All right. Good morning, everyone. Welcome to the home stretch of the Stephens Investment Conference. I'm Jeff Garro, the Healthcare IT Research Analyst here at Stephens, and it's my pleasure to be joined by R1 RCM today, and specifically Jennifer Williams, EVP and Chief Financial Officer, and Evan Smith, SVP Finance and Investor Relations. So thank you again for joining us, and welcome. Thanks. Happy to be here. Appreciate that. So we'll just kick right in with the questions, see how many we can get through, and maybe start with some more recent news first. I was hoping you could summarize the restatement news that came out this week, alongside your reiteration of FY 2023 guidance. Sure. So we announced in a release at the beginning of this week that we're restating our historical financials. We identified at the time of our Q3 earnings, literally after we did our earnings, but prior to filing our 10-Q for the third quarter, and it was identified internally by an R1 in our accounting and finance organization that there was an error related to the accounting for some of our acquisitions that we've done historically. Specifically, one acquisition that we did in 2020, one in 2021, and one in 2022. And the error was specific to the way that we treated some of the purchase price accounting. There's a very specific guidance that's out there around any payments that are made in conjunction with the transaction, things like transaction bonuses or the acceleration of stock awards and the like. If there's discretion around the ability to pay those or accelerate those, and a decision is made during the transaction process, even if, and in which case it was for our acquisitions made by the seller's board and at their discretion, and not at the discretion of us or the direction of us, the guidance states that you really need to record those expenses as transaction expenses post-close, instead of Goodwill as part of the purchase price accounting, which is what we did in all three situations. We disclosed it was about $8 million in 2021 and 2022, is what the error was. If you think about that as a percentage of the transactions, it was actually very small. One of the transactions was $300 million, and the other was over $3 billion, the Cloudmed acquisition. So it was very immaterial or small as a percentage of the transaction, but if you look at it as a percentage of our net income on the GAAP income statement, it was considered material, and therefore required us to restate. The errors were pretty isolated to the specific issue around purchase accounting. So we're in the process of going back through to restate and amend the 10-K, which will include changes to both the 2022 and the 2021 balances in the 10-K. Then, while there's no change to 2023, to the other part of your question around our results or our outlook for the full year, because our 10-Qs include the comparable periods to 2022, we need to go amend the 10-Qs as well for the 2022 periods, because there will be adjustments that flow through those periods. We're in the process of doing that now. We believe it will take, you know, weeks, not months, to complete, because it's a pretty isolated area that we need to change, and we'll get our financials back on file and move along. Great. Maybe a couple of follow-ups there. You mentioned two separate acquisitions. I think it's, you know, VisitPay in 2021 and Cloudmed in 2022. And what, you know, VisitPay occurred before you joined R1. So maybe just you could speak to the timeline and the consistency of the accounting treatment for both of those that was then revisited recently. Yeah. So, I mean, we made the decision at the time of each of those acquisitions. It was treated consistently across all three of those acquisitions, that our view was there was no benefit for R1. Our leadership team would tell you that in many cases, it creates issues when there are payments made to employees of the target, that it creates retention issues on the other side when there are payments made, and that that wasn't something that it wasn't a decision or guidance or an approval that R1 made through the process. But nonetheless, the guidance is actually pretty specific, that says in very limited situations would it not be that way. So we treated it consistently in all three of those acquisitions. I came over as part of the Cloudmed transaction. Obviously, wasn't involved on the accounting side as part of the purchase price allocation at the time of close, but the treatment was considered and treated consistently across all of those acquisitions. Understood. And, you know, I also wanted to ask, and then with the restatement, you'll revisit anything that was on the Summary of Audit Differences over the last couple of years. So any broad strokes you could provide on other topics that will get a second look as you go through this process over the next few weeks? So I've learned more about restatements over the last 10 days than I ever really wanted to learn about, and I hope I never have to use them in my career again. But one of the things you do when you identify an error that's considered material, and you go back and restate your financials, there's also, as part of any normal course audit, every company and their auditors do this. When you're going through an audit period, you have what's called a Summary of Audit Differences, and that's where you keep track of anything that you identified through the audit that may not be material, and it may not be worth the disruption of going back and adjusting every journal entry for any little change that's made. An example of that is, you're doing your audit in Q1, and you realize you find an invoice for couple hundred thousand dollars that should have been accrued at your end in Q4. It's immaterial... but it's out of period, so you put it on your Summary of Audit Differences, you agree it's immaterial with your auditor, and you move along. And over time, you know, the period of the three years that you include in your 10-K, you have a kind of an accumulation of what those audit differences are, and you're constantly monitoring those to make sure that they're not material in nature. They're usually just, you know, small items. A lot of times they'll offset each other over time, a good, you know, one in one direction, one in another, in another. But when you do a restatement, you also go back and look at the Summary of Audit Differences and clear those, 'cause if you're restating your financials, you might as well go ahead and clean up any other errors you know that are out there. So there will be some immaterial, and we disclose this as well, and we've gotten a lot of questions over, "What does that mean about other immaterial adjustments?" That's exactly what it is. And in many cases, you'll see there might be a - $500,000 impact to adjusted EBITDA on one year and a positive in the other, but no material changes to revenue or adjusted EBITDA over the period. It's just gonna be some noise in the different line items across the periods. Appreciate that. Maybe we'll put accounting to the side for a few minutes and- Talk about the fun stuff. Yeah, talk more on, you know, move to a more macro level. I was hoping you could talk about the financial health of your customer base and prospects, and in doing so, help investors distinguish between pressures for those customers and prospects that are demand drivers versus factors that influence the key KPIs in your business one way or another. You know, systems are under incredible pressures and incredible challenges right now, and we see it on both sides. From a pipeline perspective, it actually creates a lot of opportunity for us and a lot of tailwinds in the industry because providers are looking for opportunities and ways that they can improve their operations. But it also does create some challenges for us with existing customers, where they're looking at every lever possible, you know, especially if they expected a faster recovery coming out of COVID, especially this year. May have expected higher volumes than what they're seeing consistently over the year. So while it creates, and I would say that overall this is a good thing for our industry and for our business because it creates a lot of opportunities for us, it does create some challenges internally and some I would say some noise internally, where we're trying to work with our customers to make sure that their operations are stable and that they're seeing the improvements. We are seeing improvements on our KPIs. It's. You can see it in our incentive fees and the progress we're making quarter-over-quarter on the revenue there, but it's all relative to what? In many cases, a lot of our customers expected a much faster return to whatever normal is coming out of COVID, whatever that new normal is. And so we're constantly working with our customers on, you know, what are the expectations? How are they thinking about improvements on a number of metrics? Cash across the board is improving consistently, sequentially, quarter-over-quarter. AR is, I would say, improving modestly, both total AR and aged AR, but we aren't seeing it come down as quickly as some providers had hoped. And I don't really think that we will. I think that payers are going to, you know, as they improve processes, as they kind of work through some of their own labor constraints that they've seen over the last couple of years, that there will be kind of a very modest improvement over time there. But I don't... I, I, I do believe we peaked last year- Mm ... when every one of us having challenges with labor and finding labor and retaining labor, but I don't know that it's gonna return to normal as fast as our customers would like for it to do. We are helping our customers, and we have a ton of visibility into data across payers, and we can help our customers look at very specific issues if there are pockets that can be addressed. But in some cases, it's more of a return, modest return to normal, and slow improvement on payer timelines, which drives a lot of it. Understood. On a related topic, I'd like to ask about customer satisfaction for end-to-end customers. When you and Lee took your current C-suite roles, what was your assessment of customer satisfaction, and what actions have you taken? What have the results been? And maybe the last piece of the prompt is: Could you help us sort out what you've experienced at some customers with more unique business models versus your more core health system customers? Sure. So at the beginning of the year, our CEO, Lee Rivas, and I both came from the Cloudmed business, so that was an area of the business we were obviously very familiar with. So at the beginning of the year, we both said that we were gonna spend a lot of time just trying to understand our end-to-end business, get to know our customers, develop relationships with them, understand the operational model, and the details around each one of those contract models, and we have done that. We've both spent time with each of our customers and their leadership teams, their CEOs, their CFOs. In many cases, a lot of our customers have had turnover at those executive levels, so there have been new people in those roles, some of which weren't there when they originally partnered with R1. So it's kind of been a new structure for them to learn and understand as well. So we've had some really good conversations and are working with a number of our customers on ways we can continue to improve the partnership going forward. As far as customer satisfaction, going back to the first comment on the challenges in the industry, these executives are under an incredible amount of pressure, and so sometimes that does put pressure on the relationship and what the expectations are on metrics. So it's important that we have aligned metrics, very objective calculations of how we're measuring things, that we can work through with our customers, and then based on what they're trying to do and the, you know, strategy that they have for the business, how we're working with them over time. Don't forget, though, we still have, you know, a large, a very large modular business from Cloudmed, and we monitor customer satisfaction on that business as well. In that business, we have very high customer satisfaction. We have a number of customers that continue to expand on the modular side with new capabilities and new solutions and additional penetration there. The expectation is, and part of the investment thesis when we acquired Cloudmed, that eventually we would expand some of those relationships to end-to-end. That's certainly something that we continue to expect, although probably 2024 and beyond, just based on the nature and the long sales cycle that you have on the end-to-end side. One last comment on that, and it's related to some of the specific nature of customers and things that are specific to some of the structure that providers have or nuances related to businesses. And I would say that, you know, at the beginning of the year, Lee and I said, and we were very vocal about, we had some operational things to fix with some recent onboarding, some new customers, structures that didn't look like our normal customers. Very complicated structures, particularly with a large physician group and then another end-to-end customer that has very different model as far as decentralized different systems, different types of processes. I would say that on one of those, on our acute side, actually metrics improving on both customers, but we did announce in Q3 that one of those customers is gonna be transitioning away to bring a lot of it back in-house because of the nature of their business. I think there's a realization. I would say there's been no impact to pipeline for that transition and the noise that's been in the market there. There's been a realization by a number of customers and anybody we've talked to around that, that customer does look different, and they do have a very complicated model for a lot of different reasons, and a realization that, yeah, we understand why there could be some complications there because of the nature of what they do and how they do it. Thank you. And maybe to double-click on Pediatrix for a minute. Could you help us sort out what's happening contractually versus what needs to happen to have a smooth transition operationally? And then maybe you could also highlight how elsewhere across your book of business, you're supporting physician practice revenue cycle. Sure. So absent Pediatrix, we do have a very large physician business, including some that are embedded in the broader acute, like the Ascension business, for example, their physician business. So we continue to believe that that is core to our strategy, and we'll continue to support and grow our physician business overall. So that's an area that we're gonna continue to play in the market, and we think is important to the overall strategy of the business. Specific to Pediatrix, that's the customer that announced that they're gonna be moving back to more of a hybrid approach and moving a lot of their rev cycle operations back in-house. They notified us in November. We talked about it on the Q3 earnings call. The effective date of that termination is the end of the year in December. But what I would say is, we expect that it'll be a pretty complicated and complex transition back, and we'll continue to support them through that. We're just having conversations with them on what that transition plan looks like and how long they think it will take, and we're committed to supporting them through that process. I do think it will be more complicated than they expect that it will be, just based on what we've learned over the last couple of years on that customer. There is a termination fee associated with the transition, that we expect to earn and will be realized in 2024, at the time that we wrap up the transition and the conversion back to their new model of what they wanna do. But I do think, and I would not be surprised if it takes longer than what they're expecting out of the gate. Any expectation you can set in terms of a timeline to update investors on a go-forward plan there? You know, not trying to get you to, you know, predict when the transition will occur, but when can investors think about having a firmer grasp on how that relationship evolves in the final stage? I mean, our teams are still going through the project planning with them, and there's been a number of meetings, post notification of exactly what is this gonna look like. So I think as they nail down some of those transition plans and expected timing, and we have alignment on what that looks like, we'll provide more details. Obviously, we would expect that we would provide those as part of our 2024 guidance. Based on my current view, I think it would be a minimum of a six-month transition through 2024. It may take longer than that. That would be my kind of current hypothesis, but it's not final. Understood. Maybe just kind of move to a broader new business development question. What are you seeing in terms of demand on both the modular and the end-to-end side, and what in particular about the R1 value proposition is resonating? Yeah, as I said at the beginning, that the challenges in the industry create a lot of tailwinds for us on both the end-to-end and on our modular business. On our modular business, the way that we go to market there and the value prop is, there's very little risk to CFOs because there's no implementation fee, and it's really risk-free to them from a financial perspective, because the way our model works is it's pay for performance. So we find value, we find incremental underpayments, as an example, in our underpayments business, or get denials overturned if they have an issue with denials that we're helping them with, and then they pay us a percentage of those dollars that we find for them. So only, you know, they only have to pay should they have incremental value that comes in the organization. So it makes it really easy. They don't have to go find dollars to invest in out of the gate upfront in their organization. So it's a really easy opportunity for us, and in many cases, given all the challenges that they have, they come to us and say, "I need help. I don't have the staffing to help." You know, "I've got increased denials, and I need help with that." Or, you know, "We've got a large bucket of aged AR that we need help with, working through reimbursement that we believe is still valid, but we need help with that." And we're able to help them. We have the staffing. We can quickly respond and add value there. So there's certainly demand there, and there's also a great value prop and an easy sales opportunity there on the modular side. On the end-to-end side, it also creates a lot of opportunities because CFOs are realizing, coming out of COVID and with all the challenges, inflationary, finding good labor, in RCM operations, that they need help, and that technology is ultimately... You know, investing in technology at scale and being able to deploy it is really the way to improve rev cycle operations. But if there's a dollar of investment inside of a system, it's typically going to a clinical operation, not to an administrative function. And therefore, CFOs are left trying to figure out how they are going to solve some of the issues that they have. So in many cases, they look for a partner, and we can be that partner, whether they want to do a modular solution and start small, or whether they're looking for a much more strategic partnership and looking to do a more, you know, end-to-end enterprise strategic relationship that would involve outsourcing their revenue cycle operations. When we go through the contract economics, it's really hard for CFOs to ignore, because the way our value prop works and the contract model is they get a discount out of the gate. So as soon as we execute the agreement, they're able to see savings from the beginning. The way our contract model works is we make that investment to give a savings back to the system, and then as we make the transition over, we do the work to deploy technology, to transition employees to our global footprint and be able to expand and have labor arbitrage, and also to be able to consolidate vendors if we have our own capabilities through our modular solutions already and capabilities we have internally, or be able to just utilize economies of scale where we're doing it for a number of customers, and so we have better pricing mechanisms with different vendors. So there's a number of different savings opportunities. We give the savings, some of the savings, to the client right out of the gate, and then we go do the hard work over the next couple of years, and that's part of the margin maturity curve that you see when we take on new business. Appreciate that. That helps. We'll dig in a little bit further by product segments and start with the modular side. Could you frame up the demand environment, at least directionally, in terms of RFP volumes, deal size, and win rate? Sure. I mean, we've continued to see increases in demand. Many of the reasons that I just said on our modular business: it's faster revenue, it's easy, and it's fairly low risk. One other point that I'll make on the modular side and the demand for it is that we made a decision a couple of years ago at Cloudmed, that when we won new business, we created a, what we call a universal data spec, and we gather information that we need in a universal manner from their source systems. In the future, once they have one solution embedded in their organization and they have a need and need to expand or want to expand, it makes it really easy because we already have the data, and so we can almost just turn on the solution, and it's really fast to revenue, and the implementation timeline is able to be faster as you increase the number of solutions you have. That's been one change that we've made that's really helped customers, because in many cases, they have challenges. They need our help, but they also have challenges on their IT front, which could create, you know, challenges to bring in a new vendor, bring in a new partner, and be able to get the data that they need to actually be able to help them. And so that, that makes it much easier and a lot of demand for our solutions. One of the other areas that we've seen, and I, and I just mentioned this, but seeing a lot of demand is specific to AR and denials, where payers are starting to ask for more information, deny certain claims, kind of return to that pre-COVID norm, and we have solutions that can help them with that. So when they don't have staffing to be able to manage the volume internally, we can do that for them. So we've continued to see improved demand, increased demand for our solutions, and therefore increased bookings over the last couple of years, and that's really what's driving a lot of the growth in our modular business, specific to what we've talked about with the Cloudmed growth on the modular side. Excellent, excellent. Appreciate that. And, you know, that's a part of the business with a shorter sales cycle, so it benefits the P&L faster. The flip side of that, of course, is the end-to-end business, and want to ask about deals that are in the late-stage pipeline. And if you could help us parse out with those deals, what's kind of legal type blocking and tackling left versus ongoing diligence on kind of both sides, or maybe negotiation on both sides, in part to make sure that everyone's expectations are realistic, as you alluded to earlier, and that the value that's being created in the relationship is being split appropriately? Yeah, on the pipeline, Lee mentioned this in the Q3 earnings, and I would say it's consistent. We're very confident, based on what's in our pipeline and how things are progressing, that we're going to achieve the $4 billion in new business that we discussed. As far as, you know, where it is in the pipeline and, you know, is it legal? Is it negotiations on contract economics? They're kind of all related and, and I would say intermingled and part of the process. And the other thing I would say is, you know, historically, and we've gotten this feedback coming out of earnings, is that historically, the company has oftentimes announced new deals in conjunction with earnings. And so when Lee said at the beginning of the year that he expected a win in the second half of the year, people kind of marked their calendars for November 2nd, when we did earnings, that we were gonna announce a new deal. Lee and I both feel very strongly that it's more important to make sure that we're getting the alignment with customers up front on operational execution and what the success factors are in the contract, and that we get the best terms for R1 as part of that process. And the reality is, in the near term, whether we sign a deal November 2nd or December 10th or January 5th, these are long-term strategic relationships, and the near term, you know, within one month to another or specific to a calendar year versus early the next year, doesn't really matter. For us, it's really important that we get the right terms and the right economics aligned to the customer for long-term success. That's what we're gonna continue to drive to. Whether it means that it delays it a couple of weeks because we're working on alignment on a couple of the last metrics that they wanna include that are important to them from an aligned success perspective, then that's what we're gonna do. But we still feel very confident in the $4 billion based on what's in our pipeline. Appreciate that. A couple of weeks sounds better than a couple of months. So I want to ask about governance and revenue diversity. It's, it's kind of hard to ask about customers having representation on the board without also discussing in tandem the reduction in customer concentration that the company has seen over the, the last few years. So I want to ask, what's, what's the right mix of customer representation on the board, and, and how do you assure a smaller, incremental $2 billion net patient revenue prospect that these larger, long-time customers with board representation have aligned interests with them? Well, we're constantly thinking about our customer engagement model as one factor when we take on new customers. The other thing I would say is, on our board, it's served us very well to have board representation for our customers historically, because we've been—it creates alignment and creates investment from both sides in the relationship. And again, these are really long-term, very sticky, strategic partnerships that we're making with systems. And so it's important that we have that alignment. What I would say going forward is, so we have three customers, if you exclude Ascension, because they're also an investor in our business. Outside of Ascension, we have three customers, so four, if you include Ascension on our board. And going forward, I would expect if there were any new customer appointments to the board, it would only be for very large systems. I don't think based on the scale of you know, us continuing to grow the business, that we would continue to add customers at the same rate going forward as what we have historically when it was a smaller business, and it was really important with some of these scaled, very large systems that we did that. The other thing that we're considering as we continue to scale is how we think about, as part of this customer engagement model, some kind of customer advisory board. Not just on our end-to-end side, but also on our modular side. Because the reality is, over 95 of the top 100 systems are a customer of ours today, on one form or another, either on the modular side or on the end-to-end side. Going back to your question about customer satisfaction and how we engage with customers, we're trying to think about the best way to engage customers to make sure that their needs are being met, that they feel like they're being heard, that we're actually utilizing them for benefits as we think about ways to drive innovation into the business and technology and automation, and making sure we're getting customer feedback there. So there's a number of ways that that could be beneficial going forward. But we're comfortable with the governance structure that we have today, and we're always exploring ways to make it better going forward. And I think, really interesting point on the customer advisory panel board and just getting those positive feedback loops going from the broader customer base. So I know, you know, this day of the year, we're unlikely to get the precision that we'd like about the financial outlook for the next 12 months, but we have to ask, and I'll frame it up to ask about revenue visibility and growth drivers, as well as any other key variables to consider about... RCM's path to drive EBITDA margin expansion going forward? Sure. The way that I think about revenue visibility, and, you know, not just this time of year, as we're thinking about planning for 2024 and beyond, but just in general, is on our base customers, we, we actually have a lot of visibility in our base customers. We have very stable, you know, trends in our base revenue and our net operating fees based on customers. So there's a lot of visibility that we have there on our base customers, and that's relatively stable. You may—you always have a little bit of noise with, you know, either a few facilities that customers are acquiring or that they're divesting, and just natural activity in the market, but overall, that's relatively stable, both on the end-to-end side and on the modular side. So that base business is relatively stable. Then you have new business. We've talked about the $4 billion in new wins. You know, that revenue takes a while to ramp. Typically, when we sign a contract, we don't transition the first wave of employees until, you know, 5 or 6 months later. It's usually more than a quarter when we transition them, and you won't really see any revenue until you start to see those employee transitions take place. Because until then, the revenues, even though we may be charging them the base fee, it's getting netted out in a reimbursement in revenue, all kind of at that net revenue line. So you wouldn't see a lot of revenue until we start doing those transitions, and that's usually a couple of quarters. So that's the way to think about new business on the end-to-end side. On the modular side, we continue to book new deals every quarter, and the implementation timeline there is, you know, a quarter or so, depending on the nature of the service or the solution line that we're selling. And so on the modular front, sequentially, you're going to continue to see growth in that business, as we continue to implement the bookings that we're bringing on. So that's really it from a revenue perspective. On the margin side, we will continue to realize synergies. We'll realize about $30 million in synergies, which is on the high end of the range we gave at the beginning of the year, so things are going very well on that front. Next year, I would expect that we'll continue to... The synergy growth will be driven by, and we'll continue to realize synergies related to global expansion on the Cloudmed front. As that business continues to grow, we continue to add people, and we're adding them in our global operating centers. From a margin maturity on the end-to-end side, we're continuing to deploy technology and automation. We announced a partnership with Microsoft in November, and it's really around time to market on how we can embed new use cases on automation and particularly AI, and how we get faster to market and realization on some of that. So that's something we're really excited about. And then the last piece of the margin maturity is just as our new business continues to ramp. As I mentioned, it takes time to consolidate vendor contracts. It takes time to get the transition of employees and ramp our global capabilities and to deploy our technology and drive automation. We still have recent wins over the last couple of years where we have margin that's still maturing. Great. One, specific follow-up there. Any more detail that you can provide on expectations for timing of the deployment of Stage Two at Sutter? And what are the considerations that could push that timing forward or backward? Yeah, so we have completed Phase One. Most of that revenue, the run rate of that revenue and growth, we started that in Q4 of last year, so we're a year in to those transitions and the ramp of that revenue, and things are going very well. So we're stabilizing metrics, learning, you know, how to work with each other. This is an example where they've had complete turnover at the customer side. They have a new CEO, they have a new CFO, and they have a new head of revenue cycle. So you know, there's been some reeducation on even what was the contract, you know, what was the layout of the contract and the expectation, and they also have new initiatives that they're trying to drive internally. So we're still working with them on what the rollout of that looks like, and how it aligns with other initiatives that their new leadership team is also trying to get off the ground, and how we are aligned and tracking that. So still a little bit TBD on exact timing there. We've said 2024. My guess is it's, you know, the later part of the year, the second half of the year, when we start to see more traction there, just based on some of the conversations that we're having with them and time to deploy the next phase. Understood. Also wanted to ask on the revenue front, what are the key considerations for incentive fees going forward, given the macro trends, where you're at with client maturity, and the kind of couple moving pieces you have in the customer base? We said at the beginning of the year that we would see significant improvements from where we were in the second half of last year in our incentive fees, and we have seen that. So we've seen incentive fees improve sequentially, you know, once you normalize for some one-time things or some contract changes in structure that have made have created a little bit of noise in the trend line there. But overall, from a performance perspective, we've seen sequential improvement in our incentive fees. I would say as we move forward into 2024, the way I would think about it is stable. I don't think that we'll see a huge increase. We've had some contract changes where the nature of the mix of base fees versus incentive fees has changed. We saw that 2021-2022, we saw it 2022-2023, and we even saw it last quarter. Not big numbers in the grand scheme of things, but a couple of million dollars here and there, where customers may want to move into more of a base fee structure or utilize more modular solutions on some of the incentive fronts. That just creates some noise between how we account for it in the specific line items, but the revenue's still there. So the way we're thinking about it internally from a KPI line item perspective on those incentive fees, is pretty stable going into 2024 on a run rate basis. Awesome. That helps. I have a little over five minutes left. Maybe a good time to pause and see if there are any questions from the audience. Go for it, please. Curious, like, when you lose a customer, what typically would drive something like that? Is it a miscalculation of the value proposition, or do they go to a competitor, or do they decide to pull the service in-house? So we, the question was attrition on the business, and when we lose a customer, what's the reason why for the attrition? On the end-to-end side. First of all, on the overall business, we don't really see a lot of attrition. So there's two pieces of our business. On the enterprise side, these are large, long-term strategic relationships. In many cases, we're rebadging employees, moving them over to the R1 side and transitioning their end-to-end revenue cycle operations, and we've had very little attrition on that side. Part of the reason why is there's a very strong value prop where they get significant savings out of the gate. And, and there's also a recognition that we can do it better than them. Despite the fact that everything doesn't always go perfectly, it's still a very strategic partnership with a long-term relationship. And there's gonna be, you know, bumps in the road, we're gonna work together, but all of these employees, and in many cases, sometimes hundreds or, you know, thousands of employees, are moving over to R1. So it creates a really sticky contract model because their employees, these are high-turnover positions, so over time, there's turnover in the business. We're transitioning roles to our global operations center. We're deploying technology that automates, so there's not a need as their business grows, that we don't need as many people over time as we have attrition in the business. And so when you look two or three years into a 10-year relationship, the, the thought of unwinding it would be incredibly complex and incredibly expensive for a system to be able to take it back in-house. There could be an opportunity where it's competitive and they want to move to a different vendor, but the contract economics just aren't there because they get a big discount out of the gate. So I don't—I can't think of any attrition on the end-to-end side, where we've lost a material contract to another provider, kind of in package. The one that we just talked about, they're actually changing the model and gonna take part of it back in-house. And again, TBD on how that will work going forward, because that's very unusual in nature, so we'll see how that works out. But typically speaking, there's just not a lot of value to move from one provider to another because they've already realized so much of the contract economics and the disruption to the business to try to make a change after you've done it and gotten stability is incredibly difficult. On the modular side, those are solutions that would... You know, just like the risk, they're smaller, they're smaller individual relationships and solutions. There's no real customer concentration, or any material spend on each of the individual solutions, so theoretically, those would be easier for them to move. Occasionally, they may say: "Oh, we've got the staffing now to bring denials back in-house." In many cases, they still see a dip in results, and a lot of times will come back to us and say: "Actually, can you take some of it back?" Again, there's very little risk for them because they're only paying us when we find value for them, so it's really win-win. So our attrition is low single digits, even on our modular side. Want to give a little more airtime to technology and automation as part of RCM's value proposition. I was hoping you could kind of frame up where RCM is at in its automation efforts, and maybe as part of that, help us think through how, you know, we'd expect a company to automate part of the workflows that provide the most value, and there might be declining value in each incremental piece that's automated, but technology is changing very fast these days, so maybe that's not the case because of innovation. Sure. So R1 has been on this automation path for several years. In 2018, R1 launched what was referred to as the Digital Transformation Initiative, and over the last several years have been driving a lot of automation use cases and opportunities into the operational processes, in many cases, in the form of RPA, and just automating manual task that have to be done over and over again. And there's a number of automations that have been deployed over the last several years. To date, I don't have the exact number of tasks or processes. I can't remember what the latest number is. It's in the millions of tasks that have been automated, but the benefit from that has been about a 15% savings in people that we need. In many cases, some of these roles are done, you know, offshore in our global operations, but as we continue to grow our business, we don't have the need to hire people at the same rate we would have historically. W here we're transitioning now, especially with, you know, AI, generative AI, you know, the data we have coming over from the Cloudmed acquisition, so the data that we have to be able to implement and deploy large language models. We announced the partnership with Microsoft in November, and the way we're thinking about that is: How fast can we go to market with some of these use cases we've identified? On the end-to-end business, we are still very much services. We do deploy technology to drive a lot of efficiencies, and that's part of how you see that margin mature. But on top of even what's in our current model, we're looking at opportunities of how we deploy some of these use cases faster, but also to drive savings as we think about ways that we can automate or predict what's going to happen, what's needed for reimbursement, what the payers may ask for if they overturn a claim, you know, certain types of claims. Do we have the data to be able to see that, to predict it, and then be able to use technology to make the process more efficient on how we respond and ultimately get to reimbursement? Can I squeeze one last quick one in under the buzzer? How, how should investors think about the cash flow profile of the business and near-term priorities for uses of cash? Sure. So the first thing, we are growing fast, and so our top priority is making sure that we're investing in growth of the business and that we're doing the right things and making the right investments internally. We've talked some about technology and what we're doing there, but investing in the overall growth of our business. As far as cash conversion, you know, this year we'll land in the kind of mid-20% free cash flow conversion as a percentage of EBITDA. A lot of that is because we're still spending on integration associated with the Cloudmed transaction and, cost to achieve pretty significant synergies that we've assumed in the transaction model. As we move out of 2023 and into 2024, I would expect that those costs will decline, therefore driving a higher percentage of conversion of cash as we move forward on that front. There will be less of those expenses. We'll have growth in EBITDA, that will drive naturally more free cash flow conversion as we just continue to scale the business. As far as capital allocations, obviously, it's growth of the of the existing business, but also thinking about how we delever and continue to pay down debt in the current interest rate environment. With that said, we're also looking at opportunities on the M&A front, if there are new capabilities and things that we want to invest in. We make investments on the end-to-end side and growth of the business, so, you know, it's driving revenue growth. But our contract model does require investment upfront in the first 12 months, and we'll continue to make those investments as well. Makes sense. We'll have to cut it off there, but thank you again, Jennifer and Evan. You're welcome. for joining us. Appreciate it. Great. Thank you.