Good afternoon. My name is Lisa Gill, and I'm Head of Healthcare Services with JP Morgan. It i s with great pleasure this afternoon that I introduce Alignment Health. With us this afternoon, we have John Kao, who is the CEO, who will do the presentation, and then John will join myself and Thomas Freeman, CFO, for the Q&A portion. With that, let me turn it over to John.
Thank you, Lisa. We've got good news to share. We've got really good news to share. Before I share it, I wanna say something: We love Medicare Advantage. It's probably not something that you've been hearing all week, but we actually really, really like it, and we think that if you provide high quality with great outcomes at a fair price, you ought to be positioned to win in the marketplace, and that's what's happened with us. So I'm gonna get right to the outcomes I think you might be interested in. We had an AEP of 155,500 ending members for January first. It's about 47,000 of net adds equating to about 44% growth. 82% of that growth came from plan switchers in the marketplace, and eighty-six percent of that growth came from California.
I'm gonna talk about how, operationally, what we executed to get that growth in a second. The second thing you're thinking, I'm sure, is, well, with that kind of growth, are you gonna get blown up on your EBITDA guidance? The answer is no. We feel very, very confident that we're gonna get to EBITDA breakeven. He's laughing. I'm gonna tell you exactly why we have that degree of confidence as well. What's even more exciting is it sets us up really, really well for growth and, cash flow breakeven, Thomas is gonna kill me on when I say that, for 2025, and I feel really good about that as well.
And so it's really from the beginning of when we took the company public in terms of defining a new paradigm of doing Medicare Advantage is starting to come into fruition. So a couple of principles related to the model we think we have, and we, we'd like to call it a Payvidor. I'm not sure that's the perfect description, but what it does is it gives us visibility. It gives us visibility and control. And so some of the things you might have been hearing this week lack visibility. They don't have the data in a timely enough fashion to make certain actionable decisions. Because we're the plan, we can get that data, and we can do something with it. We have visibility to our cost structure. That's of critical importance.
The second thing is, the care model. It's a very capital-efficient way of controlling the costs. And so if you have the data, and you can point your resources toward where the money is, which is really in the polychronic cohort of your population, which is 10%-20% in that range, costs you somewhere between 80%-90% of the spend, right? So it just makes sense that you focus your resources there, and you do it in a capital-efficient way. We don't have a lot of bricks and mortar. That's a couple generations ago we did that. And so we use the data. We see people at the home. We have interdisciplinary care teams that take care of these patients that need the help.
This whole business was predicated on a model that is doing well by doing good, serving seniors, actually caring about doing the right thing to take care of your mom or your dad, right? And so the whole notion is, if you can identify who are the people that need the care, you envelop them with the care. What that does is it bends the cost curve consistently through control. You control the care delivery component on that component, that's where 90% of the money is. That's what allows us to invest in consistent benefits.
In turn, we spent a lot of time, you've heard us talk about in 2023, time and effort on member experience and member engagement, and our team did a wonderful job of keeping the members, the stickiness and the retention rates of our members, due to just service. Service delivery is working. So each one of these boxes you see are investments that we made to make this virtuous cycle, we call it, smoother and better running. And all of it in aggregate yielded the kind of growth that we were able to achieve. AVA, you've heard us talk about, is our technology stack. It's all predicated on this unified data architecture.
The data that we ingest comes in clean, it is cleansed, and then it's stored in a way that all the functional parts of the company can access information in a consistent manner. The reconciliation that a lot of the legacy competitors have takes that 30, 60, 90 days of latency, and that's something we've spent a lot of time on to make sure that we have real-time decision-making information. That data is then organized into these different kinds of modules: care management, stars, risk adjustment, infrastructure, and consumer growth. And so there's different kinds of applications within each one of these modules that, in turn, drive what we call value drivers. It's things you have to be good at, you have to be good at if you wanna be successful in Medicare Advantage.
On the revenue side, it's really stars, right? You've gotta be good at stars. We made a huge investment in stars last year, tracking numerators and denominators daily for every measure. This is a commitment. We took Tukey very, very seriously. It was tough. We just got by, but we did it. Very few people did in California, and we'll talk about that in a second. Risk adjustment, the suite of applications we track to be compliant on risk adjustment. When we started the business, we did not, and this was very conscious, we did not set RAF as revenue cycle. It was, in turn, part of our quality and care plan, clinical organization. Our overall RAF is, like, 1.13. It's not terrible. You know, it's not too high.
We knew there was gonna be an adjustment. We actually, you know, we talked about it for the last couple years. Adjustment came now in 2024 with V28 on the risk adjustment module. And so if you're at here at 1.13, you've got upside now. If you're sitting at 1.5 or above, you got a lot of downside. And so between the two, between stars, execution, risk adjustment execution, sales execution, branding, all of that, our AVA stack influenced to create the performance management that gives us confidence we're gonna get the EBITDA we want. Okay? This slide really is how do we do it? And the key takeaway here is, we actually manage the risk. We manage the risk, right?
We control the cost where the money is because we deliver the care to the people that are at the highest risk and the highest cost. You think about the other competitors, they don't have that capability, right? The cost management strategy is to delegate and capitate to these global cap providers. That's okay. It's a little tougher in a compressed reimbursement environment, right? Just the pure calculus of it is there's not enough money in the supply chain. I always say there's two insurance companies now. Somebody that's the, you know, the licensed insurer, somebody that's getting 85% of the global cap. It's, like, squeezing. There's not enough money in that supply chain.
We've always said, if you can be high quality at the lowest cost, you're gonna be in a position to create the highest value for that consumer. For your mom and your dad, you're gonna actually take care of with benefits, with access, right, with great service, and just treat them well. It's very, very simple. Then here, you see 74% of the membership is generally deemed to be healthy. Our algorithms would say they're healthy. They cost 5% of the institutional costs, right? 26% of the membership costs 95% of the spend, and we've separated those into three types of people. The far right, the chronic, is the polychronic. They're sick. They need help. They're the vulnerable, right?
We're there to make sure they get the care that they deserve, irrespective of income, gender, race, we take care of them. If you're a senior that needs help, we take care of you. Pre-chronic, 7%, 1% institutional claims, is pretty interesting. These folks are on the launching pad. They're not in the claims system yet, but all the algorithms, all the markers would suggest they are, they are going to need the same degree of help that the polychronic have. And then the healthy utilizer, 7%, that cost 19%, the algorithms would suggest they, they pretty much are healthy, but they had an episode requiring an admission. You know, they, they had a hip, or they had a knee or something like that.
All of this is to say, we use the technology, we use our AI to deliver more care, not to deny care, but to deliver more care, and we do that through our Care Anywhere teams. These are interdisciplinary care teams of doctors, APCs, medical assistants, social workers. All these people, every single day, are having meetings and doing rounds basically on patients. That's how we do it. It's all virtual, and everybody just knows. Everybody learns from each other. It's a very clinical organization. We're just getting better. You know, some of the algorithms that we have can define and estimate the number of people that are going to be admitted within the next 30 days, and we're continuing to increase that recall rate up to 64%.
What that means is the clinical model is getting better and smarter, and so we have really, really good clinical outcomes, 150-160 admissions per thousand. We're keeping people out of the hospital while keeping our Star Ratings high, right? That's a really good thing. It's hard to do, but it's a really good thing. And that's really what the secret sauce is that we have. Here's a timetable of investments since the IPO, and we've made investments in panel management, which is really, think of it as a case management workflow tool. CRM, we had to build from the scratch up, and that's the member experience module that's yielding huge returns through retention. Eligibility and benefit design, our whole bid process is extremely technical. We did a great job on the bids.
Really shout out to the team on that. The UM, the broker intelligence, provider data platform, case management. So all these different value drivers that are important to be successful, we've kept refining and continuous improvement, and they yield these kind of results. 90% of our members on four-star plans or above, or 4.5 stars in North Carolina and Nevada. A little bit pissed we didn't get to 4.5 in California, but we still have a chance for that for dates of service in 2024. Our NPS is 60, 4.9 star Google rating, and our disenrollment rates are 40% lower than the market. That 156 in the middle, inpatient admissions, it's very good cost management. We have very good visibility. Our clinical organization tracks this stuff daily.
It's a maniacal attention to detail, and it's organized in dashboards where they can see where the high-cost outliers are, and we manage it. Okay? And so that leads to the MBR for our Medicare Advantage business, 87%, and the five-year CAGR on the growth side of 27%. And so just to reiterate, the growth is... I'm sorry, the membership is 155,500 as of 1/1/2024. We are giving guidance that that's gonna increase to between 162,000 and 164,000 by 12/1, by the end of the year, which equates to about 38% from a 12/1 to 12/1 basis. Either way, it's very good, controlled growth.
The things that we experienced, and I would say we had tailwinds and stars, and we had tailwinds and risk adjustment, but we created those tailwinds. They didn't automatically just happen to us. And so we spent a lot of effort on retention, product leadership. Those are the bids and the tactics and the war simulations and the game theory for each and every market. Sales operations, we talked a lot about that during the year, and we executed with that, with leaders that we brought in, with more emphasis on distribution coming from our internal sources. Stars and tracking, I already mentioned that. Just transparency and sitting on top of it and grinding daily to make sure you hit those numerators and denominators.
Then we spent a lot of time on our networks, our IPAs, working with them and building our own, simulated IPAs, our pods, if you will, 'cause key is I love the IPAs, I love the medical groups, but they've gotta perform. They gotta get to five stars. They've gotta get the gap closed in risk adjustment. Gotta work with us on our Care Anywhere engagement. They need to grow with us, et cetera, et cetera. We've spent a lot of time kind of refining that network, and that led to the stars. The stars, you know, we're one of two public companies that have 4 stars in California heading into 2025. The stars that were just announced, a couple of months ago, have not yet been embedded in the 2025 bids yet. Right?
So we grew 44% with bids from last year, heading into 2024, where there's still a lot of people at four stars and some at 4.5 stars. Okay? So that's a lot of tailwind that we just created for ourselves heading into 2025. Care model continues to deliver, not only in California, but all the new markets. The performance is outstanding. Consistent, margin-focused, very disciplined. Some of you have been upset with us because we haven't just grown like crazy, but we weren't gonna chase bad business, and we didn't chase bad business this year either. It's very consistent. Consistent, profitable growth. And the risk model, same thing. Risk model is the phase-in of V28's gonna be coming in 2025.
That's gonna put more pressure on the folks that were at the 1.5 level and and above, and we see that as an opportunity for us. So those fundamental tailwinds have been really, really, thought through by us, and we executed on a lot of the operations we said we would. The other thing here, two things to just note in the, in the... There's the growth again, 44%. What's really important is the disenrollment, that middle section, right? It's like, people are not leaving. Once we get them, we're gonna also get them coded. We're gonna get them in our care model. They like us. They don't want to leave. That's so important, right? And then we're taking share. We're taking share like we told you we would. We're gonna focus, and we're gonna take share, right?
Here's why we have such high degrees of confidence in our 2024 EBITDA, right? Some of you are like, "We're worried, you know, to change your EBITDA guides." No, it's accretive business. All the bids are accretive business. We didn't raise our benefits from 2023 to 2024, 0.7%. Right? It's basically flat. Didn't chase bad business. $89 PMPM is the historical new gross-new member gross profit. We don't bid negative margin business, even for year one. You know, we're not giving golf clubs to people in our supplemental benefits. I mean, you know, this is good, solid business, and then you add to that the growth that will support the increased operating leverage.
You see kinda year-over-year, 15.9- 14.4, with those kinds of growth numbers, and you just add our growth year-over-year, you can just imagine. We're not giving guidance out yet on EBITDA or MLR or revenue yet. We'll do that come February. But we're gonna have increased operating leverage in our SG&A. All those things combined give us high degrees of confidence. The key thing is the visibility and the control. Visibility to the data soon, without latency, and then control of where the high-risk members are. That's the key and the differentiation about Alignment. You add to that this historical cohort analysis, where a new member comes in at 89%, and over time, it gets down into the 81% MLR range.
That's on the left-hand side. On the right-hand side, you have each vintage of year on the cohort. What's important to look at here is, since we implemented Care Anywhere, which is 2017, right, 'cause we knew who the people that were sick were. We had the data. We had the list. What do you do with it? That's when we implemented Care Anywhere, with those home-based care teams. The starting point is lower all the way across, and the ending point is lower all the way across. So, that contrasts to the left-hand slide, that's just kind of the average over time. But the trends are even better than what's on the left-hand side of the chart.
So you kinda add all that up, when we get the growth, that solid growth, and you add this cohort MBR improvement, it positions very, very well for 2024 and 2025. And two more slides. Just to emphasize here, the Stars advantage we have is widening. Is widening. If you look at this, 92% of our members are four stars and above. Come 2025, only 56% in California are gonna have four stars and above. That's a big deal. People are suing CMS. There's all kinds of stuff going on, right? But this was, this was not a surprise. Some people didn't take Tukey seriously. We did. CMS gave everybody ample warning for it. You know, we like it, what they're doing with Stars, 'cause it's, it's, normalizing the playing field in Stars.
We like what CMS is doing in V28, because again, it's normalizing the playing field. We like what they're doing with the broker commission stuff. It's making the playing field fair for the benefit of the consumer. That's a good thing, and that's where we're gonna start excelling, okay? And so really, to summarize, it's a breakthrough year for us. We've been very disciplined and patient, and the market has spoken in many respects. It is disruptive. It's designed to do Medicare Advantage. Investments in operations and AVA accelerating this virtuous cycle, it's making its flow better. Durable growth supports 2024 adjusted EBITDA break even. Stars. And I would say V28 are gonna be continued tailwinds for us, and 2025, I'm really excited about. I can't wait to get into those bids. With that, I think we're ready to take questions.
Great. Thanks so much, and John, thanks for the detail. I mean, a great open enrollment season for Alignment Health. When I think about some of the comments that you made, 82% were switchers. So if I think about that and the level of data and information you'll have on that patient, it's generally a better patient when we think about from a risk perspective. You also talked about 86% being from California. So how do we think about, you know, winning in the California market? What do you think was your differentiation as far as your offering goes this year? And then secondly, when I do think about that 82% that are switchers, anything that you would call out within that, I guess, class of members that are shifting over?
Yeah, it was fairly broadly distributed, meaning we got share gains from pretty much every single payer. Pretty much, you know, for-profit, not-for-profit. We get questions on, "Did you get all your... Did you get all your gains from, you know, the Bright membership?" No, we got some. I think Molina did a very good job of kind of retaining-
Mm
... those, actually. So it was across the board. And I think there's a buzz about Alignment now in the marketplace. I think some of the marketing and branding initiatives we did with Instacart created some buzz. The initiatives with Walgreens created buzz. We were very tactical in, introducing Luis Miguel as one of our spokespeople, and, and we did that kind of in, AEP, because we wanted to get the growth in OEP-
Mm.
... and also heading into next year. So that was very tactical and that created buzz. I think the other thing which is ironic is the 2025 star numbers, which came out in October, was really interesting. The broker community and the provider community value consistency. You guys kinda do what you say you're going to do.
Right.
And you do it. They respect that. What they don't like is, you know, kind of the bait and switch. We give you golf clubs here, and you know, and then you pull back, and you give a rebate, and you pull back. They don't like that. It makes them look bad. But you have consistent benefits across the board that you can retain, and you're servicing the members well, they respect that.
We, we see it in your retention number as well. I mean, is there anything you would call out there? It, the improvement year-over-year looks like it's about 100 basis points.
Oh, yeah. It's... If you recall in Q1, we were very direct. We had to make changes to some of our supplemental vendors. And we made those changes. We had to migrate them off of our chassis. We had to bring a new flex card vendor on. We had to insource our member services, again, to have that kind of control and quality that we wanted. And philosophically on the benefits, we made the decision to simplify the benefits, so that people could understand it and get what they think they bought.
Right.
It's just like, deliver what you say you're going to do, and, and we did it, and I think people appreciated it.
You also talked about stars for 2025, and if I look at your performance, it was a significant positive, especially versus the industry. What enables you to maintain that leading stars score?
I would say it's. We learned long ago, this is not a departmental function. We can't do it as a department. It has to be a company-wide commitment to actually serving the member. Like, you can't just. It's not a math exercise. Like, it's culture that is dictated by the board, by me, through every single person in the company, you just take care of that senior. And then second value of the company is support the doctor.
Right.
Support that doctor. If you actually do those two things, as people are beginning to understand MA now, it yields really good stars-
Mm-hmm
... and really good risk adjustment. I mean, it's, you know, it's, it's got, gotta be compliant.
You know, I know you and I have, over the years, have had these conversations about how do we think about your star ratings and think about breaking into new markets versus really driving membership in existing markets? Can you maybe just talk about how you're thinking about new markets?
Yeah. Yeah. No, great question. Our focus now is... You know, we've talked about expansion and scale.
Yeah.
I think the right word that we're really pinpointing now is replicability. Replicability. What's the playbook that's caused the success that we've had in California? How can we do that in other markets? And I think it starts with the provider, really an anchor provider partner. And we've got lessons learned throughout the years in starting new markets. I'm not sure I would do pure de novos, you know? It's just really hard. But if you have a good provider partner, an integrated delivery network of sorts, that have a lot of membership opportunity and branding opportunity or co-branding opportunity, I think that's a very exciting way for we to grow. And let me share this one vignette.
Yeah.
I don't know if we have time.
Yes, absolutely.
A lot of the health systems out there are, like, the branded health systems are at probably 120%-125% of capacity. They can't. There's too much demand for their beds, okay? They're getting reimbursed 100% of Medicare, fee-for-service, and they're losing money on it, right? The big guys are claims editing them, some of us have told us, to the point of 85%-86% of Medicare reimbursement for a hospital stay. Right, so they're getting hammered on Medicare admissions, which typically now is, like, 40-ish%, 42% of the hospital's admissions. And so what's the solution for that? And they've come to us, and they've said, "Boy, you know, your AVA and your ability to manage inpatient acute admissions is really good.
Right.
Can you help lower those admissions that we're getting paid 100% or less on? Because we have the brand to drive commercial volume-
Into, yeah
... into our hospitals at 200% of Medicare. And by the way, we want to joint venture with you on the plan side to drive market share." It's pretty direct. It's pretty like, logical, right? Hard to do, but we're spending some time figuring out how we can help some of these folks, and I think that will be disruptive.
Are there a lot of market opportunities around something like that? I mean, that-
Every-
... that seems pretty sophisticated.
Every one is the same. But the key is, you gotta kinda be one of these branded facilities that are 100+% of capacity.
Mm-hmm.
Doesn't work if you're at 70% of capacity.
Right. You touched a little bit on V28 and the risk model changes. You talked about your risk is today, right? When we think about the changes that are happening coming into 2024 and over the next three-year period of time. Can you maybe just talk a little bit more, give us a little bit more additional color on how we're thinking about your membership growth as it pertains to this, how you think about your existing book of business, and are there ways to manage through these risk model changes?
Yeah. I mean, it started with us from day one, is not to get hooked on high RAF.
Mm-hmm.
You know? Because if you get hooked on high RAF, you get high revenue, and if you get high revenue, you build your infrastructure around that high revenue, and when it comes down, you get hammered, which is what's happening in the industry. And so, and so particularly with some of the delegated providers, I mean, it's... If they're taking, excuse me, 85% of the risk with kind of not perfect visibility, what do you think is gonna happen? I mean, it's, like, not that complicated. For us, by starting at a reasonably, I would say, conservative, I don't think it was terrible, but it's like a conservative level, and I think, Thomas, we're at 1.5%, something like that? 1.5% a year.
Oh, yeah, yeah.
Yeah, the impact from V28.
Yeah, yeah, that we're gonna get phased in. And so on a relative basis, the key thing is it's relative.
Yeah.
Our hit is a lot less than our competitors. That gives us pricing flexibility in our bids, right? So those are the two kind of value drivers-
Mm-hmm.
-on a relative basis that we think about. And so as we think about 2025, for example, you're gonna look at, okay, in this market, we're, you know, whatever, 4.5 stars or four stars. Somebody else is, you know, 3.5 stars. Somebody else dropped from 4.5-3.5 stars. What's the financial delta, the economic delta-
Right
... between that drop? And then you add your risk adjustment-
Right
... delta to that also. That's just, we just get more revenue to start.
Right, which is gonna give you more flexibility.
More in the bids. That's right. And you add to that the cost management, the control dynamic. You know, there's a lot of conversation around utilization. Yeah, we've had a little bit of an uptick, but we also said in our 8-K, we feel very comfortable with our Q4 numbers. We're reiterating that, and we're still comfortable with 2024 breakeven.
Can we maybe talk about some of the newer states, you know, progress in places like Texas and, and Florida? I know last year we talked about that it was a little bit disappointing versus what you were hoping-
Mm
... to achieve from a membership perspective. But you, you've also talked about targeting 10,000 members in these new markets by year five.
Yeah.
Is that still the goal?
Yeah.
How do you think about 2024 and 2025 stars, and could that accelerate this timeline?
Yeah. No, yeah, what we've said is pretty much every market we've launched, you get to about 5,000 members in year three, and then once you get to 5,000, you get more mature, you have more durable management, you have more broker relationships, et cetera, and you get to 10,000 by year five. And so we want to get to that kind of operating market-
Mm
... breakeven by year three. So each of the markets we have are right around 4,000 or 5,000 right now.
Right.
It's kind of a little bit behind, but it's okay. Texas, we had, like, 100 members last year. I think it's gonna be about 3,000 this year.
Mm.
So we had a really good growth year in Texas, and we kind of built the relationships with the broker community that really resonated, and that helped. Same with. We have a handful of very, very good provider partners and health system partners. And then I'd say in Florida, we're just being very, very disciplined.
Is that because the market's so competitive?
It's so competitive, and you, we, you need, I think, an anchor medical group-
Mm-hmm
... or an anchor IDN that's differentiating, and we're spending a lot of time on that kind of development process right now. But we were very conscious to, we didn't invest in Florida until we find that partner, and we have a few opportunities.
I know you're not giving guidance today on 2024 outside of membership numbers, but just curious around your thoughts on medical cost trends as we're exiting 2023? I know that there's been a lot of talk around that here at the conference this week. And then how do you think about how that sets you up going into 2024?
Yeah. Yeah, absolutely. So, the kind of common themes this week, I think, have been around outpatient utilization. Some of the Part B drugs have become of interest with the investment community. And then the supplemental benefit utilization has been one of the new hot topics.
Right.
Across the board, from an outpatient standpoint, you know, we're really singing the same tune today that we were six months ago. This past summer, when this topic first came up, we really weren't seeing much of an increase year-over-year from 2022 to 2023. And in fact, as we close out 2023, I think we'll have seen probably a, you know, $3 PMPM increase year-over-year. But I think where our experience differs in the outpatient setting is in 2022, we did see a more significant increase as compared to 2021.
In other words, I think some of that increase for us came back sooner than maybe some of the large national players, and so I think we kind of weathered that storm during 2022, and that positioned us to not have as much of an increase in 2023. So I think we feel really good about the outpatient utilization. In terms of the Part B drugs, we have seen some of that increase in the oncology space in particular, but very much in line with expectations and something we anticipate continuing to increase in 2024. But I think we're looking to make sure we partner with the right vendors who have that oncology expertise to help us manage some of that spend.
But again, what we're seeing from an increase year-over-year standpoint has so far been very much in line with what we would have anticipated in 2023 and based on what we have in our 2024 bids. And then lastly, I'm really proud of the team on the supplemental benefit expectations that we baked into our budget, and therefore our guidance for 2023. I think we're going to round out December close, where we will close 2023 within $1 or $2 PMPM of the supplemental expense, actual expense incurred relative to what we thought when we started the year, which is not only important for 2023, but also that's obviously what we base our 2024 bid outlook on. So I think we feel really good about our assumptions heading into 2024 on that supplemental benefit expense utilization.
We spent most of our discussion today talking about Medicare Advantage, which is the much bigger piece of your business. But when I think about ACO REACH, can you talk about how it's performed in 2023 and, you know, kind of what's your outlook for 2024?
Yeah. So in terms of just maybe start with sort of our overall strategic philosophy around the ACO REACH program. We sort of had a strategic objective in mind, which was to work with our existing health plan network and partner with them essentially across a broader portion of their Medicare panel, so not just the Alignment Health plan lives, but also their traditional Medicare lives. But at the same time, we never actually really intentionally grew it. It was more organic and inbound, where a provider would talk to us and say, "Hey, we like Ava. We like Care Anywhere. Can we work with you on this ACO REACH program? Our, you know, our friend down the street is also doing it." And so we grew to about 7,500 members, and I would say our patients, traditional Medicare lives...
I would say our experience so far has been muted. In other words, we haven't really lost money, but we also haven't really made a lot of money with it. When we talk about our 20% growth targets and our long-term margin targets, we've always been very clear with the investment community that those goals were entirely predicated upon the MA opportunity, and that the ACO REACH opportunity should be considered as incremental and accretive to that goal. Flash forward, now we're a couple of years in the program. I think we still have, I'd say, maybe some kind of lukewarm feelings about it. What I mean by that is it's not something that we're investing a lot of time into growing in 2024.
I think, to the extent we continue to participate in it, it's with that strategic objective in line to work with our existing provider network. And then for us, it's, it's basically a nice-to-have. It's not a must-have, and it's not something that I think we're going to focus on when we see such a robust growth opportunity on our MA book of business.
John, you reiterated today that your goal is breakeven in EBITDA in 2024. Can you add any incremental color to timing and how we should think about, you know, any swing factors in 2024 around getting to that breakeven?
I think our OEP growth is gonna be pretty good.
Mm-hmm.
I think Dawn Maroney and her team have really done a very good job of teeing up the company for 2024 in-year growth, but also teeing it up for 2025.
Mm-hmm.
And, you know, we'll start, we'll start on the bids pretty much next week. I mean, so we're starting on it, and, and, I would say that we're gonna take the same approach: disciplined, a lot of discussion and debate, a lot of analytics, a lot of data science around the bids. And we're gonna stick to probably the same playbook, which is, which is, keep it simple, execute, give the consumer-
Mm
... what they want. I think our competitors are gonna have a hard time keeping up unless they bid negative margins.
Right.
But you never know. Some of them may do it, so.
We'll stay tuned with that.
Yeah.
Thank you so much, John and Thomas. I really appreciate it, and thanks, everyone.
Thank you, everyone. Thanks, Lisa.
Thanks, Lisa. Appreciate it.
Yes, sir.