Q2 2021 US Physical Therapy Inc Earnings Call
Yeah.
Today's conference is scheduled to begin shortly please continue to standby. Thank you for your patience.
[music].
Good day and thank you for standing by welcome to the you ask for physical therapy second quarter 2021 earnings Conference call. At this time all participants are in a listen only mode. After the.
Speakers presentation, there will be a question and answer session to ask a question. During the session you will need the press star 1 on your telephone. Please be advised the today's conference is being recorded if you would.
Require any further assistance. Please press star Zero I would now like the hand, the conference over to Chris Reading President and CEO. Thank you. Please go ahead.
Good morning, and thanks, everybody.
Welcome to the U S physical therapy second quarter 2021 earnings call with.
With me on the call today.
Carey Hendrickson, our CFO Graham Reeve and Eric Williams, Our Cove C O US Rubinstein, our general Counsel, Jon Bates, our controller and importantly, Glenn Mcdowell, who is winding up an incredible 18 years with their company.
The vast majority of the time as the Chief operating officer, 1 of the <unk>.
Thank Glenn for his incredible faithful service Glen helped us to achieve a lot over the many years he was with us.
He is going to enjoy as much improved view trading out of the Houston Beltway for the beautiful mountains in Colorado right outside of the New front door also want to welcome Eric Williams towards the first call us.
Hello.
Oh, Oh East Eric was able to attend our last board meeting of the gas and he started officially on July 1st having known Eric for over 25 years of nobody is going to be of Great addition of great leader for our company.
Graham and Glenn had been working seamlessly together to allow us to transition to proceed smoothly without missing a beat for.
For I start with an overview of the very good news quarter over the last Jon to cover a brief disclosure Jon if you would.
Thanks, Chris.
This presentation contains forward looking statements, which involve certain risks and uncertainties. These forward looking statements are based on the company's current views and assumptions and the company's actual results can vary materially from those anticipated. Please see the company's filings with the Securities and Exchange Commission for more information.
Thanks, Sean.
I want to start this morning by thanking our entire team for the work throughout the entirety of this pandemic our partners and our clinical staff in particular.
Who has done with PPE through the second the hot summer, but doing a fantastic job for their patients.
As evidenced this quarter by a record visits per clinic per day.
In for the quarter of 30.
Also very proud of all of them driving visits back up over the.
Backup over pre pandemic levels with more than a 60% improvement compared to where we were of this time last year also want to thank our sales and marketing teams and our home office staff, who support and guide them they've helped to drive record new patient indoor facilities, allowing even more lives to be positive.
With the impacted as a result of our clinicians Greg here.
1 of the thanks, our home office support departments. The teams who have largely worked remotely this past year and a half, but working very effectively and supportive of our partners efforts on.
On the ground in the many communities we serve around the country and special mentioned or clinical services and compliance teams you for.
Tirelessly to keep our staff on a patient safe and up to date with constantly evolving trends and issues surrounding this pandemic ultimately keeping facilities open and very productive for serving the needs of a patient supporters and families.
The end result of all the great work.
Excuse me as of records earnings quarter for our company.
On track for a record year again in spite of rate reductions pandemic challenges, including those that impact job seekers and employers alike.
Our team has been together a long time, our partner stay with us for the long haul and together, we find ways to overcome challenges as we have in the past, allowing us to forge ahead.
Some quick highlights on the quarter.
So we're reporting 96 cents for operating results, which is an all time high for us comparing favorably to the strong quarter..2 we had pre pandemic, we in 2019 of 81.
In spite of some closed and sold clinics. Our revenues were ahead of 2019 and of our operating profit and EBITDA were well ahead on our pre pandemic basis.
The margins have stayed healthy gross profit margin for our company for our overall company in the quarter..2 was 27% of physical therapy margins were 27, 3% and our injury prevention margins were 25, 3%, both continuing to perform very well.
All of that helped the pushout of operating income up 116% compared to a heavily impacted Q2 of last year.
Additionally, we increased our operating income margin 17, 5%.
Other highlights for the quarter include the announced the acquisition of a great group of partners and an 8 clinic practice. These guys are of great fit for us. They are highly motivated to grow we are excited about helping them do just that to expand the already.
Prominent sports medicine related services.
As the result of management's outlook for the remainder of the year, we are increasing our operating results guidance for the full year 2021 to between $3.5.
The $3.15 per diluted share.
In addition, our board has voted to increase the company's quarterly dividend from 35 per share per quarter to 38, which will be paid on September 717th 2021, the shareholders of record as of August 20th.
In closing, let me say that I am happy to see the increased attention to our space physical therapy in a very pure basis is 1 of the last health professions, where we get where we truly get to know and spend quality time with a patient.
Well at the same time, helping them to move into the function again, so they can enjoy the lives being part of my profession for the past 36 years has been 1 of the great blessings in my life and I am truly thankful that he gets to work with so many friends and beloved colleagues across our many partnerships.
As well as within our home office team, while we will always have challenges whether they come in the form of reimbursement staffing where even the pandemic. This team will continue to focus on doing things the right way internally for staff and patients and when that happens as it should we know that our shareholders.
That would be well cared for also.
Externally, we will continue to work with a group of growing group of member companies within the <unk> as well as collaboratively with the apta and the private practice section represent smaller practices in order to make progress with CMS as well as to help our lawmakers understand the huge embedded value and fit.
<unk> therapy as the primary care of muscular skeletal health.
We will continue to do our best to reflect the good or the and worthwhile attributes of the profession well the <unk>.
Same time, following our own path with our partners and our team to further grow our company, while creating shareholder and stakeholder value.
Thanks, So much for your continued support it means a lot to all of US now I'd like to turn things over to Kerry to walk through the financials in greater detail go ahead Carrie.
Thank you, Chris and good morning, everyone.
This noted and as outlined in the earnings release today, our financial performance in the second quarter of 2021 and through the first 6 months of the year has been very strong we reported record highs in many of our most important metrics in the second quarter, including volume per clinic per day total revenues adjusted EBITDA and operating results per share.
As Chris noted, we reported second quarter 2021 operating results per share of <unk> 96 of.
A record high for the company the.
The 96 cents per share is 57% higher than the 39 per share we reported in the second quarter of 2020 without relief funds and 22 cents higher than the 74 for the second quarter of 2020, including relief funds.
It's also 15 or 18, 5% higher than the 81 reported in the second quarter of 2019.
You'll note in the release that in addition, the comparison to 2020, we provided comparisons of our key metrics to pre pandemic periods in 2019, and we'll continue to do that through the remainder of this year since 2020 metrics are skewed by the impact of Covid.
Our adjusted EBITDA of $21.8 million for the second quarter 2021 was also a record high for the company excluding relief funds in the fourth quarter of 2020 the <unk>.
$21.8 million was $2.8 million or 14, 5% higher than the adjusted EBITDA of $19 million, including relief funds for the second quarter of 2020, and was $10.7 million or 97, 1% higher than the second quarter of 2020, excluding relief funds.
Compared to the second quarter of 2019, our second quarter 2021, adjusted EBITDA increased $2.7 million or 14, 1% from $19.1 million in second quarter of 19 to $21.8 million in the second quarter of 'twenty 1.
Revenues in the second quarter of 2021 from $126.9 million another record high for the company.
There were $43.1 million higher than the second quarter of 2020, and zero point $6 million or 0.4% higher than the second quarter of 2019 revenues, even though we had 21 fewer clinics open on average in the second quarter of this year due to sales and closures of underperforming underperforming.
Underperformance clinics that we completed at the onset of the pandemic.
Physical therapy patient volume per day per clinic were a record high 30.0 in the second quarter of 2021.
Our previous high was $28, 2 which was in the second quarter of 2019, which we beat by 6.4%.
Our volumes per day per clinic were $58, 7% higher than our $18.9 average visits per day per clinic in the second quarter of 2020.
We noted on our first quarter earnings call that we had record high volumes in March of this year at 29, 3 our April volumes were slightly higher than March of $29 for and then May and June where both the above 30 at $30 for and 32, respectively.
Our net rate for our physical therapy operations was $104.46 for the second quarter of 2021, which was consistent with the $104.72, we reported for the first quarter of 'twenty 1.
Our rates held up well considering the 3.5% Medicare rate adjustment that went into effect in January of 2021, our rate was down only 1.3% in the second quarter compared to the 2020 full year rate of $105.66.
Physical therapy revenues were $113.2 million in the second quarter of 2021, an increase of 56, 7% from the $72.3 million, we reported in the second quarter of 2020 the.
$113.2 million in the second quarter of 'twenty, 1 is only slightly less than the $113.4 million that we had in physical therapy revenues in the second quarter of 2019 again, despite having 21 fewer clinics open on average this quarter versus the second quarter of 19.
Revenues for the industrial injury prevention business were $10 million in the second quarter of 21, which was of 3.9% increase over the second quarter of 2000.22020 revenues of $9.7 million.
Our team also continues to do a great job managing our cost and keeping our cost increases aligned with our growth in volumes and revenue our operating costs. Excluding closure costs were $92.6 million in the second quarter of 'twenty, 1 or 73.0% of net revenues.
This was an improvement of 390 basis points as a percentage of revenue over the second quarter of 2020, which was at 76, 9% and it was 210 basis points better than the second quarter of 2019, which is at 75, 1% or 73.0% of the second quarter of 2021 also compares favorably to the first quarter.
Of this year when operating costs, excluding closure costs were 76, 9% of revenues.
Looking specifically at salaries and related costs were 54, 3% of revenues in the second quarter of 2021 versus <unk> 51, 8% for the second quarter of 2020, which was lower due to lower than normal due to salary reductions and furloughs put in place as the result of Covid.
And the 54, 3% this quarter was 160 basis points better than the second quarter of 2000.1955, 9%.
Salaries as a percentage of revenue in the second quarter of 'twenty..1. We're also 250 basis points better than the first quarter of 2021, which was at 56, 8%.
Our gross profit increased $15 million or <unk> 77, 9% in the second quarter of 2021 compared to the second quarter of 2020.
Our gross profit in the second quarter of 2021 was also higher than the second quarter of 2019 by $2.9 million or 9.2% and.
And as Chris noted our gross profit margin was a very healthy 27 zero percent in the second quarter of 2021.400 basis points better than our gross profit margin of 23.0% in the second quarter of 2020, and it's 210 basis points better than our gross profit margin of 24, 9% in the second quarter of 2019.
<unk>.
Our corporate office costs were $12.1 million in the second quarter of 2021 as compared to $9 million in the second quarter of 2020, which again was lower due to salary reductions and furloughs related to COVID-19.
Corporate office costs were $11.5 billion in the second quarter of 2019 as the percentage of revenue our corporate costs were 9.5% of revenues in the second quarter of 2021, which compares to 9.1% in the second quarter of 2019, and then 9.4% for the full year of 2019.
Interest expense on our debt was $237000 from the second quarter of 2021, which is down from $653000 in the second quarter of 2020 due to reduced borrowings under our credit line and our weighted average interest rate in the second quarter of 2021 was 237%.
The proportion of our gross profit attributable to Noncontrolling interest was $5 million of 14, 7% in the second quarter of 2021.
Our balance sheet remains in excellent position and our cash generation remains strong we ended the second quarter with $38 million drawn on our $125 million revolving credit facility, which includes $10 million that was drawn on June 30 day under 8 clinic acquisition on that date, and we had $24 million of cash at June 30.
'twenty 'twenty 1.
Our net debt at June 32021 was $27.8 million.
Which includes the 38 million of $38 million of our line of credit $8.3 million in the payroll taxes that were deferred in 2020 and of the cares Act and $1.8 million of notes payable net of our $24 million in cash.
Our net debt position at December 31, 2020 was 11.0 million.
So this year, we have funded acquisitions totaling approximately $22 million paid back $14.1 million of Medicare advanced payments that we received last year purchased non controlling interest from our partners of $9.5 million.
Dividends of $9 million and paid off $3.7 million of notes payable, but our net debt position has increased by less than $17 million with $10 million of that coming right on June the 30 due to the acquisition.
Our low leverage and our strong cash generation provides us with tremendous flexibility and sufficient capacity for the right growth opportunities.
Our financial performance in the second quarter of 2021 was strong and our management team is confident in the ability of our team to continue to perform well through the end of 2021 and forward as signaled by the raising of our full year 2021 guidance range for the second time this year and the interim increase in our quarterly dividend rate of.
Our people and our operations of proven to be engaged and resilient over the last year plus and our partners are clearly focused on the continued growth and success of their business and ours as evidenced in our results, which has and will result in increased shareholder value now.
Now, Chris I will turn the call back to you.
Great.
With that.
Concludes our prepared comments, we'd like to I'm sure. We will have a lot of questions. We'd like to go ahead, operator and open it up for questions.
As a reminder to ask a question you will need to press star 1 on your telephone to withdraw your question press the pound key.
Please standby, while we compile the Q&A roster.
Your first question comes from the line of Larry Solow with CJS Securities Hey, Larry.
Hey, good morning, Chris Good morning, Kary, Thanks for taking my questions.
Congratulations on a really strong quarter the.
This is per day really impressive.
Just can you can you maybe just share with us maybe hard to gauge but.
Really strong rebound and I don't know if there is any really.
Sort of recovery of our make up for lost time right. So all of it seems like it's probably a.
Can you can really catch up and physical therapy right. So any feel for that and you feel for mix or are there still groups in the older folks who are not coming back as rapidly or.
Or do you think the really back to normal.
And then the follow up question is.
And your guidance of us without I know theres, some seasonality, but are you sort of building in the strength are you assuming that we tail off a little bit from these record numbers.
In terms of auto.
A few things 1 I think our partners have done a phenomenal job taking care of folks.
Turning out great happy patient good results, which creates more opportunity I think we're probably moving market share I don't know that there is and I've been saying this for a while I don't know that Theres a lot of pent up demand.
Naturally.
Sports and things come back I think us.
For school comes back and recreational sports.
That will help us as well so we kind of feel like.
We can continue to do this I will note 1 thing we typically drop off in June July and the summer months people take vacations and that certainly is happening now but.
Volume from.
Volume has continued to be very strong.
We haven't seen yet.
Of the normal seasonal.
Of that occurs in the summer time and so.
What we've built in the guidance.
<unk> is a.
Oh.
Little conservatism I think.
May be relative to this the.
The Covid wave that we're seeing right now and that is really built in in the fourth quarter.
But its minor or it's not a lot. So we think these numbers that we put out are definitely doable.
We're doing everything we can the team has done a fantastic job to the.
To get this quarter.
Back under our belt and continue to build from here. So I don't know if that all of your point yes.
Yes.
Hasn't come back yet fully right, yes, yes, yes. It is the work comp growth industry continues.
As evidenced by the fact that.
As we said of what it's going to take a little longer time.
The rebuild the momentum.
The injury prevention business the.
The comp visits are still slower than they have been historically and we expect of us.
Companies are able to find and hire people that that will improve over time, but thats been affected a bit to day.
Okay, and then just shifting gears real quickly on the on the cost side. It's interesting if you look back to the 19 <unk>.
Sort of a similar patient revenue and total revenue number.
And obviously your margins are somewhat better.
And there's obviously a lot of moving parts there.
For some formulas I guess, you certainly closed I think 20, or so clinics and perhaps they were underperforming. So that was probably a plus for you guys. But also I know, there's probably been some pressure on salaries and whatnot. So I'm just trying to parse those things out and maybe you guys also become more efficient.
Post COVID-19, so any thoughts on that as we look out.
I think we have for sure I think we've become more efficient and I think our partners of doing an exemplary job keeping staffing volume valve in our ops team working with them to keep a good handle on things.
So.
I do expect that we will see.
Some salary pressure potentially I know I know the recruiting department is working hard.
I have some commentary on that 1 of the time is right.
We have some open positions and we're working to fill those <unk> been doing a great job there.
But I think we can hang onto a lot of this margin improvement I mean Kerry shared with you the numbers since 2019, we have made some some pretty good progress in the.
The team has done a good job the hang onto it so far.
Okay, Great I appreciate the thoughts and color thanks, guys.
Thank you.
Yes.
Your next question comes from the line of Steph Wissink with Jefferies.
Thank you good morning, everyone I wanted to follow up on the question regarding patient volumes per day the same.
Those record numbers quite eye-popping, so I'm wondering what your business has the capacity to process just given your current labor model, how should we think about the ceiling on that number and is there anything that youre doing.
Raise the ceiling or kind of rethink about how your flow of patients true youre visits each day.
Yes, so we're not changing our care model of Stephanie.
In our facilities do physically the certainly do have the capacity to see more patient the.
For the vast majority do we.
We've got of hire more people.
To do that and we've been working on that last day.
Last 3 or 4 months.
April May June and into July.
<unk> hired more people actually not quite double of the number of people compared to the ones that we've lost.
We are still.
Deficit and so we're looking to.
Staffed up our recruiting department.
We're working hard locally in fact I'm here in 1 of our facilities in Richmond, Virginia, They're interviewing some people here today and talk with our partner when I got here. This morning.
He was walking into an interview of nicely on the waiting just out of school. So.
We're looking for we're looking for key people.
We're hopeful that once the subsidies to not work go away hopefully this this fall that things will get a little bit easier, but the team has done a great job to date.
Wrapping in keeping people engaged and productive and that's what's allowed us to deliver the volume that we've delivered this quarter.
That's really helpful. Thank you and then just a follow up question on your growth plans. So just considering that there might be some constraints on labor how should we be thinking about acquisitions versus de novo's, and maybe anything that youre seeing in the pipeline of the potential acquisitions. The last day, you've done have been really high quality multi units.
Just curious what youre seeing in the pipeline. Thank you yes. The pipeline is good we're as busy as we've ever been.
It's a little it's a little.
So a little crazy out there right now.
Lot of different people representing companies in the market many of whom haven't done physical therapy in the past so.
Maybe on 1 hand, it's taken a little bit longer to sort through some of it will only do high quality. The things we're not in a race just shrunk things into the company.
Short term earnings if theyre going to be of bad long term fit so stuff, we do well which I'm.
I'm sure we'll get done here this year and next year it will be high quality of a lot of good opportunities out there right now.
<unk>.
As ever with.
With a lot of companies interested in this space.
We've got room to grow and we will continue to attract a lot of good people in terms of de Novo versus acquired doesn't it doesn't change our strategy at all.
Our de Novo's, we open with our strongest partnerships by and large those partnerships of doing a great job with the staffing.
And have people ready to go and so our de Novo flow. This year has been good and I don't expect us to change.
And frankly.
I think the staffing things hopefully more short term.
But we've held up well and it won't affect our interest in acquisition visa. We're just looking for the right people good people.
Thank you very much.
Thank you.
Your next question is from Mike <unk>.
With Barrington.
Hey, guys good morning, Mike.
<unk>.
I missed that just the tiny bit of the call. So forgive us touched on this but Chris.
Have you touched on just your initial take on 22 reimbursement and other was a little bit of confusion.
Within the industry may be exactly how to read some of that can you.
The talk about that at all thanks.
So what so what Mike referred to is in about the third week in July normally beginning of July CMS comes out with its proposed rules.
<unk> thousand 500 pages of.
Stuff across the all of health care.
And we're certainly part of that when they initially published their rates for 2022, they have the physical therapy at a -2% reduction.
We had our folks do the.
The modeling and the math and we came up with the different number.
And then we are in.
The <unk> group with all of these other big companies.
Everybody else did the same thing and we came up with about 3.5% reduction, we then conferred with CMS who admittedly.
Didn't didn't do their own math properly and missed published the.
The overall rate of 2%, it's really more like 3.5% so.
Look it's early I, just got back from a meeting last week with the apta and the private practice section.
And our <unk> colleagues.
<unk> focused on this for next year, we think it's very short side of it to hit physical therapy at all let alone again.
There is also on the books and it's been on the books for a while although there may be some sentiment growing 2 to forestall but theirs.
The rate reduction if PT assistance or involved in care that's been on the books for 3 of 4 years.
The effective in 2022.
We will work to staff around the so ptas don't.
Get involved in the care of Medicare patients to the extent possible.
But thats, what we face right now again going back more than a year a year ago, we face of the 9.5% reduction we were able to beat that back.
We were able to grow through that this year.
I don't know what the end result will be yet for 2022.
We'll figure it out and we will find the Oi.
Chris can I just follow up on that ask I mean at some point.
Does the CMS risk sort of access to care.
Issues in your in your view with sort of this.
Sort of recent behavior of the last couple of couple of years around pricing I mean, obviously met.
The Medicare is not 1 of the better price.
Payer group now and.
Getting worse I'm, just curious if you of any thoughts.
Yeah, No I think the risk of lot of things I think the risk access to care I think the risk.
Not recognizing the physical therapy really should be considered the primary care provider for muscular skeletal injuries.
We know from the study perspective the <unk>.
People, who with spine problems, who access physical therapy first.
For the next year or 2 the entirety of their healthcare spend goes down and the reason is because we know the impact of the exercise and mobility has on people.
It is helpful for so many different health related areas and so we've got to continue to beat the drum CMS I think is a little slow on the uptake sometimes unfortunately, but we.
We are spending more and more time with key congressional champions in building those champions and it's going to have to be a multi pronged approach.
I continue to be hopeful that we can get there because I see every day of the benefit.
And the savings that we create in the system.
And so it's just like anything else.
It takes time.
Gotcha.
1 quick question on the Delta variant, obviously, you guys being based in Texas and 1 of the.
Texas being 1 of the states that seems like it's being most impacted has have you guys either either through data July data or even anecdotally.
Got any sense of that.
Patients have.
Patient flow has dissipated in the place like Texas, where the where obviously there is the outcome.
The spread of the.
The Delta variant.
But I'm going to kick this over to Graham and give him a second.
But when we look at our <unk>.
Aggregate <unk>.
In terms of our volume.
I am not seen in the aggregate Graham what are your thoughts on taxes.
Chris we have not seen the degradation in patient volumes in Texas.
At all.
Okay fair enough thanks, guys.
Thank you.
Your next question is from Matt Larew with William Blair.
Yes, hi, good morning, I, just wanted to ask us about.
Mentioned last quarter that obviously, the number is kind of.
Pipeline discussion has taken a pause with COVID-19.
Sure.
Just curious if those.
The revenue at 10 million of Hasnt necessarily accelerate of yet, but just curious what you're hearing from folks in terms of interest or willingness to re engagement of the discussion.
Yes, we are definitely having some good discussions and we're getting things done Matt.
The challenge has been.
Historically a lot of these leads came through.
Big Big events National meetings in Chicago, or Las Vegas, or wherever they might be held around different industry verticals and so those havent come back yet.
We're beginning to see those being scheduled in the fourth quarter and so we've approached our sales cycle a little bit differently.
Being effective.
I think I think the main thing is.
It's like anything else. It just takes it takes time and these companies have different priorities right now other than trying to hire people in.
So of certain part of our business on the post offer testing part going crazy.
Really busy.
Some of the other prevention business is a little bit slower than sort of slower than it has been but it has been built as much as we had been seeing normal, but I think that will come back as well.
The people at the beginning of this this was going to be of rebuild year for the sales pipeline now interestingly, we have opportunities to continue to grow.
Outside of just the organic growth in the space and we're looking at some of those right now and in the good opportunities.
I don't know whether the all happen non will happen, but my sense is we'll get we'll get something done.
Okay. Thanks, Chris and then last 1 for me then I'll jump off us.
The staffing and labor issues.
Infocus broadly.
Broadly in the sort of space, but I guess, specifically within the physical therapy as well I think based on some of the peer commentary. So maybe you had us highlight in terms of meeting your staffing our compensation model of it you think distinguishes.
From the price base might be interesting to get that perspective.
No.
Yes.
It's no secret that I love the model that we have having partners, who arent just hired guns.
In these local markets, who live there who go to church, who who are high school boosters on the sidelines of the high School sports games.
And honestly I think that makes the difference.
And our directors.
We don't have the.
At least in our model we don't feel.
Like we've got to throw open de novo's.
No.
At a certain rate or pace, we do them, when and where we have the right people ready to go.
And that's how we've always done it and so those people when they are ready we opened centers and so we're not having to go out and hire somebody who has never been in an employee before to go.
Lee the New center and so as a result of visits per clinic.
Or where they are.
And so again I think I think having people at all levels tied into the business through incentives through ownership of just.
It makes the difference.
Yes that makes a lot of sense. Thanks, Chris.
<unk>.
And again, if you would like to ask a question at this time simply press Star then the number 1 on your telephone keypad.
Our next question is from Mitra <unk> with Sidoti.
On the Mitra.
Hi, Chris.
Hi, guys. Thanks for taking the questions.
Just a couple from me I just wanted to get a little more sense, maybe on the volume.
<unk>.
As we look at tens of demand, obviously seeing a lot of it.
Can you just coming back and helping to drive some of that also may be curious if some of them.
Additive standpoint.
Covid.
Talking a lot of your smaller mom and pop competitors. If that's also maybe something that could be driving.
The volume Youre seeing.
Yes.
Yes, we have such a fragmented industry Mitra my honest answer is it's hard to tell really us.
I could I could give you some sub position.
I think.
I mean, it's certainly not been ever hospitals first priority.
I think it's become evident the patient so many of more of our patients come to us through direct access than ever before and I think we're so much easier than.
Hitting the hospital campus in parking and trying to navigate that situation.
I think we have more resources than many of our small competitors and then we're very resilient, we have experts in certain areas and support.
I think when you have an owner for ownership group and they have to do everything they have to negotiate benefits and payroll in the.
The bills and they have to treat patients every day.
Sure enough hours in the day, some days to do that many people do really well.
I don't take anything away from them the great folks in.
The.
Do an awesome job, but it's harder to do everything without her.
Having that really deep support until the deals that we've done from the partners we brought on.
By and large they begin to grow quicker.
Because they have those resources and so yes, I think it does make a difference, but exactly how to parse that and.
Knowing exactly where 1 patient comes in light of gone previous it's almost impossible to do.
No that's fair.
Definitely appreciate the color there.
And then slightly related to the labor market.
More specifically on the sales reps I know last quarter.
You added about 14, just curious if.
Yes.
You think you need to make more investments on that front.
Or you feel pretty comfortable with the coverage.
Right now.
Got it I don't know Glenn in Graham and Eric if you'd like to speak to that at all I think in general.
Our industry is moving not away from sales reps, because I think reps are going to continue to be important for us more and more people access our care directly and so that happens through a variety of different mediums and as a result of their friends and family and hearing about great care on an Soc.
Media and other reviews and post, but I think it'll be a combination guys. What do you think in terms of a rep level right now where we are.
Chris This is Graham I think we had 72 reps total around the country right now of the distributed throughout our regions.
And.
We think we have the right number of reps right now we add them when we need to.
We're using them in various ways, but we think we have the right number of reps.
So let me sure of what that means what that means to me is as we grow as the company and for instance, as we acquire or partner with these with these companies like we did a few times this year in the late.
In 2020, often in those they don't have reps in so we're adding and those opportunities to accelerate their growth as we go forward. So but 2 grams point of the team feels like we're well positioned right now.
Okay. Thanks for taking the questions and congrats on the great quarter. Thank you for you.
You do have an additional question in queue from Mike Pitofsky with Barrington.
Yes.
On the on the good.
Revenue per visit.
Figure of what was that was there a shift.
Towards the Workers' comp Karen can you just sort of give us sense of the.
Payer mix and if there was sort of a.
Sort of a positive mix shift there.
Sure Yes.
As Chris talked about we did workers' comp is a little bit less this quarter so workers comp.
Workers comp decrease of little as a percentage of the total mix and then both commercial and Medicare is where that picked up a little bit so and as Chris talked about we expect those workers comp business to come back us.
In the back half of the year as the business of staff up okay.
Okay.
If we can hire what was the Medicare for the quarter amongst the workers' comp.
Sure.
Medicare was 31% in workers' comp of about 10, 5%.
Okay Alright.
Alright, and I did I did actually mean to say this earlier congratulations to Glenn <unk>.
A huge part of creating a lot of shareholder value here over the last the many many years and congratulations on the well deserved retirement.
Thank you.
Thanks, Mike.
And there are no further questions at this time I will turn the call back over to management for closing remarks terrific well. Thanks, everybody I know this is a busy day, we have calls scheduled after this release if you have follow up questions feel free to reach out to carrier I and we'll be sure to circle back up and have a great.
Day.
Sure.
This concludes today's conference call. Thank you for participating you may now disconnect.
Yes.
Okay.
Yes.