Terveystalo Oyj (TTALO) Earnings Call Transcript & Summary

Good morning, everybody. Welcome to Terveystalo's Capital Markets Day 2023. My name is Kati Kaksonen. I'm responsible for Investor Relations, Sustainability and Communications here at Terveystalo. I am super excited to see so many of you in person today here at the studio and many of you online as well. We have a great agenda for you today. First, before I jump into the agenda, mandatory disclaimer. And then let's talk about a little bit about our agenda today. So the purpose of this day is to give you an update of Terveystalo strategy, operating environment and our journey to value maximization. We'll talk about our progress of our 2-year profit improvement program and our near-term focus. We'll start the day with the presentation by our CEO, Ville Iho, who will talk you through the overview of our strategy that is based on the fundamental core strength of our business. Our CEO's presentation will be followed by a deep dive into commercial by our Chief Commercial Officer, Marja-Leena Tuomola, who will talk you through on how exactly are we leveraging our leadership position in this growing resilient markets. We'll follow Marja-Leena's presentation with a Q&A. And after that, we'll have a short coffee break. After the coffee break, we make a deep dive into our core competencies and what we believe are sources of competitive advantage. So our integrated care model are presented by our Chief Medical Officer, Petri Bono, and our digital competencies and solutions presented by our Chief Digital nerd, Ilari Richardt, for you today. We will follow those presentations once again with a Q&A before we go into a lunch break. Then after lunch, we come back to what is absolutely critical in this very supply-constrained market for our growth, people. Our Chief Human Resources Officer, Minttu Sinisalo, will talk you through on our winning people strategy and what that means for our growth going forward. And then finally, our Chief Financial Officer, Juuso Pajunen, will tie everything together into numbers, what that means for value creation going forward. Then a little bit housekeeping. So during the Q&A, we'll take first questions from the room from the live audience and then also via webcast. So if you have any questions, do type them in any time of the day, and we'll take them when the Q&A session follows. Without further ado, I'll take -- give the stage over to Ville.

On behalf -- Thank you, Kati. From my behalf, also warmly welcome to Terveystalo Capital Markets Day. This is a hugely important day for Terveystalo and allows us to walk you through the Terveystalo's journey, as Kati pointed out, the core strengths of our business markets, our model, our value capture. Then we'll talk about how far we actually have come already in 7 months in a profit improvement and then take a deeper look into the future as well. As a business, Terveystalo is in a very strong position. Our business model is strong. Our unique world-leading integrated care health model, data-driven health care model is really, really strong. We are operating as we'll hear today from Marja-Leena in resilient growing markets. And we have best-in-class digital tools in our hands, and we can take all of these strong elements to the next stage. As a team of Terveystalo management we have an extremely clear focus on profit improvement during this year, next year we have the Alpha program delivering already. Beyond '25, we are in a super comfortable position to maximize the value and grow our business profitably. CMD obviously is about targets and visions forecasts, and you need to have those in your models, obviously. But driving business is about execution. And today, it's a pleasure to present to you also the progress that we have made with our profit uplift. Since Q3 disappointment, only in 7 months we have made huge progress in our profit uplift, as you saw in our Q1 release, and we'll give more details on that progress. One of the headaches in last year and one of the discussion topics was the omnichannel optimization. What is the future of digital delivery in health care? And how is Terveystalo as a leading company able to optimize the omnichannel? I'm glad to say that there's plenty of potential to optimize the omnichannel. We are on track to get over prepandemic levels, and there's huge potential going forward. Also, the underlying markets are developing positively as we speak and as you saw from the Q1 release. So fundamentals in place, very clear direction and margin uplift is happening. Just as a reminder, who we are, what type of company Terveystalo is? We are 24/7 digitally sophisticated health -- integrated health platform operating into robust developing, growing private health care markets. Our core business in Finland, but we have high-quality bridgehead in Sweden as well. EUR 1.3 billion business, we are working with 17,000 health care colleagues in Terveystalo asset, 24/7, healthy, balanced private pay revenue model that's important in today's world as we all hear today, it's extremely inflation resilient as well. Very strong platform in 2 different countries, leader position in Finland with still room to grow as we'll hear today a lot of potential in our Swedish business going forward. Then as you saw from the initial entry video, it's about meaningful matters. What Terveystalo is in its core in our DNA we have extremely clear purpose. We, as a company and as a team, we are fighting for healthier life. There could not be any more inspirational purpose for any company. We are target-oriented but every action in Terveystalo is deeply rooted in our values. We always put a human being at the center. We are embracing digital innovation. We are investing in that one. But in the core of the core, we are always steered by medical science. We always look for the best of the patients and best medical outcomes. With these values combined, we are driving for functional and human integrated care. Health care that actually delivers -- health care that actually works. And that's something -- even though it sounds trivial, it's something that the health care industry in Europe and globally needs. And that's what we are doing. Our strategic focus areas are also built upon Terveystalo values. What we are concentrating during this strategy period are these 3 elements. So you'll hear today about our people strategy. In supply-constrained business and supply-constrained markets, it's all about people. We are building our leadership position as a preferred employer even further during strategy period, concentrating our people, our professionals working environment and delivery. We are concentrating on medical. We are concentrating on perfecting our data-driven integrated care model. And Petri Bono, our Chief Medical will shed more light on what we are doing in that domain. We do have great digital assets in household already today. We continue investing on those. But even more so, we continue leveraging our current digital assets. And as I tell you in more detail and our Chief, Ilari Richardt, will continue. There's a lot of potential in that domain. Values and strategic focus areas are fully 100% aligned with our target. We are targeting at industry-leading profitability and net positive societal impact. In this audience, obviously, the profitability is a trivial target. Net positive societal impact is equally important because we are a leading player. We also need to build the market not only leverage the market. That all leads to our financial targets, 5% sales growth, 12% EBITDA margin, which this team drives to achieve during 2025, less than 3.5x net debt to EBITDA and a 40% payout ratio to our shareholders. Then discussing a little bit on a general level about the markets and where we operate. Megatrends are actually driving demand for health care services and services that Terveystalo is providing. Aging population is not happening only in Finland, and Marja-Leena will have interesting details on that one. But aging population drives not only demand for health care services, but also willingness to pay for the health care services. Challenged public systems is a hot topic in Finland, but that's not only happening in Finland. It is happening in all of the aging countries. Challenged public system will spill demand in many ways to private domain. Digitalization and shift to remote care is an opportunity. And during COVID, obviously, we have learned many, many lessons how to optimize that new delivery model and a new patient flow. It's an opportunity for us. Constrained labor market at the first glance might see a negative trend for our health care service provider. We claim that for Terveystalo it is positive because as you'll hear from our people section, we are the leader. We are #1 player -- #1 employer in this market. And being able to leverage that leadership position in constrained -- labor constrained market, we can guarantee our business growth and we can guarantee our market share. All in all, all of these megatrends, which are evident, they lead to private provision health care market to grow. More details to come in Marja-Leena's presentation. When we look at the markets where we're operating, one can say that they are roughly -- both Finland and Sweden are roughly EUR 5 billion addressable market opportunities for Terveystalo. Obviously, in Finland, the market share is already super high. In Sweden, we are starting from a very low base. And that, of course, is an opportunity for us. We have -- throughout the years, we have delivered on our growth promise. Growth has been 12%. As you'll hear today, market will allow us to grow and our strategy will allow us to grow also in the future. The margin development during, let's say, post COVID, has not been where we want it to be, where we are targeting at today. You'll hear both about what's happening, what has already happened to our margin uplift, and then what's to be expected. Slicing of markets and operating model into the segments gives a more granular view on what we are doing and how we are operating this shift in Terveystalo. We have 3 different segments: Healthcare services, Portfolio businesses and Sweden. And this group, all of the targets that we are discussing are on group level. As I said before, group needs to reach 5% growth and 12% EBITDA margin and EBITDA margin in '25. Segments are very different. When you look at the size, the margin profile, also their growth potential. Healthcare Services is a very, very strong and healthy business already today. But just doing the math, of course, we need to get way higher than 12% that we are able to, on a group level to reach our target. And we are on track to deliver that one. In portfolio businesses, we are targeting at individual -- independent value creation. The businesses that are inside the portfolio businesses do not share too much synergies with the mother ship but they are healthy, nice niche businesses -- health care-related niche businesses in themselves. We'll discuss a little bit more detail on those later. As said, Sweden is a growth opportunity. We have been able to grow the business, as I'll show later and recover the margins and profitable growth needs to continue in Sweden. Healthcare Services, our core business, a EUR 900 million business, latest 12 months and 11% EBITDA margin. As I said, it's already today in its domain, it's a leading business in Finland and healthy margins, but we need to do better and we can do better. In our Alpha program, which we initiated after Q3 last year, we are targeting and concentrating on commercial, we are targeting improving integrated care, i.e., care continuity and our value capture from our care chains. We are targeting digital to really leverage the digital assets that we have and have integrated view on care chains and digital, and we are concentrating on our people, productivity, but also supply and capacity growth going forward. The progress, which we have reported with our quarterly releases can be seen here. It's very straightforward. We have delivered on the target. We are on track to deliver EUR 50-plus million total run rate impact by the end of '24. And what we are saying today is that we'll have EUR 30 million P&L impact from this program during this year. Strong start for the program. We are still in 2-year program with very strong start on track to deliver over the [ form ]. One topic which has been discussed a lot around Terveystalo model is our omnichannel and our capability to really optimize not only the volumes, but the margins for our omnichannel approach. I said earlier that there is a lot of potential in omnichannel and hybrid digi-physical -- of a [ physi-digital ] model. Before going there, one needs to understand what actually happened post pandemic for our omnichannel model. Early on in the pandemic, of course, brick-and-mortar access was limited and that led also supply to decrease drastically. We were able to replace a lot of the brick-and-mortar supply and deficit on that side with digital supply but what we saw was that the demand in those channels came with a totally different service mix. Service mix in digital was a short gear change and brick and mortar obviously also went down during pandemic due to the fact that medical had to have it during pandemic, not to do a long care change, not to do so much diagnostics they basically said for the folks that stay home just wait. This led -- these -- all of the elements, service mix, channel shift different approach to medical led to eroding margins and the impact on Terveystalo which we discussed after Q3 was fairly significant. On our way to recover, we are reversing the trends. First step, obviously, is to get brick-and-mortar supply to the same level as we had prepandemic and grow it further. On that one, we are on our way to deliver. As we said in Q4 and after Q1, supply increase has been really, really strong. When we have the brick-and-mortar supply, we are able to steer the right service and case mix, the brick and motor, so that we don't unnecessarily erode long care chains and feed to our diagnostic services. What we have also been able to improve is a referral rate in all of the channels. So basically, referral rate in physical has improved drastically since the lows of the pandemic, and I'll show some data on that one later. Even more importantly, we have learned how to use digital channel better -- much more efficient and a better way. Referral rate in digital channels has increased. Finally, productivity in our digital, which is the key driver for better profitability going forward in our omnichannel approach has improved, and there's room to improve that one even further. All in all, what we are seeing today is, yes, it took our margins down in our core operations post pandemic, but we are -- with our actions and recovery of medical processes, we have been able to recover that almost to the prepandemic level, we are on our way to go beyond pre-pandemic level. In our Alpha program, where this is a key part, we have clear and concrete actions to improve care continuity, our omnichannel profitability, cooperations beyond prepandemic. And beyond that one, there's even more potential, which we don't have concrete plans yet, but we do have the assets and we do have the capability to capture that value in long term. So we are reversing the trend as we speak. The negative story will become a positive story going forward. What we are doing in this trend reversing and recovery. Care continuity is the key. So in our model, we need to capture the value from not only appointments, but diagnostics part. That is the margin driver for Terveystalo model, and that's very important for care continuity and also medical outcomes. We have been able to improve care continuity in physical and digital with our actions. Customer steering and patient steering is other key point and topic. We need to be able to be precise on what patients to steer the digital and what patient to steer physical and also to what type of doctor will take the first appointment. We are piloting digital trials and that's -- that will be a major boost for better customer steering in future. It will be live somewhere during the summer. With the better customer steering and coupled with that one, we need to be able to steer our capacity also in more flexible manner. To steer our doctors to right channels at the right time, and we have made progress in that domain as well. Remote channel efficiency can be boosted as Ilari will describe later. There are elements in place. We have already done steps in that direction, but there's more potential there. Finally, to capture the maximum value for Terveystalo, we need to optimize the pricing in channels and it's a step of that care chain. We have already opted the pricing model for our omnichannel services, and we continue to optimize that. On the right-hand side in the graph, what you see is development in referral rates. That's the best proxy on the recovery of the care continuity and, i.e., our core processes margin potential. As you see early on in the pandemic, this [ tank ] it stayed low, but it's been recovering since H2 last year and that trend continues. A couple of words around portfolio businesses. As I said, independent value creation. We have 3 larger businesses inside this segment; Public partnerships, Staffing and Dental. And then we have a tail of smaller, nice, niche businesses. Each and every element in business have their own independent value creation and profit uplift plan, and they are executing on that one. Commenting on the progress, very happy to see that 2 of the main businesses, Staffing and Dental are recovering not only from a revenue point of view, but also the margins are improving. Public partnerships is a legacy business. It's a legacy model, old outsourcings. We don't aim -- we are not aiming at growing that part of the business anymore. That's going to be replaced by a different model as Marja-Leena will discuss later. And this is a low-margin business for the Terveystalo, legacy model, but these contracts will come to an end. So it's self-solving issue for us. Where we want to be, we are making good progress and our Public partnerships, it's a diminishing business. Finally, Sweden, as I said, we have been able to enter the market with high-quality bridge that feel good. We have been -- since the acquisition we have been able to grow the business by 30% roughly. We have been able to recover the business from lows of pandemic. And as you saw from Q1 releases, actually, the margin uplift has been accelerating. So from Q1, we reported 7% EBITDA margin. We are firmly in occupational health, organization and leadership and harmful use. During next 2 years or this year and the following year, we need to continue profitable growth of the core operations in Feelgood in our Swedish business. We also want to make our first entry into health care. That will require an acquisition. We are not looking at transformational acquisition, but acquisition either way. We also aim at truly leveraging our digital synergies in our Swedish platform during this year and next year. Tying this all up. As I said, Terveystalo fundamentals are really, really strong. We start from a solid base -- we are a leader in really strong and growing private health care markets. Our health care delivery model, data-driven integrated care is best-in-class. We do have digital capabilities and leveraging -- really leveraging those in coming years and short term, long term is a key to success, and we'll deliver on that one. In supply constrained market, supply of professionals is a key whoever has the professionals will have the business. We are #1 employer in our core market and we'll continue developing Terra Vestal as the best choice for health care professionals. Finally, as a starting point, we do have a strong balance sheet, allowing us to invest and target our focus wherever needed. As a team, as I said, we have extremely clear focus. Short term we'll concentrate on delivering 12% EBITDA margin. With the support of strong cash flow, we are then beyond 25% in a position to accelerate and -- it's inspirational for all of us to think about Terveystalo has a EUR 1.8 billion business in the medium term. With that one, I will hand over to our Chief Commercial, Marja-Leena Tuomola.

Great to see you all here and online. Happy to be here. My name is Marja-Leena Tuomola. I'm the Chief Commercial Officer of Terveystalo since 2021. I started to take are of the occupational health care business in Terveystalo. And since the operational model change in November, I started to act commercial -- as Chief Commercial Officer. This means that I'm responsible for marketing, customer steering, pricing, revenue management, sales and customer relationship management to all our customer groups, consumers, public sector and, of course, corporate customers. I have more than 30 years' experience in media, marketing, sales, digital development in both B2C and B2B businesses and also P&L responsibility. In fact, my last job before Terveystalo was in this building. I was responsible for the marketplaces, digital marketplaces and SaaS services of Sanoma. So a very deep knowledge also in digital businesses and earning models in there. I have also a wide Board of Directors experience. For example, I've been in the Board of Directors of a Finnish bank so regulated industry, also in higher -- at private higher education and now at the moment in a private equity-owned IoT, broadcasting and Telecom Company. So also learnings from there to bring to Terveystalo. During the past year, me and my team and the whole management team of Terveystalo, we have been concentrating very much on pricing strategy, which is a key driver in a supply-constrained market. So we have invested a lot in customer steering, as Bill explained, we have very nice, very interesting pilot project ongoing, and we'll be in production now in June. And that will really change how we steer customers in health care industry. The other part that has been on my table and on my team's table has been changing the sales policies and tendering policies in the Occupational Health Care business and in the public sector health care business. So there is quite a lot of work to do still. And I think that there is also a lot of opportunities to change the whole earning logic of this health care -- private health care business. Ville presented our journey to value maximization, and I will continue to talk about how we strengthen our position as a market leader in the private health care market in Finland. We have 3 main growth drivers in this market. We operate in a growing and resilient market. The private pay, private provision health care market is growing around by estimated to grow by 3% in the coming years. The public pay, private provision health care market. I will explain more about that in later, what does it mean? It's expected to grow by 6% in the coming years. The second big growth driver is the global megatrend, demographic impact, the aging population and the Finnish -- Finland-specific problem, especially in Finland healthcare system challenges at the moment. The aging population has much higher health care needs than the younger population, and they are also able to pay. The well-being services counties, they are really struggling with labor shortage and tightening regulation. The third lever is Terveystalos' very strong brand. We have a very solid customer base and our market position -- with our market position, we are able to maximize value capture. All in all, that enables us to optimize pricing, outperform the market and improve margins. Then some facts about the Finnish market. So we operate in a EUR 4.5 billion private health care market which is around like 1/3 of the total Finnish health care market. And the projected growth in the coming years -- in the coming 3 years is around 3% to 4%. After the operating model change in November last year, Healthcare Services, Finland, which I'm presenting here, is operating in 3 different markets. In occupational health care, EUR 1 billion market, 3% growth in the private clinics market, consisting of insurance customers and out-of-pocket customers, that's also around EUR 1.8 billion, with growth -- CAGR growth, 3%. And -- then we operate in the very interesting public pay, private provision market, market size at the moment, around EUR 8 billion, and the growth rate is very interesting 6%. And our colleagues in portfolio business, they are also operating in this business partly. We have a division -- nice division of labor here and also joint operations. The portfolio business operates also in dental, private provision and holistic outsourcing. And both of these markets have either low growth or then no growth. I will explain -- Bill already explained about the public partnership market, which is the holistic outsourcing market. All the segments that Healthcare Finland operates in all the segments are growing. And then we have this very interesting, very promising public pay, private provision market with 6% future growth. It will be -- it's a market to make in the future for us. The underlying market growth is very good. But what are the root causes for this demand growth that we see on the market. That's the aging population. I think that you know that Finland has the world's oldest population after Japan and Italy. And the numbers are quite sort of like solid. And we don't only have the oldest population, but also our population is a growing old, the fastest in the European Union. So we have now around 1.2 million of Finns out of the 5.5 million Finns. So 1.2 million is already over 65 years old. In the coming years, that share of the population will increase to 1.4 million. So around 25% to 26% of the Finns will be in the near future more than 65 years old. So what does this mean to us to the whole health care industry? Very obvious. The social and health care expenditure -- spend is increasing due to the growing aging population. We estimate that to grow around 6% CAGR in the coming 5 years. So the total social and health care expenditure. We read this morning in the Finnish newspapers, the well-being services counties, they are really exceeding their budgets within the -- in the first quarter of the year. So huge expenditure increases on that side can be seen every day. So what are the other implications of the aging population, the plus 65 population. So what are the other implications? I name here now 4. The health care spend for plus 65 age is 3x higher compared to younger population. So health care spend of plus 65 is estimated to be 3x higher compared to younger population. The demand for aging-related specialties like chronic care and surgical specialties that's growing. And of course, high demand -- really high demand for health care services will also increase and worsen the constraints and the bottlenecks in the public health care system. I give you some numbers that I got from my medical colleagues. At the year-end -- at the last year end, there were in the public health care, almost 11,000 patients waiting for knee or hip replacement surgery, 11,000 in the queue waiting for knee or hip replacement surgery. There are very many working-age people in the queue, having long sick leaves being away from the workforce. And they are queuing there for a very simple -- if replacement is simple, but basically a very simple operation, that could be done in the private sector. Terveystalo could take care of, according to our experts, 3,000 of those surgeries annually. A second example, 12,000 patients are waiting for cataract surgery, it is [Foreign Language] in Finnish. Terveystalo could take care of patients annually out from that queue. And so why don't we do that? Why I say that we could take? The thing is that it's not possible at the moment due to the legislation. So we are trapped in the legislation that is not necessarily best for the Finns. If the government would make the decision now that, okay, the private health care sector could help the public system to shorten the queues, we would be able in Terveystalo by year-end, start to ramp up our operations to meet these numbers. But it's a political will and, of course, needs a little bit of legislation changes also, but it's about political will. And the fourth implication of this increasing aging population is that the plus 65 customers, they have better insurance coverage. I just recently read from [ OPs ] release that there is a huge increase in health insurance. Health insurances at least in [ OP Group ] in the beginning of the year. It's for retired people. Retired people take more insurance coverage than ever before because they know that they would have to wait for 1 year in order to get the knee replacement or hip replacement in the public sector. All the factors they will drive up our demand in private health care. Then look at -- let's look at the public sector problems or challenges a little bit more deeper. As I told you in the beginning on the market slide, so we expect the EUR 8 billion public pay, private provision market to grow by 6%. And we want to be the one who is leading the market development. A little bit about like more detail about the challenges that the recently established well-being services counties are facing at the moment. There is the shortage of labor, long care queues as I explained, tight budget and they have an urgent need to offer digital services, both not only to the patients but also their professionals are demanding that they want to use better digital tools. And then there's a tightening legislation and care requirement. I take one example from here, the shortening treatment time guarantee, [Foreign Language] in Finnish. So you have heard and read in the media that the queues are months. We talk about months even in nonurgent care. So the treatment time guarantee is shorting now 1st of September to 14 days. So if there is a Q4 2 months, it is now in nonurgent cases care, it should be 14 days. And next year, in November, that will be shortening even to 7 days. So quite a lot of like work has to be done before the public sector are in these numbers? And are these deadlines met. So what is our response to these challenges? We continue to offer traditional staffing services, diagnostics like screenings and secondary health care services. But then we also have invented and developed together with municipalities and now with well-being services counties, we have developed new cooperation models such as coordinated care and care path outsourcing. So instead of large-scale total outsourcing of health care stations, we have developed a partial outsourcing or outsourcing of a certain of the medical care of a certain customer group like, for example, elderly people in nursing homes. So when our doctor employed by Terveystalo would be responsible for the medical care, all the medical needs of a group in a nursing home, or a process of -- like occupational health care is a good example of a process or like also population group outsourcing. So not the whole outsourcing of well-being areas population, but part of that, right, in the resistant business process outsourcing would be, I think, the similar to this health care world. And then we have a very good example what we are already doing with well-being areas of personal doctors. And that model is very good model to continue with other customer groups. We now do it with elderly care. And the third way that we want to help and are able to help the well-being services counties is that we are offering population-level digital tools that we are using in occupational health care. So in occupational health care context, population means a workforce of a company in the context of well-being counties, it would mean the population or part of the population in a well-being county. So what we do in the occupational health care, those tools and processes can be easily implemented and used in public sector. We can use, for example, in the preventive health care, we could use health surveys combined with AI-assisted screenings. That's what we do now in occupational health care business, it's not any vision. It is already the thing that we are selling on the other -- in the other sector. Then we, of course, offering solutions combining digital platforms and health care services. We call these new cooperation models, this partial outsourcing or combination of digital platforms and health care services, we call them integrated care partnerships. Then look at -- let's look at the -- where we are in this market at the moment. So we expect this public pay private provision market to develop towards integrated care partnerships. These are -- here in this graph, it requires a little bit of explanation first. So here, we have described and shown what are the existing and cooperation models. So let's start from the low left end, staffing. Staffing business is ongoing doctor nurse staffing, EUR 300 billion market with 5% annual growth. Then health care and our portfolio businesses are in this business. Health care services in and we are not in that business to make a small note here. So healthcare services, sales, that's diagnostic sales, secondary health care, we are in this business is EUR 300 billion market, growing nicely with 5% per annum. Then we have the outsourcing market, the holistic outsourcing market. It's a EUR 500 billion market, $500 [ million ] market, it will be decreasing, unfortunately because due to the legislation, the big deals that all the private health care providers have made those we end in the coming 5 years and the litigation prevents us to do the new kind of deals or new deals for that. So that market will be shrinking. And our portfolio business is operating in that business, as Ville said earlier. So this integrated care partnership this coordinated care, care path outsourcing, population outsourcing, business process outsourcing or health care process outsourcing, this is the way that the market will go. It's now a EUR 100 million market, but it will grow to in our estimates to EUR 300 million. And some of you might wonder where are the service vouchers. The dot would be so small, but it wouldn't get in the scale. And unfortunately, I had to say that the existing model of organizing service vouchers will not be the savior of Finnish public health care system. And it's because the production model is not efficient. And the administrative cost of -- even from the public side is too high. [indiscernible] from who said that the minimum value of the service vouchers should be EUR 800 in order to be of any help to public health system because the administrative cost of the existing voucher system is so -- there are 3 systems, 3 parallel systems. So I'm not going into details, but I wanted to only share, because I know that some of you might be expecting that the service vouchers are here, the big thing. But it has to be changed if we want that to be a big thing in the future. So integrated care partnerships that we believe is the way to go forward in the cooperation with the public health care system. So the aging population, combined with the serious problems in the public health care system will increase the demand for private health care services. And this will open up new opportunities for us in the public pay private provision market. Then to the third growth driver of us of Terveystalo, that's our market-leading position. And the market-leading position has 3 elements in my presentation. It has our position in the mark -- in the private -- integrated private health care market. And secondly, it's the strong brand; and then thirdly, it's the very diverse and solid customer base. But let's start from the integrated private health care market. We are the market leader in the integrated care health care market, except for Mainland and none of the other players are big enough to challenge our position. Furthermore, as Ville said, this is a supply-constrained market. The company who is able to recruit and retain the health care professionals will win in this market. Minttu will talk about that later in her presentation. There is no free capacity on the market at the moment. And due to the earlier merger control decisions, it is widely tough that further bigger conciliation in this market or M&A would not be possible. So I repaired the Mehiläinen would be there at the system. So this market is more or less like here with the players. This is very attractive for us. We focus on organic growth, which is supported by the underlying growth in demand as explained earlier. And then we focus on economies of scale. We are the biggest in the market. We can focus on economy scale, both in the integrated health care delivery and interdigital operations. Then about our brand. So we have a very strong brand in this market. Everyone knows what is Terveystalo . In recent years, we have systematically invested and developed our Terveystalo brand. The work has led to excellent results in all customer segments. Recent market studies show that we are the most preferred consumer brand in the Finnish market in health -- private health care. And we are the most frequently considered brand among consumers. And we are seen as the #1 provider of modern digital B2B solutions and provider of data-driven occupational health care solutions. So what does this mean to us? A strong brand brings with it increased customer loyalty, which means longer customer relationships, more increased purchase frequency and lower customer acquisition cost, of course. A strong brand increases also pricing power and also the pricing premium. And for example, from the past 8 months, we have not seen increased customer churn in our business despite of the fact that Kela reimbursements were stopped terminated in January. The consumer confidence has been all-time low during the past 8 months. And we have increased our prices in the consumer market 3x during the past 8 months. And 1 record high increase in prices in occupational health care market. My key message in this is that according to Kanta studies, equities -- brand equity studies strong brands can achieve on average, 6% to 10% higher prices for their products without significant customer impact. And to mention, also employer loyalty, a stronger the brand, the stronger the employee loyalty, and Minttu will talk about our employer branding in her slides later in her presentation. Then to our customer base. So we have a very diverse inflation resilient customer base. 90% of our revenues come from private pay customer base. Corporate customers, 58% of the revenue is consumers 31%, public sector customers 11%. We serve more than 27,000 customers in the occupational health care and more than 740,000 employees, both in the corporate and public sector. And let's then go to the start of our presentation. I hope that I can exceed my time a little bit. Very good. Thank you. I have to ask because this is one of the most important slides in my presentation. So I think we should spend some time on this slide. So how we'll grow in the EUR 4.5 billion private health care market. We are driving the growth and margin uplift in 2 different ways. First, in our biggest business segment, occupational health, which is 50% of our sales -- was 50% of our sales. Here, you can see the market size and the growth numbers, how we are going to win in this market. We will increase our productivity and what has been doing with very nice numbers. And I think Juuso has in his presentation some of the results. We are optimizing pricing and production model because there has to be a connection with the price and the production model and the service level. And we follow very strict sales and tendering policies because we make long-term agreements, so you have to be very careful in the inflation -- in the inflation environment. What kind of deals you do for the long-term future? Then in the private and public pay private provision market, we will selectively gain market share. Let's start from the top priority specialties, which, in our case, is mental health, orthopedics, pediatrics, to name certain few examples. That's 25% of our revenue, market growing very nicely. There, we will leverage our 740,000 employee customer base. We are using the processes and digital tools, as I explained, and offering them also to the public sector. Public sector is partly here included, insurance company cooperation in this section is very important, and also top of mind brand because the consumers are able to choose which brand and service provider they are using when they go to see a doctor. Then in general practice, 15% of our revenues, this is a volume section. And here, it's very important to increase the productivity, to optimize the pricing and production model, as Ville said, because this is an entry of our product. And if we are able to improve the care continuity and adherence to our care protocols, this is also a very good business. And other specialties, the smaller ones. So there we will really prioritize the specialties that we choose to operate in by growth and margin. All this we will succeed only in this growth and margin uplift if we really keep 3 fundamentals, which are common for these 2 different ways of growth and margin uplift. We have to develop further advanced customer steering, what we have right professional in right channel in right time with optimal price. We also have to take care of that our integrated data-driven care delivers the best medical outcomes because that's what the customers are paying for. They are paying for us for the best medical outcomes, and that's the core of our business. And then, of course, this game is won by the company that is able to recruit and retain the best talent on this market. Petri and Ilari and Minttu will continue with these very important topics in their presentations. And to sum up, we operate in a growing and resilient market. The demand is growing to demographic fact and due to the health care system challenges, that we have in Finland. We can -- we are able to leverage our strong brand and market position also in pricing and maximize value capture. That enables us to optimize pricing, outperform the market and to improve margins simultaneous. Thank you.

Thank you, Marja-Leena and Ville. Now we are ready to take questions. We'll take first questions from the audience and then come back to the webcast. Do we have any audience questions?

Sami Sarkamies from Danske Bank. I have a question regarding data you presented on Slide 14, where we saw that referral rates collapsed due to the pandemic also in the physical channel. So can you explain why the pandemic impacted referrals in the physical channel?

Yes. Thank you, Sami. Very important topical question. I think Petri Bono is, in a way, he has the education to answer this one. But really, what we saw making this, in a way, simple was that for majority of the cases, for example, respiratory infections, et cetera, et cetera, so the standard treatment during pandemic was stay home, don't come here, don't show up. And that was the major driver for that one. The other one was that -- that was really the key driver for that one, that one we saw. And now it's reversing as I showed and told.

And maybe a follow-up. I mean the situation has continued for quite some time. So why didn't you react earlier? I mean, based on the data, there was no improvement during a 2-year period. So why didn't you react earlier?

Well, again, very good question. The first priority early into pandemic was to get the supply up because there was really not access to physical care many times for many patients and many customers. So that was our #1 priority. And that one has to say that even for Terveystalo, it was a major change in the customer behavior. It took some time for us to learn how the channels work, how we steer customers, how we optimize the care chain in each and every channel. So learning time.

And of course, the COVID testing at the time was a heavily ramp-up exercise for Terveystalo. So most of the focus went to COVID testing in the diagnostics side.

Olli Vilppo from Inderes. I have a question for Marja-Leena. Very good presentation. And about the market, the public market, you told us that you would have like capacity to clear that queues in the public like in this large scale, but why does the legislation prevent you to do this? Is it because it's so large scale? Or can you do like only with the vote share? So how does it work?

There is -- Petri, what's in English [Foreign Language]?

I think it's something centralization act.

Yes. So Petri, could you answer this? Because this is a very specific medical thing. There is legislation preventing us doing it.

In 2017, an act of centralization was established in Finland. And that means that major surgery cannot be operated in places where you don't have emergency care appointment 24/7 available called [Foreign Language] in Finnish. And that's been a fact that restricts how much private can be used to help in larger surgeries. And actually, that's something that is quite much discussed at the moment that should that be replaced. Because, for example, in the hip replacements that is there, where the longest queues are in Finland at the moment, so that should be centralized in certain hospitals that at least perform 600 operations a year. And as a comparison, for example, in Germany, the number is 100. And actually, whether there's fast access to the emergency care in case of some complication, it's not an issue at all because let's think about one single patient who gets somewhere operated, that patient, if it's a day surgery, so actually may go back to summer house to recover from the operation that may be 250 kilometers away from the place where the operation actually was done. So it's a theoretical idea to centralize everything, but patients just don't behave that way in real life. So therefore, I think there's really room for improvement in the legislation. And that's quite key if we want to tackle the long queues in Finland. And so -- and I believe that, that will be modified now within the next 1 or 2 years.

So as I said, so there is the political will. And this is one of the topics that the private health care industry has now taken up to the government discussions. This is one of our proposals that this is the legislation -- if you really have the political will to reduce and shorten the queues so let's change this legislation, which is preventing us doing the wise thing and the right thing from the population point of view.

Yes. And maybe to add on to that one, thinking about how this type of services typically are organized. It is a standard practice internationally that basically you specialize in certain types of services. You outsource -- for example, this type of a knee and hip replacement surgeries in large-scale private sector because we are able to specialize, make it really efficient and operate it in scale. So there's nothing, in a way, special about Finnish situation. It's a standard practice in international markets.

And maybe I can add to that, that I think the basic idea was actually quite good on the centralization act. For example, if you think organ transplants and very rare procedures. But it was, I think, written in a too large way so that now when there's any way a major problem in the country to have access to operations, so there are some reasons that actually are reason for the queues in the legislation. So that could be loosened a little bit, let's put it this way. The idea is not certainly to touch on the most tertiary specialty care parts of the act, but there are also other parts that could be a little bit modified.

Any other questions from the audience?

This is Iiris Theman from Carnegie. With regards to potential orders from wellbeing service countries, so what kind of margins do you target to reach? And perhaps what is the expected time line for these orders?

Well, if I start, when we are talking about our network capacity provided from healthcare Finland integrated network. Of course, then we need to look at the replacement factor and how we allocate the capacity to different customers and different services. Our target, as I said, is well above 12% in health care services Finland in our core business. So public sector service also needs to reach on a very same target limit, depending on the case, of course. If we have loose capacity, if we have idle capacity, then that can be in certain cases sold with discount. But we and Marja-Leena's team, we have been now and will be in the future fairly strict on what type of services, what type of margins we'll allow to be operated in our integrated network.

In a supply-constrained market, you don't have 2 different kind of doors to the same service and 2 different prices. You have to be very careful with that because we most probably would be able to sell the supply-constrained capacity on the private market, in occupational health care to insurance companies with a higher margin to the public sector. So we have to really be careful, as Ville said, so we talk about capacity, really like capacity management.

Yes. Then when it comes to building new type of sort of disintegrated services to public sector, then we, in cases, will allow lower margin. Of course, taking care of that group margin targets will be reached, which is 12%. But in those cases, when we are not talking about same capacity pool, we can allow slightly lower margins. And typically, those type of services are low CapEx services as well. So fairly easy to ramp up and require limited investments into them.

And what is the expected time line for these public orders?

Yes. What we have said quite a long time is that we will see first implementations and applications from our integrated care partnerships during H2. And that's still the scenario which by we are planning our services.

Joni Sandvall from Nordea. Maybe one question regarding the insurance companies you said on the Page 35. One, that you are maybe improving the cooperation even further with the insurance company. So could you give us some comments on, from your behalf, what are the main drivers when thinking cooperation with the insurance companies?

I would say we deepen. We have a good cooperation. We want to deepen it. And the main driver, if I think about it from our customer, insurance company point of view, the main driver and their -- from their point of view, the main driver is not necessarily the cost of the treatment or surgery, but it's the whole -- the length of the care chain and the treatment, meaning, that the biggest part of cost to insurance company doesn't come from the surgery, but it comes from the sickness. Sick leaves days and possibly even work inability, workability problems. So we -- what we want to do is to take care that the treatment chains, the care chains are fast access to service, fast access to care, very short, very well standardized processes that the insurance companies see that what's the -- how long does it take really that the person is back to the workforce or back to sports or whatever is the person suffering from or what is the context. So it's the fast access, very good treatment chain and reducing the cost of the insurance company also. This is a mutual. This is our joint effort to also reduce the cost from the insurance company side. So I think this is the core. And we have a very wide network. That's also one of the fast access to service is based on our very large network. So there is a service very close by for the insurance company customer and then very fast care.

So you don't have to reserve too much capacity. I'm just thinking that is there risk that you have slack In the...

No, we don't reserve any capacity to any customer. They -- and I think that this is a quite good flow of insurance customer -- insurance customers in our network because there are not that many changes in how the population is during the winter time. You know that they hurt their knees and ankles and whatever due to slippery time. So we are reserved. Our production has made the capacity for that kind of treatments, for example. And then we know that in the summer, there are different kind of injuries and accidents in the insurance customer population. So no, no. We would love to improve -- increase the capacity, and we'll have -- love to have more insurance customers. No problem in that.

If I complement a little bit in our model. As Marja-Leena has said, fast access to care is the key, care chain efficiency is the key and also ability to showcase the effectiveness of the care chain. So there needs to be numbers to back our unique value prop up with the insurance company. As to access to care, our capacity utilization in our hospitals when it comes to facilities, basically theaters, it is lower than on public side. It's our model because there needs to be this fast access to care. There's still -- we can improve the utilization. There's room to grow in those. And if there's no room to grow, we are in a position to invest and increase number of theaters. The dynamic part of our system is the professional. So in our model, of course, since they are private practitioners, it's, in a way, automatically ramping up and ramping down. So that's not idle capacity.

I think we're running a bit over time, but if there are any other questions from the audience, let's take one more.

Sami Sarkamies, Danske Bank. I have a question on Sweden. I think you alluded that the next step is to become a player also in health care services. Just curious about the ambition level here. How sizable player do you think you need to be in Sweden in order to be relevant? And are you thinking about nationwide presence or is this going to be more centralized to larger cities?

We'll take, I wouldn't say, careful steps, but well-considered steps in Sweden. The thing is in business model, not so much in scale in first stage. So we are now well established in occupational health care. We have a nationwide network in that domain. It's a high-quality business in occupational health care. We'll complement that one with high-quality health care service, whatever that first step then is going to be. It can be local as well. But with that one, we need to be able to demonstrate that we can spice Swedish model up with our integrated model from Finland. So size is not decisive at the first stage. We are already roughly EUR 100 million business there. It's a healthy platform and we can go step by step.

Let's finish this Q&A session for now, and then we'll continue at half past with more deep dives due to integrated care model and digital solutions. See you soon.

Thank you.

Thank you. [Break]

Welcome back from the break. We'll continue now with deep dives into integrated care model and digital. First, I'll let our Chief Medical Officer, Petri Bono, to run through the integrated care model that we deliver in Terveystalo. Please, Petri.

Welcome back, everyone, after the break. My name is Petri Bono, I'm the Chief Medical Officer at Terveystalo. Been in this position for almost 4.5 years now. I'm a medical oncologist by basic background of training. And before joining Terveystalo, I was a Chief Medical Officer at Helsinki University Hospital district and also Medical Director before that at the cancer center at the same university hospital. My responsibility at Terveystalo is to lead our professionals, almost 17,000 professionals, and to guarantee that we provide best possible care for our patients and customers. Today, I'm more than delighted to tell you actually what we've done, how we've done that, what have we achieved and furthermore, how we will move forward with our integrated care model and what's unique to Terveystalo. And of course, I will also try to highlight what's the added value for the patients, for our professionals and of course, for the shareholders. I'm really proud to be Chief Medical at Terveystalo. We, at Terveystalo -- so we are a true master of providing world-class integrated care, and we can measure our results. And based on our results, we know that we are on a top-notch level. We have also all the required know-how to integrate both physical and digital services to optimize the outcome of our patients. We also know how to master integrated care. I will have some deep dives today or 2 examples, but we actually have developed 25 different care protocols to optimize care continuity and the outcome. To optimize that patients feel that they are taking care very well because they have the symptom, that's the reason why they approach Terveystalo. Our flagship units, we have established focus areas within mental, within orthopedics and within sleep medicine, and we have excellent results from there. For example, from the mental unit, we've been able to show 45% less -- 45% better in medical index outcome after the treatment at Terveystalo and within orthopedics, with our care paths, we've been able to cut down sick leave dates by 35%. And of course, when we treat our patients and customers well, at the same time, that yields great business results. It means added customer value with less sick leave days. It means higher margin at every touch point, especially in the use of different diagnostics, for example, in the use of imaging, in the use of lab testing. And of course, also, these are strongest within the focus areas that we've chosen. And what our professionals actually want to do, they want to be stuck to the medical excellence. And with our care path part model, they can concentrate on treating the patients as well as possible, and this will guarantee our market share in the number of health care professionals. We are strong, what we actually do. And when we deliver integrated care, so it's our core strength. And actually, next, I want to explain shortly what is integrated care and why does it matter. So what is it actually? So it's care that encompasses, is a seamless transition between different care modalities, primary care, secondary care, diagnostics and also post-surgery rehabilitation. Everything is happening around the patient and around the patient's need. And why does it matter? We are here to help patients, of course, this will maximize the medical outcome and very important in nowadays within the value-based health care context, we are more and more concentrating on measuring patient experience. So it's not just enough that we measure the medical indexes and outcomes, but also how did the patient feel, did they get help? And then for payers, integrated care and well-steered care paths, they mean better cost controls. And as I already mentioned, for professionals, they mean medical excellence, top-notch results from their own treatment. And for Terveystalo, lower cost for operations, maximum value capture and better outcomes. And of course, for the society, reduced health care spending, overall spending and better overall health. And then let me explain that what is unique in the care parts to Terveystalo. And what is actually our operating model here. And what it means to care continuity. We've been all used during the COVID pandemic to use telemedicine to reach out the professional very fast. But with our care paths, we can guarantee the care continuity even after the appointment to the diagnostics, to the possible surgery operation or into any other intervention. And importantly, also post-intervention therapy that may be done, for example, by the physiotherapist or some other professional. And we have these 25 care paths within the most common diagnoses. And we can actively lead them so that the patient doesn't feel that he or she is dropped somewhere between different professionals or different procedures. And we can -- by our care need assessment, we can steer customers optimally either to digital channel or to physical appointment and thereafter, also to the right further path. And of course, business wise, this means correct use of different diagnostics, correct use of lab testing, and it's not just to ensure maximal use of them, but also to help the professionals that they know what kind of test they should do when they start planning the treatment for a patient. Nowadays, with more and more data gathering all the time from different sources, it may be sometimes, if you have graduated from med school 30 years ago, to remember that what are the modern lab tests always required for certain symptoms. So we have the tools to help our professionals. And then, of course, with our tools, we can maximize the conversion of the lab referral also so that they are taken and they can be -- the results can be used in the different diagnostics of the patient to optimize the right treatment. And finally, the heart of the value-based health care and integrated care models, it's the outcome. And it's the medical outcomes, these patient-reported outcome measures that we measure from our platform and also how did they feel, our so-called patient-reported experience measures. And actually, we are very good in measuring our patient benefits. We know that after the appointment at Terveystalo, most patients feel that they are coping with their symptom or condition better than before. And actually, here's an example of an instrument. It's an international instrument that we use to measure that. So we asked a simple question after the appointment within 24 hours, that do the patients feel better or much better or the same after the appointment. And over 60% of our patients, this is based on last 3 months, 50,000 answer that they feel better after their appointment. So that we really know that how our patients are feeling after appointment did they get benefit. Unfortunately, not everyone gets immediate benefit, and there are other measures than what you measure after the first 24 hours. But let me go more into these examples about integrated care and what it means within mental health and within orthopedics. First, let's start with the mental health. Mental health, as we all know, it's a major issue that is extremely expensive for the society. And for example, in Finland, of the early expensive retirement, 77% actually occur within a population that are under 35%. And for Terveystalo's occupational health customers, so the price tag for that is over EUR 700 million annually. What actions have we actually taken to tackle these issues? First, super fast access to mental care health path. And then we have investment -- invested on different digital therapies also, and we have been able to change the treatment path of our professionals towards a more modern approach, which includes also therapies called brief psychotherapy that is causing added value in addition, for example, to antidepressive drugs if they are correctly used. And we can show that the brief psychotherapy, so the growth rate from 2019 to '22 has been 98%. So we are using that a lot more. And in the next slide, I think I can show more that why that's beneficial. However, there is still a major opportunity to grow beyond the current numbers since we know that not all patients at all are getting currently the referral to another professional to get -- help the symptom. In mental health, fast access to care means best results. However, it's not enough. We need to continue after the first contact also with the patients very well. And we have -- it's called mental chat, mental sparring, where the patients have instant access or the occupational health customers instant access to professional. And from there, they are steered either to remote channel or the physical appointment and thereafter, for example, to psychotherapy that typically lasts from 8 to 20 times. And we know that already from the beginning, they start to get a benefit from the treatment. And of course, it's important not just at the end of a psychotherapy treatment episode to measure how did the patient cope, but rather the unique thing is that now with our tools, we can steer that how the patient is doing when they answer these questions and the professional can then make a change to the treatment if they are not seeing a decline in the medical indexes how the patient is doing. And this is very important. And then if we measure NPS from the mental health focus, so it's 93%. It's super high. It's pure NPL from these customers. And then what about the outcome? What's the added value for the payer, the 1-year return of invest, it's 4.8% lower than 5%. And it's I think it's a very nice number for anyone who thinks about return of invest. Customer experience that was good, the growth in the sales of this psychotherapy, last year, 45% and then the outcome if we measure these medical indexes. So in the beginning, they are depressed, they get the psychotherapy. And at the end of the therapy, they decline to normal level, which means that they have received benefit. And most of all, very important for the employer, for the society, we've been able to show that we can cut by 1/3 the sick leave days with our care model. And this is the result, what we have received. So our care part, say, they decrease those symptoms and result in this annual return of invest was 480% for the employees, shown here. And before going to the right part of the slide, so I want to emphasize that our results, so they are also pretty unique internationally. And actually, I'm glad to go until this June to London to a meeting to give an oral presentation of our mental health care part results because they are pretty impressive. You can cut down all sick absences by 40% when the correct care part is implemented. And finally, from the right side of the slide, what the correct clinical practice means that the risk of permanent disability. So you can see 3 different curves and there is the orange curve, the uppermost curve shows that there's a 15% risk of almost 300-day permanent sick leave if the -- with chronic depression, the patient only sees the 1 and only general physician or GP. So it's not enough in mental disorders. If they get a referral to a psychiatrist, it cuts down by half the risk for permanent work disability and the lowest curve that is completely flat is that represents those patients who have received referral not just with psychiatrists but also to the brief psychotherapy. Superb result. And this is what I will be presenting in London next month. Could I get the previous slide, please. Yes, it's not change for some reason changing. No. I would like to the previous one. Now next slide is the orthopedic case. It shows here the orthopedic slide, but it's not there. Great. Thank you. So what about the deep dive into the surgical care. So it again here, we can show world-class results. If we start with the customer experience, the NPS within orthopedic surgery 96.2%. And if we go to these hip replacement surgeries, so the NPS is 97%. So we really know how to do that. And then about value capture, so how we're doing our growth last year in the orthopedic surgery, it was 14%. And in the hip and knee replacement surgeries, it was 91%. And of course, when there's a problem, how to get access to care on the public side, so we know how to do it. So also patients seek our help. And then what about the medical outcomes. So there are international standards called Oxford hip or knee indexes, so we can see that the outcome after the operation, so it increases a lot the so-called normal level, which means that less pain and better workability or supportability, whatever you want to call it. And then for the society, the workability numbers, so after show the surgery, we have shown that 34% decline in the number of sick leave days. And after this hip replacement surgeries 31% decline in the number of sick leave days. So very constant results on the medical indexes and also on the impact of the sick leave dates. Then about our processes in the operating theater. So currently, out of the hip replacement operations, over 30% are done in a day surgery setting meaning that the patient can be sent back home on the same day, and this is the highest number of any player in Finland within the public sector or within the private sector. Integrated care, it means major cost savings and here, we can see that after we implemented this care part within Orthopedics 2 years ago, we've been able to deliver maximized employee workability and cut down the total cost of the absence days significantly. And it means the patient over 10,000 savings per episode when we do this as fluently as possible with our tools, with our effective rehabilitation after the procedure. So as a summary, our investments in integrated care is clearly working, and it brings benefits for all stakeholders. We've been also able to show that we certainly can master these care parts and that results in excellent medical outcome and also makes it possible for excellent business results too because we know that the number of different diagnostic modalities that are used, for example, within chronic disorders, it's not sufficient according to the current national guidelines which are actually the same that all international guidelines are. So how we want to move forward? So within the next year, of course, we want to be even better. We want to improve still our care continuity and the medical outcome. And we know at the moment that our care continuity indexes, they are very, very -- on a very high level at the moment, but there's certainly place for improvement. Like there's always places for improvement also in the NPS measurements although our current number for all services at Terveystalo is at the moment, 85% and I showed from the case orthopedics, for example, that it was 96% or 97%. It's so high that actually it almost makes to think that can it be so high because patients are so satisfied with the service that they can get from us. We have also other means of measuring patient experience but -- and we know from them that they are in line with the NPS scoring. What we want to do further is, of course, to optimize to the multichannel care delivery and we do have their expertise so that we can steer our patients to the right channel. It doesn't always need to be physical appointment. It can be the telemedicine that helps the patient, and it varies a lot between different specialties. For example, in psychiatrics, digital therapies are mainstream that can be done for almost all of the patients. And we have already capability to develop medical device, and we want to further develop software as medical device and use them wisely to guide not only to our care decisions but also to our customer and patient steering to the right channel, to the right professional. And I think in the next presentation, Ilari will tell you more about them. Finally, I'd like to thank you for your attention, and I'm more than happy after Ilari's talk to answer any possible questions. Thank you.

Good morning, everybody. It's my pleasure to be here to talk with you today. As Ville said previously, the digital is an integral part of our strategy and the uplift program. I'm here to talk more about this topic. But first, let me introduce myself. Officially, I'm Senior Vice President of Digital Service here, but as Ville and other management maybe Chief Nerd Officer as well. I've been part of the Terveystalo digital journey for almost 10 years in various different roles starting from the software development and data and analytics. Digital enables the best medical and business outcomes. Our digital strategy is tightly aligned with integrated care, which Ville and Petri have described before. This allows us to provision the integrated care efficiently. Optimizing access to care and focusing on supply-demand balance, we're able to guide the patient through the right channel to the right professional at the right time. Increasing professional efficiency and productivity allows us to scale the business, especially in digital channels. Improving care continuity ensures the best medical outcomes for the patients and financial outcomes for Terveystalo as well. Digital solutions are already creating value and we know how to do this. To enable easy access to care, higher margins per appointment and significantly higher volumes when managed the right way. We have a good track record on developing digital vision for health care. And later on, I'm going to show you some statistics about this topic as well. We are also in a great position on creating unique competitive advantage by combining software medical expertise and data into award winning solutions. In our updated strategy, we have identified 5 key levers to improve integrated care. By capitalizing the population and organization level data, for preventive care, we have already reached really good results, especially in occupational health care. We will continue to work on this topic and in practice, it means that by gathering and processing data, we're able to detect the persons at risk of getting ill and be able to guide them towards our integrated care paths to improve their health. By optimizing access to care and focusing on supply-demand balance, we ensure that the customer gets the right treatment when needed through the right channel and gets to meet the right professional for his or her treatment. By striving professional excellence, we're able to enable our professionals to work more efficiently and which Marja is going to talk to you later on as well. By improving care continuity, we ensure that the care path produces the best medical outcomes for the patients and the best financial results for Terveystalo. By focusing on the commercial excellence, meaning pricing capabilities in digital channels and pricing capabilities in other in physical channels as well, we're able to capture the full business value of the care chains. We built the digital solutions to be modular scalable and adaptable to be able to scale them into the new businesses quickly. During COVID-19, we were able to demonstrate the speed of our development for example, in COVID-19 referral automation. Data and AI are the key enablers to succeed in the topics mentioned before. We also take truly care of the security and the compliance to make sure that the data in Terveystalo is taking good care of , and our customers can trust that our digital solutions handle their data carefully. In future, the data security and digital solution compliance will get even more important since we can see that the customers are being more aware how the data is being used and processed. Next, let me show what value the digital solutions are creating. Digital solutions create value for all stakeholders through integrated care. Patients get fast access to efficient care through the right channel and can trust that their care path continues to ensure the best medical outcomes. Our professionals can focus on the most important to meet the patient in digital and in physical channels and they can rely that the data and digital solutions help them to make the right choices. Terveystalo is a company has the most efficient and scalable integrated care parts which produced the value for the shareholders. And finally, we're able to help the society to solve one of the biggest Western world problems called [indiscernible] through the efficient integrated care. Our aim is to be Nordic-wide leader in professional excellence and in care continuity. Supporting our top line and EBITDA growth, these are 2 strategic objectives for the next 2 years. By increasing professional excellence and efficiency, we can enable our professionals to work more efficiently, both in digital and physical channels. This also improves our professional experience, making them want to work more for Terveystalo, which Marja is going to talk to you after the break. By improving care continuity and quality, we ensure that the patients get the best medical treatment and the Terveystalo is able to capture the full value of the care chain. In practice, it means that the digital solutions guide the doctors and the patients to work according to medically right care paths, which Petri has described before. We will also continue to work on preventive care and optimizing access to care, but we see the biggest opportunities coming from the 2 previous ones. So let's take a look at these business opportunities in more detail. And this slide is really important for you to understand what value the digital is creating. Digital enables easy access to care, higher margins per appointment, significantly higher volumes when managed the right way. As we can see on the left-hand side graph, the absolute EBITDA per appointment is higher in the physical appointments, but the cost of digital appointment is significantly lower, and the margin is better. The key point here is the volume and the scalability. The digital channel throughput is already twice higher than the physical and it can be accelerated to 3 to 5x higher than it's today. And this will lead to financially better outcomes. We are also confident that by focusing on care continuity as well, we're able to create great medical quality and financially sustainable treatment in digital channels as well as Ville has also mentioned is in his opening words. Next, let's take a look at some statistics about this topic. Our digital solutions are already doing the work of hundreds of persons here in Terveystalo. One case example about this is the COVID-19 chat automation, where we created end-to-end automated COVID-19 testing process, which relied on digital channels. The only touch point with the human was the actual sample taken in our clinics. All the rest was automated in the digital channels. As mentioned before, we see huge potential to make the digital channel 3 to 5x more efficient compared to physical channel. One indication is the middle graph where we introduced self-symptom assessment to the process. And just by introducing this asset to certain service area, we were able to lower the time spent in digital appointment by 2 minutes, and we see a huge potential of bringing this to more bigger use and optimizing it more further. And our professionals are using our digital solutions, a lot. One case example what that is a Terveystalo Pro mobile application where our professionals can manage their work, open new supply and manage the supply. We have over 2,000 daily users already using the Terveystalo Pro mobile app. So we are constantly connected to our professionals, even though they are not working our clinics during that time. The customer is always at the core of our digital services, and we create a digital service for our customers and our customers are loving them. Customers benefit directly from our strategy. By focusing on professional excellence and the doctors and nurses can create higher value for the customer. And the customer can be sure that the diagnosis is informed and best just for him or her. By focusing on care continuity and quality, the customer always knows what's happening next on their way of getting healthy. In practice, this means that digital channels guide the patient throughout their journey of getting healthy. By capitalizing tech data, we create peace of mind for the customers since the customers can know that we utilize his or her data to detect the possible early signs of getting ill. And by ensuring it to optimize access to care, the patients can be sure that he or she gets to meet the right professional through the right channel in the right time. And in future, this actually means that the customer only needs to know who he or she is and where does it hurt, and the digital solutions will make sure that we guide the patient in the right place. As said, our digital services are large part B2B and B2C customers. The monthly sessions in digital services are already exceeding 3 million monthly sessions each month. Terveystalo application has over 1.2 million users already. And in total, our digital services have 2.5 million registered individuals, which is a leading number in Finland. Our sales level, which indicates how many actions the call center customer service and our professionals need to do manually compare to the volume of these actions in digital channels and during the last strategy period, you can see that we have been able to improve the sales level rate a lot while keeping the customers happy. Our B2B assessment volumes in [indiscernible] service are also rising rapidly as well as the customer satisfaction measured in NPS or customer effortless score. What this is showing that we know how to build digital solutions that the customers and the professionals love and use in increasing volumes. Next, a little bit harder topic. Let's talk about medical devices and what value those are creating. First of all, medical device can be a software and regulation make sure that any software that is being used for diagnosis, prevention, monitoring treatment or elevation of disease is counted as medical device. These medical devices or software's , which are counted as medical devices are required, for example, population management, symptom assessment, automated digital channels and interactive digital therapies. Which are required for efficient digital base in the credit care. Developing medical device requires certain capabilities that the Terveystalo has. A world-class medical know-how and the real-world patient data. And to get the fast return on investment in this area, it's necessary to leverage this software that has contrast medical device the core business immediately which can be only done when these are manufactured in-house. By building medical devices, we are able to create unique competitive advantage that is hard to copy or replicate elsewhere and it allows us to move into the patient process and automate them. As said, we've got a unique competitive advantage and capabilities to make difference. That's because we can and know how to combine software medical expertise and data together. So our priority is on the left-hand side of the graph, where we can combine these 3 elements. We also see selected opportunities in other areas where the applicable solution for health care business logic doesn't exist. But our core expertise is in the area where we can combine the software medical expertise and data. And then as a summary, our focus for the '23 and '24 is in Finland. We ensured that the Alpha program proceeds as planned or faster than planned. It's regards it our capabilities. During this period, we're importing a first digital assets in Sweden in the areas where they're easily importable. For example, in remote services. During this period, we are also utilizing some of our digital capabilities to public well-being service countries as Ville and Marja has mentioned before. Then after '24 or when Alpha's reached it's goals, we're shifting our focus on Nordic expansion and scaling the digital assets to benefit business, especially in Sweden. So in summary, the big points I'll talk here about are we're successfully using digital for integrated care, and we see great potential in the future as well. We know how to build digital solutions that create value, and we know how to capture the full business impact through the digital channels. And we are able to create unique competitive advantage by doing medical devices, which combines the medical expertise, data and software together. Thank you. It is my pleasure to be here to speak with you and now I think we have the Q&A session following this. Thank you.

Thanks, Ilari and Petri. Now we are ready to take questions first from the audience.

Olli Vippo from Inderes. Question for Ilari how big is the [indiscernible] IT department? How many developers do you have in Terveystalo? Do you still buy something outside? Or is it mainly in-house development?