All right, we will go ahead and get started with our next presentation. I am Richard Close with Canaccord Genuity, covering digital and tech-enabled health. Thank you all for joining the conference this year. Our next presentation, we have Claritev just reported earnings last week. We recently, back in May, initiated on the company, have been following it from afar for a while. If you think about healthcare, it really sits in what all the problems are in healthcare right now. Affordability, access, transparency, and Claritev plays a major role in improving all those items. From the company, we have Doug Garis, CFO. Again, they just reported last week, great earnings last Friday. Great improvement in the turnaround story. Doug, thank you for being with us.
Yes, thank you.
Appreciate that. Why do we just begin, first in terms of you have a slide up here. Maybe talk a little bit about what the company does first, and then we will get into the key takeaways of the second quarter and dive deeper.
Great, and thank you, and thanks to Canaccord, for the invite. Claritev, I just celebrated my two-year anniversary here, and it has felt like we have aged in dog years because we have been up to a lot. Our core business kind of has three domains. If you are familiar with the out-of-network market, our primary and largest business is claims intelligence, where we help employers and consumers manage out-of-network costs through our insights. Our second business was the company was founded based on a network. We have a network of about 1.4 million providers and large payers, regional payers, and third-party administrators use our high-performance network as a primary or complementary network.
Finally, we have a payment revenue integrity business that focuses on prepayment, payment and revenue integrity, so before a claim is submitted and paid, capturing errors and addressing issues on claims on the behalf of payers and TPAs, as well as a whole suite of post-pay payment and revenue integrity and payment integrity after a claim is submitted and paid. Finally, we did launch a services business that really focuses on wrapping through our entire suite of products and solutions against our horizontal product and vertical market strategy. The company's been around for about 45 years. We're headquartered in McLean, Virginia, in D.C., and about 3,000 associates across the country and across the globe now because we have an international business as well.
40+ years. Wow. With respect to the second quarter, why don't you just give us the snapshot in terms of the biggest items coming out of the quarter?
Yeah. We think Q2 is a clear inflection point for the business. Q2 exit was our fifth straight quarter of growth. We've been public for a little over five years. We went public in the middle of 2020. It was a banner quarter on all the financial metrics. So it was our strongest revenue quarter since Q3 of 2022, strongest absolute EBITDA dollar quarter in about four years, and our strongest free cash flow quarter in over four years. On top of that, we recently started giving some indication on our multiyear growth plan through a bookings or an annual contract value, or ACV metric. When we look at the first half of the year, we've booked $74 million of new business, and we've created and now actively manage a multi nine-figure funnel.
When Travis and I got here about two and a half years ago, first order of business was get the business healthy, get it on the path to growth, and we're highly excited about our go-to-market and our financial performance and, most importantly, our ability to generate free cash flow while we're doing a bunch of exciting things.
Okay. You had mentioned you have been at the company for about two years. Pretty much the whole management team is new, call it over the last three or four years. You had an Analyst Day back several months ago, in the spring, and you talked about Vision 2030, and I think this year's title in terms of what you are trying to accomplish is The Way Up.
Yep
If I am not mistaken. Just talk a little bit about the transition of the management team, what is in place, and what is Vision 2030.
Sure
Where are you in the whole process?
Yeah. Great. We are a big fan. It might sound cheesy, but it is a journey. Our Vision 2030 really started with refinancing the company. When Travis and I got here, we had this very complicated capital structure, and our first order of business was to get our capital structure in order. So we refinanced the company, which concluded in January of 2025, to give us an additional three years, so to give us a chance to run a five-year play. Vision 2030 is really about the transformation journey to return to a diversified growth company. The three tenets of our transformation, first and foremost, are our digital transformation. That seems like a very played out and ambiguous term, but most technology companies have residual tech debt.
We were no different, so our first order of business on technology transformation or digital transformation was to move virtually all of our applications into the cloud. We announced a very large partnership with Oracle, and we migrated virtually our entire tech stack to OCI at the end of last year. When you look at where we are in the phasing of our technology transformation, we had announced at our analyst and investor day in March that we largely expect to be complete with that transformation in 2028. The second piece of the transformation, to use a baseball analogy, I'd say we're probably in the fourth or fifth inning, is rewriting all 400 of our applications to be cloud and AI native to take advantage of all the modern tools and technologies that are available.
We think we are very smart to prioritize the investment when we did. The next two legs of the stool for our Vision 2030 transformation, how do we run a world-class public company with better processes and systems? So we've put in a new enterprise resource planning, or ERP system. We did that last year. We actually went live with Oracle HCM on Monday. We put in Salesforce, we put in a contract management system. Getting the business fit for growth was a critical piece of our transformation. Finally, it's realigning our business to how large companies operate. So we put in a general manager structure with folks who own a full P&L across our big lines of business that I mentioned earlier, as well as a go-to-market organization under our new Chief Growth Officer, Tiffani Misencik , that's aligned to our vertical segments.
It was a very lot of work, a very lot of change in a short amount of time. But what we think is, as evidenced by our Q2 results, the business now is structurally sound to go out in the market and win. We're highly encouraged by the pace of the transformation, and the transformation will largely be complete in 2028.
Okay. Just maybe to drill down more on the growth and the bookings momentum. Last year, some good improvement in bookings. A major priority has been to re-accelerate growth, and I think you're at five quarters now?
Five quarters, that's right.
Maybe go over what the past challenges were for people new to the story, and then we'll get into some of the bookings dynamics.
Yeah. The basics, right? Starting out with actually having a CRM that can give you accurate and timely data, bringing in a Chief Growth Officer and building a go-to-market function that can identify opportunities and bring them through the lead generation process. Stuff sounds very basic, but it's hard to master. Then finally, it's going out in the market with our horizontal product, vertical market strategy to go bid on opportunities that we previously wouldn't have. A couple of great indications. We won a top three health system, so a provider. Through Claritev's entire 45-year history, until last year, we had zero provider customers. Then on another sector, our public sector, there are humongous network and payment revenue opportunities in federal and state and local governments. Our network is a high performance, highly curated, and customizable network.
In Q1, we won the World Trade Center, so the first responders and survivors of the World Trade Center, a deal that came through CMS or, excuse me, the CDC. That was a $5 million ACV deal to be the primary network for the World Trade Center Foundation. These things are opportunities that were there. But having first the organization and the telemetry into your systems and processes, and then hiring, quite frankly, capable and competent people to and incenting them to aggressively grow, were all things that we were building as we went along. If I just point to the last three quarters, taking into account the first half of this year and Q4 of 2024, we've booked nearly $100 million of ACV in just the last three quarters alone.
All right. You haven't. I think technically the target for this year is $80 million-$100 million.
That's right.
$100 million being stretch. You came across pretty confident coming out of the second quarter earnings at the top end of that range.
Yep. We feel pretty confident about the milestone we set in March, and it's reinforced by having confidence into a sales pipeline and a sales execution process and a talented team. We like our position entering the second half of the year, and that's why we felt pretty confident about coming out on earnings and stating we felt confident about the top end of the range.
All right. You talked about the funnel, the pipeline a little bit here earlier. Why don't you just tell us about you've won some business
Yep
business is coming out of that pipeline and eventually converting to revenue. Talk about the ability to refill the pipeline and where it stands maybe this year versus last year.
Yeah. Our pipeline in rough dollars is up 50% year-over-year. When you look at, we announced a little bit over a $300 million active funnel. $100+ million of that is from our new verticals. Again, identifying opportunities, even some of the opportunities like federal or public sector opportunities that have longer lead time. I would say the opportunities were always there. We just didn't have a way to categorize and to build attack plans to go seek those. On absolute dollar basis, better tracking, monitoring, but about $100 million of the $300 million funnel is from new verticals that we've recently launched in the last 12 months- 18 months.
All right. Are your salespeople, is it product by product or vertical by vertical?
Vertical. That was a very important distinction. At the end of last year, we went to a segment strategy. For instance, we have a payer segment leader, a TPA segment leader. We have provider, public sector, and international leaders that can sell the full bag. They are responsible with crafting and curating the strategy and executing against that strategy for their channel. Then they work hand in hand with our general managers, our product and technology organizations to assess opportunities and kind of build the strategy against fully attacking each one of those verticals end to end.
Okay. Then with respect to bookings, and you called this out in the conference call on Friday, but seeing a decent amount of success in third-party administration, TPAs, and maybe talk a little bit about there, the magnitude of that. You have a new leader, I think, in that area as well.
Yeah.
What is the opportunity with that?
Yeah. We mentioned it is about 20% of our revenue, and it is a place that we never actively punted and explored. We enjoy relationships with some of the large TPAs, independent TPAs, regional TPAs. I was with that leader and a large client last night, and we want to be the end-to-end technology provider. I think the opportunity within the TPA space is not indifferent to the relationship we enjoy with several of our largest payers, where part of it is just education and awareness. Recently we got categorized as a leader through Everest Group as a leader in payment and revenue integrity. A lot of the market didn't even know we offered prepayment, payment and revenue integrity solutions.
A little bit of marketing, a little bit of traditional sales boots on the ground, and a whole lot of focus and emphasis on being the end-to-end provider, especially in our network solution, and attaching it with the other things we can offer. It is just easier from a technology perspective to have fewer, less vendors. We think the opportunity in the TPA space is to consolidate vendors and to become the strategic partner for regional TPAs, large independent TPAs, and we are really excited about the kind of absolute dollar revenue growth prospects as we look at that business over the next three to five years.
Okay. That is helpful. We do probably have to cover some of the risk
Sure
associated with the story. It has been pretty volatile to the upside, to the downside
Sure
in terms of stock price. Some of that has been on updates and news items with respect to litigation and whatnot. There is the Department of Justice news that has come out over the, call it last month or so, and you also have the multi-district provider litigation. You guys have said a little bit more about those issues.
Sure
over the last month or so as that news has come out. I just want to give you the opportunity
Sure
to talk about them.
Yeah. I mean, first and foremost, what we do is good for healthcare, and we strongly believe that. When you look at our strategy and our purpose, it's to make healthcare more transparent and affordable. If you look at virtually all the folks who get healthcare in the United States, a large portion of them get healthcare through an employer, through a commercial health plan that's administered by a health insurance carrier and/or a third-party administrator. First and foremost, we think what we do is great for healthcare because we reduce cost, especially in out-of-network. So we help reduce costs on the behalf of the employer and ultimately the consumer of healthcare, and we virtually help eliminate balance bills. Starting off with the premise of what we do is good, some of the litigation has been a distraction.
We did put out an 8-K in May. We actually had a confidential DOJ probe. We were never espoused to be the target of the probe, and consequently, the DOJ closed that probe without incident recently. So that was really good news. On the MDL front, we are in a highly litigious industry, and we expect that process to largely conclude in 2028. But I think where we are now is folks are starting to understand what we do. We've met with litigators. We've been on the Hill. We've been really focusing on corporate affairs and awareness, and we have a growing number of provider customers. So we signed a top three health system. All of those things are trending positive. We've had our head down focused on running our business, right? The multi-district litigation's going to play out. It's going to resolve. We really like our case.
We're well-represented, and we have a constituent class that's also well-represented.
So you've had some positive litigation, I guess conclusion to litigation, I believe in California and Long Island.
That's right.
Anything to add with respect to that?
It just reiterates our point that some of the allegations there we think are baseless and maybe even the inverse of what folks, when they really understand what our business and the value we deliver to employers and consumers of healthcare, it is kind of the inverse of what the accusations are. I think some of the lower end district court rulings only reaffirm our position. On top of that, the closure of the DOJ probe without incident. I mean, we submitted millions of documents over a multi-year period on a confidential basis, and they closed the probe without incident. So again, you look at all of the things we have in our favor, that gives us confidence to continue to invest in the business, to support our transformation, to enable growth to hit our long-term capital allocation priorities and milestones. So we really like our position.
Okay. Let's go to No Surprises. That has its own controversies, but you are the leading player in No Surprises. So talk a little bit about that part of the business.
Sure
as a driver of volumes this past quarter, and then we can get into the IDR dispute resolution.
Yeah
controversy.
When the No Surprises Act was passed in 2022, I think that CMS had approximated that there would be maybe 20,000 claims a year. Now it is over 2 million. So there has been some recent final rulings that have come out. I think we have done a great job at adapting to them, and of course, I am going to spend $165 million on R&D this year. We are going to continue to be the thought leader, the technology and the innovation leader in the space. I think the barriers to submit claims through the IDR process are continuing to go down. So there are some things that we are waiting to see on how the ultimate volume environment play out. But in all, we really like our position as the largest independent, non-payer facilitator of NSA and disputes.
What really is our secret sauce and our moat is we have multiple ways to resolve NSA or No Surprises Act claims and surprise bill before it ever gets to the point of the IDR dispute. We have things that we can do. We have a network, I mentioned, with 1.4 million providers. We have things we can do before a claim gets to QPA. We have things we can do after a claim gets to QPA. Then finally, we have the ability to check eligibility on claims, and we have a lot of technology and innovation we are working on to help facilitate the IDR process if and when it gets to disputes.
It is something that is going to continue to evolve over time, but some of the strength of the NSA volume that we had this past quarter was associated with a pretty large client win. We had said on the call, we like the volume profile of that business heading into the second half of the year, which is part and participle why we were able to raise our guide by two full points.
Then on the new, I guess, guidance on the IDR process, lower fees and just talk about how does that impact Claritev. I think some is yet to be seen.
Yeah
How you think about that?
CMS has a portal coming out, so that's going to be interesting. It's supposed to make the process better. Then the ability to batch claims and submit them. There's obviously a skew towards certain providers and gaming the system. I think a lot of our investment and a lot of our focus is trying to automate as much as possible, and so we literally have hundreds of humans who are focused on helping run and administer the No Surprises Act and the Surprise Bill services. It's currently our third largest product category within our claims intelligence in our entire business. I wouldn't be surprised if it's our second largest product category by the end of the year. But it's something that we're going to continue. We're going to see the evolution process, and I think we mentioned this on the call.
It's really going to be Q3 or Q4 before we start to see pattern recognition with some providers reacting to the new rules. But I'm highly encouraged by the portal that CMS is putting out, and I'm also highly encouraged by the level of effort and focus my operations and my technology team are putting on making the right investments so that we can react appropriately and be ready for whatever happens here as the new final rulings unfold in the second half of the year.
All right. I'm going to combine the rest of my questions into one question.
Okay, perfect.
And we can get those answered. They are all related. Talk about EBITDA margins, where they are now, where you think they can go once digital transformation is over. Same thing with cash flow.
Sure.
Operating cash flow, free cash flow.
Yep.
What you are thinking about longer term, and then the key here is deleveraging.
That is right. Yeah, and so our capital allocation priority is obviously to invest in the business, and so that is the elevated use of capital and cash that we have in the interim, and then ultimately to delever the company. And so it does not really look exciting this year and next year from a delevering standpoint, but I had mentioned at the outset that the investments we made we thought were absolutely foundational and fundamental to unlock scale from 2028 to 2030. And so, we are at or maybe even a little bit ahead of the multi-year financial projections we gave at Investor Day. But when you think about EBITDA margins, we enjoy great EBITDA margins. Our core business is really sticky. The PSAV model adds a ton of value, and we get to keep about $0.61 on every dollar of revenue.
Across the entire portfolio, we've really affixed to the Rule of 70, which is a combination of revenue growth and EBITDA margin. As time goes on, we've incorporated things like services, which have maybe half the margin profile of our core business. Whether we operate a mid to high 60s margin business or a mid to high 50s margin business against the growth profile, we're really looking at that algorithm because that's what starts to spit out meaningful free cash flow. When you look at 2028, our free cash flow yield still doesn't look exciting. It's maybe a 5%-8% yield.
Once our transformation's done, our capital efficiency of the business, including the incremental margin from all of the investments we're making, really start to scale. We have our exit rate at 2030 right now is a mid-teens free cash flow yield business with strong growth, mid to high single digit growth and strong EBITDA margins behind it.
Awesome. Great story. Thanks.
Awesome. Thank you. Thanks, folks.