• Adjusted EBITDA: $69 million for Q4 2024, significantly above expectations; preliminary 2025 outlook between $215 million and $235 million.
• Same Unit Revenue Growth: 8.7% for Q4 2024.
• Revenue Impact from Restructuring: Over $35 million reduction in Q4 2024 due to portfolio restructuring.
• Operating Cash Flow: $135 million in Q4 2024, up from $73 million in the prior year.
• Net Debt: Reduced to $386 million from $515 million as of September 30, 2024.
• Net Leverage: Just over 1.7 times based on 2024 adjusted EBITDA.
• Full Year Revenue Outlook for 2025: Approximately $1.8 billion.
• G&A Expense Outlook for 2025: $220 million to $230 million, compared to $238 million in 2024.
• Capital Expenditures: $3.5 million in Q4 2024.

• Warning! GuruFocus has detected 6 Warning Signs with MD.

Release Date: February 20, 2025

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

• Pediatrix Medical Group Inc (NYSE:MD) reported strong fourth-quarter results with adjusted EBITDA of $69 million, significantly above expectations.
• The company completed its portfolio restructuring on time, exiting practices that represented $200 million in annual revenue, improving focus and efficiency.
• The transition to a hybrid revenue cycle management model has been successful, enhancing the company's operational stability and performance.
• Pediatrix Medical Group Inc (NYSE:MD) has a strong balance sheet with net debt of about 1.7 times, providing flexibility and opportunities in turbulent times.
• The company anticipates a preliminary adjusted EBITDA for 2025 between $215 million and $235 million, indicating a positive outlook for the year.

Negative Points

• The restructuring resulted in a revenue impact of over $35 million, reflecting a significant share of the annualized $200 million in revenue that was restructured.
• Same unit salary expense growth continues to be above the historical range of 2% to 3%, indicating ongoing cost pressures.
• The company faces headwinds in the healthcare provider space, contributing to a cautious outlook for 2025.
• Payor mix, which was a strong positive factor in 2024, is not expected to continue as a business driver in 2025, potentially impacting results.
• The company has not factored any contribution from M&A activity in 2025, which could limit growth opportunities.

Q & A Highlights

Q: Can you elaborate on the embedded same-facility volume growth and pricing expectations for 2025? A: Kasandra Rossi, CFO, explained that for volume, they experienced some acceleration in the latter half of 2024, with NICU days up nearly 3% and births up slightly. However, for 2025, they are assuming flat volume. On pricing, payor mix was a significant tailwind in 2024, but they expect it to level off in 2025. Managed care is expected to remain stable, and they anticipate some improvement in revenue cycle management (RCM) collections.

Q: Are there opportunities for improved economics in NICU management relationships with hospitals? A: Mark Ordan, CEO, stated that they maintain strong and continuous conversations with hospital partners, which is a core part of their operations. However, they are not currently projecting any increase in hospital contract revenues.

Q: What was the earnings tailwind from the improving payor mix in 2024, and how does it affect the overall performance? A: Kasandra Rossi noted that payor mix contributed significantly to pricing growth, accounting for about a third of the 6% pricing increase in Q4. Mark Ordan added that while structural changes in payor behavior might sustain this trend, they cannot definitively predict its continuation.

Q: How are you approaching capital allocation given your strong cash position? A: Mark Ordan emphasized the importance of maintaining a strong balance sheet in turbulent times, which provides opportunities, including potential M&A. They will work with the Board to determine the best course of action, considering options like paying down debt or returning cash to shareholders.

Q: What are the key areas of optimism for Pediatrix in 2025? A: Mark Ordan highlighted two main areas: strengthening hospital relationships and improving recruitment and retention of clinicians. These efforts are crucial for their future success and are a focus for the company moving forward.

For the complete transcript of the earnings call, please refer to the full earnings call transcript.