Financial Data and Key Metrics Changes - The company reported a net revenue increase of 6% year over year for Q3 2025, driven by improvements in payer mix and state-directed payments from New Mexico and Tennessee [6][12] - Adjusted EBITDA for Q3 2025 was $376 million, up from $347 million in the prior year, with a margin of 12.2%, an increase of 100 basis points year over year [11][12] - Leverage was reduced to 6.7 times, down from 7.4 times at year-end 2024, indicating improved capital structure [9][15] Business Line Data and Key Metrics Changes - Same-store net revenue increased by 6.0% year over year, primarily due to rate growth, with net revenue per adjusted admission up 5.6% [12][51] - Same-store inpatient admissions rose by 1.3% year over year, while same-store surgeries declined by 2.2% [12] - The company continued to grow its inpatient volume, although outpatient elective surgeries remained under pressure [7][12] Market Data and Key Metrics Changes - The company experienced a divergence in inpatient and outpatient surgeries, with outpatient surgeries down due to economic headwinds affecting consumer demand [19][20] - The payer mix improved sequentially and year over year, contributing to a more favorable revenue environment [12][20] Company Strategy and Development Direction - The company is focused on supporting caregivers and improving healthcare experiences, with plans for a leadership conference to discuss future vision and investments [5][6] - Strategic investments are being made in capacity and service line expansions, including acquisitions and new service lines in various markets [8][9] - The company is pursuing divestitures and has ongoing discussions for potential deals, indicating a strategic approach to capital deployment [22][26] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about future operational and financial performance, citing improvements in consumer confidence and payer mix [6][20] - The company anticipates positive free cash flow for the full year of 2025, with expectations for continued growth in 2026 driven by Medicare rate increases and state-directed payment programs [15][26] - Management acknowledged ongoing inflationary pressures but remains confident in cost control measures and operational efficiencies [13][14] Other Important Information - The company refinanced $1.74 billion of senior secured notes, extending maturity to 2029, which provides financial flexibility [9][15] - A $28 million gain from a legal settlement was recognized, contributing to reported results but excluded from same-store metrics [11][12] Q&A Session Summary Question: Thoughts on outpatient volume recovery - Management noted that economic headwinds and consumer confidence have impacted outpatient surgeries, but improvements in payer mix and consumer sentiment are encouraging [19][20] Question: Free cash flow outlook and capital deployment - Positive free cash flow is expected for 2025, allowing for strategic capital deployment, including potential tuck-in acquisitions [24][25] Question: Trends in payer denials and underpayments - Denials have stabilized since a spike last year, with investments in internal revenue cycle management and AI tools to improve efficiency [55] Question: Impact of flu season on guidance - Flu season has started slowly, but this has been factored into guidance, with no significant uptick observed yet [56][57]