Ontrak, Inc.

Good day and thank you for standing by. Welcome to the OnTrack Health fourth quarter 2024 earnings call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you need to press star 1-1 on your telephone. you will then hear an automated message advising your hand is raised. To withdraw your question, please press Start 101 again. Please be advised that today's conference is being recorded. I will now hand the conference over to your first speaker today, Ryan Holsted. Please go ahead.

Thank you, Operator, and thank you all for participating in today's call. Joining the call are Brandon LaVerne, Chief Executive Officer, Mary Lou Osborne, President and Chief Commercial Officer, and James Park, Chief Financial Officer. Earlier today, OnTrack released financial results for the quarter ended December 31, 2024. A copy of the press release is available on the company's website. Before we begin, I would like to make the following remarks concerning forward-looking statements. All statements in this conference call other than historical facts are forward-looking statements. The words anticipate, believes, estimates, expects, intends, guidance, confidence, targets, projects, and some other expressions typically are used to identify forward-looking statements. These forward-looking statements are not guarantees of future performance, but may involve and are subject to certain risks and uncertainties, other factors that may affect ONTRAC's business, financial condition, and other operating results, which include but are not limited to the risk factors described in the risk factors section of the Form 10-K and Form 10-Q as filed with the SEC. Therefore, actual outcomes and results may differ materially from those expressed or implied by these forward-looking statements. OnTrack expressly disclaims any intent or obligation to update these forward-looking statements. With that, I'd like to turn the call over to Brandon.

Thank you, Ryan, and thank you, everyone, for joining our call today. First, I'll start with the progress we are making with our new customers. Collectively, we have now secured three new regional health plan customers and four health plan expansions in the last 14 months, spanning a range of plan types, including Medicaid, HARP, commercial, and now Medicare Advantage, showcasing the versatility of our offerings. James will highlight the positive impact to our revenue of these new launches later in the call. I'm pleased to announce that our recent launch of our Whole Health Plus solution with our newest customer, Intermountain Health, is going well. In a little over a month since launch, we have enrolled over 325 members and will continue to outreach and enroll from the 2,400 remaining Whole Health Plus eligible members that we added with this new customer. Additionally, we're also seeing strong enrollment and engagement with the members from the Northeast Regional Plan, which we announced in Q3 and launched during this quarter. Since launch, we have enrolled more than 450 members in our Whole Health Plus program. For recent customer expansions, we secured a three-year contract extension with Sentara Health Plans. This agreement strengthens our long-term partnership and builds upon the 2024 successful expansion, which grew our outreach pool by 6x the size during the year. In addition, we have an existing customer who has recently expanded its geographic service area to a total of five Florida regions in February 2025, and we are in strategic discussions to potentially expand our Engage offering to include adolescents and members suffering from chronic pain conditions. Next, we're excited to share the progress we are making on our growing sales pipeline. We are in active strategic discussions with six additional health plan prospects, including a large Midwest plan that is in the late stage of our sales process. This large Midwestern plan, after sharing full member data and completing a review of fees, savings, and ROI methodology, has progressed to SOW drafting and review. Based upon our proposal that is currently in discussion, this plan could more than double OnTrack's run rate revenue and is reflective of stronger than expected alignment between OnTrack's AI-driven advanced engagement system and the plan's high needs population. As I said before, this plan has sent us their member data, and I'd like to underscore that importance, given OnTrack has a 100% success rate over the past several years in converting prospects to customers once data is received. One of OnTrack's core differentiators is our ability to ingest and analyze member-level data and to recommend a targeted population for outreach. The traction we are gaining with our customers and prospective customers reflects our expanding value proposition to our payer partners and their members. OnTrack is also now engaging with payer partners designated as a value-based provider versus a vendor, which fundamentally reshapes our economic model with an ability to provide additional value to our prospective customers. As a value-based care provider, we align the quality outcomes and HEDIS measures with medical cost savings and financial incentives that we share with our payer partners. In addition, designation as a value-based provider gives us greater access to reimbursable fees within their medical cost ratio rather than administrative vendor fees. This shift is further enabling additional pipeline opportunities and provides payers optionality and flexibility in working with us. We are very excited with the momentum we have been able to gain in 2024 and into 2025, but even more so with several opportunities we have in front of us. We see a path through the bottom of our sales funnel to double our revenue in 2025, and then through the middle of our sales funnel to double our revenue again in the following year. And now I will turn it over to our President and Chief Commercial Officer, Mary Lou Osborne, to discuss these in detail. Mary Lou?

Thank you, Brandon. I'm thrilled to share. As previously announced and as Brandon touched on, a new Medicare Advantage health plan partnership with Intermountain Health. Intermountain is a prominent healthcare system operating 34 hospitals and 400 clinics in the western United States. The contract was executed end of December and we successfully launched our Whole Health Plus solution mid-February 2025 for Intermountain's Medicare Advantage population in Nevada. Once measurable clinical and financial success has been demonstrated, Intermountain intends to explore scaling on-track solutions to a wider Medicare Advantage cohort and potentially extending on-track solutions to additional lines of business. Along with this new health plan customer, we are in active strategic discussions with six additional health plan prospects who have formally requested a clinical and financial proposal to evaluate our multiple behavioral health solutions, clinical outcomes, and estimated financial savings. Starting with the bottom of the funnel, I will provide a quick summary of each of the interested prospects that are moving forward in the sales cycle. all of which have follow-up meetings scheduled with decision makers. As Brandon mentioned, we are super excited to be in late-stage strategic discussions with a large Midwestern plan who is deeply interested in our Whole Health Plus solution for their 300,000 Medicaid members. We have been working very closely with the plan's leaders for over a year and received the plan's member data in March. We are responding daily to detailed questions about our solutions, clinical outcomes, estimated savings, and closing gaps in care. We have provided a Whole Health Plus clinical and financial proposal, which has been positively received by the PLANS team. The PLANS leadership team has expressed their excitement for OnTrack's tech and AI capabilities, such as our advanced engagement system, digital twin, next best action, and the commitment of achieving a 2x guaranteed ROI. This plan has prioritized behavioral health and recognizes the value in offering OnTrack solutions to improve member health outcomes, reduce avoidable inpatient and emergency room utilization, and produce savings. This prospect has requested for OnTrack to serve as a provider partner versus a vendor. What this means is ONTRAC will build a health plan CPT codes for the WHOLE Health Plus services that we will provide for enrolled members. A provider model is an effective and more expedient way to begin a health plan partnership. To complete and execute the provider model contract for this Medicaid plan, ONTRAC applied for state Medicaid approval, and we are thrilled to announce ONTRAC was approved on April 1st OnTrack and this prospect have multiple meetings scheduled to continue advancing all the final steps in the process before executing the MSA SOW. The next prospect is a rapidly expanding Medicare Advantage plan operating in three states prioritizing behavioral health support for high acuity members. Recognizing the urgency to identify external partners to provide additional behavioral health support for its members, the plan has expedited discussions, signing an NDA, and immediately sharing the member data, identifying behavioral health conditions that align with on-track solutions. Due to our increasing momentum, we are gaining more visibility into the potential revenue conversion for prospects in the middle of the funnel. We have four interested prospects. I will provide a summary on each. A Southeastern Medicaid plan has requested a clinical and financial proposal for their Medicaid SMI members. The plan's clinical leaders are excited about our Southeast footprint, which includes serving another Medicaid plan, supporting SMI members, and having state Medicaid approval to serve members in the state. This plan is interested in our Whole Health Plus program and potentially our engaged solution. Another large regional health plan located in multiple states is in active discussions with us. This plan is interested in OnTrack's behavioral health solutions and advanced engagement system for its commercial population. The plan's clinical team is fully engaged with delving deeper into OnTrack's innovative technologies, clinical programs, reporting capabilities, and outcome measurements. This plan has requested and we have provided a financial proposal to present to their leadership team. Another health plan prospect, a Medicare Advantage plan owned by multiple hospital systems in the Midwest region, is exploring a partnership opportunity. This plan has requested a financial and clinical proposal. They are interested in our Whole Health Plus and Engage solutions. Another prospect, a Medi-Cal health plan on the West Coast has requested a financial proposal on our quality program, supporting a few of their heated gaps in care. The plan is interested in our outreach, engagement, and support of members in assisting them with scheduling follow-up provider visits seven and 30 days after an inpatient stay and or an emergency room visit. To summarize, we have had an abundance of sales prospect activity and six customer requests for financial proposals. While not all of these prospects will close, several late stage prospects are anticipated to enter the final contracting phase within the next 30 to 60 days. The remaining opportunities are still midway in the funnel and will need further strategic discussions before advancing to the next stage. Our proactive behavioral health solutions continue to gain traction, and our total pipeline momentum continues to build, as you just heard, with six active prospects requesting financial and clinical proposals. We also have 20 additional prospects in the pipeline in some phase of strategic discussion, representing over 15 million lives. I will now turn the call over to our Chief Financial Officer, James Park.

Thanks, Mary Lou. In Q4, our revenue reached $3.1 million, reflecting an 11% decrease compared to the same period last year. The decrease was due to the loss of a customer earlier this year, slightly offset by new customers signed during 2024. We began the quarter with 2,065 members and concluded with 2,125, resulting in a simple average of 2,095. which includes 329 members that are part of our Engage program. Our revenue per health plan enrolled member per month average approximately $500. This represents a sequential increase from $449 in Q3 of 2024 and a decrease from $546 in Q4 of 2023. The sequential increase is due to disenrolled members related to a customer termination that we previously discussed which brought down the average members enrolled at the end of the quarter, while they contributed revenue during the full quarter. The primary factor contributing to the year-over-year decline in Q4 of 2024 compared to Q4 of 2023 is due to the mixed shift resulting from newer customers with different pricing structures and the inclusion of new engaged members with lower revenue per member per month. As we move through the rest of the year, We anticipate our per member per month revenue to continue to decrease compared to last year, while overall revenues are expected to increase. Regarding our Q4 membership data, we added 1,641 new members during the quarter, with 659 members enrolling in our Engage program. The current quarter's total enrollment is a sequential increase compared to the 1,166 new enrollment in Q3 of 2024, and a year-over-year increase from 654 in Q4 of 2023. Our Q4 2024 new members enrolled is the highest total enrollment in a quarter since the third quarter of 2021. Dividing Q4 gross enrollments by our outreach pool, which averaged 13,168 for the quarter, it annualizes to a 50% enrollment rate compared to 64% enrollment rate in Q3 of 2024 and 63% in Q4 of 2023. We ended the year with a total outreach pool of 25,000, which includes 20,000 for our engaged solution. And as of today, the total outreach pool is at 29,000. In the current quarter, our average monthly disenrollment rate stood at 19% compared to 11% in Q3 of 2024 and 16% in Q4 of 2023. The disenrollment rate was higher in the current quarter due to the disenrollment of members of the customer termination previously discussed. Without the impact of these members, our disenrollment rates for the quarter would have been slightly lower than historical disenrollment rates. Additionally, we saw 226 enrolled members graduate from our Whole Health Plus program this quarter. This graduation rate represents approximately 11% of the members enrolled at the beginning of the quarter, which is consistent with previous periods. Taking into account new enrollments, disenrollments, and graduations, we achieved a net increase of 60 members during the quarter. For Q4, we reported a gross margin of 61%. This represents a slight Decrease from the 62% recorded in Q3 of 2024 and 64.6% margin in Q4 of last year. Looking ahead, we anticipate our gross margins to decrease slightly into mid-50s based on current pricing and mix of revenues between our Whole Health Plus and Engage solutions. Turning to the balance sheet and cash flow statement, our operating cash flow for Q4 showed a negative $4.3 million. This compares to a negative $3.6 million in the same quarter last year and a negative $1.4 million in Q3 of 2024. As of year end, our cash reserves stood at $5.7 million. This represents a decrease from the $9.7 million we had on hand at the conclusion of the previous year. During the quarter, we drew down $1 million and subsequent to quarter end, we drew down another $1.5 million of demand notes, leaving $5.5 million available for future draws subject to approval. We are currently in active discussions for a financing option to access capital needed to continue to execute on our sales pipeline and our business plan. Specifically for Q1 2025, we anticipate revenue in the range of $2 million and $2.3 million, or a 36% to a 27% sequential decrease. This sequential decrease, and the revenue being lower than our annual run rate of $15 million from customers under contract, is due to the lost customer at the end of the fourth quarter and revenue from new customers still in the ramp-up phase. While this represents a temporary step down, We have strong visibility into achieving our revenue run rate by Q2 of 2025. This confidence stems from the progress in onboarding and enrolling members from recent launches, such as our Whole Health Plus solution with Intermountain Health and the Northeast Regional Plan. We anticipate revenue contribution from these implementations to stabilize in Q2, followed by sequential growth in Q3 as programs mature and member engagement expands. The bottom of the funnel, which includes the large Midwestern plan that Mary Lou discussed, could add an incremental annualized revenue of $14 to $16 million, which would effectively double our annualized revenue. The remaining opportunities in the middle of our sales process represent $20 million to $28 million of additional annualized revenue opportunities. With this progress we've made in our sales funnel, we see a path to double our revenue in 2025 and again in the next year. Now, we will open up for questions. Thank you.

Thank you. And as a reminder, to ask a question, you will need to press star 101 on your telephone and wait for your name to be announced. To withdraw your question, please press star 101 again. Once again, that's star 101 for questions. Please stand by. We'll compile the Q&A roster. Once again, that's star 11 for questions. I see no questions in the queue. I would now like to turn the call back over to Brandon Laverne for any closing remarks.

All right. Thank you, Victor. And thank you, everyone, for joining us on our call today. I hope everyone has a great day. Thank you.

Thank you for your participation in today's conference. This does conclude the program. You may now disconnect. Everyone, have a great day.