My name is Craig Jones. I'm one of the healthcare analysts here at Bank of America, and t oday, I have the pleasure of hosting Brandon Sim, CEO of Astrana Health. So, thanks for being here. Do you wanna start with an intro, or do you just wanna go straight to Q&A?
Sure. Real quick.
Sure. Yeah, go for it.
Yeah. Well, thanks so much for having us here. It's, it's beautiful to be in my hometown, I guess.
Yeah.
It's nice. Thank you. It's always a great conference every year and I'm Brandon Sim. I'm the CEO and President here at Astrana Health. We're a value-based care company, trying to realign the system to build infrastructure that allows for better patient outcomes and ultimately, hopefully at a lower cost. We've been growing very rapidly over the last, you know, six, seven-year period. Last year, it grew over 50% year-over-year and continued to grow in a profitable and free cash flowing manner. Some puts and takes, but broadly, you know, we just reported our Q1 results, and things came in, you know, pretty well ahead of expectations. We grew, you know, free cash flow, I think three times year-over-year. Our revenue grew, you know, well over 40%, 50%.
We're pretty pleased with the way things are going and look forward to a strong, you know, rest of the year here.
Great. All right, why don't we start with some of your inorganic growth. About a year ago or so, you know, closed the acquisition of Prospect. After the first year, you know, you've, you know, guided the high end of the $12 million-$15 million in synergies. Why don't you walk us through how the first year has gone versus your initial expectations and maybe any positive or negative surprises along the way?
Yeah, of course. It feels like we've been doing the Prospect thing for like multiple years. Like, Craig, we've been certainly chatting about it for over a year.
Yeah, for sure.
In reality, we actually closed the deal only nine months ago.
Yeah.
We haven't even gotten.
Not long.
To the year mark yet, so i t's been three quarters of reporting so far. You know, Prospect has really been on track to ahead of, you know, ahead of schedule. We're really pleased with how it's turned out. You know, of course, with any transaction, there are, of that size, you know, $707 million transaction, there are gonna be puts and takes. There are gonna be some challenges to work through. And even more so because we acquired it out of a bankruptcy situation.
But broadly, you know, we've been able to very quickly integrate from an operational standpoint, get their teams, you know, over 1,500 employees that we took on, you know, integrated with our teams under a singular operating structure, a single reporting structure, and more importantly, using the exact same care plans, care pathways and kind of clinical protocols. Also, kind of supporting all of that is the integration of the technology, so h aving the Prospect teams utilize kind of our unified data layer, our application layer, our agents that we built on top of the data, and integrating those into a singular data platform so that you can see members across both. There isn't kind of a silo of these are Prospect members and these are Astrana members.
Then, implementing the exact same, you know, care planning tools that we built, the care navigation tools that we built, and the care management tools that we built for the legacy Astrana population and the Prospect members, membership, which is substantial, 600,000 members.
Yeah.
I think that's gone well and because of all of that, we've been able to, like you said, you know, track towards the high end of the synergy range, $12 million-$15 million. We've been able to extract some of the revenue synergies already as well by, you know, combining contracts with the same payers that we might have held separately, but now are under one unified contract. We've been able to improve or get their trend, Prospect's trend to look a little closer to ours. For example, when we bought them, we were running legacy core. Astrana had around 4.5% trend. Prospect was probably around 200 basis points higher than that.
You know, we underwrote a 50-basis point improvement year-over-year on Prospect trend, and it's, even in Q1, you know, that's coming in even better than that 50-basis point improvement. We're starting to see some of the impact on the, on the care model side, yielding some early dividends. Of course, the full impact is probably gonna take, you know, 18, 24 months on that more side.
Yeah, absolutely. Why don't we follow up on the 50 basis points there, medical cost trend. I think that's pretty powerful. You know, any, you know, details into the secret sauce of why, you know, adding Prospect to the Astrana platform, you know, really enables that, you better, you know, manage trend better or whatever, however this is working?
Yeah. I mean, I think I've said this before. I mean, there's really no magic to what we do. You know, ultimately what we're doing, it's a services business. Ultimately, we're taking care of patients. You know, our doctors are being empowered to take care of patients. I think part of the secret is to not allow any patients to fall through the cracks, and i f there's something anomalous or suspicious happening, to be on top of the ball and kind of being able to see that early on and address it without it spiraling out of control and causing an issue, an MLR.
What the software really does for us, and I think you came over very kindly yesterday to our clinics and got a bit of a demo of some of the software platform, is it, one, has everything in a longitudinal data record, and two, has, you can almost think of it as a harness on top to ensure that no patients are falling through the cracks. Historically, you know, if someone forgot to call a patient upon discharge, then they forgot, and that patient doesn't get a call, and they maybe have a readmission. That's unnecessary and costs the system $20,000 that didn't need to happen.
That can still happen today in a human setting, but if someone forgets, the software is there to remind the patient or increasingly, it generally just call the patient automatically so that no one is actually falling through the cracks. That's just one example from a transition of care standpoint. There are tons of other examples in terms of gaps in care, preventive care.
There are examples around, you know, ensuring that patients who need it have their blood pressure controlled or their hemoglobin A1c controlled, or even something as simple as making sure that a patient actually gets an appointment for a follow-up with a specialist instead of, you know, them trying to call during their lunch break, not being able to find, you know, someone who picks up their phone, and then putting off that visit for one, two, six , 12 weeks, and then ultimately having chest pain and ending up in the hospital, for example. It's a variety of all the little things, kind of maybe each of them doesn't amount to much, a basis point here or there.
But when you kind of automate and ensure that all of those basis points are being picked up, you know, ultimately you get 50 basis points maybe of improvement, right?
Yeah, yeah.
Over time, that really compounds, especially as you drive more and more members, you know, through that care model.
Some tasty secret sauce there. Maybe, you know, you mentioned the revenue synergies a minute ago. You've already started to unlock those, which I, you know, it's great to hear. Am I guessing that was probably a bigger angle when you did, you know, make this acquisition? It wasn't necessarily the $12 million-$15 million we were going after. It was this, you know, revenue synergy. Can you talk us through sort of what you've already been able to unlock? You know, how big the opportunity is there, and maybe some kind of timeframe, if you want to throw any numbers out there?
Yeah, sure. I think you're hitting on an important point. It's not necessarily just the G&A synergies, which are nice, you know, certainly to have. But I think more importantly, the opportunity to inflate cost trend, which I guess is a cost synergy, but kind of is more core to the mission. Then, as you mentioned, to improve the revenue opportunities for the combined business as well. On the revenue side, you know, I don't want people to think we're just taking kind of the higher of the rates and then asking for that higher rate across both books.
I wish we could do that, but it's really not as simple as that because the payers on the other side obviously are not incentivized or inclined to allow us to do that for no reason. It really is about a partnership with the payers that we have had for decades, some of these payers, and working with them to figure out a way that our now broader network and our broader care management and quality management capabilities and better, can lead to a win-win for both the payer and us. I know that's kind of vague talk, but I'll give a concrete example. I mean, there are many payers who are still in their margin recovery path.
Part of that margin recovery means that they have to pay their capitated networks a lower amount. We would of course want a higher amount if we're gonna capture revenue synergies. Some of the ways that we can have that work is, well, if there is a group out there that is even higher cost than we are, or that either we or legacy Prospect are, could we, with our combined network and our capabilities combined, you know, geographic presence, care management abilities, so on and so forth, now take on some of the membership that that payer had assigned to a more expensive group, thereby helping the payer lower their costs, but also getting us part of what we want.
There are other examples of this kind of collaborative thinking, but ultimately, it's in a, in a choppy environment for MCOs, you know, better this quarter, but in a choppy environment broadly. You know, it's trying to work really closely and figure out how we can both get what we need, so to speak.
Yeah, choppy for sure, but a s you're saying, getting better. That's a good segue into, you know, let's pivot to Medicare Advantage or Medicare. You know, cautious optimism right out of some of the bigger national Medicare Advantage players, you know, around trend specifically. Maybe, what are you seeing in trend in Medicare Advantage? You know, what do you start with? What were your assumptions going into the year versus last year? How has that played out year-to-date?
Yeah, sure. Last year, we had a pretty successful year controlling medical cost trend. We're around 4.5%. We actually ran just under 4.5% for the year-over-year. You know, this year, we actually underwrote to 5.2% medical cost trend across the business. It's actually a slight increase. All of that really related to kind of the weighted average of the 4.5% from the legacy Astrana and then the 6.5%, you know, from the legacy Prospect, underwriting a bit of improvement, you know, on the 50 basis points for legacy Prospect.
So far this year, we've come in, you know, it's early in the year, so I don't want to be too excited, but we've come in well, you know, relative to trend, our trend assumptions. You know, of the 5.2%, breaking that down line of business-wise, we expected Medicare Advantage to be slightly better than that. We expected commercial and Medicaid to be slightly worse than that. Relative to those expectations across all lines of business, we've outperformed, you know, in terms of trend. You know, we do have a lot of California membership. We've got Texas membership. We've got Nevada membership. So, of course, weather and flu were not necessarily a large impact, you know, for our businesses, broadly. Across the board, we had lower admits.
We didn't see any anomalous spikes in any kind of particular area. We felt very comfortable coming out of Q1, you know, around trend.
Cool. All right. Awesome. Maybe final rate notice, you know, came in better at 2.5%. They delayed the implementation of the new risk adjustment data, but they did remove unlinked chart reviews. I think you said previously, you know, minimal impact from chart reviews, and you think even maybe a lower-than-expected impact from some of the other changes due to your lower RAF. So, you want to just help us explain, you know, why you are more insulated here, and then, you know, if CMS does go ahead and implement that, you know, the new data for next year or for 2028, I guess.
Yeah.
You know, what would you expect that impact to Astrana to be?
Yeah, for sure. Where we ended up, as you, as you alluded to, you know, the 2.5% net kind of average impact, t here was another approximately 1.5%, I think, for the disallowed diagnoses, you know, the unlinked chart chases and the audio-only calls. So, t hose are not parts of our model, y ou know, we don't regularly make audio calls and code based on that. We don't do unlinked chart chases. We believe that to be a very, very minimal or basically zero impact to the business. The real effective kind of rate for us on our average rate book is probably closer to 4%, the 2.5% plus the 1.5%.
That's not including the kind of anticipated RAF improvements that CMS thinks kind of all organizations will get better at RAF, you know, year-over-year by 2.5%. We feel pretty comfortable that our rate's gonna be, you know, 4%-6%, call it, and d epending on our ability to inflate RAF next year. And trend, as I mentioned, is around 5.2%, and coming down because of the Prospect improvement. We feel pretty comfortable that this 2027 is a margin, you know, margin neutral to a margin accretive year. You know, I think CMS, you know, took some of the feedback around the coefficients. Now to be fair, they also did say that they didn't think skin subs were a big.
Yeah.
Part of it, so they put out some of those coefficients anyway, which is fine. We, you know, we took the coefficients that they put out in the initial rate notice and applied them to our population's, you know, HCCs, chronic condition prevalence, and we tried to recalculate kind of what would be the net impact to Astrana had they gone live, you know, as they were projected to go live. We found that it was around a 1.5% impact to Astrana headwind. So, 1.5% versus the 2.5% for average for the industry as originally constructed.
To your question, if they were to go live next year, you know, without any changes, assuming that they didn't, like, re-regress on kind of the additional years of data.
Yeah.
That would be an additional 1.5% headwind for us to still think, you know, is obviously bad, but better than industry impact would be.
A net advantage against the industry, I guess.
Right. Kind of a quick point. [audio distortion], I think you were the one who brought this up maybe, but the further away we get from some of these skin sub, high skin sub fraudulent utilizer years, which were like 2024, 2025 et cetera.
Yeah.
You know, the more that those claims kind of move out into the sliding claims window upon which the regression will take place, right? If hypothetically, I mean, to take an extreme, if we went to like 2035 rates and they re-regress then, they would use 2032, 2033, 2034 data, and obviously none of those years would have the skin sub.
Right.
Data in it. So, really, the further away we get from 2027, you know, the less the skin sub impact we'll have, hopefully.
Yeah. Okay. That does make sense. Maybe, you know, let's say they, you know, potentially can reintroduce the, you know, those, that dynamic. Is there anything else like, you know, I think MedPAC's called out linked chart reviews potentially or maybe health risk is another one that come up. You know, if they were to go after that in 2028, you know, any idea on what the impact would be to you? And just, and maybe to you and just Medicare Advantage in general.
Yeah. Yeah, I mean, maybe I can lump all of those into a category and the category would be broadly, you know, ways to make your patient look more risky to the system, like higher cost to the system than they actually are, regardless of what the method is, right? Like it's kind of a whack-a-mole chase of like the folks will try to take advantage of one thing and then you'll get rid of it, and they'll take advantage of something else.
Maybe broadly, you know, across all the entire category and the way that Abe Sutton and others at CMS and CMMI have thought about doing that is, which they're piloting in the LEAD model, the ACO LEAD model, is to just say, "I can't always keep guessing what the next form of upcoding will be. It could be on linked today, it could be audio only tomorrow, it could be linked chase chart chases the next day. It could be HRAs the following day," right? It could be anything. Instead, I'm not gonna let you guys do coding at all.
I'm gonna tell you what I think the risk should be using AI or whatever, you know, statistical modeling they wanna do, from all the information that I have, CMS have about the patient, and I would just pay you based on what I think the risk is, and that's it. No one gets to code anything. You guys all get your toys taken away, you know? Only I get to decide what I pay you. They're piloting that in LEAD, right? They are working on this AI inferred risk model in LEAD. Ultimately, I think the convergence of all the things that you're talking about, whether it's HRA or linked chart chases or whatever, converge to the idea that CMS ultimately will just pay you what they think they deserve, you know, what they think you deserve, frankly.
I think in that environment, we are pretty okay. I think we feel very comfortable with that because I think we're actually getting paid less than what we deserve, and we're spending dollars, we're having to spend dollars on investment doing kind of more mundane and boring things that don't really help the patient, like coding more accurately than spending those dollars actually benefiting the patient. If CMS were to say, "You know what? No one's coding anymore. We're just gonna pay you what we think you deserve," we might actually get paid more than we're getting paid today and not have to spend all the dollars and the waste of doctors' time doing all the coding. So, I would welcome it, frankly, and I'm excited to see how it looks like in LEAD.
Yeah, that would be very cool. Definitely be interesting to watch the, you know, the AI risk adjustment model in LEAD. You know, it does sound like, you know, they're keen to do something, right, CMS and potentially as early as 2028. But maybe this AI model, maybe that's a little too, you know, early to go right into 2028. Is there something we can think like a middle ground? Like if they want, what could they do in the meantime to, you know, semi blow up the risk adjustment model that maybe we'll see in a technical notice, you know, this fall? Or, you know, how would you design this, you know, maybe some halfway there type of a risk adjustment model that we could see next year or two?
Yeah. I mean, even in LEAD, to your point, it's not phasing in the first year of LEAD or the second year. I think it's like the third year of LEAD, and even then, it's a three-year phase-in kind of like V28 is, like 1/3 at a time. That's a CMMI program, not even Medicare Advantage or MSSP. Probably after that, if it's successful, then they'll start thinking about phasing it into MA. I agree with you.
2035 again, like you just.
Yeah. Exactly. We're a long ways away from that, and probably the Medicare trust fund's gonna be out of money by then, so i t'll be too little too late. So, I agree with you. I think the, you know, there are some intermediary measures. I think they're doing a good job, honestly. I think you saw Chris Klomp's, you know, paper that said that V28 already decreased the overpayments by not all, but quite a lot of the 10% impact from MedPAC down to maybe 2% or 3%. I forget the number.
Yep.
You take out these unlinked chart chases, you take out these diagnoses, maybe you get that down even closer to maybe 1% or 2%. I don't know, I haven't run the numbers. You keep kind of hammering around the edges, and you get maybe to approximately equal. I think one thing, this is not me lobbying at all, but, you know, my youth thought is like one thing is instead of regressing claims on Medicare fee-for-service data to give you coefficients for Medicare Advantage, we all know that Medicare Advantage behavior for providers and for patients is very different than original Medicare, so m aybe one thought is maybe we just regress claims data against Medicare Advantage claims data instead of Medicare fee-for-service data.
Because part of the Medicare fee-for-service, part of the skin sub issue was that the skin sub fraud was happening a lot more in fee-for-service.
Right.
Why not just.
Yeah.
Maybe all of it, yeah. The incentives were not aligned, I mean, are aligned that way in Medicare fee-for-service for fraud and not aligned that way in Medicare Advantage, so w hy not just use, you know, the same universe to regress, right? That seems, you know, reasonable, but I don't know.
Yeah, no, totally. That definitely makes a lot of sense. Why don't we switch over to Medicaid? You know, let's start again with enrollment and trend. You know, what do you assume for 2026? You know, I think you said Medicaid enrollment may be a little worse than you initially expected, but the margin's actually better. You know, does that imply maybe acuity not as bad as you thought? You know, maybe any way you can dimension those two dynamics for us would be great.
Yeah, sure. We'd originally expected, you know, I think 0.75% to 1% disenrollment a month. It's called like 10-ish% to 12% for the year. We'd assumed 150 basis point headwind in terms of rate acuity mismatch. We thought the trend would rise, you know, faster than revenue would rise. We had originally sized the combination of those effects at, you know, call it, mid-20s, $25 million headwind to EBITDA. What happened, what we're seeing in Q1 so far is that disenrollment has been on the high end of that assumption range, so closer to 1% a month, so closer to 12% a year.
Whereas acuity has been, or kind of average selection from the disenrolling members has been less impactful than we thought. Those have broadly canceled out for the most part, because we have more members dropping, but the existing members, y ou know, the members dropping were less healthy than we thought they would be. We ran that a couple different slices. You know, we took the members with no claims, for example, and looked at that as a fraction of the total membership before and after these enrollments , didn't find a statistically different than, you know, statistically, you know, meaningful delta.
We took, you know, various sensitivity thresholds too, not just zero claims because, you know, what if you see the doctor once and then you don't use the system for the rest of the year? We took members with less than 10% MLR. We took members less than 20% MLR. We took members less than 30% MLR, and checked the prevalence of those members pre and post disenrollments and still didn't find a statistically significant delta, you know, in any of those kinds of thresholds . The histogram, I suppose, of like MLR distribution looked pretty similar, you know, before and after.
Yeah.
Distributionally. We feel pretty comfortable that that's the case, that there's not a huge amount of average selection in our model. Part of it we think could be due to our, the way that we receive attribution, which is, which is, you know, which is maybe different from a plan. You know, we receive attribution, which members are attributed to us as risk-bearing members if the member selects an Astrana and a PCP as their primary care physician, or if they see a plurality of encounters with an Astrana and a PCP. You know, sometimes we can get auto-assigned members too, but these other mechanisms also take, you know, play a role. It's pretty hard for you, for us to be a plurality of visits if the member literally has no visits, right?
It's also pretty hard for, i t's atypical for a member to choose, you know, actively log on, choose a PCP, but then like not use the health care system at all. Typically, those members are not even bothering to choose anyone, and maybe that stays with the plan for example.
Yeah, that's a good point [audio distortion] before. But in terms of the acuity shift, so it's good to hear that you're, you know, potentially, you know, not as high as you thought. We've heard that from other, you know, larger national Medicaid players as well. It seems like everyone is kind of calling for 2026 as the, you know, the trough for Medicaid margins, and I know you still have that disparity between rate and trend. Do you think, you know, is this the bottom? Is this the bottom for the Medicaid margins?
You know, I hope so, but I think maybe we last for, maybe I'm pessimistic, but I think maybe we're, it's this year, maybe it's a little bit into next year. Then, I would feel a lot more comfortable saying 2028's kind of gonna be a better year. Look, if 2027 ends up being a better year and we get good rate increases in Medicaid in 2027, that's also great. It just hasn't necessarily been, I'm not gonna bank on it.
Yeah. Fair enough. Maybe thinking back, maybe ask you a different way, like thinking back when we have seen this big acuity shift from the disenrollments, you know, how long, when was sort of the biggest shift, and how long do you think it will take California and, you know, others to incorporate that into the rate, right? How much longer is it gonna get until we see that big acuity shift finally incorporated?
Yeah. I think that's why there's disagreement. I mean, I think it happens in 2028, frankly. Maybe some folks think that's gonna happen next year. Look, again, we get a percentage of the premium that our partners have, so we're all on the same side here. I would much more rather prefer that California or other states, you know, Nevada, Texas, Georgia, you know, where we have Medicaid presences, have an appropriate rate update to match the true acuity and the cost of the members that we're paying for.
Okay. Yeah, it sounds like we don't know when this happened, but say we get stable trend and the rates come back, I mean, how profitable could Medicaid be for you? Like, could there be some very profitable years after maybe some not so great ones?
Yeah, I think so. I mean, all these lines of business kind of operate on a cycle, right? We saw the doom and gloom around Medicare Advantage, you know, a few years ago, and now folks feel good about Medicare Advantage again, maybe or better than they did before. That was bookended on the other side, you know, way before during COVID of everyone loving Medicare Advantage and wanting to expose themselves to Medicare Advantage as much as possible. Medicaid, we had many years of Medicaid being, you know, quite profitable as well. I think there's certainly an opportunity once states figure out the budget and we figure out the impact of OBBA and that we get back to higher margins in Medicaid.
I don't mean 15%, I mean, you know, 5%-10%, but I think that's possible.
All right. Maybe then, you know, 2027, we've got potentially work requirements, six months is coming in. You know, we're still waiting from, you know, some rulings out of CMS, I think in June. Anything you're hearing from California? I would imagine they're not going to start right away. But anything you're hearing on when we might see work requirements come in for you?
Honestly, we're not hearing.
Okay.
It's unclear to us, i t's unclear at this moment. I mean, you would think maybe not, just given the political leaning of the state, but it's, you never know these days. Yeah.
All right. Interesting. Maybe we got a couple minutes left here. You know, we would definitely hit on AI. You know, we did a great tech demo from you yesterday. You wanna just some cool use cases you've got implemented, maybe ROI from AI. Like, how do you see AI, you know, incorporate into Astrana now and next two, three years?
Yeah, sure. I think before you even get into AI, you need the substrate upon which the AI has to act, right? You need the data, you need the, the agent needs to be able to see across, or it needs to be able to see across your enterprise and actually act on that data and then perform actions in that ecosystem. It'd almost be like, you know, you work at a bank. You guys have a Chinese wall, right, between certain parts of your bank. Some things that happen on one side of the wall, you may not be privy to you and vice versa. It's similar to that
If you have a part of the bank that is doing something on the other side of the wall, you are not going to know about it, no matter how smart you are. Even if you are an AI, you would not know about it because [crosstalk].
Definitely don't know about it.
Definitely don't know about it. Yep. Because it's on the other side of the wall. I think a lot of organizations operate that way when they don't really have to. I mean, you guys have to, but a lot of organizations operate that way when they don't have to. They have all their information in different silos with different artificially constructed walls. Even if they were to implement AI or hire a fancy vendor or consulting firm or whatever to implement AI for them, it's fundamentally gonna be stuck inside of its own four walls and not be able to see stuff on the other side of the company.
So what I mean by the substrate is that we have built, every time we integrate something, every time we JV with someone, every time we add a new provider group to our platform, we integrate them consistently without fail into the unified kind of data layer, and then the conceptual concepts, the semantic layer on top of that, you know, the Astrana ontology, so that the AI has an understanding of the concepts of what value-based care, managed care, and healthcare are, and so that it can operate on that unified data layer so that it can see across the enterprise. If you don't have that to start with, no amount of fancy AI is gonna do anything 'cause it's just gonna be stuck in its little box, right? Now, of course, once you have that's not enough.
You've got to build the application layers on top that are patient, you know, patient, provider, and care management team facing. You've got to build the agents on top that can autonomously act to hopefully lower G&A or to increase the amount of care or engagement that you're offering to your patient base. Yesterday, you were at some of our clinics, you saw a bit of that. You saw some of our provider-facing tools, you know, single pane of glass.
Because we act as a single payer and we act in a delegated model, you know, we can show not just the quality, the risk adjustment, the pop health, the risk stratification, which a lot of pop health platforms can do, but we can actually combine that with, you know, the ability to submit prior auths directly in the same platform. We can combine that with the ability to see your prior auths and submit your claims and see your claims and see your explanations of payments all on the same platform because we serve as both the provider and the payer entity. To put that into practice day-to-day, you know, a provider typically who uses, I won't name a name, but like a pop health vendor, for example. Sure, they can see what their next best action could be, maybe.
They might be able to see what their gaps in care, you know, I need to fill this AWV, I need to get this mammogram done for this member. Ultimately, when it comes time to submit the prior auth to the payer, you know, United or Aetna, whoever it is, I've got to alt tab, log into the United website, log into the Aetna website, copy and paste my member information in, copy and paste my diagnoses in, press submit, and wait three days or however long for the prior auth to come back. Then, tell my patient, "Hey, now you can go call such and such doctor.
You can go schedule something with the, you know, at radiology to get your mammogram done." Then, t hey've got to wait another four weeks to get, you know, an appointment, you know, so on and so forth.
Yeah.
Because we have all that under one roof, because we're the provider and the payer, we can really make all of that seamless. You saw yesterday, you know, for example, the doctor can just click a button, an agent will actually fill in the prior auth details based on the chart information because it's integrated into EHR, submit it to us. Our back-end payer agents are auto-approving 70% of prior auths. 70% of the time, that is coming back to the doctor's office within a few seconds saying, "Yes, you're approved.
Now you can go see this specialist." Then, you can click another button you saw where it can make calls to all the in-network prioritized specialists of a certain type, figure out which of them has, you know, the next available appointment or the following available appointment, present those to the patient. They can choose one, book it, then they can just kind of do their visit right away. Yesterday, I think we tested the transition of care. You know, I pretended that I was getting discharged from a hospital, it, you know, could follow up with me. We have over 500 patients, you know, far more than that, discharge from a hospital on a daily basis across our 1.55 million members.
Now, we can reach out to call every single one of them, make sure that they're not at risk for readmission, make sure that they've gotten the medicine, the meds that they've been prescribed, make sure that they have a follow-up appointment with their PCP. All of that filters into the back-end care management platform, which you saw, where if it doesn't happen, then it's being escalated to a human where someone's calling or even, you know, we have a care- at- home team that can go and visit them in person, make sure that they're okay. Those are just some of the examples where we're obviously inflicting G&A downward, you know, 70 basis point improvement year-over-year in Q1, but also over time, that's gonna inflict medical costs downward hopefully too.
Yeah. The future's exciting. All right. Well, I think we're out of time but thank you.
Hey, thanks so much.