Hello, and welcome to the Oak Street Health fourth quarter 2021 earnings conference call. My name is Alex. I'll be coordinating the call today. If you'd like to ask a question at the end of the presentation, you can press star one on your telephone keypad. If you'd like to withdraw your question, you may press star two. I will now hand over to your host, Sarah Cluck, Head of Investor Relations. Over to you, Sarah. Good morning, and thank you for joining us today. With me today are Mike Pykosz, Chief Executive Officer, and Tim Cook, Chief Financial Officer. Please be advised that today's conference call is being recorded and that the Oak Street Health press release, webcast link, and other related materials are available on the Investor Relations section of Oak Street Health's website. Today's statements are made as of March 1, 2022, and reflect management's view and expectation at this time and are subject to various risks, uncertainties, and assumptions. This call contains forward-looking statements, that is, statements related to future, not past events. In this context, forward-looking statements often address our expected future business performance and often contain words such as anticipate, believe, contemplate, continue, could, estimate, expect, intend, may, plan, potential, predict, project, should, target, will, and would, or similar expressions. Forward-looking statements, by their nature, address matters that are to different degrees uncertain. For us, particular uncertainties that could cause our actual results to be materially different than those expressed in our forward-looking statements include our ability to achieve or maintain profitability, our reliance on a limited number of customers for a substantial portion of our revenue, our expectation and management of future growth, our market opportunity, our ability to estimate the size of our target market, the effects of increased competition, as well as innovations by new and existing competitors in our market, and our ability to retain our existing customers and to increase our number of customers. Please refer to our annual report for the year ended December 31, 2021, filed on Form 10-K with the Securities and Exchange Commission, where you will see a discussion of factors that could cause the company's actual results to differ materially from these statements. This call includes non-GAAP financial measures. These non-GAAP financial measures are in addition to and not a substitute or superior to measures of financial performance prepared in accordance with GAAP. There are a number of limitations related to the use of these non-GAAP financial measures. For example, other companies may calculate similarly titled non-GAAP financial measures differently. Refer to the appendix of our earnings release for a reconciliation of these non-GAAP financial measures to the most directly comparable GAAP measures. With that, I'll turn the call over to our CEO, Mike Pykosz. Mike? Thank you, Sarah, and thank you everyone for joining us this morning. Joining me on today's call, in addition to Sarah, is Tim Cook, our Chief Financial Officer. In this call, I'll start with a review of our 2021 performance, then turn it over to Tim to discuss more specifics around 2021 financial performance. We'll then turn to 2022, and I'll share more on our goals for the year, and Tim will provide guidance for Q1 and the full year of 2022. I wanna first thank our team for the continued dedication and focus on our patients, our communities, and our mission. Our team continues to navigate through a challenging operating environment, including the Omicron COVID surge and the historically tight labor market, especially in healthcare. Despite these headwinds, we achieved strong results across all the major drivers of performance for the fourth quarter. We had strong revenue growth driven by new patient adds in both new and existing centers. We finished the year with 129 centers, including 50 new centers opened in 2021. Third-party medical costs, which we'll cover in more detail, were in line with expectations going into the quarter despite significant headwinds from Omicron-driven hospitalizations, which were obviously not factored into the guidance we gave in early November. Direct cost of care and corporate costs were all in line with expectations as well. The net result is a quarter in which we exceeded the top end of our guidance range against revenue, membership, and Adjusted EBITDA. In the fourth quarter, we generated record revenue of $394.1 million in the quarter, exceeding the high end of our guidance range and representing 58% growth compared to Q4 2020. For the year, we generated $1.43 billion in revenue, representing 62% growth compared to 2020. Our revenue growth continues to be driven by our organic B2C marketing approach. This includes both central channels such as digital marketing and our core community-based outreach team. Medical costs have trended in line with guidance we shared following Q3. This, combined with cost of care, sales and marketing, corporate costs all in line with expectations and higher than projected revenue growth, resulted in an adjusted EBITDA loss of $228.9 million for the year, which is favorable to the top end of our Q4 guidance. When we look back at 2021 as a whole, we exceeded our revenue, center growth, and patient growth targets. Our third-party medical costs were higher than anticipated, driven directly and indirectly by the COVID pandemic, leading to lower adjusted EBITDA performance. Tim will cover in more detail how these trends progressed across the year and their expected impact in 2022. Beyond the financial metrics, we took a big step forward in 2021 in our mission to rebuild healthcare as it should be. We made significant accomplishments across the key components of our business. This will lead to a greater impact on our patients and communities, which will drive our future financial performance. We opened 50 new centers in both existing markets as well as across eight new states. To put that into context, it took us seven years to put up our first 50 centers. This expansion will allow us to serve additional communities and patients, invest in continuous improvement in our care model and patient experience, and greatly increases the embedded profitability of the business. To help mitigate 2020 headwinds in running our community-based marketing model from the Delta and Omicron surges, we markedly scaled our central marketing channels to help fill the gap and continue to see strong results from these channels. We are excited for the time when we can have both our community and central marketing channels working in concert. We were selected by the AARP as their exclusive primary care partner, a relationship that we believe will lead to increased patient growth and retention while being a differentiator for years to come. Additionally, we continue to build on our core platform, adding new care model capabilities and services for patients, which we believe will continue to improve health outcomes and lower third-party medical costs. For example, we published results around the impact of enhancements to our data and technology platform, such as implementing new machine learning algorithms to better risk stratify our patients. We expect the acquisition of RubiconMD will allow us to integrate their virtual specialty network into our care model, creating an innovative and differentiated approach to specialty care, resulting in improved care quality, lower unnecessary medical costs, and improved patient experience. We accomplished all of the above while navigating the twists and turns of 2021. We operated vaccine clinics early in the year and delivered 200,000+ vaccine doses. We navigated COVID surges in the second half of the year while still executing against all aspects of our business. We hired thousands of team members, including hundreds of providers, despite historically tight labor markets. I couldn't be prouder of what our team accomplished in 2021, and I'm excited to see what they can accomplish in 2022. Before I turn it over to Tim, I have two recent topics I'd like to address quickly, the Department of Justice inquiry that we disclosed in November and the recent announcements from CMS related to the Direct Contracting Program. On the status of the DOJ inquiry, we have begun and will continue to provide documents in response to that inquiry. Our discussions with the DOJ have to date largely been about the scope of the request and the document collection process and not about the substance of the inquiry. As such, we are currently unable to make any meaningful predictions about the timeline or outcome in this matter. As we have said previously, we strive to operate in a compliant manner, and we will work with the DOJ in a collaborative and transparent manner as we address their inquiry. On Direct Contracting and the recently announced changes to the program, we are participants in the Direct Contracting Program, as it enables Oak Street to provide our care model to patients with traditional Medicare with increased supporting services than are typically provided in primary care for traditional Medicare patients. In fact, in 2021, 100% of Oak Street Health patients in the Direct Contracting Program were located in areas designated by HHS as medically underserved, mental health provider shortage areas for both. Last week, CMS and CMMI announced important changes to the program aimed at advancing health equity and bringing the benefits of accountable care to underserved communities, promoting provider leadership and governance, and protecting beneficiaries in the model with more participant vetting, monitoring, and transparency. Having been a Medicare Shared Savings Program ACO participant for several years prior to joining Direct Contracting, we are excited to participate in the ACO REACH program and appreciate the time and effort CMS and CMMI invested to modify the program while also taking into account stakeholder concerns. We believe these changes fit well with Oak Street's model, given the communities we serve and our long-standing focus on health equity. The exact details from CMMI are still pending, but if the ultimate changes are consistent with what was communicated last week, we do not expect a material impact to Oak Street. With that, I'll turn it over to Tim to cover some more of the details regarding our financial performance in 2021. Thank you, Mike, and good morning, everyone. We continue to generate strong growth for the Oak Street platform in 2021. To recap the year, we eclipsed $1 billion in revenue, generating $1.433 billion in revenue in 2021, representing growth of 62% from 2020. We exceeded the high end of our initial 2021 revenue guidance issued in March 2021 by 8% and better than the high end of the revenue guidance provided during our third quarter 2021 call. As of December 31, 2021, we cared for approximately 114,500 patients on an at-risk basis, 4% ahead of the high end of our initial 2021 guidance and above the high end of our guidance range on our Q3 call. We opened 50 new centers in 2021, increasing our total center count to 129 as of December 31st. This represents eight more centers than the high end of our initial guidance range. Capitated revenue for the year of $1.397 billion represented growth of 64% year-over-year, driven by increases in our at-risk patient base and our capitated rates. Total prior period development related to capitated revenue from prior years, primarily 2020, was favorable by $20.8 million, driven by the result of our 2020 full year risk adjustment payments compared to our accruals and patient retroactivity. Other revenue for the year was $36 million, representing growth of 13% year-over-year. Approximately $6.5 million of the $36 million was related to favorable prior period developments from our performance in 2020 under our shared savings arrangements, the majority of which was related to the results of our ACORN ACO. Our medical claims expense in 2021 was $1.109 billion, representing growth of 80% compared to 2020, driven by the increase in patients under capitated arrangements and an increase in medical costs per patient. Total prior period development from prior years, primarily 2020, related to medical costs was unfavorable by approximately $6.7 million, driven primarily by patient retroactivity. The majority of these costs were directly offset by the capitated revenue prior period development. As a reminder, patient retroactivity is typical and occurs when health plans pay Oak Street retroactively for patients managed in prior periods but not previously included in our rosters and therefore not previously recognized in revenue or medical claims expense. During our last two earnings calls, we highlighted three drivers of our elevated medical costs. These areas represented an estimated $110 million headwind in 2021, but we continue to believe they are direct results of the pandemic and largely temporary in nature. The first, costs from COVID admissions. In our Q3 earnings call, we shared that in the first three quarters of the year, Oak Street experienced approximately $25 million of costs directly related to COVID admissions. We estimate full year COVID costs were approximately $38 million in 2021, including an estimate for the surge in COVID cases related to the Omicron variant in December. We expect January and February 2022 to have elevated costs from COVID admissions as well. We remain focused on ensuring our patients are vaccinated and have received their booster shots. We also have programs in place to ensure our patients have access to new oral antivirals. We hope as these therapies become more available, they will be effective in reducing hospitalizations and other poor outcomes in future COVID waves for our patients. The second element was non-acute utilization. In our Q2 earnings call, we discussed that non-acute utilization, including specialist visits, diagnostics, and outpatient procedures, increased in March and April following the vaccine rollout for older adults compared to our historical experience. We believe the increase in cost during the spring was partially driven by patients' increased comfort accessing medical care once they were vaccinated, relaxed payer standards due to the public health emergency, and specialist and hospital system behavior. In our Q3 earnings call, we shared that these costs began to decrease in late spring into the summer. As the year progressed, this trend continued. Comparing to our historical experience, we estimate non-acute utilization with a $35 million headwind in 2021, driven in large part by the elevated costs in the spring. However, we do not expect it to be as significant a headwind in 2022, given the lower run rate exiting the year. This is also the cost category where we feel the acquisition of RubiconMD will have the greatest impact. The final driver was new patient economics. In our Q3 earnings call, we discussed how new patient medical costs were elevated compared to historical levels, while per patient revenue for new patients declined to a level less than what we received for new patients in 2019, both on an absolute basis and significantly less than what we would have expected when considering premium trend. The net result is a decline of new patient economics driven by a combination of higher costs and lower revenue than what we have experienced historically. We estimate patient contribution for new patients was $38 million lower in 2021 compared to our 2019 new patient economics. We have looked at new patient contribution by geography, center vintage, provider tenure, and marketing channel, and we saw a similar decrease across all cuts of the data. For this reason, we do not believe the new patient economics in 2021 were negatively impacted by new centers or markets, but instead continue to believe the primary driver of lower new patient economics is lower engagement of adult, older adults, especially those in lower-income communities, by the healthcare system in 2020. Lower engagement results in both higher medical costs because of unaddressed medical conditions and lower revenue because these conditions go undocumented. As a reminder, risk scores lag by a year and depend on diagnoses captured during provider visits. Thus, the lack of engagement before joining Oak Street likely had a double effect of reducing the incoming risk score while also increasing disease burden. As discussed on prior calls, we expect the increase in per patient revenue in 2022 for these patients who joined in 2021 to be larger than our historical experience, which we believe will largely offset the higher medical costs from these patients. At this point in 2022, it is too early, and we have too few new patients to have a firm view on what revenue, medical costs, and therefore patient contribution will look like for our new patients in 2022. While these three drivers led to higher than anticipated medical claims expense and therefore lower profitability than we expected coming into the year, we are seeing these higher costs begin to subside and continue to believe that the remainder will subside over time as COVID evolves from pandemic to endemic. Moving on to cost of care. Cost of care excluding depreciation and amortization in 2021 was $294 million, a 57% year-over-year increase driven by higher salaries and benefits expense from increased headcount as well as greater occupancy costs, medical supplies and patient transportation costs. The growth in these costs were related to the significant growth in our patient base at our existing centers, as well as the growth in the number of centers we operate. Sales and marketing expense was $119 million during the year, representing an increase of 86% year-over-year, and was driven by a $36 million increase in advertising spend to drive new patients to our clinics, as well as an increase in salaries and benefits of $17 million related to headcount growth. As a reminder, growth in year-over-year sales and marketing expense was artificially inflated as our costs were partially depressed during Q2 and Q3 of 2020 due to the pandemic, which included the temporary suspension of community outreach activities and other marketing initiatives. Corporate, general, and administrative expense was $307 million in 2021, an increase of 65% or $121 million year-over-year, primarily driven by headcount costs necessary to support the continued growth of the business. Stock-based compensation represented $156 million of total corporate, general, and administrative costs in 2021, and $79 million of the year-over-year growth. Excluding stock-based compensation, corporate, general, and administrative expense grew 39% compared to our total revenue growth of 62%. As a reminder, the vast majority of our stock-based compensation expense is related to the accounting treatment of equity awards issued prior to our IPO in 2020. I will now highlight three non-GAAP financial metrics that we find useful in evaluating our financial performance. Patient contribution, which we define as capitated revenue less medical claims expense, grew 23% year-over-year to $288 million. We expect at-risk per patient economics to improve the longer that our patients are part of the Oak Street platform. Platform contribution, which we define as total revenue less the sum of medical claims expense and cost of care, excluding depreciation and amortization, was $31.5 million, a 59% decrease year-over-year from $77.5 million. This year-over-year decrease was driven by the previously discussed increase in medical claims expense, as well as a significant recent growth in our center base, and therefore the portion of our centers which are immature. The data we provided during our JP Morgan presentation reflected the losses we expect for new centers as their performance ramps over time. We expect new centers to generate an operating loss for the first two years of operation and approximately break even in year three. As of December 31st, approximately 60% of our centers have been open for less than two years, and approximately 70% have been open for less than three years. Adjusted EBITDA, which we calculate by adding depreciation and amortization, transaction, offering-related costs, income taxes, and stock or unit-based compensation, but excluding other income from net loss, was a loss of $228.9 million in 2021, compared to a loss of $92.6 million in 2020. We finished the year with a strong balance sheet and liquidity position. As of December 31, we held approximately $790 million in cash, restricted cash, and marketable debt securities. In Q4, we closed our acquisition of RubiconMD. The base purchase price was $130 million and was paid in cash. Our liquidity position will support our continued growth initiatives, primarily our de novo center-based expansion. For the year ended December 31, 2021, cash used by operating activities was $197.2 million, while our capital expenditures were $81.3 million. I'll turn it back to Mike now to discuss our focus areas for 2022. Thanks, Tim. Turning to 2022, we are excited to continue on our journey to transform care for older adults. Our focus for 2022 will be on our four core objectives at Oak Street, provide the best care anywhere, deliver an unmatched patient experience, grow the number of patients and communities we serve, and be the best place to work in healthcare. For the last two years, we've required a huge amount of nimbleness and flexibility from our teams in order to meet the needs of our patients and community. In Q2 2020, we essentially morphed into a telehealth company for a time, going from near zero to 90% of our visits being virtual. In Q1 2021, we ramped up vaccine clinics across dozens of our locations to ensure equitable access to vaccines for older adults in the neighborhoods we serve. I'm incredibly proud of these and many more efforts from our teams to be there for our patients and communities. In 2022, we're excited to have our teams, both at our corporate offices and at our centers, focusing on the core of what we do and advancing our performance across all of our objectives. We believe this focus will result in continual improvement to and scalability of our model. As we shared in our January during our JP Morgan Healthcare Conference presentation, we expect the Oak Street platform to drive strong center economic performance in 2022. Our expectation is that our centers that are over six years old will continue to be highly profitable with a subset of these centers that have 2,300 or more at-risk patients driving center contribution of approximately $8 million each. Additionally, as we showed at the conference, our intermediate centers are ramping better financially than our mature centers did at this point in their maturation. Our newest vintages are starting off similar to or stronger than our mature centers for the key KPIs that drive center results. It is for these reasons that we are confident in the unit economics of our centers and the return they will generate for investors while improving the well-being of thousands of patients. As Tim will share in more detail in a couple minutes, our view of 2022 center level performance that we shared at the conference remains unchanged and is a basis for our guidance. Because of our confidence in our unit economics, the differentiation of our model and the massive market opportunity that will enable sustained growth over the next decade, we believe we can pursue a strategy that delivers meaningful near term and longer term value creation for all stakeholders while mitigating risk from current market volatility. We are updating our new center target to 40 new centers in 2022. Our plan is to open 30-40 new centers per year through 2024. By titrating growth to 40 new centers per year over the next three years, Oak Street will achieve substantial growth with an expected revenue compound average growth rate of over 40% while reaching profitability in or before 2025. Additionally, Oak Street will continue to grow our already substantial embedded EBITDA with embedded EBITDA of over $1 billion for centers opened by year-end 2022, and more than $1.5 billion for centers opened by year-end 2024, assuming the unit economics we shared in January. We have previously indicated, we have considerable control over our capital consumption through the cadence of new center growth. If we are able to further improve our unit economics, lowering capital needed over the next couple of years, we will reinvest that capital into an accelerated pace of center openings. By titrating our new center growth in this way, we believe that we have sufficient capital to fund center growth until the business is cash flow positive without the need to raise equity capital now or in the future. Given the recent market volatility, we think this is the most prudent path to control our own destiny, mitigate any risk from market volatility, and build value for our shareholders. As noted above, we remain confident in our unit economics and our team's ability to continue to execute across the range of new center openings we've considered. We believe this approach allows us to build a fast-growing, value-creating, and transformative organization with sustained compounded annual revenue growth of greater than 40% and significantly better profitability. We remain excited to continue to execute our mission to rebuild healthcare as it should be. I'll turn over to Tim to discuss in more detail our guidance for 2022. Thanks, Mike. As Mike just discussed, we are setting our initial guidance for our center growth at 40 centers, resulting in a year-end center count of 169 centers. We expect to care for total at-risk patients in a range of 152,500-157,500, to generate revenue for the year in the range of $2.1 billion-$2.135 billion, representing growth of approximately 45% over 2021. We expected our Adjusted EBITDA loss to be $325 million-$290 million. Implicit in our Adjusted EBITDA loss guidance range is platform contribution performance within the range that we outlined at the JPMorgan conference for each vintage. Recall that our JPMorgan range took into account unknowns around future direct costs from COVID hospitalizations as well as new patient economics. Our guidance incorporates the realities that there will be COVID costs, particularly given the Omicron surge in Q1, and new patient economics are largely unknown at present, given we have relatively few of them at this point in the year. Note that due to the fewer centers in 2022, we will not generate the same level of operating leverage as we would have at having opened 70 centers. We will continue to invest in our platform to drive future performance. We will manage our 2022 new centers to minimize potential costs from delayed openings, but we do expect to incur one-time head costs included in our guidance related to centers originally scheduled to open in 2022 that will now open in 2023. As we look forward to 2023 and 2024, we would expect to open 30-40 centers in each of these years. At this pace, we will continue to strategically grow the business while minimizing the potential for a future equity raise. With performance consistent with our 2022 guidance, this pace would result in 2022 being the trough of our Adjusted EBITDA losses and cash burn, and will position us to be Adjusted EBITDA positive in 2025, while generating a revenue CAGR from 2021 through 2025 in excess of 40%. For the first quarter of 2022, we expect the following: total centers in the range of 138-139, at-risk patients in the range of 122,500-123,500 as of March 31, total revenue in the range of $505 million-$510 million, and an Adjusted EBITDA loss of $45 million-$50 million. With that, we will now open the call to questions. Operator? Thank you. We will now proceed with the Q&A. If you'd like to ask a question, you can press star one on your telephone keypad. If you would like to withdraw your question, you may press star two. Please ensure you're unmuted locally when asking your question. Please note for today, we'll be limiting questioners to one question and one follow-up question only. Thank you. Our first question for today comes from Lisa Gill of JPMorgan. Lisa, your line is now open. Thanks very much, and thank you for all the details, Mike and Tim. You know, just going back to our conference where you talked about 70 centers opening, what's really ensued in the last 7-8 weeks? Is it just simply the current markets and not wanting to have to go back to the equity markets to gain additional capital? Or has something else changed in the way you're thinking about center growth for 2022? Lisa, thanks for the question. From an operational or a market opportunity standpoint, in our view, nothing has changed. As Tim noted, the range of center ramps that we shared seven weeks ago at the conference remains the basis for our guidance. I think we still see a huge market opportunity out there for us. In some ways, I think the change in center growth is actually somewhat driven by that size of that market opportunity. We don't feel like this is a land grab. We feel like we'll be putting up centers over the next decade and beyond. When we looked at the market volatility, we didn't wanna be in a position where we had to access the equity capital markets in the future. We wanted to make sure we really controlled our own destiny and felt that, with this level of growth, we can achieve, you know, as we discussed, very strong growth, bring up the timeline to profitability, and really remove the need for an equity capital raise. Kind of that combination felt like the right approach to us given the volatility in the markets. That's very helpful. Then Mike, just a quick follow-up. You kind of brushed across the new Direct Contracting that the CMS came out with. There were two areas that I feel people are really focused on. One, governance. Maybe you can just address that. I don't think that's an issue for you since you employ your doctors. Second, how we think about risk adjustments and the cohort of patients that they're looking at. Yeah. On the governance one, I think we have the same read as you did on that one, that you know, we are a provider organization, so I think the governance rules will be more relevant for organizations that are more contractual or aggregators of doctors versus a group like Oak Street where that's what we are. That one's pretty straightforward for us. With all things risk adjustment, the devil is always in the details, so we'll you know, we'll pay close attention as more and more details are released. Our initial read is this shouldn't be a big change or impact on Oak Street. You know, I think one of the things that's unique about Oak Street, and I think we're very proud of, is we've been taking care of traditional Medicare patients since the onset of the company. Over that time period, we haven't differentiated the quality of care and the investment we make in our patients based on insurance type. The type of care that patients received in 2014, 2015, 2016, 2017, 2018, 2019, you know, all before Direct Contracting was a program, was very similar. Our baseline patient population was a patient population that's directly cared for by Oak Street at that time as well. Because of that kind of changing the reference year or kinda how you're measuring that baseline of patients has, you know, we believe, limited impact on Oak Street, therefore should have limited impact going forward. Obviously, as more details come out, we'll pay close attention. But our initial read is that shouldn't really make a big difference for us in the program. Great. Thanks for the comment. Thank you. Our next question comes from Ryan Daniels of William Blair. Ryan, your line is now open. Yeah, good morning, guys. Thanks for taking the questions. Thanks for all the data as well. Tim or Mike, maybe one for you guys regarding the archetype model that you shared recently at JP Morgan with the various vintages, and I'm curious if you could compare or contrast that to kind of where we were maybe pre-IPO a few years ago and how that's evolved. Now, I realize COVID probably has an impact here that's transitory in nature, but just any commentary there would be helpful. Thanks, Ryan. This is Tim. I'll handle that. I know there was some unintended confusion after JP Morgan regarding how the cohort data shared at that time compared to our expectations at IPO. I kind of think of this through three different lenses. The first, to the point of your question, is what has changed? You know, our initial model, archetype model, was created in the latter half of 2019 ahead of a potential 2019 IPO that we subsequently delayed until 2020. When we updated the model in the summer of 2020, you know, at that time, we were hopeful, like I think many in the marketplace were, that COVID would be relatively short-lived and the financial impact would be limited and also time-bound. You know, as we sit here today, you know, we continue to be impacted by COVID, both via direct costs as well as indirect costs, or excuse me, indirect impacts such as the growth of our centers as well as the slower growth we experienced in 2020, which has a cumulative effect on results today. As we step back and think about the net present value of the center, which is how we evaluate our center performance, we believe the impact from all these changes related to COVID was about 5%. Relatively immaterial overall, just given the fact that our centers are still achieving the same level of ultimate profitability that we thought they would at the time of IPO. The second lens is just the number of proof points substantiating our performance. At the time of the IPO, we had four centers that we categorized as most scaled, and they generated, you know, approximately $8 million each of annual contribution. Today, that number is 10 centers that we expect to generate $8 million each of contribution in 2022. Additionally, we had 19 centers today that are six years or older versus only seven at the time of the IPO, and we expect those 19 centers to generate, you know, on average, about $6.5 million of contribution in 2022. That kind of leads me to the third, which is, you know, our IPO archetype wasn't based upon our oldest centers performance, whereas what we provided in January is based more upon historical performance and our more recent centers that are outperforming that historical performance, which is why we have a lot of confidence as we think about our future results. Okay. That's super helpful color. Clarifies a lot. As my follow-up, just looking at growth in the expected at-risk lives, it looks a little bit lower on a absolute basis year-over-year versus 2021. I'm curious if you can go into some thoughts around that. Maybe as part of that, you can address just how your marketing may change here as COVID appears to be winding down and we head into the spring with things warming up. Do you expect your community-based marketing to ramp up a little bit here past Paczki Day? Thanks. Ryan, I like the reference. That's a Chicago reference right there as opposed to a Pączki Day, I hope. Yeah. It's great. No, on the kind of patient acquisition front, our assumptions that we're using for guidance project a similar level of kind of growth per center as we saw in 2021. You know, I think obviously what we're projecting to is net growth, and there's you know, multiple factors that go into it, you know, more centers, but obviously a larger installed patient base, et cetera. Last year was buoyed by direct contracting coming in in Q2, where that's obviously in the baseline starting this year. You know, our numbers today aren't assuming we reach what I talked about earlier as, you know, a goal of maintaining our central channels, but getting our community marketing back to where we had it in 2019. Now, obviously, that's our goal. As you know, COVID transitions from pandemic to endemic and people become more and more comfortable beyond the communities, you know, our hope is we can get our community events ramping back up again and really get back to the types of activities from our center-based teams as we were doing a couple of years ago. You know, we still have the same kind of staffing and approach there. That's certainly our hope operationally, but that kind of both of those working in concert is not baked into our guidance, because if there's one thing I've learned over the last couple of years, Ryan, it's to you know stop predicting what's gonna happen in the twists and turns of this pandemic. We'll you know keep assuming kind of performance to 2021 and hope we can improve from there. Thank you. Our next question comes from Justin Lake of Wolfe Research. Justin, your line is now open. Hi, this is Harrison on for Justin Lake. I think you just touched on this a little bit earlier, but I wanna make sure I'm not missing anything. You know, if I'm looking at this correctly, currently your Q1 risk-based, you know, patient guidance implies, you know, 8,500 patient adds in the first quarter, which, you know, would appear to imply 11,000 patient adds in each of the following quarters to hit the full-year guidance. I think historically we've kind of seen the MA member growth more weighted towards, you know, the first quarter versus the other quarters. Is there anything maybe unique this year that's driving the shift in cadence? Is it maybe the, you know, voluntary attribution of DC patients or anything else to call out? Thanks. Yeah. I do think direct contracting has kind of slightly changed the shape of growth across quarters. Historically, we had a fair amount of traditional Medicare patients coming into the AEP period and a set of those would change from traditional Medicare to Medicare Advantage. They would go from non-risk to at risk. Obviously with direct contracting in place, you know, a large portion of our traditional Medicare patients are in that program, and so they're already at risk. If those patients who are on direct contracting choose to move over to Medicare Advantage, right, they remain at risk and you don't really see that movement in our numbers. I think that what used to be a time in AEP of getting a bump in the beginning of the year from traditional Medicare patients moving to risk. The good news is those patients are already at risk. It's an improvement overall, but I think you'll see more kind of, I would say the word kind of similar growth quarter-over-quarter, where you won't have as much seasonality. Which, again, I think that's a nice positive for us that we can be very consistent growth across the year versus being reliant on one period of the year. Got it. Super helpful. Maybe one last one. You know, just on, you know, operating leverage, would you mind expanding upon, you know, maybe your updated thoughts on the pacing of the leveraging of the cost ratios, given that you're slowing center growth and, you know, presumably, you know, still have, you know, a certain amount of overhead, spread across your centers and maybe, you know, just relative to how you're thinking about it prior to the change in, center growth cadence or growth? Sure, Harrison. This is Tim. Thanks for the question. You know, as you know, what you're referencing is we provided a framework about G&A growth during the JP Morgan conference. You know, that was sort of just a simple heuristic. If you think about it on a more nuanced level, our G&A costs have a fixed component, there's a component that's more driven by patient volumes, and there's a component that's more driven by center volumes. The fixed cost component obviously is what it is. There won't be any change to that based upon the change in the number of centers we're gonna open. I'd say the patient-driven costs will not be that significantly reduced this year given the relatively few patients the 30 centers that were pushed would've had, because those are likely centers that we opened later in the year anyhow. If a center was already open in April, obviously we weren't gonna push it to 2023 and incur the dead cost of almost an entire year for those centers. On the center-based costs, you know, there are gonna be some savings here, but, you know, so much of these costs are regional in nature. While we may be opening fewer centers, that isn't necessarily fewer regions in this instance. We were gonna have six centers in a region before, it might be four today. We'll get the benefit of that in future years as we ultimately do open those, you know, incremental two centers in that example. We are still gonna see nice year-over-year improvement in operating leverage, just not to the same degree that we'd expected at JP Morgan. You know, it's fundamentally just given the fact that we were doing the math based on center months and there's gonna be obviously fewer center months in 2022 than we had contemplated at that time. Got it. Thanks. Thank you. Our next question comes from Kevin Fischbeck of Bank of America. Kevin, your line is now open. Great. Thanks. Maybe just to follow up a little bit on that question there. When you think about opening up 40 new sites a year versus, you know, maybe the 70+ that you might have been thinking about previously, is there a change at all about, you know, where those sites are being opened? You mentioned you went to 8 new states this past year. Would you expect the new sites to be concentrated in states that you're already in or would you still expect to be entering new geographies, entering new states? Thanks, Kevin. Appreciate the question. No, I think the approach is the same. We'll open centers both in existing markets, like some of our centers we plan to open will be in Chicago as we continue to see opportunity to take care of more patients and see demand that exceeds the number of centers we currently have. We'll also be opening up in new markets. In Q1, we opened up our first centers in Phoenix, Arizona. We'll continue to build out those. It'll be a combination of both as it was prior. Probably the way I think about it a bit more is the 70 centers we were planning to open this year, we'll still open all of those catchments. We'll just push some of those into 2023. I don't think the approach is different. Okay. Then maybe just to better understand the economics of opening up these centers, you know, does opening up a center adjacent to an existing center, you know, is that a better long-term investment, albeit maybe at the risk of short-term dilution from the existing or surrounding centers? Or, you know, is entering a new market kind of a better, you know, investment? I don't think there's a huge divergence between a new center in an existing market, or a new center in a new market. You know, we have, if you look at our kind of mature centers, the first 19 we put up, the ones Tim referenced earlier, you know, there's a huge amount of variability in the types of markets those centers are in. So obviously a number are in Chicago, our first market. But even in Chicago, some of them are in kind of more blue-collar, middle-class, you know, kind of think retired teacher type neighborhood. Some of them are in kind of dense inner-city neighborhoods that are, you know, have a much, you know, higher rate of poverty. Some of them are in predominantly Hispanic communities. Also in addition to Chicago, those first 19 centers are in places like Rockford, Illinois, and Fort Wayne, Indiana, where we have one center each. Those centers are actually, you know, doing quite well and are certainly, you know, in line or better than the average in those vintages. You know, we're also in Hammond and Gary, Indiana, Indianapolis, Detroit, and all those places are part of those first 19. The reason I say that is I think our approach remains similar to go to that breadth in that type of market, both from a size of market perspective and from a kind of demographic income perspective. When we look at, you know, kind of the ramps of the centers, it's very similar, which I think speaks to the scalability and replicability of what we do. I think in a lot of ways to think about it, Kevin, is it's almost kind of more retail in nature. You know, what drives your market is the center. The center is the catchment around the center. You know, whether you're going to Rockford or the South Side of Chicago, it's really about, you know, who are the 20,000 or so, you know, older adults you're trying to serve and, you know, are you able to engage that community and bring people in. You know, our teams have been historically very good at that across a wide range of markets. All right, great. Thanks. Thank you. Our next question comes from Jessica Tassan of Piper Sandler. Jessica, your line is now open. Hi, thank you for taking the question. If that's the case, can you just remind us of the impact that payer diversification has on patient recruitment, revenue, and operating expenses? Thanks. Jess, I apologize. You broke up there in the middle of your question. Do you mind asking it again? Yeah. Just that. Sorry, my apologies, Jessica. Your line isn't the most strongest. Is it okay if I can just disconnect your line? Is this better? If you press star one, you can re-ask a question. Apologies for that. Our next question comes from Jamie Perse of Goldman Sachs. Jamie, your line is now open. Hey, good morning, guys. I wanted to go through some of those areas of increased medical costs this year and what you're assuming for 2022. It sounds like on non-acute utilization, you're expecting that to be, you know, in line with prior trends on a PMPM basis and adjusted for vintage and all that. Just if you can confirm that. In the ranges, the low and high end of your guidance range, what are you assuming for COVID costs and for the new patient economics, you know, relative to prior trends? Sure. This is Tim. Thanks for the question. I think you categorized the non-acute utilization well. My guess is there's probably gonna be some carry forward effect, particularly given Omicron, and how it impacted not just patients, but more the system's ability to manage patients. I know even at our centers, we had a number of employees who were out because they were sick. We'll see if there is any, you know, any potential carry forward into 2022 just from the end of the year. I would expect it to be relatively limited. From a COVID and new patient experience, I think that it's hard to be overly specific with COVID just given the number of unknowns at this point in the year, and sitting here with the Omicron surge, knock on wood, behind us. You know, if we look back to 2021, I think when we got to May, we all felt pretty comfortable that with the level of vaccinations increasing or the vaccination rate increasing, you know, we were done with COVID, and then we had Delta and Omicron. We had about $35 million, or excuse me, $35 PMPM or about $38 million of COVID costs in 2021. I'd say that PMPM rate would be implicit at the bottom end of our range. The new patient economics are again very much an unknown, but I'd say at the low end of the range, we're assuming a similar level of experience to what we had in 2021. Okay. Thanks for that. There's been a lot of discussion on just the MA environment in the last couple of months. I'm just curious what you're seeing in terms of MCO pricing for MA patients and how that impacts you on a longer term basis, you know, for your PMPM assumptions when you get to that $1 billion and $1.4 billion in contribution for your 2022 and 2024 centers. Just any thoughts around what's going on in the MA market and impact on Oak Street? Yeah, obviously, the MA market, and this is, you know, a continuation of a trend that's been going on for, you know, probably a decade now. The MA market continues to get more competitive with, you know, more new plan entrants and the large existing players, you know, continue to expand into new markets and invest to grow share. So, you know, we're obviously seeing, you know, as you're well aware, higher benefits across markets and across plans. So, you know, that creates kind of two kind of implications for Oak Street. You know, on the one hand, obviously, you know, being at risk, we're also at risk for the benefits. If you know, if there's richer supplemental benefits or, you know, richer cost sharing, you know, that obviously creates a, you know, a expense for Oak Street. Although oftentimes that expense is also offset by, you know, higher benchmarks and higher rates for the plans or higher STARs performance, et cetera. The other side of it, as Medicare Advantage penetration increases, you know, a higher percentage of the people that we meet in the community are already on Medicare Advantage, which obviously helps us get a higher percentage of our patients at risk faster. There's also some, you know, some benefits from that, you know, increasing penetration as Medicare Advantage becomes more and more compelling for people. You know, there's some countervailing factors there as we think about not just, you know, 2022, but into the future. You know, obviously higher percentage of our patients at risk helps, obviously as plans are investing, it's something we'll watch closely. You know, but again, I think it's, you know, I think they're positive trends overall because what also it means is that, you know, patients, especially the patients we serve, are getting more benefits to help them stay healthy and increase their overall being. That's the most important thing, and that also does help us take care of them. Okay, thank you. Thank you. Our next question comes from Elizabeth Anderson of Evercore. Elizabeth, your line is now open. Hi, guys. Thanks so much for the question. Tim mentioned that part of the difference in terms of how you're thinking about the model for this year versus maybe some of the expectations you laid out earlier in the year was sort of a result of the deferral of center openings originally planned from 2022 to 2023. Is it possible to sort of quantify the impact on that so we can just see kind of the run rate difference into sort of core versus some of that, you know, which is presumably sort of like a more one-time cost shifting, you know, to the center openings in 2023? Thanks. Elizabeth, it's Tim. Thanks for the question. I'd say for those 30 centers, as you can imagine, you know, Mike walked through before our thought process on reducing the number from 70 to 40, we've had great success across all the centers we opened over time, never closed a center. Therefore, as we thought about one versus another, you know, we were fairly indifferent, with rare exception. Therefore, you know, we had a mind toward what we can move most effectively, both from a team bandwidth perspective as well as a cost perspective into 2022. As you can imagine, the centers that were slated to open earlier in the year, by and large, are gonna open earlier in the year. The centers that were moved to 2023 were centers that were gonna probably open later. On average, those centers were gonna have less of an impact in 2022 from a loss perspective than what an average new center might have in 2022. From a dead cost perspective, I'd say it's gonna be you know probably approximately $5 million of cost that we'll incur in 2022 that we otherwise wouldn't had we opened 70 centers. Obviously, the benefit is we would have lost far more than that on the 30 centers that we are no longer gonna open. Got it. That's helpful. I know you've been helpful in providing us updates, previously. Do you have anything to say in terms of the hiring market in terms of both doctors and then for sort of the other clinical staff at each of the centers in terms of just sort of, wages and hiring pace? Yeah, it's certainly a more challenging hiring market than we've seen in the past. From a provider standpoint, I mean, provider hiring has, you know, obviously never been easy. There's been a shortage of providers since, you know, the day we started Oak Street. We've had a lot of success over the past, you know, months and year, you know, continuing to expand, continue to hire more providers, both for new centers and also more providers to give us capacity existing centers. I think that speaks to our team and our provider service team that does that work, right? You know, for us, we really feel like we have a differentiated value proposition for our providers, just like we feel like we have a great value proposition for our patients, where they can really practice medicine the way that they want to help care for patients. They have a lot more resources to help them care for patients. Their incentives are all against, you know, quality of care versus volume, et cetera. You know, we see that in our scores, right? Where 95% of our providers say they'd recommend Oak Street as a place to work to friends or family, and 99% of them say Oak Street allows them to do their best work. We're very proud of that. I think that, you know, despite it being a tough labor market to hire in, you know, I think that value proposition, you know, allows us to, you know, to continue to hire and be successful in this environment. Our recruiting. I'd be in trouble if I said it was easy. Our recruiting team would be outside this door waiting for me. They're doing a great job in a tough environment and kind of allowing us to continue to execute. So far, the labor shortages haven't had an impact on, you know, our ability to hit our goals. That's true on the other, clinical staff and sort of as well as the provider sort of level? Yeah, I think that, you know, I obviously highlighted providers, but I think that same concept is true across the board. Okay, perfect. Thanks. Thank you. As a reminder, if you'd like to ask a question, that's star one on your telephone keypad. Our next question comes from Jessica Tassan of Piper Sandler. Jessica, your line is now open. Thanks for coming back. Curious to know if 2022 is the first year where Oak Street has zero exclusive centers. If so, just what's the impact of that payer diversification on patient recruitment, revenue per patient and OpEx at the impacted cohort in 2022? Thanks. Thanks for the question, Jess. We haven't opened exclusive centers up for a number of years now. That was really something that was. We did a large number of them in 2015, 2016 and 2017, you know, a very different period of time for Oak Street. It was a good learning experience, and I think we learned, as I think you kind of alluded to that, it's harder to grow centers that are exclusive, and so that impacts the economics. We also didn't have any last year or the year before that or I think the year before that either. I think that the kind of ramps we shared, you know, seven weeks ago, you know, that's kind of our expected ramp going forward, and that kind of takes into account these are all multi-payer centers. We actually highlighted in that presentation kind of what centers look like or what the cohort looks like without the exclusivity. I kind of would guide you to the non-exclusive boxes in that presentation. Got it. I thought there were a couple still rolling off this year. That's my mistake. Just as a follow-up, can you clarify if the $190,000 sales and marketing plus G&A per month per center is still kind of the correct way to think about OpEx in 2022, given the somewhat slower center growth? Thanks. Hey, Jess, it's Tim. Thanks. I'd say that $190,000 number that we provided a few weeks ago is more. Was contemplated more center months in the year, obviously going from 70 to 40. We were still going to need to make many of the G&A investments we were otherwise going to make. Based on my, you know, my earlier comments, that number will be higher. I believe, I'm doing this from memory, that number in 2021 was about $215,000. It won't be that high. We'll still see some year-over-year leverage, but it won't be as low as $190,000, just given many of those costs we will still incur. Got it. Thank you. Thank you. Our next question comes from Gary Taylor of Cowen. Gary, your line is now open. Hi, good morning. I think that last answer sort of hit on what I was wanting to get at just from a little bit other angle. When we think about your archetype with the lower center openings, it looks like platform contribution would kind of be targeting around $80 million this year. I'm presuming the $35 million EBITDA range in your guidance is probably more around the platform contribution than the G&A spend. By platform contribution. Yeah. Yes, that is correct, Gary. I'd say the range is really driven by the two variables that I mentioned around COVID costs and new patient economics. You know, we have a high degree of control over our G&A expenses as well as our sales and marketing, and so those, there's relatively little range for that included in the guide. Got it. Then just a follow-up. AR days were up a lot sequentially and year over year, but also days claims payable or just your, you know, third party medical expense payable was up a lot year over year and sequentially. I know usually that medical claims is more tied to health plan final settlement timing, less so than your reserving. Can you comment on either one of those, the AR days or the medical claims days? Yeah. Gary, I apologize. You hear some sirens in the background. We had a car accident outside our office. The way our contracts work, and I'll be brief and happy to follow up with folks if there's questions. You know, for some of our contracts, we are paid. I'll call it sort of on an ongoing basis, where we're making an estimate of what our surplus is, our surplus being the premiums that the plans would pay to Oak Street, less the medical costs that are being paid to third party providers. For a subset of our contracts, we're paid sort of an estimate of what that net amount will be, because obviously you don't ultimately know what that net amount is until all the medical claims settle for a period. That's about, you know, half our contracts. The other half are paid more in a manner where we're given a payment upfront by the health plan that covers some fixed costs. I'll use an arbitrary number called $150 PMPM. Then what we're doing is we're settling up that $150 relative to our actual surplus performance, in arrears. Because of the way the accounting works, until we settle with the health plan for that period of time, we're carrying that full balance of both the receivable related to the revenue and the payables related to medical claims. You're gonna see that build up over time. It's actually not IBNR. It's just a function of how those contracts settle. There's nothing unusual in there or different in Q4 than there would have been in periods past, other than the fact that you know we're continuing to grow the business, and that's obviously gonna grow those amounts. Indirect contracting is also gonna factor into that a bit at year-end because it's you know a bit of a different flavor, but more akin to that last Excuse me, the second structure I mentioned where you know we're not getting paid an estimate from CMS as to our performance. Okay. Thank you. Thank you. Our next question comes from Ricky Goldwasser of Morgan Stanley. Ricky, your line is now open. Yeah. Hi, good morning. When we think about slower center growth, 2022, 2023, 2024, this is a compounding effect, right? It adds up to hundreds of centers ultimately. How does that impact your long-term top line targets? Beyond 2022 is my first question. Then the second question, just going back to the question about labor and you being successful in hiring physicians, which clearly is great. At what cost, i.e., what are you seeing in terms of wage inflation, and how does that impact sort of your 2022 guidance in SG&A trajectory? Yeah. Thanks, Ricky. On the first part of the question around the growth, maybe it's just nomenclature, but I wouldn't say it's hundreds of centers impact if we're thinking 70 centers and now we're updating that to 40 centers. You know, over the three years, it would be 30 centers or 90 centers. It is a decrease, but you know, we'll still have by the end of 2024 250 centers. That should give us an embedded EBITDA of over $1.5 billion. I mean, still building you know, a large profitability. From a revenue growth rate, you know, we think that the compound average growth rate over the next three years will be 40% plus. Again, we still think it'll be a robust revenue growth rate. To your second question around at what cost. I think our physician compensation packages, you know, have remained similar to what they've been in the past. You know, we haven't changed them in a meaningful way. Obviously, we always have cost of living increases every year and have small adjustments. You know, as Tim shared in the guidance, right, it's still based on the same range we did for the JPMorgan presentation. One other note I would say about inflation, this is more of a longer-term view, but Oak Street is actually very insulated from inflationary pressures in healthcare in the longer term because our revenue is derived from the benchmark costs, right, for Medicare. To the extent that there is higher costs for labor in healthcare, right, whether that be doctors or nurses or medical assistants, et cetera, right, that will directly impact the cost of traditional Medicare, which obviously directly impacts the benchmarks, right, which directly impacts our revenue. Obviously, in any you know, in any given year, you know, the benchmark doesn't automatically increase, you know, real-time. It may have some you know, headwinds and tailwinds any given year. If you think about, you know, in the two-, three-, four-, five-, six-, seven-year period of time, you know, any inflationary pressure that the whole healthcare market is feeling, you know, maybe felt by Oak Street, but it will be offset by an increase in our revenue. Actually, you know, think about it very simply, the cost of a hospital admission will go up, to the extent that, healthcare labor costs go up, and that means the value of the hospital admission we save will also go up. Thank you. Our next question comes from Brian Tanquilut of Jefferies. Brian, your line is now open. Hey, good morning. It's Jack Sullivan for Brian. Thanks for taking my questions. Not to belabor it on SG&A, but maybe I'll ask the question in a slightly different way. We're shaking out at about a $30 million gap that is SG&A's $30 million higher at the high end of your guidance range versus the low end, assuming that the cohort data you provided is consistent for the low and high end of the ranges you had provided previously. I guess, you know, I just wanna understand what's sort of driving that delta. I know, Mike, you alluded to it a little bit in terms of the variable costs that are in those buckets. Is it more sales and marketing to hit a higher patient number? Is it systems cost that comes in on a per member basis? I guess any color to help us bridge that gap would be helpful. Hey, Jack, it's Tim. It may be best to compare notes. I'm not exactly certain what numbers you're using to get to that. As I mentioned to Gary, we have a relatively narrow range or assumption around G&A and sales and marketing between the high and low end of the range. I'm not certain if it is something different. My guess is it's something, whatever is driving that is more in platform contribution. Maybe we'll just, you know, refine assumptions around what's going into that number, 'cause I wouldn't expect to see that wide of a range for G&A and sales and marketing. Okay. Got it. Yeah. No, no worries on that. Maybe just a quick follow-up. I think an interesting point on conversions from direct contracting to MA. I guess along that line, have you seen conversion from either MSSP lives under ACORN into MA consistently or anything from direct contracting in 2021 over into 2022? Is that something that's actually happening and worth noting? If so, how should we be thinking about impacts on PMPMs? Thanks. Yeah. Historically, we've always seen some patients who will be on traditional Medicare and choose Medicare Advantage. Obviously, there are some patients who are on Medicare Advantage that move back to traditional Medicare. It works both ways. Although in general, we see a net kind of increase in the number of patients who choose MA compared to those that move back out of it. That's, you know, that's obviously macro for Oak Street. That's a macro trend across healthcare over the last decade as MA penetration continues to increase. We certainly see that. You know, direct contracting or the Medicare Shared Savings Program, ACO, was obviously a claims-based alignment. The patient, you know, frankly, generally didn't know that existed or that were part of the program in the Shared Savings Program. You know, so that program has zero impact on the patient's choice of health plan coverage, right? Again, definitely whether we get shared savings or not is relatively irrelevant to how the patient thinks about their health plan coverage. Direct contracting, it's a little more known to the patient because, you know, they have to sign a form to voluntarily align. Well, a lot of them do. Some of them are still claims aligned. You know, from a patient standpoint, Direct Contracting and now the ACO REACH next year, it doesn't have an impact on what the patient gets from There's no, you know, it's not insurance coverage, it's not benefits. It's about how we get paid. A patient's still gonna have the same choice. Is Medicare Advantage a better way to get my Medicare coverage than traditional Medicare, right? That choice hasn't changed just because Oak Street gets paid differently for the patient's care. That's why I think you still see, you know, the same movement you've seen in past years. Awesome. Thank you. Thank you. Our next question comes from Whit Mayo of SVB Leerink. Whit, your line is now open. Thanks for keeping the call going for just a little bit. Can you guys just spend a minute on just the competitive landscape? I mean, we're obviously seeing more providers put a strategy around primary care, and it just feels like perhaps we're seeing a little bit more capacity in some of your legacy or new markets and just, you know, obviously a lot of new lookalike Oak Street models, which is, you know, flattering and probably frustrating at the same time. I guess I'm just trying to get a handle on, you know, how this is maybe coloring your views internally about, you know, some of the economics in your existing legacy markets and future markets. Just how do you guys think about what feels like more and more people sort of encroaching on your turf? Thanks. Appreciate the question. Look, I think overall, I think we think it's a positive that more and more people are entering value-based care and investing in value-based care, 'cause it is the right answer for healthcare. You know, we need higher quality at a lower cost in this country. I think one of the things that we're proud of at Oak Street is that there are, you know, to use your term, lookalikes out there because that means we're helping catalyze change, and so that we think that's great. There's a lot of obvious investment in the space and different groups in the space, but, you know, there's a huge variety of how people are addressing the problem, how they're going to market, and their relative performance. You know, value-based care was around long before Oak Street started, and it's hard to do what we do. I think we've really proven out a level of success and scalability. You know, from our perspective, the market is still massive. As many, you know, as much as you hear, you know, kind of noise around different groups doing things, et cetera, you know, a lot of them aren't center-based models or more partner with existing provider groups, which we don't really feel like is necessarily competition per se, because from a patient perspective, you know, their experience is still the same, right? Even if their doctor gets paid differently. From our perspective, it's all about creating a really compelling patient experience, which is what really drives our growth. You know, I think a lot of the groups that are, you know, attacking the problem. I hope they're very successful, but they're really not doing it the same way we are, and we don't think it's really directly competitive. Even the small number of groups that are more similar to Oak Street and kind of more a center-based model, you know, we're all just a drop in the bucket compared to the number of providers out there. I think we shared in JPMorgan. There's something in the magnitude of 450,000 primary care doctors and primary care nurse practitioners at this time. Even if Oak Street had, you know, 1,000 full centers, right, with six care teams each, you know, we would still be like, you know, 1%-1.5% of the total providers out there. You've mentioned a couple times, new center cohorts are progressing a little faster towards profitability than old cohorts. Could you give us any color on why that's happening and, if you expect that trend to continue? Yeah. Look, we are a much more effective organization today than we were in 2013, 2014, 2015, 2016. You know, if you look back and you say that the 19th center we opened up in those years, you know, obviously they're making, you know, as Tim said, you know, kinda $6.5 million this year in contribution, and the ones that are closer to full are making, you know, $8 million or more. You know, those centers were started in that period of time, right? We are better across the board, whether it's our care model has more programs, is more robust, we use data better, we have better technology, we have better training. Kind of across the board, I think we are better at operating than we were in those days, and so we are seeing improvements. Our 2018 and 2019 vintages, despite being, you know, much bigger vintages than the earlier ones, ramped much faster. I mean, we shared that data in our presentation seven weeks ago. You can see kind of the ramps at like years for those centers. Then we look at the, you know, 2021 and 2020 centers that are relatively recently opened. If you look at the KPIs, you know, the kind of care model metrics or the growth metrics are kinda similar to or better than those same centers. I think that one of the things that gives us a lot of confidence, going forward is that, you know, obviously the return from those early centers, right, they're very profitable, they're working very well. And we feel like the model is better than it was then, and we have a lot of data to support that. That's what gives us confidence that all the centers we're putting up now will, you know, in three or five or six years, depending on, you know, when they open, will be at that kind of six and a half and eventually that $8 million of contribution range. Thank you. Thank you. Our final question for today comes from David Larsen of BTIG. David, your line is now open. Hi. Congratulations on publishing your EBITDA breakeven timeline. Just one quick question. For fiscal 2023, the Medicare Advantage advance rate notice looked pretty good in terms of expected change in revenue for MA plans coming in well above 2022. Just any thoughts around that? I guess, what are you modeling in your longer term plan for growth in revenue per anticipated patient, like if it's anywhere near 8% in 2023, would that be above, in line with or how would that compare to your model? Thanks. Thanks. Appreciate the congrats. On the 2023 rate notes and revenue, I think one thing to always keep in mind is that we are one step removed from kind of the benchmark and rate changes because the health plan is in the middle. The health plan actually provides a buffering mechanism when you think about Oak Street economics. To the extent that rates go up, generally plans will take some of that increase, and they'll invest it in better benefits for patients, which obviously to the conversation we had earlier in the call is a net benefit, right? Because it will drive more MA penetration and more patients on risk for Oak Street. From an economic Oak Street perspective, even if our revenue goes up, so will our medical costs, and they'll largely offset. The same thing happens if there's a worse rate increase notice. It wouldn't have necessarily a negative impact on our per-patient economics because the same buffering mechanism exists. Again, I think we are less sensitive to those types of things than, say, a health plan. You know, from a patient revenue growth rate, yeah, I think we had a higher step up in 2022 from 2021 than we would see in an average year. That is in part because we have a full year of direct contracting, and obviously without the plan in place, direct contracting has higher PMPM revenue than a health plan would kind of at the same risk score. Then number two, as we talked about pretty extensively as you know, you know, we felt that our patient base, especially new patients, were very under-documented in 2021, driven by lack of engagement with the healthcare system in 2020. Obviously now that we've had a chance to understand the patient's conditions and document them accurately in 2021, you know, we're kind of reversing out that under documentation. I don't think that's gonna be an ongoing phenomenon. I think it's more of a one-time catch up in that case. Hopefully that gives you a little bit more color on how we think about the increases. That's great. Thanks very much. Thank you. We have no further questions for today. That concludes today's conference call. Thank you for joining. You may now disconnect.