Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

Summary

The Journal: Medicare, Inc. Part 1 – How Insurers Make Billions From Medicare

Released on June 6, 2025 | Hosted by Ryan Knutson and Jessica Mendoza | Produced by The Wall Street Journal & Gimlet

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Introduction to Medicare Advantage

Jessica Mendoza opens the episode by explaining the foundational elements of Medicare, America's government-run healthcare program for those aged 65 and over, as well as some individuals with disabilities. She highlights that a significant portion of Medicare beneficiaries are enrolled in Medicare Advantage plans, which are government-funded but managed by private insurance companies.

“Medicare Advantage is sort of dominated by these huge insurance companies like UnitedHealth Group, Humana, Aetna and Elevance.”
[00:37]

Chris Weaver, an investigative reporter, adds that over 60 million people are enrolled in Medicare, with more than half opting for Medicare Advantage plans.

“Medicare Advantage insurers were basically gaming the system to get paid billions of dollars more and at the same time creating barriers to.”
[01:17]

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Investigative Journey

Jessica Mendoza introduces Ana Wilde Matthews and Chris Weaver, who have been delving into the intricacies of Medicare Advantage for over a year. Their investigation uncovered that insurers manipulate the system to secure additional billions in payments by adding unnecessary diagnoses to patient records.

“Medicare Advantage insurers over a three year period had got paid $50 billion for diagnoses that they alone added to patients records.”
[01:50]

The team accessed a decade’s worth of Medicare data, encompassing service charges and records, which laid the groundwork for their extensive analysis.

“Once you sort of have the data in your hands, that's just really only the beginning of the process.”
[03:58]

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Mechanics of Medicare Advantage Payments

In Medicare Advantage, private insurers receive monthly lump sums from the federal government to cover all patient care, with payments increasing based on patient health conditions. This creates an incentive for insurers to portray beneficiaries as sicker to receive higher payments.

“The federal government pays insurers essentially monthly lump sums to cover all of their care. And those lump sums go up when people are sicker.”
[04:44]

The investigation revealed that insurers were exploiting this system by artificially inflating patient diagnoses, thereby maximizing their payouts.

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Case Study: Kristin Bell and UnitedHealth’s House Calls Program

Kristin Bell, a nurse practitioner from Maine who worked for UnitedHealth from 2017 to 2024, shares her firsthand experience with the House Calls program—a UnitedHealth initiative under Medicare Advantage aimed at improving patient care through home visits.

“I liked the customer service aspect of it. You know, the reason that it was good is because the people didn't have primary care provider or intermittent primary care, especially in the rural areas.”
[07:05]

Initially, Kristin found the program meaningful, conducting comprehensive assessments, including tests like urine strip analysis to monitor patients' health. However, she began noticing that the UnitedHealth software suggested diagnoses based on her input, even when patients showed no symptoms.

“The quantaflow wasn’t very specific, basically at a relatively high rate of false positives...”
[15:59]

Kristin recounts how, under managerial pressure, she was directed to perform additional tests and record diagnoses regardless of clinical necessity. This practice led to her team receiving raises, raising red flags about the ethical implications of their actions.

“After working at the house calls program for about a year, Kristin told us that she eventually began doing the tests she was asked to do. And after that, she got a raise.”
[09:51]

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Questionable Diagnoses and Financial Implications

The investigation uncovered that Medicare Advantage insurers, particularly UnitedHealth, added diagnoses that were often unsubstantiated, resulting in substantial federal payouts without corresponding medical treatments.

Diabetic Cataracts

One notable example is the diagnosis of diabetic cataracts, a rare condition compared to regular cataracts. Data showed that UnitedHealth’s Medicare Advantage members were 15 times more likely to be diagnosed with diabetic cataracts than traditional Medicare patients, without corresponding treatments.

“According to the data seen by the journal team, UnitedHealth Medicare Advantage members were about 15 times as likely to have a diagnosis of diabetic cataracts compared to the average patient in traditional Medicare.”
[12:51]

Eye doctors consulted by the team confirmed the improbability of such high diagnosis rates, suggesting systemic manipulation.

Peripheral Artery Disease (PAD)

Another critical area was Peripheral Artery Disease (PAD). Nurse practitioners were instructed to use devices like the Quantaflow to diagnose PAD based on limited data points, leading to a high rate of false positives.

“The quantaflow wasn’t very specific, basically at a relatively high rate of false positives...”
[15:59]

UnitedHealth received nearly $1.4 billion from PAD diagnoses between 2019 and 2021. The manufacturer of Quantaflow, Semler Scientific, faced a Justice Department investigation for potential fraud, culminating in a tentative $30 million settlement.

HIV Diagnoses

The team also found that thousands of patients were incorrectly diagnosed with HIV, leading to additional payments without appropriate treatment, as evidenced by the lack of prescribed antiretroviral therapy.

“Those questionable diagnoses weren't just for rare diseases like diabetic cataracts or peripheral artery disease. They were also for HIV, the virus that causes AIDS.”
[16:32]

Experts consulted by the Journal overwhelmingly believed these HIV diagnoses were unfounded, likely stemming from misinterpretations of screening exams.

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Insurer Responses and Rebuttals

UnitedHealth defended their practices, stating that added diagnoses facilitate early treatment and lead to better patient outcomes, ultimately reducing costs compared to traditional Medicare.

“Insurers have defended their practices. You know, they've argued that some of their practices lead to diagnosing patients with serious conditions sooner so they can get the treatment that they need.”
[05:27]

However, the Journal's data contradicted these claims, showing that many added diagnoses did not result in any subsequent medical intervention, highlighting inefficiencies and fraud within the system.

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Economic and Systemic Implications

The investigation highlighted that over a three-year period, Medicare Advantage insurers received an additional $50 billion from dubious diagnoses. This influx of funds from a taxpayer-funded program underscores significant systemic flaws.

“The problem here is that insurers are layering diagnoses on patients, generating billions and billions and billions of dollars more in taxpayer funded reimbursement.”
[19:33]

Moreover, the misuse of funds contributes to escalating healthcare costs in the United States, as Medicare Advantage continues to drive growth in the health insurance sector through such exploitative practices.

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Withholding Care and Beneficiary Exodus

Another troubling finding discussed by Ana Wilde Matthews is the higher-than-average rate at which beneficiaries in their final year of life leave Medicare Advantage for traditional Medicare. This trend suggests that severely ill patients may face barriers in accessing necessary care within Medicare Advantage plans.

“We found that people in their last year of life left Medicare Advantage and went back to traditional Medicare at double the rates of other enrollees.”
[20:38]

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Conclusion and Looking Ahead

Jessica Mendoza wraps up Part 1 of the series by emphasizing the critical nature of these findings and hints at further exploration in subsequent episodes. The investigative team plans to delve deeper into how Medicare Advantage plans not only inflate diagnoses but also potentially withhold essential care from those who need it most.

“Another strategy is withholding care from patients who actually need it. The Journal reported on this, too.”
[20:38]

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Final Thoughts

The first part of the "Medicare, Inc." series unveils a complex web of financial manipulation and ethical breaches within the Medicare Advantage program. By artificially inflating patient diagnoses, private insurers are siphoning billions from a taxpayer-funded system, raising critical questions about the integrity and sustainability of Medicare Advantage.

Stay tuned for Part 2, where Ana Wilde Matthews will further investigate the implications of withholding care and the broader impact on beneficiaries.

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Notable Quotes with Timestamps:

• “Medicare Advantage is sort of dominated by these huge insurance companies like UnitedHealth Group, Humana, Aetna and Elevance.”
  [00:37]

• “What we found was that Medicare Advantage insurers were basically gaming the system to get paid billions of dollars more and at the same time creating barriers to.”
  [01:17]

• “So, for example, somebody who's obese might generate, like, a 30% higher payment for the insurer than the same person who's not.”
  [04:58]

• “After working at the house calls program for about a year, Kristin told us that she eventually began doing the tests she was asked to do. And after that, she got a raise.”
  [09:51]

• “The problem here is that insurers are layering diagnoses on patients, generating billions and billions and billions of dollars more in taxpayer funded reimbursement.”
  [19:33]

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Key Takeaways:

• Medicare Advantage plans are a significant component of Medicare, managed by private insurers who receive government payments based on patient health conditions.
• Investigative reporting revealed that insurers manipulate patient diagnoses to secure additional federal funds, leading to an extra $50 billion over three years.
• UnitedHealth emerged as a primary offender, utilizing questionable practices like diagnosing rare conditions without substantiated evidence.
• Case studies, including that of nurse practitioner Kristin Bell, highlighted ethical dilemmas and systemic pressures to inflate diagnoses.
• The misuse of Medicare Advantage funds contributes to the escalating costs of the U.S. healthcare system, with taxpayers bearing the financial burden.

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For more insights and detailed reporting, tune into "Medicare, Inc. Part 1: How Insurers Make Billions From Medicare" on The Journal, available on Spotify and The Wall Street Journal.

Transcript

[Jessica Mendoza]

Medicare is America's government run health care plan. It provides care for anyone 65 and over and some people with disabilities. But what a lot of people may not realize is that a majority of those on Medicare get it through a program called Medicare Advantage.

[Chris Weaver]

Yeah, there's more than 60 million people in Medicare and more than half of those are in Medicare Advantage at this point.

[Jessica Mendoza]

And the thing about Medicare Advantage is that the plans are paid for by the government but managed by private insurance companies.

[Chris Weaver]

Medicare Advantage is sort of dominated by these huge insurance companies like UnitedHealth Group, Humana, Aetna and Elevance.

[Ana Wilde Matthews]

And that's really why we called the series at some level, Medicare Inc. Because people think, oh, this is a government program, but it's also a huge, huge, huge business for some of the biggest companies in America.

[Chris Weaver]

I'm Chris Weaver.

[Ana Wilde Matthews]

I'm Ana Wilde Matthews.

[Chris Weaver]

I'm an investigative reporter at the Wall.

[Ana Wilde Matthews]

Street Journal and I cover health insurance for the Wall Street Journal.

[Jessica Mendoza]

My colleagues Ana and Chris have been investigating the Medicare Advantage program for over a year. So when you and the team looked into the program, what did you find?

[Chris Weaver]

What we found was that Medicare Advantage insurers were basically gaming the system to get paid billions of dollars more and at the same time creating barriers to.

[Jessica Mendoza]

Over the next two episodes, we'll lay out some of what the Journal's investigative reporting team found today is about how insurers use questionable practices to profit off of the Medicare system.

[Chris Weaver]

In total, what we determined was that Medicare Advantage insurers over a three year period had got paid $50 billion for diagnoses that they alone added to patients records. And what established was basically the magnitude and just the total amount of dollars that they were getting from sort of chasing that incentive to make people be sicker on paper.

[Jessica Mendoza]

Welcome to the Journal. Our show about money, business and power. I'm Jessica Mendoza. It's Friday, June 6th. This is Medicare Inc. Part One how private insurers pocketed billions from medic.

[US Bank]

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[Jessica Mendoza]

So Ana, Chris, why did you guys want to look into Medicare Advantage in the first place?

[Ana Wilde Matthews]

Medicare Advantage cost the federal government more than $460 billion last year.

[Jessica Mendoza]

That's a lot of money.

[Chris Weaver]

Yeah, that's right. So we decided to dip into this area, which is just a huge portion of the federal budget, so we could see how these giant insurers were operating, what kind of care they were providing, and how much they were getting paid.

[Jessica Mendoza]

In 2023, the investigations team got their hands on Medicare data that goes back about a decade. The information included things like service charges and other records.

[Ana Wilde Matthews]

Once you sort of have the data in your hands, that's just really only the beginning of the process. Nothing is simple in this program. Nothing is simple about how the insurers are paid. Nothing is really simple about what they do.

[Chris Weaver]

So we paired that with extensive interviews of doctors, medical providers, patients, and other people who interact with the system.

[Jessica Mendoza]

As they went through the data, something stood out to Chris. There were diagnoses on patients, records that were put there by insurers. This is important because of how Medicare Advantage works. For certain kinds of diagnoses, many of which are expensive to treat, the private insurer gets an extra payment from the government. That payment is meant to cover the cost of treatment.

[Chris Weaver]

The federal government pays insurers essentially monthly lump sums to cover all of their care. And those lump sums go up when people are sicker. So, like, an example would be somebody who's obese might generate, like, a 30% higher payment for the insurer than the same person who's not. Or somebody who has diabetes might generate for the insurer like, a 10% higher payment than somebody who doesn't. And in Medicare Advantage, the incentives are basically to make patients look sicker on paper because insurers get paid more when they do that.

[Jessica Mendoza]

And what do you, the health insurance companies, have to say about your reporting?

[Chris Weaver]

Insurers have defended their practices. You know, they've argued that some of their practices lead to diagnosing patients with serious conditions sooner so they can get the treatment that they need. They argue that their practices lead to better outcomes for patients and end up costing beneficiaries less than traditional Medicare.

[Jessica Mendoza]

Last year, the team published a series of stories based on the data and their reporting. One of those stories caught the eye of a nurse practitioner, and what she read really resonated with her.

[Kristin Bell]

All of the things that I'd been feeling and dealing with over the past seven years were sitting there in front of me on a piece of paper, which is why I wrote to Chris and said, you are spot on. I'm Kristin Bell, and I'm from Maine. I'm a nurse practitioner. And I worked for United Healthcare for seven and a half years.

[Jessica Mendoza]

You have the same name as the actress. Does that ever come up?

[Kristin Bell]

Yeah. So my patients would always be like, you're not the Kristen Bell. And I'd be like, yeah, sorry, here I thought, yeah, exactly. I was gonna have you sign my frozen poster or whatever.

[Jessica Mendoza]

Kristen started working for UnitedHealth in 2017. She'd visit patients at their homes as part of a program called House Calls. It's available to people who are signed up for the company's Medicare Advantage plans. The idea behind the program, according to UnitedHealth, is to help improve care, for instance, by catching diseases early, especially if it's something a doctor might have missed. The nurse practitioner visits usually took about an hour, and Kristin says she saw around four patients a day. She says the work felt meaningful.

[Kristin Bell]

I liked the customer service aspect of it. You know, the reason that it was good is because the people didn't have primary care provider or intermittent primary care, especially in the rural areas. The information that we were able to glean was really helpful, and I can't tell you how many times I would go over medications with people and they'd be missing something or they'd be taking it wrong.

[Jessica Mendoza]

UnitedHealth told us that it sends home visit findings to primary care doctors and that the visits are not intended to replace appointments with them. As part of her visits, Kristin did a lot of testing on her patients. What were you trying to assess with each patient?

[Kristin Bell]

I was trying to assess where they needed help. So, for example, we were doing urine test strips, and that gave me a lot of information about how somebody was doing. Oh, you're dehydrated. Oh, you have kidney disease. Oh, you have glucose in your urine. I'm going to call your doctor. You know, that kind of stuff.

[Jessica Mendoza]

Were you being directed to do anything specific these visits by your employer or your manager?

[Kristin Bell]

Well, it didn't seem so at first.

[Jessica Mendoza]

After she'd been with House Calls for a little while, Kristen noticed some things that made her pause, like when she entered a patient's information into her laptop or tablet. She says the UnitedHealth software would automatically start suggesting diagnoses based on what she put in. Documents show that these suggestions would appear in a so called diagnosis cartoon on the side of the screen and the suggestions would show up even if the patient didn't feel any symptoms. UnitedHealth told us that the final diagnosis was left up to the nurse practitioner and that the company is confident that its clinicians act in good faith. Kristin also started getting the message from a manager that she should do more testing on her patients.

[Kristin Bell]

My first year, I refused to do some of the tests that they asked us to do because I was like, this patient is asymptomatic. I'm not doing this test on this patient. It's just a waste of their time. It's a waste of my time. There's nothing to be gathered from this. Then when I had my annual review, my manager was like, you know, you did a great job and your patients love you and everything, but what you really need to work on is, you know, the testing that we're trying to deliver to the patients. And I said, look, you know, if somebody's asymptomatic, you know, you don't test somebody for everything. If they come into the hospital, you test them for what their having difficulties with. She said to me, kristin, we're not billing for any of this. Just do the testing. Just do it. And I was like, okay.

[Jessica Mendoza]

After working at the house calls program for about a year, Kristin told us that she eventually began doing the tests she was asked to do. And after that, she got a raise.

[Kristin Bell]

So that's when I was like, ah, that's kind of sketchy. You know, there's something going on here.

[Jessica Mendoza]

UnitedHealth told us that their nurse practitioners are not, quote, incentivized based on the number of conditions they diagnose. Chris looked at a three year period where Medicare Advantage insurers send out nurse practitioners like Kristen to run tests and add diagnoses to patient records, including diagnoses of the kinds of conditions that trigger those extra payments. The extra payments added up to about $15 billion during that time. And some of those diagnoses weren't even. That's next. Chris and Ana found that diagnoses weren't just showing up on Medicare Advantage patient records after home visits. They were also on records after patients went to see doctors or hospitals. The team found that over a three year period, all of these additional diagnoses added up to $50 billion in federal payments to the insurers.

[Chris Weaver]

These are conditions that no doctor or hospital treated and that insurers basically went behind the scenes to add or dispatch nurses to patients houses to sort of work them over, do a bunch of tests, that kind of thing, but for which they were getting no care. And it was astounding. And UnitedHealth, more than any other insurer, engaged in those practices.

[Jessica Mendoza]

The biggest Medicare Advantage provider, UnitedHealth, told us that the added payments help cover medical care and lower premiums and provide other benefits for members it also says that chart reviews reflect diagnoses made by patients doctors. According to the Journal's reporting, some of the diagnoses that insurers added to patient records were demonstrably false. One condition that they looked into was diabetic cataracts. Cataracts, which is when eyes cloud over, are common in the elderly. So is diabetes. But there's another rarer condition called diabetic cataracts, which is when high blood sugar levels cause that cloudy vision. And a diagnosis of diabetic cataracts was tied to thousands of dollars in extra payments, whereas regular cataracts weren't. According to the data seen by the journal team, UnitedHealth Medicare Advantage members were about 15 times as likely to have a diagnosis of diabetic cataracts compared to the average patient in traditional Medicare. It was this unusual condition that Kristen, the nurse practitioner with house calls, says she was encouraged to put down on patient charts.

[Kristin Bell]

So, for example, if somebody has diabetes, you know, and I look in their eyes and I see cataracts, I would put cataracts as a diagnosis. But then they would throw it back at me and say, no, no, no, no, it's diabetes with diabetic catar. Even though I didn't know if the diabetes caused the cataracts. Well, we know that the person has diabetes and, you know, just, you know, just kind of do it.

[Jessica Mendoza]

Eye doctors interviewed by the Journal team said it was unlikely that such a large share of UnitedHealth patients could have this relatively rare disease. Chris also saw patterns in the data that implied some of the patients who were getting diagnosed with diabetic cataracts didn't have the condition at all. For instance, thousands of patients who received the diagnosis had no record of ever being treated for diabetes. While other patients had already had their.

[Chris Weaver]

Cataracts treated, they had already had the lenses of both eyes surgically removed and replaced during routine cataract surgeries. And it's literally impossible to get cataracts again after you've had cataract surgery in both eyes.

[Jessica Mendoza]

UnitedHealth told us they asked their clinicians to use their medical judgment in diagnosing. The company also said it complies with guidance from the Department of Health and Human Services. Now, remember, the way Medicare Advantage works is that insurers get paid more by the government for certain diagnoses. Because diabetic cataracts are a costly condition, they come with a big payment, one that added up over time. During the three year period that Chris looked at, the government paid insurers more than $700 million just for recording diabetic cataracts, even if no doctor provided any treatment. And Medicare Advantage insurers diagnosed all sorts of diseases that were never treated, like peripheral artery disease. It's a serious condition where blood vessels get narrower and in some cases it can lead to amputations. A House Calls training manual reviewed by the investigations team advised nurse practitioners Kristin to diagnose peripheral artery disease based on results from a device called the quantaflow.

[Kristin Bell]

The quantaflow is kind of like a pulse oximeter that gets put on each foot and each hand and then they compare the hand to the feet. And what we're looking for is, is there decreased blood flow to the feet?

[Jessica Mendoza]

If the quantaflow showed decreased blood flow, Kristen was supposed to conclude that the patient had peripheral artery disease. But she says she was uncomfortable making such a definitive diagnosis just based on the device, especially since elderly people often have decreased blood flow.

[Kristin Bell]

It was a one data point diagnosis, right? Which isn't necessarily a good way to diagnose anything. But at that split second, if the quantiflo said that the person had peripheral artery disease, at that split second they had peripheral artery disease.

[Jessica Mendoza]

But the quanta flow had problems. Here's Chris again.

[Chris Weaver]

The quantaflow wasn't very specific, basically at a relatively high rate of false positives and under certain circumstances nurses who used it would say cold in the room or something, it might produce an inaccurate result. And one nurse said she used it on herself because she was so concerned about the readings that it was producing and found that she herself apparently had peripheral artery disease, even though actually she has no signs of it.

[Jessica Mendoza]

The maker of Quantaflow, Semler Scientific, said the device assesses risk for the disease. UnitedHealth told us that it tests for the disease during home visits to diagnose it early and that it expected clinicians to use their judgment. According to the Journal's reporting, those peripheral artery disease diagnoses led to nearly $1.4 billion in additional payments to UnitedHealth between 2019 and 2021. Semmler Scientific was also under investigation by the Justice Department for potential fraud. The company announced in May it had reached a tentative agreement to settle the case for nearly $30 million. The company did not respond to requests for comment about the investigation. Those questionable diagnoses weren't just for rare diseases like diabetic cataracts or peripheral artery disease. They were also for hiv, the virus that causes aids. During a four year period, thousands of Medicare Advantage recipients had diagnoses of HIV added to their records by Their insurance companies. For each of these diagnoses, insurers received a payment of about $3,000 a year. But when Chris looked into patients follow up care, many of them weren't getting it.

[Chris Weaver]

There were no physician claims, there were no drugs prescribed to them. And 100% of those people, ideally if they actually have HIV, would be getting antiretroviral therapy. And in reality, fewer than one in five were.

[Jessica Mendoza]

Right. Because the point of being diagnosed is so that you can get treatment.

[Chris Weaver]

Yeah, right. That's right. We interviewed a bunch of experts about this particular finding, you know, AIDS specialist, and they almost universally concluded that those people didn't really have hiv. What they surmised is basically that they were getting tested for hiv, screened for hiv, and that, you know, however, the insurers were reviewing charts to add diagnoses on the back end. They were picking up those screening exams and just like inferring a diagnosis out of it.

[Jessica Mendoza]

Chris says that because of the way this diagnosis is added to a patient's records, some people may not even know about it. Among the UnitedHealth patients, according to Medicare data, hardly anyone given an HIV diagnosis in that period had started antiretroviral treatment in the following years. The company said it disputes the Journal's analysis, adding that its internal data from a year later, 2022, showed a treatment rate of more than triple what the Journal found last year. Medicare Advantage insurance companies were paid more than $460 billion. Who ends up paying for that? Where is that money coming from?

[Chris Weaver]

That's us. Right? It's a taxpayer funded program. You pay Medicare taxes with each of your paychecks, and that's where it goes.

[Jessica Mendoza]

And some of this money was going toward diseases that no doctor ever treated. Right. Does that mean the system isn't really working?

[Chris Weaver]

I mean, the problem here is that insurers are layering diagnoses on patients, generating billions and billions and billions of dollars more in taxpayer funded reimbursement. And in many cases, the patients don't have them, aren't getting treated for them, and that's waste. That's waste for taxpayers, for private insurers. Medicare Advantage has driven a huge amount of growth in that industry and vast changes in the way care is provided and paid for. It's added to the kind of the runaway costs of American health care.

[Jessica Mendoza]

So it sounds like there are some holes in the system.

[Chris Weaver]

Yeah, I mean, there's a lot of ways to make money in Medicare and you know, that's fueled a lot of growth in the industry. And you know, our stories are just some of the strategies that, you know, these companies have embraced.

[Jessica Mendoza]

Billing for costly or unnecessary diagnoses. That's one strategy. Another strategy is withholding care from patients who actually need it. The Journal reported on this, too.

[Ana Wilde Matthews]

We found that people in their last year of life left Medicare Advantage and went back to traditional Medicare at double the rates of other enrollees.

[Jessica Mendoza]

That's my colleague Ana.

[Ana Wilde Matthews]

Again, why would people in that last year of life leave Medicare Advantage at a higher rate than everybody else? It raises the question of whether these people who are very sick and have very intense and expensive health needs, were running into barriers in accessing the care that they wanted or the care that they felt they needed.

[Jessica Mendoza]

We'll hear more from Ana Tomorrow on the second part of Medicare Inc. That's all for Today, Friday, June 6th this episode was produced by Jeevika Verma and edited by Laura Morris. Additional reporting by mark Maramont, Tom McGinty and Andrew Mollica. The Journal is a co production of Spotify and the Wall Street Journal. The show's made by Kathryn Brewer, Pia Gadkari, Carlos Garcia, Rachel Humphries, Ryan Knudson, Sophie Kodner, Matt Kwong, Colin McNulty, Annie Minoff, Laura Morris, Enrique Perez de la Rosa, Sarah Platt, Allen Rodriguez Espinosa, Heather Rogers, Pierce Singhi, Jeevika Verma, Lisa Wang, Catherine Whalen, Tatiana Zemis and me, Jessica Mendoza. Our engineers are Griffin Tanner, Nathan Singapak and Peter Leonard. Our theme music is by so Wiley. Additional music this week from Katherine Anderson, Peter Leonard, Billy Libby, Emma Munger, so Wiley and Blue Dot Sessions. Fact checking by Mary Mathis. Thanks for listening. See you tomorrow.