The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
The (not so) Great Unwinding of Medicaid: Actuarial Insights with Colby Schaefer
As we navigate the episode, you'll uncover the model we've crafted with the Society of Actuaries, aimed at demystifying Medicaid's complexities. Discover the coined term 'durational triangle' and why it's a game-changer for understanding enrollment patterns and risk. We'll also dissect the ways in which Medicaid acts as a beacon for healthcare innovation, and how primary care is revolutionizing the way we think about and manage health outcomes.
Concluding our session, Colby's insights, coupled with our own fervor for change, spotlight Medicaid's pivotal role in transforming healthcare. The partners of bp2 Health Ellen Brown, Justin Politi and Dave Pavlik, invite you to continue this vital discussion beyond the airwaves, and thank Colby for enriching our dialogue with his expertise and riveting life stories. Tune in to unravel the complex tapestry of healthcare, where innovation meets personal narrative, and every listener is left with a newfound perspective.
Welcome to the Reverse Mullet Health Care Podcast from BP2 Health. Today we are talking with Colby Schaefer, founding partner of Incline Actuarial Group, about how the great unwinding of Medicaid triggered by recent regulatory changes is affecting real change in healthcare, but perhaps in the wrong direction. But first, who are we? Why are we here? Why do we name our show the Reverse Mullet Health Care Podcast?
Speaker 2:We want to be relevant, informative and creative, but we also want to be entertaining and have fun. So it's party in the front, business in the back, like a mullet, only reversed.
Speaker 1:We are your hosts Justin Politi, alan Brown, dave Pavlik, remotely. We are passionate, innovative and collaborative and are committed to solving our industry's most important issues together with our clients. We have a combined 90 years experience.
Speaker 2:It just makes it sound so old. In each episode we will dig into a hot healthcare topic and dig into each other.
Speaker 1:Be gentle on me.
Speaker 2:Never.
Speaker 3:No chance, no chance that you're like my sibling rivalry here, sibling rivalry we have. You're going down.
Speaker 1:So today, as mentioned, we're talking to Colby Schaefer, founding partner of Incline Actuarial Group. We get the pleasure of working with Colby and team all the time. Colby's an actuary with more than 15 years experience where he has specialized in.
Speaker 1:Medicaid capitation rate development, value-based care, healthcare reform, modeling and designing analytics solutions. Before founding Incline, colby most recently served as chief actuary of Arizona's Medicaid agency and spent a decade in actuarial consulting focused on Medicaid and risk-bearing organizations prior to that role, so it's safe to say Colby knows the topic we are talking about today better than most in the industry, which is exactly why we were lucky enough to land him on the podcast to talk about this.
Speaker 1:But before we get into that, we're going to have a little back and forth Of course we do.
Speaker 2:It's our party in the front.
Speaker 1:And I'm really interested to hear about all the ballparks that Colby has visited major league baseball parks and I'm hoping his favorite is somewhere in New England.
Speaker 3:So you visited all of them.
Speaker 5:So fun fact, I have visited every stadium, but the Rangers opened a new ballpark three years ago and I have not been there yet.
Speaker 2:Oh, okay.
Speaker 4:And yes, the Pirates, my hometown. It's my favorite ballpark. The team is about that great Ryan. Stadium PNC.
Speaker 1:Oh shoot sorry, right on three rivers, so a lot of road trips to accomplish that feat.
Speaker 3:No doubt Wow, and your second favorite other than your home team.
Speaker 4:So surprising ones. I like Cleveland, seattle, boston.
Speaker 1:Fenway, I love.
Speaker 4:Boston, but Wrigley did not have the same field to me. Really, I just love these cool Wrigley built a lot of fun though.
Speaker 1:Yeah, well, wrigley hasn't had all the modifications that Fenway's had, Right, I mean?
Speaker 4:I mean, yeah, it's more modernized. Yeah, I'd have that on the subject field, much less than.
Speaker 2:Fenway. Okay, All right. So, as the nutty crunchy one of the group, I and I and I share this love of traveling the world. I want to know two things. I want to hear a little bit more about your national park quests. You probably heard last week when we released the episode with Dr Pittman that she is on a quest to visit every national park. So very much a kindred spirit with you on that one. But also you have a love of Italy which I share, and I want to hear more. We want to hear more.
Speaker 5:So Jerry, my founding partner at Incline, has been to even more. You know about how him and his wife and kids have traveled, but I'm over halfway there, so I love.
Speaker 2:Jerry and I share the RV thing because I lived in an RV for a year and a half with my husband, but before kids, and Jerry has been adventurous enough to do it with kids.
Speaker 5:So with two under three for quite a bit of time.
Speaker 1:Somehow the sprinter always works its way back to Florida, apparently.
Speaker 5:This is true, very true. He was just sleeping in Florida yesterday.
Speaker 2:Okay, well, so anyways, keep going. Sorry, we digress down the Jerry path.
Speaker 5:Yeah, yeah. So I love traveling this great country of ours. There's plenty more to see, but the train hopping two week Italy trip that my wife and I went on five years ago was absolutely the best and really need to go back when did you go in the country?
Speaker 5:We landed in Venice, did a couple nights there, went down to Siena that was our home base in Tuscany for three days, went to Rome for a couple of days, went to a soccer game, did all the sightseeing there, and then we went up to the Cinque Terre, spent three days there and then went up to Lake Como, flew out of Milan. Our flight was actually delayed a whole day and Milan was just where we were flying out of. We had a blast in Milan. It was a rainy day. There. We're just eating, walking around and enjoying ourselves before the kids that was before.
Speaker 3:So yeah, so if I'm doing my math right, that sounds about right so that was five years ago. So it seems like we met you around that time and it seems like for a while there. Pretty much every time we talked to you there was either another baby on the way or one had just arrived. And I just loved how you shared in your, when we asked you about your work accomplishments, you shared that any work accomplishments pale in comparison to being a father of two little girls. Must be interesting to be a dad of girls. I've got two boys, so more power to you, yeah.
Speaker 5:It's adding more gray hairs as we speak, but it's all worth it.
Speaker 2:So how old are your kids, colby?
Speaker 5:Daphne is three. She just turned three a week ago and Felicity is six months old.
Speaker 2:Oh, those are pretty names. I like that and I have a. I'm the only one in our group that has a girl, so I understand what it's like to be. I can't tell you what it's like to be a girl, dad, but I can say with a girl long but but. I'm on the other end of the. I'm on the other end of the shoot. My daughter's now 19. So it's kind of crazy to think back to when she was three.
Speaker 1:Yeah, no, he's knee deep in diapers right now. Yeah.
Speaker 2:Just knee deep in all of it. So so it is it is quite impressive, colby, all you're doing, given your commitment to your family, and so I just I do have to digress to the second, to the travel piece is I highly recommend, if you like Italy, to go to Sardinia. So it's imagine Tuscany on the Mediterranean without the crowds that you you Experienced when you were there. So just throwing that out there, I don't know if I want to tell everybody in the audience that, because we may be able to go, but I'm more.
Speaker 1:I was gonna say I'm more interested in. I'm more interested in the that you're in a bowling league. What, what type of? What type of bowling? Is it candlepin? Is it, you know, regular? What's the? And?
Speaker 2:is that a duck pin? Is a candlepins a duck pin, or is that different?
Speaker 1:duck pins different than a candle.
Speaker 3:So there's like literally I've never heard of a candlepin. I do.
Speaker 1:Podcasts.
Speaker 5:Duck pin and although candlepin can't.
Speaker 1:So new Handlepin is a New England thing. Just sticks Really. Yep, it's. It's the same ball that you use with duck pin.
Speaker 2:So we used to have an annual duck pin bowling tournament Before kids in Baltimore. We lived in Baltimore you just have the annual Bowling tournament and it was nothing but the boterie and we had a one of those big 45. That was this big 45 bottle and we would use nail polish to write the last name of whichever couple One said bowling tournament. See, I can be fun, I'm not just a dork.
Speaker 1:So, colby, let's hear a little bit more.
Speaker 5:It's very much a social league, but I've been proud of myself. My score has been improving. League play is actually tonight and unconfirmed fact is that this alley was. It's one of Pittsburgh, obviously, but it's the one in Pittsburgh that had the rose ball on a shelf. That rose ball was used for the filming of kingpin.
Speaker 4:Yes, if you remember.
Speaker 5:Bill Murray's yes they're earning a crack in. Yes, that's where that ball came from.
Speaker 1:That's awesome. That's awesome One of my favorite. You know, munson, we use that term to months and things all the time in our household.
Speaker 2:It's always cool when you can like do something and be able to bring in a movie. Yes, the people, people know about, so, all right. Well, let's jump into our topic, because I know we we have a limited amount of time but and we could talk forever on this stuff but our Platform for the podcast is does that is, discussing things that can affect real change in health care, and our topic today is the great unwinding of Medicare and it's certainly affecting Medicaid oh man, this is, yeah, this is a long day, I think, and it's only if Medicare hasn't started to unwind yet.
Speaker 2:No, it has not, although that maybe it's like a Freudian slip, but okay.
Speaker 2:So the great unwinding of Medicaid and it's certainly affecting real change, but perhaps not good change, although, colby, I think you might have a different opinion on this. We were, we were sort of dialoguing a little bit late last night about this, but so a lot of people Don't even know about this. They don't even know about this great unwinding. But I am going to quote some statistics that you recently shared on LinkedIn. As of January 16th, there have been 15 million Medicaid enrollees disenrolled. In contrast, 28.9 million had coverage renewed. That leads to a termination rate of approximately 34.1% said approximately only, as an actuary would say, at 34 percent. You then went on to note that 71% of all people who were disenrolled have had coverage terminated for procedural reasons. Can you shed a little more light on this?
Speaker 5:Yeah, and a quick background on this for listeners. So the Medicaid disenrollments were frozen as part of the COVID-19 public health emergency and that was a trade-off for enhanced federal funding. That provision went away April 2023 and states had to unwind these continuous coverage requirements. So trouble is there's a three-year backlog and people's contact information is likely out of date, and even many state staff haven't been through eligibility Redeterminations and the subsequent termination process. So it's expected that 20 million or more people will lose their Medicaid coverage during this unwinding. However, many might already have other employers sponsored coverage, so a lot of people may intentionally not respond to these eligibility requests or miss them all together. So for the ones who are still eligible for Medicaid, expect them to return to coverage months following their initial termination Something we call churn and Medicaid.
Speaker 2:Which is not good. Oh, churn is never a good word when it comes to members and patients.
Speaker 3:Right, but I think you mentioned you quoted some prior MacPAC research on the churn. What are your thoughts on that?
Speaker 5:Yeah. So MacPAC had a phenomenal study on rates of churn with consideration for these continuous coverage provisions, and churn was about 30 to 50 percent for children and young adults. Now churn doesn't necessarily mean they were always Eligible when they lost coverage. A decent number of beneficiaries, especially TANF, expansion and chip they have changes in their wages, so this income variation also leads to that high churn rate that we do see in Medicaid.
Speaker 1:That makes sense. I think you said you were about two-thirds of the way through the entire Medicaid unwinding process. Dsnps and companion LTSS programs are near and dear to my heart for a variety of reasons. How do you think they might be?
Speaker 5:impacted. Yeah, there's been varying opinions on this, justin, and anecdotal evidence on dual eligible. I think it varies state to state depending on how much data sources via ex parte processes have been used. That's a fancy way of saying you're using some other data source to verify eligibility rather than sending the form. So there are some states where duals could be more risk for procedural terminations in which Medicare enrollee didn't get the paperwork or didn't respond. Some states support online renewals. So, as you can imagine, for an older population, there's going to be a lot of variation to this. For the most part, though, older individuals generally have stable fixed income, so there's less overall disenrollment expected for these populations, but still can be impacted from state to state.
Speaker 2:Although I pale in comparison, I am also a fellow data geek and I want to hear more about your work with the Society of Actuaries on modeling the great unwinding of Medicaid. Anytime you get to work with a fancy name like that, with a fancy group like that, it's super impressive. And especially I want you to tell us what a durational triangle is and how it was used in this work. But first I have to tell you that I have a tenure as an actuary. I think we talked about this but I'm not sure. But I took one actuarial exam. I worked as a quote, unquote actuary after being an underwriter. I was underwriter first and then I moved into actuarial and two things happened that told me that that was not the path for me.
Speaker 2:So first, before I took the exam, we did the Myers Briggs. You guys know the Myers Briggs, right. So, and this was back in the day when HR wasn't a little bit frightened of what the Myers Briggs might actually do or culture so the HR people came in and we did the big Myers Briggs thing and you can kind of imagine like, if you know me or maybe even if you listen to the podcast, I'm definitely not introverted, right, I'm extrovert all the way. So they had us do was the funniest exercise. They had us all do it, and then we had to look at each attribute right, each of the four letters, and then we had to.
Speaker 2:This is where HR has changed. They had us line up on the wall of the conference room in order of where we were on the spectrum of our letter. So imagine a room of 12 people, 11 people standing on this side of the wall and every single time Ellen's standing on that side of the wall, and I was like maybe the universe is sending me a message here. So that was, that was sign number one, and then sign number two was taking the actual exam and I was like, nope, not for me, I don't need to do this for the next 10 years.
Speaker 2:I did pass the exam, but I was done. I was done. I was like that's the end of that and then I was able. I purposely moved into another opportunity and that was another story for another day, but anyway. So, getting back to the topic, can you tell us about the model that you were part of, and then also the durational triangle, or whichever order you care to disclose?
Speaker 5:Well, yeah, and first off, Ellen, I'm the expert at actuary and I failed exams more than I passed them. My first score of my first exam ever, I got a zero, and I'm old enough that it was. The grading came in through like a postcard and it comes in like two and a half months later I called SLA customer service and it said there has to be some problem here. I I got one question right, didn't I? I had no clue about how the, the grading curve worked or any of that, so that's outstanding.
Speaker 2:So so you're basically telling me, if I had persisted, perhaps I would have, I would have done, okay, but I gave up too early. We did. Actually. We were just telling the team in here that does the recording for us. We were saying that you're sort of like the. You're like the opposite of the actuary, the non-actuary or the actuary, intellectually and and professionally, but personality wise you are not. So there you go. You just backed it up by saying you're an extroverted actuary.
Speaker 5:There's some of us so um on the model. So we made this model for the society of actuaries. Um, it's very input driven, uh, so the hope is that it saves actuaries, cfos and the like a lot of work. Um, it's able to handle like nine different populations that you can plug in there. It can use a state Medicaid and chip data that we have from CMS. It can override it with your own enrollment data.
Speaker 5:So, think it from a plan perspective, a risk bearing provider right or or any other type of entity, so they can put their own enrollment data there, apply assumptions on changing risk patterns by duration of enrollment and we can obviously, you know, see, given the Medicaid churn patterns that we discussed, it causes varying level of demand based on the amount of enrollment. So this model controls for that, on top of population growth movement between cohorts, cohorts, and it simulates results of a low, mid and high enrollment scenario. So it's, you know it's been a helpful tool, um, but it's very much, you know, input driven. And I love that you mentioned durational triangle because I think it is a term that I created last year when we're when working on this model.
Speaker 2:Really.
Speaker 5:And what meaning so explain what that is.
Speaker 2:You can't just like drop that and then walk. Yeah, yeah, yeah.
Speaker 5:So, uh, triangles, typically an actual work, usually has to do with reserving, and it's not just health insurance, it could be like any type of insurance. So it's looking at the lag of payment, um, and when the actual claim payment happened versus when the claim incurred. So it does this incurred by paying my triangle, um, and you can then determine how much open risk there remains. Before you know, a month is complete.
Speaker 2:So like another way to talk more definitively about um incurred versus paid and that so it's. I mean not exactly, but it gives another kind of a firmer base on that elusive discussion.
Speaker 5:That many, yeah, and instead of instead of uh incurred for. Here it's like really duration, the month enrollment. So if it's their first month enrollment versus their seventh month, they're going to move up through the grid and other members they're going to be moving over and so it tracks them as they move that and how their acuity potentially can be changing over uh, the the course of their enrollment.
Speaker 2:So where can listeners find access to this model? Is it something that people can access, or do they have to become part of the society of actuaries?
Speaker 5:Nope, it is open to use in the public. It's on the SOA's website.
Speaker 2:Okay, cool, so there you go A little nugget of of info for some of the. Cfos out there for the health plans that are trying to sort out this great unwinding.
Speaker 5:Yeah, you just search SOA Medicaid unwinding model and you should be able to find it.
Speaker 3:Okay, cool, we'll put that in the shot. We'll put that in a show notes. Once we figure out how to do show notes, yeah, we've tried it on.
Speaker 3:We haven't been there this is all, um, so far, this, this is mostly over my head, uh, but uh, I think I'm one of the many people who don't fully understand the the gravity of of what's going on here. Um, with the unwinding, I imagine there would be changes in in in in um acuity due to these enrollment shifts. Um, that will ultimately impact capitation rates and budget per projections. Um, what other effects do you think we need to be worried about or thinking about?
Speaker 5:Yeah, dave, and like those financial, actual considerations, that's what my profession gets focused on. But ultimately, continuity of care is a concern when you have an event like this care management, member engagement or critical Healthcare navigators whether they're at the state plan or even with a provider group, they're going to be helpful to ensure people, even if they lost coverage, or able to retain, re-obtain it and then not have any gaps in care. So this is something that's going to live around for a while. I mentioned churn. That follows a year after the unwinding and we're not even finished yet.
Speaker 1:So I have a question for you. Medicaid programs are near and dear to my heart. I have my own background as to why, but I want to hear from you like how did you come to have such a passion for the Medicaid line of business, and what can it offer, I'd say, for other parts of health care?
Speaker 5:Yeah, so I don't have a personal driven passion. You kind of fell into it but then realized there's so much innovation in Medicaid where so many other parts of health care can borrow and learn from. I Remember well over a decade ago I learned about the story of Oregon Medicaid and their CCOs and basically with the waiver that they had with CMS, you know they were you know long and short of it Buying AC units for seniors. You know they're living in apartments so they're not having a deal with heat stroke. Or then rack up costs for the ambulance and emergency visits. You can get where that's going.
Speaker 5:It's pretty obvious when you explain that as this anecdotal story. But it improves health outcomes, it saves on claim expenditures, it's a win-win. And so to me, like thinking broadly, that ties to my thesis of Risk-burying organizations, so not even just states but or health plans, but also providers, like think of a provider group led by PCPs. They're front and center of the patient and that they could be agents and change and better manage their population and control their finances and handle the risk. Then there's certainly a lot of opportunity there.
Speaker 2:Yeah, our conversation the other day went even deeper when you and I were talking about a completely different thing. But we were talking about primary care clinics right, and taking risk on and tackling what many perceive to be non-health issues right, we were. We were talking about this, the point that it ultimately leaves. You know, it costs us billions of dollars for these quote-unquote non-healthcare issues and we just actually just recorded an episode. So when you talked about innovation, it really struck me because we just recorded an episode that talked about food and and food is medicine has actually gotten the most traction in Medicaid. So it it really Validates your point that Medicaid can be a proven ground of innovation.
Speaker 2:But yet it's sort of like this, this, like stepchild that we sort of put over in the corner. You know, I mean we don't, but we do as an industry. It's like, oh, medicaid, gotta solve for that, but there's not money there, but there is money. You know, it's like it's a scary proposition for many providers. So what are your what? What? Do you have any further thoughts on that one?
Speaker 5:Yeah, I mean it's no surprise, given like Medicaid generally pays less than Medicare and commercial. So from a revenue optimization standpoint it might be prudent for some providers, like physicians, to control how many Medicaid visits they get. But I think this is where the power of contracting, especially value-based care rather than fee-for-service, is key and Again I think at all sorts of primary care is being that central source for managing health outcomes for the patient.
Speaker 2:Absolutely.
Speaker 3:Colby, we ask all of our guests this what? Because you know we really want to affect, we're trying to affect real change in health care. What would your buy the world of coke moment?
Speaker 1:idea for healthcare be and Colby's too young for by the world of coke, I think.
Speaker 2:but Well, he's certainly.
Speaker 3:I'm just two decades ahead of Colby, but I we're stuck in the 70s but I'd like to teach the world you don't know that the that commercial doesn't ring a bell.
Speaker 2:It's like a kumbaya kind of.
Speaker 1:Look it up after living in perfect harmony living in perfect.
Speaker 3:Perfect harmony yes.
Speaker 4:Yeah, there you go.
Speaker 5:The, the only co-commercial that I know from the 70s, which does predate my birth a little bit, you know, has to be Steelers related, oh yeah. Yeah mean Joe.
Speaker 1:Green, Everybody knows that one yeah so tell us your thoughts here.
Speaker 4:I know.
Speaker 5:Yeah, so healthcare is an onion. That's what I always tell people, so You'll have to bear with me a little bit on this. But my actual view it looks at risk, how to best control it, not just for payers but also the population, and that's the purpose of insurance, right? And in a lot of ways American health insurance isn't quite like insurance.
Speaker 2:Yes, yes, exactly, I'm gonna interrupt. I say this all the time when I get into conversation with people. Say to me on a plane you know like well, how are you gonna fix healthcare? And I'm like well, the first thing is it needs actually be insurance, right, is it we? It's not insurance, we have sick care. So I always use the analogy of health insurance versus homeowners insurance. Like I can't get my roof, when my roof needs to be replaced in 10 years, I don't call up and make a claim on my, my homeowners insurance, right, I just have to get the roof claim it's maintenance. And that's not how. That's not so anyway, sorry back to you, colby, but I couldn't agree more.
Speaker 5:Oh yeah, and at its core, the purpose of insurance is to reduce financial uncertainty, protect against these Unexpected financial losses, and that's due to infrequent situations. So you know, to me there's always seem to be this disconnect when many Americans are saddled with a bunch of Medicaid debt or medical debt, and health insurance Isn't covering just catastrophic events. So it's a health care benefit with an insurance model, but the American consumers completely immunized against the expense, not knowing how much doctor visits or procedures cost.
Speaker 2:Yes, interrupt again Because I didn't know how aligned our thinking was on this until we had you on the episode, which is funny because we we work together a lot is. I always go back to that analogy of getting your car fixed and you don't ever just like drop it off at the shop and say, oh, just send me the bill. You know you always want to quote first, and with health care you literally cannot call the doctor's office and say how much is this gonna cost? So say, well, I'm sorry, you'll find that out once you do that. And then you add in the fact that employers are making all the decisions about benefits and too many Pricing, too many men.
Speaker 2:Yeah, exactly there is. There's too. There's too many people involved. So sorry, I interrupt it again, but I get excited whenever somebody has a similar thought process.
Speaker 5:No, I, I could see the level of excitement. So I I think the thing about this a consumerism. Consumerism is a powerful mechanism, right and in this country, and if it was more empowered within health care by having some type of health care benefit in the form of, like, let's say, a cash stipend. You have HSAs and FSAs, combined with a height of the bowl, catastrophic health insurance. You know, because there's emergency services, that we don't the luxury of being a decisive consumer, that I think we're getting somewhere. Going back to the primary care component, I think the PCP needs to be front and center as well and be afforded the time and have financial incentives to manage the risk Appropriately, like for their panel sizes. So you know, risk-bearing providers, not having one patient shuffle another and actually having time with them so they can focus on issues of access to care and housing and, ellen, when you're matching food stability and behavioral health and other issues.
Speaker 1:Yeah, no, exactly, I mean, Now I'm the one getting excited Because this is the structure that I long, I'd long for, right that we have this, you know, this opportunity to be able to access care in a way. That's the freedom to be able to interact with your provider, not worrying about this Health care, the whole the insurance aspect and what's covered here there, whatever the case may be. If, if you were, if you knew you had a catastrophic Kind of umbrella right and you're the one that's got a Investigate and pay for the other components, it just it's. To me it's a more sustainable model.
Speaker 5:Yeah, I think the trend of the system is there, but it's very, very slow. We have increasing price transparency. There's these health home models and ECOs Social determinants of health being factored in. You know, years ago there's this financial cliff in health care with the ECA and marketplace plans came in there and they took away some of that. But there's obviously a lot more work to be done to align health outcomes, affordability and take all these inefficiencies out of the system.
Speaker 3:Yeah, and so Before we let you go, colby, thanks for being on. Before we wrap up, I want to go back to the Question we asked you about what legacy you would like to be part of in health care. Can you share that everyone?
Speaker 5:Yeah, I mean there's a bunch of ideas, but I really think it comes down to like empowering primary care physicians through risk-bearing arrangements Enables those providers to tackle the risk of their population, no matter what payer, so they're not delineating between Medicaid, medicare and marketplace commercial. I think that's where my heart is going. The biggest hat that I've worn as a health actually is in Medicaid and it has a lot of innovation. It plays a major role in primary care and all these non health drivers are risks, so I think it could be very applicable, bringing all this together and me playing a role to the try and spearhead that. And the other thing about that is that Medicaid's there for people from cradle to grave and it's heavily misunderstood.
Speaker 2:Yes, I think we definitely need to do some more episodes on on Medicaid. So Well as hit, as much as I hate to in the conversation, because it's much needed. I mean, we could spend hours talking about Medicaid and, quite frankly, I think we should spend a lot more time talking about Medicaid because it is a really important component to this industry, but we have to wrap up. So thanks again everyone for joining us. I'm Ellen Brown.
Speaker 1:I'm Dave Pavlik and I'm Justin Politi. We are the partners at PP2 health their best chance for real change and, as you can tell, we could talk all day about healthcare.
Speaker 2:Drop us a line through BP to health comm and thank you very much, colby, for making the time to tell me today. Yeah, we really appreciate it. The reverse Molly podcast is produced by MMG studios in Tampa Florida. I.