EP468: Very Common Assumptions That Aren’t Actually True About Member Engagement and the Healthcare Industry, With Matt McQuide

[00:00:00] Episode 468, Very Common Assumptions That Aren't Actually True About Member Engagement and the Healthcare Industry. Today I speak with Matt McQuide. American Healthcare Entrepreneurs and Executives You Want to Know, Talking, Relentlessly Seeking Value.

[00:00:27] This conversation today with Matt McQuide is such a follow on to the episode from last week where I encapsulated a major theme from the past five or six episodes. I know I'm on a roll. The thing is, if an employer doesn't take the initiative and steer members or help them navigate through our current healthcare marketplace, this marketplace can be a very dangerous place to be.

[00:00:54] But if the employer doesn't steer plan members, somebody else is going to, right? Big, consolidated health systems are going to steer for one. They're trying to drive volume to high revenue service lines. They're trying to prevent, in air quotes, network leakage. I mean, what does that even mean? It means they're systematically trying to get specialist referrals. That's steerage. This comes up big time in a show about high cost claimants coming up with Dr. Christine Hale.

[00:01:22] And it also comes up in a show with Dr. Eric Bricker, who is back by popular demand, talking about exactly the contract machinations that health systems often use to enable high cost claimants. So that is interesting. But Dr. Bricker says on that show, he reiterates these exact points.

[00:01:42] He says not figuring out how to steer plan members and helping said members find the highest quality and most cost effective care settings, including good primary care, by the way. But plan sponsors who aren't steering plan members should realize that then somebody else is. Somebody else is driving the bus filled with members and steering that bus based on their own interests, which quite possibly are misaligned with the plan sponsors.

[00:02:11] OK, so sounds great. Steer the members. But devils in the details. How exactly do we go about this steering plan members? It is clear to many that you can't steer members without engaging them. In fact, I had a whole conversation with Dr. Kate Wolin about this today, how if you try to steer members that aren't engaged, they just they either don't pick up your phone call or they don't listen to you. So how exactly do we go about this engaging with members?

[00:02:40] These members, as many have said, don't engage. They don't want to engage. And I guess, look, there's a lot that may or may not be possible to be done with financial incentives. But at the core of it all, it would just be a whole lot easier if we could figure out better member engagement. Well, welcome Matt McQuade to the pod, because that is what we talk about today.

[00:03:01] The first topic that we're going to get into in the pod that follows is what are the assumptions that we are inadvertently making about member engagement? And assumptions, keep in mind, that are incorrect are bad, right? You know, you wind up either solving for the wrong problems and or in the process often miss the solutions that might actually work. So that's why it's just an issue to have assumptions in the first place.

[00:03:27] But this can sometimes transpire because oftentimes we don't even realize our assumptions are, in fact, assumptions. Like if there's this bedrock of conventional wisdom that gets so ingrained that we do things without even realizing what we're doing is based on assumptions in the first place. That was my feeling during this conversation with Matt today, because he brings to light three very common assumptions. The first two about health plan membership.

[00:03:52] And when he goes through them, I'm going to bet many of your first reactions are going to be the same as mine. Oh, right. These things are all conventional wisdom and they are actually assumptions. And when stated outright as assumptions, they even sound a little suspect. So the first chapter, I guess you could say, of this episode coming up that you're going to hear runs through both the assumptions that we're inadvertently maybe making and then the reality of the situations.

[00:04:21] And then after that, we get into if you consider the reality of the situations and not the assumptions, what's possible to be done differently and the results that can be achieved. This episode was, in fact, sponsored by Matt McQuade's company, Synergy Healthcare. But I want to say that how the show came to be was this. Matt asked if he could simply sponsor a show for somebody else. He said he was part of the tribe and he wanted to support our mission. I said, thank you. That is unbelievably kind.

[00:04:49] Let's just have a chat about who you might want to sponsor or the topic that you'd like to be talked about. Then we got to discussing this whole business with assumptions and they're really not good impact that can result. And I was like, yeah, the guest, it should be you, Matt. So here we are. And thanks so much to Synergy Healthcare for their generosity and for Matt for sharing his insights. Matt McQuade is, as he says, a reformed benefits consultant.

[00:05:17] Today, he is CEO over at Synergy Healthcare, which serves plan sponsors with 100 to about 4,000 members. My name is Stacey Richter. And as I just said, this episode is sponsored by Synergy Healthcare. Matt McQuade, welcome to Relentless Health Value. Oh, so excited to be here, Stacey. I am so excited to talk with you about this term member engagement.

[00:05:39] And let me tell you, you walk into a group of people who have anything to do with benefits and you throw the engagement word into the conversation. Wow. You'll hear stories. I know you have advice and some thoughts about assumptions that could potentially not be correct or not be accurate. And the problem is, if you've got assumptions that aren't accurate, then you're either solving for a problem that doesn't exist or solving for the right. Just nothing changes and gets better.

[00:06:09] I'm not a medical person. I'm a finance, economics, insurance person. I wouldn't even put health as one of my top things in my life, right? It's towards the bottom. I think that's uniquely made me understand the assumptions of sort of real people and what's going on out there. And I think that's sort of my superpower in life is understanding real people. If we're thinking about an assumption that you commonly hear employers make, what's one of them? I've got three of them that I sort of run my business on.

[00:06:37] And the first one is people that struggle with their health don't care about their health. And I think the reality is that most people actually care about their health. They just need a little help. The first assumption that we're going to tackle here is people aren't engaging because they don't care. They don't care about their health. So that's why they're not engaging. The reality of the situation is that people actually do care about their health. It's just, as you said, you need a little bit of help. And why don't you dig in on that? Like, what do you mean by a little bit of help?

[00:07:07] The first thing is health is actually hard. Managing multiple health conditions is hard. Each condition is its own thing. It's complicated. And that's where people think like they don't care. But the reality is, is people are drudging through it. And, you know, if you look at health literacy stats, they say that 50% of the population has a capacity to understand basic health information to make appropriate health decisions. And this isn't good, of course.

[00:07:34] But one of the things I think about is what assumptions are we making even from the health literacy stats? People with good health literacy are engaged in their health. I think that's its own assumption. Like, not everyone is. And then people that don't have good health literacy, they can't make their own decision. The help is what's needed. They need someone walking with them and not us assuming that they don't care. Only 50% of people in this country are what could be considered over the threshold of literate.

[00:08:03] But the level of literacy may predict whether they're able to navigate the healthcare system or whether they're able to know what to do once they get there. But it's not a predictor of engagement, particularly. Is that the point that you're making? Yeah, it's definitely not the predictor of engagement. But I think the big thing that I've learned over the years is like everyone has their moment. Their moment where all of a sudden health becomes important.

[00:08:28] And if we're all thinking that maybe they don't care or whatever, they just don't want to work hard enough, we're going to miss that moment. You got to be there at the moment where they are able to prioritize this. What I'm reminded of right now is adult learning 101, honestly, which is now we're kind of encroaching into my day job here. So I say this with all the research behind it.

[00:08:55] If I walked into a room and said, let me tell you all about the stove in your kitchen. Gather round. Let's finally learn what convection actually means. You know, like nobody is going to sit down and engage with me. But if I said your stove is broken, let me show you how to fix it so you can make dinner. Now, all of a sudden, it's a different story. So it's definitely it's not like people don't care about their stove in the kitchen. It could be just what the moment in time is.

[00:09:25] That's what's important is like we have to be there at the time where they actually meet their need, you know, at that moment. So what's an example maybe of what you're talking about? So for me, like how did I learn this and how did I learn this assumption? I mean, literally 20 years ago, I had my first large client, textile firm, average age of 50, not very healthy, claims going up. They hire me and they say we need to lower costs, but I don't want a cost shift to employees.

[00:09:55] They can't afford anymore, but I need to figure out other ways to do this. And so one of the first things that we did, and frankly, at 2004, this was not a known thing like this was new. I put in my first on-site medical clinic in and, you know, this is an advanced primary care. This is mid-level provider, 20 minute appointments, free to employees, give a small incentive to have a health risk assessment and see the nurse.

[00:10:19] And what was interesting is a group that you would consider basically doesn't care about their health for the most part. We went from 37% of the members being hypertensive when we first opened the clinic down to like 14% a few years later, cut in half. And then even last year, we still work with them. 20 years later, we were down to about 12, 13% of people hypertensive. This is major change for a group and it frankly opened my eyes. It blew my mind really. It was like, how did this happen?

[00:10:49] And you realize that just people being engaged with someone who has time with them can make a difference. And that was the start of it for me for 20 years now. If they can do that, if that textile firm can do that, anybody can do it. And then we're all making assumptions that aren't there. A lot of times people think, oh, well, people aren't engaged because they don't care. Or maybe they're not health littered enough to even understand what we're talking about.

[00:11:13] And the point that you're making is you can cut hypertension rates in half. And that's a huge deal. And obviously people have to be engaged in order to do that. So I guess money question here, how'd you do it? You know, that's the thing is it didn't take much. That's what we try to tell employers. It just takes time, right? It takes time with someone that knows what they're doing. Let me give you an example. So Teresa, one of our nurse advocates, emails me and says, hey, I have a member lost 45 pounds. I'm super stoked.

[00:11:43] And I give her a call. Like, I want to know why this happened. And what I found out was Teresa's been working with them for a couple years, working on health risks with very limited results. And then all of a sudden the member ends up in the ER. And through our data notifications, Teresa knows he's in the ER. She calls him and like has a real conversation right away. This is affecting you. Your health conditions are affecting you. You're going to be in the hospital multiple times if you're not making changes in your life.

[00:12:09] But she built over a couple of years, even though he wasn't having results, she built a relationship. And then she was able to meet him at the right moment. Then all of a sudden he's managing his weight. He's managing his conditions and he's completely changed his life. Like she was there for his moment. And this can happen if we don't make the assumption that he didn't care for two years. And that's important. Yeah, it's interesting.

[00:12:30] And I think it goes back to that sort of adult learning principle that you got to be there at the moment where this bubbles to the top. Someone, they are able to prioritize this in a life that is busy with many, many other things.

[00:12:48] But even more than that, it goes back to something that we talk about a lot on this podcast, just the importance of relationships and trust and having the time and the cognitive bandwidth to really work with people.

[00:13:01] Because, you know, if someone's just pops in out of the blue that somebody has no idea, has never heard from them before, has no idea who this person is, then you also kind of don't have that foundation of trust and relationships so that you are at the right place at the right time when that moment arrives. Yeah, I mean, no one really makes changes because some really smart nurse provider calls them out of the blue from an 800 number, right? People don't make changes with that.

[00:13:30] And if you go back 30 years ago, why did people make changes when we had like general practitioners? It's because it was a relationship. They knew them for years. And then when they tell them this is serious, they started to listen. And that just doesn't exist the same way today. Yeah, absolutely. And there was the show with Rebecca Etz from a couple of years ago where the Larry Greenberg Center, like they prove that there's literature to this effect. This isn't just something that might be an interesting hypothesis.

[00:13:53] This is very well validated that relationships and trust are the bedrock that will underpin any sort of behavior change. And if you think about it, it's even more important today. It's less evident. It's less possible just with our current healthcare ecosystem. But it's even more essential if somebody's watching TikTok videos all day or they're watching somebody's YouTube channel all day. Who knows what that influencer's medical credentials are? It might be nothing.

[00:14:21] But we've got patients and members who are forming relationships with those individuals, which may be at a counterpoint to, you know, sound medical advice. Just saying. There's lots of information out there, right? It's not that people don't know what to do and what not to do a little bit. It's that it's caught up in the world of life, right? It's just a lot of things going on. Health is a long term problem and we all have short term problems. It's so easy to kick the can down the road. And so when the moment comes for someone, you just have to have the right person there.

[00:14:52] And you certainly can't push them away because then they're not going to see their moment if they're getting pushed away. And I think that's what's critical here. Got it. Okay. So summing up, assumption number one, people that struggle with their health don't care about their health. The reality is most people actually care about their health. They just need a little bit of help. And just adding a little context, which you've said the important part.

[00:15:13] And I love how you just said that, that because health is a long term problem and we all have short term issues, what the important part is, is to be at the right place at the right time. But to be at the right place at the right time, there has to be a bedrock of relationship and trust that has already been built. Otherwise, you might show up at the right place at the right time, but the patient may not be so inclined to listen to you and to move forward from there.

[00:15:38] And I love the example that you gave about knowing that someone was in the ER because that's a moment for sure. Definitely. Listen to the show with Al Lewis. If we are thinking about assumption number two, what might that be? The first one is creating harm. This one just irritates me. So, all right. People will want optimal health if we just communicate or inspire them better. We're just going to continue to tell them that optimal health is the way to go. And the reality is most people don't want optimal health.

[00:16:07] They just don't want to be a large claim. People want to eat chicken wings. They want to eat ribs. They want to drink beer. They want to do this as long as they can and get away with it. I personally love ice cream. I would eat it like every day if I could get away with it three times a day. But I've learned over time I can't do that. But the reality is most people don't want optimal health. They just want to live their life. So what happens when everybody's just under this?

[00:16:34] Maybe just because they haven't even thought about it that what members are striving for is to, I don't know, run marathons or something. Well, I think it comes down to like who are the people who are actually communicating this? Because they've dedicated their lives to being healthy. They know the outcome. They know the outcome of constant chicken wings your whole life. They know this. So they want to help someone. But this is basic behavioral economics. The problem is people generally choose simple over complex.

[00:17:02] They choose adequate over optimal. This is a normal, basic human thing. And the problem is when you go to the end like, hey, we all want optimal health. But think of me as a person, right? Like, what does that look like? And that doesn't sound very fun. And so we're all marketing wrong. We're marketing to people this extreme thing. You're really pushing people away. And I have to talk to our own health coaches about this, our own marketing materials that go out.

[00:17:29] Let's talk to real people, not who we wish they were, who they are. What are the health coaches actually doing? That is an example of what you're talking about. Like literally get rid of the word optimal health. For one thing, like, hey, please come to this webinar. We're going to discuss optimal health. This will push people away. So what we want to do is we want to talk about how to meet people with where they really are today. The things that are dealing with them today and start them off where they are, right? How do I start off basics? And we think we're motivating them. Like, I'm going to give them this picture.

[00:17:58] One of our clients is a lumber company. And could you imagine showing a picture of a 20-something yoga person on the beach at sunrise? This is not going to engage my lumber guy. But my lumber company has less than 10% of their people hypertensive. So there's a way to do this. But we're all marketing wrong. We're trying to go to the end game and not starting where people are today. You're showing people pictures of someone that they really don't relate to or even aspire to be.

[00:18:27] And maybe I'm just dealing in cliches here, but I just can't picture most people who work at a lumber company who have some kind of aspiration to get up at sunrise and do yoga on the beach. It doesn't seem like something that's going to connect. And it could actually also be daunting. If you show a picture like that, is someone going to go to the on-site exercise class? Because what do they think?

[00:18:53] They're going to be asked to take off all their clothes and do some kind of crazy pose that they're just going to look like fools in front of everybody? You know, like I could also see that it could be really daunting. Yeah, that's a great way to say that because the lumber thing is obvious sort of like that's not going to engage them because they don't actually know they can. And most people want to be successful and they don't see themselves that way. One of the things I look at over time is wellness programs.

[00:19:22] Like if you have a voluntary wellness program with no incentives at an employer, who joins? Only the healthy people. So the healthy people come to the wellness program. And the problem with that is obvious, like they're not my claim issue anyways. But why do they come? They come because healthy people do successful healthy. Yeah, so the assumption number two that we're talking about here is that people want optimal health. And they're going to be inspired by images of optimal health.

[00:19:50] And it's just a matter of showing them the way because this is what everybody's looking for. We just got to communicate better. And the reality is it's not a question of optimal health. They know. I mean, most people at this juncture are fully aware of the fact that like a full stack of nachos with all the stuff is probably not great, but it's really good. So the idea is they don't want optimal health. They want to just live their lives, but they don't also want to be a large claim. So I think...

[00:20:19] Yeah, who does? Like if you ask people, like who does, right? Who wants to be the person in the hospital? No one does. They just can't envision themselves from point A to point B. Also, like people don't like to fail. So probably if you give them this like, oh, well, this is what good looks like. And it's again, some sunset beach yoga thing. They know they're going to fail. I think it pushes people away more than brings them in. There's just... There's so much that's sort of wrapped up in this. The idea is let's inspire them to not be a large claim or said another way.

[00:20:49] Let's inspire them to do what they need to do to not wind up hospitalized and curtailing things in their life that they are looking to do. This is really a win-win here. Yeah, absolutely. And you need to look at commercials these days. They're starting to change. So they're starting to show normal people. Yeah, I think the middle way is the perfect way to say it. So the middle way is not either extreme, meeting people where they are. What's the third assumption that you have your eye on here? The assumption that healthcare systems are paid to manage disease.

[00:21:18] That they're paid to meet someone in the middle way. That a nine-minute appointment can do something like that. It just doesn't happen that way. What's the reality? The reality is only the employer has the incentive to support disease management. Because healthcare systems aren't paid to do it. And employers, it's their people. It's their people. Their productivity, you know, their health, what they think about the company, what they think about the benefits. They're the ones that have the incentive to do it.

[00:21:44] So the assumption is, okay, let's just say we figure out that it's the middle way. Like we know that this is the way to go. We handle assumption one. We handle assumption two. We're very reality-based here. But yet then we think that the healthcare ecosystem or the healthcare marketplace is gonna achieve success or help our employees and members achieve success. And the point that you're making is, and Rob Andrews has said this over and over, people do what you pay them to do.

[00:22:14] And what we are not doing right now, most of the time is paying to keep people healthy. And clearly not saying that there are not some docs and nurses and others out there doing their all to keep patients healthy. Just saying it is generally hard to figure out how to get paid to do so. One of the other, I wouldn't call it an assumption, but let's just say one of the things out there that I think is just true, is employers don't want to fix healthcare. They don't want to.

[00:22:41] They're drug into it sometimes, but they don't really want to. So health systems want to think they manage disease and employers want to believe them. But the reality is it's not happening. And so this is an employer assumption that they have to realize that they have to fix this problem. No one else is going to do it for them. Yeah. When Lauren Vela was on the pod, maybe this was last summer, she said on no one's job description is fixing the healthcare industry.

[00:23:09] And every time I say that at a conference, all the employers start laughing, right? Because it's really true. Nobody's job to fix healthcare. But I think the point that you're making is, however, if we're trying to ensure that we have a productive workforce, Barbara Watchman from Disney was on the pod a while ago. She said, you know, protecting our human capital or something like this. Like if we want to protect our human capital, if we want to make sure that we don't have large claims.

[00:23:36] Dr. Scott Conard was on the pod talking about how every year, like the high claims are usually new people who were low cost but high risk before. And now they're high cost, high risk. It's like how you find these people and prevent them from becoming high cost. Like it's all about making sure that we're engaging and keeping people in that middle way, like exactly like you are talking about. And that is not going to happen unless the employer is doing something on their own. It sounds like you're saying.

[00:24:06] What I talk to employers about in meetings is when you think of a claim, right? A claim is a person. People are like, hey, claims are up 9%. But this is real people having real problems and real harm that could have been avoided to some degree. So when we just think about the finances, we got to think about people on the backside of this because it's not just inflation, right? It wasn't like the claim just costs a little bit more. No, this is more things happening to more people and more utilization. It's their people.

[00:24:35] It's harm that just didn't have to happen if they took a few steps. And yeah, if anyone listened to the pod from a few weeks ago where I quoted Dr. Steve Schutzer, quoting me, quoting Betsy Seals from that earlier show. This is exactly that same point, really. The second that we lose our North Star, which is what is of value or harm that is accruing to patients by whatever it is that we're doing. Ultimately, at some point, we're going to make very suboptimal decisions.

[00:25:03] So much of our spend depends really on what people choose to do or not to do, meaning patients or members. Yeah, you know, weird and obvious to say out loud, though. Yeah, and employers, like they know their people. So when it comes down to it, like they know what works for their people. They know if it's working or not working. They're the perfect people to actually assess whether a program's working or not. And are you saying that because sometimes the brochures with the yoga at sunrise, like that didn't actually come from the employer themselves?

[00:25:33] Not usually. Usually it's someone else giving them information and they send it out and then everyone wonders why no one participated or why no one was making improvements. I think at the end of the day, I actually think employers sort of know it a little bit, but they just would rather not get involved if they didn't have to. Yeah, and it's interesting that you say that, that the employer usually knows what engages with their employees. And probably if it was a seminar on something else and like no one showed up, the employer would have some kind of postmortem and think it through and be like, oh, the brochure. Right.

[00:26:03] Like they would be highly competent at figuring out what the issue is. But somehow you throw the word health care in this mix. And it almost sounds like the best practices are the things that most employers will know to be true. They sort of delegate elsewhere and then wind up with all the problems that they probably would have expected to have had if it had been anything else. They don't have the solution. I mean, it's not like this is easy to do. So you just sort of do what everyone does.

[00:26:28] And, you know, when we talk to employers and our model of what we do, they usually get it. They usually get why we could be different than what's been done now. And that's what I spend most of my time doing is talking to employers about how do you solve the middle way and what's a model that can work? So how do you solve the middle way and what's a model that can work? Once again, it comes down to trust. I believe our model is set up. We're a care navigation company. There's lots of care navigation models out there. And you're talking about Synergy Healthcare. Synergy Healthcare.

[00:26:56] Yeah, we're a care navigation company. Like I said, there's lots of models out there. Our model is we're a one employer, one nurse model. We believe to get true engagement, they should not even remember who Synergy is. They should remember who Teresa is. What I want is everyone from the CEO to the new hire to know who Teresa is. And I want them to be able to email her, call her, text her, come to open enrollment. This is what's going to matter at my moment that happens. I need to think about who that is.

[00:27:25] And so that's our model. Does that work for someone with a million employees? No. But it does work for people with 4,000 to 100 employees. That model can work. And it's been very successful. And then what we do with that. So like, I'm going to get engagement. They're going to know who Teresa is. And we have three functions that we believe help solve healthcare for that employer. And by the way, I get a lot of these things from your podcast, right? So what do my nurses need to be doing? It's perfect.

[00:27:51] So the first thing we do is we have to simplify healthcare. I have to get prescriptions to go through. I have to get surgeries approved if they need to be approved. If they don't need to be approved, someone needs to tell them why and what's my path. The first thing we do and Teresa does is solve all problems like texture. If you're at Walgreens or any chain, whatever it is, if it doesn't work, call Teresa. And so 30% of what we do is we have to solve all problems.

[00:28:20] And I'll tell you what, that creates relationship instantly. So we're all talking about healthcare and health engagement, but there's so many problems right now that it instantly creates trust because Teresa solved my issue. It's been said any number of times, like if what you're going to do is just chuck people into the healthcare marketplace at this juncture without the guidance and the support and relationships and trust. It just, it doesn't end well unless someone, again, going back to our first assumption is really health literate and really engaged.

[00:28:50] Secondly, so I now have the trust, right? People know who Teresa is. They know she solves problems. We use data to make outreach to the members that need it most at the right time. So you were talking about who's a large claimant next year. We use predictive modeling too. We know who the 15% are, who are going to be the 5% next year. And they could have $1,000 in claims right now, but because they saw this specialist not taking that medication, it hits the number. They could be in the ER, like I gave in my example with Teresa.

[00:29:18] The idea that at that moment, we need to have someone that they know that follows up with them, that calls them, that's been creating a relationship, that's able to have a real conversation at the right time. So we're going to mitigate risk for the employer. And the final thing that we do is there's so many great point solutions out there. There's good carrier programs too. There's specially drug programs, there's musculoskeletal programs, there's great mental health programs. These are all out there. But once again, the member is not going to remember them at the right time.

[00:29:46] By using Teresa, she can find the right member of the right solution and make other products, their ROI better from it. And it all comes down to engagement. And engagement has to be easy. And that's why we do this model. We have to have Teresa be easy for people. Going through your three points. The first point is both simplify and also be around to solve problems when they arise. An example that you gave was someone's trying to pick something up at Walmart or Walgreens and having an issue.

[00:30:16] There's probably any number of things which wind up happening on a day-to-day basis, especially if someone is inching probably toward being part of the 15% that becomes the... We need to be talking to you anyways, right? Exactly. One quick story. We had one of our construction clients. They work with Monica. Literally, they have a safety meeting. In the safety meeting, one of the employees starts complaining about some problem with insurance. Two other guys at a construction company. Two other guys say, why didn't you call Monica?

[00:30:46] Like, what's your problem, man? Like, they start making fun of him. He's like, oh, my bad. I forgot. I'll get with Monica. And that's engagement with an employee population that Monica knows all 300 construction guys. And they, for the most part, know who she is. So it probably, in a very interesting way, self-selects the individuals that most need the support to wind up having the relationship with a Teresa or a Monica,

[00:31:15] which really matters when the data predicts someone does, in fact, need to be doing something to stay in that middle way right now. And I can also see, it's been said so many times that like, oh, nobody, they just ignore our calls. They don't pick up. But I can see how this is a flywheel because if they've already called Monica four times because of something or other that happened,

[00:31:37] and then Monica reaches out to them, like now it's a very different gig than if this Monica person who nobody ever heard of keeps leaving messages on the phone. So I can definitely see that sort of a flywheel that's developing here. And then lastly, there are, as you said, there's point solutions, there's programs, there's lots of stuff that may be available. But just chucking them out and hoping that someone's going to figure out which one is right for them is just not simple.

[00:32:05] To go back to the first thing that you said, it could be confusing, it could be contradictory. So then having someone really help say like, hey, Pete, you should look into this and I'm going to help you sign up, etc. As opposed to just throwing them onto the intranet and hoping they figure it out themselves. And that's it. Well, they trust Monica, right? So they trust Monica. Yeah. So they almost don't even like, they're like, if you think it's okay, I'm good. Just enroll me. That's how they are.

[00:32:30] And if you go back to the textile firm I first talked about, it wasn't just about an on-site clinic, right? There's lots of solutions, lots of high value things that they did, and their nurse managed them through it. 20 years ago, their costs were roughly about 30% more than the average cost. And that's why they called us in the first place. Like, I have to do something about this to stay in business. 20 years later, lots of high value programs, especially drug programs, musculoskeletal programs, on-site PT, you name it.

[00:32:59] Now their costs are roughly 30% below average. So they went from way above to way below. Just really solving for actual problems as opposed to sort of making assumptions where, and, you know, we just went through these three assumptions. And in a way, when you say them out loud, you're like, huh, they don't even sound right. It's just they're unspoken kinds of things, which I just feel like are kind of this conventional wisdom that maybe is underpinning a lot of this.

[00:33:29] And maybe perpetuated by, like I've heard it said so many times, by actually brokers and kind of like middle people themselves. At a certain juncture, they get really far removed from the actual patients. So the one thing that I do feel like employers do have an opportunity to do is like they actually know the patients. Employers, like, you know these people and that really matters. They're the employees. They see them every single day. Yeah, they know their people.

[00:33:56] And when they find out a way to do it, most of them do it if they can realize what can be done. So if someone is interested in learning more about Synergy Healthcare, where would you direct them for more information, Matt? Go to LinkedIn. Look me up. Matt McQuade, Synergy Healthcare. My main thing is I'm just trying to encourage people to know that there are ways out there to do these things. And we post lots of articles and you can certainly message me through LinkedIn. Matt McQuade, thank you so much for being on Relentless Health Value today. Oh, thank you so much, Stacey.

[00:34:26] Hey, this is Matt McQuade with Synergy Healthcare. I listen to Stacey and Relentless Health Value every single week. There's valuable information every single week to take from it. And I just so appreciate this is around. Thank you.