Summary of US Physical Therapy (USPH) FY Conference Call - August 26, 2025 Company Overview - **Company Name**: US Physical Therapy (USPH) - **Industry**: Outpatient orthopedic physical therapy - **Market Presence**: Operates nearly 800 facilities across the United States, with a partner model where the company generally owns about 70% of each partnership [2][4][10] Core Business Model - **Partnership Model**: USPH partners with local brands, allowing owners to retain a meaningful interest while benefiting from USPH's resources for growth [4][5][16] - **Market Fragmentation**: The physical therapy market is highly fragmented, estimated at $40 billion, with no single provider holding more than 10% market share [10][14] - **Reimbursement Strategy**: Focus on states with favorable reimbursement rates to ensure reasonable margins [8][9] Financial Performance - **Growth Despite Challenges**: Despite facing Medicare reimbursement headwinds, USPH has maintained significant growth, reporting an 18% increase in the last quarter [6][38] - **EBITDA Impact**: The company has faced a cumulative EBITDA reduction of $50 million due to reimbursement cuts, with $25 million impacting this year alone [35][37] - **Current EBITDA Guidance**: Updated guidance for EBITDA is between $93 million and $97 million for the year [38] Operational Highlights - **Visit Metrics**: Average visits per clinic per day reached 32.7, indicating strong demand [40] - **Technological Investments**: Implementation of AI-assisted documentation and partial virtualization of front desk operations to enhance efficiency [41] - **Margin Recovery**: Recent quarterly margins were around 21%, with expectations to improve further [42] Growth Opportunities - **Industrial Injury Prevention Business**: Launched in 2017, this segment has grown to over $100 million in revenue and $20 million in EBITDA, with a growth rate of 20-30% [44][48] - **Strategic Acquisitions**: Focus on acquiring larger practices with at least $1 million in EBITDA, enhancing profitability through better reimbursement rates [26][16] Market Dynamics - **Regulatory Challenges**: The company has navigated significant regulatory changes and reimbursement cuts, particularly from Medicare, which have historically impacted physical therapy providers [35][36] - **Competitive Landscape**: USPH differentiates itself from competitors by maintaining a strong balance sheet and avoiding excessive leverage, unlike many private equity-backed firms [31][14] Additional Insights - **Dividend Policy**: USPH has consistently paid dividends since 2012, currently at approximately $0.45 per quarter [51] - **Share Repurchase Plan**: Recently authorized a share repurchase plan due to stock price fluctuations, although this is not the primary focus for capital deployment [53] Conclusion US Physical Therapy is positioned for continued growth in a fragmented market, leveraging its partnership model and operational efficiencies to navigate regulatory challenges and capitalize on emerging opportunities in the physical therapy and industrial injury prevention sectors.

Financial Data and Key Metrics Changes - The company achieved a record average of 32.7 visits per clinic per day in Q2 2025, up from 30.6 in Q2 2024, marking a 7% increase [10][21] - Adjusted EBITDA increased to $26.9 million, up $4.7 million from the same quarter last year, with an adjusted EBITDA margin expanding to 17.5% from 16.4% [24][34] - Physical therapy revenues reached $168.3 million, representing a 17.3% increase compared to the prior year [27][28] - Gross profit margin improved to 21.1%, up from 20.1% in Q2 2024 [22][28] Business Line Data and Key Metrics Changes - Injury prevention (IIP) revenues increased by 22.6%, with gross profit rising by 25.8% compared to the prior year [13][29] - The company added over 50 net clinics compared to the prior year period, contributing to the growth in physical therapy visits [14] - Home care visits totaled 28,493 in Q2 2025, marking the first time these visits were reported separately [25] Market Data and Key Metrics Changes - Workers' compensation represented 10.4% of net patient revenues, with visits increasing by 8.4% year over year [27] - The net rate per patient visit was $105.33, slightly up from $105.05 in Q2 2024, despite a 2.9% Medicare rate reduction [26] Company Strategy and Development Direction - The company plans to focus on expanding its injury prevention business and has identified several large contracts in the auto industry [14][18] - The company has initiated a staged rollout of cash-based programs, generating approximately $900,000 in additional revenue [37] - A share repurchase program was authorized, allowing for the repurchase of up to $25 million of shares through December 31, 2026, while acquisitions remain the primary capital allocation priority [33][34] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the demand for services, noting solid demand across most markets despite some staffing challenges [41] - The company raised its full-year 2025 adjusted EBITDA guidance to a range of $93 million to $97 million, reflecting strong performance in the first half of the year [34] - Management acknowledged the impact of Medicare cuts, estimating a $25 million hit to profit lines, but remains positive about future reimbursement rate increases [15][72] Other Important Information - The company is implementing a new enterprise-wide financial and human resources system, with associated costs expected to continue through 2026 [30] - The balance sheet remains strong, with $135 million in term loans and a $175 million revolving credit facility [32] Q&A Session Summary Question: How would you characterize demand for your services? - Demand is solid across most markets, but there are challenges in managing costs while meeting demand [41] Question: How do you view capital deployment for de novo builds? - This year is expected to be one of the strongest for de novo builds, with adjustments made to recruiting efforts [43] Question: Can you provide an update on labor management strategies? - A 25% increase in student clinical rotations has been observed, contributing to lower turnover rates [59][61] Question: What is the expected impact of Medicare rate increases? - The company anticipates a 1% to 1.75% increase in Medicare rates, translating to a potential $2 million to $3 million positive impact on revenue [71][72] Question: How is the IIP segment performing? - The IIP segment is performing ahead of expectations, with strong organic growth and continued capital deployment planned [82] Question: What are the dynamics of the home PT business? - The home PT business is new and will be reported separately, with initial results showing promise [25][52]

Core Insights - ATI Physical Therapy has transitioned from public to private ownership through a merger led by Knighthead Capital Management and Marathon Asset Management, with over 90% of voting shares involved [1][2] - The acquisition price for shares not held by the consortium is set at $2.85 per share in cash [1] - The move to private ownership is expected to enhance ATI's operational flexibility and long-term growth while maintaining a focus on patient care [2][4] Company Strategy - The merger will enable ATI to operate with greater agility and a long-term focus, allowing for continued delivery of high-quality, patient-centered care across its clinic network [2] - The management team, recognized for its excellence, will continue to receive support from the investment firms to grow the business organically and through new clinic openings [3] - The CEO of ATI emphasized that returning to private ownership will allow the company to focus on patients and partners without the constraints of quarterly reporting cycles, ultimately strengthening its service to communities [4] Company Background - ATI Physical Therapy is a leading provider of outpatient physical therapy and rehabilitation services, with hundreds of clinics across the United States [5] - The company is committed to clinical excellence and innovative care delivery, helping patients through evidence-based treatment and personalized plans [5]

Summary of US Physical Therapy Conference Call Company Overview - **Company Name**: US Physical Therapy (USPH) - **Stock Exchange**: NYSE - **Number of Locations**: Nearly 800 clinics across 44 states in the US - **Business Segments**: 85% revenue from physical therapy, 15% from industrial injury prevention [2][7] Core Business Insights - **Market Size**: The rehabilitation market is valued at over $40 billion, with favorable demographic trends due to an aging population [7][8] - **Growth Strategy**: The company focuses on both organic growth and acquisitions, with a proven business model that includes de novo clinic openings and partnerships with experienced therapists [10][29] - **Financial Performance**: - TTM revenue of approximately $700 million - Adjusted EBITDA of $85 million - Year-over-year revenue growth of 18% [11][12] Industry Dynamics - **Market Fragmentation**: No single company owns more than 10% of the market, indicating opportunities for consolidation [9] - **Demographic Trends**: An aging and increasingly obese population is expected to drive demand for physical therapy services [8][70] Financial Metrics - **Revenue Breakdown**: - Commercial insurance: 47-48% - Medicare: 33% - Workers' compensation: 10.9% (increased from 9.5% in 2023) [19][28] - **Pricing Strategy**: - Average visit rates: - Commercial: ~$103-104 - Medicare: ~$93-94 - Workers' comp: >$150 [26] - **Dividend**: Annual dividend of $1.80, yielding about 2% [57] Regulatory Environment - **Medicare Rates**: Anticipated increases in Medicare rates starting in 2026, following years of reductions [20][24] Acquisition Strategy - **Acquisition History**: Over 50 acquisitions since 2005, with an average acquisition multiple of 7.5 to 8 times EBITDA [29][30] - **Recent Acquisitions**: Notable acquisition of Metro Physical Therapy, adding over 50 clinics [16][29] Operational Efficiency - **Partnership Model**: The company retains 70% ownership in acquired clinics, allowing founders to maintain a vested interest [32][34] - **Staff Retention**: The company has a lower attrition rate (17%) compared to the industry average (30%) [64][66] Growth Projections - **Organic Growth**: Expected growth of 4-6% annually, with additional growth from acquisitions [72] - **Industrial Injury Prevention**: This segment has grown significantly, projected to reach $120-$125 million in revenue with a 15% organic growth rate [51][52] Challenges and Opportunities - **Staffing Needs**: The company is enhancing recruitment efforts to meet increasing demand, particularly from an aging population [64][70] - **Technological Integration**: Exploring remote monitoring and AI solutions to complement in-person therapy [73][74] Conclusion US Physical Therapy is positioned for continued growth through strategic acquisitions, a strong partnership model, and favorable demographic trends. The company is actively addressing staffing challenges and leveraging technology to enhance service delivery while maintaining a focus on financial performance and shareholder returns.

Financial Data and Key Metrics Changes - The company reported a record high average visits per day for the first quarter at 31.4, with a strong finish in March at 33.2 visits per clinic per day [7][32] - Adjusted EBITDA increased by 16.5% despite headwinds, with a notable performance in March [16] - The net rate for the first quarter was $105.66, an increase of $2.29 per visit compared to the previous year, despite a 2.9% Medicare rate cut [33][34] - Physical therapy revenues reached $156.4 million, up 16.4% year-over-year, driven by higher net rates and acquisitions [36] - The physical therapy margin was 16.3%, down from 17.9% in the previous year, but exceeded 20% in March [38] Business Line Data and Key Metrics Changes - The injury prevention (IIP) segment saw revenue growth of 28.8% year-over-year, with gross profit up 13.1% [39] - The workers' compensation revenue mix increased from 9.3% in Q1 2023 to 10.9% in Q1 2025, the highest since 2020 [35] - The company added 14 centers in the quarter, contributing to growth in both organic and acquisition-driven revenue [23] Market Data and Key Metrics Changes - The company faced significant weather-related disruptions, losing approximately 26,000 visits in the first quarter, primarily in January and February [32][46] - The impact of weather was particularly pronounced in major markets like Nashville and Texas, affecting overall performance [46] Company Strategy and Development Direction - The company is focused on increasing reimbursement rates through contract negotiations and expanding its workers' compensation business [34] - There is an emphasis on acquisitions as a primary focus for capital allocation, with ongoing diligence on several potential deals [41] - The company is exploring home care capabilities, leveraging the Metro acquisition to enhance service offerings [107][110] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about demand recovery following weather disruptions, with expectations for strong performance moving forward [47][48] - The company is preparing for potential economic downturns, citing past experiences and a solid demand outlook [52][54] - Management is hopeful about updating guidance in the coming months, indicating that current performance exceeds internal projections [27][28] Other Important Information - The company has a favorable debt position with $129.4 million in term loans at a 4.7% interest rate and a $175 million revolving credit facility with only $28 million drawn [40][41] - Corporate office costs were 8.8% of net revenue, down from 9% in the previous year, indicating improved cost management [39] Q&A Session Summary Question: What was the guiding volume inside the negative number for mature clinic revenue? - Management indicated that weather had a significant impact, particularly in established markets, leading to a decline in visits [46][49] Question: How has the business performed during past economic downturns? - Management noted that during the 2008-2009 recession, the company continued to grow and acquire facilities despite some negative impacts on same-store volume [52][54] Question: What are the drivers behind the IIP outperformance? - Management highlighted the effectiveness of injury prevention programs and the organic growth from existing clients as key drivers [60][62] Question: Can you provide more color on the commercial side and workers' compensation rates? - Management confirmed that commercial rates increased by over 3%, with workers' compensation rates also showing strong growth [86] Question: What are the biggest learnings from the Metro leadership meetings? - Management emphasized the strong leadership and growth plans at Metro, which could be beneficial for other partnerships [106][108]