Vitasora Health Limited (VHL) Earnings Call Transcript & Summary

Good morning. My name is Nova Taylor. I'm one of the Company Secretaries of Respiri. Welcome to this morning's webinar. I'd like to introduce you to Mr. Marjan Mikel, the CEO and Managing Director of Respiri, who, this morning, is going to present on the U.S. growth -- plans, major deals, the future of connected care and give you some background and insights to the change -- proposed change of company name. Marjan?

Yes. Thank you very much, Nova. Good morning, everybody. I hope everyone's had a wonderful weekend, and thank you very much for sharing time with us this morning. And I hope to be able to provide you with a little bit of insight into the last month in the United States and the work that's been going on over there, of course. Some updates on the capital raise, successful capital raise we recently undertook and a whole bunch of new things that have just happened over the last few weeks that are in line with a lot of the announcements that -- well, not announcements, but the promises that we've been making to the marketplace over the last few months. So it's a really exciting time for the organization. As I said, the health care system in the United States continues to evolve. There is no doubt that care management and risk-share contracts or value-based health care is the direction that health care in the United States is taking in an organization, in my opinion, and in our opinion, that doesn't have a solution that clearly recognizes that value-based contracts in the United States that are based around delivering outcomes as opposed to doing things, a fee-for-service, if you don't have a solution for something like that, you're really not going to have a solution that's a viable solution for the larger part of the market moving forward. So with that as background, I'm going to provide you with updates on what we've done in the United States and our growth plans to date. We are getting ready for some major accounts that have just been signed on as partners of ours, which I'll talk to you in a moment. Some major new deals and some announcements that I'll make today for some other major ACOs that we've also signed up. And importantly, how the future of connected care, not what I think, but what the major stakeholders in the United States and the policyholders -- policymakers, sorry, are driving when it comes to the way that they see health care provision in the United States happening. So what I will do is give you insights into all that moving forward. So what I thought I'd do is start with some of the investment highlights that were very well received by institutional and high-net worth investors that decided to invest in the organization just recently. It's important to note that since our acquisition of Orb, we now, at the end of last year, had about 6,500 patients programs enrolled, 40 contracts with clients, collectively. I took the liberty of updating this slide to include the fact that now we have 8 major late-stage contract negotiations up from 6, and I'll talk to some of those that have already landed in the next slide. At the end of last year, the average -- the run rate for the newly merged organization was $5.5 million. Now that assumes an average monthly revenue stream for Orb over the 12-month period and the average month for the final quarter of calendar year 2024 for Respiri. The clients that we have contracted, there are a potential pool of patients of about 70,000 that we are working through at the moment and are getting ready, as I said, to be able to handle the volume of these patients moving forward. So we are making changes, operational changes to the way that we operate to make sure that we can handle the volume of patients that we anticipate and forecast happening moving forward. The pipeline that we have is very exciting, and that includes the 8 major clients, which will increase our patient pool to about 350,000 Medicare patients, remembering they're our target. Medicare insured, so CMS-insured patients, all over the age of 60, all with multiple comorbidities, all insured, all essentially eligible for remote patient monitoring. We spoke about the Orb acquisition, an exciting time for us. They bring together a wonderful series of people that we now have on the ground in the United States. $4.2 million in revenues, $2.2 million in synergies across the organizations that are efficiency gains. Now we have already secured about USD 1.4 million of that and anticipate the rest of it being secured before the middle -- the end of this financial year. And there are the significant upsides in upselling across the portfolio of products that we bring together. As you know, UPEC, which is the Universal Patient Engagement Centre program, is a new service that we have got when we purchased the Orb organization. And there is a huge opportunity to undertake annual wellness visits across our patient -- sorry, our current client pools to be able to upsell to existing clients services that they really do need. And I'll talk a little bit more about that as we go through the presentation. Orb also does very little in the space of remote patient monitoring. They focus on chronic care management. So there's an immediate opportunity for us to cross-sell remote patient monitoring into their patient pool from existing clients. And that's about USD 1.5 million that we see as a short-term win for the organization. As I said, we've already commenced the integration of Orb systems integration and the savings are already being realized. So that is a wonderful achievement moving forward. I'd be lying if I said that any merger, if you will, of different organizations doesn't cause its own integration issues, personnel and otherwise, and we're working through those, and nothing that we are undertaking at the moment was not expected nor forecast to happen. So we're working through all that at the moment, working through the differences in the way we operate and taking best practices from both organizations. Important to note, the far bigger opportunity for us is getting ready for the scaled operations that we will need to undertake to be able to start onboarding the tens of thousands of patient opportunities at the major ACOs, one of which we recently announced, will be provided in the organization moving forward. Important to note that what also resonated very, very well, not just with our clients, but also the investor group, is the fact that when we do deliver our services, we have a material impact on health outcomes. We reduce one of the most expensive parts of health care delivery hospitalizations by half, length of stay in hospitals by half, ER visits by about half, improving pharmaceutical compliance by almost 100%, doubling it. These things, as we know, are the key drivers to expense buyouts when it comes to health care provision, and something that our clients, both existing and new, value very, very dearly. Now as I said, Evolent, I'll talk to in a moment, but we'll also be able to announce another client that we've just brought on board, another major ACO based out of the southern part of the United States. And as I said, wheezo remains an important part of our value proposition because, as I've said in the past, if you want to deliver health care and remote patient monitoring in patients with respiratory disorders, really the only easy-to-use reproducible data device available is wheezo. Now it will only make up somewhere between 4% and 10% of our total volume of business moving forward because that's just the epidemiology of, say, COPD, chronic obstructive pulmonary disease, in the general population. So we can't do anything about that, but it is a very important 5% to 10% of the population and something that nobody else can really do with us. So it is a unique selling proposition, but only in the context of the broader opportunities that we provide our clients as a full-service provider. And I'll just go through what that means to us as we go through this presentation. We've had some significant wins over the last month. I announced just recently the recent partnership with Evolent, New York Stock Exchange-listed organization with operations in over 12 states, and with currently about 100,000 Medicare patients across the United States. We will be commencing the contract or arrangement, I should say, with Evolent in Hawaii, and we'll be partnering with the Hawaiian IPA. Now there's been a whole heap of things happening in the Hawaiian market that I won't bore you with today, but this is a manifestation of Respiri being part on the table, driving these changes forward and being part of the solution, which is a really exciting place for us to be. Important to note that the agreement that we have with Evolent and Hawaiian IPA is in the Medicare Shared Services (sic) [ Savings ] Program, an MSSP. So it is a value-based contract, one of our first, where our partners are actually paying for our services inadvertently, and they're doing this on the assumption that our services are actually going to reduce costs because we improve outcomes. And we're heavily monitoring those. And we're using this particular agreement to further highlight the importance of being able to deliver connected care management services, which Respiri does across all chronic diseases to high-risk patients and reduce costs as a result. Important to note that this will be a Clinic in Cloud, so we will be directly dealing with Medicare, that's CMS. And the revenue streams for us for this will be somewhere between $120 and $200 per patient per month, depending on the number of services and CPT codes we deliver to that patient. This is a very exciting contract for us. This is a premier organization listed on the New York Stock Exchange, trusting us with some of their significant Medicare Shared Savings Programs and trusting that we're actually going to deliver for them to reduce their cost base based on our abilities to do so. I can announce today also, we've just entered into another contract an agreement with another major accountable care organization based out of Nashville. The organization is called The Physicians' Alliance Corporation. They exist across 14 states, have more than 5,000 doctors in their group. We will be commencing with the test program in Arizona. The patient pool there across the test sites are about 30,000 patients. Again, it will be Clinic in Cloud, somewhere between $120 and $200 per patient per month. We anticipate kicking off first patient in April of this year, so a very quick onboarding process. And then the 30,000 patients, if we assume that half of them are Medicare patients, we're talking about a total pool of about 15,000 Medicare patients that we will be analyzing to make sure that we are onboarding the high-risk, high-cost patients where we can make a material difference to their health outcomes and importantly, reduce the costs. Needless to say that these are starting points for both of these significant ACOs and 2 promises that we've made to the market in recent months. These are ACO accounts in the value-based space that we will be delivering against. And assuming we do what it is we're supposed to be doing, we're very confident that we will be progressing our services to a broader number of patients in this space across the United States. Also, very important to note that we have a number of significant late-stage discussions that I will be -- no, I shouldn't say I will be -- that I'm confident we will be announcing over the next few quarters. Another large insurance company that's listed on the New York Stock Exchange, they've got over 1 million policyholders, 74,000 high-risk patients, and they are very, very keen in making sure that they work with us to deliver services to their patients that are assisted living patients and patients that they want to keep at homes for as long as they possibly can so long as it is safe for those patients to stay at home. And I'll talk a little bit more about that opportunity later. Significantly large ACO in California, an Ohio-based health care organization, which is also very large. And again, as I said, these particular agreements, we hope to have finalized in the next month or 2 and to announce them as we have Evolent and we call them TPAC, but it is The Physicians' Alliance Corporation, another major based state-based insurer, a large Californian hospital, and a major health care organization in South Florida. So all these things are basically at a place where we're agreeing on what Is we dot and what Ts we cross. And as I said, I'm very confident that we will be announcing progress and agreements with these over the next couple of quarters, if not earlier. So it is a very exciting time for us. It's important to note that with these much larger organizations, we'll be revisiting how we deliver services, revisiting how we enroll patients, revisit how we engage with those patients and revisit the systems that we've got to make sure that we can handle the volumes of patients that are coming through. So we're looking at that at the moment, and we're certainly making sure that we are match ready for the volume of patients that we forecast to come through these. Just thought I'd take an opportunity to remind us about what it is we do. We deliver connected care management services, which includes remote patient monitoring. We are one of the only organizations that brings a turnkey solution to our patients that provides devices, a CMS- and Medicare-compliant platform and our own staff together to provide the ears, eyes and mouths of our clients' physicians with their patients when those patients are at home in the real world. And if you add in wheezo, which is a device that allows us to do that for respiratory patients, we're the only organization really that can do these services for all chronic diseases, including respiratory. Our target market very, very clearly is not private. It is CMS and Medicare. They're all over the age of 65, all Medicare insured, all multiple comorbidities and all eligible, really, on paper, at the very least, for the services that we provide, either through a Medicare reimbursement scheme or a value-based contract. I thought I'd also just show you some of the devices that we use in delivering remote patient monitoring. We've got blood pressure cuffs. We've got glucose monitors. We have got medication dispensers. We've got scales, smart watches, which are ours. We have oximetry. And of course, we have wheezo. So basically, we choose whichever device we think is the most appropriate for a patient when it comes to helping to manage that patient on behalf of our clients and doctors. When they go home, they get one of these, and we monitor these in the context of the care plans they've been put in place for these patients by their doctors and escalate issues on an exceptions basis before they become major issues. That's why we reduce hospitalizations by over half. We let people know there's an issue before there is an issue, whether that's a cardiovascular issue, whether that's a blood glucose issue, whether that's a compliance issue, whether that's a respiratory issue or an obesity or diabetes issue. This is what we do for a living. These are the devices that we tap into. These are the devices that allow us to provide a solution to every single type of chronic disease that's out there. It's really important to note, and here are the devices that we use. The challenges affecting the United States health care market are no different to anywhere else in the world. You've got a situation where, in the United States, the cost of health care is nudging -- sorry, USD 4 trillion, trillion. And they are growing at a far greater rate than the cash that's available to be able to manage them. And to give you an example, one of the clients that are in our top 8, the late-stage contracts that we're negotiating, a major U.S. health insurer. Their cost base grew by 18% last year. Now Medicare in January announced a massive 2.1% increase in funding for health care. Now no matter which way you look at it, 18% into 2% does not go. So clearly, something different has to happen when it comes to the way that funding is being deployed by insurance companies, by ACOs and by physicians to deliver more cost-effective and a better return on investment to patients when it comes to health care delivery. And things aren't going to get any easier. The population is still aging. The systems that have been set up in health care in the U.S. are no different to anywhere else in the world. They have been set up as a reactive system for acute diseases. And what I mean by that is, typically, patient feels sick, go see the doctor, doctor helps them with their illness and they go home. Now the problem with that is it doesn't work for chronic diseases. Most chronic diseases are asymptomatic. So people don't even necessarily feel that they're sick, particularly the heart problems. And usually, the first symptom of a heart problem is something pretty serious. So the only way that we can really provide a better deployment of resources in health care is by being far more proactive, not like the traditional model, proaction through a remote patient monitoring and a connected care management philosophy, in ethos, that we deliver as a partner for the likes of Evolent, for the likes of TPAC and for the likes of the other clients that we currently have. So those 2 clients, for instance, see our services as a key part in the investment strategy that they're using when it comes to the health care funds that they're deploying and what services they're prepared to fund when it comes to managing their patients. There's no better testament than that. And that makes me very excited about moving forward. The issue is not going to go away. 1 in 2 Americans has got at least 1 chronic disease. Almost every single patient over the age of 65 has got a chronic disease. 80% of them are living with more than one. Ergo, they all qualify for remote patient monitoring. That's our target market. 75% of all cost, that $4.1 trillion in annual cost, is generated by chronic conditions, yet the system today is not set up to address chronic condition management. Our services, the services that Evolent and TPAC would like us to deliver on their behalf, are seen as a key part of addressing that particular issue. And the Pareto rule in health care isn't 80-20, it's more like 80-10. So 80% of costs are generated by about 10% of the population. And importantly, Medicare spend, as I said previously, is about $1 trillion, that should be in 2023, yet they only announced a 2.1% increase in spending in January this year. So there is a disconnect. And as I said, when it comes to our ability to deliver on solutions, our results speak for themselves and they resonate with our client base. They really do. Enough of me speaking Respiri. Here are what the major opinion-leading organizations that set policies in the United States think: CMS last year, which we announced, made it very clear that the days of fee-for-service contracts with primary care physicians are limited and numbered. They want to see all major accountable care groups move towards value-based contracts by the year 2030. Now even if that's 2040, what that is clearly saying is that the days of fee-for-service versus value-based outcomes-driven contracts are limited. And if you don't have a solution in that space, you don't really have a solution. Respiri is uniquely positioned to be able to do that, particularly with Clinic in Cloud and particularly with our appetite to actually put our money where our mouth is when it comes to cost savings and rewards. On top of that, the other side of the coin, the American Medical Association has made it very clear that they don't see remote patient monitoring as a service going anywhere. In fact, they see it as a key part of the investment mix needed to address the burgeoning size of health care expenditure that we just spoke of. In fact, they've gone so far as to say they want to make it easier for doctors to be able to qualify, make it more lucrative for them to actually get paid for doing it, and make sure that it becomes a critical part of the management programs that are put in place for patients. So these 2 bodies come together to really create a quasi-regulatory environment, which is very, very, very Respiri strategy savvy. So in essence, remote patient monitoring is not going anywhere. We know from the proposed changes that should go into effect from January 1 next year that our per-patient, per-month revenue stream for the fee-for-service side of our business will double without us needing to do any more work based on the recommendations that have been made and on the assumption that reimbursement doesn't change. So it's an exciting time for us, not just because of the revenue opportunity, but because of the faith that these major organizations are putting into the services that Respiri provides and the way that we provide them. RPM is here to stay. RPM is a critical part of any investment -- health care investment strategy that these organizations see as part of the future for the United States. And we are uniquely positioned in both of those areas because we've got the best possible RPM services out there, in our opinions. And we're also very prepared to align ourselves around the way that our clients get reimbursed and rewarded. As I said, we've got a situation where we both do fee-for-service. We've gone through that a number of times. That's where we do the work and we provide an invoice to our clients for the work that we've actually done for them. They pay us, and they would get the reimbursement paid to them from whatever insurer or Medicare provider that is there for them. We also have our risk-share models where the actual per-member, per-month numbers are smaller, but they are a much larger pool of patients. Now this is one of the contracts that we're working through at the moment. And just to remind you about how this works. In this contract, we are being asked to look and quote for managing a whole cohort of patients, 5,000 of them, for about $20 per member per month. That's USD 100,000 a month for this contract, so $1.2 million a year. Now the day we sign the contract, we start getting paid that $100,000 a month, okay? Now we know that when we do the analysis and we've already received billing data for these 5,000 patients, so we know who they are, where they are, what's wrong with them, what's put them in hospital, how much they cost the system and how much they're likely to cost the system moving forward, we can then identify the high-risk, high-cost patients that need to be intervened with. Now based on the work that we've already done from our own analytical and AI capabilities, we know that somewhere between 8% and 15% of the total population of 5,000 patients, we're going to have to engage with. So somewhere between 400 and 750 patients. So if we take 10% as a middle ground, basically, we're going to be dealing with 500 patients in delivering services once we've done the analysis, which, if you amortize the $100,000 a month over, is about $200 per patient per month. So we also then are now negotiating the final pieces of the puzzle, which is how much of the savings we get to keep as an organization as paid to us by our partners. Now typically, a capitated risk-share model sees the insurance company and the client -- our client share at 50-50, depending on the contract. We're now looking at what part of -- or how much of that 50% we're going to keep as part of our contract for delivering these services. So if we assume we keep half of it, that works out to be roughly $400 per patient on program per month, but half of it guaranteed every single month. So it's -- these contracts are very, very lucrative to us. We have to deliver. If we don't deliver the outcomes, we're not going to get contract extensions. But as I said, our data speaks for itself. And I'm very confident in these. And these are the exciting things that we expect to be announcing over the next couple of quarters. And as I said, I've already touched on with the Medicare Shared Savings Programs. These are value-based contracts as well that we hope will evolve into bigger things moving forward with these clients. So we look at where we hope to be in the next 12 to 18 months on the back of all these and these contracts and the progress we're making. Into 2024, we're about 6,500 patient programs. We hope to grow that to over 30,000 within 12 to 18 months. Revenues -- monthly revenues at the end of 2024 were roughly USD 0.5 million. We hope to triple those in the next 12 to 18 months on the back of the contracts that I've just announced, both fee-for-service and importantly, some of these larger value-based contracts like the ones that I announced with Evolent and The Physicians' Alliance Corporation, TPAC. Contracted clients, I'm not really that fussed about that, but we will continue to grow those because what is key to us are those 8 other large, late-stage contracts. We have to get ready to deliver those. The 2 ACOs, Evolent and TPAC are our [ entries ] into those, and we're ready to deliver those and grow those. All the other smaller accounts, we're going to rationalize those as we move forward and focus on the bigger accounts and make some tough calls about who we keep and who we don't keep based on our abilities to be able to do 2 things. One is to impact patients' outcomes. And the second thing is how easy it is to actually do with the clients. And those calls will be made moving forward. The other opportunity is UPEC and the cross-selling I was talking about. So these are basically administrative services that we provide to patients from a remote setting. And each one of these contracts is worth circa an increased share of wallet of about $300,000 to $0.5 million per annum for existing clients. And we are uniquely positioned because we have the wheezo device, which allows us to deliver these services across any chronic disease. We've got Clinic in Cloud which allows us to undertake these value-based contracts. Without that, we can't do it. It's unique to us. We've got a turnkey solution that really allows us to say to clients, you keep being good at what you need to be good at, leave the rest to us. Leave care management to us, you focus on being a doctor or you focus on growing your ACO or you focus on managing your hospital. And very importantly, it doesn't matter how our clients get paid or reimbursed or awarded, we will align. So we're a one-stop shop that nobody else really can provide in the United States and a one-stop shop that allows us to focus on these value-based contracts. So the future is looking pretty cool for us at the moment, and a lot is happening behind the scenes, and there are new clients coming on board on a regular basis. So I'm very, very confident that we're going to be hitting the numbers that we say we're going to be hitting, and I'm very confident that we will be breaking even over that 12- to 18-month period that I'm talking about. In fact, the breakeven, the cash flow breakeven on a monthly basis will happen before the end of this calendar year. And I know that we've made promises in the past. I really can't do too much about some of what it is that it was supposed to happen and didn't happen. I can't go into some of those details. But I also -- one of the key drivers of that was clients in California. And as you will recall, there were some significant fires in L.A., which put a lot of these contracts on hold. So we're working through those as we speak. We're confident they're going to come online over the next few months. Now with that, here are some of the things you can look forward to as major catalysts for 2025. We've announced that we hope to be rebranding the organization to Vitasora Health, and I'll talk about that in a moment. And that's really to realign the name of the organization with the business that we today have, not what we used to have. You can expect value-based contracts with blue-chip health care organizations before the end of this financial year. We will be delivering those. We will be delivering a contract with a major New York Stock Exchange-listed insurer before the end of quarter 3. I shouldn't say will. Our -- we anticipate, based on the discussions we are having with the insurer that, that will be the case on or before Q3 this year. We've spoken about the other big 8s in late-stage negotiations. So over the next few quarters, we hope to be announcing the balance of those as contracted partners of ours that we will commence executing plans against. We hope to be able to develop our new annual wellness visit on the back of UPEC, the Orb offering that I spoke to, at the end of this year, which will provide us with an additional revenue stream that our existing clients really, really want to see happen. We just need to make sure that everything is kosher, that everything is compliant and that we're in a place to actually deliver that without compromising the rest of our organization. And I haven't spoken too much about this, but the wearable device trial is moving ahead in great leaps and bounds, and we hope to have all the data and an FDA package ready for submission by the end of this year. So it's an exciting time for us. The message here is you're not going to have to wait a long time for things to happen with this organization or our organization. And I'm very confident that we'll be announcing this as we move forward, as we have with Evolent and as we have with TPAC, okay? And those first patients are in next month. So an exciting time for us moving forward, and I'm looking forward to keeping the shareholder and the market base very informed of our progress. Now it would be remiss of me without introducing you to some of what it is we're doing with our rebrand, which is obviously contingent upon the EGM that is scheduled for next month. The name that we've opted for is Vitasora Health. And I've sort of given a little bit of detail into why we've chosen this name. But we basically saw it and got feedback from yourselves, the shareholders, that the name Respiri really did not reflect our business any longer. Great heritage and history in respiratory medicine, but as you saw previously, we are now a full turnkey care management provider, where wheezo is still very important to us, but it is not the only thing we do. And to that end, we really did need to focus on rebranding the organization to reflect the new full-service care management leader that we are going to be and already are in many regards. As I said, we started with wheezo, and wheezo still remains such an important part of our differentiation because without this device, you don't have a solution across all chronic diseases. That remains very important to us. We have acquired a number of organizations that allow us to provide a more turnkey solution, a full-service provider. We are very much in advanced data analytics at the moment to make sure that when we get billing data that we know exactly what needs to happen so we can identify the high-risk patients that we need to be dealing with and provide a complete turnkey solution for all chronic disease management for our clients. The name is Vita from Latin from life, and Sora, Japanese for the sky. Now different parts of the world, I get it, but it sort of embellishes what it is we're trying to do. And that is the sky is the limit when it comes to what it is we can actually provide our clients, not just from a chronic disease management perspective or care management perspective, but also how we're prepared to work with them, remembering that, that's an important part of anything. I mean if we disrupt their workflows too much, they're not going to work with us. And even worse, they'll contract with us, but won't do too much. And obviously, our complete focus is always the patient and the improvements in the lives of those patients that we can deliver by partnering with our clients and their providers. So we've got a situation, as we've discussed today, a whole bunch of new ACOs that we've contracted, new health care organizations that are also in the mix, including major insurance companies. These things are really setting us up for some significant growth opportunities in both the traditional fee-for-service side of our business but also the value-based risk share contract side of our business as well. I know from my experience and my discussions with our clients and the last 2 agreements that I've just announced a testament to this, what Respiri does -- sorry, what Vitasora will do and does resonates with them, and they are prepared to actually do something with our services in their value-based contracts. With the MSSPs or the Medicare Shared Services (sic) [ Savings ] Programs, every dollar they give to us is a dollar they have to account for. Remember that, right? We get money for this. We've got to demonstrate that we're delivering at least that much value to them as part of our services. And with our results in hospitalizations, ER visits and compliance, they know, and we're very confident, that we're going to be able to do that, and they're banking on that as well on the back of those results. So we're providing this seamless care management program, and that's really important to note. If we interrupt their workflows, nothing ever gets done. So our value proposition is you keep doing what you're doing, and we'll deliver what it is we deliver at a world-class pace to your patients, and become your eyes, ears and mouths in the real world. So you've heard me say this many times, but I'll be saying Vitasora, hopefully, from next month, where we are one of the only organizations that will be the standard for scalable, high-impact connected care services right across all stakeholders in health care in the United States and really drive care beyond the clinic, which will improve patient outcomes and drive our clients' financial well-being. So thank you very much. With that, I'll stop talking. But I want to thank you all for your time today, and I'll hand over to Nova to give me any questions that may exist. But as always, you've got my contact details. If you need or wish to speak to me about anything, give me a call or an e-mail, I may not answer immediately, but I promise that I will get back to you eventually. So thank you very much for that. Nova?

Marjan, a few questions here that are of a similar vein so I'm going to combine them for you. Can you give some insight into the competitive landscape? And specifically, for the devices that you detailed summarized on Slide 6, could you give us some insight into the competitive advantage that those devices provide the company?

Okay. Yes. Thanks. We'll start with the competitive market for remote patient monitoring. In the United States, it is a highly fragmented market. There are a lot of small players, no one owns the space, no one owns the space. So I don't even like using the term competitive environment because the competition's not really there. I mean -- and when I say that -- to give you -- let me make this point. In the time that I've been in the United States, Respiri has never been asked to participate in a tender or an RFP, a request for proposal, ever. We have never been asked to compete on price ever. In fact, all the contracts that I've discussed today, we have proactively approached these organizations to discuss how we might be able to help them. So what that tells me is the market's ready for the solution. There aren't just too many people delivering the solution in a way that our clients want to see it. And I think Evolent and TPAC are 2 examples of organizations that have value-based contracts and fee-for-service contracts that see the benefit in what it is we do as an organization and their big organizations. Now when it comes to the devices, remembering, I did say that the majority of the devices outside of wheezo are not differentiated at all. So blood pressure cuff or a smart watch or an oximeter, they don't offer any competitive advantage on their own. And this is really important because if they did, organizations that own them would have it all over all of us. Having them is a tool of the trade for our organization. We cannot deliver a service, whether that be fee-for-service or value-based contracts without devices that allow us to monitor what's happening with the patient. wheezo is different. Only we own wheezo. That gets me in the door, and that gives a conversation around providing services to respiratory patients. The bigger competitive advantage for us is taking the data that those devices deliver, analyzing that data, interfacing with patients, helping those patients understand what needs to happen with their care and escalating whatever issues could be beginning to manifest before they become major issues. So the devices on their own are not at all important because if they were, every doctor in the United States would be doing RPM, and there'd be no Vitasora/Respiri, there'd be no anyone because there'd be no business to be had because they'd be doing it. I mean that stands to reason. So having a device, having the systems, having the platform, having the expertise and having the clinical staff that are engaging with the patients on a daily basis is the competitive advantage, not the device. I hope that answers that question.

Thank you. The final question that's come through is someone wanting some additional information regarding the risk-share model. A small fixed fee plus a percentage of savings. Could you provide any color on the range of percentage the company expects?

Yes, I can. So the per-member, per-month fee and the risk component are intimately entwined. So fundamentally, the bigger the pot of gold at the end of the rainbow at the end of every year, remembering these contracts -- our contracts are typically 3 plus 3, right? But at the end of every year, the amount we get paid per member, per month is dependent on how much of the end-of-year pot we get or whether we own -- so let's just leave it at that, how much of the pot. So the bigger the amount we get at the end of the year, say -- and the highest amount that we've started talking to people about is half of the savings that they are eligible for. So in essence, a 1/4 of the total pot usually means that our fee per member per month is somewhere around the $10 mark, maybe a little lower, maybe a little higher, depending on the volume of patients we're talking about. The more we get paid per member per month, the lower the pot of gold at the end of the year. So that doesn't really tell you too much. But suffice to say that we have been in discussions with organizations where the per member, per month fees has been as low as $8, but a very large patient population, hence, mitigating risk, and a much larger 50% slice of the savings at the end of the year. Now the savings that we're talking about with that organization are in the -- if we hit what it is we're supposed to hit, the savings are circa $10 million to $15 million, so about 1/4 of that are the discussions we're having and about $8 a member per month to others where we've got to $20 per patient per month with a much smaller pot of gold at the end of the rainbow. So it really is difficult for me to give you an answer because it's sort of like a sliding scale between both. Either program are valuable for a variety of reasons. One is they're very lucrative for us if we get it right. Second thing is, once you start delivering the value that I know that we can, you become an irreplaceable partner for their clients, and they know it because they have chosen to work with us because we do something that they can't and don't want to necessarily invest in doing when somebody like us can already do it. So we bring a completely complementary set of skills into the organization. That's the really cool thing about what it is we do because we work hand in glove with these larger organizations, doing things that they know they need to do, but they don't have the infrastructure, not necessarily the abilities to deliver, and it's not core business for them, but they know it needs to become a core deliverable. But it sort of puts us in a very, very interesting position as an organization in these partnerships. Anything else, Nova?

Yes. I think the final one that we have time for. Someone asks, how many patients do we have presently on program? And what is our expected month-on-month organic patient onboarding growth?

I'd have to -- it's a difficult question for me to answer today because I don't have the latest numbers. But as I said, we are roughly at 6,500 patient programs that I can qualify. And the number of patients that we hope to be bringing on board, we're looking at, as I said, getting to 30,000 patients within 12 to 18 months. So that works out to roughly a scaled model of 2,000 to 3,000 new patients a month as we approach the back half of this year. Remembering, as I said previously, and I'm being very honest with you, we are reengineering the way that we do things to make sure that we can handle these increased volumes of patients efficiently. We can currently do them and do them reasonably well. But when we land and continue to land these larger contracts, we have currently developed new programs that will allow us to handle bigger volumes of patients that we're going to have to be able to deliver for these major contracts. And as I said, they have been developed over the last few weeks, months. We've tested them, and we know that they work. So we're in a very good position. But as I said, if we look at the onboarding, the number that we're looking at is 30,000 within 12 to 18 months. And we're currently at 1/4 of that -- sorry, 1/6 of that at the moment. So we really are in a position where the contracts that we're securing will provide us with the patient pools that we need to get onboarded. Important to note also is the risk-share contracts are independent of the patients that we have on program. We need to deliver results. And that's going to be something and a narrative change for me to you, the investor. Patient volumes will remain very critical KPI for us, but managing a patient cohort in a risk setting is a completely different way of reporting, right? As I said, we get a contract of 5,000 or 10,000 or 20,000 patients, we need to be efficient in the way that we operate those and make sure that we're targeting the right patients, and not every patient needs care management, simple as that. But our clients are going to rely on us to identify who does. And they're already doing that. Is that it, Nova?

That's all the questions that we have for today, Marjan. Thank you.

Wonderful. Thank you all. Thank you, Nova. And ladies and gentlemen, thank you again for sharing your time with me. It's a very exciting time for us as an organization. Maybe this will be the last time I say Respiri. It is important to note that, that heritage is important for us moving forward because it does give us competitive advantage in the respiratory space. But the client -- the organization we are today does no way -- the name doesn't reflect who we are. Vitasora Health is the future of our organization, and it represents the turnkey full-service model across all chronic diseases that we deliver. As I said, if anyone's got any questions, please feel free to contact me. And I look forward to sharing more information and announcements around our progress moving forward. Thank you all very much.