Financial Data and Key Metrics Changes - The company reported adjusted EBITDA of over $73 million for Q2 2025, exceeding expectations, driven by same unit revenue growth of over 6% [4][5] - Consolidated revenue decreased by just over 7%, primarily due to non-same unit activity declining by about $63 million, offset by strong same unit growth [6][7] - The full year adjusted EBITDA range has been raised and narrowed to $245 million to $255 million, reflecting improved cash position and balance sheet [5][10] Business Line Data and Key Metrics Changes - Same unit pricing increased by 3.5%, driven by increased patient acuity, strong RCM cash collections, and an increase in contract administrative fees [6][7] - Same unit patient service volumes increased by approximately 3%, with NICU days up over 6% and modest increases in maternal fetal medicine services [7][8] - G&A expenses decreased to $5.3 million from $8.8 million in the prior year, reflecting staffing reductions and decreases in other expense categories [8] Market Data and Key Metrics Changes - Payer mix remained stable compared to the prior year and on a consecutive quarter basis [6] - Accounts receivable DSO improved to 46.4 days, down over three days year over year, indicating better cash collections [9] Company Strategy and Development Direction - The company aims to be the best partner to hospitals and the employer of choice for clinicians, focusing on quality of care and operational excellence [11][12] - The addition of a new team member is expected to enhance quality efforts and identify financial and operational opportunities [14] - The company is prepared to manage through legislative changes affecting Medicaid, particularly in non-expansion states where 60% of its volume resides [15][30] Management Comments on Operating Environment and Future Outlook - Management expressed confidence in navigating headwinds in the healthcare environment, emphasizing the importance of a strong balance sheet [11][17] - The company is optimistic about its ability to manage through the impacts of the Neonatal Care Transparency Act and other legislative changes [15][30] - Future guidance reflects a cautious view on hospital landscape but expects stable margins moving forward [50][51] Other Important Information - The company generated $138 million in operating cash flow in Q2, up from $109 million in the prior year, driven by higher earnings [8] - The company ended the quarter with cash of $225 million and net debt of just over $380 million, reflecting a net leverage of just above 1.5 times [9] Q&A Session Summary Question: Can you talk about the hospital admin fees and their growth? - Hospital admin fees contributed about a third of the pricing growth in Q2, with negotiations showing success despite challenges [20][21] Question: What is the flow-through of admin fee increases to doctor compensation versus corporate? - The flow-through is estimated to be in the 30% to 40% range and is expected to be immediate [23][24] Question: What is driving the strong NICU growth this quarter? - The growth is attributed to multiple factors, including increased acuity and overall strong performance across services [27] Question: How will the Medicaid impact from the big beautiful bill affect the company? - The impact is unclear, but management is hopeful that the focus on pregnant women and children will shield them from cuts [30][33] Question: Can you elaborate on the buyback strategy and its pace? - The company is focused on maintaining a strong balance sheet and is open to share buybacks if deemed beneficial [38][41] Question: What is the update on IDR and arbitration with payers? - The process has been favorable, with the company remaining predominantly in-network and successfully negotiating with payers [44] Question: What is the outlook on revenue and margins for the rest of the year? - The company expects stable margins but acknowledges tougher comps as the year progresses [50][51]

Financial Data and Key Metrics Changes - The first quarter results exceeded expectations, driven by same unit revenue growth of over 6% and NICU days increasing by 2% [3][4] - Adjusted EBITDA was just over $49 million, significantly above expectations, leading to an increase in the full year 2025 adjusted EBITDA outlook from $215 million - $235 million to $220 million - $240 million [4][12] - Consolidated revenue decreased by just over 7%, primarily due to non-same unit activity declining by about $63 million, partially offset by strong same unit growth [8][9] - Practice level operating expenses reflected favorable impacts from cost management initiatives, with salary growth decelerating significantly year over year [4][9] Business Line Data and Key Metrics Changes - Strong volumes in hospital-based services contributed to the overall growth, with NICU days increasing by 2% and modest growth in maternal fetal medicine [3][4] - Same unit pricing was up over 4.6%, driven by favorable payer mix shifts and modest improvement in contract administrative fees [8][9] - Practice level SW and B expenses declined year over year, although increased on a same unit basis due to higher incentive compensation and salary increases [9][10] Market Data and Key Metrics Changes - The accounts receivable DSO was just under 48 days, flat compared to the previous quarter but down over four days year over year, indicating improved cash collections [11][12] - The company ended the quarter with cash of $99 million and net debt of $512 million, reflecting net leverage of just over 2.2 times using the midpoint of the updated adjusted EBITDA outlook for 2025 [11][12] Company Strategy and Development Direction - The company is focused on methodically reinvigorating relationships with hospital and health system partners and aims to be the employer of choice for clinicians [5][6] - The strategic focus is on core areas such as neonatology and maternal fetal medicine, with plans to acquire several NICU, MFM, and OB Hospitalist operations [5][6][43] - The management emphasizes the importance of being a reliable partner for hospitals, which is expected to drive growth opportunities [35][36] Management's Comments on Operating Environment and Future Outlook - Management remains cautious about the uncertain healthcare environment and economy, which influences their conservative guidance [16][19] - The company is actively monitoring changes in the economy and potential impacts on family expansion decisions, but does not see specific concerns at this time [17][18] - The management is confident in the company's ability to navigate challenges and believes that their strong balance sheet will provide opportunities for acquisitions [44][46] Other Important Information - Depreciation and amortization expense declined to $5.3 million compared to $10.3 million in the prior year, primarily due to practice dispositions [10] - Interest income on cash balances contributed to strong performance in investments and other income, which is expected to remain favorable [48] Q&A Session Summary Question: Updated thoughts on guidance - Management stated that initial guidance was conservative due to uncertainty, but first quarter results exceeded expectations, prompting an upward revision [16] Question: Concerns regarding economic conditions - Management noted that there are many changes in the economy and administration, leading to a more difficult economic environment [18][19] Question: Hospital contracted subsidies - Subsidies have always been part of the business and continue to be a normal aspect of partnerships with hospitals [24][25] Question: Seasonality expectations - Management does not foresee any changes in seasonality for 2025 and is not concerned about changes affecting the numbers [27][28] Question: Collections and DSO - Management indicated that there are no concerns regarding DSO or accounts receivable, and collections are improving [29][30] Question: Potential hospital contract wins - Management believes that focusing on strong partnerships and reliability will lead to growth opportunities in hospital contracts [35][36] Question: Update on divestitures and acquisitions - Management is comfortable with the current portfolio and sees favorable conditions for acquisitions, indicating potential opportunities in the market [43][44]