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GoHealth Reports Strong Fourth Quarter and Fiscal Year 2024 Results, Driven by a Successful Annual Enrollment Period

Globe Newswire 27-Feb-2025 7:00 AM

CHICAGO, Feb. 27, 2025 (GLOBE NEWSWIRE) -- GoHealth, Inc. (NASDAQ:GOCO) ("GoHealth" or the "Company"), a leading health insurance marketplace and Medicare-focused digital health company, today announced financial results for the three and twelve months ended December 31, 2024.

Fourth Quarter Highlights

  • Achieved net revenues of $389.1 million, a substantial 41% increase compared to the prior year period.
  • Submissions grew to 481,445, representing a 67% increase compared to the prior year period.
  • Net income of $58.0 million, a substantial improvement of $60.3 million compared to the prior year period.
  • Adjusted EBITDA1 surged to $117.8 million, a significant 107% increase compared to the prior year period.
  • Compared to the prior year period, Direct Operating Cost per Submission2 improved 27%, to an industry leading $501.
  • The integration and transformation of e-TeleQuote Insurance, Inc. ("e-TeleQuote") has driven growth and efficiency gains, delivering significant performance improvements in the 2024 Annual Enrollment Period.

Full-Year 2024 Highlights

  • Full-year net revenues reached $798.9 million, reflecting 9% growth compared to the prior year.
  • Submissions were 1,016,182, a 23% increase compared to the prior year.
  • Net loss of $7.3 million, an improvement of $144.0 million compared to the prior year.
  • Adjusted EBITDA1 of $120.3 million, a 60% increase compared to the prior year.
  • Successfully refinanced our credit facility with new five-year term and lender group.
  • Supported nearly 3 million Medicare consumers in assessing benefit options in 2024.
  • Implemented the PlanFit Save initiative and began receiving health plan compensation for membership retention.
  • Remained top partner to health plans based on Submission volume.

"GoHealth's strong 2024 performance highlights our market-leading, technology-driven approach in the digital Medicare marketplace. While we predicted favorable market dynamics, we were even more pleased by the velocity of our efficiency improvements and the immediate impact of our technology initiatives on profitability. We are energized by the opportunities ahead and are already executing on them," said Vijay Kotte, CEO of GoHealth. "The successful onboarding and optimization of e-TeleQuote, expansion of our health plan partnerships, and continued investment in artificial intelligence and advanced analytics have further strengthened GoHealth's position as a leading digital Medicare marketplace. As we move into 2025, we continue to focus on driving sustainable, profitable growth, enhancing the consumer experience, and reinforcing our market leadership through continued innovation and operational excellence."

"Our 2024 financial results demonstrate GoHealth's capacity to achieve exceptional performance through disciplined execution and strategic investment," said Brendan Shanahan, CFO of GoHealth. "The substantial year-over-year growth in net income and the 107% year-over-year growth in Adjusted EBITDA1 during Q4, coupled with significant gains in operating efficiency, reinforces the strength of our strategy. As we begin 2025, we are optimistic that the favorable market dynamics we experienced will persist through at least the first three quarters with cautious optimism for similar favorable dynamics for the fourth quarter, enabling us to build on this solid financial foundation."

(1)Adjusted EBITDA is a non-GAAP measure. For a definition of Adjusted EBITDA and a reconciliation to the most comparable GAAP measure, please see below.
(2)Direct Operating Cost per Submission is an operating metric. For a definition of Direct Operating Cost per Submission and an explanation of its calculation, please see below.
  

Conference Call Details

The Company will host a conference call today, Thursday, February 27, 2025 at 8:00 a.m. (ET) to discuss its financial results. A live audio webcast of the conference call will be available via GoHealth's Investor Relations website, https://investors.gohealth.com/. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call.

About GoHealth, Inc.

GoHealth is a leading health insurance marketplace and Medicare-focused digital health company whose purpose is to compassionately ensure consumers' peace of mind when making healthcare decisions so they can focus on living life. For many of these consumers, enrolling in a health insurance plan is confusing and difficult, and seemingly small differences between health plans may lead to significant out-of-pocket costs or lack of access to critical providers and medicines. GoHealth's proprietary technology platform leverages modern machine-learning algorithms, powered by over two decades of insurance purchasing behavior, to reimagine the process of matching a health plan to a consumer's specific needs. Its unbiased, technology-driven marketplace coupled with highly skilled licensed agents has facilitated the enrollment of millions of consumers in Medicare plans since GoHealth's inception. For more information, visit https://www.gohealth.com

Investor Relations:
John Shave
JShave@gohealth.com 
 
Media Relations:
Pressinquiries@gohealth.com 
 

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, (the "Securities Act") and Section 21E of the Securities Exchange Act of 1934, as amended (the "Exchange Act"). These forward-looking statements are made in reliance upon the safe harbor provision of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical facts contained in this press release may be forward-looking statements. Statements regarding our future results of operations and financial position, business strategy and plans and objectives of management for future operations, including, among others, statements regarding our expected growth, future capital expenditures, debt service obligations, adoption and use of artificial intelligence technologies, the impact on our business from the acquisition of e-TeleQuote and our ability to successfully integrate e-TeleQuote's operations, technologies and employees into our business, are forward-looking statements.

In some cases, you can identify forward-looking statements by terms such as "may," "will," "should," "aims," "expects," "plans," "anticipates," "could," "intends," "targets," "projects," "contemplates," "believes," "estimates," "predicts," "potential," "likely," "future" or "continue" or the negative of these terms or other similar expressions. The forward-looking statements in this press release are only predictions, projections and other statements about future events that are based on current expectations and assumptions. Accordingly, we caution you that any such forward-looking statements are not guarantees of future performance and are subject to risks, assumptions and uncertainties that are difficult to predict. Although we believe that the expectations reflected in these forward-looking statements are reasonable as of the date made, actual results may prove to be materially different from the results expressed or implied by the forward-looking statements.

These forward-looking statements speak only as of the date of this press release and are subject to a number of important factors that could cause actual results to differ materially from those in the forward-looking statements, including the factors described in the sections titled "Summary Risk Factors," "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" in our Annual Report on Form 10-K for the fiscal year ended December 31, 2023 ("2023 Annual Report on Form 10-K") and our forthcoming Annual Report on Form 10-K for the fiscal year ended December 31, 2024 ("2024 Annual Report on Form 10-K"), as well as our other filings with the Securities and Exchange Commission. The factors described in our 2023 Annual Report on Form 10-K and our forthcoming 2024 Annual Report on Form 10-K should not be construed as exhaustive and should be read together with the other cautionary statements included in this press release, as well as the cautionary statements and other risk factors set forth in the Quarterly Report on Form 10-Q for the first fiscal quarter ended March 31, 2024, the Quarterly Report on Form 10-Q for the second fiscal quarter ended June 30, 2024, the Quarterly Report on Form 10-Q for the third quarter ended September 30, 2024 and in our other filings with the Securities and Exchange Commission.

You should read this press release and the documents that we reference in this press release completely and with the understanding that our actual future results may be materially different from what we expect. We qualify all of our forward-looking statements by these cautionary statements. Except as required by applicable law, we do not plan to publicly update or revise any forward-looking statements contained herein, whether as a result of any new information, future events, changed circumstances or otherwise.

Non-GAAP Financial Measures

Throughout this press release, we use a number of non-GAAP financial measures. Non-GAAP financial measures are supplemental measures of our performance that are derived from our consolidated financial information, but which are not presented in our Consolidated Financial Statements prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). We define these non-GAAP financial measures as follows:

  • "Adjusted EBITDA" represents, as applicable for the period, EBITDA as further adjusted for certain items summarized in the table furnished below in this press release.
  • "Adjusted EBITDA Margin" refers to Adjusted EBITDA divided by net revenues.
  • "EBITDA" represents net income (loss) before interest expense, income tax expense (benefit) and depreciation and amortization expense.

We believe that excluding certain items from our GAAP results allows management to better understand our consolidated financial performance from period to period and better project our future consolidated financial performance as forecasts are developed at a level of detail different from that used to prepare GAAP-based financial measures. Moreover, we believe these non-GAAP financial measures provide our stakeholders with useful information to help them evaluate our operating results by facilitating an enhanced understanding of our operating performance and enabling them to make more meaningful period to period comparisons. Adjusted EBITDA is the primary financial performance measure used by management to evaluate the business and monitor the results of operations, as well as a basis for certain compensation programs sponsored by the Company. There are limitations to the use of the non-GAAP financial measures presented in this press release. For example, our non-GAAP financial measures may not be comparable to similarly titled measures of other companies. Other companies, including companies in our industry, may calculate non-GAAP financial measures differently than we do, limiting the usefulness of those measures for comparative purposes.

The non-GAAP financial measures are not meant to be considered as indicators of performance in isolation from or as a substitute for the most directly comparable financial measures prepared in accordance with GAAP and should be read only in conjunction with financial information presented on a GAAP basis. Reconciliations of each of EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin to its most directly comparable GAAP financial measure are presented in the tables furnished below in this press release. We encourage you to review the reconciliations in conjunction with the presentation of the non-GAAP financial measures for each of the periods presented. In future periods, we may exclude similar items, may incur income and expenses similar to these excluded items and may include other expenses, costs and non-routine items.

Key Business Performance and Operating Metrics

In addition to traditional financial metrics, we rely upon certain business and operating metrics to evaluate our business performance and facilitate our operations. The most relevant business and operating metrics are as follows:

  • "Direct Operating Cost of Submission" is an operating metric that represents costs directly attributable to Submissions generated during a particular period and excludes costs that are indirect or fixed. Direct Operating Cost of Submission is comprised of the portion of the respective operating expenses for revenue share, marketing and advertising and consumer care and enrollment that are directly related to the Submissions generated in the particular period. Direct Operating Cost of Submission, previously referred to as "Direct Cost of Submission," reflects a name change only.
  • "Direct Operating Cost per Submission" is an operating metric that represents the average performance of Submissions generated during a particular period. Direct Operating Cost per Submission refers to (x) Direct Operating Cost of Submission for a particular period divided by (y) the number of Submissions generated for such period. Direct Operating Cost per Submission, previously referred to as "Direct Cost per Submission" reflects a name change only.
  • "Sales/Direct Operating Cost of Submission" represents (x) the numerator of Sales per Submission, as defined below, divided by (y) Direct Operating Cost of Submission. Sales/Direct Operating Cost of Submission, previously referred to as "Sales/Direct Cost of Submission" reflects a name change only.
  • "Sales per Submission" is an operating metric that represents the average performance of Submissions generated during a particular period. Sales per Submission measures revenues only from the Submissions generated in the period and excludes items that are unrelated to such Submissions, including any impact of revenue adjustments recorded in the period, but relating to performance obligations satisfied in prior periods. Sales per Submission equals (x) the sum of (i) agency revenues, comprised of the expected amount of initial commission revenue and any renewal commissions to be paid from the health plan partners on such placement as long as the policyholder remains with the same insurance product, as well as partner marketing and other revenue and (ii) non-agency revenues, comprised of the enrollment and engagement services for which cash is collected in advance or in close proximity to the point in time revenue is recognized, divided by (y) the number of Submissions generated for such period.
  • "Submission" refers to either (i) a completed application with our licensed agent that is submitted to the health plan partner and subsequently approved by the health plan partner during the indicated period, excluding applications through our Non-Encompass BPO Services or (ii) a transfer by our agent to the health plan partner through the Encompass operating model during the indicated period.

Direct Operating Cost of Submission, Direct Operating Cost per Submission, Sales/Direct Operating Cost of Submission, Sales per Submission and Submissions are key operating metrics we use to understand our underlying financial performance and trends.

Certain Definitions and Key Terms

As used in this press release, unless the context otherwise requires:

  • "LTV" refers to the Lifetime Value of Commissions, which we define as aggregate commissions estimated to be collected over the estimated life of all commissionable Submissions for the relevant period based on multiple factors, including but not limited to, contracted commission rates, health plan partner mix and expected policy persistency with applied constraints.
  • "Non-Encompass BPO Services" refer to programs in which GoHealth-employed agents are dedicated to certain health plans and agencies we partner with outside of the Encompass operating model.

The following tables set forth the components of our results of operations for the periods indicated (unaudited):

  Three months ended Dec. 31,    
(in thousands, except percentages and per share amounts)

  2024   2023     
 Dollars % of Net Revenues Dollars % of Net Revenues $ Change % Change
Net revenues $389,132  100.0% $276,697  100.0% $112,435  40.6%
Operating expenses:            
Revenue share  52,236  13.4%  41,085  14.8%  11,151  27.1%
Marketing and advertising expense  99,647  25.6%  80,614  29.1%  19,033  23.6%
Consumer care and enrollment  89,683  23.0%  75,199  27.2%  14,484  19.3%
Technology expense  12,125  3.1%  11,596  4.2%  529  4.6%
General and administrative  31,659  8.1%  19,629  7.1%  12,030  61.3%
Amortization of intangible assets  23,515  6.0%  23,514  8.5%  1  %
Intangible asset impairment charges    %  10,000  3.6%  (10,000) (100.0)%
Total operating expenses  308,865  79.4%  261,637  94.6%  47,228  18.1%
Income (loss) from operations  80,267  20.6%  15,060  5.4%  65,207  433.0%
Interest expense  17,735  4.6%  17,751  6.4%  (16) (0.1)%
Gain on bargain purchase  (7,129) (1.8)%    %  (7,129) NM 
Loss on extinguishment of debt  10,463  2.7%    %  10,463  NM 
Other (income) expense, net  (1,166) (0.3)%  (776) (0.3)%  (390) 50.3%
Income (loss) before income taxes  60,364  15.5%  (1,915) (0.7)%  62,279  (3252.2)%
Income tax expense (benefit)  2,389  0.6%  379  0.1%  2,010  530.3%
Net income (loss)  57,975  14.9%  (2,294) (0.8)%  60,269  (2627.2)%
Net income (loss) attributable to noncontrolling interests  32,466  8.3%  (1,068) (0.4)%  33,534  (3139.9)%
Net income (loss) attributable to GoHealth, Inc. $25,509  6.6% $(1,226) (0.4)% $26,735  (2180.7)%
Net income (loss) per share:            
Net income (loss) per share of Class A common stock — basic $2.42    $(0.22)      
Net income (loss) per share of Class A common stock — diluted $1.56    $(0.22)      
Weighted-average shares of Class A common stock outstanding — basic  10,152     9,582       
Weighted-average shares of Class A common stock outstanding —diluted  16,370     9,582       
Non-GAAP financial measures:            
EBITDA $105,026    $42,684       
Adjusted EBITDA $117,839    $57,000       
Net income (loss) margin  14.9%   (0.8)%      
Adjusted EBITDA margin  30.3%    20.6%      
                 

NM = Not meaningful

  Twelve months ended Dec. 31,    
(in thousands, except percentages and per share amounts)

  2024   2023     
 Dollars % of Net Revenues Dollars % of Net Revenues $ Change % Change
Net revenues $798,894  100.0% $734,671  100.0% $64,223  8.7%
Operating expenses:            
Revenue share  130,612  16.3%  158,961  21.6%  (28,349) (17.8)%
Marketing and advertising expense  235,696  29.5%  205,042  27.9%  30,654  15.0%
Consumer care and enrollment  222,414  27.8%  209,234  28.5%  13,180  6.3%
Technology expense  41,046  5.1%  43,302  5.9%  (2,256) (5.2)%
General and administrative  82,116  10.3%  93,069  12.7%  (10,953) (11.8)%
Amortization of intangible assets  94,057  11.8%  94,057  12.8%    %
Operating lease impairment charges    %  2,687  0.4%  (2,687) (100.0)%
Intangible asset impairment charges    %  10,000  1.4%  (10,000) (100.0)%
Total operating expenses  805,941  100.9%  816,352  111.1%  (10,411) (1.3)%
Income (loss) from operations  (7,047) (0.9)%  (81,681) (11.1)%  74,634  (91.4)%
Interest expense  72,868  9.1%  69,472  9.5%  3,396  4.9%
Gain on bargain purchase  (84,492) (10.6)%    %  (84,492) NM 
Loss on extinguishment of debt  10,463  1.3%    %  10,463  NM 
Other (income) expense, net  (834) (0.1)%  (37) %  (797) 2154.1%
Income (loss) before income taxes  (5,052) (0.6)%  (151,116) (20.6)%  146,064  (96.7)%
Income tax expense (benefit)  2,267  0.3%  154  %  2,113  1372.1%
Net income (loss)  (7,319) (0.9)%  (151,270) (20.6)%  143,951  (95.2)%
Net income (loss) attributable to noncontrolling interests  (4,391) (0.5)%  (88,013) (12.0)%  83,622  (95.0)%
Net income (loss) attributable to GoHealth, Inc. $(2,928) (0.4)% $(63,257) (8.6)% $60,329  (95.4)%
Net income (loss) per share:            
Net income (loss) per share of Class A common stock — basic and diluted $(0.66)   $(7.19)      
Weighted-average shares of Class A common stock outstanding — basic and diluted  9,980     9,292       
Non-GAAP financial measures:            
EBITDA $173,706    $24,104       
Adjusted EBITDA $120,319    $75,091       
Net income (loss) margin (0.9)%   (20.6)%      
Adjusted EBITDA margin  15.1%    10.2%      
                 

NM = Not meaningful

The following table sets forth the reconciliations of GAAP net income (loss) to EBITDA and Adjusted EBITDA for the periods indicated (unaudited):

  Three months ended Dec. 31, Twelve months ended Dec. 31,
(in thousands)  2024   2023   2024   2023 
Net revenues $389,132  $276,697  $798,894  $734,671 
Net income (loss)  57,975   (2,294)  (7,319)  (151,270)
Interest expense  17,735   17,751   72,868   69,472 
Income tax expense (benefit)  2,389   379   2,267   154 
Depreciation and amortization expense  26,927   26,848   105,890   105,748 
EBITDA  105,026   42,684   173,706   24,104 
Gain on bargain purchase1  (7,129)     (84,492)   
Loss on extinguishment of debt2  10,463      10,463    
Share-based compensation expense3  4,747   3,405   11,281   19,564 
Professional services4  2,853   335   3,671   1,548 
Legal fees5  1,586   148   2,917   14,840 
Other (income) loss related to the adjustment of liabilities under the Tax Receivable Agreement6  293   428   293   428 
Severance costs7        2,480   1,920 
Intangible asset impairment charges8     10,000      10,000 
Operating lease impairment charges9           2,687 
Adjusted EBITDA $117,839  $57,000  $120,319  $75,091 
Net income (loss) margin  14.9% (0.8)% (0.9)% (20.6)%
Adjusted EBITDA margin  30.3%  20.6%  15.1%  10.2%
                 


(1)Represents the excess of the acquisition-date fair value of the net assets acquired over the acquisition-date fair value of the consideration transferred related to the acquisition of e-TeleQuote.
(2)Represents the loss on debt extinguishment related to the write-down of deferred debt discount and debt issuance costs in conjunction with the refinancing of the Term Loan Facilities.
(3)Represents non-cash share-based compensation expense relating to equity awards as well as share-based compensation expense relating to liability classified awards that will be settled in cash.
(4)Represents costs primarily associated with non-routine consulting fees and other professional services.
(5)Represents legal fees, settlement accruals and other expenses related to certain acquisitions, litigation, Credit Agreement amendments and other non-routine legal or regulatory matters.
(6)Represents expense related to the measurement of our Tax Receivable Agreement obligation.
(7)Represents severance costs and other fees associated with a reduction in workforce unrelated to restructuring activities.
(8)Represents an indefinite-lived intangible asset impairment charge for the twelve months ended December 31, 2023.
(9)Represents operating lease impairment charges, reducing the carrying value of the associated ROU assets and leasehold improvements to the estimated fair values.
  

The table below depicts the disaggregation of revenue and is consistent with how the Company evaluates its financial performance (unaudited):

  Three months ended Dec. 31, Twelve months ended Dec. 31,
(in thousands)  2024  2023  2024  2023
Medicare Revenue        
Agency Revenue        
Commission Revenue1 $278,362 $94,405 $506,516 $355,918
Partner Marketing and Other Revenue  27,234  16,093  75,160  87,712
Total Agency Revenue  305,596  110,498  581,676  443,630
Non-Agency Revenue  81,566  165,383  212,289  271,969
Total Medicare Revenue  387,162  275,881  793,965  715,599
Other Revenue        
Non-Encompass BPO Services Revenue        9,322
Other Revenue  1,970  816  4,929  9,750
Total Other Revenue  1,970  816  4,929  19,072
Total Net Revenue $389,132 $276,697 $798,894 $734,671
             


(1)Commission revenue excludes commissions generated through Non-Encompass BPO Services as well as from the sale of individual and family plan insurance products.
  

The following table sets forth our balance sheets for the periods indicated (unaudited):

  Dec. 31,
(in thousands, except per share amounts)  2024   2023 
Assets    
Current assets:    
Cash and cash equivalents $40,921  $90,809 
Accounts receivable, net of allowance for doubtful accounts of $1 in 2024 and $27 in 2023  4,452   250 
Commissions receivable - current  320,399   336,215 
Prepaid expense and other current assets  34,639   49,166 
Total current assets  400,411   476,440 
Commissions receivable - non-current  733,161   575,482 
Operating lease ROU asset  19,317   21,995 
Property, equipment, and capitalized software, net  29,320   26,843 
Intangible assets, net  302,497   396,554 
Other long-term assets  3,717   2,256 
Total assets $1,488,423  $1,499,570 
Liabilities, Redeemable Convertible Preferred Stock and Stockholders' Equity    
Current liabilities:    
Accounts payable $14,591  $17,705 
Accrued liabilities  121,346   86,254 
Commissions payable - current  98,771   127,265 
Short-term operating lease liability  5,705   5,797 
Deferred revenue  53,720   52,403 
Current portion of long-term debt  39,500   75,000 
Other current liabilities  4,419   5,589 
Total current liabilities  338,052   370,013 
Non-current liabilities:    
Commissions payable - non-current  177,656   203,255 
Long-term operating lease liability  34,900   39,547 
Long-term debt, net of current portion  447,865   422,705 
Deferred tax liability  22,350    
Other non-current liabilities  9,200   9,095 
Total non-current liabilities  691,971   674,602 
Commitments and Contingencies    
Series A redeemable convertible preferred stock — $0.0001 par value; 50 shares authorized; 50 shares issued and outstanding as of both December 31, 2024 and December 31, 2023. Liquidation preference of $54.6 million and $50.9 million as of December 31, 2024 and December 31, 2023, respectively.  52,962   49,302 
Stockholders' equity:    
Class A common stock – $0.0001 par value; 1,100,000 shares authorized; 10,614 and 9,823 shares issued; 10,292 and 9,651 shares outstanding as of December 31, 2024 and December 31, 2023, respectively.  1   1 
Class B common stock – $0.0001 par value; 615,917 shares authorized; 12,711 and 12,814 shares issued and outstanding as of December 31, 2024 and December 31, 2023, respectively.  1   1 
Preferred stock – $0.0001 par value; 20,000 shares authorized (including 50 shares of Series A redeemable convertible preferred stock authorized and 200 shares of Series A-1 convertible preferred stock authorized); 50 shares issued and outstanding as of both December 31, 2024 and December 31, 2023.      
Series A-1 convertible preferred stock— $0.0001 par value; 200 shares authorized; no shares issued and outstanding as of both December 31, 2024 and December 31, 2023.      
Treasury stock – at cost; 322 and 173 shares of Class A common stock as of December 31, 2024 and December 31, 2023, respectively.  (4,150)  (2,640)
Additional paid-in capital  669,346   654,059 
Accumulated other comprehensive income (loss)  (151)  (127)
Accumulated deficit  (423,208)  (420,280)
Total stockholders' equity attributable to GoHealth, Inc.  241,839   231,014 
Non-controlling interests  163,599   174,639 
Total stockholders' equity  405,438   405,653 
Total liabilities, redeemable convertible preferred stock and stockholders' equity $1,488,423  $1,499,570 
         

The following table sets forth the net cash provided by (used in) operating activities for the periods presented (unaudited):

Net cash provided by (used in) operating activities
 Twelve months ended Dec. 31,
 2024 2023
 $ (21,607) $109,141
        

In addition to traditional financial metrics, we rely upon certain business and operating metrics to evaluate our business performance and facilitate our operations. Below are the most relevant business and operating metrics for our single operating and reportable segment.

The following table presents the number of Submissions for the periods presented:

Submissions
 Three months ended Dec. 31,     
 2024 2023 Change % Change
 481,445 288,127 193,318 67.1%
         
 Twelve months ended Dec. 31,     
 2024 2023 Change % Change
 1,016,182 826,159 190,023 23.0%
          

The following table presents the Sales per Submission for the periods presented:

  Three months ended Dec. 31,       
   2024  2023 $ Change % Change
  $804 $957 $(153) (16.0)%
Sales Per Submission             
  Twelve months ended Dec. 31,       
   2024  2023 $ Change % Change
  $781 $866 $(85) (9.8)%
              

The following table presents the Direct Operating Cost per Submission for the periods presented:

  Three months ended Dec. 31,       
  2024 2023 $ Change % Change
  $501 $688 $(187) (27.2)%
Direct Operating Cost Per Submission             
  Twelve months ended Dec. 31,       
  2024 2023 $ Change % Change
  $578 $ 683 $(105) (15.4)%
              

The following are our Direct Operating Cost of Submission (in thousands) and Sales/Direct Operating Cost of Submission for the periods presented:

  Three months ended Dec. 31, Twelve months ended Dec. 31,
   2024  2023  2024  2023
Direct Operating Cost of Submission $241,259 $197,940 $587,371 $563,552
Sales/Direct Operating Cost of Submission  1.6  1.4  1.4  1.3
Image for Press Release 2054110
Image for Press Release 2054110

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