Evolent Health - Earnings Call - Q4 2020
February 25, 2021
Transcript
Speaker 0
Welcome to Evolent Health's Earnings Conference Call for the Quarter and Year Ended 12/31/2020. As a reminder, this conference call is being recorded. Your host for the call today is Mr. Seth Blackley, Chief Executive Officer of Evolent Health. This call will be archived and available later this evening and for the next week via webcast on the company's website in the section entitled Investor Relations.
There is some important introductory information. This call contains forward looking statements under The U. S. Federal securities laws. These statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations.
A description of some of the risks and uncertainties can be found in the company's reports that are filed with the Securities and Exchange Commission, including cautionary statements included in the current and periodic filings. For additional information on the company's results and outlook, please refer to its second quarter news press release issued earlier today. As a reminder, reconciliations of non GAAP measures discussed during today's call to the most direct comparable GAAP measures are available in the company's press release issued today and posted on the Investor Relations section of the company's website, ir.evolenthealth.com, and the eight ks filed by the company with the SEC earlier today. At this time, I will turn the call over to the company's Chief Executive Officer, Mr. Seth Blackley.
Speaker 1
Thank you, and good evening. I'm Seth Blackley, Chief Executive Officer of Evolent Health. I'm joined by John Johnson, our Chief Financial Officer. I'll open the call this evening with a summary of our recent results, including an update on the key themes of our strategic plan, which are: one, strong organic growth two, expanding EBITDA margins and three, optimal capital allocation Next, I'll provide an update on the market and macro environment. Afterwards, I'll share insights and highlights from across the business and how our differentiated solutions drive value for our partners.
I'll then hand it to John to take us through a more detailed financial review of the fourth quarter and full year 2020 results as well as provide 2021 guidance. I'll close with an update on the organization and a summary of our key focus areas. As always, we'll be happy to take questions at the end of the call. I will say that before turning to the financials that we are very pleased with our strong 2020 results and we feel we are well set up heading into 2021. In terms of the financial overview and results for the quarter, total revenue for the quarter ended 12/31/2020 increased 15% to $271,900,000 from the comparable quarter of the prior year.
Adjusted EBITDA for the quarter ended 12/31/2020 was $16,100,000 compared to $8,200,000 for the quarter ended December 3139. Revenue increased 20.8% to $1,000,000,000 for the year ended 12/31/2020 compared to $846,400,000 for the year ended December 3139. Adjusted EBITDA for the year ended 12/31/2020 was $41,400,000 compared to negative $11,000,000 for the prior year period. As of 12/31/2020, we had approximately 3,600,000 lives on the full platform plus an additional 6,200,000 lives on our New Century Technology and Services Suite platform. Overall, we're pleased that we executed on our key financial objectives for the year.
Next, I'll provide an update on the status against our strategic plan. With respect to the first theme of strong organic growth, we continue to be on track achieving or exceeding our target growth rates. Our differentiated products and strong market momentum led to strong performance through new partner additions and same store sales growth in 2020. We added eight new payer and provider partners in 2020, including Florida Blue Medicare, Neighborhood Health Plan of Rhode Island, EmblemHealth, Physicians Accountable Care of Utah and Molina. This was at the top end of our six to eight new partner target and it demonstrates the diversity of our partner base and the depth across our services business.
And we continue to be on plan for our growth objectives for 2021 and beyond as we utilize our core solutions to drive value in the marketplace. Today, we're excited to announce our total cost of care solution, Evolent Care Partners, has entered into partnerships with two new regional physician groups and large MSAs. We're encouraged by the high growth potential in these respective markets given the strong clinical reputations and historical performance of these two physician groups. We continue to see demand for our Evolent Care Partners offering the risk bearing total cost of care market. By partnering with efficient high quality physicians, we unlock incremental value and build opportunities with these physician led organizations as we expand geographies.
In addition to these new partnerships, Advant Care Partners has expanded regionally. We increased our lives under management in the state of Texas by entering into a three year renewal with Blue Cross Blue Shield of Texas commercial. Including the payer and provider network expansions announced today, our total lives under management for Evolent Care Partners for 2021 is up to approximately 90,000, which represents 40% growth from 2020 and a large base of total lives under a total cost of care arrangement like this. Furthermore, we are seeing strong same store sales growth with our specialty management platform, New Century Health, which successfully expanded with Centene in several markets in the fourth quarter of twenty twenty. We are pleased to report that as of 12/31/2020, '9 Centene plans are using our New Century Health technology and services suite, and we expect to add more states in Q1 twenty twenty one.
In addition to expanding geographies, we've also added pediatrics and radiation oncology management services and related fees to select Centene markets. Adding the scope, we believe, will enhance the value and ROI to our partners. The momentum in our pipeline remains strong. We see our solutions are increasingly in demand in the market, and therefore, we have good visibility into 2021. With the two new physician groups announced today, we're also well on our way towards our target of six to eight new partnerships with diversified across our solutions for 2021 and towards a long term growth target of mid teens organic top line growth.
Turning to our second strategic theme of expanding margins. We continue to make progress on our cost reduction effort in line with our expectations. Over the course of 2020, we're able to drive scale and reduce costs to expand EBITDA margins and achieve positive cash flow ahead of schedule. Looking at the fourth quarter, our financial results exceeded our guidance, driven mostly in part by strong results in our performance based arrangements, which John will discuss in more detail in a few minutes. Continuing to deliver strong operational and clinical performance for our partner organizations, coupled with our dedicated overhead cost initiatives, we believe will position us to drive enhanced margins in 2021.
We're also on track to reach our medium term goal of mid teens EBITDA margins. Finally, with respect to our third theme, I want to provide an update on our strategic portfolio and balance sheet optimization. Across 2020, we delivered on our commitment to further focus our core and exit the health plan businesses that we've now monetized or entered into agreements to monetize all health plan assets. We closed the Passport transaction with Molina in September 2020, and the Lighthouse Health transaction with Anthem closed on 02/01/2021. As previously announced at the JPMorgan Conference, we've entered into a definitive agreement to sell True Health New Mexico health plan to Bright Healthcare and entered into a definitive agreement to sell assets of Miami Children's Health Plan to Anthem.
Both of these transactions are expected to occur during the first half of twenty twenty one. We're confident that in aggregate, the capital return from all health plan investments will exceed the capital invested. And in the case of Molina and Bright, the transactions have led to ongoing services arrangements as well. The monetization of our plans and our disciplined cost focus have allowed us to delever. We paid down our senior term loan on January 8.
And as of today, we have a strong cash position and no senior debt. In conclusion, we've made significant progress on our three key focus areas. We remain focused on our high growth services business, and the strategic optimization supports our path to mid teens EBITDA margins. Before providing updates across the business, I'd like to touch on what we see in the overall macro environment and how the need to control health care costs is continuing to drive strong momentum in the market. First, with the Biden administration, we're seeing renewed energy to fight COVID, protection or expansion of the Affordable Care Act and Medicaid populations, and acceleration of the adoption of cost reducing measures that will be a tailwind for our solutions.
Second, the erosion of the federal and state tax bases is increasing pressure on Medicare and Medicaid budgets, causing CMS and state governments to continue to focus on ways to accelerate cost reduction. Medicare Part A trust fund insolvency is projected to occur in three to five years and we feel this pressure and similar pressure on state budgets will further accelerate the move to adopt solutions like ours. Continued support of Two Sided Risk is very encouraging for our partners and evergreen programs like MSSP Pathways to Success. Newer models such as direct contracting and the geographic model are likely to accelerate as those model designs are refined and we therefore view these as promising long term opportunities as well. Third and finally, the combination of unemployment, a challenging risk coding environment for Medicare Advantage plans and higher post COVID healthcare costs are accelerating sales opportunities across the business.
In summary, the macro environment is favorable, and we feel that Evolent is well positioned to take advantage of these trends. Turning to our business updates, I want to highlight achievements and recent activities across Evolent solutions. First, New Century Health, our specialty management offering focused on managing the cost and quality of cardiac and cancer care, continues to build across geographies, scope and through cross sell. In addition to the Centene market expansions mentioned earlier, we're pleased to announce New Century Health is now live at Florida Blue Medicare and Molina Healthcare of Kentucky, and Molina Washington is on track to launch later in the first half of the year. The uptake of our previously announced New Century Lite technology solution was very strong across 2020, with 6,200,000 lives on this platform by 12/30/2020.
As John will discuss in a moment, given the rapid expansion of this product, we will now publish this membership separately from the lives on our full platform under the Technology and Services suite moniker. Second, Evolent Care Partners, our total cost of care management offering focused on a provider driven population health approach to improve quality and lower costs, continues to achieve strong provider engagement and clinical outcomes. Mentioned earlier, we're excited to expand our physician network and health plan partnerships in our existing markets. We now have over 1,000 physicians in our network managing approximately 90,000 lives, which is approximately 1% of the total lives in these regions. These 90,000 lives represent over $900,000,000 in annual premium equivalent under management for 2021.
While we don't recognize gross revenue on this $900,000,000 our net EBITDA opportunity for Evolent Care Partners is based on a combination of fixed fees and the savings generated on the entire $900,000,000 of premium. Across 2020, our performance in Evolent Care Partners exceeded our expectations, contributing to our positive Q4 results. We view this solution as a strategic opportunity for 2021 and beyond. Our decade of experience leading the market in population health provides three major differentiators that drove these physician groups to select Evolent Care partners over the alternatives in the market. First, our proprietary technology platform Identify provides physicians with real time information and automated reporting, allowing them to identify the most vulnerable patients and the highest priorities.
As an example, we launched a new module in 2020 called Panel Insight. That prioritizes and scores all the critical interventions for each physician practice. The prioritization makes it easy for the practice to focus on the highest yield interventions, including risk adjustment and clinical interventions across our suite of proprietary clinical programs, while also understanding gap to goal for reaching target and max incentives for those physicians. Second, our clinical program strategy is based on a personalized approach to population health and targets impactable patients. Our care advisors and community health workers are in direct communication with patients and providers to avoid readmissions, increase engagement, and coordinate preventable care.
We act as an extension of the physician office, and the physician group can remain independent while providing better care at a lower cost. Third, we have a proven track record of success in enabling providers to drive cost savings and deliver superior quality care. As a reference point for the value created by the Evolent Care Partners solution, CMS recently announced that for 2019, the five ACOs that Evolent supported in the NextGen ACO program earned a combined $84,000,000 in savings for Medicare, receiving shared savings payments of more than $66,000,000 In addition, they outperformed other ACOs in the program on average savings by approximately 40%, as well as outperforming on quality scores. The NextGen ACO program is a good example of our total cost of care solutions proven track record and can be leveraged with private payer populations where we're beginning to gain traction as previously discussed, as well as with other future CMS programs such as direct contracting. Finally, Evolent Health Services, our administrative simplification offering, focused on helping payers streamline operations and provide outstanding service to members and providers, continues to achieve strong operational performance with current and new customers.
We're also pleased to share the team led a successful launch at Maryland Physicians Care, which went live on 01/01/2021 to support more than 200,000 Medicaid beneficiaries in Maryland. The recent go live exemplifies the unique value provide health plans and risk variant providers by coupling our industry leading clinical solutions with our end to end administrative solution. Our intense focus on machine learning drives cost savings for our customers and ultimately lowers the cost for consumers. Overall, we have confidence in our performance and we feel we are very well positioned entering 2021. Before I turn it to John, I wanted to provide a preview on how we'll be organizing for 2021.
With the expected divestiture of True Health, we will reorganize our services business into two segments. The first will be Clinical Solutions, which will include our specialty management and physician oriented total cost of care solutions along with New Century Health and the Evolent Care Partners brands. The second segment will be Evolent Health Services, which will house our administrative simplification solution and certain supporting population health infrastructure. We will begin to report the results of these segments with our Q1 twenty twenty one financials. With that, I'll turn it to John to give additional details on our financial performance as well as provide guidance.
Speaker 2
Thanks, Seth, and good evening, everyone. Overall, we're pleased with our achievement relative to our 2020 financial goals, exceeding the high end of ranges for both our revenue and adjusted EBITDA targets. Our consistently strong results across 2020 demonstrate our commitment execute against our attractive financial model, and we carry that same disciplined momentum into 2021. We entered 2020 with high visibility into a base of strong revenue growth. And as Seth mentioned, we exceeded our growth expectations, adding eight new clients throughout the year in addition to driving strong same store growth.
For the full year of 2020, we had revenue of 1,000,000,000, including $925,000,000 in services revenue, which represented 34% organic growth in services over 2019. On the bottom line, we achieved sequential improvement across the year, primarily due to strength in our performance based arrangements and continued focus on cost control efforts. Adjusted EBITDA for the full year was $41,400,000 or 4.1% of revenue, representing a five thirty five basis point improvement over our 2019 adjusted EBITDA margin. This profitability expansion, combined with a disciplined approach to investment in capitalized software development, further allowed us to achieve our positive free cash flow target for the year. In the fourth quarter specifically, our strong revenue and adjusted EBITDA results was positively impacted by both higher than forecasted shared savings in our performance based arrangements and lower than forecasted medical utilization driven in part by the ongoing coronavirus pandemic.
While we expect the pandemic to continue to add volatility to the industry in the near term, the underlying earnings power of our business driven both by our growth and our operating cost containment efforts continues to be strong. Now let me take you through our detailed results for the quarter before turning to guidance. Beginning with our consolidated fourth quarter results, revenue increased 15% year over year to 271,900,000.0 mostly through the impact of new partner additions and cross sell. Adjusted EBITDA grew to $16,100,000 relative to $8,200,000 in the same period of the prior year. Adjusted loss available for Class A common shareholders was minus $600,000 or minus $01 per common share for the quarter compared to minus $5,800,000 or minus $07 per common share in the same period of the prior year.
Turning to our fourth quarter results by segment, in our services segment, fourth quarter services revenue increased 20.8% to 246,500,000.0, up from $2.00 $4,000,000 in the same period of the prior year. The increase in services revenue was primarily driven by new partner additions and cross sell expansions within our existing partner base. Adjusted EBITDA from our services segment for the quarter was 20,400,000.0 compared to 6,500,000.0 in the prior year. Turning to our True Health segment, which we have entered into an agreement to sell to Bright Health, we had premium revenue of 30,200,000.0 in the fourth quarter. Claims expense as a percentage of premium revenue was 82% in the fourth quarter, an increase of roughly 10% over the first nine months of the year and reflective of both a modest bounce back of medical expenses as well as a premium deficiency reserve accrual that was taken against the plan's federal line of business.
Adjusted EBITDA from True Health for the quarter was minus 4,300,000.0. Turning to the balance sheet, we finished the fourth quarter with 355,300,000.0 in cash, cash equivalents and investments, including a 119,400,000.0 in cash held in regulated accounts related to the wind down of Passport. Excluding cash held for Passport, this represents $235,900,000 of available cash, an increase of $76,900,000 versus the end of the third quarter and principally driven by our strong adjusted EBITDA performance as well as 64,000,000 in cash returned from Passport in the quarter. Cash deployed for capitalized software development in the quarter was 5,900,000.0. Two January events to note on the balance sheet.
First, we repaid our 75,000,000 term loan with Ares Capital Corporation with the associated warrants granted to Ares from our December 2019 financing also retired in cash. We also received an additional 20,000,000 in cash from Passport in early January. Pro form a for these two items, our $12.31 $20.20 available cash balance was 157,300,000.0. We have no other outstanding senior debt in place today. And aside from the $27,000,000 balance on our 2021 convertible notes, we have no other debt maturities until 2024 and continue to expect adjusted EBITDA less CapEx to be positive in '21 and beyond, which will give us the ability to invest in differentiating our core services while maintaining a strong balance sheet.
An important strategic achievement across 2020 was the development and rapid expansion of our technology and services suite for oncology and cardiology. This product delivers strong ROI for our partners at gross margins that can be three to five times higher than our dominant performance suite offering. In addition to driving attractive margins, from a go to market perspective, this offering gives us the opportunity to demonstrate the value of our platform to new partners, serving as a foothold for further expansion and potential upsell to the performance suite. By the end of twenty twenty, this platform was deployed across health plan partners covering 6,200,000 lives at an average fee of 40¢ per member per month. Given the strategic importance of this product in our portfolio, we will delineate these lives separately when we announce lives in the platform each quarter going forward.
On our full services platform, which includes members on the New Century Health performance suite, as 12/30/2020, we had approximately 3,600,000 lives, up modestly from 3,500,000 in q three. Our average full services platform PMPM fee for the quarter was $22.65 compared to $17.55 in the same period of the prior year. Turning now to our 2021 outlook. With a signed agreement to sell True Health New Mexico, we are making some changes in how we report on our financials for 2021 to provide greater depth and transparency on the business consistent with our evolving strategy. To that end, we are reorganizing our services business into two reportable segments, and we are adding the New Century tech and services members as a separately reported membership number.
True Health segment financials will be reported as a discontinued operation held for sale beginning with our q one results. And as such, we are only guiding for our services business. On the top line, we come into the year with strong visibility to exceed 20% organic growth in the services business, excluding Passport. In fact, we have over 95% visibility into the midpoint of our revenue guidance. In terms of profitability, the progress on our cost work combined with the strength of our performance based arrangements will increase our adjusted EBITDA even on top of our outperformance in 2020 despite the disposition of Passport.
Specifically, the midpoint of our 2021 guidance projects an incremental 120 basis points improvement over our 2020 results. These profitability initiatives also set us up well for future margin expansion according to our plan. Looking across the year, our inter quarter EBITDA will vary as usual based on timing of new partner go lives, shared savings revenue recognition, performance based economics, and other factors. Now let me turn to guidance. For the full year, we expect total revenue of $830,000,000 to $880,000,000 With respect to full year adjusted EBITDA, we are forecasting a range of 40,000,000 to $50,000,000 For the first quarter specifically, we are forecasting total revenue of $2.00 5,000,000 to $215,000,000 And finally, we are forecasting adjusted EBITDA for the first quarter of 10,000,000 to 14,000,000 With that, I will turn it back over to Seth.
Speaker 1
Thanks, John. I want to close with a few updates on our organization as well as a summary of our key messages. Looking at the organization, we have a very strong leadership team in place with decades of experience and a deep bench to execute on the key themes of our strategic plan. Evolent continues to be a destination for healthcare's top talent and talent will continue to be a differentiator for us. Our focus on employee engagement, strong individual and leadership development and transparent communication has allowed us to retain top performers across the organization as well as achieve a firm wide engagement score of close to 90% for 2020.
This world class talent gives us a long term competitive advantage and a strong culture. As a mission driven organization, our company culture reflects an atmosphere of respect, honesty and humility. Evolent recently received a perfect 100 score on the Human Rights Campaign Foundation's Corporate Equality Index for 2020. Across 2020, we also appointed a diversity equity inclusion leader and have fostered the development of eight business resource groups for employees that focus on promoting inclusion, educating on bias and culture and supporting DE and I initiatives. I'm also proud to report that our newly launched firm wide inclusion score debuted at close to 90% and trended positively across the year.
In summary, John and I are honored to work alongside our deeply talented and dedicated team in executing on our strategy of driving strong organic growth and achieving our mid teens growth target with our differentiated solutions second, of scaling the business to drive enhanced margins and third, in efficiently allocating capital. Our high level visibility into 2021 gives us strong confidence in achieving our targets for the year. Thanks everyone for participating in tonight's call. With that, we'll end our formal remarks and we're happy to take questions.
Speaker 0
Thank you. We will now begin the question and answer session. To withdraw your question, please press star then 2. At this time, we will pause momentarily to assemble our roster. Our first question comes from Ryan Daniels with William Blair.
Please go ahead.
Speaker 3
Yeah guys, thanks for taking the questions and for all the color. I apologize if you hit on this in the prepared comments, I had another call so I hopped on late, but seems like a lot of momentum lately in physician partnerships versus healthcare systems. And I know the market in general with risk bearing appears to be shifting a little bit towards doctor groups. So I'm curious if you can comment on that phenomenon and what it means to Evolent and how that's resonating in your pipeline and close rates.
Speaker 1
Yeah, Ryan, happy to. I think you're right. Within our provider sales segment, we are selling more frequently to physician groups, in particular independent physician groups over the last couple of years. And it's based on the last decade of experience where we've had some experience of both health systems and physician groups. And have found just the slightly more nimble entrepreneurial nature of the physician groups and the kind of starting point they have without the health system assets allows them to be more aggressive at attacking the total cost of care.
And when you look at the results that we're getting and the next gen ACO results and that sort of thing, it kind of proves out that point. And so we have shifted our sales activities over the last few years in that direction. We had a lot of success, think, particularly in the last twelve to eighteen months, as you've heard lots of announcements down this category, Ryan. The two new groups that we signed and we announced today are good examples of that. And I think the Ed One Care Partners business now as a unit, when you think about $900,000,000 of premium, we have an opportunity, an EBITDA opportunity on that entire $900,000,000 based on the savings off of that premium.
And so obviously, having efficient aligned providers is critical to that. And we couldn't feel better about the setup we have. I think you'll continue to see more down the physician sector over time.
Speaker 3
That's very helpful. And then just in regards to the new metric you reported tonight on the New Century technology and services platform, is that 6,200,000.0 exclusively the newer kind of lighter version of the offering that you launched this year? Does that include lives from the Quarter New Century that are in that as well?
Speaker 1
That's the newer platform, Ryan. It's, you know, look, I'd just say it's a bright spot across the year. We had had several bright spots, but I think this is one of them. It's a nice way to roll out quickly across a larger plan, and it has a nice margin profile. And then it creates a really nice opportunity for us to come back around on those 6,200,000 lives and, have opportunities around the full performance suite, which, you know, is the Florida Blue relationship that we announced last year as an example of that.
And, so it's a nice kind of one two punch that is set up with the rollout of this light product.
Speaker 3
Yeah, I guess it's just that my math, if it's right, seems like about $30,000,000 run rate, which seems very impressive for a product you just launched less than twelve months ago. So I know if you would agree with that math, but is it around that $30,000,000 run rate?
Speaker 2
Hey, Ryan, this is John. Your math is about right. And yes, we're very pleased with the rapid rollout of an expansion of that product.
Speaker 3
And then last one for me. How should we consider the pipeline there versus kind of the core New Century? I mean, we've talked about this in the past, but I'm curious now that they have this lighter starter version of more clients are perhaps looking at this as a foot in the water before they go all in. So is it at all cannibalizing other sales? Or do you think it's incremental because you're getting a client base that otherwise might not have approached your services?
Thanks, guys.
Speaker 1
Yeah. Sure, Ryan. This is Seth again. I can take that. Yeah, we view it as incremental.
And if you look at where we've rolled out these lives, a lot of it's with some of our national relationships and the larger payers. And what's nice about it is that you can go across the country state by state very quickly. You don't have to align on what a benchmark is, which you have to do for the performance product, and that takes more time. So you can kind of get to a place where the math is a lower PMPM, higher margin, but a lot more lives. And then we will see opportunities to come in behind and set up the full performance suite as a follow on.
And the FortiBlue example, which I mentioned a minute ago is an example where that's only 125,000 lives and 75,000,000 of revenue. And so it doesn't take many of that 6,200,000.0 to convert over to make the whole thing work really well. So we view it as additive and, really excited about it.
Speaker 3
Okay. Well, I congratulate you on a great year and all the success and, progress you've made. Thanks so much.
Speaker 1
Thanks, Ryan. I appreciate it.
Speaker 0
Our next question comes from Robert Jones with Goldman Sachs. Please go ahead.
Speaker 4
Great. Thanks for taking my questions. This is Jack Rogoff on for Bob. Apologies, also jumped on late. I guess, are Centene and Molina the only customers of yours that are using New Century Lite?
Or are there others that are also in this group?
Speaker 1
No, we have a couple others. And within some of our partners, they may have a little bit of both, Some performance and some light depending on the regions in the markets.
Speaker 4
Got it. That makes sense. And then apologies if I missed this, but how do you define the full platform? Is that the full suite of New Century, or is that the full suite of Evolent services in some sense? Just trying to delineate if that's like a pure lives, or is that a more of a broad bucket?
Speaker 2
Yeah, the full platform life, Jack, this is John. Think of that as our traditional life metric. So that's inclusive of New Century performance suite lives, as well as the Evolent Care Partners lives, other lives in the administrative platform, and so on.
Speaker 4
Perfect. That's what I thought. That makes sense. And then last one for me. I guess, did you disclose what specific programs they'll be supporting with these two new regional physician groups?
Speaker 1
It's our total cost of care management solution, which is focused on the clinical side and the clinical work of reducing the total cost of care on the total premium dollar for Medicare life. So it's sort of a $10,000 annual per member number that we run at, and it's a total cost of care clinical solution.
Speaker 4
Makes sense. Thanks a lot.
Speaker 1
You're welcome, Jack.
Speaker 0
Our next question comes from Charles Rhye with Cowen. Please go ahead.
Speaker 5
Yes. Hi, this is Cal Sternick on for Charles. Question on NCH. So it looks like you guys have been having a lot of success there on the payer side with just the oncology and cardiology solutions. So curious if there are any other high cost, high acuity practices that you're exploring to maybe expand the NCH platform.
Speaker 1
Yeah, sure, Cal. It's Seth. I can take that. We are thinking about it. Right now, we're very focused on cardiology and oncology because we still have actually quite small market share nationally.
If you think about the number of lives relative to several 100,000,000 life opportunity. So the first opportunity is just to expand market share with those two. But certainly the approach that we're taking to doing this management, is I'd say provider led in a way that maybe some of the traditional specialty management offerings have not been, I think does resonate in other areas. And it's something that eventually we will do. The timing is later, and right now we're focused on cardiology and oncology.
Speaker 5
Makes sense. And then I know with Centene and Molina, they both have a big presence in the exchanges. I'm curious if and with any of the other payers you guys have as well, if there would be any benefit to the business from the special enrollment period, which could add new members or anything from enhanced subsidies. So across your partnerships, do you cover any individual lives? And is any benefit there reflected in your guidance?
Thanks.
Speaker 2
Hey, Cal. This is John. So we do have individual business on the platform. And so certainly, if there were a bump in membership there, we could be beneficiaries of that. I would not expect that to be significant.
It's a reasonably small portion of our business, but we do have individual members on the platform.
Speaker 5
Great. Thank you.
Speaker 2
Yeah. Thanks for the question.
Speaker 0
Our next question comes from Sean Wineland with Piper Sandler. Please go ahead.
Speaker 6
Hey. Thanks for the question. This is actually Matt Shea on for Sean. Seems like we've been hearing more about specialty management on earnings calls. Curious if you see the competitive environment changing meaningfully, and how you kind of think you stack up against other programs in the competitive space, maybe CVS's oncology management program, for example.
Speaker 1
Yeah, Matt, it's Seth. So I would say we have not seen a meaningful shift in the competitive landscape. The focus of our work is very deep, obviously, around oncology and cardiology. There are some other players that I would say are broader. Evercore might be an example.
And our work tends to be differentiated by our ability to drive outsized cost savings based on our focus in these areas. I think the good news is particularly for oncology, it's such a pain point in the payer community and the trends are so high that being a dedicated focused player that provides differentiated results is I think a good spot to be in. And so generally, competition is not the main issue we run into. So we feel good about the outlook for that solution, both for oncology but also for cardiology.
Speaker 6
Okay. Good to hear. And then with the recent Blue Cross Blue Shield board edition, did that play any role expanding the partnership with Blue Cross Blue Shield Texas? And maybe stepping back a bit, how should we think about further penetration with the Blues plans?
Speaker 2
Yeah, mean, it's interesting.
Speaker 1
We have obviously a couple blue relationships now out of I think 36 total. So in general, the way to think about it is that there's close to 100,000,000 incremental lives that are available that we want to do our best to go serve that community and that network. We're building credibility there. Kim's addition to the board is an important part of that. But a lot of the work is frankly doing a great job for Florida Blue and having that word-of-mouth go out to the other plans.
And so we're pretty focused right now on execution, supporting our partners that we have, and doing a fantastic job so that the references are the place we want them to be. And I think that's going to be probably the biggest driver of our success in the blue segment. We're off to a good start there, I think.
Speaker 6
Okay, got it. Thanks for the question, guys. Congrats on the quarter.
Speaker 2
Thank you. Thanks.
Speaker 0
Our next question comes from David Larson with BTIG. Please go ahead.
Speaker 7
Hi. Congrats on a good quarter. Can you maybe talk a bit about the impact that COVID is having on your book of business and your selling efforts? Is there more pressure on state budgets, for example? And is that pushing you into the Medicaid market and they continue to be receptive?
Any thoughts there? Thank you.
Speaker 1
Sure, David. So I'd say in general, the COVID impact is pretty modest for us overall. On the sales side, the increased pressure that you described on the budgets, I think will help some over time. So that's probably a slight positive going forward. On the kind of performance side and our ability to execute, COVID adds volatility to life.
General, it's probably a slight tailwind to us in 2020. For 2021, David, it's probably more neutral. And I would say in general, the guidance we gave obviously reflects our views on all this and the fact that it's pretty modest overall for us.
Speaker 7
Okay. Appreciate it. And I hop on a bit late. Sorry if you covered this. But with the Molina in cell potential for New Century Health, have you sized that?
Any thoughts there? Thank you.
Speaker 1
We haven't sized it. I mean, we're live in Kentucky. We're going live in Washington soon. They obviously have, and that represents a reasonably modest portion of the total lives. Again, kind of like the blue comment, I'd say right now we're focused on doing a great job for them as a partner.
And as we do that, hopefully we'll have opportunities to expand. It's obviously a very large opportunity depending on which states and what form it takes. You can use some of the examples like the Florida Blue example as a for instance on what a block of lives can mean. So there's very large opportunity, but our task right now is to execute, deliver, have them feeling great about it. And we'll hopefully have opportunities to address that opportunity over time.
Speaker 7
Okay, I appreciate that. Thank you.
Speaker 1
Sure, welcome.
Speaker 0
This concludes our question and answer session. I would like to turn the conference back over to Seth Blackley for any closing remarks.
Speaker 1
Great. Nice to connect with everybody. And we'll hope to talk to you live soon. Thanks a lot.
Speaker 2
Thanks all. Good night.
Speaker 0
The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.