Finally, our total G&A expense declined slightly year-over-year, somewhat mitigating practice level cost growth. Based on our third quarter results and our updated forecast for the fourth quarter, we are updating our outlook for the full-year adjusted EBITDA to a range of $200 million to $210 million, which contemplates a similar contribution in the fourth quarter to what we reported for the third quarter. Finally, as Jim referenced, we continued to reduce our borrowings during the quarter. We generated just over $81 million in operating cash flow. We repaid the remaining $40 million in revolver borrowings during the third quarter with a full revolver capacity of $450 million available to us and we ended the period with $21 million in cash.
With that, I will turn the call back over to Jim.
Dr. Jim Swift: Thank you, Marc. Operator, let’s now open the call for questions.
Operator: Certainly. [Operator Instructions] We will go to the line of Brian Tanquilut with Jefferies. Please go ahead.
Brian Tanquilut: Hey. Good morning, guys. Thanks for all the color. I guess my first question, as I think about practice-level expenses and how you are looking to address that. Are there levers that you can pull, whether it’s adjusting clinician wage rates or subsidies that you can ask for from the hospitals that we should be looking for?
Dr. Jim Swift: Hey, Brian. I will start with that. From the subsidy standpoint, it is one of the things we do look at, especially when we are looking at the OGI and new startups to make sure that we do have the available revenue to us when we bring clinicians on. So that’s certainly something that we will look at going forward. We always look at it on an annual basis. As far as the comp framework, we have the fixed and variable comp. But I think, we are trying to look at what the right mix of that is. As we have seen on the variable comp, as we have recovered in the RCM areas through the year, we have seen some variable comp that’s gone up, but we do need to look at it through the lens of which practices have both a variable comp structure and just a base comp structure and we are going to look at all of those things together.
Brian Tanquilut: Got it. Okay. Then maybe as I think about the RevCycle side, what were your learnings from the RCM transition years back that you think will make this transition smoother as you look for a third-party vendor, bring in a third-party vendor and go hybrid?
Dr. Jim Swift: Yeah. I will start and all of us can speak to it, Brian. I guess what I have learned is, I know more about RevCycle now than I ever wanted to in my entire clinician career. So I think we understand very much, and probably, it’s rooted in what we have described. We believe that our services are unique. Our services are unique at the bedside for the patient in terms of finding out as simple as things like the name of the baby and the insurance of which parent. And so we just believe we need to have people closer to the bedside that start the process on the front end in a more complete fashion. That’s why we have invested alongside our current vendor of having people here who are employed through Pediatrix that are undertaking those tasks and why we are adding in significant resources as we make this transition.
So I think we are going in eyes wide open, our entire leadership team, our entire operations team really is tightly involved in this transition. Marc, I don’t know if you have any other comments.
Marc Richards: No. I think that’s well put, Jim. I would say that, we certainly learned a lot from the last transition and those lessons learned will be applied in spades to what we plan on doing over the next 12 months or so.
Brian Tanquilut: Jim, if I could just throw a quick follow-up. I mean, you have been there for a while and before you transitioned this to an external vendor, things seemed to be working okay, it wasn’t broken on the RevCycle side. So is it pretty much like just bringing it back to how you ran things prior to bringing RCM back in the day?
