Latest / Becker’s Healthcare Podcast / Michael Hassell on Rural Hospital Sustainability, Specialty Care and Revenue Cycle Strategy

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Michael Hassell on Rural Hospital Sustainability, Specialty Care and Revenue Cycle Strategy · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where they go to
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  - pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - This is Laura Dierda with the Becker's Healthcare
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  - podcast. I'm thrilled today to be joined by
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  - Michael Hassell, chief executive officer at Melissa Memorial
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  - Hospital. Michael, it's a pleasure to have you
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  - on the podcast today. Hey, Laura. It's great
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  - to be here. Thanks for having me. Absolutely.
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  - Now I'm excited for our conversation. I know
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  - we're gonna talk a lot about,
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  - the work that you're doing at the hospital,
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  - how you're thinking about the future, and your
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  - perspective on leadership. But before we dive in,
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  - can you introduce yourself and just tell us
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  - a little bit more about Melissa Memorial Hospital?
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  - Sure. So I'm Michael Hassell, as you mentioned,
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  - CEO here at Melissa Memorial.
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  - We're a 15 bed critical access hospital on
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  - the beautiful plains of Colorado.
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  - Looks a lot more like Nebraska than than
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  - what you probably think of as Colorado. You
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  - can't you can't necessarily see the mountains from
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  - here. You gotta drive a little bit for
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  - that. So we're really very much a hospital
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  - of the plains.
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  - You know, I've been here, before years next
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  - month. Actually, I've been the CEO here, my
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  - first CEO role.
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  - Spent some time in, rural Alabama,
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  - for a couple of years just before coming
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  - out here. And other than that, most of
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  - my experience was, in Florida at, Orlando Health
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  - and Florida Hospital, now AdventHealth.
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  - So the I'm I'm kinda going backwards, I
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  - guess, in some ways. Started out a pretty
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  - big system, and I've worked my way to
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  - a a critical access hospital.
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  - Oh, it's fascinating to hear. And, you know,
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  - when you think about your career or your
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  - experiences in different types of systems and,
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  - places, you know, what really stands out about
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  - being the CEO of a rural hospital? How
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  - is your career built to that, and how
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  - is it different from being in a larger
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  - organization?
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  - You know, I joke a lot that,
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  - grew up in a big system, so I
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  - don't know how to run a a hospital
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  - like a small hospital. I kinda run like
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  - a bigger hospital.
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  - You know, to that end, I think we
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  - we try very hard. We we're always very
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  - focused on sustainability,
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  - but for us, sustainability is really about, you
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  - know, what services can we bring that will
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  - be,
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  - some type sort of positive contribution margin to
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  - the organization,
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  - and we'll bring the right kind of care,
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  - additional care out here, you know, to our
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  - hospital.
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  - You know, additionally and this has been kinda
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  - kind of interesting for me. Many times, you'll
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  - see a critical access hospital.
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  - We'll have assisted living or a skilled nursing
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  - facility with it with all the problems that
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  - come along with the different pay structure that,
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  - you know, for example, swing beds are paid
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  - a lot less, in that in that setting
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  - than they are in a hospital setting. Swing
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  - beds are really important to us here. I
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  - don't have one of those.
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  - We have a nursing home here in town,
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  - that we work as closely with as we
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  - possibly can, but it's not something we've gotta
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  - worry about the billing and the structure of
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  - or the management of. But what we do
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  - have is a little bit different and, you
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  - know, maybe maybe a little bit unique,
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  - for this position,
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  - because we we run a a pretty busy
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  - ambulance service, through our hospital
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  - that fits pretty well with my background as
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  - a paramedic. I got started in health care
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  - as a paramedic way back. Most of my
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  - work for Orlando Health and and the Adventist
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  - work,
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  - were on on a on an ambulance
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  - prior to going into administration.
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  - So I've done all that. But what we
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  - find out here and this is kind of
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  - a hidden kind of a hidden thing for
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  - critical access hospital. Just like the hospital's
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  - cost based reimbursement,
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  - you can get your ambulance service aligned as
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  - a cost based reimbursement model as well. And
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  - so we did that.
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  - We worked really hard to build that business
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  - up, and we're actually expanding that service line
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  - right now and even some of the larger
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  - nearby cities.
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  - We we we have kind of become the
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  - the tag you're at, for transport, inter facility
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  - transport,
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  - in all of Northeast Colorado and even stretching
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  - up into Nebraska and and sometimes into Kansas.
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  - That makes a lot of sense, you know,
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  - and it's really cool to hear about how,
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  - the hospital
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  - is able to provide services to the community
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  - and continues to be obviously a very important
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  - institution,
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  - you know, in in how you're working around
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  - some of the challenges as well. And to
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  - that
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  - point, what are the big trends that you're
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  - watching currently? What's top of mind for you
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  - today?
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  - Well, I think everybody's watching the, you know,
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  - the one big beautiful bill and then the
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  - consolation prize of the RHTP funding for a
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  - hospital transformation program.
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  - We certainly have our eyes on that.
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  - I think it's a mess.
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  - I I hear a lot of dissatisfaction
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  - out there with both the way the federal
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  - government released that without a whole lot of
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  - structure, without very many guardrails, it feels like
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  - at times.
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  - And then, you know, they gave it to
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  - the states to to administer
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  - and,
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  - we have our own unique problems in Colorado.
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  - Colorado is,
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  - has had a very difficult as a state,
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  - it's been a very difficult financial,
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  - couple of years.
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  - And so, you know, every every every dollar,
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  - especially federal dollars that roll in, you know,
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  - everybody looks at that like, what how can
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  - that advantage me? Right? And so we've had
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  - quite a bit of struggle.
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  - HPCF,
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  - is the the,
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  - state Medicaid
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  - director.
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  - And, it's been a challenge to try to
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  - keep them on on task. It feels like,
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  - they certainly have different ideas for how the
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  - money could be spent than than the hospital
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  - sometimes do. And we felt like we've been
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  - kinda behind the eight ball a lot. We
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  - see other states kinda progressing and getting things
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  - done. Some states have already distributed those checks
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  - to the hospitals. We're still kinda waiting to
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  - see what we're going to, to be approved
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  - for.
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  - Our applications were in several weeks ago now,
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  - and we're waiting to hear back.
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  - But we already know that the ask was
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  - about twice what the possibilities are as far
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  - as the the pool of money goes.
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  - And, we don't know if it's gonna be
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  - kind of a hunger game to see who
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  - can who can, outlast the other hospitals.
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  - We feel like we're pitted against the state
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  - itself in some areas
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  - now because they want some of those monies
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  - for for their own projects.
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  - So it's just been a constant, political struggle,
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  - I guess, in trying to trying to make
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  - sure that that we feel like this has
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  - been moderated in a way that's gonna be
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  - truly beneficial to the people it's meant to
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  - serve and it's meant to take care of.
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  - And, you know, you can disagree on what
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  - those those monies are for. You can both
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  - be right.
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  - But we think back to what was the
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  - original intent for the money and what can
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  - be best for, you know, for the end
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  - user, for the patient.
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  - Those are huge and significant questions, especially when
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  - you're thinking about, using funds from the program
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  - and and then to,
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  - how it's gonna be able to impact its
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  - true intent of patients and and people in
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  - rural communities. And to that point, I know
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  - a lot of leaders of rural hospitals and
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  - and systems are looking at it and trying
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  - to figure out how to make the most
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  - of those dollars as they come in for
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  - a sustainable future versus,
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  - you know, one off things or or purchases
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  - that might be,
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  - you know, challenging to sustain overall in the
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  - future. So how are you thinking about that?
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  - Is there any insight you can shed on,
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  - the what you've put into your applications?
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  - Well, let me start with this. It's it
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  - can be frustrating for a lot of my
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  - colleagues and for me,
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  - to say, hey. We want you to be
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  - you know, to deliver transformational
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  - care.
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  - You know, what what does that what does
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  - that really mean? There's not really a definition,
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  - you know, put forward by the the providers
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  - of the funds.
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  - And so what what's what's the word mean?
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  - That's, you know, kinda kinda step one.
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  - But you have to,
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  - you have to understand that's shaded by the
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  - fact that a lot of rural hospitals are
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  - in dire need of just, you know, good
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  - facility upgrades,
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  - just the sustainable stuff. How do you think
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  - about transformational care when you're worried about keeping
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  - the lights on and you're worried about keeping
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  - the building up? So that's been you know,
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  - that was kinda number one back, you know,
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  - almost a year ago, I guess, whenever this
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  - whole thing was kinda dreamed up.
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  - Put a they put a lot of rules
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  - in there about what you couldn't use the
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  - money for, and they tried to push you
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  - towards, you know, this idea that robots are
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  - gonna take care of us all or whatever
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  - the world doctor Oz was talking about. I'm
• 8:22
  - just said a couple of things. It just
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  - made me scratch my head. But, you know,
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  - when you think through those,
• 8:27
  - you know, how what does that look like?
• 8:29
  - So, you know, for us in our application,
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  - we still care what what service lines are
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  - out there
• 8:34
  - that, would be transformational for the people here.
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  - So you haven't got to travel as far
• 8:38
  - to get that great care,
• 8:40
  - but always with an eye towards not trying
• 8:42
  - to do anything that isn't sustainable.
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  - So I think
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  - if our application is approved, you know, we'll
• 8:47
  - have some advanced cardiac care that, I don't
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  - I'm not aware of anybody else in our
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  - rural space,
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  - you know, local to to to Colorado and
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  - and Nebraska.
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  - I'm not aware of anybody that's doing the
• 8:57
  - kind of work we're hoping to get into
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  - from a cardiac perspective.
• 9:01
  - You know, we think about our ambulance service
• 9:03
  - and how do we expand that.
• 9:05
  - You know, again, there there weren't a lot
• 9:07
  - of capital opportunities within the RHTP funding,
• 9:10
  - so we try to be creative in how
• 9:11
  - we we message these things, to to make
• 9:14
  - it make sense. So we're, you know, we're
• 9:16
  - looking at putting an ambulance,
• 9:18
  - almost three hours away to the south of
• 9:20
  - us in order to support the operations of
• 9:22
  - hospitals down there and make sure their patients
• 9:24
  - are supported and taken care of in the
• 9:25
  - best way possible. We're looking at creative ways
• 9:28
  - to, to share that labor, you know, for
• 9:29
  - the people that are gonna be on that
• 9:31
  - truck.
• 9:32
  - And then there were just various things, they
• 9:33
  - were kinda thrown into, into the mix. Not
• 9:36
  - not haphazardly at all, but but we thought
• 9:38
  - that, okay, well, how can we how can
• 9:40
  - we make these these things that we need
• 9:41
  - fit into the into the parameters of this,
• 9:44
  - you know, this funding opportunity. So those are
• 9:46
  - the kind of things we went after. It's
• 9:47
  - got a lot of, you know, advanced,
• 9:50
  - specialty care. And then, of course, you know,
• 9:52
  - we've we've we've kinda like I say, we're
• 9:54
  - we're tag, you're it. And as far as
• 9:56
  - the inter facility transfers go,
• 9:59
  - you think about in the rural space,
• 10:01
  - really easy to have an ambulance in the
• 10:03
  - town.
• 10:04
  - Really difficult to staff that ambulance.
• 10:06
  - Now everybody wants to jump off of the
• 10:08
  - tractor or, or get out behind the, you
• 10:10
  - know, the, sales counter and run out and
• 10:12
  - do a 911 call. They're all happy to
• 10:14
  - run down the fire station, around down the
• 10:16
  - EMS house, jump in the ambulance, and go
• 10:19
  - out and take care of an accident victim,
• 10:20
  - go out and take care of chest pain.
• 10:22
  - They're really good at that.
• 10:24
  - But
• 10:25
  - they're back at work in about two hours
• 10:27
  - from a call like that. They can go
• 10:28
  - out, take care of the patient, deliver the
• 10:29
  - patient to local hospital,
• 10:31
  - do their report, and go back to work.
• 10:33
  - So easy to have a volunteer service or
• 10:35
  - a fire a volunteer fire department that does
• 10:37
  - that work. It's a whole different equation whenever
• 10:39
  - you ask that same person, hey, We got
• 10:41
  - this BLS patient or this ALS patient,
• 10:44
  - that needs to go to Denver, and that's
• 10:46
  - a three hour trip one way. And so
• 10:48
  - you're gonna go to the hospital, spend an
• 10:49
  - hour getting the patient ready and, getting them
• 10:52
  - on the truck. You got a three hour
• 10:54
  - transport time. You got the trans, transition of
• 10:56
  - care so that you drop that patient off
• 10:58
  - and hand them off to the receiving hospital,
• 11:00
  - give report, all those things. Hopefully, you use
• 11:02
  - the time on the way back to, to
• 11:04
  - write your report up. You're talking about a
• 11:06
  - six or eight hour trip transport.
• 11:08
  - So if if I'm a farmer that works,
• 11:10
  - has to work the, you know, the field
• 11:11
  - or if I have a a a day
• 11:13
  - job,
• 11:14
  - it's very difficult to convince,
• 11:16
  - that person to to just take off and
• 11:18
  - go do that interslate transfer. But that's some
• 11:20
  - of the most important care. And so that's
• 11:22
  - where we are, have kinda stepped into the
• 11:25
  - into the, the breach and try to fill
• 11:26
  - that void.
• 11:28
  - Well, that makes a lot of sense. And,
• 11:29
  - you know, a great example to illustrate what
• 11:32
  - is so critical about,
• 11:34
  - being able to have these funds and supporting
• 11:36
  - rural health care, you know, in a variety
• 11:38
  - of different ways. So
• 11:40
  - that makes a lot of sense, and thank
• 11:42
  - you so much for digging a little bit
• 11:43
  - deeper into how you're thinking about these funds
• 11:45
  - and what really is going to make the
• 11:47
  - difference in the future. Now I wanted to
• 11:50
  - ask you as well what you're most focused
• 11:52
  - on and excited about looking forward.
• 11:54
  - What what what are you thinking about today,
• 11:56
  - and and what are you most proud of
• 11:57
  - from the last six to eighteen months or
• 11:59
  - so?
• 12:00
  - You know, it's been so much fun to
• 12:01
  - come out here, over the course of the
• 12:03
  - last four years,
• 12:05
  - add to our specialty clinic. You know, so
• 12:06
  - we think about our RHC, our rural health
• 12:08
  - clinic as, you know, used to your everyday,
• 12:10
  - you know, doctors visit. We certainly have the
• 12:12
  - ER and we have the inpatient side,
• 12:15
  - to service our population.
• 12:17
  - But where we really feel like we can
• 12:18
  - expand that market coverage and really do a
• 12:21
  - great job for the people of, this Northeast
• 12:23
  - corner of the state,
• 12:24
  - is in our specialty clinic. You know, so
• 12:26
  - we talked about the advanced cardiology we're trying
• 12:28
  - to bring out. That's kind of a future
• 12:30
  - look. Some things we've already done though, we
• 12:32
  - have an inpatient detox that's run through the
• 12:34
  - specialty clinic,
• 12:36
  - that has has a a hospitalist component to
• 12:38
  - it as well. So we do that three
• 12:40
  - day. Remember, we're we're bound by that, you
• 12:42
  - know, those rules about how many days you
• 12:44
  - can stay as an inpatient. So it's a
• 12:46
  - short duration,
• 12:47
  - but that was a place where we felt
• 12:48
  - like we really could could meet some of
• 12:50
  - the community health needs assessment,
• 12:53
  - questions.
• 12:54
  - We work on alcohol abuse, drug abuse, things
• 12:56
  - like that. We've added some advanced mental health
• 12:58
  - in the in the last couple of years.
• 13:00
  - We've added ear, nose, and throat.
• 13:03
  - We've worked to expand our surgery coverage here
• 13:05
  - at the hospital.
• 13:06
  - We have full orthopedics. We have big joints
• 13:09
  - and sports medicine here. So it's been working
• 13:11
  - on that specialty clinic, side where we can
• 13:13
  - really do enhancements
• 13:14
  - and bring out pieces
• 13:16
  - of that, that advanced care. So people haven't
• 13:18
  - got travel as far. They can feel like
• 13:20
  - they're being taken care of absolutely as well
• 13:22
  - as they as well here as they are
• 13:24
  - in Denver or one of the big cities.
• 13:27
  - I love that. And I I think to
• 13:28
  - look at the specialty services and what you're
• 13:31
  - able to do close to home really makes
• 13:33
  - a big difference for the community.
• 13:35
  - And, you know, I think particular when you
• 13:37
  - look at the mental health side of it
• 13:39
  - too, I know that's something that so many
• 13:41
  - communities are dealing with and trying to develop
• 13:44
  - programs around. Can you tell us a little
• 13:45
  - bit more about what's made a difference for
• 13:47
  - you there?
• 13:48
  - Sure. Well, it's finding the right people. Right?
• 13:51
  - And that's always the case for everything we
• 13:52
  - try to bring out is is trying to
• 13:54
  - find someone who's,
• 13:55
  - very confident and capable of doing that, well
• 13:58
  - to work live in a small town. You
• 13:59
  - know, we're we're a town of 2,000. We're
• 14:01
  - a county of 5,000.
• 14:03
  - And you could argue that the, the the
• 14:05
  - true coverage area is a you know, it
• 14:07
  - depends how big you draw the circle around
• 14:08
  - us. Right? We are able to go back,
• 14:10
  - about a year ago
• 14:12
  - and with one of our our partners, we
• 14:14
  - did a deep dive on where our patients
• 14:17
  - really come from. And we were surprised to
• 14:19
  - find that if you look at the continuous
• 14:21
  - ZIP codes, we threw out, you know, my
• 14:22
  - ZIP code from Florida when I first got
• 14:24
  - here. We threw out people that are just
• 14:25
  - traveling through,
• 14:27
  - acts as if, you know, far away. We'll
• 14:28
  - never regularly seek care here probably.
• 14:31
  - But we found, about 34,000 people in the
• 14:34
  - contiguous ZIP codes that seek care here for
• 14:36
  - one reason or another. So we're always trying
• 14:38
  - to think about, you know, what do we
• 14:40
  - bring or what do we add that can
• 14:41
  - better serve that serve that population.
• 14:45
  - That's fascinating. Wow. It's really interesting to to
• 14:48
  - dig into the numbers there and and see
• 14:50
  - all the different patients and types of people
• 14:52
  - that seek services at the hospital. Now before
• 14:55
  - we wrap up here, I wanted to talk
• 14:57
  - about leadership a bit as well.
• 14:59
  - Obviously, a lot happening right now in health
• 15:01
  - care and is is such a critical time.
• 15:02
  - So what advice would you have for leaders
• 15:05
  - who are growing into the space or who
• 15:07
  - have ambitions to really, be leaders like yourself
• 15:10
  - of a hospital or a system?
• 15:13
  - You know, we we do a lot of
• 15:14
  - that. I I have a a good strong
• 15:16
  - mentor
• 15:17
  - from Alabama.
• 15:18
  - We actually work together in Florida as well.
• 15:21
  - He would just tell you every every chance
• 15:22
  - he gets, he says, this is about the
• 15:24
  - relationships. So health care is about building relationships.
• 15:27
  - You know, having this phone of friends you
• 15:29
  - can call when things go bump in the
• 15:30
  - night,
• 15:32
  - build a relationship with your providers,
• 15:34
  - with your nursing staff, with with your staff
• 15:36
  - throughout the hospital. You know, whenever you, are
• 15:39
  - able to to contribute, you know, to their
• 15:41
  - lives and then then to yours, and you
• 15:43
  - come together, you know, for the betterment of
• 15:45
  - the organization of the hospital, really important. So
• 15:47
  - I think finding a great mentor and then,
• 15:49
  - try and turn those mentors into good champions,
• 15:52
  - is a really important thing for,
• 15:54
  - you know, a rising,
• 15:55
  - a rising executive.
• 15:57
  - And I think once you get here, you've
• 15:58
  - got to, certainly, we look towards clinical excellence
• 16:01
  - and how do we how do we be
• 16:03
  - responsible,
• 16:04
  - and responsive,
• 16:05
  - you know, to the people that we serve.
• 16:07
  - But I think the most important thing that
• 16:09
  - you can do in this rural space
• 16:11
  - is mind your mind your store. And and
• 16:13
  - by that, I mean, you have to look
• 16:15
  - at that revenue cycle and you have to
• 16:16
  - really get that that ironed out and make
• 16:18
  - sure that that all the money that is
• 16:19
  - available to you for the work that we
• 16:21
  - do, that all that money comes back to
• 16:23
  - us, in a in a correct way.
• 16:25
  - We certainly have all the the the struggles
• 16:27
  - of trying to get, you know, the payers
• 16:29
  - to pay and
• 16:30
  - and, to make sure we're not leaving money
• 16:32
  - on the table. So a a a full
• 16:34
  - and deep understanding of that revenue cycle is
• 16:36
  - absolutely essential to be,
• 16:38
  - to be successful. We have a a hospital
• 16:40
  - not that far away, probably within an hour
• 16:42
  - and a half hour, hour and a half
• 16:44
  - drive of where I'm sitting right now.
• 16:46
  - They just filed bankruptcy.
• 16:48
  - These are this is an area that's not
• 16:50
  - unlike where we live. It's not unlike the
• 16:52
  - the town that we serve. And so for
• 16:55
  - for that organization
• 16:57
  - to have,
• 16:59
  - to have lost its position or lost its
• 17:01
  - way and not be able to, to make
• 17:04
  - to make things work,
• 17:05
  - it's, it's concerning.
• 17:07
  - I think we're gonna I fear that we're
• 17:08
  - going to see a lot more of that
• 17:10
  - in the in the in the in the
• 17:11
  - future.
• 17:12
  - I think it comes down to make sure
• 17:13
  - we, we're very vocal,
• 17:15
  - politically,
• 17:16
  - and we I I go every year up
• 17:18
  - to DC. I spent a lot of time
• 17:20
  - in Denver
• 17:21
  - just lobbying building those relationships with these lawmakers.
• 17:25
  - It's an election year for our us here,
• 17:27
  - so I've had both of our congress
• 17:29
  - congress delegates,
• 17:31
  - been in my office in my hospital.
• 17:33
  - We look closely after the the state delegates
• 17:36
  - as well.
• 17:37
  - Hopefully, I'll be having a a an opportunity
• 17:39
  - to meet again with the,
• 17:41
  - what we we kinda consider the governor elect
• 17:43
  - the election's not over,
• 17:44
  - but it's an an awfully blue state, so
• 17:46
  - we kinda have a pretty good idea of
• 17:47
  - who the the next governor is gonna be.
• 17:49
  - That that primary is already over. So plan
• 17:51
  - to spend some time with them, and make
• 17:53
  - sure they hear the, you know, the message
• 17:54
  - that
• 17:55
  - everything isn't easy out here and that we
• 17:57
  - do need some help. So mind your store,
• 17:59
  - make sure that you're looking after the revenue
• 18:00
  - cycle, build those relationships that are important and
• 18:03
  - critical for,
• 18:04
  - you know, for all the various rulemaking and
• 18:07
  - lawmaking that might come down, and the people
• 18:08
  - that can help you affect those, state agencies.
• 18:11
  - So, you know, you wanna make sure that
• 18:13
  - you have somebody who can can help figure
• 18:14
  - out the Medicaid problem in Colorado,
• 18:17
  - for us. We can figure out how how
• 18:19
  - we can utilize we're a border state, so
• 18:21
  - we've gotta be mindful of what's going on
• 18:23
  - in Nebraska and Kansas as well.
• 18:25
  - We see their patients too, but their Medicaid
• 18:26
  - is a is a bit different,
• 18:28
  - than Colorado's for sure. So lot lot going
• 18:31
  - on there, but those are the things that
• 18:32
  - come to mind when you ask that question.
• 18:34
  - That's fantastic advice, especially thinking about how quickly
• 18:38
  - things are changing and how much,
• 18:40
  - health care needs right now in order to
• 18:43
  - continue to exist and be sustainable
• 18:45
  - moving forward. What a great example of how
• 18:47
  - you can really be impacted strongly by some
• 18:50
  - of the different decisions being made across the
• 18:52
  - board and then looking at, you know, how
• 18:54
  - you can impact those decisions on the legislative
• 18:56
  - side in the future.
• 18:58
  - Michael, thank you so much for joining us
• 18:59
  - on the podcast today. This has been such
• 19:01
  - a great conversation, really inspiring to hear all
• 19:03
  - the different things you're working on and and
• 19:05
  - how you're thinking about the next couple of
• 19:07
  - years. And I look forward to seeing you
• 19:09
  - as well at our CTO CFO roundtable. I
• 19:10
  - know you'll be speaking on a panel, and
• 19:12
  - we'll explore
• 19:13
  - more of the things we talked about here.
• 19:16
  - I'm looking forward to it. Looking forward to
• 19:17
  - some great deep dish, and I thank you
• 19:19
  - so much, Laura, for your time today.