BoneChat #103 - Vendor Credentialing is broken and RepSource Is the answer for the ortho firms.

Okay, this is bone chat number 103, featuring Cheryl Halbert. She's the startup founder of RepSource. And thanks to Al Nani for suggesting we bring Cheryl on the channel for her disruptive vendor, vendor credentialing technology. And I think every single device company needs to check out RepSource technology. And I'm going to hand the mic over to Cheryl and I'm going to put her contacts in the chat. Welcome aboard, Cheryl.

Thanks. Thanks for having me. I feel like I'm in the hot seat this afternoon, but I'm looking forward to the conversation. And thanks for having me, and thanks for suggesting it, Al. I really appreciate it. As I mentioned, we. I'm. I'm. It's not death by PowerPoint. I'm just gonna play a little promo video and then y' all can. We can just start having a conversation and hopefully go from there, because to me, this is all about you and getting what you need out of the solution versus what we need out of it. So I'll just play this and we can have a conversation.

Yep.

And the promo, I think, is no sound, so don't freak out if you don't hear any sound.

So hold on one second. All right. Can you all see this?

Yes.

All right.

Managing your healthcare vendor credentials can be overwhelming for reps juggling multiple systems and for executives facing escalating costs, delays, and compliance risks. At RepSource, we understand both sides of the equation. Field reps frustrated by complex requirements and redundant uploads. And leadership burdened by rising fees, erroneous data, and liability exposure. That's why we created RepSource and the Onerepid digital wallet. RepSource is your company's enterprise credentialing solution, built for medtech suppliers to control compliance and data ownership, eliminate third party delays and costs, reduce risk, and improve hospital access for reps and oversight for executive teams. With everything in one place, it streamlines credentialing and gets you into facilities faster. Because now your company administration is in control. The OneRep ID digital wallet lets company admins verify, issue and manage REP credentials, digitally adhering to strict universal ANSI standards and auto generating one verification letter that satisfies all hospital credentialing requirements. Stay compliant with automated updates and real time alerts, cutting credential management time from 40 hours to just 12 annually. Less paperwork, fewer delays, more time focused on your actual job. Getting started is easy. Check your compliance status on the My Credentials page. Generate your detail and verification letters. Upload your headshot and select your hospital accounts. No more repetitive uploads or chasing approvals. Your company admins now control credential verification. Third party delays are gone. RepSource ensures smoother hospital entry, fewer interruptions and stronger digital security. Your organization is embracing innovation and you're part of the change. Empower yourself with RepSource. Simplify your credentials, streamline your workday and focus on what truly matters. RepSource.com is where the shift starts. For leaders ready to reduce spend and streamline compliance, and for reps ready to get back to what matters. RepSource puts credentialing control back where it belongs at the data source.

Cool.

Could everyone hear that?

Yeah. Yeah.

Ask after I play loud and clear. Okay. So yeah, so I'm, I'm the premise of the best analogy that I can give you for RepSource and the one rep ID is think of it as clear or TSA PreCheck for vendor credentialing. Right. So this is a solution that is meant for the medtech suppliers to help solve their issue of having multiple platforms. So now just like at the, at the airport, you can go through regular security which is your third parties, or you can have RepSource in the one rep ID that's aligned to the ANSI standards. It checks the boxes for CMS and JCO for the hospitals. So they have hospitals have two boxes that they need to check. Do you have a vendor credentialing policy in place? Yes. Do you enforce it? Yes. They can check both of those boxes with our solution as well. The unique thing about what we're doing is now the suppliers and employers become the credentialers. So they get accredited to the standards, the ANSI standards. And now it becomes a conversation with the hospital of hey, our Reps are on RepSource and the one rep ID. Will you, will you accept it? Yes. It checks your boxes? Yes. Here's how it also helps you. Because hospitals know that they've got this big security gap where hospital reps are signing in with their previous employers credentials and there's nothing anybody can really do about it because the suppliers don't have control of that data, the third party does. And so that's really why we need to change this whole business model and put it back in the supplier and the employer's hands. Because the employers and the, and the suppliers, they know who's actively employed and it's a liability risk for both the hospitals and the suppliers. They know it. It's just we haven't Had a viable alternative up until now to really change it. And that's what the rep. The one rep ID is meant to do. That digital wallet. That's my sales pitch. I'm out. Nice.

Nice. All right. Nice overview. Far away. I know there's questions.

Yeah.

This is brand new too. It just, it's mean. Just came out.

So I guess the easy thing is how's your, how's your traction so far? Let's talk about the, the start, you know, the challenges of being a disruptor and providing a solution. What's. How's that been relative to your. Your target audience?

Yeah. So we just got back from Aukus where I had some really great conversations with the big strategics. I got their ear. Let me just tell. I mean I was wearing this shirt out that said tired, tired of vendor credentialing. And it worked. I mean it was a conversation starter. And so yes, we were in talks with the big strategics to get onboarded with repsource and the one rep id. So the conversations are starting. Yes. Have they, have they written me a check yet?

No.

But you know, no, if, if we don't start getting the word out there that we exist, you know, we'll, we'll never get, you know, to mass adoption. So we are very much at our infancy. But you got you. It all starts with one. Oh, I see some other hands. And as far as the hospitals accepting it, so SMI members actually make up about 30% of hospitals in the nation. And SMI has endorsed the. And has and has said, like, hey, our members, I mean, they voted nine to one. I believe, I believe that was the vote to accept the anti standards. So if you go to the SMI website and you look at their member hospitals, any of those systems should be accepting of the ANSI standards, which does make up about 80 or, I'm sorry, 30% of hospitals today. So we start with 30% of hospitals that should be accepting of the ANSI standards.

Go ahead, Mark. And then Kyle.

Kyle, I think. Kyle, I think you were first. Go ahead. Didn't Kyle raise his hand first? Yeah, go ahead.

It'll come by one of us. These conversations always end up doing that. So who is your target at the strategics that you can get to take action on something like this?

The commercial sales ops guys is who we're talking to.

So the commercial sales ops guys, are those the same team members that are involved in the other type of credentialing that is not rep track status blue, all the other hospital level stuff? There's other credentialing that companies will do outside of the commercial team, typically through commercial education and other groups, right?

Yes. I, to be quite frank with you, Kyle, varies by the. The. The organization, but that is where I have found most of the decision makers with the budget to be is in the commercial sales apps. Now, it varies because sometimes it's the VP of sales that's carrying that and is responsible for that. Sometimes there is a credentialing team, and then I'm working directly with the credentialing team. But we have actually found that about 20% of companies actually have dedicated credentialing teams thus far. I mean, it could be bigger than that, but so far that's what it seems. Seems to be. So that's why. And I don't mean to be vague with your question, but I want to answer it in the sense that it's VP of sales, VP of commercial sales ops, or the head of the vendor credentialing team is typically who we're talking to. So if you're wanting to know who you put me in touch with, it would be one of those three people, depending on the size of the organization.

That last part is probably the kicker.

Right.

Because the smaller orgs haven't built all of that out yet and are maybe even more reluctant to dip their toes into this pool because they just leave all of that hassle with the field reps to deal with until they can scale and then absorb some of that. That workload. So I follow you so far.

Okay.

I'll have more for you. I'll let Mark go.

Okay.

So, I mean, I applaud what you're doing. Thank you, everybody. Everybody loathes and hates vendor credentialing.

Yes.

And I'm old enough to remember the days in which basically there were no reps in the or and at most, you might see a Codman rep in the lounge selling instruments. And then we've gradually learned that the more reps that are in the or, the less the back table or the mayo needs to know because we're there telling them what to do. So we basically crippled their knowledge base to enable us to have more time to sell at the Scrub Sync. So that's how this all evolves. So anything like this basically starts with what's in it for me? The hospital team's going to know what they're going to ask, what's in it for me? The cartel, big companies that you're talking to, they're going to ask what's in it for me. Nobody's really going to ask the reps. I mean they'll, you know, we'll stage it, but we won't really care. The average hospital, the average hospital. The average hospital gets, or the average hospital generates several hundred thousand dollars in revenue for a vendor credentialing company for a 300 bed hospital surgery center, 40 to 60,000. They have a lot of money to throw at this to add on other layers of benefits to the hospital. That's going to cause a lot more resistance. This is really an uphill, this is a noble effort. It's an uphill climb. And I would say that unless you.

Got that to look forward to, unless.

You can, unless you can find a way to. Unless you can find a way to directly benefit the hospitals or to legislate it. And it might be just easier to pay politicians. They're pretty payable. That wouldn't be a bad way to go. Anyway, I'm not being cynical because I actually am not aesthetic, but I. So I think this is a great effort.

To answer your. To kind of pile. Not answer, but pile on to what you're saying or double click it as we say. You are correct. It will. If CMS would mandate it as part. Which I don't know, if you saw the AdvaMed letter that recently was published on September 15th urging the DOJ to get the CMS to mandate alignment, that hospitals align to the ANSI standards as part of their certificate of participation, that would, that would be a game changer because then it would, man, you know, so many people have said it's never going to happen, that we have it, we have the ANSI standards mandated across the nation. And I call bullshit because the reality is if CMS mandated it as part of their certificate of participation with a stroke of a pen, that could happen. Right? So that's one way that it can happen. I do want to address your. What's in it for me on the hospital standpoint? Because the reality is we, so we went to, we've had conversations with like the Cleveland Clinic, for example, and they recognize that vendor credentialing is not a source of truth. So as you have all these technologies that are getting implemented in hospitals every day, they don't have a source of truth for who should have access to that. Right. So that's, that's one thing. So it's kind of that identity access management piece on the digital front is, is continues to be a problem because who's authenticating and saying these are the actively employed reps that represent Medtronic Or Stryker or whoever. Because now we've got software as a med device, you've got bill only platforms, you've got communication platforms, you've got scheduling. Who should have access to that and who's managing that. Right now it's on the hospital. So there's, there's multiple things or solutions that we can provide as part of our solution, which is the suppliers and employers now controlling that information versus the rep. But the thing that gets the ear, bends the ear of the hospitals the most is the security aspect. So former representatives still being able to sign in under their former employers. They're not being nefarious, it's just, it's, it's a broken system. So you like if the, you know, I grew up on a farm. If the gate, if the gates open, you know, like you, you don't climb over it like you're supposed to, you go through it, right? Because it's the path of least resistance. Reps are doing the same thing when they, when they switch. But it's also a risk for both the former employer, the current employer and the hospital if there was an adverse event that occurred while that rep was in the, in the, in the room. And I mean, we all know it. The third party vendor, credentialing systems have washed their hands of any liability of it because it states in their terms and conditions. You know, the reps are self attesting to this and we're relying on their information. So it's a big security risk because 10, 55% of cyber attacks come through third parties for hospitals. And so they've got to have a way to control that. And it's, you know, 55% come through third parties. And the average cyber attack costs a hospital 10 million bucks.

Oh, I know. My last meeting was about cybersecurity. I think I'm the only guy on the call that owns a compliance company. So I'm always looking for other services that are directly related to, if not compliance and security. So, you know, I'm just gonna say one more thing, tiger, and I'm gonna shut up. The. I recently visited, I've spent some time in the hospital because my wife is in the hospital. I talked to a respiratory therapist And I remember 35 years ago, respiratory therapists were the bottom of the bottom hires. They were like, you know, $4 an hour people. They didn't know jack. And then like every other group over, over the years, they became credentialized and they raised the level of their professionalism. Now they're college graduates, Reps in the OR have had the opportunity to do this for 30 years, and we didn't do it. Great.

That's a great point. All right, we got three lined up. Chris, Kyle, and Al.

Hey, Cheryl. I'll go. So why is it that there's not multiple, like, vendor credentialing companies allowed in a facility now? I kind of have my take on this, and we can part with my cynicism. I typically bring to everything, but, like, why is it that, you know, intel centrics rep tracks, green security. Pick your poison. Why are they not allowing, you know, like a network. Why is it not allowing everybody to come to the table and, you know, Chris Jones just gets to pick who they want to use?

Well, there are hospitals that actually do have multiple. It's just. I will say, Chris, it's not where you and I live.

Yeah, exactly. Okay.

So Chris is in Oklahoma. I'm in Texas.

That's fair.

All right, Kyle.

Kyle, you're back.

So you said something a minute ago that I think probably falls into the category of competitive advantage that you're going to be pitching to some of the larger OEMs, where their draw towards using something like this and having some ownership of it is the sort of thing they can pitch to the hospital to say, if you're going to have a J and J med tech rep in your hospital, we can guarantee that they've been vetted by our system and we have control. And then we can lock them out if the status changes, if they violate some of your rules, something like that. That seems like that probably is the pitch to the OEMs to be able to. They then have a reason to offer an advantage over companies that are not taking ownership of this. Does that sound right?

Yeah.

Cool. I like it.

That is the number one complaint of. I'll just. Especially when you talk to credentialing teams, internal credentialing teams within these big organizations, they can. They can onboard reps all day long, but offboarding is. It's still. I mean, and. And the whole process is manual. Right. But they don't have an off switch, and they don't have any oversight of what gets submitted on what the reps are even submitting. So they're responsible for it, but they have no over control or oversight over it. So, I mean, just think about it. If the roles were reversed, do you think that a hospital would want to take liability over something that they had no control or oversight over? No, but that's the environment that we're in today. That's the system and so that is why we are saying the system needs to flip the employers, who has the contract with the hospital, it's the OEMs, the suppliers, distributors, etc. That is where the, There should be a direct line between the supplier or the OEM or the employer and the hospital. There should be no middleman. And we're just, we're a technology platform that enables that direct line of communication. We're not a credentialing team. We don't credential anything. We put that, that is now on the supplier. We are providing you with the technology to do it.

Go. L.

It's. There's like every time somebody asks a question, another question pops up in my head. So I'm going to try and not go chasing squirrels. So this goes back to something Mark said quickly, that Chris and I and 100 of us are out there screaming about, you know, who's making the money, who's, who's getting the kickbacks. Dr. Blackwood's out there doing some great things, trying to figure this stuff out. So not sure who's like on, especially on the independent ASCs. Like, I, I know these people personally. I don't think anything's coming back from like, surge of partners or anybody like that. Who's, who's doing business with the vendor, credentialing systems, what data, to me is something that's out there that we talk about too, like who's owning who, who are we giving our data to? So we're, if we're employed or choosing to do business with certain companies, that is our choice. Right. So we weigh what we give them, what we don't give them, who owns that. So there's been discussion amongst us, you know, about this basically collecting so much data on us as industry professionals, like that is very, I think, an emotional hot button to exploit if possible. And then therefore, in your diving in to do this move, invest your time, money and all the, all your, your blood, sweat and tears, what have you found out that really was surprising to you? All right, so this, this, it kind of dovetails into each other, right? Is, is Chris and I and the rest of us on this, on a, on a path here that, yeah, there's something nefarious going on or your data is being part of the, of the, of the asset that these companies are selling? And then if not, or whatever, is there something that you found in your research that you're like, holy, this is really going on. If that, if you capture that, like, if there's, and I don't Care if it's just partial answers or whatever.

Yeah. So I have dug into the privacy policies and terms and conditions of these companies, and most of them do say that they don't sell data, but they still have it. Right? And it's. It's not yours, it's theirs. But they. In most of them that we've looked into, they. They say that they are. They're not selling the data, but like I said, they still have it. We believe that your data. And on our platform, you can only see your data. You can see it, and it's yours. Like, it's written into our terms and conditions. As far as what, I was surprised. I was surprised when a VP of a supply chain of a very large hospital told me he got a $200,000 check for. For switching over to Green Security. That was over bourbon. And I feel like it's probably accurate, so. So I was surprised.

That's a good one. That's a good one. That's a good one. Chris. And I. Chris just. I think he just squeezed his chair a little bit on his.

I mean.

Yeah, I got you.

So I've got. I've got a question too, like. Or maybe this is just a comment before I get too fired up listening to some of this stuff. I mean, let's just be honest. I mean, the concept of what these are, is they're just a holding point for, like, some PDFs that I upload. I mean, because, I mean, God forbid something ever happens in an operating room catastrophic, you know, where people start getting lawyers involved. Nobody's going to care whether I'm signed into rep. Tract, Green Security or whoever it is. I mean, all that's going to start spiraling out of control back to, you know, where were you trained? What were you done? How were you taught this stuff? And then we start writing checks. I mean, rep Tracks is going to be so far removed from the conversation if it ever got to that point. So why do they put so much focus on these? I guess I'm just asking questions I kind of would like to know, like, historical answers for. It's like, why do the hospitals. And why do these people put so much of an emphasis on this now? Because, I mean, I may not look as old as some people, but I've done this for, you know, long enough to remember when, you know, I could just walk into the hospital and kind of do what I wanted when I wanted to. I mean.

Yeah. So the. The short answer is compliance. They're trying to check those compliance boxes. And I forgive Me for not. I don't want to say something if it's not, if I don't have facts behind it. But I do know that at one point in time, I don't know if it's still the case today, but there used to be even incentives for hospitals to have the reps sign in, meaning, like they would, you know, get like a dollar for you signing in, basically, or $2, right. Per for, for the check in piece of things. And so that, that then incentivized their staff to enforce or help enforce the credentialing because it would then help the hospital. I don't know if those systems or that kind of incentives still exist today. But the biggest reason why these hospitals want you to sign in, want to know is the biggest thing is the OIG sanctions, right? They want to know that. They want to know for certain that OIG sanctions and background was really. They want to know that you're not on the OIG sanctions list because that's a $10,000 a day fine for every day that they do business with you if you're found to be on that list. And then obviously, background checks, that's, you know, that's pretty understandable. They want to, they want to make sure that you're not, you know, a registered sex offender walking in there. Right? And we achieve all of those things with credentialing. But as we, as we've gone around and around on LinkedIn, especially, you know, your employer does that already, right? They already do a background check. So why do we have to have so many. And that's, you know, that's the argument of the employers as well, because ultimately, who has the contract with the hospital and who gets called into the courtroom in the event that anything in the event of an adverse event, and it's always the manufacturer, the oem, etcetera, the employer. We are the technology platform enabling that direct line to be where it should have always been. But right now we've got a, we've got multiple third parties in the middle and it, and let me just state it so that you're clear, this isn't going to happen overnight. It did. We didn't get this way overnight. It's not going to happen overnight. I do have a very aggressive goal, but, and I, we've got some cool, cool strategies to get there. But the reality is, I mean, unfortunately, it, I, it just is what it is. I mean, we're, but we're. The only way to start is to put one foot in front of the other and that's what we're doing today.

Yeah. So Kyle and Mark are up, but I. I want to reserve the last 15 minutes to talk up to brainstorm how to help Cheryl make this happen. You know what, what are some strategies? Because we got a lot of smart people here. Go ahead, Kyle.

So first I want to criticize Chris. Chris, are you suggesting that if you get a sticker when you go into the hospital and it becomes invisible in eight hours, that that is not saving lives? I think that is. That is fundamentally changing the world. Chris, you're missing out.

Yeah, well, we don't want me to get on my soapbox about things in lives. Well, okay, then I'm.

Then I'm gonna take a moment for a soapbox because this. A lot of this stuff just kind of came out of nowhere when I was spending the most amount of time bouncing around the country visiting various ors, and I didn't have the relationships with people in the room. And so I was there to call, make sales calls, or to pitch design ideas, things like that. And what I found very quickly with all this stuff was this was a very convenient excuse for someone in the hospital to tell you, no, you can't see the doctor, even if they were expecting me. And that was the first red flag that. Hold on a second. The whole patient protection manage or traffic might just be a smokescreen and an excuse. And in the meantime, there's a way to funnel and extort money out of the reps day to day by just making this an annual subscription that you don't opt into or opt out of. You're just stuck. And then it becomes a really convenient excuse for the hospital to just say, actually, we want to limit a traffic and stop bothering our doctors and keep you out. Because then it's easier for us to manage usage, contracts, the whole thing. And like you just said, Cheryl, it's just kind of continued to spiral and just become this monster that is quite gross and hard to manage and isn't actually accomplishing what it was initially built to accomplish because no one truly has the ownership of it being accurate and permanent and sustained and managed. It just has the. It has that as a costume and it's not actually doing it. So I'll leave that alone. See if Mark has a different comment. I do have some suggestions for you as far as tactical things like tiger brought up.

I would love to hear those. Oh, Mark, you're on mute.

It went back to mute.

I was born on mute. So I would agree with Kyle that hospitals for decades have been trying to figure out a way to keep reps from talking to doctors and surgeons and decision makers in hospitals. I think that vendor access had some effect on it. Probably not as severe as effect as value analysis has. That was their, certainly their ace in the hole as we've known in the last few years. The only, the one comment I wanted to make is that my compliance company, which does what we do for hundreds of practices and small hospitals, we focus on an OIG exclusion, screening state and federal and open open payments reports. And that transparency, we feel is important. The fact that a vendor credentialing company says that they check OIG is generally a false flag. They don't really do it because I've talked to them. They've paid, some of them pay me to do it. Okay. But that doesn't relieve the hospital or the, any provider based. Basically the regulations, you know, for HIPAA mandate that the provider facility does the check. So it doesn't relieve the hospital from doing the screening per se even. And they may feel comfortable that some vendor credentialing says they're doing it. I would maintain that they're probably not doing it more than most. Anyway, I just wanted to comment on that because I heard you say something about that a minute ago.

Yeah.

And I was, I was gonna share a story with you and I, I got lost in what you were sharing. So I, I will all the time.

To us, Cheryl.

Don't worry.

It happens all the time to us.

Yeah.

Wait to get older. Yeah. Let's spend the next 15 minutes.

Let's.

So if you were in Cheryl's shoes, where's the low hanging fruit? And how would you, you know, how do, how do you read? How do you reach the right people, the right companies? Go ahead, Chris.

So, you know, we've, we've talked a little bit about this, Cheryl. I think if I was going to go about it, I would start with like surgery centers and small orthopedic hospitals having the conversations with them. I mean, Cheryl, and I've talked about this a little bit because I've had conversations with some of the smaller facilities that I'm at, just like, hey, you know, would you be willing to recognize this versus, you know, I keep pounding on rep tracks, but you know, instead of rep tracks and having an agreement with them or whatever that is, since nobody can still explain it to me clearly, is, you know, would you be willing to look at this? And then part of the side for me is being a distributor and having like three different companies, four different companies now that we affiliate with, you know, how's that going to function? And Cheryl and I have talked about that a bit, but I think more of an organic approach or maybe a top down and a bottom up kind of approach from both sides. But I think, I just think that there's more adaptability in smaller facilities nowadays versus the behemoths that some of these places have turned into where you don't even know who to talk to or what door to walk in at this point. So that's kind of my take on where to start.

And I, I would take that a step further, Chris, in that everyone on this call has some friendlies. And that is, you know, I think the biggest competitive moat that we have seriously in getting this accomplished is everybody working together. And I mean, let's just be real. Nobody's out there helping the vendor credentialing companies get into a hospital. Right? You're on your own for that. But I find myself in a fortunate position in that we have figured out and done the hard work to create the system that would actually omit the need for multiple third parties and bring it down to potentially one. But I'm a capitalist and I recognize that if we do our job correctly, there will be competitors. But on that note, we have the vision of building the largest verified network of healthcare representatives so that when a, the, and one of the benefits of a digital wallet solution is that it is transferable and portable between suppliers and, and if you're a distributor rep, multiple suppliers can put their credentials into your wallet, which it really, It really bodes well for the industry and, and how, how it can benefit everyone, including the hospitals. So from that aspect, I really feel like we're at an advantage that we have somebody like yourself, Chris, that can walk us into a friendly surgery center orthopedic. So if you want an action item, if you've got a friendly that would be open to talking to us, let's start those conversations. It's not going to happen overnight, but to your point, Chris, it can happen a heck of a lot quicker and get, get done a heck of a lot easier going to these ASCs and small Ortho. We're all for it. Just make, make, make warm introductions. That's all it takes.

Okay. Grassroots. Start small. Go ahead. Kyle.

Have you done a business model as part of your pitch where you say something like, you know, the Ohio territory for X company, that distributorship does $20 million in sales and they have 18 reps. Those 18 reps have to be on three different credentialing services that cost $500 each per year and the average time that they spend that is 10 hours a month. And you just roll up the math to say, hey, for your distributorship, you guys, your Reps are losing $50,000 a year and 10% of their work time on this. Wouldn't it be nice if that could be a burden bore by the company that you are a distributor for? If that's attractive to you, Help me get in front of that company and we'll see about a free trial to demonstrate how they can integrate it into their learning management system, into their commercial operations system to demonstrate that there's a better way to do this where it's company owned and managed credentialing is that, have you put something like that together?

We have, but we, we don't do it by territory, we've just done it nationally. So on, on average it's Conservatively, Kyle, it's $4,000 per rep per year is what it's currently costing these big companies. We have calculated it to be as much as $5,500 plus. But we feel, and every time I mentioned $4,000 to these big strategics, they're like, yeah, you're right on the money. So what? I take it a little step further, Kyle, because depending upon the size of the organization that I'm talking to, that could be a 10x multiple or a 5x multiple. So if I'm, you know, if we're taking your vendor credentialing spend from $10 million down to 2 million and you're, and you're trading at a 10x multiple, I just put $20 million or I'm sorry, 80 million to your bottom line. Right, because I saved you $8 million at a 10. Oh yeah, it's 10x multiple. That's $80 million to your bottom line. I had to question myself there. I was like, wait, is that right? Yeah, so I mean, without a doubt it's, you know, we're in an environment in the healthcare system too where all these big strategics, their margins are continually getting, you know, squeezed. Hospitals are continuing to, you know, the hospitals are getting squeezed, everybody's getting squeezed. And you know, so the margins are continue to erode. And one of the things that came out of the Joey podcast that I did is these getting these big strategics to collectively not across divisions. Let's take a medtronic or striker who, you know, they've got multiple divisions, not in one division. I mean, as a whole, what is that spent that needs to be highlighted in These hospital contracts, because right now hospitals are like, well, we just, you know, we just hired this third party to do this for us, and it's not costing us anything. And it's. It. It's absolutely coming back to them. And when they see that big number, they'll pay attention. But, you know, me going in as an independent rep and saying, hey, this is how much it's costing me. They don't really care. But if a Medtronic or a Striker or a Zimmer Biomed or an Avid or a, you know, Cardinal Health goes in and highlights that big number, you know, when they're renewing that contract, they might. I mean, they're going to pay attention.

Yeah, that's their big numbers, big organizations. Okay, Dr. Maloney.

Oh, you're on mute.

There you go.

As always. So I would certainly, I would draw up a pincher campaign, go from the bottom up and the top down. And from the bottom up, I would basically do some of what you're already doing in the sense of, you know, we're 40 years overdue with a professional organization that talks about ethics and standards from the bottom up. And that's something that you can sell to the individual and to the cartel or the big companies. And then I think also from the top down, which will be the legislative and political side. And they. They're both different. They're both driven by different motivations. I said earlier, what's in it for me? You know, everything's driven by sex, fear, and greed. And I think from the, from the bottom up, I think those standards are something that we should all ascribe to. We all want to be honest and, you know, take some pride in the work that we do. We should be ethical. And I think from the top down, patient safety, patient privacy, all of those things are going to get a lot of ears from people. Listen, there's absolutely no reason in the world why we should have the Balkanization of vendor credentialing that we have, other than the fact that they were just the first ones that thought about it. And I remember when it all started, they invented things like sexual harassment, reps doing dumb. I've never seen anybody do that. Now, some of us wanted. Some of us maybe wanted to, but we didn't do that stuff. But it worked. And then the hospitals, because, you know, originally, they. Originally hospitals were getting paid, if I recall, and they kind of clawed that back because I don't think it was ethical anyway. Fun, fun, fun campaign.

Hell, yeah. So I, I think that I. It's ridiculous Strike got all W's for the most distributorships, doesn't attack this, like, with their clout and their strength in hospitals. So you have those, and then you have the organizations like the Pew that are now the ones that screwed us over by taking us direct are now back to being distributorships and understanding who's. Who's handling that cost. Right. So these very, very large distributors are pretty powerful relative to DEPEW and, and some of the other organizations. So you gotta go to them. But when I think about a market for you, it's understanding who is getting paid by these credentialing systems. You mentioned the $200,000 check. Mark Maloney mentioned, you know, a $300,000 rebate profit sharing. If that is happening in the hospital level, if it is not happening on the major surgical center level, we can have independent ASCs. But oftentimes, I would say the majority of them have management systems. Those management systems are the ones or the partial owners are the ones that handle a lot of those credentialing relationships if there is not that graft going on or that rebate program. They're the ones. The amsurg, the uspis, the. The, you know, these more regional surgery center groups to get them to understand because it's the small distributors like me now with these small companies, they're removed from that cost. They don't take it on, the distributor takes it on. So it doesn't mean anything to them to start the smaller companies because they're like, that's not our problem. Our distributors get paid higher commissions and they handle it right. But I do think like. And I. And I'm referencing this by one. I've got a surgery center. I'm very close to high volume. They're partner is surgical partners, right? So they use HST pathways. HST pathways has a relationship with clear vendor mate. I don't know what the hell it is, but either way, my reps had to pay to get on it once again. And they're just using that system. So is. Is HST pathways, are they getting kickbacks from the credentialing systems? Because that's where I. You have the benefit where everybody wants to help you. They want you to succeed. Chris wants you to succeed. I want you to succeed. Your. Your mobilization of us without looking for anything in return is instant. It's there, it's present. We're with you. We're behind you. But we've got to figure and unpack who is getting paid to keep the conversation. Stay at the facility level. Who's not who. What's happening there because I'm, I'll, I'll promote you every day, all day because it makes so much sense.

Huh.

So how do we get to the AM surge? I can get you to leadership, you know, SCA and all of like I do. I'm doing something that I'm working with a high level person who's connected, all those but you know, we've got to find out what the barrier is there because they would, they would be fantastic place for you to go to, to prove. To prove to get your foothold in.

Yeah, I think some of it is with the gpos. I mean that I know. I mean it was, it was recently announced that True Access, you know, has a partnership with Capstone Health alliance, which is a regional GPO out in North Carolina. So those types of relationships absolutely exist with the, you know, with the gpos. So you know, and, and unfortunately or fortunately, you know, hospitals as you, as you well know, they want to keep everything on contract whether it's, you know, cheaper or not. It's just is it on contract or is it not? And so I mean we will cross the, we'll cross those bridges. But I think the bigger conversations al and the reason why we're so focused, you mentioned it on the big strategics is because they have the dollars, they have the leverage with the hospitals. So if you're asking why we're, you know, trying, trying going after the big fish, it's not that we're going after the big fish as much as it's if a Medtronic, a striker, an Abbott, a Zimmer, if they close their wallets and say we're now on RepSource and the one rep ID it, it's. It's gonna start snowballing, right?

Yeah, without a doubt. Cheryl. I'm with you on that. I think that that is your strategy 100. What I'm thinking is, is where else can I affect and help and you know, movement and I was almost kind of, you know, again, it's tough for us to figure out the gpos is a whole nother nightmare mess and, and you know, shell game of money. But it's these, it's these large surgery center management companies that I think could have the opportunity if they are being extracted from as well by these credentialing systems.

Let's have a conversation and make them tell us why it can't happen.

Gotcha. Okay, I can do that.

I mean if, if the two of us have a conversation with them and they point Blank. Tell us. Well, we're getting paid. You know, I mean.

I'd say. Could you put that in writing? I mean, I'm just, you know, I, I can't wait. Talk into my lapel, if you will. I'm not going to take any more time. But I, I am here to help. I'm here to dig. I'm here to do whatever. This is a common, common fight. We're all kind of fighting for these things for our industry, Hannah.

Can one large strategic use it as a offensive against their competition, potentially by giving their reps more access and distributors or how?

Well, so it actually helps the big strategics solve a problem for the hospital. So let's take, let's take a Cleveland Clinic, for example. They've, you know, they've got so many campuses and how do they know who is actively employed on any one given day by Stryker? They don't know that because, like, it's too big. But you know who does know that is Stryker. So when Stryker goes to like a Cleveland Clinic and says, hey, we're on repsource in the one rep id, and now we control that credentialing and it's aligned to the ANSI standards, you can check your boxes. Now you also have a source of truth for managing who should have access to those technologies that you're implementing to streamline your operations. Right now we have, we, we're providing that for you by being on RepSource and the one rep ID. So we're helping you solve that problem and we're taking off your plate the need to manually. And this is no joke, Al. Another surprise was I had Cleveland Clinic tell me once a year they do a hire and fire purge of their vendor credentialing roster. Once a year.

Jesus. Jesus.

So, yeah, I didn't understand this until Cheryl and I talked last week. So when Stryker fires a rep or distributor, they, they don't take away their credential.

No, it stays on.

That's unbelievable that the turnover can be as much as 30% annually. Yeah. In these repositions. That's unbelievable.

It's like working at a fast food restaurant.

It's.

It took me 60 days to get somebody off that I fired. They wouldn't respond. They would, they just didn't change his, his access. After I fired him, I, I had.

A, I had a friend of mine the other day tell me that he, he was out of surgery or out of surgeon's office. Surgeon was like, come in here into the OR suite, and one of the nurses stopped him and said, hey, you need to sign in. And he's like, Dr. So and so is telling me I need to be back there or to come back there. And he's like, I happen to still be active on Green Security. He hasn't been with his previous company for, I don't know, five months, but he was still active on Green Security. And he just signed in and went in.

All right, we're coming up on the hour, end of the hour. And Maloney, bring us home here.

Well, I just wanted to offer to. For the organization to do all of your OIG exclusion screening at a third world price.

I might. I. We're gonna need all of. Yeah, we're gonna need to work with all of. All of the.

You're gonna need. You're gonna need credentialing stuff. And we got. We could talk more about that sort of thing. In fact, I think I'll give you a. I'll. I'll connect with you on LinkedIn. We'll talk.

Well, and you got my email.

Your email? Cheryl.com.

Yep.

That's easy.

It's in the chat. Yeah. Easy. Well, this is a hot topic, obviously. We could go on forever. We're all pulling for you, Cheryl. We'll do. It's a. The system's broken and you've got an elegant solution.

So.

Maybe we'll have you back on in six months and we'll see where we are.

That would be awesome. I'd love to. I'd love to share our success stories. Yeah.

Excellent. All right, thanks.

Thanks.

Phone chat next week. Thanksgiving. So Thanksgiving. Thanks.

Happy Thanksgiving. See ya.

Happy Thanksgiving. Bye.

Bye.