The Hidden Engine of Healthcare Economics: Supply Chain, AI, and the Future of Margin
44 min
•May 6, 202628 days agoSummary
Healthcare supply chain optimization through AI is positioned as the second-largest lever for improving hospital margins after labor. Clarion Health, founded by Steve Liu, uses AI-powered data unification and analytics to help health systems identify and capture $40-45 billion in annual supply chain waste, with immediate ROI and transformational impact on total cost of care.
Insights
- Supply chain is the second-largest expense in healthcare yet receives minimal strategic attention compared to labor and revenue cycle, primarily due to lack of visibility and perception as a back-office function rather than a margin architecture asset
- Hospitals operating at 1-2% margins can achieve multifold greater financial impact by cutting $1M in supply chain costs versus adding $1M in revenue, making operational AI more immediately valuable than clinical AI for CFO accountability
- Safety net and rural hospitals pay 15-20% premiums for identical supplies due to lack of purchasing intelligence and GPO leverage, creating a health equity problem that directly reduces funding for patient care and community health workers
- The post-COVID era ('kind after COVID') presents unique urgency: structural healthcare fragility persists but crisis mentality has faded, requiring non-incremental transformation rather than incremental tools to prevent majority of hospitals from operating in the red
- Clean, unified data across fragmented ERP, EHR, and third-party systems is a prerequisite for effective AI deployment in supply chain; raw AI on messy data compounds existing problems rather than solving them
Trends
Shift from viewing supply chain as cost center to strategic margin architecture asset requiring C-suite visibility and board-level governanceOperational AI delivering faster ROI and lower implementation friction than clinical AI due to clear CFO accountability, minimal regulatory risk, and immediate income statement impactHealth equity increasingly framed as procurement problem, not just clinical problem, with supply chain waste directly reducing resources for safety net hospitals and vulnerable populationsConsolidation pressure on legacy supply chain intermediaries (GPOs, distributors) as AI-enabled direct health system-to-supplier relationships reduce need for middlemenPost-pandemic margin crisis creating receptivity to transformational (not incremental) supply chain solutions, with 90%+ of health system leaders identifying supply chain as top-3 non-labor financial leverIntegration of supply chain officers into C-suite strategy and board discussions as prerequisite for organizational transformation and competitive survivalAI-driven supply chain automation expanding from visibility and analytics to autonomous agents handling non-clinical administrative work and manual procurement tasksGeopolitical supply chain risk management becoming strategic priority, requiring real-time visibility and alternative sourcing capabilities beyond traditional GPO models
Topics
Healthcare Supply Chain OptimizationAI-Powered Margin ArchitectureHospital Financial SustainabilityTotal Cost of Care ReductionData Unification and NormalizationOperational AI vs Clinical AIHealth Equity and ProcurementGPO Disruption and Direct SourcingSupply Chain Automation and AI AgentsRural and Safety Net Hospital EconomicsHealthcare Procurement IntelligencePost-COVID Healthcare TransformationHospital Margin Pressure and Structural FragilitySupply Chain Visibility and Real-Time MonitoringHealthcare Cost Structure Transformation
Companies
Clarion Health
AI-powered supply chain optimization platform founded by Steve Liu to help hospitals unify fragmented data and identi...
General Catalyst
Venture capital firm where Dr. Stephen Clasco serves as executive in residence, backing transformational healthcare c...
Jefferson Healthcare
Major health system where Dr. Clasco served as CEO, growing from $1.5B to $9B through supply chain and operational tr...
University of Florida
Healthcare system where Dr. Clasco previously served as CEO
Millennium Management
Hedge fund where Steve Liu worked as portfolio manager covering healthcare before founding Clarion
McKinsey
Consulting firm cited for research projecting 1,300 basis points of margin pressure on hospitals over next five years
BlackBook Research
Research firm that surveyed health system leaders finding 90%+ identify supply chain as top-3 non-labor financial imp...
Navigant
Consulting firm that published 2018 study identifying $25.4B in annual hospital supply chain waste
Paradigm
Clinical AI company mentioned by Dr. Clasco as example of transformational long-term healthcare AI investment
AI Doc
Clinical AI company mentioned by Dr. Clasco as example of transformational healthcare AI investment
Hippocratic AI
Clinical AI company mentioned by Dr. Clasco as example of transformational healthcare AI investment
People
Steve Liu
Former healthcare portfolio manager at Millennium who founded AI-powered supply chain optimization company during pan...
Dr. Stephen Clasco
Former CEO of Jefferson Healthcare and University of Florida, now advising transformational healthcare companies on m...
Scott Becker
Moderator and host of discussion on healthcare supply chain, AI, and margin optimization
Quotes
"Supply chain just always stood out to me as an area that puzzlingly was 20 to 30 years behind, right? How hospitals manage their inventory and their supply chains, decades behind other industries in the world."
Steve Liu•Early in discussion
"If you're still calling it supply chain, your CFO doesn't think it's strategic, and neither do you. So we're trying to get this further up the CEO model."
Dr. Stephen Clasco•Mid-discussion
"A dollar impact on supply chain is essentially worth a hundred hours in revenue if you're working at a 1% margin. Cutting a million dollars in cost means literally about the same equivalence economically as 100 million in revenues."
Steve Liu•Financial impact discussion
"Every dollar wasted on supply chain in a rural hospital or a safety net hospital is a dollar that doesn't reach a patient who needs insulin."
Dr. Stephen Clasco•Health equity discussion
"We have Star Wars technology for individual patients in a Fred Flintstone health care delivery system. Steve and his team are bringing that Star Wars technology to our total cost of care and margin architecture."
Dr. Stephen Clasco•Closing remarks
Full Transcript
This is Scott Becker with the Becker's Healthcare Podcast. We've got a very special discussion today with two fantastic leaders that I'm thrilled to get a chance to moderate. We're going to talk about the hidden engine of healthcare economics, supply chain, AI, and the future of margin. So for this podcast and the discussion of supply chain, artificial intelligence, and margins, But we're speaking with Steve Liu, the founder and CEO of Clarion Health, and Dr. Stephen Clasco, an executive in residence at General Catalyst, and also formerly the CEO of some major, major healthcare systems like Jefferson Healthcare, and I believe University of Florida, and just a magnificent, magnificent leader, both fantastically brilliant people. So, Stephen, let me start off with yourself, Stephen Liu. Talk for a second. You've made this big bet. You had this incredibly successful career in essentially as a manager, a portfolio manager at Millennium. And you've left to start a health care supply chain company that you started during the pandemic. Some people, most, might call you leaving this great thing that was going fantastic to start a company as insane or crazy, whatever you want to call it. Talk a little bit about what did you see that others didn't that led you to make this change? And I've watched you for the last several years. It's been incredible to watch you. Talk a little bit about what you saw that drove you to make this change. Yeah, absolutely. And thanks so much, Scott, for having me on here. As you know, I covered healthcare for 15 plus years as a healthcare investor, both in venture capital and at hedge funds. So covered it for my entire career and really have seen the evolution and have seen how backwards the US healthcare system is in certain areas and how advanced it is in other areas. And supply chain just always stood out to me as an area that puzzlingly was 20 to 30 years behind, right? How hospitals manage their inventory and their supply chains, decades behind other industries in the world. And specifically in 2020, at the peak of the pandemic, I, just like everyone else, watched how hospitals around the world were struggling to secure basic PPE, drugs, equipment, really due to supplier constraints, lack of real-time data and transparency, and lack of modern software tools. And we also saw hospitals just struggling financially to stay operational, really requiring tremendous efforts from their clinical, finance and operational and supply chain teams, right, the superheroes. And for me, that was just a wake up call that really needed to reevaluate where I wanted to focus the rest of my career and how I could help U.S. hospitals really modernize, optimize and catch up to every other industry in the world. So that was really the impetus that led me from moving as a portfolio manager to a founder and CEO at Clarion. And let me ask you a follow-up question to that. Many businesses are born sort of out of an evolutionary thought process of the founder, sort of looks at it, thinks about it, and then sort of at some point decides to really go after it and decide, I've got to build this. I want to build this. was there a specific moment, not so much a market analysis or spreadsheets, but an actual moment where you said, I'm compelled to do this. I'm really excited to do this. And it's got to be built. Was there a moment in time that pressed you forward? Yeah, I think it was active conversations that I had really 2020 and leading up to it with CEOs, with CFOs, CIOs, and CMOs at these health systems. I developed a really good network over my 15 plus years covering healthcare. And I spoke to them specifically about areas of concern and where they needed to invest in things that were overlooked. And after COVID happened, it became a top three priority where they were all realizing that they needed to massively invest in their supply chains and clinical operations, finance operations, they needed to find ways to digitize and automate all the things that they were doing. And they were already, as you know, for forever struggling with razor thin margins. And they saw the writing on the wall. They saw that over the next decade, they would see a thousand plus basis points of additional margin pressure, which meant that if things continued as is with no investment, the vast majority of US hospitals would be in the red, right? And that would be devastating for Americans in general. And so I think having that conversation with them and realizing that their thinking on this was actually changing. They were shifting from viewing supply chain finance and operations as this back office function, as this cost lever, really into a strategic asset that needed to be tremendously invested in. And seeing them really embrace that post-COVID was really the impetus that made me realize, okay, there's significant need for these advancements and these services, but there's also significant tailwinds in that you have these executives that are all for investing in change and dramatically advancing how things have been. And take a second, Dr. Clasco, talk a little bit about this. Is it supply chain? Is it total cost of care? How do you look at this? And Steve, we'll come back to you on some of this as well. You mentioned back office versus supply chain and where does it fit. But Dr. Clasco, you said publicly that Clarium is not really a supply chain company. It's a margin architecture company. Can you tell us what you mean by that and why that distinction matters? Why is that important that you're not just supply chain, you're actually trying to improve margins? Yes, Scott, you and I have had quite a few discussions about, you know, when I left Jefferson and went over to General Catalyst, I basically said I want to be part of the companies that can be transformative. So many times I talk to CEOs and I say, we don't want to put the Lego pieces together. We want things that are really going to affect our total cost of care. So supply chain, if we just say we're supply chain and you just leave it at that, then it really puts a function in the basement. I think margin architecture puts it in the boardroom. There's not one CEO or board chair I talk to or that you talk to and says we don't have to fundamentally transform our cost structure. So in some respects, it's the second largest driver of total cost of care. The first is labor and labor brings all sorts of issues to it. Hospitals, as you talk about all the time, including last week at Becker's, the good ones are running on one to two percent margins. You can't cut cost your way out of that math. So you have to really architect margin into every transaction. At Jefferson, we went from a billion and a half to a $9 billion company. Supply chain wasn't a cost center we managed. It was an asset class we engineered. And by the way, that really mattered when the pandemic hit, which is a whole other piece of this, is as we start to think about the geopolitical issues, managing your supply chain, using AI, giving yourself alternatives. So if you're still calling it supply chain, your CFO doesn't think it's strategic, and neither do you. So we're trying to get this further up the CEO model. Well, thank you. I'll come back to that question or issue in a second, because at some point sort of supply chain was thought of as like the back office and deliveries and logistics and warehouses and just getting stuff to the right bedside of the right doctor. Steve Liu, you've talked about, when you talked to L-System CEO, you think of supply chain more as a strategic lever than a back office function. Is that correct? And how does that change how you think about things when you think of this as strategy and margin architecture versus simply just trying to fix supply chain as this distinct area? How do you think about that? Yeah, definitely. And I think it's changed tremendously, Scott, even in the last five years, where, again, it was previously seen as this back office function. And now we're seeing more and more CEOs and CFOs are embracing their supply chains as this hidden strategic asset. And BlackBook Research just did a recent survey of health system leaders and found that over 90% say that supply chain is one of their top three non-labor levers that they want to focus on improving financial performance over the next 24 months. So that was a really interesting statistic, and it echoes what we've heard from our health system partners. I think, as Dr. Clasco alluded to earlier, the typical health system is at 1% to 2% margin. There was a McKinsey report put out a few months ago that hospitals will face up to 1,300 basis points of additional margin pressure over the next five years. And really, when we show them that data, they realize that how they've been operating in terms of relying on their third parties and fragmented data and really manual labor cannot continue. And they need to really take a step back and figure out how do we dramatically transform how we manage our supply chain, our clinical operations, our finance. And really, when you start to show them that data in terms of what Clarion can help identify, in terms of we've analyzed your supply chain, we've identified up to 200 basis points of overall margin expansion that we can help the health system achieve. That's really what opens their eyes and realize that, hey, we need to make this a strategic focus immediately. Scott, can I just add something to that real quick? Please. So, you know, we talk about so many AI related issues that will have an effect on health care or health system in the future. And, you know, I use this analogy because I talked to one CEO about a different issue. And they said, Steve, that sounds really interesting, but I'm losing 200 million dollars this year. I need an interventional cardiologist, not my dermatologist telling me they can move up my liposuction. That's for the future. What I need is something that can affect significantly access, quality, or total cost of care within the next 18 months. And this is a company that literally this is a model that can do that in a way that doesn necessarily affect your caregivers et cetera It's all back office things, but having a huge effect on total cost of care. Let me ask you a question on that. And I'm going to come back to both of you with a question in a moment. But first, let me ask you this question as it follows up right on what you said. Dr. Kessler, you talk a lot about what's working and not working in artificial intelligence and health care. Where is Clarion in that landscape? And why do you think operational AI like this might deliver return on investment to hospitals as well as quicker than clinical AI? Why does this work and why is it so important? Yeah, I think it's a great question. It's something that I've stayed up nights thinking about because I'm very excited about clinical AI, but it has the FDA malpractice exposure, change management, seven-year physician adoption cycle, you know, the gosh, if I'm, you know, if I'm replacing nurses, what does that mean? Operational AI has a CFO, a PNL, and a board that's saying make it better. And in Clarum's case, a contract they can sign on Friday. So I love clinical AI. You know, I'm 72 years old. I I hope when I'm in the assisted living facility, I'm doing everything with AI. But I think that what people are going to look back on, what are the real game changers operationally from 2026 to 2030 that moves the income statement? And Clarion is really built for that wave. And Steve, let me ask you this question. And then I'm going to ask each of those, you know, 30 seconds each. Then I want to talk more about Clarion and AI and what it means today versus analysts and spreadsheets. Before I do that, in all these discussions out there, supply chain is the second biggest expense in health systems. Yet it seems like everybody talks about labor for sure, particularly the last few years during COVID when contract labor blew up, those costs blew up. People also talk a ton about revenue cycle, and it's very important because it's five to 10 percent of all costs to go through revenue cycle. But why is it that supply chain as a function isn't talked about as much as revenue cycle and labor? Steve Liu, do you want to start on that? Just give us 30 seconds, and Dr. Klass, I'd love you to weigh in too. And I'm going to come back to Steve Liu on a few questions. Yeah, it's a great question, Scott. I think it's fundamentally just the lack of visibility. As you know, supply chain is not the sexiest area of investment that really jumps off the page when you're talking with venture funds, when you're talking with health system executives. It's not an AI scribe. It's not a call center automation bot. It's not a clinical diagnosis agent. But really, we think AI for supply chain is the next frontier for investment. It's the most low-hanging fruit. There's little to no PHI. You can immediately move the income statement, as Dr. Clasco said. And we think that just bringing visibility and market education to this, and we've done that as Clarium, we think that'll really get the ball rolling and get the momentum really towards C-suite seeing supply chain as a really logical next area for AI to be deployed. So that's what we've seen in the market, at least. Steve, Classico, let me ask you to follow up on that. Why does this get less attention than, you know, contract labor and labor and revenue cycle where this is so important, obviously? Yeah, well, look, I think some of it starts with us, right? I mean, as you know, Scott, my second biggest talent other than delivering babies is, you know, is basically telling stories. And I think if we call ourselves a supply chain company and then go to a CEO and say, hi, we're a supply chain company, we can't be disappointed that they're going to send us to the AVP of supply chain. But we're not a supply chain company. And I think that what we've been able to prove over the years and the places that work with us, which are a huge, diverse group of health systems, is that we can have a huge effect on total cost of care. and that gets you further up. And the second piece of that is, I think some of it is recognizing that, you know, the legacy pieces of healthcare are gonna have to change. Things aren't gonna magically change. And GPO membership has sort of been the discount club that, you know, well, I don't have to worry about that because I'm part of a GPO. And I think that, you know, you're gonna see some changes in that. So what I've been working with Steve a lot is taking the Subaru approach, right? If you remember, you know, Subaru didn't talk about their cars, but because they were the safest cars objectively, they were saying, you know, do you love your kids? Get a Subaru. And I think for Aquarium, it's, look, stop talking about having a meaningful effect on total cost of care. Yes, look at labor, but that's going to be really, really difficult. You know, really, really start to look at supply chain. And Steve, let me ask you this question. There is so much discussion about AI powered, AI everything. There's also a tremendous amount of information overload. Yet you've done a great job of actually getting through to leadership, to CEOs, CFOs. You're in some of the best systems in the country now. Talk about two things. what specifically does Clearium AI do that a spreadsheet and analysts don't do or can't do? And then talk about how do you cut through the noise? Because there's so many different solutions trying to sell into health systems. And you folks obviously have done this tremendous job of actually getting into health systems and really showing them benefit. How do you cut through that noise? And what does Clearium AI do that a spreadsheet and an analyst can't do? You definitely need clean data. And a lot of these health systems want to do the fun, exciting, sexy thing and deploy AI on top of their existing data that sits in their ERP, their EHR, their contracts database. And if you don't have fundamentally clean data, you're going to compound in already tough problem. And so for us, we've really focused over the last six years on, one, how do we unify all this fragmented and siloed data that the health system has, right? They have over 10 different systems of record data sitting in their EHR, their ERP, their warehouse management system, multiple inventory systems, contracts database. They have data that lives in third parties with their GPO, with their distributors. Each department in the hospital uses a different system of record, and they don't talk to one another. So step one, right, what Clarium does is we focus on deploying AI to identify all this disparate data, unify together. But importantly, step two, you need to actually clean, normalize, enrich this data. because if you're just deploying an AI agent on top of your existing ERP or EHR, everyone will tell you how messy, how fragmented, how bad the underlying data is. It's going to give you poor insights. And so you have to clean that data. And then really step three where we help is we help deliver actionable insights, our dollar cost savings. And where we're going next is step four. It's actually deploying AI agents on top of all that to help automate away all the non-clinical administrative work, all the manual tedious tasks that hospital workers are doing, and really freeing up their time to focus on higher priority strategic initiatives. So you really need to take this crawl, walk, run approach. And you also need a vendor that's been partnered with health systems over the last six years and built this from the ground up with their direct input. So that's where we've really focused. Let me ask you a question. Steve, you happen to be one of the most thoughtful people that I know. How important is it that once you're actually working with a system, how quickly do they have to see benefit in ROI or improvement or how this works? Because you've built really loyal customers. How does that work? How quickly does it have to work for people with a new solution today to be willing to keep on doubling down on that solution? In today's environment, Scott, it has to be immediate. You have to lead with hard ROI, cost savings, time to value. That is the number one concern of every health system CEO and CFO in the country. We already mentioned the razor-thin margins. You add another 1,000 basis points of margin pressure over the next five years. And if that happens and we don't fundamentally do something transformative here, majority of hospitals will be in the red. And think about how scary that is for the average American. No, I think that's exactly right. We're already there. We're 40% are in the red and 60% are barely above breakeven. And some are doing better, of course, but a fascinating situation. And take a second, Dr. Clasco, you've talked a lot about today's world as living in the kind of after COVID era. And what I've heard you say, not pre-pandemic, not mid-crisis, but the sort of strange in-between where the urgency is still needed, but it's faded, but the problems haven't. Like, there's still big, big problems. Why is a company that's so good at margin architecture that really helped become one of the health system's biggest, biggest areas of expense, like Clarium, so important in the kindy after-COVID era? Yeah, because, you know, if you think about it, you know, BC, before COVID, we were complacent. During COVID, you know, we were heroic. And then, you know, but there was infinite federal money, infinite urgency. Kind of after COVID is the worst of both, right? In some respects, the urgency died. But the, as you've pointed out, the structural fragility of health systems really hasn't. So we're running, health systems are running on sort of before COVID muscle memory. in a KAC reality, if you really want to look at it. The labor crisis didn't end, the supply crisis didn't end, the margin crisis didn't end. We just stopped looking at them as a crisis. So, you know, I think the KAC world requires more than incremental new tools. And I think, you know, that's what you're spending more time at the Becker's Health Entities talking about. That's what we talk about all the time among CEOs. You can run a 2026 health system on a 2019 procurement infrastructure and pretend it hold So I guess the answer to me is in my national talks I have this one sort of image of a nonprofit board Instead of risking anything new let continue our slow decline to obsolescence. And I think that complacency of BC is just not tolerable. And I think that the fact is that the entities that have used Clarion have started to understand that this is more than a supply chain company. It's solving a major problem that's affecting our bottom lines with total cost of care, allowing us to reinvest in the things that are important and potentially even reinvest in some of the things that the labor AI will affect, like reskilling. So it's a non-incremental change that really requires a CFO, CEO to pay attention. Thank you. And then, Steve, let me ask you this. Are customers buying or doubling down and partnering with Clarion because of a strategic vision, because they're in a financial crisis, need to cut costs now? And is there a difference? And why do you find the use case so attractive? Why are so people, I mean, you've had great movement, great growth, great traction. Is it the strategic vision? Is it the financial crisis? Or is it both? And is there a difference? I think it's both, Scott. I think you need to have that C-suite who buys into the five-year strategic vision and why they need to really overhaul their supply chain, their finance, their clinical operations. So you need that forward-thinking view. But in order to justify it, right, why invest now in Clarion? It's that we can deliver immediate hard ROI. We can deliver millions in cost savings. And back to your point earlier, right, on why it hasn't been a focus, I think health systems have really focused rightly so on how do we drive an increase to revenue, right, which is why rev cycle automation, prior auth automation has received tremendous investment in the last several years. We think that a lot of that juice has been squeezed, and we think that they need to reframe their thinking into how do we now cut dramatic costs out of our health system and help really dramatically expand margins. If you think about a health system operating at razor thin, low single digit margin, adding a million revenue compared to cutting a million in cost is multifold the impact, right? if you think about it. And it's always surprised me that not many people think about that perspective in terms of a dollar added versus a dollar cut and the dramatic impact that can have on the organization. But so literally a dollar impact on supply chain is essentially worth a hundred hours in revenue if you're working at a 1% margin. I mean, very simplistically. So you cut a million dollars, it's not exactly linear, but it's pretty close. In a large system, cutting a million dollars in cost means literally about the same equivalence economically as 100 million in revenues, and that's a big, big deal. Dr. Clasco, you've been vocal about trying to make sure that artificial intelligence doesn't just make the wealthy healthier, the wealthy wealthier, but that it also helps systems where there's a health equity need and how we connect it to health equity. Talk a bit about how you link those two, making margins better, margin architecture, and improving not just the wealthy systems and wealthy consumers, but also the safety net systems and the safety net consumers. Yeah, thanks. It seems like an invisible link because it's sort of designed to be. So if you think about it, a safety net hospital in Mississippi pays probably 15 or 20 percent more for the same hip implant than an academic medical center 200 miles away. It's the same screw, different price, different power, you know, depending on the GPO. And at the end of the day, the reason that that seems indirect and doesn't necessarily seem related to equity is because that premium gets paid by Medicaid, by uncompensated care budgets, by the nurse not hired on the night shift, by the community health worker who never gets funded. And we just blame on the quote system. So if you think about it, every dollar wasted on not being for exactly the reasons you said, you know, if you think about rural hospitals or safety net hospitals, of which I ran several, every dollar wasted on supply chain in a rural hospital or a safety net hospital is a dollar that doesn't reach a patient who needs insulin for us to do other transformative of thing. So I think one of the things that I've really pushed is that health equity isn't only a clinical conversation. It's partly in some respects, a procurement conversation. Nobody has it because generally the supply chain people aren't in the, you know, how do we improve health gaps and health equity meeting, but it's the same dollars, the dollars that we can save that don't get seen. And I love the analogy you used. You're right. It's like increasing your revenue by $100 million. If you wave a magic wand and increase your revenue by $100 million, you would have a lot more money to do things for the things that your mission is. At Jefferson, our mission was we improve lives. It's really hard to improve lives when your margin is minus 1% or plus 1.5%. Thank you. And Steve, similar question. A safety net hospital, a rural system is often paying, even with the GPOs, all these different things, 15 to 20 percent more for the same implant because they don't have purchasing intelligence, the same staff, the same team, the same depth. There's just only so many people to go around budget wise at rural health system, at a safety net hospital. Who pays for that inefficiency? Who pays when the system is forced to pay higher costs because they don't have that purchasing intelligence and that depth in purchasing? Is it the hospital that pays? Is it the patient pays? Is it both? How do you sort of look at that inefficiency? Yeah, it's everyone, all of the above. The patient, the doctor, the nurse, the hospital, and the U.S. taxpayer all lose in that situation. As you mentioned, Scott, the hospital ends up paying more for supplies and drugs. Those costs cede into margins and force hospitals, especially rural and safety net hospitals, to cut back on staff, investments, and critical patient care. And that gets amplified tenfold with the recent Medicaid cuts. So everyone loses in that case and why this is such an important issue. Thank you. If you could really take a lot of supply chain waste out of the U.S. health system, how much are we talking about? Just even conservatively, a small estimate of what could be taken out. And quite frankly, Steve, what are you seeing that some of your customers were taking some of the money and waste out of the supply chain? Yeah, there was a Navigant study back in 2018 that referenced $25.4 billion in annual waste on hospital supply chain spent, which was up 10% year over year from 2017. If you factor that in to the present day, factoring in inflation, price increases, increased patient acuity, that updated number for 2026 is somewhere between $40 and $45 billion per year in unnecessary spend on supply chain and operations. Think about that. That's close to the total net income of the entire U.S. hospital sector in recent years. Hospitals could potentially double their current margins if they decide to invest and go after optimizing their supply chain and their clinical operations. And that money would then directly go back to their communities, back to patient care, and really benefit everyone overall. Thank you. That's literally remarkable. And how hard is it? I mean, it's almost impossible for systems to fix without this type of solution. It's just too hard. I mean, if you think about spreadsheets and on the phone and even ordering electronically and doing all these kind of things, without a real supply chain tool to navigate this for you at the highest level, really hard to make these changes, isn't it, Steve? Absolutely. And what's really sad is that the supply chain teams, the clinical operation teams, they are the unsung heroes, right? They need to make this work with a lack of resources, lack of technology, lack of investments. And they're doing it, but they're going above and beyond, right? During snowstorms, hurricanes, they're literally bringing overnight bags and staying at the hospital for a week, right, to make sure that these supplies, these shortages, they don't ultimately impact patient care. And they've been doing that. They've been going above and beyond for decades. And really what we want to do is take that burden off of them and really help leverage AI to help automate, optimize, enhance all the manual and tedious work that they're doing to focus really for them to get back to what they studied, right, and what they wanted to ultimately do, which is ultimately serve patients and improve patient care. Thank you. And Dr. Clasco, let me ask you this kind of personal question. Since you left Jefferson as CEO after an incredible run that moved that organization around a $2 billion organization to about an $18 billion organization, tremendous, tremendous effort to integrate and grow a great system, both academic medicine as well as safety net. You step back from there, aligned yourself with General Catalyst and some others. You've really made the effort to focus on just truly transformational efforts and companies. The things I see you involved in, you don't sort of dinner. You're very, very focused in the companies that you work with. You sit on a handful of boards. You advise a number of startups. why does Clarion become that exciting to you that you choose to allocate your time and energy? And I see you put your energy to work. And it's really an amazing thing. It's literally, I come away each time I have a chance to really work with you with a remarkable sense of this mix of depth and personal skills and analytical perspective. Talk a bit why Clarion makes that cut. Look, I so believe in the power and importance of nonprofit health systems and what they mean to communities. And I've watched, you know, it's like watch a good friend with her. I watched the sort of I remember literally I was just at a meeting with a bunch of hospital executives and I having so much fun And I was at the lunch table and I going I really optimistic about the future And this is great And like they kicked me out of the lunch table because I wasn depressed So I think I think a lot of the companies that I work with are those long-term sort of transformational clinical AI companies, you know, whether it's Paradigm and Clinical Research or AI Doc or Hippocratic AI. But in 2031, somebody's going to write a definitive book on the decade we're in right now. And my guess is that the chapter on health care won't just be about chat GPT writing notes or robots doing surgery. Those will sort of be the footnotes because those have a longer gestation period. The big part of the chapter will be the CFOs who stopped accepting that this is just how health care works. that we have to have a middle person between the medical device company and the health system. The supply chain officers who finally get a seat at the strategy table, the boards that realize their second largest expense was their biggest strategic asset hiding in plain sight. You know, I'm chair of the board of a $7 billion medical device company. You know, we don't exist without the health systems and having more direct line with them. Every transformational era in healthcare has sort of had this sort of quiet center of gravity. As much as we like to complain about EMRs, it was EMRs in the 2010s, maybe value-based care in the late teens. I believe the 2020s, at least for nonprofit health systems, working with insurers will belong to margin architectures. And the systems that figure that out aren't going to just survive the KAC, the kind after COVID era. They're going to define what comes after it. And then all the really, really, really, really cool things like democratizing clinical trials and conversational AI, et cetera, will be able to be led by health systems that now have better margins. Thank you. Let me take you back to that just to put a footnote on that or an exclamation point on it. It's 2031. What's the headline for what systems have thrived? What's the headline? How do you see this? Yeah, so I think the headline is that we've Amazoned the heck out of, and not Amazon as it exists today, but the concept of Amazon when it started and had Jeff Bezos decide that they weren't just going to be a bookstore was there's no reason to have 12 middlemen or women between whatever you want and need and the people that are supplying it. And, you know, you could argue this in the pharma side around things like PBMs, etc. You're going to need transformational change in these areas. And what Clarion does, you know, with their AI, with their proven architecture, is that we can cut out some of those middle layers. And the beautiful thing about that is that it will be great for health systems. It will be great for medical device companies. It will force current middle layers to be more creative and work with us. And at the end of the day, that will be great for patients because we have to more than incrementally change this and just stop, frankly, complaining as health system leaders that the system is rigged against us. Thank you. And Steve, let me ask you two similar questions. First, when you look at health systems right now, and I know you try very carefully not to be critical, but is there anything they should stop doing immediately that they do that they shouldn't do that's just not effective or so incrementally effective that it's not worth doing? And then second, if you look at 2031, same question as Dr. Clasco, what's the headline? Yeah, I think health system leaders are doing a tremendous job and continue to. I would say my only advice would be really to stop viewing supply chain as a back office function. Bring your chief supply chain officer into the C-suite, into the boardroom. Give them a seat at the table. Learn about how your supply chain is actually run on a day-to-day basis. What are the fundamental problems? Where are they underinvested in? And how you can further support them really to unlock a transformational change. That would be my advice. In terms of the 2031 headline, for me, the dream state would be hospitals have tripled their operating margins over the last five years due to their investments in AI and automation into their supply chains with Clarion at the helm. They've achieved over $100 million annually in cost savings. Hospitals now have a single source of truth, that unified data layer, bringing in data from all their disparate systems and from all of their suppliers. Every hospital in the U.S. now has a single supply chain command center to proactively monitor their inventory, avoid shortages and disruptions. And most importantly, they've deployed AI agents to automate away all the painful back office functions, supply chain, finance and operations. That to me would be the dream headline and where we're striving towards. Thank you very, very much. And Scott, I like to channel Taylor Swift in my talks. And I would say that we're never, ever, ever getting back together with treating supply chain like a back office function, still paying premiums. That error is over. And to every CEO who's nervous about the disruption or who was going to hear from a GPO or from the vendor, I guess I'd use the shake it off. The fact is the legacy supply chain is going to try to hold on, but we need to shake it off and use this technology to really fundamentally change how we look at our back office functions and our cost of care. Now, one of the things, Dr. Clasco, that you missed or didn't mention correctly is you had said that your greatest skill was as an OB-GYN and obstetrician gynecologist. But those of us that know you know that it's also as a disc jockey, not just a doctor and not just an entrepreneur and leader and advisor. Correct? That you're also a DJ. I still DJ on Miami Yachts and DJ the HLTH awards last year in Las Vegas. So still do that a lot. That probably is my best skill. God bless. And that's where the table. And I would use, and since you brought that up, maybe a great song to play at the end of this podcast is the song by Sia, Courage to Change. We need the courage to change what is a legacy system because supply chain is something we actually have the ability to change. We don't need CMS. We don't need an external piece. We can change it with the resources that exist today. Thank you. Stephen Liu, any final comments that you wanted to share with your audience? You've really been at the heart and the forefront of this change of AI into supply chain with Clarion. Any final words? I would just say, Scott, that I get the question often from health system executives and really from my former peers on what motivates me and why I decided to leave a career as an investor and found a company in the middle of the pandemic. And for me, it was really focused on how can I positively impact the U.S. healthcare system? How can I, after having for almost two decades covered healthcare as an investor, go after some of the biggest challenges that I saw in my career and actually help hospitals lower the total cost of care? And that's really why I'm doing Clarion. There really is not a financial incentive for me to go after to pursue doing this. For me, at the end of my career, if I look back on my life and what impact I had, it's not going to be in terms of the dollars that I made for my investors or what I made during my career as an investor myself. It's going to be, did I and was I successful in helping lower the total cost of care for U.S. health care? Was I successful in helping U.S. health systems dramatically reinvent and transform this sector that has been really behind for decades? And did I have that positive impact? That's ultimately what's driving me. And so it's been a great journey over the last six years, and I'm really excited to continue this over the next decade plus. Well, thank you very, very much. I know that it's fair to say from Dr. Clasco and I that one of the things that we each find so incredible about yourself is the clarity in which you approach things and the systematic nature of them and the passion and mission. It's actually a pleasure. It's really incredible and inspiring to watch. Dr. Clasco? So, Scott, I guess I get back to the first question you asked Steve of why he left a very successful career. And I think, you know, Steve put it very well. I think, you know, I'm old enough to remember when research was, hey, I have an idea. I'm going to do research. I don't know if it's going to help anybody. We moved that to translational research. Here's the problem. Prove that you're solving it if you want to get funding. And I think what's great about Steve's approach and what's different than, frankly, some others that are saying, hey, here's this really cool technology and I'll figure out a problem to apply it to. Steve went in to Clarion and said, this is a huge problem that nobody's addressing in anything other than an incremental way. And we have all this technology. I want to solve the problem. And then we'll create slash find the technology to solve the problem. So it's really the equivalent of what we've been able to do in the single patient side with things like immunotherapy and that kind of thing of how do we solve a problem. I often say, you know, we have we have Star Wars technology for individual patients in a Fred Flintstone health care delivery system. You know, Steve and his team are bringing that Star Wars technology to our total cost of care and margin architecture. I want to thank both of you for joining us. Steve Liu, CEO, founder of Clarium, Dr. Stephen Clasco, executive in residence, general catalyst, two remarkable leaders. Thank you so much. What a pleasure visiting with both of you. I always learn something. I'm excited to continue to watch the impact that Clearium's making in supply chain. Just remarkable. Thank you both very much. Thank you, Scott. Thanks so much, Scott.