Ep. 5 Dr. Raymond Fabius: Building a Culture of Health to Flatten Healthcare Costs

Building a Culture of Health: The Competitive Advantage Employers Miss

Dr. Raymond Fabius, co-founder, president and chief medical officer of HealthNEXT and co-author of "Population Health: Creating a Culture of Wellness," reveals why mid-market companies lack the healthcare expertise to tackle rising costs—and what C-suite leaders need to do about it.

Vinny welcomed Dr. Raymond Fabius, physician executive and co-founder of HealthNEXT, to discuss population health management and strategies for controlling healthcare costs in organizations. Drawing from his extensive experience working with major corporations like GE and his transition from practicing medicine to healthcare leadership, Raymond shared insights on how employers can influence employee health and flatten cost curves.

Raymond explained how companies with a strong culture of health, safety, and well-being achieve moderate medical trends while simultaneously outperforming the stock market. His published research shows companies with a culture of health outperform the market by an average of 2% per year. He emphasized that combining strong negotiating skills with expertise in reducing healthcare needs leads to sustainable cost management, noting that a small percentage of workers account for the majority of healthcare expenses.

The conversation explored the role of employers in promoting wellness through intentional environmental design and incentive structures, the critical importance of having physician executives guide healthcare strategy, and the challenges mid-market companies face when HR departments lack necessary clinical expertise. Raymond highlighted HealthNEXT's assessment tool that compares employers to best practices and provides customized strategic plans.

Vinny and Raymond discussed generational health trends, noting Gen Z's healthier behaviors including reduced alcohol and tobacco use, and the essential role of AI in augmenting healthcare professionals. Raymond emphasized the importance of C-suite involvement in health strategy as a core business initiative and shared his commitment to advancing the field through book royalties donated to Thomas Jefferson University's College of Population Health.

Disclaimer: This content is for educational purposes only. Please discuss your specific situation with your health benefits administrator or insurance provider for personalized guidance.

Transcript

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Welcome to the Clearly Beneficial podcast,

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the show where we rip off the Band-Aid and explore the future of healthcare,

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benefits,

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and the people driving innovation in the industry.

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This episode is brought to you by Health Next,

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the company leading the way in helping employers build enduring cultures of health

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and well-being,

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reducing medical cost trends,

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and increasing organizational performance.

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To learn more how they can help you, visit healthnext.com.

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Well, thanks so much.

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This is Vinny Catalano, and this is the Clearly Beneficial podcast.

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Today,

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I'm joined by one of my faves,

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Dr.

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Ray Fabius,

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co-founder,

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president,

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and chief medical officer at Health Next.

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Throughout his career,

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Dr.

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Fabius has garnered medical and business leadership experience in an extensive

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variety of health care management areas.

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He has served as a physician executive in academics,

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private practice,

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managed care,

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the health insurance industry,

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et cetera.

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He served as global medical leader for General Electric,

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chief medical officer for Thomson Reuters,

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population health strategist for Walgreens,

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and chief medical officer for Truven Health Analytics.

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He is an author of many articles,

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book chapters,

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and five books,

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including the leading textbook on population health,

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which I just happen to have here.

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So, Ray, thank you so much for being with me today.

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Vinny, it's an absolute pleasure.

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I look forward to the conversation that we're going to have together.

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And thank you so much for plugging my book.

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I do want the audience to know that I actually don't receive any compensation for

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this purchase of the book.

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So it makes it easier for us to plug it.

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All of my royalties go back to Thomas Jefferson University's College of Population Health.

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It was the first College of Population Health that we created.

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Now there's over 40 of them across the country.

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And the textbook actually does emanate from that university setting.

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And I co-author and co-edit the book with David Nash.

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Great.

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So that's a great place to start because,

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you know,

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where I was when we first met,

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which was now,

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I think,

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like three years ago when I first heard about Health Next and what you were doing

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in the market to try to create the proper culture of population health,

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especially in the employer space.

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You know,

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I was so impressed by your background as being,

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you know,

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working at General Electric as chief medical officer.

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And so what I want to start with is,

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you know,

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you were probably already studying population health.

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You were probably already in this thing.

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And then somewhere a light bulb went off and you said,

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I can apply this knowledge to not just large populations,

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but to specific employee populations within an organization.

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So tell me about that story.

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Well, when I started as a physician executive, I actually started in the health plan space.

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And I think you know that I was a corporate medical leader for Cigna and then a

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company called US Healthcare that was purchased by Aetna.

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And then the second decade of my career,

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my first decade,

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surprisingly,

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which we could talk about if you like,

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was actually as a frontline pediatrician.

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But that my second decade was as a physician executive in the health plan space.

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And over time,

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I eventually gravitated to ultimately be the senior medical director for national

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accounts for Aetna.

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And I started to work with all of the largest clients that Aetna had.

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And in some cases,

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actually functioned as a physician executive advisor,

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particularly for the companies that didn't have a chief medical officer.

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And I started to realize that the employer has so many remarkable levers that they

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can use to influence behavior and to reward those healthy behaviors that can lead

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to better health.

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Right.

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And there were examples with many of my clients where they were doing some

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interesting things in terms of creating incentives or trying to build a best

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practice cafeteria that would highlight healthy foods in the front of the cafeteria

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and the grill would be in the back.

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And I started to take note of these separate efforts and

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And realized ultimately that the employer may be the best place to create a health

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cultural transformation.

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Right, right.

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And I kind of feel that a lot of organizations,

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I mean,

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the concept of well-being in the health insurance and employee benefit space,

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I think really started to take hold back in like 2010.

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I remember Kaiser Permanente was rolling out a lot of interesting things.

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But in the long run,

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here we are 15 years later,

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I don't know that anybody's really dented that solution because people,

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individual behavior is back to your point.

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You can't motivate people enough to do the right thing necessarily.

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And so I think organizations have struggled a lot with that over the years.

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Yeah, you need to take people through, I'll say, a process.

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Sometimes it starts with education and then motivation and then activation and then resolve.

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I mean, it's not that different than the Petraska model of behavior change, right?

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So you want to,

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in any population,

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but,

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you know,

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I like to talk a lot,

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as you suggested,

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around employer populations,

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but employers actually do have training programs and often they have training

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modules,

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right?

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And sometimes at Health Next with our clients,

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we have a chance to actually create learning modules that could,

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for example,

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going back to your past experience world,

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train people on how to get the best out of the benefits that they have.

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And you know how hard it is sometimes for people to understand simple concepts like

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co-pay,

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co-insurance,

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out-of-pocket Macs.

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And if we could train our employees just to better understand the benefits that

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they have,

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they'd be able to maximize the value of them.

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And so education is a very important starting point.

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And then beyond that,

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as you pointed out,

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creative incentive packages can actually foster people to or motivate people to

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take better care of themselves.

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And I would agree that it's somewhat sad that we actually have to pay people to

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take better care of themselves.

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Yeah.

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But the best companies over time,

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often with our guidance,

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can move from what's called extrinsic motivation,

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which is incentives,

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to intrinsic motivation.

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Because as people start to feel more healthy, that's very rewarding.

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And ultimately, it's at that point that you've really activated permanent change.

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Well, one of the things I remember I was talking about a few years back

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is when you were talking, everybody uses the term trend, right?

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And trend is that number where,

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oh yeah,

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we expect insurance to go up or healthcare costs to go up 9% this year or whatever

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the number is.

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And you'd mentioned specifically how you were able to really flatten that curve at

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GE and other organizations.

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And so take me into the trenches for a second and talk a little bit about

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Certainly,

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it doesn't happen overnight,

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but let's talk a little bit about that experience and how did you make that change

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within a large organization like that?

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Well, there's two parts to, let's say, health care expense.

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And one side you've mastered in your years as a consultant,

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and that is trying to help the purchaser,

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the employer,

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negotiate for the lowest unit cost for the health care that they need.

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What I realized as a physician executive is that it was also at the same time

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possible to work hard so that the employer's covered lives needed less units of

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health care.

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And so if you could partner really good negotiating skills,

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which is what the consulting houses do a very good job of,

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including,

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you know,

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your locked in consultants that used to be part of and Gallagher that used to be

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part of.

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If you could combine that with the research and the expertise that we've developed

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over a decade at Health Next to reduce the need for health care units,

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you can bend the health care cost curve.

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And in fact, we've proven it.

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You know,

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I published an article in the key journal,

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you know,

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for our space,

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the American College of Occupational Environmental Medicine Journal,

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Journal of Occupational Environmental Medicine,

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J-O-E-M.

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That shows that as companies score higher in our assessment tool that we've

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developed,

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assessing their culture of health,

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safety and well-being,

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their medical trend moderates.

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And it's possible at the point where you achieve a best practice culture of health,

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safety and well-being to establish flat health care costs.

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No, and I completely agree with that.

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And one of my struggles in the consulting space for a lot of years was,

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and again,

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a lot of my clients were in the mid-market,

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so we're not talking like an enterprise size of GE,

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for example,

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but let's say that that's where most companies fall in that 500 to 5,000 size.

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You're looking at, and I don't want to like, you know,

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be critical,

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but the C-suite in general has abdicated the responsibility of healthcare and

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benefits to HR.

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You know,

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and HR is swamped with a million things on their plates,

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compliance and hiring and firing and all the things that they have to worry about.

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And they have had a rough go of it over the past, you know, five to 10 years.

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Absolutely.

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So

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It comes down to no one in the house really has the skillset to know where to go

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with advice,

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right?

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Consultant comes in with a spreadsheet,

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with a book this thick,

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you're presenting it to the HR executive.

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The HR executive remembers about 10% of what the consultant said.

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They present it to the finance people.

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and you get in this cycle where if the renewal was low everybody pops bottles and

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says thank god you know if the renewal was you know 10 they may not like it but

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they're like this the finance people say oh that's what we budgeted for so that's

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okay but if it's 15 or higher you know heads have to roll and i have validated this

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with cfos from time and time again right so i kind of think the challenge is how do

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you package

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the knowledge in a way that becomes,

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you build the team between HR and finance in a way that they can understand your

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concept of unit cost and apply it to the overall program that is being created and

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developed.

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I think you've described things to a T.

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I would also agree with great sympathy that the human resource leadership team has

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a lot on their plate.

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And for them to be responsible for moderating medical trend without a clinical background

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is not fair.

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And so one of the things that Health Next,

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as we researched this,

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found is that the companies that actually did the best,

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and like you,

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Vinny,

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suggested,

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actually moderate their medical trend,

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invariably have somebody like me,

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a physician executive who's well-versed in the science of population health,

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and well-versed in all the dimensions of healthcare delivery to help guide the part

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of the process that can lead to a reduction in the need for healthcare.

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And by the way, it's not wellness programs alone.

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Let's take a minute and talk about population health.

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So for those in the audience who are not going to buy my book,

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the summary of my book is that a comprehensive effort on the part of any,

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I'll say community,

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enterprise,

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employer,

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has to include keeping well people well,

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reducing health risks,

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that exist,

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making sure that people,

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when they have an acute illness,

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have rapid access to care,

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which normally means that we need to make sure that every person has a medical

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home.

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And then pay attention to at least the prevalent diseases and conditions that exist

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inside the population and create program to mitigate their potential complications.

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And then lastly,

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for the folks that have remarkable healthcare challenges,

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often in our sphere,

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we call these high cost claimants.

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You need to make sure that these people have the best that medical management and

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care management has to offer so that they can get the very best that healthcare can

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deliver to them in the midst of these catastrophic illnesses.

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No, I completely agree.

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And I think the key challenge,

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and listen,

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I was sitting in the thick of it at times where you show up at a client,

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and in many cases,

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a lot of the clients I work with here in California were fully insured.

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So the data you have access to is pretty thin.

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You may get a high claims report, but you really...

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don't know what's going on under the hood with a fully insured program.

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For a self-insured program, you'd certainly have better data.

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But even then,

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a lot of organizations,

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when the consultant comes and presents,

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well,

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you have a certain percentage of your population has diabetes,

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certain percentage of your population has high cholesterol,

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all the morbidities,

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And, you know, organizations then say, well, what do I do about that?

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How do I fix that?

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You know, what do I do about these high-cost claimants?

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How do I deal with these long-term chronic illnesses?

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I can't fire the employee.

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You know,

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what's the best way to,

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you know,

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once you've looked under the hood,

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Ray,

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how do you attack it?

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So,

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you know,

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the best way to start,

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and this is what we've done at Health Next,

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is to establish an assessment tool that can compare the employer that you're

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working with to best practice and identify their gaps from best practice and then

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remedy the gaps differently.

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in the appropriate sequence until they achieve best practice.

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To really make that possible,

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the first several years of the existence of Health Next,

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we basically just studied the companies who had built benchmark cultures of health,

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safety,

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and well-being

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to identify actions that were successful.

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And we initially identified 218 actions,

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and we organized them eventually into 10 best practice pillars.

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And more recently, we consolidated these 218 actions into what we call 50 factors.

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And we have digitized our process and infused it with the artificial intelligence

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and something called dynamic publishing so that when we complete the assessment,

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we literally,

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Vinny can push a button and within a few moments,

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have a highly customized multi-year strategic plan

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for the employer to follow to remediate the gaps that were identified.

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And this is very important in the appropriate sequence.

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So you can't do some things even though you want to until you do other things,

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which may be more fundamental.

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and may actually not have the same impact.

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So for example,

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of course you would want to address high cost claimants early if you're trying to

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control healthcare costs,

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because the basic premise is that one or 2% of the workforce is spending a third or

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even 40% of the dollars.

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And the research is very clear that if you put complex case managers

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certified nurse case managers who are highly trained to help people who have very

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significant medical issues,

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the return on investment for that is pretty extraordinary.

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I want to dig into that statement for a second, because I think most employers don't have

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the right team in place to execute the strategy like that, right?

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Very few organizations have a chief medical officer,

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very few organizations have the nursing knowledge in-house and the ability to

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deliver that.

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they only in the employer's mind,

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they're only going so far as I provide insurance to my employees,

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they need to go find out where they go use it as long as it's within network,

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etc,

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etc.

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They're not really taking the active role in the care journey of the healthy and

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the not healthy within the organization.

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And I think that's where

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And I would say,

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I mean,

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I think you probably know better than I do,

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but it's probably 95 or more percent of the companies behave that way.

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I mean, most companies don't have that infrastructure.

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Right.

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I mean,

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I'll call the audience's attention to a relatively recent article written by

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Deloitte,

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the title of which is the Health Savvy CEO.

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In this article,

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Deloitte suggests that,

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as you were suggesting earlier,

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that the CEO and the C-suite have to become better informed about health care,

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and they can't

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delegate the responsibility of a healthy workforce to just the human resource department.

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They have to be actively involved.

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And of course, we have found certainly that when the C-suite champions

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health and well-being, the cultural transformation inside the organization is much more rapid.

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So it is something that we hold fast to.

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In fact, it's our first pillar is around leadership support and management alignment.

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And this is where I believe, you know, the role of the consultant needs to be paramount, right?

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They, you know, consultants

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they try to dig where the ground is soft, right?

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They're looking for the next client.

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And usually I'd say even to this day, most consultants go the HR route.

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The savvy ones are starting to talk to the C-suite and talk to the CFO and show the

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data and look at things.

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Because if the CFO really began to dig in, I mean,

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You know, accepting budgeting for a 10% increase every year is insanity.

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I mean,

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I did this analysis about a year ago where I looked at when I started in the

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insurance business as a broker in 2003,

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you could insure an individual for $150 a month or a family for $450 a month.

(00:22:03):
Now you're at a point where you're insuring one person a month.

(00:22:07):
Your net unit cost is $1,000 for a single employee and $3,500 or more for a family.

(00:22:14):
You put 10% on that.

(00:22:15):
It's insane.

(00:22:15):
I don't know where it stops.

(00:22:24):
Here's a here's the sad reality.

(00:22:27):
You know, analysis shows that that's where most workers raises are going to.

(00:22:34):
So instead of them getting an increase in their hourly wage or their salary,

(00:22:41):
that that that money goes to just covering their health care costs.

(00:22:54):
If we could do a better job of controlling health care costs,

(00:22:58):
it could contribute to the next bull run of the stock market.

(00:23:02):
And I think that's brilliant research around that.

(00:23:05):
You know,

(00:23:05):
it's it's worth telling the audience that I've now written nine articles in the

(00:23:12):
medical literature that show that companies that distinguish themselves in terms of

(00:23:16):
building a culture of health,

(00:23:18):
safety and well-being outperform the stock market.

(00:23:22):
And in fact, my last article, I actually ran a mutual fund for a decade.

(00:23:30):
And I'll say, sadly, it only had one investor in the mutual fund, me.

(00:23:40):
But I took my own money.

(00:23:42):
And using some of the research that we learned at Health Next and only public

(00:23:50):
domain information,

(00:23:51):
I built a portfolio of best practice companies.

(00:24:00):
In this culture of health,

(00:24:02):
safety and well-being movement,

(00:24:04):
and it outperformed the S&P 500 by 20 percent over that 10 year period.

(00:24:09):
So you can look CEOs and CFOs in the eyes now and say that.

(00:24:16):
A culture of health,

(00:24:18):
safety,

(00:24:18):
and well-being is worth 2% increased market cap compounded annually,

(00:24:24):
which is a very big number.

(00:24:26):
And it gets you away, Vinny, from the return on investment for a diabetes program.

(00:24:33):
Well, every dollar spent on insurance is a dollar that flies out the door.

(00:24:37):
No question.

(00:24:38):
No question.

(00:24:39):
Not to mention,

(00:24:41):
this is a very important kicker,

(00:24:43):
and that is that for every dollar – and I try to – I frame this often with a dear

(00:24:48):
CEO.

(00:24:49):
Dear CEO,

(00:24:51):
for every dollar that you spend on healthcare costs,

(00:24:54):
you're losing $2 to $3 of performance.

(00:24:58):
in your workforce.

(00:25:00):
And and this analysis has been pretty well cultivated in the literature.

(00:25:05):
So, you know, a healthy worker is more engaged.

(00:25:12):
They engage in more discretionary effort because they're well enough to do so.

(00:25:17):
A healthy worker is not absent very often.

(00:25:21):
A healthy worker is less likely to get injured at work.

(00:25:29):
They're less likely to go on disability.

(00:25:35):
And when you look, they're much less likely to go.

(00:25:41):
Leave you if you have a culture of health,

(00:25:44):
safety and well-being because you engender a caring spirit and loyalty.

(00:25:50):
And so all these things add up.

(00:25:53):
And that's the reason why these companies outperform in the stock market.

(00:25:59):
yeah yeah that's it that's fascinating you know and and i you know as you're

(00:26:03):
talking you know what's coming to mind is and we've got about five minutes or so

(00:26:07):
left so i want to just give give us that warning yeah that's sad i'd love to talk

(00:26:11):
to you no i'll bring you back ray i mean we're just getting warmed up i feel but

(00:26:16):
there's two there's two things that that i i want to kind of touch on the first is

(00:26:21):
As you're talking, we're seeing interesting trends, generational trends.

(00:26:27):
Gen Z's behaviors are different than millennial behavior or Gen X or boomer behavior.

(00:26:36):
And they do tend to lean more healthy.

(00:26:38):
They're not drinking as much.

(00:26:40):
They're eating more healthy.

(00:26:41):
The whole structure of their way they live life is different than even the millennials.

(00:26:48):
And so is that something you're seeing?

(00:26:52):
Yes, and I think it can make us all optimistic.

(00:26:58):
Maybe all this hard work toward trying to create a movement toward greater health

(00:27:05):
and well-being is starting to catch hold.

(00:27:09):
I am encouraged by the fact that college campuses are experiencing less binge

(00:27:16):
drinking,

(00:27:18):
less smoking,

(00:27:20):
Um, and, um, and there's literally nobody smokes anymore.

(00:27:23):
I mean, they just have to have their phone in their hand, but no, but no one smokes anymore.

(00:27:27):
Um, uh, I can't tell you how satisfying that is.

(00:27:32):
Uh,

(00:27:33):
cause you know,

(00:27:33):
when I started in this space,

(00:27:36):
uh,

(00:27:36):
the prevalence of smoking was two,

(00:27:39):
three times greater,

(00:27:41):
uh,

(00:27:42):
than it is today.

(00:27:43):
And, um,

(00:27:45):
You know,

(00:27:45):
you only have to watch a few people suffer and die from lung cancer to understand

(00:27:53):
how much of a victory it is when we can markedly diminish the incidence of lung

(00:28:01):
cancer by diminishing the prevalence of the adoption of this noxious health risk of

(00:28:09):
smoking.

(00:28:11):
And so, you know, that's terrific.

(00:28:13):
And the fact that there's less, you know, alcohol consumption.

(00:28:17):
And I also want to mention that the younger people are straight out willing to talk

(00:28:24):
about mental health issues.

(00:28:27):
And they're breaking down the stigma of mental health.

(00:28:31):
And they're increasingly considering it as if it's just another condition like

(00:28:38):
diabetes or heart disease.

(00:28:41):
And so people have no problem coming forward and saying, I have a medical issue.

(00:28:51):
And now increasingly, they're coming forward and saying, I have a mental challenge.

(00:28:58):
And the tools are developing better to adapt.

(00:29:07):
Healthcare organizations are adapting to deliver care more effectively and in a

(00:29:12):
more timely manner.

(00:29:13):
I mean, there was a moment probably about two years ago where...

(00:29:16):
man,

(00:29:17):
you couldn't find a psychologist because none of them were taking insurance and

(00:29:21):
none of them were playing that game.

(00:29:23):
And now you have any number of quality online virtual tools out there that people can access.

(00:29:30):
And even now,

(00:29:31):
and I don't want to go down this rabbit hole in this conversation,

(00:29:35):
and maybe we'll definitely set up for another one,

(00:29:37):
but the rise of AI.

(00:29:39):
And I mean,

(00:29:40):
you're already using AI at Health Next to build the strategic framework for a

(00:29:45):
company.

(00:29:46):
But AI,

(00:29:47):
whether it's on the healthcare delivery side or the employee benefit side or

(00:29:51):
whatever,

(00:29:52):
is really roaring around.

(00:29:54):
And the question is, you know, is it all good?

(00:29:55):
Where is it all heading?

(00:29:56):
But I don't want to talk about that right now, Ray, because we'll be talking for another hour.

(00:30:00):
Yeah.

(00:30:02):
Let me just quickly just say that,

(00:30:05):
you know,

(00:30:06):
the way we see it is that it doesn't replace,

(00:30:10):
let's say,

(00:30:10):
a chief medical officer in our case,

(00:30:13):
but it remarkably augments the power of that chief medical officer.

(00:30:17):
And the same thing's true with clinicians.

(00:30:21):
I mean,

(00:30:21):
if you really,

(00:30:22):
as you mentioned,

(00:30:22):
you know,

(00:30:22):
it's hard to get people to change their behavior.

(00:30:25):
And one of the ways you can do it is through a trusted relationship with a care

(00:30:28):
provider,

(00:30:30):
particularly a primary care doctor.

(00:30:33):
But increasingly, these tools and AI will accentuate the power of that relationship.

(00:30:42):
Right.

(00:30:42):
No, I agree.

(00:30:44):
So before we close, just two quick questions.

(00:30:48):
As per this whole conversation,

(00:30:50):
what's the one thing you want the listeners to take away from this interaction with

(00:30:55):
you?

(00:30:57):
Well,

(00:30:58):
it's worth mentioning that through the science of population health and the

(00:31:06):
increasing understanding of the components of well-being,

(00:31:11):
it is possible to build campaigns inside of employers,

(00:31:19):
inside of communities,

(00:31:22):
and other enterprises that can actually make it possible for whole populations

(00:31:31):
to act in a more healthy,

(00:31:33):
safe and well manner and reduce their illness burden and improve their performance

(00:31:41):
at work,

(00:31:42):
at home and at play.

(00:31:45):
And as a consequence, be more prosperous.

(00:31:48):
Well, that's a great summary, Ray.

(00:31:50):
I appreciate that.

(00:31:52):
And so the last question,

(00:31:53):
and we just talked about drinking,

(00:31:55):
so I'm not sure if you actually drink,

(00:31:57):
but if you do,

(00:31:59):
I have a wine Instagram called Vines with Vinny,

(00:32:03):
and I've been doing content for about,

(00:32:05):
I don't know,

(00:32:05):
three,

(00:32:06):
four years now.

(00:32:07):
It's just fun.

(00:32:08):
And so I like wine from all over the world.

(00:32:10):
So do you have a favorite grape region, Vintner?

(00:32:14):
I mean, tell me about one great thing you like about wine.

(00:32:18):
Well,

(00:32:19):
you know,

(00:32:19):
I have two wines that I like very much,

(00:32:22):
and I've gotten to be pretty expert in these two wines.

(00:32:27):
One is Pinot Noirs, and the other are Dry Rieslings.

(00:32:31):
And the reason I chose those two is they're actually universal wines,

(00:32:36):
as you know,

(00:32:37):
and so they can go with almost anything.

(00:32:40):
Right.

(00:32:41):
And and so I appreciate those wines for that.

(00:32:44):
And I like to be that kind of person also who's can,

(00:32:48):
you know,

(00:32:48):
can universally mix with with everybody.

(00:32:51):
So it sort of represents me.

(00:32:53):
And are you drinking just out of curiosity, the dry Rieslings?

(00:32:56):
Are you getting those from Finger Lakes?

(00:33:00):
I do get them sometimes domestically, but I have a preference for European ones.

(00:33:08):
But for the Pinot Noirs, I still gravitate toward Oregon and Willamette Valley.

(00:33:16):
Oh, great.

(00:33:16):
No, that's good to know.

(00:33:17):
That's great to know.

(00:33:18):
Well, good.

(00:33:19):
Well, Ray, thank you so much for being my guest today.

(00:33:22):
I thought it was a great conversation.

(00:33:25):
And I believe that,

(00:33:27):
you know,

(00:33:27):
we'll definitely circle back here in a couple of months time and have another

(00:33:32):
conversation because there's a lot more to talk about.

(00:33:34):
And I appreciate you and Health Next and everything you guys are doing.

(00:33:39):
Yeah, thank you so much.

(00:33:40):
And thank you for being able to be part of this wonderful podcast series.

(00:33:47):
I'm grateful for the opportunity.

(00:33:49):
Okay, Ray.

(00:33:50):
Well, thanks so much.

(00:33:51):
Take care.

(00:33:51):
Bye.

(00:33:56):
This podcast reflects the personal views of the host and guests,

(00:34:00):
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(00:34:03):
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