Phreesia, Inc.

Good morning, ladies and gentlemen, and welcome to the Freesia fiscal fourth quarter and full year 2021 earnings conference call. At this time, all participants are in a listen only mode. Later, we will conduct a question and answer session and instructions will follow at that time. I would now like to introduce Balaji Gandhi, Vice President Investor Relations for Freesia. Mr. Gandhi, you may begin.

Thank you, operator. Good morning and welcome to Freesia's earnings conference call. for the fiscal fourth quarter of 2021, which ended on January 31st, 2021. Participating on today's call from Frisia, our Chief Executive Officer and Co-Founder, Haim Indig, Chief Financial Officer, Tom Alvier, and Senior Vice President of Marketing and Business Development, Michael Davidoff. Following prepared remarks from Haim, Michael, and Tom, we will conduct a Q&A session. A complete disclosure of our results can be found in our earnings press release issued yesterday evening, as well as in our related Form 8K submission to the SEC, both of which are available on the investor relations section of our website at ir.freesia.com. As a reminder, today's call is being recorded and a replay will be available following the conclusion of the call. During today's call, we will make forward-looking statements within the meaning of Section 27A of the Securities Act and Section 21E of the Securities Exchange Act. Although we believe that the expectations reflected in these forward-looking statements are reasonable, these statements relate to future events or our future operational or financial performance and involve known and unknown risks, uncertainties, and other factors that may cause our actual results, performance, or achievements to be materially different from any future results, performance, or achievements expressed or implied by these forward-looking statements. Furthermore, actual results may differ materially from those described in the forward-looking statements and will be affected by a variety of risks and factors that are beyond our control, including, without limitation, statements about our future financial performance, including our revenue, cash flows, cost of revenue, and operating expenses, our anticipated growth, our predictions about our industry, the impact of the COVID-19 pandemic on our business, and our ability to attract, retain, and cross-sell to healthcare provider clients. These statements are also subject to other risks and uncertainties, including those more fully described in our filings with the SEC, including in our annual report on Form 10-K that will be filed with the SEC later today. The forward-looking statements made on this call speak only as of the date on which these statements are made. We undertake no obligation to update and expressly disclaim the obligation to update any forward-looking statements to reflect events or circumstances or to reflect new information or the occurrence of unanticipated events except as required by law. We will also refer to certain financial measures not in accordance with generally accepted accounting principles in order to provide additional information to investors. These non-GAAP measures should be considered in addition to and under the substitute for or in isolation from our GAAP results. A reconciliation of GAAP to non-GAAP results may be found in our earnings press release and supplemental materials, which were furnished with our Form 8K filed after the market closed on March 30th with the SEC. It may also be found on our investor relations website at ir.freesia.com. As a reminder, we are participating on today's call from four different locations, so we appreciate your patience with us. I will now turn the call over to our CEO, Hyman Dick.

Thank you, Balaji. Good morning, and thank you for your interest in Frisia. Our fourth quarter reflects continued solid performance. Total revenue was $41.8 million, up 27% year over year. The average number of provider clients was 1,808, up 13% year over year. Average revenue per provider client was $17,858, up 7% year over year. Life sciences revenue was $9.5 million, up 58% year over year. Adjusted EBITDA was negative $85,000. a decline of $1.4 million year over year, reflecting our continued investment in long-term growth. Our performance over the past year was truly a team effort. There are two unique aspects of the past fiscal year that I would like to highlight and acknowledge. First, the transition to remote work. From the earliest days of the pandemic, everyone at Freesia has had to adapt to full-time remote work. often in the same living space as their roommates or families who are working or learning remotely as well. This has allowed us to continue to grow our team to over 800 folks who work tirelessly for our clients and their communities. Our team grew 55% in fiscal 2021, with growth spread across all areas of our organization, service and support, sales and marketing, research and development, and G&A. The recruitment and onboarding of hundreds of new team members in the pandemic environment was particularly challenging. There is no playbook to draw from. Our human resources team and managers across the organization adapted to the new environment by testing new approaches to recruitment and onboarding that we believe will strengthen our processes going forward. We will continue to invest and learn together as we adapt our company to permanently remote-first environment. Second, the development of new solutions such as our COVID-19 screener, intake for telehealth, and vaccine delivery management, all of which were not part of our near-term product roadmap when we entered fiscal 2021. These modules are helping our clients operate safely and efficiently through the pandemic. We saw significant client growth with our average provider client count in the fourth quarter, increasing by over 200 clients year over year. These clients range from small ambulatory practices who are onboarded quickly to large health systems that engaged us and will likely look to expand their relationship with us over time. We will continue to invest across the organization to support our work with all the new and existing clients. Finally, we grew through acquisition. In October 2020, we integrated two web-based workflow applications co-developed by Geisinger and Merck that focused on patient communication and medication adherence respectively. In January 2021, we acquired QDoctor, an innovative company in our space who we have known for six years. Both of these additions to Frisia were led by our operating executives. I've asked Michael Davidoff, our SVP of Marketing and Business Development, to join us today to provide an overview of the QDoctor acquisition.

Michael? Thank you, Han, and good morning, everyone. QDoctor was founded in 2013 by Patrick Randolph. Patrick and his team set out to address the need for providers to reduce patient appointment cancellation and no-shows and ultimately accelerate patient access to care. According to industry data, cancellations, reschedules, and no-shows can reduce a provider's revenue by over 20%. What attracted us to QDoctor was its set of high-value SaaS features that will expand the value of our appointments-based offering. QDoctor's software is designed to identify patient appointment cancellations and no-shows and automatically fill those gaps in the schedule by pulling forward future patient appointments. We tracked QDoctor's progress in this space for many years and determined that it would take too long to replicate it through internal development. In addition to QDoctor's strong product offering and cultural fit, roughly one-third of QDoctor's clients are existing freezer clients, which we believe speaks to the complementary nature of our product. As we indicated in our earnings press release, the total consideration for the acquisition consists of $5.8 million in cash paid on the acquisition date, $2.1 million of liabilities incurred, and $2.2 million in performance-related contingent payments. Over time, we believe the underlying QDoctor technology will enhance our employment-based solution and the overall value of the Frisia platform to healthcare providers and patients. I'll now turn the call back to Hans.

Thank you, Michael. Before handing it over to Tom for his final quarterly review of the financials, I would like to acknowledge Tom's contributions to Frisia. Tom joined us in 2012 and brought with him half a century of experience in public accounting and growing technology businesses. He played an important role in our successful transition from a small venture backed company to the Frisia that was introduced to all of you through our IPO in 2019. I speak for the entire Frisia team, including our board of directors, in thanking Tom for his contributions. We wish him and his family all the best as he begins his next chapter in semi-retirement at the end of April. Going forward, we will also benefit from his experience in a new advisory role, and I will continue to enjoy his friendship. Tom?

Thank you, Haim, and good morning, everyone. I'll review the income statement, balance sheet, and cash flows for the fiscal fourth quarter and update our outlook for fiscal 2022. First, total revenue was $41.8 million, up 27% year over year. Subscription and related services revenue was $18.8 million in the quarter, up 25% year over year. Payment processing fee revenue was $13.4 million in the quarter, up 15% year over year, reflecting a continued recovery in patient visit trends, but still slightly below pre-pandemic levels. Provider revenue, which combines revenue from subscription and related services with payment processing fees, was $32.3 million in the quarter, up 21% year over year. The two drivers of the 21% provider revenue growth in the quarter were average provider client growth, up 13% year over year, and average revenue per provider client up 7 percent year-over-year. As we indicated last quarter, provider-client growth has been trending higher, reflecting increased demand for our offerings. That being said, our land and expand go-to-market strategy tends to result in quarter-to-quarter variability between the contribution of client growth and revenue per client. This has been the case for many years as our historical results show. Life Sciences revenue was $9.5 million in the quarter, up 58% year-over-year. Our team continues to execute on closing new business and delivering messages to very targeted patients. Now let's move on to expenses. I will review several expense line items on an adjusted non-GAAP basis. which excludes stock-based compensation expense from each line item. Please note that a full reconciliation of GAAP to non-GAAP measures, including adjusted EBITDA, is included in our earnings press release in our Form 10-K to be filed with the SEC. Cost of revenue was $6.8 million, or 16.2 percent of total revenue, up 320 basis points year-over-year. The year-over-year trend reflects the ramp-up we discussed last quarter in our client services organization to support our growth. On a sequential quarter basis, cost of revenue as a percentage of revenue was down 10 basis points. Sales and marketing expense was $12 million, or 28.7% of total revenue, up 530 basis points year-over-year. The increase reflects the accelerated investments we previewed earlier in the fiscal year to support our current and future anticipated growth. Research and development expense was $5.9 million, or 14% of total revenue, up 10 basis points year-over-year as a percentage of revenue. Note that we expect the pace and level of investment in R&D to accelerate over the next several quarters and dollars will be allocated across the existing platform as well as into new products and solutions. General and administrative expense was $9.5 million, or 22.8% of total revenue, down 180 basis points year-over-year as a percentage of revenue. We continue to ramp up public company expenses particularly in finance and legal, and we expect to begin to see operating leverage in the fourth quarter of fiscal 22. Payment processing expense was $7.8 million, up 12% year-over-year. Payment processing margin was 42%, up 120 basis points year-over-year, due to the mix of transaction type and lower cost routing of payments. Longer term, we expect payments margins to return to the 40% range with a quarter-to-quarter variability due to transaction type mix and interchange fees. Adjusted EBITDA was a loss of 85,000, a decline of 1.4 million year-over-year. The decline is largely due to the acceleration of investment across the company, but most notably in sales and marketing in the fourth quarter, as we capture the growth opportunities we are seeing in the market. Shares outstanding as of March 26th was $44.9 million. Cash on the balance sheet at January 31st was $218.8 million, down $35.3 million from October 31st. However, we paid down our $21 million revolver in the fourth quarter. Cash flow from operations from the quarter was $4.1 million compared to $1.3 million in the prior year quarter. Capital expenditures for the quarter were $7.5 million, up $4.3 million year-over-year, a significant increase reflects our ramp-up in data center equipment purchases and capitalized software to support our growth. Our outlook for revenue growth in fiscal 22 remains 20 to 25 percent, which translates into a revenue range of $178 to $186 million. We expect our overall cash outflow to increase in fiscal 22 compared to fiscal 21 as we continue to ramp up hiring and infrastructure across the organization to support our anticipated growth. In closing, the past eight years, with Freesia have been an incredible journey, and I'd like to thank Chaim and the entire Freesia team for their partnership and support, and I wish the best to Randy and the finance team members who have been so dedicated to our mission and growth over the years. We're ready to take your questions. Operator?

Thank you. At this time, we will be conducting our question and answer session. In order to ask a question, please press star, then the number one on your telephone keypad. In order to allow for as many questions as possible, we ask that you please limit your questions to one question with one related follow-up. Your first question comes from the line of Ryan Daniels with William Blair. Ryan, your line is open.

Yeah, good morning. This is Jared Haasen for Ryan. Thanks for taking the questions. Just wanted to ask maybe a quick one to start on the life sciences revenues. Obviously, that was strong again, both on a year-over-year basis as well as sequentially versus last quarter. And I think last quarter you talked about, you know, kind of continuing to make some investments and maybe feeling a little bit better about the team and then kind of where that product line is positioned in the marketplace. So just curious if the strength here this quarter has more to do with any sort of seasonality factors, you know, thinking maybe year-end budget flush with pharma clients, or is it really just, you know, kind of continued execution with the sales team and just a really strong demand environment?

Good morning. And, you know, I love talking about our life sciences org. What I'd say is that it's just execution. You know, I want to, as much as, I'd love to be able to point to a one-time seasonal thing. Like at the end of the day, the team has just been doing a really good job of really focusing on clients and making sure that we deliver phenomenal value and strong ROIs and are clearly articulating our value.

Got it.

Yeah. Thanks for that. That's good color. And then, um, I guess just maybe a bigger picture question, kind of thinking more longer term. Given all the things that have kind of changed from a demand perspective over the last year or so and product lines that you have developed, as well as the pace of hiring and the way in which you've kind of transformed the cost structure a little bit, is there any reason to think about you know, any sort of meaningful difference in your longer-term, you know, margin targets for the business? Or do you still feel like, you know, eventually getting to maybe 20% adjusted EBITDA margin is the right sort of longer-term target?

That's still the right target for us. I think the only thing we've done is increased our investment levels to support what we see as our ability to grab unfair share of market. We're very... This is my excited voice. We're very enthused about the reaction, feedback we're getting from our client base, and we're going to keep leaning in and investing to capture that share. Okay, great.

Thanks for that. Cheers.

Your next question comes from the line of Stephanie Davis with SVB Larynx. Stephanie, your line is open.

Hi, guys. Thank you for taking my questions and congrats on the quarter. So looking at your three revenue lines as you look forward to next year, you've got likely acceleration in your subscription growth because you just had a huge Salesforce investment. You have likely acceleration in payment processing because of the COVID comms. So that leaves life sciences as the plug to make 20% to 25% growth. But all market signals and recent performance there suggest that that shouldn't be decelerating dramatically. So could you help me reconcile that?

I can't reconcile your numbers, and I tend not to run the business by plugging, but I will say that we feel that the investments we've made across the board are really paying off. And all of our early indicators that we see are very, very positive. And I think our life sciences team is capturing also an unfair share of market gains too. So we feel good across the board. But that being said, I have no idea what the recovery is going to look like. And we just know that we're going to keep supporting our clients in which way possible.

Maybe ask another way. Is there anything that will cause deceleration in that life sciences revenue?

I'm sure if you thought enough ways, there's ways you could decelerate it, but we're really focused on continued growing it. I don't know if that, I don't really wake up and think about how I could decelerate the business.

Okay, fair.

We're pretty pumped about it. Everyone's sort of running hard here, so we're really excited.

So how do you get to only, like at the midpoint, three points of revenue growth acceleration?

The numbers get bigger?

No, I get that. The point is the only three points. It's not that three points is heroic.

Yeah, I mean, I just say, you know, the acceleration in and of itself is, you know, a move up from our growth rate historically. So I just have to sort of take it that way.

Okay, fair. And a quick follow-up on the QDoctor is it sounds like there's only a third overlap in your client base. Are you going to use this more as a capabilities expansion, or is there a cross-sell opportunity for incremental revenues there? Is that two-thirds that doesn't have it?

We both think this is capabilities, and it will allow us to cross-sell other applications. It will fit into applications that we are cross-selling to our client base. It's already integrated. We've had early success to date already. So it's been good.

All right. Thank you.

Cheers.

Your next question comes from the line of Scott Schoenhaus with Stevens. Scott, your line is open.

Thank you. Hi. Hi, team. I wanted to ask you a balance sheet-related question I thought was interesting. Property, plant, and equipment nearly doubled from last quarter. I wanted to see if you could provide more color on what investments you're making there and what that means for your business.

We're making, because of the big ramp in volume, we're also making fairly significant investments in data centers. So a lot of that is just to add significantly more capacity.

And is that also a sign that you're continuing to succeed upmarket into larger hospital systems? You need these larger data centers or more data centers?

To be clear, I think we're succeeding not just in large health systems, in the mid-tier and large ambulatory groups and surgery centers. Frankly, I think the team is doing a phenomenal job across the board. I think we've had some really nice wins in all the markets that we've been tackling. I'm just very pleased. And so we want to make sure that we continue to invest to continue to support the market share gains that we're winning.

Great. Just a follow-up there. So you're obviously seeing success in selling to across the board client base and taking share. How does the dynamic change between provider-client growth and average revenue per client given these larger land and expand opportunities with larger hospital systems? Just to be specific, are there cross-selling and up-selling opportunities once you expand into these systems? Is there a way to think about the average revenue per provider growth kind of accelerating in the back half of the year into fiscal 23. Just trying to get more forward there.

Yeah. I think when you think about one of the things that we pointed out even in our TAM, we didn't think that we were going to be able to grab as much payment volume in a large hospital system, so you're seeing some of that shift happen. But look, we're all And we view those metrics as tightly tied together, both average revenue and revenue per client. Those are metrics that internally the entire leadership team is strongly tied to. Thanks, Han.

Your next question comes from the line of Sean Weiland with Piper Sandler. Sean, your line is open.

Hi. Thank you. Good morning. I'd like to better understand, you know, payments up 15 percent, life science revenue up 58 percent. I would suspect that both of those have at least some correlation to visit volume. Can you discuss what the, you know, the separation there is?

They are. There is some correlation to visit volume. You're correct. But the life sciences revenue has other drivers to it, as does the visit, as does the payment volume. You know, since we did see a slight drop in our where we where the payback was, the was tied to Frigia. But we've also done a great job of cross-selling more visits to different life sciences customers using our significant investment in data science.

Okay. Can you just, as a follow-up, you know, what was the overall trend in visit volume for the year across the platform? And how is pricing holding up in the payments business? Hey, Sean, this is Balaji. Hey, the Commonwealth data, which we've been putting out, I mean, we want to be clear, we don't disclose visit data as a KPI or anything like that. But you can see, you know, the data from Commonwealth, which spans pretty much the entire fiscal year, that it basically got within low single digits of pre-COVID levels by the end of the year. But overall, I mean, it was clearly down year over year. I don't know if that helps here. And it's more tied to payments, as Haim said, than it is to life sciences. There's some nuance to life sciences with payments. There's much more of a direct impact.

Okay. And how about the pricing in the payments business? I'll give you.

Can you characterize the pricing environment in the payments business?

Sean, I think you're talking about our take rate. Is that correct? Yes. It's been pretty flat sequentially. It's down like a hair, but not much sequentially.

Okay. Thank you very much.

Your next question comes from the line of Hannah Bade with DA Davidson. Hannah, your line is open.

Hi, thanks for taking the question. As Freesia moves upmarket with larger health system clients coming online, putting pressure on the percent of patient volumes processed through Freesia, can you ballpark where we should expect this percent to moderate?

Can you repeat that, Hannah?

Yeah, on the stat, the 79% this quarter of patient volume processed through Frisia, obviously it's going to move more upmarket, the larger health system clients coming online. That's going to put some downward pressure on that statistic. Can you ballpark where we should expect this to moderate as you move more upmarket?

Yeah, I mean, I think, you know, I'll let Jaime and Tom follow up on this one, but it It's a function of, you know, just the types of clients we add quarter to quarter and the type of growth we get. So there's definitely mix in there. So it's hard for us to, I think, tell you, you know, what the pay-to-back rate is going to be. You know, there's a little bit of chicken and egg there. But I think, and I don't know if Tom can weigh in here, but that change, the delta in that percentage, is a reflection of moving up marketing, the decline that you saw. Anything you want to add, Tom?

No, I don't think so, Andrew. As we add health systems and if they don't take payments, you'll see that decline.

Okay, thank you. That's very helpful. And just one follow-up. With a recent and likely episodic shift to vaccines, mass vaccination sites, pharmacies, and grocery stores, as opposed to traditional ambulatory care centers, are you seeing any customers impacted in regards to the visit uplift that they might have been expecting specifically for COVID vaccines?

Not sure I understand the question. Can you try again? Yeah, absolutely.

As vaccines kind of may shift away from a traditional doctor's office and an outpatient care center to, say, a CVS, have you seen any customers kind of be impacted in regards to customer revenue they were expecting to get in office because vaccines have shifted to kind of these external care centers like a pharmacy?

I don't think our clients, and this is conversations we've had with them, are waking up thinking that vaccines are a revenue driver. I think that what we're seeing is our clients and provider groups and health systems are mostly looking at this as how do they vaccinate their communities as fast and effective as possible. And I know a bunch that are partnering with the pharmacies locally and other organizations. I think the goal is to try to vaccinate the population as effectively as possible and not to think about this as a profit driver. And we don't monetize it in any meaningful way.

Got it. Thanks, guys.

Thanks.

Next question comes from the line of Ryan McDonald with Needham. Ryan, your line is open.

Yes, good morning. Tom, best of luck in semi-retirement. Great working with you. My first question... Yeah, thanks. My first question is, I guess, for Haim. You know, obviously seeing some continued strength in new logo growth, curious to hear how the newest group of SDRs that you added in throughout 2020 are impacting that new customer logo growth. How are they ramping in terms of productivity versus your internal applications?

You know, I've been really – I've been very – Please would be an understatement. I sat through one of the weekly demand gen calls last week, and I know Tom sat through a couple of them too, and they're just doing a good job. They're really able to reach out to people effectively. They're doing their calls effectively. We're seeing good demand gen. I don't want to say I'm pleasantly surprised because I'm not surprised because we have a phenomenal organization, but they're doing this. as expected. And we're very excited for the new the new group of folks that we have on the team.

Great. And as a follow up to that, as you as you sit on those types of calls and listen to the dynamics of the market, Is there anything that you're seeing in terms of incremental change in whether it's, you know, heightened demand or as your reps are out, you know, talking to prospective customers? Is there noise of other vendors sort of that are in the same markets right now? We've certainly heard a lot of noise from financing of other vendors in this space, but I'm curious to hear how early stages the market opportunity still is here.

I still think, you know, we've always heard noise for 16 years. Everyone's always, I've always thought that this space is easy to be in and delivering solutions is all it requires is a website or a press release. Our general view is raising money and putting out websites and press releases doesn't create product to drive a phenomenal amount of value. So I think what we're doing is making sure that our customers get products and that drive a phenomenal amount of value, great value, and then rolling out and trusting us even more for more products. And that thesis has proved phenomenally well for years, and we're not seeing any change in it. And I think when we use usage as our North Star, we want to make sure not that we just get our product sold, but that patients use it. And we transfer the work to the patient, you get this amazing ROI. Yeah. I don't think now is any different. I just think that the numbers get bigger and the press releases get louder.

Great. Thanks for the color and congrats again on a good quarter.

Cheers.

Your next question comes from the line of Sean Dodge with RBC Capital Markets. Sean, your line is open.

Yes, thanks. Good morning. Maybe on the acute care opportunity, when we think about timing and a potential ramp for that, is there anything you can share with us to kind of help better frame that out? And obviously, hospital workflows are a lot more complicated. So is it just a lot of de novo development work you're having to do? Is it a lot more integration work? How far along do you think you are on that? And then I'd imagine sales cycles, sales processes are different too. Anything just to kind of better frame up timing?

Look, I think we're going to keep investing. I don't think this is the fifth inning. It's probably closer to the second inning. And, you know, we're seeing real value propositions and wins. And, yeah, we're going to keep investing heavily in the product, in the workflow, in the integrations, in the people, in the process, and in the value that we provide our clients. And if we just keep rinsing and repeating with the same formula and we keep doing it at scale i think we're going to keep having the success that we've had previously and hopefully at even greater degrees okay and then um and just to clarify i don't we don't have any data to say that the sale cycle is longer okay um on uh

Maybe on social determinants, it was about a year ago now you guys began to highlight the work you were doing there. I think it was initially in North Carolina, building in the ability to screen for those, integrating that into the intake process. Is there any interesting developments, updates you can share there?

Yeah, I think we just did a, we've been doing a bunch of work, and Michael could talk to this also, around vaccine hesitancy in different communities. and understanding vaccine hesitancy and understanding the impact of the virus on different communities, often tied to their social determinants. But this is an area which we have not slowed down our investment, and we think it makes a material difference to health care delivery and patients in America. Michael, you want to add to that?

Yes, thanks for the question. I think I would just add that we're continuing to invest in our clinical team and expanding that group, and they're doing some incredible work with measuring hesitancy and working with our clients to really understand how they can improve the ability of the delivery of the vaccine to groups that just might not be comfortable getting the vaccine right now. So we're, you know, it makes us extremely proud and really speaks to the mission of the company.

Okay, great. Thanks again.

Your next question comes from the line of Daniel Grosslight with Citi. Daniel, your line is open.

Hi, guys. Thanks for taking the question. Congrats to a strong quarter. I just have a quick question on the patient payment volume. If I divide patient payment volume by the average provider client in the quarter, I get a sequential increase versus 3Q of about 1% versus an 8% sequential increase from 2Q to 3Q. So I'm just curious of any trends you've seen recently on the payment, the patient payment volume per provider growth was a large sequential increase in 3Q due to a bolus of larger clients coming aboard, et cetera. And how should we think about the growth in patient payment volume per provider for fiscal year 2022? There's a lot in that question, so maybe just to break it down, Daniel. So, Tom, maybe the first part is it was sequentially, Daniel, you're trying to understand payment volume trend from, was it 2Q to 3Q or 3Q to 4Q? Exactly. So I'm trying to understand the patient payment volume per provider client, right? sequential growth trends, because it grew pretty rapidly in 3Q, about an 8% sequential increase per provider, and then slowed to around a 1% sequential increase. Still very, very good relative to historical, but a sequential slowdown. So I'm just trying to understand the trends underlying the sequential growth in payments per provider and how to think about that in 2020, fiscal year 2022.

Dan, I think there's probably some seasonal impacts in there and some impacts from our land and expand strategy that make it somewhat difficult to answer that question crisply. You know, the decline in per provider patient payment volume has a lot of factors that go into it. size of the customers, et cetera. So it's tough for me to give you a forecast as to what that's going to be in the future.

Okay. Okay. Understood. All right. And then I guess another question I have is on the vaccine rollout, there's been some good press reports on how you've been helping some of your clients with the intake process there. And I know you're giving it those capabilities away free of charge, similar to what you did with telehealth modules. But I'm curious how you may leverage some of the goodwill or the learnings that you learned during the vaccine rollout into a growth acceleration in fiscal year 2022, i.e., will this accelerate some of the sales prospects that you had in the pipeline?

I think it helps us i think all these things you know when you do right by clients and you build really amazing products that help massive amounts of people the general view that i have and everyone here has is the positive outcomes usually follow and that's something we've seen traditionally and untraditionally through our entire existence in 16 years so we It's not a halo. I think we've built some really amazing products that have helped us win clients because of it. We have won clients because of it, and our clients feel really good about us being able to support them through tough times, and that's part of the relationship that we build. But also, it's just the right thing to do, and I want everyone to understand that we will always endeavor to try to always do the right thing. It's important. It's important.

Understood. All right, guys. Thanks.

Your final question comes from the line of John Ransom with Raymond James. John, your line is open.

Good morning. Hi, I think you need to practice that excited voice a little bit. That wasn't all that excited. But the question I have is recently Visa MasterCard talked about maybe bumping up the interchange fee. You know, they pull back after some political pressure. But just help us size, if that does go up, what does that mean for your famous business?

Hey, Todd, you want me to take this? I do. Well, give them your excited voice first. Give them yours, because you were pretty excited about that.

Hey, John, I think they announced about a 10-biff increase in their list prices.

in feb january or february um and that's what they backed off on i assume now that's a rumor i don't know the exact number but that's what i read in the press as to what their price increases would have been on a list price basis in april so that that gives you some some stuff so can you translate that to free your revenue in case our calculator down here is broken

if it does get through it means that we don't have to pass on an increased cost to our providers so it means that these are mastercard unfairly taxing health care providers in america just got put on hold for a little bit it's pretty it was good thing you know i think it's really um it's it's great that they have that pressure okay gotcha um

The other question, and I'll probably be the only guy that doesn't understand this, but could you say again why you transitioned to larger clients? That 79% ratio that you referred, that puts some pressure on that number. Why is that ratio lower than it is when you're doing mostly smaller doc offices?

In the sales cycle, what we've often found is in very large health systems, the treasury group, of the large health systems have tight relationships with large banks. And often they give them their credit card processing as part of those relationships. And so it often takes some bit of maneuvering to be able to pry that away from the banks who are unfairly charging and taxing them for it. That's generally what we've seen. And it's often tied to lending relationships.

I got you.

Okay. Okay.

And, you know.

Go ahead. John, you there?

John, if you would like to press star one to reach you up.

We left John ran.

John, line is now open.

And she cut me off. Reminds me of home. The jump in FD&R, I'm sorry, marketing, is that mostly just a headcount issue in FD&R or is there something else going on there?

Yep, it is. It's us investing in that future team. Great. Thank you. Thank you.

This concludes our question and answer session. I'll now turn the call back over to Haim Ending for closing remarks.

Thank you, everyone, and thank you again, Tom, for your last earnings call. And we appreciate everyone's support, and we'll talk to you in a couple months. Cheers.

Ladies and gentlemen, this concludes today's conference call. On behalf of Frisia, thank you for participating. You may now disconnect.