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Welcome everyone to the Becker's Healthcare podcast series.

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I'm Mariah Muhammad, writer and moderator with Becker's

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Healthcare. And I'm thrilled to have with me

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today Steve Tringale, president of Mass General Brigham

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health plan. Steve, welcome to the podcast. We're

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very excited to have you join us today.

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To To get us started, would you mind

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please introducing yourself and telling us a bit

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about your background?

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First, thank you for having me, today.

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I'm Steve Tringale. I'm president of the Mass

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General Brigham Health Plan.

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We're a health plan of approximately

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400,000

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members

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across commercial Medicare Advantage

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and Medicaid,

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product lines.

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We also will be entering,

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the dual eligible product line, so we have

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a full product portfolio.

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And we are focused

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really on

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building a model which

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takes advantage

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of our integrated health care system

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in using

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the incredible resources at Mass General Brigham

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to provide our members with

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a better experience,

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a better clinical outcome, and quite frankly,

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a better product

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than other health insurers

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and and really take advantage of that combination

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of world class care

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and comprehensive coverage that we can provide.

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Yeah. Yeah. Wonderful. Thank you so much for

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giving us that background. So

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health care in hospitals and health plans, health

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care overall is really, changing rapidly right now

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as I'm sure you're, well aware. What are

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some of the biggest issues you're following in

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health care this year so far?

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Well, it is, in fact,

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both the fragility and the volatility of of

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both the delivery systems and insurers at the

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same time

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is something I have not seen

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very often in my career.

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So when we look at that level of

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volatility

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in the marketplace,

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when we look at,

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the level of accelerated

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change that you usually get

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in the first year of a new administration

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and a new congress,

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and you put all of those things together,

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keeping

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our plan

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focused

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on our North Stars,

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which are essentially

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providing that member

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focus so that they're having a better experience

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and a better outcome

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and

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taking advantage

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of our integrated delivery system.

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We try and stay focused on that, but

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at the same time,

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be flexible and agile

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to be able to pivot to respond to

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both expected and unexpected challenges and opportunities

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that are gonna be created by what is

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a rapidly changing and a rapidly consolidating industry

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on

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Yeah. Yeah. Absolutely.

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And,

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you know, saying this type of change being

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something you haven't seen much in your in

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your career, is this something that's kinda making

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you nervous? And if not, is there anything

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that you are most excited about,

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whether in tech, whether,

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something that is changing overall or anything else

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that's making you nervous?

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So

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I don't know that I'd use the word

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nervous as much as

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focused.

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There are a number of areas that require,

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an extraordinary

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level of focus right now.

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Access is a huge issue and access from

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a financial basis,

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which means making sure that the products can

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stay affordable,

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and access

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from a physical basis, which means

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dealing with the primary

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care shortage, which is affecting

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both delivery systems and health plans across The

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United States, and we're no exception to that.

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So coming up with build to purpose,

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solutions on the primary care side

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and using

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AI,

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not just

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at the the health plan level in terms

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of

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managing our claims,

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volumes and managing,

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denials and prior approvals,

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using AI

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to improve the member experience,

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to enhance the ability

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to

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help the member navigate and move to a

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very complex

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delivery system

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to be at the right place, to get

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the right care at the right time,

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to make sure that we're providing the member

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with the highest level of

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digitally enhanced

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responses to some of

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the clinical challenges, whether it be

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in the area of of

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high end imaging,

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or whether it be in using

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AI to help our analytics to focus on

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what are the right mix of services

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to provide to a member so that when

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we look at issues like the lifestyle challenges

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between diabetes and obesity,

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that

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we're not solely focused on

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do, we approve

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the provision

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of a GLP one, but what are the

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right

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mix of services

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that we should wrap around the provision of

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that GLP one

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that's going to help that member

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succeed over the long term

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to have

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better health outcomes and not just have

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some weight loss, to change the way they

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look at some of their lifestyle decisions,

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to change the way that they

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approach some of their day to day activities,

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whether it be,

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food based, whether it be exercise based, etcetera.

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In having,

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using AI to build analytics to help us

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on those issues

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as much as some of

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the core insurance issues, which have quite frankly

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gotten some negative press

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in in terms of how other companies are

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using it. We wanna use AI

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to improve the member experience and to improve

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the member outcome.

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Yeah. Yeah. Absolutely. Thank you so much for

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sharing that. And access overall is definitely something

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I've heard other techs talk about in different

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ways as well.

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And,

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going with this kind of theme of change

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and implementing different things,

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in your opinion, what would the most effective

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health care leaders need in order to be

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successful in the next two to three years,

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do you think?

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A couple of things.

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I think the biggest challenge, quite frankly, in

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the short term is leadership.

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There is so much going on

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that you need to keep your teams

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focused

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on the business of the business

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and at the same time,

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flexible and agile

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to, as I said, to take

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advantage of opportunities,

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not just to respond to some of the

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specific challenges out there.

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In terms of the focus on the business,

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you know, we're really proud that over the

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last two years, we've won

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recognition

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as from JD Power

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as the most trusted

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plan

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in the commercial marketplace in Massachusetts,

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a market which has some very strong competitors,

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and we've won that two years in a

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row.

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That's an example of staying focused.

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At the same time, an example of staying

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flexible and agile.

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You've all written an enormous amount about some

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of the challenges that this

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health system all over the country faced

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when,

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Stewart Healthcare went into bankruptcy.

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Our team,

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stepped up and immediately

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looked at

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every member that we had, every individual member

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that was in a steward facility to make

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sure that we could maintain continuity of care

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and a care regimen for patients who are

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in active cancer treatment, active cardiac treatment, etcetera.

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And they did that while we were running

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the the rest of, you know, the plan

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activities on a day to day basis.

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That's the kind of response that I think

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you're gonna need from good health plans

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to continue to operate in a system

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which is almost guaranteed to have

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a lot more bumps in the road, a

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lot more change,

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a lot more consolidation over the next two

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to three years. What we're seeing go on

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right now is not a one year

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interlude.

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There is a a a significant sea change

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going on in delivery system right now.

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So whether it's,

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digital innovation,

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it's whether working with our delivery system

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to improve integrated models of care, which differentiate

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us

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in the market,

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whether it's the blocking and tackling of

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customer service across very different product lines, whether

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it be commercial,

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Medicaid,

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geriatrics with Medicare Advantage.

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We need to

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to continue to improve

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what I think has been

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rather good performance, quite frankly.

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So,

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you know, the focus on continual improvement in

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a period of rapid change

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is a challenge from a leadership perspective.

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So the last piece of that is I

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need to challenge my leadership team,

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to be great two way communicators.

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The leadership teams have a pretty good window

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on what's going on

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at the policy level, at the state level,

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at the federal level, at the national level.

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But we need to be teaching,

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explaining,

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and be transparent about both the market dynamics

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and the political dynamics

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that are driving some of that change.

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And at the same time, we need to

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be sitting down with our workforce

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and be active listeners

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and make sure we understand how this is

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impacting them in the way they have to

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undertake their duties on a day to day

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basis.

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While this is a huge challenge for leadership,

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sometimes I think we forget

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how daunting some of this change can be

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for the overall workforce.

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So I think in many ways, the biggest

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challenge

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for senior executives, for senior leaders,

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for myself,

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is to be,

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as I said, sort of that great two

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way communicator

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because

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people will respond to challenges if they understand

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why they need to do it. It's a

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lot harder to respond to those challenges,

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and it's a lot more it's a lot

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more stressful to respond to those challenges

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if you really don't understand the underlying dynamics

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about what's going on.

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Yes. Yes. Absolutely. Thank you so much for

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those final thoughts. This has definitely been an

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informative discussion. And, again, I wanna thank you

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so much for coming on Becker's HealthCare,

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especially for the first time, and I look

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forward to connecting with you again soon.

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Sure. Thank you very much.