Astrana Health, Inc. (ASTH) Earnings Call Transcript & Summary

All right. Good afternoon, and welcome back to the UBS Healthcare Conference. I'm pleased to be joined on stage here with Apollo Medical Holding with Co-CEO, Brandon Sim, Brendan, welcome to the conference.

Thank you so much, Andrew, and thanks to UBS for having us. Really nice to be here with all of you in personally. So thank you.

And I am Andrew Mack, I'm the UBS health care providers analyst here at UBS.

So to start, Brandon, why don't you give us a bit of background on the company for those unfamiliar in the room. Help us understand how you're differentiated versus other value-based care providers?

Absolutely. First of all, thanks again for being here. Happy to engage with you all at a later time if there are any questions that we didn't get to today, Apollo Medical Holdings or ApolloMed for short, is a health care company focused on helping independent doctors as well as physicians of all kinds, successfully take on risk-based contracts under value-based care reimbursement models and excel in them and help them feel like they are operating as part of an integrated health care delivery network through the infrastructure that we are building. That's operational infrastructure, that's technological infrastructure and it's something that we've been doing for over 25 years, starting from our humble roots in California and now kind of spreading across California and into multiple states as well. We're currently serving around 1.2 million members under both value-based contracts as well as in peer services models. And that spans multiple lines of business, including Medicaid; Medi-Cal in California; commercial lines of business, both HMO and PPO; Medicare Advantage, of course, and Medicare fee-for-service populations through our participation in various CMS, CMMI innovation programs. We became public around 5 years ago now in 2017, and we've had a strong track record of profitably delivering growth over those last 5 years in the public markets. We see a lot of exciting potential ahead in our ability to enable and grow profitably with independent affiliate doctors, and we plan to continue doing that both in California and elsewhere through multiple lines of business.

And you mentioned those California roots, a lot of your experience to date has been in that California market. Can you talk about your expansion outside of California, including how you select new markets?

Yes, absolutely. So California is a unique market, as I'm sure many of you know. There is a long history, especially in Southern California in terms of delegated models, delegating risk down to provider groups from the part of insurers and our payer partners. We have benefited from that trend. We've been kind of founded and created in the flames of that advanced value-based care model and full delegation down to provider groups. And so that's something that we're very familiar with taking on. In other parts of the country, it's not as prevalent to have payers delegate not only risk but also other payer services such as prior authorizations, claims adjudication and processing, network management, quality, so on and so forth, down to provider groups. And so as we move outside of California, we're going to be making the value proposition to payers, "Hey, instead of running your own network, and not being able to control costs as well, why not give us control of the network?" Why not allow us to take care of your patients for a fixed percentage of your premium, still guaranteeing them a profit while also allowing us to take on all the operational tasks that they might have otherwise had to do, for example, prior auth claims, credentialing, so on and so forth. And for many payers, that's a very attractive prospect, having to -- being allowed to, let's say, re-delegate Part A and Part B, for example, at 85% of premium or more to a partner like a Polymed as we grow into new regions together with a payer. And so I think to answer your question, our experience in a very mature value-based care market in Southern California and California at large, I think it prepares us very well to move into markets where perhaps it's dominantly -- predominantly a fee-for-service reimbursement mechanism and as more and more systems and payers want to get into value-based care over time.

Great. And your membership mix is diversified across Medicare, Medicaid and the ACA exchanges. What are the benefits of serving a diverse patient population? And how should we think about that mix as you grow? Would you expect that to be relatively consistent or do you have a proclivity to lean into a certain patient group, whether it's Medicare or something else?

Yes. No, absolutely. Thank you for highlighting that. As Andrew mentioned, it's a very diverse mix of groups across population types, across Medicaid, managed Medicare, Medicare fee-for-service, exchange, commercial, so on and so forth. And the reason for that is because historically, we were a physician founded and kind of built around the idea of serving local communities. That's part of the reason we are an affiliate model instead of building clinics partially because it's capital efficient, but also partially because we believe that -- at the end of the day, value-based care and health care is about changing behavior, right? It's about making sure that the patient, the next time they want to run to the ER for something that's not necessary. They're going to talk to their PCP first, or talk to a care navigator, talk to one of our nurses. It's about making sure they realize maybe some of their choices might lead to chronic conditions that otherwise could have been avoided. It's at the end of the day about behavior change for the patient, and we're trying to help change the behavior of physicians and help them influence what the patient does. And that's kind of how we are able to serve patients at the MLRs that MLR, MCRs that we do and generate positive cash flow because of our ability to change patient behavior. And we think that the way to do that is by working very closely with community physicians who understand the needs and the nuances of each local community. Health care, often people say, is very local. We truly believe that. And we think that only by partnering with local physicians who are integrated deeply into the communities that they serve, can they effectively affect change such that we can lower the cost of health care as a whole without affecting quality at all?

And does the care model change at all as you address those different populations, I imagine they would have different needs. Just talk about the approach to care across those populations.

Absolutely, absolutely. And so as you had asked earlier, why do we take care of kind of the whole population? Because when our communities go to our local PCPs, for example, they're coming in often as a family. It's a mom, a dad, maybe the grandparents, their kids. Some of them could be in Medicaid, someone Medicare, some might even be dual eligible, so might be on commercial. They've got a job, for example. And so we're not trying to exclude any part of a physician's patient panel. We are trying to build tools and infrastructure operationally from a tech perspective as well that allow doctors to really serve the entire community who might come in to see them. And as you pointed out, different parts of the community may need different types of clinical programs, different kinds of kinds of intervention, different care plans associated with them. We see Medicare Advantage patients, for example, obviously, have very defined categories of chronic conditions and risk and how those are -- that's very well understood by the community, and Medicaid, perhaps a larger different set of problems that they might face in terms of social determinants as well as others. And so at the end of the day, the infrastructure we're building is purpose-built for each population. But the actual care interventions might be different, and that's taken -- that is implemented by our 200-plus strong care teams, managers, nurses that we have employed here at ApolloMed at the corporate level.

Got it. Let's talk about the profitability of the business. Your 2022 guidance indicates EBITDA margins in the low to mid-teens range. That's noticeably higher than a lot of your peers. Can you talk to the economics of the model and how you've been able to achieve differentiated profitable growth?

Yes. That's something that we're excited about. It's that we're able to demonstrably show clinical and financial outcomes, while growing maybe not at 200% a year, but still planning to grow 30% to 45% a year, even ex-M&A. And that's something we're able to do because of the high-touch unique model that I just described the idea that we're going to go into the community, work with community physicians and help them get to the next level rather than going in building a new box, but putting in our own doctor and saying, go learn the habits and the proclivities of the local community in a couple of years, and we expect to pay back right away. And so we're working with doctors who already know the patients, who have been seeing the patients for years. I PCP, for example, my families PCP, I've had the same PCP my whole life, and they're an ApolloMed doctor, for example. I was born in one of the Polymed partner hospitals in Los Angeles. And these are communities and doctors who really know and understand each other. And so that's part of our ability to -- and at the end of the day, like I said earlier, effect change in behavior because there's that trusted relationship between a physician and his or her patient. In addition to that, we have a lot of technological tools. I'm not going to sit here and pretend that there's a lot of machine learning or AI necessarily because I come from an engineering background as well, quite frankly, it's not even that complicated most of the time. A lot of it is simple risk ratification, it's workflow management, it's automating the things that can be automated. It's kind of keep it simple, to be honest, and what we're doing is we're enabling the 200-plus strong care team that is employed at the Polymed corporate level to really address the parts of the population they need to address. It's our model, which places a critical amount of importance on primary care, but also on multi-specialty care on hospitalists because primary care today only makes up 2% to 3% of the total spend, as defined by CMS. In our population, we see primary care taking up to 4% or 5%, 6% because of the investment in primary care. But still, that's 94% of the dollar that is not being taken care of in a primary care office. And so our approach, both multidisciplinary, multi-specialty and working in the hospitals really allows us to control the cost of the whole dollar and not focusing only on kind of the primary care cost, even though we still believe those are one of the most important parts of the health care ecosystem.

Got it. That's helpful. Can you talk us through -- walk us through how the margins typically evolve when new physicians come on to your model? What's been the experience there -- is there a J curve associated with that model? And where do you think the mature margins are in this business?

Yes, absolutely. So we see that a lot whenever we bring on new cohorts of patients, so to speak, right? And so typically, for example, in a CMS innovation model, DCE or ACO reach or prior to that MSSP or NextGen ACOs, there's a sliding kind of rolling benchmark that is based on the last 3 years of claims expenditures for each line beneficiary. And so for example, it might be 60%, 30%, 10% for the last 3 years. And so really, there's not an element of picking a patient that's healthy or anything like that. It's just taking all the patients and again, affecting behavior change such that you're over time beating the benchmark repeatedly every single year. And every year as we move along, obviously, that 60%, 30%, 10% window slides to the next year and all you got to do is beat it again. And so we do definitely see kind of year 0, year 1 patients are not coming in far below benchmark because perhaps they've never been they have not had their behavior modified, so to speak, by other systems they've worked with before. As time goes on, we normally see by year 2, year 3, that there are noticeable behavioral changes that are reflected in some of the clinical statistics we reported in our investor deck. So things like average length of stay in hospitals, things like admit rates to the hospital, ER admit rates, readmission rates to hospitals, a lot of inpatient related metrics really show the amount of behavior change that we're able to spur as well as kind of percentages of annual wellness visits completed by our seniors, certainly goes up as they spend longer and longer in our system. And so over time, we're able to change behavior to lower medical costs. We're able to negotiate better with payers to increase the percentage of premium that we're getting from them in exchange for taking on that risk. And by driving all these levers in combination, we're able to drive mid- to high-teen type EBITDA margins, while growing very quickly as different cohorts mature through that process.

Great. And you mentioned 30% to 45% growth. That certainly seems like a high-growth target. Can you help decompose the drivers of that growth?

Yes, absolutely. So I think we're in an exciting time right now for value-based care. I'm sure you all feel it as well. It doesn't feel like that probably in the markets, but there's just a tremendous amount of demand for these kinds of services. For an independent doctor especially, the amount of complexity that he or she has to deal with in order to participate in value-based care. Don't even talk about succeeding in those programs. Just to participate is staggering. I mean they have to do reporting, they have to do contracting. They have to do credentialing. They have to do quality measures, and they are like 30 different quality measures. And it keeps changing every year, too. The bar keeps changing, things keep -- the alphabet soup is tremendous -- especially for an independent doctor. And so for many doctors, the choice is, especially coming out of med school, do I join a health system? Do I work for an Optum or Kaiser or one of our peers who are employing doctors? Or do I want to start a private practice -- and we're making sure that it's not that difficult, relatively speaking, to start a private practice and still be a part of this value-based care movement that they're hearing all about and want to be a part of. In some ways, we're almost seeing more organic demand than we can even account for. I mean we have to hire more people to even get everyone integrated kind of to the extent and at the speed that we would like. That being said, to break down that 30% to 45% number, we're seeing a lot of -- there are a couple of different levers that we can drive organic revenue growth. The first is through pure membership growth, right? We add additional members. Each member has a certain per member per month, PMPM-type payment associated with him or her and total revenue growth. That's an obvious one. And we think we can drive organic growth in membership around 10% to 15% a year kind of baseline. In addition to that, we can increase the revenue mix, so to speak, right? We can increase the amount of PMPM per member that we get. And so if we're able to take on larger percentages of the premium dollar, for example, then we're able to take on a higher PMPM blended across our patient population, and that kind of accounts for a lot of the other maybe 20%, 25% there to get to those numbers we talked about. Some examples of moving up the risk ladder include $0 if they're all fee-for-service to maybe a couple of percent, if it's PCP cap only to maybe 30% or 40% of Part A plus Part B for professional outpatient risk and then moving up to maybe high 80s to 90% if we're taking on both professional and institutional risk. And so that's something that we are working on moving each cohort up the risk-based premium chain, so to speak, while still making sure that we have the resources, the care managers the operational infrastructure to support running those populations at the same MLRs that we've come to expect for overall profitability for the company.

Got it. And as you grow 30% to 45%, how will you be able to maintain that profitability of low to mid-teen margins. Can you just talk through the impact that, that level of growth will have on your margins?

Yes. So each new cohort that we're bringing in, whether it's moving up a risk run, so to speak, or bringing them in at some given run, but it's a completely new member. Whether it's one or the other, certainly, we expect a lower margin on that patient population in year 0 and year 1, maybe even into year 2. We expect that to kind of increase and improve as time goes on, as they spend more time in our system. And so what we're going to do is kind of bring on cohorts now that will, so to speak, mature in a couple of years and keep doing that at a rate such that the margins still stay in that kind of low teens figure and at scale should be in the 15% to 20% EBITDA margin kind of range. And the waterfall kind of is very simple for a business like ours, capitated revenue, minus costs associated with those patients, claims paid out, capitation paid out, minus some OpEx which we try to be as efficient as possible with our automated technology tools. The rest is just EBITDA margin. And so really, there are only a couple levers we have to pull, lower costs, lower OpEx, and you get more, you get the margins that we're talking about here.

Got it. That's helpful. Moving on to the ACO reach program. I think you've noted that you think you're uniquely positioned to succeed and thrive under that model. How is your past experience with the NextGen ACO shaped your care approach for ACO reach? And how is that program developing versus your expectations?

Yes. No, thank you for bringing that up. In the past, we had participated in other CMI innovation programs, as you had alluded to, NextGen ACO being one of them, next-generation accountable care organization. In that program, we took care of original Medicare patients, so Medicare fee-for-service folks who did not elect to have Medicare Advantage coverage under Part C. And in that program, we had close to 30,000 aligned beneficiaries, managed a benchmark of over $400 million, publicly available information and manage them quite well, quite successfully. In the NextGen program among analogous ACOs in the NextGen program, we were that save the most gross savings for CMS in the entire country out of all the next-gen ACOs that participated in 2020 -- in performance year of 2020. And so that track record of being able to, again, affect change in populations, affect where they decide to utilize, how they utilize and what's appropriate for them without sacrificing quality, it has been proven in our NextGen ACO performance. It's a lot of the same members who are now in our DCE. And if we are to be participating in the ACO reach program, which I can't comment on publicly at the moment, there will be a lot of the same members and a lot of the same care teams trying to make changes to behavior for new patients if they were to come.

Got it. And are you able to share the direct contracted members that you have today or just the growth of that program over the next few years?

Yes. I can't go into specifics, unfortunately. We may disclose that at a future quarter. I would say that it's slightly down relative to the number I just cited in the NextGen ACO program. But we do expect kind of a huge amount of growth in that segment going forward to the tune of certainly higher than the business as a whole. And the reason for that is because, again, like I mentioned there, there's so many doctors who are interested in having the Medicare fee-for-service parts of their panel participate in some kind of value-based program. One doctor may have, for example, 100 Medicare Advantage patients and 50 align Medicare fee-for-service patients Historically, they would not be able to do anything value-based with those 50 fee-for-service patients by participating in a CMS innovation program, which is kind of the point -- the reason why they exist in the first place, they're able to have financial incentives for applying the same value-based methodology they do in the MA program to those fee-for-service program participants and receive financial rewards for doing so. And so we're really trying to help them get there with their entire patient panels.

Got it. Let's transition to medical cost trend and utilization. As we enter an endemic state of the pandemic, what are your expectations around deferred utilization and acuity for the balance of the year? And any sort of early indicators for how Q2 cost trend is developing?

Yes. Yes. I mean that's something that's top of mind for us, obviously. At the beginning of the year, in another health care conference, we had -- I had guided towards perhaps 400 to 500 basis point increase in medical cost ratio throughout the course of the year on both the professional side and on the facility side of risk that we're taking. We're fortunate enough to say that in Q1 at least, we do not see the full 400 to 500 bp increase come to pass. It wasn't quite as high as that, so it came in better than expected. We still have projected for the rest of the year, the same increase to that plus 100 to 500 from the MLR from 2021 and it remains to be seen whether we end up getting there or not or if utilization patterns have permanently shifted as a result of the pandemic. But I would say that it hasn't gone above and beyond kind of pre-COVID trend lines.

Does that step up in MLR? Where -- how does that compare to the pre-COVID baseline? Does that get you back to where cost trend was pre baseline? Or just give us a sense of that expectation versus 2019?

Exactly right. Yes. The 400 to 500 bp increase is an assumption that will return to pre-COVID trend lines. And I just want to make it clear that when I say 4% to 5% increase, I'm not talking about 95% to 100% MLR. I'm talking about high 70s to low 80s type MLR. So it's still a very well-managed population, I'd say.

Got it. And that's a blended MLR across all of your patient populations, correct? That's right. Any differences you would note in utilization trends across that patient mix?

There are slight differences in terms of trend because we serve a very diverse population. So we are seeing things, I think, that other managed care organizations have also reported that for example, commercial members maybe a little quicker to come back to utilization than seniors, let's say, on Medicare, right? And so we see a number of visits, number of claims, utilization rates increase faster for the commercial population, which is to be expected. So we're seeing minor changes like that, but nothing out of the ordinary.

Got it. On the M&A front, during the quarter, you made 2 tuck-in acquisitions, Jade Health and Orma Health. Can you speak to the strategic merits and impact of those 2 acquisitions?

Yes, absolutely. So these are both fairly small acquisitions. I'll note that neither of them triggered our materiality threshold for reporting the actual purchase price, which is $10 million. So less than that. I'll maybe tackle the Jade one first. Jade Health is a primary care multispecialty group of physicians in San Francisco City. They serve traditionally underserved populations across all lines of business, Medicare Advantage, Medicare fee-for-service, Medicaid, commercial, so on and so forth. And so our very natural fit for the kinds of patients that -- patients that we already serve today. They've been serving the community for over 20 years, our mainstay in the community and -- like I mentioned earlier, we're very pleased to be working with community physicians to help them get to the next level in terms of contracting, in terms of efficiency, in terms of being able to use technology to help change their patients' behavior for the better and save costs and at the same time. So that's something that we're excited about just closed. So we'll probably start seeing the impacts of that maybe a tiny amount in Q2, mostly Q3 and onward. For Orma that was something that closed in Q1 actually. And so Orma Health was a startup in San Francisco and the Bay Area, where very small, had a couple of different offerings, remote patient monitoring for high-risk patients, blood pressure, minor cough, smart scale, things like that, a technology backbone for ingesting information from all of these different sources as well as providing some MSO like functions, services like functions for direct contracting entities and ACO reaches next year when that program begins. And so they were providing analytics, almost a SaaS-like product, charging PMPM to various groups participating in the CMS innovation program. So we're very excited about their addition because not only are they brilliant people, so we're very excited to have them work alongside them. One of them is a President of our value-based care solutions and other is our Chief Analytics Officer. We're also using their RPM platform as a way to wedge, so to speak, into fee-for-service predominant practices, not only in California, but in other states so that they might consider us as their managed care provider or join us in our ACO reach or DCE. For example, they just entered a new -- they just entered Nebraska in Q1. They entered Tennessee. There the RPM platform has been growing, I think, 8% or so month-over-month, and we're looking to use that as a launching board for us to sell our other managed care services and ACO reach services into those practices.

Got it. And if we take a step back, when you look at the M&A pipeline, how would you characterize that pipeline? And what opportunities are most attractive to you?

Yes. The pipeline is always full of things. But at the moment, because of the state of the public markets and how valuations are for us, in particular, it has been -- I'll admit, slightly difficult to cross that public-private kind of bid-ask spread that's going on. We're trading at low teens LTM, EBITDA, adjusted EBITDA leased. We're still seeing privates trade a bit higher than that to say the least. And so it is a bit difficult to underwrite the purchase of something private in any size, right? So I think while there are still some things we expect to get done because we believe there's a mutually beneficial arrangement between us and the acquiree, so to speak. We think we'll certainly slow the pace of acquisition. We think the organic pipeline is strong enough to garner the 30-plus percent growth that we're talking about for the next 3 to 5 years. So we're going to focus on the organic pipeline, bolt-ons where they make sense and continue to execute the model growing that rate while maintaining the same profit margins we've historically delivered.

Got it. I want to follow up on one of the comments you made around the specialty strategy. That seems to be one of the distinguishing features of Apollo's model is its focus on multi-specialists and hospitalists. So can you walk us through how you work with specialists and others to differentiate the care model?

Yes, absolutely. So again, we -- I don't want to kind of take away anything from primary care physicians. We think they are the quarterback, the most critical element in a patient's care generally. However, it is important to have kind of a very closely knit connections between primary care doctors and the specialist network, which also serves their patients and their line beneficiaries. To give you an example, patients often have heart palpitations. And it may be a common response mechanism for them to immediately go to the ER, especially if they've had maybe traumatic experiences before or have a history of cardiac problems. If a PCP is perhaps not in a value-based care system, they may be perfectly content with the patient going to the ER every time because it's not something that the PCP wants to have responsibility over necessarily. But if there is a PCP who is very trusted by the patient and the patient will give the PCP a call and the PCP can work very closely with the cardiologists in our network, for example, to have the cardiologist sneak in a visit perhaps with that patient in between visits or see them right away, that may prevent an ER visit that is very preventable. And most of the time -- I don't want to say most, but much of the time, those types of ER visits are actually just something that can be monitored at home or can be monitored by the cardiologist remotely. And so that's just one example that happens over and over again and other specialties as well, where if there's true coordination between the patient, his or her primary care doctor and the specialty network, we can really avoid some of the hospitalizations, ER utilizations that could otherwise be preventable and can lower the total cost of care while providing a better experience for the patient.

Right. And back to those primary care physicians, that is core to the model and finding the right doctors who are aligned with the company's strategy would be paramount to Apollo Medical. How does Apollo source physician groups into its business model?

Right. Yes. That's a great question. And something that we're working on as we speak. Prior to this year, we didn't even have a business development team. I mean it was just myself and some of the cofounders who are physicians kind of going around talking to doctors about the complexities that they face, trying to understand what those complexities are and then designing from the ground up technology and operational solutions for those problems that they face day to day as they try to participate in value-based care. Even to this day, we just hired a Chief Growth Officer. We're very excited about him and his team. He's starting to onboard a business development team. So that's something that we're looking for like-minded physician, so to speak in communities across California, but also in other states nearby who may have similar demographics and similar problems as the physicians we currently serve. And the other major channel is kind of word of mouth and inbound requests. We have doctors saying, we heard about you from a friend. Can you be our services provider. Can you help us get a contract with so and so payer. And that's something that we -- that's really kind of made up the pipeline for our first half of the year so far.

And what's the experience level and profile of a physician who partners with Apollo?

Right. On average, these are physicians who are -- well, almost exclusively, these are physicians who are independent doctors. So they work -- they're private practitioners. They have their own clinic. They -- and because of kind of the financial requirements of having a private practice, these are normally doctors who are maybe further out from their residency days, put it that way. Folks who have built up some patient panel, have understanding of the community that they're serving, run a successful private practice, but maybe mostly fee-for-service but want to get into value-based care and want to get into capitated arrangements with payers. And so we're very focused on helping those doctors, especially those who have kind of a very wide diversity of patients on their panel, where if they go to one of our peers, for example, they may not be served as a whole. They may only be served in one particular segment of their patient panel. And so they would come to us to get kind of the comprehensive level of service.

Got it. And part of that value proposition that you delivered to physicians is technology. Can you speak to the technological platform that you bring to the table and some of the differentiating features of that technology?

Right, absolutely. So I think one of the main interesting parts of the technology platform is that it's been really built by my team essentially in the last 3 years. I was the first software engineer at Apollo when I started in 2019. And over that time, we've built kind of without really impacting profit margins at all kind of under the hood all sorts of tools ranging from payer automation tools, over 50% of prior [indiscernible] completely automated, 90% of claims adjudication and processing completely automated to care management tools and workflow tools to analytics tools around quality, risk adjustment, annual wellness visit and risk stratification. And so maybe it's helpful, I'll go really quick here because I know we're running out of time. The journey of how a primary care physician might interact with our platform. If I'm a primary care physician, first of all, my reception is my front office staff. In a traditional system might have to -- when a patient comes in, check their ID card, their benefits card and maybe call or look up on an online portal, what their eligibility is, what their co-pay is what their deductible is, all of these kind of details about the benefit in the plan. Instead of having to go to 20 different payers' websites. Depending on who comes in, you would -- for us, you would only go to ApolloMed's website. We would aggregate everything, all automated on the back end and display information to offices from an office staff. During the actual visit itself, all the data that you might need across any point of care will be aggregated together into our ApolloMed platform. So even if it's a lab that you have no affiliation to you whatsoever, you can still feel like you're part of an integrated delivery system because all that information is there at your fingertips. And when you submit a prior AUTH in an HMO system, for example, normally, what you'd have to do submit to United or [indiscernible] or whoever, and wait a couple of days for them to say, "Yes, you're approved for this service, this referral, No, you're not. You got to modify it or resend it. For us, like I mentioned, over half of our prior outs are automatically approved. And so right there, you press submit. It will come back right away half the time and say, this is approved. You can tell the patient right away that they can go see that specialist on the same day in that same visit. They don't have to go home. They don't have to wait a couple of days and they get access to care much more quickly. When you're done with your visit, you submit your claim, instead of submitting to 20 different payers across 3 lines of business, the cartesian matrix product of like 60 different things. You're just meeting to 1 payer, ApolloMed. You're sometime the claim to us, we're adjudicating your claim. We're giving you 1 check, 1 EFT payment, whatever it is, with 1 explanation of benefits for all of your patient panel as much of them are on ApolloMed and you don't have to kind of reconcile payments from 20 different payers across 3 or 4 different lines of business. So just kind of that quick journey. I'm not even getting into the analytics back end part of it or the care management part of it, you can kind of see the myriad of touch points that a primary care physician might have with our platform. I'm not saying that any of this is rocket science, right? No one is kind of doing any artificial general intelligence or anything like that with this platform. But it does make the doctor's lives easier. That's our goal, and it simplifies a lot of administrative burden for them. So again, they can focus on being that trust agent for their patient and affect behavior change. Again, we're coming back to that idea of allowing doctors to serve as a trust agent for their patients.

Got it. That's helpful. In the last minute here, any final comments or anything that you want to leave the audience with here today?

Yes. No, I mean, I think we're very excited about where value-based care is going in this country. We want to do our part in hasting that process as it comes and helping fee-for-service practices transition very gracefully and financially successfully into value-based care programs. And quite honestly, I'm very excited about the work we do each and every day. We see the benefits of it as doctors get to spend more time with their patients. We see the actual clinical outcomes. And it's very rewarding. So I'm just grateful to have you all here along with us on this journey.

Great. Well, thank you so much for joining us here today, and please enjoy the rest of the conference.

Absolutely. Thank you so much, Andrew. Appreciate it.

Thank you.