The other thing that I would point out in terms of, kind of positive impact on free cash flow or cash flow from operations, would be our interest payments as we continue to refinance some of our debt and pay down some of our debt. Our cash interest will be significantly lower in 2023 than it was in 2022. In addition, in 2022 as part of the refinancing and debt payoff. We did have to accelerate some of our cash interest payments, which resulted in effectively on a couple of those tranches paying more than 12 months of interest in the year. So, as that goes away and then with the lower interest rate on the piece that we finance and a lower debt balance, we’ll have approximately $50 million to $60 million of lower interest €“ cash interest in 2023.
Operator: Our next question will come from Andrew Mok with UBS. Please go ahead.
Unidentified Analyst: Hi, this is on for Andrew. Could you walk us through the trend in inpatient acuity throughout the year? And with your focus on investment in higher acuity service lines, how do you expect acuity to trend in 2023? Thanks.
Tim Hingtgen: Sure. Sure, Thomas. This is Tim. I’ll kick it off, and Dr. Simon feel free to weigh in. In terms of our acuity progression throughout the year, as we pointed out in our earlier remarks, on lower to €“ relate to lower medical case mix index. And so, depending on the level of COVID in the prior year quarter, it certainly impacted our year-over-year comps. But as the year went on and as I mentioned, we grew some of our inpatient surgeries saw some of those volumes improve throughout the year. We did see our surgical case mix improve, which yielded a stronger gain by year-end and overall case mix index. On €“ versus 2019, I don’t know if we pointed this out earlier, but we did actually grow our case mix index versus 2019 across both medical and surgical.
So, we believe that’s evidence of our investments in the service line strategies, the recruitment strategies, and the transfer centers success of bringing higher acuity patients into our health care systems. So, while we saw a dip in last year versus 2021, we’re really pleased with what we saw versus 2019. Lynn, anything to add?
Lynn Simon: I think the only thing that I would add is, as far as we’re seeing an increase in higher acuity cardiovascular services and then also some neurology. So, we are focusing on some of those high-end procedures, as well as other service lines, putting effort into and we’re saying some of the gains from that.
Unidentified Analyst: Thank you.
Operator: This concludes our question-and-answer session. I would like to turn the conference back over to Mr. Tim Hingtgen for any closing remarks. Please go ahead, sir.
Tim Hingtgen: Thanks, Chuck, and thanks to everyone for spending time with us today. Let me end today by thanking the caregivers and support teams across our organization to provide patients with safe quality health care. They do a remarkable job. I also want to acknowledge our local health system and CHS leadership teams who’s sharing our commitment to achieve the best results possible. Working together, we look forward to reaching our goals and providing value for all of our stakeholders in 2023. As always, if you have additional questions, you can always reach us at 615-465-7000. Thank you.
Operator: The conference has now concluded. Thank you for attending today’s presentation. You may now disconnect.
