Rae Woods (00:42):
From Advisory Board, we're bringing you a Radio Advisory, your weekly download on how to untangle healthcare's most pressing challenges. My name is Rachel Woods. You can call me Rae. The pressure facing the healthcare industry is just continuing to mount, but in this week's episode, I actually want us to focus on health plans. Honestly, plans can get a bad rap, but I'm not sure that's always fair. The reality is that in 2025, payers are experiencing higher costs due to higher utilization and the rise of expensive treatments. They're also feeling more pressure from the public, particularly when it comes to their transparency and their affordability.

(01:25):
Look, this is a business podcast and we're always here to help our listeners improve their business performance, and to do that in a way that supports their mission. And I would argue that all of these market pressures coupled with rising public scrutiny is exactly why it is so important for plans to get a handle on clinical costs, especially because if they don't and plan costs go up, those costs get passed downwards.

(01:49):
The truth is plans have already done a lot over the years to try to lower costs and improve their performance, and today, we're not going to introduce a new set of strategies, but rather tell plans exactly how to get the most out of the tools that they have to reduce clinical costs, and by that, I mean more than just utilization management. To do that, I've invited three advisory board experts, Chelsea Needham, Morghen Philippi, and Rhea Jain. Team, welcome to Radio Advisory.

Morghen Philippi (02:20):
Hey, Rae.

Chelsea Needham (02:22):
Hi, Rae.

Rhea Jain (02:23):
Thank you.

Rae Woods (02:24):
I want to do something that might be a little bit uncomfortable or maybe vulnerable for me before we get into the details of our conversation. I feel like there's a bit of an elephant in the room. We talked about this when we talked about the policy environment thus far. The truth is the entire healthcare industry is grappling with more distrust in traditional healthcare institutions, and historically, I hope you don't mind me saying, I feel like health plans have actually borne a lot of the brunt of public scrutiny. In fact, even within the industry, plans can sometimes get a bad rap and maybe even be seen as dare I say greedy. But here's the thing, I don't think that that stereotype is fair or maybe if it's even rooted in business realities facing health plans. Level set for me and for our audience, what is the state of the health plan market, and what are some of the big headwinds that health plans are facing?

Morghen Philippi (03:17):
There's a lot of vitriol right now, and I'm going to use the word vitriol. I think it builds on an already not great relationship between plans and members, and like you talked about, other stakeholders in healthcare. Plans are often seen as the greedy ones. I think you nailed it, but this moment is particularly different. You have even more frustration and anger from members and plans are having to deal with that. You also have a time in which plan finances are really not great.

Rae Woods (03:45):
So on the one hand, there's this rising public scrutiny, but we also have to recognize the financial position that health plans are in.

Morghen Philippi (03:51):
Absolutely right. And plans are in a really rough spot, if I'm honest. We had a lot of plans just release their finances, and we're looking at them from 2024. There are at least four Blues plans in particular I can think of off the top of my head that were looking at huge losses. I'm talking about $220 million losses. It's not a small number. It is not a great time in the financial department for plans, and you can think about this of where providers were just a few years ago in the middle of the pandemic in which they really were in a really, really, really rough spot and didn't know what to do. Plans are looking at that now. It seems like it's repeating itself in the plan world, and I would say that there are a few reasons driving that.

(04:36):
So we're looking at some of that utilization that came out of the pandemic, the tail end of the pandemic, I would think about it still hitting plans. High cost drugs has to be mentioned here. GLP1s and other cell and gene therapies, super expensive. Plans don't know what to do with that. It's hurting their finances, and then you are also seeing some of these other advancements all at that same time as the increased public scrutiny.

Rae Woods (05:00):
And I have to say, health plans are a little bit between a rock and a hard place. They've got this really poor financial picture that they have to get their hands around at the same time that the relationship they have with the public is perhaps at a low point. I do want to push here for a moment. Despite those business realities, is this really the right time to have a discussion about how health plans can better manage costs?

Rhea Jain (05:24):
Surprisingly, I'd say yes, and it's because we're really revisiting the entire toolkit. Usually when we talk about cost management, we're thinking about utilization management, and there is a good reason for that since health plans have been relying a lot on UM since it helps them curb costs and see hard savings from it.

Rae Woods (05:47):
Utilization management meaning I am trying to make sure the right people, the right members I should say, get the right treatment at the right time, but not any more than that. So I'm being really careful in making sure that there's prior auths in place and all the tools that health plans use that frankly some people don't like, to make sure utilization is at the right pace.

Rhea Jain (06:07):
Exactly, right. But what they're doing now is thinking broader. So they're thinking about the member relationship, they're thinking about their provider partners, they're thinking about quality in utilization. So along with utilization management, they're looking at strategies like care management, value-based care, wellness programs. And I'd say it's not all about the plan's bottom line. As healthcare costs rise, we've seen a lot of these costs actually be passed down to the consumer, and plans we've talked to in this research want to stop that. A lot of what they're reaching for in their toolkit is to prevent those costs from being passed to employers and members.

Rae Woods (06:52):
Which by the way, would only make the public distrust and scrutiny on plans worse. So there are two big reasons to get their hands around costs. There's the traditional business drivers, and then they also don't want to be in a place where they're pushing those costs onto their employers, their members. And it sounds like what you're saying is utilization management alone isn't going to cut anymore. We have to broaden our aperture.

Rhea Jain (07:16):
Exactly right.

Morghen Philippi (07:17):
Rae, I'd like to jump in here if I can and just say that I think that's a really important point to repeat, that plans are really doing this with the end consumer in mind. Yes, their finances matter too, but it is about the end consumer, that end member and patient. And even in the case of utilization management, they're not, most plans, looking to deny care that people just need to deny it. They're trying to in the end get folks to, as you said, the right care at the right time.

Rae Woods (07:44):
Because they're risk managers. That's what health plans are fundamentally. They are managing the risk of their population pool.

Morghen Philippi (07:50):
100%. And I think that in today's moment, that comes off as really intense, rough abrasion, and it's hard to remember the goal at the end of helping that end member get to really good care at the right time, which is really the goal for all of these clinical cost management strategies that in the end reign in costs for both the plan and the consumer.

Chelsea Needham (08:09):
Yeah, I understand the importance of health plans using utilization management as a clinical cost management tool, but I do think it's important to validate the member's experience with prior authorization and utilization management tools. From that perspective, it can cause tension between the member and the health plan because in some instances, there are and there have been cases where a health plan has either reversed the decision for a member to get care or receive a particular service. And so there is some validation in that experience and I do not think that plans are not aware of that, but it's something that they are looking to be more intentional about moving forward and building that relationship, which is why it's important for them to better understand the other tools available to them in the clinical cost management levers or tools if you will.

Rae Woods (09:02):
I appreciate that you, Chelsea, and you, Morghen, are pushing me to think beyond just the health plan. In this case, you're pushing me to think about the member, both wanting to protect the member from having more costs passed on to them and also validating the real frustrations they have with their experience with healthcare and with health plans in particular. Let's keep pushing beyond health plan. Let's be honest, our listeners are not just payers. Why do other stakeholders in healthcare need to understand what is happening in the plan space and their approach to cost management more specifically?

Morghen Philippi (09:34):
I'm thinking about two big stakeholder groups here. First, providers, and second, professional and managed services or vendors. So first, providers, let's think about the role within this process that they're playing. In the end, plans are mostly paying for care that providers give, and so if you're talking about clinical cost management, it's easy to think, "Oh, plans are just trying to cut money away from providers." That's not what's happening. Sure, that's some of it. You're going to look at things like contracting. It's easy to think UM is just saying, "We're not going to have them get this care from you, so we're not going to pay you providers." But there's a lot of partnership that could happen here too. So value-based care is a clinical cost management tool.

(10:16):
Trying to work with providers, change this entire funding mechanism and make sure care is really high quality and the right care is getting provided in the right way at the right time, but that's a clinical cost management tool. Population health management, care management, also clinical cost management tools that providers are going to care a lot about. They want their patient with diabetes to have well-managed diabetes. Plans want that too. There's room for partnership here.

Rae Woods (10:42):
So what I'm hearing is in general, there is a lot more urgency for plans to first of all focus on cost management, period, but also to expand their aperture and look at other options to manage costs beyond just utilization management. That's not to say that utilization management won't continue, but we've got to look at other tools in our tool belt as well. If that's the case, are you here to tell us that there are new effective approaches that you've found in your research that we need to tell folks is the new approach to clinical cost management?

Chelsea Needham (11:13):
I think the answer to that is absolutely no.

Rae Woods (11:16):
Oh, no.

Chelsea Needham (11:19):
There is nothing in this space that's necessarily new and going to solve any health plan's clinical cost management problem, and I don't think we need to be looking to any new and shiny objects in this space. What we need to be looking to is better utilizing the tools that we already have, understanding some of those other levers like care management, like employing wellness programs that may address social determinants of health, and really understanding how to leverage those tools to better inflect costs.

Rae Woods (11:48):
Okay, this is intriguing me. So it's not that we're going to be debuting new tools. It's that plans need to do a better job of deploying the tools that they already have. I have to ask, why do plans struggle with that today?

Chelsea Needham (12:03):
There is really so many things that cloud clinical cost management strategy for health plans, and one of the reasons is there are really so many things that they could run at, that they could tackle. If you think about all the clinical cost problems that they have to balance, whether that's utilization, whether that's different disease states, they could really employ their strategies in so many different ways. And so the hard part is understanding, what are the actual problems that they have that are specific to their health plan, but then also understanding where they can actually drive change and better manage within those problems that they have at their health plan.

(12:43):
But then secondly, they have to understand what actual solutions in their toolbox are going to work well for their specific problem. So it's becoming and gathering a better understanding of what's unique to their health plan and not just trying to run at where they're seeing across the industry higher cost trends, but really understanding what's unique to their health plan and having the data to support that.

Morghen Philippi (13:08):
So I actually think that there's an analogy here when we're thinking about the problems and how to pick the problems and then how to address them. I think you can think about an old house. I actually live in an old house. There are 5 million projects I could work on at any given time, and so step one is being like, do I want to redo my floors or do I want to redo my bathroom? My counters are really old. Any of these are an opportunity, and if I try to do them all at once, I won't do them well. So first, pick what you want to do, and then I get to that bathroom and I'm like, "Okay, what tools do I even need to address this problem? And then how am I going to do this really well once I decide those tools?"

Rae Woods (13:44):
Or what's going to give me the biggest bang for my buck when I resell my house or whatever, if I continue to twist this analogy.

Morghen Philippi (13:50):
A hundred percent, a hundred percent.

Rae Woods (13:52):
I can totally understand that with so many opportunities on the table, it can be hard to figure out where to start. But if I put my provider hat on, one of the criticisms, somewhat valid, is that providers say, "But wait a minute, you have so much data." Why is this still so difficult to pinpoint the biggest cost opportunity and the most inflexible cost opportunity?

Morghen Philippi (14:14):
I think that's a fair criticism and I see why that is the perception in the market. I would say two things. One, though plans have a lot of data, it takes a lot of time to get that data, so claims data is pretty slow. There's a lot of data that is just not real time, and so plans sometimes feel like they're being reactive and trying to figure out what their problem was. Where's our real time data? That's in process for a lot of plans. The second thing is sometimes I think it is so much data that it's debilitating.

Rae Woods (14:45):
Yes.

Morghen Philippi (14:45):
And so how are you going to go through all these filters? What questions are you going to ask? Your data team could spend seven years asking questions about the same dataset, because there is so much data.

Rae Woods (14:56):
And by the way, that's something that providers listening can absolutely empathize with, the amount of data that they have that isn't actually usable.

Morghen Philippi (15:02):
For sure, and so how are you making sure you're asking the right questions to figure out what your problems are? That's a really big ask.

Rae Woods (15:08):
And I know that Chelsea said that what plans find might be individual to that health plan, but I have to believe we can help a little bit here. What kinds of cost opportunities are our listeners most likely to find?

Chelsea Needham (15:21):
It's difficult to answer because it's going to vary depending on where a plan is located, how big their plan is, what their membership population looks like, potentially what line of business that health plan is in, whether they're a Medicare advantage plan or Medicaid plan. As an example, I know of a health plan that deals with a large membership that has substance use disorder, and so they found that that population was seeing higher utilization in the emergency department. And so with the data that they had, they were able to see that correlation between their membership and their utilization, and they were able to scope that as a priority population to inflect change and lead initiatives to help better manage that population. So that's just an example of having the data, understanding what's happening with a specific population, and then subsequently leveraging that data to inflect change in a population.

Rae Woods (16:17):
I'm a little bit surprised that you mentioned substance use disorders as a primary opportunity, which I think speaks to the fact that there are differences plan to plan. What advice do you have for our listeners to actually go about capturing that data, cleaning it, finding those areas of opportunity because we know it may be so different plan to plan?

Chelsea Needham (16:37):
One of the things that we have increasingly been seeing is their implementation of total cost of care teams, and this is something that as a health plan, at this point, it feels absolutely necessary. These total cost of care teams allow health plans to be able to not only align on opportunities, but really to look and understand opportunities from their assessment of what's happening with the data, but also to create a roadmap for the organization to ultimately tackle where they're seeing those cost drivers. Not only does it help to identify some of the cost opportunities, but it also allows for a deep dive into all of those areas that are often hidden in so much data that health plans have, and really just allowing the health plan to define their final priorities and commit to those opportunities.

Rae Woods (17:32):
Are these total cost of care teams common?

Chelsea Needham (17:35):
They used to be more common pre-pandemic, and then when the pandemic came around, a lot of health plans restructured and reorganed so they weren't as common. And now post-pandemic, as we see utilization drive back upwards, we're seeing more interest in developing some of these total cost of care teams as well as other cross-functional teams that are focused on monitoring cost trends that are specific to their organization.

Rae Woods (18:03):
And focusing on making the most of their partnerships with other stakeholders in healthcare to manage value-based care, which Morghen said is another urgency driver here.

(19:54):
So let's say you've got the team, you've managed to get the right kind of data and you've identified the right opportunity. That's actually only half the battle. What can plans actually do then that's outside of traditional utilization management to bring costs down when they've identified and prioritized the right area?

Morghen Philippi (20:15):
Yeah, what I think you're getting at, Rae, is how do they choose the right tool? I would say that they need to be thinking really diligently, and that's not to say that plans don't think diligently, but I think they need to really write it out and do some hard calculations and almost make themselves a score sheet, and they should be evaluating each of these tools on three things.

(20:34):
So first, obviously ROI, is it going to pay off? Is it the right tool for that? But I think there's two more that are sometimes forgotten or seen as less important and they need to be important in this moment. One, what does that specific health plan care about? So for example here, you can talk to a health plan that is in a very isolated market and their provider networks are very limited in their options. Anything that is going to really be abrasive to those providers is off the table. They're going to say, "We need to deprioritize those levers and really prioritize ones that really embrace our provider relations." The third piece that is huge in this moment, and we already talked about it, plans should be evaluating these levers on likeability. It is a moment in which they really, really, really need to pick likeability with members and providers, which we already hinted about with that number two. What your plan thinks and cares about right now should really be likeability.

Rae Woods (21:30):
This feels really familiar to conversations that we've had on this podcast before about the employer market, that employers have a set of tools they can use to manage their own costs, their own rising unsustainable costs, but they also have to balance not pissing off their employees. And it's actually really hard to think about benefit design while also managing costs, and that feels very similar to this conversation.

Morghen Philippi (21:53):
Very similar., Rae, And I would say you can also see in the employer market times where likeability is more important and less important. Think about when the labor market is tight versus not, this is a moment for plans in which likeability is really important.

Rae Woods (22:06):
And I appreciate that you're pushing for more precision in how you actually deploy the tools to reduce costs, but I don't mean to be too basic here. What actually are the tools? There's this set of tools that are around traditional utilization management. The other one that I've heard you say is more around care management and population health. Are there other kinds of tools that we need to describe to our listeners?

Chelsea Needham (22:33):
So utilization management is one of several tools within a clinical cost management toolbox. So you could think of utilization management, okay, that could be your hammer or you could think of care management to be your wrench, and then you could think of benefit design to be a screwdriver, and then referral management, then SDOA services, wellness programs, all of these are different tools within this greater clinical cost management toolbox. So utilization management is just one tool of many tools.

Rae Woods (23:04):
And then what does best in class implementation of all these different kinds of tools actually look like for plans?

Chelsea Needham (23:12):
That's the million-dollar question.

Rhea Jain (23:14):
I'd say it looks like three things. Number one, I would say don't reinvent the wheel. See where you can be a partner or a resource and supplement existing efforts that providers are already doing on things like care management.

(23:31):
Number two, you have to start leveraging technology where you can. We know that plans are increasingly stretched thin and they need to use their resources wisely, so to do that, you really need to start looking at how tools like AI can reduce your admin burden while allowing you to also expand your reach and achieve scale.

(23:54):
And then number three, I'd say data is key. Proactively setting a plan to track and evaluate the metrics that can show the value of your initiative. So I think organizations that do this well are good at showing the ROI of their cost management strategies, having regular proactive communication with their IT and their data teams so that down the line you can really actually measure the impact, whether you're looking at things like changes in cost or quality or utilization.

Rae Woods (24:30):
You just said ROI, which totally triggered me to thinking about the dozens of conversations I have with population health leaders that actually really struggled to show a clear ROI sometimes for their care management programs. Or they can show maybe cost reduction but not quality, or they can show things like closing care gaps or those leading indicators, but financial ROI just takes a lot more time. And now, we're suggesting that plans do some of this care management as well and support with and partner with providers. What advice do you have for plans to do this well, and is there anything that maybe they can learn from the providers who've been trying to do this for some time?

Rhea Jain (25:10):
So just like you hinted at, cost savings is important to prove but it's not the only metric of success for plans. One CMO that we spoke to actually framed it as ROI cubed, which means that as a health plan, they're looking at ROI as cost, utilization and quality. And oftentimes, I think with care management, those things really do go hand in hand.

Rae Woods (25:34):
And I'm assuming that utilization is probably an earlier indicator, then cost, then quality.

Rhea Jain (25:40):
Right, exactly right. And I think plans can learn a lot from providers about care management, and I think in fact, to do care management well, plans should not be reinventing the wheel but actually going back to the basics, and to me, that means two things. Plans can be most effective by just actually filling in the gaps for providers. So go to provider groups and understand, where do they need more resources? Where can you as a plan be most meaningful in care management?

(26:13):
Number two, focus on the relationship. Ground your efforts in your members' health goals. We know that a lot of people don't want to hear from their health plans, so you have to put in a lot of effort to become a trusted partner. Don't pick up the phone and ask 10 to 20 questions right off the bat about your member's hypertension, but instead, start with how can we help? And then go from there.

Rae Woods (26:38):
I think the messaging actually really matters here, messaging to members and messaging to provider partners, because with the provider partner at least, the goal is actually the same. We want to help you do care management in a way that is more successful. That actually helps both business model. And also it matters to message to the end user because we're in this moment of deteriorating trust, and if that member or that patient doesn't trust that you've got their best interests in mind, no one is going to get the positive outcome that we're looking for.

Chelsea Needham (27:12):
One thing that I think is important to mention as we talk about all of these tools, whether we're talking about care management or utilization management, is that the first goal is not to just save money. The first goal should and has always been to provide care to members and to improve their care and improve quality, which ultimately leads to more efficiently spending your money. And so that leads to savings when you can better manage the care for your membership, and so that is the first goal, and I think we just have to keep that in mind that we're not doing this to save money. We're doing this because we want to improve the health of our membership, and ultimately, that does drive cost savings as well. So just putting that at the forefront.

Morghen Philippi (28:06):
I actually think this brings us to something that we're seeing in plans, and that's this almost marrying of UM and CM. And so plans know that they're not doing UM well, we talked about this earlier, and they know that care management is likeable, that there are new ways to do care management that are paying off and that it's a good option. And so there's a way for plans to make UM and CM better work together that gets those members to that high quality of care that is more palatable and really works with those providers.

Rae Woods (28:39):
And if they do that, like Chelsea said, one of the goals is that they're going to see better cost management, but that's not the only goal. So what kinds of metrics are health plans likely to see if they do this well?

Rhea Jain (28:50):
I t hink we can think about it in three categories. First, there's strategic alignment. If you're able to understand and prioritize your utilization hotspots, everyone across your plan better understands your goals. You're frequently updating your priorities to account for changes in the market, and everyone can do their job better to think more strategically across the organization. And that leads into the second advantage, which is competitive advantage in the market. So doing this well means you have a unique strategy that sets you apart from other plans, and you'll really benefit from communicating that unique strategy to your provider partners, your vendors or other stakeholders. And then of course, there's cost management, which is a huge advantage. If you do this well, you'll know which strategies work for you and which ones aren't working. You can evaluate the ROI cubed of your technology and your other investments and then know where to continue to invest.

Rae Woods (29:51):
I appreciate that throughout this conversation, we've been talking about how health plans can make the most of the tools they already have to identify the biggest area of opportunity and deploy the right kinds of solutions that reduce costs in a way that supports their mission, that supports their members and supports their provider partners. If that's the ultimate goal, what do you want our listeners to do right now to help them advance towards this solution?

Morghen Philippi (30:17):
Honestly, Rae, I would start by having the folks who are driving these decisions stop. I know it's hard to make time in your day, but stop, even for 15 minutes, and write down how you think you're doing this right now. How are you doing CCM? How are you doing clinical cost management? Because you might be surprised that you're skipping some steps. They are not actually looking really diligently at what is my problem, what is the tool I'm using and how am I going to implement it? And just stopping and pausing to think, "Okay, how am I going to do each of those three steps? Who am I going to talk to? What tools am I using? What problems am I having?" I think sometimes we get lost at that high level view and we're just going along and there's burning fires everywhere. Just taking a minute and stopping to ask those three questions.

Rhea Jain (31:01):
And don't work in silos. To do this, you really need to pull all of your experts together, pull different teams together to look at total cost of care strategically. So you need to have your data and analytics team working together, your research and expertise team, and you as the CMO need to pull all of these people together and be the strategic thinker.

Rae Woods (31:26):
Well, Chelsea, Morghen, Rhea, thanks so much for coming on Radio Advisory.

Chelsea Needham (31:31):
It's been fun. Thank you, Rae.

Rae Woods (31:39):
Look, I know it can be frustrating that sometimes every Tuesday, I'm telling you to do something that's different. The good news about this week is that you actually already have the tools and the abilities to do clinical cost management well. It's just a matter of deploying those tools as effectively as possible and making sure that you're keeping your member, your partners, and your business all at the center. And remember, as always, we are here to help.

Abby Burns (32:12):
Hey, this is Abby Burns. Here's what our advisory board research team is watching this week.

(32:20):
The Department of Health and Human Services issued layoff notices to 10,000 employees across several agencies last week as part of a broader reorganization that will have widespread impacts across the department and the healthcare industry more broadly, including public health and medical innovation. This round of layoffs wasn't the first for HHS this year, and it likely won't be the last, since the department has said it plans to reduce its headcount by about 25% or 20,000 people total.

(32:47):
You've probably heard by now that the FDA and the CDC have been the agency's most affected. Each has lost about a quarter of its workforce so far. Across both agencies, the restructure included removing or forcing out several individuals in leadership roles across offices like the Center for Biologics Evaluation and Research at the FDA, the Center for Forecasting and Outbreak Analytics at CDC, NIAD within CDC. That marks a lot of institutional knowledge walking out the door. It also targeted administrative staff that are critical to FDA and CDC fulfilling their functions on a daily basis and communicating with the public.

(33:25):
At a high level, these layoffs are going to affect our collective capacity to do things like collect, interpret and act on public health data, evaluate and monitor food, drug and medical device safety, bring new drugs to the market. On a day-to-day, we can expect it to be a lot harder, slower, and frankly, more confusing to try and work with these federal agencies.

(33:50):
One specific example I think is helpful to get a grasp on both the near term and long-term impacts is around FDA user fees. The FDA process for reviewing drugs and medical devices is funded and operated on a system of user fees. I'm not saying that's the best method. I'm saying that's how it works. Staff that negotiate and process those fees have been affected by the layoffs. That means the review process for certain drugs and devices will necessarily slow down and risks grinding to a halt, which means frustration for manufacturers near term and slower speed to market for things like drugs, starting now and looking into the future.

(34:31):
We're recording this on Friday morning, April 4th, so it's very possible that more has happened here in the meantime. We're keeping an eye on layoffs, potential reinstatements, and the broader HHS restructure. If you're interested in hearing more about the short and long-term consequences of the department shakeups, let us know.

Rae Woods (35:12):
New episodes drop every Tuesday. If you like Radio Advisory, please share it with your networks, subscribe wherever you get your podcasts and leave a rating and a review. Radio advisory is a production of Advisory Board. This episode was produced by me, Rae Woods, as well as Abby Burns, Chloe Bakst, and Atticus Raasch. This episode was edited by Katy Anderson, with technical support provided by Dan Tayag, Chris Phelps and Joe Shrum. Additional support was provided by Leanne Elston and Erin Collins. We'll see you next week.