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Hello, everyone. This is Jacob Emerson with the

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Becker's Payer Issues podcast.

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Thrilled today to be joined by Richard Green,

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who is the president of CleverCare Health Plan.

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Richard, thank you so much for taking the

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time to be with me on the podcast

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today. Thank you, Jacob. It's my pleasure.

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Absolutely. And, Richard, before we dive into everything

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we wanna talk with you about, can you

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tell us a little bit more about yourself,

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your background in health care, and what it

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is that you do today at CleverCare?

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Happy to. I'm the president of CleverCare health

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plan.

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CleverCare was founded to provide a culturally sensitive

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and competent Medicare Advantage health plan.

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We give members access to care that's delivered

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in their own language and with their own

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unique cultural traditions in mind. And we have

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a value based care model that essentially blends

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eastern and western.

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Moved into the role of president, where I

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oversee the day

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moved into the role of

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president where I oversee the day to day

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operations of the company as well as the

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financial strategy.

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Before,

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joining CleverCare,

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I

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really dedicated my career nearly thirty years to,

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financial and operations

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roles across both payers as well as groups.

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And most recently, I served as the COO

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and CFO of AppleCare

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Medical Management, which was one of the first

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acquisitions

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within OptumCare.

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Wonderful. Well, like I said, we really appreciate

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you taking the time to join us today,

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Richard. And I I wanted to get started

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by talking about some recent news from CleverCare.

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The company has just opened its its new

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flagship community center,

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and which is now the fourth CleverCare community

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center in California as I understand it. So

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talk to us a little bit about this

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new center and and what role your community

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centers play in in the overall growth and

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retention strategy at CleverCare and how you wanna

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measure their impact on on member experience, on

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outcomes,

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engagement. Give our listeners a full picture of

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of how you're thinking about this.

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Absolutely.

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You're right. The Rolling Heights Community Center is

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our fourth location, and our community centers

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are really at the heart of our mission.

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And these centers are part of how we

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invest in our members and deliver

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on our commitment

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of being a reliable partner.

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What makes the center special is that they

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blend eastern and western approaches to wellness.

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Our members can attend tai chi classes,

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participate in community classes on mental health

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and dental care,

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or come together for

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community

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building events that might include

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lessons on technology,

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book clubs, birthday celebrations.

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And we even have,

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found some talent within both our associates and

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our members with, live music. We like to

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do a lot of, sing alongs.

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Everything is offered

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in

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languages primarily spoken by our members

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covering, Mandarin, Cantonese, Vietnamese, and Korean.

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The Rowland Heights Center,

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as I mentioned, is our fourth center joining

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our centers in Monterey Park,

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Westminster,

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and Koreatown.

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In 2024,

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our three

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legacy

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centers generated nearly four, 18,000 visits, which tells

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generated nearly four, 18,000 visits, which tells us

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our members are actively engaging,

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and we're seeing that engagement,

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translate into better satisfaction,

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better retention,

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and, you know, really increased connectivity with our

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members. These centers, are actively engaging, and,

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connectivity with our members.

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And

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these centers position us to deliver an exceptional

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member experience and build deeper, more meaningful relationships

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with the communities we serve.

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And these centers are places

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of connection and belonging, and that's

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a foundation of our growth.

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That's fantastic. And then it's amazing to continue

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to see to build out these community centers

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in the in the markets that you serve,

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Richard.

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I also wonder if, you know, I I

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wanna talk a little bit about, the the

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Medicare Advantage landscape more broadly and some of

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the news and trends we've been seeing this

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year,

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with with companies all over the country.

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We've as you know, we're seeing plans consolidate

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their offerings, tighten margins heading into 2026.

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So I wonder if you could explain for

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us how CleverCare specifically is navigating some of

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these industry headwinds while continue continuing to invest

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in in what you just talked about, these

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culturally tailored care and and community based services.

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Yes.

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We believe

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our combination of eastern and western medicine,

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along with teachers like the community centers resonate

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with the, with our community.

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And we're focused on investing and expanding

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much like our Rowan Heights Center, which just

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opened,

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as as a as a perfect example.

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We're able to do this because we've proven

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our model, which honors culture and tradition, delivers

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financial results.

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Since '23, we've more than doubled in size,

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growing to nearly 30,000

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members.

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As you alluded to, it's no secret

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that national payers have found the transition to

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value based care challenging.

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Outcomes based models

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tend to take time to deliver on cost

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savings,

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but we feel as though we're leading the

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way with a sustainable

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model that works.

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Central to our success

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is the trusted relationship

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we've developed with providers in our network.

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We ensure seamless claims processing,

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timely and accurate claims payments.

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And unique to CleverCare,

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our network

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includes 700

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directly

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contracted acupuncturists and other nontraditional

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specialists.

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We've also maintained stable and reliable benefits

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over the last couple of years, giving

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both our members and our brokers

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confidence in our commitment to them. That stability

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combined with our financial performance is what has

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allowed us to continue to invest

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in things like our community center while others

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may be pulling back.

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Sure. That makes a lot of sense. And

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and, clearly, CleverCare is a very unique health

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plan in terms of its, its offerings and

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benefits, and it's clearly working in terms of

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the growth you've seen in enrollment over the

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last few years, Richard. I wonder in that

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vein where you see the biggest openings for

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innovation or or differentiation

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in in Medicare Advantage over the next few

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years, whether that's in,

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growth in your benefit design, care delivery, member

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engagement.

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How do you continue to see CleverCare innovate

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in in the MA space?

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Sure. I think the biggest opportunity

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is exactly,

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what we've been doing at CleverCare

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is just continuing to create a model that

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blends eastern and western medicine

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while focusing on removing barriers and improving outcomes.

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In, benefit design, there's a real opportunity to

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reflect members' actual health traditions.

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As I mentioned earlier, our network includes 700

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directly contracted acupuncturists,

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and these aren't extras.

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In fact, for many people, they are core

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to how they approach

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health and wellness

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and help create a sense of real connection.

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In care delivery,

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being a reliable, transparent, and trustworthy partner matters

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and creates a foundation for better care delivery.

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And in member engagement, physical presence in communities

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through our centers makes a difference.

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Engagement,

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especially when delivered

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in our members'

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own language, is what drives better outcome.

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And the plans that will differentiate themselves are

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the ones that genuinely understand and serve their

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members' unique needs

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while maintaining

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financial stability to deliver on their commitments year

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after year.

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Absolutely. And and we're for sticking on that

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is our is our last question, Richard, in

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terms of some of the advice or final

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thoughts you would offer all the other insurers

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listening

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what what would you

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share with them? At first, I would I

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would say

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don't chase unsustainable growth.

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Build something that lasts through strong operational

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foundations,

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genuine relationships

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with the provider network,

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and a clear understanding of the communities you

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serve.

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The industry is at such a critical moment,

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so it's crucial to understand that sustainable growth

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requires a different approach than the past.

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Our approach is to focus on maintaining the

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stability

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that allows us to invest for the long

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term.

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And to that point,

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we're posed for continued growth in investing.

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And over the last few months, we've brought

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on a new chief information officer,

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vice president of operations,

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and vice president of sales, all seasoned leaders

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that understand Medicare Advantage. And that's the kind

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of investment that

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positions ourselves as well as others for sustainable

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successful growth.

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Wonderful. Well, Richard, I hope you keep us

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posted on the continued innovations and and growth

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at CleverCare.

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But I wanna thank you for taking the

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time to chat with us and and for

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sharing your insights about all the new stuff

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going on at the at your company. We

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really appreciate it.

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Thank you very much, Jacob. I appreciate the

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opportunity.

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Yeah. And to our listeners, if you'd like

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to listen to more podcasts from Becker's Health

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Care, you can visit beckershospitalreview.com.