Progyny, Inc. (PGNY) Earnings Call Transcript & Summary

This presentation is for Bank of America clients only. If you are a member of the media or press, please disconnect now. Good morning, good afternoon, based on where you are. Thank you all for joining us for this session of BoA Global Healthcare Conference. I'm Michael Cherny, the health care tech and distribution analyst. It's my extreme pleasure to have with us today senior management from Progyny, one of the leading fertility and family planning companies in the U.S. With us today, we have CEO, David Schlanger; and CFO, Mark Livingston, and we're going to do mostly a fireside chat.

But before we kick off, I don't know, David, is there any comments you want to make just to kick things off in terms of any recent developments or anything about Progyny that you want to make sure for anyone who's not as familiar with the story they really know?

Well, no. I mean, look, I think the recent developments are consistent with what we talked about on the call. We continue to have a really strong presence in the market here reflected in both our ability to bring new logos on board and in our high levels of client retention and client satisfaction. So we are really having another year where we were really successful in putting in place building blocks for long-term value in a really strong -- a stronger presence in the industry. So we expect going into 2022 that we're going to be a much bigger company than we are now. Kind of consistent with the remarks that we made in August about expecting kind of growth next year off a much bigger number, kind of from a percentage basis, somewhat consistent with this year.

And I think that's a great jumping off point in terms of understanding the business. And maybe just start with where we are sitting here on September 15. Your sales force as well as your senior execs have been very active in pursuing new clients, pursuing clients that you've been building multiyear relationships with. Can you just give us a sense on how the selling season is progressing relative to your expectations? And especially for a lot of the clients that pause last year because of all things COVID-oriented, what are they telling you this year?

Well, the first thing I would say is that, thankfully, despite the fact that the external environment is still different and more difficult than we probably would have expected, it's a normal selling season, at least with respect to large companies making benefits decisions. They've largely gotten back to normal. Certainly, last year, at this time, in the heart of the pandemic before there was vaccinations and really no light at the end of the tunnel, decision-making was really kind of halted by many companies as they were just really dealing with the pandemic. But we seem to be on the other side of that now and things feel very normal. I'm sure a lot of the selling has happened remotely and there's fewer in-person meetings. But from a process decision-making perspective, priority perspective from all these large self-insured employers, they've gotten back to normal. So what that's meant for us is that we've had an extraordinarily active selling season, continues to be that way. I'll remind people what we said in August that sales activity and pacing, at that time, were ahead of where they've been in prior years. And again, we were very pleased and optimistic where selling season was going to end up. We still feel that way and still stand by those comments. Now where we are in selling season is, as I think you probably know, Mike, but many of the people on this call may not know is that the bulk of the commitments we get happened between August 15 and October 15. And we're so -- as you can tell, we sit here, I think today is actually September 15, if I'm correct. We're exactly in the middle of the commitment season. So certainly, when we have a call at the beginning of November, we're going to know exactly where we stand. But as we said in August, and which continues to be the case, we are having a very active selling season. We're very pleased with the level of activity and the level of commitments. And we think that sets us up really nicely for the strong year next year. So that's kind of where things sit right now.

And David, if I can unpack that a little deeper. In the last few years since I've gotten to know the business, one of the things that I very much noticed is the continued evolution of the customer base. The fact that it seems like every time you put forward new data, you have more industries represented, different companies beyond what at first was a very technology-heavy customer base. As you go through the selling season and you talked about return to normality, are you seeing that across the entire level of prospects? Are you seeing any areas -- not looking for specifics, but any industries or any sub parts of the country where people still are hesitant to move forward? Or is there simply an awareness that we could potentially wait 1 year to evaluate this, but from a competitive hiring perspective, 2 years feels like a lot?

Yes. Look, I think you said it nicely kind of at the end of your question there that our ability to sell and our ability to grow the business has really been across industries, across geographies, across customer sizes even. So -- and it's really very gratifying to know that the Progyny benefit is attractive and addresses real issues for companies kind of across that spectrum. And these companies are experiencing the same issues. They are competing for the best talent. They're trying to do the right thing by their employees. While at the same time, spend their money in the most effective and efficacious way, I think we help them do that. We help them do that regardless of where they fit, either geographically or size-wise or by industry. So we continue to see both the old and the new economy represented really well. So whether it's a retailer or a software company, their employees are being driven by the same social trends. People are waiting longer to have kids. The biological clock is real. More and more people are experiencing infertility. The treatments are expensive and complicated. They need that level of support, both financially and what we do with our PCA supporting them emotionally and with knowledge. All the same drivers exist but, in fact, it's just become more and more acute as the nation's kind of awareness of discriminatory practices in the past continues to be heightened. And the desire amongst most employers and most people to not -- to stop any of those discriminatory practices. So whether it's discrimination against female workforce or against your LGBTQ population, benefits that help them address those are very, very attractive and we fit into that bucket. So again, the drivers that are helping propel our business really are happening across all of those customer segments.

And along those lines and thinking about their alternatives, one of the things that I know has been appealing about the Progyny story is the fact that you're so heavily focused on this one area of the world: fertility and family planning, which is not a more robust solution. Obviously, any major carrier can offer some level of fertility and family planning coverage as part of their overall offering. And so as you go forward, are there anythings from a competitive perspective that you've either seen in this selling season or that concern you in terms of traditional carriers and whether or not they might become more honed in on [Audio Gap]

[Audio Gap] whether it was internally or whether it was from external sources like yourself or the investment community. We're kind of getting asked the same question, Mike. You guys are doing really well, why aren't the carriers going to eventually wake up and do this? It's now 5 going in -- this is going to our sixth year. The carriers have more important issues to deal with. And they've really shown no efforts to improve their fertility programs other than maybe coming up with a new name or a new PowerPoint presentation. But from a subsequent perspective, really haven't done anything. And there are a lot of structural issues that make it difficult to them to do something. Our business model is fundamentally different than theirs. They provide ASO services. We don't. We're a value-based business model. So to incorporate that into their ASO offering would be complicated. But even from an operational perspective, everything we do in managing our patients with our PCAs, in building and managing our network with data and our network management team, they're not set up to do. They'd have to do a lot of retooling of their operations for fertility when they have many other priorities, I don't envy the carriers having to deal with thousands of diseases and conditions. So again, they've shown no inclination to do that. So we've largely faced the same competitive kind of environment that we've been dealing with for a handful of years now. And I would tell you even with respect to the direct competitors, we lose virtual -- we see them hardly ever in a competitive situation and lose business to them even more rarely. In fact, almost never. So again, our -- as we said all along, our primary competitors are the carriers and they seem to have largely adopted the status quo approach to fertility. So we operate largely at the same competitive environment. We're very cognizant of what's going on out there. We pay attention very carefully. We're mindful of competition. But again, it has not impacted our ability to sell at all or our ability to demonstrate our value proposition.

And just along those lines, and I want to get into a couple of topics after, but in terms of thinking more back to the competitive environment, one of the things that does come up in terms of some of the newer start-ups is where they fit in the value chain. Progyny is -- does a fantastic job at getting the family to the birth and to the birth of a baby. And then most of the services on Progyny haven't been focused beyond that where it seems like some of the new competitors are more focused on what happens with the baby and the parental care after. As you think about how people are trying to competitively differentiate versus you, is there an opportunity over time to continue to expand various different areas of your service offering, similar to the way that you did with the pharmacy benefit offering when you introduced that a few years ago?

Sure. We do believe those opportunities exist. And as we've talked about it before, Mike, we are actively assessing kind of those opportunities. And we're doing that in a way that we think makes the most sense. So we're spending a lot of time with our customers, be it our client advisory board and directly to understand what real problems they have and what real problems they have specifically in maternity. Now you know maternity is a gigantic area. Many billions of dollars are spent on it every year. It's one of the higher -- kind of higher cost and higher expense areas for most large employers. But similar to the fertility benefit, which was created to solve real problems for employers. And in fact, employers got together and kind of outlined their problem with fertility. And out of that, the elements of the Progyny program were born. We're only going to expand into areas where we can solve a real problem and create real value, whether it's from a member perspective by improving health, improving member experience and/or from the employer perspective by creating financial value via better outcomes, more efficient use of services. We have found, many of us who've had long health care careers, that it's ill advised to try to create something that has questionable value and just sits kind of on top of your benefit program because it's the first thing to go when P&L gets tight, right? Because you're not creating real value. And we know that those types of programs when it comes time for the renewal, the CFO is asking, "Hey, what value did you get in this program? And is it worth the money?" So maybe you can get the sale, but the renewal is tough. I think what you've seen from Progyny is that the renewals for us aren't tough because we create real value. So that's the lens that we're going to look at all those adjacencies. We don't have to have something just to have it. We have that. We want to have something but it really does provide real value to our customers because that's the type of thing we're going to bring to them. And we do believe in the women's reproductive health area that some of those opportunities exist. And as we get more kind of detail about what's next for us, we'll actually be talking to it, talking to folks like you about it and the rest of Wall Street. So -- but we're just not there yet.

Got it. So I'll save the questions about whether or not you're looking to expand the maternity side [Technical Difficulty] services for another one of these fireside chats. Maybe turning back to more recent trends. You highlighted on the quarter some interesting utilization dynamics that I think the term that either one of you or Pete used was abnormal, I think there were some other more creative terms that we'll save for another day. But as you think about what you're seeing from a leading indicator perspective, clearly you have made no changes to guidance at this point in time relative to it just being made on the quarter. But what do you see as the factors that are shaking out that you're still tracking? And are there -- given COVID dynamics, are there any other leading indicators that you think will become increasingly important in making sure that the pathway towards both this year's guidance as well as strong growth you outlined for targeting for next year can be hit and achieved?

Well, just -- we should probably remind everybody participating in this chat today, just kind of what we said at the end of -- on the second quarter call at the beginning of August rather because I think it is pretty instructive of where we see things. At that call, just to remind everyone, we said that at the beginning of July, we saw a fairly sudden -- and I think Pete's words, if they were his words, abnormal kind of change in utilization patterns. And just to be specific, what we meant was appointment scheduling as it related to kind of initial consoles and the initiation of new IVF cycles. And it was some softness unlike in the spring of 2020 where our revenues potentially went down [ 85-plus-percent ]. This was obviously, although sudden and abnormal, didn't have as broad-based an impact. So I think we talked about at the lowest point in the first few weeks of July. And Mark help me, we were off 11.5% or 12% or something like that from where we would have expected things to be. And again, it was kind of sudden. And the theory that we postulated at the time was that that change in appointment scheduling behavior coincided with the summer season and the summer season where things were newly opened up in this country. Restaurants were open, people could travel domestically. And obviously, we don't have great insight into why people don't call us so that small percentage of people, it wasn't that chose not to book appointments and call us. You don't know what they're doing, but we did check with the rest of the industry, spoke to the providers, and they were seeing the same thing. So they were seeing some softness in appointment scheduling. And they postulated it was the same reason that it was vacation time, it's the summer. It's the first time in a couple of summers people could get away. And many of the providers were even saying, "Look, even our own doctors want to take vacation for the first time." So they're going away for a couple of weeks this summer. We also said in August that after the first couple of weeks of July, we started seeing things ticking back up as people started booking appointments and scheduled appointments for end of August, beginning of September as their vacations were going to end. We're still comfortable with those statements. We're not -- we don't think it's advisable on this call to try to update those utilization numbers. The quarter is going to end in a few weeks and when we have the next call, we'll provide a more fulsome view of what happened from the utilization perspective. But we're still comfortable with the trends that we identified in August, which were -- which was that kind of sudden abnormal drop. And then a few weeks later, the beginning of a recovery back towards a more normal trajectory. So that's kind of where things are at. And again, when we talk about the full quarter results, again, we'll give a more fulsome view of what's happened from a utilization perspective over the entire quarter.

Understood. And that's helpful from a clarity perspective and I understand the business. I want to go back to the comments that you've made about the expectations, at least in the early part for '22 and the growth rate. Obviously, continuing to be strong off of a bigger base. We all, myself included, get heavily focused on selling season, new customer wins and what new logos you can add. But the reality is, too, you have a lot of very successful viable strengthening customers that are continuing to add members as well. Can you just remind us all for your legacy customers, what the process that they have is from -- to onboard new employees that they hire into what amounts to a new customer to you for the Progyny system?

Well, I'll say many of our customers continue to hire. And as any new employee, if they elect their benefits coverage through the -- through that employer, Progyny is automatically included. So there's no kind of additional onboarding required. As soon as they sign up for benefits, they get the benefit as they continue to hire. Is that what you're referring to, just kind of continue the hiring in our existing employers?

That and then is it safe to say that if we're all tracking hiring trends across the country that see hiring trends from companies that we can all surmise or your customers are likely to lead to a pretty quick conversion to new potential Progyny utilization because the memberships -- the members are quickly added to your roles?

Yes. I mean that's how it happens. And typically, when that happens, the utilization rate for that particular customer is what it is, doesn't really change that much as they hire. So you would expect the similar utilization rate against that new group of employees as they come on to the benefit. Mike -- you're muted, Mike.

Yes, you'd think at this point of the pandemic that I'd be able to figure this out completely, but the double click on the mute, unmute certainly didn't work.

Well, I'll say I think it's a good sign, Mike, and that I think you subconsciously want to get back to having these fireside chats, the real chats where we actually sit there together, so.

I'm looking forward to Vegas 2022 for that perspective.

Us too.

With that being said, you touched very briefly on the patient care advocates. And I think this is one of the pieces that doesn't necessarily get enough play at times in terms of conversations. Can you just give a sense on those patient care advocates on how the base of them has evolved, grown, expanded their capabilities and expanded over time? And how you think about them as that -- as a true competitive moat, competitive weapon when you're going out and pitching to win more business?

Well, look, certainly, just from a numbers perspective, as you all would expect, as we continue to add more members, obviously, we add more patient care advocates to help take care of those members. Now the good news is we've continued to get more efficient in that. So the hiring doesn't necessarily have to be proportionate because early on, many of the things that patient care advocates were talking to members about, we realized they didn't need to talk to them. It was about a bill or about appointment scheduling. A lot of those things could be automated. So we continue to grow the group. They go through extensive training before they ever talk to a patient. One of the nice things about what's happening with the patient care advocates, similar to the rest of the company, as we've gotten bigger, as we've gotten more successful, as we became a public company, our ability to hire really quality people into that organization has continued to improve. So we're getting more and more nurses, more and more fertility nurses because they realize that it's a continuation of kind of their whole personal mission to take care of people. They just do it in a different format, but they're really still taking care of people and in a very intimate way because they do really develop relationships with their members. We, as an organization, continue to look for ways that the patient care advocates can have a bigger impact on their members. There's a well thought-out member journey. We look for additional ways to intervene in that member journey to provide additional value. So it's a constant evolution of that service. All of those interventions are carefully kind of monitored, measured. For effectiveness, the PCAs are constantly monitored and measured for quality. And what's been really nice about that whole organization is that as we continue to grow and we grow in a very challenging way, which is a stair step growth where every January 2, you're [ a length ] percent bigger than you were 3 days before. We've continued to be able to improve service levels, improve our NPS scores, improve our customer satisfaction scores. And that's not by accident. That is by design where we work very hard to continually improve the process and how well we take care of members and you can see it in the results. So we feel really good about that. We feel really good about it being a competitive moat because it is not easy. And we've been really fortunate. The leaders of that organization come from the fertility industry. They come from the patient care element of the fertility industry and they've really designed a fantastic program from initial training all the way on through how they come monitor PCA quality. So something we're very proud of. I know you've probably heard this before, but I do like to brag about it. We've had babies named after PCAs. I don't think you can find that very often in the managed care industry.

One thing I'd add to that, Mike, is an interesting dynamic. So we look at that team as being a bit of the beating heart of the company. We actually affectionately call the area of the office they work in as the egg. But we have a number of folks that start their career with us through that PCA role. And they actually progressed -- they progressed into different parts of the company, sort of bringing that member-facing service level experience to finance to provider account management teams that deal directly with our providers and clinics, and even our sales team and they've had success in sort of each one of those parts of the company. So it does sort of help infuse that culture even further into the non-sort-of-customer-facing group. So really a great success story, I'd have to say.

It's a great one. One of our most passionate and a very successful salesperson is an ex PCA. She can actually talk to clients about exactly what their members are experiencing because she spent a few years talking to them. So it's a really great point. And I think it's reflective of our broader culture at Progyny where we really are committed to growing our employees' careers, providing personal growth for them, not just business growth, but personal growth for them and you see it throughout the organization. So we've had a lot of really pretty -- from a chronological age perspective, some pretty young people step up in a big way and they play very key roles in our organization now. And it's great to see it. Really, really satisfying to see that.

And that's great to hear from my end. And yes, I love anecdotes like the baby naming. I always remember one of the first names we had where you talked about -- I think you just had your first Progyny baby for an employee there, that type of stuff goes to show that the model can work on a very small scale.

Interestingly enough, one of the people that had the first Progyny baby just had their second Progyny baby. So yes, it's actually really nice. And look, we live by what we sell to everybody else. So we feel at home also.

I'll make sure to add that one employee to my model for -- to make sure it's captured appropriately. Turning back to the pharmacy side of the business. I think it's important to take a step back, especially as thinking about the future, to look at what drove the decision to roll out this area of the business. Clearly, it's been successful. The attach rate has been strong. Can you just remind us on what some of the challenges that your customers were seeing relative to specific ties of fertility drugs that you were able to solve? And I guess, the second question to that is, what type of customer -- what customer chooses not to use your pharmacy services at this point in time?

So the first thing we heard, we started hearing it from providers was that patients can't get their medication on time. It's taking 2 weeks to get the new medication. At which point they missed that month's cycle and they had to schedule a month out, which if you're a couple going through infertility issues, that's an interminable weight when you're all keyed up and ready to go. On top of that, the medications are self-injected. It's a difficult course of injected or self-injected hormones. Patients were feeling kind of who's supporting them in that? Who's helping them learn how to do the injections? Who's doing them for them if they can't do it themselves? So patients weren't feeling supported. So we started looking into, can we solve just the patient issues just to make a better patient experience. As we started getting into it, and I have a PBM background early in my career, we realized that on top of the patient issues, the employers who were paying the bills weren't really getting the best deal they could have. And on top of pricing, there was overprescribing going on, so they were paying for very expensive medications that weren't being used. So really, like the core medical benefit, there was a real -- there was a couple of real problems to solve. The first was the patient experience problem. The second was the economic problem and employers were paying too much money for the drugs. And through careful patient experience design, a simplified authorization process and going to the drug manufacturers ourselves and negotiating around rebate agreements, we were able to solve all those issues. So we now have a program where the employer pays less, they pay less for less drugs because not only are there less cycles, but there's no waste. And the patient has a much better experience. They're fully supported from a clinical perspective, they get their drugs on time, they don't miss any cycles. So to your question, so with all those great benefits, why wouldn't every company take it when they take the medical benefit. And the answer is clearly just a logistical one. Because at big companies, there's always a separate person that's in charge of their PBM relationship. And just like the medical benefit gets carved out of the carrier relationship, the drugs have to get carved out of the PBM relationship. So it's another operational effort that has to go on at our customers and depending on what's going on internally with the customer, the PBM side of the house may not be able to make that change in a given year. So the take rate last year for 2021 starts was 84%, so 84% of new customers took the pharmacy benefit. So the vast majority. And what happens is we then -- if they don't take it right away, we get into kind of active -- the upsell mode, where we try to upsell those customers to the pharmacy benefit in the future. And we've been very successful in upselling customers that didn't start with the pharmacy benefit. Remember, most of the customers that the initial kind of 40, 50 customers of the company didn't have the pharmacy benefit because it didn't exist. So right now, we're at a point where 73% of the existing customers have a pharmacy benefit. I think we talked about in August. We're also happy with the upsell season. That's partly driven by us going after the 27% that don't have it. So we continue to make great progress with the pharmacy benefit. And we're not going to ease back on those efforts until 100% of our customers have the pharmacy benefit because we believe they all should.

And along those lines, you talked about pharmacy benefit as an area where there's upsell. But you spend a lot of time on the calls talking about upsell. And so maybe just to frame for everyone here, if you have a customer that just has a base fertility, call it, one smart cycle approach when they first sign up with you, what is the total opportunity that they have that Progyny can further upsell to them to make the benefits that they're buying from Progyny more valuable?

Yes. Well, I'm not going to try to quantify it because it's a really kind of complex question, but I will tell you this...

More qualitative than quantitative.

Yes. So qualitatively, first of all, most customers start -- the average start is 2 to 3 smart cycles. But certainly, after a couple of years when the data exists to show, well, how -- depending on whatever they think, whether it's 1 or 1 plus 1 or 2 or 3, we can start showing customers how many of their members maxed out on the benefit and start talking to them about do they want to provide -- start providing that coverage and how much that will cost them. So we have a significant number of upsells every season. This is no season -- this season is no different where employers add smart cycles. We have upsells where an employer who might not have included fertility preservation, also known as egg freezing, in their initial benefit, they can add that. If they didn't include pharmacy, they can add that. There are certain other things like do they cover frozen -- the purchase of donor tissue. Sometimes they don't cover that initially, that could get covered and that's an upsell. So all of those things. Additional populations, they may have had in California, Washington state a Kaiser population that wasn't initially covered. We can add those populations. So there are a number of mechanisms that we can look at a customer and say, "Are they really optimizing what we could bring them?" And the account managers that are in charge of that then start talking to their customers about where we think we can add more value to their benefit program, but it's in all of those categories.

Yes. Taking back to the provider side, and you talked about them being important partners. What has changed in terms of the way that you manage your provider network, especially as you get bigger, especially as you get a greater diversity, in particular, I would say geographic diversity in all likelihood of customers. How does that change your approach towards ensuring the appropriate curation of your network?

Well, the nice thing is that one of the things that changed since we -- since I -- since myself and Pete first joined the company is, we don't really like to convince providers anymore that we want to join the network. They -- most providers in this industry viewed as a privilege, part of the Progyny network. And from a size perspective, remember, we've talked about this before, we're largely opportunistic now in adding new providers to the network. We have what we believe is a robust network that has really solid national coverage. We do encounter certain situations where a particular employer in a geography may want a provider added at a certain location that they have historically -- their members they believe have historically like going to. We'll endeavor to add that provider if that provider can meet our network inclusion standards with respect to that quality volume, et cetera, their practice patterns. So nothing is really changing on how we manage the network. And again, the network is largely the right size now. We have approximately half the doctors in the country that represent about 2/3 of the cycle. So these are the higher volume doctors that -- and particularly the doctors that are generating the best outcomes and are the most desirable doctors and the ones that members tend to want to go to see because of their well-established practices that have -- again have good outcomes. So we continue to do it the same way. And it's all based on data. It's all based on having a very collaborative relationship. We've talked about it before. We make our doctors lives better. They see -- if you think about what we do for doctors, they see a higher volume of patients because we bring all these employer customers to the table. The patients they see are armed with an excellent benefit plan design. They're educated and supported by our PCAs. They tend to make the right decisions, which lets the doctors beat -- engage in best practices and generate the best outcomes. And then from an administrative perspective, we make the doctors lives really easy, we're very easy to deal with. There's none of these kind of crazy hoops to jump through on authorizations. We pay them the full amount for their services. There's no patient reimbursement they have to collect. So again, I get back to where it was before. Doctors want to join our network. And unlike where it was 5 years ago, we had to beg the best doctors to be in. Now they're begging us to be part of the network because of everything we bring to the table.

And along those lines, one of the things that you talked about relative to that willingness of doctors and excitement of doctors to join the network is that the restrictiveness that they'll put forward relative to the payers, willingness just to work with Progyny or Progyny a much smaller grouping of payers versus others. Have they not changed during COVID, especially as you've been able to continue to sustain your success? I assume there might be opportunities for even more restrictive networks, more opportunities for them to work more closely with you? Have you seen any of that?

I've heard some anecdotal stories about some providers going -- between my cash business and my Progyny business, I don't need to deal with the commercial carriers anymore. So hoping to stop taking their coverage, but it's more anecdotal than there's kind of any science behind it. Look, we do know that a significant percentage, somewhere around 30% of our providers have pretty limited carrier relationships, us and maybe one other, but don't broadly work with the carriers. And I think that's reflective of just kind of who we are vis-a-vis the traditional carriers. But for all the reasons I said before, doctors don't view us in that same kind of boat that they view the large commercial carriers. And think that working with us is a lot easier, a lot more beneficial to their practices.

Yes. As we come to the end of time, I want to at least spend some time, essentially below the revenue line, but thinking through on some of the cost opportunities you have. This is always, from every interaction I've had been an incredibly well-run lean organization. The company growing 40%, 50%. Usually, don't see as being EBITDA positive at any point in time. And so as you think through the best way to modernize -- we've seen you modernize your operations, you talked about the PCAs and more scale that you have over a larger customer base. How much does automation tech enhancements continue to play into the role in the service value you will provide forward to your members?

Yes. Do you want to talk to this, Mark?

Sure, sorry. Yes. Look, I think one of the things that -- and I've said this a number of times, one of the things that Dave and Pete had the foresight of doing back in the early days is not to under invest in the infrastructure, that would be necessary in order to kind of build this company out. And Dave has made some references to some other things that were done early on, but we have like enterprise-level systems that will scale with us. Now we're always looking at different ways of automating things. I mean, we've got literally tens of thousands of members who we're in interactions with, so from a billing standpoint, et cetera. We're always looking for new ways of doing that. From a customer service standpoint, so again, just wrapping up on the sort of administrative things, we're always looking for ways to smooth things out and to make them more efficient. Again, many of us in management have had relatively long careers at a number of different companies and have done this kind of work before. So happy to continue to bring it to Progyny as it's growing like this. One of the things that we've also done is we've brought artificial intelligence technologies to some of the things that we're doing with our interactions for members. So looking to spot different trends, whether it's in some of the voice interactions or e-mail interactions or what have you, that can help us spot for whether it's clinical trends or things that we can bring to help again continue to improve that member experience. So yes, we're sort of looking at all things and trying things out to see what we can do to kind of stay ahead of the times, if you will.

Yes. Look, there's -- for all those things, there's a lot of great third-party software out there that we can build on and integrate into our system. So the good news is we've not had to kind of reinvent the wheel, it's really about, as Mark said, getting the right technology, integrating it in the right way. And as he said, we have a lot of experience in that. And if you think about the last spot that Pete and I were at, we were essentially running a technology company. So we certainly know how to leverage existing technologies and we've been really good at that. So we have not had to reinvent the wheel, but we are very tech-enabled from an infrastructure perspective.

Awesome. Well, I'm seeing the light saying that we're just about out of time. So I want to stop it there. But David, Mark, as always, thank you for your color on the business. Congratulations on your success and looking forward to further updates on utilization of the selling season as we move through the rest of this year into '22.

Thanks, Mike. Thanks for having us at your conference. We appreciate it.

Yes, we do. Appreciate it. Good talking to you.

Take care.