Ladies and gentlemen, the program is about to begin. At this time, it is my pleasure to turn the program over to your host, Joanna. Good morning, everyone. My name is Joanna Gajuk. I'm the Equity Research Analyst at Bank of America, covering healthcare facilities and managed care. And together with Andy Pressler and Allen Lutz, it's my pleasure to welcome you to our second day of the B of A Home Care Conference. So we hope you enjoyed the sessions yesterday and that you will find some valuable fireside chats and panels today as well. So I'm happy to start the day today with Enhabit, one of the largest home health and hospice providers. And today with us, we have Barb Jacobsmeyer, President and CEO, and Ryan Solomon, who's the newly minted CFO, and also Joby Williams, who's the Senior Vice President of Strategic Finance and Treasurer. So maybe, and thanks so much, the team, for joining us. So I figured, you know, we should start with Ryan. I know, first of all, welcome to Enhabit. And I know this is your really second day on the job, but I figured, you know, we should have you give any comments you might have this morning. Yeah, good morning. Thank you, Joanna. Appreciate it. I look forward to bringing my broader experience to the group, including industry experience to Enhabit and reviewing things with a fresh set of eyes. As you mentioned, it's only day two. So I look forward to more interaction with the investment community in the new year. But thank you. Sure, thank you. So yeah, I guess we'll go into Q&A, but just a reminder to the audience that if you have any questions for the speakers, please use the Q&A section next to the webcast, and I'll be happy to pose a question on your behalf to the team here. So I think we should start with a couple of different disclosures the last, I guess, week or so. So first, the 8-K that the company filed last week, a couple of slides in that as well. But I guess the disclosure that was of note was the company reached a new multi-year agreement with UnitedHealthcare. So can you, you know, share a little bit more details about this update? Sure. So yes, we've been kind of in the works with United for quite a while, and we were pleased to be able to get into an agreement. I will say that while the contract is not going to be considered a payer innovation contract, the contract did allow us to have, you know, a creative benefit considering the size of UnitedHealthcare. And so three main reasons that we did end up executing on that agreement is it does allow us to be considered that full service provider to our referral sources. It also allows us to now turn full attention to growth versus replacement. As you know, the efforts had been going on to replace the census that we had. And the third reason is we do still have some contracts, more regional small ones that are not considered payer innovation. It does now allow us to be more on the offense with those to be able to negotiate either at a payer innovation level or at some point term those contracts. So again, pleased to be able to initiate this new agreement effective January 1. So just to follow up, so you said this is not a, I guess, a fully, you know, innovation contract, but can you give us a little bit of sense of the rates? I mean, it sounds like if you agreed to renew this contract, the rates must have been much better. So just a sense of, you know, where you are at these rates, if you can give us, you know, without maybe disclosing the details, but you know, how close, I guess, it's to kind of the episodic type rate versus the per-visit rate. Right. So as you mentioned, we cannot go into actual details about the terms of the contract, but did feel that the terms were at a place that were very agreeable to us to allow us to continue to be in contract with United. They are still at a per-visit rate. But again, you know, that's about the most we can share as far as it relates to the terms. And also in the slides, I know you have them here up here, but you talk about the $11-$13 million pricing increase in 2025 in home health. So it sounds like you're not willing to share the details, but that number includes, I guess you previously talked about Medicare rate update, right? That's going to be $2 million-$3 million increase year over year. And this $11-$13 million assumes some, you know, continued improvement in some of these contracts. So because of the United size, is it fair to assume that, you know, they are a big chunk of that number, or is there some other numbers that we should consider here? What's included in that $11 million-$13 million? Sure. Well, first, you're right. On the third quarter call, we talked about $2-$3 million benefit from the final rule. That was for the industry impact of the 0.5% improvement for Enhabit. Now that we've been to evaluate our patient mix and our geographical, because wage index is a large piece of that, it is about a 1% benefit to Enhabit. So that's the updated information here. As well as you do have that impact, your episodic payers, so that same 1% would go across our episodic payers, as well as, as you mentioned, the rest of that would be the non-episodic improvement in rates. Okay, that's great. And I guess maybe staying on the slides, because there's a couple other, you know, comments, which I guess you had made previously, but on the hospice business, right? So clearly that was a nice, you know, improvement in the third quarter, and you talk about the expectation for the growth to be mid to high single digits. So I just want to clarify, is it organic, or does it include de novos and maybe acquisitions? And also to that end, can you talk about what gives you confidence that you can grow, you know, mid to high single digits in hospice? Sure. So it does include the de novos. It does not include any acquisitions. So it is organic and de novos that are included. And the confidence really comes from when you see, and if you don't mind, I'll just go back to this one really quick to show that sequential monthly growth that we've experienced in our census for hospice that continued into October and November. So if you really look at, you know, while sometimes there can be a little softness around December and January because of patients not wanting to elect over the holidays, you can see though that the way we will potentially exit the year versus coming into the new year. It is a nice bump above where January was. So we're confident that we'll be able to continue that growth and really enter the year in a better place in 2025 based on how we're exiting 2024. This is great, yeah. And thanks for that color as well. And I guess similarly, you have this disclosure here on home health, right? Admissions to grow mid to high single digits. And I guess on the third quarter call, you talk about revenues to grow low to mid single digits. So that still implies some negative mixture that's going on. Is that the way to think about it? I think it's a couple of things. You know, we will, I think, continue to see some payer mix shift. So that I do think we expect some of, but I would say that that is also related to the fact of only getting a 1% pricing update. So that's kind of why you have the variance there versus on hospice. You just don't have that sort of market basket rate update that one would need to see those revenues grow in line with the admissions. And I guess another recent disclosure, I guess outside of this 8-K, was around the opinion that was issued, I want to say maybe more than a week ago, from Delaware Chancery Court. It was regarding the litigation that involved Enhabit and two private equity firms, right? So can you walk us through the decision? Because it sounds like plaintiffs are entitled to 43% of ongoing profits, but also there's reimbursement for legal fees. So how should we think about it? And specifically, you know, any help you can give us in terms of the breakout, because obviously Encompass and Enhabit were part of that, you know, lawsuit, I guess. So how would this, how would you think about splitting, I guess, the 43% of ongoing profits that was disclosed here? Sure. Well, I think a couple of things. One, you know, obviously the opinion was a very important milestone in this litigation, but the court has not yet entered the final orders. So, you know, pretty far back into the 116 pages, there is some information about the work that needs to be done over the next 30 days between the plaintiffs and the defendants. That work has already started. And what I would say is that, you know, really there'll be a lot more details that will come out, you know, once there is a final order. But as you mentioned, Joanna, I think it is important. If you look at, you know, page five of the opinion, Dr. I mean, Judge Will did write on there that, you know, whenever she was talking about Encompass, she really was including all plaintiffs. So as you mentioned, it does include Encompass and Enhabit, and that was filed after the spin. So a lot more will be forthcoming because there's a lot of work still to be done over these next 30 days. Okay. So I guess we should ask you a little bit later, but I figure I should ask now. But thank you for that. Sure. But coming back to fundamentals, I don't think it's in this slide right because it's very short, but on the call, right, you also, so we talk about the volumes, you know, you touched on the pricing, but you also talk about cost savings, right? So you continue to make a very nice progress there. So you talk about for next year, right, I want to say $3 million from overhead, and there's $1.5 million from outsourcing. And I guess we can see in third quarter, G&A ratio came down. So can you talk about a little bit more about these different cost savings areas and how we think, how we should think about, you know, heading into next year and going forward in terms of the G&A ratio? Because obviously the ratio came down very nicely. So is it a good starting point that we should think about? Sure. So a couple of things. For third quarter, there was a bit of that that was impacted by, you know, lowering the incentive comp for 2024. But I would say, as you mentioned, we have put a lot of efforts forward and anticipate, you know, the $3 million that we've already made decisions on, $1.5 million of that we've not experienced at all yet. That will be as we roll out, you know, the outsourcing of the coding. So we'll experience that in 2025. And I will tell you, as we are going through the budget process right now, we are taking a hard look at every area of G&A. So there will be, you know, a lot more information to come when we do our full year guidance, you know, in early 2024. But one of the things that we really are focused on is how can we use technology and AI to help us in those repetitive, redundant, more back office type tasks so that we can become more efficient and look for areas of savings in that aspect of G&A. And moving on to home health rate outlook. So like you mentioned, the final rate was 0.5% for the industry. So thanks for clarifying that for the companies, actually, you know, better because of the wage adjustments there. But still, you know, 1% is well below what the wage inflation is, I would assume. So maybe can you talk about, you know, the wage inflation you would expect heading into next year? And also what are some ways that you could try to, you know, kind of close that gap, so to speak, between the rate update and the wage growth? I mean, you kind of touched on the cost savings, but is there anything else you want to add to that? Sure. I would say, you know, we're probably entering another year where it's going to be important for us to stay competitive with the wages in our markets. We do believe, you know, around that 3%-4% is a good place to be combining merit and market adjustments. So as you mentioned, the 1% from CMS is really not enough for that. And so really the focus continues to be focused on productivity, optimization. And as we grow, that increases our ability for optimization because at a local branch, as that branch census grows, that's when they're really able to add LPNs, you know, PT assistants, OT assistants so that we can really focus on that optimization. And the other piece I would add is the visits per episode, right? We've continued to use the Medalogix tool. We've seen nice progress here in 2024. We believe there's still opportunity there, so when you look at, you know, not only fee-for-service, but the other episodic payers that we have, it's really about that right care plan for the acuity of the patient to manage those visits per episode so that we can use the other visits for new starts of care and other patients. In that regulation, you know, the behavioral adjustment was reduced, right? But the CMS keeps talking about the recoupment, which, you know, a pretty meaningful number, right? Over $4 billion. So that would be, you know, over 25% of the annual spending on the industry. So very, very big numbers we're talking about here. So how, you know, what are your expectations? How the government is going to try to either implement this or postpone it or spread it out? You know, any thoughts on that large recoupment as CMS keeps talking about? Sure. Well, I think, you know, first, you know, it's been always good to see that we've had bipartisan support for the home health industry. But I do think we'll have an opportunity within the new administration as we talk about, you know, how do we best use the dollars in the Medicare Trust Fund to really focus on the fact that, you know, if these cuts continue, the lowest cost setting of care is going to be greatly impacted. And that then would mean there's going to be more access to the higher cost care settings than there is the home care. And so really that focus on, you know, there's been evidence of closures of branches across the country. There's been evidence of not having the referral conversion for patients because of capacity issues across the industry. So I think really focused on if we want to preserve access to the lowest cost setting, then we need to protect that access. And so I do think that there will be a new opportunity to really focus on that within the new administration. And since you mentioned new administration, that was my other question too. You know, any other comments about implications to your businesses post-elections? You know, anything you expect to come out that, you know, could impact your businesses? No, I mean, I think the main thing is, you know, we're hearing more about making sure, right, being good stewards of the resources, and so again, I think the industry has done a better job, I think, over the last year or so really providing data to show kind of the access issues, to show that it is affecting, especially in rural markets, some closures, so I think there's been good data and it will give us, you know, an additional audience to present that information to, to really get attention, especially to, you know, those temporary adjustments. Right, exactly. And I guess switching a little bit to the Medicare Advantage contracting, right? So you guys have been on that for a couple of years now and make you very nice perks, especially with the United, I guess, though it's not innovative contract. But can you give us kind of a state of the union where you are right now on this? You know, what% of your MA book is in those per-visit contracts versus the more innovative, you know, episodic type contracts? And can you also touch on the rates, because I guess by our math, the non-Medicare revenue per visits, so that includes, you know, different contracts in there, but it's still, you know, 29% below the Medicare rate per visit. So sort of kind of, you know, what needs to happen to be able to kind of narrow that gap, I guess, over time? Or is that even possible? I think it's possible. And again, you know, as you know, our payer innovation kind of ranges between that 0% - 25% discount. And so the focus really is to continue to move as much of the non-Medicare into the payer innovation contracts. That's going to happen within the contracts that we have. We continue to have a pipeline of contracts that we're working on. And then, as I mentioned earlier, it also is about, you know, we've been working to renegotiate some of those smaller, you know, regional contracts, a lot of those that came over years with acquisitions. And now that we have gotten across the finish line with United, it was really about either getting them to a payer innovation rate, these smaller agreements, or terminating them. So that really then the focus is on, you know, getting more patients into those payer innovation contracts. That's really what's going to help that rate continue to improve over time. So is there a sort of a targeted timeframe in mind where you would be able to narrow the gap? I mean, is there a way that, you know, or is there a path that you can actually close the gap entirely, or there's always going to be some sort of discount? Because I guess that's what Medicare Advantage plans try to do. They try to pay a little bit less than, you know, the prevailing rate would be. Yeah, I think it's going to be a journey of closing that gap. I don't think it's going to happen that the full gap's not going to be closed anytime soon. But I do think that there will be continued progress on closing that gap. We have been successful in signing a lot of those contracts as episodic. That again gives us the opportunity to not only have better rates within that agreement, but also again, managing those visits per episode so that we have those for the right patients with the right acuity. And that's another area of opportunity to continue to work to improve that rate per visit. Because also on the flip side, Medicare Advantage plans are seeing their own rate pressure, right, in 2024 and then into 2025, also star rating pressure. So do you see this being sort of an obstacle for your innovation team as in, you know, is it getting harder to get these contracts moved or the rates improved because the plans themselves are seeing pressure? I think it creates a real opportunity for our payer innovation team. I think on how it's looked at by the Medicare Advantage payer depends on how they look at their data. If they're looking at the data like home health is a commodity and they're just looking at another place to squeeze more dollars, then you're right. I think there's risk there. But I would say that the majority of them have started to understand that home health is the lowest cost setting. And if they really want to focus on those high cost dollars of emergency room visits, hospitalizations, and re-hospitalizations, they need timely access to high quality home health providers. So if they are willing to look at their data more wholesomely, then I think it gives our payer innovation team quite the opportunity to talk about the value that Enhabit brings to them. And the other area around payers, right? It's been providers complaining about these pre-authorizations, utilization management. So are you seeing any changes there? Because like you mentioned, at some point, you know, those plans are faced with just high rejection rates, right? Or just not able to access the care that they would need for their members. So kind of what are your observations more recently around these, you know, activities from the health plans? Is it getting worse, better, or the same? You know, it's quite the variety. What I would say is that, again, for those payers that we can sit and show that timely initiation care can really prevent hospitalizations and re-hospitalizations, we have seen some of the payers that we're contracted with actually waive pre-auth for the initial episode, saying, you know, we don't want to delay getting the home health care out to them. We understand how timely access is critical. And so we do have some plans that have waived that pre-auth for the initial. Now, they may still require an authorization for a recertification, but that's because they believe, right, that the patient has received the care at that most urgent time. We do have others, though, that continue to expect the pre-auth, and we bring data back to show them that, you know, then if they want that, they have to focus then on timely pre-auth because they can sometimes be the biggest barrier of the patient getting that timely initiation of care. Right, exactly. And, you know, there were specific comments. I mean, less from the home care providers, but more from some of the acute care hospital providers about increasing denials in third quarter. So have you seen that? We've seen more of some payers trying to deny more on the respite side of things. And so again, it's really important for us to go back and share information with them that, you know, we cannot continue to see the patient in hopes that they're going to auth and approve a respite. And so you really can end up with a disruption in service if it's taking them seven to 10 days to give us, you know, re-auth. And so it's really been more on that part of it, but we bring back specific details to the payers to share that with them so that they understand kind of the predicament they're creating. Because especially a patient who, let's say, for example, a wound care patient, if we don't get a quick re-auth or if they try to deny on the back end, they're really increasing the risk that that patient's going to end up in the hospital. So that's where it's really important for our payer innovation team to be involved with our revenue cycle team to be able to share very timely, specific data with the payers. Right, exactly. And maybe we can also touch because MA or the Medicare Advantage, you know, penetration has been growing nicely, but I guess the Medicare fee-for-service admissions declined like 9% in your third quarter, right? And sequentially, I mean, maybe there's some seasonality and some hurricanes, I guess you called that out a little bit of a headwind there. But can you talk about your market share? I remember you've been talking about this, you know, Medicare fee-for-service, you know, I guess dynamics were, you know, Medicare Advantage being very aggressive in certain markets in certain locations and, you know, these patients would be switching to Medicare Advantage. So kind of where you are on that front, are you still losing share or you think that has stabilized when it comes to Medicare fee-for-service? We do feel that we are stabilizing. If you look at, you know, really our last couple of quarters, we've been around 44% of our admissions have been fee-for-service Medicare because, as you mentioned, there is some seasonality just in the overall volume. We've been around that 44%. Now, what I will say is that what we've seen is we do have some markets that are regaining some market share. We have others that we're finally seeing it kind of flatten a little bit. We do have some markets that continue to lose market share. And those are the markets that there's a, you know, real focus on how can we share those best practices from the markets that have really turned the corner so that those business development teams can focus on how to regain and stabilize that fee-for-service in their markets. So we do, every time we get a quarterly update on the market share, we look at it at that local branch level and not only, you know, are they losing, but who are they losing to and how do we, you know, readdress their books of business so that we can get back to regaining that fee for service share. So yeah, so is there any color you have from these markets where you're losing share? Sort of who's the, I guess, who's gaining and like why it's happening? Sure. So what I would say is that, you know, we've learned several things from the markets that are doing well. One of probably the biggest ones is really how those teams have been agile with their books of business. So, you know, one of the examples that I've given for a while now, because I think it is a really important one, is this company has for a long time had a very successful role in assisted living and senior living settings. It's been a great place to be to serve those communities because it can be very efficient. You know, a nurse and a therapist can go and sometimes spend almost their day in those settings. The problem is that those settings have been the most ripe for move to Medicare Advantage. You know, you get one really good salesperson from an MA plan in one of those buildings, and it's amazing how quickly that building can change in its payer mix, and so where we've seen markets that have kind of adjusted and said, okay, well, we need to look at where else do we need to spend our time so that we can balance our payer mix. There's others that have kind of maintained that referral relationship because it's been a strong one, but we're seeing it negatively impact the payer mix of that local branch, so it's really about being more agile in how they're building out their referral base and that book of business, and that's kind of the work that we're doing with the team to look into. We use Trella to look at that Medicare claims data and really understand how to build out that referral business. I guess, so you mentioned some more pressure, I guess, on recertifications from some of these payers. When you talk about your outlook for the year, you reduced the guidance. You called out $2 million from the hurricane headwind, but also you mentioned lower recertifications. Can you flesh it out a little bit more for us when it comes to the latter, you know, what's driving that dynamic? Sure. Well, some of it is about this update in books of business. You know, again, those patients that I mentioned that are in, you know, like the assisted living or the senior settings do tend to be more community referrals. The physicians are trying to keep them out of the hospital. So they do tend to come to us with more chronic conditions. Those patients do tend to recertify more. But as we've kind of adjusted some of our focus on our books of business to get more of institutional, particularly institutional early, because there is one of our MA payers that does reimburse us more for institutional early so that we can help get their patients out of the hospital. So when you turn your focus to more of those institutional early settings, those patients do come needing less recertifications. They need more of that initial urgent home health care to help them get back home, get settled at home, but they don't tend to recertify at the same rate. And so it's really about at that local level, reestablishing how are you going to grow your home health census. If your book of business is now going to be less referrals, well, then we need more admissions. So it's really, you know, resetting those targets for those branches and those business development teams so that we can grow the census. And I guess that's a nice segue. You know, you said the growing census because obviously the biggest constraint has been for a couple of years now, right? The labor, right? So can you talk about the hiring and retention? And, you know, we've seen nice improvement there. So this is great. But kind of, you know, what's the state of labor in home health right now and kind of how you're thinking about this going forward? Because obviously, like you mentioned with the rate cut, they're only being 1%, you know, that's still sort of not matching where this nurse wage growth would be, right? So kind of how are you thinking about managing through that and where's the status of the labor pool in home health? It's really been great to see how the candidate pool has increased, particularly this year. We've seen nice growth in our candidate pool. I would say our Enhabit opportunity though is to continue to get smarter on, you know, how to make smarter hiring decisions because we do still have our greatest opportunity in managing the turnover within those first six months. Once a nurse or a therapist is with us for a year, our retention is really strong. It really is about when we hire those individuals that have never worked in the home setting, and it is a very different setting. We want to make sure we can give opportunity for people who want to work in this setting, but how do we paint that picture at the time that they're an initial candidate to have them as much as possible understand what the environment is like so that we're not investing a lot in onboarding and precepting only to have them decide this is not the work setting that they want and they want to go back to a facility setting. So that's our greatest area of opportunity. I would say though, seeing the strong candidate pool is a good sign. We do have some markets that are harder than others. Those are ones that we continue to look at and say, do we need to do a market adjustment so that we can be more competitive? And then there are some markets where we're seeing some tightening for therapy. And so that's a focus for us as well. I guess on your other business in hospice, can you also kind of comment on the similar? So we've seen the hospice census we just mentioned at the beginning of the conversation that was, you know, improving nicely through the year and actually grew, you know, the census grew year over year in third quarter. So can you talk about your labor situation, I guess, in hospice as well? Sure. So, you know, I think one of the best things we ever did was investing in the case management model. We knew that that added some fixed cost, but what we have found is being able to commit to candidates for hospice that we have the on-call and the triage covered. We've seen, you know, nice hiring and retention in hospice. We do not have any capacity constraints. And I think that's why we've continued to see that nice sequential growth. So it really has been about stabilizing that clinical workforce so that we can really put attention to growing our business development teams, growing our books of business, adding our admission departments so that we can be quick to say yes to the referral sources and continuing to grow that hospice census. I would think that the rate environment helps, right? Because I guess the hospice rate update has been much better. So what is it for the company? Because I guess there's some adjustments there versus the industry. Some companies talking about much higher hospice rate update. Do you have an estimate for that? Right. So for the company, it's right below 4%. So we saw a nice impact for our hospice pricing. So, still very, very nice update there. And I guess talking about hospice and census growth, so, you know, obviously nice improvement, but still, you know, there's some of your competitors where, you know, the growth has been really very, very strong, high single to even low double digits. So is this something that, you know, you could be striving for? I know you're guiding to much smaller numbers, which are solid. So I'm not saying it's bad. I'm just asking, you know, trying to figure out like, you know, how sustainable is the growth from these other providers? You know, can other companies, other hospice providers grow as fast? Yeah, I think it really does come down to, you know, the markets that you're in. I know some of them that have seen kind of that double digits have a very strong presence in Florida, which is a CON state for hospice. And so, you know, when we look at, you know, for example, in some of our CON states, you know, we do see that higher growth because you do have more of a captive audience, if you will, not, you know, quite the proliferation of competitors in the market. So again, I think our ability to continue to grow that mid to high single digits is really going to be based on us being able to be that quick answer to a referral source so that they can really feel confident that, you know, that Enhabit's going to be there. Again, sometimes the answer is no, the patient doesn't qualify. But what that discharge planner really wants to know or that physician wants to know quickly is, does this patient qualify for hospice? We've really done a good job in improving that turnaround time. In hospice, the rate updates that you mentioned are pretty good or I guess much better than home health. I understand it's not fully covering the entire cost inflation that the industry has experienced the last few years, but nevertheless, you know, pretty good updates are relatively speaking. But then on the flip side, in hospice, there are more, you know, changes, I guess, on oversight, right? So can you talk about this a little bit, how you're thinking those changes could impact the company? Because obviously there's this special program that's supposed to launch the kind of, you know, targeting providers, but there's also more audits and other things. So kind of can you give us your views of those changes in hospice and how those could impact the company? Sure. So we've been very supportive in, you know, in the additional oversight because we do feel that there are some bad players out there. And so we welcome the oversight because we feel very confident in, you know, our practices. I would say on the Special Focus Program, the one concern is that unfortunately some of the folks that are not the good players out there don't have enough data to be able to be then considered one of those in the low, you know, decile. And so the concern is that the focus if you're trying to find those players, that is probably not the way to do it. But again, we feel confident in, you know, in our policies and our procedures and our documentation. So, you know, we welcome the oversight, but feel that there's other things that could be done to maybe look for some of those that are more the bad players out there, if you will. Thanks for that. And I guess there was also this proposal that was, I guess, put out by one of the congressmen that kind of outlined very detailed, I guess, changes or potential reforms in hospice that included even, you know, switching from per diem rate to per visit rate. But it also included some other provisions that were more around like oversight and increased kind of, you know, scrutiny a little bit more on hospice providers. So any commentary on that proposal, whether this, you know, you're hearing any traction in DC on that? Yeah, I haven't really heard a lot of traction on it. Obviously, that would kind of overhaul the whole program. I do think there are ways for them to measure, you know, there are the visits in the last days of life, which is a very important metric, right? It's when, you know, you have usually your higher visits are when the patient first comes on to hospice because you're working to make sure they have all the supplies, the equipment, that they're, you know, stable with good support in the home. And then you really need to be there in those last days of life. And again, our use of the Muse tool helps us to really make sure that we are there in those last days of life. So I think there are ways to already look and measure those outcomes to make sure that, you know, the patients are receiving the visits and the care that they need. So I think, you know, in an interim, there are other ways for them to look at it because otherwise, as you mentioned, that changing to the per visit obviously would be a big change for the whole hospice industry. Exactly, and I guess a couple of, I guess, the summarizing questions that I've been asking all the presenters during our conference, so when you look out into 2025, I understand you don't have a guidance, you know, you kind of outlined some of the elements which are helpful, but sort of as you look out to the next year, what are some of the biggest changes you expect to see for the industries, for home health and hospice? Sure. I mean, I think we'll see some of the same things we have been seeing, you know, right, the move to Medicare Advantage. So we're in a better place going into 2025 as we've continued to progress through payer innovation. You know, the focus obviously on our labor. I would say the thing that I would say may be different in 2025 or more attention is, again, how can we use technology and in particular, how can we use AI as it relates to more of those like back office type functions? How can we really work to be more efficient as possible? I think there's things we can do with scheduling, communication with the patients on their schedule, things that right now take a lot of people time to do. You know, how can we be more efficient so that, you know, our team members can spend the time they need taking care of patients and not doing some of these repetitive, redundant tasks that they currently have to do? I guess the very last question, in one word, how would you describe the outlook for your industries? I would say one word would be growth. Great. That's a very nice way to end this session. So thank you so much, Barb, Ryan, Joby. Thank you so much for joining us. And I guess thanks everyone for listening. And this is not the end of the day yet. We're just starting. So please stay tuned for the rest of the day for additional sessions. Thank you. Thanks, Joanna.