Creating Patient-Driven Value in a Changing Healthcare Economy

Zak Eisenberg is the Vice President of Merritt Healthcare Advisors, which provides investment banking services to healthcare services organizations. In his role, he manages the strategic development and execution of ASC, surgical hospital, and physician practice transactions. Zak specializes in sourcing and analyzing transactions and capital and negotiating and structuring investments. Previously, he was a Biofund Venture Analyst at New Orleans Bioinnovation Center, a biotech and life science-focused venture capital firm, and led the analysis team at a renewable energy-focused private equity firm.

Here’s a glimpse of what you’ll learn:

• [1:50] Opportunities for creating value through improved patient experiences
• [6:37] The rise of value-based care and its financial implications for large healthcare organizations
• [12:20] How the healthcare landscape has shifted to enable innovation in care delivery settings
• [15:12] Financial partners’ roles in scaling physician-led practices
• [19:05] Foundational steps physician practices can take to prepare for growth
• [23:33] The qualities buyers look for in M&A transactions
• [26:13] Alternate methods for structuring healthcare transactions

In this episode…

As the healthcare landscape shifts rapidly, practices are under pressure to grow, innovate, and cut costs — all while improving patient outcomes. With rising labor costs, increasing payer complexity, and mounting administrative burden, how can physician-owned businesses stay competitive without losing focus on care?

Zak Eisenberg, John Nantz, and Barry Tanner recommend aligning operations with value-based care principles. This requires optimizing the patient experience even beyond in-office visits, leveraging tools like AI to provide support between appointments and decrease costs. Strategic partnerships with payers, clear internal visions for growth, and selecting the ideal capital partners can position practices to scale effectively.

In part two of the Transaction Healthcare webinar, Kayla Marty continues her discussion with Zak Eisenberg, John Nantz, and Barry Tanner about creating value in the healthcare system. Together, they talk about reducing system waste, how investment capital drives innovation, and how to prepare for a transaction.  

Resources mentioned in this episode:

• Zak Eisenberg on LinkedIn
• Merritt Healthcare Advisors
• Merritt Healthcare Advisors email: contactus@merrittadvisory.com
• John Nantz on LinkedIn 
• Redwood Advisors 
• Barry Tanner on LinkedIn
• Kayla Marty on LinkedIn
• McGuireWoods

Quotable Moments:

• “I think we have to view value through the eyes of the patient.”
• “Employers are now on the hook for their cost, which I think is a really good thing.”
• “The really valuable ones are people who understand healthcare and have done some of the growth initiatives.”
• “You can get capital from lots of sources, but you can’t get know-how from all.”
• “Having a clear and aligned vision of success is critical.”

Action Steps:

1. Develop a clear vision for your practice’s growth: Defining specific goals and aligning your team around them lays the groundwork for long-term success. Without clarity, growth efforts can become disjointed and stall progress.
2. Engage with partners who bring strategic expertise, not just capital: Financial support is valuable, but experienced partners can offer guidance on complex growth initiatives. Their know-how helps avoid costly missteps and accelerates execution.
3. Prioritize patient experience beyond the clinical visit: Enhancing care touch points outside the exam room improves satisfaction and outcomes. This approach also reduces reliance on high-cost emergency or urgent care services.
4. Explore value-based care opportunities with payers: Partnering to deliver more efficient care models can drive revenue and improve quality metrics. Even starting small can lead to significant long-term financial and operational gains.
5. Invest in scalable infrastructure early: Building systems for onboarding, integration, and reporting prepares your organization for future growth and potential M&A. These foundational elements signal professionalism to buyers and investors alike.

Sponsor for this episode…

This episode is brought to you by Merritt Healthcare Advisors.

Merritt Healthcare Advisors is an investment bank with a unique focus on healthcare providers and their businesses.

Merritt leverages the healthcare industry expertise of its owner-operators, clinicians, investors, and advisors to develop surgical facilities that perform safe, efficient, and cost-effective procedures.

To learn more, visit https://merritthealthcare.com/.

Episode Transcript

Zak Eisenberg  0:00  

Hello and welcome to Transaction Healthcare. I’m Zak Eisenberg, Vice President at Merritt Healthcare Advisors. Merritt Healthcare Advisors is an investment bank with a unique focus on healthcare providers and their businesses. Transaction Healthcare is a podcast focused on addressing questions and concerns at the intersection of healthcare transactions and business. Zak Eisenberg here, this is a special episode from a webinar we delivered. It was so interesting that we wanted to share this part of it with you on the podcast. It’s brought to you by Merritt Healthcare Advisors. We’re a healthcare focused investment bank. We don’t work on anything else, mostly with provider businesses. Usually we’re working with physician entrepreneurs, helping them to raise capital or sell their business, or sometimes helping them to buy other practices or invest in other types of ancillary service lines. Now we’re happy to share this part of a webinar with you, featuring John Nantz, partner and founder at Redwood advisors. Kayla Marty, a partner at McGuireWoods, and Barry Tanner, the interim CEO at Boomerang Healthcare.

Kayla Marty  1:10  

Barry, if I can just go back to you and maybe shifting gears just slightly here. So there’s some themes that you brought up that brought up John brought up, and it’s all about creating value. It’s creating value for payers, creating value for patients, and creating value for any investors, and then also physicians with their own time, giving some control back to their clinical practice, where they don’t have to spend time doing certain aspects from an administrative process. Can you just speak a little bit to how you see the biggest opportunities for creating value in the next year, two years, kind of that short term window.

Barry Tanner  1:50  

I think the biggest opportunities, from my perspective, Kayla, center around the patient experience within healthcare. And what I mean by that is that, you know, we, we operate in kind of an encounter world in health care. So the patient comes to an office or goes to a surgery center or a hospital, and there’s a certain encounter, but there’s a there’s a whole, whole world of health care that takes place when the patient walks out of your clinic or out of your surgery center or out of your hospital, the care continues. And I think the biggest value creation opportunity is, how can we help patients when they’re not in front of the provider, but still provide them with access to care, access, to get their questions answered. And I think a lot of that can be driven by AI, if you’ve if you follow, you know, one of the companies that I tend to follow in this space is Hippocratic AI. They’ve grown tremendously. They’re in almost every specialty. It’s very patient oriented, and it penetrates all aspects across the care continuum. Meaning, what I mean by that is that from the from scheduling to prior authorization to care plan development to follow up, to care, navigation outside. I mean to me, within that scope, that’s where value can be created. And I think, you know, we all are suffering from the cost of labor. It’s gone up tremendously since COVID. I don’t see that changing cost of benefits is increasing at 10 to 15 to 20% a year, in some cases, I think we and still the demand there is, I think most of the people that I work with want to deliver better care and achieve better outcomes, and the only way to do that as a, with a as a, you know, at a reasonable cost, I think, is to take care of the patient when they’re not in front of the provider, because they’re, you know, in most cases, they’re accessing care and very you know, ers urgent cares, you know, they’re accessing care at various points because of the convenience of it very expensive. But I think if we could actually have more patient provider interaction, even if it’s automated through AI, and help the patient avoid accessing care at the I’ll say the more expensive points, I think that’s where an awful lot of value can be created within the healthcare system as a whole. There’s also a lot of waste. I have to say, at some point, I feel like we just simply have to do a better job of carving more waste out of the system. And I and the best way to do that, in my view, is. Is to really form partnerships with the payers, which is historically in again, never been done. I think the payers have access to a wealth of information with regard to cost in almost every disease state that we would be interested in. If we could start working in a more cooperative, slash collaborative fashion, with the payers. And I’m not trying to boil the ocean here, but if we could start small and say, let’s identify the problems that you’re having with with GI care, or the problems with COPD, and let’s tackle that one state and see if we can identify areas where we could generate savings, and then we’ll share the savings to some degree, which is a continuous process. I think that’s where the I think that’s where true value can be created. But I want to circle back to where I started is I think we have to view value through the eyes of the patient. I think, as a patient, I my perception of value is often not necessarily in I don’t know the quality of the procedure that was just delivered to me, necessarily, but I know the quality of the care that I received from walking into the office. How was I received? Was I greeted by name? How was I treated? There’s a lot of value creation in that patient experience, and I think that is something that’s going to, I think it’s going to come into its own over the next four to five years in a big way.

John Nantz  6:37  

Yeah, it’s all, oh, go ahead, John. I was gonna, you gotta, you gotta, you keep us in line. Because I know me, Zak and Barry. Love the lovely talk about all this. But I want to say, I want to say one thing that I think is really important and I think is relevant to the folks likely to be listen to this, which is on the value based care piece. 10 years ago, we’ve been talking about value based care for 30 years, longer than that, depending on how you know, how strict you want to be about the time clock. Not even even 10 years ago, there was very little happening. In reality, five years ago, you started to see it really take off in some cases. And I have seen it with some of my clients, particularly the larger ones where you’ve got, you know, two, 50 million, a billion dollar plus in collections, where it is becoming a meaningful percentage of the business, like more than 10% of their revenue. And that’s very exciting. So on the demand side of value based, care what’s happening. And I just this is, I just like to give people this. This information is the insurance model is changing. So again, 1020, years ago, a lot of employers, unless you were a mega cap company like a JP Morgan or something like that, they would basically get classic insurance. Now, most employers above 250, 500 people are self insured, and they’re using insurance companies ASO so administrative services only. What that means is that employers are now on the hook for their cost, which I think is a really good thing, right? They’re starting to say, Wait, I’m the one paying dollar for dollar when waste is happening. So what that means is we now have an actor in the industry who’s actually interested in getting more efficient care, right? And that’s what’s driving on the demand side. On the supply side, what you’re seeing is, and again, I just wanted to, like, validate Barry’s point with concrete examples. So we worked with a women’s health organization. I just want to make this really concrete. We were a Women’s Health Organization. I’m not going to say which one, I’m not going to say what states, but I’ll just, I will say it’s women’s health because we’ll make the example more tangible. And they made a value based agreement with some large insurers, ends up some of the states they were operating in. And they basically said, Look, give us a capitated payment per birth, right? Like, it’s a very clear episode of care. We know when someone like we can tell by the CPT code, yep, this person’s pregnant. We can tell when the baby was due like so it’s very easy to measure, right? We know how many women are in this category, and they say, Hey, give us, you know, a certain amount of money per case. What they found, with very rudimentary analysis, was that the variation in cost per birth by hospital varied by three times. It was about $15,000 on average, to $45,000 per average. Okay, no one had ever looked into that. No one ever even taken the time to look okay. So we did, and it was three times the difference. And then we said, well, our physicians are the ones telling people what hospitals to use. Let’s encourage them to go to the lower cost cost of care. And by the way, the lower cost ones had half the C section rate, which was one of the reasons they were lower cost so and there was no difference in population. So let’s set aside the ethics of that issue. But bottom line was, the physician said, Hey, let’s start directing people to the lower cost and higher quality locations of care, and we saved nine. Millions and millions and millions of dollars, right? We reduced the C section rate. We had better patient outcomes. I mean, it was just a crazy win. I mean, that’s how basic This is. Because people think, oh, value based care, that’s so what does that even mean? That’s so complicated. This is how simple it is. Now, doing all of that, doing the analysis, negotiating it, executing on it. I don’t want to sit here and say it was easy. It was easy. It took a lot of work, and we were really involved in it. So I you know, I can tell you, it was a lot of work, but it worked, right? And I think we’re better off the health system overall. The country is better off for that work. I think that’s a really exciting thing going on. I think it’s going to be supported by AI, because I think it makes AI make some of the stuff easier to do. And again, for providers and whoever else is listening to this, just being cognizant of I think we’re moving into a world where there’s going to be more there’s going to be more rigor around quality and patient experience and value than I think there was 20 years ago. And I think that’s a good thing for the country, and I think it’s good thing for us as patients. I

Kayla Marty  11:03  

Right? And that actually dovetails into a point you made earlier that I just want to highlight, which is the shift inside of service. So that is a, what you just described, is a form of value based care, right? It is a incentive by the provider and the payer to shift the side of service. Well, one thing that I’ve noticed, in fact, and John, it’d be great for you to speak to this, but we are uniquely positioned with certain types of investment capital, whether it be private equity funds, family offices, strategic buyers, to create settings of care that don’t necessarily exist today. So great example, right is the proliferation of surgery centers. One of the things that has happened is the ability for group practices to take outside investment, whether it be from private equity funds or otherwise even debt financing, in some instances, and be able to make, you know, one two room centers from a gastro perspective, a urology perspective, and that is providing a side of care that was otherwise not available. So Zak, John, can you speak to the way in which the transaction environment has actually given a shift and a push to that innovation?

Zak Eisenberg  12:22  

Sure, yeah, it’s, it’s an interesting question, because, you know, of course, necessity drives invention, but also, I think savvy entrepreneurs, whether they’re physicians or otherwise, look for arbitrage opportunities, right? And I think what has primarily driven this shift is people, and mostly physicians at the start seeing the opportunity to say to the payer, exactly the example John gave, it’s costing you $30,000 per procedure in the hospital. I’ll do it in the AC for 15,000 and that’s a that’s a great, great pathway for driving costs down in the system. I think where you have seen some innovation, especially as of late, is really in the home health care side of the equation where lots of care has started to shift the home, which was, I think, originally, lots of this, or most of this care that shifted there was taking place in long term care facilities, or L tax, these types of places. And now you have many companies that have have started, and some of them are quite large in the last few years, that have really become not just staffing companies, but full service home health care companies, where they bring all the equipment to your home if someone is in need of some sort of long term care solution, if a patient needs that. And of course, that’s also helping to drive down costs, because the number one cost, or one of them, for all practices and all facilities are facilities. Facilities are extremely expensive to operate, and so I think that’s why you’re seeing some pressure in especially the LTCH and long term care market, and Kayla, just remind me the second, second piece of this question wasn’t just about innovation and site of care, but I think you you were also mentioning something else, which I missed.

Kayla Marty  14:40  

Yes, so like how transactions and financial investors specifically can help propel that so for example, right? ACs are extremely expensive to build, so if a independent physician group, for example, wanted to build one, they have a few options, right? They can park partner with somebody already. Market. Number two, they can go out and get very significant debt financing to build it. Or, number three, they can take on capital in the form of by a financial partner that will assist in that growth,

Zak Eisenberg  15:13  

right? Or, or they can take on a personal guarantee with what some of them do. But, yeah, I would say it’s interesting, because I think this is where you see a divergence in terms of the quality of partner, because you can get capital from lots of sources, but you can’t get know how from all of those partners. So the really valuable ones are as as far as partners are concerned. And the ones you want in your corner are people who understand health care and have done some of the or undertaken some of the growth initiatives that you’re interested in before. So, for example, building an AC is not simple. They those are very complex businesses, and the development of them is equally as complex in terms of architecture design, regulatory approval, etc, Medicare certification. So there’s a lot that just goes into the development, let alone the operation. And if it’s the first time you’re doing it, it’s often helpful to have someone, of course, who who knows how to do that, but outside of differences between financial partners. I think having as a physician practice, or as an entrepreneur in this space where you have built your own practice, having someone who thinks about the world differently from a financial perspective and puts certain structure in place, both financially and otherwise, can really help to professionalize an organization. Having that third party that your business is responsible to in terms of reporting as well as keeping you accountable, can really help the organization become more professionalized. So one thing lots of investors, I think, share across the board, and this is true, whether they are health care investors or not. Is especially if you’re you’re not a debt investor, but an equity investor. Almost universally, equity investors are very good at picking out talent, because that is one of the core ways that they can ensure a successful investment, and whether that’s their new partner or a way to improve the organization through securing, let’s say, a capable CEO or CFO CDO, all different types of people to help drive the organization forward. I think that’s that’s true for most financial sponsors. The last point on this is, you know, of course, like with any industry, you have some financial investors who just want to be silent partners. In many ways, you might be giving something up there. Yes, they might be slightly cheaper in terms of the amount of equity that they take in the business, but you’re not getting, I’d say, the the value add, that’s non financial that can come from having a knowledgeable financial partner and investor who really understands business generally and good financial practices, which can help drive a business into the future. John, I don’t know if you have anything to add to

John Nantz  18:26  

to that. No, I really don’t. I know we got a lot of questions. I thought you said it really well, so I would, I won’t add to it.

Kayla Marty  18:34  

No problem. So before we move into the next section, the last question I want to talk about in this topic area is, everybody’s looking for those small wins, right? Like, everybody wants to know, what are the low hanging fruit? What can I do now? Maybe John, if it, if I stick with you, like, what would be your recommendation on that when people aren’t ready to take those mammoth leaps, they’re not ready for that big value based care contract or that big new investment. But like, where are the small wins? Yeah,

John Nantz  19:05  

well, let me, I mean, maybe we ask the slight like, maybe I take it to spin the question a little bit, which is, if you’re still in that physician owned category, you know, what should you be doing to create value for yourself? Right to position yourself for a long term growth, or position yourself for a for a transaction, you know, working with Zak. So what I would basically say, I do think the basics go a long ways in this and for those folks. So number one and this, and I have a lot of conversation with people in this, in this space, so I’m speaking from experience, having a clear and aligned vision of success is critical. Do you want to grow, or do you want to stay the size you are if you want to grow? Is the rest of your physician team, assuming that’s the equity owners. Are they aligned with that and are the aspirations you have around growth? Clear, and are you allowed to align around those? Lot of it isn’t just they say, Hey, look, I want to be a small doc practice. That’s all I want. Other ones are a bit more ambitious. Hey, I want to build something. So one i If you want to build something, surround yourself with people who either feel similarly or support your vision, and then, you know, be clear about what your vision is. And having clarity here is really, really important. So I really encourage people to be clear. So it’s like, hey, you’ve got a $6 million practice and you’re in, you know, one city, and within four years, you’d like to be a $20 million practice, and you’d like to be in multiple cities, and you’d like to double your physician base, and you’d like to bring on mid levels to help kind of give you some leverage, right? And really articulating in concrete terms what that looks like. I think that’s the number one thing physician practice groups can do to benefit themselves, is having a clear vision of success, right? And most people, they have some, but it’s a bit unclear, and it’s not aligned, right? And so, like, you have to start there, right? What is success look like? And then if you, if you’ve done that, you know, building out, what are those systems that are going to let you to actually accomplish that? So I see a lot of groups have spent a lot of time on clinical care, but they haven’t spent any time on Well, what are the levers you can pull to go bring other physicians on. You can go hire them. You can go, you could do a merger, you could do an acquisition, right? But, like, those are the ways you can get more doctors right. And so if you want to grow significantly, you’re going to have to be good at one of those. And that’s where a lot of doctors really struggle, is, is one of is one of those three. And then the third piece is, you know, having some perspective on financials. If you want to grow you need some, typically, some form of capital right to pay for the facilities that that are quite expensive, Kayla to your point, or to do a merger or an acquisition, or to onboard a physician and be able to pay that person what’s needed for some period of time as they ramp up, like you’re going to need some debt. And, I mean, the vast, vast majority of business practices are very much like cash, right? Cash to Cash, like I make cash, I spend cash. This is a, you know, I’ve got this much in my bank account, in the business bank account, my not my personal bank account, but my business one. That’s the max I can spend. And that type of thinking really, really, really limits what you can do. So that would be my, you know, recommendation, if you just take that basic playbook, you really can, you really can, can do something. And I, you know, if physicians have the hunger to to try to go down that path, right, you know, we encourage it and also reach out if you’re if you are ambitious. I know myself, Barry Zack, are all happy to talk to people who, hey, look, I want to grow my practice right. Reach out to people like us. We’re happy to help right and give you some advice as you navigate that journey.

Kayla Marty  22:56  

Yeah, absolutely. And John. A lot of people, when they’re thinking about growth, they’re also thinking about M and A, whether organic M and A or being acquired by somebody else. And so Barry, you’ve been through it more than anyone. So if I can stick with you, when somebody is looking at a potential M and A transaction from a buyer’s perspective, because you sat in that seat a lot of time. What are they looking for in a partner? And then Zak, if it’s okay, I’m going to come to you and talk about what we can be doing from the sell side perspective.

Barry Tanner  23:33  

Yeah, I think sort of come back Kayla to what John was talking about, which is, as a buyer, I’m looking for, you know, a relatively cohesive practice, one that has governance, they have clinical standards, and they have a sort of a demonstrated track record, or at least a desire to grow. And what I mean by that is, you know, have they demonstrated that they can bring new practitioners into the practice? That can be that all by itself, can be a very difficult thing for some practices, the hiring, the onboarding, the integration of new physicians into a practice, is really critical, and the ability, the demonstrated ability to do that successfully, is very encouraging, I think, to any any potential investor in that practice. I would also say, have a plan, as John was alluding to growth, have a plan in some areas of the country. It could be about adding or combining other practices to make one larger practice, or maybe that you’re somewhat limited in your geographic area, but limit, but limited only to the extent of bringing in same specialty practitioners. So for. Think about vertical integration. You know, if you’re if you’re in my last business, if we were a practice in medical oncology, well, what about if we added radiation oncology? What about if we were to add laboratory? What about adding a PET scanner? What about adding clinical trials. I mean thinking about how you can capture more of the services around your area of practice and vertically integrate the demonstrated ability to do that, I think is very encouraging to any investor, because, again, it’s all about growth. If, if someone is going to come in and invest in the practice, I don’t care what the multiple is. The fact of the matter is, any investor is looking for a return, and most of that is not going to in health care. It’s not going to come from increases in pay or reimbursement, highly unlikely. So it’s going to come from growth in one form or another. So that demonstrated ability to bring in new practitioners and integrate them, I think, is, is absolutely critical. That’s actually,

Zak Eisenberg  26:13  

yeah, Kayla, I was just going to jump off of that last point for Barry, because I think one thing we often see practices very much struggle with. And this is when there may be a little larger is when they do try to pursue their own M A, and it’s really for the reason that Barry just laid out, though there there are other causes for this, which is that integration of two distinct practices and really distinct practice cultures is very, very challenging. This is another area where many of the, I’d say, sponsor backed platforms that have failed, have failed because of this issue, because they have not been able to successfully integrate many disparate practices across multiple states, or within the same state, across multiple cities, because it’s very difficult to grow an organization in this way if you do not have a common vision to John’s point and a common culture. It’s an interesting challenge as well, but it’s also an opportunity where, I think savvy operators, if they focus on integration and culture, can sometimes actually go through these transactions without capital. So just taking a, you know, slightly skeptical view, you do need capital most of the time, but sometimes you can structure these transactions in non cash fashions, either for equity in a combined business, or for other types of non cash instruments, like a seller note, which is essentially a piece of debt that is not from a bank, but it’s From the business that you’re actually purchasing as the acquiring, as the acquiring practice on the other side, thinking from a seller’s perspective, the number one thing that we think about is really patient continuum of care. So John and Barry said this in a slightly different way, which is that as as the business you know, of course, you want to add more physicians, but you don’t want to add any position. So an orthopedic practice certainly doesn’t want to add a cardiologist. There’s not the type of synergy from the patient perspective that you would expect to see. But an orthopedic practice can expand into what we think of as the musculoskeletal continuum for a patient, where you can touch the patient along every point of their care journey as it relates either to an episode of of care or a chronic condition, where you can really support them throughout, throughout treatment of that of that condition, and so continuum of care. What? What does that include for maybe non physicians who are listening in? It’s things like surgery, if they need it, physical therapy, if I’m using the orthopedic example, imaging, urgent care, that’s where lots of musculoskeletal ailments originate is actually in urgent care settings. So think a broken bone or or a pulled ligament, something like this. And so if you’re at that transition point, and I would say, by the way, this isn’t just good advice for physician owned businesses, but even for first time, private equity or sponsor back businesses that are new to the PPM space, or maybe this is their first time in, say, specialty care, but they’re not new to health care or family medicine. Is that you, I think? And. Barry said this earlier, you really need to take the perspective of the patient first, and then you can think about building a business around the patient’s needs in that particular area. And the reason why staying focused in your particular vertical, say musculoskeletal or cardiovascular or oncology. The reason why this is useful is because you create significant cost synergies along the way. And eventually, if you get large enough and lucky enough to work with someone like John Nantz, you can negotiate value based contract, which is eventually where the system is going. And there are some very large examples of this. So I’ll just call out a platform that I think a lot of I know the management team there, and I think they are doing a great job showing what the future of health care can look like, while driving cost down. And this is health outcomes, performance. Hopco, which is a very large business now started by physicians. And physicians have always been the core of that business, and actually most of their management team, the majority of their management team, remains physicians. Today, it is for profit. It is sponsor backed, but they have taken a route of being very, very focused in their muscular, skeletal space, and they have also achieved value based care, mainly through density in a particular market, in their particular care continuum. So I think John brought up some great points earlier about I think the tactical decisions that you can make to grow your business. Should I build an ASC now, or should I invest in imaging? And those are great, but I think from a strategic standpoint, especially when you’re talking about provider businesses, it’s really especially, I think, from an investor standpoint, whether it’s a health system or or a sponsor, they look at density, and they think about really being part of the patient’s journey for their entire, I’d say, life cycle.

Outro:

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