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Hello, everyone, this is Jacob Emerson with the

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Becker health care podcast. Thanks so much for

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tuning in today where we're thrilled to be

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joined by a very special guest. Doctor Sac

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and Jai is the President and Ceo of

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Scan Group.

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Doctor Jane, thanks so much for taking the

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time to be with us on the podcast

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today. Thank you, Jacob. It's great to deal

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with you. Yeah. Likewise. And before we dive

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in, hoping you can tell us a little

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bit more about scan group for those that

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may not be familiar and what it is

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that you all do there.

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Scan group was founded in 19 77 by

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a group of community activists that we affectionately

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called 12 angry seniors.

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This was a group of individuals who believed

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that there had to be a better way

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to age in Long Beach, California.

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And

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they built a network of services,

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called the senior care action network

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that was aimed to better address the needs

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of older adults in the Long Beach community

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and adjacent areas.

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The the scene of imagination that they had

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in 19 77

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has grown into a movement

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we now are,

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diversified healthcare care entity that serves

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over 300000 people, in California,

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Arizona, Nevada, New Mexico, Texas and

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Pennsylvania.

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We operate a large not for profit, Medicare

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advantage plan. We operate medical groups, including welcome

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health, My place health, health care and action,

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and Home based Medical.

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It is

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incredibly gratifying

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to be scans leader

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at a time of a lot of change

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in health care, where where there's is greater

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focus on

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health equity, greater focus on

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the sustainability

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of not for profit health care,

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greater focus on segmentation to serve distinct populations,

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and it's it's really excited to be representing

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scan on your podcast today.

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Yeah. And you mentioned such a that the

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that the root of the organization is addressing

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the needs of seniors. And this month's scan

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released its first environmental social and governance report,

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showcasing

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your impact on seniors and the un house

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population. Can you share key takeaways or notable

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statistics from that report that resonated with you

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most.

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Look, I'm I'm very proud of this report.

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But I will tell you we initially resisted

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putting it together in the first place.

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You know, that... It's become, you know, I

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I think a pro form a activity in

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a lot of organizations to write an es

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report and know, when 1 of our board

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members, Rosemary Turner asked us to do 1?

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We said, well, everything we do is Es.

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Why are we... Why do we need to

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do this report. We, of course, didn't tell

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her that, but we went ahead and, you

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and did the report. And we've had to

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thank her since then because it allowed us

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to really think about everything that we're doing

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and in the collective. And everything that we're

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doing to

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serve the populations that matter most to us.

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And when you take a big step

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it's it's something that we're all really, really

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proud of. The deep investments we made in

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the homeless services.

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The investments we made in health plans that

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focus on populations that others have forgotten, like,

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our affirm product, which is focused on Lgbt

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lgbtq plus seniors.

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The efforts that we're really making to enhance

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our employee experience and

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be a health plan that actually provides good

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health benefits to its employees. Imagine that.

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So, you know, I think when we when

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we start to think about all of the

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pieces that come together. It really helps us

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feel like we're an exe in

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organization to the industry. We're... By no means

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perfect. We have lots of things we can

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do better, But I think when you put

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it all together, what it really represents is

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a blueprint for an ethical company that's trying

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to do the right things.

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Us for data, And what I can tell

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you is we we now provide medical services

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to about 2000

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unique individuals every month.

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Through our health care and action medical group

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that's focused on providing clinical services and housing

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support services

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to people experiencing homelessness.

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So we're we're in a pretty exciting place

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of impact.

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You know, we have a... The affirm product

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has now grown to sort of, you know,

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over a thousand

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Lgbtq plus seniors or or people who are

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attracted to that that plan.

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We're helping people who are unseen, feel seen.

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And that is, you know, honestly, just very

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gratifying.

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2000 unique services provided per month to those...

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Experiencing homelessness. That's an amazing statistic. And it's

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so fascinating in hear that you were hesitant

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to even do this report at first,

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I do wanna talk about your care delivery

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models, though. And as I understand that they're

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designed to care for some of the most

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vulnerable seniors that you serve.

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From from your perspective such, and I know

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you just touched on this a bit, But

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why is it so important for scan group

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to to serve these populations? And what inroads

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have you made with tackling the homeless crisis

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in the states that you serve.

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Look, you know, so I think that the

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the you know, health care and action was

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really inspired by, you know, some early career

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work that I did

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with,

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Cambridge Health alliance,

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which,

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offered a a program called Cambridge healthcare for

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the homeless.

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And, you know, what you quickly saw when,

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you know, you're providing homeless

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health services to

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people who are experiencing homelessness

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is that their homelessness is either caused by

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health care problems or exacerbated

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by health care problems.

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And,

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you know, in when we think about the

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scourge that is homelessness. And when you think

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about the embarrassment that we all feel or

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should feel about homelessness.

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You realize that we have just an incredible

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opportunity, to address the needs of of

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homeless older adults

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through

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you know, a medical group that's actually focused

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on their needs Now we started out with

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the intent of serving homeless older adults, you

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know, a list consistent with our mission. But

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something happened along the way, which is, you

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know, in search of

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older adults, you know, who are the fastest

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growing portion of the homeless population,

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you know, we couldn't ignore everyone else in

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the community. And

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you know, now

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health action has contracts with,

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the city of C City, the city of

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West Hollywood,

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you know, various other health plans,

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you know, various

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private for profit health plans various public,

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not for profit health plans,

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we even received a a very generous donation

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from, Ben post to 2 of a million

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dollars

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to actually bring,

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you know, our our services to the County

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of San Mateo.

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And, you know, the we talk a lot

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about product markets fit in health care. There's

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unfortunately fantastic product market fit for health care

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and action where People are looking for a

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solution that's gonna address some of the root

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causes of homelessness, and that's really what we're

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what we're delivering.

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Yeah. It's amazing. And it's clearly very impactful

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work and it's it's good to know that

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a group like scan is is on the

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ground doing this work. In these communities.

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Let's talk about, the health plan side of

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the business for a second, such and your

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tier 6 formula offers

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13 commonly prescribed brand name drugs at 0

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dollars to 11 dollars per month 4 seniors,

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10 of which are on the Biden administration's

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negotiation list.

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What went into being able to offer this

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to your members and and what are you

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hearing in terms of the affordability that you're

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offering for these drugs? Look, every every whole

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plan can... You know, decide where it's gonna

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put its dollars, and we truly believe that

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we wanna make sure that the drugs

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that we would want for ourselves or for

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our family members are available

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you know, in an affordable way for

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our our members. And, you know, the truth

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is is that we know that high c

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pays are a huge barrier

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to members actually, you know, receiving the drugs

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that are prescribed by their doctors. So many

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people,

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for go filling their prescriptions or taking their

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medicines

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because their

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prescriptions cost too much money, and these are

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people on fixed incomes. And you know, the

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ultimate long term impact of not taking your

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medicine is poor health outcomes. And so when

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we think about benefit design it's, when we

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think about what we wanna do for the

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people we serve,

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we do everything we possibly can to try

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to reduce dan barriers to the things that

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we think are gonna move the needle the

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most. It's why we have the generous, you

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know, tier 6, 0 dollar copay for those

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expensive drugs,

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but it's also why we have 0 dollar

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c pay for primary care, 0 dollar c

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pay for

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specialty, 0 dollar c pay for

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hospitalizations, in in some of our most popular

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products

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because we really wanna make sure that, you

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know, people don't have,

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a sense of a barrier. And which brings

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me to a really important point, which is

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there's a lot of criticism of Medicare Advantage

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today.

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And I I just wanna make sure that

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people recognize that 1 of the things that

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Medicare Advantage is doing is really increasing affordability

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of care to a population of seniors who

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really need their affordability to to be improved

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because traditional Medicare if if you haven't looked

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at it recently,

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actually covers very little

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And so I think there's a lot of

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misplaced nostalgia for traditional Medicare,

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you know, when plans like scan are using

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instruments like tier 6.

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To really make, you know, drugs affordable

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and drive

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improvements in health outcomes.

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Yeah. And your point is... Heard loud and

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clear as well as the fact that you

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mentioned in the past to me directly of

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the amount of low income people that are

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on Medicare Advantage plans, and and they receive

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care, through these services.

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But in that vein such and, we've also

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previously discussed scans

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population specific Medicare advantage plans designed to meet

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the unique needs of women of Lgbtq plus,

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older adults. You have your partnership with Apollo

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Med to provide care, to Asian and Hispanic

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adults,

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you know, you don't hear

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initiatives like this from health plans often. So

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anything new to share here on these on

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these plans, how has enrollment been so far?

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Yeah. We're we're in early innings. I would

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say, you know, the most popular of these

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products so far has really been our firm

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product which

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you know, is our Lgbtq plus product. When

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we started it, we we thought we were

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doing something, you know, symbolically,

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which you know, supportive of

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Lgbtq plus seniors thinking we might get a

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hundred members, maybe 200 members. And when we

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got 500 in our first year and now

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thousand.

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We realized we might be beyond to something,

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which really I think spurred us to think

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about other groups of people who are not

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necessarily well represented in the Medicare Advantage

291
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product portfolios.

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1 of which is women which is probably

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shocking to people because, you know, more than

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50 percent of seniors are women, But how

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many of those products actually speak to their

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needs? How many of their... Those products

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actually specifically have interventions and programs to design

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to support the health needs of women.

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Very few. How many have actually

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you know,

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I'd identify a bunch of services that could

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actually

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improve the health of, you know, hispanic patients

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or Asian patients know, I think clover

305
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clever care in our market has been an

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example of a really successful

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Asian focused health plan. But, you you know,

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I I throw a lot of inspiration. III

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see competition there, but I also see

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inspiration, which is

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opportunities for us. To do better for specific

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populations who probably

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don't necessarily be, you know, feel seen or

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heard

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by traditional, you know, health plan marketing and

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traditional health plan products. So

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you know, I think the future of all

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health care is really segmentation.

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Segmented approaches to interacting with patients, providers,

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communities,

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vendors,

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And and so, you know, I I would

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say it's a core

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foundational principle of how we organize and manage

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the company. Is to really think in terms

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of of populations. Some people say, well, you

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know, how does that align with health equity,

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you know, if you're slicing and d the

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population that way, And I would say, it...

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We're aligning with health equity by really,

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you know, allowing people to feel seen in

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ways that they aren't necessarily seen.

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You know, in traditional products where

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they don't necessarily feel like their distinctive attributes

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and qualities aren't necessarily reflected.

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Absolutely. And then let's say on the topic

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of of the future of health care specifically,

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Medicare Advantage. As you know, the the industry

339
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is facing big reimbursement and audit changes from

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Cms. You mentioned there's increasing

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segmentation and market competition. So beyond these population

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specific health plans, how is scan navigating these

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industry changes over the next few years. Look,

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I I frequently stated the the Golden days.

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Of Medicare advantage are over. And I kinda

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I kinda like that in a lot of

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ways. Because I think, you know, this business

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was

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probably too easy for to for a long

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time.

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You know, if if if reimbursement were cut,

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it forces you to do more with less,

353
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forces you to be sharper from forces to

354
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forces you to refine your thinking.

355
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And so, you know, we're taking a hard

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look at our products and trying to understand

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what's really needed and what's not really needed.

358
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We're taking a hard look at our administrative

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cost structure and asking hard questions about you

360
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know, whether, you know, some of our vendor

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relationships, make the most sense for us for,

362
00:13:33,041 --> 00:13:35,528
you know, whether there's opportunities to disrupt them

363
00:13:35,759 --> 00:13:38,465
you know, obtain lower prices, and then frankly,

364
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you know, better serve our members or maintain

365
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benefits.

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So I I think,

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you know, pressure is a privilege. I think

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there's an ability to

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ultimately,

370
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use that pressure to try to drive, you

371
00:13:51,758 --> 00:13:54,857
know, sharper approach to things, and and that's

372
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the kind of muscle that we're building its

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00:13:56,525 --> 00:13:56,764
skin.

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00:13:57,797 --> 00:13:59,386
I like that That pressure is a privilege.

375
00:13:59,545 --> 00:14:00,180
That's a really,

376
00:14:00,673 --> 00:14:02,265
fantastic perspective. I didn't come up with it.

377
00:14:02,424 --> 00:14:04,893
That's that's philly bill billie Jean King. So...

378
00:14:05,371 --> 00:14:07,282
But but I believe it. Right? So Yeah.

379
00:14:07,441 --> 00:14:09,925
Good hit a star billie jean king pressure

380
00:14:09,925 --> 00:14:10,562
is a privilege.

381
00:14:11,359 --> 00:14:13,032
And as a tennis player myself, you know,

382
00:14:13,191 --> 00:14:15,262
I I feel that. It's... You know, when

383
00:14:15,262 --> 00:14:15,762
your

384
00:14:16,394 --> 00:14:18,232
standing in the baseline and and, you know,

385
00:14:18,312 --> 00:14:19,990
you're getting a ball hit at you at

386
00:14:19,990 --> 00:14:22,387
a hundred miles an hour. Mh. That's that's

387
00:14:22,387 --> 00:14:24,600
fun. But you'll also... You'll also need to

388
00:14:25,274 --> 00:14:27,180
have an approach to really really manage it.

389
00:14:27,339 --> 00:14:28,848
And I think that's what's going on in

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00:14:28,848 --> 00:14:30,992
our industry right now is is the pace

391
00:14:30,992 --> 00:14:32,342
of play is increasing,

392
00:14:32,833 --> 00:14:35,060
the intensity of play is increasing, And I

393
00:14:35,060 --> 00:14:36,014
think we all have to get a little

394
00:14:36,014 --> 00:14:38,321
bit more competitive a little bit tougher and,

395
00:14:38,798 --> 00:14:40,388
have our heads a little bit more fully

396
00:14:40,388 --> 00:14:42,630
in the game. Yeah. Yeah. No. It's great

397
00:14:42,630 --> 00:14:44,618
advice. And in that vein, any any final

398
00:14:44,618 --> 00:14:46,685
thoughts or final pieces of advice you would

399
00:14:46,685 --> 00:14:49,332
offer all the health plan, health system leaders

400
00:14:49,389 --> 00:14:50,423
listening to us today.

401
00:14:51,074 --> 00:14:52,832
Look, I, you know, 1 of the things

402
00:14:52,992 --> 00:14:55,469
I'm reflecting on increasingly these days is

403
00:14:56,508 --> 00:14:58,186
is why it's so hard to change in

404
00:14:58,186 --> 00:14:58,985
health care. And I...

405
00:15:00,196 --> 00:15:01,152
Have to say that we're...

406
00:15:01,789 --> 00:15:03,701
I'm I'm now almost 2 decades into a

407
00:15:03,701 --> 00:15:04,918
career trying to

408
00:15:05,692 --> 00:15:07,524
make health care better, and I feel like

409
00:15:07,524 --> 00:15:08,343
it's it's

410
00:15:08,893 --> 00:15:10,481
you know, mostly getting worse. I think it's

411
00:15:10,481 --> 00:15:13,206
getting better in terms of there's silos scientific

412
00:15:13,500 --> 00:15:16,535
innovations, you know, lots of ideas are maturing

413
00:15:16,535 --> 00:15:18,602
and so we have better therapies for diseases

414
00:15:18,602 --> 00:15:20,113
that were previously death sentences.

415
00:15:20,670 --> 00:15:22,658
But we're delivering, you know, 20 first century

416
00:15:22,658 --> 00:15:25,441
science you know, through nineteenth century delivery systems.

417
00:15:26,014 --> 00:15:27,689
And we're patti ourselves on the back for

418
00:15:27,689 --> 00:15:27,848
it.

419
00:15:28,566 --> 00:15:30,321
And so, you know, I think we need

420
00:15:30,321 --> 00:15:32,714
a leadership revolution in health care. I think

421
00:15:32,714 --> 00:15:34,069
we need to get out of the toxic

422
00:15:34,069 --> 00:15:34,569
positivity

423
00:15:35,266 --> 00:15:37,215
that you know, kinda traps us

424
00:15:37,591 --> 00:15:39,764
and start seeing things clearly, which is

425
00:15:40,380 --> 00:15:42,769
things can be better. Things should be better.

426
00:15:43,566 --> 00:15:45,991
And we have to stop, you celebrating

427
00:15:46,363 --> 00:15:48,766
great top line, you know, and bottom line

428
00:15:48,821 --> 00:15:49,376
financial results,

429
00:15:50,010 --> 00:15:52,151
what do we know that patient care could

430
00:15:52,151 --> 00:15:52,547
be better.

431
00:15:53,276 --> 00:15:55,340
And that the experience of being a clinician

432
00:15:55,340 --> 00:15:57,165
could be better and the experience of being

433
00:15:57,165 --> 00:15:59,229
a a patient could be so much better.

434
00:15:59,626 --> 00:16:01,553
And so that, that's the mission that I'm

435
00:16:01,553 --> 00:16:03,870
on. That's the mission I'm inviting everyone else

436
00:16:03,870 --> 00:16:04,829
to be on with me,

437
00:16:05,628 --> 00:16:06,187
because I think,

438
00:16:06,986 --> 00:16:08,940
we need to stop... Normalizing

439
00:16:09,559 --> 00:16:12,199
abnormal things in health care. So I will

440
00:16:12,199 --> 00:16:14,600
leave this podcast on that note.

441
00:16:15,651 --> 00:16:18,663
Your candidate perspective is very much appreciated, Doctor

442
00:16:18,742 --> 00:16:20,724
Jane, and I also just wanna thank you

443
00:16:20,724 --> 00:16:22,467
for taking the time to sit down with

444
00:16:22,467 --> 00:16:25,105
us. And for sharing more about the very

445
00:16:25,105 --> 00:16:27,491
impactful work that you, your team and at

446
00:16:27,491 --> 00:16:29,717
scan group are are clearly doing. So thank

447
00:16:29,717 --> 00:16:32,024
you. It's it's an honor. Thank you so

448
00:16:32,024 --> 00:16:32,183
much.

449
00:16:33,151 --> 00:16:34,581
If you'd like to listen to more podcasts

450
00:16:34,581 --> 00:16:37,282
from Becker healthcare, you can visit Becker hospital

451
00:16:37,282 --> 00:16:38,735
review dot com slash.