Vital Signs - Healthcare Trends, Challenges and Innovations

Speaker A: M welcome to the Financial Executive's Edge, a production of the Financial Executives Journal. Here, finance meets bold leadership. Join us for sharp insights, uh, unfiltered conversations and practical strategies to elevate your thinking, drive change, grow your impact and empower your career. This isn't just insight. It's your edge. The Financial Executive's Edge.

Speaker B: Welcome to the Financial Executive's Edge. Today's podcast centers around vital signs, health care trends, challenges and innovations. I am Lynn Gargano, your host and moderator with the Financial Executives Network and Group, alongside Andrew Silverman, my co moderator and lead transactional and tax policy strategist at UH Bloomberg Intelligence. In this episode of Vital Signs, we will explore the trends, challenges and and innovations reshaping healthcare and the pharmaceutical industry, from rising cost and drug pricing to employee benefits and biotech AI breakthroughs. Today we are joined by Ted Pizzo, Managing executive and client advisor of Healthcare and Insurance at Locton, alongside his colleague Dr. Shaelyn Buck, Chief Medical Officer leading clinical strategies at UH Locton. We're also joined by Matt Hendrickson, medtech analyst at Bloomberg and co host of Vanguards of Healthcare. Our guest today will help us unpack what's driving the broken healthcare system. So whether you're in healthcare HR or just plain health conscious, vital signs keeps you informed of what's ahead. So with that, let's get started. As we know, we're in the middle of open enrollment season, so there is no better time than the present to discuss the rising healthcare costs. So with this, I'm going to toss the first question out to, uh, ted pizzo and Dr. Shaelyn Buck. What do you think are the main drivers of rising health care costs in the US today?

Speaker C: So I'll kick us off with this one, Lynn. I was just asked this question the other day, actually said, if you can define m one thing, one thing that can be fixed around health care, what would that one thing be? What's kind of the root cause? And, uh, you know, I sat there for a minute and then thought about it and answered, misaligned incentives. And so what I mean by that is that as you think about all the stakeholders within healthcare, and I realize this is a macro view, but you think about all the stakeholders in healthcare, um, whether it's from pharma, PBMs, the medical carriers, or insurers as we sometimes refer to them, uh, providers, health systems, um, the patients. Right. What everyone seems to be doing and has been doing for a while is really protecting their margins. And so what that then leads to is kind of a misalignment, uh, within the system. And so what you see is, um, just constant increases, Whether it's treatment costs, medication costs from hospitals and health systems, we're, um, seeing increases as it relates to facility costs or inpatient, um, costs. So, uh, that's really, from a fundamental level, that is what's driving. I call it the margin of error. I know it's kind of a play on words, right? But the margin of error is really what we're talking about now. What are we seeing then as it relates to employers and employer health plans? Um, that is manifesting in several ways. Uh, one, I would say is with specialty drug costs. We're seeing, um, new treatments, uh, for more complex, rare conditions like gene therapies that are coming down the pike. We're also seeing chronic conditions that are increasing. So the disease burden is increasing. And not only are we seeing folks with just one condition, we're seeing multiple conditions. In fact, we look at our most complex patients within an employer's health plan, those that are spending 100,000 or more in medical and pharmacy claims. Almost 61% of them have three or more chronic conditions that they're dealing with. So that's adding to, uh, the complexity. And so I think it's all of those factors together that are driving the cost that we're seeing. And we really don't see an end in sight at this point. And I know Ted's feeling the pressure with our clients as we're talking about renewals. So. Ted, talk a little bit about that.

Speaker D: Yeah, sure. And, uh, this is such a great topic, and it's a discussion we have with our clients, um, probably at least three times a week. And, you know, first and foremost, uh, we have clarity of mission in that we work closely with our clients to strike a balance. And that being they. They want to offer a robust benefits package, um, while they're facing these escalating healthcare costs. And at the same time, we work closely with them to sort of help change behavior and reduce risks and manage their costs. And it's daunting, candidly. Um, so, you know, that said, in answer to your question, the main drivers, on a macro level, piggybacking, uh, off of what, uh, Dr. Buck said is you got medical services and drugs. Right? And what's been the case for a long time is, um, the cost in the U.S. sort of per unit for whether it's doctor's visits, hospital stays, surgeries, um, is significantly higher than it is abroad. A good example would be an MRI. Routine MRI might cost $1,000 in the US and that may cost $100 to $200 in many European countries. So, you know, the cost of health care is high. And then the other component is the administrative costs. And in the US we have a highly complex multilayered insurance system that requires a lot of resources for billing and claims and so forth. So these kinds of issues are huge. You have chronic issues and disease, lifestyle factors. Uh, but there remains one key issue is, uh, because I always like to lean on positive, um, despite its high cost, the US healthcare system does have key advantages. And that's, you know, medical innovation and high cost care, top facilities and rapid access to advanced treatments. But those costs are real and clients are constantly trying to adapt to that.

Speaker B: Okay, so taking all of this, you know, together, when you think of all the different types of reforms, or maybe some of the suggested reforms, and of course the most notable reform like the Affordable Care act, how do we put all of this together to help solve and rein in these long term costs? Is it, and is pricing transparency playing a role in it? And if you reduce healthcare costs, does that reduce or disrupt provided income or access to patients? How do we try to navigate that Course?

Speaker D: We've been helping clients with obviously ACA reform since it was passed almost 14, 15 years ago. And while the ACA made strides in expanding access to health care, the system's structural issues like high prices, fragmented care, um, and political resistance have made it difficult to tackle the root causes of rising health care costs. Also, to my way of thinking out of the gate, the individual mandate penalty was relatively weak. So, um, you have an issue where enforcement was weak. And too often people don't really value insurance unless they anticipate immediate medical needs. Um, and then, you know what, uh, exacerbated some things In I guess 2019, it was the federal mandate penalty was eliminated. So, uh, that's. Research has showed that, you know, modded modest decreases in enrollment among healthier people and so you don't have enough, uh, availability to spread the risk pool.

Speaker B: Matt, what are you kind of seeing on the healthcare front in the industry at this point or feedback that you're receiving? I know you have your own podcast on this and you do lots of research in this area. Any thoughts?

Speaker E: Well, uh, it's interesting two thoughts that came to mind. First, the hospital constraint on capital purchases for what we're seeing in the pharma and the medtech side is, you know, the rise of, you know, using robotic systems. You're thinking of intuitives, da Vinci, uh, robot for procedures that used to be done manually with the show is showing a better efficacy and effectiveness in treating various diseases for soft tissue. But it comes at a $2 million price tag. And so these hospitals not only have to navigate these rising pharmaceutical costs that are per procedure, but they also have to think about how they're going to be able to finance these capital equipment because they are using them and they don't want to be left behind when other hospitals are saying that they're using the latest robotic technology. The other thing that's interesting that I'm, um, hearing with the rising costs and everything, it comes to mind is the pattern cliff that you're seeing with a lot of these key pharmaceutical drugs and the rise of biosimilars that are going to be coming in. So from a pharmaceutical perspective, you almost have to see them trying to maximize revenue before these patents, um, expire, as well as how are they going to be able to finance the R and D dollars for the next wave of new innovation.

Speaker B: Interesting. So I'm just going to toss this out to the group because I know we're making lots of advances, you know, in the, in the healthcare sector, and there's, you know, a lot of momentum there. But can we look to other countries or are there any other lessons we can learn outside of the US for whether they get the health care system right and the right structure? Is there anything to be learned either from m countries like Australia or the Netherlands or anywhere else?

Speaker C: Yes, I think so. I think where we see systems that are less fragmented so you have this greater cohesion. And so as a physician, I'm going to think about the patient journey.

Speaker B: Right.

Speaker C: So let's think about a patient journey. One of the highest cost areas right now for employers is cancer care. So moving from, you know, prevention or early detection all the way to survivorship. And when you look at that patient journey and track that patient journey, it is extremely fragmented. And so we have patients that are having to navigate the system as opposed to the system helping to navigate patients.

Speaker E: You know, it makes you think of maybe some of these private payers, um, and they have a patient who is, you know, 60, in their early 60s, and may need a knee replacement procedure done. Well, are they going to try to use other alternative options before a full knee replacement kind of kicking the can down for Medicare to cover that cost when it comes down the road? Um, those type of fragmented costs doesn't allow the patient to be treated at the right time potentially. Um, and so that's kind of something to think about too. When you think about kind of a fragmented having the payers, um, versus a universal system.

Speaker C: Yeah, absolutely. I will also position that our system is built as a disease care system and so disease is profitable. Prevention and lifestyle interventions, for example, aren't profitable. And it's um, even the way that our code sets are designed, it's around procedures, uh, treatments, you know, disease codes. But when we think about innovation in the U.S. it's really been centered around um, procedures and pills. I use the three Ps, procedures, pills and products. Right. So let's create additional layers within the system with all of these pieces instead of innovation around process. Right. And so we've created this fragmented approach and we've tried to solve with different um, products or treatments without asking fundamental questions around the processes and how those processes are centered around the patient and how we can reduce fragmentation and improve efficiencies within the system.

Speaker D: What's fascinating to me is you look at chronic disease and lifestyle factors, right? Um, there's high rates of obesity, diabetes, heart disease and you know, kind of related conditions that lead to this sustained expensive care needs and why that matters. About 90% of US healthcare spending goes towards people with chronic conditions. But drilling down even further because we track um, claims down to the individual level and uh, less than 2% of the population accounts for about half of the healthcare costs. So these chronic conditions, lifestyle factors are huge and they also are an area for vendors to have profitability built into their margins.

Speaker B: Yeah, it sounds like our healthcare system maybe needs a little bit more investment on the preventive side. Right. I know there's some incentive in employee plans where you get some credits. Right. If you're a non smoker or you have some type of other type of healthy lifestyle to kind of mitigate some of the risk of illness. But it sounds like maybe we need a little bit more investment on the preventive side since we're so focused on this disease coded, focused system that we have. Right. It's all about uh, the reactive approach to medicine as opposed to being preventive and upfront about it.

Speaker C: Yeah. And Lynn, we oftentimes will bucket lifestyle into, and I'm using air quotes here, the wellness bucket. Right. And really what we need to be focused on is evidence based lifestyle medicine. Lifestyle medicine is a practice of medicine and there's uh, incredible, incredible evidence around the use of nutrition therapy for example, to really get to the root of some of the most prevalent chronic conditions that we have in this country. But yet that's not really incentivized. In fact, we're Telling our employers who are asking us about the obesity epidemic and particularly because their costs with GLP1s have been increasing significantly. In fact, that's one of the major drivers we've seen over the past couple of years with um, employer plans. They're saying, is there something else that we can be doing? And we're saying yes, you need to expand your benefits around this evidence based therapy. It's beyond wellness. We're not just talking about step challenges here. We're talking about actual uh, medical care that is focused on evidence based lifestyle interventions.

Speaker B: No, absolutely agree 100%. And maybe now we'll move into adapting certain strategies around employee sponsored insurance.

Speaker A: Yeah, I think that's a good uh, segue to move into companies keeping costs down. How are uh, rising premiums affecting employer sponsored insurance and what strategies are companies using to manage that burden? When I ask that question, I guess the thing that I think of first and foremost is GLP1S. Are our companies deciding not to cover things like that or are they using different strategies to keep the cost down?

Speaker C: I was talking with someone uh, the other day and actually a pharmacist who has a pin that says ask me about GLP1s. I said let me borrow that pin. Because it seems like every day we're being asked about GLP1s, you know, so here, here's there's a bit of a reality check on GLP1s. So I'm going to give you a stat. We just did a study on this looking at um, our self funded employer clients over the past two years and those that cover GLP1's for weight management, not for diabetes. Um, pretty much everybody covers them for diabetes. But we're talking about those that have elected to cover GLP1s for weight management. They saw almost an 840% increase in the per member per month spend for these GLP1s. And that's unsustainable. And so what we've seen is that a lot of employers have pulled back on coverage because they're saying we're, we need to put in the strategy. Can't just open the floodgates. We've got to have the strategy that can help make this cost effective and also helps to make sure that the people who really need GLP1s are getting GLP1s and have the right support. Because GLP1 should not be used as a standalone therapy. I want to make this really, really clear because it's kind of gotten lost out there in the national conversation. GLP1s are an adjunct to evidence based lifestyle intervention for obesity and overweight management. What does that mean? It means they're not first line therapy and they're not standalone therapy. So if you're just giving people GLP1s and this is my opinion as a physician, if you're just prescribing GLP1s without that support, that lifestyle based support, then that is not appropriate utilization of GLP1. So what we're seeing employers do is say, hey, let's push the pulse pause button right now and then let's make sure we build the right strategy that can support cost effective coverage and responsible coverage of GLP1s.

Speaker E: I'm seeing a similar trend here on the equity side once again bringing up uh, robotics and Intuitive Surgical. A, um, lot of their commentary has been declining sales with regards to bariatric surgery as some of these patients, patients are continuing to take GLPs. Um, their language has changed slightly and kind of um, coincides with uh, Dr. Buck's, um, commentary. There's some patients who have been on GLP1s and are coming off and then are going to bariatric surgery. So that's an interesting component in itself because you're almost doing a double dip of the cost where you're spending all this money on GLPs, but you're still going to end up with a bariatric surgery anyway. Um, so it's just something to think about with this cost analysis going forward is if you are expecting X percentage of these patients to be getting a procedure done anyway, why not just go with the procedure in the first place? Um, and then the other part of the language is there still are new patients that are jumping onto GLPs, um, and that they're going through, through that, um, you know, the pharmaceutical cycle first. Um, and so there still is that top of the Funnel, patients trying GLP1s for weight loss first. Um, and it just. So it's a stay in tune m or stay tuned for whether or not um, you know, those patients will actually have the lifestyle, um, you know, credentials as well to help with the GLPs. Or if they're just going to go that down that road of just ending up with bariatric surgery Anyway.

Speaker A: How about HSAs? High deductible plans with HSAs, is that something that um, people are attracted to, um, are companies attracting future uh, employees with those sorts of plans or is that becoming more popular, less popular?

Speaker D: Um, it's been very popular over the last say 15 years. Right. And um, it makes sense. But again you have to break it down to the individual level because they look at their HSAs, they look at their individual set of circumstances and then they have to say, I'm going to participate. Employers, I get like, we partner with employers closely and they, you may know, seed HSA accounts to get engagement. But uh, uh, so the pros with HSAs are huge. Um, the challenge is it's, it's a, it's a communications event, right. And, and you have to tie it to the individual and make sure that they understand what is in their best interest. Because at the end of the day, some very bright people, employees in different industries, um, but they have so much coming at them and you have to get their attention. We've seen, you know, PhDs with our stem industry clients and they sort of will come at open enrollment, uh, to say, okay, where do I sign? How do I enroll? And they move on. So you want to get their attention. So there's a lot of momentum around. We used to have like one communications person 15 years ago in this office. We've got about 70. Because you've got to uh, meet people where they are, communicate with them based on their individual set of circumstances.

Speaker C: It really depends on the industry and the employer profile. If they have a highly compensated workforce, definitely going to see HSAs qualified, um, high deductible health plans with HSAs as more attractive because even they're looking at it as a financial planning vehicle. Right. But when you have a population that um, is at ah, a lower compensation level and they are just looking at how do I make ends meet. Right? They're looking for predictability. And so they actually may, and there are studies that show this, they may actually not engage with care, preventive care for example, and we call it a reactive care pattern. You may see within that segment of the population that it's more of a reactive care pattern. So they're using the emergency room, they're just using care when they're sick or something's broken. And they may delay care even with, um, cancer screenings, uh, for example, even if it's covered 100%, there's still some confusion there. They're just afraid to go in and get a screening because they may, if something's found, it gets billed as a diagnostic and then that, that um, they have to pay out of pocket for that. And so it really depends on the population that you're looking at. We have seen some employers. One particular employer that I work closely with, they have manufacturing, um, and distribution centers. And you definitely see a difference in the utilization Pattern with the corporate segment of the population and then those that are in these distribution and manufacturing centers. And we did a study and noted that preventive care, they were not engaging in preventive care. And then when they took the qualified high deductible health plan HSA away, moved back to a PPO and made it more predictable, you saw an increase in engagement with preventive care.

Speaker A: And do you see large distinctions between large employers versus small employers?

Speaker D: One of the main distinctions is um, if in our industry if you're a larger employer, um, you usually have a self funded health plan and that means you're paying for your healthcare costs and you're seeing the actual cost of the care versus just a premium you pay that's guaranteed and that allows you with larger employers who are self funded to get more transparency in terms of what the costs are, what the cost drivers are.

Speaker A: All right, now looking into our uh, crystal ball, where do you think that employee health benefits will look like uh, in 10 years if we follow the current trends?

Speaker C: Look, employers are having to decide between because the health care costs are rising. I mean we see our actuaries have projected for 2026 an 8 to 10% increase in combined and pharmacy trend when you just look at paid claims, um, for 2026. So um, I mean this is not going away, right? And so employers are at this place, I mean I'm m talking to employers that are in communities, right, that serve as the anchor employer within a community. And they're saying how do I keep my doors open? How do I not lay off people? Because health care costs are increasing so much and they're getting squeezed as, as this audience knows more than any from all of these other um, angles as well as it relates to cost. And so employers are saying we're going to have to make bold moves, bold changes. And what I'm a little concerned about, um, frankly is things like ICRAs which we are seeing more conversation about, which is the individual contribution for um, healthcare reimbursement. And so basically we're going to give you a defined amount of money and then you go out into the individual market and get on a plan. Well that's great for helping make costs more predictable. So that removes the variability that you see within the high cost segment of the population which is really where employers are really strained when it comes to unpredictability. Right? And so they're saying we need, we need vehicles right here, right now that allow us to be more predictable and don't blow our budgets. And so things like ICHRA become Very attractive because it helps to um, improve that predictability. And I will tell you this. Looking at, I spent a lot of time looking at high cost claims trends within employer health plans and about 1% of the health plan population drives about a third, third. So this is often people's jaws drop when they hear this, but about a third of the total health plan spend within uh, so within that health plan. And that is where you see that incredible variability and that's what they're really trying to attend to right here, right now. My fear is that we're going to see more employers pull back on supporting um, their, their workers health which is then like squeezing the balloon, going to show up in areas like work comp, like absenteeism, like disability.

Speaker B: Absolutely. And I think we've covered a lot of ground on the root causes of rising healthcare costs and the significant challenges that are faced by employee sponsored um, insurance plans. But I just want to pivot a little bit now. We touched upon this a little bit earlier but I would like to take a deeper dive into kind of, you know, the transparency or maybe lack of transparency right. On the pharmaceutical side of drug prices and, and what the whole drug development life, uh, cycle looks like. How do you think drug prices here in the US compare internationally? Why is there such a huge gap between drug pricing in the U.S. versus outside the U.S. i think one of

Speaker E: the things to consider when it comes to these prices is the costs to develop and to sell these devices or to sell these pharmaceutical compounds. Um, you know, you're seeing the J and J's and the mercs and all them have R and D exceeding 10% of sales. Um, the sales force to reach out to these patients is um, you know, a costly endeavor for the, for the pharmaceutical companies. Um, so it turns into how are you able to make these investments profitable from a company perspective. Um, and so you know, when you have a rare disease, you're throwing in billions of dollars for a small population based patient population, you have to cover that cost by charging more per patient. Um, now that as we're kind of going past kind of the traditional innovation in cardiology in the initial cancer um, treatment, you get into that rare and rarer disease states that we're trying to cure. Um, that is one of the reasons why you're seeing you know, an elevated average cost per um, prescription drug for, with regards to the US versus International, uh, there's, it's a kind of a black box and it turns into how much is the US revenue covering that the R and D expenses and the sga, uh, expenses that we're talking about and then is the US Sales is covering that. Is the international one just kind of, I don't want to say goodwill, but is it more of reaching out to those patients who may not be able to afford it? Maybe the pharmaceutical companies have in the back of their minds of what company, what insurance programs can afford a more costly version of the drug to cover those expenses down the road. That, that's kind of the black box that goes behind the story there.

Speaker B: So Matt, are we then saying that there's a, uh, large gap between maybe the research and development on the investment side and the ultimate final retail price of these drugs?

Speaker E: The companies, I mean that's the thing though. These publicly traded pharmaceutical companies, they're focusing on what they have to report in the quarterly earnings. Um, and so in order to get to those quarterly earnings and gain, you know, exceed what consensus is expecting, they have to look at the overall business model and see what is the price for those prescription drugs to be able to cover the new costs that they're doing as they're trying to expand and reach out to newer and newer disease states out there.

Speaker C: Again, there's the margin. Um, I'll speak from my experience, I actually worked within the contract research organization industry, um, so running large lab for clinical trials. And so it's very, very, very, um, intimately involved with that side of the R and D. And I think the outstanding question is, is the US Uh subsidizing pharma R and D? That's the question. And then you take it a layer deeper and then you say, and I'll talk about rare conditions. Then you ask the question, are US employers subsidizing pharma R and D? And I think with, I think the answer to that is increasingly yes. And here's the data behind that. So we're seeing the pipeline, the pharma pipeline, um, increasingly focused on um, condition or on treatments for uh, rare, ultra rare conditions as an example. And where do these show up? They show up in children. And where are children covered? Um, we see within employer health plans, we often think of just the employees. Right? Well, it's actually 50% of the members on the health plan are employees. The other 50% are non employees. And when we look at the data, particularly for self funded employers, who of course are taking on this financial risk, right? So I would argue they are subsidizing pharma R and D, so they're taking on the financial risk. Up to a quarter of their members are under the age of 20. So now you think about these rare conditions and you think about who is going to feel the impact of these uh, gene therapies in particular for rare conditions because they're showing up at children, it's going to be employers. And so that's the type, I think those are the types of kind of tough questions and um, getting deeper, diving deeper into what are the actual economic dynamics that are at play here that we need to really be asking. Because at the end of the day, like I will say this, we looked at um, claims over a million within uh, our book of business, self funded employers, uh, looking at about 4 million lives, we saw about a 45% increase over a two year period in million dollar claimants. When you normalize that. So per thousand lives, a 45% increase. And what is one of the things that's driving that? It's these therapies for rare conditions that can be 2 million, 3 million, $4 million. And that's paid claims. That's paid claims. And so you have a small employer like we talked about before, with 500 employees, they get a $4 million claim. And in some situations we're seeing some of these therapies that are ongoing that just we have to ask the question, is that sustainable?

Speaker A: All right, so I thought what we'd do now is maybe pivot to AI. And uh, Matt, I know this is an area that you uh, enjoy thinking and talking about, so maybe I'll give you first crack at these questions. Um, so, uh, I guess to start out, what do you think are the most promising applications of AI in healthcare today?

Speaker E: I believe it's going to be very effective in coronary artery disease. Um, and it's going to be anything that requires, um, a CT scan, um, that you know, just requires an extra degree of, you know, granularity in the diagnostic process. Um, and so I can talk, I feel like I can talk for hours about this. But let's just start with that coronary side and you know, you have a congestion in your coronary artery. At what point do you need to be treated for that disease? And so there's, you know, the doctor has to make the decision and you know, if they go in too early, the treatment wasn't necessary. It was too costly for the hospital and for the patient and for the payers. If they wait too long then, you know, you're going to have acute, you know, complications with either a heart attack, um, or other, you know, other ailments with heart failure. So trying to find that sweet spot of when to treat is very important for the doctor. And being able to determine more accurately when to start treating and how to treat is what makes AI so important. It's that extra tool, that extra calculator that allows the doctor to make a more precise diagnostic of what is on going or diagnosis about what actually is going on in the coronary arteries and with the lesion.

Speaker A: And maybe, um, looking into that crystal ball again, I know one of the main problems that we have in the United States is the fact that we have, uh, a lot of healthcare providers in places like New York City or Manhattan, but maybe not so much in Manhattan, Kansas. Um, do you think that AI and maybe even, uh, healthcare robots can, can, um, shape patient access and sort of bridge that gap between the places that we have a lot of healthcare providers and the places that we don't have a whole lot?

Speaker E: I mean, yeah, I think just the. Being able to utilize AI as a tool for the scanning is going to be very important. So we're talking about the hospitals in Kansas being able to, um, have a better understanding of the scans to help them out with their treatment decisions, um, because, you know, let's say they only do theoretically five to ten scans a week, while those, you know, large institutional hospitals in New York are doing hundreds and hundreds and hundreds. So just having the experience of what the AI is telling you from hundreds and hundreds and hundreds of scans versus just your mental memory of the five to ten scans you're doing a week, um, that's a, that's a huge benefit right there.

Speaker B: And that brings us to the end of our Vital Signs podcast. A huge thank you to our guests ted pizzo and Dr. Shaelyn Buck and Matt Hendrickson for bringing their insights and perspectives to the table to help us to better understand and navigate the challenging healthcare system. Thank you for joining us. Until next time, stay well.

Speaker A: Thanks for listening to the Financial Executive's Edge. If today's episode started, sparked new ideas, or helped sharpen your perspective, be sure to follow and review us on your favorite podcast platform. You can also visit financialexecutivesjournal.com for more insights, articles, and upcoming episodes. Until next time, stay sharp, stay strategic, and maintain your edge. The Financial Executive's Edge.