Financial Data and Key Metrics Changes - The adjusted EBITDA for the quarter was approximately 15millionbelowinternalforecasts,primarilyduetopractice−leveloperatingexpensesandsoftpatientvolumes[3][34]−Thefull−yearadjustedEBITDAoutlookhasbeenupdatedtoarangeof200 million to 210million,reflectingexpectationsforsimilarcontributionsinthefourthquarterasreportedinthethirdquarter[4]BusinessLineDataandKeyMetricsChanges−Year−over−yearexpensegrowthatthepracticelevelwasevenlysplitbetweensalariesandincentivecompensation,withunderlyingsalarygrowthacceleratingbyroughly100basispointscomparedtothesecondquarter[54]MarketDataandKeyMetricsChanges−Same−unitpricinggrowthreflectedyear−over−yearrecoveryinrevenuecollectionratesandpayormixagainstachallengingquarterin2022[27]CompanyStrategyandDevelopmentDirection−Thecompanyplanstomakestructuralchangesinambulatorypracticestoenhanceearningspotential,addressingvariancesinfinancialperformanceacrossindividualpractices[22]−Adecisionhasbeenmadetotransitiontoanewvendorforrevenuecyclemanagementservices,aimingtocombineinternalteamswithexternalefficiencies[24][60]−Thefocuswillbeoncapitalallocationprioritiestobuildoncoreservices,positioningthecompanyfavorablyinthephysicianserviceindustry[38]Management′sCommentsonOperatingEnvironmentandFutureOutlook−Managementacknowledgeddisappointingresultsduetosoftpatientvolumesandpersistentcostinflation,emphasizingthebeliefthatcurrentoperatingresultsdonotreflectthecompany′sfullearningspotential[34]−Thecompanyiscommittedtoaddressingcosttrendsandmakingnecessarychangestoservicelinefootprintstostabilizegrossmargins[36]OtherImportantInformation−Thecompanygeneratedover81 million in operating cash flow and repaid 40millioninrevolverborrowingsduringthethirdquarter,endingtheperiodwith21 million in cash [28] Q&A Session Summary Question: How are you addressing practice-level expenses? - Management is exploring levers such as adjusting clinician wage rates and seeking subsidies from hospitals to manage practice-level expenses [29][44] Question: What are the learnings from the previous RCM transition? - The management highlighted the importance of a hybrid model, combining internal teams for front-end functions with external vendors for back-end efficiencies [60] Question: What drove the headwind in non-same-store revenue? - The company noted that the review of the portfolio and footprint contributed to the net negative in non-same-unit revenue [62]