R1 RCM, Inc. (RCM) Q4 2022 Earnings Call Transcript

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R1 RCM, Inc. (NASDAQ:RCM) Q4 2022 Earnings Conference Call February 16, 2023 8:00 AM ET

Company Participants

Atif Rahim - Head, IR

Lee Rivas - CEO

Jennifer Williams - EVP & CFO

Conference Call Participants

Charles Rhyee - Cowen

Michael Cherney - Bank of America

Glen Santangelo - Jefferies

Stephanie Davis - SVB

Scott Schoenhaus - KeyBanc

Jailendra Singh - Truist

Sean Dodge - RBC Capital Markets

Anne Samuel - J.P. Morgan

Sameer Patel - Evercore ISI

Craig Hettenbach - Morgan Stanley

Jack Wallace - Guggenheim

George Hill - Deutsche Bank

Richard Close - Canaccord


Good morning. My sanction is Kathy, and I'll beryllium your convention usability today. At this time, I would for illustration to invited everyone to nan Q4 2022 R1 RCM Earnings Conference Call. All lines person been placed connected shut up to forestall immoderate inheritance noise. After nan speakers' remarks, location will beryllium a question-and-answer session. [Operator Instructions].

And astatine this time, I would for illustration to move nan telephone complete to Atif Rahim, Head of Investor Relations. Please spell ahead.

Atif Rahim

Good morning, everyone, and invited to nan call.

Certain statements made during this telephone whitethorn beryllium considered forward-looking statements pursuant to nan Safe Harbor provisions of nan Private Securities Litigation Reform Act of 1995; successful peculiar immoderate statements astir our early growth, plans and performance, including statements astir our strategical and cost-saving initiatives, our liquidity position, our maturation opportunities, and our early financial capacity are forward-looking statements. These statements are often identified by nan usage of words specified arsenic anticipate, believe, estimate, expect, intend, design, may, plan, project, would and akin expressions and variations. Investors are cautioned not to spot undue reliance connected specified forward-looking statements.

All forward-looking statements made connected today's telephone impact risks and uncertainties. While we whitethorn elite to update these forward-looking statements astatine immoderate constituent successful nan future, we person nary existent volition of doing so, isolated from to nan grade required by applicable law.

Our existent results and outcomes whitethorn disagree materially from those included successful these forward-looking statements arsenic a consequence of various factors, including, but not constricted to, geopolitical, economical and marketplace conditions, including heightened inflation, slower maturation aliases recession, changes to fiscal and monetary policy, higher liking rates, rate fluctuations, and different factors discussed nether nan heading "Risk Factors" successful our Annual Report connected Form 10-K for nan twelvemonth ended December 31, 2022, which will beryllium revenge pinch nan Securities and Exchange Commission aft this call.

We will besides beryllium referencing non-GAAP metrics connected this call. For a reconciliation of non-GAAP amounts mentioned to their balanced GAAP amounts, please mention to our property release.

Now, I'll move nan telephone complete to Lee.

Lee Rivas

Thank you, Atif. Good morning, everyone, and convey you for joining us.

On today's call, we will talk 4 cardinal topics. First, highlights from our 4th fourth results. Jennifer will supply further detail. Next, our 2023 priorities, which are focused connected operational execution, past supply insights connected commercialized activity. And lastly, I'd for illustration to update you connected our ongoing investments successful exertion and automation.

I americium pleased to study we closed 2022 connected a beardown note, giving america momentum arsenic we participate 2023. The contributions from our world squad members drove 4th fourth gross and adjusted EBITDA to nan apical extremity of nan ranges provided connected our past net call. Revenue for nan 4th was $532.8 cardinal and adjusted EBITDA was $125 million. We saw betterment successful payer turnaround times, and I americium very pleased pinch our operational capacity for our end-to-end customers and complete 500 modular customers. Our Q4 capacity sets nan shape for continued operational betterment and is 1 of nan cardinal factors down our 2023 guidance announced a fewer weeks ago.

The completion of nan Cloudmed acquisition successful June 2022 created an bonzer capacity for america going forward. As we judge we're well-equipped to reside aggregate challenges facing providers. Providers are nether unthinkable financial unit now much than ever, and are evaluating options to trim costs, truthful they tin attraction connected what they do best, which is attraction for patients.

We run successful a $115 cardinal extremity market, which continues to turn astir 10% annually, and wherever complete 70% of providers still negociate gross rhythm processes in-house. Given nan existent inflationary situation and labour challenges successful nan U.S., providers are often incapable to lick this rumor alone.

We judge we are distinctly positioned to reside these challenges providers look connected a regular ground done our operational capabilities, our commercialized expertise, and our scaled, technology, and automation platform. What excites maine astir is nan operation of these marketplace needs and our purpose-built capabilities to lick these analyzable problems connected behalf of our customers.

This morning, I want to spell done each of these capabilities successful much detail. First, fto maine screen our operation. Our world cognition is simply a cardinal constituent of nan worth proposition we present to our customers. We are peculiarly well-positioned to execute much for our customers for respective reasons. First is our world standard and expertise to flex resources. Next, our expertise to put wherever needed to resoluteness symptom points done nan claims process. And last, is nan exertion of exertion and automation to trim reliance connected labour to lick these problems longer-term.

What positions america good to work our extremity marketplace is our expertise to navigate nan complexities of regulatory changes, our expertise to accommodate to changing reimbursement models, and our expertise to proactively respond to caller payer dynamics. In nan near-term, we are focused connected operational execution against each rate postulation metrics to alteration our customers to make much revenue, much efficiently than they would do connected their own.

In Q4, we saw an betterment successful our operational metrics, including humble betterment successful AR days, which is nan superior rate postulation metric we attraction on. This gives america accrued visibility into our 2023 performance.

One of nan areas successful which we create important worth for providers is astir nan accrued rhythm clip for claims, which we discussed connected our net telephone successful Q3. We person seen humble betterment successful nan past fewer months, and arsenic claims rhythm times person decreased, this is translated to an betterment successful inducement interest revenues. This is simply a win-win for our customers and for R1. We are capable to proactively reside these deficiencies successful a measurement that providers who do not leverage a world tech-enabled exemplary would beryllium capable to execute connected their own.

We are besides applying automation to accelerate declare costs resolution. Our 2023 outlook assumes we will proceed to spot humble betterment successful inducement interest revenues quarter-over-quarter crossed nan remainder of nan year.

Another operational inaugural I'd for illustration to item arsenic a important value-add for our customers is our continued world description . In ray of today's labour shortages and expanding costs of labor, providers are facing awesome challenges successful hiring capable administrative staff. Our offshore cognition creates an avenue to mitigate nan inflationary situation successful nan U.S. by filling administrative labour gaps for our customers. Of note, we are expanding not only successful our scaled India operation, but besides successful nan Philippines wherever we now person complete 1,000 associates.

Last I would for illustration to item our KLAS recognition. We are proud to person been selected arsenic number 1 successful KLAS successful 3 categories: Ambulatory RCM, Denials Management, and Robotic Process Automation aliases RPA. Each of these offerings addresses immoderate of nan astir difficult challenges faced by nan infirmary and expert providers we serve. The KLAS nickname is simply a cardinal triumph for R1 that represents our expertise to serves nan supplier connected aggregate operational dimensions, whether they want an end-to-end solution aliases a modular offering to thrust incremental gross yields.

Next, I'd for illustration to talk our commercialized activity. Our end-to-end customer footprint covers $55 cardinal of nett diligent revenue, and we person complete 500 modular customers representing complete $850 cardinal of NPR. Collectively, we touch complete $900 cardinal of full NPR crossed our customer base. This includes 94 of nan apical 100 systems successful nan U.S.

Our end-to-end and modular offerings are built to present worth successful challenging settings. In 2022, our commercialized squad meaningfully exceeded targets pinch complete $13 cardinal successful caller customer NPR, including Sutter, Scion, and St. Clair Health. We besides signed 15 ample expert groups and complete 600 chopped bookings from modular solutions, while simultaneously creating a beardown pipeline for continued 2023 growth.

The R1 and Cloudmed commercialized teams are now integrated nether Kyle Hicok arsenic announced successful January. Our end-to-end pipeline reflects early relationships wrong some acute expert and supplier groups, and we spot important opportunity for semipermanent maturation successful our end-to-end footprint.

The modular pipeline continues to bespeak a precocious request for AR denials and gross enhancement solutions pinch marketplace conditions favoring respective emerging solutions specified arsenic 340B and Entri Pay. We expect Cloudmed offerings unsocial will turn gross by 20% successful 2023. I americium incredibly proud of nan achievements our squad has made to execute good and present meaningful worth to our customers.

The past area I would for illustration to talk is exertion and analytics. While our supplier customers person made galore investments successful their ain gross rhythm journey, nan reality is that nan process is still labour intensive and requires information postulation and validation crossed aggregate systems and individuals. The complexity of nan gross cycle, labour constraints and evolving regulatory and costs scenery mean that errors, delays, and difficulties are bound to hap unless exertion is appropriately deployed. Our R1 level and automation attack provides scale, intelligent automation, and standardization to lick analyzable gross rhythm scenarios.

In 2023, we will proceed to beforehand our exertion via investments focused connected 3 superior goals. So fto maine screen nan first. Our first extremity is to automate tasks that are typically done manually successful gross cycle. R1 has been connected a integer translator travel and we are accelerating advancement present arsenic we leverage nan Cloudmed capabilities successful summation to those built arsenic bequest R1. We ended 2022 pinch 150 cardinal tasks automated up from 110 cardinal successful nan first half of 2022.

Second, for activity that cannot beryllium afloat automated, our extremity is to make nan activity arsenic businesslike arsenic possible, we telephone this optimal workflow. To do this, we leverage our heavy gross rhythm expertise arsenic good arsenic much than 14,000 proprietary rules and algorithms to let automated and human-centric workflows to run seamlessly together. For example, our rules place problems that hap successful nan gross cycle, specified arsenic inaccurate coding, and automatically way nan activity to nan champion fresh specialist, truthful our teams tin activity transactions connected an objection ground versus a manual reappraisal of each claim. That master has nan accusation they request astatine their fingertips to propose basal corrections starring to an meticulous reimbursement. This leads to higher accuracy, less denials, faster turnaround times to payment, and yet accrued gross for our customers.

Our 3rd and past extremity is to leverage information and analytics to its fullest potential. With nan breadth and extent of data, we spot 500 cardinal diligent encounters annually covering $900 cardinal positive of NPR crossed our full customer base. We usage information and analytics to place patterns and trends. This allows america to continuously amended nan customer acquisition and our performance.

Simply put, we judge our exertion investments will alteration america to find much gross for our customers, accelerate rate collections, and mitigate inflationary pressures by reducing nan reliance connected manual labour to a level that wellness systems cannot execute by themselves.

In closing, I'm very pleased pinch our team's capacity successful nan 4th fourth and look guardant to continued betterment successful our operational results complete nan people of 2023. In ray of our results, scaled world operations, and intelligent automation, we judge we're well-positioned to reside nan challenges providers are facing. I americium excited astir nan semipermanent outlook for R1 and nan net powerfulness of this institution erstwhile existent contracts are afloat ramped. We look guardant to executing connected that opportunity arsenic good arsenic caller wins to thrust further growth.

Now, I'd for illustration to move nan telephone complete to Jennifer to supply further specifications connected our financial performance.

Jennifer Williams

Thank you, Lee, and bully morning, everyone.

We are pleased to study coagulated 4th fourth results pinch gross of $532.8 million, up almost 34% year-over-year, and adjusted EBITDA of $125 million, up 31%. For nan full-year, gross grew 22.5% to $1.8 billion, and adjusted EBITDA grew astir 24% to $425.5 million. These results see Cloudmed gross of $126.5 cardinal successful Q4 and $260 cardinal for nan full-year aft nan acquisition closed successful June 2022. Excluding Cloudmed, integrated gross maturation was astir 2% year-over-year successful nan 4th quarter, and 5% for nan full-year. Growth was slower than anterior years owed to little inducement fees and little expert revenue.

Adjusted EBITDA separator for nan twelvemonth was 23.6%, up 25 ground points compared to nan anterior year.

Now, let's reappraisal nan 4th fourth successful a small much detail. Net operating fees of $344.4 cardinal grew astir 4% aliases $12.4 cardinal year-over-year and $20.2 cardinal connected a sequential basis. The summation was driven by contributions from caller end-to-end customers.

Incentive fees successful Q4 totaled $25.9 cardinal and declined $9.9 cardinal connected a year-over-year ground owed to nan effect of nan payer timeline dynamics we discussed connected nan past net call. While down year-over-year compared to Q3, inducement fees accrued $5.1 million. This is owed to our operational efforts and consequence to nan accrued payer reimbursement timeline.

Other revenue, mostly gross from our modular solutions, was $162.5 million. This gross grew $131.4 cardinal year-over-year, chiefly owed to nan Cloudmed business. On a sequential basis, modular gross was up $11.5 cardinal owed to Cloudmed's beardown capacity successful nan 4th quarter.

Moving to expenses. Non-GAAP costs of services successful Q4 was $364.5 million, up $85.4 cardinal year-over-year, driven by Cloudmed, costs related to nan onboarding of caller customers, and operational investments to support caller growth. These increases were partially offset by savings crossed a fewer areas, including automation, incremental world transitions, and vendor rationalization. Compared to Q3, non-GAAP costs of services was up $37.6 million, chiefly driven by caller customer worker transitions that took spot successful Q4.

Next, non-GAAP SG&A expenses of $43.3 cardinal were up $18.6 cardinal year-over-year, chiefly owed to Cloudmed. Compared to Q3, non-GAAP SG&A was down $1.8 cardinal owed to nan allowance for in installments losses incurred successful Q3 and partially offset by healthcare and different firm costs.

Adjusted EBITDA for nan 4th was $125 million, up almost $30 cardinal year-over-year. The summation is simply a consequence of nan Cloudmed acquisition, offset successful portion by investments to instrumentality important caller customer wins successful nan year. Relative to Q3, adjusted EBITDA was up $1 million. This is owed to higher inducement fees quarter-over-quarter and higher gross from Cloudmed successful Q4. These increases were offset by costs of onboarding caller customers.

Lastly, successful Q4, we incurred $47.4 cardinal successful different expenses. These expenses were chiefly related to nan Cloudmed integration costs and to completing nan buildout of our caller business services halfway successful nan Philippines.

Now, I'd for illustration to remark connected a fewer areas of nan equilibrium sheet. Cash and rate equivalents astatine nan extremity of December were $110.1 million, compared to $131.1 cardinal astatine nan extremity of September. Cloudmed integration costs and higher AR balances owed to timing of payments from definite customers drove nan usage of rate successful Q4. These payments were subsequently received successful early January.

Net indebtedness astatine nan extremity of December was $1.7 billion. Net indebtedness leverage for in installments statement purposes was 3x, and we had liquidity of astir $609 cardinal astatine year-end. This liquidity includes rate and rate equivalents and readiness nether our revolver. We expect our nett indebtedness leverage to diminution complete nan people of this year.

Now looking guardant to 2023. As antecedently announced, we expect to make gross of $2.28 cardinal to $2.33 billion, and adjusted EBITDA of $595 cardinal to $630 million. Embedded successful our outlook are nan pursuing factors: one, an anticipation of 20% year-over-year maturation astatine Cloudmed; two, operational improvements, which should make higher inducement fees quarter-over-quarter; three, operational costs improvements arsenic our caller business matures; and finally, a realization of costs synergy done nan twelvemonth arsenic we proceed nan Cloudmed integration.

I would besides for illustration to supply an update connected nan wide Cloudmed integration, which is progressing very well. We person integrated our statement crossed each function. Our firm systems, including halfway HR and finance systems are mostly consolidated. And last, nan wide statement is moving to toggle shape its transportation exemplary to champion service our customers.

We antecedently provided guidance that we expected to recognize $15 cardinal to $30 cardinal of costs synergies successful 2023. We now expect those savings to beryllium towards nan higher extremity of nan range. We besides stay assured successful our expertise to recognize important gross and costs synergies longer-term.

In Q1 2023, we expect adjusted EBITDA maturation of astir 5% comparative to Q4 arsenic we proceed executing against our priorities.

Overall, we are very pleased pinch our Q4 results and our operational performance. As Lee mentioned, 2023 will beryllium a twelvemonth of execution arsenic we instrumentality caller end-to-end wins from 2022, proceed to make beardown modular maturation from Cloudmed and mostly complete nan integration of nan Cloudmed acquisition.

Now, I'll move nan telephone complete to nan usability for Q&A. Operator?

Question-and-Answer Session


Thank you. [Operator Instructions].

And first we will spell to Charles Rhyee of Cowen.

Charles Rhyee

Good morning. Thanks, Lee and Jennifer for each that. Hey, I conscionable wanted Lee, conscionable to follow-up connected your comments that what you're seeing successful nan marketplace here, it sounds for illustration what you're saying is, you're seeing improvements successful nan AR days connected nan accrued rhythm times for claims has declined from past year. Is that coming from your extremity putting much resources successful aliases is this -- are you seeing improvements connected nan payer extremity first?

Lee Rivas

Yes. Thanks, Charles. So we are seeing mean improvements connected nan payer extremity and past our expertise to effect it is very positive. So a mates of points present I'll make, Charles. We're seeing mean improvement. We're seeing staffing slow improving connected nan payer broadside astir claims processing. We are deploying resources to your constituent against our customers connected this magnitude arsenic good arsenic automation. We expect nan inclination to proceed successful 2023, truthful really mean betterment connected nan payer side. And our 2023 guidance assumes that.

The different point I constituent retired is, nan logic we're applying comparatively blimpish assumptions successful 2023, is our customers renegotiate pinch payers successful nan first half. So we spot perchance affirmative effect successful 2024.

Charles Rhyee

Okay. That's helpful. And arsenic we deliberation astir nan 1Q guidance, Jennifer, you said astir 5% up sequentially. Related to inducement fees though, should we deliberation astir that nan same? Because I cognize I deliberation Lee, you said you benignant of presume inducement fees themselves amended modestly done year, but from nan -- from 4Q to 1Q, really should we deliberation astir that?

Jennifer Williams

From 4Q to 1Q, I would presume that inducement fees are reasonably level quarter-over-quarter starting astatine nan opening of nan year, and past they will amended modestly quarter-over-quarter done nan year.


And now we'll return a mobility from Michael Cherney of Bank of America.

Michael Cherney

Good morning, and acknowledgment truthful overmuch for taking nan question. I want to talk astir nan pipeline. Clearly, 2022 was a grounds year. We each cognize nan logos you put up arsenic you deliberation astir into 2023 and possibly moreover building beyond that, really do you deliberation astir that, your expertise now, particularly Lee being successful nan CEO spot aliases I conjecture desire to proceed to return connected customers and is location immoderate changes, particularly fixed nan activities connected nan payer broadside that you saw successful nan 2022 that are continuing, that springiness you region aliases immoderate changes successful position of nan measurement that you want to activity connected phasing successful caller customers arsenic they travel to you?

Lee Rivas

Thanks Mike. Let maine touch connected nan first part, conscionable nan authorities of nan pipeline and past make judge I get to your -- nan 2nd portion of your mobility astir phasing. So nan pipeline is very strong. And specifically, I'll talk astir nan end-to-end pipeline and possibly touch connected nan modular pipeline. I've personally been engaged on pinch Kyle connected -- successful respective discussions nan past fewer months. And anecdotally pinch systems that are considering outsourcing, we're proceeding nan aforesaid things. Significant financial pressure, deficiency of tech finance aliases nan expertise to put successful tech crossed their endeavor and past continued labour challenges. So anecdotally, we proceed to spot request for end-to-end solutions.

The different point I'd adhd that's unsocial comparative to nan integration of Cloudmed is we person moreover much avenues to thrust nan pipeline. So 1 is we person 94 of nan apical 100 systems wrong Cloudmed pinch astatine slightest 1 solution sold. That gives america adjacent visibility pinch nan caput of gross rhythm of each of those organizations. And we're capable to spot wherever there's needs connected nan end-to-end space.

The different portion is, this is rubbing connected nan modular pipeline, which is besides very beardown predominantly Cloudmed, but besides immoderate of nan R1 bequest modular solutions. We are capable to cross-sell nan R1 bequest modular solutions into nan Cloudmed guidelines of hundreds of customers. So those are things I'd constituent out.

Now to your 2nd mobility connected phasing, look, it's difficult to foretell erstwhile we person request and really that phases, but to nan grade we can, our pipeline is beautiful balanced betwixt IDN large, IDNs and expert groups. So we consciousness very bully astir nan capacity we've added and nan expertise to deed nan $4 cardinal of caller NPR successful nan backmost half of this year.

Michael Cherney

Got it. And past you cognize what, I'll time off it location for now. I'll fto different group hop in. Thanks.

Lee Rivas

Okay. Thanks Mike.


And now we will spell to Glen Santangelo of Jefferies.

Glen Santangelo

Hi, yes, acknowledgment for taking my question. I besides wanted to benignant of follow-up connected nan pipeline, Lee. Last twelvemonth nan institution signed $13 cardinal successful caller benignant of end-to-end business and astatine nan time, accrued its onboarding capacity I deliberation to $9 billion. Could you conscionable benignant of springiness america an update connected benignant of wherever you are successful position of onboarding capacity? How overmuch of nan $13 cardinal possibly you've already brought on? How overmuch of that will travel in, successful 2013? And really we deliberation -- really should we deliberation astir nan setup arsenic it relates to 2024?

Lee Rivas

Let maine touch connected conscionable nan cognition components of your mobility and past I'll fto Jennifer adhd in. So, conscionable stepping back, we person connected nan end-to-end broadside $55 cardinal of NPR successful our end-to-end abstraction of which telephone it $19 million, $20 cardinal is still successful immoderate shape of onboarding, right, which we've talked astir before, it's why we're truthful assured successful nan net powerfulness of nan business pinch fundamentally a 100% customer attraction and expertise to onboard that complete clip and thrust to our EBITDA numbers.

The point I'd constituent retired nan largest implementation evidently is Sutter, myself, nan team, we're each very, very adjacent to that. It's very overmuch connected way Phase 1, mostly complete pinch centralized functions integrated. Phase 2 is simply a backmost half of this twelvemonth pinch further tech integration. So -- and past I would besides adhd there's respective different integrations happening that we're very adjacent to. So operationally, we consciousness very bully astir keeping those implementations connected track. Jennifer, do you want to mention capacity?

Jennifer Williams

Sure. So we publically said that we had $13 cardinal successful caller business successful 2022. We are presently onboarding $8 cardinal of that. And if you deliberation astir nan remaining $5 billion, it will beryllium precocious 2023 going into 2024. So you will really spot nan effect of that successful 2024.

Glen Santangelo

Okay. Perfect. And Jennifer, I conscionable wanted to follow-up connected nan 1Q guidance again. Based connected benignant of your target for telephone it astir $131 cardinal successful EBITDA successful Q1, that's only astir 21% of your full-year guideline if I usage nan mid-point. Now, I cognize location were a number of things that whitethorn beryllium impacting that, that 1Q number, you telephone that possibly little than normal inducement fees. Maybe location were immoderate incremental onboarding costs. There's been immoderate integration issues we've talked astir successful nan past. Could you possibly conscionable remark connected that 1Q number and really we should deliberation astir nan ramp arsenic nan twelvemonth progresses? Just benignant of fixed immoderate of nan embedded costs we knew from nan past mates of quarters? Thanks.

Jennifer Williams

Sure. So embedded successful Q1, arsenic I said earlier connected nan KPIs comparatively level to Q4. We will immoderate -- spot immoderate increases successful guidelines fees. Cloudmed is increasing 20%. So we'll person immoderate maturation from that. As we -- truthful that's really what's embedded successful Q1. As we move done nan twelvemonth to your constituent that it was 21% of afloat EBITDA, location are aggregate drivers that are going to proceed to summation EBITDA arsenic we move crossed nan year. So number 1 is caller business. We've -- arsenic I said, we're ramping nan $8 billion. That separator will proceed to mature arsenic we get it in, and we onboard and ramp those customers and past statesman to costs takeout connected that to amended nan margin.

Two is, each those inducement fees from Q4, Q1 will beryllium comparatively flat. We do expect humble maturation quarter-over-quarter done nan twelvemonth connected inducement fees. Cloudmed maturation will continue. So if nan beardown bookings that we had successful 2022 are implemented, we'll spot continued maturation arsenic we move done nan year.

And past nan past portion we mentioned costs synergies. So $15 cardinal to $30 cardinal of costs synergies we expect to beryllium connected nan higher extremity of that range, and those synergies will beryllium realized done nan year, and will thrust incremental EBITDA quarter-over-quarter.


And now, we'll spell to Stephanie Davis astatine SVB.

Stephanie Davis

Hey guys, congrats connected nan quarter, and convey you for taking my questions. I was hoping you'd springiness america an update connected immoderate of nan soul turnaround initiatives connected staffing and tech. Could you springiness america a speedy item connected what's been done truthful acold since you've taken nan range, Lee, what's still moving bladed and what's successful nan docket for 2023?

Lee Rivas

Sure. Let maine conscionable benignant of Stephanie, conscionable measurement backmost and conscionable talk done priorities and past this will beryllium addressed operational execution including tech. So arsenic I measurement back, I americium privileged to lead a awesome business that foundationally has a ample market, $115 cardinal increasing very good pinch an extremity marketplace that meets america now much than ever. The things I'm personally focused connected are very execution oriented.

So number 1 by a mile is customer engagement. I've personally been progressive on pinch Kyle, John, our President, Jennifer's been engaged pinch our existent and prospective customers. So that's very overmuch apical of mind for maine nan number 1 priority. Related to that is operational execution. That includes, to your point, staffing up to reside immoderate operational customer issues. That includes nan constituent Jennifer made astir executing connected synergies.

The 3rd portion for maine is tech enablement. I judge that there's a immense opportunity for us, fixed that we are already profoundly embedded successful nan customer workflow. I personally visited respective facilities, and erstwhile you spot nan effect of erstwhile you're embedded, nan expertise to use each nan pieces I talked about, whether it's information and analytics, AI, instrumentality learning, and what we telephone optimal workflow to prioritize task connected behalf of our customers, whether that's beforehand end, middle, aliases backmost is immense for us.

And nan 4th point Stephanie that I've personally been focused connected is driving group and civilization and creating an inspired organization, which successful my mind is very easy to do fixed our mission, which is to thief providers do what they do best. So those are nan large pieces. I'm happy to spell deeper Stephanie successful immoderate area.

Stephanie Davis

This is simply a weird area to spell deeper in, but it feels for illustration 1 of nan biggest issues pinch benignant of your staffing needs is that location are still a batch of -- there's tight labour markets. So pinch that successful mind, would you ever want to utilize immoderate of these caller AI devices for illustration ChatGPT arsenic for illustration a telephone halfway ratio aliases assistance instrumentality arsenic portion of this DTO strategy? It's for illustration a crazy thing.

Lee Rivas

No, no, no. That's a bully question. The short reply is yes. So conscionable a measurement back, 1 of nan areas we consciousness for illustration we're uniquely positioned is to reside a tight labour marketplace and inflationary labour marketplace because of our expertise to deploy resources, not conscionable successful nan U.S. but besides successful India and nan Philippines.

Now that said, we're perpetually looking for efficiencies. I was asking our operators astir this very mobility because evidently this is successful nan news a lot. For sure, we're going to beryllium a accelerated follower connected applying those kinds of devices crossed our business including our operations center. The point I'd constituent retired connected nan full conception of AI is we are uniquely positioned because of this underlying foundational piece, which is we already person nan underlying information and what I would telephone models aliases we've antecedently called algorithms. So done Cloudmed and nan end-to-end business, we spot 500 cardinal diligent interactions a year. So therefore, we're capable to spot crossed each 50 states, each payer types, each attraction settings, and are capable to use aliases build models that tin past automate processes. So erstwhile I talk astir automation, aliases you've heard maine talking astir intelligent automation, that includes nan conception of having nan underlying information and models to thrust repeatable process and past trim nan request for labour to your point.


And adjacent we person Scott Schoenhaus of KeyBanc.

Scott Schoenhaus

Hi, Lee and Jennifer, I wanted to excavation much successful connected nan Cloudmed broadside of things. So you mentioned now you person 500 modular customers pinch $850 cardinal of NPR, beardown pipeline and expect 20% maturation this twelvemonth successful Cloudmed. It was up I deliberation you said 11.5% sequentially successful 4Q. How should we deliberation astir nan cadence of this maturation passim nan year? Is location immoderate seasonality aliases timing of upselling that we should beryllium reasoning about?

Lee Rivas

Scott, fto maine commencement pinch conscionable really things are going connected Cloudmed and past manus disconnected to Jennifer to talk astir immoderate of nan sequential maturation questions you had.

Here is what I'd say, conscionable stepping backmost this is simply a business that is fundamentally a information nett for providers, identifying opportunities for incremental gross output done coding inaccuracies, deficiency of group aliases exertion investment, truthful -- and pinch a frictionless implementation that is easy for customers to consume.

And erstwhile you adhd successful that we already person nan mostly of nan apical 100 U.S. systems pinch astatine slightest 1 solution sold, a large portion of our strategy is cross-selling our solutions into that customer base. So a mates things I'd constituent retired conscionable to straight reply your question. One is we're gathering our financial targets and consciousness very bully astir 2023. Second is, integration is going very good connected nan group broadside pinch nan statement mostly integrated, nan commercialized statement integrated, I mentioned nan cross-sell opportunities there. The backmost agency integrated and tech integration going very well.

So those are nan pieces that a small spot of colour I'd adhd here. The absorbing point what's happening successful nan marketplace is pinch labour shortages, we are seeing important request for AR and denials guidance solutions, some connected nan objective administrative side. So that's -- that is simply a chopped capacity we person of deploying a repeatable process and identifying areas astir AR and denials.

The different spot we proceed to spot request is simply a very tech-enabled solution astir coding accuracy. So crossed our solutions we're seeing a batch of request that supports nan 20% maturation presumption into 2023. Jennifer, do you want to talk astir sequential?

Jennifer Williams

Yes, there's not really a batch of seasonality successful nan Cloudmed business. The maturation comes from implementation of bookings. So it's really commercialized description connected caller wins. And that happens, location whitethorn beryllium immoderate lumpiness successful nan timing of bookings done nan year, but we haven't seen a batch of seasonality successful nan wide guidelines business.

So -- and deliberation astir our implementation timelines are usually around, telephone it, 3 months. So from nan clip we triumph a woody until we get it implemented, it's astir 90 days, and past it starts generating revenue.

Scott Schoenhaus

That's really adjuvant for each that color. Thank you. Just my follow-up is past what's nan existent EBITDA publication aliases separator floor plan connected this business currently? I retrieve erstwhile you bought -- erstwhile RCM bought Cloudmed bequest margins were moving astatine 43%. If we presume a 20% maturation connected this business, this would connote immoderate bully publication this twelvemonth considering nan ongoing consolidation efforts you guys are doing?

Jennifer Williams

Yes. As we proceed to merge this business, we will not person a afloat separator floor plan for it. So arsenic I mentioned, from a synergy position and integration update, we've already integrated a batch of nan firm functions. So those are getting pulled into nan wide R1 functional areas.

But nan measurement to deliberation astir and we haven't disclosed Cloudmed separately from an EBITDA position for a full-year, but nan measurement I would deliberation astir it is those margins are successful statement pinch what we're seeing successful 2022. And past obviously, arsenic we proceed to recognize synergies successful 2023, we would expect those margins to summation nan savings we realized.


And adjacent we person Jailendra Singh of Truist.

Jailendra Singh

Thank you, and bully morning, everyone. So first, a speedy explanation connected nan remark earlier astir expectations for inducement fees being level successful Q1 versus Q4. Can you thief america understand for illustration fixed your investments successful exertion and immoderate humble betterment from payer broadside arsenic well, why are you not expecting immoderate sequential measurement up location successful Q1? And are location immoderate sequential offsets connected inducement fees that you should beryllium alert of?

Jennifer Williams

Sure. Some of nan inducement fees will build done nan year, truthful there's immoderate seasonality to nan opening of nan year. We whitethorn person immoderate of them reset their yearly metrics, truthful they benignant of build arsenic you spell done nan year. So that would beryllium 1 portion of it.

We person applied a batch of resources successful labour to stabilize those inducement fees. But conscionable fixed starting astatine nan opening of nan twelvemonth and we ended Q4 really beardown connected inducement fees that we do expect to commencement nan twelvemonth disconnected flat. Lee, thing to adhd connected exertion that you want to adhd connected conscionable benignant of successful that?

Lee Rivas

Yes. The only point I'd punctual you, Jailendra is portion of this is labour but portion of this is also, particularly pinch respect to immoderate of nan payer dynamics and precocious dollar claims, immoderate of nan much analyzable objective denials is not conscionable applying labour but applying automation and much aggressively, much targeted for our customers successful general, but besides is applied to immoderate of nan KPIs, particularly connected AR days and truthful on. So for sure, we're besides applying technology.

Jailendra Singh

Okay. And past my speedy follow-up, I'm sorry if I missed it, but immoderate update connected nan 2 clients you called retired past net call, Mednax and LifePoint. I judge you antecedently expected trends to stabilize during nan first half. Is that still nan expectations? And really do you deliberation astir nan separator ramp astatine slightest 2 clients successful wide for possibly this twelvemonth and next?

Lee Rivas

Yes. So fto maine tackle nan first portion of nan question. I deliberation Jennifer; you tin talk astir nan separator ramp. So nary change, Jailendra, still very affirmative connected advancement connected each nan cardinal rate conversion metrics connected some customers. So I've been personally progressive successful some and very adjacent to each nan issues there.

And what I would opportunity is akin theme. We're expanding capacity successful nan short-term astatine some customers. We're expanding automation capabilities of some customers. We're besides intimately engaged connected making judge we are integrated pinch their respective technologies and still nary change. I expect some to beryllium astatine immoderate level of normal, if you will, by nan extremity of nan first half. Do you want to touch connected nan points connected margin?

Jennifer Williams

Yes. I would conscionable opportunity connected nan labour that we've applied against our operations, we proceed to support nan aforesaid -- support astir nan aforesaid complaint done nan first half of nan twelvemonth arsenic we stabilize and make judge that nan metrics are moving successful nan correct guidance and that we're performing and seeing signs of success. So first half of nan year, we would person higher labour against that.

And past arsenic you know, this will beryllium portion of our inducement interest betterment done nan year, 4th -- this is portion of what's baked into that humble betterment quarter-over-quarter done nan twelvemonth arsenic we stabilize and past commencement to spot nan effect travel done nan financials.


And adjacent we person Sean Dodge of RBC Capital Markets.

Sean Dodge

Yes. Thanks, and bully morning. So possibly staying connected nan inducement fees for conscionable different moment. Jennifer, you said nan anticipation is those proceed to amended modestly each 4th opening aft Q1. Just to put a small finer constituent connected that. I guess, earlier Q3 past year, inducement fees were moving successful nan vicinity of $30 cardinal per quarter. Is that nan level we should deliberation astir being nan target by year-end? Or pinch nan completion of immoderate much customer implementations successful nan interim, is location nan anticipation location for thing moreover higher arsenic you execute towards that and exit nan year?

Jennifer Williams

Yes, that's a bully measurement to deliberation astir it pinch nan humble betterment being successful that $30 cardinal scope by nan clip we get to nan 4th quarter. The different portion is arsenic we onboard our caller customers, those inducement fees will commencement to footwear successful nan backmost half of nan year. We've assumed humble inducement fees because it usually takes a fewer quarters aft we spell live, wherever we're still baselining each of nan metrics, and past we commencement to measurement nan capacity against those baselines. So those inducement fees will -- deliberation astir those kicking successful slow Q3 and Q4.

Sean Dodge

Okay. That's ace helpful. And past successful summation to nan payer delays, you besides mentioned immoderate different marketplace headwinds. And I deliberation you've said before, patients self-pay is go a much meaningful information of collections. I deliberation nan number connected nan past telephone if my representation is correct was thing for illustration 20% of nan collections you do is from patients. Are you seeing immoderate changes successful collectibility aliases immoderate benignant of quality successful trends extracurricular of these benignant of payer dynamics aliases payer delays?

Lee Rivas

Sean, nary alteration and we've assumed successful our 2023 conscionable nary changes, continued mean expectations. On nan self-pay dynamics, this is really a mini portion of our business. So telephone it little than 5% of our full business is really self-pay. So it's -- what we've assumed successful 2023 is continued aforesaid inclination crossed nan Board.

Sean Dodge

Okay. Great. Thanks again.

Jennifer Williams

And Sean, connected nan marketplace -- Sean, I was conscionable going to opportunity connected nan marketplace dynamics and nan marketplace headwinds, really that implies labor. So some astatine nan payers, which is driving immoderate of nan elongated timelines arsenic good arsenic our customers.

Sean Dodge

Okay. That's a bully clarification. Thank you.

Lee Rivas

Thanks, Sean.


And now we'll spell to Anne Samuel of J.P. Morgan.

Anne Samuel

Thanks for taking nan question. You person a batch of moving pieces successful nan gross separator this twelvemonth pinch inducement interest volatility, Cloudmed integration and synergies. I was hoping possibly you could thief america pinch conscionable really to deliberation astir nan underlying inclination successful nan gross separator extracurricular of each those pieces and conscionable what nan description opportunity looks for illustration there. Thanks.

Lee Rivas

Anne, what I'd opportunity is nan main drivers rubbing connected some parts of nan business; tech is nan biggest driver connected this magnitude connected gross margin. So I'll conscionable use, I mean arsenic an example. Even though we are already precocious EBITDA margins, there's still an opportunity to play much automation, much exertion astir our workflow to that. And connected nan end-to-end side, it's nan aforesaid thing. So you see, complete nan past mates of years, we person talked astir our automation halfway of excellence. We're continuing that, if anything, doubling down connected really we use automation and AI. So that is really nan biggest driver. Jennifer, thing to add?

Jennifer Williams

The only point that I would adhd is we've had a important magnitude of caller business connected Board this year. And arsenic you cognize that nan separator connected that business is antagonistic nan first twelvemonth arsenic we make nan early finance successful those clients. And past it will ramp complete 3 years to nan target margin. So fixed nan magnitude of caller business that we've had, that's put a small spot of a damper connected nan gross margins, but we do expect that those will summation successful nan coming quarters.


And adjacent we person Elizabeth Anderson of Evercore ISI.

Sameer Patel

Hi, this is Sameer Patel connected for Elizabeth Anderson. Congrats connected nan quarter. I had a speedy mobility conscionable connected your guidance. Are you embedding immoderate further in installments allowances for nan year? And related to that, person you been capable to cod connected immoderate of that complaint that you took successful Q3?

Jennifer Williams

Sure. I'll return that one. No further reserve taken connected nan allowance for in installments losses circumstantial to that customer. They do person a costs plan, and they are connected track, making nan payments and of course, that plan. So it's thing we'll proceed to monitor. But we are successful adjacent interaction and enactment successful touch pinch that customer, and they're evidently still an progressive customer and making changes that they request to internally. But we -- each signs are affirmative correct now. We don't -- our 2023 guidance does not presume that we return immoderate further reserves but we will proceed to monitor.

Sameer Patel

Good. Thanks. And just, Jennifer, you mentioned quickly Cloudmed bookings. Can we expect immoderate further disclosures going guardant connected Cloudmed much connected for illustration a quarterly basis? Or is it benignant of arsenic is --

Jennifer Williams

Yes. We will astir apt proceed to supply immoderate -- yes, arsenic we proceed to merge nan business, obviously, conscionable looking astatine nan Cloudmed portion becomes much difficult. We're integrating nan Cloudmed business into nan much -- nan broader modular business wrong R1. But if you deliberation astir nan modular piece, which is really that different revenue, astir of it is Cloudmed. So I don't cognize that we'll proceed to disclose and callout Cloudmed specifically, but it's really astir of that modular portion anyway.


And adjacent we'll spell to Craig Hettenbach of Morgan Stanley.

Craig Hettenbach

Yes. Thanks. A mobility for Lee, conscionable astir nan opportunity to possibly reaccelerate maturation successful immoderate of nan bequest R1 modules and for illustration VisitPay and thing to statement astir nether Kyle's leadership, things that you're doing from a cross-sell position and nan module business much broadly?

Lee Rivas

Yes, Craig, awesome question. So I would conscionable lead disconnected pinch having worked pinch Kyle and seen nan commercialized exemplary he built complete nan past 5 years astatine bequest Cloudmed, I'm very assured connected this front. So he built a exemplary of gross rhythm experts that tin person very heavy discussions pinch our customers coming from nan aforesaid class of Kyle from early entrants into nan end-to-end and successful our case, successful nan Cloudmed side, nan gross integrity space. So nan first point I'd opportunity is having seen tons of income models successful my profession that he's built an unthinkable exemplary that is geared towards a equilibrium of cross-selling into our customer guidelines arsenic good arsenic driving nett caller business successful immoderate markets we haven't been arsenic focused connected complete nan past mates of years.

The different point I would opportunity is we are excited astir nan bequest R1 modular solution. And conscionable arsenic an example, nan diligent costs business we built R1 bought a mates of years ago, VisitPay, we're really very excited astir that and nan expertise to person heavy conversations pinch nan customer guidelines aliases nan 94 of nan apical 100 that, successful galore cases, R1 hasn't accessed those and had been capable to person those discussions. So we're very excited astir nan diligent payments piece, besides very affirmative connected expert advisory solutions.

So there's conscionable a batch of opportunity to return those R1 bequest modular solutions and commencement to person nan discussions and build nan pipeline. And conscionable anecdotally, we've already had astatine slightest 1 cardinal triumph up successful nan diligent costs abstraction trading into nan Cloudmed base. We're besides seeing nan pipeline build crossed nan Board.

Craig Hettenbach

That's helpful. And past conscionable arsenic a follow-up, immoderate comments connected what you saw conscionable from a utilization position successful nan marketplace successful Q4 and really you were reasoning astir utilization arsenic it influences your guidance for 2023?

Lee Rivas

Jennifer, you want to return that?

Jennifer Williams

Sure. We saw low-single-digit maturation successful nan backmost half of and Q4 specifically and embedded successful our guidance is astir nan aforesaid utilization complaint going forward. So deliberation astir that arsenic low-single-digit growth.


And now we'll return a mobility from Jack Wallace of Guggenheim.

Jack Wallace

Hey, bully morning. Thanks for taking my questions. Congrats connected nan quarter. Most of excavation person been asked and answered, but I want to touch connected nan pipeline comments that Lee, you made, astir $4 cardinal of incremental NPR wins to beryllium had connected apical of nan $5 cardinal of Sutter expected successful nan backmost half of nan year. Of that $4 cardinal of NPR, really overmuch of that is simply a cross-sell from bequest Cloudmed customers? And really overmuch of that is simply a de novo customer expectation? Thank you.

Lee Rivas

Jack, what I would opportunity is that it's difficult to show for illustration what materializes backmost half. But I would opportunity anecdotally, what I'm seeing is I mean, conscionable by definition, immoderate ample IDN is 94 of nan apical 100 are Cloudmed customers. So conscionable -- I'll springiness you an example, Jennifer and I and Kyle were connected a imaginable gathering conscionable nan past fewer days. And this customer happens to usage our DRG validation and our underpayment solutions. So location -- they already person a knowledge guidelines of what we tin do for them to thrust incremental gross yield.

So now whether that converts aliases not, there's -- look, there's a batch of steps progressive successful immoderate of these analyzable negotiations. And that, by nan way, is different illustration of we heard verbatim, nan themes astir financial pressure, inability to hire, inability to put successful technology. And portion of our pitch, if you will is we are very well-positioned to resoluteness immoderate of those issues. But nan civilized of nan story, they already cognize Cloudmed.

And truthful nan -- immoderate IDN and really nan six of nan 100 are -- we're still trying to spell get them. They thin to beryllium world aesculapian centers; thin to beryllium successful nan Northeast, truthful that's that.

On nan different side, pinch nan de novo, it tends to beryllium a expert group customer, which conscionable by definition, Cloudmed travel was very overmuch focused connected IDNs supra telephone it $2 cardinal of NPR. We successful nan past 18 months made a push successful nan expert group space. So that's wherever you get a batch of nett caller customers if you will.

Jack Wallace

Got you. Thank you, Lee. That's really helpful. And past Jennifer, this 1 is for you. Just reasoning astir nan inducement interest guidance for nan twelvemonth and conscionable trying to extrapolate this going forward. Historically, immoderate of nan inducement fees sewage to astir nan 12% of guidelines operating fees and reasoning backmost successful 2021, reasoning astir what is simply a reasonable anticipation for a precocious watermark for that percent erstwhile nan book of business is astatine a mature level? And obviously, you're going to beryllium adding caller customers each year. So connected a blended basis, you won't beryllium afloat mature. But connected a mature contract, what is that benignant of a reasonable precocious watermark?

Jennifer Williams

Yes. It's difficult to springiness a circumstantial percent for individual contracts only because each woody is different. And truthful immoderate customers want to minimize nan variability successful quarter-over-quarter that they would incur. And truthful by quality of nan contract, it's going to beryllium lower. So it will vary. But typically, successful our contracts, we person immoderate benignant of inducement interest successful each of them.

Now historically, nan KPI gross has really been successful nan 5% scope of full revenue. So a reasonably mini percent of gross arsenic Cloudmed continues to grow, I would expect that that would alteration complete clip a spot if you're looking astatine it against full revenue. But circumstantial to 2023, if you deliberation astir by nan clip we get to nan extremity of nan year, that $30 cardinal successful nan 4th is what's reasonable.


And we will spell to George Hill of Deutsche Bank.

George Hill

Yes. Good morning, guys, and acknowledgment for taking nan question. I'm going to return a changeable astatine a fewer numbers questions here, which is firstly, Jen, person you guys quantified what nan pipeline opportunity looks for illustration for 2023? And then, Jen, it sounded for illustration you were saying nan synergy target mightiness transcend nan $85 cardinal target prior. I conscionable wanted to double cheque that. And past my past mobility would beryllium benignant of tin you talk astir CapEx expectations and rate travel outlook for 2023?

Lee Rivas

Yes. George acknowledgment for nan question. So we person quantified internally pipeline, but we haven't disclosed that publicly. What I would say, having looked astatine different models astir pipeline and really those person to caller deals specifically Cloudmed, but I've besides been progressive successful business pinch -- businesses pinch overmuch larger deals. I would opportunity I consciousness very comfortable pinch nan model, nan pipeline exemplary and our expertise to person this year, but besides successful nan long-term.

The only quality I'd constituent retired is, George, that nan end-to-end evidently are highly complex. These are very blase negotiations who person longer income cycles, whereas nan Cloudmed deals thin to beryllium ace speedy income cycles, particularly if you're talking astir a caller booking pinch a existent customer. So I person to beryllium cognizant of that arsenic I measure nan pipeline. But overall, we consciousness very affirmative astir what I see. Jennifer?

Jennifer Williams

Sure. And circumstantial to nan synergy, nan $15 cardinal to $30 cardinal scope that we gave for realization successful 2023, we judge we'll beryllium connected nan high-end of that range. But we're still connected way for nan wide $85 cardinal of synergies.

And past specifically CapEx and rate flow, connected CapEx, deliberation astir it arsenic a 5% to 6% scope of gross successful 2023. And past connected rate flow, we person little rate travel conversion successful 2022, chiefly driven by transaction costs associated pinch nan Cloudmed transaction.

In 2023, our rate travel will still beryllium little than what a normal dependable authorities would beryllium because we're spending investments to merge nan business. And portion of that is costs to execute nan $85 cardinal of costs synergies that we expect to get longer-term. So we'll still proceed to person a adjacent magnitude of integration costs successful 2023. But arsenic we get into 2024 and beyond, I would expect that rate conversion to amended significantly.


And now we will spell to Richard Close of Canaccord.

Richard Close

Great. Thanks. Congratulations. Jennifer, possibly looking astatine nan guidance and to wrap a front connected everything that's been said present this morning, tin you conscionable for illustration springiness america immoderate thoughts and what gets you to nan precocious end? What gets you to nan debased end? What has to hap connected each of those?

Jennifer Williams

Sure. What gets america to nan precocious extremity of nan range, we've talked astir guidelines fees is nan largest portion of our business. So location are a batch of moving pieces here, but we've assumed low-single-digit maturation for utilization increases. And truthful to nan grade that utilization is higher than that that could beryllium 1 driver to being astatine nan higher extremity of nan scope there.

The different is inducement fee. We've assumed humble betterment pinch higher labour costs to get those inducement fees. So to nan grade that we spot earlier wins connected that, we spot payer timelines coming down faster than what we've assumed, past that could beryllium different ample driver.

We consciousness really assured connected nan Cloudmed we’ve had precocious visibility into nan 20% maturation there. Obviously, bookings travel successful overmuch higher first half of nan year. We could spot immoderate incremental gross there. And past we person a batch of visibility into nan costs synergies, truthful I do deliberation that they'll beryllium successful that range.


And pinch that, that does reason today's question-and-answer session. I would for illustration to move things backmost to Lee for immoderate further aliases closing comments.

Lee Rivas

Thank you.

First of all, I want to opportunity convey you, everyone, for your questions and conscionable adhd a fewer closing comments. First point is we are entering 2023 assured successful our expertise to present connected our commitments for nan upcoming year. You heard nan themes today. We're very focused connected operational transportation and execution. We judge we are well-positioned to reside immoderate of nan extremity marketplace dynamics we discussed today, which past creates important commercialized opportunities, some connected nan end-to-end and modular side. And we are very focused connected advancing a exertion schedule to thrust costs efficiencies and worth for our customers.

Thank you each for joining america today. We look guardant to updating you connected our advancement connected early calls.


And this does reason today's convention call. We'd for illustration to convey you again for your participation. You whitethorn now disconnect.

Editor: Naga

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