巴克莱2Q25医院调查：量增长放缓但成本控制良好

9Restricted - External U.S. Health Care Facilities & Managed CareNEUTRALU.S. Medical Supplies & DevicesPOSITIVEU.s. Health Care Facilities & ManagedCareAndrew Mok, CFA+1212526 5496andrew.mok@barclays.comBCI, USMingchuan Song+12125269787mingchuan.song@barclays.comBCI, USThomas Walsh+12125265096thomas.walsh@barclays.comBCI, USTiffany Yuan+12125265568tiffany-yuan@barclays.comBCI, USU.S. Medical Supplies & DevicesMatt Miksic+12125269189matt.miksic@barclays.comBCI, USWilliam McMahon+12125263816william.mcmahon@barclays.comBCI, US forinpatient surgery growth from 3.1% to 3.6% (see Figure 2), but we put more weight intorespondents views on Q2 vs. the full year at this point. Within the context of respondentprocedures as having the most significant sequential step up from Q1 to Q2, followed by roboticsurgery, cardiac surgery, and AF ablation. Reconciling growth expectations of our respondentsandconsensusestimatesismademorechallengingduetoonelesssellingdayinQiformanyofour covered companies, while Q2 will not be impacted by a selling day deficit. But if we were tosee sluggish surgery trends and slower volume growth in Q2, in-line with this survey, we wouldexpect UW-rated ZBH and oW-rated EW and SYK to be most impacted. Conversely, ouranalysis indicated that OW-rated BDX, ABT and (surprisingly) ISRG are best positioned tomanage through a slowdown in procedure volumes (please see our note Who's Most Sensitive to2025U.S.ProcedureVolumes?,publishedNov21,2024).MedTech (Miksic): Expectations for 2025 Robot Purchases Remains Healthy, But Temperingslightly from 2023 and 2024: The majority of our respondents expect to purchase at least 1robot this year (73%), however this is down slightly from the annual purchasing behavior ofthese respondents in 2023 and 2024, where 80% purchased at least 1 robot per year. While theseshifts in expected demand are relatively modest, and overall purchase expectations remainpositive for robots, we view these data as worth watching, particularly as hospitals begin todigest the changes in Medicaid funding set to go into effect next year. In addition, we note thatoverall sentiment among respondents has deteriorated over the past four quarters, from64-65%positivein2H24,to51%inQ1andonly41%forQ2.Negativesentimenthasalsoincreased from an average of 10% in 2H24 to 22% in Q2 (please see Figure 12). Interestingly, theoverall expectations for capex budgets remains positive (55% of respondents expect to increasecapex spending in 2025, and 28% expecting spending to remain the same). These figures arefor spend have swung significantly into larger hospitals (up 0.9%), with flat growth nowexpected forsmall hospitals. This reverses the trend of 3-5% growth expectations for smallhospitalapex over the prior four quarters, and flat to down spending expectations for largerhosietals (please see Figure 15). Names in our universe most exposed to robotic surgery demandGnclude OW-rated ISRG, SYK, GMED, MDT and UW-rated ZBH, and to a lesser degree EW-spending in general are OW-rated SYK, BDX and BAX, while OW-rated ABT, EW, MDT and BSXare among least exposed (please see our note MedTech Names Most (and Least) Exposed to U.S.Cap Equip Sales, published Mar 6).2 Healthcare Provider Volume & Cost Trends4Hospital IT Budgets & Capex Trends9Capex Budget Trends92025 Capex Allocations By Hospital Size10HCIT Spending Allocations.11Telehealth Utilization & Market Fragmentation11Revenue Cycle Management (RCM) Industry Trends13Expectations for Q2 Volume Growth and Capex Spending are Mixed .. 14Survey Respondent Profile16 Healthcare ProviderVolume & Cost Trends2Q25Volumes:Ourlatestsurveyindicatesadecelerationof50-100bpsacrossmostvolumecategories, which finished +2.5% on average including inpatient admissions. OP surgeries sawthe largest sequential moderation at -110 bps leading to +2.5% growth in the quarter, followedby IP surgeries (-90 bps to +2.0%) and ER visits (-80 bps to +2.8%). IRF discharges were theexception with growth up modestly (+20 bps to +2.5%).·FacilityExposureo Hospitals: HCA, UHS, THC, SGRYo ASCs: THC (USPI), SGRYBehavioral: ACHC, UHSInpatient Rehab:EHC5.0%4.2%4.1%.4.1%3.9%3.9%4.0%3.6%3.6%3.292.9%2.9%2.9%3.2%2.8%2.6%2.5%2.0%Outpatient SurgeriesER VisitsBehavioral HealthDischargesFY25 Volume Expectations: Looking ahead, initial bullish FY25 volume expectations wererevised down by 50 bps to +3.7% on average across all categories with ER visits seeing thelargest sequential decline (-110 bps to +4.3%). 2.8%2.5%2.3%%6"IRF Discharges4 Policy outlook: On the policy side, respondents continue to view the expiration of ACAenhanced subsidies as the most disruptive policy risk (42% vs 38% last quarter). Meanwhile,concerns around state-directedpayments moderated (22%vs.28%previously)likelyduetothedelay of provider tax cuts until 2028 in the final OBBB. We think this is a wide gap versusblock grants/per-capita caps (18%) and site neutrality (18%) are largely unchanged.Next,weaskedapproximatelywhat shareoftotal revenue isexpo