Hi, everyone. Thank you so much for coming to the Jefferies Healthcare Conference. My name is Mia Moss. I'm an analyst here at Jefferies, and it's my pleasure to introduce Aric Coffman and Atul Kavthekar from P3 Health Partners.
Thank you so much. Can you guys hear me fine without a microphone? Okay. I have to just walk around a little bit. No, you need a mic? Okay.
For the screen, yes.
Great to be with you all. I'm Aric Coffman. I'm the CEO for P3. And as she mentioned, I'm accompanied by our CFO, Atul Kavthekar. Excited to talk to you today about P3 and where we are and what we're doing as a business. We're going to just jump into the materials here. So I've been with P3 now for about five weeks. Came on board at the very beginning of May. And I really think this is a unique opportunity business, which is the reason that I came over and left what I think is a really good opportunity to come to what I think was a great opportunity. By background, I'm a general surgeon by training. Got interested in the healthcare business when I recognized that the healthcare system was as sick or sicker than the patients I was caring for.
And ultimately, went to business school to learn to speak business, and then started running groups and taking them from fee-for-service into value-based care. And that was circa 2012 when I really dove full in into that part of the business. Had the privilege of selling our company to Healthcare Partners, which was a very well-known and established, accomplished organization doing value-based care in California, Nevada, and Florida. And then ultimately, that business sold to DaVita not too long thereafter and became DaVita Medical Group. It was at that time that I actually met the team of P3. They were then part of Healthcare Partners Nevada. So Dr.
Sherif Abdou, who stays on the board and is my senior advisor, who I'm succeeding along with the rest of the executive team, are all well-known folks to me for the most part, and then a couple of new faces as we've moved along. I left DaVita Medical Group in the Southwest United States and went and ran the Everett Clinic and a wraparound IPA network there in the Pacific Northwest. And again, taking that group from fee-for-service into value-based care with a focus on seniors. We also did risk and Medicaid and did quite well in growing that business and creating profitability and moving them along the trajectory.
Then the last couple of years before I came to P3, I went into the startup world and I worked with Adam Boehler at Rubicon Founders, and we founded a company called Honest Medical Group, again focused on seniors, a little heavier in ACO REACH than what P3 is today, but a mix of ACO REACH and MA. And it was based out of Nashville, but we had businesses in New York as well as in Michigan. So what excited me about coming to P3? And I think there's a couple of things. And I'll have Atul when you come up. I'll just have you do a quick intro. A couple of things. One is the team. So there's a lot of experienced team members, and not just at the exec team level, but down into the organization.
I think that skill set comes through in the way they've been managing their patients. There's 126,000 full-risk lives today. 92% of that is MA. The balance is ACO REACH. Running last year at about $1.3 billion, and we're on track this year to meet our guidance between $1.45 billion and $1.5 billion. We've had reasonable growth. We really think about growth from a county-to-county level. We've expanded now to 27 counties in the five states where we are. We continue to improve overall medical margins, so the difference between premium and overall cost. Atul will cover some of the legacy markets where we can demonstrate those cohorts as we move forward. We've got a really big network. We have 2,900 PCPs in the network. There's still a lot of room for inherent growth in this book of business.
This is just a snapshot of the states where we are today. So you see a lot on the West Coast. And then we also have some operations in the Tampa/St. Pete area where we have a pocket of lives there as well, partnered with over 20 different payers. And so when I think about what that allows us to do, it's a combination of both national payers as well as local payers, which I think is really important to get density in the markets where you are from a patient-per-provider panel perspective. In terms of what does P3 do, and I think that top line is it's really about getting alignment in the healthcare system. And what we're trying to get alignment around is aligning the payers to the providers and also aligning that with what the patients want to get out of it.
The way that we do that is we create foundationally contracts with either the MA payers or the federal government through ACO REACH that are full-risk contracts. And that allows then the clinicians to get paid for their outcomes and the good work that they do. What the patients get out of this is they get better access overall to their PCPs as well as services they wouldn't get otherwise from P3, whether that's care management or that's interventions that can happen in the home. So we provide them with things that they wouldn't get otherwise. And what that's created is a really nice situation in which we've had very high persistency of our patient lives. So 90% of our patients have carried over from 2023 into 2024. It was 86% the year before that and was well below 86% in the years before that.
So we're demonstrating that some stickiness. We also have over 97% retention of our PCPs. And this creates a flywheel. So when you have that good patient base that's persistent and they get more repetition in the system, you tend to get better outcomes. And we're seeing that in utilization. So our utilization numbers demonstrate things in admissions per thousand as an example that's well below what you'd call the middle of a well-managed line of 180. We're actually running at about 150. And those are the hard things to do. So the hard things in this business are really around changing utilization patterns. And when we look back quarter-over-quarter, we continue to see steady, if not improvements in those numbers looking all the way back to the beginning of 2022. And Atul will cover some of those numbers with you in a minute.
We mentioned the foundational contracts, the physician retention, and then what's really in this that allows the providers to be successful is we then take in and aggregate all that data and we turn it into information that the docs can use to then change the outcomes for their patients. I think it's really important that we have an experienced team that has done this before. So many of these folks did this at Healthcare Partners and other places, and we continue to grow that team with the right skill sets. So how does it work?
The way it works is we take in all the disparate information, whether that's claims information, pharmacy data, ADT feeds to let us know when patients are going into the hospital, and we aggregate that data into our data warehouse, and we create a risk stratification methodology that then allows us to do targeted outreach. The interventions we then do with those patient populations are centered around both care management, where we're doing proactive outreach to those patients, working on their disease states and providing them services they wouldn't get before, as well as utilization management, getting those patients to the right side of service at the right cost. So this really allows us to target those resources in an efficient way. Then we use technology to actually get information back to the PCPs through a couple of ways.
We have a provider portal where they can see not only how they're performing on things like coding and those kinds of things, but they also get notifications when their patients hit the ED and are admitted to the hospital. We use tools like P3 Care Connect and P3 Engage. Those are really more tools designed around care managers and patients to help them communicate with one another out in the field. Then all the analytics around the systems that you need in order to target and create those interventions. We mentioned on the last earnings call, in addition, we've partnered with Innovaccer, and that's an important partnership for us, mainly around what we think that their capability set is going to enhance around AI. We are not a technology company. We are a relationship company.
And we wanted to partner with a technology company that is making significant investments in that space to help accelerate our ability to get the kinds of outcomes that we'll be able to do with some of those new technologies. Atul, I'll turn it over to you.
Sure. Thanks, Aric. My name is Atul Kavthekar. I'm the CFO of the company. Nice to meet you all, and I appreciate everyone taking the time. I've been with the company since December of 2022, so just a little bit over 18 months. And I'd like to walk you through a couple of slides that illustrate some of the details that we're really proud of at P3. On the slide in front of you, this is a case study. This is our most mature and largest market, Arizona in particular.
So we've presented in a longitudinal format some of the financial results for that market to give you a sense of how we progress, how the company progresses over in a systematic way over the few years that we've been there. And you can see across the top row, you can see, for example, membership and the number of providers that we have within our networks and the number of health plans. And you can see a nice steady progression of, call it top line, the results of which are shown in the second row, the bottom row, which is really showing around Part C revenues. And you'll notice, for example, that over this timeframe, we've grown overall Part C revenues by 300%+. And while we're at it, not only that, but we've grown the PMPM, so the unit cost improvement, the unit pricing improvement has been almost 50%.
So that is something that we feel good about. We think that there's still a lot of upside opportunity across the enterprise with regards to our RAF score. And we're going to continue this. And you see a lot of these same patterns repeating themselves in our other markets as well. This is one of our total five markets. Something just to kind of a little bit more detail on what Aric mentioned a bit earlier around some of the metrics. We talked about the revenue side on the prior page. This is now talking to the expense side, the medical expense side. And one of the things that we are very proud of are the KPIs. Now, these are three of the metrics that are very highly correlated to medical expense.
You can see these are the amount of IP admits, inpatient admits per thousand, visits per thousand, and SNF per thousand. You can see in these metrics that they're generally flat and in some cases, as Aric mentioned, even improving a bit. So a couple of things I'll point out here is if you look at, for example, the middle row, that's the reference that Aric made earlier, the middle of mid-well managed set of numbers, the line is something in the order of 180. We have been hovering and we've been holding, maintaining at around 150 and even improving in the last couple of quarters. So we feel really good about our ability to manage this over an extended period of time better than the average, better than the middle of mid-well managed, for example.
Second observation is in the fourth quarter, there was a lot of talk around increased utilization. Well, the data that we have suggests that that's not exactly the case, at least for the markets in which we operate. So that's something we observe and we manage and monitor very carefully. And then finally, even though the earlier part of this year hasn't really materialized, it's a little bit early for the claims run-up to be completed and be able to be very quantitative around it. We are seeing, and we've got a couple of different ways of triangulating around it. We haven't really seen anything that looks outside of what is sort of normalized seasonal levels of these metrics. So again, we're feeling like this is something that we've got under control that we continue to manage and looking for opportunities to get even better at this.
So talking about growth, some of the growth opportunities, we have a number of growth opportunities available to the company. Probably the first and the most sort of lowest hanging fruit, if you will, are sort of the existing markets in which we operate. We operate in five markets. We manage about 126,000 members at this point. There is a lot of opportunity to expand within the 3,000 or so physicians that we are affiliated with, getting a greater penetration within those physician panels and being able to expand substantially just in the markets we're operating, not needing to go out and lay out additional and incremental capital to go into new markets in which we will be starting from zero. So there's plenty of opportunity there, and we've been targeting those in particular in the near term and will continue to do so going forward.
Having said that, there are new market entry opportunities. We'll be very, very selective in how we approach those and will be very focused on certain metrics like cash payback periods, time to accretive, those types of metrics. Medical margin progression, we've kind of showed you some metrics and some KPIs that we follow carefully. There are a lot of initiatives that are underway right now. The operations team has been very, very effective in finding new opportunities, things that we haven't done in the past, and finding ways to be more efficient, smarter, train our physicians better, and overall manage our medical costs even better than we have in the past. And then lastly, operating leverage, we reduced our operating expenses by almost 30% year-over-year as we announced in the first quarter.
That was done without any impact, any measurable impact to the patient experience or patient quality. So again, we're very proud of that. That was done principally in the back office and nothing that was patient-facing. So we'll continue to refine that. We'll continue to look for opportunities. Innovaccer is an opportunity, for example, that Eric mentioned that is not only an opportunity for us to improve our data analytics, but also find some cost efficiencies. And bringing all of this together more on a consolidated basis, just to give you some overall metrics around the company, membership growth has been substantial, almost 27% from 2022 to the first quarter announced of this year. And on a first quarter basis, and we just represented it on a Q1 for comparative purposes, substantial revenue growth, 42% quarter over the two-year stack.
Medical margin where it all combines, and I think there's still quite a bit of opportunity here, almost 118% growth year over year on a full-year basis. So we think that there's not only have we been seeing the right trends, we've been seeing the right trends in all of our markets. We're seeing it on a consolidated level, and we think that there's still a lot of opportunity to get better. So maybe I'll turn it back to you, Aric, if you want to close a couple of comments.
So when I think about what we started with and then where Atul went, I just want to emphasize how critically important it is for us to focus on utilization and the fact that the teams have been successful in managing clinical results. That really is the hard part. The base of this business is really solid. We've got a big network. We've got 126,000 lives that are being well managed with room for growth within those existing practices, which means that we can grow very efficiently. And if I were to snap the chalk line on this business today, as we've given in our guidance, we're $20 million-$40 million of EBITDA positive for 2024. Well, we really have kind of an unlocked additional $200 million within this business.
The way that I get to that is we know that within this population, we have up to 30% of our seniors have not been coded at all, meaning that their chronic conditions have not been captured. When I look at well-managed organizations, that's probably more a number like 10%. As I think about interventions, those are concrete things coming on board I can help the teams with around discipline, things we can tick off the list, look at each one of those individual 40,000 patients that are in the panel and create interventions around how we're going to get them the care that they need to close care gaps and accurately code and document.
And if we just did that just on that patient population and those patients just had one chronic condition, that would change the metrics for us this year by as much as $70 million to the bottom line. So I know that there's a really, really healthy business underneath all of this. And then we have capability sets that are unique. So being able to pay claims on portions of our population as well as being able to do utilization management, those unlock additional potential for us to get way upstream on those patients because we don't have to wait for the plans data to come back and us to have interventions. And those are areas we'll continue to make investments and grow those things out. So thank you all for your time and attention this morning. We're happy to answer any questions that you might have for P3.
Yes, sir.
What portion of your business is Medicare Advantage versus commercial versus Medicaid, if any?
Yeah, we are almost all senior. In the seniors, we have 92% is Medicare Advantage and 8% is ACO REACH. And I think one of the potentials, if you just back the napkin for us in terms of what the potential is on ACO REACH as an example, there's probably a 300,000 patient go-get potential within that population of our network today. So when I think about the average PCP carries 2,000 patients. That's an average panel size for a PCP. We have 3,000 PCPs roughly in the network, which means that they're caring for 6 million people. About a third of that is probably Medicare. So you've got 2 million of those patients are Medicare. And of the 2 million patients, we're only helping our clinicians right now with a small fraction of their patients.
As Atul was talking about going deeper with our clinicians, that's really where those patients exist. We already have established relationships. We already have boots on the ground. We already have data connections. And so that kind of growth is the growth that will help us really accelerate even within the geographies where we are before we have to go put down a new flag. Any other questions? Okay. Well, great. Well, thank you all very much. It's been a pleasure.