Q3 2022 CareCloud Inc Earnings Call
Welcome to the Coeur Cloud, Inc. Third quarter 2022 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'll now turn the call over to your host Natalie Garcia Ms. Garcia you may begin.
Good morning, everyone welcome to the Coeur cloud third quarter 2022 conference call.
On today's call are Mehmood Hawk, our founder and executive Chairman Hottie, Choudhary <unk>, our Chief Executive Officer, President and a director and Bill Korn, Our Chief Financial Officer.
Before we begin I would like to remind you that certain statements made during this conference call are forward looking statements within the meaning of section 27 of the Securities Act of $19 33, as amended and section 21 E of the Securities Exchange Act of $19 34 at the method.
All statements other than statements of historical fact made during this conference are forward looking statements, including without limitation statements regarding our expectations and guidance for future financial and operational performance expected growth business outlook and potential organic.
Growth in acquisition.
Forward looking statements may sometimes be identified with words, such as will May expect plan anticipate upcoming believe estimate or similar terminology and the negative of these terms or forward looking statements are not promises.
<unk> or guarantees of future performance and are subject to a variety of risks and uncertainties many of which are beyond our control, which could cause actual results to differ materially from those contemplated in these forward looking statements.
These statements reflect our opinions only as to the date of this presentation and.
And we undertake no obligation to revise these forward looking statements in light of new information or future events.
Please refer to our press release and our reports filed with the Securities and Exchange Commission, where you will find a more comprehensive discussion of our performance and factors that could cause actual results to differ materially from these forward looking statements.
For anyone who dialed into the call by telephone.
They want to download our third quarter 2022 earnings presentation.
Please visit our Investor Relations site, IR Dot care cloud dotcom click on news and events, then click IR calendar click on third quarter 2022 results conference call and download the earnings presentation.
Joining me on today's call, we may refer to certain non-GAAP financial measures. Please refer to today's press release announcing our third quarter 2022 results for a reconciliation of these non-GAAP performance measures to our GAAP financial results.
With that said I'll now turn the call over to our CEO Hottie Chowdhry Hardy.
Thank you Nikki.
And thanks to all of you for joining us today sort of a third quarter earnings call.
First to review some high level financial highlights we are very pleased to announce our second consecutive quarter of record bookings driven by a strong initial reception to our wellness offerings, namely chronic care management and remote patient monitoring.
We see an enormous opportunity to expand our total addressable market and generate meaningful growth to these product introductions and then go into more detail on that shortly.
Our third quarter revenue and EBITDA of $33 7 million and $4 8 million, respectively, compared to $38 million and $6 7 million in the prior year quarter, which was expected and built into our projections.
On today's call I would like to discuss.
A deeper dive into care clouds record bookings that continued to grow due to the newly launched products and heightened focused on organic growth.
Our innovations and next generation of digital health, including the recent launch both remote patient monitoring.
Results from the recent class survey, which rarely put care cloud on the map with respect to multiple digital health categories and finally, an update on all of our sales pipeline.
First with respect to bookings we are pleased to report that the third quarter represented over highest ever bookings quarter in the history of the company, which we believe was directly correlated with the early strength of our suite of digital health solutions under a wellness Fay.
Mmm type of chronic condition. According to the data from NIH.
Additionally, it is great source of incremental revenue for the provider with little to no upfront cost for them.
Balances bookings momentum sense of a launch in April demonstrate that its value is clearly resonating with over physicians base.
Similar to the last couple of quarters by not the norm to get too granular around over bookings matrix. We think it's important to share. This information with you as it ties directly to the conversion after Lobos pipeline activity that we provided a lot of details around the last couple of quarters importantly demonstrate data.
Increased investment in product innovation, and sales and marketing spend are paying dividends.
Importantly for modeling purposes.
You want to call out what is typically a longer than usual tail. So bookings conversion to revenue in ever been in this business.
We note that one dollar of wellness bookings does not translate to one dollar of revenue one or two quarters later, rather monster confirmed b work with customer to sign up their patients and only once the patients are enrolled in the actual chronic care management visits remote patient monitoring.
<unk>.
Onboarding of both physicians and patients typically takes nine to 12 months to fully ramp up.
After this initial period, we do not realize the entirety of booking visit revenue rather it is a gradual process to build up to that steady state on an annualized spaces as.
As you mentioned last quarter, given the sensitivity around bookings in general quarterly volatility. Please note that investors should not expect us to provide bookings matrix every quarter.
<unk>, which was launched last quarter continues to generate a strong marketplace response and later September the announced the launch of a remote patient monitoring solution.
While we details this solution on our earnings call last quarter as a refresher the RPM solution gives health care providers the ability to monitor elements of their patients held outside the clinical setting.
More proactive and improved care delivery.
Two collaborations with leaving device makers. This program enables providers to get real time information on their patients health status and make proactive clinical decisions rather than waiting for a scheduled follow up visit.
<unk> generated RPM bookings of $6 million and just the last 30 days since its launch.
We are very excited about the enormous potential to leverage over existing client base and drive meaningful growth and a wellness segment.
As mentioned last quarter, we believe we can generate up to $50 million annually from over existing customer base alone.
We are honored that cloud was recently recognized in the 2022 best in class survey in the category of small practice ambulatory EMR PM, we're offering integrated software and services to practices with 10 physicians are less.
With a a mission to drive innovation that creates better financial and operational outcomes for physicians and practices. We are proud that of a EMR NPM solutions are being recognized by the medical providers that provide direct feedback to class.
Those of you not familiar the class recognition is the most reputable market research organization specific to the healthcare market and as compared to the consumer reports of healthcare.
In addition to class.
The respective publishers.
Recognize care clouds products and services under E. H R and RCM categories just over the last few months. This includes business Dot com for best Medical software and best medical billing services.
Adviser portable comprehensive health care technology solution Tech radar for the best electronic health record software and various others, a more detailed list of available and presentation along with <unk>.
We are also in the running for other reward categories of best in class for which results are yet to be announced similarly, we are currently under review by in 5000 for best in business for Health services and products and fast company for most innovative company, but over a digital health sweet.
These accolades.
Gave us confidence that fear and waiting in the right direction and are succeeding in our goals as alleviating burnout experienced by practice physicians streamlining their back office processes, while driving superior collections.
We are pursuing this recognition as part of our business strategy to focus more aggressively on Brian the weirdness and organic sales.
Cloud <unk>, an objective third parties have given us These awards and certifications.
Vips that have a pipeline of new customers at the end of Q3 was $28 million, a 40% increase above the $20 million, we had in the third quarter of 2021.
This amount does not include care cloud wellness, which represents an entirely different set of potential customers and opportunities cross selling to the existing customer base. All told we are thrilled with the early reception to both our wellness offerings chronic care management and remote patient monitoring evidenced by available.
To date.
To summarize.
Trail to deliver a second executive quarter of record bookings in Q3 a.
Sales and marketing efforts continue to ramp and early results are encouraging as evidenced by clouds and booking and an all time high in customer reception to avert products.
We are harnessing the power of increase brand awareness to help drive organic growth and we look forward to reporting over progress as we close out the remainder of 2022.
Now I will turn the call over to Bill for a closer look at our third quarter, an ear to date results.
<unk>.
Thank you Harry and thanks, everyone for joining us on the call today to discuss our third quarter results.
Third quarter was broadly in line with our expectations.
During the reduction and revenue from two clients that we discussed last quarter.
On today's call I'll review, the quarterly results and discuss our year to date performance in greater detail.
Taking a look at our results for the first nine months of 2022.
Revenue year to date was $106 $3 million, an increase of 4% compared to $102.1 million in the first nine months of 2021.
With 84% of our revenue generated from our technology enabled solutions.
Here to date.
<unk> net income was $4.9 million.
Compared to a gap net loss of $686000 in the first nine months of 2021.
This equates to a loss of 45 cents per share after subtracting the preferred share dividends.
Our non-GAAP adjusted net income for the first nine months of 2022 was $12.4 million or 81 per share.
During the first nine months of 2022.
Our adjusted EBITDA was $16.6 million an increase of $546000.
Or 3%.
$16 million in the same period last year.
Our adjusted EBITDA margin year to date of 16% is consistent year over year.
Our third quarter revenue was $33.7 million representing.
Representing a decrease of $4 $6 million or 12% year over year.
The year over year decline was due to two factors.
The primary factor was a reduction in recurring revenues from the two large customers we mentioned last quarter.
These customers that came to us as part of a prior acquisition are in the process of merging their operations with other health systems, which utilize a different EHR platform.
We continue to see an impact from their wind down <unk> revenue and since they were high margin accounts. This.
Impacted our third quarter profitability as well.
A secondary factor was the decline in our non-recurring professional services revenue from the second quarter.
This revenue primarily from our <unk> our business is running at approximately a 30 million dollar annual run rate.
Due to completion of a large project during the second quarter of 2022. This.
This revenue was a bit higher during the second quarter and levels off in the third quarter.
This was anticipated and as part of a normal fluctuation in that business.
Just on the timing of project starts Incompletions.
This normal fluctuations is not impact the annual revenue run rate of that business.
Our GAAP net income of $1.1 million was down from $1.5 billion in the third quarter of 2021, a decrease of 30%.
Our GAAP net loss was 18 per share based on the net loss attributable to common shareholders, which takes into account the preferred stock dividends declared during the quarter.
Or non-GAAP adjusted net income was $3.3 million or 21 per share.
Adjusted EBITDA, a $4.8 million decreased 28% from last year.
And our adjusted EBITDA margin is 14%.
Now I will turn to the balance sheet and cash flow.
We ended the third quarter with $4.9 million of cash and equivalents and nothing drawn on our $20 million line of credit with Svd.
Networking capital was $5.1 million and.
We generated $7 million of cash from operations during the quarter $15 $1 million a year to date.
We are reiterating our 2022 guidance with revenue to be in the range of $140 million to $143 million.
And adjusted EBITDA to be in the range of $22 million to $24 million.
As I mentioned last quarter, we are continuously looking for game changing deals.
And look forward to updating you when appropriate on that front.
We are also very excited to announce that will be hosting our first analyst and Investor day on Monday December 12th.
This will be a virtual event to showcase our company at a depth and breadth that will be entirely due to the investors and analysts community.
Purpose is to Reacquaint investors with our story.
And go into detail on how care cloud has evolved from a consolidator one building companies.
To a leading edge indispensable partner to physicians and hospitals as they navigate.
The next generation of healthcare technology.
There will be opportunities to hear from and ask questions of members of our leadership team and sales and operations.
We will provide additional information about the new care cloud products and our long term strategy to hardest innovation and growth to drive new business.
Please look for a formal invitation to this event shortly after the Thanksgiving holiday.
We are proud of our progress in 2022 and it is clear that our new product solutions are resonating we've.
We've carved out two distinct pathways to organic growth.
Through new business development, as well as leveraging our relationships with existing customers and creating value at products to complement their existing care cloud platforms.
Our organic growth continues to increase and we look forward to providing more details during our analysts and investors day.
With that I'll turn the call over to Mehmood voice closing remarks.
Thank you Bill.
We're very proud of our accomplishments to date and.
And even more with respect go for care cloud future hold.
I would like to thank our customers shareholders and all our associates for their trust loyalty support of care cloud mission.
We will now open the call to questions.
You would like to ask a question. Please press star one on your telephone keypad now and you will be placed into the queue in the order received.
Please be prepared to ask your question when prompted.
Once again, if you would like to ask a question. Please press star one on your phone now.
Our first question comes from Jeff Cohen from Ladenburg Thalmann. Please go ahead Jeff.
Good morning, everyone. This is destiny on for Jack I Hope, you're all doing well and congratulations on so many accolades in the last couple of months I think that's that's really wonderful I guess quickly I'd like to start around your commentary with the wellness platform and the the cycle that you're talking about I know.
Wellness is relatively new and remote patient monitoring is even newer so I'm wondering is there an opportunity to make that nine to 12 months a bit faster as you gain learnings from your physicians and and whatnot or is that gonna be a cycle you are expecting for the for the remainder.
Good morning, Destiny and then thank you for joining and thank you for your question.
As you mentioned the two things we know we launched this.
Under the wellness umbrella this forest chronic and management in the second quarter, we are still in the process of.
The data that we have is only about a quarter of all the above two quarter award on the chronic care management site and the data that we have Florida more efficient monitoring we just launched it above the 30 days back and re signed two contracts already but we do not have enough data to support that with the final numbers are going to look.
Play with based on the industry averages and.
For the last two.
What is of data we anticipate this.
<unk> have to be somewhere in the same.
Same timeline between nine to 12 months. It also depends on the adaptability from the patient standpoint, because this is this thing is meaningful to industrial this thing is comparatively new foundation standpoint do so.
<unk> ability, we hope will improve over the next one you from the patient standpoint, but did something we need to see some for nowadays slightly we are anticipating a full ramp up off between nine to 12 months.
Okay. That's really helpful. Thank you and then I'm wondering if you could just talk a bit more about that pipeline you discuss outside of wellness I think he said it was about 28 million if I'm not mistaken can you just talk about the competition of that pipeline.
The greater question Destiny, and as I mentioned that this pipeline excludes the wellness and if you think about the third quarter bookings about 50% of those bookings are coming from wellness. So when you're looking at 28 million pipeline.
The RAF between.
First of all it does not include wellness and for the rest about 50% of the us.
The enterprise <unk> about 20% to 30% is mid size and the rest are the smaller practices are we still see a lot more direction towards the enterprise lines, which we considered by the 25 provider plus practices.
<unk> switches in addition, today, which is a whole different story.
Specifically sharing the numbers in terms of the pipeline.
In the first phase it extensively focusing towards a existing client base and the way we are looking at getting this wellness chronic care management, Andrew motivation monitoring together.
Disappeared from over existing nine base to be able to generate up to $50 million annualized revenue over the next one to two years timeframe. So this level of opportunity that we see from the existing client base and we are planning on.
During the second phase.
Announcing more extensively for the overall market place where from the new logo standpoint, using these two services. These two products as a driving force to assigned more business and began issuing those all around.
Investors day in December .
Okay that makes sense. Thank you and I guess that kind of leads into my next question, which is how are you leveraging some of these cross selling opportunities as we're now in one of the busiest quarters.
Typically turn of seasonality standpoint.
Maybe a desk and you might have to elaborate a question.
A little bit more but.
Whether it's the third or the fourth quarter. The wellness is that right Ms.
Major.
Still keeping the wellness as a separate line item. So we can track it.
Actively tangled.
Kind of an up sell for us as well so keeping that is nine.
Our numbers for up sales or just take the example of this last quarter.
Year to date numbers about 5% to 10% between that number of the new bookings were coming from over upsell activities during the quarter and this is again, excluding the wellness.
Okay got it yes that was exactly my question. Thank you and then it gets last one for me and then I'll jump back and came here I didn't hear much about force. So I'm just wondering if that's still a focus and you're still seeing uhm interest there or if that's kind of gone more towards the back burner as you focus on organic developments and the like thank you for taking our questions.
Destiny and announced start the entering <unk>.
The division head for.
For for the care plan for Us and we can get some more color. We absolutely continued to focus on force as well and year to date of fees to located about 20% of bookings are coming from divorce and now along with the help of Tomatoes are division has started to work more.
Leveraging the existing health police relationships, we are seeing more and more opportunity towards that and.
Would you like to jump in fees.
Absolutely.
Thank you <unk>.
Excellent question always enjoyed talking about force.
Certainly what we saw in two three was for substantial hospital clients, which is kind of new territory for us that have come through the relationships of <unk>, which has continued proof of concept.
In addition to that the pipeline being full four.
Between organic growth has been exceptionally for <unk>. In fact, we have some opportunities out there with household names you would all know too early to announce that yet, but super excited about where that's going.
Ability to.
Kind of leapfrog from.
The hospital deal then into the big larger companies.
Where we can provide those workforce extinction opportunities. So it's been going extremely well. Thank you Robert.
Excellent. Thank you for taking our questions.
Thank your destiny.
And our next question comes from Alan Clean for Maxim Group. Please go ahead Allen.
Yes, good morning for your two large hospital customers that churned could you give us a sense of what the quarterly revenue is associated with them and <unk> is it.
Fully turned off or is there like a little more that's to come. Thank you.
Great. Thank you at into further question and good morning outside of the answers and I'll.
Hand, it over to bill for to for any of the from the numbers of the impact core Cleanflicks perspective. This was to fall info from the.
And the zooming out 10000 feet. These two customers are are sort of our unknown during the due diligence we looked at it there was a there was a certain level of risk and more as they were being acquired by larger groups as well as a different implementation of the health systems.
This was factored in into the valuation of those acquisitions.
Then even more than what we what we were anticipating.
A small very small fraction of revenue Li Mei anticipate come in from <unk>, one of those two clients in the next year, but that's in the whole scheme of things is Netflix negligible, so I wound faster that too much and in too.
<unk>. The 2000 2003 outlook is going to be based on these two customers.
But bill would you like to add any comments from your site.
Sure So sir Alan.
Allen.
These two clients together, where.
We're a good chunk of revenue most of that decline has occurred in Q3, but I would say, there's there will still be a little additional declined because.
As you would expect when a when a large hospital system goes through a multi year project of implementing and EHR like an epic it's a long process that doesn't go on.
Oh.
All units within the hospital at one time and as they have been been turning on.
To to epic they weren't using our EHR.
But there was they had a an initiative to essentially movie RCM business, so that you'll see a little bit of a headwind from that in Q4.
Wow.
One of these clients will will remain a client next year, but.
But they won't be there won't be a top client they won't be one of the top five bill there'll be a small clients. So.
Yeah. We're we're fortunate that we were able to to get a lot of revenue in a lot of profit out of them during the during the time that we serve them.
Alright, Thank you and my last question is.
Tell us a little about how you're thinking about the <unk> environment with valuations pulling back.
Could that be creating maybe maybe more potential opportunities. Thank you.
Sure Allen. So we are always looking for good M&A deals and does you know sometimes people will say bill <unk>.
15 months since you guys bought something what what are you. What are you doing and the answer is every week, we're looking at at one or more deals now.
As you know.
We've got certain criteria, we look at an investment and say we want to get a return on that investment in in three or four years. So.
Even though public market valuations have declined a lot over the last 12 months. Unfortunately, there's a lot of private companies, who haven't raised money for awhile.
And they turned down raising money cause they didn't like the terms and so have you asked that and they'll say well Gee last time I raised money. It was it five times revenue I'm, hoping to have my first year of profits next year. So I think I'm worth five times revenue and will look at that and say if you are five times revenue and you are no profit how long does it take me to get a payback on that investment.
It doesn't even make sense.
So we're always looking we're always hopeful we're fortunate that we have many available sources of capital. So we're not letting that be a constraint in terms of doing deals.
But we're also not willing to do a deal on terms that we don't think you're going to be accretive to to shareholders. So.
There is nothing to talk about today hopefully when we have a conversation is down the road. We will have some exciting things do you have to tell you about but rest assured.
We're always looking for things that if you know somebody who you think would be a good fit please feel free to give.
Give us their name.
Thank you.
And our next question comes from Mark Weisenberger from be Riley Securities. Please go ahead Mark.
Yep. Thank you good morning drilling down a little bit more on the bookings and pipeline of the $7 million in new bookings what percentage was from new customers versus kind of up cells to existing.
Customers and other pipeline well Percenters net S are represented in there.
Okay, great. Thank you remark in the morning.
You break it down to 7 million. So first to fall out of the $7.1 million that be closed in anybody's recurring bookings in the third quarter about 50% of that is coming from redness and virtually all of this madness is it's where it's success with cell into the existing customer base.
And separate to that in addition to it or to go through for the rest of the so about 22% was the new bookings the new sales that we have done and.
Up cell number just for the border other than.
Other than the redness was about those two 3% between two and 3% so but I think the way you should look at it.
There is a tremendous excitement in the industry and opportunity and this is just even just looking at the existing client base towards the services such as chronic here and the motivation monitoring and the need to see the results for the motivation monitoring we continue to grow in.
Separate to the wellness.
From the new lows and still some up sales.
Expansion of the services within the existing client base and this $7.1 million does not include any of the <unk> revenue because that's a one time project based revenue.
Understood.
<unk> are not included in that $28 million pipeline as well.
Yes that is not included in 2000 8 million pipeline disciplining Dominion pipeline is just whatever recurring business that we are anticipating that we track design training designs made us off as a separate is a separate lately.
Understood. Thank you and then year to date, it looks like sales and marketing spend is up about 13% over last year I thought maybe the company was kind of targeting closer to 20% based on some of the returns you are seeing so is it possible that bookings could have potentially grown faster.
Or if you spent more and as your thoughts on kind of allocation to those expenses changed at all.
Great question Mark.
If you think about it from the the headcount perspective, the headcount has significantly increase but the sales and marketing spend as you are seeing is not increase as much as we were initially forecast in good budget and we were able to much more effectively ramp up the sales and marketing team off.
Offshore as well in addition to onshore so dad's, helping us up to a certain extent and managing.
This expense space in a much better in a more effective way so today roughly between sales and marketing together nauseated about 50%.
Headcount offshore and the rest of the 50% onshore. So this country building up to a certain extent.
In that initial number forecast that we were.
We will be presented we still are running.
On the.
Basis close to somebody between the same 42 between 40.
40% conversion into a dollar revenue.
Between 40 to 50 number I was hoping we are on track from the <unk> perspective, we're on track in terms of the ramping up to a sales and marketing team and we already have started to see the results. If you look at the last two consecutive quarter in terms of the final bookings.
5.253 in the second quarter record booking quarter third Gore payment further above up to seven one and B R.
Anticipating similar results so for the fourth quarter as well in terms of bookings.
Very helpful. And then just the final one for me.
As you scale, the wellness offering I guess and maybe specifically related to the CCM. What does your capacity to scale that look like is that something that has more of a linear trajectory or can it materially accelerate if the appropriate resources are in place and what are those resources looked like thank you.
And then thanks Mark.
<unk>.
Increasing may be having you may not be able to understand the question exactly woodsia.
We took a conservative estimate by we took the patients.
Find out the patient eligible to do for a breakfast.
Poor chronic care management, and we are taking it about 40% to 50% adoption rate, yes, you're right. This can improve but this thing beings competitively noon the industry. This is.
A similar level of the patient adaptability aspect that's coming in.
If you think of them for the very first time in my entire life history of a patient of the call comes in trying to explain can you would you be willing to give us 20 minutes and 40 minutes each month over the phone call and we can help improve your overall health condition. So it takes us some time to convince the patients I said this we believe this.
Keep on improving because of the same patient may now start receiving a call from a couple of other peers as well. So they will start avernus will keep on improving but.
<unk> need to see.
Next to 12 months houses things improve.
But this is this is how we are looking at it at this point it is an opportunity, but it's hard to exactly forecast out it's going to look like over the next 12 months.
And Mark I'd say right now, it's really driven more by the demand from the patients Ah, it's not necessarily supply constrained.
Because initially as we started providing this in addition to to having people have around we're using a third party.
And we've got the.
Ability to to continue do retro ramp up supply and demand.
As demand grows so.
Right now I wouldn't forecast any constraints on our ability to service. These customers I would look at it as as how fast is the the new market going to take off.
Great. Thank you very much.
Thanks to our next question comes from Kevin D. D from HD Wainwright. Please go ahead Kevin.
Hello. Thank you for accepting my question. This is Michael Johnson, calling on behalf of Kevin D. D <unk>.
So in terms of standards in place for the Internet of medical things and remote monitoring devices that are added to care clouds wellness products wheat.
Are there any constraints to which devices your platform can interface with.
As you request and Michael and thank you.
There is no limit.
No limitation or capability issue in terms of our system can integrate grid and just to elaborate further there today. They are two separate.
Would say group of devices, one would be which are F. D. A approved and can be used under for those two more patient monitoring reimbursed symbol claim.
So that someone liza even if you're if we are giving the device to the patient be known that even for the device of the cost efficient there'll be the first of all we will get the reimbursement to the patient is not going to cost anything for to the patient. So that's that's the one way there is a whole other set of devices, even if you're thinking about is an exam.
Simple and Iowa's or Android smartwatches. They can collect a lot of data with most of those things are to be not FDA approved we still can use those to collect data and give the guidance to the provider to take the next actions are the next best steps for example, intubations temperature.
Or not.
At the right level the blood pressure level is not at the right level and they are using the non F. D. A approved device that the doctor can skills still schedule a appointment with that patient, which can result into developing doctor patient as well as the increase the revenue for the practice. So those are the two differences to summarize the answer.
No. There is no limitation, we can connect with FDA approved device or any other devices. They will be two different track of strategy in terms of the patient <unk> being in the revenue recognition for the client as well as for us.
Okay, great. Thank you and next question.
So patient adherence to appointments, there's some issue for health care providers.
Kerr clouds data suggests that appointment's initiated by health care providers instead of patients may be improving adherents.
Very good point Mike.
Michael that you highlighted in this is what's how we are looking at it has been moving towards the debate restarted calling is the next generation of healthcare system. There has been a shift from <unk>. We are seeing this shift from a transition from patient driven appointments versus towards the.
<unk> being driven by the healthcare provider and like anything else. There may be in the next few years next five years, probably most of the appointments will be driven by the healthcare providers as more and more of these technology is becoming available as well as a shift towards value based gear accountable care organizations in the light.
We do not have the specific numbers today that how much shift b C. Today, but yes, there has been a gradual shift and this this car will keep becoming more of a steeper and they will be aboard adaptability down the road.
Mmk much appreciate it at one final question, how do demographics among patients affect their acceptance rates for using tech driven services and care cloud wellness and how was this influencing your marketing and beady efforts.
Thanks, Mike and Unfortunately, we did not look at that number to date, but to your point as an example of remote patient monitoring most of the deductibility because of the coverage from Medicaid or the CMS is coming from the elderly patients because.
The chronic conditions for diabetic patients are of high blood pressure most of that is towards the elderly patient.
It's also exist on the economy carrier, but under chronic HD because those encounters are today Lee Mercy.
For a commercial as well as the government bears.
We'll see if we can see the patient of a different age age groups, there, but we didn't need to run and it didn't have a better results and we will have some some more better results as we started to see more of the implementation of declines being ramped up under the motivation monitoring.
Great. Thank you I appreciate you, taking my questions and I'll pop back into cute.
Thank you thanks Micheal.
As a reminder, if you would like to ask a question. Please press star one on your phone now.
And at this time, there appears to be no further questions.
We would like to thank everyone who is joining this today. We appreciate your interest in a sense of company and your participation on key call. We look forward to speaking with you again next quarter and thank you all and have a great team.
Thank you.
This concludes today's conference call. Thank you for attending.
The host has ended this call goodbye.