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SPECIAL EPISODE: Securing the Healthcare Payment Maze PART 2: Why Healthcare Needs a Crash Course from Banking NOW!
This is episode 2 of Artificially Intelligent with Sam Maule and Maia Bittner, a new podcast from Money20/20. We are again putting them on our feed because of the immediacy of this story and the importance of payments and competition in our national infrastructure.
Sam Maule and Maia Bittner have invited Boe Hartman, the CTO and co-Founder of Nomi, to pull up a chair again at our virtual table to share insights on the repercussions rippling through the healthcare payment systems, laying bare the stark financial and personal implications for providers and patients alike.
As we navigate the turbulent waters of a $4 trillion industry caught in the throes of a major claims processing shutdown, we uncover the unseen winners of this crisis and confront the startling differences in regulation when comparing healthcare to the banking sector. The conversation pivots scrutinizes the antitrust landscape and its potential effects on healthcare competition and innovation. Tune in for a thought-provoking exploration into the intertwined worlds of healthcare policy, economics, and the cutting-edge efforts by companies like Nomi to forge a more direct and efficient marketplace for us all.
Boe Hartman article: Why Healthcare Needs a Crash Course from Banking Now!
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Hey everyone. I'm Maya Bittner
Sam Maule:And I'm Sam Maule. Welcome to Artificially Intelligent brought to you by Money2020.
Maia Bittner:So on today's episode we're doing a follow-up on the Change Healthcare hack that happened on February 21st and is still ongoing. We're going to discuss what's unfolded over the past week, the impact from a payments perspective and how we think this is going to unfold from a regulatory perspective.
Sam Maule:This story is absolutely crazy, Maia. I was missed you last week when I recorded this, but as soon as I sat down with you and we kind of cut up a little bit, this is amazing, isn't it? I mean, I really don't have another way to describe this other than the word amazing.
Maia Bittner:It's so and I am still you've talked about this can't believe it's not on the front page of every newspaper I saw. It was on the front page of the Washington Post March 4th and it's being picked up, but it is having such a huge impact on a critical part of our economy and I actually, Sam, I don't know if you saw this, but I tweeted about this on February 22nd and the reason I tripped over this even and I was like why is this not all over my Twitter feed? Is because, you might know, I recently had a baby and one of the things that you do when you have a baby is they're like they advise you to get the T-dap vaccine for anyone who's going to be visiting the baby, right? So grandparents and things like that make sure you're up to date. The important part of that is the P, which covers whooping cough, which is very dangerous to newborns.
Maia Bittner:I asked my mom to go get the Tdap vaccine and she went into the pharmacy and the pharmacy said sorry, there's been a huge nationwide hack that's affecting almost every pharmacy and we cannot tell you if - my mom is under Medicare- if Medicare will cover this vaccine or how much it's going to cost for you, and my mom is very cost conscious, and so she said I'm not going to get it, Like, if I don't know how much it's going to cost me, I'm not going to get it until you guys figure it out. And so this is such a tiny, minor thing. It's just a tiny minor vaccine. Whooping cough is very rare anyway, but I was affected by this on on day two and I tweeted about it.
Maia Bittner:I was like my local pharmacy says there's a nationwide cyber attack on pharmacies and my mom can't get now, can't as an exaggeration, but my mom doesn't want to risk having to pay the potential full retail price of a vaccine, and so she's not getting it. And then I've started to see things pick up since then. But I really feel like this should be everywhere, and I think the reason it's not everywhere is, in general, most patients are getting the care that they need. They're getting the drugs that they need, they're going to the doctor, and so, fortunately, though it's causing a lot of harm, most of the harm is not on the end customers.
Sam Maule:Yeah, it's going to be. Just to frame this out for those that listened to the last episode. We've asked Boe Hartman, the co-founder and CTO of Nomi, to come back on. Boe, how you doing? You've had quite the week, and I think it was just yesterday. You were actually quoted in a piece that Axios wrote around this. Kindly give us a quick update on we can talk about that piece, but also kind of where we're at now.
Boe Hartman:Right. So, as you guys are saying, and we all agree, this is a piece that is just running under the radar Since we've talked. Last week, we are now getting policymakers who are actually coming alive on these topics. The White House had the CEO of UnitedHealthcare, who is the parent company of ChangeHealthcare, yesterday in DC to go over that. Providers are filing for bankruptcies, the loan programs are being rolled out, which I think we should discuss. The money flow all around that as well, because that makes my head explode. Payments still not flowing and we're starting to get our heads wrapped around what the operational hurdle that is to speed at us that will be out there. Young companies that are alternatives to change are actually starting to get hundreds of thousands of transactions which are putting their infrastructure at stress. So it's actually really interesting unfolding and I'm starting to put some of my mind to what are, I think, the steps, are the steps to go forward? How do we unwind this dangerous risk to this critical infrastructure?
Sam Maule:I'll give you one quote out of the piece that you said I still love is that this has punched a hole in 20% of the US economy and it appears at the moment no one's being held accountable.
Boe Hartman:Yeah, Actually, in the other math that we did is it's nearly 5% of global GDP. So think about that. Think about that for a second. And the reason why I think that folks aren't screaming yet is because it's not affecting your opportunity to go get care. But, like I said on the last session, providers are getting 0% of revenue and 100% of case rate and they're running out of money to pay their staff. So there's a timeline that is quickly approaching us to where they won't be able to pay staff. They won't be able to pay vendors.
Maia Bittner:Well, I saw that is having an impact. So there's a nursing home in New Jersey that just closed down temporarily. But they said, hey, we can't pay our staff. Our staff is not going to come in if they're not getting paid. So we can't take care of people if we can't submit the claims and get paid for them. And so the nursing home shut down. People got to be taking care of elsewhere.
Boe Hartman:While this is ongoing, and just under the waterline. That's happening all over the United States and you've definitely seen that. So, yeah, so it is fascinating and what's interesting is these providers are owed money for care they've given and we can measure that. We can use the metrics to where a UHG can pay them, like what their normal flow would be, to actually make sure that these critical, critical parts of our health care and economy stay alive.
Sam Maule:There's a great blog post by a doctor, jared Dijewski. I slide your name, jared, I apologize. I'm sure we can provide a link to this. In the show notes he said you kind of think about this Change health care processes. $2 trillion worth of claims each year, $2 trillion, and it's literally shut down everybody, I guess no-transcript.
Boe Hartman:Yeah and think about that two trillion. It's not just the two children, it's the three and a half trillion we talked about because, just like the, just like the Visa Mastercard rails, you might not be connected to change as part of the exchange, but there's a party in that flow of that transaction. That that is right. So to complete that transaction as we know it in payment and banking, if you have to have a healthy, robust rail contract, so even if you're you are not connected to the change exchange platforms, a Counterparty in that flow could be and it is stopped, those as well, right. So you've done it. I mean, do you guys think it's a place we should talk about? The other side of who gets, who's making real big money right now?
Maia Bittner:Well, what I was gonna ask you know, whenever something's happening, I don't understand right, when this is, it's going on three weeks of Billions of dollars in impact, I always say, well, what are the incentives? Right, like, who's making money here, who's not making money here? When I think about so Facebook, right, also of a massive scale. If Facebook goes down, facebook stops making money, and I think that kind of lights a fire under people's asses to go fix it, you know. And so I'm curious. I mean, yeah, bo Sam, right, so change is down. Who is making money? Who is losing out in this situation?
Sam Maule:Everybody strap in for this next answer that Bo is about to give, by the way.
Boe Hartman:Yeah. So if we think about the construct of money flow right in this world, so you have United, united healthcare that has its subsidiary. That's Transaction, as I described. People are connected to it in varying different ways to make these transactions take place. The transaction, as my said, aren't flowing, but companies are still paying their premiums to United healthcare, so the premiums are still flowing into their coffers.
Boe Hartman:They're also sitting on the money that already exists that hasn't flowed out, that are sitting there, so they're making float. That the one of the weird things about these payers is that their quasi shadow treasure Banks is what they are right, because they're sitting on float and they manage float as part of that, so they're getting inflows of premiums, they're not paying claims out and they're making float, so they stand to make a massive windfall. As a part of us now, as as Sam and I were talking a bit earlier, if this was a banking situation where it was down, that money would be earmarked to pay out at a later date and you would be, the bank would be held to account of how much money that they were sitting on and how much they were making based on this event of accountability. So again, this is another place where we need to separate the care from this conversation and focus on the economic impact of this payment situation.
Maia Bittner:Well, and so I mean, when you're talking about this, this is kind of the classic insurance business model, right? You get paid premiums and you don't pay out. I do think we tried to regulate this to limit the extent To which insurance companies can do this and health insurance companies Does. Is that gonna play into effect here? Is there? I know they have to pay out some percentage of premiums they receive, but I don't know the details of that regulation. Is there a time frame?
Boe Hartman:Yeah, yeah, I mean, in this case it's, it's fairly silent. I mean, you know again and I think we touched on it last time and I definitely have touched it with other reporters in last week and I had a very senior health reporter agrees me on this on this aspect of this industry, the regulation is very thin compared to what Sam and I experienced at banking Not even close, right, it's not even in the same ballpark, and so it's fairly silent. Because I'm not need, like, okay, the premiums or the percentage of premiums that they got, well, they can't push them like right now as far as they claim again, but what about the float? What about the interest of that money that you know right, like again, and and and it's silent on that topic, right, and we're talking, we're talking hundreds of millions of dollars like this is. This is not insignificant.
Boe Hartman:And, again, because it's so opaque and because, unlike banks, they, they are not required to report this in the same manner that you would inside of the banking construct, no, it's, it's, it's so hard to determine what it is. I mean, it's taken us three weeks and you know, we're now starting to get numbered, where people are actually quoting numbers, and even those numbers are like you know. The one person quoted you know two trillion to change right, but it doesn't count for the other trillion other parts. So so it is. It is so opaque in this domain that we actually have to make it Transparent so that we can make it better, so we can put good policy employees.
Sam Maule:What's even funnier, if you really want to geek out on payments and Maya bow and myself we are payment geeks this is what we do. We know within payments that as far as how you communicate, there's ISO standards. There's there are standards set on on payment flow for this. What is fascinating with this is Is that their great string on on Twitter from an account, sack canter, talking about the impact HIPAA has of all things. I think we're all familiar with HIPAA, but HIPAA actually set and established a standard for the electronic transactions when it comes to insurance and this money flow. You know what 99% of the insurance companies use for the flow. Who set the standard for this is change healthcare. So if you're trying to get off of change, you're looking at months worth of programmers going in and rewriting these standards because there's not a set standard for this. The industry set comes from change. This is the most circular snake eating itself thing I've ever seen in my life and if this was banking, we would all be in front of Congress right now.
Maia Bittner:Well, and that's I wanted to ask. You know, how much of a free market is it? You know, I understand that change is a clearinghouse. Can you choose whoever it is? I was, you know. I was chatting with my friend, ellen De Silva. She's at summer health and she says most of these small practices don't even pick a clearinghouse, it just gets bundled in with their electronic medical record system.
Boe Hartman:That's 100% correct, right? So you go, epic Turner, or even some of the smaller ones. They're already bounded to change and if you look at the history of what changed it change went around and they bought up all these little tiny exchanges way back when and then they became a patchwork. And you know, we saw this in banking when banks got rid of other banks. The systems weren't integrated and they were these patchworks of connections and again there was no oversight or policy to give good guidance on this aspect. Cms, hhs this is really this is kind of a weird space for them. So they really are not experts in the domain and this quasi or this shadow banking industry grew up on public. You have the smaller ones, like Waysar and Alibon. They're sending contracts out to provider groups and the product group are sending unread lines back to them in five minutes and saying, yep, let's get on it.
Boe Hartman:So you have these smaller organizations who are getting stretched way beyond their capabilities and the operational impact is going to hit them soon too, right, because what's going to happen is they're going to get huge transaction volumes. They're going to be stressed, they have to go on modern architecture, but you know, when you go from a couple hundred thousand to a couple hundred million transactions. It's a different ball game completely, and so it is definitely not a free market. And again, the mind blowing thing about it is folks don't realize how much of a monopolistic situation creates this risk. And if you look at the, if you look at the UK, dear chairman, letters from the 2012 Nat West collapse of technology, it actually sets a greater framework to allow you to say how do you actually create good, solid infrastructure like this in an open, free market? That is the UK banking ecosystem.
Maia Bittner:So, and I will. I was just going to say you know tech, bring it back to Facebook, bring it back to technology. Tech also operates at huge scale, like this right, there's so much of tech and fintech that's doing trillions of transactions and I don't know. I mean not to brag, but like I feel like we've kind of figured it out, like we know how to build resilient systems. Right, you do redundancy by default. You've got multiple databases, multiple database backups. Yeah, your servers in different regions use multiple banks. Svb bitch you in the ass if you weren't doing that. Right, it's like we've got all of the different pieces and I feel like I might have an idea what's actually happening right now at change, which is like something went down. They paid the ransom, right, like a naive perspective is everything should be back up Unconfirmed.
Sam Maule:Okay, rumors are, rumors are what the ransom was paid?
Maia Bittner:But you know that you can build that. It's like you're going to have a set of cascading failures. It's going to affect stuff. As they bring things online, they're going to realize not everything is working as expected and I really think it's like. I feel like there are a lot of lessons that could be learned from the way that tech operates at a scale like this.
Sam Maule:I mean we talked about this last week, though that we've been. If you're in banking and payments, you've been through the crucible, we've been through the fire, and there's a ton of lessons that can be learned from there when it comes to the regulatory side, when it comes to the redundancies that need to be there. Right, maya, we talk about stress tests all the time with banks. If you look at the US banking system, it's kind of hard to argue that we're not stronger than ever right Over here and from a standard. So the lessons are all here. It's just. You know, bo, I mean that's the question I would ask is so where do we go from here?
Sam Maule:I mean, I know there's a lot of talk going on in DC. There was a I saw on Twitter. Dan Diamond, very good reporter, said he spoke with Barry Sanders yesterday. Senator Sanders, who's a longtime critic, by the way, of United Health Care shocking. He also sits on the Senate's health panel, by the way. He called the spiraling crisis a very important problem and told me he's considering Senate hearings as just a question of how we fit it in. I think they're going to fit in.
Boe Hartman:I think it's safe to say Well, I was going to say Barry Sanders loved him when he was running back. I think he burned him.
Sam Maule:Oh no, sorry, detroit everybody, the greatest running back of all time.
Maia Bittner:And let's.
Sam Maule:we should actually do a show on that. I'm sorry, Bernie, with your mittens and polities, but yeah.
Boe Hartman:So about a year or so ago.
Boe Hartman:I actually authored an article with just exactly what you're saying. Yeah, is that the health industry can actually take the lessons from banking. So, for example, when I landed in this industry, I started looking at it. This industry looks like banking from the early odds into the early teens and then when the FinTech Wars took place around that 2011, 2012, 13, 14, 15, right, but this industry can actually take that roadmap from the FinTech banking era and learn so much. To skip to your point, skip forward and actually improve the way that I would, the way that I'm thinking about it right now, when we're speaking to some policymakers soon as one is Sam to one, let's take the lessons from banking. Two, this is an economic and national critical infrastructure topic.
Boe Hartman:This is not about a doctor caring for a patient. We do that pretty well. This is about how do we actually protect and create, to my point, the resiliency that we already know how to do for our nationally critical processes. Right Three, we need to hold the participants who are engaged in this to a higher level. Right, we need to create the incentives to actually open this market up so that one single model player who can be taken down with the golden BB for those of you who know that reference and actually create an environment where these other players can come in, help reduce the cost, increase the efficiency and the transparency.
Boe Hartman:And then, lastly, this needs to be a joint hearing between finance oversight and the healthcare oversight, because the committees that oversee health are not equipped for this topic. They just don't have the back. When I talk to them, I have to whiteboard it very basically so that they can go oh, we understand, okay, now we see the problem right, and so we need to actually do that. And I have an incentive it could be tax deductions for provider networks that actually do the IT investment on their EHRs to connect into multiple exchanges, right? So the sorts of things that we need to create.
Sam Maule:And Bo, when you and I were talking I think it was yesterday, a day before that a couple of things we want to flag. We said it in the last show. Please understand this was a government sponsored attack. This hack was government sponsored, so you can go and read about that everybody. So that's one. So when you talk about critical infrastructure, it shows you how susceptible we are for an entire system to be taken down, so that has to sink in. The other half of this is you don't want the pendulum to swing too far. Right, we've all come out of banking, we all survived 2008, and what typically happens is something like this is a pendulum's Swings, the full arc, right. So this is a chance to go in there and do this right. When you know when we're talking about from a regulatory standpoint, we're coming from a standard standpoint and the lessons coming out of banking and payments the road map is there for this the road maps there.
Boe Hartman:And then my and Sam, as you guys know from last time we talked um when, when UHG United healthcare, through optum, spent 12 billion dollars on change healthcare 12 billion and the DOG stepped in To say let's review it from monopolistic practices and it was struck down by a federal judge. Right, this is exactly what that overview would have Hopefully surface up that we have. We injected a massive amount of risk into the, the environment that's what I'm saying.
Maia Bittner:Talk about regulation. Now you know, I think it's important, but it's kind of like closing the fence after the horse has escaped, like should we have just blocked this in the first place? Um, and, I think United knew how much they had to gain, which is why they defeated.
Boe Hartman:That's what they spent 12 billion Exactly, and and and people go. Well, didn't the risk exist when change was out there? Yes, but if change during that, that trans a transaction, we could have had the conversations of how do we put a competition and how do we help, you know, the companies like the no me's and the elevons and everyone that are that are trying to create diversity in the market, right, yeah let me get not to outrage everybody a little bit more.
Sam Maule:But why not a great article in prospect org that talks about an Oregon medical practice that, again you know through this, basically had Zero funds to operate. I mean, the doctors pulled together To be able to pay staff to keep this going. Their only option that they have was to push a sale to anybody want to guess to him United health care.
Maia Bittner:That's I was gonna ask. I mean right, cuz it's this vertically integrated monopoly. Are they picking up these struggle?
Boe Hartman:Yes, but what one of Optum's practices is? They go in and they purchase Provider providers that are that are fail. That's, that's actually part of the part of a playbook that, if we could.
Maia Bittner:Do is free to my his face right now I would I mean I, this is so nasty.
Sam Maule:United Health Care comprises of 2642 separate companies Collectively ranked at 71 over this I.
Boe Hartman:I did the only ones powerful enough and if you look at Raytheon, raytheon, massive defense contractor, right, they have oversight, they have detailed oversight. And again, I'm not calling for master regulations, just Sam's point. I'm saying good policy, yes, right, there's good roadmap, and but as well as we also have to to create it so that that these innovators can come in like like an Omi, help and actually Create a diversity. That would create a quasi-exchange competition like we haven't been competition is good.
Boe Hartman:Right so that? So that, for example, we have providers scrambling to get on these new exchanges? Right if they. If we would have had a construct like we have with the credit bureaus, like we talked last time, or or the different payment rails that we have across the United States, all I would have to do is say, okay, we're gonna increase traffic to these other channels, and the process would still be sound like you worked in the UK vote.
Boe Hartman:You really do. Yeah, right, so I mean it is so again, like I really think, and you know, and and same Maya, like we need to use your platform, we need to bring the thought leaders together, that in your audience, and we need to actually say here's the plan, this is where we're gonna go right, because that's what, no, we try to do is. We're trying to say like this is you know, this is a crisis, and here's the plan and here's how we're approaching it, here's what we recommend, so we can actually get exchanges of ideas that we can, that we can approach the, the different committees, and we can approach the different policymakers and say this is so important. This is the things we have to go do and, to the point, you both made the roadmaps there as bankers. We've seen it, we've been through it, we've done it.
Maia Bittner:And it does feel like right. Increasing competition would help mitigate how vulnerable we are to things like this happening and help reduce the risk. I saw health and human services wrote a letter pleading healthcare leaders To help make it easier to switch clearing houses, and it does seem like there's been a little bit of work there. But, like Sam said, it's hard to move that type of standard quickly. Um, but even backing up a little bit, I mean, of course, this is top of mind because this must be the no me mission, but it's a little crazy that we need middlemen to know how much providers are gonna get paid in the first place. So yeah, having more middlemen as options and a free marketplace to choose between them is a more reliable system. But part of my brain is like, well, could we cut them out entirely? Like do we need to rely on a middleman for our healthcare system to function?
Boe Hartman:Right. So you know, no, me, no, me stands for no middleman, right, and somebody would go but hey, aren't you a middleman? No, we are about creating the efficiency, the market of what you're talking about. Right, so you know you're gonna have to have third parties in the flow. Whatever it is, the problem is the market itself is just not efficient, right, the market has all these middlemen in the way. That is actually building inefficiency because it creates their opportunity of Revenue, right?
Boe Hartman:So the thing we didn't talk about last time 40% of every dollar that is spent on care Does not make it to the end provider and it's picked off along the way by administration, organizations and that sort of stuff, and and that's, that's actually on the good side, that's the upside, right? And and that's 60 cents doesn't make it to the provider for like nine months, and then what will happen to? Someone will come back later and they'll claw it back, right? And so each of us have all our stories about this industry and how and how it's so inefficient, massively inefficient, right? And so our big mission is how do you make it efficient? Because the real cost of health care in the United States is about 30 50% less, right?
Sam Maule:it is mind-boggling, like the only thing I can equate this to is doing your taxes right. Guess how much you, how much you tell me, I guess you know. If you get it wrong, you're a lot of trouble and when it comes to health care, as somebody who has four kids and is Pushing 16, everything else that's. That's always the fun part, right when you're going into happy procedure Like, what's it going to run me? I have no idea, they have no idea. We'll let you know. Yeah, it's most amazing industry I've ever seen.
Boe Hartman:Yep and and so yeah.
Boe Hartman:So I think this is a monument. I'm so glad you guys are giving the opportunity to engage with your community. You know, I come from this community and we really. There's opportunity for us to lead, to be thought leaders, and we need to be. This is so monumentally important because we're losing providers, um, on a daily basis. Insurance commissioners Across the states are having to say, hey, how do we actually give the loan to keep a provider in place? And I'm like, but there's four trillion dollars ploshing around this market and we know how much a provider made on a monthly by monthly basis. Why don't we actually give them that Right?
Maia Bittner:Right. It seems like we're so good at right casual forecasting and we know that right like loan, payback rates are really high. When it's caused by something like this right which is not the fault it's like they're still providing the things. It's almost like earned wage access, but for medical practices and for physicians, it's like we could look at what are you doing for people we should be able to know, looking at historical records, and we should be able to lend people the money they need accordingly but the the impact to individuals lives.
Sam Maule:I'll keep coming back to this. There's a cancer clinic in Arizona that serves 16,000 16,000 patients. That said they had three weeks worth of operating income. That's it 16,000 individuals. So both again, critical infrastructure, right, it's not that that care can't take place, it's that the back end of this, that payout not happening. So again, I'll keep saying it how this isn't front page News is bad.
Boe Hartman:Yeah, so yeah so and and that's that's why I said, wow, this is an economic, economic issue that we had to pound on, so, so, yeah, so that's that's why it's looking like, the more we get it out, it's starting to get picked up. Like I said, my calendar starting to fill up with Interviews so we can get the message out. And it's funny, all the interviews start the same, especially the healthcare reporters yeah, this is a big story. We're also shocked about how no one's really picking this up. But yeah, it's the monopoly and you can't fight them. But that's the problem. That's the problem right.
Maia Bittner:I mean Sam was talking about its critical infrastructure. Some people would argue such critical infrastructure should maybe not be run by private corporations and it's a setup that's that's not really destined for success and and, and you know, private corporations.
Boe Hartman:I think the private industry has to be engaged with it. But just like the clearing houses, right, the clearing houses are guaranteed by the government and everybody pipes into it, right, and then that creates a market to allow the market to function. Right and it's every participant is held to a standard, and, and that's what we need, that we need to move in that, in that direction, right? So I feel that that's where this, this message, is.
Sam Maule:Yeah, what I would tell any regulator, anybody in the space that's listening. I highly encourage you To speak to people like Bo and my folks that have built systems that align to this so well folks that Know you, know that understand payments inside now, but but unfortunately we're out of time here. My, you want to close this out.
Maia Bittner:Yeah, you know, that does it for this week's artificially intelligent podcast, though United needs to do better, I have to admit. So, personally, I actually love doing incident response, and part of me is I love what it's it's like being an early-stage startup, everything's on fire.
Maia Bittner:You're. I love it. So I'm a little bit jealous of the incident response team at United, though they need to pick up their game. Hey, we love hearing from listeners. Go out and give us a review, preferably five stars. Wherever you listen to podcast, this helps our group, us, grow our audience. And, hey, you can reach out to us too. We love the conversations. We love the feedback. We'd love to hear your ideas for how to make this system better on. The best place to find me is on Twitter. I'm at MAA B. I don't know if you can hear aria, my new daughter, in the background. Bo, where's the best place for our listeners to engage with?
Boe Hartman:you. So I think I engaging no me, health, you know on the web at me, help that calm or on all the socials, I think it's the right way. If folks want to interact with me, the easiest way to do it is at Twitter, at BO, eha, hr, tma and also LinkedIn. Some of the posts that we're making that together and that I'm doing through others can interact if there as well.
Sam Maule:Excellent. Well, folks, you can hit me up on LinkedIn or Twitter at Sam all. I want to thank everybody for listening for this incredibly important in my opinion Episode, and I want to thank you all for listening. We'll see you next.
