Financial Data and Key Metrics Changes - Revenue for Q1 2025 was approximately $559 million, representing a 14% increase over the prior year period [5][19] - Adjusted EBITDA for Q1 was $67.4 million, reflecting a 93.1% increase year-over-year, primarily due to improved pay rates and cost-saving initiatives [5][19] - Consolidated gross margin was $183.6 million, or 32.8% [19] Business Line Data and Key Metrics Changes - Private Duty Services (PDS) revenue was approximately $460 million, a 16.5% increase, driven by 10.9 million hours of care, a volume increase of 6.1% [19][20] - Home Health and Hospice revenue was approximately $56.7 million, a 3.9% increase, with 77% of admissions being episodic [21][22] - Medical Solutions revenue was $42.5 million, a 3.6% increase, with revenue per unique patient served at approximately $477, up 6.9% [23][24] Market Data and Key Metrics Changes - Preferred payer agreements accounted for approximately 54% of total PDS Managed Care Organization (MCO) volumes, up from 50% in the previous quarter [11] - The episodic mix for home health was 77%, with total episodic volume growth essentially flat compared to the prior year [12][22] Company Strategy and Development Direction - The company is focusing on five primary strategic initiatives: enhancing partnerships with government and preferred payers, identifying cost efficiencies, modernizing the medical solutions business, managing capital structure, and engaging employees [15] - The company anticipates 2025 revenue to exceed $2.15 billion and adjusted EBITDA to exceed $207 million, reflecting an improved outlook [16][28] - The acquisition of ThriveSkilled Pediatrics is expected to enhance the company's preferred payer and government affairs strategies [17][56] Management's Comments on Operating Environment and Future Outlook - Management noted that the labor environment remains a primary challenge but expressed optimism about the demand for home and community-based care [6][14] - The company is encouraged by recent rate increases and preferred payer agreements, which support recruitment efforts and caregiver wages [14][25] - Management highlighted the importance of aligning clinical capacity with preferred payers to achieve normalized growth rates across all business segments [7][12] Other Important Information - The company achieved five rate enhancements for the PDS segment in Q1 and aims to increase preferred payer agreements from 22 to 30 by the end of 2025 [10][11] - Liquidity at the end of Q1 was approximately $266 million, providing room for operational investments [26] Q&A Session Summary Question: Update on targeted states for rate increases and preferred payers - Management reported five government affairs rate increases and two preferred payer wins in Q1, with expectations to achieve ten GA rate increases by year-end [30][31] Question: Insights on operating cash flow and EBITDA conversion - Management expressed confidence in generating operating cash flow and free cash flow in 2025, with Q1 cash outflow better than anticipated [35] Question: Details on one-time EBITDA benefits - Management identified strong cash collections and retro rate increases as key contributors to the $11 million EBITDA benefit in Q1 [40][41] Question: Contribution of Thrive acquisition to revenue and earnings - Management indicated that the Thrive acquisition aligns well with the company's culture and strategy, but it has not yet been included in guidance due to timing [56][59] Question: Updates on Medicaid policy and advocacy efforts - Management noted positive bipartisan support for Medicaid program integrity and ongoing dialogue with federal counterparts [62][64] Question: Size of rate enhancements and outlook for wage increases - Management clarified that the five rate enhancements were beneficial but expected future GA rate wins to be more modest, with a focus on passing through wage increases to caregivers [67][70]