Good morning, everyone. Thank you for coming to the Evolent Health session. For those of you whom I've not yet met, my name is Ryan Daniels. I'm the HCIT and Healthcare Services Analyst here at Blair, and it's my great pleasure to introduce our speaker from the company. Joining me to my right is Seth Blackley, who is the company's Co-Founder and Chief Executive Officer. In the audience and at the breakout, which will be up in the Maher Room, we'll also have John Johnson, the company's Chief Financial Officer, who's in the front row, and Seth Frank, who heads Investor Relations, directly behind him. So really excited to have Evolent here today. It's our first presenting company, and this is good because it is our top alpha generation idea.
I think it's a really interesting opportunity here after a recent pullback, given some noise on utilization, in the market, which we think is a little bit mischaracterized, in regards to the impact it'll have on the company. But that's something we could probably get into in the breakout, so I won't go into it here. More importantly, a really interesting asset that has been developed over the last four or five years, both through organic growth and some M&A activity, including an announcement this morning that's pretty exciting, is the company acquired some AI assets, to integrate into their operations to help with provider workflow, reduce burnout, increase satisfaction of their clinicians. So it's always interesting to have some recent news to discuss, for the Growth Stock Conference. So very pleased, again, to have the team here. A couple quick things.
Again, as I mentioned, we'll be up in the Maher Room for the breakout session. And number two, just recall that all the disclosures are at our website at williamblair.com. So with that, I'll turn it over to Seth.
All right. Thank you, Ryan. One of the most thoughtful analysts I've been around for a long time and has been a very helpful partner to us in communicating the business. I really like spending time with Ryan, except he makes me feel so short. That's the only problem. But thank you, Ryan. So I'm gonna do something a little unusual, knowing this is a growth conference, and there's some people who are less deep on healthcare, but really just start with a very brief description of the company in layperson terms. Okay, so, I guess, how many people in the room have had a family member or have personally experienced a diagnosis with cancer, cardiovascular disease, or a musculoskeletal disorder, right? Pretty much everybody.
What Evolent does is work with physicians, the treating physician for those three conditions, to help improve the quality and reduce the cost of those conditions. So upon diagnosis, cancer diagnosis, cardiovascular diagnosis, or musculoskeletal diagnosis, what is the best evidence to treat that particular condition? Make sure that the patient is receiving the best evidence, and, you know, like manufacturing and many other fields, it turns out that lower defect, higher quality care is lower cost care. And that's fundamentally what we do. We get hired, as you can see on this page, by the insurance companies to help deliver that higher quality, lower defect care through engaging with the physicians directly. And in doing so, we significantly reduce the cost of care. Often 20% reduction over a multi-year period. We guarantee that result often to our payer partners.
We do it on behalf of our motivation is ultimately the patient, my family member, your family member, each of us individually, and we do it through working directly with the physicians, oncologists, cardiologists, and musculoskeletal, neurosurgeon, et cetera, okay? You can see here on this page a little sample for who our customers, the largest health plans in the country are our customers. Think of us as a category perspective, as the leader from our perspective in value-based specialty care. You've heard a lot about primary care companies. We are a value-based specialty care company. In terms of the focus of the organization, how do we actually drive value for shareholders? There are three themes that we have used to guide the company consistently. One is strong organic growth. We'll show you in the next page.
The business has been growing very quickly for a number of years now, four years straight. We have less than 5% penetration, so our market share is low. It's a $150 billion addressable market. We have 5% share, and as we'll talk about in a minute, we have significant running room, even within our existing customer base. So if we cross-sell all of our products to our existing customers, that's a $50 billion opportunity. So of the $150 billion market opportunity, $50 billion is directly addressable through cross-sell. The second big theme we have is around driving profitability. The team and I are a little bit old school with respect to how we think about managing the company.
We like EBITDA, we like EBITDA growth, we like cash flow, and we have been very focused, as you'll see on the next page, about driving that cash flow. 70% of the business is from a Tech & S ervices product that has higher margins. 30% is from a more risk-based model, and we'll talk about that in a minute. Then the last theme for shareholder value creation is around thoughtful capital allocation. I'll spend a lot of time on this towards the end. In terms of the history of the business, just to put this up here, it has been a very fast-growing business, over 40%, excluding divested assets. Over the last few years, we've divested a few assets to really focus the company around value-based specialty care and the EBITDA CAGR has been even faster.
We'll talk about this again more at the end, but also very high cash conversion from that EBITDA. I mentioned the TAM a few minutes ago. It's $150 billion. If you look at the teal-colored circle, that is the opportunity within our current customer base to cross-sell. So 50 of the 150 we can get at through cross-selling, and the business is, you know, midpoint of guide for this year's $2.6 billion. So obviously, a fair bit of running room there.... In terms of the customer problems, if you're following the managed care market today, there are a bunch of pain points in the managed care market. Their costs are growing really quickly, their cancer costs, their cardiovascular costs, et cetera. And because of those issues, we're getting, I'd say, very significant inbound demand for our product.
Calls from health plans, including the last couple of days, "Hey, help us manage our cancer costs, cardiovascular costs, and MSK costs." If you follow healthcare, you might have seen a recent South Park episode that circulated about sort of a parody of how complicated the U.S. healthcare system is, and we've seen, anybody who raised their hand earlier, you've seen it. When there is a diagnosis: Have you gotten your imaging? Did you get it? Did you get a pre-authorization approval for it? Which doctor do you have to go to? Do you have to call the insurance company back? There's a sort of a mess of trying to navigate the healthcare system, and I'd say we're trying to simplify that. It is hard to receive coordinated, integrated care. Our job, from our perspective, is to make that easier, better, higher quality, and lower cost.
There's a bunch of problems with the healthcare system. I won't go into immense detail, given this is a growth conference, but, our job from our perspective and our mission is to, again, how do we make that journey easier for the patient and save roughly 20% of cost over time? That's what we do. In terms of the products, I mentioned this earlier, at the top of the page, Oncology, Cardiology, and Musculoskeletal are the main pillars of this business. We do a lot underneath that in terms of providing the diagnostic reviews and the like, genetic reviews to do that work, but it really is oriented around these specialties. There's a lot we do around giving the physician incentives and guiding them towards that best care, but ultimately, at the end of the day, it's really those specialties that are the core.
Let me give you an example in cancer, which will bring this to life a little bit. So, there are a little over 10,000 oncologists in the country across the 50 states. We work with most of them, okay? And on behalf of our health plan customers, when a patient is diagnosed with cancer, we look at that case in the middle of the page and say, "Okay, it's a 48-year-old male patient with this genetic profile, has a diagnosis for non-small cell lung cancer," just as a for instance. If that's the case, often there will be 10, 12, 15 different therapeutic regimens that are possible, and that's 'cause there's a huge explosion of pharmaceutical interventions. You're staying at the Sheraton across the street. There's a huge oncology conference going on right now.
You hear of drugs like Keytruda that are, you know, by themselves, $25 billion of revenue, bigger than McDonald's, you know, and this is one drug for cancer. So you think about that and the huge explosion of the number of different therapeutics that can be applied, and then consider that there are over 100 mutations for the typical tumor, okay? So you put all that complexity together, and the average oncologist has an array of options for treating that patient that I mentioned, okay? And in this example, you can see at the top, look how many example. Those are the different choices, A through I. Each of those are different treatment regimens for that patient.
What we do is we use the evidence on the left-hand side of the page, some of which is proprietary to Evolent, and say, "What is the best treatment for the patient?" There are 300 journal articles coming out each month in cancer. Pretty hard for the typical oncologist to keep up. The average oncologist is reading four of those articles, so there's hundreds of other articles that they're not keeping up with. We do read them all. We ingest them into our technology platform, and we compare what is the treatment plan the physician is recommending to our best practice. So if this is my mom, what cancer treatment regimen do I want for her, okay? Or your family member. And we compare it to, first, efficacy, and that eliminates some of the treatment suggestions, go down a row. We then look at toxicity.
How it would affect the patient? Quality of life, financial toxicity. Some of these things are incredibly expensive for the patient. The leading cause of bankruptcy in the United States is medical bankruptcy. 20% copay on a $50,000 drug is a problem for a lot of people. And then, at the very bottom, we look at the cost, in that order. And if the physician is recommending care for that patient that's anything other than B or E, those are the two treatment plans that we think are both roughly equivalent in terms of value, we will intervene. That happens about 15% of the time, 20% of the time, depending on the market. So we get that data at the point of care from the physician, I can explain in a second how we get that data, before the treatment plan starts.
We then have roughly 1,800 clinicians that work at Evolent. 300 physicians, 1,500 nurses. 8 million times a year, we are outreaching to those physicians or reviewing those cases manually. 8 million times, cancer diagnosis, MSK diagnosis, cardiovascular diagnosis. And some portion of the time, we are going to the physician and saying, "Hey, based on the latest evidence, we suggest a change, and here's why." And you can see on the far right-hand side of the page, in this cancer example, when a patient receives the better care, higher quality care, there also is often a cost savings. That's again, because many times, if you go with the wrong treatment the first time, you're gonna be coming back in three months and switching to the right one. You've wasted three months of tumor growth, you've wasted dollars, et cetera.
And so this is fundamentally what Evolent does, is intervene 8 million times a year and provide the right incentives for those physicians to get the right care. You know, I can tell you all day long why I think this is great. I'm obviously biased. If you look at our customers, though, and they're voting with their feet around their perspective on our product and the value that it's creating, you can see three case studies here from Centene, Molina, and Humana, three of the biggest plans in the country, adding additional services from Evolent across lots of different categories of care. And this, to us, is the ultimate measure of whether we're doing a good job, is what do our customers think? I'm really proud of this.
The other thing that I'm proud of and excited about is that despite all that, we have huge runway left. This is a list of our top 10 customers blinded. We're roughly 16% penetrated with those customers, meaning payer D, blinded, we have a 97% of the opportunity is still in front of us. And I think, again, when people are getting to know Evolent, and do I like this story? For me, this is probably the most important, interesting piece of information, which is our customers are growing with us, and they like us, and there's still a whole lot of runway left. And, you know, if you go back and look at our last 12, 16 quarters, you'll see most of the announcements are from our existing customers growing with us. And again, I take a lot of pride in that.
The team takes a lot of pride that means we're doing a good job, we're fulfilling our commitments, and they're voting with their feet. In terms of the growth algorithm, you know, I've just talked a lot about existing customers, but if you look at the four levers here, one of them is adding new partners. We have 70 health plans today. There are a bunch of health plans we don't yet have, like, logos that are brand new to us, that, you know, we have no relationship with, and that's one of the levers. Within that, you can be adding unique members. So even if we've signed a customer, we only have maybe the commercial population or the Medicare population, you can add members. We have about 40 million Americans today on the platform.
Obviously, there are, I think, over 350 insured Americans, so there's another opportunity there. The third lever is to add products. So even if we have, let's say, a Humana, which is a real case example, we work with them in Oncology. We don't do anything in MSK or very little in Cardiology, so there's an ability to add products in addition to adding lives. And then the last, the fourth lever, and we'll talk about this in a minute, is we have two products at Evolent. We have a Tech & Services product for people who don't know it, you know, think higher margin, more like SaaS margin business, 50% margin. And then we have a risk-based product. And about 5% of our lives are under the risk product, and about 95% are under Tech & Services product.
Converting members from Tech & Services to risk is another growth opportunity. It is both a revenue growth opportunity and a very significant margin growth opportunity. Speaking of those two products, here they are. The Performance Suite is risk-based, meaning we will guarantee that the cost of Oncology will go down. Our revenue and fees are over $20 per member per month when we do it that way, so pretty significant. And our margin, EBITDA margin at the bottom is 12%-18%. The second model is the Tech & Services model. Much lower revenue, as you can see, and about 50% margin coming to the bottom line. Again, more of a Tech & Services model versus a risk model. If we have our preference in life, we would have more on the top.
The gross dollars are more attractive to us on the top than they are on the bottom, but we really just sort of follow what the client preference is in terms of what we drive. About 70% of the EBITDA of the company today is in the bottom, the Tech & Services, and about 30% of the EBITDA is in the top. And that's important in an environment where people are worried about utilization and healthcare cost. A lot of our profitability comes from the Tech & Services side. We are seeing a lot of growth in both categories. One of the questions we get a lot is, "Hey, show me that you are making money under that risk product," the top one that is 30%. What this is is a cohort analysis over multiple years that shows that margin maturation.
We are on track for this margin maturation, including through this year and where we're headed for the end of the year. You know, I won't walk through the detail on the slide, but this will show you across each of the cohorts, from mature on the far left to year one, year two, year three. It does mature, so the first year of a Performance Suite product is low margin, the second year is sort of medium, and the third gets to maturity. One of the commitments that John and I, John, our CFO here, and the team have made is around a $300 million EBITDA run rate exiting this year. So think of, you know, a $75 million quarterly run rate EBITDA by the end of the year, building off of Q4 of 2023. Here's a bridge to that.
You know, I'll just sort of give you the simple answer, which is we feel really good about it. There are puts and takes every year, and even in a high-utilization environment, we have the ability to make adjustments. And because of this, we'll talk about it later, we feel really good about getting to this $300 million exit run rate and have, I think, very clear deliverables to get there. We have some small go-gets left on things like a $4 million quarterly go-get on new revenue signings that we all have done by the end of the year. But again, across the board, we feel very good about reaching that $75 million number. I wanna end just with a short conversation about our capital allocation priorities.
You know, this was the third of the three pillars of growth, profitability, and capital allocation. You know that there are three basic principles we have in capital allocation. The first is being really good at organic R&D and investing in our product. We spend about 1% of revenue on CapEx that are enhancing the product. We're constantly listening to our customers about what do they need and what do they want, and we've done a fair bit of that, and I feel really proud of the R&D that the team continues to do. The second is around what I would call sort of thoughtful, disciplined M&A. We've never been a company that buys companies at frothy valuations. We have always done accretive transactions, but things that are very practical and drive very near-term value for the firm.
We've had a number of these, I think, which have been very successful and helped make Evolent bigger and more attractive to our customers because we can offer more products. And then the last piece, you know, I think particularly important in this environment, is just making sure that we're maintaining reasonable leverage levels, and we feel really good about that, of course. In terms of a quick case study on the M&A, of those three, the M&A is the middle one. We bought a business last year called NIA. You know, the transaction has gone really well. It was a, you know, I'd call a medium-sized acquisition for the company. Brought on 1,000+ people, over time, close to 1,500 people. Added a really important capability.
The thing that's the most, from my perspective, important data point on the page is that the effective multiple that we paid from day one to month 24 is about 45% less, and we did that through cost and revenue synergies and retaining their clients. That to me is execution. It's about doing a good job with the integration and the team and the people, but also being, you know, disciplined about taking out the cost. We have done that. We have clear line of sight to that 45% multiple reduction, I think is an important case study and sort of one of the ways that we can create value for shareholders. Ryan referenced it, you know, wouldn't be fun if we didn't talk about AI.
So let's talk about AI for a second, which is one of our capital priorities, both organically, but also from an M&A perspective. If you think about what I've talked about today and think about your family member or my family member receiving care, and the South Park episode, if you haven't seen it, go look it up. It's sort of depressing and funny, but the complexity of healthcare, right? How hard is it to go get the care you need? And there are a couple factors that AI, we think, can help make that easier, okay? One is taking in all the clinical evidence. I said 300 journal articles a month, consuming that, aggregating it, putting it into a policy model that we can use to compare evidence. That's one.
Second is if you have a family member or friend that's a provider, they'll tell you a lot about burnout. Ryan talked about this. 14 hours a week is the average amount of time these physicians and their offices are spending on dealing with the back and forth with the insurance companies. It's a huge pain for them to deal with. AI can help with that. And then the last thing, you know, for us and our payer clients, sometimes we spend 30 minutes, 20 minutes, depending on the case, with our clinicians, going to identify through the EMR data and aggregating information to figure out what's going on in this case and are they receiving the right care. And on that far right one, I wanna focus on that for a second.
We think if it takes 30 minutes today, we think with AI, we can allow a physician or nurse to do that review in 15 minutes, as a for instance. Evolent spends about $150 million a year on salaries for physicians and nurses. If we can help them do that in half the time, that's a $75 million efficiency opportunity. It means we have to hire a few people, fewer people as we grow at 40% a year. It means that we can free up their time to do other value-added things to help the patient navigate the system. It means that we can provide our product to our payer customers more efficiently. We can hit our margin targets, right? And so what I wanna, you know, the announcement we made this morning is a deal with Machinify.
Machinify is a Google Ventures, Battery Ventures-backed company that was founded in 2018. I think the leading AI product for administrative efficiencies in the market. Incredible team. The data science team came from Netflix and other known Valley locations that are sort of the most sophisticated data science engineers and team out there. They have three products today, one of which is doing the work that we do, and they have two other products unrelated to Evolent. We've acquired the product that they developed over the last six years that is relevant for our business.
We paid $25 million, we'll talk about in a second, to carve that asset and the team and the data science models out, and we have the exclusive worldwide royalty-free license to, to use that, integrate it, and the team fully into our platform. What that allows us to do, I mentioned on the last page, if we are spending 30 minutes on average on a case, we think with this platform, we can do it in over time, half the amount of time. 30 minutes, but 15, that is what they've proven, a 55% reduction with one of the largest payers in the country. That's not gonna all happen, you know, within 12 months, but it will happen across the Evolent base over time. So I think the first value proposition of this deal is very significant efficiencies for Evolent and our clients.
I think, again, rough justice ballpark, if we spend $150 million, there's a 50% savings opportunity. There's a $75 million opportunity around that platform today, and of course, that $150 million of spend is gonna grow a lot for Evolent over time. And so it's gonna be a very significant eight-figure opportunity for Evolent, for efficiencies. The second thing it's gonna do is allow Evolent to go to any of our clients and offer to support specialties and spend well beyond the three: Oncology, Cardiology, and MSK. So if I'm a health plan, and I'm using Evolent for those three specialties, but I also want somebody to do reviews on spending outside of those areas, what about neurology? What about ophthalmology?
All these other spend categories, we can now use this platform, licensed on a SaaS basis, for those payer clients and allow them to do that kind of work directly. And they can benefit at a 55% savings level, to use that example, in terms of efficiencies. And again, I wanna really highlight that also means that you're gonna get faster turnaround, more cases that are auto-authorized, things that are good for patients and good for families and good for physicians. Physician burnout and just the experience for patients. So I could not be more excited about the transaction. I think it's incredibly interesting. A little more background on the transaction itself. I mentioned the business, Machinify. It's a very sophisticated company. Very excited to be partnered with them in the time ahead.
You know, I mentioned that the transaction itself, the exclusive royalty fee-free, perpetual use of the code that will be transferred to us, integrated into our platform. We'll also be receiving contracts with a leading payer that are about $6 million of annual revenue, and the team who is gonna be joining Evolent over time. So really excited about it and excited about the partnership. I mentioned the terms earlier. It's about $25 million of cash. The business is break even as we close, and it'll be accretive very quickly by Q1 based on the efficiencies that I talked about. So I'm happy to answer questions. We think it'll close at some point in Q3.
Just to close out the session here, got a minute and 30 seconds left before we go to Q&A, is just reiterating our guidance. We continue to feel very confident in all the numbers on this page. We mentioned this on the Q1 call, in particular, with respect to the full year guidance, the $300 million run rate number. I'd say over the last month, since we had our earnings call, we've had incremental, very positive conversations with our clients that give us, you know, even more confidence about all these numbers on this page and feel very well set up to hit these numbers. You know, more importantly, I think, continue to hit the long-term growth rates and the long-term margin targets for the business.
So, with that, I'll wrap it up and say thank you for hanging out with us here for a few minutes, and we'll see you in the Q&A session.