Excellent. All right, well, thank you. Why don't we get started? For our next presentation, we're excited to have R1 RCM here. Obviously, a lot has happened in the last 12 or 18 months, and so a lot for us to sort of get through. Jennifer Williams, representing the company, the Chief Financial Officer, Evan Smith, who heads the investor relations function, right here, in the front row. And I'm, for those of you who don't know me, I'm Glen Santangelo. I cover the healthcare information technology and, especially pharma sectors, at Jefferies. So with that, why don't we just sort of jump right into the Q&A, and, we'll take it from there. You know, I get it, the quarter was a few weeks ago. The ink's not completely dry in the press release, so maybe as a starting point, why don't we just talk about 1Q, how you think the company sort of did operationally? Obviously, everybody was scared and anticipating the change impact in 1Q. You sort of quantified that, but, you know, just give us sort of a quick recap on 1Q and what you think sort of the company's doing well, and then, and then we can talk about the change impact on the guidance and, and so on. Sure. We were very pleased with our performance in Q1, overall with the business. In Q1, our core underlying business performed very well. We had good cost containment. We delivered from an operational perspective across both of our end-to-end and our modular solutions. We closed a large transaction in Q1. Acclara was an acquisition that was completed and closed in mid-January, so started the early conversations around integration for that acquisition. And we also signed, in conjunction with that, a very large new customer win on our end-to-end business, in Providence, so $14 billion in NPR. So that was a new customer win that happened in January. So a busy quarter for us. Overall performance was well, not despite the Change impact that happened, which was a cyber event that we had in Q1. It was a vendor in the RCM space of one of the clearinghouses that prevented a lot of our customers from being able to process claims to the payers that ultimately will impact the timing of cash that they receive. So that happened in Q1. It had an impact in our first quarter, primarily related to incentive fees that we earn on balance sheet metrics. So with that outage and providers being unable to process claims, AR in the quarter went up, cash went down in the quarter. And so those were two particular metrics for which we oftentimes earn incentive fees on our performance that impacted the metrics for those incentive fees that ultimately impacted our financial results. But pretty self-contained, and outside of that, the core performance of the business performed very well. And, Jennifer, you said $9.5 million in 1Q and $25 million for the year, and you lowered your EBITDA guidance by, I think, $22.5 million at the midpoint, so that's pretty much all Change. So at Change operationally, everything's sort of as you expected. Is that a fair characterization? Yes. At Change, everything is going as expected with the original guidance that we gave at the beginning of the year. It was $9.5 million in the first quarter. That was mostly revenue in the first quarter, so we did not really have any incremental costs, but all of that revenue flowed straight through. For the year, we did say $20 million in revenue and $25 million in cost. That revenue impact is essentially KPIs that we expect to remain inflated, and really related to balance sheet metrics across the quarter, and then at the end of the year, we do expect some impacts related to denials. So while the clearinghouse was down, authorizations that normally take place, pre-authorizations and some of those types of transactions, as well as some of the claims scrubber, that, Change has a piece of software on the front end that checks claims before they go to the payers to ultimately prevent denials, and obviously, that was impacted. So we do expect we'll have some increased denials in the back half of the year. So revenue impact based on KPIs, and then about $2 million of cost a quarter. But given where we sit at, you know, on June 6th, I mean, do you feel like this issue is solely contained to 2024? Like, you feel like operationally we're beyond it, but the damage is unfortunately done. You've been able to quantify the damage. Is there any impact? Do you foresee any impact on 2025? Not that you want to comment on 2025, but should we hopefully expect this issue to be in the rearview mirror by the end of this year? We still expect that there will be some denials that roll into 2025 and Q1 of 2025, in particular. So the denials impact will be Q4 and Q1, but that's consistent with what we expected at the time that we gave the updated guidance for 2024 and then the overall impact. All right. Maybe just sort of shifting gears, a lot of people, I guess, want to talk about the, you know, the possible takeover of the company, and I'm sure there's not much you can say. I mean, we've made the case that I thought the cash flows had been underappreciated. I don't know if you've seen the LBO model we've been sort of randomly publishing, and so, happy to hear anything you can say, but I'm not assuming you can't. But what I really wanted to ask about, very factually speaking, were these investor rights agreements that are in place. It's our understanding, and this is all facts, right, that the investor rights agreements prevent your two majority shareholders from acquiring any additional stock up until June of next year, but there were waivers that were put in place that go to a certain date this month. Could you just elaborate on those investor rights agreements in a factual way? That's exactly right. In the filings, the 13D's, there were waivers to some of the restrictions in the investor rights agreement that were waived, and the special committee that was formed by the board has allowed the two parties to have conversations, and has given them a deadline of June the 13th. June the 13th. I guess it would be the independent board, which does not include any of those representatives from TowerBrook or New Mountain, would make any decision as appropriate? That's right. So we formed a special committee of the board that is only independent directors. Those waivers expire on June 13th? Correct. Okay. All right, and so then if, if nothing happens by June 13th, now they're precluded from buying any additional stock until June 2025? Unless they get an extension of the waiver. Perfect. Correct. Okay, thanks. Is there anything else you want to say about the deal? No. Okay. All right, I didn't think so. Figured I'd ask. All right. You know, following the quarter, very, very frustratingly, you know, there was another one of your customers was a victim of a cyberattack, right? So now we're getting all the same questions, right? What's the impact of this? I mean, you don't need to say their name. I'll say it, everybody knows it's Ascension, right? And so everyone's trying to figure out what that means for their business, and maybe if you could just talk about the nature of your technology relationship with Ascension, and how a cyber incident at, in, within their system could ultimately work its way back up into you. I mean, it's recognizing the relationship is different than Change. So we are connected to Ascension systems based on the technology that we have and the work that we do on their behalf. That said, in the early hours of understanding that there was some kind of a compromise to their system, Ascension asked all of their vendors, w e had identified it on our end that there was some issue. Ascension asked all vendors to disconnect from their systems, which we did within a very, very short period of time, within minutes and, and certainly in the early hours of the notification. And so we disconnected, and we've done an incredible number of scans and continue to do scans, and there's no compromise to our systems, no indications of any kind of compromise to our systems. So our systems are okay, the R1 systems, but we did have to disconnect from Ascension. In the early days of the outage, the first priority was making sure that our systems weren't compromised, obviously, but helping Ascension make sure that patient care was not disrupted. So what that meant is from a revenue cycle perspective, as people came into the emergency room, and oftentimes our technology would be helping registrations and authorizations and all the insurance information, that reverted to paper. We're back to manual processing things manually so that we can continue patient flow. From an elective procedure perspective, there were some elective procedures that were asked to be rescheduled or delayed, but from those ED volumes were still very much flowing but in a manual way, and we've continued to support Ascension that way. So I don't want to draw an analogy to Change, right? But it seems like their business faced some level of disruption. I mean, we don't know how much disruption. I mean, and that obviously flows back upstream to you guys. And I'm not asking you to give any guidance or anything, but is it this gonna be one of those situations where you ultimately will see some level of an impact, and you'll quantify it, and life will move on and this won't impact 2025 in any way, shape, or form, hopefully? There will be some impact, very similar to Change from a base fee perspective. Remember that our, the large majority of our revenue is based on cash collections. We earn a percentage of all cash collections, so as cash will be delayed in their business, we expect to have an impact on our base fees. That is really just timing. So it will be a shift in our base fees, likely from Q4 to Q1. And depending on how quickly markets are recovered, will there be anything that bleeds into Q2 base fees of next year? What about your incentive fees? And then on the incentive fee front, very similar to Change, the metrics related to AR, the metrics related to cash, and the metrics related to denials will likely impact our KPIs. The quantification of that impact is still to be determined, and really, the reason why we're still assessing the impact is because we don't have full visibility to exactly what the recovery looks like by market. So Ascension's been very good about keeping the market updated on where they are on recovery for each of their markets and when they expect to have their EMRs back online. But the EMRs back online doesn't necessarily mean that everything is flowing as needed. You still have to reconnect all of the technology back into those EMRs and all the ancillary software that touches the EMR. There's still some timeline after those initial EMRs come up before we're fully operational again. If we could just again shift gears to managed care now, right? If we wind the clock back to 2022, right, we saw some increased reimbursement pressure from managed care, right? Which ultimately maybe there was less pressure during the pandemic, more pressure coming right out of the pandemic. That ultimately had an impact, you know, on the provider universe, which ultimately has an impact on you. So, it feels like it's been a stable environment for the past 12-18 months. I don't know if that's a fair characterization or how you would sort of characterize that environment right now, and I don't know what type of visibility you have on that for the balance of 2024, but if there's any sort of high-level commentary you could make on that front. We've continued to see all of our payer timelines stabilize. They have not come down. They increased kind of sequentially quarter-over-quarter through 2021 into 2022, and peaked in the second half of 2022. And they've slowly started to come down, but they've really plateaued and stabilized, and that's in line with what we expected to happen. We don't think that there's gonna be some magical reduction in those timelines that's gonna happen overnight. We think there may be a slow, steady kind of return to whatever that post-COVID return to normal is. But our business, we've assumed that it remains relatively stable. But how do investors get comfortable that those timelines won't tick up? Well, we're, you know, w e are deploying technology- Yep. To automate- Yep And speed up the process by which we get both documentation to the payers, and when we get feedback from them, that we're able to respond back to them and provide them the information that they need to process the claims. Yeah. We also have put in place teams of people to work on payer escalation, so specific relationships with payers, where we're monitoring what the payers are doing, where we have backlogs by customer in certain areas. So we've put in place some processes to better manage it. All right. Maybe, maybe another topic that garnered a lot of attention last year in 2023, were the integration issues of LifePoint and sort of pediatrics. Well, pediatrics kind of felt like a unique situation. We don't need to talk about that anymore. Can we talk about LifePoint or any other sort of integration issues? And it sort of was our view that it, at least as an outsider, it felt like the company won too much business in too short of a timeframe, and maybe the organization operationally felt a little stretched. And I don't know if that contributed to the integration issues. I mean, maybe a good problem to have, winning too much business, and so how do you think about the integration risk of kind of what the company has on its plate at this point in time? You know, we don't really wanna talk about performance of any specific customer. Sure. But with that said, if we back up to wins that, you know, we won in 2020, 2021, 2022, we did win a lot of business, and we were growing very fast. That said, it was a little bit of the perfect storm in that you had inflationary demands that were impacting payers, and thus those timelines were going up, and the timelines to get cash reimbursed were elongated. But you also had, you had a number of different things that were going on: return to COVID, trying to find skilled labor in the hospitals, et cetera. So as we were trying to onboard new business and deploy new business, you had a lot of other macro things that were happening at the same time. With that said, as we look at deploying one of the largest new wins that we've had in company history and our continued pipeline, we feel very good about the pipeline that we have, and we're still continuing to pursue opportunities in the market. So we don't look at deployment as being a constraint to us right now and our inability to take on new business. If you back up, some of that was just a perfect storm at the time. It's been my view that the company should almost, like, stop winning new business and just should integrate what they have, let the existing contracts mature, let the margins and cash flows come up, and that might be the best defense for the company and maybe a key to a higher multiple. Do you disagree with that logic? I mean s orry, maybe that's an unfair question to ask you, but, like, it just seems like, you know, that there's so many moving parts, that if things just sort of settled down and the existing business could mature and the margins and cash flow could improve, the equity might be worth more in that scenario. It's a little more nuanced. I would not say that we're going to stop trying to win new business and take ourselves out of the market from commercial conversations. That's certainly not the intent. But what it allows us to do is really consider the type of business that we would consider taking on and making sure that it's, you know, business that fits with our strategy, that fits with the type of customer, the type of structure that we would want, the scope of services that we would want to have. So it allows us to really think about the type of new business that we would want. That's on the end-to-end side, and then on the modular side, obviously, which is a very large piece of our business, and I think one that's sometimes underappreciated, the amount of opportunity that we have in the market. We're continuing to still perform very strong there. Bookings are performing very well, in line with our expectations, and we still expect that business to continue to grow double digit. Thank you for that. Some of the challenges that have impacted your business, obviously, you know, emanated from your customer base being under a little bit of pressure, which, unfortunately, led to some bad debt expense, right? Maybe not surprising in hindsight, but as the CFO, how closely are you monitoring the health of all your existing customers? Do you feel adequately reserved for or prepared for any sort of financial challenges, or do you see any potential heightening bad debt risk within your customer base? The reality is, hospital systems are under an incredible amount of financial pressures across the board, but it is something that we're monitoring. Is it getting a little better, or is it getting a little worse? I think it's stabilizing. You know, some of the issues that we had in 2022 and early 2023- Mm-hmm Were related to some of the physician businesses. No Surprises Act, you know, kind of the aftermath of the No Surprises Act and some of the pressures that it put on some very specific companies. But we are continuing to monitor the financial health of businesses, and we are having conversations with those customers that are under challenges on how we can work to support them, but also make sure that we're paid for our services. We did take an increase in bad debt reserves, both in 2022 and 2023, and I think we got a lot of that behind us. That said, I do think bad debt will remain a bit elevated compared to probably the historical pre-COVID amounts over the next couple of years, and we've assumed that in our guidance. Okay. Can we talk about Sutter and Providence? 'Cause we get a lot of questions on those. It feels like Sutter phase II on hold. Maybe they had some management changes or doing some reevaluation. Could you just talk about where Sutter is in the process right now? Yes. So Sutter, as a system, has undergone a number of management changes. They have a new CEO that joined in late 2022, in 2022. They have a new CFO that just recently joined, and that's the, you know, that role has turned over a couple times, as well as their RCM leadership. And so anytime you have turnover in systems, typically the first thing that happens is likely inaction on some of these things, as they get in, and they're trying to figure out, you know, the structure of their priorities and what they're trying to do within the business. That said, we all have an open dialogue. Sutter is a very large customer of ours, a very important customer of ours, and we're performing well on phase I. I was gonna say, do you think phase I is going well from an- Yes Operational standpoint? I think phase I is going well from an operational perspective. Look, there's always room for improvement. I'm not gonna say that everything's perfect, but it is going well, and metrics are certainly improving from kind of those baseline periods of when we took over. So we're starting to see some good momentum, both in what we expected from a model perspective on the majority- Yep The margin, and both the operational metrics. Maybe the same question on Providence, obviously, more recent. You talked about Acclara a little bit, but can you talk about, you know, the integration of that large customer, the timeline, sort of where you are in the process? Sure. So Providence is the new business that we won in Q1, closed in January, that I mentioned earlier, and it was both a 10-year contract for the Providence acute business that we signed, which we expect to be about $300 million of revenue over the next several years, so a lot of embedded growth in the business at roughly a mature stage, about 30% margins, so in line with our overall margin targets. It also included an acquisition of some assets that Providence has either built or bought over the last several years, a company called Acclara, that was owned by Providence, and they mainly provide modular-type solutions, very complementary to our Cloudmed solutions and other modular solutions that we have. So that acquisition also closed in January, and that it's between $275 million, and is about what we expect in revenue this year, is the guidance that we gave, the latest guidance. And that business, obviously, the revenue post-transaction started right out of the gate. We think there's a lot of synergy opportunities there, and integration is going very well. A lot of those system cutovers will happen the second half of this year, and so we're in the middle of those integration plans. But we feel very good about the synergy opportunity, which we had guided about $50 million of cost synergies that will be realized over the next several years related to the Acclara acquisition, as we begin to integrate that in with our existing modular business. Okay. I got two minutes left and two more questions, so hopefully we, we can squeeze them in. You know, the, the fiscal 2024 guidance assumes a ramp over the remainder of the year, and so, you know, just sort of given, you know, all the moving pieces we just talked about, like, what sort of gives you the confidence in that ramp that's sort of implied in the, in the full year guidance? So we typically have a ramp in our EBITDA first half versus second half, just based on our base fees and the cash collections. That's before you think of any impacts of the Change outage and what that looks like, which we expect will create volatility or for some fluctuations between Q3 and Q4. But generally speaking, we always have a ramp of EBITDA just based on the seasonality and posting days that drives cash collections and ultimately our base fees. Other items that impact the ramp is the rollout of Providence. So we expect to begin deploying that new business in the second half of the year. Employee transitions will begin to take place in Q3, and so we'll see that revenue start to ramp in the second half. Our modular business is growing double digits, so quarter-over-quarter this year, we'll continue to see growth as new bookings are implemented and begin to drive new incremental revenue. We have synergies that we're still realizing from the Cloudmed acquisition and will begin to realize from Acclara that will drive incremental EBITDA. And last but certainly not least, is technology, and automation and impacts from that that we expect to see in the second half of the year. All right. Maybe for the last question, this may be a little bit unfair, so feel free to push back. You know, I'm just kind of curious to get your thoughts on the stock, and I'm kind of curious as to what you think is the key to a higher share price. Do you think it's more revenue growth? Do you think it's more consistent execution, better EBITDA? B etter cash flow? Like, what, in your mind, what are some of the most important metrics that you're like, "we really gotta do better at this, because that's the key to unlocking a higher share price? I think it's all of the above. And I think it's stability. We've had a lot of headwinds and noise, despite, when you look at it, very strong execution of the business over the last, call it 18 months. So we've continued to win new business. We've got to actually see that through to maturity, get it in, and make sure that we're realizing the revenue. We've got to see the maturity on the EBITDA from some of the recent wins, and we are seeing that, but I think it's just proof points to continue quarter-over-quarter executing against that. And then one that you didn't mention, but is something that we're very focused on, is free cash flow and cash generation. If you look over the historical period, the EBITDA has not converted to cash at the rate we would expect. We know that, and we realize that, and we are very, very focused on making sure that the EBITDA flow through actually results in cash generation going forward. Okay. We're essentially out of time, but I want to give you the last 20 seconds, if there's anything else you think we didn't touch on, any last-minute message you want to leave with our investors here? Sure. Look, we're very bullish on the business. We believe there's an incredible amount of opportunity. Providers need our services more than ever, and I think the events over the last four or five months in the market with some of the cyber-related incidents that have caused outages have only made providers realize that they need a strategic partner that can help them through some of those. And I think we've been that to our customers over the last several months, and I think that will provide a lot of opportunities for us in the future. Okay. That's great, Jennifer. Thank you very much. Evan, thank you. Thank you all for joining us. Any questions, please feel free to follow up with us or Evan directly, and we're happy to try to help. Thank you, everyone. Thanks, Jennifer.