Claritev Corporation · NYSE:CTEV
Claritev — Investor Day (March 2025)
58 slides from Claritev's investor day presentation, Mar 5, 2025
Slide 1: Investor Roundtable March 5, 2025
1 Investor Roundtable March 5, 2025
Slide 2: Introductions: Claritev Team
2 Introductions Claritev Team Travis Dalton Chairman, President & CEO Doug Garis Chief Financial Officer Jerry Hogge Chief Operating Officer Michael Kim Chief Digital Officer Sean Crandell SVP-General Manager, Data & Decision Science Tiffani Misencik Chief Growth Officer Carol Nutter Chief People Of
Slide 3: Disclaimer: Forward-Looking Statements
3 Disclaimer Forward-Looking Statements This presentation includes statements that express our management’s opinions, expectations, beliefs, plans, objectives, assumptions or projections regarding future events or future results and therefore are, or may be deemed to be, “forward-looking statements”
Slide 4: Agenda
4 01 Setting our Vision – CEO Perspective Travis Dalton – Chairman, President & CEO 02 Planning for the Turn in 2025 Doug Garis – CFO 03 Technology-Driven: Creating a Platform for Growth Michael Kim – CDO 04 Product-Led: Developing Solutions that Create Value Jerry Hogge – COO Sean Crandell – SVP, D
Slide 5: Setting our Vision – CEO Perspective
5 Setting our Vision – CEO Perspective Travis Dalton – Chairman, President & CEO
Slide 6: Claritev Overview
6 Claritev Overview 700+ insurance carriers, plan administrators and other payor clients 100K+ employers/ plan sponsors WHO SERVEWE SERVE A healthcare technology, data and insights company focused on improving affordability, transparency and quality. 60M plan members and patients with access to our
Slide 7: Opening the Aperture for Healthcare
7 Opening the Aperture for Healthcare We seek to open the aperture on affordability, transparency, and quality and meet mutual interest in healthcare, and optimal health plan performance. Value to Payors: • Managing Risk • Increasing Access • Improving Health Outcomes • Fair Reimbursement Value to E
Slide 8: What We Believe
8 Combining technology, data and insights to improve affordability, transparency and quality What We Believe We believe transparency leads to better data, information, and insights. Better insights = Better markets and better healthcare We believe in transparency for Payors, Providers, Employers, Pa
Slide 9: Why are we rebranding?
9 Why are we rebranding? Why the name, logo and new colors? Reflection of our transformation as a healthcare technology, data and insights company focused on affordability, transparency and quality Allows us to better represent the vast constituents we serve across the healthcare ecosystem and the d
Slide 10: 2024 was the Foundation
10 2024 was the FOUNDATION ADVANCE C-A-F CLARITY of Purpose ALIGNMENT of Talent and Accountability FOCUS on Pillars & Metrics Fit for growth Rigor | Discipline • Reinforce Sales Growth Culture • Improve Sales & Revenue Forecasting • Diversify the Business Mix • Establish and Advance 5-Year Strategic
Slide 11: Enterprise Data Platform
11 Enterprise Data Platform Data Warehouse | AI/ML | Language Models Technical Infrastructure Oracle Cloud Infrastructure | Apex Tools | Externally Sourced Claims Data The Vision Tech-Enabled Platform Supporting the Healthcare Continuum COMBINING Technology, Data and Insights TO IMPACT Affordability
Slide 12: 2025 is the TURN
12 2025 is the TURN Drive value and new product in the core Open new markets; compete and win new business Create financial & operational excellence; transform business model Bring best talent and career growth opportunities Focus on innovation and promote the brand PRODUCT/ TECH Technology-Driven G
Slide 13: Early Proof Points
13 Early Proof Points • Transaction closed in January 2025 • 99.75% participation outcome Refinanced Entire Debt Structure 01 • 3-year extension of one of our largest clients • 8% increase in covered lives for VDHP | $16M ACV Additional Value from Core Clients and Product Sets 02 • Oracle | Enables
Slide 14: The Future
14 The Future THE FOUNDATION and THE VISION CAF, Fit for Growth, Horizons THE TURN Launch Brand, New Products, Business Models, Markets THE WAY UP Focus and Disciplined Execution, Sales Aggression, Growth THE WAY FORWARD Sustained Growth, Independence, Culture, Product, Acquisitions REALIZE THE VISI
Slide 15: Where Our Transformation Leads Us
15 Where Our Transformation Leads Us World-Class Talent and Leadership with Growth Mindset Serving the Entire Healthcare Continuum Sustainable Growth Diversified Business Model and Product Suite Organic Product Capability Leading with Data, Analytics and Technology Capital Structure that Fits the Bu
Slide 16: Planning for the Turn in 2025
16 Planning for the Turn in 2025 Doug Garis – Chief Financial Officer
Slide 17: Financial Highlights
17 Financial Highlights Strong foundation to achieve growth objectives in Vision 2030 Plan We generate substantial earnings (with ample cash conversion) to provide dry powder for us to focus more deeply on penetrating our mature markets with ~$16B addressable market size while we accelerate entry in
Slide 18: Capital Allocation Prioritization
18 Capital Allocation Prioritization With the closing of the debt refinancing in January 2025, our primary and priority use of capital is investment in our business to drive organic growth. HIGHEST PRIORITYOrganic investments to fuel Vision 2030 Plan Debt paydown Value creating M&A Share buybacks HI
Slide 19: Revenue trend excluding one client
19 Excluding impact from one large client, we expect business to grow sequentially throughout ‘25 Revenue Trend excluding One Client Trailing Twelve Months Revenue Excluding One Client ($Millions) $617 -4% $740 20% $737 0% $759 3% $786 4% MSD +4-6% 1Q20 2Q20 3Q20 4Q20 1Q21 2Q21 3Q21 4Q21 1Q22 2Q22 3
Slide 20: Vision 2030 Transformation – Program Overview
20 Vision 2030 Transformation – Program Overview Digital Transformation & Technology Modernization Business Realignment Business Process Optimization Modernize technology platforms and systems through Oracle Cloud Infrastructure Collaborate across enterprise to connect front to back office Foc
Slide 21: FY 2025 Guidance as Reported
21 FY 2025 Guidance as Reported 1 We have not reconciled the forward-looking Adjusted EBITDA guidance included above to the most directly comparable GAAP measure because this cannot be done without unreasonable effort due to the variability and low visibility with respect to certain costs, the most
Slide 22: Financial Glidepath
22 Financial Glidepath This year Within 3 years Vision 2030 Net Revenue Retention1 - Core Business - Growth Areas (VDHP + D&DS) - Growth Areas % Total Revenue 98% to 100% 97% to 98% 115% to 125% 7% to 8% 103-105% 100% to 102% >130% >15% >106% 102% to 104% >130% >20% Adjusted EBITDA margin2 62.5% to
Slide 23: Technology-Driven: Creating a Platform for Growth
23 Technology-Driven: Creating a Platform for Growth Michael Kim – Chief Digital Officer
Slide 24: Accelerating our Vision with Technology and Data
24 Accelerating our Vision with Technology and Data Signed Oracle Partnership 1 Launched Trident – Enterprise Data Platform Initiative 2 Acquired BST: Data, Information, Insights 3 Built AI & Data Science Capabilities 5 Launched Digital Modernization 4
Slide 25: Oracle Partnership
25 Empower Future Growth Opportunities Enable Faster Innovation and Delivery Increased Savings | Lowered Risks Best in Class Performance, Flexibility, and Reliability + Oracle Partnership Competitive Differentiation Our partnership with Oracle encompasses multiple components to drive operational eff
Slide 26: Employer Platform Integrated with HR Management Solutions
26 Employer Platform Integrated with Human Resource Management Solutions Provider Network Optimizer Claritev Data & Analytics Oracle Employee Census Data Integrating the power of Oracle’s technology with Claritev’s data and insights to automate a labor- intensive workflow creating a guided experienc
Slide 27: Trident Data Platform – Sample Data Assets
27 Trident Data Platform – Sample Data Assets C O L O S S U S Benefit Plan Optimization & Risk Analytics • Medical Claims • Prescription Claims • Dental Claims • Vision Claims • Wellness Data • Benefit Plan Design • Employee Eligibility Healthcare Pricing Analytics • Public MRF data • Dynamic qualit
Slide 28: Trident Vision
28 20% Data-as-a- Service T R I D E N T Analytics-as- a-Service Innovation-as- a-Service Insights-as-a- Service Model-as-a- Service Trident Vision 2 Enabling a marketplace for Healthcare data applications and services
Slide 29: Using Data to Empower Providers with Price Transparency Insights
29 20% Efficiently compare specific rates at the code level across multiple payors Using Data to Empower Providers with Publicly Available Price Transparency Insights Expansive 500 billion MRF records from 150+ payors and growing for comprehensive benchmarking Clean Leveraging data science and healt
Slide 30: Digital Modernization: PaaS, DaaS, SaaS
30 Digital Modernization: PaaS, DaaS, SaaS 4
Slide 31: AI/Data Science Capabilities
31 AI/Data Science Capabilities Award winning data science applications New Chief AI Officer Data scientists with deep academic & industry experience Capabilities across Data Science, AI, Linear Optimization Operating model transformation opportunities Product Opportunities Launching Greenhouse for
Slide 32: Break
&claritev” Break
Slide 33: Product-Led: Delivering Solutions that Create Value
33 Product-Led: Delivering Solutions that Create Value Jerry Hogge – Chief Operating Officer
Slide 34: Affordability, Transparency and Quality Solutions
34 Affordability Solutions Analytics | Network | Payment Integrity Transparency Solutions PlanOptix® | CompleteVue Quality Solutions Benefits Optimization | Risk Models | Quality Mgmt. PRODUCTS
Slide 35: Network, Analytics, Payment Integrity and Data Solutions
35 Build and manage custom healthcare provider networks with access to 1.4M credentialed providers Data-driven reimbursement solutions for out-of-network claims & support for NSA compliance Identify, correct and prevent improper billing to optimize accuracy and reduce waste and abuse in the healthca
Slide 36: Doubling our Total Addressable Market
36 $12-14B $1-2B Claritev Offering Value-Driven Health Plan Services Doubling our Total Addressable Market $14-18B Claritev Offerings CORE MARKETS Mid-single-digit long term growth EXPANSION MARKETS High single/low double-digits long term growth • OON Analytics [$3-4B] • Provider Networks [$5-6B] •
Slide 37: 2025 Product Roadmap Highlights
37 2025 Product Roadmap Highlights Analytics-Based Network Payment & Revenue Integrity Data & Decision Science • ProPricer (w/ Reference-Based Pricing [RBP]) • Subscription Pricing Model: Network, RBP, and Financial Negotiations • ProPricer (Key Client Delivery) • VDHP – Point Solution Integration •
Slide 38: Solutions overview by business area
38 Build and manage custom healthcare provider networks with access to 1.4M credentialed providers Data-driven reimbursement solutions for out-of-network claims & support for NSA compliance Identify, correct and prevent improper billing to optimize accuracy and reduce waste and abuse in the healthca
Slide 39: Product Demonstrations
39 Product Demonstrations Sean Crandell – SVP-GM, Data & Decision Science
Slide 40: Overview of Products
40 Overview of Products BenInsightsTM CompleteVueTM Network Optimization Applies modern technology to gather, cleanse and transform a client’s financial and clinical data, then apply analytic tools to make it actionable – including: • 200+ plan performance reports • Risk scoring models • ‘Smart Card
Slide 41: BenInsights
41 BenInsightsTM Optimizes plan designs with comprehensive analytics Auto-identifies problems and provides actional recommendations to address
Slide 42: CompleteVue
42 20% Efficiently compare specific rates at the code level across multiple payors CompleteVueTM Expansive 500 billion MRF records from 150+ payors and growing for comprehensive benchmarking Clean Leveraging data science and healthcare expertise for price transparency gains Actionable Delivered as a
Slide 43: Network Optimization
43 A holistic approach to generate custom, right sized solutions for now and into the future Network Optimization DATA SCIENCE & OPTIMIZATION Network Adequacy Quality Cost Price Transparency Access & Appointment Availability Marketability Complex Existing Network Optimized Network Configuration for
Slide 44: Market-Aligned: Rethinking our Growth Engine
44 Market-Aligned Rethinking our Growth Engine Tiffani Misencik – Chief Growth Officer
Slide 45: Markets and channels served
45 Patients Payors Brokers | Employers Gov’t Channel Partners (e.g., Oracle) Providers
Slide 46: Market Aligned
46 Market Aligned Our product and services serve across multiple markets and distribution channels Payors* Brokers | Employers Providers Gov’t (Federal / State) Channel Partners (e.g., Oracle) Analytics-Based Services Payment & Revenue Integrity Network VDHP Data & Decision Science Existing New Entr
Slide 47: Growth Objectives and Organization Transformation
47 GROWTH OBJECTIVES • Achieve significant growth of top-line revenues • Increase diversification of the business, penetrating new markets • Sell enterprise solutions across vertical markets Alignment of our Talent Operational Excellence Commitment to our Clients New leadership team, aligned to segm
Slide 48: Serving our Clients
48 Serving our Clients Who We Serve Payor Clients700+ Broker | Employer Clients2,140+ Provider-Health Sponsored Plan Clients30+ WHAT’S DIFFERENT Tailored support based on client needs and strategic goals Proactive engagement to drive client delight and build deeper relationships Client education and
Slide 49: Key Growth Area | Provider Segment
49 Key Growth Area | Provider Segment Launch in rural health and grow into adjacent markets Cultivate channels and partnerships to scale Build relationships with National and State Associations Maximize data and decision science to ensure outcomes D&DS | Price Transparency and Market Analytics - Com
Slide 50: Claritev Provider Offerings | Market Potential
50 Example – Claritev Provider Offerings | Market Potential Claritev through our market position between payor and provider is uniquely positioned to provide solutions for the Provider Market to improve revenue, quality and lower costs Initial Focus on Rural and Mid-Market Health Systems and Partner
Slide 51: Key Growth Area | Broker/Employer Segment
51 Key Growth Area | Broker/Employer Segment Cultivate relationships with top national and key regional brokers VDHP D&DS Products – BenInsights, Ceres, PlanOptix D&DS | Risk Analytics & Insights KEY OFFERINGSGROWTH STRATEGY TARGET MARKETS Early Results 2025 Pipeline Opportunities | BenInsights [All
Slide 52: Closing Remarks
52 Closing Remarks Travis Dalton – Chairman, President & CEO
Slide 53: Key Takeaways
53 Key Takeaways World Class Technology and Data Platform Multiple Avenues to Drive Growth from Existing & New Products Durable, Proven and Highly Profitable Core Out-of-Network Business Scaled, Best-in-Class Operating Platform to be Leveraged New Talent and Leadership Team Aligned on Growth Strateg
Slide 54: Thank You
&claritev” Thank You
Slide 55: Appendix
@ claritev” Appendix
Slide 56: Reconciliation of GAAP and Non-GAAP Items
56 Reconciliation of GAAP and Non-GAAP Items $ in thousands, except share data (1)"Other expenses, net" represents miscellaneous non-recurring expenses, impairment of other assets, gain or loss on disposal of leases, tax penalties, non-integration related severance costs, implementation costs for cl
Slide 57: Reconciliation of GAAP and Non-GAAP Items, continued
57 Reconciliation of GAAP and Non-GAAP Items, continued $ in thousands, except share and per share data Three Months Ended Year Ended December 31, 12/31/2024 9/30/2024 6/30/2024 3/31/2024 12/31/2023 12/31/2024 12/31/2023 Net income (loss) $ (137,965) $ (391,450) $ (576,727) $ (539,689) $ (31,391) $
Slide 58: Reconciliation of GAAP and Non-GAAP Items, continued
58 Reconciliation of GAAP and Non-GAAP Items, continued $ in thousands Three Months Ended Year Ended December 31, 12/31/2024 9/30/2024 6/30/2024 3/31/2024 12/31/2023 12/31/2024 12/31/2023 Net cash provided by operating activities $ (33,413) $ 72,842 $ 18,471 $ 49,716 $ 27,702 $ 107,616 $ 171,720 Pur