1 00:00:00,480 --> 00:00:02,639 This is Laura Dierda with the Becker's Healthcare 2 00:00:02,639 --> 00:00:04,799 podcast. I'm thrilled today to be joined by 3 00:00:04,799 --> 00:00:07,519 Greg Poulson, senior vice president and chief policy 4 00:00:07,519 --> 00:00:09,599 officer at Intermountain Health. Greg, it's a pleasure 5 00:00:09,599 --> 00:00:11,059 to have you on the podcast today. 6 00:00:11,359 --> 00:00:12,740 Great to be with you, Laura. 7 00:00:13,394 --> 00:00:15,234 Now I'm really looking forward to our conversation 8 00:00:15,234 --> 00:00:16,754 because I know Intermountain is one of the 9 00:00:16,754 --> 00:00:19,554 most innovative health systems out there and truly 10 00:00:19,554 --> 00:00:21,314 is on the forefront of a lot happening 11 00:00:21,314 --> 00:00:23,954 not only in technology and innovation, but also 12 00:00:23,954 --> 00:00:25,634 in how you're growing your system and thinking 13 00:00:25,634 --> 00:00:27,179 about health care as a whole. 14 00:00:27,579 --> 00:00:29,420 So, you know, I'm excited to learn more. 15 00:00:29,420 --> 00:00:31,500 But before we dive in, I'm wondering, could 16 00:00:31,500 --> 00:00:33,359 you tell us a little bit about Intermountain 17 00:00:33,500 --> 00:00:34,939 as it is today and what makes it 18 00:00:34,939 --> 00:00:35,439 unique? 19 00:00:37,020 --> 00:00:37,520 Sure. 20 00:00:38,619 --> 00:00:40,539 I'm not sure we're really unique, but I 21 00:00:40,539 --> 00:00:42,399 think we may be a little bit unusual 22 00:00:42,675 --> 00:00:45,234 in the sense that, although we're a a 23 00:00:45,234 --> 00:00:49,975 relatively large hospital organization with 33 hospitals across 24 00:00:50,274 --> 00:00:51,715 five states, I think, and, 25 00:00:52,515 --> 00:00:55,495 and a large number of of physician practices 26 00:00:55,715 --> 00:00:57,414 that participate with us 27 00:00:57,750 --> 00:00:59,049 and a broad 28 00:00:59,509 --> 00:01:02,009 array of ancillary services. 29 00:01:02,629 --> 00:01:04,170 We've been in the 30 00:01:04,469 --> 00:01:07,349 health insurance business now for about forty years, 31 00:01:07,349 --> 00:01:09,290 and we're the the the largest, 32 00:01:09,829 --> 00:01:10,890 insurer in 33 00:01:11,349 --> 00:01:11,849 our 34 00:01:12,224 --> 00:01:13,444 primary communities. 35 00:01:14,545 --> 00:01:17,665 And that, makes us think about the world 36 00:01:17,665 --> 00:01:20,965 somewhat differently and has given us some focus 37 00:01:21,025 --> 00:01:21,525 around, 38 00:01:22,305 --> 00:01:25,265 when we talk about, providing value, it gives 39 00:01:25,265 --> 00:01:26,165 us some additional, 40 00:01:26,704 --> 00:01:29,659 both some additional thoughts, but also some additional 41 00:01:29,719 --> 00:01:30,219 tools 42 00:01:30,680 --> 00:01:33,819 that, that that have given us, I think, 43 00:01:34,040 --> 00:01:36,200 a different kind of focus that maybe some 44 00:01:36,200 --> 00:01:36,859 would have. 45 00:01:38,200 --> 00:01:40,200 Absolutely. And I think that's just such a 46 00:01:40,200 --> 00:01:41,500 really great point because 47 00:01:41,844 --> 00:01:44,965 having that ability to understand the provider side 48 00:01:44,965 --> 00:01:47,045 as well as the health plan side, 49 00:01:47,685 --> 00:01:49,765 puts you in a a spot where you 50 00:01:49,765 --> 00:01:50,644 can make, 51 00:01:51,045 --> 00:01:53,604 progress towards what I know we've been talking 52 00:01:53,604 --> 00:01:55,364 about for years and years now. We need 53 00:01:55,364 --> 00:01:56,969 to think about value, think about, 54 00:01:57,450 --> 00:01:58,590 caring for populations, 55 00:01:59,049 --> 00:02:00,030 and really truly 56 00:02:00,329 --> 00:02:03,130 figuring out how to find that happy medium 57 00:02:03,130 --> 00:02:04,590 where everybody is, 58 00:02:05,209 --> 00:02:06,569 able to work up to the best of 59 00:02:06,569 --> 00:02:08,110 their abilities, it seems like. 60 00:02:08,409 --> 00:02:10,889 I think that's right. And, at least from 61 00:02:10,889 --> 00:02:12,525 my perspective, one of the 62 00:02:13,004 --> 00:02:14,064 really lovely, 63 00:02:14,685 --> 00:02:16,924 components of that is that for for so 64 00:02:16,924 --> 00:02:18,064 many of our friends, 65 00:02:18,924 --> 00:02:19,905 the relationship 66 00:02:20,364 --> 00:02:22,444 between the payer and the provider is one 67 00:02:22,444 --> 00:02:25,025 of of tension as opposed to one of 68 00:02:25,245 --> 00:02:25,745 coordination 69 00:02:26,044 --> 00:02:28,144 and focused cooperation. And 70 00:02:28,659 --> 00:02:30,840 I think we find that there are tremendous, 71 00:02:32,020 --> 00:02:33,159 innovative opportunities, 72 00:02:34,020 --> 00:02:36,659 when the two sides are able to bring 73 00:02:36,659 --> 00:02:38,520 their collective strength together 74 00:02:38,979 --> 00:02:41,655 and be able to, take a a focused 75 00:02:41,895 --> 00:02:44,694 approach on helping people live the healthiest lives 76 00:02:44,694 --> 00:02:46,935 possible, which is both our our mission and 77 00:02:46,935 --> 00:02:47,675 our tagline. 78 00:02:49,495 --> 00:02:51,574 Absolutely. Oh, you know, and what a great 79 00:02:51,574 --> 00:02:53,974 segue into, you know, thinking about from the 80 00:02:53,974 --> 00:02:56,769 strategy down to, you know, the the 81 00:02:57,069 --> 00:02:59,629 execution level. What is the accomplishment that you're 82 00:02:59,629 --> 00:03:01,069 most proud of from the last year or 83 00:03:01,069 --> 00:03:01,569 so? 84 00:03:02,669 --> 00:03:05,150 Well, you know, we've, we've we've not done 85 00:03:05,150 --> 00:03:08,289 anything that's a radical departure from our history 86 00:03:08,509 --> 00:03:09,810 in in the last year. 87 00:03:10,305 --> 00:03:12,645 We continue to focus on proactive 88 00:03:12,944 --> 00:03:15,185 care, which is the the term that we 89 00:03:15,185 --> 00:03:17,504 use for sort of value based care. But 90 00:03:17,504 --> 00:03:20,145 but value based care has morphed in, so 91 00:03:20,145 --> 00:03:22,224 many different ways in terms of what what 92 00:03:22,224 --> 00:03:23,985 people mean when they say it and when 93 00:03:23,985 --> 00:03:24,885 they hear it. 94 00:03:25,189 --> 00:03:27,750 And so we wanted to, to to have 95 00:03:27,750 --> 00:03:28,650 a term that 96 00:03:29,270 --> 00:03:30,009 we could, 97 00:03:30,949 --> 00:03:33,669 understand at least within our own internal discussions. 98 00:03:33,669 --> 00:03:34,409 And so, 99 00:03:34,870 --> 00:03:37,689 we've we've used the phrase proactive care, 100 00:03:37,990 --> 00:03:39,050 as as a 101 00:03:39,784 --> 00:03:42,025 definition of what it is that we really 102 00:03:42,025 --> 00:03:44,425 want to, want to do, which is to 103 00:03:44,425 --> 00:03:45,965 help people proactively, 104 00:03:47,305 --> 00:03:49,144 to be as healthy as they can and 105 00:03:49,144 --> 00:03:51,384 avoid the need for some of the very 106 00:03:51,384 --> 00:03:52,764 expensive and unpleasant, 107 00:03:53,784 --> 00:03:57,319 health care experiences that, that otherwise would would 108 00:03:57,319 --> 00:03:58,539 be coming their way. 109 00:03:59,960 --> 00:04:00,620 I guess, 110 00:04:01,080 --> 00:04:03,159 what the the other thing that I would 111 00:04:03,319 --> 00:04:05,080 well, let let me stay with that for 112 00:04:05,080 --> 00:04:06,599 just a second and say that, you know, 113 00:04:06,599 --> 00:04:08,919 that that happens not only when we have 114 00:04:08,919 --> 00:04:11,935 people who are within our own insurance world, 115 00:04:11,935 --> 00:04:14,835 but it also happens with, other Medicare patients, 116 00:04:14,895 --> 00:04:17,235 other commercial patients that come to us. 117 00:04:17,694 --> 00:04:19,795 And it helps us, I think, to, 118 00:04:21,055 --> 00:04:21,955 have a more 119 00:04:22,910 --> 00:04:25,230 holistic view of what we might be able 120 00:04:25,230 --> 00:04:27,069 to do that would be effective in their 121 00:04:27,069 --> 00:04:29,250 lives and and help them to move forward. 122 00:04:29,949 --> 00:04:31,169 So that's sort of, 123 00:04:31,629 --> 00:04:34,189 you know, a continuation of what, what we've 124 00:04:34,189 --> 00:04:36,350 been doing. Something that we've been trying to 125 00:04:36,350 --> 00:04:38,665 do in the last year with, with with 126 00:04:38,665 --> 00:04:39,564 some good results 127 00:04:40,105 --> 00:04:40,925 is simplify, 128 00:04:41,865 --> 00:04:43,725 the the whole health care process, 129 00:04:44,504 --> 00:04:47,384 both for our, our members and patients, but 130 00:04:47,384 --> 00:04:48,444 also for our caregivers. 131 00:04:49,225 --> 00:04:51,485 And we see enormous complexity 132 00:05:01,220 --> 00:05:04,360 serious approach. Our our CEO, Rob Allen, 133 00:05:04,819 --> 00:05:05,175 has 134 00:05:05,654 --> 00:05:08,394 decided that, the the one of the legacies 135 00:05:08,534 --> 00:05:10,454 he'd like to leave behind is a is 136 00:05:10,454 --> 00:05:11,675 a simpler organization, 137 00:05:12,055 --> 00:05:14,394 easier to navigate, easier to understand, 138 00:05:15,014 --> 00:05:17,334 easier to participate in. And so those are 139 00:05:17,334 --> 00:05:19,834 our two big foe OSI this last year. 140 00:05:21,990 --> 00:05:24,069 That's helpful to know and understand. I I 141 00:05:24,069 --> 00:05:26,949 know no easy task really to, make the 142 00:05:26,949 --> 00:05:30,149 complexity of health care simpler in bringing you 143 00:05:30,149 --> 00:05:32,970 into a space where, you know, you're really 144 00:05:33,189 --> 00:05:36,044 able to care for patients and and make 145 00:05:36,044 --> 00:05:37,504 the experience better for them. 146 00:05:38,444 --> 00:05:40,724 From looking ahead, where do you see some 147 00:05:40,724 --> 00:05:42,444 of the big growth opportunities in the next 148 00:05:42,444 --> 00:05:43,584 twelve months or so? 149 00:05:44,125 --> 00:05:46,044 Oh, you've you've kind of hit a hot 150 00:05:46,044 --> 00:05:47,745 button for for me at least. 151 00:05:49,319 --> 00:05:51,560 And and and let me just head down 152 00:05:51,560 --> 00:05:53,959 this path, and and I I hope that, 153 00:05:54,120 --> 00:05:56,360 that I there won't be too controversial here, 154 00:05:56,360 --> 00:05:58,519 but I think that it's really important to 155 00:05:58,519 --> 00:06:00,839 note that growth should never both be a 156 00:06:00,839 --> 00:06:03,444 primary goal or strategy in at least my 157 00:06:03,444 --> 00:06:06,025 perspective, and I think our organizational perspective. 158 00:06:07,045 --> 00:06:10,165 Goals and strategies should be built around value 159 00:06:10,165 --> 00:06:11,465 enhancement for stakeholders, 160 00:06:12,245 --> 00:06:13,764 you know, those that we serve and those 161 00:06:13,764 --> 00:06:15,685 that help us to do so, our patients' 162 00:06:15,685 --> 00:06:18,699 members, the community broadly, and the caregivers that, 163 00:06:19,020 --> 00:06:20,240 that we work with. 164 00:06:20,939 --> 00:06:23,339 So I think the statement that if you're 165 00:06:23,339 --> 00:06:25,980 not growing, you're dying is extremely common, but 166 00:06:25,980 --> 00:06:27,680 I think it's extremely wrong. 167 00:06:28,220 --> 00:06:30,555 I think it's caused a remarkable amount of 168 00:06:30,794 --> 00:06:32,875 over the last couple of decades, and the 169 00:06:32,875 --> 00:06:34,875 road to growth for its own sake is 170 00:06:34,875 --> 00:06:37,454 is, as we all know, littered with wreckage. 171 00:06:38,475 --> 00:06:41,274 The wise and virtuous strategies that we should 172 00:06:41,274 --> 00:06:44,414 be building are around value creation for patients, 173 00:06:44,759 --> 00:06:46,060 beneficiaries, and caregivers. 174 00:06:47,079 --> 00:06:49,000 And at least my perspective is that such 175 00:06:49,000 --> 00:06:51,180 strategies may well include growth 176 00:06:51,720 --> 00:06:54,139 either as a component part of the strategy 177 00:06:54,199 --> 00:06:56,860 or as an outcome of the successful implementation 178 00:06:57,159 --> 00:06:58,139 of that strategy. 179 00:06:58,805 --> 00:07:01,384 But to speak of growth as the strategy, 180 00:07:01,524 --> 00:07:03,464 I think, is neither wise nor virtuous. 181 00:07:04,324 --> 00:07:06,024 I do wanna be clear that 182 00:07:06,725 --> 00:07:10,024 growth is very often both necessary and beneficial, 183 00:07:10,324 --> 00:07:12,245 but only as part of the goals and 184 00:07:12,245 --> 00:07:13,944 strategies that create value. 185 00:07:14,699 --> 00:07:17,020 This is why I'm disturbed when growth is 186 00:07:17,020 --> 00:07:19,040 discussed as the goal. 187 00:07:19,420 --> 00:07:22,000 I think that misses the mark both strategically 188 00:07:22,060 --> 00:07:22,879 and consequentially 189 00:07:23,259 --> 00:07:25,199 leading to outcomes that serve 190 00:07:25,660 --> 00:07:28,220 neither the organization or its stakeholders, and I 191 00:07:28,220 --> 00:07:30,139 think we've seen lots of examples of that 192 00:07:30,139 --> 00:07:31,654 over the last decade or so. 193 00:07:32,354 --> 00:07:34,115 Let me give you an example, though, that 194 00:07:34,115 --> 00:07:36,595 I think may may focus it for for 195 00:07:36,595 --> 00:07:38,514 some of us, and at least it focuses 196 00:07:38,514 --> 00:07:39,654 it for us at Intermountain. 197 00:07:40,914 --> 00:07:43,074 I think, some of your listeners may be 198 00:07:43,074 --> 00:07:44,055 aware of Civica, 199 00:07:44,599 --> 00:07:47,479 which is an innovative value adding generic drug 200 00:07:47,479 --> 00:07:47,979 company. 201 00:07:48,360 --> 00:07:49,259 It was created 202 00:07:49,879 --> 00:07:52,599 to provide generic drugs that are overpriced or 203 00:07:52,599 --> 00:07:54,919 in short supply or often both at the 204 00:07:54,919 --> 00:07:55,659 same time. 205 00:07:56,519 --> 00:07:57,259 If Intermountain 206 00:07:57,560 --> 00:08:00,154 had viewed the provision of generic drugs to 207 00:08:00,154 --> 00:08:03,115 the market as a growth opportunity rather than 208 00:08:03,115 --> 00:08:05,615 as a way to increase value for shareholders 209 00:08:05,834 --> 00:08:06,574 and stakeholders, 210 00:08:07,274 --> 00:08:10,074 shareholders meaning broadly the communities and people we 211 00:08:10,074 --> 00:08:10,574 serve, 212 00:08:11,220 --> 00:08:13,620 we would have approached the development in a 213 00:08:13,620 --> 00:08:15,539 much different way and I believe a much 214 00:08:15,539 --> 00:08:18,339 less desirable way, and the overall outcomes would 215 00:08:18,339 --> 00:08:20,979 have been far less. So I think that 216 00:08:20,979 --> 00:08:23,024 that we always need to put, 217 00:08:23,425 --> 00:08:26,384 growth into a perspective of what it's doing 218 00:08:26,384 --> 00:08:27,845 to further our mission, 219 00:08:28,625 --> 00:08:31,824 further our ultimate goals, and further the value 220 00:08:31,824 --> 00:08:34,644 that we provide. Otherwise, we can get distracted 221 00:08:34,865 --> 00:08:35,664 and head off in, 222 00:08:36,464 --> 00:08:39,080 in ways that, are not contributory to to 223 00:08:39,080 --> 00:08:41,799 the overall benefit of the, folks that we 224 00:08:41,799 --> 00:08:43,580 have responsibilities for. 225 00:08:45,480 --> 00:08:47,799 And that's, you know, a really fascinating way 226 00:08:47,799 --> 00:08:50,120 to look at it. And, I appreciate your 227 00:08:50,120 --> 00:08:51,960 thoughts on growth here because, you know, you're 228 00:08:51,960 --> 00:08:54,745 right. Having that ability to focus in on 229 00:08:54,745 --> 00:08:57,465 what's creating value for those stakeholders, especially the 230 00:08:57,465 --> 00:08:59,404 patients, but, you know, really, everybody, 231 00:09:00,185 --> 00:09:02,105 who's involved in the process makes a big 232 00:09:02,105 --> 00:09:04,745 difference. And that example of Civica two is 233 00:09:04,745 --> 00:09:06,809 so prudent right now, especially as, 234 00:09:07,210 --> 00:09:09,769 so many organizations are finding it challenging to, 235 00:09:10,649 --> 00:09:11,309 keep their, 236 00:09:11,769 --> 00:09:14,009 supplies seeing their expenses rise and those kinds 237 00:09:14,009 --> 00:09:15,690 of things. And so, you know, when you 238 00:09:15,690 --> 00:09:17,769 look at it through that lens of value 239 00:09:17,769 --> 00:09:18,269 creation, 240 00:09:18,649 --> 00:09:20,330 and from your role as, 241 00:09:21,095 --> 00:09:22,455 being the chief policy officer. 242 00:09:23,654 --> 00:09:25,495 What does that look like for you? How 243 00:09:25,495 --> 00:09:26,075 do you, 244 00:09:26,535 --> 00:09:27,035 navigate 245 00:09:27,415 --> 00:09:29,254 the the world around you when you're trying 246 00:09:29,254 --> 00:09:32,615 to, primarily stay focused on creating value for 247 00:09:32,615 --> 00:09:33,754 the patients and caregivers, 248 00:09:34,215 --> 00:09:36,154 involved in the health care delivery process? 249 00:09:36,970 --> 00:09:38,730 Well, it's a it's as as you, 250 00:09:39,769 --> 00:09:40,669 certainly imply, 251 00:09:41,049 --> 00:09:44,490 it's enormously challenging to not be distracted by, 252 00:09:44,730 --> 00:09:47,529 by by many of the the factors that 253 00:09:47,529 --> 00:09:48,009 can, 254 00:09:48,649 --> 00:09:51,370 dilute our focus on on value for the 255 00:09:51,370 --> 00:09:52,784 folks that we care for. 256 00:09:53,745 --> 00:09:56,225 The the biggest advantage that that that I 257 00:09:56,225 --> 00:09:58,004 have seen is our board, 258 00:09:58,704 --> 00:09:59,824 and I hope boards, 259 00:10:00,225 --> 00:10:02,485 across the across the country, 260 00:10:03,504 --> 00:10:05,365 who are there to represent, 261 00:10:06,059 --> 00:10:07,420 at least in the case of not for 262 00:10:07,420 --> 00:10:10,700 profit organizations, hopefully, through there to represent the, 263 00:10:10,940 --> 00:10:12,860 the folks that we serve, the patients, the 264 00:10:12,860 --> 00:10:14,000 members, the communities. 265 00:10:14,860 --> 00:10:15,360 And 266 00:10:15,740 --> 00:10:18,879 though the our board has been very effective 267 00:10:19,179 --> 00:10:19,920 at constantly 268 00:10:21,085 --> 00:10:24,705 requiring of us that we report the benefits 269 00:10:24,764 --> 00:10:27,904 that we're achieving with our strategies in terms 270 00:10:28,524 --> 00:10:31,325 of helpfulness to the communities, helpfulness to the, 271 00:10:31,965 --> 00:10:34,605 to the individuals that we care for, and, 272 00:10:34,605 --> 00:10:37,389 hopefully, good stewardship with the resources that have 273 00:10:37,389 --> 00:10:39,090 been entrusted to us. So, 274 00:10:40,750 --> 00:10:43,149 certainly, our board is is very, very helpful, 275 00:10:43,149 --> 00:10:46,370 and and that trickles into our daily reports 276 00:10:46,590 --> 00:10:48,670 that that that come up when we're looking 277 00:10:48,670 --> 00:10:50,955 at what are we providing to the to 278 00:10:50,955 --> 00:10:52,955 the folks that we're caring for. Are we 279 00:10:52,955 --> 00:10:55,274 being as as cost effective as we can 280 00:10:55,274 --> 00:10:57,915 be? Are we being value effective in in 281 00:10:57,915 --> 00:11:00,575 helping people to avoid the need for, 282 00:11:01,754 --> 00:11:03,535 what what could be rendered unnecessary 283 00:11:03,915 --> 00:11:07,070 services if if appropriate interventions are taken earlier. 284 00:11:07,850 --> 00:11:08,910 And that oftentimes, 285 00:11:10,009 --> 00:11:13,450 is not compatible with revenue generation. So there's 286 00:11:13,529 --> 00:11:14,269 there again, 287 00:11:14,889 --> 00:11:18,410 having having a board that represents the, the 288 00:11:18,410 --> 00:11:21,105 the community interest, the, the interest of the 289 00:11:21,105 --> 00:11:23,745 patients that we see is is a is 290 00:11:23,745 --> 00:11:25,204 a good help and a reminder, 291 00:11:25,824 --> 00:11:28,225 to to keep us from always believing that 292 00:11:28,225 --> 00:11:30,164 the bottom line is the bottom line. 293 00:11:32,259 --> 00:11:34,579 What an excellent point. Thank you so much 294 00:11:34,579 --> 00:11:36,339 for digging in a little bit deeper there. 295 00:11:36,339 --> 00:11:38,980 Now I know a lot of opportunities ahead, 296 00:11:38,980 --> 00:11:41,459 but challenges as well. What are the the 297 00:11:41,459 --> 00:11:43,779 challenges or potential headwinds that you have your 298 00:11:43,779 --> 00:11:45,764 eye on most closely right now and and 299 00:11:46,004 --> 00:11:48,004 anticipate navigating through over the next year or 300 00:11:48,004 --> 00:11:48,504 two? 301 00:11:50,085 --> 00:11:53,465 Well, we're certainly seeing dramatic changes or potentials 302 00:11:53,764 --> 00:11:56,565 for dramatic changes in federal policy, and I 303 00:11:56,565 --> 00:11:58,725 think they're evolving in ways that are at 304 00:11:58,725 --> 00:12:00,820 least are not yet clear to me. 305 00:12:01,600 --> 00:12:04,000 And so being light on our feet and 306 00:12:04,000 --> 00:12:05,699 being able to be responsive 307 00:12:06,000 --> 00:12:07,220 to to changing 308 00:12:08,320 --> 00:12:11,440 dynamics at the regulatory level, at the payment 309 00:12:11,440 --> 00:12:12,740 level, at the, 310 00:12:13,285 --> 00:12:15,625 particularly in the Medicare world and 311 00:12:16,165 --> 00:12:18,184 very likely in the Medicaid world, 312 00:12:18,884 --> 00:12:21,605 being ready to, to to adjust the way 313 00:12:21,605 --> 00:12:24,725 that we think so that we can work 314 00:12:24,725 --> 00:12:25,225 effectively 315 00:12:25,684 --> 00:12:26,184 and 316 00:12:26,559 --> 00:12:29,040 effectively meet the needs of the beneficiaries that 317 00:12:29,040 --> 00:12:31,120 that depend on us, I think is going 318 00:12:31,120 --> 00:12:33,200 to be a big challenge over the next 319 00:12:33,440 --> 00:12:35,940 particularly, probably the next eighteen months or so. 320 00:12:36,720 --> 00:12:38,100 On a more very 321 00:12:38,804 --> 00:12:40,745 specific one, I think rationalizing 322 00:12:41,365 --> 00:12:42,745 the expanding pharmaceutical 323 00:12:43,205 --> 00:12:45,445 expense is is one that I think is 324 00:12:45,445 --> 00:12:47,945 enormous. I mentioned civica early, and for, 325 00:12:48,965 --> 00:12:52,325 generic drugs, that's at least a a tool 326 00:12:52,325 --> 00:12:52,825 that 327 00:12:53,190 --> 00:12:56,090 we and others, have now shared in creating 328 00:12:56,230 --> 00:12:58,250 to to to be beneficial there. 329 00:12:58,710 --> 00:13:00,149 But in terms of the, 330 00:13:00,549 --> 00:13:03,450 drugs that are are not generic, that are 331 00:13:03,509 --> 00:13:04,009 are, 332 00:13:04,790 --> 00:13:08,924 increasingly capable I mean, wonderful technology, wonderful capabilities, 333 00:13:09,164 --> 00:13:11,184 capabilities, wonderful new opportunities 334 00:13:12,205 --> 00:13:14,365 that can help people to have healthier and 335 00:13:14,365 --> 00:13:15,184 better lives. 336 00:13:15,804 --> 00:13:18,205 But we need to also find ways to 337 00:13:18,205 --> 00:13:21,424 make that cost effective and and cost beneficial. 338 00:13:21,804 --> 00:13:24,790 It's our constant hope. It's my constant hope 339 00:13:25,090 --> 00:13:27,170 that we can find ways to bring Moore's 340 00:13:27,170 --> 00:13:29,970 Law or some analog of that to bear 341 00:13:29,970 --> 00:13:32,790 in health care so that we can take 342 00:13:32,850 --> 00:13:36,129 very invasive and expensive procedures that we provide 343 00:13:36,129 --> 00:13:38,745 today, replace them with something that is much 344 00:13:38,745 --> 00:13:40,764 less invasive, much less risky, 345 00:13:41,225 --> 00:13:44,585 and hopefully also lower cost that'll allow people 346 00:13:44,585 --> 00:13:47,245 to, to live effective, healthy lives, 347 00:13:48,105 --> 00:13:50,504 with less medical what what we think of 348 00:13:50,504 --> 00:13:51,725 as medical intervention, 349 00:13:52,740 --> 00:13:54,919 but allow us to, to actually 350 00:13:55,379 --> 00:13:57,940 liberate them from some of the, the the 351 00:13:57,940 --> 00:13:59,720 burden that they face with disease 352 00:14:00,100 --> 00:14:02,600 and some of the the the high impacts 353 00:14:02,899 --> 00:14:04,660 that they may have to go through through 354 00:14:04,660 --> 00:14:05,879 our current health system. 355 00:14:06,475 --> 00:14:08,154 But we need to find ways to do 356 00:14:08,154 --> 00:14:09,774 that that that really 357 00:14:10,235 --> 00:14:13,835 also meet with the financial imperatives that, that 358 00:14:13,835 --> 00:14:16,335 we're seeing in in our country, 359 00:14:17,115 --> 00:14:18,335 really throughout the world 360 00:14:19,190 --> 00:14:21,929 where the cost of health care is increasingly, 361 00:14:23,350 --> 00:14:23,850 becoming 362 00:14:24,149 --> 00:14:24,649 challenging 363 00:14:25,429 --> 00:14:26,330 as populations 364 00:14:26,789 --> 00:14:27,830 age and, 365 00:14:28,149 --> 00:14:29,210 we have greater 366 00:14:30,470 --> 00:14:32,490 numbers of people with chronic diseases. 367 00:14:33,154 --> 00:14:34,754 There need to be ways that we can 368 00:14:34,754 --> 00:14:36,455 meet those needs technologically, 369 00:14:37,875 --> 00:14:40,375 much like we have in computer and communications, 370 00:14:41,235 --> 00:14:42,294 with Moore's Law. 371 00:14:44,995 --> 00:14:47,315 Absolutely. I think that's really helpful to understand 372 00:14:47,315 --> 00:14:47,634 and, 373 00:14:48,195 --> 00:14:48,934 great to 374 00:14:49,289 --> 00:14:51,370 kind of think through things on that lens 375 00:14:51,370 --> 00:14:54,089 because, you know, you're right. There's not really 376 00:14:54,089 --> 00:14:56,089 a clear picture of how, some of these 377 00:14:56,089 --> 00:14:58,190 federal policies will change. But, ultimately, 378 00:14:58,889 --> 00:15:00,730 you know, looking at where the health system's 379 00:15:00,730 --> 00:15:04,350 at right now in providing that, pathway for 380 00:15:04,409 --> 00:15:06,455 as much as possible the financial stability, 381 00:15:07,075 --> 00:15:09,634 to continue operations and serving the community is 382 00:15:09,634 --> 00:15:10,214 a huge 383 00:15:10,514 --> 00:15:11,014 challenge. 384 00:15:11,475 --> 00:15:13,475 So, you know, I think there's a lot 385 00:15:13,475 --> 00:15:15,495 there and a lot to unpack, but especially, 386 00:15:16,274 --> 00:15:18,754 you know, from of the leadership perspective, being 387 00:15:18,754 --> 00:15:20,375 able to look ahead, but also, 388 00:15:21,080 --> 00:15:22,759 not too far ahead so you can still 389 00:15:22,759 --> 00:15:24,679 make sure you've got the problem solved for 390 00:15:24,679 --> 00:15:27,179 today to keep you, stable for the future. 391 00:15:27,720 --> 00:15:28,220 Absolutely. 392 00:15:29,720 --> 00:15:31,879 Excellent. Well, before we wrap up here, I'm 393 00:15:31,879 --> 00:15:33,654 wondering, could you talk a little bit about 394 00:15:33,654 --> 00:15:35,654 the number one thing that you're doing right 395 00:15:35,654 --> 00:15:37,815 now in order to set Intermountain up for 396 00:15:37,815 --> 00:15:39,115 that long term success? 397 00:15:41,014 --> 00:15:41,495 Well, 398 00:15:41,975 --> 00:15:43,975 I'm going to to morph the one thing 399 00:15:43,975 --> 00:15:47,115 into two things because I think that, again, 400 00:15:47,549 --> 00:15:50,269 keeping a focus on proactive care, which we 401 00:15:50,269 --> 00:15:52,429 think is is at the very core of 402 00:15:52,429 --> 00:15:52,909 what, 403 00:15:53,309 --> 00:15:54,049 what what 404 00:15:55,549 --> 00:15:58,350 what we're expected to do by our community 405 00:15:58,350 --> 00:15:59,070 and what, 406 00:15:59,629 --> 00:16:01,870 what we should be expected to do, I 407 00:16:01,870 --> 00:16:03,019 think, is essential. But 408 00:16:03,365 --> 00:16:04,964 in order to do that in a in 409 00:16:04,964 --> 00:16:07,444 a more effective way and to make it 410 00:16:07,444 --> 00:16:10,644 easier for both our our patients and members 411 00:16:10,644 --> 00:16:11,544 and caregivers, 412 00:16:12,565 --> 00:16:13,304 the simplification 413 00:16:13,764 --> 00:16:16,804 processes that we're trying to, pursue right now, 414 00:16:16,804 --> 00:16:19,500 that we are pursuing right now, I think, 415 00:16:19,980 --> 00:16:21,820 are are key. So I really would put 416 00:16:21,820 --> 00:16:23,919 it in both of those two areas, proactive 417 00:16:24,059 --> 00:16:25,039 care and simplification. 418 00:16:27,820 --> 00:16:29,579 Absolutely. Well, Greg, thank you so much for 419 00:16:29,579 --> 00:16:31,339 joining us on the podcast today. This has 420 00:16:31,339 --> 00:16:34,664 been just a really helpful and insightful conversation, 421 00:16:34,664 --> 00:16:36,105 and I look forward to connecting with you 422 00:16:36,105 --> 00:16:36,845 again soon. 423 00:16:37,304 --> 00:16:38,284 Well, thank you.