CDI metrics: a case study with Banner Health

- Well, welcome everyone to today's webinar, how Banner Health is using clinical documentation improvement metrics to drive uncharted opportunities and outcomes. My name is Jakob Emerson, and on behalf of all of us here at Becker's Healthcare, thank you so much for taking the time to be with us. Before we begin, I'm going to walk through a few quick housekeeping instructions. You can submit any questions you have throughout the webinar by typing them into the Q&A box you see on your screen. Answers will be provided via email following today's webinar. Today's session is being recorded, and will be available after the event. You can use the same link you used to log into today's webinar to access the recording at any time. And if at any time you have trouble with the audio or visuals, try refreshing your browser first. You can also submit any technical questions into the Q&A box. We're here to help at any time. So with that, I'm very pleased to welcome our esteemed panel today. Before we get started with that, I'm hoping you all can tell us a little bit more about yourselves and briefly describe your roles within the clinical documentation improvement and analytics teams at Banner Health and Optum. So Jessica, Beth, I'll go to you first.

- Thank you so much Jakob, and hello industry leaders, and I'm honored to be here today. So my name is Jessica Risner, and I'm the Senior Director of Clinical Documentation Improvement and Clinical Denials at Banner Health. We are based out of Phoenix, Arizona, and located throughout six Western states. My background is nursing, more specifically heart-lung transplant and neurosurgical care. Beth, over to you.

- Good morning. I have worked in the CDI department for the last eight years. My role for the last two years has been as the CDI and Acute Care Program Manager. I'm the IT Liaison for the two departments and Program Expert for Optum. My roles include doing analytics, education, workflow development, testing functionality, and being a liaison for any IT programs, projects within Banner that impact the use of Optum.

- And Daniel, how about you?

- Perfect, thank you, Jakob. Good afternoon everybody, good morning, wherever you might be watching this. My name is Dan Schofield, Senior Strategic Product Manager with Optum in provider market solutions, specifically enterprise, computer-assisted coding, and clinical documentation integrity 3D. I work closely with Beth and Jessica and their teams, centered around reporting and analytics especially. So Jakob, very happy that you were able to invite us here today to talk about artificial intelligence automation and reporting. I've been in healthcare reporting for about 20, 25 years, so that's my background.

- Fantastic, well super glad to have you all all with us. Let's dive right in. Jessica, talk to us about some of the challenges that motivated Banner Health to invest in, to enhance CDI technology and advanced analytics within your CDI program.

- Sure, Jakob. So I think we face a lot of challenges that other health systems do in relation to CDI encoding data. When we came to Optum a few years ago, we were really looking to streamline our workflows, increase efficiencies through chart prioritization, and the use of the case markers that Optum has for their clients. One of the things we really enjoyed is that it really does provide a comprehensive source for CDI and coding data that we as the client have direct access to and are able to best tell our story through our data. Working with Dan and his team, we are able to build reports, as well as the reports that Optum have available for their clients on the standard, so that is really nice. And also, we were looking for a way to decrease technology maintenance for our IT team internally. In Optum, what we've accomplished was that. And we work really closely with our coding team. We have a philosophy that coding starts with CDI, and we wanna be able to hand off that record to our coding partners for them to get right in there and help support DNFC. And so Optum allows us to streamline the handoff of that chart between the two departments. Some other similar challenges that other health systems may face, of course, is around length of stay and capturing all of those CCs, and MCCs, and SOI diagnoses that help support clients that stay. Quality methods around PSI. Optum has a really robust PSI support program as well as us. Those go hand-in-hand, and of course the O/E ratio. So that really is some of the challenges we were looking at and motivated us to invest in the technology so we can really look at that length of stay, the accuracy of the documentation, and the seamless workflow between CDI and coding.

- Fantastic, so Daniel, Jessica mentioned some of those challenges that Banner Health was facing, including wanting to streamline their workforce more and improve efficiency overall. Can you talk a little bit more about how Optum supports hospitals through similar challenges using automation and AI and CDI technologies?

- Perfect, yeah, thank you, Jakob. Optum has been investing heavily in artificial intelligence for years, really. And it's at the centerpiece of the solutions, the ECAC and CDI solutions that Banner Health is taking advantage of. And that's part of what we call our EHR plus one approach, meaning that Optum aims to be everything that can be found outside that's complimentary the EHR to find efficiencies within those workflows and provide the additional complimentary information that helps the coders and the clinical documentation specialists do their job. So for the way artificial intelligence helps, we have a tool called clinical language intelligence, right? And if you can imagine, it's taking all the information from Banner Health and other hospital systems in real time. Like, just imagine all these documents flowing over. And then it reads through all that information and puts codes on the case and identifies potential documentation improvement opportunities. Maybe it's something that the clinical indicators indicate maybe should have been documented, or maybe was documented, but the clinical indicators don't support it. So that's really where the engine, that artificial intelligence comes in. And why does that matter, how that help Beth and Jessica at Banner Health do their jobs? Well, first, every single case has been reviewed artificially by a system before a person picks it up, and that just makes their jobs, hopefully, easier, so that they already have the codes on a case and these markers on a case that they can use to identify relevant query opportunities or prioritize certain cases for review if there's more markers or other certain criteria. And hopefully that really frees up their resources and their teams to focus on bigger opportunities, higher function opportunities, like engaging with providers and education.

- So it really sounds like, Daniel, this AI technology is targeting and helping reduce some of that administrative burden that coders and clinicians can often face, and letting them focus on, like you said, bigger opportunities that are out there. Beth, could you talk a little bit about how Banner Health has transitioned from using standard metrics to advanced metrics, and what's some of the new opportunities or insights that these advanced metrics have revealed for you all?

- Yeah, we were able to use all of the new data, or additional data that we got from Optum to look into a lot more of these advanced metrics. And I have to say the release of the BI analytics platform has really helped us dive into those advanced metrics. We can build custom reports along with the standard reports that Optum provides all of their clients. And those have allowed us to pull in the more in-depth metrics that go beyond just looking at the DRG shifts. We've also been able to work with our internal analytics team and pull in additional data that's not available in Optum, like some marketing strategy information, some state data, things that we'd reported. And combining all those together gave us opportunities that we were able to pursue. So we're looking at HCCs, risk-adjusted diagnoses, quality measures like the PSIs, we started doing some mortality reviews, and we've changed up our prioritization of our case reviews based upon those clinical markers that Dan had just talked about. And with all of this, we've developed a multidisciplinary team that reviews our PSIs and our mortality cases, and we also have developed provider scorecards, we have an Optum-provided report that's a compare report that compares us nationally to their other team or other facilities, which allows us to see exactly how we are performing, and we can provide that to the provider so they can also see how they perform against everyone else. Some of the other things that we have is we've been able to develop reports where we look at cases that were reviewed by CDI, and if they were reviewed, did coding need to send additional queries? What was missed by our CDI team potentially? And then we can provide education to our CDI team, to the providers, and we can support the discharge not final coded numbers, and we can also gauge other opportunities that we find while doing all of that research.

- Interesting, and Dan, you had mentioned how long that Optum has been investing in these technologies. Let's take a step back for a sec. Can you talk to us about why it was important for Optum to invest in advanced analytics in CDI?

- Yeah, perfect, Jakob. Yeah, I think, hopefully, hearing what Beth is focused on will allow me to extrapolate on that, because there's all this information. I talked about the the medical record, and then Optum's generating a bunch of system-generated information, and you have markers, and you have dates and times, and diagnosis codes, and DRGs. A ton, I mean, millions and millions of ancillary data points. So reporting, at its simplest form, is just to take all that information and turn it into something that somebody can read and try to interpret and take a decision from. So all this activity is going into to a system, and if there isn't a report, advanced report or simple report, then nobody knows what's going on inside the system. So it's really a way to measure, in some cases, it may be the productivity of a team, it may be a prioritization queue. Looking at things in different ways to say, "Okay, where's the low-hanging fruit? Or where have we already accomplished some of that, and where do we need to go a level deeper to identify those next level opportunities?" And Banner Health has done a wonderful job leveraging our, what we call ad hoc. Beth touched on this a little bit, which is a user-defined, or a custom... And we have a team that that would engage, and certainly I can engage with with our customers, but really help take some of that data and put it in a format that makes sense to the person that's going to be consuming that information so that they can make a decision. So that's reporting 101, I think, is to take that information, the the ton of data, make it simple. And what we've found, Jakob, is that not everybody consumes information the same way, especially in hospital systems. And so we've tried to make the system approachable. We provide a lot of educational opportunities as well to our customers so that they are on the inside and seeing why we're generating information the way that we are. But that ad hoc reporting tool really allows for the information to be served up to the audience in a consumable fashion. And it could be even a system. We're working on a project with Banner Health right now, where it's system to system talking, where we're providing reporting and then they are ingesting or importing that information into their system so that they can talk more closely together. So, I mean, I could go on forever on reporting and analytics, but at its simplest form, it's information for decision making. And if a report's done right, the decisions make themselves, but that's not always the case.

- Yeah, no, absolutely. And it really sounds like at the end of the day, these advanced analytics are providing more clarity around what you said, Dan, what is going on inside the system? So, Beth, obviously, implementing, as you know, obviously, implementing an enterprise wide metrics communication strategy is a challenging thing to do. So could you outline the steps that Banner Health took to effectively communicate these metrics to a wide range of stakeholders? Daniel had mentioned people read things in different ways, so can you take us through how Banner Health approached that?

- Yes, so we have multiple means of communication that we follow. We have quarterly meetings, live meetings, where we meet with the individual facility stakeholders. We have... Jess, correct me, 'cause I know I'm gonna get this wrong. I know we cover 20 of our facilities, but there's a total of 32 total hospitals. Yeah, and we cover 20 of those. So we meet with those facility leaders every quarter during a live meeting and share our current KPI metrics. They also have access to them on our SharePoint site. And in those months when we are not actually meeting with them, they do get an emailed summary of that report, and those KPI reports are available to be viewed by anyone within Banner. Everyone has access to that SharePoint site, and we have a internal CDI intranet site, and that also contains the link so they can go there. We also have multiple meetings with the stakeholders for engagement and education every month, be it either system-wide at the facility level or a few facilities getting together. And our education leaders and our CDI leadership attend those to help provide explanations of the data and to give them background. We have found that we need to frequently provide education as to what a DRG is, how it's impacted, and how we can make changes. It's not an easy thing to understand, and so frequent conversations come up about that. And as Dan mentioned, we are currently working with Optum to send us over data directly from the system, and we're going to be building out a centralized dashboard for our KPI that will be within the analytics reporting area.

- Got it. So multiple locations where these metrics can be accessed, and it sounds like various mediums in terms of how this strategy is being communicated across Banner Health. Really interesting. Daniel, how would you say that Optum encourages the reporting of CDI metrics?

- Thanks for the question. And maybe from hearing Beth and and Jessica talk, maybe they don't need a lot of encouragement. But, I mean, we offer a ton of engagement opportunities. We talk with our customers all the time one-on-one. So what's really top of mind individually for each hospital system, you'd be surprised. You would think that there's... And of course there is common denominators, but it really involves pulling back a layer or two and getting underneath and understanding the different views of information and what the executive leadership is prioritizing that given day. But just to tick off a few, every time we release our software and our reporting, we have a live training where we invite all our customers to come and hear the latest and the greatest. We have user groups, which is less of a training, and more of an interactive session. And steering committees, where we include our customers to be a part of the development process of these reports, that we're taking and their feedback into what we generate for them, and that we're hitting the mark precisely. We offer clinical education that have CEUs attached to it that we then refer back to the reporting that supports some of that clinical education. So I can't say enough. I mean, the more we talk to customers, the better, from my perspective. We also have what we call a performance management program that is presented by our strategic value advisors. And as part of that, Beth referred to... We present Banner Health's information, but also comparative to their peers. And we use our experience with other customers that are using our ECAC CDI platform to make potential suggestions, or recommendations, or even just highlight some of the things that may be occurring, just so that they may be aware of where they might be a little different than their peers. So that's PMP approach. And then the last section that I would highlight is in the technology itself. So we talked about how everybody consumes information in different ways. So we need to make sure that the technology itself is making the reports as available as possible. So scheduling the reports for distribution so that you don't have to think about coming into a report and generating it, and what was the last time when I looked at it, how was it filtered? Saving off filters so I can say, "All right, what was the last month metrics versus the last year?" Being able to get to that with as few clicks as possible. We talked about the ad hoc, and looking into the future, I think we'll get to real time alerts where the information is identifying based on certain thresholds. "Hey, did you know this?" That's real artificial intelligence when it comes to reporting, when the information has crossed a key metric, a KPI, if you will, and it triggers something to happen, whether it's just an alert to Jessica or Beth, or whether it's system-related that causes some activity to occur. And I think the last two points is we're making the information as real time as as possible. So I mean, we talked about the exchange of information back and forth together, and I think making that information so that the reports are representing the information as it appears within the coding and CDI system in tandem. I mean, there's always gonna be some kind of a delay as the information moves down the track, so to speak, but making it as real time as possible, I think really encourages confidence in the information. And then my last point will be, I mean, there is no replacement for accuracy in data, and we made sure that the information that we're presenting to our customers is accurate as possible. And when there is a question, we will absolutely take it and research it to the nth degree to make sure there that there's that maximum confidence in the information that we provide to our customers.

- So Jessica, I wanna switch gears here from everything that we've been talking about and talk about another important piece of this conversation, if not the most important piece. How this data-driven decision making has impacted patient care and quality outcomes at Banner Health.

- Absolutely, so here at Banner Health, we have a very strong focus on patient safety. And as we all know in the industry, patient safety metrics are driven by the coding. So that code set is really important. And we've been able to work with Optum to ensure that the top 25 codes within that code set include all of those imperative quality scripts. We are able to customize codes to be able to be pushed up and auto sequenced, and then Optum also does auto sequencing of codes and groups of codes like health hazard codes that they know are important, and they push those up to help support the quality metrics within the code set. And those don't get varied and under-reported. How the data translates into the clinical and the bedside environment has been really exciting. Over the last couple of years, we have been able to develop a multidisciplinary team that consists of our physician advisors, our quality, our acute care coding, and CDI. We come together every Tuesday and we review PSI accounts together, and Optum really helps us drive that conversation within that multidisciplinary team. We were able to identify an opportunity within PSI 12, which is pulmonary embolism and repeat venous thrombosis rate. So working with our quality partners and working with our physician leaders, we were able to develop a new initiative here at Banner Health that is very specific for our post-surgical patients to be able to get them up outta bed, prevent those PEs and DBTs. And we use the Optum data to be able to grasp that and have those critical conversations with the stakeholders. And this is another way of how the CDI and coding data can translate to the bedside and really help to impact our patients. Some other areas where we're looking at using Optum data is really to evaluate service lines. Evaluate service lines based off of length of stay, quality metrics, and using that information to help drive quality of care conversation. We've been looking into OB service lines, length of stay across all service lines, and also, the inpatient only list, and using those flags and how many cases that we're actually receiving with the inpatient only to be able to interact with the providers quicker. Because if we wait for the actual denial, a lot of time can pass in-between that. But if we can get to the stakeholders faster about the inpatient only procedures being coded incorrectly and where can we actionably prevent those in real time, the providers really like that, because they can remember, "Oh yeah, I just did that case last week," and it's a little fresh in their mind of what they did and where their opportunities came by. So kind of thinking about the data in a little bit of a different way has really helped us and our patient healthcare plan.

- So Jessica, you had mentioned how the data from Optum is allowing your care teams in different multidisciplinary teams across Banner Health to meet regularly to really target areas where you can improve patient care. Daniel, I think that naturally leads me to ask you how Optum then incorporates that feedback from their CDI clients to ensure that you can offer BI analytics products that support clients' needs better.

- Perfect, yeah, I mean, I would use one word, and that's listening. I mean, we listen to our customers. I think if you listen correctly, you're gonna hear loud and clear what customers want, what hospital systems need in their reporting. I mean, even just reading the the latest headlines, you can certainly get a sense for what decisions are being taken and where the hot topics are. And so, I mean, I mentioned a few of these, but I'll go over 'em again. Inviting our customers to participate, we call it a roadmap, right? A product roadmap. And we release our software, and our solutions, and our reporting platform on a regular basis. So we try to get ahead of as much of that as we can. I mean, we try to stay ahead, and we communicate with our customers to say, "This is what we're planning on doing, let us know, are we hitting the mark?" And I think the key aspect is to listening to what the market and what your customers are telling you, and then appropriately reacting to it.

- Yeah, yeah, no, absolutely. So Optum is just directly listening to what the Banner Health team is telling them about these tools. Jessica, I wanna come back to you though and ask a little bit more about the patient outcomes. Can you share some specific success stories or case studies that really highlight these tangible improvements that you all have achieved with Optum through your CDI automation and analytics initiatives?

- Absolutely, so we know that excellent care is being done at the bedside, right? And it's our job as CDI and acute care coding to really educate and make sure that all of that bedside care that is being provided translates to the codes, right? So working with the providers on documentation improvement, sending those queries, and getting all of that into numbers so it goes up in the metrics. I co-lead our mortality initiative here at Banner Health, and one of the things we've been really looking at is our O/E ratio, like a lot of health systems do across the nation. And Optum has really helped us to be able to drive the accuracy of our severity of illness and with mortality. And being able to really help that expected number to, again, show all the amazing care that is happening at the bedside and getting that into the metrics. One of the other areas that I mentioned, the IPO list in my previous response. One of the other areas that often really helps us is with our denial. So they do have clinical validation markers, and those clinical validation queries sent to our providers really do support the denial that may hit on the backend. So that prevention piece within those validations denials and markers, we actually were able to do a cost saving percentage. So we sort of looked at our processes and said, "If the denial doesn't hit the denials team and the CDI prevented that denial, they really should get some credit for that." So with support of our executive leadership, we were able to do a cost savings percentage, and that percentage goes directly towards our KPI within CDI. So we are able to actually show that direct impact on the patient's record for accuracy, and that denials prevention piece, which is, of course, cost saving for any health system. So that has been really wonderful. Our length of stay, our CC and MCC analysis, and that partnership of looking at that analysis each month and each quarter with Optum has been very valuable. Making sure that our capture rates look good compared nationally and also across our own hospital, making sure that that is all consistent. You can also use data to help support case management and utilization review, partnering with them on the working DRG and making sure that they understand that this is the accurate working DRG and here's the expected then to stay associated with that. So there's awareness there for discharge dispositions, getting the patients out of the hospital, because as we all know, the longer they stay, the sicker they get, and it's really important we get those patients out timely and transition them to the next appropriate level of care. So just sort of partnering with the denials team, partnering with our quality team, partnering with the case management team, and using all of that data within Optum, and with the CBI, and with the coding team, create from the documentation, really showing where the opportunities are across the enterprise, not just within.

- Yeah, and I mean really hearing you talk about this, Jessica, it's very obvious how helpful this partnership with Optum has been. Like you said, across a lot of different mediums and teams, case management, denials, your care teams. It's really interesting to hear you talk about this. If you were going to sum up everything that we've talked about today and your entire relationship with Optum, what would you say it's been like to partner with them to support your initiatives overall?

- Absolutely, so strategic partner is really the word that I would use. I think that's a buzzword that a lot of people use, but I really feel that Optum lives up to that, strategic partners. They sit with us, they go through our data. They really do listen, Dan was right, they really do listen to what we're trying to achieve. They educate us on our potential gaps within the data itself so we can better understand what we're looking at, and they really help the leadership team drive those initiatives and identify opportunities that maybe we thought about, but just taking it to the next level, which has been really, really helpful. I think too, often think beyond just the leadership team. And they wanna be partners with our review staff as well. So through that, they do offer CEUs and educational opportunities in regards to query opportunity, better understanding of the use process, better understanding of coding rules and regulations, Optum has a whole breadth of education for our staff also. So they really wanna support every single level of our organization, and you know, they check in with us to see how we're doing. Just a random, "Hi," email, which I think is really fantastic. And our partnership is really that, it is a partnership, and we have built that trust over the years with each other, which I think is fantastic, and we don't find that in every vendor. So it's really wonderful that Optum lives up to that strategic partner.

- Yeah, well that's really fantastic to hear. And with that, Jessica, that does conclude the discussion portion of our webinar. So let's go ahead and shift over now to our audience Q&A. Our audience members can submit any questions they have into the Q&A box below, and our panelists will follow up with any that we don't get to via email. So Daniel, I'm gonna come to you. Looking to the future, any emerging trends or technologies that really excite you in CDI and the healthcare analytics space right now?

- Sure, and you know, I just wanna thank Jessica and Beth too after those nice words to say yeah, it's been a pleasure working, certainly, with those teams. Future directions, Optum is focused, and you heard from Jessica about denial prevention and what we would refer to as friction within the transactions between the provider and the payer. And what we're focused on is trying to make that transaction as frictionless as possible, to really streamline that process, the workflow, whatever label you wanna put on it. I mean, there's so many steps in the process, I don't need to belabor that point. And sure, artificial intelligence is a part of that, and automation and reporting is a part of that, but it's a big picture focus for Optum. I think, looking more generally, I mean, big data, I don't know if that term still resonates with anyone, but it's really in it's sweet spot. I mean, we're able to build products like BI analytics because the technologies exist to take all that information, crunch it down, present it, even an ad hoc report, in minutes we're able to do that for customers. So the advent and the realization of the benefits of big data, I think, is really just getting started, and the fact that all of this information is up in the cloud so that we're closer integration with Banner Health and sharing information back and forth. I mean, the dividends of of that are gonna continue to multiply as all these systems are put up in the cloud. Means they can all talk to each other. There's no more disc space considerations. The limitations are being removed from the technology so that they can really start to solve some significant problems.

- So, fair to say then, Dan, that everything we've talked about today is really just the beginning of what you're foreseeing is gonna happen with these relationships moving forward.

- I certainly hope so.

- Wonderful. Well, I have to ask you too, for all the healthcare leaders listening today, what's your best advice for them? Who hear the success that's happened between Banner Health and Optum and wanna emulate that. They want to get started themselves and wanna enhance their CDI and analytics efforts. What would you tell them?

- If you're gonna ask me, I would say to embrace technology. Maybe that's too easy of an answer. I would love to hear what Jessica and Beth have to say on the topic. But technology, and especially when it comes to information sharing, it really does make life more simple. Whatever scenario you wanna throw at it. And I realize that this industry has seen a lot of change in the last 15. From ICD-9, 10, that's still a recent advent, you know? So I think just embracing it and being able to see ahead of of the curve a little bit, and try not to hold back on the potential opportunities that technology can offer.

- I think too, with the embracing of the technology, that is really, really key and understanding the technology. But you also have to be willing to ask really tough questions, and also be willing to look at the data honestly, and identify those opportunities honesty. I think sometimes data might show you things that you may not have expected. And so as a leader, you kind of just need to be prepared for that. And once the data's validated, is to really look at your culture, look at your workflow honestly, and make those changes to impact that technology. And really bringing your staff along for the ride, right? This is a group effort, right? This is a team sport, and if you don't include the reviewers on up to the leadership with this data journey, you may miss your target. So understanding the data, looking at that data honestly, translating it into your workflows, and including your staff, I think, are all really, really key to success.

- And Beth, I'd love to hear from you as well. Your best advice for the healthcare leaders listening today, really wanting to emulate the success that Banner Health and Optum have found together.

- So my best advice would be to work with your partner, whoever that would be, for getting the data analytics. Whether it be an internal partner or whoever your vendor is for the product that you're trying to get your data from, that is going to be your best way to be able to get the data, to analyze it for making those decisions and finding those opportunities. I really think it's important to share what's going on with them so that they can help you find what is best going to help.

- Great advice from the three of you, so thank you. Daniel, last audience question I wanna pose to you. You had mentioned we're on the frontier of healthcare analytics today, so can you clue us in a little bit on what Optum is working on next in this field of CDI automation and analytics?

- Sure, thanks, Jakob. Just to touch on a few things, continuing to leverage reporting and analytics, and shift the dynamic, what we say shift left, and try to bring some of those engagement opportunities with the provider further upstream. So an example of that would be mobile query, where we're able to ping physicians on their phone with relevant query information, which would have the impact of driving down the turnaround time on specific queries. Identify as many opportunities with taking transactions and going straight to bill. Trying to, again, frictionless, less interaction with the case as possible to try and get it to move down the tracks. And then in my area, in terms of reporting and analytics, we're looking closer at the codes on cases, the individual diagnosis and procedure codes on cases, to try to take our analytics to that next level. There's been a lot of buzz on social determinants of health, for example, and I think that's really... And those are based on, and Beth and Jessica know this better than I do. Those are very specific diagnosis codes that have to appear on a case, and it causes a bunch of workflows to stem from that, both while the patient is in the hospital, but then after the fact, because it has such an impact. So I would think that we're just on the beginnings of those code-level discussions. So as it it pertains to reporting, we're gonna get deeply involved in analyzing the combination of codes on a case and see what that can tell us.

- Well, it sounds like really exciting things ahead, but unfortunately, that is all the time that we have for today to discuss them. So I want to thank our panelists for their excellent insights, and Optum for sponsoring today's webinar. To learn more about the content presented today, please check out the resources section on your webinar console, and fill out the post-webinar survey. On behalf of all of us here at Becker's Healthcare, thank you so much for taking the time to be with us, and we hope that you have a wonderful rest of your day.