Pediatrix Medical Group Q1 2025 Earnings Report

Pediatrix Medical Group EPS Results

• Actual EPS: $0.33
• Consensus EPS: $0.25
• Beat/Miss: Beat by +$0.08
• One Year Ago EPS: $0.20

Pediatrix Medical Group Revenue Results

• Actual Revenue: $458.36 million
• Expected Revenue: $451.44 million
• Beat/Miss: Beat by +$6.91 million
• YoY Revenue Growth: -7.40%

Pediatrix Medical Group Announcement Details

• Quarter: Q1 2025
• Date: 5/6/2025
• Time: Before Market Opens
• Conference Call Date: Tuesday, May 6, 2025
• Conference Call Time: 9:00AM ET

Pediatrix Medical Group (NYSE:MD), together with its subsidiaries, provides newborn, maternal-fetal, pediatric cardiology, and other pediatric subspecialty care services in the United States. It offers neonatal care services, such as clinical care to babies born prematurely or with complications within specific units at hospitals through neonatal physician subspecialists, neonatal nurse practitioners, and other pediatric clinicians. The company also provides maternal-fetal care services, including inpatient and office-based clinical care to expectant mothers and unborn babies through affiliated maternal-fetal medicine subspecialists, as well as obstetricians and other clinicians, including maternal-fetal nurse practitioners, certified nurse mid-wives, sonographers, and genetic counselors. In addition, it offers pediatric cardiology care services comprising inpatient and office-based pediatric cardiology care of the fetus, infant, child, and adolescent patient with congenital heart defects and acquired heart disease, as well as adults with congenital heart defects through affiliated pediatric cardiologist subspecialists and other related clinical professionals, including pediatric nurse practitioners, echocardiographers, other diagnostic technicians, and exercise physiologists; and specialized cardiac care to the fetus, neonatal and pediatric patients. Further, the company provides other pediatric subspecialty care services, such as pediatric intensivists, pediatric hospitalists, pediatric surgeons, and pediatric ophthalmologists, as well as pediatric ear, nose, and throat physicians, pediatric gastroenterologists; and support services in the areas of hospitals, primarily in the pediatric emergency rooms, labor and delivery areas, and nursery and pediatric departments. The company was formerly known as MEDNAX, Inc. and changed its name to Pediatrix Medical Group, Inc. in July 2022. Pediatrix Medical Group, Inc. was founded in 1979 and is based in Sunrise, Florida.

Pediatrix Medical Group Q1 2025 Earnings Call Transcript

Key Takeaways

• First quarter same unit revenue increased by over 6% driven by strong hospital-based service volumes (NICU days +2%) and favorable payer mix, leading to adjusted EBITDA of just over $49 million, well above expectations.
• Management raised full-year 2025 adjusted EBITDA guidance from $215–235 million to $220–240 million, while noting ongoing healthcare and economic uncertainties warrant a conservative stance.
• Consolidated revenue fell by 7% due to portfolio restructuring, but was offset by same-unit pricing up 4.6% and improved RCM cash collections, with practice-level expenses decelerating for the fourth consecutive quarter.
• Pediatrics is deepening strategic hospital partnerships—recently contracting new NICU, MFM and OB hospitalist operations—to reinforce its core women’s and children’s services and drive future growth.
• The balance sheet remains solid with $99 million in cash, net debt of $512 million (2.2× leverage) and stable DSOs (~48 days), reflecting disciplined cash flow management despite first-quarter incentive payouts.

Presentation

[Operator]

Certain statements and information during this conference call may be deemed to be forward looking statements within the meaning of the Federal Private Securities Litigation Reform Act of 1995. These forward looking statements are based on assumptions and assessments made by Pediatrics' management in light of their experience and assessment of historical trends, current conditions, expected future developments, and other factors they believe to be appropriate. Any forward looking statements made during this call are made as of today, and Pediatrics undertakes no duty to update or revise any such statements, whether as a result of new information, future events or otherwise. Important factors that could cause actual results, developments and business decisions to differ materially from forward looking statements are described in the company's filings with the SEC, including the sections entitled Risk Factors. In today's remarks by management, we will be discussing non GAAP financial metrics.

[Operator]

A reconciliation of these non GAAP financial measures to the most comparable GAAP measures can be found in the morning's earnings press release, our quarterly and annual reports and on our website at www.pediatrics.com. With that, I will turn the call over to Mark Carden, Pediatrics Medical Group's Chief Executive Officer.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Thank you, operator. Good morning, everyone. With me today is Cassandra Rossi, our Chief Financial Officer. Our first quarter results exceeded our expectations, driven by same unit revenue growth of over 6%. This included strong volumes in our hospital based services, with NICU days increasing by 2%, as well as more modest growth in maternal fetal medicine, along with continued favorable payer mix.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Our practice level operating expenses continued to reflect the favorable impact of our cost management initiatives, partially offset by higher incentive compensation base on our strong financial practice results. As a result, adjusted EBITDA of just over $49,000,000 was significantly above our expectations. I'm particularly pleased with the continued sharp focus on same unit salary, expense trends have decelerated for the fourth consecutive quarter. As a result of our strong financial performance for the first quarter compared to our expectations, we are raising our full year 2025 adjusted EBITDA outlook from a range of $215,000,000 to $235,000,000 to a range of $220,000,000 to $240,000,000 While we are pleased by our first quarter results, we remain mindful that we continue to be in a period of great uncertainty both in healthcare and throughout the economy. Our operating results for the first quarter include the effectiveness of our strategic approach to the portfolio management activities that we completed in 2024 and our commitment to creating value for our shareholders.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

This is a direct result of the hard work, collaboration and dedication of our team, and we're excited to build upon these results. In February, I talked about our strategic priorities '25, and in particular our focus on methodically reinvigorating the relationships that we have built over many years with our hospital and health system partners. I also spoke about all we are doing reasonably to be the employer of choice for physicians and other clinicians who provide the extraordinary critical care our patients require. I'm very pleased to report that I along with our operating leadership team are actively engaged here and we are pleased with the early response. We recently contracted to acquire several NICU, MFM and OB Hospitalist operations and a part of a hospital systems portfolio because we believe that that system views us as the best and most reliable partner in these areas.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

I believe this is directly tied to our renewed active engagement both with our practices and with hospital system leadership. We won't win every opportunity, and at times hospitals choose to bring things in house, but we are hard at work to be the best and most responsive partner possible. At Pediatrics, we are our people, the women and men who provide the finest possible clinical care in a very difficult area. Here too, we are very actively focused on our recruiting, onboarding, development, and retention efforts. We are confident that this focus will meaningfully bolster our core.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

If this blocking and tackling strategic focus sounds a bit boring to you, you're probably getting my point. Pediatrics has always been at its best, and we are focused passionately on our core, and that is exactly where we are today. This is now providing growth opportunities for us, and we believe strongly this will continue. With that, I will turn the call over to Cassandra.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Thank you, Mark, and good morning, everyone. I'll provide some additional details in a few areas. Our consolidated revenue decreased by just over 7%, driven by non same unit activity, which declined by about $63,000,000 primarily related to the impacts from our portfolio restructuring activity. This decrease was partially offset by strong same unit growth of over 6%. Same unit pricing was up over 4.6%, driven by favorable payer mix shifts and modest improvement in contract administrative fees.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

This was combined with favorable impacts from strong RCM cash collections. On the cost side, practice level SW and B expenses declined year over year, also reflecting our portfolio restructuring activity. On a same unit basis, these expenses did increase year over year, but the increase was primarily related to higher incentive compensation based on strong practice results as well as salary increases. Importantly, salary growth decelerated significantly year over year and on a sequential quarter basis as compared to the second, third and fourth quarters of twenty twenty four. Our G and A expense decreased modestly year over year, primarily reflecting the favorable impacts from the staffing reductions across shared services that were completed in the prior year, partially offset by increases in other expenses, including billing and collection fees, certain professional services and information technology.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Depreciation and amortization expense declined to 5,300,000 as compared to $10,300,000 in the prior year, primarily reflecting the impacts of the practice dispositions. We expect our D and A expense will be fairly consistent going forward. Other expense was $4,000,000 as compared to $8,100,000 for the prior year period, primarily reflecting an increase in interest income on cash balances as well as a decrease in interest expense on lower average borrowings at slightly lower rates. Moving on to cash flow. As a reminder, we are a user of cash in the first quarter of each year as we pay out incentive compensation and other benefits, namely four zero one matching contributions. We used $116,000,000 in operating cash in the first quarter compared to $123,000,000 in the prior year. The differential was primarily due to higher earnings and increases in cash flow from AR, partially offset by decreases in cash flow from accounts payable and accrued expenses, primarily related to those incentive compensation payments. We ended the quarter with cash of $99,000,000 and net debt of $512,000,000 This reflects net leverage of just over 2.2 times using the midpoint of our updated adjusted EBITDA outlook range for 2025.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Our accounts receivable DSO of just under forty eight days were flat as compared to twelvethirty one, but down over four days year over year, primarily related to improved cash collections at our existing units. Finally, I'll briefly touch on our updated 2025 outlook, noting that the increase was predominantly related to the top line revenue growth achieved during first quarter versus our expectations. The comps for the remainder of 2025 become increasingly challenging and accordingly remain materially in line with our original 2025 expectations. With that, I will turn the call back over to Mark.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Thanks, Cassandra. Operator, we will now open the call for questions.

[Operator]

Thank you. We will now begin the question and answer session. Your first question comes from the line of A. J. Rice with UBS. Your line is open.

[A.J. Rice, Managing Director at UBS Group]

Thanks. Hi, everybody. Maybe just on the updated thoughts on guidance. I know coming into the year, I think the basic base case was flat volumes and flat pricing for the year. Obviously, you were up 1.6 volumes and 4.6 on pricing in the first quarter.

[A.J. Rice, Managing Director at UBS Group]

I know you're saying comps get tougher, but does the flat pricing and flat volumes look conservative in light of what you've seen so far this year?

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Well, when we gave our initial guidance, we said we were intentionally being a little bit on the conservative side, given the uncertainty that prevails. Since that uncertainty has probably only accentuated in health care and around the economy, we continue to have a conservative stance. It's simply that the first quarter, AJ, exceeded our expectations by enough that we said it doesn't make mathematical sense to stay at the old level. Certainly the amount of EBITDA that we already have in the till is what gave rise to the increase. Is it still conservative?

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

I think only for the same reason as it was before. We still see headwinds in health care and the uncertainty in the economy, but that's why we raised it as we did.

[A.J. Rice, Managing Director at UBS Group]

And just speaking to that uncertainty, I know to some degree people can make decisions about expanding a family based on what's happening in the economy. Is that what you're mainly talking about? When you look at the things that they're specifically looking at in Washington around budget reconciliation, I wouldn't assume that those were, you know, addressing changes with the expansion population and etcetera, some things that would potentially, I guess, limit supplemental payments, which you don't directly benefit from. Are there things that you're watching that are of concern, or is it more just that general sense of ebb and flow on bursts that happen sometimes in economic ups and downs?

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

It's not because of that specifically or anything specific. I would say that right now, my view is not a partisan view, is that there are a lot of changes that are swirling in the economy and through the administration. And we don't know how they'll fall out. So there are a lot of things that are being considered in the budget today. But there'll be a lot of horse trading.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

And we'll see how things work out. So I just think it's a more difficult economic time when, because of that uncertainty, we all hope it'll work out well. And in a time like that, I think it's harder to say with the same clarity where we think we'll end up. Nothing more than that.

[A.J. Rice, Managing Director at UBS Group]

Okay. All right. Thanks a lot.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Sure. Thank you.

[Operator]

Your next question comes from the line of Your line is open.

[Pito Chickering, Analyst at Deutsche Bank]

Hey, good morning, Mark, good talking to you again. Can you talk about the hospital contracted sort of subsidies? If we go back to sort of pre COVID, did hospitals get any subsidies? Are they getting subsidies today? And just sort talk about that dynamic in your business.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Yes. Subsidies have always been part of the business and they continue to be. Part of being a partner with a hospital is working together to figure out what's best, and if we're a good partner, then subsidies in many times are called into play. We have a very good relationship with our hospital system, so that's just part of the overall relationship that we have. It's normal business, nothing's changed.

[Pito Chickering, Analyst at Deutsche Bank]

Have the amount of subsidies been increasing in the last year or so, or are they as a percent of your sort of total revenue still relatively flat?

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

We don't break it out separately, but I'd say that there's no if it was a notable change, we probably would say it.

[Pito Chickering, Analyst at Deutsche Bank]

Okay, fair enough. And then sort of to Ajay's question around just guidance for the year, looking at seasonality, is there anything different this year that we should think about from seasonality, whether it's what you guys see in the pipeline or as you think about sort of payer mix changes that would impact seasonality? Or should we be expecting a fairly normal seasonality as you look at sort of first quarter EBITDA as a percent of what your normal? Is there any reason why that would be different this year versus other years?

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

No, we don't see any different seasonality in 2025. And some of the things that you mentioned, that AJ mentioned, that we're looking at, it's not that we're forecasting a change or concerned about a change that would affect 2025 numbers, we just don't know yet.

[Pito Chickering, Analyst at Deutsche Bank]

Okay, great. And the last one here is collections, looking at the DSOs, those sort of continue to sort of get better, but they're still sort of elevated levels. Guess when you look at aging of the buckets within those receivables, are there any areas there that could be a risk for taking charges or are collections continuing to improve across the board and ensure there's no risk of collections at this point looking at your receipt?

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

I will let our Collector in Chief answer that call.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Hey, Pito. No, so we don't see anything that concerns us there from a DSO or AR in certain buckets. And again, like you said, DSO was flat right around forty eight days, and that's actually a level we think makes a lot of sense for the business right now. So everything's going well in the RCM area. And we hope at some point not to have to talk about it every quarter.

[Pito Chickering, Analyst at Deutsche Bank]

Great. Thanks so much, guys. Nice job.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Thanks.

[Operator]

Your next question comes from the line of Jack Slivin with Jefferies. Your line is open.

[Jack Slevin, VP - Healthcare Services Equity Research at Jefferies & Company Inc]

Hey, good morning. Thanks for taking the questions and congrats on a really strong quarter. Just wanted to see if you could expand with a little more color on the points you brought up around potential hospital contract wins. It feels like it's been a pretty static market, although you've been clear that that's a focus. I guess just trying to understand maybe a little bit more about within some of those conversations, what do they look like?

[Jack Slevin, VP - Healthcare Services Equity Research at Jefferies & Company Inc]

Is there this or is there a potential that we could see an acceleration in hospitals looking to outsource in light of a lot of challenges they're facing on other fronts, whether it be regulatory or fundamental right now? Thanks.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Our belief is that our strength from the beginning, and no pride of authorship here, has been to be the best partner for hospitals in women's and children's services where we're very strong. I think we believe that by really focusing on those relationships, making sure that we are really reliable counterparties, that we're working on issues, positive issues and accentuating them and problems and nipping them in the bud, that we're very good at that. So what we're talking about doing is focusing on those areas. Also to have a good partnership, you have to be a very good recruiter. We are only our people.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

So we think there again, if we focus on that, that gives us additional strength. We believe, obviously, that if we are the best in women's and children's services, and we focus on both these areas, that we believe we will gain from that, we will grow because of that, because we think hospital systems will say, gee, why would we do this ourselves when we can work with a partner that's as reliable as they are that provides best in class service for women and children and babies.

[Jack Slevin, VP - Healthcare Services Equity Research at Jefferies & Company Inc]

Got it, really helpful color. And then just a couple of things to close the loop on the model here for you, Cassandra. Just on the understand there's sort of moving pieces on the dispositions, but that practice supplies and other operating expense line flagged as being quite low, I guess, relative to what I was expecting, I think what Street was expecting. Is there I guess, is that the right level to think about going forward as we cast things? Or is there any additional color you can give on that metric?

[Jack Slevin, VP - Healthcare Services Equity Research at Jefferies & Company Inc]

And then the other piece just being, can you talk a little bit about the components of the NICU volume growth and what sort of births and length of stay looked like in the quarter? Thanks.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Sure. So first on the Supplies and Other, I think that, yes, that reflects the practice disposition activity and it is a good way to look about that line going forward. Nothing material that should flex there. And on the NICU stat, so yes, NICU days, of course, were up two percent. Births were also up just over two percent.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

And of course, those births are just in the hospitals in which we provide services. I'd say admits were up just a touch, probably less than a percent there. Lent of stay was also up just a touch, maybe just a touch over one percent. And the admit rate itself was a bit flattish in the mid-fourteen percent range.

[Jack Slevin, VP - Healthcare Services Equity Research at Jefferies & Company Inc]

Got it. Very helpful, and congrats again on a strong quarter.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Thanks

[Operator]

Your next question comes from the line of Philip Chickering with Deutsche Bank. Your line is open.

[Pito Chickering, Analyst at Deutsche Bank]

I think I can let you guys get away with this being over this early. I guess, can you guys sort of give us an update on sort of where we are on the divestitures? How is it tracking? And as you're looking at your portfolio today, are you guys comfortable with the assets you have today? Do you see potential for other areas to divest?

[Pito Chickering, Analyst at Deutsche Bank]

And as you look at the acquisition market, are you seeing multiples normalize out? You start deploying capital in terms of doing deals. Can you just sort talk about both sides of the business? Thank you.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Well, first, to your timing of your question, we thought we were ahead of projections on ending earlier, but we will answer your question anyway. We are very comfortable with the portfolio that we have. Now, any organization that manages well is always looking at ways to optimize what we do, but we are very pleased with the broad restructuring that we did, and it accomplished what we hoped it would do, period. So we will continue to look and try to always find ways to improve what we're doing, but we don't foresee anything sweeping. And certainly the core areas of neonatology and maternal fetal medicine, OB hospitalists and pediatric intensive care, they're all part of our core, and none will disappear.

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

And we also have some in select areas, some hospital subspecialties that are also very important to us. So we see any change there. And I think there was another part of your question. On multiple acquisitions, we think it's a relatively favorable environment for us as an acquirer. So I think maybe it's a result of all this turbulence, and maybe it's because other people don't have the kind of balance sheet that we have, they're not able to do what we can do. We think that will provide some opportunities.

[Pito Chickering, Analyst at Deutsche Bank]

That's sort of kind of what I was leaning into is as you think about all the headlines coming out of DC around Medicaid cuts and the business being such a Medicaid focused business that wouldn't now be a pretty great time for any weekends to sell into you guys, you guys could take advantage of that sort of near term volatility?

[Mark Ordan, CEO & Chair of the Board of Directors at Pediatrix Medical Group]

Could be. Could be. So our phone lines are open.

[Pito Chickering, Analyst at Deutsche Bank]

Okay, Fred. And then last quick model question. Investments and other income was quite strong this quarter, I guess. What drove that? And how should we be thinking about that for rest of the year? Thank you so much.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Sure. So that is really from the interest income that we're earning on that cash that sat in our balance sheet. We have those parked in pretty attractive rate vehicles right now. And so as we continue to build cash and continue to earn interest income, that line will look favorable.

[Pito Chickering, Analyst at Deutsche Bank]

Great. Thanks so much.

[Kasandra Rossi, EVP, CFO & Treasurer at Pediatrix Medical Group]

Thank you. Thanks, Pito.

[Operator]

Thank you. I'm not showing any further questions in the queue. Ladies and gentlemen, that concludes today's call. Thank you all for joining. You may now disconnect.

Participants

Executives

• Mark Ordan, CEO & Chair of the Board of Directors
• Kasandra Rossi, EVP, CFO & Treasurer

Analysts

• A.J. Rice, Managing Director at UBS Group
• Pito Chickering, Analyst at Deutsche Bank
• Jack Slevin, VP - Healthcare Services Equity Research at Jefferies & Company Inc