1 00:00:00,160 --> 00:00:02,639 Hi, everyone. This is Brian Zimmerman with Becker's 2 00:00:02,639 --> 00:00:04,660 HealthCare. For today's podcast, 3 00:00:04,960 --> 00:00:07,299 I'm excited to be joined by Nirne Patel, 4 00:00:08,000 --> 00:00:11,599 EVP and GM Benefits One, chief digital officer 5 00:00:11,599 --> 00:00:12,820 for Simplify Healthcare. 6 00:00:13,279 --> 00:00:15,285 Thank you so much for joining us today. 7 00:00:15,365 --> 00:00:17,125 Thank you, Brian. Thank you for having having 8 00:00:17,125 --> 00:00:19,204 having me here. Alright. Nunez, so let's get 9 00:00:19,204 --> 00:00:21,625 started with a simple introduction. Why don't you 10 00:00:22,085 --> 00:00:24,085 share a few details about your background and 11 00:00:24,085 --> 00:00:26,085 the work you're doing? Yeah. Of course. 12 00:00:26,564 --> 00:00:29,039 So I get excited at the intersection of 13 00:00:29,199 --> 00:00:30,260 healthcare and technology. 14 00:00:30,560 --> 00:00:32,880 I've been in healthcare space for about fifteen 15 00:00:32,880 --> 00:00:35,039 years and then in in tech for pretty 16 00:00:35,039 --> 00:00:37,760 much all of my career. At Simplify, we 17 00:00:37,760 --> 00:00:40,420 are solving two problem areas, 18 00:00:41,295 --> 00:00:43,635 benefits the problem of benefits management 19 00:00:44,255 --> 00:00:46,575 from an end to end value proposition for 20 00:00:46,575 --> 00:00:47,075 payers 21 00:00:47,774 --> 00:00:50,655 and the problem of provider data management. So 22 00:00:50,655 --> 00:00:52,914 these are the two areas we focus on, 23 00:00:53,295 --> 00:00:53,614 and, 24 00:00:54,270 --> 00:00:55,250 we have an incredible 25 00:00:55,630 --> 00:00:58,049 set of capabilities and customers which, 26 00:00:58,510 --> 00:01:00,670 solve these problems across different markets. So we 27 00:01:00,670 --> 00:01:02,270 specialize in how do we solve this for 28 00:01:02,270 --> 00:01:03,250 Medicare, Medicaid, 29 00:01:03,630 --> 00:01:06,430 commercial, and all the markets, involved. Yeah. And 30 00:01:06,430 --> 00:01:08,564 that that that data management challenge, 31 00:01:09,045 --> 00:01:11,005 I'm sure can create some silos Yeah. 32 00:01:11,605 --> 00:01:13,605 From from time to time. So I guess 33 00:01:13,605 --> 00:01:16,084 from your point of view, how are payers 34 00:01:16,084 --> 00:01:18,005 are doing this really well? How are they 35 00:01:18,005 --> 00:01:20,965 breaking down operational silos between the insure between 36 00:01:20,965 --> 00:01:22,745 insurance and and and care delivery? 37 00:01:23,450 --> 00:01:25,209 Yeah. No. I think I think that's a 38 00:01:25,209 --> 00:01:26,510 that's a great question. 39 00:01:27,209 --> 00:01:28,890 You know, at at a at a very 40 00:01:28,890 --> 00:01:29,950 macro level, 41 00:01:30,650 --> 00:01:32,170 the way we see it is there are 42 00:01:32,170 --> 00:01:34,969 two aspects of of care. There is there 43 00:01:34,969 --> 00:01:36,890 is what I call it design of care, 44 00:01:36,890 --> 00:01:38,750 and then there is delivery of care. 45 00:01:39,555 --> 00:01:40,515 And I think, 46 00:01:41,155 --> 00:01:44,515 where most successful payers and even paywiders, right, 47 00:01:44,515 --> 00:01:47,155 are increasingly going towards is how can we 48 00:01:47,155 --> 00:01:49,075 bridge that gap? Because at the end of 49 00:01:49,075 --> 00:01:51,155 the day, the continuum of care for a 50 00:01:51,155 --> 00:01:51,655 member, 51 00:01:52,780 --> 00:01:53,599 would require 52 00:01:54,219 --> 00:01:56,799 these two areas, right, to be highly integrated. 53 00:01:57,260 --> 00:02:00,140 So for example, when you're designing the care, 54 00:02:00,140 --> 00:02:02,140 you will be looking for what are some 55 00:02:02,140 --> 00:02:04,299 of the shared risk models from a delivery 56 00:02:04,299 --> 00:02:06,540 of care you would like to incentivize the 57 00:02:06,540 --> 00:02:07,040 member. 58 00:02:07,474 --> 00:02:09,794 So designing of the care would mean what 59 00:02:09,794 --> 00:02:12,375 are your strategies with respect to your network, 60 00:02:12,754 --> 00:02:14,675 are there vertical integration option if you are 61 00:02:14,675 --> 00:02:16,854 taking shared risk and capitation models, 62 00:02:17,235 --> 00:02:19,334 what kind of member experience you wanna deliver 63 00:02:19,394 --> 00:02:20,935 before you onboard the member, 64 00:02:21,439 --> 00:02:22,500 and what kind of personalization, 65 00:02:23,039 --> 00:02:25,439 right, you want to deliver after you onboard 66 00:02:25,439 --> 00:02:26,099 the members, 67 00:02:26,479 --> 00:02:27,139 in particular, 68 00:02:27,680 --> 00:02:30,180 during their their care delivery process. 69 00:02:30,639 --> 00:02:32,560 So when we look at these silos, there 70 00:02:32,560 --> 00:02:35,014 are common denominators. Right? Benefits is a common 71 00:02:35,014 --> 00:02:35,514 denominator. 72 00:02:35,814 --> 00:02:37,574 You would want to know when you're shopping 73 00:02:37,574 --> 00:02:39,574 for your insurance plan, how much it's gonna 74 00:02:39,574 --> 00:02:40,074 cost. 75 00:02:40,375 --> 00:02:42,134 And you would want to know the same 76 00:02:42,134 --> 00:02:42,634 question 77 00:02:43,014 --> 00:02:45,094 when you're actually in the middle of a 78 00:02:45,094 --> 00:02:45,835 care episode. 79 00:02:46,610 --> 00:02:49,969 So benefit is one kind of data layer, 80 00:02:49,969 --> 00:02:52,370 which we believe is a common denominator, which 81 00:02:52,370 --> 00:02:55,590 kinda threads the needle between designing the care 82 00:02:55,729 --> 00:02:57,810 and delivery of the care. The last thing 83 00:02:57,810 --> 00:03:00,050 you want is to create a fragmented data 84 00:03:00,050 --> 00:03:02,395 source for such an important layer, which is 85 00:03:02,395 --> 00:03:04,074 where which is the problem we are trying 86 00:03:04,074 --> 00:03:04,655 to solve. 87 00:03:04,955 --> 00:03:06,974 We enable a source of truth for benefits 88 00:03:07,354 --> 00:03:10,495 so that all different stakeholders from actuary 89 00:03:10,794 --> 00:03:12,175 to product design development, 90 00:03:12,715 --> 00:03:15,215 to your customer service, to your claims team, 91 00:03:15,560 --> 00:03:17,719 to the to the care delivery providers who 92 00:03:17,719 --> 00:03:19,180 need access to those benefits, 93 00:03:19,479 --> 00:03:22,039 they all are essentially getting a consistent view 94 00:03:22,039 --> 00:03:23,819 of benefits because it's sourced 95 00:03:24,280 --> 00:03:26,439 from the same source of truth. So those 96 00:03:26,439 --> 00:03:28,439 are some of the value propositions we bring 97 00:03:28,439 --> 00:03:30,199 to the table. And, essentially, you kind of 98 00:03:30,199 --> 00:03:31,935 break down the silos by building 99 00:03:32,314 --> 00:03:34,794 an integrated layer across the continuum of care. 100 00:03:34,794 --> 00:03:36,715 Yeah. And that that that tie in or 101 00:03:36,715 --> 00:03:38,235 that bridge, so to speak, is that the 102 00:03:38,235 --> 00:03:38,735 benefits 103 00:03:39,194 --> 00:03:39,694 information 104 00:03:39,995 --> 00:03:41,834 serve serving as, like, sort of that bridge, 105 00:03:41,834 --> 00:03:44,254 like you said, between design of care, delivery 106 00:03:44,314 --> 00:03:44,974 of care. 107 00:03:45,514 --> 00:03:47,269 And, of course, you know, we're we're talking 108 00:03:47,269 --> 00:03:49,050 about health care in 2025. 109 00:03:49,110 --> 00:03:50,489 So I gotta ask you 110 00:03:50,870 --> 00:03:52,870 what role sort of when doing that work 111 00:03:52,870 --> 00:03:53,769 with with benefits, 112 00:03:54,549 --> 00:03:56,709 and shaping that member experience as you put 113 00:03:56,709 --> 00:03:59,414 it, what role is AI and analytics playing 114 00:03:59,414 --> 00:04:01,754 in helping make this a connected experience 115 00:04:02,134 --> 00:04:04,235 from, you know, benefit navigation to 116 00:04:04,614 --> 00:04:06,634 the proactive care that that I believe, 117 00:04:06,935 --> 00:04:08,614 you know, all of the the the idea 118 00:04:08,614 --> 00:04:10,215 here is to get to a place like 119 00:04:10,215 --> 00:04:12,694 that where there's more proactive care? Yeah. Yeah. 120 00:04:12,694 --> 00:04:15,509 Yeah. Well, you know, we are in this 121 00:04:15,509 --> 00:04:17,129 incredible wave of AI, 122 00:04:17,589 --> 00:04:19,750 here at Becker's. Right? It's hard to even 123 00:04:19,750 --> 00:04:22,569 walk 10 steps without not hearing AI. True. 124 00:04:22,949 --> 00:04:25,129 Yep. So it's it's very exciting. 125 00:04:25,990 --> 00:04:27,129 We we have taken 126 00:04:27,774 --> 00:04:29,714 the mandate of applied AI 127 00:04:30,175 --> 00:04:33,074 at on two fronts. The first one is 128 00:04:33,774 --> 00:04:34,675 how can we 129 00:04:35,055 --> 00:04:35,555 make 130 00:04:36,254 --> 00:04:37,394 access to knowledge 131 00:04:37,935 --> 00:04:41,520 easier? And that becomes more along the lines 132 00:04:41,520 --> 00:04:43,779 of how can we personalize what's important 133 00:04:44,080 --> 00:04:47,060 on the benefits level. So we recently launched, 134 00:04:47,600 --> 00:04:48,740 an AI assistant 135 00:04:49,120 --> 00:04:51,439 feature to benefits one platform. We call it 136 00:04:51,439 --> 00:04:54,165 Benny, which is Benefits Native Intelligence. And, essentially, 137 00:04:54,165 --> 00:04:56,024 the the mandate for Benny is 138 00:04:56,485 --> 00:04:58,165 how can we make sure that, 139 00:04:58,725 --> 00:05:00,964 you have access to all different kinds of 140 00:05:00,964 --> 00:05:03,625 benefits information we house within our platform 141 00:05:04,509 --> 00:05:07,310 almost in a natural language manner. So things 142 00:05:07,310 --> 00:05:09,790 like, hey. I'm gonna go and about to 143 00:05:09,790 --> 00:05:11,730 have a broken bone injury. 144 00:05:12,270 --> 00:05:14,050 What it might cost me? 145 00:05:14,430 --> 00:05:17,170 Now to answer that question, today, you may 146 00:05:17,314 --> 00:05:19,074 be on the phone with a customer service 147 00:05:19,074 --> 00:05:21,154 rep. Right? And and and and and you 148 00:05:21,154 --> 00:05:23,334 will be dealing with calls or multiple, 149 00:05:24,435 --> 00:05:26,514 checkpoints where you would try to get that 150 00:05:26,514 --> 00:05:27,014 information. 151 00:05:27,954 --> 00:05:30,160 Benny would make it easier because we would 152 00:05:30,160 --> 00:05:32,319 source it directly from where the care was 153 00:05:32,319 --> 00:05:34,800 designed again. So this is a perfect example 154 00:05:34,800 --> 00:05:36,400 where the delivery of care and design of 155 00:05:36,400 --> 00:05:38,980 care are kinda eating from the same bucket. 156 00:05:39,199 --> 00:05:40,660 Mhmm. And that just allows, 157 00:05:41,759 --> 00:05:44,319 that removes the human error. It removes the 158 00:05:44,319 --> 00:05:46,504 silos. It it takes the friction and the 159 00:05:46,504 --> 00:05:48,504 rate limiters away, and it gets you to 160 00:05:48,504 --> 00:05:50,665 the source of information and the knowledge as 161 00:05:50,665 --> 00:05:52,745 fast as possible, as natural as possible. So 162 00:05:52,745 --> 00:05:55,145 that's one use case of AI where we 163 00:05:55,145 --> 00:05:56,845 can deliver a lot more personalized 164 00:05:57,225 --> 00:05:58,764 experience on the frontline, 165 00:05:59,785 --> 00:06:02,660 by just limiting the distance from the source 166 00:06:02,660 --> 00:06:04,980 of truth. Yeah. The second one will be 167 00:06:04,980 --> 00:06:06,980 on more on the back office side where 168 00:06:06,980 --> 00:06:08,340 you would want to do a lot more 169 00:06:08,340 --> 00:06:08,840 automation. 170 00:06:09,620 --> 00:06:12,439 So, for example, if you would want to 171 00:06:13,324 --> 00:06:16,524 match your member benefits, right, with incoming data 172 00:06:16,524 --> 00:06:18,925 sources, you would want to automate the end 173 00:06:18,925 --> 00:06:19,904 to end workflows 174 00:06:20,205 --> 00:06:22,925 using an agentic layer to to take care 175 00:06:22,925 --> 00:06:24,305 of your back office functions. 176 00:06:24,685 --> 00:06:26,860 As it comes to benefits and provider, those 177 00:06:26,860 --> 00:06:28,539 are the areas which we are also looking 178 00:06:28,539 --> 00:06:30,539 at. So you can you can you can 179 00:06:30,539 --> 00:06:32,539 talk to Benny in future, right, and say, 180 00:06:32,539 --> 00:06:34,300 hey. I would like to renew this plan 181 00:06:34,300 --> 00:06:35,919 for next plan year. 182 00:06:36,459 --> 00:06:38,485 Show me, right, what are some of the 183 00:06:38,485 --> 00:06:41,044 plan recommendations I should be making as I 184 00:06:41,044 --> 00:06:43,144 look into design of care for next year. 185 00:06:43,444 --> 00:06:45,925 Now when you actually have that level of 186 00:06:45,925 --> 00:06:48,485 sophistication, you will be able to create and 187 00:06:48,485 --> 00:06:51,110 compile and design a plan. So your starting 188 00:06:51,110 --> 00:06:54,490 point of taking that process is incredibly sophisticated, 189 00:06:54,550 --> 00:06:56,269 and that would mean that you would save 190 00:06:56,269 --> 00:06:57,829 a lot of time, cost, and you can 191 00:06:57,829 --> 00:07:00,310 spend more time, right, designing the care versus 192 00:07:00,310 --> 00:07:02,870 dealing with, a lot more manual processes which 193 00:07:02,870 --> 00:07:03,610 exist today. 194 00:07:04,074 --> 00:07:05,754 Yeah. When I when I come back to 195 00:07:05,754 --> 00:07:07,675 sort of sort of Benny and thinking about 196 00:07:07,675 --> 00:07:10,095 that that sort of, that sort of capability, 197 00:07:10,634 --> 00:07:12,714 I think it's come up being on-site at 198 00:07:12,714 --> 00:07:15,115 at Becker's Parachute's roundtable come up a lot. 199 00:07:15,115 --> 00:07:16,955 Like, the the demand for such a tool 200 00:07:16,955 --> 00:07:18,910 is high, and the need for it for 201 00:07:18,910 --> 00:07:19,889 members is high. 202 00:07:20,189 --> 00:07:21,169 When you think about 203 00:07:21,550 --> 00:07:23,870 how complex insurance can be to to the 204 00:07:23,870 --> 00:07:24,769 average member, 205 00:07:25,149 --> 00:07:26,669 being able to cut through the noise, not 206 00:07:26,669 --> 00:07:28,589 have to be on hold to have a 207 00:07:28,589 --> 00:07:31,149 direct answer. I mean, are am I reading 208 00:07:31,149 --> 00:07:32,985 that correctly just from the rooms I've been 209 00:07:32,985 --> 00:07:34,125 in during the conference? 210 00:07:34,425 --> 00:07:37,245 Yeah. Absolutely. You know, we we have multiple 211 00:07:37,625 --> 00:07:41,465 solution options that simplify Benny. It essentially solves 212 00:07:41,465 --> 00:07:42,525 the problem of, 213 00:07:43,305 --> 00:07:44,845 exposing benefits information 214 00:07:45,145 --> 00:07:46,360 to all all of the product 215 00:07:46,899 --> 00:07:49,939 design, actuary, right, document management, compliance, a lot 216 00:07:49,939 --> 00:07:52,100 of the stakeholders which we have. We also 217 00:07:52,100 --> 00:07:54,819 have benefit inquiry solution, which empowers the day 218 00:07:54,819 --> 00:07:56,500 in the life of a customer service and 219 00:07:56,500 --> 00:07:57,080 the member. 220 00:07:58,115 --> 00:08:00,354 So again, it's all the same source of 221 00:08:00,354 --> 00:08:01,095 truth information. 222 00:08:01,954 --> 00:08:03,894 The demand is high because, 223 00:08:04,354 --> 00:08:06,595 as we both know, Brian, it's a it's 224 00:08:06,595 --> 00:08:09,235 a team sport. The moment you are about 225 00:08:09,235 --> 00:08:11,814 to embark upon an episode of care, 226 00:08:12,589 --> 00:08:14,910 you are talking you're you're talking to at 227 00:08:14,910 --> 00:08:17,389 least interact with anywhere between 18 to 25 228 00:08:17,389 --> 00:08:17,889 people, 229 00:08:18,349 --> 00:08:20,689 and that's the simplest form of care. Mhmm. 230 00:08:20,750 --> 00:08:21,970 And as you are interacting 231 00:08:22,349 --> 00:08:24,509 and as your as your care delivery needs 232 00:08:24,509 --> 00:08:26,430 gets more complicated, you will just have more 233 00:08:26,430 --> 00:08:26,774 stake 234 00:08:27,975 --> 00:08:30,018 Right? You not only have doctors, but you 235 00:08:30,018 --> 00:08:30,367 have to you have to schedule appointments. You 236 00:08:30,367 --> 00:08:31,435 have to talk to insurance 237 00:08:31,894 --> 00:08:33,815 companies on how much you are going to 238 00:08:33,815 --> 00:08:36,534 pay for it. If you are prescribed, let's 239 00:08:36,534 --> 00:08:37,034 say, 240 00:08:37,735 --> 00:08:40,110 you know, pharmacy, now you have pharmacist. So 241 00:08:40,110 --> 00:08:41,970 now you will go back to your formularies 242 00:08:42,110 --> 00:08:44,110 and understand, hey. What what is this drug 243 00:08:44,110 --> 00:08:46,350 type? Tier one, tier two, tier three. So, 244 00:08:46,350 --> 00:08:48,669 again, this pendulum kinda keeps swinging between who 245 00:08:48,669 --> 00:08:50,429 designed the care, which is more along the 246 00:08:50,429 --> 00:08:52,110 lines of payers and who is delivering the 247 00:08:52,110 --> 00:08:53,789 care, which is more on the providers and 248 00:08:53,789 --> 00:08:54,289 pharmacy. 249 00:08:54,815 --> 00:08:57,375 But as a member, I would be talking 250 00:08:57,375 --> 00:08:59,134 to both of these because I'm trying to 251 00:08:59,134 --> 00:09:01,214 take care of the episode of care, right, 252 00:09:01,214 --> 00:09:01,875 for myself. 253 00:09:02,334 --> 00:09:04,254 So we see an incredible demand here of 254 00:09:04,254 --> 00:09:05,774 kind of bridging this gap because at the 255 00:09:05,774 --> 00:09:08,095 end of the day, one common goal across 256 00:09:08,095 --> 00:09:10,290 both of these entities is how can we 257 00:09:10,290 --> 00:09:11,909 improve the life of a member and how 258 00:09:11,909 --> 00:09:13,909 can we make sure that they are delivering 259 00:09:13,909 --> 00:09:16,070 and meeting the outcomes, right, the healthy outcomes 260 00:09:16,070 --> 00:09:18,789 we all intend for. Yeah. And and speaking 261 00:09:18,789 --> 00:09:20,570 about that, I think what you just, 262 00:09:21,269 --> 00:09:22,710 what you just shared kinda gets at this, 263 00:09:22,710 --> 00:09:24,549 but to zero and even closer, but maybe 264 00:09:24,549 --> 00:09:26,794 a a a finer point on it. What 265 00:09:26,794 --> 00:09:28,875 are the most important moments that shape a 266 00:09:28,875 --> 00:09:29,934 member's perception 267 00:09:30,554 --> 00:09:32,634 of of the benefits they're getting of of 268 00:09:32,634 --> 00:09:34,095 the value from their plan? 269 00:09:34,875 --> 00:09:35,595 Yeah. I think, 270 00:09:36,075 --> 00:09:38,954 it's it's almost like the perception of the 271 00:09:38,954 --> 00:09:39,870 member is 272 00:09:40,269 --> 00:09:43,570 so intertwined with the market or the 273 00:09:43,950 --> 00:09:46,350 care access channel, which they're coming from. And 274 00:09:46,350 --> 00:09:47,730 what I meant for 275 00:09:48,350 --> 00:09:50,750 the moments that matter for a Medicare member 276 00:09:50,750 --> 00:09:51,730 will be different 277 00:09:52,269 --> 00:09:53,649 than a Medicaid member, 278 00:09:54,029 --> 00:09:55,089 which will be different 279 00:09:55,924 --> 00:09:58,004 from a commercial member. If you look at 280 00:09:58,004 --> 00:09:58,504 Medicare 281 00:09:58,884 --> 00:09:59,384 member, 282 00:09:59,684 --> 00:10:00,424 for example, 283 00:10:01,365 --> 00:10:04,024 every year they have an opportunity to shop. 284 00:10:04,485 --> 00:10:04,985 Right. 285 00:10:05,605 --> 00:10:07,044 And that would mean that, 286 00:10:07,524 --> 00:10:08,345 every year 287 00:10:08,769 --> 00:10:11,669 there is just an extremely hyper focus on 288 00:10:12,049 --> 00:10:13,190 access to care, 289 00:10:13,690 --> 00:10:14,190 experience 290 00:10:14,690 --> 00:10:15,269 to care, 291 00:10:16,209 --> 00:10:17,750 because you would want, 292 00:10:18,129 --> 00:10:20,470 like, anywhere from onboarding and retaining 293 00:10:20,929 --> 00:10:21,509 a member 294 00:10:21,845 --> 00:10:23,845 all the way to making sure that, you 295 00:10:23,845 --> 00:10:25,625 know, their care needs are met. 296 00:10:26,004 --> 00:10:28,644 And a Medicare member in an urban Chicago 297 00:10:28,644 --> 00:10:31,764 versus Medicare member in a rural Chicago, rural 298 00:10:31,764 --> 00:10:32,745 Illinois. Right? 299 00:10:33,125 --> 00:10:35,764 Could be very, very different need. Right? So, 300 00:10:35,764 --> 00:10:37,929 so I think moments that matter for a 301 00:10:37,929 --> 00:10:39,389 Medicare member would be 302 00:10:39,769 --> 00:10:42,410 how good is your broker network system, which 303 00:10:42,410 --> 00:10:43,710 can educate the member, 304 00:10:44,730 --> 00:10:46,750 how aware you are with their current 305 00:10:47,129 --> 00:10:50,269 care needs, and how accessible that care is. 306 00:10:51,144 --> 00:10:53,304 And the problem for Medicaid would be completely 307 00:10:53,304 --> 00:10:55,304 different. What are the social determinants? They are 308 00:10:55,304 --> 00:10:57,164 much more amplified, right, for Medicaid. 309 00:10:57,625 --> 00:10:59,865 Versus with commercial, you're talking about, hey, what 310 00:10:59,865 --> 00:11:02,345 employer are we talking about? What kind of 311 00:11:02,345 --> 00:11:04,684 benefits is that employer subscribed to? 312 00:11:05,129 --> 00:11:07,610 So I think that the moments that matter 313 00:11:07,610 --> 00:11:08,830 for the member are 314 00:11:09,290 --> 00:11:11,210 onboarding and educating the member. I think that 315 00:11:11,210 --> 00:11:14,029 is a common theme there across all markets. 316 00:11:14,809 --> 00:11:17,965 Customer service becomes an important one, and then 317 00:11:17,965 --> 00:11:21,085 access to care and provider experience becomes an 318 00:11:21,085 --> 00:11:23,725 important one. So across all three markets, those 319 00:11:23,725 --> 00:11:24,945 are the common denominators. 320 00:11:25,725 --> 00:11:27,485 But there are so many nuances as you 321 00:11:27,485 --> 00:11:29,970 can imagine. Onboarding a Medicare member would be 322 00:11:29,970 --> 00:11:32,129 very, very different than onboarding a commercial member. 323 00:11:32,129 --> 00:11:33,829 So the devil is really in the details. 324 00:11:34,209 --> 00:11:35,809 You know, one may think that, yes, these 325 00:11:35,809 --> 00:11:37,569 are the areas we want to improve and 326 00:11:37,569 --> 00:11:40,850 kinda get more sophisticated on. But the playbook 327 00:11:40,850 --> 00:11:43,264 for each one of these market is extremely 328 00:11:43,324 --> 00:11:44,924 nuanced and different. And I think those are 329 00:11:44,924 --> 00:11:47,565 the areas, right, which we essentially offer a 330 00:11:47,565 --> 00:11:49,345 lot more value for our customers. 331 00:11:50,204 --> 00:11:52,764 In considering everything we've we've we've talked about 332 00:11:52,764 --> 00:11:53,664 so far, Nirneh, 333 00:11:54,284 --> 00:11:56,049 what do you believe should be on the 334 00:11:56,049 --> 00:11:57,029 top of the innovation 335 00:11:57,570 --> 00:11:59,350 agenda this year for payers? 336 00:12:00,610 --> 00:12:01,250 Yeah. I think, 337 00:12:01,889 --> 00:12:03,990 I think it's it's really enabling 338 00:12:04,370 --> 00:12:07,029 more integrated, connected journey for 339 00:12:07,409 --> 00:12:08,070 the members 340 00:12:08,915 --> 00:12:11,335 and and your internal stakeholders alike. 341 00:12:11,955 --> 00:12:12,455 So, 342 00:12:13,554 --> 00:12:14,054 personalization 343 00:12:14,835 --> 00:12:15,815 of benefits, 344 00:12:16,274 --> 00:12:17,815 which allows to meet 345 00:12:18,675 --> 00:12:20,535 more competitive needs in the marketplace, 346 00:12:21,235 --> 00:12:24,054 much more member facing needs in the marketplace, 347 00:12:25,129 --> 00:12:27,710 partnerships with providers and different entities, 348 00:12:28,330 --> 00:12:30,809 especially on value based and other shared risk 349 00:12:30,809 --> 00:12:34,330 arrangement that kinda start shifting the the output 350 00:12:34,330 --> 00:12:35,629 to the outcomes conversation. 351 00:12:36,330 --> 00:12:38,945 So we're excited about that trend line. Mhmm. 352 00:12:39,184 --> 00:12:40,804 But at a at a macro level, 353 00:12:41,184 --> 00:12:43,764 we believe that the more bridging the silos 354 00:12:43,825 --> 00:12:46,144 happen between design and the delivery of the 355 00:12:46,144 --> 00:12:48,485 care, I think that's kind of the shared 356 00:12:48,785 --> 00:12:51,424 space, right, where it's a win win win. 357 00:12:51,424 --> 00:12:51,861 And when I say win win win, and 358 00:12:51,861 --> 00:12:52,154 there are three stakeholders here, there's member, there 359 00:12:52,154 --> 00:12:52,654 is 360 00:12:53,629 --> 00:12:54,690 holders here, there's member, 361 00:12:55,149 --> 00:12:56,830 there's peer, and provider. So how can we 362 00:12:56,830 --> 00:12:58,049 get these three wins? 363 00:12:58,669 --> 00:13:01,789 And it's really founded in how well we 364 00:13:01,789 --> 00:13:02,529 can integrate 365 00:13:02,909 --> 00:13:04,589 the delivery of the care and design of 366 00:13:04,589 --> 00:13:05,250 the care. 367 00:13:05,894 --> 00:13:07,995 AI is making a lot more 368 00:13:08,375 --> 00:13:09,675 lot more of these 369 00:13:10,055 --> 00:13:13,014 use cases much more easier, faster, and more 370 00:13:13,014 --> 00:13:13,514 accessible. 371 00:13:14,455 --> 00:13:16,535 We, we have use cases like how can 372 00:13:16,535 --> 00:13:18,774 we do how can we recommend plan for 373 00:13:18,774 --> 00:13:20,855 a particular member or a particular market. Right? 374 00:13:20,855 --> 00:13:21,355 So 375 00:13:21,789 --> 00:13:24,269 your your journey of onboarding a member becomes 376 00:13:24,269 --> 00:13:25,410 a lot more smarter 377 00:13:26,350 --> 00:13:29,470 knowing what was the delivery of care formula, 378 00:13:29,470 --> 00:13:32,029 right, which worked for that member. So with 379 00:13:32,029 --> 00:13:34,929 all the data available between peers and provider, 380 00:13:35,355 --> 00:13:38,075 some of these use cases on enabling a 381 00:13:38,075 --> 00:13:41,274 connected journey becomes much more easier. And those 382 00:13:41,274 --> 00:13:43,034 are the value propositions we bring to the 383 00:13:43,034 --> 00:13:43,934 table at Simplify. 384 00:13:44,315 --> 00:13:46,554 Yeah. And can we talk about I think 385 00:13:46,554 --> 00:13:47,610 that's that's, 386 00:13:48,169 --> 00:13:50,409 an important point. Maybe we can go even 387 00:13:50,409 --> 00:13:53,049 deeper for for our final question here, which 388 00:13:53,049 --> 00:13:53,950 is really about, 389 00:13:54,490 --> 00:13:56,649 you know, they're either payers are gonna have 390 00:13:56,649 --> 00:13:58,809 to partner, obviously, here or they're gonna have 391 00:13:58,809 --> 00:14:00,730 to to to build solutions of their own 392 00:14:00,730 --> 00:14:02,774 to sort of get to this future state, 393 00:14:03,254 --> 00:14:05,335 fill this need that members have, and, you 394 00:14:05,335 --> 00:14:06,934 know, the the payers that do this are 395 00:14:06,934 --> 00:14:08,215 gonna be the ones that thrive in the 396 00:14:08,215 --> 00:14:10,455 future. So I guess the final question is, 397 00:14:10,455 --> 00:14:12,394 what should they be looking for in partners, 398 00:14:12,695 --> 00:14:14,535 or what kind of capability should be looking 399 00:14:14,535 --> 00:14:16,500 for as they go to build their own, 400 00:14:16,820 --> 00:14:18,740 so that they can get to this future 401 00:14:18,740 --> 00:14:20,659 state of a more connected future for for 402 00:14:20,659 --> 00:14:22,820 members? Yeah. No. I think that's a great 403 00:14:22,820 --> 00:14:25,059 that that's a great question. So it's almost 404 00:14:25,059 --> 00:14:26,120 like, you know, 405 00:14:26,500 --> 00:14:27,720 there are two constraints, 406 00:14:28,580 --> 00:14:31,299 which which which we see. The the first 407 00:14:31,299 --> 00:14:32,120 one is 408 00:14:32,954 --> 00:14:35,134 really invest and improve upon 409 00:14:35,674 --> 00:14:38,095 personalizing your experience for your members. 410 00:14:39,034 --> 00:14:41,355 And on the other end, there is an 411 00:14:41,355 --> 00:14:43,134 incredible pressure of 412 00:14:43,754 --> 00:14:45,134 doing that at scale 413 00:14:45,434 --> 00:14:47,454 without adding a lot more cost. 414 00:14:48,240 --> 00:14:50,259 And if you look at these two constraints, 415 00:14:50,480 --> 00:14:51,940 right, it's inevitable 416 00:14:52,320 --> 00:14:54,580 for you to not leverage platforms. 417 00:14:55,039 --> 00:14:57,120 And what platforms bring to the table, what 418 00:14:57,120 --> 00:14:59,620 platform thinking brings to the table, the technology 419 00:14:59,759 --> 00:15:01,620 which comes into picture here is 420 00:15:02,105 --> 00:15:04,024 it can kinda allow you to kill both 421 00:15:04,024 --> 00:15:06,985 birds with same stone. Right? So on the 422 00:15:06,985 --> 00:15:08,985 on the front line and on your digital 423 00:15:08,985 --> 00:15:11,384 front doors, it can enable a personalized experience 424 00:15:11,384 --> 00:15:13,785 for the member because it's using the data 425 00:15:13,785 --> 00:15:15,884 to have a much more integrated 426 00:15:16,509 --> 00:15:18,769 story, more accessible story for your members. 427 00:15:19,709 --> 00:15:22,750 And, for your back office teams, it brings 428 00:15:22,750 --> 00:15:26,190 incredible automations. So your manual silos goes away, 429 00:15:26,190 --> 00:15:28,750 which is exactly where a lot more admin 430 00:15:28,750 --> 00:15:31,965 savings and cost and a lot more exhaustion, 431 00:15:32,024 --> 00:15:33,884 frankly speaking, because there 432 00:15:34,504 --> 00:15:37,544 are highly regulated environments, which has timelines, which 433 00:15:37,544 --> 00:15:39,384 are high pressure. And there's just a lot 434 00:15:39,384 --> 00:15:41,884 of customers try to kinda endure that. 435 00:15:42,264 --> 00:15:45,065 So having a platform which allows you to 436 00:15:45,065 --> 00:15:45,565 improve, 437 00:15:46,789 --> 00:15:49,129 on personalizing for your members at scale, 438 00:15:49,829 --> 00:15:52,389 at the same time not adding more cost. 439 00:15:52,389 --> 00:15:54,949 Like, we have a story with, our customer 440 00:15:54,949 --> 00:15:57,829 where they improved their NPS score by 12 441 00:15:57,829 --> 00:15:59,929 points without really adding, 442 00:16:00,345 --> 00:16:03,725 you know, any person on their employee staff. 443 00:16:04,184 --> 00:16:06,504 Now it cannot be possible because as you 444 00:16:06,504 --> 00:16:07,524 grow in, 445 00:16:07,944 --> 00:16:10,204 in geographically in more markets, 446 00:16:10,584 --> 00:16:12,044 as you add on more members, 447 00:16:12,424 --> 00:16:14,044 if you're not adding more 448 00:16:14,929 --> 00:16:15,829 admin cost, 449 00:16:16,769 --> 00:16:18,690 it it's a litmus test, right, on how 450 00:16:18,690 --> 00:16:20,769 the degree of automation and sophistication you have 451 00:16:20,769 --> 00:16:23,250 in your operating protocols. Those are the areas 452 00:16:23,250 --> 00:16:25,089 which we we think are going to be 453 00:16:25,089 --> 00:16:26,309 important for, 454 00:16:27,404 --> 00:16:30,365 for journey onwards. Yeah. Appreciate that that sort 455 00:16:30,365 --> 00:16:32,924 of, it it's very easy to conceptualize the 456 00:16:32,924 --> 00:16:34,205 way you put it in terms of this 457 00:16:34,205 --> 00:16:36,284 becomes a litmus test in terms of how 458 00:16:36,284 --> 00:16:38,065 effective the technology is being. 459 00:16:39,004 --> 00:16:40,524 And, Nirne, it was a pleasure speaking with 460 00:16:40,524 --> 00:16:41,884 you today. Thank you so much for coming 461 00:16:41,884 --> 00:16:44,259 on the podcast. Yeah. Sounds good. Likewise, thank 462 00:16:44,259 --> 00:16:45,480 you so much, and, 463 00:16:46,100 --> 00:16:47,720 have a nice day. Yeah. Absolutely. 464 00:16:48,419 --> 00:16:50,899 I also wanna thank Simplify Healthcare for sponsoring 465 00:16:50,899 --> 00:16:51,799 today's podcast. 466 00:16:52,166 --> 00:16:53,846 Invite our listeners to tune in to more 467 00:16:53,846 --> 00:16:56,725 podcasts from Becker's Healthcare by visiting our podcast 468 00:16:56,725 --> 00:16:58,905 page at beckershospitalreview.com. 469 00:16:59,046 --> 00:17:00,485 Hope you all have a wonderful rest of 470 00:17:00,485 --> 00:17:01,145 your day.