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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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Thrilled today to be joined by a special

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guest. Doctor Puja Mittal is vice president and

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chief health equity officer at Health Net. Doctor

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Mittal, thank you so much for taking the

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time to be with me on the podcast

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today.

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Sure. Thanks for having me.

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And before we dive into everything we wanna

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talk with you about, can you tell us

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a little bit more about yourself, your background

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in health care in terms of your career,

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and what it is that you're doing today

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at HealthNet.

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Sure.

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So,

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I am a family doctor.

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I came to that through,

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my mom, who was also a family doctor.

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I grew up in Southern California, and,

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she was working at an FQHC there with

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primarily farm workers.

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And, through just watching her my entire childhood,

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that that became my goal as well. And

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so,

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I went to medical school, school, became a

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family doctor, did residency in Southern California working

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with farm workers,

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and,

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really since then have had a career that's

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focused on caring for the underserved. And so,

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I was an academic clinician working at Boston

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Medical and then after that, UCSF

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for many years before coming over to the

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plan side. And so

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I have been at Health Net for,

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eight and a half years.

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I've had a lot of different positions here,

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a lot of different

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roles, and have had the opportunity to learn

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a lot of different aspects of health care,

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I think, Medicaid, commercial,

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and Medicare. And for the last four years

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or so, have been the chief health equity

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officer.

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And so

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that means that,

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I have three essential areas of focus at

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Health Net. One is broad population health, so

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really looking at the health of the individual

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and the populations we serve and improving,

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disparities in health outcomes amongst those populations.

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The second is more broadly equity focused benefits,

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so things like ensuring that we are,

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have enough community health workers, enough doulas,

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and other

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sort of surround staff that we call nontraditional

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providers supporting our members and ensuring the quality

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of those benefits.

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And then the third is is more broadly

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health equity strategy. How do we ensure that

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everything that we're doing at the plan really

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takes an equity focus and an equity lens,

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to ensure that we're meeting the needs of

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those who are most vulnerable across the state?

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And so

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Health Net really has a pretty broad footprint.

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We're in 14 counties,

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everything from very urban counties such as Los

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Angeles County to very rural counties like Imperial,

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and,

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some of the northern

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rural counties. And so our

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populations are are quite diverse.

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And we have, in different regions of the

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state, different populations that we really hone in

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on, from my team's perspective to ensure that

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we're meeting the needs of those who are

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most vulnerable, those communities.

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Wonderful. Well, I I really appreciate that overview,

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Puja, and, and really appreciate you taking the

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time to sit down with us and share

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your insights with our listeners.

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I wanna get started by,

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asking you what are some of the biggest

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issues that you're following within health care right

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now. And I and I ask that question

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given that it's a time of transformative

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change, both for private organizations like yours, but,

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of course, also,

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policy wise, both the state and federal levels

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when it comes to Medicaid and things that

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will affect your members. So,

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what's top of mind for you? What are

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you keeping an eye out for in the

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media, in in the latest data?

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What are you keeping an eye out for

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in terms of what's gonna be impacting your

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your membership?

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Yeah. There there are a handful of things.

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One,

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big one, of course, is, federal funding for

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Medicaid,

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because that directly impacts what we're able to

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do,

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in our day to day work. And so,

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I'm keeping an eye on that broadly. What

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does that look like? Are we going to

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have to change within our state,

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who's covered with Medi Cal? And so that's

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a big one.

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Another is

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also looking at federal funding and federal funding

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subsidies for the Exchange population

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and where that might shift things.

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If there is less federal funding for,

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for,

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the members on the exchange,

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that will shift

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some of the things that I know Covered

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California has been really successful in doing in

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terms of

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supporting

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benefits and subsidies so that people are not

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having to pay as much out of pocket

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for their benefits.

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And so that's another thing that I'm keeping

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an eye on, just in terms of trying

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to understand

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what type of health care will be accessible

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to people and if we're going to see

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any shifts in

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who is able to access

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broader health care.

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Another thing that I'm keeping an eye on

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is

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telehealth solutions

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and,

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the shift and how those are permeating in

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different regions

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of the state and of the country. And

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so, I think there's been a bit of

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a push and pull in using telehealth as

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a way of extending access,

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particularly in rural areas,

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and then

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how that is affecting

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those who are practicing in those areas and

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what that does to the way that patients

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are shared. And so just trying to understand

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better and kind of keep an eye on,

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you know, how do we best use telehealth

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and what does it really mean for access,

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particularly for those who are

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underserved.

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And, you know, there's good data that shows

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that a lot of the

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changes in telehealth,

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availability of,

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therapy, for example behavioral health therapy, has not

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necessarily benefited those who are most vulnerable. It

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really does end up supporting,

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higher socioeconomic

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populations. And so really trying to see how

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that continues to change, if see that become

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more equitable over time or if there's something

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that we're gonna need to do from a

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policy perspective

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to support that.

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Absolutely. That's three major topics that I think

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most health care executives right now are keeping

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their eyes on. Medicaid reimbursement changes,

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ACA subsidies, and whether those will be allowed

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to expire, and then what you just mentioned,

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Puja, as well, the the telehealth shifts that

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we're seeing all over the country, especially when

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it comes to Medicare right now. Yeah.

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So

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when you think about your your member population

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and what you're in charge with in terms

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of serving them, what what gives you the

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most concern right now in terms of health

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equity trends that you are seeing,

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in the California counties that you serve?

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I'm gonna come back to the technology piece

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because I think equitable access to technology is

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a really important one.

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And,

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you know, I think there's real policy implications

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around

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the access of broadband,

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for example,

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and the inequitable access to broadband.

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You know, I I we used to talk

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about,

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Internet service or broadband access as being something

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that's a nice to have but not a

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need to have. And more and more in

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today's world, it's essential. It's an essential part

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of our,

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you know, social drivers of health. If we

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don't have access to broadband internet, we don't

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have access to being able to really function

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in the world, particularly when it comes to

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health care where so much of it requires

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that type of access. And so

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I'm, I'm looking at, you know, what does

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it look like to really make that

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broadband access accessible and

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affordable

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because we know that it's often more expensive

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in poorer communities.

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And then

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so the broadband access is one piece of

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it, but then the other piece of it

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is how are we taking all these innovations

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that are occurring in

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technology

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and being able to apply those to our

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communities that are most in need? And so

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looking at, you know,

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telehealth access to,

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behavioral health therapy and ensuring that those huge

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gains that we've made, right, there are many,

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many providers that are now,

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bringing in really diverse

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sets of therapists so that whatever

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whatever type of background you're seeking in your

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therapist, you can find. If you're a veteran

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and you're looking for a veteran therapist, you

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can find that. If you are,

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you know,

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a queer

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Asian woman, for example, you can go in

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and find a therapist that sort of understands

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your culture and reflects that. But how are

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we ensuring that those

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technologies, those advancements,

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are getting out to those, in the Medicaid

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community

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who may actually have less access to that

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type of care already.

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And so, that's something that continues to be

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top of mind for me because it's so

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important

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in terms of

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really being able to meet the needs of

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our communities in the most equitable way.

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Absolutely. And so you're you're focused on democratizing

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access to new technologies for for the underserved

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populations,

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that's that HealthNet serves.

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And and I imagine, that access to broadband

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Internet is a major challenge, especially in some

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of those far Northern California and

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coastal counties. So really interested to hear you

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talk about

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that. On the flip side of my my

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last question,

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what are some of the trends among your

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your member population that you're really seeing,

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improvements in terms of health outcomes or technology

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access,

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trends where you're you're excited about where things

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are moving for you and your Health Net

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members?

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You know,

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I've been really excited to see that people

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are in more and more engaged with care.

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I mean, really, one of the biggest struggles

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that,

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we as a plan have and and most

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plans have is driving engagement, sort of engaging

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those unengaged members.

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And so I think because

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of our

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flexibility

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in multimodal outreach

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and being able to leverage technology in a

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way that meets the needs of the people

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that we're serving,

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we've been able to drive engagement in new

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ways. And that's really exciting to me because

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the first step in improving any outcome

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is driving engagement.

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And then the second is making sure that

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when they are engaging with us that they're

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having a good experience.

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And I think we're making progress in both

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of those

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both of those, and so that to me

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is really encouraging.

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I am also particularly

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excited about, just from a systems perspective and,

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like, as a as an industry,

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the potential for

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AI to help

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improve and extend

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clinical

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care. And I think that's a really interesting,

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forefront that we're at now is how we're,

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how we're going to be able to use

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AI to

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extend our reach, right? Can we use it

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to,

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build large language models to pull

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unstructured data from an EMR

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and then use that to drive insights that

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we can use to better engage our members,

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right? So I think there's a we're on

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the precipice of a huge amount of potential

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to

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better use the data that already exists

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to to meet the needs of our members

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and give them a better experience.

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Yeah. And it's so exciting to hear leaders

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like yourself talking about the potential

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for AI and and, what it could do

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to improve

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health outcomes among your members. Because, you know,

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I know sometimes it can be very easy

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for for for media organizations like us to

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focus on some of the negative aspects, but

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it's you know, we're we're hearing from leaders

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constantly about, how this is going to continue

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to transform the industry and and health outcomes.

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So really exciting to to hear you talk

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about that as well, Puja.

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I I should ask, you know, you've been

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in this industry for a long time, and

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you've you've clearly been very successful to to

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the to where you've gotten.

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So for our audience of health plan leaders

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listening in for all all from all over

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the country, what would you tell them in

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terms of what, the most effective health care

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leaders need to be successful,

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especially moving forward over these next two to

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three,

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what are sure to be very transformative

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years for the industry?

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Yeah. Thank you for the question. I

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you know, I think in the equity space,

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generally, there's always this need to

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focus on an overall

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or overarching set of strategies,

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but be flexible

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in how you're getting there. Because as things

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shift, there's different resourcing available for certain things,

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and there's different interest in focusing on certain

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pieces.

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And so I would say a foundation of

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strength in terms of an understanding a clear

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understanding of strategic focus,

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but the ability to be flexible and pivot

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as needed to to achieve that focus. And

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I think for us,

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equity strategy. One is place based work. How

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are we able to

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look at a particular region or a particular

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population,

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understand what their

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what their assets are in that community, and

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then understand where the opportunities are, and then

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be able to come in as a plan

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and support

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to improve outcomes in that particular community. And

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that really requires

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being aligned to where the needs are in

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that community and responding.

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And so I think place based work is

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one thing that allows us to like hone

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in on a goal of improving outcomes, but

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be flexible about the path to get there.

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And then the second is really member experience

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and honing in on

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member experience being at the center of everything

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we do, because if we know that we're

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getting

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people engaged and they're having a good experience,

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their outcomes will improve.

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And so

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the other is keeping member experience at the

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center of everything we do and then being

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creative and flexible

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about how we

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influence that.

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And so,

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you know, we do have a clear overarching

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set of strategies, but I've had to be

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very flexible and pivot many times to be

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able to continue to drive the work forward,

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as the environment changes, as resourcing changes,

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and,

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and as our focus,

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continues to to move us forward.

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Wonderful. I some great advice for our audience

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and I think a great place to leave

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things. So, Doctor. Mittal, I wanna thank you

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for taking the time out of your day

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to sit down with us and and for

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sharing your insights with our listeners. We truly

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appreciate it.

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Thank you so much, Jacob, for the opportunity.

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If you'd like to listen to more podcasts

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00:14:47,345 --> 00:14:51,125
from Becker's Healthcare, you can visit beckershospitalreview.com.