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, impacted by 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 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 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 noted that the labor market remains stable, with initiatives in place to support workforce development [45][80] 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 guidance? - Management stated that the first quarter performance was solid, and guidance for 2025 remains appropriate [31][32] Question: How to achieve productivity and manage turnover? - Management highlighted that operating leverage is created by pushing more volume through the organization, and turnover rates are lower year-over-year [42][44] Question: Clarification on revenue per adjusted admission increase? - Management noted that the increase was driven by payer mix trends and outpatient revenue growth, despite a decline in outpatient surgery case volumes [53][55] Question: Changes in Medicare Advantage behavior and length of stay? - Management indicated that Medicare Advantage continues to run a bit higher on length of stay compared to traditional Medicare, but no significant changes were observed [68] Question: Impact of tariffs on supply sourcing? - Management mentioned that 70% of supply expenses are contracted with firm pricing for 2025, and 75% of supply expenses come from the U.S., Canada, or Mexico [73][75] Question: Competitive environment and CapEx priorities? - Management noted no substantial changes in competitors' behaviors, but the company is positioned to gain market share if competitors face challenges [100][101]