Vijay Kotte
Analyst · RBC Capital Markets. Your line is open
Thank you, John, and good morning, everyone. I'm pleased to share with you today our 2023 results, which reflects significant year-over-year improvement in revenue, adjusted EBITDA, and operating cash flow. The shift to the non-agency operating model continues to drive cash generation. Our consumer centric focus enables our evolution from enrollment to engagement with trust as the foundation. We provide guidance and insight to Medicare consumers in a landscape marked by confusion and uncertainty. Over 65 million people in the United States are eligible for Medicare and about half of them are on Medicare Advantage plan. One-third of Medicare beneficiaries live in accounting with more than 50 plans available to choose from. Navigating these options can be confusing and stressful. We are proud that our team helped over 2 million consumers assess their benefit options in 2023, leveraging our proprietary Encompass workflow, including our PlanFit tool and PlanFit Checkup. Backed by analytics from nearly 30 million consumer touch points and machine learning technology, our proprietary PlanFit tool helps GoHealth's licensed agents match consumers to the best plan for them based on their profile and priorities. During the fourth quarter 2023, we announced the launch of PlanFit Checkup. PlanFit Checkup removes the stress and enhances the experience for consumers shopping for a Medicare Advantage plan. As we previously shared, there are three consumer outcomes for a PlanFit Checkup. One, we enroll a consumer in a new plan because it's the best thing for their needs. Two, we tell the consumer about a better plan and they choose not to switch. Or three, we reassure the consumer that they are in the best plan for their needs and no enrollment takes place. Importantly, GoHealth agents who complete a PlanFit Checkup are compensated regardless of whether the assessment results in an enrollment. In the Q4, we performed over 300,000 PlanFit Checkup’s. We enrolled over 200,000 of these consumers into a better plan option for their needs. Over 100,000 additional consumers were told they were on the best plan already and we did not enroll them in a new plan. We provided this peace of mind to the consumer whether we already had a relationship with them and more importantly, when we did not have an existing relationship with them, thus building and reinforcing trust in each and every instance. During 2023's annual enrollment period, we faced the best test of the integrity of the PlanFit Checkup experience. Our marketing initiatives worked as planned. Our agents showed up, worked hard, and took more opportunities per day than ever before. However, from a health plan product offering standpoint, this AEP was different than we have previously seen. An analysis from Milliman revealed that for the first time in recent years, benefits for Medicare Advantage plans stayed relatively flat year-over-year. This led to a market environment with minimal product differentiation, providing few incentives for consumers to switch plans. The traditional enrollment centric broker model might have still switched consumers to new plans with similar benefits or even subpar benefits to get a commission, but we chose to honor the integrity of our PlanFit Checkup process and the investment in trusted relationships with consumers and only recommended a change when there was a justified reason to do so. With our high integrity process, in 2023 we expanded our market leadership and continue to be a leading producer of Medicare Advantage policies for our primary health plan partners. We believe our Encompass transformation is working. As a reminder, we launched the Encompass workflow in 2022. We are now operating at scale with all key partners. With over 75% of our employed agent submissions in Q4 flowing through the Encompass workflow, we have observed a market increase in submission quality as seen by lower complaints and CTM rates. Our strategic shift has significantly impacted revenue composition. Over 50% of revenue is now generated from the non-agency line, surpassing our traditional agency line or lifetime value revenue. Leveraging the Encompass workflow and adjustments to our LTV revenue recognition process has led to a stabilized back-book asset valued just under $900 million net of our constraint reserves. This stability is evidenced by the absence of a Lookback Adjustment for the first time in several years. While we observed positive retention trends in late 2023, we have opted not to adjust LTV positively at this time. Underlying that approach is our expectation that there will be benefit disruptions for the 2025 benefit year, potentially leading to more switching. We're investing in long term trusted relationships and not just trying to maximize the short term return of an enrollment. We believe this is not only the right thing to do, but also the right thing for the business and the right thing for health plans. It is in the best interest of the consumer and 100% in line with what CMS is looking for from brokers. We are excited about the brand and proof points we are establishing and the proprietary tools, tactics, and incentives we have built. We recognize that health plans are facing regulatory changes for Medicare Advantage that may impact benefit investments. There is no question that Medicare Advantage continues to have a strong value proposition for Medicare eligible consumers. We expect to see more shopping and likely more switching as uncertainty on benefit stability appears probable in the upcoming AEP. More than ever, consumers will need to find a trusted advisor to help them navigate the volume of options and the impact of benefit changes, and we believe GoHealth is that trusted advisor. Instead of providing specific 2024 guidance, we will share our general expectations for several key areas of our financial performance. First, we expect submission volume to grow in line with the overall Medicare market. Second, we expect our revenue to be flat year-over-year with incremental operating efficiency resulting in modest margin expansion. Finally, cash flow from operations is expected to be flat to slightly up as we continue our transition into the Encompass model and shift to non-agency revenue. There are a handful of market factors that could influence our performance in the year. First is the final rate notice on commissions impacting 2024 AEP. Second is the final 2025 marketing rule from CMS impacting 2024 AEP. Third is the degree to which there is health plan product and benefit differentiation between 2024 and 2025, which will indicate the amount of switching we should expect. Fourth is marketing efficiency within this election season. And finally, there is a relative health plan competitiveness and the effect on planned mix. Any of these factors alone or combined could significantly affect our performance for the full year 2024. We expect these key variables to become clear throughout the year with some of the most material remaining unknown until the early part of Q4, right before and during AEP. Our strategic and long term outlook remain resolute, driven by a commitment to transforming the consumer healthcare journey. I am extremely proud of our team as they navigated through an important and transformative year punctuated by a unique AEP. They rose to the occasion, embraced plan fit, and delivered peace of mind through our compelling consumer value proposition. With that, I will turn it over to Jason to detail our financial results.