Q1 2022 Uphealth Inc Earnings Call
Okay.
Welcome to the apparel, Inc. First quarter 2022 financial results Conference call.
At this time, all participants will be in a listen only mode.
Later, we will conduct a question and answer session.
I will now turn the call over to your host Shannon Devine Investor Relations. Mr. Ryan you may begin.
Thank you operator.
During today's call management will be making forward looking statements. Please refer to the company's SEC filings, including the company's annual report on Form 10-K, and quarterly report on Form 10-Q to be filed for a summary of the forward looking statements and uncertainties and other factors that could cause actual results to differ materially.
Really from those forward looking statements.
Upheld cautions investors not to place undue reliance on any forward looking statements. The company does not undertake and specifically disclaim any obligation to update or revise these statements to reflect new circumstances or unanticipated events that occurred.
As required by law.
Paul will report will refer to pro forma revenue pro forma gross margin and adjusted EBITDA. These metrics are not determined in accordance with GAAP and therefore are susceptible to varying calculations.
Definition calculation and reconciliation to the financial statements on a non-GAAP measure can be done in the tables included in our press release.
We believe these non-GAAP measures and upheld financial results provide useful information regarding certain financial and business trends and the results of our operation.
I will now turn the call over into upheld CEO for Nash.
I'll, let krishnan.
You may begin.
Thank you Shannon.
Welcome everyone to upheld first quarter 2022 earnings conference call. Please.
Please refer to our website to review the presentation that captures all discussion.
Please join me now on slide five.
I'll begin our time with you today by saying that I hope you've seen this morning's announcements from <unk> board of directors, taking that Samuel Murphy will be joining upheld as chief Executive Officer in July .
Sam has been a successful global leader in health care, a publicly traded company for almost 20 years. If you haven't seen the press release, we issued earlier this morning.
As you to read it for more details about <unk> background and career.
Most recently executive Vice President and head of healthcare at EXL service.
<unk> expertise span health care services and technology solutions.
Have consistently driven results with operational excellence I am.
I'm confident.
Sam will lead upheld enter a new phase of dynamic growth and innovation and I'm very pleased that he is joining the company.
Until <unk> comes on board I will continue to serve as CEO .
He begins as CEO I will work closely with him to ensure a smooth transition and begin a new role as the company's chief strategy officer with a focus on strategic initiatives and partnerships.
The past few quarters for us as a public company has been a time of growth.
We have completed the integration of our operations and continue to execute on strategic priorities of growth and profitability.
Everything we do is led by our vision to reshape and transform the massive healthcare industry to take cockpit with next level with better asset quality call outs.
Outcomes.
And I am once again incredibly proud of our team.
Jim is the engine behind our growth, but we also thank them for the hard work creativity and dedication that has brought us this far.
Slide six presents the framework for today's reports.
I will first take you through a brief business overview and share some of our recent wins.
And Martin Beck, our CFO will walk you through the Q1 earnings.
We will open the call to questions and answers at the end of our presentation.
Before I hand, the call over to Martin to go over the detail financial I would like to touch on some of the quarter's highlights and business wins.
And we begin with slide eight.
We'd like to start with our investment summary, the core reasons that make up about a growth story with potential to build substantial value.
Solid profit dependencies.
We offer unique and differentiated set of advanced technology products and services.
Substantial competitive advantage, especially as many incumbents struggle with technology that accumulated over decades.
We have demonstrated solid performance across all three business lines, all of which operate in large markets with critical needs.
We continued to show strong revenue growth $76 million in Q1, 2022, compared with $33 9 million in Q4, 2021, a sequential 6% increase and an 18% increase from pro forma Q1 2021 to Q1.
<unk> 2002, and this growth combined with margin expansion to 43% in Q1 of 2022.
We continued shifting of revenue mix towards higher margin product lines.
Provide the foundation for increased profitability.
Integrated care management generated $2 6 million with a gross margin of 63%.
Virtual care infrastructure generated $13 6 million, 43% of total revenue with a gross margin of 47%.
Services generated $17 7 million of revenue, 49% with a gross margin of 35%.
We have a solid cash and working capital position to meet our growth needs for the year.
On slide nine you will see that we have had a good start for 2022.
Formed well at <unk>.
Our revenue targets.
$36 million and also enhanced gross margins to 43%.
Our integrated platform.
Platform intranet.
Went live at the largest health plan and the largest specialty mental health plan participating in Cal aim California's ambitious initiatives to innovate, how we deliver services and care for the Medicaid population.
Medicaid is the largest public health plan in the United States, providing benefits for almost 90 million individuals.
The platform was also opened up to provide the networks delivering enhanced care management and community support services.
Critical elements of the Taliban initiatives.
Our virtual care platform, Marty one for large and long term contracts with language interpretation with a total additional value up $15 million in some of these wins, we also display leading competitors.
Increasing console patient volumes on the marquee platform also drove higher revenue.
11% increase in gross margin quarter over quarter because of operating leverage.
We closed three new provider network contracts with health plans for a view of our out services, Florida Blue new direction and bright house.
We also extended contracts with third party administrators for the veterans administration to deliver behavioral health services to its assets.
We continue to execute on our company wide transformation initiatives focused on growth profitability execution excellence and organization discipline.
This quarter.
<unk> us well for continued success in 2022.
Domestic guidance for the full year of revenues between 205 and $233 million.
Gross margin between 42 and 43%.
And adjusted EBITDA between 14, and $19 million, representing 7% to 8% defense.
EBITDA margin.
Turning to slide 10.
Our products and services help transform healthcare around integrated models of care that can deliver improved quality cost and.
And outcomes.
Collectively our business line, bringing the capability needed for the next chapter of digital health.
Unmatched capabilities, some three integrated business line integrated care management virtual care infrastructure and services.
Turning to slide 11.
Our integrated care management platform enabled managed care organizations healthcare providers counties and governmental agencies implement a wide range of programs to improve health for some of the most complex population.
We have a little over 8 million lives under central that platform in.
In Q1, the business generated $2 $6 million in revenue.
Q4, 2021, and Q1 this year both decreases in revenue from this business due to timing of revenue recognition. We expect Q1 this year to be the last quarter affected by the timing issues.
We continue to integrate Cincinnati with other technology and services we have.
<unk> implemented the ability to launch marquee video collaboration fronts, intranet, providing an additional and powerful channel for care teams to collaborate.
But with this integration we have the ability now to bring integrated language interpretation and translation services to Simpson that clients, specifically health plan and Kathy.
We've also launched a campaign to bring the capabilities are central to health systems that are market customers, who are also in various value base ultimate payment arrangements.
We're also engaged in two proposal to provide services to manage health combined with the technology capability of the integrated care management platform.
These proposals are part of our attempts to add advisory and managed care services to the integrated care technology offering.
Note that we continue to make strong progress.
Our efforts to collect outstanding receivables from a European customer that were written off as bad debt expense in the fourth quarter of 2021.
We continue to expect a positive resolution of this matter.
Turning to slide 12.
With $15 6 million in revenue from Q1.
<unk> platform continues to win substantial contracts to provide language interpretation.
We continue to also gain market share with some recent wins that are display leading competitors.
We now have a presence and partnership with U S health system across.
<unk> thousand 300 facilities and locations.
In India, we are seeing tremendous growth and consolidation using Buffalo live virtual care platform.
Provided 173000 consultation.
Digital clinics in Q1, 'twenty two up from 42000 in Q1 of 'twenty one.
And we expect continued expansion of volumes about digitally and health centers in India.
Turning to slide 13.
Our services business net.
And ill health behavioral had Q1 revenues up $17 7 million.
We deliver medications manufactured and personalized across all 50 U S States and comprehensive behavioral health program. The deadline first responders and other population.
We also added provided network contracts.
<unk> are in network with Cigna, and Blue Cross Blue Shield, a new direction among other health plans.
We have approach to healthcare provider 10 systems to deliver solid site visits integrated with the marquee platform.
This integration establishes the foundation for an expansion of multi based services, we can provide to current clients.
On slide 14.
You will see that our customers span the entire healthcare spectrum.
Academic medical centers integrated health systems community hospitals managed care organizations counties and governments.
And our clients represents some of the largest and most prestigious institution in these segments.
Turning to slide 15.
Our products and services address the needs of very large markets.
And we are uniquely positioned at the intersection of three fundamental core capabilities.
Great care technology platform virtual care infrastructure and technology enabled services that are required for the digital transformation of health care.
We compete with company at the level of capabilities provided by our individual business lines.
Products and services, we offer as an integrated whole. However is unique at substantially differentiated most clients today are looking for integrated solutions, rather than attempting to implement the integration of disconnected solution themselves.
Even with our specific business line, we have significant competitive advantages.
Our integrated care platform is unique in being designed from the ground up for connected care from E&ps are virtual care infrastructure is unparalleled and the ability to bring virtual care model to primarily.
Royalty acute and critical care.
Services enabled with technology are evolving to fill a critical gap.
Allows us clients.
To expand and manage programs to optimize health.
I'd like to turn now to some truly inspiring case wins and accomplishments from the quarter.
Turning to slide 17, Youll see that Marty had four major contract wins with an estimated $15 million in new contract value.
Essentially, Texas, essentially Michigan, Ascension, Indiana, and well start.
The language is most in demand at the new facility.
Vietnamese and bromine.
And these interpretation services that we offer.
The market platform continued to provide a fundamental and critical service to address disparities in access to care and we have numerous testimonial. In addition to the quote on this slide.
Tremendous impact we have in patients' lives.
Turning to slide 18, we have seen tremendous growth with our Hello life platform, our virtual care infrastructure to provide affordable and high quality primary acute and critical care population to currently have limited access to care.
We now have 505.
Active digital clinics with 29% growth inflation consolidation from Q4, 'twenty one to Q1 'twenty two.
You've seen over a four.
Year over year growth in consultation and we have a significant impact on the populations. We serve many individuals spreading the word of our clinics and services virally through word of mouth.
Turning to slide 19, we recently extended our contract with Alameda County.
Continuing the expansion of Alameda, Social health information exchange community Health record, Google AD data sources organization and program to deploy various integrated care initiatives.
Okay.
This.
Very innovative effort developed over the last three years is fundamental to achieving the ambitious goals set by count aim.
Medicaid programs I mentioned earlier.
Capabilities, we provide the county is central to coordinate care and manage health for individuals and populations with complex medical behavioral health and social determinants of health.
Turning to slide 20.
We are providing increased access to behavioral health services for veterans and first responders with additional provider network contracts with health plans, including Florida Blue new direction at Brighthouse.
This expansion of access to high quality and comprehensive behavioral health services, especially critical today.
Providers are seeing increasingly severe levels of mental illness addiction and drug overdose.
Turning to slide 21.
I'd like to now touch on key points.
Our transformation program.
Our brand is executing on our strategic priorities for growth.
Debility operational excellence and disciplined working closely and intentionally with a leading global consultancy, we have made substantial progress on our priorities.
On slide 22, Youll see our focus for the transformation initiative, which is to realize the full potential of our businesses.
Presents the greatest opportunities for growth.
At Marquis and although life.
With <unk> we are in.
In hunting and packaging a comprehensive suite of data integration and analytics care management workflow solutions to enable our clients to more quickly implement integrated care initiatives.
It could provide these solutions in pre package and pre configured solutions that are quick to implement with best practice protocols and guidelines embedded inside them.
With Marty we are leveraging our continued competitive wins to provide not only the leading solution for language interpretation and translation, but also to deliver a wide range of telecom saltation use cases.
Model that connect patients that provided Netflix the already delivered right here.
As we have seen post the pandemic.
This novel for virtual care is.
Preferred substantially over AD hoc consolidations with providers that do not build long term relationships with patients.
Hello life.
We will scale and optimize our digital health centers and hospitals across India, focusing on the configuration that deliver the highest return on invested capital.
We will also launch advisory and managed care services combined with the <unk> technology platform to help our customers implement programs as they adapt to new mortgage payment care delivery and population health management.
In addition to the product and service initiatives. We've described we have also implemented numerous initiatives to drive operational synergies across the company and processing innovation efficiency and governance.
On slide 23.
Highlighted some of the accomplishments to date of our transformation program.
We've completed an extremely comprehensive planning prospects that identified initiatives to meet our goals with clear deliverables owners and timeline.
We refined our go to market strategy to deliver intranet to different customer segments as the threat of ready to go package solution that we expect will increase pipeline shorten sales and implementation cycle and also broaden the scope of potential customers.
With an integrated company wide sales team. We were also able to increase sales volume of our marquee platform with nine RFP win displacing.
Displacing leading competitors.
The initiatives to gain operating leverage also resulted in an increase of 11%.
Gross margins of the marquee platform.
We've implemented an optimized processes to better manage revenue forecast, Brexit, then and cash as well as contracts and compliance.
This is answered slide 24.
The goal of these initiatives and our transformation program.
The growth.
Profitability and cash flow operating performance and disciplined and to create the organizational structure and culture needed to establish ourselves as the market leader.
For growth and profitability, we're focusing on specific concrete initiatives related to our business lines with the greatest potential for growth and margin.
Initiatives range of operating performance include driving operational leverage, creating companywide shared services optimizing and automating processes around sales operations procurement and administration.
An organizational structure, we completed a blank sheet redesign of our organization consolidated a number of functional areas across the company, including sales marketing finance HR communications product and technology.
Culturally we are driving an organization committed to a clear definition of roles ownership okay.
Stability and reward for performance.
To summarize then before hand.
I hand, it to mark them to get into more detail on financials for the quarter.
Our first quarter has been strong financial meeting projection on revenue growth and profitability.
Continuing the transformation of the company to a cohesive global public kind of price.
We are solidly positioned to execute and meet our financial targets for 2022.
To drive continuous had profitable growth in the years ahead.
We closed significant contracts increased client and revenue introduced new products and we continue to execute on our transformation program initiatives.
We're excited about the future.
And we are well capitalized to become a leading sports and physical health with a unique and unmatched combination of technology platform virtual care infrastructure and services.
With that I.
I will turn the call over to Martin Beck, our CFO to go into more detail on our financials.
Thanks, very much for mesh we appreciate everyone joining us today.
Before I begin my review of our first quarter results I want to first comment on the presentation change kind of results in comparison periods recall that we completed the merger transactions on June nine 2021, and so it was already from that date forward, but we have consolidated results that we can report on a GAAP basis.
In addition, due to timing factors related to the various business combination transactions as well as the global scope of our operations. It was not possible to provide consolidated results on a GAAP or pro forma basis for Q1 2021.
This was the first full year that upheld financial statements will include all of the businesses combined in the June nine transactions.
Okay.
Turning to slide 26, you will see that revenue for the first quarter of 2022 was $36 million, which was in line with our expectations.
This represents an 18% growth over Q1, 2021 numbers, which we reported on our non-GAAP combined basis and represents a 6% growth rate over Q4 2021 revenues for <unk>.
Margin was 43% and the <unk>.
Adjusted EBITDA was negative $1 $3 million.
On slide 27, now looking at revenue breakdown by segment on a GAAP basis services, which again includes our digital pharmacy and behavioral health businesses was the largest contributor to $17 $7 million or 49% from the first quarter's total revenues.
Virtual care infrastructure was next with $56 million of revenue of 43% of the total.
Integrated care management had GAAP revenue of $2 6 million or 7% in the first quarter totals.
We expect that our revenue from integrated care management will increase significantly during the remaining three quarters of the year as new contracts are at it.
Moving along to slide 28, the company's revenue mix continues to shift towards the higher margin virtual care infrastructure and integrated care management segments, which increased from 48% of Q4 2021 total revenues to 51% of Q1 2022 revenues.
We expect the revenue contribution from integrated care management, and virtual care infrastructure to return to levels that we reported in Q2 and Q3 of 2021 as revenue and integrated care management ramps up over the course of 2022.
Together, we expect those higher margin businesses will account for an increasing percentage of total revenues going forward.
On a geographic basis, 90% of first quarter revenues came from the United States and 10% came from India.
The Companys gross margin on a GAAP basis was 43% in the first quarter up from Q4's gross margin of 22%, which was adversely affected by the expense recognition issues and integrated care management, which we discussed on our last call.
First quarter margins by segment were as follows integrated care management, 63% virtual care infrastructure, 47% and services 35%.
We view gross margin is a key metric for our power and is being useful for comparing our results to PFS.
Accordingly, but we also provide some additional color on our gross margins from a trend perspective, as well as framing them within the context of our overall financial model.
Gross margins at integrated care management increased from minus 169% to 63% as a result of not having to recognize expenses associated with the group's European contract.
Margins and virtual care infrastructure increased from 39% in Q4 2021, 47% in Q1 2022, largely as a result of operating leverage in the U S health business.
Gross margins in our services segment increased from 34% to 35% from Q4 2021 for Q.
<unk> 2022, as a result of higher volumes and behavioral health businesses.
First quarter net income on a GAAP basis included a $4 $8 million reduction in the fair value of the derivative liability associated with the convertible notes.
This revaluation.
As a result of changes in the company's stock price during the first quarter.
But a reduction in derivative liability was recorded as a gain on fair value of derivative liability component of other income in the company's consolidated statements of operations.
First quarter adjusted EBITDA was negative $1 3 million.
Which was along with revenue in line with our expectations adjustments were made for the previously mentioned change in the value of the derivative liability and certain nonrecurring expenses, including consulting and restructuring expenses.
As a reminder, adjusted EBITDA is a non-GAAP measure and we've included a reconciliation of GAAP operating loss to adjusted EBITDA in the press release.
I want to spend a few minutes discussing the companys liquidity position.
As of March 31, 2022, the company had an unrestricted cash balance of $52 million and $22 million of current portion of debt, which is made up predominantly of noticed the shareholders.
The company repaid its forward purchase agreements. According to the terms of that contract on April nine 2022.
As we noted on our year end call, we repaid approximately $20 million of relatively high coupon Indian debt in 'twenty one.
Don.
We're in the process of refinancing this debt with lower coupon rupee denominated cash and expect to complete that refinancing sometime during the course of the next two quarters.
We continue to make strong progress in our efforts to collect accounts receivable from a European customer that were written off as bad debt expense in the fourth quarter and continue to expect a positive resolution of that matter.
We are confident that our current cash position and the financial performance of the business, which we continue to expect to become operating cash flow positive during the third quarter will provide us sufficient liquidity to execute on our current growth plans.
If youll turn to slide 29, as I mentioned during our last earnings call. We expect strong revenue growth and solid gross margins to continue in 2022.
We're forecasting 2022 revenues of $205 million to $233 million, an increase of 38% to 56% over 2021, and gross margins of 42% to 43%.
We're forecasting adjusted EBITDA of $14 million to $19 million in 2022 with improvements stemming from expense consolidation and the realization of some of the operating leverage inherent in our businesses.
Over the next five years or so and also to maintain the annual revenue growth of approximately 35% increase.
Increased gross margins to 45% to 50% and to increase our adjusted EBITDA margins for 15% to 20%.
Closing on slide 30, I want to reiterate what <unk> said with respect to our transformation work, we're making substantial progress toward our integration and transformation goals and that work is unlocking revenue and cost synergies.
Excited about the future of <unk> and look forward to a strong year.
That concludes our prepared remarks, operator, we're now ready to take questions.
If you'd like to ask a question. Please press star one on your telephone keypad now.
You will be placed into the queue in the order received.
Please be prepared to ask your question when prompted.
Once again, if you have a question. Please press star one on your phone now.
And our first question comes from Mike We don't harm.
Your line is <unk> good morning, Thanks for hosting US today, congrats on the quarter.
You touch quickly on the revenue collection, maybe you can talk a little bit more about the moving parts this quarter.
Last quarter, and whether you have confidence around collecting the revenues that are in flux over the over the next few quarters.
Okay, let's start with that.
Hey, Mike it's not taking how are you.
Good good how are you.
That's good thanks, so yeah as you know.
We wrote off.
$15 $6 million.
Receivables that were booked in Q2 and Q3 of 2021.
Did not recognize any revenue in Q4 or Q1 from that customer.
And we have been aggressively pursuing collection.
That outstanding receivable balance.
We are in.
Daily weekly contact with the customer and we feel that we're making progress there cockpit data on collection, but as I said in my prepared remarks, Mike we're confident that we're going to collect that full amount.
Great.
You put out a release earlier this week around digital dispensary consultations and some great numbers around that in terms of growth can you just talk a little bit more what is driving that.
Where do you expect that to go based on the recent redeployment from Congo also financial implications of that as well.
Great. Thanks, Thanks, a lot Mike.
So what we are seeing as.
As you know we have.
505 active.
Little clinics.
India, now and what's driving the growth in terms of comps.
Consolidation is really the ramping up of the.
Utilization of these services by the population we serve.
<unk> also had.
A ramp up in the utilization at the legacy hospitals, but the primary driver of growth is the <unk>.
Now second phase of the new digital clinics that we've deployed where we're now.
Creasing the service volume.
At these clinics.
No.
Oh I'm sorry.
And then presuming that.
In addition, we've had substantial growth in the virtual care infrastructure around the market platform.
Assuming.
Mike Your question was around the digital clinic destroyed.
Additionally, in India is that correct, yes, okay perfect.
One last question in terms of.
Look at the revenue and obviously your guidance kind of what's your comfort levels around there around the predictability about that in terms of reoccurring revenue how should we think about that going into next year as well versus the onetime contract.
Mike It's Scott I'll take that one so if you look at <unk>.
Pipeline, we've got pretty good visibility into the next three quarters, given the contractual nature of.
The integrated care management business into virtual care infrastructure business.
And as you saw in 2021 our revenues.
During that year ramps sequentially quarter over quarter.
So we feel confident that we will be able to post down numbers.
In terms of.
Recurring revenues.
As you know Theres no GAAP definition of recurring revenues.
We look at recurring revenues.
Along the lines about to sort of <unk> businesses.
That is integrated care management and virtual care infrastructure. So.
Essentially all of the revenue.
Integrated care management.
Is under contract and the bulk of the virtual care infrastructure revenues under contract. So.
It's fair.
Fair to say that as you look at our total revenue mix those two groups make up about 51% of the revenue and the vast majority.
Charity of that is recurring in nature.
Perfect.
Last one I think you on.
The release, you talked about operating cash flow positive third quarter kind of what's your confidence around that and kind of your capital needs over the next 12 months, how should we be thinking about that in terms of obviously, if you need to go to the market is very expensive.
Kind of if you could give us color on those issues.
Yes.
When you look at the performance of the businesses in the first quarter it shows progress.
Each of the businesses.
Towards that objective.
The objective of being operating free cash flow positive sometime in the third quarter and we fully expect to be able to realize that objective.
With that.
I did mention that we're looking at.
Bringing on some rupee denominated debt at a lower coupon than the debt, we repaid in the fourth quarter.
And we're confident that.
That that.
And really cash flow characteristics.
The businesses going forward.
Give us sufficient liquidity to be able to.
Realize our projections without having to go back to the.
The markets for any capital.
Perfect. Thank you I appreciate the color today.
Thanks, Mike.
Okay.
Okay.
Yes.
Mr. Chairman you can begin.
Sorry, it was a quiet out there for a little bit can you guys hear me now.
Yes, Frank.
Yes. This is Frank.
Hi, Brian .
Yes.
Perfect.
So I just wanted to ask on the.
The revenue ramp.
It's a pretty nice ramp to the <unk>.
Back end of the year, you're going to see the quarter come in where it did but it sounds like integrated carrier is going to be a strong contributor to driving that ramp through the back half. So maybe just provide any color youre comfortable with.
We should think about the quarterly cadence of revenues throughout 2022.
Yes.
Well as as we discussed on our last call Frank we have cigna.
Significant project in West Africa that we did recognize in the first or the fourth quarter, we would expect that to be coming online.
In Q2 or Q3.
One with a couple of other material tax that will.
As your mesh said in his remarks provide a pretty significant ramp in the integrated care management.
Set of revenues and we continue to expect strong performance across.
The other businesses.
Throughout the end of the year.
Okay. That's helpful and then.
There's been a fair amount of commentary on it but I think it's worth circling back to just to make sure. We're all fully on the same page with the different moving pieces can you just give us a pro forma balance sheet before the rupee denominated debt is refinanced.
Back into that from cash just trying to get to.
A very clear understanding after the forward share purchase agreement was paid back where cash in different debt levels currently stand.
Yeah. So obviously we will.
You'll see all that detail when we file the Q.
As I said, we have $52 million of unrestricted cash and $22 million of short term.
Liabilities look forward share purchase agreement that we repaid on April the night was repaid out of restricted cash. So recall that we had a little bit north of $18 million of restricted cash on our balance sheet at 12 31, we used that.
To repay the forward share purchase agreements so our unrestricted cash balance remains.
North of $60 million.
Is that helpful.
Perfect. Okay, and then just the last one for me in the virtual care infrastructure business good to see the growth there can.
Can you maybe tease out the growth from Hello life versus Marty seems like both are growing nicely, but maybe a little bit more color on the growth profile of each would be helpful.
Sure.
So Frank.
We are seeing and the.
Marquee platform growth is a combination of increased utilization of existing facilities as well as new contracts that are adding to the footprint, we have and as we've mentioned some of those new contracts also display thing in.
Incumbents.
<unk>.
The increase in total minutes of consolidation through a combination of those factors is what's driving growth in the market business in the Hello line.
Product line.
Really looking at is.
Second phase of the deployment of the clinics that we implemented earlier.
It might be a provision which are now ramping up in terms of the number of consolidations that.
That we're delivering.
Abstention increased Forex last year, 29% I think.
From last quarter and.
What we are.
You need to do there is addressed what remains a very substantial demand for this model.
Healthcare in India.
To address the.
The needs of a very very large population and we'll continue to see that demand increasing.
Our capacity to deliver as well.
Just to add a little bit to that Frank.
We encouraged to see the operating leverage in.
And the virtual care infrastructure reflected in the increased gross margin.
Our U.
U S <unk> business.
It was up 10 full percentage points in terms of gross margin.
Tied to.
So better pricing at high volume so.
We continue to look forward to see that.
Thanks, that's great color. Thanks for taking my questions I'll stop there.
Thanks Frank.
Yeah.
And I'll turn the call back over to the moderators.
Sure.
Paul.
Im pretty sure that none of us can hear you're speaking.
I don't know if your phone is on mute.
Is there anything that you are saying.
This is the conference operator, you can hear me.
Now we can yes.
Do we have any other color.
I apologize.
I was saying that we have no further questions in queue, but let me pull the audience. One more time. If you do have a question. Please press star one on your total Q bed now.
I apologize for that.
And we do have a question from Randy arrangements.
Your line is open.
I'm sorry, this is Matt <unk> Richard.
Close enough risks refer great. Thanks, Hi, guys.
Hi, Matt can you hear me.
Just a couple of questions.
I can yes. Thank you.
So the integrated care management of $2 3 million.
You said that there were some revenue that was deferred or not recognized before through the first quarter do you mind, helping us quantify sort of how much that was and do you anticipate recognizing revenue in the second or third quarter.
Yeah, So hey, Matt It's Martin speaking.
As we discussed on the last call.
We did not recognize $8 $3 million worth of revenue associated with the project in West Central Africa.
We didn't recognize that in Q1, either but we would expect to recognize it in Q.
Q2, or Q3 going forward.
And that $8 $3 million per quarter or annual.
Annual.
Okay.
And so.
Call that the last quarter. Your commentary was you were redirecting assets from West Africa to India to meet demand.
Are you still doing that or you are reversing and renewing the contract in West Africa.
That is not related to integrated care.
<unk>.
You are talking about the digital clinics.
Is that correct, yes, yes.
So we are.
As you recall those clinics were not to have a shift too.
The Central Africa, and we are.
As we mentioned last call deploying doses in gap in a model where they are initially deployed.
Satellite clinics around our hospitals, where they were able to deliver both.
Outpatient care and refer.
A portion of the.
Patient population.
The adjacent hospital inpatient care and that is proceeding.
As we speak.
Okay, Great and then just a second question if I could.
The Medicaid waiver program in California, and 8 million lives.
How much of that revenue is.
As reflected in the $2 $3 million of integrated care revenues in this quarter.
Or is the nature of the contracts such that the revenue contribution to your builds as the year progresses.
Yes.
As we mentioned at two levels.
Our revenues associated with the population and the revenue increases.
An increasing percentage of that population enrolled in programs.
Got it but I guess is that program expected to be a meaningful contributor to revenues and integrated care business This year and 'twenty two.
We expect a significant pipeline, but it also builds up Matt.
And that could be a contributor to the revenue this year.
Okay.
The County, you said that was extended through through win.
That contract has been extended through.
Of the 15 months.
Okay, great. Thank you very much.
Thanks, Matt Thanks for your questions.
I think we're having some technical difficulties with the operator.
Brings our call to an end I appreciate everybody taking the time.
And we will look forward to communicating again next call. Thanks, very much everybody. Thank you.
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