Q4 2023 WELL Health Technologies Corp Earnings Call

Welcome to the World technology.

Louis: Technologies fourth quarter and full year 2023 conference call. My name is Louis now via conference operator today at this time all participants are in a listen only mode. You will conduct a question and answer session later in the call.

Tyler Baba: It should be restricted to analysts only T cell at this conference being recorded I'll now turn the call over to Mr. Tyler about bot manager of Investor Relations. Mr. Baber, you may begin.

Tyler Baba: Thank you operator, and welcome everyone to warehouse fiscal fourth quarter and annual financial results Conference call for the three and 12 months ended December 31 2023.

Hamed Shahbazi: We are increasing our annual revenue guidance to be in the range of $950 million to $970 million, representing annual revenue growth of up to 25%. In the past, I've mentioned our goal of achieving $1 billion in revenue. With the revenue guidance of $950 million to $970 million that I provided today, we're easily within reach of that $1 billion milestone. Keep in mind that this annual guidance does not include any unannounced acquisitions.

Tyler Baba: Joining me on the call today are how much about the chairman and CEO and <unk> the company's CFO.

Tyler Baba: Trust that everyone has received.

Tyler Baba: I have received a copy of our press release that was issued earlier today.

Tyler Baba: Portion for today's call other than historical performance include statements of forward looking information within the meaning of applicable securities laws.

Tyler Baba: And future oriented financial information and financial outlook information. These forward looking statements involve known and unknown risks uncertainties assumptions and other factors many of which outside of loss control and that may cause the actual results performance or achievements of while to differ materially from the anticipated results performance or achievements implied by such.

Hamed Shahbazi: Even though we're now favoring organic growth over acquisitions, we do continue to have a pipeline of mostly smaller tuck-in acquisition opportunities, and we expect a number of them to be completed this year, which should put us in a position to report that we've crossed the $1 billion revenue figure on a run rate basis by the end of 2024. For our annual adjusted EBITDA guidance, we expect to be in the range of 125 million to 130 million, representing annual growth of up to 15%, and the rest of the team. Our improvements in EBITDA in 2024 are driven by several factors, but I'll quickly point out four of them. One, WELL has implemented a comprehensive cost optimization program to enhance its operational efficiency and profitability.

Tyler Baba: Forward looking statements.

Tyler Baba: These factors are further outlined in today's press release and can be found in our management discussion and analysis.

Tyler Baba: We provide forward looking statements solely for the purpose of providing information about management's current expectations and plans relating to the future. We do not undertake or accept any obligation or undertaking to release publicly any updates or revisions to any forward looking statements to reflect any change in our expectations or any change in events conditions assumptions.

Tyler Baba: Our circumstances.

Any such statements.

Hamed Shahbazi: This program has been implemented in both Canada and the United States and includes a streamlined approach to staff restructuring, increased utilization of technology, and, where possible, AI for process improvement and optimization, consolidation of suppliers, tighter integration of our business units, and other cost optimization initiatives, which are expected to result in millions in annual cost savings. Two, continued performance from our Canadian operations. Which experienced a 39% year-over-year increase in four-wall EBITDA to $45.2 million. We will talk a bit more about this later as our Canadian business has significant momentum. Three, last year's acquisitions of MCI and the large Manitoba clinic had a dampening effect on our EBITDA last year.

Tyler Baba: Any such statements are based.

Tyler Baba: If it is required by law. We may also use terms such as adjusted gross profit adjusted gross margin adjusted EBITDA adjusted shareholder EBITDA adjusted net income and adjusted free cash flow on this conference call all of which are non-GAAP and non <unk> measures for more information on how we define these terms. Please refer to the definitions that out in today's press.

And in our MD&A.

Tyler Baba: The company believes that adjusted EBITDA is a meaningful metric.

Tyler Baba: It measures cash generated from operations, which the company can use the working capital requirements.

Tyler Baba: Service future interest and principal debt repayments and fund future growth initiatives adjusted EBITDA should not be construed as an alternative to net income and loss determined in accordance with IRS and with.

Hamed Shahbazi: However, our clinic transformation team and shared services teams are already hard at work in their efforts to optimize and digitize these clinics. And as such, we expect them to have improved margins and profitability in 2024, and four, in addition, the acquisition of Care Plus by WELL USA last year, which added incremental revenue and EBITDA to our core anesthesia business, as well as our provider staffing services, which had a strong organic growth profile associated with it. We expect strong cash flow generation in 2024. And given that we plan to focus more on organic growth, which includes our clinic absorption program and acquisition volume, we plan to use our positive cash flow to reduce debt levels this year, thereby also reducing our interest expense run rate. 2024 is also a significant milestone year for us as we have important timelines related to both our U.S. digital patient services businesses, Circle Medical and WISP. Both of these businesses have call option and IPO registration option timelines that expire in the near future unless extended.

Let me turn the call over to Mr. <unk>, <unk> chairman and CEO.

Tyler Baba: Thank you Tyler and good day, everyone, we hope that you're all keeping safe and healthy and we appreciate everyone for joining us today, we're extremely.

Speaker Change: Really pleased to be with you today and discuss our annual 2023 results, which was a record breaking year in which we achieved record revenue record adjusted EBITDA record patient visits and positive net income.

We achieved 36% overall revenue growth in 2023 with over 15% organic growth in the business, which includes clinics added to the network for nominal consideration as part of our clinic absorption program.

Speaker Change: We remain committed to the company's continued focus on tech, enabling health care providers and supporting them and simplifying their work lives modernizing and digitizing their clinical practices and delivering the best health care possible and this is evident in our increasing patient visits during.

Speaker Change: During the year 2023, well delivered over $4 2 million patient visits to our physical and virtual clinics and a total over $1 $7 7 million patient interactions well now serves more than 34000 healthcare practitioners with our SaaS and technology services in Canada alone, which is equal to approximately more than <unk>.

Speaker Change: One out of every three health care providers in the country.

We're extremely passionate about supporting our providers and everyday we focus on supporting them better.

Hamed Shahbazi: And as a result of that, we've begun to partner with minority shareholders and management to consider strategic alternatives for both businesses, which could include a sale of one or both assets. Given how we believe this could be a key positive catalyst for WELL in terms of significantly delivering and returning value to shareholders. With that, I would now like to turn the call over to our CFO, Eva Fong, who will review the financials for fiscal 2023 and the fourth quarter of 2023. I will then come back and provide further commentary on our business units. Eva

Speaker Change: This attitude and focus is what allows the company to continue to witness healthy growth across all business segments, including both online and in personal care channels.

Speaker Change: We expect our strong performance to continue into 2024, we do not foresee any material influences or challenges that would impair our ability to deliver solid results in 2024 and any of our businesses as we are poised to maintain and even accelerate our growth without meaningful capital allocation, while delivering an enhanced profitability.

Speaker Change: <unk>.

And I'm pleased to provide our 2024.

Speaker Change: Annual guidance as follows.

Speaker Change: We are increasing our annual revenue guidance to be in the range of $950 million to $970 million, representing annual revenue growth of up to 25%.

Eva Fong: Thank you, Hamed. I'm pleased to report that we had very strong results for the 3 and 12 months ended December 31, 2023. Our overall annual financial results were as follows. Total revenue for the year ended December 31, 2023 was $776.1 million compared to total revenue of $569.1 million for the prior year, an increase of 36%, driven by acquisitions and organic growth during the past year. WELL's organic growth for the year was approximately 15%.

Speaker Change: In the past I've mentioned, our goal of achieving $1 billion in revenue with the revenue guidance of $950 to $970 million.

Speaker Change: That I provided today, we're easily within reach of that $1 billion milestone keep in mind that this annual guidance does not include any unannounced acquisitions.

Speaker Change: Even though we're now favoring organic growth over acquisitions, we do continue to have a pipeline of mostly smaller tuck in acquisition potentials, and we expect a number of them will be completed this year, which should put us in a position to report that we've crossed the $1 billion in revenue figure on a run rate basis by the end of 2024.

For our annual adjusted EBITDA guidance, we expect to be in the range of $125 million to $130 million, representing annual growth of up to 15%.

Eva Fong: Adjusted gross profit was $372.3 million in 2023, an increase of 23% as compared to adjusted gross profit of $303.3 million in 2022. Adjusted EBITDA was $113.4 million in 2023, an increase of 8% as compared to adjusted EBITDA of $104.6 million in 2022. Adjusted EBITDA to WELL shareholders was $88.4 million in 2023, an increase of 15% as compared to adjusted EBITDA to WELL shareholders of $76.6 million in 2022. Adjusted net income was $52.4 million, or $0.22 per share, in 2023, a decrease of 2% as compared to adjusted net income of $53.7 million, or $0.24 per share, in 2022. Adjusted free cash flow was $42.4 million for 2023, a decrease of 13% as compared to adjusted free cash flow of $48.9 million for 2022. The decrease was mainly due to higher tax and interest payments, offsetting the increase in shareholder EBITDA.

Speaker Change: Comparatively we achieved 8% growth in adjusted EBITDA in 2023, and 73% growth in 2022 as you can see our expected EBITDA growth is accelerating as our expected EBITDA growth is significantly higher than it was in 2023, and we expect this to happen with less capital allocation activity.

Speaker Change: Our improvement in EBITDA in 2024 are driven by several factors, but I'll quickly point out four of them. One well has implemented a comprehensive cost optimization program to enhance its operational efficiency and profitability. This program is being implemented in both Canada and the United States and include.

Speaker Change: A streamlined approach to staff restructuring increased utilization of technology, and where possible AI for process improvements and optimization.

Speaker Change: Consolidation of suppliers tighter integration of our business units and other cost optimization initiatives, which are expected to result in millions in annual cost savings.

Speaker Change: Two continued performance from our Canadian operations, which experienced a 39% year over increase in four wall EBITDA to $45 2 million, who will talk a bit more about this later is our Canadian business has significant momentum.

Three last year's acquisitions of NCI and the large man turbo clinics had a dampening effect on our EBITDA last year. However, our clinic transformation team and shared services teams are already hard at work.

Eva Fong: Net income was $16.6 million or $0 per share in 2023, a decrease of 11% as compared to net income of $18.7 million or $0 per share in 2022. We calculated earnings per share based on earnings attributable to WELL. Our fourth quarter financial results were as follows. We achieved record quarterly revenue of $231.2 million in Q4 2023, an increase of 48% as compared to revenue of $156.5 million generated during Q4 2022. This growth was driven by acquisitions and organic growth. Well-achieved a record adjusted gross profit of $101 million in Q4 2023, an increase of 26% as compared to an adjusted gross profit of $80.2 million in Q4 2022. Growth in the companies at just the gross profit is attributable to higher revenue in the period. Well-achieved a record adjusted EBITDA of $30.8 million in Q4 2023, an increase of 13% as compared to adjusted EBITDA of $27.2 million in Q4 2022. Adjusted EBITDA attributable to WELL shareholders was $22.6 million in Q4 2023, an increase of 7% as compared to adjusted EBITDA attributable to WELL shareholders of $21.1 million in Q4 2022.

Speaker Change: In their efforts to optimize them digitize these clinics and as such we expect them to have improved margins and profitability in 2024.

Speaker Change: And four in addition, the.

Speaker Change: The acquisition of Kerr, plus by well USA last year, which added incremental revenue and EBITDA to our core anesthesia business as well as our provider staffing services, which had a strong organic growth profile associated with it.

Speaker Change: We expect strong cash flow generation in 2024, and given that we plan to focus more on organic growth, which includes our clinic absorption program in acquisition volume, we plan to use our positive cash flow to reduce debt levels. This year, thereby also.

Speaker Change: <unk>, our interest expense run rate.

Speaker Change: 2024 is it also a significant milestone year for us as we have important timelines related to both our U S digital patient services businesses circle medical and with both of these businesses have call option in IPO registration option timelines that expire in the near future unless extended and result.

Speaker Change: And as a result of that we've begun to partner with minority shareholders and management to consider strategic alternatives for both businesses, which could include a sale for one or both assets given how we believe this could be a key positive catalysts for well in terms of significantly delevering and returning value to share.

Speaker Change: Holders.

Speaker Change: With that I would now like to turn the call over to our CFO, Eva Fong, who will review the financials for fiscal 2023 and fourth quarter of 2023, I will then come back and provide further commentary on our business units Eva.

Eva Fong: Thank you Amit I'm pleased to report that we had very strong results for the three and 12 months ended December 31 2023.

Eva Fong: Our overall annual risk financial results were as follows total revenue for the year ended December 31, 2023 was $776 1 million compared to total revenue of $569 1 million for the prior year, an increase of 36% driven by acquisitions and organic.

Eva Fong: Adjusted net income was $11.5 million, and the rest of the Adjusted free cash flow was $12.7 million in Q4 2023, an increase of 23% as compared to adjusted free cash flow of $10.3 million in Q4 2022. This was mainly due to higher EBITDA generation. Net income was $33.8 million, or $0.12 per share, in Q4 2023, an increase of 53% as compared to net income of $22.1 million, or $0.09 per share, in Q4 2022. We calculated earnings per share based on earnings attributable to WELL.

During the past year.

Speaker Change: Well its organic growth for the year was approximately 15%.

Speaker Change: Adjusted gross profit was $372 3 million in 2023, an increase of 23% as compared to adjusted gross profit of $303 3 million in 2022.

Adjusted EBITDA was $113 4 million in 2023, an increase of 8% as compared to adjusted EBITDA of $104 6 million in 2022.

Eva Fong: In the fourth quarter, WELL generated 9% of its revenues from truly recurring and subscription revenues and 88% of its revenues from its highly reoccurring patient services revenues. This means that approximately 97% of its revenues are highly predictable. Well ended 2023 with a solid balance sheet; as at December 31st, 2023, WELL had cash and cash equivalents of $43 million. On January 26, 2024, the company refinanced its syndicated credit facility with JPMorgan Chase Bank for US$300 million, consisting of a primary US$175 million credit facility with an additional US$125 million accordion for future growth. The credit facility includes two new syndicate members, Bank of Montreal and Export Development Corporation, which is wholly owned by the Government of Canada, and the term has been extended to January 26, 2027.

Speaker Change: And just the EBITDA two while shareholders was $88 4 million in 2023, an increase of 15% as compared to adjusted EBITDA, two well shareholders of $76 6 million in 2022.

Speaker Change: Adjusted net income was $52 4 million or 22 cents per share in 2023, a decrease of 2% as compared to adjusted net income of $53 7 million or 24 two.

Speaker Change: <unk> 24 cents per share in 2022.

Speaker Change: Adjusted free cash flow was $42 4 million for 2023, a decrease of 13% as compared to adjusted free cash flow of 48 9 million for 2022.

Speaker Change: <unk> was mainly due to higher tax and interest payments offsetting the increase in shareholder EBITDA.

Speaker Change: Net income was $16 6 million or zero cents per share in 2023, a decrease of 11% as compared to net income of $18 7 million or zero cents per share in 2020, we calculate earnings per share based on earnings attributable to well.

Eva Fong: WELL continues to be in good standing and fully compliant with all components related to its two credit lines, J.P. Morgan in the U.S. and Royal Bank in Canada. The company's total bank debt increased to $297 million at the end of Q4 2023 due to cash required for the Care Plus acquisition. This compares to total bank debt of $293 million at the end of the prior quarter, Q3 2023. WELL's shareholder leverage ratio also increased slightly as a result of the higher bank debt levels to 2.7 times as at the end of Q4 2023 compared to 2.6 times in the prior quarter, Q3 2023. Please note that we define the leverage ratio as total band debt, less cash on hand, divided by shareholder adjusted EBITDA after certain performer adjustments. We exclude convertible debentures from this calculation because convertible debentures are not included in our bank covenant.

Our fourth quarter financial results were as follows well achieved record quarterly revenue of $231 2 million in Q4, 2023, an increase of 48% as compared to revenue of $156 5 million generated during Q4 2022.

Speaker Change: This growth was driven by acquisitions and organic growth.

Speaker Change: Well achieved record adjusted gross profit of $101 million in Q4, 2023, an increase of 26% as compared to adjusted gross profit of $80 2 million in Q4 2020.

Speaker Change: Growth in the Companys adjusted gross profit is attributable to higher revenue in the period.

Speaker Change: Well achieved record adjusted EBITDA of $30 8 million in Q4, 2023, an increase of 13% as compared to adjusted EBITDA of $27 2 million in Q4 2020.

Eva Fong: In terms of our share capitalization, as of March 20, 2024, WELL had 264,130,019 fully diluted securities issued and outstanding. That is my financial update, and I turn the call back over to Hamed. Thank you, Eva.

Speaker Change: And just the EBITDA attributed both to well shareholders was $22 6 million in Q4, 2023, an increase of 7% as compared to adjusted EBITDA attributable to well shareholders of $21 1 million in Q4 2022.

Hamed Shahbazi: I'll now provide some specific outlook on the business units. First, our Canadian clinics business, which is now overseen by Dr. Michael Frankel, our Chief Medical Officer. This division includes our primary care business and our WELL diagnostic centers, previously referred to as My Health.

Hamed Shahbazi: Overall, Canadian clinics achieved total revenue of $230 million in 2023, an increase of 27% from 2022. The fourth quarter was another record quarter for Canadian clinics with revenue increasing 31% as compared to Q4 2022, driven by healthy organic growth in our primary care clinics, as well as the acquisition of NCI Ontario clinics and our first clinic in Manitoba. For 2024, we're expecting revenues from our Canadian clinics to be over $300 million, along with strong EBITDA margins as we expand margins for the newer clinics in our network. We believe the Canadian market continues to be an enormous generational, untapped potential opportunity.

Speaker Change: Adjusted net income was 11 <unk>.

<unk> 2 million or five cents per share in Q4, 2023 as compared to adjusted net income up $12 5 million at five cents per share in Q4 2022.

Speaker Change: And just a free cash flow was $12 7 million in Q4, 2023, an increase of 23% as compared to adjusted free cash flow of $10 3 million in Q4 2022.

Speaker Change: This was mainly due to higher EBITDA generation.

Speaker Change: Net income was $33 8 million or <unk> 12 per share in Q4, 2023, an increase of 53% as compared to net income of $22 1 million or <unk> <unk> per share in Q4 2022.

Speaker Change: We calculate earnings per share based on earnings attributable to well.

Hamed Shahbazi: This is very much a land grab opportunity for the company, given its strong digital business that supports over a third of all physicians in the country, its growing brand recognition, and the structural advantages we enjoy as a large physician group in the outpatient market and the largest owner-operator of outpatient clinics across the five most populous provinces of Canada, namely Alberta, BC, Manitoba, Ontario, and Quebec. Providing multiple services, including primary care, diagnostic, allied health, specialty care, and longevity medical services.

Speaker Change: And the first quarter, well generate at 9% office revenues from truly recurring and subscription revenues and 88% of its revenues from his highly we re occurring patients services revenues.

Speaker Change: This means that approximately 97% of its revenues are highly predictable.

Well into 2023 with a solid balance sheet.

Speaker Change: At December 31, 2023, well had cash and cash equivalents of $43 million.

On January.

Speaker Change: January 26, 2024, the company refinance is syndicated credit facility with JP Morgan Chase Bank for U S 300 million consisting of our primary U S $175 million credit facility with an additional U S $125 million accordion for future growth.

Hamed Shahbazi: With 167 clinics and 98 facilities in Canada, we are the largest player, and yet we only have approximately just under 1% of all physician spending in Canada, which is a large multi-billion dollar opportunity. We believe we can grow our Canadian patient services business from $300 million in 2024 to exceed a billion dollars as a standalone revenue business in the not too distant future. And generally speaking, we don't see why we wouldn't be able to achieve up to 10% of the market share over time.

The credit facility includes two new Syndicate members bank of Montreal, and export Development Corporation, which is wholly owned by the government of Canada.

Speaker Change: And the term has been extended to January 'twenty six 'twenty 2027.

Hamed Shahbazi: Our Canadian clinics business is also generating significant profitability. In 2023, Canadian clinics' four-wall EBITDA grew by 37.8% year-over-year to approximately $33 million in adjusted EBITDA, which is roughly two-thirds of the total four-wall operating EBITDA profit in our Canadian business, which includes our SaaS and services business as well. This increase in profitability in our Canadian clinics business is proving that our business model is working. For example, in our primary care segment, where our outlook for 2024 is very strong, we are at times acquiring clinics that have low EBITDA margins. And in some cases, such as the MCI Ontario clinics and the Manitoba clinic, these clinics had negative EBITDA margins.

Speaker Change: Well continues to be in the standing and fully compliant with all covenants related with his two credit lines.

Speaker Change: P Morgan in the U S and brawl bank in Canada.

Speaker Change: The company's total bank debt increased to $297 million at the end of Q4 2023 due to cash required for the cash calf care plus acquisition.

Speaker Change: This compares to total bank debt of $293 million at the end of the prior quarter Q3 2023.

<unk> shareholder leverage ratio also increased slightly as a result of the higher bad debt levels to two seven times at the end of Q4 2023 compared to two six times in the prior quarter Q3 2023.

Hamed Shahbazi: And it will take a couple of quarters to see improved EBITDA margins. Once a new clinic is added to our network under the leadership of Jeremy Mikkelwin, our clinic transformation team extensively uses our own digital practitioner enablement platform and shared services program to modernize and digitize these clinics, which results in improved cost efficiency and operating support for physicians, along with a significant improvement in EBITDA margins. We genuinely believe our clinic transformation team and capabilities are a unique superpower of the company and are helping physicians improve their business clinic by clinic. We believe the issue of lack of digitization is existential for our primary care clinic industry in Canada.

Speaker Change: Please note that we defined leverage ratio as total bank debt less cash on hand divided by shareholder adjusted EBITDA after certain pro forma adjustments, we exclude convertible debentures from this calculation because convertible debentures are not included in our bank covenants.

Speaker Change: In terms of O share capitalization as of March 22024, well had $264 million 130019 fully dilutive securities issued in outstanding.

Speaker Change: That is my financial update and I'll turn the call back over to Hana.

Hamed Shahbazi: If a clinic doesn't digitize and relieve low-leverage work to software and workflow, it simply cannot survive given the growing cost of labor. Well, our current pipeline of new clinic opportunities is roughly 50 clinics, of which approximately a third would be actionable under our absorption model, where we have minimal acquisition costs, and the balance would be under our regular M&A program. In this pipeline, we're still seeing lower multiples and significant opportunities to acquire quality clinics at low prices, particularly in primary care. The clinic absorption model is a very unique opportunity for WELL.

Hana: Thank you Eva I'll now provide some specific outlook on the business units first our Canadian clinics business, which is now overseen by Dr. Michael Frankel, Our Chief Medical Officer. This division includes our primary care business and our well died.

Hana: Diagnostic centers previously referred to as my health.

Overall Canadian clinics achieved total revenue of $230 million in 2023, an increase of 27% from 2022 fourth quarter was another record quarter for Canadian clinics with revenue, increasing 31% as compared to Q4 2022, driven by healthy organic growth in our primary care clinics.

Hana: As well as the acquisition of NCI, Ontario clinics, and our first clinic in Manitoba.

Hana: For 2024, we're expecting revenues from our Canadian clinics to be over $300 million.

Hana: Along with strong EBITDA margins as we expand margins for the newer clinics in our network. We believe the Canadian market continues to be an enormous generational untapped potential opportunity. This is very much a land grab opportunity for the company given its strong digital business that supports over a third of all physicians in the country.

Hamed Shahbazi: Because of our national footprint, increasing brand recognition, and the strong support and value proposition that we provide our healthcare providers, doctors are seeking us out to join the WELL network and take over the operation of their clinics. Doctors are facing such significant technology challenges and administrative overhead issues that they increasingly don't want to run their own clinics and are seeking out WELL to become their operating partner. Under this absorption model, we simply take over the lease of the clinic, and the doctors join our network. There is no capital cost in most cases, and for this reason, we see absorbed clinics as merely an extension of our own recruitment efforts.

It's growing brand recognition and the structural advantages we enjoy as a large physician group in the outpatient market and the largest owner operator of outpatient clinics across the five most populous provinces of Canada, namely, Alberta, BC, Manitoba, Ontario, and Quebec, providing multiple services, including primary.

Care diagnostic Allied health specialty care and longevity medical services.

With 167 clinics in 98 facilities in Canada, we are the largest player and yet.

Hana: Only have approximately just under 1% market share of all physician spending in Canada, which is a large multibillion dollar opportunity. We believe we can grow our Canadian patient services business from $300 million in 2020 for it to exceed $1 billion as a standalone.

Hana: Revenue business in the not too distant future.

Hamed Shahbazi: Here, instead of recruiting physicians, we're recruiting entire clinics with a full roster of patient and provider relationships. We believe that our organic growth in the recruitment of absorption opportunities will continue to significantly grow in 2024. And now a few words about WELL Health Diagnostic Centers, which is essentially a rebrand of My Health Centers. WELL Health Diagnostics achieved record revenue of $111.3 million in 2023, which was entirely driven by organic growth. Revenue in the fourth quarter was a slight decline compared to Q3, which is reflective of our normal seasonality.

Hana: And generally speaking, we don't see why we wouldn't be able to achieve up to 10% of market share over time.

Hana: Our Canadian clinics business has also generated significant profitability in 2023 Canadian clinics four wall EBITDA grew by 37, 8% year over year to approximately $33 million and adjusted EBITDA, which is roughly two thirds of the total four wall operating EBITDA profit in our Canadian business.

Hana: Which includes our SaaS and services singles as well.

Hana: This increase in profitability of our Canadian clinics business is proving that our business model is working.

Hana: For example, in our primary care segment, where our outlook for 2024 is very strong where at times acquiring clinics that have low EBITDA margins and in some cases, such as NCI, Ontario clinics in the Manitoba clinic. These clinics had negative EBITDA margins and we will take a couple of quarters to see improved EBITDA margins.

Hana: Once the new clinic has added to our network under the leadership of Jeremy nickel when our clinic transformation team extensively uses our own digital practitioner enablement platform and shared services program to modernize and digitize These clinics, which results in improved cost efficiency and operating support for physicians along with this.

Hamed Shahbazi: Q4 revenue was also slightly lower than Q4 of last year. However, as with previous years' cycles, there was a regular due to COVID restrictions being lifted in 2022, which drove increased revenue towards the end of the calendar year. Notwithstanding the lower revenue, overall unique patients grew by 5% year over year for Q4 2023 versus Q4 2022. For 2024, we are expecting our diagnostic centers to achieve another year of record revenue in EBITDA. Organic growth is driven by the expansion of services and an increase in the number of health care providers, which allows us to serve more patients.

Significant improvement in EBITDA margins, we genuinely believe our clinic transformation team in Capa and capabilities are unique superpower of the company and are helping physicians improve their business clinic by clinic.

Hana: We believe the issue of lack of Digitization is existential for a primary care clinic industry in Canada.

Hana: A clinic doesn't digitize and relief low leverage work to software and workflow, it's simply cannot survive given the growing cost of labor.

Hana: Well its current pipeline of new clinic opportunity. This roughly 50 clinics of which approximately third would be actionable under our absorption model, where we have minimal acquisition cost and the balance would be under a regular M&A program.

Hamed Shahbazi: Our operating team, led by Dina Sergi, has done a fantastic job optimizing costs while the business continues to grow and gain momentum. I'm pleased to share a couple of new services also provided by WELL Health Diagnostic Centers. One, first, as of Q4 2023, we are participating in the expansion of PET scanning for prostate cancer screening. Previously, such studies were only performed in hospitals, but due to increased demand and Cancer Care Ontario guidance, this is now offered in selected integrated community health service centers such as ours. Secondly, the government of Ontario will allow women to self-refer for mammograms beginning at age 40 under the Ontario Breast Screening Program, which will begin in the fall of 2024.

Hana: In this pipeline, we're still seeing lower multiples and significant opportunities to acquire quality clinics at low prices, particularly in primary care.

Hana: The clinic construction model is a very unique opportunity for well because of our national footprint, increasing brand recognition and the strong support and value proposition that we provide our health care providers doctors are seeking us out to joined the well network and take over the operation of their clinics doctors are facing such significant technology challenges.

Hana: Administrative.

Hana: Overhead issues that theyre increasingly don't want to run their own clinics and are seeking out well to become their operating partners.

Under the subscription model, we simply take over the lease of the clinic and the doctors joined our network. There is no capital costs in most cases and for this reason, we see absorbed clinics as merely an extension of our own recruitment efforts here instead of recruiting physicians, we're recruiting entire clinics with a full roster of <unk>.

Hamed Shahbazi: Although this becomes available this year, we're already seeing a notable increase in mammograms of 11% from Q3 2023 with an intensification in awareness. We're also keeping a close eye on Ontario's Bill 60, Your Health Act, which allows out-of-hospital facilities to perform publicly funded surgeries and diagnostic procedures, including MRI and CT scans. We understand that there may be a call for new applications in the coming months, and we intend to support the diagnostic needs of the province of Ontario. We are now seeing acquisition multiples finally start to moderate and become more reasonable for specialized care and diagnostic opportunities. Given this, we're looking forward to expanding our diagnostic centers to more provinces in 2024, and we'll now discuss the outlook for our WELL Health USA business. Our WELL Health USA patient and provider services revenue was $144 million in Q4 2023, an increase of 55% as compared to $92 million in Q4 2022.

Hana: And provider relationships, we believe that our organic growth and recruitment of absorption opportunities will continue to significantly grow in 2024.

And now a few words about well health diagnostic centers, which is essentially a rebrand of my health centers well health diagnostic.

Hana: <unk> achieved record revenue of $111 3 billion in 2023, which was entirely driven by organic growth revenue in the fourth quarter was a slight decline compared to Q3, which is reflective of our normal seasonality Q4 revenue was also slightly lower than Q4 of last year as the previous year cycle are there.

The ratio was irregular due to COVID-19 restrictions being lifted in 2022, which drove increased revenue towards the end of the calendar year now.

Hana: Notwithstanding the lower revenue unique overall unique patients grew by 5% year over year for Q4 2023 versus Q4 2022.

Hana: For 2024, we are expecting our diagnostic centers to achieve another year of record revenue and EBITDA organic growth is driven by expansion of services and an increase in the number of health care providers, which allows us to serve more patients are operating team led by Dina <unk> have done a fantastic job optimizing costs, while the business that.

Hamed Shahbazi: Revenue growth over the past year was due to growth in all three of WELL Health USA's lines of business, Circle Medical, WISP, and CRA. First on CRH and RADAR, which we are now referring to as provider staff, CRH closed out another successful year in 2023. While anesthesia continues to be a mainstay for CRH, the mid-year acquisition of Care Plus Management also added the complementary recruiting and staffing business, which operates under the name of Radar Healthcare Providers. The full integration and related synergies of these businesses are now complete, and we believe this acquisition will prove to be successful for years to come. Q4 is typically CRH's strongest quarter, and this year's results were as expected. Overall, Q4 2023 revenue was up 79% versus Q4 last year, while fiscal revenue was up 50%. Specifically, CRH anesthesia revenue grew by 24% year over year in Q4 and 25% for the year, while CRH O'Regan business was flat.

Hana: <unk> continues to grow and gain momentum.

Hana: I am pleased to share a couple of new services also provided by the World Health diagnostic centers.

Hana: One first as the.

Hana: Q4, 2023, we are participating in the expansion of pet scanning for.

Hana: For prostate cancer screening previously such studies will only performed in hospitals, but due to the increased demand and the cancer care, Ontario guidance. This is now offered in selected integrated community Health service centers such as ours.

Secondly, the government of Ontario will allow women to self refer for minimal grams, beginning at age 40 under the Ontario breast screening program commencing in the fall of 2024.

Hana: Although this becomes available this year, we're already seeing a notable increase in mamograms of 11% from Q3 2023 with an intensification in awareness.

Hana: We're also keeping a close eye on Ontario's Bill 60, Your Health Act, which allows out of hospital facilities to perform publicly funded surgeries and diagnostic procedures, including MRI scans we.

Hana: We understand that there may be a call for new applications in the coming months and we intend to support the diagnostic diagnostic needs of the province of Ontario.

Hamed Shahbazi: The rest of what is now known as WELL Health USA's growth was driven by the addition of provider staff. As a reminder, provider staffing is a premier and trusted staffing and locum tenens business specializing in anesthesia. Provider staffing provides recruitment and placement services along with temporary staffing to its national network of provider groups, hospitals, and ASDs across over 30 states. Provider staffing is an important addition to the WELL USA family as its portfolio of services targeting the GI marketplace now includes three prongs. One, hemorrhoid banding with the company's O'Regan medical device, which is the U.S.'s leading band ligator device. Two, anesthesia services for routine colonoscopies.

Hana: We are now.

Hana: Acquisition multiples finally start to moderate and become more reasonable on the specialized care and diagnostic.

Hana: Opportunities.

Given this we're looking forward to expanding our diagnostic centers to more provinces in 2024.

Hana: I will now discuss the outlook for our well health U S a business.

Hana: Our well help USA patient and provider services revenue was 144 million in Q4, 2023, an increase of 55% as compared to $92 million in Q4 2022 revenue growth over the past year was due to growth in all three of well help usa's lines of business circle medical with.

Hana: And CRH.

Hana: First on CRH and radar, which we're now referring to as provider staffing.

<unk> closed out another successful year in 2023, while anesthesia continues to be a mainstay for CRH. The midyear acquisition of Kerr plus management also added the complementary recruiting and staffing business, which operates under the name of radar health care providers.

Hamed Shahbazi: And, of course, three, provider staffing solutions. We look forward to adding more services to this GI-focused service bundle. And now on to our U.S. digital patient services businesses. First, Circle Medical. Circle Medical continues to successfully execute on its direct-to-consumer patient acquisition strategy, which resulted in a record quarter. Growth accelerated in Q4 to 29.9 million, representing 32% growth compared to the same quarter the previous year, all organically driven. Patient volume grew from 422,000 to 563,000, and Circle ended 2023 with year-over-year revenue growth of 39%. Circle's fourth-quarter results also benefited from a one-time billing true-up at the end of the year for services provided in private quarters.

Hana: The full integration and related synergies of these businesses are now complete and we believe this acquisition will prove to be successful for years to come.

Hana: Q4 is typically CRH is strongest quarter and this year's results were as expected overall Q4, 2023 revenue was up 79% versus Q4 of last year.

Hana: While fiscal revenue.

Hana: <unk> was up 50%.

Hana: Specifically the CRH anesthesia revenue grew by 24% year over year in Q4, and 25% for the year, while the CRH O'bregon business was flat.

Hana: The rest of what is now known as well health Usa's growth was driven by the addition of provider staffing.

Hana: As a reminder, provider staffing as a premier and trusted staffing and locum tenants business specializing in anesthesia provider staffing provides recruitment and placement services along with temporary staffing to its national network of provider groups hospitals, and ASC are crossover 30 states.

Provider. So I think it was an important addition to the well USA family as its portfolio of services targeting the GI marketplace. Now includes three pronged one hemorrhoid banding with the company's O'bregon medical device, which is the U S is leading band like eight or device to anesthesia services for routine colonoscopy and of course.

Hamed Shahbazi: The company is increasing its investment in R&D, where it expects to double the headcount this year with technical hires in its Montreal facility being a priority. Key focuses for 2024 will be mainly related to platform upgrades, including the company's aggressive AI roadmap, which is quite exciting as Circle Medical is launching its own AI Scribe and AI-powered physician co-pilot capabilities to support its own provider network workforce of over 300 providers. Circle has also entered into a partnership with the MILA, the Quebec AI Institute, giving it access to collaborate with the Institute's 1,200 AI researchers while retaining IP. Circle has also resumed state expansion for the first time in two years.

Hana: Three provider staffing solutions, we look forward to adding more services to this Gi focused service bundle.

Hana: And now onto our U S digital patient services businesses first circle medical surgical medical continues to successfully execute on its direct to consumer patient acquisition strategy, which resulted in a record quarter growth accelerated to Q4 and 2000.

Hana: To $29 9 billion, representing 32% growth compared to the same quarter the previous year all organically driven.

Hana: Patient volume grew from 422000 to 563000 circle ended 2023 with year over year revenue growth of 39%.

Hamed Shahbazi: Since the beginning of 2024, Circle has launched virtual care in four new states, Georgia, Michigan, North Carolina, and Ohio, and is expecting to launch in additional four states by the end of Q1, bringing the total number of active states to 38. Looking ahead to 2024, Circle Medical is on track to match its previous year's revenue growth rate of over 30% year-over-year while maintaining EBIT deposits, and now a few words about WISC. I am pleased to report that WISP reported record revenue in Q4 with improved profitability. WISP also successfully completed its plan to launch 10 new products in 2023.

Hana: Circle fourth quarter results also benefited from a onetime building true up at the end of the year from services provided in prior quarters.

Hana: The company is increasing its investment in R&D, where it expects to double the head count this year with technical hires in Montreal facility being a priority.

Hana: Key focuses for 2024 will be mainly related to platform upgrades, including the Companys aggressive AI road map, which is quite exciting as circle medicals launching its own AI scribe and AI powered physician co pilot capabilities to support its own provider network.

Workforce of over 300 providers Circle has also entered into a partnership with the Mueller, Quebec, AI Institute, giving it access to collaborate with the Institute's 1200, AI researchers while retaining IP.

Hamed Shahbazi: From a cost optimization perspective, WISP has successfully renegotiated pricing with its pharmacy partners and is committed to more cost-effective nurse practitioner hiring on the provider team. We expect WISC to report record revenue again in Q1 with continued profitable growth as the business ramps up marketing spend and continues to lean into new product development with plans to launch its new fertility offering shortly. Finally, our SaaS and technology services businesses. SAS and Technology Services revenues from our Platform Solutions Group were $20.2 million in Q4 2023, a year-over-year increase of 60% as compared to $12.6 million in Q4 2022, an increase of 27% as compared to $15.9 million in the prior quarter.

Hana: Circle has also resumed.

State expansion for the first time in two years since the beginning of 2024 circles launch virtual care in four New States, Georgia, Michigan, and North Carolina, and Ohio and is expecting to launch in additional four states by the end of Q1, bringing the total number of active states 38.

Hana: Looking ahead to 2024 circle medical is on track to match its previous year's revenue growth rate of over 30% year over year, while maintaining EBITDA positive.

Speaker Change: And now a few words about west I.

Speaker Change: I am pleased to report that with report reported record revenue in Q4 with improved profitability with also successfully completed its planned to launch 10, new products in 2023.

Speaker Change: From a cost optimization perspective, with the successfully renegotiated pricing with our pharmacy partners and is committed to more cost effective nurse practitioner hiring on the provider team.

We expect with to report record revenue again in Q1 with continued profitable growth as the business ramps up marketing spend and continues to lead into new product development with plans to launch its new fertility offering shortly.

Hamed Shahbazi: The increase in revenue was due to a bounce back in our cybersecurity and data protection business in the fourth quarter, as well as organic growth in our remaining SAS and services platform business. Last year, WELL bolstered its cybersecurity portfolio with tuck-in acquisitions of SeekInto and Proact, bringing on board seasoned cybersecurity professionals in the process and strengthening our ability to serve over 190 corporate and government customers across North America. These acquisitions are performing well, and we expect cybersecurity to have an improved overall year in 2024 as compared to 2023. In 2023, we announced that OceanMD signed a $38.5 million contract with British Columbia's Public Health Service Authority to provide an array of digital services such as e-referrals, e-consults, and e-orders to help further tech-enabled providers with best-in-class digital interoper

Finally, our SaaS and technology services businesses.

Speaker Change: SaaS and technology services revenues from our platform solutions group were $20 2 million in Q4, 2023, a year over year increase of 60% as compared to $12 6 billion in Q4 2022.

Speaker Change: An increase of 27% as compared to $15 9 million in the prior quarter Q3 2023.

Speaker Change: The increase in revenue was due to a bounce back in our cyber security and data protection business in the fourth quarter as well as organic growth in our remaining SaaS and services platform business.

Last year, well bolstered its cyber security portfolio with tuck in acquisitions of seek into and proactive bringing onboard season cyber security professionals in the process and strengthening our ability to serve over 190, corporate and government customers across North America. These.

Speaker Change: These acquisitions are performing well and we expect cyber security to have an improved overall year in 2024 as compared to 2023.

Hamed Shahbazi: Thus far, our implementation in BC has been proceeding as planned, and I'm pleased to announce that GoLives is expected in the first half of 2024, at which time we will also start to receive high-margin license revenue from this relationship. OceanMD is already the dominant e-referral solution in the province of Ontario. In Q2 2023, we announced OceanMD went live across Nova Scotia.

In 2023, we announced that <unk> signed a $38 $5 million contract with British Columbia's public Health service authority to provide an array of digital services such as E. Referrals E. Consult any orders to help further tech enable providers with best in class digital up interoperability choice thus far.

Hamed Shahbazi: And with the recent win in B.C., we feel OceanMD has the potential to become the e-referral standard across the country. OceanMD is a key component of WELL's platform and is emerging as a leader in patient engagement for e-referral solutions. Ocean's e-referral software allows primary care providers to send their requests to specialists through the Ocean e-referral network instead of faxing, emailing, or mailing them, which makes surgical consult referrals easier and reduces wait times for patients.

Speaker Change: Our implementation in BC has been proceeding as planned.

Speaker Change: And I am pleased to announce that go lives is expected in the first half of 2024 at which time. We will also start to receive high margin license revenue from this relationship.

Speaker Change: Ocean M. D is already the dominant E referral solution in the province of Ontario in Q2, 2023, we announced and Ocean M. D went live in <unk>.

Speaker Change: Cross, Nova Scotia, and with the recent win in D. C. We feel ocean MD has the potential to become the E referral standard across the country.

Hamed Shahbazi: We're pleased to report that Ocean delivered more than 876,000 e-referrals in 2023. And a couple weeks ago, we announced that, thus far in the year, we're at 1.2 million e-referrals in the last 12 months, demonstrating already significant growth and acceleration over the past year. This is a real achievement, and we're very proud of the Ocean team for making this a positive impact on the Canadian healthcare ecosystem. In 2023, we launched WELL AI Voice, which has been a big hit with healthcare providers because of its ability to cut down on administrative time and increase patient engagement, giving physicians time back in their day. The adoption metrics of WELL AI Voice are testament to the value created for physicians. WELL AI Voice seamlessly integrated into 131,000 patient consultations in 2023, reclaiming time for clinicians that was previously lost to administrative tasks while enriching patient care quality.

Speaker Change: Ocean MD is a key component of wealth platform and is emerging as a leader in patient engagement and referral solutions oceans that your referral software allows primary care providers to send their request the specialists through the ocean you referral network instead of faxing, emailing or mailing, which makes surgical coastal.

Speaker Change: Referrals easier and reduces wait times for patients.

Speaker Change: We're pleased to report that ocean delivered more than 876000 referrals in 2023, and a couple of weeks ago, we announced that thus far in the year. We're at $1 2 million you referrals in the last 12 months, demonstrating already significant growth and acceleration over the past year.

Speaker Change: This is a real achievement and we're very proud of the ocean team for making this a positive impact in the Canadian health care ecosystem.

In 2023, we launched well AI voice, which has been a big hit with health care providers because of its ability to cut down on administrative time and increase patient engagement, giving physicians tied back into the day the adoption metrics of well AI voice are testament to the value created for physician.

Speaker Change: Well AI voice has seamlessly integrated into 131000 patient consultations in 2023 reclaiming time for clinicians that was previously lost to administrative tasks, while enriching patient care quality well AI voice has been successfully rolled out to over 25, well known clinics.

Hamed Shahbazi: WELL AI Voice has been successfully rolled out to over 25 well-known clinics. Our continued expansion of WELL AI Voice within our own clinic network demonstrates our dedication to leveraging our AI capabilities to also benefit WELL physicians, as well as our broader clinic network. Overall, our technology platform services group continues to perform with the rollout of AI-based tools and achieving record sales in Q4. Lastly, our platform solutions group, which is now led by our CEO Amir Javidan, formed a dedicated public sector group to support large-scale health systems and care delivery networks that underpin the public sector. The objective of this group is to combine and deliver product offerings that are specifically suited to the public sector's unique scale and requirements.

Speaker Change: Our continued expansion of <unk> voice within our own clinic network demonstrates our dedication to leveraging our AI capabilities to also benefit well physicians as well as our broader clinic network.

Overall, our technology platform services group continues to perform with the rollout of AI based tools and achieving record sales in Q4.

Speaker Change: Lastly, our platform solutions group, which is under the leadership now under the leadership of our COO mirrors evidence formed a dedicated public sector group to support large scale health systems and care delivery networks that underpin the public sector.

Speaker Change: The objective of this group is to combine and deliver product offerings that are specifically suited for public sector unique scale and requirements.

Hamed Shahbazi: If you'd like to learn more about this, please visit our new dedicated public sector website at wellhealth.solutions, that's wellhealth.solutions as the URL. Now, I'd like to provide some commentary on our partnership with Heal Well AI. As you may remember, on October 1st, we completed the transaction with MCI One Health, whereby WELL acquired the clinical assets from MCI, and the remaining business of MCI was recapitalized and launched as Heal Well AI, a company focused on AI and data science for preventative care. WELL is currently the largest shareholder of Heal Well with an option that would give WELL a control position in Heal Well as defined on an IFRS WELL currently holds 22.7 million shares of Heal Well, thereby representing 20.8% of the issued and outstanding voting securities of Heal Well.

Speaker Change: You'd like to learn more about this please visit our new dedicated public sector website at well health Dot solutions.

Speaker Change: That's well health Dot solutions as the U R L.

Speaker Change: And now I'd like to provide some commentary on our partnership with <unk> AI as you May remember on October 1st we completed the transaction with NCI, one health, whereby well acquired the clinical assets from Mci and the remaining businesses NCI was recapitalized and lunch as heal well AI.

Speaker Change: Company focus on AI and data science for preventative care.

While it is currently the largest shareholder of heal well with an option that would give well they control position in heal well as defined on an ifr's financial reporting basis, well currently holds $22 7 million shares of uol, thereby representing 28% of the issued and outstanding voting securities of <unk>.

Speaker Change: L.

Hamed Shahbazi: WELL's Health Call Auction gives WELL the right to acquire up to an additional approximately 30 million Class A subordinate voting shares and the same number of Class B multiple voting shares of the company. If WELL exercises this option, it will have well over 40% ownership on an as-converted basis. We're extremely happy with the progress that the Heal Well team has made in such a short period of time. Since its launch, Heal Well has raised approximately $29.5 million in convertible debt and equity funding, completed two acquisitions of Pentavir and IntraHealth, and made one minority investment in. More recently, you may have seen the announcement that I've taken on the chairman role at Heal Well. I took on this role because the boards of both WELL and Heal Well felt that there was strong alignment between WELL and Heal Well.

Speaker Change: <unk> call option.

Speaker Change: Well the right to acquire up to an additional approximately 30 million class a subordinate voting shares and the same number of class b multiple voting shares of the company if well exercises its option well, we'll have well over 40% ownership on on an as converted basis.

Speaker Change: We're extremely happy with the progress that <unk> team has made in such a short period of time since its launch Hill, well has raised approximately $29 $5 million in convertible debt and equity funding completed two acquisitions of pent of your niche health made one minority investment in Doctor Lee.

Speaker Change: More recently you may have seen the announcement that I've taken on the chairman role at Stilwell I took on this role because the boards of both well and heal well felt that there is strong alignment between well and heal well.

Hamed Shahbazi: I believe my appointment is also strategically very important for shareholders of both Heal Well and Well, given the shared objective between the companies to create the most advanced and easy to use AI-inspired tools that can equip care providers with various co-pilots that can help them improve the diagnosis of rare and chronic diseases, improve the efficiency of their practice, and improve patient health outcomes. WELL has also entered into a strategic alliance agreement with Heal Well that has enabled us to launch WELL AI decision support to our network of clinics and doctors. Given that some patients who have chronic or complex care needs may have hundreds or even thousands of pages of clinical notes, it's unrealistic for physicians to be expected to have a dynamic understanding of all patients' charts and detailed requirements.

Speaker Change: I believe my appointment is also strategically very important for shareholders of both heal well and well given the shared objective between the companies to create the most advanced and easy to use AI inspired tools that can be quick.

Speaker Change: Care providers with various co pilots that can help them improve diagnosis of rare and chronic diseases improve efficiency of their practice and improve patient health outcomes.

Speaker Change: <unk> has also entered into a strategic alliance agreement with <unk> that enabled us to launch well AI decision support to our network of clinics and doctors.

Speaker Change: Given that some patients who have chronic or complex care needs may have hundreds or even thousands of pages of clinical notes. It's unrealistic for physicians to be expected to have a dynamic understanding of all patients charts and detailed requirements as such we expect that over time decision support will support physicians in.

Hamed Shahbazi: As such, we expect that over time, decision support will support physicians in numerous ways. More recently, KeeL Well announced that it has signed a services agreement with both WELL Health USA and our U.S.-based subsidiary Circle Medical, which expands its footprint in the United States and will enable U.S. healthcare providers with a suite of AI-powered preventative care solutions. Keele Well's Pentavir division has partnered with Well Health USA's CRH Medical to access anonymous U.S. healthcare data to gain insights into supporting patients who are dealing with inflammatory bowel disease and other GI conditions.

Speaker Change: Numerous ways.

Speaker Change: More recently <unk> announced that it has signed a services agreement with both well health USA and our U S based subsidiary Circle medical which expands its footprint in the United States and will enable U S health care providers with a suite of AI powered preventative care solutions.

Speaker Change: Hill will pinch of your division has partnered with well health USA CRH medical to access anonymous U S health care data to gain insights and supporting patients who are dealing with inflammatory bowel disease and other Gi conditions.

Hamed Shahbazi: Through the agreement, Pentavir's Darwin AI platform will analyze over 200,000 US patients in a secure and compliant manner across 21 states to understand the real world dynamics between biological prescribing and treatment outcomes. Meanwhile, Heal Well's Cure Health will integrate its proprietary AI platform with Circle Medical's electronic medical record system, expanding its footprint to over 30 U.S. states. Cures AI will screen for and flag individual patients with whom the healthcare practitioner might consider future investigation for potential earlier diagnosis of rare diseases.

Speaker Change: Through the agreement Penta viewers Darwin AI platform will annualize over 200000 U S patients and a secure and compliant manner across 21 states to understand the real world dynamics between biological prescribing and treatment outcomes.

Speaker Change: Meanwhile, feel wellcare health will integrate its proprietary AI platform with circle Medicals electronic medical record system, expanding its footprint to over 30 U S States.

Speaker Change: Curious AI screen will screen for and flag for individual patients with whom the health care practitioner might consider.

Speaker Change: For future investigation for potential earlier diagnosis of rare disease.

Hamed Shahbazi: We believe Keele Well can be one of the most consequential AI healthcare companies in the country and also with global appeal given its partnership with Well and given the technology it has already acquired and developed. Keele Well's ability to unlock insights from data that inform the creation of AI-powered physician co-pilots will be very key moving forward in an industry that badly needs to support its care providers better. Before we take questions, I'd like to provide some additional color on our Q1 2024 expectations. Despite our bullish annual outlook for 2024, we're expecting some normal seasonal weakness in the first quarter. Q1 has typically been the weakest quarter for CRH and its anesthesia business due to payer mix shifts and the renewal of patient deductibles coinciding with year-end.

Speaker Change: We believe kill well can be one of the most consequential AI health care companies in the country and also with global appeal, given its partnership with well and given the technology. It has already acquired and developed.

Speaker Change: Here well its ability to unlock insights from data that.

Speaker Change: That informed the accretion to <unk>.

Speaker Change: AI powered physician co pilots will be very key moving forward in an industry that badly needs to support its care providers Center.

Speaker Change: Before we take questions I'd like to provide some additional color on our Q1 2024 expect expectations. Despite our bullish annual look for 2024, we're expecting some normal seasonal weakness in the first quarter Q1 has typically been the weakest quarter for CRH and its the anesthesia business do.

Speaker Change: Two payer mix shifts.

Speaker Change: And the renewal of patient deductibles coincides with year end.

Hamed Shahbazi: We're also expecting Circle Medical revenues to decrease from Q4 2023 to Q1 2024 as there were some one-time items in Circle Medical's Q4 results that won't be repeated in Q1. In addition, our cybersecurity revenues can be lumpy, and our strong results in the SaaS and technology business aren't likely to be repeated in Q1. In terms of our adjusted EBITDA, due to the seasonal and one-time revenue factors in Q4 2023, we expect our Q1 adjusted EBITDA will not reach the same level as Q4 2023. Furthermore, the positive results from our cost optimization and staff restructuring efforts won't begin to materialize until the second quarter.

Speaker Change: We're also expecting circle medical revenues to decrease from Q4, 2023, Q1 2024 as there were some onetime items in Q and circle Medicals Q4 results that won't be repeated in Q1 in.

Speaker Change: In addition, our cyber security revenues can be lumpy and our strong results in the SaaS and technology business arent likely to be repeated in Q1.

Speaker Change: In terms of our adjusted EBITDA due to the seasonal and onetime revenue factors in Q4 2023, we expect our Q1 adjusted EBITDA will not reach the same level as Q4 2023. Furthermore of the positive results from our cost optimization and staff restructuring efforts won't begin to materialize until the second.

Quarter due.

Hamed Shahbazi: Due to these factors, we expect a sequential decline in our adjusted EBITDA from Q4 2023 to Q1 2024. Nonetheless, we're expecting continued revenue and EBITDA growth in Q2 and into the back half of 2024. In summary, we are very pleased with our financial performance in 2023 and look forward to delivering strong results again in 2024. Our outlook remains very positive, and hence I'm confident in our upgraded annual guidance. We have many tailwinds driving growth in the business, and we have a committed and disciplined team to ensure we can deliver on our objectives. Finally, I want to thank you all for joining us on this call and thank our shareholders and investors for their continued support. The capital markets have been very supportive of our vision and have provided us with the funding needed to pursue our goals.

Speaker Change: Due to these factors, we expect a sequential decline in our adjusted EBITDA from Q4 2023 to Q1 2024. Nonetheless, we're expecting continued revenue and EBITDA growth in Q2 and into the back half of 2024.

Speaker Change: In summary, we are very pleased with our financial performance in 2023 and look forward to delivering strong results again in 2024, our outlook remains very positive and so I'm confident in our upgraded annual guidance, we have many tailwind driving growth in the business and we have a committed and disciplined team to ensure we can deliver on our objectives.

Speaker Change: Finally, I want to thank you all for joining us on this call and thank our shareholders and investors for their continued support the capital markets have been very supportive of our vision and it provided us with the funding needed to pursue our goals I would also like to thank wells senior management team and all our employees and contractors for their tremendous.

Hamed Shahbazi: I would also like to thank WELL's senior management team and all our employees and contractors for their tremendous effort and for creating a strong and inclusive culture that has helped us be recently independently certified as a great place to work by the Great Place to Work Institute of Canada. This is a fully independent process, and as such, certification is a reflection of the company's strong commitment to creating a positive and progressive workplace culture. As usual, I would also like to thank our team of healthcare providers and frontline workers who provide unbelievable patient care every single day. They remind us why we're here, and we're here to support them.

Speaker Change: Separate and for creating a strong an inclusive culture that has helped us be recently independently certified as a great place to work by the great place to work Institute of Canada.

Speaker Change: This is a fully independent process and as such.

Speaker Change: Certification is a reflection of the company's strong commitment to creating positive and progressive workplace culture.

Speaker Change: As per usual I would also like to thank our team of health care providers and frontline workers, who provide unbelievable patient care every single day, they remind us why we're here and we're here to support them.

Hamed Shahbazi: And with that, we'd be very pleased to take some questions. Operator, Thank you, and ladies and gentlemen, we will now begin the question and answer session. Should you have a question, please press the star followed by the number one on your telephone keypad. Should you wish to decline from the following process, please press the star followed by the number one.

Speaker Change: And with that we'd be very pleased to take some questions operator.

Speaker Change: Thank you and ladies and gentlemen, he will now begin the question and answer session should you have a question. Please press star followed by the number one I Gotta telephone keypad should you wish to declines on the fallen process. Please press the star followed by the number Q1 moment. Please for your first question.

Operator: One moment, please for your first question. Your first question comes from the line of Christian Sgro from 8 Capital. Christian Sgro's line: Hi, good afternoon, and thanks for taking my questions. The first one is Alaska's on the margin profile, which we just touched on.

Your first question comes from the line of questions to go from eight capital. Your line is open.

Speaker Change: Hi, good afternoon, and thanks for taking my questions.

Speaker Change: The first one on the Oscars on the margin profile, which we just touched on and within the clinical absorption programs one in Canada.

Hamed Shahbazi: And within the clinical absorption program, so in Canada, what's the average timeline to get operations and margins to the segment average? And maybe you can use MCI clinics and the Manitoba clinic as an example of how it's progressing and where you normally see everything optimized within these acquired clinics. Thanks for your question, Christian.

Questioning Analyst: What's the average timeline to get operations and margins to the segment average and maybe accuse Mci clinics in the amount of global clinic as an example of how that's progressing and cleaner and we see you know everything optimized within these acquired clinics.

Speaker Change: I think thanks for your question Christian really we have a couple of different phases typically.

Hamed Shahbazi: Really, we typically have a couple of different phases. Typically, when we identify an absorption clinic or if we acquire a clinic that has lower EBITDA margins, typically, we believe that within the first 100 days, we can make our sort of first order of improvements. And so we see an improvement right away, just given what we know about where these clinics should be operating, even without a lot of tech digitization. Then, really, our clinic transformation efforts start to get deployed, and that can take several months.

You know we typically.

Speaker Change: When we when we identify an absorption clinic or.

Speaker Change: Or if we acquire a clinic that has lower EBITDA margins typically we believe that within the first 100 days, we can make our sort of first order of improvements.

Speaker Change: And so we see an improvement right away.

Speaker Change: Given what we know about.

Speaker Change: Where were these clinics should be operating even without a lot of tech digitization.

Speaker Change: Then really our clinic transformation efforts start to get deployed.

Deployed and that can take several months. So I would say are really a couple of quarters before we start to see the second order of improvements.

Hamed Shahbazi: So I would say, really, a couple of quarters before we start to see the second order of improvements. And then we really start to refine and integrate other forms of care and drive additional synergies, which gets into sort of the year two area. The thing to really think about is, when we buy clinics, or when we absorb clinics, we really look at one key factor, and that is wages as a percentage of total revenue. You know, a well optimized and digitized clinic operates with less than 10% of total revenue attributable to wages.

And then really we start to then refine and integrate other forms of care and driving additional synergies which gets into.

Speaker Change: Just to sort of the year or two area.

Speaker Change: The thing to really think about is when we buy clinics.

Speaker Change: Or when we absorbed clinics, we really look at one key factor and that is the wages.

Speaker Change: As a percentage of total revenue.

Speaker Change: Well optimized and digitize clinic operates less than 10% of total revenue attributable to wages and we regularly encounter clinics that have over 20% and this is what we like to see this is where we know we can make a difference and we you know.

Hamed Shahbazi: And we regularly encounter clinics that have over 20%. Hopefully, that provides some perspective. That's all helpful, Hamed.

Speaker Change: For example, RBC clinics most of them are 8% now so they're there they're operating extremely well.

Speaker Change: And it does typically take one to two years to get right down to that 8%, but we will.

Hamed Shahbazi: I'll ask a second question on margins as well. But first, congrats on the guidance for the revenue side and for providing some points of guidance both for 2024 and Q1. So is it fair to say that margins will increase quarter by quarter through the year? Is that the way we should think of the cadence of improvement to that goal? Or is there any other seasonality that you'd flag or have us think about?

Speaker Change: Make several points of percentage points of progress within the first few months alone hopefully that provides some perspective.

Speaker Change: That's a far Oklahoma I'll ask a second question on margins as well and first congrats on the guidance for you on the revenue side and providing some points of guidance for <unk>.

Speaker Change: 2024, and the Q1.

Speaker Change: So is it fair to say that margins will.

Speaker Change: Increase corner by corner excuse me here is that the way, we should think of the cadence of improvement to that goal or is there any other seasonality.

Speaker Change: Flag or how to think about.

Hamed Shahbazi: Well, as you know, seasonality has existed in our business for a long time. This is just the way that the payer and deductible dynamics work in our largest division, you know, in terms of EBITDA generation and that CRH. So this is fairly predictable seasonality.

Speaker Change: Well as you know seasonality is existed with our business for a long time. This is just the way that the payer deductible dynamics work in our largest division Ah.

Speaker Change: In terms of EBITDA generation, and that's and that CRH.

Speaker Change: So this is this is this this is fairly predictable seasonality.

Hamed Shahbazi: As far as, you know, the rest of the business, we just implemented a cost optimization program. So we'll certainly start to see that impact Q2. But, you know, we've been very strong in terms of meeting our guidance, and we have a lot of confidence in the 125 to 130 million. Note that that, you know, essentially results in about a 15% increase in absolute EBITDA generation from 8% last year. So that's pretty meaningful. And that demonstrates acceleration in EBITDA generation, which I think is really an important goal for the company. Thanks very much for taking my questions, and I'll pass the line. Thank you, Christian. Your next question comes from the line of Doug Taylor from Canaccord Genuity. Your line is open. Yeah, thank you. Good morning or good afternoon.

As far as the.

Speaker Change: The rest of the business you know, we we just implemented a cost optimization program. So we will certainly start to see that impact Q2.

Speaker Change: But you know we've been very strong in terms of meeting our guidance and we have a lot of confidence in the $125 million to $130 million note that that.

Speaker Change: Essentially results in about 15% increase in absolute EBITDA generation.

From 8% last year.

Speaker Change: So that's pretty meaningful and that demonstrates acceleration in EBITDA generation.

Speaker Change: Which I think is really an important goal for the company.

Speaker Change: That's helpful. Thanks, very much for taking my questions and I'll pass the line.

Speaker Change: Thank you Christian.

Speaker Change: Your next question comes from the line of Doug Taylor from Canaccord Genuity. Your line is open.

Douglas Taylor: Yeah. Thank you good morning, or good afternoon.

Hamed Shahbazi: I also will echo Christian's congratulations on the top line growth momentum and follow up with another question on margins. I think you've articulated what the margin profile should look like this year. The overall midpoint of your margin guidance for the year would suggest a level, percentage-wise, equal to Q4. And so I guess my question is, as we look out to when you've got the current clinic portfolio fully optimized, what do you see as the margin potential, EBITDA margin potential for the business as a whole, or when should we expect to see the benefits from the scale that you're building within your various operations? Yeah, no, thanks for that question, Doug.

Douglas Taylor: I also will echo questions. Congratulations on the top line growth momentum and follow up with another question on margins.

Douglas Taylor: I think you've articulated what the margin profile should look like this year the overall.

Douglas Taylor: Midpoint of your margin guidance for the year would suggest.

The level of percentage wise equal to Q4, and so I guess my question is you know as we look out to when you've got the current clinic portfolio fully optimize what you see as the.

Douglas Taylor: The margin potential EBITDA margin potential for the business as a whole or when we should expect to see the benefits from the scale that.

Douglas Taylor: You're building within your various operations.

Speaker Change: Yeah no. Thanks for that question, Doug I mean, generally speaking I think we've been able to demonstrate that in the primary care side of things. We can we can drive these margins well into double digits.

Hamed Shahbazi: I mean, generally speaking, I think we've been able to demonstrate that on the primary care side of things, we can, you know, drive these margins well into double digits. So, 10 to 15%, and some of the best performers can go up above 20%. And our specialized care program, you know, they're durably over 20%. So, really, margins over time are going to be more reflective of the different cohorts and how mature they are in the network. And so, you know, if we were to stop adding new clinics, obviously, that margin profile overall on a blended basis would grow, you know, you know, pretty significantly over time. But, you know, it's our expectation that we will continue to add new clinics and that there'll be a mix of immature.

Speaker Change: So the 10% to 15% and some of the best performers can go up above 20% and our specialized care program.

Speaker Change: They're they're durably over 20%.

Speaker Change: So so really then margins over time are going to be more reflective of the different cohorts and how mature they are in the network and so if we were to stop adding new clinics.

Speaker Change: Obviously that margin profile overall on a blended basis would grow.

Speaker Change: You know pretty significantly over time, but you know, it's our expectation that we will continue to add.

Speaker Change: New clinics, and and that there'll be a mix of immature and mature cohorts, which will which will kind of land us in the kind of a blended.

Hamed Shahbazi: And mature cohorts, which will kind of land us in the kind of, you know, you know, blended margins that we have today. And I think that will continue for a while. And, you know, we're really trying to elevate and scale up our clinic transformation business because we think that's really the key, as I mentioned in my script, that's the superpower of the company. That's something that you don't really see anyone else in the country have.

Speaker Change: Blended margins that we have today and I think that will continue for a while.

Speaker Change: And you know, we're really trying to elevate and scale up our clinic transformation.

Speaker Change: Business, because we think that's really the key as I mentioned in my script you know that's the superpower of the company. That's something that you don't really see anyone else in the country have and so.

Hamed Shahbazi: And so as we scale that up, we'll be able to take on more clinics, and we'll be able to basically digitize and modernize faster, which means that we'll be able to also open the spigot and take in more clinics and just given the opportunity that we have to acquire very cheap assets and digitally transform them. I mean, we're creating a cornerstone asset here for the Canadian ecosystem that is really unparalleled. So we're very, very excited about that. We understand that. There There may be hope of optimizing margins in the near term, and certainly some of our operations will do that. But, you know. For us, it's really important to continue to bring in some of those more immature cohorts and continue to evolve the journey overall. Okay, thank you.

Speaker Change: As we scale that up we'll be able to take on more clinics that we'll be able to basically digitize and modernize faster, which means that we'll be able to also open the spigot and taken more clinics.

Speaker Change: And just given the opportunity that we have to.

Speaker Change: To acquire very cheap assets, and and and and and digitally transform them I mean, we're creating a cornerstone asset here for the Canadian.

Ecosystem that is really unparalleled. So we're very very excited about that we understand that there may be a.

Speaker Change: Our hope of <unk>.

Speaker Change: Optimizing margins.

In the near term and certainly some of our operations, we will do that but.

Speaker Change: No.

Speaker Change: For us, it's really important to us to continue to bring some of those more immature cohorts and continue to evolve the journey overall.

Hamed Shahbazi: A second question for me. You mentioned the prospect of potentially achieving 10% market share within the Canadian market over time, which is, as you say, cornerstone and unprecedented. Is there anything regulatory-wise, you think? I mean, given that we haven't seen that kind of concentration within primary care in Canada before, do you see any hurdles to that kind of objective? We really don't.

Speaker Change: Okay. Thank you a second question for me.

Speaker Change: You mentioned the prospect of potentially.

Speaker Change: Potentially achieving 10% market share within the Canadian market over time, which is as you say a cornerstone in an unprecedented is there anything regulatory wise you think I mean, given that we haven't seen that kind of concentration within primary care in Canada before.

Speaker Change: Do you see any hurdles to that kind of objective.

Speaker Change: We really don't and we're frankly being cheered on by public health because you know we've been very careful to not be disruptive to public health interest and requirements. So this is why even though we're very innovative we don't really call ourselves disruptive to the market because.

Hamed Shahbazi: And we're frankly being cheered on by public health because, you know, we've been very careful not to be disruptive to public health interests and requirements. So this is why, even though we're very innovative, we don't really call ourselves disruptive to the market because we're really supporting the single payer system. We obviously have our private care systems and clinics as well. But, you know, I think what's really important here is that doctors need support. And I think the public health and public sectors are increasingly realizing that physicians don't want to run clinics. They do want to partner and have an operating partner that provides professional management like WELL. So, no, we don't know of any such issues.

Speaker Change: We're really supporting the single payer system, we obviously have our private care systems.

Speaker Change: Systems in clinics as well, but.

Speaker Change: I think what's really important here is it doctors need to support and I think increasingly public health and public sectors realizing that.

Speaker Change: <unk> don't want to run clinics, they do want to partner and and have an operating partner that provides professional management like well. So no. We don't know of any any such issues and of course, 10% is a long way from where we are today that would imply you know more than a $3 billion Canadian Clint.

Hamed Shahbazi: And, of course, 10% is a long way from where we are today. That would imply, you know, more than a $3 billion Canadian clinic business by itself, which, again, we think is very possible, just not only in terms of the market dynamics but because of the need. You know, we are, you know, we're a G7 country with a $330 billion healthcare ecosystem growing every year at a pretty good clip. But, you know, we've never really focused on creativity.

Speaker Change: Business by itself, which again, we think it's very possible just just not only in terms of the market dynamics, but because of the need.

Speaker Change: We are we were G seven country with a 330 billion health care ecosystem growing every year at a pretty good clip and.

Speaker Change: We've never really focused on creating networks.

Hamed Shahbazi: We've never really focused on creating networks, you know, pan-Canadian national networks across the country. So, I do think it's possible. I think WELL is the company that's way out in front and can do it. And, you know, we are very much partnered with public health, as you can also see. They're engaging with us in terms of our digital platform. So, we're not seeing any friction there.

Pan Canadian National networks in the country. So I do think it's possible I think wells the company this way out in front and can do it.

Speaker Change: And we are very much partner with public health as you can also see there they are engaging with us.

In terms of our digital platform. So we're not seeing any friction there and were really strategically focused on being a front of public sector.

Hamed Shahbazi: And, you know, we're really strategically focused on being a front for the public sector. I appreciate your perspective there. I'll pass the line.

Speaker Change: I appreciate your perspective, there I'll pass one.

Hamed Shahbazi: Thank you. Your next question comes from the line of William Wood from Re-Re-Reilly. Your line is, Yes, thank you for that. And congratulations on the year and thank you for taking on questions. So we're just curious, have a couple of questions on the guidance. The guidance was obviously raised from $900 million to $950 million to $970 million. Just curious how much of this increase is organic and is there a particular segment you see outperforming prior estimates, or is it across the board? And maybe how should we look at organic versus non-organic growth across the three segments? Yeah, so this is primarily organic. We actually haven't really even factored inorganic growth as part of this.

Speaker Change: Thank you. Your next question comes from the line of William <unk> from B Riley.

William: Your line is open.

William: Hi, yes, thank you for that and congratulations on the year and thank you for taking our questions. So we're just curious.

William: Couple of questions on the guidance the guidance was raised obviously from 900 to 952.

William: $970 million just curious on how much of this increase is organic and is there a particular segment you see outperforming prior estimates or is it across the board and maybe how should we look at organic versus nonorganic growth across the three segments.

Speaker Change: Yeah. So so this is primarily organic.

Speaker Change: We actually haven't really even factored.

Speaker Change: Inorganic growth as part of this so you know.

Hamed Shahbazi: So, you know, I think you're going to see fairly normal growth in our US Patient Services Division, CIRCLE, and WISC. And, as I mentioned in my script, and as far as CRH is concerned, the anesthesia business has sort of lower single-digit growth, but our new provider staffing business has, you know, good, strong organic growth. So I think we're going to see, you know, good growth there. And then, of course, our Canadian clinics business, you know, from going from 230 to well over $300 million this year, that's pretty substantial. So, you know, as I mentioned in my script, there's sort of continued tailwinds and performance in terms of extrapolating what happened in 2023. We expect, all that we really expect to be happening is the Canadian business gaining momentum, probably a bit more than before. It's pretty clear that there's just no one like WELL in Canada.

I think youre going to see fairly normal CRO scores growth in our U S patient services division circled with so that.

Speaker Change: There were.

Speaker Change: You know that as I mentioned in my script.

And as far as CRH is concerned the anesthesia business has sort of lower single digit growth but are.

Speaker Change: Our news provider staffing business has good strong organic growth. So I think we're going to see.

Speaker Change: Good growth there and then of course, our Canadian clinics business.

Speaker Change: Uh huh.

Speaker Change: From going from 230.

Speaker Change: Oh, well over $300 million this year, that's pretty substantial.

Speaker Change: So you know as I mentioned in my script, there is sort of you know <unk>.

Speaker Change: <unk> continued tailwind in performance.

Speaker Change: In terms of extrapolating what happened in 2023 week, we expect all of it we really expect it to be happening is the Canadian business, gaining momentum probably more than before it's pretty clear that there's just no one like well in Canada.

Hamed Shahbazi: And I think it's safe to say that we are pretty dominant in this market, and the market really needs us. We know there is a healthcare crisis.

Speaker Change: And I think it is safe to say that we are pretty dominant in this market and the market really needs us we know theres a health care crisis, we know that providers are struggling and and they're seeking technology support from us and operating support from us. So I really do think that.

Hamed Shahbazi: We know that providers are struggling, and they're seeking technology support from us and operating support from us. So I really do think that, you know, we have something special in terms of being able to support those providers. And it's really important for us to do that. Excellent, thank you.

Speaker Change: We have something special in terms of being able to to support those providers and it's really important to us to do that.

Speaker Change: Excellent. Thank you and then for your for your M&A activity, you mentioned or the.

Hamed Shahbazi: And then for your M&A activity, you mentioned or you expect that along with sort of capital allocation might be coming down a little bit in 2024. But what are you looking for as far as the amount of M&A targeting in fiscal year 24? And then how will you maybe divide that? Will it mostly be acquiring new clinics or acquiring new services? Yeah, great question.

Speaker Change: You expect that along with sort of capital allocation might be might be coming down a little bit in 2024, but.

Speaker Change: What are you looking for for as far as the amount of M&A targeting and fiscal year 'twenty four and then how are you maybe how would that be divided will mostly be acquiring new clinics or acquiring new services.

Speaker Change: Yeah, Great question, Yes, we definitely.

Hamed Shahbazi: Yes, we definitely, you know, given the step up in organic growth, we just don't need to buy our growth as much as before. And so, you know, gearing up and really tooling up for that organic growth is really key for us. Our M&A, and as I mentioned, we will continue to do some M&A, and we will fund that ourselves through cash flow. I think a lot of that will be in Canadian clinics. And I think some of that you'll see in, as we've done before in a kind of normal course with WELL USA and CRH. So those are probably the two areas. I don't see us going out and buying, you know, a lot of digital assets right now. Those assets tend to be more expensive.

Speaker Change: Given the step up in organic growth, we just don't need to buy our growth as much as before and so you know.

Speaker Change: So gearing up in and really tooling up for that for that organic growth is really key for us.

Speaker Change: Our M&A and as I mentioned, we will continue to do some M&A.

Speaker Change: And we will fund that ourselves through cash flow I think a lot of that will be in Canadian clinics, and I think some of that you'll see and it is as we've done before and kind of normal course with well USA in CRH. So those are probably the two areas I don't I don't see us going out and buying.

Speaker Change: A lot of digital assets right now those those assets tend to be more expensive and we don't really need to buy them anymore. We have an incredible.

Hamed Shahbazi: And we don't really need to buy them anymore. We have an incredible technology team and platform team that's developing fundamental technology and partnering with great companies, you know, externally as well. So, this is evidenced by all the innovation that you're seeing at the company. So, you know, there was a time when we needed to build out those capabilities. We don't really anymore.

Speaker Change: Technology team and platform team Thats, developing fundamental technology and partnering with with great companies.

Certainly as well.

Speaker Change: So as evidenced by all the innovation that you're seeing at the company. So.

There was a time when we needed to build out those capabilities, we don't really anymore.

Speaker Change: Yeah.

Hamed Shahbazi: Okay, that's helpful. And then lastly, on sort of the circle and or WISP, you mentioned that there might, could include a sale of one or both assets. You know, are you thinking, you know, is there a potential to retain some of the ownership so much, you know, closer to a partnership, or are you thinking more, or like a full spin-out, or are you thinking actually much more of a sale for these assets? I mean, we're looking at all of those options.

Speaker Change: Okay.

Speaker Change: That's helpful.

Speaker Change: And then lastly on sort of the.

Speaker Change: The circle and or wish you'd.

Speaker Change: You'd mentioned that there there might you could include a sale of one of those assets.

Speaker Change: Are you thinking.

Speaker Change: Is there a potential to retain some of the ownership so much closer to a partnership or are you thinking more or like a full spin out or are you thinking actually much more of a sale for these assets.

Speaker Change: I mean, we're looking at all of those options.

Hamed Shahbazi: You know, obviously, when you write these agreements, you include as many options as you can because you don't know what the environment is going to be like years downstream. And so, you know, I think we did a great job when we wrote these agreements because we have a lot of options. We have the right to take them public. We also have the right to call the balance of the shares. We could bring in, you know, private equity to take on the minority components that we don't own, or we could engineer a full sale.

Speaker Change: You know obviously when you write these agreements you you included many options that you can take because you don't know what the environment is going to be like you know years downstream and so you know I think we did a great job. When we wrote these agreements because we have a lot of options. We have the right to take them public we have the right to call the balance of the shares.

Speaker Change: We could bring in private equity to take on the minority components that we don't own or we could or we could engineer a wholesale and I think all of those options are on the table.

Hamed Shahbazi: And I think, you know, all of those options are on the table. I think I was just pointing out that to the extent that, you know, one or both of them does result in a full sale, we would be intentional about returning some of that value to shareholders through a reduction in debt and possibly through a pretty aggressive buyback. And so, you know, that's a developing story, and I think we'll see some real action this year.

Speaker Change: You know.

Speaker Change: I think I was just pointing out that to the extent that.

Speaker Change: One of one or both of them.

Speaker Change: It does result in a full sale, we would be intentional about rich.

Speaker Change: Turning some of that value to shareholders through reduction in debt and possibly through a pretty aggressive buyback and so.

That's a developing story that I think we'll see some real action this year.

Hamed Shahbazi: So, you know, stay tuned for that. That's why I wanted to include that at the front end of my script. Got it.

Speaker Change: So stay tuned on that that's why I wanted to include that at the front end of my script.

Speaker Change: Got it I appreciate that extra color and thank you again for taking our questions.

Operator: I appreciate that extra color, and thank you again for taking our questions. Of course. Thank you. Your next question comes from the line of David Kwan from TD Securities. Your line is, Good morning.

Speaker Change: Of course.

Speaker Change: Thank you. Your next question comes from the line of David Kwan from TD Securities. Your line is open.

David Kwan: Good morning.

Hamed Shahbazi: I appreciate the color on the clinics, Hamed, in terms of the margins and where you think they could go. I know when you guys initially rolled out WELL AI Voice initially, I think the initial tests you talked about, I think some doctors had somewhere around 30% or maybe north of 30% time savings. Does AED have an updated number in terms of the cost saving or the time savings that these doctors are finding? And how do you see the potential margin impact as you deploy more of these AI-based solutions in your clinics? Where could margins end up going? Yeah, it's a great question, Dave. I mean, I'll just give you some color.

David Kwan: I appreciate the color on the clinics on it in terms of the margins and where they do you think they could go I know when you guys had rolled out.

Well AI voice initially I think initial test you talked about I think some doctors, having somewhere around 30% or maybe north of 70% time savings.

David Kwan: Do you have an updated.

David Kwan: Number.

David Kwan: In terms of the cost savings and time savings that destock or finding and.

David Kwan: How do you see the margin potential margin impact as you deploy more of these.

David Kwan: Technology AI based solutions in your clinics, where margins end up going to.

Yeah, It's a great question, Dave I mean, I'll just give you some color what we're finding is that.

Hamed Shahbazi: What we're finding is that for each consult, particularly in primary care, physicians are getting about three and a half minutes back. So consider the fact that, you know, a physician that sort of meets and slightly exceeds that median income for a physician needs to see about 40 patients. So that's more than two hours returned per day.

Speaker Change: For each consultants, particularly in primary care physicians are getting about three and a half minutes back.

Speaker Change: So consider the fact that you know a physician that debt.

Speaker Change: There.

Speaker Change: Sort of meat and slightly exceeds that median income for physician needs to see about 40 patients a day.

Speaker Change: So that's more than two hours returned per day now.

Hamed Shahbazi: Now, physicians can use that time to see more patients. You know, that extra time that they've received back, they can improve their quality of life. They can feel better about their business.

Speaker Change: This is Ken can use that time.

To see more patients.

Speaker Change: That extra time that they've received back they can they can improve their quality of life. They can they can feel better about their business. So it doesn't always necessarily come back into margins unless physicians want to take on more of a load.

Hamed Shahbazi: So it doesn't necessarily necessarily come back into margins unless physicians want to take on more of a load. But we are definitely seeing that it is helping our physicians. We're seeing that it is alleviating their workload and improving their administrative burden, and we do believe that it is resulting in improved patient visits. It's probably too early for us to be able to say, hey, this is the main reason. Because there's a lot that we do to support physicians. And it is a very different experience for them when they own and operate their own clinic versus being in a WELL clinic.

Speaker Change: But we are definitely seeing that it is helping our physicians, where we're seeing that that it is alleviating.

Speaker Change: Their workloads and improving their administrative burden and we do believe that it is resulting in improved patient visits it's probably too early for us to be able to say.

Speaker Change: Say hey. This is this is the main reason because there's a lot that we do to support physicians and it is a very different experience for them when they own their own and operate their own clinics versus being in the world clinic and I think with time, we'll be able to better draw conclusions to margins, but the ability to be able to you know.

Hamed Shahbazi: And I think with time, we'll be able to better draw conclusions about the margins. But this ability to be able to, you know, with clarity and specificity say that we return, you know, hours a day to a physician is really remarkable. I mean, I don't know if there's been anything for a very long time that has been as influential and helpful in terms of returning, you know, time back to them. No, that's helpful.

Speaker Change: With clarity and and.

Speaker Change: And and and and specificity save that we return you know hours a day. So a physician is really remarkable I mean, I I don't know if there's been anything for a very long time that has been as.

Speaker Change: Influential and helpful in terms of returning.

Speaker Change: The time back to them.

Speaker Change: No that's helpful. Thanks Tommy.

Hamed Shahbazi: Thanks, Hamed. And then just on the U.S. business, there was that cyber attack on change healthcare. Curious to get a sense of if you saw any impact on your business. I'd assume at the very least that there was, it'd be on the collections front, but I want to get your take on that.

Speaker Change: Then just on the U S business.

Speaker Change: David is that the cyber attack on change healthcare curious to get a sense of if you saw any impact on your business I would assume at the very least otherwise it would be on the collections front, but I wanted to get your take on that.

Hamed Shahbazi: Yes, absolutely. It's a historic attack on the largest healthcare company in the world, which is UnitedHealthcare and Change. And Change, of course, is a very large healthcare payments clearinghouse. So it's affected a significant number, I'd say a good majority of healthcare companies in the U.S. And for us, the only slowdown and the impact that we would feel, and this is more temporary, is just the rate at which we receive cash from the clearinghouse. Now, Change and United are also in the process of standing up a kind of cash framework solution to help support folks who need to be able to receive that cash until their systems are back up and running.

David Kwan: Yes, absolutely. So it's a historic attack on on the largest health care company in the World, which is Unitedhealthcare and change and change of course is a it's a very large health care payments clearinghouse. So it's affected a significant number I'd say a good majority of health care.

Companies in the U S and for US you know the only slowdown.

Slow down debt and the impact that we would feel and this is more temporary it's just the rate at which we received cash from the clearinghouse now.

David Kwan: Now changes and United have also in the process of standing up a.

David Kwan: A a a kind of a cash framework solution to help support folks who.

David Kwan: Need to be able to receive that cash until their systems are back up and running. So this is all pretty manageable and I.

Hamed Shahbazi: So, this is all pretty manageable, and I think Change is doing a pretty good job recovering and supporting people in the industry. But, for sure, those first few days and weeks were quite challenging for the industry.

Change is doing a pretty good job recovering in supporting people in the industry, but for sure you know those first few days and weeks, where we're quite a quite challenging in the industry, but I think you know we're sort of moving in the right direction and we don't expect any material impact from this.

Hamed Shahbazi: But I think we're sort of moving in the right direction, and we don't expect any material impact from this to affect us well. That's great. Thanks. Excuse me, ladies and gentlemen, this ends our Q&A portion for today's call. I would like to turn it back to Mr. Hamed Shahbazi for closing comments.

David Kwan: To affect well.

Speaker Change: That's great. Thanks.

Speaker Change: And accuse me, ladies and gentleman. This ends our Q&A portion for today's call I would like to turn it back to Mr. How much your basi for closing comments.

Hamed Shahbazi: I'd like to thank everyone today for joining and for the great questions from the analysts. We look forward to meeting with you after Q1, and we appreciate all your support. Thank you, presenters, and ladies and gentlemen, this concludes today's conference call. Thank you for participating in this webinar. Thank you. Thank you for watching!

Howie Basi: I'd like to thank everyone today for joining in for the great questions from the analysts we look forward to meeting with you after Q1 and and we appreciate all your support.

Speaker Change: Thank you presenters, ladies and gentlemen. This concludes today's conference call. Thank you for participating you may now disconnect.

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