Good afternoon. Thank you for joining us. My name is Lisa Gill. I am the Healthcare Services Analyst with JPMorgan. It is with great pleasure this afternoon that I introduce InnovAge. Presenting for InnovAge is CEO Patrick Blair. Post that, we will take some Q&A from the podium. Thanks very much, Patrick.
You bet. Well, thank you, Lisa, for the opportunity to present today. Thank you for those in the audience who've decided to join us today. By way of background, my name is Patrick Blair, and I'm the President and CEO of InnovAge. I joined the company in December 1st of 2021 and was appointed CEO in January 1st of 2022. I've been here a little over a year now. Prior to InnovAge, I held senior leadership roles at Amerigroup, Anthem, and BAYADA Home Health Care. I have a lot of deep experience in government programs like this. You know, it's a pivotal time for the company, particularly as we continue to work through some audits that took place over the last couple of years.
You know, we've been under an enrollment sanction in two of our larger markets, the last, you know, the last year. We're making great headway there, and I'm excited to tell you a little bit more about the company. We've accomplished a lot. You know, most notably, I think we've taken the opportunity to really build a sustainable platform for growth point going forward. I look forward to telling you a little bit about the journey we're on. With me today is Barb Gutierrez. She's our Chief Financial Officer, and she's been with the company about six years. Let me just move through the slides here. Let's see. All right. Green button.
Top.
Oh, top green button. Okay. Sorry. There we go. I may be making some forward-looking statements in the presentation today. Just I encourage everyone to read the disclosure and the presentation will be on our website. For those of you who are unfamiliar with a PACE program, you know, what we do in essence, is coordinate and provide preventive care and primary care, as well as acute care and long-term care services and supports to very underserved populations in the communities that we serve. These individuals have very complex healthcare needs, social needs. Without the services we provide, many of them would be living in nursing homes. It's really a program designed to help people live safely in the community. We care for our patients using an interdisciplinary team.
That's sort of the core element to a PACE center. We also maintain a proprietary network of specialists, much like a managed care organization would, to help us deliver care and deliver the services that we don't deliver inside the PACE organization. We in essence combine the dollars for both Medicare and Medicaid in order to deliver a really comprehensive set of services focused on helping people live in the community. I think we believe at our core that PACE really is the gold standard when it comes to community-based integrated healthcare. It's because of the expansiveness of the services that we offer that we're able to offer a very participant or patient-centric approach. It helps improve health outcomes, drive quality, all while lowering costs and helping people live safely in the community.
Currently today, we operate 18 centers in five states with approximately 6,500 participants as of September 30th. We have two de novo centers that are virtually ready to go in Florida, in Tampa and Orlando. They've yet to be operational, but I'll mention a little bit more about them. PACE overall operates in 32 states, and the average size of a PACE center is very small, about 200 participants. The PACE program continues to serve a very large and growing market. We estimate that there's roughly 2.5, 2.2 million members who are eligible for PACE, and we think the total addressable market is north of $200 billion.
The simple math on that is if you just take the, you know, the Medicare population, about one in six of them are a dual eligible. That's an element that's required for eligibility to the PACE program. Of that number, one in four are also nursing home eligible, which is a second eligibility criteria. We're dealing with a subset of the Medicare and Medicaid population. It's a very frail population that's consuming a lot of resources, and it's really our privilege to serve them. I like to, you know, think of it as it's such a remarkable program that, you know, I feel a moral responsibility to grow the program. It's such an exceptional program for seniors in need.
Our employees really view it as an opportunity to deliver transformational impact to a very vulnerable population, and allow us to all live by the doctrine of, you know, doing well by doing good. We're the largest PACE provider, in the U.S., by number of participants, and we're the only publicly traded, PACE provider. Our value proposition really resonates with all of the stakeholders that we feel accountable to. Our participants have a chance to live safely, in their own home. Which is, you know, very important to all of us or in the community, and avoid the confines of a nursing facility. Families have much less of a stress burden. As we know, family members often provide a lot of the caregiving to seniors in the family.
We're able to dramatically reduce the burden on families. The governments themselves get increased access to a very robust set of services and coordination on those services. States are always looking to rebalance the supports for long-term care from a facility-based model to a community-based model. I think PACE really allows our states, and then they have the fiscal predictability of a capitated payment system. All of this makes PACE very attractive to state governments increasingly so. For our physicians, you know, I hear from, you know, our docs that it really allows them to practice medicine the way they were trained to.
You know, with an interdisciplinary team, small panel sizes, ability to spend plenty of time with their patients, being rewarded for quality, not quantity, and having a team that's able to help carry out the instructions on the care plans that the providers play a big role in creating. In some ways, we refer to it as just a real win-win for stakeholders, much like other value-based programs. In terms of the eligibility criteria, I touched on a few of these things, but someone has to be 55 or older. They have to be eligible for both Medicare and Medicaid simultaneously. They have to live in an eligible service area. They have to require support, often with two or three activities of daily living.
That can be everything from ambulating or walking around the home, housekeeping, food preparation, toileting, showering. You know, needing help with those things is what qualifies someone for a PACE program. They have to be able to live independently in the community with PACE services to be eligible as well. It leads to a very complex participant. The average age for our participants is 77 years old. The average number of chronic conditions for a PACE participant is eight. The average number of prescriptions is nine. They need significant assistance with their activities of daily living. Without the services that we provide, it's nearly certain that without the right family support, people are gonna go into an institution. That's really the core of what makes someone eligible for PACE.
By coordinating the care and delivering much of the care inside the four walls of our center, you know, we can really drive improved outcomes, better quality, all while achieving fairly dramatic cost savings relative to what Medicare and Medicaid would've otherwise paid, had they stayed in a fee-for-service program or even a managed program. You know, we believe that the center is really important for a good reason, because, you know, through regular center attendance, it allows us to have line of sight on the risks that these patients have, not only with their medical situation but also with their social situation. This allows us to sort of help us catch potential issues sooner.
It allows us to triage into the correct setting much more effectively, and avoid costly emergency room visits, as well as subsequent hospital admissions, which is very common after one of our participants goes into an emergency room. We believe PACE programs have a real advantage over traditional managed care programs, who try to serve these populations, but they're serving them often they're forced to coordinate, you know, more at an arm's length. You know, we're in a unique position where we're not only coordinating all of the care, we're seeing someone up to two to three times a week in our center. Our ability to really understand what their needs are and how to divert high-cost unnecessary care or risky care is a core part of what we do.
You can see here from the slide itself that we're very effective at reducing ER visits and hospital admissions, as well as readmits. You know, this has been, I'll say, risk-adjusted to reflect similar populations with other risk scores. Like other risk-bearing government contractors, We need to manage medical costs and medical cost trends of our population, which makes us very much a payer as well as a provider. Most importantly, what we're able to do is to forestall or avoid nursing home admissions. That's really the key to what we do. Even this week, as I've met with interested parties and investors, you know, I get a lot of questions that attempt to draw comparisons between Medicare Advantage and PACE.
The two programs are similar in that we both are characterized as integrated care. There is some significant similarities in terms of populations, but there's a lot of differences between us and a Medicare Advantage plan. You know, as I mentioned earlier, the first most notable is that the participant has to meet a nursing home level of care. That is a often a very small subset of what any Medicare Advantage plan would cover. That means they're at risk of institutionalization if they don't receive these integrated services. PACE benefits include the full array of Medicare benefits, plus the full array of Medicaid benefits. We take in about $7,000 per member per month, sometimes much more than that based on risk scores for every member we care for.
If you're looking at a Medicare population, maybe it's 900 - 1,100. There's a very big difference in the populations and the benefits that we offer to the population. We think our model is, you know, a very robust model. Probably, I'm not aware of any other programs in a value-based environment that take as much financial risk as a PACE program. As I said, one of the things that makes the model very unique is that we're both a payer and a provider, and we have to be excellent at both. I don't think that's really been the heritage of most PACE programs.
They've really excelled at delivery of care, but less so in terms of the things you need to do to be able to manage a full risk population, and manage total cost of care and cost trends. The combination of being a provider and taking full risk for Medicare and Medicaid really positions us well to be an excellent resource to states who are looking to, control the cost of this population. You know, given my managed care experience, prior to InnovAge, you know, this is one of the big focus areas for me, is to bring to, InnovAge, some of the fundamentals of being a great, managed care organization and payer. If you think about the team, I mentioned the IDT.
This is really the hub of not only care coordination, but the hub of delivery in our centers is made up of these interdisciplinary teams. It's a very patient-centric model. It involves a minimum of 11 disciplines, which develop and manage individual care plans for all of our participants. The team includes, you know, a center director, someone who runs the center, social workers, nurse practitioners, nurses, primary care physicians, dentists, physical therapists, occupational therapists, home care professionals, drivers, dieticians, behavioral health therapists. I mean, we employ all of these individuals in our center, and then we contract for specialist services.
The team is critical to monitoring the progress of participants, exchanging information, looking for change of condition, looking for changes to be made in the care plan, and get ahead of risk that exists for the population. As I said, in addition to the delivering the care through the interdisciplinary care team, it's critical that we function as a payer that can manage, you know, complex medical costs. You can see here on the slide that includes things like provider network management. Just like any other health plan, we have to build a network. We have to make sure we have the right composition of providers. We have the right unit cost of the providers in that network.
From a resource management, very akin to what you would refer to as utilization management, this is about using evidence-based guidelines to make sure people are getting the right care and that we're optimizing quality, value, and cost. Claims payment. We pay a lot of claims because all of our third parties, whether it's a hospital or a cardiologist, they're billing us just like they would any other health plan. We have to be very rigorous on how we pay claims and ensuring that we're paying accurately and appropriately. And then risk adjustment or risk payment accuracy, it's really important. We have a very chronic population. On the previous slide, you see that our risk scores are nearly double what you would typically find in a Medicare Advantage population.
It's just critical that we focus on being paid fairly for the risk that we're shouldering the characteristics of the patient. When I think about this past year, calendar year 2022, it was a really important and transformational year for the company. You know, we really used the time to strengthen the foundation across every facet of our business. We've meaningfully upgraded talent across every division of the company. Still a lot to do. We added an independent chairman to our board in addition to our financial sponsors. You know, we've expanded and built, I think, what is a, you know, an excellent compliance program that, you know, doesn't stop when the audit stops. It continues to go.
It continues to self-audit every month and ensure that we're delivering high-quality compliant care everywhere we can. We closed a lot of critical technology and people gaps. We started to introduce this notion of being a better payer, a better manager of medical cost trends. We started to introduce those capabilities. I'd say we laid the foundation, and we still have a lot of work this calendar year to do. Then we invested in some technology. You know, one of the things, looking back on the business and sort of what contributed to some of the deficiencies that were identified in our audits and then ultimately led to the sanctions was our operating systems. You know, we were operating on, I think it was three or four medical records.
We've worked in a strategic partnership with Epic to create a customized version of Epic that's gonna be the first ever designed exclusively for a PACE program. We've brought up our Virginia centers on that. We're implementing our Pennsylvania centers now. We're making great progress there. I just couldn't be more proud of the organization, the team, and the support that we've all received from our board of directors and investors to make these long-term investments, which set us up for some durable growth going forward. You know, to be clear, it's a work in progress. It was a very transitional period for the company.
You know, we're still trying to return to a sense of normalcy post-COVID, you know, while also navigating these audits, and it's been a real challenging task for myself and the team. We couldn't be more excited about where things stand now after a year's hard work focused on it. With respect to regulatory update, you know, on the regulatory front, it's hard to know how familiar folks are with the company, we had two enrollment sanctions, not dissimilar to what occurs in a Medicare Advantage program. In Sacramento, California, one center, then in our six centers in Colorado, we had enrollment freezes. We could serve the members we had, we could not grow. We finished all audits. All audits have been completed.
In Sacramento, we were released from sanctions by CMS, and for the state, they completed their audit just before Christmas. We're waiting to hear back on the outcome of that. In Colorado, both the state and CMS completed their audits just before Christmas. We're also waiting to hear from both of those regulatory agencies on next steps. As I said before, I think we continue to be, you know, a wonderful solution for government payers, and I generally believe that the regulators have a desire to see us be successful. You know, I think there's a. It's easy to be dubious of regulator intentions, but, you know, I can say I've been elbow to elbow with regulators for over a year, and they want us to be successful.
At the same time, they have a job to do, and they've got to make sure that we're delivering compliant care for every participant. That's part of it. You know, looking forward, you know, I'm not sure our growth strategy is any different than anyone else's. It's multipronged. You know, we're very focused to begin with on reinvesting in our business as it relates to the operating excellence and operational infrastructure, and ensuring we have a compliant organization. It's really about responsible growth in our existing centers. We have a lot of capacity in our existing centers. That's a priority for us. I'll spend a moment on that. We have two new de novo centers. We have our eyes on other markets.
Just between those two de novo centers, we've got north of 2,300 participant capacity out of 6,500 participants we serve today. A lot of intrinsic physical capacity in the organization. We've also built some staffing capacity through the audits that will help with our scaling as we come out of this. Then we look at partnerships. You know, we're looking at lots of really interesting, you know, asset-like, capital-like partnerships that we think exist with a variety of stakeholders. This has been a great forum to catalyze those conversations. There's a lot of real interest. Then on the acquisition front, you know, we're always looking at acquisitions.
You know, we certainly always keep the pipelines a little smaller now than it has been in the past because we've been so focused on our knitting, so to speak. We think there's a great opportunity for that going forward. As I mentioned with organic growth, it really is the most capital efficient and most, you know, margin accretive way to grow. We're really focused on putting the sanctions behind us and then very focused on filling as much capacity in our centers as we can. You know, the marginal benefit of every new member in those centers is much greater than, you know, going out and breaking new ground and building a new market, which is a part of what we'll do, but we want to get the centers filled first.
We have some staffing that we built up in order to see our way through the audits, and now we're gonna be able to deploy that staffing. We didn't fire anyone. We didn't let anyone go in the year we've been operating, all with the intention of making sure we pass the audits and that we're ready to go when it's time to begin serving more seniors again. Lastly, in terms of the investment highlights, you know, I think it's, as I pointed out, it's important to know this is just a large and growing market. You know, people ask: Well, you know, COVID probably led to a lot of deaths of seniors with, you know, these sorts of chronic conditions. You know, didn't that shrink your opportunity to serve?
I think just at the same time, you know, there were seniors that weren't eligible for PACE, that COVID accelerated that group, you know, to become more eligible for PACE. Any way you look at it, the addressable market for PACE is large and growing. You know, we have an industry-leading model in our view. You know, we've certainly had our challenges, but we still have a great team and a great model. The unit economics on the business, we believe we can return to them over time. It's hard to know today exactly how future, you know, unit economics will compare to maybe what we were doing before we went public. I think the reality is we see a, a real opportunity for attractive margins for investors going forward.
We're building a model that's scalable, and we should be able to enter new markets more quickly. We should be able to integrate new businesses more quickly. We should be able to reach profitability more quickly. You know, these are all objectives that we've been planning for, during this period that we've been addressing the issues. With that, I think we're gonna move to.
Great.
Q&A.
Sounds great. Patrick, first off, thank you for all the details. You know, when we think about the PACE program, it's been around for 30 plus years, but the penetration amongst dual-eligible members is still low single-digit, as you talked about today. Part of this perhaps is due to the historic absence of for-profit participants. Can you talk to us about, you know, why it's been so under-penetrated and how the competitive landscape in PACE has evolved over the last several years, especially since we now have for-profit entities coming in?
Sure
into the market?
Well, I think your point about not-for-profit, I mean, what Lisa's referring to is, you know, you couldn't be a for-profit PACE operator before 2016 when the law was changed. Prior to that, all PACE were not-for-profit. The vast majority were associated or owned by, you know, a local hospital system. I think part of the reason PACE hasn't grown as quickly is 'cause it's gonna take a while for that to happen. You still have a lot of nonprofits, and virtually all PACE are nonprofits. You know, it makes it, you know, I think their aspirations to grow geographically are different than a for-profit entity. Access to capital is often more challenged than you might find in a for-profit world.
You've got to shoulder, you know, quite a bit of startup cost before you see revenue. I mean, I think those are all very relevant. I think they can be a greater burden for not-for-profit. You know, I think some of the slow growth really is anchored around the not-for-profit aspect of this. I think also, you know, it's not lost on me, and I think it's partly is 'cause of my career, you know. In my last 15 years, I spent a lot of time on Medicare Advantage and its evolution, adding Special Needs Plans and I-SNPs, et cetera. I mean, that was a big focus of CMS. I spent a lot of time on health exchanges, another enormous focus by CMS.
You think about states, their big move was not only, you know, traditional Medicaid managed care, where they're moving moms and kids into privatized Medicaid, but then they started moving seniors and people with disabilities. You had Managed Medicaid Long-Term Care. Those are three, four massive programs that for CMS and states involved millions of covered lives and had a lot of sort of bang for the buck financially and took a lot of attention from states and CMS. I think some of the reason PACE has grown slower is it just hasn't been able to be a priority. I do believe now that those programs are all in place, all functioning exceptionally well, I think states are now starting to say, "What's next? What's the next natural extension of value-based care within a state long-term care program?
Should PACE sit alongside Medicaid Long-Term Care as an option?" I think that's the kind of thing that could really unlock the growth opportunity. It's gonna take time, but I think that's why. In terms of new competition, I think you've seen a lot more for-profits come in. I think it's a mixed story on their success to figure this business out quickly 'cause it is very complicated. I'm enthusiastic. The more for-profit companies that come into PACE, there's plenty of seniors who need our support. By virtue of how PACE programs generally operate exclusively in a territory, it's a different competitive dynamic than, say, Medicare Advantage, where you may have 10 plans in one territory. I really do believe that the more for-profits that enter the space, the better.
I think it just raises the awareness and appreciation of PACE.
I'm sure you and Barb are so tired of talking about the sanctions and the audits. It's so nice to finally see that you're getting towards that finish line. As we sit here today, did CMS, the audit results, did they give you any detail on where your performance, and you did well, and, you know, versus areas of improvement? Did they give you that level of detail so when we think about maybe some of your other facilities and take those learnings and be able to bring that to the other facilities?
Yeah. Yeah. Well, they certainly, as you'd expect from regulators, they hold their cards close to their vest.
Yes.
They're not out telling you what a great job you're doing all the time. It is clear, based on our interactions on the positive side, that the areas I think we've done a really nice job, I think the timeliness of care delivery is something we've dramatically improved. How quickly we're getting people care has been an important improvement we've made. You know, I think all PACE programs have challenges coordinating care with providers outside of their centers, so specialists and hospitals, etc . I think that's an area where we've done a much better job, is coordinating with external providers to the program. Documentation, you know, that is a very big critical thing within a PACE program, is it's like document, document. If you didn't document it, you didn't do it.
Even if you did do it, you didn't do it if you didn't document it. I think our documentation has really improved during this period. Where's their opportunity, the one area I would say and sort of akin to the external is, you know, when someone goes into a skilled nursing facility or to assisted living facility, our responsibility as PACE program doesn't go away. I mean, they're still our participant. The expectation is that they will receive the same level of coordination and engagement as they would receive in our center. That's an area that we still have to improve. You know, managing care or coordinating care of someone living in a facility when that facility's struggling with all the same issues we struggle with from a staffing perspective is a tough one.
Yeah. I mean, I think that's the other thing that's come up a lot this week is, you know, both inflation as well as staffing issues. Maybe if you can give us an update on where you are on staffing issues today.
Yeah, sure. Barb, you wanna hit that one?
Yeah. Glad to. As Patrick said, you know, we've really closed the gap, quite a bit on staffing. We, I would say in the first part of calendar year 2022, from that beginning, we've closed the gap. Not easy.
Mm-hmm.
A lot of challenges and certainly, you know, some cost to that. We've closed the gap, which has resulted in this capacity, particularly in Colorado.
Right.
Right? We've closed the gap on staffing, and now we have this very intentionally, and we have the opportunity to grow and grow into that capacity. One of the related questions that you might ask is related to contract labor. That's been another place where we've had to supplement our staff, you know, as most of the folks in the market have. We're very focused on our costs, and we've made some progress. We don't think we'll be able to unlock the full opportunity, though, until we're out of sanctions. The bottom line is we've made really good progress.
You know, the other question that we get is around how do you pick where your next de novo facility goes?
Yeah. No, that's a good one. Barb, you can supplement. Well, we spend a lot of time on that. You know, there's only 50 states. As you would expect, we're looking at all 50 states, and then there's a subset of those that have characteristics related to the density of the eligible population, for example. We look at drive times.
Mm-hmm.
Not only is it a dense population, but can you get them to center in a convenient drive time? We look at the network dynamics. You know, can we get, you know, unit cost contracts from our providers that will work in our model? Is there appropriate access from a, from a specialty perspective? Sometimes real estate and the cost of real estate can be relevant to our decisions. We take a pretty, I think, disciplined look at every market and try to weigh the short-term and long-term ROI of center selections. You know, Florida's a great example of where, you know, we've got 2 40,000-plus sq ft state-of-the-art facilities because in Tampa and Orlando are very dense, eligible populations. The traffic patterns are very positive. There's great health systems to work with, great providers to work with.
There's a large staffing pool that we can access. All those things go into that calculation.
Can you talk about the cost, Barb? Like, when you.
Sure.
you choose that new market, obviously you talked about real estate, you talked about staffing, but-
Yep.
Is there a timeline to profitability?
Yes. on average, the de novos, depending on the size, depending on the market.
Is forty thousand square feet the-
Um, that's a-
the average size?
It's the larger size.
That's a larger size. You know, the cost can be somewhere between $15 million and $20 million, depending on the market. You know, if it's here in California, it's gonna be a little bit higher. Whether we build the facility or we lease it, and all those factors. Somewhere in that neighborhood, and that includes the cost of the facility. We have some pre-opening losses and, you know, just getting things started because we have to be fully staffed and functional before we can even be approved to start.
Right.
Then there's some initial losses. Generally speaking, our de novos are positive contribution margin in about 12 months. In large part it's because of all the things Patrick said. We do our homework before we go into a market, so we really know what that market opportunity is. In most states, other than California, those markets are assigned to a PACE program. There's really no competition in that market. Again, we really know going in, and so we've got pretty quick profitability.
I think one of your slides showed that you're not at full capacity at any of your-
Right. That's right.
-current centers. Is that...
Yeah. Yeah, that's right. We, you know, we think we have, excluding Florida, we have the capacity to double the size of the company with just the capacity we have. You know, it's not easy to fill that capacity. It takes time, we're also getting, you know, much better at member acquisition and the strategies used to attract people to the business.
You've done some M&A deals in the past.
Mm-hmm. Mm-hmm.
How are you thinking about opportunities, organic versus inorganic growth, both near term and longer term? You know, how are you thinking about private market valuations today?
You want me to take it?
I'll start.
Yeah, you start. Go ahead.
Yeah, you know, we're really optimistic about both M&A and de novo work. I think we're trying to continue to balance the near term focus on compliance and on operational excellence while also, you know, making sure that we've got a platform for scalable growth. We're, we're very interested in it. You know, given the sanctions that we've been under for the last year, you know, we've not been active enough where I think I've got a read on valuations and where they are. They seem to be a bit of a moving target right now in every industry, including ours. We're gonna ensure that M&A is gonna be a strategically and financially attractive addition to the company. You know, we're not gonna do anything that isn't accretive and works for us.
I think it just reinforces our three-pronged growth strategy that we set out to do from the beginning, and we're, you know, we're still on that path. A lot of opportunity with the organic growth, de novos, and acquisitions. It's a real balanced approach.
Just given your background, coming from the managed care industry, do you think that owning a PACE entity is something that would make sense for managed care to own?
That's a great question. I do. I do. We talked to enough managed care organizations to, I think, have validated that, especially the large multi-line...
Mm-hmm
-managed care organizations, I mean multi-line not in just that they have multiple lines of business like Medicare Advantage and Medicaid, et cetera, but if they also have specialty services. You know, maybe they have behavioral health, maybe they have pharmacy.
Mm-hmm.
You know, those are all services that we consume.
Right
as part of a PACE program. I think, you know, large multi-line managed care organizations would see PACE as an attractive part of their portfolio. I doubt any of them would try to do it organically. I think that they would buy their way in.
Mm-hmm.
I think it'd be a great fit for a multi-line.
When you say multi-line, just so people.
Oh, sorry.
In this room understand. I think we're thinking about it the same way, more the services side of their business versus the health plan side of their business.
Yeah. Even within the health plan side of the business, you know, they may have traditional Medicare Advantage, Medicare Advantage Special Needs Plan. They may have Medicaid Managed Long-Term Care. If you think about it, I'm not sure I could articulate what is the aging continuum exactly, but PACE fits in that. Someone could be a Medicare Advantage plan, doesn't need support, got COVID, exacerbation of chronic conditions, challenges living independently at home. That person is not good risk for a Medicare Advantage plan.
Right.
If they were able to have that individual in an asset that they owned, that was a PACE. Now they've taken high risk out of their existing risk pool, lowered their overall MLR because they've done that, and now are getting higher absolute margins based on having the participant in a program that they're getting paid, you know, $7,000 per month.
Right.
-versus $1,000 per month. I think that it fits really nicely with, you know, health plans, and we'd love to figure out a way to partner with one.
We have only two minutes left, Patrick.
Yeah.
We like to leave with this question, and I know that you've been through a lot in the last 12 months.
Does it show? I'm losing my hair. I'm losing my hair. I'm getting my roots.
As we sit here in 2024, what do you hope that investors will better appreciate about InnovAge that they don't today?
We made the most of a very challenging situation. You know, that we used the opportunity to really strengthen as many parts of the business as we possibly could within the time that we had. We didn't, you know, just focus on the minimum amount to deal with the audits. You know, we could have just said, "How do we do the minimum to get out of this situation?" We didn't do that. We really used the opportunity to build a more scalable platform. I don't want anyone to leave the room, thinking, you know, we've got it solved. We have a lot of work left to do as a company. We're excited to do it.
Great. We'll leave it there. Thank you very much.
Thank you.
Thank you.
Thank you, everyone.
Thank you very much.