think will further drive growth in the work comp category. And it's absolutely our highest-paying segment of the business and going well. So it's gone great and I think it'll continue to grow going forward as we move through the year.

所以這個類別的成長非常非常好。我認為這與我們在大幅增加網路參與方面所做的努力直接相關。我們還有另外九份工作補償合約將在第三季和第四季上線，我認為這將進一步推動工作補償類別的成長。這絕對是我們收入最高的業務領域，而且進展順利。所以它進展順利，我認為隨著我們今年的發展，它會繼續成長。

Thank you.

謝謝。

Any additional questions, Mr. Haase?

哈斯先生，還有其他問題嗎？

No. That was great. Appreciate all the color. Thank you.

不。那很棒。欣賞所有的顏色。謝謝。

(Operator Instructions)

（操作員說明）

Michael Petusky, Barrington Research.

邁克爾·佩塔斯基，巴靈頓研究中心。

Hey, Mike.

嘿，麥克。

Hi. So, I guess, I wanted to circle back in terms of things that you can do. I know that you guys have done some initiatives in terms of automation, particularly with the front desk. And I'm just wondering, have you guys sort of maxed out what you can do there? Or is there more that can be done to sort of maybe alleviate some of the pressures you're feeling around labor in that part of your business?

你好。所以，我想，我想回顧一下你可以做的事情。我知道你們在自動化方面做了一些舉措，特別是在前台方面。我只是想知道，你們在那裡已經盡了最大努力了嗎？或者是否可以採取更多措施來減輕您在該業務部門中感受到的勞動力壓力？

I don't think we're maxed at the front desk, Eric. I don't know if you or Graham want to touch on that. But we're still fortunately and unfortunately, I think we still have opportunity there and we're early in it yet, I think, on some of that automation change.

我不認為我們的前台已經人滿為患，艾瑞克。我不知道你或格雷厄姆是否想談談這個問題。但我們仍然幸運和不幸，我認為我們仍然有機會，而且我認為我們在一些自動化變革方面還處於早期階段。

Yeah, Chris, I think that's a very fair description of where we're at. I think there's still opportunity here. We haven't taken advantage of all of the functionality that is available to us. And that really goes back to some integration issues that we're having with our EMR vendor that we're working through as it relates to the ability to turn on some of that functionality.

是的，克里斯，我認為這是對我們目前處境的非常公平的描述。我認為這裡還是有機會的。我們還沒有利用我們可用的所有功能。這實際上可以追溯到我們與 EMR 供應商之間存在的一些整合問題，我們正在解決這些問題，因為它與打開某些功能的能力有關。

So it's going slower, but it's not going to be the magic pill. I think it's going to help some, but it's not going to have this major, major impact in terms of decreasing front office staff. I think at our larger facilities, it creates efficiencies for us, but we're continuing to look at other opportunities besides automation in terms of how we can leverage administrative costs within our business. And more to come on that as we go down that path. And we'll share it with you guys as that vision unfolds.

所以它會變慢，但它不會成為靈丹妙藥。我認為這對某些人有幫助，但不會對減少前台人員產生如此重大的影響。我認為在我們較大的設施中，它為我們創造了效率，但我們正在繼續尋找除自動化之外的其他機會，以了解如何利用我們業務中的管理成本。當我們沿著這條路走下去時，還會有更多的事情發生。隨著這願景的展開，我們將與大家分享。

And one other initiative that was talked about maybe 12 months, 18 months ago that I haven't heard a lot about since is GPO. And I mean, is that something that's still at all a meaningful focus? Or is that also sort of very marginal in terms of impact?

另一項舉措是 GPO，大約 12 個月、18 個月前就有人討論過，但此後我就沒有再聽說過。我的意思是，這仍然是一個有意義的焦點嗎？或者說，就影響而言，這也是非常微不足道的嗎？

Yeah. It's --

是的。它是--

Go ahead, Graham.

繼續吧，格雷厄姆。

Yeah. Go ahead. Well, we're still working through it.

是的。前進。嗯，我們仍在努力解決這個問題。

No. Go ahead.

不。前進。

We're still working through it. It's been challenging in some areas. We're looking at different options for how we can do different savings mechanisms. We do have it stood up. It's rolled out to probably about 45% to 50% of our clinics.

我們仍在努力解決這個問題。在某些領域這一直具有挑戰性。我們正在尋找不同的選擇來建立不同的儲蓄機制。我們確實把它站起來了。我們大約 45% 到 50% 的診所已推出該服務。

We've seen some savings, but it hasn't moved the needle as much as we were thinking it might. So we're looking at some different options on how we might be able to get some more movement on that sort of span.

我們已經看到了一些節省，但它並沒有像我們想像的那樣產生巨大的影響。因此，我們正在考慮一些不同的選擇，以了解如何能夠在這種跨度上取得更多進展。

Okay. And I think, I guess, just to sort of wrap up this idea, I mean, is there an issue, Chris, do you feel like in terms of getting partner buy-in on some of these initiatives that really is needed, where you want to let these guys, they're entrepreneurial guys, you want to let them run their business, but at some level maybe they're not taking advantage of all that you guys could help them with in terms of optimizing? I'm just curious if maybe --

好的。我想，我想，只是為了總結這個想法，我的意思是，克里斯，你是否覺得在獲得合作夥伴對其中一些真正需要的舉措的支持方面存在問題，你在哪裡？是企業家，你想讓他們經營自己的業務，但在某種程度上，他們可能沒有利用你們在優化方面可以幫助他們的所有優勢？我只是好奇也許--

Yeah.

是的。

-- recalibration of how this works would be helpful.

——重新校準其工作原理將會有所幫助。

Yeah. No. I actually don't think that, and that's not to say that in any initiative that we don't have people who are excited and early adopters and other people who are going to come on with a little different perspective. But I think our partners have done a great job and we've built a lot of trust over the years.

是的。不。我實際上不這麼認為，這並不是說在任何舉措中我們都沒有興奮的人和早期採用者以及其他會提出一些不同觀點的人。但我認為我們的合作夥伴做得很好，多年來我們建立了許多信任。

It varies by category and by specific activity, whatever it is we're doing. For instance, right now, and we've been working on this for a while and it really has been, as Eric mentioned, the systems issue, but remote therapeutic monitoring, which is an opportunity that CMS provides to us to interface with patients and as they perform their home program and maintain a level of consistency.

它因類別和特定活動而異，無論我們正在做什麼。例如，現在，我們已經在這方面工作了一段時間，正如 Eric 所提到的，這確實是系統問題，但遠端治療監控是 CMS 為我們提供的一個與患者互動的機會，當他們執行家庭計劃並保持當一定程度的一致性時。

We think that's really important and we thought it was important a year ago. But we couldn't get the vendors and systems to talk efficiently. And while we had partners who were interested in it, it was too clunky and it was difficult and we've finally gotten the vendor interface worked out, taken a lot longer than we had hoped. That's the nature of things sometimes.

我們認為這非常重要，我們一年前也認為這很重要。但我們無法讓供應商和系統進行有效的對話。雖然我們有對此感興趣的合作夥伴，但它太笨重而且很困難，我們終於解決了供應商介面，花費的時間比我們希望的要長得多。有時這就是事物的本質。

You bring different companies together and you try to get things to work and try to push as hard as you can. And if it's too inefficient, it doesn't get adopted as readily. So there was a period of time, for instance, on that initiative and rollout where we just had to press pause. Because it wasn't worth beating the drum on and getting people frustrated, so we had to focus on other things.

你將不同的公司聚集在一起，努力讓事情順利進行，並盡力推動。如果它的效率太低，它就不會那麼容易被採用。例如，有一段時間，在該舉措和推出過程中，我們不得不按下暫停鍵。因為不值得大肆宣揚並讓人們感到沮喪，所以我們必須專注於其他事情。

That's the nature of operations. I mean, you live on relationships and you focus where you think you can get the greatest return. And if you're working on 100 things, you're probably not getting a lot done. You have to focus on the key things that are going to make a difference.

這就是營運的本質。我的意思是，你靠人際關係生活，你專注於你認為可以獲得最大回報的地方。如果你正在做 100 件事，你可能並沒有完成很多事情。你必須專注於那些能帶來改變的關鍵事情。

And so I think our partners do a good job; I think they understand. They're certainly not fighting. But these are day-to-day, minute-to-minute issues that just require a lot of attention and precision. And in some places, we've got to dial in a little better.

所以我認為我們的合作夥伴做得很好；我想他們明白。他們當然不是在打架。但這些都是日常、每分鐘的問題，需要大量的關注和精確度。在某些地方，我們必須做得更好。

In other places, we're going to have to just figure out that the reality is it's going to be a little bit more expensive. And we're going to have to come up with some other revenue opportunities to offset it. And that's just the nature of the business right now.

在其他地方，我們必須弄清楚現實情況是它會更貴一些。我們將不得不想出一些其他收入機會來抵消它。這就是目前業務的本質。

Let me just sneak one last one in and then I'll get off.

讓我偷偷地把最後一顆放進去，然後我就下車了。

Yeah.

是的。

In terms of sort of the labor headwind and just on the other side, the CMS cuts of the last several years. I mean, is there -- do you think there's an opportunity for APTA, other sort of leaders in terms of this industry to go and say, look, at this point, like, something is going to -- we're at a place where something's going to give and then -- and --

就勞動力逆風而言，另一面是 CMS 過去幾年的削減。我的意思是，你認為 APTA 以及該行業的其他領導者有機會說，看，在這一點上，好像有些事情會發生——我們正處於一個地方那裡會有一些東西，然後——然後--

Yeah.

是的。

-- access to service and all the rest of it is going to be impacted. Like, this just feels like it has gotten to a point where it's almost enough is enough. I'm just curious if you guys have been talking about a way to go to the powers that be and say, look, we need some help here. Everybody else gets price increases relative to inflationary pressures. And we continue to face these headwinds, but we still face the headwinds in pricing and then the headwinds in paying clinical and just front office staff? Thanks.

——獲得服務和所有其他方面都將受到影響。就像，這感覺就像已經到了幾乎已經足夠了的地步。我只是好奇你們是否一直在談論一種向當權者尋求幫助的方法，並說，看，我們這裡需要一些幫助。相對於通膨壓力，其他所有人的價格都會上漲。我們繼續面臨這些逆風，但我們仍然面臨定價的逆風，然後是支付臨床和前台人員工資的逆風？謝謝。

Thanks. Mike, the world's complicated, but this particular issue isn't complicated. We know that we save on the medical side of things. We know that we save significant costs. We know that patients who go through a course of physical therapy spend less on the entirety of their healthcare in a year or 18 months following a course of PT.

謝謝。麥克，世界很複雜，但這個具體問題並不複雜。我們知道我們在醫療方面節省了開支。我們知道我們可以節省大量成本。我們知道，接受物理治療療程的患者在 PT 療程後一年或 18 個月內的整體醫療保健支出較少。

For a Medicare age patient, they're going to spend less, particularly being more active, more socially engaged, more activity, lower A1c, all of that. It's not lost on anybody. In most APTQI, which I'm a part of, and all of the big companies for the most part are a part of, along with the APTA, we're in DC now a lot. And we don't run into many lawmakers who think that we should have had these cuts or they're necessary or they make sense to them.

對於 Medicare 年齡的患者來說，他們會花更少的錢，特別是更活躍、更多地參與社會、更多的活動、更低的 A1c，所有這些。任何人都不會失去它。在大多數 APTQI 中，我是其中的一部分，所有大公司大部分都是 APTQI 的一部分，還有 APTA，我們現在經常在華盛頓。我們並沒有遇到很多立法者認為我們應該進行這些削減，或者它們是必要的，或者它們對他們來說是有意義的。

But Washington's been a bit of a dysfunctional place. We've all noticed that. And so unwinding these, which have a secondary budget impact relative to the neutrality has been difficult. They've been mitigated, but they haven't been unwound. I hope we can at least mediate a cut for 2025 as we have in the more recent period and then we should move into a system which allows us to have cost of living based rate changes.

但華盛頓一直是個功能失調的地方。我們都注意到了這一點。因此，解除這些相對於中立性具有次要預算影響的措施一直很困難。它們已經得到緩解，但還沒有解除。我希望我們至少可以像最近一段時間一樣，在 2025 年進行降息，然後我們應該進入一個允許我們根據生活成本進行利率變化的系統。

I mean, if you look at the accumulation, I don't know exactly what it's been, but it's close to 10% that we've absorbed in this year on an accumulated basis. But in this year, if you look at where we are compared to where we were in 2019, it's tens of millions of dollars that fall straight to the bottom line or specifically get removed straight from the bottom line.

我的意思是，如果你看看累積情況，我不知道具體是多少，但我們今年累積吸收的金額接近 10%。但今年，如果你看一下我們與 2019 年的情況相比，你會發現有數千萬美元直接落入底線，或者直接從底線中扣除。

It's been an every year thing. I'm not whining. It is what it is. We've got to deal with it. But if you've given me a neutral to 1% to 2% increase every year, what we could do with that would be amazing. I think we're about to turn the page and it's been a long time coming. And we're kind of tired of being in this lost cycle that we've been in, but I think we're nearing the end.

這是每年都會發生的事情。我沒有發牢騷。就是這樣。我們必須處理它。但如果你給我一個中立的每年 1% 到 2% 的成長，我們能用它做的事情將是驚人的。我想我們即將翻過這一頁，而且已經等了很久了。我們已經厭倦了這個迷失的循環，但我認為我們已經接近結束。

We will continue to press our DC constituency hard with the way the world is. It's just hard to get necessarily the aggregated attention that you need to make dramatic change. But we're not giving up.

我們將繼續向我們的華盛頓選區施加壓力，要求他們了解世界的現狀。只是很難獲得做出巨大改變所需的集中註意力。但我們不會放棄。

Very good. Thanks, guys. Appreciate it.

非常好。謝謝，夥計們。欣賞它。

Thanks, Mike.

謝謝，麥克。

Larry Solow, CGS Securities.

拉里·索洛，銀河證券。

Great. Thank you, guys. I just have question on the workers' comp, I guess more from a high level, this used to be like a mid-teens percent of your business, right, pre-COVID, and obviously, the world has changed a little bit. Our remote work accelerated, but I feel like your target audience can't really be remote in terms of their working field.

偉大的。謝謝你們，夥計們。我只是對工人的補償有疑問，我想更多的是從高層來看，這曾經佔你業務的百分之十左右，對吧，在新冠疫情之前，顯然，世界已經發生了一些變化。我們的遠距工作加速了，但我覺得你的目標受眾在他們的工作領域上不可能真正處於遠端狀態。

So I'm just curious, structurally, is there anything different that has caused the dramatic decline in workers' comp volume over the years since COVID?

所以我只是很好奇，從結構上來說，自新冠疫情以來，是否有什麼不同導致了工人薪酬數量的急劇下降？

Larry, I wish I had a perfect answer for that. I mean, all of our companies that I'm aware of post-COVID saw a pretty significant drop in workers' comp percentage. I can't tell you that I know why that makes sense or why it would happen, but it has happened.

拉里，我希望我有一個完美的答案。我的意思是，據我所知，在新冠疫情之後，我們所有的公司的員工薪資百分比都出現了相當大的下降。我不能告訴你我知道為什麼這是有道理的或為什麼會發生，但它已經發生了。

And all we can do is focus on what we do and that focus has been to retrain, particularly a front office, to make sure that communication and follow-up across the comp world, multiple constituencies who have interest in the case. It's the payer, it's the case manager, maybe the company, the doctor, of course, always, but it's just that continuous retraining. And we focused on that.

我們所能做的就是專注於我們所做的事情，重點是重新培訓，特別是前台辦公室，以確保整個公司、對案件感興趣的多個選區的溝通和後續行動。是付款人，是案件經理，也許是公司，是醫生，當然，總是這樣，但這只是持續的再培訓。我們專注於此。

And as Eric said, we've gotten access to a broader network. And to be honest, through COVID, we were dealing with other things at the time. And along over that period, which was a couple of years, give or take, on best turnover, you lose people and you lose some traction.

正如埃里克所說，我們已經獲得了更廣泛的網絡。說實話，透過新冠疫情，我們當時正在處理其他事情。在這幾年的時間裡，不管怎樣，在最好的營業額下，你會失去人員，也會失去一些吸引力。

So we're trying to get it back. I'm not going to promise that we're going to get back to 14%. But as Eric said, we are growing our comp visits at a rate that's a pretty nice rate. So we'll see where it ends up.

所以我們正在努力把它找回來。我不會承諾我們會回到 14%。但正如艾瑞克所說，我們的公司訪問量正在以相當不錯的速度成長。所以我們會看看它最終會在哪裡。

Okay. If I just may squeeze one last one on a more positive note --

好的。如果我可以以更積極的方式擠出最後一個--

Sure. Sure.

當然。當然。

As Carey said, the industrial venture business obviously grew nicely, low-double digits on an organic basis. What's the driver there? And does that business, is that a contra-indicator of employment?

正如凱裡所說，工業創投業務顯然成長良好，在有機基礎上實現了低兩位數成長。那裡的司機是什麼？這是否是就業的反指標？

Because obviously, although I know the labor market is tight, things are maybe getting, unemployment's coming up a little bit, so things are maybe loosening a little bit or getting worse, maybe better for you guys in a sense. But what's going on in the business that's driving that growth?

因為顯然，儘管我知道勞動市場緊張，但情況可能會有所改善，失業率會上升一些，所以情況可能會有所放鬆或變得更糟，從某種意義上來說，也許對你們來說更好。但推動這種成長的業務中發生了什麼事？

Yeah. Simply, it works. It works really well. We now have more programs and services and program lines than ever before. When we started, we had one primary and a couple very peripheral, and now we have 15 or 20 different individualized programs. As a result of some of the acquisitions that we've done, those have all integrated well and some of the growth that we've had, both in the team and our service offering.

是的。很簡單，它有效。效果非常好。我們現在擁有比以往更多的計劃、服務和計劃線。當我們開始時，我們有一個主要項目和幾個非常外圍的項目，現在我們有 15 或 20 個不同的個人化項目。由於我們進行了一些收購，這些收購都很好地整合了，並且我們在團隊和我們的服務方面都取得了一些成長。

So one, it works; it saves money. We're seeing companies where we get a foot in the door, be willing to expand from just their most problematic sites across the country so that there is a really nice organic intra-customer growth opportunity. We're seeing, as you might guess, as risk managers and heads of HR move within an industry or within an industry area to different companies. And they've had good luck with us, good success before. It's not luck, good success. They're bringing us in.

所以一，它有效；它省錢。我們看到一些公司踏入了大門，願意從全國最有問題的地點進行擴張，這樣就有了一個非常好的有機客戶內部成長機會。正如您可能猜到的那樣，我們看到風險經理和人力資源主管在一個行業或一個行業領域內跳槽到不同的公司。他們和我們一起運氣很好，之前也取得成功。這不是運氣，而是成功。他們要帶我們進來。

And look, companies are dealing with a musculoskeletal issue that is a significant problem for them. And the words getting out that these types of programs, they work. And so it's a combination of things.

瞧，公司正在處理肌肉骨骼問題，這對他們來說是一個重大問題。人們說這些類型的程序是有效的。所以這是多種因素的結合。

But I'm really proud of our teams. We've added and grown and strengthened these teams over time. And they're doing a good job right now. I expect the momentum that we have will continue.

但我真的為我們的團隊感到自豪。隨著時間的推移，我們不斷增加、發展和加強這些團隊。他們現在做得很好。我預計我們的勢頭將繼續下去。

In terms of the question about how it relates to where the economy is, I would say, some of these programs are cyclical in that when the economy is blowing and going, they're busier and some are counter-cyclical. So in other words, maybe when labor gets really tight, our post-offer testing, which is meant to screen out people who might get injured down the line or likely to be injured, we have companies in some segments that we can't find anybody, we can't screen anybody out.

至於它與經濟狀況有何關係的問題，我想說，其中一些計劃是週期性的，因為當經濟蓬勃發展時，它們會更加繁忙，而有些則是反週期的。換句話說，也許當勞動力變得非常緊張時，我們的報價後測試，旨在篩選出可能受傷或可能受傷的人，我們在某些​​領域有我們找不到的公司任何人，我們不能篩選任何人。

And so as labor gets tighter, some of those programs slow down, but that's always in the mix. Now we have enough diversity across our programs to where if we see a slowdown in one, we're seeing a pickup in another. And it doesn't show up as much. So it's just pretty steady overall.

因此，隨著勞動力變得更加緊張，其中一些計劃會放緩，但這始終是混合在一起的。現在，我們的專案具有足夠的多樣性，如果我們看到一個專案放緩，我們將看到另一個專案的成長。而且它並沒有出現那麼多。所以整體來說還是比較穩定的。

Got it. Great. Thank you, guys. Appreciate it.

知道了。偉大的。謝謝你們，夥計們。欣賞它。

Thank you.

謝謝。

And ladies and gentlemen, at this time, if there are no further questions, I'd like to turn the floor back over to Chris Reading for any additional or closing comments.

女士們、先生們，如果沒有其他問題，我想將發言權交還給克里斯·雷丁（Chris Reading），徵求任何補充意見或結束語。

Okay, Jamie. Thank you. Listen, I know this was a long call. I want to thank everybody for your questions, your attention. I know we have some follow-up calls scheduled, so please reach out to Carey or I, and we're happy to spend time with you. And just know that we're working hard on these opportunities. So have a great day. Thanks again. Bye.

好吧，傑米。謝謝。聽著，我知道這是一通漫長的電話。我要感謝大家的提問和關注。我知道我們安排了一些後續電話，所以請聯繫凱里或我，我們很高興與您共度時光。只要知道我們正在努力抓住這些機會。祝你有美好的一天。再次感謝。再見。

Once again, ladies and gentlemen, that will conclude the US Physical Therapy second-quarter 2024 earnings call. Thank you for your participation. You may disconnect at this time.

女士們先生們，美國物理治療公司 2024 年第二季財報電話會議到此結束。感謝您的參與。此時您可以斷開連線。