U.S. Physical Therapy, Inc. (NYSE:USPH) Q4 2023 Earnings Call Transcript

Carey Hendrickson: Yes, I think — consistently, we’ve been between 8.5% and 9% of total net revenue on that corporate cost number for several years. And I think that’s how to think about it is as a percent of revenue because we do have to add some additional costs [Technical Difficulty] some clinics that we add as we go forward. So I think thinking of it in that 8.5% to 9% of total revenue number [Technical Difficulty] Joanna?

Operator: We’ll take our next question from Jared Hoff with William Blair.

Carey Hendrickson: Jared?

Jared Hoff: Thanks for taking the questions. Just first one from us, and maybe just sticking with levers from a margin perspective, and maybe thinking over the next couple of years, I was curious to think about just how you — the trends from a hiring and staffing perspective. I think in recent quarters, you talked about a little bit of a shift in mix to PT assistance. So I’m just curious to hear how you’re thinking about that mix and the availability from a staffing labor perspective. Any trends there to call out from an operating cost perspective?

Christopher Reading: Yeah, I would just say this, the market continues to be tight, but I wouldn’t call it unforgiving. [Technical Difficulty] recruiting team here combined with some partners locally, our ops folks, everybody is working together to do a good job, to get new clinicians into the company. We’ve always been a PT-centric company. More licensed therapists considerably more than PT assistants, to also licensed physician. But look, if we have a good opportunity with a great PT assistant, we’re not going to probably pass on it either. So the relationships have been reasonably steady between PT and PPA the last year. If we can improve those a little bit, really where we just have to be sensitive to it is on the schedule more than anything with respect to federal patients. But market — it’s competitive market, but we’re doing okay. Eric, anything you want to add to that?

Eric Williams: No, I think you summed it up pretty well. We’ll continue to invest in additional resources as the company grows to help us from a recruiting perspective. And our clinical turnover number this year was the lowest number we’ve had in five years. I know it was a 1.5 percentage points better than 2022, which also helped us from a business per-day perspective. So we continue to get better from a retention perspective, and we continue to get better in terms of our ability to source license staff across the organization.

Jared Hoff: Helpful on. And then sticking with this theme of levers for margin expansion, another area I was hoping to hear an update on was, in the past, you talked about rolling out group purchasing across the platform. Just was hoping to hear a little bit more color in terms of just how penetrated that is across your footprint of clinics and then to what extent you see any incremental leverage opportunities from continuing to consolidate purchasing?

Christopher Reading: Yeah. Well, I mean, you have to unfortunately divergent tractor. You have the rollout of group purchasing, which we’ve done, and that’s pretty complete. And then you have overlaid on that just general inflation. And so I think it was the right thing to do. I think it was smart to do. We didn’t get it done day one last year, so it rolled out across the year. So we’ll see that carry forward. You saw some of that, probably a small part of that show up in our total cost per visit last year. But look, we were — inflation has been a little challenging to. And so I’m sure that what we got, we gave some of that back in inflation. So that’s not a big lever. Our big focus is driving additional volume through our facilities, which give us a little overhead coverage and help us be a little bit more efficient. And that’s really what it comes down to more than anything else.

Carey Hendrickson: Yeah. And Jared, just to add on that, I will say that you do gain operating leverage as you increase your volumes at our existing clinics because the fixed costs remain relatively the same, right? So the incremental margin on those extra visits is higher than your overall margin. So that should help us as we go forward if we can keep those costs in line or maybe even a little bit better on a per-visit basis as we go forward, which I think we can do.

Jared Hoff: Again, very helpful color. And the maybe we’ve talked around some of the puts and takes to the outlook in 2024. I guess, maybe just to put a fine point on, when we think about the low to high end of the range for adjusted EBITDA guidance in 2024, is the biggest swing factor in your opinion just timing related to when you complete the M&A deals that are assumed in that outlook? Is it potentially some variance in your assumptions around the rate trends for the year? Just would love to unpack a little bit about that in terms of just what kind of drives that variance from the low to the high end?

Christopher Reading: Yeah. Let me give Carey a break, and I’m going to take that. I mean, guys, when you run a company, there are things every day that happen, and you try to control as many things as you can, and you try to have a great crystal ball. And when you’re running close to 700 facilities, and you’re delivering care, I mean, it’s not all one plus one equals two every day. And so we have a series of things that we’re very familiar with that we have to do well. We have to drive additional volume, volume that we’re projecting for July and August and September of the year ahead. We have to get contracts updated and renewed and carry those contracts forward and bring in relatively the same mix or a slightly better mix of patients than we’ve had.