Jason Schulz - CFO
Analyst
Thank you, Vijay, and thank you all for your continued interest in the GoHealth story. There are many moving parts this quarter, but the key takeaway is that the proactive steps we took in the second half of last year to create a much more efficient operating model and drive increased adoption of our Encompass solution resulted in a materially better business profile, which directly improved cash flow from operations and our unit economics. On today's call, I will be referencing a supporting slide deck, which is available on the GoHealth Investor Relations website. Today, I will be discussing five primary topics. First, I'll spend a couple of minutes walking you through the adjustments to Q4 and full year 2022 to normalize our results. This includes our lookback adjustments and discussing the decision to exit our non-Encompass BPO Services business. Second, I will explain in more detail our lookback adjustment each of fiscal quarter. Third, I want to discuss the improved economic and cash flow profile of our Encompass solution versus our traditional LTV model. Fourth, I'm going to illustrate the margin expansion we saw in Q4 2022 versus Q4 2021 of our internal Medicare business by leveraging the Encompass solution on the more efficient operating model we built in the second half of 2022. And in closing, I'll give an update on our cash flow performance and deposition. Let me now walk you through the adjustments I just referenced, which are illustrated on Slides 10 and 11 of the investor deck located on the GoHealth Investor Relations website. These adjustments are made with the intent of providing transparency into our operating performance in Q4 2022 and full year as well to provide you with the right jump-off point when discussing our 2023 outlook. Included in our Q4 2022 reported financial statements is a lookback adjustment related to business sold in 2021 and prior with $266 million reduction to revenue and $187 million reduction to adjusted EBITDA, which can be seen on Slide 10. Excluding the impact of the LTV lookback adjustment made this quarter, our net revenue would have been $336 million, and our adjusted EBITDA would have been $92 million. Including smaller negative lookback adjustments in Q1 through Q3 of 2022, the total full year lookback adjustment for 2022 is $276 million reduction in revenue and a $193 million reduction to adjusted EBITDA. This is illustrated on Slide 11. On a full year basis, excluding the Q1 to Q4 look back adjustments, our net revenue would have been $907 million and our adjusted EBITDA would have been $63 million. As Vijay mentioned, we have made the strategic decision to exit our non-Encompass BPO services business. In Q4 2022, non-Encompass BPO Services represented $34 million of revenue and $7 million of gross margin, which is illustrated on Slide 10. Slide 11 provides the full year 2022 non-Encompass BPO Services revenue of $111 million and $20 million of gross margin. Excluding the impact of the LTV look back adjustment made this quarter and normalizing for the exit of our non-Encompass BPO Services, our Q4 2022 revenue would have been $302 million, and our adjusted EBITDA would have been $85 million, which is depicted in the last comps on their respective graphs on Slide 10. On a full year 2022 basis, excluding the Q1 through Q4 lookback adjustments, and normalizing for the exit of our non-Encompass BPO Services, our revenue would have been $797 million, and our adjusted EO would have been $42 million, which is illustrated on Slide 11. We think providing you with full transparency to these adjustments to our full year 2022 results is important as this is what you should compare our '23 guidance to. One additional item of note. Historically, we were using carrier approved submissions, which reflects policies sold from our traditional LTV model. As we continue to transition to the Encompass solution model, carrier improved submissions is not an accurate definition of the services we provide under the Encompass solutions model. Given that both the traditional LTV model and the new Encompass solutions model will both exist, we believe it's more informative to define the combined activity as submissions, which you will see in our financials going forward. Next, I'd like to provide you with some additional detail related to our lookback adjustment. To preempt some natural questions, I want to address why we were making a lookback adjustment this quarter when others in the industry are making opposite claims regarding LTVs and future potential adjustments. Simply put, we are making this adjustment for policies sold in 2021 and prior years because: one, we believe the market dynamics around the beneficiaries we serve have changed, especially around the annual beneficiary shopping patterns; and two, given the meaningful volume of policies sold over the last several years, we now have observed more data than ever before, allowing us to conduct a better informed and detailed actuarial analysis. Importantly, note that the $266 million lookback adjustment also includes a constraint we placed on our back-book commission receivable. Ultimately, we believe the actions we are taking will reduce our future exposure to LTV risk, the size of the adjustment and the constraint on the back-book works in the current market dynamics and anticipate continued future pressure on LTVs. It is important to remember our Encompass solutions model diversifies a material amount of our go forward revenue away from the traditional LTV model, further reducing our future risk. And finally, we are broadening our ways to pursue new demographics of the beneficiary population that make sure less switching behavior by testing book benefit and experience oriented marketing messages. Given the importance of the diversification into the Encompass solutions model, I want to do a quick refresher on the economic profile and how it compares favorably to our traditional LTV model. Please view Slid 12 of our earnings presentation. On this slide year we have illustrated the annual unit economics and cash flow differences between our traditional LTV model and our Encompass solutions model. As you can see, we have a high variability in our traditional LTV model, preferably related to revenue. This is driven by product and health plan mix as well as the less predictable LTV revenue estimates due to switching. In comparison, our Encompass solutions model is much more predictable as it is based upon services rendered during the sales process which is predicting the life time value of a policy. The evident point of difference between the two models is around year one cash flow. On the right side of Slide 12, you can see that the cash flow profile in year one of the traditional LTV policy sold is negative by approximately $280 for each policy sold. In comparison, we have a meaningfully positive year one cash flow profile of $275 for each of the sale completed under the Encompass solutions model, representing a change of $555 in cash per policy on a year-long basis. Ultimately, under either model, our goal is to drive better beneficiary choice, experience and satisfaction, resulting in a high trusted relationship. Regardless of the exact payment model we have with our health plan partners, intend to have the same operational model in our marketplace for all health plan partners for this upcoming AEP. This will not only drive continued improved quality and experience for the beneficiaries we serve, but it will also help further drive a more efficient operating model. Q4 2022 results demonstrate the combined impact of the more efficient operating model, leveraging the Encompass solution. On Slide 13, we are comparing our internal Medicare unit economic performance for Q4 2021 versus Q4 2022, adjusting for the impurity impacts of the previously discussed LTV lookback adjustments and their respective impacts to both 2021 and 2022. As you can see, our Q4 2022 sales per submission is $971, an increase of 27% year-over-year. This increase was driven by our more tenured agents performing high-quality sales, which is realized through improved effectuation rates. In addition, we saw more predictable revenue through the Encompass solutions platform, with nearly 50% of our sales in Q4 being completed through this platform. The more efficient model that was built in the second half of 2022 had a significant impact on our cost per acquisition, resulting in a 22% year-over-year improvement. This improvement was driven by favorable marketing costs and beneficiary conversion rates achieved through our more tenured agents. As a result, in Q4, our internal Medicare business achieved 49% gross margins or $479 per submission, which is a significant improvement compared to Q4 2021, where we saw 18% gross margin or $136 per submission. The combination of having a more efficient operating model, increased penetration of our Encompass solutions, and disciplined expense management, has produced a meaningfully positive result on our cash flow from operations. On Slide 14, you can see that we achieved a positive $61 million of cash flow from operations for the full year 2022, which is a $360 million improvement compared to the full year 2021. This improvement was one of the primary objectives of management, and we are thrilled with the result that the collective team has delivered. By retaining our best agents to drive high-quality enrollment activities, exceeding our Encompass penetration goal, focusing on highly efficient operating model and tightly managing our expenses, we have materially strengthened our liquidity position from just a future months ago. Because of our strong cash flow position and increased liquidity, in the fourth quarter, we paid down $155 million of debt plus principal payments, bringing our total debt down from $670 million in Q4 of 2021 to $510 million in Q4 2022. This is illustrated for you on Slide 14. It's also important to note that we have an untapped $200 million revolver for same-day access to liquidity if ever needed. Due to our strong operational results and much improved liquidity position, we are in full compliance of our debt covenants for Q4 2022. As you might recall, we have had to amend our covenants for each of the last four quarters. We are pleased with the relationship we have with our lender partners and don't anticipate a need for further covenant amendments in the future. This includes achieving 12-month leverage ratio for Q4 of 2023 as defined in our debt agreements. Based on the successes from our 2022 exit run rate performance, a more efficient operating model, enhanced commercial relationships, followed results from our Encompass solution and our planned 2023 strategic initiatives, we expect to be able to achieve our guidance ranges that Vijay mentioned earlier. We made meaningful strides in 2022 and set the foundation for profitable growth, improve the margin and cash flow profile and are on our way to greater predictability of our financial results through our well-positioned business. I'll now turn the call back to Vijay to provide closing comments. Vijay?