On this episode, we venture down memory lane to understand the humble beginnings and monumental victories of our guests -- Alison Green, CEO of Bien Chez Soi, Conner Nelson, Director of Operations for CSI Pharmacy, and Joey Hsu, VP of Operations and Strategy with MedTech Healthcare – recorded live at the Better Outcomes User Conference. This trio from the home-based care industry will inspire you with their stories of growth and perseverance.
Our accomplished guests delve into how simple mindset shifts can bring about massive change, the importance of understanding caregivers' reality, creating scalable processes, transitioning from mid-sized to large-scale companies, and how technology has changed the game. Tune in to this episode to gain valuable insights from these industry stalwarts and see the home-based care industry from a whole new perspective.
If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.
On this episode, we venture down memory lane to understand the humble beginnings and monumental victories of our guests -- Alison Green, CEO of Bien Chez Soi, Conner Nelson, Director of Operations for CSI Pharmacy, and Joey Hsu, VP of Operations and Strategy with MedTech Healthcare – recorded live at the Better Outcomes User Conference. This trio from the home-based care industry will inspire you with their stories of growth and perseverance.
Our accomplished guests delve into how simple mindset shifts can bring about massive change, the importance of understanding caregivers' reality, creating scalable processes, transitioning from mid-sized to large-scale companies, and how technology has changed the game. Tune in to this episode to gain valuable insights from these industry stalwarts and see the home-based care industry from a whole new perspective.
If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.
Welcome to Home Health 360, a podcast presented by AlayaCare. I'm your host, Jeff Howell, and this is the show about learning from the best in home health care from around the globe. Hi, everybody, and welcome to another edition of Home Health 360. Today we are broadcasting live from the better outcome stage in Niagara Falls, so if you hear any background noise, there's approximately 50,000 people that are here. If you don't hear anything at all, then our producer, Ryan, has done an amazing job to extract the background sounds. I have a few clients that we're going to interrogate for the next 40 minutes on stage. I thank them in advance for their bravery. And why don't we go around the horn and tell us who you are and what your role is at your company?
Alison Green:I'm starting so, Alison Green. I'm the founder and CEO of Bien Chez Soi. is the biggest home care company in the province of Quebec. We have about 1,000 caregivers that help people in their homes and we're really at the forefront with AlayaCare in the innovation and change and better outcomes for the province of Quebec and the solutions that we can bring in the home care sphere.
Conner Nelson:Fantastic. I'm Connor Nelson. I'm director of operations for CSI Pharmacy. We're a specialty pharmacy and home infusion provider. We're primarily focused on immunoglobulin therapy.
Joey Hsu:I'm Joey Xu. I'm the VP of operations and strategy with MedTech Healthcare. As the name suggests, we do neither Med nor Tech. We're an Illinois-based home care and adult daycare company.
Jeff Howell:Well, let's get us started off with. Tell us a little story about something you've been proud about over the last few years.
Alison Green:We had a conversation about this conference beforehand and what came to mind was something actually quite silly. I think everybody in this room, we want to help people, we want to make a difference, we want to have an impact, but we have to make sure that we are celebrating small wins. And so, for me, becoming an entrepreneur, I was 23 years old. I didn't have very much confidence in myself, in being able to have the impact that I wanted, and for me, the day that I was going to have a conference room was going to be the day that I was like CEO of a big company. So, for me, my best win was the day that I got my conference room.
Conner Nelson:We kind of have a similar story. We started out, really, as a mom and pop, 30 patients, five employees working in a small building that leaked every time it rained. So for us we had a similar one. When we finally got an actual building with seats, with conference rooms, with bathrooms, that was the day we felt like, okay, we've really made it, we're a real company.
Joey Hsu:We're halfway there.
Alison Green:Missing the bathrooms.
Joey Hsu:So for us, I think the thing that I'm most proud about is kind of our pace of change, right. So if I think about the past few years and what's changed, you know, in 2019, medtech was at a standstill when it came to growth. Now we are looking at over 20% per year, and growth is one thing right, but when we look at kind of the pride that people have in the company, that's increased a lot as well. So that's both caregivers as well as office workers, and I think for us, what that speaks to is that people actually believe that MedTech as a company is making lives better for our clients and we're doing a better job of actually delivering that, I think. Lastly, we're having more fun as we do it.
Joey Hsu:So a caregiver walked into the office probably two years ago and what she said was she looked around and she was like wow, these have really changed around here. She said people smile a lot more. That's just insane, and I think those are big changes for any company, but for us in particular, I was proud because of where we came from. So if I think back four years ago, it was very hard for us to do any kind of change. There was a lot of things that were broken, and so I think, over the past four years, going from a company that was at standstill and it was hard to make change to a company now that's growing and is having fun doing it, I think that's what I'm proud about.
Jeff Howell:Yeah, we're all hardwired to want to progress and I suspect that those smiles are a consequence of just being able to get whatever it is, however small it is. Getting something done allows you to have that like. The perfect life is not one without problems, it's one with solvable problems, absolutely so. You all have these grassroots stories of used to be mom and pop. And then here we are now Tell us a story. I'm going to put it in the blank here.
Alison Green:We were probably at the beginning on Excel sheets and the authorizations by paper. I know I'm not supposed to be calling out Alaya care in this specific podcast, but for us, alaya care, alaya care was just a game changer for us. So we were a mom and pop shop where I had my own location. I had maybe about a hundred caregivers that were helping people in their homes, and I really wanted to surround myself with the most amount of entrepreneurs as myself that wanted to have the same mission and vision of helping our elderly population. So I converted my model into a franchise model about six and a half years ago, and Alaya Care was really the tool that allowed us to be able to do that, because we went from one location to 42 locations, from 100 caregivers to 1000 caregivers, in the span of five or six years and without being able to optimize, collect that data, make intelligent decisions, be connected with our entrepreneur franchisees and our caregivers that are, you know, two extensions, finally, or two levels away from us, was something that was essential to our growth.
Jeff Howell:And just to give people context, quebec is about the same population as Virginia, so imagine an agency that has 40 locations in Virginia for about nine million people. That's incredible.
Alison Green:Yeah, thank you.
Conner Nelson:Yeah, I can remember, and it's so funny to look back now and think, oh my gosh, how did we ever do that? Using outlook calendars to have each nursing visit scheduled and nurses plugged in across the group and thinking, oh my gosh, what happens if somebody deletes just one of these? Who's going to catch it? Having the Excel sheets where they'd be sent out each day of, okay, here's the patients we're going to touch and fill today. Looking back now and you just laugh like, oh, what were we even thinking? How did we get through any day?
Alison Green:Made us stronger.
Conner Nelson:Yeah right.
Joey Hsu:We were potentially a step behind that, because I remember walking in and, on the first day, sending an email and then by the end of the day I had no responses from any of the staff. And I walked out there and I was like hey, did anyone see my email? And they told me we don't check emails. So first step was literally just getting people to use like stepping from paper to digital, getting us to use basic tools, right, and so, yeah, it's been a big transformation.
Jeff Howell:How do you know if you're at the right pace of change, Like how do you know if you're going too quickly or if you're not going fast enough?
Alison Green:I'm going to call out George on this one. As CEO of a company, sometimes you feel like going very fast and you have so many ideas and you want to conquer everything and do everything.
Alison Green:And so when I'm in a room with my team, with my family which is my team in my conference room and I can see that everybody's just a little bit worried about how we're going to get this done. Like, yeah, that's the right pace of change. So, yeah, I think that we have to continue evolving. The demands are extraordinary. Like April was saying last year in the conference, we're at like a market important moment where we need to be present. We need to be leaders of our industry to show the change. We can't expect other people our neighbors, whatever to do it. We need to own it and be those leaders. So so, yeah, I think that if you have a mindset of leading people that want to make a difference, that's the right pace of change.
Conner Nelson:Yeah, for me I see it correlated or connected to rate of growth. So high rate of growth, you need high rate of change. They've got to operate together. If they don't, you know, tomorrow 10, 100 new patients come on board. The problem from yesterday is going to compound and continue to grow. The ability to just be lightweight and really just reinvent the entire company overnight is incredibly helpful and, I think, necessary when you're in. We've been growing 100% for the last three consecutive years. So each week I look back and think, man, I can't believe we did it that way. I hope we keep looking back each week thinking yeah.
Joey Hsu:Allison said something that was interesting before. She said that healthcare changes incredibly fast and it's hard to keep up, and so I don't think that there is a pace of change that's too fast unless your company can't keep up with it, right? So if your change is poorly executed because you're moving too quickly, then that's probably too quick. On the two slow, I think there's probably two ways to think about it. One is you could take the faster than your friend and not the bear mindset, right, you just got to look down the street and say, am I changing faster than the company that's down there? If so, then you're probably changing. You know it's good.
Joey Hsu:The other is, as we all know, there's a lot of regulatory change. There's a lot of changes to even like billing processes, labor laws, whatever it is, and those things I tend to think of as distracting factors, right? So if we're thinking about how do we improve patient service and quality of care, keeping up with regulatory changes, for us the idea way, or, you know, keeping up with how to actually bill your claims, those are things that take time away from those, the ability to improve. So your pace of change, if you want to get better and not fall behind has to be fast enough, where you can take care of all those things and still have enough time to improve your quality of service.
Jeff Howell:Right. Working in your business, working on your business. You got to handle both. If you could go back in time, what would you change and do differently?
Alison Green:One thing you begin to sound slightly arrogant, but I would change nothing. I think that every opportunity is an opportunity to learn, and had we not had those struggles, well, we wouldn't be where we are today. So I, really, I would, really would not change anything. Sorry, that's not a very good answer.
Conner Nelson:No, I think that's perfect, because that kind of touches on exactly if the staff never had the chance to encounter that struggle or really grow than today. They're going to be less useful, you know, it's just more. Oh, I'm doing the process because, well, that's the way you do it, this is, it works this way, rather than knowing the why. And well, we've changed it because of this, it's going to prevent this issue.
Alison Green:And I think what's important in that is building a culture, a company culture where people feel safe to be able to say this happened. This is the error. We need to improve this and it being a movement where we're all focusing on better outcomes. And if you create that, that culture and that safety within your team, then there aren't things that you would change or there's no errors, it's just optimization and cultures where employees not only feel empowered to come forward with problems.
Jeff Howell:but hey, I found this problem, but I also have a proposed solution for it as well.
Joey Hsu:Right, right For us. I think it's definitely similar. But one thing I'd like to touch on, too, is, like when we first started, change was really hard, right, we were a mom and pop, just like Connor, and we had a chicken and egg scenario where everything felt like it needed to be fixed. But how do you fix everything when everything's broken? How do you even get started? And I went into it initially with kind of a consultant mindset, because that's where I came from, and so, you know, the thing that always rings in my head is, like, how do you get leverage from your team, right? And so this idea of like, okay, hey, I'm used to essentially going into a room saying, okay, here's what we're trying to achieve. And okay, what are some ideas, how do we approach it? What do we do today? And you kind of lay that out and the team kind of tells you during the daily updates, like, okay, what went wrong and what can we do better. Looking back now, I think that slowed us down Right. So let me just give an example of like it looked like before.
Joey Hsu:When I stepped into the company in 2019, one of our mandates was to grow in home services, and that sounds simplistic. So I thought, hey, we just have to have a better way of getting clients right. And I asked our scheduling team like, hey, okay, why aren't we getting more clients? And they're like we're turning down clients because we don't have caregivers. And then I looked around and said, okay, well, I'm going to try and grow our caregiver recruiting, but couldn't do that because we didn't have a recruiting team and we weren't posting our positioning, right, we couldn't post our position anywhere because our application package was 50 paces of paper that had been zerox so many times. It was hard to read, right? So, like, how do you post that on Indeed? And then you think about it and you go, well, you could just hire an experienced recruiter, right, and they could help you with this.
Joey Hsu:And I felt like if I brought in a recruiter at that point, I would have just set that person up for failure. The people, the processes, the environment, the culture just wasn't there to improve. So what I found from there was this idea of being, when everything seems to be broken and the resources that you have don't allow you to get started on improvement. What I found was being the trailblazer yourself can get you out of that cycle, right? So for me and I doubt any MBA programs out there recommend this, but for me, I was the recruiter and the client intake person for two years. I took that off of the teams and started doing it myself.
Joey Hsu:I think that helped in a few ways. Right One was the level. The speed at which we were able to improve our processes went up dramatically. Right, because every single time I'm on a call with an applicant, I was thinking okay, how could that conversation have gone better? What time should I be calling them? Should I be calling? Should I be texting? Should I be emailing?
Joey Hsu:I was making the change right away, right, something that I don't think team members are able to do as fast. You can imagine that now you have, you're making 10 changes over the course of a day, rather than just making one change during your team meeting at the end of the day, right, so the pace of change was much faster. The second was that, in terms of results, I was measuring like our results were not good, right, I was trying to get a sense of what good looked like in a new system. And so if you think about, okay, you're making these calls and you're actually in the weeds to some degree, you're thinking about okay, if I have 200 people and I call them, how many are actually responding, how many are getting through the hiring cycle right, how many are actually being productive at the end of the day? And those are things where you know in the future.
Joey Hsu:When I passed off the process, I was able to hold the team accountable to the same kinds of metrics. That told me what good was. The last was initially when I tried essentially involving the team in a lot of these, call it, like how do we change discussions? Things wouldn't work and it was confusing to me because it was a question of is it the strategy that's not working or is it the execution Right? And it was super confusing like which way it's going and progress was slow. I knew when I took it on execution-wise I was going to try to the utmost of my ability and the execution was fine. I also knew I was trying every single way to make the strategy work and what that told me was if I wasn't seeing results, it's not a problem of the execution, it's a problem of the strategy right. So I got to move on a lot faster, I think when everything was broken and confusing, like jumping in and doing it kind of myself helped to break a lot of that cycle as well.
Jeff Howell:The power of the beginner's mindset coming in and not accepting. This is the way that, because it was a founder-led company that you guys acquired. That's right. I love when you had said how the philosophy is not how have we always done it, but how should it ought to be done, right.
Joey Hsu:Yeah, so this is probably true of mom and pops and founder led organizations maybe every organization out there, but I think, conor, you touching on it too I would call our old company a founder dictatorship, right, and I called her. So the founder told you what to do when you followed that process, right, and where that led us was to a place where people did the process. But, to Conor's point, like they didn't ask the why, right, and they understand the why, and so when better processes, better technology, better ways of doing things came up, we never moved. And that's why, in 2019, everything was still on paper, that's why we didn't adopt technology in general, and so the challenge for us was, if we're starting in that kind of place and that's our culture when I would ask something like, okay, hey, how do we change something? Right, the number of and we were seeking a better solution, we had a better solution the number of times in a meeting where someone would say, oh, that's a great idea.
Joey Hsu:That's really going to help everyone. Oh, but we can't do it because 80 year old Erica is used to doing it this other way. Right, and the way that we used to do it, it just shot down a lot of ideas and are featuring towards a lag group of home makers which, frankly, probably represented five to 10% of our population just kept us from being able to move forward at all and really, what broke that was to point, shifting to a mindset that's like where we ought to be right and starting from first principles and saying, hey, if we were the apple of home care, an applicant applied with us. What does that look like? Right?
Jeff Howell:Yeah, and mission care collective who's speaking over the next couple days? They've got some amazing data. I was surprised to find out how few caregivers have a credit card and how few caregivers would have a laptop or a desktop. So, to your point, the there should be a frictionless way for them to fill in a form on a website that has the fewest possible questions, just to get the process started. Right, it shouldn't be anything that you can collect more data later on, but it should be all about barrier to entry. How do you just get started on mobile? Speaking of which, why don't we skip ahead to the question that I have on caregiver attraction and retention? Are you guys doing anything in the way of automating, or what's it look like to be able to have a strategy to fill your pipe? Your have successful businesses. You're no longer at the stage for waiting for your three walk-ins to come in every month. Yep, what are you guys doing? I know you're doing some cool things with Facebook. What are you guys doing?
Alison Green:So I think the basis is really your brand, your culture, your values and making sure that every person in your organization, even though they're far and they're in people's homes, that they understand how, in their small way, they're contributing to something bigger. I think that is a key to retention, but I think a big part of our industry as well is référencement. I'm French, by the way, even though my name is Allison Green. I know that throws people off, but yeah, so I think it's about really understanding your caregivers, what their needs are and where they are. Like, we were talking about TikTok yesterday and we actually sent out a survey I'm losing all my English words A survey, Thank you. A survey to know where all our employees are, and 98% of our employees are on Facebook. They're not on LinkedIn, they're not on Instagram, they're not on TikTok, they're on Facebook.
Alison Green:Probably lots of people in this room don't use Facebook anymore. So, for example, something that's working very well is we're working with Meta, where we're putting ads through Facebook, through Meta, where there's a really small list of information that we need so name, phone number, way to contact them, what kind of position that they're looking for and then we're doing the work to be able to go understand? Are they a part of the values? What is it that they would like? And then bring them into the family, but really making sure that that first step is as seamless and as easy as possible for the people. Can I get the start on that?
Jeff Howell:Which one Meta? Yeah, m-e-t-a, okay, okay, yeah, so they have something specific. It's yes, yeah. I thought it was like a third party. No, no, no, no.
Alison Green:Yeah. So it's really about, I think, being with them and understanding what their reality is. Your caregiver's reality that's not necessarily the same as yours. So something that really worked with us as well, since we have 42 locations, is we do a roadshow. So, for example, next year we're going to be doing a roadshow where I'm going to be going with my HQ team to visit all of our locations, all of our caregivers, and host moments and moments that we're able to speak, exchange. What is it that you like, that you don't like? What works with, for example, a Liacare? How would you like to be recognized? What's the most valuable thing in your life? Is it time? Is it freedom? Is it choice? Is it money? And really making sure that our HR, our brand, that everything that we are putting so much energy in, speaks to them, not assuming things right.
Conner Nelson:I don't know that we've done much in terms of automation. For us at least in our industry, patients and nurses are tied so closely together. You're talking eight hour plus infusions. So if a patient comes to us, their nurse comes with them, or vice versa, if we hire a nurse, we get all the patients that were tied to her. So really we've just focused on let's make sure whatever the nurse wants, whatever the patient wants, we get, because they're going to be talking. And one of the most organic ways that we've grown is just patient chat rooms on Facebook. They start talking, they hear about us and since the patient comes on board, we get whatever nurse was tied to them.
Jeff Howell:They say, oh, we want to be with that patient, yeah, and I would imagine for infusion you have a lower turnover ratio and then a stronger degree of continuity of care if you're doing eight hour visits.
Conner Nelson:Right when you're talking about eight plus hours in the home. You really want to like whoever's coming in your house.
Jeff Howell:Yeah, sure.
Joey Hsu:Yeah, for us, we're starting down the path of automation. We're focusing on two areas. One is recruiting and the other is and I'm actually curious for the audience like how many of you, for your recruiters, do they spend over I don't know 70% or 50% of their let's say, 50% of their time doing just paperwork, uploading things, as well as compliance, following up, maybe, like how much of their time is spent there? Oh, no one, 30%, still no one. All right, we spent a lot of time on it. So, for our recruiters, 50% of their time was probably spent on literally uploaded like uploaded files of their application and putting it, whether it's in our G drive and their staff files or putting it on a government website, right. The other time was spent on compliance related things, for whether it was our regulator, so IDOA, or it was for Department of Labor or things like that, right. So that took a lot of our time.
Joey Hsu:When we think of the Apple, of home care and what that should look like, the majority of a recruiter's time should go towards building the Relationship with the applicant and not spending time on paperwork, right? So for us, we basically thought how can we automate as much of that paper like Transfers, even like simple reminders to say hey, did you fill out? Did you fill out X? Did you go and get your fingerprint? Yet All of that we're trying to shift to a machine. Right, and if a machine can take 50% of that work or 40%, like that's all time that we're going to rededicate towards the experience of, essentially, a recruiter being able to build a relationship with the applicant.
Jeff Howell:Yeah, and From what we saw from Adrian and Layla this morning, that seems like a pretty good application of complex enough but structured enough to be able to live in a world where we can ask a machine to do those repetitive tasks so that, as you say, everything should be about a spending the time to develop the human components of building Relationships, because that's the only part that the the human by themselves can do, right, the robot can't do that stuff.
Joey Hsu:Yeah, right, I must catch you to tea and stuff like that gets better, but yeah, so that's where we should focus, or offer.
Jeff Howell:If caregiver retention and attraction is by far the number one thing people talk about, what's something that is not getting the attention it deserves?
Conner Nelson:I Think, when I look at the majority companies in this room in particular, we're all gonna be in that small to medium-sized space. No, it's gonna be in the ultra large of CVS or larger Metasys. One of the the biggest, I think, mistakes that companies can make is they'll look at the larger tier company and say, okay, that's what I need to do to get there. I need to map out my structure, my processes to match theirs, which is really the wrong strategy, because that's what it takes to stay where they are, not what it took to grow there. Hmm, and so it's just been really key, I think, to look at and say, let's make sure we're lean, let's make sure we stay lean, we keep the processes that make sense, and not try to just say, all right, what's the next leadership position that we need?
Joey Hsu:and just blow out the structure. When we think about retention and when we think about recruitment and Kind of the labor shortage that has happened during COVID and afterwards, the focus has shifted to be just do I have enough numbers and do I have enough caregivers in general, yeah, both recruiting as well as availability, and I think we've lost at least on our side We've lost a little bit of the attention on quality and training and how good these caregivers are and just like, anybody is better than nobody. So I think that's probably the next stop or that's focus.
Alison Green:I think what we're not focusing enough on is the fact that People that go into home care, health care, whatever it may be so I'm talking about, let's say, our caregivers at the HDS Wah, you automatically go into caregiving because you want to make a difference in people's lives, and I think that's something that we're not talking about enough is making sure that we are protecting those caregivers as the leaders of an industry, because it's very easy when you want to help someone to To push them to do more Because they're doing it with their heart. So people that are very driven by heart purpose. I think that, as leaders of our industry, we have to make sure that we understand that about our community and that we are the example of making sure of taking care of yourselves as well, right?
Jeff Howell:and the number one reason exiting caregivers provide as to why they left was a lack of communication Because they got hired, and number two reason is they didn't get ramped up in their hours. Yeah, so they need the love and they need the paycheck right from the beginning. If you guys were consultants and there's a lot of mid-sized companies in the crowd what advice would you have? What's the one thing that you would be the path you would be going down to advise companies on how to get over the hump, from going from mid-sized to large.
Alison Green:Yeah, for me, I think there's a couple of things Automization I'm not inventing a word Of everything in your company, like making sure that you are able to Quantify, have KPIs Calculate every single piece of your client journey, your caregiver journey, and being able to make decisions Based on data and facts, is essential, because going from a middle-sized company to a large-sized company is a dangerous moment where, when you're playing with much more Cards, there's much more risk involved as well.
Alison Green:So I think that would be my first thing, the second being an entrepreneur. I don't know if there's lots of entrepreneurs in the crowd, but I think it's really just surrounding yourself with people that are better than you at everything, so that you can have full confidence in these people's decisions where they want to go, and really Believing in them to be able to help you get where you want to get. As a leader, I think you need to have vision, but I don't think that you should be necessarily in the operations every day, because then you're not Leading a team, and I think that going from middle to large is a tricky spot for any business where somebody Really has to take the leadership role in terms of culture and ambassador of your company, and you have to really have a solid team to make sure that the day-to-day repetitive tasks Are being done by people that that that you trust and that are better than you know what you do.
Jeff Howell:No, and the ambassador leads up areas of change that weren't uncovered before exactly previous dictators that might be listening to the podcast.
Conner Nelson:Yeah, I would say, to focus on really processes for scalability and, in particular, looking at those processes that work not because of the process but because of the person, where everybody has that one, where, if that person's gone, everything falls to pieces, or when it comes to a question, they're like I don't know. Just just go ask Brittany, she knows why it works this way. Really harnessing and looking at those and making sure that the process works, regardless of who's completing it, because then it's scale them. Then you can actually grow and not have to work.
Jeff Howell:Yeah, and when Brittany moves on, you still have a system in place. Everything still turns on.
Joey Hsu:I'm just curious how do you change the process to make it stable and not threaten Brittany?
Conner Nelson:Yeah, I know job security can definitely come in that, but I really see that as an opportunity to Take someone and say that they can be a process owner and help develop the processes elsewhere and make sure the department's actually working, rather than Really being the reason that things aren't going through as fast or as good as they could.
Jeff Howell:And, in my experience, every time you change a process you have 10 new problems for Brittany to solve you.
Alison Green:If you're in hyper growth, that's for sure.
Joey Hsu:Yeah, I think, for us. So we were a mid-sized company and we probably still are. We're, hopefully, on our journey to being a large-sized company. Our biggest challenge in terms of moving was our I would say our mediocre success, right? So if we were to like a large-sized company that was doing great and everything was fantastic, we could just keep doing what we were doing right, and that would have worked. If we were on the verge of bankruptcy, that would have pushed us to move as well and improve.
Joey Hsu:I think that we were in this dangerous middle ground where, because we were profitable and because we had a ton of clients already, the danger was that we would just rest on our laurels and there was a risk to making those big-sized changes that everybody can see. Hey, if we go down this direction, it'll be better, right, but there's a lot of risks and we could lose people along the way, right, or, I don't know, people could quit because they don't like essentially our change. I think being willing to take that risk, to make the move because you know that the endpoint is better, I think is what gets you to essentially be a big-sized company and, frankly, to keep growing there as well.
Jeff Howell:The enemy of great is good. Yeah Well, guys, we're bumping up against our time so I'll get you out of here on my signature question. Give us a reason to be optimistic about the future of care and where the clients call home.
Alison Green:I think we're at a huge turning point and we have the chance in home care and health care and I was talking about this with Yatsen before we all want more and better, and our industry is ready to collaborate and work together and be a large community of competitors, of people that have different stories from different regions in the world, and all of the elements are in place for us to make that difference, and I think that all the players at the table want to help each other to get there. So I feel very optimistic about the future of home care.
Conner Nelson:For us in the infusion space, especially specialty pharmacy, the kind of existential threat is, of course, pbms and how much can get locked away into a CVS, united Health Care with Optum and some of those, and so really what I think makes me in particular optimistic is seeing legislation in different pieces in states where they're starting to push back and force patient choice, because when I look at the crowd and I see other infusion companies, I know that's the best route to improving patient care, rather than you got three options and this is all you're going to get.
Joey Hsu:I think the players in this room, everybody that I met here, are brilliant and if the leaders are strong and the industry has a good chance. I also think that essentially, our industry was probably a lot harder 50 years ago with no technology and just like phones. I think that technology such as AlayaCare has helped a lot to make a remote workforce a little bit more manageable and us to be able to manage the quality of the care there as well. So I think that technology now is probably making our ability to improve a lot better.
Jeff Howell:It is my distinct honor and privilege to be the host of Home Health 360. I always take notes every time I have guests on. I have a story from a colleague, Amanda Gamera, who's about to hire someone who listened to every episode to educate herself before getting hired to AlayaCare. And that's not possible by me, but by the thought leaders that come on the show. I'm sure we accomplished that today. And what do you say? Audience? Do you want to give the listeners a little taste of what it's like to hear an ovation from 50,000 people? Thank you, guys. Home Health 360 is presented by AlayaCare. The easiest way to stay up to date on our new shows is to subscribe on Apple Podcasts, Spotify or wherever you get your podcasts. We also have a newsletter you can sign up for on alayacarecom forward slash home health 360 to get alerts for new shows and more valuable content from AlayaCare right into your inbox. Thanks for listening and we'll see you next time.