Lisa Clive: Hi, Helen, been a while. Congratulations on the promotion and good luck with the big changes ahead. Just a few questions on just your thoughts on treatment volumes. Can you comment on what the COVID excess mortality was in Q4? And what are your assumptions for that for 2023? Second part of that is, DaVita made a lot of noise at Q3 around missed treatments having picked up and stayed quite high through 2022, which they said was a 100 basis point headwind to their treatment volumes, which they have expected to continue into 2023. We’ll see what they update us on that later. But can you just comment on how missed treatments have been trending for you and whether we should expect a year-over-year change in any way and whether it’s sort of elevated?
And then the last piece relating to your treatment volumes is just around transplants. There’s about 20,000 transplants in the US every year. I assume given your market share that roughly 35%, 40% of that is your patients. Has that number stayed pretty steady? Has it actually gone down in the pandemic due to lack of operating room capacity? There was a big push under Trump initiative to try and increase transplants. Has that number been going up? I’m just sort of curious and then also in light of the regulatory change where there’s now drug coverage for patients under Medicare which could help some of those patients maintain those transplants in a healthy way. Just trying to think about some of the puts and takes around patient volumes as the next few years unfold.
Thanks.
Helen Giza: Thanks, Lisa. It’s great to hear your voice. Let me make sure I capture all of those. And if I miss something just tell me at the end, but I think I was scribbling furiously here. Treatment volumes in Q4 were pretty flat. So we didn’t see anything untoward there. In terms of the missed treatments, and I think we saw this kind of phenomena in lower growth in Q2 to biased in Q3. And I think at this point, both of us are saying who we don’t know. So we are turning that into — okay all we can look at now is where we are with our organic growth and that’s why I think we’re kind of for us for sure at FMC calling it the plus one minus one for 2023. So — and then as it relates to COVID and the excess mortality we’d always guided 5,000 to 6,000 for the full year.
We ended the year. And bear in mind these are still somewhat — not completely final because of the data lag, but we ended the year with around 5,200. So a little less than we had expected. And it’s — at the peak we were seeing this excess mortality driving around 400 basis points. And now we’re seeing that at around 250 basis points. So I think that gives you the swing of where we’re seeing that. And then just maybe as we think about our same market decrease that’s been coming — as I already mentioned, that’s been coming down a little bit every quarter where we were at minus 1.9% at the end of the year. And then on transplants, you mentioned 20,000. We’re seeing that a little bit higher, maybe around 25,000. So I think there’s a little bit of an increase, which obviously is likely to be supported by some of the executive orders there as well, but an increase but still quite small numbers in terms of the overall patient volumes.
Did I miss anything, Lisa?
Lisa Clive: No. I suppose just — well, I guess maybe just one follow-up on the excess mortality round COVID. Essentially, the average has been that roughly 20% of your patients die to your COVID increased that by a few percentage points. Do you think we’re sort of stuck at a slightly higher mortality rate just because these are such clinically vulnerable patients or just trying to think about how that looks going forward?
