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Earnings Call: Q4 2022

Mar 30, 2022

Operator

Ladies and gentlemen, thank you for standing by, and welcome to the Phreesia Fiscal Fourth Quarter 2022 Earnings Call. At this time, all participants are in a listen-only mode. We will provide instructions for the question- and- answer session to follow. First, I would like to introduce Balaji Gandhi, Senior Vice President of Investor Relations for Phreesia. Mr. Gandhi, you may begin.

Balaji Gandhi
SVP of Investor Relations, Phreesia

Thank you, operator. Good morning and welcome to Phreesia's Earnings Conference Call for the Fiscal Fourth Quarter of 2022, which ended on January 31, 2022. Joining me on today's call are Chaim Indig, our Chief Executive Officer and co-founder, and Randy Rasmussen, our Chief Financial Officer. A complete discussion of our results can be found in our earnings press release and in our related Form 8-K submission to the SEC, including our quarterly stakeholder letter, both issued after the markets closed today. These documents are available on the investor relations section of our website at ir.phreesia.com. As a reminder, today's call is being recorded, and a replay will be available on our investor relations website at ir.phreesia.com following the conclusion of the call.

During today's call, we may make forward-looking statements, including statements regarding trends, our anticipated growth, our strategies, predictions about our industry, and anticipated performance of our business, including our outlook regarding future financial results. Forward-looking statements are subject to various risks, uncertainties, and other factors that may cause our actual results, performance, or achievements to differ materially from those described in our forward-looking statements. Such risks are described more fully in our earnings press release, our stakeholder letter, and our risk factors included in our SEC filings, including in our annual report on Form 10-K that will be filed with the SEC tomorrow. The forward-looking statements made on this call will be based on our current views and expectations and speak only as of the date on which the statements are made.

We undertake no obligation to update and expressly disclaim the obligation to update these forward-looking statements to reflect events or circumstances after the date of this call or to reflect new information or the occurrence of unanticipated events. We may also refer to certain financial measures not in accordance with generally accepted accounting principles in order to provide additional information to investors. These non-GAAP measures should be considered in addition to and not as a substitute for or in isolation from our GAAP results. A reconciliation of GAAP to non-GAAP results may be found in our earnings release and stakeholder letter, which were furnished with our Form 8-K after the markets closed on March thirtieth with the SEC and may also be found on our investor relations website at ir.phreesia.com. I will now turn the call over to our CEO, Chaim Indig.

Chaim Indig
CEO and Co-Founder, Phreesia

Hi. Thanks everyone. Thanks for joining us. You'll notice that Balaji didn't say we're in three separate locations. They came over so we can do this call together. Really good to see Randy and Balaji in person. I hope everyone had a chance to read our shareholder letter which was put out. I guess we'll take the first question.

Operator

At this time, if you would like to ask a question, please press star followed by the number one on your telephone keypad. We ask that you please limit yourself to one question. Your first question comes from the line of Anne Samuel with J.P. Morgan. Your line is open.

Anne Samuel
Executive Director, JP Morgan

Hi, guys. Congrats on a great quarter, and thanks for putting out a long-term target. Appreciate it. You know, as we look out at the growth over the next three years, was hoping maybe you could provide a little bit of color on how we should think about the split between provider-client growth and revenue per provider-client because, you know, historically you've said, you know, new clients should grow at about a 5% rate with revenue per provider-client at mid-teens to get to that 20%, but the split's been a little bit different recently. So, should we think about it maybe as a bump in clients early on, and then later on the revenue per provider-client will catch up, as those clients expand? Thanks.

Randy Rasmussen
CFO, Phreesia

Anne, I think, you know, when you think about it, you know, we have a table in the quarterly letter that shows, you know, over time how the, you know, average revenue per client has continually gone up. I think when we look at it, you know, our main selling motion is land and expand. So, you know, sometimes there's timing between quarters where we land a client and the client number goes up, and then it follows up as we, you know, expand into that, in that healthcare client and, you know, move the revenue up. I think in a period where we've done a lot of investment, I think there's, you know, higher client growth than we have seen in prior periods.

I think on a quarterly basis you'll see that average revenue per provider-client vary a little bit, but over the long run still rise year- over- year.

Anne Samuel
Executive Director, JP Morgan

That's helpful. I guess just on the spending for this year, how should we think about the cadence? Should we think about it as, you know, perhaps higher, you know, initially kind of you know, as you are continuing to spend and as you move towards profitability, you know, kind of coming down? Should we think about it as kind of evenly spread throughout this year?

Randy Rasmussen
CFO, Phreesia

I think when you look at it, you know, when we look kind of back at Phreesia's history, we were profitable historically. There were three years, you know, after we went public where we were putting up, you know, positive Adjusted EBITDA every year. In 2021 is really where, you know, we decided there's this great market opportunity and we should really invest in people.

Most of that investment was in the last fiscal year that we had in 2022. Most of the hiring and expense adds has already been done, and we feel like we're in a really strong position to reach the, you know, half a billion- dollar target that we have for 2025. When you look at the year of fiscal 2023, what you're really seeing is a full year of expense. We're not necessarily adding large numbers of additional resources, or you know, increasing expenses. It's more of the rise, you know, from a relative year-over-year because there's 12 months of expenses included in the 2023 numbers.

Operator

Your next question comes from the line of Sean Dodge with RBC Capital Markets. Your line is open.

Thomas Keller
Equity Research Associate, RBC Capital Markets

Hey, good afternoon. This is Tom Keller on for Sean. Thanks for taking the questions. Had a question on subscription pricing. Do those existing contracts have any sort of pricing mechanisms built in if related to inflationary pressures or otherwise? Or is that something maybe exclusively negotiated during contract renewals or just with new clients?

Randy Rasmussen
CFO, Phreesia

I mean, it's typical for us to include language in there that gives us the ability to raise prices as contracts renew year- over- year. So generally, yes, we do have those types of provisions that allow us to increase price over time.

Thomas Keller
Equity Research Associate, RBC Capital Markets

Okay, good. On Life Sciences, I guess how are you allocating those investment dollars there in that business? I guess where do you see the most opportunity going forward within that segment?

Chaim Indig
CEO and Co-Founder, Phreesia

Maybe I didn't totally understand the question. Can you reframe it, so I understand? This is Chaim.

Thomas Keller
Equity Research Associate, RBC Capital Markets

Yeah. I assume Life Sciences is receiving some of the kinda same investments.

Chaim Indig
CEO and Co-Founder, Phreesia

Yeah.

Thomas Keller
Equity Research Associate, RBC Capital Markets

I guess where's the focus there? Are there, you know, more, you know, newer products and services or capabilities, a bigger, you know, sales force, or just anything to kinda help frame that.

Chaim Indig
CEO and Co-Founder, Phreesia

All right. I'm gonna wax on for a little bit here about our life sciences team. The team is just amazing. Okay? David has done an amazing job. We have leaders that have been called out in the industry. We're not just excited about product, which I'm gonna talk about in a minute. I'll talk about our insights product, which is just won best product of the year from PM360. Is that right? Yeah. At best new product. It's just. You know, I was with our life sciences team last week at their off-site meeting, and just the energy and the organization is just amazing.

We are gonna keep investing there as we invest all throughout the organization, but really just the performance and the collaboration that they have as a team has just been wonderful to just be part of. I'm pretty excited about the leadership there. We, yeah, we're gonna keep investing. We're proud of what they're doing.

Thomas Keller
Equity Research Associate, RBC Capital Markets

Okay. All right. Good stuff. Appreciate the color.

Operator

Your next question comes from the line of Jessica Tassan with Piper Sandler. Your line is open.

Jessica Tassan
Director and Senior Research Analyst, Piper Sandler

Hi. Thank you so much for taking the question. I'm interested if you could maybe talk about the TAM opportunity across, subscription payments and life sciences revenue lines in the payer market. I think you guys reaffirmed the roughly $9 billion TAM in the deck today. Just how do we think about the incremental opportunity that you see, as you broaden your market to payers? Thanks.

Chaim Indig
CEO and Co-Founder, Phreesia

I think we're still in the early days of that era of the payer market. We have payer clients now. Some of our provider clients have frankly turned into payers over the last couple of years. I think we've all seen the market evolve, and some of the change in language is also representation that, you know, a lot of our clients have started to take on risk and, you know, nsure members at the same time that we've also increased our offerings in the payer market.

You could expect us as the investments start to point in the direction of where we're you know what the market looks like. You could expect us to come back to market and articulate sort of the what we think the opportunity is and you know what our go-to-market will be in that. I promise we're Balaji's pretty good at making us do that over time. Did I answer?

Jessica Tassan
Director and Senior Research Analyst, Piper Sandler

That's helpful. Thank you.

Chaim Indig
CEO and Co-Founder, Phreesia

Did I-

Jessica Tassan
Director and Senior Research Analyst, Piper Sandler

Yeah, I think that's really helpful. I guess just a quick follow-up would be, do you need any incremental products, or are you just selling essentially the same stack or suite into that market, at least as you think about it today?

Chaim Indig
CEO and Co-Founder, Phreesia

Why don't I take a step back, which is work continuously, and we have for 17 years as an organization, investing in both our existing product and new products. I think all good technology companies are investing in new products for their existing and new users at all times, and we're committed to doing that. If we're not investing in new products, we might as well just, you know, call it a day, right? Expect us to continue as we have both for, you know, pre-public and post-public, investing in new products. You know, some of the ones pretty excited about that we've come out, you know, like we've entered new markets around Queue. We've come out with our Connect offering. You know, super pumped about our PatientInsights offering.

We expect to both sell existing products into that market and new products.

Jessica Tassan
Director and Senior Research Analyst, Piper Sandler

Awesome. Thank you.

Chaim Indig
CEO and Co-Founder, Phreesia

Thank you.

Operator

Your next question comes from the line of Richard Close with Canaccord. Your line is open.

Richard Close
Managing Director of Digital and Tech-Enabled Health Equity Research, Canaccord Genuity

Yeah, I had a couple questions. First of all, congratulations on a strong year. Questions with respect to the new client growth, obviously you pointed out the 200+ clients in the fourth quarter was almost as much as fiscal, I think 2019 and 2020-

Chaim Indig
CEO and Co-Founder, Phreesia

Isn't that cool?

Richard Close
Managing Director of Digital and Tech-Enabled Health Equity Research, Canaccord Genuity

-or in a two-year period. Yeah. I'm curious about looking forward, though. Do you think the pipeline is strong enough to support a similar type of growth that you guys just reported in the fourth quarter? Any perspective there would be helpful.

Randy Rasmussen
CFO, Phreesia

Yeah. I mean, I think if you look at our target of the, you know, half a billion-dollar in 2025, I mean, that implies, you know, 27%-29% annual growth. You know, as I said, you know, we made a decision in 2021 to put significant investment in the business and, you know, we're seeing results from that. That's, you know, really what gives us, you know, some level of comfort to put it at a target like that because we do continue to see client adds and success in the sales organizations.

Balaji Gandhi
SVP of Investor Relations, Phreesia

Hey, Richard, this is Balaji. Just, you know, on your comment about client growth, I think one of the other things we just said in the letter is, you know, we think we've got multiple paths to get there. I think Randy, your question just talked about sort of the cadence and then, you know, the growth you see with land and expand. I wouldn't look at any quarter as a reflection of how it might go in the future.

Richard Close
Managing Director of Digital and Tech-Enabled Health Equity Research, Canaccord Genuity

Okay. That's fair. Appreciate that. On the life sciences, I think it's, you know, great you guys I think you called out like a million patient surveys or, you know, you surveyed more than a million patients in calendar 2021. You know, as we think about, you know, fiscal 2023, obviously I think the new budgets for, you know, marketing by pharma that, you know, set as you enter the new calendar year. I'm just curious your thoughts, obviously with a significantly higher number of provider clients, you're gonna have that many more patient interactions. The demand, I'd suspect, for your life sciences business would be, you know, significantly higher as well. Any comments that you can provide in terms of, you know, the budgets that you've seen for your life sciences clients?

How should we think about that in terms of maybe year-over-year growth here for fiscal 2023?

Chaim Indig
CEO and Co-Founder, Phreesia

Richard, just sort of you're asking about how budgets and life sciences customers impact our, like, growth outlook?

Richard Close
Managing Director of Digital and Tech-Enabled Health Equity Research, Canaccord Genuity

Yeah. Not as much as the growth outlook. It's just, you know, the pharma budgets are, you know, marketing budgets are set for like the calendar year, right? So, when it begins in January, I think the timing typically is. You know, obviously you've grown the client base significantly, and you're gonna have that many more patient interactions. I suspect that life science companies would be increasing, you know, potentially their budgets they're allocating to someone like Phreesia. Are you seeing that?

Chaim Indig
CEO and Co-Founder, Phreesia

I think I could say comfortably that we expect to do better this year than we did last year.

Richard Close
Managing Director of Digital and Tech-Enabled Health Equity Research, Canaccord Genuity

Okay. I'll take that as a yes.

Chaim Indig
CEO and Co-Founder, Phreesia

I'm working, Richard. I'm working really hard. Like, Balaji's like, "All right. We're gonna work really hard on you answering." All right. So how did I do? Did I do okay?

Richard Close
Managing Director of Digital and Tech-Enabled Health Equity Research, Canaccord Genuity

Yeah, you're fine.

Chaim Indig
CEO and Co-Founder, Phreesia

All right. Awesome. All right, guys.

Richard Close
Managing Director of Digital and Tech-Enabled Health Equity Research, Canaccord Genuity

Thanks.

Operator

Your next question comes from the line of Daniel Grosslight with Citigroup. Your line is open.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Hi, guys. Thanks for taking the question. I was hoping you could put a little bit of a finer point on expense growth in fiscal 2023 and beyond. If I look at the non-cash expenses per full-time employee, we've obviously seen a pretty dramatic increase this quarter, and that's carrying over to fiscal 2023. Outside of just headcount adds and salary, are you seeing any structural shift in how you're managing that expense side of the ledger? i.e., are you having to invest more in product development as you enter into some of these newer markets like the payer market or as you get bigger into the health system market? Curious why we are seeing such a dramatic shift, not just in headcount, but in non-cash expense per FTE.

Randy Rasmussen
CFO, Phreesia

I think when you're looking at non-cash expense, are you talking about like stock compensation?

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Oh, sorry. Expenses excluding non-cash expense.

Randy Rasmussen
CFO, Phreesia

Okay. I mean, I think.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

So-

Randy Rasmussen
CFO, Phreesia

I think that's.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Yeah.

Randy Rasmussen
CFO, Phreesia

How we-

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Sorry, go ahead.

Randy Rasmussen
CFO, Phreesia

Estimate, right. I think G&A is a good example where, you know, as we've looked out and said, you know, what is the growth opportunity and what size of company are we going to be? Making sure that we have, you know, scale to reach that. You know, we made a significant investment over the past couple of years, and I think, you know, as we articulated in the quarterly letter, we feel like we've achieved. You know, G&A is a good example of that, where we've achieved the level of staffing and systems and investment that we've made to support, you know, a company that reaches this, you know, $500 million run-rate business.

You know, from the perspective of, you know, more growth, I think it's minimal, you know, from this perspective because much of the investment is there. I think what we're really looking for, you know, in the years beyond fiscal 2023 is, you know, operational leverage on that investment, you know, which improves our efficiency across the board.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Okay. There's nothing, I guess, structural in how you're thinking about investing in new verticals and product development that's causing this pretty dramatic increase in expenses per FTE, right?

Chaim Indig
CEO and Co-Founder, Phreesia

No.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Okay.

Chaim Indig
CEO and Co-Founder, Phreesia

No.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

And then-

Chaim Indig
CEO and Co-Founder, Phreesia

But-

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Sorry, go ahead.

Chaim Indig
CEO and Co-Founder, Phreesia

We're profitable. We like being profitable. We expect to get back to profitable.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Yep. Makes sense. Then on the payment processing expense, that came in, you know, a little bit higher than historically around 61-ish% of payment processing revenue, versus historically it's been around 58%. Is there anything that's causing this increase in payment processing expense specifically?

Randy Rasmussen
CFO, Phreesia

I mean, I think there's always a little bit of mix, you know, how cards are processed, you know, card present, card not present. You know, visit volumes that can impact that, quarter-over-quarter. You know, as that business grows, as you're aware, you know, Visa and Mastercard have also announced a price increase. We see some fluctuation in that over time. You know, we also have the ability in our contracts to raise price,

Chaim Indig
CEO and Co-Founder, Phreesia

It's those fancy reward cards that are killing us, man. Those stupid reward cards.

Daniel Grosslight
Senior Research Analyst of Healthcare Technology, Citi

Yep. Yep. Okay. Understood. All right. Thanks, guys. That's it for me.

Chaim Indig
CEO and Co-Founder, Phreesia

Sure.

Operator

Your next question comes from the line of John Ransom with Raymond James. Your line is open.

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Hey, a couple from me. Can you help us tease out the effect of Insignia on both revenue and members? What, how much does that help in the quarter?

Randy Rasmussen
CFO, Phreesia

Yeah. I mean, I think when we announced Insignia last quarter, it's not material to the results from a revenue perspective. I mean, you can see the, you know, the purchase price, it is a small tuck-in, you know, acquisition, so it doesn't really impact our outlook significantly.

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Okay. Second question. I mean, if we just do the simplistic analysis of SDRs to next twelve-month revenue, I mean, you more than doubled your SDR force from July 2020 to July 2021. You know, you're calling for a nice uptick in revenue, but it looks like the revenue per SDR would have to drop pretty meaningfully to just grow top line acceleration by 500 basis points, you know, when you're more than doubling the SDR. Can you kinda help me understand the relationship between revenue and SDR count? Is there something structural where that correlation, which was pretty tight for a couple years, has kinda broken down?

Randy Rasmussen
CFO, Phreesia

I mean, I think from the perspective, right, of the SDRs are lead generation, so, you know, it's really at the beginning of the revenue cycle. I think, you know, one thing to keep in mind is that we made significant investments in the last year, and we are seeing, you know, 12 months of that expense. I think you see a dip in productivity when you're looking at, you know, revenue per headcount statistics or revenue per cost. You know, I think that dip is temporary, you know, as efficiency, you know, those resources are in place. They've been working for, you know, 12 months, and they become more productive. There's always a period of time where you're onboarding, training. I think it's kinda normal to see a temporary dip in the statistics.

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Okay. I know you've never grown at that pace. Then lastly, I mean, we've learned that, you know, you've onboarded Tenet Healthcare as a hospital client. I guess I would've thought that might have engendered a press release and a little bit of a marketing opportunity for you. So what's your philosophy? Was that something they asked you not to do, or is it just you guys are quiet and modest and wanna keep your light under a bushel?

Chaim Indig
CEO and Co-Founder, Phreesia

You know, I think what's important is not putting out press releases. It's doing good work for our clients, John. The work generally over 17 years has paid off immensely, right? Like, when we put out press releases, it's usually because we get asked to do, right? I generally believe in a philosophy that, you know, we should just do wonderful things for all of our stakeholders, and over time, it always works out positively, right? You know, frankly, I love that our clients are positively talking about us publicly and privately. But you can

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Well, Chaim, let me teach you the merits of shameless and substance-free self-promotion, you know. I think we need to talk more about that.

Chaim Indig
CEO and Co-Founder, Phreesia

Like, you know, you're not the only parent who let marketing, you know, drives her crazy. You know, it's. We've definitely increased our, you know, our conversations about a lot of what we're doing with our clients on a lot of the social media outlets, which I personally am not really on, so be it.

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

I'll look forward to your Instagram page. Thank you.

Chaim Indig
CEO and Co-Founder, Phreesia

Thanks, John.

Operator

Your next question comes from the line of Stephanie Davis with SVB Leerink. Your line is open.

Joy Zhang
Equity Research Vice President, SVB Leerink

Hey, guys. This is Joy Zhang on for Stephanie. Thank you for taking my question. I wanted to circle back to the payer market question again. So, I was hoping if you can give more color on what exactly some of the new solutions could look like, and what problems you're tackling. Also, how much are those products leveraging the capabilities you've acquired from Insignia Health?

Chaim Indig
CEO and Co-Founder, Phreesia

Joy, just to be clear, are you asking about the Insignia acquisition?

Joy Zhang
Equity Research Vice President, SVB Leerink

I think you mentioned earlier that there'll be new products in addition to the Insignia Health acquisition, as you expand into the payer market.

Chaim Indig
CEO and Co-Founder, Phreesia

Yeah, I'm sure. Like, there will be, and there are. I think we're in the early days of it. You know, philosophically, our thesis is as we, you know, as we have a better understanding of what those products, you know, how we're gonna take them to market, and we're ready to talk about our early adopters and, you know, some of our later stage adopters, then we usually are more public about what those products do. I promise you, Balaji's, unlike press release Balaji, Nick will talk about this. It's just a little early right now for us to be talking about it, but we're really excited about what the team is doing there. I think it's a little too early for us to share too much about it.

Obviously, it's an area we're investing in.

Joy Zhang
Equity Research Vice President, SVB Leerink

Yeah. No, that makes a lot of sense. I understand it's early days. Maybe as a follow-up-

Chaim Indig
CEO and Co-Founder, Phreesia

Wait. Hold on.

Joy Zhang
Equity Research Vice President, SVB Leerink

Sorry.

Chaim Indig
CEO and Co-Founder, Phreesia

One other thing.

Joy Zhang
Equity Research Vice President, SVB Leerink

Go on.

Chaim Indig
CEO and Co-Founder, Phreesia

I'm very excited about some of the work that Dr. Hibbard and the team have been doing around the Patient Activation Measure®. We think that is. It's not just an important instrument. From a payer standpoint, I think it's just an important instrument generally for healthcare for folks to be able to understand how we, as patients, are activated in our healthcare. I think that that's something that there's hundreds of research studies on, and we're really excited to be able to really expand the footprint and the knowledge base around patient activation.

Joy Zhang
Equity Research Vice President, SVB Leerink

Got it. Very helpful. As a follow-up, your half a billion- dollar target for FY 2025 obviously reflects a quarterly run rate of $125 million. This would imply kind of a significant step up from the Street's FY 2024 numbers, and I think it implies something like 40%+ growth. Can you maybe just reconcile that level of acceleration with your long-term growth target of 20%-25%?

Randy Rasmussen
CFO, Phreesia

Well, I think, you know what, we've previously communicated, right, that our long-term growth rate was 20%-25%. When you look at the half a billion- dollar run rate in 2025, that implies, you know, 27%-29%. We did significantly increase our growth rate into the high twenties.

Chaim Indig
CEO and Co-Founder, Phreesia

Yeah. Joy, I think you know, I think we've also said that there's a long-term growth rate of 20-25%, but given the investment levels we made in fiscal 2022, there could be periods where it's higher. I think the $500 million is indicative of that. But I don't know the percentage you threw out. That doesn't sound. 40% doesn't seem to make sense. I think Randy's math is probably closer, but it would sort of have to be about what quarter in 2025 you know got to $500 million.

Joy Zhang
Equity Research Vice President, SVB Leerink

Got it. Perfect. Thank you.

Operator

Your next question comes from the line of Glen Santangelo with Jefferies. Your line is open.

Glen Santangelo
Managing Director, Jefferies

Oh, yeah. Thanks for taking my question. I just want to follow up on a couple of the questions that have already been asked because I think what we're all trying to really wrap our heads around is, you know, we're seeing expenses tick up at a very accelerated rate here at the same time that revenue growth is decelerating pretty sharply. I think we're having trouble sort of reconciling why that's the case. If you look at sort of the FY 2025 guidance you've now provided, right? I mean, we're looking at 27%-29% revenue growth next year, but then you got to step up at least to the mid-30s, you know, in 2024 and 2025 to get to 500 by the end of the year.

Revenue growth dips, then it re-accelerates, and we don't really have great visibility on the expense base in 2024 and 2025. As we think about this path to return to profitability, is the expense base in fiscal 2023, is that the number, or will there be continued investments in fiscal 2024? Cause the way the release reads, it's a little bit unclear that we're gonna approach profitability in 2025. Could you give us any more color on the trends as we think of the Three-year view?

Chaim Indig
CEO and Co-Founder, Phreesia

I know, Glen, and I'm very excited that you asked me the question, but I'm gonna hand the baton over to Randy because he's probably gonna do a better job of answering it than me. Is that cool?

Glen Santangelo
Managing Director, Jefferies

Yeah, that's fine. I'll take the answer from anybody.

Chaim Indig
CEO and Co-Founder, Phreesia

All right. Go, go, Randy.

Randy Rasmussen
CFO, Phreesia

Yeah. Glen, you know, I think if you look at fiscal 2023, as we mentioned in the quarterly letter, that's really the low watermark, and we have done a significant amount. That investment has set us up to reach the half a billion- dollar goal in 2025. You know what that means is that we're not planning a lot of expense acceleration. What you're seeing in 2023 is really the investment that we've already made, but we made it in the latter half of the last fiscal year. You know, the increase from 2022 to 2023 is really the impact of having a full 12 months of those expenses. You know, from operating we don't feel like we have to make significant investments to achieve those growth rates.

You know, that's where the approach to profitability in 2025 comes from.

Glen Santangelo
Managing Director, Jefferies

Okay. That's helpful. Basically, the run rate in 2023, that's like a reasonable run rate within reason to think about for fiscal 2024 and 2025, so we can model the leverage off that. Right? Is that correct?

Randy Rasmussen
CFO, Phreesia

Yeah. I think from an expense perspective, there's 23 is a good number. Of course, you know, we continue to make investments, but not, you know, at the rate that we made in this last fiscal year where we did a lot of, you know, additional headcount hiring. I think that moderates.

Glen Santangelo
Managing Director, Jefferies

Yeah

Randy Rasmussen
CFO, Phreesia

Significantly in 2023.

Glen Santangelo
Managing Director, Jefferies

Randy, if I could just maybe ask you one quick follow-up on the balance sheet. You got $314 million in cash, and I saw, you know, you increased your revolver up to $100 million. Let's just say you got a little over $400 million in capacity, right? I mean, you guided, you know, EBITDA down, let's call it $150 million. Help us think about not only just the return to Adjusted EBITDA profitability, but really a return to positive cash flow, right? Do you think you have enough cash between what you have on hand and the $100 million revolver to make it to positive cash flow before having to raise capital from somewhere else?

Randy Rasmussen
CFO, Phreesia

Yeah, I think if you look at, you know, the $314 million that we have on the balance sheet, we feel like we have a very strong position on our balance sheet. You know, we did raise the line of credit from $50 million to $100 million, and we haven't been using that, so that we have the full capacity of that line. You know, I think, you know, for fiscal 2023, we're very comfortable with the strength of our balance sheet and being able to fund the business.

Glen Santangelo
Managing Director, Jefferies

All right. I guess the question was can you make it to 25 with the cash you have?

Randy Rasmussen
CFO, Phreesia

Yeah. I mean, I think from the perspective, we're not really giving, you know, explicit guidance way out on that basis. But I think we feel confident in the balance sheet in this year.

Chaim Indig
CEO and Co-Founder, Phreesia

You know, Glen, to say, you know, the term approach profitability, and I think all of Randy's comments, you know, expenses expense growth decelerating and revenue growth accelerating, from the historical. You know, I think you could probably put some estimates together and see, you know, how much cash we probably need in the business, but I don't think we can comment specifically on your question.

Glen Santangelo
Managing Director, Jefferies

Perfect. You gave me a lot to work with. Thanks a lot.

Operator

Your next question comes from the line of Ryan MacDonald with Needham. Your line is open.

Ryan MacDonald
Managing Director and Senior Equity Research Analyst, Needham

Hi. Thanks for taking my questions. First wanted to start on the MEDITECH and Cerner integrations and validations. You know, can you just discuss the opportunity that partnering with these additional vendors creates, especially as you're going after sort of the upper end of the market with the health systems and hospitals, and perhaps how that can unlock the opportunity versus what you were doing previously? Thanks.

Chaim Indig
CEO and Co-Founder, Phreesia

I think I've been pretty consistent with saying eventually we got to be everywhere, right? That's sort of our goal. You know, we started this 17 years ago to build a small business. Look, we as much as we compete with pretty much every EMR vendor, we're also partnered with almost all of them, or we work with them, or we integrate with them in a collaborative way and work with their technology like interchange and interoperable with them, and we're committed to always doing that. I think this is just a view that, you know, we've been, you know, having success in those markets, and we just wanna make sure that the integration is, you know, like how our clients wanna be. We look forward to working with them. Like, they've been great so far.

Ryan MacDonald
Managing Director and Senior Equity Research Analyst, Needham

Excellent. My follow-ups on the life sciences business and I know we talked about it a little bit here, but as we think about the trajectory of the end market and the shift towards digital marketing spend, we've obviously seen a multiyear pull forward in the investments there. As you're thinking about expectations for fiscal 2023, you know, what sort of moderation in spend are you expecting or in the movement of that spend over to digital channels, you know, in the implied sort of assumptions for this year and what are, I guess, are you hearing from your clients from that perspective?

You know, are we still very early innings or is this an instance where, you know, we saw a really aggressive pull forward and that, you know, now they're, you know, satisfied with kind of the levels we're at? Thanks.

Chaim Indig
CEO and Co-Founder, Phreesia

You know, I think all clients are different, and I think, you know, working with, you know, and talking with our clients and our team that work with them all the time, all of them are consistently looking at what programs and partners drive a phenomenal amount of value. During, you know, the shift, like the rapid shift during COVID, there was a lot of programs that were run, including ours, that provided a huge amount of value. If they provide a huge amount of value, you tend to do more of it, right? I'm sure that there was a bunch of programs, digital or not, that didn't provide a lot of value, and they probably won't do more of those.

I think sort of putting a bucket under a one size fits all, like, do I think like we're going back to the day of as many pharma sales reps calling on doctors? No. That's my opinion, and the data seems to correlate to that. Do I think that a lot of the investments in products that have been made and new tactics, if they bear fruit, you're gonna keep doing more of it. I don't know if I. You sort of skate. I don't know if you know, I'm from Edmonton, right? Like very big Edmonton line is you skate to where the puck is going, right? Sort of view like no one's putting that genie back in the bottle.

Ryan MacDonald
Managing Director and Senior Equity Research Analyst, Needham

I guess, would you say that in those conversations, like, are you seeing instances where now these vendors are starting to talk about consolidating spend against those more effective channels that you talked about? Thanks.

Chaim Indig
CEO and Co-Founder, Phreesia

I do think that there's more spend continuously going towards channels that have proved to be very effective, which the data has shown we are one of those very effective channels. Not only are we one of those effective channels, we are one of those channels, one of the few channels with broad scale to reach those patients and help them understand the therapies available to them and learn more about the therapies that they are on. We are very excited about continued investment in this area.

Operator

Your next question comes from the line of Joe Vruwink with Baird. Your line is open.

Joe Vruwink
Senior Research Analyst, Baird

This goes back to John and Glen's questions a little bit, but the incremental revenue you've been adding kind of per expense dollar has been really efficient for the last few years now. If I just think about the EBITDA guide, it would seem more growth is possible if I just keep efficiency ratios the same. I guess what are the puts and takes? You know, you talked about onboarding a lot of new hires, but as they ramp and become productive, that would seem to help efficiency. I guess what are some of the considerations or, you know, is just more growth possible, but maybe you just need to get a little deeper into the year to see it?

Chaim Indig
CEO and Co-Founder, Phreesia

I think we need to get further into the year to see how some of these investments pay off before I would say that. I also think, which is also I think we have telegraphed really important to note, wages have gone up, right? We wanna be an employer of choice at all times, and part of that thesis is making sure that we pay and comp like our total compensation level for our teammates is good, right? In life, you sort of get what you pay for, and we wanna make sure we get the best, and I think we have a lot of the best.

I do think that has played into some of the efficiency levels, but I also think that now that we understand what that looks like as an organization, we have to make sure that we get back to the place where we feel the investment level should be. It'll take a couple quarters, but I feel pretty good about it.

Joe Vruwink
Senior Research Analyst, Baird

Okay. Thank you very much.

Operator

Your next question comes from the line of Ryan Daniels with William Blair. Your line is open.

Ryan Daniels
Partner and Group Head of Healthcare Technology and Services, William Blair

Yeah, guys. Thanks for taking the questions. I guess a lot of the big picture ones are asked, so I'll go to some nuances. Looking to get an update on what the traction's been with Connect. Are you seeing more growth there, and is it really focused more on the core or the plus offerings? How broad is the network today that you've been able to develop?

Chaim Indig
CEO and Co-Founder, Phreesia

It's growing. I think some of the metrics that we're looking at right now, so we're pretty excited about the offering, Ryan. It's growing very quickly. The thing we look at, which is probably harks back to the days of like how we've always thought about our business is not the size of the network, but how much usage and volume are we putting through it, and we're seeing volume increase pretty rapidly. I'm not, for the same reason, excited about press releases. I'm not excited about lots of product that doesn't get used. I care about whether the products we build and deploy and invest in get heavily like are heavily used by all the stakeholders.

Internally, we often call it utilization, although we're moving more and more towards activation as the terminology that we use. We think it's more appropriate. It's going in the markets, in a lot of the markets it's in, it's growing fairly rapidly.

Ryan Daniels
Partner and Group Head of Healthcare Technology and Services, William Blair

Okay. That's helpful. Then I noticed you guys are offering a free trial of your services, I think through June, and I'm curious if you've done that before and if that's a big demand stimulator. If so, you know, what the conversion rates have looked like from offering a free service to paying clients.

Chaim Indig
CEO and Co-Founder, Phreesia

I think it. Yes, we do often for a lot of our products and both for new and existing clients. We'll often test out different promotions, and we'll do them at different times of year for different types of products in different markets. Generally speaking, you know, we have a analytics team that, you know, looks at sort of the uptick and how it's going and what the sensitivity is on it. I would say that if the team is running a promotion and it's broadly adopted, it's probably effective and it's working. If it doesn't work, then they tend not to do that promotion or offers.

Ryan Daniels
Partner and Group Head of Healthcare Technology and Services, William Blair

Yeah. Fair enough.

Chaim Indig
CEO and Co-Founder, Phreesia

I don't think it's like. I will say that it's not like, you know, offering until June, there's continuously rolling different types of things that they look at for different segments of the market. They try to use, you know, as much data as you can to decide what's working and what's not. It's really about making sure that people understand the things that we do and how they could drive a huge amount of value to their organizations and patients and value to their patients. I think, Randy.

Randy Rasmussen
CFO, Phreesia

Yeah. I think one thing that we look at too is, you know, what are the retention rates of new clients? We included that in the quarterly letter, right? On a revenue basis, it's, you know, approximately 95%, and on a client basis it's 90%. We find as we're acquiring customers, they're staying with us and, you know, as Ty said, the utilization and the activation of our product is high with these customers.

Ryan Daniels
Partner and Group Head of Healthcare Technology and Services, William Blair

Yeah. Understood. Then maybe final one I'll ask here is a bit of a big picture question. We've discussed this in the past, but if we think of macro drivers, obviously there's labor shortages which are likely to continue, and you can help with that. There's the kinda movement to digital front door, and you can help with that. There's the need to drive activation and bring patients back into the care workflow post-COVID. A lot of things moving the market, and that's probably what's driving a lot of your growth and investment. I'm curious if there's any one trend that you see as most significant and sustainable when you speak to your clients that's really pushing them towards your solution. Thank you.

Chaim Indig
CEO and Co-Founder, Phreesia

Ryan, you know, I think one of the things that we have talked about this over the years, and I think one of the benefits that has sustained our growth for all these years is that our acknowledgement that it's not a one size fits all. You know, Evan often says there's no silver bullets for anything. It's just making sure that we continuously deliver a phenomenal amount of value for all of our stakeholders. If we think about our products and our team and all the things we do, you know, it becomes very fulfilling when you know that you might go in, you know, a client might start using us for one reason, and over time, you know, the value proposition won't shift, it will just grow.

And that to me is sort of a hallmark of what makes a great business. That's also why our retention we look, we thought about it as we were writing their stakeholder letter, you know, why was it important for us to, you know, disclose some of our retention metrics? Cause we think it's important for all of our stakeholders to understand that that the investments we're making are really for that long-term value and for our clients and their patients. I also would say like, you know, as you think about value propositions, it's not the same for everyone. For some people it's labor, for others it's cash flow, for others they have to solve a clinical problem, and we're how they do it.

Ryan Daniels
Partner and Group Head of Healthcare Technology and Services, William Blair

All right. Appreciate all that, and thanks for all the color. Congrats, and congrats to David and all the life sciences success in particular. Been really outperforming our thoughts. Thanks.

Chaim Indig
CEO and Co-Founder, Phreesia

Yeah. They're that team is just doing great.

Operator

Your next question comes from the line of John Ransom with Raymond James. Your line is open.

Chaim Indig
CEO and Co-Founder, Phreesia

John, you're back.

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Hi. I know you missed me. The French word segue, a beautiful segue into Life Sciences. You guys, I'm old enough to remember that you used to kind of dourly talk about Life Sciences being this, you know, forever flat business, and now it's not. You've praised the team, but is there kind of for us who look outside, is there a simple correlation we can draw between your labels among your provider group and your Life Sciences revenue, or is what's driving the growth something different than that? I would think the more providers that you add, the more eyeballs that see the ads and the more money you can make. Can you kinda help us out with sort of some simple correlations there?

Chaim Indig
CEO and Co-Founder, Phreesia

Well, your correlation that you are making is wildly important. The network has grown significantly, and I think we did wanna, like, paint that picture for a reason. You know, that has without question given us the world scale, right? We have a broad reach. We're able to segment appropriately. We invested significantly in data science and being able to, you know, understand and segment population better. We invested in just a phenomenal team, but we've also invested in new products like our PatientInsights product, right? Like, that gives us and our clients much better visibility and understanding about what consumers are saying and what matters to them, why they matter. That's been a really powerful tool in our arsenal to be able to, you know, demonstrate significant value to our clients.

I think we link to it in our John. I don't know, did you see the PatientInsights report yet? Like the example we put out about migraine?

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Yeah.

Chaim Indig
CEO and Co-Founder, Phreesia

That stuff just isn't easily accessible to a lot of people, and we've made it accessible to our clients. You know, we're pretty excited because what that also does is demonstrates the depth of understanding we have about patient population.

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

You know, again, a good segue. We're like bread and butter. You know, there are a number of companies who are trying to capture this digital move by big pharma from running midnight ads on TV channels, hoping to catch one fish to much more targeted ads. Do you have a perspective of what Phreesia brings to the table when you're talking to a manufacturer versus some of your rival competitors who kind of come at it maybe a little different way?

Chaim Indig
CEO and Co-Founder, Phreesia

Look, I think that there's different parts of a marketing funnel and, you know, there's some tactics that are used to sort of, you know, get people into an office, right? There's some tactics that are used to, you know, get you to switch messaging. What we really talk about is when we engage a patient, it's a patient. You don't have to guess, right? We don't talk about it as consumer marketing. The only people we really reach are patients, and they've opted in for us to deliver a very targeted message that's, because of the information we have, relevant to their healthcare.

When you deliver something that's opted in and relevant and it's at the right time, it's wildly effective in being able to engage those patients in their care. What we've been able to demonstrate is that engagement has a very strong ROI, and we're able to do it at scale and reach patients that would otherwise be pretty hard for these organizations to be able to reach right before they are about to see a care provider.

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Thank you, sir.

Chaim Indig
CEO and Co-Founder, Phreesia

You know, how'd I do?

John Ransom
Managing Director and Director of Healthcare Research, Raymond James

Oh, Chaim, you know, that's as excited as I've ever heard you so, you know, I give you an A.

Chaim Indig
CEO and Co-Founder, Phreesia

That might be a good place. All right. Well, I will say it's much nicer having Randy and Balaji here with all doing it all together. Thank you everyone for participating, and I think I do like the evening call more than first thing in the morning, so maybe we'll make this how we roll moving forward. Thanks everyone, and I'll talk to you all soon.

Operator

This concludes today's conference call. Thank you for joining. You may now disconnect.

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