NeueHealth, Inc. (NEUE) Earnings Call Transcript & Summary

Good afternoon. My name is Lisa Gill, and I'm the health care services analyst with Morgan. It is with great pleasure this afternoon that we have with us Bright Health Group. Presenting for Bright Health Group is CEO, Mike Mikan. Post Mike's presentation, he will join myself; and CFO, Cathy Smith, over at the table to take questions. With that, Mike?

Great. Thanks, Lisa, for that introduction and JPMorgan for inviting me to speak this afternoon about the incredible work that our team at Bright Health Group has been doing over the past year. It goes without saying that there has been significant challenges across our sector for the 2021 IPO class and Bright Health Group as a company. As I'll talk about today, despite those challenges, the team has done a tremendous job rallying around our mission and focusing the company on where we drive the most value in the health care ecosystem. I've never been more excited about the potential future -- the future holds for our company. While our strategy has sharpened, we are more convicted than ever in our Fully Aligned Care Model, and we believe the opportunity has only expanded. The business we're presenting today takes the best of Bright Health and removes the volatility of the ACA insurance business, doubling down on the segments of the business where we create the most value. Before we go further, I'll note that our presentation may contain forward-looking statements and non-GAAP measures. Please reference the presentation slides posted on our website and our SEC filings for the associated disclaimers. Bright Health is focused on making health care right together by delivering personalized and affordable health care for aging and underserved consumers through our Fully Aligned Care Model in the largest markets in the U.S. Bright Health brings together care providers and health care payers in a financially and clinically-aligned model that leverages what we call the value layer of health care to drive improved outcomes and results. We have simplified and focused the company on 2 operating segments: Consumer Care, which is a value-driven care delivery business that manages risk in partnership with external payers; and our Bright Healthcare business that now exclusively focuses on a delegated senior managed care model with a tight group of providers in California. As we enter 2023, we believe we have a strong foundation to grow profitably and serve consumers across the country. In 2023, we expect to be a $3.4 billion to $3.6 billion revenue company, managing over 125,000 Medicare Advantage consumers in our Bright Healthcare segment and serve between 275,000 and 300,000 value-based consumers with external payers in our Consumer Care segment. We are also reiterating today our expectation to be adjusted EBITDA profitable in 2023. We believe the business is well positioned for the current market environment with significant future upside as we expand our refined model nationally. We have focused and simplified our business for 2023. With the exit of the Affordable Care Act marketplace as an insurance carrier, we have reduced the volatility of the business while also strengthening our capital position. Both our Consumer Care segment and now our senior-focused Bright Healthcare segment support our accelerated path to profit -- adjusted EBITDA profitability in 2023. We are focused on consumer-directed health care in the largest U.S. markets, health care markets of Florida, Texas and California, which are also among the fastest-growing, providing significant opportunities for expansion. Our business is now balanced across value-driven care delivery and delegated senior managed care, adding stability and diversification. Our businesses have many years of experience operating in the communities they serve. And over the past 6 years, we've developed technology and proprietary capabilities to enable providers to successfully manage the total cost of care and population risk. Our Consumer Care segment works with a broad set of payer partners across the spectrum of consumer-directed lines of business. And for 2023, we have strong consumer retention, and we have secured deep payer partnerships with specific payers in each of our markets. In addition, our Consumer Care segment includes a scaled and well-performing direct contracting, now the ACO REACH program, managing traditional Medicare beneficiaries that leverages the same core capabilities as the rest of the segment. The scale and breadth of our business as well as deepening national and payer and provider partnerships means that we have multiple drivers to support long-term profitable growth at a national scale. Bright Health has been built as a company with a consumer and a value-first orientation, which we believe addresses some of the key challenges in health care today. The current health care system was not built with the consumer in mind, where high costs and misaligned incentives keep consumers from getting the care necessary to maintain their health. Only a small percentage of health care spending is directed to primary care. And the penetration of value-based care is very low, particularly outside of Medicare Advantage. These challenges are compounded by limited data sharing between payers and providers in the health care system, resulting in gaps in care and wasteful spending. Bright Health believes the best way to address these challenges are through our Fully Aligned Care Model that builds clinical and financial alignment between payer and care providers with the requirement that data and technology are shared to drive better outcomes. To deliver measurable success in value-based care models, we believe that we need to focus on the activities that drive the most margin expansion. This value layer of health care is the common set of value-additive capabilities across managed care and care delivery that drive consumer satisfaction and better health outcomes at a lower total cost of care. Engaging consumers, directing them to the best sites of care, selecting providers based on the best quality and outcomes, enabling providers to take population risk all drive this value creation. For example, in 2022, we made over 0.5 million provider-driven touches to members and patients attributed to our clinics. We're applying these tools, methods and insights to enable care providers across both our Consumer Care segment and Bright Healthcare segment to drive better outcomes for aging and underserved consumers that are our members and patients. We're using our technology and data to push insights out to the care providers, allowing them to make interventions in patient care and drive better clinical outcomes. We carefully measure the success of our value-based care model has in driving better outcomes for consumers and in lowering the total cost of care, and we've seen differentiated results. We're confident that our focus on the right capabilities and solutions for consumers and providers in the value layer of health care is changing the way health care is delivered. A critical component of executing on our strategy is a common economic model that rewards these value-driven activities. On the Consumer Care side of the business, we work with our health plan partners to manage the total cost of care for consumers we are managing, earning a PCP cap payment to cover operating costs, but more importantly, earning a share of the savings we generate relative to the targeted total medical costs. On the Bright Healthcare side of the business, we're working with our care provider partners to manage the total cost of care for the seniors delegated to each of our care provider partners. And like the Consumer Care side of the business, we have opportunities to share in the savings relative to target total medical costs. Importantly, it is the core capabilities I highlighted earlier that drive success in value-based arrangements in both segments of our business. And our ability to create value through consumer engagement, care management, network management and provider enablement drives these shared savings that benefit our payer and provider partners as well as Bright Health. As we look back at 2022 for Bright HealthCare, consumers attributed to our Centrum clinics in Florida and Texas delivered a greater than 15% total cost of care improvement compared to those affiliated with other providers. As we look to the future, we expect to deliver improved results to our portfolio of external payer partners. We are so convicted in this model because the Fully Aligned Care Model delivers a win-win-win value proposition for stakeholders. Bright Health helps consumers find affordable personalized health care that meets their unique needs. We're meeting consumers where they are through clinic visits, virtual care or in-home, all driving high consumer NPS scores of over 80 in 2022 across our clinics. We help providers support population health management and move along the continuum of value-based care toward greater risk sharing and value creation, enabling providers to share in the value that we create together. And we help payers better predict and manage medical spend through risk sharing and capitated total cost of care arrangements, driving the improvement we noted -- I noted earlier in total cost of care compared to the market. Our businesses have been operating in their local communities for many years with deep-rooted relationships offering unique solutions tailored to their communities. Health care is local, and every market is unique. We have native language speakers in our call centers and among our care providers, supporting consumers in multiple languages, including Chinese, Vietnamese, Spanish and more. We facilitate income assistance programs, immigration assistance and make sure that our providers are representative of the patients they serve. We have curated our networks of providers to ensure that it is strategically aligned with the patient populations we serve. Our care providers have developed trusted relationships with their patients, driving loyalty and retention, making us an attractive partner for health plans. We are serving aging and underserved communities, often with complex and unmet health needs, and are enabling our provider partners to do so while maintaining competitive outcomes. This shows up in our data as well across all of our lines of business, including the example we give here of lowering readmission rates for our DCE now the ACO REACH members. And as you can also see, we are driving lower utilization while providing better access to care. We deliver our Fully Aligned Care Model through 2 operating segments, serving the fastest-growing consumer segment in health care in the largest markets in the U.S. Our Consumer segment includes our clinics in Florida and Texas, our affiliated care providers and our ACO REACH business and is projected to generate over $1.6 billion in revenue in 2023. We expect to end 2023 with between 275,000 and 300,000 value-driven consumers, including approximately 65,000 from the ACO REACH program. Our Bright Healthcare business operates Medicare Advantage plans, serving aging and underserved consumers in California through our Brand New Day and Central Health Plan brands. We are forecasting 2023 revenue of greater than $1.8 billion and expect to end the year with greater than 125,000 Medicare Advantage consumers in this business. On an enterprise level, we are well balanced between care delivery and managed care with significant growth opportunities in both segments. As we look to the future, we think it's important to understand what we've built over the last 6 years. From 2016 to 2022, we were building out the key foundational capabilities of the Fully Aligned Care Model. We developed the core capabilities necessary to take and manage risk, building out the clinical, financial and technology alignment between the payer and the care provider. The scale we achieved in 2022 in the ACA marketplace insurance business, in alignment with our value-driven care delivery business, helped move the IFP commercial market toward value-based care arrangements. As a result of our investment in the Fully Aligned Care Model, we have become a leader in value-driven care in the commercial risk market. We have also demonstrated with Bright HealthCare consumers and with external payers that our Fully Aligned Care Model delivers superior results, with leading clinical outcomes and more affordable care. In the next 2 years, we're focusing on demonstrating the strength of our fully aligned care model with our strategic partners. Our Consumer Care segment has deepened relationships with existing and has contracted with several new external payer partners to retain value-based consumers that were Bright HealthCare ACA marketplace members last year. Our Bright Healthcare business is focused on continuing to improve performance and strengthening our alignment with our care provider partners. Long term, we're focused on capital-efficient growth and building our expected -- building on our expected 2023 profitability. We intend to continue growing our Consumer Care business with external payer partners within existing markets and over time, expanding into new geographies. In addition, we're building on our Medicare and Medicaid value-based consumers served through our Consumer Care segment and expect to accelerate the growth within those lines of business. We also continue to have a significant opportunity to grow our market share in California, working closely with our care partners. I want to drill down on the growth opportunity for our Consumer Care segment. In 2022, our Consumer Care segment served over 500,000 value-based consumers, with a large percentage of those attributed patients coming through the relationship with Bright HealthCare's ACA marketplace insurance business. While Bright HealthCare has exited the ACA marketplace as an insurance carrier for 2023, our Consumer Care segment has retained a high percentage of these consumers. The strong relationships between providers and patients and our existing and new payer relationships means we expect 70% of the consumers in our clinics to be members that we previously served. This high level of retention gives us both meaningful scale and familiarity with the population, giving us high confidence to manage total cost of care and continuing to deliver differentiated results in partnership with our external payer partners. We expect the Consumer Care segment to deliver $1.6 billion to $1.8 billion in revenue in 2023, driven by 70% growth from external payer relationships and the expansion of our ACO REACH business. We believe our Consumer Care segment is nicely positioned to benefit from increased adoption of value-based care models over time. Our Consumer Care segment now has more than 20 external payer relationships for 2023 and is diversified across health benefits product categories, including commercial, Medicare Advantage, Medicaid and traditional Medicare through the ACO REACH program. As I mentioned earlier, the business operates 75 clinics and an affiliate management business in Florida and Texas as well as a much broader service area through our greater than 2,400 affiliated physicians in our ACO REACH and physician enablement businesses. Our team has done a tremendous job adding new payer relationships since we announced our Consumer Care segment would no longer have the affiliated Bright HealthCare ACA members, including adding many of the largest health care payers in the country. We also view this as a clear demonstration of the demand in the market for the value of our Fully Aligned Care Model. Our Bright Healthcare segment has a solid foundation to deliver continued growth and performance. We expect to deliver at least $1.8 billion in revenue, representing 12% year-over-year growth in our California Medicare Advantage business. In addition, the integration and operational improvements that are underway drive our expectation for a medical cost ratio between 86% and 88% with an operating cost ratio of approximately 10%, excluding noncash and corporate overhead charges. Our Medicare Advantage plans are differentiated with a focus on underserved consumer populations. We're building on our strong market position, having already reached 5% market -- Medicare Advantage market share in Los Angeles County, and we're growing statewide. We serve a large patient population in special needs plans, where we are the third largest chronic SNP in the country. Furthermore, we have a successful model focused on culturally-responsive offerings that build on our deep partnerships with local delegated care providers and our community relationships. Near term, we're focused on optimizing the performance of our Medicare Advantage business, driving improved profitability and integrating capabilities across our plans. We also continue to work on refining our provider and referral networks, driving Stars improvement over time and adjusting our plan offerings to drive margin improvement. For 2023, we're focused on specific priorities that will drive the future success of the business. We have taken substantial actions to rightsize our cost structure for our go-forward business, and we'll continue to watch our expenses carefully. We are carefully managing the runout of our ACA marketplace insurance business as we resolve medical claims and work with regulators to recover excess capital from the regulated entities. We are also focused on fundamental execution in our Consumer Care segment and Bright Healthcare segments with a key goal of delivering on adjusted EBITDA profitability in 2023 and getting to positive free cash flow. We're mindful of the challenges we've had in our business and are engaging and inspiring our team members around our mission. We've streamlined management and organizational accountability and have strong leadership across our businesses. While we're focused on delivering against our 2023 results, we are also working to strengthen the foundation of the business to support future growth opportunities in 2024 and beyond. Part of strengthening the foundation for future growth were the key steps we took in the fourth quarter to bolster our parent company liquidity. We ended the third quarter with over $220 million in parent company liquidity and raised $175 million through our convertible preferred equity issuance in October. We also expect to recapture surplus risk-based capital from our regulated entities as we wind down our ACA marketplace insurance business pending claims runout and regulatory approval. We expect uses of cash to include losses associated with our discontinued operations and cash needs for the go-forward business. The operational efficiency efforts we've made in the go-forward business have supported an improvement in our cash projections for the company. We expect the net of our starting parent company cash balance and the positive and negative cash items to result in a projected year-end 2023 pro forma liquidity of $200 million to $300 million, including future surplus risk-based capital recapture. This projection includes an assumption that our credit facility remains drawn at $300 million at the end of the first quarter of 2023, but we expect our improving liquidity and our expectation for adjusted EBITDA profitability to give us additional options around the credit facility over the course of the year. With respect to 2022, we're still closing our books and plan to report our full year '22 results at our upcoming earnings call. With regards to the ACA marketplace insurance business, which we exited at the end of 2022, utilization has been stable and modestly lower throughout the year, which we believe is a key indicator to performance. The cash plan included in our presentation incorporates our expectations on performance inclusive of all runout costs. We have positively revised our 2023 outlook this week, including a projection for an increase in value-based consumers in our Consumer Care segment. The key driver has been our success in contracting with payer partners to recapture Bright HealthCare value-based consumers in our clinics and affiliates. We now expect 210,000 to 235,000 value-based consumers from external payers by the end of 2023, in addition to maintaining our forecast for 65,000 ACO REACH consumers for year-end 2023. The increase in projected value-based consumers drives the upside to our Consumer Care and enterprise revenue projections, where we now expect $1.6 billion to $1.8 billion and $3.4 billion to $3.6 billion in revenue for 2023, respectively. The range of revenue reflects our forecasts for initial attribution and in-year attrition of value-based consumers from our payer partners and any impacts from membership mix and risk adjustment. To make comparisons to reported numbers easier, we're now providing our forecasted operating cost ratio on an adjusted basis, and we expect the ratio to be between 11% and 12% for the year. We continue to expect to be profitable in 2023 on an adjusted EBITDA basis. Today, we are introducing our long-term outlook for Bright Health. We expect annual revenue growth of 20% or greater, which will support an operating cost leverage and lower our long-term adjusted operating cost ratio to below 10%. We expect successful execution on our Fully Aligned Care Model will drive significant value creation and supports our expectation for long-term adjusted EBITDA margins between 6% and 9%. So in summary, Bright Health has built a differentiated, Fully Aligned Care Model that is well positioned for the future of consumer-directed health care. Financially, we have accelerated our path to profitability with our more focused model and having strengthened our capital position. We're in large, attractive markets serving aging and underserved consumers. Our business is well diversified with our Bright Healthcare and Consumer Care segments, and we're building on our partnerships with payers and providers to be successful in value-based care models, and we have a solid foundation for profitable capital-efficient growth. Thank you. Lisa, we're happy to take some questions.

Thanks very much, Mike, and thank you for the detail today. Can we just start big picture, the strategic pivot to exit the ACA exchanges and move exclusively to MA? Can you maybe just give us some background on why you felt that was the best decision? And why not keep maybe a few states instead of exiting everything?

Well, it goes back to -- as the company was founded, the company was founded on an integrated model, where we align the interest between care providers and the financing of care. And so one of our objectives early on as a company was to build scale within that alignment model, and so having the ACA marketplace insurance business was a core driver to that. And keep in mind, as I said earlier, value-based care models outside of Medicare Advantage is still relatively low in penetration. And so Bright HealthCare, as an insurance carrier, was fully committed to value-based models. And so that was a core driver for us, not only to get to scale but also build the foundational capabilities of the company that I talked about earlier. As we got into the later part of last year, combined with the fact that we were really successful earlier in previous -- the previous year of contracting with external payers, we realized that it was more capital efficient, but it was also a great opportunity to leverage the scale and depth and breadth of leading health care payers that we could partner with that now will become more interested in aligning with value-based care. And so from a strategic perspective, while we're no longer in the insurance ACA marketplace business, the foundational capabilities of our model, the Fully Aligned Care Model, really built within the value layer of health care remains the same. And we see the opportunity is only enhanced or greater with the partners that we've partnered with. And I understand the question around certain markets. But when we looked at the markets that we thought were most attractive for us, we thought the biggest markets in the country felt pretty good to us. Florida, Texas and California, 90-plus million people. And as you know, there's a diversified set of payers that we can partner with in Florida and Texas. And we love our care partner, IPA partners, in California as well.

And you talked about maintaining those ACA members through partnership with NeueHealth on the consumer side, and you talked a little bit about value-based care in this consumer product. Is this a risk model? Is this a shared risk model? Is it a fee-for-service model? How do I think about that model and the future of the model?

Well, I'll start with it's a risk model, right? It's -- we are -- we do believe that the future of health care is going to continue to shift to value-based arrangements, where more and more, there will be an alignment of interest and a shifting of risk to the care provider community. But our models vary depending on the market and how deep our relationships are with our payers and our delegated senior care IPAs , if you will. So today, on the Consumer Care segment side, we participate in risk arrangements across basically all lines of business on the consumer-directed side. So Medicare, Medicaid -- or Medicare Advantage, Medicaid, the ACA insurance as well as the ACO REACH. In the senior Medicare business, we're one of the largest Medicare risk primary care model in Ocala, which is right outside of Orlando and The Villages, the fastest-growing senior retirement community, we manage about 11,000 Medicare Advantage customers today with leading payers, and we take full global cap risk. In the ACA marketplace, depending on the partnership and kind of the legacy that we have in the market, meaning how well we know the market, the relationships generally start with a PCP cap, targeted medical costs, and we share upside/downside with the corridor around it. So we have limited downside, limited upside. Over time, though, our intention is to move to full global capitated risk because we think that we have the levers in that value layer of health care to control underlying medical spend.

When we think about your Medicare Advantage business, maybe just let's spend a couple of minutes here and talk about how you're competing in the marketplace, what do you think your strengths are. And then you talked about 125,000 lives. But when we think about the open enrollment period that just ended, can you talk about your adds and net number for the year?

Well -- so let's start with our team. I'd say part of our strength is our team. We've got a great team of people dedicated to our mission, to our growth and performance in California. So I'll start with them. Second, I would say we've been operating in California for many years. Even though our company -- our enterprise company is relatively young, the companies that we operate in California have been around for 20-plus years, and so we've got strong relationships in the local community. And one of our, we believe, are differentiated is the partnerships that we have with delegated IPAs and a core set of care systems. And so we're focused on where we can differentiate, and where we differentiate are those areas that are generally underserved communities. So whether they're ethnicity-based dense communities or a demographic like the aging, frail elderly with the chronic SNP plans, those are all areas that we think we can differentiate, go deep with our care providers who want to align interests, who want to combine our clinical models to really manage that population better. We think we can continue to differentiate and grow there. And then the other growth pillar for us is really just continuing to expand statewide. We really grew out of Southern California. We're now in Central California and also in Northern California, but significant opportunities in partnership with our care partner IPAs to grow in those other markets. And then with respect to AEP, as I mentioned, this year, from a Medicare Advantage perspective, we're really focused on integration and operational improvements. Two years ago, we put together a plan to get to profitability. We've grown significantly over the last 2 years. We've added about 45,000 MA lives during that time period and so we really wanted to focus on operational improvement. So we thought we'd be flat to net slightly down as we terminated some relationships and really focused on core relationships. To our pleasant surprise, we ended up in the positive side of that. So we're favorable in terms of net new adds. But I'll also remind you, Lisa, as you probably know, we don't rely necessarily on the annual enrollment period for our only growth. Since we're heavily into the chronic SNP population, we can grow all year long. Last year, we grew 10,000 members between December and December. So we believe we'll continue to grow in-year. Maybe not at that pace, but we continue to believe there's growth opportunities there.

Pre-IPO, you had talked about getting to a 4-star rating, and I think you and others have been challenged by the -- especially the COVID guardrails going away. Can you talk about your expectation or time line to achieve that 4-star rating again?

Well, look, it is a disappointment for us not to be a 4 star. But -- and I don't want to, by any means, underappreciate how important it is to be a high-quality provider. We were challenged with some of the changing in the formulas and the weightings of caps and what have you, but we're also challenged with just the significant growth that we've seen over the last couple of years. And so while it is a disappointment, we still are very focused on becoming a 4-star plus plan over time. We think that's achievable over the next year or 2. But it hasn't limited us with growth, and it really hasn't limited us with performance. And you see where we're targeting an 86% to 88% medical loss ratio that we have high confidence. And in partnership with our care partners IPAs, we only see it as an opportunity for future performance, upside for our combined partnerships. But I'd also say one other thing is as we've grown so much, as most people study Medicare Advantage, with this type of growth, it takes a couple of years really to get accurate codes to capture with our patient base. And that's been studied and well-known, and we see that as an additional opportunity. So we're very focused on Stars improvement, including risk capture of codes and accuracy of coding and continuing building on our relationship with IPA partners to grow.

We've had this great opportunity to have a number of the managed care companies here this week, and the ruling for Rave will come out February 1. And so I'd like to hear your perspective and what you expect from the ruling and how you think it potentially will impact both the industry as well as Bright.

Yes. On this one, Lisa, I'll probably punt and say I'd like to wait to see the rule. I mean we've all got our opinions and what have you. This is what I will say. We all know health care has regulatory changes that impact the industry. We believe if we've got a high consumer satisfaction, low-cost high outcome, great outcome model that we're going to perform. And so I think I'll wait until the rules come out before I weigh in on that.

Okay. We'll talk about it once the rules come out. On the other side, I think many of you know in the room that we will get the preliminary Medicare rates in the first quarter of the year as well. The last couple of years, they've been better than expected, right, over 4%. The anticipation is that maybe it won't be so great going into 2024. But again, any early thoughts on what you're expecting?

Well, they have been favorable. Of course, 2023 was a favorable year. It's part of our expansion, and we're grateful for that as we get to our targeted margins, if you will. But I think it's incumbent upon all of us in the health care industry to control costs and to -- while doing it with improving outcomes. And so that's why I'm so convicted in our model and why I believe one of the reasons we're so -- continue to be so excited about California is we think California is leading in terms of an aligned care, where you've enabled providers over many years to understand how to take community risk and by doing so, make better decisions and eliminate the wasteful spend that I talked about earlier. And so I believe if model done right, we don't necessarily need the types of increases that we've gotten in the past. And I think, dare I say, if we're really going to control health care costs in America, we better do a better job, and that's why I think our model is part of the future.

The other question that comes up, and you talk about California, especially Southern California, which is very progressive, right, around health care and have done a much better job than other places across the country in controlling costs, is the ability to replicate that in other parts of the country. Can you talk about maybe some of your experiences and what you think from a future perspective around that ability to really truly replicate that in other areas of the country?

Okay. So I've been saying alignment models were going to go across the country now for about 20 years. So I'm hoping at some point, I'll be right, and I do think it is. I think it is happening. And I'll say this, while some may or may not agree with me, I do think government is an impetus for change. And the more we see the government trying to align and drive relationships with providers directly, I think you're going to continue to see this value shift and more effort to have providers manage the risk of the population. So that's a core driver of change. But I'd also say this. I think Medicare Advantage, there's numerous businesses, you've seen them here today over the last couple of days, who are focused on risk delivery models that are a good starting point to go in and take -- drive the change of total underlying management of costs compared to Medicare fee-for-service. Look, when Medicare Advantage came to be, it was a government-private payer partnership, and the goal was to drive down costs, and we think these models get after it. I think more and more -- and we think we're part of that change, as I mentioned earlier. We think more and more, other parts of the country, not only geographically, but other lines of business will move to more of an alignment model, and we think that's where the future of health care is.

And part of that is ACO REACH, right?

It is, yes.

And so if I think about the 65,000 patients or members, whatever term you want to use for next year, and I think about how you did in the program this year, any changes as it shifts from direct contracting entity to ACO REACH or ways that you feel like you're better positioned when we think about that program going into next year?

I'm not sure I would say that it's any different from year-over-year or what have you. But I do think the more and more our provider partners, including our own employed doctors, utilize the tools that we provide them, utilize the data, focus on risk stratification and managed care capabilities, the better we're going to perform. We're really excited about how our ACO REACH performed in 2022. We're really excited about '23 and beyond. But I really think it's more about getting physicians who maybe weren't introduced to managed care now introduced to managed care and enabling them to perform in managing population risk. The more they get a better understanding of using the tools and methods and the insights that I've talked about, the better we're going to perform over time.

I don't know how much time we have left here.

15 seconds.

Okay. In 15 seconds, what will people appreciate in 2024 about Bright Health Group they don't today?

I think they'll appreciate how the fully aligned care model drives differentiation, superior results and how we're investing in the value layer of health care and we're pointing to the future of health care, where the puck is going, so to speak. So we hope that the market appreciates that.

Great. Thanks so much, everyone.

Thank you.

Thank you.