Latest / Becker’s Healthcare Podcast / Inside Healthcare Private Equity and Policy with Dr. David Klein and Joseph Mercer of Marwood Group

Transcript

Inside Healthcare Private Equity and Policy with Dr. David Klein and Joseph Mercer of Marwood Group · Becker’s Healthcare Podcast

• 0:00
  This is Scott Becker with a special episode
• 0:03
  of the Becker's health care and the Becker
• 0:05
  private equity podcast.
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  We're thrilled today to be joined by two
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  brilliant leaders.
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  We're joined today by two leaders from the
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  Marwood Group, and the Marwood Group's got a
• 0:14
  fascinating history, and they'll tell us about that
• 0:16
  as well. We're joined by Joseph Mercer and
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  doctor David Klein.
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  Joe, doctor Klein, can I ask you to
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  take a moment to introduce yourself? Joe, you've
• 0:26
  been with the Marwood Group for eleven, twelve
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  years now. Tell us about the Marwood Group
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  and where you guys focus and specialize
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  and how it came to be. You've grown
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  this tremendous presence in the sort of private
• 0:37
  equity world, health care private equity world. Tell
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  us a bit about yourself and the Marwood
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  Group, and that doctor Klein left You to
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  also tell us about yourself and your career,
• 0:45
  which has been nothing short of brilliant.
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  Joe. Thanks, Scott. Thank you for having us.
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  Yeah. Joe Mercer. I'm the managing director in,
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  in Marlboro's DC office. As you said, been
• 0:54
  here eleven years.
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  I started in health care policy working at
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  the centers for Medicare and Medicaid services where
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  I did Affordable Care Act implementation, including a
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  few years, helping to set up the ACA
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  exchanges.
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  Got to Marwood to, to to work on
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  health care service and managed care as, a
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  publishing analyst, in our, like, more research focused
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  practice. But, as anyone who has worked in
• 1:18
  around Marwood, knows, you know, you'll get swept
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  up into the private equity diligence space very
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  quickly, which is what happened. And now I
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  remain our lead publishing analyst on all federal
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  regulatory legislative issues, but, but, I spent a
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  lot of time in those same areas in
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  the private equity side as well. Marwood itself,
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  been around for just over twenty five years.
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  Started as a little bit of, like, let's
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  make a better connection for health care policy
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  between between DC and Wall Street so you
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  don't have another bipartisan budget act in 1997
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  situation where, you know, by side analysts are
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  learning on earnings calls that their that their
• 1:50
  companies are are getting smashed to pieces,
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  and, and instead, maybe let's, let's let let
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  them know in advance. Obviously, that's a that's
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  a market that's grown,
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  quite a bit across DC and a lot
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  of different folks. The sell side's gotten better.
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  But as we launched doing that, we had
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  a lot of interest in, hey. Can you
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  give us,
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  more deal support? Can you, you know, work
• 2:09
  more directly with companies? And so started a,
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  private equity diligence practice that was originally very
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  focused on federal regulatory work, but has expanded
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  to to state commercial payers,
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  strategy,
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  compliance work where we have an, you know,
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  a a a nation and growing very quickly
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  performance improvement practice, but just taking off of
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  that base and going a lot of different
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  directions, working with more corporates now, things like
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  that. But that's, that's the the thumbnail sketch
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  of of how we got here with Marwood.
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  No. Simply remarkable. And Marwood's built built sort
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  of the premier practice in this private equity
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  diligent space. Could you give us a sense
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  of what that looks like and how that
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  evolved? Sort of the typical project, it became
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  a thing where for many types of deals,
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  and I see it most particularly in health
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  care, you almost need a Marwood report to
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  do the deal. Talk about how that all
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  developed and where those reports really focus.
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  Sure. I can give a few thoughts, and
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  I'd love to hear David because David's been
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  on the other side of it as a
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  client. So I'd love to hear some of
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  his thoughts as well here. I mean, look.
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  What we, you know, we set out to
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  do is, work with work with the private
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  equity sponsor to say, like, you know, here
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  are our key issues. And most times, we'll
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  have, you know, we'll have an initial introductory
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  call, which you start to poke around on
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  an asset.
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  And we'll say, here's what we know about
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  it. Here's what, you know, here's what we
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  know so far. Here's what we'd want a
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  diligence. Here's where we wanna go deeper. What
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  are your key questions? And also, hey, by
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  the way, here's what you don't know you
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  don't know. Let's get into that. And so
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  the engagement themselves typically in the, you know,
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  three to four week range, though, you know,
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  I would say that's maybe crept crept down
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  a little bit in the last few years
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  as people have been you know, deal structures
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  have changed a little bit
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  with, you know, multiple work streams with the,
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  you know, with the project manager on top
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  and and just trying to synthesize
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  across the various different,
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  across the various different work streams.
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  Those key questions to have a
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  combined
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  a combined focus on,
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  you know, on the risk and opportunities,
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  for for a given business all, you know,
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  within the within the bounds of health care
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  regulatory, but also, obviously, in the strategy side
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  as well. And I think some of the
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  interesting places where we've grown when it comes
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  to things like the commercial, you know, commercial
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  payer practice and the strategy practice is that
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  the leaders we have on those on those
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  teams are interacting very closely with all the
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  regulatory folks as well. So there's a ongoing
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  dialogue of, you know, we talked to we
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  talked to Humana. Humana said this. Does how
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  does that align with how you guys are
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  reading the policy? How do you think that's
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  going to align? Or, hey, the people are
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  saying the market's gonna grow this amount or
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  our model says this. Are there any regulatory
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  watch outs? Like, hey, we're watching the ACA
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  broker market
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  scream up, you know, all up into the
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  right. Anything coming down the pipe that's gonna
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  change that? And obviously, our answer answer to
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  that is yes. So it's a it's a,
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  you know, interactive process across the organization that
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  I think gets a a pretty a pretty
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  solid,
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  set of you know, could be could be
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  25 slides in a PowerPoint presentation at the
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  end, or it could be it could be
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  350
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  depending on depending on the scope of work
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  and, and how much goes into it.
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  Thank you so much. And and doctor Klein,
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  you've had this brilliant career. Could you tell
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  me a little bit about your background,
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  your career,
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  whether you still share for their main beliefs
• 5:19
  and and and what you see in baseball
• 5:21
  this year with your Blue Jays? But tell
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  us about your career and and all that
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  you've done. And then now joining Marwood as
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  a senior adviser, what brought you to Marwood
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  and the excitement with that?
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  I guess I deserved the Maple Leaf poke
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  after, I alluded to the state of your
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  golf game before, we started the the podcast,
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  Scott. So, I do sadly continue to cheer
• 5:41
  for for the Maple Leafs. It's, it's something
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  I refer to as a genetic disease here
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  in in Canada, so not not something I'm
• 5:48
  proud of. And Blue Jays, who knows? Hope,
• 5:51
  hope springs eternal. It was a great year
• 5:53
  last year, and we'll see.
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  You know, my career,
• 5:57
  different than most or different than many, that
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  likely,
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  are on this podcast. I I, am a
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  physician by training and practice,
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  continue
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  to work as an academic
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  critical care physician here at the University of
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  Toronto leading a a large,
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  inner city type,
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  medical surgical cardiac intensive program,
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  care program here at University of Toronto. And
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  and what that's given me in my career
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  is
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  a a very real grounding
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  in the patient,
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  and what's really happening on the ground,
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  in in the system,
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  and to the patient. And I've worked both
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  in Canada and The US and and in
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  a number of other jurisdictions related to that.
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  Got involved in the health care business world,
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  first, helping start the Canadian health care practice
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  at McKinsey here and then spending a number
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  of years,
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  with McKinsey in in North America.
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  Went to business school, in Chicago at the
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  Kellogg School and then really got involved in
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  health care private equity
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  as an operating partner first with a fund
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  here called Imperial Capital,
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  really well known health care investors and and
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  helped,
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  them along the way
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  build, some of the,
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  the great roll ups,
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  that that they did, including companies
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  like Dental Corp, VetStrategy,
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  and others, and a number of,
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  successful,
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  exits with them and then spent
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  six years,
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  with Searchlight,
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  in New York, London, and Toronto building their
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  health care practice and,
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  have also,
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  continued to be a little bit involved,
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  in the policy side,
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  and with,
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  our government here and as adviser to to
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  other governments on on health systems and,
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  and where money meets medicine. But, you know,
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  and then joined the Marwood Group just after
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  Labor Day this year. And
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  and, you know, that came to be because
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  I truly believe that there is
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  a triad or triangle,
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  as it relates to health care investing with,
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  one, corner of that triangle being the the
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  clinical need and and really
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  building a business that does what's right for
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  the patient and and,
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  and for the system.
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  The second point of that triangle,
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  being the business and the finance, and, you
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  obviously need to get the math right. And
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  the and then the third piece being the
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  policy side.
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  And, you know,
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  if I were to answer
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  the question you asked, Joe,
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  more simply,
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  coming from the investor side is, you know,
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  if you've ever been to an investment committee
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  with a health care deal and the first
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  three risks aren't regulatory
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  or stroke of the pen in one way
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  or another, then you're probably not looking at
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  the deal the raw the right way, and
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  that's the way I was always
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  always trained. And so, you know, the reason
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  Marwood, I think, has become more and more
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  important is because,
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  the policy environment is becoming increasingly more complex,
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  and, certainly, these days, increasingly more volatile.
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  And, and so if you're if you're not
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  understanding that at at the highest levels,
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  then,
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  then I think,
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  you shouldn't be, skiing the double blacks.
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  Yeah. A 100%. So you'll move to skiing
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  also a place where I struggle too, skiing,
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  golf, all these things. But but, doctor Klein,
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  a magnificent career. What are the top two
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  or three trends you're thinking about this year
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  when you look at health care investing or
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  the health care policy world, the top two
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  to three trends? And then, Joseph, I'll ask
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  you the same question, the the two or
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  three biggest policy trends that you're keeping your
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  eye on.
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  Yeah. Look. For me, I think coming at
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  it from the clinical side and and coming
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  out of COVID, we,
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  we very much learned,
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  the vulnerabilities
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  of of of large institutional care models.
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  And so I think there continues to be,
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  a focus and a shift,
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  in in providing
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  care and integrating care in lower cost settings
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  of care. What you know, that's home care.
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  That's hospice care. That's
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  any and all sources of,
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  of care outside of large institutions and
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  all that it takes to support that. So
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  that's understanding the data.
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  That's the,
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  the health care IT, the remote monitoring,
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  everything that goes with following the patient through
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  their patient journey.
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  I think that that's a really important bucket.
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  I think that there
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  you know, we we continue to be under
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  significant fiscal restraint in in the health care
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  system.
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  And so,
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  whether it's ways to optimize revenue
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  through things like revenue cycle management,
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  or take out cost through technology,
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  like AI,
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  and improve workflows.
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  That's gonna continue to be a focus,
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  in in an environment,
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  where we continue to be an under strain.
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  And and then, you know, I think there's
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  also an increasing
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  focus, in
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  finding
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  models of care
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  where,
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  you whether they be direct government paid, like
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  value based care or employer health models,
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  where you have much better alignment between clinical
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  outcomes and the dollars you're spending versus traditional
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  fee for service models. So I think those
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  are all really important areas,
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  and, I'm sure Joel will have some,
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  important policy comments and other comments along those
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  lines.
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  Thank you so much, doctor Klein. Joel, your
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  thoughts on a couple of the biggest trends
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  that you're watching from sort of a policy
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  perspective or just a health care private equity
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  investing perspective?
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  Sure. Absolutely. I mean, I think one one
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  really big one, the one that you can't
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  get away from is your house state budgets
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  will be impacted by the one big beautiful
• 11:53
  bill act. We both have short term issues.
• 11:55
  Right? States are updating their their tax structures
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  to either reflect the one big beautiful bill
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  act changes, which can reduce revenue or and
• 12:02
  they're also looking at, hey. You know, Medicaid
• 12:05
  populations are aging just like the overall population.
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  So you're seeing increases in spend in personal
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  care services and nursing facilities, you know, and
• 12:12
  things like that, which are expensive even in
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  in the aggregate, even if, you know, personal
• 12:16
  care services are not that expensive on a
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  on a more micro level. And so you're
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  and you're living through this with the eye
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  towards
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  work requirements in 2027
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  and then and then actual budget pressure in
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  many,
• 12:28
  states in 2028. And so I think,
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  stop thinking about the initial state reactions
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  to their own budget pressure, like, outside of
• 12:37
  one big beautiful bill act and how that
• 12:38
  might impact various different services. Because I think
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  the way we've looked at it is, you
• 12:42
  know, spent a lot of time,
• 12:44
  especially with public investors, talking about hospitals. But
• 12:47
  on the private side, we've seen a lot
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  of attention on some of these areas that
• 12:50
  could be considered more defensive positions, you know,
• 12:52
  ABA,
• 12:53
  institutional
• 12:54
  developmental disability services,
• 12:57
  personal care services. But then you have you
• 12:59
  have state actions in the last few months
• 13:01
  that that that really challenged that narrative. There
• 13:04
  were some changes in reimbursement that have been
• 13:06
  since been reversed in North Carolina just as
• 13:08
  an example.
• 13:09
  Then you also have the overlay of a
• 13:11
  fraud, waste, and abuse effort at the federal
• 13:13
  government, that has, made some challenges for personal
• 13:16
  care services, ABA providers in Minnesota and could
• 13:19
  conceivably see some contagion to other states. And
• 13:22
  so I think that there's like a,
• 13:24
  hey. These are
• 13:26
  more protected than other areas in Medicaid, but
• 13:29
  how protected are they and how might be
• 13:31
  we want might wanna structure our deals, but
• 13:33
  also structure operations and compliance
• 13:36
  both before and after after the deal to
• 13:37
  make sure that this is an investment that
• 13:39
  can, you know, is is is not just
• 13:40
  dependent on, on reimbursement rates, but is dependent
• 13:43
  on being, you know, like a a a
• 13:45
  very high quality actor, in a in a
• 13:48
  increasingly,
• 13:49
  complex space. That's the one.
• 13:51
  The other one is that the Trump administration
• 13:53
  has done just a tremendous amount in, you
• 13:56
  know, in Medicare Advantage rulemaking,
• 13:59
  in various different models. And, you know, David
• 14:01
  mentioned VBC, and VBC has been a little
• 14:04
  bit of a dirty word in,
• 14:06
  you know, in private equity investing the last
• 14:08
  few years when you've seen some of those,
• 14:09
  you know, some of those scaled players in
• 14:11
  Florida that have focused very heavily on Medicare
• 14:14
  Advantage be, you know, see a lot of
• 14:17
  pressure with regulatory changes.
• 14:19
  I think the way that we will look
• 14:20
  at this is that you now have in
• 14:22
  the LEED model, which launches in 2027 as
• 14:25
  a as a successor to the ACO reach
• 14:27
  model.
• 14:28
  You have an opportunity maybe for some new
• 14:30
  applicants to come up and try to play
• 14:32
  in a in a space that is,
• 14:34
  that is it's not necessarily the easiest place,
• 14:37
  but it builds on the type of operational
• 14:40
  considerations that can be very valuable to MA
• 14:42
  plans as you're not just able to pull
• 14:44
  the risk adjustment lever over and over and
• 14:46
  over again and have a successful business. Some
• 14:48
  of that blocking and tackling becomes important.
• 14:51
  And the same applies to continued partnerships with
• 14:54
  Medicare Advantage Plans where you can look at
• 14:56
  it as
• 14:57
  we're going to you know, if you if
• 14:59
  you're a player who's always rely very heavily
• 15:01
  on risk adjustment, you may be more disadvantaged
• 15:04
  compared to a smaller,
• 15:06
  VPC player or a, you know, a more
• 15:08
  nascent player that has doesn't have some of
• 15:11
  the,
• 15:12
  some of that lingering,
• 15:14
  lingering
• 15:15
  reliance
• 15:16
  on an an outdated,
• 15:18
  regulatory structure.
• 15:20
  The other part of that too, I think
• 15:22
  that you have a model, the access model,
• 15:24
  which has seen a tremendous amount of attention
• 15:26
  trying to improve chronic care
• 15:29
  through outcome measures. We've actually heard a little
• 15:31
  bit the last few weeks that you see
• 15:33
  some MA plans starting to say, you know
• 15:35
  what? We think that these access,
• 15:37
  access model measures are a really valuable thing
• 15:40
  to ask of our, of our provider partners
• 15:42
  and our VBC partners. And so you can
• 15:44
  see how these
• 15:45
  regulatory changes
• 15:47
  are forcing
• 15:48
  operational considerations
• 15:50
  and potentially presenting opportunities in VBC,
• 15:53
  but also present some, you know, some risks
• 15:56
  to more established players. So those are a
• 15:57
  few things that jump out at me.
• 16:00
  Thank you very, very much. And, Joseph, let
• 16:01
  me ask you a follow-up question. When when
• 16:03
  you look at what you see your clients
• 16:05
  or Marwood most focused on this year, what
• 16:08
  would that be? What what's the biggest focus
• 16:10
  this year?
• 16:11
  Gosh. It is I mean, things are all
• 16:13
  over the place. I mean, I think we
• 16:15
  continue to see a lot of focus on
• 16:18
  anything that says, you know, blank services,
• 16:21
  payer services, pharma services, provider services. There are
• 16:24
  still, you know, some lingering reluctance to get
• 16:27
  into the more directly reimbursed spaces.
• 16:31
  But at least when it comes to
• 16:33
  at least when it comes to Medicare, I
• 16:35
  think those have been a focus.
• 16:37
  We've seen a little bit a little bit
• 16:39
  more just like, the, like,
• 16:41
  half an eye open in the morning,
• 16:44
  for, you know, for physician practice management companies
• 16:47
  to to get back in there. But a
• 16:49
  lot of a lot of services,
• 16:51
  and then the other place we're seeing a
• 16:53
  lot of action in the HIT space is
• 16:56
  around, like, RCM vendors and a lot of
• 16:59
  vendors that call themselves RCM that are doing
• 17:01
  things like helping with the no surprises act
• 17:04
  IDR process. So it's a a much more
• 17:06
  fragmented market, I think, than we saw a
• 17:08
  few years ago because in the absence of
• 17:11
  some of the, you know, everyone wants to
• 17:13
  do PPM or everyone wants, you know, we
• 17:15
  still have a lot of people very interested
• 17:16
  in fusion, for example. But a little more
• 17:18
  fragmented as people try to find little areas
• 17:21
  where,
• 17:21
  there's, you know, some some
• 17:24
  high quality firms providing real, you know, real
• 17:26
  value to providers and payers in an environment
• 17:28
  where, you know, payers are trying to squeeze
• 17:30
  out whatever they can with difficult medical cost
• 17:33
  trends and providers are trying to, get ahead
• 17:35
  of whatever the payers are doing.
• 17:37
  Yeah. If I could put the ball on
• 17:39
  the tee,
• 17:40
  for Joe again, you know, I think one
• 17:42
  of the areas,
• 17:44
  across all of this,
• 17:46
  that is extremely,
• 17:48
  busy at Marwood and and busy for portfolio
• 17:50
  companies broadly is compliance,
• 17:53
  whether that's, you know, Medicaid related to what's
• 17:55
  gone in Minnesota or other things. I think,
• 17:58
  any organization,
• 18:00
  right now that's operating in in the health
• 18:02
  care environment is feeling a tremendous amount of,
• 18:05
  of scrutiny around around compliance.
• 18:08
  And,
• 18:09
  and I know Joe and his teams are
• 18:11
  are working very, very hard with, a broad
• 18:14
  range of,
• 18:16
  both portfolio company clients and the diligence,
• 18:19
  related
• 18:20
  request to ensure that,
• 18:22
  that that is all happening at at at
• 18:25
  the highest level for for folks.
• 18:27
  Thank you so much. And, David, to follow-up
• 18:29
  on that, you see this from a slightly
• 18:31
  different mindset for or or position than than
• 18:33
  Joseph as a practicing physician too,
• 18:36
  and an entrepreneurial physician.
• 18:38
  What are you most focused on and excited
• 18:40
  about this year?
• 18:41
  What am I most focused on and excited
• 18:44
  about?
• 18:46
  You know, I I think that
• 18:48
  2026,
• 18:49
  most people expect to be
• 18:52
  a year,
• 18:54
  of increased activity again where where deals start
• 18:58
  getting done again, and some of the log
• 19:00
  jam
• 19:01
  of 2024,
• 19:02
  2025,
• 19:04
  starts to
• 19:06
  starts to break.
• 19:08
  And so
• 19:09
  what I'm excited
• 19:10
  for is to see that hopefully start to
• 19:13
  happen,
• 19:14
  to see,
• 19:16
  multiples,
• 19:17
  come to a place where deals are more
• 19:19
  transactable,
• 19:21
  to see
• 19:22
  financial players
• 19:24
  in in the market, lenders and others,
• 19:27
  getting,
• 19:28
  more excited. And I think a lot of
• 19:29
  what unlocks that again,
• 19:32
  on the policy side is,
• 19:35
  is
• 19:37
  what I've called and and sort of took
• 19:39
  out of JPMorgan conference this year,
• 19:41
  decreased volatility around policy. And so, you know,
• 19:45
  while,
• 19:47
  the first year of of the Trump administration,
• 19:50
  we had wild
• 19:52
  swings in markets,
• 19:54
  related to
• 19:55
  some pretty wide,
• 19:57
  policy,
• 19:58
  kind of decisions around things like MFN and
• 20:01
  other the big beautiful bill and others. We've
• 20:03
  come to understand those a little bit more
• 20:05
  and how they will play out,
• 20:07
  in in a little bit of a more
• 20:09
  predictable way.
• 20:11
  And and so, you know, what I'm most
• 20:14
  excited for
• 20:15
  is to see the logjam break, and and
• 20:17
  hopefully that is the case.
• 20:20
  Thank you. And, hopefully, less volatility. And, Joseph,
• 20:22
  let me turn it back to you.
• 20:24
  More or less volatility in the health care
• 20:26
  world this year, and are there areas you
• 20:28
  see
• 20:29
  where there's more money being invested, more excitement
• 20:32
  than others? Joseph, any thoughts there?
• 20:35
  Yeah. I mean, I I would love to
• 20:37
  say, oh, we'll have less volatility. I think
• 20:39
  that David's right that we're seeing that, like,
• 20:42
  the levers
• 20:43
  the administration's pulled a bunch of levers, and
• 20:45
  now there's a level of, like, let's see
• 20:47
  how things play out. But, of course, like,
• 20:49
  again, we we've talked about this a few
• 20:51
  minutes ago, but going into JPM, I was
• 20:53
  like, yeah, that things will be relatively stable.
• 20:54
  And then in the week prior, there was
• 20:57
  a, you know, we we all of a
• 20:58
  sudden, Minnesota and fraud and the potential contagion
• 21:01
  spread spread,
• 21:03
  across the landscape. It was all I talked
• 21:05
  about for two days in unexpected manner.
• 21:07
  That said, I do think that, like, this
• 21:09
  will be a year of reacting to the
• 21:11
  many changes from last year, and that is,
• 21:14
  you know, that that does mean that policy
• 21:16
  has to interact with operational considerations and strategy
• 21:19
  and compliance considerations as David highlighted.
• 21:22
  I think to that end, where people are
• 21:25
  trying to spend money is, I think or
• 21:26
  or where we've we've seen a lot of
• 21:28
  interest is in areas where there's been a
• 21:30
  little bit more stability for longer. One of
• 21:32
  the examples we see a lot of a
• 21:34
  lot of, calls on these days is businesses
• 21:36
  that have benefited from the No Surprises Act
• 21:39
  independent dispute resolution process, whether that be providers
• 21:42
  that are receiving relatively robust rates because they've
• 21:45
  been successful in the IDR process
• 21:48
  to the, you know, to the,
• 21:51
  you know, RCM vendors that are helping providers
• 21:54
  of all sizes, not just large, you know,
• 21:56
  large previously private,
• 21:58
  private equity backed ones, but smaller providers as
• 22:00
  well, helping them
• 22:02
  try to take advantage of a process that
• 22:04
  can work for them if they do it
• 22:05
  the right way. And then payers looking to
• 22:07
  have, you know, looking to have a better
• 22:09
  a better mouse trap. And and, obviously, you've
• 22:11
  seen some large,
• 22:12
  large companies, multi glen cells, things like that
• 22:14
  be very successful there in in in gaining
• 22:17
  business there, but, you know, maybe the next
• 22:19
  step in the line. So I think that's
• 22:20
  a good example of where we've seen, where
• 22:22
  we've seen a lot of interest is where
• 22:24
  there has
• 22:26
  been more stability or where you can bracket
• 22:28
  the risk a little bit better. And so
• 22:29
  that that's that's one big example where
• 22:33
  if you had to say this is a
• 22:34
  change from a year ago, the interest, that's
• 22:36
  a a marked change as that as that
• 22:38
  has seen a little more stability in the
• 22:40
  regulatory and legislative,
• 22:42
  perspective.
• 22:44
  Thank you so much. And and doctor Klein
• 22:45
  and Joseph, I'm asking both of you these
• 22:47
  questions. Both of you are professionals,
• 22:49
  have had these fantastic careers.
• 22:52
  Doctor Klein, as a physician,
• 22:55
  Joseph, by background, as a lawyer.
• 22:57
  Take a moment each of you. What advice
• 22:59
  would you give to evolving leaders? And, doctor
• 23:02
  Klein, I'll start with you, you know, about
• 23:04
  having great careers, being impactful, keeping it interesting.
• 23:07
  Any advice that you would give to emerging
• 23:09
  leaders? And then then, Joseph, I'll ask you
• 23:11
  the same question.
• 23:12
  Yeah. Look. I think for me, it's been
• 23:14
  about playing the long game and,
• 23:16
  always just adding new pieces,
• 23:19
  that
• 23:20
  that continue to to make me better at
• 23:22
  what I do and and and smarter at
• 23:24
  what I do. And, I continue to do
• 23:27
  that
• 23:28
  today, and, that would certainly be advice I
• 23:32
  would give a a young leader.
• 23:34
  One of my common,
• 23:36
  pieces of mentorship advice that that I give
• 23:38
  young leaders is to find ways to put
• 23:40
  yourself in self in rooms that you don't
• 23:42
  belong, and that's also something I've done, throughout
• 23:45
  my career. And,
• 23:47
  you know, having served coffee at
• 23:50
  board meetings, when I was in McKinsey,
• 23:53
  consultant, with some of the biggest leaders in
• 23:56
  business to, you know, any other stage of
• 23:59
  my career. That that's really allowed me to
• 24:01
  to learn things and and learn the inner
• 24:03
  workings
• 24:05
  of
• 24:06
  of of business and medicine and other places
• 24:09
  just by exposing myself to great people and
• 24:12
  and putting myself in rooms. And so, you
• 24:14
  know, that would probably be it for me.
• 24:16
  I might steal the Wayne Gretzky line, the,
• 24:18
  you know, skate to where the puck is
• 24:19
  going and not where the puck is, but
• 24:22
  but that that's probably it for me in
• 24:24
  sports analogies.
• 24:26
  No. Absolutely love it. And and, Joseph, your
• 24:29
  advice for emerging leaders, and and how did
• 24:31
  you transition from law into leadership
• 24:34
  at Marwood?
• 24:35
  And tell us a bit about the the
• 24:36
  arc of your career because it's a magnificent
• 24:38
  career.
• 24:40
  Yeah. Thanks. Yeah. I mean, I I think
• 24:42
  the what brought me from,
• 24:45
  law school to working in federal policy was
• 24:48
  just seeing to to David's point about going
• 24:50
  where the puck, the the puck is going
• 24:52
  is the ACA passed as I was finishing
• 24:54
  up my my law school career and, say,
• 24:56
  hey. I need to be involved in that
• 24:57
  because that seems like the place to go.
• 24:59
  And, you know, I tell people all the
• 25:01
  time going over to Marwood is that you
• 25:03
  work in the government long enough. They want
• 25:04
  you to do one thing really well. I
• 25:06
  wanted to do lots of things really well,
• 25:08
  and I wanted to be pushed and and
• 25:10
  have, you know, and and have an opportunity
• 25:11
  to look at many different, many different topics.
• 25:14
  I got that and more at Marwood.
• 25:16
  And so, you know and and one of
• 25:17
  the huge advantages I've had and I think
• 25:19
  one reason that I've been able to be
• 25:21
  successful is I've looked at the looked at
• 25:24
  my career as an opportunity to say, who
• 25:26
  around me knows this better and how can
• 25:28
  I learn and how can I how can
• 25:29
  I reflect on on what they've done? And
• 25:32
  and and that's been a big advantage. Once
• 25:34
  I started really leaning into that at Marlwood
• 25:36
  and and listening to all the people with
• 25:38
  more knowledge in different areas, I feel like
• 25:40
  that really allowed things to to accelerate. And
• 25:42
  that's that's the number one piece of advice.
• 25:44
  It's it's connected. Right? Number one, be curious.
• 25:46
  And number two, really take advantage of the
• 25:48
  people around you that that might know one
• 25:50
  area better, and it's an opportunity for you
• 25:52
  to, you know, sort of piggyback off them.
• 25:55
  No. Just a fantastic
• 25:56
  I I cannot believe how quickly our time
• 25:59
  went today.
• 26:00
  Doctor Klein, Joseph Mercer, what a pleasure to
• 26:03
  visit with you. You could learn more about
• 26:05
  the Marward Group, online. Marward Group's become sort
• 26:08
  of the preeminent
• 26:10
  in in this regulatory
• 26:11
  analysis piece that they do for private equity
• 26:14
  deals. Just a remarkable
• 26:16
  sort of arc of of that business growth
• 26:18
  and how they've become so central
• 26:20
  to deals and transactions in the private equity
• 26:22
  space.
• 26:23
  Congratulations on both of your fantastic success. And
• 26:26
  I wanna thank both of you for joining
• 26:27
  this special combined episode of the Becker's Healthcare
• 26:30
  and the Becker Private Equity Podcast. Thank you
• 26:32
  so much for joining us. Thanks so much,
• 26:35
  Scott. Thanks, Scott.