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Welcome to the Becker's Healthcare podcast.

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I'm Chris Sosa, the copy chief here at

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Becker's. I am thrilled to be joined by

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Dan Larson, principal and chief strategy and marketing

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officer at HealthBridge Children's Hospital. Dan, thank you

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for joining us today.

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Thank you, Chris, for having me on.

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Wonderful. Dan, for our audience members who are

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not familiar with you and your work, could

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you please introduce yourself and tell us a

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bit about your background?

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Sure. So my name is Dan Larson.

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I've been in health care since, 1989,

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as as a principal owner of three different

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businesses. The the one that the HealthBridge Children's

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Hospital is a current business.

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Initially developed a partnership with my sister who's

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a speech pathologist in 1989,

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and we founded a company called South Coast

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Rehab Services,

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which contracted with skilled nursing facilities throughout the

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country.

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We we drew that to about 17 states

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and 240

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some contracts, and then we end up selling

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it to one of our, actually, one of

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our clients. And we became their in house,

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rehab company once,

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the

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the Sniff business and Medicare business went to

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prospective pay. So that was in 1997.

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And as as part of that,

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we were involved in in another takeout of

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SunHealth from from Regency.

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And when we were managing,

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that rehab department, we had a little group

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in there called Meridian NeuroCare,

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which was really a kind of residential based

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spinal cord and and traumatic brain injury rehab

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business. We we liked it a lot. And

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so when, Sun went to purchase that deal,

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we asked, Rick Matros and and,

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yeah, if we could go in and buy

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it. He said, absolutely. So he, along with

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Bruce Broussard, former Humana guy, he was our

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CFO at the time.

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We purchased Little Meridian NeuroCare, renamed it Care

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Meridian,

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and grew that to a multisite operation to

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32 sites, and then we we we exited

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that business as well.

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In in the mean so most of my

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career has been kind of in this post

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acute rehab space. I did do a short

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stint here in St. Louis,

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where I was the CEO of Premier Care

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Orthopedics, which is a kind of a roll

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up strategy for practice management roll up strategy

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for orthopedic surgeons.

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And then we also founded a group called

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Signature Health Services, which was a large which

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now got large MSO.

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So, again, most most of my space has

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been in the in the in the rehab

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post acute side of it. And, really,

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the the pediatric hospital is very similar to

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that. We have four levels of care. We

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have, we have both, acute beds and subacute

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beds. We have LTAC. We have

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acute rehab.

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We have subacute, and we also have outpatient

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services. So I I never say never, but

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I think,

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after thirty five years, this will probably be

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the last company I start.

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Well, clearly, you've had a lot of experience

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in any number of areas in in health

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care, Dan. So

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what exactly about

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investing in starting Helpbridge Children's,

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appeal to you in particular?

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So I'm a I'm a huge proponent. So

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take a step back.

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Most of the stuff I've been involved in,

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deals with especially the the care meridian phase

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of it dealt with

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really complex injuries that required

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really long

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long recoveries,

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multisite kind of, you know, kind of care

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model. And so understanding that the family is

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going through this recovery process and there's gonna

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be multiple providers involved,

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I was a huge advocate for, you know,

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having a coordinated care model. So we had

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actually, at Care Meridian,

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with,

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Santa Clara Valley,

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hospital, we developed a program called NeuroNet,

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which was really a collection of four different,

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companies

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that provided that full level of care with

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a common,

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nurse navigator as the case manager,

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from the onset of the injury all the

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way to home. And so that coordinated care

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model was a huge deal to to us.

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We we saw,

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the outcomes were much better. The client satisfaction

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was much better. And so we as we

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looked at this segment of of pediatric care,

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most of these kids are, you know, very

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fragile, medically complex kids.

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It's the same it's the same problem, same

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business problem. And so we are, you know,

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working hard to build out that full continuum

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on the post acute side, and then and

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then working and coordinating that with our with

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our for hospitals,

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in the in our markets that like the

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CHOC hospitals of the world. So it's it's

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really, you know,

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again, taking these kids that are medically complex

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and have these long recoveries and and building,

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both efficiency into it and predictability for families.

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I understand. I mean, clearly, there's a lot

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of work involved with that, Dan. Given all

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that that you've just laid out for us,

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what are your top priorities today?

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So we are,

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we're working with several different hospitals to, you

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know, to,

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put process to that coordinated care model, that

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nurse navigation.

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Again, think we think that is is real

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key. We also are looking at at ways

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where the ED boarding problem, what especially with

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these kids that need,

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acute beds where we can accept these these

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children directly out of the EDs.

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That's a that's a big push of ours.

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And then,

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you know, again, these kids most of these

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kids are going home with some level of

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permanent disability

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and and ongoing medically complex issues. So there's

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a, you know, high risk for these kids

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to bounce back. And so we're implementing a

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program called safe at home, which is a,

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you know, post discharge predictive risk scoring framework

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so that we can,

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look at

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the the the the things that basically impact

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that child's life that could end up causing,

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you know, a negative event like a seizure

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or something else that would require rehospitalization.

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So and we're, you know, we'll overlay that

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with AI tools to be able to look

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at these trends and hopefully get to a

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point where we can start predicting, okay,

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if these things are happening, the risk for

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this is is as acts. And so what

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we wanna be able to do is support

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those caregivers at home to be able to

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give them a little bit of a heads

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up as we start seeing trends that are

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developing

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that could, you know, potentially end in some

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negative event that would require a rehospitalization.

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Dan, I'm glad you mentioned trends. With respect

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to those, whether it's the safe at home

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program, which sounds like a terrific, if not

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a very complicated and challenging endeavor that you

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have going on. How do you think your

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role is going to change, and how is

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the role of your team going to change?

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Well, I don't know necessarily if my role

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will change that much. I I, you know,

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as as an owner too, I have my

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hands as you can imagine in finance and

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everything else. My my primary focus though every

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day is is really the the the strategy

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and the payer side of the market.

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So I don't really anticipate

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much change to my role, but a lot

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of our clinical people are are required

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in in these, development meetings. And so they've

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never, you know, they've never been in them

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before. So it's all kind of new territory

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for them,

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participating in more business process than, you know,

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being on the floor clinical. But we have

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great experts, and

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and, these different models are predicated on the

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fact that, you know, again, we can we

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have the clinical goods to deliver. So I

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need them involved in that in that development

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process.

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Lastly, Dan, I have a two part question

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for you. Sure.

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Here's how it goes. So I would like

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to know what exactly is making you nervous

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about health care in general right now, whether

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it's pediatrics related or not, and what are

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you excited about?

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Well, on on the pediatric side,

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obviously,

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unless you've been living in an alternate universe,

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you know, we we see, you know, the

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the headlines every day about the prospective

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Medicaid cuts,

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coming down. And so,

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you know, it it depends on how that,

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you know, how those end up happening and

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how that would affect us. Most of the

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kids that we take care of,

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tend to be Medicaid

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at some point.

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And in California,

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if you're if if you have a catastrophic

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injury or illness and it goes more forty

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five days, you get put in at the

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into the CCS process. So,

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it's a covered it's a covered actually, a

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a covered level of care within the state

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of California, which is unique. And so not

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knowing fully how that plays out,

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you know, we're we're we're watching it. We're

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we're a little bit nervous. We're we're anticipating

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that,

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given the space that we're in and and

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we're in such a cost savings,

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level of care, we should be okay. But,

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you know, it all depends. And and from

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our perspective,

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since it's pediatrics, we're not worried about, you

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know, the the work requirement,

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or any of that. So

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we're just kind of a niche player in

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that. So we're watching it carefully, but it

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definitely is something that, you know, it had

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has us concerned.

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On the on the, you know, what makes

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us excited,

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you know, this level of care,

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is unique. And the the reason why it's

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unique is if you look at Medicare,

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Medicare cut cuts across all 50 states. Right?

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So you have the same you have a

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well worn path to these adult continuous of

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care, short stay, LTAC,

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acute rehab, SNF,

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assisted living, home health.

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Those are all licensed,

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levels of care with reimbursement.

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When you look at our level of care,

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it's predominantly Medicaid, so it's a state by

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state effort. So there's no way really where

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you can just go this business model is

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gonna work in every state because there might

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not be the reimbursement for it. However, we

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as we see the trends, California has gone

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to a % managed Medicaid.

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We're seeing more and more managed products,

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that growing.

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That gives us the ability to negotiate deals

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directly with the insurance companies and not state

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itself to get the right rate structure.

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So we're we we, you know, we feel

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like we're in the in the early minutes

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of the first quarter of the game, and

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there's no 800 pound gorilla yet. And there's

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a lot of organic opportunity out there. And

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so and and we we know that this

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business is, was founded in February.

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I tried to buy it when I was

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at Care Marine, and I couldn't get it

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done, but we eventually did,

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personally. But this this this proof time and

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time again to be able to create, you

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know, outstanding outcomes at a lower cost price.

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And a lot of these kids would would

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formally just live in the children's hospital. That's

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an inappropriate level of care. So we think

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estates are looking to reduce cost spend, as

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the insurance companies are looking to, you know,

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find alternatives to higher cost, you know, types

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of settings, I think, you know, this level

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of care is is is perfect.

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We see it you know, health systems are

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gonna, you know, want it.

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Insurance companies are gonna want it. So we

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we just I think this is the one

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true thing where you kinda you always see

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those business slides with the hockey stick. I

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think this is as these states become more

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managed and as we start to see this

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roll out, I think you're gonna see, you

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know, big growth,

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if, you know, three to five years out.

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That's when it's gonna take off. So, we

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just wanna be we wanna be on the

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front end of it.

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Dan, thank you so much for all your

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time and your insights today. You've been very

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generous, and we can't wait to share them

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with our audience soon.

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I appreciate it, Chris. Thanks so much.