1 00:00:15,316 --> 00:00:22,876 Speaker 1: Pushkin. Imagine you're going to buy a car. You go 2 00:00:22,916 --> 00:00:25,316 Speaker 1: to the lot, you test drive the car, You tell 3 00:00:25,356 --> 00:00:27,796 Speaker 1: the sales guy I like it, I want to buy it. 4 00:00:28,436 --> 00:00:31,836 Speaker 1: And the sales guy says, go ahead, drive away. Car 5 00:00:31,916 --> 00:00:35,196 Speaker 1: is yours and you say, okay, great, But how much 6 00:00:35,236 --> 00:00:37,996 Speaker 1: is this car going to cost? And the sales guy goes, 7 00:00:38,556 --> 00:00:41,756 Speaker 1: I don't know. I can't tell you. Maybe it's twenty 8 00:00:41,796 --> 00:00:45,596 Speaker 1: thousand dollars, maybe it's thirty thousand dollars, maybe it's forty. 9 00:00:46,076 --> 00:00:47,956 Speaker 1: We'll send you a bill in like a month when 10 00:00:47,996 --> 00:00:51,236 Speaker 1: we figure it out. This is obviously absurd. It's not 11 00:00:51,276 --> 00:00:53,956 Speaker 1: the way buying a car works, but it is a 12 00:00:54,076 --> 00:00:55,996 Speaker 1: lot like the way it works when you go to 13 00:00:56,036 --> 00:00:59,956 Speaker 1: the hospital for say, surgery. Nobody can tell you in 14 00:00:59,996 --> 00:01:02,876 Speaker 1: advance exactly how much it's going to cost, and then 15 00:01:03,036 --> 00:01:05,556 Speaker 1: a month later, when you don't have any painkillers left 16 00:01:05,556 --> 00:01:13,796 Speaker 1: to blunt the impact, you get the bill. Surprise. I'm 17 00:01:13,876 --> 00:01:16,796 Speaker 1: Jacob Goldstein, and this is what's your problem. My guest 18 00:01:16,796 --> 00:01:19,916 Speaker 1: today is Chris Severn, the co founder and CEO of 19 00:01:19,996 --> 00:01:23,636 Speaker 1: Turquoise Health. Chris's problem is this, how do you make 20 00:01:23,716 --> 00:01:30,196 Speaker 1: healthcare prices transparent, not just for consumers, but for hospitals, insurers, businesses, 21 00:01:30,596 --> 00:01:33,876 Speaker 1: for everybody. People have been trying to solve this problem 22 00:01:33,876 --> 00:01:36,316 Speaker 1: for decades, but there's a good reason to think that 23 00:01:36,396 --> 00:01:40,756 Speaker 1: this time really is different. In twenty nineteen, the federal 24 00:01:40,796 --> 00:01:44,916 Speaker 1: government issued a new rule. This rule said insurers and 25 00:01:45,036 --> 00:01:48,836 Speaker 1: hospitals are going to have to publish their prices, not 26 00:01:48,876 --> 00:01:52,396 Speaker 1: just the fake list prices that nobody pays, but the actual, 27 00:01:52,676 --> 00:01:57,316 Speaker 1: real negotiated prices. This rule is just starting to take effect, 28 00:01:57,836 --> 00:02:00,396 Speaker 1: and Chris says it's impact in the long run could 29 00:02:00,476 --> 00:02:05,956 Speaker 1: be huge. So it's a pretty simple story. You know, 30 00:02:06,996 --> 00:02:12,396 Speaker 1: before twenty nineteen, the true price of healthcare was unknown 31 00:02:12,676 --> 00:02:16,796 Speaker 1: to anybody who wasn't privy to these contracts negotiated between 32 00:02:16,836 --> 00:02:19,956 Speaker 1: insurance companies and hospitals. And this is a this is 33 00:02:19,996 --> 00:02:23,836 Speaker 1: an insane fact. Oh insane. I mean, it's obviously true. 34 00:02:23,836 --> 00:02:25,276 Speaker 1: If you're a patient and you're going to go and 35 00:02:25,316 --> 00:02:26,596 Speaker 1: they can't tell you, is it going to cost a 36 00:02:26,636 --> 00:02:29,276 Speaker 1: thousand dollars? It could cost five thousand, they can't tell you. 37 00:02:29,476 --> 00:02:33,036 Speaker 1: But like one hospital didn't know what another hospital was charging, 38 00:02:33,356 --> 00:02:37,716 Speaker 1: different insurers getting wildly different rates, like just a weird, weird, 39 00:02:37,956 --> 00:02:41,676 Speaker 1: huge money world, exactly, And it is crazy. And that's 40 00:02:41,676 --> 00:02:44,996 Speaker 1: the world that sort of I professionally grew up in 41 00:02:45,116 --> 00:02:47,316 Speaker 1: for ten years and we were just used to it. 42 00:02:47,356 --> 00:02:50,116 Speaker 1: You know, these secret PDF contracts that were protected as 43 00:02:50,396 --> 00:02:52,756 Speaker 1: trade secrets could not be disclosed. There were these things 44 00:02:52,796 --> 00:02:54,796 Speaker 1: called gag clauses. When you say you grew up and 45 00:02:54,796 --> 00:02:59,196 Speaker 1: you were a consultant for hospital billing, basically, right, exactly exactly, 46 00:02:59,436 --> 00:03:02,556 Speaker 1: And you know, there's an interesting nugget in ACA that 47 00:03:02,716 --> 00:03:08,276 Speaker 1: required hospitals to disclose their standard charges was the word okay, 48 00:03:08,316 --> 00:03:11,636 Speaker 1: And it was basically the Obamacare law that was passed 49 00:03:11,876 --> 00:03:14,516 Speaker 1: more than ten years ago, now right, yep. And nothing 50 00:03:14,556 --> 00:03:17,276 Speaker 1: really happened with that for a while, and then legislators 51 00:03:17,276 --> 00:03:20,876 Speaker 1: started turning attention and rulemakers started turning attention to it, saying, hey, 52 00:03:21,236 --> 00:03:23,556 Speaker 1: we really need to get the prices of healthcare out there. 53 00:03:24,036 --> 00:03:26,796 Speaker 1: We're going to and this came through the Trump executive 54 00:03:26,876 --> 00:03:29,516 Speaker 1: orders in twenty nineteen. There were a few of them. 55 00:03:29,676 --> 00:03:33,876 Speaker 1: Hospitals must disclose their standard charges for the price of healthcare, 56 00:03:34,236 --> 00:03:37,716 Speaker 1: and insurance companies must disclose their standard charges. So you've 57 00:03:37,716 --> 00:03:42,596 Speaker 1: been working in basically hospital billing, right, hospital revenue, you 58 00:03:42,676 --> 00:03:46,196 Speaker 1: see this rule come, Like, when do you decide to 59 00:03:46,196 --> 00:03:48,596 Speaker 1: start the company and like, how does it fit with 60 00:03:48,636 --> 00:03:53,396 Speaker 1: this story? Yeah, so the rule was proposed, so the 61 00:03:53,436 --> 00:03:55,916 Speaker 1: executive order. I remember where I was with my co 62 00:03:55,996 --> 00:03:58,996 Speaker 1: founder Adam because we were running a business together separately 63 00:03:59,476 --> 00:04:02,236 Speaker 1: or separate from Turquoise, and we saw the rule come out. 64 00:04:02,276 --> 00:04:04,076 Speaker 1: We were like, are you are you reading this same way? 65 00:04:04,116 --> 00:04:07,196 Speaker 1: I am. We're like, I think this means all these 66 00:04:07,196 --> 00:04:10,356 Speaker 1: contracts we see are going to become If it is 67 00:04:10,396 --> 00:04:11,756 Speaker 1: what you think it is, it's going to be a 68 00:04:11,756 --> 00:04:14,516 Speaker 1: big deal. Right, Oh yeah, totally. This is going to 69 00:04:14,516 --> 00:04:17,316 Speaker 1: totally flip the economics of healthcare on its head. It 70 00:04:17,396 --> 00:04:22,076 Speaker 1: could create true consumerism and healthcare. It could create true 71 00:04:22,516 --> 00:04:25,396 Speaker 1: macroeconomic pressures in healthcare, and I want to be a 72 00:04:25,436 --> 00:04:28,796 Speaker 1: part of it. Essentially. So it's this moment when when healthcare, 73 00:04:28,836 --> 00:04:32,116 Speaker 1: when this giant part of the economy that has been opaque, 74 00:04:32,556 --> 00:04:34,756 Speaker 1: is going to get less opaque, It's going to get 75 00:04:34,756 --> 00:04:38,196 Speaker 1: more transparent. You think maybe patients will finally be able 76 00:04:38,236 --> 00:04:40,756 Speaker 1: to actually figure out what healthcare is going to cost, 77 00:04:40,756 --> 00:04:43,236 Speaker 1: maybe they'll be able to shop around. And you decide 78 00:04:43,276 --> 00:04:46,236 Speaker 1: to start this company, Turquoise Health, to kind of get 79 00:04:46,276 --> 00:04:49,276 Speaker 1: in on this moment. What exactly are you setting out 80 00:04:49,276 --> 00:04:54,036 Speaker 1: to do. So we decided late twenty twenty that we 81 00:04:54,036 --> 00:04:58,436 Speaker 1: were going to build the price transparency page of every hospital. 82 00:04:58,796 --> 00:05:00,636 Speaker 1: You know, a hospital's website's not very good, they're going 83 00:05:00,676 --> 00:05:05,516 Speaker 1: to hide this information. So at the time, I went 84 00:05:05,556 --> 00:05:11,516 Speaker 1: on a New Year's vacation with my girlfriend at the 85 00:05:11,556 --> 00:05:13,836 Speaker 1: time now my wife, and I was on my computer 86 00:05:14,436 --> 00:05:18,716 Speaker 1: New Year's Eve checking hospital websites with Adam, my co founder, 87 00:05:18,756 --> 00:05:21,156 Speaker 1: and we were basically waiting for these files to come live, 88 00:05:21,316 --> 00:05:24,836 Speaker 1: these pricing files to come live. And I remember laying 89 00:05:24,876 --> 00:05:26,916 Speaker 1: out by the pool with my laptop and just like 90 00:05:26,956 --> 00:05:31,916 Speaker 1: refreshing common health system pages because these files ended up 91 00:05:31,916 --> 00:05:35,316 Speaker 1: being so hidden, just like we predicted on every hospital's website. 92 00:05:35,356 --> 00:05:37,596 Speaker 1: So to go find them to make sense of them 93 00:05:37,956 --> 00:05:40,556 Speaker 1: became really our whole challenge of last year a twenty 94 00:05:40,636 --> 00:05:44,596 Speaker 1: twenty one. And then this year there was another step 95 00:05:44,676 --> 00:05:48,076 Speaker 1: right where insurers also had to post what they pay 96 00:05:48,436 --> 00:05:53,556 Speaker 1: for each procedure freach hospital. Yes, that was just the summer, right, Yeah, 97 00:05:53,596 --> 00:05:57,276 Speaker 1: this is step two and that is just another huge 98 00:05:57,276 --> 00:06:02,156 Speaker 1: watershed moment. So can we go online right now and 99 00:06:02,196 --> 00:06:06,236 Speaker 1: like actually look at something that will sort of help 100 00:06:06,316 --> 00:06:09,436 Speaker 1: me understand kind of how this works and why it's meaningful. Yeah, 101 00:06:09,436 --> 00:06:11,276 Speaker 1: So how would you like me to do it? Would 102 00:06:11,316 --> 00:06:13,956 Speaker 1: you want to pull up a page or um? So? Okay? 103 00:06:13,956 --> 00:06:17,436 Speaker 1: So I have turquoise dot health uh and it says 104 00:06:17,676 --> 00:06:21,316 Speaker 1: enter service name or code and has a zip code. UM, 105 00:06:21,996 --> 00:06:25,676 Speaker 1: So exactly what's a what's a what's a good basic service? 106 00:06:25,756 --> 00:06:28,076 Speaker 1: That's gonna just tell me what to enter? Just talk 107 00:06:28,156 --> 00:06:32,316 Speaker 1: me through it? Yeah. I usually type in colonoscopy. Okay, 108 00:06:33,676 --> 00:06:37,876 Speaker 1: there's a lot of different uh sub subsets that that 109 00:06:37,956 --> 00:06:41,156 Speaker 1: auto populate. Is there one particular version of it I 110 00:06:41,156 --> 00:06:44,796 Speaker 1: should type in? Yeah? Maybe some diagnostic colonoscopy is is 111 00:06:44,796 --> 00:06:50,596 Speaker 1: pretty common, okay, colonoscope Comma diagnostic yep um. And the 112 00:06:50,756 --> 00:06:53,556 Speaker 1: zip code here in New York. Okay, So I got 113 00:06:53,556 --> 00:06:58,116 Speaker 1: one hundred and twenty six results yep um, and it 114 00:06:58,156 --> 00:07:01,396 Speaker 1: looks like what it's showing me first is the is 115 00:07:01,436 --> 00:07:05,316 Speaker 1: the cash price? So there's Memorial Sloan Kettering, very well 116 00:07:05,356 --> 00:07:08,596 Speaker 1: known hospital four thousand, one hundred and thirty six dollars, 117 00:07:08,596 --> 00:07:11,676 Speaker 1: So seems like a lot. But then I scrolled down 118 00:07:12,116 --> 00:07:15,356 Speaker 1: and I see New York Presbyterian, while Cornell Medical Center 119 00:07:15,436 --> 00:07:19,836 Speaker 1: also fine institution eleven thousand, seven hundred dollars. So the 120 00:07:19,836 --> 00:07:23,076 Speaker 1: difference between four thousand and eleven seven hundred for the 121 00:07:23,116 --> 00:07:25,756 Speaker 1: same procedure is huge. We kind of know this, right, 122 00:07:25,756 --> 00:07:28,396 Speaker 1: it's absurd. We also know that the cash price is 123 00:07:28,436 --> 00:07:31,476 Speaker 1: not that meaningful, right, it's sort of arbitrary. It's weird. 124 00:07:31,796 --> 00:07:34,316 Speaker 1: Most people don't pay it. So it also says, see 125 00:07:34,316 --> 00:07:36,396 Speaker 1: all rates? Should I click? That? Is that where the 126 00:07:36,396 --> 00:07:39,916 Speaker 1: action is? Yeah, and when you see y'all rates, you'll 127 00:07:39,956 --> 00:07:44,196 Speaker 1: see a drop down of whatever insurance plans they disclosed 128 00:07:44,516 --> 00:07:48,156 Speaker 1: to let me do. Oh, one of them doesn't take 129 00:07:48,156 --> 00:07:53,756 Speaker 1: my insurance, which is kind of surprising to meet. This 130 00:07:53,796 --> 00:07:57,996 Speaker 1: can't be right, There's no way. There's no way. Sloan 131 00:07:58,076 --> 00:08:00,636 Speaker 1: Kettering doesn't take Signet and doesn't take Blue Cross. Right, 132 00:08:00,676 --> 00:08:03,796 Speaker 1: there's no way. And so the open secret in healthcare 133 00:08:04,396 --> 00:08:10,076 Speaker 1: in our industry is that even though the rule required 134 00:08:10,156 --> 00:08:14,196 Speaker 1: hospitals to disclose their negotiated rates, their prices for healthcare, 135 00:08:14,956 --> 00:08:19,076 Speaker 1: pricing often is not that simple. It's not a flat 136 00:08:19,156 --> 00:08:21,996 Speaker 1: dollar amount, and so sometimes the way that a rate 137 00:08:22,076 --> 00:08:26,036 Speaker 1: is calculated is using a formula or convoluted math, so 138 00:08:26,196 --> 00:08:30,556 Speaker 1: they omit it. So is this not that useful yet? 139 00:08:30,756 --> 00:08:32,276 Speaker 1: Is that what I should take away from this that 140 00:08:32,356 --> 00:08:35,196 Speaker 1: like this really common procedure at this really big hospital, 141 00:08:35,236 --> 00:08:38,276 Speaker 1: they don't have the information for like really big insurance companies. 142 00:08:38,316 --> 00:08:41,516 Speaker 1: That seems like a problem. And now what we have 143 00:08:41,636 --> 00:08:45,116 Speaker 1: is a bit of Swiss cheese. You know, you sometimes 144 00:08:45,116 --> 00:08:48,196 Speaker 1: find the rate and sometimes you're left scratching your head 145 00:08:48,596 --> 00:08:51,636 Speaker 1: with cheese with maybe more whole than cheese. At this point, 146 00:08:51,676 --> 00:08:54,316 Speaker 1: still we don't have all the information we need yet, 147 00:08:54,316 --> 00:08:58,236 Speaker 1: like is it coming yep, So we're at a snapshot 148 00:08:58,236 --> 00:08:59,956 Speaker 1: in time where this is still you know, we're in 149 00:08:59,996 --> 00:09:04,596 Speaker 1: the first inning and as of July first, we mentioned 150 00:09:04,596 --> 00:09:08,196 Speaker 1: that pair rule that came out. That pair rule remedies 151 00:09:08,236 --> 00:09:10,636 Speaker 1: the issue that you're looking at, and that means that 152 00:09:10,676 --> 00:09:13,556 Speaker 1: companies like Turquoise can fill in the gaps of what 153 00:09:13,596 --> 00:09:15,716 Speaker 1: you just mentioned. So we probably now have in our 154 00:09:15,796 --> 00:09:19,316 Speaker 1: data the signa rate from Memorial slum kettering, and you're 155 00:09:19,316 --> 00:09:20,996 Speaker 1: going to add that if I come back in what 156 00:09:21,236 --> 00:09:24,236 Speaker 1: a month, six months, when's it couldn't be there? Yeah, 157 00:09:24,236 --> 00:09:26,236 Speaker 1: this is pretty new. So we're forty nine days in 158 00:09:26,316 --> 00:09:28,916 Speaker 1: and we're gonna be rolling out services at a time, 159 00:09:28,956 --> 00:09:31,556 Speaker 1: so you know, realistically one to two months for now 160 00:09:31,596 --> 00:09:35,596 Speaker 1: for common services like that you would see this really soon. Yeah, 161 00:09:35,636 --> 00:09:38,876 Speaker 1: so there's there's a lot of optimism. So so okay, 162 00:09:39,316 --> 00:09:41,636 Speaker 1: the data is some of the data is there now 163 00:09:41,676 --> 00:09:44,076 Speaker 1: but kind of not enough, right you, kind of there's 164 00:09:44,116 --> 00:09:46,316 Speaker 1: some critical mass and like we're almost there. There's going 165 00:09:46,396 --> 00:09:49,316 Speaker 1: to be a lot more information available about pricing in 166 00:09:49,356 --> 00:09:52,636 Speaker 1: a really granular way soon. Yes. So then the big 167 00:09:52,676 --> 00:09:55,716 Speaker 1: question is like what's it gonna mean? Who's going to 168 00:09:55,796 --> 00:09:59,876 Speaker 1: do one with it? We have a couple of different products. 169 00:09:59,956 --> 00:10:02,636 Speaker 1: One is a data product that's basically like get an 170 00:10:02,676 --> 00:10:06,436 Speaker 1: idea of the rates an XYZ region and so who 171 00:10:06,476 --> 00:10:10,996 Speaker 1: would use this? Um and new surgery center may use 172 00:10:11,116 --> 00:10:14,476 Speaker 1: is to figure out where to set up shop. So 173 00:10:14,556 --> 00:10:18,196 Speaker 1: you have money, you're an investor, you want to start 174 00:10:18,196 --> 00:10:20,756 Speaker 1: surgery centers, and you see that this particular kind of 175 00:10:20,796 --> 00:10:23,316 Speaker 1: surgery that you are set up to do is like 176 00:10:23,516 --> 00:10:26,396 Speaker 1: really expensive at a certain place, you might go open 177 00:10:26,436 --> 00:10:29,276 Speaker 1: your surgery center there and offer it at a lower price. Yeah, 178 00:10:29,956 --> 00:10:31,556 Speaker 1: Like it's so silly. I'm a nerve, but I get 179 00:10:31,636 --> 00:10:33,996 Speaker 1: goose bumps thinking about that, because it's like, if you 180 00:10:34,036 --> 00:10:36,996 Speaker 1: see that there is a health system that is you 181 00:10:37,356 --> 00:10:41,116 Speaker 1: got the whole northeast portion of a state, just unlock 182 00:10:41,236 --> 00:10:43,916 Speaker 1: and their prices are really high. And now you might 183 00:10:43,956 --> 00:10:46,676 Speaker 1: see a savvy entrepreneur say, hey, I'm going to PLoP 184 00:10:46,676 --> 00:10:50,556 Speaker 1: a bunch of orthopedic surgeons out in Northeast forever, and 185 00:10:50,676 --> 00:10:53,276 Speaker 1: we're gonna start undercutting this health system because we know 186 00:10:53,316 --> 00:10:56,156 Speaker 1: how much it costs to do this procedure. So that's one. 187 00:10:56,356 --> 00:10:58,956 Speaker 1: What are some other kind of lines of business for you? 188 00:10:58,996 --> 00:11:02,556 Speaker 1: What other kinds of people or institutions are paying you? Yeah, 189 00:11:02,596 --> 00:11:05,996 Speaker 1: So one example is we have several startup insurance companies 190 00:11:06,036 --> 00:11:10,116 Speaker 1: paying us. And these startup insurance companies say, hey, wow, 191 00:11:10,556 --> 00:11:14,396 Speaker 1: some of those other insurance companies in my market don't 192 00:11:14,436 --> 00:11:18,876 Speaker 1: seem to be operating efficiently in negotiating appropriate prices for 193 00:11:18,916 --> 00:11:22,196 Speaker 1: this population. And we think we can create a leaner 194 00:11:23,116 --> 00:11:27,396 Speaker 1: health insurance platform so that we could charge you know, 195 00:11:27,436 --> 00:11:30,836 Speaker 1: our patients pay less and they have a better member experience. 196 00:11:30,836 --> 00:11:33,556 Speaker 1: And so that's I'd say, that's in the same vein 197 00:11:33,596 --> 00:11:36,276 Speaker 1: as like a large employer will come to us and say, hey, 198 00:11:36,716 --> 00:11:39,836 Speaker 1: we've been working with this carrier for a long time, 199 00:11:39,876 --> 00:11:43,036 Speaker 1: and we just want insurance company with this insurance company, yeah, 200 00:11:43,076 --> 00:11:44,676 Speaker 1: and we just want to see if there are other 201 00:11:44,676 --> 00:11:47,196 Speaker 1: options out there and if we're getting a fair deal. 202 00:11:47,436 --> 00:11:50,916 Speaker 1: And that's a very common conversation we have. Are like 203 00:11:51,156 --> 00:11:54,276 Speaker 1: big hospitals coming to you also are big insurance companies. 204 00:11:54,276 --> 00:11:56,356 Speaker 1: I mean, so far you've talked about the kind of 205 00:11:56,596 --> 00:12:01,316 Speaker 1: STARTUPPI you know, disruptor types. What about the kind of 206 00:12:01,356 --> 00:12:04,436 Speaker 1: big incumbents are they? Are they your clients? Yeah, there's 207 00:12:04,436 --> 00:12:06,636 Speaker 1: a lot of the big I mean, the big incumbents 208 00:12:06,676 --> 00:12:11,196 Speaker 1: are They're concerned, they're concerned, they're over priced, They're concerned 209 00:12:11,796 --> 00:12:16,036 Speaker 1: that they are not doing all they can to get patients, 210 00:12:16,316 --> 00:12:19,516 Speaker 1: and so they are coming to us. And part of 211 00:12:19,516 --> 00:12:22,956 Speaker 1: the thing with hospitals is they're not just competing with 212 00:12:22,996 --> 00:12:27,716 Speaker 1: other hospitals, right, They're also competing with places like outpatient 213 00:12:27,836 --> 00:12:30,836 Speaker 1: surgery centers, and it seems like there's huge potential for 214 00:12:30,916 --> 00:12:34,476 Speaker 1: price competition there. Yeah, So we talked earlier about a 215 00:12:34,556 --> 00:12:37,956 Speaker 1: NIE meniscus repair. If you get that NI meniscus repaired 216 00:12:37,996 --> 00:12:43,556 Speaker 1: done in a hospital outpatient department, you have a different 217 00:12:43,676 --> 00:12:46,276 Speaker 1: cost structure because that hospital has to run, lights have 218 00:12:46,356 --> 00:12:50,316 Speaker 1: to stay on, they have a bunch of employees. And meanwhile, 219 00:12:50,596 --> 00:12:52,996 Speaker 1: you know, five miles down the road there may be 220 00:12:53,036 --> 00:12:56,796 Speaker 1: a surgery center with a very comparable surgeon, and the 221 00:12:56,836 --> 00:13:01,276 Speaker 1: cost structure is just simpler. You know, they've got the nathesiologists, 222 00:13:01,276 --> 00:13:04,636 Speaker 1: they've got a smaller building, they've got fewer nurses, simpler 223 00:13:04,636 --> 00:13:07,956 Speaker 1: billing practices, simpler contracts. A lot of these surgery center 224 00:13:08,036 --> 00:13:11,036 Speaker 1: contracts are just almost like a restaurant menu. Can you 225 00:13:11,076 --> 00:13:12,996 Speaker 1: give me just a sense? I mean I could, I 226 00:13:12,996 --> 00:13:14,716 Speaker 1: could go look it up, or we could look it up. 227 00:13:14,716 --> 00:13:17,276 Speaker 1: But do you know since I mean, if meniscus repair 228 00:13:17,356 --> 00:13:19,956 Speaker 1: is when you look at a lot, yeah, more or less, 229 00:13:20,556 --> 00:13:23,076 Speaker 1: what might the price be at the hospital versus at 230 00:13:23,116 --> 00:13:27,116 Speaker 1: a at a surgery center. Yeah, very common to see 231 00:13:27,316 --> 00:13:30,516 Speaker 1: common knee procedures and shoulder procedures, all those kind of 232 00:13:30,596 --> 00:13:33,956 Speaker 1: like ligament surgeries to run in the twenty to thirty 233 00:13:33,996 --> 00:13:37,276 Speaker 1: to forty grand range at a hospital all in, and 234 00:13:37,276 --> 00:13:40,636 Speaker 1: then at a surgery center sometimes you know, five to ten, 235 00:13:41,556 --> 00:13:48,476 Speaker 1: so huge, ten versus thirty is wildly different. Yeah, that 236 00:13:48,476 --> 00:13:51,916 Speaker 1: that happens all throughout the US. That's extraordinary. Let's just 237 00:13:52,156 --> 00:13:54,876 Speaker 1: let's just sit in that for a sec right, Like, 238 00:13:54,916 --> 00:13:57,036 Speaker 1: I know we're used to healthcare blah blah blah, but 239 00:13:57,076 --> 00:14:00,356 Speaker 1: like that's that's out of control in some way, Like 240 00:14:00,396 --> 00:14:05,356 Speaker 1: that shouldn't persist. That doesn't make sense and why why 241 00:14:05,676 --> 00:14:08,396 Speaker 1: why has that persisted until now? I mean, it's part 242 00:14:08,436 --> 00:14:10,836 Speaker 1: of it market power? Is it that you know a 243 00:14:10,836 --> 00:14:15,076 Speaker 1: lot of places there's basically one hospital and so the 244 00:14:15,116 --> 00:14:17,596 Speaker 1: insurance company kind of has to pay what the hospital 245 00:14:17,636 --> 00:14:20,996 Speaker 1: asks because it's the only hospital. That's a huge part 246 00:14:20,996 --> 00:14:23,676 Speaker 1: of it. That's probably the main driving thing. It's just 247 00:14:23,836 --> 00:14:27,476 Speaker 1: market power and no other options. So it's kind of 248 00:14:27,676 --> 00:14:30,836 Speaker 1: an antitrust problem. Although if you recognize the surgery center 249 00:14:30,996 --> 00:14:34,556 Speaker 1: as part of the market, then like there's a solution. 250 00:14:34,636 --> 00:14:36,356 Speaker 1: You don't have to go to the hospital. There is 251 00:14:36,356 --> 00:14:39,636 Speaker 1: a competitor. Well, that is the problem. How easy is 252 00:14:39,676 --> 00:14:43,636 Speaker 1: it to affect change in the market, Like how easy 253 00:14:43,676 --> 00:14:47,116 Speaker 1: is it for a top orthopedic surgeon to open a 254 00:14:47,156 --> 00:14:50,716 Speaker 1: surgery center and to move out of the hospital environment. 255 00:14:50,996 --> 00:14:53,636 Speaker 1: And it's that a regulatory question. Is it a sort 256 00:14:53,636 --> 00:14:57,996 Speaker 1: of access to capital question? Like what affects that? It's 257 00:14:57,996 --> 00:15:03,276 Speaker 1: all the above, regulatory access to capital, comp practice privileges. 258 00:15:03,316 --> 00:15:05,636 Speaker 1: You know, once you're out, you're out, like forget about 259 00:15:05,916 --> 00:15:08,156 Speaker 1: you can't if the hospital says if you go open 260 00:15:08,196 --> 00:15:10,396 Speaker 1: a surgery center, you can't admit patients to the hospital. 261 00:15:10,476 --> 00:15:13,236 Speaker 1: Anymore they do. Yeah, oh yeah, that's definitely a thing. 262 00:15:13,316 --> 00:15:16,636 Speaker 1: So how easy is it for this side of service 263 00:15:16,636 --> 00:15:20,436 Speaker 1: shift to occur? And so there are a bunch of barriers, 264 00:15:20,436 --> 00:15:24,636 Speaker 1: and I think price transparency forces will work to you know, 265 00:15:24,916 --> 00:15:35,876 Speaker 1: be down those barriers. Okay, but really, really, what is 266 00:15:35,876 --> 00:15:38,116 Speaker 1: it going to take to get to a world where 267 00:15:38,116 --> 00:15:40,276 Speaker 1: we know what a trip to the hospital is going 268 00:15:40,316 --> 00:15:44,716 Speaker 1: to cost before we go to the hospital. That's coming 269 00:15:44,796 --> 00:15:51,356 Speaker 1: up after the break. Now back to the show. What's 270 00:15:51,396 --> 00:15:53,756 Speaker 1: the thing you haven't figured out how to do yet? 271 00:15:53,796 --> 00:15:55,716 Speaker 1: What's like a problem you've been kind of working on 272 00:15:55,756 --> 00:15:59,236 Speaker 1: but you feel like you haven't really cracked yet. So 273 00:15:59,316 --> 00:16:05,356 Speaker 1: there's two big ones. One is how do we convince 274 00:16:06,516 --> 00:16:12,436 Speaker 1: and or enable the providers and payers to agree to 275 00:16:12,436 --> 00:16:17,156 Speaker 1: an upfront price for healthcare? So a hard problem we're 276 00:16:17,196 --> 00:16:20,596 Speaker 1: working on is for your average insured patient to give 277 00:16:20,636 --> 00:16:23,276 Speaker 1: them an upfront binding price that the hospital and the 278 00:16:23,316 --> 00:16:26,996 Speaker 1: insurance company will stand by. And there's a new rule 279 00:16:27,036 --> 00:16:30,876 Speaker 1: coming that seems relevant, right where the kind of the 280 00:16:30,916 --> 00:16:34,076 Speaker 1: explanation of benefits that you get after you go whatever 281 00:16:34,156 --> 00:16:36,276 Speaker 1: to the doctor, you're supposed to be able to get 282 00:16:36,316 --> 00:16:38,916 Speaker 1: that before you go, Right, that's like a thing that's coming. 283 00:16:39,036 --> 00:16:42,036 Speaker 1: Is that relevant here, Yeah, And that is a huge 284 00:16:42,036 --> 00:16:44,916 Speaker 1: complexity ahead of us, and it's still dependent on new 285 00:16:45,036 --> 00:16:47,716 Speaker 1: rulemaking coming out of the government any day. I mean, 286 00:16:47,756 --> 00:16:51,156 Speaker 1: it's probably like there is some amount of actual complexity 287 00:16:51,196 --> 00:16:54,396 Speaker 1: in healthcare where like the body is complicated. They don't 288 00:16:54,396 --> 00:16:57,716 Speaker 1: know what's going to happen, Like there's a reason, you know, 289 00:16:58,516 --> 00:17:00,356 Speaker 1: especially if somebody's really sick, they got a lot of 290 00:17:00,356 --> 00:17:02,956 Speaker 1: things wrong with them. The hospital doesn't know what's going 291 00:17:02,996 --> 00:17:04,756 Speaker 1: to have to happen, Like I feel like there's cases 292 00:17:04,756 --> 00:17:08,756 Speaker 1: where they in good faith don't know totally and it 293 00:17:08,836 --> 00:17:11,716 Speaker 1: just comes. This is where actualaries come in the law 294 00:17:11,756 --> 00:17:15,036 Speaker 1: of large numbers. If one person comes in for that 295 00:17:15,116 --> 00:17:18,836 Speaker 1: nimniscus repair and they have some comorbidities, turns out there 296 00:17:18,836 --> 00:17:22,036 Speaker 1: in the operating room an hour longer than planned, that 297 00:17:22,116 --> 00:17:24,836 Speaker 1: could be a loss for the surgery center of the hospital. 298 00:17:25,116 --> 00:17:27,796 Speaker 1: But if a hundred patients come in, then you know, 299 00:17:27,916 --> 00:17:30,276 Speaker 1: ninety out of one hundred will follow a similar cost structure, 300 00:17:31,076 --> 00:17:33,196 Speaker 1: and so they should be able to promise to charge 301 00:17:33,236 --> 00:17:36,156 Speaker 1: some average rate that over time is the right price 302 00:17:36,276 --> 00:17:38,636 Speaker 1: at which they can run their business at a profit. Yeah, 303 00:17:38,676 --> 00:17:41,436 Speaker 1: and that's happening in some places, but it needs to 304 00:17:41,476 --> 00:17:43,756 Speaker 1: happen in more to create that kind of coverage of 305 00:17:43,796 --> 00:17:47,036 Speaker 1: the market. Like we've discussed. Okay, so that's one, what's 306 00:17:47,036 --> 00:17:51,276 Speaker 1: the other. The other is pretty much the same problem, 307 00:17:51,756 --> 00:17:54,036 Speaker 1: but more to B to B level. How do we 308 00:17:54,076 --> 00:17:59,396 Speaker 1: create a binding, easy to reconcile payment between the insurance 309 00:17:59,436 --> 00:18:01,556 Speaker 1: company and the hospital, Because that's where a lot of 310 00:18:01,596 --> 00:18:07,636 Speaker 1: the waste happens in healthcare, is the billing and claim 311 00:18:07,636 --> 00:18:11,916 Speaker 1: adjudication mumbo jumbo that goes on between those two entities. 312 00:18:12,036 --> 00:18:14,916 Speaker 1: That's way more than with patients. Right, Presumably the vast 313 00:18:14,956 --> 00:18:17,516 Speaker 1: amount of money and healthcare is not going from a 314 00:18:17,636 --> 00:18:20,156 Speaker 1: patient's wallet to the hospital. It's going from the insurance 315 00:18:20,196 --> 00:18:22,476 Speaker 1: company to the hospital. Yeah, the lion's share of the 316 00:18:22,516 --> 00:18:26,236 Speaker 1: waste here that affects our GDP and our premiums and 317 00:18:26,236 --> 00:18:30,156 Speaker 1: our salaries is coming through that B to B transaction. 318 00:18:30,236 --> 00:18:33,836 Speaker 1: And so tell me about like in a way it's surprising. 319 00:18:33,876 --> 00:18:35,196 Speaker 1: I mean, if you know about healthcare, it's kind of 320 00:18:35,196 --> 00:18:38,476 Speaker 1: not surprising, but sort of naively it's surprising because you 321 00:18:38,476 --> 00:18:41,356 Speaker 1: would think, oh, insurance companies are giant and hospitals are giant, 322 00:18:41,356 --> 00:18:43,876 Speaker 1: and they do so many of these procedures. What's the 323 00:18:43,956 --> 00:18:49,236 Speaker 1: problem there. I'll give you an example hopefully that helps. Yeah, 324 00:18:49,636 --> 00:18:55,396 Speaker 1: often if you go in for that nimniscus repair, a 325 00:18:55,436 --> 00:18:58,116 Speaker 1: few other things might happen. They might clear out some 326 00:18:58,236 --> 00:19:01,436 Speaker 1: other cartilage. At the end of the day, you might 327 00:19:01,516 --> 00:19:04,396 Speaker 1: end up with three different procedures build on your claim. 328 00:19:04,916 --> 00:19:08,236 Speaker 1: And if there's any issue with the claim and what 329 00:19:08,396 --> 00:19:11,116 Speaker 1: you end up with our people like me in the 330 00:19:11,276 --> 00:19:13,556 Speaker 1: last ten years, well, we'll go through in data mind 331 00:19:13,596 --> 00:19:18,396 Speaker 1: and find those discrepancies and charge a fee and sort 332 00:19:18,436 --> 00:19:22,836 Speaker 1: of push these reconciliations back and forth for years after 333 00:19:22,876 --> 00:19:25,516 Speaker 1: the fact. So, just to be clear, what you wind 334 00:19:25,596 --> 00:19:29,756 Speaker 1: up with is the hospital and the insurance company negotiating 335 00:19:29,836 --> 00:19:32,996 Speaker 1: on a case by case basis, people at both places 336 00:19:33,076 --> 00:19:35,636 Speaker 1: getting paid to It's kind of like going to court. 337 00:19:35,676 --> 00:19:37,516 Speaker 1: They're not going to court, but they're arguing over like 338 00:19:37,796 --> 00:19:40,036 Speaker 1: did you do this one procedure on this one patient 339 00:19:40,076 --> 00:19:42,836 Speaker 1: this one day. That's what you're talking about. It's exactly that. 340 00:19:42,916 --> 00:19:45,836 Speaker 1: And what ends up is this really long, honestly years 341 00:19:45,876 --> 00:19:49,636 Speaker 1: long process where these case by case reconciliations are happening, 342 00:19:49,916 --> 00:19:52,556 Speaker 1: which is wildly expensive, right, and we end up paying 343 00:19:52,596 --> 00:19:55,916 Speaker 1: for that in our health insurance premiums huge industry and 344 00:19:56,116 --> 00:19:58,756 Speaker 1: we don't benefit from that. Like, it would be great 345 00:19:58,796 --> 00:20:00,876 Speaker 1: to get rid of that. It would be an efficiency 346 00:20:00,876 --> 00:20:04,116 Speaker 1: gain that would lower healthcare prices. Yeah, So how do 347 00:20:04,196 --> 00:20:07,076 Speaker 1: you get rid of that super costly back and forth? 348 00:20:07,516 --> 00:20:10,476 Speaker 1: That's a good, big problem. Do you get rid of that? 349 00:20:10,476 --> 00:20:13,036 Speaker 1: That's the hard thing I guess is this is an 350 00:20:13,076 --> 00:20:16,876 Speaker 1: industry that's slow to adopt new software. They're setting their ways. 351 00:20:17,356 --> 00:20:19,356 Speaker 1: It's very difficult. I think that's one of our biggest 352 00:20:19,356 --> 00:20:21,756 Speaker 1: problems ahead of us if we want to simplify this 353 00:20:21,836 --> 00:20:25,996 Speaker 1: payment and healthcare is you can't just build that future solution, 354 00:20:26,036 --> 00:20:28,996 Speaker 1: but you've got to build the steps to get there. Okay, Yeah, 355 00:20:29,076 --> 00:20:30,756 Speaker 1: that's a big part of what our team's working on. 356 00:20:30,876 --> 00:20:35,356 Speaker 1: Baby steps, Baby, baby steps. So's the what's like, what's 357 00:20:35,396 --> 00:20:37,356 Speaker 1: the middle ground? I get the end is it's just 358 00:20:37,516 --> 00:20:40,116 Speaker 1: software and there's no people whose job is arguing over 359 00:20:40,196 --> 00:20:43,716 Speaker 1: mindy repair, right, But what's what's the step between here 360 00:20:43,716 --> 00:20:47,116 Speaker 1: and there? The middle ground for both of those problems. 361 00:20:47,156 --> 00:20:49,236 Speaker 1: You know, the patient payment and the B to B 362 00:20:49,356 --> 00:20:56,316 Speaker 1: payment is enabled by this new law that takes effect 363 00:20:56,596 --> 00:20:59,636 Speaker 1: essentially in twenty twenty three. We're still waiting for guidance. 364 00:20:59,676 --> 00:21:02,916 Speaker 1: And it's a piece of No Surprises, the No Surprises Act, 365 00:21:03,316 --> 00:21:05,716 Speaker 1: and you mentioned it earlier. If that says you are 366 00:21:05,916 --> 00:21:10,276 Speaker 1: entitled to a good faith estimate in advance of care, okay. 367 00:21:10,956 --> 00:21:15,836 Speaker 1: If that estimate of your cast share ends up being 368 00:21:15,836 --> 00:21:18,676 Speaker 1: off by a certain amount four hundred dollars the amount 369 00:21:18,716 --> 00:21:22,916 Speaker 1: currently proposed, then you as a patient have recourse to 370 00:21:23,196 --> 00:21:25,716 Speaker 1: reconcile that and to argue it, dispute it. Meaning you 371 00:21:26,116 --> 00:21:28,316 Speaker 1: might not be on the hook. You might not be 372 00:21:28,356 --> 00:21:30,316 Speaker 1: on the hook for the big bill that you were sent. 373 00:21:30,796 --> 00:21:35,316 Speaker 1: And so that presumably gives everybody in the system an 374 00:21:35,396 --> 00:21:38,556 Speaker 1: incentive to come up with a number in advance and 375 00:21:38,636 --> 00:21:41,956 Speaker 1: stick to it and not argue about it after exactly 376 00:21:42,316 --> 00:21:45,156 Speaker 1: let me ask you. Let me ask you one. There's 377 00:21:45,196 --> 00:21:47,716 Speaker 1: kind of a subtext here for me. I mean, really, 378 00:21:47,716 --> 00:21:52,476 Speaker 1: what we're talking about is bringing market forces to bear 379 00:21:53,036 --> 00:21:57,596 Speaker 1: on healthcare to make healthcare more efficient than better, which 380 00:21:57,636 --> 00:22:01,116 Speaker 1: makes sense in a certain way of thinking. I do wonder. 381 00:22:01,156 --> 00:22:03,076 Speaker 1: I mean, clearly, there are a lot of things where 382 00:22:03,116 --> 00:22:06,236 Speaker 1: the market works great. It does seem like healthcare is 383 00:22:06,276 --> 00:22:09,356 Speaker 1: a place where there are a bunch of reason to 384 00:22:09,396 --> 00:22:12,396 Speaker 1: think market forces might not work great. Even if we 385 00:22:12,516 --> 00:22:15,316 Speaker 1: set up the market better. Right, patients are scared, they 386 00:22:15,356 --> 00:22:20,156 Speaker 1: trust their doctor. It's intermediated by insurance. And so I 387 00:22:20,156 --> 00:22:22,156 Speaker 1: don't know if this question is like too big, but 388 00:22:22,316 --> 00:22:25,116 Speaker 1: does it even make sense to try and make the 389 00:22:25,196 --> 00:22:31,476 Speaker 1: market work in healthcare? I would argue by saying that 390 00:22:31,516 --> 00:22:34,076 Speaker 1: the consumer can decide if they if this is worth 391 00:22:34,116 --> 00:22:36,396 Speaker 1: it for them to make a change. So an example is, 392 00:22:36,716 --> 00:22:39,756 Speaker 1: if you love your doctor and you care about your 393 00:22:39,756 --> 00:22:42,476 Speaker 1: health or your family member's health, it is your right 394 00:22:42,556 --> 00:22:45,356 Speaker 1: to decide if that is worth more to you. And 395 00:22:45,436 --> 00:22:47,276 Speaker 1: maybe the drive to get there is worth more to 396 00:22:47,316 --> 00:22:49,556 Speaker 1: you than the five thousand dollars you can save. And 397 00:22:49,596 --> 00:22:51,836 Speaker 1: so maybe what the market forces in healthcare how they 398 00:22:51,836 --> 00:22:55,956 Speaker 1: differ is just that it will take more for there 399 00:22:55,996 --> 00:22:59,276 Speaker 1: to be a change of the consumer decision or the 400 00:22:59,276 --> 00:23:02,396 Speaker 1: purchase or decision than it does in other industries. Right, 401 00:23:02,436 --> 00:23:04,796 Speaker 1: It's not like an airline where if one airline is 402 00:23:04,876 --> 00:23:07,596 Speaker 1: twenty five bucks less, like sure, I'll fly on that airline. 403 00:23:07,596 --> 00:23:10,236 Speaker 1: It's not exactly. There's a bun of qualitative things that 404 00:23:10,316 --> 00:23:12,556 Speaker 1: come in around. If you trust your doctor, if you 405 00:23:12,556 --> 00:23:16,676 Speaker 1: feel you're cared for, that make it a slightly different market, 406 00:23:16,756 --> 00:23:23,236 Speaker 1: but not entirely in a minute, the Lightning Round, including, 407 00:23:23,316 --> 00:23:26,076 Speaker 1: among other things, how to talk to your doctor about 408 00:23:26,116 --> 00:23:35,076 Speaker 1: how much something is going to cause. That's the end 409 00:23:35,116 --> 00:23:38,036 Speaker 1: of the ads. Now we're going back to the show. Okay, 410 00:23:38,396 --> 00:23:40,396 Speaker 1: almost done. Last thing we're going to do is a 411 00:23:40,476 --> 00:23:45,516 Speaker 1: lightning round. Great. What's another domain where pricing is opaque 412 00:23:46,076 --> 00:23:49,596 Speaker 1: that would benefit from more transparency? Well, you know this 413 00:23:49,876 --> 00:23:53,396 Speaker 1: is this is interesting, but I've had price transparency as 414 00:23:53,396 --> 00:23:57,956 Speaker 1: a Google alert for years, and I have seen the 415 00:23:58,076 --> 00:24:02,356 Speaker 1: other industries where this is a hot topic cattle, agriculture, 416 00:24:02,796 --> 00:24:07,276 Speaker 1: and foreign currencies, foreign exchange markets. Yeah, it's like a 417 00:24:07,316 --> 00:24:10,756 Speaker 1: recurring thing. Those three things come up. Agriculture meaning like 418 00:24:11,116 --> 00:24:13,556 Speaker 1: wheat or what like I don't even know what that means. Yeah, 419 00:24:13,716 --> 00:24:17,236 Speaker 1: various produce. And I've collaborated this by asking a few 420 00:24:17,236 --> 00:24:19,436 Speaker 1: friends in those industries like, hey, keep getting these alerts, 421 00:24:19,516 --> 00:24:23,156 Speaker 1: this is a problem. They're like, oh, yeah, you should 422 00:24:23,156 --> 00:24:26,196 Speaker 1: fix that once you fix healthcare. Good. Those are not 423 00:24:26,356 --> 00:24:29,116 Speaker 1: three I would ever have guessed that's interesting. Do you 424 00:24:29,196 --> 00:24:32,996 Speaker 1: might think you might fix those once you fix healthcare? No. 425 00:24:33,276 --> 00:24:36,276 Speaker 1: I think what's more reasonable is there are other countries 426 00:24:36,316 --> 00:24:40,076 Speaker 1: that have a very similar problem where private insurance and 427 00:24:40,876 --> 00:24:43,036 Speaker 1: providers follow the same kind of archetype that we do 428 00:24:43,076 --> 00:24:45,236 Speaker 1: in the US that I'd be curious, like ten years 429 00:24:45,236 --> 00:24:46,916 Speaker 1: down the road if some of the stuff could work 430 00:24:47,156 --> 00:24:50,076 Speaker 1: in other countries. Ah, So not doing something else in 431 00:24:50,116 --> 00:24:53,156 Speaker 1: the US, but doing healthcare pricing in other countries. Exactly 432 00:24:54,516 --> 00:24:59,156 Speaker 1: from working in healthcare pricing and revenue, what have you 433 00:24:59,236 --> 00:25:03,196 Speaker 1: learned about pricing and negotiation that's helpful to you, you know, personally, 434 00:25:03,236 --> 00:25:08,956 Speaker 1: say in other domains? In other domains, Yeah, like you 435 00:25:09,316 --> 00:25:11,516 Speaker 1: good when you like go to buy a car or 436 00:25:11,716 --> 00:25:16,316 Speaker 1: you know, I honestly it's not another domain. But I 437 00:25:16,396 --> 00:25:20,436 Speaker 1: can help anybody in my family and myself know the 438 00:25:20,476 --> 00:25:24,156 Speaker 1: price of care in advance, because right now in healthcare, 439 00:25:24,196 --> 00:25:26,636 Speaker 1: it takes a lot to figure it out. So like 440 00:25:26,676 --> 00:25:29,476 Speaker 1: one superpower is that I feel like I'm able to 441 00:25:29,556 --> 00:25:33,436 Speaker 1: navigate costs and healthcare maybe before other people are quite ready. 442 00:25:35,316 --> 00:25:37,156 Speaker 1: You get a lot of like calls from your family 443 00:25:37,316 --> 00:25:39,476 Speaker 1: all the time and just walk through like, hey, here's 444 00:25:39,516 --> 00:25:43,116 Speaker 1: the best worst case scenario for you to plan for, 445 00:25:43,276 --> 00:25:45,516 Speaker 1: and here's some things to ask your doctor as you're 446 00:25:45,556 --> 00:25:49,676 Speaker 1: going through that process. Yeah, it's weird when you ask 447 00:25:49,916 --> 00:25:53,436 Speaker 1: doctors about pricing. Often they don't want to talk about 448 00:25:53,476 --> 00:25:56,316 Speaker 1: it in my experience, or they don't know. Yeah, So 449 00:25:56,436 --> 00:25:58,956 Speaker 1: the way you ask a doctor about pricing is less 450 00:25:58,956 --> 00:26:01,356 Speaker 1: how much does this cost? And more of do I 451 00:26:01,396 --> 00:26:03,516 Speaker 1: really need this right now? Or could this wait five 452 00:26:03,596 --> 00:26:05,716 Speaker 1: days for me to go to that you know, imaging 453 00:26:05,756 --> 00:26:09,556 Speaker 1: center or somewhere else to get this done. That's a tip. 454 00:26:09,716 --> 00:26:11,996 Speaker 1: You snuck a tip in, and I appreciate snuck a tip. 455 00:26:13,196 --> 00:26:15,516 Speaker 1: If everything goes well, what's a problem you'll be trying 456 00:26:15,556 --> 00:26:22,476 Speaker 1: to solve in five years? If everything goes well. So 457 00:26:22,596 --> 00:26:24,876 Speaker 1: for us, what that means is that it's as easy 458 00:26:24,916 --> 00:26:26,836 Speaker 1: to know the price of healthcare as it is buying 459 00:26:26,836 --> 00:26:30,516 Speaker 1: a toaster on Amazon. If everything goes well, the next 460 00:26:30,556 --> 00:26:34,756 Speaker 1: problem is really making sure we have all the right 461 00:26:34,876 --> 00:26:37,956 Speaker 1: data in front of the patient. So not just price, 462 00:26:38,116 --> 00:26:43,196 Speaker 1: but the quality is still a big issue. Accessibility, So hey, 463 00:26:43,236 --> 00:26:45,316 Speaker 1: can I have this in three days or do I 464 00:26:45,356 --> 00:26:47,556 Speaker 1: have to wait two months? And so there's all these 465 00:26:47,556 --> 00:26:50,396 Speaker 1: other we call them like pillars of the healthcare value 466 00:26:50,396 --> 00:26:53,676 Speaker 1: proposition that we want to tackle in price. It's just 467 00:26:53,716 --> 00:27:02,156 Speaker 1: where we're starting. Chris Severn is the co founder and 468 00:27:02,236 --> 00:27:06,316 Speaker 1: CEO of Turquoise Health. Just a quick note, this show 469 00:27:06,396 --> 00:27:08,676 Speaker 1: what's Your problem is going to take a two week 470 00:27:08,756 --> 00:27:13,156 Speaker 1: high US. We will be back on Thursday, September twenty 471 00:27:13,236 --> 00:27:17,516 Speaker 1: ninth with more shows. Today's show was produced by Edith Russolo. 472 00:27:17,876 --> 00:27:21,556 Speaker 1: It was edited by Robert Smith and engineered by Amanda 473 00:27:21,676 --> 00:27:25,196 Speaker 1: ka Wong. I'm Jacob Goldstein and we'll be back later 474 00:27:25,196 --> 00:27:25,676 Speaker 1: this month