Good afternoon. I'm Peter Anevski, Chief Executive Officer of Progyny, and a member of the Board of Directors. I'm very happy to welcome you to the Progyny 2024 Annual Stockholders Meeting. Before I call the meeting to order, I'd like to welcome our board members in attendance and introduce the business team members who are with us today. The other officers of Progyny in attendance are: David Schlanger, Executive Chairman; Michael Sturmer, President; Mark Livingston, Chief Financial Officer; and Allison Swartz, General Counsel, who will also be acting as Secretary for today's meeting.
I'd like to also introduce John Vella of Ernst & Young LLP, Progyny's independent auditors, who is available to respond to appropriate questions. We thank all of you for joining us today. The meeting will now officially come to order. We will proceed with the formal business of the meeting as set forth in your notice of annual meeting and proxy statement. After the formal part of the meeting, we will give you an opportunity to ask any questions you may have. We'll begin the meeting with a brief update on the business. As a reminder, remarks made today and in response to any questions may include forward-looking statements.
Forward-looking statements involve risks, uncertainties, and other important factors which are described in our SEC filings, including our first quarter Form 10-Q, and our actual results may differ materially from such statements. Any forward-looking statements that we make during the meeting are based on our beliefs and assumptions today, and we have no obligation to update them. In addition, we may also reference certain non-GAAP financial measures during this meeting. For a reconciliation of each of these measures to the most directly comparable GAAP metric, please refer to our quarterly press releases that are available on our investor relations website.
We're holding today's meeting virtually. We believe that a virtual format enables easier access and participation by our stockholders, helps increase stockholder attendance, and saves the company and its investors time and money, in addition to being an environmentally friendly and sustainable format. Before we move on to the formal business of today's annual meeting, I'd like to provide a few highlights of what we accomplished in 2023, which was another exceptional year for Progyny. In 2023, we achieved record levels of revenue with growth of 38% over 2022, profitability with a 17.2% adjusted EBITDA margin, operating cash flow, generating nearly $190 million or more than twice what we achieved in 2022.
As important as these financial metrics are, we were equally pleased with our operational achievements in 2023 as well. Once again, we maintained our near 100% retention rate, driven by the remarkable levels of member and client satisfaction that we continue to achieve year after year, while also concluding yet another strong selling season, which yielded more than 85 new clients, including our first ever population with the federal government. This continues the momentum we've seen in every selling season since our IPO.
In fact, our last three selling seasons, which have been the most successful in our history, have resulted in more than 3.7 million new covered lives cumulatively. On the strength of that result and our high rate of retention, we expect to have over 460 clients, representing approximately 6.7 million covered lives under management in 2024, demonstrating the strong demand we see for our superior fertility and family-building solution. On the network side of our business, in 2023, we continued to achieve industry-leading clinical outcomes in fertility care for the 8th straight year, while also deepening our already highly collaborative relationships with clinical providers.
We also extended our network's reach to include more than 1,000 of the highest quality REIs and RUs in the country. With the expansion of our member base and network reach, we helped the largest number of members in our history realize their family-building dreams in 2023 through healthier and faster journeys overall, while also controlling costs. Since launching our solution in 2016, we've helped hundreds of thousands of people successfully navigate what would otherwise have been a complex, stressful, and overwhelming course of treatment.
We're extraordinarily proud of that, even more so because we've routinely achieved NPS scores in the 80s, which is an exceptional achievement for any industry, let alone healthcare. In short, 2023 was an extraordinary year for Progyny, and we've entered 2024 with considerable momentum. Even with our rapid growth over a short period of time, we continue to be at a very early stage of penetrating our target market, with just a mid-single-digit % of our addressable clients or covered lives. We've continued to expand our market opportunities, most recently by adding labor populations and then the federal government. As we look into the future, we see additional opportunities to further expand our TAM over time.
We also see opportunities of deepening our relationships with existing clients as well. With our proven history of delivering real and sustained value in family-building services, we have a significant advantage when our clients are looking to address other gaps they see in healthcare, particularly with respect to patient access, member experience, and cost efficiency. That's why Progyny is uniquely positioned to expand beyond our already industry-leading platform into other areas that further support life's other key milestones . . . We've made investments in our product organization to enable us to quickly add new features to existing services or expand into new areas that make sense for us and our clients.
This includes preconception support, where we can help address conditions that impact the ability to conceive, such as PCOS or endometriosis, or maternity, where we can help expectant mothers navigate the pregnancy journey, or postpartum, as new parents look for support as they adjust to the new addition to their family and think about their eventual return to the workforce. These services are being included in our 2024 selling season for both new clients as well as upsell activity among existing clients for contribution beginning in 2025.
Though it's early in our selling season, the activity we've seen thus far, whether that's conversations around upsells, new sales, or the advancement of new strategic partner relationships, has been positive, deepening our belief that all the macro trends that have been contributing to our long-term success remain intact. These trends include demand for fertility benefits that's stronger than ever, particularly among the millennials who are in the prime of their family building years. Family building and women's health benefits that have never been more relevant or more timely with employers, particularly as they look to modernize the coverage they're providing in order to better support their employees' needs.
In doing so, they're enhancing the efficiency of their recruitment and retention efforts, while also meaningfully improving workforce productivity. Finally, employers are demonstrating their commitment to family building and women's health. They're doing so through a number of ways, by adding coverage when they don't already have it, or expanding the coverage they already have to provide even greater access to care, by broadening the scope to include other pathways, such as adoption and surrogacy, and by including other services in their programs, such as preconception, parenting, and menopause.
By leveraging our proven strengths in patient education and support, evidence-based care pathways, network management, and outcomes measurement, Progyny continues to successfully differentiate itself in the market by raising the bar for what employers should expect from their benefit providers. This experience ideally positions us for continued success in 2024 and beyond. We look forward to updating you on our progress in future calls. With that, we'll now move to the next portion of today's meeting. Will the secretary please report at this time with respect to the list of stockholders of record and the mailing of the notice of the meeting?
I have at this meeting a complete list of the stockholders of record of our common stock on April 3, 2024, the record date for this meeting. This list is available for viewing and has been available for inspection for the past 10 days at 1359 Broadway, Second Floor, New York, New York. I also have an affidavit certifying that on April 12, 2024, a notice of annual meeting of stockholders of Progyny was deposited in the United States Mail to stockholders of record at the close of business on April 3, 2024. This affidavit of mailing will be filed with the records of the meeting.
At this time, I'd like to introduce Kayla Walsh of Computershare, who has been appointed to act as Inspector of Election at this meeting. Ms. Walsh has taken and subscribed the customary oath of office to execute her duties with strict impartiality. We will file this oath with the records of the meeting. Her function is to decide upon the qualification of voters, accept their votes, and when balloting on all matters is completed, to tally the final votes. Will the secretary please report at this time with respect to the existence of a quorum?
I have been informed by the Inspector of Election that proxies have been received for approximately 93.7% of the outstanding shares of common stock entitled to vote at this meeting. This constitutes a quorum for the meeting today, and we may now carry out the official business of the meeting.
We will now proceed with the formal business of this meeting. There are three proposals to be considered by the stockholders at this meeting.
The time is now 3:12 P.M. on Thursday, May 23rd, 2024, and the polls are now open for voting on all matters to be presented. The polls will be closed to voting after we go through the matters to be voted on. We will address questions during the Q&A portion of the meeting. If you have a question, please submit it by emailing investors@progyny.com.
The first item of business is the election of our four Class II directors to serve until the 2027 Annual Meeting of Stockholders and until their successors are duly elected. The nominees for Class II directors are Peter Anevski, Roger Holstein, Jeff Park, and David Schlanger. No other persons having been nominated in accordance with the company's bylaws, the nominations are now closed. The second item of business today is the ratification of the selection by the Audit Committee of the board of directors of Ernst & Young LLP as Progyny's Independent Registered Public Accounting Firm for the fiscal year ending December 31, 2024.
The third item of business today is the approval on an advisory and non-binding basis of the compensation of the company's named executive officers. That was the final proposal for today's meeting. The secretary will now describe the voting procedures.
If you have already voted, there is no need to vote now unless you would like to change your vote. If you have not voted and you would like to vote now, or if you would like to change your vote, please go to www.investorvote.com/pgny. Enter your control number from the notice and vote your shares. We'll pause for a moment to give anyone who hasn't yet voted a chance to vote. Each share of common stock is entitled to one vote. Please note that this is the last call for votes. The time is 3:14 P.M., and the polls are now closed for voting.
The preliminary report of the Inspector of Election covering the proposals presented at the meeting is as follows: The proposal to elect each of Peter Anevski, Roger Holstein, Jeff Park, and David Schlanger as Class II director of the company is approved. The selection of Ernst & Young LLP as the company's independent registered public accounting firm for the fiscal year ending December 31, 2024, is ratified. The compensation of the company's named executive officers on an advisory and non-binding basis is approved.
We expect to report our final voting results on a current report on Form 8-K, to be filed with the SEC within 4 business days of the conclusion of this meeting. The preliminary inspector certificate of the votes cast is accepted as presented. We thank all of the stockholders for their participation. The formal portion of this meeting is now adjourned.
This concludes the formal portion of today's meeting. We will now answer questions from stockholders. There being no questions, the meeting is now adjourned. Thank you all for attending the Progyny 2024 Annual Meeting and for your continued support. That will complete the Q&A portion of the meeting. There being no further business, the meeting is now adjourned. Thank you all for attending.