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

Good afternoon, and welcome to the third day of the Virtual JPMorgan Healthcare Conference. My name is Lisa Gill, and I am the health care services analyst here at JPMorgan. With us this afternoon, we have LifeStance Health. Presenting for LifeStance this afternoon will be Mike Lester, CEO, as well as Pablo Pantaleoni, who is the Chief Digital Officer. We'll then have Danish and Mike, CFO, join us in the Q&A. But let me kick it over to Mike Lester to run through some slides. Mike?

Thank you, Lisa, and thanks, everyone, for joining today. And Pablo, it's also great to have you join me as well.

Thanks for having me, Mike.

It's wonderful to have the chance to connect with everyone, albeit virtually this year, and we look forward to getting together again in person in the near future. On Slide 2, we've included our forward-looking statements. Please note that today, we're not updating or reiterating guidance for year-end 2021 financials or for 2022. We'll be providing an update during our fourth quarter earnings call in March. On Slide 3, we've included a few data points that represent LifeStance at a glance. First and foremost, we're a mission-driven company committed to improving access to personalized, trusted and affordable mental health care. We started the company in 2017. And as of Q3 2021, we employ 4,375 clinicians in 31 states across approximately 500 centers. We have over 250 commercial in-network payer contracts and provide a hybrid, virtual and in-person model, both of which helped us provide mental health care to access to over 0.5 million unique patients in 2021. This has all contributed to a strong revenue growth with nearly $600 million of revenue for the trailing 12 months ended Q3 2021. On Slide 4, I'd like to share some background on the history of LifeStance. Our team shares a long history of successful health care entrepreneurship, having founded multiple companies together. LifeStance is the fifth health care company I have started over the last 37 years, and the third company our team has started together over the last 20 years. Summit Partners and Silversmith Capital Partners, investors in our prior company, said, "Let's keep the team together," and gave us $100 million to go figure out the next big problem in health care. LifeStance is the culmination of that search, with us officially starting the company in March of 2017 to reimagine how mental health care is delivered in the country. Turning to Slide 5. LifeStance is the nation's largest tech-enabled outpatient mental health platform offering a hybrid model of care. If we've learned anything over the last 4 years, it's that mental health is non-discriminating. There's no one face to mental illness. There are literally tens of millions of faces. Our mission is to help those tens of millions of people lead healthier, more fulfilling lives by improving access to trusted, affordable and personalized mental health care. We believe when mental and physical health care are unified, the result is a much healthier individual and, quite frankly, a healthier society. To state it plain and simple, you should think about LifeStance as the primary care for your brain. On Slide 7, as I mentioned, we're the nation's largest tech-enabled outpatient mental health company employing a hybrid, virtual and in-person model of care. We exclusively W-2 employ over 4,000 psychiatrists, nurse practitioners, psychologists and licensed therapists. It's important to note that these are not a bunch of 1099 independent contractors working for multiple telemedicine companies. These are W-2 employed clinicians that work exclusively for LifeStance. And we're in network with more than 250 payers, resulting in significantly improved access for patients at a lower cost. All of this translated into significant revenue growth. And as I'll talk about in a moment, we have a lot of runway ahead of us just in our core market, enabling our growth to persist. We've also been adjusted EBITDA positive since inception. On Slide 8, let's talk a bit about the mental health care marketplace. Mental health is a massive disease burden in our country. The prevalence is greater than cancer or heart disease. The TAM for outpatient mental health alone was $116 billion as of 2020, and is expected to grow at double-digit rates to over $200 billion by 2025. The demand for our services is accelerating. You can't pick up a newspaper anywhere any day and not read about the mental health crisis in the country. In fact, in a very recent USA Today survey, almost 9 in 10 voters believe there is a mental health crisis in America today. On Slide 9, you can see the problems that we set out to solve. I'll cover each of these on the coming slides. First, on Slide 10 is the lack of access. The facts are these. 53 million Americans today are living with a mental illness, 1 in 5 adults and 1 in 6 children have a mental health issue. Patients are having to wait months to get an appointment to see a therapist or a psychiatrist. An untreated mental health creates significant burdens on the patient's health and the entire health system. Second, on Slide 11 is the lack of affordability. Even if patients can get access, they face issues in affording their care. On the left, almost 50% of psychiatrists do not accept commercial insurance, meaning they operate in an out-of-pocket, cash pay model only, which leads to significant barriers to accessing care. That leads to 1 in 4 patients having to choose between getting mental health care they need or their daily necessities. And third, on Slide 12 is the lack of scale in our organization. This is a highly fragmented market with 95% of mental health clinicians operating as independent providers. That means limited ability to make investments in critical practice infrastructure such as no EMR, no outcomes tracking, no virtual capabilities, less time to see patients. Literally, most clinicians' EMR is a #2 leaded pencil. And lastly, on Slide 13, the lack of care coordination. Many primary care physicians are in need of a mental health partner to coordinate the care of their patients. As you can see on the left, untreated mental health creates significant burdens on the entire system, including higher overall medical cost. On the right, you can see it also has a significant cost to employers in lost productivity. On Slide 14, we founded LifeStance to solve these challenges. We're improving access and affordability. These 2 are inextricably linked, and we do that in a coordinated way. We're improving access with a hybrid model where we can provide care in person at one of our outpatient centers or through virtual capabilities. We're improving affordability by providing a network of over 250 commercial payers in a market that is largely expensive and cash pay. And our scale allows us to invest in digital tools facilitating care, creating a collegial working environment, reducing the administrative burden for all of our clinicians and creating a referral network for our primary care partners. On Slide 15, our model transforms mental health for all stakeholders. For patients, we offer convenient, affordable, high-quality care, both in person or virtually, and delivered care to over 0.5 million unique patients in 2021. For clinicians, we provide a best-in-class work environment with the infrastructure and technology to allow them to focus on patient care. For referring primary care physicians, we offer a national network for referrals, and in some cases, colocation with our outpatient mental health clinicians. And for payers, we not only reduce overall medical costs for their members who were able to demonstrate data-driven outcomes. On Slide 16, our goal is to unite digital and in-person excellence to transform mental health care for patients. Again, we believe in a hybrid model of in-person and virtual care delivery. It's important to understand that mental health patients and mental health clinicians both want a combination of in-person and virtual visits. That hybrid model is really the future of health care delivery. We're creating a gold standard digital patient and clinician experience, providing the latest digital tools, from online scheduling and patient clinician matching, to outcomes data tracking tools leading to the highest quality of care possible. On Slide 17, back to our biggest asset, our clinicians. Creating a new model for mental health clinicians is a central foundation of our mission. To achieve this, we've set out to solve key clinician pain points, which we call our 6 points of value, including a mission-driven culture, strong work-life balance and competitive compensation. Most recently, we've added a seventh point of value, which is creating an ownership mentality among our clinicians by including them in our employee long-term equity incentive program. Our clinician value proposition is resonating, demonstrated by our tremendous net clinician growth. On Slide 18, many primary care physicians are in need of a mental health care partner to coordinate the care of their patients. 40% to 50% of a primary care physician's patient population has a mental health diagnosis. We've built relationships with thousands of primary care physicians who refer patients to LifeStance. Our relationship with PCPs are a win-win as we provide high-quality mental health care for their patients while they are a major source of referrals for us. Our overall patient acquisition cost is minimal due to these sticky relationships, combined with our payer relationships and online self-referral. There's no economic relationship with any referral source. On Slide 19, our payer partnerships are critical to our success in improving patient access. In the highly fragmented mental health industry, our scale is unmatched as we provide payers thousands of clinicians to deliver mental health care to their broad membership base in a low-cost outpatient care setting. Success with our payer partners speaks for itself. Since 2017, we've grown to over 250 national and regional payer relationships and have never lost a payer contract. On Slide 20, as mentioned previously, we have a massive $100 billion TAM that is growing at double-digit rates. We are the largest outpatient mental health provider in the country, offering in-person and virtual care, and yet we are still 1% or less of the market based on revenue, patients and clinicians. This means we have significant white space in front of us for growth. Slide 21 lays out our systematic approach to near-term and long-term sustainable growth. Our core growth strategy breaks down into 3 pillars. First, we enter new markets through acquisitions. From there, we run our build market density playbook to hire or acquire more clinicians in our existing markets. Finally, we deploy our tech-enabled services to reach the entire population of the states we operate in, not just the population within driving distance of one of our centers. Focusing on the right hand of this slide, as we look to the future, our next growth horizon is to expand into integrated care models, including value-based care. We currently have programs in place with Medicare Advantage plans, a large dialysis provider and others. We truly believe in our fully integrated care model, integrating mental health care into primary care where all stakeholders win. Long-term analysis shows that $1 spend on collaborative early mental health care saves $6.50 in total medical cost. LifeStance is on the cutting edge with these partnerships, leading the mental health care industry and the direction of a fully integrated care model. While we lead the industry in these new models of care, it's important to understand that the runway and growth opportunity we have in our core market is enormous, and we've barely scratched the surface there. On Slide 22, the first sector of our growth strategy is geographic expansion. By acquiring clinicians in new states, we gain access to those states' clinician populations. We currently operate in 31 states and have a long-term growth plan to deliver services to all 50 states through either in-person or virtual care. On Slide 23, you can see the powerful de novo growth engine that has helped us build density and increase scale. Our center margin unit economics remain robust with 2x return under 2 years. And our 2020 cohort has strong unit economics, operating between 35% to 40% center margin on average. On Slide 24, you can see that clinicians drive our growth. When we started LifeStance, our model was center-driven. We've developed the capabilities for virtual visits as a tool in our toolbox. When COVID hit, our visits moved from 5% virtual to over 90% within weeks. We've now seen that trend down in 2021 to the low 80s. Long term, we think the right mix for access and great patient care is approximately a 50-50 virtual and in-person mix. What this means is that while we built a model with physical space for our clinicians, we have some long-term flexibility to grow clinicians beyond the 4 walls of our real estate. In the near term, we view our centers as a differentiator for both clinicians and patients and have not made dramatic changes to opening plans for 2022. But over time, we may be able to gain leverage by optimizing our space to align with where we expect visits to trend in the long term. For us, growth is all about clinicians, not the footprint of our centers. With that, I'll turn it over to Pablo, who will share an update on digital, our third growth driver.

Thanks, Mike. Turning to Slide 25. We believe that digitally-enabled care starts with people. In order to build engaging and useful digital experiences at LifeStance, we use a human-centered design approach to get a more robust understanding of our patients' and clinicians' needs. We interviewed over 120 people and surveyed almost 2,000 across all different perspectives, our patients, their families, other patients that seek care, our clinicians and clinicians that work for other companies to get a more robust understanding of their experience and pain points. We were able to get a deeper look into their journeys and workflows while also trying other digital health tools. On Slide 26, through this discovery research, we could better understand what most people go through when seeking care. This is just a generic version of that journey that gives you a glimpse into the patient, clinician and admin staff experience and all the ups and downs. It was important for us to look at the experience from all of the 3 lenses, and we realize how much one stakeholder's experience could impact another. So for example, when we look at the admin staff experience, we realized how much impact inefficient tools had on their ability to gather patient information to prepare the clinician for the -- at the first visit. We found that this journey is not just happening at LifeStance, but in most behavioral health providers in the U.S. On Slide 27, these were some of the interesting insights we found in our discovery that has informed what we've been working on. Over half of the patients said that clinician match was the top factor in booking the first appointment. Clinicians told us that getting patients set up for the first consult had the greatest impact on their job satisfaction. And finally, we also learned that support in between visits was critical for most patients we spoke to. On Slide 28, through this journey, we identified large opportunities to redesign solutions across the entire end-to-end experience. Today, we already have solutions to offer at every single stage. But to revamp the experience, we decided to start with finding and booking care since these were the biggest pain points for patients, their families and clinicians. This stage is pivotal in improving access to the right care and successfully setting up the rest of the experience. To give you a glimpse into how we're addressing this, we wanted to share our new booking and intake experience. And I'm going to play a quick video. [Presentation]

On Slide 30, this new online booking and intake experience solves some of the major pain points we found earlier. Improving the match between clinician and patient leads to higher satisfaction for both the patient and the clinician; also allowing for patients to choose how they want to receive care, in person, via telehealth or a mix of both; and finally, collecting the necessary patient information upfront that better prepares a clinician for that first visit. We are currently running a pilot in Ohio and will be rolling out across the country through 2022 to early 2023. On Slide 31, while we're sharing this online self-service experience for booking and intake, it is critical that any experience we create is fluid across the different channels we offer at LifeStance. For example, we're designing similar tools for our intake staff to offer a consistent experience for those who prefer to book their first appointment over the phone. We're designing this digital experience to feel warm and welcoming across our virtual phone or in-person interactions with our patients. And with that, I'll turn it back to you, Mike.

Thanks, Pablo. We're really excited about the rollout of this technology as part of our broader digital road map. Pablo is part of the great leadership team we've built, the team that provides us with deep bench strength. As we've grown, we've brought on a number of individuals with various backgrounds and patient experience, both in-person and virtual, and mental health specifically. And we've had 0 turnover in the leadership team since we started the company. And last but not least, on Slide 33, I'd like to highlight our commitment to social responsibility. We started LifeStance with the important mission of increasing access to high-quality affordable care. At the same time, we're committed to diversity and inclusion, as evidenced by the makeup of our Board, executive team and employees. And we're also committed to philanthropy through the LifeStance Health Foundation, which we started with an endowment of $10 million. And finally, we're committed to being the employer of choice within the industry and we're recently certified as a great place to work. In conclusion, on Slide 34, I'd like to recap our investment highlights. We are reimagining mental health care with a national platform and disruptive, hybrid care delivery model. We have multiple growth levers to capture a massive market opportunity, and we've delivered strong growth since inception with profitable unit economics. And lastly, we have an experienced, dedicated leadership team. With that, Lisa, I'm happy to turn it over to Q&A.

Great. Thank you so much, Mike and Pablo, we really appreciate the comments. I understand that the other Mike will also join us. And Danish, I know I said your name wrong the first time, so I'm going to make sure I get it right here in the Q&A. But Mike Lester, you talked a little bit about the fact that you will give an update on Q4 that there's nothing within your presentation. Is there anything incremental you can share as to how we think about how the quarter has gone and how you're thinking about looking into 2022?

So I'll let Mike Bruff address the financial piece of that first, and then I'll add on to that, if that's okay.

Yes, that's perfect.

Well, look, first, we're not necessarily going to comment on any financials today. We're still in the close process. But there certainly are a lot of questions that we get around a few key topics, and maybe we can give some color commentary on those. They are around the Omicron variant, if there's been any impact there, and then around, clearly, our clinician growth and in the [ physician ] rate. I'll kick it off with maybe the -- any potential impact from the Omicron variant. Operationally, we did see an uptick in visit cancellations in late December, primarily due to clinician and patient illness. But until we finalize our close, we won't be able to quantify any relative impact on the fourth quarter performance. What I'd leave you with on this topic is, yes, like most companies, we're not immune to these COVID-related challenges. But our hybrid model allows us to navigate these dynamics better than most. And that's because we can seamlessly transition between in-person and virtual care. But I wanted to give you that update that we've seen operationally. And Mike, maybe I'll turn it back over to you to give a couple of more highlights.

Sure. And as Mike said, we're still closing our books but are pleased to report that we've seen another quarter of solid clinician growth in Q4. And we're also happy to report that retention remained stable in Q4, aligned with our expectations of 80% annualized. So we feel like we've addressed that. We're laser-focused on clinician retention and note that we have continued to grow our net add of clinicians significantly.

Mike, on that topic, you've talked in the past about when we did have the turnover in clinicians around exit interviews and just really trying to understand, is this lifestyle, other places that they're leaving for, is there any incremental color that you can share with us that you've learned now that the retention rate seems to be steady here again at 80%?

Sure. Like any company, we have people leave for a variety of reasons. However, we believe that this incremental increase that we saw in clinician departures has been really driven by personal motivations, burnout driven by pandemic fatigue, some retirement, schools closing, so child care needs have increased significantly. We haven't seen this incremental retention issue be a result of people going to competitors. They're just leaving the marketplace. And I think the macro debate in the country is going to be ongoing for the next year as we try to figure, all of us, not just LifeStance, not just health care, but all industries try to figure out whether is this transitory or is this something structural we're going to have to figure out in the long run.

And along those lines, we've heard about wage inflation across everywhere, not just health care, but especially in health care. Have you had to raise compensation levels in order to retain people? And how has the equity program been a differentiator for you?

Sure. Danish, do you want to answer that?

Sure. Yes, happy to. So in terms of wage inflation, we're not seeing any unusual wage inflation in our sector above and beyond what we've always planned for in our models and guidance. Our clinician types have always been in high demand, and we've historically recognized that in the way we set our compensation structure and how we plan for wage increases for our clinicians over time. In terms of the equity program, it's still early days, but the program has been resonating in its intention, which has created an ownership mentality amongst our clinicians. The equity program is highly valued by those who want the best of both worlds. Meaning outside of LifeStance, clinicians have to choose between being a solo entrepreneur owner or being an employee. At LifeStance, they get all the benefits of being employed while also being able to participate in being an owner, which we believe is a unique differentiator.

Danish, one of the things that we get questions around, are those new clinicians and time of what it takes to get them to full productivity. Is there a difference in the time line between a clinician that you hire versus acquire would be the first question. And then secondly, what are some of the steps you can take to get those clinicians to full productivity even faster?

Yes. So there's not a significant difference in the time line it takes to ramp new clinicians versus what we view an acquired clinician being able to move to kind of "maturity," which is they're both in the ranges of 4 to 6 months. The way they get there is slightly different, meaning that a hired in clinician, we ramp by placing new patients on to their schedule and filling them up over that 4- to 6-month period versus an acquired clinician is typically coming in with a full caseload, but it takes us approximately that 4 to 6 months in order for us to transition them over to our payer rates and be able to enjoy any kind of revenue synergies as they transition again onto our rates. In terms of being able to shorten that, that really has been the -- what we've always witnessed since inception of the company. There's always things around the edges that we are investing in, in terms of improvements in credentialing processes and continued focus on bringing down time lines around patient fill and/or marketing. But in general, that's what we've always witnessed and has stayed pretty consistent.

With respect to the outlook around de novo openings, and Mike Lester, I heard you at the beginning say, it's not really about the centers, it's about the clinicians. But people find you through the first 3 quarters of 2021 surpassing the 78 you opened in 2020, do you have a longer-term target for the number of de novos you expect to open would be my first question. And then secondly, have you seen either a positive or negative change in any of the key metrics, including average time to break even or payback or time to maturity?

So our growth driver is clinicians. And the de novo centers are just the real estate in which they work. So as a result, we really haven't set long-term targets for de novos. We used to talk about de novos a lot and the number of de novos that we were going to open. But in this new world and this hybrid model, and if I'm correct, then the ideal mix of in-person versus virtual visits is 50-50. It's all about the number of clinicians. And technically, I can go double the number of clinicians that I have and not change my real estate footprint. We're going to continue to open de novos because we think that's an attraction for clinicians as well. But the hybrid model really is the differentiator for us. And as far as the metrics of the de novos, the metrics really have remained largely consistent through 2022, which is our latest mature cohort. We monitor the de novo return metrics, but that's really a secondary KPI for us. Since clinicians are the growth driver, we really maintain a greater focus on clinician growth now.

And acquisitions have been part of your story as well. Can you maybe spend a couple of minutes talking about the acquisition pipeline at this point? Has there been a change in the level of competitiveness in the marketplace? I can't agree with you more how important mental health is to overall health care. And we hear this from the health plans we follow and others. So I'm just curious if you've seen a change in the competitive marketplace as far as, one, who maybe you're competing against to win that acquisition; and two, if anything else has changed around pricing or anything else?

Sure. So our acquisition pipeline remains very robust with a number of medium to small-sized practices. We've acquired almost everything of any size out there, which has created a little bit of a barrier to entry for a lot of people that are trying to get into the in-person space. And this really limits the number of new potential competitors. We continue to see the same day-to-day players on some deals. However, in 2021, really, our deals were sourced on a proprietary database with no intermediary auctions. So we have a 10-person M&A team. We probably have the largest and most accurate database of all the mental health practices in the country. So we feel really good about that. And including clinicians in our employee equity program now significantly differentiates LifeStance value proposition for potential sellers and the clinicians associated with sellers. So we think it allows us to offer a win-win to both the practice owners and their clinicians. And average deal size has remained pretty consistent. There's not a lot of significant number of large targets to materially impact our average. That said, there could be opportunities somewhere in the future to consolidate some of the larger competitors.

One of the differentiations for LifeStance is that in-person or virtual. Can you maybe just spend a couple of minutes talking about telehealth competitors? And are you really competing head-to-head with them? Or the fact that you do provide in-person as well, you don't really see them from a competitive standpoint? And any color you could give us around that?

Sure. We don't see the pure play telemedicine companies as significant competitors. Again, there's this huge imbalance. There are so many patients that we need to get to. Patient volume isn't our problem. But we also -- not all of them, but most of the competitors -- most of the telemedicine companies, we're providing care to a little bit higher acuity level of the patient. So we're not taking care of the worried well, though there's certainly a need to take care of the worried well. All of our patients have a diagnosis, we bill a CPT code to a third-party payer for every service that we provide. And we're not seeing any new entrants with a hybrid model gain any significant traction today.

How about competition though on the clinician side. Are you seeing any competition with those telehealth providers to either attract or retain clinicians?

Danish, could you answer that?

Sure. Yes. We're not seeing anything different than what we've historically seen, which is there's always a subset of the clinical population that is looking for part-time independent contractor work versus we're really focusing in on the clinicians that are looking to build a career on a fully employed basis over a long term period. So though we do, in some cases, come across them, generally, we're appealing to different subsets of the clinician population. And I would argue that we're appealing to the larger group of the 2.

Just kind of going back, we talked a little bit about de novos, but as of the end of the third quarter, when you reported, you were operating in 31 states. Can you talk about near-term expansion plans, how many additional states or MSAs do you plan to enter in the next couple of years? And has the pandemic or the lower clinician retention rate impacted your plans around geographic expansion in any way?

No, we ultimately think that we need to be in all 50 states, either virtually or in person. There are 36 states that we have targeted that's primarily driven by population. We're not running off to Montana or South Dakota, as an example, just purely due to population. But we don't have a target of we need to go be in X, Y, Z states a certain period of time. We have so much growth in the markets that we're in, and it's important to continue to build geographic density and market power in the markets that we're currently in.

And payer relationships, being an in-network provider, I think even a number of the telehealth providers many times are direct-to-consumer and they're not always part of a managed care network, would appear to be a key competitive advantage for you in attracting patients as well as other mental health providers that are out of network, right? So if you think about the fact that you've talked about 250 payer contracts, including several with national providers, can you talk about where your penetration rates are today with some of those payers within the markets that you currently operate? Is there still a big white space opportunity within those payer contracts?

Yes. So for each of the markets that we're in today, we are in network with all significant commercial payers in that market from the standpoint of patient volume. Over 90% of our patients are treated in network. So in the markets that we're in, we feel like we really have the in-network coverage buttoned up pretty good. And payers receive us with open arms because they're so desperate to have a mental health clinician network to provide to their members.

Yes. And I think we've talked to some of the payers that you've worked with, Mike, where they've talked in the past of, if they build a center, we can fill it with our patients alone. So when we think about those kinds of opportunities, is it really just the clinicians that are somewhat holding you back at this point, being able to really just attract the clinicians in the marketplace? Because it seems to me like there's absolutely the demand on the other side.

Yes. Clinicians are our rate-limiting step to growth. The patients, that's our goal is improving access to affordable, trusted mental health care. The patients are out there. We just need to go out and find more clinicians that can see and help solve that patient demand issue.

You've talked in the past about some pilot programs as we think about this shift to value-based care, including 2 with payers and providers and 2 with self-insured employers. Can you talk about how these pilot programs have gone and whether you've seen upside or how you measure the progress of these kinds of programs?

Yes. So we're early in that game, but we do truly believe in a fully integrated care model. That's the -- all stakeholders win, the patient wins, the payer wins, the clinician wins. I mean, it's just a fantastic model. So we're excited about moving the ball towards whole person care, including Medicare Advantage plans, primary care groups, and we're recently working with a large dialysis provider to integrate mental health into that patient population. It's a long game, though, so it takes a good couple of years to put enough data together to really demonstrate the overall medical care cost savings. And we're doing it with the groups that we're doing it with because they're the only ones that can really measure this. It's been done in academia before because academia is a closed system and academia has demonstrated that spend $1, save $6.50, but nobody has really done it in the for profit world in a big way yet. So you really have to do it in partnership with a payer because the payer is the only one that gets to see all claims paid and can actually measure this. So we're 6 months into this. I think it's a couple of years before we see some really interesting data. But keep in mind, we just -- our core business, we just need to keep doing what we're doing because of the demand that's out there, keep hiring clinicians. We just think that long term, the integrated care model is the right answer for all the stakeholders.

Yes. No. And like I said, I couldn't agree with you more. We only have little less than 2 minutes left together. And as we think about the last 12 months and really look forward to the next 12 months, right, so hopefully, we're going to be sitting on the stage together in 2023. But what do you hope that investors or what do you think investors will appreciate about LifeStance 12 months from now that perhaps they don't appreciate today?

I hope it's the fact that we can sustain robust growth in different market conditions, pre-COVID, post-COVID, great resignation and beyond. So all because of our flexible model and the one challenge we're facing, which is keeping up with demand. It's also important for investors to remember that clinicians drive our growth, not centers. So we used to be focused on centers, but because the company was originally almost 100% in-person, now we have this hybrid model, it's truly about clinicians, and it's a true differentiator for us.

Great. We'll leave it there. Thank you so much for participating this afternoon. Thank you to everyone that joined us. If you have any questions, feel free to reach out to me or anyone on my team, or to Monica and Investor Relations. Thanks so much, guys. I appreciated seeing you.

Thank You, Lisa. Good to see you.

Take care.