1 00:00:00,080 --> 00:00:02,000 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,000 --> 00:00:03,859 Becker's Payer Issues podcast. 3 00:00:04,400 --> 00:00:06,240 Thrilled today to be joined by Scott Burton, 4 00:00:06,240 --> 00:00:08,720 who is the market president for Providence Health 5 00:00:08,720 --> 00:00:10,099 Plans commercial business. 6 00:00:10,400 --> 00:00:12,160 Scott, thanks so much for taking the time 7 00:00:12,160 --> 00:00:13,939 to be with me on the podcast today. 8 00:00:14,000 --> 00:00:15,394 Yeah, Jacob. It's great to join you. Thank 9 00:00:15,394 --> 00:00:17,714 you for inviting me. Absolutely. And before we 10 00:00:17,714 --> 00:00:19,074 dive into everything we wanna talk with you 11 00:00:19,074 --> 00:00:21,394 about, a few timely trends going on in 12 00:00:21,394 --> 00:00:22,994 the industry, can you tell us a little 13 00:00:22,994 --> 00:00:25,314 bit more about yourself, your background in health 14 00:00:25,314 --> 00:00:26,675 care, and what it is that you do 15 00:00:26,675 --> 00:00:28,535 today at Providence Health Plan? 16 00:00:29,309 --> 00:00:31,070 Sure. I've been in in health care now 17 00:00:31,070 --> 00:00:32,289 about fifteen years. 18 00:00:32,670 --> 00:00:34,590 This is actually my second career. I made 19 00:00:34,590 --> 00:00:36,909 the intentional choice to join health care and 20 00:00:36,909 --> 00:00:39,009 and certainly health insurance in in particular 21 00:00:39,469 --> 00:00:41,549 after my daughter was born. I would say 22 00:00:41,549 --> 00:00:43,789 it wasn't the best of experiences for our 23 00:00:43,789 --> 00:00:45,875 family. And as I was looking to change 24 00:00:45,875 --> 00:00:48,354 careers, I was questioning what would be my 25 00:00:48,354 --> 00:00:49,094 next calling. 26 00:00:49,634 --> 00:00:50,295 And, ultimately, 27 00:00:51,075 --> 00:00:53,314 I wanted to make health care better for 28 00:00:53,314 --> 00:00:54,534 my daughter's generation. 29 00:00:55,234 --> 00:00:56,549 What could I do to have an active 30 00:00:56,549 --> 00:00:58,309 seat at the table to make health care, 31 00:00:58,549 --> 00:01:00,950 a different experience when she has a child 32 00:01:00,950 --> 00:01:01,689 of her own? 33 00:01:02,070 --> 00:01:04,229 Over the years, I've added improving the health 34 00:01:04,229 --> 00:01:06,709 care experience of my parents' generation as well 35 00:01:06,709 --> 00:01:07,689 as they get older. 36 00:01:08,069 --> 00:01:10,310 And so as I transitioned into health care, 37 00:01:10,549 --> 00:01:12,344 I came from a media background, and so 38 00:01:12,344 --> 00:01:13,484 so I started through communications, 39 00:01:13,864 --> 00:01:14,364 but, 40 00:01:14,745 --> 00:01:16,825 ultimately worked my way over to the business 41 00:01:16,825 --> 00:01:18,665 side. I was with a blues organization in 42 00:01:18,665 --> 00:01:21,084 the Pacific Northwest for about thirteen years, 43 00:01:21,545 --> 00:01:24,584 before transitioning to Providence Health Plan. My charge 44 00:01:24,584 --> 00:01:26,905 here at Providence Health Plan is overseeing our 45 00:01:26,905 --> 00:01:27,405 commercial, 46 00:01:28,030 --> 00:01:30,450 business across all of our operating states. 47 00:01:30,909 --> 00:01:32,530 That includes p and l accountability, 48 00:01:33,469 --> 00:01:34,930 sales, account management, 49 00:01:35,390 --> 00:01:37,950 working with our chief product officer on product 50 00:01:37,950 --> 00:01:38,450 innovation, 51 00:01:38,750 --> 00:01:41,069 and ultimately with all of our executive team 52 00:01:41,069 --> 00:01:43,094 on the sustainable growth of our business. 53 00:01:43,875 --> 00:01:45,795 I've been here a a little over three 54 00:01:45,795 --> 00:01:47,715 and a half years and, just a a 55 00:01:47,715 --> 00:01:49,814 wonderful organization, mission oriented, 56 00:01:50,275 --> 00:01:53,334 and, committed to growth, across the Pacific Northwest. 57 00:01:54,480 --> 00:01:56,239 Fantastic. Well, like I said, we appreciate you 58 00:01:56,239 --> 00:01:58,079 taking the time to chat with us. So 59 00:01:58,079 --> 00:01:59,760 you've been in the industry for a while 60 00:01:59,760 --> 00:02:01,680 now. You've seen a lot of trends and 61 00:02:01,680 --> 00:02:04,019 changes and evolutions over the years. 62 00:02:04,319 --> 00:02:05,840 And one thing, Scott, that we've been hearing 63 00:02:05,840 --> 00:02:08,400 a lot about recently, especially these last few 64 00:02:08,400 --> 00:02:09,955 years, from employers 65 00:02:10,335 --> 00:02:12,254 and certainly from carriers as well, is a 66 00:02:12,254 --> 00:02:13,155 lot more interest 67 00:02:13,455 --> 00:02:16,915 in individual coverage health reimbursement arrangements or ICRA's, 68 00:02:17,694 --> 00:02:20,175 as an alternative to the traditional group model 69 00:02:20,175 --> 00:02:23,155 that everybody knows and is familiar with. So 70 00:02:23,330 --> 00:02:25,830 talk to us about this from your perspective. 71 00:02:26,449 --> 00:02:28,610 Where is demand for this new model coming 72 00:02:28,610 --> 00:02:31,169 from? How do you see it reshaping the 73 00:02:31,169 --> 00:02:33,909 employer sponsored markets in the years to come? 74 00:02:34,370 --> 00:02:36,530 Yeah. I've been been studying ICRS for some 75 00:02:36,530 --> 00:02:38,530 time now. There's a a lot of interest 76 00:02:38,530 --> 00:02:39,944 in them. And, you know, I I I 77 00:02:39,944 --> 00:02:41,865 think if I step back from the product 78 00:02:41,865 --> 00:02:44,025 itself and say, why is the product even 79 00:02:44,025 --> 00:02:44,844 being discussed? 80 00:02:45,305 --> 00:02:47,865 You know, we look at, affordability and the 81 00:02:47,865 --> 00:02:50,344 percentage of an operating budget that health care 82 00:02:50,344 --> 00:02:53,405 represents for employers, and it continues to grow. 83 00:02:54,000 --> 00:02:56,080 It's you know, historically, we've thought about it 84 00:02:56,080 --> 00:02:58,340 as amongst the top three expenses 85 00:02:58,879 --> 00:03:00,020 for most employers. 86 00:03:00,400 --> 00:03:01,840 You know, I think right now, it's it's, 87 00:03:01,840 --> 00:03:03,599 you know, it's sitting at number two for 88 00:03:03,599 --> 00:03:04,419 many employers, 89 00:03:04,719 --> 00:03:07,520 taking up sometimes as upwards of 25% 90 00:03:07,520 --> 00:03:09,254 of a company's operating budget. 91 00:03:09,735 --> 00:03:12,055 There was a, a pretty stark, 92 00:03:12,455 --> 00:03:13,915 Kaiser Family Foundation 93 00:03:14,215 --> 00:03:15,814 study that was done. I I think it 94 00:03:15,814 --> 00:03:17,094 was in 2024, 95 00:03:17,094 --> 00:03:18,314 if I remember correctly, 96 00:03:18,615 --> 00:03:19,514 where they surveyed, 97 00:03:20,375 --> 00:03:22,694 financial and other executive level, 98 00:03:23,730 --> 00:03:26,550 staff across employers across the nation. 99 00:03:27,090 --> 00:03:29,810 And nine out of 10 said at the 100 00:03:29,810 --> 00:03:31,889 time that they weren't sure if they'd be 101 00:03:31,889 --> 00:03:35,110 able to afford to offer employer sponsored benefits 102 00:03:35,169 --> 00:03:36,194 by 2030. 103 00:03:36,754 --> 00:03:38,694 And, yeah, I think just a a bellwether 104 00:03:38,754 --> 00:03:40,675 moment for the industry to say, you know, 105 00:03:40,675 --> 00:03:42,355 what does that tell us about the path 106 00:03:42,355 --> 00:03:45,715 that we're on, relative to sustainable costs and 107 00:03:45,715 --> 00:03:48,215 and access to health care, through employers? 108 00:03:48,889 --> 00:03:50,889 I spent some time at AHIP this year, 109 00:03:50,889 --> 00:03:52,889 and ICRAs were a big part of the 110 00:03:52,889 --> 00:03:53,389 conversation 111 00:03:54,090 --> 00:03:56,969 relative to, you know, A lever, one of 112 00:03:56,969 --> 00:03:59,469 many that were being discussed, but A lever 113 00:03:59,610 --> 00:04:01,150 to try to create affordability 114 00:04:01,449 --> 00:04:02,830 for some of those employers. 115 00:04:03,289 --> 00:04:05,144 I think there's a second dynamic to it 116 00:04:05,144 --> 00:04:05,805 as well. 117 00:04:06,504 --> 00:04:08,504 Particularly, you know, on the smaller end, this 118 00:04:08,504 --> 00:04:10,344 is where ICRA's, you know, tend to to 119 00:04:10,344 --> 00:04:13,164 have most interest, small to midsize employers. 120 00:04:13,625 --> 00:04:16,264 Just this notion of, you know, is is 121 00:04:16,264 --> 00:04:17,485 managing benefits 122 00:04:17,810 --> 00:04:19,750 really part of what I want to, 123 00:04:20,529 --> 00:04:22,930 focus on as a business leader? Do I 124 00:04:22,930 --> 00:04:25,250 wanna focus more on running my business, or 125 00:04:25,250 --> 00:04:27,490 do I wanna focus on being in in, 126 00:04:27,490 --> 00:04:28,389 you know, the benefits, 127 00:04:29,009 --> 00:04:30,930 arena? And I've heard from a a lot 128 00:04:30,930 --> 00:04:32,870 of folks that, you know, I'd like to 129 00:04:33,185 --> 00:04:35,585 to provide some sort of funding to my 130 00:04:35,585 --> 00:04:37,504 employees so that they can, you know, receive 131 00:04:37,504 --> 00:04:39,665 benefits. I understand it's part of talent attraction 132 00:04:39,665 --> 00:04:41,585 and retention, but I don't wanna manage a 133 00:04:41,585 --> 00:04:43,425 benefits program. And so then I think there's 134 00:04:43,425 --> 00:04:46,720 two paradigms depending on, how the executive leader 135 00:04:46,720 --> 00:04:49,199 sees their role in benefits and their ability 136 00:04:49,199 --> 00:04:50,259 to afford benefits. 137 00:04:51,600 --> 00:04:53,600 And, Scott, just to give our listeners a 138 00:04:53,600 --> 00:04:55,919 sense of where ICRA stands right now, what 139 00:04:55,919 --> 00:04:58,125 some of the latest trends and data points, 140 00:04:58,605 --> 00:05:00,365 are are showing. Can you give us a 141 00:05:00,365 --> 00:05:01,665 sense of what you're seeing, 142 00:05:02,045 --> 00:05:03,904 across across the marketplace there? 143 00:05:04,685 --> 00:05:06,605 Jacob, there's a lot of interest in ICRA 144 00:05:06,605 --> 00:05:08,125 right now for sure. A lot of folks 145 00:05:08,125 --> 00:05:10,625 talking about them. I think context is important 146 00:05:11,004 --> 00:05:13,425 as we think of, adoption first. 147 00:05:13,850 --> 00:05:14,670 So while 148 00:05:15,129 --> 00:05:17,129 the ICRA is a a big focus of 149 00:05:17,129 --> 00:05:18,889 conversation right now, if we look at the 150 00:05:18,889 --> 00:05:21,709 data, there are about 500,000 151 00:05:21,769 --> 00:05:24,490 ICRA employees on plans right now across the 152 00:05:24,490 --> 00:05:24,990 country. 153 00:05:25,449 --> 00:05:26,269 In contrast, 154 00:05:26,649 --> 00:05:28,415 we've got got about a 150 to a 155 00:05:28,415 --> 00:05:29,694 160,000,000 156 00:05:29,694 --> 00:05:30,194 employees 157 00:05:30,574 --> 00:05:32,574 on those traditional group plans that we've been 158 00:05:32,574 --> 00:05:35,694 operating on historically. So ICRA is point o 159 00:05:35,694 --> 00:05:36,995 o 3% 160 00:05:37,375 --> 00:05:39,694 right now of the nation's population. Now with 161 00:05:39,694 --> 00:05:41,634 that said, that's not meant to discount 162 00:05:41,939 --> 00:05:44,180 the traction and the inertia that's centered around 163 00:05:44,180 --> 00:05:46,680 it. Bailey and Company, that's a Nashville, 164 00:05:47,139 --> 00:05:49,060 merchant bank that's kind of focused on growth 165 00:05:49,060 --> 00:05:51,220 in late stage, health care and health tech 166 00:05:51,220 --> 00:05:51,720 companies, 167 00:05:52,100 --> 00:05:54,805 they did an estimate recently looking at how 168 00:05:54,805 --> 00:05:57,045 fast is the IPRA market growing. It's about 169 00:05:57,045 --> 00:05:59,685 60% year over year. So there's a lot 170 00:05:59,685 --> 00:06:01,365 of focus and attention on it, but I 171 00:06:01,365 --> 00:06:02,904 think context is important. 172 00:06:03,524 --> 00:06:05,544 I'm also hearing as I'm talking with, 173 00:06:06,004 --> 00:06:09,064 CFOs, with IPRA vendors, with HR VPs, 174 00:06:09,439 --> 00:06:12,099 There are emerging some clear pros and cons. 175 00:06:12,159 --> 00:06:13,680 Yeah. I think the pros from kind of 176 00:06:13,680 --> 00:06:14,740 the ICRA advocates, 177 00:06:15,199 --> 00:06:17,599 they point to federal and state policies that 178 00:06:17,599 --> 00:06:20,879 they feel advantage, ICRA expansion and growth. They 179 00:06:20,879 --> 00:06:23,345 point to carrier and ICRA collaboration 180 00:06:23,725 --> 00:06:24,545 that's increasing 181 00:06:24,925 --> 00:06:27,024 specifically around technology integration 182 00:06:27,485 --> 00:06:29,105 of those ICRA vendor platforms. 183 00:06:29,884 --> 00:06:32,064 And then they also point to ICRA vendors 184 00:06:32,204 --> 00:06:33,105 working together 185 00:06:33,644 --> 00:06:35,745 to actually market and raise awareness. 186 00:06:36,569 --> 00:06:38,810 Some of the cons that, let's call them 187 00:06:38,810 --> 00:06:40,349 maybe skeptics are raising, 188 00:06:40,889 --> 00:06:41,389 employees, 189 00:06:41,849 --> 00:06:45,209 may have limited individual plan options compared to 190 00:06:45,209 --> 00:06:47,129 what's available to them in small group and 191 00:06:47,129 --> 00:06:48,349 large group plan offerings. 192 00:06:48,964 --> 00:06:51,064 How the small group and large group rates 193 00:06:51,444 --> 00:06:53,685 from, you know, the small group environment to 194 00:06:53,685 --> 00:06:54,745 the indie environment 195 00:06:55,125 --> 00:06:58,165 isn't always positive for employees. Take Command Health 196 00:06:58,165 --> 00:07:00,404 has a great heat map tool that allows 197 00:07:00,404 --> 00:07:02,404 you to look at the pricing relativities in 198 00:07:02,404 --> 00:07:04,085 every state and even down to a county 199 00:07:04,085 --> 00:07:04,585 level. 200 00:07:05,099 --> 00:07:07,579 And then simply health plan risk. Is this 201 00:07:07,579 --> 00:07:10,459 arbitrage? Are you moving revenue going from a 202 00:07:10,459 --> 00:07:12,219 small group line of business or a large 203 00:07:12,219 --> 00:07:13,279 group line of business 204 00:07:13,659 --> 00:07:16,300 over to your individual line? And is that 205 00:07:16,300 --> 00:07:19,185 financially advantageous to the business or not? 206 00:07:19,584 --> 00:07:21,185 And then I think finally, the last piece 207 00:07:21,185 --> 00:07:23,504 is just investment trends. Where is the money 208 00:07:23,504 --> 00:07:26,785 flowing? We see venture capital and private equity 209 00:07:26,785 --> 00:07:28,404 leaning into this space heavily. 210 00:07:28,865 --> 00:07:32,225 Remodel Health, for example, announcing recently they've raised 211 00:07:32,225 --> 00:07:33,925 more than a $100,000,000. 212 00:07:34,129 --> 00:07:36,789 Fatch has raised more than $40,000,000. 213 00:07:37,009 --> 00:07:39,490 But what we haven't seen yet is the 214 00:07:39,490 --> 00:07:42,069 ecosystem go through any sort of consolidation 215 00:07:42,529 --> 00:07:44,930 event. So a lot of companies starting up, 216 00:07:44,930 --> 00:07:47,604 a lot of investment dollars coming in, At 217 00:07:47,604 --> 00:07:49,764 some point, there's likely needed to be a 218 00:07:49,764 --> 00:07:51,064 consolidation event 219 00:07:51,365 --> 00:07:55,284 where mergers and acquisitions sunsetting of unsuccessful vendors 220 00:07:55,284 --> 00:07:55,784 occurs. 221 00:07:56,964 --> 00:07:59,204 That's really interesting to hear you say all 222 00:07:59,204 --> 00:08:01,544 of that, Scott. It's really good context. Definitely 223 00:08:02,069 --> 00:08:05,189 some cons compared to the traditional small and 224 00:08:05,189 --> 00:08:06,409 and large group models. 225 00:08:06,870 --> 00:08:08,709 Big inertia in this market, a lot of 226 00:08:08,709 --> 00:08:11,029 money flowing in, but in the grand context 227 00:08:11,029 --> 00:08:13,129 of things, still a very, very small 228 00:08:13,430 --> 00:08:15,909 segment of of the overall health insurance industry. 229 00:08:15,909 --> 00:08:18,225 So it's great context for our for our 230 00:08:18,225 --> 00:08:20,544 listeners to have. And to your point, going 231 00:08:20,544 --> 00:08:21,604 back to that KFF, 232 00:08:22,305 --> 00:08:23,524 study that you cited 233 00:08:23,904 --> 00:08:25,285 in terms of the unsustainability 234 00:08:25,664 --> 00:08:27,604 of rising care costs for employers, 235 00:08:27,904 --> 00:08:29,664 some of the most recent estimates we've seen 236 00:08:29,664 --> 00:08:31,425 on our side of things is that from 237 00:08:31,425 --> 00:08:32,250 employer groups, 238 00:08:32,730 --> 00:08:34,970 estimating that health cost could rise as much 239 00:08:34,970 --> 00:08:35,870 as 10% 240 00:08:36,330 --> 00:08:38,889 next year alone. So employers see this coming 241 00:08:38,889 --> 00:08:39,710 down the pipeline. 242 00:08:40,330 --> 00:08:42,429 How is Provenance specifically approaching, 243 00:08:43,210 --> 00:08:45,629 alternative arrangements, perhaps not even just ICRA, 244 00:08:46,085 --> 00:08:49,365 to help your employer customers control these costs 245 00:08:49,365 --> 00:08:51,684 while still continue to deliver that value that 246 00:08:51,684 --> 00:08:54,024 the employees are going to continue to expect? 247 00:08:54,884 --> 00:08:56,404 Yeah. We're we're looking at it, I think, 248 00:08:56,404 --> 00:08:57,545 in in four paradigms. 249 00:08:57,924 --> 00:08:59,559 We see it as an ecosystem. I don't 250 00:08:59,559 --> 00:09:01,419 know that product design alone 251 00:09:01,799 --> 00:09:03,639 is is going to be sufficient to address 252 00:09:03,639 --> 00:09:05,899 those affordability challenges for employers. 253 00:09:06,360 --> 00:09:08,039 The first arena that we're looking at is 254 00:09:08,039 --> 00:09:09,100 provider contracting. 255 00:09:09,480 --> 00:09:10,459 And can we 256 00:09:11,334 --> 00:09:14,134 negotiate collaboratively with our provider partners, but also 257 00:09:14,134 --> 00:09:15,914 firmly with our provider partners? 258 00:09:16,375 --> 00:09:18,294 And that includes our own system. We're part 259 00:09:18,294 --> 00:09:20,394 of an integrated delivery system as well. 260 00:09:20,774 --> 00:09:23,014 Providers need to be fairly compensated for the 261 00:09:23,014 --> 00:09:24,774 care that they deliver, but at the same 262 00:09:24,774 --> 00:09:26,529 time, we need to advocate on behalf of 263 00:09:26,529 --> 00:09:28,929 our members and our employers in the face 264 00:09:28,929 --> 00:09:31,089 of these rising health care costs. And so 265 00:09:31,089 --> 00:09:32,629 that's area one of focus. 266 00:09:33,409 --> 00:09:35,730 Area two for us is really care claims 267 00:09:35,730 --> 00:09:36,789 and payment effectiveness. 268 00:09:37,409 --> 00:09:39,794 You know, our entire organization is focused on 269 00:09:39,794 --> 00:09:42,274 a portfolio of work designed to ensure that 270 00:09:42,274 --> 00:09:43,794 our members are getting the right care and 271 00:09:43,794 --> 00:09:45,475 the right care setting at the right price, 272 00:09:45,475 --> 00:09:48,115 that classic triple aim. But we're also trying 273 00:09:48,115 --> 00:09:48,774 to optimize, 274 00:09:49,235 --> 00:09:51,174 all of our claims and payment processes 275 00:09:51,759 --> 00:09:54,159 that can lead ultimately to tens of millions 276 00:09:54,159 --> 00:09:56,720 of dollars of annual savings. We're looking at 277 00:09:56,720 --> 00:09:59,919 our own administrative efficiency. Are we operating as 278 00:09:59,919 --> 00:10:02,240 efficiently and as lean as we can to 279 00:10:02,240 --> 00:10:04,159 ensure that we're doing our own part to 280 00:10:04,159 --> 00:10:05,779 to control costs and expenses? 281 00:10:06,254 --> 00:10:09,054 And then finally, product innovation, determining what are 282 00:10:09,054 --> 00:10:11,554 the current and future products and plan designs 283 00:10:11,774 --> 00:10:14,335 that our customers could benefit from. And, you 284 00:10:14,335 --> 00:10:16,174 know, I think we're seeing work being done 285 00:10:16,174 --> 00:10:18,115 in all four of those areas simultaneously 286 00:10:18,894 --> 00:10:21,455 to try to address these, these cost challenges 287 00:10:21,455 --> 00:10:21,955 facing 288 00:10:22,870 --> 00:10:25,589 employers. Got it. So a four pillar strategy 289 00:10:25,589 --> 00:10:27,289 for PHP to really tackle, 290 00:10:27,830 --> 00:10:29,769 what continues to be these rising costs. 291 00:10:30,230 --> 00:10:32,309 Scott, if we're staying on the topic of 292 00:10:32,309 --> 00:10:34,809 of rising costs and and the ACA marketplace 293 00:10:34,870 --> 00:10:35,529 more broadly, 294 00:10:36,164 --> 00:10:38,325 As you know, going into next year, the 295 00:10:38,325 --> 00:10:41,365 the marketplace is facing some real crisis issues 296 00:10:41,365 --> 00:10:42,585 in terms of affordability, 297 00:10:43,205 --> 00:10:46,644 market stability. We're already seeing, major increases being 298 00:10:46,644 --> 00:10:48,825 approved in states all over the country. 299 00:10:49,205 --> 00:10:51,419 So how do you think that this issue 300 00:10:51,419 --> 00:10:52,559 is is affecting 301 00:10:53,019 --> 00:10:55,179 the health your health plan strategy as you 302 00:10:55,179 --> 00:10:58,080 balance that growth and sustainability you just detailed? 303 00:10:59,019 --> 00:11:00,299 Yeah. You know, as we look ahead into 304 00:11:00,299 --> 00:11:02,220 2026, I don't think there's any question that 305 00:11:02,220 --> 00:11:04,940 the ACA marketplace is under significant pressure. We're 306 00:11:04,940 --> 00:11:08,235 seeing rising premiums, the potential exploration of those 307 00:11:08,235 --> 00:11:10,574 enhanced subsidies, regulatory uncertainty. 308 00:11:11,195 --> 00:11:13,595 So for PHP, you know, our focus and 309 00:11:13,595 --> 00:11:16,394 strategy is about balance. We remain committed to 310 00:11:16,394 --> 00:11:17,855 serving ACA members 311 00:11:18,290 --> 00:11:20,450 where we can deliver value, but we're also 312 00:11:20,450 --> 00:11:22,070 trying to be thoughtful about sustainability, 313 00:11:22,450 --> 00:11:24,950 focusing on markets where offerings are competitive, 314 00:11:25,649 --> 00:11:29,110 where, members have meaningful support. And then, certainly, 315 00:11:29,170 --> 00:11:31,424 at the same time, we're preparing for growth 316 00:11:31,424 --> 00:11:33,985 and we're having conversations around ICRA and and 317 00:11:33,985 --> 00:11:34,725 other options. 318 00:11:35,345 --> 00:11:36,664 I think we would say that we are 319 00:11:36,664 --> 00:11:36,784 advocates, 320 00:11:37,904 --> 00:11:40,245 for policies that preserve affordability, 321 00:11:41,105 --> 00:11:43,929 that enhance product design, that, you know, expand 322 00:11:43,929 --> 00:11:46,089 into models that can meet members where they 323 00:11:46,089 --> 00:11:46,589 are. 324 00:11:46,889 --> 00:11:48,889 But, ultimately, I think it's making sure that 325 00:11:48,889 --> 00:11:51,549 we're positioned for longs, long term stability 326 00:11:52,009 --> 00:11:53,129 while keeping coverage, 327 00:11:53,450 --> 00:11:55,289 accessible to our members and and to the 328 00:11:55,289 --> 00:11:56,589 communities that we serve. 329 00:11:57,424 --> 00:11:57,924 Absolutely. 330 00:11:58,464 --> 00:12:00,304 Well, Scott, before we go, you know, we've 331 00:12:00,304 --> 00:12:02,625 touched on we've touched on ICRA, we've touched 332 00:12:02,625 --> 00:12:05,125 on rising health costs going into next year, 333 00:12:05,504 --> 00:12:07,504 and and we've touched on the instability of 334 00:12:07,504 --> 00:12:10,049 the marketplace next year as well. So is 335 00:12:10,129 --> 00:12:12,049 is there anything else we're missing there or 336 00:12:12,049 --> 00:12:14,149 any final bits of advice you wanna offer 337 00:12:14,209 --> 00:12:16,049 all the other health plan leaders that are 338 00:12:16,049 --> 00:12:16,870 listening in? 339 00:12:17,809 --> 00:12:19,730 Yeah. Yeah. I I think there's three things 340 00:12:19,730 --> 00:12:21,970 that I'd probably leave with. One, you know, 341 00:12:21,970 --> 00:12:23,889 we have to, as as an industry and 342 00:12:23,889 --> 00:12:25,110 as individual companies, 343 00:12:25,615 --> 00:12:27,215 always look at where we can be the 344 00:12:27,215 --> 00:12:29,455 best stewards of of health care dollars. I 345 00:12:29,455 --> 00:12:31,455 I think PHP has always tried to do 346 00:12:31,455 --> 00:12:32,815 that, and I know we're doubling down on 347 00:12:32,815 --> 00:12:33,795 that effort now. 348 00:12:34,175 --> 00:12:36,014 Yeah. The the second piece is there are 349 00:12:36,014 --> 00:12:37,695 pros and cons of of all of these, 350 00:12:37,695 --> 00:12:40,070 you know, alternative health plans. Right? We've talked 351 00:12:40,070 --> 00:12:40,889 about ICRA's. 352 00:12:41,269 --> 00:12:43,290 Some have have viewed it simply as arbitrage 353 00:12:43,350 --> 00:12:46,070 of moving membership from small group in in 354 00:12:46,070 --> 00:12:47,830 the lower end of large group over to 355 00:12:47,830 --> 00:12:48,970 the individual business. 356 00:12:49,350 --> 00:12:51,690 Is that the right financial move for, 357 00:12:52,070 --> 00:12:54,315 for carriers? Right? You need to to evaluate 358 00:12:54,315 --> 00:12:55,054 that as well. 359 00:12:55,514 --> 00:12:56,955 And I think it's also the the third 360 00:12:56,955 --> 00:12:57,695 piece maybe, 361 00:12:58,394 --> 00:13:00,795 really easy for any of us right now 362 00:13:00,795 --> 00:13:01,274 to, 363 00:13:01,754 --> 00:13:03,455 fall victim to fads, 364 00:13:04,235 --> 00:13:07,035 heavy investments in marketing. You know, I I'm 365 00:13:07,035 --> 00:13:09,730 approached regularly by vendors of all sorts of 366 00:13:09,730 --> 00:13:10,549 different products. 367 00:13:10,850 --> 00:13:12,769 And it'd be really easy to say, well, 368 00:13:12,769 --> 00:13:14,610 maybe that's the silver bullet or maybe this 369 00:13:14,610 --> 00:13:16,450 is the silver bullet. The bottom line right 370 00:13:16,450 --> 00:13:18,450 now, there is no silver bullet. We have 371 00:13:18,450 --> 00:13:20,529 to work on multiple fronts and do the 372 00:13:20,529 --> 00:13:22,149 hard work right now that's required 373 00:13:22,565 --> 00:13:24,964 to, help this industry and help all of 374 00:13:24,964 --> 00:13:26,404 those whom we serve get to the other 375 00:13:26,404 --> 00:13:28,105 side of this crisis that we face. 376 00:13:29,204 --> 00:13:31,524 Fantastic. That's some great last pieces of advice 377 00:13:31,524 --> 00:13:33,445 for our listeners. So, Scott, I wanna thank 378 00:13:33,445 --> 00:13:35,204 you for taking the time to chat with 379 00:13:35,204 --> 00:13:37,284 us and for sharing your insights with our 380 00:13:37,284 --> 00:13:39,870 listeners. We really appreciate it. Absolutely. Thank you 381 00:13:39,870 --> 00:13:42,190 again for the time. Yeah. And to our 382 00:13:42,190 --> 00:13:43,710 listeners, if you'd like to listen to more 383 00:13:43,710 --> 00:13:47,570 podcasts from Becker's, you can visit beckershospitalreview.com.