Q4 2026 InnovAge Holding Corp Earnings Call
Speaker #1: After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you'll need to press *11 on your telephone.
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Speaker #1: And now I'd like to introduce your host for today's program, Ryan Kubota, Director of Investor Relations. Please go ahead.
Speaker #2: Thank you, operator. Good afternoon, and thank you all for joining the InnovAge Q4 2026 and fiscal year-end earnings call. With me today is Patrick Blair, CEO.
Ryan Kubota: Thank you, operator. Good afternoon, and thank you all for joining the InnovAge 2026 Q4 and fiscal year-end earnings call. With me today is Patrick Blair, CEO, and Ben Adams, CFO. Jen Browne, President and COO, will also be joining the Q&A portion of the call. Today, after the market closed, we issued an earnings press release containing detailed information on our 2026 fiscal Q4 and year-end results. You may access the release on the investor relations section of our company website, innovage.com. For those listening to the rebroadcast of this call, we remind you that the remarks made herein are as of today, Tuesday, 8 September 2026, and have not been updated subsequent to this call. During our call, we will refer to certain non-GAAP measures.
Ryan Kubota: Thank you, operator. Good afternoon, and thank you all for joining the InnovAge 2026 Q4 and fiscal year-end earnings call. With me today is Patrick Blair, CEO, and Ben Adams, CFO. Jen Browne, President and COO, will also be joining the Q&A portion of the call. Today, after the market closed, we issued an earnings press release containing detailed information on our 2026 fiscal Q4 and year-end results. You may access the release on the investor relations section of our company website, innovage.com. For those listening to the rebroadcast of this call, we remind you that the remarks made herein are as of today, Tuesday, 8 September 2026, and have not been updated subsequent to this call. During our call, we will refer to certain non-GAAP measures.
Speaker #2: Ben Adams, CFO; Jen Brown, President and COO, will also be joining the Q&A portion of the call. Today, after the market closed, we issued an earnings press release containing detailed information on our fiscal fourth quarter and year-end 2026 results.
Speaker #2: You may access the release on the Investor Relations section of our company website, innovage.com. For those listening to the rebroadcast of this call, we remind you that the remarks made herein are as of today, Tuesday, September 8, 2026, and have not been updated subsequent to this call.
Speaker #2: During our call, we will refer to certain non-GAAP measures. A reconciliation of these measures to the most directly comparable GAAP measures can be found in our earnings press release posted on our website.
Ryan Kubota: A reconciliation of these measures to the most directly comparable GAAP measures can be found in our earnings press release posted on our website. We may also make statements that are considered forward-looking, including those related to our 2027 fiscal year projections and guidance, future growth prospects and growth strategy, our clinical and operational value initiatives, the impact of ongoing macroeconomic, geopolitical and industry-related challenges, reductions in PACE reimbursement rates and changes in risk adjustment methodologies, legal proceedings, enforcement actions and litigation and disputes, including civil investigative demands and other expectations. Listeners are cautioned that all of our forward-looking statements involve certain assumptions that are inherently subject to risks and uncertainties that can cause our actual results to differ materially from our current expectations.
Ryan Kubota: A reconciliation of these measures to the most directly comparable GAAP measures can be found in our earnings press release posted on our website. We may also make statements that are considered forward-looking, including those related to our 2027 fiscal year projections and guidance, future growth prospects and growth strategy, our clinical and operational value initiatives, the impact of ongoing macroeconomic, geopolitical and industry-related challenges, reductions in PACE reimbursement rates and changes in risk adjustment methodologies, legal proceedings, enforcement actions and litigation and disputes, including civil investigative demands and other expectations. Listeners are cautioned that all of our forward-looking statements involve certain assumptions that are inherently subject to risks and uncertainties that can cause our actual results to differ materially from our current expectations.
Speaker #2: We may also make statements that are considered forward-looking, including those related to our 2027 fiscal year projections and guidance, future growth prospects and growth strategy, our clinical and operational value initiatives, the impact of ongoing macroeconomic, geopolitical, and industry-related challenges, reductions in payor reimbursement rates and changes in risk adjustment methodologies, legal proceedings, enforcement actions and litigation and disputes, including civil investigative demands, and other expectations.
Speaker #2: Listeners are cautioned that all of our forward-looking statements involve certain assumptions that are inherently subject to risks and uncertainties that can cause our actual results to differ materially from our current expectations.
Speaker #2: We advise listeners to review the risk factors discussed in our annual report on Form 10-K for fiscal year 2026 and any subsequent reports filed with the SEC.
Ryan Kubota: We advise listeners to review the risk factors discussed in our annual report on Form 10-K for fiscal year 2026, and any subsequent reports filed with the SEC. After the completion of our prepared remarks, we will open the call for questions. I will now turn the call over to our CEO, Patrick Blair. Patrick?
Ryan Kubota: We advise listeners to review the risk factors discussed in our annual report on Form 10-K for fiscal year 2026, and any subsequent reports filed with the SEC. After the completion of our prepared remarks, we will open the call for questions. I will now turn the call over to our CEO, Patrick Blair. Patrick?
Speaker #2: After the completion of our prepared remarks, we will open the call for questions. I will now turn the call over to our CEO, Patrick Blair.
Speaker #2: Patrick?
Patrick Blair: Thank you, Ryan, and good afternoon, everyone. I would like to begin by thanking our InnovAge colleagues, our participants and their families, our government partners, and our shareholders for their continued trust and support. As we close fiscal 2026 and begin fiscal 2027, I want to spend a little more time than usual today putting our results and our outlook into a broader context. Fiscal 2026 was an exceptional year for InnovAge and a key milestone in the transformation of the company. We entered the year with clear objectives: deliver high-quality care for our participants, grow census, continue strengthening the operating foundation of the business, maintain a strong culture of compliance, and translate the investments we have made over the last several years into improved financial performance. We delivered against those objectives.
Patrick Blair: Thank you, Ryan, and good afternoon, everyone. I would like to begin by thanking our InnovAge colleagues, our participants and their families, our government partners, and our shareholders for their continued trust and support. As we close fiscal 2026 and begin fiscal 2027, I want to spend a little more time than usual today putting our results and our outlook into a broader context. Fiscal 2026 was an exceptional year for InnovAge and a key milestone in the transformation of the company. We entered the year with clear objectives: deliver high-quality care for our participants, grow census, continue strengthening the operating foundation of the business, maintain a strong culture of compliance, and translate the investments we have made over the last several years into improved financial performance. We delivered against those objectives.
Speaker #3: Thank you, Ryan. And good afternoon, everyone. I'd like to begin by thanking our InnovAge colleagues, our participants and their families, our government partners, and our shareholders for their continued trust and support.
Speaker #3: As we close fiscal 2026 and begin fiscal 2027, I want to spend a little more time than usual today putting our results and our outlook into a broader context.
Speaker #3: Fiscal 2026 was an exceptional year for InnovAge and a key milestone in the transformation of the company. We entered the year with clear objectives, delivered high-quality care for our participants, grew census, continued strengthening the operating foundation of the business, maintained a strong culture of compliance, and translated the investments we've made over the last several years into improved financial performance.
Speaker #3: We delivered against those objectives. Adjusted EBITDA increased approximately 175% compared with fiscal 2025, and we believe we are ahead of schedule to achieve our 10-plus percent long-term adjusted EBITDA margin target.
Patrick Blair: Adjusted EBITDA increased approximately 175% compared with fiscal 2025, and we believe we are ahead of schedule to achieve our 10-plus percent long-term adjusted EBITDA margin target. Importantly, we would have generated strong net income for the year, which was ultimately impacted by one-time legal accruals. The rate environment also developed somewhat more favorably than we anticipated during the year, which contributed to our performance. The larger story of fiscal 2026 is the continued improvement and growing durability in the underlying business. We are operating with stronger leadership, better technology and data, and substantially more discipline around how we manage medical costs, operating costs, and performance. I have said for some time that the best measure for the health of our company is when employee engagement, participant satisfaction, quality outcomes, census growth, and financial performance, our five pillars, all improve together.
Patrick Blair: Adjusted EBITDA increased approximately 175% compared with fiscal 2025, and we believe we are ahead of schedule to achieve our 10-plus percent long-term adjusted EBITDA margin target. Importantly, we would have generated strong net income for the year, which was ultimately impacted by one-time legal accruals. The rate environment also developed somewhat more favorably than we anticipated during the year, which contributed to our performance. The larger story of fiscal 2026 is the continued improvement and growing durability in the underlying business. We are operating with stronger leadership, better technology and data, and substantially more discipline around how we manage medical costs, operating costs, and performance. I have said for some time that the best measure for the health of our company is when employee engagement, participant satisfaction, quality outcomes, census growth, and financial performance, our five pillars, all improve together.
Speaker #3: Importantly, we would have generated strong net income for the year, which was ultimately impacted by one-time legal accruals. The rate environment also developed somewhat more favorably than we anticipated during the year, which contributed to our performance.
Speaker #3: But the larger story of fiscal 2026 is the continued improvement and growing durability in the underlying business. We're operating with stronger leadership, better technology and data, and substantially more discipline around how we manage medical costs, operating costs, and performance.
Speaker #3: I've said for some time that the best measure for the health of our company is when employee engagement, participant satisfaction, quality outcomes, census growth, and financial performance—our five pillars—all improve together.
Speaker #3: We believe they can in fiscal 2026, and that provides evidence of that. I'm incredibly proud of what our team accomplished, but I'm even more focused on what the progress of the last several years now enables us to achieve.
Patrick Blair: We believe they can, and fiscal 2026 provides evidence of that. I am incredibly proud of what our team accomplished, but I am even more focused on what the progress of the last several years now enables us to achieve. Internally, we have begun describing the evolution of the company in three chapters. InnovAge 1.0 was about building the platform. The organization transitioned from its not-for-profit roots to become a for-profit, and ultimately a publicly traded company. We expanded geographically, opened and acquired centers, invested significant capital, and established a national PACE platform capable of serving thousands of seniors. InnovAge 2.0 was about strengthening that platform. It began during a difficult period for the company when operational compliance needed to be strengthened.
Patrick Blair: We believe they can, and fiscal 2026 provides evidence of that. I am incredibly proud of what our team accomplished, but I am even more focused on what the progress of the last several years now enables us to achieve. Internally, we have begun describing the evolution of the company in three chapters. InnovAge 1.0 was about building the platform. The organization transitioned from its not-for-profit roots to become a for-profit, and ultimately a publicly traded company. We expanded geographically, opened and acquired centers, invested significant capital, and established a national PACE platform capable of serving thousands of seniors. InnovAge 2.0 was about strengthening that platform. It began during a difficult period for the company when operational compliance needed to be strengthened.
Speaker #3: Internally, we have begun describing the evolution of the company in three chapters. InnovAge 1.0 was about building the platform. The organization transitioned from its not-for-profit roots to become a for-profit, and ultimately a publicly traded company.
Speaker #3: We expanded geographically, opened and acquired centers, invested significant capital, and established a national PACE platform capable of serving thousands of seniors. InnovAge 2.0 was about strengthening that platform.
Speaker #3: It began during a difficult period for the company, when operational compliance needed to be strengthened. Over the last four years, we have worked to address those issues: executed operational improvement opportunities, improved relationships with our regulatory partners, strengthened clinical and operational leadership, implemented a payor-specific Epic EMR across the enterprise, standardized processes, invested in our people and infrastructure, and developed substantially greater visibility into the performance of the business.
Patrick Blair: Over the last four years, we have worked to address those issues, executed operational improvement opportunities, improved relationships with our regulatory partners, strengthened clinical and operational leadership, implemented a PACE-specific Epic EMR across the enterprise, standardized processes, invested in our people and infrastructure, and developed substantially greater visibility into the performance of the business. At the same time, we returned to growth and significantly improved our financial performance. Much of that progress occurred faster and created more value in a shorter period than we anticipated when we began the work. We are now entering what we think of as InnovAge 3.0. If 1.0 was about building the platform and 2.0 was about strengthening it, 3.0 is about scaling its capabilities and capitalizing on the opportunity in front of us.
Patrick Blair: Over the last four years, we have worked to address those issues, executed operational improvement opportunities, improved relationships with our regulatory partners, strengthened clinical and operational leadership, implemented a PACE-specific Epic EMR across the enterprise, standardized processes, invested in our people and infrastructure, and developed substantially greater visibility into the performance of the business. At the same time, we returned to growth and significantly improved our financial performance. Much of that progress occurred faster and created more value in a shorter period than we anticipated when we began the work. We are now entering what we think of as InnovAge 3.0. If 1.0 was about building the platform and 2.0 was about strengthening it, 3.0 is about scaling its capabilities and capitalizing on the opportunity in front of us.
Speaker #3: At the same time, we returned to growth and significantly improved our financial performance. Much of that progress occurred faster and created more value in a shorter period than we anticipated when we began the work.
Speaker #3: We're now entering what we think of as InnovAge 3.0. If 1.0 was about building the platform, and 2.0 was about strengthening it, then 3.0 is about scaling its capabilities and capitalizing on the opportunity in front of us.
Speaker #3: Our objective is to build an increasingly sophisticated, value-based care platform capable of serving meaningfully more seniors, while delivering strong, sustainable performance that allows us to reinvest in the business and earn an appropriate return.
Patrick Blair: Our objective is to build an increasingly sophisticated value-based care platform capable of serving meaningfully more seniors while delivering strong, sustainable performance that allows us to reinvest in the business and earn an appropriate return. This starts with our core PACE business. There remains considerable opportunity to grow census within our existing footprint, expand the capacity of our centers, and diversify the channels through which eligible seniors learn about and access PACE. 3.0 also means looking across a longer time horizon. We are strengthening our capabilities as both a payer and a provider so that we can better manage quality, total cost of care, and participant outcomes. We are investing in technology and AI to improve clinical decision-making, productivity, and the participant experience. We are evaluating opportunities to increase the physical and operating capacity of our existing centers.
Patrick Blair: Our objective is to build an increasingly sophisticated value-based care platform capable of serving meaningfully more seniors while delivering strong, sustainable performance that allows us to reinvest in the business and earn an appropriate return. This starts with our core PACE business. There remains considerable opportunity to grow census within our existing footprint, expand the capacity of our centers, and diversify the channels through which eligible seniors learn about and access PACE. 3.0 also means looking across a longer time horizon. We are strengthening our capabilities as both a payer and a provider so that we can better manage quality, total cost of care, and participant outcomes. We are investing in technology and AI to improve clinical decision-making, productivity, and the participant experience. We are evaluating opportunities to increase the physical and operating capacity of our existing centers.
Speaker #3: This starts with our core PACE business. There remains considerable opportunity to grow census within our existing footprint, expand the capacity of our centers, and diversify the channels through which eligible seniors learn about and access PACE.
Speaker #3: But 3.0 also means looking across a longer time horizon. We're strengthening our capabilities as both a payer and a provider so that we can better manage quality, total cost of care, and participant outcomes.
Speaker #3: We're investing in technology and AI to improve clinical decision-making, productivity, and the participant experience. We're evaluating opportunities to increase the physical and operating capacity of our existing centers.
Speaker #3: We're beginning to more actively evaluate de novo markets, M&A opportunities, joint ventures, and other partnership models that could expand our reach over time. And we intend to remain energetically engaged with policymakers as they consider ways to expand PACE, and potentially apply some of the capabilities of the model more broadly.
Patrick Blair: We are beginning to more actively evaluate de novo markets, M&A opportunities, joint ventures, and other partnership models that could expand our reach over time. We intend to remain energetically engaged with policymakers as they consider ways to expand PACE and potentially apply some of the capabilities of the model more broadly. Not every opportunity we evaluate will become part of our strategy, and we will continue to be disciplined about where we invest our time and capital. What has changed is our ability to look further ahead at a broader set of opportunities while continuing to execute within the core business. There is an essential point I want to emphasize as we talk about this next chapter. Our ambitions for InnovAge 3.0 do not change the foundation on which we operate.
Patrick Blair: We are beginning to more actively evaluate de novo markets, M&A opportunities, joint ventures, and other partnership models that could expand our reach over time. We intend to remain energetically engaged with policymakers as they consider ways to expand PACE and potentially apply some of the capabilities of the model more broadly. Not every opportunity we evaluate will become part of our strategy, and we will continue to be disciplined about where we invest our time and capital. What has changed is our ability to look further ahead at a broader set of opportunities while continuing to execute within the core business. There is an essential point I want to emphasize as we talk about this next chapter. Our ambitions for InnovAge 3.0 do not change the foundation on which we operate.
Speaker #3: Not every opportunity we evaluate will become part of our strategy, and we will continue to be disciplined about where we invest our time and capital.
Speaker #3: What has changed is our ability to look further ahead at a broader set of opportunities, while continuing to execute within the core business. There's an essential point I want to emphasize as we talk about this next chapter.
Speaker #3: Our ambitions for InnovAge 3.0 do not change the foundation on which we operate. Quality of care and compliance remain non-negotiable. PACE participants are among the most medically and socially complex individuals in the healthcare system.
Patrick Blair: Quality of care and compliance remain non-negotiable. PACE participants are among the most medically and socially complex individuals in the healthcare system. Our participants, their families, CMS, and other state partners place extraordinary trust in us. We take this responsibility very seriously. The lessons of the last several years are deeply embedded in how we operate the company today. As we grow, we intend to continue investing in operations and clinical leadership, compliance infrastructure, data and monitoring, and the systems necessary to identify risk and variation earlier. We will not compromise those standards. An important part of preparing for this next chapter was strengthening the operating leadership of the company. Earlier this summer, Jen Browne joined us as President and Chief Operating Officer. Jen brings significant experience leading complex multi-site healthcare and value-based care organizations, including senior leadership roles at Optum and Stride Health.
Patrick Blair: Quality of care and compliance remain non-negotiable. PACE participants are among the most medically and socially complex individuals in the healthcare system. Our participants, their families, CMS, and other state partners place extraordinary trust in us. We take this responsibility very seriously. The lessons of the last several years are deeply embedded in how we operate the company today. As we grow, we intend to continue investing in operations and clinical leadership, compliance infrastructure, data and monitoring, and the systems necessary to identify risk and variation earlier. We will not compromise those standards. An important part of preparing for this next chapter was strengthening the operating leadership of the company. Earlier this summer, Jen Browne joined us as President and Chief Operating Officer. Jen brings significant experience leading complex multi-site healthcare and value-based care organizations, including senior leadership roles at Optum and Stride Health.
Speaker #3: Our participants, their families, CMS, and other state partners place extraordinary trust in us. We take this responsibility very seriously. The lessons of the last several years are deeply embedded in how we operate the company today.
Speaker #3: As we grow, we intend to continue investing in operations and clinical leadership, compliance infrastructure, data and monitoring, and the systems necessary to identify risk and variation earlier.
Speaker #3: We will not compromise those standards. An important part of preparing for this next chapter was strengthening the operating leadership of the company. Earlier this summer, Jen Brown joined us as President and Chief Operating Officer.
Speaker #3: Jen brings significant experience leading complex, multi-site healthcare and value-based care organizations, including senior leadership roles at Optum and Strive Health. She has experience across clinical operations, quality, growth, and performance improvement, and understands what it takes to build scalable operating systems.
Patrick Blair: She has experience across clinical operations, quality, growth, and performance improvement, and understands what it takes to build scalable operating systems. Although Gin has only been with us for a few months, she has moved quickly to understand our centers, our people, our opportunities, and the areas where we can continue to improve. Her addition gives us significantly greater leadership capacity at precisely the time we are asking the organization to take another step forward. Her immediate priorities include driving greater consistency across centers, strengthening center-level accountability, improving our use of Epic across the entire interdisciplinary care team, improving the participant experience, and building the operating and analytical capabilities necessary to support our next phase of growth. There are several investments underway in fiscal 2027 that illustrate how we are thinking about InnovAge 3.0. Let us start with participant experience.
Patrick Blair: She has experience across clinical operations, quality, growth, and performance improvement, and understands what it takes to build scalable operating systems. Although Gin has only been with us for a few months, she has moved quickly to understand our centers, our people, our opportunities, and the areas where we can continue to improve. Her addition gives us significantly greater leadership capacity at precisely the time we are asking the organization to take another step forward. Her immediate priorities include driving greater consistency across centers, strengthening center-level accountability, improving our use of Epic across the entire interdisciplinary care team, improving the participant experience, and building the operating and analytical capabilities necessary to support our next phase of growth. There are several investments underway in fiscal 2027 that illustrate how we are thinking about InnovAge 3.0. Let us start with participant experience.
Speaker #3: Although Jen has only been with us for a few months, she has moved quickly to understand our centers, our people, our opportunities, and the areas where we can continue to improve.
Speaker #3: Her addition gives us significantly greater leadership capacity at precisely the time we're asking the organization to take another step forward. Her immediate priorities include driving greater consistency across centers, strengthening center-level accountability, improving our use of Epic across the entire interdisciplinary care team, improving the participant experience, and building the operating and analytical capabilities necessary to support our next phase of growth.
Speaker #3: There are several investments underway in fiscal 2027 that illustrate how we're thinking about InnovAge 3.0. Let's start with participant experience. We're investing in a more connected participant experience across the entire journey, including how participants and families communicate with us, receive information, schedule care, and understand what to expect.
Patrick Blair: We are investing in a more connected participant experience across the entire journey, including how participants and families communicate with us, receive information, schedule care, and understand what to expect. Our Participant 360 and Voice of the Customer initiatives, along with investments in omni-channel communication technology, enhanced integration of inbound calls, scheduling, and transportation, are aimed at creating a more consistent and seamless experience across our centers. Next, our technology and data infrastructure. Over the last few years, we have made substantial investments in systems including Epic, Oracle, and Salesforce. The opportunity is to make those systems work more effectively together and make the information they contain more useful to the people delivering care. At the center of the PACE model is the interdisciplinary care team. These teams continuously evaluate participants and identify opportunities for small, proactive interventions that can prevent much larger clinical events.
Patrick Blair: We are investing in a more connected participant experience across the entire journey, including how participants and families communicate with us, receive information, schedule care, and understand what to expect. Our Participant 360 and Voice of the Customer initiatives, along with investments in omni-channel communication technology, enhanced integration of inbound calls, scheduling, and transportation, are aimed at creating a more consistent and seamless experience across our centers. Next, our technology and data infrastructure. Over the last few years, we have made substantial investments in systems including Epic, Oracle, and Salesforce. The opportunity is to make those systems work more effectively together and make the information they contain more useful to the people delivering care. At the center of the PACE model is the interdisciplinary care team. These teams continuously evaluate participants and identify opportunities for small, proactive interventions that can prevent much larger clinical events.
Speaker #3: Our participant 360 and Voice of the Customer initiatives, along with investments in omnichannel communication technology, enhanced integration of inbound calls, scheduling, and transportation, are aimed at creating a more consistent and seamless experience across our centers.
Speaker #3: Next, our technology and data infrastructure. Over the last few years, we've made substantial investments in systems including Epic, Oracle, and Salesforce. The opportunity is to make those systems work more effectively together and to make the information they contain more useful to the people delivering care.
Speaker #3: At the center of the PACE model is the interdisciplinary care team. These teams continuously evaluate participants and identify opportunities for small, proactive interventions that can prevent much larger clinical events.
Speaker #3: We have an opportunity to surface better information and insights directly into their workflows, so our teams can make more informed decisions earlier. We also have an opportunity to get significantly more value from Epic.
Patrick Blair: We have an opportunity to surface better information and insights directly into their workflows so our teams can make more informed decisions earlier. We also have an opportunity to get significantly more value from Epic. During fiscal 2027, we are working to expand its standardized scheduling, visit types, and documentation across interdisciplinary teams. This should give us greater visibility into capacity, productivity, and care delivery patterns while also strengthening clinical and compliance oversight. The third area is artificial intelligence. We are approaching AI pragmatically and with discipline, with appropriate human oversight and accountability built into how these tools are developed, tested, and used. Every use case must answer a basic question. Can it help us improve care, improve the participant experience, reduce administrative burden, or help operate our centers more efficiently? If it can, we test it, we measure it, and if the results justify it, we scale it.
Patrick Blair: We have an opportunity to surface better information and insights directly into their workflows so our teams can make more informed decisions earlier. We also have an opportunity to get significantly more value from Epic. During fiscal 2027, we are working to expand its standardized scheduling, visit types, and documentation across interdisciplinary teams. This should give us greater visibility into capacity, productivity, and care delivery patterns while also strengthening clinical and compliance oversight. The third area is artificial intelligence. We are approaching AI pragmatically and with discipline, with appropriate human oversight and accountability built into how these tools are developed, tested, and used. Every use case must answer a basic question. Can it help us improve care, improve the participant experience, reduce administrative burden, or help operate our centers more efficiently? If it can, we test it, we measure it, and if the results justify it, we scale it.
Speaker #3: During fiscal 2027, we're working to expand and standardize scheduling, visit types, and documentation across interdisciplinary teams. This should give us greater visibility into capacity, productivity, and care delivery patterns, while also strengthening clinical and compliance oversight.
Speaker #3: The third area is artificial intelligence. We're approaching AI pragmatically and with discipline, with appropriate human oversight and accountability built into how these tools are developed, tested, and used.
Speaker #3: Every use case must answer a basic question: Can it help us improve care, improve the participant experience, reduce administrative burden, or help operate our centers more efficiently?
Speaker #3: If it can, we test it. We measure it. And if the results justify it, we scale it. We're particularly encouraged about the potential for AI-enabled physician decision support.
Patrick Blair: We are particularly encouraged about the potential for AI-enabled physician decision support. We recently completed pilots of two capabilities designed to give our clinicians better information and insights directly within their existing workflows while keeping clinical judgment and decision-making firmly with the provider. The first is an AI-enabled consultation agent designed specifically around the complexities of frailty in geriatric care. It is intended to provide our primary care physicians with on-demand clinical information and specialist-level perspectives to inform their evaluation of a participant. In our pilot, the tool helped physicians manage a broader range of clinical needs within the interdisciplinary care team, and was associated with fewer external specialist referrals. We also piloted a medication optimization agent that reviews a participant's medication regimen in the context of their broader clinical information and surfaces potential opportunities for medication and dosing optimization for the clinician to consider.
Patrick Blair: We are particularly encouraged about the potential for AI-enabled physician decision support. We recently completed pilots of two capabilities designed to give our clinicians better information and insights directly within their existing workflows while keeping clinical judgment and decision-making firmly with the provider. The first is an AI-enabled consultation agent designed specifically around the complexities of frailty in geriatric care. It is intended to provide our primary care physicians with on-demand clinical information and specialist-level perspectives to inform their evaluation of a participant. In our pilot, the tool helped physicians manage a broader range of clinical needs within the interdisciplinary care team, and was associated with fewer external specialist referrals. We also piloted a medication optimization agent that reviews a participant's medication regimen in the context of their broader clinical information and surfaces potential opportunities for medication and dosing optimization for the clinician to consider.
Speaker #3: We recently completed pilots of two capabilities designed to give our clinicians better information and insights directly within their existing workflows, while keeping clinical judgment and decision-making firmly with the provider.
Speaker #3: The first is an AI-enabled consultation agent designed specifically around the complexities of frailty and geriatric care. It is intended to provide our primary care physicians with on-demand clinical information and specialist-level perspectives to inform their evaluation of a participant.
Speaker #3: In our pilot, the tool helped physicians manage a broader range of clinical needs within the interdisciplinary care team, and was associated with fewer external specialist referrals.
Speaker #3: We also piloted a medication optimization agent that reviews a participant's medication regimen in the context of their broader clinical information and surfaces potential opportunities for medication and dosing optimization for the clinician to consider.
Speaker #3: Both pilots demonstrated the concepts in a controlled environment, and we are now beginning to scale these capabilities more broadly across the organization. It's still too early to quantify their impact on quality, utilization, or economics, but we're encouraged by what we've seen to date.
Patrick Blair: Both pilots demonstrated the concepts in a controlled environment, and we are now beginning to scale these capabilities more broadly across the organization. It is still too early to quantify their impact on quality, utilization, or economics, but we are encouraged by what we have seen to date. We also have several additional AI use cases in development that we expect to pilot over time. Scheduling and transportation are other good examples. Transportation is fundamental to PACE and extraordinarily complex operationally. We coordinate thousands of trips for participants with different clinical needs across large geographic areas while simultaneously coordinating center schedules, outside medical appointments, and care team capacity.
Patrick Blair: Both pilots demonstrated the concepts in a controlled environment, and we are now beginning to scale these capabilities more broadly across the organization. It is still too early to quantify their impact on quality, utilization, or economics, but we are encouraged by what we have seen to date. We also have several additional AI use cases in development that we expect to pilot over time. Scheduling and transportation are other good examples. Transportation is fundamental to PACE and extraordinarily complex operationally. We coordinate thousands of trips for participants with different clinical needs across large geographic areas while simultaneously coordinating center schedules, outside medical appointments, and care team capacity.
Speaker #3: We also have several additional AI use cases in development that we expect to pilot over time. Scheduling and transportation are other good examples. Transportation is fundamental to pace and extraordinarily complex operationally.
Speaker #3: We coordinate thousands of trips for participants with different clinical needs across large geographic areas, while simultaneously coordinating center schedules, outside medical appointments, and care team capacity.
Speaker #3: We believe AI and better analytics can help us anticipate demand, improve routing and scheduling, reduce cancellations, and make better use of the capacity we already have.
Patrick Blair: We believe AI and better analytics can help us anticipate demand, improve routing and scheduling, reduce cancellations, and make better use of the capacity we already have. Taken together, we expect these investments to translate into measurable improvements in the performance of the business, not just new capabilities. A better and more consistent participant experience should improve satisfaction and retention, reduce voluntary disenrollment, and support stronger net census growth. Better data, analytics, and clinical decision support should help our care teams intervene earlier, limit unnecessary utilization, and more effectively manage the total cost of care. There is also something occurring outside of InnovAge that I believe is valuable to the long-term story. The level of federal interest in PACE feels as strong as it has been at any point in recent years. We see this developing along two parallel tracks. The first is the existing PACE program.
Patrick Blair: We believe AI and better analytics can help us anticipate demand, improve routing and scheduling, reduce cancellations, and make better use of the capacity we already have. Taken together, we expect these investments to translate into measurable improvements in the performance of the business, not just new capabilities. A better and more consistent participant experience should improve satisfaction and retention, reduce voluntary disenrollment, and support stronger net census growth. Better data, analytics, and clinical decision support should help our care teams intervene earlier, limit unnecessary utilization, and more effectively manage the total cost of care. There is also something occurring outside of InnovAge that I believe is valuable to the long-term story. The level of federal interest in PACE feels as strong as it has been at any point in recent years. We see this developing along two parallel tracks. The first is the existing PACE program.
Speaker #3: Taken together, we expect these investments to translate into measurable improvements in the performance of the business, not just new capabilities. A better and more consistent participant experience should improve satisfaction and retention, reduce voluntary disenrollment, and support stronger net census growth.
Speaker #3: Better data analytics and clinical decision support should help our care teams intervene earlier, limit unnecessary utilization, and more effectively manage the total cost of care.
Speaker #3: There's also something occurring outside of InnovAge that I believe is valuable to the long-term story. The level of federal interest in PACE feels as strong as it has been at any point in recent years.
Speaker #3: We see this developing along two parallel tracks. The first is the existing PACE program. There is meaningful work underway with CMS, CMMI, the National PACE Association, and PACE organizations to better understand the barriers that have historically limited the growth and adoption of PACE, and could responsibly allow the existing program to serve more seniors.
Patrick Blair: There is meaningful work underway with CMS, CMMI, the National PACE Association, and PACE organizations to better understand the barriers that have historically limited the growth and adoption of PACE and could responsibly allow the existing program to serve more seniors. We believe this is an important conversation. PACE has demonstrated that a fully integrated, full-risk model can produce strong outcomes for highly complex seniors while helping them remain safe in their homes and communities. Yet PACE continues to serve only a small portion of the population that could potentially benefit from the program. So understanding barriers to growth, whether they involve awareness, enrollment, eligibility, program requirements, development timelines, or other structural issues, is essential if the country wants more seniors to have access to the model. The second track is more exploratory.
Patrick Blair: There is meaningful work underway with CMS, CMMI, the National PACE Association, and PACE organizations to better understand the barriers that have historically limited the growth and adoption of PACE and could responsibly allow the existing program to serve more seniors. We believe this is an important conversation. PACE has demonstrated that a fully integrated, full-risk model can produce strong outcomes for highly complex seniors while helping them remain safe in their homes and communities. Yet PACE continues to serve only a small portion of the population that could potentially benefit from the program. So understanding barriers to growth, whether they involve awareness, enrollment, eligibility, program requirements, development timelines, or other structural issues, is essential if the country wants more seniors to have access to the model. The second track is more exploratory.
Speaker #3: We believe this is an important conversation. PACE has demonstrated that a fully integrated, full-risk model can produce strong outcomes for highly complex seniors while helping them remain safe in their homes and communities.
Speaker #3: Yet PACE continues to serve only a small portion of the population that could potentially benefit from the program. So, understanding barriers to growth—whether they involve awareness, enrollment, eligibility, program requirements, development timelines, or other structural issues—is essential if the country wants more seniors to have access to the model.
Speaker #3: The second track is more exploratory. There are productive conversations occurring with CMS and CMMI, both directly with individual PACE organizations and through the National PACE Association.
Patrick Blair: There are productive conversations occurring with CMS and CMMI, both directly with individual PACE organizations and through the National PACE Association, about whether some of the capabilities and attributes that make PACE successful could potentially be applied to additional senior populations. These conversations are still early. We do not know where they will lead, whether they will result in a new model, or on what timeline. We are therefore being appropriately measured about it, but we are honored to be a part of the dialogue and to provide our experience, ideas, and feedback. I think the two tracks should be considered together. The first question is how we strengthen the existing PACE program and responsibly remove barriers that prevent it from serving more eligible seniors today. The second question is whether elements of PACE's core model could extend to other populations. Both reflect a broader question facing the US healthcare system.
Patrick Blair: There are productive conversations occurring with CMS and CMMI, both directly with individual PACE organizations and through the National PACE Association, about whether some of the capabilities and attributes that make PACE successful could potentially be applied to additional senior populations. These conversations are still early. We do not know where they will lead, whether they will result in a new model, or on what timeline. We are therefore being appropriately measured about it, but we are honored to be a part of the dialogue and to provide our experience, ideas, and feedback. I think the two tracks should be considered together. The first question is how we strengthen the existing PACE program and responsibly remove barriers that prevent it from serving more eligible seniors today. The second question is whether elements of PACE's core model could extend to other populations. Both reflect a broader question facing the US healthcare system.
Speaker #3: We're exploring whether some of the capabilities and attributes that make PACE successful could potentially be applied to additional senior populations. These conversations are still in the early stages.
Speaker #3: We don't know where they will lead, whether they will result in a new model, or what the timeline will be. We're therefore being appropriately measured about it.
Speaker #3: But we're honored to be a part of the dialogue and to provide our experience, ideas, and feedback. And I think the two tracks should be considered together.
Speaker #3: The first question is how we strengthen the existing PACE program in responsibly removing barriers that prevent it from serving more eligible seniors today. The second question is whether elements of PACE's core model could extend to other populations.
Speaker #3: Both reflect a broader question facing the U.S. healthcare system: How do we care for a rapidly growing senior population with increasingly complex medical and social needs in a way that produces better outcomes and allows more people to remain in their homes and communities?
Patrick Blair: How do we care for a rapidly growing senior population with increasingly complex medical and social needs in a way that produces better outcomes and allows more people to remain in their homes and communities? Our view is that PACE organizations have an important role to play in that conversation. Earlier this year, HHS' Office of the Assistant Secretary for Planning and Evaluation released a study examining outcomes across integrated care models for individuals eligible for both Medicare and Medicaid. Among its findings, PACE participants experienced fewer hospitalizations and emergency department visits and lower mortality than comparable beneficiaries in non-integrated Medicare Advantage plans. We also had the privilege of hosting HHS Secretary, Robert F. Kennedy Jr., at our Thornton, Colorado center, where he was able to see firsthand how an interdisciplinary care team brings medical care, long-term services and supports, transportation, nutrition, and social services together around the participants.
Patrick Blair: How do we care for a rapidly growing senior population with increasingly complex medical and social needs in a way that produces better outcomes and allows more people to remain in their homes and communities? Our view is that PACE organizations have an important role to play in that conversation. Earlier this year, HHS' Office of the Assistant Secretary for Planning and Evaluation released a study examining outcomes across integrated care models for individuals eligible for both Medicare and Medicaid. Among its findings, PACE participants experienced fewer hospitalizations and emergency department visits and lower mortality than comparable beneficiaries in non-integrated Medicare Advantage plans. We also had the privilege of hosting HHS Secretary, Robert F. Kennedy Jr., at our Thornton, Colorado center, where he was able to see firsthand how an interdisciplinary care team brings medical care, long-term services and supports, transportation, nutrition, and social services together around the participants.
Speaker #3: Our view is that PACE organizations have an important role to play in that conversation. Earlier this year, HHS's Office of the Assistant Secretary for Planning and Evaluation released a study examining outcomes across integrated care models for individuals eligible for both Medicare and Medicaid.
Speaker #3: Among its findings, PACE participants experienced fewer hospitalizations and emergency department visits, and lower mortality than comparable beneficiaries in non-integrated Medicare Advantage plans. We also had the privilege of hosting HHS Secretary Robert F.
Speaker #3: Kennedy Jr. was at our Thornton, Colorado center, where he was able to see firsthand how an interdisciplinary team brings medical care, long-term services and supports, transportation, nutrition, and social services together around the participants.
Speaker #3: We don't know where any policy discussions may lead, and our outlook does not assume any changes to the PACE program or future opportunities. But the combination of growing evidence supporting the model, an aging population, increasing pressure on institutional care, and a high level of engagement from federal policymakers makes this a key moment for PACE.
Patrick Blair: We don't know where any policy discussions may lead, and our outlook does not assume any changes to the PACE program or future opportunities. But the combination of growing evidence supporting the model, an aging population, increasing pressure on institutional care, and a high level of engagement from federal policymakers makes this a key moment for PACE. Let me now turn to fiscal 2027. We're targeting an ending census of approximately 8,625 to 8,850 participants, representing census growth of approximately 5% to 7.5%, total revenue of approximately $1.05 billion to $1.085 billion, and adjusted EBITDA of approximately $105 million to $115 million. I think it's important to put this guidance in context. On our last call, we discussed our expectation that the fiscal 2027 rate environment would be more tempered than we experienced during fiscal 2026.
Patrick Blair: We don't know where any policy discussions may lead, and our outlook does not assume any changes to the PACE program or future opportunities. But the combination of growing evidence supporting the model, an aging population, increasing pressure on institutional care, and a high level of engagement from federal policymakers makes this a key moment for PACE. Let me now turn to fiscal 2027. We're targeting an ending census of approximately 8,625 to 8,850 participants, representing census growth of approximately 5% to 7.5%, total revenue of approximately $1.05 billion to $1.085 billion, and adjusted EBITDA of approximately $105 million to $115 million. I think it's important to put this guidance in context. On our last call, we discussed our expectation that the fiscal 2027 rate environment would be more tempered than we experienced during fiscal 2026.
Speaker #3: Let me now turn to fiscal 2027. We're targeting an ending census of approximately 8,625 to 8,850 participants, representing census growth of approximately 5% to 7.5%.
Speaker #3: Total revenue of approximately $1.05 billion to $1.085 billion, and adjusted EBITDA of approximately $105 million to $115 million. I think it's important to put this guidance in context.
Speaker #3: On our last call, we discussed our expectation that the fiscal 2027 rate environment would be more tempered than what we experienced during fiscal 2026. We now have better visibility, and overall, the rate environment has continued to trend better than we expected when we gave initial guidance.
Patrick Blair: We now have better visibility, and overall, the rate environment has continued to trend better than we expected when we gave initial guidance. This provides some additional support to our top-line outlook. Like many states across the country, some of our state government partners are navigating meaningful fiscal pressures, and the implications of our rates are not yet fully known. California and Colorado are two markets where we have worked with our state partners in the PACE rate-setting processes, which have yet to conclude. We've incorporated what we believe are responsible assumptions into our fiscal 2027 outlook based on the information available to us today, while recognizing that the ultimate rate outcomes are not yet final. Together, California and Colorado represent approximately 70% of our census.
Patrick Blair: We now have better visibility, and overall, the rate environment has continued to trend better than we expected when we gave initial guidance. This provides some additional support to our top-line outlook. Like many states across the country, some of our state government partners are navigating meaningful fiscal pressures, and the implications of our rates are not yet fully known. California and Colorado are two markets where we have worked with our state partners in the PACE rate-setting processes, which have yet to conclude. We've incorporated what we believe are responsible assumptions into our fiscal 2027 outlook based on the information available to us today, while recognizing that the ultimate rate outcomes are not yet final. Together, California and Colorado represent approximately 70% of our census.
Speaker #3: This provides some additional support to our top-line outlook. Like many states across the country, some of our state government partners are navigating meaningful fiscal pressures, and the implications of our rates are not yet fully known.
Speaker #3: California and Colorado are two markets where we have worked with our state partners in the PACE rate-setting processes, which have yet to conclude. We've incorporated what we believe are responsible assumptions into our fiscal 2027 outlook based on the information available to us today.
Speaker #3: While recognizing that the ultimate rate outcomes are not yet final, together, California and Colorado represent approximately 70% of our census. On Medicare, we currently expect our county rate increases, adjusted for the continuing transition of the V28 risk adjustment model, to result in a net rate increase of approximately 1.5% to 2.0%.
Patrick Blair: On Medicare, we currently expect our accounting rate increases, adjusted for the continuing transition of the V28 risk adjustment model, to result in a net rate increase of approximately 1.5% to 2.0%. Vin will provide more detail on the components of our guidance. From my perspective, the main point is that fiscal 2027 gives us an opportunity to demonstrate the increasing durability of the business. We will not have all the same rate increases that contributed to fiscal 2026. Our ability to continue growing earnings in fiscal 2027 will therefore depend increasingly on execution. That means growing enrollment and improving retention, tightening our management of utilization and total cost of care, reducing variation across our centers, and using technology and AI with the goal of operating the company more efficiently and effectively.
Patrick Blair: On Medicare, we currently expect our accounting rate increases, adjusted for the continuing transition of the V28 risk adjustment model, to result in a net rate increase of approximately 1.5% to 2.0%. Vin will provide more detail on the components of our guidance. From my perspective, the main point is that fiscal 2027 gives us an opportunity to demonstrate the increasing durability of the business. We will not have all the same rate increases that contributed to fiscal 2026. Our ability to continue growing earnings in fiscal 2027 will therefore depend increasingly on execution. That means growing enrollment and improving retention, tightening our management of utilization and total cost of care, reducing variation across our centers, and using technology and AI with the goal of operating the company more efficiently and effectively.
Speaker #3: Ben will provide more detail on the components of our guidance. From my perspective, the main point is that fiscal 2027 gives us an opportunity to demonstrate the increasing durability of the business.
Speaker #3: We will not have all the same rate increases that contributed to fiscal 2026. Our ability to continue growing earnings in fiscal 2027 will, therefore, depend increasingly on execution.
Speaker #3: That means growing enrollment and improving retention, tightening our management of utilization and total cost of care, reducing variation across our centers, and using technology and AI with the goal of operating the company more efficiently and effectively.
Speaker #3: Before I turn the call over to Ben, I want to recognize the approximately 2,500 InnovAge colleagues who made fiscal 2026 possible. Behind every metric we report is a participant whose life is affected by the care we provide.
Patrick Blair: Before I turn the call over to Ben, I want to recognize the approximately 2,500 InnovAge colleagues who made fiscal 2026 possible. Behind every metric we report is a participant whose life is affected by the care we provide. It is a senior who can remain living in his or her home and community. It is a family with greater peace of mind. It is a caregiver who knows there is an interdisciplinary care team managing the complexity of their loved one's care. That is our purpose. Today, we are operating from a very different position than we were four years ago. We have a stronger organization, a stronger leadership team, a more capable operating platform, greater financial capacity, and considerably better visibility into the business. We have demonstrated an ability to execute consistently over several years. Yet throughout it all, quality, compliance, and the well-being of our participants remain the foundation of everything we do.
Patrick Blair: Before I turn the call over to Ben, I want to recognize the approximately 2,500 InnovAge colleagues who made fiscal 2026 possible. Behind every metric we report is a participant whose life is affected by the care we provide. It is a senior who can remain living in his or her home and community. It is a family with greater peace of mind. It is a caregiver who knows there is an interdisciplinary care team managing the complexity of their loved one's care. That is our purpose. Today, we are operating from a very different position than we were four years ago. We have a stronger organization, a stronger leadership team, a more capable operating platform, greater financial capacity, and considerably better visibility into the business. We have demonstrated an ability to execute consistently over several years. Yet throughout it all, quality, compliance, and the well-being of our participants remain the foundation of everything we do.
Speaker #3: It's a senior who can remain living in his or her home and community. It's a family with greater peace of mind. It's a caregiver who knows there is an interdisciplinary team managing the complexity of their loved one's care.
Speaker #3: That is our purpose. Today, we're operating from a very different position than we were four years ago. We have a stronger organization, a stronger leadership team, a more capable operating platform, greater financial capacity, and considerably better visibility into the business.
Speaker #3: We have demonstrated an ability to execute consistently over several years. And throughout it all, quality, compliance, and the well-being of our participants remain the foundation of everything we do.
Speaker #3: We're excited about fiscal 2027 and increasingly confident in the longer-term opportunity ahead of the company. With that, I'll turn it over to Ben for more detail on the financials.
Patrick Blair: We are excited about fiscal 2027 and increasingly confident in the longer-term opportunity ahead of the company. With that, I will turn it over to Ben for more detail on the financials.
Patrick Blair: We are excited about fiscal 2027 and increasingly confident in the longer-term opportunity ahead of the company. With that, I will turn it over to Ben for more detail on the financials.
Speaker #2: Thank you, Patrick. We are pleased with our fiscal 2026 performance. Building on Patrick's comments, I'll focus on the financial results that demonstrate the progress we've made across the business.
Ben Adams: Thank you, Patrick. We are pleased with our fiscal 2026 performance. Building on Patrick's comments, I will focus on the financial results that demonstrate the progress we have made across the business. Starting off our fiscal 2026 highlights with census. We served approximately 8,230 participants across 20 centers as of 30 June 2026, which represents annual growth of 6.3% and sequential quarter growth of 2.2%. We reported 24,520 member-months in Q4, an increase of approximately 6.6% compared to Q4 of fiscal year 2025, and an increase of approximately 1.9% over Q3 of fiscal year 2026. Total revenues increased by 15.9% to $989.7 million for fiscal year 2026. The increase was primarily driven by an increase in member months, coupled with an increase in capitation rates.
Ben Adams: Thank you, Patrick. We are pleased with our fiscal 2026 performance. Building on Patrick's comments, I will focus on the financial results that demonstrate the progress we have made across the business. Starting off our fiscal 2026 highlights with census. We served approximately 8,230 participants across 20 centers as of 30 June 2026, which represents annual growth of 6.3% and sequential quarter growth of 2.2%. We reported 24,520 member-months in Q4, an increase of approximately 6.6% compared to Q4 of fiscal year 2025, and an increase of approximately 1.9% over Q3 of fiscal year 2026. Total revenues increased by 15.9% to $989.7 million for fiscal year 2026. The increase was primarily driven by an increase in member months, coupled with an increase in capitation rates.
Speaker #2: Starting off with our fiscal 2026 highlights, with census we served approximately 8,230 participants across 20 centers as of June 30, 2026, which represents annual growth of 6.3% and sequential quarter growth of 2.2%.
Speaker #2: We reported 24,520 member months in the fourth quarter, an increase of approximately 6.6% compared to the fourth quarter of fiscal year 2025, and an increase of approximately 1.9% over the third quarter of fiscal year 2026.
Speaker #2: Total revenues increased by 15.9% to $989.7 million for fiscal year 2026. The increase was primarily driven by an increase in member months coupled with an increase in capitation rates.
Speaker #2: The increase in capitation rates includes rate increases for both Medicare and Medicaid, and the increase in member months was primarily due to growth in our California, Colorado, and Florida centers.
Ben Adams: The increase in capitation rates includes rate increases for both Medicare and Medicaid, and the increase in member months was primarily due to growth in our California, Colorado, and Florida centers. Compared to Q3, total revenues increased by 4.0% to $262.0 million in Q4, primarily driven by growth in member months and higher capitation rates. The capitation rate increase was largely attributable to Medicare risk adjustment reconciliation and a full-year Colorado Medicaid rate true-up, both recognized in Q4. We incurred $449.8 million of external provider costs during the fiscal year, a 4.3% increase compared to fiscal year 2025. The increase was driven by an increase in member months, partially offset by a decrease in cost per participant.
Ben Adams: The increase in capitation rates includes rate increases for both Medicare and Medicaid, and the increase in member months was primarily due to growth in our California, Colorado, and Florida centers. Compared to Q3, total revenues increased by 4.0% to $262.0 million in Q4, primarily driven by growth in member months and higher capitation rates. The capitation rate increase was largely attributable to Medicare risk adjustment reconciliation and a full-year Colorado Medicaid rate true-up, both recognized in Q4. We incurred $449.8 million of external provider costs during the fiscal year, a 4.3% increase compared to fiscal year 2025. The increase was driven by an increase in member months, partially offset by a decrease in cost per participant.
Speaker #2: Compared to the third quarter, total revenues increased by 4.0% to $262.0 million in the fourth quarter, primarily driven by growth in member months and higher capitation rates.
Speaker #2: The capitation rate increase was largely attributable to Medicare risk adjustment reconciliations and a full-year Colorado Medicaid rate true-up, both recognized in the fourth quarter.
Speaker #2: We incurred $449.8 million of external provider costs during the fiscal year, a 4.3% increase compared to fiscal year 2025. The increase was driven by an increase in member months, partially offset by a decrease in cost per participant.
Speaker #2: The decrease in cost per participant was primarily driven by a decrease in permanent nursing facility and short-stay nursing facility utilization, as well as a decrease in pharmacy expenses associated with the transition to in-house pharmacy services.
Ben Adams: The decrease in cost per participant was primarily driven by a decrease in permanent nursing facility and short-stay nursing facility utilization and a decrease in pharmacy expenses associated with the transition to in-house pharmacy services. The decrease in external provider cost per participant was partially offset by an annual increase in assisted living and permanent nursing facility unit costs and an increase in assisted living utilization. During Q4, we incurred $115.7 million of external provider costs, an increase of 2.2% compared to Q3 of fiscal year 2026. The increase was primarily driven by an increase in member months. Cost of care, excluding depreciation and amortization, was $312.1 million, an increase of 16.1% compared to fiscal year 2025. The increase was due to an increase in member months, coupled with an increase in cost per participant.
Ben Adams: The decrease in cost per participant was primarily driven by a decrease in permanent nursing facility and short-stay nursing facility utilization and a decrease in pharmacy expenses associated with the transition to in-house pharmacy services. The decrease in external provider cost per participant was partially offset by an annual increase in assisted living and permanent nursing facility unit costs and an increase in assisted living utilization. During Q4, we incurred $115.7 million of external provider costs, an increase of 2.2% compared to Q3 of fiscal year 2026. The increase was primarily driven by an increase in member months. Cost of care, excluding depreciation and amortization, was $312.1 million, an increase of 16.1% compared to fiscal year 2025. The increase was due to an increase in member months, coupled with an increase in cost per participant.
Speaker #2: The decrease in external provider costs per participant was partially offset by an annual increase in assisted living and permanent nursing facility unit costs, as well as an increase in assisted living utilization.
Speaker #2: During the fourth quarter, we incurred $115.7 million of external provider costs, an increase of 2.2% compared to the third quarter of fiscal year 2026.
Speaker #2: The increase was primarily driven by an increase in member months. Cost of care, excluding depreciation and amortization, was $312.1 million—an increase of 16.1% compared to fiscal year 2025.
Speaker #2: The increase was due to an increase in member months, coupled with an increase in cost per participant. The overall increase was driven by higher salaries, wages, and benefits associated with higher wage rates; an increase in third-party fees and shipping costs associated with in-house pharmacy services; an increase in contract services; an increase in supplies and administrative costs; and higher fleet costs, inclusive of contract transportation.
Ben Adams: The overall increase was driven by higher salaries, wages, and benefits associated with higher wage rates, an increase in third-party fees and shipping costs associated with in-house pharmacy services, an increase in contract services, an increase in supplies and administrative costs, and higher fleet costs inclusive of contract transportation. For Q4, cost of care, excluding depreciation and amortization, increased 7.7% compared to Q3. The overall increase was primarily due to an increase in fleet costs, including contract transportation, an increase in supplies and administrative costs, and salaries, wages, and benefits due to higher wage rates. Center-level Contribution Margin, which we define as total revenues less external provider costs and cost of care, excluding depreciation and amortization, which includes all medical and pharmacy costs, increased 48.2% to $227.8 million in fiscal year 2026, compared to $153.6 million in fiscal year 2025.
Ben Adams: The overall increase was driven by higher salaries, wages, and benefits associated with higher wage rates, an increase in third-party fees and shipping costs associated with in-house pharmacy services, an increase in contract services, an increase in supplies and administrative costs, and higher fleet costs inclusive of contract transportation. For Q4, cost of care, excluding depreciation and amortization, increased 7.7% compared to Q3. The overall increase was primarily due to an increase in fleet costs, including contract transportation, an increase in supplies and administrative costs, and salaries, wages, and benefits due to higher wage rates. Center-level Contribution Margin, which we define as total revenues less external provider costs and cost of care, excluding depreciation and amortization, which includes all medical and pharmacy costs, increased 48.2% to $227.8 million in fiscal year 2026, compared to $153.6 million in fiscal year 2025.
Speaker #2: For the fourth quarter, cost of care excluding depreciation and amortization increased 7.7% compared to the third quarter. The overall increase was primarily due to an increase in fleet costs, including contract transportation, an increase in supplies and administrative costs, and benefits due to higher wage rates.
Speaker #2: Central-level contribution margin, which we define as total revenues less external provider costs and cost of care excluding depreciation and amortization—which includes all medical and pharmacy costs—increased 48.2% to $227.8 million in fiscal year 2026, compared to $153.6 million in fiscal year 2025.
Speaker #2: As a percentage of revenue, central-level contribution margin increased 500 basis points to 23.0%, compared to 18.0% in fiscal year 2025. For the fourth quarter, central-level contribution margin was $62.6 million, compared to $61.0 million for the third quarter of fiscal year 2026, an increase of 2.5%.
Ben Adams: As a percentage of revenue, Center-level Contribution Margin increased 500 basis points to 23.0%, compared to 18.0% in fiscal year 2025. For Q4, Center-level Contribution Margin was $62.6 million, compared to $61.0 million for Q3 of fiscal year 2026, an increase of 2.5%. As a percentage of revenue, Center-level Contribution Margin of 23.9% decreased by approximately 30 basis points compared to 24.2% in Q3 of fiscal year 2026. Sales and marketing expenses of $34.4 million increased 21.8% compared to fiscal year 2025, primarily due to increased headcount, wage rates, and marketing spend to support growth. For Q4, sales and marketing expenses increased by 13.6% compared to Q3 of 2026 as a result of additional marketing spend and consulting services. Corporate general and administrative expenses increased 36.4% to $166.5 million compared to fiscal year 2025.
Ben Adams: As a percentage of revenue, Center-level Contribution Margin increased 500 basis points to 23.0%, compared to 18.0% in fiscal year 2025. For Q4, Center-level Contribution Margin was $62.6 million, compared to $61.0 million for Q3 of fiscal year 2026, an increase of 2.5%. As a percentage of revenue, Center-level Contribution Margin of 23.9% decreased by approximately 30 basis points compared to 24.2% in Q3 of fiscal year 2026. Sales and marketing expenses of $34.4 million increased 21.8% compared to fiscal year 2025, primarily due to increased headcount, wage rates, and marketing spend to support growth. For Q4, sales and marketing expenses increased by 13.6% compared to Q3 of 2026 as a result of additional marketing spend and consulting services. Corporate general and administrative expenses increased 36.4% to $166.5 million compared to fiscal year 2025.
Speaker #2: As a percentage of revenue, central-level contribution margin of 23.9% decreased by approximately 30 basis points compared to 24.2% in the third quarter of fiscal year 2026.
Speaker #2: Sales and marketing expenses of $34.4 million increased 21.8% compared to fiscal year 2025, primarily due to increased headcount, wage rates, and marketing spend to support growth.
Speaker #2: For the fourth quarter, sales and marketing expenses increased by 13.6% compared to the third quarter of 2026, as a result of additional marketing spend and consulting services.
Speaker #2: Corporate general and administrative expenses increased 36.4% to $166.5 million compared to fiscal year 2025. The increase was primarily due to the $36.8 million net increase in our litigation and settlement expenses, primarily related to the accrual for various legal matters; higher employee compensation and benefits expenses as a result of organizational restructuring activities, executive severance, increased headcount, and higher wage rates; partially offset by lower variable compensation.
Ben Adams: The increase was primarily due to the $36.8 million net increase in our litigation and settlement expenses, primarily related to the accrual for various legal matters, higher employee compensation and benefits expense as a result of organizational restructuring activities, executive severance, increased headcount, and a higher wage rate, partially offset by lower variable compensation, the year-over-year increase of consulting services expense and software license fees. For Q4, corporate general and administrative expenses decreased 56.8% to $33.1 million compared to Q3 of fiscal year 2026. The decrease was primarily due to litigation costs and settlements recorded in Q3. Net loss was $0.7 million compared to a net loss of $35.3 million in fiscal year 2025. We reported a net loss per share of $0.02 compared to a net loss per share of $0.22, each on both a basic and diluted basis.
Ben Adams: The increase was primarily due to the $36.8 million net increase in our litigation and settlement expenses, primarily related to the accrual for various legal matters, higher employee compensation and benefits expense as a result of organizational restructuring activities, executive severance, increased headcount, and a higher wage rate, partially offset by lower variable compensation, the year-over-year increase of consulting services expense and software license fees. For Q4, corporate general and administrative expenses decreased 56.8% to $33.1 million compared to Q3 of fiscal year 2026. The decrease was primarily due to litigation costs and settlements recorded in Q3. Net loss was $0.7 million compared to a net loss of $35.3 million in fiscal year 2025. We reported a net loss per share of $0.02 compared to a net loss per share of $0.22, each on both a basic and diluted basis.
Speaker #2: The year-over-year increase of consulting services expense and software license fees. For the fourth quarter, corporate general and administrative expenses decreased 56.8% to $33.1 million, compared to the third quarter of fiscal year 2026.
Speaker #2: The decrease was primarily due to litigation costs and settlements recorded in the third quarter. Net loss was $0.7 million, compared to a net loss of $35.3 million in fiscal 2025.
Speaker #2: We reported a net loss per share of $0.02, compared to a net loss per share of $0.22, each on both a basic and diluted basis.
Speaker #2: Our weighted average share count was approximately 135.7 million shares for the fiscal year, on both a basic and fully diluted basis. For the fourth quarter, we reported net income of $9.8 million, compared to a net loss of $29.9 million in the third quarter.
Ben Adams: Our weighted average share count was approximately 135.7 million shares for the fiscal year on both a basic and fully diluted basis. For Q4, we reported net income of $9.8 million compared to a net loss of $29.9 million in Q3, and net income per share of $0.06, each on both a basic and diluted basis. Adjusted EBITDA was $94.6 million for fiscal 2026, compared to $34.5 million in fiscal 2025 and $24.3 million for the quarter compared to $30.5 million in Q3 of fiscal year 2026. Our adjusted EBITDA margin was 9.6% for fiscal 2026 and 9.3% for Q4. We do not add back losses incurred by our de novo centers in the calculation of adjusted EBITDA.
Ben Adams: Our weighted average share count was approximately 135.7 million shares for the fiscal year on both a basic and fully diluted basis. For Q4, we reported net income of $9.8 million compared to a net loss of $29.9 million in Q3, and net income per share of $0.06, each on both a basic and diluted basis. Adjusted EBITDA was $94.6 million for fiscal 2026, compared to $34.5 million in fiscal 2025 and $24.3 million for the quarter compared to $30.5 million in Q3 of fiscal year 2026. Our adjusted EBITDA margin was 9.6% for fiscal 2026 and 9.3% for Q4. We do not add back losses incurred by our de novo centers in the calculation of adjusted EBITDA.
Speaker #2: And net income per share of $0.06, each on both a basic and diluted basis. Adjusted EBITDA was $94.6 million for fiscal 2026, compared to $34.5 million in fiscal 2025, and $24.3 million for the quarter, compared to $30.5 million in the third quarter of fiscal year 2026.
Speaker #2: Our adjusted EBITDA margin was 9.6% for fiscal 2026 and 9.3% for the fourth quarter. We do not add back losses incurred by our de novo centers in the calculation of adjusted EBITDA.
Speaker #2: We define de novo center losses as net losses related to pre-opening and startup ramp through the first 24 months of de novo operations. Accordingly, de novo losses have decreased in fiscal year 2026 as our Tampa, Orlando, and Crenshaw centers have progressed beyond the initial 24-month de novo period.
Ben Adams: We define de novo center losses as net losses related to pre-opening and start-up ramp through the first 24 months of de novo operations. Accordingly, de novo losses have decreased in fiscal year 2026 as our Tampa, Orlando, and Crenshaw centers have progressed beyond the initial 24-month de novo period. We incurred $10.6 million of de novo losses in fiscal year 2026. This compares to $15.3 million in fiscal year 2025. For Q4, de novo losses were $0.3 million associated with our planned centers in California. This compares to $3.9 million of de novo losses in Q3 of fiscal year 2026. Turning to our balance sheet, we ended the quarter with $97.9 million in cash and cash equivalents, plus $43.4 million in short-term investments.
Ben Adams: We define de novo center losses as net losses related to pre-opening and start-up ramp through the first 24 months of de novo operations. Accordingly, de novo losses have decreased in fiscal year 2026 as our Tampa, Orlando, and Crenshaw centers have progressed beyond the initial 24-month de novo period. We incurred $10.6 million of de novo losses in fiscal year 2026. This compares to $15.3 million in fiscal year 2025. For Q4, de novo losses were $0.3 million associated with our planned centers in California. This compares to $3.9 million of de novo losses in Q3 of fiscal year 2026. Turning to our balance sheet, we ended the quarter with $97.9 million in cash and cash equivalents, plus $43.4 million in short-term investments.
Speaker #2: We incurred $10.6 million of de novo losses in fiscal year 2026. This compares to $15.3 million in fiscal year 2025. For the fourth quarter, de novo losses were $0.3 million, associated with our planned centers in California.
Speaker #2: This compares to $3.9 million of de novo losses in the third quarter of fiscal year 2026. Turning to our balance sheet, we ended the quarter with $97.9 million in cash and cash equivalents.
Speaker #2: Plus $43.4 million in short-term investments. We had $63.3 million in total debt on the balance sheet, representing debt under our senior secured term loan and finance lease obligations.
Ben Adams: We had $63.3 million in total debt on the balance sheet, representing debt under our senior secured term loan and finance lease obligations. Turning to fiscal 2027 guidance, which we included in today's press release, and based on information as of today, we expect our ending census for fiscal year 2027 to be between 8,625 and 8,850 participants. Member months to be in the range of 101,000 to 102,500. We are projecting total revenue in the range of $1.05 billion to $1.085 billion, and adjusted EBITDA in the range of $105 million to $115 million. We anticipate that de novo losses for fiscal 2027 will be in the range of $0.4 to $0.8 million. I will also provide some additional color on a few of the components that comprise our guidance assumptions.
Ben Adams: We had $63.3 million in total debt on the balance sheet, representing debt under our senior secured term loan and finance lease obligations. Turning to fiscal 2027 guidance, which we included in today's press release, and based on information as of today, we expect our ending census for fiscal year 2027 to be between 8,625 and 8,850 participants. Member months to be in the range of 101,000 to 102,500. We are projecting total revenue in the range of $1.05 billion to $1.085 billion, and adjusted EBITDA in the range of $105 million to $115 million. We anticipate that de novo losses for fiscal 2027 will be in the range of $0.4 to $0.8 million. I will also provide some additional color on a few of the components that comprise our guidance assumptions.
Speaker #2: Turning to fiscal 2027 guidance, which we included in today's press release, and based on information as of today, we expect our ending census for fiscal year 2027 to be between 8,625 and 8,850 participants.
Speaker #2: And member months to be in the range of 101,000 to 102,500. We are projecting total revenue in the range of $1.05 billion to $1.085 billion, and adjusted EBITDA in the range of $105 million to $115 million.
Speaker #2: And we anticipate that de novo losses for fiscal 2027 will be in the range of $0.4 to $0.8 million. I will also provide some additional color on a few of the components that comprise our guidance assumptions.
Ben Adams: Starting with revenue, as we highlighted last quarter, we are expecting a Medicare rate increase of 1.5% to 2% and low single-digit rate increases for Medicaid. As a reminder, Medicare rates are based on county-specific rates established by CMS and updated each January, as well as prospective risk score adjustments that occur in January and July. Effective 1 January, we will move to a 50/50 blend of the V22 and V28 payment models as part of CMS's ongoing transition to V28. The anticipated impact of this change is reflected in the guidance we are providing today. We expect fiscal 2027 to be a year focused on preserving and expanding upon the progress we've made while navigating a more challenging rate environment and making disciplined margin management a key priority.
Ben Adams: Starting with revenue, as we highlighted last quarter, we are expecting a Medicare rate increase of 1.5% to 2% and low single-digit rate increases for Medicaid. As a reminder, Medicare rates are based on county-specific rates established by CMS and updated each January, as well as prospective risk score adjustments that occur in January and July. Effective 1 January, we will move to a 50/50 blend of the V22 and V28 payment models as part of CMS's ongoing transition to V28. The anticipated impact of this change is reflected in the guidance we are providing today. We expect fiscal 2027 to be a year focused on preserving and expanding upon the progress we've made while navigating a more challenging rate environment and making disciplined margin management a key priority.
Speaker #2: Starting with revenue, as we highlighted last quarter, we are expecting a Medicare rate increase of 1.5 to 2 percent, and low single-digit rate increases for Medicaid.
Speaker #2: As a reminder, Medicare rates are based on county-specific rates established by CMS and updated each January, as well as prospective risk score adjustments that occur in January and July.
Speaker #2: Effective January 1, we will move to a 50/50 blend of the V22 and V28 payment models as part of CMS's ongoing transition to V28.
Speaker #2: The anticipated impact of this change is reflected in the guidance we are providing today. We expect fiscal 2027 to be a year focused on preserving and expanding upon the progress we've made, while navigating a more challenging rate environment and making disciplined margin management a key priority.
Ben Adams: Importantly, our focus on margin discipline is intended to ensure we have the flexibility to invest in future growth opportunities while maintaining the strong operating foundation Patrick described. To support this effort, we will continue to build on our clinical and operational value initiatives while pursuing additional efficiencies across the organization, while we remain committed to delivering high-quality care and outcomes for our participants. I also want to quickly mention that our two Florida centers and our Crenshaw Center in California have transitioned out of their de novo status, and as a result, will not be included in the calculation of de novo losses in fiscal 2027. De novo losses in the upcoming fiscal year are primarily related to Bakersfield. Overall, we believe our guidance reflects a balanced outlook that is designed to protect margins, maintain quality, and support continued sustainable growth across the business.
Ben Adams: Importantly, our focus on margin discipline is intended to ensure we have the flexibility to invest in future growth opportunities while maintaining the strong operating foundation Patrick described. To support this effort, we will continue to build on our clinical and operational value initiatives while pursuing additional efficiencies across the organization, while we remain committed to delivering high-quality care and outcomes for our participants. I also want to quickly mention that our two Florida centers and our Crenshaw Center in California have transitioned out of their de novo status, and as a result, will not be included in the calculation of de novo losses in fiscal 2027. De novo losses in the upcoming fiscal year are primarily related to Bakersfield. Overall, we believe our guidance reflects a balanced outlook that is designed to protect margins, maintain quality, and support continued sustainable growth across the business.
Speaker #2: Importantly, our focus on margin discipline is intended to ensure we have the flexibility to invest in future growth opportunities, while maintaining the strong operating foundation Patrick described.
Speaker #2: To support this effort, we will continue to build on our clinical and operational value initiatives while pursuing additional efficiencies across the organization, and we remain committed to delivering high-quality care and outcomes for our participants.
Speaker #2: I also want to quickly mention that our two Florida centers and our Crenshaw center in California have transitioned out of their de novo status.
Speaker #2: And as a result, will not be included in the calculation of de novo losses in fiscal 2027. De novo losses in the upcoming fiscal year are primarily related to Bakersfield.
Speaker #2: Overall, we believe our guidance reflects a balanced outlook that is designed to protect margins, maintain quality, and support continued sustainable growth across the business.
Ben Adams: In closing, fiscal 2026 marked a meaningful step forward for InnovAge. We improved profitability, strengthened center-level performance, and ended the year with a strong balance sheet. Looking ahead to fiscal 2027, our focus will be on disciplined execution. While the rate environment is expected to be more moderated than fiscal 2026, we believe continued progress in utilization management, operating efficiency, and enrollment growth could position us to preserve margins and continue building shareholder value. Operator, that concludes our prepared remarks. Please open the call for questions.
Ben Adams: In closing, fiscal 2026 marked a meaningful step forward for InnovAge. We improved profitability, strengthened center-level performance, and ended the year with a strong balance sheet. Looking ahead to fiscal 2027, our focus will be on disciplined execution. While the rate environment is expected to be more moderated than fiscal 2026, we believe continued progress in utilization management, operating efficiency, and enrollment growth could position us to preserve margins and continue building shareholder value. Operator, that concludes our prepared remarks. Please open the call for questions.
Speaker #2: In closing, fiscal 2026 marked a meaningful step forward for InnovAge. We improved profitability, strengthened center-level performance, and ended the year with a strong balance sheet.
Speaker #2: Looking ahead to fiscal 2027, our focus will be on disciplined execution. While the rate environment is expected to be more moderate than in fiscal 2026, we believe continued progress in utilization management, operating efficiency, and enrollment growth could position us to preserve margins and continue building shareholder value.
Speaker #2: Operator, that concludes our prepared remarks. Please open the call for questions.
Speaker #1: Certainly. And our first question for today comes from the line of Benjamin Rossi from JPMorgan. Your question, please.
Operator: Certainly. Our first question for today comes from the line of Benjamin Rossi from JPMorgan. Your question, please.
Operator: Certainly. Our first question for today comes from the line of Benjamin Rossi from JPMorgan. Your question, please.
Benjamin Rossi: Hi, all. Thanks for taking my questions. When we think about PMPM trends for next year, you mentioned net rates being up 1.5% to 2%, Medicare up in a similar range, and then Medicaid in the low single digits. Can you just walk us through some of the variables going into your PMPM assumptions and how you are factoring things like county level rates, risk adjustments, and other puts and takes? Then with the potential policy driven areas, you mentioned the V28 shift. How are you factoring those changes into your assumptions regarding risk adjustment calculations? Thanks.
Benjamin Rossi: Hi, all. Thanks for taking my questions. When we think about PMPM trends for next year, you mentioned net rates being up 1.5% to 2%, Medicare up in a similar range, and then Medicaid in the low single digits. Can you just walk us through some of the variables going into your PMPM assumptions and how you are factoring things like county level rates, risk adjustments, and other puts and takes? Then with the potential policy driven areas, you mentioned the V28 shift. How are you factoring those changes into your assumptions regarding risk adjustment calculations? Thanks.
Speaker #3: Hi, y'all. Thanks for taking my questions. When we think about PMPM trends for next year, you mentioned net rates being up 1.5% to 2%, Medicare up in a similar range, and then Medicaid in the low single digits.
Speaker #3: Can you just walk us through some of the variables going into your PMPM assumptions, and how you're factoring things like county-level rates, risk adjustments, and other puts and takes?
Speaker #3: And then with the potential policy-driven areas, you mentioned the V28 shift. How are you factoring those changes into your assumptions regarding risk adjustment calculations?
Speaker #3: Thanks.
Speaker #2: Yeah, sure. Hey, Ben. So we can let me give you some highlights. So we obviously look at we get the Medicare county rates. And then they're adjusted for the phase in of V28.
Ben Adams: Yeah, sure. Well, hey, Ben. Let me give you some highlights. We obviously look at, we get the Medicare county rates, and then they are adjusted for the phase in of V28. This year, we are 10% V28, 90% the old model. Next year, it is going to be 50/50, and I believe it kicks off in January when it phases in. We get basically a half a year of the 50/50 phase in. We have gone through and looked at the calculation about how that is going to affect us. And obviously for PACE plans, we are impacted differently than MA plans. One of the things that we have spoken about before is what happens with dementia coding, which obviously is treated favorably under V28, and so we get a boost there because of the high prevalence of dementia among our participants.
Patrick Blair: Yeah, sure. Well, hey, Ben. Let me give you some highlights. We obviously look at, we get the Medicare county rates, and then they are adjusted for the phase in of V28. This year, we are 10% V28, 90% the old model. Next year, it is going to be 50/50, and I believe it kicks off in January when it phases in. We get basically a half a year of the 50/50 phase in. We have gone through and looked at the calculation about how that is going to affect us. And obviously for PACE plans, we are impacted differently than MA plans. One of the things that we have spoken about before is what happens with dementia coding, which obviously is treated favorably under V28, and so we get a boost there because of the high prevalence of dementia among our participants.
Speaker #2: This year, we're 10 percent—well, 90 percent—excuse me, 10 percent V28, 90 percent the old model. Next year, it's going to be 50/50, and I believe it kicks off in January when it phases in.
Speaker #2: So we get basically half of the year of the 50/50 phase-in. We've gone through and looked at the calculation about how that's going to affect us.
Speaker #2: And obviously, for PACE plans, we're impacted differently than MA plans. One of the things that we've spoken about before is what happens with dementia coding, which obviously is treated favorably under V28.
Speaker #2: And so we get a boost there because of the high prevalence of dementia among our participants. So all of that sort of factors in together to go to that 1.5% to 2% increase on the Medicare side that we've talked about.
Ben Adams: All of that sort of factors in together to go to that 1.5% to 2% increase in the Medicare side that we have talked about. On the state rates, it is a little bit more complicated because two of our states, California and Colorado, are very important to us.
Patrick Blair: All of that sort of factors in together to go to that 1.5% to 2% increase in the Medicare side that we have talked about. On the state rates, it is a little bit more complicated because two of our states, California and Colorado, are very important to us.
Speaker #2: On the state rates, it's been a little bit more complicated because two of our states, California and Colorado, are very important to us.
Speaker #2: And the rates for California don't get finalized until a little bit later in the year, and we've got some working assumptions internally about how we think about those that factored into our budgets and into our guidance.
Patrick Blair: The rates for California do not get finalized until a little bit later in the year, and we have got some working assumptions internally about how we think about those that factored into our budgets and into our guidance. Same thing for Colorado. We are waiting for the final public policy adjustments there to know what the net impact is going to be like. We have rolled all of that into our assumption about rates going forward, for next year. And we think based on what we have seen so far and all the intelligence that we have today, that obviously the rates are not going to be as robust as they were last year. But if you think about the rate environment we are going to have this year, we think it is one that we can operate within effectively.
Patrick Blair: The rates for California do not get finalized until a little bit later in the year, and we have got some working assumptions internally about how we think about those that factored into our budgets and into our guidance. Same thing for Colorado. We are waiting for the final public policy adjustments there to know what the net impact is going to be like. We have rolled all of that into our assumption about rates going forward, for next year. And we think based on what we have seen so far and all the intelligence that we have today, that obviously the rates are not going to be as robust as they were last year. But if you think about the rate environment we are going to have this year, we think it is one that we can operate within effectively.
Speaker #2: Same thing for Colorado. We're really just waiting for the final public policy adjustments there to know what the net impact is going to be.
Speaker #2: So we've rolled all of that into our assumption about rates going forward for next year. And we think, based on what we've seen so far and all the intelligence that we have today, that, obviously, the rates aren't going to be as robust as they were last year.
Speaker #2: But if you think about the rate environment we're going to have this year, we think it's one that we can operate within effectively.
Speaker #2: So, we view it as being a manageable rate environment for 2027, even if it may not be as robust as it was last year.
Patrick Blair: We look at it as being sort of a manageable rate environment for 2027, if not as robust as it was last year.
Patrick Blair: We look at it as being sort of a manageable rate environment for 2027, if not as robust as it was last year.
Speaker #3: Super helpful. And I guess, as a follow-up, Patrick, I appreciate your commentary on the three chapters for InnovAge and some of the scaling efforts as part of this third chapter.
Benjamin Rossi: Super helpful. I guess as just a follow-up, Patrick, I appreciate your commentary on the three chapters for InnovAge and some of the scaling efforts as part of this third chapter. When we think about strategic growth priorities as you head into 2027, at a high level, how are you prioritizing efforts to scale and add to existing centers versus adding new centers via M&A, de novos, or JV partnerships? Can you just give us an update on how you're thinking about your M&A pipeline as well? Thanks.
Benjamin Rossi: Super helpful. I guess as just a follow-up, Patrick, I appreciate your commentary on the three chapters for InnovAge and some of the scaling efforts as part of this third chapter. When we think about strategic growth priorities as you head into 2027, at a high level, how are you prioritizing efforts to scale and add to existing centers versus adding new centers via M&A, de novos, or JV partnerships? Can you just give us an update on how you're thinking about your M&A pipeline as well? Thanks.
Speaker #3: When we think about strategic growth priorities, as you had in the 2027 plan, at a high level, how do you prioritize efforts to fill and add to existing centers versus adding new centers via M&A, de novos, or JV partnerships?
Speaker #3: And can you just give us an update on how you're thinking about your M&A pipeline as well? Thanks.
Speaker #2: Yeah, thanks a lot for the question. I think our focus continues to be the capacity in our existing centers. We certainly have capacity, and we're working hard to explore ways to create more operational capacity in our existing centers as well.
Patrick Blair: Yeah. Thanks a lot for the question. I think our focus continues to be the capacity in our existing centers. We certainly have capacity, and we're working hard to explore ways to create more operational capacity in our existing centers as well. I think when we think about de novos, I think in general, we are establishing a pretty high bar for what's an effective and appropriate de novo for us. I think, we think the right acquisitions over a three-to-five-year period could deliver a better return on invested capital than de novos. We certainly have a couple of markets that over the next few years we'd like to enter, but we're also coming off a period where we had a pretty heavy de novo thrust with both centers in Florida. The Crenshaw market was essentially a de novo in many ways, and then our Sacramento center.
Patrick Blair: Yeah. Thanks a lot for the question. I think our focus continues to be the capacity in our existing centers. We certainly have capacity, and we're working hard to explore ways to create more operational capacity in our existing centers as well. I think when we think about de novos, I think in general, we are establishing a pretty high bar for what's an effective and appropriate de novo for us. I think, we think the right acquisitions over a three-to-five-year period could deliver a better return on invested capital than de novos. We certainly have a couple of markets that over the next few years we'd like to enter, but we're also coming off a period where we had a pretty heavy de novo thrust with both centers in Florida. The Crenshaw market was essentially a de novo in many ways, and then our Sacramento center.
Speaker #2: I think, when we think about de novos, in general, we are establishing a pretty high bar for what’s an effective and appropriate de novo for us.
Speaker #2: I think we believe that the right acquisitions over a three- to five-year period could deliver a better return on invested capital than de novos. We certainly have a couple of markets that, over the next few years, we'd like to enter.
Speaker #2: But we're also coming off a period where we had a pretty heavy de novo thrust, with both centers in Florida, the Crenshaw market was essentially a de novo in many ways, and then our Sacramento center.
Speaker #2: So I think we've got a pretty high bar for de novos on the M&A side. I think that's probably where we'd be more interested in finding the right opportunity.
Patrick Blair: I think we've got a pretty high bar for de novos. On the M&A side, I think that's probably where we'd be more interested in finding the right opportunity. I think Crenshaw is a good example of buying a business that was sort of in the early stages of its growth and wasn't meeting expectations. By virtue of sort of connecting it to our platform, we've been able to grow the market significantly, and the business is performing real well. I think there's more there. The team is proactively approaching and reviewing everything coming to market. I'd like to believe that when a PACE program is considering a sale, we're a likely call. It's been mentioned, the business now is producing strong cash flows and cash conversion, and we've got a lot of opportunity on the balance sheet.
Patrick Blair: I think we've got a pretty high bar for de novos. On the M&A side, I think that's probably where we'd be more interested in finding the right opportunity. I think Crenshaw is a good example of buying a business that was sort of in the early stages of its growth and wasn't meeting expectations. By virtue of sort of connecting it to our platform, we've been able to grow the market significantly, and the business is performing real well. I think there's more there. The team is proactively approaching and reviewing everything coming to market. I'd like to believe that when a PACE program is considering a sale, we're a likely call. It's been mentioned, the business now is producing strong cash flows and cash conversion, and we've got a lot of opportunity on the balance sheet.
Speaker #2: I think we—I think Crenshaw is a good example of buying a business that was sort of in the early stages of its growth and sort of wasn't meeting expectations.
Speaker #2: And by virtue of sort of connecting it to our platform, we've been able to control—excuse me—grow the market significantly, and the business is performing real well.
Speaker #2: And so I think there's more there. The team is proactively approaching and reviewing everything coming to market. I'd like to believe that when the PACE program is considering a sale, we're a likely call.
Speaker #2: It's been mentioned. The business is now producing strong cash flows and cash conversion, and we've got a lot of opportunity on the balance sheet.
Speaker #2: But at the same time, we're going to keep a pretty high bar related to M&A as well, just given the strength of our core business and the business that we see there.
Patrick Blair: At the same time, we're going to keep a pretty high bar related to M&A as well, just given the strength of our core business and the business that we see there. So we're going to be very disciplined. But we're looking at all of the avenues as it relates to growth. I think that's one of the things that distinguishes sort of this next chapter from the last two is we have the capacity, the time, the leadership expertise and capacity to really start looking more aggressively into sort of the growth side of the equation. The bigger the platform, the more of a competitive advantage that that should provide us as we explore new opportunities.
Patrick Blair: At the same time, we're going to keep a pretty high bar related to M&A as well, just given the strength of our core business and the business that we see there. So we're going to be very disciplined. But we're looking at all of the avenues as it relates to growth. I think that's one of the things that distinguishes sort of this next chapter from the last two is we have the capacity, the time, the leadership expertise and capacity to really start looking more aggressively into sort of the growth side of the equation. The bigger the platform, the more of a competitive advantage that that should provide us as we explore new opportunities.
Speaker #2: So we're going to be very disciplined but we're looking at all of the avenues as it relates to growth. And I think that's one of the things that distinguishes sort of this next chapter from the last two, is we had the capacity, the time, the leadership expertise and capacity to really start looking more aggressively into sort of the growth side of the equation and the benefit of the platform, the more of a competitive advantage that that should provide us as we explore new opportunities.
Speaker #3: Great. Thanks for the commentary here.
Benjamin Rossi: Great. Thanks for the commentary here.
Benjamin Rossi: Great. Thanks for the commentary here.
Speaker #1: Thank you. And our next question comes from the line of Matthew Gilmore from KeyBank. Your question, please.
Operator: Thank you. Our next question comes from the line of Matthew Gillmor from KeyBanc. Your question, please.
Operator: Thank you. Our next question comes from the line of Matthew Gillmor from KeyBanc. Your question, please.
Speaker #3: Hey, thanks for the question. Maybe following up on the 2027 guidance discussion, and particularly on the margin expansion. I think the guidance implies 10.3% adjusted EBITDA margins.
Matthew Gillmor: Hey, thanks for the question. Maybe following up on the 2027 guidance discussion, particularly in the margin expansion. I think the guidance implies 10.3% adjusted EBITDA margins versus the 9.6% you reported for fiscal 2026. So nice expansion there, even with some of the investments you mentioned. Ben had mentioned sort of a disciplined approach towards margin management as a priority. I was hoping you could give us some flavor for what that entails and ultimately what is driving the margin upside in 2027, even on top of some of the investments that you have highlighted for us.
Matthew Gillmor: Hey, thanks for the question. Maybe following up on the 2027 guidance discussion, particularly in the margin expansion. I think the guidance implies 10.3% adjusted EBITDA margins versus the 9.6% you reported for fiscal 2026. So nice expansion there, even with some of the investments you mentioned. Ben had mentioned sort of a disciplined approach towards margin management as a priority. I was hoping you could give us some flavor for what that entails and ultimately what is driving the margin upside in 2027, even on top of some of the investments that you have highlighted for us.
Speaker #3: Versus the 9.6% you reported for fiscal '26, so nice expansion there, even with some of the investments you mentioned. Ben had mentioned sort of a disciplined approach towards margin management as a priority.
Speaker #3: I was hoping you could give us some flavor for what that entails, and ultimately what is driving the margin upside in 2027—even on top of some of the investments that you've highlighted for us.
Speaker #2: Yeah. Hey, Matt. I think, well, sort of going back to philosophically how we're approaching it— we said a couple of years ago at our Investor Day that we really thought that sort of 10% plus was what we think of as the long-term sustainable margin.
Patrick Blair: Well, sort of going back to philosophically how we are approaching it. We said a couple of years ago at our investor day that we really thought that sort of 10% plus was what we think of as the long-term sustainable margin. When we think what that means, it really means that first of all, it allows our state and federal partners to get good value for the dollars that they are investing in the PACE program. It allows us to earn a good margin and give our shareholders a very good return on their investment. Most importantly, it provides more than enough funds for us to invest in the quality of our participant care and ensuring that our participants really have a top-notch experience with us. So that philosophy that we really laid out 2 and a half years ago has remained unchanged.
Patrick Blair: Well, sort of going back to philosophically how we are approaching it. We said a couple of years ago at our investor day that we really thought that sort of 10% plus was what we think of as the long-term sustainable margin. When we think what that means, it really means that first of all, it allows our state and federal partners to get good value for the dollars that they are investing in the PACE program. It allows us to earn a good margin and give our shareholders a very good return on their investment. Most importantly, it provides more than enough funds for us to invest in the quality of our participant care and ensuring that our participants really have a top-notch experience with us. So that philosophy that we really laid out 2 and a half years ago has remained unchanged.
Speaker #2: And when we think about what that means, it really means that, first of all, it allows our state and federal partners to get good value for the dollars that they are investing in the PACE program.
Speaker #2: And it allows us to earn a good margin and give our shareholders a very good return on their investment. Most importantly, it provides more than enough funds for us to invest in the quality of our participant care and ensure that our participants really have a top-notch experience with us.
Speaker #2: And so that philosophy that we really laid out two and a half years ago has remained unchanged. And so when we think about what we're saying this year, without commenting specifically on margins because the guidance sort of is what the guidance is, I think we've sort of looked at the business and said, going forward, we're getting some efficiencies out of third-party care by being mindful of what our utilization rates are.
Patrick Blair: When we think about what we are saying this year, without commenting specifically on margins, because the guidance sort of is what the guidance is, I think we've sort of looked at the business and said, going forward, we are getting some efficiencies out of third-party care by being mindful of what our utilization rates are. In terms of our internal cost of care, we are getting some efficiencies out of that business. Jen Browne, who joined us recently, is really spearheading the effort to put a lot of data analytics down into the centers so we can really monitor closely the utilization and the efficiency that comes out of that area. We think that is going to be very beneficial to margins this year going forward.
Patrick Blair: When we think about what we are saying this year, without commenting specifically on margins, because the guidance sort of is what the guidance is, I think we've sort of looked at the business and said, going forward, we are getting some efficiencies out of third-party care by being mindful of what our utilization rates are. In terms of our internal cost of care, we are getting some efficiencies out of that business. Jen Browne, who joined us recently, is really spearheading the effort to put a lot of data analytics down into the centers so we can really monitor closely the utilization and the efficiency that comes out of that area. We think that is going to be very beneficial to margins this year going forward.
Speaker #2: In terms of our internal cost of care, we are getting some efficiencies out of that business. And Jen Brown, who joined us recently, is really spearheading the effort to put a lot of data analytics down into the centers, so we can really monitor closely the utilization and the efficiency that comes out of that area.
Speaker #2: And so, we think that's going to be very beneficial to margins this year, going forward. And then also, you've probably seen over the last three years or so, us becoming more efficient on the general and administrative line items.
Patrick Blair: Also, you have probably seen over the last three years or so, us becoming more efficient on the general and administrative line item, and we expect that trend will continue this year as well. When you think about the goal of defending to slightly improving margins and getting towards that long-term sustainable margin, it is really all three of those components working in concert together that will get us there.
Patrick Blair: Also, you have probably seen over the last three years or so, us becoming more efficient on the general and administrative line item, and we expect that trend will continue this year as well. When you think about the goal of defending to slightly improving margins and getting towards that long-term sustainable margin, it is really all three of those components working in concert together that will get us there.
Speaker #2: And we expect that trend will continue this year as well. So when you sort of think about the goal of defending the slightly improving margins and getting towards that long-term sustainable margin, it's really all three of those components working in concert together.
Speaker #2: That'll get us there.
Speaker #3: Great. Very helpful. And then on the policy discussions that you mentioned with CMS, I think there were two areas that sort of stood out to me.
Matthew Gillmor: Great. Very helpful. Then on the policy discussions that you mentioned with CMS, I think there was two areas that sort of stood out to me. One was reducing barriers and also looking at adjacent populations. I appreciate these discussions sound pretty early, but I was hoping you could give us some flavor for where the opportunities are from where you stand, for example. So what are the barriers that could be removed that would make a big difference? What are the types of adjacent populations that would benefit from PACE? That sort of thing. Any details would be helpful. Thank you.
Matthew Gillmor: Great. Very helpful. Then on the policy discussions that you mentioned with CMS, I think there was two areas that sort of stood out to me. One was reducing barriers and also looking at adjacent populations. I appreciate these discussions sound pretty early, but I was hoping you could give us some flavor for where the opportunities are from where you stand, for example. So what are the barriers that could be removed that would make a big difference? What are the types of adjacent populations that would benefit from PACE? That sort of thing. Any details would be helpful. Thank you.
Speaker #3: One was reducing barriers, and then also looking at adjacent populations. And I appreciate these discussions sound pretty early, but I was hoping you could give us some flavor for where the opportunities are from where you stand.
Speaker #3: For example, what are the barriers that could be removed that would make a big difference? What are the types of adjacent populations that would benefit from PACE?
Speaker #3: That sort of thing. Any details would be helpful. Thank you.
Speaker #2: Yeah, thanks for your question. I’ll take the second part first, which is about the barriers to PACE. Most of the barriers center around making it easier to enroll in PACE.
Patrick Blair: Yeah, thanks for the question. I will take the second part first, which is sort of the barriers to PACE. Most of the barriers center around making it easier to enroll in PACE, as well as making it easier to expand and enter new markets. At its core, there is variations of specific regulations that we have provided feedback on that we think could be very helpful. But it is really about making it easier to enroll in PACE, building awareness of PACE, making it easier to market and build awareness to the program, as well as the ability to apply and expand into new territories much more easily. So that is sort of the core. When you think about sort of the market adjacencies, I think there is just a recognition that there is a large and growing population of Medicare-only adults. So they are not dual eligible, they are Medicare only.
Patrick Blair: Yeah, thanks for the question. I will take the second part first, which is sort of the barriers to PACE. Most of the barriers center around making it easier to enroll in PACE, as well as making it easier to expand and enter new markets. At its core, there is variations of specific regulations that we have provided feedback on that we think could be very helpful. But it is really about making it easier to enroll in PACE, building awareness of PACE, making it easier to market and build awareness to the program, as well as the ability to apply and expand into new territories much more easily. So that is sort of the core. When you think about sort of the market adjacencies, I think there is just a recognition that there is a large and growing population of Medicare-only adults. So they are not dual eligible, they are Medicare only.
Speaker #2: As well as making it easier to expand and enter the markets. Those are sort of at its core, those are the variations of specific regulations that we provided feedback on that we think to be very making it easier to enroll in pace, building awareness of pace, making it easier to market, and build awareness to the program, as well as the ability to apply and expand into new territories much more easily.
Speaker #2: So that's sort of the core. When you think about the market adjacencies, I think there's just a recognition that there's a large and growing population of Medicare-only adults.
Speaker #2: So, they're not dual eligible. They're Medicare-only. Many of them are adults with functional impairment, and they sit upstream of PACE today. They're not yet eligible for Medicaid.
Patrick Blair: Many of them are adults with functional impairment, and they sit upstream of PACE today, and they are not yet eligible for Medicaid, but they are already on kind of this measurable trajectory toward institutional care. If you think about many of the models today, they are not really designed for the population that sort of sits upstream of PACE, the Medicare beneficiaries. They are not designed to manage this combination of functional needs and clinical needs in a really coordinated way. I think what we believe and what other PACE programs believe that what is missing at sort of at scale, is a model that can consistently deliver that center-based care, supported by an interdisciplinary team, that is accountable for outcomes, that is seeing the patients with high frequency. There is a lot of in-person engagement.
Patrick Blair: Many of them are adults with functional impairment, and they sit upstream of PACE today, and they are not yet eligible for Medicaid, but they are already on kind of this measurable trajectory toward institutional care. If you think about many of the models today, they are not really designed for the population that sort of sits upstream of PACE, the Medicare beneficiaries. They are not designed to manage this combination of functional needs and clinical needs in a really coordinated way. I think what we believe and what other PACE programs believe that what is missing at sort of at scale, is a model that can consistently deliver that center-based care, supported by an interdisciplinary team, that is accountable for outcomes, that is seeing the patients with high frequency. There is a lot of in-person engagement.
Speaker #2: But they're already on kind of this measurable trajectory toward institutional care. And if you think about many of the models today, they're not really designed for the population that sort of sits upstream of PACE, the Medicare beneficiaries.
Speaker #2: They're not designed to manage this combination of functional needs and clinical needs in a really coordinated way. And I think what we believe, and what other PACE programs believe, is that what is missing at scale is a model that can consistently deliver that center-based care, supported by an interdisciplinary team that's accountable for outcomes, and that's seeing the patients with high frequency.
Speaker #2: There's a lot of in-person engagement. So the conversations that are happening at various nodes in the policy-making and regulatory market are really asking this overarching question: Is there a population upstream of PACE where one could test whether an earlier center-based interdisciplinary model for these Medicare beneficiaries with functional limitations could change the trajectory of that functional decline?
Patrick Blair: The conversations that are happening at various nodes in the policy making and regulatory market are really asking sort of this overarching question, is there a population upstream of PACE where one could test whether an earlier center-based, interdisciplinary model for these Medicare beneficiaries with functional limitations, could you change the trajectory of that functional decline, reduce acute and post-acute utilization, which benefits Medicare, reduce long-term nursing facility care, which would benefit Medicaid, would lower the total cost of care, could slow the spin down of these populations to Medicaid, which saved both the federal government and the state government money based on how the program would be funded. As I said, these are early conversations.
Patrick Blair: The conversations that are happening at various nodes in the policy making and regulatory market are really asking sort of this overarching question, is there a population upstream of PACE where one could test whether an earlier center-based, interdisciplinary model for these Medicare beneficiaries with functional limitations, could you change the trajectory of that functional decline, reduce acute and post-acute utilization, which benefits Medicare, reduce long-term nursing facility care, which would benefit Medicaid, would lower the total cost of care, could slow the spin down of these populations to Medicaid, which saved both the federal government and the state government money based on how the program would be funded. As I said, these are early conversations.
Speaker #2: Reduce acute and post-acute utilization, which benefits Medicare. Reduce long-term nursing facility care, which would benefit Medicaid. Would this lower the total cost of care?
Speaker #2: Could slow the spin-down of these populations to Medicaid, which saved both the federal government and the state government money based on how the program would be funded?
Speaker #2: So, as I said, these are early conversations. We're not privy to or involved in all of the conversations that we understand are occurring. But we think there's real interest and curiosity among the policymakers about how the PACE model of care could serve a population upstream of PACE.
Patrick Blair: We are not privy to or involved in all of the conversations that we understand are occurring, but we think there is real interest and curiosity among the policymakers about how could the PACE model of care serve a population upstream of PACE. We are just honored to be a part of it and honored to be able to share our thoughts and ideas. There is also great work being done by the National PACE Association and other PACE organizations on the same topics. It is a kind of an exciting time to be thinking about how the PACE model could be used to serve new populations.
Patrick Blair: We are not privy to or involved in all of the conversations that we understand are occurring, but we think there is real interest and curiosity among the policymakers about how could the PACE model of care serve a population upstream of PACE. We are just honored to be a part of it and honored to be able to share our thoughts and ideas. There is also great work being done by the National PACE Association and other PACE organizations on the same topics. It is a kind of an exciting time to be thinking about how the PACE model could be used to serve new populations.
Speaker #2: And so we're just kind of honored to be a part of it and honored to be able to share our thoughts and ideas. But there's also great work being done by the National PACE Association and other PACE organizations on the same topics.
Speaker #2: So, it is kind of an exciting time to be thinking about how the PACE model could be used to serve new populations.
Speaker #3: Very helpful. Thank you.
Matthew Gillmor: Very helpful. Thank you.
Matthew Gillmor: Very helpful. Thank you.
Speaker #1: Thank you. And our final question for today comes from the line of Jared Haas from William Blair. Your question, please.
Operator: Thank you. Our final question for today comes from the line of Jared Haase from William Blair. Your question, please.
Operator: Thank you. Our final question for today comes from the line of Jared Haase from William Blair. Your question, please.
Speaker #4: Hi, it's Christine Raines on for Jared. Thanks for taking our questions. I'm hoping you can give some color on the pacing of census and revenues contemplated in your guide.
Christine Rains: Hi, it is Christine Rains on for Jared. Thanks for taking our questions. I am hoping you can give some color on the pacing of census and revenues contemplated in your guidance.
Christine Rains: Hi, it is Christine Rains on for Jared. Thanks for taking our questions. I am hoping you can give some color on the pacing of census and revenues contemplated in your guidance.
Ben Adams: I am sorry, you broke up a little bit there, part of the question. If you would not mind repeating it again.
Ben Adams: I am sorry, you broke up a little bit there, part of the question. If you would not mind repeating it again.
Speaker #2: I'm sorry, you broke up a little bit there. Could you please repeat part of the question, if you wouldn't mind?
Speaker #4: Oh, I apologize. I was just asking about the cadence of census and revenues. That is contemplated in your 2027 guide, correct?
Christine Rains: Oh, I apologize. Just about the cadence of census and revenues that is contemplated in your 2027 guide.
Christine Rains: Oh, I apologize. Just about the cadence of census and revenues that is contemplated in your 2027 guide.
Ben Adams: Yeah. Got it, the cadence. Okay. I guess what I would say is, the thing about the business I think we have seen over the last 2 or 3 years is, when you think about census, it has become relatively predictable for us. If you go back and you take a look at the census increase over the last couple of years, and you go back and make an adjustment for some of the lonely issues we discussed last year in the first 6 months of the year, you will see a pretty steady increase in census, kind of quarter by quarter. Just to remind everybody, when we go through the census build or the enrollment build over the course of the year, we usually have a very good Q1, which, for us, it is kind of like the September quarter. The Q2 is usually pretty good.
Ben Adams: Yeah. Got it, the cadence. Okay. I guess what I would say is, the thing about the business I think we have seen over the last 2 or 3 years is, when you think about census, it has become relatively predictable for us. If you go back and you take a look at the census increase over the last couple of years, and you go back and make an adjustment for some of the lonely issues we discussed last year in the first 6 months of the year, you will see a pretty steady increase in census, kind of quarter by quarter. Just to remind everybody, when we go through the census build or the enrollment build over the course of the year, we usually have a very good Q1, which, for us, it is kind of like the September quarter. The Q2 is usually pretty good.
Speaker #2: Yeah. Yeah. So I've got it. The cadence. Okay. So I guess what I would say is, the thing about the business, I think we've seen over the last two or three years, is when you think about census, it's become relatively predictable for us.
Speaker #2: If you go back and take a look at the census increase over the last couple of years, and you go back and make an adjustment for some of the enrollment issues we discussed last year in the first six months of the year, you'll see a pretty steady increase in census, kind of quarter by quarter.
Speaker #2: And just to remind everybody, when we go through the census builder and the enrollment builder over the course of the year, we usually have a very good first quarter, which for us is kind of like the September quarter.
Speaker #2: The second quarter is usually pretty good. It's the third quarter where we typically see some softness, and that's related to some of the competition associated with open enrollment during that period of time.
Ben Adams: It is the Q3 where we typically see some softness, and that is related to some of the competition associated with open enrollment during that period of time. Then we sort of return to a more normalized rate of enrollment in Q4. The way I think about it is, if I were you guys building a model or things like that, I would go back and look at the last few years, make a little bit of an adjustment for the first 6 months of last year related to the lonely issue that we talked about, and then think about 3 quarters of relatively steady growth with a pause in the middle during our Q3.
Ben Adams: It is the Q3 where we typically see some softness, and that is related to some of the competition associated with open enrollment during that period of time. Then we sort of return to a more normalized rate of enrollment in Q4. The way I think about it is, if I were you guys building a model or things like that, I would go back and look at the last few years, make a little bit of an adjustment for the first 6 months of last year related to the lonely issue that we talked about, and then think about 3 quarters of relatively steady growth with a pause in the middle during our Q3.
Speaker #2: And then we sort of return to a more normalized rate of enrollment in Q4. So the way I think about it is, if I were you guys, building a model or things like that, I would go back and look at the last few years—make a little bit of an adjustment for the first six months of last year, related to the LONI issue that we talked about.
Speaker #2: And then think about three quarters of relatively steady growth, with a pause in the middle during our third quarter.
Speaker #4: Got it. That makes a lot of sense. And then, you've previously talked about seeing some cost benefit this year from bringing in-house certain functionalities, like pharmacy.
Christine Rains: Got it. That makes a lot of sense. Then you have previously talked about seeing some cost benefit this year from bringing in-house certain functionalities like pharmacy. So I am wondering if you can put any numbers to this incremental benefit, and also if you see any other areas of care that you think it would make sense to bring in-house as of now.
Christine Rains: Got it. That makes a lot of sense. Then you have previously talked about seeing some cost benefit this year from bringing in-house certain functionalities like pharmacy. So I am wondering if you can put any numbers to this incremental benefit, and also if you see any other areas of care that you think it would make sense to bring in-house as of now.
Speaker #4: So, I'm wondering if you can put any numbers to this incremental benefit, and also if you see any other areas of care that you think it would make sense to bring in-house as of now.
Speaker #2: We don't break out specific dollars associated with those initiatives, but I think what you've seen is a general step up in margins.
Ben Adams: We do not break out specific dollars associated with those initiatives, but I think what you have seen is you have seen a general step up in margins in the business for the last couple of years, and that really reflects the fact that we have brought in-house things like DME and palliative care and behavioral and other things, as well as our own in-house pharmacy. So I think all of those have done a couple things for us. First of all, and probably most importantly, they have given us much more operational control over the business. So we can ensure much higher quality for our participants, and we have much more control over operations than if we were to delegate some of those activities to contracted third parties. Then obviously the benefit to us is we recapture some of the margin that we would have otherwise ceded to folks.
Ben Adams: We do not break out specific dollars associated with those initiatives, but I think what you have seen is you have seen a general step up in margins in the business for the last couple of years, and that really reflects the fact that we have brought in-house things like DME and palliative care and behavioral and other things, as well as our own in-house pharmacy. So I think all of those have done a couple things for us. First of all, and probably most importantly, they have given us much more operational control over the business. So we can ensure much higher quality for our participants, and we have much more control over operations than if we were to delegate some of those activities to contracted third parties. Then obviously the benefit to us is we recapture some of the margin that we would have otherwise ceded to folks.
Speaker #2: In the business of the last couple of years, and that really reflects the fact that we've brought in-house things like DME and palliative care and behavioral and other things, as well as our own in-house pharmacy.
Speaker #2: So, I think all of those have done a couple of things for us. First and foremost, and probably most importantly, they've given us much more operational control over the business.
Speaker #2: So we can ensure much higher quality for our participants, and we have much more control over our operations than if we were to delegate some of those activities to contracted third parties.
Speaker #2: And then, obviously, the benefit to us is we recapture some of the margin that we would have otherwise ceded to folks. So, it's really showed up for us in two different ways.
Ben Adams: So it really showed up for us in two different ways. I think going forward, a lot of the core activities that we wanted in-house, we have probably in-housed at this point. Patrick talked about in his comments, the fact that, in this 3.0 version, we are a little bit more of a forward-leaning organization. So we are going to be looking towards growth opportunities in the future, recognizing that a lot of the turnaround or the turnaround is complete, and a lot of the operational things that we have to do, we have really satisfied over the last 8 quarters or so.
Ben Adams: So it really showed up for us in two different ways. I think going forward, a lot of the core activities that we wanted in-house, we have probably in-housed at this point. Patrick talked about in his comments, the fact that, in this 3.0 version, we are a little bit more of a forward-leaning organization. So we are going to be looking towards growth opportunities in the future, recognizing that a lot of the turnaround or the turnaround is complete, and a lot of the operational things that we have to do, we have really satisfied over the last 8 quarters or so.
Speaker #2: I think, going forward, a lot of the core activities that we wanted in-house, we probably have in-house at this point. And Patrick talked about in his comments the fact that, in this 3.0 version, we're sort of a little bit more of a forward-leaning organization.
Speaker #2: So we're going to be looking towards growth opportunities in the future, recognizing that a lot of the turnaround or the turnaround is complete and a lot of the operational things that we have to do, we've really satisfied over the last eight quarters or so.
Patrick Blair: I think to add to that, Ben, just the notion of we do feel that AI is one of the tools that we feel can help us get more out of the platform that we already have. So, all the areas Ben mentioned, the opportunity now that we are approaching very pragmatically and with a lot of discipline, is how can we use AI, not for the sake of saying we are doing AI, but really through the lens of solving specific problems where we believe that technology can improve care, can improve the participant experience, or just make us more efficient. I think the clinical side of the business, all of the clinical disciplines that go into an interdisciplinary team, we are seeing a real opportunity to address variation that you can find from a distributed multi-site business.
Patrick Blair: I think to add to that, Ben, just the notion of we do feel that AI is one of the tools that we feel can help us get more out of the platform that we already have. So, all the areas Ben mentioned, the opportunity now that we are approaching very pragmatically and with a lot of discipline, is how can we use AI, not for the sake of saying we are doing AI, but really through the lens of solving specific problems where we believe that technology can improve care, can improve the participant experience, or just make us more efficient. I think the clinical side of the business, all of the clinical disciplines that go into an interdisciplinary team, we are seeing a real opportunity to address variation that you can find from a distributed multi-site business.
Speaker #5: I might add to that, Dan, just the notion that we do feel AI is one of the tools that can help us get more out of the platform we already have.
Speaker #5: So, all the areas have been mentioned. The opportunity now, that we're approaching very pragmatically and with a lot of discipline, is: how can we use AI?
Speaker #5: Not for the sake of saying we're doing AI, but really through the lens of solving specific problems where we believe that technology can improve care, improve the participant experience, or just make us more efficient.
Speaker #5: And I think on the clinical side of the business, all of the clinical disciplines that go into an interdisciplinary team—we're seeing a real opportunity to address variation that you can find in a distributed, multi-site business.
Patrick Blair: There is lots of variation on what services are provided, how much of those services are authorized and ordered by our providers. So, using AI in this world of clinical decision support, where we are developing tools that can bring, I think about it as sort of a specialist level of insights directly into the physician workflow and creating the opportunity to help our physicians manage more conditions within the interdisciplinary team. When a specialist is needed, make a more precise referral to the right provider. These are tools that we think could be particularly powerful in helping us manage the total cost of care. Ben mentioned pharmacy. We have already implemented a pilot that uses AI to help identify polypharmacy issues, drug interactions, and participants who might benefit from having the pharmacist more engaged. We are talking about scheduling and transportation.
Patrick Blair: There is lots of variation on what services are provided, how much of those services are authorized and ordered by our providers. So, using AI in this world of clinical decision support, where we are developing tools that can bring, I think about it as sort of a specialist level of insights directly into the physician workflow and creating the opportunity to help our physicians manage more conditions within the interdisciplinary team. When a specialist is needed, make a more precise referral to the right provider. These are tools that we think could be particularly powerful in helping us manage the total cost of care. Ben mentioned pharmacy. We have already implemented a pilot that uses AI to help identify polypharmacy issues, drug interactions, and participants who might benefit from having the pharmacist more engaged. We are talking about scheduling and transportation.
Speaker #5: There's lots of variation on what services are provided, how much of those services are authorized and ordered by our providers. And so using AI and sort of this world of clinical decision support, where we're developing tools that can bring—I think about it as sort of a specialist level of insights—directly into the physician workflow.
Speaker #5: And creating the opportunity to help our physicians manage more conditions within the interdisciplinary team. And when a specialist is needed, make a more precise referral to the right provider.
Speaker #5: I mean, these are tools that we think could be particularly powerful in helping us manage the total cost of care. And Ben mentioned pharmacy.
Speaker #5: We've already implemented a pilot that uses AI to help identify polypharmacy issues, drug interactions, and participants who might benefit from having a pharmacist more engaged.
Speaker #5: We're talking about scheduling and transportation. Back to the comment about growth: how can we create additional capacity inside our core business so that we can achieve our growth targets without needing to be reliant on a de novo market entry or M&A?
Patrick Blair: Back to the comment about growth, how can we create additional capacity inside our core business, so that we can achieve our growth targets without needing to be reliant on a de novo market entry or M&A. We see using AI to help us in our scheduling and transportation in particular, that is going to be a big opportunity for us. I will just add that on. A lot of what we are trying to do, what we have done in the past around bringing third-party clinical disciplines into our portfolio, now we are going to go back behind those and ask the question: how can AI create more value? That is sort of the path we are on right now.
Patrick Blair: Back to the comment about growth, how can we create additional capacity inside our core business, so that we can achieve our growth targets without needing to be reliant on a de novo market entry or M&A. We see using AI to help us in our scheduling and transportation in particular, that is going to be a big opportunity for us. I will just add that on. A lot of what we are trying to do, what we have done in the past around bringing third-party clinical disciplines into our portfolio, now we are going to go back behind those and ask the question: how can AI create more value? That is sort of the path we are on right now.
Speaker #5: And we see using AI to help us in our scheduling and transportation, in particular, that is going to be a big opportunity for us.
Speaker #5: So I'll just add that on. A lot of what we're trying to do—and what we've done in the past—around bringing third-party clinical disciplines into our portfolio now, we're going to go back behind those and ask the question: How can AI create more value?
Speaker #5: And that's sort of the path we're on right now.
Speaker #4: Got it. Really helpful context. Thank you.
Christine Rains: Got it. Really helpful context. Thank you.
Christine Rains: Got it. Really helpful context. Thank you.
Speaker #1: Thank you. This does conclude the question-and-answer session as well as today's program. Thank you, ladies and gentlemen, for your participation. You may now disconnect.
Operator: Thank you. This does conclude the question and answer session, as well as today's program. Thank you, ladies and gentlemen, for your participation. You may now disconnect. Good day.
Operator: Thank you. This does conclude the question and answer session, as well as today's program. Thank you, ladies and gentlemen, for your participation. You may now disconnect. Good day.
Speaker #1: Good day.
Operator: Goodbye.
Operator: Goodbye.
