From Ad Impressions to Lifetime Care: Measuring What Really Matters with Jeremy Rogers

[MUSIC] Many CFOs around the country say, without margin, there is no mission and there's some truth to that. You got to keep the lights on. But I think it's keeping the top of funnel wide open. We want to provide care for all Hoosiers. Everyone in our state who needs care, we're open for them. But you want to be strategic. Not all growth is equally weighted. There are some services that are maybe more profitable, have more correlation to long-term health. I mean, our mission here is to help Indiana become one of the healthiest states. We can't do that alone just by offering primary care or other low-acuity services. We have to offer a suite of different services across the care continuum. Across a patient's lifetime, you've got to balance all those things. So I've been really excited to have this conversation today because I think most of us know that if we want to break over reliance on paid search, it's more than just experimenting with media mixes and different channels. You really have to build a strategy of first-party data. You've got to figure out how are you going to move beyond last click because if you stand up a bunch of channels and you don't have that part figured out, it may fail because of lack of proof points. And you need to think beyond just a single job to be done of acquisition. How do we win the most valuable patients? How do we think about lifetime value beyond that initial appointment? And I'm joined today by who I think is one of the maybe the Kim Kardashian of health care, one of the biggest thought leaders and influencers in health care. Maybe not that famous, but Jeremy Rogers, he's vice president of digital marketing and experience over Indiana health. I've known Jeremy for a while. I truly mean this. I like really respect if Jeremy has a thought or has something to say about a topic. We should listen. And he was kind enough to give me an hour today to dig into this and have that conversation together. Thanks Jeremy, welcome. You got it right. You flatter me too much. Way too much. You deserve it, man. All right, let's just get into it. Like why bother at all? No one's going to fault marketers in health care from investing heavily in intent capture that drives appointments. Like why should we even bother to just give up? Just put all your money in Google. Why care? Yeah, so I think there's nothing wrong with kind of last touch demand capture. Still very important, but the reality is in this post pandemic world, the supplied demand curve is much different than it used to be. I mean, many clinics around the country are already full. They're already at capacity. So in that environment, acquiring a net new patient may not be the highest priority. If you can't service that patient downstream, think special to care, think procedures, chronic care management, things like that. If you can't service those patients, is that really the best use of your marketing dollars? What I would say there, we've tried to frame that and look across the entire patient journey. So maybe it's about driving more lifetime value with that customer. Maybe it's about the loyalty, the retention. We talk about share of care, share of wallet. In many cases nowadays, those types of metrics are as important or maybe even more important than acquiring one single net new patient. If I'm a CMO in healthcare, and I have great metrics on the bottom of funnel strategies, and I can see that they're working, and Google search ads is probably the single greatest advertising platform built in the history of mankind. It works. It's not a faulty product. How does the overreliance on Google, you mentioned share of wallet as one example, but how do they show up in the numbers? How would I know as a CMO that it's time to start thinking about things beyond Google search? Yeah, I think you look at churns. So are you bringing in a patient for a primary care clinic, or for an urgent care visit? Are they sticking with your system? Are they seeking out that deeper care with your broader delivery network? If the answers know, if you have high churn, if your LTV is relatively low compared to local competition, then maybe you're doing a good enough job, top of funnel, but you're seeing a lot of abandonment, mid funnel or bottom funnel, that's what I would look at, dig into the metrics around that. Is my, you know, I'm not a healthcare marketer, I never have been, I've spent four years in this market. Is my worldview wrong in that, even though I'm providing health services, like Indiana, you're providing health services to all different types of patients, but is my worldview wrong that like, even with that, you have to keep the lights on, and you have to figure out how to win the most valuable patients as well, so that your hospital system is successful. Is that like a, is that the wrong worldview for someone outside of healthcare? No, no, no, it's not the wrong worldview. I think we wouldn't use the term of valuable around patients. I think you've got to be careful how you frame it with physicians, other care providers. But I think the reality is there's a virtuous combination of the margin and the mission. You know, many CFOs around the country say, without margin, there is no mission, and there's some truth to that. You've got to keep the lights on. But I think, you know, it's, it's keeping the top of funnel wide open. You know, we, we want to provide care for all hosiers. If you look at the finances of our industry, there are certain types of encounters that are more profitable. The average primary care appointment in our country is a lost leader. You don't make money off of that. Systems make money off of procedures, operations, other types of chronic care services. That is where the profitability equation comes into play. That's not all of it, but you've got to factor that in in terms of your overall pipeline. Yeah, I've heard that, what you just said, I've heard that before, which is that first appointment isn't necessarily the thing that is the thing that matters most to the business. It's, it's, are we actually winning? And you've talked to me in the past about share of wallet. Are we actually able to help service you across the other things that you'll need from us? That's what you mean by LTV, I'm guessing. You can go. Exactly right. After Google, right? If we're, if we're all in alignment that Google is a critical part, just, just bottom of funnel actions are a critical part of our strategy. I would never build a strategy that didn't show up the bottom of the funnel. Make sure I was really good there to capture any kind of intent that's coming my way or any kind of demand. As we think about like building beyond that foundation, what should the full funnel strategy look like in healthcare? Or what does it look like for you? How are you thinking about this? Yeah, I would frame it, Ray. It's, it's really not one funnel. If you look at a patient's healthcare life cycle, it's a series of funnels. And so you're, you're winning that relationship every time. Not, you know, most patients are not in market for healthcare services very often throughout a year. It may be a handful of times depending upon their health. But every time they're seeking care, you're putting them through a new conversion funnel. You've got the benefit of having that relationship with them. We've talked before like there are no other industries that have more data about their customers than a health system. It's how we, how we use that data to help nudge a patient to engage a patient to engage them. There may be times when they do or they're overdue for a healthcare service, they may not even realize it. As a marketer, we can use those signals to really, you know, drive that loyalty, drive that engagement. To me, that's the, the full journey of patients entire life cycle of healthcare. There are those micro conversions along the way that we should focus a lot more on now than that we did before. That really resonated with me. What you just said is that like a patient, a consumer may not actually be in market very often throughout a year. I can relate to that. Like I'm not in market. I'm not actively looking for healthcare. But then there are moments where I am. And I'm not actually like Google searching. Like I'm actually not searching that I'm calling friends. I'm networking. I'm thinking about brands. I recognize that that really resonates. And, and you know, that just describes it. Like a lot of healthcare isn't intent capture. It's it's demand generation, right? Bingo. Bingo. If you could, like maybe even just because I think you think about the world probably in like different service lines and different services that, you know, Indiana Health can provide for consumers. If you could, if you feel comfortable, what would you walk us through the journey of a consumer through one of those service lines? Like how does that look in practice? Outside of just someone querying for something in Google. Yeah. Yeah. Happy to, Ryan. I'll paint a broad brush because no two journeys are the same depending on is it low acuity care is a high acuity. Imagine a patient who's just received a life altering diagnosis. Their journey is very different than someone who's seeking like urgent care or very low acuity care from a primary care provider. Typically though, there are those intent signals. So a patient may they may have a symptom. They may know they have a need. It typically nowadays begins digitally. They're searching. They're using their AI agent of choice. A Google search would have you to seek out options. What type of care should I be seeking from that? they're then going into that conversion funnel. Like where can I receive care? Where should I receive care? Is it covered by my insurance provider? Can I get in, you know, nowadays it's more difficult than ever to actually get in to receive care. So there's that calculus coming in play too. So they're going through that part of the funnel. Then once they've chosen, they're booking the appointment. Nowadays, more often than not, there's a self-service piece. It may be a via an app or a via web portal. What have you? They're typically scheduling on their own. Then you get into the care delivery part of the funnel, things like registration and arrival. And you may be physically in a clinic or a hospital. You may be doing a virtual care encounter. Regardless, you're entering that care delivery part of the journey, you're engaging a provider physically or virtually. They're rendering care. They're asking questions about you, capturing information. From that point, there's a diagnosis. There's a therapeutic. They're giving you a prescription. They're giving you a therapy, a treatment. What have you? Then there's basically everything after care. So there's the relationship piece. There's the health and wellness piece. There's the favorite part, the billing piece, which we all love in healthcare. Patients are traversing that too. And it's really very cyclical. Like these journeys are not linear. Like there are many different on and off ramps. You may go back in. You may need a second opinion. You may have to go back for further treatment. It just keeps iterating from there. And that's kind of the archetypical customer journey in provider healthcare. What about, let me give you a story. This is a true story. My dad passed away from cancer a while ago. And when my dad was diagnosed with cancer, the conversations that we were having were around, what are the, he lived in the mid-Atlantic area. What are the best healthcare brands? And how can my dad get into trials or how can you go meet with experts to get second and third opinions about this? And that was definitely, my dad had intent. We all had intent as a family. But we didn't show up initially, digitally. There were no LLMs, but even if the word today, I don't think I would need it to have searched there. How, how does that factor into your strategy like above intent channels? How do you think about marketing to make sure that when that moment happens like my family had? And sometimes it's less severe. It could be, I tore my knee skiing and veil over the weekend and I need to go get orthopedic care in Indiana. How do you get to that? - Yeah, you're spot on Ray. So I think that's something my team focused heavily on. It's kind of a dual intent approach there. So patients are searching for the nature of their illness. What would the treatment be? Then they're quickly pivoting to, okay, what are the best care options? Depending upon the severity, they may be looking for the most convenient, the closest, the most accessible, or they may be looking for the best. Who is the best surgeon? Who is the best cancer provider in my area, in my state, in my country? There are many patients who are willing to travel around the country to receive the best care. And that's appropriate in many cases. So in those scenarios, it's really incumbent upon us to make sure the information we publish externally is the most accurate and reflective of our capabilities. So it could be things like provider credentialing, it could be things like capacity, quality data, hours of operation. It's really one of our core responsibilities is any of that brand information, whether it be provider information, location information, service information, we have to make sure that is as accurate and contemporary as possible. That's very difficult for large health systems that are employing thousands of doctors. You have hundreds of clinics and hospitals, things like that. That is a full-time job in and of itself. And not to mention now with LLMs, making sure they're reading, "Are you providing the right structured data? Is your schema appropriate? Are you pushing out data in a timely fashion? It's a lot of work. It's a huge effort." This is the experience part of your title, right? It's also like once you get somebody, it is to your property, is to your front door, what is that experience going to be like? Because that's a big part of the battle, especially given the nature of consumers today in our expectations. You're right, Ray, but that's what I love the most about my job. It's that balance of brand and experience. And I would argue in healthcare, our brand is really nothing more than the totality of the experience as we deliver to a patient or a customer. That's our brand. It's not a logo or advertising. It's what we deliver. The thing that comes up in a lot of the conversations that I have, and I'm curious how you've solved this, is that even when people will nod their head at this conversation, and they'll look at it and say, "Yeah, but these two or three tactics, that's where it's easiest for me to measure." Even if I invest in these other things, the actual conversion is likely to happen in spot A or spot B. How do you move beyond that? How do you show to leadership that these other channels are effective and that they're having the desired outcome to your business goals? Yeah, I think you've got a really aligned on what are true conversions. Just booking an appointment is not necessarily the true conversion. Is it actually a care gap? Are you incentivized to actually provide value-based care? Is it the health of the patient in the end? Can you demonstrate through your marketing activities? Are you driving healthcare outcomes? And nowadays, in many cases, you can do that. Like we can truly track a patient from A to Z and C, "Hey, how did we acquire them? How did they come in?" And are we actually improving their health over time? Are they getting the screenings they're required to get? Are they following through an adherence? All of those things tie together. At the end of the day, that's the true measure of our success as marketers. It's not just getting new people in the door to a clinic. It's are we actually affecting the behavioral change? Yeah, this is the world I've always grown up in, which is show up to a board meeting. And I need to be able to link my campaigns and strategy to the actual outcome, which in B2B SaaS is revenue and retention, like the similar to your goals. What I've heard, I was at a conference maybe a year or so ago and a huge health system spent about $3 million to connect these dots. Like, what is that lift? Like, what do you need a data science team? How do you do that at Indian Health? Yeah, it's not easy, that's for sure. So you do have to spend a lot of time and energy with the plumbing, like connecting the underpinning data sources. You mentioned earlier, first party data. You have to have a very robust first party data strategy. You cannot rely upon third or fourth party data, not possible. You have to find the right partners that can do the heavy lifting to integrate with your EHR. You have to have that back in data connectivity to be able to flow that through. That's important. And I think you also have to be of a mindset that this is really a marathon, not a sprint. You can't do this like in two or three months. Like, prior to my time in healthcare, I was used to these quick sprints, okay, do the integration, watch the data you're done. In healthcare, it's an annuity. You're basically signing up for the care and feeding on this integration over time. So I think what I remind my team is we're doing very important work. This is people's lives and health that's at stake here. So it's worth the investment. It's not just financial investment. It's the energy and time that goes into it as well. So it's not how it's not easy, it's for sure. - I think it's so key to what you said because I did say at the outset of lifting your head outside of things like paid search and looking for other things. But I say that also with the reality of most people I talk to, still cannot connect their campaign level data to the outcomes that we're talking about and that by itself in this world where Google's a bit of a slot machine, for example, that's a big gap. Like are your campaigns actually delivering some leading indicator or are they actually delivering the thing that matters most? The thing that they run into Jeremy is like getting other internals, like the marketing team in general doesn't have the power to get IT to invest in, you know, I've got Epic. How do I make sure I can connect these thoughts? They're busy, like it's not because they don't want to help. It's because their resource can strain as well. How have you been successful? What advice would you give to people to get that buy-in internally from things groups that aren't marketing? - Yeah, sorry, I think you're spot on, Ray. I think a lot of it is you have to go back to articulate the real value of marketing. If marketing is really designed to drive growth, it's really how are you driving the right growth? It's not just opening the door and having anybody come in. You have to be able to tell a story through both a narrative and the data to prove, hey, we are driving strategic growth. We are acquiring and retaining the right patients at the right time, delivering them to the right care teams. If you can connect those dots and show, you have to show the ROI, it can't be fake, it has to be real, true ROI. If you can do that, you're gonna get incremental investment. Now, it may not be all the investment you need day one, but you have to be willing to iterate and grow and keep going back to the well where appropriate, but you can do it. Are there certain champions that, you know, when you think about the other executive stakeholders, is it like a finance champion, is it CO level? Like who do you, who, if you don't have buy-in, like who should you start by winning over? - Well, I think it takes a village. You have to find people who have common goals. like people who are people who are incentivized by growth. Is it a particular service line? Is it a medical group? Is it a hospital? It may vary based upon the nature of your health system, but you have to find people who have common motivation and then help them understand that your problem is also their problem. And if you can partner with them, you mentioned IT earlier. If you can get a consortium of business leaders to go to IT and say, "We have to do this. We need this. Yours is not the only voice. Marketing is an important voice, but it's not the only voice in that concert." When I think about in a board meeting, when you're meeting with other executives or stakeholders, you have to be really to the point on what data matters. What is the data that really matters when you're in front of the CO or the executives at the organization? What are those key proof points? Yeah, for me, we've been lucky for several years. Our NPS has been on our corporate scorecard. So that's one of our top four metrics for the entire enterprise is our NPS. We can then drill into it. So I can show service line level NPS. I can show clinic level NPS. I can even show like for a given provider, what is the NPS for their patients? And so using that type of data, we've been able to build a narrative around, hey, if we have higher NPS, we're driving more LTV. We're driving more retention. And that's a proxy or a leading indicator for financial growth. We've been able to build that story over multiple years. That's key. We talked about share of wallet or share of care, being able to leverage first party data and augment that with claims data were appropriate to show. Are we growing our share of wallet? If we acquire a new patient, are we able to drive that loyalty over the lifetime? Those are the types of metrics that really matter to business leaders. They do. So you mentioned, and I love that you think this way because as a B2B SaaS marketer, I have to think into dimensions. I have to think about new business for you. It's new patients. And I must think about not just retention, but I need to think about, can I offer more services to my customers and expand them? Or do you think of that in that way, not just retaining your patients, but how do I expand their wallet? Yeah, we do indeed. Like I mentioned earlier, not every patient's in market for new services all the time, but we know those moments that matter in their healthcare journey. So whether, think about it, say, a young family, they're expecting their first baby, those are, that's the first time they're consuming those services from a health system. We want to be top of mind when they're considering where to have that baby. That's one example. Think about an older patient who's received a life-changing diagnosis. We want to be top of mind, have that brand affinity, have that relationship, and there are dozens or even hundreds of those types of journeys across the healthcare continuum that we've got to show up for each and every day. Because you focus on, since LTV is such like your critical part, how does that show up and you're thinking around channels and investment? Like what changes when your mind is thinking beyond just the acquisition? Yeah, I mean, channel mix is clearly different in healthcare than other industries, no doubt about it, but I think from our perspective, it really is, if we've done a lot of work over the years segmenting our patients, so we have general, we can make general observations around based upon behaviors, psychographic information, we have lookalikes, we have propensity models, things like that. You can apply those types of thinking in a compliant way when you're doing campaign planning, we're doing broader brand planning, all those things come into play. We tend to do a combination, we look at our access, so for certain services we offer, if we don't have adequate capacity, there's no point driving more demand if we can't service that demand. We take that into consideration. I mentioned NPS earlier, if the NPS for a given service is not good enough, why would we want to drive a new customer in to have a bad experience? That's not good for anyone, so we look at that too, and then we also factor in the financial health. So there are certain services that are more strategic that may not be quite as profitable, but if they have a long tail value, if there's downstream value, we'll make investments there. And so it's frankly like 3D checkers in that situation, Ray, looking at all those dimensions to figure out what's the right mix. And what kind of team do you have that you have a data science team? Like what do you leverage as resources to help you get to the truth there? We're blessed here in a big health system. We have lots of data and lots of data scientists, so we leverage first party data. We have a couple of really strong agency relationships where they're leveraging their data science capabilities as well. It's, I've been here 10 years now. It's an area that's changed quite a bit. Like our data lake approach, our data warehouse is way, way more robust than it was five years ago, 10 years ago, and we're making continued investments there. We have to. It's kind of an arms race. When you talk about the, this is an area that I've like, heard people are starting to think more about, like I was recently talking to another CMO and they have had some changes in their system and the services that they have brand preference for are services that they're going to support, but they need to go identify their brand and new areas of service where like they're the third or fourth brand in the area. And they recognize this need for more targeted approach to go find them. What do you, is that, do you achieve that by pairing your own first party data with third party data sets in a, in a HIPAA compliant way to like help with that targeting? Is that how that works for you? We do indeed. And we also layer and array a lot of market research. We're blessed to have an in-house primary market research team. We do a lot of testing, a lot of trial and error because we serve lots of audiences, urban, suburban, rural patient populations. What works well for one segment will not work well for another. Indiana, I believe, are not as a fairly diverse state, both geographically and just from a population perspective. We have to make sure that we're showing up in the right way for those audiences. - Yeah, I love that you just, as you were saying, like rural and urban, I was thinking of multiple conversations I've had where like for people in urban, crazy to say this in 2026, but in suburban area, in rural areas specifically, like the internet isn't as prevalent as one might think or isn't as widely used as one might think. So different ways of communicating with consumers and patients don't work there. What are some, like some of the things I've heard is like shockingly direct mail is an incredible lever for some of these communities where in our brain sitting here right now we're thinking like everything shows up digitally. Like what are some of the findings that you've had that have surprised you of how you can reach your patients? - Yeah, that's one example, Ray. I think we've looked at community outreach. So in some of these more rural areas, are there community partnerships where they're kind of, whether it's community centers or other kind of centers of gravity for the culture in that area has been very effective to us. We look at interface relationships. We have lots of good, good partnerships with faith-based organizations here in Indiana. I think we've got to be careful though just because we can't generalize there are rural areas that have good technical capacity. They actually, in some cases for example, they may skewed more towards virtual care because they would rather take a video visit than travel an hour or more to have an appointment with a physician. So in some cases actually it actually skews the opposite direction. So I think you've got to be careful on that type of one size fits all approach there. - Yeah, that's right. That's like gets into the experience side which is I may have different channels to communicate but what's the best way? Because people are so busy or people don't have access in the way we take for granted. - Yeah. - And you actually service them properly if you don't understand how to match them to the service they need. - An example that I'll give you is like in rural areas like urgent care clinics. You may be 90 minutes or two hours away from an urgent care clinic. There's no point in me promoting a clinic to you when you can't get there conveniently. So how do we optimize that based upon day parting or geographic proximity? It's all part of the equation. - So there was one part of this. Like one part for me that's surprising is the lack of people who can connect to the outcome in healthcare like you just described. The other part that's surprising to me where you just went which just seems so intuitive is and if I wanted to deliver like great, great care to people which I know everybody does, then I need to make sure that it's really easy for them to identify the best way to get that care, the best time. You know, like people don't have a lot of time to take the day off to get care. Why is it so rare to see that kind of experience in healthcare? I go to your website or there's some access point and I can very, very easily figure out right now how to get care in the way and the time that's right for me. - Yeah, I would say in general Ray, a lot of it is up until a few years ago, a lot of systems didn't really put the patient at the center of decisions like that. It was more about hey, I wouldn't use the word paternal but it was more of an inside out kind of go to market approach and through the pandemic, through other kind of consumer related expectations rising, you're finding more and more systems have to operate more like a consumer company. There, we as patients have more choice now in our healthcare delivery than we ever have before, whether it's financial choice or preferential choice. And so if you kind of embrace the reality, that you're having to win these customers, these patients over every time they're in market for care, it flips on its head the way you go to market and areas like that. It has to. >> That makes so much sense. >> You mentioned there's a lot of orchestration and what we're talking about, of connecting dots and making sure you can actually layer in different data sets and making sure you can actually create a great experience. I think has it been a year? I can't remember how long ago you said this, but I think you told me a while ago, this shift, first-party data and making sure that you actually harness your first-party data is going to be such a critical thing in healthcare. Why do you decide what we just talked about? What are some of the other reasons that that's going to be critical? >> Well, I think especially you mentioned the EHRs earlier, you can get only so far by just leveraging the peer-out-of-box EHR data. That only gets you so far, but when you think about a patient's life, it's left-brain, right-brain. There's the consumer data set, so the data you're throwing off, the data you're engaging with before you become a patient, then everything affords. If the EHR is the source of truth for all of the care data in the middle, you have to have a way to connect those dots. You have to know, okay, when is Rhea engaged as a patient or when is he in market searching for other types of care? That's really where the first-party data strategy makes it hay, basically, because you've got to be able to have those intent signals going back and forth between. You've got to understand when have I come out of a care delivery experience and I may be looking for other support? When may I be open to nudging for further engagement, if you do that solely based upon EHR data, you basically have one hand tied behind your back as the reality. Especially for certain parts of the care equation, there are other smaller, more nimble players who will be nipping at the edges if you don't have a strategy to do that. I forget about the part of healthcare, which is like there's been an extreme amount of investment in alternative healthcare, whether they're startups, whether it's the big brands that were not in healthcare before, like the Amazon's of the world, that's another factor that's kind of forcing some of this kind of consumerization of healthcare. It is, right. They're attacking at the edges where they think they can generate not arbitrage profit, but drive value, drive profit, that's where they're attacking. They're not building new hospitals. They're building around the edges for those kind of sticky moments. That's what they're doing. Yeah, it makes sense. Yeah, hospitals are not, like building cars, hospitals are not, do you see things to do for tech companies? No. I said at the beginning, I really mean it. I view you so much as a thought leader. You've been on this journey and you've really thought through like what is the best way to like service our patients. A lot of people, and I'm going to make a wide sweeping generalization. It's very nuanced. I know that, but a lot of folks are not able to optimize end to end and understand like all the way down to let alone patient, like booking and appointment. They don't know LTV very well. They're tired in Google. It's like really heavily weighted in Google. And then the experience where I think a lot of the conversion rate optimization, how do I make sure that when you get to the thing you want, you can successfully like deliver that to somebody. It's really lacking in many ways. So if people are on this call and either they're angry at me for calling that out and they're like, wait, I'm trying to do as much as I can, or they're nodding their head at that. What are three actions that people should take after this podcast? Like what are some simple actions they should take to start to connect those dots a little bit more? Yeah, so great question. But I think first thing, you've got to start somewhere. Like you can't, you can't build it in one day. You've got to take these small bites at a time. So if you can't, if you can't measure the entire funnel, okay, what can you measure? Can you, can you measure micro conversions, partial conversions, start there and then iterate on that? You've got to have a long-term view. Like if you don't have a first-party data strategy, I think you're behind, you're behind the evil right now is the reality. So you've got to get going there. Figure out what are those attributes? What are the data assets you really need to create that full consumer 360 portfolio? Like to truly know a customer, what are the attributes you need to have? And what are the sources of truth for that? It may end up being you've got disparate systems. It could be EHR. It could be billing systems. It could be CRM. You've got to have a strategy to connect them. That's really, really foundational. And then just build on that. And I think third point would be, what are your, what are your growth priorities? Right, right now, if you're, if you're not careful or intentional, you can be growing in the wrong ways. Are you growing? Are you bringing in the wrong customer? Are you bringing in patients that you cannot serve us downstream? Like I mentioned earlier, with the budgets that we have nowadays, we cannot afford to throw away money or not use it to the best of its ability. So you've got to be very strategic in where are those dollars going? And are they being driven towards those customers who are of the highest value? That's never been more important in our industry. Yeah, it feels like about a year ago, I've started forming the view after talking to a lot of marketing leaders that there's like this doing more with less moment. And now it feels like that's actually moved beyond healthcare. That just seems to be a growing trend, even in VC backed B2B SaaS, like how and and and and and on the same amount of money. Is that, is that still, is that still an accurate worldview for this moment? Oh, yeah, been only speeding up. Absolutely. What do you, how's it impacting, how does it impacting your decision making and your investment? Like are there things that you used to do that you're just not doing anymore? Yes, absolutely. So we're having to rationalize everything. I mentioned ROI earlier, like the payback periods that we're looking for now for any new investment are radically faster than they ever were before. That's just the reality. So I wouldn't even like without a compelling business case, things won't even make it off the table. They wouldn't even be up for conversation at this point. So that's that's never been more true. You know, we're having to kind of figure, I mentioned this supply demand curve earlier. There are situations now, whether think about like healthcare, you hear a lot about the talent challenge we have. You may have to shift some of your consumer acquisition dollars over towards supporting talent acquisition or recruitment so that you're being asked to serve different audiences now. That's a new reality many of us are facing too. So it's it's not easy. That's for sure. Yeah, I've seen I've seen more and more not to get tactical, but I will LinkedIn. I've seen more and more marketing teams. And at first, I'm like, why are you doing LinkedIn's not a consumer market? Oh, because you're trying to recruit employees for your healthcare brand. You need to like market to those people, those indices and doctors and whoever. Yeah. If we can't be effective supporting talent acquisition, that affects our supply. Like we have to grow our supply to be able to grow our demand. Yeah. Yeah. That's great. That's just yeah. In B2B SaaS, that's one problem we generally don't have is like if we build software, we don't have to be constrained by supply. You're in a different world. You mentioned that the change in the way you look at payback has changed. I haven't seen that on my side very much like in B2B SaaS and VC backed. We do have like a bit more generous payback as long as like retention, LTV is healthy. So that's something I haven't heard before. Like how much has it changed for you? Like how extreme is it? It's been a seed change. And a lot of it frankly is about opportunity cost because if you look at health systems, our margins are so tight right now. CFOs are saying how can I allocate dollars to get the most return? And so if it's not, if it's a marketing initiative, maybe compared to a clinical initiative or an operational initiative, that payback period is a key way of kind of aligning across the different competing priorities. All right. Last part of the conversation I want to have is like a little bit of galaxy thinking because I know we both like to do this occasionally just to at least for breath or fresh air beyond the practical day to day. Where are we going to be at the end of the decade with AI in health care? What's like what's for you specifically as the digital marketing experience leader? How radical is the change going to be for all of us? I think by the end of the decade very radical. I mean, I think right now a lot of people are focused on some of the back office. Like where the most immediate payback right now in health care is kind of the non-patient facing. So whether it's administration or back office, a lot of opportunity there. If you look over the span of a decade though, I think patient facing automation will be massive. We talk about patients engaging with their own data using their own agent in terms of gathering their data, helping them navigate. Like you mentioned your dad's care experience. Imagine if you had your own LLM. It's ingesting all of your data, making recommendations to you in real time. That's what's happening. You've seen some of the announcements this week where there are large LLM partners that are creating health care specific consumer products. We're in the first inning of this ray. So I think that that's where we're going to be. I think it will take multiple years for it to mature because right now there's still a huge trust issue. People don't trust. I mean, you You have to really open up trust to be able to share your most intimate data, but once we get to that point, it will unlock a lot of automation. It will unlock a lot of just really transformative care delivery because in the day, it's all about keeping people healthier. And that's what excites me is the technology can actually be a force multiplier with the data to provide far better outcomes for patients. Back to our supply and demand. Do you think it has some potential to help you alleviate some of the supply side constraints that you face as a marketing leader? 100%. Yeah, the reality raised today, we will never reach the staffing levels we had before the pandemic. We as a country are just not training enough physicians, nurses, OR technicians. The AI automation are absolutely a way to create the efficiency in the machine to allow those providers and care team members to do more to be able to be able to we talk about practicing top of license, let them spend more of their time engaging with patients, not doing back end administration. No doubt. Jeremy, this has been an amazing conversation. I really appreciate you investing time with us and looking forward to seeing you at an upcoming event. You got it right, it was great to be here. Thank you. Today's episode is brought to you by FreshPaint. If you're a healthcare marketer under pressure to do more with less, FreshPaint helps you stretch fixed budgets, prove what's working and protect the strategies that drive growth. FreshPaint brings performance and privacy together in one platform. So you can see real outcomes across channels and double down where ROI is highest. With FreshPaint, privacy becomes your performance advantage, turn better data into smarter decisions, find more high-value patients and keep your growth plans on track. Learn more at freshpaint.io