Ladies and gentlemen, welcome to the WELL Health Technologies Corp. Second Quarter 2023 Financial Results Conference Call. My name is Jenny. I will be your operator for today's call. At this time, all participants are in a listen-only mode. We will conduct a question-and-answer session later in the call, which will be restricted to analysts only. Please note this conference is being recorded. I will now turn the call over to Mr. Tyler Baba, Manager, Investor Relations. Mr. Baba, you may begin.
Thank you, operator, welcome, everyone, everyone to WELL Health's fiscal second quarter financial results conference call for the three months ended June 30th, 2023. Joining me on the call today are Hamed Shahbazi, Chairman and CEO, and Eva Fong, the company's CFO. I trust that everyone has received a copy of our financial results press release that was issued earlier today. Portions of today's call, other than historical performance, include statements of forward-looking information within the meaning of applicable securities laws, including future-oriented financial information and financial outlook information. Forward-looking statements are necessarily based upon a number of estimates and assumptions that, while considered reasonable by management, are inherently subject to significant business, economic, and competitive uncertainties and contingencies.
These forward-looking statements involve known and unknown risks, uncertainties, assumptions, and other factors, many of which are outside of WELL's control, that may cause the actual, actual results, performance, or achievements of WELL to differ materially from the anticipated results, performance, or achievements implied by such forward-looking statements. These factors are further outlined in today's press release and in our management discussion and analysis. We provide forward-looking statements solely for the purpose of providing information about management's current expectations and plans relating to the future. We do not undertake or accept any obligation or undertaking to release publicly any updates or revisions to any forward-looking statements to reflect any change in our expectations or any change in events, conditions, assumptions, or circumstances on which any such statement is based, except if it is required by law.
We may use terms such as adjusted gross profit, adjusted gross margin, adjusted EBITDA, shareholder EBITDA, adjusted net income, and adjusted free cash flow on this conference call, all of which are non-GAAP and non-IFRS measures. For more information on how we define these terms, please refer to the definition set out in today's press release and in our management's discussion and analysis. The company believes that adjusted EBITDA is a meaningful metric, financial metric as it measures cash generated from operations, which the company can use to fund working capital requirements, service future interest and principal debt repayments, and fund future growth initiatives. Adjusted EBITDA should not be construed as an alternative to net income or loss determined in accordance with IFRS. With that, I will turn over the call to Mr. Hamed Shahbazi, Chairman and CEO.
Thank you, Tyler, and good day, everyone. We hope that you're all keeping safe and healthy. We appreciate everyone for joining us today. We're very pleased with our record-breaking quarter and to be visiting with you today. In our quarter, we achieved record revenue and growth across all key metrics. Our record revenue, adjusted EBITDA, patient visits, and provider count are a testament to the company's continued focus on tech-enabling healthcare providers and supporting them in simplifying their work lives, modernizing and digitizing their clinical practices, and delivering the best healthcare possible. WELL exited Q2, 2023, with over 3,200 providers and clinicians delivering 1 million patient visits, over 1 million patient visits, in fact, in the quarter through our own physical and virtual clinics, without counting any of the technology interactions or technology-enabled visits that happen with other people's providers.
In addition, WELL Health had more than 31,000 providers supported by our own SaaS and technology services. We are extremely passionate about supporting our providers, and every day we focus on supporting them better. This attitude and focus is what's allowed our company to continue to witness healthy growth across all its business segments, including both online and in-person care channels, with minimal impacts due to recession, inflation, supply chain, or other macroeconomic effects. Thematically speaking, there are a few catalysts that I want to touch on in today's presentation, they are as follows: one. continued resilience in our multidimensional healthcare delivery platform that has allowed us to continue to deliver outstanding record results 18 quarters in a row and allowed us to yet again upgrade our guidance this quarter for the balance of the year.
The growth of our R&D teams and costs demonstrate that we continue to invest in our growth, not only with M&A, but with internal investment, constantly strengthening our internal ability to grow and innovate. This is not only contributing to the health of the company but positioning us to grow organically, as evidenced by our big OceanMD contract win today. Three, our continued focus on artificial intelligence and strategic, internal and external planning and investments that allow us to leverage AI to help our providers and patients at scale while becoming a more efficient company. Four, our disciplined M&A growth engine and how it continues to yield tremendous results. Five, our relentless focus on integration and digitization. WELL has exhibited a keen focus, both in the U.S. and Canada, to improve efficiency and leverage our size and scale by integrating aspects of our business.
Our efforts to constantly improve and tighten up our integrations never really stops due to our growing capabilities, new innovations, and our dynamic company culture. As we've discussed before, at the heart of our company is our digital platform, which is being worked on by an internal team of over 100 dedicated product and engineering professionals, and several dozen more externally on both sides of the border. In Canada, our platform is quickly becoming one of the most important stretches of the digital health superhighway for healthcare communications by enabling interoperability between HIS systems and core EMR systems and primary and specialized care providers.
This was recently evidenced by our recent win with OceanMD in British Columbia, where we were awarded a significant CAD 38.5 million contract by the PHSA to help modernize and digitize the province's workflows with our next generation eReferral and eConsult platform. This contract win exemplifies just how strong our platform is, especially given that we now have substantial contracts with Ontario, Nova Scotia and now BC, with other provinces engaged deeply with our business development teams. We are now working on taking our platform to the next level by elevating our product roadmap with the help of AI-related technologies. We're pleased to report that all of our business units are executing well, and we're expecting to have strong performance for the remainder of 2023.
The company does not foresee any material influences or challenges that would impair its ability to deliver solid results in 2023, as we are poised to invest in and achieve significant growth while delivering on enhanced profitability. Just last month, we increased our annual guidance by CAD 50 million to be in between CAD 740 million and CAD 760 million for the year. I'm pleased to provide an upgrade to our revenue guidance, which we now expect to be in the upper half of the CAD 740 million-CAD 760 million annual guidance. Essentially, we're expecting annual revenue to exceed CAD 750 million, representing annual revenue growth of at least 32%. Just a reminder, our guidance does not include any unannounced acquisitions.
We also continue to guide for maintenance of rule of thirty performance for the year. Achieving CAD 750 million in revenue this year is a significant milestone, which demonstrates that we're well on our way to reaching CAD 1 billion in annual revenue. Our strong organic growth profile and compelling acquisition opportunities gives us visibility into achieving CAD 1 billion revenue run rate within two years. For our Adjusted EBITDA, we're also pleased to reiterate our guidance for annual Adjusted EBITDA to increase by more than 10% over 2022 levels. Our revenue growth continues to outpace our EBITDA growth in 2022 due to the reinvestment of any excess cash flows back into the business for growth. In addition, our acquisitions this year have had lower operating margins than our existing businesses.
It is quite common for us to acquire businesses that aren't as profitable as our own, as we then digitize and modernize these assets and increase their operating margins to be more in line with our own profitability profile. This is what we do, and this is what we have a proven track record of doing, improving the growth and profitability of our acquired assets. With that, I would now like to turn the call over to our CFO, Eva Fong, who will review the financials for fiscal quarters, 2nd fiscal quarter, 2023. I will then come back and provide further commentary on our business units and outlook. Eva?
Thank you, Hamed. I'm pleased to report that we had very strong results for the three months ended June 30th, 2023. Our overall second quarter results were as follows: WELL achieved record quarterly revenue of CAD 170.9 million in Q2 2023, an increase of 22% as compared to revenue of CAD 140.3 million generated during Q2 of last year. This growth was driven by acquisitions and organic growth. Year to date, WELL has achieved organic growth of 15%. WELL achieved record Adjusted Gross Profit of CAD 90.8 million in Q2 2023, an increase of 20% as compared to Adjusted Gross Profit of CAD 75.5 million in Q2 2022. Growth in the company's Adjusted Gross Profit is attributable to higher revenue in the period.
Adjusted gross margin percentage was 53% in both Q2, 2023 and 2022. WELL achieved record Adjusted EBITDA of CAD 27.8 million in Q2, 2023, an increase of 5% as compared to Adjusted EBITDA of CAD 26.4 million in Q2 of last year. Adjusted EBITDA attributable to WELL shareholders was CAD 22.3 million in Q2, 2023, an increase of 16% as compared to Adjusted EBITDA attributable to WELL shareholders of CAD 19.2 million in Q2, 2022. Adjusted net income was CAD 14.4 million, or CAD 0.06 per share in Q2, 2023, as compared to Adjusted net income of CAD 17.5 million, or CAD 0.08 per share in Q2, 2022. WELL generated 11% of its revenues...
from truly recurring and subscription revenues, 87% of its revenues from its highly recurring patient services revenues in Q2 2023. This means that approximately 98% of its revenues are highly predictable. I will now review our semantic Q2 results. Our Canadian patient services business achieved another record quarter, with revenue of CAD 54.2 million in Q2 2023, an increase of 24% as compared to CAD 43.7 million in Q2 of last year. With both primary care and MyHealth specialized care clinics achieving record revenue in this quarter. Primary care revenues increased in 39% to CAD 24.9 million in Q2 2023, compared to CAD 17.9 million in Q2 2022, primarily due to organic growth and acquisitions.
During the second quarter, we completed the acquisition of five primary care clinics located in Calgary, Alberta, from MCI Onehealth Technologies Inc., which are expected to generate approximately CAD 10 million in annual revenue. In Q2 2023, MyHealth revenue increased 13% to CAD 29.3 million, as compared to CAD 25.8 million in Q2 2022. This year-over-year growth is attributable to an increase in diagnostic procedures performed and the addition of new cardiologists to MyHealth's practice. The second quarter is also the seasonally strongest quarter for MyHealth, resulting in a 12% increase in revenue compared to prior quarter Q1 2023.
Our WELL Health USA patient services revenue was CAD 103.5 million in Q2 2023, an increase of 30% as compared to CAD 79.6 million in Q2 2022, driven by growth over the past year in all three of WELL Health USA's lines of business, that is, Circle Medical, WISP, and CRH. In Q2 2023, CRH revenues were CAD 63.4 million, an increase of 25%, as compared to CAD 50.9 million in Q2 2022. CRH, CRH's case volumes also continue to be very strong, with over 135,000 anesthesia cases completed in Q2 2023, an increase of 8% compared to Q2 2022. Case volumes in the second quarter were positively impacted by the acquisition of Affiliated Tampa Anesthesia Associates, which closed in the prior quarter in Q1 2023.
CRH sold more than 32,000 O'Regan System units in Q2 2023, compared to over 45,000 units sold in Q2 2022. This year-over-year decline was due to a promotional campaign in the prior quarter, Q1 2023, when CRH saw a record of over 59,000 O'Regan System units. With the conclusion of this promotional campaign, Legata unit volumes decreased in Q2, but have now returned to near normal levels in Q3. Circle Medical revenues were CAD 21 million in Q2 2023, an increase of 34% as compared to revenue of CAD 15.6 million in Q2 of last year. Although Circle Medical experienced strong year-over-year revenue growth, as we had guided in our Q1 conference call, we were expecting softer results as compared to Q1 2023.
Circle Medical has been focused on expanding its physical clinic footprint over the first half of the year to support the forecasted end of the public health emergency by the U.S. federal government. That would end some COVID regulations associated with telehealth medicine, which, which, more in-person visits is required. Circle Medical now has 27 physical clinic locations across 21 states in the U.S., a significant increase compared to last year, when Circle Medical only had twi physical locations in the state of California. As Hamed will cover in the outlook portion of our comments today, Circle Medical is back in growth mode now, and we're expecting a healthy finish in the back half of the year.
WISP achieved revenue of CAD 19.1 million in Q2 2023, an increase of 46% as compared to revenue of CAD 13.1 million in Q2 of last year. In the first half of the year, where customer acquisition costs are lower, we were intentional in reinvesting operating cash flows generated by this business back into WISP's growth. The balance of the year should continue to see strong growth with slightly improved profitability. SaaS and technology services revenues were CAD 13.3 million in Q2 2023, a decrease of 22% as compared to CAD 17 million in Q2 2022. This decline was due to timing of contracts in the company's cybersecurity-related business. Cybersecurity and data protection revenue tends to be lumpy, which resulted in strong quarterly revenue in Q1 2023, followed by lower revenue in this quarter.
We are expecting Q3 revenue to bounce back again for this segment. Outside of cybersecurity, our remaining SaaS and services platform business increased 29% on a year-over-year basis to CAD 11.3 million in Q2 2023, from CAD 8.8 million in Q2 2022. WELL Health ended Q2 2023 with a solid balance sheet. As of June 30, 2023, WELL Health had cash and cash equivalents of CAD 35.6 million. WELL Health continues to be in good standing and fully compliant with all covenants related with its two credit lines, JPMorgan in the U.S. and Royal Bank in Canada. The debt from the two credit lines was approximately CAD 233 million as of June 30, 2023.
I'm also pleased to report we have further reduced WELL's shareholder leverage ratio to 2.3x as at the end of Q2 2023, compared to 3x as at Q2 2022, and compared to 2.6 x in the prior quarter as at Q1 2023. We define leverage ratio as net bank debt, excluding convertible debentures, less cash on hand, divided by shareholder adjusted EBITDA. The improvement in WELL's leverage ratio was achieved by a decrease in the company's debt levels and an increase in shareholder adjusted EBITDA over the past year. In terms of our share capitalization, as of August 9, 2023, WELL had 257,539,249 fully diluted securities issued and outstanding. That is my financial update, and I turn the call back over to Hamed.
Thank you, Eva. I will now provide some specific outlook on our business units. First, with primary care. We're expecting our primary care business to exhibit healthy growth in the second half of the year due to both organic growth and the acquisition of clinics from MCI Onehealth in Alberta and Ontario. During the second quarter, we completed the acquisition of five clinics from MCI, which are located in Calgary, and will have a positive revenue impact to our Q3 results. On July 19th, WELL Health entered into an agreement with MCI that includes the acquisition of all but one of their clinical assets located in Southern Ontario, which are expected to generate annual revenues of more than CAD 21 million.
This acquisition brings more than 130 physicians to the WELL Health family and significantly expands WELL Health's footprint and breadth of services in Ontario. These MCI clinics in Ontario are expected to come on board in October and provide a revenue boost to our primary care business in the fourth quarter. Initially, we're expecting EBITDA to be negatively impacted by the acquired MCI clinics in Alberta and Ontario. Notwithstanding this, we've established a strong plan to improve the efficiency and output of these clinics by leveraging WELL Health's operating playbook, which includes extensive use of our Practitioner Enablement Platform. As we go through the process of digitizing and modernizing these clinics, we expect them to become profitable in 2024.
One of the exciting aspects of this acquisition is the fact that we will now have a much larger base of primary clinics, care clinics in Ontario and can refer into our MyHealth specialized care network, which will only strengthen our overall business in Ontario. That leads us to MyHealth. MyHealth had an outstanding quarter with strong year-over-year growth and improved profitability, with Q2 being seasonally the strongest quarter for MyHealth. We do expect MyHealth's revenue to decline in Q3 2023 compared to Q2 due to seasonality. However, we anticipate a healthy trajectory as demonstrated in year-over-year strength in the back half of the year. In reference to Ontario's Bill 60, Your Health Act, which allows out-of-hospital facilities to perform publicly funded surgeries and diagnostic procedures, including MRI and CT, we continue to await the highly anticipated final regulations and call for applications for licensing.
Although exact timelines are not publicly released, we anticipate a call for applications to occur in Q4. MyHealth Centre continues to be highly engaged throughout the process with the optimism of serving the patients of Ontario and helping reduce MRI and CT patient times the following calendar year. If successful in obtaining MRI, CT licenses, additional capital costs to purchase the scanners and extensive leasehold improvements would be required. We anticipate lead times of close to nine months to have these services fully operational in clinics. As such, we don't expect any revenue in 2023 from the release of this regulation. I'll now discuss the outlook for our newly branded WELL Health USA business. On July 27th, the company announced that it had rebranded CRH Medical and launched WELL Health USA, a multidisciplinary healthcare business spanning primary and specialized care with on and offline operations at scale.
WELL Health USA's goal is to mirror WELL's mission of tech-enabling care providers in the United States while digitizing and modernizing their healthcare businesses. In addition, WELL Health USA will leverage its deep U.S.-based healthcare expertise and structural advantages to create a whole new category of shared services that will benefit and deliver improved integration and facilitate further growth between WELL's U.S.-based lines of business. WELL Health USA is a highly profitable and rapidly growing business, with operating run rate revenues of approximately CAD 500 million. It's also important to note that we have a really outstanding team there, with over 100 years of combined experience in allocating capital, integrating and growing healthcare businesses, and working inside of some of the largest and most prominent healthcare companies in the United States.
The different lines of business under WELL Health USA include CRH Anesthesia, CRH O'Regan, Radar Healthcare Providers, Circle Medical, and WISP. I'll now provide a quick update on these businesses. First, CRH. CRH is having an outstanding year so far. We expect CRH Anesthesia's case volumes to continue to follow normal seasonal patterns in 2023, with the highest number of cases increasing in each quarter, with Q4, 2023 again being forecasted as the strongest revenue quarter again this year for CRH. CRH Anesthesia Services should get a boost in revenue in Q3 from the addition of 18 ASC practices from the CarePlus acquisition as well. Also, CRH's efforts to digitize operations are bearing fruit. CRH has invested substantially into its revenue cycle management program, with implementations of numerous new digital tools designed to improve business intelligence, collections visibility, and collections performance.
On June 22nd, 2023, the company announced that CRH had made strategic investment in Graphium Health, a leading EMR company focused on anesthesia practices. The investment is part of a strategic alliance designed to further digitize and modernize CRH's back, billing and back-office processes. Based on a recent pilot project with Graphium Health, CRH had demonstrated that it had improved its time to capture billable charges by 58% or 5.6 days, and reduced its overall accounts receivable balance at the pilot project site by 24%. As a result of the successful pilot and investment, CRH Medical plans to expand this initiative to at least 54 additional ASCs over the next three years, where CRH provides anesthesia services. Secondly, Radar. We're very pleased to be welcoming the Radar Healthcare Providers team to the WELL family as part of the Care Plus acquisition.
Radar provides staffing and locum tenens services focused on anesthesia providers, with a specialization in anesthesiologist recruitment and placement for its network of customers, which include provider groups, hospitals, and ASCs across 29 states. With a database of over 70,000 anesthesia providers to leverage, Radar has served over 150 clients to date and is well positioned to further increase its footprint of providers and clients. Radar adds significant upside for growth and diversification beyond clinical anesthesia services to include recruitment services. Radar is also well positioned to serve as a shared service provider, shared service for provider recruitment and billing services to the other U.S.-based businesses in WELL's portfolio. WELL Health USA intends to expand the scope of Radar to other specialties and healthcare professionals, such as physician specialists, primary care, and nursing professionals.
We're off to a great start with Radar so far and seeing revenues and growth in line with our expectations. Now for Circle Medical. Last quarter, we mentioned that there would be some temporary softness in medical, Circle Medical's Q2 results, as management's focus had shifted from expanding its physical clinic network and the prompt return to growth as the company makes growth its primary priority again. We were right on both accounts. The Circle Medical team put an enormous amount of focus and energy into being compliant with the end of the Public Health Emergency in May, and expected removal of COVID era waivers, allowing companies such as Circle Medical to prescribe controlled substances via telemedicine.
This involved expanding its in-person clinic network from a few clinics to 27 and seeing over 13,000 telemedicine patients, 66% of our target in person within one quarter, a logistical feat unmatched by Circle's competitors. The waivers were extended at the last minute, and we are optimistic that recent moves by the DEA will lead to a more flexible regulatory environment that allows for prescription of controlled substances without an in-person appointment, where clinically appropriate. Either way, we are resilient and extremely well prepared for any direction that the DEA takes, given our robust in-person clinical network and proven ability to rapidly adapt to changing circumstances. We were accurate in our prediction of a rapid return to a focus on growth post-public health emergency.
Based on booking data, we have high confidence that Circle Medical is already exceeding a run rate of over CAD 100 million, and profitable in August, and we expect strong month-over-month growth for the balance of the year. The growth in revenues and our projections for the balance of the year has primarily to do with Circle Medical growth team, turning their attention from establishing a strong physical network to onboarding physicians. In fact, in the last four weeks, we have increased the number of physicians onboarded by more than 25% over the previous month, and continue to ramp up as we have retooled our provider recruitment process to onboard more providers in less time than before. Now a few words on WISP.
Last quarter, we discussed how WISP is retooling some of its key product and distribution partners, which resulted in slower growth in Q2 and minimal Adjusted EBITDA contribution in the first half of the year. I'm pleased to report that WISP has mostly completed this work, and we are now expecting revenue growth to be stronger in the second half of the year with improved profitability. Additional spending in Q1 and Q2, primarily on marketing costs to gain new patients and drive additional revenues, is already starting to pay off thus far in Q3. In fact, July was a record month of revenue for the company, with $5 million in revenues. With the recent launch of our new and improved online platform, we are now able to launch new products more quickly and efficiently and have plans to launch 10 new products over the next several months.
For example, just a couple weeks ago, WISP became the first telehealth brand in the United States to bring DoxyPEP, the morning-after pill for STDs, to market. Finally, our SaaS and technology services business. As we had previously guided in our last call, cybersecurity and data protection business had close to its best quarter ever in Q1. Being a lumpy business, Revenues declined in the second quarter, as we had expected. Cybersecurity revenues can often be impacted by the timing of hardware shipments at the end of the quarter. Thus, far our Q3 is looking like a stronger quarter again, with several contracts delivered. We're expecting a bounce back in cybersecurity revenues, while the rest of the SaaS services business continues to perform with steady growth and profitability.
OceanMD is a key component of our SaaS and technology services group and is emerging as a leader in patient engagement and eReferral solutions. Ocean's eReferral software allows primary care providers to send their requests to surgeons through the Ocean eReferral network instead of faxing, emailing, or mailing, which makes surgical consult referrals easier and reduces wait times for patients. OceanMD is already the dominant eReferral solution in the province of Ontario. Last quarter, we reported that OceanMD has been selected by the province of Nova Scotia for its eReferral solution, and this week, obviously today, OceanMD, we reported, signed a CAD 38.5 million contract with BC's PHSA to provide an array of digital services such as eReferrals, eConsults, and eOrders, to help tech-enable providers with the best-in-class digital interoperability tools.
With this win in BC, we feel Ocean MD has the potential to become the e-referral standard across the country. Ocean MD has notably proven its ability to reduce wait times by as much as 52 days, including a 35 day reduction in referral processing time alone, thereby significantly improving access to care. In Ontario, the implementation of Ocean MD's platform was shown to result in a 12% reduction in medically unnecessary MRIs, underlining a direct cost-saving impact for provincial health systems. One of the things that is really truly special about Ocean is that it's the only piece of commercial software that we know of that connects with all the major EMR and HIS systems in the country.
That means that it connects into TELUS Health, Accuro, WELL's OSCAR, and other EMR systems, in addition to major EMR and EHR systems for hospitals such as Epic and Cerner. Moving on to the WELL EMR Group, we're also very excited to report that our Intrahealth EMR team was selected by another government agency in New Zealand on a significant multimillion-dollar contract, which includes over CAD 1 million in ARR and more than CAD 1 million in implementation services. I'll now provide an update on our AI-related activities. We're incredibly excited about the potential of AI in healthcare. Our vision is that AI-powered solutions can have positive impact on the healthcare sector by giving healthcare providers clinical and decision support tools that will give them their time back, enhance clinical productivity, and provide a better patient experience.
We're determined to faithfully support and tech-enable healthcare professionals with the very best technology available, which now includes significant investments in AI-based products and services. Last quarter, I highlighted that WELL Health had made AI a priority, and I'm pleased to report that we're starting to see some of the operating improvements as a result of leveraging AI internally, including, one, reduced team member queue, queue monitoring. One of our platform team's first, first-line support group now leverages GPT-4-powered AI solutions that pull answers from internal resources and automatically responds to inquiring customers. Two, we're leveraging intelligent chatbots to provide improved access to knowledge outside of support hours, as well as improved response rates and experience for patients who are reaching out for support.
Three, a number of our internal development teams have been heavily leveraging Microsoft GitHub, Copilot, and starting to benefit from generative AI solutions that can significantly increase developer productivity. In addition to this, we're working on compelling new products and enhancements to roll out to our provider network. In Q2, we did just that with the launch of several key initiatives, including WELL AI Voice and the WELL AI Investment Program. A few words on AI Voice. WELL AI Voice is a transformational ambient scribe product that leverages generative AI to dramatically reduce a provider's administrative burden by privately and securely capturing a patient encounter and conversation, and automatically generating a succinct and medically relevant chart note for the patient interaction.
WELL AI Voice is a powerful tool that is able to communicate seamlessly with WELL's EMR products, making it easy for providers to deploy, manage, and benefit from the technology quickly without having to harmonize the usage of disparate tools. Providers love WELL AI Voice because it allows them to focus more of their consultation time on the patient and spend less time taking notes. Patients love the experience because they no longer have to compete with the doctor's laptop for attention. One of our physicians was recently quoted by our sales team as saying, "WELL AI Voice has made my work life amazing, and now I look forward to coming to work to use it." Strong statements like this demonstrate the value of WELL AI Voice and the real impact it has on day-to-day lives of physicians.
We've had a controlled rollout to ensure quality, safety, and security, and ensure that results are as intended to date. We can say that WELL AI Voice has seamlessly integrated into more than 5,000 patient visits so far. We've seen strong user growth, with the average physician using the tool for more than 230 sessions per month. All this demonstrates growing trust in our product and its efficiency in the real-world healthcare setting.
While we are providing this technology for subscriptions in our EMR network, we are also planning to roll out it out to the majority of WELL's primary care operations in the balance of the year and are excited about the benefits that it, that it affords our internal network. As part of our commitment to developing AI technologies, WELL announced the AI investment platform, whose goal it is to invest in at least 10 companies and to ensure that each investee has a strategic alliance agreement with WELL and allows it to benefit from WELL's healthcare ecosystem. Since launching the program, we've already connected with more than 125 new companies and have spent considerable time to narrow down the group to approximately 30 companies, where we're having deeper conversations.
We are already in discussion on terms with a handful of these companies and expect to have some exciting developments to share soon. Before we conclude the call, I'd like to provide some additional commentary on the MCI strategic alliance and investment. As part of the agreements with MCI, WELL purchased the MCI Ontario clinics for consideration of CAD 1.5 million and acquired the debt of a key creditor for CAD 3.5 million to help facilitate the deal. Finally, WELL will also lead a new investment round into MCI, in which WELL will commit at least CAD 2.5 million as part of a convertible debenture financing of up to CAD 10 million. Going forward, MCI will be strategically focused on its leading AI, data science, and rare and complex disease detection platform.
Well also intends to enter into a strategic alliance agreement designed to provide Well clinics with leading-edge technology from MCI and better position MCI as a key national leader in Canada. As part of the strategic alliance, Well will join MCI's board of directors, and subject to satisfaction of certain conditions, Well will also hold an option to acquire up to 30.8 million Class A and Class B shares in MCI over time. This means that Well will have an opportunity in the future to acquire control of MCI OneHealth in the event it elects to do so. It elects to acquire the multi-voting shares it has optioned out, subject to the terms and conditions of its various agreements, covenants, and rights. We believe the multi-billion dollar disease detection industry is a big opportunity for MCI with its CureHealth platform.
CureHealth is already available on the apps.health platform and is integrated into WELL's OSCAR Pro EMR. We're looking forward to working with MCI in developing and amplifying this world-class technology. In addition, we believe MCI is an ideal company for building additional healthcare-related data science and AI technologies. We're really excited about the upside investment potential offered by the new strategic direction and the recapitalization of MCI OneHealth. We have big and extensive plan, plans here, folks. Stay closely tuned. In summary, we are very pleased with our financial performance thus far in 2023 and look forward to delivering strong results again for the balance of the year. Our outlook for 2023 remains positive. Hence, I am confident in upgrading our annual guidance again, with more of our guided EBITDA appearing in Q4 versus Q3.
Please keep in mind that the big contract we'd announced today doesn't contribute meaningfully to this year's results. We have many tailwinds driving growth in the business, and we have a committed and disciplined team to ensure that we're able to execute on our objectives. In closing, I will provide an update on our ongoing ESG program. I'm proud to have released WELL's second ESG report on July seventh, entitled Taking Care of The Care Providers. This report highlights WELL's ESG strategy, reporting initiatives, and targeted actions. WELL is a purpose-driven company that aims to transform the world for the better. As such, our ESG report outlines this objective. Finally, I want to thank you all for joining us on this call today, and thanks to our shareholders and investors for their continued support.
The capital markets have been very supportive of our vision and have provided us with the funding needed to pursue our goals and support our providers. I would also like to thank WELL's senior management team and all our employees and contractors for their tremendous effort. In particular, I'd like to thank our team of healthcare practitioners and other frontline workers who provide unbelievable patient care. They remind us every day why we're here, and we are here to support them. With that, we will be open to receive some questions now. Operator, can you please facilitate?
Thank you. Ladies and gentlemen, we will now begin the question and answer session. Should you have a question, please press the star followed by the one on your touchtone phone. You will hear a three-tone prompt acknowledging your request. Questions will be taken in the order received. Should you wish to cancel your request, please press the star followed by the two. Your first question is from Allen Klee from Maxim Group. Please ask your question.
Yes, congrats on the strong results. In regards to the OceanMD contract with British Columbia, that's for CAD 38.5 million. Can you tell us when you think revenues may start and the CAD 38.5 million is spread over how many years?
Thanks, Allen, for the question. It's a five-year contract. For the balance of this year, we expect to do some services work, so, it'll be fairly minor revenue generation this year as we, as we sort of ramp up the services and implementation side of the business. Then we'll start to see the real licensing revenue come on next year. I think, you know, then we'll see, you know, much more meaningful contribution, you know, to our, to our results next year.
Thank you. One other follow-up question. For Circle Medical, could you go into a little bit more of the actions that you've taken and why that gives you confidence that with the change in the regulations, that this is going to return to growth mode? Thank you very much.
Yeah, thanks. I mean, it was really just the focus of the team. You know, the entire focus of the team went to preparing for the PHE, as that was a, you know, a date that was very much forecasted by the Biden administration. At that point in time, it was forecasted that a number of those COVID-era conveniences would fall off. It was very important for us to have the in-person network set up. Since that time, that same team has now, you know, moved their focus towards growth. We're very pleased with what's happened because, again, based on booking data in August here, we can certainly see that has been, as we thought would be, a U-shaped recovery.
This was a sort of a, a temporary. Let's think about it as a lost quarter of growth, really, to support the PHE, and now we're back to the kind of growth that we had been accustomed to over the last couple of years. We, we are. It's really the focus of the team and the retooling of the provider acquisition. We are frankly seeing, you know, tremendous results in provider acquisition. Provider acquisition was, was, was fairly impacted by the focus on the PHE. Now that, that, that whole growth team is, is back focused on, on, on engaging those providers. I believe just in one week, we onboarded between 15 and 20 providers, which is really incredible and very, very difficult to do.
Thank you.
Thank you. Your next question is from Christian Sgro from Eight Capital. Please ask your question.
Hi, good afternoon, and thanks for taking my questions. I'll also start on the OceanMD win this morning, and congrats. We already asked about the timeline there and what to expect this year and next. I'm just wondering, you know, with Ontario and Nova Scotia already live, is the model there? It, it seems transactional and doctors opt in, as the benefits are clear to practitioners and patients. Do you expect, you know, a similar sort of, of ramp as doctors come on board next year or the following, I guess, similar to, to the provinces you're live in already, for this all to become, you know, high-margin, scalable revenue over time?
Yeah. Thanks, Christian. you know, each of these contracts is a bit different. I would say that the, the, the BC contract is probably the best one so far, just in terms of the predictability that we have and, and for revenue. This is why we haven't really announced contract values before for Ocean. I, I, I think, I think we're, we're, we're very excited by that, and it, and it reflects kind of the, the plan to roll this out in a very comprehensive fashion in BC, which is, which has been a little bit different than, than the approach that was sort of organically taken in Ontario.
Even though the government, you know, backed it significantly and funded it, it was still fairly, fairly opt-in based and organic in Ontario, which obviously was very successful. As you're probably aware, we have over 8,000 physicians signed up in Ontario. We, we do expect, you know, again, a faster ramp here in BC. I hope that's helpful.
That's perfect. That is helpful. Thank you. I'll ask you just one more question. Another congratulations in order for the big CarePlus acquisition closing. My question there, just anything you're, you know, able to share on the financial profile to help with our understanding of the size and, and for modeling? And then you, you touched on it in the prepared remarks, but some of the synergies or integrations you see ready out the gate across that CRH in the U.S. business.
Sure. Yeah. I mean, look, I, I, CarePlus effectively has three components to it. From a revenue perspective, really, really two components, and that is the, the Radar recruiting and then the ASC business, which I referenced in my, in my script. You know, what's, what's, what's really unique and great about this asset is that, you know, the, the ASC component fits, you know, perfectly within our network. You know, we're, we're very good, likely, acquirers for that. But, you know, we already had a little bit of, of, of, call it, you know, personnel revenue at CRH. We were already sort of dabbling in this area of, of lending our providers out to other sites, and this really turbocharges that.
You know, the Radar recruiting really strengthens the entire CRH Anesthesia platform, but it then allows us to extend that platform into other forms of care providers, which then, you know, position us to provide, you know, very valuable, you know, shared services and provider recruiting to our other U.S. lines of business. We're very pleased with that. When we express, some of this confidence that we have in EBITDA, you know, it is really coming from the fact that, you know, we're getting some EBITDA from the actual acquisitions, but we're expecting some nice synergies there as well. You know, generally speaking, we expect there to be roughly a 10% EBITDA margin, you know, contribution with the activation of all those synergies.
Given what we paid for it, I mean, that really puts us in a position where, you know, we generally paid, gosh, you know, with, with all those synergies, probably in the order of 5x to 6x EBITDA. Obviously, we have to work hard to make sure that those are synergies that we can obtain. If you know well, you know that we are very, very rigorous in assessing those, those synergies. We would put these more in the, in the less speculative or non-speculative, bucket than we would the speculative. Hopefully, that gives you a little bit of color.
It's very helpful. Thank you for taking my questions.
Thanks, Christian.
Thank you. Your next question is from Rob Goff from Echelon. Please ask your question.
Thank you very much for taking my question, and congrats on the quarter.
Thanks, Rob.
You were, you, you were pretty bullish in terms of saying watch for big and substantial things from Cure and the data analytics. Can you describe a bit more of your, your picture there, your strategy, and like a timeline for that unfolding?
Well, look, I mean, you, you have to wonder, why are we so excited about making NCI a national leader? Really getting behind them. First of all, we've been watching NCI for quite some time. You know, we felt that they were a company, you know, with a great group of people and an excellent idea, but they were essentially two businesses. They were in a clinic business, and they were in the data science business. When we approached them, we said, "Gosh, we think we can be really helpful here, and help you focus in on one strategic focus." This is why it made so much sense for us to buy the clinics.
You know, we're not about to invest in another company and help make them extremely successful without being really involved ourselves. The ability for us to then, essentially, you know, leverage this option that we have negotiated as part of our transaction documents to be able to, you know, acquire, you know, Class A and Class B shares, which afford us access to their multi-voting shares, is, is, is quite meaningful and basically allows us to really consider the potential to activate a path to control with NCI. That's very meaningful. It's not something that happens every day, especially with a senior-listed TSX company. You know, we have a partnership already with them.
It's, it's a, it's an early stage one, but we have seen Cure Health in action within our apps.health marketplace, and we can see that it works. We can see that patients and providers are deriving value, the pharma community is deriving value. They have some of the biggest names in pharma that are paying to participate in, in this business. So again, our, our advantage in, in, in, in having this ecosystem-based approach with apps.health has allowed us to see the best that Canadian healthcare has to offer. We, you know, with, with now, you know, as I mentioned in my script, you know, we expect to dramatically improve the number of clinics that, you know, that Cure has access to and really empower our providers with that technology.
That really kind of overnight makes NCI, call it sort of the remaining company, a national leader. I think you're gonna see significant investments and growth in that business over time and, you know, quite a lot of enthusiasm. So, that's why I mentioned stay tuned and expressed the excitement around it.
Thank you very much. One more, if I may, and it's on OceanMD. Could you talk to whether the provincial wins to date have been on a competitive basis? Is this a platform that you could see taken across other Commonwealth countries?
Absolutely. All of these wins are extremely competitive, Rob. You know, we, you know, hats off to the talented and committed team at OceanMD and our platform services group. You know, you got to be really good to win these contracts. They're very long sales cycles that involve a tremendous amount of, of, of hard work, to, to, you know, basically surpass that threshold or proof to demonstrate, to provincial, and public health leaders that, that we've got what it takes. And look, yes, we're already thinking through our, our international strategy. You know, we've already started some conversations, but, you know, we have so much momentum here in Canada. We don't want to take our eye off the ball. As I mentioned, we do have other provinces that we're engaged with, and we hope to be, you know, talking about more wins, with Ocean in the future.
Thank you, and congrats.
Thank you, Rob.
Thank you. Your next question is from Michael Freeman, from Raymond James. Please ask your question.
Hi there, Hamed, Eva, Tyler. Congratulations on, on some really great results and, and, boosting-
Thank you.
... the guidance for the year. My question is on is on WELL Health USA. You know, I, I appreciate this, this rebranding and also, also the provision of shared services, very similar to the model that we see in Canada, and we see it working in Canada. I'm wondering what are, you know, in the early days of providing these shared services across the network, what are some aspects that are that are similar to the Canadian context? You can leverage the expertise from the Canadian context, and what aspects might be unique to the US context that you're tackling anew with this new effort?
Yeah. Thank you, Michael, for the question. You know, there's, there's, there's a number of ways where WELL Health USA can help our other lines of business. I'll give you one, one, one example. Each of Circle, WISP, and CRH presently use different legal and professional services. You know, they're getting, you know, they, they all have, you know, good, competent counsel and professional advisors, but they're different ones. So just, just, aligning and harmonizing that to one, we expect will, you know, improve cost performance. One of the key components of the recent CarePlus acquisition for CRH is Premier Choice Billing. So now we have, you know, quite robust revenue cycle management capabilities internally. You know, we, this is one big area of focus.
You know, this is not something we've decided to do, but aspirationally, one day we could decide to provide revenue cycle management to, you know, all of Circle, for example. Presently, Circle is paying an external vendor today, millions of dollars per year. That would be millions of dollars to the bottom line if we could activate that. Again, it's not something we've decided to do just a second, but I know it's something that management's really thinking about working on. That's a great example of, let's say, a more aggressive, aspirational one, and then there's lower hanging fruit, like legal, professional, insurance, you know, HR systems.
You know, you know, CRH just has, you know, very, you know, mature systems and, and, and excellent agreements that they've already, you know, structured with, with providers to support their employee base. There's, there's a lot to draw on there.
All right, great. That's very helpful. Now, I'd like to talk about the, you know, the acquisition pipeline you're, you're, you're dealing with today. I wonder if you could, you could describe, you know, the, the, that profile and, and composition of that, of that pipeline, you know, in recognition of, you know, this continued narrative coming from you and the team describing, you know, potentially CAD 1 billion in revenue within the next couple of years. And, you know, doing some quick math, it looks like, you know, another CarePlus type acquisition could nearly get you there. I wonder if you could comment on this.
Yeah, good point, Michael Freeman. Well, look, if we did another CarePlus Management-like acquisition, it would happen pretty much instantly. If you look at our revenue run rate, to achieve more than CAD 750 million for the year, our revenue run rate is obviously a lot, we're gonna end the year a lot higher than that. I would say that we're The reason why, you know, I'm mentioning it, and it's in our press release and my quote is, is we think this is a very achievable goal in the next couple of years without really big acquisitions. Just with respect to our regular sort of bolt-on, our diet of bolt-on clinics and our organic growth.
It's not to say that there won't be anything bigger, but I think, I think to your point, we can just accelerate that and draw that, that goal in a lot tighter and, and earlier if, if we make another big, big acquisition. So yeah, I mean, all, all those opportunities are at our disposal right now.
That, that's really helpful. If, if you'd entertain one more quick one. Also talking about CarePlus. You know, CarePlus, it looks like the EBITDA margin profile is relatively different from the rest of the business, and, you know, would likely impact the EBITDA profile for the balance of this year and going into next year. While some of the some of WELL's earlier acquisitions, you know, will benefit from the WELL's team's hands, being, being on it and optimizing profitability there. I wonder if you could talk about, you know, EBITDA outlook for 2024?
Sure. I knew this question was coming. We took a very deliberate approach in 2023, which was, you know, we wanted to demonstrate that we were committed to a certain material step up in EBITDA growth, but we were very intent on demonstrating that we are a growth company. Outside of that, of that defined step up in EBITDA growth, we were then going to invest the balance of our cash flows into growth, and that's really working. I think, you know, there are other, other companies that are very successful.
Again, looking at other mature TSX companies, you know, we, we, we've seen at least a couple that have employed this methodology, and I think it's going to be the same type of approach for next year. Where we then take our, sort of total, 2023 EBITDA. We then, you know, make a commitment, probably similar to this year's commitment, and we say, "Hey, look, we're going to continue to invest, the rest of our EBITDA and cash flow, free cash flow in, in growth." I think it's the right thing to do because, you know, we are still, you know, fairly alone, especially here in Canada, with respect to our, our activities and growth, and, and particularly in M&A, with, with smaller clinical networks.
I really wanna stay focused on growth, particularly because we, we've been able to demonstrate that as we grow and acquire these clinics, we have been able to help providers. By helping providers, the byproduct of that is we've been able to grow and improve margins and growth in these clinics. We're getting pretty good at this. Of course, we're, we're loading up on more clinics, so our, our, the execution will be more difficult, but we're up to the challenge.
All right, this is great. We look forward to seeing all this growth. Thanks very much, Hamed.
Thank you.
Thank you. Your next question is from David Kwan from TD Securities. Please ask your question.
Morning. Wanted to get some color on the Circle business. I know in the segment information, the EBITDA looks like it turned negative this quarter. I suspect that was obviously the distractions that led to the revenues declining sequentially, but I'm assuming also kind of the costs of all the clinics and the start-ups there. Just understand how you see the clinic rollout impacting the margin outlook for Circle's business?
Yeah, thanks, David. You're right. There's definitely, you know, a lot of with the focus of starting up and driving, you know, all, all that clinical infrastructure did impact our Q2. You know, we're done now. I mean, we're, we're not really expecting to grow the clinical network too much further at this point in time. You know, we built appropriately for the end of the public health emergency, and we, you know, we're very robust, we're very, we're very much ready for any, any decision that the DEA or the public health officials take in the United States, given that they've, they sort of kicked the can down the road on some of those COVID-era conveniences.
Just in the past few days, we've also heard that the, the DEA may again, you know, improve some of those conveniences. It's, it's possible that our clinic network is, is now very comfortable for us in terms of, of, of where its positioning is. I, I, I think we're well positioned. I think that we're, we're going to demonstrate, a, a, a fairly strong, you know, back half of the year, weighted, you know, in profitability into Q4, and I, and I think Circle's gonna deliver.
You expect that the business can return to positive EBITDA in Q3 and Q4 and into next year then?
Absolutely. Absolutely. We, we, we, we already see it in August. You know, July was a transition month, but we did see higher revenue. August, you know, definitely is on track for our growth objectives for the balance of the year. We will see positive EBITDA in Q3, you know, but much higher numbers in Q4. That's sort of what we're looking at.
Great. Just one last question: It looks like, I guess, 27 of the 33 clinics in the U.S. are Circle Medical, and I think the balance are the CRH branding clinics there. I'm guessing that none of them at this point are kind of multidisciplinary, where you might bring in services from WISP or CRH in particular. Just curious, you know, how many of those clinics would you like to see kind of these multidisciplinary clinics, similar to what you might have here or what you have here in Canada?
Yeah. No, thanks. We actually do have a couple of multidisciplinary clinics. We have a couple of sites where Circle and CRH are collaborating already, which is, which is great to see. We do expect that we're gonna start to add WISP over the next quarter or two. You know, those discussions in terms of, you know, what does, what does the WISP in-person offer look like? What does it tackle? Where would the sites be? Those are all starting to kind of roll out now, in terms of thinking through what the implementation of that would look like. I would say that's very much, you know, we're sort of setting the table this year and we'll provide some guidance for 2024.
I, I think we'll, we'll hopefully see some more momentum now that, you know, we've launched WELL USA into 2024 on multidisciplinary.
That's great. I appreciate it.
Thank you. Your next question is from Jason Zandberg, from PI Financial. Please ask your question.
Thanks for, for, letting me ask some questions. Just first of all, I'd like to again, congratulate you on the, the OceanMD contract. That's a big win.
Thank you.
I wanted to know, I wanted to know, are you able to talk at this point about any bids in the other provinces? Sort of what would be the expectations of, of rolling this out, you know, in, in other provinces?
Yeah. Look, I, I, I unfortunately, I can't get into specific names, but we do have one other province that we, you know, we hope to be contracting with in the not-too-distant future. And, and discussions with other provinces, you know, are always occurring and going on. The other thing I'll mention is that there are, you know, you know, further activities and developments ongoing on the, on the, on the national scale. You know, as, as we talked about earlier this year, there's increased investments going into, you know, from a federal funds perspective, into digitization efforts for the country. One of those priorities is eReferral for the country.
We are, we're also engaging in those efforts, and we do believe that they will bear fruit, albeit those will occur more slowly over time, and they could also show up and, and, and, and manifest through the provinces themselves. It is great to know and see that e-Referrals is a federal priority as well. Being already in a great position and really being a national platform already between BC, Ontario, Nova Scotia. I think we're very well positioned to acquire some additional business there. Hopefully, that's helpful.
Yeah, no, that's very helpful. Just, one further question. You, you talked a lot about the, you know, potential upside of MCI as a standalone after you've purchased the clinics in terms of their, their Cure AI applications. Just wanted to know in the, you know, you have that call option. I don't believe in the press release, it talked about the cost you to execute that. Are you able to divulge that information at this point?
You know, we, we haven't publicly, you know, talked about the quantum of the call option. I'll just say that it's not prohibitively expensive for us. Something that, you know, if, if we see the right environment and, and opportunities, it's something that I think is well within our means. That's, you know, I wouldn't be playing up our, our ability to carry out a, you know, and, and accomplish a, a, a, you know, pass the control transaction if that was prohibitively expensive. We'll just put it that way.
Yeah. Okay. No, that's great. Thank you very much.
Thank you.
There are no further questions at this time. I will now hand the call over back to your host for closing remarks.
Thank you very much, everyone, for, you know, being with us today and hearing about our developments. Thank you for the great questions from the analysts. Again, we are excited about our growth and momentum. Lots going on. We look forward to returning in three months and presenting our Q3 financial results. Until then, enjoy the rest of your summer. Be safe. Thank you.
Thank you. Ladies and gentlemen, the conference has now ended. Thank you all for joining. You may disconnect.