Thank you to Todd Friedman, who runs investor relations at Accolade, for joining us today at the Stephens Annual Investment Conference. For anyone that doesn't know me, or online, I'm Jeff Garro, the Healthcare IT Analyst here at Stephens. We'll just kick right into the questions. I'll start kind of broader macro and market, and knowing that Accolade is focused on employer-sponsored health insurance, which we think of as least prone to regulatory shifts. I think it's still a prerequisite question this week, and even more so with more news coming out yesterday afternoon. Anything that you think that current or prospective Accolade shareholders should be monitoring with respect to the Trump administration and individuals nominated to step in at HHS and CMS? Yeah, and thanks, Jeff, for having me here today. You know, at a high level, no. There's nothing that we've seen or heard that we think would change things. But maybe it's helpful just to put it in the context of what Accolade does. If you think about our business at the highest levels, we help people understand their benefits, understand their health care better. You know, people hire us to run all their back-end advocacy navigation, which really becomes the member services. We become the place that all employees go for their health care needs. And then, of course, we expand that with access to primary care, and second opinions, and partners. Any change in health care essentially makes those services more valuable. And so while it's really too early to know what changes might happen that could have an impact, positive or negative, we haven't heard anything that would make us believe anything other than potentially more opportunity. The only thing that I think has come up that is a little more concrete is this notion of every new administration, everyone entering any kind of government health care position, wants to somehow break up the. I don't want to use the word monopoly is the wrong word. But the high share that the carriers seem to own. They really own the payments. They own the providers. They own all these pieces. And this notion of creating more competition between those carriers. If that becomes true, or suddenly companies have more options, if it becomes easier to change carriers, that change creates complexity for our customers, the employers, which is what we help them do better, and so I don't want to say it's a good or it's a positive or negative, nothing has come up that makes us think it's a negative, and if anything, we believe it does present the opportunity to work with our customers more closely to help them and their members understand the health care system better. Excellent. I appreciate that. Accolade is a strong connective tissue between a variety of different benefits and other vendors for employers. And kind of a related question is the enduring macro theme over the last year has really been inflation. And health care, I'd say, has not and will not escape that. And the data we've seen show health care costs, including, of course, insurance premiums, forecasted to rise again over the next calendar year. So how's that backdrop impacting the priorities of the CFOs, Chief Human Resource Officers, and other benefit leaders that Accolade sells into? Yeah. I mean, again, it feeds in a lot of ways to our core value proposition, which is, in a world of ever-increasing health care costs, how do you manage that? And you've seen navigation advocacy over the years become a more widely understood and appreciated way to manage those increasing costs. Now, having said that, if you're a CFO and you're now in what's now the third or fourth year in a row of pretty elevated health care costs, coming out of COVID, where you have this sort of lull of utilization as it picks up, they've had multiple years now of 8%-10% increases in their health care costs. And this is where you see the benefit buyers in the HR departments disconnect from the finance office a little bit. You like to see these plays. You like to see companies where they're all sort of swimming in the same direction. But your HR team is ultimately trying to create a better employee experience, and the health care experience is a big part of that for their employees. If you're the CFO, though, what you get every year is, hey, by the way, I need to get a model of an 8% increase in my health care costs. No, I'm not getting more doctors. No, I'm not getting more benefits. No, I'm not getting anything more for that. It's just going to cost you more. And so for a CFO, that's very tough. And then you see on top of that, but I've got this great way to go solve that. It's called advocacy. It's an additional 2%-3% on top of that cost, but they're going to guarantee savings down the road. The savings down the road is a wonderful offset to the increased cost, of course. We're usually guaranteeing an ROI of 1.5x-2 x what you spend on Accolade. But still, if you're the CFO sitting there with an 8%-10% increase in your health care costs, your immediate instinct is, yes, let's go spend 2%-3% more. So it raises the need and the awareness of advocacy. I think if you're in the finance chair, though, you're always going to take an extra moment before you commit to any additional spending. And that's not unusual. That's been the case since Accolade was formed 15 years ago. Excellent. That makes sense. Maybe take that a little bit further. We've asked this question often, but I think it's helpful to kind of hear a gradual evolution of the answer, and starting to think of navigation as more of a must-have and less of a nice-to-have, but maybe you could give us a little more perspective on how you think about incumbent health plans as the primary competitor to this place, and you essentially referenced the higher costs and higher premiums, and there has to be some kind of animosity from the CFOs and chief human resource officers about just paying 8% more and not getting anything more. Yeah. I think your last point there is exactly right. No one ever has been happy saying, so let me get this straight. You're going to charge me more, and I get nothing more for that. That's always been a bit of an adversarial relationship between CFOs and their health care providers. And so let me maybe take a second part of that question first, and then come back to the nice-to-have, must-have question. While people get excited about juicy, competitive takeaway stories, the reality is the vast majority of our market is still greenfield. It is folks who do not use a navigation or advocacy solution. It is a carrier solution, which is providing all the member services, all the navigation. And it's a customer saying, I want to move away from that model. It hasn't worked for me. And so I want to see there's another way to deal with this. So most of the deals that we are seeing where there are RFPs being published are essentially takeaways from a carrier for that functionality. I would love to say we've moved from the nice-to-have to must-have. I would say that I don't know if there was ever a period in this market which was sort of low-hanging fruit. It's always been a big discussion about a significant purchase that someone's making to change how they deliver the health care experience to their employees. We definitely have seen a shift in the advocacy navigation world to greater market acceptance. You see this now that when the larger consultants, so Willis Towers Watson, and Aon, and Mercer are working with a customer, almost always they're looking at bringing in a navigation or advocacy solution as a way to think about managing that health care experience better. And so if you were to ask, though, this is where it gets a little, it can be confusing to an investor. If you were to go talk to a consultant and say, what percent of your clients are using some form of navigation? They're going to say, oh, almost all of them, 80%, 90%. You say, OK, how many of them are getting that from the carrier, which you just consider navigation because it's the basic member services? That number comes way down. Then you say, OK, how many are doing digital-only navigation, like a Health Advocate, or a Rightway, or a HealthJoy, right, where they're getting an app which is designed to just manage, let people know what their benefits are? It comes down even further. When you look at the companies that provide a more fulsome navigation experience, where you have a frontline care team of care advocates, nurses, clinicians, it's really Accolade, Quantum Health, and Included. And among the three of us, we have less than 1,000 customers total who are doing full advocacy. And this is in a world of more than 30,000 customers. So we are still very much in the early stages of this game. It has definitely raised its awareness in terms of market perception and understanding of what a well-run advocacy solution can do to your overall employee experience. Is it a must-have yet? I don't know if we're there just yet. The part that I think the really good finance teams get, where you see a CFO kind of go from not just the person you engage with from a business perspective, but a real business partner, is they begin to recognize that that health care experience means more than just where they go to the doctor. Employees that are having better health care experiences, their productivity is higher. Their absenteeism goes down. That means that your retention gets better. So your recruiting costs go down. Your training costs go down. There's a much bigger economic value story here to the CFO's office than just the cost of health care. Excellent. Excellent. All helpful comments, and maybe we could start to translate that into the pipeline for Accolade. And the nature of the pipeline has changed over the last few years. You have direct commercial clients with varying start dates. You have standalone Expert Medical Opinion. You have the newer Accolade Care offering, and you have Health Plans partnerships, so maybe you could comment about those different areas of the pipeline and how the selling season has evolved. Yeah, I appreciate that. It's a great question because especially for people who looked at Accolade three or four years ago, coming back to the story today, it's a very different looking business than it was four years ago. Four years ago, when we sold just advocacy navigation solutions, you could pretty much take that summertime selling season where people have a January 1 plan year. They're making changes to the plan design. They need to sign a contract, get an open enrollment process in place, and then go live. In those days, you could take the ARR to the ACV, and that gave you 95% visibility for the following year. Today, as we've expanded to include things like expert medical opinion, Accolade Care, which is virtual primary care, we're selling through and directly to health plans. That notion of a selling season and the pipeline has changed quite a bit. So you still have that core business. You still have that core advocacy business, which is still, if you're looking at a January 1 start date, you're going to have a selling season that wraps up in the summer months because you've got to be signing contracts in October to get an implementation in place to do an open enrollment in November. That's still a big part of that pipeline. But if you're just bringing in expert medical opinion, you're just bringing in a virtual primary care, you're not tied to that January 1 date. You can actually turn that on almost any time. And so you have Accolade Care standalone deals. You have expert medical opinion deals that are both sold directly and through health plan partners that are just not tied to a summer selling season. And then on top of that, you have more recently, we've announced deals with people like Blue Shield of California for their Virtual Blue plan, or Select, which is part of Arkansas Blue Cross and Blue Shield, these sort of virtual-first plans where they may be selling to a customer who has a January 1 start, but they also may be selling services into existing customers, again, where they're not as tied to that traditional selling season. And so when you look at the pipeline, the pipeline is larger now than it was last year. I think to your earlier question, you are seeing greater demand for these solutions, absolutely. We see that in the RFP flow. We see that in the discussions we're having. But from a traditional selling season perspective, it has shifted around quite a bit. On top of that also, by the way, you still have customers, and this has always been the case, who are usually larger customers, but they're not in a two to three-month implementation process. They're making decisions today for a January 1st, 2026 go live. So again, they're not tied to an October, November time frame to get live. They're thinking about, I'm going to make a really massive change to my overall plan design, and that's going to happen 12 to 15 months from now. I was at a customer not too long ago at their benefits fair. They have 11 different health plans from three different carriers in their offering. You don't make a change to that plan in two to three months. You're planning that out well in advance. Excellent. I appreciate that update. And you talked about the annualized contract value or ACV metric. And it's getting a little bit harder to translate that into a financial forward-looking estimate for us analysts, but we're still going to try. And towards that end, the ACV number includes a number of estimates. A really easy one is just number of employees that your customers have. It's likely fairly steady, but it's still something you have to estimate on a forward-looking basis. And there's performance fees. There's usage-based fees. There's health plan enrollment. And so all of those have different challenges in estimating where your internal expectations are and how they contribute to ACV. So just comment on the role of estimates in that contract value metric and why the metric is both predictive of future performance, but also maybe conservative if Accolade executes well over the next 12 months or so. Yeah. I don't know if I'll speak to whether it's conservative or aggressive, but no false flattery intended. You've always done a really good job modeling ACV and ARR and how that flows together. People call and say it's too hard to do it. I'd say, I don't know, Garris seems to do a pretty good job of it. So you've understood the puts and takes, and you're right. It has gotten more complex over time, and so when you look at ACV, which is our annual contract value, that's the number at the end of the fiscal year of contracts that are signed and where we can predict the revenue contribution over the next year. You're correct. Back in the time when we were just advocacy only, that was almost everything was a per employee, per month, multiplied times number of employees. It was a fairly predictable number. The real variability in that was performance guarantee achievement. With the addition of things like expert medical opinion and virtual primary care, those are contracts. And they have a value. And we have to compensate our salespeople on the expected value. But there is an estimate of the usage. So if someone signs an Accolade Care customer contract for virtual primary care, how many of their employees are going to use it? How many of them are going to pay us a $99 doctor's visit fee? Is it 5%? Is it 10%? Is it 20%? Same thing on expert medical opinion. Especially expert medical opinion, when we acquired 2nd.MD three years ago, their business was going through a transition where they used to charge per employee per month, but they moved to more of a case rate. So they get paid for every consultation. When you have that, you have an estimate of utilization. So there is a portion of that ACV, the ARR and ACV number now, which is an estimate of usage. And you're correct that if we're high or low, we might be conservative or aggressive on that number. So there's potential for higher usage driving higher revenue. So there's variability in that number. The good news, it's not like we're putting our finger in the air and just hoping what may happen. EMO, expert medical opinion, is a business that's been around for a while. The average utilization in any company is fairly predictable. You can look at a company's historical usage, number one. If they're a new customer, you can also look at the number of surgeries they've had, the number of conditions where there might have been an expert medical opinion suggested. And so it is an estimate. It's an estimate based on years of data and usage that drives that. The one part now, which is different, we talked about this two quarters ago, and I think this was a little bit new for the street, was whereas in our consumer business, it's very easy to think about, I've got to spend money to get consumers to come to PlushCare. When we talked about member marketing, I think people thought, wait a minute, I didn't think you had this additional marketing need to drive usage of those services. If someone's an advocacy customer, so they're talking to our frontline care teams, our care advocates, our nurses, our clinicians, yes. If someone calls in and says, I just went to a doctor. I was told that I need knee surgery. What do I do? We can say to that person, well, your company pays for 2nd.MD. You should get a consult. So you drive engagement. You drive usage through that frontline care team. But if someone's just a standalone EMO customer or a standalone care customer, I don't have that engagement engine. So there you have to do traditional member marketing, email campaigns, phone campaigns, could be mailers still. And so there's a member marketing spend there. And then similar to a consumer business, you decide how much am I willing to spend at the margin to get that incremental customer while still protecting my profit objective. So there are more puts and takes to that number now than there were before. There's still a very large part of our revenue is highly visible, still coming from this per employee, per member, I'm sorry, per employee, per month model. But there is this portion now on the usage side, which has got some more variability to it. Sorry. I boiled that down. Sounds like some more potential for variability, but all still data-driven, and sounds like at the end of the day, still a high conviction level in that ACV number being predictive. Yeah. It's a kind way of saying I gave you a very long answer. So let me summarize it for you. But yeah, no, you're correct. If you think about usage has been growing faster than access fees. And so usage will be roughly 30% of the business today when it was zero four years ago. That portion of that ACV, which is usage-based, is growing. And that's the part that's got some variability to it. Excellent. We'll use that as a segue for an update on the direct-to-consumer virtual care business. I wanted to ask how growth and customer acquisition costs are trending as Accolade stays pretty true to your primary care focus while there's been a ton of noise in the broader virtual care space around weight management and cash pay for, call them, lifestyle-type treatments in direct-to-consumer health care. Yeah. The consumer business is interesting. It's a great business. I know when we acquired that business three years ago, there was a lot of sort of rumblings out there. A, would Accolade just sort of kill the consumer business? Obviously, we've more than doubled that business in the last three years, so quite the opposite of killing it. And let me speak for a quick second about the strategic value of that business to the broader Accolade business. The platform that PlushCare built, the scheduling platform, the physician platform, the member platform, is the core of our commercial business there. And so anecdotally, there was a customer last year. I remember we were selling, and they had the question of, well, your Accolade Care business is relatively new. How do I know you'll be able to handle adding all of our employees to the platform? The answer was, well, the platform is PlushCare. Accolade Care and PlushCare are the same underlying platform. And so we're not talking about going from a membership base of zero to something in the care. We have this base of millions of people served through PlushCare. The doctors are on the platform already. So that business is very important strategically, both from growing from a consumer standpoint, but also for serving as the base for the enterprise business. But back to your specific question on the consumer side, you're right. That's a traditional business where you're buying web keywords to drive consumer acquisition. In some areas, right now, it's cold and flu season. That's traditional. This is always a pretty heavy time for people saying, my kid's got the sniffles. What do I do? And we say, well, you can use PlushCare instead of going to the. That might be a better option. And so there are some of those elements that are seasonal. In the spring, you'll have allergy season. Right now, you're right, though. When you have very high-profile areas like weight loss, they can be real drivers of demand to drive increased customer acquisition. But at the same point, the more popular something like an event like that is, the more you get players in the market who are willing to overspend in terms of customer acquisition costs. And so we've been pretty disciplined about saying we're going to manage the revenue growth side there against the profitability targets. What happens with, will the GLP-1s come off the shortage list? Will they not? That drives, will you be able to keep compounding or not compounding? That's going to have an impact on those customer acquisition costs. For companies right now that are compounding GLP-1s and driving really high customer acquisition costs, that's going to make us be a little smart about how we think about where we spend the dollars. Those things do tend to come and go. And it's our general belief that when those drugs are off the shortage list, you will not be allowed to compound them, and you'll probably see some more rationality come back to that marketplace. The last part of your question, I just saw this news. I was behind a day or two in my news. I assume you're talking about maybe the Amazon announcement about charging a pay-as-you-go for certain condition-specific things. Our view has always been that we want people to get good health care. If you're coming to PlushCare, you may have a very specific need, which is, I want to manage my weight, and so you have a program. You're competing for that dollar, but PlushCare has always been about primary care. That's been the real differentiator, while even as you've seen some of the traditional telehealth providers see low to negative growth, PlushCare has continued to grow. It's because this is not about a simple telehealth visit. This is about building a longitudinal relationship with a primary care physician, just that person is seeing you through your phone, not in a doctor's office, and so I don't think the underlying value proposition between PlushCare changes all that much. You will hear noise in the market every now and then about this cool offering or that cool offering or $10 a month for I think the Amazon news had like, "I want to replace my hair." And so it was like $10 a month or something. We're not chasing that dollar. What you are seeing is even in the context of a person who's coming to PlushCare for something like weight management, the relationship we're trying to build with them is, yes, we'll help you manage that condition. However, we want to become your primary care physician as well. And so that's why you've seen the growth in that business, which looks different than a traditional telehealth business. Excellent. Yeah. I think underappreciated aspect of PlushCare has been the ability to convert whatever is the traffic-generating topic of the day, be it COVID or weight management, into demand for the primary care-focused business. Let me hit one thing real quick. I know you're about to go to your next question, but you triggered something for me that I want to mention. On the enterprise side of that business, on the commercial customer side, what that often looks like. We often say people come for the urgent care, but stay for the primary care. It's the person who calls up because they can't get an appointment with their doctor. And so they call Accolade to say, I'm trying to figure out what to do. Can you help me find a doctor? Or where's urgent care? And we'll say to them, well, your company pays for this thing called Accolade Care. I can get you on the phone with someone in 15 minutes to 30 minutes. Why don't you do that? Your company pays for it. They may pay for it outright, or they may just make it part of your copay, whatever it might be. But why go to the urgent care? Why go to the urgent care and sit there when you can take care of this in 30 minutes? What you often find people do is say, well, that was a really good experience. That wasn't my normal visit. That was a primary care doctor doing a one-off visit. This just happened with my daughter last week. She was sick. She'd been sick for a while. She called her primary care doctor. They couldn't see her for two weeks. And so she went to urgent care. She called me later. I'm like, well, why didn't you call Accolade? She's like, I didn't think about it. It's my daughter. So she should be thinking about it. The point is, in that situation, you find a person who does not replace your primary care doctor, but they sort of become your backup. I have that. I have a PlushCare doctor, Dr. Hang, and he's who I call if I think something's wrong and I don't want to go see my doctor. I just want to do a quick phone call. So that becomes pretty common that when a person gets into that funnel, they now go to Accolade Care for something, which is maybe a one-off reason. It could be an urgent care replacement. They often then will recognize that's a good option and will come back. Yeah. Back in ours, it's pretty straightforward that even two primary care visits, one with a PlushCare doctor and one with your in-person longtime primary care doctor, are still more efficient than an ER trip. We pay for Accolade as our personal company benefits. We give every employee and their dependents a certain number of visits. It's paid for. I mean, Accolade has to pay for it, has to pay the doctor and whatnot, but it's part of our benefits, and it's good because we're trying to drive that use case. We'd rather have that cost in our business than an ER visit, in which case the cost can get out of hand, and for me personally, I pay the bill when my kid goes. If I haven't hit my deductible yet and I've got to go pay for this money out of pocket, I'd much rather you go to the thing that's free than the thing that is not free, and so driving that utilization, driving that awareness, this goes way back to one of your early questions. That's the usage growth over time that, yes, creates some variability, but ultimately we believe is upside over time as that usage case becomes more widely understood within the customer base. One more granular question on direct-to-consumer virtual care. For the folks out there monitoring the weekly flu numbers and thinking of the seasonal impact, is it correct to assume that that's more of a fiscal fourth quarter event, so December to February of 2025 for you guys versus kicking off aggressively here in November? Yeah. Cold and flu season, yeah, it's a good question. I mean, this is the historical trend of the business. You just have certain things at certain times of the year that drive inbound. And so cold and flu season is one of those things in the wintertime, seasonal allergies in the spring. In the summer, people are on vacation, so they can't see their doctor. They don't know where urgent care is. That can drive inbound demand. And so there's lots of things every season that can drive it. So I'd be careful. I just don't want to provide any sort of guidance in terms of what it does from a revenue perspective. But yeah, the winter months, as you'd expect, is when you'd see higher cold and flu demand into PlushCare. Understood. Maybe we'll transition to a couple of discrete revenue-type questions, and hoping you can give a quick overview of Accolade's government business. What components of that business are contributing to FY 2025 results and guidance and then the potential for Accolade to play a role larger or smaller in the next generation TRICARE contract that should be kicking off here January 1st next year? Yeah. It was a big deal. T-5 was a big process for the Defense Health Agency to come up with their next generation of health care for what they call their beneficiaries. Today, Accolade is working with something called the Autism Care Demonstration. As you know, we had a pilot before for navigation that the pilot expired, and we're looking to see how that rolls into the next generation. One of the things to understand about T5 is the way that, and for anyone on the phones listening, the government essentially divides the country in half. They have an east and a west region. They went through a big process to award those regions. On the east, it was Humana who had the east before. They did shrink the size of the region for Humana. The west used to be a company called Health Net. TriWest now is the plan that's managing the western side. The way that the T-5 works is you have those essentially prime contractors. And then underlying all that, there's a bunch of required services they have to provide and then a bunch of innovations that are part of the contract the government wants to see part of that. And so we had this conversation with investors for a while. We haven't given a lot of color because the prime contractor is the one who really controls the timing, the rollout, et cetera. On January 1, when they go live, there's a bunch of things they have to do that if a beneficiary picks up the phone and calls, they can deliver that information. The innovations, it's less clear. And so where we've worked with the vendors, it's more on the innovation side. Fiscal 2025 essentially still has revenue from that. That's the current fiscal year for those listening. We have a February fiscal year is the Autism Care Demonstration. Rolling forward, we haven't modeled a lot of revenue there, but still TBD as to what happens with the partners and the carriers there and the timing and phasing out any potential revenue there in the next phase of T-5. Excellent. Appreciate that. And know that Humana is an Accolade customer, historically a good relationship for the company. So there's some nice potential there and appreciate that it's not really in the numbers yet. I want to ask Lee's thoughts around performance guarantee and cost-based performance guarantee execution. Over the last two years, big focus on GLP-1s as a cost driver that's caused some variability. But since we last spoke, a lot of the managed care companies have been reporting higher specialty costs, particularly oncology costs. So wanted to check in whether that's a trend that you've observed in the employer-sponsored market that could be a potential headwind to earning PGs in this fiscal year. Yeah. Our performance guarantees on the savings side, it's always important to remember that we're measuring against an index. We're not committing to a hard number, and so what you may remember was a big point on a deal earlier this year that we did not win because one of the things was a competitor who committed to a really low fixed data point for health care trend. We don't control overall health care spend. If health care spend grows 10%, it'll be hard for us to drive a 3% increase in spend, so what we're committing to with our customers is that they're going to do better than the index by some percentage, and so we agree on what that index is. It could be something like the Milliman Index. Some of the consultants have their own indices. And so to the question, if health care costs are growing, whether it's because of GLP-1 or oncology or whatever it might be, you would tend to expect that to grow across the board. You expect the index to grow. And so unless our customers are having some unique experience with their health care costs, the core Accolade value propositions should still hold true. Now, at the end of the year, we look at discrete events, more premature babies, for example, which can be very expensive. If you had four preemies last year and you had six this year, is it normal you'd have 50% more? Those might be costs the actuaries agree to exclude from that calculation. So in general, the answer is those elevated costs should not have a big impact on our ability to achieve the PGs because we're measuring against the index. Now, within that, if you go back to the COVID days, this is where an index can fall short. It's an average. And so if you looked at health care spend across the country during COVID, you had this number. But if you were in a high vaccination state, you might have one experience. If you're in a low vaccination state, you might have a different experience. If you were in a business that was essential where workers had to go to the factory floor still versus people who stayed home, you'd have a different experience. So you always have the risk of some discrete event that could impact your ability to hit that PG. But to your question was, if health care cost overall is elevated, does that impact our ability to hit our PGs? The answer is the answer should be no. And you see that where our attainment of PGs through the years has been really consistent, both in high spend years and low spend years. Because if it costs us down for everybody, it should be down for our customers as well. If it's up for everybody, it should be up for our customers as well. So in general, we're still expecting about the same performances as we have historically. But that's also why we have a February fiscal year because you have to get those December claims in to go through the accounting and actuarial work around that. Excellent. I appreciate that. And the idea that potentially more FX is a better setup for Accolade to create value and. I missed part of your question. Sorry. In general, do you see health care costs going up for some of these things, like GLP-1 for oncology? I think you're seeing this in the overall numbers. The trend lines that we've seen this year are expecting a higher health care trend this year. So the answer would be yes to that. Appreciate that and talked about it a little bit earlier, but maybe follow up a little bit more on Accolade Care, the enterprise primary care solution. I think you've kind of managed expectations around the business-to-business-to-consumer multi-stage process and relatively early days in the effort, but maybe you could discuss the lessons learned on the B2C business-to-consumer part of it and reframe for investors how we should think about the trajectory of that component of usage-based fees going forward. Yeah. We do learn a lot from the B2C business. It was one thing that the founders of PlushCare always talked about, which was delivering an experience which is not measured against a traditional healthcare experience. Delivering an experience that's measured against the best consumer experiences. And so when they started that business, they said, "Look, if NPS for healthcare companies is low single digits, if not negative, that's not the goal." The goal is not to be better than a crappy doctor's experience. Look at Costco. Look at Apple. Look at Chick-fil-A. Companies who have NPS scores in the 70s, 80s, 90s, that should be the experience we're going for. So this wow experience. And so that was the consumer side. This is why we didn't go rebuild an enterprise version of the product. They already had an amazing customer experience. Why would we change that? If anything, we've incorporated more elements of that experience into the Accolade experience in our app, in our digital experience, or on the website, or even with a human being if you're talking to us on the phone. And so one, we've seen that. We've seen that if you say to a person on the phone, "Don't go to the ER. We have this great thing called Accolade Care that your company pays for," if they have that experience, that's it. It's a one and done. They're not coming back. The flip side to that is in a model where people see that that's a very simple experience, the follow-up is good, the doctor's experience is good, the doctor has better access to the data about your benefits, not only will you come back, but you might come back more often. There are times that I don't think I need to go to the doctor because I got a little thing. This is down. I'm not going to go spend my time going to the doctor's office or the ER, but if I can go on my phone and get an appointment in 15 minutes, I'll do that. And so I think what we've seen is twofold. One, that experience is critical to driving repeat engagement. And two, the way you drive adoption of that over time is multifaceted. We knew from our old, traditional advocacy model that we built this relationship with the members over time. And because you build that relationship, even for something like, "I got a bill, I understand it," and they call, if they have a good experience with the care advocate, they're going to call Accolade back. Or they may go to the website, maybe do whatever. That's translated over time into, "Oh, your company has a diabetes solution that they pay for. You should use that." Driving increased utilization of partner solutions. That same model becomes true for care. The ability to build that relationship early on with that nurse, with that care advocate is what drives the members' trust in Accolade to drive increased engagement over time. And so I think that's sort of one lesson learned. The other one, though, I don't want to lose sight of is you think about some of these health plan partnerships. A real difference with a Virtual Blue plan versus Accolade Care being used with a customer is we don't walk into a customer day one when we sell Accolade Care and say, "Go have all of your employees replace all their primary care doctors with Accolade doctors." That's not the model. We already know that 30% of their employees don't have a doctor selected. It's a good chance of that 30%. It might be people that are 23, 24 years old who aren't going to the doctor. And so we don't expect all 30% of them to choose an Accolade doctor tomorrow. There's going to be a ramp. When we sign an Accolade Care customer, day one, we have 0% usage, and we expect that to grow over time. A difference would be with a Virtual Blue plan, for example, where if a company chooses Blue Shield of California's Virtual Blue, they're being told, "Your first doctor visit has to be a virtual visit." So we do have different expectations for those customers, how those will grow over time. Those are brand new relationships, but the early data we're seeing on that is very good, and in fact, Blue Shield of California published their own one-year data that showed increased uses of preventative care, lower uses of and overall lower health care costs, so the model works. It's a model that doesn't just turn on like a PEPM model day one. It grows over time. Excellent. Yeah. You get customers to sign up for Accolade Care first, and then you have to get the employees to start utilizing. That's correct. The service. You get my daughter, who should know about her own father's company and has used Accolade Care before, and still in that moment because she's 22, didn't think to go that route and went to urgent care. Maybe we'll pivot to margins. And Accolade has certainly doubled down on its commitment to profitability over the last year. And you've kept adjusted operating expenses at a roughly low $50 million level for about nine quarters now. So the question is, what gave management confidence that that's an appropriate level of spend to deliver against your growth targets? Yeah. I think to answer this question, I do need to go back a few years. Because if you go back to when Raj joined Accolade about nine years ago, one of the first things Raj and Mike and Cav, the team that came on board, Steve joined at that same time, was to recognize that to grow and scale this business, they had to build a technology platform to sustain it. It was very much a boots-in-seats business. You had the benefits in a book that people would use to talk to members. And so starting eight, nine years ago, we began effectively overinvesting the technology side, really building a data ingestion platform to look at the health care world and say, "There's data out there in lots of different forms. It doesn't all look the same. But if we're going to serve these members, especially large employers who have multiple different plans, different benefits, different offerings, we've got to be able to take all this data in and ingest it and normalize it in a way that we can talk to a member and have a human conversation." And so we've made those investments over time, both from a data platform, but also new innovations, like things that we can do in terms of making recommendations, understanding the members better to make sure that we're making the right next step for them in their health care journey. And so today, we're sitting in a place where we've talked to consultants about this. Our technology platform is just leaps and bounds ahead of what else is out there in the marketplace. Our ability to understand a member and then look at them and say, "This person is a certain age in a certain part of the country with a certain family health history. Here's the three things that are most likely to happen next for them." Let's not say to them, "Oh, by the way, you might be diabetic. That's not a good conversation," but you surface recommendations to them in a way which is what's the right next thing for them in their health care journey, and so I make this point because that technology platform today, especially as we begin to think about things like how does AI play in health care, actually are real drivers not just of the member experience, but also the margin story. So if I kind of go from top to bottom on the gross margin side first, you've seen incremental improvement in gross margins every year. There's a couple of things underlying that. Number one, there's a bit of a product mix shift. Some things like a primary care visit or a trusted partner referral, they carry a higher margin than our traditional advocacy solution. And so you've got a little bit of a product mix impact there. But in the frontline care teams themselves, we've also done things operationally that drive improvements that allow us to scale in that business without having to necessarily grow the headcount. So we introduced a technology last year through a partnership with a company called Observe.AI, where we essentially use AI to listen to every phone call with every member. We transcribe those calls at the end of the call. We look for things like language or verbiage that indicates a possible need for an escalation so we can get ahead of those things before they become issues. But significantly, when a care advocate or a nurse completes a call, they have an amount of time to go write up their notes from that call and then get back in the queue. By doing the automated note transcription, we've reduced that by 50%. So now you're actually freeing people up. You're increasing their productivity and increasing our ability to scale without having to add headcount at the same rate. A quick comment from one of our doctors who said, "I now use that note-taking capability. It doesn't just reduce my time after the call, but whereas before, I would talk to the patient and I'd be typing and talking and typing and talking, I can now just talk to the member. I can talk to the patient 100% because I know the notes are accurate at the end of the conversation. So I'm actually having a better doctor-patient engagement than I would without the technology," so on the gross margin side, you'll continue to see expansion there, both from using technology, driving greater digital engagement with members too, as people become more accepting of their phone as a way to manage your health care. To be clear, that will grow. You will never lose the human element. We get dinged a lot because we have this human-based service. But I'm sorry, if you're talking to a doctor about a weight management issue, you probably also may be seeing a therapist. You may have an MSK issue. Obesity is the number one leading cause of cancer. You're going to be a polychronic, multi-chronic condition patient. You're not managing that through an app. An empathetic human being on the phone that helps you manage that care is critical. And so we're going to always have that human element and never lose that. When you get to the operating lines, I'll just start with the technology side. We have the investments that we've made before. We're able now to rationalize those investments. We bought two companies, 2nd.MD, and PlushCare. When you buy a company, you don't just throw out everything they've done before. They have platforms. They have roadmaps. So over three years, we've begun to rationalize that and begin to flatten that technology structure. So there's been room to get efficiencies out of that business as well. On the sales and marketing side, what was historically only a direct selling model, we now sell through partners. We sell through health plans. So you get some leverage there as well. And G&A, it's just G&A. You hopefully can grow G&A slower than revenue as a public company. But within each of those lines, you have room there to get some efficiencies. And lastly, a year and a half ago, we made some structural changes to begin to flatten the organization. We've continued to look at things like where our headcount is, our location strategy. We have a decent-sized operation in Prague that we've had for eight years. Do we need to hire engineers in places like Seattle and San Francisco where they're very expensive, and we can hire them in Vancouver or Prague? We looked at offices where, as we did acquisitions, we found ourselves with a number of office locations that was probably more than you need for a company our size. So part of that, managing the expense line, has been discipline. And part of it has just been also beginning to rationalize what was a structure that built up over time as we've expanded the footprint. I appreciate that you guys have achieved some of your profitability targets on the way to bigger profitability targets while also kind of shifting resources within each line to fuel the next steps. So we appreciate that. I'm going to go a little bit over here with one last question. I want to make sure to hit capital deployment. Business approaching free cash flow positive for the year, $25 million in net cash on the balance sheet. How should investors think about capital deployment from here? Yeah, you're right. Net cash about $25 million. We still have about $211 million of our convertible debt out there that's not due until April 2026. From our understanding, having talked to a number of people about that, there are good options to us to think about how to handle that convert. I mean, look, it's a 50 basis point coupon. Cash in the bank does better than that. So today, our convert is actually net positive in terms of generating cash. That said, it's now a significant piece of the overall value of the business. And so we think we need to think about that in terms of what's the right next step for managing that. One thing we did say last quarter on our call, we don't need $200 million in the bank to run this business. There's some number called around $75 million-$100 million that we think is a responsible number of cash to have in the bank to run the business that we want to have some operating flexibility. But generally, I would say that we look at that net cash position. We have said that we will be cash flow positive this year, and we will be cash flow positive going forward. And so that net $25 million in cash today with what should be an increase in cash going forward gives us quite a few levers that we can look at in terms of how we want to handle the convert over time and overall capital structure. Excellent. Appreciate that. All right. Well, we'll stop there. But thank you again, Todd. Appreciate it. Thanks for the questions.
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