Financial Data and Key Metrics Changes - The adjusted EBITDA for Q3 2025 was $87 million, exceeding expectations, with a full-year adjusted EBITDA outlook of $270-$290 million [4][6] - Consolidated revenue decreased by just under $54 million due to portfolio restructuring, partially offset by strong same-unit growth of 8% and same-unit pricing up about 7.5% [6][8] - Operating cash flow generated in Q3 was $138 million, compared to $96 million in the prior year, driven by higher earnings and increased cash flow from accounts receivable [8][9] Business Line Data and Key Metrics Changes - Same-unit pricing increase was driven by solid revenue cycle management (RCM) cash collections, increased patient acuity in neonatology, and an increase in contract administrative fees [6][28] - Salary growth for the third quarter was modestly below the previous five-quarter average of 3-3.5% [7] - A net gain on investments in divested businesses was $21 million, contributing to other non-operating income [7] Market Data and Key Metrics Changes - The company maintained a strong market position with over 1,300 physicians and 1,170 advanced practice providers across 322 locations in 33 states [11] - The company has a comprehensive clinical data warehouse with 37 million patient days and 2 million NICU admissions, supporting its research productivity [11] Company Strategy and Development Direction - The company is focused on enhancing technological support and has developed a proprietary system called BabySTEPS to assist clinicians in caring for high-risk NICU patients [12][13] - The company aims to strengthen its operations in pediatric surgery, neurology, and cardiac intensive care, while continuing to build partnerships with hospital systems [16][41] Management's Comments on Operating Environment and Future Outlook - Management acknowledges significant healthcare headwinds but sees many opportunities to strengthen operations and results [17] - The company is optimistic about the potential benefits of exchange credits for expecting mothers, although the exact impact remains uncertain [37] Other Important Information - The company repurchased 1.2 million shares in the quarter, totaling 1.7 million shares to date [4] - The company ended the quarter with cash of $340 million and net debt of just over $260 million, reflecting a net leverage of just under one times [9] Q&A Session Summary Question: Thoughts on capital deployment and share repurchase - Management has been aggressively buying back shares and is exploring various opportunities for growth, both internally and externally [20] Question: Impact of portfolio restructuring on market dynamics - Management believes the restructuring has strengthened the company’s focus and improved the environment for recruiting new practices [21][22] Question: Breakdown of strong pricing in the quarter - Strong pricing was driven by RCM collections, increased acuity, and contract administrative fees, with expectations for stability in payer mix [27][28] Question: Guidance on seasonality and volume factors - Management indicated that there are no significant changes in volumes expected, but variability may arise as the year ends [30][31] Question: Long-term outlook and potential opportunities - Management is optimistic about future partnerships with hospital systems and believes financial strength will provide additional opportunities [38][40]

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]