Q4 2020 Tabula Rasa HealthCare Inc Earnings Call
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Good morning, ladies and gentlemen, and welcome to the fourth quarter and for year 'twenty 'twenty Tabula Rasa Healthcare, Inc. Earnings Conference call. At this time all participants are in a listen only mode. Later, we will conduct a question and answer session and instructions will follow at that time, if anyone should require sister.
During the conference. Please press Star then zero under touched on the telephone as a reminder.
This conference call May be recorded I will now turn the conference over to your host Mr. Kevin Dill.
Thank you and good morning, I'm, Kevin Dill corporate counsel for Tabula Rasa healthcare.
The company intends to avail itself of the Safe Harbor provisions of the private Securities Litigation Reform Act of 1995.
Certain statements made during this call will be forward looking statements within the meaning of that book.
These forward looking statements are subject to risks uncertainties and other factors that could cause tabula rasa healthcare's actual results to differ materially from those expressed or implied by the forward looking statements.
These risks and uncertainties include the developing nature of the market for technology enabled healthcare products and services and potential changes to laws and regulations that may impact our clients.
For additional information on the risks facing tabula Rasa healthcare, please refer to our filings with the SEC, including the risk factors section of our 10-K.
A recording of this call is accessible through a link on the Investor Relations page of our website and it will be available for 90 days.
I'll turn the call over to Dr. Calvin Knowlton, CEO, chairman and founder of Tabula Rasa healthcare.
Good morning, and thank you for joining us.
For our fourth quarter 2020 earnings call. In addition to Dr deal with me today are Dr. <unk> Knowlton co founder Chief marketing, New business Development Officer, Mr. Brian Adams, Chief Financial Officer, Dr. Kevin Boesen, Chief sales officer, where solar and Kevin will both be available to respond to questions. After we conclude our pre.
Third remarks.
As a reminder, this conference call and webcast is accompanied by a Powerpoint presentation available at the IR section of our website and I would encourage you to you to use it to follow along.
We are.
Pleased with our finish to 2020, delivering fourth quarter revenue of $77 $1 million, which was above the high end of our guidance provided in November 2020 of $74 million to $76 million and driven by solid execution across both our major operating segments I'd.
I'd like to focus my comments on four areas as reflected on slide three.
Pace.
Pharmacist provider prescribe wellness.
Third 2021 and future growth initiatives.
And for research and development pillar achievements.
First while the pandemic has slowed the strong net growth that pace programs have historically experienced unfortunately due to COVID-19 deaths.
This is temporary due to imminent vaccination programs and has further highlighted the benefits of enrolling in pace. According.
According to CMS and the National Pace Association as of January 17, 2021, nursing homes out of 52, 1% infection rate and a 10, 3% death rate as compared with an infection rate.
16, 4% in the death rate of three 1% for pace organizations for.
Further.
Patients by.
While our 66% less likely pace participants less likely to contract COVID-19 or die during COVID-19.
With the resurgence of the virus in late 2020 and increased death rate among pace participants the strong recovered recovery. We initially saw on October weakened into the early part of 2021.
That said, we are encouraged by the recent trends as seen on slide for <unk>.
According to the National Pace Association, there has been a dramatic improvement in their first two weeks of February in terms of less new viral cases and less deaths.
Again, we believe this trend will hold as our pace members receive vaccination in the coming weeks and months as enrollment continues along with the opening of new pace centers in.
In fact, we are starting to see good progress with vaccinations in pace organizations throughout the United States as an example, in California, where a new COVID-19 vaccination site.
Designed specifically for the communities most vulnerable seniors opened on February 11th at West pace in San Diego County, with a goal of Vaccinating 500 or more seniors per day.
The second topic is pharmacies.
The pandemic has emphasized the critical role pharmacists play and the even larger influence pharmacists will have in primary care as part of a long term movement towards value based care.
In the short term are prescribed wellness network of pharmacies is contributing to the nationwide effort to vaccinate Americans and as of February 11, prescribe wellness has administered more than one 5 million COVID-19, vaccinations across nearly 2000 pharmacies for.
Pharmacies are leveraging prescribe wellness contactless registration forms and integrations that we have with state vaccine databases.
In early February to accelerate vaccination efforts, the Biden administration announced the launch of the federal retail Pharmacy program, a private partnership with 21 National Pharmacy partners and networks of independent community pharmacies, representing 40000 pharmacy locations nationwide.
Among those participating pharmacies are a number of prescribe wellness clients, such as HEB, CPE and network and health Mart.
The third area I'd like to discuss shortly is.
Some of our key investment in growth initiatives in 2021 and beyond.
As highlighted in our press release, we had a strong sales year.
Led by our health plan payer Division.
Given the wealth of opportunities on our existing and new markets, we plan to aggressively invest in sales and marketing.
First by growing our sales force head count by more than 50% in 2021, and second by expanding our marketing initiatives involving enhanced digital marketing efforts and adverse drug event thought leadership campaign, and med wise campaigns targeting health plans and pharmacist exam.
Examples of five new or emerging markets, we plan to further penetrate in 'twenty and the years ahead. Our first large self funded employer groups second pharma using our unique multi drug simulation platform.
Third at risk provider groups for.
Fourth the broader Medicare market, including MA plans fifth state government Medicaid programs in fact as part of his annual budget address yesterday on Tuesday February 23rd New Jersey Governor Murphy announced his administration is supporting current legislation that will apply a risk.
Reduction model to prescription drug services under the Medicaid program. This is the legislation that recently passed unanimously and the New Jersey Senate and now waits for the New Jersey Assembly.
We have similarly exciting new opportunities that have recently closed or are in our sales pipeline and more on these initiatives in the coming months.
Dr. Linda Tatlock, one of our recent senior executives, who joined our team is playing an integral role in enterprise cross selling.
Within our pace membership base, we have an enormous opportunity to cross sell our five core solutions led by our bundled medications science offering and comprehensive pharmacy fulfillment.
These offerings for example at the end of 2021 were adopted by just 35% of our base of nearly 45000 pace participants providing us with significant opportunity for continued market share expansion.
Fourth I wanted to share some of the major accomplishments from our research and development team.
We had a record year in 2020 with 47 publications in peer reviewed journals, which is more than the prior two years combined.
Along with 353 citations in these papers looking.
Looking to 2021, we have some exciting new research peer reviewed publications underway, including in six different categories first the association of our med wise the risk score predicting premature mortality.
Second a number of MTM focused articles showing the significant savings we scored on the cohort of patients with whom we intervened.
Third proven outcomes of one of our large self insured employer groups.
Fourth pharmacist driven interventions for patient outcomes focused on payers.
Fifth pharmacogenomics effective applications in opioid prescribing and.
Six a robust multidrug simultaneous medication regimen stimulation for pharma as I mentioned previously.
With that I now will turn it over to Brian.
Thanks, Kyle I'm going to focus my comments on our 2021 outlook, but first wanted to provide some additional color on the fourth quarter. Our solid performance was driven by our organic and inorganic growth within our care venture healthcare segment.
For Sonic contributed $3 $6 million of revenue during the fourth quarter, which was nearly equally divided and paste product and paste solutions revenue.
Turning to <unk> healthcare I'm pleased to report this segment performed as expected showing modest sequential growth versus the third quarter as we successfully addressed the challenges that negatively impacted our third quarter results.
For the full year 2021, we're introducing formal guidance as follows.
Total revenue in the range of $336 million to $356 million, the midpoint of which represents 16% growth.
Our growth rate in the first quarter and first half of 2021 is depressed due to pace census, and client attrition discussed in more detail on a moment we.
We expect our growth rate to improve significantly in the second half of 2021 and return to the historical levels, we've experienced pre COVID-19 as these trends begin to subside.
Non-GAAP adjusted EBITDA in the range of 26% to $32 million, the midpoint of which represents 33% growth or two times the rate of growth for revenue and a margin of eight 4% or 110 basis point improvement over 2020.
Our profitability in the first quarter marks the low watermark for 2021 and is impacted by the modest revenue growth and higher cost structure coming into the year to support our growth plans.
Our press release on slide six provide the building blocks behind our revenue guidance relative to when we spoke in November there are two notable changes.
First as Cal touched on is the resurgence of COVID-19 in late 2020 and early 2021.
While our overall enrollment rates remain extremely strong across all of our pace clients. We did see higher death rates in January and February resulting in negative net enrolment for both months recent data from the National Pace Association has shown a progressive decline in death rates over the past for weeks something that we have also seen in our client data.
We're encouraged by these recent trends and expected return to a more normal growth rate by the second half of 2021 as vaccines become more widespread.
Second as noted in our earnings release, we did have some client attrition representing about 5% of revenue primarily related to one customer.
This will have a more pronounced impact on the first half of the year, we expect to more than offset these losses with the significant expansions. We are seeing at several key accounts secured in 2020 as well as incremental sales contracts secured by our growing sales team.
And with that I'll turn it back over to Dr. <unk> Knowlton for closing comments Calvin.
Thank you Brian.
Despite some early headwinds, notably with our pace.
Debt population, we are looking forward to a much better year in 2021, we're making the necessary investments to advance our medications science and suite of technology solutions as well as to expand our sales and marketing team to support even stronger growth in the years ahead on.
Operator, please open the floor for question and answer.
At this time, if you would like to ask a question. Please press Star then the number one on your telephone keypad.
And your first question comes from Ryan Daniels with William Blair.
Yeah, guys. Thanks for taking the questions and the color. If we think about the sales and marketing investments clearly med wise payer bookings are doing well on that pipeline looks robust. However, you still have this huge cross selling upsell to the core pace clients. So.
Can you talk a little bit about how you're going to allocate that debt pretty market uptick in sales and marketing spend going forward to your various products.
Sure. Thanks, Brian This is Kevin I. Appreciate the question, we have I think youre right in terms of the comments that we've made have focused on some other growth areas outside of the pace market, but we are also making tremendous amounts of growth in the sales team within the pace organization as well so we have about a $400.
Rent growth over the last year and the number of folks that we have selling in that in the PE space and then further supported by.
The work Thats the lenders doing.
Cross selling and leveraging some of the new assets that we brought into our total product offering.
Okay. Thank you for that and then maybe one for Brian just as we think about new business conversion I think the press release indicated that should drive about 700 basis points of your growth expectation, how does that compare to <unk>.
On normal years, say 19, or 20, and what level of visibility do you have based on the pipeline on conversion rates to actually hitting that.
That kind of delta that seems like the biggest potential driver to either end of the range. Thank you guys. Thanks, Ryan that's a good question, we based our forecast on 2021, which or excuse me on 2020, which is relatively conservative looking at the conversion rates by our existing <unk>.
Sales infrastructure.
And then rolled that forward with the incremental head count that we've on boarded at the end of 2020 early 2021.
Additional folks that we're planning to bring on in the first half of the year anybody later in the year, obviously wouldn't.
Have the ability to really contribute to 2021 revenue so.
We used 2020 conversion rates as our baseline, which we think is likely conservative.
Yeah.
Your next question comes from Glen Santangelo with Guggenheim Securities.
Yes. Thanks for taking my question, Hey, Brian I also wanted to follow up on on the guidance a little bit in the release, you talked about bookings being up 58% in the quarter and your sales pipeline now being up sort of 92% versus maybe where it was.
This time last year could you help us sort of reconcile those comments and put that into perspective relative to the <unk> 2021 guidance on the top line and as part of that.
I think you just suggested in your prepared remarks that you expect it to be growth kind of more normalized in the second half of the year and I guess I just wanted to try to give the.
Updated sense from you like what is normalized growth at this point, how should we think about maybe the longer term.
Growth algorithm relative to what you've discussed in the past. Thanks, Yeah, good questions, Glenn and I'll, probably end up tag teaming with Kevin but.
But as you think about.
And I was starting to describe this with Ryan's question.
The effort required by the sales team to deliver on those numbers, we've got the pipeline today.
And Thats really what we were trying to communicate with some of those statistics.
Is that the pipeline is there it's really about continuing to onboard new sales professionals to pull those opportunities through the pipeline. So we.
We feel really good about the conversion rates exiting 2020.
And now it's just about horsepower so.
The new individuals', we plan to bring on over the coming months, we think are going to be really impactful.
And as you.
Look towards the latter half of this year and the growth rates are typical growth rate in pace is about a little over 1% sequentially for each month. So we've seen about 15% organic growth on an annual basis in a non COVID-19 year.
I would expect it to get to that level.
Starting in probably Q3.
And.
The year over year growth rates in Q3, and Q4 debt, we're forecasting are about 25%.
Which we think based on the sales infrastructure and the investment that we're making.
Is a good forward looking expectation related to growth Kevin anything you would add to that.
I would say a couple of our core services, particularly on the health plan side, there is a much better opportunity in 2021.
As there was in 2020 comparatively so some of the services, where we were providing.
Medication adherence support aligned with our med wise time of day dosing.
Slowed as the pandemic hit at the early part of the year on patients were allowed extra sales.
Extra quantity and so as that returns to normal in 2021.
It's also an opportunity for us to accelerate implementation of some of the deals that we're closing as well. So we feel like we'll be back debt, what we would expect that pre pandemic this year.
Okay. Thanks for the comments.
Your next question comes from Sean Dodge with RBC capital markets.
Thanks, Ed Good morning, maybe maybe staying on the sales pipeline for a moment can you give us a broad sense of the composition of that its up 92% now year on year.
Is the bulk of the pipeline now med wise and these are relatively larger contracts youre going after or are these a bunch of smaller opportunities are the expansions of new clients and earn anything on how they could or youre expecting them to kind of flow in.
Were converted into revenue over the course of the year. This January centric stuff or is this stuff that can kind of launch intra year.
It's a great.
Great question, it's actually a mix of all of those so I think from a focus standpoint.
Clearly, what we've tried to transition to a broader deeper relationship with our Metlife science, so and some of the clients that we've picked up in the last couple of years, it's much broader than a traditional MTM relationship where.
Working on Medicare part C measures, which are that medical measures that appropriate medication management really helps drive.
So much broader deeper relationships with larger clients for larger deal sizes on the health plan side, but also a tremendous amount of growth on the PE side as well, so being able to leverage some of the assets that we have on the pay side, particularly with our farmers star acquisition and looking at clients that use pharma stars at DBM, but are not.
Necessarily using our pharmacy services just yet.
That's a big opportunity for us and those are large deal sizes as well and then we do focus on plans that we can implement throughout the year traditional MTM is a calendar year start, but we've had some great wins in the Medicaid space.
That allows us to implement programs mid year and then.
Other services I mentioned adherence services that we can implement throughout the year as well.
Okay. Thanks.
And then on.
On the pace guidance you said the guide assumes a weak first half for the year followed by an improving second half can you give us just a little bit more detail on on what that means are you assuming continued declines incentives for the next couple of months or given what we've seen now in February or are you, assuming some kind of stabilization and then the back half is improving.
Just some growth or are you expecting a pretty quick return to kind of the historical 1% per months kind of sequential cadence.
This is GAAP, yes, we had January showed.
Negative net for us because of the tremendous amount of deaths.
But yet we still had over 300 350, new admissions and the same in February.
February was about 10%.
90% less desk from kind of January it was almost a breakeven months. So we expect that.
March and the rest of the months now we are going to get back from them.
Yes.
Sean as it relates to the second half for the year.
I was just describing we're basically maybe.
Kind of flat for Q1, given what happened in January and expecting a little bit of improvement in March.
And then seeing a slight uptick in the second quarter going back to that normal growth rate.
Really starting in the July timeframe of about 1% per month.
Okay, Alright, that's great. Thanks again.
Your next question comes from Sean Weiland with Sky Your Sandler.
Piper Sandler pretty close. Thank you. So you mentioned that youre going after some new markets next year large self funded employer groups at risk providers Medicare advantage state Medicaid programs I might've missed one.
I.
Can you just maybe talk a little bit about your go to market strategy in these areas, where the area of focus is and within your guidance that you outlaid.
What some of your underlying assumptions are with respect to these new markets.
This is Kevin Thanks for that question I'll address some of the go to market in the areas that we mentioned so.
One other areas is still core for us on the risk side and those are the Medicare advantage programs one of the things that.
Leveraging our pace assets. So we've typically thought about tabula rasa ass.
Our health plan side, and our pace side, but theres a lot of new assets and things that we have on the pay side that are applicable on attractive to our health plan market. So we have traditional Medicare services that we've offered relative to things like traditional MTM on <unk> programs.
Our opioid solutions, but we've recently contracted with startup that MA plans that are looking at also leveraging our <unk> and Tpa services. So part of our Medicare strategy has been to also look at some of those smaller startup plans with a more broader set of services.
We can provide to them as an example in the employer space. It's very similar in terms of what we're looking at relative to what the health plans like.
Self insured employers that have risk on the medical side that really haven't paid attention to.
How they can leverage a pharmacy benefit to manage that is really a key portion of that we've contracted with to supplement the sales team.
On companies that live in that employer space that benefit broker space to help us bring some of those solutions together that similarly can include our <unk> services Med why science services.
On.
And even some of the other assets that we have on.
R Pharma strategy is really built around using our science to health.
From a company's predict the safety of medications in general populations using our <unk> risk score and then in the health system space very similar to where we're looking at.
Yeah.
The Medicare space as those.
Health systems have to take risk relative to the same things that that Medicare advantage companies are looking for really supporting them in a population health strategy and helping manage that.
Through appropriate medication use.
And then I know, we spent a little bit of time talking about our our state strategy looking at the Medicaid programs and really modeling.
The work that we're doing in new Jersey.
Okay.
How much of the guidance is leaning on these new market opportunities. So so sean today.
The majority of our guidance is focused on the commercial Medicare Medicaid space, which is where we've been spending the most time.
And there is there's very little baked into our guidance related to the pharma and at risk providers at this point. So those are just emerging opportunities.
You know I would say, it's pretty much immaterial for 2021.
Okay, Great and then.
The VAT vaccine rollout in the.
The participation among some of your independent pharmacies is there any revenue associated with that or any tangential revenue opportunities associated with that.
Not necessarily I think there are opportunities just for really identifying pharmacists as primary care providers and expanding their practice in addition.
We're providing.
Our med wise.
Tom on Midwest technology, right in the patient engagement center. So there are greater opportunities for client engagement in that regard generally the vaccines or generate revenue for the pharmacist themselves.
Yes.
The initial vaccine and then the follow up vaccine administration that vaccines themselves are covered by the healthcare system.
I think Theres also okay, Sean Theres also.
In order to.
Access our state vaccine databases registries that we have for every state they have to have to.
Be a client of prescribe wellness and get a certain module by a certain module from us. So its there is revenue on that yes, absolutely.
Okay. Thanks, so much.
Your next question is from David Grossman with Stifel.
Thank you.
Just follow up a little bit on on some of that.
The kind of changes or additions youre, making to the sales and marketing organization.
I'm just curious what type of person do target to add given how unique your model is in and maybe just.
A follow up to that.
What has really been the biggest gating item.
For the new sales efforts that you've faced thus far and the non pays for markets.
And what can you do to kind of address some of those obstacles.
David Thanks for the question and the opportunity to do a little recruitment so for.
For that sales team, we are looking for people that have a really good understanding of the healthcare system.
For the markets that we're involved in and I think to your 0.1 of that one of the opportunities that we have is to really look at all the things that tabula rasa has to offer and being able to work with our health plans or at risk providers community.
Community pharmacies to really understand how the pieces can fit together from a solution standpoint. So it is complicated in terms of making sure that you do understand healthcare so thats.
An important part of that we brought on some great people in 2020, and we're really excited about their success from Q3 to Q4. It was really one of the first times that typically we would have seasonal decline in Q4, and our <unk> business and we didn't see that this year. So it's showing signs of.
Really turning around that that health plan business and coming back out of the pandemic. The challenges that we faced probably mostly on last year were just relative to access it was very difficult.
To see clients that trade shows were canceled.
And so if you didn't have relationships with people it was difficult to get on the door and get started so that's certainly something that we look for is while the opportunity to have some relationships with clients, but we're starting to see that debt.
The market really adapt on sort of come out of the pandemic. The much more forward looking meetings with health plans are easier to get the virtual tradeshows are starting to turn back to regular trade shows and so I think that access all help as well so.
Hopefully that answers the question.
Kevin do you just wanted to touch on for a second.
How we started the year in 2020 versus how we ended the year with the types of sales professionals, we had on debt.
Sure.
Great comment too so heading into 2020, we had primarily regional based director level salespeople.
With the intent of really driving that lead generation through.
Number of we had planned to attend probably 100, plus different health plan and pharmacy related trade shows and so we've transitioned away from from that as those.
Shows were canceled and we brought in some executive level Vice president level.
Sales folks that have broad levels of experience in the PGM space.
And the health plan space.
So really understanding benefit design and where these opportunities are so we transitioned in 2022.
Level sales per cent and we're starting to see the benefits of that.
Great.
From a marketing perspective on this on brand awareness and medication safety issue of awareness, we had launched a medication safety campaign in 2020 and had reached millions of people through broadcast media.
And we're seeing the benefits of that but still the idea of medication safety and the problem with it.
We're providing thought leadership.
Education.
Alright, great well. Thank you. Thank you for that and just one more question. If I may just on the guidance. The 'twenty one guidance on a range of $20 million, which.
It looks to be equal to the 7% of revenue growth that's contributed from in your bookings.
Should we take from that that you feel you have strong visibility on the low end of the range today or and if not what.
What are the components for the guide that remain that have the lowest visibility as debt.
Reacceleration of pace.
At the end of the year or do you feel that with the new openings that you mentioned in the press release.
Good read on that today.
Yes, David we feel very good about the low end of the range.
Especially what we've seen happen throughout 2020 with pace census, I mean, there was a.
A little bit of a stall as the pandemic emerged.
In the spring timeframe and then we saw progressive growth.
Despite not having vaccines at the time. So there was a kind of a resurgence of that growth. So now that the the.
The dynamics are pretty different.
<unk>.
The.
Flying in the number of deaths over the past for weeks.
Dean has been really aggressive we feel really confident in getting back to a normal growth rate, but that is the kind of the biggest.
Piece of our guidance debt.
We remain watching very closely but we feel we feel really good about the bottom end based on all the factors that we've described and where we sit today.
And.
Just if you could remind me was.
Opening a pace centers delayed.
Delayed significantly in 2020 as a result of the pandemic and I'm just trying to get a read on just.
How visible you know kind of the new openings are I know, they're not that material to this year, but they certainly will impact 2022.
Well there were some delays, but they were not significant the programs that we're expecting to open data open.
And of course.
2021, we have quite the pipeline of existing and new client expansion sites that are scheduled to start.
I see.
Alright, very good thank you very much.
<unk>.
And again for any questions. Please press Star then the number one on your telephone keypad and your next question is from Stephanie Davis with <unk> Leerink.
Hey, guys. Thank you for taking my question.
I'm sure you are.
Never going to want to talk about this topic again for this.
But could you tell us a little bit more about large contract attrition.
Are there any read throughs relative to prioritization of the MTM program or is this a company specific are competitive takeaways or negotiation.
Yes, Stephanie that's a good it's a good question. It's good to talk to you. This is Kevin I'll address that.
Regarding that client we did decide we did not renew that MTM contract with them.
We did not net sever all relationships with them. So there are programs that will be supporting we.
We see from time to time that plans look to outsource in source and.
That's part of.
Some of the challenges that we face.
With with that client in particular.
We had lost some other business due to a merger and the healthcare space and a number of the clients and patients went to a new client of ours. So we actually over the last couple of years. It picked up a lot of that business through a growing relationship that we have on the wellcare side of things too so.
I wouldn't.
I wouldn't personally read too much into that.
I think we've made the adjustments and more confident in terms of where we are today.
Alright.
Helpful. Maybe we never talk about that.
Sure.
Uh huh.
Ryan I would love to hear a little bit more about just kind of the cadence of that ramp up from.
Low single digit growth in one Q2 double digit exiting year end could you can you help for second time sure. So as you are looking at the first part of the year clearly the pace census.
Having an impact.
As well as the.
The contract.
That we were just discussing those two things are primarily what are depressing the numbers in the first quarter as we come in.
Kevin and his team have done a phenomenal job building the pipeline and we have seen an acceleration of conversion rates with that team.
As he mentioned.
We've migrated to a bit of a different structure and I think that that's been extremely helpful.
In terms of win rates and so we do continue to see those accelerate.
And as we begin to bring on new <unk>.
New sales folks.
We do we do expect that debt when rates are going to increase throughout the year. So you're right first quarter second quarter, we are looking at.
Single digit growth rates, but getting to about 25% in both Q3 in Q for the biggest piece of that is as we expect pace growth rates to really accelerate throughout the second quarter into the third.
That's going to have a very material impact.
And coupled with an increase in contribution from the sales team. So I think we're seeing really positive signs on all fronts.
By having a negative net enrollment in January and February the fact that we're sitting here.
With with the vaccine rollout across pace.
On a very aggressive rate right now I think debt.
It's very reasonable to assume that we get back to that 25% growth rate.
In the second half for the year, which is very much in line with what we saw pre COVID-19 for the entire business. So.
Yes, more of a step function kind of DNA, a gradual ramp and then exiting then is that 25% growth more normalized yes, that's what we believe.
25% on a on a more normalized basis.
So the <unk>.
Past years the.
At least over the past couple of it's been a little bit more lumpy throughout the year and our target is to have more per.
Predictable sequential growth.
And kept the types of organizations that Kevin and his team are targeting right now because he was describing earlier Ken launch at any point throughout the year. So we're not held to that Medicare calendar year timeframe.
We do have the ability to launch those programs and there's been a couple of wins recently debt.
That will help us to meet those goals going into Q3.
Perfect. That's super helpful. Thank you guys sure. Thanks Deb.
At this time there are no further questions. This does conclude today's conference call. Thank you for your participation you may now disconnect.