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Imagine this. You're at the Swiss Hotel in

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Chicago surrounded by top executives from leading insurance

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companies and health systems.

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Welcome to Becker's Fall Pair Issues Roundtable, November

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4th through 6, 2024.

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Picture the excitement as you gather business cards

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from over 500 executive level attendees,

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building invaluable connections.

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Feel the energy as you participate in over

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26 educational sessions led by 90 elite speakers.

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Envision yourself engaging in lively discussions about new

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health plans, hospital at home models, behavioral health,

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and price transparency.

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Now imagine being inspired by keynotes from boxing

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legend, Sugar Ray Leonard, and 4 time NBA

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All Star, Chris Webber. Their stories will leave

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you motivated and ready to innovate.

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Don't miss out on this unique opportunity. Get

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registered today. Visit beckershospital

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hospitalreview.com

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and click on the events page to find

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the conference website. That's the beckers hospital review.com

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events page. See you in Chicago.

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Hello, everyone. This is Jacob Emerson with the

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Becker's Payer Issues podcast.

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Thanks so much for tuning in today where

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we're joined by Curative's CEO, Fred Turner. Fred,

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thanks so much for taking the time to

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be with us on the podcast today. Thanks

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for having me on.

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So, Fred, before we dive into everything we

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wanna talk with you about and we wanna

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hear more about Curative, Can you tell us

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a little bit more about yourself

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and your background within health care?

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Yes. I'm, British originally.

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Born and raised in the UK, but been

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out in the US for

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over 10 years now. Originally got started in

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health care in the in the lab industry,

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actually doing a high throughput

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STD testing and screening for antibiotic resistance,

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in STDs.

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And then,

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that was my first startup company and, actually

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was was trying to get out of the

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lab industry and

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into,

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taking on risk in, in sepsis patients to

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try to improve outcomes. That was the very

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first version of Curative

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at the very beginning of 2020.

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Got sucked back into the lab world with,

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COVID 19 testing and

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helping scale up the COVID 19 testing efforts.

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And that was, what we call curative 1

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point o,

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And then, obviously, now onto the the payer

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side with the curative health plan.

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Yeah. Absolutely. And, you know, some of our

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listeners

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might not be familiar with that transition journey.

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So can you talk to us a little

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bit more about that, the company more broadly?

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When did you get started?

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Can you explain the the transition from COVID

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testing company to a health insurer? And then

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who are you serving today? What kind of

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membership do you have, and what are the

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markets that you're in? Yeah. Absolutely. So we

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actually when Curator was first founded in January

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of 2020, we were, as as I say,

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working on sepsis outcomes, and we had a

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pilot set up with a hospital in Wisconsin.

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And

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we're kind of excited to to try and

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move that forward. And we we managed to

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do it for over about 6 weeks until

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COVID hit and closed down,

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any external clinical trial partners at that hospital.

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And so we thought, you know, maybe we

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can help with this testing thing for a

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few weeks until it all blows over.

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Obviously, it lasts a little longer than that.

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We ended up scaling the company from 7

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to 7000 employees in the 1st 12 months.

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Ultimately, grew it to, to do about 10%

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of all US,

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PCR COVID tests.

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We operate across all 49 states, 3636,000,000

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tests. We're everywhere apart from Hawaii.

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So it was

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a very sizable business,

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but, obviously, you know, it was a very

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much a short term need. And we

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serve that short term need, but then recognize,

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you know, this is not a a long

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term need. And so even from the beginning

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of kind of 2021,

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we were focused on what comes next.

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And we looked at a a number of

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different things, you know, some stuff in the

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lab industry. We actually briefly looked at buying

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a hospital,

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kind of similar to what General Catalyst is

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is now doing,

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with their acquisition of a health system and

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kind of trying to infuse it with tech.

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Ultimately decided not to do that

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and decided that there is a gap in

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the market in the commercial health plan space,

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where the other players are generally focused on

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Medicare or Medicaid and not really on actually

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trying to bring any innovation to the commercial

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health plan space,

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particularly on the fully insured side.

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So the curative health plan, it's a large

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group employers,

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51 FTEs and up, that we serve.

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Currently,

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we work with employers that are headquartered in

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either Texas, Florida, or Georgia.

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Fantastic. So it sounds like massive growth during

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the pandemic, then a switch to health insurance,

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within these last few years.

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Fred, you you you touched on,

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the the lack of innovation, as you say,

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within the commercial insurance space. And as you

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know, this this industry is is very dominated

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by a few powerful players, really only a

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handful of,

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companies nationally, and it's a very highly regulated,

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a very difficult industry to enter in as

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a new company. So talk to us a

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little bit about what you're telling employers, what

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you're telling individuals

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about why they should choose and and take

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a bet on Curative versus

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some of these more ingrained health plans that

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that probably offer, you know, much larger larger

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provider networks and things like that?

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Yeah. It really comes down to, do you

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want to invest in actually keeping your employees

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healthy

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and maintaining the health of your population and

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managing their cost long term?

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Or you focused on,

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you know, putting up the deductible and getting

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a short term win when people skip all

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of their preventative visits, but having ever increasing

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health care costs long term and being hit

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with a 20% renewal every year. You know,

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and that's really what we're trying to fight

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with the curative health plan. So

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one of the the issues that we identified

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in the market is the rise of high

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deductible health plans,

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and the effect that that's having on

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the care that members are seeking. You know,

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obviously, the idea with the high deductible plan

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is that a member will be an informed

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consumer, and they'll they'll go and shop for

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the best prices, and they'll only get high

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value care.

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Unfortunately,

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it it just doesn't really bear out in

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reality.

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And, generally, what happens is members actually just

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avoid,

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all

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care, including and especially preventative care. They skip

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their colonoscopy. They skip their mammogram. They don't

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go get their checkup because you're charging them

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money to go do that.

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It's just one more excuse for them to

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avoid that engagement that you actually really want.

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And so

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an increase in cost sharing tends to save

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money in the 1st plan year because you

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don't get those claims for those preventative services.

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So you save a little bit of money

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in the 1st year, but by the 2nd

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year, you're already seeing that catch up with

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you. What could have been a primary care

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visit is now an emergency room visit. You

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know, what could have been a specialist visit

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is now a week long hospital stay.

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And so you actually start to see your

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claims cost go back up again. And then,

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generally, by the 3rd year, claims cost will

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be actually above where they would have been

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if you hadn't put that cost sharing in

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place.

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The problem is 3 years is kind of

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a long time horizon. So you get to

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end of 3 years, and employers say,

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what did we do last time our health

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care costs increased?

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Oh, we put up the deductibles. And that

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worked last time, so we should do that

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again. And you kinda get caught in this

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spiral of just passing more cost off onto

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members,

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driving, greater and greater patterns of care deferral,

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and getting the population

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basically sicker and sicker because you're not getting

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that engagement. You're not managing chronic conditions.

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You know, you're not getting members into care

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at the appropriate time. You're waiting for something

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to go catastrophically

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wrong and then paying for the hospital claim.

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So we're trying to do that very differently

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with the curative plan.

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All members have no out of pocket cost

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for the first 120 days.

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And then during that 120 day window, they

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have to complete what we call a baseline

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visit.

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It's a mix of an onboarding to the

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health plan with a preventative,

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health visit. It's done with our staff. It

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takes about an hour. And as long as

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you complete that baseline visit, you continue to

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have no out of pocket cost for the

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whole plan year. So no deductibles, no co

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pays,

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no coinsurance,

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$0 out of pocket for any in network

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services. You can see your PCP. You can

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have a baby. You can get cancer care.

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It'll be $0.

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But if you don't do your baseline visit,

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on the 100 and 21st day, you will

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revert back to a $5,000

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deductible and 20% coinsurance.

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So it's a big $5,000

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carrot and stick to actually engage just once

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a year

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in your own preventative health. And we find

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that is very effective at driving member engagement.

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We get about 98% of our members

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actually engage and complete that baseline visit.

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And that's really the first step in their

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journey to reengaging with the health care system

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and actually managing their health proactively.

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And so through that, we're able to

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significantly

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reduce,

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those unnecessary and preventable hospital visits.

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We actually

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are running about 30% below a Milliman well

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managed benchmark in terms of inpatient admits and

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inpatient bed days.

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And all of that comes down to engaging

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members early, getting them into primary care, getting

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them to take their medications,

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all of the basic stuff that we know

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works. But doing that scale across 98% of

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your population,

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you can actually keep people healthy and decrease

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your long term health care costs as an

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employer.

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Wow. I mean, that's fascinating to hear hear

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you take us through that in some of

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these numbers you're seeing, especially around the the

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baseline

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visits.

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I imagine no co pays, no coinsurance, no

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deductibles is is very enticing,

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to to many employers. So fascinating to hear

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about, Fred. And and how many total members

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are you at now with the company?

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We're at about 55,000 members now. Wow. Amazing.

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So you you just announced an expansion

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into Georgia in August.

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What's the strategy behind that? Why are you

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going into Georgia, and and where are you

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operating right now?

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Yeah. So right now, the majority of the

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business is in Texas. That was our first

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market. We launched in Florida at the beginning

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of this year. So we are now starting

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to see some really good traction,

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in Florida and seeing a lot of growth

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out of that market. For us, you know,

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we we want to be a national payer.

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We want to, you know, eventually be across

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all 50 states.

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Obviously, we wanna grow

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at a responsible pace.

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And so, you know, it's gonna it's gonna

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take us some time to be, to be

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national,

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but it's really for us focusing on where

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our employer is headquartered.

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We already have members across all 50 states.

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You know, we have members everywhere,

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who work for employers that are headquartered out

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of Texas or Florida. So for us, Georgia

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was the the logical next step

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where, you know, there are a lot of

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employers based there.

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And

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for us,

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the speed to, to launch was, was relatively

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quick. Sort of a similar regulatory framework to

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what we see in Texas and Florida.

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Sure. Absolutely. And are are you finding that

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employers are coming to you,

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wanting to offer health benefits for the first

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time, or are a majority coming to you,

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having a traditional health plan with some of

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these big players and and wanting to reduce

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their costs? What's kind of the shake up

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there?

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Yeah.

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Most of the time, we're replacing, like, a

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Blue Cross or United, right, a Bruker plan

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that they're currently

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offering. Understood. Makes sense. Alrighty, Fred. Well, what

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else are we missing? You you have the

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ears of a lot of health plan executives

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from all over the country right now. So

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any final thoughts or or bits of advice

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you'd wanna offer before we go today?

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I think, you know, one of the the

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biggest things is people need to be willing

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to to try something new if we wanna

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get a different result. Yeah. This is one

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of the biggest things we face with employers

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is

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they

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are upset when the deductibles keep increasing and

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they get a 20% rate increase every year,

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but they're not willing to do something different.

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Right? If you I think Einstein's definition of

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insanity, right, was doing the same thing again

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and again and expecting a different result.

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If we want to change the outcome, we

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have to be willing to change what we're

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doing.

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Fantastic.

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Fred, thanks so much for taking the time

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to sit down with us, and for sharing

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your insights with our listeners. We truly appreciate

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it. Absolutely. Thanks for having me on. If

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you'd like to listen to more podcasts from

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Becker's Healthcare, you can visit beckershospitalreview.com.