[00:00:00] Stacey Richter: On episode 532 a few weeks ago, Chris Klomp from HHS was talking about ER, emergency room usage, as a signal, not just a statistic.
If too many folks show up in the ER, consider this a signal that there's something missing. It means a patient who doesn't have access to primary care, or maybe specialist care, or maybe doesn't know where to go to get the care, or is too sick to figure this out. Or maybe there's onerous prior auth requirements or long delays that you can avoid if you just go to the ER and/or a clinical organization is requiring upfront payment that a patient doesn't have on hand to make an appointment. Right?
All of these things are things that are blazing red flags that patients, who are also members, are lost.
If you consider a lost patient as a patient having a wildly poor patient experience, then it becomes, I don't know, kind of inarguable that true patient experience in healthcare is not like a superficial amenity such as pianos in the lobby or espresso machines.
Patient experience is instead a direct operational consequence of the architecture underpinning any given patient journey, or lack of architecture underpinning any given patient journey as the case may be.
And by the way, the irony of talking right now about underlying architecture for the patient journey being the solve for what patient experience really should be, yeah, this irony is not lost on me.
We currently have a healthcare industry slightly obsessed with architecture, but I'm talking the real estate kind with lots of marble and waterfalls and fancy art, of course.
But yeah, instead of the real estate kind of architecture, in the show today, we concern ourselves with making sure that our patient's journey is architected, that there's true design thinking here for what we want our patient experiences to be and/or member experiences to be, because same thing.
Unequivocally, without this kind of architecture, the kind that holds together a solid patient journey, we're not going to get patients, ie, members, the right diagnosis and the right treatment for that diagnosis, and we probably also won't get outcomes at an affordable price. We're just not. For all the reasons that we talk about endlessly in episode after episode on this podcast.
Listen to the episodes with Preston Alexander, [Episode 482], Vivian Ho,[Episode 466], Shane Cerone, and Dr. Sam Flanders,[Episode 492] or go back and listen to the first episode with Dr. Suhas Gondi [Episode 404] for maybe places to start.
I say all this to say, or more accurately, for Robyn Leone to say coming up here, if we are talking about patient experience, this right here, getting the right diagnosis, right care, affordable price, is what the measure of patient experience really should be. I mean, otherwise, what are we even doing here? It's supposed to be a healthcare industry.
But in many respects, we often measure experience in ways that don't include how easy and affordable it is to walk out having been appropriately cared for.
Bottom line and key takeaway from this conversation with my guest, Robyn Leone, today: patient experience is a function of experience architecture. Good intentions, clinician empathy, and customer service cannot overcome a bad structural design.
And I say that in defense of clinicians as much as on behalf of patients and plan sponsors. True experience means organizational leadership getting architecture right to enable the right diagnosis and the right treatment at a fair and affordable price. And plan sponsors, you get what you pay for intentionally or otherwise. So yeah.
Robyn Leone talks about architecting the patient journey as building three buildings, metaphorical buildings now, that we should be constructing so that patients can make it through their encounters with the healthcare industry having received the highest value possible care as the default.
The three buildings in your member and/or patient experience journey should be building one, access and navigation. So this is what happens prior to anybody needing care. That's the first building.
The second building houses delivery and care coordination. So this is what happens during the care episodes, how well is the whole person treated. And then the third building is what happens after, where there should be transparent and accountable billing.
And right, a lot of this will only work if a provider is working with plan sponsors who get in there and probably have direct contracts, who are deliberately paying for the patient experience that the plan sponsor wants their members to receive, and is actively involved in steering and tiering. And also, with an underline, is investing, I would say, in true measurable, accountable, advanced primary care.
Robyn Leone, my guest today, is the Chief Experience Officer over at ZERO.Health. This entails looking after ZERO’s three main customer bases, meaning the patient/member, the employer, as well as the clinicians or provider organization.
So therefore, she's the perfect person to have this illuminating, light-filled, open floor plan conversation with today.
My name is Stacey Richter. This is Relentless Health Value. Thank you so much to ZERO.Health for providing some financial support to Relentless Health Value to cover the cost of producing the episode today. Also, thanks so much to our founding sponsor, Aventria Health Group.
Robyn Leone, welcome to Relentless Health Value.
[00:06:27] Robyn Leone: Thanks for having me, Stacey
[00:06:28] Stacey Richter: So let's just jump in here. What is patient experience?
[00:06:33] Robyn Leone: Well, I think a high-performing system or organization, their experience must be judged on whether the patient obtains the right diagnosis at the right time, the right and appropriate treatment for that diagnosis, and can afford the treatment without any financial ruin.
I think that's it in a nutshell.
[00:06:56] Stacey Richter: So patients have a great experience when they get the right diagnosis, they get the proper, appropriate treatment at the right time, and they can afford their care. I'm gonna just interject here and say that is not what I thought you were gonna say. Most of the time, I don't know, maybe a piano in the lobby would come up.
[00:07:16] Robyn Leone: Oh, that, and, "Oh, we'll have espresso machines, and we'll have valet parking."
[00:07:21] Stacey Richter: What's the danger there, though? Like, what's the danger if somebody starts talking, you say patient experience, they say espresso and pianos?
[00:07:30] Robyn Leone: Then what do you measure, right? The only thing you can change are the things that you measure.
So you measure how many lattes you give out. You measure how many people smile when they watch the piano play itself, instead of measuring what were the outcomes. Can people actually show up and get their treatments? Do they put off those treatments 'cause they can't afford it? You lose sight of the actual delivery of healthcare and serving patients' best interests.
[00:08:03] Stacey Richter: So many things have come together for me right now because I see exactly what you're saying. What gets measured gets managed, and maybe we shouldn't be surprised by the vast number of atriums that are currently being built because that's what we inadvertently probably are measuring.
[[And when I say inadvertently measuring, what I mean by that is probably a combination of what's getting measured and what is frankly not getting measured.
For example, a clinical organization is likely not measuring the experience of patients who never show up because they fear how much it will cost, or they are in the process of not getting needed care for other reasons.
It's also tough to get a grasp of how many patients got outcomes driven appropriate and affordable care when how you ace most patient satisfaction surveys is, yeah, get better parking, liberally prescribe antibiotics, or prescribe, I don't know what the latest trend is on TikTok, like prescribe anabolic steroids from dubious sources. Not sure if I'm joking or not.
Just saying, we have patient experience measures that might be better suited to like a hotel, not a hospital. And then we wonder why all of us are paying for hospitals to look like hotels while they still have high hospital-acquired infection rates or ER mortality.]]
So if I'm thinking about the patient experience being, did the patient actually leave with appropriate, affordable healthcare that resulted in good outcomes.
How does that... How do I achieve that? What's, what's my first step here? What do I start thinking about?
[00:09:57] Robyn Leone: Well, I think we have to think about it as architecture, right? Because if you don't build the right structure, you never get the right experience. So, you know, if we stick with that architecture analogy, I think we could think of it as a series of three buildings, and at the simplest level, those three buildings happen before the care, during the care, and after the care.
[00:10:23] Stacey Richter: The patient experience starts way before the patient even enters the premises. Let me dig in here. If I started circling the first building, what is it, what do you mean exactly? Like, from a patient experience perspective, what has to be identified and built or blueprinted before the patient even arrives at the care setting relative to patient experience?
[00:10:50] Robyn Leone: Yeah. So as we consider constructing these buildings, the patient doesn't exist in isolation, right? There's three parties. They all have to be on the same page: the patient, the clinician, the employer paying for most of it. Everybody has to be aligned on what is building this house, or it's not gonna work, right?
So if we think about that very first building before the care takes place, you're really looking at access and navigation at its core. Because what tends to happen is a referral gets dropped onto the patient by a doctor, right? What happens next? Total confusing administrative void.
So the doctor thinks they did their job. "Hey, I want you to get this MRI." The patient just kind of walks out of the office thinking, "Well, where do I go? Is my insurance gonna cover it? How much is this gonna cost me?" And we don't know, like, between that happening, whether or not they're gonna show up, right?
So it's, to me, from a patient perspective in that very first encounter, I mean, it has to be frictionless access.
[00:12:07] Stacey Richter: So we're thinking about patient experience, and if you listen to patients complain, you will see very clearly the complexity of our healthcare system that we're chucking people in the middle of to try to figure out who to go to from the beginning. Or where to go for some service. To your point, maybe there's an imaging direct- like, there's so many different ways that a patient can get lost, and that's patient experience.
Like, that's more patient experience than like, was someone nice to them when they called because by the time the patient's calling, they're probably at work, number one, trying to figure out how to make a phone call in their car. But also they shouldn't have even had to figure out how to find the time to go out to their car to make a phone call.
It's, it's almost like a little bit too reactive at that point. So what do I do?
[00:13:01] Robyn Leone: If you're really focusing on experience, then the experience from the clinician's point of view that either their organization or people that are partnering with them, we have to get this freedom from these, you know, prior auth burdens, check boxes, just all this nonsense that's driving burnout, right?
So you focus on that clinician experience in order to enable them to provide a better patient experience.
[00:13:33] Stacey Richter: So you're saying, like, as an employer here, so if I'm, I'm thinking like a plan sponsor, how do I construct. Because I'm taking this as actionable for me, the employer here. Are you saying that it's possible for me to provide a better experience for the doctors that are serving my members? Like, I should take that as my remit.
[00:13:55] Robyn Leone: Absolutely. There's, you know, you're looking at your benefit package to better understand what offerings are out there. We are way beyond having to stick within that traditional, well, I just have my carrier. I'm gonna let, you know, patients fend for themselves.
Employers can take a really active role in either partnering directly with provider groups, partnering with organizations that do direct bundled contracts, really holding navigation and advocacy vendors accountable to truly support, and automating those high-value steerage so that care starts literally at the right site, not the most expensive default place. So there's ownership on all three parties within that first area.
[00:14:52] Stacey Richter: I always say, like, nobody's job description on a plan sponsor is transform the healthcare industry, so this is a little untoward to be talking about it like it's a plan sponsor's responsibility. But at least in the short term, it almost feels like it sort of has to be, um, sadly.
So okay, so our first building that the plan sponsor really needs to be contemplative of is kind of exactly what we're talking about. Like, think about what's happening before even the care and make sure that this is set up so that the patient can actually have a good experience once they need care, is kinda how I'm taking it.
Okay. So let's just say we've got building one constructed. Not necessarily saying we've got the landscaping figured out, but at least we've got we have a good sense of... 'Cause this is, this is big stuff that we're talking about now, but you gotta start somewhere.
And let's just say that a plan sponsor and a clinical organization too, like, we have collaboration between parties, we've got some direct contracts set up, we've figured out how we're engaging members, right?
Like, we've done all of the things that need to happen. We've thought through what we want the patient experience to be.
Okay, so now someone needs care. Now we're walking into building two here, which is the what needs to happen during the delivery, the actual care delivery. If we're thinking about patient experience, what is building two, what's the architecture there?
[00:16:15] Robyn Leone: Well, building two is really about from a patient perspective, is being treated as a whole person, not a collection of all these separate body parts. You know, having to go to all these different clinicians.
That fragmentation is really a result of kind of the degradation of our primary care system. You've talked with many guests about the cost of it, why is, you know, why is it not being funded?
But really understanding that if patients can't get timely access, they're gonna either go without care, or they're gonna turn to really expensive alternatives. So I think we start to frame this in looking at how do we reduce the downstream costs? And if I'm an employer, just looking at what I spend on primary care, you know, isn't necessarily gonna tell me a solution.
But when you look at advanced primary care solutions in place today, and being able to have patients have a true relationship with a primary care doctor, we get this holistic end-to-end care while solving building one, getting, you know, the right, the right diagnosis, the right treatment, and, you know, hopefully a transparent, affordable price.
[00:17:40] Stacey Richter: So what I'm hearing you say is that the big pillar in the architecture of building two is getting the primary care, advanced primary care, having a strong game there.
But then also, if I'm thinking about this from the clinician side, there is just such angst right now, for very good reason, amongst primary care clinicians, just given the, you alluded to it, pretty much decimation of primary care in the fee-for-service ecosystem that we currently have, exacerbated by the RUC, all kinds of things, the structural things that have been transpiring here.
So if I'm thinking about how I wanna get a patient the best experience while they're in the process of getting care, you know, either in one episode or a string of episodes because now there's a thing that's going on with this patient's health, the best way to do that is to ensure that they have a primary care home base.
That they have somebody who's helping them that they already trust, who can make sure that they're getting directed to the something that is in line with what is both most affordable but also the highest quality, aligning with the direct contracts potentially that the employer has in place, but also making sure that the patient feels like their whole person is getting taken care of.
So building two is really, like, probably as a first step, but get your primary care house in order, it sounds like.
[00:19:08] Robyn Leone: Absolutely, because what you're doing is you're solving the problem at the front door. Instead of the fact that as you're meandering around building two trying to get care delivery, trying to get all the doctors to talk to each other, costs have gone up, outcomes are out the window, nobody understands what's happening, and the patient suffers at their most vulnerable point, too.
So why not fix it at the front door instead of trying to fix it later or deal with the consequences, especially from the employer. Because what that means for the employer is high ER rates, really high specialist costs, duplicate services over and over again, less productive employees for sure, and obviously less, less healthy as well.
[00:19:55] Stacey Richter: Yeah. There's been a lot of conversation about what does the data show relative to leveling up primary care relative to downstream costs. One thing that is very, very clear, though, is that the less primary care that is available, the higher ER costs are. That is very, very well established.
Middle of last year, I think I did a, a show [Episode 467] that is entitled something like “Less Primary Care is Higher ER Visits”, so it probably is not very hard to find. [Also Episode 464 with Al Lewis]
[00:20:22] Stacey Richter: So house, house number two from a patient experience perspective is primary care, trusted relationships, this care coordination. And you start thinking about patient experience, like again, when you start thinking about when it goes horribly wrong, it is always some patient who's just kind of like lost trying to figure out, they're not sure where to go, they're not sure what to do. They're making phone calls. It's really scary, especially if you just got diagnosed with something and you have no idea what to do or where to go or who to make an appointment with.
[00:20:53] Robyn Leone: Right. Yeah. Or you're being asked to take the next step, but you're faced with this $1,500 bill from the first step.
You're like, "Well, what's this step gonna cost me? And who's, how is this gonna make me better? Who's advocating for me?" I think that causes a lot of unknowns, and it causes patients to stop treatment, you know, before they truly finish. And many times the clinician doesn't get accountability into that.
[00:21:25] Stacey Richter: Which probably leads us to building number three here.
So maybe we should take the path over there, which is what happens after. And a lot of times what happens after is the financial repercussions of earlier decisions.
So let's just say somebody walks out of that first I Just Got Care, and now they're in the after zone. Talk about patient experience relative to billing just to simplify this.
[00:21:56] Robyn Leone: Yeah. Well, I think we have to focus on the fact that employers are still paying the majority of healthcare costs, 80%, right? But that 20-
[00:22:06] Stacey Richter: For their plan, you mean...
[00:22:07] Robyn Leone: For their plan, right. For their plan, they're paying about 80%. But as you think about how much those costs are going up, you put that 20% onus onto a patient, and if, you know, we're getting better at transparency, but we're not there.
And so what really needs to be in place to have the best patient experience is there's no surprise bills or unexpectedly large bills. You're expecting something to be around $50 and it's $900 or, or something.
Getting better at real time upfront pricing, or programs that can offer it at much significantly lower cost or no cost, is ideal.
[00:22:54] Stacey Richter: It definitely reminds me of a conversation [Episode 525] that I had with Dr. Cristin Dickerson from Green Imaging, where you're just talking about fee-for-service, there's probably two different kinds. One of them is some fee for some service. We're not quite sure what the fee is. We're not quite sure what the service is, right?
Which is exactly what you're talking about. What that's gonna result in is a patient getting an unexpectedly, probably large bill.
So I think what you're saying is that if we really wanna improve patient experience on the back end, like smacking them with a, "Surprise," that's wildly higher than what they thought it was gonna be.
You know, and/or they're in the midst of a fight, which I think sometimes we underestimate. Like, oh, well, the insurance will eventually pick it up. You're getting this EOB sitting on the kitchen counter that says you owe $57,000. Like, you're gonna panic, and it doesn't matter if a month later it gets straightened out, right?
Like, that is not a good experience trying to go to sleep every night wondering if you're gonna lose your house.
On the other hand, you've got a known fee for a specified service, and if that's the case, then everybody knows what it's gonna cost. There's gonna be nothing unexpected for either the plan sponsor paying 80% of the bill or the enrollee paying whatever's left over.
[00:24:15] Robyn Leone: Yeah, and a majority of people are not going to understand that something went awry with the billing. A personal example, just got my yearly mammogram, and I had switched insurance, and I gave them the insurance information. I get the bill from the radiologist, says I owe $497.
I'm like, "No, it's a preventive screening. It's, it's gonna be zero dollars." And then I read the fine print. They didn't submit it to insurance. But so many people are going to think, "Well, my insurance paid for part of it, so I must owe this $497 bill", and maybe they start the process of paying it.
So really, that real-time upfront knowledge, what is this going to cost me? Do I have other options? And I think, you know, making sure, I think many organizations do a great job of advocating and helping patients become better advocates to understand healthcare, because our healthcare illiteracy is too high, because it's too complicated for anyone to navigate successfully.
[00:25:26] Stacey Richter: Yeah, and if we're also thinking about this building number three, long conversation [Episode 521] about this with Andrew Tsang about revenue cycle management a couple of months ago.
But you do have, I mean, like, 30% or something of the cost of healthcare is going to fighting over who's gonna pay the bill.
In the olden days, a clinical organization that got a network contract, you knew how much you were gonna get paid, and you, you could count on getting paid. Like, that's why you wanted to be in-network.
The longer the time goes by, the more it is not necessarily a given, and you gotta spend a lot of money fighting over getting paid and dealing with the denials, and it's a long game, and there's the float. There's all kinds of perverse incentives that are involved there.
So even if we're thinking about this from the clinical organization's perspective, especially if it's an independent physician that doesn't have a floor filled with people doing rev cycle, helping to ensure that everybody knows what the price is and everybody knows what the payment is ultimately gonna be could make a really big difference here.
[00:26:32] Robyn Leone: Well, when I think of the clinician inside building three, right, which is should be financial transparency and accountable settlement, right, after the care, the clinicians get put in this very tough position because they're waiting months, months for reimbursements, which is ludicrous.
It's forcing them in that second building to require patients to pay upfront before care is given, before care will get scheduled, right? I mean, recent articles talking about, you know, before you'll even have a surgery scheduled, "Oh, it looks like you owe $2,000 on your deductible. Soon as you pay that, we can get you scheduled."
And that is the result of the clinicians being pulled in both directions in building three of saying, "Well, I can't, I can't float all this money that I'm trying to collect from members and waiting for carriers to pay me." So really being able, it should be designed to get a fair settlement quickly, submit the claims.
I mean, we have all these, you know, timely billing laws in place now, but it's more on the submission side. So getting that accountability more on the payment side is absolutely where we need to go.
[00:27:56] Stacey Richter: So if we're thinking about the advice overall, like we've got our three buildings here. If I'm thinking about this from the standpoint of the plan sponsor, union, self-insured employer, what do I do? Like, what is a really tactical “What now?”
[00:28:16] Robyn Leone: Yeah, what now? Well, I think if, as a plan sponsor, I would ask four things, and you will probably they'd probably be asking this, you know, their broker partners for assistance. But I think starting off to say, "What are we really spending on primary care? How much are our employees and their covered dependents with chronic conditions using the system?"
Really looking at this from a people perspective to say, when we look at our plan dollars, what's being spent? Are they being managed? Are they showing up in the ER? Really understanding that.
And then I think the third question is, what are we paying for high-volume stuff, right? MRIs, CT scans, MSK procedures, you know, specialty infusions now are going berserk.
And then lastly, where's the gap of what did we pay, what did the provider really receive? You know, and what's kinda happening in the middle to understand do we need to look at solutions that don't force us to solely rely on this insurance carrier? So that's my key advice for plan sponsors.
[00:29:30] Stacey Richter: We're thinking about this relative to patient experience, but also that patient experience is echoing what the care journey should be.
Because if the care journey is great, the architecture of that care journey, they run through the process like it was designed to be run through because it was designed, they should have a great experience. It should be the right diagnosis, the right care, the right time, the right price, right? Like, that's how it should be managed.
So your first thing is how many patients are actually doing it that way, right? Like, if we've set up primary care, then what is the utilization of primary care? How much are they paying for high-volume things? If we're, we're talking about affordability and everybody's going to the most expensive place in town, you know, Ivana Krajcinovic talked [Episode 501] about how an infusion at one place was literally a million dollars more. That's gonna not be affordable either this year or next year when premiums go up.
And if you start thinking about it that way, then we can be really proactive about what the experience is that we want. That is actionable information that we can then take back and really proactively think about what we want our supply chain to be.
And if it's a high-value service, John Quinn called it a subassembly [Episode 524]. We can set up a subassembly so that we're navigating patients over to what that subassembly looks like and sounds like.
So just being very thoughtful about what we're not leaving it up to chance.
[00:30:55] Robyn Leone: Yeah, and I think they can demand hard metrics tied to both clinical and financial accountability. Not soft satisfaction surveys, right?
I think, you know, we, we get too wrapped up. We talked about the satisfaction of something, but really understanding the metrics behind what's happening clinically, what's the financial impact of that, and as plan sponsors start to really look at it from that lens, I think there's a level of empowerment that when they start to put solutions in place and they see those metrics for the first time, it's inspiring.
Like, oh my gosh, I actually feel like we have a little bit more control, and our employees and their family members are coming to us thanking us for, you know, improving the quality of their lives.
[00:31:49] Stacey Richter: Yeah, and another issue with these, with the satisfaction surveys that you start hearing more and more about is that because everyone has heard the stories about someone going bankrupt and losing their house, the bar is so low.
Like, sometimes the satisfaction surveys are like, "Wow, I didn't lose my house, so five stars." The benchmarks must be taken into consideration as they're reviewed.
But again, what are we doing here? If we're trying to pay for healthcare, then what does good look like relative to the care, I think is a really, an interesting and kind of a banger of a point that it just like, just get back to basics here.
Like, first principle is the care is supposed to be right care, right time, right price.
[00:32:35] Robyn Leone: Yeah.
[00:32:36] Stacey Richter: If I'm thinking about this from a clinical perspective, there are a number of clinicians that listen to this podcast. What advice do you have relative to this, the three buildings patient experience conversation for them?
[00:32:50] Robyn Leone: Well, I think it also is, ties into similar advice for the employer is that the clinicians don't have to just rely on contracts with carriers. They can seek direct contracting partners, right, that are really gonna value the clinical expertise over the coding volume or throughput, because they're gonna be measured on the patient experience.
I think also really understanding different relationships and how they impact how much more quickly they could get paid.
[[00:33:24] Stacey Richter: To be specific here, practices considering getting into direct contracting, which is what Robyn is alluding to here as the different relationship, definitely ask direct contracting vendors for their, for example, median days to payment, not their target days to payment, what their median is.
You wanna weigh lower reimbursement against reduced accounts receivable and less time doing prior auths and/or fighting denials.
Because, yeah, if anyone is playing the float, meaning carriers, ASOs, TPAs, what they want to do is slow walk payment. This is how they keep money in their own bank accounts and earn interest on that money for as long as possible.
Listen to the episode with Preston Alexander This point is what underlies what Robyn is gonna say right now.]]
[00:34:19] Robyn Leone: I think there's an interesting financial state, conversation for clinicians around what is the impact of this carrier float and what would it look like if they got paid, you know, two weeks after they submitted a claim, and were able to navigate that, expand, not have so many people in the practice dedicated to tracking down denials, but really just said, "Gosh, we have this flow of, of patients. We get to see them, we submit our bills, we get paid, we get to, we get to do what we went to med school for."
[00:34:55] Stacey Richter: I think you're raising a point also that comes up a lot on the show. There's a lot of advantages in formally having the ultimate purchasers of care working with the ultimate deliverers of care, especially physician-led, independent operations, right?
Like, having the buyer and the ultimate purveyor actually having conversations with each other, actually working together, putting a vise grip on the middle. It just, it, it's so illuminating at a minimum.
[00:35:27] Robyn Leone: Yes.
[00:35:28] Stacey Richter: And at a maximum, there is so much money that is possible just to ensure that the purchaser's actually paying for healthcare and not some intermediary to do something which may be unnecessary.
Or maybe it's not, but maybe it's unnecessary. You'll figure that out. Robyn Leone, talk to me a little bit about ZERO.Health.
[00:35:51] Robyn Leone: Well, ZERO is a direct contracting solution. We contract directly with all kinds of specialty providers, right? Labs, imaging, surgeries, infusions, really adding in direct primary care to the mix as well.
And employers, self-funded employers partner with ZERO for everything we talked about today, really ensuring that the experience across all those that are involved in the healthcare system works more smoothly. And as we like to say, that is healthcare simplified. So that's a little bit about ZERO.
[00:36:28] Stacey Richter: Yeah, and I definitely would recommend if anyone has other questions, Dr. Stanley Schwartz, also one of the founders of ZERO, was on the pod [Episode 486] maybe it was last year. So for more, for more thoughts from thought leaders over at ZERO, definitely go back and listen to that show.
Robyn Leone, thank you so much for being on Relentless Health Value today.
[00:36:49] Robyn Leone: My pleasure. Thanks, Stacey.