Bright Health Group, Inc. (NYSE:BHG) Q4 2022 Earnings Call Transcript

Ben Rossi: Got it. Thank you. And just as a quick follow-up here on your clinic footprint. Just with your 75 owned primary care clinics, we’re assuming a lot of membership growth is going to come mainly from in-clinic growth, but what kind of capacity do you have available in your current centers? And what kind of CapEx needs do you think you’d need for the clinic base in 2023?

Mike Mikan: Well, we still have capacity, it varies by location. And so, I’m not sure I would quote an aggregate amount, but we still have some capacity. But, as we’ve talked about before, our model is really predicated on managing community risk. And we build our clinic strategy to manage not only the community risk that we have but expected or based on the demand with our customers. So, we don’t know, but we do expect growth opportunities going forward. So, we will be likely adding more clinics over time, either in our current locations or in new locations. But our current marketplace, there are markets of Houston, Dallas, Miami and Fort Lauderdale, we still have capacity to take on additional growth.

Ben Rossi: Got it. Thanks for the color.

Operator: Thank you. Our next question comes from Kevin Fischbeck of Bank of America. Kevin, your line is now open. Please go ahead.

Kevin Fischbeck: Great. Thanks. Can you provide a little more color on the EBITDA bridge that you’re giving here around the Consumer Care, $30 million to $55 million improvement, exactly kind of what’s driving that? I think you mentioned a little bit about the mix between where the members show up clinics versus affiliates. Can you just remind us kind of the economics of the members in each of those buckets and which would be more favorable to see the growth in?

Cathy Smith: Yes. So, I’ll start, Kevin, and then, obviously, Mike can help, too. So, the first bucket is, as we’ve moved into third-party payer contracts, we structured those contracts to be what we think is a good balance for us going forward for profitability. And then, next to your point, we did note in the prepared remarks that our owned clinics while serving those value-based care lives performed better than what we saw in the consumers that are associated with the affiliate clinics. We still strongly believe in the affiliate model. But over time, it will just take more time to mature. So, today, our own clinics do perform better, and we are seeing that mix shift, which I also said, I think, in the prepared remarks. So that’s what’s really driving that $30 million to $55 million you see on the bridge.

Kevin Fischbeck: But I guess, I don’t fully understand the comment about — you’re putting more downside protection in these contracts. Does that mean that in 2022, you were losing money in these contracts and now you just — you expect to lose less in these contracts, and that will allow ?

Mike Mikan: Yes. Remember, in 2022, we had a relationship with Bright HealthCare in the ACA marketplace, significant start-up cost to invest in Florida last year, invest in Texas this year as year one, and they were full downside risk. So, they shared in the start-up nature of those markets. And so yes, our expectation is going forward for the lives that we’re serving in those markets with our — with the relationships that we’ve established with external payers will perform better for us in 2023.

Kevin Fischbeck: Okay. And then, it looks like you’re looking to get to profitability in both segments. Any initial thoughts on the Medicare rate update, I guess, in particular, the coding adjustment and how that might impact your business in California, but then also the new health business?

Mike Mikan: Yes, go ahead.

Cathy Smith: Yes. Sorry, you ask about — I think you’re asking about the RADV decisions that are coming out and if that’ it, I would say we’re still…