EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD

[00:00:01] Episode 462, Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts. Today I speak with Dr. Scott Conard. American healthcare entrepreneurs and executives you want to know, talking, relentlessly seeking value.

[00:00:29] Hello tribe. I hope everyone is holding up in this Q1 where there is so much going on. I feel like I'm juggling 10 plates while running on a treadmill that keeps stopping and starting. I'm reading at random intervals. How you doing? This podcast with Dr. Scott Conard today, first of all, I enjoyed how it came to be. Brian Ulig, an employee benefit consultant of some acclaim, came to me and offered to sponsor a show for someone else, not himself.

[00:00:57] I gotta say, it's stuff like this that warms my heart. It's this village that we have here, this tribe of relentless folks trying so hard to stand up for and help patients. So thanks again to Brian Ulig. Also, this has nothing to do with the show that follows. Remember the episode with Cynthia Fisher from December? We'll link to the episode in the show notes. This is the one where we talked about the growing problem of medical spread pricing. If you have no idea what I'm talking about, no worries, just go back and listen to that show.

[00:01:27] But if you do, Brian Ulig was able to save $80 million for a particular employer client and he was doing a bunch of different things, but combating medical spread pricing was one of them.

[00:01:40] Okay, so today I am speaking with Dr. Scott Conard. If that name sounds familiar, you might remember it from the earlier episode where Dr. Conard told for the first time ever his story about how he had built an amazing advanced primary care practice only to find it destroyed basically by perverse incentives.

[00:02:01] Yeah, it's a dramatic and I don't know, pretty tragic tale actually. So do go back and listen to that earlier show if you haven't already. Dr. Scott Conard talked today about the evolution of his life's work. Right now, Dr. Conard is doing a bunch of work with Mike Adams from 7-Eleven helping their plan members. A lot of this work is centered on and about a few pretty striking but very common insights that many plan sponsors will find in their own data.

[00:02:29] It turns out about 70% give or take of people who wind up costing the plan whatever the high cost threshold is in any given plan year. These higher cost claimants didn't fall out of the sky unexpectedly, 70% of them. They were actually high risk but low cost in prior years.

[00:02:50] So the trick is to find these individuals and help them not fall into the high risk and high cost part of the graph. Again, identifying high risk patients who are currently in the low cost zone who any given plan year are going to go out of that zone and get into the high cost area. So if we're thinking about best practices to avoid this, I'm going to run through Dr. Conard's list that we mostly run through in the show that follows, although some of the steps in the Stepwise we cover more thoroughly than others.

[00:03:19] Okay, so here's the Stepwise best practice approach to managing population health at the plan sponsor level. Step one, get the data. Not to divide everyone up into, you know, disease buckets or whatever you call them, but to run a whole person risk score for each member. You got to treat a patient like a human being after all, not the sum of a whole bunch of disconnected body parts.

[00:03:41] Miriam Paramore has a harrowing story about her father's end of life if you want to dig in on that and cry a tear or two. But bottom line, human beings are one system, not a coterie of disconnected parts. So that's step one, do the whole person risk score with the data. Step two, get members access to advanced primary care teams.

[00:04:03] And those teams should be empowered and equipped to make referrals to demonstrably excellent specialists offering high quality, appropriate and optimized care. Step three in Dr. Conard's Stepwise best practice approach to managing populations of patients. Align benefit designs and what you want members to be doing to ensure that they have access to get this appropriate, optimized care that we just talked about. Dr. Mark Fendrick talked about this on a show from a couple of years ago.

[00:04:33] I'll link to it in the show notes. He talks about benefit designs and optimized medical care being like peanut butter and jolly. And here's why he said that. If, say, for example, a doctor tells a patient with diabetes to go get a foot exam regularly so, you know, they don't wind up needing their foot amputated. And if the patient responds, sounds great, doc, but I can't go get my foot examined. I can't afford the copay of the office visit. Then, yeah, patient loses. Doc, by the way, gets dinged on their quality scores.

[00:05:02] And the plan sponsor winds up, I was going to say footing the bill, but that might be a terrible pun if we're talking about foot amputations, winds up paying the bill for some pretty expensive and also pretty avoidable disease exacerbation. So step three is align benefit designs with care pathways, what we want members to be doing. So that's number three.

[00:05:21] Number four, the fourth thing in our best practice stepwise to managing populations of patients is to use a tool like my personal health assistant, for example, or a navigator to make sure members are engaged and are navigating the health care system along these optimal pathways that we just talked about. Dr. Scott Conard talks a little bit about this. My personal health assistant today.

[00:05:44] It's a service his team offers that engages unengaged patients and is a needed companion to many advanced primary care efforts. Lastly, lastly, we touch a little bit in the show today on community run primary care. This is a community paying for primary care for community members, just like they pay the fire department and the police department.

[00:06:06] For all the reasons that we talk about on the show, it's maybe cheaper for a community to make sure that their neighbors get primary care so that they don't go uninsured to the hospital for an exacerbated condition, run up a huge bill that guess who winds up funding? Local employers through higher cost shifted hospital prices and taxpayers, of course. Maybe in the long run, it'd be cheaper to keep the town healthier. And it also, I don't know, just feels like the right thing to do.

[00:06:33] I will mention primary care for all Americans has a free practical guide to organizing to bring high value primary care to communities. Dr. Scott Conard, my guest today is founder and partner over at Converging Health. Converging Health has a data practice, a consulting practice, and also my personal health assistant, which Dr. Conard talks a bunch about in the show that follows. Today, as I mentioned, the show is sponsored by Brian Ulig.

[00:07:02] And here is my conversation with Dr. Scott Conard. Dr. Scott Conard, welcome to Relentless Health Value. Hey, I'm so excited to be here, Stacey. Let's change the world. What do you say? Let's do it. Okay, so let's run through some typical points to ponder and maybe conventional wisdom. And for sure, that conventional wisdom might be correct and not applying otherwise. But most people will say that the first step to doing population health or one of the first steps is going to be to get your data.

[00:07:27] You need the data to be able to gain insights to figure out what to do. For example, wow, do we have a lot of musculoskeletal spend? And I recorded a podcast which is going to go live in a couple of weeks. Turns out these days, 6% of total costs for most health plans are emergency room visits right now. So, basically, get the data and then get a bead on what's actually happening in that plan data.

[00:07:54] I'm having a strong visceral reaction to what you just said. Because I think it's indicative of the way we think about data wrong, not the way we think about it right. So, it's interesting what your emergency room spend is. It's interesting what your musculoskeletal spend versus your cardiometabolic versus your cancer spend is. But a human being, we've got to throw the actual accounting approach away and we've got to engage a whole person risk strategy.

[00:08:22] Because the person who's got the back pain is obese and they have diabetes. And the person who has a cancer also has COPD and they have atherosclerosis to their lower extremities. And so, what we do is we come at them with this diabetes and hypertension solution and they're like, excuse me, I'm in hospice with stage 4 lung cancer. It's like, are you kidding me? Or, hey, you can get 100 points if you go walk a 5K and we have a corporate sponsored one this weekend. Would you please sign up? And they're like, I just had neck surgery. I can't feel my left arm. And it's just embarrassing.

[00:08:52] The dentist Bishop used to call it the Easter egg hunt, where we give people points if they go do things, regardless of the human being that you're talking to. So, what's interesting to me in the data that you alluded to was, what are the challenges this human being has to address in order to lower their health risk and therefore decrease their likelihood of having a clinical event and increased cost? What do they need to do to become healthy and decrease their illness?

[00:09:21] So, what I'm understanding you say is that it's not just like a whole bunch of, you know, we're dividing people into the... It's allopathic medicine. It's like people are a car. You've got a carburetor. You've got an engine. You've got tires. You've got upholstery. And we're going to talk about everybody in your company's engine looks like this and everybody in your company's tires looks like this. And it's like, you need to treat the car, not just change a tire. Okay. So, let me restate our step one here, which is get your data.

[00:09:47] But what should be done with it isn't the typical divide everybody into diseases. What should be done is have some kind of equation algorithmically where you're assessing whole... You call it the whole risk score. The whole person risk. The whole person risk score.

[00:10:04] So, effectively what we're doing is we're scoring, you know, based on all of their whole person, what the categories are in that population of who's really at high risk, who's not. Right? And we're staggering the individuals in our population relative to that because that is going to determine what the risk is overall as opposed to like what is the musculoskeletal risk or something like that. That's actually very interesting and a big paradigm shift.

[00:10:33] So, that's number one relative to the get your data. It's such an opaque system. It's not a system. It's such an opaque marketplace. And so, you get a person who doesn't understand what they really need to do trying to figure out what to do and they talk to somebody at a water cooler and they say, oh, I went to, you know, Dr. Hatchet and Dr. Hatchet, you know, cut this off me and now I feel better. You should go. And it's completely inappropriate care. So, the flaw or the fly in that ointment was that people didn't understand what's going on.

[00:11:00] The other fly is that I feel fine is I am healthy about 60% of the time and I feel fine is I just haven't gotten symptoms about 30% of the time. And the rest is I don't feel fine and I've got symptoms of the people. So, what happens is people will delay engaging in care while there's something you could do to reverse it.

[00:11:23] In fact, in the data, what we find is 70% of the time when you have somebody that becomes a high-cost claimant or has a higher cost associated with them, we call them high-risk, high-cost individuals. 70% of the time, if they had gotten appropriate intervention, preventive care, medications and changed their lifestyle, they would not be there. Okay, so that's why it's so important to get the data, but it's not just about getting the data.

[00:11:46] It's like, it's really what are you doing with it and making data-driven decisions based on someone's risk score so that we're optimizing the usage of the system, not kind of chucking people into various point solutions with the issues that you've described. So, let me say, systematically driving people into the most dangerous healthcare marketplace ever created in the world is not a good idea. The CFO should get very upset with that and say, let's not do that.

[00:12:15] Driving people into an optimized system of outstanding care, the greatest system in the world, when they have a need and it's appropriate, will save that same CFO a ton of money.

[00:12:27] And the HR suite, honestly, needs that CFO, COO, CEO to get on board with getting people to clinically optimize high-quality care so that they don't have to fund the 70% of things that happened that didn't need to happen that are now high-cost. We've got step one, get the data, but use it to optimize high-quality care, right? Like, it's not just a get the data. Oh, look at the cancer.

[00:12:56] It is very much, there's a roadmap for what should be done with that data. What is the whole person risk score of any given individual that are in that population? So, that's number one. We've got our second step here, which is to get our advanced primary care game strong so that the team there is empowered and equipped to refer to specialists with proven outcomes on appropriate care.

[00:13:21] Maybe there are, I've heard it said, green, yellow, and red options of specialist practices, for example. So, Stacey, I think that you're really hitting on incredibly important things. And by the way, just a quick sidebar. There's a group of us that started an organization called PrimaryCareForAllAmericans.org. And all it is, is a statement that every person in America needs to have access to high-quality primary care, period. It's got to be done at a community level. It's not something you'd legislate from Washington.

[00:13:49] And so, this is how do people in a community figure out how their primary care is going and how they can improve it so that every person in a community gets appropriate care. And the stunning thing for me, Stacey, is that if everybody, like, let's suppose that they said, oh, we've got water, we've got waste removal, we've got police, we've got fire, and we're going to now put primary care in. The cost of primary care for everybody in the community to get it is the same as fire and police.

[00:14:17] And it would decrease the cost, for the CFOs listening, it would decrease the specialist and facility costs so dramatically it would fund it. Now, I don't believe in, you know, in the state running things. But the question that we're trying to do is get people to figure out how do we make sure everybody gets access to primary care. Because we as taxpayers, let's be real, we as taxpayers through Medicaid, Medicare, uninsured care, that then they transfer the cost over to private insurers.

[00:14:44] We are paying for people not getting preventive and primary care. Preventive and primary care are an investment. The rest of health care is an expense. And you can invest in that smartly, and it will pay for itself three times over. And we can link to a, in Rhode Island, they're doing, there's a really good example of a community that installed, I'm not sure what the right word is, stood out care. That's right.

[00:15:10] They found everybody but 200 people had access to effective primary care. And so the community said, we're going to, they went to the primary care doctor said, would you care for these 200 people? Yes. How much would you charge? $40 a month. And they just wrote a check for them. So now all of a sudden, these people who are showing up in the emergency room and very, very sick, we're getting proactive care. And it saved them a lot. Read hospital press releases. They say they have to charge plan sponsors more because of all the uninsured or underinsured patients that are showing up.

[00:15:38] So, you know, like this is not like there's some curvy line that's very squiggly from point A to point B. Like we have a pretty direct correlation between let's get everybody good primary care, not transactional primary care. It is relationship based advanced primary care. This primary care team has the data to know which specialists or specialist practices are achieving the better results.

[00:16:02] Doctors who have demonstrated alignment with the general appropriateness measures, which is a term that at least Marty McCary, Dr. Marty McCary uses. He was on the podcast in 2024, in September 2024, talking about that if anyone wants to go back and listen to it. You, my friend, we're going to talk about an example, like a real live example. And maybe we can kind of like bring this home, all these sort of theoretical concepts that we talked about.

[00:16:27] Maybe let's talk about them in the context of like a very exemplar patient study. Mike Adams is the one who is designing and implementing with his leadership team a new approach at 7-Eleven. And Brian Eulig is an example of a plan of a broker consultant who gets it. And so here's a real example from the last year. There's a woman, I'm going to call her Margaret. That's not a real name. But when we did the whole person risk score, it was high. And 100 is what it was. And this is not on a scale of 1 to 100.

[00:16:57] This is on a scale of 1 to about 200. So it's high. And she had spent $14,324 in the last 12 months. She'd missed 16 days of work. And she'd gone to a primary care office where she had seen the seven-minute nurse practitioner visits. And I'm not bashing nurse practitioners. They're necessary and important. But she was running through the fee-for-service system in the usual way. She'd had five emergency room visits.

[00:17:23] She had not gotten her cervical cancer screening, mammogram, and colonoscopy, although she was the age she needed all of them. And the ER doc on the last visit said, you need to go see a back surgeon and sent her to a back surgeon who said she needed surgery. And so she reached out to what we call the personal health assistant and said, I can't afford to continue to live my life this way. It's bankrupting me. What do I do? She felt hopeless and helpless. So the plan benefit structure that was designed by the company she's in

[00:17:51] actually is designed to minimize the cost if you seek and get appropriate care. So what happened was that she got a different primary care clinician, one that was aligned with her in terms of the risk profile. And by the way, I just want to make a slight aside and say on-site, near-site clinics, and prepaid advanced primary care solutions are an example of the way a lot of companies are addressing this. And I think it's brilliant. And it makes a big difference. And I've got the data to prove it.

[00:18:21] But anyway, so this particular person, she didn't have access to that, but we got her to, let's say, a green advanced primary care provider who got her in, educated about what's going on. She got her cervical cancer screening, mammography, colonoscopy. Thank goodness they actually turned out to be okay. And set her up with a nurse practitioner in his office. And she, the nurse practitioner who loved to educate, taught this woman about what was going on.

[00:18:46] The personal health assistant also got her connected with their weight loss program that they have at the company. So fast forward a year later, she's got primary care. She's engaged. She's on the right medicine. She's gotten the preventive services. She weighed 30 pounds less. Her risk score had dropped down to 41 from 100. The projected spend of a person with a risk score of 41 is $3,500 a year.

[00:19:12] So the projected spend at 104 for the next 12 months would have been $25,000 on average. So we took her from a person who, with a prospective risk score, was going to spend on average $25,000 down to a person who's going to now spend $3,500. So all CFOs, please take note, we spent about $3,000 on her and some medication that cost about $800. And we decreased the likelihood of you writing a $25,000 check dramatically.

[00:19:42] And now she wasn't feeling hopeless, helpless. By the way, she had missed, she still missed five days of work in the last 12 months. And those five days were for the colonoscopy and the mammogram. And she had caught a cold. And she went to physical therapy for her low back pain. But she was able to do most of that at home through a really innovative point solution that really works. Because in musculoskeletal, point solutions make a huge difference. So this woman's life was completely transformed.

[00:20:12] She had a guide, the personal health assistant, that, by the way, is not a nurse. It is not a clinician. It is just a person that understands their health benefits, how to work the healthcare system, how to use the point solutions effectively, and is connecting her along the way and walking side by side with her through the process. So what we just did, what we just heard, is how do you take the chaos of the most dangerous healthcare marketplace in the world and create a healthcare system that promotes health within your company?

[00:20:40] I could go over 100 examples that are very similar to this, where they stayed engaged, they afforded it. The cost was covered. Most of the prevention was, for this woman, her out-of-pocket this year was under $500. So the median deductible, she spent $500. Recapping what you said there, because I think that was very striking, and this is kind of another thing I guess you can do with the data, is correlate the risk scores with the spend.

[00:21:07] So as you said, the whole person risk score is from zero to 200. She was around 100, and she was costing, you know, those around the 100 range. $14,000. Yeah. If you look at her actual spend the year before she started to work with the personal health assistant, it was $14,324. Looking at that risk score, projecting the average person with the risk score spends $25,000 a year. So believe it or not, she came in under the average, but still she had meter deductible and was very toxic. Okay.

[00:21:34] Margaret had spent $14,400, but the average spend with her same risk score was $25. So chances are she's going to regress to the mean, and we're going to have a, yeah, spend is just going to increase. Through this program, the team got her from the 100 risk score down to a 41, and average at 41, whole person risk score is $3,500, which obviously is considerably less.

[00:22:03] I also could just think relative to the whole attract and retain talent mandate that, wow, this feels so comforting. As you said, she's hopeless and helpless. Like just to now have hope and feel helped would just have such a psychological safety versus kind of being chucked in the chaos of the healthcare marketplace and being told to fend for yourself, which as you said, and I think this is becoming increasingly clear, is very dangerous.

[00:22:33] It's dangerous financially, it is dangerous from an overtreatment standpoint, like people are becoming aware of this. So if we are even just thinking about it from the attract and retain, having a solution like this feels, I'm sure it feels daunting for every plan sponsor listening, but there is a pathway, there is a road to get to a place like this. It's not like anyone is, you know, taking a machete and has to go hacking through the jungle, right? Like this has been done. There is a road to get to a solution like this.

[00:23:02] So it's possible to work with an entity like yours to get this done. Let me ask you one last thing here. It is often said, and I often hear that 5% of any given population is 50% of the cost. And because of that, I have talked to plenty of pretty sophisticated plan sponsors who are like, you know what, we're not going to do anything really with the people who are in air quotes, I feel fine or they're healthy or whatever, because it never works out, right?

[00:23:30] Like you wind up spending a ton of money and the cost curve does not get bent. So we're going to focus entirely on the 5% and we're really going to make sure that those dollars are spent very wisely. Like, you know, make sure that oncology patients get nausea med because turns out oncology patients with nausea are the most common cause for readmissions. Like that is what we're going to solely throw our backs into.

[00:23:56] If you're confronted with that sort of philosophy and maybe a lot of historical data to back that up, what do you say? What we know is that the people that are high risk, high cost. And by the way, when we define high cost, we're actually saying, you know, more than $6,500 a year is high cost. Okay. So what we see in our data is there's somewhere between nine and 14% of the population that is spending 80% of the money.

[00:24:22] And by the time you're spending $6,000 plus a year, it's not routine preventive and primary care. You're actually in the system. You're floundering around in the ocean of, oh my gosh, what do I do next? And that's why we chose that number is because when you look at that, that's where people need a lot of support. And it's going to be specialist facilities and optimization of pathways of care, which we didn't really talk about a whole lot today.

[00:24:45] So 60% of the people that are in that high risk, high cost will either die, go on disability, retire, or they'll go back into the low cost the next year. I.e. they have a heart attack. They spend $100,000. The next year they're going to their family doctor and cardiologist and getting a stress test and they spend $4,000. And so a new 60% is going to replace them. And guess where it comes from? It comes from the high risk, low cost.

[00:25:12] And so what those companies are arguing, and I appreciate their frustration in having wellness programs not work in the past. I'm not being critical. But what they don't appreciate is that the people who are now going to move in and replace those high cost people, 70% of the time, if they had gotten basic preventive and primary care, would not be migrating up there. It's like saying we're going to let the houses catch on fire and we're going to discharge a fire truck. And we think that's the best way to decrease the cost of fires in our community.

[00:25:42] It doesn't make sense. You put fire alarms in, do the basic things to keep the fires from happening. Or when they get on fire, you catch it early, you put it out before it damages the house. Because even though you put the fire out of the house, it's not like that house is livable the next day when it's been that far destroyed. You've got to go rebuild the whole thing and that's expensive. So it is a strategy that is not going to get them where they want to get is what I believe.

[00:26:08] So what I'm hearing you say implicit in that, it's not like this 5% like came out of nowhere a lot of times. I mean, maybe some of them do. Like all of a sudden they get some life-threatening cancer that just like happened. Brain cancer, pancreatic cancer, gallbladder cancer. Yeah, I mean, people 30% of the time, they got struck by lightning. And it's not fair. It just is. So that's 30% of the time. But you actually do have 70% of the time it was a slow roll up to that top point.

[00:26:34] Or it was like a kind of a building situation that all of a sudden crescendos. So it is in fact possible using the data, the whole person risk scores to identify these people that are on their way to what is probably going to be within a short enough period of time, a costly, problematic from a health standpoint, like bad for everybody situation. And, you know, there's a lot of ways to do this wrong, as you said,

[00:27:03] where you're just poking and prodding and doing all kinds of stuff to all kinds of people and basically over-medicalizing and spending a whole ton of money. It's not getting you anywhere. Certainly there's ways to do this wrong. But if you do this right, that's what you can accomplish. What I would say is don't boil the ocean. Don't take 100% of your population and force them into the healthcare system thinking somehow that's going to save money and make people get right care. That has been proven beyond a reasonable doubt to not work. Get your data, find the 30%, figure out what they need, like have a care plan for them,

[00:27:32] give them a guide to go through the system that you have created with your point solutions and, you know, you're optimizing the network and your bundled care if you have that. And have the guide walk them through. What you'll find is bad things don't happen. We've seen that movement from the high-risk, low-cost to high-risk, high-cost. In the company I'm talking about, 23% of the people in the low-cost, high-risk population moved to the high-risk, high-cost last year.

[00:28:00] We have corporations that we've worked with for years. We've gotten that down to as low as 11%. But on average, 15% is very possible after two years. And every time someone moves from the high-risk, low-cost, which is about $1,500 a year, to high-risk, high-cost, which averages $35,000 to $33,000 to $35,000, depending on your network contracts, you just save $28,000. And it's very easy to do the math on, okay, if we have a solution that costs $200,000,

[00:28:27] we need to get in there and keep 10 people from migrating up. And it will fund that. And on average, you can do four to 18 times that if you have effective programs in play. You're going to have like 30% that migrates from they were not on the radar. In other words, they weren't high-cost to... Right. They weren't engaged. Yeah. To all of a sudden they are. So it feels like it came out of the blue for the plan sponsor.

[00:28:55] But in a way, we're not using our data and calculating this because they didn't actually come out of the blue most of the time. Well, cancer has been in a woman's body, let's say breast cancer or cervical cancer, three to five years before it's diagnosed. Hypertension, diabetes, high cholesterol has been in a person's body five to 20 years before there's a complication. There's plenty of time to get in there and get in the game and help that person. But saying, let's hope they make it to Medicare and let's just wait till they blow up and somehow

[00:29:22] spend less on them is a really challenging way to run your life. And, you know, to avoid prevention in primary care is to damn yourself to you have a good year. You have a good year. It's a horrible year. And you reset the base point and then you have a good year. And based on sort of the numbers that you're sharing, you said you got to only find 10 patients and keep them from progressing and you pay for the whole programs. That is a very small percentage of patients. Right.

[00:29:49] And so in the large company that we've been talking about today, if we reduce the percentage of people that go from the high risk, low cost to high risk, high cost, just by 3%, it will save $12 million for the plan. The cost is under a million dollars. I was just going to say it's not $12 million. We get an 11 to 1 ROI. And we know because of historically being able to do that again and again, that over the next 18 to 24 months, this is not in 12 months, but 18 to 24 months, as we get people through

[00:30:17] that, they meet their guide, they get to know their guide, they like their guide. And by the way, this is not a call center. This is a one-on-one relationship. It is not a transaction. And that is something that so many people are missing today is having that trusted guide. As we know, we're going to be able to accomplish it and we're going to track the numbers as we do always in those situations. So talk about Converging Health. Stacey, as this mindset that we've gone over today has evolved over the last 18 years,

[00:30:41] we ended up having to create a company called Converging Health that has the clinical analytics that actually do the risk scores and figure out what's going to happen to people and gives them that care plan. So that's the first part of our company. The second part is companies got frustrated seeing that their risk scores weren't going down and people weren't getting healthier. It was not a healthcare system. It was just a financial extraction system. And so we created My Personal Health Assistant at their insistence and one of them funded it actually.

[00:31:10] And so we have the My Personal Health Assistant, which creates the guides to help people navigate their health benefits, healthcare system literacy and their health literacy. And then we have consulting because how to apply this and what the timing is. Every company is different and they have different geography. They have different challenges and they have different sizes. So we have a consulting division both on one side for ACOs and medical groups and transforming their care that Dr. Mike Tugge leads and then on the corporate side.

[00:31:40] But our goal isn't to have just ongoing consulting. It's to teach them, give them the data, have them put effective tools in place and need us less and less over time because their people are healthier and we've added years to the life and life to the years by empowering the individual people through effective plan benefit design to take control of their health and well-being. Converging Health, we've got the clinical analytics side of the house. We've got the My Personal Health Assistant, which is navigation and coaching and all the things that are wrapped up in the one-to-one relationship.

[00:32:10] And then we've got the consulting arm. Dr. Scott Conrad, where can people find you if they are interested in learning more? Yeah, converginghealth.com is probably the easiest place and we'd love to help support people through this journey as much as we can. Dr. Scott Conrad, thank you so much for being on Relentless Health Value today. I think you're so wonderful, Stacey. I just think you're fantastic and I'm so honored to have gotten to be here with you. Thank you so much. You're changing the world. This is Dr. Scott Conrad from Converging Health encouraging everyone to listen to Relentless Health Value.

[00:32:40] Stacey, I listen to your show every week. I can't wait for it to come out. Both because I love the people you have on. They're brave, courageous people who are willing to speak out. And that is really challenging in today's political environment. And two, what I learn. And I always learn something. And what comes to me as I listen to this is, who can I share this with? And so I will send the Relentless Health Value link, text it to people and email it to people. And it's amazing to me how people listen.

[00:33:09] They get turned on to you and they change the way they're designing their health benefits. They're reviewing their contracts. They're getting their PBMs contracts. And it is so exciting to be able to have you in the world doing that because I don't know of anybody else that has the wisdom and the vision that you're putting forth and bringing the people that you are on your show. And I'll see you in the world.