Danish Qureshi: Yes. So, this is Danish. So what you generally see with the patients is, there is a preference for in-person or virtual for the initial visit. However, even the patients that are selecting in-person for their initial visit, enjoy the flexibility of being able to move back and forth between in-person and virtual over the course of their treatment with their clinicians. And so that’s one of the real positive factors of being able to operate a hybrid model is it gives a significant amount of flexibility both for the patients and the clinicians, as well as not just increases access, but the consistency of patients adhering to their care plan by not skipping visits and being able to switch an in-person visit that for whatever is going on in their personal life may be difficult for them to get to, they can then convert to a virtual visit and continue with their care plan.
Jack Senft: Great. Thanks. I appreciate that. As we think about the investments you discussed for 2023 and beyond, I want to focus on the second investment you mentioned, which is the credentialing piece. Just curious if this will help to increase leverage when it comes to payers, and especially with negotiations, if you can just comment on how that might impact the payer side. And then secondly, if this does have an impact, do you have any expectations on when to see the results flow through? Thanks.
Danish Qureshi: So, the investments in our credentialing process, and specifically, the systems that we mentioned, or Dave mentioned in the prepared remarks, is really about improving the speed and the quality of our onboarding experience for our clinicians and helping them to get to ram faster over time. So, that’s the primary purpose area. Would not give us €“ the credentialing system would not give us any particular leverage with payers. However, as Ken mentioned, in his section, one of the areas of focus that we have this year is pruning the bottom 25% of payers for us. And those bottom 25% contribute less than 1% of our total revenue. And so we are taking complexity out of the system, improving our administrative processes, as well as we can put our attention to the payers that are a more significant portion of our total business, as well as the ones that are value our services and what we provide throughout the country.
Operator: Your next question comes from line of Brian Tanquilut with Jefferies.
Brian Tanquilut: Hi, good morning guys. Congrats on the quarter. I guess Ken, my question for you, as I think about your client or patient retention. Obviously, we have got the macro backdrop here and the normalization out of COVID. And people are going back to work in-person. What are you seeing, and maybe what differentiates you from what maybe some of your more virtual competitors or peers are seeing? And how do you view the sensibility of the business, especially given your insurance exposure?
Ken Burdick: Brian, I think the €“ as Danish has referenced, the ability to meet our patients where they are, sometimes they want an in-person, sometimes they want a virtual, that creates a stickiness. And he also made a really important point, which is it also leads to a more regular cadence of visits. So, sort of less skipping visits which is so important to the mental health treatment that our patients receive. So, we think this is obviously the best model. We are seeing the increase in demand for in-person visits. But it’s not dramatic. It’s not drastic. Think of it in terms of maybe it’s a pointer to each quarter. We don’t know where it’s going to settle out, but we reached a sort of a high point during the height of COVID, at about 95% virtual, we are now getting towards the mid-70s. And we don’t see a change in that slow and steady trend. So, we like our positioning as a hybrid model.
Brian Tanquilut: Understand. And then I guess on the recruitment front, are you seeing any change or any maybe increased interest from some of the more traditional small practitioners as again, COVID is normalizing and maybe some of the volumes from those people running pure hybrid models are changing? So, just any color on recruitment would be helpful. Thank you.
Ken Burdick: Sure, yes. So, our organic recruiting engine continues to remain very robust. And like we mentioned in the prepared remarks, approximately 80% of our clinician adds in 2022 came through our organic recruiting engine. So, we feel very good about where we are positioned there and continue to make investments in scaling that team going into 2023. As far as kind of competition from mom and pops, we are not really seeing any difference in the market related to their increasing the amount of focus on recruiting than we have ever seen in the past. It’s always been a competitive market and we have really built organic recruiting position ourselves well there.
Operator: Your next question comes from the line of Jamie Perse with Goldman Sachs.
Jamie Perse: Thank you. Good morning. Just wanted to spend a minute on the revenue growth guidance for 2023. I think just with the organic hires from 2022 and the acquisitions from 2022, just the maturing of the new clinicians, gets you pretty far along in terms of getting to the growth guidance for 2023. And so I am trying to understand what’s embedded in 2023 guidance for incremental new organic hires, and then productivity, I think? On productivity said slight increase in revenue per visit. But beneath that, what are you assuming for kind of just incremental visits per clinician, just trying to understand a couple of those drivers of the growth guidance for €˜23?
Dave Bourdon: Yes, appreciate the question. This is Dave. As far as the full year guidance for 2023 from a revenue perspective, first thing and I said in my prepared remarks is we are not assuming any operational improvements. So, from a productivity perspective, we are assuming €˜23 to be pretty consistent with €˜22. Second point I would make is, we are not going to guide on clinicians, but we are expecting clinician growth as Danish mentioned just a minute ago, we do have a robust clinician recruiting engine. And so we are expecting clinician growth, and that will drive visit growth throughout the year. And we feel good about mid-teens organic growth coming from the business.
Jamie Perse: Okay. And then just on the center margin guidance as well, it looks like that’s up as the percent of sales year-over-year, I get there some benefits from the real estate optimization where I think rents like 8% or 9% of center cost, but for the bigger piece, which is physician compensation, what are you seeing there? Is that stable, or are you seeing pressures there just given how much demand there is for these types of clinicians out in the market? And in that context, where incentive margins go over time?
Ken Burdick: Yes. So for the most part, our clinicians are not salaried. And so we have less exposure from a wage perspective, versus some of the other companies. And we are not seeing margin compression. As you just noted, we are guiding to a little bit of margin expansion in center margin in 2023, as our rate increases help offset the wage increases that we are passing on to our clinicians.
Operator: Your next question comes from the line of Kevin Caliendo with UBS.
Kevin Caliendo: Hi. Thanks for taking my questions. I wanted to talk a little bit about the impact of the payer contracting and how to think about it? If you are consolidating more at it, I am guessing more at a national level with some of the payers or the like, and what does that end up doing in terms of overall rates? Do they become better or stronger if you are getting rid of some of the smaller and more regional payer, can you just take us through sort of how this works and what the impact is with your relationship with the payers and on your reimbursement?
Ken Burdick: Kevin, even though it’s a large percentage of the payer contracts, it’s de minimis percentage of our visit volume. So, in Danish’s respond, he talked about, we can take 25% of our payer contracts out, and it represents less than 1% of our volume. So, therefore, it’s really not going to have much leverage on our rates. The leverage is in the administrative simplicity that it creates. And it’s going to help, it will be one of the things that will help contribute to running a more efficient business.
