I think we're ready to get started now. If everybody could again grab a seat and we'll get going. Welcome everyone to AdaptHealth's first Capital Markets Day. It's great to see everybody here live and in person. Of course, we welcome everyone joining us via the webcast. I'm Anton Hie, VP of Investor Relations. As many of you guys here know, I spent over 20 years on the sales side, so spent plenty of time in those seats right there. You know, hopefully, you think what we bring you today is gonna be more compelling than some of the analyst days that I had to sit through. We've got a great, I think, agenda lined up today. First, before we get to that, though, a quick bit of housekeeping. We'll be making forward-looking statements throughout the day and referencing non-GAAP financial measures, so be aware of the inherent risks with that. A great agenda. Steve will kick us off. Steve Griggs, our CEO, will kick us off with an overview of really the critical role that AdaptHealth plays in the healthcare continuum and the value that we add for all our patients, our referring providers and our payers, but especially our patients. You'll get to hear from several other leaders throughout the organization on how we add that value and, of course, where we see our long-term opportunities ahead of us. Before we get started, I would also note we've got a lot of material to get through. There will be two Q&A breaks, so if everybody could just hold their questions for that, then we'll pass the mic around. Of course, everyone on the webcast can submit questions via the chat function. Before Steve takes the stage, I wanna play a quick video for you that tells a little bit about AdaptHealth, what we do and who we are. Anton, we're pretty proud of that video. It shows a lot about AdaptHealth, but we're gonna talk about a lot of those things that are in there today. First, welcome and thank you for coming. Like Anton said, we're gonna talk about the important role we play in the healthcare continuum out there in the marketplace. In addition, we're gonna tell you where we've been, where we're at today, and where we're gonna head. In addition, we'll also put out some goals out for 2025 and our commitment to those goals. Finally, you'll hopefully see from all of our team members here how the connectivity between all these operations and these focuses things they do, how they interact with each other, you know, well and make each other better. Certainly, we wanna be able to be part of the reducing the overall cost of care, but our commitment is to improving patient lives. We do this by staying true to our mission, which is to empower patients to live their best lives. Now, we interact with tens of thousands of patients a day. Some of those are very, very critical. For instance, a patient recently went on to hospice. We were called in. We bought various pieces of equipment, but in particular, a ventilator. We educated that patient, we encouraged that patient, and that patient made a very unusual exit from hospice. They went off hospice and back to regular care. That doesn't happen much. Obviously, the patient was very excited about that. We were very excited about that. But I can assure you, those hospice providers were also very excited about that. We're a big company, $3 billion in revenue. Some important points are 90% of our revenue is recurring. That allows us to do things and plan for things in the future, knowing that recurring revenue is there. We've grown very fast, up 6x in revenue since 2019. With that, of course, we had what we call a systems lag. We spent an incredible amount of time over these past few months and last year and a half in getting the systems up to date, not just for a $3 billion company, but for a company that has the aspirations that we have. We're right in the middle of this move to the home, and we're perfectly positioned as more and more stuff is heading to the home. The reason that people wanna move to home is all on cost containment and trying to reduce the cost of care. One of the consequences of reduced cost is less in-person patient encounters. What does that mean? That means that the patient encounters that do happen become that much more important. Our 36,000 encounters that we do each day, we believe becomes very critical and very valuable to people in the healthcare arena. Our 3.9 million patients that we serve, that we coordinate the care through insurances, through their specialists, through the healthcare systems. That's our job, is to coordinate this care with, again, our 36,000 daily home deliveries. We're a national company. Our company's service area is 95% of the people within the continental United States. Healthcare is local, and we know it's local, so we have to be a local provider. We have to react and act and adapt to the local demands of each marketplace. That being said, being a national provider does bring us benefits that can benefit the people. That's scale, that's systems, and that's most importantly, expertise. We play in these three chronic diseases predominantly, and we're top positions in all of them. That's obstructive sleep apnea, that's diabetes, that's COPD, that's congestive heart failure. We do it through these pieces of equipment that you see here, CPAPs, BiPAPs, CGMs, et cetera. One misconception about us is that we are a home care company. We are much, much more than that. Did you watch the U.S. Open? In the U.S. Open, you saw players playing in the U.S. Open that had CGMs on their arms. I'm gonna fly out of LaGuardia later tonight, and years ago, LaGuardia was the first airport that I saw in there through security to make sure that not only you took your laptop out, but you took your CPAP out. There's a 73-year-old pickleball player who's legendary around the club that I'm at, and he wears his port POC as he plays pickleball. My best friend, one of my best friends, known him for 40 years, played golf with him, he's a snorer. I begged him to get a sleep study. Wouldn't do it. One day, he's just walking up the eighth green, and he's short of breath. Two days later, he's in the cardiologist's office. Two days after that, he had a stent. Shortly thereafter, with the doctor's encouragement and mine, he got that sleep study. We did a home test on him. That home test showed he had obstructions. Now we got a piece of equipment. He was severe. With severe, a CPAP is continuous positive airway pressure. A BiPAP has it go both ways. For that patient that's severe needs that type of bilevel. Well, his insurance company doesn't want to approve that yet. We worked with the insurance company, and finally, we got him on the BiPAP. Now he's on a BiPAP, and he's a heart patient, so we gotta watch him. He's doing better and better and better, but he's just not quite getting the results that we would like or his doctor would like. His doctor encouraged him to go get a full PSG in a sleep lab. Sure enough, in that sleep lab, they identified not only did he have obstructive sleep apnea, but he had central apneas. His brain was making him stop breathing. He had to move up into an advanced to a piece of equipment called ASV. Now, this ASV, he put that on there, and within a short period of time, he was able to sleep 7, 8, 9 hours. That's my buddy. I've been playing golf with him a long time. For the past 10 years, I've watched his handicap go from 8 to 12 to 14 to 16. Last year, because his handicap is so up, and now he's crossed the 65 mark, he's able to play the up tees. Within a year now, his handicap is now a 10, and this is right now, it's 11. Went down as far as a 10. When you look at a handicap system, just 'cause you move up, doesn't allow your handicap to drop. The fact that he's hitting the ball 15 yards farther isn't because he moved up from the up tees. My rationale and my logical conclusion is the ASV did it. He would actually concur with that. I'm surprised when I walk around and I have an AdaptHealth shirt of how many people come up to me and say, "Wow, I'm a patient of AdaptHealth," or I come to these events, and people take me off to the side. Now, I don't know why I'm surprised, because 1 in 90 people in the United States are an AdaptHealth customer. Think about that. If I go to a football game, it's a big football game, there's hundreds of potential of AdaptHealth customers. When you're out there and you're seeing patients that are in wheelchairs, you're seeing patients that have the CGM on them, you're seeing patients that get portable oxygen, you're seeing that patient take his CPAP out as he gets on to through security, not most likely, but highly likely, that's an AdaptHealth patient. I said that we shouldn't be considered a home care company. I consider us more of an everyday, any day, and every time company, an anytime company, because our patients are using this equipment and services across the day, whether they're at home or at work or at play. Chronic diseases, you know, is a big cost. $4 trillion in healthcare spending a year. We offer solutions to that. We are right in the middle, again, because we can monitor patients at home, we can treat patients at home, and more importantly, we can keep patients at home. Now, within healthcare, I've been in healthcare a long time, and there's always controversies about this and that, but one thing that is universally accepted is the three pillars of health, sleep, nutrition, exercise. We participate in those with our patients and try to get them to do better jobs in those three pillars of health. Some is quite obvious. Obviously, OSA and sleep, you know, for sleep. But COPD, we're giving that patient, again, that equipment to be able to keep them mobile and ambulatory and exercise. Certainly, a well-managed diabetes patient can get the nutrition that they like and is good. As we move on, strategic accomplishments that we've had in the last two years, we've completed the integration of AdaptHealth and AeroCare. That was the biggest deal that AdaptHealth had ever done. I obviously came from the AeroCare side, and now we've been able to merge these companies together. Now through that merger, yes, we picked up a lot of synergies, but those synergies were locations, personnel, and then some contracts. What we haven't been able to do, because really because of the recall of Philips kind of derailed it for us, is get the benefits of all the great things that we do and that it did at AeroCare and that we do at Adapt and now make it across the company yet. That's a big mission for us throughout, you know, 2023. Diabetes is now integrated through our whole business. It's not a standalone place for it's within our whole business. The reason it is, 'cause every meeting we go to, every meeting, with any kind of healthcare, system or managed care, diabetes is top of mind. Why? Because it's so critical to all the things in there, and a diabetes patient, when they get sick with anything else, just gets magnified to the max. We have to, when those things have to have a solution for their diabetes patients. Integrated cloud-based work system. A year and a half ago, you know, there was a disjointed. There were things going on. They were doing okay, but they weren't talking to each other. They weren't communicating with each other. Our CTO and Josh have worked tirelessly to try to bring all these systems together, and now they actually are communicating and all. That same data, we have incredible people. A lot of them are here today, and they're all now working on the same stuff, the same data, and they are aligned now on what we're trying to accomplish. There's no question that we've been pioneers in e-Prescribe, e-ordering, and e-delivery. That brings efficiency to us, no question. More importantly, for that patient, it gets our equipment out to that patient sooner. It's much, much better patient satisfaction, not just for us, but also for the doctor and, you know, the health plan for that matter. Cross-selling. Everybody's talked about it for years. Everybody's failed at it for years. The reason you fail at it is just much more than cross-selling, as it's said. It has taken an expertise that's located in a part of your company and spread it around across the broad base of your whole company. Your ability to do that was pretty challenging until recently. Now we have the ability to move information across our company at incredible speeds. If we're in a doctor's office and we have a traditional HME rep talking to a GP about diabetes and they have a question, they can get on their cell phone, type that up quick, and have an answer just like that from our team because of the way we have that communication. Then they can also send documents really quick and get that to the right person very fast and very efficiently, so we're able to do it. We're very, very excited about that initiative, and it's really a defining moment for our company. We've been through a lot over these last few years, managing marketing headwinds with the PAP recall, COVID, inflation. You know, particularly with COVID, we're very, very proud of the role that we were able to play during the pandemic and being able to supply oxygen to those patients in need during this pandemic. Over the years, you know, we've made tremendous progress. We've both AdaptHealth and AeroCare had a strategy of geographic expansion. Why? Because the barriers to entry to open up a location in this business has become extremely big and extremely large. That does a couple things for us. One is it protects our locations now. Those barrier entries, now, if you're in the state, you can open up one. But if you're going to a fresh state, I know as much about DME as anybody, and I wouldn't go to a fresh state and open up from scratch anymore. It's just not worth it, so you wanna buy your way in there. That's what we did. That's what Adapt did. Now we're in 47 of the continental United States, so we have the ability in those states to do pretty much anything we want. We're still not in Montana. You know, maybe that will happen. Montana is a great state. I would pretty confident saying it would be very, very difficult, if not impossible, for a company to start today and do what AeroCare and Adapt have done over the past 20 years. There's just not enough people out there. There's not enough companies out there to be able to acquire in there, and it's very, very difficult. Our franchise, if you will, of 767 locations is somewhat protected. In 2022, like I said, we started, you know, how can we optimize what we're doing? How can we get better at what we're doing? How do we integrate and get that and growing that? That's all building to what we call AdaptHealth 2.0. What is AdaptHealth 2.0? That is moving from fee-for-service to value-based. All right, so value-based. We have the tools, we have the processes that payers and risk-taking organizations need. We can make sure that the right patient gets the right equipment at the right time through our e-Prescribe technology. Our world-class patient engagement and patient satisfaction that we're able to do through our OTL system makes the patient encounter not just good for us because of the time it gets in there, again, it makes it good for the doctor and the plan. For MA plans, when we're talking to Medicare Advantage plans, they're very interested in that. Why? Because today, they hear they're on these Star Ratings, and those Star Ratings determine their reimbursement rates. A big portion, 40% of that Star Rating is based on patient satisfaction. When we talk about our OTL system, it's getting a lot of traction. Ben Chambliss, the Head of Managed Care, is here today. He can tell you that how that's become a big selling point in his calls. All right. Here we go. 2025, you know, our goals are $4 billion in revenue, $1 billion in Adjusted EBITDA, and $300+ million in cash flow. How do we get there? As a CEO, what you like when you have goals out there is, are they reasonable? The answer to this one is yes. Are they obtainable? The answer to this, yes, because there's multiple ways for us to get there. We don't have to hit on everything perfectly to get there. We have several ways, one of them being PAPs, the PAP comeback. Certainly, that's a big one. The rest of them are just doing the stuff that we've been doing for years. Non-acquired growth, continue to grow our business. Operational excellence. Again, it's putting together and just doing the things that we already do well in parts of the company, doing it across the company. The strategic M&A that we'll do. Then all this is, or at the same time we're doing this, which is that's just going to work and the execution, we're starting to build the pipes and put in the processes for this AdaptHealth 2.0 and value care. Now, the monies that we spend for that, I promise you, will deliver what we were looking for in the future, but it delivers results today. You won't hear me get up here in 2025 and say, "We didn't make it because of all the money we spent on value-based care." You might hear me say, "Because the money we spent on value-based care, it was even easier to hit our goals." Everything that we're doing to be able to become competitive and be that provider of choice, all that money that was spent will get benefits today. All right, PAP. Save you asking me the question, save some time in our Q&A. First, we bottomed out in our PAP census in February. Since then, we've had steady growth in our PAP census, which is PAPs on rental. Now, remember, a PAP is rented for somewhere between 6-13 months. That's all we get for it, then they just become a resupply patient. Okay? We're out of this thing. Where are we at with PAPs? Somebody already asked me, you know, over there as they were getting a bagel this morning. I'm gonna give you and let you decide where we're at, and I'll give you my opinion too. There's a piece of information that's out there that's very, very important. ResMed has dramatically increased their supply of patients and production of equipment. Dramatically increased. What does that tell you? It tells you several things. Now of those, about half are connected device, AirSense 11, and about half are AirSense 10. They're not connected, they're card to cloud. With those informations, we know what? ResMed can dramatically increase their production. They can, I believe, at least double, if not more than double their existing. They have the capability to do that. In addition, it tells you that because of that levels that they're building at, that the components, except chips, you know, they're getting more and more secure in that supply chains. Mick Farrell, CEO of ResMed, has done a great job at expanding and going deeper and deeper into the supply chain that they need to get that security that they're gonna be able to get those components. Finally, it's chips. I see Deutsche Bank, Jefferies, all these various firms here. Y'all know more about chips than I do. Y'all should know what's gonna happen with chips. Everything we're reading shows that the chip availability is getting better and better in the marketplace. I suspect that more and more of those ResMed machines will become connected as we go through. That's ResMed. In addition, other suppliers have stepped up and been able to vastly increase their production of PAPs into this market. There are two in particular. As I sit here today, Respironics has been an incredible partner for me for 35 years. If they don't come back to the market, 2023, whether they come back or not. In 2023, we will have enough PAPs on there for current demand in 2023, and we will start getting enough PAPs to go into the backlog that's been created. If Philips does come, then the backlog of the work in the backlog, if Philips does come back, will happen faster. Regardless, it's gonna happen. My opinion. Non-acquired growth, you know, basically, we just need to keep doing the things that we're able to do. e-Prescribe is a big one that as we continue to expand the e-Prescribe, expand our care-based model, we're getting more and more attention from not just doctors, but health systems on solutions that we can do for them. Deeper payer engagements. We're now being able to have these nice conversations with payers about, you know, how can we work better together. It's not all just about price. It's not all just about price. Our technology, our patient advocacy, and how compliance and RCM work together, all that stuff produces a product for the marketplace that the doctors can, and the referral sources can engage with and be committed that when they send a patient to us, that we won't be back in there asking for more information as a lot of our competitors do. All this is leading to, as we get more patient engagement early on, more physician engagement, and engaging them electronically becomes very, very important. Because patient engagement and provider engagement are critical to everybody as healthcare moves more, you know, away from the institutions and into the home. Industry tailwinds. We're lucky because we have the boomers, if you will, moving in through Medicare. It's just a demographic trend that Medicare is one of our highest growing segments of our population. Those people absorb and need and have a lot of chronic diseases. A COPD patient today is living longer than they've ever lived before. Why? Well, it's because the technological and medical advances in cardiology and in pulmonary have just increased the life of that patient and in cancer treatments. Those things aren't debilitating the patient, and now that COPD patient is living longer. Plus, we're all interjecting ourselves earlier into that COPD patient's life. Again, these product categories, you know, are gonna continue to grow. We've seen tremendous growth. In addition to that, what's the patient want? Patient doesn't wanna be in an institution. No way do they wanna be in the nursing home. They're gonna do everything they possibly can to stay out of the nursing home. Margin improvement. In our goal, that indicates a 25% margin. How do we get there? Well, the CPAPs get us halfway there. All right? Our remaining organic growth and that organic growth comes with that incremental growth comes with incremental profitability that's significantly more than 25%. As those grow, we do better in that'll drive that up. These operating efficiencies that we know that we're gonna get, all we have to do is do what we do in the Northeast and the Southeast and the Northeast, et cetera. What we do in RCM, we do it all across, you know, our businesses and make people work within that, and all the projects that we have out there, we just gotta do it across our organization. We will pick up margin share. If you add those up, we go well in excess of 25%. What backs us down there is the two boogeymans that are out there, inflation and labor pressures. We know that that's gonna contract us a bit, but we're very, very confident that particularly PAPs and the organic growth will drive our margins up. Today, we're top three across the portfolio. We're a leader in electronic ordering, a leader in patient engagement, and the future, again, is this move to value-based care. We have all the pieces and parts to do it. We have to assemble them, and we have to get adoption. We have to work with our payers and work with our health systems to get more on e-Prescribe, more on documentation flow. Again, with our e-Prescribe, it's very crucial that for managed care is that we can get the right patient on the right equipment at the right time by using that system. Finally, or not finally, but close to it, ESG. It's very important. The Securities and Exchange Commission will come out with more guidelines, but we are committed to it as an organization for our employees, our customers, our shareholders, our stakeholders. We're all committed to it. We've already done some preliminary work. We have some surprisingly good results and maybe not some surprising challenges that we have to work on. So we'll be re-releasing our plan next year. With that plan, we'll show not just where we're at, but how we're gonna continue to improve. Today, you'll meet more of the executive team, and they'll show you how they're working together to be able to accomplish these things and their commitment, not just to 2025, but beyond. Our board members, many of them are here today. We wanna thank them for their support and their expertise that they lend to us as we go through this mission, you know, at AdaptHealth. In summary, we've transformed the business. We're capitalizing on what we got today, and we're putting together the stuff for value-based care in the future. Thank you. Next up, Josh and Albert. Thank you, Steve. Thank you everyone for joining today. Nice to see a lot of familiar faces in the room. Wanna give a little bit of kind of background of AdaptHealth, a little bit, speaking a little bit now and then gonna focus more on AdaptHealth 2.0 a little bit later this morning. You know, my story, for those of you who are not familiar with it, I got into the HME business in 2005 with a $25,000 investment and an entrepreneurial vision, if we'll call it that, to compete in what was, at the time, a very antiquated and dated business model built on heavy reimbursements and inefficient operations. When we founded AdaptHealth in 2013, our vision was to create a scaled, diverse product offering and best-in-class technology to not only create an efficient and profitable business with recurring revenue, like Steve mentioned, but also mass relationships with millions of patients living and aging at home. I'd like to focus today on the first part of my address on what we have done, what we've built, and why we've built it. Later, when I address AdaptHealth 2.0 and give you guys a little bit more color about that, we'll go a little bit deeper on what that all means. In executing the vision that we've had over the last nine years, AdaptHealth has acquired. AdaptHealth and AeroCare, with their combination, have acquired hundreds of HME respiratory and supply businesses, pushed new technologies in home healthcare, and more importantly, established itself as a leader in home health equipment and supplies with a broad and growing product portfolio in the categories of sleep, respiratory, HME, supplies, diabetes, infusion, and orthotics, among others. Today, AdaptHealth spans over 750 locations in 47 states and continues to grow and evolve as a leader in the HME and supplies industry. AdaptHealth continues to be an acquirer of choice in the HME respiratory and supply business. We are adding density in adjacent geographies and expanding into more categories and products to add scale. As we integrate, we continue to extract significant synergies in the areas of product cost, resupply operations, labor, and technology. We are still seeing attractive opportunities in the marketplace in our targeted 4-7x synergized EBITDA range, and we'll continue to be disciplined buyers for the right opportunities in the right time. Shifting to more recent operations and the vision of the platform coming together, sort of why we've built it. Our 2022 focus, which we previously communicated, has been putting tremendous amount of effort around maturing as a public company. Albert and Jason are gonna add some more color to the details and specifics of this, as well as integrating AeroCare and 23 other acquisitions in 2021 that were completed, and continue to drive operational efficiencies as we go forward. One of the nice opportunities about our business is that, like Steve mentioned, in spite of broader inflationary pressures, we have been able to leverage our platform to drive significantly more revenue per employee, as well as drive operational technology to create OpEx efficiencies. This effort has a lot more runway and involves a collaborative effort between our operational and technology teams. Our CTO, Albert Prast, who comes from a large public company experience, has been an amazing partner to the operation in driving transformative technology change, and we're excited to tackle the opportunities to extract more of these in the months and years ahead. Albert's gonna talk a little bit about some of the tools that we use, how we're thinking about our platform, what some more specifics around where we're going. Without further ado, Albert, I'd like to call you up to say a few words. Thank you. Yeah. A rep who sold us paper alone for the company. I'm not kidding about that. about that. We had very little email. We had no technology partners that we could purchase off-the-shelf tools for. I would tell people we kinda had to make our own clothes. Most of the budget, most of what we did was really spent on just table stakes type of things. You know, we did that for a long time. In the early 2000s, we went in different directions. I joined, built another company that we sold to a payer, and then I ran cloud computing for a large payer for a little bit. Then Steve called me and said, "Hey, I've got this DME company, again. You wanna come back and join me and do it again?" So, you know, I looked at all the people I was working with at the time, and we were doing digital health and digital therapeutics and all this cool stuff that was just software, and you didn't have to touch things, inventory things, move things. I said, "You know, Steve, yeah, I'd like to come do it again." People thought I was a little nuts at first. Maybe I was, but, you know, we have such a growing demographic. It is an industry that has such great need, and having done this before was kinda like the opportunity to go back to high school or college or the first company you did, where you realize that technology was not at the point you wanted it to be, and it is now, so you could do things that you never did before. It also allows you to identify the things that maybe we had done in the past that we don't wanna do again, and other people might not know that if they're just getting into the industry for the first time. That gave us, I think, a little bit of an advantage and some speed. You fast-forward to the focus. Our focus was that we need to move equipment, get equipment to patients, make sure that the patients are compliant, make sure that it works as expected, we get good patient satisfaction, and we wanted to do all of this without any paper. When you go back to our original locations, we had, again, copiers, paper, file cabinets. They were all full. If you look at the version of today, very little, if any, paper. We try to do everything electronically from beginning to end, and I think we've done really well with that journey. What does that result in? Happier patients, better patient care. They know exactly where they are. We know where they are. We share the same artifacts. We have a better referral partner experience with not only the physicians who we work directly with, but the health systems as well as providers. We have a much better and easier method to be able to make decisions and build workflows, and that's through data that I'll talk about in a little bit. I came from the AeroCare side with Steve, as I mentioned, and I've been here for about a year and a half, and so we had two fairly like-sized companies coming together that did not do things exactly the same way. Initially, my focus was, you know, to look at the team, to look at where we were from a technology standpoint, and really build from the bottom up, layers of the cake, if you look. Tactical and defense, table stakes. We have an awful lot of people working offshore. We need to be, you know, best of breed, ensure no data flows out of the country, security risk, migration, big deal, focused on that. Have done it before. Not that hard to do, but you have to get procedure policy process in place to do it. Moving a little further up the stack is really around being proactive as opposed to reactive with network operation centers that we didn't have. I've put one in place that's actually I'm pretty proud of, and it's very sophisticated. So we monitor everything that we can monitor. We monitor weather. We monitor political events. We monitor all of our systems. We're monitoring response times. We're monitoring how current the data in our data layer is so that we can empower the business. It's kind of been. It's been more than fun to watch really in the last 8-12 months, how we've educated people on this single data layer and being able to access data. You know, usually if you're a technology person, you have a lot of the business always wants to find, "Well, I access this data, and there's something wrong." We're not finding that anymore. We're getting the business accessing the data and say, "It's amazing. It's current, it's accurate, and it allows me to move forward." It's really becoming dial tone. Moving up the stack, and concurrently with what we did, I've really focused on building a best-of-breed R&D team. That team is really taking the data, our processes, our policy, and both headless, and I'll get to that in a minute, as well as application-based and developing solutions to help different personas, constituencies, people that we work with within the business, and I'm really proud of what we've done and how we've done it. Let me tell you how we've done it, which I think is interesting. I had a lot of relationships in this industry from a prior life and then this life. So I hired some really great people who I've worked with for a long time, who know the industry exceptionally well. Maybe they weren't as current in some of the emerging technologies, you know, that you find the younger people just getting out of school are current in. I hired a bunch of them as well and have mixed them together in two locations, one in Winter Park, Florida, and one in a Tampa technology center that we've spun up. They're working exceptionally well together, and we're taking the old method and the old processes around our industry with people who have done it and understand it, and we've really merged that well with some of the latest cloud technologies and things that you could do with moving data very, very quickly. The result is, it's noticeable now. I'm not gonna go into each one of our tools in detail, but I wanted to talk to you about a few of the things that we're doing and the tools that are top of mind to me right now. This isn't an exhaustive list, but if we look at this sort of like a clock, if we start at 11 o'clock, our OTL, which is our online tracking tool, is the most mature tool that we've built. We built that at AeroCare. Steve and I did that beginning in 2015. OTL stands for Online Tracking Log. What that should mean to all of you is that my team is really good at building software. We're not so good at naming things. But what the objective of OTL is really to be able to track pretty much everything. I wanna track where the driver is, I wanna track where the equipment is, I wanna track where the patient lives. We wanna notify the patient what time we're showing up, and we wanna make sure that we get feedback from the patient when we leave the home. I'm gonna talk about OTL a little bit more in the next slide. My app, which is my Adapt patient portal, again, I don't love the name, but it's better than OTL. We started this with our diabetes group, but really what it is it's a mobile app today. It will also be a web portal as we expand it. We took the focus that, you know, I took with all of our employees with, you know, security and SOX and all these things going on. We enable single sign-on that many of you probably have. People need to access from 5 to 20 systems. I don't want them to remember passwords and log in to 5-20 systems. I want them to have a single relationship where they log in once and they know what to do. We have a unique capability in our company where we drive to the home and we see people when we deliver equipment. I can have those drivers with a QR code, have all the information around a patient and say, "We're gonna put this on your phone so we have a direct dialogue with you." We onboard them very, very quickly and can get them running with an app that has proactive notifications, allows them to see where their orders are in the process, when they're eligible to order, which is a big deal primarily for the diabetes patients, and then know when it's coming and be able to reorder. The key with this app is we're releasing it for diabetes, but if I'm here next year talking to you, there'll be circles behind this with all the other areas of the business that the same application, slightly different or enhanced workflow will be in there, which means you have one single sign-on to the company, and you can work with the diabetes group, you could work with the supplies group, you could work with the oxygen group, the sleep group, whatever you know, you wanna do. I think that that's impactful and gonna have value. You know, if you wanna play devil's advocate and say, "Well, everybody doesn't wanna have an app or download it on the phone," okay, they don't have to. We have headless technology that will work with SMS if that's your channel of choice, and we're also releasing an Adapt switchboard that I haven't really seen anywhere else. To define it at a very high level, one of the areas you can go to, whether it's on the web here or in the app, is you could select what department you wanna contact and your preferred method of communication. I want you to text me. I wanna set up an appointment. I want you to call me. I wanna be able to chat with you. We record the mechanism that the patient or the physician, whoever's interacting with us, chooses, and we're identifying that channel of choice and storing it in that data layer. Over time, we're gonna get smarter and better. You know, the read here is that when somebody tells you, "This is how I wanna communicate and when," they may not be telling you when they wanna communicate and how, but they don't know that. We have to use the data to derive those insights, and we're beginning to do that. We have a partner order tracking tool that seems very simple, but it really has made a big difference, and I never thought that it would be as well received as it was. What this is, it's just another instantiation, just another way of assembling how on behalf of a large payer that may have a cohort of patients with specific need, they may hand you X number of patients, 5, 100, 1,000, 10,000. Those patients have similar need, but they wanna see what's going on with them in near real time. We basically gave them a view into our system with an app, with messaging around it, where we can message between our payer partners and the company around a patient or around a specific order for the patient. The uptake was beyond anything I've seen, and Ben Chambliss, who's here, can talk a little bit more later. We're getting really good feedback from the market for this application as well as OTL working together. E-commerce, I'm gonna talk about in a few minutes. We have a dual path for both traditional e-commerce as well as serving our patient base, and I have a slide on that that I'll go over in a minute. AdaptHealth Referral Management, think of this as our internally built, CRM system for our reps who work specifically with referral sources. Gives them visibility into everything that they need to do that day within a specific referral source and their patient base, as well as being able to, you know, take notes, identify, you know, preferred times to visit, names of people in the office, et cetera. The last thing, which we didn't build, but we have several partners, is e-Prescribe, where this begins the paperless journey. We have many people, and we encourage all of our referral sources to use e-Prescribe, so we do things electronically, the way lots of other folks do it today. A lot in that slide, let's move on a little bit deeper into OTL. We started—Steve and I went down this path from the AeroCare days, but we've rolled it out in the last year and a half working with Adapt very, very quickly. We have almost 700 locations up and running today and about 7,500 users. It's really battle-tested. It works exceptionally well. It's easy to use for the driver to understand. We built the technology and load this on your large iPhone form factor iPhone, which we give them and follow the truck. It lets them know where they need to be, when they need to be. It provides reconciliation from a revenue cycle standpoint and for working with the back office as well as lets our patients know with an email or a text, "Hey, your driver's on the way. This is their photograph. This is what they look like." You know, think about it with an aging population, people who are older at home right now, they may be alone. You don't just want random people showing up, knocking on the door without knowing who they are. We're using advanced technologies like BIMI to make sure that you know, we have non-repudiation on those emails so they can be confident that you know who's coming and when they're coming, and that the email message was actually sent by us. That may be a little bit over clubbing what we need right now, but we're thinking about these things and building toward the future. All of this is in a very compliant HIPAA and SOCs sort of tool, and it's really made a big difference for our business. You know, this is one of the things I think that we're proudest of because this, you know, this is a result of bringing that technology in and asking questions in a way that we never asked before working with our patients. You know, just like when you get out of an Uber or most of what you do in other areas of life right now, when we leave, we ask the patient through an email, "How'd we do? What do you think?" It's not necessarily to say, what did we do right or what did we do wrong, but what are we doing that you are really elated about, or what are we doing that you really think maybe we should do different? We continue to tweak and adjust with the data that we feedback. We've had this year alone 2 million deliveries on our OTL system. We're getting 20% response from these activities that we're sending out to people, so they do wanna tell us what their thoughts are, and our Google rating has gone up to a 4.8. Needless to say, it was a lot less than that. I think we're pretty proud of where we are, and it's working, and we continue to use this feedback loop, and we'll continue to operate that going forward. Part of what OTL and our feedback loop taught us is that patients sometimes said, "I love working with you all. You're a trusted partner and brand. I'd like to do more or have more." Some of them said, "I'm even willing to pay for it, you know, with a credit card, cash pay approach." The company has taken, you know, a two-pronged approach to this. The AdaptHealth Marketplace, which is new and branded to our website, it'll be launching on the 14th of October. I wanna caveat that with we had this at AeroCare, as well, but you know, we just did different branding and have modified the store. This is a marketplace for our current patients to come in and engage with the company. We don't spend a lot of money on acquiring the patients in this marketplace. We can use email, flyers, package inserts, talking to patients, you know, via OTL. We could put it, you know, in the email. We already know the patient. We already know there's a need, and this is just giving people a store where they could come and buy some of the products. In addition, we have several properties in the CPAP space, the oxygen space, you know, breast pumps, things of that nature that are traditional e-commerce, where we have, you know, Google AdWords. We do spend for organic, inorganic search, and we look for patients that are not currently engaged with the company. You know, this is exciting, and it's part of what my group does, and we're making it seamless into some of the apps that I mentioned that we're building before. I could spend an hour on this slide, and I have about, you know, a minute. You know, data is really what has made all of this available. When you look at when I said we've got to go up the stack and after, you know, we solve security and risk and compliance, the next thing was taking all of the siloed data that we have in typical healthcare companies and get it into one place. I think what has really helped is one of the areas of focus was with our communication channels that we have with patients. You know what it's like to dial into you know a call center system where you're bounced around, you may leave a message that never gets returned. Nobody knows that you called. When you finally get to somebody, they don't have accurate information in front of you. We did a really focused approach of integrating our location-based PBXs, which are phone systems that you typically would find in an office where you walk in, where people have work to do that includes answering the phone but is not exclusively answering the phone. Then our call centers, where we have people who are specifically focused on answering the phone, responding to chats. Then within that technology, we have dialers. IVR, interactive voice response units that may call out directly to patients. For example, that's how we do reorders in our CPAP resupply business. About 47% of them are now touchless, that it's time for you to reorder. A phone call comes to you. A very nice sounding piece of technology speaks to you and says, "Would you like to reorder? Press one for yes, two for no," that sort of thing. At any rate, we've built this data layer that's available in near real-time for pretty much all of the data in the company. We're still adding, you know, a few things that are smaller pieces. But the vast majority of our data is there. It's accurate, it's up to date, and it really is allowing us to change the way we interact with patients, with our payers and our providers, and, you know, processes. This is what's really important because when you look at the process piece, when you look at the internal piece, analyst type, you know, people in our business, the business analysts say, "You know, I wanna get in front of a computer, and I wanna look at data, and I wanna find, you know, a needle in a haystack." That's great. My group looks at the data and says, "We're gonna let machines identify patterns, and we're gonna let machines identify workflows that we're then gonna take the raw data, throw it up into our microservices layer, and let that do things, you know, with our phone system, with email, with chat, with other ways of reaching out to our patients and our payers on their own." In addition, this same layer powers all of those applications that I mentioned before. It sounds, you know, great. We have five, six, 10 different applications that we're providing for people, but it's all riding off of the same core. It's all using the same set of services, but they're assembled differently based on who's using it. I think that's important. To summarize, you know, we've focused at really being efficient at leveraging, you know, scale and technology. When I mentioned before the things that, you know, we know to do, and the things that we know not to do. As an acquisitions company, one of the more difficult things, and something that's usually not a point of focus is eliminating technical debt, eliminating old contracts, eliminating things that you don't need, making sure you're communicating with the people in the field. We're not gonna be doing this that way anymore. We've got a standard process. We have best-of-breed technology, and we can scale off of this. A hyper-focus on getting things to operate in the same way has been a real focus, and it's made a difference. That has allowed us to really get deeper into our patients, our providers, our payers. Better health outcomes with happier patients. That's proven not only by Google, but Leila's gonna talk a little bit about that, as well. Our providers are happier, and we're easier to work with. That results in more referrals, of course. Our payers are talking to us about things that they never were able to speak with us about before because we didn't have the acuity, we didn't have the flexibility, the capability to be able to move quickly and assemble things the way that would meet their needs, and in many cases, deliver it in a white labeled solution, which we're doing. You know, the great news is I've got a management team and a board that understands that technology is what is driving the future. The company is committed to investing in technology. We're doing that in an appropriate and a cadenced speed. You know, you can go as fast as you can, but you cannot go any faster. We're not taking the approach of just throw money at something. Let's go acquire something that doesn't fit into our architecture, and we'll drop it in, and we'll get to it later. As many of you know, that never happens. You know, we continue to move. We accelerated this year. We fixed a lot of the things that were required with a deep integration of two companies and expect just more and to go faster and faster and continue to drive with these technologies. With that, I am gonna hand over to our Chief Compliance Officer, Wendy Russalesi, and she's got some great stuff to talk to us about. Thanks, Albert. Good morning, everyone. My name is Wendy Russalesi. I'm the chief compliance officer for AdaptHealth. Today, I'm going to give you an overview of our compliance program and share some insight into how we approach compliance at AdaptHealth. We'll start off talking about why healthcare compliance is important. We'll provide details as to how we've designed and implemented our compliance program. We'll talk a little bit about how we monitor the industry for our priorities going forward. There's a variety of reasons why a healthcare organization would implement a compliance program, but a key reason is to deliver quality patient care. We believe that our foundation is strong. Our program has a strong foundation in ethics and integrity, raises a consistent awareness of compliance throughout the business, and prevents misconduct, which allows us to achieve our goal of delivering the best patient care while minimizing the business risk. Years ago, when we started talking about branching out our program into an enterprise program, our compliance officer team felt it was important that we have a compliance mission statement. We had all come from organizations where compliance was viewed as burdensome or the adversary, and we were determined to do it different. We wanted to have a positive relationship with the business, and we wanted to deliver a supportive program that adds value to the company. This chart right here shows you some of the key milestones of the program evolution. Back in 2017, we started the process of retiring the individual subsidiary compliance programs, and we transitioned to the enterprise corporate compliance program. That gave us one code of ethics and business conduct. It implemented policies to support that. We created a comprehensive education program, and we also developed a very rigorous internal monitoring program, which gives us pretty much real-time visibility into the business practices and helps us identify any types of trends that need immediate correction. Then lastly, we launched an annual enterprise risk assessment program, and this is a process that all of the management team participates in. It's very helpful for us, because, you know, our team is small in comparison to such a large organization. It really helps us understand what's going on out in the operation, what people are thinking, what they're feeling, we need to take a look at. We use that data that we collect from that process, and we help to identify risks in the organization and also mitigate risk for the business. In 2020, we expanded the scope of our program to incorporate new lines of business, and at the same time had a slight distraction of supporting the business through a public health emergency. That took up a lot of our time that year. In 2021 and continuing to date, we scaled the program to integrate the largest acquisition the company has done so far. We also participated in an independent assessment of our compliance program. We'll talk more about that in a future slide. Through the enterprise program, we have a consistent framework that helps us influence the compliance-first culture, empower the business' success, and focus on technology, not only within our program, but also within the business. Our program incorporates all of the required elements from the Office of the Inspector General guidance, as well as factors from the Department of Justice's evaluation of corporate compliance programs. Our team is led by professionals that are certified in healthcare compliance, HIPAA privacy and security, and also billing and coding practices. Our compliance-first culture starts at the top, and we benefit significantly from strong support from our board of directors and our executive leadership team. The compliance program is independent, but yet it incorporates reporting lines into the board compliance committee as well as the company's chief executive officer. The board and the executive leadership team, they're active and they're engaged in monthly and quarterly meetings. They're making the appropriate inquiries as to if our program is adequate, and they're always ensuring that we have the appropriate resources. Our enterprise compliance team collaborates pretty much daily with all of the business partners such as sales, operation, IT, and our revenue center team. This daily collaboration is important because it really helps the business deliver a clear and more effective message to referral sources, which results in us delivering a safe and effective patient onboarding experience. We empower the business' success through education, policies, best practice recommendations. While annual compliance training is a requirement in most compliance programs, we also provide monthly live sessions to the business. We feel that this is a benefit because it helps equip our people with the knowledge they need to know to navigate the current risk environment. Our team also plays a very active role in the due diligence process for any of our merger and acquisition activity. Through this process, we're focused on identifying any red flags that exist within the organization, and then developing a plan of how we're going to mitigate that risk as it transitions into AdaptHealth. Typically, all acquired organizations start to transition into the AdaptHealth Enterprise Compliance Program within the first 30 days of ownership. Focusing on the use of technology within our own program, back in May of 2016, we launched a proprietary compliance workflow that we refer to as Audit Share. We saw a need for this as the company was growing. We were receiving a significant amount of billing audit requests from governmental and non-governmental payers, which is typical. We really needed a way to manage that activity for our centralized audit team. We launched this proprietary workflow, and it gives us real-time visibility into what's happening with our audits. We can see our audit outcomes, we understand what are the trends and what are the emerging risks that are coming out of this audit activity. From all of that information, we're able to present that monthly to the business, and that helps improve our audit outcomes overall. In 2021, the board of directors commissioned an independent assessment of the compliance program. They really wanted to understand that our program again was adequate to support the scale of the organization and also to support the company's growth strategy moving forward. We contracted with an independent auditing firm who has a very strong background in fraud and compliance. Ultimately, through this five-month process where they reviewed policies, education, and attendance of that education, and compliance matters and discipline, they've concluded that our program is well-designed, it does work, and that is well above DME standards. How we set our future priorities for the program is really just staying in touch with what's happening in the healthcare industry and also enforcement trends. We routinely monitor the OIG Work Plan. There's new items that are added by the government to that work plan every month. It's been especially active in COVID, so we are really focused on using that as a key resource. We also evaluate our enterprise risk assessment data, and we're looking at our hotline disclosures to see what are people thinking about? What do they think might be of concern or the type of questions that they have. We understand how do we tailor future education? How do we set new policies for the business? Like I said, we're also monitoring the enforcement trends that are coming out in the industry. It gives us an interesting perspective of how, you know, we think we understand something, but then in actuality, how the government has looked at that practice in another organization. Monitoring all of these items helps us set our priorities to move the program forward and to achieve our goals, to drive better patient care, to mitigate emerging fraud and abuse risks, and again, to support the company growth strategy. With that, I'll turn the program over to Leila Vargas. Thank you. All right. Good morning. I'm Leila Vargas, and I lead our sales and marketing teams at AdaptHealth. I have been in the HME industry for 15 years. You've seen the facts and figures and statistics, everything that shows where AdaptHealth is today. I'm gonna talk to you about where we're going and how we're gonna get there, and it all starts with the heart of our organization, our patients. We can easily get wrapped up in the numbers, but we have to remember, those numbers are patients, and those patients are people. They're our friends and neighbors, our parents, our grandparents, our kids, and we can change their lives with the products and services we provide. This is what we've defined as our brand promise. This is the contract we make with our referral partners, our patients, and their families. We're always reminding our employees that this is our noble purpose. This is why we do what we do. We take care of patients with healthcare issues that are creating challenges. The patients we take care of have progressive, irreversible diseases that may not have a cure, but it's our ultimate goal to take those patients from just existing with those conditions to living their lives. That's why the phrase living versus existing has become so important to us, and that's what we're doing every day. These are the high-quality products and services that we've become the experts on. A lot of our patients have multiple conditions that require treatment with a combination of these products. What we see often in healthcare today is that it's managed in silos. You've got one doctor managing the patient's diabetes, another doctor managing the patient's respiratory disease, and then another doctor managing their incontinence issues. We are in the best position to facilitate coordination of care across multiple platforms and across the country. With 3.9 million patients already on service, we have an incredible opportunity to start with them and be part of that solution for connected care. To accomplish this, we have the absolute best team out there representing us every day. We've got over 1,000 clinicians in patient homes. We have over 650 sales reps in the field, in doctor's offices, and in hospitals. What makes this team different is our salespeople are not just salespeople. We've trained them to be educators and facilitators. The ordering process can be very complex, and doctors are really frustrated with this. They know what the patient needs. They just don't know how to get it for them. That's where we step in. We've trained our reps to help the doctors every step of the way in the process to get our patients what they need. In the hospital, we have liaisons there helping transition the patients home safely. We've made our reps and our liaisons valuable resources to our healthcare partners. We see the impact this team is making through our market leading positions. Our goal is to be number one in every one of these categories, and we can achieve that if we continue to gain market share and continue to do a great job for our patients. Our approach is all about being patient advocates, and we are teaching every employee in our company to identify patients that are struggling, who we can help. We're also really big on physician education, specifically with our primary care physicians. We spend a lot of time educating them on identifying the patient early in the disease process because we know if they get on our services earlier, we can help them stay healthier longer. Healthcare has become really disconnected, and unfortunately, patients can easily slip through the cracks, especially when they're coming out of the hospital. In the hospital setting, you've got case managers, social workers, in a lot of cases, what they call COPD navigators, all working to discharge that patient as quickly as possible because reality is they need that bed for the next patient. We see it as our job to get the patient everything they need to keep them out of the hospital and keep them where they want to be, in their home. This wheel up here is what we call our Circle of Hope. This is how our specialized, centralized teams are all working together to do just that, to keep the patient at home and to deliver on that brand promise. We've got multiple layers of clinical oversight here with the local respiratory therapists that are actually in the patient's homes. We have sleep coaches. We have a respiratory pharmacy that delivers nebulizer medications directly to the patient's home. The real differentiator here, and something we're really proud of that we know no one else has, is our care coordinators. Think of them as case managers for the patient in the home. The goal of our care coordinators is to identify struggling patients as early as possible, so we can intervene and prevent a hospital readmission. They're working a lot with our non-invasive ventilator patients. Breathe a Little Easier is our program for non-invasive ventilation and really our biggest opportunity in respiratory. Of everything we do, of all the products and services we provide, nothing changes a patient's life like a non-invasive ventilator. We focus on COPD because it's the third leading cause of death. We're tracking our outcome data because we want to be able to say, "We're not just talking the talk, we really are changing patients' lives." These are our numbers today, and they're good, and they're well above the industry averages, but we're committed to getting them higher and higher. This 84% compliance rate, we really want that to be 90% or above. We wanna use the tools and technology that Albert's team has created to be able to feed that information directly to our sales reps, so that they can take these statistics on their patients and patient success stories and go to their doctors and go to our hospitals and show them that we're making a difference. It's not that the patient's using the machine 90% of the time. It's that because he's using the machine 90% of the time and feeling better, and we got involved earlier, he's not just sitting at home in his recliner all day. He's getting out of his house. He's going to pick up his grandkids from school, taking them to get ice cream, going to their soccer games. That is living versus existing, and that's what we're doing here. Every time we bring on a new patient to our company for non-invasive ventilation, we ask them their goal. This is an important part of our process. Not necessarily their healthcare goal, their personal goal. What do they wanna be able to do when they feel better? A lot of times it's something really simple. Maybe they just wanna be able to get themselves dressed on their own, make their own breakfast, be able to check their own mail, things that we take for granted. Maybe it's something bigger. Maybe they have this big dream trip that they're hoping one day they feel well enough to go on. Or maybe, like the patient I'm about to share with you, they just wanna be able to walk their dog again. We're gonna play a video for you. They say, "I don't know why I coughed. I was doing that." I said, "I merely coughed to see if you were listening." It started, and it was good. It was like a burst of fresh air. They were very efficient, which did surprise me because efficiency always surprises me. I felt right from the beginning, it did make a difference. The next day, I was feeling clearer in the lungs, and I was surprised by that. I can write and work while I'm using it. Looking forward to feeling a little bit better every week. I would want to say thank you. I've been very impressed by the service, the rapidity of the service, really. Quick and so solicitous. To me, it's been a major comfort because I feel as though you're standing there behind me. That's a good feeling to have, that somebody's there behind me. Stories like that are what keep us all going because this is what we're doing here. Now we're gonna talk about technology. We provide our reps with tools no one else has. We know this because when reps come to us from other companies or through acquisitions, they're shocked. They've never had access to patient information the way that they do at Adapt. The OTL has really been our secret recipe for many years for this, and it really gives our salespeople a competitive advantage. When I'm out riding with reps, spending time in the field and talking to doctors all the time, I can tell you no one has access to real-time patient information like our salespeople do. It's very impressive to our accounts, and they use it to be very helpful to them and to be a resource. The OTL ties in really closely with our digital ordering and e-prescribe goals. The number 1 problem that our doctors have is documentation as it varies from payer to payer, and digital ordering solves that problem. It's good for everybody. It's good for us because we get accurate information in our system faster. We can process the order faster, get the patient set up quicker, our ultimate goal. It's good for our doctors and our health systems because they have visibility. They know where the order is every step of the way. They see that we've processed the order, and the patient's gotten the equipment, and they can see how quickly that happened. It's best for the patient because the patient gets set up quickly, and then they can start using their therapies and benefiting from them. One feature that I wanna share about the OTL that's my personal favorite and really impresses our referral sources but also the start of our patient satisfaction success is the on-the-way delivery feature. Albert mentioned this briefly, but picture your grandmother. She's at home alone, and she just found out from her doctor that she's going to be getting oxygen. She's at home anxiously awaiting the delivery of that oxygen. With us, she knows exactly what to expect. She receives a text letting her know the estimated time of arrival of our service tech and that it's gonna be Dave and Dave's picture. It's like Uber for oxygen. She knows exactly when he's coming, who's gonna be at her door, it immediately puts her at ease, and that's the elevated service that we're providing. That's what we're teaching our reps to go out and share that message. We'll also talk about ARM, so AdaptHealth Referral Manager. I was a rep in this industry for many years, and I know personally how challenging it is to keep up with everything, all the patients, all the orders, all the documentation for all the accounts. I used to jokingly say that I dreamed of a day where, as a rep at our company, I could open up my phone, see that today is Friday, and that I have 18 accounts I need to visit and every single patient that I need to follow up on, every order, every documentation, anything that I need to do to be more efficient. Thankfully, Albert and his team have created that for us in ARM. We needed this because we needed to be more productive, we needed our reps to be more organized, and we need them to move faster through the day. When our reps can move very quickly through the day, they can cover more area, they can touch more referral sources, help more patients, and make a bigger impact. We highlight the importance of our training program because we know we're different in the way we train our employees. We invest a lot in our training program because it works. We bring people together from all over the country to one place, so they can see the big picture of what we're trying to accomplish here. Every time, they leave feeling proud to be part of AdaptHealth. That's the commitment that we need from our reps to go back to their local markets that they know better than anybody, so that they can go make a bigger difference there. We have a few strategies to continue to grow. First one's driving new referrals. Today, we get business from about 70,000 primary care physicians and 70,000 specialists, and there's a little over 1,000 health systems that we can partner with. We feel like we still have a tremendous opportunity to further penetrate the market with the products that we already provide today and as we continue to add more high-quality products to our services. Then again, continued education of our physicians, mainly our primary care physicians. This has always been a big focus for us. It will continue to be a big focus for us because we know if we get the patients on our services earlier, we can keep them healthier longer. There's still so much more we can do for our 3.9 million patients that are on service today. Many of them, again, having multiple conditions and needing multiple of the products that we provide. We want to extend more of our services to our existing patients and our existing referral sources. Next up, of course, is cross-selling. Cross-selling has always been a challenge. It's one we're certainly up for, and we're going after because we recognize the opportunity. With our HME reps already having relationships with 70,000 primary care physicians, we know that's the place to start. We've already started this. I've been part of a lot of these conversations with our doctors, and they're just thrilled to hear that we're gonna be adding more products and additional products that we can provide for their patients. There's a lot we're gonna be able to do with this. Everything we do is in an effort to change more patients' lives. We realize the better job we do taking care of our patients and the easier we make it for our doctors and our hospitals to refer to us, the better we do as a company. That makes us more and more committed to our patient-first approach. We've invested a lot of time and effort and money into the people and the processes and the tools and technology that have gotten us to where we are today, and it's served us very well to date. Now we're in the best possible position to continue to perfect what we already do and continue to expand, but most importantly, to continue to take more and more patients every day from just existing to living their best lives in the one place they wanna be, their home. Thank you. Next up, I'm gonna invite Shaw. Thank you, Leila. My name is Shaw Rietkerk, and I lead central operations for AdaptHealth. You've heard a lot of great information this morning on multiple components which drive AdaptHealth and make us the company that we are today. What I wanna do is actually take you through a journey of our tech-enabled intake process and revenue cycle workflows that drive the better outcomes for the patient, let us expand our resupply revenue and fuel growth for the organization. Let's start at the beginning of the process, which is the referral. e-prescription is definitely the top way to get an order today, not just for AdaptHealth and HME, but healthcare in general. It's a higher quality order. It requires less touch points back to the physician and allows you to expedite delivery of that service. Adapt was a pioneer in delivering and implementing, e-referral or e-prescription into the HME space, and we continue to be the leader in driving that across the industry. EMR integrations, fax. Yes, today, there's still faxes that come in, also are part of the process, and we have custom-built technologies around those as well to drive the same high quality level of that order and move it quickly into the process. As we move into the process, eligibility becomes the next big part of the workflow. It is critical in the beginning part of the process to understand do we have the right payer, the right plan, and do we understand reimbursement for that service? Part of that reimbursement is what is the patient's responsibility. We need to engage that patient early in the process, let them know or understand their responsibility, and complete that process prior to delivery. You want delivery of that service to be all about the patient, not about the billing, not about what your payer is and trying to get this after the fact. You need that delivery to be patient-centric and drive them to that service. We've heard a lot about OTL today because OTL honestly is a game changer for us, and it's a game changer in this industry. When you look at the delivery from a perspective of the patient, we have that pre-delivery communication to the patient so they know who's coming, they know when they're coming, and what to expect. Once the driver is there, the technician is there, it also drives that patient engagement experience. It ensures that they're getting the proper education, the proper support on the therapy that's been provided. It ensures that we have compliant documentation to bill for the services provided. It also drives the communication methodologies moving forward past that visit. As that technician leaves the patient's home, they know how to communicate with AdaptHealth. Once the technician leaves, then it also allows that patient to provide feedback on the services. Good or bad, we take all the feedback to heart. That is what drives the improvement and as we go through the process. Once the order has been delivered, we look at claims submission. We have custom-built technology that looks at every claim prior to being submitted to the clearing house. This monitors payer rules. It monitors rules by product, by patient type, by service orientation. Through that whole process, this engine lets us know that we are delivering a clean claim to the clearing house. AdaptHealth has less than a 1% rejection rate on our claims. We're very quick to get the claims out, and we're very fast to get paid for those claims. However, just like any other organization in healthcare, AdaptHealth is not immune to payer denials, slow-paying payers, missing payers that, you know, claims just happen to disappear. Through that process, we have a custom-built workflow for the back end with our revenue cycle management team. That workflow assigns the right claim to the right person based on their skill set and how quickly they've been able to resolve claims and efficiently they've been able to resolve claims in the past. Through that process, we're able to efficiently resolve that claim and get it through adjudication. While adjudication may be the end of the journey for that order, it is not the end of the journey for the patient. It's just the beginning. Using our smart logic, we then move the patient into the Adapt ecosystem. That ecosystem could be PAP adherence for a PAP patient. Maybe clinical follow-up for a vent patient, maintenance of support for other respiratory patients to ensure their device is always working properly, or it moves them into the ecosystem for resupply. Resupply is a big part of the Adapt organization, and through that logic, it drives those patients into the resupply for contact at the appropriate time for follow-up. Looking in general, the tech-driven workflow that we have today are patient-centric processes that are built around that workflow, and then our RCM expertise has driven us for the success that we have moving forward, both in driving patient outcomes, growing resupply revenue, and fueling growth for the future. With that, I'm gonna turn it over to Anton for us to start our first Q&A session. Thanks, Shaw. Great job. I guess Steve, Leila, Josh, Wendy, if you could join us up here. Albert, you too. Yep. We'll take, you know, we've probably got, call it 20 minutes. We'll leave a little time for a break. Of course, if you could hold your financial questions to the second period, that would be great. Yeah, Dave, go ahead. Yeah, good morning. David MacDonald from Truist. Two quick questions for you. First, just on the value-based conversations that you're having with payers, are there any additional disease states or services that they're kinda consistently asking for where we may see some expansion? Then the second question is, given everything that's happened in the last two years and some of the market pressures that clearly lean on the smaller guys more, has there been any nuance change in terms of how you think about that $300 million of free cash over time and, you know, competitively leaning on folks as opposed to deploying capital to do acquisitions? Thanks. Yeah, sure. I'll address the value-based question, then we'll turn it over to Steve. You know, a lot of our conversations with payers today, you know, there's a lot of buzz around value-based care in the marketplace. I personally think, and from what we're seeing, it's relatively early innings in terms of where this is gonna go. I think most of that's driven by technology evolving. We're seeing a lot of activity on M&A and companies trying to position theirselves to get into the home more effectively. I'll cover that a little bit more about why we feel we're positioned well, a little bit later. I think the reality is the disease states that are obviously immediate focus for a lot of payers are the ones that are driving the most overall cost of care, particularly, you know, diabetes, CHF, obesity, COPD, sleep apnea. You know, we'll call these patients the frequent flyers of healthcare dollars, and they're consuming, you know, 80%+ of the healthcare dollars that get spent in this country. You know, payers are really zoned in, and a lot of them have programs, you know, case management programs and other things that they're dabbling into to try to drive down costs in those disease states. What we feel is missing is really that patient touch point and relationship and connected technology within the home that really can transform the home into a much more efficient cost of care and also patient preferred, but also really keeping folks as technology continues to evolve out of the hospital in the home. We're really having conversations around our core disease states, and we'll talk a little bit more about those that we cover and the relative census and large amount of patients that we have. That's kinda what we're seeing now. Steve, you wanna... Yeah. Dave, thank you. Yeah, we expect cash flow to increase pretty dramatically in 2023 and then even more in 2024 and then more in 2025. Our plan today is to use that cash flow for acquisitions, exactly to do that. Because as earnings go up, you know, our leverage will come down significantly. If we keep in this process of targets, you know, our leverage will get down in the low twos to EBITDA, and we can use that cash for acquisitions. Oh. Good morning. Thanks for having us today. Brian Tanquilut from Jefferies. I guess my question is for Leila, since Anton will keep the financial questions for later, right? There you go. As we think about the growth of your sales force, I mean, what are the plans that you have in place in terms of sales force growth? Then maybe tying it to Josh's comments earlier about productivity per employee, what does that look like, and what are the challenges that you're seeing now in terms of hiring and, you know, the kinds of salespeople that you're looking for? Mm-hmm. How hard or how easy has that been for you guys? The team we have today, we've got about 650 reps. We have a mix of really experienced reps who've grown up in this industry like I have, and then a lot of the open positions we have, we're filling with new college graduates. Those experienced reps serve as mentors for these new graduates that are young and hungry and wanna get into healthcare. We really haven't had any challenges hiring for sales. We have very few open sales positions at any given time. They're filled very quickly. The real goal is for our reps that we already have to be able to do more. That's why we wanna use ARM and some of these other technologies that we've built for our reps, so they can cover more area. We want our reps to be able to expand with the reps that we already have. Yeah. Let me add to that, you know, 'cause I've been around for a lot longer than Leila. Historically, every company would try to hire an experienced rep, and that's all they look for. They already got relationships, they got the stuff, they get to going, you know, fantastically. So that's how I would always try to do it. Leila, several years ago, started hiring these young, inexperienced, didn't know squat about our business, and trained them and went out there to do that. Last year, in our sales awards presentations, the vast majority of the award winners were young reps with less than two years experience. It's incredible. So the world has changed, and the interactions of what the doctor's office is looking for has changed dramatically over these past three or four years. They're looking for reps that are very helpful, whoever can help solve the problem faster, not necessarily who's been around the longest. Pito? Thanks. Good morning. It's Pito Chickering in Deutsche Bank. One of the competitive advantages for Adapt since I've known you guys has been using technology and using technology to create better patient satisfaction as well as better margins by just using that technology. Obviously, when you acquired AeroCare, you've sort of gone deeper within that technology, and you know, it's been pretty effective. I guess the question is, a lot of the technology you guys first used, well, it came off the shelf. Are you seeing your competitors begin to react to what you guys are doing? Does it narrow your competitive advantage? Well, certainly on the e-Prescribe front, you know, AdaptHealth and AeroCare are by far the leaders of those. As we get those doctors to be able to use e-Prescribe, they can pony right on back, those, you know, our competitors on any of those doctors, they can do that. It certainly is benefiting them, but we're so far ahead of them with all the rest of our referral sources that I think they'll be constantly behind. On the other technologies, let's take the OTL. They're all trying to do stuff, but most of them have legacy systems, AS/400 systems. At best, they're putting this, you know, phony technology on top of old technology. You know, they just got a long ways to go, and we just think that we just gotta keep innovating and keep progressing. We can't stand still, and we won't stand still. As long as we don't, we should have continued that technology advance. I mean, if your large competitors historically have been very tech, you know, sort of behind where you guys have been at DOS-based systems. Have you seen them invest a lot in technology as they've watched your success at this point? Yeah, no question. They're trying. No question. Albert, that sounds like one you might not be afraid to take, too. Yeah, I mean, it's nuanced a little bit. When you look at the technologies, I think you started your initial question with some off-the-shelf sort of things. That's tying back to when I was talking about the typical silos. There's some tools out there that may not be perfectly built for our domain, but that you can buy and use off the shelf and say, "Oh, we have this great new technology. It's gonna change things." They talk about things like APIs, and you can have access to the data and data liberation and data liquidity. You have to think of an API effectively that most of the software providers will offer. That's like drinking through a straw, okay? What we've done with the data layer that we've built is we have a firehose. When I talked about the concurrency of data, the accuracy of data, it being available when and where you need it, I'm able to get that to one place, you know, usually within a 2-3 minute delay of the business. You try to do this through an API. It becomes very, very labor intensive to keep everything identically in sync. Now, APIs are great. We use them for an awful lot of things that we do. You know, just, you know, think of that using a straw versus a fire hose. Building off of a legacy platform, and again, going back to why did I come back here after being in a different industry and looking before. I had a whiteboard to do this. The technical debt piece, when I mentioned that is the difficult piece, technologists typically and business people across industries hand-wave that. "Well, we have this old stuff. We're gonna keep it around for a while." That's the worst thing you can do because the hardest thing about being a technologist is identifying the things that you need to shut down and shut them down today and not be afraid of that people are gonna scream at you because they are. You know, "We need this. We can't do it." No, we don't, and it's going today. Turning things on is really fun. You go to the store, and we're buying new stuff, and I got a new puppy, and I'm bringing it home. That's a lot of fun, and that's what people like to do, and it's easy to sell. When you have to deal with the difficult decisions in life, end of life, whether it be a computer, a system, a process, the end of life process is not fun. It's really important. I think we have done a good job of that. Great. I think Whit's got one. Yeah. Hey, thanks. Steve, just back to the merger of AeroCare and AdaptHealth. You sort of referenced early in your introductory comments that you've extracted the synergies, but given the challenges with the supply chain, et cetera, that you haven't had the opportunity to really smash together best practices. Can you maybe elaborate a little bit more on where you are in some of those initiatives, what you're doing, any way to perhaps quantify the success that you're seeing at this point? Yeah. They’re a lot of them is in the RCM function, and that's spreading that RCM, the process that AdaptHealth did across all of the locations. RCM really starts in the branch. Now these AeroCare branches are part of this RCM system. They now understand it better. Our DSOs are dropping, our holds are dropping. We're collecting cash faster than ever before. Our collection rates are improving. That process is just in the beginning stages of that. Within that, too, we were very good about auto pay, getting patients on auto pay, where they would pay their co-pays automatically, you know, through a credit card on file. That process now is being put into the AdaptHealth locations, and that's picking up. Then with PAP compliance, you know, we had a difference in PAP compliance. Ours was better, but now we're starting to merge those processes together. Within this, issues that we had with Philips, it kind of derailed that. Now we're getting over that. Now we can put out there and get those patients on set. That's three. There's probably a half a dozen more that we could talk about that we're gonna try to get to. When you look at that, we see that as 10s and 20s and 30s of millions of dollars, each one of those things that I just described. I think Matt had one in the front row, and then Joanna. Joanna? Hi, Mathew Blackman from Stifel. Leila, you mentioned the cross-selling opportunities, but you also called out challenges that need to be overcome. Can you just give us a sense of what some of the biggest challenges are? Are they structural or technological? I don't know if Steve or Josh wants to chime in as well. Any thoughts there would be helpful. Yeah. I'll be happy to take it 'cause I've been frustrated forever. It starts with the rep. If you're going to a doctor, the HME rep has a relationship with the PCP doc, and Rodney's team over here wants to sell in diabetes to it. That HME rep goes to that doctor. Well, they're not in control of everything that can go in there. Am I gonna go try to sell something into this account that's gonna disturb my account and my honey hole, if you will, and my relationships coming out of there? They're very hesitant to do that. But what's been able to make them less hesitant is the build connectivity that we have and how they can get instant looks of how what's happening on the diabetes team. They don't have to understand everything that is required for a diabetes order. That's what we had to do in the past with cross-sell. Today, they just have to be able to introduce diabetes to that PCP. Now, that PCP is gonna make one or two decisions on the patients, assuming that they're fond of it. One is, "Okay, I wanna get CGM on my patients. Which patients qualify? Help me get to that." Then we can put the team in place to it. Or they might say, "I really don't wanna do this, but you know what? The CGM is important. Let me refer it to the endocrinologist." That endocrinologist has a relationship with Rodney's team. Almost every endocrinologist has some relationship with our diabetes team. That's the secret now. With cross-sell, you don't wanna have to force your people to become experts in everything. You wanna be them to be introduced and let it take over. I think Joanna had one in the front row here. Thanks. Thank you. This is Joanna Gajuk with Bank of America. This question coming back to value-based care in two parts, very quickly. One, do you need additional investments or anything that would allow you to grow it faster? Second, you know, are actually payers pushing you forward, or is it actually you actively going out and pursuing these opportunities with payers? Sure. Yeah. Thanks, Joanna. I'll cover some of that a little bit more depth, a little bit later this morning. The short answer is a lot of the value-based care evolution is going to happen through technology, mainly as kind of an ability to take out administrative costs for the payer, able to give them better data and insight into where the order is, and overall just provide a much more seamless connection to the payer, which will allow us to drive more volume and growth within the wallet share of specific payers. That's kind of short answer to your first part. Second part is it's both. Like, we're having conversations with payers that don't wanna deal with the fragmented HME marketplace. They're not so fond of some of the intermediaries that sit between HME providers and them as kinda TPAs or quote-unquote network aggregators in that middle level between the HME provider and the payer. I think a lot of that is gonna get more traction. Again, a lot of what we're doing on our existing technology investments is going to be focused and is focused around this kind of payer connection. We're gonna see more of this. You know, we have the scale, we have the patients, we have the broad product portfolio, we have the visibility and the technology. Now what payers aren't realizing is, "Wow, we didn't realize you guys were so big. We didn't know you had this technology. We didn't realize you could address these pain points for us." That's step one. Step two is saying, "Okay, as our data collectively gets better," and a lot of payers, you know, talk about data, but the reality is that for data to be better and for all of us to understand, okay, how is this patient doing? What's their disease state progression? How many touch points did we have with the patient over the last few days and weeks and months? Where are they at? What's their blood sugar level like? Are they sleeping? How's their COPD being managed? We actually have visibility into that today. This is not something we need to do. This is not a moonshot. This is really just about us taking that and packaging it for a payer, for a payer to be able to say, "Wow, I can do so much more with a lot less complication, a lot less admin costs, and overall lower the cost of care." 'Cause at the end of the day, in a recessionary environment, inflationary environment, that is going to get some real traction, we believe, over the next, you know, 12, 18, 24 months in terms of being able to bring down the overall cost of care. I think we have one more from Pito here, and then I think Brian's got one back there. Probably grab it. Sorry. This is actually a compliance question for Wendy. This sector historically has had a lot of issues with compliance. We've seen OIG reports over my lifetime around issues around compliance. Obviously, we've never seen any issues with you guys. Can you sort of refresh us on how many audits you guys sort of face a year? What's the success rates of those audits, the process you have to go through those audits? Have you guys ever had a whistleblower complaint? And then what keeps you up at night as a compliance officer? Okay. What was your second to last question? Have you had, like, any whistleblowers? Our audit environment shifted significantly because of the pandemic. What we saw was a pause in governmental audits from Medicare and all of their contractors. They paused everything for about a period of 6 months or so. When they resumed our audit activity, it is not yet back up to what the normal levels were pre-pandemic. There are some product lines that they are staying away from, and I believe that's because the public health emergency is still ongoing. For example, respiratory, oxygen, CPAP, you know, they're looking at it from a program integrity standpoint. As far as routine widespread audit activity, we're not experiencing that right now. They're looking in other lines that they typically didn't look at before. To talk about sort of how our audit activity has grown, it's difficult right now. I think that the PHE will probably see an end to that soon. My expectation is they're really going to ramp- up afterward. Then probably 2023, we'll have more, you know, visibility on what our new normal looks like from an audit activity standpoint with the AeroCare and the AdaptHealth organizations merged together. Pre-pandemic, our success rate was about 72%-74%. You know, I don't know that there is anything that keeps me up at night. You know, there's a lot that we have to, you know, have fall under our scope of responsibility. There's a lot that we need to be ahead of. I'm confident that over the years, we've assembled a team, we have great resources, we have a great partnership with the business. I mean, all of us working together, we sort of navigate that curve really well that lets me get a few hours every night. One more for Brian. Well, you asked about, you know, whistleblowers, and so we disclose our inquiries by the government. Christopher Joyce, you know, I don't know whether they're a whistleblower or not, but we get inquiries from the government all the time, and they're disclosed in our 10-K. Yeah, I'm sorry, I forgot to address that for you. That's all right. What I wanna add on to that is, our hotline is an independently managed hotline, and we promote that throughout the company. There's company-wide postings. It's in all of our compliance communication, all of our training. Basically, you know, we're telling the business, "If you see something, say something." We do conduct, on occasion, compliance exit interviews just randomly, just making sure that the individuals haven't seen something in their time at AdaptHealth that, you know, has them concerned and that they're leaving with. Also making sure that they know how to get in touch with us after they leave if they do think of something. I think, you know, we really have established a very open line of communication with the business, and I think that helps sort of, you know, drive down that potential for people feeling like we're not doing something right and, you know, we're not correcting it and going to talk to someone else about it. Next question is for Shaw. As we think about, you know, the potential for a recession coming up, I mean, how are you thinking about patient pay and what are the trends that you're seeing there and, you know, how are you preparing for that? Just in general, in healthcare, you're seeing a trend of more patient responsibility from a co-pay and deductible perspective. We've seen that inch up year over year, and I would expect we would continue to see that. What we've done specifically at Adapt is become more proactive in that process, more proactive to require that payment upfront versus billing after the fact. I think we see that shift in healthcare all over. You can't go to the doctor today without paying your co-pay before seeing your doctor. That shift in taking that ownership up front has really helped us to increase those collection rates and patient pay and let us stay ahead of that curve. Yeah. Brian, I don't think we'll see a decline in our patient pay collection percentages, but what we will see a decline in is refusal of taking the service and the equipment. And that's really where we see it affecting us, you know, probably the greatest as recession comes along. Thanks, guys. We'll take a short break now. Running a little behind, but we can catch up if everybody keeps it tight, and we'll get back in here at 11:00. Thanks. Exactly. That's what happens when you get everybody together again. Still got a few stragglers outside, but I think we can probably get going if we need to. If there's anything we need to get the webcast of them, I guess it's still going. Yep, I'll admit that 11 was probably ambitious, but we do have a tight schedule and a lot of material, so we'll get through it though, and we'll make up for it. Moving on to the second section here, the good news is you already know this guy, so we don't really need to do any introduction. We'll move on to some of the more business line or category sort of discussions with Shaw Rietkerk. All right. Excited to come up and talk again about sleep and respiratory. Two critical areas for us, two of the biggest areas for us in the company from a revenue perspective, and it's how we service the patients in those areas that really count. Let's jump into sleep. What do we do? We actually positively change thousands of patients' lives, new patients, every day by enabling them to have a good night's sleep. Thousands of patients. We do it through our strategic partnerships, so through our vendor partnerships, our manufacturing partnerships, so that we're able to deliver on the needs of those patients. We do it through our extensive payer network. Over 2,600 payers that we work with at AdaptHealth today to ensure we can provide those services to the broad patient base. We do it through delivering better outcomes. Delivering those better outcomes, those higher adherence rates, drive that better experience for that patient. AdaptHealth is number one. We are number one in sleep. We are the largest sleep provider in the country. With $1 billion in net revenue and 280,000 patients in our rental census today for PAP, 1.2 million patients into our resupply program. We are by far larger than any other competitor in the market. How do we do it? How do we change their lives? It starts with technology. When we look at PAP specifically in technology, it starts with that patient being set up. It starts with registering that device at the beginning of that setup to not only communicate with the patient, so the patient sleeps that first night and sees really how well they did. It also goes to the provider, so that provider who referred that patient to us, that patient's clinician, also gets that information, so they can see how their patient is doing on therapy. It also goes to our sleep coaches so that we can start that process of 90 days of adherence monitoring to drive them to success in that therapy. Patients today, and COVID drove a lot of this, get set up in different ways. If you go back three or four years ago, everybody came into the office, you sat down face-to-face, and that's just how you set up a machine. That's how you got onto therapy. COVID changed that a lot and made it virtual. While a lot of that shifted back into the office and back into the group setting again, we still have to be able to service the patients when in whatever way they need to be set up. With that, we utilize technology now that actually fits the mask to the patient's face. By completely looking at the camera, taking a picture, it identifies the mask with very high accuracy so that they have success the first time, the first night's sleep. It also moves the patients into our adherence monitoring program so that our sleep coaches can start what they do best, which is drive success in the PAP adherence process. We have over 200 sleep coaches today at AdaptHealth. Those sleep coaches live and breathe making the patient compliant to their therapy of PAP adherence for CPAP. With the technology that we have in place today, it helps them do that by telling them which modality the patient wants to be used for communication. How are they doing? Are they answering a phone? Are they responsive to text? Is there a preference via email? It allows us to work and communicate with the patient in a way that works best for that patient. It also looks at their utilization. It looks at their behaviors, and through an algorithm, lets us know which patient we may need to call every single day versus a patient that may need to be called once a week or once a month because you can see how their therapy is aligned. By using that, it allows us to touch the harder patients, the patients that need the most help first and get them compliant, while a lot of patients can get to that compliance on their own because they know how to use or do well with the therapy itself. As a result of that, our PAP adherence is 350 basis points above the national average. When you're talking about thousands of setups a month, that's a significant number of patients becoming adherent into the process. It improves the quality of life, it lowers the cost for the payers, and it also pushes more patients or drives our resupply revenue in that growth into resupply. Let's talk about respiratory. What do we do in respiratory? We optimize the patient's quality of life. We do that because we take a personalized approach to that patient. We look at their lifestyle individually to understand what type of therapy they need. A person may be on oxygen, but oxygen has multiple types of therapy, whether it's a POC, whether it's tanks, whether it's a patient who wants tanks but likes to do it themselves and fill them at home, or whether it's a patient that just uses oxygen at night and needs that stationary unit. There's a difference in every patient and how they utilize the therapy for their activities in life. With that's the first thing we look at from a patient's perspective. We're also a full service provider, so that respiratory patient is not only getting oxygen or maybe ventilation, nebulizer from AdaptHealth, we have the ability to also provide them with the medications that support the devices that they need through our pharmacies. We also have the mobility devices that they need because a lot of them have mobility issues. Diabetes, they can move into diabetes, sleep, PAP, the adherence in our resupply program. Because of being a full service provider, that respiratory patient now is part of the Adapt ecosystem, and we can be that one stop to serve that home care need of that patient. We also have predictability. Predictability in when the patient's gonna get their product. We cover OTL a lot throughout the day because it is so critical to the process of this patient. That patient knows my tanks are running low, I call in, I'm gonna have more tanks there tomorrow afternoon at 6:00 P.M., and Johnny's bringing them to me. It's critical. It's part of their life every day, living with the disease and the therapy around it. We help drive that predictability. We also use tech to drive patients to the right therapy. The right therapy may be nocturnal oxygen. We use overnight pulse oximetry testing in today's market, so we can do the testing with the patient at home, get the results, and then work with the provider to put them on the right oxygen therapy. We're thinking proactively in that process that helps us to drive that. That's also done with disease progression. As we're monitoring the patients and the results throughout that process, that patient may need to move on to a different level of therapy. Through our technology and monitoring in our clinical programs, we can identify that and proactively work with the provider to make those decisions with the patient. We become that patient's connection to that provider from the home care. We're number two in respiratory as an organization, so we are the second largest from a market share perspective. We do approximately $547 million a year in revenue in respiratory, and we service 290,000 patients in oxygen and ventilation on our census today. It's an enormous responsibility and a responsibility that we take very seriously to service those patients. When we look at the difference, the difference comes from the beginning. It comes from monitoring that adherence. It's a, it's a company that takes the clinical portion of this very seriously and driving that adherence to utilization throughout that process. It's intervening. We have, as Leila spoke earlier, a very large clinical team that monitors our patients, that delivers into the home, and we take that intervention to get them compliant on therapy, to move them to the appropriate therapy if they're not on it today, and to work with their physician to help make that happen. We monitor on outcomes, right? Outcomes being hospitalizations, very critical to reduce hospitalizations, and that's what this therapy allows and drives for the patient. In ambulation. Ambulation is so critical when you're a respiratory patient. Steve talked about it earlier with somebody being able to go out and play pickleball at 73 because they can carry their POC with them. The battery beeps, they know they go get another one, plug it in, and they can continue to do that. Your quality of life doesn't have to change because you're on respiratory therapies. It's providing the right therapy that moves for your life or aligns to your lifestyle and what you need to do. Let's talk about some of the priorities to support the growth. We need to continue to grow PAP. Continuing to grow PAP helps us to continue to grow PAP resupply. We need to capitalize on our referral sources for oxygen, which I'll cover in a moment as well. We need to continue to utilize our clinical expertise to drive that growth. When you look at PAP new start setups, there's a backlog today. Getting those setups and driving to there, it's not a hard task. It's continuing to have those partnerships, continuing to drive into the referral sources that we are the provider of choice, and we do that from providing better outcomes for their patients. When they see better outcomes for their patients, that drives them to continue to refer those patients or their new patients to AdaptHealth. It's through our increased adherence rates. As part of that, it's also continuing to look at our M&A and our strategic M&A in these areas. We've seen a lot of growth over the past few years because of this M&A, and it's a continued focus as we grow in these areas. Same with PAP resupply. PAP new starts drive more PAP resupply, of course, but more than that, it's moving into more of an electronic environment for PAP resupply ordering. Today, 47% of our orders are ordered electronically by the patient, meaning we didn't call the patient. The patient reached out, went online, completed the order, and they completed the order themselves. What we see with electronic ordering is the order is generally larger, meaning they've selected more items because they can see what's available to them, and they know what they need. It also happens more often. A patient may not answer the phone the first time you call, and you call again a week later. When they go on an online order, it's instant. Everybody is used to the instant Amazon environment, and this is kind of going online and ordering your resupply so you can have them tomorrow. In this same area of acquiring growth as well. Looking at our M&A strategies from a PAP perspective and a PAP resupply. Oxygen is a little bit different. If we go back to the beginning of COVID, Adapt was a big player at the beginning of COVID to help our referral sources deliver to their patients. Not only because we were able to take their patients and service them on oxygen and ventilators when a lot of other providers were not, we were able to actually service those providers and provide them with oxygen equipment, them with ventilation equipment, so they could service the patients in the hospital. We became the vendor to them. We became the provider in a different way and built those relationships. It's that type of partnership between the health system and Adapt that drives and continues to drive our increased referral growth and how people look at Adapt as an organization. Again, we need to continue in the early intervention, identifying the patients that should be on oxygen therapy, providing them with that overnight testing, and then working with their providers to move that forward in the process. We do that across every region of the organization today, and it will be a continued focus of ours as we continue to move forward. Then lastly, with vents. Vent is a clinical sale. We have a national clinical sales team for vents dedicated to this process. For us to continue to grow in vents, we need this clinical expertise. It's a, it's a tough subject with a patient. It's a hard process. We have also taken the approach of ambulation with vents, so there is portable vents available today in working with our vents patients, so they actually can have a portable vent and have an ambulation as well and movement outside. Then the disease state progression, so continuing to look at those patients that are on oxygen therapy today that should be on a vent for therapy and working with their provider. To close out, we have a lot of growth ahead from an organization. We have the technology that drives it from an intake process. We have the patient-centric processes that help to drive it from patient care. We have the revenue cycle processes that help to drive it from an organizational and a revenue perspective to be well positioned as we continue to grow. With that, I'm gonna turn it over to Rodney, head of our diabetes division. Oops. Thank you, Shaw. Good morning. Thank you for coming. My name is Rodney Carson. I am responsible for the AdaptHealth Diabetes Division. I appreciate the opportunity today to speak about our business, and I think we have a very exciting story to tell. When I think of our business, 3 points come to mind. One, I think we all realize that diabetes is a costly disease that is rapidly growing. Secondly, the AdaptHealth Diabetes Division, our business, has attained scale, and we're ready to grow and drive organic growth. In less than 2 years, we've become the number 3 player in the market. Rest assured, we're not content with being number 3. Finally, our continued focus on process improvement and technology investment will preserve and enhance our relative market share going forward. This slide speaks to the enormity of the diabetes market. 37 million Americans have diabetes. That number has tripled since the year 2000. Diabetes and disease complications of diabetes represent 14% of U.S. healthcare dollars in an aggregate about $327 billion of annual medical cost. Many diabetics have one or more comorbid conditions. Many of them are listed on this graphic. They include urology, ostomy, oxygen, sleep apnea, wound care, incontinence. I think it's important to note that our core HME business and our very considerable supplies business, which does report to me, can address all these needs. This clearly creates a number of attractive cross-selling opportunities. What's driving the growth of the diabetes market? Aging population, clearly a huge driver, and I think folks have spoken to the increased number of Medicare beneficiaries in previous presentations. The increased prevalence of obesity in the United States, the increased coverage of Type 2 diabetics, and the increased pace of technological innovation. These are all important drivers of the growth in the diabetes market. AdaptHealth is scaled and ready to drive non-acquired organic growth. This is where we're at today. $665 million of diabetes-only revenue based on Q2 2022 annualized. Approximately 250,000 patients on census. We have 93 dedicated diabetes sales reps in the marketplace. This is the largest in the industry. Our product mix, 76% of our current product mix is attributed to continuous glucose monitors, 24% all other diabetic products, and I would add that this 24% is heavily dominated by insulin pump and related disposables. We have a nicely diversified revenue mix, as you can see. 49% governmental, 45% commercial, and 6% pharmacy. What will help us drive growth? First and foremost, we have very deep relationships with each of the leading diabetes manufacturers. We have weekly calls with each one of them and quarterly business reviews. We have a broad product offering all diabetes products in all product categories. I will mention that unlike many of our smaller competitors, we have direct contracts with each of the manufacturers. We do not have to rely on wholesalers. As I mentioned earlier, through our core HME business and supply business, we have access to products to address the needs of polychronic patients that have other comorbid conditions. We now have a customer success video that we'd like to play. I have this very distinct memory of him laying in the bed and looking at that tiny little body and just thinking, "How do I ever send this child to college?" We were thankfully able to come in and speak with a pump specialist who had no skin in the game for one pump over another and just talked us through all of our options, the pros, the cons, and helped us to make that decision for what pump was going to be the best for our child. The CGM just absolutely was a game changer for our family. I feel like it's a convenience. It's so nice for our family that it's just auto-ship. We get the text message, "Are you ready for these supplies?" "Yes." Boom, it shows up at my house. The customer service has always been a wonderful support for us. You know, if we did have a question or any sort of concern, it's always been taken care of in a very prompt manner. I would just like to say thank you for giving us that hope and for making our lives safer and manageable and to make us know that our children can just go out and live a normal life, thanks to the technology we have available. They've just been along the journey with us the whole time. Nice patient testimonial, one of our patients from Nebraska. Okay, let's talk about how we drive growth and benefit from operational efficiencies. What's the avenue for future growth? Drive non-acquired growth and operational efficiency through standardization of processes and technology. What does that really mean? That means putting all of our acquired entities on the same operating system, the same telephony platform, and the same multimodality outreach program. This is absolutely critical to creating operating leverage and synergies amongst all the acquired entities. I must say, we're not 100% there, but we've made tremendous progress, and we've noted considerable operating efficiencies from the accomplishment of this objective. Both on M&A, we bought and integrated 7 diabetes-specific companies in less than 2 years. I think that's a fairly impressive feat. Three, leverage diabetes as a gateway for outpatient monitoring. I'm not gonna steal any of Josh Parnes's thunder. Josh, our president, will be speaking to this in a few minutes. Key initiatives to drive organic growth. As we mentioned, we have multiple cross-selling opportunities within our universe of 3.9 million patients. I think this is a... While Steve mentioned it's not gonna be fall out of bed easy to execute, I think it is a huge opportunity that we're poised to really make tremendous progress on. Salesforce expansion. We have the opportunity, and we'll talk a little bit later about our HME reps that have been trained to market diabetes products and are actively marketing diabetes products. But we also have the opportunity to add diabetes-specific reps in territories that are current white space, where we have little or no presence between the combined HME and diabetic sales force. We also have the opportunity to grow our Medicare share. Quite frankly, Medicare has not been a high focus for our combined platform. Certainly with the aging of America, the demographic wave that is here, we see that as an attractive avenue for future growth. We've talked about how do we leverage technology. Albert spoke at length about the number of apps. He talked about myAPP, our patient app. The gateway to driving patient engagement through technology is really two-dimensional. One, drive e-Prescribe. If you were to ask any manufacturer and even our competitors, they would admit that AdaptHealth was the pioneer in diabetes for electronic prescription adoption. It frankly exceeded my expectations. I think we have a number of people in this room, including Josh, Steve Feldman, that were really pioneers in the design and adoption strategy for us. The other point that I think frankly differentiates us from other companies in our space is our multi-channel outreach campaigns. We don't rely simply on the telephone. We don't rely on text messages. We have a multimodality capability in that basically the key is understanding what modality each patient prefers and then sticking to that mode of contact, and we found that that's had a, you know, huge positive impact on things like reorder rates. Operational efficiency. It's not just getting people on the same platform, it's getting people to adopt a similar and frankly identical workflow. As you might imagine, buying seven companies in less than two years, not only were those companies not on the same operating platform, but many that were on the same operating platform had different workflows. For example, one company might have 72 WIP states, another might have 56, so the workflow has been organized differently. The other thing that we're doing with, I think a fair degree of success, is we're re-regionalizing the front-end intake process and centralizing the back-end reorder in RCM platforms. If I had more time, I could go into the rationale there, but there is a fairly compelling value proposition in doing each of these. Okay. What's our strategy for maximizing lifetime patient value? Quite simply, how do we get more patients? How do we get more orders per patient? How do we get more dollars per order while simultaneously improving health outcomes and driving patient satisfaction? The key drivers here, expand our referral base, deeper penetration of our existing referral base. Let's get more from the same referral sources. Refill optimization. I think we do a particularly good job on refill optimization, but I still think there are opportunities for improvement on this front. We need to do a better job, and we have opportunities for improvement to better cross-sell BGM, CGM, and pump patients. Every pump patient we have should have an attendant CGM. Everybody on BGM that qualifies for CGM on a medical necessity basis should be getting that product from us. Of course, we continue to expand our payer contracting network. Absolutely critical to move up to number two or number one. Okay. We've talked about. We've bought seven separate diabetes-specific companies in the last two years. We need to leverage this track record of success. We've added $450 million of LTM revenue via acquisition. I think it's important to understand some of the criteria selection, some of the attributes we look for when we evaluate a potential target. These would include things like payer mix, complementary contract coverage. Do they have contracts in a certain geography that we don't have? Geographic density. Basically, what kind of moat do they have relative to competitors in that marketplace? These two are huge. Product cost synergies. Most of the companies we have bought do not have direct manufacturer contracts, so there's a cost of goods arbitrage attendant with those acquisitions. Most don't have the technology we have. Many are doing manual outbound dialing, have no multimodality outreach capabilities whatsoever. Very, very compelling. Of course, you know, as you might imagine, there is a compliance component to this. Wendy and her organization does an exhaustive, you know, review of charts and chart notes to make sure there are no regulatory or compliance issues. We also require a third-party QOE to evaluate the quality of earnings. I think we've got that down pretty good. Tying this all together, integration of workflow, operating systems, outbound patient outreach, absolutely critical to our ongoing success. In conclusion, we compete in a large addressable market that is growing rapidly. I think we all realize that. We have the largest sales force with respect to a diabetes-specific sales force. We also can leverage Leila's organization of 600+ HME reps that are in complementary markets. Again, all have been trained in diabetes and all are actively selling diabetes-related products. Finally, through increased process standardization and ongoing investment in technology, all the things that Albert spoke about at length, we think differentiate our diabetes capabilities relative to competition. Thank you for your time. Josh? Thanks, Rodney. All right. There's a lot here, and I know the hour is late. I wanted to introduce what it is that we're doing on AdaptHealth 2.0, what does it mean? This is really gonna be something that we're gonna be talking about, not just today, but on a go-forward basis. I wanna just really get everybody up to speed about the pillars and how we're thinking about it, and where we think it goes from here. What is AdaptHealth 2.0? We spent a little time talking about what we've built, right? The platform, the large presence in many disease states, clinical infrastructure, 1,000+ professionals and clinical professionals that we have working for us. Everything from respiratory therapists to path technicians to nurses. Scale and products, payers, disease states, geographies, 2,500 payers that we contract with directly plus. We spent a fair amount of time today talking about a lot of the technology that we've built and are continuing to invest in. How do we move from best-in-class technology to really change the model and transform the home with technology into really a place of outcomes, healing, and most of all, patient preference and comfort? Healthcare, as we all know, is moving into the home very quickly. Technology into the home is also evolving rapidly. The home, we all know is, it's well documented, is a solution to temper rising costs of hospital and institutional care. I mentioned before about inflation and recessionary environment. Cost is going to be more and more of a conversation, a topic, a goal that healthcare in general in the United States, the continuum of care, what place of service is more efficient, where do patients wanna be? Really, the answer is going to be in innovative home care models to really drive aging in place, dealing with the baby boomer population as they get older in a much more cost-effective and patient-preferred manner. How are we at Adapt positioning ourselves, and what do we currently do today, and what are we going to do in the future to drive a better model? You know, there are a lot of ideas and, you know, obviously the foundation is important, and we spoke about that. There's a lot of models out there that position themselves as potential breakthroughs in home health and home health technology, and many of them don't really go anywhere. When I look through, I mean, I'm sure we all think about why some things are successful in the home. Some of the things that are gonna be the next best thing never really make it. I think of three common denominators of why they don't work. To me, and I'm sure there's more, a lot of them are not cost-effective, right? They need huge investments in patient acquisition costs and technology. They need, you know, how do we get to so many millions of patients living in disparate locations and houses and settings, and how do we effectuate and drive change in a lot of those customers' homes? I'd say that's one issue. Second issue is a lot of these things are not scalable. There's only a certain amount of people in this country, and we're already seeing this challenge, of limited amount of nurses, caregivers, that are able, trained, willing to be able to take care of us and seniors as we age in our homes. That's not a scalable solution. Clearly, technology has to be part of the solution. To me, the biggest, I would say, shortfall of some of the current models that are out there is that they don't have an existing and trusted patient relationship, with the patient in the home. You could have the best technology in the world, you could have the best solution, but there's a bridge the gap between how do you get it into that patient's home? How do you get the patient willing to try it? How do you get them used to the change that's gonna be involved in adopting something new? How do you ultimately drive a better outcome without having a patient relationship? Our foundation that we spoke about broadly today really addresses these three concerns. Cost-effective, scalable technology, and establishes a well-established, trusted patient relationship that we have with our patients. I'll talk a little bit about more what that exactly means. Before we discuss the three pillars, a lot of what we're doing today and have already done is really about broadening and deepening what we feel is super important is our pipes in the home and our relationships to the patients. Almost 4 million patients today and growing. Physician relationships, payer relationships. When we enhance our relationships with all these stakeholders, we sit at a very unique crossroads between the payer, the patient, and the physician to be able to bring them together without this costing a tremendous amount of money. It's really about leveraging pipes that exist in a little bit of a different fashion. How do we do this? How do we leverage these pipes into the home, and how do we feel that what we're gonna do is gonna be something that over the short, medium, and long term is gonna make a tremendous difference? Really we think about this in three pillars. We go over each of these in more specific color. I'll be happy to answer any questions in M&A after, but we're gonna see this evolve over the next couple of months and years. First one is connected care. Spend a little time talking about what that means for AdaptHealth and how we're thinking about that, how that feeds into chronic disease management of patients in the home in different disease states. Ultimately, about payer technology connections and how we're working with payers closer from a technology perspective to both drive out costs and ultimately drive better outcomes. On the connected care front, AdaptHealth today, and I think a lot of folks, maybe even before today, before getting educated about what exactly we do, has significant experience over many, many years dealing with millions of patients and managing a fleet of over a million connected medical devices in patients' homes. This obviously consists of connected CPAP, BiPAP, ventilators, CGM, and others. There are existing and evolving payer-pay models around now taking care of patients in the home and connected care, particularly remote patient monitoring, RTM, which is Remote Therapeutic Monitoring. As these revenue models evolve, there's more opportunity to put more devices in patients' homes, more connected devices in patients' homes, and help monitor their progress. These devices, such as what we have today, obviously in CGMs, connected PAPs, connected vents, connected oxygen scales, blood pressure cuffs, pulse oximeters, are going to be the health gauges or the thermometers in the patients' homes that, for not much more cost than what we're doing our business today, give the physician, the payer, the patient, and us a much clearer picture of how these patients are doing and how they're managing their chronic diseases at home. That feeds into our chronic disease management strategy. Remote patient monitoring, like I said, is the measuring sticks, really the touch points to understand change in condition in the patient from a clinical perspective, and then what can we do as Adapt to really help drive better outcomes and help patients manage their chronic diseases at home. By gathering those clinical data points that I mentioned with all those devices, blood pressure cuffs, scales, CGMs, you know, connected oxygen concentrators, connected vents, CPAPs, we're gonna get vital chronic disease stats combined with these emerging revenue models of RPM and RTM. Adapt can really layer on a clinical and technology component to leverage the data coming from connected devices. To drive better adherence, like we were talking about, the adherence focus of a lot of our products, to driving the patient closer to their clinical plan that was outlined by the physician and the medical team, and really connect the health system, the payer, the physician, the patient, and the suppliers to a more collaborative, better outcome and a lower cost of care. That drives and feeds into how we're thinking about this from a payer perspective. In today's model of a relationship between a payer and a provider, I know Joanna, you asked a question earlier about that, there exists a lot of multiple pain points and inefficiencies currently. A lot of what a payer spends money on today, and there's a lot of talk in the managed care world about prior authorization, admin cost, just overhead of running a payer, auditing, you know, putting a QA process to make sure that they're spending money on utilization management. A lot of the current technology that Albert outlined and some of the things that we're working on, and we'll talk about one in a minute, particularly that comes to mind as we address this. There's ample opportunity that we have already started down the path on, and we feel that that has a lot more legs to drive what we have now with physicians. It's really a digital ordering capability, an ability to do prior authorizations electronically, an ability with our OTL and evolving technology for the payer to actually see when they call in and say, "Hey, who do I call to get an oxygen concentrator? Who can I call for a CGM?" The preferred networks for health plans are gonna be driven about cost, efficiency, and customer satisfaction, and over time, are gonna shift to more outcomes-based models. All the technology that we have to run internally and are dealing with physicians and our sales teams is adopting now to address the needs and the pain points of the payers. We feel this is very exciting. There's a lot of runway here. Payers right now, you know, DME is not a, you know, HME, DME, respiratory, not a huge part of their spend. But when we couch it in, it's not the product, we're focusing on the disease states. Disease states of diabetes, COPD, CHF. Yes, we provide products for these patients. We also have relationships. We have pipes into the home. We have connections with the doctor. We can put the technology in the home. We could put these connected devices in the home that can measure, and then we can also layer on a clinical follow-up program like we do in a lot of other product categories that we currently do. We can evolve that and expand that to more disease states to ultimately give a better picture. I think some of the points that Albert was making was our data layer that we've invested in over the last year and a half is gonna be super important and critical to be able to ultimately gather that data and make meaningful decisions and help payers, physicians, health systems, make meaningful healthcare decisions about patients in specific disease states, and really help drive home care at a lower cost using our existing pipes into the home. To that effort, and to achieve this, we built out a direct payer technology that's in its early stages, but has a lot of room to go and been getting a lot of traction in payers that we've rolled this out in and in payers that we're continuing to have conversations in. This really allows us to leverage our relationship, like I said before, with our 2,500+ managed care organizations and payers across the country to reduce admin costs, avoid delays in discharge, keep patients at home and out of the hospital in more expensive settings. Especially for MA plans, you know, patient satisfaction, HEDIS scores, a lot of those measures are around, did the patient have a good experience? Is there transparency around where their product is and how they're doing? Can they get in touch with their supplier relatively easily? Is the doctor aware of what's going on? Are we addressing gaps in care? This is where AdaptHealth 2.0 has started down the path, and this is where we're going. Over the longer term, some of these things are in the early innings, some of these things are a little bit more advanced. Really, the healthcare system that we see and that we deal with in terms of physicians, payers, we're in a very, very unique position that I don't think a lot of people understand with the amount of patients that we serve and the velocity of patients that come to us every day through all the different product categories that we service. We're not like a home care agency that's only seeing a limited number of people, 'cause like I said, people and the people business is not necessarily scalable. When you're dealing with multiple products that you could quickly leverage on technology to CGM, diabetes, sleep apnea, oxygen, respiratory, nebulizers, a lot of the products we have touch a lot of the critical disease states that are driving 80%+ of the spend in this country. It's not just about dropping off products and saying, "Have a nice day." We spent a lot of time talking, and this has been a focus of ours for a number of years. We're not just a distributor. We take care of patients at home. We're clinical. We can follow up with them. We're installing technology not just at the physician and the payer level and the hospital level, but in the patient's homes, and teaching them and educating them about how technology is gonna help make their care at home and help them stay healthier longer at home and out of the institution. I'd like to just close by, you know, saying that some of these efforts, like I said, are early stages. We don't expect to get rewarded by folks in the marketplace until these things are done, but we fully expect to hold ourselves accountable to get these things done, to make these patients' lives better at a lower cost, and really help change the landscape of what home healthcare and technology looks like as we move forward in the months and years ahead. I wanna thank everybody for their time today. I wanna turn it over to Jason Clemens. Our CFO is gonna give an overview on the financial aspects. Thank you. All right. Thanks, Josh. Can you all hear me okay? All right, great. Many of you, I think probably all of you I know here in the room, and I'm sure many here dialing in on the telecast, we've had the chance to speak over the last several years as I've been part of AdaptHealth. So our sincerest thank you for being here with us today. This is a huge milestone for the company. You know, frankly, just a couple of years ago, we were still privately held. In 2019, as you know, we went public, came into the public markets and the public eye. Just two years later, in 2021, we surpassed emerging growth company status. Today, we're a multi-billion-dollar public company, and this is part of what big public companies do. We're glad to take our first crack at Capital Markets Day, and appreciate you hanging with us. I know it's been a long day, we're almost at the end. We're getting there. You know, as we started planning Capital Markets Day, I really had two expectations. The first was, you know, a chance to introduce this talented management team that I get to be part of, for you to see the people that are actually operating the company. You know, the folks that make this place go. You haven't seen them before. You see Steve and Josh and Jason and Anton. You know, part of that expectation was also giving you more data about the unit economics of these business lines, which I think we've accomplished. I think it'll be helpful in our discussions going forward together. You know, I had an expectation that frankly, our operators and our leaders were gonna manage the day. My second expectation was, this is great. I finally get a chance to like, you know, relax. I don't need to present today. Anton's got a big job. He's got to manage me. He said, "Wait, wait, wait. CFO excluded from the agenda might not work. By the way, I know you hate slides, but you gotta bring slides." Here I am. I got some slides. We'll get to that in a few minutes. In thinking about the message for today, you know, again, probably fewer numbers. We'll talk numbers in a minute. If I'm in your shoes, I wanna know what the CFO really thinks about this company and this investment, and I wanna know what the CFO really believes about this company and this investment. That's what I'm gonna talk about before the slides. You know, I think it's a tremendous company. I think we'd put this management team up against anybody in the industry. There's only one person on the senior team that has less than 15 years in the home medical equipment industry, and you're looking at him. I'm proud to be the weak link of this group of folks that you met today. You know, I think that. I think we've got a bright future ahead, and, you know, that's really fueled by deep beliefs that I've got about AdaptHealth and about the mission that we serve. To help you understand my beliefs and why I feel that way, I'm gonna rewind a little bit. We're gonna go back to March of 2020. Crazy time, especially for folks here in New York City. You know, COVID was running rampant, obviously. Businesses were shutting down. The economy and the stock market was on the verge of collapse. That was the first time I heard about AdaptHealth, 'cause I got a call from a recruiter that said, "Hey, we'd like to introduce you to Josh Parnes and the management team at AdaptHealth. You know, you should really take this call." Reflecting on that, I know for sure, for certain, it was the absolute worst time in my lifetime to possibly consider starting an interview process with a company on the other side of the country. My wife nudged me. She said, "Oh, come on. Meet Josh. You know, it's 30 minutes. What do you have to lose?" We had that call, and I remember. I don't know if Josh knows I'm gonna go here, but I remember that call very, very vividly. I was in Miami at the time, working in healthcare. Get on the call. I'm kinda staring out the window a little bit, not taking it that seriously. The first thing we talked about were our families. The second thing we talked about were our hobbies and what we hope to get out of life. It wasn't a typical interview. You know, next we talked about investments, our philosophy on that. We talked about our management philosophy and how we run companies, how we run businesses. You know, Josh told me about that $25,000 investment that you heard about earlier. Well, there's a little more to that story. That was a $25,000 loan. I learned that, you know, at a young age, you know, Josh took a huge risk, huge bet. You know, he had a lot of kids at the time, probably a few more now. You know, he put his family's livelihood on the line for a bet that he believed in. Well, I'll tell you, I got off that 2-hour call that was scheduled for 30 minutes. I looked at my wife and said, "I'll tell you what, this place has culture right." We'll talk about that here in a couple more minutes. I really left thinking that. The most important discussion we had on that call was about partnership. I knew Josh had a partner already in his CEO, but I told him. We didn't know each other, and I pushed him and said, "Look, if you're not ready for a third leg of that stool, for another partner to come into this, I'm the wrong guy. You need a different CFO." Without hesitation, that's what they were looking for. I'll tell you know, same discussion I had with Steve Griggs when I met him. How do we end every call? We talk 3x a day when the days we're not together. I'll try to do my Griggs impression. Says, "All right, partner, we'll talk to you later." You know, I believe that. I feel that partnership from Steve. I feel it from every person here on the senior leadership team. I feel partnership. You know, the next questions I really had to answer about Adapt, and am I gonna take this giant risk for my family is, you know, what's the purpose of this company? Why does the company exist? What's this thing gonna look like in five years? Am I gonna add value every day and be part of that contribution and about getting this company to that place in five years? You know, coming from healthcare, you know, I stepped back and looked at the Triple Aim. You know, so the Institute for Healthcare Improvement, Triple Aim, I think any company in healthcare, you're one of four types of companies. You either don't know about the Triple Aim or don't care about the Triple Aim. I promise you those healthcare companies exist. There are healthcare companies that will tell you that they're delivering every day on the Triple Aim, and that fourth type of company are the companies that every single day are contributing to the Triple Aim of the Institute for Healthcare Improvement. For those generalists or non-healthcare folks in the room or on the call, you know, those that triple aim is really about improving the health of our populations. It's improving the patient experience. That includes outcomes and satisfaction, and that includes doing it all at a lower cost of care. I challenge anybody that was here today listening to our discussion to tell us how we're not part of delivering the Triple Aim every single day. I saw that back when I learned about AdaptHealth, and I said, "This is the kind of place that I could really be part of." Finally, you know, I heard about the job. I met Terry Connors, our audit committee chairman, on a video call. I met Richard Barasch, our board chairman, on a video call. Basically, the job that I understood, they, you know, they needed a CFO. The job that needed to get done was to recruit the kind of talent you need to run public company operations, to install an ERP. We needed one desperately to support the growth goals that the company had at the time. We needed to create a control environment that was ready to support the acquisition engine that we were continuing and growing upon. It was we're gonna be ready to stand up to a SOX 404(b) audit once we exited emerging growth company status. The last thing I kinda caught up on in the interview was we also have some challenges with accounts payable. We'll talk about it here in a minute. You know, that was the job that I understood. All of that is what compelled me to take the biggest risk of my life. I packed up my family in July of 2020, a month before I had bought a house, sight unseen, in Philadelphia. I'd enrolled my only child, my son, in a school, sight unseen, and I joined a company that I had only met a couple of folks on video, some on phone calls. I'd never stepped foot in any AdaptHealth facility, and I took that job sight unseen. That's the bet that I took a couple of years ago. I'm glad I took it. Now we can get into some of the CFO stuff. We can talk about some of the levers of growth and profitability that we've been talking about all day. You know, when I got here in 2020, you know, the company was already doing what they said to me that they were going to do. You know, we wanted to grow our TAM, you know, our total addressable market, and we wanted to, within those total addressable markets, expand our wallet. Well, how do you do that? You get bigger. That's what we were focused on. We were focused on getting big. We were a regional provider. Over the course of 2020, we made important acquisitions in the Carolinas as well as Texas, so that density was growing. Within HME, certainly with the AeroCare acquisition in early 2021. I mean, I showed up at Adapt and realized we were getting in the middle of an LOI with AeroCare. Wow, this is gonna be big. You know, then secondly, on the product categories, we acquired the PCS division from McKesson in early 2020. You know, that brought us into our supplies to the home categories. We bolted on ActivStyle in July of 2020, so those companies operate together today. You'll see that in our financials under supplies to the home. Then very importantly, we acquired Diabetes. Rodney Carson joined our team that year. As Rodney said, you know, we then bolted on 7 more diabetes acquisitions to create essentially every product in the catalog for home medical equipment. We accomplished that goal. Revenue went up 6x over that timeframe. Okay, well we've got now the sales force that we need, the sales leader that we need, I'd add. We've got you know pushing 1,000 sales reps all over the country in all product categories. We're starting to cross-sell and we're national footprint. We've achieved what we set out to achieve back in 2020, which was to get dense, get all the products, and bring scale, which certainly helps on purchasing. You know after the AeroCare acquisition, and there were 22 later that same year, I'd add, you know, we were really focused on the technology that you heard about today from Albert. You know, at the time, in 2019, 2020, you know, we were awfully fragmented. I mean, our rev cycle was working pretty well. Shaw has been here for a long time, you know, leading that effort. It wasn't nearly as integrated or I think simplified maybe as it is today. It's a testament to Shaw Rietkerk and Albert Prast and many other people. We had no ERP. We were running an old clunky, you know, an old premise-based general ledger. We had no human capital management platform. We're getting people paid, you know, on time, but, you know, that was really all we had. We didn't have an HCM. We had no CRM. You know, there was no real customer relationship management to speak of. Now, I've been in locations. I know there were Post-it notes around, and I know people that have reminders to call people back, and that's essentially what this industry was when you know, the team joined. You know, that was where we were. Today, you know, very different story. We got Oracle Fusion as our ERP. I think we got a best-in-class ERP. We've got what we think is a best-in-class HCM that's hardwired into Oracle. We've built our own CRM. You heard about that with the OTL and with RM and everything that Leila said, that vision she had of being able for a sales rep to understand what was their workflow for the day. Who do they need to go see? Where do we need to sell? What problems do we need to fix with a patient? Who do we need to upgrade? Who do we need to evaluate? That all lives today in a cloud-based platform. Then finally, rev cycle, also a cloud-based platform. All these systems are hardwired into Oracle, right? I mean, that's a huge deal for us. I mean, some of that control environment we talked about earlier, wouldn't say we're done, all right? This will be a journey, but that was a huge deal for us to get there. Then on the early innings of e-Prescribe, you know, we talked about, you know, Rodney and Steve Feldman leading that effort. I mean, in November of 2020, you know, we had acquired 3 diabetes businesses at that point, and we had zero orders coming through e-Prescribe. Today, that's over 50%. They went so fast. I didn't know that they were gonna make it there, but they went so fast that today, you know, we're the leading e-Prescribe operator in the company as it relates to home medical equipment. You've heard about e-Ordering, you've heard about e-Delivery, and so that's who we are as an organization, and that's where we're going. All of those investments and all that work translates into what you're seeing on revenue per employee and what you're seeing on people and infrastructure. People and infrastructure is salary, wage, and benefit. It's rent and occupancy. It's SG&A, of course. You know, and those dollars are continuing to drive down as a percent of revenue. We're getting the leverage. We're getting that operating leverage. As Steve said, 25% Adjusted EBITDA margin is our goal by 2025. Half of it, we expect, will come from PAP repair, PAP equipment and the repair that comes with that. The other half is coming from operating leverage and organic growth that comes in at a higher margin that we'll talk about and Steve referenced earlier. This is the engine that's driving the efficiencies within our company. Then finally, how do we accelerate value? How do we drive more cash into this business? You know, that's really what we're focused on today. You know, we had 600,000 patients on resupply census back in 2019. Now 1.4 million today on resupply census. The reason resupply census is so important, why you should really keep an eye on our sales versus rental revenue every quarter, is that there's literally no capital intensity with a purchase. As that patient gets on rental and comes off rental and as part of that resupply census, right? You're not deploying CapEx to support that, right? Those dollars are flowing after gross margin and your variable cost, that's flowing to cash. That's that cash flywheel that we've been talking about over the course of the day. That's a very important part of the business to understand. DSOs have come down. Again, you know, we talked about that. Shaw and his team should be credited for that. I think I challenge anyone that would say a healthcare acquisitive company that is simultaneously driving DSOs down, all right, is not. I won't use the R word. You know, that company is acquiring intelligently, and they're integrating well. I think that's what we've done. Now, days payable outstanding, it was what was described to me in that interview process. We were over 100 days of DPO. Some of the analysts in the room say, "Well, okay, dum dum, your DPO goes down, that's a bad thing for cash, right, CFO?" Well, yes, but look, the company was in a state that we needed to tighten up and pay suppliers on time as per our contract. We're doing that now. That's what we've demonstrated over the last 12 months. We're avoiding late fees and penalties that come with that, and we're taking advantage of prompt pay discounts, which we've hardwired into our agreements. What you're seeing now is more normal spread between DSOs and DPOs. You know, we'll continue reporting this. You're gonna see it as we drive working capital and as we drive cash flow into this business. The final thing I'd add here is, you know, the other thing the ERP is doing is it's allowing us to start leveraging the visibility on fixed assets and inventory, right? To squeeze dollars out of inventory turns as well. Your working capital is obviously critical lifeblood to any business, and we've got an extreme focus on it. I'm sorry, I missed an important part here. You know, the free cash flow chart that I'm showing here, so there's a lot of adjustments on here, kinda like Josh said in his last presentation. You know, we're not a management team that's asking for credit for this. I wouldn't look at it that way. What we're saying here is that we've got a deep belief in producing 6%-7% of our revenue as free cash flow in 2023 because of this data, and we believe that will extend to 8% in 2025 to hit our $300 million + free cash flow target. These are one-time events. I think you all know about the CARES Act. We are at about the final stages of paying back the $50 million that the company took on in 2020 as part of the COVID-19 relief package. Then additionally is the AP tightening that we talked about following the Oracle conversion. You're looking at about $50 million spent through the end of Q2 on that. Again, once your DPO and your DSO is in line, I mean, AP starts becoming a source of cash, again, a very moderate source of cash, but you know, if you're managing things properly, that's the way things should work, and that's what we expect to happen, you know, now that we've done this work. $77 million on what? $1.433 billion of revenue in the first half. You're looking low 5%, as a percent of revenue for free cash. Of course, as you know, first half, things are a little tighter due to deductible resets and patient responsibility and things like that. Again, we've got every confidence, every degree of confidence that we're gonna hit the numbers that we're putting up here as we get into 2023. Where are those investments gonna go? I'm not gonna spend a lot of time here 'cause, you know, we've talked about this all day long. I mean, our highest and best use is, and we believe will continue to be M&A. We acquire accretively on every deal. We're gonna stay disciplined on that M&A approach. We are an acquisition company, taking a breath at the moment, as you've seen, but you know, this will continue. Technology investments, I think you heard a lot about that today. We think we got the right team to deliver them and continuous improvement investments that will continue to drive operating leverage through the business. Finally, you know, intelligent return to shareholders. You know, right now, we've got an authorized share buyback program. You know, we will continue to buy opportunistically when it makes sense, and return that capital to the investor. A little bit on balance sheet. I'm not gonna read anything on this slide. The one thing I'll say, which is very, very important, is the goals that Steve set out here for us for 2025, we believe we can do that without borrowing a dollar of debt or raising a dollar of equity. That's a huge deal, right? We believe that we will get to the targets that we're implying through organic work. I mean, we'll do M&A, but that's gonna come from cash flow, and we think we can self-fund. Finally, revenue. I won't drain this. Glad to do more bridging during Q&A or, you know, in the coming weeks as we meet one-on-one. As you're exiting the year at a little over $3 billion, I mean, 8% organic growth, which is what we believe. Forget the PAP repair for a second. You know, let's say it's repaired. Well, 8% is what we believe, and for the next three years, that should drive $800 million of revenue into the business, you know, getting us to about $3.8 billion. That leaves $200 million left. I think we've demonstrated if we needed 200 M&A to hit the goal that the CEO is setting out. I think we demonstrated that we can accomplish that. That's on the top line. When you get to Adjusted EBITDA, Steve talked about this and the two points of repair roughly of PAP coming back online. Well, we've talked about $65 million of impact of headwind EBITDA within 2022. That's in our guidance, the guide that we got on the street right now. That was contemplated and included there. You take our $645 midpoint, you add 65, that's 710. That $800 million of organic growth that will come in in revenue, let's say it comes in at 30% Adjusted EBITDA margin. Griggs was like, "No way. It'll come in way higher than that. Let's say it's 30%, right? So that's $240 million. I mean, that leaves us about $50 million to make up the difference, and, you know, M&A could get there. I haven't even talked about operational efficiencies yet, and I've been on record since I took this job, you know, we will drive 30 basis points a year of margin improvement through the technology that we're installing and through the programs that we're running. So, you know, I didn't do formal bridges here because we talked about free cash flow. I didn't do formal bridges here because to Steve's point, there's so many avenues to achieve the goals that we've set out that, you know, I could put a scenario modeling table up here in front of you all, but you all can do that too. I think that just basic math gets us there, you know, very comfortably. Again, I think you're looking at a management team that's gonna get it done. With that, I'd say that's enough out of me. Maybe we'll move on to some Q&A. I don't know who this is. Somebody Jason behind. Great. Thanks, Jason. I guess we get Shaw, you need to come on up back up one more time. Same thing with Josh and Rodney. We probably can go till we'll see how we do, 20, 30 minutes. I think Dave's got us again. We'll get Whit over here. I guess a couple of questions first, Josh, just on coming back to value-based care again. When you look at connected care patient monitoring, is anyone else competitively kind of doing this in a meaningful way? You know, you've laid out a lot of 2025 targets. Can you give us a sense of what percentage of your revenue right now is in some type of value-based arrangement? Where do we think that's gonna be in 2025? I just got one other follow-up. Yes. Thanks for the question. I would say in the HME industry in general, we're not aware of anybody that's doing this. I think what you do see is that there are remote patient monitoring companies. Now we're talking. Separately, there are chronic disease management entities, you know, separately. I don't see them really integrated into a typical home care, home medical equipment infrastructure. It's typically has evolved as a separate business model. I just think that there's a lot of compelling reason to put those business models together and really leverage, I guess, the, you know, what's missing in some of those business models is the relationship with the payer, the scale, the relationship with the patients, and kind of the existing infrastructure that doesn't have to be rebuilt from scratch. You know, a lot of the new technologies that are out there, I mean, I think you see it a little bit with, you know, a Medassist and a hospital at home program starting to come together. You're starting to see more of that shift. This is kind of everybody's got their own take on it, and we're not really that pie in the sky kind of management team. We're very practical, like, what could we do incrementally? How do we help? How is what we're gonna do not cost an arm and a leg, but also be able to drive meaningful organic growth and make a difference in the lives of the patient? That's kinda how we're thinking about it. Currently, I think we have a little bit less than about $100 million in revenue. Call it 3% currently. I mean, I think conservatively 5%-10%, you know, of revenue would be on these alternative arrangements that we're talking about in 2025. Could go faster, but I think for you know conservative estimate, it's probably a decent one. Just the quick follow-up, in terms of CapEx, you know, if we take a look at, you know, past a lot of the technology spend, you've talked about resupply growth. Should we think about that CapEx as a percentage of revenue numbers starting to leak lower, in the out years? It will, but here's the nuance. As PAP repairs, we would expect to put up much more capital to acquire equipment and to get it out on patients. I think what we demonstrated today with getting patients on the rental census and ultimately onto that resupply census, which is where that real cash return comes from. I think you'd all say, "Yeah, go get as many PAPs as you can get." I promise you that that's what these guys are doing right now. Except that, Dave, yes. I mean, we expect to get a couple of points out of CapEx as a percent of revenue. Some of that is, frankly, just the profile of the business beginning to change and that resupply census continuing to grow. I think Whit had one, and then we'll get over to Brian. Thanks. Maybe just to start on the cash flow conversion, Jason. If you ballpark it, let's just assume $300 million. Yep. CapEx in that 25 number. Obviously, you have to get to $600 million EBITDA. That's an improvement in the cash flow conversion. What are the single largest drivers that you see from today to then that gets you know, enhances your confidence in that $600 million? Sure. I'd say the adjustment slide that you saw up there, let's say that's behind us. We've tightened up, we paid back all the CARES funds, and we've tightened up DPOs to a more of a normalized level. I'd say first and foremost is the swelling of our resupply census. Again, no CapEx requirement there. As that gets bigger and bigger, we went from 600,000 patients in 2019 to 1.4 million on that census today. Assume that same trajectory, and that's gonna bring tremendous cash into the business and increase that cash conversion. That by far is the biggest part of this. Secondly, is working capital. You know, we think there's a couple of days to go in DSOs. What do you think, Shaw? You know, in DPOs. I'm sorry. He's right here. So, I got him right here. So, you know, a couple of days to go in DSO, arguably a couple of days to go on DPO, you know, as we continue to use our purchasing power to drive better terms, not just price, but terms with our suppliers. You know, we're confident that we'll drive that. Then finally is within just tighter inventory management and everything that. You know, we're in the early innings of this, but everything that Oracle is giving us the scale to do, you know, we're confident that we'll drive more cash out of that. The guys on either side of me are definitely pushing me to drive more and to drive faster. Yeah. The second question I had is just as it relates to the public health emergency and when this, you know, sunsets at some point, you know, we would expect to see additional, you know, prior authorization kick back in. There's been a lot of relaxation, a lot of other areas. But any other, you know, any other things that you're paying attention to or things that are tied to the public health emergency that we should be aware of? And then if you could also just maybe comment briefly just on health plans, claim edits, anything that they're doing today that they weren't doing, you know, 6-12 months ago. Well, when the health emergency does sunset or stop, you know, we were getting some benefits in increased reimbursement. Those will go away. We believe the ones in the rural areas will stay 'cause that got put in prior to the health PHE and just got extended during it. The ones that are in the non-rural, non-bid areas, we expect those to go away. That'll be. Of course, the sequester has gone away too. Those are the two big revenue reductions. We expect a pretty healthy increase on CPI. If you kinda measure those up, it should be net plus to us, you know, when you put those two together. Your question on- On any claim edits or anything else that, you know, any change in that environment, I guess, is. Prior auth. Yeah, prior auth. Oh. We didn't see a significant reduction in prior authorization requirements. We saw more leniency in documentation requirements for the process. However, we still maintained our same level of requests in working with the physicians. I think we've prepared ourselves for the fact that the pressures are going to come back in. Electronic ordering has helped us with that as well, so we're able to maintain that. But I don't see a significant impact from authorizations. Thanks. I think Brian had one, and then we got Pito up front. Awesome. Hey, Jason. Just as I think about the organic growth guidance that you gave- Yep. Obviously, there's a recovery that we're gonna see in PAP next year. How are you thinking about the cadence of growth and then maybe margins as well as we see that big recovery in PAP next year? Then I'll- Sure. Have one follow-up. Sure. I'll be careful on this to not kinda trip on formal guidance or anything like that. I'd say two things. Firstly, you know, 8% is a good way to think about our average. Now, as PAP is repairing, and we've got this huge amount of patients on backlog, you should expect outsized growth over that typical 8% as we fulfill that backlog and then as we come back to normal, which is that 8%. You know, it's reasonable to assume that, you know, 8% is very achievable because you're gonna have this big kick from fulfilling the backlog. Then same thing on margin. I mean, we think two points on revenue will repair as part of PAP coming back. Some of that is the nuance of the rental. Dollar rental revenue really drops, you know, almost 100% to EBITDA. As that rental revenue repairs, you know, it's gonna bring margins up significantly. Got it. For Rodney. As I think about CGMs, you know, obviously, we've seen some deceleration in growth even from, you know, Dexcom's side, so it's not just you guys, right? How are you thinking about the outlook for CGM going forward as a product category? Yeah, I mean, I guess if you could answer that question. Just the pharmacy benefit discussion as well. I think that's a great question. I think, you know, there are a number of dimensions to the answer to that question, many of which we don't know. I would start with what is the terminal penetration rate for intensively managed diabetes? Is it 65%? Is it 80%? Certainly I would start there. You know, I'm confident in the guidance that we've given that we'll be able to grow at or beyond the rate of market growth for CGM. I think the key to hypergrowth is the expanded coverage for Type 2 diabetics, frankly. I think we all would probably acknowledge that. Okay. Pito, and then I think Mike's got one over here. Andrew. Hey, thanks. Pito Chickering, Deutsche Bank. A follow-up to Brian's question, but it's more on the margin side. With CPAP coming back in 2023, you talked about $65 million, you talked about half the margin coming from CPAP. Is it fair to think that the margin improvement over the next couple of years will be more front-end loaded in 2023 because- Yes. Because of the CPAP? Okay. Half of that, you know, 300 basis points will probably be in 2023. Mm-hmm. Okay. Then a question on the diabetes side. A couple questions here, so I'm gonna hit you. What happens in CGM if Libre begins to take market share away from Dexcom's or has it impacted your growth? Then what is your exposure to Medtronic? If the 780G gets approval, you know, what impact do you think that could have on your outlook to diabetes? Well, we have great relationships with both Dexcom and Abbott, so I really don't wanna, you know, speak to anything other than that we would make more money if you know, our- Because of the lower price point, wouldn't your gross profit dollars shift sort of more negatively if you go from Dexcom, you know, again, to Libre? No. No, our gross margin would expand dramatically. Our revenue dollars would go down. Okay. For Medtronic, do you guys sell for Medtronic, and if 780G gets approval and begins to get share in the U.S., how would that impact your sort of multi-year view of diabetes growth? Well, the 780G, as you know, has been accepted very well in Europe and outside the United States. Certainly, we have an emerging relationship with Medtronic. Today, we have a larger relationship with Tandem. I think that there is ample opportunity for us to grow our Medtronic market share, and certainly, we're working on that as we speak. Okay. Then last one on non-invasive vent. Can you just, you know, refresh us what percent of revenue you use- Sure. Income from non-invasive vent today, and what's your views around if competitive bidding, a competitive bidding come back to non-invasive vent? Yeah. I can start on numbers, and I think Steve and Josh will have some comments on competitive bidding and likelihood or non-likelihood. You know, respiratory is about 20% of our top line. You can think of vents as about a quarter of that, so 5% roughly of top-line revenue. We've you know, disclosed that publicly, but as a reminder, it's right around 5%. As far as competitive bidding, I think we're getting too late in the year for it possibly to happen in 2024, so we're now talking about maybe 2025. You're gonna have to be well out of the pandemic, and you're gonna have to be well into supply being available, right? Like right now, you legally couldn't bid on a competitive bid because you don't have the supply. So that has not a separate path, but also we have some ventilation issues with Philips' issues with ventilation. So those have to be all be kind of cleaned up that you have to have supply, then quite possibly, competitive bidding could come in 2025. Competitive bidding's been very good to AeroCare, been very good to Adapt. Our policy for competitive bidding is pretty simple. We're supportive of competitive bidding as long as there's one thing in there that's currently not in there. If prices go up, we get them. As long as that's in there, we're very supportive of competitive bidding, and we think we can sell that to the legislators. Thanks. Yeah, I think Mike right there. Hi, Michael Murray, RBC. You noted half of your EBITDA margin targets will be CPAPs coming back to the market. When Philips comes back online, there will be more industry supply than previously, which could put pressure on CPAP prices. Was that contemplated in the margin expansion target? No, it was not. Could you give us a sense of potential, you know, what it could potentially be? Yeah. It's you know, I mean, like, logically, you might step back and say, "Well, if there's more units, there's more suppliers, prices will come down." The dynamics of these negotiations are very complex and very nuanced. I mean, we buy a lot of different types of products. It's not like a single CPAP, and it's got a price point, and because you've got multiple vendors, that naturally it'll come down. I mean, we're buying CPAPs, BiPAPs, ASVs, you know, the soft goods and everything that comes with it, vents, you know, concentrators. I mean, these manufacturers, you know, we buy so much from them and it's just complex and nuanced. Yes, logically that makes sense, but you know, we haven't baked in upside there for those reasons. Okay. We would look forward to that negotiation. Just a quick follow on, given current inflation and the slowing economy, could you discuss impacts on your business, specifically in diabetes? Well, you know, certainly, there is economic sensitivity to the therapy. Depending on the payer, the therapy can be extremely expensive. We have seen a bit of that in Q2. Certainly pump therapy can be very expensive. I've probably seen from some of the public filings that, you know, pump placements have slowed somewhat in Q2. Certainly there is economic sensitivity to the therapy. Thanks, Rodney. Okay, another one from Matt down here. Mathew Blackman, Stifel. Rodney, you mentioned intensively managed patients and the driver of diabetes growth, dependent on what we think penetration is. We may very well be on the cusp of seeing coverage for basal-only patients, so not intensely managed, which is an orders of magnitude larger opportunity. Is that contemplated at all as you think about some of the diabetes business and the market trajectory over the next several years? You know, that's a great question. You know, we're cautiously optimistic. We're seeing a few Medicaid-oriented payers being very inquisitive on type 2 coverage. But I would say today we are not seeing what I would call widespread consideration across commercial payers for type 2 coverage. If we saw Medicare come down with a positive decision in the next 12-18 months, we should think that would reflect positively on the outlook for your business as well, right? Yeah, I agree. Yeah. Absolutely. I think Joanna had one in the front row again here. Thank you again. This is Joanna Gajuk again, Bank of America. A couple of questions. First follow-up on the inflation question. The question was asked about impact to volumes, but on the flip side, can you talk about how you managed to pass it through to your payers? You know, the traction you're getting and maybe any way to quantify the increases versus the historical and also what you assume in your target. Sure. growth going forward. Sure. As a refresher, you know, we'd start with the DMEPOS fee schedule that's published by the CMS on or about December of each year. You know, the way that fee schedule works is it anchors into the rolling 12 CPI-U from the previous June. As you know, last year, that was what? I guess 6 points and change. They apply a labor productivity factor that I won't pretend to be able to explain. I don't know that we've got anyone that can explain the labor productivity, but it was a deduction from that, call it 6% down to 5.1%. About $30 million for our business. Now, I would say majority of that does pass through to manufacturers. Some of that's inflation surcharge, you know, product refreshes. I mean, you know, new products typically cost a little more. They've got more product, they've got more, you know, technology, things like that. You know, our guide assumes from a rate perspective, steady rate. I said guide, that's the wrong word. Our goals, our current guide, likely our next year guide, and certainly our 25 goals, you know, it assumes a steady rate. If you look at the CPI-U through June of 2022, last thing I saw, I think that was 8 points and change. Look, there will be a labor productivity factor applied against that. You know, that'll result in the DMEPOS fee schedule increase for 2023. Same dynamic, you know, we would expect to pass through much of that, downstream to manufacturers. I wouldn't say we're absorbing, everything, you know, every dollar of inflation or certainly labor is running fuel. I mean, you know, through that mechanism. I think through our operating leverage, we are absorbing the rest. I was thinking about the payer relationships and whether the Sure. Payers are recognizing this. Yes. Yeah. Right. whether you're seeing acceleration or expect acceleration in your pricing going forward. So far, we haven't had great success with our payers increasing the rates. We've mentioned Ben Chambliss a few times. We'll mention him once again over there in his quest to get that done. The payers have been very cooperative on methodology and how they work with us, but they're all slow to increase. We are having those conversations and, you know, what it amounts to in 2023 is yet to be seen. I'll just add something there, is that there's a blend of having a discussion with a payer about an increase in rates or a sit down and how do we collectively, 'cause payers aren't just looking to say, "Oh, the inflation, we're gonna pay out more," right? They're gonna look to leverage their provider relationships into cost efficiencies for them so that our scale, our technology, our ability to take costs out of the model can result in a cost sharing. Doesn't have to be straight value based, it could be fee for value. We're having a number of those conversations, I think particularly because of the inflationary environment, those conversations are getting a lot more traction. Because the reality is the barrier to entry, and I think Steve mentioned this initially in his remarks, was the barrier to entry and competitive bidding and rate reduction environment favors a larger, more scaled company that can adapt to that. Pardon the pun. But, you know, our ability to drive technology, OpEx efficiencies, connect with the payers directly, allows us to really collectively take cost out of the model in a collaborative way with a payer. So it's not just, "Oh, okay, inflation's this, now pay me that." It's a much more nuanced discussion about how do we work better together, and how do we drive more of the wallet share from that payer to a larger, more scaled company like us. The last question, I guess, or it's two parts. One is, the comments about the PAP and how you expect this to grow to drive the growth in margins and whatnot. Should I read into this as, in terms of the implications for this year, in terms of your guidance? Because I didn't see any explicit comments about the guidance, you know, reaffirming or changing it, today. Thank you. Yeah, we feel fine about the guide. We reiterated just a couple of weeks ago, I guess. You know, yeah, there's no change. You know, today was really about the big picture, where we're heading and where we think we'll get in the next three years. No change there. Thank you. I think we've got time for one more from Andrea back there. Thanks for squeezing me in. I guess my first question was, I guess embedded within the 8% organic growth guidance, you sort of mentioned in passing on the PAP side an assumption around share gains. I guess how much of that organic growth is predicated on those share gains? And do you think you could get it from some of your bigger competitors, and where are those share gains achievable? Sure. I think Steve and Josh can talk about with the competitive dynamic. In terms of the math, you know, we're just assuming PAP is running at the 7%-10% that Steve presented earlier this morning. At the end of the day, it's a weighted average. You know, this year's 4% is assuming a -5% to -6% on sleep. As we said in Q2, I think we're gonna do better than that. Maybe some other product lines we won't do as well as we had originally put up in the guide. At the end of the day, we think collectively we'll deliver the 4%. All this is saying is the -5% to -6% relates to 7%-10%. Now, again, that's likely to be outsized as the backlog comes on, and so that would bring the 8% up. Timing is, it's unclear. You know, as months go by, we'll provide more clarity on that for you all. In terms of the competition and winning share, guys, what do you wanna add? Well, I think winning share comes from a couple different perspectives. One is we have been very open to taking other manufacturers' product and supporting those and working with our referral sources to be able to allow us to use those. Some people have not done that. Some people have avoided the card to cloud strategy because it causes more expense to do that. We haven't done that. When you look at those two things, and we had a natural larger share of ResMed going into this than the industry did. If you look at somebody that's been able to supply their historical backlog at, I'm just gonna pick out numbers, please don't hold these to me, at 30% versus somebody that's at 70%, that person has been supplying at 70% of their historical and somebody versus somebody's been planning at 30%, they're gonna be able to get to when PAPs are ample through their backlog faster. When they get through their backlog faster, they're gonna have opportunities to move market share. Thanks. Then just a separate question, Jason. You discussed some of the IT investments sort of being ongoing. I guess, you know, maybe I'm just curious about sort of the when we think about that stacking against your LRP, you know, through 2025, mid-teens EBITDA CAGR. I guess, when does that magnitude of the investment start to dissipate so there's more of a discernible margin benefit? When would that occur? Yeah, great question. You know, I'd probably peg that at 18 months, somewhere between 12 and 18, but 18 feels fine. You know, on the last call, we talked about the hardening of the Oracle environment, including just essentially every SOX control we had prior to Oracle. It's different now. It's much better, but it's gotta be redocumented, retested. There's significant cost that comes with that. We had pegged that at about $10 million in year for 2022. You know, Oracle hardening and SOX hardening, we will lap. Like, we're getting in the final stages of that, even here as we speak. Now, some of the additional investment that Albert talked about, there will be additional dollars spent on driving the working capital improvements that we spoke about. There will be cash investments that go into this. We think G&A, as a percent of revenue, we will hold steady for the next 12-18 months. I think as you're starting 2024, we'll start seeing the leverage within G&A as well. Great. Thanks. We probably have Steve, you wanna. We may have some closing comments from Steve here, if everybody wants just to hang. I know we've gone over time a little bit, but there is lunch out there to the extent anyone can hang out with us and we'll get you fed. Yeah. I think we've laid out, you know, what we've been able to accomplish to assemble our opportunity. That opportunity's been assembled, and so it's there for us to execute on. Some of that execution, you know, in 2022 is more just putting the systems and the processes around it. Now we're gonna execute on that opportunity, and as we execute on that opportunity, we're gonna move into this, what we think is the, you know, significant opportunity for the company, is this transition from fee for service to value-based care. For us, it's about execution. It's all there. Our people gotta go to work. They gotta do their job. If we do their job, we should be very successful. With that, thanks, everybody, thanks for the time, and we really, really appreciate the questions, the interest, and your support.