Innovating Radiology Access: OneImaging’s Blueprint for Healthcare Savings

In this episode of Healthcare on the Rocks: Employee Benefits with a Twist, hosts Brittany Hardaway and David Pittman talk with Elan Adler, co-founder and CEO of OneImaging, and Melinda Raymond, Senior VP of Sales. The discussion revolves around OneImaging’s innovative approach to reducing healthcare costs through optimized radiology services.

Elan and Melinda share their journey in the radiology space, from the inefficiencies they witnessed firsthand to the creation of OneImaging. Elan’s early career exposed him to numerous pain points, like patients being unprepared for imaging due to lack of digital tools. This inspired him to start a company aimed at making radiology more accessible, affordable, and efficient for both patients and employers.

The conversation touches on how OneImaging saves employers significant amounts on imaging costs while improving the employee experience. Melinda highlights the importance of seamless integration within existing health plans, stating that OneImaging’s approach results in a hassle-free process for both employers and employees.

One key success metric they share is that OneImaging has saved some employers up to 82% on imaging costs.

The episode wraps up with insights into how AI and digital tools will continue to reshape the healthcare landscape in the coming years.

Key Takeaways:
  • OneImaging aims to make radiology more accessible, affordable, and efficient.
  • The company focuses on integrating into existing health plans without requiring extra apps or steps for employees.
  • OneImaging can save employers 60-80% on imaging costs, equating to millions in savings.
  • They’ve built a network of over 4,000 accredited centers across 48 states, ensuring fast access to quality imaging.
  • The future of healthcare will likely see more consolidation, AI integration, and a shift toward quantifiable ROI.
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Episode Transcription

[00:00:00] Brittany: Welcome back to Healthcare on the Rocks: Employee Benefits with a Twist. I'm Brittany Hardaway, Director of Strategic Partnerships at Springbuk. 

[00:00:09] David: I'm David Pittman, Vice President of Marketing. Today, we're thrilled to have two special guests joining us from OneImaging, a company that's revolutionizing the radiology space. We have Elan Adler, the co-founder and CEO of OneImaging, and Melinda Raymond, who is the Senior Vice President of Sales.

Welcome, Elan and Melinda.

[00:00:29] Elan: Thank you.

[00:00:31] Brittany: All right. So let's get to know, each of you. What are some of your interests and hobbies outside of work? Elan, you can go first.

[00:00:41] Elan: if you can't hear my dog huffing in the background, usually it's taking my dog for a long walk, in the morning and after work. Really into exercising, going to the beach on the weekends, playing pickleball or tennis, and trying new restaurants.

[00:00:59] Brittany: Awesome. What about you, Melinda?

[00:01:03] Melinda: So my husband and I have three kids, so a lot of our life revolves right now around kids sports, and we live in Asheville, North Carolina, and so love to be outside, hiking, biking, camping, and I, like Elan, have become a massive pickleball fan.

[00:01:21] David: I love to hear that. I play a lot myself. how are you? Are you good? Mediocre? Tell me. Yeah.

[00:01:30] Melinda: that's a hard, that's a hard way to answer. I think good, until I play against some other people, then you're like, Oh, I, it was crushed by the, senior citizens at the YMCA. there's always someone better than you.

[00:01:44] Elan: I'd say, I usually play with my dad on the weekends, and it's usually like what Melinda said, it's, the senior citizen folks that end up, being sneaky good that crush me 11, 11 0, after I've won a couple of games. so yeah, I'd say always good until I play someone who's, who has a lot more time and attention to it.

[00:02:11] David: yeah. The ones that spend all their winters in Florida or Arizona come back and yeah, you don't want to play them.

[00:02:19] Elan: Yeah. Strategies, the great equalizer a little bit, and pickleball.

[00:02:23] David: It truly is. Yep. maybe we'll get into some strategy on your business here. So let's, dive into today's topic. So Elan, you first, walk us through maybe your early career experience, and seeing how radiology works from the inside of, as I understand it, you worked at both Ohio Health and Cleveland Clinic, which of course is one of the best hospitals in the world.

What did you see firsthand that made you think, Hey, I need to start a business like OneImaging?

[00:02:52] Elan: Yeah. I actually started my career off as a radiologic technologist, doing MRI scans at Ohio Health for a couple of months, and then moved to South Florida to manage their outpatient radiology business at the Cleveland Clinic, and that was before going to sales and product development for Siemens or consulting at Siemens.

Yeah. I was managing, RadNet, and the Siemens equipment and install base they had there. So my experience is very much outpatient-based, in the bulk. And I think being like hands-on, you kind of just notice a lot of like redundancies, like paper forms that you're using, like, why can't someone, why can't we just, automate that digitally and send out screening forms, for instance, so that before a patient comes in to get their exam, you don't, they don't find out in person that they may have like metal in their body, as an example, and not be able to get an MRI or be allergic to iodine and can't get iodine contrast for a CT.

And so there were a lot of inefficiencies that lacked tech enablement or assistance from technology that over time, it's like death by a thousand cuts. You just lose a lot of efficiency.

[00:04:01] David: Smart move. Melinda, how about you? What was your background and how did you end up at OneImaging?

[00:04:09] Melinda: Yeah, I came to, OneImaging from about a 15-year career in digital health. And I was prior to OneImaging, I was with Sharecare leading sales and partnerships in our employer market. And prior to that, was on the product side at a company called Healthways that was acquired by Sharecare. but ultimately OneImaging, you know, Elan and I crossed paths in the world of digital health, and I was so compelled by, the mission and the value that OneImaging was bringing.

it. We'll talk more about this throughout the podcast, but just this sense of real hard dollar savings and, an area that really has been unlooked at in a lot of healthcare, especially among, employers and TPAs in terms of reducing spend.

So that was a compelling story and a great opportunity to come and help grow this company.

[00:04:59] Brittany: Yeah, our industry is very small. It's all about who you know, right? Elan, what major problems did you set out to solve when founding OneImaging?

[00:05:11] Elan: I think just like most people in healthcare, the main things were, everyone knew who was like a friend or family member that I worked in radiology. And the typical question I would get was Elan, my doctor wrote me an order to go get an MRI or a CT or an ultrasound, whatever it may be. Do you know where I can go to get this exam done?

I know it's super expensive. Where can I get it done at the lowest cost that works with my insurance plan, that has a good radiologist that can get me in for an appointment the soonest? 

So those four tenets for like the end user experience, which was that I couldn't answer those questions as someone who worked as an expert in the field, I would say, or more experienced in the field.

And I wanted to solve that, but not just solve it, but how do you get, better care, more homogeneously, how do you get lower costs? How do you get appointments sooner? And then of course, making it all work with your insurance plan. And so that's what compelled me or drove me to end up creating OneImaging. 

[00:06:12] Brittany: What challenges did you face when founding OneImaging? what successes have you experienced as well?

[00:06:18] Elan: I don't come from a background in insurance, so I had to learn the way health plans and insurance works from scratch. That was probably the biggest challenge. I think when we even originally created the business, it was not, we didn't know how to make it work with insurance plans. So it was even a B2C product to start.

And then quickly we had to learn also, even though imaging is the second most utilized service in healthcare by claims volume, people don't remember about their healthcare generally until it's affecting them negatively, and then they don't remember what they have as a healthcare benefit or coverage, from their insurance plan until they need it. 

And so understanding that we needed to also develop a thesis and a core principle of around that of people using OneImaging or ending up using OneImaging without realizing or remembering they have it was a core tenet and principle to, or challenge we had to overcome and figure out how to solve. Some of the successes side, I would say come from the excitement and the first customer who was like, yes, let's use this. And then the second customer and then the third and being able to go live with customers and start to develop proof of how well it was working. For one of our customers, we were saving them about 82%, I believe it is, month over month on their imaging spend. That alone was really the core, success early and being able to take that and then go get, employers and customers who have 20, 30, 30 plus thousand lives and say, Hey, we see that this works, let's go ahead and do this.

And then seeing health plans go, wow, this is, this is awesome. We're seeing big employers, wanting to roll this out. We should be paying attention and maybe we should embed this and talk about, rolling this out to more of our employers. And that was, I think those were the successes that we started to see that got us, got me really excited.

[00:08:22] David: So one of your unique aspects, at least to me, is, that you do sell and you started out selling directly to employers. So what, how did you make that choice? 

[00:08:33] Elan: We ended up talking, I talked to a investor very early on our first, our very first investor and, brought OneImaging, which wasn't even called OneImaging at the time to him as, a product or service to invest in a business to invest in, and he was the one who brought it to my attention. 

He had invested in XP health and a ton of other big companies. And he works closely with a lot of large corporations and, said to me that this is very similar to some of the other investments in the space that he saw, and this really needs to be provided. to corporations as a part of their health insurance plan or a benefit.

And that's actually where I learned about it. And then it took me a while to really learn everything about what a self-insured employer was or self insurance versus fully insured. and then learn what captives were or TPAs and, what all these terms, what all the terminology means and how to create integrations and how like billing has to work and all these different parameters around it.

So that's how it got started though, and selling B2C just doesn't make as much sense for our type of service or business. and so realize that was the opportune moment to very early on, make a switch or transition into, selling to employers.

[00:09:55] David: Yeah, that's a steep learning curve to A, just learn all the terms, but then what are the subtle differences between them all? Yeah. and so another thing when you were answering the previous question, the, me as the marketing guy, it sounded like it was a branding challenge for you, because you were talking about how do you get people to remember OneImaging, that's where they went and go back to you the next time.

[00:10:23] Elan: Yeah, I think being part of the insurance plan, allows you to do that. It creates awareness and the different tools that we can use inside of being part of the insurance plan and the ways that we're able to engage with members allows us a lot more targeted flexibility. And we learned so much going from B2C to B2B. realizing how much health insurance plan spending goes towards imaging, whether that it's 13 percent of cost. So there's a huge opportunity of, there's a huge value proposition for employers themselves, of course – a very clear ROI that's quantifiable, it's large and immediate, and that sticks out and that's different.

But the component of, okay, now we know that 20 percent of members make up 80 percent of the spend or the top 10 percent of members that use imaging make up 66 percent of the spend. And being able to say that what we've realized is we overlooked this glaring forest beyond the trees situation that imaging is something that's pervasive across all disease states, that we see it contributing 15 percent plus towards diabetes, neuro conditions, GI conditions, women's health conditions, cancer, and realize like the data was presented always in a different way. And being that we can see now that it goes into all these areas, that really we can engage those members, especially those with chronic conditions that are getting six to 12 exams a year, and make sure that they that this is part of their, the workflow for them to get, healthcare. 

So that's some of the ways that we've seen, we can, latch into a plan and, get engagement.

[00:12:07] Melinda: I'll just add to that. We know that the employee benefit space is crowded, and I think about the everyday employee, and, getting their benefits guide and often times. employers have 10 to 15 point solutions, and they all have different names, and they all serve different purposes, and all have different apps, and are all kind of fighting for the attention of that employee who is already strapped for time and energy and money. And so one of the key tenants of OneImaging is saying, how are we successful while not competing in that same way?

How can we be successful as an integrated part of the health plan? How can we work behind the scenes, with the imaging centers, with the health plan, with the TPA to make sure that we're able to support that member, we're able to get them a lower cost exam, but do so without them in that moment, which is often a stressful moment when your doctor says you need an MRI or CAT scan, even to remember they have the service.

[00:13:03] Brittany: Absolutely, Melinda. That is a great point. as a, I consider myself to be an educated consumer for healthcare or in healthcare, and it is just daunting sometimes to just remember all of those things that you just, mentioned on top of having this illness or this chronic or, event that just happened, you're all scatterbrained.

So Melinda, you were at Sharecare for nearly eight years, right? How is your, how is the healthcare space different today than what it was then?

[00:13:35] Melinda: Yeah, we've seen a lot of change. I remember my Healthways days in early 2010, 2011, it was the onslaught of the member portal, in this sense of saying, how do we, have one place where individuals can go and understand more about their healthcare?

And then in the last 10 to 15 years, you've seen, as I mentioned before, a ton of different solutions that are so important coming to market in a lot of different areas.

And you've seen, advocacy companies trying to help navigate people. We have so much. I think that what we're seeing now is this shift to saying budgets are tighter, employers have to find cost savings, and the solutions that are rising to the top in kind of this consolidation market are those that have a really strong, hard, compelling ROI.

We're seeing more and more of that, as clients are interested in talking to us and we can show, one, we can be a good ecosystem partner and play in the context of the solutions you already have, but two, you don't have to wait two or three years to see the savings, that they, employers need solutions where they can see and feel that savings in the short term.

So I think that's just changed over time. I think that employers, consultants are becoming more educated about what's out there and what works. And I asked a consultant a couple of weeks ago, I said, what's like the hot thing on the market? What are your clients doing? And they responded with they're not adding more, they're in a season of taking away, they're in a season of doing less, and they're in a season of figuring out, what's really working, what's not working, and especially after COVID, when so many solutions were added to support, support employees, I think we're a few years out saying, what's beneficial, what's helpful, what can employers afford in 2024 and 2025.

[00:15:23] Brittany: Great points for sure. So when you go out to pitch OneImaging to employers, what do they find most compelling?

[00:15:32] Melinda: Yeah, great question. I'll take, a shot at it, then Elan, you know, feel free to add as well. So I think a few points that we've already hit on, I think one, we really play a, back end role, if you will, in the context of the health plan. And so I think this thought of we don't have an app, we don't have, something that members have to proactively engage in to recognize the savings is really important.

I think two, we provide just a hard ROI. We're saving employers 60 to 80 percent on imaging spend. That equates to roughly about $3 million per 10,000 employees. And that's based upon a pretty conservative, utilization of about 50 percent of exams. And all that to say is, the savings are really massive.

And so I think for employers to say there's still solutions that I can implement for, this coming year that I could recognize millions of dollars of cost savings is incredible, with relatively no disruption to my population is really important as well. I think the other piece of it is, we recognize that, while cost savings are important, this understanding of how do we drive high, higher quality in radiology and how do we get people their appointments quicker.

We hear oftentimes from employers that, they hear stories of, my, my employees had to wait three weeks to get an MRI that was ordered by their doctor. They just couldn't get an appointment. And so OneImaging just really steps in the, steps in there to help make sure that people can get high-quality appointments, much quicker.

And I often say, as a mom, we know that 35 percent of imaging care is deferred because people are just concerned around the cost of it. And I just, I can't imagine having to push out care for myself, for my kiddos. And Being able to step in and let someone know that maybe a $2,000 exam is now a few hundred dollars and they should go ahead and get that and how do we help them get that scheduled and really hold their hand through that process.

Employers are thinking about cost, but they also want a positive experience for their population. They want this to be easier in what they know is a complex healthcare ecosystem. So those are the things that we hear time and time again are compelling to employers. 

[00:17:42] David: Elan, anything that you would like to add to that?

[00:17:45] Elan: I would just add when it's affecting half of your, half your employees. it's, it's a lot of employees that are going to walk away really happy and feel very fortunate that they work for the employer that they do. so that, I think that's a big element to it as well.

[00:18:05] David: Each employer is different, especially when you have different types of, and each category has kind of employee, you really have something to gain, I think, from it, especially based on their condition state, and providing like an end to end, solution and coordination around everything, letting them know what to expect, to helping them get the report afterwards is all super helpful for members, especially when they're going to see a specialist or another type of provider afterwards.

So Melinda was making the point that, a couple of your goals are trying to make the experience faster and more affordable. And in my research, I saw that you have something, I don't know, 4,000 accredited centers in 48 states. how did you go about building out that, large of a network? And Elan, I'll start with you first.

[00:19:01] Elan: One thing that I learned from working in the radiology space before is that you have to be like really sensitive to not creating friction for them individually. So being able to manage, any type of payment coordination or manage any type of care coordination, it has to be very seamless and you can't ask people to create net new stuff, especially when you're already a new organization or a company on the block, the first response is going to be, who are you and what do you do? And why do you, do this? How do you do this? So being able to blend in with the existing operation, required a lot of, I'd say like background expertise, which was really my bread and butter before, and, helping manage or consult to manage so many imaging centers. 

And that was, ultimately then followed up by calling these providers over multiple years and speaking to them and sharing what our, value proposition was and how our system simplifies things for them and can provide them, value and volume. And a lot of phone calls and there's no secret sauce to it.

It was a lot of brute force. Yeah.

[00:20:37] David: Welcome to being an entrepreneur, right? Melinda, is there anything that you wanted to add on that point?

[00:20:44] Melinda: No, I think that one of the things that I really appreciate about the, partner providers we work with is we're really solving a problem for them. we know that 30 cents of every dollar is spent on administrative costs. We know that their cancellation rates often 25 percent every day, that patients that don't show up because they're, they don't know how much this is gonna cost or they don't know what the experience is gonna be like.

And really the heart of OneImaging is how do we solve problems for providers and then in turn, be able to get lower cost for the clients that we serve. And we, it's, always great to be in healthcare when you can solve two problems at once, solve the provider problem while solving problems for employers and that's really the crux of what we do and makes it a compelling, value proposition.

[00:21:35] David: Let's talk about the costs a little bit more. What are some of the costs that are associated with employers in the radiology space, and how are you helping reduce those?

[00:21:47] Melinda: when we really look at like-for-like exams, and we really work within the context of really five kind of main categories of exams, and our goal is just to, by again, provide, solving those problems for the providers, getting these reduced rates, really allowing employers to unblock those rates for members, and typically, we see that, OneImaging offers rates that are 60 to 80 percent lower than what's commercially available today.

And that's really only the hard cost of the exam. that's not taking into account, as I mentioned, deferred care. Individuals that are not getting, an exam that their doctor thinks they need. And that ultimately leads to potentially a delay in a diagnosis. 

So we don't even account kind of those kind of cost savings areas, delays in care, but we really are looking at those hard dollars on, like-for-like exams. 

[00:22:39] Brittany: actually I'd say there's an abundance of awareness as well from members. If you look up some of the most commonly searched items as regards to cost in healthcare, I believe there's an article about it, MRI comes up like 40 is like 45 percent of all searches MRI price.

[00:22:59] Elan: So it's something that people are very cognizant of as well. and we see, exams that have been processed for thousands of dollars, essentially. It almost doesn't seem to line up with what we also hear from a lot of providers that there's downtime on the equipment and opportunity to have more volume.

So when you look at like kind of the arbitrage of volume versus, availability, there's flexibility there to be able to create opportunity and drive down costs. An interesting statistic, for instance, that I recently learned was that the city of Pittsburgh alone has more MRI machines than the entire country of Canada. And you just look at something like that alone, and they have different problems than us, but in their healthcare system, but when you look at the arbitrage of availability and volume, you're able to really define that. And if you can do it a good job of that, you're creating value for others and that's how you get those good costs.

[00:24:02] Melinda: We spend a lot of our time educating employers on radiology. Elan referenced this earlier, but, I think when employers look at their top drivers, we've just been in an industry that's often looked at this from a condition-specific lens. Most employers would know it's cancer, it's MSK, it's, gastro, it's neuro.

they're not necessarily thinking about the service line. And so that has been an interesting part of the cost conversation, is just helping employers really identify and understand, their cost tied to a service line like radiology, similar to a, pharmaceutical service line as well. And so helping them understand what those costs are and helping them understand what the, levers we have to help reduce that.

[00:24:51] Brittany: That's a helpful explanation. Thank you. So I have to chime in from a personal perspective. last September, my husband was playing pickup basketball late at night. It was, I don't know, eight at eight in the evening. a guy ran into him as he was going up for a layup and totally blew his knee out. And when I say blew his knee out, torn patellar tendon, torn MCL, torn PCL, sprained ACL, excuse me, it's too much all at one time, right?

So that experience, alone, ambulance ride, all of that, but then having to follow up to find an MRI, not vendor, but a place that offers MRIs at that time of night or even the next day. that's a catastrophic injury. What type of service, or can you explain how, if we had OneImaging, how that would work for us as a member? What happens next after he needs an MRI?

[00:25:54] Elan: For starters in that situation, he's going to the emergency room and I wouldn't say to use OneImaging, of course. but, he's going to have a lot of follow ups. Also side note, like glass half full, I hope he had gotten "and one" at least and, to be able to make the basket. but, but, he's gonna have a lot of pre-surgical planning, post-surgical implants, integrity, probably undergo physical therapy as well. And there's gonna be a lot of imaging along the way over the next few months.

And that's where we really come into, place. That physician will most likely end up ordering that exam and that'll get sent in to us. And if it's not sent in to us, we'll, be notified of, that exam happening in one way or another and be able to actually proactively reach out, with a text and email communication, letting him know that OneImaging, helps provide the radiology benefits coverage for the health plan and to, click this link or call this number to have his care coordinated and to book his appointment.

Okay. And from there, we really take care of the rest and get everything sent over and all pertinent information, we'll do some of those things as mentioned, letting them know, here's what to expect, for your exam. You maybe shouldn't wear anything with zippers, as an example, wear comfortable clothes that don't have, metal eyelets around, a sweatpants, string, for instance.

Things that can streamline that and prevent him from getting that care or any delays. And then go in and get his exam and have a copy of that report because he may need to have that report shared with his specialist who's doing that surgery. And one thing that we're working on for the future that isn't finished yet, but is hopefully going to be a Q2 launch is to be able to share and send and receive and host those images.

So that way his surgeon, for instance, can have access to that. If they need to do surgical planning, they have access to images that they can use right there. And that's, going to really expedite the process and not create any delays, getting disks or anything like that for the surgeon and, be able to get that surgery maybe two weeks earlier, for instance, so he can recover two weeks earlier.

And that's how we think about that.

[00:28:08] Brittany: I'm pleased to note that three surgeries later, he is now, I would say 89 percent back to normal. He won't ever be normal in that knee, just the, complexity of the injury, but we're, we got there. So thank you for that answer.

[00:28:26] Elan: Of course. 

[00:28:28] David: yeah, I, tore an ACL many years ago and that alone was bad enough. I, that just makes me cringe even thinking about that. Yeah, poor guy and probably poor you. I'm sure you had to, yeah, okay. I, like to. When we talk with entrepreneurs, especially, I like to have them pull out the crystal ball. So now is that time, Elan, what are your bold predictions for the digital health space in, let's say, I'd like to say the coming decade, but she's, let's just go three to five years. 

[00:29:09] Elan: I think that the, something that we've heard about is benefits buyers having a lot more, folks reaching out to them than they've had before. I think that there's going to be a stronger emphasis on like the actuarial side of the business. 

And obviously the economy is not quite the same as it used to be, so as we look at it from like a macro view, I think that we're going to see a lot more folks talking about cost reduction. they already are, but in a very, we're going to be asked to do it in a more quantifiable way. So if we're not already doing it, it's, going to be about how that's expanded upon, how we're quantifying it.

We're actually also going to start to see solutions acquire one another or, maybe forced to, we haven't seen that, and a lot of people are talking about that now as well. because I think people are being asked to have more consolidated solutions. So if that's like a hybrid of virtual and in-person care where it was only virtual before or whether that's in person adding virtual, I think there's going to be a lot more consolidation around that.

I think we're also going to see a lot more flexibility with how administrators work with employers as well, since it's so normalized at this point. I think administrators that are most flexible with the employer are the ones that are going to be the most successful. And so those are just two general high, high macro views that I'm, that I think are going to occur, at least in the, foreseeable future.

[00:30:48] Brittany: Melinda, what about you? What are your bold predictions?

[00:30:53] Melinda: It's a great question. as Elan was talking, I think that, just how AI changes healthcare, personally, I just think about how ChatGPT has changed my world in the last six months and the work that I do, and I just have to believe that AI is going to dramatically have some big changes.

I'm definitely not at the center or the expert of that, but excited to see how that manifests itself. I also just think this, need for how we think of how we buy other services, how we procure other services, and how we see more of that in healthcare. I think about just, getting an Airbnb or, anything else that we buy as consumers and how different healthcare is in that.

And, that's one of our goals, and we often make the analogy, is like, when you come to the OneImaging site, we want it to feel like an Airbnb-like experience, where you know exactly what you're paying, you know the, proximity based upon, your home location or where you are right now.

So I hope that we continue to see more, more of that in healthcare where consumers understand, understand what their options are, understand what they can expect to pay, understand what this means in terms of cost and quality, but hopeful for, all of those things to, to make it a better experience.

[00:32:12] David: I'm very hopeful for that too. I think, healthcare has been a big black box for most of us for. it's starting to change and, organizations like OneImaging, you're, helping make that happen. So thank you to both of you. And I do want to thank both of you for sharing your thoughts and all these stories with us today and data, love the data.

It's clear that OneImaging is making some significant, strides in transforming our access to radiology services and for that, we thank you.

[00:32:47] Melinda: Awesome. Thanks for your I appreciate it. 

[00:32:49] Brittany: All right. And for our listeners, be sure to subscribe to Healthcare on the Rocks: Employee Benefits with a Twist, so you don't miss out on more insightful conversations like this one. Thanks for tuning in.