Inventurus Knowledge Solutions Limited analyst Q&A

Thank you. Ladies and gentlemen, we will now begin the question-and-answer session. The first question comes from the line of Seema Nayak from ICICI Securities. Please go ahead.

Hello. Yes, congratulations on the first quarter after listing, and thanks for taking my question. My first question is, out of your service offerings such as RCM, coding, Scribble, etc., which one is getting the maximum traction? And what is the revenue breakup of service offerings? And my second question is regarding AQuity, what kind of cross-selling traction are we seeing with the newly acquired large set of clients?

Thank you for the question, Seema. I appreciate it. So, as it relates to your question around which of the 16 features are seeing the most traction, I am happy to note that actually we have sort of stratified these 16 features into three feature clusters; revenue optimization, clinical support, and value-based care, based on the type of value they create for the customer. And at this point I can tell you that we are seeing a pretty secular growth trend across those features. Also, given that our go-to-market now is really not feature-wise but is really much more platform, I had mentioned earlier that our go-to-market now has pivoted from you can buy certain features to either you buy the clinical bundle or you buy the administrative bundle. And the clinical bundle consists of about nine of the 16 features, and the administrative bundle consists of about seven of those 16 features. And so, given that we are going to market in that manner where either the customer buys the entire clinical bundle and then they can pick and choose from the administrative bundle, or they buy the entire administrative bundle and they can pick and choose from the clinical bundle, we do not really report numbers based on individual features. But I am happy to note that the growth is secular across the three feature clusters or the two bundles, depending on how you look at it. Your second question was really around the AQuity cross-sell. Look, like I would mentioned earlier, we actually had anticipated that the cross-sell will take a little longer to actually put into motion, because we had to create an overlay consultative sales engine that would take some of the more transactional point solution-based relationships that AQuity traditionally had and elevate them to a platform sale. So, we actually created that overlay cross-sell engine in the first six months of the fiscal. But happy to note that in Q3 itself we were able to start to see traction in the cross-sell motion. There are several deals that we were able to consummate in Q3. The one that I am able to publicly announce is the Louisiana Children's Medical Center, which is a very significant health system in the New Orleans area. But there are several other marquee systems that are already starting to consume other manifests of the IKS platform beyond what they traditionally had in the AQuity relationship. So, that's one of the reasons why we have been able to deliver a 16% year-on-year growth for Q3 in spite of the muted effects of cutting the AQuity customer tail as well as offering customer discounts and incentives in order to allow us to transform their operating model that is now then showing up on the bottom line.

Thank you, and all the best.

Thank you. The next question comes from the line of Abhishek Kumar from JM Financial. Please go ahead.

Hi. Good morning, Sachin. Always good to hear from you. A couple of questions from my side. First, as we look at 12% dollar revenue growth year-over-year this quarter, can we break this down between the growth in the heritage IKS business and in the AQuity? The reason I am asking is, as you pointed out, there is some dampening impact of tail cutting and offshoring. So, just wanted to appreciate the strength in the heritage IKS business from a year-over-year perspective.

Great question, Abhishek. Thank you. And good to hear from you. So, look, obviously, because the dampening effect of the revenue is largely in the AQuity installed base, obviously the IKS legacy business and installed base is actually growing significantly faster than the 12%. While we do not want to give specific numbers because we really are now operating like one company and one platform, I will tell you that the growth in the legacy IKS business has been robust. Also, there's been some tremendous new logo addition, like I called out in deals like Palomar and Western Washington and Radiology Partners, which are all reflecting in the IKS numbers. And so yes, the IKS business is back to its historical growth rates, which you have evidenced FY '22 to '24. The legacy AQuity business obviously is going through a dampening effect. But again, as the AQuity cross-sell motion starts to truly get activated and kick in, we hope to be able to overcome that. And then obviously the blended growth rates will continue to be far superior than the 12% that the industry is going at.

Okay. Maybe a related question. When I look at the standalone numbers, on a Y-o-Y basis they seem to have kind of remained flat or a slight decline actually. So, I was wondering if that standalone number is a reflection of heritage IKS business or there are some subsidiaries which are excluded and therefore my reading is wrong.

Sachin, I can take that. So, the standalone numbers are not reflective of legacy IKS business. We have other subsidiaries in the U.S. where the rest of the revenues have been booked. So, I think you should refer to Sachin's comments on the growth related to the legacy IKS business.

Okay. One last question from my side. Palomar deal, we have mentioned that we have paid upfront guarantee of Rs. 139 crores and Sachin, you indicated that it's a 15-year deal. So, first, I wanted to just understand the structure and does this Rs. 139 crores, or $16.5 million, represent the saving that we will do for them over the 15 years that the tenure of this deal is for. Any color on how we structure and then how overall what kind of ROI, etc., we make on this upfront investment? Thank you.

Great question, Abhishek. Thank you. So, the way the Palomar deal is structured is like I was saying it's a 15-year no out for convenience deal and what's most unique about it is that they are committed to deploying the full 16-feature manifest of the IKS platform from the get-go. At the deployment of this full 16-feature platform, we actually anticipate that the value created, the net economic value that we will create for Palomar at the confluence of the costs that we will save for them and the revenue upsides that we will generate for them will be many multiples of that $16.5 million. I cannot reveal exactly how much, but it will be many multiples of the $16.5 million and so hence we were comfortable advancing that $16.5 million to them, and the way the deal is structured is the first $16.5 million of the net economic value add that will be created will come to IKS. After that, up to a certain threshold, the net economic value add is shared 50-50 between IKS and Palomar, and then another certain threshold, a larger amount of the benefit accrues to Palomar. So, a very unique deal structure. Very exciting for us, because traditionally our deals, even though our customer stickiness is longer, tend to be four to five year-duration, this is 15 years, no out for convenience, full manifest to the platform. And based on our estimates of the value that will be created which is many multiples of the $16.5 million over the 15 years, not only will we expect to claw back the $16.5 million relatively rapidly, but then start to add significant non-linearity in our margins beyond the traditional gross margins that we expect from our platform.

Great. Thank you, and all the best.

Thank you. The next question comes from the line of Srivathsan from Avendus Spark. Please go ahead.

Yes. Hi, just two quick questions. One, does the last year sale numbers factor in the full three quarters of AQuity? That's one. Second, just wanted to get your sense on this Palomar deal, is this a first deal of this nature and is there any existing revenue from this client that's sitting in the financials already? Thank you.

So, this is absolutely our first deal with this customer and that makes it even more exciting that now large customers are trusting us with the full manifest of the platform in such a long-term deal construct. So, there is no other existing revenue from Palomar prior to this deal, which makes it even more exciting. As to your earlier question about the nine months, I am sorry, I did not quite catch the question. Maybe Nithya, if you did, you can answer it or if you can please repeat your question.

Yes, I did. So, to your question, in Q3 FY '24, there is two months of AQuity baked in.

Okay, thank you.

Thank you. The next question comes from the line of Gaurav, an investor. Please go ahead.

Yes. Thanks to the IKS team for this and congratulations on the phenomenal results. One of my questions is, as we talk about integration and amalgamation of AQuity into the IKS structure, are we also looking at any other similar acquisitions now or in the near future?

Thank you for the question, Gaurav. Look, I think the AQuity acquisition, as you know, was the first significant acquisition that IKS did after nearly 16 years of existence. And we did this through a combination of the cash we had on the balance sheet and a very conservative amount of debt as a multiple of our EBITDA. Through this, as you know, we have created a massive customer base that we are actually trying to right size so that we could really focus on those 500-odd enterprise scale customers. And I think, as I mentioned before, those 500-odd enterprise scale customers employ 150,000-odd physicians, which is 18% of the entire U.S. physician market. If we were to be able to successfully cross-sell our platform across those 500-odd customers, we are talking about a 90x growth opportunity from our current scale. So, our preferred growth path from here is really going to be organic in nature, given the massive customer base that we develop. Our inorganic strategy will be much more focused on perhaps bleeding-edge technology-type acquisitions, where we will be able to bring the power of our massive customer base and the access to data and context that we have, by which we can mature that technology rapidly. So, the inorganic strategy will be much more focused on tuck-in tech acquisitions. As a gene pool, we are not a company that relies on acquisitions for growth. In fact, even before we did AQuity, as you know, we were growing at nearly 30% year-on-year CAGR. So, AQuity was a unique strategic merger, really, that we embarked on, and I think we have a lot of good work to do ahead of us to capitalize on the benefits of that. Inorganic activities will be much more focused on technology to accelerate our journey from human-led tech-in-the-loop to tech-led human-in-the-loop.

Got it. Thank you, Sachin.

Thank you. The next question comes from the line of Sagar Dhawan from ValueQuest. Please go ahead.

Yes. Thank you for the opportunity, and congratulations on a good set of numbers. Just a question on the Slide 14 that we have in the presentation, revenue from top 10 customers, which is there Rs. 272 crores. Does this include any customer which has gotten consolidated in this top 10 into the acquisition of AQuity, or these are only the top 10 customers of the IKS ex of AQuity?

If you are referring to the Q3 FY '25 number, this includes top 10 customers of the consolidated entity. But if you are comparing it to Q3 FY '24, there was only two months of AQuity, as I mentioned before.

Right. So, could you please provide the revenue from the top 10 customers on a Y-o-Y basis, ex of AQuity, just from the top 10 customers of IKS, ex of AQuity?

We can take this offline. Somebody from our team will be in touch.

Sure. And there's just another question on the cross-sell opportunity. Just wanted to understand whether, basically what kind of revenue per client potential do we see in the AQuity's customer base for the cross-sell, if you can just provide some guidance on that.

So, that's a good question. Look, I think one way to think about that is that our opportunity set in a customer tends to be, if they are spending about 15% of their revenue on these tasks, at the full manifest of our platform, they will probably end up paying us, depending on their specialty mix, payer mix, something in the range of 10% to 12% of revenue, right? And so when you start to think about 18% of America's physician market existing in these 500-odd large enterprise scale customers that we will want to retain and cross-sell to, you can start to do the math. Typically, the 500-odd customers that we are really going to focus on, at the full manifest of IKS, should all be able to generate nearly $100 million a year of revenue to IKS. And that's the type of customer base that we are retaining. And that's sort of the ACV potential at the full manifest of the platform. That's also why the Palomar deal is so exciting for us, because it starts to set a paradigm for customers embarking on journeys that apply the full manifest to the platform. So, that's sort of a high-level way of thinking about what the ACV potential will be is that we are really focused on retaining those 500 customers across the legacy IKS and legacy AQuity customer base that at full manifest could be $100 million ACV customers.

Understood. Thank you and all the best. That's it from my side.

Thank you. The next question comes from the line of Nilesh Jain from Astute Investment Management. Please go ahead.

Hi, congratulations on a great set of numbers. Firstly, I had a question on AQuity. At the time of acquisition, when we had acquired, it was a 9% margin. Where are we now in terms of journey to presently, at what margins will be AQuity operating? That's my first question. And maybe I can take other questions.

So, thank you for the kind remarks. I will say that, like I was saying earlier, we are now operating like one platform. And so, we really would not like to reveal individual margin profiles of AQuity and IKS, but it'll suffice to say that there's obviously been significant margin transformation in the legacy AQuity business. And our estimate of being able to get to sort of the mid-30s on a blended basis was based on that journey, except that we have been able to accelerate that journey significantly faster than we had thought. And so, we have gotten to nearly a 31% EBITDA margin and a 32-odd percent adjusted EBITDA margin in this quarter itself. But I think you can safely assume that the AQuity margins are well on their way to transformation and there is still a significant runway ahead of us. One of the math that I would share with many people in the roadshows was that, for every human that we are able to transform or replace through a combination of our technology and some supervision through a global human capital, we are able to create about, give or take, $20,000 a year of additional gross margin through every human that we replace. And when we started out, there was nearly 2,500-odd humans in the U.S. So, depending on what we are able to take that down to, based on our customer agreements and customer comfort, that will eventually signal sort of the end of that runway for AQuity margin transformation. I will say that we are probably not even at the halfway mark yet.

All right. All right. My second question is, you mentioned you have around 16 tasks. So, just wanted to understand, are there any other features or tasks where you are not present and which are not part of your offering. And what would be those and if you are looking to add those as well?

Absolutely. Great question. Thank you. So, look, I think at any given point of time, we have at least two or three new features or tasks that are in co-development with customers that obviously continue to then increase the TAM further than what is available today. And so happy to note that we have at least two or three in co-development right now. One such example, for example, would be several tasks within the value-based care feature cluster of our platform. That value-based care phenomenon in the U.S. is going through a major shift. Initially a lot of the focus was on risk and quality optimization, whereas now the focus is in total cost of care management. And so when you start to think of care coordination, transition of care management, risk stratification of populations, utilization management, at least the back office of the utilization management, those would all be new features. Also, there are some other features within the physician's workflow that are applicable both in fee-for-service and value that are under development. For example, one example for that would be order entry, both synchronous and asynchronous order entry. So, yes, constant development of new features. I would not be surprised if we would reveal three to four new features over the next 12 to 18 months.

Good to hear. And then last question is, I mean, we have seen that there's been a lot of M&A activity recently by private equity on the RCM side. So, where do you see competition on your revenue optimizing side of offerings, which you have? How do you see them and how do you compete?

It's a good question. Look, I think that's a very interesting market, and it's really changing rapidly. If you think about it, one way to think about it is, traditionally, there were sort of two genres of companies in the web cycle space, maybe three genres of companies. One, U.S.-based companies that were directly contracting with healthcare providers and leveraging a combination of their U.S.-based human capital, their U.S.-based technology, and subcontracting a bunch of offshore labor to deliver the RCM outcomes to customers. So, companies in that genre would be companies like R1 RCM, which was formerly called Accretive, or Ensemble Health or Conifer. Those would be that type of RCM companies. The second type of RCM companies were the ones that grew up and traditionally as Indian task vendors, those are the ones that I think have been a lot in the news in the Indian ecosystem. You heard of Access Healthcare and GeBBS and Omega. Their legacy was where they were subcontractors of tasks for U.S. RCM companies, but they did such a good job of executing and got to so much scale that now they are actually going upstream and trying to acquire customers directly in order to be able to deliver those efficiencies to the customers. Might that create some channel conflict? Maybe, but we have to give them credit for the type of scale they've driven. And then the third genre perhaps is a company like us that was neither a U.S. company nor an Indian company, but deliberately created a global execution model with proprietary technology and always had direct customers in the U.S. where we took accountability for their outcomes. And so I think those would be the three genres of the companies. I feel like all those three genres today are converging into that globally enabled tech-driven RCM solution. Some of us perhaps started like that. Others are converging to that. So, it will be very interesting to see how the winners emerge in this space. But again, remember, our competitive positioning is that RCM is just one part of the overall value chain of chores that physicians are straddled with. And so our competitive positioning really and our right to win often has been that not only are we a best-in-class RCM, but we are actually able to drive a lot more improvement in the physician productivity through our clinical support solutions. And then also beyond the fee-for-service patient panels that are affected by RCM, we are actually able to help physicians with their value-based care patient panel with our VBC feature cluster.

Thank you for that detail. Just a last bookkeeping question. You generated around Rs. 500 crores to Rs. 600 crores of operating cash flows. By when do you think you will be paying off your entire debt or you will become debt free? That's it. Thank you.

So, all things remaining equal, remember, we have operated for 16 years with no debt and actually significant amount of cash. So, all things remaining equal, we should be able to get debt free sometime next fiscal. But obviously, there might be other uses of capital, including tuck-in tech acquisitions, more innovative arrangements with customers where we align the value that we create with their outcomes. And so depending on that, there might be some dethrows to that. But all things remaining equal and us not embarking on any such endeavors, there's no reason why we wouldn't be debt free next year.

Thank you. And all the best.

Thank you. The next question comes from the line of Siddharth Mishra from Fidelity International. Please go ahead.

Hi, Sachin and Nithya. Good to hear from you. I wanted to ask a couple of questions. One is, firstly, I appreciate the very long-term opportunity which is there and congrats on the progress which you have done in the AQuity acquisition. I just had a question on the deals which you won in the last quarter. What is the ramp timelines of these deals and when do they convert into revenues? And secondly, Q4 will be, I think, the quarter where you will have a base where you have the full AQuity company in the base. So, do you expect to grow as strong as we have seen in this quarter, even in Q4, considering the ramp-up of the deals which you won in Q3? And secondly, this is more of a philosophical question. So, you are at 750 customers as of end of December 2024 and you want to get to that 500 customers with AQuity. So, just wanted to understand, how aggressive will you be in cutting the AQuity clients versus having also a good overall growth, top line growth? Will you kind of go in a pace which will still keep our overall growth good in the double-digit category? Or do you think you will first be very aggressive in cutting AQuity clients irrespective of what impact it might have on revenues? And then how will it impact your profitability growth as well? So, these are two questions.

Great. Thank you. Thank you, Siddharth. So, look, first of all, just to sort of recap, our theme for FY '25 was to cut the lowest hanging fruit of the tail that we definitely do not want to play with going forward, which I think we have executed on for the large part, and really get the blended margins of the business to the place that they need to be in. And so as you have seen, we have really been executing to that. And I am fairly confident that we will be able to continue to execute to those themes in Q4 and beyond. The one way to think about it is, even in spite of all of the rationalization of customers as well as transformation of margin-related discounts, we have delivered a 16% year-on-year growth. And this is before the cross-sell has gotten activated. And this is before, like you noted, some of the ramp effect of the IKS new customers come into play. So, I have maintained through the roadshows, and I will still maintain that the opportunity that we have created for ourselves is to execute far faster than the 12% TAM growth over the next 10, 15 years, not just over the next few quarters. So, I have no reason to believe going into Q4 and well into the next several years, we have any reason to slow down that growth to any lower than much faster than the 12%. So, that's one. Yes, we will continue to optimize margins. We have been a little lucky in that we have been able to accelerate that faster than what we had originally thought. And I think as long as we stay on that path, maybe we get to the steady-state margins towards the mid-30s instead of the next two years within a year. So, yes, I do believe that we will be able to deliver significantly faster than the 12% growth and continue to run towards that steady-state EBITDA margin profile of getting to the mid-30s over the next year. As it relates to your specific question about when these deals will ramp, all of these three deals actually have gone live as we talk and they will ramp through Q4 of Fiscal ‘25 and Q1 of Fiscal ‘26. So, the full effect will be felt over the next two quarters and that will continue to reflect in even faster year-on-year growth than perhaps we have been able to witness in Q3.

Yes, thanks for that. So, just to clarify, the 16% year-on-year growth which is shown in this quarter is over a base which had only two months of AQuity, right? And in Q4, you are saying that even with the full impact of AQuity acquisition in the last year, you still expect to grow very strongly. Is that a fair understanding or --

While I am not giving formal guidance, I think that will be safe to assume.

Okay. Got it. Thanks. Thanks a lot.

Thank you. The next question comes from the line of Chirag Kachhadiya from Ashika Institutional Equities. Please go ahead.

Hi, am I audible?

Yes, please go ahead.

Yes. So, I have one question. So, every year, what average price increase took place in for the 16 available features on platform for the existing legacy clients? Yes.

So, good question. Thank you. Look, first of all, let's all recognize that we are operating in an environment where it's significantly intensely competitive and customers are looking for more and more value from their partnerships. Having said that, I think a reflection of the strength of our platform has been that we have cost of living adjustment clauses in our contracts with most of our customers that are indexed to U.S. inflation. And we are working hard towards not only retaining those clauses, but then also creating further non-linearity opportunity in our contracts through conservative, but unique value-sharing arrangements like we have done in the case of Palomar and several others. So, generally, we have COLA indexed to U.S. inflation and beyond that, we are coming up with value-sharing constructs that will give us further protection and enhancement of margins.

Okay. In addition to my question, so in the growth which we are anticipating north of 5%, that is industry growth, what is COLA led and net new growth will be there on incremental basis? Yes.

Yes, I think the bulk of the growth is actually incremental growth, I would just say that the bulk of the growth is actually incremental growth, because legacy AQuity really did not have much COLA in their contracts at all. And so I would say, the bulk of the future anticipated growth should be attributed to real growth in existing customer volumes or new customer additions.

Thank you. The next question comes from the line of Ruchi Mukhija from ICICI Securities. Please go ahead.

Hi. I have two questions. We have announced three large deal wins. Sachin, can you define for us what constitutes large deal for IKS?

Yes, that benchmark continues to change, Ruchi, over a period of time. But I will say that in today's world, a large deal for IKS still is one that is able to contribute north of $10 million in annual contract value per year.

Got it.

Now, many of these deals will take some time to ramp to that. But as long as they have that type of a commitment and potential embedded in them, they will qualify for the large deal.

Noted. Secondly, we have given aging of our top 10 and top five clients. The aging reported for three quarters implies that they have been shown in our top five and 10 accounts. Is that the right understanding? And the reason for that? The second part of this question is, what business attribute by you, as a management team, look to track when you are looking at a client aging? Is the client vintage, which stresses the deep client relationship? In that case, this number should show consistent and gradual increase? Or is it a churn, which has been the characteristic of this metric when you look at the past history?

Hi. Let me take that, Ruchi. Thank you for the question. So, what do you see on the slide in terms of vintage of top five and top 10, the numbers are not really comparable. If you look at IKS legacy, our vintage has only improved. There are some clients after AQuity acquisition who got into our top 10 and top 5 who had slightly lower vintage. So, that's the reason you have seen, let's say, if you are looking at Q3 FY '24, our top five client vintage, the numbers might look like it's come down from six to five, it's only because the mix changed with AQuity acquisition.

So, going forward, what I am trying to understand is the churn is a constant feature of this metric, or should we expect that the large client stay in this top position and this vintage keep on increasing?

No. This vintage will keep on increasing. I think at the outset, Sachin had mentioned that 95% of our revenues are from repeat clients. And I can share that even amongst the AQuity clients, since our acquisition, we have not really lost any top clients that we are focusing on. And of course, IKS clients as well remain steady with us.

Got it. Thank you and all the best.

Thank you. The next question comes from the line of Devesh Mehta from Preeti Investment Managers. Please go ahead. Ladies and gentlemen, Devesh has left the question queue. We move on to our next question, which is from the line of Hemendra Kumar, an investor. Please go ahead.

Good morning. Thanks for the opportunity. I really appreciate the business, the model of what IKS operates. My question is, as you have a platform helping admin jobs and taking care of physicians' tasks, etc., what is the company's perspective on continuum of care to patients? Maybe I am not aware of U.S. policies about patient care. And are you doing anything in that aspect where you can devise a model where you can give a dietary management or lifestyle management, cardiovascular management, etc., all such lifestyle diseases where you can focus? Because you have a very large human capital and maybe you can operate on this model also. But again, as a pilot project, can you do the same for patients in India so that as a pilot batch, you can generate the same across the U.S.? Thank you.

So, Nithya, do you want to take that? I had trouble following the question.

I did too. I am sorry. If you do not mind repeating the question.

Yes. My question was basically on continuum of care to patients where typically you are operating a model which is of physicians taking care of admin tasks, physicians, etc., joining the hospital and exiting the hospital, etc.. But is there any model from your side of continuum of care to patients who are leaving the hospital and leading a life where they are having lifestyle diseases, chronic conditions, and are we doing anything to manage such people? Is there a policy in the U.S. where you can contact patients and give continuum of care because you have a large human capital? And can you do the same in India also?

It's a great question. Actually two questions there. So, yes, like as I was referencing when the question was asked around some of the new features we are creating, our entire offering that enables total cost of care management in fully delegated risk contracts actually involves exactly that, where we are building care coordination, transition of care management models, enabling effective home-based care for patients, community-based care enablement, all of that is really aimed at managing the patient across their journey within the continuum of care, including their home. And so yes, from our total cost of care offering, sir, we will actually start to take baby steps in the realm that you are talking about because the reality is that outside of end-of-life care, as much as 60% to 70% of all cost of care is driven by chronic lifestyle disease. And to manage those patients, one needs to sort of follow them and meet them wherever they are in their care journey. So, yes, we will start to see significant expansion into managing our customers' customers, which is our customers' patients across the continuum of care. As it relates to India, we feel right now we are still focused in the U.S. The Indian market to us seems a little immature. For example, a lot of the ambulatory physician office-based care isn't even covered by insurance. So, as the Indian market matures a little bit, I am sure there will be learnings from our journey in the U.S. that we will be able to bring to India, but that's not an immediate-term focus.

Yes. Thanks for that answer, but I just want to update you that from 2008 or '09 onwards, the workshop dome of a U.S.-based company has invested in continuing of care for the diabetes management molecule in India and I was a part of that program which was successful and I have seen reduction in HbA1c, cardiovascular management, patient satisfaction, etc., dietary management. It was a wonderful, wonderful program. So, you can take feedback from such companies and implement and maybe guide your team on management practices, etc. Thank you.

Thank you for the suggestion.

Thank you. Ladies and gentlemen, as there are no further questions, I now hand the conference over to Mr. Saransh Mundra for his closing comments.

Hi. Thank you, everyone, for joining our first earnings call. It was a really insightful session. I think many more participants came in than we expected. For any further questions, please feel free to reach out to me or anyone in the company. We will be very happy to answer you. Thank you, everyone.

Thank you.

And again, I will just end by saying that we are literally at the start of this, what I think is a multi-decadal secular journey to drive sustainability in the U.S. healthcare market and we are super excited to have you on this journey with us.