Financial Data and Key Metrics Changes - In the first quarter of 2025, diluted earnings per share, as adjusted, increased more than 20% year-over-year to $6.45 [9] - Adjusted EBITDA grew 11.3% over the prior year quarter, with an adjusted EBITDA margin improvement of 110 basis points [20][22] - Cash flow from operations was $1.65 billion in the quarter, with a decrease attributed to working capital changes [24] Business Line Data and Key Metrics Changes - Inpatient admissions grew 2.6% year-over-year, equivalent admissions increased 2.8%, and emergency room visits rose by 4% [10] - Same facilities revenue grew almost 6%, driven by volume increases and approximately 3% higher revenue per equivalent admission [11] - Surgical volumes were mixed, with inpatient surgeries slightly up and outpatient cases down [10][33] Market Data and Key Metrics Changes - Same-facility managed care equivalent admissions increased by 5.4% compared to the prior year quarter, while same-facility equivalent exchange admissions surged by 22.4% [20] - Exchange volume represented about 8% of equivalent admissions and approximately 10% of revenues for the quarter [108] Company Strategy and Development Direction - The company is focused on maintaining operational discipline while continuing to invest in its strategic agenda, including increasing the number of facilities by 3.3% [12][13] - Capital allocation strategy includes $991 million in capital expenditures, $225 million in share repurchases, and $180 million in dividends [25] - The company is investing heavily in technology and digital transformation to improve operational efficiency and clinical care [132][133] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the overall demand for healthcare services and the company's ability to navigate through uncertain policy environments [14][18] - The company is developing plans to address potential adverse impacts from health policy changes and tariffs, drawing from experiences during the COVID-19 pandemic [17][75] - Management remains optimistic about maintaining market share gains and operational efficiencies despite competitive pressures [100][101] Other Important Information - The company reaffirmed its guidance ranges for the full-year 2025, indicating confidence in its operational performance [26] - The company reported an $18 million increase in net benefits related to Medicaid in the first quarter of 2025 compared to the prior year quarter [23] Q&A Session Summary Question: Any major changes in assumptions embedded in the reiteration of guidance? - Management stated that the first quarter performance was solid, and guidance for 2025 remains appropriate [31] Question: How do you get that much leverage this quarter? - Management explained that operating leverage is created by pushing more volume through the organization, which improves profitability and margins [42] Question: Can you clarify the revenue per adjusted admission increase? - Management noted that the increase was driven by payer mix trends and improved acuity, with managed care positioning improving year-over-year [55][59] Question: Any changes with MA plan behavior denials? - Management indicated that there were no significant changes in denials and underpayments that materially impacted financial results [68] Question: How is the surgical schedule and block time utilization looking? - Management believes that demand for healthcare will remain strong, with expectations for surgical volumes to recover [126] Question: Can you speak to your technology agenda? - Management highlighted significant investments in technology and digital transformation to enhance operational efficiency and clinical care [132][133]