Transcript
Jake Shubert (00:00) hey, Melissa. Hey, Hannah. How’s it going?
Melissa Campbell (00:04) How are you today?
Jake Shubert (00:06) Doing pretty good. How about you? Great. Nice?
Hannah Marston, RI Health Center Association, RI (00:10) Made it to your destination. Safe and sound.
Jake Shubert (00:14) Funny enough. No, I ended up not going on Sunday. I had my first ever like real back injury, which is not fun. I think on the scale of back injuries, I think I’m pretty lucky. So like, you know, I can’t complain too much, but the idea of like getting on a plane and sitting for five hours, I was like that’s just never going to happen. So, I ended up having a little more time at home but.
Hannah Marston, RI Health Center Association, RI (00:43) You got your haircut looks good. Yeah.
Jake Shubert (00:46) The haircut was pre back injury, so.
Melissa Campbell (00:50) Yeah, they look good, pre back injury, right? Jake?
Jake Shubert (00:53) Yeah, yeah, yeah, exactly.
Melissa Campbell (00:55) It’s a humbling moment, the first back injury.
Jake Shubert (00:58) Very, very much. So, it’s like, oh, all right. This is, this is how it’s going to be now. Okay? I’m.
Melissa Campbell (01:03) not even going to tell you what the future holds. So, yeah, let’s like two decades older than you.
Jake Shubert (01:08) Yeah. Let’s let’s keep the whole ignorance is bliss thing going on. It’s like.
Melissa Campbell (01:12) The magic, a surprise of the magic. So, yeah, and,
Jake Shubert (01:16) and Hannah, were you going on pto? I’m trying to remember, I think you were traveling somewhere, right? Yeah.
Hannah Marston, RI Health Center Association, RI (01:20) So, tomorrow morning, I get on a plane, but it’s a short ride headed to Nashville for a loan. And so.
Jake Shubert (01:26) Nice. That’s awesome. Have you been there before? Yeah.
Hannah Marston, RI Health Center Association, RI (01:29) Several times, it’s like our disneyland.
Jake Shubert (01:32) Okay. There you go.
Hannah Marston, RI Health Center Association, RI (01:32) We love it there? Yeah, my coworker just said you should buy a house there. I’m like, well, I don’t know.
Jake Shubert (01:38) Yeah, I’ve.
Hannah Marston, RI Health Center Association, RI (01:40) done that probably 10 years ago if we’re going to do that, but.
Jake Shubert (01:42) Yeah, yeah. Right. Yeah. That’s cool that, you know, all the spots though. That’s awesome. Sweet. Well, we can jump into things for today. So we set up 30 minutes for today’s. Call transparently like I don’t know if we’re going to need the full 30 minutes but obviously happy to use it if it is needed. But kind of like our idea for today’s, call is like as we’re having these conversations, there’s kind of like two separate tracks to the conversation right there’s. The first track which is like with everyone from different centers involved making sure that, you know, josh and myself that we’re answering their questions, that we’re learning about their specific workflows, and hopefully, you know, getting to a place where they’re confident and excited about how we can potentially help. Then there’s the secondary track which is like, okay, if the centers do decide like, hey, this actually has value. This makes sense. How do we actually manage the procurement process? How do we manage, sort of like getting everyone what they need? So that’s kind of the track we wanted to focus today’s, call on, which is understanding like, okay, if this is something that, you know, comes to fruition, like what does that kind of look like? How can, on the downside? Like how can we be helpful and help make the process more efficient? So that was kind of the idea for today’s. Call. Does that sound like a useful agenda for the two of you?
Melissa Campbell (02:58) Yes, that makes sense. Okay. Cool.
Jake Shubert (03:01) Anything else that either of you wanted to cover on today’s? Call again? Maybe.
Melissa Campbell (03:07) This happened on the last call too. It’s sort of some of those things in the health centers got their answers to like, what is our, their support? You know, their customer support throughout the process. You know, troubleshooting like I’m assuming all those answers have kind of were answered in the prior call? Like they’ve shared some of their pain points with you and, you know, you’re able to kind of lay out. This is what this looks like, right? This is how we provide customer cert, this is what’s available to them. This is they have a primary person or they have a call center or, you know, turnaround times, all of those, all of those were.
Hannah Marston, RI Health Center Association, RI (03:47) Answered.
Melissa Campbell (03:49) By the health for the health centers. Yeah.
Jake Shubert (03:51) We covered a good portion of that and especially a lot of the workflow and turnaround time and stuff I think we’ve talked about support a little bit but not like extensively. And that’s definitely something that Melissa, I think is like worthwhile for us to spend more.
Melissa Campbell (04:04) Time on. Yeah, I feel like that’s kind of a critical component because one of the biggest issues in this is the hiccups and the hangups and working with some of our human resource folks and their HRIS stuff right there. There’s a lot of bumpiness. So having that kind of a clear understanding of that I think will be very valuable as you go through this process of laying that out, I think is going to be important.
Jake Shubert (04:29) Yeah, I totally agree. I think like whenever any new like software kind of tools come in like that onboarding implementation is like really important for like the long term health. So, yeah, I’ll make note of that. Yeah. And.
Melissa Campbell (04:39) Also like what training? So, if staff needs training, like building that in there as well, I think.
Jake Shubert (04:45) Yeah. And we do provide training during like the onboarding?
Melissa Campbell (04:48) Yeah, yeah.
Jake Shubert (04:50) That’s a great call out. Yeah.
Melissa Campbell (04:52) And it, and also as a periodic like staff turns over. So how can they access the training? Whether it’s an on demand training or something like that? So those are just some things… that I had on my mind. Yeah.
Jake Shubert (05:06) Yeah. 100 percent. I appreciate you bringing it up. Anything else that’s like sort of top of mind for either of you or like that you’ve heard from any of the health centers that would be helpful for us to cover?
Hannah Marston, RI Health Center Association, RI (05:18) Not necessarily from the health centers, but I’m wondering if part of our conversation might include.
Melissa Campbell (05:26) Like almost.
Hannah Marston, RI Health Center Association, RI (05:29) Do you work like if you work with other groups? Like if it’s kind of like a group purchasing like in other words, instead of these health centers coming from you coming at you separately, if we can get some kind of a value of coming as a.
Melissa Campbell (05:42) Larger group?
Hannah Marston, RI Health Center Association, RI (05:44) Through Riker, yeah.
Jake Shubert (05:46) That’s how we’re thinking about it, right? Which is like, yeah.
Hannah Marston, RI Health Center Association, RI (05:49) Probably, I was hoping so. So good. Okay.
Jake Shubert (05:51) Yeah, that’s how we’ve done it in the past and that’s how we’re thinking about it, which is like, I don’t know if this is like a crappy analogy but like kind of like the buying wholesale discount, right? Where it’s like every group is like pulling the resources together and centrally managed through Riker, but every organization has their own like disparate instance, right? Where there’s like security and access provisions and all that kind of stuff. So, yeah, that is totally how we’re thinking about it. It sounds like that’s kind of how you’re thinking about it as well is like sort of going through the Riker umbrella.
Joshua Levitan (06:16) But I think it makes sense to like dig in a little further here. And I think you’ll explain why as we move through the call. So, Hannah when you typically do that, do you paper it on Riker, or do you use the collective bargaining to secure different discounts and then paper it with each organization separately? The?
Hannah Marston, RI Health Center Association, RI (06:37) Most recent, we papered it with Riker, and then each organization will have, you know, their baa with.
Jake Shubert (06:42) You know?
Hannah Marston, RI Health Center Association, RI (06:44) You guys.
Jake Shubert (06:45) But,
Hannah Marston, RI Health Center Association, RI (06:46) there is this master agreement at Riker, and all the invoicing goes through Riker. So.
Joshua Levitan (06:52) Okay. And then they’re distributing, they’re paying you back through however you handle that with them, correct?
Hannah Marston, RI Health Center Association, RI (06:58) So we’re kind of, yeah, we’re at risk in the middle there, but that’s how it’s done, Jake.
Joshua Levitan (07:04) We should you want to get into this piece now?
Jake Shubert (07:07) Yeah, we can totally get, I guess josh, I’m able to defer a little bit to you first thing. I just want to call out just because you brought it up kind of, I guess hopefully good news on the baa side since we manage P… AI, we don’t manage any phi in the platform. We actually don’t need to go through the baa process. We should hopefully help expedite some of the steps. And we do have like a master services agreement and all that kind of stuff that we can share with you guys. Do you guys have like an in house legal team through Rika? Is that like an outside consultant? Like how does?
Hannah Marston, RI Health Center Association, RI (07:35) Yeah, we typically, we have outside counsel if we need to run agreements, you know, that kind of thing?
Jake Shubert (07:40) Yeah, that makes sense. So, like if it’s helpful, I can always share sort of the msa with you guys and just have them have their sort of initial look at it especially since outside counsel typically takes a little bit longer than like internal teams, at least from, yeah, exactly, at least from my direct experience. But, yeah… I think what you’re saying definitely streamlines the sort of overall process and how we’re thinking about it too. I guess, josh, I don’t want to step on your toes. Were there any initial stuff you wanted to flag as we get into the details of that here?
Joshua Levitan (08:09) No, I think Jake, we need to what we had talked about, we should go through the SKU flex and the, yeah, how that plays on.
Jake Shubert (08:16) Yeah. Okay. So what josh was talking about is like with our, the way we contract and the way we sort of price overall, I’ll give, I think Hannah, we talked about this briefly, but that was probably like a month or so ago. So I’ll do a little bit of like a, of a refresher, the way medallion, the way that we price our pricing model is there’s sort of two key components to it right there’s. Like the typical sort of software fee. We call this medallion core. And this is to use medallion as like a provider data management tool and powers all the downstream automations in the platform. And the second piece is really where the services come in which is like, okay, medallion is now doing these credentialing packets and doing these enrollments and doing this work on behalf of, you know, these health centers. So we’re charging based on volume, right? How many enrollments are we doing? How many credentialing packets? Are we processing right? Those sort of general volumes? So a core part of why I sent that scoping questionnaire via the Google doc was, so we have a general sort of like ballpark idea like, okay here’s, kind of what the volumes look like, what I want to call out here and apologies, it’s kind of like a long winded me rambling, but what I want to call out here is like, we understand that this is like an inexact science, right? It’s very hard to predict these things a year out or two years out or three years out. That’s pretty difficult. So, what josh was mentioning is our contracts come with what we call skew flexibility, which means that between line items of the contract, or even between years of the contract, Rica or these health centers can move things back and forward to account for that sort of variance, right?
Jake Shubert (09:50) So if you guys do less enrollment than you expect, but more credentialing than you expect. You could shift sort of that spend over or in year one. If the centers grow less than expected, right? You can take that delta in spend and move it to year two or year three. Or the reverse where you pull forward from year two or year three, the contract to cover any sort of gaps. What’s important here. Is that when we’re thinking about this as like a overall Rica umbrella organization encompassing, you know, four or five different health centers is how we think of the skew flexibility between organizations, right? So if we’re looking at, you know, let’s say, ccap for instance, and we’re looking at east bay, right? Like how we wanna sort of set up? Those divisions where, you know, is it okay if east bay takes a little bit of usage from wood river or is it, do we wanna keep that totally, you know, separate entities, right? So that’s sort of how we’re getting into the skew flexibility conversation here and kind of the nuances of contracting through a parent organization with multiple, you know, child organizations. I guess josh, again, that was a lot of me talking. Anything that I missed that we wanna call out there. Yeah, I.
Joshua Levitan (11:06) Think the important reason why we wanna broach this now too is like what Jake said, but then also the implications like Hannah and Melissa for you. Like we don’t want you to have to be in a situation where every month or every quarter or every year, you to have to like run these like consumption numbers and try and figure out exactly how many services each organization used, and then bill them like for those services. Because that is gonna be administrative work that.
Hannah Marston, RI Health Center Association, RI (11:41) Is, is that really cumbersome? Yeah, to be.
Joshua Levitan (11:44) Honest, like in all of these scenarios that I personally have worked, we’ve avoided this by saying, like let’s essentially negotiate the per unit cost with the parents so that you get the volume based discounts by coming in at scale but then paper it separately so that we avoid this completely. Oh, because otherwise, you’re oh, go ahead because otherwise, like you’re gonna, and there, if that is a non starter, like there might be a way we can try and automate this reporting, like we can talk to our teams about that, but like if it was all, so, let’s say all four of us are a health center, right? And we all think that we’re gonna hire five new providers, but I hire six, I’ve stolen that work so to speak from one of you and I now owe medallion or the parents that we all bought through more. And there are probably gonna be six or seven small line items on each quote. It’s like the caqh management, licensing, credentialing monitoring and the core seats. So it’s not just like one cost per provider that you need to run the math on it’s. Like there were 20 providers and they each got a credentialing packet and we monitored each of them. And then we did 47 enrollments across those 20 providers. So like is all the data in the platform to be able to make this math somewhat repeatable and easy in a spreadsheet? Yes, it is. But it’s gonna have to be pulled. And then you’re gonna have to figure out how to say to east bay, this month, you owe us 7,000 dollars, and last month you owed us 2000 dollars, but you thought you were gonna just owe us 5,000 dollars every month, right? Does that make sense?
Hannah Marston, RI Health Center Association, RI (13:32) I hear what you’re saying for sure and the way you’re the way you’ve structured it in the past with others where we kind of come together, you get the volume discount and then paper it separately. The health centers are still getting the benefit of how we have done it when we papered it, but it’s just administratively less burdensome. Okay, that’s definitely something we need to consider. Yeah.
Melissa Campbell (13:59) I guess I also think about trend data, right? So, like as this is happening and as these services are like having an understanding. So if a contract’s a year, you know, getting that data is important just to see where the services are going, right? Where are the dollars going? What are we seeing? And just to try to kind of estimate, you know, maybe future.
Jake Shubert (14:25) Yeah, needs.
Melissa Campbell (14:26) As well because it is a very turbulent, I understand it’s a very turbulent kind of system totally in terms of credentialing and needs so, but, and in terms of how customers don’t.
Joshua Levitan (14:38) extract, right? Yeah, you know, there’s other factors in there. Yeah, I mean, I think.
Melissa Campbell (14:44) that’s helpful information, you know? Yeah.
Jake Shubert (14:47) Oh, sorry. Sorry, Melissa.
Melissa Campbell (14:49) No, no, no, I just, you know, because you’re saying like, oh, the system doesn’t do this, but, you know, as you’re having an understanding where the services are going or where’s the volume, you know, whether it’s getting used more, maybe this is getting used more than that in the service lines.
Joshua Levitan (15:04) Exactly, right. And like the other way that we could handle this, but this is a bad idea is like we could put a hard cap on each service number in each sub account if we were contracting through you at Rica to make sure that no one exceeded what they had estimated, right?
Joshua Levitan (15:21) Yeah. But then you run into a scenario where a health center needs to backfill because someone left and they have a really important hire to make and need to get that person. And then they have to go to you and you have to go to us and we have to change that cap, right? So, like that gets sticky too. And like that’s not like, yeah, we want to make your life easy. We want everyone to benefit from the collective bargaining, but like, I don’t want to put two hours of excel spreadsheets and then building custom invoices on Hannah’s desk every month.
Melissa Campbell (15:50) I appreciate that. Josh and I.
Jake Shubert (15:55) Would just say like I hope it’s not coming across that like we’re trying to make this complicated. Like our goal isn’t to complicate things we’re just trying to provide like since we’ve seen this before like the best practices and like just really think through things. Cause, yeah, I mean we’re… pretty much what I’m trying to say is like as we have these discussions, we’re happy to try to figure out how we can best accommodate the structure you guys are looking for. But we just sort of want to call out the granularities that we know do make a difference and try to work on those like ahead of time and hopefully it doesn’t come across as complicated or stressful. But we’re just trying to make sure we’re like being the best potential partner and it’s actually like structured the way that’s going to be the healthiest for every health center, but then also at the parent level too nice. I.
Melissa Campbell (16:40) Appreciate that. If we look at like uds staffing a little bit, that could sort of help us as well, right? Like across the health centers, just to have an understanding. Yeah, absolutely. Yeah. Just to get a snapshot of like, oh, you know, PC or east bay has this or because they all, they are very different sizes.
Joshua Levitan (17:02) Yeah. And like this is like what Jake and I do all day, like the medallions, like the way that we price here is meant to be in line with the work that we do and the value.
Joshua Levitan (17:11) And we want our customers to have flexibility to expand and contract across products or in years. But like we never nail a quote 100 percent and we know that, and we are transparent about that. Like the goal, like let’s say we were just working with one health center, we would run through all of the math that Jake sent over and we try and get as close to the pin and we don’t want to underestimate because if you consume more then you need to come back for like an early renewal and we don’t want to overestimate because that hurts your cash flow. So like the goal is to get as close to the pin as possible and know that there are assumptions in that math, but everyone be clear on that, try and be super accurate and look if things change, we obviously can sign early renewal and there obviously are ways to year to roll consumption from year one into year two. But like, it is a moving target and that’s the element that makes this more confusing when you think about like the group buying, right? So you.
Hannah Marston, RI Health Center Association, RI (18:02) don’t bill based on a volume, you bill like a, you figure out the amount per month and that’s what you bill for the contract. And then if there’s overage, you pay extra or if there’s underage, it’s not a word. Probably it folds to the next year or.
Joshua Levitan (18:16) Yeah. I mean, essentially pulling back the curtain like just from like how this works for like we’re a venture backed like software as a service company. So like for us, like if we, if a customer took an action and then we bill for that, we like our investors would have a little, would have a little freak out, right? So like we need to.
Hannah Marston, RI Health Center Association, RI (18:36) Try they want their money. Yeah, yeah.
Joshua Levitan (18:38) And it’s also about like it’s also about like forecasting our revenue as like a software company. And so that’s why we have to like come to the okay, like we think it’s going to be 150 K a year. And here’s the math that breaks that down. But then, and that 150 K, like we want to break that up quarterly. Like Jake is a magician and can get the quarterly broken up like we don’t necessarily need it. Hopefully, I’m not over committing for him here, but we’re not always, you know, saying we did that up front in the year, but that’s the commitment amount like the contract is signed to.
Joshua Levitan (19:10) But then effectively like the skew flex that we’re talking about like in a sense that’s now a gift card and every serve every piece of medallion, whether it’s the management or the credentialing or the pay enrollment has a price and you consume against that gift card.
Jake Shubert (19:24) Yep. That makes.
Hannah Marston, RI Health Center Association, RI (19:25) sense to me. Yeah, cool. Right? I guess sort of like.
Jake Shubert (19:30) Zooming out a little bit. Also just curious coming off of the demo. We did have you gotten, have you guys heard any feedback from the health centers? Like were they excited? Was it positive? Just sort of curious, for any feedback that they provided? I actually.
Hannah Marston, RI Health Center Association, RI (19:41) Haven’t heard from them, but seeing you saw what I saw but seeing their reactions seemed very positive. I thought, I mean, I, the people most people were on camera, I think. Yeah.
Jake Shubert (19:54) And.
Hannah Marston, RI Health Center Association, RI (19:54) the reactions that I saw, I feel like they were positive they were pleased with what they were seeing and hearing. Yeah.
Jake Shubert (20:02) I felt the same way. I just wasn’t sure if they related any like feedback back. But, yeah.
Hannah Marston, RI Health Center Association, RI (20:05) Actually, yes. And, I did. I, I’m backpedaling now, I did see the CFO from providence at an event this week and he mentioned that Carol had talked to him about it. He didn’t say he kept, he kind of keeps things close to vest a little bit, but he did say that she had spoken to him about it. So, that’s great. Yeah, they’re talking. Yeah.
Jake Shubert (20:29) I, I’m not surprised. The CFO plays stuff close to the vest wouldn’t be the first time that I’ve heard that they’re a.
Hannah Marston, RI Health Center Association, RI (20:35) Quiet crew. Yeah.
Jake Shubert (20:36) Yeah, pretty much.
Hannah Marston, RI Health Center Association, RI (20:38) Yeah. Well, I guess.
Jake Shubert (20:40) Sort of so, process wise. We have this call, on the thirtieth coming up, which we’re really looking forward to. I know I sent over the scoping questionnaire stuff. I guess I’m just sort of curious like for your, for, like your opinions on like how should we structure the evaluation from here? Like what do you think the not, in terms of like, I guess I’m asking this question, trying to make sure we’re checking the boxes on figuring out if we are or are not a good fit, and if the health centers are or are not interested, cause if we ended up not being the right fit, like, that’s totally okay too, but it’s just a little complicated working with like so many different, organizations all at once. And like we’re happy to set up individual time with organizations or keep doing things collectively. But I’m just not sure like besides pricing and that kind of stuff like what else, should be involved in the evaluation process from here? And who else should be involved if anyone at the centers needs to be involved,
Hannah Marston, RI Health Center Association, RI (21:38) So, the next meeting, I, are you thinking maybe involving more people in that meeting? Or are you thinking that after that like?
Jake Shubert (21:47) Next step, I would say probably after that would be like if there are other people who need to be involved like signing off at the particular health centers or whatever. It might be like, I think that’s when those folks would like.
Hannah Marston, RI Health Center Association, RI (21:56) To go really decision makers, cause at this level, they’re not making, you know, right? Totally, they’re going to their CFO or they’re going to their, let me figure that out. Cause I’m I know you’re right there, there’s going to be people higher up that need to be involved in the decision making, and I do think that the pricing is going to make,
Jake Shubert (22:19) You know, obviously.
Hannah Marston, RI Health Center Association, RI (22:21) It’s a large part of the decision for them as well. So,
Jake Shubert (22:25) When we know.
Hannah Marston, RI Health Center Association, RI (22:27) A little bit more about that,
Joshua Levitan (22:29) Yeah. And it also is probably worth mentioning Jake, just the bva process that we like to include with pricing. Yeah.
Jake Shubert (22:36) Yeah, totally, josh. So, what I was going to say is internal.
Joshua Levitan (22:38) Speak, bva, we’ll explain that in non internal acronyms, yes.
Hannah Marston, RI Health Center Association, RI (22:43) That’s what that is, but I may, I’m probably completely wrong. So I’ll let you go.
Jake Shubert (22:48) Josh is referring to like, our business value assessment, which is pretty much where we like to figure out like kind of like return on investment summary for like more decision maker, folks, and obviously, like the people we’re talking to would love to have them be part of those conversations as well, but helping sort of the leadership figure out like if this is or is not something that they want to move forward with. Just transparently like how I’m not sure how, you know, you guys at Ryka, or the centers themselves are like thinking about pricing, but like, we don’t know where we’re going to land pricing wise yet, cause we don’t have the scoping inputs but like just to be transparent, like, I don’t doubt that we’re going to be more expensive than the current state, right? The current state is largely, there’s no software tools in place or people are just doing spreadsheets, like, obviously, this is going to be a jump from nothing to something, right? So, like, I have no doubt we’re gonna be more expensive than sort of the current run of play,
Hannah Marston, RI Health Center Association, RI (23:40) So, I, I’m.
Jake Shubert (23:41) not sure how, like if there’s like an overall budget across the health centers or how each health center is sort of thinking about this. But, I do want to call out that like there’ll probably be a different framework of thinking about pricing since we are managing things end to end and obviously are going to be more expensive, than doing nothing.
Hannah Marston, RI Health Center Association, RI (23:58) No, that makes sense. I mean, the one that the one that may be less of a delta is providence cause they like they had a person and so they’re like trying to figure out should we hire a person or a solution? And yeah, so, I understand.
Joshua Levitan (24:15) That there’s two arms of it, which is like offsetting manual labor when you had one person like providence who was doing this, that’s really easy to consider. That becomes harder to consider when little pieces of this are little pieces of five people’s job. Yeah, and it’s like, you know, they get 10 hours back, but they didn’t own this completely. Well, what does that 10 hours mean to the business?
Jake Shubert (24:37) But,
Joshua Levitan (24:38) regardless, like sort of, the, operational time that is removed by medallion managing things is one aspect of this.
Joshua Levitan (24:46) The other aspect of this is like what we generally refer to as like revenue acceleration, which is like if we are speeding, if providers can now blanket statement, see patients and like bring in claims 30 days faster. And the average provider, you know, accounts for a 1,000 dollars of claims a day. Like there’s in some ways, it’s new revenue. In some ways. It’s also just speeding up that cash flow. But, it’s a little bit less of a hard like, hey, we’re going to remove 40 hours and you can calculate the time per hour. And then, you know, what medallion costs. It’s a little bit more about like bringing dollars into the organization quicker to help with like cash flow and sort of expanding over time, the amount of dollars that come into the organization. Yes.
Hannah Marston, RI Health Center Association, RI (25:37) So that’s sort of what you illustrate in that bba?
Jake Shubert (25:40) Yes, both.
Joshua Levitan (25:41) Of those is what we would illustrate. Yeah, we want Carol to be able to go to a CFO with as much data on it as possible and not say this is a really cool tool. And I love the demo. But like, yeah, this is why this matters for the health of our organization and the health of our patients.
Hannah Marston, RI Health Center Association, RI (25:55) Yeah. Okay.
Joshua Levitan (25:57) Yeah.
Hannah Marston, RI Health Center Association, RI (25:57) And I don’t have visibility into like what their budgets are. Yeah, we don’t get into that,
Joshua Levitan (26:04) So, I, so, but.
Hannah Marston, RI Health Center Association, RI (26:07) Again, I appreciate what you’re saying, and I don’t doubt that, right? Like, it’s gonna be more.
Joshua Levitan (26:15) Than what they’re.
Hannah Marston, RI Health Center Association, RI (26:16) spending now, but it’s a value proposition too. So, okay. And the,
Joshua Levitan (26:22) very real scenario here. Is that like when we actually get down to it, of all the parties that we’re talking to right now, some but not all want to move forward.
Jake Shubert (26:30) Yeah.
Joshua Levitan (26:31) Which is again, totally okay, right? We’re not the right fit for everyone.
Hannah Marston, RI Health Center Association, RI (26:36) It doesn’t have to be an all or nothing. Well.
Joshua Levitan (26:38) I mean, obviously, the more, like the way that we’re gonna go and get the best discount is based on volume, like, with any there’s volume based discounts. So, like, you know, and that’s sort of what we were talking about before, right? Like if I’m making up numbers, but if all of the provider count across all of Rika is a 1,000, Jake and I are going to finance really, Jake, and saying, like we’re pricing this as if it was a 1,000 person org, then we’re just dividing it into five contracts, the total va, and we usually like to get finance to be as friendly as possible, especially when we’re dealing with nonprofits and fqhcs, and we understand the value served to communities and the position that you’re in based on legislation and the world and all sorts of other stuff, right? So, there’s you know, informal leverage that we have there in terms of maximizing your price. But like the, it’s an interesting game, right? Because like, we need to provide pricing for people to move forward and decide if they’re in or out. But there is also like the more people that are in the lower that we can argue for the price to be. Yeah.
Hannah Marston, RI Health Center Association, RI (27:37) Now, that makes sense. And, if thundermist starts to be a part of this and providence is a part of this. Those are our two biggest health centers those.
Joshua Levitan (27:45) Are the.
Hannah Marston, RI Health Center Association, RI (27:45) biggest, yeah, but,
Melissa Campbell (27:47) that’s why I think that customer support. Like what are the other benefits that surround that, right? We understand that you can increase productivity by having your provider, you know, working sooner or that type of thing. But I think it’s helped it’s always helpful to talk to them.
Joshua Levitan (28:02) Yeah, Jake, maybe that should really be the next meeting with everyone?
Melissa Campbell (28:05) Yeah, like build that in there. So they have that kind of.
Hannah Marston, RI Health Center Association, RI (28:08) Before we even.
Joshua Levitan (28:09) Break off like that’s a good call with everyone like here’s, the support model. Yeah, here’s, the implementation walkthrough. Yeah.
Hannah Marston, RI Health Center Association, RI (28:18) Yeah. So next steps, what are you, what? Like what do you need me to do? What? Like, yeah.
Jake Shubert (28:25) You’re asking the question that I normally ask things that are next steps from here. So, we already have the call set up in the third. Everyone like josh called out. We can make that like a implementation onboarding support focused conversation as well as like answer any outstanding questions. The number one thing that it will be most helpful is like any gentle nudges either of you can make to the organizations to fill out that Google doc questionnaire,
Joshua Levitan (28:50) That’s that’s.
Jake Shubert (28:51) by far, the most important thing at this point. And then following our call on the thirtieth, I guess josh, this might be me talking out loud and kind of like a question for you, but josh, I, yeah, I guess josh wants to ask, do you think after the call on the thirtieth, that we should start having breakout sessions with individual orgs to sort of get the granular details on certain state, make sure we validate any scoping questions, and start working on the, you know, individual business value assessments that will then be sort of the global one across Rika?
Joshua Levitan (29:26) Yeah, yeah. Sorry, Jake, I got like a sos slack that just pulled my attention for a sec. Would you mind repeating that for me?
Jake Shubert (29:35) No worries. I was asking, following the call we have on the thirtieth, should we from there, start scheduling individual breakout sessions with each health center? Yeah. Okay. Cool. That’s what I.
Joshua Levitan (29:44) thought, I think it’s the Q a and the, and all the stuff that Melissa called out, is well done as a group and into Q a, like there might be some of that comes up once we split off, but I think it’s really valuable for your organizations to hear the like, the more questions, the better, right? So, I like that the Q a is together because people are learning more than they would if they only asked their own questions. And then I think at that point, we split off. But the parallel track as Jake said of collecting all that data between now and that next meeting and afterwards, just helps us get the ball rolling internally. So.
Jake Shubert (30:15) I think I had to sort of summarize we’ll have this call on the.
Jake Shubert (30:28) Air, we’ll schedule like on the call on the thirtieth, we’ll schedule breakout sessions with all the organizations who are interested. And then for the four of us on like a sort of a global parent level with Rika, maybe we can just meet every two weeks or so. Whatever sort of relevant is have that check in of like, okay, how are things looking? How are we tracking for like a decision maker conversation? How are we looking at sort of like bundle discounts, like all that kind of stuff. We can have sort of this touch base for sort of, the macro perspective of like what this might look like. That sounds good. Cool. Yeah. And.
Joshua Levitan (30:59) I’m I thought of one more thing I’m spitballing here. And so Hannah, I don’t know if this works for you and Jake honestly, I don’t really know if this works for us, but if there is some element of like if we project ahead like some sort of master service agreement that we execute with Rika, but that has no.
Jake Shubert (31:16) po or,
Joshua Levitan (31:18) quote or follow up attached to it, but that like somehow gives us a relationship that then makes it easier for the organizations to contract with us. I don’t know if that is at all possible, but if that is, it is something we should talk about because I think the implication here is as well like as we’re trying to see this in this direction because it is so much cleaner and easier for you guys. The implication though is then it’s like five legal processes that we’re potentially running. And I don’t know if there’s any ever like you sort of established terms from a contractual standpoint, but then let the, let each organization make amendments to those. But then bill those separately. Does that make any sense to anyone?
Melissa Campbell (32:06) I’m hearing it, but I’m not sure. Yeah, I think four here are the five, right? How is it, who’s getting the bill? But yeah, you know, it’s almost like there’s some core but there’s some individual billing or something going, yeah.
Jake Shubert (32:21) I think we can noodle on that, josh. I think the heart of it is like, how can we, since we’re going to be doing discounting on the parent level? Like how can we do this in a way that we’re just going directly? Like from a legal process, we’re having like a universal legal agreement through Rica? It would be, yeah, would be the idea. And like I said, we could share our msa ahead of time and have our outside counsel look at it. I think the question would just be if, and we don’t know this for sure. But if we do have to contract at the individual health center levels.
Joshua Levitan (32:53) Maybe.
Jake Shubert (32:55) there are just order forms that at those levels, but there’s a master services agreement across Rica that applies to all the organizations.
Joshua Levitan (33:04) And I don’t mean to throw more confusion in here because it was literally just a crazy idea and it might not be possible for either of us. But if it saves the health center’s time in procurement and legal, if it saves medallion time. Like if there’s a chance that could be a win, but maybe we should table that until we get a little further along. But I see Hannah, your brain looks like it’s churning a little bit.
Melissa Campbell (33:26) Yeah, I’m very, I gotta, yeah.
Jake Shubert (33:29) We have two.
Melissa Campbell (33:30) Other two other things to look at too, Hannah with the maven project and the.
Jake Shubert (33:36) the.
Melissa Campbell (33:36) other, yeah, the other, so maybe there’s something in those agreements that has happened that could be a problem for this?
Jake Shubert (33:44) Yeah, that could be, that could be, we’re certainly open to ideas.
Jake Shubert (33:49) I hope you guys aren’t leaving this call way more stressed or confused than you had joining the call. That was definitely, not our intention. You’re good. I just played.
Melissa Campbell (33:58) It on a Thursday. So your brain starts kind of.
Jake Shubert (34:02) And Hannah.
Melissa Campbell (34:03) Said it’s in Nashville that’s got to be that’s all good. Well.
Jake Shubert (34:08) I think we’re off all set for right now. Hannah, safe travels to and from Nashville, excited to hear about your trip, we will reconnect on the thirtieth, it doesn’t have to be this week, but maybe next week if folks still haven’t, filled out the questionnaire, maybe just give them a gentle nudge would be very much appreciated. Okie.
Melissa Campbell (34:27) Dokie. Sounds good. Cool.
Jake Shubert (34:28) Well, thanks as always. Great. Chatting with you both and we will connect soon.
Melissa Campbell (34:32) All right. Thanks later. Bye.