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Earnings Call: Q2 2023

Sep 7, 2022

Operator

Good morning, ladies and gentlemen, and welcome to the Phreesia fiscal second quarter 2023 earnings conference call. At this time, all participants are in a listen-only mode. We will provide instructions for the Q&A to follow. First, I would like to introduce Balaji Gandhi, Senior Vice President, 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 second quarter of 2023, which ended on 31 July 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 the 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 included in our quarterly report on Form 10-Q that will be filed with the SEC tomorrow. Our 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 these 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 an 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 filed after the markets closed today 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

Thank you, Balaji, and good evening, everyone. Thank you for participating in our second quarter earnings call. In case you didn't spend the last 30 minutes reading all of our earnings material cover to cover, let me share some key highlights and additional commentary. Revenue in the second quarter was $68 million, up 33% year-over-year. I wanna thank the team for putting up our sixth consecutive quarter of over 30% revenue growth. In the quarter, our average number of healthcare services clients was 2,776. We added 250 average healthcare services clients sequentially, establishing a new Phreesia record for the fourth straight quarter. This represents 40% year-over-year growth. Healthcare services revenue, which is the combination of subscription and related services and payment processing revenue, was up 29% year-over-year in the second quarter.

On a per average healthcare services client basis, subscription and related services revenue remained in the $11,000 range in the second quarter, reflecting both our land and expand go-to-market motion and the significant growth in average healthcare services clients. Payment processing revenue grew 20% year-over-year in the second quarter after having grown 38% year-over-year in the last year's second quarter. In last year's second quarter stakeholder letter, we attributed the 38% growth to catch-up utilization from the reopening during the pandemic. Phreesia now impacts more than 1 out of 10 patient visits in the United States every day, helping patients become more activated in their health and achieving better health outcomes.

The size of our network and the strong execution by our team helped fuel growth in life sciences revenue of 46% year-over-year, which was on top of the 95% year-over-year growth in the last year's second quarter. Moving on to our outlook for the rest of the fiscal year. We now expect revenue for fiscal 2023 to be in the range of $273 million to $275 million, tightening our previous range of $271 million to $275 million. We expect average healthcare services clients to increase by at least 200 in the fiscal third quarter as our investments from the last couple years continue to fuel our growth.

The operating leverage we began to see in the first quarter gained momentum in the second quarter, and we expect to return to Adjusted EBITDA profitable in fiscal 2025. Based on our strong performance, we've taken up the Adjusted EBITDA outlook for the fiscal year to a range of negative $109 million to negative $106 million from our previous range of negative 126

Randy Rasmussen
CFO, Phreesia

To negative $122 million. We remain comfortable with our ability to finance our fiscal year 2025 growth plan, and expect to end fiscal 2023 with $165 million to $170 million in cash and cash equivalents. We believe our investments over the last couple years are helping us keep our product best in class, build more amazing new products, expand our relationship with existing clients, and grow our network with new clients. We believe our capital allocation strategy sets us up to deliver on our financial targets for fiscal 2025 and beyond. We continue to focus on driving shareholder value. Operator, I think we can open it up to Q&A now.

Operator

Your first question comes from the line of Anne Samuel with J.P. Morgan. Your line is open.

Anne Samuel
Executive Director, Equity Research – Healthcare Technology and Distribution, JPMorgan

Hey, guys. Congrats on the strong logo growth. I was hoping maybe you could provide a little bit of color on the EBITDA guidance raise. You know, it's quite a bit more than the second quarter outperformance. Was just wondering, are there any incremental efficiencies you're finding in the back half, and if so, you know, what are those? Thanks.

Randy Rasmussen
CFO, Phreesia

Thanks for the question. I mean, I think we're really proud of the team for, you know, focusing on spending money smartly. You know, I think as we had stated, you know, in the past, we think about each dollar that we spend very carefully. You know, the team has done a great job watching the expenses, and I think that just continues in our culture. We think about every person that we hire and every dollar that we spend on software or services as important. It's just a continued focus on making sure that what we spend money on adds value to the business and helps us grow. Where we don't need to spend money, we pull back.

Anne Samuel
Executive Director, Equity Research – Healthcare Technology and Distribution, JPMorgan

That's great to hear. Maybe just another one. Your Life Sciences business was once again, you know, really strong. That seems to be bucking the trend that we're hearing from other companies with Life Sciences customers. Was just hoping you could provide a little bit of color there on, you know, what you're seeing in Life Sciences and if there's been any shifts in the marketplace.

Chaim Indig
CEO and Co-founder, Phreesia

Well, first. How you doing, Andy? First, the network's growing a ton. The investments we've been making on growing the network have really paid off in being able to just expand our footprint, deliver more messages to more patients that add more value. Second, the team is just amazing. They've been doing a great job. You know, I don't think we would be where we are if we hadn't been investing in the products and in the people. I'm just so impressed by execution all the way through with our Life Sciences org, frankly, with everyone. I'm calling it out based on this question.

Anne Samuel
Executive Director, Equity Research – Healthcare Technology and Distribution, JPMorgan

That's great. Congrats on a great quarter.

Chaim Indig
CEO and Co-founder, Phreesia

Thank you.

Operator

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

Glenn Santangelo
Managing Director, Jefferies

Good evening, and thanks for taking the questions. Chaim, I just also wanted to follow up on the digital advertising question. I mean, could you give us a sense for maybe how much of that is already contracted when you look at sort of the balance of the year and maybe how much you have to win on a quarter-by-quarter basis? Because I'm just kinda curious, you know, with half the third quarter just about over, I'm kinda curious as to what type of visibility you maybe have in that life sciences growth for the balance of the year.

Chaim Indig
CEO and Co-founder, Phreesia

We have a fair bit of visibility to the fiscal year. There's a couple things, Glenn, around just the way we've always done our fiscal year. January is sort of the real bogey for us, that we don't have as much visibility to, 'cause often those come in in next year's contracts. Does that make sense? 'Cause like our clients' are fiscal year, then it really comes in in next fiscal year, that one month bogey.

Glenn Santangelo
Managing Director, Jefferies

Right. You're kinda suggesting you have pretty decent visibility up through December, right? The final month of Q4 falls into theoretically a different fiscal year for your clients. Is that what you're saying?

Chaim Indig
CEO and Co-founder, Phreesia

I'd say we have decent visibility.

Glenn Santangelo
Managing Director, Jefferies

Okay. Then I just wanted to follow up with Randy on the balance sheet. Randy, I mean, you guys, this is the first time I think I've seen you give specific cash flow guidance by forecasting the cash balance at the end of the year. If I sorta, you know, look at that number, $165 million to $170 million, and take that sort of in concert with kinda your EBITDA guidance for this year and also the fact that you're calling out fiscal 2023 as being the low water mark in EBITDA, is kind of the implication there that you feel very comfortable, sorta making it, you know, through your fiscal 2025 goals of Adjusted EBITDA profitability with the cash that you currently have on the balance sheet?

I'm also curious, is there any other sort of, you know, capacity that you have access to that we should be thinking about? Thanks.

Chaim Indig
CEO and Co-founder, Phreesia

No, I'm gonna Glenn, I'm gonna let Randy answer that question. I think the reason we decided to put it out there and, like, print it is it's just a lot easier. There's just no confusion, right? 'Cause this way we don't stumble around with the answer that we think is important to a really important question. I'll let him answer.

Randy Rasmussen
CFO, Phreesia

Glenn, you're exactly right. We're confident where our cash balances are. We don't have any borrowings on our line of credit, and we have adequate cash to execute on our 2025 plan, so we're feeling really good about our cash.

Glenn Santangelo
Managing Director, Jefferies

Randy, how big is that line of credit? Just remind us.

Randy Rasmussen
CFO, Phreesia

It's $100 million.

Glenn Santangelo
Managing Director, Jefferies

Okay, perfect. All right. Thanks, guys.

Chaim Indig
CEO and Co-founder, Phreesia

Thanks, Glenn.

Operator

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

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

Hey, guys. Nice quarter. Thanks for taking the questions. Another one on the guidance outlook. I don't think in the past you've offered guidance on net new client additions. You're expecting another strong quarter there of at least 200. So what's helping with the visibility there? Is that related at all to, you know, some of the trial packages you're allowing people and seeing high conversion there such that, you know, you have a pretty good feel that those are gonna turn into paying clients by the end of the quarter?

Chaim Indig
CEO and Co-founder, Phreesia

Well, we do have pretty good visibility to the quarter, and Balaji wanted to make it easy for everyone to model, to be fair. We just took Balaji's advice on giving a little bit more visibility, so it was easier to model. Ryan,

Balaji Gandhi
SVP of Investor Relations, Phreesia

I don't think it's a change in our visibility.

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

It's just more disclosure thing. That's why you're the best, Balaji. I appreciate that. Maybe just a t the prepared comments, you have a comment in there about the potential to drive revenue per client for the subscription and related services up to $126,000 versus where it is today. You know, a tenfold increase. Can you talk a little bit longer term about how that will figure into the growth algorithm, maybe after the, you know, bolus of new client additions starts to slow down, how you can push them to get more value from your system by expanding the services that they purchased? Thanks, guys.

Balaji Gandhi
SVP of Investor Relations, Phreesia

Ryan. I can answer the bigger part of the question, but I just wanna clarify. I think you might be doing some quarterly math on annual math because I think we would think about the opportunity to be about 3x. You sort of took the quarterly subscription revenue we did per client and annualized that. It'd be about a third of the 26,000.

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

No. I'm just referring to the comment in the release about when you created the TAM of $6.3 billion, saying 50,000 subs at 126 subscription-related services. Getting up, you know, from current levels to that level to clarify.

Balaji Gandhi
SVP of Investor Relations, Phreesia

Got it. Got it.

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

Thank you.

Balaji Gandhi
SVP of Investor Relations, Phreesia

Maybe second part of your question to behind financial.

Chaim Indig
CEO and Co-founder, Phreesia

I think I remember, Ryan. It's how are we gonna get more people to buy more of our products and expand?

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

Exactly.

Chaim Indig
CEO and Co-founder, Phreesia

All right. You know, it's a pretty simple philosophy that, you know, started years and years ago whenever I started the company. First, you do what you say you're gonna do. You provide as much value as you possibly can to your clients. You treat them really well, and then you expand your footprint. And then when you expand the footprint and you provide a ton of value and you treat them really, really well, they buy more product, and they're willing to try more. And then that product's successful, and then it provides a phenomenal ROI to them, and then they go to the next one and then another one. And you're able to do that because you hire amazing people and you pay them well to build great products, and then you implement it really well, and it becomes a virtuous cycle. All right?

Where you do what you say you're gonna do. You treat people well. We just try to do that.

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

All right. Fair enough. I appreciate the caller. Thank you.

Operator

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

Richard Close
Managing Director, Canaccord Genuity

Thanks. Congratulations. Maybe a somewhat of a follow-up to that last question by Ryan. You know, the average revenue per client declined, and obviously, you've had significant new client adds over the last several quarters. Also introduced new offerings over the last year, referral management and I guess Appointment Accelerator to name a few. How are you thinking about the average revenue per client, you know, and timing of when maybe growth reaccelerates on that line item? I can take that. When we look at the average revenue per client, it also includes our payments business. When we talk about it going down, we're really talking about the effect of payments where, you know, payments is growing 20%, where our client growth, you know, is growing, you know, up to 40%.

Randy Rasmussen
CFO, Phreesia

That's the main driver. If you look at the average revenue per subscription client, it's actually been very consistent over the last six quarters. If you look at how many clients we've been adding, you know, for the last three quarters, we've been adding over 200. The three quarters before that, it was around 100. We're actually very happy that the subscription per client has remained fairly constant, even though we've had a huge uptick in the number of clients that we're adding. You know, I think we think from our perspective that it's pretty healthy, and it is hard to, you know, increase that statistic when you're adding so many clients every quarter.

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

Okay. Maybe just on utilization, you made some comments there, and I was curious if you could provide a little bit more context, you know, stating revenue outlook incorporates our expectations for utilization in the current environment. Is there anything else to add in terms of just, you know, what you're seeing from utilization or expecting in the back half of this year?

Balaji Gandhi
SVP of Investor Relations, Phreesia

I mean, it's Richard, are you asking about patient utilization in the ambulatory setting? I mean, we look at it regularly and think it's sort of embedded in how we think about our outlook for the year.

Chaim Indig
CEO and Co-founder, Phreesia

In the acute care, like, you know, we sort of see it all on a daily basis.

Richard Close
Managing Director, Canaccord Genuity

Are you asking me in America? Okay.

Randy Rasmussen
CFO, Phreesia

Just, you know, maybe a little bit more context in terms of what is baked into your guidance. Are you looking for any improvement, or is it just, you know, the status quo?

Chaim Indig
CEO and Co-founder, Phreesia

I'd say hope is not a strategy, Richard. Right? Generally not been our like, my philosophy. I'm a pretty pragmatist on this, and I think Randy is too.

Richard Close
Managing Director, Canaccord Genuity

Okay.

Chaim Indig
CEO and Co-founder, Phreesia

Like, we don't look for utilization to pop in the second half. I think that's a. You know, we don't see it, so. We're not hearing our providers telling us they're getting ready for the big bolus that's about to come. I don't know. Did I answer your question? Or did I just-

Richard Close
Managing Director, Canaccord Genuity

That's fine.

Chaim Indig
CEO and Co-founder, Phreesia

Okay.

Operator

Your next question comes from Ryan McDonald with Needham. Your line is open.

Matt Shea
Managing Director, Needham

Hey, guys. This is Matt Shea on for Ryan. Thanks for taking the question, and congrats on a solid quarter. Wanted to touch on payments. We've been hearing about rising patient self-pay balances at some provider practices, which in some cases are turning to bad debt. Curious if you're seeing this with your clients, and if so, what impact rising patient balances might have on the payments outlook.

Chaim Indig
CEO and Co-founder, Phreesia

I haven't seen that in any of our numbers, and if we did see that would generally bubble up, and I haven't heard of any. We also manage hundreds of thousands of active payment plans, and we don't see any general trend change in any of those across the country. Randy, have you heard?

Randy Rasmussen
CFO, Phreesia

I don't think we've seen anything that would indicate what we're talking about in our data yet.

Chaim Indig
CEO and Co-founder, Phreesia

I can pretty much guarantee there's someone at Phreesia listening to this call right now that's gonna try to figure out if that is the case. If we do hear it, I'm sure we'll talk about it, but we haven't seen it in our numbers.

Matt Shea
Managing Director, Needham

Okay. That's good to hear then. One other one would be, Epic held a user group meeting conference in August and announced single sign-on to unify their patient portals and also mentioned the desire to develop and deploy some text-based scheduling and intake solutions. It sounds like patient portals are getting better, and EHR vendors are maybe interested in moving into text-based offerings. Just curious if you could comment on the competition and complements that your EHR vendors, partners create and then what impact Epic launching a text-based patient intake solution might have on your existing relationship. Thanks.

Chaim Indig
CEO and Co-founder, Phreesia

I can't comment on any specific company, but I can say that it's a lot of work to do the things we do at scale, and, you know, we've had competition for our products for as long as we've been running Phreesia. I think that that's a good, amazing thing. Doing what we do at scale with complex data and getting it live at clients and making sure that all variety of different patients in different settings can use it, pretty hard. There's a reason why we have the investment we have in not just our current products but in our future products, that we feel pretty comfortable about our outlook. What we do is hard, right? But I also think competition makes everything better. Like, frankly, I'd love to see healthcare in America improve faster.

If it does it because more people are innovating, that's great.

Operator

Your next question comes from Stephanie Davis with SVB Securities. Your line is open.

Stephanie Davis
Senior Managing Director, SVB Securities

Guys. From Grasant MacLaury. Thank you for taking my question. I was hoping you can give us a refresh on the payment processing ramp when you first sign up a client. How should we think about the lag until you're at full run rate, and what sort of optical drag could this create in revenue per, just given your client growth continues to be outside?

Chaim Indig
CEO and Co-founder, Phreesia

Wait. Stephanie , you were a little bit choppy for us. Okay. I heard payment processing ramp, but I don't think any of us heard the question super clear. Do you mind repeating it?

Stephanie Davis
Senior Managing Director, SVB Securities

All right. No worries.

Chaim Indig
CEO and Co-founder, Phreesia

Okay.

Stephanie Davis
Senior Managing Director, SVB Securities

I am at a conference, so I apologize for any background noise.

Chaim Indig
CEO and Co-founder, Phreesia

It's okay.

Stephanie Davis
Senior Managing Director, SVB Securities

I was asking if you could walk us through the payment processing ramp for when you first sign up a client and how that could lag until you're at full run rate because I'm trying to look at the optical drag that you're gonna have on your revenue per metric in the near term.

Chaim Indig
CEO and Co-founder, Phreesia

I'll answer some of it, and then I think Randy will answer, might have to answer the other part. There's a couple parts about payments. One, it's when we do a land and expand, some of the drag is just simply, like, as we add locations, we're picking up more payment. Right? Then the other thing which I think is, you know, as we add into the organization, we add more payments. Some of it also has to do with as we ramp, we pick up more cards on file, we pick up more payment plans, and that just becomes a building nature on how we ramp up payments. I do wanna stress that there's also seasonality in our payment numbers.

Payments tends to not grow, and frankly, it has just annual seasonality tied to the deductible is probably the best way to think about it.

Randy Rasmussen
CFO, Phreesia

Yes. I just.

Stephanie Davis
Senior Managing Director, SVB Securities

Understood. Oh, continue. I'll follow up after.

Randy Rasmussen
CFO, Phreesia

I was just gonna say, you know, we count the customer when the first dollar of revenue comes in. So as soon as they start using our payment solution, we will count them as a client. As Ryan said, you know, there's usually a ramp-up period where they're transitioning to us because there's always an incumbent.

Payment provider in place, so it may take, you know, 3-4 months for them to fully be onto our payment solution or more. It depends on, you know, the size and how complex they are.

Stephanie Davis
Senior Managing Director, SVB Securities

Another one on the payment processing side, like, 'cause that was really helpful. Is it safe to guess that there was a shift away from last quarter's discounting given the quarter-over-quarter increase in transaction yield, or is there anything else to call out there just giving us a healthy step up?

Randy Rasmussen
CFO, Phreesia

I mean, there's different things that can affect that. I mean, it's also the mix of cards, like what they're paying with, if it's Amex or Mastercard, if it's card present, card not present. There's a lot of things that go into that that can affect that effective rate.

Chaim Indig
CEO and Co-founder, Phreesia

There were some fee changes from the carriers.

Stephanie Davis
Senior Managing Director, SVB Securities

All right. Thank you, guys.

Chaim Indig
CEO and Co-founder, Phreesia

Thank you, Stephanie.

Operator

Your next question comes from Daniel Grosslight with Citi. Your line is open.

Daniel Grosslight
Senior Research Analyst, Healthcare Technology, Citi

Thanks for taking the question, and congrats on the quarter, guys. I'd like to follow up on one of Richard's questions around utilizations. I know you mentioned kinda you're not going on a hope here, but if you listen to what many providers in the public markets have said on 2Q's, non-COVID utilization remains depressed. If you look at kind of the flu season that you know is happening in the southern hemisphere right now and speaking to doctors where they think kind of inventory utilization's gonna go in the second half, can you just put a finer point on how you're baking utilization into your estimates now? Are your clients still at kind of less than pre-COVID utilization, and how should we think about that going into the second half of the year?

Randy Rasmussen
CFO, Phreesia

I mean, we look at it every week. To be honest, there's some weeks that are up, and then there's some weeks that are down. You know, I think we generally feel like we don't have enough data to conclude that there's a COVID effect or there's not a COVID effect. You know, I think we model it in the sense of, like Chaim said, we're not expecting some huge comeback. I think, you know, typically when you look at our revenues throughout the year, it's pretty consistent from quarter to quarter. You know, there's seasonality where there's more payments, earlier in the year, and then that kind of trails off towards the end of the year and newer clients come on and, you know, generally that's flat quarter to quarter, during the middle of the year.

Chaim Indig
CEO and Co-founder, Phreesia

We do have, like, we have the data in real time, right? We used to have big screens when we had offices where you could see the utilization in real time, so.

Balaji Gandhi
SVP of Investor Relations, Phreesia

Daniel, one thing I will say that, you know, public now 13 quarters, and I think in trying to help people at least do some modeling, the overall payment volume that we report every quarter, if you look at that, and I think many of the analysts do look at it this way, if you look at that on a per client basis, it's pretty clear the commentary from our letter and, you know, Chaim's opening comments that, something, you know, unusual was going on with a lot of sort of catch-up utilization, last year, and we're still working through that. I think that's pretty evident.

Daniel Grosslight
Senior Research Analyst, Healthcare Technology, Citi

Okay, good. You know, some folks selling into the provider market, not your direct peers, but other, I'd say, health tech, provider-focused health tech companies have had some issues selling into the provider market. They're seeing elongated sales cycles, et cetera. You're not seeing this, which is great. I'm just curious, what's resonating the most in the market now? And are you seeing any degradation in kind of the starting price and module upsells that would suggest that some folks are being a little more conservative given some pressures in the provider market?

Chaim Indig
CEO and Co-founder, Phreesia

I'm gonna take this opportunity to give a huge shout-out to our provider sales organization and our go-to-market team, first and foremost. Like, the reason we're doing well, like without a question, is our client success team, our sales organization, our demand gen team, our marketing team. They are just doing a phenomenal job. I'm just so excited every time I get on the weekly calls, and I listen in. That's the first point. I'm sort of calling them out right now and saying thank you, although they'll hear it on the all-company call later. Next, it's land and expand, and that's part of our selling motion.

I think that's wildly important, and we've sort of been pounding on the table for more than 13 quarters, and we want everyone to understand that's our selling motion, that, you know, we believe at Phreesia that we should build trust. The way we build trust is we land in an account, we provide a phenomenal amount of value, then we grow our footprint, and then we get the right and the privilege to continue to grow that account. We think that's the way we work. That's how we invest money. It's more expensive on the onset, but the payback, we believe, is significantly better, and it gives us better visibility and a better client experience.

Daniel Grosslight
Senior Research Analyst, Healthcare Technology, Citi

Thanks.

Chaim Indig
CEO and Co-founder, Phreesia

You know, frankly, we, our products provide just amazing value.

Daniel Grosslight
Senior Research Analyst, Healthcare Technology, Citi

No degradation in kind of that starting price or no conservatism seen in folks buying up additional modules?

Chaim Indig
CEO and Co-founder, Phreesia

Well, like, no. We haven't seen any of that.

Daniel Grosslight
Senior Research Analyst, Healthcare Technology, Citi

Great. Thanks for the caller.

Chaim Indig
CEO and Co-founder, Phreesia

Cheers.

Operator

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

Jessica Tassan
Director and Senior Research Analyst, Healthcare IT and Delivery, Piper Sandler

Hi. Congrats on the quarter, and thank you guys for squeezing me in. I was hoping you could maybe give us a little bit of detail about whether or not your life sciences revenue growth has anything to do with kind of your mix of specialists. Just secondarily, was curious to know how life sciences revenue is able to grow without kind of commensurate utilization per provider. Just 'cause we've historically sort of thought of the life sciences offering as being impression-driven, but would love to know if that's changed at all. Thanks.

Chaim Indig
CEO and Co-founder, Phreesia

No, no problem. All right. I'm gonna answer the second question first, mostly 'cause I probably have already forgotten the first question, and so then I'll re-ask it. You know, I wanna be clear, like the network has grown tremendously. We do most of our revenue monetization for life sciences, not all of it, but most of it, is on after we deliver the message to the patient in a very targeted, consent-driven model, right? Patients opt in. But as the network has grown, our overall usage has grown. Since we've been public, the network has more than doubled, right? You know, if you play it out, just 13 quarters, we've just had tremendous amount of volume growth. We're seeing one out of every 10 visits right now, in our network.

That's, you know, that's one and two. It's not just the number of specialists, just the sheer volume of patients that we see has helped us. You know, having that view longitudinally and being able to provide the right type of content for them to help them drive the right type of care and has been very, very valuable to patients, which has allowed us, you know, to significantly expand our life sciences revenue. I don't know. Did I answer that? Yes, I totally forgot the first question, so you-

Jessica Tassan
Director and Senior Research Analyst, Healthcare IT and Delivery, Piper Sandler

No, I think you answered honestly all of them. I guess just my follow-up would be, is there sort of a Life Sciences ROI that you would be pointing us to? Just curious to know, is Patient Insights, I think you guys mentioned this in the letter, is that a new billable product, and does it change your view of the TAM for Life Sciences segment at all? That's it for me. Thanks.

Chaim Indig
CEO and Co-founder, Phreesia

We do have a website for life sciences. It's lifesciences.phreesia.com. You can totally go there, and there's a bunch of ROI examples on there. It's a great website. You should go there every day. I do. It's wonderful. Is there a third?

Jessica Tassan
Director and Senior Research Analyst, Healthcare IT and Delivery, Piper Sandler

Is Patient Insights a new billable product?

Chaim Indig
CEO and Co-founder, Phreesia

We do sell it. We've mostly been bundling it in because it's so valuable. We have gotten quick, just great feedback from clients on it, and we are using it right now as, we're getting people used to using it as a, an offering. I'd say right now it's mostly being bundled in. Just if it does change the TAM, I promise you Balaji will make us put out another TAM and talk about it. That is not coming now, though.

Jessica Tassan
Director and Senior Research Analyst, Healthcare IT and Delivery, Piper Sandler

Awesome. Thank you.

Chaim Indig
CEO and Co-founder, Phreesia

No, thank you.

Operator

Your next question comes from Jack Wallace with Guggenheim. Your line is open.

Jack Wallace
Director Equity Research, Guggenheim Partners

Hey, guys. Thanks for taking the questions and congrats on another really solid quarter and a really solid first half of the year. Just wanted to hit the software sales or software revenue per provider client question from a different angle. Maybe it'll help us get a little bit better context for the relatively flat rate we've seen over the last 6 quarters. You had some accelerating client wins. Just thinking about the cohorts from the first half of this year and how they've matched up relative to cohorts from the prior 2 years, are these new customers coming on buying more or less software than the prior cohorts?

If you know to use the prior cohorts as a potential guide, what kind of lift in upselling you have those prior cohorts seen, if not maybe on an annual basis, but in you know some trajectory, to kind of just give us something to think about as you're building your client base. Thank you.

Randy Rasmussen
CFO, Phreesia

You want me to take that one?

Chaim Indig
CEO and Co-founder, Phreesia

Sure.

Randy Rasmussen
CFO, Phreesia

I mean, I think, you know, we are generating, you know, most of the new revenue from new client adds, as you've seen in the numbers. I think, you know, from the perspective of they are buying multiple products, you know, I think it kind of varies by customer size. I don't know if there's any, you know, distinct pattern. I think, you know, where we've seen it is just the sheer volume of new customers just has depressed that statistic or kept it, you know, flat. As I mentioned before, you know, we're adding a lot of clients, you know, twice at the rate than we have, you know, if you look over the last, you know, six-month or six-quarter period.

You know, we continue to also expand in those clients. I don't think there's a particular, you know, pattern or cohort that, you know, that's an indication. I think we've just been-

Chaim Indig
CEO and Co-founder, Phreesia

We're just doing really well.

Randy Rasmussen
CFO, Phreesia

We've just been selling in lots of different areas and across the board.

Chaim Indig
CEO and Co-founder, Phreesia

Jack, the other thing is, you know, we did share four years worth of, you know, gross revenue retention and client retention. Then you obviously saw the subscription revenue per client holding in spite of, you know, adding almost 2,789 clients year-over-year. I think that just sort of suggests that people are still starting to work with us in the same way.

Jack Wallace
Director Equity Research, Guggenheim Partners

That's helpful. Just a housekeeping item for me. How many SDRs did we end up with at the end of the quarter?

Chaim Indig
CEO and Co-founder, Phreesia

189.

Jack Wallace
Director Equity Research, Guggenheim Partners

Gotcha. Thank you.

Chaim Indig
CEO and Co-founder, Phreesia

I'm sorry, 187.

Operator

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

Joe Vruwink
Managing Director, Baird

Great. Hi, everyone. I think in the past you've discussed 6-18-month timeframe for really knowing the productivity of a new hire, and I guess we're kind of in that timeframe for last year's class, and we're also now starting to see the revenue per employee metrics trending higher on a year-over-year basis. Is productivity all going according to plan, or does the improved EBITDA outlook for the year essentially say this is now tracking better than your expectations?

Chaim Indig
CEO and Co-founder, Phreesia

I would say I do know. I'm just trying to think how much. I'd say the team is doing unbelievably well, and we're tracking better than our expectations.

Randy Rasmussen
CFO, Phreesia

I'd say all the metrics we are tracking are moving the direction that we want them to very strongly.

Chaim Indig
CEO and Co-founder, Phreesia

We expect productivity to go back to where it was.

Randy Rasmussen
CFO, Phreesia

Our cost to acquire is looking really good. Our revenue per employee is looking good.

I think we're pleased.

Joe Vruwink
Managing Director, Baird

Okay. Great. Then I know this fiscal year is meant to be the low water mark for EBITDA. I'm curious if you look at specifically the trend in subscription gross margin that increased sequentially, and obviously you onboarded a lot of new clients, so I would imagine you probably had a stable, you know, customer success and implementation team behind that. Do you think it's too early to maybe call the trough in subscription gross margins, and we should kind of expect further improvement from these levels? Or might there still be some incremental investments needed there?

Randy Rasmussen
CFO, Phreesia

I mean, in Q1 we had actually talked about that, you know, we had expectation that, you know, gross margins less, you know, payments or the subscription margin as you're referring to, you know, would go up in the low 70s%. I think, you know, this quarter you see it improve. You know, that improvement, like everything else, we've done a little bit better than we thought. You know, I think the organization is really thoughtful about spend and how we're using resources, so, you know, we expect that margin to continue to improve the second half.

Joe Vruwink
Managing Director, Baird

Great. Thank you very much.

Operator

Your next question comes from Joe Goodwin with JMP Securities. Your line is open.

Joe Goodwin
Director Equity Research - Software, JMP Securities

Great. Thank you so much for taking my questions. Your employees have sequentially come down the past two quarters, and I'm just curious, is that natural attrition or is that forced attrition? Any commentary would be great.

Chaim Indig
CEO and Co-founder, Phreesia

I don't know how you answered that question, Bud. Look, I think it's natural attrition and, you know, I think the team has done a very good job of making sure that folks we wanna keep are well rewarded, and the team has done a phenomenal job. W e do see ebbs and flows, but I think more important is, I think I'd say our team, what? is up 2x from 12 months ago.

Randy Rasmussen
CFO, Phreesia

Almost triple over three years.

Chaim Indig
CEO and Co-founder, Phreesia

Almost triple over three years. That, we tend to look at it not on a quarterly basis, you know, but trending over time.

Joe Goodwin
Director Equity Research - Software, JMP Securities

Understood. Okay. Thank you. You commented on the retention briefly earlier in the call, but there's been no movement on your client healthcare services client retention at all? You haven't seen anything, you know, maybe from the macro or anything like that?

Chaim Indig
CEO and Co-founder, Phreesia

No.

Randy Rasmussen
CFO, Phreesia

It's held consistent with. You know, we look at it on a monthly basis, and it's consistent where it's been in the past year, so.

Joe Goodwin
Director Equity Research - Software, JMP Securities

Got it. Okay. Thank you.

Operator

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

John Ransom
Managing Director, Raymond James

Hey there. If we were to look at the customers you're adding today, you know, you talked about 200 and then the ones you added this quarter, so let's just call it 450, round number. Is this customer class on average a bigger set of providers, as in bigger hospital systems or bigger doctor groups? Or is the average sort of TAM, on a per provider basis today kinda the same as you've added all along?

Chaim Indig
CEO and Co-founder, Phreesia

John, they're all different sizes. They're enterprise clients. They're small. They're medium. The one thing they all are though is they're all land, and then we look to expand them. We're absolutely seeing more large clients, but we're also seeing tons in the midsize, and we're seeing, you know, those that are part of networks. I'd say the team has just done a phenomenal job of selling across the spectrum and helping to provide, you know, Phreesia to all those that need it. We think of it in terms and more as enterprise versus health system.

John Ransom
Managing Director, Raymond James

Okay. Secondly, I mean, I think, you know, we understand the core of Phreesia, and you guys are adding new capabilities. If you were to kinda isolate on one or two capabilities that you've added, is there anything that, you know, gosh, this is going better than we thought and this could be the next big revenue? Or is it more that we should think about it as the company is what it is, and these are just enhancements that kind of, you know, accentuate around the core, if you will?

Chaim Indig
CEO and Co-founder, Phreesia

All right. Well, you know, I don't think the company is what it is. Like, we've been making significant investments. You know, I'd say the investments we've been making around products and life sciences have been great. You know, hopefully over the next quarters we'll be making some other announcements and some new products that are getting a lot of traction we're excited about.

Our access products have been unbelievably successful, and that's, you know, around appointments and how people get into providers. We've had, you know, insights. It's just been one of the most rocking products we've had in years. I'd say, John, we've made big investments in R&D and in people, and those investments we're starting to see pay off, right? We're building great products. That are adding a ton of value. I don't-

John Ransom
Managing Director, Raymond James

You went, virtual a couple of years ago. I may have my timing off, but so it doesn't sound like that's really been an impediment to productivity or creativity.

Chaim Indig
CEO and Co-founder, Phreesia

We were already hybrid pre-COVID, right? In a lot of ways, I think this made it easier for everyone to work on an equal playing field. Has it been harder for some? L ike right now, Balaji and Randy are sitting around my kitchen table, right? Like, so, like, you know.

John Ransom
Managing Director, Raymond James

What's for dinner? What's for dinner, Balaji? Is it good or no?

Balaji Gandhi
SVP of Investor Relations, Phreesia

We have takeout.

John Ransom
Managing Director, Raymond James

Burrito.

Balaji Gandhi
SVP of Investor Relations, Phreesia

Next time you'll have to cook us a healthy meal.

Chaim Indig
CEO and Co-founder, Phreesia

Look, I think, like, as an organization, our view is, you know, how do we make sure that we just do what's right for our clients and build great products? Our product organization has just done a phenomenal job of understanding what the client needs are and just iterating and building and testing and making sure that the products we build get used and provide a phenomenal amount of value. We just care about making sure that we make healthcare outcomes. We attract people that wanna make-

John Ransom
Managing Director, Raymond James

Great. That's it for me. Oh, sorry, I broke up. That's it for me. Thanks, guys. Appreciate it.

Operator

There are no further questions at this time. I'll turn the call back to Chaim for his closing remarks.

Chaim Indig
CEO and Co-founder, Phreesia

I wanna thank everyone for joining us to the call. I wanna thank everyone on our Phreesia team and all of our shareholders, and I hope everyone has a great start to the month of September, and hopefully we see everyone in the fall. All right. Bye-bye.

Operator

This concludes today's conference call. You may now disconnect.

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