All right. Well, I think we'll get started. I know there is one minute to go, but we might as well get started. Good morning, and welcome to eHealth 2023 Analyst and Investor Day. This is our first analyst day since 2019. The entire senior leadership team is very excited to host you. We'll also extend our welcome to webcast participants. Today's presentation is also being recorded and will be available for audio replay only, on our investor relations website. Just to cover a couple of housekeeping items. Today's presentation will contain forward-looking statements that are outlined here and have been posted to our IR website.
Today, we'll also be discussing certain non-GAAP financial measures that we're going to reconcile to the most directly comparable GAAP financial measures in the appendix of the presentation, which also going to be available for your review in the deck. Before I get started, quickly, the agenda for today, our Chief Executive Officer, Fran Soistman, will lay out the vision and future of eHealth. After that, select set of our senior leaders will outline how we're building and bringing this vision to life. We're going to have a presentation by our Chief Marketing Officer, Michelle Barbeau, speaking about marketing strategy and brand opportunity. We will have our Chief Operating Officer, Roman Rariy, talk about the telesales transformation. After that, we'll take a quick break, and our Chief Digital Officer, Ketan Babaria, will talk about our technology and product differentiation.
After that, our Chief Business Officer, Gregg Ratkovic, will discuss our relationships with carrier partners and will introduce our guest speaker for today, Senior Executive from Aetna, Mr. Armando Luna. After that, we'll break for lunch. After lunch, our Chief Financial Officer, John Stelben, will discuss three year financial outlook and talk about eHealth financial model. Finally, we'll conclude the day by a 30-minute Q&A session, and all of today's speakers will be participating in that Q&A session. Now it's my pleasure to introduce our Chief Executive Officer, Fran Soistman.
Thanks, Kate. Well, good morning, and thank you again for participating at eHealth Analyst and Investor Day. We are really excited about this day, an opportunity to tell our story more comprehensively, and give you a glimpse of what we think is certainly available to us with effective execution for the future. This is a picture of from my home office study, and it displays a small sample of sports memorabilia. I'm a sports memorabilia collector. I'm very passionate about it. It may surprise you why I'm so passionate. It's not just to have the artifact, but it's the symbolism of those artifacts. It's great people, great athletes who were major contributors to great teams that achieved great outcomes. I was a competitive athlete for a good part of my life.
What I learned through that process about the dynamics of bringing good people together and everyone aligned and working towards a common goal and achieving great outcomes, it transfers into your professional life, into your business life. It's been, I would say, one of the major contributors to my career, is having that foundation of team dynamics from my competitive days. I've applied that throughout my career, and it has served me and served the organizations that I've had the privilege of working with incredibly well. This is what we're building at eHealth, and we've made incredible progress since I arrived 18 months ago. For those of you who don't know me, a little bit about my background. I've spent 4 decades primarily on the carrier side.
In those four decades, I've done just about everything with exception to delivering clinical services. That's something I aspired. The irony of that is I had aspired early in my life to be a physician. Working in healthcare and health insurance is about as close to it as I could get. No regrets, by the way. I, it's been an incredibly rewarding career. I've been associated with organizations where my responsibilities were leading P&Ls of, you know, half a billion to as much as $50 billion. I touched it all. I've touched mergers and acquisitions, integrations, divestitures, downsizing, winding down, turnarounds, accelerated growth businesses. I've seen it all over these four decades, which I think has equipped me particularly well to lead eHealth at this point in our journey.
Where I started, where we are, and where we're going, will touch all of those experiences, which I'm excited about. I have three children, adult children, and one of my goals throughout my life has been to, in some way, contribute to improving our health, our health delivery system, healthcare delivery system. I think along the way, I have made contributions, but it still isn't where it needs to be, and I think everyone in the room would agree there's lots of opportunities to improve it. At eHealth, I have a unique opportunity to lead a great team and a great organization of highly engaged employees that are motivated to provide a great customer experience and to work with our carrier partners in supporting their objectives.
To do it not just based on volume, but also based on quality and based on a memorable customer experience. This is what we're doing at eHealth, and we're gonna be sharing a lot of stories today about that. Lastly, of course, we are fiduciaries to our company, and we have shareholders. We have shareholders here today. It is constantly on our mind, how do we return value? Because we know investors have choices where they choose to invest their money, and there are certain expectations in doing so, and we wanna deliver on those expectations. This whole team is very aligned to that. I would say there's two questions that I've been asked repeatedly since I joined the organization. Number one was, why did you take this job? Number two, what is the investment thesis for eHealth?
Interestingly enough, they're not mutually exclusive, my answer to that. They're very intertwined. I had worked with eHealth as a vendor early in my career, my Coventry days, when we were standing up our individual business. We actually contracted with eHealth and utilized their platform to make it possible, and that goes back into the late 90s, early 2000 period. When I joined Aetna, we utilized the relationship with eHealth as a part of our distribution solution. Coincidentally, I have interacted with eHealth throughout my career, so I knew a lot about the company. Obviously, there was a lot of things that you don't know about a company until you're actually part of that company.
You know, I did my diligence, met with all of our directors, looked at the Qs, the Ks, and had a pretty good idea of what this company was about. Until you're on the ground and you have an opportunity to really dig in, that's when you really get excited about the untapped potential, and I'm gonna talk a little bit about that untapped potential. Some of the basic tenets of the investment thesis, and there's five of them that I've utilized, we are in a growing consumer, consumerism environment. What we're all about is making that possible, making that journey possible, simple, meeting customers on their terms when, where, and how. There's demographic, very favorable demographic headwinds, or I should say tailwinds, that, you know, provide an abundance of opportunity. I'll be calling some of them out today.
Carriers, I was talking to a few of you before the start of this, and one of the common themes was what carriers say in earnings calls. Sometimes they'll make a comment about proprietary, and there's an overreaction to those comments. Having been on the carrier side for much of my career, and Armando's here, we've been together for many years, you do wanna have proprietary capabilities. It's not efficient, economical, or possible to support your overall growth objectives with proprietary only. You need outsourced distribution, but you need it with the right terms, right? The right understanding of expectations, the quality, the customer satisfaction. We play a very meaningful role there, and that role will continue to evolve and mature in time. That covers 2 and 3.
The fourth, our omni-channel capability, our telesales capability, our online platform, both assisted and unassisted, and our strategic partnerships really provides something truly unique in this sector. It does allow people to go on this journey of selecting their health benefits in a way that best suits them. We learn differently as people, so we need different tools to help that process of learning, understanding, processing, and ultimately making a decision omni-channel environment allows for. Lastly, the industry is at an inflection point. I think that started last year. We made some significant transformation changes that are still underway in various stages. We're gonna talk about that today. Others followed. The days of growing at the expense of the bottom line are over. The days of focusing purely on volume and not on the experience are over.
I think that bodes well for everyone, the carrier partners, beneficiaries and consumers, and us, because we will be able to achieve the bottom line results that investors expect of us, more rational. Going a little deeper, the marketplace continues to grow. This chart best depicts that, what we expect to happen over the next 2 years in terms of those market segments, Medicare Advantage has already achieved that 50% of all Medicare-eligible population. That continues to grow, and the individual market continues to grow. We have the Medicaid redetermination that just started last month that will go on, you know, for 12 to 13 months. That'll be a state-by-state environment. Decisions, or I should say expectations of what is achievable will vary from state to state. I should also mention the ICHRA, the Individual Coverage Health Reimbursement Arrangement.
This has been around for a couple of years, but it's starting to gain traction. Just as three decades ago, when employers shifted from defined benefit pension plans to defined contribution, 401(k)s, this is the path that this industry is on in terms of employers switching to a defined contribution. It makes so much sense in so many areas, portability, cost controls, empowering people to select plans that best meet their needs as opposed to selecting one carrier, thinking that that carrier can meet all of their employees' needs. We're excited about that. The digital adoption, the chart at the bottom, there is, as you can see by the last box on the right, the 56 to 64 age cohort are very accustomed to already enrolling online, probably through their employer or exchanges or other options. They like that experience.
The digital adoption is only gonna increase over the next five, six, seven years. We're gonna have a lot of agents with baby boomers aging into Medicare eligibility. This represents a significant opportunity for eHealth because we have an end-to-end solution that is truly industry best, and we continue to make thoughtful strategic investments in our platform to take it to the next level. Sector at the inflection point. I think the key takeaways here is that, number one, the focus had been on volume and not on relationships. We help people make their health choices, their health benefit choices, but we have to have multiple touch points in order to establish a relationship, and that hasn't been happening as an industry. eHealth has already made that pivot.
We are working on that right now to add more dimensions to our relationship, not just the sales process, but the service process. How can we help? How can we be there when someone does wanna do a market check to see whether or not they're getting the best value? It's an important part what we do. e-brokers, telesales is an important part of the carrier growth strategy. They can't achieve their objectives without having strong and effective relationships with us. Again, emphasis on the enrollment quality, the customer experience that has greater value today than it had two or three years ago. Member acquisition. You know, the cost of lead generation, making those investments in the right places where you can get the right LTV to CAC performance.
We are very diligent about that, and you'll be hearing from Michelle and Roman and John a little bit more about that. Of course, regulatory changes. We have the final rate notice came out, Star Ratings resetting, new rules, all of those things. It's part of what we do. It's part of our environment. We're very accustomed to navigating that, and that's not gonna change for the foreseeable future. I think we'll always have those regulatory challenges that come along, but we're equipped to navigate them, and we do it particularly well. I think it's also important to point out that there are small, medium-sized companies in this sector, and the capital environment is particularly difficult, as you all know. I think there will be a shakeout over the next two, three years.
This sector's gonna look a lot different two or three years from now than it does today. eHealth intends to be the recognized leader in every measurement, everything that we do. Opportunities to establish ourselves as leaders in all of these categories. We have to be agile because it is a dynamic market. We have chosen a strategy of offering a broad choice of carriers. We value those carrier relationships. We believe consumers value choice. Healthcare is local, and with value-based care continuing to gain more and more traction, particularly in the Medicare Advantage program, knowing what is happening in local markets in terms of delivery system, social determinants of health, this is critical for our benefit advisors to understand. This makes them more effective as they're talking through choices and needs of beneficiaries.
We made a decision last year to stand up two local dedicated teams, local meaning focused on local markets, and we're expanding that, and Roman is gonna be sharing more details about that when he presents. The sector is definitely ripe for disruption. When I joined the company in November of 2021, I did what most leaders do. They go through a period of assessing. I accelerated that assessment process because we had some challenges that just needed immediate attention. Part of that was assessing the team. Over the course of twelve months, I reconstituted the leadership team, and that leadership team is with us today. It's a great team in that they bring diverse experiences, capabilities. No one on that team has an ego. We work well together. We work incredibly well together. We meet every day.
In fact, you know, taking a page out of the NFL playbook, each one of us has this, and it reminds us what we're doing every day in terms of what's important. It reminds us about our mission, our vision, our strategic objectives. We're always aligned. We meet every day at noon for a huddle, and that's how we stay aligned because it is so dynamic. Things are happening very quickly. There are changes that we implemented last year. I spent time with Gregg's assistant, meeting with our top carrier partners, and that's invaluable to listen to what they have to say. What are we doing well? What we could do more of, what we could do less of? How do we advance the relationship? These are critically important relationships. You have to work them every day. It's like any good partnership.
You have to work it every day. We have a team of folks under Gregg's leadership that work those relationships. I get out there and I meet face-to-face, and I value that time with all of our carrier partners. Kate Sidorovich and her team and I started working together in the summer of 2022, working on a three year strategic plan, which we presented to our board in the fall. It provides a roadmap of what the opportunities are, prioritizing those opportunities and a roadmap to get there. We set the one year operational priorities. Most importantly, we embarked on a massive transformation plan. When I say that, it was based on my takeaway of the assessment, and that is we have a valuable asset here, a very valuable asset, but change is needed.
We needed to change our financial discipline, we needed to change our organizational discipline, operational, change the culture of the company, and make some strategic corrections. We did that. I'm gonna be sharing a little bit more about that. The overarching objective of transformation was not just to change things for the sake of change, but it's changing things because there are opportunities emerging, and we needed to be ready for those opportunities. We need to manufacture opportunities and respond to opportunities, all towards the goal of returning the company to profitable growth. On the financial side, and John Stelben is gonna go a little deeper on this, we took out over $110 million in costs last year, a combination of fixed and variable. There's still opportunities for efficiencies, for fixed cost, reduction of fixed costs with space.
We are remote first, we do have, space throughout the country, and we've been able to, eliminate some of that, and more of it will be eliminated over time. Re-engineering the telesales organization. Roman will cover this a little deeper, 1.0 achieved great results. We improved our conversions in last year's ADP by 25%. We drove CTMs down by 50%. That was 1.0. We're now on 2.0. When I arrived at eHealth, it didn't take me long to realize that our telesales and our online organizations were siloed. They weren't coordinating. They weren't aligned. In some cases, they were working across purposes. That doesn't exist anymore. It is one team working together.
It's Michelle and Roman and Kate, always in lockstep, always in lockstep to help lift each of those channels, and what Gregg Ratkovic and his team do on our strategic partnerships. The alignment and the cooperation, the collaboration occurs daily. This is how we're gonna fulfill greater performance. An area that I'm really excited about, Michelle Barbeau's gonna go much deeper on this this morning, is redesigning our marketing strategy and introducing a branding strategy. The branding strategy will be integrated into the marketing. So it's not a standalone branding. It is integrated in marketing, and Michelle Barbeau will tell you more about that. It's focusing on audience segmentation. It's focused on moving away from the generic messaging and really telling the value proposition of eHealth, what we do and why it matters. You're gonna see a video today.
You're gonna hear from consumers, from them, what they are excited about when they learn about what eHealth does. It's a compelling video. You don't wanna miss it. Of course, branding. Branding occurs. You know, eHealth hasn't historically spent much on branding. We haven't featured our name. That changes. That changes. We're very proud of this organization, and we think that telling the story of what we do, eHealth, that name will begin to resonate. It's not a hard name to remember. Customer pledge. We got this one done last year. We came up with a pledge of what customers can expect when they work with eHealth, what we're committed to, what the experience will be. This whole leadership team was involved in construction of that, and we shared it with our customers, beneficiaries, our carrier partners, the entire organization, and even regulators.
I was surprised by the reactions I got from regulators. I mean, I think it invoked more confidence that we get it. We get it. Lastly, setting the foundation for diversification. We have many capabilities that were underinvested in over the past few years. The focus was Medicare Advantage almost exclusively. We have these assets that we see great potential, like IFP, like MedSup, like the individual market and ancillary services. The introduction of broader BPO dedicated carrier arrangements, which essentially is just a variation of what we do as eHealth as an independent, impartial organization. We can work in a different dimension with our carrier partners, and Gregg will talk more about that. Throughout the 25 years, eHealth has been transforming the way consumers shop for health insurance.
This is a little, you know, sort of a simple version of our ecosystem. The objective is to be a transparent benefit advisor, providing great educational content so that consumers can understand what is available and what the differences are, and then having the tech tools for those who prefer to go online. We have a culture of compliance. We aren't regulated by CMS, but our carrier partners are. We're a downstream delegated entity, and we have to behave as if we are the regulated organization. Everything we do is with a mindset of we have to abide by what the carriers who contract with CMS are required to do. Over the course of 25 years, you know, before eHealth, it was a very paper-intensive environment. eHealth over years has been changing that to create these new capabilities. This is where we are today.
This is what we're working on right now. Continuous member touch points, loyalty, retention, proven retention, calling out the brand. Very specific new omni-channel tools. Last year, we introduced chat and co-browsing. They provided important lift. They improved the customer experience. We're now evolving that even further. We have appointment scheduling capabilities. We offered that last year. It's a great service. It also provides an opportunity for us to manage our sales operations even more effectively in terms of how we load balance throughout the day. The local market strategy I touched on, and then obviously continuing to nurture those carrier relationships. The competitive thesis, when we look at what eHealth does, unbiased broad choice relative to carriers feet on the street and telebrokers, we offer something that no one else offers, broad choice.
Our competitors often really focus on three, four, or five companies. We work with the multinationals. We work with regional players, with niche players, delivery systems. We offer broad choice because it matters in the local market. A true omni-channel platform. We're not one-dimensional. We have multiple ways to work with us. The other choices are very limited. Our tech difference. Again, we've been evolving this over years and years and years, substantially ahead of everyone else. Brand is the big opportunity. Carriers have great brand recognition. eHealth will be striving to have that same kind of brand recognition, but with the association of what the value proposition is. Carriers, how important are they? They're critically important. They enable us. We have 70% of the senior leadership team has worked in the carrier side, 70%. That's powerful.
We know what is expected because we did that when we were with the carrier, when we worked at the carrier. We understand their needs, their expectations, and the consequences of failing. There's no learning curve here. We got it. We did it. We've carried that in. This team that I've assembled lives it, and that gives us a great advantage in how we work with our carrier partners. We've been doing this as an organization for 25 years, going back to the pre-ACA days with individual, and then over the last 10 years, focusing more on the Medicare side. Expanding our collaborations, critically important.
We do that through the BPO, through onboarding, how we can help add value to carriers in addressing needs that they have that we are uniquely qualified to do. The vision for the future, and each one of my colleagues that follow us will be touching on these throughout the morning and early afternoon. We are striving to be the gold standard in the industry, and that's best measured by consumers, beneficiaries, and carrier partners. They will be ultimately determine, are we living up to that standard? A distinct consumer brand. Again, Michelle is gonna cover that pretty extensively. Retention is an enormous opportunity. It's a challenge, but it's enormous opportunity. And one of our four objectives is built on increasing member retention. For every 1% improvement in retention, we get a 4% lift in our LTV revenue. It's significant. Targeted investments in tech.
I mentioned the chat capabilities, the co-browsing capabilities, our scheduling appointment. We're evolving those now so that we're ready for the AEP to take it to even new levels of success. Revenue diversification plays a major role in our ability to get to profitability sooner rather than later. Lastly, enhanced capital structure. It's our balance sheet. How do we make it stronger? John will cover that. We're motivated to achieve profitable growth, strong cash flow performance, and returning shareholder value. I started with great people, great teams, working together to create a great culture, a healthy business culture to achieve great outcomes. That's our story. That's what you're gonna be hearing from my colleagues, how they are affecting that in their respective areas. Thank you.
Thank you. Hi there. It's an awesome setup. Great cultures, great team, great leaders. It's exactly why I joined eHealth. Nice to meet all of you. I'm Michelle Barbeau, our Chief Marketing Officer. I'll give you a little bit of an overview of me. I've joined with decades of marketing expertise, coming from very top organizations, and success that really, for me, also personally drives from leadership, leading teams and businesses to growth, and also a real passion for consumers, understanding their needs and how to solve their problems. At General Mills, I helped build iconic brands like Yoplait, Betty Crocker. I turned a declining billion-dollar Pillsbury product portfolio of warm, fresh from the oven baked goods back to growth.
While maybe hard to resist that yumminess of Pillsbury, you know, you start to wonder, does the world really need more biscuits? seven years ago, I shifted into healthcare for more purpose-driven work. As Fran talked about, it's complex, and there are real consumer challenges to solve. I, you know, have had a successful career in transformation and turnaround, and quite frankly, I wasn't looking to leave when eHealth reached out, almost about a year ago this time. In fact, I had never heard of eHealth, but I'll tell you kind of the 3 reasons that really drove me to want to join, maybe the same reasons that I'll join you to want to continue to invest in our growth is that, 1, that passion for our purpose and the beneficiaries, which you've heard. 2 is the people.
Getting to work with this really smart team. We all have that same bias for action against our shared goals. Three, that transformation. We really are building something very special here. Getting to apply my talents, driving profitable volume growth against consumers' needs, it's extremely gratifying, and honestly, I'm honored to be part of this. Where did we start? Last year, I joined not long before AEP, and we made great progress against our goals. We started with a very thorough audit of every campaign, every channel, and we reduced. As you know, we pulled back spending behind anything that wasn't profitable and wasn't working. In some cases, that meant pulling out of channels like DRTV that under the old strategy just weren't working at the time.
We further optimized and leaned into what was working, and that allowed us to significantly improve our COAs. That optimization also drove higher quality leads, which also contributed to enhanced telephonic conversions. Again, really proud of what we achieved in year one, kind of the start of the marketing, evolved marketing strategy. The marketing strategy goes so much more beyond optimizations. It is really about, at the heart of it, putting the consumers first. Along those lines, I'm gonna ask you to think of yourself as a beneficiary. If you're not yet 65, maybe think of your parents or grandparents and kind of go through their shoes because I think that's how you'll understand how this marketing strategy will be so impactful to the business. When we understand our consumers and we solve for their needs, the business grows.
I know that sounds super simple, and very one-on-one, but you will see, in fact, I will show you that we are really at the forefront leading this industry in that. Okay. Again, you're a Medicare beneficiary. You need to select your plan for this year, and this is what you experience from the industry. I'm just showing you visuals for the sake of time. If you were to hear these ads, or again, I encourage you, like, go through these materials with your parents this year, you will see that they all sound and feel very similar. There's usually an authoritative spokesperson. They're telling you to act now, get all the benefits you deserve. You see supers, right? Time's running out, call today. They all feel very generic, and that shows up in the metrics that we all look at every day.
Yes, there's been some pullback, more rationalization of spend among brokers, this is still a really competitive space. You're competing for those eyeballs in that short 10-week period, often in the same channels. That shows up, right, with higher media costs, higher COAs, higher churn, because if it all looks and feels the same, there's not really that recognition and brand awareness that is being built. Fran mentioned this. Sorry. Fran mentioned this. It is true. We think this industry is at an inflection point, really, it is ripe for disruption. There is a real need to be able to help consumers through this process. We spent hours actually talking to consumers to understand what works and what doesn't. They told us that that sea of same advertising is not helpful. They feel bombarded.
They feel overwhelmed. One gentleman, you'll hear from him in a bit, but he talked about how he looks forward to December 7th every year. That's the last day of AEP. Like, so sad that that's a date he knows to look forward to. You know, they've often come from a more narrowed selection, right, from employer plans, and now it's this whole new world to navigate of new plans and rules to understand. They often feel lost and alone. Another gentleman told us how he had to go to 35 different websites to make a plan selection. Like, you can do all of that with us, right? 1 click. Anyway, that's...
At the end of the day, like, they still don't always feel good that they made that right selection because there's so much detail and information to try to understand. Then it starts all over again the next year because there's new plans and new regulations. Again, it is really clear that consumers need a different solution in this space. Lo and behold, we have the solution. Really, it's what I said. It's our marketing strategy puts consumers first and uniquely positions eHealth to win because we can solve their needs. Oops. Let's kinda go through the five core components of the overall marketing strategy. I'm gonna touch on each one of these a bit more, but we need to build that differentiated brand.
We need to separate ourselves from that noise. For the first time, really tell consumers who we are and embed that differentiated value prop into every touchpoint to drive immediate conversion. Second is greater audience segmentation and personalization. Medicare is not a one-size-fits-all audience. We need to tailor messaging, media, the experience, and again, that will drive further increased conversion and better economics. We need to expand our channel mix. We can be where our audiences are. We will do this in a test-driven, methodical approach. I'll take you through that. Fran mentioned, I'm gonna double down. I won't spend a lot of time here because Roman will. Retention is critically important to us. We are going to be shifting and moving to a data-driven, multi-touch, omni-channel strategy that is really about building those lasting relationships beyond just that one-time transaction.
Yes, it starts with the brand and making that great first impression. It's understanding the drivers of churn and how we can offer a different solution and fill their needs. Probably most important, but again, underlying and guiding all of this, the marketing strategy, is the economic return, right? How we will evaluate the profitability of each of our marketing investments. That's taking that disciplined approach with more efficient COA, looking at every campaign, so we're optimizing against our LTV to CAC guidelines. Driving that higher retention will drive higher LTVs, and then that brand building, which will be in-period ROI initiatives. Let's go through each of these in a bit more detail. Building your brand. As an investor, you may wonder, is this some splashy multi-million dollar campaign just to build awareness over time?
As a consumer, you know that that's not the case, that is absolutely not how we're looking at this. Brand is the North Star that guides the company. It guides every interaction. Think of a company like Apple, right? That stands and oozes that sleek, simple design that shows up in their product, their packaging, their store, in their customer service, and yes, in their marketing. It really distinctly differentiates them from competition, and consumers are willing to pay more for that. The same is true with eHealth, right? It will guide everything we do from our hold music, the interaction of that first call or how they visit. It will go into every campaign. Again, this idea, it's not some separate brand-building campaign sitting on the side. It's embedded to every single touch point to drive immediate conversion.
The other reason why invest in brand is that companies with stronger brands consistently deliver higher returns and outperform their peers. They also drive significantly higher click-through. We know from our data, higher click-through drives higher conversion. At eHealth, we have a significant opportunity. 60% of our outreach has been unbranded, so we really just aren't even telling them who we are. The unbranded outreach drives 1.5 times higher churn. We've kinda been the same, right? Saying that same messaging hasn't really been branded, not super surprising, but we have very low aided awareness. What is our brand opportunity? Our brand opportunity is to shift from being kind of that great, powerful Wizard of Oz, hiding behind the curtain, adding to the sea of same messaging that consumer frustration, to being their helpful guide.
You know Yoda is not the hero of the story. Yoda is the guide that helps Luke fulfill his potential. Similarly, eHealth will be the guide, being able to help them navigate through their journey and find the right plan for their needs. How does eHealth become Yoda? Our brand strategy, that North Star, this is not outward-facing language, by the way. This is just our internal guide, but it's consumers remarkably transparent advisor. That means that we listen to them, we simplify, we help them compare all of those options, right? They don't have to go to the 35 different websites. We empower them to make their decision when, where, how they prefer. We are transparent in everything we do in a way that is worthy of remark because it is so different than what they are currently experiencing.
This has been the core of our offering. We just really have never communicated this. Again, we talked to those same consumers that I was talking about earlier. We shared with them kind of a top-line summary of our value prop and our services. They told us that it is differentiated, compelling, and highly motivating. Don't take my word for it. We're gonna show you the video 'cause it's just much better to hear it from their words.
Unbiased, clear, concise information, the ability to answer all my questions, the ability to essentially act as a comprehensive clearinghouse. If they can do all that, I'll marry it. Yeah, thank you.
Is it fair to say that if you're feeling frustrated now, a company like this would give you confidence?
Unquote. Absolutely.
The next time that you were to search for insurance, how likely would you be to use eHealth?
Very likely. They are that unbiased clearinghouse. Absolutely. 10.
Okay. What is your likelihood that you would search for information on eHealth in the next, we'll say, three months?
In the next 2 months.
Oh, yeah. 100%. What's not to like? Yeah. I think it's fantastic. I would go use them.
I'd go check them out.
Okay. everyone would give it a 10?
Yes.
Yes. As soon as I get home, the first website I'm going to is eHealth. It's exciting to know that there is a light at the end of the tunnel.
Pretty amazing, right? Just for the record, we did not pay them. That's a completely independent moderator. This was purely just to start to gain some insights into our brand and the opportunity, but very compelling space that we're going into. What we are currently working on is taking that brand strategy and turning that into that external consumer representation, right? What will it look like, the brand look and feel, the value prop messaging, the logo, et cetera. That will all be updated for AEP, and again, threaded into all new marketing campaigns, our experience, and so very excited to be able to share that with you in the coming months. The second pillar of that strategy is growing audience personalization. I'm gonna ask you to go back to recall that you are a Medicare beneficiary.
You're bombarded with that sea of sameness, now you start to see the light at the end of the tunnel with the helpful guide. Remember that not all Medicare audiences are the same. Some of you are new to Medicare. Some of you need to switch because you're paying too much for too little. Some of you are looking for the lowest cost with all-in-one benefits, while some of you are willing to pay more because you live in different states and you need access to doctors anywhere. Some of you have just moved, and you've lost coverage. Some of you care deeply about the local piece, as Fran talked about, sticking with your local physician and that local hospital network. Some of you are not yet Medicare. You're still younger, maybe self-employed and looking for individual and family coverage.
You get the point, but the point is that we are going to be personalizing end-to-end experience, and really diversifying our business in a whole new way, in a way that's very different from our competitors. What that means is a few things, right? That tailoring means that we're developing data-driven audience models, so we can accurately identify and reach each of those segments. That means tailoring the messages. There's the brand that's threaded throughout, but you've had to be distinct messages that meet their needs and motivations. You need to tailor the media, so we can show up where they are.
You need to tailor the experience, the online, the telephonic, the shopping and the enrollment experience so that we can pay off and deliver against what we've promised in the marketing. When we do all of that, it shows up, right, in all the metrics that we want, with higher conversion rates, satisfaction and retention. As I said, really increases our opportunity as a business to diversify and extend outside of that AEP, OEP time period. The third pillar of the strategy is expanding our channel mix. I'll point your attention to the arrow because probably is going in the opposite direction of what you would think, and you would be correct. A marketing funnel usually starts up at the top of the funnel. You build awareness in mass reach channels like TV, radio, print.
You move consumers into the middle of the funnel for consideration, reaching them in channels like social. When they're primed and they're ready to convert in the bottom, and you're there in search to be able to do that. The reason that the arrow is going up is because we need to build that full funnel. We have been almost primarily very heavily weighted to bottom funnel channels only. Search, affiliate, direct response. The reason that we need to build out that full channel mix is because that is how marketing generates the greatest return. I have seen that time and time again when you can orchestrate the channels across awareness, consideration and conversion. Second, as I stated, we simply need to be where our consumers are. Again, I'll walk you through an example.
As a consumer, you need to make a high stakes decision. This time, let's say you need to purchase a car. Do you immediately go online to search, and that's how you make your decision? Likely not, right? You've been influenced by TV, print, radio, social. You have brand perceptions of different features, and that all influences your decision. Let's go also a step further. Let's say that half of you are in the market looking for a Ford pickup truck, and half of you are looking for a Volkswagen Bug. You are likely very different consumers, right? Not only is the channel mix different, but so is the programming, the type of TV shows you watch, your news consumption that's different. Similarly, at eHealth, we need to tailor that to each audience, our channels, our media mix, and our partners, right?
That is how we will drive the most effective results. Oops. I'm not building as we go. Sorry. Here also, what I can tell you is that as we expand our channels, we can play into our inherent strengths as an omni-channel fulfillment capability. Fran talked to this a bit, but in the past, we have had just some of our channels that drive solely into telephonic conversion and some that drive just solely into online, and we are moving away from that. All of our media channels will be able to drive into that omni-channel experience so that consumers can engage in the way that's best for them. As we start to build this mix, we will test our way into this, starting this AEP. You'll start to see us in channels like TV, social, and some programmatic media.
Also, as we build this mix, obviously it's very important in terms of how will we be measuring success. We'll be continuing to hold ourselves to those very strict LTV to CAC profitability guidelines, which is why we're going to test our way into these. We are building a new marketing mix model. We will be moving away from last touch attribution, which means that assigns conversion performance to the last channel that a consumer before they came to reach eHealth. What that means is it ignores the impact of any other channel that played a role in that decision, and it places inaccurately too much weight on those bottom funnel channels.
We are investing significantly, getting great talent in place, in our marketing analytics, and so we are building a new multi-touch marketing mix model that allows us to measure channel incrementality and know with precision the role that each of those channels is playing in consumers' decision-making and profitability. Finally, because we are doing this in a test-driven way, we can remain a bit opportunistic and flexible, so we'll be able to lean into the channels as we see stronger performance. As we move to this consumer-first strategy, I can tell you all of these different components I have seen this, I've done this multiple times. This is what works to drive growth. Very important, right? What will be those measures of success? How will we see that show up?
It will mean higher conversion rates, lower COAs, stronger member retention, and increasing that brand affinity. That leads to being able to expand our enrollment margins and consistently, over time, having that sustainable competitive differentiation. Marketing plays a critical role, as you can see, in getting to our positive EBITDA in 2024 and that continued margin expansion beyond. In summary, I think we made great progress in 2022. We pulled back spend, reducing what was unprofitable, leaning into what was working, and we were able to expand our margin to 29%. However, a lot of it was still generic on branded media, really going to that broad audience. Again, just to put a fine point on it, right?
As we move into 2023 and beyond. Critically important, we maintain that disciplined approach to our spend to maintain profitability, but we start to deliver that differentiated brand and value props, giving consumers that light at the end of the tunnel that will drive immediate conversion increase. Being able to tailor our audiences, the media, the messaging, and the experience to our core consumer and expanding beyond to diversify the business. As I talked about, starting to expand that channel mix to the full funnel, reach consumers where they are, but doing it in that really thoughtful, test-driven approach. We are absolutely confident that as we do this, that will lead to that further expansion as we've projected over the next three years. I'll just end with reiterating that I joined eHealth because I see the vision. I am incredibly excited about where we're heading.
I think the path is very clear, and the transformation will be meaningful. Marketing plays a critical role in this. We determine who to engage, how to engage, and how to bring in those high quality leads that are primed and ready for conversion. I know that no one loves a high quality lead that's primed for telephonic conversion more than my colleague, Roman. I'll let him take it away from here.
The high quality leads position great sales organizations to perform on the next lvel. I'm Roman Rariy. I'm the Chief Marketing Officer. I'd like to spend a few minutes today to tell you about the work we've done in 2022 to transform our telesales organization, and then we'll discuss in more details work which we're doing now to position us to win now and in the future. I'll start with telling you a couple of things about myself. You picked up on my accent. I was born and raised in Soviet Union. I got here 25 years ago. First part of my life, the first part of my career I spent as a scientist. I got my bachelor in chemistry from Moscow State.
I got my PhD from Moscow State as well in chemistry. I worked at MIT. I did my postdoctoral studies at MIT. I worked at Procter & Gamble, which is a consumer goods company, transitioned to pharmaceuticals, and did product development for precision therapeutics. At some point, I decided that I would like to start a new chapter of my life, and I used the Wharton School as a launching pad for that. I spent two years in Philadelphia doing Wharton MBA full-time, healthcare and finance. After that, had a variety of roles, a diversity of roles in different industries. I worked at L.E.K. Consulting, which is a strategy firm, strategy consulting firm.
I spent several years with Kraft Heinz, which is a food company in the United States, China, Australia, New Zealand. When I returned to the United States, prior to eHealth, I worked for a company, Lionbridge, which is in the translation and localization services. As you can see, I bring the variety of experiences in different functions and companies. The reason Fran Soistman brought me into the organization is because I bring 30 years of experience of doing two things remarkably well. One, I can understand what really matters. I can cut through information clutter and understand what really matters now. Two, I can adapt and take actions that will help the organization to deliver on what really matters.
I'll tell you a quick story which takes me back about exactly 30 years back. I was a student at Moscow State University, was preparing for the exam. In parallel, country was really falling apart and we had empty shelves. That's true. It was a period in the history of the country where we had empty shelves. I had a choice to make. Exam is tomorrow, I have a choice to make. Either I wait in the student cafeteria for 2 hours to get a meal or I study. I was very clear that studying was the most important thing to do at that moment. I had to support myself somehow.
I had to have some nutrients. I went to the store and the thing which was available, was baby food. I still remember those boxes, those smiley faces, the smiley kids, you know, child face on the box. I figured, well, if baby can eat it, I probably can do that too. I bought a few boxes, came back to my dorm, mixed it up. I think I triple x'd the dose because I'm a bigger person. It helped me. It carried me through the day. It was the first time I realized that babies have been duped into drinking baby food that does not taste well at all. Still, it helped me. It carried me through the day.
I took the exam. I aced it. That was the really for the first time, probably going back in time, this was the first time that I had to make a choice. I had to really boil down what matters the most to me at that moment, and then adapt and find a way to accomplish the mission. I bring that. I carried that with me throughout my life. I bring that to work every day. I'm gonna speak about the telesales, transformation, 1.0. As Fran mentioned, we're done with 1.0. We're in the middle of 2.0. I bring that ability to cut through the clutter, understand what really matters, and take actions, adapt and take actions to work every day.
This was, this is something that I applied as we drove as an organization, telesales to telesales transformation. Let me start with remind you something you may recall Fran talking about, which is we'd like to establish our goal is to establish eHealth as a gold standard in health insurance distribution. We believe industry needs a gold standard, and we believe we can be one. Our other goals, build a highly efficient year-round, full-time ad-advisor model and drive enhanced member economics through higher conversion and retention. A quick view where we're now. Organization, one of the things we're very proud of is that we work really well together. We have a strong marketing, sales, and sales ops collaboration.
These 3 units really work well together and it helps us to cut through a lot of information clutter. Just to remind you that we have our organizational structure on the telesales side consists of benefit advisors, formerly known as sales agents. We have sales management, we have a dedicated retention team. I'll speak about that later today. We, at the moment, predominantly full-time internal advisory model. 2023, where are we focusing? We're enhancing our infrastructure. We're increasing diversity of our operating model. We have carrier-agnostic model, which is predominant model that we operate in, and we're actively building carrier-dedicated models. We're scaling the activities that worked last year, and we'd like to do more of that. We're scaling local market.
We're scaling, we are building, we're actively building out member loyalty and retention initiatives. Also, you've heard Michelle speak about audience targeting. When the different audiences come to us, we have to address them differently. As Michelle is building audience targeting on the marketing side, on the telesales side, we're training our agents, and we're building capabilities to address different audiences differently to allow for continuity of customer experience. You also heard Fran talking about MedSup, IFP, SMB, ancillary. All these capabilities are must-have our sales organization, and we're building stronger. We're getting stronger there every day. For the rest of the presentation today, I'd like to talk about 2023, what are we doing there. Before I jump there, I'd like to cover two things.
One, I'd like to quickly align on carrier-agnostic and carrier-dedicated models so we're on the same page. After that, I'll quickly talk about 2022 accomplishment and things we've done that worked really well. After that, for the rest of the talk, we'll focus on 2023 initiatives, which are really exciting. Let's talk about carrier models. We have As I mentioned, we have 2 fulfillment models, and the key for us to have 2 models is to enable operational diversity. Our main model is a carrier-agnostic model and carrier-dedicated is model which we're actively building. Let's talk about carrier-agnostic model. You see the value chain here. Demand generation through eHealth, lead acquisition efforts, then leads come in being assessed. We use the proprietary lead assessment and call routing algorithm.
Leads are matched with the benefit advisor who is best to field to help that individual. This is also done through the proprietary algorithm. Active advisory and sales happens. Our remarkably transparent advisors help individual to find best plans for their specific circumstance. We're using our proprietary plan matching algorithm for that as well. Post-sale enrollment and verification and then ongoing retention. When you look at the carrier-dedicated model, it's somewhat similar to that. Lead generation is done by carriers. Leads generated by carriers come to us. Lead assessment still happens. The lead assessment and benefit advisor happens, and then advisory and sales happens using the portfolio of plans provided by that carrier. This is why it's called carrier-dedicated.
We're dedicating, we're limiting number of plans available for that agent for the beneficiary because the lead came from specific carrier. Post-sale enrollment and verification happens in a similar fashion. These two models are operational today. We started building the, we built the carrier-dedicated model, enhanced it last year, and continuing to enhancing it this year. Let's talk, let's spend a couple of minutes on what happened in 2022. These are the key, not all, but key activities that we engaged in 2022. There's a lot on the slide, let me group them a little bit. Here. First group of activities I would classify as doing things we're doing, but doing them much better.
The other way of saying is better management. What are the better management things? We enhance management processes and reporting. We flatten the sales organization. We achieve enormous cross-functional alignment, not only between sales and marketing, but between sales and product, sales and carrier team, sales and finance. The other area that are classified as new processes. You do things better. You use the same process you have, you just do them much better because you bring operational rigor to that every day. On top of that, you build new processes. New process that we built last year, revamp hiring process. We revamped our hiring processes. One of the remarkable thing we've done is we allowed supervisors to hire their own teams. Now our sales supervisors hire their own teams.
They interview the agents they work with later, and they go with them through the training, which creates enormous team morale and camaraderie which pays dividends later on. We also started Sales Master University, something that a vehicle that we use to train agents and supervisors and people go through different stages of the training. They get different belts from white to black. It's extremely comprehensive multi-year educational efforts. The other area is the long-term valuable projects. We can call it long-term valuable projects. What are they? Well, we piloted local market project last year. I'll speak about that in a second. We deployed omni-channel strategy. You've heard Fran talking about this. It wasn't always the case.
It wasn't always the case that omni-channel strategy was alive and kicking. It was the case before that each channel will work independently. That's no longer the case. Now, our beneficiaries, our customers, have a chance to start where they are. You wanna start online? No problem. You can continue online. You can complete the application online. You can get help with chat. If you'd like to call us, we'll pick you up exactly where you left off online, and we'll complete the application telephonically. If you wanna start telephonically and then complete application using online tools, not necessarily online, but online tools, we can do that too. This is the start of what we believe will become truly industry-standard omni-channel experience.
All that combined gave us 25% increase in conversion rate and decrease CTMs by 50%. CTMs is Complaints Tracking Module. That's how CMS tracks customer complaints. Let's switch to 2023. In 2023, we will do more of what worked in 2022, and we'll start new initiative. Worked in 2022 is focus on local markets. I have a slide on that later in the presentation. We'll talk about it in details. We'll do more of that. We're scaling this up. We're really putting efforts into member loyalty and retention program. You've heard Fran mentioning this. This is our one of the key focuses for the company. You've heard Michelle speaking about that. This is not a sales-driven program.
I'm presenting it here. Member loyalty and retention is a company-wide initiative. People from all functions work on it. It's marketing, it's product, it's sales, you name it. Diversified product sales. I mentioned it. You've heard Fran mention it. You've heard Michelle saying this. Medicare Advantage is our main product at the moment, but we're making conscious efforts to develop our internal capabilities to offer MedSup, IFP, SMB, and ancillary. This training efforts, cross company training efforts are happening constantly. On the sales side, this is focused more about, focused more on training our sales agents to be able to recognize opportunities and to be able to offer best products for our customers. BPO, business process outsourcing. This is where customer dedicated model, fulfillment model lives.
This is the area which we're actively building within the organization. This diversifies our operational capabilities, and this diversifies our revenue streams as well. In alignment with the audience targeting. Cannot stress this enough. You've heard Michelle mentioned it. Fran spoke about this. When you reach people, when you reach different audiences and they come to eHealth, we need to be able to service them differently. That training and development of our agents is ongoing part of our, of all our training modules. Let's talk in more details about local market strategy. This is my favorite slide here in this presentation. This presentation has many good slides, but this is my favorite one. I can summarize everything to say here in one sentence. Healthcare is local, and insurance distribution should be as well.
Let's unpack that a little bit. Healthcare is local. I don't think I need to convince you that that is true. Let's look into details. Local to whom? Carriers. Carriers know that healthcare is local. Even though we offer many plans from national carriers, every national carrier knows that the plan design is local and Star Ratings from CMS are local, too. Carriers don't need to be convinced that the healthcare is local. They know that. What about our strategic partners? What about hospital system? What about pharmacies? They also know that. They know that the healthcare is local. This is where they work in the local community, in the corner pharmacy. What about our beneficiaries? What about you? You also know that the healthcare is local.
Your primary care doctor, your specialist, it's a name, it's a person who works in a specific location. Yes, the person is a part of broader network, maybe national network, but it's extremely local. Healthcare is as local as it gets. Distribution of a healthcare should be local as well. We're a national organization, but we're recognizing the fact that to take the company to the next level, we need to start thinking local because people we serve and people we work with think local. It really benefits us and the entire organization in the industry to think local. All right. How does it look? Well, we started a pilot last year. We took two states. We took state of Illinois and state of New York, and we said, "Let's run a pilot." We spent some time selecting the states.
We looked at n-number of factors such as population, Medicare-eligible population, Medicare penetration, our own strength in those states, and many other factors. We ran a pilot on these two states. We dedicated agents, and we said, "You will be taking calls. You will be servicing beneficiaries from the state of Illinois, and you'll be working with the state of New York," which allowed people to really get familiar with the local landscape of carriers, local landscape of providers, and enabled us to better service beneficiaries. How do we measure that? Well, we measure it based on conversion. Conversion improved in higher than national average for us. We said, "Okay, this is great. This is working. Let's do more of that.
Let's do more of what's working." This year, we expanded these two local markets into six. We call it clusters because you see that some of them are no longer a single state. We added three states to Illinois cluster. We added Wisconsin, Indiana, and Michigan. To New York, we added Pennsylvania and New Jersey. We formed the Georgia cluster consisting of Carolinas and Georgia, and then 3 clusters, which are state clusters of Florida, Texas, and California. Right now, as of today, we operate in 6 local market clusters, and we do see improved performance for local clusters because people, because agents who work there, they take extreme pride in servicing specific area. They get to know the area. They get to know the plans. They get to know other things. They check the weather.
They check the scores of a sports game. They can talk to people about something that they relate to, which creates enormous bonding on the call. It's a big deal. We fully intend to continue that trend and evaluate additional markets for 2024. I'd like to switch gears and talk about a little bit. This is my second favorite slide. Again, if you were to take home one line here from retention and member loyalty, all we need to do really is to do two things well. Find the right plan for the beneficiary in the life circumstance the beneficiary is in right now. That changes. That changes.
One, life changes, circumstances change, the key is to find the right plan and match the right plan with the beneficiary given the circumstance the beneficiary is at. Then engage the beneficiary after sale. Post-sale engagement is a key driver here. We do plan matching really well. As I mentioned, we have a proprietary algorithm that matches beneficiary with the best plan for that person in the present moment. Post-sale engagement, it's one of those easy to say, difficult to do things. Let's unpack it a little bit. What do we really mean by post-sale engagement? It's a variety of things which really starts with ability to reach beneficiaries after the sale, ability to have opportunities to contact beneficiaries with additional offerings, with information, with educational materials and so on.
One of the foundational efforts which we're taking here, we're putting additional effort, both human and product efforts into enhancing our ability to capture contacts: phone, email, anything. Next is onboard. We believe that first 30 days after beneficiary signs up for the plan are the most critical one to start beneficiary interacting with the plan. And this is also opportunity to identify additional products that beneficiary may benefit from, which are complementary to the initial purchase. Here in the onboarding phase, which is really first 30 days, we're developing very targeted campaigns for plans and beneficiaries who we know based on our experience and based on the algorithm.
We have a proprietary algorithm that runs and determines high churn or beneficiaries at risk of a high churn. Here we're developing additional programs, additional outreach programs that will educate beneficiaries about their plans, get them to use the plans earlier, sign up for primary care. I have here social determinants of health, which is becoming more and more important in the Medicare market. PCP match, additional plan utilization services, signing up for PCP appointments. It's a small little thing, it definitely increases. We notice that increases the plan utilization and reduces churn. Engage. Once you're on board, post first 30 days, we need to engage.
We launched about three years ago, we launched customer center. We're right now working on enhancing that customer center and really using it as a platform which will run our loyalty programs from. We would like to switch from 1-time transaction. You buy, we help you to purchase a plan, and we're done. No. We'll help you to purchase a plan today. We'll help you to start using the plan within first 30 days. We contacted you 60 days into it to ask you, "How are you doing? Do you need anything else? Is the plan working out for you? If not, let's talk about it." We say, "Well, there are other products that you can purchase if something is not working.
We need additional services." We have that as well because we carry a portfolio of products we can offer. We plan to launch this at scale in advance of AEP, and I'll be updating more on that later. This is really the core of our initiative here or the core of the retention program this year, is to switch from retention to member loyalty. We want loyal members. We want people to know eHealth. The branding initiative that Michelle spoke about is a part of that process. Then, of course, retain. As I mentioned just now, focus here is shifting from plan retention to member retention because people's needs change, and we see that. Year-over-year, life changes. Plans change. Plans change as well.
Our goal is to match beneficiary with the best plan for them. Come back to us and we will do it for you. To facilitate that, we're also thinking about personalized outreach campaigns prior to AAP. There's a lot of work here being done, and stay tuned, we'll update you more in advance of AAP. Summarizing. You might have a question. You might be sitting with a question. These are all great things you're talking about, Roman. These are like great initiative. You guys are clearly doing a lot. How would that land in the KPIs that we look at every day? Year-round advisor utilization, which is a cost KPI. Conversion, which is profitability. LTV retention, that is revenue.
I summarized here on the slide our view of how every initiative that we spoke about today or mentioned, or mentioned briefly impacts those KPIs. As you can see here, pretty much majority of these KPIs are being impacted by every initiative, some more than others. We feel really good that initiatives that I mentioned today, which were successful in 2022 and we're building on for 2023, will not only allow us to serve our beneficiaries better, but also will improve our financial position. I'd like to bring us back to where we started. We started saying that our goal is to establish the eHealth as a gold standard in health insurance distribution. We're gonna do that by doing two things remarkably well.
We're going to provide superior consumer experience rooted in best-class advisor onboarding, training, and coaching, supported by the proprietary technology tool. I believe things I mentioned today should leave you inspired by the fact that we are doing all that. As Fran mentioned, compliance is a foundation of our work. Everything we do must and will be compliant. The other piece of the puzzle here is the strict adherence to compliance principles that focus on unique requirements for each step of the sales process and post-sales interactions. We're very serious about this. With that said, I'm not sure how about you, but all this talk makes me hungry for baby food. Let's take a 10-minute break. Back in your seats sharp in 10 minutes, please. Thank you.
Hi, everybody. We'll be resuming in about one minute. Thank you.
We're gonna start again right now just to keep things running on time. I'd like to welcome our Chief Digital Officer, Ketan.
Show of hands, how many of you still use point-and-click cameras? How many guys still use standalone Garmin GPS devices, those Garmins? Not many of you. The fascinating thing is these technologies were invented, adopted, and became irrelevant in a relatively very short period of time. Technology is changing so fast, the pace is ever-increasing, and the consumer preferences are changing with it too, very quickly. Hi, I'm Ketan Barbaria. I'm here to tell you about how we at eHealth are leveraging these technologies to improve our customer experiences and their ever-changing needs. Before we do that, I'll give a quick introduction about myself. I discovered coding very early on. That green cursor on a black screen was very attractive to me.
I learned coding at a very early age, and over a period of time, I have learned and coded in, like, 10-plus languages. I obsessively read and still read about technology. I love, love tech. Right from the days of C/C++ to ChatGPT now and blockchain somewhere in the middle. I have been following tech most of my life. I did my undergrad from IIT, and it worked as well in design and engineering fields. After that, I moved to Bay Area. I've lived an entire professional life in the Silicon Valley, and I've seen all the trends over the years. I worked at some of the cutting-edge technology companies, like PayPal, eBay, and startups like M1 Finance and Roofstock.
One thing is common throughout all these companies where I worked at is all of them were trying to disrupt or they were trying to really reinvent the fields, their own fields by leveraging technology. That brings me to eHealth. Why am I here? eHealth is a transformation story. It has an amazing mission, great people, as Fran mentioned, it's going through transformation. I am a techno-optimist. I truly believe that technology is a force for good. It can make this world a much better place, and I'm here to leverage that and make something good at eHealth. eHealth was actually born in Silicon Valley, it's at the heart of all that we do. It is one of our key differentiators.
It enables us to orchestrate interaction among our three primary constituencies: our beneficiaries, our advisors, and our carrier partners. I'll walk through each one of them in detail. We operate on a principle that our beneficiaries, as Michelle mentioned, are not a homogenous group. They have different preferences, they have different tech proficiencies, and different needs. We have built a truly flexible platform which provides best-in-class experience, which is personalized to their needs. For example, if folks who come to our site and who are not sure about the kind of plans that they need, we provide very easy-to-use guided shopping flow where they can try to understand their needs and then figure out the plan that they are more interested in.
We support thousands of plan comparison is one of a very important criteria, as Michelle mentioned, when customers come to our site. They're looking at us as an unbiased party to compare the different plans. We provide that functionality. Remember, it's just like, it's not just functionality or let's just compare like hundreds of plan together. To help them narrow it down and bring it to a manageable whole. For folks who are still not sure, okay, what does this plan mean? Does this support this, that or the other? We provide chat options for them to chat with a live agent, and then I'll show you an example of how delightful that experience could be. One of the things that we take pride in is our deep integration with our partners, and we keep all our plans up to date.
We know which plan supports your PCP, the plans which support your pharmacy, a beneficiary can come and very quickly look at the plan which actually meets their need based on the kind of PCP or pharmacy needs that they have. All of this and more is also available on the telesale side. We are only one out there which truly supports omni-channel enrollments. You can start in one and end in another, but we truly support end-to-end across all channels. Let's look at a demo which shows example of creating a delightful experience leveraging technology for our beneficiaries, which we shot as a promo video internally, but I'll share it here. How cool is that? If we just look at the tech behind it's amazing.
Like being able to think of latency, thinking about having them see the same screen at the same time. There's a lot of cool tech behind that, it's all wrapped up in a beautiful interface. This is just the beginning. We are working on a lot of other interesting ideas. As we speak here, we are currently having a hackathon in our offices, there are tons of good ideas coming out of that as well. We are very excited about that. Let's switch gears and talk a little bit more about our advisors. For our advisors, we provide powerful tools that empowers them and enables them to provide a great customer experience. Something that Roman mentioned, each lead that comes in is rated on multiple factors.
We have built this AI model which takes the lead, we look at our agents. Based on multiple criteria, we make a real-time connection between the two. This is very powerful, since it allows us to maximize our conversion based on the kind of the lead potential that we have. Second, as I mentioned earlier, we keep our plan up to date, we provide very powerful tools for our agents, for our advisors to quickly go through it and narrow it down for our customers. We provide very easy-to-use tools, you quickly enter the PCP information, it suddenly narrows down the plans. You enter your pharmacy, suddenly brings down the number of plans available.
An advisor can very quickly go through thousands of plan and pick few which are very relevant to the beneficiary. Finally, this is a cool one, the plan recommendation. We have built a very interesting and complex recommendation engine, which we are very proud of there, which helps you provide your guidance to the advisor. Like, I'm interested in this, but I'm not interested in that. This is top of my list, but this is third in my list.
When an advisor is talking to you on the call, they can very quickly change the ranking of various factors, and you can get instant answers to the plans which are best suited for your top priority, second priority, third priority, so that they can provide the plans best suited for you. Let's talk a little bit about our carrier partners. We already have a pretty close relationship with them, but we are building ever tighter relationships with them by leveraging the technology platform that we currently have. Such integrations enable us, as we mentioned earlier, to get plan information and keep it all updated, but also provide an up-to-date enrollment information to them. We are also working with the partners to create a dedicated fulfillment BPOs.
That's something that Gregg will also be talking a little bit about. Then we are working on post-sales engagement, like HRA and appointment settings. We firmly believe that digital will be a key differentiator for our future success. As Fran mentioned earlier, digital adoption will continue to grow as younger cohorts age into Medicare. We are also noticing a pretty strong uptake in the percentage of total applications coming through online assisted and online unassisted channels. Finally, we are noticing significant jump in customer center account creation. As Roman talked about it earlier, this is gonna be a key pillar for us to increase our engagement with our customers and improve retention.
All of this will allow us to have a deeper engagement with our customers. Our goal is, due to this and other efficiencies that we gain, we'll be able to drive more enrollment per advisor. This is very important slide. I'll tell you why. Our online funnel has significant opportunities. If you see on your left, even a small 50 bits improvement in our online conversion could lead to $42 million in incremental operating income. That is a big area of focus for us here. We already have multiple initiatives working to improve this. We are building personalized experience, as Michelle and Roman both mentioned, that will continue to improve our overall experience on our site and provide personalized experience based on where you come from and what you're looking for.
You could be new to Medicare, you could be switcher, we are working on providing a personalized experience based on what you're coming here for. Mobile is very important for us. We are optimizing the overall flow so that they, our customers, can get the best experience when they come through a mobile or a tablet channel, you do not have to stretch it out, move it around to see what the content is. We are optimizing it for mobile. We are analyzing the overall funnel, looking at drop off from page to page for each of our vendors, running multiple A/B tests to improve conversion from page to page as customers are coming onto our website.
As you mentioned, we are investing in customer center improvements, which will help drive customer engagement and build long-term loyalty for us. Where do we go from here? As I mentioned, our tech platform is at the heart of all that we do. We are guided by providing the best-in-class experience for our customers. We intend to bring and build deeper relationship with our carriers. Finally, for our advisors, we're gonna build best tools possible for them to be most efficient and provide best experience to our beneficiaries. As Fran mentioned, we are at an inflection point, and we are already far ahead in our tech capabilities. We enjoy sizable lead compared to others. We are committed to expand that advantage thoughtfully, prudently, and as efficiently as possible. Thank you.
That sizable lead is a key differentiator in what separates eHealth from a very crowded field. I'm Gregg Ratkovic. I'm your Chief Business Officer with eHealth. I've been with the company now 25 years. What's unique is I spend half my time with the carrier, with PacifiCare and United, and the other half in the external distribution. You know, I'm a lifelong LA Angels fan, and some of you might laugh, as I know there's some definite Yankees fans in this room. In being an Angels fan, I've always watched the Dodgers from afar. I've watched how they practice. I've watched what they do. I didn't live in their shoes. What's interesting about my experience is I played on both teams. I played on the Angels, and I played on the Dodgers.
I know how that carrier and the Dodgers thinks. My team is the single point of contact in working with the carriers to handle their unique needs and services that they want and desire. I just noticed I didn't send you to my pixelated slide. Carrier relationships are critical to our business. That wasn't always the case before Fran. Carriers were more of a commodity. The carriers are central to everything we do. Having the supply that we have, having the relationships that we have, having the daily conversations that we have, they're critical to our choice model in driving all the way through to our benefit advisors that Roman talked about earlier, because they understand and believe what the market and what that carrier, that customer has to offer.
In a moment, I'll bring Armando up here, and he'll reaffirm and drive why eHealth is so critical to the diversification and growth strategy for their business. We truly do see a different customer than the individual carriers. We see somebody that's more technologically savvy. We see somebody that's more interested in going online, being able to work with the assistance of an agent, being able to use the incredible tools that Ketan went through that allow the customer for us to fulfill our customer's mission, which is to make sure we can see them and experience our tools when, where, and how they wanna be served. We were a first mover in the space when the carriers needed us most, when complaints were coming through, and we worked collaboratively with those relationships that we had.
I can look at Armando, he was one of them. We actually sat down, we did the right thing for that consumer. We made sure that we improved our experience. We made sure that we put that customer first. In all, you've seen the numbers. We improved the CTM scores by 50%-60% in many of the cases with our carrier partners. That was really important because it developed trust in that relationship. That trust then allows us to diversify and leverage our platform. We've talked about diversification. Diversification is not only in revenue, we've talked about how that works on the revenue side with our dedicated enrollment, moving away from the 606 accounting and actually driving dedicated enrollment for our carrier partners. Also product diversification. We can't be a one-trick pony.
We can't be reliant on just MA. We've got Medicare Supplement. We've got a team dedicated to Medicare Supplement. We've got ancillary products and services with hospital indemnity that work well with our, with our Medicare Advantage plans. Dental, vision, and hearing that works well with Medicare Supplement. Then we have our under 65 brands that we continue to leverage and influence so that they can start with us and end with us all the way through Medicare. We have incredible data and insights. We can utilize that data to help out our partners like Armando, who are developing products and services that are important to their customers and our customers. We bring that all together in a simplified solution that is a winning combination between our carrier, the individual, and of course, this incredible team that you've heard from. It doesn't end there.
Post-enrollment engagement is critical. We have to continue talking to them. That retention has to live in everything we do. It's okay if they wanna change plans, but they certainly shouldn't leave eHealth. We should always be that brand that matters and comes back to eHealth over and over again just to reassess their needs and ensure that they still have the right plan and they're still on the right products, and that if there are other products and services that we can, we can offer to the consumer. All of that comes together. I'm happy now to bring up Armando Luna. Armando's been with CVS Health as an officer. He's been with the company now over 11 years. He's been in the industry for 35 years. I can tell you, I think I've worked with him for all 11 years.
I wanna welcome Armando, thank him for his partnership, and let him tell you a little bit about the importance of our relationship.
Thank you, Gregg. Unless you're gonna click for me, you might wanna give that up.
You're gonna need it.
Thank you. Remember, it's a partnership. You have to share. Before I get going, I wanted to first touch a little bit on the term partnership, right? You heard some of the speakers talk sometimes about vendors, right? Partnership implies that there's some mutual goals that together you're trying to accomplish, right? I think it's important to have that context because as you're evaluating, right, the business model for eHealth and its effectiveness, right, you sort of wanna understand how the organization operate. I always tell people that organizations are really made up of processes, right? You can see the legal e-entity, the paper, right, the corporation, the funding, and so forth. At the end of the day, it's those processes.
I'm hoping, Simon, that I will answer your question today about why do we do business, right, as we go through this process. To do that, I wanted to start first on a little bit more about my company, CVS Health, right. If we think about CVS Health, what it is that we're trying to do is we're looking to become the leading health solutions destination. Leading health solutions destination, right. That's what CVS is all about, right. What that implies is that we need to recognize, right, to be the a living organization, that you need to be able to attract customers in different ways, right. You all are familiar with our pharmacies, I hope, right. I know Fran went to one of our CVS pharmacies yesterday, right.
It's important to know that As an organization, right, we're looking at the overall health solutions, right? To be leading, you have to be able to recognize that people come to us in different ways. Gregg mentioned a little bit about their customer profile, right? There's customers that come in a different way. There's people that will come directly to our Aetna products, which is what we offer for insurance purposes, because of the brand. Others need assistance, right? It's trying to find a way of attracting different groups of people. If we were only doing direct to consumer in our model, we'd be attracting a more narrow group of folks, right? When you're trying to understand the customer dynamics, right, you wanna make sure that you have options and choices, right?
Think about how you guys got here, right? Some of you live here, you may have driven your own car. That's your choice, your own proprietary, right? Others may have found that picking up an Uber, right, was more convenient. Others may have had a different service, right? Consumers are like that. They, depending on their needs, they're looking for different solutions, and we believe that we need to be able to cover different options for consumers to come to us. The second item is, we're really looking to deliver a superior healthcare experience. What that implies from a acquisition perspective is that, you wanna be able to anticipate whether or not the right product is being offered.
When we look at organizations, like eHealth, we have to look at, do they have the ability to identify what's gonna happen, right, to that consumer? What are their needs? Can they match the different solutions that we offer with the needs of that consumer? We recognize that we're not always the right solutions for every consumer, right? When an Aetna product is, we want them to be able to do that match. Having an experience, though, remember, it starts with expectations. That means that, we want their people to know a little bit more about just the product they're selling. What's gonna happen to me, right, once I enroll in the product? What happens on day one? How do I activate my benefits, right?
What we love about the relationship that we're building, and you heard some of the presentations, is we're looking at the journey beyond the decision-making of making the purchase. Think about the last time, right, you bought your car, right? Yeah, it smelled good. You had the key and so forth. Now it's in your garage. You're gonna turn it on. Do you remember everything that you need to do, right? Do you know all the gadgets and so forth? Healthcare is like that. Most people are not familiar with everything they need to do, right, to activate their benefits. It's understanding how to take advantage of that that is critical, right? We're in a business of dealing with people. We're setting expectations for that experience. We need partners and companies that can do that. It's beyond just that initial sale.
Somebody will say, "Well, selling might be easy." Yeah, the sales really happens when you actually solve a problem, right? We talk all about solutions. If you can identify the problem and you can deliver the right solution, you're gonna go a long way. In our business, right, we're trying to ensure that health-related issues are addressed. We think in terms of health outcomes. What's interesting is that, when you look at health, you have to start with your mindset. Some people may be in a wheelchair, but they believe they're semi-healthy. They may not be able to even walk around the block with their grandkids, but they believe they're healthy, keep that in mind. We wanna make sure that we're able to pursue and help people achieve those goals, right?
From a mind perspective, mental health is critical, right? We also wanna be able to look at health from the perspective of the emotions, right? We make decisions based on emotions, right? I know many of you are very quantitative, at the end of the day, there's an element of how you feel, whether or not you like a company, right, when you provide that endorsement. There's a combination of qualitative and quantitative. It's very similar to the outcomes that we're looking for, right? We wanna make sure that emotional aspect is taken care of. Of course, right, we need to ensure that physically the body's taken care, right? There's a pain, there's a problem, right, that you have from a healthcare perspective that needs to be addressed.
I'm just sharing this because I want to visualize the complexity of being in this business. It's not just about having a scale of benefits like in the old days. It's really about understanding what those needs are and how do you create those connections. That's where the magic is. It's more, a little bit more complex than that. In our partnership, right, we look to deliver different solutions, right, to different problems that are out there. People are looking for protection, right? If you think about the last time you bought or renewed your life insurance product, right? You buy life insurance to have a degree of protection. You wanna be taken care of, right? That's why we have MedSup products. A medical supplemental product is a way of achieving that.
Other people are looking for that care coordination, right? I've been with an employer. I got my insurance there. They always told me what to do. Don't have the ability to have access to a way of achieving access to a care coordination. That's where some of the Medicare Advantage Plans come in. Those subtle differences, right? Become important on how the products get positioned. That's why you heard some about the technology and the analytics that Roman was describing, right? Creating that match means that you have to be able to understand where the consumer is coming from. Allows you to see, okay, what are people looking for, right? Do they want some assistance, right? On accessing the care. There are products like Dual Special Needs Plans, right? That help people. They provide transportation, right?
You learn through the interaction that, wait a minute, I don't have transportation to go see the doctor. I may not even have enough means to buy the diversion baby food, right? That we heard earlier, right? There are programs that provide help with basics like food, right? Having that match, imagine that agent, right? Creating the connection. Imagine the marketing activities are going on. That's what we're visualizing from our end. I just want you to appreciate the complexity of what we're having to do together, right? To achieve that loyalty, to be able to achieve that trusted relationship, right? It requires to understand that level of detail. It's not a single transaction.
Now, the other piece that I wanted to highlight, as I mentioned earlier, there's different ways that people go about acquiring their insurance, their access to coverage, as I like to call it, right? Some people know what they want. They wanna do their own research. They're very good at working through the internet, calling different sources and getting information. They come directly to us, right? We're prepared for that. There's other people that wanna be able to compare and contrast. That comparison and contrast requires to have somebody that could provide that advice. Do we have the right product? Where do I go, right? Think about the last time you were looking for some new solution, a new product, right? That you're not familiar with.
How do you know which product to buy, right? You hear about different brands. I live in Texas, lately the weather has been changing a lot. We began to look for... Oh, gosh, every time the power goes off, you know, we have these storms, and sometimes the temperature is 120 degrees. We probably need to find something to help us keep up with the power, right? I began to look at different companies. There were, like, 30 different companies that I could go for. Some were telling me I can get it for free if I do something and I put some solar systems and so forth. It was mind-boggling, right? Now, I ended up calling somebody that was an expert associated with State Farm, sort of like a broker.
They guided me through the process and said, "This is the size of your house. This is what you need to be looking for, right? This will help you from that perspective." I got the guidance. I didn't know what to do. I was overwhelmed by it. I didn't study, right? That field. I didn't work in that field. It's the same situation for consumers. Now, the other factor that we're seeing is, there's changes. Changes on how people go about buying benefits. The pandemic actually accelerated the changes. I remember, my in-laws, by the way, just moved to live with us now in the last, it's gonna be 18 months. I'm counting the months because it's a very intense relationship. You have to make a commitment, right? To do that.
I remember going and taking them to restaurants, right? I had to use my phone to illuminate the menu and to make sure they see it. Now we go and the menus have these QR codes. They pull up their phone, and they read the QR code, and I'm, like, blown away by that. I'm like, "Wow, how much they have changed, right? From they're having difficulty reading the menu to now pulling up their iPhones and reading the QR code. My father-in-law is 97, and he's I mean, if you ask him to do something with an Excel file, he doesn't know how to do it. If you ask him to research something on the internet, he doesn't know how to do it.
He can grab his iPhone, read a QR code, and read a menu. It's a significant change that is going on, right? I wanted to highlight that because as consumers change, we need companies that are able to adapt to those changes, right? Yes, we're doing things internally as for our Aetna products, right? Within CVS to adapt to that technology. We also know there's different consumers that are buying in a different way. In fact, I saw this statistic the other day, and we were looking at different purchase behaviors, right? I was asking what has happened, right? Even before the pandemic and nowadays after the pandemic, what are the buying behaviors?
If people were buying digitally at the rate of 5%-10%, what we're seeing is, at least within looking for advisors, right? To compare and contrast, like my situation with, trying to maintain the power of my home. Companies that specialize on providing digital and phone support, right? Are being selected for purchase purposes at a rate that is 150% of what it was five years ago. It's a dramatic improvement. Hence my comment about my father-in-law with his QR code, right? There's more consumers feeling more comfortable, right? Interacting from that perspective. Whereas in contrast, I was looking at the field agents, still dominant, source, right? An important one, right? They come to your house, they engage with you face-to-face. But from the relative percentage, it's been decreasing, right?
People are now beginning to think about, "Hey, do I want somebody that I don't know to come to my home, or do I have the convenience here?" I have my son in California, I trust on his advice on buying insurance. I'm calling a company like eHealth, I wanna have a connection, we don't have time to have the agent connect with both of us who are in different... I'm in Texas, he's in California. How do we connect to make that decision, right? There's technology now that enables that. Being able to also be responsive to the needs of consumers is critical, right? Having the immediate information. I remember five years ago, right, we would have, we still do, we have agents that visit people's homes, right?
You look at the trunk of their cars, right? It's full of booklets and so forth. Imagine how responsive you can be when you're looking at all those papers versus using the technology. They always tell me, right, yesterday we were having dinner, and they were telling me, "Well, when you're in New York, make sure you do things quickly. Finish your sentences very quickly, right? Finish on time. Move," right? Well, people want more responsiveness. There's no time, right, to go through a booklet, if you will. The reasons why we're working, right, with eHealth is, one, and to me it's very important. I know Greg talked a little bit about the CTMs, but when they made a commitment to us in terms of the volume, right? The membership, right?
We always talk about the panel, right? How much growth the book of business, the membership book of business is gonna experience. We put together marketing plans. We put together activities around retention. How are you gonna grow it, right? The one thing that they've been predictable, especially in the last probably the last two to three years, right, is that when they commit to a number, they deliver. Why is that important to us? Because remember, we, as we get more members, we need to make sure we have the clinicians on our staff. We need to have the customer service. We need to have all that infrastructure that people need for that engagement, right? We only deliver on good quality of care if we are properly sourced.
Knowing that we have the membership that we had expected, right, becomes critical. Swings up and down, while they might be good sometimes, may not be good for service and retention. The second point that I wanted to highlight is from a CTM perspective, right? That's a quality common indicator that we all use, right? There's been a significant amount of collaboration, right? In the way that you heard some of the descriptions, right? We're going to basics like, let's listen to a call together. What led to that confusion? Oh, wow, we didn't tell them that that doctor that they selected is quite busy, and when they were trying to get an appointment, they were gonna have to wait two weeks. That created a complaint, right? How do we make sure that we look at elements like that?
Are you changing doctors? Is that the doctor that you're in with, right? That may change how quickly you get an appointment. It sounds simple, but it does take time, right, when you're looking at that engagement level. What happens on day 30, right? What's the process, right? You heard comments about the enrollment verification process. They onboard you, right? That becomes important. Everybody wants to know what to expect. If you don't have those processes, right, they're trusting eHealth to be able to give them the right advice. That trust can only be built if there's confidence that they know what they got into, right? They recommended this product. They put their trust on us, right? We have to deliver on our end, right?
Obviously, as a carrier, right, there's an obligation that we have because they put their trust on us to deliver on our service experience. They help us by ensuring that consumers know what to expect and guiding them through that process. That ability of an organization and a business model that can interact to help us achieve that is what makes a difference, right? CTMs don't just change because you have different folks and so forth. I wanted to close with the term partnership one more time. We achieve that joint goal of growth when we do a few things, right? Number one, is the people component, right? Organizations, right, are made up of people and processes, right? We've seen how they have invested on developing their people, right?
Every person that they have is an ambassador for us, right? If there's a problem, and it's not handled properly, right, Aetna, CVS can be blamed by that, 'cause they're our ambassador. Think about what we do on foreign relations as a country, right? We send our folks, our vice president and others, right, to speak to other countries. We have eHealth talking to those folks on our behalf, right? It's important to us that they have the right talent, the development of the people, right? It's not just about making sales, it's about creating those relationships. If they're sustainable and they're getting the trust, right, it's good for us because we're building on each other's brand trust, right? We're building it together. Again, when you analyze a company, I will ask you, look at their business model.
Yes, also look at the talent and how it's being developed. It's not just at the top, but even the people that are actually interacting with the consumers. Number two is that experience. How do we make sure that they're setting the right expectations for the buyers, whether they sold a final expense product from us, Dental, vision, hearing, MA, Medicare Advantage product, regardless of the product that they offer, right, from us, we wanna make sure that we have the right expectations. We also are learning with them those changes in consumer behaviors. We all are changing. There's a transformation going on in the industry. We spend a lot of time talking about how are people buying, right? That they're satisfied coming online. There's something different on that digital experience.
What are the profiles of those people, right? We know how to differentiate and anticipate needs, right? That becomes important, right? Instances like the chat, right? That, hey, people are... thanks to Amazon, they're teaching them how to do that. They come in and buy an insurance, right? They're using technology like that. Are people ready? What are the activities and how it should work, right? Do we have to prepopulate the databases, right, before the consumer interaction? That becomes critical. It's not just getting a vendor to do it for you, right? You have to know what the journey is gonna be. If you have the skills to manage and build a journey, you're gonna have something successful. Same thing with the solutions, right?
They're going to be hearing, and you guys know they do a lot of research on consumer needs, right? People that are aging in, right? Switchers. You saw Michelle's slide where they were looking at different stages of when people make enrollment. It's important to us to understand what are they looking for. You know, we may have certain features that are not in our products. We need to know, right, from that process what's new, what do we need to add? There's always that collaboration on what features, what products do we need to add, right? To our set of solutions and to the platform. Now, the last point that I wanted to touch on is the fact that people change over time, right? They may have sold a Medicare Supplement product to somebody on our behalf.
All of a sudden, the individual, the client that they got, finds that they need to move to a different state and they no longer have the support that they had, and now they need more active engagement because now they're living in sunny Florida, right? They're by themselves, right? Their family stayed back in New Jersey. All the support system that was there is no longer needed. A transition to an APD becomes a solution, right? That's a way of extending that customer relationship, but also making sure that you know when it's appropriate to make changes, right? We pay very careful attention to when do we have a need to trigger a change in that product, right? Going back to my analogy on cars, right?
I remember driving a nice red Corvette when I was young. When I got married, I began to have kids. We have three car seats. They didn't fit in the car. I got an SUV. I mean, that was a convenient way, right? Life changes, right? And you need to ensure that you know that, you know where your consumers are to determine the right product. That ability to not only... Yes, we wanna keep people in a single product, fine, but there's times that the needs change. That ability of understanding the portfolio and understanding where those folks are in their needs basically creates an opportunity, right, to build a loyalty. Now, our job as a carrier is to deliver those solutions. There might be times that we don't have what they need, right?
Another carrier will have a better solution. That's fair, right? we're not good at everything, right? We recognize that. The products that we're good at, we wanna be able to be given a fair shot, right? That's where that becomes important. It's really an element that ensures, it might be a greater persistency for John, right? we might have a little bit of disruption in between, but we wanna make sure we satisfy the client over time, right? We will have different solutions, right? that we wanna deliver. Just keep that in mind, right? It's not just, how long a person stays with a given product. It's really how you build a relationship, right? Whether or not, the client, right, remains there, and they have that confidence.
At the end of the day, right, eHealth is trying to build, right, a trusted relationship with a different type of customer, right? That's what's important, right? Hopefully that helps understand, right, why, at least from one carrier's perspective, right, why we do business with them. With that, thank you, Gregg, for the opportunity of being here and I hope you have an enjoyable lunch. We did not cook the lunch, we don't claim responsibility for that. We hope you enjoy it, and you'll have, what, 45 minutes you're giving them? All right. Thank you all.
I believe so. Thank you, Armando.
All right.
Thank you so much for your partnership.
Thank you.
Okay.
We are going to resume the program in about five minutes. If you can just start making your way back.
All right. I got the hi sign from Kate. Good afternoon. I'm John Stelben. I'm the CFO. I left the ranks of the retired, about six months ago to join eHealth, to work with somebody that I've known, learned from, and respected for over 25 years, our CEO, Fran Soistman. Before I joined eHealth my wife and I were building a retirement home in Florida. We spent time designing it, a couple of years building it through the pandemic, with all the ups and downs that you might expect through that. We finished the construction, we furnished it, we moved in about 18 months ago. It wasn't. That was just the start. It was just the beginning. It was a house, it wasn't a home.
It needed a lot of work, punch list, just the 100 details it takes to get it just exactly perfect. That took another year. As we were finishing that up, I realized I have more to give, I have more to contribute, and I was thinking about what was the right opportunity to do that. I had a couple of things that it had to satisfy. 1, I wanted to work with people I know and trust. 2, it had to be challenging. I'm not a caretaker by nature. 3, I had to be able to make a difference. When Fran called me, it was the proverbial perfect fit, and so here I am. The analogy I would make is that when Fran joined in late 2021, he was building a house.
He was designing the future state, building a management team, making sure there was a strong foundation for future profitable growth. We're here today to tell you guys about how we're gonna turn this company into the gold standard for online health insurance education and enrollment. I'm hitting the button. There we go. In early 2022, we started a transformation and implemented a comprehensive cost reduction plan. That's really a way of saying we decided to start spending the money smarter than we had. There are some familiar faces here, one left from back in our Coventry days. We used to say something about there's only 100 pennies in $1, and that's today.
Really our plan was around making sure that every penny we spent added value, marketing, people, technology, and that's what we did. We took out over $110 million on an annualized basis. I'm sorry. Okay, there we go. In 2022, we exceeded guidance on all those metrics. March, you saw we ended with $203 million in cash, $800 million in commissions receivable. For 2023, we're projecting to start growing again. The levers are in place to drive margin expansion, and we're projected to be EBITDA positive in fiscal year 2024, and operating cash flow positive for the trailing 12 months ended March of 2025. The picture of our revenues. Today, and I emphasize the word today, about 70% of our revenues are Medicare Advantage commissions.
What's important is tomorrow and the future, and what we're gonna do in this business to diversify our revenues. While Medicare is a great growth trajectory into the future, we wanna grow our commercial businesses, we wanna grow our products, and we wanna grow the cash flow dynamics of those products. We'll do that through the BPO and additional dedicated carrier services you heard about this morning. We're leaning into those carrier relationships and our direct-to-consumer experience to really grow our commercial products more. One I'm particularly excited about really is the ICHRA business that Fran mentioned earlier. I liken that to the transition from defined benefit plans, pension benefit plans to 401(k)s. It took a little time, but today everybody has 401(k)s. It's not a matter of if, it's just a matter of when.
The important thing to take away from this is, this is all built today. We may have underinvested in it in past years. It may have been sidelined because of a primary focus on MA commission growth. It's there, it's scalable. We do it today, and we're ready to grow it. A little bit about the cash and revenue cycle. I get asked a lot of questions about this. We account for commission revenue under ASC 606 or lifetime value accounting. What that means is that our work is complete when we have an approved application from a carrier. In Q4, during the AEP, as we convert those calls or we get those online conversions, we will book our estimate of the lifetime value of that application into revenue.
We get a little bit of the cash related to that in the fourth quarter. Most of it comes in Q1. As members renew in following years, we get that renewal cash. I think what's important to understand here is that when you look at our financials today, you really need to look at cash flow on a trailing 12-month basis as of March 31st, because that best reflects the matching of the revenues in Q4 and the related cash receipts in Q1. I think I'll say this a couple of times today, our view is that we will be at break-even cash flow from operations in March of 2024. An important metric in our business is LTV to CAC. Really what that is, it's revenue over the cost to acquire that revenue.
You can see the history of the Q4 over the years. You can see that in 2020 and 2021, as the company was moving to really a growth at any cost, you can see how the margins started to suffer, bottomed out in 2020, in 2021, we brought it back in 2022 from the cost reduction program, smarter marketing spend. The LTV to CAC is important because the simple math is a 1.5 is about a 35% gross margin. Our fixed costs today are running in the sort of low 30 range. You create profit when your gross margin is obviously above your fixed cost. We have a cyclical business, though. 50%-60% of our commissions in Medicare are booked in the fourth quarter.
The next biggest quarter is Q1. Q2 and Q3 are the smallest. What's important there is we need to drive the LTV to CAC into the high ones in Q4 because it's difficult to get the LTV CACs into the high ones in quarters where you have lower revenue, and especially in Q2 and Q3, where you have lower revenue and you're ramping up your telesales for AEP. The impact of everything that happened in 2022 was most visible in Q4. You can see that revenue dropped 20%, earnings improved 76%, and cash flow improved by $84 million. I think that it's evidence of a disciplined approach. It's evidence that the fixes that were put in place are working. What does that mean for 2023?
I mean, you've seen our guidance, at the midpoint, it's 6% growth. At the midpoint of guidance, we're getting near break even on EBITDA. Certainly, as I indicated earlier, break even operating cash flow at March of 2024. It's a clear trend of improvement. The vision we wanna share with you today, where are we going over the next few years? Revenue growth. We believe we can grow 8%-10% annually. We believe we can get EBITDA margins in the 8%-10% range by 2025. We believe we'll be positive cash flow by March of 2025. How are we doing that? Well, you've heard it all day. It's revenue diversification. It's expense management. It's improving the LTV to CAC ratio. It's really watching the pennies every day and making sure we're doing what's smart.
It's also making sure we're taking care of our carrier partners and taking care of the beneficiaries who put their trust in us helping them make their decisions. A snapshot of the balance sheet. $202 million in cash, $800 million in commission receivables. We have sufficient liquidity to bridge us to positive cash flow. We will look over time to improve our cost of capital and our capital structure. With everything we're doing to improve the company, we'll be able to approach the markets when they improve from a position of strength. This is my favorite slide. $800 million of commission receivables. It's the most audited number in our financial statements, from the inputs to our LTV models all the way through the sales process to what we put on our balance sheet. It gets intense scrutiny internally.
It's where I spend a lot of my time, as well as our external auditors and their valuation specialists. It's real. It is real. Two things I'd point to to help you get comfort around that statement. One is, since 2018, we have cumulative positive tail. That speaks to the conservatism in our models. Also, you can look at our LTVs. They are relatively stable over time. You have not seen our LTVs jumping up and down as you might see elsewhere in the industry. These are great indicators of stability. The key takeaways here, I think. You've heard all day, significant progress in 2022, getting us to 2023 improved performance, and getting to the growth rates I just spoke about. We'll continue to build on the progress, and we have a plan in place to drive sustainable, profitable growth and cash flow generation.
I firmly believe that because of a few things. One, the management team that you heard speak today. Two, our CEO, who I've known for 25 years and has grown profitable business wherever he's been. Three, the 1,700 eHealth employees who get up every day who work hard to make this company better. They do it because we have a mission. We're in the helping people business at the end of the day. We help people make one of the most critical decisions they can make about their health insurance coverage and their wellbeing. We take that seriously. When we help people do that and we find the right plan for them, that's rewarding. It's very rewarding for benefit advisors on the phone.
It's rewarding for all of us who are in maybe in the back office, who know that we're all doing our part to make this right for people. Being in the people business is a good business for us. To bring this all around, I started this out with what I was sort of building and how I got here. When you think about it, businesses, a collection of businesses make up an industry, and a collection of homes make up a neighborhood. eHealth is gonna build the best home in the neighborhood. Thank you.
Thank you, John. Everybody's favorite part, the Q&A session. Everybody who has presented today will be on the panel. I will complete the microphone. Just raise your hand. You know, once the panel assembled, we're gonna start asking questions. Come on up.
Where's the...
Hey, Jonathan Yong from Credit Suisse. Appreciate all the call today. It was really helpful to get all this color on the business and the, all the updates that you've done. I guess, first, on the 8% to 10% revenue growth, I guess, what are you assuming in terms of adding more members coming online that are yours versus the LTV growth? How much is coming from the other business lines that you're going to stand up? When I think about MA, I usually think mid to high single-digit growth, and you talked about a 1% improvement in retention leads to a 4% LTV bump. I'm just trying to marry all those components when I think about that 8% to 10%.
Yeah. Thanks for the question. I'm gonna have Jon start it out, and I'll supplement.
Okay.
I'll take that, I'll take that in pieces. When we go through our LTV models, you know, we can model out that the 1% improvement in retention will increase LTV values by 4%. That's something that will happen over time. We would observe that, meaning as we look at our renewals each year, as we look at the cash coming in, we can see that retention improve. It's not something that just happens. Oh, we see retention this month, and LTVs go up. It happens over time. We think about this revenue growth in several pieces. One, just if you just look at the secular growth rates in MA, we think we can be right, in line with that.
This year especially, there could additional shopping given the rate increase from CMS, given the RADV, given other things. The LTVs, we think can improve over time, not just from retention, just but the annual commission rate increase, which I think since 2015 or 2016, I think the CAGR on that is in the 4-point range. You get a natural increase there. It's also growing the other businesses too. The commercial businesses we talked about, our ancillary business. If you think about the BPO business we discussed, certainly, you know, that the BPO business alone can be a couple of points of growth. It's, it's a mixture of many things, and that's the beauty of diversifying the revenues streams in the business. We can grow in multiple ways. I'd add one more thing.
I think Jon's answer is spot on. There'll be mix changes, right? There'll be share change as going back to my comments about the inflection point. I think those organizations that perform at the best of their game, the top of their game, they're gonna capture more share. While I understand where you're coming from in terms of the mid-single digits, I think that sort of assumes things remain the same, and I think we're gonna see opportunities for us to capture more share during the next couple of years.
All right, great. Just turning to the other businesses that you plan on developing a little bit more, I guess, how much more incremental investment do you think that you need to apply to those businesses? I know that they're currently stood up to some extent right now, but they're obviously, I assume, will need more resources to really grow them. How much more do you think you need to plow into those businesses versus MA? Thanks.
It's really a minimal investment. You know, it's what we do today. The infrastructure, the operating model, the platform, it's all in place. It's a matter of leveraging some of this, number one. As we ramp up when we're in a BPO type arrangement, that's built into the economics in terms of how we enter a contract. There may be a modest difference in timing, but it's not comparable to what happens in the broker of record business where, you know, you're waiting a quarter for the cash to come in. It's really a minimal investment.
Thank you. Ben Hendrix from RBC Capital Markets. I wanted to get your idea of where you believe the optimal business mix is or if you have a target right now in terms of BPO, carrier, dedicated type businesses? Is it just kind of what's coming in and level of interest among carriers, or is there kind of a defined target right now out there that you're working towards?
Thanks for the question, Ben. I think it's since it's so early, right, we have to demonstrate consistently that we are well equipped to manage this business effectively and meet expectations, exceed expectations. We're gonna have to earn it, and that's what we're all about. I think that over maybe the two to three year period, I'd like to see us, you know, get somewhere in that 15%-20% range. Again, we have to earn it. Word is getting out that we do it, once we have another year under our belt, we'll intensify our outreach so that we have proof of concept. We're really good at this. It works. I mean, it works for the carriers, right? In terms of meeting their growth objective in perhaps a more focused manner.
They really get two bites of the apple, right? 'Cause we continue to work with them as eHealth in an impartial, unbiased manner, but then become an extension of their organization, with a firewall, of course, to help drive even further growth. John, do you wanna say something?
I was just gonna say, Fran, and two, it's good business because it's good margins. The cash flow dynamics are great. We win this business not because we're the cheapest, but because we're the best. We're the best at converting the calls and putting membership into the carrier, and so that's important. That's why we win the business.
Yeah. In a compliant way. Gregg, is there anything you wanna add to that?
No. I think John really hit it well. I mean, it's everything that we've done from, you know, having this choice agency model all the way through to managing the quality of the business I spoke about earlier, to now manifest ourself in more of a specific way for the carrier to see different opportunities in a BPO model and then to what Michelle's talking about in the brand. We can then drive more of that funnel into a carrier that may be gaining that volume, but our tools that we've talked about with Cayte, those tools become specific to that carrier, and we have a relationship in three different ways. We have to earn it, we have to build it, and we have to extend it, and that's, I think, what's really critical here.
Hi, Daniel Grosslight with Citi. Thanks for all the great detail here. The question's similar to Jonathan's on incremental investment, really focused on the incremental investment needed for some of these marketing initiatives and agent initiatives. What kind of investment do you need to make there? Maybe you need it on the technology side, too. I don't wanna leave you out. What do you need to do in terms of spend to really bring these new initiatives to market?
I'm gonna tag team this one, Daniel. Let's start with John with the numbers and then ask Michelle and Roman to supplement. Cayte. Sorry, Cayte.
If you look at sort of our CapEx a year, it's the biggest piece of it is the internally developed software. The numbers fluctuate a little bit, but, you know, between internally developed software and other CapEx, it's in the range of $15-$20 a year. I think that as we think about these investments, we go through a process to understand what these are, what we think the impact to the business will be, and we prioritize them. Some of them we don't do, because if they don't the ROI is not there, we're not gonna do it. It's we wanna be careful with our cash, we wanna be smart about the future.
I'll speak a bit to the marketing piece of it specifically. You know, in the model, there is some level of growth for marketing investment, what I would say is very similar to what I said as we talked about expanding our channel mix, is that we need to do that in a methodical test-driven way. This isn't like an all-in, go crazy and spend, right? You really need to sort of test the market. We need to learn and find our way there. As you see those pockets of success, then you can continue to be able to lean in, right? It's really clear that path to ROI. I wouldn't say that there's some sort of set, you know, specific investment from a marketing standpoint. We really need to do that over time.
I will echo it. Excuse me. I will echo that on the sales side. Really, the incremental investment you can think of when it comes to initiatives that we talked about earlier today would be development of specific training programs because agents are being trained as a baseline. We're talking about the development of the specific programs and then implementing them. That would be not. Because agents are being trained, we're just gonna train them in different things, let's say, local markets. We're gonna be training them in the specifics of the local markets as opposed to national. The only small incremental investment is the development of the program itself. I would say that almost negligible.
Finally, on the technology. Ketan?
On the technology, point of view, our mantra is doing more with less. That is one. Two, bringing in discipline to our overall software development process so that we are not wasting resources. Third is focus and making sure that we are not running in 100 different directions, making sure we are delivering and building things that matter to business and get it out as quickly as possible.
I would sum it up this way, Daniel. We think about it as an opportunity to sort of self-fund the incremental investment by improving our LTV to CAC performance, continuing to drive improvement with conversion rates. It's basically freeing up capital that would otherwise in an inefficient model have to, you know, work harder to generate the top and bottom line results. That's really how we're approaching it. Let's go about this. We know we're gonna get continued improved improvements. Let's repurpose those savings into additional investments.
Yeah, that makes sense. If I just look at what happened last AEP in 2022, on an MA equivalent basis, CC&E was down around 6% year-over-year. Marketing was down around 28% year-over-year. I'm wondering, as we think about your margin improvement for the next few years, how much juice is left to squeeze out of that efficiency on a, on a per MA basis? Are we thinking kinda mid-single digit declines? How should we think about that in our models?
You wanna take it?
Sure. I would say two things. I think when it comes to Medicare, you've got to think about it in two different ways. One is there's room to improve in the LTV to CAC on the telesales. You can see our numbers there. Q4 of 2022 was 1.4. We can drive that higher. It's not just the marketing spend, it's also the sales mastery and the execution and making sure we're driving better leads to and continually training our agents to convert them. The other piece then too is our online unassisted, because as Ketan pointed out, we continue to try to improve that experience. If we can just improve that conversion rate a little bit, it has pretty big payoff.
Afternoon, guys. Fran and the team, I think you did an amazing job today. I want to give you guys a lot of credit. I think that the fact that after the last six or seven weeks and these concerns of a death knell of an industry, that you would come out and guide ahead of street expectations today for your revenue growth the next two years speaks a lot about your confidence in the business. I have two questions, one for Fran and one for John. Fran, obviously, you've been in discussions with your carrier customers in the last few weeks, six weeks, eight weeks, about what's been going on post the CMS ruling.
What gives you the confidence, and therefore shareholders the confidence, that you think you're gonna be a share gainer, that your business has improved and will get even better with your relationships with the carriers based on some of these changes, which seems like will go the way where the winners will take a larger percentage of the business? My second question was to John. You know, your confidence in the business, I think, was really powered by the comment that your cash will be at least break even for the trailing 12 months of 2024, which is basically the next 12 months. From March of 2023 to March of 2024, you're out there saying you will be cash break even and then cash flow positive. We're 3 months into that.
Can you give us some color on what gives you the confidence that you're not gonna lose any cash over these next 12 months and then proceed to generating positive cash in the future? Thank you.
Well, let me first thank you for your very kind compliments to this team. We did this for you. We know this already, but we wanted to make sure we told the story in a way that resonates with our investors and with the analyst community, so thank you for that feedback. My confidence continues to get stronger and stronger simply based on where we've been, where we are, and a very clear vision of where we need to go. This team has demonstrated, and we've only been together as a team a very short period of time, 'cause I was adding members of this team throughout last year, and, in fact, Ketan is really our newest member, having joined earlier this year.
In that time span, you know, we've demonstrated our ability to transform our sales process and generate significant improvement in conversions to improve the quality side by driving down CTMs by 50% and more. We doubled down in our interactions and communications and collaborations with our carrier partners. You know, perhaps, you know, if I brought anything to this organization, it's the relationships that I had when I was on the carrier side. After decades of working with many of these, some of them working in the same place at the same time, others, you know, you get to know people in the industry, and while you're competitors, you establish rapport. I've just great respect for those who are leading our carrier partner organizations 'cause I've worked with many of them for decades.
The state of those relationships is very strong and very healthy, but we don't take that for granted at all. We know it's all about what have you done for me lately? That's good, right? I think that keeps us focused, it keeps us sharp, keeps us agile, and appreciative. Because of these relationships, we continue to look for ways to demonstrate greater value beyond what they look for first. That is, helping grow their business in a compliant and in a quality fashion, high customer satisfaction, high retention. There's other things we can do that we touched on today in terms of adding value with helping with onboarding, helping their new members, our customers, get their first PCP appointment, helping with the HRA process.
We continue to identify those things that are really adjunct to our core capabilities. I mean, we have those relationships through the sales process. How do we utilize that to endear ourselves more with our customers as well as help them with their new members? You know, taking out $110 million in cost was a big lift, and we did it. We did it incredibly effectively. We navigated through some of the organizational disruptions that come with that, and rebuilt the confidence of our employees. One of my other key hires who's not on the panel, but she's in the, in the audience here, is our Chief People Officer, Jana Brown. She's my partner. She's our partner in what we're doing to build this culture of success.
It's getting our employees to believe again in this company. We've created a brand-new mission statement, a new vision. I can't be accused of plastering on the walls because we're remote first. We just help people internalize it to remind them why they come to work every day. What is it we're doing here? We're always mindful of where we gotta get to, how do we get there? How do we get there with a sense of urgency? There's always when you're, you know, in a turnaround situation, and I'd say that we're nearing the end of that turnaround because we can see, you know, when we achieve profitable performance, and we have a demonstrated track record to give me confidence, to give John confidence, to give this whole team confidence, we're gonna get there.
No one is rowing in a different direction. We're all rowing together. I've been doing this a long time, and this is one of the best teams I've worked with, and I've worked with some really great teams in my career. I've really been fortunate. That's at a high level. John, I'll let you take the second question.
Yeah. I would say, it's really not a sexy answer. I get up every day and we think about, how are we gonna do better today? What are we gonna do to improve our cash flow? What are we gonna do to ensure that we can hit our numbers? What I'm lucky is that in a lot of organizations, the CFO has to sometimes be the guy with the stick and be people other stuff. I don't have to do that here. Everybody is on the same page. In fact, some folks at this table, Michelle, pushes me. I get confidence because we got some mom-momentum going in Q1, and just working with people every day, and we're very focused on what matters.
There's not extraneous BS around the place. It's what are we gonna do today to drive forward?
I guess, what I was trying to get at more was, what have you learned in the last 8 to 10 weeks that gives you the confidence after speaking to your partners and your business that the enrollment period this year and in the future will be so positive for you after so much worries about what could be in the industry?
Sure. Let me try to be a little more clear with that. I think what you're referring to is when CMS published the new rule. That ambiguity in the rule, which is quite common in CMS rules and regulations by design oftentimes, but we're accustomed to that, and I was pretty comfortable that we were gonna get to a better place, but it's on CMS's timeline. They're the regulator, right? It's their prerogative. And while there hasn't been a broad public statement, we've seen correspondence to clarify that inbound calls are not subject to the 48-hour cooling off period or in the scope of appointment. And we were talking with our carrier partners the entire time.
They largely were in agreement that the rule doesn't apply to inbound. Until you get that absolute clarity from CMS, you know, you just have to be very careful. When it came out in the draft form, you know, we saw what could happen, and we started working on solutions. What do we do well today that we could do better to address this, if indeed this becomes the rule? You know, we won't have clear visibility of what carriers' plans are until after they've submitted their bids. That goes through a reconciliation process with CMS. Greg and his team will start meeting with our carrier partners on what their plans are in terms of the specifics in July. Each year, we go through that same process.
We're, you know, we have detailed information in terms of what the plan is in what markets, so that we can plan accordingly. I think there's gonna be some carriers that will be more mindful of protecting their books of business and will try to manage the risk of volatility with plan designs and disruption to beneficiaries. I don't think everyone's gonna be in that same place. I think that there'll be companies that are just the stakes are higher, or, you know, a company that has managed its Stars performance incredibly well doesn't have that kind of disruption risk nearly as great as those who perhaps had a bigger setback with Stars. We think that if there is more shopping, we'll be prepared for it.
You know, we'll anticipate where on a market-by-market basis, carrier-by-carrier basis, where there's the greatest friction, and make sure we go on offense with our customers to help them navigate. There's sometimes a foregone conclusion that you have to switch. We don't buy that. Right? Oftentimes, what you have is the best value. You just need to hear it from an expert and not the pharmacist. I hope that helps you a little bit.
Obviously, being one of the leaders in the space, it's important to hear the confidence speaking to the carriers, if things are really gonna be pretty as planned this enrollment period and not really change dramatically from what was in previous years.
Well, the carriers have navigated. I mean, you know, many of us on this panel have personal experience navigating some of the, you know, the challenges that they're facing right now. Carriers are very resourceful. They're very resourceful in looking for ways to reduce either their administrative costs to improve the utilization management, to drive cost savings or medical co-care savings that give them a little more room to navigate, as opposed to always having to go to either, you know, decreasing benefits or introducing a premium, because they know the consequences of that. They're very sophisticated, the industry's evolved tremendously in the last decade.
Hi. Thanks for the question. I'm trying to unpack your long-term sales growth of 8%-10%, and I'm trying to put that into context with both long-term Medicare Advantage growth that's kinda growing that eight-ish to ten-ish percent. What does that assume? Does that mean that eHealth is gonna grow in line with the Medicare Advantage industry? I look at kind of the slides today, and I think, well, that would assume no increased share of e-brokers. You had that interesting slide about the younger cohorts in Medicare Advantage prefer online sales. Can you just I'm trying to reconcile all those kind of forces with your long-term sales growth of 8%-10%. Did that question make sense?
Yes. Santik, thanks for the question. I'm gonna have John field the math part of it, but from a strategic perspective, I'll just remind you that the numbers, the ranges that John went through really represent the composite of a business. It's not, you know, it's not indicative of exclusively Medicare. We see opportunities with IFP, with small group, with MedSup, and ancillaries. It is a composite. The BPO, again, we have great aspirations in terms of what we can do over the next couple of years there. It's an all-in range. John, you wanna?
Fran, you said it perfectly, actually. The other thing in numbers too, what we're thinking about the commercial business. The beauty of the diversification is, if sort of any one channel, let's say, slows down, we have other channels that we can push to keep going. I will say we do think.
I don't have a crystal ball. We think the ICHRA is a big opportunity for the future. I think also that underneath the products and getting our LTV to CACs improved in, call it Q2 and Q3, is our ability to sell other products like MedSup and to get more new to Medicare sales in the business. That's gonna help push the revenue growth rates.
Thanks. I have a question about the capital structure. Can you discuss or describe a future capital structure from two perspectives? First, can eHealth self-finance growth going forward over the next three to five years? Second, can the cash generation improve the capital structure between preferred and debt options and still allow the company to grow? Within that context, can you refresh my memory on how big the H.I.G. preferred is and when it'll be put back to eHealth since it is so far out of the money?
Start with the second part maybe.
I think that, you know, today, our capital structure is expensive. I mean, we've got, you know, two pieces. You've got the HIG preferred, and we've got the Blue Torch. You know, our goal is to improve profitability and improve cash flow, and that will give us options. I can't tell you exactly what we're gonna do, but I know that the best way for us to have options on this capital structure is to improve profitability and generate positive cash flow.
Sandy, could you maybe repeat the first part of your question?
Thanks. Can eHealth self-finance growth then, going forward over the next three to five years?
Yeah. Certainly our goal is to do that. We do it, again, to Jon's point, start with generating profitability and positive cash flow. It also goes back to the efficiencies that we're, you know, we are executing on. We already got 1.0 done on sales. We're at 2.0 now, technology. Driving efficiencies, eliminating some, I'll say, fixed costs that are no longer serving a purpose, right? We have the space that an abundance of space that we are managing away over time. That's gonna free up funds.
The marketing, you know, we think that there is pretty significant upside opportunities as we launch our new marketing strategy with audience segmentation, having strict disciplines with our LTV to CAC expectations, how we manage that, and, you know, initiating new channels that we believe are less crowded that could yield better results. The branding, you know, I wanna be very clear about this 'cause I've gotten a couple questions at the break. The branding and the marketing go hand in glove. They're not mutually exclusive. We're approaching this very differently. Michelle stated that in her presentation, but I wanna reinforce that. The branding and the marketing are intertwined. That's a very efficient way to approach it. It applies across everything.
Everything we're doing in this company will feature the eHealth brand.
Hi. On the BPO business, can you explain how the lead flow will work? Is the outsource or the business that you're doing with the carriers as they're in-house, will you be driving leads to that business as well, or is it totally, you know, the lead flow is from the carriers themselves? Also just in terms of the rev rec, can you just walk through the rev rec and the cash collection in that business, just to refresh me on that? Thank you.
I'll answer the first and then I'm gonna hand over to Jon here. Two separate, two separate parts of the business with our, with our platform. One is obviously that choice agency platform where we'd represent that carrier driving our leads, using our sales agents to convert and deploying our technology. The dedicated carrier side is the carrier driving the lead through their platform and their cost while we're deploying our agents to drive that higher the conversion and obviously a better quality experience. We, we do have a path in both areas, but they are separate to just make sure that we keep our choice platform.
Pure
... pure compared to the dedicated.
I think how these arrangements work is that there's a fee you're paid for your actual work getting done for your teleforce. Then there's a success fee based on actually converting the leads that you're being sent into sales. We'll recognize revenue as on the success fee as we get approvals, and we'll recognize revenue, I believe, on the cost reimbursement as we incur. What's nice about these arrangements are they're good margin arrangements. If you remember the slide where I showed under the LTV, I get 40% in the first year and then renewals, I'm getting 100% in essence up front. The cash flow dynamic is great for us.
It looks like there's no more questions, so we'll pass the floor back to Fran for closing.
Great. Well, I wanna first start with thanking you for being here today. Thank our investors, thank the analysts who cover eHealth. We appreciate your participation. I started the day sharing my passion for teams and my experience and passion for growing championship teams. I hope the time we've spent together today, you've seen we have a champion-championship grade team before you. In the interest of time, you only saw about half of the leadership team. The other half are sitting over there, and they are critical contributors to the company's success. We took today to paint a picture of where this team can take eHealth, why we're each here.
We all had choices as to what we could do in our careers, but we're here because we believe in a common vision. We believe in the investment thesis. We believe in our business case, and we work it every day. Our job now is to earn your confidence, to maintain your confidence because you all have choices. We want to reward you with our business performance so that you are satisfied shareholders, and those of you who cover us feel confident in what you're reporting is something that this company can deliver on. Thanks to you all very much.