ModivCare Inc. (MODVQ) Earnings Call Transcript & Summary

December 6, 2022

OTC Pink Market US Health Care conference_presentation 39 min

Earnings Call Speaker Segments

Joanna Gajuk

analyst
#1

Good afternoon, everyone. Thanks so much for joining us. My name is Joanna Gajuk. I'm the health care analyst here at Bank of America. And it's my pleasure to now host this session with ModivCare, one of the largest providers of health care services that is quite diversified. They provide non-emergency medical transportation, but also personal care, as well as meal delivery. So there is a lot to talk about. And today who we have is Heath Sampson, President, CEO; but also Kevin Ellich, the Head of IR is joining us; and Zach Miller, who is in Corporate Development. So we will go right into the Q&A. And a note to the audience is that if you want to ask a question, you can use the box next to the webcast and post the question. And I'll be more than happy to relay the question to the team here.

Joanna Gajuk

analyst
#2

So I guess first, Heath, can we start kind of big picture question here in terms of the growth algorithm for the company? Like I mentioned, there's different businesses here, but I guess tying all this together, has value there too. But can you talk about the expectations for the organic growth for each of the elements and for the company?

L. Sampson

executive
#3

Yes. Well, good afternoon, good morning to everybody. So we're glad to be here. BofA, thanks for allowing us to make time with all of you. So we appreciate it. Hope everybody had a wonderful Thanksgiving or looking forward to the holidays. Oh, time is flying. So it's the same here at ModivCare. And Joanna, you said this. We are a diversified company, unique really, that has services that address supportive care services, allowing people to age and live in their home as well as get people to their appointments. If you think about where health care is going, where it's continuing to grow, it's really in the space that we're in. So we're fortunate to be able to have these services that really address the social determinants of health, the inequities that we have in health care. And all of our offerings do that. So I guess there is a lot of growth. There's a lot of growth because of the marketplace, but there's also a lot of growth because of what we're doing. So from a macro perspective, consistent with what we've said early on in the summer when we had our Investor Day, we expect to grow around 7% to 10% across the entire company. Different areas that we're in, again, our transportation business, our NEMT business or what we call our mobility business, our personal care business, our remote monitoring business and then our kind of starting meals business, they have different growth rates based on where they are in their life cycle. But in general, that's the growth rate that we feel very comfortable achieving, is that 7% to 10%.

Joanna Gajuk

analyst
#4

So when it comes to the transportation business, the 7% to 10% targeted growth rate right there, what's the main driver here? Is it adding new contracts or growing the existing contracts? Can you kind of flesh it out a little bit for us?

L. Sampson

executive
#5

Yes, it's all the above. So it's the growth in the marketplace, both on the Medicaid side as well as the Medicare Advantage side. And the Medicare Advantage side because of where it is. It's a smaller part of our business right now, about 15% of our business. That growth rate is larger primarily because transportation as the benefit continues to outpace the growth of MA. You go to all the large payers and even newer payers that are coming in as they're adding that as a benefit. So that's MA growth. And then just winning new contracts as well. And that gets to ensuring that we're providing great member experience and then winning our fair share. Consistent with what we said in the past, we win and retain the majority of the business kind of in that 90% plus. And we expect that to continue. So it's a combination of growth in the marketplace, our sales efforts in MA and then winning and retaining our disproportionate share to the marketplace.

Joanna Gajuk

analyst
#6

And when it comes to personal care, right, when it -- we hear other companies talk about the historical, I guess, mix that normally they would have in terms of volumes versus pricing contributing to the growth now has been shifted more towards the rates. So can you talk about what -- how you're thinking about the 7% to 9% growth for personal care business, how much pricing versus volumes? And specifically, what has been the breakdown, where these trends have been this year?

L. Sampson

executive
#7

Yes. So for the personal care business, the industry as a whole and us included the demand for our personal care services continue to outstrip the supply for us and our competitors. And that's been that kind of prior to COVID, through COVID and is the same now. As this industry continues to mature, that actual gap even continues to grow. There's a number of states, fortunately, the states that we are in, they understand the value of personal care and understand what it does. And it keeps and changes outcomes for people. So they're actually increasing the amount of personal care. And that has been reflected in a lot of the rate reimbursement changes that we had in '22. So those have been even above our expectations. And what's that allowing us to do? That's allowing us to share and increase our wages for our caregivers, therefore, being able to recruit and retain more. So that growth rate in reimbursement and then really the relative wage increases will be in that kind of low to single digits kind of going forward. I think the big bump that we had in 2022, I expect that to normalize to the mid -- low- to mid-single-digit range. But again, most importantly is the states are viewing this as a positive offering, and it really does change outcomes at a much lower cost. So we're excited of where we're positioned in personal care. We expect to grow within our footprint. A lot of opportunity for organic growth via taking business as well as opening up de novos.

Joanna Gajuk

analyst
#8

So in terms of the rates, you said you expect the rates into next year to sort of normalize. But are there still additional states of yours that did not access the ARPA funding yet and you expect them to still bring it in next year? Or that's already played out?

L. Sampson

executive
#9

Yes. So you hit on a couple of things. So what the states have done is actually giving ARPA funds, but they've also increased reimbursement rates. So they've done both. The largest benefit in 2022 has been the increase in reimbursement rates, which is great because that's long term. I also do expect ARPA funds to continue into 2023 as well. So the reimbursement in ARPA fund into personal care, especially in the Northeast where we're concentrated, I expect that to continue and it will benefit us and enable us to continue to grow.

Joanna Gajuk

analyst
#10

And I guess a follow-up question here from the audience around the Medicaid redetermination. So with the PHE extension and expiry at some point of -- I guess as of now it's April. But expectation is that states will start to kind of look at their roles and there could be some members losing coverage through Medicaid. So I guess the question is, what is the estimate and timing on losing members and implications for ModivCare from these all changes?

L. Sampson

executive
#11

So consistent to what we've said before that we believe we can manage through that, to get a little more deep on that, where that could impact us -- and again, we can manage with that -- is not on the home side we believe because of personal care, specifically, there's just a large demand. So that redetermination -- and we don't -- it's a fee-for-service business. So we don't foresee redetermination on the home side to be a risk. In fact, with what the economy is doing and potentially a recession, that actually will be a tailwind for us. And that is same on the mobility side. I think if there is a recession, I expect that, that will actually help us on the redetermination. But in general, for our contracts in our states and where we know we're going to have the opportunity to gain volume, we believe that we'll be able to manage through that on the mobility side and stay consistent with our growth expectations and margin expectations across all of ModivCare. But the main focus will be on mobility. In the event where a state may move faster than they expect or we expect, we also believe that we can appropriately share the pricing changes. Our relationship with our payers and states is clear on what the membership is. And on an annual basis, we look at that and make sure we're on the same page. So in the event that there is an opportunity or a risk that we won't be able to manage through this -- again, I don't think we will -- we'll be able to alleviate that with some minor pricing changes.

Joanna Gajuk

analyst
#12

And you mentioned recession and the implications for the businesses. So can you flesh out a little bit more in terms of where you see the impact here? I assume you meant more on the labor pool improving?

L. Sampson

executive
#13

Yes. So I think it's both. I think the main driver that we're seeing on the labor pool, which really is primarily with the drivers and then the caregivers, that, we see more people come back to work. And you couple that with what we talked about earlier around our ability to pay more, we're really seeing the labor market improve on that side. And that would continue if a recession was to happen. That just happens across all industries. The other item is just the unfortunate of what people are going to be going through and typically in a recessionary time, Medicaid membership also outpaces as well. So there's a 2-pronged benefit if a recession does happen.

Joanna Gajuk

analyst
#14

And just talking about labor and staffing. So maybe we can talk about that, because, obviously, it's very topical across all health care services settings really. So we've been hearing comments around labor, that things are improving, but kind of slower than expected. So kind of can you tell us what you have been seeing over the course of the year, but also more recently? Are there any notable changes in terms of recruitment or retention? And also, how do you expect labor market to kind of play out into next year? Do you expect a significant improvement? And also, when it comes to wages, what you kind of think would be the range of wages that you would have to put in place into next year?

L. Sampson

executive
#15

Yes. So I'll start with the -- mainly these questions get to the personal care business or home care in general. And first, I'll start there. And just a reminder to everybody. We don't have clinical. So we don't -- we aren't hiring -- we have nurses, but not the significant amount of nurses that are needed to deliver on home care. That's a structural problem that I think the industry is going to deal with for many years to come. For us, it's hourly employees that go into people's homes to provide personal care. So that challenge is similar to what -- across all industries, is, how do we get these hourly people back to work? For us, we've seen improvement. And if you -- the metric that we really focus on that is a good proxy is: what is the growth in hours for that? And you've seen kind of each quarter a growth of 2 percentage points each quarter. End of Q4, we're actually higher than that. We're higher -- we're in the kind of mid-single digits around growth rate. And that has to do with -- I mean, 30% is the improvement in the environment. The other, call it 70%, is what we are doing around that to ensure that we can recruit and retain. And that involves providing additional services like cell phones, better health care, real-time pay, community-based consulting. So those areas together, an improving labor market coupled with our added on services, they're allowing us to grow. And I expect that to continue at this kind of current rate in fourth quarter into 2023 on the personal care side. On the rest of ModivCare, there's another -- a couple of -- 2 buckets that would be our general hourly employees that work in our care services and contact centers. What we've done in the last couple of years, our retention rates are at the lowest levels, our recruitment remains strong. So our ability to retain and recruit hourly employees in our care centers or contact centers remains strong. The other item -- and this is the hourly employees that do our driving, that has been a struggle through 2022 and those have been reflected in our cost increasing in 2022. The good thing is, in these last couple of months, that's stabilized. So I believe we stabilized that now. And I expect that balance or imbalance that happened on the labor side within transportation to stay that way through 2023. So now it's our job to implement our initiatives to lower our costs, both on the ability to give transportation providers more volume so they make more money, therefore, costs can come down. And two, what we do operationally around -- primarily around call avoidance. That's going to allow our margins to get in the range and at the higher end of the range that we've talked about. So long story short, environment improving, our efforts that we're doing around integration and initiatives are overcoming some of that or magnifying the benefit of what's happening in the marketplace.

Joanna Gajuk

analyst
#16

So I guess in terms of the personal care staff, can you talk about the turnover ratios in terms of where you've been tracking this year versus where it was, say, before the pandemic? And kind of how do you expect this to progress into next year?

L. Sampson

executive
#17

We perform well there, in the 40% range. So our turnover is at that 40%, which is -- it depends on who you're talking to. It's in certain markets better than the marketplace. So we feel proud of where we are now. There was some bumpiness during COVID. That is one of our secret sauces that we have, and it's more in line with our key assets that we had pre-pandemic. But our retention rate -- again, that 40% turnover rate is where we're at. And I expect to maintain that or slightly improve as we move into 2023.

Joanna Gajuk

analyst
#18

And I guess another business you mentioned earlier in terms of the remote patient monitoring way, that has been growing much faster, right? Clearly, that's a new business for your, a new entrant. So is it really just increasing penetration of the service that's driving that growth? And how do we think about kind of the sustainable growth for that business?

L. Sampson

executive
#19

Yes. That business has been wonderful for us. And in the marketplace with our states and payers, it's gaining traction because they see the value off of that. And it really -- there is the core kind of emergency response, where somebody needs to hit their button when they have a need, that continues to grow. And we continue to steal market share because of our great customer service. In addition, that is -- and then there's the ever-developing vitals monitoring, that -- we have that as well. So that's a high growth rate and the industry is growing high on that. That's relatively small to our emergency devices, but that's going to continue to grow and the marketplace is going to continue to grow. The heavy growth rates in addition to what's happening on the Medicaid side is on the MA side. That is growing well above -- kind of in the -- anywhere from 20% to 30% growth rates on that in MA, and I expect that to continue because we see the value. The other item -- and this is really important and it really helps us especially down the road. We have engagement in our model. So it's not about just providing a service when somebody needs help. But 9 out of 10 times when someone hits their device, it's not because they have an emergency. It's because they want to talk to somebody or they want to test it. So that's a chance for engagement. And that's why we've developed this new -- the new product called E3, where we collect data and then even push scripts to help change outcomes for our payers. That is working. We can target a population to ensure they get their flu shot, ensure they get their colonoscopy. That directly affects star ratings for MA members, directly affects people getting better outcomes. So we're really excited about our model on collecting data and then changing outcomes, and we're seeing high acceleration in growth on that E3 side as well. So long story short, the strong growth rates that we talked about in RPM, we expect those to continue and we expect it to be an ever important part of our business going forward.

Joanna Gajuk

analyst
#20

And you mentioned MA as one of the payers that's growing the fastest, but it sounds like it's maybe not that big. But obviously, Medicaid and managed Medicaid, these are your biggest players. So when it comes to these different contracts you have, do all your contracts include all the service lines? And also in that context, can you talk about the cross-selling opportunity here?

L. Sampson

executive
#21

Yes. So consistent with what we've talked about before, the evolution of bringing these together will start with -- our focus is selling each point solution. The next phase is cross-selling. The next phase is bundling, and eventually down the path to value-based care. So right now, the cross-selling opportunity is really taking hold. And then primarily what we're getting on that is coming from our high relationships that we get from mobility and cross-selling remote patient monitoring in E3. That's where the cross-selling effort is currently happening. I expect in '23 that will happen more from a cross-selling perspective. And then within each of the -- and then we move to bundling and value-based care. But again, value-based care from a bundle perspective is down the road. The one thing that I'll add here, and this is important maybe in a question that comes out, what we're seeing in each of our solutions right now or our point solutions is moving beyond just the fee-for-service that we currently get in the home business to performance payments, performance payments for changing outcomes. I talked about E3. But even on the personal care side, we have contracts in certain states where we get paid for changing outcomes. I expect that to continue to accelerate, and that will become a more meaningful part of our financials as well as a meaningful part of our business to ensure that we're sticky and adding more value. And we'll get more and more performance payments as we continue to prove that our services change outcomes.

Joanna Gajuk

analyst
#22

So yes, definitely. That's another topic that's of interest here during the conference in terms of value-based care, because, obviously, there's different shades of these different types of contracts that you can do. So maybe you can talk about that a little bit more in terms of what percent of your revenues really comes through these different types of value-based care contracts? And also, what do you expect this percent to be, say, in 3 to 5 years when it comes to value-based care?

L. Sampson

executive
#23

Yes. So right now, it's in the single digits, millions of dollars when you think about value-based care. And there's different shades on that. And let me back up a little bit. Some people think value-based care is taking full risk on a contract, like a true kind of risk bearing entity, and there's different shades, all the way from getting performance payments to full risk. On the transportation side, we are full risk and we take a lot of that. So in essence, some people think that, that's value-based contracting. But we don't distinguish it differently and more in line probably with what many of you on the phone are thinking. Excluding what's happening in transportation, value-based care is really around getting paid for lowering the cost of providing care or changing outcomes. And that's primarily now in our home business. And I talked about E3 and then I also talked about what we're doing in the personal care side. Again, that's small right now, but a deliberate approach for us to start getting bonus payments that are real and achievable. So taking it a step at a time, in line with where the industry is moving. A couple of examples on the personal care side. Just even being electronic and starting to collect some data from a caregiver and what a caregiver is doing, is a component of value-based care and adds value to our payer. Going one step further to start collecting data around is there -- are there trip risks, is there a change in someone's behavior, those are the bonus payments that we are getting now and I expect that to continue. So the industry as a whole or people that are sophisticated like us that can do that, I expect that to accelerate. That being said, in '23, it will remain relatively small. But as the months and years go by, I expect that to accelerate and continue. How we actually get paid, does it get worked into a bigger fee-for-service maybe. It's likely a combination of fee-for-service and bonus payments. The full ride on taking risk is down the road and not a big priority for us. I'm happy to get our share of that risk sharing value-based payment when we change outcomes.

Joanna Gajuk

analyst
#24

And you mentioned, obviously, the Medicare Advantage becoming a bigger payer. But specifically on personal curve, right, it's been kind of slow really versus what you would have expected based on how CMS allowed the MA plans to really cover and include some of these non-health care-related services, right, into settlement benefits. So yes, more plans clearly offering this. But my understanding is that the plans will use it more like a marketing tool because the number of hours that they cover and also the length of the shift that they cover is really not where it should be. So kind of what's your view of the MA business in personal care? What needs to happen for MA to be really a more meaningful player for personal care services?

L. Sampson

executive
#25

Yes. So you hit on -- I do think CMS needs to develop and mature on that. I also think the industry needs to continue to mature. If you think 10 years ago, and even today, the industry is made up of a lot of mom-and-pops, not a lot of regulation. But that continues to change. In certain states, it's accelerating a lot. So I think the industry needs to continue to mature and CMS needs to recognize that. Because does someone get in the home for a certain type, how long do they stay, all those items that we are all grappling with need to be figured out. But what's happening now is that we do understand that it's beneficial and for many people that have certain illnesses, it absolutely helps and changes outcomes. So we're at this point of that coming together with this maturing model. So I expect the large states and payers and CMS and us to help with that. You'll start to see it accelerate. Relatively small right now, but that will continue to develop as the quarters and years go by. The other item for us as a business perspective, there's so much opportunity on the Medicaid side, as we talked about before. So for us, that's gravy from a financial perspective. It's the right thing from a health care perspective. So we don't need it. We want it. We can focus and maintain our growth and improve just focusing on Medicaid right now. But again, we're at the table to ensure that the MA side will grow on the personal care side at the appropriate rate.

Joanna Gajuk

analyst
#26

So did I hear you right? You said 15% of your personal care business is MA? Or was it the overall company?

L. Sampson

executive
#27

That was the monitoring -- that was the monitoring business.

Joanna Gajuk

analyst
#28

So how big is the MA in personal care?

L. Sampson

executive
#29

Oh, sorry, sorry. Monitoring is 20%. Medicare is 15% on transportation. On personal care, it's really small.

Joanna Gajuk

analyst
#30

Okay, minimal. Okay. And we actually have a question from the audience in terms of, I guess, MA. And I guess it ties to the different business lines because I guess the question is, what else really fits here in the model when it comes to addressing the social determinants of health because, clearly, the company is trying to address those? So I guess the question is, what else fits in there? And would you be considering adding these assets through acquisitions?

L. Sampson

executive
#31

So we cover the majority of the wheel when it gets to social determinants of health, right? The one wheel that we could cover is probably more on the mental health side. We do think we are addressing that on what we're doing with starting to change outcomes and what's happening in remote patient monitoring, where we're engaging with members. But really, that's probably one area that we're missing. Obviously, a big part of social determinants of health is housing. We're not getting into that. We're really in the -- really the supportive care services, and we have them all but mental health. We have more than enough. So there are no plans to make any acquisitions around filling out or missing something. And the other item that is important, we have it, but it's still pretty small is meals. That is really important. That will continue to get important. But we have reset that, launched with a new partner, with a new process. And I look forward to updating people as we go each quarter, because that needs to grow with us to really fulfill what a company like ours can offer on the MA side around social determinants of health. So again, we're unique. We're the only one that has all these offerings. And I think we're in a good spot where we are right now. We just need to grow each area and combine them together.

Joanna Gajuk

analyst
#32

So you mentioned the meal delivery business, because I guess that was actually -- I have it on my list to check on you if there is any update. But it sounds like we have to wait a little bit longer to hear a little bit more about this, right? So is there any time frame in terms of like your expectations where things could be happening and you see it in the market?

L. Sampson

executive
#33

So the one thing that I'm really excited about and encouraged about is we have a strong plan and a strong road map of where we're going. We have a new partner. We know where we need to expand. We have these contracts starting. We have the target starting later down the road. So '23 is really scaling and operationalizing what we have built today. So it makes sense to update each quarter where we are on that to get to where -- I want to give you kind of larger numbers what it means to revenue and EBITDA margin, again, each quarter. But likely that's going to be '24 and beyond. Because our approach and focus plan is to ensure we build a model that can scale and grow in the longer term, so. But I feel good about the team and the process we have in place and the targets we have in place.

Joanna Gajuk

analyst
#34

So did I hear you right that you already have interest from the plans? Or you have some contracts that once you...

L. Sampson

executive
#35

Yes. So we do have some contracts right now and a lot of interest from the plans. If you look at all the big payers, meals is an important part of their offering, whether that's meals that are more longer term and more tailored for the Medicaid side, or MA side, which are typically more episodic when people come out of the hospital. They are buying it in the market today and are really excited about our ability to deliver with them. And they're patiently waiting for us to make sure we have a model that they can grow and scale with us on. So it's a business that's out there, and many of the competitors are doing fine at it and I look forward to competing with them.

Joanna Gajuk

analyst
#36

So what are the biggest obstacles? Is it really the logistics? Or is it the right type of meals? And I guess, yes, is there something you can do completely differently versus your competitors?

L. Sampson

executive
#37

Yes. So most of our competitors -- most of the people that are doing well in there, own their kitchen. And we -- our approach is to be asset light on that, and this is an important strategic decision. And when you have kitchens, especially now, it's really tough to make money if you're only in one service line. So I think the value if you're going to be in the business of offering food, you need to offer food to medical, to student housing, to kids daycare. You need to have it all in order to have a profitable business, which is why we're not -- right now, our strategy is not to own it, and we'll contract with somebody and maybe be their exclusive health care provider. That allows us to be asset light. It allows that food company to diversify and have scale around providing food over their entire cost structure. So I think that asset-light model, partner with the right provider, that's what we needed to do. That was the biggest issue. Now it's a matter of building our internal capabilities to ensure that we can deliver it the right way. It's a referral sales type business, very similar to our personal care and remote monitoring business. Leverage that apparatus, the model, that's what we're doing.

Joanna Gajuk

analyst
#38

And we diverted from the question around adding new service plans, because I was also thinking to ask you whether any interest in terms of operating comm health or hospice, these other types of services that are being delivered at home. Though, they are not Medicaid. It's obviously Medicare. So I don't know if that's what's kind of making them less attractive to what are you trying to do?

L. Sampson

executive
#39

There's a lot to be said around focus and execution with our strategy around social determinants of health and supportive care non-clinical. I think it's the right approach where we are today. Lots of opportunity to grow within that space. And so right now, we're sticking to that and that's our focus. I do think -- and this is probably a broader conversation for a different time. This supportive care service, what social determinants of health actually means and that connection to changing outcomes, there's still a gap there and there's only a few companies that continue the evolution of health care in general. But for us, the focus, the priority and what we have is where we're at.

Joanna Gajuk

analyst
#40

And so something you mentioned earlier on your, I guess, business around transportation and how the driver pool rate that's been challenging for you. And at the same time, you have this driver shortage, you have the higher fuel prices, right? And you moved the vast majority of your contracts in the business to capitation, like you mentioned. So can you talk about that, going forward how it's going to play out? Are there annual inflationary aspects to these contracts? So are you going to expect the cost inflation to be more appropriately reflected in these contracts? And also do you expect to have something similar in your other businesses? Or that's really applicable to that transportation business?

L. Sampson

executive
#41

Yes. So contract repricing and engagement on our customers' populations happen all the time. Even though we may have a 3- to 5-year contract, our methodology and approach is to stay engaged with our customers. And we're really looking at that. And if you look about -- since -- kind of I've been here in the last 2 years. We have appropriately increased pricing or decreased pricing to ensure it's aligned with that mix of population. That will always continue. And if it makes sense to higher prices because of normal CPI or inflation, that has happened and we can -- we see that that's happened. However, we have hit that really peak on what's happened in 2022. For us, costs are no longer rising. The labor market, like I talked about before, is normalizing, stabilizing. Coupled with the model where we're providing more volume, not just rate, I think we're in a really good spot to maintain and lower costs on the transportation side going into 2023. And then in the event that we need to, we'll adjust prices with our payers. Again, our business -- a 10% to 12% EBITDA margin is wonderful, it's what we guide to. It's not a 20%, 30%. So again, I'm not apologetic. And by the way, large payers with our relationships, looking at the CFO, she or he agrees. And that's a big part of how we got to where we are today. So again, I feel really good about our model and managing through and improving on the cost side on the mobility side.

Joanna Gajuk

analyst
#42

And I guess another question related to the discussion we had before around MA and expanding into new services. But just in general, has the company -- I'm very inquisitive -- clearly grew through adding these new businesses, where you spent, let's say, over $1 billion since 2020? So the question is whether you're going to still continue to add on personal care services? Or is there any of the other business lines where you're looking to grow? So I guess trying to assess where the interest would be kind of in the medium term.

L. Sampson

executive
#43

Yes. So in the short term, it's about executing what we have, integrating and growing organically. That is the biggest bang for the buck we have right now and that's our priority. And then you'll see that. And especially, starting in '23 because of our strong cash flow profile, that's going to allow us to delever. And then at some point when the time is right and our leverage is at the right spot, the long-term vision is for sure to continue to have a national footprint on the home side. And that will make sense for us to start making acquisitions when the time is right in the midterm. But again, short term it's about execution and organic growth. That's what we need to do. And then when we build that machine where we can make acquisitions and just plug them in, that will be even more beneficial. So we will be making it in the kind of mid- to longer term, but we need to, in '23, prove that we can delever and execute on what we talked about. That's the focus.

Joanna Gajuk

analyst
#44

Yes. And actually, the last question on the leverage here. Because I guess the company is approaching 5x in terms of debt-to-EBITDA leverage, right? And you previously stated the goal to get to -- closer to 3x leverage. So the question is, what kind of time frame we're talking about here to get to that leverage and also how you're going to get there?

L. Sampson

executive
#45

Yes. So the 5x is gross. Kind of from a net perspective, we're at 4x when you take out our cash. So 4x net leverage. Our goal is to be at 3x net leverage, consistent with what I've talked about for the last couple of years. That's the right level considering our capital structure. And then from our cash profile, you know we're CapEx light, way less than 1% of our revenues. You know our debt structure, so you know our interest payment and our cash taxes. So really, our adjusted EBITDA less those 3 items is a good proxy for free cash flow. Which is why when we get through paying these kind of COVID cash flow benefits that we accumulated in 2020 and 2021, when we're done with that in Q4, we'll be back to that cash flow generation and be in a position to delever because that's the way our business has performed.

Joanna Gajuk

analyst
#46

All right. So would you say that you expect to get closer towards turns -- or 3x leverage towards the end of next year? Or is it kind of more like a 2-year period of time?

L. Sampson

executive
#47

So the right way -- when you think about it, when you do the -- do your modeling off our adjusted EBITDA less of those items, the free cash flow is going to be kind of $100 million to $125 million. So that quickly can get us down.

Joanna Gajuk

analyst
#48

All right. Sounds good. Yes, that's all the time we have for this session now. So thanks, gentlemen, for joining us today, and thanks to the audience for participating. I hope you enjoy the rest of the day. Thank you.

L. Sampson

executive
#49

Yes. Yes, thank you very much. I appreciate it. Take care everybody.

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