1 00:00:00,160 --> 00:00:01,919 Hi, everyone. This is Lucas Voss with Becker's 2 00:00:01,919 --> 00:00:03,600 Healthcare. Thanks so much for tuning in to 3 00:00:03,600 --> 00:00:06,000 the Becker's Healthcare podcast series. It's great to 4 00:00:06,000 --> 00:00:08,240 have you. Today, we're going to talk about 5 00:00:08,240 --> 00:00:08,740 capitalizing 6 00:00:09,199 --> 00:00:11,219 on momentum, payer perspectives 7 00:00:11,759 --> 00:00:15,539 on value based care in 2025. 8 00:00:15,925 --> 00:00:18,725 And joining me for today's discussion, very excited 9 00:00:18,725 --> 00:00:21,285 to have her, is Carrie Kettleson, president at 10 00:00:21,285 --> 00:00:23,605 Vertex Health. Carrie, thanks so much for being 11 00:00:23,605 --> 00:00:25,144 here today. It's great to have you. 12 00:00:25,525 --> 00:00:28,324 You're so welcome. Happy to be here. Thank 13 00:00:28,324 --> 00:00:30,185 you for the warm welcome. 14 00:00:30,829 --> 00:00:32,909 Absolutely. It's fantastic to have you. Well, before 15 00:00:32,909 --> 00:00:35,310 we get started here, could you introduce yourself 16 00:00:35,310 --> 00:00:37,310 to our audience and share a bit about 17 00:00:37,310 --> 00:00:38,530 your work in health care? 18 00:00:39,390 --> 00:00:41,950 I'd be happy to. Who doesn't like to 19 00:00:41,950 --> 00:00:44,210 talk about themselves? Right? Right. 20 00:00:46,164 --> 00:00:49,204 So currently, I serve as the president of 21 00:00:49,204 --> 00:00:50,185 Vertex Health. 22 00:00:50,564 --> 00:00:53,204 I lead a team focused on delivering technology 23 00:00:53,204 --> 00:00:56,585 enabled solutions that drive financial and clinical 24 00:00:57,539 --> 00:00:59,559 performance across the health care ecosystems. 25 00:01:00,420 --> 00:01:03,399 So at Vertex Health, we offer bespoke solutions 26 00:01:03,539 --> 00:01:05,000 for both payers and providers. 27 00:01:05,619 --> 00:01:08,920 Our solutions are focused on clinical data retrieval, 28 00:01:09,540 --> 00:01:10,040 interoperability, 29 00:01:11,295 --> 00:01:12,515 risk adjustment coding, 30 00:01:12,894 --> 00:01:14,515 quality, heat of subtraction, 31 00:01:15,055 --> 00:01:16,834 and advisory and consulting 32 00:01:17,935 --> 00:01:20,334 around all of these areas. We also have 33 00:01:20,334 --> 00:01:22,734 a platform that's a self-service tool that can 34 00:01:22,734 --> 00:01:25,215 be used by both payers and providers alike 35 00:01:25,215 --> 00:01:26,754 for any of these use cases. 36 00:01:27,590 --> 00:01:29,269 One quick thing that I'd also like to 37 00:01:29,269 --> 00:01:31,750 mention is, you know, with our services and 38 00:01:31,750 --> 00:01:32,409 our resources, 39 00:01:32,790 --> 00:01:34,170 especially around coding, 40 00:01:34,549 --> 00:01:36,790 we have the largest employed coding team in 41 00:01:36,790 --> 00:01:37,450 the industry 42 00:01:38,069 --> 00:01:40,704 specific to risk adjustment. We have have over 43 00:01:40,704 --> 00:01:41,665 13,000 44 00:01:41,665 --> 00:01:44,885 coders with experience and expertise in all forms 45 00:01:44,944 --> 00:01:46,325 of risk adjustment coding, 46 00:01:46,784 --> 00:01:48,805 all lines of business. So that includes 47 00:01:49,665 --> 00:01:51,525 Medicare, ACA, Medicaid, 48 00:01:52,319 --> 00:01:54,420 as well as Radb e purposes. 49 00:01:54,880 --> 00:01:56,180 We offer retrospective, 50 00:01:56,799 --> 00:01:58,099 prospective, concurrent, 51 00:01:58,400 --> 00:01:59,540 and claims validation. 52 00:02:00,000 --> 00:02:02,819 So a little bit about Vertex Health there. 53 00:02:03,200 --> 00:02:05,120 I think for myself, over the course of 54 00:02:05,120 --> 00:02:08,294 the career my career, I've had a unique 55 00:02:08,354 --> 00:02:08,854 opportunity 56 00:02:09,155 --> 00:02:11,394 to work across a full spectrum of health 57 00:02:11,394 --> 00:02:11,894 care. 58 00:02:12,275 --> 00:02:15,254 So operating on behalf of payers, providers, 59 00:02:15,634 --> 00:02:18,055 and large integrated health systems. 60 00:02:18,995 --> 00:02:21,209 That end to end experience has really given 61 00:02:21,209 --> 00:02:23,069 me a deep practical understanding 62 00:02:23,689 --> 00:02:25,389 of how health care is delivered, 63 00:02:26,090 --> 00:02:27,469 reimbursed, and optimized. 64 00:02:28,250 --> 00:02:30,909 It's also really shaped my ability to identify 65 00:02:30,969 --> 00:02:33,049 where friction exists. You know, what are the 66 00:02:33,049 --> 00:02:35,574 problems that we need to solve and how 67 00:02:35,574 --> 00:02:36,474 to remove it, 68 00:02:36,935 --> 00:02:38,715 whether it's through data automation 69 00:02:39,014 --> 00:02:41,194 or better alignment across stakeholders. 70 00:02:42,055 --> 00:02:44,715 So I'm very passionate about helping organizations 71 00:02:45,094 --> 00:02:47,175 scale value based care in ways that are 72 00:02:47,175 --> 00:02:49,675 sustainable, collaborative, and human centered. 73 00:02:50,775 --> 00:02:52,430 And And it's fantastic to have you on 74 00:02:52,430 --> 00:02:54,530 simply because of that tremendous experience 75 00:02:55,310 --> 00:02:58,030 and the problem solving aspect to this. I 76 00:02:58,030 --> 00:03:00,830 wanna jump into our conversation here. The joint 77 00:03:00,830 --> 00:03:03,550 report from the National Association of Accountable ACOs 78 00:03:03,550 --> 00:03:05,090 and health tech company Innovexxer, 79 00:03:05,594 --> 00:03:07,614 They showed more than 60%, 80 00:03:08,074 --> 00:03:11,375 sizable number of respondents, anticipate increased revenue 81 00:03:11,834 --> 00:03:14,555 from value based care, and we'll refer to 82 00:03:14,555 --> 00:03:16,555 it as VBC just to make it a 83 00:03:16,555 --> 00:03:17,455 little bit shorter. 84 00:03:18,235 --> 00:03:20,254 And I'm curious from your perspective, 85 00:03:21,099 --> 00:03:23,580 what's driving this momentum right now, and what 86 00:03:23,580 --> 00:03:26,060 are some of the implications for pairs as 87 00:03:26,060 --> 00:03:27,680 they're navigating this environment? 88 00:03:28,939 --> 00:03:31,099 Great question. I think so let's talk a 89 00:03:31,099 --> 00:03:33,314 little bit about, you know, kind of three 90 00:03:33,314 --> 00:03:35,955 points on the momentum and then get into 91 00:03:35,955 --> 00:03:36,775 those implications. 92 00:03:37,715 --> 00:03:39,795 I think a couple of key pieces on 93 00:03:39,795 --> 00:03:41,094 the drivers for momentum. 94 00:03:41,474 --> 00:03:43,814 Number one would be just policy and regulatory 95 00:03:44,034 --> 00:03:44,534 support. 96 00:03:45,180 --> 00:03:47,419 CMS has set an ambitious goal to have 97 00:03:47,419 --> 00:03:48,800 all Medicare beneficiaries 98 00:03:49,180 --> 00:03:52,000 in an accountable care relationship by 2030. 99 00:03:52,860 --> 00:03:55,120 This policy direction is accelerating 100 00:03:55,419 --> 00:03:58,794 the adoption of alternative payment models and it's 101 00:03:58,794 --> 00:04:01,935 providing a clear pathway for providers and payers 102 00:04:02,395 --> 00:04:05,034 to transition from fee for service to value 103 00:04:05,034 --> 00:04:05,855 based arrangements. 104 00:04:06,555 --> 00:04:09,055 I think the second big piece would be 105 00:04:09,194 --> 00:04:10,655 advancements in technology 106 00:04:11,810 --> 00:04:14,790 and really around the integration of advanced technology 107 00:04:14,849 --> 00:04:17,810 such as AI and predictive analytics. It's really 108 00:04:17,810 --> 00:04:20,870 enabling payers and providers to better manage population 109 00:04:20,930 --> 00:04:21,430 health. 110 00:04:21,970 --> 00:04:23,670 And these tools are really facilitating 111 00:04:24,129 --> 00:04:25,270 proactive care. 112 00:04:25,824 --> 00:04:28,785 They can identify at risk patients as early 113 00:04:28,785 --> 00:04:31,125 as possible. There's personalized interventions. 114 00:04:32,064 --> 00:04:34,464 And, ultimately, this leads to improved outcomes and 115 00:04:34,464 --> 00:04:36,225 cost savings, which is the name of the 116 00:04:36,225 --> 00:04:38,379 game. It's what we're all after. And then 117 00:04:38,379 --> 00:04:40,459 finally, I would say that there's, you know, 118 00:04:40,459 --> 00:04:43,579 financial incentives and market dynamics that are playing 119 00:04:43,579 --> 00:04:44,560 a role here. 120 00:04:45,019 --> 00:04:47,740 The financial benefits of VBC, you know, whether 121 00:04:47,740 --> 00:04:50,620 it's shared savings or performance based incentives, are 122 00:04:50,620 --> 00:04:53,264 becoming more and more apparent. And then additionally, 123 00:04:53,324 --> 00:04:56,604 you've got influence from private equity interest in 124 00:04:56,604 --> 00:04:58,064 physician practice management. 125 00:04:58,444 --> 00:04:59,264 That's increasing. 126 00:04:59,884 --> 00:05:03,245 We're seeing, you know, particularly in specialties that 127 00:05:03,245 --> 00:05:04,625 align with VBC, 128 00:05:05,084 --> 00:05:07,485 and it's further driving the adoption of these 129 00:05:07,485 --> 00:05:07,985 models. 130 00:05:09,459 --> 00:05:12,019 As far as implications for payers, you know, 131 00:05:12,019 --> 00:05:15,319 as as payers navigate this evolving landscape, several 132 00:05:15,540 --> 00:05:16,839 considerations are paramount. 133 00:05:17,939 --> 00:05:19,079 Strategic partnerships, 134 00:05:19,379 --> 00:05:22,500 critically important. So collaborating with value based care 135 00:05:22,500 --> 00:05:25,375 enablers and streamlining the transition process. 136 00:05:26,314 --> 00:05:29,055 You know, these partnerships help reduce administrative 137 00:05:29,355 --> 00:05:32,495 burdens. They standardize payer provider interactions, 138 00:05:33,675 --> 00:05:35,055 enhancing care coordination, 139 00:05:35,514 --> 00:05:38,175 ultimately leading to those better health outcomes. 140 00:05:39,350 --> 00:05:42,009 Data is all always a big topic here, 141 00:05:42,149 --> 00:05:43,689 specifically around integration 142 00:05:44,069 --> 00:05:44,810 and analytics. 143 00:05:45,509 --> 00:05:48,230 So investing in that robust data infrastructure is 144 00:05:48,230 --> 00:05:48,730 crucial. 145 00:05:49,350 --> 00:05:50,490 Seamless integration 146 00:05:50,790 --> 00:05:54,555 of clinical, financial, operational data, it allows for 147 00:05:54,714 --> 00:05:58,894 informed decision making, effective risk management, and targeted 148 00:05:59,115 --> 00:06:02,414 interventions that improve patient care and reduce costs. 149 00:06:03,035 --> 00:06:04,954 And then finally, you know, at the heart 150 00:06:04,954 --> 00:06:06,555 of all this is the patient and the 151 00:06:06,555 --> 00:06:08,735 member. So member engagement and support, 152 00:06:09,470 --> 00:06:12,370 engaging members through personalized care management programs, 153 00:06:12,990 --> 00:06:14,050 wellness incentives, 154 00:06:14,670 --> 00:06:17,649 supporting, you know, for social determinants of health, 155 00:06:18,029 --> 00:06:20,769 those can enhance the participation in these BBC 156 00:06:20,910 --> 00:06:21,410 initiatives. 157 00:06:21,935 --> 00:06:24,335 And this approach also fosters a more patient 158 00:06:24,335 --> 00:06:27,134 centered care model and also contributes to better 159 00:06:27,134 --> 00:06:27,955 health outcomes. 160 00:06:28,975 --> 00:06:30,654 Those are the kind of the high points. 161 00:06:30,654 --> 00:06:33,055 I think in summary, I would say the 162 00:06:33,055 --> 00:06:35,395 anticipated increase in revenue from 163 00:06:35,769 --> 00:06:38,269 VBC is driven by supportive policies, 164 00:06:38,810 --> 00:06:39,949 technology advancement, 165 00:06:40,409 --> 00:06:41,550 financial incentives. 166 00:06:42,009 --> 00:06:45,289 And payers that embrace these strategic partnerships, they 167 00:06:45,289 --> 00:06:47,689 invest in the data integration, and they focus 168 00:06:47,689 --> 00:06:48,750 on member engagement, 169 00:06:49,314 --> 00:06:52,115 will be well positioned to thrive in this 170 00:06:52,115 --> 00:06:52,615 evolving 171 00:06:52,995 --> 00:06:54,055 health care landscape. 172 00:06:55,314 --> 00:06:56,915 Yeah. Absolutely. There's a lot of moving parts 173 00:06:56,915 --> 00:06:58,514 of this, which I think you all mind 174 00:06:58,514 --> 00:07:01,014 very, very nicely, and that's obviously making things 175 00:07:01,314 --> 00:07:02,935 more complicated for organizations. 176 00:07:03,475 --> 00:07:05,290 That's why they need good partners as as 177 00:07:05,290 --> 00:07:06,029 you've outlined. 178 00:07:06,970 --> 00:07:09,129 There's obviously a lot of optimism around this. 179 00:07:09,129 --> 00:07:11,290 There's a lot of positives, a lot of 180 00:07:11,290 --> 00:07:13,870 talk about growth and the opportunities this brings, 181 00:07:14,250 --> 00:07:16,475 but there's also the worry about sort of 182 00:07:16,475 --> 00:07:18,634 the barriers that come with it and that 183 00:07:18,634 --> 00:07:19,134 organizations 184 00:07:19,595 --> 00:07:20,814 are presented with. 185 00:07:21,194 --> 00:07:24,475 How should payer organizations think about supporting provider 186 00:07:24,475 --> 00:07:27,194 readiness in all of this while keeping their 187 00:07:27,194 --> 00:07:28,574 own strategic goals 188 00:07:29,035 --> 00:07:29,774 in mind? 189 00:07:31,169 --> 00:07:33,569 That's a great question, and one that's more 190 00:07:33,569 --> 00:07:35,729 relevant than ever. Not only just what we're 191 00:07:35,729 --> 00:07:37,750 talking about today, but recent 192 00:07:38,689 --> 00:07:41,350 items in the news, recent policy and regulatory 193 00:07:41,410 --> 00:07:43,669 things that are being considered that are still 194 00:07:43,834 --> 00:07:46,314 to be determined are going to influence this 195 00:07:46,314 --> 00:07:49,995 as well. Mhmm. Payer organizations are under immense 196 00:07:49,995 --> 00:07:51,834 pressure. They need to grow, they need to 197 00:07:51,834 --> 00:07:53,754 manage their risk, and they need to improve 198 00:07:53,754 --> 00:07:54,654 patient outcomes. 199 00:07:55,274 --> 00:07:58,154 But none of that is possible without strong 200 00:07:58,154 --> 00:07:59,879 aligned partnerships with providers. 201 00:08:00,660 --> 00:08:03,459 And supporting provider readiness, you know, isn't just 202 00:08:03,459 --> 00:08:06,040 a nice to have. It's essential for advancing 203 00:08:06,100 --> 00:08:06,839 shared value. 204 00:08:07,699 --> 00:08:09,160 In order to do this effectively, 205 00:08:09,540 --> 00:08:11,639 payers need to think beyond transactional 206 00:08:12,019 --> 00:08:12,519 relationships 207 00:08:12,995 --> 00:08:15,335 and shift more towards strategic collaboration, 208 00:08:16,355 --> 00:08:18,694 which means investing in data transparency, 209 00:08:19,314 --> 00:08:23,154 workflow integration, and tools that truly support providers 210 00:08:23,154 --> 00:08:24,295 at the point of care. 211 00:08:25,089 --> 00:08:26,769 You know, it it also I think it 212 00:08:26,769 --> 00:08:27,669 means listening. 213 00:08:28,050 --> 00:08:31,729 Mhmm. Understanding the operational realities provider space and 214 00:08:31,729 --> 00:08:34,289 co designing solutions that align with their capacity 215 00:08:34,289 --> 00:08:35,110 and incentives. 216 00:08:35,970 --> 00:08:38,289 At the same time, payer organizations have to 217 00:08:38,289 --> 00:08:41,065 stay grounded in their own strategic goals. The 218 00:08:41,065 --> 00:08:41,884 key is to identify 219 00:08:42,264 --> 00:08:43,004 the overlap 220 00:08:43,625 --> 00:08:46,125 in areas where provider success directly 221 00:08:46,504 --> 00:08:49,865 aligns and supports payer outcomes, whether it's improved 222 00:08:49,865 --> 00:08:52,925 risk adjustment, quality metrics, or patient experience. 223 00:08:53,860 --> 00:08:56,740 And by approaching growth as a joint effort 224 00:08:56,740 --> 00:08:59,799 where you've got shared accountability and aligned incentives, 225 00:09:00,340 --> 00:09:02,100 I believe we can move the industry forward 226 00:09:02,100 --> 00:09:04,200 in a way that's both scalable and sustainable. 227 00:09:05,540 --> 00:09:06,899 You know, that's one of the things we've 228 00:09:06,899 --> 00:09:09,144 seen at Vertex Health. We've seen the power 229 00:09:09,144 --> 00:09:12,024 of tailored enablement where payers give providers the 230 00:09:12,024 --> 00:09:15,384 insights and infrastructure they need while preserving that 231 00:09:15,384 --> 00:09:16,284 clinical freedom. 232 00:09:16,825 --> 00:09:19,544 And this balance is what drives long term 233 00:09:19,544 --> 00:09:20,044 success. 234 00:09:21,759 --> 00:09:24,159 Yeah. Absolutely. And you've touched on on it 235 00:09:24,159 --> 00:09:26,480 earlier and now again, which I think is 236 00:09:26,480 --> 00:09:28,799 very, very crucial to this. Right? We talk 237 00:09:28,799 --> 00:09:31,199 about technology. We talk about you've touched on 238 00:09:31,199 --> 00:09:31,699 AI, 239 00:09:32,000 --> 00:09:33,919 but you've also, you know, talked about data 240 00:09:33,919 --> 00:09:36,345 analytics and insights. And and the survey that 241 00:09:36,345 --> 00:09:38,445 we highlighted at the beginning of our conversation 242 00:09:39,065 --> 00:09:39,565 also 243 00:09:40,024 --> 00:09:42,524 showed that 70% of respondents were 244 00:09:43,304 --> 00:09:46,184 expressing confidence in these tools and AI and 245 00:09:46,184 --> 00:09:48,205 technology to scale their strategies. 246 00:09:49,210 --> 00:09:52,190 How are you seeing payers use these technologies 247 00:09:52,570 --> 00:09:53,309 to improve? 248 00:09:53,690 --> 00:09:55,450 And I also am really interested in this 249 00:09:55,450 --> 00:09:55,950 too. 250 00:09:56,330 --> 00:09:57,309 Are you particularly 251 00:09:57,690 --> 00:09:59,929 excited about anything that's coming up that you've 252 00:09:59,929 --> 00:10:01,769 been seeing heading into the second half of 253 00:10:01,769 --> 00:10:02,590 the year here? 254 00:10:03,835 --> 00:10:07,035 Great question. So, yes, I'm excited. So I'll 255 00:10:07,035 --> 00:10:09,434 talk a little bit about high level, and 256 00:10:09,434 --> 00:10:10,955 then I'll talk about some of the pieces 257 00:10:10,955 --> 00:10:12,014 that I think particularly 258 00:10:12,394 --> 00:10:14,555 are exciting and could really have a major 259 00:10:14,555 --> 00:10:16,095 influence in this space. 260 00:10:17,179 --> 00:10:20,059 AI and data analytics are absolutely transforming how 261 00:10:20,059 --> 00:10:21,759 payers approach value based care. 262 00:10:22,139 --> 00:10:23,279 We're seeing organizations 263 00:10:23,659 --> 00:10:26,379 use these tools to identify care gaps. They're 264 00:10:26,379 --> 00:10:28,000 stratifying patient risk. 265 00:10:28,539 --> 00:10:30,399 They can predict future utilization 266 00:10:30,700 --> 00:10:32,000 with impressive accuracy. 267 00:10:32,674 --> 00:10:35,814 So this allows for more proactive targeted interventions 268 00:10:36,434 --> 00:10:38,834 that not only improve outcomes, but they drive 269 00:10:38,834 --> 00:10:41,254 the efficiency and the cost savings. Mhmm. 270 00:10:41,554 --> 00:10:44,115 What's exciting right now is the shift from 271 00:10:44,115 --> 00:10:47,894 retrospective reporting to real time actionable insights. 272 00:10:48,459 --> 00:10:49,200 For example, 273 00:10:49,580 --> 00:10:52,299 using an AI driven coding assistant or a 274 00:10:52,299 --> 00:10:54,399 predictive model at the point of care. 275 00:10:54,940 --> 00:10:58,080 This helps providers document accurately in the moment, 276 00:10:58,299 --> 00:11:01,100 so this improves risk adjustment reporting and also 277 00:11:01,100 --> 00:11:03,919 quality scores without adding administrative burden. 278 00:11:04,835 --> 00:11:06,595 Heading into the second half of the year, 279 00:11:06,595 --> 00:11:07,335 I'm particularly 280 00:11:07,875 --> 00:11:10,855 excited about the advancements in NLP and automation 281 00:11:11,475 --> 00:11:12,695 and clinical workflows, 282 00:11:13,394 --> 00:11:16,355 and this includes AgenTek AI and the use 283 00:11:16,355 --> 00:11:19,154 of large language models, which I'll expand on 284 00:11:19,154 --> 00:11:19,894 in a moment. 285 00:11:20,370 --> 00:11:22,529 But these technologies are finally getting to a 286 00:11:22,529 --> 00:11:24,370 place where they can ease the load on 287 00:11:24,370 --> 00:11:27,250 both payers and providers, and that's critical for 288 00:11:27,250 --> 00:11:27,750 scaling 289 00:11:28,289 --> 00:11:29,509 VBC sustainably. 290 00:11:31,169 --> 00:11:33,669 So a little bit about why I'm excited 291 00:11:33,889 --> 00:11:36,585 in some of these these pieces. So AgenTic 292 00:11:36,585 --> 00:11:37,085 AI 293 00:11:37,865 --> 00:11:39,945 is is the next big leap in health 294 00:11:39,945 --> 00:11:40,684 care technology. 295 00:11:41,304 --> 00:11:44,504 Unlike traditional AI, it doesn't just analyze the 296 00:11:44,504 --> 00:11:45,965 data. It takes action. 297 00:11:46,904 --> 00:11:49,004 So think of it as a virtual teammate 298 00:11:49,065 --> 00:11:50,365 that can schedule appointments, 299 00:11:50,860 --> 00:11:54,379 close care gaps, optimize coding, or even support 300 00:11:54,379 --> 00:11:56,559 clinical decision making in real time. 301 00:11:57,179 --> 00:11:59,919 It has the power to help reduce administrative 302 00:12:00,139 --> 00:12:03,600 burden, improve outcomes, and scale value based care. 303 00:12:04,295 --> 00:12:06,615 And the real power is it gives time 304 00:12:06,615 --> 00:12:09,014 back to providers and lets them focus on 305 00:12:09,014 --> 00:12:10,154 what matters most, 306 00:12:10,535 --> 00:12:11,595 caring for patients. 307 00:12:12,535 --> 00:12:14,955 And as we think about large language models, 308 00:12:15,175 --> 00:12:17,894 they're actually at the heart of several of 309 00:12:17,894 --> 00:12:18,960 these AI categories, 310 00:12:19,920 --> 00:12:20,899 especially NLP, 311 00:12:21,679 --> 00:12:24,019 generative AI, and agentic AI. 312 00:12:24,480 --> 00:12:27,460 So LLMs are large language models, 313 00:12:27,840 --> 00:12:30,500 very heavy buzzword right now in the industry. 314 00:12:30,879 --> 00:12:33,014 They're really the engine behind a lot of 315 00:12:33,174 --> 00:12:35,274 innovation we're seeing in health care AI. 316 00:12:35,975 --> 00:12:36,475 They 317 00:12:37,174 --> 00:12:41,095 power everything from clinical documentation assistance to virtual 318 00:12:41,095 --> 00:12:41,995 care agents. 319 00:12:42,695 --> 00:12:45,095 What's unique about them and different is that 320 00:12:45,095 --> 00:12:47,975 they it has the ability to emulate human 321 00:12:47,975 --> 00:12:48,475 reasoning. 322 00:12:48,960 --> 00:12:51,620 And so their ability to understand, summarize, 323 00:12:51,920 --> 00:12:54,639 and generate human like language allows them to 324 00:12:54,639 --> 00:12:55,540 extract insights 325 00:12:56,320 --> 00:12:59,519 from unstructured data, like clinical notes or medical 326 00:12:59,519 --> 00:13:00,019 records, 327 00:13:00,559 --> 00:13:03,120 and even draft progress notes, patient letters, or 328 00:13:03,120 --> 00:13:04,179 prior auth appeals. 329 00:13:05,254 --> 00:13:07,575 So LLMs can play a central role in 330 00:13:07,575 --> 00:13:10,394 agentic AI because not only can they interpret 331 00:13:10,615 --> 00:13:13,495 intent, but they can also take action across 332 00:13:13,495 --> 00:13:13,995 systems. 333 00:13:14,375 --> 00:13:16,855 So whether it's recommending next steps for care 334 00:13:16,855 --> 00:13:19,195 or helping automate revenue cycle tasks, 335 00:13:19,690 --> 00:13:21,709 they're enabling a more conversational, 336 00:13:22,250 --> 00:13:25,129 intelligent layer of automation that's finally intuitive for 337 00:13:25,129 --> 00:13:26,909 clinicians to to use. 338 00:13:28,089 --> 00:13:30,589 In in short, I would say LLMs are 339 00:13:30,649 --> 00:13:33,449 the foundation of a more natural human human 340 00:13:33,449 --> 00:13:36,225 centered AI in health care, and they're helping 341 00:13:36,225 --> 00:13:37,845 us turn data into action 342 00:13:38,225 --> 00:13:40,165 in a way that's scalable and sustainable. 343 00:13:40,705 --> 00:13:43,024 And all of these pieces are are absolutely 344 00:13:43,024 --> 00:13:45,845 critical for success in BBC and that ongoing 345 00:13:45,904 --> 00:13:49,205 partnership and collaboration between payers and providers. 346 00:13:50,769 --> 00:13:51,269 Yeah. 347 00:13:51,570 --> 00:13:53,250 You outlined that beautifully. I think I'm just 348 00:13:53,250 --> 00:13:55,589 gonna cut that to explain LLMs. 349 00:13:56,690 --> 00:13:57,669 That was a fantastic 350 00:13:58,049 --> 00:14:00,529 fantastic explanation, and there's so much happening in 351 00:14:00,529 --> 00:14:02,529 this space. Carrie, thank you so much for 352 00:14:02,529 --> 00:14:04,690 being on today and sharing your insights. This 353 00:14:04,690 --> 00:14:06,070 was a fantastic conversation. 354 00:14:07,705 --> 00:14:10,524 Thank you. I I've enjoyed the conversation. 355 00:14:10,904 --> 00:14:12,504 I think if I had to add one 356 00:14:12,504 --> 00:14:14,365 thing, it's just important 357 00:14:14,904 --> 00:14:17,225 how important it is to stay people focused 358 00:14:17,225 --> 00:14:18,445 in all of this. 359 00:14:18,789 --> 00:14:21,929 With all the buzz around AI, data, innovation, 360 00:14:22,309 --> 00:14:24,149 it's easy to lose sight of the fact 361 00:14:24,149 --> 00:14:26,549 that everything we do, whether it's improving risk 362 00:14:26,549 --> 00:14:27,049 adjustment 363 00:14:27,590 --> 00:14:30,470 or scaling value based care, it's ultimately about 364 00:14:30,470 --> 00:14:33,049 helping real people get better care. 365 00:14:33,365 --> 00:14:35,444 I'm I'm excited about where the industry is 366 00:14:35,444 --> 00:14:38,004 heading, but I'm even more excited about the 367 00:14:38,004 --> 00:14:40,485 potential we have when we bring the right 368 00:14:40,485 --> 00:14:42,664 people, tools, and purpose together. 369 00:14:43,524 --> 00:14:45,444 At the end of the day, progress happens 370 00:14:45,444 --> 00:14:47,684 when we show up, listen, and lead with 371 00:14:47,684 --> 00:14:48,184 intention. 372 00:14:49,049 --> 00:14:50,570 And I think we're on the cusp of 373 00:14:50,570 --> 00:14:52,509 some really meaningful change. 374 00:14:52,970 --> 00:14:55,309 So thank you for having me. Much appreciated. 375 00:14:56,730 --> 00:14:59,149 Yeah. Absolutely. It's more than just the buzzword. 376 00:14:59,209 --> 00:15:00,990 Right? We need to get over the buzzword 377 00:15:01,404 --> 00:15:02,225 to action, 378 00:15:02,524 --> 00:15:04,924 which I think is so key. Thanks again, 379 00:15:04,924 --> 00:15:06,524 Carrie, for being on, and we also want 380 00:15:06,524 --> 00:15:09,004 to thank our podcast sponsor, Vertex Health. You 381 00:15:09,004 --> 00:15:10,684 could tune in to more podcasts from Becker's 382 00:15:10,684 --> 00:15:15,345 Healthcare by visiting our podcast page at beckershospitalreview.com.