LifeStance Health Group, Inc. (LFST) Earnings Call Transcript & Summary

[Audio Gap] and direct them to Lester or Bruff, just to keep it clear. So thank you, gentlemen, for joining us today. I really appreciate it. I think Mike Lester, let's start with you. Just for those folks that are on the line listening and that aren't familiar with LifeStance, it's a new company to the public market, certainly in a very important area of health care. But I want to give you a chance just to introduce LifeStance as you've come to the public market and as people get familiar with your business.

Sure. Thank you for having us today, Steph. So we're the largest outpatient mental health care company in the country today. We employ 4,400 -- approximately 4,400 clinicians across 500 centers in 31 states, providing basic mental health outpatient services for patients across the country. It's a very large market, a $100 billion market today, growing at double digits. We feel very good about our business model as well as the long-term economics of our business despite the current operating environment and the labor market that we're all experiencing. So we have a very -- it's a very highly differentiated model, in that it's a hybrid model where we can provide in-person care or virtual care. And I would tell you, about 80% of our visits today are virtual. That was a lot higher at the peak of COVID, and it's been ticking down about 1 point per month over the last year. Ideally, we think the right mix of in-person versus virtual care is about 50-50. We know that patients want to have that in-person connection with their mental health provider. And so we're able to do both.

Very helpful. I think there's been a lot of curiosity about the business. If you look at the stock chart, it would tell a very distinct story, which might not be the full story. So I want to spend some time at the beginning of this session, just really busting some of the myths that might be out there about your model. Maybe the first thing is just to talk about the labor issues that you're seeing right now, retention rates, some of the feedback that you're getting from individuals that are leaving your organization and just help to ground that this isn't a mass exodus from your model to somewhere else or competitive model.

Yes, sure. So before going public, we had an 87% retention rate. That's what we talked about on the roadshow and in the TTW meetings. And then I feel like we were the early reporters of this in Q2, sort of the canary in the coal mine. And unfortunately, I think we were penalized for that. But we talked about we started seeing a higher attrition rate, so our retention rate was going down slightly, and we sort of became concerned about that. Now in Q3, that's all everybody talks about, right? The whole world has recognized it. Wall Street Journal came out just last week and talked about the mass exodus of people from the workforce. So we've been laser-focused on clinician retention and we've developed a number of very, very specific tools to improve our retention and make LifeStance a destination of choice for mental health clinicians to want to work. So Mike, if you want to comment any addition about that?

I would say that the tools that we have in our toolbox are focused on different parts of the turnover. As Mike mentioned, pre-IPO and kind of a history of the business, 2019, 2020, the retention rate was at 87% and within the 13% inverse turnover there, people were leaving for a variety of reasons. People will leave companies because they want a different, call it, structure, they want to go to a competitor and try something new. And those things are -- those things remain in our turnover rates today. It's really that change that happened in late June from a forecast perspective and what we saw play out pretty much to our expectations in the third quarter from a forecasting perspective is that the increased turnover or reduction in retention is really related to people leaving the workforce. And kudos to the operational teams here at LifeStance who really went after a much higher touch execution of talking to clinicians more frequently, deeper exit interviews in addition to what we had been doing. So we really want to address those -- the dip in retention, which is driven by that pandemic fatigue, people dropping out of the workforce that people are reading about. But Steph, we're still -- we've still got a broader population and we're always going to be doing things around improving and strengthening the value proposition for clinicians who come to LifeStance because that's just going to strengthen overall retention. So we're thinking about it in both ways. This kind of near-term macro debate, but also what can we control? And how can we continue to strengthen what we think is an industry-leading value proposition?

So let's spend a little bit more time talking about that 7 points of retention change. Can you give us some measures of what you're finding in those deep exit interviews? Is there a common pattern? I mean, you used the word burnout on your conference call, which feels like a really heavy word, that this has been a really tough cycle for this industry to navigate through a global pandemic and just the burdens on mental health more generally. So talk a little bit about the exit interviews, where those folks are doing. And then I think the follow-up question we're getting asked from investors is, are you staying in touch with those therapists to the extent that when they want to reenter that you do put yourself in a full position to be the destination of choice?

Yes, that's a great question. So we continue -- we're doing these deep exit interviews, and you heard Mike talk about it, we lose clinicians, just like all employers lose people that just changed jobs. But I would tell you that this incremental loss or this 87% to 80%, that is primarily due to the additional pressures that our clinicians are feeling. They have the same pressures that their patients have. They have childcare issues, right? They're having compassion fatigue. They have COVID burnout, pandemic fatigue. They're taking care of a higher acuity level of patient than they've taken together and taken care of in the past. So it's just playing out. And we're trying to live our mission. We want to take care of the well-being and mental health of our own clinicians, just like we want to take care of the same for our patients. So we're -- we've developed this very flexible work environment, where they can control their schedules. We commented that we felt like they're going to take another day or 2 off during the holidays this year that they would have not normally taken, just to sort of deal with this. And we do -- we have a team that we call all of the clinicians that have left over the last year. Because, again, most of this incremental number of leaving, they didn't go somewhere else. They just left the workforce. So we're calling those people, and we have had a number of them come back to work. They weren't sure whether they were welcome back at work. Of course, they're welcome. They took their month or 2 or 3 months off and all of a sudden, they're recharged and they want to reengage. So we are -- that's our #1 target to call our clinicians that have left and see if they want to come back.

And Mike and Steph, if you don't mind, maybe just add a moment of incremental color there. What's happening in the labor market, whether people want structural flexibility or temporary flexibility, we don't know. And is the burnout something that's going to be ongoing? How is it going to change the way that the labor market thinks about workplace and work life? One of the things that we did discuss in our call and was evident in the third quarter is that despite the dip in retention, we still increased 400 clinicians net in that environment. And I would suggest to you, yes, we have 4,400 clinicians. We're one of the largest, if not the largest in the country. But there's still over 600,000 clinicians in the market. And I got to believe that they're experiencing the same thing that we are. They're experiencing the burnout. And in that -- in this environment, looking at LifeStance as an option to go from your individual practice or a small practice or even a large practice, where LifeStance as a company can remove some of the burdens upon you like scheduling and collections and calling people and things like that, we believe that our value proposition is even stronger in an environment like this and that will help us navigate through this. And again, that's why we're being very convicted to the long term.

Yes.

I think -- let's spend some time in this area because I think this is incredibly important. And the way that you framed it, Mike Bruff, I think, is really important as well, which is this kind of short-term, tactical near-term response to try to give your clinician some space and time to recover. And then there are strategic structural areas that you're investing behind. So maybe thinking about those 2 areas of your toolkit, are you still convinced that the value proposition that was established pre-pandemic still exists, but maybe just needs to be amplified from a structural perspective? So let's talk about those areas first. And then let's talk about, in the very immediate term, the next 90 to 120 to 150 days, what you're doing to really wrap your arms around that clinician pool to try to minimize further attrition levels, but also to make sure that your gateways back in are well fortified. So maybe let's divide it into those 2 buckets.

Sure. So I'll take the first part of that. So we have developed a very systematic approach to each clinician. So we actually have a red light, yellow, green light on every clinician. And if you're a yellow or red, it's a high-touch thing, you're hearing from the company all the time, we want to understand what your stressors are, where is your mindset from a work perspective? Are you thinking about leaving? Do you want more time off? So it's very systematic. We've also assigned champions to every single clinician. So somebody is reaching out to that clinician from an advent standpoint, on a weekly basis, how are you doing this week? Is there anything that we can do to support you? Anything. So we're very, very in tune. It's a very high-touch environment for us right now. The other thing that we've done is, as not a reaction to this, but it turns out that it is going to be a powerful retention tool for us is we've rolled out our equity program for 2022 across all employees. Now it happens to be that 4,400 of our 6,000 employees happen to be clinicians. So we think it's one of the largest equity rollouts to a group of clinicians in the country. And it's the last 2 months of this year that they are qualified for the plan. So they have to be W-2 employees and effectively work -- working full time. So it's based on the productivity. And then we will be making annual grants that vest over 4 years. So every year, they will get a grant. And we think that's going to be a very powerful retention tool and a way to build a considerable amount of wealth over the long term. I can let Mike talk briefly about the cost of that because this wasn't -- this isn't just an additional clinician cost.

Yes. We have planned a pre-IPO model for us just to continue to build out the public company infrastructure. That's a multiyear investment. We had plans to grow our clinician base and build out the support and infrastructure for that growth. We're going to move forward with those investments. Those are year-on-year investments that we had expected to make. The only real inflection to those, which was incremental, was the $10 million that we deployed in the back half of this year. 70% of that was really to support a higher-than-expected clinician growth, which is a good problem to have, especially in a labor market that we're in. The second piece on that, the 30% of the $10 million was around deploying business operations team to go look at our end-to-end processes. You can think about the normal enterprise work streams of book-to-cash, higher to term, cure to pay. They're a little bit different semantics in our company, but those are the things that we're looking at to see if we can get -- generate more leverage or generate leverage faster, either through time to revenue or through operating efficiencies. So really pleased with the work that, that team is doing. Nothing to call out yet, but really pleased with the progress there. So that's an ongoing investment, which will impact next year. But we are building -- we're building LifeStance for the long term. And the reason why we remain incredibly convicted on this, irrespective of the labor market, is that our unit economics have not changed. The clinician contribution -- individual clinician contribution, individual clinician productivity has remained relatively consistent. Our de novo economics, even with the refresh, remain relatively consistent. And as we had mentioned in prior conversations, we have an existence of our 2020 de novo cohort approaching 40% center margin. And we have another cohort that's at the 35% range. So we already have kind of mature and maturing cohorts that at the unit economic level are already achieving some of those long-term aspirational targets. So yes, we're dealing with something that is current. It's real. I love the way that the management team has stepped up and attacked this. But the long-term market opportunity, the unit economics of the company, give us conviction that we still need to invest for the long term. But we're also going to have to think about how we navigate through this cycle and remain very disciplined in times that have slightly heightened uncertainty. You have to remain very disciplined and core to your mission. So that's what we're thinking through, Steph, as we work our way through the remaining part of our 2022 plan.

All right. So I want to just fact check some figures because going through the diligence process to where we are today, there have been a few nuanced changes. Clearly, the retention figure is the biggest one, capturing most of the headline and the curiosity among investors. Mike, you just mentioned also the $10 million of kind of a pull ahead, but it's going to retain in the cost base or stay in the cost base going forward. And I'm curious to come back to you a little bit on this evaluating work streams, where you might be able to realize some leverage at the enterprise level a little bit sooner. So let's leave that out for a second. But has there been anything else, whether it's at the center level or at the enterprise level, that has changed other than the fact that you're actually growing faster than that pre-IPO model would have suggested?

Nothing that -- no. I mean, from the economics of the model, no. Other than the investment that I already talked about, no. The retention impact, the investments that we put in, those are the 2 drivers of the change in the model from the IPO to what we -- the preliminary outlook that we discussed in our third quarter call.

One of the questions we've been getting from investors, and I think it's just coincidental, but it's a point of curiosity is, we've seen significant levels of attrition that started in June across many health care services areas, across many retail areas. Is it purely coincidental that it aligned with the rollout of vaccine mandates across a lot of organizations? Or was that just -- is there something psychologically about -- this all started in March of last year, we're at month 15 and people start to realize, I'm really exhausted. Talk a little bit about that, just as a hindsight observation. Did you do anything internally from a regulatory perspective or a compliance perspective around vaccines or a return to the clinics versus virtual that might have instigated some of that attrition?

Yes, we didn't do any that I would be shocked if it had anything -- and in our company, I'd be shocked if it had anything to do with vaccine mandates. Again, you think about the vast majority of our workforce is working at home, right? So it's -- we don't think it's that. This is all about compassion fatigue and clinicians just dealing with a higher acuity level with their patients, and then they're dealing with the same issues that the patients are dealing with when they get home. So it's just a burnout issue, in our opinion.

And Mike, can you talk a little bit about -- because you are a very systematic organization with a lot of data, so I also want to give you a chance to talk about that statement that it's a higher acuity level. Can you just help us think through what you're seeing in your dashboards that's saying, listen, these are -- the caseloads haven't changed, but the case intensity has changed. What is the measurement that you're looking at?

So it's really -- we typically see the top 4 diagnoses that we see are anxiety, depression, bipolar, schizophrenia. What's changed significantly is the level of anxiety and then the anxiety and depression are pretty much kind of tied together. So those -- we haven't seen bipolar really change. We haven't seen schizophrenia really change. So it's really anxiety and depression that have gone up significantly. And then you also have patients that were being seen once a month that now want to be seen once a week. So it's just a lot more intense. And unfortunately, that makes scheduling more difficult for a new patient that needs to be seen because all of our clinicians have full schedules. So we're trying to -- our mission is all about improving access for patients. And so we're very focused on how do we get access for all this new patient demand that's out there versus existing patients wanting to be seen more frequently.

And talk a little bit about that pipeline. One of the things that actually got choked up on when we were going through the diligence phase when you talked about the wait, that there are patients that need mental health, clinician time and have to wait and just the risk in that wait. So talk a little bit about how that pipeline looks today where you're -- what you think you can do to help narrow that pipeline over time, not in the next, again, 2 quarters, but over the next 2 to 5 years.

Sure. So super frustrating, average wait for a psychiatrist today is still 6 months. And so we're very focused on -- part of the wait issue is and our access issue is a lot of patients can't afford cash pay. And so that's what our -- one of our missions is we want to build a business that is in-network commercial insurance. So when we go open up a de novo, we're pulling a lot of those cash pay patients into an insured environment. And we're pulling a lot of patients that aren't receiving care at all because they can't afford cash pay into an insured environment. So we're trying to hire as many clinicians as we can. As soon as we hire clinician, 6 months, they have a waiting list of patients and that's the way we're trying to address it.

You actually set up my next question, which is about the payer relationships because that is a unique feature of your model. And actually, one of the biggest things in our diligence process when we talked to clinicians that had left private practice and joined your platform, was just how easy it is to become part of the payer network or the referral network and to take away that administrative burden around what feels like this mountain to climb to file the forms and to get reimbursed. So talk a little bit about those payer relationships and then again back into that value proposition as you're hiring new clinicians, how you're onboarding them and getting them into those networks as quickly as you can.

Sure. So we have over 250 third-party payer relationships now. That continues to increase gradually month-over-month. And those are all in-network contracts. They are typically 3-year contracts that have evergreen renewals. At any point in time, we're in discussions with multiple payers just because we have so many, they don't all renew on a December basis, so to speak. And we have -- you have payers that their customers, Coca-Cola, Delta, Microsoft, are screaming at them every day that they don't have an adequate provider network for mental health clinicians. So we're on the top of the radar screen for payers because it's one telephone call to get 4,400 clinicians teed up to help build out their network. So we think we have good payer relationships. It also gives us some leverage with payers. I would tell you, generally speaking, we've looked at a lot of acquisitions, so we've seen a lot of data. Generally speaking, I would tell you that mental health clinicians are reimbursed 85% of Medicare and that's what drives them into a cash pay business. We see 120% to 130% of Medicare allowing us to pay our clinicians slightly above market, hopefully, another retention tool that we have and continue to hire more clinicians and build better access.

Another thing that struck me during the diligence phase was that you have a pretty unique proprietary technology to take a patient inbound request and define the right commission. And this is something that's so incredibly important because as we talked about the life cycle of your treatment plans, they tend to be months in length. And so that relationship equity becomes incredibly important. So talk a little bit about that matching software. Don't give away any secrets, of course, but just how important that is. And then one of the things we've been thinking about is as you bring clinicians back or as you drive better retention and utilization, is there a way to step up that matching software to make sure that clinicians are seeing the kinds of patients that they want to see and that their loads aren't over-skewed to heavy acuity or high acuity?

Yes. So that's a good question. I mean hardly anybody thinks about -- matching is a two-way street, right? Very few people think about, is it the right match for the clinician? Generally, people think about, is it the right match for the patients? So we're very -- we have a very good patient matching, very personalized patient matching experience. We're building digital tools to enhance that, that we'll be rolling out over the course of 2022 and 2023. Some of that's in testing as we speak. But the flip side, and we think it goes back to -- we think about this a lot more because it goes back to retention is, is this the right patient for this clinician, does this clinician like this type of diagnosis. And so we've started to think a lot more about the reverse of that is, what type of patients do you want to see? Do you prefer bipolar, schizophrenia, a much higher acuity level patient? Are you more comfortable with moderate to low anxiety and depression? So we're constantly talking to our clinicians about that right now and making sure that we get this right match. And our -- all the digital tools that we're doing -- and we have done hundreds and hundreds of interviews with our patients and with our clinicians and have developed this product innovation map, and that we're going to roll out that is very patient and clinician focused. And again, that's in testing now, and we'll continue to go to version 2, 3 and 4 over the course of '22 and '23.

All right. Last one, Mike, I'm going to -- Bruff, I'm going to bring you back in. And this is -- just double click on the equity program, because you referenced one thing that I just want to make sure we get clear because it's based on productivity. Productivity in the mental health industry is a little bit of a hard term to wrap your head around -- wrap our heads around. What does productivity mean?

Sure. Yes. I mean, look, our clinicians -- are vast majority of them, they are full-time W-2 clinicians. That's our model. So for us to put a condition to be a full-time W-2 clinician, I think it's expected. So it's just holding up the value proposition on both sides of the equation here. What we've done, and I think is wonderful, is not only do you have to meet that productivity, for lack of a better word, requirement, to get awarded, you have to maintain through the vesting period, and it's over a 4-year vest. So it keeps the value proposition going both ways. And I think it's a wonderful tool. The -- from a CFO speak, the accounting on this is just -- it's just normal that we will account for it in stock-based comp, which will be adjusted out of adjusted EBITDA. And from a size perspective, from a pool size, I try to [ be in ] of any other -- of all of our peers. There's nothing outrageous there, and it's also not anemic. It's positioned well for all of our team members, clinicians and non-clinicians. I think we're still working through the depth, breadth and amount per employee type because we want it to be as deep as possible, but at the same time, it has to be meaningful and it has to have the right teeth from a retention perspective. So those are things that we're working out. And I think once we finish that step, we'll come back out to The Street with an update to the SBC model.

Okay. That's helpful. I want to step back now. I feel like we've spent time talking about the immediate effects. And I want to go back bigger picture around growth. And this was one of the most compelling things as you came to the public market. Again, you've talked about the addressable size of this market is enormous. It is growing fast. Clearly, this is an area that enterprise customers, payers, I would say, more even society is underwriting increasingly. So talk a little bit about just the mechanics of the growth drivers. What is the growth driven off of? And what is that growth horizon intending to look like? How do you think about the rate of growth that you can sustain?

Yes. So our growth is -- growth driver is super simple, number of clinicians, right? That's just -- it's super simple, that's our unit economic. That's what drives everything. It's not centers. We get a lot of questions about, well, how many de novos are you going to open up this year? And in 2020, we didn't know where COVID was going. So we stayed committed to the number of de novos that we did, and we had a record number of de novo openings. That could very well change next year because if you think -- if we believe that 50-50 is the right answer of in-person versus virtual visits, one could argue, I can go double my clinician size and not open up another de novo, right? Because I've got 50% at home, I can backfill 50% of our offices and still be off to the races. So it's all about the number of clinicians. That's the key driver for us. That's why we're so laser-focused on making this the destination of choice for a mental health clinician to work.

And Mike, just as a clarification on that. As you're thinking about your forward mapping in that growth forecast, I don't recall specifically what the opening target was by year. But is some of that dependent on this drip effect of digital dropping back to physical? I mean you've talked about 1 point kind of per month you're at 80% digital still. Is that really the tripwire that you need to see that physical back to a level where it would justify the investment in the incremental unit clinic?

Yes, but it would have to go below 50% for me to say, I need to go open up more de novos before I'd double the size of my clinicians. Doubling the size of my clinicians is a lot. And I think it's going to be several years before we see 50-50 right now. I think it's going to come back slower than people think. And again, we're agnostic to that because we have rate parity. So we're totally agnostic as to the point of care. We just want to do what the best thing is for the -- from a patient perspective.

Yes. The flexibility -- what the -- if it's a 50-50 model or where we are today, which is 80% telehealth, 20% in person, what that gives us is flexibility in our capital deployment. And the growth rate -- the top line growth rate is really going to be -- it's driven by clinicians. It's not driven by whether or not we have a center. The center is just the physical space for the in-person. So in times like this, when we still have elevated telehealth as a mix of our overall visits, this just gives us an opportunity to flex on the number of centers to ensure that we remain disciplined in our capital deployment as we work through this. And that's something that we're really looking at and considering in the 2022 planning process, but capital discipline is very high priority for us.

We'll continue to open de novos. We're already in Q4 of next year on our de novo planning. So a lot of those already baked in the ground, leases signed. But we do think about now we have the ability to flex a lot more since we know tele is here to stay.

And Bruff, just from an accounting perspective, I want to be kind of eyes wide open around what that might mean. If you're migrating more of your dollars to digital recruitment activation for your virtual model, that's going to hit your P&L. But if you're capitalizing your clinic costs, that's going to be in your CapEx budget. Is there a shift in the dollars that we should be conscious of just as a sliding scale, not so much on a point in time, but just being open to the notion that things could move from the income statement to the cash flow statement, essentially?

No. I don't -- if I understand your question, Steph, the answer is no. When we hire a clinician, the clinician has the flexibility to move between hybrid and in-person. We're not hiring a clinician to do one or the other. So that's kind of the beautiful thing about the model is the clinician and the patient can move back and forth whenever he or she chooses. All we're saying is that our growth driver revenue is not coupled with having to open that de novo.

Got it.

So -- yes, as Mike said, we're still going to be opening de novos. We have conviction that the in-person is extremely important. It's just that when you're in the market dynamics like this, you just want to be very mindful and take a second and third look at the flexibility that this model provides from a capital discipline perspective.

I think this is incredibly important, I'm going to phrase it back to you and course-correct me if I'm incorrect. You do not need a clinic in a local market in order to hire clinicians. You need clinicians in a local market, and if they want to do in-person appointments, you are going to provide a clinic space for them to do that.

That's exactly right.

Okay. I think that's really important. So the extent of your growth can be persistent without shovels in the ground, that is not a precursor to the growth?

That is exactly right.

Okay. That's very helpful.

And we think that creates more of that flexible environment that clinicians are looking for. So we've been asked, well, don't you have clinicians that want more flexibility so they're going to Talkspace or BetterHelp or one of those other good companies out there? And that's not the case. They have the same flexibility with LifeStance as they do there. We're just not 100% tele, we can do both.

That's great. And your clinicians have that option when working with their patient?

That's right.

Are you finding that you're talking about 1 point a month, which is 12 points a year, that's a pretty nice pace of rotation back. What's the distinction between those that are seeing patients in person versus those that are staying virtual? Is it the patient's discretion? Or are you finding some clinicians are more willing to just return to kind of a pre-pandemic balance more quickly?

It's a little bit all over the board. I would tell you that it's typically worked out between the patient and the clinician, right? I can tell you where we have clinicians going back to the office, patients flock back to the office. You can tell they're craving that in-person connection with their mental health provider. But they also saw that tele is super convenient and they're willing to do some of it, they just don't want to do all of it, virtually.

Well, I can tell you that I'm looking forward to seeing you in person...

Same here.

So lovely to know you over Zoom, but I'm very much looking forward to it. All right. We're running up on time. So I want to give you a couple of questions that are kind of final thoughts. Is -- just as you think bigger picture about the dollars that you have raised and where you're going to invest, and then secondarily, as you think about that distinction in the market and where you bring value to the patient and the clinician, let's just finalize with a couple of thoughts there. Investment priorities, and again, this is many years, not just the next year, and then also, how do you reinforce continuously that value proposition to your clinicians and your patients?

Yes. Mike, do you want to take the investment piece first?

Sure. Yes, the first piece as we think near term, the next 24 months is going to be a lot of the things that I think people would expect a new public company and growth oriented is around getting the public company infrastructure set up. That's going to continue on for the next 24 months. And we will look -- we made a strong investment, I believe, in making sure that as we build that, we're going to build it as efficiently as possible to get -- maximize our leverage on that. I think outside of that near term, the investments that we will prioritize are going to be the investments in growth in clinician and patient experience. So the digital tools and reinforcing that hybrid model and having patients and clinicians be able to move across channels seamlessly. And those digital tools and the innovations that we deploy for clinicians and patients also work seamlessly with our back office functions. So we would like to have as seamless of an experience and not only for clinicians and patients, but also for our internal functions as well. So that's where I see us making those investments, but it's really those things differentiate us in the market. Those things support our value proposition for clinicians, and they support and drive the growth in a passive market opportunity. Mike?

And Mike, we continue to feel very good about the runway that we have ahead of us in our core business. we don't have to pivot. We don't have to change. We don't have to do anything differently. We just need to keep executing heads down and hire as many clinicians as we can. And then longer term, we're excited about the virtual starting to slowly tick down to a little bit more in-person, because we really like to be embedded -- physically embedded inside primary care. And where we're in about 50 large primary care group practices now and when we're there, it's just better patient care. There's a lot of data out there in the academic world that has demonstrated that if you spend $1 in mental health care, you save $6.50 in overall medical care cost. So that's the big win for everybody. I mean the payer wins, the patient wins, the clinician wins, everybody wins if everybody's mental health care is taken care of.

That sound like good economics.

Yes.

I think we'll leave it at that. I think that the takeaway for all of us, certainly is to seek out mental health, if necessary, if needed. Hopefully, it's from one of your practitioners, but certainly to advocate as well to make sure that the accessibility continues to advance. And I want to thank you both for your work in that because I always say, when I talk to investors, this is really worthy work that you're doing and has incredible purpose.

We appreciate your time.

You bet. And thank you, everyone. If you do have any follow-up questions, please reach out to us. We're happy to get you in touch with Monica, the Head of IR. She's listening in the background, and she does a great job in getting connected with Mike and Mike. So gentlemen, thank you very much. And everyone, please have a safe and wonderful day and a great weekend.

Thanks, Steph.

Yes. You, too. Bye.