Steve Filton: And I know your question was not directed at the behavioral business, but I would make the point that, we’ve done quite a bit of portfolio management in the behavioral business over the last five years or 10 years. If somebody wants to take our 10-K list of properties from 10 years ago, behavioral properties and compare them to today, you can see that they’re quite different. We’ve closed facilities, we’ve sold facilities, we’ve merged facilities where they’re underperforming and where we’re looking to increase efficiencies. We tend not to disclose that, because individual transactions are non-material, but there has been a fair amount of portfolio management on the behavioral side and then, again, we’re open to that. I think we’re ready for the next question.
Operator: Thank you. One moment for our next question. Our next question comes from Kevin Fischbeck with Bank of America. Please go ahead.
Kevin Fischbeck: Great. I was wondering if you could give us an update on where wage growth is across both the acute and the psych businesses today and to the extent that, labor is still a gating factor on the psych side of things. How do you think about the incremental return of just raising wages a couple of percent to potentially drive more volume back to the facilities? Thanks.
Steve Filton: Yeah. I would say that wage growth has moderated a little bit from its highs in both segments. I think we’re probably in that 4% to 5% range of annual wage inflation, and obviously, we’ve made, as again, I think, we said in our prepared remarks, a fair amount of progress in reducing premium pay, which includes temporary traveling labor and overtime and shift differential, that sort of thing. And as — I’m sorry, you want to say…
Marc Miller: No. Well, the question is, we look quite often as to whether or not it makes sense to raise wages as a way to increase capacity and we have done that in certain areas. It’s not as easy as one might think, but we definitely look at that and we try to figure out if there are areas where that would make more sense. The other factor for us is we have high occupancy in a lot of these facilities. So we’re constantly looking and reviewing ways that we can add beds to the facilities to increase capacity. And one of the things when Steve talks about the portfolio rationalization that we’ve done on the behavioral side in the last few years, what that also allows us to do is spend less time on facilities that are not growing and really spend more of our time figuring out how to do programmatic growth, not just beds, but just changing program offerings at certain facilities and changes like that that we think will have a positive effect.
So we’re doing a lot of that as well.
Steve Filton: But I would just say, and I think, Kevin, what to some you’re asking, do we think about the efficacy of paying increased wages to attract that last 1% or 2% of the workforce that would help us increase our volumes. And that’s really the why — when and why we use temporary labor, because the challenge is, if we hire somebody for that, last position or last two or three positions in the facility and they’re making $5 an hour more than everybody else in the facility, in short order, everybody in the facility will be making that same wage. So that’s the consideration we have to use. We certainly acknowledge that we want to fill every position we can, but we understand that there are implications to paying up to do that.
Kevin Fischbeck: Okay. Great. And then I guess I just want to maybe push back a little bit on the guidance for acute care hospital volume growth, kind of just being more pre-pandemic growth rates of 2% or 3%. I guess when I look at your same-store volume growth going back to 2019 and just trying to get forward, I think, you’re only like about 4% above where you were in 2019 five years later, when you would normally be thinking you’d be growing 2% or 3%. So you’re still — in 2019, we might’ve thought your volumes would be 10% or 15% above those levels. So, why is normal growth off of only 4% up like the right number? Shouldn’t there be more pent-up demand or normalization in demand within your markets while in normal growth?
Steve Filton: Yeah. I mean, and again, though, particularly the comparison that you’re talking about, Kevin, I think it’s wholly inappropriate to exclude the $150 million of Nevada supplemental from a comparison to 2019, because I think what we would say in Nevada is we’ve had virtually no Medicaid increases for this period of time, and as a result, and we’ve been questioned about this, our margins in Nevada have declined, et cetera. So to then say that, we’re going to exclude the $150 million from comparing where we were margin-wise to 2019, again, I think, is a flawed approach. And again, that’s not to say we believe that even with the supplemental payments, et cetera, there is still more growth to go in the acute division and more recovery to be had to get closer to those pre-pandemic margins. But I think, excluding the supplemental payments from that is a flawed way of looking at it.
Kevin Fischbeck: I’m sorry. My question was kind of more around the volumes, like, it feels like to me, like your volume guidance, it feels like your volumes haven’t really rebounded to the long-term trend line yet. So I’m still not sure why you’re only growing normal. Wouldn’t you still be trending back to the long-term growth rate in volume? Shouldn’t you be growing fast in 2% to 3% for another couple of years?
Steve Filton: I mean, our adjusted admissions in 2023 grew by 5% or I think actually over 6% for the year. Obviously, I think those are historically a high level of admission growth. We’re projecting that at some point that starts to moderate.
Kevin Fischbeck: Okay. All right. Thanks.
Operator: Thank you. One moment for our next question. Our next question comes from Jason Cassorla with Citi. Please go ahead.
