Good afternoon. We ready here? Good afternoon, everyone. My name is Lisa Gill, and I'm the Healthcare Services analyst for JP Morgan. It is with great pleasure this afternoon that we have with us Oak Street Health. With us this afternoon, we have Mike Pykosz, CEO, Tim Cook, CFO. After the presentation, Mike and Tim will join me here for a just brief Q&A session. I'll turn it over to you, Mike. Thanks, Lisa. Lisa. Thanks everyone for joining to hear more about what we're building here at Oak Street. Lisa, I don't know, next year you'll get the big room. I don't know, when do we get to move up? I'll give everyone a second to read this disclaimer. I assume you've all read it and understood it. Look, four things we wanna cover here today. First off, we'll talk a little bit more about really how the purpose-built platform we have at Oak Street Health is addressing the root causes of high cost, low quality, and poor experience for Medicare patients. Talk about how we've taken that purpose-built platform and created a national scalable model with a systematic approach to market entry that really is supported by Canopy, our proprietary technology. We'll talk about the performance of our care model and really how that performance has been demonstrated across geographies, has been demonstrated across different program types. Then I'll turn it over to Tim to talk about what I know you actually all really wanna hear about, which is the unit economics, both in 2022 and how that's pushing forward to 2023. Given I know that really what you wanna hear about is what Tim's gonna cover, I'll try to go relatively quickly through the beginning so we have enough time for that and Q&A at the end. For those of you who are less familiar with Oak Street Health, at the highest level, what we do is pretty simple. We operate primary care centers. For those of you taking pictures, by the way, for the record, the haircut was from Sport Clips. Appreciate you liking it. The slides are on our website as well. What we do at Oak Street Health is really simple from the highest level. Like all things in healthcare, as you kinda peel back the layers, it gets more and more complex. We operate primary care centers. We focus on older adults, really focus on moderate to lower income older adults. What we've done is we've... Essentially, we specialize in care for that patient population. We've created a model from the ground up that really optimizes the right resources and the right care that those patients need. We invest a lot more upfront to take care of our patients and to keep them healthy, improve the experience, and keep them out of the hospital. Because such a huge percentage of medical costs is driven by hospitalizations, by keeping our patients out of the hospital, we can actually save a ton of money overall on our patients' total cost of care. We can invest a lot upfront, keep them healthier, keep them out of the hospital. That saves a lot of money, and we can enter in value-based or risk contracts, depending on what words you wanna use, so we can capture the savings we generate, and that's what pays for the investment in care and drives our economic model. Today, we have 169 owned and operated centers. We're in 21 different states. Or in December, we have 159,000 at-risk patients receiving our care, a little over $2 billion of revenue, and 6,000 team members who we call Oakies. I won't spend a ton of time on this slide because I know the problems in the U.S. healthcare system are well known, and they're well documented. I think it takes... It helps to take a second to really think about what is the problem we're trying to solve at Oak Street? The reality is the U.S. healthcare system is expensive. We spend more than 200% per capita compared to any other industrialized country. Despite spending twice as much as those countries, we have worse health outcomes. The experience both for patients and also physicians is very poor in healthcare. We kinda think about what's driving that problem. Obviously, older adults are more expensive, people who are moderate sort of income are more expensive, and so much of the cost today in the healthcare system is people with chronic illnesses that aren't being well cared for, and that turning into acute episodes and driving huge amounts of cost. Solving that problem creates a massive market opportunity for Oak Street Health. We talk about our core addressable market is moderate to lower income older adults in suburban and urban areas. To us, that means people up to 300% of the poverty line in places like Youngstown, Ohio, Rockford, Illinois, Fort Wayne, Indiana, all the way up through New York City. Those are the places and the patient population we operate in today. That core market is about half of Medicare, 30 million Medicare beneficiaries. Creates a $3 billion-$50 billion market opportunity for us at Oak Street Health. I get the question a lot, "Well, you know, do you wanna go serve higher income patients, or can you be more of a rural model?" The reality is, probably yes, but the current core market we have today would support 10,000 Oak Street centers. We have 169, so we have a while to grow in our core that we're proven before we need to branch outside of it. Thinking about what we do differently at Oak Street Health and thinking about why our care model works so well, I like to start with what happens in a normal primary care setting, right? What happens in kind of your standard fee-for-service primary care doctor's office where the vast majority of people are getting care today. If you think about that and you juxtapose what we do at Oak Street Health, you can really start to see why the results are so great. One of our biggest beliefs is the level of results we generate is just something you can't build, you can't do if you're off of a fee-for-service chassis. Time with patients, right? Our doctors see about a quarter as many patients on their panel at capacity in the panel than the average doctor. We specialize in one patient population. We have a lot less patient visits per day. Our patient visits are longer, and we reserve a huge amount of time every day for our providers to proactively get ahead of problems with our patients as opposed to addressing the patients who are in the exam room that day. We've integrated a lot of different programs outside of just traditional primary care that are either under-reimbursed or not reimbursed in the traditional system, patients have trouble accessing. An example of that would be behavioral health. We have an integrated behavioral health program. Another example would be social support programs with social workers, et cetera, for social determinants of health. Programs around functional support, et cetera. Oftentimes, the technology that primary care is using is an EMR. Most EMRs are really built to be part of a big integrated delivery system and keep referrals within the system and help bill effectively, right? That isn't driving the specialized and longitudinal care that patients really need. Where at Oak Street Health, we have our own proprietary technology. Kinda making that comparison of what exists out there for the vast majority of patients and what we're doing at Oak Street Health helps frame how we're able to generate such strong results and do so consistently. One of the keys to the consistency of our success has been our go-to-market strategy. The vast majority of our centers are de novos. We identify a neighborhood that needs more investment in primary care. We build a center. They're all about the same size, 10,000 sq ft. All of them have a community room. For those of you who visited an Oak Street center, I think you can attest, they don't look and feel like a normal doctor's office. And that's purposeful. We hire and train team members. We have the same staffing ratios, same training programs, same onboarding programs, everywhere we go. The net result of this approach to scaling is we're able to generate very consistent results across geographies. Small markets, big markets, different geographic parts of the country, different benches of Oak Street centers. We'll share more of those results in a little bit. We've expanded relatively quickly over the past three, four years. As you can see from this map, are now in 21 states. We are a multi-payer platform. You see we have relationships across those states with, you know, the big national players as well as a number of, you know, local and regional players in the neighbors we're serving. Just as importantly, you know, we're not a model that found lightning in a bottle in one geography and is trying to expand that everywhere, right? We are actually very geographically dispersed. We obviously started in Chicago. Some people ask me, "Well, why Chicago? Why'd you start there?" 10 years ago, we lived there, and that's why, that's why we started the company. Still live there, for the record. That one thing we again really think is a very big differentiator at Oak Street Health is just the number of centers, the number of our patients, and the results outside of our home market. Another thing we're very proud of here at Oak Street Health is the consistent results we've generated outside of just Medicare Advantage. Obviously, Medicare Advantage and risk-taking with Medicare Advantage plans is the bulk of our at-risk patients and is a huge driver of our success. Previously, in 2020, we were in the Medicare Shared Savings Program. We were in the top 1%, four, out of 513 groups in the program, as far as savings rate. We were the only ACO in the top 10 that operated out of the Midwestern states we operate. The other ones were in different geographies. Again, we're very proud of that. One reason I would highlight that, as you can see on the left-hand side, the revenue, the costs, and the economics in the Medicare Shared Savings Program are basically the same as they are in Medicare Advantage, which is what you'd expect if you operate a care model and you're taking great care of people, and you're driving results by keeping patients healthy and out of the hospital. The thing I'd point out about the Medicare Shared Savings Program is there is no HCC risk adjustment in the program, right? It's a completely different methodology. We think that shows that this is really a story about a better care model, taking better care of people. Again, we're very proud of that. Enter 2021, we transitioned from the Medicare Shared Savings Program to the Direct Contracting Program because we think the economic mechanism of taking full risk for shared savings fits our model much better. We were the number one Direct Contracting Entity in net dollars saved. We were number two in net savings rate. If you look at multi-state DCs, right? The number one was a very small, single market Direct Contracting Entity. If you look at any Direct Contracting Entity that is in more than one state, ours is in, you know, 12 states. If you look at any Direct Contracting Entity that's in more than one state, we had over two times the savings rate of any of those groups, right? I think again, it shows you even amongst, the most innovative groups that are in this new program for innovative risk-taking groups, our results were kind of, head and shoulders above others. The quality of our care model and the quality of our patient experience is what drives, two of the biggest enablers of our center economics and our financial model. Again, the two biggest drivers of the kinda economic model of Oak Street Health are, how well we're taking care of our patients, how well we're lowering hospitalizations, and what that creates is our per patient per month patient contribution. That's one big driver. The other big driver of our results at Oak Street Health is how many at-risk patients we're caring for per center. One thing we wanna make sure people understand is what we see internally around the consistency of our results. If you look at the graph on the left here of all these beautiful color lines, what that is, it is PMPM patient contribution. Which is our per patient per month revenue minus our per patient per month third-party medical costs. How many dollars are we saving per patient through our care model over patient tenure? As you can see, the longer we've had a patient, the more profitable they are at Oak Street. The kind of teal line is the average. What you can see is a huge, there's a very tight dispersion around markets. We included every state above a threshold of at-risk members. That includes states we entered into relatively recently, like Texas, and it obviously includes Illinois. We actually called out Illinois here because what we wanna make sure people understand is this is not a story of Illinois being this fantastic market, and we try to make everything look like Illinois. Illinois is actually, if you can see, right about average. We have a number of markets that have performed much better than Illinois. We have some that, you know, are a little bit worse. You can see, again, a very tight dispersion, a very similar trend across all of our states. Again, every color line there is a different state at Oak Street Health, and we included every state we have above 7,500 at-risk members. Again, I think that hopefully really shows the geographic consistency of our model. I'm spending so much time on this one graph because it's my favorite chart in the deck, I wanted to make sure we did it justice. Happy to take any questions just on that chart later on. Tim will take the rest. On the right-hand side is patient growth. This shows our center vintages, so what year the center opened, 2013 all the way to 2022. Again, shows that consistent ramp as we fill centers up over time. The one outlier on the bottom is our 2013, so our first vintage was actually our slowest growing. The reason we don't have the early data points is we didn't keep data back in those days. We had to wait till we got a little more sophisticated to actually have records. As Tim will remind me all the time, one of the centers there is much smaller than the rest of our centers. It was a mistake to put it up, and Tim, I apologize. I didn't mean to mess up your charts. Again, what you see here hopefully is a, is a clear consistency of growth, a consistency of the drivers across the tissues of Oak Street Health. We're not static here at Oak Street Health. While we've had a similar approach from the early days of de novo center-based models focused on Medicare patients, we have definitely added a lot over time, and it's one of the positive cycles that is so exciting for us looking forward at Oak Street Health, because the more we grow and the more we scale, the more we have resources to invest to improve our model. Over the years, we've added 24/7 phone coverage. We added our integrated behavioral health program. We've added our home-based primary care for our sickest patients. We added a lot of telehealth over the pandemic. About a year and a half ago or so, we bought RubiconMD. A little over a year ago, we did our partnership with AARP. All of these things are, you know, continuing to play out and drive better and better results going forward. Again, as we get bigger and bigger and have better and better results and scale more, we keep adding more programs, more interventions that help our patients. That drives even better results, and it's a really, again, positive reinforcing cycle we have at Oak Street. While we're very proud of our results to date, we are very confident the best years are ahead of us. Now the fun stuff. Thanks, Mike. Nice haircut. You got a nice look there. It's a treat to actually have one. People don't listen to me and so they just talk, listen to you drone on. Anyway. Last year at the conference, we provided a range of expectations for 2022 performance, as you can see on this slide. What that range was essentially we sensitized two variables that were key headwinds in 2021, direct COVID costs and new patient economics. The high end of that range represented 2019 performance against those two variables. No COVID costs, obviously, 'cause there wasn't COVID in 2019, to the best of our knowledge, and historically normal new patient economics. The low end of that range was 2021 performance against those same dimensions. You can see those ranges indicated on the chart in the upper left by the green, the green bars, the light green bars. We've updated this chart for our current estimate of how our vintages will perform in 2022. If you'll get the green, the orange dots, you can compare those to the green bars, and you can see almost across the board, we outperformed relative to our initial expectations coming into 2022, from as every vintage. Despite that outperformance, we did incur about $60 million of headwinds related to those two variables. The first being direct COVID costs, which represented about $25 million of headwinds for 2022, and about $35 million of new patient economics. You can see the new patient economics impacting the year zero and year one cohorts on this page, and that's because those cohorts have a higher percentage of their patients as new patients, 'cause they're new cohorts. Whereas, our other vintages were less impacted by that dynamic. We were able to offset about $30 million of those $60 million of headwinds through very strong care model execution on our existing patients. Well, we're quite proud of that. As we think about what that means for the business more generally, that means the ultimate financial profile, financial opportunity center is actually greater than we would've thought coming into the year. As we continue to mature the business and more patients move along the patient tenure curve, and our patient mix skews towards more tenured patients, that outperformance will have a greater impact on enterprise-wide results. That will do. Taking that 2022 performance and rolling it forward to 2023 and what our expectations are for our cohorts in 2023. First of all, we expect to see a lot of the same trends continue in 2022 around patient growth and strong care model execution. In the chart in the upper right, what you'll see is the same orange dots in the prior page. That's just 2022, our estimate for 2022 performance across each vintage. The green dots are the same. That the green dots represent the performance of our oldest vintages, our 15 centers that we opened from 2013 through 2015, and how they performed all the way through 2022. We've updated them for 2022 expectations. The purple bars you see on the upper right represents our expectations for how our vintages will perform in 2023. The midpoint is our best guess, and we're ±1% on medical costs is how we determine the high and the low end of those ranges. Just to kinda help you read the chart, where the orange, or excuse me, where the purple bars are above the dark green dots, that means we're, in 2023, we're expecting to outperform how our oldest vintages have performed over time. You can see that's pretty much every vintage. Where the purple bars are higher than or above the orange dots, that means we're expecting 2023 to be better than 2022. Again, for most vintages, that is true. I'd say the one obvious exception to that on this chart is just the year four vintage. As those of you who follow Oak Street know that we've mentioned this vintage several times. The 2018 cohort of centers has been exceptionally strong performer. We expect to see that strong performance carry through for the 2019 vintage in 2023. You can see that in year four, our expectations for the 2023 vintage are still well ahead of, or excuse me, the 2019 vintage performance in 2023 are still well ahead of what we experienced in our oldest vintages from 2013 through 2015. We expect our 24 oldest centers, so those are the centers in the year six-plus category in the far right, to generate on average $6.7 million of platform contribution in 2023. I'll note that that's approximately the same as what we experienced last year. However, this year that cohort added five centers from our 2017 vintage. For those of you who are keeping close track of our performance, that vintage had a large number of centers that were initially exclusive with one payer. We have expected and have seen those centers ramp behind our typical J curve. Despite the fact that that year six cohort is inheriting those five centers, we are still expecting to see similar levels of performance as we experienced last year. Our 15 most scaled centers, these are centers that are the most full, we expect to generate $8.5 million of overall margin each in 2023. Obviously, well, I don't know if it's obvious or not, but we expect to continue to see growth on all of those centers as, you know, we still have plenty of capacity, even in our oldest centers, and of course, obviously a tremendous amount of capacity in our, in our newer centers. What that means is, for 2023, we'll see about a $110 million increase in platform contribution relative to where we were in 2022, with platform contribution being approximately $195 million. Of that $110 million improvement, about $25 million is coming from stronger performance across the business. We're seeing weighted average 10 years increase, or excuse me, weight average performance increase from 2022 to 2023. The other $85 million is just this is the maturation of our centers along that J- curve. One thing I'll note is for our 2023 new centers, we're expecting 35 centers, which is the midpoint of the range that we provided at JPMorgan last year for 2023 and 2024. Moving down the P&L to SG&A. As we talked about a simple rubric for Oak Street as we think about SG&A costs and modeling those out, is to think about it in terms of SG&A dollars per center a month. In 2022, we saw a nice operating leverage where SG&A cost per center month declined about 6% to $205,000 per center a month. We expect to continue to see nice operating leverage in 2023 with about a 5% reduction to approximately $195,000 per center a month for the year. If you do the math on 35 centers I mentioned a minute ago, assuming those open mid-year, that's about $440 million of total SG&A costs for 2023. We still expect at maturity that a center will have approximately $125,000 of SG&A costs per center a month. I was pushing the wrong button. To wrap it all up, what does this mean from a guidance and outlook perspective for 2023 and for the remainder of 2022? On the left side of this page, just updating everyone on our expectations based upon our Q3 results in November, where we thought the year would shake out. We opened 169 centers, which was our goal for the year. At-risk, our performance for at-risk members revenue and adjusted EBITDA is gonna be at the high end or better for 2022 once we report results here in the next several weeks. Taking what I just walked through from a cohort perspective and putting it into these metrics for initial preliminary 2023 outlook. We expect to have 204 centers open by year-end 2023. Again, the 35 new centers I mentioned. 205,000-210,000 at-risk patients. Revenue of $3 billion-$3.15 billion, and an adjusted EBITDA loss of $265 million-$225 million. From an embedded EBITDA perspective, which we think is a great metric, represents the earnings power of the installed center base. You know, based upon the eight and a half million dollars that we expect our most scaled centers to generate in 2023, deducting from that the $125,000 of SG&A cost per center a month, that maturity gets you to about $7 million of adjusted EBITDA per center. Multiplying that by the 204 centers we expect to have open at the end of the year means about $1.4 billion embedded EBITDA in the business by year-end 2023. Very proud of our results for 2022. Very enthusiastic about where we think we can be in 2023. I remain really committed to continue to execute very strongly against our care model and our patient growth expectations. Mike, you wanna. Sure. Wrap things up? Just to probably reinforce what I said in the beginning, I think some of the keys to what we do here at Oak Street Health is it is still a large and unpenetrated market opportunity. Obviously, over the last couple of years, there's been more and more value-based care entrants into the space. The reality is the vast majority of older adults are still cared for by kind of more traditional doctor's office, or frankly, going to the emergency room for care if they can't find a doctor. We feel like we're still in the very early innings of our broader industry and certainly Oak Street growing, building out, and scaling. Because of our purpose-built model, we can drive fantastic results and drive very strong patient outcomes. The de novo approach allows us to do that consistently across geographies and across vintages, which hopefully the results we outlined really play out. That drives very strong unit level economics, which drives a very consistent ramp. As Tim said, creates a huge amount of embedded EBITDA, not as a kind of a hockey stick projection, but just as pushing forward the results we have today. Finally, one thing we're very proud of is not only we hit the numbers overall that we shared a year ago at this conference, but the results we're projecting to improve this year at a center level. That's the, that's the consistency and strong performance that we aim to achieve, and we're proud of it. Thanks very much. Mike, when we think about competition in this space today, we think about a number of different center players as well as others in the marketplace. When you're thinking about a new market and going into that new market, what are the things you look for, number one? Number two, how do we think about the differentiation between Oak Street and some of the other clinic-based models? Yeah, I think, I think number one on that, the biggest things we look for honestly is the types of neighborhoods and demographics that we've been successful in. I think one thing that we're really proud of at Oak Street is that, you know, we've made this work across every market we've entered. I think if we would've... You know, we ended up debating in early years of should we do Philadelphia versus Atlanta. We ended up doing Philadelphia, and then we did Atlanta later. The reality is, whatever order we went, I think it would've been the same outcome, right? I don't think there's been any magic. As much as I wanna, you know, say we were brilliant in the early days, I think, you know, we went to markets because, you know, they were close or because we felt there was a need, and we just keep seeing that need repeat itself market over market. What I think is more important is where you locate within any big city. I think, you know, over time, and we're definitely on this journey, you know, we're gonna be in all the big cities in the country. Once we go to a big city, we go to the kinda smaller sub-markets around that city. Went to Dallas, and now we're in Tyler, Texas, and places like that. We'll continue that approach. What we also find is, you know, one center isn't enough for the catchment. In our more mature markets like Chicago, Indianapolis, Philadelphia, Detroit, we've had to go back and add more centers, because we just find the demand really outstrips what one center can you know, serve, even if the center is, you know, five, 10 minutes from someone's house. Given that, just given the depth of the market, we, you know, where other groups are is relatively low on our list. The reality is another center-based or kind of, physician-enabled model may be in that market, but the vast majority of people aren't cared for by that model. They are cared for, by, again, a normal doctor's office or people just going to the ER for care, and we just feel like our patient experience is so differentiated. I think what people are realizing as well is even compared to kind of the groups in value-based care, I think there are big differences in market entry approach, patient experience, scalability, consistency, care model results, and I think we're really proud, and we would say I think the data supports that. I think we, you know, we feel that we are kind of leading the pack on those mentioned. Yeah. Just going back to those metrics, thank you again for sharing the cohort data at our conference. We really appreciate that. When we look at this and the average being $7 million per center, versus some of the other players that have public numbers out there today on the center basis, can you maybe just talk about some of the things that are really differentiated for Oak Street versus, you know, some of the others that are probably more in like the $2 million-$3 million range when we think about center economics? Sure. Sure. I think, you know, the first thing is, you know, not all centers are the same, right? Right. There are very, you know, differing sizes. Ours are 10,000 sq ft, others are 5,000 sq ft. You know, Tim and I joke that our first center at Oak Street is only 5,000 sq ft, has less exam rooms. It's done phenomenally well in a patient contribution perspective, but it'll never make $8.5 million a year 'cause just it has about half the number of patients. One thing to take into account is kinda the size and scale of the center does make a difference. Also is, you know, what kind of center is this, right? Some people have, you know, centers, but they're actually serving all different patient types. Right. Some people more by physician, you know, by doctor's offices, and they call it a center, but it's really just a doctor's office. I think what is defined as a center is very different across different types of groups. That's kinda piece one, I think is the difference there. Piece two, and I think that the most meaningful thing is the results, right? Direct contracts is the interesting thing to pay, you know, look at from this perspective because in some ways it is a kinda independent, publicly available scorecard the government has released, on care model results. We're really proud. If you're gonna generate kind of twice the savings, right. Mm-hmm. As any other group out there, then of course you should expect better economics at the center level, and we're certainly seeing that. You know, as we think about, again, just coming back to the cohort data one more time, your expectations going into 2022, and then. Yeah. For the most part, right, beating those expectations, we understand the five centers that you had wi th a former partner. As we think about the amount of visibility you have as we sit here today, maybe can you just talk to us about, like, what are the key components to that visibility and, you know, as you think about that member, right? So the acuity level of the member, how you treat that member or patient cohort, what are some of the things that we can look for beyond your once-a-year data? Everyone loves to ask that question. In a different way, Lisa, but yours is more direct. I'd say one is, you know, I think our guidance is a good indicator, right? Yeah. Last year, we, the way I told folks is, listen, to the extent that we're performing in line with or ahead of our guidance, that should mean all else equal, at least on a weighted average basis, we're performing as well or if not better than the cohorts that we provided. As we think about results for 2023 or for any year really for that matter, you know, centers we obviously have a high degree of confidence around. We've got a real estate pipeline. We've been doing this for a long time. You know, we opened 40 last year. We feel highly confident we can open 35 this year. You know, patients, there's always some question on patient growth, but again, we have a lot of ability to impact that and a lot of it's how we come into the year, coming out of AEP and our ability to engage patients. Revenue kind of follows suits from patients. Really the question is, the reason why we sensitized medical costs is, like, that is the variable, right? Again, I, we've seen really strong results from our team, particularly in the latter half of 2022, but just more generally on our ability to engage and manage our patients, to Mike's point, and the efficacy of the care model. Anyways, the simple answer is you kinda just have to track our guidance. I mean, the reality is that there are so many centers in the more recent cohorts that we could not outperform we had to outperform massively on our earlier cohorts in order to offset underperformance in our earlier cohorts. The reality is, if we're performing well in line with or ahead of guidance, it's because we're seeing strong performance across the board. To that point on medical cost trends. You know, we've talked about flu. We were just at lunch with Humana, talking about flu, and we saw this right after Thanksgiving timeframe, or right around Thanksgiving, right, we saw flu kind of shoot up, and now it's flattened out. I don't think we've ever seen a double flu season. Do you feel like we've captured what needs to be captured in the fourth quarter numbers? Does that make the first quarter medical costs look a little bit better from a respiratory perspective, would be my first question. Secondly, we get a lot of questions around pent-up demand. You know, we heard other large managed care companies give guidance saying, "No, no, we don't think there's pent-up demand," but the acuity level could be higher. If you should've had a knee surgery, maybe now there's some incremental surgery that has to happen within that surgery and therefore the cost is higher. I mean, so I know that's like two questions in one, but all leaning back to medical cost trends. Yeah. I hope you're right on January being lower, given the fact that we don't see two flu seasons. Well, besides everybody from here, just so everybody knows, they're gonna go home with some kind of respiratory illness. Yeah, exactly. Yes. Yeah. You're smart to wear a mask. It wouldn't be, it wouldn't be complete without a deluge of rain and some sort of respiratory illness. Yeah, we'll see. It's obviously too early to know. I'd say generally speaking, our results or our experience thus far around respiratory illnesses is consistent with our expectations. And the reality is, it isn't necessarily serving seniors, so RSV is a factor, but maybe a little less so of one, you know. Any of these things could obviously become an issue. It's more about do they become hospitalizations. Right. That's where obviously it becomes a much more expensive episode. We can track that on a more real-time basis because we do have insight into which of our patients are going to the hospital. Depending upon what market we're talking about, we know why that patient was admitted. Therefore, you may not know whether it was flu or RSV versus COVID, but you know it was a respiratory illness. I'd say again, you know, it's all within the band of our expectations. What that means for January, I couldn't tell you quite yet, but. How about on the any, you know, kind of acuity level versus pent-up demand? Yeah. You know, Well, we've certainly experienced that, right? That was Q2 of 2021. Yep. Days we don't wanna relive for a variety of reasons. The reality is like, so that has been a factor. I think, you know, that was extraordinary because you had the measures that were taken in 2020 where the world was essentially shut down. There was really no access to care. You had a period of time in early 2021 where, you know, our patients were the first patients eligible for vaccines, so a huge vaccination wave. You know, post that, just this surge in care, which we saw actually fall off relatively quickly. By summer, that surge was back to normal. What we've seen, you know, what we would say internally, I think we've mentioned this to you more than twice, is like, utilization isn't something that happens to Oak Street, it's something that we proactively manage. The extent that we are operating our care model with the fidelity that we wanna see it operate with, like, we should be able to see us manage that utilization. We will see, but, you know, our expectation is for 2023 that we can manage through, or manage our patients effectively. So. You're talking today about adding 45,000-50,000 incremental patients going into next year. Can you talk about, you know, the marketing practices today, like now that things are open back up again versus the digital channels and other things you used during COVID, would be my first question. Then secondly, can you just remind people if there's, you know, when we see membership for one managed care versus another, I know you have a strong relationship with Humana, one of the larger players in the marketplace, but, is there anything that we should be looking at? Like, so if somebody loses membership versus somebody gaining membership, does that matter to your model? Yeah. On number one, you know, really we break our marketing channels into two groups. One, a kind of our local community outreach channel, which was the vast majority of what we did pre-pandemic. All of our centers have people we call Outreach Executive, who are essentially a cross between a salesperson and a community health worker. They're really meeting people in the community and really educating them about why primary care is important and why you get a different primary care experience. The reality is no one shops for primary care. If they did, if it were more of a consumer item, we would win big because the kind of experiential elements we give people is essentially concierge medicine for free. The challenge is people, you know, generally are, "I have a doctor," or, "I don't like going to the doctor." Right. You have to kind of change behavior. For a lot of our neighborhoods, it becomes more, you know, "I just go to the ER when I'm sick. I haven't gone to the doctor my whole life because I never had insurance," et cetera. There's a lot of behavior change, and that's why the community-based approach works really well. Obviously, when COVID hit, we couldn't do the community-based approach. We did a lot more essential channels. We set up a central call center. We did a lot of digital marketing. That actually worked really well. We just keep improving on that incrementally over time. In kind of late Q3, early Q4 of last year, we did a relatively large advertising series of television ads. That actually drove really nice results. Something we'll definitely repeat again in 2023. I look at it actually maintaining both those approaches and really trying to incrementally improve all of them. Like, I know we can do better on the community outreach levers. We were better in 2019 than we are today on those. It's still coming back, the relationships are still reforming the communities, et cetera. We'll keep incrementally improving that, you know, while looking to maintain or improve our central channels. I think the combination can obviously drive better and better growth. We, you know, the growth we're projecting is a function of that. You know, hopefully, that becomes, you know, something we can, you know, keep driving better and better growth on and fill centers up faster. As far as the payer question, you know, one of the, I think, nice pieces about being multi-payer, is that we're, you know, we're not as reliant upon, you know, one payer's biz or one payer's AEP. Obviously with payers, we have better relationships with and more members with, have a great AEP. That's, you know, that's great. We love seeing that. In large part because they're great partners and we want them to succeed. In past AEPs, when other players have done better, you know, we'll maintain the membership, right? Because the patient will stay with Oak Street Health, and they'll just switch plans, but they'll still be our patient, and therefore they'll still be in a risk contract. I think that's one of the nice things about the kind of multi-payer national model, is you're less impacted by other's AEPs. Although obviously, we do love seeing, and it's a slight tailwind when the payers we work the most with do well. Tim, a question for you. Yeah. 2025 expected to break even, EBITDA. Don't need capital to get there. You have a new $300 million line of credit. How do I think about uses for that line of credit? Yeah. From, from our perspective, that's really a liquidity backstop. We, we remain committed to our de novo model. From our perspective, you know, what we wanna making sure we had is we had clear line of sight to get to where we wanna be, adjusted EBITDA break even in 2025 and have the cash to generate that or to get us there, if not earlier. We'll see. It's fewer years remaining now, but we're working hard to get there. From our perspective, that's really it. You know, we'll open 35 centers this year. We'll revisit that number in 2024. I think from our perspective, we sleep better at night knowing that we've got the liquidity to get there if there are any bumps in the road. Right. We only have, like, one minute left, and so I like to end these presentations in asking Mike, when we're sitting here one year from now in a much bigger room. Yeah. What will investors appreciate about Oak Street that they don't appreciate today? You know what? Honestly, probably nothing. Because what we're gonna do is have the same presentation, Chin's gonna walk you through the same two slides. You know, our goal is to walk through the same two slides and show you the same thing, right? Consistent performance and that importance performing year-over-year. If we're in the same place, or a better place where we can say, "Hey, here is how the curve is," and the I don't know what color we'll pick. The purple dots are above- Yeah. The orange dots and that's great, right? That, that means our model is being successful. From our perspective, that is one of our keys, right? It's not trying to be someone we're not or try something new. It's just, this works and we're gonna keep doing it. If we can incrementally improve it, that just pulls forward the profitability and that's also means we're helping a lot more people. Right. It's a matter of getting the investors to understand this for the room. Thank you very much. Thank you so much for doing this today. Thank you. We really appreciate it.