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Imagine this. You're in the heart of Chicago

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mingling with the brightest minds in health IT.

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You've arrived at the 9th annual Health IT

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plus Digital Health Plus RCM conference taking place

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October 1st through 4th at the luxurious Hyatt

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Regency Chicago.

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Picture the excitement as you collect countless business

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cards, forging invaluable connections with over 25 100

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executive level attendees.

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Feel the buzz of ideas flowing as you

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engage in meaningful conversations about the future of

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healthcare technology.

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Envision yourself attending sessions led by over 415

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elite speakers,

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gaining insights that could transform your organization.

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From digital transformation and telehealth to clinician burnout

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and cybersecurity,

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each topic is designed to spark new ideas

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and provide actionable takeaways, but it doesn't stop

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there. Imagine sitting in a packed auditorium listening

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to motivating keynotes from some of the biggest

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names in sports. Four time Super Bowl champion,

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Rob Gronkowski,

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WNBA

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champion, and author, Lisa Leslie,

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and NFL legend and ESPN

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analyst,

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Eli Manning, will be there sharing their stories

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and inspiring you to reach new heights. All

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around you, the future of health IT unfolds,

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and you're not just a spectator.

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You're an active participant.

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Don't wait. You can find the event website

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and get registered by visiting peckershospital

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healthcare podcast.

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I'm thrilled today to be joined by Casey

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Hossa, chief information officer and security officer at

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Health New England. Casey, it's a pleasure to

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have you on the podcast today.

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Laura, it's a pleasure to be here. Thanks

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for the opportunity.

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Well, absolutely. And I'm excited to have you

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on the line today because I know there's

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so much happening in changing in the digital

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transformation

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in the health care space and particularly

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around security as well. Just being a big

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focus this year, we've seen some really big,

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breaches and challenges in the cybersecurity space. And

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so I'm looking forward to learning a little

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bit more about your perspective on how you're

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thinking about,

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you know, what you're doing today and and

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growing in the future. But before we dive

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into my discussion, can you tell me a

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little bit more about yourself and, your background?

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No. I'm happy to.

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You know, I I,

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I spent the last couple of decades in

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health care, but, probably early in my health

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in my career,

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I spent a lot of time in almost

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every industry outside of health care.

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Right? And so a lot of it's been

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focused on, you know, organizations like Deloitte and

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Ernst, where we brought innovative solutions forward.

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And so the past couple of decades, I've

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really spent quite a bit of time across

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a couple of different organizations in the healthcare

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vertical.

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I spent some time at, actually, here in

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Chicago, one of the largest privately held loose

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plans, HCSC.

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And then I had the opportunity to be

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a CIO,

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for a provider system, a 9 hospital provider

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system in Washington State,

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then pivoted and took an opportunity to really

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drive something different in the world of Medicaid,

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specifically with duals and

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behavioral health. And I was the CIO in

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that space.

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And I joined,

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Health New England

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just about 3 years ago.

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And what's interesting with Health New England is

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we're a provider owned payer

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in Western Massachusetts. So it's a great opportunity

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to think about how do you bring together

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sort of

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the relationship,

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being a provider owned organization and and get

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address some of the friction points and opportunities

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to to really have a strong relationship with

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the providers in this space, and specifically our,

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you know, our parent company,

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and have an impact for our members.

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And so quite a bit of work across

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a number of dimensions in this space.

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Well, it's great to hear. You know? And,

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certainly, I can imagine each different experience has

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given you different tools and,

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abilities to, you know, jump in and, as

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you said, be primed for some of the

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challenges and opportunities in the health care space

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today. And I know, like you were mentioning,

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that relationship between the providers and the, health

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care organizations as well as the payers, it

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seems like across the board is becoming more

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and more essential to have that,

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you know, kind of strong relationship

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between them as health care continues to evolve.

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So that's really fascinating to see.

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From your vantage point, what are some of

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the opportunities and headwinds that you have your

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eye on right now?

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You know, I I think all of us

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are looking at some of the same areas,

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but

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specifically in our region,

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right, we've got some unique opportunities and challenges.

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And so I think Massachusetts

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in particular really is a microcosm

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of national trends,

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because we're often very progressive in terms of

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our policies,

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and just early adoption of healthcare innovations.

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And, I think the areas that we're focused

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on in terms of potential opportunities are similar

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to many of the other payers, I would

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assume.

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And a lot of this has been sort

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of the onset recently of AI, right? And

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I think there are some publications out there

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that begin to talk about what AI can

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potentially do in the payer space with some

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significant savings on the administrative cost side,

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savings on the medical cost side,

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as well as improvement in revenue. And so

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we're certainly like many other organizations thinking about

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how do we get that established, what are

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the opportunities and how do we begin to

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understand how to apply those technologies to really

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those broader problems that are out there?

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You mentioned it, digital transformation,

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right?

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And I think for us, we live in

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a region that's pretty tech savvy, and oftentimes

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are early adopters.

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They were early adopters of EHRs. So it

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really provides a nice fertile ground for us

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for additional innovation.

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And so how do we we're looking at

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how we continue to enhance customer experiences

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and drive things that are focused on data

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integration, so that we can take advantage of

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the broader healthcare ecosystem

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and provide a much more personalized experience.

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The other areas that we're focused on are

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things that are

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you know, again, I had been out in

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the market for a while, but I think

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we're getting to a place where the maturity

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and the tools have really helped us begin

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to emphasize

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things like, you know, value based care with

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quality and cost effectiveness, right?

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And, you know, developing much more,

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I'll call it, robust risk adjustment models,

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care management programs.

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Again, looking at the region, you know, we've

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got aging population, right? And so it creates

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significant opportunities for Medicare Advantage Plans. And so

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we're looking at how do we begin to

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differentiate ourselves like others,

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better understanding our members, offering up tailored products,

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tailored benefits.

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I think the other areas that are, again,

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focused

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on opportunities are telehealth and telemedicine. And I

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think everybody is looking at and we are

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as well at how can we kind of

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expand on the promises that have been out

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there, especially for rural areas,

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things like clinically integrated

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information exchanges, right? Again,

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how do we take advantage of that and

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bring that forward?

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And then I would say,

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like everyone, we're always exploring risk bearing arrangements,

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right? Care coordination,

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enhanced population health outcomes,

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and all those, I think, really are just

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good opportunities.

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I think in the conversation, you talked a

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little bit about headwinds,

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right, as part of the question.

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I would say,

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you know, the health care industry is just

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heavily regulated.

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Right? And so

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Massachusetts

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often leads the way in terms of implementing

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new policies.

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And so, you know, like all organizations, we're

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very much focused on compliance and regulatory, how

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do we develop the expertise to navigate the

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complex environments.

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And I think as a CIO, what that

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means is oftentimes we've got to be pretty

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agile in responding to updates to IT systems.

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You know, talent and retention

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is a big part of what we were

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focused on. There's always, you know, an opportunity

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to take advantage

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of talents and data analytics,

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cybersecurity,

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digital health.

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You know, there's we I mentioned digital

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transformation, but consumer expectations are

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there's an easy button out there. Right? There's

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a there's a rise in health care,

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and health consumer expectations

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around personal access, right, transparent services,

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making sure that everything's offered in advance, right,

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being insight, identifying the next steps,

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you know, and the associated digital platforms

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and messaging that comes along with that.

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Because I think all of us, you know,

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and I think retail has been ahead of

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the game in a lot of ways,

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just reset the customers and consumer expectations for

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personalized care, convenient access,

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right, transparency

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and cost,

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and making sure that and you've you mentioned

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it at the start of this. Right? How

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does all this maintain how do we maintain

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sort of a security

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and compliance associated with this critical space?

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And and I think

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there's a number of dimensions associated with that.

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One of them actually is in the world

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of AI, there's a lot more automation across

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the tool sets in the security space that

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allow us to

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put more quickly understand patterns and

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opportunities

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to almost automatically

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turn things off and turn off risk areas

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and isolate, challenge areas where you might have

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some unusual patterns that occur.

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And so I think all of these really

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provide a set of headwinds and opportunities, right,

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hand in hand.

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And so ourselves along with others are continuing

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to look at and invest appropriately

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to help us you know, in terms of

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long term success and and, again, delivering value

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to our members and and,

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the community.

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That's fascinating to hear, you know, and really

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a lot of the things you mentioned, all

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coming together, whether it's looking at some of

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the areas where, you know, you can,

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optimize the value based care, the quality, the

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cost effectiveness,

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and then integrating

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systems, the digital transformation to be able to

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better coordinate care and,

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facilitate the flow of information.

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And then to thinking about that consumerism aspect

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and how patients and their,

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00:10:30,774 --> 00:10:32,934
you know, demand for care and the experience

275
00:10:32,934 --> 00:10:34,649
that they want from their health care journey.

276
00:10:34,649 --> 00:10:36,570
It's just it's been really fascinating to see

277
00:10:36,570 --> 00:10:37,789
how all of those things,

278
00:10:38,490 --> 00:10:40,809
are changing the way health plans and health

279
00:10:40,809 --> 00:10:43,850
systems are operating and and, you know, thinking

280
00:10:43,850 --> 00:10:45,450
about what they need in order to be

281
00:10:45,450 --> 00:10:46,750
successful in the future.

282
00:10:47,825 --> 00:10:49,285
You hit all the right buttons.

283
00:10:49,985 --> 00:10:51,985
No question about it. And it's not not

284
00:10:51,985 --> 00:10:53,985
an easy task to pursue. Right? There's a

285
00:10:53,985 --> 00:10:55,985
lot of coordination, a lot of complexity to

286
00:10:55,985 --> 00:10:56,725
all of it.

287
00:10:57,425 --> 00:10:58,325
And, you know,

288
00:10:58,705 --> 00:11:01,205
there's a there's a element of this associated

289
00:11:01,345 --> 00:11:02,959
with personal privacy.

290
00:11:03,500 --> 00:11:05,899
We're talking about we're not talking about, hey,

291
00:11:05,899 --> 00:11:07,740
Casey is getting this pair of shoes on

292
00:11:07,740 --> 00:11:09,120
Saturday that he ordered

293
00:11:09,740 --> 00:11:12,959
on Amazon. We're talking about individual health care

294
00:11:13,579 --> 00:11:16,079
and things that are very personal. And sometimes

295
00:11:16,220 --> 00:11:17,839
disease management and chronic

296
00:11:18,184 --> 00:11:19,725
disease management that gets

297
00:11:20,264 --> 00:11:21,084
pretty complex.

298
00:11:21,544 --> 00:11:24,044
And there's a lot of interactions across

299
00:11:24,664 --> 00:11:25,884
caretakers and

300
00:11:26,264 --> 00:11:28,524
the health payer, etcetera. So

301
00:11:28,985 --> 00:11:30,745
a lot of complexities. If it was easy,

302
00:11:30,745 --> 00:11:32,445
I think it would have been done already,

303
00:11:32,504 --> 00:11:34,329
right. People would have figured it out and

304
00:11:34,329 --> 00:11:35,709
there'd been an easy button.

305
00:11:37,370 --> 00:11:38,029
Yeah. Absolutely.

306
00:11:38,809 --> 00:11:40,490
You know, I I think a lot of

307
00:11:40,490 --> 00:11:42,409
executives and leaders in the health care space

308
00:11:42,409 --> 00:11:43,629
wish that easy button,

309
00:11:44,889 --> 00:11:47,375
existed in front of them. But, you know,

310
00:11:47,375 --> 00:11:48,995
I I know it's a lot more complicated

311
00:11:49,134 --> 00:11:50,815
than that as you mentioned. Otherwise, you know,

312
00:11:50,815 --> 00:11:52,975
we would be in a different place, today.

313
00:11:52,975 --> 00:11:55,535
But how are you thinking about growth and

314
00:11:55,535 --> 00:11:57,934
adding value overall in the future? What does

315
00:11:57,934 --> 00:11:59,774
that look like for you, especially on the

316
00:11:59,774 --> 00:12:01,475
technology and security side?

317
00:12:02,559 --> 00:12:05,299
Yeah. For us, it's a continued focus on,

318
00:12:05,919 --> 00:12:06,899
digital transformation

319
00:12:07,200 --> 00:12:07,700
innovation.

320
00:12:08,080 --> 00:12:08,580
Right?

321
00:12:08,960 --> 00:12:10,639
You know, there's there's a lot of cloud

322
00:12:10,639 --> 00:12:13,039
based platforms. There's a lot of automation with

323
00:12:13,039 --> 00:12:14,639
AI that we're taking a look at and

324
00:12:14,639 --> 00:12:15,539
thinking about.

325
00:12:15,995 --> 00:12:18,475
And again, how do we deliver those through

326
00:12:18,475 --> 00:12:20,174
mobile apps, telehealth services,

327
00:12:21,034 --> 00:12:22,254
omnichannel capabilities.

328
00:12:22,794 --> 00:12:24,235
I spent quite a bit of time early

329
00:12:24,235 --> 00:12:26,394
in my career with in a number of

330
00:12:26,394 --> 00:12:27,214
other industries.

331
00:12:27,834 --> 00:12:30,475
And so these concepts have been around for

332
00:12:30,475 --> 00:12:30,975
decades.

333
00:12:31,839 --> 00:12:34,240
They just need to be implemented differently in

334
00:12:34,240 --> 00:12:35,139
each of the industries.

335
00:12:36,000 --> 00:12:37,620
Data analytics and AI,

336
00:12:38,000 --> 00:12:39,220
in fact, I just finished

337
00:12:40,159 --> 00:12:42,740
some individual coursework at the University of Chicago

338
00:12:42,799 --> 00:12:44,740
because there's so much to be harnessed

339
00:12:46,144 --> 00:12:49,445
with AI and some of the models, AIMO

340
00:12:49,504 --> 00:12:50,945
and some of the data models that are

341
00:12:50,945 --> 00:12:52,544
out there and the insights that you're able

342
00:12:52,544 --> 00:12:54,384
to get. And so much of it is

343
00:12:54,384 --> 00:12:56,784
really focused on making sure that you've got

344
00:12:56,784 --> 00:12:58,164
good clean data

345
00:12:58,620 --> 00:13:00,940
that you can make good decisions on. And

346
00:13:00,940 --> 00:13:02,639
that's always been a constant struggle,

347
00:13:03,179 --> 00:13:05,740
you know, for decades. And it's been in

348
00:13:05,740 --> 00:13:08,379
almost any industry and health care even more

349
00:13:08,379 --> 00:13:10,160
so just because of the privacy

350
00:13:10,955 --> 00:13:12,735
associated with so much of that information

351
00:13:13,754 --> 00:13:16,075
and the compliance and regulations that we need

352
00:13:16,075 --> 00:13:16,654
to apply.

353
00:13:17,274 --> 00:13:19,195
All of us are focused, I think, on

354
00:13:19,195 --> 00:13:21,915
cybersecurity and data privacy. It just has to

355
00:13:21,915 --> 00:13:25,090
be, right. It's we've got to protect our

356
00:13:25,090 --> 00:13:27,509
sensitive member data. We've got to ensure regulatory

357
00:13:27,570 --> 00:13:28,070
compliance.

358
00:13:29,170 --> 00:13:31,090
It's a top priority for all of us.

359
00:13:31,090 --> 00:13:33,810
And there's a lot of sensitivity to it,

360
00:13:33,810 --> 00:13:35,810
not only in the industry, but across the

361
00:13:35,810 --> 00:13:37,430
leadership. And that's been

362
00:13:37,995 --> 00:13:40,235
really positive. I think the one positive maybe

363
00:13:40,235 --> 00:13:41,134
out of it is

364
00:13:41,995 --> 00:13:45,115
everybody's focused on it, everybody recognizes the importance

365
00:13:45,115 --> 00:13:47,595
of it. And I think it just puts

366
00:13:47,595 --> 00:13:49,455
us in a much better place to put

367
00:13:49,850 --> 00:13:52,029
you know, 0 trust security frameworks,

368
00:13:52,889 --> 00:13:55,629
encryption safeguards across all platforms.

369
00:13:56,730 --> 00:13:57,389
I think,

370
00:13:57,769 --> 00:13:59,450
you know, I talked a bit about AI

371
00:13:59,450 --> 00:14:00,190
and data.

372
00:14:01,290 --> 00:14:01,361
And this particular industry is so rich in

373
00:14:01,361 --> 00:14:01,950
information, right? And

374
00:14:02,855 --> 00:14:03,355
different

375
00:14:04,215 --> 00:14:04,715
organizations,

376
00:14:05,894 --> 00:14:06,295
providers, payers, and the platforms, I think can

377
00:14:06,295 --> 00:14:06,795
really

378
00:14:18,250 --> 00:14:20,329
differentiate and create a level of growth and

379
00:14:20,329 --> 00:14:21,389
value for organizations.

380
00:14:22,089 --> 00:14:24,350
And we've talked about the other pieces, right,

381
00:14:24,649 --> 00:14:27,690
member experience with technology, cloud computing platforms that

382
00:14:27,690 --> 00:14:29,309
allow us to move some things forward.

383
00:14:30,009 --> 00:14:30,509
We

384
00:14:30,954 --> 00:14:33,615
those things are just not buzzwords, they're reality.

385
00:14:34,714 --> 00:14:36,394
We've been able to see that. I've seen

386
00:14:36,394 --> 00:14:39,034
this in many organizations as well as ours

387
00:14:39,034 --> 00:14:39,534
today.

388
00:14:40,315 --> 00:14:42,254
We're able to move things much quicker

389
00:14:43,210 --> 00:14:45,549
and deliver solutions much more effectively

390
00:14:46,809 --> 00:14:48,509
and reduce the cycle times

391
00:14:48,970 --> 00:14:51,289
associated with some of these platforms and the

392
00:14:51,289 --> 00:14:53,450
experiences and the learnings that have been had

393
00:14:53,450 --> 00:14:55,230
over the course of time.

394
00:14:55,690 --> 00:14:57,345
And so we've been able to do a

395
00:14:57,345 --> 00:14:59,365
lot, I think, in a short window for

396
00:14:59,665 --> 00:15:02,404
a small organization taking advantage of these,

397
00:15:02,865 --> 00:15:05,285
you know, oftentimes off the shelf capabilities.

398
00:15:06,144 --> 00:15:07,825
And then I would say maybe some of

399
00:15:07,825 --> 00:15:09,184
the other things that are out there maybe

400
00:15:09,184 --> 00:15:10,085
further out,

401
00:15:10,610 --> 00:15:12,070
Laura, are things like,

402
00:15:13,009 --> 00:15:15,090
I've I've been in technology for decades, so

403
00:15:15,090 --> 00:15:16,610
I'm always a big fan of what you

404
00:15:16,610 --> 00:15:17,350
can do.

405
00:15:18,290 --> 00:15:21,009
But, you know, blockchain, again, because it enhances

406
00:15:21,009 --> 00:15:21,509
security.

407
00:15:21,970 --> 00:15:22,790
There's transparency.

408
00:15:23,250 --> 00:15:24,080
There's an efficiency of transactions. And so, you

409
00:15:24,080 --> 00:15:24,379
know, I'm hoping that, as we look a

410
00:15:24,379 --> 00:15:24,705
little

411
00:15:25,904 --> 00:15:28,625
I'm hoping that, as we look a little

412
00:15:28,625 --> 00:15:31,184
further out, those are sort of the technologies

413
00:15:31,184 --> 00:15:33,205
that we can begin to take advantage of.

414
00:15:33,345 --> 00:15:35,904
And then the other piece that's out there

415
00:15:35,904 --> 00:15:38,705
is there's been a pretty significant pivot over

416
00:15:38,705 --> 00:15:40,720
the course of time here where a lot

417
00:15:40,720 --> 00:15:41,299
of organizations,

418
00:15:42,320 --> 00:15:44,100
especially tech companies, startups,

419
00:15:44,639 --> 00:15:45,539
and in the Massachusetts

420
00:15:45,919 --> 00:15:47,840
region, right, we just got so many of

421
00:15:47,840 --> 00:15:50,500
those because it's a pretty tech rich area.

422
00:15:51,039 --> 00:15:53,360
There's a lot of collaborations, not only across

423
00:15:53,360 --> 00:15:55,220
peers, but with some of these, organizations

424
00:15:55,679 --> 00:15:56,144
and

425
00:16:01,825 --> 00:16:03,045
solutions that address

426
00:16:03,585 --> 00:16:06,884
health coaching and chronic disease management. So

427
00:16:07,425 --> 00:16:09,684
a pretty long winded answer to

428
00:16:10,065 --> 00:16:10,804
sort of

429
00:16:12,679 --> 00:16:14,839
the opportunities for for growth because I think

430
00:16:14,839 --> 00:16:16,279
there's quite a few of them in this

431
00:16:16,279 --> 00:16:17,259
particular space.

432
00:16:18,360 --> 00:16:20,679
Well, that's exciting to hear. And, certainly, you

433
00:16:20,679 --> 00:16:21,179
know,

434
00:16:21,559 --> 00:16:23,399
having that ability as we've talked a little

435
00:16:23,399 --> 00:16:24,059
bit about,

436
00:16:24,674 --> 00:16:27,575
just the automation, the technology, the artificial intelligence,

437
00:16:27,634 --> 00:16:30,355
then blockchain too, making come back into the

438
00:16:30,355 --> 00:16:32,995
conversation in health care in a meaningful way,

439
00:16:33,394 --> 00:16:35,735
is just fascinating. And I I can imagine

440
00:16:36,115 --> 00:16:38,514
from your perspective looking on the technology side

441
00:16:38,514 --> 00:16:40,730
and seeing all the challenges that we've talked

442
00:16:40,730 --> 00:16:42,429
about in in ways that,

443
00:16:42,809 --> 00:16:45,549
the technology can streamline that is really helpful.

444
00:16:46,250 --> 00:16:47,769
But on the flip side, I I know

445
00:16:47,769 --> 00:16:50,169
just thinking about the economics of health care

446
00:16:50,169 --> 00:16:52,555
today, every dollar is precious. So, you know,

447
00:16:52,555 --> 00:16:55,435
when you're looking at these growth opportunities and

448
00:16:55,435 --> 00:16:56,654
technology and consuming,

449
00:16:58,075 --> 00:16:58,575
optimize,

450
00:16:58,955 --> 00:17:01,675
from the capabilities that you have, what is

451
00:17:01,675 --> 00:17:03,835
one risk or investment that's still worth making

452
00:17:03,835 --> 00:17:05,195
this year even if you even have a

453
00:17:05,195 --> 00:17:05,934
tight budget?

454
00:17:07,269 --> 00:17:09,910
In in my opinion, I think it's really

455
00:17:09,910 --> 00:17:10,410
the,

456
00:17:11,430 --> 00:17:15,190
risky but rewarding investment of continuing to expand

457
00:17:15,190 --> 00:17:17,369
into value based care. Right?

458
00:17:17,910 --> 00:17:20,549
It's just it's a high stakes investment, right,

459
00:17:20,549 --> 00:17:23,085
for for for payers as you begin to

460
00:17:23,085 --> 00:17:25,025
dive deeper into

461
00:17:25,404 --> 00:17:27,025
VBC models, right,

462
00:17:27,565 --> 00:17:30,144
because it's complex and it's a risky endeavor,

463
00:17:30,204 --> 00:17:32,304
but the potential awards I think are substantial,

464
00:17:33,244 --> 00:17:33,744
right.

465
00:17:34,605 --> 00:17:36,625
The opportunity to improve

466
00:17:37,325 --> 00:17:38,464
top health outcomes,

467
00:17:39,750 --> 00:17:43,109
taking on more risk, greater incentive, the opportunity

468
00:17:43,109 --> 00:17:46,250
to focus on preventative care, chronic disease management,

469
00:17:46,710 --> 00:17:50,009
the integration of Cures and its corresponding solutions,

470
00:17:51,525 --> 00:17:52,265
the stronger

471
00:17:52,884 --> 00:17:53,384
provider

472
00:17:53,765 --> 00:17:55,924
partnerships that can lead to better care and

473
00:17:55,924 --> 00:17:57,465
delivery and overall,

474
00:17:57,924 --> 00:18:01,125
hopefully, reduced cost. Right? And we've talked about

475
00:18:01,125 --> 00:18:03,799
this, right, that the relevant communication

476
00:18:04,099 --> 00:18:04,599
services

477
00:18:06,819 --> 00:18:09,139
and anticipating member needs. So sort of that

478
00:18:09,139 --> 00:18:11,240
personalized member experience, right?

479
00:18:11,700 --> 00:18:13,079
That I think is important.

480
00:18:13,700 --> 00:18:14,440
And I

481
00:18:15,059 --> 00:18:17,720
believe that we've made so many strides forward

482
00:18:19,894 --> 00:18:20,954
in data analytics,

483
00:18:21,575 --> 00:18:24,535
right, that give us the opportunity to begin

484
00:18:24,535 --> 00:18:27,755
to, especially with the interoperability and exchange of

485
00:18:28,134 --> 00:18:29,835
some very important information,

486
00:18:30,809 --> 00:18:33,130
the opportunity to do the analytics around it

487
00:18:33,130 --> 00:18:34,990
and really begin to be better prepared

488
00:18:36,649 --> 00:18:38,990
and understand the risk and understand the complexity

489
00:18:39,529 --> 00:18:42,730
and respond appropriately and take actions. And a

490
00:18:42,730 --> 00:18:43,789
lot of that takes

491
00:18:44,125 --> 00:18:46,704
a level of trust that's developed,

492
00:18:47,644 --> 00:18:48,704
across organizations,

493
00:18:49,884 --> 00:18:51,265
to be able to do that effectively.

494
00:18:52,284 --> 00:18:54,765
And so the tools and the information and

495
00:18:54,765 --> 00:18:56,910
the insights that are coming out, if you

496
00:18:56,910 --> 00:18:59,230
can begin to build that trust relationship and

497
00:18:59,230 --> 00:19:00,850
leverage those tools, I think

498
00:19:01,390 --> 00:19:03,090
it is the one investment that,

499
00:19:04,430 --> 00:19:05,890
feels, I think, benefits.

500
00:19:06,190 --> 00:19:06,690
And,

501
00:19:07,470 --> 00:19:09,789
honestly, at the bottom line, right, improves the

502
00:19:09,789 --> 00:19:11,890
patient's health and outcomes and and

503
00:19:12,565 --> 00:19:14,965
a significant impact to quality. So I think

504
00:19:14,965 --> 00:19:17,384
it's the one area that so many technologies,

505
00:19:17,845 --> 00:19:18,744
we talked about

506
00:19:19,205 --> 00:19:20,105
digital transformation

507
00:19:20,805 --> 00:19:23,765
and AI and data and interoperability, but they

508
00:19:23,765 --> 00:19:24,904
sort of all converge

509
00:19:25,205 --> 00:19:26,184
to be able to

510
00:19:26,724 --> 00:19:28,105
make this kind of an impact.

511
00:19:28,859 --> 00:19:31,019
So, I I think it's the the one

512
00:19:31,019 --> 00:19:33,440
space that's worth the worth investment

513
00:19:34,619 --> 00:19:35,759
for for organizations.

514
00:19:37,579 --> 00:19:39,019
That makes a lot of sense. And, you

515
00:19:39,019 --> 00:19:41,279
know, it's just fascinating to see how,

516
00:19:41,819 --> 00:19:43,684
the value based care,

517
00:19:44,125 --> 00:19:46,684
has evolved, especially in the last 5 to

518
00:19:46,684 --> 00:19:48,204
6 years or so. I know in the

519
00:19:48,204 --> 00:19:50,384
past, there's been energy around it and then,

520
00:19:50,525 --> 00:19:51,184
you know,

521
00:19:51,805 --> 00:19:54,444
not as much movement, and actually implementing it

522
00:19:54,444 --> 00:19:57,105
on the provider side for many organizations than,

523
00:19:57,325 --> 00:19:59,759
you know, still having to be in the

524
00:19:59,759 --> 00:20:01,919
fee for service world to some degree and

525
00:20:01,919 --> 00:20:02,579
not moving

526
00:20:02,960 --> 00:20:05,519
as quickly as they probably could into value

527
00:20:05,519 --> 00:20:07,039
based care. And so, you know, when you

528
00:20:07,039 --> 00:20:07,779
look at,

529
00:20:08,399 --> 00:20:10,960
what's happening today, is there anything that, you

530
00:20:10,960 --> 00:20:13,200
know, you're doing differently or that you're seeing

531
00:20:13,200 --> 00:20:13,664
a different,

532
00:20:14,625 --> 00:20:15,285
type of,

533
00:20:15,825 --> 00:20:18,305
approach to, I guess, in order to really

534
00:20:18,305 --> 00:20:20,404
make sure that, you know, these types of

535
00:20:20,625 --> 00:20:23,825
investments and, the move towards value based care

536
00:20:23,825 --> 00:20:26,160
in more risk based models is something that,

537
00:20:26,320 --> 00:20:28,340
you know, is gonna stick and be meaningful

538
00:20:28,400 --> 00:20:30,259
for organizations in years to come.

539
00:20:31,119 --> 00:20:32,960
Yeah. I mean, I think it's the,

540
00:20:33,519 --> 00:20:35,519
it's the advantages that some of the technologies

541
00:20:35,519 --> 00:20:36,720
and some of the data and some of

542
00:20:36,720 --> 00:20:37,299
the insights,

543
00:20:38,000 --> 00:20:38,740
are are bringing,

544
00:20:39,785 --> 00:20:41,544
And and some of the AI components as

545
00:20:41,544 --> 00:20:44,025
well. Right? I mean, we all behave differently.

546
00:20:44,025 --> 00:20:47,224
We all respond differently. And and the the

547
00:20:47,224 --> 00:20:50,585
the patient engagement and and their active engagement

548
00:20:50,585 --> 00:20:52,285
in the process is so critical.

549
00:20:52,744 --> 00:20:54,444
And so I think that's sort of

550
00:20:55,259 --> 00:20:56,400
the the pivot. Right?

551
00:20:56,940 --> 00:20:59,259
The the opportunity to to gain more insight,

552
00:20:59,259 --> 00:21:00,859
to be able to to to set the

553
00:21:00,859 --> 00:21:02,619
right incentives, right, to be able to make

554
00:21:02,619 --> 00:21:03,519
the right connections.

555
00:21:04,220 --> 00:21:05,900
And then I I think the other element,

556
00:21:05,900 --> 00:21:07,340
and I mentioned this a bit about,

557
00:21:07,660 --> 00:21:10,785
the data outside of it. Right? We're also

558
00:21:10,924 --> 00:21:12,224
so focused on

559
00:21:12,845 --> 00:21:16,285
integrating information and, oftentimes, clinical information. But in

560
00:21:16,285 --> 00:21:17,265
addition to that,

561
00:21:17,644 --> 00:21:19,664
there's been quite a bit of focus on

562
00:21:19,724 --> 00:21:23,549
social determinants of health, right, and addressing social

563
00:21:23,549 --> 00:21:24,049
needs,

564
00:21:24,750 --> 00:21:26,829
the things you would expect, housing, food and

565
00:21:26,829 --> 00:21:28,049
security, transportation,

566
00:21:29,390 --> 00:21:31,890
but also, you know, collaboration with

567
00:21:32,269 --> 00:21:33,970
local organizations and

568
00:21:34,444 --> 00:21:37,724
and, trying to track the effectiveness of some

569
00:21:37,724 --> 00:21:39,744
of these initiatives that sort

570
00:21:40,204 --> 00:21:40,785
of adds

571
00:21:41,484 --> 00:21:43,265
to, I think, the overall success,

572
00:21:43,644 --> 00:21:45,345
that you can create in this space.

573
00:21:45,644 --> 00:21:47,164
But a lot of it is just evolving

574
00:21:47,164 --> 00:21:48,845
to a place that's much better. And I

575
00:21:48,845 --> 00:21:50,009
actually think there's

576
00:21:50,809 --> 00:21:51,210
a space

577
00:21:52,170 --> 00:21:54,130
having spent some time in the provider world,

578
00:21:54,130 --> 00:21:54,570
there's,

579
00:21:55,289 --> 00:21:58,509
and so there's this Utopian precision medicine opportunity.

580
00:21:59,049 --> 00:22:00,349
But I think there's also

581
00:22:01,289 --> 00:22:03,309
an opportunity on the payer side

582
00:22:03,849 --> 00:22:04,750
to get to

583
00:22:05,965 --> 00:22:08,384
a much more view of

584
00:22:09,005 --> 00:22:11,105
a position plan almost, right?

585
00:22:11,725 --> 00:22:12,705
And one that

586
00:22:13,164 --> 00:22:13,664
fits

587
00:22:14,285 --> 00:22:16,545
the individual that fits the need.

588
00:22:16,845 --> 00:22:17,825
And so I think

589
00:22:18,569 --> 00:22:19,470
there's an opportunity

590
00:22:20,329 --> 00:22:22,190
as a in the marketplace, right,

591
00:22:22,649 --> 00:22:24,009
that begin to think about how do we

592
00:22:24,009 --> 00:22:26,429
do that and what does that take

593
00:22:26,889 --> 00:22:28,269
us in the long term.

594
00:22:29,130 --> 00:22:31,015
That makes a lot of sense. And I

595
00:22:31,015 --> 00:22:34,394
I feel like, as you mentioned, just the

596
00:22:34,855 --> 00:22:38,615
type of, technology and insights and ability to

597
00:22:38,615 --> 00:22:41,674
really make strong decisions based on that information

598
00:22:41,734 --> 00:22:42,394
and data,

599
00:22:43,494 --> 00:22:45,920
it does make a difference. Now, Casey, before

600
00:22:45,920 --> 00:22:47,220
I wrap up here, I'm wondering,

601
00:22:47,839 --> 00:22:49,599
what are some of the opportunities you're most

602
00:22:49,599 --> 00:22:51,359
excited about for the future? How are you

603
00:22:51,359 --> 00:22:52,579
looking at growth and,

604
00:22:52,880 --> 00:22:55,119
really, moving forward over the next couple of

605
00:22:55,119 --> 00:22:55,619
years?

606
00:22:56,720 --> 00:22:57,779
You know, for us,

607
00:22:58,865 --> 00:23:01,045
it's really the the digital transformation

608
00:23:01,424 --> 00:23:04,785
opportunity. Right? It's understanding how we can begin

609
00:23:04,785 --> 00:23:06,085
to take advantage of,

610
00:23:06,705 --> 00:23:08,404
I'll just say, AI.

611
00:23:09,025 --> 00:23:10,465
And a lot of this is gonna be

612
00:23:10,465 --> 00:23:11,285
a bit of,

613
00:23:12,059 --> 00:23:14,860
I don't know, maybe trial and and and

614
00:23:14,860 --> 00:23:15,759
testing and,

615
00:23:16,539 --> 00:23:18,539
figuring out where it makes the most sense

616
00:23:18,539 --> 00:23:20,140
and what we can begin to do with

617
00:23:20,140 --> 00:23:20,640
it.

618
00:23:21,580 --> 00:23:22,720
But I would say,

619
00:23:23,580 --> 00:23:25,019
when you take a look at it, there's

620
00:23:25,019 --> 00:23:25,840
there's opportunities

621
00:23:26,220 --> 00:23:26,720
across

622
00:23:27,955 --> 00:23:28,775
care management,

623
00:23:29,475 --> 00:23:30,134
care coordination,

624
00:23:30,755 --> 00:23:31,815
improving our,

625
00:23:33,394 --> 00:23:36,215
I'll call it, our overall medical cost. There's

626
00:23:36,515 --> 00:23:37,015
opportunities

627
00:23:37,955 --> 00:23:39,575
in reducing some of the administrative,

628
00:23:40,914 --> 00:23:43,095
and friction that's associated with

629
00:23:43,940 --> 00:23:46,440
some of the existing processes that are oftentimes

630
00:23:46,579 --> 00:23:47,559
very manual

631
00:23:48,420 --> 00:23:50,819
and paper based to some degree and maybe

632
00:23:50,819 --> 00:23:51,880
not paper, but

633
00:23:52,819 --> 00:23:54,759
faxes that are still used in the industry,

634
00:23:54,819 --> 00:23:55,319
etcetera.

635
00:23:56,339 --> 00:23:58,599
And then I mentioned a bit about tailored

636
00:23:59,234 --> 00:24:02,355
or maybe more precision plans, right? But I

637
00:24:02,355 --> 00:24:02,855
think

638
00:24:03,474 --> 00:24:05,494
in optimizing how you

639
00:24:06,194 --> 00:24:08,434
create you know your member and you know

640
00:24:08,434 --> 00:24:10,454
the communities and you know the market.

641
00:24:11,234 --> 00:24:12,615
How do you begin to

642
00:24:13,990 --> 00:24:16,589
improve and bring that information together and deliver

643
00:24:16,589 --> 00:24:17,450
a much more

644
00:24:18,230 --> 00:24:20,490
insightful set of products and plans

645
00:24:21,269 --> 00:24:23,049
and do the right outreach

646
00:24:24,230 --> 00:24:26,569
with the right connection and digital experience

647
00:24:27,349 --> 00:24:28,009
to maintain

648
00:24:28,710 --> 00:24:30,832
the number retention and and to build on

649
00:24:30,832 --> 00:24:31,704
that relationship and to really create a trusting

650
00:24:31,704 --> 00:24:33,224
relationship. Because I think in this particular space,

651
00:24:33,224 --> 00:24:33,724
there's,

652
00:24:34,025 --> 00:24:37,065
so much that so much good that that

653
00:24:37,065 --> 00:24:39,224
is being done and that can continue to

654
00:24:39,224 --> 00:24:40,045
be done.

655
00:24:44,079 --> 00:24:46,259
And being able to highlight that

656
00:24:46,720 --> 00:24:49,119
and to share that and to build that

657
00:24:49,119 --> 00:24:50,179
relationship versus

658
00:24:50,720 --> 00:24:51,460
a transactional

659
00:24:51,759 --> 00:24:52,740
relationship, right?

660
00:24:53,359 --> 00:24:54,880
I get an EOB or I get a

661
00:24:54,880 --> 00:24:56,295
bill from a provider and

662
00:24:57,255 --> 00:24:58,934
how do you take it forward, right? How

663
00:24:58,934 --> 00:25:01,335
do you begin to look at what detail

664
00:25:01,335 --> 00:25:04,055
is done in terms of understanding where you

665
00:25:04,055 --> 00:25:05,975
left off and what you might be looking

666
00:25:05,975 --> 00:25:06,795
for next?

667
00:25:07,335 --> 00:25:08,075
And so

668
00:25:08,880 --> 00:25:11,279
I think those are just areas for growth

669
00:25:11,279 --> 00:25:12,740
as we go forward.

670
00:25:13,119 --> 00:25:15,680
And I'm pretty excited about the opportunity to

671
00:25:15,680 --> 00:25:18,400
bring these things and these technologies together and

672
00:25:18,400 --> 00:25:19,539
see how we can impact

673
00:25:20,160 --> 00:25:22,325
them in a positive way, our member base

674
00:25:22,325 --> 00:25:24,164
and and the quality of the quality of

675
00:25:24,164 --> 00:25:26,505
health and and the outcomes associated with it.

676
00:25:27,605 --> 00:25:29,285
That's amazing to hear it. Casey, thank you

677
00:25:29,285 --> 00:25:30,805
so much for joining us on the podcast

678
00:25:30,805 --> 00:25:32,164
today. This has been such a fun and

679
00:25:32,164 --> 00:25:34,404
informative conversation, and I look forward to connecting

680
00:25:34,404 --> 00:25:35,464
with you again soon.

681
00:25:36,220 --> 00:25:37,980
Laura, it's been it's really been a pleasure.

682
00:25:38,220 --> 00:25:40,000
I always love talking about this.

683
00:25:40,940 --> 00:25:42,860
It's it's been a space that I've been

684
00:25:42,860 --> 00:25:44,000
focused on for

685
00:25:44,539 --> 00:25:46,240
way longer than I wanna admit.

686
00:25:47,500 --> 00:25:49,980
And, it's just such a space that, you

687
00:25:49,980 --> 00:25:51,200
know, all of us experience

688
00:25:53,025 --> 00:25:54,005
and need, right,

689
00:25:54,704 --> 00:25:56,625
at different levels at different points in our

690
00:25:56,625 --> 00:25:57,184
life. But,

691
00:25:57,984 --> 00:25:59,424
it's so important. And,

692
00:26:00,224 --> 00:26:01,505
I'm looking forward to seeing what we're going

693
00:26:01,505 --> 00:26:02,625
to be able to do in the future

694
00:26:02,625 --> 00:26:04,865
and really appreciate the opportunity to come on

695
00:26:04,865 --> 00:26:05,845
here today and

696
00:26:06,527 --> 00:26:08,467
share a little bit of my thoughts with

697
00:26:08,527 --> 00:26:09,586
you in the audience.