{ "docId": "019dd923-622c-750b-8b99-4fdf89a4b224", "docSlug": "bcbeb3ac7b21", "documentTitle": "Progyny, Inc. (PGNY)", "authorId": "54_Spruce_Point_Capital", "authorName": "Spruce Point Capital Management", "documentKindSlug": "activist-deck", "documentKindLabel": "Activist deck", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2023-02-07 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 68, "pageCount": 100, "prevPage": 67, "nextPage": 69, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 0, "notes": "Uses CDC report excerpts to invalidate PGNY's internal performance claims.", "elementsJson": [ "headline_text", "paragraph", "callout_box", "screenshot" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b99-4fdf89a4b224/68", "deckHref": "/decks/019dd923-622c-750b-8b99-4fdf89a4b224", "deckJsonHref": "/decks/019dd923-622c-750b-8b99-4fdf89a4b224.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b99-4fdf89a4b224#slide-68", "components": [ { "bbox": { "h": 0.15, "w": 0.78, "x": 0.19, "y": 0.3 }, "kind": "callout", "text": "We believe PGNY ignores the advice of the CDC and SART by comparing fertility outcomes between individual clinics. Different clinics are defined by different fertility treatments and patient demographics (as we discuss below). Moreover, a focus on the performance of PGNY in-network clinics ignores the facts that: (1) PGNY selects clinics for their network based on their outcomes data, and (2) those clinics are NOT exclusive to PGNY.", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f6556206-7010-49f7-9868-43f89d9e902a", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.23, "x": 0.53, "y": 0.53 }, "kind": "list", "text": "Some clinics see more than the average number of patients with difficult infertility problems. Some clinics offer ART to most potential patients, even those who have a low probability of success. Others discourage such patients or encourage them to use donor eggs.", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "34d26945-6ab0-42ac-b8e8-25f1b619020a", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.23, "x": 0.05, "y": 0.53 }, "kind": "list", "text": "8. Can I use clinic success rates to measure the quality of ART services? Although the quality of ART services can affect the reported outcomes, patient characteristics such as age, race or ethnicity, infertility diagnosis, or existing medical conditions can also contribute to differences in ART success rates.", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b49b3e37-c065-43b8-aafc-0f2f73a05db0", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.23, "x": 0.29, "y": 0.53 }, "kind": "list", "text": "Interpretation of Fertility Clinic Success Rates: Many people considering ART will want to use the information presented online in ART Fertility Clinic Success Rates to find the \"best\" clinic. Comparisons between clinics must be made with caution. Many factors contribute to the success of an ART procedure.", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "dcdbfdc9-6e0b-4c72-ab43-8589596517fb", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.35, "w": 0.21, "x": 0.77, "y": 0.53 }, "kind": "paragraph", "text": "Given PGNY's client base, its members are skewed toward states like CA, CO, IL, MA, NJ, NY, OH, and TX. All these states have state-mandated fertility insurance coverage. The CDC has found that fewer embryos are transferred, more IVF births occur, and fewer multiples are observed in states with fertility coverage mandates, thus biasing PGNY outcomes data.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "199592ac-2ac0-49fe-a07a-508a039c3306", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.05, "w": 0.45, "x": 0.05, "y": 0.47 }, "kind": "paragraph", "text": "Excerpts From the CDC’s 2019 Assisted Reproductive Technology, Fertility Clinic and National Summary Report", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "4a48b0f8-31ef-45cf-abdd-9b99d6dde2d5", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.11, "w": 0.92, "x": 0.05, "y": 0.18 }, "kind": "paragraph", "text": "We believe PGNY’s outcomes data should not be relied upon, as it suffers from three fundamental issues of comparability: (1) different clinics, (2) different fertility treatments (driven by different fertility diagnoses and patient motivations), and (3) vastly different patient demographics. These issues, as well as other methodological issues, were largely ignored by the Milliman study assessing PGNY’s outcomes data.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "84532558-5ad0-4358-8160-a96f7b9f1f42", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.03, "w": 0.6, "x": 0.05, "y": 0.96 }, "kind": "source-note", "text": "Source: CDC 2019 Assisted Reproductive Technology, Fertility Clinic and National Summary Report, CDC website", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a68fbfd0-8059-421b-9d7f-20417273410c", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.65, "x": 0.31, "y": 0.05 }, "kind": "title", "text": "We Believe PGNY’s Claims of “Superior” Outcomes Are Highly Questionable, As The Data Sets Are Fundamentally Not Comparable", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "ae3965ed-86d6-4f02-88e5-2301e63d98da", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [ { "name": "authority-citation", "slug": null, "matchId": "fdbbffb5-d93d-4bdb-949b-c40464adb68b", "evidence": "Citing CDC reports to challenge company claims", "confidence": 0.9 } ], "arcBeats": [ { "to": 100, "from": 61, "beatId": "470ad4dd-317c-46c8-baea-551e7894c3b9", "arcName": "Overcoming the Monster", "arcSlug": "overcoming-monster", "beatName": "Resolution", "beatSlug": "mountain-resolution", "evidence": "The document concludes with a detailed analysis of PGNY's valuation and downside risk.", "position": 4, "confidence": 0.8, "parentBeatName": "Resolution", "parentBeatSlug": "resolution" } ], "loops": [ { "to": 100, "from": 61, "name": "Mece Breakdown", "slug": "40-mece-breakdown", "bestFor": "Problem structuring, ensuring completeness, strategic analysis", "matchId": "db636762-5e9e-4cb6-8376-e0923a5a5438", "evidence": "The document presents a detailed analysis of PGNY's valuation and downside risk.", "position": 3, "objective": "How do PGNY's issues impact its valuation?", "structure": "The Whole -> Category A (distinct) -> Category B (distinct) -> Category C (distinct) -> Complete Coverage", "confidence": 0.7, "description": "Divide a complex topic into mutually exclusive, collectively exhaustive categories" } ], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }