Rae Woods (00:02): From Advisory Board, we are 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. Abby Burns (00:13): I'm Abby Burns, joining today as co-host. In the first episode of this year, we talked about the vertical integration that's been happening across the healthcare industry. We've talked about how players from plans to big retail to private equity have been buying up assets that really span the care continuum. We talked about how they're buying pharmacy assets, home health, primary care, specialty care. There's one important omission from that list. No one was buying hospitals. Speaker 3 (00:41): The phrase hospital-less ecosystem is a thing you hear in healthcare for a reason. Speaker 4 (00:46): Some of Optum's acquisitions of Kelsey-Seybold and Atrius, those are so in line with their ambition to build a hospital-less IDN. Speaker 5 (00:52): There kind of aren't any hospitals anymore. They're all health systems, right? Speaker 6 (00:57): I just want to know why you guys don't own hospitals. What's wrong with that? Speaker 13 (01:02): You are the one person on this stage that is burdened by a hospital. Yes. Speaker 6 (01:07): Yes. Rae Woods (01:14): I listened to that clip, and I got to say, I stand by what we said at the time. But our savvy listeners will know that something has changed. People weren't buying hospitals, at least until now, in January of this year. (01:30): General Catalyst, which is a venture capital firm, announced that they plan to acquire Summa Health, which is a hospital-based health system in Northeast Ohio. And immediately, this raised a bunch of questions for me. It raised a bunch of questions for you too, right, Abby? Abby Burns (01:45): Yep. Rae Woods (01:46): And I think we need to talk about it on this podcast, and frankly, talk about whether or not we were wrong to say that no one is buying hospitals. Abby Burns (01:54): Yup. And, Rae, I think we should bring Vidal back to have this conversation. Vidal is not only our hospital and health system expert, he's actually been on Radio Advisory before, talking about the growing role of private equity in healthcare. Rae Woods (02:08): Yeah. I completely agree. Let's bring Vidal back on. (02:11): Vidal, welcome back to Radio Advisory. Vidal Seegobin (02:14): Hello. Abby Burns (02:15): Hey, Vidal. Rae Woods (02:16): You are going to join me and Abby to work through our reactions, what we've read, what we've learned, to figure out, what do we do to make sense of what's been happening in the news. Vidal Seegobin (02:28): I'm excited to try to read some tea leaves and maybe hopefully make someone a little bit more insightful for listening to us. Rae Woods (02:34): Yes. (02:35): Maybe we should start with what's actually happened. Vidal Seegobin (02:38): Sure. I can give you a top line. So General Catalyst, which is a venture capital firm that invests in healthcare, has announced that they are going to acquire Summa Health, which is a health system, with a provider sponsored health plan that operates in Ohio. And the intention there is to, as their press release state, to accelerate value-based care adoption and performance, and likely a whole host of other factors that we're going to try to game out and debate over our time together. Rae Woods (03:13): And I saw this headline too, a couple of weeks ago, at least the specifics around Summa. And I'll admit, my reaction was... I think I went [inaudible 00:03:23]. Abby Burns (03:24): I forwarded the headline when I saw it in my inbox immediately to Rae. I was like, "Have you seen this yet?" Rae Woods (03:31): Well, because we realized we needed to do an episode on it. But honestly, I shouldn't have been shocked. I had kind of forgotten that they had teased this a couple of months ago, right? Vidal Seegobin (03:43): Well, I would say I was shocked, but for a slightly different reason. I was expecting there to be a longer timeline between the announcement of their intention to an actual name. And so I was a little caught off guard on that respect. Rae Woods (03:55): Because they announced their intention in October of 2023 at HLTH, on stage, and I think they were trying for that kind of shock value then. It didn't work on me at that time, because for me I went, yeah, well, we'll see what it actually happens. Abby Burns (04:14): You were skeptical it was going to happen. Rae Woods (04:16): I was skeptical. I was skeptical. So maybe you're right, Vidal. The speed was definitely an indicator there, October to February. Vidal Seegobin (04:24): For sure. Abby Burns (04:25): I'm wondering, Vidal, were you surprised to see that it was Summa? Obviously, as our managing director over health system research, you know the health system landscape quite well. Vidal Seegobin (04:37): Interestingly enough, a lot of the research we've been debating at the Advisory Board over the last two to three months on health system growth has really been oriented around state dynamics. So we were trying to think of, was it going to be North Carolina? Was it going to be South Carolina? And so, those were the debates we were having. (04:53): I will admit that I totally missed the boat on looking at the Midwest, which would be a major error and oversight on my part. And I think we'll talk a little bit more, the more that I dig into the details here, the more I think it's a really, really smart play. Rae Woods (05:07): Do you think the location matters, the fact that it's Ohio matters, or were they looking more at health systems that, to your point, have a provider arm and have a health plan arm? That was more of where I would be narrowing down. I don't know that I would've thought about which states would they look at. Vidal Seegobin (05:26): So here's the reason why. When you're researching, you get kind of preoccupied with certain components and you start to dig in really deep on that. I've been just really taken back by how much demographics play a role in terms of market growth, market projections, particularly as it influences in-patient, outpatient shift. And there's just a general kind of number of people who have commercial insurance, versus are covered by public insurance models. So that's just largely where my brain has been and where the debates have been. Rae Woods (05:55): And that makes sense then why you were thinking North Carolina, because there's a huge- Abby Burns (05:59): And growing. Rae Woods (06:00): Early Medicare population there. Yeah, not the old old, the I've just aged into Medicare, I'm doing my early retirement fun in the sun, maybe not so fun as wanting to go to Florida, but I'll be in North Carolina where obvious. Abby Burns (06:13): Yes, exactly. My current home state. Vidal Seegobin (06:16): Nice. Rae Woods (06:16): This was kind of our reaction was, at first, a little bit of, maybe shock is too strong of a word, but it at least caught our attention, which, let's be honest, that was the intention. The intention was to catch everyone's intention. And then as we started digging into things, we started to connect the dots and things made more and more sense, which I want to talk about in this conversation. (06:36): But before we get there, what's been the market's reaction? Vidal, you're the one that's actually talking with health system leaders. What have they said in the week since the announcement? Abby Burns (06:48): I'm also glad we're having this conversation now because it's been about a month at this point since the announcement was made. So I think the first week or so, I was seeing all the same information kind of parroted in different sentence structures. So I'm curious to get your thoughts now that a little bit of dust has settled. Vidal Seegobin (07:05): So I would say that the kind of on the ground health system executives that I'm talking to are not really focusing on it on a too detailed fashion. I think part of the reason why is just all the things that we were talking about earlier, Rae, about health system performance and trying to get their house in order. So maybe there's not been enough time. Abby Burns (07:25): They have enough on their plates? Vidal Seegobin (07:27): Yeah, to think about things that are happening into the future. (07:29): And I also think, part of maybe a bias that I am carrying is, having watched these moves and these announcements in a number of years, there is still a, okay, your announcement was faster than I expected, but there's a whole bunch of other hoops you've got to get through, and the actual performance is going to be important. So this story still has a lot of legs to it, so let me just wait a little bit- Rae Woods (07:51): And you're right about that kind of initial gut reaction versus then the deeper analysis that comes. I will admit to the two of you that I was giving a couple of kind of big presentations on the state of healthcare to different groups of executives, right when this announcement happened. It's important for us to stay on top of the news so that when we have those conversations, we know what we're talking about and can reference the latest things that have happened. Abby Burns (08:17): But one of the other reasons that I was interested in getting your take on what the market's reaction has been is there's been a lot of, maybe consternation is the right word, maybe not, about PE firms buying assets in healthcare. And specifically, there was a recent study released around when a PE firm buys a hospital, how does that affect quality? I have some thoughts about the methods of the study, so I don't know that we can take it in one broad brush. But has that been any of the conversation when folks are clued into this? Rae Woods (08:50): Yeah. The pushback almost. Vidal Seegobin (08:52): So, the one thing I will say is, over the last two years, health system leaders or this VP level have become much more aware of the dynamics and behaviors that animate private equity behavior. So more people will tell you, yeah, they're just in it. They'll turn it around or cut costs in five years and then they'll spin it off. And I think there is, at least in some of those cases where the private equity firm has intervened and you've seen lapses in quality, I think part of that is attributable to changes that have happened in staffing mix and just general staffing levels. (09:26): The thing I would just caution, just to be a fair advocate for what the truth is right now, all health systems are seeing flagging quality levels, both in terms of hospital acquired infections as well as patient falls. So I wouldn't cast the very evil breaststroke on private equity firm as doing this every single time, when there's a system-wide problem or a sector-wide problem right now on that. Rae Woods (09:51): That's one of the... I like that you said the phrase, adding this evil veil that we have talked on the podcast before, is inaccurate when it comes to PE. (10:01): The other one that I'm hearing about now is in the context of, Summa will be changing from a not-for-profit health system, to a for-profit entity under this. And again, I think very unfairly, there's this veil that protects unfairly not-for-profit health systems, that of course need to still make money, and an unfair veil that kind of criticizes for-profit health systems that continue to provide high quality patient care. That's the other one that I hear. Abby Burns (10:31): In other words, necessarily casting not-for-profit hospitals as the good guys and for-profit hospitals as the bad guys. Rae Woods (10:37): Yes. Exactly. Vidal Seegobin (10:40): I think it's a great push. I think we chatted a little bit about, does the change in or intention to change designation from not-for-profit to for-profit meaningfully indicate any disruptive or significant changes in terms of what we could potentially see into the future? And obviously, I'm not a lawyer nor have not dug in too deeply in terms of what this could potentially mean, but my general sense is that, a for-profit status probably gives you more latitude to raise funds through multiple different channels, which I think a venture capital firm would probably want to enable. It probably gives you more latitude on the financial engineering side, if you imagine anything spins out from this initiative, which again would probably just give you more degrees of freedom to pursue any options that come out. And that would be my read, which doesn't seem, again, necessarily bad on the surface, just to reiterate the point that we were talking about earlier. Abby Burns (11:35): The other thing I would point out is, one thing that General Catalyst has said publicly is that, well, typical private equity deals might have a five year, a 10 year time horizon. They are not coming into this deal with that in mind. This is a long term play. So that's another differentiator. (11:52): And I think one thing that kind of shows this is the ethos of Silicon Valley is, move fast and break things, which is 180 degrees away from how healthcare works. General Catalyst kind of put their own spin on that and they have moved intentionally and built things, which I think is a lot more palatable to, specifically, health systems. Rae Woods (12:15): Yeah. A lot more palatable, a lot more realistic, a lot more true. Vidal Seegobin (12:21): Yeah. The other thing that I think came out of, at least, if you want to cast a critical eye to private equities, interactions with healthcare or investment in healthcare, there was a penalty that the tourists played who tried to jump into healthcare without the deep expertise and knowledge that's required to be able to navigate the regulatory, the payments, the expertise that kind of codify or just kind of characterize the industry. Our conversations with everyone in General Catalyst tends to show that there's a deep level of expertise and respect for healthcare and why things are the way that they are, even if they are trying to disrupt and change it. Rae Woods (13:00): Well, and deep respect, I will say, for Marc Harrison. I don't want to discount the kind of Marc Harrison of it all in this conversation, because, you're right, when the tourists come in, there's this moment where the incumbents kind of go, yeah, bring it on. You try to do what I do, you see how hard it's going to be, and I don't want to discount that we are talking about someone who has led efforts, not just at Intermountain at the Cleveland Clinic. He has an exceptional career in healthcare. I don't think that we should weigh the success or failure of this deal purely on one person, but I also don't think that we can ignore it. (15:12): I do want to talk about what's next. So we've kind of gotten this initial reaction, and the reaction as the dust has settled, and now we're starting to see more meaningful predictions, more attempts at reading the tea leaves in terms of what this could actually mean. And I will tell you, there is one overwhelming narrative that I hear, which is, this is just a value-based care play. One, is that true? And is that it? Vidal Seegobin (15:41): It's a great question and one the team has been trying to debate as much as you can. If you were to take a step back and abstract out, what are the key components and building blocks that you'd want to have in place in order to really accelerate performance and adoption and value-based care coming out of a health systems perspective, you probably would want to see all of the pieces that Summa has. We talked about a health plan. We talked about a relationship with doctors. We're talking about a pretty well run, not over capacity in-patient model. So all of those pieces in and of themselves make sense. (16:18): But I also want to be honest that we've been talking about value-based care adoption for the better part of a 10, 12 years, and it is not a simple thing to do even when you have the building blocks. So I think that there is obviously one world where General Catalyst, with Marc Harrison, with all the building blocks, with the backing of capital, and with the right suite of technology, can really make or break through this next jump barrier that's been keeping more health systems away from seeing value-based care as a bigger part of their business and their revenue stream. I think that's the hardest of the options you could imagine. Rae Woods (16:55): Really? Abby Burns (16:56): You're saying that you could see if General Catalysts, or I guess we could narrow it to HATCo, if HATCo's experiment essentially with Summa, intentional experiment with Summa, is successful in moving this health system further toward value-based care, that could have a ripple effect on encouraging other health systems to move further into value. Am I hearing that right? Vidal Seegobin (17:17): So that's an interesting question, and I think that I'm of two minds of that question, because I think part of it is, if I said earlier that the building blocks are critically important to generating the kind of outcome, if you don't have the building blocks, then does that mean that it is actually replicable? So that's part of the interesting part of it all. So is this a bounded experiment that actually proves the point that, only with all of these elements, can you do it? Or is there something translatable that is portable and movable to many different markets? That I think is also really, really hard to do. I think that's why Risant was in the news and out of the news. Rae Woods (17:56): I was just going to talk about Risant. Yeah. I mean, that seems to me as the most direct comparison to what we're seeing here, which is, let's try to take an organization with the building blocks of value-based care, and try to push for more scale, and do it in a way where we can have an influx of capital, we can have sharing on the backend and revenue cycle and all of that stuff. How do you compare what's happening with Summa to what's happening with Geisinger and Kaiser vis-a-vis Risant? Abby Burns (18:29): Good question. Vidal Seegobin (18:31): We were chatting a little bit about running some of the numbers between looking at Geisinger, Intermountain and Summa, and I think, generally speaking, all of the kind of building blocks you'd expect from either of these health systems kind of remain true. In terms of bed occupancy rate, they're pretty close. They all have... Well, Geisinger and Summa, their dominant payer is their provider sponsored health plan, so that's a good indicator as well. And you're generally seeing still pretty dominant in-patient revenue that make up how they make their money or their direct patient care revenue. (19:08): So generally speaking, they seem to be pretty comparable on some of those superficial metrics. I think part of the dynamic with Risant is, I've been waiting for, and maybe this is going back to the earlier point that we were making about the announcement, I've been waiting for more people to say that they've joined, right? Rae Woods (19:26): Yeah. Oh, yeah. We're all just kind of like, what is this going to be? Abby Burns (19:29): We have the first mover. We need the second mover. Vidal Seegobin (19:33): Right. Whereas I think the Summa situation feels like much more bounded and controlled. And I think there's also... Again, you said, Rae, not to overestimate the Marc Harrison part of the equation, but I also don't want to underestimate the Marc Harrison part of the equation. So there is probably a reality where Marc Harrison, who's a talented executive with an exceptional pedigree, with the right building blocks, with the intention and backing of a venture capital firm that wants to make this financially as well as performance successful will drive success. But I think, again, it all breaks down to whether or not that's replicable or not, or do they build a playbook that they can scale and do over and over again? And I don't know. Abby Burns (20:16): And to your point, Vidal, in a given market, with the right conditions. Rae Woods (20:20): I mean, hold on, value-based care can't be the answer, the path forward. We said, that's the kind of common language that's been reverberating in the weeks since the official announcement. But is there another scenario that could be possible for what the ultimate business goal actually is here? Vidal Seegobin (20:39): So the one that I like more, because I think I can see many different ways that this could become the reality, is research from the Advisory Board has talked about the challenges around adopting and rolling out technology based changes in the in-patient side. For a whole host of reasons, large enterprises are usually really change adverse and particularly technologies feel more disruptive than they do feel additive or helpful. (21:07): But General Catalyst has a pretty solid suite of technologies that I would imagine can be trialed, experimented, and then shown to have ROI because it's been applied in the real world setting, that you could then prove to others, we know not only that it works, but how to run it and adopt it in your system quickly and effectively in partnership with your clinicians. I think that that's a very, very powerful additive tool and clarity, if you're trying to spin out or get adoption behind these technologies. Abby Burns (21:39): And I would say, General Catalyst also has a network of health systems that they work with, that's intended to be a kind of sandbox. I think they have 20 systems, and they range from for-profit to not-for-profit, academic, international. They do run the gamut. So there's also a chance to potentially export what you learn in a proof of concept, okay, let's test it out in other parts of what is a controlled sandbox. Vidal Seegobin (22:06): You actually have two concentric circles. So you've got the Summa testing environment, and then you've got the next wave of partners as a beta test, and then you can then roll it out in a third wave. I think that would be very interesting and very plausible world in which we could operate in the future. Rae Woods (22:21): Which perhaps, again, speaks to the fact that we shouldn't just lump General Catalyst as any other PE firm, or that they're not going to take the same kind of model of, let's come in, cut costs, focus on getting to profit, sell, move on. Vidal Seegobin (22:38): I was going to say that there's a third weird option that I would say, which is, we talked earlier about shrink to grow, which is oftentimes disproportionately focused on the shrink part. Rae Woods (22:49): If you don't know what Vidal is talking about, you need to go back to his episode from earlier this year, which was terrifying and also excellent, in terms of what the future of health systems needs to look like in this moment of us saying, actually, the growth path might need to be smaller. Vidal Seegobin (23:05): So I also want to give the entire pedigree of, or back bullpen of former Advisory Board researchers who've said for a number of years that, the structural situation for hospitals and health systems has been very, very challenging, and will only get more challenging if you don't make moves. I think COVID-19 only put gasoline on that fire, and now we're finding more and more health systems who are underwater, even if the situation feels a little better, which is to say, structurally, we may not be able to operate under this historical, large fixed cost base, low margin business. So things need to stop. Cost needs to be rebased. And we may need to stop doing things. So that's that idea of shrinking in order to grow, right? (23:49): And I wonder, when we know that we are a labor addicted part of the industry, healthcare is labor addicted, and we've got these technologies which, if run effectively, can offload tasks, could shift tasks, could make the composition of my work much more top of license, and if you have the technology that's been developed by General Catalyst, you use it in HATCo by embedding it in the in-patient model, in the health system model, or in the health system world, could you then do what we've always hoped we could do, which has never seemed to be possible, which is to see real productivity gains or real, a top of license work in using technologies additive to the work team as opposed to something that we just have on the side of the desk or becomes disruptive? So it becomes a world where we rebase the cost safely with technology. Abby Burns (24:47): And by the way, I don't think you can get away with doing that, as a not-for-profit health system. Rae Woods (24:52): Not to the level that you're describing in your kind of wild thought. I think the for-profit status perhaps protects them a little bit there, if that's the path. (25:03): I want to ask the question that's perhaps on our listeners' mind. So we've been saying for years, on this podcast and that Advisory Board, that when we think about how consolidation is going in healthcare, how vertical ecosystems are growing, the assets that they're acquiring, hospitals have always been at the bottom of the list, or have just not even been on the list at all. Given what we've seen with Summa, even with Risant, do you think that that is going to change? Are people going to start buying hospitals now, or maybe even only a certain kind of hospital? Vidal Seegobin (25:38): So it's a great question and let me just start at least with what the data is showing. So mergers on the hospital and health system side have been, it could generally kind of flat, but are increasing compared to where we were in the pandemic period, and that actually makes a lot of sense. But what we're finding is, disproportionately, one of the partners or health systems in the merger equation are a distressed asset. And so part of what we're seeing is, bigger health system is acquiring a distressed health system, I think with the intention to at least rightsize the ship, improve performance or maybe shunt out certain services or parts of the business that no longer are fit for purpose. (26:24): Now, we also know that mergers very rarely return on the kinds of quality and financial outcomes that they're intended to do. So I'd say, first, the question, I will expect to see more mergers this year on the health system side, because there are people who either have some potential financial latitude and are perhaps ready to sell. Abby Burns (26:50): So you're saying, hospitals will continue to buy other hospitals? Vidal Seegobin (26:55): So that's what we're seeing right now in the market. But they also want to overlay the fact that we are still in a world where the FTC is playing a chilling effect on big mergers in general. So there's the part of the intention which is, there are assets that are up for grabs that I think people who are savvy and smart and are looking for the next way to grow inorganically have some things they can pick from. But then they also have to triangulate that against an FTC, which is like, wait, why are you doing that? What's going to be the impact? What's your overlay in-patient populations? So it's a hard question. I'm just basically laying out the tension, not really giving anyone an answer, which I apologize for, but I don't want to lie to anybody. Rae Woods (27:39): But I'm not sure that our logic is incorrect. We're not sitting here going, we were wrong. Actually, the right investment is that everybody should be buying hospitals, especially because, to your point, Vidal, of all of the challenges that hospitals face, the burden... I truly believe that it is a burden to run an acute care enterprise, when it comes to running a health system business, running a provider business. It is a necessary business that I never think is going to go away, of course, but it is a difficult business to run. Vidal Seegobin (28:11): Well, I also think about a little bit of this tension between relevance and profitability. So health systems and hospitals' in-patient capacity, in-patient services are not going to go away. Demographics just point to more of that need. Rae Woods (28:26): Of course. Vidal Seegobin (28:28): But I think, increasingly, it is difficult to cover your costs with a little bit of excess in the operating environment that we're in right now. And so if we're bringing it back to the conversation about private equity, private equity, I think, by definition, has to look for opportunities to grow smartly and consistently and with minimal risk. And that, generally speaking, is not a hospital and health system on average. So I think that's something important. Rae Woods (28:55): Which is again, why we all had this moment of, wow, when the announcement happened, which is why we're having this conversation. Abby Burns (29:06): Okay. So we talked about a couple of the goals that HATCo or General Catalyst have with acquiring Summa, or we talked about moving more toward value-based care. We talked about creating this learning lab for how we can more effectively deploy some of these technologies. But, Vidal, do you have a sense for what success or maybe even failure would look like for General Catalyst, in terms of the experiment that is acquiring a hospital, and on what timeline they would be comfortable potentially naming that? Vidal Seegobin (29:36): So I'll start with this, not scarier, but potentially scarier outcome, which is, HATCo, Summa unlock the code on scalable drag and drop hospital tightening up of the ship that you can translate and do time and time again. So the actual- Abby Burns (29:57): That sounds good to me. Vidal Seegobin (29:58): Yeah, the lesson learned is like, hey, we know how to run a tight health system model. We can do that for you, and we can do it time and time again. And we can do that also in a situation where you see high quality, high reliability for outcomes, which I think is the baseline definition for value-based care. So I think that they... So they crack the code, they figure it out, they can run it and scale it, and that's something that comes at as an outcome. (30:26): I think the more likely situation is that, Summa sees improved performance. Their operating margin improves. Their amount of expenditure on staff decreases because they've shifted those kinds of tasks to technology, and probably now have some real winners in terms of the portfolio of technologies that they've been incubating that are now becoming industry standard. I think that's a second option. (30:51): And in terms of timeline, I would imagine, three years might be a good time to prove that the technology, and we know the playbook for running a technology, that's "scarier" version, I have no idea how long. 5, 10, 10 years? Who knows? Rae Woods (31:07): So then, what are you going to be watching for? What are you and your research team and Advisory Board going to be watching for, to signal whether this experiment is going to work? Vidal Seegobin (31:19): So I will run into the world, Rae, that you've kind of come up from, which is, I want to be... I'm very curious to how clinicians and physicians are thinking about all of this, because all of this stuff is, again, made and broken based on whether or not you've got the clinicians on board. And- Rae Woods (31:35): A hundred percent. Vidal Seegobin (31:37): I want to hear how they're reading the tea leaves. What are they seeing? What are they expecting? How are they being kind of wooed in this change? Because I think that's the way that the rubber will hit the road, and that's what I would be spending disproportionate time trying to figure out. Rae Woods (31:54): Yeah. I could not agree more. I think you can always have the best laid plans, the best financials, the best incentives, but it actually comes down to the non-financial incentives. It comes down to... I know of people think that culture is a fluffy word, but it really comes down to the agents who are going to embrace or push back on and actually do the change, which in healthcare is always going to be the clinicians. It's always going to be the doctors. It's always going to be the nurses. It's always going to be the people. (32:22): Well, we're going to keep watching this. You're going to keep watching this. Abby and I will keep talking about it. Keep bugging you, Vidal, so thank you for coming on Radio Advisory. Vidal Seegobin (32:31): Thanks for letting me nerd out a little bit. Rae Woods (32:36): Look, we covered a ton in today's episode, and honestly, a lot of this conversation, this messy conversation, was us reacting to the news. And I know that you, our listeners, are doing that yourselves, and I want you to resist the urge to make an instantaneous kind of gut reaction, gut change, based on this news, or frankly, any other headline that you see. Abby Burns (33:00): Yep. Rae, to me, this falls under the bucket of something exciting to watch, potential examples of how different players are harnessing all of the innovation that we're seeing in the industry, not necessarily something that needs to change your strategy today. Rae Woods (33:14): That's right. Abby Burns (33:15): But I know that, at Advisory Board, and at Radio Advisory, we are going to continue to keep our finger on the pulse of this. So remember, as always, we're here to help. Rae Woods (33:39): If you like Radio Advisory, please share it with your networks. Subscribe wherever you get your podcasts and leave a rating and a review. (33:46): Radio Advisory is a production of Advisory Board. This episode was produced by me, Rae Woods, as well as Abby Burns, Kristin Myers, and Atticus Raasch. The episode was edited by Katy Anderson, with technical support provided by Dan Tayag, Chris Phelps, and Joe Shrum. Additional support was provided by Carson Sisk, Leanne Elston, and Erin Collins. We'll see you next week.