All right. Thank you guys for joining us on what is our first ever Oak Street Health Investor Day. For those of you here in Chicago, I really appreciate you taking the trip. It's great to see people in person. For those of you who are attending virtually, at least it's not a Zoom screen, and it turns out everyone at Oak Street Health has forced us online. We have that going for us. We're learning a lot already. I think we'll have a great agenda here today. One of our big goals is to give people a better sense of what we think makes Oak Street special, what we think makes Oak Street unique, and what gives all of us here at Oak Street Health so much confidence that we can transform healthcare for older adults. Before I jump in too much, here is the disclaimer slide. For those of you who, I know a lot of you do wanna read it in a lot of detail, it is on our website if you need to access it there. One of our goals today is to make sure all of you get a chance to meet more of our team at Oak Street Health. People have heard from me in earnings calls, questions, and investor conferences that I think we have the best team in healthcare. I think you'll get a chance to see a lot more of that here today. I also know that many of you are tired of hearing from just Tim and I. I think you also appreciate the opportunity to hear from a lot more Oak Street team members. To that end, our first speakers will be Dr. Ali Khan, our Chief Medical Officer of Value-Based Care, and Dr. Julie Silverstein, our Chief Medical Officer of Care Delivery. They'll share a lot more details on the Oak Street Health care model and how that allows us to provide the best care anywhere. After that, Murali Balakumar, our Chief Information Officer, and hopefully, if the timeline is on time, Dr. David Buchanan, our Chief Clinical Officer, will discuss how data and technology drive performance at Oak Street Health. They'll talk to you about Canopy, our proprietary technology and data platform that is a key enabler of both our results and also our ability to scale. Katie Rehberger, our Chief People Officer, will talk about and along with Jim Lipuma, our Senior Vice President of Outreach, will talk about our community and our central channels for marketing and how we leverage them to drive patient growth based on our differentiated patient experience. Brian Clem, our Chief Operating Officer, and Lindsay Arnold Sugden, our Chief Clinical Operations and Learning Officer, will provide more details on our approach to center openings. They'll talk about how we're able to leverage a consistent approach to drive consistent performance and enable our national expansion. After that, Geoff Price, our Co-founder and Chief Innovation Officer, will talk about how we invest in our model to continue to drive improved performance and how that'll enable us to scale into the future. Finally, Timothy Cook, our Chief Financial Officer, will give more details on how our approach will drive long-term value for shareholders. After the presentation, we'll have questions. I'd ask everyone to hold your questions till the end. I'd appreciate it. For those of you attending virtually, feel free to put your questions in the chat or email them to Sarah Cluck, our Head of Investor Relations. After the questions, for those of you in person, we'll have lunch, and we'll do our clinic tours. Before I turn it over to more of our team, I did wanna do a quick high-level overview of Oak Street Health for those of you who are less familiar with our organization. Oak Street operates primary care centers for older adults on Medicare. Our mission is to rebuild healthcare as it should be. We opened our first two centers on the north side of Chicago in 2013. At the highest level, our model is simple. We invest to improve the prime. We've invested to improve the quality of primary care for Medicare patients. By improving care quality, we can improve health outcomes. That lowers acute episodes and lowers hospitalizations. That leads to lower overall costs for our patients. We enter into value-based contracts to keep the savings we generate from keeping our patients healthy and out of the hospital. Those savings pay for our investment in primary care and drive our margin. Today at Oak Street, we operate 137 centers across 20 states. As of year-end 2021, we had about 116,000 patients under service contract, and we have a little under 5,000 team members we call Oakies here at Oak Street. As many of you have heard from me before, the challenges of the healthcare system are very well documented. We have an unsustainable cost trend. We spend more per capita than any other industrialized nation. Despite this spend, we have worse quality outcomes than those same countries. Furthermore, patient satisfaction is poor. The Net Promoter Score for the average primary care physician is a - 1.2. What's even more amazing about that stat is we've used that stat in our IPO roadshow and really every time we've done these types of presentations. They just updated it. I was really surprised to find that it actually has gotten worse over the last couple of years. It's gone from a three to a - 1.2. Despite a lot of focus on patient experience in healthcare, patients aren't feeling a better experience. It's actually eroding for them. In addition to patient experience issues, there's issues for providers in healthcare. We have a shortage of primary care providers, which is obviously becoming acute now. Yet burnout is a huge problem for healthcare professionals, especially for physicians, with over 40% of providers reporting some burnout symptoms. These issues are especially problematic in Medicare. Poorly managed chronic conditions compounded by social factors lead to preventable acute episodes for older adults. These episodes drive up costs. Case in point, 96% of Medicare spend relates to chronic illnesses. These chronic illnesses need to be managed longitudinally in a way that the current system is not well suited to. There's a massive market opportunity for organizations that are able to solve these huge challenges in healthcare. We talk about our core addressable market at Oak Street to be low to moderate income older adults on Medicare in suburban and urban areas. These market sizes span places like Rockford, Illinois, Youngstown, Ohio on the small end, all the way up to major metropolitan areas like Philadelphia, New York City, and here in Chicago on the larger end. We have proven our success across these demographics and across these types of markets. This addressable market has a revenue opportunity of $325 billion for Oak Street. It's growing into the core markets that we've proven our success in. The Medicare market is growing at 7% a year. Because of this massive market, we can have substantial and sustained growth over the next decade and beyond. To put it into perspective, to serve the addressable market today, we would need roughly 10,000 Oak Street centers. That need is growing by 700 additional centers every year. Despite our growth we've had so far, the white space for Oak Street Health is only getting larger. Looking at it another way, there are 460,000 primary care providers in the U.S. today. When we have 1,000 full Oak Street centers, from our 137 today, we'll need about 6,000 providers. Even at 1,000 full Oak Street centers, we would still have only slightly more than 1% of primary care providers employed at Oak Street. Because of this massive market, we can enable sustained growth long into the future in our core market with our core approach. You'll hear a lot more about this and a lot more details on this during the in-person presentations and during our center tours. Again, we really feel like our approach to solving these issues and these challenges, our approach to growing into our market is going to drive both sustained growth and differentiated results. We built this platform from the ground up to customize it to the needs of older adults. We also built this from the ground up to solve the challenges faced by traditional primary care offices who are trying to take care of chronically ill patients today and not getting the results that we need. Additionally, the components of our platform, which you'll hear a lot more about, they all work together and are self-reinforcing. We're really excited to share more about how our model is transforming healthcare for older adults. With that, you've heard enough from me. I will turn it over to Dr. Khan and Dr. Silverstein. Thanks, Mike. I appreciate the time today. We're really excited to be here to, you know, talk to you in detail about, you know, the overall aspects of what it's like to practice at Oak Street and really dig into why for us, you know, this has been an incredibly joyful experience to be here and to build this fantastic care model. I'll just introduce, you know, kind of a quick point of introduction. I'm a primary care doc. I'm a practicing general internist. I work in East Garfield Park, which is a neighborhood in downtown Chicago, a few miles from here. It's about 3 miles away from Chicago's downtown business district in the Loop. It's a community without a grocery store. It's a community that has no hospital access outside of Cook County 3 or 4 miles away. For many years, until we showed up, only one other primary care clinic. Those 3 miles in terms of distance from downtown to East Garfield Park, just four stops on the subway, represent 18 years of difference in terms of life expectancy. An average person growing up in just 3 miles away is gonna die 18 years earlier because of the compounding of different social stress factors and other, you know, disparities that exist in that community. For me, I think that's the, you know, the reason I came to Oak Street, was that knowing that the work that we do in this care model, not only just to deliver care, but to really think about how are we making sure that somebody who can't access any grocery store in their community is getting food, right? How are we doing the work to help people live their best life over and over again in communities across the country? That's all the reason to be here. I've spent about a decade in the value-based care delivery space. I was talking to some of you earlier, you know, obviously, and have sort of been around the block. I came to Oak Street three years ago because I firmly believe, I think as do we all, that this is the place that is delivering superb care for seniors and other Medicare enrollees more reliably, more consistently, and honestly, more creatively than anybody else out there. As we talk about why we believe so much in this model, this really starts with who we serve. We've spent a decade building a model that, you know, focuses on the needs of seniors and other Medicare eligibles, many of whom are in communities, working-class communities, immigrant communities, or other communities of color, where there just isn't access to any sort of primary care services or pharmacy services, much less high-quality care, right? We firmly believe that's the kind of care our patients deserve. Providing that excellent care to our patients is our main foundation. Who are those patients? Well, they're pretty complex, right? As we talked about, they're Medicare eligibles. They live in all sorts of diverse communities. Most of them are coming to us with multiple chronic medical conditions, and a lot of them are coming to us with, on average, seven or more medications. We know this because in most of our visits, we actually ask people to bring their pill bottles, right? I can tell you from earlier this week in clinic, so often what happens is that somebody will come and I'm doing the work of looking at a prescription bottle, checking the date. It says, you know, January 15. This was filled a couple months ago. I should have at least 30 pills left. All too often I go in, and I find that there's actually like in a 90-day supply, I should be almost done, there's like 78 pills left, right? What have we identified in terms of whether somebody's actually taking this or not, and why? More often than not, we find that like somebody's got three different bottles all in at the same time for the same blood pressure medication from three different doctors, none of whom spoke to each other. None of whom did the work of coordinating or trying to find out because they didn't have the time to do it. That patient wonders why they keep passing out every three days. It's because their blood pressure is too low, because they're just trying to go through the motions of doing what they've been asked to do or doing what they've been told. Those pill bottles and that reconciliation is really emblematic of the challenges that patients like ours face. They're stuck in between all the different players in healthcare. They're bouncing back and forth between hospitals and specialists and other places. They don't know who to turn to, who to believe or who to trust, right? Oftentimes they don't have a lot of trust in the healthcare system overall. They worry alone, and they honestly, they worry about more difficult things that hopefully none of us in this room have had to think about in terms of whether they're going to afford their diabetes medication or whether they're going to pay their electric bill because they have to make that choice every month. That is the work that we, you know, try to overcome every single day at Oak Street. We know this because we screen every single one of our patients. 50% of them have that kind of social gap, some sort of income insecurity, food insecurity, housing insecurity. We know that 42% of them are so income-constrained that they also qualify for Medicaid. When you serve across 20 states, there's a lot of variance in who qualifies for Medicaid. It means, you know, money's tight, and 50% of them identify as either Black, Hispanic or Latino or Indigenous. Suffice to say, ladies and gentlemen, this is not cherry-picking. This is addressing the biggest problem in American medicine for people for whom scar tissue against the healthcare system has built up over and over again over decades. The work that we do then is to try to remove that scar tissue. The way that we do that is by building trust, right? Building trust takes time, and really it takes consistency. Our care model spends a lot of time trying to build on consistency. How we do that is pretty simple. As Mike mentioned, we try to keep people healthy, happy, and out of the hospital, which are just things that typical primary care in this country doesn't do. It doesn't. We don't have the time, we don't have the resources, or they may not have, you know, the wherewithal to think about how we do that work. In the Oak Street model, we focus when we invest on three things rather than typical primary care. If you remember one thing, I'd remember this. It's time, it's resources, and critically, it's follow-through. From a time perspective, as you can see, the average doctor, my doctor, right, at One Medical down the street, has a panel of 2,000 unique, you know, patients that he's taking care of. At Oak Street, we don't think that's right in terms of doing the proactive work that matters to care for people well. We bring that down to 500. The average doctor visit in most American primary care is 18 minutes or under. For most of our patients, that's double. We don't see you a couple times a year. On average, we see you 9x a year. For our highest risk patients, even higher than that, as Dr. Silverstein will explain. More critically, we spend time being proactive. We can take a third of our week to say, "Hey, how are we thinking about you? How are we building care plans? How are we executing on that work?" That's nonexistent in normal practice. The second piece is resources. From a resource perspective, we build big teams. I don't wonder as a primary care doc or as one of our nurse practitioners, "Hey, I wonder if our patient got that CAT scan that we were getting to rule out whether they have lung cancer or not." Instead, we use our big teams of social workers, community health workers, clinical informatics specialists, nurses to find out, did that test get authorized? Did it get scheduled? Did it get done? Do we have the results? And what happens next? Our whole job is finding this out, right? Because we are here to ensure follow-through, which is third. When we prescribe medication, we don't wonder whether our patients can afford it. We turn to the pharmacists on our teams or in our in-house pharmacies at many of our centers. We ask, "Hey, what's this gonna cost? Can we find a different alternative?" We actually ask our patient, "Do you think you can afford this? And if not, let's figure out how to get you the support that you need using the rest of our team to find out what you might qualify for." Instead of wondering, as it happens a lot in primary care, "Gee, my patient's really out of sorts from his depression. I really hope he gets in to see a therapist because he really needs it." We hand off, as Dr. Silverstein will explain, to our in-house team in real-time, therapists, psychiatrists, and other mental health specialists who are doing that work every day, integrating our clinics in real time to make things happen. We work to make sure that things don't fall through the cracks on any patient. That's not an easy feat, trust me. It's so easy as a doc in day-to-day practice to be caught up in, "This guy's calling me 'cause his testosterone is low," right? "This person's calling me because he needs a shower chair. Another patient's calling me because she needs an urgent visit because, you know, something's going on in, with her, with a new cough," right? All these things are inbound all day, right? There's no time in normal fee-for-service practice to actually think about how I plan. How I plan for the visit that I have later that day with a patient I've known for 12 years. He's got advanced cancer, and he wants to die with dignity, right? How we build that plan, how we have that conversation, how we just listen to his fears, right? In a visit that's not behind a computer, in a visit that's not just 15 minutes in and out. That's where, you know, that's where our model shines. Without that intentionality, without that proactive piece of building care plans, acting upon them, filling in those details, crossing the T's and dotting the I's every day, we wouldn't get the results that we deliver in markets across the country. 'Cause that's what the Oak Street care model does. We catch people when they stumble, and we help them to not worry alone. That sounds great, right? What's your care model? That can be the easy question. I can tell you there's a lot that goes into what we do. It's a rather simplified version, but even on this, there's still a lot here. I'll break it down for you. There's three parts to what we do. One, how we introduce patients to Oak Street and initially assess them, which Dr. Silverstein will dig in on with a great deal of depth in a little bit. Second, how we engage patients in the Oak Street version of launch to primary care, which we're really proud of. Third, how we help patients navigate the healthcare system. The first piece is really spending time upfront to help put a picture together of where our patients sit at this moment in time and determine the level of worry that we should have for each patient. That level of worry that's informed by data, by our clinical team's opinions, by other, you know, a bunch of other factors, helps us identify then how often we should be touching and interacting with that patient and critically, who else on our big care team should be involved in making sure we follow through and execute against the plans and the agendas that we set. The second piece, our launch to primary care model, that's the mechanism by which we ensure consistency. That level of worry that we talked about before informs the dosage of primary care that we give, how often we see people for in-person visits, what other interventions we wanna do, how we involve the rest of the big care team. It also informs in our population management work that Dr. Silverstein will dig into how often we are proactively thinking about a patient, at what intervals, be it daily, weekly, monthly, or, you know, even more frequently. Third, and I think this is the most exciting thing about practicing here, we have this ever-expanding set of programs and tools that are evidence-based and well-validated from across the medical literature to help people get the care that they deserve in real time. The real time thing is really important. I don't know how many of you have ever, you know, sat around waiting for a referral or worrying alone about, "Gee, I wonder what this heart doctor's gonna tell me when I see him next week," or, "What is the orthopedist gonna say about my knee that's been bothering me for weeks?" Right. I have a patient that I've been seeing over the past few months who we've diagnosed with, you know, reasonably advanced kidney disease, and we've been engaging her with our whole interdisciplinary team. We've been doing a lot of work. But I have a question that I need a kidney doctor to answer, which is, given her type of kidney disease, what kind of options does she have for dialysis? 'Cause that's where she's heading. Could she get a transplant? Does she want dialysis, you know, and so on. Even before we answer the questions of does she want dialysis, right, and how can she have that really informed conversation? In traditional primary care at any of the big shops here in Chicago or across the country, I'm waiting 11, 12, 13 weeks until I get that patient in to see that doctor. That's just its nature, right? We have to wait for authorization. We have to wait for all these other things and trying to get that scheduled, fitting them in. There's a lot of, you know, behind-the-scenes work that can be complicated for people to navigate. With RubiconMD, and with, you know, the beauty of an e-consult platform, is that we know from the best of the medical literature that in most cases, in fact, up to 70% of the time, the question that I have for that kidney doctor could be answered just by a simple conversation. No need for an appointment, no need for anything else. So with Rubicon, when I asked that kidney doctor on the Rubicon platform the same question, I cut that 13 weeks down to four hours. With that information in hand, my team can take it, right? We can then do the work of bringing that back, bringing that information on dialysis back to our patient, sitting down with her and putting in the time, exploring her fears and concerns, talking to her about what decisions make sense for her overall life. A lot of times she'll likely pick the choice of a home-based dialysis solution that's simpler for her to manage, easier to navigate, safer, and cheaper than what happens all too often for patients like mine, who are stuck in between their primary, a kidney doctor, and somebody else, not sure who's running point. Their kidney function continues to go down, and then they end up in an ER one day in full-on kidney failure, starting dialysis in ICU with a big catheter in their neck, wondering what happened. That's the third piece that we work on, right? That's the care navigation. We wanna make sure nobody's sitting in that ICU with that big catheter starting on dialysis. We have the time in our model to do the right thing, to do the work of once we've decided what dialysis option's there, to get them in for the right kind of, you know, pre-procedures, to get them in for the right screenings, to sit down and talk about what nutrition choices they have to make. That's work that today doesn't happen in primary care because it's not stuff that we have time for. That's the kind of, you know, hard, deeply meaningful work that we do every day at Oak Street. That's the unique joy of practicing here, of practicing in a model that's optimized for the patients that we serve, right? For the specific population that we serve. It's incredibly data-driven, and that is holistic by design to make sure we're addressing the entirety of people's needs. We invest in time, resources, and follow-through to earn that trust. As Dr. Silverstein will show us, Oak Street Primary Care doesn't just stop at sort of, you know, typical primary care alone, and the details here really matter. Thank you. As we just heard so nicely from Dr. Khan, the Oak Street care model is really different from traditional primary care. I practiced in a traditional practice as a general internist for 25 years. We knew what to do, we knew what we were missing, but we didn't have the time to do it. It's absolutely thrilling to be at Oak Street to be able to provide the quality care that we know our patients deserve. I'm gonna start off talking to you about one element of our process, which is our intake and assessment process. We already talked about how important it is to spend time with patients. We know that when we listen to our patients, they're comfortable, they become confident in the care that we provide, and that leads to trust. In the medical literature, it's very clear that if a patient trusts their clinician, they're much more likely to adhere to the care plan that's developed between the two of them. Creating trust is one of the most important ways that we drive excellent outcomes at Oak Street from the very beginning. What happens at that intake? Starting over here on the left side of the slide, a patient will see us 2x-3x within the first month of joining Oak Street. The very first visit is called a welcome visit. Appropriately named. We want people to know we wanna take care of them. We want to have them be there. We wanna work with them and create a care plan for them. What happens at that welcome visit? The patient spends at least 40 minutes with their provider and a large amount of time with other people on the care team. We do health screenings that are tailored for older adults, like asking about falls risk and asking about depression questions, things that are important in helping us get to know and understand them. We do a thorough medical evaluation, taking a careful clinical history, and we begin to think about what the treatment plan could look like, and we discuss with the patient what our plans are to work with them. In addition, the patient sees another important member of our care team called the Patient Relations Manager. This is really unique to Oak Street that we have someone in our office, in every single office, who understands Medicare, and they understand the benefits, and they explain that to our patients. Often, we find that patients are not taking full advantage of the benefits that are available to them. Let me give you an example of what this looks like. Last week I saw a patient in an office in New York for a welcome visit. She was a 68-year-old woman with a history of hypertension, and we noticed that she had high blood pressure at the time she came into the office. As it turned out, once I began to talk with her, I realized she was not taking any of her medication. I spent some time listening to her, hearing about what her concerns were. I then explained my take on her illness and the importance of taking her medication. I told her what I thought were the priorities for her care plan, and at the end of that, she looked at me and she said, "Wow, no one ever spent the time that you did to explain to me what this is all about. I'm gonna go home and start taking my medication actually, as soon as I get home." One of the best things about that conversation, and one of the reasons that it was so effective, was that I could do it while looking at the patient. I did not bring my computer into the room. I had a medical scribe there who was documenting in the corner quietly so I could speak in earnest face-to-face with the patient. We find that that's not enough. Our seniors are complicated. They have medical histories that extend way back many years. They're often not able to share all the important information about them. We need information. We need medical records. We need to understand more about them. At Oak Street, we've taken that very challenging problem and created technological solutions that allow us to access data. On the middle panel here on this slide, it's called out a number of different types of information that we like to see. Specialty care, primary care history, whether they've been in the hospital and payer data, if it's available. Our systems aggregate that information, digest it, and bring it to our internal systems. What that means is that I, as a doctor in the office, can provide incredibly accurate and specific care that's tailored to the individual. An example of this would be that when I see a patient, I might know that it's time to order a vaccination, or I might be able to identify that they are in need of a cancer screening test, and I can order that test. This is quite unique and completely unavailable in other offices. On the right-hand side here, what you see is that we synthesize that information and get a 360-degree view. This is the differentiator, and this is what's important to remember. By combining careful clinical assessment with historical data, we are able to create a comprehensive view of the patient, and that puts us in a unique position at Oak Street to create a comprehensive, personalized care plan for each and every patient. I'm gonna move on now and talk a little bit about population health. Dr. Khan spent some time talking about how important it is to spend time taking care of patients when we are not face-to-face with them. All of these activities are geared towards keeping our patients happy, healthy, and out of the hospital. When we do that, everybody wins. Here are three things that are called out to help you understand what it means to do population health. First is the daily huddle. This is a unique activity, and it is not optional in our centers. Every single day in every single center at every location at Oak Street across the country, our care teams gather for at least 40 minutes to discuss the care of patients who are not even in the office yet. We review their care plans. We think about what health interventions they need, and we also can give consideration as to whether there are other people besides the primary care provider that the person should see while they're in their office. It's absolutely amazing to see the team orchestrate their work and then execute it as people come in. Second listed here is the weekly planning meeting. This is a time, at least an hour every single week, where our care teams gather with our social workers and community health care workers and staff to review the care plans of our highest-risk patients. These are patients who may be identified as being likely to be hospitalized or even to die in the upcoming year. We want to be sure we're doing everything we can to keep those patients healthy and certainly out of the hospital. We make sure we're doing everything to provide excellent care. Things we may discuss might be something like, who's a key family member we should contact? Or has the patient's hospital bed arrived at their home? Thirdly listed here is the longitudinal care plan. We have wellness coaches. Their job is to meet with patients to identify what the patient's healthcare goals are. We take those goals, and we combine them with our medical goals to create our care plans. It's really important for us to know what motivates people. In order to make a behavior change or to adhere to a care plan, one has to be motivated. If a patient tells me that her goal is to dance at her granddaughter's wedding, I might be able to use that to help ease them into it to participating in physical therapy. I did actually meet such a patient at Oak Street last year, during a time that our outreach team, our growth team, which you'll hear about shortly, had organized a Zumba event in the community room in Philadelphia. There was a woman who was dancing, and she pointed to her cane in the corner of the room, and she said, "When I came to Oak Street, I could barely walk with that cane. Now I'm dancing." Really amazing. Made me feel fantastic. What's the lesson here, and what's the take-home on population health? We drive superior outcomes by continuously planning for even our highest-risk patients, and we combine that with frequent contact with the patients to keep even those highest-risk patients healthy and out of the hospital. Next, I'm gonna turn to one of our integrated programs to speak a little more in depth about integrated behavioral health. I think you'd all agree that we can't separate our minds from our bodies. It's also well known in the literature that patients with chronic disease who suffer from depression fare worse. In other words, their chronic diseases are not as well controlled if they are also depressed. Unfortunately, mental illness is very common. One out of five approximately having mental illness, often in the form of depression, and millions of people who suffer with mental health difficulties are unable to access or have delays in access to care and behavioral health. Oak Street was chosen to overcome that barrier specifically and purposefully by creating an integrated behavioral health program to make that service available across all locations across the country. We use a model called the IMPACT model. This is a model of collaborative care where the primary care provider, the behavioral health specialist, and the psychiatric specialist do just that. They collaborate to treat the patient. As you can see on the right-hand side of this slide, 43% of our patients have resolution of their depression symptoms in this model, and that result is equivalent to the national well-regarded studies of the IMPACT model. I'd like to use another example of how this works in the office. I saw another 68-year-old woman last week for a welcome visit. Only this patient was much more complicated than the first one I told you about. This patient had chronic kidney disease, hypertension. She had lung disease. She was having difficulty walking and chronic pain. She had a skin concern also of note, and she had depression, and she was running out of her medicine. She had seen her former primary care provider just days before coming to see me. That provider had referred her to four specialists, among them a psychiatrist, saying, "You can't get any more medication unless you see a psychiatrist." She was quite concerned. She had trouble walking, and she was afraid she wouldn't be able to get to her appointments. The subway station in her New York neighborhood was up several flights of steps, and her financial situation made using rideshares prohibitive. The last thing this lady needed was to run out of her depression medicine. I refilled her depression medicine gladly, knowing that if needed, within days or weeks, I could access our integrated behavioral health and get a consultation from someone if I felt I needed that to continue to treat her depression. By the way, I also took care of her skin condition and told her that if we decided she needed other specialists, we'd begin using our virtual platform that Dr. Khan spoke about, Rubicon, and I could get information without her even having to leave her home. When we bring most care into our office, the trust that I discussed earlier is transferred from the primary care provider and the care team to others, which makes it really powerful to take care of patients in this way. I've spoken a few times about the excellent outcomes we achieve, and now I'm gonna be a little more specific about what that looks like. We've talked about taking time to listen to patients, the importance of getting to know them, the importance of spending time thinking about them when they're not in front of us. What does it yield? Just three things called out here. First, diabetes. Diabetes is one of the most common awful diseases of older adults. It causes significant morbidity and mortality by causing heart disease and chronic kidney disease. We know that if we can control blood sugars, the likelihood of those complications is reduced. At Oak Street, 85% of our patients have their blood sugar controlled. That is 6% higher than the industry five-star benchmark across the nation. 87% of our female patients have had mammograms done for screening for breast cancer. That's 12% higher than the five-star benchmark. Colorectal cancer screening, something that's really notoriously difficult to get people to adhere to, our rate is 88%, a whopping 14% higher than the industry benchmark's average. I want you to remember one important piece here. These fantastic results are being achieved in incredibly complex patients who historically have had financial and social barriers to achieving these kind of outcomes. I can give you many more examples, but instead, I'm gonna turn it back over to Dr. Khan to wrap up our conversation about the care model. Thanks, Dr. Silverstein. I have to say, I think the examples that you shared are just, I mean, incredibly refreshing because, again, the point here is, like, we're doing the simple things the right things, right? Refilling somebody's prescription is just the right thing to do as opposed to then you have to go to two other people to get this done, right? The time that we put in where somebody can actually dance in Zumba, which I certainly can't do now, a year after starting with a cane and not being able to ambulate, that's the work that we do over and over again, right? I think the aspect of our care model that I really want you all to come away with is that how consistently we see that trend over and over again across our national footprint for patients of all types, right? As this slide talking about your contribution shows, the longer patients stay with us, just like that woman in Philadelphia, the better their health outcomes. Over time, the greater the savings that we can then capture to reinvest back in this care model. We know how that happens, as Dr. Silverstein described. It starts with assessment. It gets into the little details, making sure we're consistent on ensuring that somebody's actually picking up their medications and taking them, right? Making sure that we're consistent in helping them find the supports to make sure they can afford that electric bill. Making it consistent in terms of how we're deploying community health workers or our care teams to actually make sure that they're making the right dietary choices. You know, like overcoming the small things in real-time, crossing those T's and dotting those I's to make sure we're actually making impact, right? That consistency is what we do over and over and over again. Repeatedly, the more time patients spend with us, especially two, three, four years in, the more their care improves, the more we get their chronic diseases under control, and the more freedom that they have out of the hospital, healthy, happy, and at home to live more activated, more joyful lives. That then enables us to do this everywhere. We see this here in our oldest centers here in Chicago or in our newest centers in states all across the country. The core of why this we are able to do this is value-based care. If you remember only one thing from this slide, remember this. Every only. As we get to that, in primary care, on the dollar that we spend in Medicare today, $3 cents-$5 cents are spent on primary care and preventive care across the country. We flip that paradigm on its head. We invest heavily in the big teams, health educators, primary care, you know, nursing, community health workers, everyone that we described. That enables us to actually do the work consistently, keeping people out of the hospital, bringing hospitalizations down by over half, preventing people from bouncing back to the hospital if they do make it there, bringing ER visits down, and really critically, delivering a patient experience, as shown by our Net Promoter Score, that people actually like, which is such a rare feat in American medicine, right? The savings we generate from that work then reinvest, enabling the continuous evolution and growth of our care model that we've been really fortunate to witness over the past few years as we've added more programs to continue to pursue with depth the kind of work that our patients need. That reinvestment, that work is just not possible in fee-for-service, as most of us know all too well from years of practice in that environment. What's more, and I think this is really compelling, in our value-based model, we're actually able to deliver returns across the board. We can deliver returns to the federal government. As Mike and Geoff will talk about later, the work that we've done in our Medicare Shared Savings ACO over a number of years is the fourth best performance of hundreds of ACOs all across the country, from the biggest systems in healthcare to the smallest physician-led practices. We deliver $1,200 a year in savings on Medicare beneficiaries with nothing more than just deploying our care model over and over again. No fancy tricks, no utilization management, nothing. We deliver returns to our patients, as Dr. Silverstein described, in how well we're able to take care of folks, keep them out of trouble, and deliver fantastic upfront, upstream preventive care. Third, and this is one of the most deeply meaningful, you know, pieces of Oak Street for me, we invest in communities. Every time we open a new center, we're investing $ multiple millions into a community from a built environment perspective that oftentimes hasn't seen that kind of investment in years. Every time we open a center, we're adding dozens of high-quality, accessible, well-paying jobs that we intentionally recruit and hire from within just a few mile radius of the communities that we serve, from doctors and our practice leaders all the way to our Welcome Coordinators, drivers, and other team members. In fact, in Philadelphia, we do such a good job of this that 88% of our team members live within just a couple mile radius of those centers. Our centers, you know, are in neighborhoods that are highly vulnerable, structurally marginalized, and places that oftentimes aren't easy places to find grocery stores or jobs. That's a home run. To us, that's meaningful returns to communities, meaningful returns to our patients, and meaningful returns to us as a company as a whole. You'll see at work in the thriving centers you'll visit today some of our most represented centers in terms of doing the work to do the right thing, right? To help patients become healthier and happier by doing the small things over and over again. What they exemplify is that when we invest in time, resources, and follow-through to build that trust that Dr. Silverstein mentioned, that's rewarding for everyone. If you don't want to take it from us, we've got a video up next from some of our clinicians on the ground in the field in Texas and Illinois, who tell you from their own eyes what it's like to be Oak Street. Hopefully. I came to Oak Street Health about two years ago. The reason is because I think that this organization does better by patients who are really in need of good primary care than any organization that I've seen. It's family. You know, they are so kind here, when they greet you, they smile. I started medical school in New Orleans, Louisiana, in post-Katrina New Orleans. I really got to see firsthand how different healthcare can be for different communities, different demographics, and it was heartbreaking. A lot of times, the patients don't get good quality health care out there. They don't get one-to-one with their providers. They don't get questions answered by their provider. Here in Oak Street, we take time with the patients, and we provide it one-to-one with them. I think they feel more comfortable and secure with the kind of care they're receiving. They wanna help you. They don't wanna just put you out there and say, "Well, you need to take this and that and the other." She explains everything. Tuwanda Williamson is thorough. Did I say she's thorough? I just stay so firmly on all the patients who I've had the pleasure to know since coming to Oak Street, and I can't imagine a practice that looks more fulfilling than this one. Video makes me proud to be a part of Oak Street. Good morning, everyone. My name is Murali Balakumar. I'm the CIO of Oak Street Health. I'm actually kind of a new kid on the block. I've been here for just about eight weeks. My background, I come from financial services. I've had technology leadership roles at GE Capital, JPMorgan Chase, and most recently was the CIO of the credits and debit business at a large firm called Fiserv. When the Oak Street opportunity came up, the thing which was most compelling to me, in addition to the opportunity to work with this fantastic team, what was most interesting to me was the deep intersection of technology and data with the amazing mission of helping people and using value-based care to scale lives. That intersection of technology and data is really exemplified by our flagship technology platform called Canopy. What is Canopy? Canopy is a modern clinical workflow tool. Sorry. The IT guy always has technical challenges, right? Canopy is a modern clinical workflow tool that's optimized for value-based services that presents providers with a really full holistic view of the patients and brings data through in the form of data and insights in the form of workflows and UIs to their desktop. Canopy is built from the ground up to run on the cloud. It builds on what are called microservices, which allow it to scale very easily, supporting the growth that Mike had mentioned. It also allows much less maintenance and downtime in the system, and it allows us to easily and quickly add new features, which is very important as we continue to enhance the system. Canopy also uses APIs to connect with various external service providers in the healthcare ecosystem to bring different types of data into the platform. It's actually built on top of an EHR as the back end, and that's used for compliance and billing. On the front end, it gives the providers a set of UIs, workflows that are really designed for usability and help them make the best possible decisions for our patients. Sean Gerety, a very well-known user experience expert, once said, "The technology you use impresses no one. The experience you create with it, that's everything." That's what Canopy is about. It's about creating an experience that puts the Creating an experience that puts the provider at the center of the process and gives the information about the patients to providers so they can deliver the best possible experience for that patient. I talked about usability and the fact that Canopy is designed from the ground up in usability. We've, as a team, have invested a huge amount of effort and time into obtaining provider feedback into the platform, you know, through beta testing, through focus groups. We also have tools that actually are embedded into the system that allow us to measure usage, dwell times on various screens, and ensure that information is fed back into designing enhancements so we can continue to improve the system. This focus on patients and provider experience, along with its technical capabilities, we're proud to say won Canopy the 2021 Innovation Award from MedTech Breakthrough. If you stay tuned, I think very shortly we'll be announcing another very major technology award in 2022. This slide essentially summarizes the major functions of Canopy. It, with its API-centric design and data intake capabilities, Canopy is able to bring in data from various data sources across the healthcare ecosystem, from EHRs to hospitals to payers to CMS, and pulls all of that into the platform. We have a number of proprietary predictive analytics models using AI machine learning that then essentially dissects the data that Canopy's brought in and create, you know, can do things like determine what are the risk levels of various categories of patients, you know, when should we intervene, how should we intervene, and basically creates recommendations around some of the data. Those recommendations are then provided to the providers in the form of UI and workflows that allow them to essentially focus on patient interaction with all of the data and insights being at their fingertips and allows them to come up with decisions that deliver the best possible care for our patients. As an example, when you know, Canopy might look at the data, a patient history and risk data, and determine that a particular patient needs to come into the clinic twice a month, or maybe they only need to come in once in two months. That recommendation is provided to the provider, and it's also you know, Canopy also creates tasks and workflows that basically allow that patient to get scheduled according to that visitation frequency. I spoke about the fact that Canopy is kind of optimized for value-based care. It has a number of features that enable our care teams to, you know, review things like hospital admissions, the emergency room visits, and also, you know, organize some of the meetings that are reviews that Dr. Silverstein talked about, multidisciplinary reviews of high-risk patients. These activities typically in a traditional fee-for-service model are not given much emphasis because they're not billable. In the case of value-based care, they become critically important to making sure we actually deliver the best possible care for our patients. Closing, I wanna paraphrase George Couros, the author of The Innovator's Mindset, who once said, "Technology will never replace great physicians, but great technology in the hands of great physicians is transformational." Now I'd like to hand the mic off to one of those great physicians, the architect of this transformation, Dr. David Buchanan, who's gonna give you more details on Canopy. Thank you. Thank you, Murali. It's been an absolute pleasure working with Murali these last few months. He's really taking our technology teams to the next level. Thank you for joining us and helping us with that. I'm David Buchanan, Chief Clinical Officer. I'm a practicing general internist and the leader of our product team, which designs Canopy. As Julie and Ellie were describing earlier, we have very complex patients, both medically and socially. We treat them with robust multidisciplinary care teams in our centers, and we have specialized programs to meet the needs of specific patients with certain clinical issues. That's a lot of complexity. How do we handle that kind of complexity and still produce excellent results at scale? One of my favorite academics is John List. John A. List is a University of Chicago economist who's famous for doing real-world economics trials, looking at markets and organizations. He just wrote a book on scaling called The Voltage Effect. In that book, one of the themes that he highlights is that easy-to-use software scales. When we look at our complex patients, our complex teams, and our complex programs, we can produce consistent, excellent results because we use Canopy as the operating system of our care model. Canopy, as Murali mentioned, will help care teams define how often the patient is seen and will define which roles see the patient when they come in and also will, in some cases, automatically enroll them in certain programs when they need specific services. If easy-to-use software scales, how easy is it to use Canopy? Just as context, you heard from Dr. Silverstein and Dr. Khan that we really focus on our patients, not our computers when we're in clinic. Dr. Silverstein in particular often talks about during welcome visits, leaving the computer outside the exam room so she can focus on the primary goal, which is building trust with a new patient that everything else is built on. Nevertheless, our care teams use Canopy for an average of four hours a day. As you heard, we have an electronic health record that they could technically do all their work in, but because Canopy is easy-to-use software, unlike electronic health records, people are drawn to it. Because they use it during the day, it gives us the opportunity to guide their workflows, present recommendations from machine learning algorithms to them and overall hardwire our care model. By the way, Merle's not in charge of technical support for the hotel. I'm gonna next walk you through two examples of how we use Canopy in specific situations. The first is rooming. Rooming was our first feature we built in Canopy. The intention with rooming is to empower our medical assistants to provide comprehensive assessments on a consistent basis in both our new centers and our veteran centers. Before we built this feature in Canopy, and throughout my career in ambulatory care, I've always had medical assistants that help patients get from the front of the building in the waiting area back to the exam rooms. Generally, they would also take the patient's basic vitals along the way. Occasionally, you know, due to you know, hard work and relationship building with the medical assistants, I would also get them to do additional assessments on top of that. Often these were kind of bespoke arrangements that would fall apart as soon as someone was, you know, off on PTO or called in sick. We decided to address this issue of how to improve the performance of our large medical assistant team by looking at all of the assessments that our patients need. Believe me, with the complexity of our patients, they really need a lot. We then removed the assessments that really can only be done by a medical provider, because they require some triage or thinking along the way to complete the assessment. That left a lot that the medical assistants can perform. We then front-loaded all those assessments into the beginning of the visit during the rooming process, so that when the medical provider enters the room, they have all this information at their fingertips. They understand the condition of the chronic conditions. They understand if the patient has depression, loneliness, or other issues that have emerged. That allows our providers to really focus on the complex tasks that only they can address. Since we've rolled this out, we now have very consistent and robust assessments on our patients every day across our centers. Let me just talk about a particular patient I saw. Apparently, we all had very interesting last days in clinic 'cause on my last day in clinic, I was seeing a patient I hadn't seen in a while. During the morning, I had gone through the huddle, as you heard, we do it for all of our patients, and planned out what I was gonna do to help this patient. He had multiple chronic conditions, and so I was planning to focus on those during the visit. During the rooming process, though, my medical assistant learned that actually his chronic conditions were doing reasonably well. You know, maybe could have used a little fine-tuning, but in the big picture, we're on track. She also discovered, though, that the patient had depression, which had not been an issue during past visits. This allowed, first of all, the patient to be automatically enrolled in our depression treatment program that Dr. Silverstein mentioned. For the behavioral health therapist who's on-site in the building and I to jointly address this patient's depression and come up with a treatment plan in that moment that will more rapidly get that person back to good medical health. I know for many years of taking care of patients that the truth is, if someone has very bad depression, I mean, if you don't really care if you live or die, why would you care if your blood pressure is well controlled or not? It's really a foundational upstream issue that we have to address in order to be able to also manage those other conditions well. The next example I'll give is referrals. One of the challenges in ambulatory care is getting patients, especially patients as complex as ours, from the primary care office to have a successful high-quality encounter with a specialist. The referrals module helps our patients consistently get high-quality specialist care, both in person and through virtual specialists. If I describe the way things were before we built this operating system for referrals into Canopy, you'd be surprised at the level of dysfunction that's present. For example, when we have a patient, of course, we need to refer that patient to a specialist who's in-network for that insurance provider that insures the patient. The information we get from the insurance companies, literally 50% of the time, the information on that specialist is incorrect. Basic things like, does this specialist actually accept this insurance or not? Or, what is the address where this specialist will see patients, and things like phone numbers and fax numbers. Literally, at the beginning of this work, we had a lot of specialists whose address was a P.O. Box where they received billing information from the payer, but that was listed as the place the patient was supposed to go to receive their care. In addition, with taking care of seniors and people with disabilities with multiple chronic illnesses, there are many logistical challenges of just navigating to different institutions to get care and to show up with authorization numbers and paperwork. We've sought to solve those challenges as we build Canopy. Finally, and probably most importantly, who are the best specialists for this patient to see? I've been in practice in the Chicago area for the last 20 years, and people always ask me, "Oh, do you know a good cardiologist, gastroenterologist?" Sometimes I do. The truth is, you know, we kinda work in different spheres. I still, you know, don't always have an answer to that question, especially when it's narrowed down to someone who's in-network and physically close to this patient's house and speaks Spanish, for example. As we've built referrals into Canopy, we've addressed all of those issues. We've gotten externally validated data on just demographics and address and the plan information for all of our payers and our patients. We've built systems that automatically fax information to the specialist office so that when the patient shows up, even if they didn't bring things with them, the specialist office has all that information with them. We've created workflows where we can get the authorization numbers sometimes in real time, so we can give the patient all the information in real time, as opposed to sending it to them later. Most importantly, we've worked with external vendors who provide comprehensive quality rankings on all the specialists that we work with. This allows us to assure that we're getting the patient to the right team member. What this looks like when I'm in clinic is I bring up referrals in Canopy, and there are three tiles there that are the specialists that meet all those criteria for that patient and the specialist that I've selected. I don't have to look through a long payer book full of bad information. I just am served up the ones that are gonna provide the best care possible. With our recent acquisition of Rubicon, now we have a fourth tile. The first tile that pops up is, "Click here if you want to submit this as a Rubicon referral." As you've heard, we get that information back typically the same day. We have advice to guide the care of that patient as opposed to waiting for the person to get in to see a specialist. Those are just two examples of many features we've built into Canopy that hardwire our care model in different areas and produce exceptional results, but also consistent results across all of our markets. Last, I'll show you a video of some of our providers talking about their experience using Canopy. Couple more. The great thing about Canopy is that Canopy was developed in-house from the ground up to meet the needs of treating patients first and foremost, providers, and also our clinical teams. We can actually find on Canopy specific actions to address risk factors. As a patient's smoking is one of their major risk factors, we can get actions directly related to the smoking. That could be referring them to an Illinois Quitline, starting them on medication, referring them to behavioral health. Canopy actually has a tool that will bring up a list of recommendations that we can then select for that patient based on their specific risk factors. We have an incredible feature we're using right now, and this is RubiconMD, where I can do a referral right in the room with a patient as a problem is presented to me that I may not know the answer. A patient had a skin lesion. With the patient's permission, I took a picture of the lesion. I was able to send it to the specialist while they're in the room. Within a couple of hours later, I received a response that no biopsy was needed. It was a benign lesion, and I could call the patient and the daughter that afternoon. It saved them time. It saved them money. It saved them waiting for referral and trying to figure out how to get to the specialist. What is phenomenal about Oak Street is the amount of data they have, but that they make it relevant and comprehensive for each patient. It provides us resources and tools to act on the information that we have. One of the things I think is great about Canopy is that it's ever-evolving. The Canopy team is always looking for ways to improve the Canopy experience for Oakies and for our patients. Once we have that information, we can just have that direct conversation with the patient, with the, you know, with the scribes helping us. It's basically eye-to-eye contact without me, you know, spending the majority of the time staring at a screen or a keyboard. Such a powerful video, and I think really shows the impact that our technology has, not just on our providers, but also on our patients. I'm Katie Rehberger. I'm the Chief Growth Officer. I'm here today with Jim Lipuma, our Senior Vice President of Outreach, and we're here to talk about Oak Street Health's unique growth model. Once we get the slide up. No words on the slide, but hopefully, you can see it online. We'd be remiss to start this section about growth without talking about Oak Street Health's exceptional patient experience. You've heard tidbits of this through Dr. Silverstein and Dr. Buchanan and Dr. Khan as they talk about how they interact and treat their patients. Our teams and our centers, our providers, as well as our service team, from the Welcome Coordinator at the front desk to the patient relations manager, to the people checking out and having the patients book appointments, work really hard to make sure that our patients feel valued, feel heard, and feel respected. That creates the trust that Dr. Silverstein was talking about that enables our patients to stay engaged in our model. I'll give a quick example. I am not a provider, but this is a story relayed to me from a provider on our north side who had a patient that he was having a lot of difficulty getting engaged in the in-chair model, was missing appointments, said he didn't want to take his prescriptions. Rather than lecturing him every time he did show up, this provider just listened and learned about this man. He learned that the man was an avid coin collector. The man asked, "Can I bring in some coins to show you?" He said, "Sure." He brought in his coins, and he talked about his coins to the provider, as well as the Welcome Coordinators, as well as the patient relations managers. Everyone learned a lot about coins. More importantly, he started wanting to come into his appointments. Of course, we had to spend a few minutes listening to the coin talk. After that, the provider was able to engage him, was able to get him to start understanding why he had to take his medication, why he had to come in so frequently. That patient became, over time, an engaged patient. That's just one example of how the exceptional experience we deliver really is different from most traditional primary care providers. To be honest, it makes Jim and I's job a whole lot easier on the growth side when we deliver such a unique product, for lack of a better word. Our job is really to go out into the communities and educate people about what we do. Once we deliver that experience, they wanna come back. In addition, these patients are really excited to share with their friends and communities about Oak Street and how we are so different. This definitely helps across the board from a growth side in terms of getting patient referrals, word of mouth, and just building our brand within the community. Jim and I will dive more deeply into each of the three components of our growth model. Before we do that, there are two things that I wanna make sure you take away from our discussion. The first is that community outreach is, and always has been, the bedrock of our growth model. Though COVID certainly presented some challenges, as our community outreach teammates were not able to interact face-to-face as often as we would have liked, with communities opening up, we're incredibly excited to have the opportunity to grow rapidly through those channels again. The second thing to take away is that at Oak Street in general, but on the growth side in particular, we're extremely agile. We are able to modulate up and down different growth channels as the external environment requires us to and as we desire to ensure we're getting the most efficient cost per acquisition. With that, I'll hand it over to Jim to talk a little bit more about our community outreach team. Thanks, Katie. If you're unfamiliar with the term outreach, you're not alone. First time I had heard the term was when I was joining the organization. I come from a more traditional sales background where the terms account executive or account manager are more readily used. I quickly found out that it was the exact same thing, different term, same principle. Which is you have a service that you provide that brings value, and you go out to the market and you share that in abundance. That's what outreach is all about. Community outreach, as Katie mentioned, is the cornerstone of what we do as an organization. We have these beautiful centers. Brian will come up and share more, but they're beautiful. In every community that we're in, they're the marquee spot within that community. It's a natural extension to have people go out into the community to share that, to have those conversations about what we do and direct people back in. That's what we do. Today, there'll probably be 200-300 events that take place that our people are doing. It could be in a food bank, it could be in a senior center. It could be playing bingo in a residence. Every one of those are important to us. We have a variety of things that we do. What's really important is not necessarily the event, it's the connection that we make to the people that we're in front of. We don't go around and just talk about what we do. We have to earn the right to be able to share that. That starts with asking and listening. These are just standard sales principles. Ask and listen, and then earn the right to move forward. We take a lot of time on the asking side of this. We wanna understand. A couple of questions we may ask. First, if you were to call your primary care physician today, could you get in today, tomorrow, the next day? Or do you have to wait weeks or even months? Often we hear weeks or months. How about the follow-on question? When you leave that appointment, how do you feel? Do you feel heard or do you feel rushed? Often we hear, all too often we hear, "I had barely any time to really get my needs addressed." We ask a lot of these questions, and then we come forward and say, "We're different, significantly different than anything you've seen. Let us show you." It's a really important thing to understand that we have to ask questions to engage, to begin a relationship. We have people that go out in the community. They're called outreach executives. Our outreach executives, we look for certain things. First, we wanna find them in the community. We have a center there. We wanna find people that know the community, understand the community, and care about the community. We really work to that. The vast majority of our outreach executives live within five miles of the center in which they work. They can relate really well. You may think, "Well, this guy came from a sales background. He probably recruits salespeople." Not the case. Rather than look at titles, I look at attributes. Who specifically? I teach this to all of our frontline leaders. Find people who care and find people who want to care about their community, who care about the people within the community, and they care deeply about our mission. They want something for themselves or their families. They wanna buy a home, they wanna pay off their debt, they wanna put their child through college. Because when you have both of those things, good things happen. Sometimes we have people that care, but they don't want, and will they drive our mission? Sometimes we have people that want, and they don't care, then they get a call from a recruiter, and then they move aside for a few dollars more. We need to find somebody who has both of those things. You have to possess a care and a want. It's that important. I use this term, you need to find people who have a big heart and a strong why. That's what we try to find. Our interviewing is a detailed process to uncover those attributes. The people in the front row here, this is a big part of our executive team, and the people that are employed in our organization, we all understand one thing. It is a privilege to be a part of this organization. Seriously. I've always been drawn to a mission. When do you ever have a mission where you can save someone's life or extend their time on this planet? I mean, there's nothing like this. We find people that understand the same as all of us understand, and it's really important to find people. Rarely do we speak the term selling. I never use that term internally or sales. That's not the term we use. It's helping. As in how many people did you help today? That's really what we center to because then that centers back to the mission. We wanna keep people tied tightly to this mission, not self, you know, selfish, what's in it for me, but what we're in it for, and that's to help people survive. I think we'd all agree that the most important thing we do is we hire talent, really good people. That's gonna keep me up at night. I am looking for talent. I put puzzle pieces together. I want the right people in the right job. What are you gonna do after that? You have these great people here. What do you do next? We look for a couple things. Say it right and say it enough. Those are two umbrellas. How do you get to that? We spend an inordinate amount of time with our top 20 sales professionals or people that are out in the field, our outreach executives. We study them. We listen to what they say, we watch what they do, and then we build curriculum around that, and then we teach that curriculum. To teach it, we certify it, which means people have to be videotaped, everyone in the outreach side videotaped, studied. They look at themselves, they grade themselves, people grade them, and then they pass, and then they're certified. Now we have really good people who know what to say. Now come the math in the business. I talk about it often. I never really liked math, but it is part of our life. It's a big part of what we do here. We know exactly how many contacts need to be made in a day. We know exactly how many quality conversations have to take place within a day per outreach executive to have the proper outcome. I don't spend any time on outcomes. I spend 100% of my time on action. My team is focused on action. Did we take the right action today? If you did, it will lead to the proper outcome. Katie just mentioned, you know, we dealt with some headwinds. I mean, everybody did. This was a worldwide issue. Nothing unique to us. What was unique is that the group that we have to get in front of, we could not access. I mean, it was shut down, right? Nobody could get in. Family members couldn't get in. How horrible is that? Here we are trying to drive a business, right? Trying to move our business forward. We did. You're gonna see some numbers. We took a bit of an impact, but nothing like you would expect when your entire base of people you can't access. We are creative, and we are resilient, and we drove hard in that period. I'll leave you with a quote. Abraham Lincoln said, "If I had six hours to chop down a tree, I'd spend the first four sharpening the ax." I can tell you this, for the last eight months, we have been sharpening the ax, waiting for this moment to just hit us a week ago, where the doors to the castle are open. We can go back into what made us, which is the senior centers, and spend time with people who've been lonely for a long time. They need us. They want us. We are ready. We've been preparing for this very moment, and we're gonna take advantage of this moment right now. We've been looking forward to it. We are ready. We're excited for what's to come. Perfect. Over to Katie. Thanks, Jim. I'll reiterate our excitement, and I think you probably got the whole audience excited about what we can do on the outreach side now that our communities are opening up again, and we're able to be in events like this again, and see people's faces. In addition to our outreach members, we also invest in a variety of what we call central marketing channels. Digital marketing is our largest of these channels. We invest in things like Facebook, paid search ads, WebMD, and several other health-specific channels. In addition, we're able to leverage pretty local marketing in things like radio and out of home to both build our brand awareness and help support our outreach teams out in the field. I'll give one example. I know many of you are either in New York or from New York City, where we have several centers in Brooklyn, the Bronx, and Queens. A couple months ago, it was pretty shut down again due to Omicron, and seniors were not getting out very much. We certainly couldn't go into senior living buildings or anything like that. New York is a relatively new market for us. We haven't been there a long time. It's not like Chicago, where we've been there a very long time and have a lot of awareness already. We invested in some pretty strategic and very local out of home on subway stations, near drugstores, all in the neighborhoods around our centers to give our outreach teams as well as our central marketing call center a little more visibility as they're reaching out over the phone. Someone could actually say, "Oh, yeah, I saw that when I was going to Walgreens." It actually worked quite well, and we saw both our central marketing and our outreach performance increase. We leverage that local marketing really strategically and surgically where we think it can make the biggest impact for the smallest number of dollars. Success in our central channels relies on our central marketing call center, and this became ever more important during the pandemic when we were doing a lot more telephony. We've invested greatly in our central marketing call center over the past few years, and we are poised now to grow and expand geographically, leveraging that resource. Continued growth and scale also allow us to invest more in our brand. Over time, we've layered on several different aspects to increase our brand awareness and improve our brand perception. There are two opportunities that I'm incredibly excited to talk to you about today that are gonna be new this year. The first is our new relationship with AARP. Jim's gonna talk a little bit more about it, but given the huge impact that it's going to have on our growth strategy, I couldn't let him steal the show totally. AARP is one of the most recognized brands for senior people in the country. Over 90% of people recognize the AARP brand. Over 70% of people trust the AARP brand to make recommendations in the healthcare space. In addition, AARP has 38 million members across the country that we now have access to communicate with and to educate about the Oak Street model. I have one example of how we're leveraging this partnership and the massive organization that is AARP, which is coming up in just a few weeks here. AARP has a subsidiary called Wish of a Lifetime, which grants wishes to elders in the community to fulfill a lifelong dream. We're partnering with Wish of a Lifetime to generate those wishes through events in every single one of our centers. We'll reach out both to our patients and to the communities around us, and specifically to AARP members around our communities, to have them come in, submit their wishes and of course, get to know us and get to know Oak Street. That's just one example and one tiny piece of AARP, and there's much, much more to come in our partnership with them over the coming years. The second opportunity is our brand refresh. For those in the audience, you have gotten a notebook which shows our new brand. We've updated our visual identity to be friendlier and more accessible to our patient base. It's been a long time coming, but we're rolling out the brand refresh in conjunction with our AARP partnership, to kind of kill two birds with one stone efficiency-wise, and replace things like signage and external window clings, all in one fell swoop versus incrementally. It's definitely an exciting time for Oak Street from a brand perspective, and we look forward to making a step-function improvement this year and continuing to build on our brand in years to come. We'll wrap up our section with some data. As you can see, other than our first vintage, which is on the far right, which I believe Mike was the outreach director for those one or two centers, so we'll put that one on him. We deliver incredibly consistent and generally improving results. Our comprehensive growth model and the various channels that we've created over time enable us to do this even when we're challenged with things like COVID. We've learned a lot through the COVID period. We learned a lot about investing in central channels, about upleveling our call center, and about how to operate an outreach model when we can't be face to face with others. We look forward to combining these learnings with a incredibly re-energized outreach team, who is now able to get out into the community to deliver what I believe will be our best growth year yet and will hopefully continue to push us up into the upper left quadrant of that graph. Now I'm gonna show you a video to show a bit what Jim and I have been talking about, in terms of the outreach teams and the patients that they're interacting with. I actually started off as a Welcome Coordinator nearly seven years ago, and from there moved into the community outreach side of things. The great thing about that is I really got to venture out into the communities that we work within and see just how much they needed our service. From explaining to individuals the services that we offer, listening to kind of the gaps that they currently had within their healthcare, and then getting them signed up to become patients with us. You can get an appointment, see your doctor, and get a visit in with your doctor and know that your health is just as good. Know that you are gonna live a few more years. That's what Oak Street Health has done for me. The great thing about being a Welcome Coordinator is that I really got to be the first touchpoint of individuals walking in. You get different facets of individuals being nervous, shy, and really being able to talk to them about just what we offer. Individuals telling me, "You know, you've made this process a lot more exciting. You've made coming to the doctor fun." The great thing about community outreach, I got to do a lot of internal events where individuals would come into our community center and really experience bingo, arts and crafts. Individuals would sign up to become patients. Getting individuals signed up to become patients with us, I've had individuals tell me, "You saved my life," which is something I never thought that I would hear. They're trying to help you. You wanna live a good, long life, but you don't wanna be in a wheelchair, you know, not functioning, just existing. You wanna live. Being a community outreach associate, I got to go directly into those communities and interact with those individuals and explain to them, "Hey, you have this great service right in the exact neighborhood of where you live. You don't have to go an hour to your provider. You don't have to wait six months before you can get in for a doctor's appointment. My doctor is Tuwanda Williamson, very good doctor. I'm very happy with her. I'm feeling a lot better. Matter of fact, I'm getting younger instead of getting older. You know, Oak Street does that to me, period. Good morning. Thank you. It's been a long time since we got to stare people in the face, so it's great to have a little bit of give and take this morning. I'm gonna turn over to Brian to introduce himself, and then I'll take over for a few minutes. Yep. Brian Clem, Chief Operating Officer for Oak Street Health, and I've been with the organization for almost seven years. My name is Lindsay Arnold Sugden. I joined Oak Street as a division president nearly three years ago, following a nine-year career at DaVita Kidney Care and DaVita Medical Group. Today I serve as our Chief Clinical Operations and Learning Officer, and I also maintain leadership with my dyad partner, Dr. Ali Khan, for our West Division at Oak Street. In my role as Chief Clinical Operations and Learning Officer, I have responsibility for ensuring that we operate our care model across all of our care centers in standard and consistent ways, and for ensuring that our team is prepared and empowered to deliver on our mandate to rebuild healthcare as it should be. Brian and I are really excited to share with you today the many ways that our expansion model at Oak Street is highly replicable, similar to our profile, which you just heard about in our care model. Before we do that, I'd love to tell you a patient story which is obviously thematic of the work that we do here at Oak Street. In January, we opened our very first center in Arizona. It is located in a community called Apache Junction, which sits on the eastern edge of Phoenix, right at the foot of a beautiful mountain called Superstition Mountain. Our outreach executives, as you heard from Jim, were out canvassing the community prior to the open of that center, and they met Patty and Robert. Patty and Robert had recently relocated from Chicago to Apache Junction. Before our outreach executives could even get close enough to them to start a conversation, they noticed their badge. They noticed the Oak Street badge and shouted, "My husband and I are already Oakies." Patty and Robert had just relocated from Chicago to Meridian Mobile Home Park in Arizona and went on to share with our team what an impact their time at Oak Street Health in Chicago had had on them and on their health. Patty was so moved to learn that we were about to open in her new community of Apache Junction that she was in tears. This story is impactful for many reasons. First, the amazing forces that came into play to bring Patty and Robert back into our orbit are pretty incredible. Second, I'm really moved by how touched Patty was to know that she need not worry about finding great healthcare, having relocated to a new state with her husband, Robert. Mostly, I really love this story because it reinforces the replicable ways that we choose to expand. In the very same way that we use very specific criteria to identify Patty's neighborhood in Chicago as a place to build an Oak Street center. A neighborhood full of people like Patty, who benefit from Oak Street's care model. We use the exact same criteria to define where we would build in Arizona, and we ended up finding another community of people just like Patty, who would benefit from Oak Street's care model, and we even happened to find Patty herself. Let me turn it over to Brian to talk a little bit more about our expansion model. Thanks, Lindsay. Thanks for sharing. I love that story. It really illuminates how across all the ways we make an impact at Oak Street, none are more exciting than bringing Oak Street care to a new community that hasn't yet had the benefit from it. As the map shows, seniors across a large part of the country are now gaining access to care from the Oak Street team. By the end of this year, Oak Street will be operating in 20 states, representing over 50% of the U.S. Medicare population. Now, we're showing this national map. Also important to know, we understand deeply that high-quality care is delivered locally. That's why at Oak Street, we've built a model that both enables our teams to immerse in the individual communities that they serve, while also launching new centers from a platform that scales nationally. Over the next few minutes, Lindsay and I are gonna share key elements of our organic de novo approach to growth and how this model has generated the consistent, repeatable, predictable results and national scaling that you see in that map. Expansion at this scale is enabled not only by our proven replicable model, but also through our relationships with a network of health plan partners. We have the assurance of knowing that as we prepare to enter new communities across the country, we have health plan partners already in those markets that are ready and eager to partner with us to impact the health of those communities. For every new Oak Street center, there are three primary phases of launching the Oak Street model into a new community. First, we identify the specific neighborhood to enter. Across the country, there are countless neighborhoods that could benefit from Oak Street care. We take a data-driven approach to identify those specific neighborhoods where Oak Street can have the greatest impact. Second, we build the standard Oak Street building. I hope that each of you will join us later today as we offer Oak Street center tours. If you do, I can assure you it will not look like a typical doctor's office. All of our centers are built for the specific purpose of welcoming and caring for older adults, infused with the warmth and welcome that helps all of our patients immediately feel at home. Third, we hire and train the Oak Street team. We hire a team of dedicated professionals that have a passion for our mission. We train and equip them with the tools and techniques of the Oak Street Care model. I'd like to take a moment to elaborate on the first phase of the Oak Street Health expansion process, identifying the neighborhood to enter. At Oak Street, we have a deep understanding of the characteristics of communities that need us most. We apply those lenses and data-driven algorithms to communities across the country of large and small. This predictive capability gives us confidence that we are going to select the neighborhoods which will have the greatest demand for Oak Street Care. After we've identified the neighborhood to enter, we then home in on specifically which location we can best serve our patients from. By immersing in the communities we serve, we place our centers in locations that are convenient for our patients, typically close to where they live. You won't find these in medical complexes, but more commonly in retail areas, and often with a public transportation stop. To give you an example, my office at Oak Street is in our Speedway center on the west side of Indianapolis. It's in a Speedway shopping plaza. There's a grocery store, there's a Dollar Tree, there's a couple of restaurants, there's a variety of other retail shops. Our patients love this convenience. More importantly, this convenience enables our patients to fully participate in the high touch Oak Street care model. I'd now like to return to the second phase of the Oak Street expansion process, building the standard Oak Street building. I often tell people, if you've been inside one Oak Street center, you can likely give a tour at any of the rest. In fact, my first job at Oak Street was to launch and then run our first expansion market back in 2015. I can tell you the centers that we built and opened in 2015 in Indianapolis look very similar to the centers we're building and opening today in 2022. All of our Oak Street centers are built for the purpose of welcoming and caring for older adults. The back clinical space with its open layout is designed specifically to accommodate the collaboration inherent in our Oak Street model with large interdisciplinary teams. Our community room in the public front part of our clinics is so vital to the life of an Oak Street clinic. In fact, these community rooms often take on the feel of a living room to the neighborhood in which we serve. One more time I'll put in a plug. Join us for the Oak Street center tours that we're offering later today. If you've never been inside an Oak Street center, I find it to be such a helpful way to get a true feel for the Oak Street culture. If you have been in an Oak Street center before, it'll be a great way for you to see firsthand the real similarities from one Oak Street center to the next. Now I'm gonna hand back to Lindsay, and she will talk more about the Oak Street team. Thanks, Brian. I'm fortunate to get to talk about our most valuable resource at Oak Street, our team, which for people we call Oakies. As I mentioned before, I used to work at a large multi-state, multi-specialty group, and my team worked with hundreds of providers of all types, acquired, employed, and affiliate practices. No two practices looked or worked the same way. They had different workflows, different staffing models, different titling, different electronic health records. The list went on and on, but perhaps most telling, there were also varied levels of commitment to value-based care. As a long-term operator, that made it very difficult to drive consistency. As a value-based care operator, I've long admired Oak Street's standard approach to caring for patients and to caring specifically for seniors. What's special about Oak Street is that caring for patients with complex needs is extremely complicated. You've heard that today. Our approach at Oak Street is simple. Every center is staffed identically, and every person in the centers that you will meet today on your tours is employed by Oak Street, which drives alignment across the organization. Every role has consistent titling and job expectations from center to center. Every center team is deploying the same processes that you heard about from Dr. Silverstein and Dr. Khan earlier today, the same care model processes to keep our patients well. An average center can house six care teams, and in Oak Street, a care team is comprised of a provider, which is a physician, a nurse practitioner, or a physician assistant, as well as a medical assistant and a scribe. You've already heard a little bit about how important that scribe role is to ensuring that our providers can look our patients in the eye and develop the kind of trusting relationships that truly impact behavior. That core care team of the provider, the scribe, and the medical assistant then work with other center-based roles, social workers and nurses, to really round out the care team and to wrap our arms around our patients and their caregivers. As the center scales, we add incremental services into the care team, including, as you heard again before, behavioral health, mental health clinicians, and also transition support. The transitions team is there to ensure that when a patient does get hospitalized, we have a very smooth transition plan for them out of the hospital, back home, or to another care setting. Our care teams are supported by regional leadership teams and then are backed by centralized functions that work best at scale. You've heard a little bit about those earlier today as well. Because our model is unique, and hopefully that has come through today, we invest heavily in talent development to, one, create an internal pipeline of leaders and, two, to ensure that our team has the training and support that they need to feel prepared and empowered to take great care of our patients. Over the last two years in particular, we've really organized and invested in an organizational objective to be a great place to work. This means several things to us. Fundamentally, it means, first, that we ensure that new Oakies feel very connected to our mission, that they are prepared in their training, and that they feel a deep sense of belonging at Oak Street. The second is that we offer ongoing learning and development opportunities for them, as well as skills refreshers, because we continue to innovate at Oak Street, which means we need to be a place of continual learning. Third, we create programs to grow leaders within the organization, which helps ensure that our culture permeates all clinics. I'll offer just one example on that. In the last three years, we've recruited 40 post-MBAs from top-ranked business schools into Oak Street. 39 of those 40 individuals remain with us today, and 42% of them with at least one year of tenure have been promoted into even more senior leadership roles within the company. Our expansion is also a very important part of our engagement strategy at Oak Street. Oakies get very excited when we announce the opening of a new market, and we have a lot of people raise their hand and say, "I'm so excited about the opportunity to move to X place. I have family there. I have friends there. I've always wanted to try it." They also get excited about the opportunity to continue growing their career, to get promoted, or even just to be a part of the excitement of opening a new market or of opening a new center. We don't rely on those transitions, however, to ensure that our new centers are successful. We have a well-constructed in-center training team that dispatches to every one of our new centers to make sure that our teams train elbow to elbow in all of our care model practices. Lastly, I wanna talk a little bit about culture at Oak Street. Our Oakie culture and our very intentional focus on diversity, equity, and inclusion differentiate us within healthcare. You've learned a lot about the population that we serve, and we strive to be the best in healthcare when it comes to inclusive practices, both in our teams and in our centers. I wanted to read you a couple of quotes. These came from one of our teammate engagement surveys and were thoughts offered by teammates about our diversity, equity, and inclusion practices. "I believe Oak Street Health has done a great job welcoming people of all walks of life. It has created different outlooks and perspectives in all work areas and really has brought out the best in our teams." Another, "I feel Oak Street Health exceeds expectations for an organization of this size to do all that is possible to promote equality regardless of age, race, background, or beliefs." We are very proud to be recognized as a great place to work by many top organizations, but we're also doubling down on that investment. We are halfway through a years-long engagement with the Disney Institute that is very focused on making sure that our culture remains a key attractor for people to come to work at Oak Street, but also, to flow into our unmatched patient experience. Through this work, we are further reinforcing our culture and the positive behaviors it manifests, and we are confident that it is going to have the right downstream impact on both patient experience and teammate experience at Oak Street. In the end, what I really love about Oak Street is that it is what ensures that people like Patty, whether in Chicago or Apache Junction, feel a deep sense of belonging to Oak Street and a deep desire to continue engaging with us wherever they may live. Let me turn it over to Brian to share some data about the consistent results this approach produces. We'll conclude our portion with sharing some of the data that we use to evaluate our performance as we scale, and we'll share that across a few dimensions. As we look at the growth of our patient panel sizes over time, as we look at our medical cost performance as we grow, and as we look at our labor cost performance as we scale, what you'll see from this slide is that the model works, and it works increasingly well as we scale. You'll see that this performance is consistent. This performance is predictable and this performance is repeatable now as it has been for 157 centers. We're now going to show a video that showcases a little bit more on our team. I love our mission, and that is the reason why I continue to be here seven and a half years after joining this organization. Rebuilding healthcare as it should be starts with the right focus on patients and providers. I'm inspired by our ambition to transform neighborhoods all over this country and bring the equitable care that older adults deserve. There's gonna be ups and downs, and healthcare is a lot of work, and it's a lot to try to rebuild an imperfect system. Along the way, if you connect back to your why, you're always gonna find that motivation, and you're always gonna be able to re-energize yourself in the work. I love the company, I love the growth, I love being able to help other people, and I love to make a difference. I feel working at Oak Street definitely helps make a difference in other people's lives. For us to be able to know that we put a smile on their face, that we were able to be that first resolution with the patients, and for me to know that I was a part of that means everything. I have had such a good experience from the time I walked through the door. They give me the confidence not only in my professional life, but with, you know, my personal life and my personal goals. When I saw this opportunity and I read the description and what the company stood for, that's what I applied immediately. Good morning. I'm Geoff Price, and I'm really delighted to be here with you today. In my time, I will share how scale benefits our organization, how it reinforces our success, and how it creates strategic differentiation for our organization. First, I'll pull together a number of the pieces that you heard today, many of which point to our proven approach to scaling the organization. Second, I'll share our view on the benefits of scale, along with some specific examples. To begin, I'd like to summarize why Oak Street is well-positioned to achieve scale at the national level. You've heard our team talk today about the standardized and consistent approach we take to key aspects of our business. A standardized approach helps us achieve scale, helps us have repeatable results, and it helps us do that in a predictable way. Dr. Khan and Dr. Silverstein talk about our evidence-based care model, which is applied consistently across our entire footprint. Murali and Dr. Buchanan spoke about Canopy, which is a consistent platform to help us power our clinical model. Brian and Lindsay spoke about our standardized approach to expansion, which enables every Oak Street center to operate using the same model, the same systems, the same team structures, the same trainings, and then ultimately the same culture. Katie and Jim spoke about our standardized approach to growing the patient base that we serve. It allows us to grow rapidly while also operating consistently across all of our markets. All of this builds to a consistent, repeatable approach to our operations and consistent, repeatable results follow. At Oak Street, we view scale as significantly beneficial to our organization. Really, really important. You can think about the benefits of scale as really falling into two different frameworks. The first way to think about it is that scale can really fuel differentiation in our service offering. The dynamic at play here is as follows. As we grow the number of patients that we serve, we become responsible for an increasing amount of aggregate third-party medical spend we have under management. As that spend under management grows, we're able to take an ROI-driven approach to enhancing our care model. Those enhancements can improve our medical loss ratio. They can improve our clinical outcomes. They also almost always enhance the services that we offer. They enrich the service offering at Oak Street and make Oak Street a more attractive place to get care relative to alternatives. That differentiation in our service offering can fuel additional growth, thereby creating a virtuous cycle. I'll share some examples of how this has played out for us. Second way to think about the benefits of scale are just areas where being in a larger organization directly benefits us. A classic example here is, as we grow, we'll be able to spread our fixed costs over a larger base, improving our operating and financial performance. There are also examples of gaining efficiency in our marketing work, gaining additional predictive capabilities out of our data science models with larger datasets. Other things along those lines. To make this come alive a little bit, I'll share a few specific examples on how we've enhanced our model as we have grown. When we first started in 2013 with two centers in the north side of Chicago, Edgewater and Portage Park, we had very few options on how we were gonna operate. Essentially, everything had to happen within the four walls of that center, and we kept it very simple. As we grew, we were able to make investments to improve outcomes and patient experience. One of the first things that we did was to create a 24/7 call center so our patients can access us at any time. This improves convenience, but it also allows us to get in front of potential emergency department visits by being more available. That made sense at a relatively small scale. From there, we integrated other services that you've heard about today, like behavioral health, which many of our patients need. For our high-risk patients, we started sending care teams into the home to manage their care in the home setting. There are many other examples like this, and the ones I actually wanna spend the most time on are our recent acquisition of RubiconMD to expand into virtual specialty care, and then also our new relationship with AARP, which is, another really exciting thing that we're excited to share. Looking a little more closely at virtual specialty care via RubiconMD. For context, specialty care in the U.S. is really broken. It's expensive, it's fragmented, and it's really challenging for many of our patients to access. For those reasons, we long knew at Oak Street it would make sense to in-source at least some components of specialty care at some point in time. By in-sourcing those services, we think we can solve those problems. We think we can provide access, we think we can better coordinate care, and then ultimately, we can lower medical spend through the application of evidence-based clinical guidelines. It wasn't until recently, however, that we managed enough third-party medical spend for us to be confident that there was an ROI on in-sourcing some of these services. When we started digging into this work, a couple years ago, it quickly became clear that RubiconMD was really a perfect fit for us. They are the leader in virtual specialty care. They have hundreds of specialists across every major specialty. The core Rubicon offering is an e-consultation. It's a virtual offering. It's web-based. It can easily get integrated into Canopy. And because it's virtual, it plugs into our national footprint very easily. In our markets large and small, we have access to high-quality specialty care within our four walls. We're really, really excited about the potential here. The acquisition of Rubicon closed in Q4 of last year. The initial goals for the integration are to seamlessly integrate the Rubicon platform into Canopy, to triple the number of e-consultations that we complete, and to reduce third-party specialist spend by 10% in 2023. Standing here today, we're really pleased with how things are going and the integration is proceeding well according to our expectations. This is really a great example of that virtuous cycle I mentioned earlier, that as we grow, we're able to better optimize the third-party medical spend that we manage while also enriching the services that we offer and making Oak Street a more compelling place for our patients to get care. The next example that I speak about is our relationship with AARP. Last year, we announced that Oak Street Health was the only healthcare provider organization in the country to be selected by AARP to carry the AARP brand name. This means that we can use the AARP logo and name in outreach, in marketing, on signage, and in other applications that we're working on with them. This is a great recognition for our organization. AARP is, as Katie mentioned, one of, if not the best known brand among older adults in the U.S., and they really did a thorough evaluation of healthcare providers in the country. They evaluated providers based on patient experience, quality of outcomes, and ability to scale nationally. Oak Street really stood out on those dimensions. We strongly believe that through our work with AARP, we will add patients more efficiently and more effectively and really differentiate our services in the eyes of consumers, particularly the 38 million AARP members nationwide. While the relationship with AARP is new, and it's hard to be able to attribute any recent growth to it, what I can tell you is we have really come to see already the power of the AARP name in our outreach and our marketing activities. We really believe that there's a lot of benefit that will redound to the organization through this relationship. It's also worth noting that this is a relationship that was enabled by our scale. AARP is a national organization. They're in 50 states. It's important to them to work with an organization like us. That is, that also intends to have a national scale. Again, we couldn't be more excited and optimistic about what this relationship will bring to us. We look forward to meeting many, many new patients through this exciting new channel and continuing to innovate on the services that we offer alongside AARP. To conclude my section, I really wanna leave you with two things. First is that Oak Street Health is well-positioned to scale nationally through our consistent approach, our focus on people, process, and technology. Second is that there are real benefits to scale for our organization. It helps us differentiate our offering, and it really reinforces our success as well. With that, I will hand things over to Tim Cook. Thanks, Geoff, and good morning, everyone. Just before I start, I just wanna thank everyone for those of you who are here in attendance for making the trip to Chicago. It's great to finally put faces with names. I'm glad I came to this suite. I also just wanna thank the Oak Street team. We've learned a lot over the last year and a half as a public company, and in the last several months, we've learned how much effort is required to produce an event like today. I'd just like to thank Sarah and Lane and Pat, who have put together a great presentation and have invested a lot of time in the last few months. Thank you all for being here, and thank you to the team for all the hard work. Mike and I often talk about the consistency of our unit economics and how this consistency gives us confidence in our ability to sustain, if not improve, our financial performance. The inputs of our success are not financial. The inputs are all the elements that you've heard from our team this morning. I'd like to take a minute to level set on the key drivers of our financial performance, our platform contribution in particular, and how what you've heard today drives our consistent results. Our financials begin with our patient economics, captured here in the slide with the patient contribution per patient you see in the box in the center of the page. Patient contribution per patient is just a function of the revenue we generate per patient, plus the medical claims expense we incur for those patients. The key input to our success in patient contributions per patient is the fidelity of our care model that Dr. Silverstein and Dr. Khan walked us through earlier. Our focus on patient care is our singular care model, purpose-built to meet the needs of chronically ill seniors, deployed across all of our centers via common technology platform. We also have Canopy, as described by Dr. Buchanan earlier, enables us to consistently and effectively manage the medical claims expense of our patients. You may recall Dr. Khan also had a slide that demonstrates how those economics improve the longer a patient is with the treatment platform. While we're very proud of our care model, as you can tell, it means very little if we don't have patients to serve. To see patients on the far left of this slide, Katie and Jim walked us through our marketing approach and our strategy to drive patients to our center in a repeatable manner, and the consistency of these growth results over time. The final element is on the right side of this page, and that is the cost of care. Cost of care represents all the costs we incur within the four walls of an Oak Street center, including our care teams, our support teams, patient transportation, medical supplies, rent, and utilities. Lindsay and Brian walk us through our highly formulaic approach to managing our center operations. From the selection and layout of our new centers, to how we staff those centers as they grow, to how we train our team members, all of which strengthen and reinforce the consistency of our care model and our results. Net of all this is the platform contribution you see at the bottom of the page. Because of our highly methodical approach to these key drivers and the refinement of that approach, we're able to generate consistent levels of platform contribution over time. I'd just like to spend one more minute on our care model and some of the results that highlight our ability to be effective regardless of the structure of any one risk program. As it was mentioned earlier, we were an ACO participant in the Medicare Shared Savings Program from 2018 through 2020 until we enrolled in the direct contracting program in 2021. In 2020, our ACO generated the fourth best results across 513 participants nationally, saving approximately 17% compared to our benchmark. We are tremendously proud of these results and believe they speak to the rigor and strength of our clinical operation. Importantly, the Medicare Shared Savings risk adjustment works differently than it does for the Medicare Advantage. Specifically, CMS eliminated any increases to non-demographic risk scores for patients continuously enrolled in MSSP. What that construct meant is that we did not get the benefit over time of any increases for our patients' risk scores. Therefore, our savings were, without a result, of increases in risk scores over the life of the program. What we've laid out on this slide is the results from our 2020 ACO performance compared to results in 2020 for our Medicare Advantage Part C business, which is the best apples-to-apples comparison to the cost and benchmark within the ACO world. As you can see by those orange dots, the surplus that we generated in each of these programs is roughly identical. Additionally, within MSSP, the way you calculate savings is to use a benchmark period. Many of the patients that we served were actually patients of ours during the benchmark period. Which means the costs that we were comparing ourselves to were already managed by Oak Street. Therefore, I believe actually our MSSP savings would have been higher if we were looking at a population that had just walked straight off the street into Oak Street. The work we do around documentation is important because it allows us to calibrate and determine the level of intensity with which we deploy our care model against our patients. It is not the root of our success. The source of our success is a comprehensive clinical model that you heard today, and the outstanding health outcomes we generate for our patients. The finance guy now will run platform contribution into numbers. Some of you may recognize this slide. We presented some similar information at the JP Morgan conference a couple months ago. This slide illustrates a few things. The first is the steady improvement we experience over time as our centers mature. You can see that on the upper right chart in those orange dots. Those orange dots represent the results of our 15 centers that we opened from 2013 through 2015, and how the platform contribution of those centers increased as the patient panel scaled at those centers. I'd like to compare those results to the green bars you see. Those green bars represent our initial range of expectations for our 2020 performance for each vintage from what we knew at the beginning of January, prior to issuing our 2022 guidance. Our 2022 guidance was ultimately a narrowing of those ranges. The primary driver of those ranges is our assumptions around the headwinds we experienced in 2021 and how they may or may not manifest themselves in 2022. Just one other point of clarification, so year two on that slide would be our expectation for our 2020 cohort and how the 2020 cohort would perform in 2022. For year three, it would be the 2019 cohort, so on and so forth. The high end of that green bar represents no COVID costs, new patient economics consistent with our 2019 performance. As I said in our last earnings call, we know there'll be COVID costs in 2022, given the Omicron surge in January and February. The high end of this range is not necessarily relevant for 2022. However, it does illustrate where we'd expect our centers to perform were it not for the COVID headwinds, which we do hope will dissipate at some point in the near future. Thankfully, we're all here, so hopefully that's on the wane. The low end of those green bars represents PMPM COVID costs and new patient economics consistent with our performance in 2021. One thing that's telling is when we compare these green bars to where those orange dots are, you can see that those green bars are a margin higher than each of those orange dots. That means we're getting bigger. Our expectation for our vintages in 2022 is that they will outperform where those original 15 centers performed at the same point in their evolution. The one exception would be the year five cohort vintage that you see on this slide. Those are 2017 vintage centers, which represents five centers, three of which were initially exclusive with one payer when we opened them. That exclusivity hindered those centers' growth. If we exclude those three centers and look at the other two centers in that vintage, you can see those then represented by the bottom bar. You can see the results for those centers are in line with, if not slightly ahead, of our legacy performance. To put some numbers against this, if you consider the far right green bar on this slide, that far right green bar represents centers that in 2022 will be in years six or greater of operation. These are centers that we opened from 2013 through 2016. That represents 19 centers. At the midpoint of the information that we provided this morning, which you can see on this page, we expect those 19 centers to generate, on average, $6.5 million of platform contribution in 2022. If you go one level deeper, if you look at the 10 most scaled centers within those 19 centers, these are centers that will have 2,300 patients every month in 2022. Those centers will generate, at the midpoint, $8 million of platform contribution in 2022. Importantly, all 19 of these centers still have excess capacity, still have opportunity to grow, and they've yet to reach plateau in their results. It is these platform economics and the steady improvement we've seen over time and across markets that gives us confidence that the data you see on this page will serve as a baseline for our unit economics in 2022 and beyond. One of our regrets as an organization, and I mean Mike and Geoff, because they were the guys here at the beginning who made some of these decisions, was that we opened too few centers early in our evolution. All kidding aside, I think the more modest pace probably allowed, enabled us to iterate the model and create the chassis of the machine we're talking about today. The reality is that means we have fewer mature centers or scaled centers that can support the investments that we're making in new centers. On this slide, we've broken our centers down into three buckets. The first bucket is our new centers. These are centers that have opened for two calendar years or less. As you can tell on the prior page, these centers are generally losing money and are before ramping to break even. The second bucket is our ramping centers. These are centers that have opened from three to five years. These centers are profitable on a four-wall margin basis. However, depending upon where they're at in that three to five range, they may or may not be covering the SG&A investments we make to support the growth and operations of those centers. The final bucket is our scaled centers. These are centers that are in year 6+ of operation, which have hit their profitability stride. These are the centers that really are the source of the profitability that allows us or covers the investment that we'll make in new centers. We've got a table on the bottom of the slide assuming that we open 40 centers in 2022, the high end of our range. At the end of 2022, 70% of our centers will be in that new bucket, and the average age of our centers will be only 2.0 years old. Which interestingly is higher than 2021. At the end of 2021, the average age was 1.8 years. Assuming we open 40 centers in 2023 and 2024, the high end of what we discussed in our earnings call. By the end of 2024, 48% of our centers will be new. The average age will be about three years. On the top half of the page, I've illustrated what those years look like when placed or superimposed on top of our profitability curve. That green line is simply the midpoint of the green bars from the prior slide, with the one exception that in year five we've put the midpoint of the dotted box versus a solid box, as we think the dotted box is a better representation of where we should expect future performance to be. You can see at the end of 2024, we're still very early along that profitability curve and really have not hit the acceleration point that we expect to experience over the next couple of years. To put some specifics behind that, we would expect those 249 centers to have the ability to grow platform contribution 25% annually for seven years based upon where they sit on the curve at the end of 2024. Now let's talk about platform contribution at Morpheus Enterprise level. Borrowing from some of the concepts in the prior slide. On this slide, we've taken our expectations for platform contribution in 2022, 2023 and 2024 and broken it down between centers, new centers, those centers that are less than two calendar years old, and all of our other centers. Again, on this slide, we've assumed that we open 40 centers in each of 2022, 2023 and 2024. What this slide illustrates is that because the pace of new centers is constant over that period of time, you can see the investment we're making in new centers, the light green bars on the left side of each of those stacks is fairly consistent over that period of time. However, because so many of our centers are transitioning from new to ramping or scaled, you can see 51 centers at the end of 2022 to 129 centers at the end of 2024. We are generating significant amounts of incremental profitability from those centers. That profitability will help push the overall business to corporate breakeven in 2025. will also allow us to adjust the requisite SG&A investments that we need to make to support our growth and operations. We've also highlighted on this slide what our platform contribution assumptions would be for 2022, 2023 and 2024. Going from approximately $68 million in 2022 to approximately $340 million in 2024. Representing annualized growth of over 100% over those two years. I asked a few math folks in the audience to arrive at those numbers, just to give you a sense, for 2022, we used the midpoint of our guidance. For 2023 and 2024, we took the midpoint of the JP Morgan guide that you saw a few slides ago and just applied that against the number of centers we expect to have in each period. Didn't assume any improvement beyond year six, and also adjusted year five for those exclusive centers. To tie it all together from a growth perspective, I've laid out our growth expectations across the key drivers over the next couple of years. In the upper left you can see our center growth. By the end of 2024, assuming 40 new centers per year for the next three years, we'll be operating 249 centers at the end of 2024. In the upper right, we expect to be serving approximately 300,000 at-risk patients, representing growth of over 45% annually from where we were at the end of 2020. On the bottom left, for revenue, we'd expect similar growth and expect to achieve about $4.2 billion in revenue in 2024. In the bottom right, we've highlighted the netted profitability of those 249 centers at the end of 2024. It should be approximately $1.3 billion based upon the same math that we had outlined in our presentation in January. In closing, we have a very special business highlighted by our mission and our focus on our patients, as hopefully you've heard from our team today. We sit in a very unique position in healthcare, and that our success is entirely dependent upon our ability to lower, to improve our patients' health outcomes and their vitality. To achieve this on a national scale, we've had to engineer our business for consistency. We believe that the depth of our market, plus the replicability of our de novo model, positions us very well for growth over the next several years. With that, thank you for your interest. I'll turn it back to Mike to wrap things up. Thank you, everyone, for taking the time to listen to our team and learn more about what we believe makes Oak Street Health special. Just a couple points I want to leave you with before we get into Q&A. First, just how much all the different components you've heard about today reinforce each other, and also how all those components are all necessary to have together in order to have a model like Oak Street's. The quality of care we offer, the in-depth care model that we leverage is what drives the savings that pays for that model and makes it work. We can only operate that type of model by focusing on one patient population. We need to be an older adult-focused group in order to drive the care model results that we're able to drive. That same care model, the time with our patients, the focus we can create on serving their needs is what creates an amazing patient experience. We can use that amazing patient experience to grow our centers in a de novo fashion. We couldn't offer senior-focused care model without having de novo growth. You need an older adult-only patient population to work off of. Having all these components fit together, the de novo growth, the B2C-focused operating or B2C-focused outreach model, the in-depth care model focus model, all those components fit together. They enable each other, and they reinforce each other. That's what allows us to drive the level of results we do. That's gonna allow us to continue to drive that really positive cycle that Geoff talked a lot about. Of investing in our care model, driving better patient care, driving better patient experience. That leads to more patient growth, enabling us to keep growing centers to more markets, which will enable even more investment, which will enable even better outcomes for our patients. That positive cycle will continue. I'll leave you with five takeaways. Number one, again, our model is purpose-built, designed for older adults on Medicare. Number two, Canopy, our proprietary technology platform, is fully integrated with our operations, and that helps us drive consistently superior results. Number three, our community and central marketing channels allow us to grow our patient base based on a B2C approach, where older adults are choosing us because of the patient experience we can offer. Number four, our consistent approach to hiring, to training, and to leadership is what drives the consistent culture and the consistent results across markets and across initiatives. Finally, number five, taken together, our platform leads to replicable and compelling unit economics as Jim described. With that, I will invite our team to come up, and we will do Q&A. All right. Our first question is from our online viewers. How has Oak Street been handling the tight labor market? Healthcare has been particularly hard hit after two years of COVID surges. With your rapid growth, do you see any concerns with hiring in your centers? I appreciate the question. Lindsay, maybe I could turn it over to you to talk a little bit more around, how we are able to attract and retain great team members even today. Thanks, Mike, and thanks to whomever asked the question. We are not immune from the volatility in the market related to labor and certainly just impacting healthcare as well as every other industry. What we are very focused on is controlling the things that we can control. What we know right now is that people are being very particular about where they wanna work, and they should be. We all wanna work in a place where we feel empowered, and we feel engaged, and we feel like we're contributing. This question comes up most frequently related to providers, so I'll probably spend a little bit of time focused there, assuming that that might have been some of the genesis of this first question. A few thoughts. One, I actually heard this quote the other day, and it stuck with me because it was a reference to an oak tree, and we of course are Oak Street Health. An oak tree will descend its roots both deeper and broader if it knows that its canopy can stretch higher. I really like that analogy when it comes to talent development, but because what we know is that when people are at an organization where they can grow and they can evolve and they can develop, they're going to deepen their roots into the soil and stick around. What you hopefully heard from us today is that we are creating many opportunities to grow and develop our team, within Oak Street, both to fuel our expansion and to ensure that we have the right internal leadership pipeline in our highly unique model to continue our expansion. Also to make sure that we are a great place to work and that we're investing in and empowering our team to their greatest potential. Related to providers, we have an exceptional in-house provider services team, that has managed to find us incredible providers for every single center that we have opened. To my knowledge, in the last three years that I've been at Oak Street, we have not delayed a center opening related to having a great provider on staff who was ready to start accepting welcome visits. The second is that we've been working really hard to build our brand across the country and preemptively in the markets that we're planning to go into. We've now achieved a really beautiful spot that we hope to continue to grow, where we have quite a bit of brand awareness among the provider cohort, and folks are calling us, in addition to us doing a lot of outbound calling. This is a different place to practice, as you heard from Dr. Silverstein, Dr. Buchanan, and Dr. Khan, and that's extremely attractive to many providers who are looking for something different than fee-for-service practice medicine. The other thought that I have is around the investments that we're making in the leadership program. I mentioned before one for post-MBA grads. Let me talk about a couple that we have for providers. Again, it's very difficult to grow provider leadership, and so we take a firsthand approach to doing that at Oak Street. We do this in a couple ways. One, several years ago, we invested in a fellows program where we bring wonderful physicians who are just graduating from residency into Oak Street. We give them the opportunity to pursue an MBA at Kellogg. We have a partnership with Kellogg, and we give them lots of leadership experiences in addition to clinical practice and grow them into center medical directors and over time, senior medical directors within Oak Street. We've hired 15 of those people over the last 13 years. They all remain with us. Some of them are still in their MBA program, and we already have a good contingent of those who have already adopted center medical director roles across the country. This year, we're also introducing a new program that is very similar for nurse practitioners. All of you spend a lot of time in healthcare, and you know that nurse practitioners are becoming an increasingly important part of the provider workforce. The same is true at Oak Street. We are introducing our very first cohort of nurse practitioner fellows into Oak Street this fall, I guess, which is very important from a brand-building perspective as we continue to expand our search across the country for nurse practitioners to work in our clinics. Those are just a few examples of the way that we are trying to take a very controlled approach to managing the volatile labor market. We're not immune, but we're doing everything that we can to ensure that we're a great place to work. David Windley, Truist. Just a quick question on patient engagement. Let's say the back half of this year, kind of post Omicron, do you guys expect the community event activity or volume to be back to where it was, kind of to 2019 levels? I guess the second question I would ask is, can you talk about remote outreach capabilities that you were forced to kind of further enhance during the pandemic, and how additive those are to these events? Then third, is there anything that you learned during COVID that has kinda tweaked the way you're thinking about engaging patients on a go-forward basis? Thank you for the question. Jim, maybe I'll turn it over to you to talk about how you see our queue levels in the community in the back half of this year. Katie, maybe you can take the second part of that around our learnings and different channels we've built. It is on. First, we have just a very small window to judge based on. It's really just the last couple of weeks. There is an appetite. You know, as I mentioned, we had been preparing for this moment, as have many of our partnerships that we have in the field. They've been looking for us to start supporting them. Think about some of the senior homes. There's a lot of people that joined those senior homes in the last couple of years we haven't even spoken to. We wanna get in front of them, and they want us to come in there and try to breathe some life back into their community. The appetite is strong, both on our end and on the relationships that we have out in the field. Second question. Yeah. On the second question about things we've learned that we'll layer on with post-COVID. I think we have opened a lot of new channels over the last few years in order to compensate for the fact that we couldn't do community outreach. We are doing things like WebMD. We have some really targeted digital marketing that we can actually leverage physical addresses to target people online that we've seen a lot of success in. We'll continue to do those things post Omicron and as COVID becomes endemic. It really just adds an additional layer onto what we were doing pre-COVID and a lot more capabilities specifically in the digital space, but also in out-of-home and some other areas as well. Hi, Elizabeth Anderson from Evercore. I was wondering if you could talk about some of your early findings from RubiconMD. Sort of, I know you talked about not only is it, sort of, you're not necessarily using it for visits, but you can just do inquiries and things like that. Do you have an early sense on the sort of either percent of requests you can handle or how that's impacting the cost of specialist care? And then specifically on mental health, do you have a mental health provider at each of the locations? I just wanna make sure I understood that part of it as well. Geoff, why don't you take both those questions? Yeah. Perfect. Let me take your second one first. Mental health. Behavioral health is actually integrated into every Oak Street Health location in two ways. It's actually separate from RubiconMD. The first is we have in-person behavioral health therapy, which is typically provided by a licensed clinical social worker level person, and that person has the time, and their time is structured to have longitudinal relationships to manage depression and other sort of mid-level mental illness. The second way that we cover behavioral health is through telepsychiatry. We have a team of psychiatrists who use telemedicine to supplement the in-person care. We find that within the broad swath of mental health needs, psychiatry or also psychiatric nurse practitioners only need to get involved occasionally. The behavioral health specialists that we have can cover many of the needs. Having both of those allows us to, in a cost-effective way, deploy that everywhere. As it pertains to RubiconMD, we really feel like we're just scratching the surface in terms of what that platform can do for us. The way that we have built Rubicon into Canopy is that Rubicon is essentially the default option for every time you're thinking about referring out. It's like the first thing to do is, "Hey, can you use an e-consultation in this way?" That it can't cover 100% of circumstances, but we think it's a very high percentage can at least be evaluated via RubiconMD. Some of them may result in needing an in-person specialist visit, but that'll be a much more targeted and efficient visit if a visit does need to happen. Down the road, this is now thinking 2023, 2024, we view the RubiconMD platform as actually the chassis on which we can build more synchronous virtual specialist visits, so that just like we have telepsychiatry in our behavioral health program, we could also have a cardiologist on video or fill in the blank other specialists. We really think we're early innings, but the expectations we have for the acquisition are going really well. We're really increasing the volume of usage of RubiconMD. Again, I think we're really excited about what can come from here. Hi, this is Michael Ha from Morgan Stanley. I'm trying to get a sense of just how sensitive your $6.6 million mature platform contribution margin is to different variables like varying market demographics or risk scoring or potential rate cuts. For example, I'm looking at your most recent and upcoming markets. It appears the household median income is significantly higher than your legacy centers. Given your target demographic is lower income, higher socioeconomic need, how sensitive is the gross margin target to being in perhaps more affluent markets where people might be healthier and have more health care resources to contribute to their social? Yeah, maybe I'll take that one. The markets that we target at Oak Street Health have actually been remarkably consistent across the life of the company. One of the reasons that is the case is because in the very early days of Oak Street, when Justin and I made the mistake of not building enough centers, which I would agree, Tim, was certainly a mistake in hindsight. In those days, we were trying to prove the breadth of the type of markets we could go to, right? That was one of the proof points we wanted to do, is show the diversity and kind of expanse of our target market could be. Those are the first 19 centers that Tim shared. They're just the first 19 we put up. They're actually in a wide variety of markets across a wide variety of demographics. Those centers are in inner city Chicago. That is a number of them. But they're also in highly Spanish-speaking neighborhoods in Chicago as well, where 90%+ of people speak Spanish. Some of them are in areas in North and Northwest Chicago that are much more middle income. Think like retired teachers, kind of union members, that type of demographic. Which is kind of more on the moderate income end of what we do. They're not just in Chicago also. Those same 19 centers contain centers in Indianapolis, as Brian referenced. They contain centers in Hammond and Gary, Indiana. They contain centers in Fort Wayne, Indiana, and Rockford. In Detroit, Michigan. Both kind of core urban markets, very heavy Hispanic market. It's also markets like Rockford that, if you ever been to Rockford, it's a great place, but, it's not a bustling metropolitan area by any stretch. It's 100 miles from here, surrounded by cornfields, about 150,000 people. There's a lot of breadth in what we do, both from a type of market, suburban to urban, and also demographics as far as income and demographics as far as race, in those first 19. When I look at where we're going today, I don't think there's a shift away from, those first 19 at all. I'm not sure if it's just a function of kinda how data is being pulled in the analysis or what you're looking at. When we look at our predictive algorithms that Brian referenced that predict the areas where Oak Street is gonna be successful, there are plenty of places that look just like the places we've been successful, 'cause it's a very wide breadth of what is out there in this country that we've really proven that success in. Am I next? Yeah, you're next. You have a microphone. Go. This is Gary Taylor from Cowen. I have two questions, one for the physicians and then one for a combo of Mike and Tim. For the physicians, if you have an existing practice, how do you think about coming to Oak Street with the resources and the interdisciplinary care team that wraps around you, theoretically bringing some of your patients with you, versus other models that are out there where there's an affiliate model that may say, "Keep your own practice. We'll partner with you. We'll teach you how to do value-based care. We'll be your partner in that." Or clearly, there's companies now that are just outright acquiring physician practices to either develop their own practices or to move into clinics. How does a physician evaluate that decision when there's so much demand for primary care capacity right now? Dr. Ali Khan, if you wanna talk about both, you know, why you chose us and how you think about our other doctors. Sure. I think that it's really interesting, and it's hard to be in the minds, the hearts and minds of every physician who's making that decision. What's most important is that we really look for folks who understand what we're doing, who align with our mission, and who feel some of the things that you heard our providers express today, especially on the videos. If they are aligned and if they're interested in caring for the communities that we wanna take care of, in the way we want to, then we are, our arms are open. I can tell you from having worked in large health systems in the past that trying to transform, if you will, care is very, very difficult. Basically, I came to Oak Street because I was responsible for primary care in a large health system, and I was tired of the word transformation. Changing somebody's heart and their mind, and I think Jim talked a little bit about the want and the care, is very, very difficult. When we hire people who are aligned with what we do and who are choosing to provide care in the way we want to, and who are ready to benefit from the systems that we've built to be successful in care delivery, those are the right people to come to us. I think individuals, when we meet them and when we describe what we have to offer, make that choice for themselves, and we're certain that we get the right folks on board at Oak Street. I might only add, I think one thing that we see kind of across the space in the past 10 years is a little bit of maturation of independent practices. A lot of physicians who've kind of been through the wringer of more piecemeal transformation or the goal of physician enablement or provider enablement or whatever buzzword we have, right? I think exactly what Dr. Silverstein mentioned. They've been through that. They've gone through potentially an accountable care organization or two. They've seen that, like, things can get hard, right? In terms of providing one model of care for one set of patients and a totally different model for somebody else, right? Or that maybe this, that approach hasn't enabled them to save the independent practices and trying to, you know, keep alive and with one or two or three providers for the past few years. I think we saw this really clearly in the pandemic, where as practices were closing and people were looking for other options, the primary care market has a bevy of opportunities, as you mentioned, right? When they come to see us and when they see that this is built from the ground up, the system is designed to do the kind of work that they've wanted to do for decades, but haven't felt that they've been able to. I think most concretely, right, that disincentive that exists in traditional primary care, even in some of these co-managed practices, just aren't present, right? That's very compelling. You see people vote with their feet over and over again, whether that's here in Chicago, in Memphis, Tennessee, in Detroit, Michigan, or, you know, all over the country. I think as we're in that combination of a more maturing workforce that's aware of kind of what the distinctions feel like more viscerally day to day. You know, just the mass effect that we have from how we're doing this in lots of different places. Those two come together to create a lot of synergy for us that make us a really attractive opportunity. I certainly agree with Dr. Khan. Just to add to that, I've been at Oak Street for about four years. Before that, I was in an organization that had about 100 residents who were going into primary care every year from their training programs. I only remember one resident over many years who actually went and started his own private practice. It's just, you know, when people are now coming out of training, they're really looking to practices that exist that have the robust services and that we have. First of all, I think, you know, if people are looking to go on top of other practices that exist, that's just a managing resource, I think over time, as opposed to the new graduates who are looking for places like Oak Street. Thanks for that perspective. My second question would be, you know, given the archetype and the initial losses as the center, you know, builds capacity, has there been any consideration for some of the maybe tactical changes some of the other center operators have talked about, such as, you know, year zero or year one, we're not at risk, you know, until we've had the patient, you know, been for a year and they're coded properly. Doing kind of the acqui-hire thing that brings a large patient panel initially. Has there been any consideration for any tactical changes for opening new markets that way? Yeah. You know, actually I'll let Brian take that one. Brian, why don't you talk about Brian? Obviously, we have talked about our changes in event. Talk about kind of why we hire the providers we hire, why we really stuck with the de novo approach, why we're not buying practices, kind of all those aspects. Yeah. Happy to talk about those things. I think I'll also say we are able and have success at taking risk from patient number one in the center. We have a national risk pool, and we've got a model that works. The J curve on profitability for a new center is the investment that we make in the Oak Street team. You'll get to see I keep making the plugs for the tours. I loved to be a tour guide when I was younger. You'll see it's expensive what we do. We invest in a beautiful building. We invest in a large interdisciplinary team to take great care of our patients and not let them slip through the cracks. It's that investment that we make up front that creates the J curve. I think as we have looked at that is not something we want to or are willing to cut corners on because the care that the standard we have for the care that we give our patients and frankly, that our patients deserve, and that has generated the results that we shared up there. It's one where you don't cut corners. It's one where it's important that there's not one or two key things that you do for the patient. It's the thousand little things that you do consistently, repeatedly, each and every day. We don't want to sacrifice there. We make that investment in the big team to take great care of our patients. That's kind of the source of the J curve and why it looks like it does. Yeah, just to put a very fine point on what Brian said there, centers aren't profitable in the first couple of years because of the investment in our team. New patients, despite not having the profitability of a more existing patient, are still profitable. Obviously in 2021 we experienced a headwind from new patients. After three years of Oak Street Health, we have revisited that decision. It's always the right decision to take risk on them. Immediately because we tend to make an impact on their costs relatively quickly into the journey of them being patients. Just to quickly on the other small questions you asked. What's more important on the provider side, and I think Dr. Silverstein nailed it, is they want to be part of Oak Street Health. They believe in our model, and they wanna practice medicine like we do. If we can find a doctor who has all those components and also has patients they care for wants to come work at our center, I mean, absolutely. We would love to bring that doctor on. Now, keep in mind, a lot of doctors have non-competes, so it's easier said than done to have them kind of move across the street. For us, the most important thing is they want to be part of Oak Street Health. They want to see our patient population. They wanna be part of our model. We're not gonna cut corners around that and say, "Well, we'll bring in your practice, and you can still see your commercial patients and do different things." I think that's not what we do. That's not who we are, and we're never gonna achieve the level of results we're able to achieve as consistently as we achieve them, if we don't stick to that. I think that's why, again, we love the unicorns that have all the right components as a provider and also can bring a lot of patients with them. There's not that many unicorns out there, despite what my daughters think. Hi, Calvin Sternick from JP Morgan. I wanted to circle back to the digital marketing channel question. 'Cause I know a couple of quarters ago you guys called out lower economics on patients who came from digital marketing channels versus community channels, at least initially. I guess, first, you know, do you still sort of see that being the case in 2022, or is that just a one-year anomaly? Then, you know, how do you see the mix of digital versus community efforts going forward? Is digital gonna be stickier going forward? Just lastly, what do your customer, I guess, patient acquisition costs look like digital versus community marketing? Yeah. I'll turn it over to Katie for the second part of the question. On the first part of the question, we did share that in Q2 as a hypothesis of why we thought our new patient economics potentially were worse in 2021 than previous years. As the course of 2021 kept going, and we got obviously significantly more data points through several months of more new patients, we did see that start to normalize. We actually saw, thankfully, the new patient economics improve against from the baseline we started from in Q2. We also saw that more and more it became really more of a revenue issue. Risk scores just seemed lower on all of our new patients. The gap between the different channels really started to converge a bit. I don't think we'll see. When we look back in 2020 and earlier years, I don't think there'll be a big headwind we're creating by bringing on patients from, you know, non-community based channels, which is something I think we did talk about a bit as a potential reason why we were seeing those things. I think the more we got more and more data, the more we were doing with that data, it became very apparent to us that our hypothesis that it was people that weren't accessing the healthcare system at the same rate in 2020 than they did in previous years was playing through in 2021. Obviously 2022, it's pretty early in the year, so we don't have that many new patients. The ones we have, we don't have that many data points on, so it's a little too early to say what's gonna happen this year. You know, we're, I'd say guardedly optimistic that it'll start to kind of go back to what we've witnessed in the past. Katie, I'll turn over to you to talk about kind of how you see the channel mix into the future and how you think about acquisition, those types of things. Yeah. Thanks for the question. So our digital channels are extremely efficient and have been, and we continue to optimize against those. I think if we think about mix and how our digital interacts with the other channels we have, we kind of said this before, but outreach has always been and will always be the bedrock of our model and will continue to get the majority of our patients from that channel. That said, the goal is obviously to maximize and increase both channels. We'll be rapidly growing digital as we're rapidly growing what we're seeing from outreach. We don't have a goal in terms of specific channel mix. We really look at the efficiency and the cost of acquisition, and ideally we're turning both up, because we're able to achieve an efficient cost of acquisition across both sides of the house. Then I wanted to ask just a separate on technology. I mean, you guys talk a lot about Canopy, and I know that a lot of the other physician-enabled platforms out there. I mean, they all talk about, you know, the capabilities that they have. I'm just curious, have you guys done an analysis of Canopy versus some of your competitor platforms? I'm just curious, you know, how you think, I guess, where you think Canopy is advantaged versus some of the others and what some of the areas for, you know, potential opportunity might be. I'll, David, do you wanna take that one, or Geoff, do you have more competitor information, probably more on Canopy? You go first, and I'll complement. Thanks for the question. I would say that as we look to develop Canopy, we're pretty focused on our internal care model and just continually optimizing it, as opposed to comparing ourselves to our competitors. I realize that others, of course, are using technology as well. I would say, you know, one of the things I didn't mention earlier, that I think is important that we use ours for is, because we build our system with cutting edge tools, we can deploy different systems to individuals on the same team, and really do A/B testing and things like that to continually optimize. We're really pretty internally focused on just continuing to get better and better in a way that, you know, is not possible with an off-the-shelf electronic health record, for example. I think the only piece I'd add there is, because we're so focused on Oak Street, we're able to actually focus on some things that may seem non-obvious when you hear about them. That should make a huge difference for outcomes. David talked about our rooming component of Canopy earlier, which on its face sounds, like, very uninteresting because, like, how everyone has gone and gotten roomed at a doctor's office, like, you know, dozens of times in your life. But actually doing it the same way every time with the same screenings, with a really simple workflow that an MA is guided through, helps us both deliver consistent results on our quality metrics, which are really, really strong. It helps us, like, onboard people so much more quickly. We're adding so many centers, so many people to our team all the time. Looking at what are the pain points in our team's day and then trying to, like, streamline that and make it super easy to use in Canopy really enables us to grow a lot more quickly. Some of these things which don't seem to be like, again, just the most obvious ones actually are really big value unlocks for us. Of course, we have a bunch of data elements behind the scenes, and we're doing a ton of analysis and a ton of work to tee up important information. Of course, we're doing that too, but we can actually focus on our team in a way that I think makes us differentiated. The small thing I would add to that, all of these components fit together. Because we have this network, which I think Lindsay highlighted really well when she was talking about her previous experience today around open diabetic care. Because our operations are the same, our roles are the same, our trainings are the same, we actually leverage the technology. That's not just an overlay of, here's your suggestions and some recommendations we used to look at, you know, after hours. It is embedded, like, during the day in your workflow when you're rooming a patient, when you're seeing the patient, and it's the same team working off the same system, right? It's not just an overlay technology to kinda help you with population health. It's actually the operating system for our teams during the day. You can't build an operating system for the teams during the day unless it all operates the exact same way with the same roles and the same training, et cetera, et cetera. I think that's where we're really excited about where our technology is going because we're going to start seeing deeper and deeper results in what really happens with the patients. I have another online question. This is from Kevin Fischbeck with Bank of America. It's asking about competition and first mover advantage. Can you talk about your experience in finding good locations, recruiting doctors, getting patients in markets where there is competition and where there isn't? Yeah, Lindsay Arnold Sugden, I'll turn that one over to you. It'd be great if you could talk about your experience in, you know, opening up new markets and if the difference between whether there's another value-based player or not and kinda how that impacts things or doesn't impact things. Previous to taking on this role as Chief Clinical & People Operations Officer, I expanded one of our divisions from one state to eight states, including our westward trajectory. I've had the privilege of opening a lot of Oak Street centers over the last couple of years. We also get asked this question about competition a lot from applicants. It's a question that I am used to answering. Number one, we love going into a market where other people who are invested in providing great care to patients. We are very specific, as you've heard, about where exactly we wanna build and where we know that we can have a great impact for the patient population in a given community, and we're not going to trade on that. We also don't shy away from going into a community where there is another value-based care player because a rising tide lifts all boats. When there are more players in the market who are invested in providing great care for patients, it ensures that we all play at the top of our game and that we are all doing the right things to drive alignment in terms of patient outcomes. We certainly have from a provider recruitment perspective, providers who I think the question has been asked of the clinicians on the stage here a little bit as well, why they chose Oak Street. Certainly, as providers are considering a transition from fee-for-service medicine to value-based care, they come and talk to the various value-based care entities that are out there. We don't worry about finding the right person if they're going to visit with the various players in the market, because we know that the right people will choose Oak Street. It is not an encumbrance to us. We welcome the opportunity to invite more players into the market who can give great care to patients. Our hope and expectation is to always exceed patients' expectations such that they will choose Oak Street, and that providers will choose Oak Street as a great place to practice. Yep. Can I jump in, Mike? Please. From the outreach side, one of the first things I noticed when I joined the organization was the rigor we had on the, what we call the back of the house. I noticed that was done really, really well, and I noticed that the outreach side could use some of that rigor. We learned as much as we can about how you open a center effectively from an outreach perspective when you go in the market, whether it's a competitive market or not. We then built out a playbook around that. We now have a new center opening team that is specifically goes into areas to make sure that we operate that playbook with the rigor that's necessary to open effectively. That just launched recently, and we have some of our top people that are part of that team to go in. From a competitive standpoint, we don't spend a lot of time worrying about it, because I don't think anybody does anything the way that we do it, not even close to the way that we do it. We focus on execution. That's what we focus on. We focus on doing our job in the right way with the right people every single day, and we don't spend any time or energy really focused on the competitive side. Thank you. Thanks. Jamie Perse from Goldman Sachs. Two quick questions. First, I was hoping you could just update us on your partnership with Walmart, what you're finding there and your experience there, economics too, if you can describe what you're seeing there. Secondly, you talked about the benefits of scale. You've been looking at this ESRD program and others, unsure. Can you give us an update on if you're at the level of scale where those are starting to have an impact and any other clinical categories you're evaluating? Geoff, you wanna talk about both Walmart and the other clinical? Sure. Yep. In Walmart, just for everyone's common understanding, we have three locations in Texas where we have an Oak Street center that's essentially attached to the front of a Walmart location. We don't break out the results of those individually, though what I can say is they are similar in look and feel to a typical Oak Street center, though a little bit smaller. They have extended hours that more closely match the Walmart store hours, and they are they're not senior only. It was important as part of that relationship that we're able to serve anyone who walks into the store. You know, despite that, we actually do tend to see mostly Medicare patients and the patient-level economics that we see in those centers, you know, broadly track what we would expect in a typical Oak Street center. Really, it's been a positive relationship so far. It's still relatively early in the maturity, we continue to monitor that. In terms of other clinical programs, you know, we take a really rigorous ROI-driven approach. Our ESRD program is still relatively new, though it's a very targeted patient cohort, and so we are able to enroll the people who qualify for that program into it quite successfully. You know, relatively quickly can start to track leading indicators that look like it will have a nice impact. Though again, we probably need more than you know the period of time we've had to totally declare victory there. It's a sufficient evidence so far that we're expanding it to new markets. We continue to look at other areas. You know, we talked a little about care in the home today. That's something we continue to evaluate and try to measure the ROI on. I think a lot about transitions in care from hospital to home in a again a very rigorous way. Those are really the ones that are top of mind for us right now. We're really trying to build the operations of each of those before trying to add on too many other things onto that plate. Joe Slevin with Jefferies. Thanks for taking the question. This probably relates to Jamie's question a little bit and to Elizabeth's earlier one. We're seeing a lot of sort of upstart specialty risk-taking providers that are coming to the market, both on the private and then public side. I guess, you know, I wanted to gauge sort of where you're at in terms of willingness to engage with them or look at subcapitation arrangements. My presupposition is that based on your vision for RubiconMD and maybe some of the above industry diagnostic stats you put out, that you would wanna keep that risk in-house, but just wanted to sort of see exactly how you're thinking about it going forward. Maybe I'll take that one. There are two dimensions we look at. One is how integrated we feel like that offering is with our base offering. For example, I think our doctors give really compelling reasons why behavioral health needs to be integrated with primary care. We were never gonna sign up with a subcap on behavioral health because we sort of just actually support a good primary care, not a siloed, the same silo in most of healthcare. We're just one of the silos in healthcare. That one we're gonna do, we're gonna keep, right? There's one partnership we have announced with a third party, which is New Century, which is on oncology. While there's reflections we make on our patients on oncology, we're talking about chemo medications and some of those formulary results. That's not our area of expertise. That's gonna happen outside of Oak Street. The patient choice. We wanna be really good at diagnosis. We wanna be really good at the longitudinal treatment of the patient as a person. But as far as the medications, I think we can stay away from that one. That's an example of a place where we have kind of worked with a third party to kind of maybe control the relatively small spend more. I think there's opportunities in the middle. We're always evaluating those both on how integrated is it with what we do every day and how much we wanna own it versus is this a good place to give away? The second thing is just kind of a speed. We can't do everything. There may be things we say, "Hey, we're gonna work with a third party on this for the next three years," even if we think we can do it really well, it's just not far enough along our roadmap. The one thing we really push ourselves on, which Geoff said, is every year we cover the whiteboard with 30 things we want to do. I think all 30 things would be good ideas, but we can't do all 30 things, and if you do, you'll do all 30 things very poorly. We're gonna pick three or four of them that have the highest impact and the, you know, best ease of implementation. Some of those other things are things we can say, we can find someone else that can manage the town over time, sure we'll share the risk, and then, maybe we'll keep that relationship going, or maybe someday we'll decide to do it ourselves in the future, and we'll cross that bridge when we get to it. That's how we probably will evaluate them, but I think it's a relatively high bar to bring someone else in, especially when it's really close to the primary care side. All right, I'm getting the we are already way over time, and we got to end questions. Guys, thank you for the engagement. We appreciate it. For those attending virtually, thank you. We'll come out to lunch, and then we'll go to our centers. Thank you, everyone.