Humana Inc. (HUM) Earnings Call Transcript & Summary

Okay. Good morning, everyone. This is Bob Jones. I cover the health care services space here at Goldman. Welcome to the Humana session. Very excited to have Humana with us, one of the largest health benefit companies in the country. I'm joined from the company by Brian Kane, CFO. We also have Amy Smith, VP, Investor Relations. So welcome to you both. Thanks for participating this year.

Great. Great to be here.

I thought, Brian, we would just dive right into questions. Obviously, a lot going on these days in general and as it relates to the business. I thought just starting with utilization, it's obviously been significantly impacted in the current environment, which certainly can cause some unique and tricky situations as a managed care organization. Could you maybe just give us a sense on what you're seeing kind of real-time overall from a health care utilization standpoint as we sit here almost in mid-June?

Sure. Really consistent with some of the things that we've been talking about, obviously, utilization remains depressed. The back half of March and April were particularly depressed. We have seen a bounce back in May. I would say it's still meaningfully below overall. It's the normal levels, but we have seen a bounce back. I would say in southern states, for example, you've seen more of a bounce back than, obviously, northern states like the Northeast, for example, although our presence is, as everyone knows, much smaller in the Northeast. So the impact would be a little bit bigger for us, but still meaningfully below where we would expect. The area where we have the most data is on inpatient admissions, and that's because we get authorizations. And so that data is most robust. Some of the other service categories, particularly for later in May and June is where we don't get pre-ops, it's very hard to know exactly where we are. But I would say on the inpatient side, just to give some context, the back half of March and April were above 30% down versus normal. And inpatient admissions constitutes, call it, 30-plus percent of our spend, but it's a good indicator more broadly. That number has come down to more around 15% in May in terms of being down relative to normal levels on the inpatient side. The other area where we have very good data on is primary care because we own primary care clinics. We've seen a lot more people coming into the clinics, seeing their doctors than we've had in March -- the back half of March and April, it was almost 0. Almost our entire practices were utilizing telehealth. In certain markets today, it's back up to 80%, even 90% in certain markets of visits in person. So that's a good thing. And we have seen a commensurate rise in some of the other downstream spending categories, not to the extent of primary care, but still has come up pretty meaningfully. So that's probably where we are, as people saw, in the prior public setting. We talked about second quarter earnings north of $10, that's where we're at. And obviously, that's driven by an MER that's going to be lower than normal. So hopefully, that's helpful.

No, no, that's very helpful. And actually, that was where I was going to go to next. I was just thinking about the cadence of 2Q in the back half. And appreciate the commentary on, at least, directionally, where 2Q could shake out. I guess maybe as you think about that in the context of the full year, could you talk about just some of the mechanisms or levers you have to kind of manage to the full year if you do put up such an unprecedented and clearly disproportionately high 2Q EPS number?

Yes. Well, there are a number of things that we're doing. And I would describe them as investments in our members, investments in our providers and then investments in really our core business, both -- more short term to ensure that 2021 is set up for success; and then longer term, really creating longer-term sustainability for our business. But most of the dollars have been spent on members and providers. On the member side, I think people saw that we've waived all co-pays for primary care and behavioral health in all settings. We were the first to do that. We thought that was an important step to take with respect to getting people's confidence to come back into the health care system. And we waived in any setting. So whether it's telehealth or in the office setting, the member wouldn't be responsible. We think it's really important for members to be able to get their care. We -- a number of our members, we want to make sure that we've actually engaged with substantively, just given some of the chronic conditions they have. And so we've spent a great deal of time making outreaches to these members and really have bolt-up our calling efforts with our nurses and to some extent social workers reaching out to really -- at this point, over 1 million members are making those contacts, which has been really important and costly but really important to do. But I would say that's certainly a big initiative waiving the co-pays. We've also sent, what we call, safety kits, care kits to all of our members across all of our membership base across business lines, which includes Humana masks. So people -- you'll see people walk around with green masks, that came from us. Again, really in the spirit of giving people confidence coming back into the system, among other instructional tools and ways that they can get comfortable rejoining the health care system. We've been very involved in shipping hundreds of thousands of meals to many of our members, members who have real social determinants that drive physical health and food and security is one of them, especially in these times where a lot of members don't have access to food. And so we've shipped, like I said, many hundreds of thousands of meals, and that will go into the millions as we go into the back half. We've made a number of advances to providers, some of which is not earnings based, but some is. I mentioned in a prior public setting that we waived financial recovery for a period of time. That's now back on. And while we'll get that money back eventually, there will be impacts on the quarter. For example, you'll see negative prior period development in our business lines on account of that since we recover a number of claims that we expect in our reserving. That won't happen. And so some of that, we'll get back this year. Some we'll get back next year. Some we might never get back just the way the processes work, but we thought that was a good investment in our providers. We've extended loans and credit to our providers to help them get through these difficult times. And we've turned off other, what I call, utilization management-type functions that we recently reinstated for later in May. But for April, May, that would be a hit on some of our earnings numbers because we typically restrict certain procedures from happening in an inpatient setting. But again, in this instance, we wanted that to happen. And then finally, I would just say things like in-home assessments, for example, where we have nurse practitioners or primary care doctors going into the home to provide a clinical assessment of the member to get them the care that they need. But it also allows us to capture the risk codes, the documentation necessary to get paid for 2021. And so we are going to ramp those up dramatically. We've already started much higher than planned. And the reason for that is to really capture some of the documentation that we won't have received because of the April and May slowdown and so that's some use of those excess dollars. And then finally, as I said, really building out our integrated strategy. There's a number of accelerations we can do on the IT side, on the business model side, how we're going to address a number of the more difficult conditions going forward, how we're building out our home strategy where we continue to put dollars and accelerate dollars in that direction. So a number of things where we're spending those dollars, but we've committed to getting back to our initial guidance range. It's not -- it's a definitely an art, not a science. And so we're working through that as the year progresses.

No, that's super helpful. I guess just one last follow-up on this. As you just reiterate -- you've reiterated, you just talked about the guidance range for the year, the $18.25 to $18.75. Under a scenario, Brian, where maybe trend doesn't come back as quickly or anywhere close to pre-COVID levels, how much flexibility and how nimble, how quickly can you actually pull some of those levers you just discussed in order to really manage within that range? And I totally appreciate the point that it's an art not a science because of the way this year is going to play out. But just curious how much control or flexibility you have over getting there?

Well, it's a fair question and it's something that we think a lot about because you're right. If utilization doesn't bounce back as we are planning effectively for it to get back closer to normal by certainly later this summer, where we could even see in certain circumstances running a bit above normal utilization and then sort of settling back down to more normal utilization. If that doesn't happen or there's a second wave, for example, which we truly hope that isn't the case, but were that to happen, that could impact our utilization assumptions. And to answer your question, I would say, within a reasonable amount, I think we'd be able to manage it. Obviously, if there's significant depression of utilization, then that would be more challenging. But we have -- we're clearly ready to release funds to the extent that more dollars are available within a reasonable range, is the way I would describe it.

No, that's fair. I mean I guess the other interesting dynamic created from this whole situation is obviously trying to price appropriately for next year in kind of an unprecedented trend line, if you will. So maybe just on the bids, the MA bids that were due earlier this month. Any thoughts you could share just around maybe how this year's process in putting bids in? How the considerations varied from previous years?

Yes. Well, it was a complicated year. I thought last year was a complicated year with all the rebate craziness, but this year definitely exceeded the complexity because of what you just described around trying to get our -- not only our trend right, but also our revenue right for 2021 because of some of the risk adjustment phenomena that we've talked about, though I feel good about where we ended up, and our plan to hit our numbers for 2021. But it was complex. We started with the normal bidding assumptions, which is what is our actual 2020 cost baseline pre-COVID, which is always a challenge to get right because you don't have a lot of data before you price. This year, we had even fewer data because really it ended in February. By mid-March, the data was distorted. So really only had 2 months of good data to price with, which is, again, less than normal. But we did see better utilization going into 2020 and the first few months of 2020 than we had initially anticipated and guided towards, and we had mentioned that on the first quarter call. So we try to make an assessment of what that would be and bake that into pricing. We then have to make an assumption around what normal trend levels would be based on the economy and other things and normal trend factors, unit cost being an important one and a host of factors that drive secular trend, assess what we think our trend vendors are, meaning what are the things we're doing to reduce trend and then make a COVID adjustment. Where do we think -- once sort of things settle down, where will utilization be? There -- some people would argue that, that there's still some catch-up to do. And so you could see it running hot for a little bit. There are others who believe that it will run below the normal for a while as people are getting adjusted coming back into the health care system. And also importantly, perhaps there will be a shift from more institutional settings to noninstitutional settings, and we've seen the home continue to be an attractive place to get care done. And so I think we've taken a prudent course as we thought about trends, really taking into account all potential scenarios and eventualities. And again, I think we've tried to be prudent. Our goal was to put a product on the street that we could be proud of that members would respond to, that was fitting of the environment in which we find ourselves but also generates nice EPS growth and really balance that growth and margin that we always strive to do. And I think we've achieved that balance. We obviously have more to say about that as we go later into the year, but hopefully, that gives you some color.

No, that's helpful. I guess just a follow-up question around bids, and I know this is something you can't answer because, obviously, you don't know what other bids would be. But just thinking about it at a higher level, do you think this year there's added risk that the range of bids could be much wider than normal? I mean obviously, just hearing your last response, it's a very complicated year to try to think about how cost will play out for this MA population next year. I mean do you think there's any risk around this bids being a much wider range than normal?

I think it's possible. I think, generally, the people who set the market, I think, are sophisticated. So when you think about our major competitors, I think they understand this business very, very well. And so I think they're going to be rational in their pricing. But I do think the incremental uncertainty caused by COVID, for sure, can create more variance and really depends on how people view the various outcomes that could happen. So I think it's possible. I think the HIF helps as well. I think the HIF does provide a nice tailwind for folks to be able to incorporate some of the uncertainties, but it's possible.

No, that's a good point. I guess just -- you kind of mentioned this, but moving over to just to risk adjustment in this environment, another challenge that's been created from this COVID situation. I guess on your end, I know CMS has been flexible with the channels you can do to get your population properly risk adjusted. But just curious any thoughts on how this has been playing out in the current environment for Humana?

Well, it is a challenge just because of the way the process works, which is you get paid based on the 2020 risk that you have in terms of the members that you have. And so it's important that both new members as well as existing members get documented or redocumented for the conditions that they have. And a lot of those codes, a lot of those documentation comes inorganically, meaning that a person goes to the doctor, sees the doctor, the doctor marks on the chart what the condition is, and that gets submitted to us and then we can submit that to CMS for risk-adjustment purposes. To the extent that visit doesn't happen, then we have to capture some other way. The good news is, particularly on our existing members, but also have pretty good ideas on our new members, given some of the patterns we've seen, we know where to go and we know where to look. And so we have a sense from a sort of in-home assessment, where we want to make sure we get to our members. And it's important because a lot of these members have chronic conditions, and we need to get to them and provide them that care. Similarly, on the telehealth side, as you alluded to, CMS, thankfully, and we very much appreciate, allows us now to use video telehealth to have that documentation which is a change from the past. Historically, you had to actually have an in-person encounter. They've moved to video for this year, and that's helpful as well. So we're going to use a combination of video, telehealth, in-home assessments as well as really encouraging people to the extent they're comfortable to come back to see their doctor. The good news is, and we've seen it in our own primary care clinics, which we own and operate, we have seen a real desire on the part of our members to actually see their doctor in person. And so we have seen a real increase in that, which is good news.

No, no, for sure. That makes a ton of sense. And I think maybe the other one that we get sometimes around this is just [Technical Difficulty] Star ratings will be determined and future bonus payments related to that. So could you just remind us how CMS has outlined Star ratings and how they'll be used to determine future bonuses? And then just given the strength of your number of 4-plus Star-rated plans, does this kind of create a bit of a [indiscernible] actually for Humana?

Well, so just the way they're doing stars and the calculation is confusing and complicated. And so we like to talk in terms of bonus years to get everyone level set. So for bonus year 2022, which is the results we'll get in the fall, that's based on service periods for HEDIS, which is the clinical gaps in care, based on service periods for 2019, the codes of which and the details of which you -- a lot of times retrieve through chart retrieval in early 2020. CMS has recognized that the chart retrieval process obviously can't happen if you can't go into the provider's office. And so it effectively frozen the bonus year 2021 scores into 2022. Same thing with the CAHPS scores, which is the customer receive feedback and perspective on their carrier. And so from that perspective, in theory, 2022 should -- the risk should be reduced in terms of where our Star ratings are going to come in at it. I think we feel good about bonus year 2022 because they've removed that variability, which is a good thing. Bonus year 2023, which is based on service periods in 2020, is still to be determined. You have that same issue as we do for MRA in that the numbers aren't going to the doctor, and so it's harder to close those gaps in care, get the screenings done, do the things that we typically would do if they're not coming in to see their doctor. And so that's still TBD with CMS, and we're working with them on bonus year 2023. I think in part it's going to depend on how quickly things bounce back, and we can get people to see their doctors. I think -- so that's still outstanding. But again, that would be for bonus year 2023, which we'll get in the fall of 2021 in terms of the results.

Understood. No, that's helpful. I guess, Brian, maybe moving over to the primary care strategy. I know last week, you announced details for the first phase of your 3-year expansion project for partners in primary care. It sounds like based on the release at least that things are still on track there despite the current COVID situation. Is that a fair assessment of that strategy? And then maybe if you could just remind us how that will play out over the next 3 years, that would be helpful.

Sure. I think it is a fair assessment. And really, the idea was to partner with Welsh, Carson with about a $600 million fund to allow us to build out at least 50 clinics over the next 3 years, hopefully more and that is on track. As you mentioned, we announced we would be in Las Vegas. We're expanding in Houston, really densifying in Houston, which is great. And then expanding to Shreveport, Louisiana. You'll see additional announcements over time. But we are full speed ahead on building those out, getting ready for AEP. We have doctors recruited. We have lease assigned, buildings being built out. The team has not slowed down. The only impact that really the COVID crisis is having is more around the marketing and the community events and the things that we like to do to get the market ready for a launch. It's sort of softening the market. That's harder to do when you can't have these in-person events. But other than that, we are on track to open these centers, and we're excited about it. Welsh, Carson is a great partner, and they're fully committed to what we're doing, and we look forward to building these out.

Yes. No, and I'm sure this is a big part of the goal you laid out at the Investor Day of doubling the number of your MA members that are in primary care models from, I think, it was around 8% currently. Maybe could you just talk about longer term, Brian, like how penetrated do you envision assuming that the partners in primary care strategy plays out as planned? How penetrated do you think over time you can get into your MA members utilizing one of your primary care arrangements?

I think it's going to depend a little bit on how quickly we grow the denominator, so to speak, meaning that we sell a lot of products to people who aren't buying an HMO product, aren't buying a product that has a doctor attributed to it. We want to do that. They're profitable members. And over time, we're able to migrate those members to a proprietary asset. So I'm hopeful we could still get that percentage up to where you just described and double that percentage. We've been fortunate that we've been growing the base so quickly that it takes time to migrate those members into these settings. That's certainly our intent. And we have really committed to growing and building out our primary care strategy and getting more of those members in there. It's hard to forecast exactly what that percentage of total members is going to be just because the variables in growth -- of underlying growth. But that's certainly our intent. We find that when members are in these settings, every element of the performance is better, whether it's the quality they get, the clinical performance, the financial performance, the membership stickiness in terms of them staying with us. So it's a really great setting to get health care done. And so we're doing everything we can to move those members into those settings. It's just that we have a lot of new members coming in. So getting that migration and the percentage of total, it's hard to move that number up, just given the rate at which we're growing, but we're certainly trying to do that. The absolute numbers are going up dramatically, obviously. It's just -- it's the percentage because of the denominator.

Right. No, of course, of course. I guess, maybe just one follow-up there. You mentioned a lot of things that are better in these arrangements than if they weren't in these arrangements, one being financially. I think in a typical MA relationship with a provider that you're not associated with the economics are fairly understandable. And I think on the other end, when you fully own the provider, I think those economics are understandable. This is, obviously, some of the arrangements you have are probably somewhere in between, if you will. So is there anything you can share just around how we should think about the profitability of an MA member that participates in one of these types of arrangements versus those other 2 scenarios?

Well, we haven't given a lot of detail around that. I would say that broadly, if you think about an MA member having -- if we're hitting our target margin of 4.5% to 5% and when they're in those settings, the insurance plan is much more likely to be in that range towards -- certainly towards the top end of that range than if they're not in those settings. And then there's the downstream profitability from the clinics and that you own. And so it depends on the maturity of that clinic, but you could see easily those margins, if not meaningfully more than that in the clinic setting, if you're successful at managing the member and once they're at maturity. It takes time to get them to maturity. But the margins on the clinic business, if run well, can be attractive. So you significantly increase the profitability there for an MA member, but it's a lot of hard work to get there.

No, I'm sure, for sure. I guess maybe just one broader question around this. Clearly, Humana has been a big proponent of value-based care, in general, value-based reimbursement. I would imagine, I know it's temporary, but those that -- those providers that have been participating in capitated arrangements in one way or another, obviously, in this environment have probably fared mostly temporary, but any thoughts on maybe how the current situation maybe could help accelerate the willingness of providers, more providers to want to engage in value-based arrangements?

Yes. I think what this crisis has shown is that people who are engaged in these relationships, where they're accountable for the care of their members, and they directly financially benefit when members are healthy, have performed much better. I mean there's the cash flow dynamic, which is they get -- typically get a percent of premium or some kind of primary care capitation amount for every member that they see. And so they get that every month, and that's cash flow. So they don't have the cash flow challenges that truly fee-for-service doctors have, which is a big deal. And then secondly, because of the way they're incentivized, they've been the most innovative in embracing new technologies like telehealth, for example, and really wanting to go out and see their members. We've seen significant adoption of telehealth, particularly among our value-based providers. They were the first to embrace it. They're figuring out ways to getting to home. They're figuring out ways to contact their members telephonically, even if they can't do it by video. So it's just -- it's a better model because all the incentives are aligned, which is what's great about Medicare Advantage. It's just -- all the incentives are aligned. I mean we, at Humana, are effectively capitated by the government. And it's the same thing where we're capitating providers downstream. They have that incentive to do the right thing by their members to get to a better outcome. So we are big obviously proponents of it. We do think this crisis will accelerate it. And we certainly had more discussions around that kind of payment model for more of our members. But we'll see where it goes. I think we're going to see continued adoption of some form of value for our providers.

No, I think that makes sense. Brian, you mentioned it earlier, but I wanted to go back to the HIF and the benefit for 2021. Now that bids are in, any more disclosure or thoughts around how much of that benefit could, in fact, flow through next year? Or just any context on how you'd have investors think about the benefit from the HIF in 2021?

Well, I would just say that we've -- as I said a few minutes ago, we just continue to strike the balance between top line growth and bottom line growth and also investing in our business for the long term to create the sustainability that we need to continue to be very competitive. I'm really not prepared to comment any further than at this point in the year than I've done already. I just -- again, I think, hopefully, investors think that we've struck that balance and some years have been very volatile with the HIF coming in and out. We're going to try to do that again, and we'll have more to say later in the year about it.

No, that's fair. I guess on another topic that we get questions on is ESRD and their coverage now within MA. It sounds like the company has gotten a little bit more comfortable about new ESRD members than maybe you were when this first came out. I was wondering if you could maybe just elaborate here and talk about how you're thinking about that population at a high level. I think what was once perceived to be a potentially fairly significant headwind, maybe isn't positioned that way now. But just curious, your thoughts on how you're thinking about the ESRD population.

No. The way you described it is fair. I think the team has done a lot of work to mitigate the impact on the ESRD exposure. We do expect a reasonable amount of ESRD members coming into the Medicare Advantage next year. And so we've been very focused on 2 ends. One is the clinical side and really spending time developing the clinical capabilities that we need and to manage these populations. Where they get very expensive is when they're not on their regular regimens and they crash into the ER, and that's where all the bad things happen. And so that's what we want to avoid to keep them stable. And so we've been working really hard on that over a period of time. That's going to be a multiyear strategy, candidly, to get that right, both doing it ourselves and working with partners. And then there's, I would call, more of a supply strategy, which relates to unit costs in terms of where the care gets provided as well as innovation around supply. On the unit cost side, I think the team has done a nice job of making sure our unit costs are where they should be in -- with these members. And I think some of the network adequacy flexibility that's been provided will -- is and will continue to be helpful over time as we engage with others to build out innovative sites of care, whether in the home or what we call micro clinics, where they haven't been before. And so I think there's really a combination of things has gotten us more comfortable that the ESRD headwind will be more manageable next year. And over time, we really want to create a much better program and clinical outcomes for these members, which we think we can do.

No. Yes, that makes a ton of sense. And I guess, Brian, one other area that has come up, we've gotten questions on is just how companies will handle the annual enrollment period in light of COVID-19. Anything you manage doing differently? Or as you think about preparing for the enrollment period?

Well, what we've seen, clearly, in the COVID crisis is a shift towards telephonic more than it's even been in the past. I mean a good majority of our sales today are telephonic, but really preparing more field-based brokers, both internal and external, to be able to drive sales telephonically, I think that's an area where we've got to continue to shore up and make sure that our distribution force is able to sell effectively telephonically and using digital channels as well, although the adoption of pure digital has been pretty low in this space to date, I think largely given the complexity of the sale and the complexity of the product. But we've spent a lot of time and effort working with our partners and internally to figure out how we make that pivot to the extent -- particularly to the extent the field sales don't come back nearly as fast. Now as the world opens up, hopefully, this will be less of a challenge. But no matter what happens, I think we'll be well positioned to address the main theme.

Yes. No, I think everyone is probably in the same boat there as well. Yes, I guess just one other one in this current environment, this being, obviously, an election year, we do get a lot of questions around what should or shouldn't people be worried about as far as potential changes, both legislatively and just regulatory. So at a very high level, I'd be curious if there's anything that you would have on folks' radar, whether it be proposals like the Medicare age being changed. That would be obviously an important one as it relates to the bulk of your business. But another one that we get to and I don't know if you've gotten a lot on is direct contracting. So maybe those 2 specifically, but also I'd open it up for any kind of general thoughts on what you would or wouldn't have on investors' radars from a legislative and regulatory standpoint.

Well, it's a fair question. And obviously, there's a lot of game at the play here. We got to see what happens and what the various proposals are. There are certainly proposals like the 2 you just mentioned that could be meaningful opportunities for Humana. Obviously, to the extent they lower the age of Medicare and Medicare Advantage being an important part of Medicare, that would for us be a very significant opportunity because our commercial book is very small. And obviously, we're a leading player in Medicare. And so that would be a big opportunity. Now obviously, the assumption underlying that is that the funding mechanism is appropriate, and we have to understand all that, but you could see potentially a significant volume of potential customers coming into the system that we can reach with our Medicare chassis and so that could be quite positive. Certainly on the direct contracting side, the details are very vague, but the idea of using our capabilities to manage traditional fee-for-service lives, whether we do it at the plan level or at the provider level with our own assets, there's just a lot of things that we're working through. And candidly, there's just not a lot of detail yet to be able to comment more specifically than that. But conceptually, we're open to it, and we'll see where it goes.

Yes. No, I thought it was encouraging, at least, they put a start data out there for April of next year. But yes, to your point, details are still hard to come by. I guess, Brian, just in the last couple of minutes that we have, I want to just maybe touch on capital deployment. I know some of your peers and even just folks within health care services more broadly have suspended share repurchases in the current environment. Just wanted to check in kind of real-time to see what your latest thoughts were on capital deployment priorities in this environment.

Well, look, we believe in doing share repurchase. It's not something we're going to do now for the reasons you alluded to. We'll see as the year goes on. But returning capital to shareholders is an important use of capital. But we do have a number of strategic things that we look at, I would say, primarily on the services side. If you look at our 3 lines of business, really home, pharmacy and primary care are areas that we're always looking to expand our capabilities and deepen our capabilities. So to the extent something comes across our radar screen, we would definitely pursue it. I would say most of them are small that we see. For example, we bought Enclara, which is the hospice pharmacy. We're really excited about that. But I would call it a huge acquisition. You'll see us continue to invest in smaller, more early-stage companies, where we can get an early -- we can help influence the Board and the direction of the company and use our membership base to help them build out their capabilities, which we love that model and then have an option to buy it, which is something that we -- that's something that we do often. So we control our destiny and also get a nice financial return, which is important. There are obviously bigger assets out there like Kindred, where we have 40%, and the put/call starts next July. And so we'll see where that goes. And then also to the extent there are plan assets that are out there, we'll look at those if we can get something done at a reasonable price and -- but tend to be single state or single market or maybe several markets, but they tend to be smaller. And also, there's some technology things that we look at, although that's always a debate on the technology side, where do we want to own versus where do we want to partner. Our biggest technology partnership is with Microsoft, which we're excited about. I think they're excited about it. We work very closely together with really the -- I think on cutting-edge of the cloud conversion in the managed care space in terms of the types of things that we want to do with our data and with our analytics and really cocreating with Microsoft some really interesting ideas that we're working together on. So I would say it's a comprehensive perspective on capital deployment, but we always want to be very judicious about our use of capital, make sure it's earning a good return.

Got it. No, I think that makes sense. Well, look, we're up on time. So Brian and Amy, I want to thank you both for taking time with us today, and I wanted to thank everybody who was able to zoom in or dial in. I hope everybody is enjoying the conference, and have a good day.

Thank you.

Thank you so much.

Thanks.

Take care. Bye-bye.