1 00:00:00,080 --> 00:00:02,639 This is Brian Zimmerman with Becker's Healthcare. Thank 2 00:00:02,639 --> 00:00:04,000 you so much for tuning in to the 3 00:00:04,000 --> 00:00:05,219 Becker's Healthcare podcast. 4 00:00:05,919 --> 00:00:07,759 Today, we're going to talk about health plan 5 00:00:07,759 --> 00:00:09,539 readiness for 2026, 6 00:00:09,679 --> 00:00:11,859 trends shaping the next phase of change. 7 00:00:12,244 --> 00:00:14,744 Joining me for this discussion is Steve Levin, 8 00:00:14,884 --> 00:00:16,344 CEO of Quest Analytics. 9 00:00:16,725 --> 00:00:18,164 Steve, thank you so much for being on 10 00:00:18,164 --> 00:00:20,504 the podcast. Thanks for having me, Brian. 11 00:00:20,964 --> 00:00:22,804 To get going here, can you can you 12 00:00:22,804 --> 00:00:25,064 share a bit about your yourself, your professional 13 00:00:25,204 --> 00:00:25,704 background, 14 00:00:26,859 --> 00:00:28,699 what you're doing as as as CEO of 15 00:00:28,699 --> 00:00:29,519 Quest Analytics? 16 00:00:30,059 --> 00:00:31,439 Yeah. So who am I? 17 00:00:31,899 --> 00:00:33,119 Exactly. It's 18 00:00:34,539 --> 00:00:37,820 so, look. I usually describe myself as a, 19 00:00:38,219 --> 00:00:39,359 reformed consultant. 20 00:00:40,024 --> 00:00:42,504 I was a HP management consultant. I did 21 00:00:42,504 --> 00:00:45,884 a corporate development and sort of, strategy work, 22 00:00:46,505 --> 00:00:48,024 among my clients for a lot of years 23 00:00:48,024 --> 00:00:48,524 for 24 00:00:48,905 --> 00:00:49,645 health plans 25 00:00:50,184 --> 00:00:51,244 and payer companies, 26 00:00:51,704 --> 00:00:52,445 health systems, 27 00:00:53,420 --> 00:00:54,799 consumer product companies. 28 00:00:55,259 --> 00:00:57,659 And then, at at some point after, you 29 00:00:57,659 --> 00:00:59,359 know, over a decade or so, 30 00:00:59,739 --> 00:01:01,199 I decided I should try and, 31 00:01:01,579 --> 00:01:03,019 pre you know, do what I preach, if 32 00:01:03,019 --> 00:01:05,599 you will. And I hopped over the wall. 33 00:01:06,334 --> 00:01:08,094 One of my clients invited me to start 34 00:01:08,094 --> 00:01:08,674 a company. 35 00:01:09,134 --> 00:01:09,614 So I, 36 00:01:10,174 --> 00:01:12,734 engaged in building a venture. Right? Built a 37 00:01:12,734 --> 00:01:14,414 new company for a decade or so in, 38 00:01:14,575 --> 00:01:16,354 predictive analytics and rev cycle 39 00:01:17,055 --> 00:01:20,180 back when, big data and SAS was all 40 00:01:20,180 --> 00:01:22,020 brand new. This was 2005, 41 00:01:22,020 --> 00:01:23,240 2006 era. 42 00:01:23,620 --> 00:01:27,319 Built a predictive analytics business, serve serving providers, 43 00:01:27,859 --> 00:01:29,719 health systems, and, hospitals. 44 00:01:30,260 --> 00:01:31,159 And from there, 45 00:01:31,540 --> 00:01:32,745 that ultimately was 46 00:01:33,145 --> 00:01:35,385 acquired by sort of a middleware company, a 47 00:01:35,385 --> 00:01:35,885 clearinghouse. 48 00:01:36,584 --> 00:01:38,185 So I got to go from the provider 49 00:01:38,185 --> 00:01:40,125 side to the middle. And then, 50 00:01:40,665 --> 00:01:42,265 in 2020, 51 00:01:42,265 --> 00:01:43,405 by the start of COVID, 52 00:01:43,704 --> 00:01:44,760 I joined Quest, 53 00:01:45,480 --> 00:01:47,799 and I became, CEO here, which is sort 54 00:01:47,799 --> 00:01:49,900 of a capstone opportunity for me. 55 00:01:50,280 --> 00:01:53,020 Quest is really interesting, you know, network design. 56 00:01:53,560 --> 00:01:55,319 We live at sort of the e the 57 00:01:55,319 --> 00:01:57,579 intersection of of, payers, 58 00:01:58,040 --> 00:01:58,540 providers, 59 00:01:59,454 --> 00:02:01,775 regulators, and then, you know, networks or what 60 00:02:01,775 --> 00:02:04,015 members experience and health plans are built on. 61 00:02:04,015 --> 00:02:05,234 So it's a very interesting 62 00:02:06,174 --> 00:02:07,394 spot in the middle. 63 00:02:08,014 --> 00:02:09,854 And, you know, in in the kind of 64 00:02:09,854 --> 00:02:12,574 softer moments, I would say, it's a great 65 00:02:12,574 --> 00:02:13,074 mission. 66 00:02:13,375 --> 00:02:14,879 We're a company that is 67 00:02:15,760 --> 00:02:18,159 exclusively focused on helping every American get access 68 00:02:18,159 --> 00:02:20,480 to health care and helping sort of find 69 00:02:20,480 --> 00:02:22,240 those networks and make them work. So it's 70 00:02:22,240 --> 00:02:25,280 it's really quite exciting. So, that's who I 71 00:02:25,280 --> 00:02:25,780 am. 72 00:02:26,080 --> 00:02:28,615 Wonderful to have you. I think your your 73 00:02:28,615 --> 00:02:31,094 professional journey lends you an interesting perspective in 74 00:02:31,094 --> 00:02:33,094 in sort of sitting in this this this 75 00:02:33,094 --> 00:02:35,094 intersection space. Right? I think that's also a 76 00:02:35,094 --> 00:02:37,495 valuable perspective for for our listeners to get. 77 00:02:37,495 --> 00:02:37,995 So 78 00:02:38,295 --> 00:02:40,135 let let's get into it. Health plans, of 79 00:02:40,135 --> 00:02:42,330 course, are, you know, getting ready for another 80 00:02:42,330 --> 00:02:44,990 year of significant regulatory and market change. 81 00:02:45,449 --> 00:02:47,610 What are the most important pressures you're seeing 82 00:02:47,610 --> 00:02:50,189 as sort of these plans look toward 2026 83 00:02:50,409 --> 00:02:53,324 and how they're shaping strategic priorities? You know? 84 00:02:53,405 --> 00:02:55,584 There's always transformation disruption 85 00:02:56,125 --> 00:02:58,444 happening in health care. Of course, it's not 86 00:02:58,444 --> 00:03:00,944 static, but this does seem like an 87 00:03:01,245 --> 00:03:01,745 exceptionally, 88 00:03:03,564 --> 00:03:05,965 interesting moment in in in the industry. So 89 00:03:05,965 --> 00:03:07,930 can you expand on how health plans are 90 00:03:07,930 --> 00:03:09,370 sort of getting ready for the changes that 91 00:03:09,370 --> 00:03:09,949 are coming? 92 00:03:10,489 --> 00:03:12,729 Look. It you know, it so first off, 93 00:03:12,810 --> 00:03:15,769 it is an interesting time, and health care 94 00:03:15,769 --> 00:03:18,009 has never been static. It's it's always been 95 00:03:18,009 --> 00:03:20,489 changing. I think the pace of change recently 96 00:03:20,489 --> 00:03:21,709 has really picked up. 97 00:03:22,569 --> 00:03:23,069 And, 98 00:03:23,425 --> 00:03:25,824 you know, I think every everyone listening to 99 00:03:25,824 --> 00:03:28,724 this understands that there's sort of margin pressure, 100 00:03:29,344 --> 00:03:31,025 in health care, and that problem has gotten 101 00:03:31,025 --> 00:03:32,004 much more acute. 102 00:03:32,544 --> 00:03:34,865 You know, behind that, there's a bunch of 103 00:03:34,865 --> 00:03:37,409 different things that are shaping that shape that 104 00:03:37,490 --> 00:03:39,810 pressure and that acceleration, which in some ways 105 00:03:39,810 --> 00:03:40,469 are gonna 106 00:03:40,930 --> 00:03:42,930 drive what we think of as 2026 107 00:03:42,930 --> 00:03:46,050 and sort of what payers, providers, regulators are 108 00:03:46,050 --> 00:03:47,889 all thinking about and likely to be kinda 109 00:03:47,889 --> 00:03:48,790 trying to accomplish. 110 00:03:49,490 --> 00:03:50,949 You know, we have 111 00:03:51,375 --> 00:03:52,114 the underlying 112 00:03:52,655 --> 00:03:55,215 cost drugs, devices, equipment, all 113 00:03:55,854 --> 00:03:57,935 those continue to kind of accelerate and, you 114 00:03:57,935 --> 00:03:59,155 know, increase in cost. 115 00:03:59,534 --> 00:04:00,435 We have utilization 116 00:04:00,735 --> 00:04:02,655 that's that's gone up, sort of a little 117 00:04:02,655 --> 00:04:04,254 bit of the hangover out of the public 118 00:04:04,254 --> 00:04:05,074 health emergency. 119 00:04:05,790 --> 00:04:07,710 All of that is leading to sort of 120 00:04:07,710 --> 00:04:08,849 MLR pressures, 121 00:04:09,389 --> 00:04:11,010 challenges of sort of 122 00:04:11,629 --> 00:04:14,349 having the cost and the margin match the 123 00:04:14,349 --> 00:04:15,090 plan design. 124 00:04:15,870 --> 00:04:17,790 We're seeing, as a result of some of 125 00:04:17,790 --> 00:04:18,670 this, all these, 126 00:04:19,069 --> 00:04:19,569 events, 127 00:04:20,095 --> 00:04:21,935 a series of things. So first off, we're 128 00:04:21,935 --> 00:04:24,435 seeing regulators get really sensitive to 129 00:04:24,894 --> 00:04:27,235 real provider access. Is the provider 130 00:04:27,535 --> 00:04:29,794 seeing patients? Is this location real? 131 00:04:30,574 --> 00:04:31,475 Is there sufficient, 132 00:04:32,175 --> 00:04:34,415 you know, availability? So average wait time sort 133 00:04:34,415 --> 00:04:34,980 of things. 134 00:04:35,460 --> 00:04:37,879 That that focus on access is 135 00:04:38,180 --> 00:04:41,139 really, you know, pressing things around data and 136 00:04:41,139 --> 00:04:42,920 data integrity. We'll get to that later. 137 00:04:43,460 --> 00:04:46,660 Providers are are facing real contract and and 138 00:04:46,660 --> 00:04:49,300 and rate challenges, and they are consolidating. So 139 00:04:49,300 --> 00:04:50,360 we're seeing the continued 140 00:04:51,064 --> 00:04:53,384 consolidation of provider groups. So we're seeing health 141 00:04:53,384 --> 00:04:55,805 systems get bigger. We're seeing groups get bigger. 142 00:04:56,185 --> 00:04:57,785 You can see that when you look around 143 00:04:57,785 --> 00:04:59,944 and look at the contract disputes. I'm up 144 00:04:59,944 --> 00:05:01,324 in the New England area, 145 00:05:01,865 --> 00:05:02,365 and, 146 00:05:02,839 --> 00:05:03,500 you know, 147 00:05:03,879 --> 00:05:05,660 Bay State Health and and 148 00:05:05,960 --> 00:05:08,439 South Coast Health, we're seeing every almost everyday 149 00:05:08,439 --> 00:05:10,759 challenges of of in network, out of network 150 00:05:10,759 --> 00:05:12,460 negotiations with our local 151 00:05:12,839 --> 00:05:15,400 payers up here. And then we're seeing, you 152 00:05:15,400 --> 00:05:18,045 know, the the payers themselves trying to figure 153 00:05:18,045 --> 00:05:19,024 out how to 154 00:05:19,485 --> 00:05:20,305 do more, 155 00:05:21,165 --> 00:05:24,444 manage utilization against the premium and control sort 156 00:05:24,444 --> 00:05:26,064 of the the whole premium dollars. 157 00:05:26,605 --> 00:05:27,824 It is becoming 158 00:05:28,204 --> 00:05:29,884 like a you know, one of the things 159 00:05:29,884 --> 00:05:31,165 that I like to think of it is 160 00:05:31,165 --> 00:05:32,064 a game of Tetris. 161 00:05:32,420 --> 00:05:33,860 This is why we all play the the 162 00:05:33,860 --> 00:05:35,620 the game of Tetris, and so the blocks 163 00:05:35,620 --> 00:05:36,279 are falling. 164 00:05:36,819 --> 00:05:39,720 Groups are getting bigger. The financial challenges 165 00:05:40,020 --> 00:05:42,259 are getting bigger, and the blocks are falling 166 00:05:42,259 --> 00:05:44,259 faster. We we have to sort of make 167 00:05:44,259 --> 00:05:45,080 these networks 168 00:05:45,779 --> 00:05:47,160 kind of all fit, 169 00:05:48,134 --> 00:05:50,074 and it's speeding up. 170 00:05:50,694 --> 00:05:51,974 You know, I think the the pace of 171 00:05:51,974 --> 00:05:53,334 change in Washington has gone up a lot 172 00:05:53,334 --> 00:05:54,954 too recently. We're seeing more 173 00:05:55,414 --> 00:05:58,294 more innovation out of CMS, more innovation at 174 00:05:58,294 --> 00:05:59,974 the state level in the regulatory thing. So 175 00:05:59,974 --> 00:06:02,460 all this stuff is accelerating faster faster and 176 00:06:02,460 --> 00:06:02,960 more 177 00:06:03,900 --> 00:06:06,160 pressing. More pressing. The stakes are high. 178 00:06:06,620 --> 00:06:08,540 You laid out so much of of what's 179 00:06:08,540 --> 00:06:10,800 happening in the environment to make that sort 180 00:06:10,860 --> 00:06:12,620 of that pace of change that that is 181 00:06:12,620 --> 00:06:14,460 easy. If you ever played Tetris, it's really 182 00:06:14,460 --> 00:06:16,925 easy to to picture that when things start 183 00:06:16,925 --> 00:06:18,605 moving a little bit faster, it gets real 184 00:06:18,605 --> 00:06:19,665 tricky. So, 185 00:06:20,925 --> 00:06:22,845 wanna get here now to I wanna reference 186 00:06:22,845 --> 00:06:24,764 sort of a survey we did earlier this 187 00:06:24,764 --> 00:06:25,504 year that 188 00:06:25,964 --> 00:06:28,524 suggest high performing plants often operate with more 189 00:06:28,524 --> 00:06:29,024 targeted, 190 00:06:29,324 --> 00:06:30,384 streamlined networks. 191 00:06:31,310 --> 00:06:32,449 With that in mind, 192 00:06:32,910 --> 00:06:35,389 what what data insights should executives rely on 193 00:06:35,389 --> 00:06:37,470 to assess the performance of their networks? I 194 00:06:37,470 --> 00:06:39,009 know access is super important. 195 00:06:39,470 --> 00:06:41,629 But especially if they're considering a narrow network 196 00:06:41,629 --> 00:06:43,709 strategy, what what should be they be be 197 00:06:43,709 --> 00:06:45,425 looking at measuring? It 198 00:06:45,865 --> 00:06:46,264 it's, 199 00:06:46,745 --> 00:06:49,485 so your your research was very, very, 200 00:06:49,944 --> 00:06:50,444 enlightening, 201 00:06:51,064 --> 00:06:53,144 and it actually, by the way, just it 202 00:06:53,144 --> 00:06:55,464 it married or kind of matched some research 203 00:06:55,464 --> 00:06:56,844 done by the the KFF 204 00:06:57,470 --> 00:06:59,310 who similarly did some work looking at Medicare 205 00:06:59,310 --> 00:07:00,930 Advantage Plans and star ratings. 206 00:07:01,389 --> 00:07:03,790 Their research showed that sort of it's e 207 00:07:03,949 --> 00:07:06,830 you know, low performing networks of three stars 208 00:07:06,830 --> 00:07:08,990 and less tend to be narrow narrow as 209 00:07:08,990 --> 00:07:11,724 well, but they found that high performing networks, 210 00:07:11,724 --> 00:07:14,444 the five stars, were also narrow. I mean, 211 00:07:14,444 --> 00:07:15,824 they're actually in fact the narrowest, 212 00:07:16,365 --> 00:07:18,444 which was reinforcing to what you guys are 213 00:07:18,444 --> 00:07:20,604 talking about, which is, you know, bigger is 214 00:07:20,604 --> 00:07:22,704 not necessarily better when it comes to networks, 215 00:07:23,404 --> 00:07:25,584 and the member experience and the provider. 216 00:07:26,770 --> 00:07:27,650 I think what 217 00:07:28,050 --> 00:07:30,850 it's interesting is for for many years, we've 218 00:07:30,850 --> 00:07:32,370 all thought that the way to kind of 219 00:07:32,370 --> 00:07:34,550 control cost is to kind of 220 00:07:35,009 --> 00:07:35,910 shape utilization 221 00:07:36,530 --> 00:07:38,069 of of how members 222 00:07:38,514 --> 00:07:40,355 utilize health care. So we're gonna help influence 223 00:07:40,355 --> 00:07:42,355 them and direct them to better doctors, or 224 00:07:42,355 --> 00:07:43,254 we're gonna try 225 00:07:44,194 --> 00:07:46,615 and kinda, you know, bad words like gatekeep. 226 00:07:47,074 --> 00:07:47,895 And and 227 00:07:48,514 --> 00:07:51,235 when increasingly, what what everyone is seeing is 228 00:07:51,235 --> 00:07:53,415 that a better designed foundational 229 00:07:54,040 --> 00:07:56,759 network actually leads to a better experience. It 230 00:07:56,759 --> 00:07:57,580 leads to, 231 00:07:58,439 --> 00:07:59,259 less abrasion 232 00:07:59,560 --> 00:08:02,780 for providers. It leads to better natural 233 00:08:03,160 --> 00:08:04,860 care routines, care pathways. 234 00:08:06,185 --> 00:08:08,985 It leads to better outcomes, more satisfaction, lower 235 00:08:08,985 --> 00:08:11,165 cost, all that good stuff. And 236 00:08:12,345 --> 00:08:14,985 even regulators are understanding that bigger is not 237 00:08:14,985 --> 00:08:17,145 necessarily better. What they really want is true 238 00:08:17,145 --> 00:08:20,569 access. They want to understand that that, are 239 00:08:20,569 --> 00:08:22,110 all these primary care doctors, 240 00:08:22,970 --> 00:08:24,430 in fact seeing patients? 241 00:08:24,810 --> 00:08:26,829 Are all these locations, in fact, real? 242 00:08:27,370 --> 00:08:27,870 And, 243 00:08:28,410 --> 00:08:30,910 you know, so what we're we're seeing 244 00:08:31,529 --> 00:08:32,684 that it's, 245 00:08:33,165 --> 00:08:36,764 a conversation about network composition, who's in, who's 246 00:08:36,764 --> 00:08:38,384 out, how to think of that. 247 00:08:38,764 --> 00:08:39,404 You know, even in 248 00:08:40,605 --> 00:08:41,965 step back for a sec. We even use 249 00:08:41,965 --> 00:08:44,684 the word like narrow network. A narrow network 250 00:08:44,684 --> 00:08:48,379 may have a lot of primary care access 251 00:08:48,840 --> 00:08:51,720 points. A narrow network may be actually quite 252 00:08:51,720 --> 00:08:53,820 broad for ambulatory surgery centers. 253 00:08:54,279 --> 00:08:56,200 It may just be narrower as it gets 254 00:08:56,200 --> 00:08:57,960 to whether it's the acute or some of 255 00:08:57,960 --> 00:08:59,420 the some of the more 256 00:09:00,565 --> 00:09:04,164 value sensitive things like oncology or other specialties. 257 00:09:04,164 --> 00:09:04,904 So, like, 258 00:09:05,284 --> 00:09:07,445 narrow, we ban you a word like narrow 259 00:09:07,445 --> 00:09:09,865 around, and it every network 260 00:09:10,245 --> 00:09:11,945 in every sort of care 261 00:09:12,450 --> 00:09:14,050 footprint has very, very, 262 00:09:14,450 --> 00:09:17,830 specialized and sort of nuanced dimensions to it. 263 00:09:17,970 --> 00:09:18,950 And that's what 264 00:09:19,410 --> 00:09:21,170 it really comes down to sort of the 265 00:09:21,170 --> 00:09:22,710 the challenge for for executives. 266 00:09:24,050 --> 00:09:26,629 It you really do need some very granular, 267 00:09:26,769 --> 00:09:28,475 high quality local data. 268 00:09:29,014 --> 00:09:30,154 You need to understand, 269 00:09:31,254 --> 00:09:32,075 the provider, 270 00:09:32,774 --> 00:09:35,415 their care capabilities, like what kind of services 271 00:09:35,415 --> 00:09:38,375 they really do. We should understand their their 272 00:09:38,375 --> 00:09:40,934 their their value in that care service. So 273 00:09:40,934 --> 00:09:43,190 is it, you know, low cost and not 274 00:09:43,190 --> 00:09:46,069 always high value. Low cost can be low 275 00:09:46,069 --> 00:09:46,569 cost. 276 00:09:47,429 --> 00:09:49,509 And so what's the value at the care 277 00:09:49,509 --> 00:09:52,069 site? And, ultimately, I think that we're finding 278 00:09:52,069 --> 00:09:53,909 that it's more and more important for people 279 00:09:53,909 --> 00:09:54,809 to think about 280 00:09:55,914 --> 00:09:58,714 the network relative to other networks in the 281 00:09:58,714 --> 00:09:59,214 market. 282 00:09:59,754 --> 00:10:02,714 This is a consumer product at some level. 283 00:10:02,714 --> 00:10:05,355 Right? We are trying to create a have 284 00:10:05,355 --> 00:10:06,495 a have a consumer 285 00:10:06,875 --> 00:10:08,634 experience great health care, and so you need 286 00:10:08,634 --> 00:10:09,294 to understand 287 00:10:09,699 --> 00:10:12,339 the provider, the service line, and then sort 288 00:10:12,339 --> 00:10:14,279 of the other options in the market. 289 00:10:14,899 --> 00:10:17,299 And the last part, Brian, which I think 290 00:10:17,299 --> 00:10:18,899 we all intuitively understand is, 291 00:10:19,620 --> 00:10:22,039 networks are, you know, highly dynamic. 292 00:10:22,820 --> 00:10:23,959 3% 293 00:10:24,019 --> 00:10:24,759 of the 294 00:10:25,125 --> 00:10:28,165 provider kind of at location information is changing 295 00:10:28,165 --> 00:10:29,225 in any given month. 296 00:10:29,764 --> 00:10:32,264 Providers are retiring, groups are restructuring, 297 00:10:33,125 --> 00:10:35,285 offices move. I mean, like, for a lot 298 00:10:35,285 --> 00:10:37,445 of reasons, the network that was here last 299 00:10:37,445 --> 00:10:38,745 month isn't here today. 300 00:10:39,559 --> 00:10:42,120 Right. Right. It's it's it's an interesting space. 301 00:10:42,120 --> 00:10:43,720 And and it it's a lot to get 302 00:10:43,720 --> 00:10:45,019 your arms around too, 303 00:10:45,480 --> 00:10:47,240 in terms of really getting that that that 304 00:10:47,240 --> 00:10:49,799 accuracy and understanding what's happening in in markets 305 00:10:49,799 --> 00:10:52,120 and your networks. So what steps can can 306 00:10:52,120 --> 00:10:54,345 health plan leaders take to to really 307 00:10:54,745 --> 00:10:57,064 strengthen performance and get more efficient, but they've 308 00:10:57,064 --> 00:10:59,725 also gotta maintain compliance. Right? Yeah. 309 00:11:00,264 --> 00:11:01,865 Can you talk a little bit unpack that 310 00:11:01,865 --> 00:11:04,105 for us, especially when it comes to ensuring 311 00:11:04,105 --> 00:11:07,625 that private provider data accuracy, network adequacy, those 312 00:11:07,625 --> 00:11:09,625 those types of things that you're mentioning? How 313 00:11:09,625 --> 00:11:12,870 can you pursue better performance while maintaining compliance? 314 00:11:13,649 --> 00:11:14,629 Right. You know, 315 00:11:15,009 --> 00:11:16,850 interestingly so a lot of people at the 316 00:11:16,850 --> 00:11:18,149 moment, a lot of organizations, 317 00:11:18,769 --> 00:11:20,370 if they don't step back and think about 318 00:11:20,370 --> 00:11:22,949 the network, the network is sort of 319 00:11:23,534 --> 00:11:24,674 one of the few 320 00:11:25,294 --> 00:11:26,754 or the core assets 321 00:11:27,294 --> 00:11:30,115 that connects all parts of the of a 322 00:11:30,815 --> 00:11:31,475 a payer, 323 00:11:32,254 --> 00:11:34,034 business. Right? It's 324 00:11:34,335 --> 00:11:35,934 part you have the bills that to be 325 00:11:35,934 --> 00:11:38,789 compliant, then you have to design it so 326 00:11:38,789 --> 00:11:41,029 that it sort of meets the membership and 327 00:11:41,029 --> 00:11:42,169 the market needs. 328 00:11:42,549 --> 00:11:45,590 You have to, you know, fit the network 329 00:11:45,590 --> 00:11:47,429 and match it to the product and the 330 00:11:47,429 --> 00:11:47,929 offering. 331 00:11:48,309 --> 00:11:50,995 The network will dictate in many ways what 332 00:11:50,995 --> 00:11:53,714 members they're gonna see and and where who 333 00:11:53,714 --> 00:11:56,034 they're gonna be working with. So it it's 334 00:11:56,034 --> 00:11:59,174 a very, very it's an enterprise wide asset. 335 00:11:59,794 --> 00:12:01,394 And I think that gets to this sort 336 00:12:01,394 --> 00:12:03,634 of the imperative for what a a payer 337 00:12:03,634 --> 00:12:05,154 needs to do as they look to kind 338 00:12:05,154 --> 00:12:05,519 of 339 00:12:06,080 --> 00:12:08,800 really be, you know, performing here. The the 340 00:12:08,879 --> 00:12:11,379 yes. At one level, they have to create 341 00:12:11,440 --> 00:12:13,519 sort of a single place where their network 342 00:12:13,519 --> 00:12:15,300 data lives. They need to create 343 00:12:16,559 --> 00:12:18,100 a, kind of a clear, 344 00:12:19,075 --> 00:12:20,294 trusted enterprise 345 00:12:20,754 --> 00:12:21,815 source of content. 346 00:12:22,274 --> 00:12:25,634 They need to be somewhat rigorous, relentless, and 347 00:12:25,634 --> 00:12:28,695 continuous on making sure that their database is 348 00:12:29,475 --> 00:12:31,475 higher fidelity. And if those are the things 349 00:12:31,475 --> 00:12:32,214 that's perfect, 350 00:12:33,080 --> 00:12:34,779 it just sort of has to be continually 351 00:12:34,840 --> 00:12:35,899 managed and maintained. 352 00:12:36,600 --> 00:12:37,680 The second thing you need to do is 353 00:12:37,680 --> 00:12:40,040 you need to make that content available across 354 00:12:40,040 --> 00:12:42,200 their company so that their it guesses their 355 00:12:42,200 --> 00:12:43,820 teams that are focused on compliance, 356 00:12:45,174 --> 00:12:46,934 need access to that content to make sure 357 00:12:46,934 --> 00:12:49,495 they understand and are analyzing relative to the 358 00:12:49,495 --> 00:12:51,034 the regulatory requirements. 359 00:12:51,654 --> 00:12:54,134 But they also need that same information available 360 00:12:54,134 --> 00:12:55,894 for their mark in market teams who are 361 00:12:55,894 --> 00:12:59,529 thinking about their their messaging and their marketing 362 00:12:59,669 --> 00:13:01,769 in their in their kind of sales 363 00:13:02,230 --> 00:13:05,110 programs. And so you need we would think 364 00:13:05,110 --> 00:13:07,529 of it you need a network decisioning tool 365 00:13:07,590 --> 00:13:09,290 that crosses the organization, 366 00:13:10,309 --> 00:13:12,889 serves a content to each of your 367 00:13:13,345 --> 00:13:15,745 kind of your teams that are sort of 368 00:13:15,745 --> 00:13:17,924 at the front lines of delivering 369 00:13:18,384 --> 00:13:20,384 in delivering health care to their to the 370 00:13:20,384 --> 00:13:20,884 market. 371 00:13:21,264 --> 00:13:23,424 It needs to be kind of workflow enabling. 372 00:13:23,424 --> 00:13:26,565 It needs to eliminate handoffs or simplify handoffs, 373 00:13:26,860 --> 00:13:29,040 and it needs to get the right information 374 00:13:29,100 --> 00:13:31,200 to the experts at the right point. 375 00:13:31,580 --> 00:13:34,080 You know, the network conversation needs to move 376 00:13:34,139 --> 00:13:36,320 from being what I think it is reactive 377 00:13:36,540 --> 00:13:37,360 to proactive. 378 00:13:37,740 --> 00:13:40,559 It needs to help everybody sort of understand 379 00:13:40,620 --> 00:13:42,684 not only not where they've been, but where 380 00:13:42,684 --> 00:13:44,065 they wanna get to. 381 00:13:44,444 --> 00:13:44,845 And, 382 00:13:45,485 --> 00:13:47,485 a lot of what we see in, across 383 00:13:47,485 --> 00:13:49,264 the industry is conversations 384 00:13:49,964 --> 00:13:52,225 not about the business or the network, 385 00:13:52,684 --> 00:13:55,164 but about sort of whose data was more 386 00:13:55,164 --> 00:13:56,464 right or or wrong. 387 00:13:57,139 --> 00:13:59,240 We need to shift this from a data 388 00:13:59,460 --> 00:13:59,960 debate 389 00:14:00,419 --> 00:14:03,000 to one about of action and decisions. 390 00:14:04,259 --> 00:14:06,740 I I appreciate the comments. And and and 391 00:14:06,740 --> 00:14:09,460 I think, you know, to do this work, 392 00:14:09,460 --> 00:14:11,139 to do what what you're talking about doing, 393 00:14:11,139 --> 00:14:12,945 getting your arms around that data, making that 394 00:14:12,945 --> 00:14:14,965 content available across their company, 395 00:14:15,425 --> 00:14:17,825 messaging, informing, marketing, all all that, Steve. Right? 396 00:14:17,825 --> 00:14:19,684 You're gonna need you're gonna need 397 00:14:20,384 --> 00:14:22,144 a a a particular emphasis on on on 398 00:14:22,144 --> 00:14:24,465 technology, and there's perhaps a a two letter 399 00:14:24,465 --> 00:14:27,259 acronym. I'm dancing around here. But what's the 400 00:14:27,259 --> 00:14:29,200 what's the role of technology 401 00:14:29,820 --> 00:14:32,460 in this process and driving innovation? And, I 402 00:14:32,460 --> 00:14:34,700 guess, what should folks help plan leaders listening 403 00:14:34,700 --> 00:14:36,860 to this really be paying special attention to 404 00:14:36,860 --> 00:14:38,080 in 2026? 405 00:14:38,355 --> 00:14:39,095 Yeah. Look. 406 00:14:39,394 --> 00:14:41,794 So I think, you know, we we are 407 00:14:41,794 --> 00:14:44,195 seeing and I've and I've seen that every 408 00:14:44,195 --> 00:14:46,834 every organization has a CRM tool. Right? They've 409 00:14:46,834 --> 00:14:49,334 they've they've got someone doing their client relationship 410 00:14:49,394 --> 00:14:52,034 management and doing marketing and messaging. And mostly 411 00:14:52,195 --> 00:14:53,254 most people have 412 00:14:53,660 --> 00:14:54,160 some 413 00:14:54,620 --> 00:14:55,680 single enterprise, 414 00:14:56,300 --> 00:14:59,360 accounts receivable and accounts payable application. And organizations 415 00:14:59,580 --> 00:15:02,080 have a single if you're if you're in, 416 00:15:02,700 --> 00:15:05,740 materials, you've got an ERP in in resource 417 00:15:05,740 --> 00:15:08,544 planning and supply chain. Well, I think networks, 418 00:15:08,924 --> 00:15:10,764 is a similar spot. We need an enterprise 419 00:15:10,764 --> 00:15:12,705 network platform, decisioning platform. 420 00:15:13,644 --> 00:15:15,504 So you need a tool that connects it. 421 00:15:15,644 --> 00:15:17,725 But but all these tools, as as you're 422 00:15:17,725 --> 00:15:18,524 alluding to, 423 00:15:19,085 --> 00:15:21,504 are are reliant on great data 424 00:15:21,830 --> 00:15:23,509 and sort of bringing that data to a 425 00:15:23,509 --> 00:15:24,330 single spot. 426 00:15:24,789 --> 00:15:27,110 I think it they then need sort of 427 00:15:27,110 --> 00:15:28,330 what I think are accepted 428 00:15:28,710 --> 00:15:29,210 analytics. 429 00:15:29,909 --> 00:15:32,789 In the unique thing about networks is because 430 00:15:32,789 --> 00:15:33,610 of the geolocation 431 00:15:33,990 --> 00:15:37,684 aspect of them, they're they're understanding a network 432 00:15:38,065 --> 00:15:40,325 and how it meets a member need is 433 00:15:40,625 --> 00:15:43,585 very processing intensive. It's a time and distance 434 00:15:43,585 --> 00:15:44,085 calculation. 435 00:15:44,545 --> 00:15:45,605 There's an experience 436 00:15:46,065 --> 00:15:46,965 driving issue, 437 00:15:47,519 --> 00:15:48,179 and you need 438 00:15:48,559 --> 00:15:50,720 what are effectively sort of the in the 439 00:15:50,720 --> 00:15:51,860 accepted endorsed 440 00:15:52,399 --> 00:15:53,459 measures of that, 441 00:15:54,000 --> 00:15:56,820 so that people can rely on the conversations 442 00:15:57,120 --> 00:15:57,699 of measurement. 443 00:15:58,480 --> 00:16:00,639 And then lastly, you need to kinda put 444 00:16:00,639 --> 00:16:02,079 all this stuff in the context of a 445 00:16:02,079 --> 00:16:03,794 workflow, and you have to connect people. And 446 00:16:03,794 --> 00:16:06,115 I think this last part is where we're 447 00:16:06,115 --> 00:16:06,855 gonna see 448 00:16:07,235 --> 00:16:09,714 that two letter acronym that you are kinda 449 00:16:09,714 --> 00:16:12,274 dancing around, which is AI and Agentic and 450 00:16:12,274 --> 00:16:14,274 what we're seeing in there. I think with 451 00:16:14,274 --> 00:16:15,014 good data, 452 00:16:15,509 --> 00:16:18,730 with good analytics, you can start to accelerate 453 00:16:19,190 --> 00:16:21,929 the kind of the insight and decision making 454 00:16:22,230 --> 00:16:24,009 with some of this Agentic technology. 455 00:16:24,790 --> 00:16:27,910 You can put experts at the edges of 456 00:16:27,910 --> 00:16:28,410 organizations 457 00:16:28,790 --> 00:16:31,154 and get them access to content that in 458 00:16:31,154 --> 00:16:33,074 a way that they can engage with it 459 00:16:33,074 --> 00:16:35,095 faster and get fat better decisioning. 460 00:16:35,954 --> 00:16:38,294 So it's a really exciting time. 461 00:16:38,674 --> 00:16:39,894 You know, we're seeing 462 00:16:40,195 --> 00:16:43,074 organizations really get excited about this idea of 463 00:16:43,074 --> 00:16:44,134 a network platform. 464 00:16:44,679 --> 00:16:47,720 We're seeing people understand the power of data 465 00:16:47,720 --> 00:16:49,559 and and the need to to kind of 466 00:16:49,559 --> 00:16:52,679 really govern and and and kind of integrate 467 00:16:52,679 --> 00:16:53,660 the data pieces. 468 00:16:54,120 --> 00:16:55,740 And, slowly but surely, 469 00:16:56,200 --> 00:16:58,519 getting excited about AI and how it can 470 00:16:58,519 --> 00:17:00,059 be real workflow enabling. 471 00:17:00,815 --> 00:17:03,934 Yeah. Because the the the AI technology component 472 00:17:03,934 --> 00:17:05,775 of it, it's it's kind of there. Right? 473 00:17:05,775 --> 00:17:08,115 It's it's got the capacities. It's but it's 474 00:17:08,174 --> 00:17:10,515 it's kind of about getting that data right, 475 00:17:10,575 --> 00:17:12,734 getting that data underneath it so you can 476 00:17:12,734 --> 00:17:14,835 you can really unlock the 477 00:17:15,200 --> 00:17:17,700 the the power of that technology. Correct, Steve? 478 00:17:17,920 --> 00:17:20,000 Yeah. And it's funny. When I think about 479 00:17:20,000 --> 00:17:21,700 the AI space, a lot of 480 00:17:22,160 --> 00:17:24,339 we're not looking at AI to tell you 481 00:17:24,400 --> 00:17:26,579 which doctor is the best answer. 482 00:17:27,144 --> 00:17:28,904 You know? Yes. It you know, it it 483 00:17:29,065 --> 00:17:31,865 it's not it it's it's not hard to 484 00:17:31,865 --> 00:17:34,204 say, look. In this in this market, 485 00:17:34,505 --> 00:17:35,565 here are three 486 00:17:36,424 --> 00:17:37,484 potential configurations 487 00:17:37,865 --> 00:17:40,049 for your network to be to meet your 488 00:17:40,049 --> 00:17:41,029 business objectives. 489 00:17:41,409 --> 00:17:44,289 And so the technology can help you do 490 00:17:44,289 --> 00:17:44,789 that, 491 00:17:45,169 --> 00:17:46,609 you know, get you to three or four 492 00:17:46,609 --> 00:17:48,149 different scenarios faster. 493 00:17:48,450 --> 00:17:50,289 But there's gonna be an expert who's gonna 494 00:17:50,289 --> 00:17:53,009 look at those scenarios and and evaluate them 495 00:17:53,009 --> 00:17:55,025 for sort of the the things 496 00:17:55,565 --> 00:17:58,365 static model or and kind of an agent's 497 00:17:58,365 --> 00:17:59,424 not gonna get to. 498 00:17:59,884 --> 00:18:01,904 So I think there's, yes, there's something about 499 00:18:01,965 --> 00:18:02,465 more 500 00:18:02,924 --> 00:18:05,404 insight faster for people through some of the 501 00:18:05,404 --> 00:18:07,565 Genentech stuff. But the second part I think 502 00:18:07,565 --> 00:18:09,345 is really important, which is workflow. 503 00:18:10,289 --> 00:18:13,090 I think, the AI stuff is gonna be 504 00:18:13,090 --> 00:18:15,509 really, really transformative in helping take 505 00:18:15,890 --> 00:18:17,670 content from one end of the organization 506 00:18:18,450 --> 00:18:20,850 and move it rapidly to the other side 507 00:18:20,850 --> 00:18:23,090 and say, hey. You may not know this 508 00:18:23,090 --> 00:18:25,795 yet, but here's what happened with this market. 509 00:18:26,095 --> 00:18:28,115 You've got an emerging gap or 510 00:18:28,414 --> 00:18:29,154 this organization 511 00:18:29,535 --> 00:18:30,355 has changed, 512 00:18:31,214 --> 00:18:33,615 its affiliations, and now you've got sort of 513 00:18:33,615 --> 00:18:36,494 competitive issue. Here are three choices. What do 514 00:18:36,494 --> 00:18:38,339 you wanna do about that? The ability to 515 00:18:38,339 --> 00:18:40,839 get that content across the organization fast, 516 00:18:41,779 --> 00:18:42,599 really powerful. 517 00:18:43,460 --> 00:18:46,920 Yeah. Excellent. Yeah. Truly, truly able to conceptualize 518 00:18:47,059 --> 00:18:48,660 just how powerful that would be for an 519 00:18:48,660 --> 00:18:51,765 organization. For, ultimately, for for for for members. 520 00:18:51,765 --> 00:18:53,924 There's just so many different benefits that could 521 00:18:53,924 --> 00:18:55,284 come from that sort of vision of the 522 00:18:55,284 --> 00:18:55,784 future. 523 00:18:56,164 --> 00:18:58,325 Is there anything, Steve, we didn't touch on 524 00:18:58,325 --> 00:19:00,744 our conversation today that you wanna make sure 525 00:19:01,044 --> 00:19:03,765 to to leave listeners with? Maybe it's something 526 00:19:03,765 --> 00:19:05,980 you wanna reemphasize or a fresh point. I 527 00:19:05,980 --> 00:19:07,339 kinda leave it to you. But how do 528 00:19:07,339 --> 00:19:08,799 you how do you wanna close out today? 529 00:19:09,419 --> 00:19:10,299 So, look, 530 00:19:10,619 --> 00:19:12,619 you know, Brian, we started with this comment 531 00:19:12,619 --> 00:19:15,500 about how it's a complicated time and it's 532 00:19:15,500 --> 00:19:17,359 a real challenge and the margin pressure. 533 00:19:17,994 --> 00:19:21,034 I think, you know, I'm really excited. I 534 00:19:21,034 --> 00:19:22,974 see people at all these organizations 535 00:19:23,914 --> 00:19:26,394 facing real difficulty, but also facing it with 536 00:19:26,394 --> 00:19:27,134 some optimism. 537 00:19:27,755 --> 00:19:29,134 I'm really motivated 538 00:19:30,089 --> 00:19:31,630 by the meaningful 539 00:19:32,250 --> 00:19:33,069 kind of creativity, 540 00:19:33,450 --> 00:19:34,269 the innovation, 541 00:19:35,289 --> 00:19:38,329 the changes that I'm hearing from our clients 542 00:19:38,329 --> 00:19:40,829 and, you know, around the ecosystem, providers, 543 00:19:41,609 --> 00:19:42,109 payers, 544 00:19:42,835 --> 00:19:43,335 regulators, 545 00:19:43,875 --> 00:19:45,955 and there's a real optimism. It may not 546 00:19:45,955 --> 00:19:47,894 feel that way, but I think people are 547 00:19:48,195 --> 00:19:49,955 looking at the future saying it could be 548 00:19:49,955 --> 00:19:52,115 great. And I'm really excited. I know I've 549 00:19:52,115 --> 00:19:53,875 got hundreds of people here at Quest that 550 00:19:53,875 --> 00:19:57,069 are excited about sort of the the power 551 00:19:57,069 --> 00:19:58,450 of what's ahead. So 552 00:19:59,069 --> 00:20:00,750 put it all together. It you know, we 553 00:20:00,750 --> 00:20:03,230 can help hundreds of millions of Americans get 554 00:20:03,230 --> 00:20:04,130 better health care. 555 00:20:04,750 --> 00:20:06,990 Well, Steve, it really was a pleasure and 556 00:20:06,990 --> 00:20:09,650 truly appreciate you ending on that that optimistic 557 00:20:09,789 --> 00:20:10,690 note. I think, 558 00:20:11,095 --> 00:20:12,454 important for all of us to get healthy 559 00:20:12,454 --> 00:20:14,534 doses of of optimism these days. Thank you 560 00:20:14,534 --> 00:20:16,054 so much for coming on the podcast, Steve. 561 00:20:16,054 --> 00:20:18,454 We also wanna thank our podcast sponsor, Quest 562 00:20:18,454 --> 00:20:18,954 Analytics. 563 00:20:19,335 --> 00:20:20,934 You can tune in to more podcasts from 564 00:20:20,934 --> 00:20:24,054 Becker's Healthcare by visiting our podcast page at 565 00:20:24,054 --> 00:20:25,994 beckershospitalreview.com.