Q1 2022 Multiplan Corp Earnings Call
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Hello, everyone and welcome to the multi plan Corporation first quarter 2020 earnings Conference call. My name is Charlie and I will be coordinating the call today, we will have the opportunity to ask your questions at the end of the presentation, if you'd like to register your question. Please press star followed by one on your telephone keypad.
I will now hand over the call to shorten the gassy AVP of Investor Relations at Multibank Corporation to begin Sean. Please go ahead.
Thank you Kelly good morning, and welcome Tim Multibank first quarter 2022 earnings call. Joining me today is Darryl White, Chief Executive Officer, and Jim <unk>, Chief Financial Officer.
All is being webcast and can be accessed through the investor information section of our website at www dot multiplayer dot com.
During our call we will refer to the supplemental slide deck that is available on the Investor relations portion of our website along with the first quarter 2022 earnings press release issued earlier this morning before.
Before we begin I'd like to remind you that our remarks and responses to questions may include forward looking statements within the meaning of the private Securities Litigation Reform Act of 995 actual results may differ materially from those stated or implied by forward looking statements due to risks and uncertainties associated with our business, which are discussed in the risk factors included in our annual.
Report on Form 10-K for the fiscal year ended December 31, 2021, and other documents filed or to be filed with the SEC.
Any such forward looking statements represent managements expectations beliefs and forecast based on assumptions and information available as of the date of this call. While we may elect to update such forward looking statements at some point in the future. Please note that we assume no obligation to do so.
Certain financial measures, we will discuss on this call are non-GAAP financial measures. We will we believe that providing these measures help investors gain a better and more complete understanding of our financial results and is consistent with how management views our financial results.
A reconciliation of these non-GAAP financial measures to the most comparable GAAP measure to the extent available without unreasonable effort is available in the earnings press release and in the slides included in the Investor Relations portion of our company's website.
I would now like to turn the call over to our Chief Executive Officer Dale life sale.
Yes.
Thank you Joanna and good morning, everyone and welcome to the multi planned first quarter 2022 earnings call.
John said joining me today is multi plant CFO Jim Harris.
As I look back on my first 100 days as CEO of multi plan I stand encouraged by the trajectory of our company and I'm confident that we are tracking to our full year expectations.
We have now produced seven consecutive quarters of growth and a sustained record of strong performance. The operating environment continues to normalize as the tragedy of Covid becomes less disruptive to our everyday life.
Now have many NSA implementations in progress and are increasingly assure that we will have a handle on how to help our customers and what it means for multi plan.
We remain focused on investing in new markets and new initiatives to drive growth encouraged by our growing set of M&A opportunities and confident in our financial flexibility to pursue these opportunities while continuing to de risk the balance sheet.
Our first quarter results, yet again demonstrated a considerable earnings power of our business and our ongoing fundamental momentum.
First quarter revenues were $298 million up nearly 17% from the prior year quarter and basically in line with fourth quarter 2021.
Our robust year over year growth reflected both the dissipation of the Q1 2021, COVID-19 impact and strong organic growth.
Adjusted EBITDA was $225 4 million up nearly 18% from the prior year quarter and up just under 1% from the fourth quarter 2021.
Both revenues and adjusted EBITDA exceeded the first quarter expert expectations, we communicated in February .
In the first quarter, we generated $194 9 million in cash flow from operations and free cash flow of $175 million.
Our performance is the direct result of the value we provide to our payer customers the employers and other health plan sponsors and the members. They serve in the first quarter, we generated $5 6 billion in potential identified savings a growth rate of over 9% from the prior year.
On billed charges of 31 7 billion as shown on page seven <unk> on page eight of our supplemental deck.
Demand for our services have never been stronger last quarter, we discussed how our multi plan solutions delivered value to over 100000 employers and other health plan sponsors in 2021, we have positioned our broad set of medical management and payment accuracy solutions to accommodate a.
Wide range of health benefit plan designed to help our health care payer customers served its vast footprint of employers.
This service breadth meets not only the considerable range of preferences across these employers. Both also the cyclicality of their preferences as the overall labor environment causes employer priorities to shift between cost efficiency and benefit attractiveness.
Multi plant solution breadth is particularly relevant today because by all accounts employers are in the midst of a war for talent.
Employers are more challenged than they had been in years to retain and attract employees and benefits matter to employees.
Research by health equity suggests more than half of employees named healthcare benefits as the greatest driver of job satisfaction. Another 78% report that these benefit impact their productivity.
At the same time employers consistently right the cost of providing these benefits among their top concerns a 2020 to Willis towers Watson survey indicated that 94% of responding employers slight managing health care benefit cost as their number one priority.
This should not be surprising since the cost of healthcare benefits is second only to wages and was estimated at well over $800 billion in 2021.
In a tight labor market employers must work on even finer line to balance benefit cost against benefit richness mulch.
Multi plan has been helping payers and employers navigate these tradeoffs between cost efficiency and benefit attractiveness for over 40 years.
Why we offer both network solutions and reference based pricing solutions and combinations of the two that help payers and plan sponsors customized approach to medical cost management that meet their particular needs. It's why we introduced value driven health plans that payer referenced based pricing with.
Member and provider engagement tools to minimize balance billing.
And it's why we involve a staff of physicians in both the algorithm development and the operations of our payment integrity services to achieve higher levels of provider acceptance.
We know from experience that no single approach fits all and that a swinging pendulum from cost effectiveness to benefit attractiveness makes adaptability imperative multi plans broad set of cost management and payment accuracy services provides flexibility in how they are accessed.
And then what combinations, allowing payors and health plan sponsors to tailor their cost management strategies to their specific goals and to adjust those strategy as the labor market conditions evolve.
Today with employers are laser focused on retaining and attracting talent and in the context of rising healthcare costs and accelerating health youth services utilization as Covid dissipates, our customers are taking full advantage of the flexibility we provide.
We are seeing it in our pipeline and in our new business wins.
Our larger customer initiatives currently underway or completed include an estimated $40 million in potential new annual revenues encompassing all of our service categories network based services analytic based services, including no surprises Act services and payment and revenue integrity <unk>.
Services spanning both pre and postpaid modalities.
About 66% that those estimated revenues are for services not previously in place with our customer.
The remaining 34% related to expansion of services with existing customers or the reconfiguration of these existing services.
Our broader pipeline is robust and increasing with velocity altogether across the enterprise. We are working on 650 active opportunities representing over $200 million in annual revenues.
In Q1, we added over 390 opportunities with current estimated annual annual revenue of $36 million.
The growth in our Q1 pipeline spanned across all service categories in all market segments.
During the quarter, we closed on 192 opportunities expected to generate over $27 million in annual revenues once fully ramped as with our pipeline our new wins were across all service categories.
All market segments.
We are particularly pleased with the momentum building in our health plan segment for multi solution sales, which again underscores the demand for the customization. Our solutions provide for example, with one regional health plan, we sold an expansion of reference based pricing the end to end surprise billing service.
And prepayment integrity services for both commercial and Medicare advantage lines of business.
With another plan, we sold both payment integrity and Medicare advantage network access.
To another we sold network access reference based pricing and value driven health plan services.
Yes.
With regard to NSA services customer implementations and our pipeline continue to progress nicely.
In our prior earnings call. We noted that we had good visibility into the NSA compliance approaches of our larger customers and we are engaged in active implementations with the majority of them.
Visibility continues to improve as we secure more of our customer base.
We now have 98 completed NSA implementations ranging from managing the end to end process to performing the backend negotiation and arbitration to adjusting existing cost management hierarchies.
Another 26 NSA implementation projects are in process most of them for the end to end service. Additionally, we have NC NSA related opportunities with 41 customers in the sales pipeline.
While still early NSA related claim volume is tracking to our expectations given.
Given the typical lag we experienced in our business about two thirds of the total claims received in Q1 were for dates of service before the law took effect for groups with renewal dates of January one 2022.
So we really didn't see material NSA related activity from our implemented customers until March.
Based on trends in April which was the first full month of substantial NSA activity, we expect to be closer to a full run rate of NSA related activity and volume by the end of Q2.
Yes.
The negotiating strategies that both payers and providers seem likely to continue to evolve, particularly given recent legal challenges to the NSA regulations that introduce uncertainty around the treatment of the qualified payment amount, where tpa and arbitration and.
In February a federal judge in Texas vacated the portions of the Msas interim final rule that had given primacy to the <unk> and the independent dispute resolution or <unk> process, except for air ambulance claims.
The judges decision, which was effective immediately and nationwide places the <unk> on equal footing with other factors that may be considered in the IVF process.
And April HHS announced that it would appeal that ruling and we expect the fifth circuit Court to review and rule on the case in the next few months.
In addition to the Texas ruling there are several other cases challenging the interim final rules or the interim rules prioritization on the <unk> in the <unk> process and one arguing that some of the broader provisions of the NSA or in fact unconstitutional.
Assuming the Texas ruling stands we believe payors and providers could have a greater desire to avoid post payment negotiation and arbitration the outcomes of which seemed more uncertain without the primacy of the PPA.
On the margin this could imply greater utilization of our prepayment negotiation network or other pricing services, which is in our legacy wheelhouse.
In any case, given our unique end to NSA solution, we are well positioned to provide services along the entire NSA continuum and a shift in emphasis between prepaid and postpaid activities in either direction would not change our view that we have a critical role to play.
Administering NSA services for our customers or our projection that NSA will be a net headwind of less than 2% of revenues in 2022.
In summary, our Q1 2022 results continued our string of strong performance.
We are seeing robust demand for our services and our business activity as well as the pipeline and new business wins.
We are on track to achieve our 2022 performance expectations, and our unparalleled breadth and flexibility of our solutions position us well to help payers and employers navigate through this economic environment.
I remain encouraged by multi plants trajectory and confident about the future.
Before I hand, the call off to Jim I would like to take a moment to thank our 2400 multi plant colleagues their devotion to our mission to deliver affordability of efficiency and fairness to the U S health care system through dedication to operational excellence and their commitment to outstanding.
<unk> service are the heart of this great company.
With that I'd like to turn the call over to Jim to discuss our results in more detail Jim.
Thanks, Dave Good morning, everyone today I'll be updating you on our first quarter financial results and our outlook for the remainder of the year.
As Dale noted earlier, our positive fundamental momentum continued with another strong quarter of earnings in Q1 2022.
Both revenues and adjusted EBITDA exceeded the guidance, we set for the quarter.
As shown on page four of the supplemental deck Q1 revenue was 298.0 million up 16, 9% over Q1, 'twenty, one and essentially flat with Q4 'twenty one.
Organic revenue growth remained robust in the first quarter as shown on page five of the supplemental deck. Excluding the revenue contributions from our acquisition of discovery and normalizing for the decline and the impact of the COVID-19 pandemic during the quarter revenues in Q1, 22 were up $21 million or nearly 8% over Q1.
'twenty, one and down $3 million or about 1% sequentially.
As shown on page six of the supplemental deck Q1, 'twenty to growth over the prior year quarter was driven by 24, 8% growth in analytics based services 17, 5% growth in payment and revenue integrity services.
While network services declined a modest one 1%.
Our performance above guidance this quarter reflects a few underlying components.
As we have discussed our revenues lagged the data service for the claims by an average of six to eight weeks.
Our Q1 revenues largely reflect claims activity from November December and January .
So the first few months of our quarter reflected calendar 2021, pre omicron claims activity, which was quite strong and above our expectations drill.
Driven, especially by analytics based services and within that financial negotiations.
As Omar Omicron began to impact January and some early February claims we saw slowdown in utilization offset in part by the benefit of revenues from Covid testing claims.
Lastly, the impact of NSA only affected a small portion of our quarter's activity and was less than expected negative impact.
So the quarter had some extra tailwind that we were happy to capture.
As page seven as detailed on page seven of the supplemental deck, we estimate the COVID-19 related revenue impact in Q1, 'twenty two was approximately $3 million to $5 million down from an estimated $5 million to $7 million in Q4 'twenty one.
Down 18% to $22 million from the prior year quarter and slightly lower than what we were anticipating for this first quarter of 2022.
First quarter Covid related revenue impact was less than expected due to positive variance from Covid testing claims in January and February and better than expected complimentary network performance.
Our March activity began to exhibit a slowdown of COVID-19 testing to a more baseline level as we exited the quarter.
Turning to expenses first quarter 2022, adjusted EBITDA expenses were $72 6 million up from $63 8 million in the prior year quarter and down slightly from $74 7 million in Q4 2021.
And consistent with our guidance for the quarter.
The increase of $8 8 million over Q1 dollars 21 was driven predominantly by higher personnel costs, reflecting an increase in head count.
And by a full run rate of expenses related to the BHP acquisition, which closed at the end of February 2021.
Adjusted EBITDA was $225 4 million in Q1 dollars 22 up 17, 9% from $191 1 million in the prior year quarter and up just 1% from $223 six in Q4.
The estimated COVID-19 related impact on adjusted EBITDA in the fourth quarter was approximately $2 million to $4 million slightly lower than we anticipated.
As shown on page five excluding the adjusted EBITDA contribution from the CHP acquisition and normalizing for the impact of the COVID-19 pandemic. Adjusted EBITDA for Q1 was 22 was up eight 7% over prior year quarter and up one 6% sequentially.
With first quarter revenues and adjusted EBITDA, both exceeding our expectations adjusted EBITDA margin came in at 75, 6% in Q1 20 to 60 basis points above the high end of the range implied by our guidance and also up 60 basis points from a margin of $75.
And both prior year quarter and sequential quarters.
Our costs are relatively fixed versus variable so our EBITDA and our EBITDA margin benefited from the high conversion of our revenue outperformance to the bottom line.
We continue to generate significant operating cash flow in the first quarter net cash provided by operating activities was $194 9 million.
As a reminder, our cash flow tends to be higher than our first and our third quarters, given the timing of our interest and tax payments.
We also benefited from the timing of receivables in this quarter our.
Our Q4 2021, ending receivables were a bit high at $99 9 million due to the timing of customer receipts that were properly received in the first week of January .
So by the end of our Q1 2022, our receivables balance normalized to a level of $78 2 million.
First quarter free cash flow as a result was $175 million.
Turning to our outlook at this time, we are maintaining our full year 2022 guidance provided in February and detailed on page 11 of the supplemental deck.
Given stronger than anticipated first quarter results and as I will discuss momentarily our smaller full year COVID-19 impact than initially anticipated we are tracking towards the higher ends of the guidance ranges of one.
Six to $1 two zero billion for revenue and 850 to 875 for adjusted EBITDA.
We are encouraged about how the year is progressing and how we are performing against our plan and we will reassess our guidance for the full year on the second quarter earnings call.
As we look to the second quarter and beyond we expect continued strong performance in our underlying operating results as health care utilization further normalizes and as we've maintained strong momentum with our customers.
We expect this momentum to help us grow through modest revenue headwinds, we outlined in our last earnings call with the combination of growth in core services and growth initiatives driving underlying annual growth of 6% to 9%, partially offset by a modest net headwind from the NSA as outlined by the guidance and revenue bridge provided in February .
As Dale mentioned earlier, we continue to project a net headwind of up 2% from the NSA for full year 2022, which includes the impact of known customer wins and a couple of known customer losses.
And at the upper end of the range some caution around the behavior of our smaller customers who are later to decide on how to implement the NSA.
Because we experienced any average six to eight week lag between data service and receipt of claims.
Clients were still in the earlier stages of operationalized Theyre NSA approaches the effect of the NSA on our Q1 results was immaterial, but will become more tangible in Q2.
We expect COVID-19 to be continue to be a modest drag on our results.
Given the aforementioned Laggan received claims some of the old omicron surge related claim dynamics, which are illustrated on page seven of our supplemental deck are still flowing through our claim mix.
As we look towards our Q2 'twenty two results, we expect the COVID-19 related impact on revenues to increase slightly and look more like the $5 million to $7 million range, we experienced in the fourth quarter of last year as the quarter will reflect healthcare utilization in February March and April.
Which we expect it to be modestly suppressed due to the omicron surge in the early part of the quarter.
And as we experienced a smaller offset from COVID-19 testing and other COVID-19 related claims.
Stepping back however, the broader context is that the marginal impact of Covid on our results is continuing to moderate.
And barring another surge in U S. Covid cases is likely to track at less than 2% of our revenues for the remainder of 2022.
Accordingly for full year 'twenty, two we have lowered our estimate of Dakota COVID-19 related revenue impacts of approximately 15% to $20 million from our prior estimate of 20 to 20 $25 million to $30 million and we have lowered our estimated COVID-19 related adjusted EBITDA impact of approximately $12 million to $16 million from our prior estimate of 20 to 26.
Yes.
We continue to expect.
Adjusted EBITDA margins of around 70, 373% for the full year 2022.
Which compares with our first quarter margin of $75, six and 2.2 hundred basis points below our full year 2021 margin of 75 zero percent.
As outlined by the guidance and expense bridge as provided in February we expect margin compression to be driven by a combination of structural cost pressures investments in our platform to customize and enhance our solutions for our customers and support our NSA related solutions and targeted investments in our products and capabilities to support our growth initiatives.
We would expect structural expense increases to begin flowing through more fully in the second quarter as our salary increases and head count additions begin to impact our base expenses from the start of Q2 <unk>.
Investments in our platform and growth will build over the remaining quarters of this year.
Reflecting these factors and as outlined by page 12 of our supplemental deck for the second quarter, we are guiding to $285 to $295 million in revenues and $205 million to $215 million and adjusted EBITDA.
After an unexpectedly strong first quarter trends in claims activity for February March and April are tracking more like what we originally expected for this period.
And along with the NSA headwind predict a quarter slightly below Q1 levels, but consistent with our overall outlook for 2022.
As we sit here in April we're feeling very good about the strength of the underlying trends of the business center customer momentum.
Finally, turning to the balance sheet and capital our total an operating leverage ratio net of cash were five three times and three eight times down from five 7% and $4 two respectively in the fourth quarter.
The improvement in our leverage ratios reflect the stronger trailing 12 months adjusted EBITDA and the strong cash flow generation in the quarter.
As noted earlier, we continued to generate strong cash flow and ended the first quarter with $350 million of cash on the balance sheet up from about $185 million in the fourth quarter.
Our rapid cash generation underscores the flexibility we have to balance our priority of investing to grow the business against our objective of making progress on our leverage ratios over time.
As it pertains to capital allocation our priorities remain the same.
Our highest priority continues to be investing in the business to drive organic growth and long term value.
This is followed by augmenting growth through strategically and financially attractive M&A and then by reducing our leverage as.
As many of our investors emphasize we have an abundant set of options to deploy our cash whether it's M&A or debt retirement.
We will continue to take an opportunistic but balanced and disciplined approach to deploying our cash and after that you measure on an annual not quarterly basis as we move forward.
That wraps up my comments I'd like to turn it back over to Bill.
Jim. Thank you very much operator would you kindly open it up for Q&A.
Yes.
Of course, if you're allowed to ask a question. Please press star followed by one on your telephone keypad, if you'd like to be truly a question. Please press star Philip I'd say I'm preparing so ask your question. Please ensure you I mean, you said locally.
Our first question comes from Joshua Raskin of Nephron Research Joshua Your line is now open.
Okay.
Hi, Good morning. This is actually Mark <unk> on for Josh Thanks for taking the question.
I had a couple of quick ones. So first just wondering if there was any way you could size the impact of no surprises act on revenues in the first quarter.
Like.
Like for example, do you know how much revenue you're generating through the new NSA related activities that you discussed.
Yes.
Okay.
Yes.
Thanks, Marc this is Jim.
The first quarter really did not have a material effect of surprise billing.
Services.
I would say in.
The last month of the quarter in March we started to see some of that activity driven and if you just the claims lag et cetera.
And we're now seeing in April we saw a much fuller run rates. So the first quarter really doesn't have.
Any material effect of the NSA claims revenue in it.
But as we as we switch over into the new quarter and our guidance for Q2 reflects it.
<unk>.
Claims volume starting to track and its tracking against our expectations.
Got it. Thank you and then one last one was there any material changes to the.
The composition of your top 10 customers in terms of revenue for the quarter.
Nothing material to report.
Great. Thank you.
Thank you Joshua our next question comes from Steve Valiquette of Barclays. Steve. Your line is now open.
Hi, everyone. This is Stephanie on for Steve.
I was just wondering if you could give any progress updates on those smaller customers that you cited that could still maybe come back to multi <unk> been I think surfaces.
Okay.
Sure This is dale.
We continue to implement.
Implement I think you asked a question around the NSA Act and we continue to.
See more more visibility into our into what we call our tail that smaller that smaller end of our customer base.
As we indicated to you in our last earning call we had great line of sight and great visibility as.
As we move forward with our larger customers and that we were engaged and active implementations with the majority of them.
Those now over as you could imagine we've completed 98 completed implementations.
Ranging from as I said ranging from <unk>.
Managing that full end to end process to performing some of the backend negotiation in an arbitration process. So so we've moved beyond our top customers and are continuing to move downstream. There is another 26 implementation.
Mentation in process.
Most of them again as we as we continue to move further into our customer base and we have another 40, another 41 or another.
NSA related opportunities with 41 customers and the sales pipeline.
So we continue to deepen our penetration with NSA as we move downstream end market.
Okay got it and then sort of in a similar vein. Thanks, Mike talked about a pretty strong like upcoming pipeline. Just wondering if that will have any sort of material shift in the customer mix moving forward.
I don't think so not not a significant.
Or material change, but but obviously, we're thrilled about the robustness and the velocity of our pipeline and the number of activities in our pipeline across all product lines in all market segments.
And of course, we continue to work across all of our market segments in all of our customers. It's always been a goal of ours to deepen our penetration into the health plan market segment and into the third party administrators segment using the strength of our product portfolio, the depth and breadth of our services and engage with.
Then and focus on the areas that are most important to them, including the government related programs like Medicare advantage.
Okay great.
Thanks.
Thank you as a reminder, if you'd like to ask a question. Please press star one on your telephone Keypads now that star followed by one on your telephone keypad now.
Our next question comes from Daniel gross of Citi. Your line is trying to open.
Hi, guys. Thanks for taking the question I wanted to go back to the guidance and particularly the <unk> guidance and the sequential step down implied by the midpoint of guidance. So if I look at revenue guidance around the $8 million step down sequentially from one tier and a little higher so higher decremental mark.
EBITDA of around $15 million.
I think I heard Jim mentioned that you expect higher COVID-19 headwinds and <unk> that gets you back into benefit from some of the testing and they know Macfarlane.
I'm curious if you can help bridge some of that that additional $6 million.
Much of a decline on revenue.
From from <unk>, and then same thing on EBITDA with the greater than 100% decremental margin where are those additional costs coming from sure sequentially.
Sure. Thanks, Daniel Good question.
I would say.
I'll take the top line and then we'll talk about the cost side.
On the top line, yes, the sequential step down is a function I would say a couple of things, but underlying this is the strength of our core business. So on the margin what we're talking about is maybe two 2% to 3%.
Delta between Q1, and Q2 and the components of that but not digitally precise but the components of that are first of all Q1 had a lot of Q4 data service claims that were really.
Quite strong we'll be dealing with Q1 data service claims this quarter. So there's a little bit of Covid effect, we had very little impact of NSA and the last quarter, we will see the NSA impact in this quarter and.
I think that really does and a little bit of excess COVID-19 testing.
That is just going to dissipate so what what we're reflecting here is really the March April run rate of the business, which I will remind everyone is tracking exactly to where we expected it to be this is not.
The first quarter was just add a little bit of extra tailwind to it the <unk>.
Second quarter is really back on track to what we expected to happen. So we feel very good about Q2.
And where the demand side.
And how we're navigating the NSA, which ALB, which al.
As a testament to how nimble are 2400 employees have been and how agile they have been in terms of responding to this so thats just on the revenue side feeling very good on the expense side, what youre seeing here is the decline in our expenses as we as we move into the second quarter into two pieces number one.
We are adding head count, but number two we're starting to see.
Had.
Merit increases that started flowing in March.
And we're seeing some of that come through so our.
Our cost base is now tracking as expected as we March through the year. So you will start seeing it in the first quarter. As we guided was was just didn't see some of those costs flow in and we're going to start seeing a step up over the course of the year, but again completely on track with our expectations.
Yes, that's very helpful. And then just going back to the NSA.
Dynamic here that zero to 2% headwind assumes that.
And then effectively implemented.
As contemplated by the CMS rules.
The lawsuits are effectively thrown out I E. The privacy of that with CPA.
Right, so any any different and in that meeting.
Tpa privacy effectively goes away with that.
The upside to your numbers.
Well I think we are we.
We started we started the year with guidance that PPA with under the regulatory expectation that CPA with privacy and we put out our guidance then.
Then came along the TMA, which arguably could have.
It could have.
It helped our pre negotiation activity and there is we've got the Hs.
<unk> lawsuit that made that might put it back so as it's bouncing from guardrail to guardrail. What we can tell you is that fundamentally we feel very good about our guidance.
No matter, where it lands from a regulatory perspective, we don't think it's going to materially affect the revenues our MSA revenues when it might affect us the geography, whether it's pre negotiation are our prepayment and post payment in terms of the outlook and Dana we feel really good about about our.
<unk> set regardless of which way the ruling the ruling comes out or our ability to provide an end to end solution.
And as is spot on and whether they the ruling is upheld or overturned.
We feel very good about assisting our ability to assist our customers and assuring their compliance with the surprise pool rule regulation, whether the that particular part of the wall because remember they only part of that that ruling it only changed arbitration.
The impact of the rest of surprise bill and the processes remain in place as originally as originally contemplated by the interim final regulations.
Yeah that makes sense, thanks for the color and congrats on the strong quarter.
Thank you.
Thank you as a final reminder, if you wish to submit a question. Please press star followed by one on your telephone keypad now that star followed by one on your telephone keypad.
At this time, we currently have further questions. So I'll hand back to Mr. <unk> for any closing remarks.
Operator, thank you very much.
We appreciate the continued trust and confidence in.
And your questions today, and we look forward to talking to you again on Q2. Thank you.
Ladies and gentlemen. This concludes today's call you may now disconnect your lines.
Okay.