As you’ve probably seen, and we see it in our markets here that the whole development of a concierge type of practice where Medicare and maybe even other insurance payers are not being taken, and it’s all goes to self-pay is a trend that I think will continue as long as the system does not recognize the need to make the investments in a reimbursement atmosphere that will attract the talent and allow for the investment that we in the US are still capable of doing and bending the cost curve for the delivery of health care. And that disconnect just has to change, we saw a change dramatically during COVID, so that we know when the pressure is on to deliver better health care that the government can respond to that. And I think we are in a similar, although less noticeable crisis right now.
And whether we’re that agent to change or others, our agents have changed. That change is coming. It’s got to come with other changes in health care where we move to perhaps more value-based medicine for reimbursement, population health and other things that will require short-term investments, but we’ll have long-term gains. And I think that will always as a country, you have to suffer through this until the conversation, much as I talked about, becomes a dialogue and not just a monologue based on the government’s desire to try to just rearrange the chairs on the deck of the Titanic.
Q – Unidentified Analyst: Great. That sounds like a longer term view of things. In the near-term, do you think the best case scenario for this year would be that they kick the can down the road to next year? And just the near-term, do you think that, that year after year taking the can down the road is likely to continue?
Howard Berger: Yeah. I ,guess the best thing to do is kick the can down the road. That’s what the government is famous for. But I think even if you kick that can down the road, it’s a recognition of the fact that in many aspects, our health care system is broke. And the sooner we have more of a conversation, which truly looks at the root causes and that just tries to lower access. I’ll give you perhaps the best example of this that we have. Right now, there is a clear benefit to screening for lung cancer predominantly, obviously, from smokers. Risk assessment tools have demonstrated that perhaps in excess of $15 million Americans are at risk for lung cancer and that there is reimbursement for that [indiscernible]. Right now, only 6% of the people who are risk assessed or even less are getting that.
And in the VA system, which is effectively a single payer system, that number is even less than 6%. I think it’s a quality that the opportunity to really change the dynamics and impact of lung cancer, which is the greatest — highest mortality rate amongst all cancers is not something that is aggressively will be in pursuit and instead, hurdles are placed for patients who are risk assess to be able to easily get a lung scan just as a woman is capable of getting a mammogram due by self referral. And I know I’m kind of stepping on a little bit of thin ice year because there is controversy about this. But the one place that isn’t controversy is earlier diagnosis leads to better outcomes. And the more that we delay taking the aggressive actions necessary to earlier diagnosis.
And I’m not just talking about lung cancer. I’m talking about all types of long-term chronic diseases, cardiac diseases, diabetes, et cetera, which imaging has unique opportunities to be the tool, the agent and the tool of change needs to be adopted in a more urgent and aggressive manner than what any of the payers or the government is currently doing. So everything is kicked — kicking the can down the road, but at some point, this will only cause further stress on the system, and it’s time just to have all of us put out big boy pants on and tackle these issues because we have the technology to do it. And the fact that we don’t is really reprehensible for all of our healthcare leaders to not take a more aggressive action on this.
Q – Unidentified Analyst: Right, right. Thanks for that. Maybe I could squeeze one more in on Alzheimer’s. Can you give us any updates on preparations going into providing for the medical imaging needs for those patients as more treatment options come online?
Howard Berger: Yes, that’s a great question. We expect that there will be a significant increase in imaging as some of the new Alzheimer’s drugs et further adopted. All of us should be aware, just like everything else in healthcare, it’s a slow process, but much like the experience that we’ve had with prostate cancer and the adoption of PET CT scan, which has fundamentally change the whole diagnostic and therapeutic approach to prostate cancer is possible in Alzheimer’s disease. We now have tools to detect it earlier and quantify the benefit of these new drugs, but they come with potential side effects, which imaging can also help identify earlier and more accurately. So I expect that over the next couple of years, all of the forces inside health care will start taking advantage of these new drugs and imaging will be at the forefront to help make this a more effective tool in diagnosing Alzheimer’s.
Alzheimer’s is probably another under diagnosed disease. And while the number I hear of 5 million people that have been diagnosed with Alzheimer’s, I think you probably double that number and people that could be diagnosed earlier before the more severe symptomatology makes the diagnosis more after it, if you will. So while we’re not certain how to build the revenue opportunity into our models at this point in time. I’m confident that sometime in ’24 and probably more in 2025, it will have a substantial impact for our Imaging network, which, again, is built in the most densely populated areas where the majority of Alzheimer’s patients reside. So we expect to see substantial benefits from that. And probably that we can be part of bending that curve in the diagnosis in the earlier diagnosis and ultimately, treatment of Alzheimer’s.
Q – Unidentified Analyst: Great. Thanks for the color and thanks for taking my questions.
Howard Berger: Thank you.
Operator: Our next question comes from Rishi Parekh with JPMorgan. Please go ahead.
Rishi Parekh: Thanks for taking my questions. I guess I just have one around your comments that you’re actively looking at acquisitions. There are numerous opportunities, and some of them include fell ventures or failing ventures. Can you just walk us through the characteristics of the acquisitions that you’re pursuing? And if you’re looking at more of the challenged assets, what are you seeing in terms of multiples given their leverage profiles and given some of the possibilities that they’ve either underinvested in their assets or all needed or impaired relationships? Thank you.
