All right, great. Well, welcome. Last day of the conference, we will bring it on home, Mark. So appreciate you being here. We are pleased to have with us COO Mark Hirschhorn. So welcome. Thank you, Craig. Before we get started, I do have to read for important disclosures. You can find them on the Morgan Stanley website, www.morganstanley.com/researchdisclosures. With that, Mark, I wanted to start on the government side of your business just because I feel like that is the important pivot in terms of where you are seeing a lot of activity and momentum. Perhaps just take us back to the initial DHA, what was required to get to where you are today, and we can build off of that. Well, I appreciate the opportunity, and thanks again for having me here. The military and the opportunity underscoring where we have pivoted over the past two years to principally focus on the government opportunities as well as domestic payers came about as a result of a probably five-year-old relationship now with the DHA. When they came to us seeking a platform that can enable all of their clinicians to reach any of the service men and women and their families with video compliant and security protocols that had not previously existed, it was a fresh build for us. It was an undertaking that we believed we can accomplish in a period of approximately a year and a half. Along the way, we got to understand and to know the individuals who were involved in that decision-making. Clearly, many people in those government positions have changed, but their focus on enabling care and moving towards an innovative technological solution for all of their services, underscoring the need for the compliance with the MHS GENESIS Oracle-based platform, was something that held true throughout. Our first really dipping the toe into that experience was launching with the DHA and covering now approximately 10 million service members. We also were invited in from an opportunity that the VA, I think very timely, of course, after we've now had two years of successful service past our initial implementation point. The VA came to us with a very similar need, and I think the validation from their colleagues down the hall led to us having an opportunity to present, to validate some of the ROI, and the ability to launch and to rely on a platform that is going to service, yet again, another cohort of approximately 10 million veterans. That's great, and I do want to build on that. You've also early on partnered with Leidos, so I'm just curious, given their experience in this market, are there things you learn from working with a company like that and how you see this market as you go forward in terms of relationships like that versus now you're direct and have exposure with these government agencies? Well, we're certainly looking forward to being direct, but at the same time, it's somewhat of a bittersweet change. Leidos and some of the other partners were absolutely wonderful. They essentially held our hand throughout this process and guided us towards successful implementation and launch. Their project managers have tremendous experience. The tenure of many of the individuals on their team really helped lead us to a successful launch. I don't believe we would be able to have done that in the timeframe that we did. We would have had the normal growing pains and stumbled, and I think we were very fortunate to have had them leading us through this process. Now that we're going direct, we're going through some of the initial challenges, going through contracting and pricing and working on a number of things that we had hoped would have been completed about a month or two ago. But we're now getting to know people and form relationships. Also, the fact that there are people involved who weren't there at the initial launch. So it takes time. Relationship-building is going on. The contracting is coming into place. And we hope to be in a place where we can announce a longer-term direct contract over the next several weeks. Got it. To that point, you had announced on the earnings call that letter of intent. And I'm just curious how competitive that process was. It doesn't have to be specific, but just give us a sense in terms of what really appealed for them in terms of getting a sole source and providing you with that opportunity. Well, so the letter of intent is specifically to the VA. So that's one opportunity that I can tell you the VA had been looking at options for the past two years. They went through a diligence process of at least a year and then announced to us this year their intent to move forward with us. Also, changes in the VA that have now led to them having to go back and essentially review and appoint new individuals to now lead in the contracting process, which they've made it clear to us they would like to have completed prior to the year-end. Got it. Anything on the competitive nature of this in terms of as they kind of evaluated you and potentially others out there in the. Well, we certainly know there were competitors because we're constantly being critiqued, or I should say, criticized in scope, in optionality around the Platform, as well as pricing. It's still in a very meaningful way being addressed at basic contract levels today. We're not close to signing in the next several weeks, but we hope to be there in the next couple of months. Got you. You mentioned before having kind of their friends down the hall helps. Yes. It's a great proof point. There's that. Anything else you would point to in terms of your capabilities where you feel like you kind of came out on top in this process? Well, I think we proved that we have the technical wherewithal, and we certainly have the support teams behind us because while this is a SaaS type of relationship and a platform implementation that we do frequently for Blues plans and other payers, the level of security, the level of building production and testing style applications for the government to ensure they were ready to launch was something that we had not done in the past. I don't think that level of discipline and support exists with many of our competitors. We had to step it up. We had to ensure that we were able to move from implementation in a market or two to a full nationwide and international availability. Again, something that we had not done before, and it took us beyond a year and a half to get that ready. Got it. Just building on that, you touched on the security side. I think anytime working with a government agency, a very important factor. Anything else you would point to in terms of differences in these solutions for government versus commercial? Well, this is a far more robust platform. I would say the government cloud and a number of other requirements, because of the fact that we work within the government, the number of individuals that we had to get certified, the fact that everything around our processes is specific to the DHA, we really cordoned off that area of the company, and it required significant investment, significant education, and a lot of behavior change. Got it. All right. Well, exciting momentum for you in this space. I do also want to touch on just commercial and really just starting with what is resonating with your customers in the marketplace. You mentioned more focus on payers of late within that business. Yeah. The nice thing about really refining our focus is that we speak to the payers more frequently today, and almost to a shocking extent, we have found that nearly half of those payers are looking to change some aspect of their contractual relationships with either independent standalone third-party providers or those who they have for years now had a legacy relationship with on the virtual care side. That obviously presents an opportunity for Amwell. The unfortunate part is that most of the individuals that these payers have not really optimized their relationships or the products, and they have not seen the ROI they expected. When it really comes down to it, they have not seen the level of engagement. Every one of these payers is still in that single-digit level of engagement with their members, regardless of the cohort. Numbers like that were fine when the products were introduced nearly 10 years ago. The step function that everybody expected and that significant behavior change to shift your trust to digital delivery, just hasn't occurred at the pace most expected. Yeah. You also have, it's been a very volatile backdrop for payers in the last few years with different regulations and kind of some pressures they've been under. With that, what are some things that you feel like are resonating the most in terms of what you can offer them as they consider some of these moves? Well, several of the payers that we're in discussion with today have engaged with us because they're disappointed with where their products sit today. They want a channel that can ensure that they can be relevant to their employer clients, to other cohorts of their membership as well. They want to ensure that they can maintain almost a surveillance over those members to ensure that they're using the most appropriate forms of care. We're also introducing a number of our third-party products, whether that be Sword, whether that be a number of cardiometabolic solutions. They want to see those individuals not just visit those point solutions, but see it all in a very comprehensive way and follow them through that journey. They understand that we can deliver that on the Amwell Platform, so we're getting an opportunity to reintroduce ourselves to these payers who may have contracted with us 5 or 10 years ago, but came to us principally for what we had delivered specifically at that time, which was virtual urgent care. We've now matured to virtual primary care, a number of other services as well, but the core rooting has always been in that 24/7 nationwide availability of virtual urgent. Got it. You mentioned before on the government side, where you have done a lot of work and have expertise versus maybe some of the competitors who arguably would have to catch up. I know if I go back a few years when Converge was rolling out, there was a lot of discussion in the marketplace. You have other alternatives, whether it is Zoom or Microsoft Teams. Can you maybe just give us an update today on the commercial side, what you see in the marketplace through a competitive lens? Yeah. The interesting thing is, if you bifurcate the opportunities for Amwell, our SaaS platform is effectively powering now the government solutions. Those solutions do not necessarily rely on the Amwell Medical Group, our clinicians, our nationwide providers, in backing up or supporting the clinicians who are employed by the federal government. In all other commercial aspects, we rely on AMG either primarily as we do through Elevance and a number of other payers, a number of other Blue Cross Blue Shield payers. They can use our medical group to provide that backstop to their medical group and to their providers. We do not necessarily have to sell technology alone. We can sell technology along with our clinical services or even standalone clinical programs, in addition to ensuring that it is all provided over the Amwell Platform. The Amwell Platform is what had matured out of the initial Converge launch a couple of years ago. Got it. Then just building on, you mentioned payers are going through the motions now in terms of what their vision was, what they want to see delivered. How do you think about, if you want to call it white label solutions, like an Amwell will use versus internal development, again, they have a lot of things going on today in terms of managing their business. What are you finding that is resonating most, and are there still areas where they will rely internally? Well, I think the payers in general had approached us over the years with one or two common themes. It was either access for clinical programs or it was helping to bring cost of care down. Today, they are actually introducing what I think is a more relevant concept to them, which is the consumer experience. They are looking to us to help them channel their members through multiple steps of care coordination. They believe that through the Amwell Platform, that might be a brand new channel for them to ensure that not only can they hand off in a very seamless way, white labeled behind their name and behind all of their protocols, but they can ensure that those members come in not just for one specific need, but can be ensured that they could have digital delivery of multiple services, including those third-party or single point programs, but all being delivered through one entry point, being the Amwell Platform. Got it. I love the segue just to some of the business mix you touched on before, kind of the SaaS and all that's an important driver of margins, and like you said, you still have AMG to leverage in situations where customers want that. But just maybe walk us through where you are in this business mix transition, where it stands today and over a multi-year period, that mix of business where things could be heading. The company really went through a very challenging period about two, three years ago, when it found itself somewhat of a bespoke development shop providing both platform, services, hardware, and also bespoke therapy and therapeutic solutions for hospitals, for health systems, for payers, and for employers. You can't be everything to everyone, and in healthcare, it's extremely hard finding a center of excellence, one alone, but looking for five channels is as close to impossible as you could get. So the focus and the discipline that we decided to pivot with two years ago, I think has dramatically changed the face of the company. While we had to part ways with more than half of our colleagues, we were also able to resource the development and the standardization around the platform that is now powering government health solutions and payer health solutions. We certainly have de-emphasized our other channels, and again, as a result of that, I think we have found our sweet spot, and we continue to not only see improvement in our financial picture, but we also see greater interest from the payers. I think our message has been resonating because we are more focused, and we can pay greater attention to and be more responsive to payer needs. Instead of trailing behind them and trying to be responsive to their needs, we're coming at them today in a joint and in a very, I think, strong way of partnering and providing in a conciliatory tone, though recognizing where their challenges are, and to some degree knowing that we've walked the walk with them for these past several years, but coming up with novel approaches. Got it. Like you said, a pretty meaningful change across the organization, and I would echo what you said, you've seen some stability in the business, which is great after a couple of rocky years. That's for sure. Maybe just give us some context in terms of your organization, in terms of not exactly behind the scenes, but just how it's responded and the position you're in today, coming out of this period of the pivot. Well, in all sort of dramatic transformations that companies go through, you like to believe that you've created a team that has the camaraderie, has the mental capacity, and also has the emotional capacity to move forward with fewer resources. In this case, in certain ways, we've actually identified as a result of narrowing our focus and reducing the footprint of the business. In many ways, the individuals who are focused on these two remaining but very focused channels, they're getting more resources. So they feel energized. We've got management meetings going on in Manhattan right now for the past couple of days, and there's a renewed surge of confidence in our ability to deliver. Of course, with the budding VA opportunity and as we're transitioning to a prime vendor for the DHA, these opportunities present people with new business challenges, but also additional resources. As we had to pare down some of our colleagues' teams, we are also now hiring. We are hiring aggressively in areas that we know are going to create value for us and for shareholders over the next several years. That is great. When you think about the model transition and shift more towards SaaS, what does that mean to just the visibility of your business on a go-forward basis? Well, as you know, the visibility is going to be far more reliable. While we still rely in a material way on visit, and visit volume, and seasonality, the more that we can clearly invest in and ensure that clients are engaged with us on the broader opportunities of taking on our SaaS platform, the more opportunity we have to forecast spend in the future, return on investment, and also just pure investment back into that platform. We know that it had been extremely innovative and sort of bleeding edge at the time of launch, but we cannot be naive to believe that it does not require continued investment, and that is something that we have to do today as we are listening to our clients. I think in the past, we were not listening as well as we could have, and I think we are doing a better job of that. Got it. Bringing this together, how do you size the potential kind of market opportunity that you are selling into? As you have kind of rebased the business, once you get back to growth, what is a reasonable kind of longer-term growth algorithm for Amwell? Yep. Growth has definitely been a challenge over the past several years, again, with a lack of primary focus on the areas that I've identified now or where we will be investing. I believe that the market, if we're sitting in our position today with the opportunities with the government and the several payers that we've had for many years now, the tenure with those payers, again, provides us with the right to sit at the table with those payers who we know are looking at opportunities. We've been engaged in proposals and also invited into some of the largest payers in America. We think the opportunity ahead of us is in the hundreds of millions over the next several years, and that can underscore and really help to substantiate where we believe a return to growth should be back into the low- single- digits. Clearly, we have a ways to go, but we have line of sight into a number of opportunities that we've already discussed here and those that the sales team is maturing in their pipeline. Got it. If we can just build on that, if I think about hundreds of millions of opportunity and return to low- single-digit growth. From a margin profile perspective, and again, there's been a big reorg, and I think you have the organization in a place where you need to be. How do you think through, you're on the doorstep of breakeven, which by the way, you've come a long way in terms of getting there. But just as we get to breakeven and beyond, what are some of the important levers to drive margins? Well, we recognize getting to breakeven as a validation of our, I'll say, management's promise to the shareholders, to the board, that we could control costs and obviously also project out our revenue over the eight quarters where that promise and that objective was made. Going forward, we're not shy acknowledging that growth was somewhat nonexistent for the past two years when you think about churn and think about divestitures. Net growth just didn't materialize, and we understand that growth is first and foremost. We'll spend in order to ensure that we have a relevant product in the marketplace, and we continue to drive value for our payers and for the government. But growth is the number one objective for the company, and that's been made very clear to all who have responsibility in the company. Got it. When you get back to growth, is there an element of whatever you are growing, it is X percent from an OpEx relative to that ratio? How do you think about that in terms of the investments required versus what could maybe drop down to margins? That was a question that was posed in our management meetings because there are a number of opportunities to monetize some of the resources, some of the assets that we have. We have to say no more frequently these days because top-line growth obviously comes at a cost. If we are not delivering growth within a margin profile that we have communicated to the team, we are not interested in doing it. That has enabled us to, once again, narrow our focus and ensure that this is durable growth, and this is along the lines of what our platform needs to do in delivering value to payers. It sounds like Net won't fall back on the You mentioned before, you are doing a lot of things. You cannot be everyone to everything. Just the bar is high in terms of whatever you are going to pursue that makes sure it is economical and. That is right. We have a big team of very gifted colleagues, both in development and product, and I think over the years, it was very difficult for our leaders to say no. There were innovators who came in looking for solutions, and we knew that out of all of those companies in the field, we were likely best equipped to foster a new innovation and to deliver something over a 6 or 12-month period. Quite frankly, that, once again, led to very fragmented goals and opportunities within the business. As a result of the discipline that sits in the business today, we go through a very diligent oversight with those teams, and we ensure that we stay aligned. Got it. Maybe just sticking on the operating leverage, anything you would point out internally, use of technology or AI that will help you run the business more efficiently on a go-forward basis? Yeah. We are delicately but very opportunistically launching AI throughout the entire company. There are objectives that have been communicated to the company that we believe are going to help us scale. So when I refer to that low- double-digit growth over the next several years, it's going to come at a much more profitable, and a far more meaningful contribution to the bottom- line, principally as a result of using technology, AI, supported AI-backed technology throughout the company's administrative first, and then, of course, through the technical and program design features of the company. We're going through a dramatic change right now. We're educating all of our colleagues. We're investing in that education, but we're actually forcing our colleagues to adapt to what we believe needs to be an AI-powered Amwell. Got it. I do want to touch on just capital allocation. The company was well-capitalized, so you've been able to invest through this period of a pivot. As you get to break- even, what do you see in your seat as the best uses of cash? Are there tuck-in capabilities? Could they be return of cash? How do you think about that? Well, the board wants us to ensure that we have a durable business for the next several years. Our three-year business plan and the investments required still enable us to sit on a very meaningful amount of cash. We've got certain investors who have asked us to initiate a buyback. We've got a number of individuals who have come to us with some very interesting M&A opportunities. I think we need to get past the end of this year, where these two very meaningful contracts need to be behind us. The opportunity and the visibility into the duration of those contracts will, I think, help to ensure that the opportunities for cash allocation, capital allocation, are informed by how much visibility we have into our business for the next several years. Got it. I am sure you hear no shortage of feedback in terms of what you could be doing, but makes total sense in terms of get on the right track and let that dictate the opportunity set. How do you think about just as we go into next year, just strategic priorities of what you really want to execute on and make sure you hit on the next 12 months or so? Well, we have a number of product roadmap priorities. We have got known deliverables for two or three of our largest clients who, again, make up nearly 70% of our revenue. We have a number of key positions that we need to build. So we have got our work ahead of us, and it has been clearly delineated in a budget and a formation of the business plan for the next couple of years, but it needs to be refined over the next several months. Again, the clarity around those pending contracts will give us what we believe is necessary to now solidify those plans. Got it. How do you think about just risk factors other than just general macro type conditions? I know for the VA, I am sure you want to get to that contract and see that through. But any other risk factors to be aware of that are top of mind for you? Well, dealing with the government is always a risk factor. That is why we like to see longer-term contracts. We were very disappointed, almost to the degree of being shocked last year, when our behavioral health solution was pulled out of the solution for the DHA. We would love to see that brought back into the conversation. We would like to see that again, have the VA entertain that as well. We have a number of other solutions that have been market-tested with larger payers, with populations that are significantly higher than the government's population. We think again, we have earned the right to sit at that table and not just pilot those, but engage in a meaningful way in distributing those services over the entire 9.5 to up towards the 19 million beneficiaries of these services. Got it. As we wrap- up here, as we've discussed, a lot of change with the company. I would say a better foundation in terms of where you got the business to, and now it's about execution and scaling. From the outside looking in, for investors that are now taking another look at Amwell, what are some of the things that you think would be overlooked or really most important to observe and make sure you're hitting on the next year? Yeah. Craig, as you note, we became an underappreciated company as a result of duly deserving the penalty box for the years that we sat in it. We're lifting our head above the water. We've delivered on a few things that, I think you asked me the same question a year ago, it may have even been two years ago. At the end of the day, we have to execute. We have to deliver on those things that we said we would. We told everybody that we fully intended to be the partner for the DHA. We succeeded in that. We suggested we'd have additional opportunities for meaningful use within the government as a result of successful implementation and creating value, and most critically, delivering care in a reliable and secure way to those dependents. The other thing was curtailing our R&D and wrapping- up a year or two of financial results that we had stated at the beginning of the year we were committed to deliver. I think we've done that eight quarters in a row. We've done so while protecting cash, and we're coming out of this with an intent to return to growth. I think if you find that the objectives around securing those longer- term contracts, having greater visibility on a SaaS platform-driven P&L, ensuring that our platform remains technologically relevant, and continuing to grow and offer additional opportunities for payers, then we're doing what we said we would do. Execution is key, growth and execution being the two primary objectives. Excellent. I think we'll wrap there. Really nice to see the progression towards some of the things we've talked, like you said, in the last year or two. Thanks for spending time with us today. I appreciate it. I would not have been able to do this without a great team behind me. Once again, we appreciate the opportunity to be here again. Perfect. Thanks so much, Mark. Thanks, Craig. All right. Thanks.
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