We have a significant investment we’re making in clinical education. Our Galen School of Nursing continues to grow, and we’re really encouraged by what those programs will do for our facilities and our people over time. So those things are all part and parcel to a very comprehensive effort to make sure we have the right amount of staff, they’re supplied with the right technology and resources to deliver high-quality care and they can be successful in growing our company. So we’re pretty encouraged by where we are.Operator Your next question comes from the line of Calvin Sternick from JPMorgan. Your line is open.Calvin Sternick Thanks for the questions. Wanted to ask about capacity. I know you said 1.5% for the quarter but still above pre-pandemic levels and labor improving.
So just want to get a sense, what are some of the other key variables for getting the declination rate back down to historical levels? And where do you think you can get to by year-end? Thanks.Sam Hazen Well, hopefully, we get back to pre-pandemic levels. We benchmarked a lot of our metrics against where we were in 2019, so that we can have a comparison of, sort of, more normalized environment. But obviously, our leverage, and as I just mentioned, is very important to our abilities to open up all of our bed capacity and surgical capacity and so forth. Even in our emergency room capacity sometimes can be constrained, because of staffing levels and such.I think it will continue to get better as we went through the first quarter, March was better than January as an example.
So that’s a positive trend within the quarter. We’re hopeful that, that will sustain itself as we move through the balance of the year. And as we look at some of our hiring and the timing of that hiring, that should line up with some continued improvement as we sequentially move through the year.So those are the main things. Some — we have capital that will come online over the course of the year, as we always do. That will help in certain circumstances. But I think the most important variable is staff and getting sufficient staff into our facilities, allowing us to open up our beds and so forth appropriately.Operator Your next question comes from the line of Steven Valiquette from Barclays. Your line is open.Steven Valiquette Great, thanks.
Good morning, everybody. So really one main question here. When looking at some of the hospital-related volume commentary from medical device companies over the past week or two, at least one of them suggested from their view that hospital volumes were the strongest in January and February, then normalized in March. And I know no one really likes questions on the monthly performance. So really just my more high-level question is if you could just comment on whether or not the momentum in your overall operations was generally pretty consistent throughout the quarter?And then also, is the full-year ‘23 guidance increase meant to reflect mainly just the upside witnessed in 1Q? And is the rest of the year outlook is generally unchanged from your prior view?
Or should we all expect strong momentum from the first quarter to continue into 2Q? Just kind of an all of thoughts around all that for just the overall operations would be helpful. Thanks.Bill Rutherford Well, again, I think we’ve seen momentum on there. So yes, the guidance is, I think, is referenced by a few others, principally the performance in the first quarter that we saw. But as we look at volume through the quarter, I think it was pretty consistent on there. We’re feeling positive with some of the trends we’re seeing, it’s hard to call exactly what may happen and exactly what period they will. But we continue to see good demand in the markets. We continue to add our capacity, continue to be able to serve that. So we think we’ve incorporated all reasonable assumptions into the guidance going forward.
And that’s where we stand right now and we’ll continue to monitor as the year goes on.Operator Your next question comes from the line of Jason Cassorla from Citigroup. Your line is open.Jason Cassorla Great, thanks. You noted favorable payer mix in the quarter. I was hoping you can give us a sense on commercial — on core commercial volume growth split out between exchange-related volumes and then just pure commercial. And perhaps if you saw in 1Q or are currently seeing any commercial volume pull forward perhaps ahead of potential coverage changes later this year? Or do you think that commercial volume trend is just more broad-based? Any color on that would be very helpful. Thanks.Bill Rutherford Yes. I mean, as I mentioned in my comments, our non-COVID commercial volume was up a little over 11%.
So obviously, that’s a stat we’re very pleased. We’re very pleased with the exchange enrollment. We saw really good enrollment across our states. Some of the publicly released data that you’ve seen, we’ve seen exchange enrollment in Florida, up 18%, Texas up close to 30%. And that [Technical Difficulty] pretty well with where we would expect exchange volume to be. Our exchange volume just year-over-year was up, what, 19% or so for the quarter. It’s hard to make some of those comparisons pure on the non-exchange because COVID has such an impact on that.But if I back up and look at the non-COVID growth of managed care at 11, it is still pretty strong. And even overall, we were up 4%. So again, we’re thinking that there’s good payer mix will continue, good demand.
We still see basically full employment in most of our markets. So we’ll see where that plays out. But we are pleased with the health insurance exchange activity that we’re seeing across the markets.Operator Your next question comes from the line of Sarah James from Cantor Fitzgerald. Your line is open.Sarah James Thank you. I’m trying to piece together a few of the comments that you made on contract labor. You talked about getting down to about 6.5% to 7% exiting the year. Is that in line with what you’ve been thinking before? I thought you guys were a little bit lower. And then how do you think about reinvesting the savings of that? So how much is going to wage inflation versus actually increasing headcount? Or is any of it falling to the bottom line as sort of a margin relief?Bill Rutherford Well, I mean, there’s a lot of moving parts in our labor side.
And obviously, our focus has been reducing the utilization of our premium labor, and that has allowed us to continue to invest in our employed workforce. And we continue to invest in our existing employees both through wage rates, as well as hiring that was spoken about earlier on the call. And so when we roll it all up, we kind of look at the overall impact. And yes, we are fortunate that as we’ve been able to reduce contract labor, that’s allowed us to make the investments into our employed workforce. I think that will continue.I think our commentary around our expectations has been reasonably consistent. If you looked at where we ran kind of pre-COVID, it was probably in that 6% range. We think we can continue to make progress on that. So it’s fairly consistent.
