Financial Data and Key Metrics Changes - The company reported adjusted EBITDA of $69 million for Q4 2024, significantly exceeding previous guidance [10] - Consolidated revenue growth was just over 1%, with same unit growth of 8.7%, primarily offset by the impact of portfolio restructuring [18] - Operating cash flow for Q4 was $135 million, compared to $73 million in the prior year, with a reduction in net debt from $515 million to $386 million [21][23] Business Line Data and Key Metrics Changes - The company completed a portfolio restructuring, exiting practices that represented $200 million in annual revenue, which was a drag on earnings [10] - The decline in practice-level expenses reflected the restructuring, with same unit salary expense growth remaining above the historical range of 2% to 3% [20][31] Market Data and Key Metrics Changes - The payer mix was a significant positive factor in 2024, contributing to strong operating results, although it is not expected to change significantly in 2025 [30][61] - The company anticipates flat volume in its 2025 outlook, despite some acceleration in the latter half of 2024 [37][38] Company Strategy and Development Direction - The company aims to prioritize patient-centric care, strengthen hospital relationships, and manage its improved financial position effectively [13][14] - A preliminary expectation for adjusted EBITDA in 2025 is set between $215 million and $235 million, reflecting a cautious outlook due to uncertainties in the healthcare provider space [14][17] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the company's prospects despite acknowledging headwinds in the healthcare sector [17] - The focus for 2025 includes maintaining stability in the revenue cycle management (RCM) process and seeking improvements through automation [29] Other Important Information - The company ended 2024 with cash of $230 million and plans to build cash again in 2025 [23][24] - The impact of the portfolio restructuring is expected to provide an annualized EBITDA benefit of approximately $30 million, with a third realized in 2024 [27][81] Q&A Session Summary Question: Can you provide more details on the 2025 outlook? - Management indicated that they are baking in flat volume growth and stable pricing expectations for 2025, with a focus on maintaining performance under the hybrid RCM model [36][40] Question: Are there opportunities for improved economics in NICU management? - Management confirmed ongoing discussions with hospital partners but did not incorporate any increases into their forecast [44] Question: How much of the strong pricing in Q4 came from improvements in contract admin fees? - Approximately one-third of the pricing component was attributed to hospital admin fees [75] Question: What is the expected EBITDA tailwind from exiting primary and urgent care clinics? - The exit is part of a broader restructuring, with about a third of the expected $30 million EBITDA benefit realized in 2024 and the remainder anticipated in 2025 [81] Question: What are the company's plans for capital allocation and returning cash to shareholders? - The company is focused on maintaining a strong balance sheet and will evaluate the best uses of cash, including potential debt repayment or shareholder returns [88][90]