Financial Data and Key Metrics Changes - The company has increased its estimate of the potential impact from the expiration of enhanced subsidies from $50 million to a range of $50 million to $100 million, primarily affecting the acute care division [4][5] - The company reported a $25 million EBITDA loss in Q2 due to delays in obtaining deemed status for the Cedar Hill hospital, with an additional estimated loss of $25 million for the second half of the year [21][23] Business Line Data and Key Metrics Changes - The acute care division is expected to see same-store revenue growth in the range of 5% to 7%, with surgical volumes being somewhat soft compared to previous years [17][18] - The behavioral health segment is experiencing labor shortages, impacting the ability to meet demand, but improvements in recruitment and retention are anticipated [45][48] Market Data and Key Metrics Changes - Approximately 6% of adjusted acute admissions are exchange patients, which is lower than competitors like Tenet and HCA, indicating geographical differences in patient demographics [8] - The company expects to capture more market share in behavioral care as it addresses labor shortages and improves recruitment [51] Company Strategy and Development Direction - The company is prepared to implement cost efficiencies and modify its cost structure in response to potential revenue reductions from the loss of exchange volumes and Medicaid supplemental payments [10][12] - The company is exploring M&A opportunities, particularly in the acute care sector, if financially distressed not-for-profit hospitals become available [57][58] Management's Comments on Operating Environment and Future Outlook - Management described 2024 and 2025 as the first clean post-COVID years, expecting a return to normative growth models [17] - The company is optimistic about the sustainability of its growth rates, particularly in the acute care division, despite some softness in surgical volumes [18][19] Other Important Information - The company is leveraging technology, including AI, to improve operational efficiency and reduce costs in areas such as revenue cycle management and patient follow-up [38][40] - The company anticipates that Medicaid supplemental payment programs pending approval could add $150 million to $200 million annually if approved [14][15] Q&A Session Summary Question: What is the impact of potential subsidy expiration? - Management noted that there is speculation about an extension of subsidies, but they have increased their estimate of the impact on revenue due to potential loss of coverage [4][5] Question: How is the company addressing cost efficiencies? - Management indicated that they have a menu of options to adjust the cost structure and are prepared to react to regulatory changes [10][12] Question: What is the outlook for surgical volumes? - Management expects surgical volumes to improve incrementally as the year progresses, although they have not seen dramatic changes in Q3 [19] Question: What is the status of Cedar Hill hospital? - Cedar Hill is awaiting deemed status approval, which is expected soon, and management anticipates improved financial performance following this approval [22][23] Question: How is the labor market affecting operations? - Management reported that labor pressures have stabilized, with wage inflation returning to more normative levels [26][28] Question: What is the outlook for commercial rates? - Management expects contractual price increases from payers to be in the 4% to 5% range moving forward [33][34] Question: What is the company's approach to M&A? - Management is open to M&A opportunities, particularly in the acute care sector, if financially distressed hospitals become available [57][58]

Financial Data and Key Metrics Changes - The company reiterated its earnings guidance for the year, including increases in EBITDA and free cash flow following Q2 results [3] - The leverage ratio is just above three times EBITDA minus non-controlling interests, indicating a strong balance sheet [3] - Over $100 million in out-of-period Medicaid supplemental payments contributed to about a third of the guidance raise, with the majority attributed to core operating performance [8] Business Line Data and Key Metrics Changes - The acute care business demonstrated strong operating expense controls and high-acuity strategy, leading to consistent earnings generation despite volume fluctuations [10][11] - USPI (United Surgical Partners International) reported strong revenue growth, with same-store revenue growth exceeding 7% in the first half of the year [40] Market Data and Key Metrics Changes - The company noted stable operating conditions, with labor costs returning to traditional levels and professional fees showing flat sequential growth [39] - The demand environment remains stable, with no significant changes in market or operational parameters affecting demand [14] Company Strategy and Development Direction - The company is focused on high-acuity strategies, which are less elastic and provide more consistent earnings [10][11] - There is an emphasis on capital investment in clinical technologies and growth strategies, with plans to pull forward capital expenditures to drive market share [35][36] - The company is actively engaged in policy discussions regarding the extension of premium tax credits, which are seen as crucial for small businesses and the healthcare industry [18][19] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the business's operational excellence and ability to generate earnings regardless of volume fluctuations [10][12] - The company is optimistic about future growth opportunities, particularly in the USPI segment, and is prepared to adapt to policy changes [36][46] Other Important Information - The Conifer Health Solutions business has expanded and maintained margins despite challenges, with improvements in automation and AI-driven processes [53][55] - The company has successfully integrated acquired assets and is generating operating leverage, enhancing growth potential [41] Q&A Session Summary Question: How would you characterize the core performance excluding Medicaid figures? - Management indicated that the majority of the guidance increase was based on strong organic performance, including high volumes and acuity in the hospital space [8] Question: What are the expectations for the second half of the year? - Management stated that they have not changed their demand forecast and are focused on operational excellence to drive earnings [14][15] Question: What is the company's stance on potential policy changes regarding premium tax credits? - Management highlighted the importance of extending premium tax credits and the growing recognition of their value among policymakers [18][19] Question: How is the company managing costs related to labor and supplies? - Management reported stable operating conditions, with labor costs returning to traditional levels and effective expense management [39] Question: What is the outlook for capital investment in the hospital business? - Management expressed confidence in their capital investment strategy, indicating that they are well-positioned to invest for future growth [30][31]

Financial Data and Key Metrics Changes - First quarter revenue increased by 4% to $1.5 billion compared to the prior year, driven by a 2.7% growth in adjusted admissions and a 1.2% increase in net patient service revenue per adjusted admission [11][12] - Adjusted EBITDA grew by 2.5% to $98 million, with supply costs as a percentage of revenue declining by 60 basis points year over year [7][16] - Total cash at the end of the first quarter was $495 million, with total debt outstanding at $1.1 billion, resulting in a total available liquidity of $790 million [16][17] Business Line Data and Key Metrics Changes - Admissions grew by 7.6%, with inpatient surgery growth at 3.4%, while outpatient surgeries declined by 2.3% [5][12] - The growth rate of physician professional fees was 6%, down from 13% in the same period last year, indicating a moderation in cost growth [7][63] - The integration of 18 NexCare Urgent Care clinics is expected to generate additional downstream volumes in the Tulsa and Albuquerque markets [8] Market Data and Key Metrics Changes - The company is experiencing strong demand in its existing markets, with an average market growth rate of about 3% per year [40] - Exchange volume growth was significant, with admissions in the quarter growing by 40%, contributing to mid-single digits as a percentage of revenue [60] Company Strategy and Development Direction - The company is focused on expanding its outpatient and acute care hospital footprint, supported by approximately $500 million in cash and a favorable lease-adjusted net leverage ratio of three times [4][9] - A disciplined approach to evaluating M&A opportunities is being pursued, with increased interest in the company's joint venture model from potential academic and non-profit partners [8][9] - The company aims to achieve margin expansion of 100 to 200 basis points over the next several years through operational initiatives and supply chain efficiencies [7][19] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the durability of demand, attributing strong volume growth to operational improvements and the strength of the markets [40] - The company reaffirmed its full-year 2025 financial guidance, indicating a solid start to the year and strong momentum [9][17] - Management noted that while payer claim denials have increased, they do not expect a significant impact compared to the latter half of 2024 [13][28] Other Important Information - The company is in the final stages of recruiting a Chief Development Officer to support its focus on M&A activities [4] - S&P upgraded the company's credit rating to B+ from B, reflecting improved net leverage and cash flow profile [17] Q&A Session Summary Question: Inquiry about seasonality and EBITDA decline - Management indicated that a sequential decline in EBITDA is not abnormal and attributed it to various factors including flu season impacts and timing issues [22][26] Question: Follow-up on elevated denials - Management confirmed that the increase in denials is consistent with previous trends and highlighted a slowdown in payments on clean claims [28][29] Question: Supply chain initiatives and opportunities - Management noted participation in a GPO and ongoing improvements in service line utilization as key areas for margin expansion [30][31] Question: Update on expansion initiatives - Management reported a growing pipeline for new market opportunities and emphasized the importance of strategic acquisitions [46][53] Question: New Mexico DPP program approval timeline - Management expressed hope for approval by the end of Q2, based on positive indications from state and CMS conversations [54][56] Question: Exchange volumes and payer mix - Management confirmed strong exchange growth, with admissions increasing significantly and operating in mid-single digits as a percentage of revenue [60]

Financial Data and Key Metrics Changes - The company reported net income attributable to UHS per diluted share of $4.8 for Q1 2025, with adjusted net income per diluted share at $4.84 [4] - Adjusted admissions to acute care hospitals increased by 2.4% year-over-year [4] - Same facility net revenues in the Acute Care Hospital segment increased by 5% compared to Q1 2024 [5] - EBITDA increased by 21% after excluding Medicaid supplemental payments [5] - Cash generated from operating activities decreased to $360 million from $396 million in Q1 2024 due to delays in Medicaid payments [6] Business Line Data and Key Metrics Changes - Same facility net revenues at behavioral health hospitals increased by 5.5%, driven by a 5.8% increase in revenue per adjusted day [5] - Adjusted patient days were relatively flat compared to the prior year, impacted by the leap day in 2024 and adverse weather conditions [6] Market Data and Key Metrics Changes - The company experienced a reacceleration of patient day growth in March 2025 [6] - The Nevada supplemental program received $82 million in payments in April, related to Q1 revenues [6] Company Strategy and Development Direction - The company is focused on managing operating expenses effectively across both business segments [8] - The opening of new facilities, such as West Henderson Hospital, is expected to contribute positively to EBITDA [10] - The company reiterated its full-year earnings guidance despite uncertainties in the external operating environment [11] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in underlying business performance despite external uncertainties [11] - The company anticipates achieving a behavioral patient day revenue growth target of 2.5% to 3% for the year [15] - Management acknowledged ongoing challenges in labor markets but noted improvements in staffing levels [78] Other Important Information - The company spent $239 million on capital expenditures in Q1 2025 and repurchased $1 million of its own shares [7] - The company has $1.02 billion of available borrowing capacity under its revolving credit facility [7] Q&A Session Summary Question: Insights on behavioral health volumes and future guidance - Management confirmed that the full-year guidance of 2.5% to 3% patient day revenue growth remains reasonable despite a slow start in Q1 [15][20] Question: Updates on Medicaid supplemental payment programs - Management indicated that approvals for Tennessee and D.C. programs are expected, but timing remains uncertain [16][17] Question: Impact of tariffs on supply chain - Management noted that approximately 75% of supply chain purchases are insulated from tariffs, and they are monitoring vendor responses [26][28] Question: Trends in acute business and acuity - Management reported that acuity was muted in Q1 due to a busy flu season but expects normalization as the year progresses [62] Question: Expense management and premium labor costs - Premium pay costs were consistent at $63 million, and management is optimistic about sustaining operating expense controls [70][72] Question: Updates on commercial rate negotiations - Management stated that overall guidance for acute care revenue growth remains at 5% to 6%, with no significant impact from payer behavior noted [105][106]