Jared Haase

Jared Haase of William Blair asked about the drivers of the 18% increase in benefits expense and sought long-term guidance on free cash flow growth.

Answer

EVP & CFO Doug Coltharp explained the benefits expense increase was driven by a higher frequency of large medical claims over $100,000, not specialty pharma. He projected that long-term free cash flow growth would be similar to the current trajectory, supported by EBITDA growth and tax benefits from bonus depreciation.

Jared Haase of William Blair asked about other areas of OpEx leverage beyond labor that drove strong EBITDA performance and their durability, as well as the key drivers for sustaining high quality metrics amidst rapid growth.

Answer

CFO Douglas Coltharp explained that while high volume creates broad OpEx leverage, the most significant impact was on the SWB line, and he expects productivity metrics to normalize over the year. CEO Mark Tarr attributed sustained quality to a strong focus on staffing, training, and onboarding, emphasizing that growth is contingent on maintaining high-quality outcomes. CFO Douglas Coltharp added that the company has achieved its highest-ever Net Promoter and employee engagement scores.

Jared Haase asked for more details on the clinical career ladder programs, specifically requesting data on workforce participation rates and the quantifiable impact on turnover for participating clinicians.

Answer

CEO Mark Tarr confirmed the program's success in improving retention, citing overall RN turnover down to 20.4% and therapist turnover at 7.7%, but did not have specific participation data on hand. CFO Douglas Coltharp acknowledged that the company tracks this data internally and would be prepared to answer with specifics in future calls.

Jared Haase asked whether strong same-store growth was driven more by underlying demand or by market share gains from other settings like SNFs, and also inquired about the payer mix dynamics.

Answer

CEO Mark Tarr responded that growth is a combination of both strong organic demand from demographic tailwinds and market share gains. CFO Douglas Coltharp added that the total addressable market is underserved, with only 14% of eligible patients nationally going to an IRF. He noted that broad-based discharge growth across Medicare, MA, and managed care demonstrates a value proposition that resonates with all payers.

Jared Haase asked about InnovAge's outlook for achieving its 8% to 9% EBITDA margin target, inquiring about the expected cadence of margin expansion and the balance of opportunities between center-level margin and operating leverage. He also explored potential for automation and AI, particularly with the Epic EHR system and other technology partners, to reduce costs.

Answer

CEO Patrick Blair and CFO Ben Adams attributed past margin improvements to a combination of growth, clinical value initiatives, and effective medical cost management, noting that over 40% of care is delivered in-house, providing significant control. Ben reiterated confidence in reaching the long-term margin target. Patrick and President and COO Michael Scarborough discussed leveraging AI-driven tools from partners like Epic, Oracle, and Salesforce to enhance efficiency, accuracy, and optimize business processes in areas such as clinical care, compliance, and enrollment.

Jared Haase asked about the trajectory of EBITDA margins, the feasibility of achieving the 8% to 9% target, and the primary drivers of leverage between center-level margin and operating leverage.

Answer

CEO Patrick Blair and CFO Ben Adams attributed margin improvement to double-digit growth, clinical value initiatives, and effective medical cost management, noting that InnovAge directly controls over 40% of care costs. They expressed confidence in reaching the long-term margin target. Patrick Blair, President and COO Michael Scarborough, and CFO Ben Adams also discussed leveraging AI and automation through technology partners like Epic, Oracle, and Salesforce to enhance efficiency, accuracy, and cost reduction across clinical care, operations, and compliance.

Jared Haase from William Blair asked about InnovAge's EBITDA margin outlook, the cadence of margin expansion towards the 8%-9% long-term target, and the balance of opportunities between center-level margin and operating leverage. He also inquired about opportunities for automation and AI, specifically leveraging Epic's new features and broader technology partners to reduce costs and improve efficiency.

Answer

Patrick Blair (CEO, InnovAge) and Ben Adams (CFO, InnovAge) attributed margin improvement to double-digit growth, clinical value initiatives, and medical cost management, noting that over 40% of care costs are delivered in-house, providing significant control. Ben expressed confidence in achieving the 8%-9% long-term margin target, stating the company is 'halfway there.' Michael Scarborough (President and COO, InnovAge) added that they are leveraging AI-driven tools from technology partners like Epic and Salesforce for clinical care, process optimization, efficiency, and accuracy, highlighting a 'best-in-class' technology strategy.

Jared Haase of William Blair & Company asked for more detail on InnovAge's engagement with policymakers regarding the value of PACE and questioned the conservatism in the reaffirmed fiscal 2025 census guidance, given the company was already at the midpoint.

Answer

CEO Patrick Blair explained that their stepped-up engagement with policymakers has been met with interest in how to expand the PACE model, distinguishing between low direct risks and potential indirect risks from state budget pressures. CFO Benjamin Adams addressed the guidance, stating that the company views its guidance collectively across all metrics and that potential variability from Q4 risk score true-ups justifies maintaining the current range.

Jared Haase from William Blair & Company inquired about how disruption in the Medicare Advantage market has impacted InnovAge's messaging strategy and asked for the rationale behind the impairment charge for the planned Louisville facility.

Answer

CEO Patrick Blair stated that while their fundamental strategy hasn't changed, InnovAge proactively increased marketing spend to differentiate PACE from Medicare Advantage offerings, which improved participant retention and enrollment. Regarding the Louisville facility, Blair explained that after regulatory sanctions, their slot was awarded to another provider. After exploring all alternatives, the company determined that exiting the market and writing off the asset was the most prudent decision to resolve a legacy issue.

Jared Haase asked for more detail on the assumptions behind the full-year guidance, particularly the low end of the census target, and inquired about the key drivers of improved employee and participant satisfaction scores.

Answer

CFO Ben Adams affirmed the guidance, describing an expected linear progression in census growth with a seasonally slower third quarter. CEO Patrick Blair added that the financial impact of this growth will be more weighted to the second half of the year. Blair attributed the rise in satisfaction scores to a clear company vision, a focus on making employees feel heard and recognized, and a belief that engaged employees deliver superior service, which in turn drives participant loyalty and growth.

Jared Haase of William Blair & Company asked for clarification on the state-level enrollment delays impacting census growth and whether they were still tied to Medicaid redeterminations. He also asked a broader question about the competitive landscape, particularly the entry of health systems like Kaiser into the PACE market.

Answer

CEO Patrick Blair clarified that current enrollment headwinds are now more related to state processing throughput for level-of-care assessments, rather than Medicaid redeterminations, and are concentrated in a few larger states. Regarding competition, Blair stated that InnovAge welcomes Kaiser's entry into PACE, viewing it as a validation of the model that will build overall market awareness, rather than a significant competitive threat, especially since most states grant exclusive territories.

Jared Haase asked about the development of the AccessOne acquisition, Phreesia's comfort with the asset and market, and the deal's scale compared to previous acquisitions.

Answer

Chaim Indig (CEO & Board Member) explained that Phreesia has followed AccessOne for years, aligning with their mission and customer needs, making it a well-considered strategic move.

Jared Haase inquired about the development of the AccessOne acquisition, Phreesia's comfort with the asset and market, and its scale relative to previous deals.

Answer

CEO Chaim Indig explained that Phreesia had been monitoring AccessOne for many years, was familiar with its executives, and felt comfortable with the asset due to its alignment with their mission and customer needs. He emphasized it was a well-considered, long-term decision.

Jared Haase asked about the impact of AI on the competitive landscape, particularly from new VC-backed entrants, and whether customer behavior is changing, such as including AI in RFPs or creating dedicated budgets.

Answer

CEO Chaim Indig responded that while AI is a powerful tool enhancing Phreesia's products, clients buy solutions to complex problems, not just 'AI'. He noted a 'flight to quality,' with providers returning to trusted partners like Phreesia after negative experiences with smaller, less stable competitors, and affirmed AI is driving significant value within the platform.

Jared Haase, on for Ryan Daniels, followed up on Network Solutions, asking if the improved visibility into fiscal 2026 was a broader pharma trend or specific to Phreesia's platform gaining priority.

Answer

Executive Balaji Gandhi clarified the comment was Phreesia-specific, comparing this year's visibility to last year's. He credited the company's product and Life Sciences teams for driving this improved outlook through product development and execution.

Jared Haase of William Blair & Company L.L.C. asked about the new Aetna partnership, questioning how Evolent's existing density in Florida contributed to the win and what the margin ramp profile would look like.

Answer

CEO Seth Blackley described the Aetna agreement as an innovative, marquee partnership poised for multi-state expansion, with Florida being a logical starting point based on Aetna's membership and needs. CFO John Johnson added that the margin ramp is expected to follow the standard Performance Suite model, targeting a 10% margin within the first two years of the contract.

Jared Haase from William Blair & Company asked for perspective on how potential changes in immigration policy could affect the home care workforce. He also sought clarity on the sustainable long-term organic growth rate for the hospice segment.

Answer

President & COO Bradley Bickham stated that Addus is seeing no current impact from immigration policy, as only a small fraction of its workforce (~600 of 50,000) is on work-eligible visas. Regarding hospice, he suggested that a sustainable long-term organic growth rate is likely in the 5% to 7% range, moderating from the recent 10% which was boosted by post-COVID recovery and specific operational improvements.

Jared Haase of William Blair & Company asked if the workforce retention and hiring improvements Addus has experienced are reflective of an industry-wide trend. He also questioned whether the increased churn in Medicare Advantage plans at the start of the year had any impact on home health volumes.

Answer

W. Bickham, President and COO, confirmed that the labor environment has improved industry-wide since the COVID era, particularly in personal care, though clinical hiring remains challenging in certain areas. He stated that MA plan churn did not materially impact home health volumes, noting their episodic vs. non-episodic mix has remained stable.

Jared Haase from William Blair asked if the policy focus on efficiency could accelerate value-based care adoption and sought more detail on the challenges in the clinical labor market versus personal care.

Answer

CEO R. Allison agreed that the policy environment could indeed catalyze a shift to value-based models, which he views as a significant advantage for Addus given its experience in demonstrating cost savings. President and COO W. Bickham explained that the clinical labor challenge stems from a national shortage of nurses and wage competition from institutional settings, whereas the labor pool for personal care is more stable.

Jared Haase of William Blair & Company asked if pressure on managed Medicaid payers from states could negatively impact funding for personal care services. He also inquired about the sustainability of the stable labor environment into 2025 and what factors could potentially disrupt current hiring trends.

Answer

CEO R. Allison expressed confidence in state support for personal care, noting that in most of their states, reimbursement rates are dictated by the state, not the managed care plan, insulating Addus from those pressures. President and COO Brad Bickham stated that hiring has been solid for over a year in personal care and improving on the clinical side, and he does not foresee any near-term factors that would materially impact these positive trends.

Jared Haase of William Blair & Company asked for details on investments in administrative automation and care navigation, and whether their impact would be greater on member retention or new growth. He also inquired about supplemental benefit utilization trends.

Answer

CEO John Kao stated the investments impact both retention and growth by systematizing workflows to enable scale. He cited recent implementations of new EHR, HR, and claims adjudication platforms (integrated into AIVA) as foundational work that will yield future efficiencies in claims payment and care navigation. Regarding supplemental benefits, Kao confirmed that negative variances from the prior year have been corrected and utilization is now in line with expectations.

Jared Haase asked if Doximity is seeing changes in how pharma clients allocate budgets across different digital channels, and requested an update on the News Feed's ad load, its capacity for more advertising, and its future growth importance relative to newer products.

Answer

CEO Jeff Tangney responded that Doximity continues to gain share due to a 'flight to quality' based on superior ROI, noting that some clients' experiments with programmatic channels were unsuccessful. He clarified that News Feed ad load has not increased; rather, monetization has expanded into new workflow channels like point-of-care, which has been critical for growth without impacting the core user experience. He highlighted the News Feed's 30% year-over-year growth in articles tapped as a key success metric.

Jared Haase, on for Ryan Daniels, questioned if there were notable differences in user engagement by specialty and asked for details on the implied step-up in operating expenses for the second half of the year.

Answer

CEO Jeff Tangney highlighted that endocrinologists are heavy users of telehealth and noted the rapid growth of the Nurse Practitioner (NP) audience, supported by the new 'NP Navigator' tool. CFO Anna Bryson explained the H2 OpEx increase is driven by seasonally higher sales commissions, increased costs from purchasing weekly prescription data, and strategic hiring in commercial R&D and sales.

Jared Haase asked about the technical and practical challenges of data integrations, such as difficult systems or security issues, and whether Definitive Healthcare offers incentives to encourage adoption. He also inquired about the new agency partnership strategy, its expected impact on the go-to-market motion, its contribution to 2025 guidance, and if it targets specific client segments.

Answer

CEO Kevin Coop explained that data integrations are handled flexibly through various methods like Snowflake, Databricks, pre-built connectors for platforms like Salesforce.com, and complex master data management services. He noted that this intentional focus has led to double-digit growth in integration engagements, which historically improves retention. Regarding the agency strategy, Coop stated it applies to all customer sizes, primarily in the provider and diversified markets. He anticipates direct channel sales will show returns quicker, but the agency channel represents a larger long-term opportunity and is expected to contribute to results this year.

Jared Haase inquired about the year-end churn dynamics, seeking color on the magnitude of the increase, the drivers behind customer downsells, and whether the issue remains concentrated in the life sciences sector. He also asked if the 2025 guidance assumes continued sales cycle elongation.

Answer

CFO Richard Booth confirmed that Q4 churn was unfavorable compared to the prior year, primarily in life sciences, and guided for a Net Dollar Retention (NDR) in the low to mid-80s for 2025. CEO Kevin Coop added that the issue is mainly downsells, not lost clients, and outlined strategic efforts around customer value delivery and master data management to improve retention. Booth also detailed the 2025 revenue guidance, noting Q1 as the low point with moderation expected throughout the year.

Jared Haase asked for key learnings from the recent leadership meeting with the newly acquired Metro team and whether any of their successful practices could be translated across other U.S. Physical Therapy partnerships. He also inquired about the specific factors making the home care opportunity attractive.

Answer

CEO Christopher Reading expressed high praise for Metro's leadership, growth plan, and mentorship culture. He identified Metro's unique "cradle-to-grave" service model, which includes pediatrics, home care, and having PT, OT, and speech therapists in facilities, as a key strength that is already being shared with other partners. Regarding home care, he explained its attractiveness stems from the ability to treat patients who are temporarily homebound and would otherwise be missed, providing clinician flexibility and capturing an incremental, profitable revenue stream.

Jared Haase asked about the drivers behind the organic growth acceleration in the Injury Prevention (IIP) segment and the company's visibility into its continued double-digit growth. He also requested color on the key differentiators that enabled the company to win a large new contract in the quarter.

Answer

CEO Christopher Reading attributed the IIP segment's strong performance to successful cross-selling, expansion into new industry verticals, and growing market awareness of injury prevention's value. For the large contract win, he highlighted the team's strong reputation in the auto industry, service quality, and established relationships as being more critical than pricing.

Jared Haase from William Blair & Company inquired about the drivers behind the more favorable technology-to-services revenue mix (80/20) for new Ignite clients compared to the legacy DOS platform (50/50).

Answer

CEO Dan Burton confirmed that the shift is driven by Ignite's modularity, ease of installation, and its typical pairing with specific, technology-driven application layer solutions that have a tangible ROI and require less implementation services. He noted that this favorable 80/20 mix supports the company's strategic priority of driving higher-margin technology growth and shareholder value.

Jared Haase inquired about the primary drivers behind the forecasted acceleration in net new platform client additions, from 21 in 2024 to approximately 40 in 2025.

Answer

CEO Dan Burton attributed the growth to three main factors: an improving end market with healthier hospital operating margins, the superior modularity and lower price point of the new Ignite platform, and a significant cross-sell opportunity within their base of over 900 application-only clients. He noted this strategy is already showing results, with the company on pace to add 10 new platform clients in Q1 2025, supporting the full-year target.

Jared Haase of William Blair inquired about the strength of the Q4 bookings pipeline and its role in supporting the company's anticipated return to double-digit revenue growth in 2025.

Answer

CEO Dan Burton detailed three core building blocks for 2025 growth: a record number of net new platform client additions, expansion with existing clients through higher-margin tech and nonrecurring contracts, and inorganic growth from acquisitions feeding the cross-sell engine. Burton expressed confidence that the current pipeline supports these growth drivers and the reiterated 2025 outlook.

Jared Haase inquired about the strategic changes related to enhancing customer centricity and the financial impact of transitioning the DAAP solution's data services to a subscription-based revenue model.

Answer

CEO Stephen Silvestro explained that customer centricity involves making it easier for clients to do business with OptimizeRx, ensuring a positive experience to drive renewals and expansion. He and CFO Edward Stelmakh detailed that shifting the data component of DAAP to a subscription model will increase predictable, recurring revenue, improve margins, and enhance visibility. Stelmakh noted that while it's hard to quantify the exact mix, DAAP represents a growing portion of the business, and its data component is the focus for this subscription push.

Jared Haase inquired about the current demand environment, asking which specific products are resonating most with clients and if there are any shifts in hospital investment priorities.

Answer

CEO Matt Hawkins confirmed strong demand entering 2025, driven by providers' focus on efficiency and operating margins. He highlighted significant interest in solutions that prevent claim denials, such as Eligibility Verification and Prior Authorization, as well as the new generative AI-powered Denial and Appeal Management solution. He also noted the company started 2025 with a more robust pipeline than in 2024.

Jared Haase asked for more detail on the functionality and rollout cadence of the new 'Insights Plus' reporting tool and questioned the drivers behind the expected pickup in M&A activity.

Answer

CEO Robert Frist described Insights Plus as a significant upgrade built on modern technologies like Snowflake, offering faster performance and enhanced analytics to measure learning effectiveness. It is sold as a buy-up, generating incremental revenue. Regarding M&A, Frist cited improving macro conditions, including better price valuations for targets, and stated the company is now ready to integrate acquisitions after a period of focusing on its core platform. He expects initial deals to be small, supportive tuck-ins.