Claritev Corporation ($CTEV)

I'm Todd Freeman, I run Investor Relations here at Claritev. Really appreciate everyone making here for the Investor Day today. We're going to do a couple of things here at the beginning, just kind of quick logistics, the usual disclaimers and safe harbor and then we'll get rolling with the agenda. So of course, for everyone on the webcast, thank you for joining us. We're going to run through a pretty full agenda here today that will go until about 5:00. We'll save questions to the end because we've got some time at the very end for all of our executive leadership and the speakers to come back on stage to talk and answer some questions. So if you can hold the questions until then, that would be great. First, of course, today, we're going to make some forward-looking statements. There are, of course, always subject to risks and uncertainties, and so we direct you to our SEC filings, our 10-K, our earnings release for any disclaimers as well as talking about non-GAAP items. And so you can also find the reconciliations to those measures in our filings. And so please take a moment to look at those if you need to. A couple of things we're quick about today. First of all, thank you to the NYC. Thank you all for coming here. It's a great location. Really appreciate everyone showing up. I've been here for about 5 months now. And I'll say that when I joined the company, I think I saw a lot of the same things that existed that a lot of the other leadership team has said. They just saw this company that was really serving the health or ecosystem in a way that had a much larger opportunity to make an impact on how health care experience in this country. And so I was really, really impressed by the team when I came here. But one of the things that I've noticed here and we've talked about the business itself, is that, well, as we talk to investors, I think there's not this wonderful understanding about how our products or solutions actually impact the entire health care life cycle, everything from when someone is looking for insurance all the way through to paying it. And so today, what we're going to do is spend some time walking you through that life cycle, walking you through our products and how we actually address all parts of that life cycle. And then ultimately, we'll close with a discussion about AI and our financials. And so I'd like to kick off first with the video that kind of talks about that life cycle and we'll kind of set the stage for the day. So if we can roll that video, please. [Presentation]

So that's what we're going to talk about today. We're going to walk you through that life cycle and bring to you the agenda that walks you through the different solutions we sell, our customer base and ultimately how that feeds our business model. So we've got a pretty full agenda. We're going to keep things moving along pretty quickly here. We'll kick it off with Travis, our CEO, to talk about our vision and how we execute against that vision. Then we're going to walk through step by step from the left side, from the employers looking for insurance for their employees, to the provider world, eventually a claim gets created and talk about our core solutions and then ultimately talk about the payment cycle. We'll then wrap with a discussion about AI, and then Doug will wrap it up at the very end to talk about how that all feeds our business model. We got a great set of speakers. We've got a number of people here from Claritev, both across the executive team and going a little deeper as well. And then I'm most excited here that we've got a bunch of customers and partners here as well. So I thought we would be a good chance to give you the opportunity to hear from some of our customers and hear how they think about Claritev in the market in general. So to start, I'm going to bring up our President and CEO, Travis Dalton, to get it started.

Thank you. Appreciate it. Welcome, everybody. Thanks for being here. That video seemed pretty simple, right? Does anyone had a health care experience that actually worked like that? Health care is pretty misaligned. We operate across that continuum. We're going to talk about that today. I actually think that there's a moment coming where things do start to be more simple. You've got a situation where you have technology and AI, data and interoperability have been the thing over the last decade. And I think there's a moment where providers and payers start to align, and you'll hear from them today. So we have one provider client. We have a payer here. At the end of the day, I think they want the same thing. Providers want quality, cost and a right price and payers want to manage risk and a fair reimbursement. Those 2 things can live together. We actually believe that. Anyway, good afternoon. I'm Travis. Thanks for being here. Todd, thank you for setting this up and all you've done. We appreciate you. I told Todd after our investor calls like if this doesn't go well, say goodbye to tide. All right. So he is totally redeeming himself today so far, so far. So this -- but this is a big day for us. And obviously, I started 2 years ago here, and they've been kind of gearing up for this, looking forward to it for some time. So we're happy to be here. Getting the content, but people time to time, ask me, how are you doing? I'm doing freaking great. I'm doing great. I mean, we've got great clients. We've got a team that you're going to meet today, which is 1 of the exciting things for me as you get to see the team. and we've got purpose. And if you put those 3 things together and you execute long enough, good things happen. So for me, I get super motivated every day to work with a great team on stuff that matters. And that's kind of why I came here. And so we've got a fulsome agenda, as Todd mentioned, I'm going to jump right in, and we'll push forward. So our purpose is simple. The words are simple. It's not always easy to achieve. But we will be laser-focused on transparency, affordability and access, had access because of our network, which I think is unique to us in many ways. Really, this idea of reducing friction, I think, is part of what we do today, but it's a big part of the future of how we see the company evolving over time, and you'll hear about that today as well. And we'll make decisions, and we will allocate capital against the clarity of our purpose, which should be simple. And so the reason you have purpose and you have clarity is because every day, there's -- the micro decisions get made every day across our 3,000 people. If they know what they're deciding against mentally, they make a good one. That's why we spent time on clarity as the first part of the company's formation when I got here, clarity alignment the focus. So our purpose is going to be simple, to quote the great movie Office Space. What would you say you do around here? This is what we do around here, right? So we serve an incredible set of clients over 700 payers, 100,000 employer and plan sponsors, 1.4 million providers, over 60 hospitals directly now in patient care settings, and 60 million plan members. Our solutions are focused around our network. So many of you are familiar. We think that's a unique asset to us, and you're going to hear more about that today from Jerry. Really focus on access and cost. So our network, we're investing in our network. We think we can -- it's more malleable. We think we can curate networks. So I'm going to talk a little more about that in a minute. Claims intelligence, fair reimbursement, bringing an insight to what is an otherwise pretty opaque situation in health care, particularly out of network. And so we're known for that. We're going to continue to do that. We're investing heavily in surprise bill. You'll hear about how we're using AI today inside of our surprise billing solution, our NSA solutions. Payment revenue integrity. So I was really glad to see the demo set up over here and a lot of folks around it, but that is a massive area of growth, I think, looking at fraud waste abuse and inefficiency. So I'm not even imputing motive, it's just a lot of inefficiency in the coding world and how that works. And then finally, data and analytics, so bringing pricing transparency, prediction models, managing risk, this idea of looking at high-cost claimants and how do you handle that? So our friends from Kinetic Health are here today to talk about how employers are managing cost using this kind of data. And so that's a lot of what we do. The other thing I'll say, and for me, it's all growth, all growth. So I'm not going to say [indiscernible] the network is going to do all freaking growth. So I came here. So it's not just 1 area we expect to grow. We expect to grow every single area of our business across all these segments as we go forward, and I'll talk about how we intend to do that. And so that's what we do, you'll hear a whole lot more about that from the team. Look, our journey, I said this, those of you that heard on the call, we set out with a Vision 2030 journey and that idea, not Vision 20 minutes, not vision this quarter, not vision tomorrow. I know that's important. Short-term results matter, intermediate plans matter, but a long-term view. You've got to think big to grow big. And so we're thinking like that, and we're thinking bigger. And we're executing against this. And we came and said, "Look, we're going to lay a foundation for the company." And so I'll talk about what we did there. We branded last year the turn, which was kind of a bold thing to do at the time. I said the words before I was sure it was going to happen, speak it into existence. But I felt like we had good plan, enough execution, enough smart people to figure out, and we're figuring it out, returning to growth more quickly than I had expected, frankly. We're calling this year the way up. So it's a growth year for us. And the way forward is really around innovation and technology and expanding our client base. So this is our journey. The team, my team knows, I use it all the time, say-do ratio has to be 1:1. You say you got to do it, and we're committed to keeping our promises. And so I think it's important to make sure all of you know that as people that are interested in the company, you have a financial interest, some of you have maybe put some of your personal credibility on the line for us. That's not lost on us. trust me when I tell you this. I feel a debt of gratitude for that, but I also feel responsibility, right? And so we are we will keep our promises. In '24, we started the company. We not started, but I joined. We set out to create client focus. We have 30 KPIs that we use inside the company. That is my report card to the Board. All of our associates know that. We restructured our debt. You see familiar friendly faces in the room. I'm sure that, that was a blast for all of us. I think we finished that at 1 on like the 24th, January -- December 31, something like that, we got it done. That was a big deal for us. There are a lot of things we could have done, but for me joining, that was a big moment and going to the Board and saying, "Look, here's what I want to do. out to run this company for growth over a period of time." I don't want to take other alternatives that might have been easier at the time, but we thought it was the best thing to do is keep our promises and commitments to our debt holders who I think we owed commitments to. And so we restructured our debt to go forward to make sure that we were doing that. Launched our plan for 2030. We'll talk about it, and then we refreshed the leadership team. So that was an important year for us. In '25, we rebranded the company not to put new paint on there, but we earn the right to rebrand because we're executing against a technology refresh. We launched new markets. So last year, we reported out $67 million in new bookings. That's new ACV bookings for us, which was a great year. We moved to Oracle Cloud. At the time, that also was part of our strategy was not just new market expansion that was positioning for a tech-forward future. That's important, particularly in an AI world, right? So that investment we made in '24 is starting to pay off for us as we look at our present and future. We renewed our top 10 clients. This is not a melting ice cube cone. It is not. Then asked that for a long time. We are going to grow the company, and we're going to talk about that today, I'm going to give you clear examples. And we returned to revenue growth right? I think we exited 6.7% year-over-year growth in Q4. Is that right, Doug? Keep me honest? Close enough. Close enough for the CEO, he'll clean it up later. But we returned to growth. That was a good sign. It's a good sign and as we go forward. So 26, we've branded as the way up. So we're forecasting single-digit growth. This is -- I can announce today, which is an exciting announcement for us. We actually, in the last 2 weeks, have signed 1 of the top 5 largest health systems in the U.S. to a multiyear managed services agreement. So we will be providing Tier 2 support for the EMR and their clinical systems, in addition to opportunities to sell through all of our products and services across the entirety of that health system. And this is well over 500 points of care, well over. And I'm not going to say the name yet, but I'm going to announce that we're firmly in that business. So that puts us significantly ahead. We start -- you'll hear from 1 of our great clients today who is our pioneer client, the Carlinville. We're now moving upstream into much larger venues, which was our plan all along and making it real. Keeping a promise. I said that the day I got here. We're going to do that, and we did it. I also can announce that we were selected -- I mentioned we had some government news to announce. So in the government vertical, we were just selected with our partners from GDIT to be the network for the World Trade Center. So we're going to create a national network for first responders as part of this opportunity that was awarded with our partner from GDIT. This is a huge win for us. This is something, again, horizontal products, vertical markets. We would not have bid that in the past, but we did it because we started looking across new vertical markets with existing products. And it turns out our network is highly expansive, and we're able to curate it in a meaningful way, which was very attractive as you look at the way that the movements have been demographically for first responders over a long period of time. So we can create that network. That's another big win for us early this year that's come. We've had -- we expect growth in new logos. And then I've -- our Chief Growth Officer is here. I'm not resetting our guide today, I'm not doing that. Todd, make sure you heard that, Todd. What I am saying is we've challenged our team to do $100 million in sales. So I'm expecting the team to do $100 million in sales. That's what we're going to quote them against, that's what they're going to get paid against. That is our goal for our team is to deliver that. And so as I think of all that, I look at it, and I think we're delivering our promises, and we know how to sell around here. So where I came out of it did for 20 years, and it's starting to show up, which is a good indicator for our future going forward. So we listen, we saw problems and we sell. All right. So this is -- this says vision but vision, vision has really become strategy, has become reality because we're executing against it. And when I step back, 3 things jump out. One, we're laser focused on our clients, which we said; two, we're going to be technology-driven investing in technology, not just Oracle, but other technologies. You'll hear from our Chief Digital Officer. And we're going to be product led. So we're making more stuff. We're making more products. You'll see our road map today. Again, there was no road map when I came. I asked for it on my second day here and it did not exist. We have one now. When you have road maps, you can tell clients what's coming, they can budget for it, plan for it, you can sell more stuff. And so the idea of creating product-driven road maps, listening to your clients, yields better results over time across multiple verticals. That's how the company is going to grow. And really, I would tell you, we're doing it from the bottom up. There are a lot of choices that could have been made. But ultimately, the choice that we made at the senior leader and Board level was we're going to build the company for growth over a long period of time. So we're investing in our technology infrastructure, Oracle Cloud, but also development tools. We're investing in our data platform. So the ability to structure data and use that data in a meaningful way against AI tools and capabilities embedded in workflow, more clearly defining our products. And as I mentioned, we're launching managed services business this year. We think that gives us a massive opportunity for client acquisition to pull through all of our products that we think have benefits, and there's a big need for that in the market. And so we're going to be aggressively pursuing that. And then as we've said before, we've talked about horizontal products and vertical markets. And I've highlighted a few today, but we had -- I would just tell you it's working. We had 30 new logos last year. And so as you look at that, we had 4 international clients that we signed, 16 payer and TPA clients, 6 providers, 1 government agency, 2 employers and 2 supplemental. These are net new clients. So we're 10% to 12% less reliant on our top 10 than we were 18 months ago. That's significant for us. So that allows us to diversify the business, allows us to withstand some things beyond our control. It allows us to grow in a more robust way, and it positions the company for success over a long period of time. We're a more robust and healthier by far than we were in 2024. And so that's a good thing for us. And I've mentioned some of the specifics. I won't necessarily cover them again, other than to say we think that some of those things I've announced are really a good indication for us as we go forward, that our strategy is working. And so we'll continue to focus on that in a material way. Okay. So kind of 1 more slide, and then I want you to hear from some clients. We're very confident that we're well positioned for the future, very confident. Confidence is one thing, proving it in reality are another. And I'm -- I think that there are going to be 3 things that are going to matter. All these things you see on the screen are true. We have a network at scale. Not too many people can compete with that. We had the largest PPO in the country. We also can curate it now with products and advancements we've made, which you'll hear about today. We do have high provider acceptance. So we have low abrasion in our services across our portfolio. We're very good at regulatory and responding quickly to regulatory change. We have depth of client relationships. We also have proprietary data. And so we have thousands and thousands of embedded business rules inside of individual solutions for clients. And when you think about an AI future, which I'm sure we'll talk about more, which Fernando is our Chief AI Officer, will come up in a little bit. Data rights, workflow and trust are going to be the 3 things that I think separate winners from losers. And data rights are negotiated with clients and in health care because it's PHI and PII, data rights become the moat because the data is to be used for client-specific use. That's how we use it individually. That's different than I'm trying to how you acquire toothpaste is different and happening in health care for years and years. You see the data becomes the advantage and the ability to use it because you have the relationship and the data rights agreement on how you would use that is important in health care. We're embedded in the workflow. So as I mentioned, we have proprietary rules. We have IP that's not easily recreated by anyone, including our clients. And we have high value because we have workflow embeddedness. And then ultimately, we have trust. There's a belief that we'll be responsible because we've been responsible with our clients over many decades. And so as you look at those 3 factors, our view, and I think it's going to play out in the market and it gets starting to, in some ways, it's early, is that platforms just point solutions will be winners in an AI future, that data rights are going to be the moat and that AI will accelerate product development. And so as we think about that, we view the winning formula as platform plus proprietary data, plus embedded AI equals winning. And that's us. That's largely us in the area that we serve. And so we're not just -- we're not fearful of the AI revolution. We're actually here for it. And we have a team that's using it today. We've been using it. We have real examples. We're driving real value and real automation inside of the business. So we think it bodes well for us both on the top line growth, but also in terms of operating leverage over time as we advance the company. And so why Claritev? We think we have a competitive advantage. And we have to go prove that out. But I do believe it's starting to show up in sales backlog growth and forward-looking metrics, and we'll talk more about that today. Okay. So that was the wind up. I think I'm more or less on time. But what's most important, I think, is that you'll hear from, not just from us, but you hear from some of our clients. And so what I wanted to do was bring up one of our clients. So I'm going to welcome Mike Feeney to come up. He has been an employee benefit space for some 25 years, founded Trace Health in 2021. So I have a high respect for the founder story, which is great. Also, tech forward, very much so. And then I'd say, focus on underserved communities in some ways, which is a real message, which is on purpose for us considering our relationship with National Rural Health and some of the work we're doing. So Thanks, Mike. Welcome. Well, you can sit down, we'll sit down here and do a Johnny Carson style or whatever it is, dating myself. But thanks for being here. Why don't you just tell the group a little bit about yourself.

Yes. No, I appreciate it. Thank you for being here. thanks for having you here. So Trace Health. Sorry, I lost a clip. There we go. Trace Health is a bunch of things. And I'll start by saying who we serve. We serve a lot of variable hour employees, underinsured, small- to medium-sized businesses, all in the level-funded, self-funded arena. We are a payer in our core. So we're a TPA, a third-party administrator. We're also an MGU. What that means is we're a managing general underwriter, we control and manage the risk associated with all of our plans. What ties that all together for us is proprietary technology. In order to deliver a good product quickly to a variable hour employee, maybe it's a driver, maybe it's a restaurant worker, whoever that might be, and have them understand their benefits quickly and be able to access it is very important to us, which is why partnering with someone like Claritev is very important to us. They have the same vision to serve those communities and with a tech forward approach.

Yes. And you kind of hit on it, but I mentioned our focus on affordability, transparency, access cost. How are you all using some of our solutions? And how are you thinking about that?

Yes. And I took some notes because you you brought up things that I forgot I was -- we were using with Claritev. So mainly, our big piece that we started with Claritev was networks. You mentioned the vast network they have One of the interesting things for Trace was we were able to tap into their API to utilize their network search. I think we might have been the first one to do it. I'm not sure if anybody else is. But basically, it allowed that small group, that small employer, that variable hour employee to go on our app and quickly search a provider, find a provider, get quality of care scores, cost transparency, all those things, we're able to incorporate using an API through Claritev. Claims intelligence. We use BenInsights, Claims analytics, very important for us as an MGU, managing small group health plans that are self-funded, very volatile. Very important for us to know what the risk associated with those plans will be. Reference-based pricing, which I think is a very fast-growing market, specifically in the smaller groups. So reference-based pricing as well as the repricing. You mentioned NSA, the amount of network services. We -- and I'll steal 1 of your lines, we like to go vertical. So when we have a good partner, we try to use as much services as possible and especially if they're tech forward friendly, which obviously Claritev is. So all those services we provide are necessary in our marketplace. We move very quick. We add a lot of really small groups every month, and they have to be able to move very quickly as far as getting benefits, getting ID cards, finding providers understanding when a claim is being paid, understanding what an EOB is, all those things. And with our connectivity through Claritev, we be able to access that.

Yes. I think you guys are using Vistara, and you're using BenInsights, which is great to see the use. The more use we get, the more we listen, the more use cases we find. And so we think that data analytics product actually is very important for us going forward. The other thing you mentioned was APIs. I didn't talk about it, but that was another reason that we set out on a technology vision was because we actually thought we could produce APIs off of that. and become a platform versus simply a point solution, right? And so this idea of being a platform really hinges in some ways off your ability to serve up APIs and other data. It's also another competitive moat and frankly, it attacks our competition. because not all of them are doing the same thing and some of what they offer are just commodities in my mind. And so we think that, that has multiple parts to the strategy is using those APIs -. So I'm glad to hear you using them. And that you remember you're using. So that's good. Look, we talked about -- I talked about some challenges. I didn't spend a lot of time on the macro health dynamics. But maybe you're living it every day. You're seeing it. What are -- how do you feel about some of the challenges you're facing? What are some of the bigger ones? And what do you need to be successful?

Yes, as a payer, specifically in the market we serve, technology is the only way I believe that you can successfully move forward in that marketplace and scale. AI on the top of the list. The ability to -- if you know the landscape of health care, insurance companies, TPAs, it's a variable degree of technology, right? Some are good, some aren't. That's no knocking anyone else. Claritev, I think, has been the best and are still getting better. And that's crucial for a member to know their benefits, to be able to access their benefits, to be able to understand why claims are being paid, why claims are being denied, how to find a provider. All of those things, specifically in the world we live in with rising cost of health care and specifically in the Space almond, which is small group health care, technology is the best way to educate and to inform and specifically, again, as being an MGU with managing risk, very important that we know what's going on within our groups and within our population.

Yes. And how are you -- just kind of one other question for you and I'll let you add anything you want after that, but how are you thinking about AI? Are you getting approached by like lots of point solutions. We didn't really rehearse this, but are you seeing just a bombardment of that? Or is it kind of hard to figure out what the landscape looks like?

It's become more and more -- when we go to these events like Asia, there's just a lot of people walking around, trying to position their AI tools. for us where we see it -- what we've done so far versus where we're going. For now, we've done -- doing a little bit of customer service, so provider calls. Provider calls typically go into the TPA. They sit in queue, and there's a call center waiting to answer or respond. A lot of those questions can be answered very quickly rather online or just some data insight from the AI tool. So we're starting to incorporate that. We also have an AI widget internally that helps us know our book of business from a membership level and claims perspective. And then where we want to go is we want to be able to have analytics that will help us to understand the risk, it will help make decisions. It will help at renewals. It will help have members understand how their benefits are being used or what prescriptions to get. So there is a whole way to expand into the AA market, and being in front of it and the insurance is going to be foremost.

Yes, absolutely. I mean we see opportunities in our call center, we see opportunities in financial negotiations, IDR, those are all areas that are, I think, really well set up to use AI to get better insights. And so our team will talk about that a little bit more. And I have a huge respect. I mean we could have -- we had quite a few clients that wanted to participate with us today. We actually asked Trace to come up because of the entrepreneurial journey, I have a lot of respect for that, but also you guys are thinking because you're new to the market, you're serving, there's a level of creativity, right? And so it's highly beneficial to us to work with creative partners that are challenging our tech forward posture. And so that's why I really was happy for Mike to come, which I appreciate you being here. Is there anything else you want to add? And if not, we'll move on to the next phase.

I would just say I've -- as a founder, we've gone to -- we've spoken to a lot of companies similar to Claritev. To us, there's no one else that has been more forward thinking as far as what we're trying to do from a technology perspective. And I think it's really important because as most of you know, the space has always been behind. And I think we're collectively moving it forward in a space that's usually underserved or don't understand this benefits as much as they should. And there's a -- now that we're able to deliver it through these tools, I think it's important.

Okay. Yes, I appreciate it, Mike. And Mike, you bootstrapped it I don't know if you're looking for investors, but there's a whole bunch sitting right here. So Mike is here, if you want to talk to Mike.

I left my carpet there.

All right. way, I appreciate it. Thank you so much for coming in. Glad you made it. Thank you.

Thanks, everyone.

Okay. So all right. So just to reorient it back. So to the video, you talked about claims life cycle, when to start with payer that's thinking about technology in a unique way. We hear about employer next, and then we'll have provider come up as well. So I'm trying to orient you back to where we started, which is that life cycle of a claim and think about where we fit inside of that continuum over and over. So with that, I'm going to call Sean up, Sean Crandall, who's our GM SVP of Claims Intelligence. And I always tell people, if you want someone who knows some stuff, Sean knows some stuff, man. He was probably the #1 resource for me when I joined the company in terms of educating me on a lot of things. So I encourage you to find him on a break or otherwise because he's wildly knowledgeable in the area. And all around, great guys. So Thanks, Jon. Appreciate it.

Hello, everybody. How are you Good. All right. Again, Travis, thank you. Sean Grandell, I head up our claims Intelligence Solutions. We heard a couple of themes in the last presentation, really around some things I want you to think about, like complexity of care. And you've heard risk, okay? These employers and payers are really trying to manage risk and how do they do that, okay? Again, the traditional model is you have a broker consultant that's working with the payer, okay? And an employer. So what tools can they use. And again, the HR team, you'll hear from some HR representation right after this, is that HR team has limited resources, okay? What tools, what technologies can they use to look at cost, risk? What are they offering their benefit plan? So I will walk through one of our staple solutions within our data and analytics solution line, which has been insights, okay? And then I'll walk through our partnership with Kinetic, and then we'll really talk about realizing the value of an insight. Because I can tell you about an insight, but I need somebody to take action on it that actually translates into value, okay? So with that being said, let's take a look and dive a little bit further into what type of issues employers are facing today. When we're really looking at it, there's a number of different things that employers are faced with, with very limited resources internally. Imagine trying to consolidate different data sources, which is health care spend, Rx spend, admin fees, et cetera, all onto a consolidated platform. That's a very difficult thing to do. A lot of times, our HR people are having to work with their brokers and consultants kind of retrospectively to say costs have already happened. They are going to be happening, okay? How do you get ahead of that and manage a little bit more proactively, and I'll touch on that in the base -- in a minute. One of the other things that they're dealing with is, as Travis and Mike talked about earlier is point solutions. What point solutions are the right ones for the people that I have, okay? And how does that fit within my actual benefit plan design. So really looking at a solution that starts with an employer making a decision about their benefits, okay? The last is -- I really talked about is the complexity of the ecosystem as an employer, and you're going to hear from the employer lens of this as well is, am I being a fiduciary, okay? Am I making the right decisions for my employees? And do I have the right vendors in play? So again, going back to risk and cost, 6.5% an annual increase year-over-year is a tough pill to swallow, okay? That's tough for not only the CFO, but it's a tough thing for employees as well. So how do we provide solutions that basically bend that cost curve, okay? And the first fundamental thing we really have to get and we work with employers on is the difference between being reactive versus proactive. So instead of 6 weeks before renewal, let's put a bunch of reports together. And let's see if we can cobble together something that decreases our renewal rate, okay? This cycle and with BenInsights that we'll talk about, it has to be a continual ecosystem where it's engaging really around the 5% of the population that account for a vast majority of the spend. How do I engage those people before things happen to make a material impact? And you'll hear real examples of that, okay? Again, the other things that when you're proactive, you can really match cost to quality. So how do I proactively engage to make sure Sean goes to the facility that fits what's the risk profile is within [indiscernible]. And so we'll talk about that momentarily. But again, being proactive translates to actual value, okay? So if I can get ahead of something that 6.5% goes a lot lower, okay? So highlights just -- I love the view of -- the way that we look at this is, is truly a partnership between the talent team, our finance team to really analyze employer data across the organization, again, to really reduce the spend, how do I gauge, how do we make a better benefit package for my employees to use through a consolidated platform, okay? A few key things as well as we will continually try to get this -- so somebody is not just accessing another system in another -- we want to seamlessly integrate this into the employer experience through various HCM platforms as well. And last, but not least, the advisory aspect of it. Like our platform, BenInsights, generates insights and engagement tools, okay, that somebody can take action on. And when they do, that shows back up on the platform. So it's that continual evolution of the actual platform that makes it so value-added, okay? So with that being said, I'd like to bring Sarah up here from -- Sarah Michaels from Kinetic Health. And Sarah is a practicing nurse as well as the Chief Clinical Officer of Kinetic Health. And Sarah is a partner of ours. And when I talked about actually getting value and realizing value, our partners are the ones that are helping us do that for our employers. So Sarah, can you kind of give a brief outcome -- or overview of Kinetic Health, what you do and really how we've interacted with the insights and the tools that we have?

Yes. And 1 honor is to be here presenting as a partner today. We ourselves have been clients of Claritev for the past 10 years. Really, the company was created as a result of BenInsights and the insights we were able to gather. Kinetic Health exists to enable benefits, employer benefit strategy. We want to help enhance benefits. And we do that because we use the data analytics tools and we pair that with the clinical lens to transform health care risk management as it exists today. Think of us as a team of clinical consultants for nurses, pharmacists, dietitians, registered licensed clinical social workers, the list goes on, but we are versed in the benefit space using our clinical insights to actually figure out how do you manage risk at the individual member level, and we do that by using the data insights to identify who's going to be an ongoing risk to the plan as well as who is at risk to being a large cost claimants. RAN did a really good study, and that's actually where Kinetic grew from. RAN found that for every $1 employer groups for investing in wellness programs. They only got $0.50 back on that dollar. But for every dollar they invested in health programs, they saw a $3.80 return on that investment. What does that mean? It means that for too long, we use the 2 words interchangeably, health and wellness are actually 2 completely different concepts. Wellness is lifestyle management. Who has a condition to -- or who -- lifestyle management is how can I prevent something down the line? Tobacco cessation is probably the most well known in the employer health space. We used to incentivize tobacco cessation programs, but the problem is that requires a workforce to stay consistent for 20-plus years in order to see your ROI on that dollar, whereas health is who has a condition today, think about cancer, think about a high-cost medication. And if you actually pair yourself alongside that member and you actively manage those claims, the concept is quite simple. You improve lives. And as a result, you decreased the cost of health care as a whole. That's why we've really created this partnership, which is use the data to create those actionable insights to actually change the trajectory of a claim.

So Sarah, let's talk a little bit about how would be your model? And what is the missing link that you want to get across to employers as you're talking with them compared to the traditional models that are out there today?

So [indiscernible] groups, we don't have a data problem. In fact, you guys know that data is everywhere, especially in the world we live in today. What I love is now we have a tool that combines all of it to create those easy insights. We're looking at medical claims, pharmacy claims, clinic data, even any sort of payroll data that we have that we can get into one singular platform to create those easy insights for us. What you had just shared a little bit ago, I want to extremely highlight. 5% of members are making up greater than 50% of health care risk. I'll go one step further, and I say it's usually only a handful of individuals who are making up 50% or greater of overall claims spend. Think about a self-funded employer and what that means for a group. We're talking 5 people might be truly driving all of their claims costs. I had a group last week where it was one individual who was spending over 75% of the total planned spends. And when we looked at the data, for a while, we said it's not a data problem, it's a decision-making problem. What are we doing? Are we just taking reports and being reactive to those reports? Are we saying, "Hey, where can I actually intervene to change that trajectory of the claim?" And so Kinetic Health really does just that. We want to work not just with the tool, but directly with the plan members because the best claim is the claim that we can actually avoid we want to be in front of that. We want to work also with those carriers to be able to say what prior auths exist today. What case notes do you guys have to say what the trajectory of this member's care looks like? And we can't just rely on the patient alone to change the trajectory of their claim. We have to actually work directly also with those providers to say, "Hey, if we realize there's a discrepancy, what can we do about the discrepancy to start decreasing cost of care?

So one of the things that's great about this as well is, again, BenInsights is also available through the Oracle Fusion HCM ecosystem, really getting that direct feed of data to employers. So the future view it's hard for employers to access data, okay? Getting that consolidated view on the same platform that their HCM system is, it brings together the latency of data and puts it right in the hands of the employers. So Sarah, can you walk through a couple of case examples, maybe let's start on the medical side, of really take insight and form it into action and real-time value for that employer?

Sure. This is actually one of my favorite examples because if you read on the screen, this was a group that was only 75 employee lives. We're not talking large scale. We don't need to go to Fortune 500 companies. We can go all the way down to these small groups and really make a huge impact on their claims. This was a group that was running exceptionally high. But when you looked at the claims data within the platform, we saw that there were only 5 individuals that were driving nearly $1 million of the total plan spend. As a result, what does the insurance carrier want to do. They wanted to laser or add excess risk to those and the amount of nearly $1 million. Now the power of using the data analytics platform, it's given me a complete clinical picture of what's going on within those individual members. We can pull up all 5 people, and we can look down to a Band-Aid level. We can see exactly when the diagnosis had occurred by looking at when the scans were done. We can look at how many rounds of treatment have already been done. And we can use our clinical insight to actually judge what the future spend is going to be on the clinical insight we're able to gain. When we did just that, we also work directly with the carriers. We got those additional case nodes. We found that for the majority of these individuals, they were actually already in remission. We found that for others, they simply needed a maintenance medication. What the power of all that data allows us to do is negotiate directly for that employer group. We were able to remove all of that excess risk replacement with only a $250,000 aggregate and specific deductible. And for that 75 life group, they were able to save over $700,000. That is a very real example of how you can leverage the data, you're managing it on a monthly basis, but more importantly, you're bringing power to your employer groups when it comes time to go into your renewal by presenting all of the facts.

So a great example of actual fixed costs, but there's so many other applications that this could be used for really identifying low quality of care with high complexity, high complexity of care, low quality. So there's so many different like use cases for the data. And when you pair data with clinicians that take action and delivers meaningful savings. So this is not just on the medical side. Do you have any other examples like really on the pharma side that could also talk to?

So you guys know these costs are rising every single year. oftentimes trend is expected to exceed double digits now in the pharmacy increase alone. That is because not just pharmacy spend, it's actually those hidden medical drugs that are being infused on the medical side. And so that's why groups often come to me and be like, we don't have a drug problem. You actually do because if your pharmacy costs are low, chances are, your highest costs are actually hitting on the medical side. That's why it's so important to have a tool that you can actually go into the data to figure out what are those medical J-code drugs that are running on your medical side. This was a perfect example of the work we do on that monthly basis. The key is a monthly basis. As the tool is getting loaded from the carriers, you want to be analyzing it every single month. So we identify the first month that hits rather than waiting until the full 12 months of the plan you have hit. This is obviously going to help reduce overall risk. Well, for this specific client, they had a dependent on a very rare medication for a rare form of dwarfism. This medication was being infused at $55,000 per week. It was going to be ongoing for the entire life of this dependent. So as long as this member was on the plan, this claim was going to be on the plan. We were able to use the insights that you probably saw demoed here today to figure out the acquisition cost of that drug was actually $11,000. That markup was coming from the provider directly. Now this seems like a crazy scenario, but the reality is we see 400%, 500% markup every single day. This is real. It's why eyes need to be in the data to figure out, again, how can we intervene at that specific individual level. When we did just that, we were able to go back. We did not want to take the member of this medication. And in fact, we didn't even want to change the place of service. This child had been going to their provider for several years, but we needed to work knowing this data directly with the carrier, get a phone call directly with the provider to say, "Hey, we know the acquisition cost is close to $11,000. How can we negotiate this to keep the member getting the same care from your facility? So they actually met us at the $11,000 acquisition level, charge a simple markup for the actual administration of the medication, so they still made money at the facility level, but we were able to save this group $44,000 per week, which equated to over $2 million of planned savings every single year. That is the power of using the tool, taking the analytics and actually doing something with it.

Thank you, Sarah. So I just want to recap. We have the BenInsights platform just drives insights to our end users and now having partnerships available for our employers to solve some of the issues that we talked about, really drive sustainable value. And again, that -- like the annual increases that employers are faced with, if we can take that and really reduce the cost of care, and I'm going to bring up Douglas Garis and Carol Letter now and to really give another example of a real life use case of BenInsights. Thank you, Sarah.

Hi, everyone. How are you doing? All right. So I think we've joked around before and say, we have to eat our own dog food. And our case study is really talking about how we use our bed insights tool and ourselves, which we think is an incredible platform and something that we're excited to talk about relative to our experience. So I'm not going to beat this to death, but it's no surprise that health care costs are out of control for employers. What people realize through the evolution of plan design and health insurance acquisition, the employer is the one that is responsible for most of the care with respect to employees signing up for health care. For a CFO, health care costs are my second largest P&L item only behind what I pay my W-2 wages. So if I think about it, my per employee per year expense, and most companies is anywhere from maybe $6,000 to $12,000, no exception here at Claritev. So you look at this envelope of increasing price I'm left with a very tough and dare I say, abrasive conversation with Carol. And...

I would say it's abrasive.

It's fantastic now. But I think traditionally, what we're trying to convey with our BenInsights platform is the conversation, we think should be different. So as we go into a planning year and as we go through our benefit design process on the windshield is once in more than a decade health care inflation, and that is not easing up anytime soon. So there's 2 perspectives here. There's the mean Grumpy CFO who says, "I got rising cost, I need to manage my P&L. I need to manage margin." And then also on top of looking for cost avoidance, I'm also managing my fiduciary responsibilities, right? We're a public company. We have a whole lot of things that we have to make sure that our plan design appropriately captures thinking about ERISA. But at the end of the day, we have one ultimate end goal, and this is where I'm going to turn it over to Carol and speak about our experience with BenInsights because we do have 1 shared goal. I promise you.

We do. I mean I will say that I have been in this space for 25 years, and I -- this is the first time I've actually shared stage with my CFO because of this shared goal that health care and health investment is huge. It's a huge part of my job, and it's a huge part of Doug's job. But when we really started looking at our platform and leveraging our own platform, we said, wait a minute, we both had the same shared goal, which is how do we maximize the benefit for our employees but also maximize the benefit for our company as well from the economics. And so Doug, yes, he's a dollars and cents person, and I really look at it from the workforce. So how am I attracting, how am I retaining, how am I engaging a workforce through health care, right? You have to be competitive, you have to differentiate yourself in the marketplace and health care and what you're offering your employees, we call them associates is meaningful. And so after I've been doing this for about 25 years or so over that period of time, I started looking at my health care investments, what I call a true value. So that's T-R-U-E. So first, talent. Is my health plan or is it really attracting, retaining talent, return on investment? Is there a meaningful value that I'm getting from those dollars that I'm spending? Understanding, is there an actual understanding of how our employees can leverage their benefits and engagement? Our employees seeing value? Is this where they are meeting their needs on the home front, how they're looking at their cost? And before BenInsights, that was really a kind of a hope dream that I had saying, okay, this is what I'm hoping to get out of it, but I often didn't, right? I looked at it once a year in a really compressed time frame. I'm getting all of this data at once. And at the same time, I'm having to make decisions about how I'm going to spend in the upcoming year. It's not a really great dynamic. And so like many employers, we're facing rising costs, right? Every year, you just kind of get it set and forget it, okay, it's going to go up. I know it's going to go up. Okay. Well, what do you do about it? Okay, I could either -- we could either just absorb the cost from a company perspective, which is many do. Many companies also share that cost with employees, which is a hard message, right? Having done this for over 25 years, going to the employees that I support and saying, yet again, costs are going up. there were years saying costs are going up and the benefits are going down. That is a tough message. And when you've got a lot of internal chat boards and things like that, it was also hard to kind of get the feedback that I was getting. But when we started using BenInsights, what we did is we took 3 years of claims data. And we said, okay, what can we learn from this? What can we learn from our own data? How are our own employees the benefits that we're providing. And we got a ton of transparency that really was transformational. And on the next slide, we'll go over what our achievements were, but for the first time and again, over 25 years, I know exactly where those cost drivers are. What's really impacting, who it's impacting, why is it impacting? And so I've got the transparency piece. But most importantly, I now have the clarity piece and say, hey, what do I do about it? How can I be really targeted and really focused to make smarter decisions about these health care dollars that we're spending. And when I really started looking at the tool and taking a step back, saying, "I've got clinical data that sordid a great job talking to us about financial and workforce, I've got the trifecta of all this information that now, in a predictive targeted way, Doug and I can partner and say, "All right, what do we do? How do we best leverage these dollars, again, for our associates, our employees and also from a financial perspective of the company? All right. So what did we hear, Doug, do you want to start. drumroll, please, drumroll, please.

We saved over $1,200 per employee on our health plan in 2025. without sacrificing benefits in a year where most on a like-for-like basis where most employers actually passed pretty significant inflation on to their associates.

That's right? And so we're going to start off. This is a big number, and we do want this to be up here because this is absolutely what we've experienced over the last 3 years, and not many employers can say that. And what we're able to pass on to our associates, I think, is even is even the larger accomplishment. So there's really 3 main impacts that we saw. First was financial, right? So we've got the $4 million in total benefits spend. We also did not pass any sort of employee contribution increases on to our associates. I can tell you saying that to a crowd of 3,000 people, it was a lot easier than saying, "Hey, benefits are going down, costs are going up. And that's just the way it is, right? It's happening everywhere else. You can read any kind of news article about it. But that's not the communication, that's not the engagement that I'm having with associates at Claritev. So the first was the financial impact. The second was around utilization of care. So utilization of our benefits. And the third was a stronger connection with what are the values of our workforce, what our workforce was valuing in terms of what they were looking for in benefits. And so as we looked at the data and we became very, very specific and focused on what we're finding, and as we apply different strategies and mitigation approaches, we lowered our ER visits by 12%. We adjusted our primary care physician and specialist co-pays. We amended deductibles and out-of-pocket maximums. We added 2 more pharmacy deductibles. And we also negotiated more favorable carrier contracts and increased our stop loss retention, and that was really, really big. And I did not have the information, frankly, the confidence before BenInsights to go back to our carrier and saying, "Hey, that's not good enough. And it started this negotiation, me being in a much more proactive often substance than a defensive stance that, as I said, I had been in really in 25 years prior to. So this is how the utilization of care, how we really made improvements. The last piece was around our workforce and having a stronger connection to the values of our workforce. And so I mentioned that we've got clinical data. We've got financial data and workforce. And so that's where the Oracle Fusion comes in. And so we have this platform connected in with my employee landscape data, all of those employees send this information. I'm able to see real time. So I don't just use BenInsights once a year. I use it on an ongoing basis to hold myself accountable what's working, what's not, where do I need to make a change? But the other interesting part is most companies do annual employee surveys, maybe do it a couple of times a year. We do. And 1 of the questions is, what would you like to see more of? We get lots of feedback. But 1 of the areas we get feedback is from a benefits, "Hey, I'd like to see more in X. I'd like to see more and Y. This is what's meaningful for me. So before BenInsights, those were just words on a page. And I would do my best, again, I was limited, mirroring that with the clinical information of how people are actually consuming benefits, I was able to truly see clearly what we needed to be able to offer to our employees to have that stronger connection engagement. We added more support for MSK. We added more support for women's health. Our company is made up of 63% women. We added more support for mental health. We saw a big increase with individuals that still have their children on plans, and we're seeing a big spike in needs for mental health. We also have a stronger partnership with [indiscernible] and a variety of other solutions that they're able to offer our associates, and that's directly coming from not only what we saw people, how they are consuming our health care, but what they were saying in various surveys. All of that led to a much stronger improved employee experience. We have very, very high survey results from Great Places to Work and in part because we listen. We're taking all the various data inputs that we have, and we're looking to make more informed, more targeted decisions on what we think is best for our associates. And again, because it's such a great number, we do want to -- we're going to end on, again, the $4 million in savings. But linking back to the employee -- or to the health care life cycle, so it doesn't stop with plan design, employees become patients. And I'd like to bring Jigar Patel, who is our Chief Medical and Product Officer, who's going to share with you how we support providers through our process and also the delivery of care. Jigar?

So good afternoon. Thanks for coming. My name is Jigar Patel. I am a physician. I have the unusual distinction of having 2 very disparate titles, Chief Medical Officer and Chief Product Officer. So why did I come to Claritev. It's been about 11 months. And I came for 2 main reasons. One, I get to blend my history of medical science and product experience in working in technology for the last 18 years. That's pretty unique. And to listen to the vision before I came was, we want to shift left. We want to think about providers as a part of the continuum and enhance our services in that space. And then be a technology-enabled product-focused company. So it was a golden opportunity for me to use a lot of different things I have in my background and have an impact at Claritev and in health care in general. I have, for the last 18 years, focused on scaling and how do I think about improving more lives than I would as a pathologist. The lab I ran was part of before I joined Cerner at the time, we ran about 5 million tests a year. And that probably covered about 100,000 people. When you talk about then moving to a Cerner and then an Oracle, you're talking about your scope getting even larger. Now you think about claims that cover the United States and the scope is even larger. So it's very gratifying to me to think about our products affecting health care at a different level and a different scale than I've seen before. In review, we've talked about plan design with Mike and Trace Health. How do you help someone pick a plan, then the enrollment and the understanding of the benefits with Carol Doug, Sarah and Sean. And now I'm going to focus on that provider lens. What do we think about, how do we provide care, and how do you provide the economics for that care? My entire career, I've always heard no margin, no mission. So providers also have to make a margin so they can provide care for persons, and that's very important. It's a core of a lot of why people become nurses and physicians and therapists of all kind. So with that, the challenges in health care are many. This is not a surprise. It's been the headline for a long time, was exacerbated by COVID, of course. Professional shortages. Labor and operating costs are continuing to go up and there're professional shortages across the board, go from primary care to nursing to therapists, you name the field from a medical profession perspective, and there is a shortage. Talk about the volume of data I would contend. The health care data is perhaps the most complicated set of data that's available out there from a clinical perspective, not even thinking about claims and the payments and the other things that we've talked about also. And that's why people go to school for many years to understand those things and aggregate that data over time. It's vast and rich and the opportunity to marry that to the economic side is there are plenty of opportunities there, and we want to go in that direction. The complexity of the administrative burden of health care is also wildly above and beyond, one of the most regulated industries out there. And in my career -- for the first time in my career in the last 2 years, more physicians are employed by hospitals than not. When I came out of training, you were expected to go join a big group, hang a shingle and become a small business. that is less and less true because in part for the complexity. So physicians are looking to take a paycheck home now, they don't want to run a small business. They want to take care of people and getting rid of the complexity from a contracting and how do I get paid and keep my business open has become less and less important to those providers. The big headline for the last 10 years has been also consolidation of health care providers. We're seeing a lot of them move together. You're also seeing new entrants in the fields, the Amazons, the Optums and they're taking on providers to provide services and also think about how do they capture a market that is ripe for the things they feel they have expertise in as well. Behind all of that is the complexity of health care itself. Medically, technologically pharmaceutically. It's pharmaceutically. Those are all increasing at rates that are very, very different than when I was in training. Not a day goes by when somebody says, "Hey, have you heard of this drug or what does this procedure mean? They're all brand new over time. And part of what you learn in medicines, you have to continue to learn because it is ever evolving. And the technology is pushing us there. That technology also and the ability to take care of people in a lower acuity place has made the people that do get admitted to hospitals, very, very high acuity. So that is very different than it has been in the past. There used to be an era where if you had a baby and you went into the hospital, give you there 5, 7 days, and that was fine. That's not it anymore, right? For those of you that had a kid or you're in and out, right? That's the goal. So it's the utilization of that very expensive space that people are trying to maximize. So all of these things are influence the provider market and those are cost pressures that they have to consider. So how do we help or how can we help them understand their space better. Over here, we were showing 1 of our transparency tools. We're showing the sister to the one I'm talking about here. And basically, we have taken the 5 billion public records that were required to be published by payers and providers, and taking that 500 billion records and created a solution that provides transparency into negotiated rates across the United States. Why you can say anybody can do that? When you look at the data itself, it is quite complex. And also, there is a lot of variability in its completeness. So we've used our knowledge as a company in health care economics to make sense of those 500 billion records. When you do that, you can actually start to understand in any given region for any number of payers and any number of providers, what does health care cost for any given thing. So that might be, I'm going to have an elective total knee arthroplasty. I'm going to have my knee replaced. That we can tell you down to the MSA and even to the ZIP code what does that cost in those providers in that area. What is the contracted rate for that service? So that's really important. The goal for that legislation was to have all the people in the world know what it exactly cost to take care of and do anything that they would pay for from a health care perspective. The nature of the data being as large as and as complex is that hasn't happened without a translation like use of complete view. So we cleaned that data. We give you confidence scores on how good that data is. There are gaps in the data from a locality perspective. Some people are more prone to provide accurate data than less. So we have to do that. the trick from a product perspective is to make it actionable or make it informative in a way where everyone can understand what that is. That is to give you a simulator like you see on the screen here. If we adjust our rates in our facility to be comparable to our peers in the area, what's our revenue opportunity if we go into that negotiation with a better understanding of where we stand from a market perspective. Sometimes you're going to win, you're going to win, you're below and there's opportunity for those rates to go up in comparison to your peers. Sometimes you're going to lose, sometimes your rates are higher. And that actually is probably -- you just won't mention that one. You'll keep taking that one. So how do you give people that right information so they feel more confident? And we're going to have a couple of our partners from Carlin Villare hospital come. And they're going to tell you about what do they have to do in the past to do this? And my favorite story of listening to Brian, and I'm going to spoil it now we'll have them expand on it is, he has been guilty of picking up the phone, calling down the street and asking what would I -- if I want to have this procedure done, what would you charge me? That is an unusual world when a CEO, CFO, someone in the hospital has to understand where they stand in the market, they have to go secret shop their competitors. So with all of that, we can start to then give intelligence into an opportunity for better reimbursement potentially for the services and appropriate reimbursement. So with that, that complete view analytics gives you an understanding of where you stand in the market from a where am I negotiated in the payers that are there? How do I compare it to Medicare, all those sorts of things. It also gives you insight into where is my market leakage? And could I have a service line opportunity to keep health care local for me? So if you think about rural America in particular, every day, there's a decision whether or not we bring that service here or we have to ship at 50 miles down the road to a major medical center. So is there opportunity to understand that and have a strategic investment in those areas. It could be as simple as colonoscopy services. And so if you bring those in region, you keep people closer to home and you provide something that's valuable service that can be beneficial to the provider organization, but then also to the patients. We talked about simulation, understanding where you're standing if you increase a little bit here, a little bit there, decrease a little bit here. What does that look like from a next negotiation with the next payer? The complexity of these contracts is, they are very complex, but you can go in with a better understanding of where you stand and have the data there to say, I don't think this one is fair, this one is fair, etc. And then that financial viability. When you have the understanding of where can I potentially have a better stance on the market, I can actually get to better information about where I stand with getting paid for those services and getting paid appropriately. Travis mentioned the top 5 health system that we've signed in America that we'll be announcing, hopefully shortly. But we had to justify and think about why is this important? And why is this good for Claritev? We're going to be doing technology management services. Many us have a history in that space supporting electronic health records. Well, that's getting close to the data. I talked about the complexity of that data and then how do you use that data in concert with claims data. that can be new and powerful. So this gives us an opportunity to work with providers with large data sets and see how we can marry those 2 things that are often not pushed together. So we will do the implementation applications and management of those things from a technology perspective, but work with them on new ideas around was that data good for from an economics and care perspective. We've heard from a number of folks on BenInsights in health care, in particular, one of the largest concerns for any CEO running a hospital is the health of their workforce. And that is a hard environment to be in. It's a stressful environment to be in. So BenInsights has an immediate lift to them as well as employers. We want to make sure that those professionals that are out there stay healthy, well and come to work and take care of people. And so they have to be well themselves. We talk extensively about complete view and price transparency and how you gain insights and how do you push those things to provide understanding of where you are in the market, leakage, service line opportunities, grow your business kind of conversations. And then finally, coding accuracy. We have a long experience as a company in providing accurate coding. And it can be applied evenly on any side of the fence. Coding is coding. They're objective rules and that you can understand. If you get a better code, you can get a better clean claim. And you get more clean claims, that's less people touching those and actually bringing down your cost, your administrative burden in your organization. And then venturing in with some partnerships over the years here into clinical documentation improvement. Nothing happens like in most things, unless you've written it down, and it's very clear, and you will prevent other people coming back and say, "Hey, I need you to prove this thing? Or what's the substantiation for this thing if your documentation is better as well. So with that, I have the pleasure of bringing up Mr. Brian Burnside and Jay Hodges. Brian is the CEO of our [indiscernible] Hospital in Illinois. And Jay is the Chief Financial Officer there as well, if you gentlemen want to come over this direction or wherever you want to and they're going to talk about their story, Carlin Villari Hospital and how they've worked with Claritev to go from having less information to having more information now. So take it over to you, Brian.

Thank you, Dr. [indiscernible]. And just to clarify, it was always my wife who called a competitor to find out about the MRI [indiscernible]. I'm pleased to introduce Jay Haas Jay is our long-term CFO, and really excited to have him with us today. And we'll have a lot of conversation about what Claritev has meant to our organization. Let me start just by saying something really simple. Our hospital is in the middle of a corn field, okay? Before you throw a lot of shade on that though, let me tell you why that's important because we are also a sophisticated health care organization that's looking toward the future. of the rural transformation in health care. And I was really pleased to hear Travis to describe us as a pioneer organization in terms of partnering with curative because we believe that what we've accomplished with Claritev's guidance in our organization, certainly scalable. And certainly, you can see that with their most recent announcement of the systems in the country. So we're really excited about what's happening in Central Illinois. We're halfway between St. Louis and Springfield. And if you know much about Illinois, you know that, that is not a growing suburb of Houston, okay? I mean it's a modest era that -- and that has about a population of about 40,000 people. But there's our hospital. And the story of our hospital over the last 5 years that I've been the CEO, there I've been a hospital CEO for 20 years overall, but for the last 5 years, I've served at [indiscernible] Area Hospital. And my board, my Chief of Staff, Dr. Lawson, other members of our medical staff and our employees, believe it or not, believe that there is a rural transformation in health care that's coming. There's a portion of the One Big Beautiful Bill Act that has the rural health care transformation program in it. we're being told to transform. We're being told in rural America to take a claim of our position in the care continuum, and that's what we've been doing in [indiscernible]. So you can that we set out over the last number of years to say, how can we create a model for a rural health care system of the future. How can we take a small independent hospital and say, boy, this organization is having some successes in terms of culture, in terms of service to the community in terms of value added to employers and say, boy, that might not be a bad approach for other rural hospitals across the country. So my favorite word is momentum. What we needed to do is create some momentum as an organization. We were pretty stagnant and stable for a period of time. But organizationally, we generated some momentum. We put primary care at the center of our strategy. And ultimately, that's something that rural health care does really, really well is primary care. But we augmented our primary care with nearly every specialist support physician that a rural community would need at any time during the course of the month. So we have general surgery, GI, orthopedics, allergy, ENT, pulmonary, behavioral health, podiatry, wound care, cardiology, urology, a vascular surgeon, ER and hospital team, neurology, rheumatology, ophthalmology, nephrology, oncology, gynecology and pain management, all serving our small rural community. They're not there every single day, but that fractional use of physician services is certainly what our community needs. And that has allowed us to say, you know what, we can create a comprehensive rural health system for our community. And we've set out to do that. We heard earlier that talk about the importance of employee culture. [indiscernible] Area Hospital has a top 5% culture in the hospital industry, according to press gaining. And not only do we have a fair amount of just great fun with our teammates, we also really invested in their benefit structure, which became a strong competitive advantage for our organization in retaining nurses and techs. In fact, our hospital turnover is 12% compared to an industry average of 20%. So you see why I'm kind of sharing with you the rural resurgence, the rural transformation is an important issue for this country. And while many rural hospitals are struggling and it is a challenge, there is opportunity there as well. And so this is an -- this is what has happened over the last 15 years. This is from our audited financial statements. Again, we're not a huge organization. I'm standing on Wall Street. We're not a huge organization. But over the period of 2010 to 2020, you could see modest growth in net patient services revenue, $15 million to $25 million. Over the last 5 years since I've been there, and Jay and I have been working together and we've been working with Claritev, our net patient services revenue has grown from $25 million to today, we're operating a $57 million net patient services budget. So net patient services revenue is not what we're charging. That's not what we're charging our payers, it's what we're getting paid. It's what it is receipts for actual services rendered to our community. We've been able, through data supplied by Claritev, to help better align our services with the services that our community needed, and we've been able to work towards pricing those services at appropriate levels for our market. So ultimately, here we are an independent rural hospital, not in a growing suburb of Houston that has been able to provide greater services to our community by using the data that's available to us. So long story short, I met Travis when we were at a National Rural Health Care Association Conference in Kansas City. And Claritev is a sponsor of the National Rural Healthcare Association. And as I heard Travis talk about his vision and talk about the importance of data, I mean I just got so excited in the room because I'm a data guy, right? And I represent, I believe, the future of health care leadership. And I thought, "Man, what do I not have as a small independent rural hospital? I don't have the resources to do this type of big data dive. Let me see if I can find a partner who knows something about data science." And boy, what Jay and I learned during the first little bit of that time was really that, that was just a wonderful decision. The amount of information that we received about services in our market that we were capable of providing, but needed to do a little bit of development on was quite astonishing. The number of cases that we learned that we weren't on par with other competitors in our area in terms of our charging, that was also some findings that had real dollar opportunities for us. So Claritev helped us to identify $50 million in market leakage that we weren't touching at that period of time and also identify some other opportunities for us within, again, our reimbursement rates. So my message to you all today is from the perspective of an admittedly rural hospital in the middle of a corn field, there are hospitals like us out there that are thinking about what the future of rural health care can look like. And the idea isn't that it's all just doom and gloom. If you use the data, I like to call the data our superpower. If you use the data, if you lean into the data and you have a better understanding of what your market is doing, you don't have to guess as a rural hospital CEO and that can help you make better use of the resources that you have in providing care to your local community. So we've been thrilled with using both the complete view package. We're getting some information out of the BenInsights package to some degree, and it has really been foundational in our work to evolve our organization. So just happy to share that story with you, and I wanted to give you that perspective. We believe that as a pioneer in the Claritev provider space, we think that this type of thing is scalable, and you can see that with the larger contract that they just closed. Thank you for your time.

Thank you, Brian. We've got a couple of questions here that we're going to post to Jay and Brian because getting to why this is valuable to them is really important. So what first stood out about the approach to Claritev takes compared to traditional solutions? I'm sure as the CEO, as a CFO, you have somebody in your office every week trying to pitch something that will help you run your organization better. What was different in this instance?

As I mentioned, we met at the National Rule Healthcare Association, and it was the absolute use of true big data. This was the first time that I had really seen an organization present to me about the use of the big claims data and processing it that way. A lot of different demographic studies and assumptions that other consultants would have made in the past, but this was all based on true claims data that was occurring within my community and within my region. So I would argue that that's been 1 big piece of it. The second big piece of it, once we began working with Claritev was, I mean, the depth of the professionalism, right? I mean again, I mentioned that we're a smaller hospital sophisticated, we are sophisticated, but we just don't have the same resources that an organization like Claritev does. And so to be able to pair our level of sophistication with their level of professionalism and data science, I think, has been a winning approach.

Yes. I often will talk about organizations I visit that don't have huge analytic departments. And I'm pretty sure [indiscernible] Hospital doesn't have that. Jay, how do the new insights change the way your teams made decisions? I mean, Sarah talked about decision-making with the data is the key here. How was it transformed at [indiscernible] Hospital after working with Claritev?

Well, let's go back to the data, right? So as a small rule hospital CFO, we were begging for this kind of data for years. You would never have it, you'd want to go to your payer and so we think you're underpaying us. You had nothing to go on, right? So now we have hard actionable data that we can now go back to Blue Cross or Cigna, Aetna, whoever and using the complete view data, right, we can show that, hey, you were underpaying us for these service lines, these procedures, these diagnoses. We actually have something concrete to go for. Then also kind of separately on a -- we can use the data to look at denials, right? So we knew for years, the payers have been denying us for whatever reasons, right? So now we can see why, how much and what we can do about it. So we take the data, we can do something about it.

Right. Yes, it's fascinating to me, going as growing up as a provider, I never had any of those data. And as I worked to join Claritev, it was fascinating to me to see the variability in that data.

I think that the way we're viewing this, too, is we're not viewing this as a negotiation leverage type of thing. I think we're saying this is a great level setting for both sides of the equation, right? Payers want to pay what needs to be done to provide services to a community. We want to be able to do the same type of thing. And I think that just the idea of having a level set is a great place for both sides to be in.

That's a great point. Thank you for that. So looking ahead, either of you can answer, or both of you, what excites you most about the data-driven health care and then the role that AI will play in it because it's everywhere, and it's going to get to rural America, too?

Sure. Well, I think we're both kind of tag team this. But I believe that, again, the data allows you to really match the services that you're providing or the services your community needs the services that you're able to provide. So if you need to develop some of your nurses to have higher skills, if you need to do something along those lines, recruit a particular type of physician, doing that with the data is crucial. So I think that's probably my first thought is the data takes all the guess work out of rural health care leadership.

Yes. And then from the AI perspective, we're certainly moving more and more closer to being early adopters. We have not -- haven't been on the bleeding edge for sure, but we certainly see the role that it plays, especially in revenue cycle management, again, pre auths, denials, coding, et cetera. So we've already begun autonomous coding projects, et cetera. So we're really excited about the AI side right of it.

Yes. I think the I tell folks all the time that AI is going to help us get above water a little bit, and then we can start to do new things from a care perspective. So I want to thank all of you for listening to us. I'm going to bring Todd back. Thank you, Brian. Thank you, Jay, for joining us and talk telling the [indiscernible] story. Thank you. SP1 And I'm going to give it back to Todd, who's going to take the break here.

I've been -- I think my first Investor Day was 1992, and this is the first time I can ever say we're ahead of schedule. So we're going to be a little different than we've got on the schedule here. We'll take a break at about 3:00. There is such a good traffic before the demos, we're going to the demo stations turn on again. And we'll come back at 3:00 here to keep the day going. So far today, we've covered that first half of that life cycle that we showed you kind of from looking for insurance to looking for care. When we come back from the break, we're going to go to the core of our business, the heart, how a claim gets created after care happens, and there's a point of what happens when the claim is created and what do we do for that all the way through to the payment. So we'll take a break now, and we'll be back in 30 minutes. [Break]

Rather than describe from an operations perspective, the details of our solutions, I thought I'd describe them in terms of the benefit they provide to our clients and why we think they are differentiated on a value basis that is enduring. So I run the operations organization for Claritev. We've got about 1,800 associates that deliver the services and solutions to all of our clients. We maintain a very tight alignment with our Chief Growth Officer, Tiffany Masencik, who is here today. listening to our clients to not only modernize the solutions that we have, but bring new things to market as well as we seek to expand not only into new logos to offer our current clients more things. So as part of being the Operations Officer, along with the 4 general managers that run each of the portfolios at our organization, we're responsible for delivering services with -- that meet our quality standards and the timeliness of our clients. that are top of class in terms of unit cost and top of class in terms of benefit to our clients, and therefore, revenue and revenue growth declarative. So we also want to minimize the error rate in the operations, everything that we do. 1% error means, all things being equal, we've got about 18 people working on not their highest and best use. You get it wrong by 10% that's 180 people. So we look at that, right? And a lot of engineers, a lot of people with industrial systems engineering degrees in the organization, a lot of health care executives or people with backgrounds in health care in the organization, that the principles you're Todd and school are kind of basic principles and higher order principles. So there's a tendency among people with engineering training to optimize things that should no longer exist, right? So we look at the way that we do things, the way we deliver each of our services make sure that our processes, our procedures, our methodologies and our technology are the best that they can be and then optimize them for lowest unit cost and the highest benefit to the client, and therefore, how is revenue to Claritev. So we'll go to the next chart, right? So we've got some statistics here, kind of put all of that in perspective, right? I'm going to talk about 4 things and kind of run through these 6 statistics on our business. I'm going to talk about our core lines of service and kind of give an example of why each one of them is value differentiated in the marketplace to our clients, and why they help us win and grow. I'm going to talk about our solutions and innovation pipeline that is aligned with our current set of solutions and products to keep them modern, to keep them competitive, keep the maximum benefit for existing clients and new ones and talk about a number of new innovative solutions that we're going to bring to the market this year that are aligned, not only with our annual operating plan and budgeted for, but also with our long-term vision, which we call Vision 2030, now Vision 2031. And then finally talk to you about our latest innovation in our network business, which is our oldest business, called Novero. So starting at the top left, right? So we talk about 750 plus payers, so we've got deep and long-lasting relationships with. The reason that matters is there's a lot of complexity to contracting with payers and the providers, and we do both, right? So what that has done is give us the insights to shape the data sets that we use, the algorithms that we use to make each operating part of our business the most effective and efficient that they can be. And that is not something that you flip a switch or use AI to replicate. That is our 40-plus year, 45-year history of being in this business and optimizing and learning and adapting along the way. 30 million claims processed each month. Point of that stat on this chart is to show you that we operate a business that is at scale, and we'll continue to scale for the growth that we foresee in our Vision now 2031, without increasing the operating cost of that growth linearly. $25 billion of savings identified, right? So we send back a claim that's been repriced, recoded or applied against our network, it's a recommended price that ultimately is either accepted on its face or it isn't. And so we look at that, we look at how we -- for each of our different services and solutions, we look at what's the maximum number of claims that came in the front door of the shop, are we maximizing the percentage of claims that we can actually do something with? And are we suggesting a market clearing or fair market price that has a high acceptance rate? That's 2 reasons to limit patient abrasion and to limit the manual after work or after math that happens if it's not accepted. And so for data Data iSight, our -- we've improved materially the percentage of claims that we're able to actually operate on. And our acceptance rate varies by month depending upon of the claims and the mix of the providers that are originating those claims, but somewhere between 96% and north of 98% acceptance rate on first pass. That means we've optimized that to a point where there's right. So we look at every single service and solution we offer in just that same light. Processed about $180 billion worth of bill charges. And related to those savings, right? That means we saved the average patient about $900 on the versus bill charges. So we're delivering benefit to our clients, and we look at maximizing that value every single day, can we find a higher or lower -- higher discount or lower clearing price for each of these claims depending upon type of service, which provider, where in the country. Bottom left, the 1.4 million providers that we've got on our PHDS network, it's a number we talk about a lot, but I want to put it in context on the next chart when I talk about what the value of that really is, and I'll go back to the example that Travis used in his opening remarks, talk about the World Trade Center program. And then finally, 86 million code combinations, right? So this kind of goes to our Payment & Revenue Integrity business, where we've got a number of prepay postpay and then Revenue Integrity solutions that are designed on different code and combinations of code to look for fraud, work for waste look for reviews. And I'll give an example of where we've differentiated ourselves with a major national client of ours based upon the quality of the data that we use to create the algorithms that we use and the efficiency and the savings that we get for our clients, right? So on the network, Travis mentioned the World Trade Center program. It is a government program that was procured out of the center for Medicare and Medicaid services, specifically the CDC. It started as a network rate here in New York City and the surrounding area for people with very specific respiratory and other elements, as you can imagine, a result of the 9/11 attack. And those people have migrated around the country. So it's now a nationwide program. Well, that was differentiator #1 for us because we've got the [ 1.4 million ] that we talk about a lot. But a key part of the evaluation criteria, the government always has a very rigid process and RFP proposal negotiations and ultimately an award. And I'll talk about that award in a second. But what we did as a part of that, sometimes the government not only exchange documents with you or RFP proposal questions, answers, but give you a chance to come before them and do an oral presentation on your solution, which we did in this case. And so I will tell you, I've been through a number of those in my career, have probably done 50, 80, 100 government contracts over my career. This one went went as smoothly as any, if not the smoothest of all of them. And what we did, we show the mapping of our existing network to the people and their particular elements across the country and where we had gaps. We showed them the contracting process and methodology that we use to fill those gaps to meet the adequacy requirement of the network. And we can do it faster and faster and faster than I think anybody else and we distinguish ourselves on that basis and also on our price. We delivered a value price. So to unseat an incumbent in a government contract generally is a pretty heavy lift. The incumbent protested the award and the procedure for that as you go in front of you write a brief, essentially like a mini court case, but it's adjudicated by the General Accountability Office. And what they do is look at the way the agency structure the RFP, was the scope clear, were the evaluation criteria clear, was -- were they applied fairly or equally to all the bidders? And I would say out of maybe or 50 protests that I've lived through in my past lives, generally, the remedial action is, hey, CDC, go back and -- government agency, go back and look at this, looks like you require it wasn't clear, evaluation criteria wasn't clear or you didn't apply the valuation criteria fairly or equally. In this case, the GAO denied the claim. It's essentially summary judgment, you're done. And it was because we had distinguished our network, our solution, our approach to managing the network and our price by such an amount they absolutely denied the case. So that goes to the value of the network. On claims intelligence, that business, Data iSight, reference-based pricing, it also includes our No Surprises Act Solution, all of which report to John Crane, who you'll hear from again here in a minute. But just based upon the most recent public use file data that published by CMS, our success rate is 7 percentage points better than some of the competitors you might think of when you think of Claritev for NSA work and all domains across all providers, all people who are providing NSA services include a lot of the national companies. And why is that? Well, if you buy NSA services from us in a kind of what we call our complete solution, we have -- we try to price that claim against our network, and again, leveraging those 1.4 million providers, and the claims get cleared there. We've got prepayment negotiations that we -- again, we've got algorithms curated by data that we've accumulated over the years, try to settle those claims before they go to postpay, and then we've got a postpaid negotiation solution, similar data set, algorithm, try to settle the claim quickly. But now that there's been about 3-plus years of public data by CMS about the success rates at the IDR phase, which is the last phase, which is like a mini arbitration, essentially what it is. There are 15 companies that do that. And overall, the providers prevail about 8 times out of 10. Well, they all know that now. And so what we find is a greater percentage of NSA claims are being pushed to the IDR phase, which is more people intensive, but what we've done there is, and you'll hear about this from, I think, Michael later on, we use AI and other automation to write better briefs for the IDR to substantiate the market clearing price that we think is a fair price for that informed by past practice, right? So the fact that we've been in this business so long, we're able to arrive at a market clearing price that distinguishes our service by 7 percentage points against everyone else. That's value differentiation for NSA. It also allows us to scale that business without scaling the cost of providing it linearly. And finally, in our Payment & Revenue Integrity portfolio, and you're going to hear from Brad Ross, who's the General Manager for that part of our business, a number of things that I would point out, one of our large clients has their own in-house capability. And so we really like we think we can add value to that part of your company, save money. And so we got data from them that had already been through their algorithms, and we found hundreds of millions of dollars of incremental savings from either fraudulent coding, upcoding, miscoding, so broad waste abuse, and then combinations of codes, the use of override codes. Again, developed over years and years and years of being in the business. And that's a highly automated capability we call ACE, the automated code editor. For complicated claims, complex medical procedures, we've got a small team of clinicians and physicians to look at those claims, but we enable them with the same kind of technology to make them more productive so they can handle more claims and be more productive and keep our cost and servicing those lower. And then finally, in Payment & Revenue Integrity, I'll tell you, you've all seen in the news all the fraud waste and abuse that's going on in Medicaid in particular, but also Medicare. But it's ramping across commercial health care as well, in the news nearly every single day. Our team, using ACE, detected a targeted attack on one of our payers where they were essentially ordering a very expensive DNA test that had nothing to do with the ultimate reason for care. And they got so brazed and they kind of tested the waters. It was targeted at this one payer in one city. And then they shared -- it was clear they were sharing the patient list. And so the claims started coming in from multiple cities and we detected that, saved our clients millions of dollars of fraudulent claims. So I would tell you across all of these 3 core areas of our business, we have intellectual property, past performance and AI-enabled capabilities that give us a lasting competitive differentiation in the marketplace. Product road map, right? So this isn't just a patriotic looking blue, white and red chart. It really is a set of priorities that my general managers and myself, along with Dr. Patel, and Tiffany [indiscernible] and Michael Kim and his AI team have decided these are the priorities that deliver maximum value to our current clients. Those are the ones you see the 30-plus in red. And then 18 new things that we're going to bring that either complement or fill another gap in the marketplace. And you can kind of see we organize them by portfolio. And this is -- or supported in our annual operating plan and aligned with our long-term vision to maximize the probability of growth that's characterized there. So you'll hear some -- I won't go into too many details, but I'll just say every one of these things, our team is really good at delivering on time, on scope and on budget. And so each one of these things has been mapped into our annual operating plan across the 4 organizations that I mentioned to make sure that we not only achieve what we think those -- the value of those products what we do so on time and maintain our competitive advantage versus everyone else in the marketplace. And then finally, PHCS Novera, right? So having a nationwide network is great. But depending upon who you are, whether you're a local TPA, a regional TPA, a national payer, anything -- any of those 3 or anything in between, you may not care as much about a national network. You may care more about a regional one or a local one, statewide one and then to use out-of-network in which we can also cover with our claims intelligence business for everything else. And so what this does is it looks -- again, based upon proprietary data that we have, we looked at the top 50 metropolitan statistical areas and identified areas of practice and areas of focus, so geographic focus and practice focus to optimize for each of our segments, right? And so we go to market by segment, again, led and aligned with Tiffany's team and [indiscernible]. And we've identified millions of incremental lives. It will not be a cannibalization of the clients that are already using our network service, but offer growth that has dramatically accelerated 5-year outlook for our network business. And so this is enabled by another AI tool that we use to build and tailor those networks quickly. Used to take weeks, if not months, depending upon the complexity, both in terms of practice area specialties and geography down to minutes, right? And so this is an innovation that we're bringing to the market this year, and we've already launched 3 markets, and we'll continue to launch in a prioritized fashion, again, aligned with selling to TPAs, selling to brokers, selling to other payers, consumers of our network services. And that's my last chart. And so I'm going to turn it over to Sean. Again, he runs our claims intelligence business to talk about some exciting innovations that are happening inside of his portfolio. Sean?

Thank you. Hello again. Great to be here again. So again, I run our claims intelligence solution line. It includes everything from our reference-based pricing to surprise bill services. our Vistara product, et cetera. So I want to talk to you today about just the work repricing. And you heard earlier in the earlier discussions, Brian Burnside from Carlinville, pricing is a lever to create affordability, okay? You heard Brian say, "I have a charge amount. And I have something that actually gets repriced and finally paid." So our solution lines, a lot of our reference-based pricing solutions, but it also can be looked at from a network standpoint. So if you look at our core area, our core areas, again, is out of network care, okay? So if we look at repricing functions from out-of-network care, we really are in all aspects of the member's journey, okay? And out of network really comes in 2 different forms. The first form is where the member had no choice, okay? And you also -- you'll hear surprise bill services. This is a regulation, no surprises at that governs how bills are handled when there is an issue with an ER doc, or if there's a participating provider that is rendering or a participating in hospital with a nonpar physician at a power hospital. So these are all things that covers. So Claritev solutions and our repricing efforts have functionality when the member had no choice. Really the second form is what I'll call discretionary care to where I, as a member, chose to get services out of network. And so we've really built our solution set, whether it's the actual network itself or our negotiators that are calling on behalf of that payer and member to really reduce the cost of care. And then we also have our Data iSight or reference-based pricing solutions as well. And you've heard earlier, we operate off of an annual operating plan, where we are investing in our core areas. And we're also enhancing those areas as well. What else can we bring to this situation and this process to add additional value within the ecosystem, okay? So our journey has really taken us -- but if you take a step back and we look at what really happens behind the scenes is we get a claim from a payer, okay? That payer sends us a claim, it's out of network. So it's usually, on average, the rate has stayed consistent really the last since about 2021 at about 7% of paid dollars, okay? When we get that claim, again, going back to the employer portion I talked to you about, decisions on how out of network care are rendered are chosen by the employer and the broker together. So I, as a retailer, will choose a certain way I can handle out of network care. Or if I'm a bank, I will choose this way. So it's really governed at that employer level on how out-of-network care is handled, okay? So again, we get that claim. And we have interactions, and we see over 100,000 different group IDs. So if everybody goes home after this, pulls out their ID card, that group ID, we see over 100,000 plan sponsor IDs a year, okay? And those are all decisions that are being made on that employer level, okay? So once we get that and somebody is actually using a solution base that has a reference base, what actually happens, okay? So we have configurations and we saw earlier, all the different rules that are involved with how a claim could flow through the system, but Claritev has been around for 45 years. We have been in the forefront, leading different reference-based solutions. I can tell you 20 years ago, it was charge-based methodologies like our [indiscernible] product, okay? We've seen Medicare trends going to people pricing against Medicare. But again, we've also created other products that look at what people are actually paying in the market or what is a cost and then add margin to that and use that as the vehicle for delivery. But we're also evolving. Being on the forefront, we would -- we want to innovate as well to reach additional market, additional clients, et cetera. So we've created a pilot product already, really around transparency data. Now I know a lot of you -- there is a lot of activity over on the plan optics area. How can we use $400 billion records as a blueprint for a pricing product so that employer, if they selected, hey, I want to use price transparency data, which is that no surprises, that's what the legislation was intended on is to get that data out there. I've been doing this a while. I never thought we would see a complete blueprint of every managed care agreement. Different bid. Now the thing with it is, is the perception of the market, okay? There is a view of the payer and there's a view of the hospital, okay, of what the actual rates are. And the great thing about what you heard from the demonstrations is our right in the investment that we've made in that data itself. I'm going to tell you right now when it comes out of the payer or it comes out of a hospital, there's a lot of interpretation, okay? And you'll hear Fernando you'll hear the team, we have a right to win in this space, okay? We have strong infrastructure technology led by Michael Kim as well as 45 years of experience in pricing this kind of data. I was having a sidebar conversation is think of a deal that was done between a payer and a provider that was done 20 years ago, okay? You have to fit that in CMS' format today. That's a tough thing to do. Things have changed over the last 20 years. But having that context, and that understanding of contracts and taking that and applying it to the existing infrastructure that we have in place is our right to win, okay? With that being said, it's an exciting future for our area. We're innovating and continually investing in our core, and Brad is going to take us through some of the investments that we're making in the PI space.

Thanks, Sean. Brad Ross, revenue integrity product vertical. And I've been here for a cup of coffee, but I have been in payment revenue integrity for a very long time. And what I'll tell you is the way that clariti approaches our solutions here, it's generating a new energy that I haven't seen anywhere else. And a lot of that is driven by our core solutions that Sean talked about, the network that Jerry talked about and others. Combining that, we're not just focused on generating additional savings, we're focused on reducing abrasion and partnering with our clients in those networks. So it really is different. I really believe we have the opportunity to do something transformational and disrupt with the traditional payment and revenue integrity vendors are doing. So in Payment & Revenue Integrity, we've provided care to a member. The claim has been submitted, which is very complex. And as the claim starts to go through the life cycle, that billing process has 2 interjection points. It's pre and post payment. So in the prepayment space, we are looking to identify savings before the claim is paid, post payment, after payment of going through more complex claims where real time was not a potential. But when those 2 work in concert, we reduce the opportunity for improper payments for our payers as well as providing fair and accurate payment to those providers. So not all these issues that we identify are fraud. They are usually simple mistakes. But as they continue to go left unchecked, that increases the burden and the administrative waste in the system. So in our prepayment phase, you'll see there we have 3 solutions, 1 that we'll be launching very in the near term, but our advanced code editing or a solution really works in concert with our technology and algorithms and applying an expert review component to find additional savings that your traditional technology-focused primary editors do not find today. And that's the combination of both those aspects of bringing technology and experts together to really deliver that value. Our itemized bill review, which focuses on inpatient or outpatient claims that are paid percent of charge, we identified savings for our clients on 98% of the claims that we review. So we're selecting claims that have the most higher likely for an opportunity for an overpayment to really deliver value for those clients. As we look beyond, we'll be launching, as I said, DRG. So continue to expand our solution set here as the industry moves left up into the payment stream. We want to be further upstream, delivering a comprehensive solution set because our clients demand it, right? They're looking for more opportunities to reduce waste, abuse in the system. And we'll talk a little bit more about what is DRG or diagnostic-related group on here in a minute. So in the post payment space, these active after a claim has been paid. One of the -- we have our coordination of benefits in our subrogation business that really will work to identify other payers or third parties that are liable for payment. So our advanced technology identifies and weeds out low opportunity claims or cases so that teams can focus on the most high probability opportunities to remove waste in the system. And then we'll have our data mining solution. It's a very comprehensive solution based on many years of experience, which really dials in on adjudication issues, contract compliance issues. And we're not just going and taking back those dollars from the providers and working with our payers, but we're also trying to prevent leakage with our -- and working closely with our payers and providers to fix maybe an adjudication issue, whatever it may be. And as Jerry alluded to earlier, when you stack all these up together, we're continually finding dollars, whether it's behind the internal processes of the payers that they have in place due to the complexity of the payment life cycle or other vendors that they may have operating in their Payment & Revenue Integrity stack. And then for the year last year, so these solutions combined generated almost $2 billion in medical cost savings identified for our clients. And as we look to the future, we're going to be looking at expanding our solution set to, like I said, DRG and diagnostic-related grouping. You may ask, what is DRG. So DRG is a payment methodology for inpatient claims. It uses patient demographics, diagnoses, procedures to come up with a payment methodology that is simplified. Unfortunately, that does not mean that coding and billing practices are simplified. So these claims are just as subject to improper payments, mistakes, adjudication is used and whatnot. So they require an expert review. So what will happen is we'll receive the claim as we do today. It will run through our analytics we will then select the claim and flag it for review. And this review is a little bit different because we'll be requesting the medical record directly from the provider. Once that medical record is received, it'll actually go across our clinical team, which is made up of physicians, coders, nurses that will go and compare the medical record to the actual claim. And then findings are sent to the payer where there is potential overpayments as well as education to the provider, right? So at the end of the day, -- our mission is to provide transparency and fair payment. So we provide additional information to the provider that can inform them of the decisions that were made and why their coding and billing practices were changed. So this will be the foundation for expanding our ACE platform. ACE has operated at scale. So we're going to continue to expand that as a complex claim platform in the pre-pay space. And we'll continue to look to add new solutions to it. in the years to come as the health care landscape evolves. So just kind of building on that. So why now? I think you've heard across the board, we've talked about our network, if we run payment [ enter ] on our network, and I think it's clear to call out that savings we've generated is not just on out-of-network claims as both on out-of-network and in-network so as well as our network. So if it's not good for our network, we don't want to run it. We will not run it on your network for our clients. And I think that really speaks volume to the relationships and trust we've built along with the foundation of the technology and scale that we run at. So we will be launching this shortly. Can't wait. It's a really exciting opportunity, not only for our clients but also the team at the end of the day. I'd like to -- we've talked about -- sorry about that, but we've talked about selecting the right plan, finding the right provider. And then after the claims [indiscernible] happens, but there's still one more aspect the life cycle that is a challenge for the health care life cycle, and that is making sure that payments are made fairly and timely. And I'd like to introduce our Chief Strategy Officer, Will Mintz.

All right. Thank you, Brad. Hello, everyone. I'm Will the Chief Strategy Officer at Claritev and I'm joined today by Tom Dean, the CEO of ECHO Payments. And as you've heard through the day, Claritev has solutions for every point in the health care life cycle as we defined it. The final point being payments. And given our deep client relationships with over 700 payers, 45-plus years of experience in claims, 1.4 million provider network. And now as you've recently heard, moving solidly into provider services. We truly have an end-to-end solution or end-to-end offering for our clients. And for payments, this final point in the cycle we've chosen to go to market through our partner, ECHO. So Tom today is going to walk you through a little bit about who ECHO is talk about how ECHO solutions add value to our clients, talk about the differentiation of ECHO and their solutions in the marketplace. So with that, Tom?

Okay. So today's portion of the presentation will be made in the spirit of March Madness by the point guard and the power forward. But -- so just a little bit about ECHO and again, what we do, our [ horror ] solution that we offer is we help health care payers pay health care providers. We have a lot of other solutions, but that's our core solution. We're a 30-year-old company, privately held. And some of our claims to fame we service over its 450 payers today. We distribute $220 billion worth of payments. That figure is when I say we distribute, what I mean is that when a payer is going to pay a provider, the first thing we do is go get money from the payer, and we're involved in those dollars are tracked and cleared on accounts that we control. So that's much different than some of our competitors, which if they put any kind of piece of paper called a check, and they happened to mail it. they count those as billions of dollars of payments that they make. So that's not ECHO. ECHO is actually involved in every dollar clears against an account that we control. We have the two things that probably are most distinguished. ECHO are in the left-hand corner in the right-hand corner, upper corner of this slide. The first one is that we have over -- for every one of our payers, we have over 90% digital adoption of payments. That leads the industry. And there's many reasons for that. One is that we have more digital payment modalities or types than anybody else. For instance, we distribute to over 60,000 providers. We have a network that distributes digital checks. We also look into block boxes digitally rather than printing and mailing the payment to the lockbox to things that are unique about it. And then in the upper right-hand corner, it's very important that you properly incent new providers. That might be some sort of joint venture that creates another provider, anytime there's a new provider entity, what we have to do is figure out how would they prefer to receive a digital payment. And we have, through a series of methodologies. We have 83% of the time within the first year seeing a provider, we can create a digital payment to that provider. If you look at what's important to the industry and what I decided to do is just give you an example of a case study. So this is a primarily Medicaid payer that also has other lines of business. And this particular payer has about 2 million members that they serve. They have -- they have a number of challenges that they that are important to them. So when we came to this payer, they said, first of all, we've had a plateau in our acceptance of digital payments. So it's about 75%, a little bit less. We also have three major adjudication systems, but we have a common staff that services members out of those three systems. So we have a challenge because we want to answer questions that our members might have and/or that providers in our network might have, and we can't do that today because each system has its own process for getting that information. And then finally, they had -- so in the health care space, if a payer pays a provider over $600, they have to send a 1099 to that provider and the government. And the IRS is not very -- doesn't have a sense of humor if you don't get the provider's name and address and everything else, correct, and they find people for that. And it does take quite a staff and particularly in this payer's case because they had multiple adjudication systems they had to try to figure out across the three adjudication systems as an example, did our payments exceed $600. What we did was we were able to implement our -- and we are the only vendor in the marketplace that also does comprehensive 1099 processing. So that was just another thing that, that provider needed. So again, if you look at the next slide, we were north of 90% in all the categories of digital adoption after implementing this particular payer, which was the main goal that they had there's differences in terms of electronic remittances versus payments and all that kind of stuff, but not to get too technical, we achieved north of 90% in all those categories. One of the reasons we were able to do that is that in the provider world, many times one provider has multiple business offices the data business office. So imagine on a hospital, but I have several clinics also in my health network, right? You may have a different business office for your clinical payments [ senior ] hospital payments. That's just an example. Emergency department might use. A billing company even though the rest of the hospital prices is their payments in-house. So we have over 1.6 million different provider locations billing locations, and we know what the profile that's what they will accept in terms of digital payments for every one of those. So then we also are able to -- because of our platform, we have an Omnibus accounting platform, which just means that we have a way regardless of the type of payment that we make regardless of where that payment came from, what adjudication system, a payer paid from we're able to have a unified view across that whole spectrum and someone will be able to say, you funded the payment you sent the payment. This is the dispensation of any payment regardless of the payment modality. So again, makes us unique. And then we [ kind ] of took care of all their 1099 processing, they don't have any issues with that any longer. So why the Claritev of relationship is important to ECHO. ECHO has a direct sales force, but most of our customers are obtained and service in some way through partnerships. We have very few partners, and those partners have to be significant and bring something to the picture. The best way I could -- I can sort of demonstrate that on a slide is to say, you've heard many, many people talk about all the great things that Claritev does and the claims reimbursement cycle. And so I won't go through those again. But suffice it to say, at the end of the process, the payer adjudicates a claim and then has to actually move the money associated with that, right? It means it goes out of the payers account and winds up in providers account somehow. And that's where ECHO takes over. So what we feel is if we've got a partnership with Claritev, we have to breed when it comes to the claims imbursement cycle up to and through the adjudication process, combined with best of breed when it comes to actually not only paying the provider, but helping the provider bill and collect from their patient. So we have a complete -- we covered the complete spectrum. And we think there's incredible opportunity for us to share information, to further automate processes and all that kind of stuff. So addition to the fact that this was a very comprehensive and nature relationship. We also partner with Claritev because we believe that they've made the same kind of investment commitment to technology that we have and so the opportunity to collaborate and further work on new solutions for the marketplace is very important to us.

And I'll just add that the partnership selection process was pretty robust for ECHO going through a full build by borrow partner. And we took a viewpoint of how do we future-proof this end of the business. And so we've been talking about competitive moats, being the infrastructure as ECHO is and delivering the payment to the provider and being that deep client relations -- that we have such deep client relationships at Claritev, that foundation really helps us truly future-proof all the different types of future-focused payment modalities, all kind of starting with this partnership here with ECHO to give us that closed loop and the end process. So with that, just to kind of recap a little bit about what you've heard today. Claritev is bringing transparency across the life cycle for health care. You heard earlier that you're leveraging our BenInsights product, providing the transparency to employers to plan sponsors to beneficiaries as they select design and optimize their benefits, moving forward into adjacent spaces, in health care, such as our provider businesses, to really leverage our transparency tooling to help with service line optimization and planning. And finally -- or not finally, our core business, where we -- as you heard, Jerry, we're making substantial investments in our core around our claims processing, our claims optimization business. And then as Tom and I just discussed, completing that end-to-end loop across the health care life cycle with what we'd like to feel -- what we feel is a very differentiated and very sticky payments offering. So I'm going to invite Michael Kim, our Chief Digital Officer; and Fernando Schwartz, our Chief AI Officer up here to talk to you a little bit more in depth about the AI that -- how we're using AI and how we're leveraging it throughout our entire offering. So with that.

Thank you very much. You know a company like ours is serious about technology when they allow a nerd like me up in the stage. I'm accompanied today with by Michael, our Chief Digital Officer. And my name is Fernando Schwartz, Claritev's Chief AI Officer; and I'll tell you a little bit about myself, my background. Before joining Claritev, a long time ago, I was in academia. I'm a former math professor turned into industry. After leaving academia, I went into online advertisement for some time and then into health care working on a few startups in health care. And more recently, I was the Global Head of Data Science at Merck in the Commercial division. And after that, prior to joining Claritev a year ago, I was leading AI at ADP, the HR and benefits company. So we're here today to tell you about what are we up to with AI at Claritev? And I know that it's my favorite topic and probably a really hot topic for the for the space as well. So I'd like to start first to tell you a little bit about the vision, where are we going with AI here. And the vision is clear. The vision is to position us as a global leader in technology innovation. And we're going to achieve that by becoming what's called AI-native. This is a clear vision that we have. And when we think about that vision, we're thinking about three areas where we want to explore and use this technology. On the one hand side, we want to talk about transformative products. That is to say, think about applying AI into the products that we have to make them stickier, more powerful, ultimately generate revenues to the organization. That's one pillar that we're looking at. So thinking about how do we use this technology to optimize our operations. And so you have to think about like generating internal efficiencies, and there's quite a bit of room there for us to become more efficient using AI. Last but not least, I would say that becoming AI-native means that we are now -- we have the ability to become really innovative and try new things quickly, as you all have seen this technology really announce for that. A little bit of bragging rights for the organization. I would say, first, late last year, KPMG and Oracle had a Hackathon around agentic AI, which was attended by companies like DocuSign and other like tech firms. We won this hackathon, the team that we have in place. We currently have over 50 AI models in production, and we're going to be releasing a couple of dozen more this year. And last but not least, a really important topic for us has to do with responsible AI. And in that space, we were co-signatories and co-authors of responsible AI framework that was put out there by one of the leading national AI coalitions in health care. So we're taking responsibility quite seriously internally. We formed some cross-functional teams with legal and other partners internally to really make sure that we're doing this in a responsible way. So how do we realize this vision of being AI-native and really at the forefront of technology. We're thinking about -- so I'll give some sense around three areas we are working on. First, you got to have the right infrastructure to be able to do AI at scale like we are intending to do. And for that, we foster a deep partnership with Oracle. We are using their services and their high-performance cloud infrastructure to be able to build scalable systems that are going to help us operate where we want to go. At the same time, we've partnered with open AI to power our generative AI offerings and our agentic workflows. We also have a partnership with [ Entropic ] in the Middle East region. Last is our focus on what we're calling core, which is our Claritev operational reasoning engine. This is something that I particularly quite fond of. Maybe I'm going to quote my nerdiness there. But if you think about it, in health care, there is little to no room for error. Generally speaking, in regulated environments, you want to use technology and you want to avoid mistakes. But when you think of GenAI, that GenAI in itself is a technology that is prone, I mean, ever more or less to committing some errors. So how do you combat that? That's a technology that we're building about reasoning. It's called automated reasoning. And this technology allows you to provide with the checks and balances to the generative piece that's out there. So we believe that this is going to be a huge differentiator for our technology out there. I will go into a couple of examples of how we are applying AI today. Just to give you a sense of where we're at, and then I'll pass it on to Michael to wrap up this section. So first, I want to talk about a tool that we have, a product that we have out there that is called Pro Pricer. This tool has been around for a couple -- for a year plus. And what Pro Pricer does is that it maximizes savings with the minimum number of appeals for our clients when they're looking out of network claims. So you can imagine that, that gives flexibility to our clients and really eliminates the complexity of the decision-making process in semi real time when you're processing claims, again, to maximize savings and minimize the number of appeals for someone with the math background, that sounds pretty [ man ]. All right. And then I'll also give you like a small sense of what our Surprise Bill Services does and how do we use AI there. Many of you -- I'm sure all of you are familiar with the -- No Surprises Act, which was put out there by the government somewhat recently. The No Surprises Act allows for some kind of -- some form of negotiation litigation, if you like, of the between payers and providers. It established a framework by which claims can be argumented and so having the behavioral analysis at hand, which we have built into this product really allows us to really model the willingness of payer providers coming into those negotiations to try to avoid excessive charges and whatnot. And so there's a behavioral piece to that. And we also have now a generative piece, which is tied to what we call deep research which allows us to basically enhance the defensible and well-informed arguments that are needed to provide these negotiations to empower these negotiations. So we feel really good about this tool. Actually, the data puts us at 7 percentage points more effective than anything else out there in the market with this tool that we have. Now granted, it's still pretty challenging environment, but we are 7 percentage points higher than anybody else out there with this tool. So with that said, I'll pass it on to Michael to continue the conversation. Thanks.

Thanks so much, Fernando. As Fernando indicated, my name is Michael Kim and I'm the Chief Digital Officer and have been for the past 11 years at the company. So I'm one of the legacy guys that are still around. And I'm here because I've seen an amazing transformation over the past 2 years under Travis' leadership. As one the analysts wrote, it's -- it's not your grandfather's multiplan. It's been amazing to see the evolution. And I think you saw it today in some of the presentations. That's not what we were 2 years ago. I'm here because I believe in the mission of the company. I'm here because I believe with the right team. And I'm here because I believe we're going to deliver our strategy, Vision 2030 and that by so doing, that we are having a material positive impact on the health care industry. And so I'm super excited to play a real small role in making that happen. And so that's why I'm still here and excited about being part of multiplan. So the two questions that I'm going to focus on over the -- and Todd gave me the go ahead, I can run a little bit long because these were the same questions that I got asked over the break and actually before we got started. And so these are the two common questions that are asked. The first question is, is AI overhyped, right? And then that's quickly followed paradoxically by the question will AI or an AI company, displace or make obsolete Claritev? So those are the two questions. And I got those same questions actually before we started. So I just have two slides. I'm going to run a little bit long. It's going to -- originally, I had 5 minutes, but I want to address those two questions, right? So to answer the first question. I want to anchor it based on the road map slide that you saw that Jerry presented earlier. When you think about the hype around AI, there are really two parts of that. There's the AI scientists and the work that they're doing. And that's the examples that Fernando gave. The AI models, whether it's machine learning, predictive, whether it's agentic AI, that's what AI scientists are working on. But the other part is a software engineering part, right? So can you use AI to accelerate the software engineering, right? We've embraced both of those elements. So this road map here is a really ambitious, aggressive set of product capabilities that we want to build out over the course of the next year. Now add on top of that, the digital modernization effort that's going on. Add on top of that and Travis throughout a big number, $100 million ACV target, right? That translates into more clients being signed, which translates into a lot more technology work because we have to implement those clients right? And then on top of that, we still have a set of -- we have to make the doughnuts every day. There's a core set of systems that we want to continue to enhance, maintain. That's a ton of work. when you look at those four buckets. Fortunately, from a couple of years ago on the software engineering side, we started embracing AI, right? We have OpenAI, get-up Copilot. We're testing Anthropic, Cloud. And so we've been actively embracing AI to accelerate our software development process, right? And we're seeing a 20% or 30% productivity lift from adopting that -- that's one of the reasons we feel good about our ability to deliver this product road map. The reason and those that have the huge hype around AI saying, why isn't it not 90% or 100%. Why aren't the coding agents? And the reason is Travis had it in his first slide, one of his earlier slides. It's because the hundreds of thousands of custom rules and code that are reflected into our system. Like if you use prompt engineering and say, "Hey, build me this code. That's a generic code. Unfortunately or fortunately, for us, our clients said, "That's great, but there's 20 exceptions to that. right? I wanted to do this instead of that, I wanted to do this and so that requires a lot of interaction with our clients and customization, which is a moat for us and that's why the lift in productivity is not 90%, but it's humans in the loop that actually take the generic model and then need to customize it based on all of these exceptions that are created, right? So on the software engineering side, we feel really good that AI is having a substantial substantive impact on software engineering. And then the second part, which is what the AI scientists are doing, we feel and Fernando covered a couple of cases where it is really transforming the value that we're delivering to our clients and the way the products work, and so when I take a step back and say, is AI overhyped say Yes, there's probably a little bit of hyperbole. But when I think about Claritev, do I think AI is going to be transformational the answer is an absolute resounding yes, both from what the AI scientists are doing in terms of how that changes our products how that changes our business operations processes to make it more efficient and more effective. It changes product development efforts, and it also changes the way we are engineering our software. So I absolutely believe that AI is transformational from Claritev's perspective. So if it's transformational -- sorry, the one additional note I will say about AI is Fernando talked about being an AI-native company. right? So the way we think about AI is not a bunch of PhDs and geeks like Fernando in a corner developing elegant AI models. We think about it as integrated into everything that we do, right? We think about it as part of our strategy. We think about it in our products. We think about it in software engineering and this page here, and I've highlighted all of the AI deliverables as a part of our product road map. It's integrated into everything that we do. So that's what we mean by a AI-native company. It's not a bunch of academics in the corner. It's embedded into everything that we do. All right. So the second part is, if it is transformational, why couldn't an AI or an AI company replace what you're doing, displace you or make you obsolete. And the answer to that question, I think, is we don't believe that that's a threat to us. We believe that's an opportunity for us. We think it's an opportunity for us because -- and the examples that we selected were good examples of why we think it's an opportunity and not a threat. Like think about an AI company or a new entrant trying to replicate Pro Pricer or what we do with surprise bill services. and the massive hill that they would have to take to accomplish that, right? For Pro Pricer, it looks at all of our products, our network product, negotiation product, reference-based pricing, and we optimize the workflow and what we think is going to have the deepest savings at the lowest appeal rate, right? A new entrant doesn't have a network like we have a network of 1.4 million providers under contract. Again, AI company can't replicate that. right? And that's a critical part of the values that we're delivering, right? When you have a network, there's no appeals, right? That's a massive moat. Another part of that is, we have deep, trusted relationships with our clients and they're willing to sense their claims. I can tell you, having worked with a lot of our clients, it's really hard to sign a contract and get them to send you their PHI, right, and do business with you. And the 700 payer relationships we have, they're sending us the claims today. That embedded workflow is a massive moat that we have today, right? So we have deep trusted relationships both with payers and we have writers under contract. We're embedded in their workflow. We have data and so Travis talked about the data that we have that we use that they've sent and we have 45 years of that. We have 200 billion claims. We have $500 billion records that we import every month around price transparency. There's a massive amount of data that we have. Some of it's proprietary, some of it's public, but we've integrated all of that, and that gives us an awful lot of insights and intellectual property that we have, right. That's a massive moat. And so when I think about the opportunity versus threat, like we love AI companies big and small. Big ones would be the front. They're called Frontier Labs. Fernando has been educating me. That would be open AI, right? That would be all of the large LLM providers. That will be Google Gemini, that would be Anthropic Cloud that would be Elon Musk's xAI having crack, that would be Me-LLaMA. Those are large language models. Those will be the big companies, and then there's start-up companies, right? We love all of them. Like we have this moat we're happy to partner with anyone, like we use LLM tools. They're happy to part with us, and we've met with the executive teams of some of those companies. We're happy to plug and work with start-ups that want to plug themselves into our chassis in our workflow, right? If they have a point solution that delivers value for our clients, and we don't have that. We're happy to partner with them, right? So when we think about AI and will they replace. The first comment I said is 20% to 30% productivity gain, they can't completely replace us. Maybe 10 years from now, they could, but I don't think over the course of the next 5 years, that's anywhere within the realm of possibility, right? So the proof point was all of these companies are approaching us to partner with us to plug themselves into our workflow and our client relationships. So we feel really, really good about our competitive advantage. All right. First and foremost, as I said, to kind of wrap up, is AI transformational? Absolutely. We think it's driving transformation products. We feel like it's driving transformation and how efficient and effective our processes are? Reflected in -- both Jerry and Travis had 7 percentage points on a tier than anyone else in the IDR place. And driving our innovation and product development efforts and our software development processes as well. So we 100% think it's transformational. And the second part is like AI, AI companies like, we feel great about that that's an opportunity for us, not a threat. We're incredibly paranoid. And so we continue to monitor the situation closely to see what's happening. But today, with the current state of health care and the complexity that it has and all the customization that's required and the experience that we have, we think it's a mass opportunity and a moat for us, not a threat today. And so with that said, I'll be happy to take any additional questions on AI strategy at the end of the day in the Q&A. But I want to bring up our closure, our CFO, Doug Garis. He's going to share how everything you heard today kind of comes together, create durable profitable business and financial value. So he's going to wrap up for the day. Thank you.

All right. The closer. The good news is we save the math for last. I think a lot of you are excited to hear our update on the business. and how we're thinking about the future. I have a lot of content, and I will note that we are still ahead of the schedule, which is fantastic. I also do want to say, again, big thank you to Todd and the team. I think this has been an incredible day so far. We're humbled to be on the floor of the NYSE and to be with you all. I know a lot of folks had some challenges getting here, including some of our partners. And so we're internally grateful for that. So I'm going to cover a few things today. First, our guiding principles, why we felt like now is the time to accelerate investment plan for growth. I'm going to talk about the drivers of our business at a macro level. I'm going to spend a minute or 2 talking about ACV and bookings. It's a new metric we introduced this year. We spent a lot of time today talking about that. I'm going to talk about our Vision 2030 operating leverage. Why we're doing the tech modernization and why we think the time is now, why the investment has a great economic return. I'm going to briefly hit 2026 [ glance ] just because we are coming out of our guide over the last few weeks. And then finally, I'm going to drumroll end on our Vision 2030 model, which includes a midpoint of '28 with actual figures and then our exit rate for Vision 2030. Okay. So we're going to continue to kill folks with the journey because the journey is as important as the mission. And so when I look at 2025, to me as a CFO, the three most important ingredients of the [indiscernible] were the completion of the debt refinancing to reset our capital structure to provide us a few additional years of runway and an attractive cost of capital. The ability for us and the commencement of our tech modernization with a successful completion of the lift and shift to OCI. And then finally, stabilizing our core business so that our investors and folks have belief that we can turn this company into a long-term growth engine. And then when we think about 2026, there's been a lot of sports analogies today. We are playing offense. And so when we look at the deep road map, the elevated level of investment, each one of these is informed by a client, informed by a product road map, interrogated by a leadership team, supported by strong financials and business cases and then armed with a sales organization that can actually prove that they can sell things. And so the pronouncement from Travis this morning about $100 million internal aspiration is strong double-digit growth on strong double-digit growth. And then finally, with respect to going on offense, it's in go-to-market, product technology and innovation. We think we will continue to be the market leader in certain categories, and we're going to continue to double down and invest in those categories. All right. So when I think about our [ guidance ] principles let's start with our addressable market. Previously, if you look at the first bubble, our core addressable market is a very large market. right? It is a $16 billion market within a multi-trillion dollar industry because only a fraction of a time does a claim go out of network. We've made our business out of building a curated network with robust reference-based pricing and analytics and enforced by payment revenue integrity solutions to catch boohoos on claims as they go through the adjudication and payment life cycle. When you look at the next three bubbles, over the last year and change, more than doubled or addressable markets from $16 billion to over $35 billion. And when you look at the next bubble on payer and provider analytics, we acquired a company in 2023 that was formerly known as BST that has now become data and analytics. And you've heard from multiple customers and partners today, how they're using our products to deliver economic value to them. When you look at that market, just that market alone is equally as big as our core market and from prior lives, that market is growing mid- to high single digits and even in some aspects, double digits. That is where we have our data assets. And we strongly feel that we have the right to play and win in those markets. And then finally, when you look at alternative employment networks, we acquired a business a few years ago, formerly known as HST, now rebranded as Vistara which is a reference base plan reference-based pricing health plan in a box, that brokers, TPAs and folks who are looking down market to provide value in par for smaller employee populations. And then finally, in our international business, we launched our international business in May of last year. That business is now generating revenue. We expect the revenue to increase. We've signed four clients and we have an international team now based in Dubai, that is dozens of folks and growing. And so moving on to our addressable markets. The pie has grown and our investment to surround the pie is what is informed by our capital allocation. So simply put, we're here to diversify our business, and we can only do that by accelerating growth and becoming less reliant on a few large customers to underwrite our capital structure. So if we do that over time, we delever and derisk the business. But priorities, 1, 2, 3, 4, 5 are investing in our Vision 2030 plan. That is our tech modernization, the alignment of general managers with bag sellers and segment leaders and a shared service and set of tools and processes to make sure that we have the highest probability of running a strong growth internationally focused company. We're going to continue to focus on debt pay down. There is no mistake. We are in a highly levered situation, but we did put a renewed focus on M&A within the envelope of our capital structure, and we completed a small tuck-in acquisition of a company, OPCG, that was a catalyst for us to land a top five provider system, which we announced this morning. Okay. So now let's go to the drivers and the macro. There's three basic macro drivers that affect our percentage of savings are our [ PSA ] business, which is about 85% of our revenue. First one is out of network volume and I have details on each one of these that I'll walk through. But out of network volume has been stable at approximately 7% of all health care claims over the last 5 years. We expect that trend to continue. That's what we've modeled in our Vision 2030 plan. Second is claims mix. We've talked about this consistently over the last year, and we have some evidence to support that care is moving outside of the four walls of the acute care hospital moving into rural, moving into higher acuity specialty areas. And we think that is a tailwind for our business. And then finally, regulatory and policy changes impact client budgets and how they're spending money. If you look at our response to some of the significant legislation changes that have happened over the last few years. There was some hysteria that out-of-network would go away. And when you look at a product like NSA, when NSA was passed in 2022, NSA and Surprise Bill is now our third largest product category within our largest segment, claims intelligence. Okay. So now clicking into out of network. There's a couple of key important points. We sampled [ Meredith ] data going from 2020 to 2024. And what happened in that 5-year period. There was a global pandemic, there is a major regulatory change with NSA, and there was a recovery from a hyperinflationary environment as a result of the pandemic. If you look at the out-of-network claims from a sample from a pretty large sample close to $500 billion of claims over a multiyear period, you can see the non-network provider line was stable between 7% to 7.7%. So we think this market is mature. We think this market is here to stay. And then moving on to Specialty Products, something that, again, we've messaged is care is moving outside of the four walls of the hospital and into outpatient settings. When we look at our top 10 specialty practice areas, takes up over 80% of our identified savings. And importantly, it makes over 90% of our claims volume. And then finally, payer networks are mature, right? Don't let the data speak for itself, but out-of-network exposure and payer organizations do their best to limit in narrow networks. There's a few reasons beyond the 7% that a claim might go out of network. We look at provider behavior. We look at certain specialty areas and then just proverbial access and care gaps that happen in things like rural settings, which we talked about a little before. All of that underwrites what we believe to be a stable and consistent market over the last 5 years and through our model period over the coming 5 years. All right. Moving into our savings and savings by specialty. So the top two pie charts represent the 80% of identified savings. This is provider and facilities outpatient with the key categories. And the bottom left is inpatient, which is 20% of our savings and about 10% of our claims. And then the graph on the bottom right shows the highest acuity special areas in which you can see if you stack weight the exit price to 100 from Q4 of 2024 and look at the next year, some of our highest volume categories between surgery, behavioral health, emergency medicine and pathology have anywhere from 5% to 15% core inflation in the charges. So that is critically important to understand because the movement of care to where our savings perform the best has inflation layered on top of it in some of these categories, which have increased as a percentage of our total claims are increasing at a high market rate. This graph on the bottom right shows health care inflation. Okay. So now thinking about the buildup on how the increase in inflation and charges and the increase of specialty categories that we perform well, hooks to our revenue or percentage of save revenue, which is most of our revenue. First, our claims volume on an absolute basis from Q4 of '24 to Q4 of '25 was down 11%. That absolute claim volume decline was largely precipitated by one client, but if I strip that client out, the client that in-sourced some volume, claims would have been modestly down still, okay? So start off that with the kind of baseline. Now approach the inflation from charges that I covered on the bottom right of the last slot. Charges per clean up 11% from Q4 to Q4. Turns out our products work pretty well, and we had favorable mix. We're able to identify additional value based on a base level of inflation in those specialty categories that drove our increase in identified savings and the mix improvement. And we spent a whole lot of time today talking about things like Pro Pricer, like auto flow like NSA and [ prevents ], we spend a little bit of time and effort making our products work better. We have hundreds of thousands of rules and when you look at our revenue per claim on an absolute dollar basis from Q4 '24 to Q4 of 25, our revenue per claim was up $10 per claim, north of 66% against a comp of 56%. So again, when we look at the future, these trends are important to capture and have on to. But this is a walk of what happened in our business in our business over the last 12 months. Okay. Final point on regulatory and policy. We're in a highly regulated industry, and we have had a flurry of recent activity, right? I would say the most significant activity between one big beautiful bill, the ACA subsidy of rural health transformation in the last 15 years. And so transparency is no longer optional, especially among state and federal agencies who are clamoring for savings because their budgets are constrained. And so when you think about our strategy being on the focus on affordability and transparency, it has a center of gravity with our customers as well as a center of gravity with policymakers. And so we believe strongly in affordability and transparency and we're prepared for any subsequent and future regulatory changes, but that is the reality of being in a highly regulated business. Okay. Moving on to ACV and Bookings. I'm going to brag for a minute and our Chief Growth Officer, Tiffani Misencik is in here, but humungous [indiscernible] to the team for building a sales organization and creating a double-digit path growth to bookings. But let's just look at the numbers. Our go-to-market success in '25 was not an accident. We made purposeful investments to align segment leadership with bag sellers client success. And the result of that was a $67.3 million bookings year that, keep in mind, takes 2 to 4 quarters to turn into revenue with a $23 million booking quarter in Q4 and on the year, we closed 650 opportunities with 30 net new logos. On top of that, we closed 108 deals over $100,000 of ACV and that rate of larger deals closed was up 30% against 2024. Our average deal size was up 50%. And importantly, our average deal cycle improved by 30%. So we started giving indications of building a sales funnel. Sales funnel throughout the course of the year from Q1 to Q4 exit, created an additional 150% funnel off the base. We now enjoy a multi 9-figure funnel with an invested in sales organization that can help us deliver our aspirational target that we covered this morning. The final point I would make here is the pie chart, 70% to the upsell cross-sell on the organic growth, over 70% of our $67 million of bookings came from our current installed base. It was selling new things to our current customers. You heard Trace Health has bought virtually everything from us, all the way to organic growth within -- within our core account base. And then importantly, 30% of our bookings came from net new clients. And so we like the diversification here. When you see the proof points of a horizontal product, vertical market strategy, aligned with segment leadership, general managers to deliver be this is probably the most important slide to say our strategy is working. All right. So on to operating leverage. So we teased this at our investor roundtable last year. We got some questions from investors, why are you investing so much money? Why aren't you delivering free cash flow faster? And what does the lift and shift to Oracle and rewriting all of your applications mean. So 2/3 of our time and effort on our transformation is devoted to the tech modernization. The big milestone was the lift and shift ahead of schedule to OCI, which enables us to take advantage of all of the future tools and technology that Oracle is going to develop. But if you think about it, cloud-native modern platform, unified data architecture set up to scale globally and enable us to capture all of the innovation that's going to happen in the incoming years with the extension of AI. We expect to be largely complete with our tech modernization in calendar '28, and I'll cover that in the financials in a few seconds. On top of that, we expect an approximately 30% to 35% economic return from the incremental investment that we're making. This is important because if you think about why we would invest a dollar of capital and what would the expected return, our internal expectations are if a project doesn't deliver or an investment doesn't deliver roughly our unlevered free cash flow return, I would rather pay down debt than invest in the project. So we have a pretty large investment that unlocks growth, unlocks new markets and has a pretty good and pretty attractive financial return. And then the other areas I would just highlight on business realignment and business process optimization as a large public company and as esters, you should just expect us to do these things. So aligning a general manager organization to segment leaders and our go-to-market function is just what big companies do. And so we're going to operate like a big company, and we're going to focus on building the internal tools, systems and processes to address the future but those two elements are part of our transformation as well. And now when I think about clicking down into our technology transformation, I mentioned that we did the lift shift which we completed on OCI. We do have some onetime CapEx that shifts to OpEx and that bakes into our run rate this year, but I thought it helpful to provide kind of three flavors of ice cream for you today. First is our Pre-Transformation level of investment and what we are spending our time and effort from a software capitalization perspective. So we historically have said and I looked at even our last Investor Day that we did in 2023, we said we spent roughly half the time running our business capital half the time on growth. Well, over the last few years, our revenues declined. So we took a circumspect look at what we spent our time and effort with respect to growth capital to reposition. But if you look at the capital intensity, it's about 11% to 14% of revenue. Mid-Transformation, we do expect a slightly elevated capital as a percentage of total revenue. And if you look importantly, pull a lot less time on run capital, that is the benefit of scale at the lift and shift to Oracle, right? We're not running data centers anymore. Michael and his team don't have to buy hardware, software, manage the overhead of data center assets. And importantly, if you look at the rest of the pie chart, 70% of the time on transform and grow. Post-Transformation, so we expect the transformation to be complete in approximately 28 post transformation is where we really get scale and capital efficiency. We're still going to spend a little bit of time thinking about transformation as we should. But we think we're going to nestle into about 1/3 or so of our time on run cost. And most of our time on a refined list of growth objectives, but the most important thing to realize it's on a much more capital-efficient foot work. And if you look at the 10% to 12% capital as a percentage of revenue, that is probably in line, maybe slightly less than Pre-Transformation, but it's working on the right things with a map against either product innovation or something that a client has indicated to us that they want us to deliver. Okay. So a few -- we talked about these at length, but a few of the digital transformation examples in action. So you make an investment decision as a company, what are you looking for? Well, I mean, they're looking to take revenue up cost down or improve client satisfaction and retention. So if we look at the investments to deliver revenue growth, we talked about insights today, we also talked about the data platform. So right now, we have a marketplace with several APIs that partners can hook into our data infrastructure where data is accessible and available. That is fundamentally a different revenue model than a PC-based payer services company. As a technology platform, we're going to continue to invest in those areas because there is there is revenue potential there. And especially with BenInsights, we heard a lot today about new customer acquisition and the go-to-market through Oracle. From a cost reduction, think about the lift and shift OCI and the capital efficiency you get from getting out of running a data center. And I think about our NSA products, right? We had mentioned that auto flow, which is the middle top box and the improvements we made afford us the opportunity to enjoy a 7% competitive advantage against our nearest competitor on a much higher volume set. And then finally, turning insights into action. The NSA insights on the bottom right is the first cloud-native data API that gives real-time self-service to our customers which makes us a whole lot -- that better execution makes us a whole lot stickier with our customers improves client retention, eventually, we believe, improves better revenue. Okay. I'm going to hit on '26 guidance really quick. We had just covered this, but the baseline kind of three points here. Revenue growth, EBITDA growth, return to positive free cash flow with an elevated investment profile. And so when I look at the revenue walk, we ended '25 at $9.65 of revenue is approximately 4% growth year-over-year. We did commercially sign a onetime commercial agreement with a large P&C customer. So I would step down my revenue base by 2%. My gross revenue retention is an indication of how much of our core business and our total business we retain before any sales activity happens. So what we're saying is in any given year, and this year, what we've modeled is $0.93 to $0.95 on every current customer dollar before you apply market factors, before you apply ACV from incremental bookings, we're counting on delivering. It's a combination of expectations around modest volume and kind of all the other net churn and attrition because we are in a competitive environment. We expect to retain $0.93 to $0.95 on every dollar. That is an incredibly sticky business. We then applied 4% to 5% market factors. We are counting on improved mix. We talked about the increases from the elevated acuity levels, and we talked about health care inflation playing out. But we have a baseline assumption of market factors and mix helping us 4% to 5%. So if you're walking left to right, we expect our base business, our total business to be approximately flat before we add new things that we've sold. And on a raw dollar basis, our guide is 2% to 4% growth. If you exclude the onetime revenue from the property and casualty business not repeating, it's a mid-single-digit growth business, which aligns well to the bookings that we delivered that will eventually convert to revenue. Okay. So now moving on to our revenue mix summary. So we wanted to provide a couple of points of view. on what is composed within our revenue. So the graph on the left shows our revenue type as a percent of total revenue. We indexed to 2022 because it was the last time we were greater than $1 billion of revenue. And again, the guide range implies us returning in that range this year. But as you can see, when I look at PSAV revenue as a percentage of total revenue in '22, it was over 90% of our revenue, and we exited '25 with PSAV revenue being approximately 84% of revenue. A couple of important points there. Our PSAV business is a great business. It is a high-margin business, and we expect it to be a big part of our business going forward through our Vision 2030 plan. However, when we talk about derisking our business and diversifying the business, we're looking at other ways to deliver durable revenue growth. And we've announced several -- in the last several earnings calls, several large enterprise deals that behave like recurring revenue businesses. We're going to continue to look for ways to diversify our revenue stream. But this is an important point that diversification will mean PSAV remains still a good part of our revenue, but I would expect this trend to continue to decline over time. The graph on the right, Travis had mentioned it, but when you look at our client density as a percentage of our total revenue, one of the fears is what happens if one customer does X or Y. The point of building a diversified business is you have a lot of customers who do business with you. We acquire a lot more customers. And when you look over that same period, we're about 10% less reliant on our top 10 customers. So in 2022, our top 10 customers were nearly 80% of our revenue. We exited '25 and our top 10 customers were under 68% of our revenue. Again, thinking about diversification, thinking about horizontal products to vertical markets, activating new logos. The plan is to continue to chip away at both of these so we can build a more diversified and scaled business over time. All right. Moving on to the 2030 model. So now taking a look at our business from the foundational year to the turn. We've done a whole lot of work, and we've invested a whole lot of time and effort over the last 2 years to get our business fit for growth. when we look at '26 on the surface, it doesn't look like a really exciting year, right? Hey, you guys grew 4% last year. That's great. You're calling a 2% to 4% number at kind of flat to down margins. What I would say is '26 for us is an execution year. We're purposely investing between $20 million to $25 million in our go-to-market functions to deliver strong double-digit bookings growth. And what we're doing is building a company that has a durable and growing foundation that eventually scales against our investment period through Vision 2030. Now on to growth and profitability. If you take the midpoint of the guide and apply that to '28, we expect '28 to be at least $1.1 billion of revenue on at least $675 million of EBITDA, which implies a business that grows 4% to 6% at low 60s EBITDA margin. Why is that important? We have a steady core where we renewed our large customers. We're booking new revenue, which over time, when you look at the ACV to bookings lag to revenue, takes about 2 to 4 quarters. And so we think we start to really get momentum into '27 and through '28, but still on a more steady growth plane. And at the midpoint, still pretty pleased with a mid-single-digit growth with good EBITDA contribution. Now taking that forward Vision 2030, we expect growth to accelerate. And I think the key point is the financial aspiration we laid out last March when we had our Investor Summit was we had the aspiration to become a Rule of 70 company, which is actually pretty rare. And what a Rule of 70 company means is that when you add revenue growth plus EBITDA margin, it sum total 70. If you look at the midpoint of our guide and the exit rate for 2030, that's exactly what this implies. What it also implies is a business that delivers at least $1.3 billion of revenue on at least $800 million of EBITDA. I would also note that we expect our technology modernization to largely be complete in 2028 and the impact and efficiencies that we get from operating leverage start to really take hold from '28, '29 and -- excuse me, in 2030. All right. Now moving on to free cash flow. So we talked about returning to positive free cash flow this year. And the midpoint of our '28 guide is at least $75 million of levered free cash flow at less than 7x leverage. Again, '28 will have a small piece of investment as we complete our tech modernization, but you're starting to see what looks like a business that generates excess free cash flow. And when I look at our 2028 milestone and I look at our free cash flow yield, it's about a 6% to 7% free cash flow yield as a percentage of revenue. From 2028 to 2030, however, once tech modernization is done, once the compounding effect of our ACV and new bookings turns into revenue, and once the capital efficiency of the business from our tech modernization completes, we look at a business that is about 5x levered that generates approximately $225 million or more of levered free cash flow. And when I look at the free cash flow yield on this business from '28 to 2030 improves approximately 3x to the mid-teens. Okay. And so I'll leave you with this before I hand it back to Travis. We get asked often about what's our target operating model. So we thought it helpful to provide to our investors and analyst community. When I look at our gross margin, so taking our revenue minus our cost of goods sold, we expect to run a gross margin in the mid- to high 70s, which is at the top end of a common technology company. Technology companies run gross margins historically anywhere from 60% to 85%. We're expecting to run gross margin in the mid- to high 70s. When I look at R&D, we will have a small component of R&D that's non-capitalized. And then when I look at sales and marketing and G&A, so SG&A, we expect that to be about 11% to 13% of our revenue with a higher index towards sales and marketing as we get more scale leverage in G&A as a result of some of the investments. But again, when we look at the kind of midpoint in the implied guide, it is an EBITDA margin business that supports a 7% to 9% growth business that gets us to the sum total of a Rule of 70 company. All right. With that, I'm going to hand it over to Travis, and I think we have plenty of time for Q&A, and I'm sure you guys have questions.

Okay. Thanks, Doug. Appreciate it. CFOs don't usually get a round of applause. Enjoy that soak that in, Doug. So a couple of things, and then we will take some questions, my favorite part of the day. One is I got to commend you all, your ability to focus is immense. I've been sitting here watching. It is a focus group, perked up quite a bit. And Todd keeps his job. So where's Todd? We successfully got through. Thank you, Todd, for that. I appreciate it. We were all rooting for you. You've done it -- really, it's been a really good day. Okay. So this is a lot of information. I'll just take 2 minutes and sum it up. So some key takeaways beyond, obviously, the financial picture that Doug showed where hopefully, we're starting to give you more detail, more information, decode the business so you can model it. That's our goal. But we're going to laser focus on our clients. You got to meet some great people. So you haven't had a chance to see this full management team, so you got that today. And as I say, for me, as a CEO, purpose actually matters a lot because I need people to get motivated every day to do the things that you just described there. It's not easy. We have purpose because we have purpose, we show up with enthusiasm. We are executing. So we're on a journey. We talked about that earlier. We're focused on it, and we're generating results. And so the results are starting to come. No doubt about it. And we work across the life cycle. And so I know we -- sometimes we talk about things in snippets because we have short amounts of time to discuss them. But today was useful because we're able to see where we interact across the entirety of the life cycle from payer to RCM all the way to provider. That's important. We're growing. So pipeline growth, you've seen material growth in our pipeline, our sales pipeline. Our bookings are coming. They're starting to come, and we're growing. And revenue is starting to come from that. We're getting, I think, more there I say, elegant in our ability to predict revenue conversion. We keep working on that. We know it's super important to all of you in the room. And we'll be investing for growth, but we're also investing for operating leverage. So we expect those 2 things to come together in a meaningful way for us over the course of this journey in the near future, not in the way distant future. And there's enough proof points in reality there that's showing up. So we wake up every day kind of angry because we're -- we think we're wildly undervalued. We don't think we're getting the credit for what we've done since I've been here anyway. And so we're going to continue to try to prove ourselves every day to continue to earn your trust as you think about the many things you could do in terms of your investment thesis and the way you're evaluating your company. Really quickly, this is -- I think my first few months here, I actually put this up and so this is what we're going to become and very early in the journey. And we're demonstrating success on every single one of these. So we've upgraded the management team materially. We've added hundreds of new clients when you look at our recent closures and our new markets. Our goal is durable, sustainable growth, not simply going back to the same well consistently day after day. We want to create a durable, sustainable business that has a variety of customers and clients that we can withstand ups and downs based on market dynamics and still grow and deliver our results. So we're diversifying the business. We like our position with products. We like our position with AI. And we've got rigor and discipline in the business from the work that Jerry has done, where we think we can get more value while we reduce operating costs over time. And so you really put all that together, the piece that we have to unlock the full potential of the shareholder value is around the capital structure. We know that. And as Doug said, I tell the team, look, you can assume there's one way out and it's through. One way out and it's through. And through is organic growth. So we're going to grow the business. And so our assumption is we're going to delever the business over time, and we're going to do it with precision with smart investments and keeping our promises to those of you that invest in the company. And so I'll close it there and say I think we have time for a few questions, but we're very happy with the progression that we're making against what we want to become. And we know that it's starting to show up in results and it's starting to show up with people in the room because when I first started here, all I did is go to leverage finance conferences. Are we going to talk to investors, like no one cares about you. I was literally what I was told over and over. Well, a few people care about us. So you're in the room. So we're making progress because we're becoming relevant, and we're going to continue to do that and focus on that. And so thank you for your time. I'm going to -- we'll just open for questions. So I know that -- I told the team like this is not going to be one of those conferences where everyone is like want to go home, there are going to be questions. All right. So we'll just jump in. Todd, do you want to...

Hopefully, the audio -- there we go. If you have a question, just make sure you got the mic. So we start on that side of the room.

Good. I'm going to cheat. I'm going to ask 2. So just some maybe clarification. You guys spent a good amount of time on BenInsights and CompleteVue. So could you just remind us the revenue models for those segments? And then any sense of revenue contribution would be helpful in terms of putting those in order? And then second question would be, what would you need to see that would change your capital deployment focus on the organic opportunities? I am not naive. I got the stress on that. But are there certain areas, certain things that could happen where you would emphasize debt paydown or even strategic M&A on the other side?

Yes. So maybe let me I'll just use this. Is this line? Okay. So maybe let me start with that. And so start with the second question first, and then maybe I'll kick it over to Jerry and team to talk about BenInsights. Taking a look at an investment like our tech modernization is obviously a big investment. It's a multiyear investment. When we look at the strategic opportunities that provides, it starts with if you're going to invest in dollars, is going to provide an attractive return, we think a 30% to 35% economic return, which is a barometer for unlevered free cash flow is where we would draw the watermark to say, does it make sense to accelerate debt paydown? I think with our tech modernization, there's both an offense and a defensive component, which is why it was fundamental for us to start with the investment with Oracle and our tech modernization this year, right? It's to unlock all the future revenue potential, and we provided a base case. We expect to grow the business, and I think the tech modernization was fundamental. As we look at the future, the expectation when we start delivering excess free cash flow is to use significant proceeds to delever the company. So when you look at us arriving on an approximately 5x levered company by 2030 and generating a couple of hundred million of free cash flow a year, the expectation is a good use of those proceeds are to help accelerate delevering. And when you think about it, that to us is a prudent use of capital in the medium to long term. The big investment and the focus on the tech modernization, we think was both an offensive and defensive measure. And we simply needed to do the investment, and we're really happy about the prospects of it. And then on BenInsights, we don't give out specific and the data and analytics business is reported within Claims Intelligence from our segment reporting. We don't give out specific details. That's something we might share in the future. The business is still relatively small. But in terms of the revenue, maybe you could just speak about kind of clients and the revenue model.

Thanks, Doug. So what has now been Insights was one of the capabilities we purchased by way of BST in 2023. And we spent a good bit of our investment time modernizing that and getting it to a maturity level where we've sold it to a number of clients, right? So it really -- it begins with plan design, right? And it pairs well with all of the other products and solutions that we offer from ACE coding the claims correctly, you can apply our network to it. But in terms of the stand-alone BI Insights revenue model for -- I think that was your essence of your question, we're -- ultimately, we will sell it as a service inside of human capital management systems. So it becomes kind of the TurboTax for health care plan design, broadly available to large and small businesses across the country, but also a tool that enables TPAs and other payers to provide that service better than what's out there in the marketplace today for more than a couple of handfuls of clients where we've gone in and done an assessment on a payer's book of business. Generally, depending upon how good they are and how long they've been at it, we find between 5% and 20% incremental benefit to the employer, right? And so we've licensed that as a software as a service, along with a PSV component for upside given the variability that can happen during any plan year.

Stan Berenshteyn, Wells Fargo. I guess 2 questions. First, maybe a follow-up on Benefit Insights. It seems like it's a pretty crowded field. There's a lot of services in that area. I guess how do you stand out? How do you displace existing vendors that are already in the space?

Yes. So maybe I'll take the first shot at that. So when you look at the delivery mechanism, managing your plan spend is not a technical problem, it's a behavior problem. And so if you look at the distribution of how analytics are sold today, that distribution is carried through brokers and consultants. And so the big aha that we had as we started unpacking what was the BST and BenInsights was the delivery mechanism through human capital is where all of the other employee information is. And so replatforming BenInsights to be able to be sold as an enterprise piece of technology, to Carol's point earlier, allows a benefits professional to assess her or his employee population on a daily basis. We think that is a buying behavior that we're aspiring to change with partners like Oracle -- but primarily, it's been a distribution problem on how benefits and savings programs have been sold through brokers and consultants.

Yes. I think I'll just add a comment. I mean, the -- I'm not sure there's a lot of -- that I would call highly truly competitive for a lot of what we can actually do. I do think there's a lot of commodities out there that offer data. So here's some transparency data, here's some information, basically taking the MRF files and other publicly available means and putting them together in something. The real value is in the insights, which is what Tara talked about with Kinetiq earlier, the way Kinetiq uses it and actually takes that insight and turns it into meaningful cost takeout relative to, say, drugs. For the single patient example, which is $2.4 million. So I actually think there's a service wrapper for this that distinguishes the business, which is how we'll get more sell-through, which is why I was very enthusiastic about signing a large health system because the next thing we're going to do is we're going to pull through our products like BenInsights with consulting attached. And so that has been the single most vexing problem since I've got here in my mind is getting full value for that business. When everyone you talk to immediately sees the value, they're like, everyone should just buy that. We had the discussion on break with someone, right? But it's hard to get it through the channel of health care. The channel of health care is broker, TPA, consultant and other, which is inside of a fixed PEPM they're not moving off that PEPM. So you need to either be inside of that and displace someone or you got to find a path, a different path, which is why I like vertical markets because we have multiple paths. We're going to try a direct-to-employer path through HCM. We're going to try a TPA-based path. We're going to try a broker-based path, and we're going to try a direct to provider path along a managed service offering. So I think we have to attack the problem from multiple angles to get full value from the analytics business versus just a pure productized thing that you just fire into a market. And I think that's going to be a differentiator for us.

Okay. And maybe just a quick follow-up on AI. So you obviously, you have a lot of focus there. A lot of the last mile delivery of the services that you do, it seems like negotiation requires on actual headcount. Do you see AI potentially displacing or maybe driving efficiencies in that area where you can maybe leverage AI there?

Maybe Michael and pass it to Jerry.

Yes. The answer to that question is absolutely yes. So a lot of the work that we have is as we're modernizing, we're actually building agentic AI, generative AI to automate a lot of the manual tasks that require human decision-making. So yes, there's a definite plan, and that is part of what we're planning on doing.

I just want to add on side that, that project that won the hackathon was the last mile for sites. We won that hackathon with KPMG and Oracle.

So one example of that, Stan, was -- and Jerry talked a little bit about this, the surprise bill services, IDR, very manually intensive. So something that took 3 weeks to put together is an hour now, generating IDR briefs, which is the argument that's used. Part of it is predictive modeling on what's effective. Part of it is generative AI where human being doesn't actually have to spend days writing a brief that it's done by it. So absolutely. It's little things, but it's a much broader context that we have.

Yes. And then I think you asked about our negotiators, right? So financial negotiation our negotiators in that part of our business and clinical. We do a lot of hiring in that -- in those areas. But if you look at kind of the average productivity in terms of revenue generation, the benefit they get for clients, it's a pretty wide distribution. As you come up the learning curve, as you get to form relationships with the providers and the other constituents, the other counterparties. We've used the tools to not only improve the capacity of each person to process more claims and cases per day, but to get a higher benefit per claim and getting people up that learning curve faster, we get a lot of benefit, fewer headcount, better results for our clients and better revenue for Claritev.

We have about 5 minutes left. So disaster, we're going to kind of keep it going rapid fire here for our team as well.

Great. This is Jason Cassorla at Guggenheim. Just a quick clarification to start. The new top 5 health system, is that part of the $80 million to $100 million of ACV or separate or incremental? And then maybe just a question on CompleteVue. You've discussed a bit earlier on the price transparency that's helped pricing disconnects. But an interesting point you flagged is the volume discovery side of the equation, like leveraging CompleteVue for reducing leakage or using data to underwrite new service lines. Could you maybe just talk about how CompleteVue can help bring down the total cost of care for an individual despite perhaps maybe rising prices as you have that discussion?

So the answer to the first question is yes. And we'll probably give some more details on the next earnings call since it's just officially signed. But the answer to the first question is yes. And then who do you want to take the CompleteVue question? Maybe, Sean?

Yes. To answer your question around like lowering the cost of care, I want to refer back to Brian and what Brian was talking about. Brian is in a rural market, okay? And his price points are lower, okay, than somebody actually going into an urban market. So by him opening up new additional lines, he's capturing that volume at a lower price point. So it's beneficial for both payers and providers. So Brian is raising his net revenue, keeping things local as well as he's helping the overall cost structure as well. Does that help?

Jess Tassan with Piper Sandler. It's been super helpful. I wanted to just come back to the top 5 health system win. Can you just describe what is the managed services offering? How is it build? What segment does it sit in? And then I guess, just how does the margin profile of that managed services offering compare to your existing business? And should we kind of expect CompleteVue to ramp through managed services lynchpin or foothold type deals in the future?

Yes. So maybe I'll answer the latter part of that first. So we'll give those details on the Q1 earnings call, and we'll walk through the segmentation and the model. The managed service business is not going to be like Data Insights or a PSAV business. We think about the total package of selling through managed services with other offerings to arrive at an attractive margin business in total. But we would expect the business to probably be half as profitable as our core business. is our first client. So for us, the learning is incredible as anything. But I think when you look at the story around surrounding with other technology and solutions, we would expect that relationship to grow. And when you look at the total client, we would expect the margin to be north of what the managed services agreement would explicitly denote.

Yes. And I'll just step into the -- what is it? Look, there's a massive, I would say, need for capability insights for health systems and hospitals that have EMRs and other systems that can't maximize the use clinically, let alone procedurally with other pricing tools. And so since the day I got here, I've been fielding calls about stepping into that. And we've been actually fending it off wanting to make sure that it was on strategy, on brand for us, we could get to the attractive margin profile that we wanted, and we had other products that we could pull through massive client acquisition if you're able to sell it over and over and over and over. And so what we don't intend to be is a managed services company. What we do intend is to acquire clients and pull through our products associated. So example would be we will not be providing a Level 1 help desk and doing password resets. I not going to be doing that. But what we will do is look at complex clinical workflows helping them understand how to maximize the use of the technology they have. And oh, by the way, let me just go out in every region you have, which is every state for this particular client. I'm happy to go do a pricing study for you. I'm happy to go do a competitive analysis for you. I'm happy to show you Ben insights and how that works and where we think we can find value for the drugs that you're using and the prices that you're paying for those. So I view it as a material opportunity in the provider segment in order to use the totality of our tools, but also some of the expertise that, one, we have here because we've hired folks how to do this. But two, we also acquired -- that's why we did that tuck-in, frankly. because it was an ability to get this client in an adjacency and use some of our existing products. That's how we're thinking about it.

We have time for one last one here, Daniel.

Thanks for all the detail Daniel Grosslight with Citi. I guess I want to focus a little bit on the '26 guide or the building blocks to the '26 guide and then bridge that to the longer-term projections. And really want to focus on the gross retention being down 5% to 6%. If we back out the large client attrition from last year, Doug, I think you mentioned it was kind of flattish from a volume perspective. So why are we seeing kind of this decline in the gross revenue retention if, in fact, we are seeing that -- and then as we bridge to '28 and 2030 and beyond, can you help us think through those building blocks, gross revenue retention, mix shift, ACV and inorganic growth as we get to that high single-digit growth rate?

Sure. So what we attempted to do was simplify the components of our revenue. And the reality is before you apply any net incremental bookings, so before sales activity, we try to walk the components of kind of a base volume environment that was slightly down last year and walk that against how we've modeled for kind of the base business, including all churn and attrition, which, like I said, a low to mid-90s retention is actually a fairly good thing. But we do have -- we do have clients that attrit, right, small clients. We operate down segment, our Vistara business, for instance, you're rebidding a lot of small deals and resigning a lot of small deals. So I would think about it in terms of we're planning low single-digit volume decline that is being offset by continued favorable price and mix. And again, I think I would refer back to the specialty categories. We would expect that to continue. And then really, when you layer in the revenue conversion from the new bookings in ACV, we think the second half of the year is especially where our stronger bookings at the end of last year start to compound to revenue. So when you look at the exit rate of this business, its it's comfortably at the top end of the guide. And then thinking about the components of gross and net revenue retention going forward, we would -- we didn't provide explicit details through '28 and 2030. But the trend is, and especially if you think about another strong double-digit bookings growth year, as we continue to grow our bookings, and we said -- Travis set a target for $100 million. But if you just take kind of a strong double-digit growth number and compound that over time, the next 2 to 3 years, we stabilize the core business. We have a compounding growth business. That's how we go from kind of a mid-single-digit growth midpoint to a high single-digit growth exit from '28 to 2030. But we wouldn't expect -- when you look at kind of gross and net revenue retention, we've taken a modest and moderate view of base volumes with basically price and health care inflation and mix offsetting those. and then the growth rate from the new bookings to really start to compound '28, '29 and 2030.

Yes. And I'll just add one thing to that. I mean we're trying to give you the best visibility we can to model something that we don't fully control. And we don't control what happens on the other side of the employer group where they go. I mean they switch between all the time. So we don't have total control over whether they use Cigna, Elevance, United, et cetera. So there's always movement on the other side of that, that isn't even always a reflection of our capability or service. It's just simply groups move between payers. So there's some natural movement there that creates some level of attrition for us on the client base. But my experience, that's an extremely high number. I mean we were -- we thought we were doing incredibly well at like 88% in prior lives. So we'll take this all day, but we have to sell -- I'm not solely a salesperson until I have to sell. we need to sell our way into growth against that number now that we're able to peg it to a percentage based on our historical averages.

We're out of time. I want to say thank you to everybody. To go us 4 hours, your day, 5 hours is a great commitment, and we really do appreciate it. Thanks to everyone on the webcast for listening in. I'm going to turn it back to Travis here for some just final remarks, just to say goodbye in a moment. But I appreciate you all coming, and we look forward to your follow-ups and talking to you soon.

Yes. I don't have anything to add other than send us your questions, send us your feedback. What do we do well, we not do well, what did we do well. We'll listen, and we appreciate it. Thanks for your time.