Good afternoon, everyone. Thank you for joining. Going to give it a moment for others to join in as we've just kicked off. While we wait for other participants to join, we have launched a two question poll. So you should see that pop up in your Zoom polls. Feel free to start thinking through your answers in these questions, we'll use that as part of our jumping into the presentation today. It looks like we have a decent amount joining us, so I'm gonna go ahead and kick us off. So as I said, good afternoon, everyone, and welcome. I'm Emily Hubbard, a senior research associate at NCQA, and I'll be moderating today's webinar, Rising Cut Points Demand Smarter Home Based Gap Closure, How One Health Plan Matched Every Open Gap to the Right Modality, At Home Kits, In Home Visits, and Virtual Care. Before we get started, I'd like to introduce today's speakers. Let's go ahead to that slide. And for anyone who's just joined as I do this, we have two poll questions open for you that we'll take a look at after these introductions. So Kyle Waters is cofounder and chief product officer at ASH. ASH brings the health plans brand into the member's home with at home testing and multichannel engagement. And Justin Larkin, MD, is chief product officer at Sprinter Health. Sprinter Health provides in home and virtual care teams that close multiple care gaps in a single visit. Today, Kyle and Justin will share how two home based care companies that could otherwise be competitors instead came together around one program and one shared dataset. They'll walk through what they learned, sharing a case study and practical takeaways, and then we'll have a couple of... Or then we'll open for q and a with the audience. So you'll have the opportunity to submit your questions through the q and a feature at any point during the presentation, and we'll address as many as we can at the end of the session. So with that, if anyone has not had a chance to answer the two questions, I'll give it a couple more seconds before I close. Alright. I see about 27 of 50 participants, so almost 50% response rate. And in question one, how are you closing CareGaps today? The largest answer was engagement and outreach strategy followed by at home testing partner. So those were at 8570% respectively. With lower responses were house calls partner followed by homegrown solution and other. So why don't I pause there and see Justin and Kyle if you wanna share any reactions to that? I'm happy to repeat that if helpful. Awesome. Thanks, Emily and, Kyle and NCQA more broadly for organizing this. Excited to be here and participate in this conversation. And, what I would say just in general reactions, it looks like there's a broad set of strategies being deployed primarily anchoring on engagement and outreach, which aligns very closely, I think, with a lot of the goals that we have to further help patients and members engage with their community care teams to close gaps. And then it looks like a decent 30 to 40% of folks are using other in home programs and a much larger within home testing program. So, in the program today, and Kyle, feel free to add on other perspectives here. We'll get to touch on how all these can actually align into one cohesive strategy. Yeah. No. I think my key takeaway is that we have a lot of people in the right place. This is exactly what we're here to talk about is how we can bring all of those options into one, because, really, I think a core belief that Justin and I both shared in our companies and our partnership is that, there's just not one way to reach a member, and every member is unique. And so we wanna kinda bring that view into, gap closure. Great. Thank you. And the second question was how many in home solutions or vendors are you currently using today? Almost half of those that responded said two to three. That was followed by one and then zero and then more than four. So I'll see if you have any reactions to that as well. Yeah. I mean, we see this very often. You know, multiple vendors, lots of overhead there with having to manage all of them. And I think, again, that's one of the reasons that the partnership we have with Sprinter is so unique in the sense that we're able to operate as one and help remove some of that pain and overhead for actual teams at plans. And I think we've seen really great success from it. Justin, if you have anything to add there. Yeah. A big plus one of the comment there. The only other thing I would mention is I think the emphasis here on many folks having two to three or even more than four different vendors are managing really brings into the question of how do we know where to best deploy our members, whether that's engagement strategies, whether that's in home, whether those are kit vendors. And so excitingly tees up really nice segue into a lot of what we'll cover today, is how do we get upstream to understand the needs. Right. Well, good start to the session, and I'm actually going to hand it over to Kyle and Justin to take us through. Awesome. Well, we wanna, you know, start first with just some actual, you know, setting the stage on where we are with 27 star ratings that recently came out and kinda what that means for how we are kind of approaching these programs with our clients. And, you know, I think the key takeaway is that, you know, fewer contracts actually reach four stars even as overall performance improved. And so what that has, you know, taken... We're gonna keep stats we've seen taken away from that are these numbers around how many MAPD contracts went to four plus stars, which was down from the previous year, How many contracts themselves, you know, we have... We're down by about... Down from 22 to 15, and then the overall kinda weight of 3.99. And I think the, you know, key thing that we've taken away from this has been that plans have gotten better, but the line has moved further away. And so that's kind of a lot of what has driven the conversations we're having today with plans. So while that line has moved faster than the field, you know, this has come down to really where these cut points set. And, you know, I think what... One of the most interesting ones to me has been CAD. It's moved the most, seven to 10 depending on the star level. And, also, most importantly, all these different measures aren't just for Medicare Advantage. They apply to all kinds of lines of business. So, we've seen a lot of great movement, but the finish line keeps moving too, which is why, you know, we're here having these conversations today. Kind of building on that, what we'll kind of be focusing on within our case study that we'll discuss shortly are these kind of shared focus measures that we've had with, Sprinter, in our partnership with this particular plan. And those have sit across, GSD, CAD, and CCS. And these are really, interesting for us in the sense of the weight sitting with g h... GSD, the, you know, prevalence of CAD, and the, you know, decrease that we've seen kind of in movement on there. And then the really exciting changes we're seeing around CCS itself. This has proven to be really exciting to see opening for use... For at home use cases. We've seen a large prevalence and it's a whole new frontier in many ways for us on how to engage a new patient population, which I think has kind of been really an exciting thing to dive into. There's a lot of standard kind of industry norms around what GST and CAT are going to do. CCS is... It really is something unique that we're figuring out in partnership. And I know for me has been one of the most exciting things to work with my product team on as we partner with Sprinter and their delivery side team as well because we have some really exciting programs in that space that are really kind of new frontiers for all of us. I guess frontier is the word today, and and you're not hearing about AI for once. But with that said, I'm gonna hand it over to Justin. He's kinda gonna start diving into kind of the differences in our approach. Yeah. Thanks, Kyle. And, I appreciate setting the stage on the problem space more broadly. We're gonna shift gears a little bit more into the playbook considerations of the conversation, how to think about the steps and how the approach more broadly that we can take together in order to drive impact. As everyone on this call experiences as Kyle teed up, there's an immense amount of evolution. And to be honest, whiplash and stars in quality today, cut points continue to move. Things are predictably unpredictable. And what we found with many of our plan partners is that taking a one size fits all broad outreach approach falls short and might perform this year. But as the cut points move, it's really tough to keep up with the changes. And so what we're excited to dive into today is really this conversation of how plans having more data than ever, but still struggling to stratify members into the right programs. How can we get upstream of that to understand what are the actionable buckets to take some of that data, to augment that data, to consider the many factors that we can consider to determine what's the highest success, highest impact path that we can get an individual member on. And what we think about extensively is if we take a broad approach, really, our our success ceiling is set at the population distributions. It's really set at chance. But if we match to the right pathway, then we can ultimately not just have impact this year, but create compounding impact year over year. And so we're gonna dig into much more of the how there. And so, Kyle, if you wanna go to the next slide. The first key is really starting upstream of outreach, and we think a lot about precision starting well before we ever pick up a phone or send an SMS to a patient. And this really starts with how do we augment the clinical picture that we have on individuals. As I alluded to before, plans have an immense amount of data today. But one of the biggest challenges that a lot of our partners face is how you take the information that you have and augment that with other sources to get a deeper picture of who those individuals are. On the right hand side of this chart, what you see is a a number of patients and members that have a CBP gap. They all look relatively the same within claims data. We know that they've had the diagnosis of hypertension in the past. They've had a second measurement that codifies the gap, but ultimately, we don't know much more beyond the fact that they are gaps within the claims data. If you click once to reveal the other side there, what gets super interesting is that by augmenting the data streams that we have, and this is something that we do upstream of any engagement where we connect with health information exchanges, we connect with pharmacy data, we connect with lab data streams, which enables us to get to clinical encounter level data on over 95% of the patients or members that we go to see ahead of any kind of intervention, whether that's a kit or an in home program. We get to about seventy to seventy five percent of their clinical encounters. And what emerges on the other side is instead of having, you know, 50 rows of gaps that all look relatively the same, we start to have a much clearer clinical picture and start to realize that really interesting cohorts start to emerge in that clinical data. So before everyone looked like, you know, the same CBP gap, what we start to see in this data, and maybe just to take a step back, what this data is actually showing is all of the measurements of blood pressure that this patient has had over the last several years and shows the range of where those measurements have fallen. And the the circle without the fill is their most recent measure. And what you see in these in these different cohorts is that in the top in green, you actually have people that based on claims looks like gaps, but actually their most recent measurement was in range. Those are false gaps. Those are gaps that we can close immediately through this clinical encounter data. In the yellow, you see folks who... The majority of their blood pressure measurements have actually been in range, but by chance, the most recent was actually out of range, suggesting that something like a simple measurement has a very high probability of closing the gap. And then as you progress at the acuity spectrum of these individuals, you realize that some of these need a little bit more in home programming, a little bit more care management. Others really need much more deep intensive handholding to expect them to be within range. And armed with this data, you can imagine how that ultimately sets us up to be able to have a much clearer picture of what the next step should be for these individuals. Kyle, if you wanna go to the next slide. We also carry this understanding of the patient into the next steps of outreach and engagement. This isn't a one size fits all approach to how we find these folks, what channels we use, what messaging we use at the point of engagement. We really bring Silicon Valley grade AI learning loops to make sure that the exact channel, the exact content, the exact messaging that's most likely to meet the patient where they are is what's used, and we learn from those over time. That can be things like whether or not we use white labels, whether or not we use brands on the calling and caller IDs, which channel we use in the outreach. It can also, inform how we think about where we reactivate different members based on the reason that they initially, didn't book an intervention, whether that's a kit or an in home program. And so we try to bring this precision approach not just to understanding what the clinical need is, but also how to approach engagement. Next step. Kylie, you can click to the next slide. Lastly here, folks, we wanted to simplify a little bit tee up a bit of a framework that we'll use to guide through the the rest of the pre... Playbook content here. As we think about having success and impact in quality, it really comes down to validating the gap or said another way, validating what is the underlying clinical need that that individual has and then matching to the right modality, and then ultimately assessing the programs based on real hard fast impact metrics and ROI getting beyond just simplistic metrics there, and we're gonna walk through those in additional detail. Kyle, if you wanna click to the next slide. I'll start and tee up a little bit on the validation question. We alluded to this on the previous couple of slides around clinical data enabling us to have a much clearer picture of who the patient is. Tactically, that same data stream can also help us to close gaps where gaps are already closed or at least be armed with a lot more context as we go into the next step around modality. Now as I showed on that CDP example, there were a number of folks that already had measurements that proved that they were within compliance. Most recent measurement was compliant. Similar trends exist with our GSD and KED populations. For those individuals where that evidence exists, we can put that through a rigorous QA process to make sure that that measurement was in the right setting, that it had the right, condition surrounding it, that, it it is something that can ultimately plug into a HIE does engine for, for audit proof, credit on the numerator. But also, critically, we can have impact on the denominator. Denominator. We dig through that same clinical data to understand are there folks that actually shouldn't be on this gap list at all because they've had a hysterectomy and obviously can't be a cervical cancer screening patient because they're frail, because they're in hospice or palliative care. And so we're able to impact both the numerator and the denominator through the data piece. And the last thing that I'll I'll mention in terms of of key areas for impact here, we can also identify cohorts where they've partially completed the gap. As the slide alludes to, KED is a great example of that where they might have had the eGFR reading but are lacking the u... ACR. They might have had vice versa. There might be other criteria that we learn that better inform how we should approach the exact clinical intervention and channel that we we ultimately deploy them into. The interesting thing is that through this data upstream approach, we're able to, yes, route people to the right intervention. But as the red box below alludes to, we can actually identify very high prevalence of false gaps. We're able to close with CBP, for example, about 18% of gaps through data alone requiring no downstream clinical intervention. We can close GSD at a similar clip. Coal CCS, have high single digit closure rates through data alone. And the beauty of this is that when you couple this with kit programs, with in home programs, you can usually almost double the overall impact of the program. If you can get to 15 or 20 or 25% through your in home and kit initiatives, you can layer another 18 to 20 on top of that through the data driven gap closure piece of this, which, you know, putting my physician hat on as we think about deploying critical resources, minimizing patient abrasion and patient, and maximizing patient experience becomes a really powerful tool in our pocket. Kyle, you can go ahead and advance to the next slide as I hand it back to you to about how we actually match the right modality. Yeah. Absolutely. You know, all that member intelligence piece that Sprinter goes through and that Justin's team kinda puts together really, complements well with kind of our partnership together and how we're able to bring those modalities into one. So we... Either either a member is gonna be assigned a ASH kit itself. They'll have either been maybe perhaps a false gap already been closed, or they'll be assigned an in person clinician visit or a virtual visit based off the actual modality that makes sense from what we pull from that same shared, file. So the same eligibility file comes to both of us. We partner together as we go through and ultimately pair all this with still routing through their PCP. But most importantly, you know, one thing that kind of comes across here, no one ever actually, depending on the modality, if they fail on one, that's not where we stop. And so the idea is that a member is never just dropped off. There's never just a kit sitting there in their home. There's never... If they aren't responding to that, perhaps, you know, we do need to send someone in person not responding to in person. Let's send them a kit. So it had that flexibility too in that feedback loop to be able to kinda constantly find the best routing to meet that member where they are. So how those kinda get matched are both by gap and by member and their actual, you know, intention. So, you know, if we see these values that are borderline compliant, say a member has values that are close to compliance, they're a great candidate for either an in person visit or at home kit depending on what other gaps they might have to close. You know, we can... Oftentimes, there's many more gaps that can be closed if we go in person. That kind of waiting goes in as well. Otherwise, usually, a kit's very helpful. Perhaps they're outside of a geographic service location, getting a, you know, a care coordinator or a care individual into a home, a practitioner can be quite tough in certain rural locations. That's where at home test kits can come available. And sometimes there's just not care that's available in person. We see this a lot for the CCS gap. And in that case, you know, at home kit is very helpful. I'm gonna pass it over to Justin here on these last few since they do head more into his neck of the woods. Yeah. Yeah. Just echo a couple of themes that alluded to. We wanna take a dynamic approach here. It isn't, you know, look at their historical data, match them to the program, and then just let that run. You learn a lot in the process. We learn in that data that there might be folks for whom in in home kit isn't sufficient. So we'll start with, an in person in home visit or virtual visit. But, also, there are things that might arise through those interactions, whether we learn learn through the engagement patient preference where we discover clinical escalations that occur that warrant a high level... Higher level of care. We wanna make sure that these pathways have the best guess at what should be that be that initial first clinical intervention, but then quickly fall back to critical other pathways that emerge based on what we learned throughout. And critically as well, if we run into a bit of a wall on the engagement side, we find patients aren't engaging around a specific modality, we can shift others to ultimately drive the most impact for the programs overall. And as I hand it back to Kyle, that's one of the big points that we wanna think through is how do we assess program of the individual interventions and also think about the global ROI that we can drive for your health plans through these programs. Absolutely. And I think that's one interesting thing. We look at this feedback on how, a lot of y'all are managing, you know, three to four on this. We're often measuring the actual cost inherently to ship the kit out, to get a kit returned, or to send someone to the home. And instead we're not talking about the actual gap closed, we're talking about the touch point. And so when we talk about measuring, we really want to take a look at what that total modality cost was over the overall gaps closed. You know, a sprinter in a home can close multiple gaps. At home testing kit can also close multiple gaps. We're able to then kind of pair that with we want to weight that based off of the measure weight. You know, GSD being weighted three, CAT and CCS weighed once. Also, what is your distance to the cut point? We want to prioritize those measures that have fewer points to cross a star. And then we also don't want to lose sight finally, of like the other value that we can bring to the overall clinical quality. In many cases, we're connecting people to a PCP. We're always making sure this goes back into their care flow. Our desire is to get them off this list for next year and to make sure that we can get them into traditional pathways and get them actually participating in their health. You know, some of our most unengaged individuals that we'll often encounter will see statistically significant amounts of them asking for help finding a PCP. And that's just always really exciting to see this branded touch point, this, you know, showing in care and bringing that brand into the home, however we may be doing that leading to that impact. So I think that we'll just kinda... We'll dive specifically into the case study. Justin, I I'll just hand it over to you for this slide. Yeah. Yeah. We wanna make this real and make this tangible and and also highlight the overall impact that this can drive. And so to tip the case study a little bit here, both and ASH, we had the privilege of working with a large national health plan across hundreds of thousands of NA members across a couple dozen states across almost 10 different, quality measures, really touching on the full spectrum of triple weighted and other measures that are our plan priority. And the result, as was alluded to, is that we've seen critical movement on every one of these measures that ultimately layered up to very favorable impact on the overall star ratings. And excitingly, it set a foundation for year over year impact where this isn't just about being able to check the box, close the gap this year, but having those folks on the right pathways will hopefully continue to drive compounding impact year over year. And to the point of, you know, this joint webinar here, also excitingly created a a great opportunity to to collaborate with a couple of different vendors doing Sprinter and Ash to think about how can we drive even greater reach across GSD, across KD, and by working together, get to the the right member population with the right interventions. And so we're excited to walk through a bit of the how on that as I hand back to Kyle, but we'll also get to the hard fast impact that we're able to drive as well. Yeah. You know, the how in this particular case was a really fun one to work at because we both have such different strengths and focuses, and we're able to kinda bring those to the table. And, you know, we have that first gap file, that plan eligibility and claims are reviewed, Again, looking to see, you know, what insights we have on who is at the cusp and all the different awesome member insights that Sprinter is able to bring to the table. From there, when we kind of validated those gaps and exclusions, we're able to route, we were routing through to modality. In many cases, that would mean a sprinter into the home. In other cases, it would mean an at home test kit. And we then moved into delivery. So in delivery itself, there was so many things that we learned along the way. There were adjustments we had to make and a lot of collaboration on, you know, what members were responding to, how they were responding, what education was working, what education wasn't. Our goal was to ensure that, you know, we had a unified conversations we have. And so you might have an interaction with a with Sprinter's team virtually. They have full insight into where that kit is in your home on its way. They're encouraging you to do that. Vice versa, our language is feeding back to that as well as we brand that within that co branding with Sprinter and the plan, ultimately bringing that brand into the home and bringing that brand into the experience, be it through a person or a kit. And then reporting back from there, you know, where the actual returns were. And this is where, again, hearkening back to, you know, not every modality works for everyone. We also don't always get it right when we assume the right modality, and this is that point that where we really get to bring that in and say, these individuals under this group in classification are not responding to this. They actually do need someone in person more high touch. You know, your first reaction may be, well, well, in home is more expensive than a kit. But at the end of the day, it's about the value of that gap being closed and getting the most gaps, you know, done at the highest value. So it may be much more high value for us to get in person, you know, in the home to close a CAD gap versus just letting them sit there as an un empty box is just kind of they're ignoring. And in other cases, they may not wish to have that person in the home. And so our ability to flex and do multiple waves as we adjust, you know, our team's gotten very used to kinda, hey, we have a new wave, new set. We'll adjust back and forth to make sure we can actually hit those numbers. But enough about that. We'll talk a bit about the actual results. And I'll speak quickly to the at home side and then and pass it back over to Justin to talk about the in person side. At the end of the day, we closed a little over 1,600 gaps with a kit return rate of about 17%. And a reminder that's across multiple different gaps themselves. And overall average time to receive the kit process results, the entire end to end, usually three days at each of those points. We can get a member through in about seven days through the entire experience. And through kind of partnering on with Sprinter on the engagement campaigns and really thinking about where these members were, we were able to make really, really interesting content for them that we had a really high engagement rate on, Up to a 40% engage... Open rate on many of the emails and texts that we were sending that were really taking a moment to help member understand why they received this kit, why it's important, and why they actually need to respond to it versus just, you know, focusing on purely action oriented, perhaps, you know, more abrasive communications. And I think that's one of the really key things that we have. We, you know, often get concerns around member abrasion from a lot of communication. By really tailoring this communication and doing it also in partnership with the communication that Sprinter is doing, we're able to really reduce any of that abrasion and make this be a really cohesive experience for the member. So they themselves feel their brand is looking out for them, not just more or less harassing them. With that said, I'll... Justin, I'll hand over to to talk about kind of the in person and virtual visit success. Yeah. Thanks, Kyle. To not bury the lead too deeply here, one of the things that we love to reflect on is that, yeah, through the joint program here, being able to close over two two hundred and twenty thousand gaps for the members that we were able to engage and and provide care to across the kit programs, across the in person and virtual visits. And really interestingly that, you know, while a very large number of those came through the tests that are done in home through the kits or through the in person and and virtual visits. Also, critically, a very large number of those were through the digital mechanisms of finding the data of evidence from the past that showed that these patients actually had those gaps closed already. We're on a good path with their existing community teams. But a couple of things to highlight here, and this speaks, I think, heavily to Kyle's last comments there around how we think about the patient experience and the abrasion question or concern. The beauty is that the patients and members are are merging from these pathways with a net promoter score of 90 plus, which is something that you only see really with the most beloved brands, meaning that the experience was high quality, meaning it's something that they would wanna recommend to a friend, meaning that there is affinity that's occurring both to the health plan through the... Through those visits, but also back to these in home interventions, which one of the beauties of that is it drives, again, a compounding year over year impact. We see that people year over year engage in much higher rates and that patients we had visits with in the previous year, end up booking at a much higher rate in the the following year just given the positive experiences that that they had. The one other thing that I'll highlight here is actually the first number in that purple box, which is we're able to close multiple gaps in every visit. We have some folks who have four or five or six different open gaps. We have others with a single gap. As we think about the impact and especially the ROI of of these programs, we're really proud that we're able to close multiple gaps with every touch point, which also goes back to reducing member abrasion instead of having three or four different vendors reaching out in a single touch point. With this joint effort between ASH and Sprinter. We're able to close multiple gaps, and minimize the abrasion and and drive patient experience there. So overall, a lot that we're very proud of to have accomplished with our health plan partners with ASH in conjunction with the various programs that we have. And I'm really excited to continue that momentum into the next year. Kyle, I'll go ahead and and hand it back to you as we kind of round home here and and summarize up a bit of the takeaways. Yeah. Absolutely. You know, when we talk about these kind of moves as we look into our playbook is for '27, what we're building on here, you know, first, we're wanting to take them up to validate every gap. You know, leveraging clinical data and understanding if that gap really truly exists, what all is needed to close that gap. You know, I think one thing we haven't... We didn't really touch on that was a a unique piece of this program too was we were able to look for KED specifically and make sure we only got what the member really needed. In many cases, a member just needed a creatinine ratio or urine UACR. And when we just need that, it's even less abrasive from a collection perspective and we're able to more quickly close that gap because we have creatinine somewhere else or EGFR somewhere else. We're able to really tailor in and focus a box or a kit in our valid... Or in a visit on just that one piece we needed or the four or five pieces that we needed to actually close a gap. From there, you know, looking at matching that modality to the gap, again, we're raising their abrasion, getting that high net promoter score by saying, how does this member wanna be spoken to? They wanna be hand... Through a in person experience. Do they want to do something very quick? What's stopping them from being able to actually take care of themselves and participate in, you know, the actual program itself? Sharing that one data layer has proven to be, you know, an extremely key component. The back and forth that we have on sharing data with Sprinter has been extremely powerful across all the different programs as we say, well, what's working here? What's not working here? What efforts is Sprinter putting in? What efforts is ASH putting in? That, you know, unified approach, avoiding that, you know, bifurcation of a whole bunch of individual vendors fighting against each other has led to a much greater unified outcome. Escalating and not repeating is that kind of... He's saying, well, if we don't get the response we want, how can we escalate to the right response based off the weight of that's... Of that measure and what our goals are themselves. And most importantly, starting early. You know, we have this tendency in this space to do a q four push to really push through and kind of chase ultimately at the end of the day, starting early because we have this data, allows us to to to get and reach those members that are not going to respond much earlier because we're able to determine kind of where those gaps are gonna sit and start building that runway of of that, you know, hitting those numbers in both the numerator and the denominator already early on within q one. It's definitely a more, more efficient way to use dollars to actually kind of meet these needs. Very excited to continue doing this, with Sprinter. It's been an extremely fun program to work on and and one of the most exciting ones that we've been able to do here at ASH. I know one of our favorite things to to talk about. With that said, I think I'm gonna hand it back over to Emily to kinda carry us on. Great. Thank you. That was a really helpful look at how a more coordinated and tailored approach can help plans validate gaps and match members to that right type of care. But with that, we're gonna move into audience q and a. So as a reminder, you can submit questions using the Zoom's q and a feature. We'll get to as many as we can with the time we have remaining. We have, a a good chunk of time here. I don't see any in yet, so I'll give everyone another moment to submit questions. And, I'll go ahead and start us with a broader question, to both of you. For a health plan looking at its own population, how do they determine where to start and which gaps or populations to prioritize? Yeah. I'm I'm happy to to take a first pass there. One of the things we work very closely with our health plans on is that exact question of how do we think about prioritizing within the population where you can drive both the most clinical impact and have that clinical impact trickle down to stars or HIE or broader quality goals and impact. And a lot of that starts with some of these data runs where we can start with what the plans have in in hand as they think through looking at the claims data, looking at the HIE data they might have access to. How attached are those individuals to their care teams? If they have a really closely established care relationship, might suggest that they're likely to be on the path to close those gaps just through that relationship alone, maybe prioritizing earlier in the year people that have a lower, what we call, care team attachment score, and we can get into more of of how we think and calculate that. But beyond that, once we realize who are the patients that are most likely to be impactable by some of these complementary care team interventions becomes a question of of strategy. And oftentimes, that's a question of which measures are top of mind, which age contracts are performing higher or lower. And, the beauty of the programs that we've built in lockstep with ASH is that we can get two geographies that many others can't in terms of the programming, whether that's through a kit, through a virtual visit, through sprinters on the ground. We're able to come up with a bespoke strategy. So would just... To summarize, think about where are their patients that are the most impactful able by the clinical interventions, and then where can we align most to the the impact that the plan is hoping to drive on given measures and given populations. Yeah. I think one way we've seen this really come to play is through, you know, taking a, a phased approach when it comes to the at home kits themselves, when we're doing kind of programs that are focused on that. And and I'll speak more to that since, you know, I think the data side has been really well covered by Justin. I think that when we take that approach, oftentimes, you know, this is a huge opportunity to bring your brand into the home. You know, the white labeling of this is really key. And, in many ways, you know, looking at which, you know, with the weight of the exact measure and looking to kinda take the approach of getting that in, often just that kid getting into the home starts a conversation with a member that allows us to understand exactly what they need. And that's usually what excites me more than anything else. Yes. We have ratings to worry about and improve upon, But being able to get a member to say, hey. I'd like to, you know, talk to a doctor. What options do I have available? And perhaps, you know, an extra, you know, care continuum is almost more exciting than getting their head gap closed. I think in many ways, it can be a huge opportunity to kind of start a health journey for somebody. Thank you both. And we do have some audience questions coming in. So one question is, what techniques or recommendations do you have to receive better engagement from our members? We have a high UTC or members not answering their phone. So just curious if you have any suggestions or best practices. Yeah. I I spent a lot of time reaching out to members who don't wanna be reached out to or are wanting to ignore. So I definitely have some thoughts here. You know, I think, what we found is, you know, SMS continues to proves to be very powerful for us. We're finding, pairing that with iMessage or RCS is proving to be really helpful. You really can't underestimate the power of a branded caller ID, you know, ZIP... With a area code that's from the actual place, you know, you're coming from. But I think what's interesting is that each member wants to be often spoken to in a different way. Some really do wanna receive those emails and read them. Some do want text. Some do want phone calls, and others find it very offensive that you're calling them versus texting them. And I think it's a... You know, for us, the number one thing we do is we listen to those signals and adjust how we're talking to that member appropriately. And then I think one thing we often skip over that has been, you know, really powerful is we wanna be very action oriented. We're all saying, hey. I want this member to do this action. That's where we're approaching it first. Oftentimes, the member needs to be educated first. And so we spend a good amount of time educating them on why should I do this? You know? When I think about the GSD measure, you're calling me to prick my finger to give you a one c. I'm... In my mind, I have, you know, I have a a monitor on me. Why do you need why do you need this specifically? Helping them understand why this matters to the overall... Why a one c is, also important in top of knowing their glucose levels, etcetera, proves to be, a mountain of itself to get over. Otherwise, it it can often feel like the plan is just pestering them to do something that they see no benefit to doing themselves. And I think that's the big hump that we have to usually get over. Yeah. I love those points. Maybe just to add a a couple that that we do in addition to those. One of the things we think a lot about is that there are a whole host of different tactics that you can use to improve engagement. But one of the really interesting things that we found is that the response to those tactics, whether it's branded calling, whether it's the exact language and content in the message itself, whether it's leading with an SMS following up with a call, there's actually substantial variability geography by geography. And also plan by plan, there are places where the plan's brand is really strong. There are other places where that plan, maybe euphemistically is still building the credibility in that brand. And so we think a lot about how can we learn that for this plan and this geography with this patient base, this is the mechanism to take. And in the ZIP code next door, maybe we take a different approach in tactic. The one other thing that I'll say and, is, you know, a theme that we haven't touched on as much in this program, but one of the things we think a lot about is how do we have messaging to the patients that makes it clear that we are in their care team, and we are working on behalf of them and integrating closely with their existing community PCP or their existing community care team that all of those results that we obtained through these visits are being fed back to their PCPs that we're showing up to the door with context on the things they've already done with their PCPs so we're not duplicating efforts. And so as much as we can message to the individual members and patients that we're part of your care team or showing up to help complement what you already have in place instead of replace helps with one of the biggest rebuttals, which is often, I already have a PCP. Like, why do I need this? And so I'm just trying to make that really clear and and, incredible from the outset. Yeah. Really, really helpful considerations for engagement. Thank you. Next question is about special populations. Have you had any experience with this approach with the D SNP population? Yeah. I'm happy to jump off there. The short answer is yes. It's it's not a majority of our patients that we deal with, but many of our MAs do have dual populations. And we've had relative success in both the engagement side and also the clinical interventions being successful with those patients. Sometimes with, you know, some additional needs and hand holding that we learn on the engagement side in particular, but, the short answer is yes there. Yeah. We spend a a decent amount of time working with plans on these, you know, populations too. We... We've cover every different type population, and I can I can go usually on for hours about the unique components of each one even down to the plan and how they're responding and how much they, you know, their stronger feelings and and different paths across each of them? But, for the most part, it is a lot of the same. You know, a lot of these members don't understand why we're on... Why they're on the list. And why is that a bad thing? There's a lack of trust, you know, with them from that. And that's one thing about with these with these white labeling of of kits, which is a real big key tenant in, you know, our engagement strategy is that oftentimes, you know, we let that get into the home, let that sit there, let that be a physical component they see before we start aggressively reaching out to them. And that usually just makes things more tangible. So a lot of the same, you know, mechanisms all across the board to just kind of meet that member where they're at in their health journey. Great. Thank you. We have another audience question, and I see we still have time. So if anyone in the audience wants to add to the Q and A, please do so, and we'll continue tracking those. The next question is, what's the difference between a health plan's data access compared to the data you're using to inform engagement? Yeah. That's a great question and and one that we get often as we talk about some of these data augmentation approaches to close gaps. And and maybe to zoom out a little bit about why we built these data connections in the first place. We, often found, you know, in early days of Sprinter that we'd call a patient or we'd get into their home, and we'd hear, you know, wait. You're here to take my a one c? I just did this two weeks ago with my doctor. Like, what's what's going on? Why are we duplicating effort here? At first, we're like, oh, maybe they didn't realize it's a different task or something else. And and the broader problem space that emerged was this need where we are assuming clinical responsibility for these patients, getting in the home to do clinical interventions with them. We wanted and needed to have a much broader understanding of who they were. And so we connected in with, dozens of different HIE's with pharmacy data streams, lab data streams, all in the service of coming to the home with that clear picture of who these patients are. And to get tactful on the answer here, often our health plans will say, well, we have HIE connections, and we have claims data. Why can't we see this information? But the reality is that, most of those plans are limited to connecting with local HIE's or trying to access broader HIE's through what's called a health care operations use case where the response rates are trivial to none. In contrast, we as a a treating provider or as a medical group with clinical responsibility for these patients are able to access a broader range of of HIEs and a broader range of clinical encounter data sources. And also those various data sources are required to respond to those queries given that it's being done within a treatment use case and to inform next steps in care. And so it's both a question of a breadth of data source, but also a responsiveness of to... Of those networks to a treating medical group versus a health care operations use case that ultimately drives some of the opportunity. Some of the conversion rates that we discussed earlier of, you know, if we get to a list of of CBP patients or GSD patients, about eighteen percent of those end up being false gaps is really the kind of proof of there is, a broader range of of data uplift that can happen from the perspectives we can bring to those patients. But happy to get more specific if there are more details there that the question was intending to get at. We'll leave Alan. Oh, sorry. I don't have much more to add there. You know, my answers are gonna be much more tactical around correct addresses and things like that. We definitely kinda tear down. And I think in many ways, that's often proved to, you know, some of the... That these are usually your most unengaged members. So the data you have on them just is inherently incomplete, down to even their phone number. And you can imagine how much that spreads out as well as when it comes to claims data. Thank you. Alright. Another question came in related to the data, and and just broader gap closure. So how does the health plan get credit for the closed gap once identified in your data? So maybe you can talk about how this applies more broadly. Yeah. Yeah. Happy to touch on that. The... A couple of key steps in going from having some signal and clinical data of a suspected false gap or a gap that's already been closed to actually getting credit from that. The first step is actually validating the veracity of that. We, you know, we'll see the signal in the data itself, then we have these highly, highly complex QA mechanisms that dig into every single question. So for example, with CBT... CBP, ensuring that the blood pressure was taken in in the right setting, that it wasn't taken in an emergency department, that it wasn't taken in an ASC surgical center right after an endoscopy, making sure that the blood pressure, is also in the context of the broader patient picture, that they're not given meds or other things that might interfere with that. So there's this deep process of making sure that when that piece of data is ultimately handed off, that it will pass every level of rigor, not just in terms of getting it uploaded into the HEDIS engine, but the... Any audit over to review that piece of information. We also think a lot about provenance, being able to identify exactly what encounter that came from, who was the provider in those encounters. And then we're able to summarize that up, link it with the source evidence, hand it off to our partners, and then a nonstandard supplemental, file that allows them to get that into their HIE to send engines and allows them to see impact there. We also support them through their processes with their various internal audits and external audits if needed, and have had a 100% pass rate in all of those audits in the past in terms of primary source verification to make sure, again, that these signals that we see in the digital data correspond to any, type of data that they would have to pull in a in a primary source verification process. Thank you. Okay. Another question from the audience. We as a health plan already partner with Sprinter but do not use the Sprinter Relay system. Is that the platform where Ash and Sprinter collaborate? Let me try to unpack the the question here a little bit and summarize for folks, given that there's some naming of of products and things that we wouldn't spend as much time on today. When we talk about Sprinter Relay, that is the clinical intelligence system that is, you know, finding the data sources and identifying patient need and where where, relevant, also closing gaps with that information. And so Sprinter Relay is something that can be integrated as part of some of our in home programs. It's also something that we do more broadly through care coordination and care planning even if we don't have an in home program set up in those geos and with those patients. So that is, really kind of the data side, and clinical intelligence side of of the product that we were talking about earlier. That second half of that question, is this the platform where Ash and Sprinter collaborate? Sprinter Relay will inform the clinical need that that patient has and thus will inform whether we go to a kit modality or an in home modality. But it is not... Like, if you're not a Sprinter Relay customer, it doesn't mean that you can't benefit from the ASH and Sprinter care delivery interventions. It just means that it wouldn't be as targeted and and precisely oriented. So both of those lines can exist in independence, but also have the most impact when coupled together. Thank you for clarifying. Okay. I'm gonna zoom out a bit, and ask a broader question. If other organizations are interested in this type of partnership, what steps should they take? Where do they start? Kyle, do wanna take a first pass there? Yeah. Totally. So, you know, when, either... On either side, honestly, reaching out to Sprinter or Ash, will kinda work together to kinda bring that to you and and help you kind of understand what those next steps will look like. We partner on a variety of programs, a variety of use cases. There is use cases where it's gonna make more sense to align and paper up with ASH versus Sprinter, vice versa. And we have some great go to market teams that can help kind of gap... Get that... Get you in the right direction there. I know that, you know, this is something that is actively being discussed for the most part by the Sprinter's commercial team while they're out there. I know it's something we actively discuss often. So my short answer is just ask and we will we will make that happen. Yeah. And maybe just to add to that, I know that we're, you know, rounding kind of third base in this measurement year '26. There's also still room for impact. We have a number of partners that we're talking to now about how we can think about care programs that round out the year that get them off on the right foot for next year, but also in particular on the on the relaying clinical intelligence side. Is there an opportunity for us to still drive gap closure impact this year? Absolutely. Is there opportunity for us to, ultimately get to the stratification of your member base to understand where should we dedicate time and resources in q one, q two, q three next year? Absolutely. And so we would encourage you all to outreach. We definitely walked through the most comprehensive version of the offering today, which is this integrated multi partner care delivery side with the clinical intelligence piece. But we're really here to help think collaboratively of how can we impact the specific areas of interest, but also cut time to impact to be as efficient as possible. Alright. I see one last audience question, which is what is your present... Presence like in New York State? Yeah. I mean, from the ASH side, we're headquartered in New York state, in New York City specifically. So, you know, we are very active in New York State. As far as all of the gap closure tests that we do here, they all are approved from the Wadsworth Center, as lab developed tests and can be run within the state of New York. So we do actually a a lot of testing within New York state itself. And, yeah, just to complement that, we have both on the ground in home presence in New York and also, obviously, the clinical intelligence layer applies there as well. And an interesting, point that's relevant both to New York and and many other states across the country, the beauty of the kit program plus the in home piece plus the logistics systems that we built allow us to get to rural, suburban, urban regions alike. Because I think about 60% of our visits today are actually in rural actually in rural communities. And so, to be clear, the multimodality aspect of this with ASH and the logistics capabilities really enable us to get to anyone anywhere. We're physically on the ground in in 24 states today and counting, but we can design a program to drive impact across the board. Awesome. Well, thank you both, Justin and Kyle. I think that's a good place for us to wrap up today. So I wanna thank you both for sharing your experience and insights today, and thank you to everyone who joined us and submitted questions for this really robust discussion. We appreciate you spending your time with us and hope you have a great rest of your day. Thank you. Thanks, y'all. Have a good one. Thanks, everybody.