1 00:00:00,199 --> 00:00:02,597 Hello, everyone. This is Erica Spice Mason with 2 00:00:02,597 --> 00:00:05,234 the Becker Healthcare care podcast series. Thank you 3 00:00:05,234 --> 00:00:06,193 so much for tuning in. 4 00:00:06,992 --> 00:00:08,670 Today, I'm thrilled to be joined by 2 5 00:00:08,670 --> 00:00:11,070 guests from Quest Analytics to talk about the 6 00:00:11,070 --> 00:00:13,296 benefits to payers of network benchmarking. 7 00:00:14,011 --> 00:00:16,554 We have with us Sub S, the Senior 8 00:00:16,554 --> 00:00:17,928 vice President of Network 9 00:00:18,396 --> 00:00:19,531 at Quest Analytics 10 00:00:19,903 --> 00:00:22,601 and Bob Tavern, the sales solution executive at 11 00:00:22,680 --> 00:00:23,394 Quest Analytics. 12 00:00:24,188 --> 00:00:26,250 Sub ba and Bob, welcome to the podcast 13 00:00:26,250 --> 00:00:27,939 performance Thank you so much for being here 14 00:00:27,939 --> 00:00:29,533 today. Thanks, Erica. 15 00:00:29,932 --> 00:00:30,410 Thank you. 16 00:00:31,287 --> 00:00:33,120 Yeah. Thrilled to have you both. And before 17 00:00:33,120 --> 00:00:34,396 we get into our discussion, 18 00:00:34,968 --> 00:00:36,399 I was hoping you both might share just 19 00:00:36,399 --> 00:00:38,307 a little bit more about yourselves, give our 20 00:00:38,307 --> 00:00:39,523 listeners some context. 21 00:00:40,215 --> 00:00:41,567 So Ba, maybe we can have you get 22 00:00:41,567 --> 00:00:42,044 us started. 23 00:00:43,413 --> 00:00:46,284 Sure. Yeah. And, eric, thanks again for, having 24 00:00:46,284 --> 00:00:48,039 us, on the podcast here. 25 00:00:48,836 --> 00:00:50,591 So this is Sub sebastian Seal I've been 26 00:00:51,149 --> 00:00:52,799 in the healthcare space 27 00:00:53,396 --> 00:00:55,305 health and data space. I should say for 28 00:00:55,305 --> 00:00:57,215 the... For a little of 20 years now. 29 00:00:58,169 --> 00:00:59,124 Last 12 years, 30 00:00:59,840 --> 00:01:02,642 I spend time at adopt, and then try 31 00:01:02,642 --> 00:01:03,520 to that I've 32 00:01:04,079 --> 00:01:06,314 work for another health care data company that 33 00:01:06,314 --> 00:01:09,187 is no part of, Iq. And the common 34 00:01:09,187 --> 00:01:11,756 thread across all, my tenure in these 2 35 00:01:11,756 --> 00:01:15,667 companies is data analytics product and basically telling 36 00:01:15,667 --> 00:01:17,982 a story with with data that's kind of 37 00:01:17,982 --> 00:01:18,222 where, 38 00:01:19,353 --> 00:01:21,184 I spend most of. Okay? Well. 39 00:01:22,378 --> 00:01:24,208 Thank you, Sebastian. And thank you again, Erica 40 00:01:24,208 --> 00:01:26,755 for the opportunity. This is Bob Kevin harris. 41 00:01:27,009 --> 00:01:29,401 Sales solution executive at Quest Analytics. 42 00:01:30,199 --> 00:01:31,794 I'd come from Healthcare Service 43 00:01:32,432 --> 00:01:35,222 Corporation where I have the privilege and opportunity 44 00:01:35,222 --> 00:01:35,962 to serve 45 00:01:36,910 --> 00:01:41,046 across 4 major divisions for 25 years. Super 46 00:01:41,046 --> 00:01:43,432 excited to join quest analytics and bring my 47 00:01:43,432 --> 00:01:44,489 health care experience 48 00:01:44,958 --> 00:01:48,707 forward in supporting our network performance and benchmarking 49 00:01:49,317 --> 00:01:50,268 area of healthcare care. 50 00:01:52,663 --> 00:01:55,295 Fantastic. I really appreciate the intros from me 51 00:01:55,295 --> 00:01:57,528 both, and it sounds like you've definitely got 52 00:01:57,528 --> 00:02:00,160 the expertise to drill down a little bit 53 00:02:00,160 --> 00:02:01,777 more into this topic of 54 00:02:02,247 --> 00:02:04,890 health plans and their network performance. So 55 00:02:05,264 --> 00:02:06,534 Sub ba, I was hoping you could get 56 00:02:06,534 --> 00:02:08,915 us started and just kind of give us 57 00:02:08,915 --> 00:02:10,875 a bit of a broad idea of this 58 00:02:10,995 --> 00:02:11,875 topic area, 59 00:02:12,675 --> 00:02:15,395 how do health plan networks currently measure performance. 60 00:02:15,634 --> 00:02:17,895 And what metrics are most critical for evaluating 61 00:02:18,115 --> 00:02:19,395 the efficacy of these networks, 62 00:02:20,607 --> 00:02:23,867 Sure. What great way to kick off this 63 00:02:23,867 --> 00:02:26,570 this topic or this discussion here. So help 64 00:02:26,570 --> 00:02:27,706 plans should typically 65 00:02:28,495 --> 00:02:32,094 have about 5 or 6 major areas that 66 00:02:32,094 --> 00:02:34,014 they would measure themselves on. 67 00:02:34,735 --> 00:02:36,814 And in the list I'm gonna talk about 68 00:02:36,814 --> 00:02:38,508 is in no particular order, 69 00:02:39,145 --> 00:02:41,376 they're all equally important. So first, it comes 70 00:02:41,376 --> 00:02:44,004 to mind is clinical related measures. Like, 71 00:02:44,721 --> 00:02:44,960 outcomes, 72 00:02:45,534 --> 00:02:47,450 which is, like, he measure that's a measure 73 00:02:47,450 --> 00:02:48,567 of care and service, 74 00:02:49,206 --> 00:02:52,878 then, quality measures and patient safety, hospital like, 75 00:02:53,038 --> 00:02:56,084 required conditions come this this bucket and then, 76 00:02:57,280 --> 00:02:59,832 population, health management, which is, how are they 77 00:02:59,832 --> 00:03:02,304 managing their chronic condition of the prop of 78 00:03:02,304 --> 00:03:05,754 the population and preventive care, early detection, things 79 00:03:05,754 --> 00:03:07,514 like that. So that's the first... That's the 80 00:03:07,514 --> 00:03:08,734 first 1. And then 81 00:03:09,034 --> 00:03:12,254 the second area of measurement here is 82 00:03:12,794 --> 00:03:15,210 utilization, like, how is the utilization across, like, 83 00:03:15,370 --> 00:03:15,530 say, 84 00:03:16,330 --> 00:03:18,650 resource management and the services management going on? 85 00:03:18,810 --> 00:03:19,210 So meaning, 86 00:03:19,930 --> 00:03:22,009 what is the geometric mean length of stay 87 00:03:22,009 --> 00:03:22,490 of my, 88 00:03:23,063 --> 00:03:25,681 set of my members when the encounter sepsis. 89 00:03:25,998 --> 00:03:28,617 Like... So, the utilization is a big, 90 00:03:29,331 --> 00:03:31,806 component of measurement for for help... Plans and 91 00:03:31,806 --> 00:03:33,634 also, like, how many tests are done, 92 00:03:34,429 --> 00:03:37,052 prevent you or diagnostic and things like that. 93 00:03:37,847 --> 00:03:39,913 The third area of measurement is 94 00:03:40,470 --> 00:03:41,544 plans cost management, 95 00:03:42,003 --> 00:03:45,358 which is mostly, like, medical expenses, what's their 96 00:03:45,358 --> 00:03:48,075 medical loss ratio? What's the total cost of 97 00:03:48,075 --> 00:03:50,159 care, again, a big 98 00:03:50,874 --> 00:03:52,623 measurement area for health plans. 99 00:03:53,338 --> 00:03:55,961 Then the the fourth 1 will be, 100 00:03:56,452 --> 00:03:58,223 wanna say member satisfaction. 101 00:03:58,676 --> 00:04:01,717 Like, this is an important, piece of measurement 102 00:04:01,773 --> 00:04:03,123 because they want their members to be happy. 103 00:04:03,281 --> 00:04:03,917 They want, I mean, 104 00:04:05,049 --> 00:04:06,966 a member retention is a is a big 105 00:04:06,966 --> 00:04:09,443 measure for them, and it comes out through 106 00:04:09,443 --> 00:04:11,701 age gaps and that can impact their ratings 107 00:04:11,761 --> 00:04:14,890 with Cms and also that will indirectly kind 108 00:04:14,890 --> 00:04:16,247 of impact the payment. 109 00:04:17,126 --> 00:04:18,105 So... And then 110 00:04:18,802 --> 00:04:21,995 the fifth the 1 is operational efficiencies, 111 00:04:22,569 --> 00:04:25,470 again, timelines of care, claims processing 112 00:04:25,770 --> 00:04:28,009 efficiencies, these come to mind in that. And 113 00:04:28,009 --> 00:04:30,820 then last but not least, at least, from 114 00:04:30,820 --> 00:04:34,237 a measurement standpoint regulatory and compliance related. These 115 00:04:34,237 --> 00:04:36,382 are and say, are they meeting in Secure 116 00:04:36,382 --> 00:04:37,097 standards or, 117 00:04:38,067 --> 00:04:40,855 they are they in line with, compliant with 118 00:04:40,855 --> 00:04:41,754 state and federal 119 00:04:42,210 --> 00:04:42,710 regulators 120 00:04:43,405 --> 00:04:45,635 agencies. So those are kind of broad candidates. 121 00:04:45,794 --> 00:04:47,644 There's a lot more under of them that 122 00:04:47,644 --> 00:04:49,564 they measure. But I think in every other 123 00:04:49,564 --> 00:04:51,404 measure they make can roll up into 1 124 00:04:51,404 --> 00:04:52,144 of these 125 00:04:52,444 --> 00:04:54,204 6 buckets that I just mentioned. 126 00:04:55,245 --> 00:04:57,487 Each And that's fantastic. Thanks so much, Sub 127 00:04:57,487 --> 00:04:59,635 ba. So it sounds like we're looking at 128 00:04:59,635 --> 00:05:00,351 clinical measures, 129 00:05:01,067 --> 00:05:02,180 utilization, cost management. 130 00:05:02,513 --> 00:05:03,331 Member satisfaction, 131 00:05:04,499 --> 00:05:06,565 operational efficiencies and compliance, you know, it's a 132 00:05:06,565 --> 00:05:09,448 pretty wide range of measures that 133 00:05:10,075 --> 00:05:12,058 payers are looking at to measure their overall 134 00:05:12,058 --> 00:05:14,280 performance. So I wanted to take that just 135 00:05:14,280 --> 00:05:15,177 a little bit 136 00:05:15,629 --> 00:05:16,684 further and 137 00:05:17,154 --> 00:05:19,232 considering all of those elements, can you kind 138 00:05:19,232 --> 00:05:21,570 of discuss the role that benchmarking plays 139 00:05:21,949 --> 00:05:24,267 in and how this helps payers really improve 140 00:05:24,267 --> 00:05:25,865 their network performance as well? 141 00:05:27,473 --> 00:05:28,108 Yeah. I mean, 142 00:05:29,061 --> 00:05:31,204 the the 6 measurements that I talked about. 143 00:05:31,363 --> 00:05:32,712 So let me extend that, 144 00:05:33,267 --> 00:05:36,235 into your next yep, the question around benchmarking. 145 00:05:37,035 --> 00:05:40,634 These 6 measures are not mutually exclusive. The 146 00:05:40,634 --> 00:05:42,074 age measure kind of, like, 147 00:05:42,728 --> 00:05:44,718 leads into the others, or so your cost 148 00:05:44,718 --> 00:05:46,948 management can be a function of utilization and 149 00:05:46,948 --> 00:05:49,279 clinical outcome. So they're they have very good 150 00:05:49,416 --> 00:05:50,372 relationship between each other. 151 00:05:51,103 --> 00:05:51,603 So 152 00:05:52,216 --> 00:05:56,033 benchmarking can create real measurable goals for these 153 00:05:56,033 --> 00:05:56,590 health plans. 154 00:05:57,464 --> 00:06:00,089 They reveal performance gaps in these areas for 155 00:06:00,089 --> 00:06:00,566 health plans. 156 00:06:01,217 --> 00:06:04,402 And, they also can highlight areas of improvement. 157 00:06:04,959 --> 00:06:07,507 They also can highlight best practices, and they 158 00:06:07,507 --> 00:06:10,713 create awareness around, what the industry standards, are, 159 00:06:11,032 --> 00:06:13,110 etcetera, etcetera. So I'll give you a couple 160 00:06:13,110 --> 00:06:15,748 of examples here. So if I'm a health 161 00:06:15,748 --> 00:06:17,746 plan, Like, I wanna know what is the 162 00:06:17,746 --> 00:06:18,645 risk adjusted 163 00:06:19,675 --> 00:06:22,061 30 day mortality rate for chest pain, 164 00:06:22,857 --> 00:06:25,981 patients, chest pain period. For my members with 165 00:06:26,038 --> 00:06:27,311 provide us in my network. 166 00:06:27,804 --> 00:06:31,075 Versus those in my competitors network. Right? 167 00:06:31,793 --> 00:06:34,447 And if the rate is comparatively higher 168 00:06:34,999 --> 00:06:36,594 I will... I as a health plan will 169 00:06:36,594 --> 00:06:38,131 ally align in sign incentives 170 00:06:38,668 --> 00:06:42,278 to improve this outcome or are just provider 171 00:06:42,735 --> 00:06:44,570 composition in my network. So members have access. 172 00:06:44,824 --> 00:06:47,224 To higher quality providers. So that's can that's 173 00:06:47,224 --> 00:06:48,444 an example where 174 00:06:48,904 --> 00:06:51,084 benchmark can come handy. The other thing is 175 00:06:51,384 --> 00:06:53,625 it's not only about clinical outcomes. As I 176 00:06:53,625 --> 00:06:54,365 mentioned earlier 177 00:06:55,314 --> 00:06:59,206 benchmarks can also help with cost management initiatives. 178 00:06:59,524 --> 00:07:02,645 Like, for example, care coordination. How often 179 00:07:03,274 --> 00:07:06,411 my members that I've been through a surgery 180 00:07:06,869 --> 00:07:09,207 post discharge, end up in an un scheduled 181 00:07:09,905 --> 00:07:10,065 Event. 182 00:07:10,879 --> 00:07:13,354 Versus my competitors. Right? Because that is an 183 00:07:13,354 --> 00:07:13,753 expensive, 184 00:07:14,631 --> 00:07:15,110 affair for, 185 00:07:15,749 --> 00:07:19,282 work from from emotional standpoint from dollar standpoint 186 00:07:19,341 --> 00:07:21,430 everywhere. Right? So if my number is higher 187 00:07:21,430 --> 00:07:22,546 than market average, 188 00:07:23,183 --> 00:07:24,379 I need to take action to, 189 00:07:25,176 --> 00:07:28,205 like, increase care coordination. So there's a flow. 190 00:07:28,539 --> 00:07:30,288 There's there's there's a follow, 191 00:07:31,242 --> 00:07:34,342 call with, with the Pcp post discharged within 192 00:07:34,342 --> 00:07:35,773 5 days or something like that. 193 00:07:36,584 --> 00:07:37,084 And 194 00:07:38,183 --> 00:07:38,742 the other 195 00:07:39,541 --> 00:07:42,258 important thing that Benchmarks can provide is, do 196 00:07:42,418 --> 00:07:45,795 I have more low value care providers 197 00:07:46,347 --> 00:07:48,729 compared to my... To the market median? Right? 198 00:07:48,888 --> 00:07:51,191 It's not always comparison against your competitor or 199 00:07:51,191 --> 00:07:53,970 the next next health plan. But what is 200 00:07:53,970 --> 00:07:55,002 the market median? 201 00:07:56,052 --> 00:07:58,942 Meaning, these are providers that have increased 202 00:07:59,638 --> 00:08:02,347 utilization with no evidence of improved clinical outcome. 203 00:08:02,586 --> 00:08:05,173 So do my... For example, do my 204 00:08:05,550 --> 00:08:07,643 antibiotics go directly to any knee surgery 205 00:08:08,100 --> 00:08:10,785 without trying physical therapy like that because that's 206 00:08:11,223 --> 00:08:11,541 I mean, 207 00:08:12,258 --> 00:08:14,569 that can increase the cost of care without 208 00:08:14,569 --> 00:08:16,481 trying everything before going to the next 1. 209 00:08:16,720 --> 00:08:17,437 Next big 210 00:08:18,569 --> 00:08:19,288 item, which is. 211 00:08:20,087 --> 00:08:21,705 So benchmarks can 212 00:08:22,164 --> 00:08:25,220 really be critical to our gaps 213 00:08:25,534 --> 00:08:28,730 subsequently diagnose the problem and measure the impact 214 00:08:28,730 --> 00:08:29,950 of any corrective 215 00:08:30,888 --> 00:08:34,419 action. So again, I know, Bob, you you 216 00:08:34,419 --> 00:08:36,980 probably have dealt with this directly, I mean, 217 00:08:37,220 --> 00:08:39,299 in your in your time during your time 218 00:08:39,299 --> 00:08:40,019 and the payer. 219 00:08:40,980 --> 00:08:43,475 Anything you would add for the roll of 220 00:08:43,475 --> 00:08:44,034 benchmarks here? 221 00:08:45,475 --> 00:08:46,355 Absolutely Sub ash. 222 00:08:47,475 --> 00:08:50,115 Benchmark and services are really several roles and 223 00:08:50,115 --> 00:08:52,837 helping the how plan, evaluate network performance. 224 00:08:53,871 --> 00:08:56,335 A few examples would be helping to service 225 00:08:56,335 --> 00:08:57,687 baseline plans for health plans. 226 00:08:58,244 --> 00:09:00,231 Through which network performance can be measured, 227 00:09:00,884 --> 00:09:04,085 compared against utilize and evaluating network performance of 228 00:09:04,085 --> 00:09:05,605 the physicians and facilities, 229 00:09:06,404 --> 00:09:08,736 in the cases of network contract affecting, rate 230 00:09:08,736 --> 00:09:09,135 adjustments, 231 00:09:09,932 --> 00:09:10,808 negotiations and renewal, 232 00:09:11,605 --> 00:09:14,713 also supporting, the provider and vendor contracts, 233 00:09:15,670 --> 00:09:18,339 acting, with contracts that are based to its 234 00:09:18,637 --> 00:09:20,414 Sla and performance guarantees, 235 00:09:20,792 --> 00:09:23,186 pay for performance, fee for service models, 236 00:09:24,158 --> 00:09:25,908 And also look looking for, like for, like, 237 00:09:26,226 --> 00:09:27,363 comparisons against 238 00:09:27,738 --> 00:09:29,908 provider specialists for member satisfaction. 239 00:09:31,413 --> 00:09:33,747 Additionally, they they can also be utilized, 240 00:09:34,763 --> 00:09:35,821 within payer 241 00:09:36,358 --> 00:09:37,975 organizations for achieving marketplace 242 00:09:38,352 --> 00:09:40,447 differentiator. So for example, on C qa 243 00:09:41,956 --> 00:09:43,871 to, the point you mentioned earlier a population 244 00:09:43,871 --> 00:09:45,944 how how could health equity initiatives. 245 00:09:46,981 --> 00:09:49,294 They're also used by regulators to help to 246 00:09:49,294 --> 00:09:52,021 establish the standards or which payers are required 247 00:09:52,021 --> 00:09:52,579 to achieve, 248 00:09:53,536 --> 00:09:56,589 for example, state departments of insurance, Medicaid Rfp. 249 00:09:57,445 --> 00:09:59,917 And then lastly, really focusing more around the 250 00:09:59,917 --> 00:10:00,635 quality lens. 251 00:10:01,610 --> 00:10:03,069 Of those providers 252 00:10:03,529 --> 00:10:06,490 and how do we ultimately steer members into 253 00:10:06,490 --> 00:10:07,389 higher quality 254 00:10:07,850 --> 00:10:09,929 providers and helping them with their health care 255 00:10:09,929 --> 00:10:10,169 decisions? 256 00:10:11,459 --> 00:10:14,321 Yeah, Bob S, these are such great insights, 257 00:10:14,480 --> 00:10:15,355 and I think it really... 258 00:10:16,149 --> 00:10:18,955 Everything you've shared really speaks to how benchmarking 259 00:10:19,488 --> 00:10:19,988 can 260 00:10:20,378 --> 00:10:22,129 provide a lot of insights in so many 261 00:10:22,129 --> 00:10:23,959 areas of the business. I think we've touched 262 00:10:23,959 --> 00:10:26,050 on patient or member satisfaction. 263 00:10:26,505 --> 00:10:29,390 We've talked about clinical quality, we've talked about 264 00:10:29,390 --> 00:10:32,743 the quality of specialists and how providers are 265 00:10:32,743 --> 00:10:34,041 performing against 266 00:10:34,419 --> 00:10:36,036 market performance and 267 00:10:36,349 --> 00:10:38,107 I can only imagine that these measurements, 268 00:10:38,667 --> 00:10:41,005 while helpful. They're probably rather complex 269 00:10:41,384 --> 00:10:41,884 to 270 00:10:42,583 --> 00:10:45,560 not just track and measure, but also to 271 00:10:46,034 --> 00:10:48,432 monitors. So, Sub, I was hoping you could 272 00:10:48,432 --> 00:10:49,790 shed a little bit of light on the 273 00:10:49,790 --> 00:10:52,427 role of third party benchmarking services. You know, 274 00:10:52,507 --> 00:10:54,606 what role do they play in helping payers 275 00:10:54,745 --> 00:10:55,245 evaluate 276 00:10:55,559 --> 00:10:57,635 network performance. And if you could share any 277 00:10:57,635 --> 00:10:58,135 examples 278 00:10:58,513 --> 00:11:00,988 of how those services have provided actionable insights 279 00:11:00,988 --> 00:11:03,463 for network improvements that would be fantastic. 280 00:11:05,867 --> 00:11:07,240 Yeah. I mean, I think 281 00:11:07,851 --> 00:11:08,351 benchmarking 282 00:11:09,041 --> 00:11:12,057 as a topic in itself is is pretty 283 00:11:12,057 --> 00:11:14,559 complicated. Like, even you could you could have 284 00:11:14,620 --> 00:11:16,539 benchmarking in in a better idea of ways. 285 00:11:16,779 --> 00:11:18,379 Right? So 1... The first 1 is, like, 286 00:11:18,539 --> 00:11:20,860 you you compare against yourself. That's still, like, 287 00:11:21,115 --> 00:11:23,115 I mean, how did I do as as 288 00:11:23,115 --> 00:11:23,835 a health plan, 289 00:11:24,955 --> 00:11:27,695 last year compared to this year. Right? So 290 00:11:27,754 --> 00:11:30,566 that's fundamental that's foundation and everyone should be 291 00:11:30,566 --> 00:11:32,713 doing And that's a bare meeting. Right? You 292 00:11:32,713 --> 00:11:35,837 compare against yourself year over year and and 293 00:11:35,894 --> 00:11:37,881 are you trending in the right direction. Right? 294 00:11:38,375 --> 00:11:40,394 And and this is not super complicated 295 00:11:41,654 --> 00:11:44,534 and doesn't necessarily need a third party resource. 296 00:11:44,695 --> 00:11:46,294 So, like, because you got all the data, 297 00:11:46,629 --> 00:11:48,700 you crunch the numbers. Again, you need some 298 00:11:48,700 --> 00:11:50,692 analytics talent in in house we kind of 299 00:11:50,692 --> 00:11:52,763 do that. But you crunch the numbers, and 300 00:11:52,763 --> 00:11:54,515 you see how you're trying and most help 301 00:11:54,515 --> 00:11:55,631 plans do this. Like, 302 00:11:56,838 --> 00:11:59,856 not not rocket science. Right? The the challenge 303 00:11:59,856 --> 00:12:02,477 comes in, like I mean, knowing what the 304 00:12:02,477 --> 00:12:05,597 market capacity is I think that's where things 305 00:12:05,597 --> 00:12:06,416 start to get 306 00:12:06,794 --> 00:12:09,908 tricky and and complex. Right? If if my... 307 00:12:10,307 --> 00:12:12,223 Again, I'll I'll go back to, like, say, 308 00:12:12,543 --> 00:12:13,841 if my members 309 00:12:14,392 --> 00:12:17,177 when they end in the hospital for pneumonia, 310 00:12:17,495 --> 00:12:18,847 they're in the hospital for, 311 00:12:19,484 --> 00:12:21,234 say, 4.3 312 00:12:21,234 --> 00:12:22,291 geometric millions, 313 00:12:22,999 --> 00:12:24,356 as zinc inpatient stays. 314 00:12:25,074 --> 00:12:27,070 Is that good bad? Like, I mean, okay. 315 00:12:27,229 --> 00:12:30,102 Last year, I was 4.2 and 4.3 and 316 00:12:30,102 --> 00:12:32,587 going up. But... I mean, So knowing in 317 00:12:32,587 --> 00:12:35,133 what the market is, I think is is 318 00:12:35,133 --> 00:12:37,439 very important and that's what Benchmarks will 319 00:12:38,076 --> 00:12:40,869 do. Right? And so there... There's a lot 320 00:12:40,869 --> 00:12:43,489 more I can go deeper into into, like, 321 00:12:43,568 --> 00:12:45,552 the third party services. But again, 322 00:12:46,425 --> 00:12:47,164 I, I 323 00:12:47,552 --> 00:12:49,380 love to get it here from Bob his 324 00:12:49,380 --> 00:12:52,241 point of view because, Bob, you were in 325 00:12:52,241 --> 00:12:54,307 leadership role at health plan and and you... 326 00:12:54,545 --> 00:12:56,628 You dealt with this, like, first hand? Like, 327 00:12:56,788 --> 00:12:58,883 did you do, like, homegrown 328 00:12:59,260 --> 00:13:01,972 benchmarking or did you go outside and and 329 00:13:01,972 --> 00:13:04,126 and source it from outside? Like, and what 330 00:13:04,126 --> 00:13:05,721 are the pros and cons of each approach? 331 00:13:06,534 --> 00:13:07,414 Should light on that. 332 00:13:08,375 --> 00:13:11,034 Absolutely. There... There definitely is some homegrown 333 00:13:11,414 --> 00:13:11,894 benchmarking, 334 00:13:12,534 --> 00:13:15,174 but it's also limited. Typically line of business 335 00:13:15,174 --> 00:13:18,527 level. So we... We've noticed different levels of 336 00:13:18,527 --> 00:13:20,829 benchmarking when you're looking at a commercial population 337 00:13:20,829 --> 00:13:21,964 versus a government 338 00:13:22,496 --> 00:13:22,654 population. 339 00:13:23,705 --> 00:13:25,465 You know, the other thing that we're we're 340 00:13:25,465 --> 00:13:27,945 thinking more about is, you know, just the 341 00:13:27,945 --> 00:13:30,504 health equity lens and how do you, know, 342 00:13:30,585 --> 00:13:31,085 ultimately, 343 00:13:32,277 --> 00:13:35,937 deliver guidance on actual insights from paying attention 344 00:13:35,937 --> 00:13:37,312 to race ethnicity, 345 00:13:38,324 --> 00:13:38,801 language, 346 00:13:39,293 --> 00:13:40,191 cultural competency, 347 00:13:40,725 --> 00:13:42,418 inclusive programs for, 348 00:13:43,032 --> 00:13:46,110 diverse member populations and ultimately how do you 349 00:13:46,388 --> 00:13:48,457 deliver a network that's gonna help to meet 350 00:13:48,457 --> 00:13:49,275 that member 351 00:13:49,650 --> 00:13:52,275 population where they are in close proximity to 352 00:13:52,275 --> 00:13:53,253 what they need 353 00:13:53,723 --> 00:13:55,237 and based on the type of care that 354 00:13:55,237 --> 00:13:55,954 they're looking for. 355 00:13:56,671 --> 00:13:58,902 Yeah. I mean, going back to your question, 356 00:13:59,061 --> 00:14:00,735 Eric around, like, I mean, third party, 357 00:14:02,089 --> 00:14:03,147 benchmarking service 358 00:14:03,859 --> 00:14:07,055 actually, they they assume... They are in this 359 00:14:07,055 --> 00:14:08,334 in this space for a, 360 00:14:09,212 --> 00:14:10,571 from a very long period of time, they 361 00:14:10,571 --> 00:14:11,630 have a lot of data 362 00:14:12,261 --> 00:14:14,727 understand the nuances of it. So there are 363 00:14:14,727 --> 00:14:18,067 advantages to the third party sources where they 364 00:14:18,067 --> 00:14:20,869 have a data infrastructure talent pool and to 365 00:14:20,869 --> 00:14:23,026 maintain this on an ongoing basis. Right? And 366 00:14:23,026 --> 00:14:23,186 then, 367 00:14:23,905 --> 00:14:25,743 the other advantage is they have a very 368 00:14:25,743 --> 00:14:28,700 broad, holistic and, like, global view of the 369 00:14:28,700 --> 00:14:30,544 problem. At hand. Because it's like, 370 00:14:31,496 --> 00:14:34,832 because of that 10000 hour role, if you 371 00:14:34,832 --> 00:14:36,340 if you know, on a given. If when 372 00:14:36,340 --> 00:14:38,167 you do this over and over, again, you 373 00:14:38,167 --> 00:14:40,091 you tend to get better and better and 374 00:14:40,091 --> 00:14:42,398 your experience kind of speaks very clearly. Like, 375 00:14:42,557 --> 00:14:44,864 that's what when somebody is, like, doing this 376 00:14:44,864 --> 00:14:45,364 purely 377 00:14:45,739 --> 00:14:47,092 on a day in day out basis, 378 00:14:47,664 --> 00:14:49,981 So they can identify patents very very quickly, 379 00:14:50,141 --> 00:14:51,920 and they have the ability to layer 380 00:14:52,379 --> 00:14:53,278 additional data 381 00:14:53,657 --> 00:14:56,468 on top of the simple comparison. Like claims 382 00:14:56,468 --> 00:14:58,644 data, for example, they can take claims data 383 00:14:58,782 --> 00:15:01,575 on top of network data and provide much 384 00:15:01,575 --> 00:15:04,565 deeper insights, which is critical because sometimes your 385 00:15:04,785 --> 00:15:08,384 superficial, just comparing counts getting misleading. I I 386 00:15:08,384 --> 00:15:11,080 might have 25 percent of my provide an 387 00:15:11,198 --> 00:15:13,815 network in really high efficient bucket, 388 00:15:14,370 --> 00:15:17,248 but are you really getting activity 389 00:15:18,016 --> 00:15:20,504 for this from this 25 percent... This 25 390 00:15:20,504 --> 00:15:22,424 percent drive only 3 percent of your activity. 391 00:15:22,664 --> 00:15:25,804 That's not good. Right? So that level of 392 00:15:25,865 --> 00:15:26,764 detailed analysis, 393 00:15:27,799 --> 00:15:30,036 can be possible when somebody is, like, really 394 00:15:30,036 --> 00:15:31,634 doing it on on a day to day 395 00:15:31,634 --> 00:15:31,954 basis. 396 00:15:32,513 --> 00:15:32,753 Mh. 397 00:15:33,472 --> 00:15:35,883 Yeah. I really appreciate those add ons. S 398 00:15:35,883 --> 00:15:38,834 and and Bob, especially your perspectives from all 399 00:15:38,834 --> 00:15:41,466 of your time at a payroll organization. This 400 00:15:41,466 --> 00:15:43,699 has been a great discussion. Our time has 401 00:15:43,699 --> 00:15:45,869 come to a close so quickly, but I 402 00:15:45,869 --> 00:15:48,346 just wanted to thank you both again for 403 00:15:48,346 --> 00:15:50,823 for joining this discussion and also Sub sebastian 404 00:15:50,823 --> 00:15:53,480 highlighting some of the capabilities and 405 00:15:53,954 --> 00:15:56,122 and really the capacity that third party 406 00:15:56,575 --> 00:15:57,551 services can 407 00:15:57,925 --> 00:15:58,822 really help 408 00:15:59,275 --> 00:15:59,775 organizations 409 00:16:00,228 --> 00:16:02,950 with in terms of understanding, having access to 410 00:16:02,950 --> 00:16:05,129 the benchmarking data, understanding the nuances 411 00:16:05,589 --> 00:16:07,990 and analytics as well. So again, thank you 412 00:16:07,990 --> 00:16:10,389 both for for being on the podcast today. 413 00:16:11,044 --> 00:16:12,260 Yeah. Thank you very 414 00:16:12,873 --> 00:16:16,453 opportunity in. Definitely enjoyed the the conversation. Thank 415 00:16:16,453 --> 00:16:17,010 you, Eric. 416 00:16:18,139 --> 00:16:21,335 Great opportunity. Appreciate it. Oh, thank you both 417 00:16:21,335 --> 00:16:23,333 again, and we'd also like to thank Quest 418 00:16:23,732 --> 00:16:25,650 Analytics for sponsoring this episode today. 419 00:16:26,303 --> 00:16:28,135 Listeners, please be sure to check out other 420 00:16:28,295 --> 00:16:32,039 Becker healthcare podcasts at becker hospital review dot 421 00:16:32,039 --> 00:16:32,199 com.