Latest / Becker’s Healthcare Podcast / The State of Healthcare M&A: Trends, Opportunities and Risks

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The State of Healthcare M&A: Trends, Opportunities and Risks · Becker’s Healthcare Podcast

0:00
This is Scott Becker
0:02
with a special combined episode of the Becker's
0:04
health care podcast and the Becker private equity
0:07
in business podcast.
0:09
I'm thrilled today to to talk with two
0:11
brilliant leaders from VMG Health.
0:14
We're joined today by Lucas Rescio and Emily
0:17
Rises,
0:18
and and Lucas is a managing director.
0:21
Emily's a director, both brilliant professionals. And we're
0:24
gonna talk today about the state of health
0:26
care mergers and acquisitions,
0:29
trends, opportunities,
0:30
and risks.
0:32
Can I ask you to start,
0:34
Lucas and and Emily,
0:37
to take a moment and introduce yourself
0:39
and share a little bit about your work
0:41
in sort of the
0:43
health care and sort of the business and
0:45
deal environment in health care?
0:48
Absolutely. Thanks, Scott, for having us here today.
0:50
Lucas Rescio, managing director within VMG Health's financial
0:53
due diligence practice, which means that primarily I'm
0:56
working on quality of earnings analyses,
0:58
networking capital analyses,
1:00
and any really
1:02
accounting or financial due diligence that may occur
1:04
prior to a transaction or partnership,
1:08
taking place here. So, Emily, if you'd like
1:10
to go next.
1:11
Yeah. Scott, thanks again for for having us
1:13
both here today. My name is Emily Rises.
1:15
I'm a director at DMG Health's valuation and
1:18
transaction advisory service line. What that means, I
1:21
primarily help clients,
1:23
whether that's a health system, a management company,
1:25
a private equity portfolio company,
1:28
establish the price for a contemplated transaction, working
1:31
with buyers and sellers
1:33
to help figure out what what should this
1:35
deal be worth.
1:36
Thank you so much. And and and talk
1:38
for a second, and And I'll ask one
1:40
of you to take the lead in the
1:41
first question, one of you to take the
1:42
lead on the second question, and each of
1:44
you to comment on on on all the
1:46
questions.
1:47
Lucas, let me start with you here.
1:50
Last year, there were about a thousand different
1:53
closed
1:54
health care mergers and acquisitions transactions,
1:57
and that's across sort of the private equity
1:59
space as well as the health system space.
2:02
In a year that seems like not a
2:04
busy year for deals,
2:06
there were still a ton of deals getting
2:08
done.
2:09
What are some of the key observations that
2:11
your team has
2:12
with respect to all that activity,
2:15
and what might would it mean for health
2:16
care in the future?
2:18
Right. Absolutely. So first thing is that the
2:21
activity does continue, and this is in part
2:23
out of two veins. Right? One is growth,
2:25
and one is survival. And so when we
2:27
think about those two things, there are a
2:28
lot of and Emily can talk about this
2:30
in more detail. But there is this idea
2:32
of, okay, if we're a hospital or health
2:34
system and we wanna continue care in a
2:36
region,
2:37
we want to keep these facilities open. And
2:39
so some folks need to partner with a
2:41
larger and broader organization to make that financially
2:43
feasible.
2:44
The second would be that if we're in
2:46
growth mode and we're talking about perhaps a
2:48
different type of
2:50
provider and
2:51
business enterprise out there. They want to grow
2:54
their revenues, their EBITDAs, expand their geographic footprint,
2:57
etcetera. And so the deals continue to get
2:59
done at the tuck in size. And so
3:01
one of the things that we're tracking closely
3:03
within our realm
3:05
is that the top quality assets seem to
3:07
have poked their heads up again, let's say,
3:10
and are willing to explore these types of
3:12
partnerships because we have a little bit, not
3:14
perfect, right, but a little bit more certainty
3:17
around the economic environment
3:19
and some of those headwinds that existed and
3:21
uncertainties that plagued 2025 if we were to
3:24
kind of poll the audience.
3:25
Those things seem to have reached a level
3:27
where we're now comfortable with how uncomfortable we
3:30
are. So So those top quality assets has
3:32
started to come out again, especially some of
3:34
these independently owned groups,
3:36
because we're finding valuation, and this is where
3:38
Emily will be able to contribute
3:40
a tremendous amount of knowledge.
3:43
The valuation gap between buyers and sellers is
3:46
converging.
3:47
They're finding common ground in terms of what
3:49
the multiples should look like, what types of
3:52
earnings they should be getting credit for, the
3:54
types of activities which are driving value.
3:56
And so when we see those things taking
3:58
place, it's all very encouraging.
4:01
And and in truth, when Emily and I
4:03
were reviewing together here to hear a thousand
4:05
transactions, it to your point, it didn't quite
4:07
match how we thought we felt about the
4:10
market previously. But, Emily, I'd I'd kinda look
4:12
to you for your thoughts too here.
4:14
Yeah. Just stepping back on a at a
4:16
macro level,
4:17
agree everything
4:19
with what you said, Lucas.
4:21
If we flash back fifteen months ago, it
4:23
was when 2025
4:24
started. We started the year with a lot
4:26
of uncertainty
4:27
and that that led to softness at the
4:29
beginning of the year, which is why at
4:31
a full year deal level, we look
4:34
soft to flat prior years.
4:36
But that that deal momentum and deal value
4:39
really picked up kind of sprinted towards the
4:41
end of the year, and we saw a
4:43
lot of momentum closing out the year. Some
4:45
of the the themes, if I had to
4:47
characterize deal motivation, deal activity within 2025,
4:51
echoing everything Lucas said, there is
4:54
a lot of headwind a lot of industry
4:56
headwinds in the acute care space. There's significant
4:59
interest in the inventory and outpatient services space.
5:02
And then from a private equity deal volume
5:05
perspective,
5:06
there are
5:08
a lot of tuck in opportunities
5:09
that are driving deal deal value,
5:12
and then a lot of emerging platforms that
5:14
are looking for exit opportunities.
5:17
And and, Emily, I'll ask you a a
5:19
a follow-up question.
5:21
Valuations,
5:22
what are you seeing in terms of the
5:23
the closing of the gap of valuations?
5:26
And and I'll ask you this question, and
5:28
and I I'll then ask Lucas to give
5:31
his thoughts on this question too. I'm gonna
5:33
ask you about valuations.
5:35
I'm gonna ask you about verticals,
5:37
and then I'm gonna ask you about the
5:38
Aggies. And and it will go in that
5:40
order, but we'll start with both of you
5:43
on valuations. What are you seeing on valuations?
5:45
And I'm gonna come back to the Texas
5:47
A and M question a little bit later.
5:49
But but talk to us a little bit,
5:50
Emily, about valuations
5:52
and and where are you seeing that? I
5:54
mean, Lucas mentioned some of that delta
5:56
between if you went back five years ago,
5:58
sellers thought they could sell at a huge
6:00
multiple.
6:01
Those multiples compressed over the years.
6:03
Buyers got more careful even though it was
6:05
so much money to put to work if
6:07
in the private equity space. Health system space
6:10
sometimes a little bit different.
6:12
But you had this huge gap between what
6:14
sellers thought they should get or might might
6:16
have felt like they needed to get, particularly
6:18
if they're private equity financed versus what buyers
6:20
were willing to buy to pay. What are
6:23
you seeing in terms of some of that
6:24
closing of that gap?
6:26
Yeah. That's a great question, Scott.
6:29
If we flash back to
6:31
where we were
6:32
six years ago now, was COVID,
6:35
there was a lot of uncertainty around profitability
6:38
and financial performance,
6:40
and then there was a lot of pausing
6:42
of deal volume.
6:44
In 2021,
6:45
there was this huge surge of
6:48
deal volume, deal value.
6:50
Organizations
6:51
wanted
6:52
to recover
6:53
investment strategies that put on pause throughout COVID.
6:56
So there was this huge spike in deal
6:58
volume, and then it was really a free
7:01
let's let's pay whatever we need to pay
7:03
to get deals closed, to get deals done,
7:05
to start getting capital to work again.
7:08
And we saw a surge in
7:11
in valuation multiples
7:13
really across
7:15
verticals, across the industry. It was a a
7:17
really crazy time.
7:19
Since 2021,
7:21
things have really softened. People are investors are,
7:25
you know, they might have gotten burned with
7:26
some of the hefty price tags in in
7:28
some of those deals and they're really trying
7:31
to absorb what we did buy in 2021.
7:33
And really since then, we've we've sent we've
7:35
seen a lot of just consistency
7:38
and stability
7:39
in deal volume and and value happening.
7:41
Where we
7:42
are today,
7:44
one of the things that's helping align
7:46
buyer and seller expectations, we're seeing a lot
7:48
more
7:50
burnout structures in some of these private equity
7:53
deals where maybe there is a valuation gap
7:55
still because I still wanna be priced at
7:57
how
7:58
my buddy was priced in 2021.
8:01
And we're seeing earn out structures,
8:03
the adoption of an earn out structure in
8:05
a lot of deals, becoming more and more
8:08
prevalent. And what this can do, it can
8:10
protect the buyer because
8:12
if part of my purchase price is dependent
8:15
on post transaction financial performance, then I'm going
8:18
to be realizing the return that I'm paying
8:21
for. And then it it helps the seller
8:23
get a little more comfort that they're getting
8:25
their their full value. Lucas, would love to
8:28
to hear your perspective on that question too.
8:30
Absolutely. Emily nailed it, Scott.
8:33
And
8:34
what we've really seen from the financial due
8:36
diligence side is there's that calming also. Right?
8:39
We talk about multiples. How have those changed?
8:41
But the other very equally important side of
8:44
the equation is multiple of what. Right? And
8:46
there was this,
8:48
disparate
8:49
belief in terms of what should be credit
8:51
or not credit, whether you were the buyer
8:53
or the seller. And what we found is
8:55
kind of this very nice equilibrium of terms
8:58
of
8:59
reasonable
9:00
earnings and reasonable growth and how do we
9:03
find common ground in terms of not putting
9:05
ourselves in a position, like Emily mentioned,
9:08
of paying a high price on a high
9:11
dollar value on a high multiple
9:13
and then being in an operational purgatory where
9:16
now we have to manage our way through
9:18
that and kind of grow our way out
9:19
of
9:20
perhaps a a rate induced issue
9:23
and
9:24
find a way for us all to be
9:25
successful. Right? At the end of the day,
9:27
these deals are about partnerships and finding ways
9:30
for
9:31
everyone to find success
9:33
and meaning in the way that these things
9:35
kind of produce value at the end of
9:37
the day beyond just economic value. Right? And
9:39
so those things, they help they've helped find
9:41
alignment in terms of what we're seeing today.
9:44
And I think that that kind of hygiene
9:46
that's out there is another reason why those
9:48
top quality assets are saying, okay. Now this
9:50
is getting interesting.
9:52
Right? Now we're in a place that makes
9:54
business sense to us. And it's important to
9:55
remember, these sellers, whether they're financially sponsored or
9:58
they're independent,
9:59
they are really good operators of their business
10:02
as well. So just all interesting things as
10:04
we see these groups come together.
10:07
And I'm a ask you a question, Lucas.
10:09
And and and here here's the question.
10:12
Is I've had a chance to work with
10:13
VMG Health for literally twenty plus years,
10:16
just a magnificent
10:18
firm
10:19
with great people and great talents and sort
10:22
of the type of firm.
10:23
You you get what you expect
10:26
coupled with fantastic sort of what I would
10:28
say is customer service
10:30
and and and the ability to work really
10:32
closely with clients in a really intelligent way.
10:36
Now I'm gonna tie this together.
10:38
One of the things over the years, The
10:40
Wall Street Journal
10:41
always has studies
10:44
on
10:46
the best
10:47
schools and colleges to recruit from.
10:50
And one of the things that's always noteworthy
10:52
is
10:53
a a a couple of the schools that
10:55
always rank really high
10:57
are Notre Dame and Texas A and M.
11:00
And and and, quite frankly, another big 10
11:02
school that I went to, University of Illinois.
11:04
So I I noticed it because University of
11:06
Illinois does well in that too. It's sort
11:08
of places that create hardworking, smart professionals
11:11
that that sort
11:12
of stay on careers, stay on task, and
11:14
so forth. Notre Dame, Texas A and M,
11:16
U of I, and many other schools, but
11:18
those are particularly often noted by the Wall
11:20
Street Journal as as schools to recruit from,
11:23
particularly Texas A and M. Is it a
11:25
coincidence
11:26
that the two of you have these great
11:28
professional reputations in both from Texas A and
11:30
M, or is it part of the culture
11:32
of Texas A and M and VMG
11:34
that that coincides?
11:36
Number one, we appreciate the partnership over the
11:38
years, Scott, and and thrilled to hear and
11:40
thankful to hear you say those things. And
11:42
it is not at all a coincidence. We
11:44
recruit from
11:46
schools that instill in their students
11:48
the same things that VMG Health believes in
11:50
very truly and dearly. So as we focus
11:52
on Texas a and m, which both Emily
11:54
and I are former students of, we
11:58
I had to pull up here just so
11:59
I can speak to it directly, but six
12:01
core values of Texas A and M, each
12:03
one labeled above the Memorial Student Center,
12:06
respect, excellence, leadership,
12:08
loyalty,
12:09
integrity, and most importantly, selfless service. When we
12:13
think about what VMG Health does and why
12:15
it's so important to us to find like
12:17
minded individuals
12:18
is that selfless service side. Right? At the
12:20
end of the day, this this is a
12:22
customer service, a client facing business where we're
12:26
helping individuals
12:27
find the right answer. Right? Our biggest goal
12:31
as an organization is to be a trusted
12:33
adviser. It's not to lead the league in
12:36
sales or to do any of those other
12:38
things, but just to really provide
12:40
sound, meaningful advice to organizations
12:43
carrying out meaningful missions. And so not at
12:46
all a coincidence, Scott, to your question. It's
12:49
100%
12:49
in alignment of how we think about delivering
12:53
true value to our clients. And that starts
12:56
with our people, of course, and our people
12:58
from top to bottom are the most important
12:59
resource that our team has. And we put
13:02
a great deal of care into aligning ourselves
13:04
with schools such as those. So it's funny
13:06
you mentioned Notre Dame as well. We have
13:08
a a large number of Notre Dame alumni
13:10
on the team as well. It's it's just
13:12
critically important to us.
13:14
Yep. Yep. And we've seen it over the
13:16
years. I I've literally visited with
13:18
the founders and leaders
13:20
and now the new CEO, West Champion, but
13:22
Greg Koonsman and Jen Johnson and and for
13:25
literally twenty plus years or more. And it's
13:27
really a remarkable organization in terms of just
13:30
this this mix of sort of greatness
13:32
coupled with
13:34
a pleasure of people to work with that
13:37
are client service oriented. And so it's it's
13:40
it's,
13:41
sincere in reality.
13:42
Let me ask you this question, Lucas, and
13:44
I'll start here and ask Emily to then
13:46
tie together on this as well.
13:48
Looking ahead,
13:49
the m and a environment,
13:51
where do you see it evolving, and where
13:53
are some of the biggest opportunities and risks
13:55
as we sort of move through 2026
13:58
and into 2027?
14:00
Right. So there's been some very meaningful activity
14:02
that's taken place
14:04
in the 2025
14:05
and even here in 2026 that's providing a
14:08
lot of
14:09
opportunistic
14:10
optimism. Right? And it's pretty balanced. It's measured.
14:13
It it's not just fluff because we're at
14:15
the end of q one here. Right? It's
14:17
it's meaningful in the way that it's presented.
14:19
And that's some of these larger deals. Right?
14:21
As we think about
14:22
mergers and acquisitions and what that means,
14:25
there's the tuck in strategy of smaller groups
14:28
joining larger groups and then larger groups joining
14:31
ever larger groups or finding ways to make
14:33
the divestitures out. And there's a number of
14:36
kind of
14:37
very
14:38
pertinent examples that exist
14:40
at the end of 2025 and into 2026
14:43
that are driving a tremendous amount of the
14:46
kind of tailwinds that do exist. We mentioned
14:48
headwinds earlier, but the tailwinds are there also.
14:51
And so what we're seeing in terms of
14:53
the evolving is very much as Emily mentioned.
14:55
It's the meeting of the minds around the
14:57
multiples and top quality assets and what that
15:00
definition means to whom and when. There's this
15:03
meeting of the minds that just continues to
15:05
occur here. But then also, we need to
15:07
be thoughtful about, okay,
15:09
how long
15:11
and what is the the balance of opportunity
15:13
that exists for these groups to mature along
15:16
their cycle
15:17
and to continue to find the right partnerships
15:19
that enable them to increase
15:21
patient outcomes, to increase the access to patient
15:23
care, and, again, carry out these very critical
15:26
missions that they're all driven to achieve.
15:29
And so that that's a little bit there.
15:30
Emily, I'd I'd love your opinion on this,
15:32
and maybe we can throw it back and
15:33
forth here for a little bit. But would
15:35
would love to hear your thoughts as well.
15:37
Yeah. So so thinking about the the biggest
15:40
opportunities
15:42
in the coming years for m and a
15:43
environment,
15:45
really on the on the private equity side,
15:46
Lucas, you mentioned it, but I wanna expand
15:48
a little bit on the when you said
15:50
the maturity of the cycle.
15:53
Historically, we've seen
15:55
portfolio companies, private equity firms trying to hold
15:58
these portfolio companies
15:59
around,
16:00
call it, five years, three to five years
16:02
in the average hold period.
16:04
We're seeing a a significant percentage of these
16:07
private equity assets that are approaching
16:10
seven years or longer
16:11
hold periods.
16:12
And and why that's important is is these
16:15
investors, they're
16:17
really trying to look for exit opportunities so
16:19
they can start to realize
16:21
the returns for their investors. So
16:23
looking at this
16:25
inventory of assets that could be coming to
16:27
market and there could be an appetite to
16:29
sell these maturing portfolio companies.
16:33
The question becomes,
16:34
where where is the exit opportunity
16:37
and and how will that drive
16:40
deal volume in the coming year or years?
16:42
The consensus we're seeing is that it is
16:44
a more favorable exit environment, so we would
16:46
expect
16:47
that opportunity to be there. But where are
16:49
we gonna exit to?
16:51
One option,
16:52
the exit to another platform, we we saw
16:55
that some looking at the TowerBrook Solace
16:58
transaction this last year.
17:00
Another
17:02
exit opportunity could be
17:04
looking at an IPO. We saw LumeXa
17:07
IPO back in December.
17:09
So that's that's one avenue.
17:11
But a really common and evolving strategy that
17:13
we're seeing is an exit to a strategic
17:16
buyer.
17:17
So an organization that's looking
17:19
to have the portfolio company really fit their
17:21
long term strategic goals. We saw this with
17:24
a a big mega deal this year was
17:26
the Amsearch Ascension deal.
17:28
Ascension was really looking to expand their outpatient
17:30
strategy
17:31
given the headwinds that we're seeing on in
17:33
the inpatient environment and the overall industry shift
17:36
to outpatient. So that investment in Amsearch really
17:39
really fit their
17:41
expansion to outpatient strategy.
17:43
Other exits to strategic buyers we've seen
17:47
is the GI Alliance, Cardinal, looking towards that
17:50
that fertile vertical integration,
17:53
opportunity and really getting some some opportunities around
17:57
drug spend and scale there.
17:59
Lucas, anything else to add? I'm thinking
18:01
about who are we gonna exit to in
18:04
2026 activity.
18:06
The only thing that we'd also add is
18:08
that we're talking about, okay, how do we
18:10
how do we sell the whole enchilada. Right?
18:12
There's also this opportunity for some of the
18:15
parts to be the better way to think
18:17
about this. Right? Groups have added in. They
18:19
found what they're good at, where their core
18:21
competencies are, and there may be opportunities to
18:24
continue to divest into these areas so that
18:26
we continue to find ways
18:28
for businesses to perform well in terms of
18:31
economic performance, but also to do good in
18:33
the communities in which they're at and put
18:35
these assets
18:36
and these very talented individuals
18:38
top to bottom through these health care organizations
18:41
in a position to give the best care
18:43
that they can while also having the support
18:46
from the financial economic regulatory compliance side that
18:49
they're deserving of. And so there's a lot
18:51
of unique combinations to Emily's point that
18:55
are viable and we're seeing people pursue today,
18:58
and the interest is just really it's really
19:01
there in terms of how do we find
19:02
the best path forward on these things.
19:05
No. I think that's right on, and I
19:07
think fantastic
19:08
thoughts. And but you really do have the
19:10
situation
19:11
where so many private equity funds and investors
19:14
are holding assets, companies they invested in, practices
19:18
they invested in, far longer than they anticipated
19:22
doing so.
19:23
Some of that's because some of those are
19:24
performing very, very well, and there's not been
19:27
the right exit pricing. Some of that's because
19:29
they're performing not that well, and they still
19:31
gotta figure out what to do with those
19:32
assets and where they could still grow them
19:34
and so forth. And I think Emily's point
19:36
and your point, and some of that going
19:38
through IPO
19:39
for the bigger, bigger platforms,
19:41
some of that going to strategics, which we
19:43
weren't seeing a few years ago, and some
19:45
of it going to other platforms. I think
19:47
that's all that's all correct.
19:49
And and, Lucas,
19:50
any of the things you're watching currently in
19:52
the private equity or health care environment,
19:54
that you wanted to comment on? And then,
19:56
Emily, I'll ask you the same question.
19:59
Right. So what we're continuing to hear is
20:01
this idea, and I don't know where it
20:03
originated, Scott, but this idea that The US
20:06
health care system is not health care, it's
20:07
sick care. Right? We wait for there to
20:09
be a problem, and then we treat the
20:11
problem. Well, the thesis and things that I'm
20:13
seeing a lot of conversation in right now
20:15
is, well, how do we kind of flip
20:16
that script? How do we start putting the
20:18
population in a better position
20:20
to avoid
20:22
some of these outcomes? Right? And you look
20:24
at the rates of of cancer in young
20:26
people, the average age keeps dropping lower and
20:28
lower and lower. Why is that right? And
20:30
so you think about why are we developing
20:33
these issues? And there's a lot of conversation
20:35
happening now in three areas that all kind
20:37
of coalesce together in this idea of wellness.
20:40
Right? There's the functional health. How do we
20:43
put ourselves in a position
20:45
to maintain
20:47
our health and fitness instead of repair the
20:50
accidents that happen along the way? How do
20:52
we think about concierge medicine and just making
20:55
it available to individuals on a cash pay
20:57
basis because the wait times to get a
20:59
new primary care provider can be tremendous. Having
21:02
just moved to a different part of Dallas,
21:03
I can attest to what that looks like
21:05
when you're trying to find a new primary
21:07
care provider.
21:08
And then third is this ideas of food
21:10
is medicine. Right? How do we put ourselves
21:13
in positions to somewhat contain costs
21:16
based on improving our habits on the front
21:18
end first,
21:19
right,
21:20
and practicing this idea
21:22
of an ounce of prevention is worth a
21:25
pound of care. Right?
21:26
How do we put that into place, and
21:29
what does the economic model look around that?
21:31
There's a lot of interest on, you know,
21:33
if you think about what care looks like
21:35
for a person throughout their lifetime,
21:37
how do we move further out in front
21:40
of the disease and the ailments
21:42
to get into prevention? So So there's a
21:44
lot of interesting conversation, a lot of interesting
21:46
businesses out there today trying to solve for
21:48
that problem, but that's certainly the one thing
21:50
that I would ask,
21:51
that I would mention here for today's listeners.
21:54
But, Emily?
21:55
I, I would echo all those points, Lucas.
21:58
I think there's gonna continue to be
22:00
a focus
22:01
on outpatient services, thinking about
22:04
the
22:05
elimination of the inpatient only list, the site
22:08
neutrality
22:09
regulations
22:10
from a broader
22:12
regulatory environment.
22:13
You know,
22:14
they're thinking about looming risks on the horizon.
22:17
And we've got HR one and how that
22:20
could impact Medicaid and the insured population
22:24
in the future.
22:25
And we've got, continued scrutiny around some private
22:28
equity investment in health care on a state
22:30
by state basis. So
22:32
I think there's there's definitely opportunities in all
22:35
the areas Lucas mentioned and a lot of
22:37
outpatient services.
22:39
And then there's also some risks on the
22:41
regulatory side, and the balance between those two
22:43
will will help shape what deal volume and
22:45
value looks like in the coming years.
22:48
Lucas and Emily, I I wanna tell you
22:50
what a pleasure it is to visit with
22:52
you.
22:52
Thank you so much for joining us today
22:55
on in this combined version of the Becker
22:57
private equity in business podcast and the Becker's
22:59
Healthcare podcast.
23:00
Each of you are fantastic to visit with.
23:02
It's been great to watch your career growth,
23:05
both of you, and just fantastic to visit
23:07
today.
23:08
True leaders in sort of the health care
23:10
m and a space and evaluation and quality
23:12
of earnings world. Thank you so much for
23:14
taking time with us today. Thank you, Scott.
23:16
Yes. Thanks so much, Scott.