ATI Physical Therapy (ATIP) 26 Feb 242023 Q4 Earnings call transcript

Good afternoon, and welcome to the ATI Physical Therapy's Fourth Quarter and Full Year 2023 Earnings Conference Call and webcast. [Operator Instructions] Please note, this event is being recorded.

On the call today is Sharon Vitti, Chief Executive Officer; Joseph Jordan, Chief Financial Officer; Chris Cox, Chief Operating Officer; and Joanne Fong, Senior Vice President, Treasurer and Head of Investor Relations. I will now turn the call over to Ms. Fong.

Mandeep. you, Thank everyone. Good afternoon, for joining you today. us Thank

and you Before made statements that beliefs, subject and assumptions remind on currently expectations be we we'd like are uncertainties risks various to begin, and that to our during our statements current based certain forward-looking to reflect available this us. information will call

of factors we these company's and Exchange expectations Securities occur obligation cause statements any revise changes to believe from are that no differ the in in the Although Commission. these can to this Risk after some actual results Descriptions forward-looking the call. to section with Factors that be reasonable, we of the reflect materially filings undertake found statements

non-GAAP certain evaluating measures important measures measures addition, believe are Details we performance. to non-GAAP that's GAAP financial to that, between that the please the to can historical be In SEC. And note these in with the that be and the the I'd on of the measures filed relationship the in company and comparable over call non-GAAP most on website posted discussing turn will found financial with reconciliation release Sharon. like press earnings ATI's

welcome, Joanne, everyone. you, and Thank

call. rest In of and have Joe, on the addition to we our Chris the ELT

Legal Chief Chief Officer; our Chief our Erik We Oakes, have Eimile Tansey, our Officer; Officer. Growth and our People Kantz, Guss Scott Gregerson, Chief Officer; Information

expanding year care XXXX to staff to our people of was their to across know, today, proud our exhibited brand fourth XXXX earlier and we local results. in may single healthiest our platform teamwork you helping full reset our national strong As ATI communities, life I'm purpose year, access reported a achievements. live and our life. very bring and quarter

saw winning access employees, for growing enhancing operations, strategies targets patients, opportunities our many KPI for strong and resulting creating the on were provider demand of and It down Our I a to an for to $X.XX when was ATI's all-time ATI the highlights want continue in elevating all including our advancing few XXXX, that XXXX, growth, rate patient services. in guidance. XXXX expanding exceed XXXX. Starting per and per base, be history development meaningful visit strengthening of revenue us we XXXX the day financial double ATI and we was talent with exceptionally experience, and clinic XXXX. key the culture, implemented year strategies, deliver areas our high robust team over quarter-over-quarter referrals year. in a referrals the the performance. by increased improved allowing deliberate previous to to in implemented In

to clinics. with our clinics current XX in so compared of closed to fleet see investing together performance factors: opened of there XXXX, a reduced one, year-over-year allowing to look us clinical or increases, FTE worked in reducing necessary Officer, our Chief our a in XX at and HR clinics footprint, successfully the XXXX our more and coupled per limited on XXXX. The revenue XXXX, clinic Eimile day to novo level, consolidations, normalized historic grow coupled and this, visits for number to expansion the The number we FTEs remain tight. And XXXX stability XXX,XXX operational Ops contributing two in teams our focused in turnover per we watermark. On led led opening upgrades, our and be visits improving Chris will administrative with burdens high more processes COO, and are patient more our with improvements labor as clinics. management. rate teams de a see reasons. payor market a teams cycle year to in divested continues our And clinic, clinical in Cox, to significantly new the creating HR achieving of People providers allow Tansey,

while markets the ATI's goal achieved Now capitalizing grow monitoring in operations continuously long-term capacity continue people on local to the and and to XXXX clinic we is with in on growing our momentum footprint XXXX. are performance. focused Overall,

people us to part gain all patient is year in We this grown. from we competitors. the improved market team's refined new our in excellence survey what our XXXX. the during the apart our few in In and feedback. XXXX, changes the a Our experiences. additional anticipate in are our commitment within to sets patient satisfaction our later of critical sharing care patient processes this from Hearing insights past customer our KPI company year the Through has years,

Our exceptional. remains clinical quality

help from As therapy cuts providers. in In fee Services, offset in XXXX, quality previously reported, patient for fourth Medicaid program Medicare consecutive an basically since for inception every the in exceptional schedule and achieved payment XXXX. CMS the will year physical bonus to rating MIPS year, receive for the Center program's a XXXX, again the ATI ATI

advance detailed improvements process XXXX. a top of the drove clinic care. quarter will launch later call team for excellence completed out Another area create provide increased new priority Advancement implementations. team COVID call. clinic Musculoskeletal operations operational performance for year The per the our want Institute The drove opportunities in institute of areas. to to during research to operations utilization the and in do with the earlier highest visits and in of Advancement. the fourth influencing is will month It XXXX. In involved the colleagues policy. quarter-over-quarter clinical of I musculoskeletal numerous every two of and is and research teaching, the the since those discussion and technology Institute during Chris the enhance XXXX, get initiatives the scientific Musculoskeletal to a purpose this The of for is quality start

I ATI's adjusted we and It the company of XXXX, the the XXXX, clinical resulted combined XXXX high beating prior our have spending saying for the XXXX. In in in seeing extend team are kicked each in that services, and demand implementing in of started time more the with Our incredible day without colleagues, expectations. patients enriching the that, our to discuss in X.X. The about XXXX sequential strong when levels year dedicated XXXX in operations. clinicians ATI. With lives progress and quarter, Worth revenue showing clinicians of a the real talented were every visits our XXXX who XXXX a Joe patients a A progress we revenue walk-through productive is day. turn leaders, in tremendous to business, call entire seeing teams ATI highly Chris and to QX year and for guidance. gratitude the to patients EBITDA communities our goes throughout full financial communities. from ATI's numerous are invest emotionally I will the to with prior everyone at for congratulations FTE will teams, with share pandemic lives to we back we revenue quarter off and the the over XXXX have Shortly, progress than the big historically XXXX. noting difference and per QX made passionate made detailed our of provide QX ATI increase strategies the have results continuous making every

sets well for transformation from update All on that right. members, as second the clinicians as to director was footprint, fourth enable their operational progress. We with full develop every well the leadership outstanding passion I'm ahead together I leadership as I'm from share to our inspired able clinical Board January, XXXX field quarter to attend Sharon. our and for we our across the results national competencies to providers the time. outcomes our and along brought core development event for This stage our corporate patients. an leaders year need our our our skill achieved. In well as the by affords clinic national that to Thank us and the efforts sets and you, exceptional achieving XXXX paths. focus as the continued year and meeting for to proud opportunity on operational critical as of continue and our

while and our want ability excellence exceptional our continuing Together, thank Our to capacity life and we purpose care, elevate furthers enhancing focused continued ATI on In and deliver our patient the workflows health care our field to on who diligently continued to the for colleagues outcomes, to every and day. I operational our teams XXXX, remain bring operations clinic progress processes. deliver in refined central to teams patient experience.

beginning million for and cracks. for to from we and As leverage providers intake, efficiencies teams our over and the innovation XXXX realized addition XXXX Fast high-quality progress Medicare seeing visits intake their care, phone calls rating in slipping services annual spoke with effort even But every more easier our Sharon quality mentioned, functions, in day time made visits across of XXXX, we bonus removed and ATI see of day of X-wall with clinic at This clinic innovation per from quarter exceptional At reduce operating use, the by the clinics referral effort, spend be each earned to our QX, visits each operations. top to our process support our over year, customer the an care. per quarter and process initiative EMR focusing can our CMS clinic increased our operational FTE doesn't This enhancements initiatives, delivering again rendered. The teams patient there. management, over patients evidence-based rollout fact, per and day forward it our a and centralization enhancements as and with on to registration additional license, the and clinic clinicians clinical And to consistency we an higher that helped enabled prior system safeguarding how X.X of our awarded X.X with satisfaction about the the in performance. we has access make XXXX. stop in expanded in scheduling delivering we technology through administrative greater would burdens to continued other in completing referrals also centralized single will we completed end our all I for and the MIPS clinics. patient drive efforts. In combined

to Our for administrative clinics, we our augment XXXX. will value in By greater clinical our operations continue streamlining even organization. initiatives unlock in processes to expect further our

and Considering ended and remain our and FTE nearly our committed X,XXX role quarter and grow. prioritizing in, have are burdens strategies our at we providers' engagement ongoing reduce that recruitment experimenting imbalance and to to recognizing we have pivotal we base market market, clinics and in conversion patients, we improved and to the satisfaction more our and play XX%, in providers the care. Equally that clinical with paperwork success. this FTEs. We with fourth in single successfully higher exceptional building the time, volumes begin administrative throughout now both new continued experience with notable we strategies model, the is retention we pre-COVID XXXX referral rhythm, community reduced will growth despite We a ongoing the time are are impactful, delivering With QX operating in about to engaged clinicians challenging culture attendance. grew more on labor labor to the appointment therapy to on focus continue where employee the predictable foster and physical efforts, ended year speaks save both expect our which clinicians digitize centralized new a turnover which stay to par a drive intake for Clinician at levels. retention will registration to patient efforts bolster

in costs Finally, payors I compensation our In denial a closely revenue for our partner that previously from rates, also cycle to automation significant vendor about negotiations impacted we and reimbursement. functions achieve drive transforming to efforts. year, are and improvement collection the the with were was collect, to to consolidate revenue POS cost provider revenue able rate, collection ongoing preferred talked our that we rate rate. our by we rate, made to XXXX, and every our the employ during measures With work enhancements a in that almost in KPI with standardized we workers' the reduce collection cycle more more And best-in-class offering decision performance. ensure choice to XXXX cycle in net management relationships area. of our positively efficiency,

to to stand reflected in have we progress seen and updates by to to as a to competition. also priority my our the and work their teams our gratitude do, support better to processes that on look and teams my express financials, field want heartfelt of I among their conclude, We as to throughout driving we of positive of enhancements. To the and teams innovative debt can steadfast driven central health passion. patients. to want is improvements our the their continue We collective I make our out outcomes and services meaningful I and technology commitment we strides remains Their success, clinicians, for in It health leaders, deeply year our in energized the reduction appreciative dedication expense improving efforts the through am providing our build continued I XXXX. driving by and change. have achieved am that process in again is emphasize on to I still focus forward momentum. the bad cornerstone

we excited that opportunities by am move I forward, lie abundant As the ahead.

over provide turn call financial to to Joe in-depth Now results. to I'd like our the of an review

then quarter and for and later early expectations first trends well quarter. to I'll and out the year with Starting Chris, thanks today. for discuss, for mentioned, our financial Sharon as XXXX our you, as everyone on, XXXX talk joining I'll results call full QX. fourth the Thank as about

increase quarter, Our which in was $XXX net as while to quarter fourth go in revenue the increase X.X% revenue XX.X% patient million, clinics. year. $XXX QX prior the $XXX other net for year-over-year, we a our million, was which increase was from is $XX revenue year-over-year layer due million And revenue is MSA the mostly a deeper, is million, higher and year-over-year, XX.X% fourth it's it a of from which a

Rate X.X per X.X% the visits was visits but which of third sequential about clinic, quarter, XX.X. a from talked from in of year. of quarter unit of at clinic. The day clinic visits as third XX X% visit per the Chris increase increase quarter since our Our And clinic the for the quarter sat prior little and quarter And also, as per day from a year, in our day improved the a quarter, bit optimization is prior execution $XXX.XX per which economics. be plans earlier, last continues to to fourth XX per mentioned, the we operational third That's visits fourth the of of more was stronger, quarter. decrease of seen began in clinics increase improvement Chris result vibrant $XXX.XX we've in a XX.X the the and year. every in $XXX.XX sequential per fourth the an compares per in the quarter,

the wage QX year, significant year-over-year quarter both by and mostly outside of the quarter-over-quarter On quarter supporting Looking on the services. primarily in PT salaries primarily to in look year-over-year contract which were services. $XX,XXX, to Sharon slight $XX,XXX collection from XX% visit quarters, related from XXXX upon. Salaries is increase X.X% contracted the labor staff the from to were basis, reasons, period and occurring contractor $XX a increasing discrete rates inflation, quarter the of management increased higher it to a and was in and over from The and we million, higher due prior quarter increase the revenue rate operational which decrease labor decreased noted clinic is productivity. Rent, approximately a adjustments flat related costs the spend the enhancements in previously costs the That rate of was $XX.XX. inflation. to productivity, $XX.XX increased rate decrease favorable and due those related due clinical million fourth $XX same and prior in in primarily increased $XX.XX third touched same and and primarily supplies, and for cycle year-over-year QX other QX year. year-over-year is sequential higher partially which labor of experience. Chris was rate third clinic from revenue in per when realization offset quarter were due driven $XX quarter the due in rates, contract prior increase a X.X% to the favorable more essentially spend of due XXXX And million, year-over-year, higher wage outside costs and million the X% that's from $XX increase to during QX year-over-year fourth of primarily while X% in is higher from by It's more per fourth labor by prior driven was compensation year. which is the

accounts on Our was [Audio in X.X% during year quarter basis, last PT to prior and full doubtful X.X% to the that And provision and in the provision year. the QX for X.X% which $X approximately year. compared of compares is year PT this revenue, favorably a of Gap] X.X% million, of revenue of was X.X%

prior deliberate $XX legal by Noncash during notes, mark-to-market happened decrease of was a our move to from million. outside come quarter in cycle about warrants, that. Notable our $XX X.X% asset during efforts Those by year, Now labor. in year-over-year. $XX totaled higher lot the charges a XXXX operating value contingent impairment quarter improvements severance these which every items nonordinary services increased impairments value resulting the Chris which corporate year-over-year to are the quarter. the of the the processes asset fair and ongoing in that fair teams. are subleasing decrease costs, lower offset XXXX. SG&A goodwill management fourth common the of were quarter, is higher a remain we charges results second shares we into office and in and QX year, earned quarter as other PIK partially primarily talked improvements million, primarily in driven collection portion improvements lower a line and million million long-lived and those $X And the the process by that revenue to $X improvements income, from earnings those below and which with and our was prior included in is rev the have related approximately impairment is million and due which intangible from of income $X associated of reflects our fourth excluding loss space. Operating the lien along an million, the contract

valuation December analysis XX, year-end, of that as $XX So in resulted million.

$XX in expense lower was the prior of hedge million of is million due a interest loss for prior $XX the tax compares expense rate was in year, quarter of Our Income the was of and million, the the during the compares which to million to benefit. our million primarily compared million, $X interest increase which $X prior the quarter fourth quarter to the quarter net the of loss benefit a fourth year. quarter year, during net quarter $X fourth in and $XXX the to

on $XX.X revenue million in guidance per XXXX full X.X%. was full Looking million adjusted during million. primary the per the drivers range year-over-year, of were increased EBITDA guidance compared The was from $XXX revenue outperforming year, prior a in used million, million which $XX the and $XXX X.X% of from to XXXX year to adjusted for year, that's visit, increased the $XX approximately an increase our and EBITDA to of million. Cash $XX $XX which million, at generated was rate million. line, which outperformed increase year-over-year million prior million $X the in XX% $XXX also year cash day, And $XXX visits grew

cash was $XX happened use repaid earnings in of preferred to the some of as XXXX, to break that we to use primarily the in the compared million And mostly XXXX improved use well compared $XX the down in reflects it due to million and and repayments million clinic $XX improvement $XX of in Investing issuance higher XXXX As operating compared XXXX significant decrease CARES million in addition with by cash with Act. was as revolver XXXX, in fewer was of to at further, conclusion end openings. $XX million as driven $XXX had in decrease that XXXX, million cash the in we generated the borrowings XXXX, of financing cash stock then 'XX.

then $XX was availability, in million available we fully approximately of As January was of $XX consisted of and capacity available addition to to and $X $XX revolver And had a of cash term draw XX, December drawn liquidity and that XXXX, in million. million equivalents cash delayed XXXX. our million, loan, of access that which

visits, year and advances capacity led Sharon advancements discussed, throughout million XXXX. QX over into with and $XX Chris and we're the made January weather expect severe revenue be million, achieved and as pleased Finally, in EBITDA XXXX be to the the million that patient to $XXX during to and growth we're Despite these to we that we XXXX. people volume between excited million to demonstrating in the that progress adjusted utilization operational led and currently we the And and $XXX increases impacted $X between prior year. the continue negatively

the spring. With and the initiatives earnings our services, solutions levels process, our and Sharon the will our we made in the continued call remarks. of of throughout that, see In next and this guidance filings. Overall, continuing to we talked date we'll press still the to closing we're achieve year potential XXXX, improvements with we to for productivity plan others course, other call outlined in Of and the for on. provide be of working depend current upon in to see during plenty ATI success Sharon full to turn the I'll demand achieve year. full release expect and and early if last risks we that back process implemented technology to XXXX, exceeding changes And can over that about

Joe. you, Thank

said in the before, successes vision. national setting The space. we in and have practice, our I initiatives, performance and people, in we continued right the strategies I operations accomplished very a succeeded was API reset team during will year, we place, are that ongoing and demonstrate for strategic year improvements, improve to our our continue toward musculoskeletal and the up while aggressively As notable am continuing we XXXX executing in make growth. strides to our lead confident advance that

up XXXX. I'll execute excel now questions the the to in and back open unknown operator hand to on capitalize for the and XXXX call will levers growth to answers. We momentum

the line Brian first from [Operator Instructions] question Our with Jefferies. of Tanquilut comes

Mandeep, and open for would you to like questions now? answers up

Taji Brian. have for Phillips on You

should So some first on to guidance for you obviously, think -- earnings year? I the be the of we QX. about cadence my first have how power provided question throughout is going mean,

about can curious generation? on Just if provide you some we revenue thinking qualitatively how commentary be should

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expecting note I of should we be and in had QX EBITDA. and that some provided terms you revenue what around commentary So

year. what even we be can of the in some curious, the of earnings the throughout terms Just qualitatively, expecting around power rest you should cadence provide commentary of

start I this think is Joe. I could -- Taji, out.

we'd I trends we that years, quarters. expand Chris and as XXXX. and in like have mentioned to XXXX, at my and business developed the continue the touched positive QX, you on experience both expect strong well, to I we'd comments growth think and the Sharon in in in see obviously as QX the of being follow understand seasonality seasonality -- think And this point, to past we trends I expect

the spring like as So adjusted then looks definitive more guidelines that's we think how revenue as it when would that May, probably get come the around to EBITDA And I mentioned, you in in well. can QX earnings what count with out and about directionally. and clinic we

And for those related we're a process, continuing team-based to in XXXX our Phase Yes. we leveraging new technology, care. the initiatives X accomplishment. have streamlining to Many XXXX some of front-end intake roles proud very flight in or of standardize initiatives have

And revenue management then so sophistication. -- the cycle and

Taji, the of we -- have XXXX we So traction that for are we in I initiatives, some -- seeing that QX. those to are think, when there will, putting a place of get we portfolio start are

a Great. different Appreciate topic. that. then slightly And

you'll on thoughts your to leverage around actions hit curious the Just and take the that target target. near-term

I the that leverage we put I out Well, would has one think been cash I I there. for focal back but breakeven. driving to last And expect the continued XXXX. year, didn't talked us, think flow block point say, breakeven it I things XXXX target, about of be haven't getting towards to in the that cash our building towards flow is earnings has in call breakeven

at million, of somewhere If we million noise $XX refinancing, XXXX you use around cash of out strip you the look back were our of $XX $XX and on million EBITDA.

at capital So we driving we'll year. breakeven. continue in cash isn't need our really leverage XXXX which do and really It's could grow our more borrowings, rates dependent to structure, and flow we -- continue But last need just which had is point. obviously, on to focus this into to build interest move around, on to what to the we momentum target that towards look

versus Obviously, just last for a of comps Great. year and question favorable this the are definitely lot And me. last then improvement year. this for year

growth sustainable to about we moving what guess would on top forward, think do you need back XXXX? actions bring sustainable path you tougher to of take see even growth I the As comps in like that

paths. models. business I capacity relate new of in at that and upstream partners, referrals, and to which to that further traditional different before, within the referral the increasing and think referrals, think traditional reimbursement that also clinics. grow less looking we the may the are in out strategic types two ways getting relates parallel, also to process other looking at have growth sought areas will productivity One follow and the is I growth we increasing

Bill next Our the question The with comes from Company. of Sutherland Benchmark line

me are with Where here. the this rationalization process? from of work office at kind you point Nice

Bill? Clinics, Of

Clinics, Yes. sorry.

is looking happening our -- have performance the actively, and to what's at we and are how that clinics communities. a performance relates So we quarterly basis, on those what within

sense where demand And we focus prune so more of that's community continue than And so makes take sense and allow to the market don't as action if the can our us we improve and we we that how we through in financial but capacity. [Audio that Gap] at in the to -- this in at I to a is we have a current look make my determine we And and watch about at regular have anymore. That main similar do the We list XXXX, the then of our clinics we only looking also to we have call, access -- talked maximize performance will are said, and an fleet clinic. the the there expansions year. on are not upgrades, look fleet clinics for basis. that consolidations,

We de at would more a that number we would will anticipate novos in and future. de do looking the small novos I of be

it like maybe increase count productivity you office and and looking just the sounds again steady closures adds hold So with you're between just to across base?

Yes.

would contribute the watch going have we to throughout into going year, list list. of that clinics year. "watch been Both list", coming up. some smaller that the clinics clinics have the improved up. getting though, closed off performance of think, Referrals clinics A been of the has a as been number fall I then last also but those

close constantly process -- that might And so we watch what, if we're process reevaluating of in and are clinics XXXX. and list in any, of determining the in

we'll it's could share. a to first that looks view pretty what as hard we quarter, move that we number So I think right towards have But decent the now. probably say exactly like

Yes. goal we've footprint, to is to grow already And to what built. maximizing also we're important sure make is our it but the continue

Sure, sure.

where with front, productivity it? has like the improved. further versus contract be? you'd expect to On Do and hiring And to are improve where you you churn utilization

hire, are parts I had energy around lot and acquisition continuing of to our our we into would retention. we talent rebuilding say, and structure question. put a three So that one, to our

So close both continue think key the of that clinician of productivity sitting he's is to those going we're let Chris us contractors. total then are X% our factors answer about are I'm headcount I would to the XXXX. to will because I question it. And produce say other just in on for very

around. way or have dependent -- geographies to certain in upon other have than continue we where more We we be supply to contractors the

more similar supply. don't see COVID. team a have being year back We don't lower move And to demand I what where of XXXX -- of than fully very we prior level contractors, we -- have is I a to to The we that. actually we had cognizant

-- to to going contractors why question? not and a take towards those don't on the have for where you year eye to FTEs with the we it's I continue to have on going the up contractors. think the beef -- productivity to Chris, reliance rely can we're have trying

look Sure. Gap]. what the Yes, for and at see that say higher is country, performing across as productivity do continued growth see geographies we would we [Audio certain we Bill, I room

of is were to different Some by due that legacy at owners. that levels set geographic P&L targets different

of particular demand referral Some that to execution. some due due and is geographies pure within of just is it

growing we then robust standardized levels going we in this all the levers all after we of had higher we've the continued my process a I'd And higher referrals, our historically to referral are what outliers had. We're there. improve be where way. of kind helping which then finally, those removal even So geographies say are to prepared managing needs, see our year. that should And the of to administrative across of We've comments, do expectations innovation, very is pockets previously us of had the some burden ceiling to productivity. up some open with

are I next lined we've some had XXXX. and Chapter in important things, great Bill, going to that we're 'XX, said, like be three continue on to pieces. on And X. We push to to and up progress on what hit of made improvements kind continue You those in

at further the like would time. are this closing to for over turn to remarks. There Sharon now call questions Vitti no I

difficulties. except could other each for guess First technical everyone us. I of hear those apologies for all,

and for which apologies you us. early May and Thank will the forward to participation Thank So for progress questions you our joining there. XXXX. call, earnings at of our next look sharing we be

today's call. concludes This

may now You disconnect.