Executive Summary

Absence management programs are under increasing pressure from regulatory expansion, workforce complexity, and heightened employee expectations. Traditional operating models, reliant on manual case handling and fragmented systems,are no longer sufficient at scale. Artificial intelligence (AI) is emerging as a practical enabler, not as a replacement for human expertise, but as a mechanism to improve consistency, efficiency, compliance, and the overall employee experience.  This is being accomplished through both operational execution and technology development, and points toward a more streamlined ecosystem in the near and longer-term future.

The Operational Impact of AI in Absence Management

Shifting from reactive case handling to guided employee journeys

Operational friction in absence programs is highly predictable. Intake errors, incomplete documentation, repetitive employee inquiries, and complex policy interactions account for a significant share of administrative burden. AI-powered conversational tools are increasingly deployed to manage these high-volume, low-variability interactions.

Rather than replacing case managers, however, AI can enable guided leave journeys —helping employees initiate requests, understand requirements, and receive timely updates without needing repeated human intervention. It can also improve clarity and consistency while reducing call volume and manual effort.

Reducing cycle times through targeted automation

Absence operations involve extensive repetitive work: generating notices, tracking deadlines, verifying completeness, and summarizing case histories. AI-driven automation can support these tasks by drafting correspondence, flagging missing information, and consolidating timelines for faster review.

Organizations such as the International Foundation of Employee Benefit Plans (IFEBP) emphasize that AI adoption in leave management is increasingly focused on speed, accuracy, and employee understanding, not simply cost reduction. Many vendors are therefore responding by embedding AI directly into absence workflows rather than positioning it as a standalone tool. The operational result is improved throughput, fewer reopenings, and more predictable outcomes.

Enabling proactive workforce planning

Historically, absence management has been reactive: organizations respond after a leave occurs. AI can enable predictive insights, including forecasting absence likelihood and duration to support staffing and coverage planning. Machine learning models can identify absence patterns and duration risk, while also emphasizing the need for validation, explainability, and ethical safeguards.  When used appropriately, these insights support planning and early intervention, and improved workforce scheduling and roster stability.

Strengthening compliance and risk controls

Absence and disability programs have inherent compliance risk, and can be subject to inconsistent decision-making, and financial leakage. AI techniques long used in insurance, such as anomaly detection and predictive flagging, can be applied to help focus investigative and quality assurance resources. Crucially, these tools are designed to surface risk signals, not replace human judgment. Oversight will remain essential, particularly in medically and legally sensitive cases.

Technology Development Trends Shaping the Future

Natural language as the primary interface

Absence management is policy-intensive and emotionally complex, making it well suited for natural language systems. Modern platforms are building AI capable of interpreting employee questions, retrieving relevant policy language, and providing clear explanations—while escalating uncertainty to human specialists.  While trust is foundational, effective systems are able to prioritize:

• Policy-source transparency
• Clear escalation paths
• Guardrails that prevent overreach
• Empathetic, employee-appropriate language

Intelligent document processing

Medical certifications and eligibility documentation remain unavoidable. Next-generation platforms are moving beyond digitization to document intelligence—extracting structured data, identifying missing elements, and summarizing key information automatically. This can reduce reviewer fatigue and improve consistency across cases.

Predictive analytics with governance

Predictive absence models are transitioning from experimentation to production. However, research in absenteeism prediction underscores the importance of bias testing, explainability, and appropriate use boundaries. Leading organizations are therefore pairing predictive analytics with governance frameworks that define acceptable use cases, monitor outcomes, and ensure privacy-by-design principles.

What Organizations Can Expect

In the near term, or over the next one to three years, the absence industry can expect to see a number of enhancements in the way that insurance carrier and third-party administrator (TPA) service models are operating as a result of AI utilization, such as:

• AI copilots supporting case managers with summaries, next-step guidance, and draft communications
• Employee-facing AI assistants embedded into delivery models
• Expanded use of predictive analytics for staffing and capacity planning
• More sophisticated fraud and leakage detection adapted from insurance analytics

In the longer term, the most significant shift is anticipated to be architectural. Absence, disability, payroll, and HRIS systems will increasingly operate as better orchestrated ecosystems, with AI coordinating workflows across platforms. Additionally, organizations can expect continuous compliance models, where policy changes are proactively tested against real scenarios and documented automatically reflecting broader AI governance trends in what has become an increasingly regulated and ever-changing industry.

Conclusion

AI is not transforming absence management by eliminating human involvement. Instead, it is enabling human-centered, scalable operating models that can reduce administrative burden, surface risk earlier, and improve the employee experience without sacrificing compliance or judgment.

In a recent article featured on the New England Employee Benefits Council (NEEBC)’s blog, our Consultant, Grace Giannattasio, provides a state-by-state update on PFML changes in 2026 in the New England area. You can find NEEBC’s full article here.

Choosing employee benefits can feel overwhelming. There are more options than ever, rising costs, and constant changes to laws and regulations. The challenge for employers is not offering everything, but rather offering benefits that actually support employees as their lives change, while still making sense for the organization.

Looking at benefits through a life-stage lens can help. Instead of grouping employees by age or job title, this approach focuses on what people need at different points in their lives. It also recognizes that employees don’t move through these stages neatly—someone might be growing their career while caring for a parent or starting a family all at the same time. Benefits should be flexible enough to keep up while balancing cost, compliance, and operational impact.

Early Career and Entry Level Employees

Employees early in their careers are often enrolling in benefits for the first time while also navigating work-life balance and the challenges of a new workplace. While nearly all employers offer health coverage, many younger employees do not fully understand how to use it or what it costs them.

At this stage, affordability and simplicity matter. Employees tend to value preventive care, mental health support, and basic financial tools that help with budgeting, emergency savings, and student loan repayment. Clear education is critical, as communicating benefits is often rated poorly by employees, which directly affects utilization.

Time off also plays an important role. Flexibility to manage personal needs helps early career employees build healthy work habits and reduces the risk of burnout or early turnover in an already competitive labor market.

Employees in the Family Building and Caregiving Stage

As employees progress in their careers, many begin juggling work with caregiving responsibilities. More than one in six U.S. workers provides unpaid care to a family member, and most caregivers report difficulty balancing those responsibilities with their jobs.¹

Healthcare and leave benefits become especially important at this stage. Coverage often expands to include partners and dependents, along with increased use of maternity care, fertility services, pediatric care, and postpartum support. Leave programs are critical, and employers face the added challenge of ensuring employer-sponsored leave coordinates appropriately with federal, state, and local mandates.

Without adequate support, employees are more likely to reduce hours, postpone advancement, or leave the workforce altogether. Additional benefits such as dependent care, flexible scheduling, resource navigation, and financial planning support can help employees remain engaged and productive. Manager awareness is also key, since employees often turn to their direct manager first when life events arise.

Mid-Career Employees

Mid-career employees often hold deep institutional knowledge and occupy key leadership or technical roles. Losing them can be expensive, with turnover costs estimated at roughly one-third of an employee’s annual salary, factoring in hiring, training, and lost productivity.²

Benefits at this stage often center on balance and long-term health. Preventive care, screenings, condition management, and strong benefit navigation tools help employees manage growing responsibilities inside and outside of work. Time off remains important, whether for caregiving, family needs, or rest.

Retirement planning also becomes more significant. Access to education and financial guidance can help employees make informed decisions about both their careers and their future financial security.

Employees Entering Late Career and Retirement Planning State

As employees approach retirement, healthcare usage typically increases, and coverage becomes more important than cost alone. Strong provider networks and condition management are common priorities.

Most U.S. workers have access to employer-sponsored retirement plans, but participation often lags behind access, highlighting a need for better education and guidance.³ Financial counseling, retirement readiness programs, and phased retirement options can support smoother transitions while helping employers plan for workforce changes.

What Matters At Any Stage

Some benefits are important regardless of career stage. Flexible work arrangements, family care support, and professional development consistently rank among top workforce priorities.⁴ Technology also plays a major role: benefits that are difficult to understand or access are less likely to be used effectively.

Ongoing communication is essential. When education occurs only during open enrollment, employees are more likely to feel confused and make rushed decisions. Year-round education in multiple formats improves understanding and utilization.

Making Practical Decisions

Rising healthcare costs and benefit expenses require difficult decisions each year. While most employers view health benefits as a top priority, offering too many options can overwhelm employees and increase costs without improving outcomes.

A life-stage approach helps employers focus on what delivers the most value, regardless of where employees are in their careers. Investing in preventive care, wellness programs, financial education, comprehensive leave offerings, and clear communication can reduce long-term costs and turnover. At the same time, staying compliant remains essential as leave laws and healthcare requirements continue to change.

A benefits strategy built around real-life needs, not just demographics, is more sustainable and more impactful for both employees and employers.

¹Caregiver Statistics: Work and Caregiving, Family Caregiver Alliance, https://www.caregiver.org/resource/caregiver-statistics-work-and-caregiving/
²Average Turnover Rate by Industry (2026 Update), Corporate Navigators,  https://www.corporatenavigators.com/articles/recruiting-trends/average-turnover-rate-by-industry-in-2024/
³Worker Participation in Employer-Sponsored Pensions, https://www.congress.gov/crs-product/R43439
⁴30+ Employee Benefits Statistics in the U.S. (2024/2025), https://high5test.com/employee-benefits-statistics/

To attract and retain top talent, employers continue to invest heavily in comprehensive employee benefits programs. While offering a wide range of health and well-being options is well-intentioned, an unintended consequence often emerges: choice overload. Employees may appreciate having options, but without the time, expertise, or clarity to evaluate them, navigating benefits can quickly become overwhelming.

This is where care steerage and smart navigation come into play. Together, these strategies are designed to simplify healthcare decision-making, improve the benefits experience, and help employees access high-quality, cost-effective care with greater confidence.

What Is Care Steerage?

Care steerage is a benefit design strategy that guides employees toward higher-quality, more cost-effective providers and care settings based on objective measures, such as quality outcomes, cost efficiency, and an individual’s specific healthcare needs.

Rather than leaving employees to navigate complex provider networks on their own, steerage uses data and structured pathways to support better decisions. At a high level, steerage typically falls into two categories.

Active Steerage

Active steerage involves real-time, personalized support. Employees may interact with nurse navigators, care concierges, or trained benefits coordinators who engage employees by phone, chat, or online portals. These experts help identify appropriate providers based on medical history, new diagnoses, upcoming procedures, and geographic preferences.

Passive Steerage

Passive steerage empowers employees with self-service tools, including online provider directories, mobile apps with cost and quality transparency, and provider and facility comparison tools. By making pricing and quality data more visible, employees are better equipped to make informed choices independently.

Why Steerage Matters

The primary goal of care steerage and smart navigation is to encourage quality-based and cost-conscious healthcare decisions that improve outcomes while reducing unnecessary spending. Many benefit plans reinforce these choices through design features such as tiered provider networks that highlight high-value options, lower copays or out-of-pocket costs for preferred providers, and incentives for using primary care or outpatient settings rather than higher-cost inpatient care.

For employees, this often translates into lower costs, better care experiences, and greater confidence in using their benefits.

Common Features of Smart Navigation Programs

Smart navigation complements care steerage by leveraging technology, often enhanced by AI, to make benefits easier to understand and use. Common design elements include:

1. Personalized communications that deliver targeted guidance based on life events, care needs, or upcoming decisions.
2. Digital decision-support tools, such as mobile apps and online platforms with cost calculators and provider comparison features tailored to individual and family needs.
3. Value-based plan integration, where navigation tools are embedded within Tier 1 or value-based networks that reward employees for choosing high-quality, cost-effective care.

Benefits for Employees and Employers

When smart navigation and care steerage work in tandem, they deliver meaningful benefits for both employees and employers. For employees, these programs help reduce search fatigue and the frustration that often comes with trying to find the right healthcare resources. With access to expert guidance through personal concierge services and decision-support tools, employees are better equipped to make informed healthcare decisions and identify lower-cost providers that still deliver high-quality care.

For employers, this approach can drive stronger returns on investment, help control unnecessary and wasteful claims spending, improve overall benefits engagement, and positively impact employee recruitment and retention, ultimately contributing to a healthier and more satisfied workforce.

Sources:
– Wellness360 Blog, Benefits Navigation: Simplifying Healthcare with Technology, September 2025
– 10 Best Benefits Navigation Platforms for 2026, Recruiters Lineup, October 2025
– Best Employee Benefits Navigation Companies, CBINSIGHTS

What is Nurse Navigation?

A nurse navigator is a registered nurse who guides patients through the often complex healthcare system, coordinating care and serving as an advocate. Navigating healthcare independently can be overwhelming, time-consuming, and costly, particularly for employees managing chronic conditions, complex treatments, or new diagnoses.

Nurse navigation provides personalized, end-to-end support—from diagnosis and treatment planning to recovery—by unifying benefit utilization, provider coordination, and cost-efficient clinical care. This approach ensures employees receive the right care, at the right time, at the right place, while reducing confusion and delays.

Employer adoption is growing rapidly. Currently, 37% of self-insured employers implement a healthcare navigation solution, helping employees access the most appropriate care and resources. ¹

The Role of a Nurse Navigator

Nurse navigators offer a variety of services tailored to patient needs:

Education

• Helps employees understand diagnoses, treatment options, and benefits, bridging gaps in healthcare literacy.

Fast-Tracked Care

• Streamlines the care process by handling prior authorizations, scheduling appointments, coordinating labs and tests, and ensuring all prerequisites are met for timely care.

Advocacy

• Acts as the employee’s primary point of contact and advocate, providing guidance and support throughout the care journey.

Care Logistics

• Assists with travel arrangements (car services, hotels, flights), financial or insurance issues, and access to other support resources.

Emotional Support

• Provides empathy and guidance, offering a trusted relationship for patients and their families to navigate fears, questions, and concerns.

Why Nurse Navigation Matters

Healthcare is increasingly complex, and employees often face multiple challenges when trying to access care. Navigating between multiple providers, understanding specialty networks, and deciphering benefit structures can be confusing and time-consuming. Rising deductibles and out-of-pocket costs add financial stress, while care gaps, particularly for chronic or high-acuity conditions, can lead to delays, complications, and unnecessary expenses.

Nurse navigation addresses these challenges by providing personalized, proactive support throughout the healthcare journey. By coordinating care, assisting with benefit utilization, and guiding employees through complex treatment plans, nurse navigators reduce barriers and ensure employees receive the right care at the right time. Clinical evidence demonstrates the effectiveness of this approach. For example, patients with advanced pancreatic cancer who had access to a nurse navigator had a 104% higher probability of survival after one year compared to those without navigation support. ² Similarly, oncology patients using nurse navigation services reported an increase in satisfaction from 66.5% to 87.4% and a drop in no-show rates from 3.8% to 0.4%. ³

Beyond clinical outcomes, nurse navigation also improves employee engagement and benefits utilization. Employees are more likely to understand their coverage, attend necessary appointments, and make informed care decisions when they have a dedicated resource guiding them. This support not only improves health outcomes but also generates measurable value for employers through reduced unnecessary spending and higher ROI on benefits programs.

Different Models of Nurse Navigation

Employers have several options when implementing nurse navigation:

1. Standalone point solution vendors – specialized navigation services that can be added to existing benefits.
2. TPA-integrated navigation – larger third-party administrators offer nurse navigation as part of their platform, creating seamless integration with claims, wellness, and leave management.
3. Hybrid approaches – combining internal case management with external navigation support to meet the needs of specific employee populations.

Choosing the right model depends on the population served, plan structure, and organizational goals.

How Nurse Navigation Supports Employers

Nurse navigation is more than a benefit perk; it is a strategic tool for addressing key employer challenges. By proactively coordinating care, nurse navigators help manage rising medical costs, increase engagement, and reduce fragmentation in the healthcare system. Employees experience better outcomes and higher satisfaction, while employers benefit from reduced unnecessary spending and improved ROI.

Employers considering nurse navigation should assess their current plan offerings, population needs, and integration options to ensure the solution complements their existing benefits ecosystem without disruption.

As the healthcare landscape becomes more complex, nurse navigation has emerged as an essential solution for modern employers. Providing employees with expert guidance, care coordination, and emotional support reduces barriers to care, improves outcomes, and increases engagement. Whether implemented as a standalone solution or integrated into existing plans, nurse navigation delivers measurable value for both employees and employers.

¹State of Healthcare 2024, Employee Benefit News (EBN) National Employer Study, sponsored by Quantum Health, which found 37% of employers are offering healthcare navigation services to support employee access to care. https://www.businesswire.com/news/home/20240410953008
²Cruz, Z. (2025, September 15). Impact of nurse navigation on overall survival and timeliness to care in patients with pancreatic cancer in advanced stages. Journal of Oncology Navigation & Survivorship. https://www.jons-online.com/issues/2025/september-2025-vol-16-no-9/impact-of-nurse-navigation-on-overall-survival-and-timeliness-to-care-in-patients-with-pancreatic-cancer-in-advanced-stages
³Strengthening oncology patient navigation enhances outcomes and access to care. Oncology Nurse Advisor. (2025, May 13). https://www.oncologynurseadvisor.com/reports/strengthening-oncology-patient-navigation-enhances-outcomes-treatment/

When we think of travel, many of us envision picturesque beaches, historical sites, or national parks. For others, travel is driven by healthcare needs, often combining treatment with tourism activities or recovery time. This practice is commonly referred to as medical tourism.

The prevalence of medical tourism is difficult to quantify, but the American Association for Physician Leadership (AAPL) estimates that approximately 1.4 million Americans travel abroad each year for medical care. ¹ For employers, this does not indicate that their health plans are misaligned with benchmarks, nor is it something to control. However, it is a growing reality that benefits from education and proactive navigation. The opportunity is to frame your approach not as cost-cutting, but as an access and risk management consideration. Without thoughtful planning, organizations may face hidden costs, care gaps, and employee dissatisfaction, particularly when complications arise after an employee returns home and seeks care under an employer-sponsored plan.

Why Employees Seek Care Abroad

Risks for Employer-Sponsored Plans

Because most medical tourism occurs outside of employer-sponsored benefit plans, it typically involves no preauthorization, limited quality vetting, less structured follow-up care, and reduced cost predictability for unplanned complications. While participants generally assume these risks while abroad, employers often absorb downstream impacts once employees return home. These may include postoperative complications such as infections, additional surgeries, extended recovery periods, and related leaves of absence.

One of the most significant challenges is the lack of coordination with domestic providers, including limited sharing of medical records before and after procedures performed abroad. As Renée-Marie Stephano, JD, Chief Executive Officer of Global Healthcare Accreditation, explains,

“When patients arrange medical travel independently, without involving their primary care provider, physicians may be left out of the loop. That makes it difficult to review the treatment plan, ensure it aligns with the patient’s medical history, and properly manage follow-up care once the patient returns home.” ²

Establishing a Philosophy Around Medical Tourism

Rather than implementing rigid policies that aim to discourage or restrict international care, employers may benefit from establishing a philosophy, not a policy, regarding medical tourism. This approach focuses on governance, education, and equity rather than enforcement. Many organizations currently take a passive approach, addressing complications only after employees return home. While this requires minimal oversight, it can result in unintended inequities and inconsistent employee experiences.

In developing a philosophy, employers may consider factors such as equity and access, employee experience, cost transparency, and organizational risk tolerance. Often, the most effective approach involves modeling scenarios across health plans, disability programs, and time-off policies for employees seeking care domestically and internationally. Practical steps may include adding educational resources about risks, clarifying coverage expectations, planning for post-travel care coordination, and aligning leave and disability benefits with health benefits.

Looking Ahead

Medical tourism is expected to continue growing in the coming years. According to Forbes, the global medical tourism market is projected to grow at a compound annual growth rate of about 25.2% through 2030, reflecting rising demand as more individuals combine travel with healthcare services. ³ While medical tourism may not present immediate challenges today, establishing a clear foundation and philosophy now can help employers better manage risk as participation increases.

As with other benefits decisions, employers should apply the same attraction and retention principles when considering medical tourism. Rather than viewing it as a perk to promote, it should be treated as a plan governance consideration. While employers cannot prevent medical tourism, thoughtful planning can help reduce risk, manage complications, and support better outcomes for employees, dependents, and employer-sponsored plans.

¹American Association for Physician Leadership (AAPL), medical tourism estimates
²Physician Leadership Journal, “Medical Tourism — Who, What, and Where,” Renée-Marie Stephano, JD
³Forbes, 5 Tips Business Leaders Can Learn From The Rise In Medical Tourism, noting that the global medical tourism market is expected to grow at a CAGR of 25.2% through 2030.

As summer winds down, the Disability Management Employer Coalition (DMEC) hosted its 2025 Annual Conference in vibrant Austin, TX, a city known for its live music, bold flavors, and innovative spirit. The dynamic setting was the perfect backdrop for this year’s conversations around the ever-evolving world of absence, accommodations, compliance, and employee wellness. Professionals from across the industry gathered to unpack new legislation, discuss workplace trends, and explore tech-driven solutions to modern challenges. Here are three key themes that emerged from this year’s conference:

1) Championing Wellbeing

Mental health has been a conference staple in recent years, but 2025 brought a more integrated, human-centered approach. Discussions extended beyond mental illness to resilience, emotional intelligence, caregiving, and holistic employee support strategies. The rise of neurodiversity, trauma-informed leadership, and care-inclusive policies showcased how employers are adapting to meet a broader spectrum of employee needs.

– In the session, “Compassionate Leave: Reimagining Employee Well-Being,” presenters explored how companies are expanding leave programs to support emotional well-being, not just physical health.

– A dynamic discussion titled “Neurodiversity in the Workplace: Employee Expectations and Employer Obligations” highlighted how organizations can create inclusive environments and meet accommodation needs for neurodiverse employees.

– In “Empowering Caregivers in the Workplace: A Collaborative Approach to Well-Being,” panelists shared strategies to support the growing population of working caregivers through benefits design and workplace flexibility.

2) Technology & AI

This year’s sessions made one thing clear: we’re at a true inflection point when it comes to technology. With AI, data integration, and digital tools maturing, organizations are rethinking how leave is managed, from predictive analytics to employee experience platforms. Several thought leaders challenged the industry to balance automation with empathy, and to ensure tech doesn’t come at the cost of compliance or care.

– In the session, “Technology Can Make All Your Absence Dreams Come True … Or It Can Be Your Worst Nightmare!” speakers tackled the pros and cons of tech platforms, with a focus on implementation pitfalls and how to avoid them.

– During “Defining the Future of AI in Absence Management: Review of Think Tank Findings,” presenters walked through key outcomes from a recent industry think tank focused on the ethical use of AI in leave processes.

– The presentation, “There’s an AI for That! The Future of Integrated Absence Management and How AI Connects the Dots,” showcased how leading employers are already using AI to streamline decisions and improve the employee experience.

3) Compliance & Accommodation Strategies

Compliance remains a foundational topic, and this year brought a new level of pragmatic guidance and real-world scenarios. Sessions ranged from ADA accommodations and “good faith” practices to FMLA audits and courtroom insights. The clear takeaway? Employers must remain agile and informed while developing repeatable, scalable compliance frameworks.

– The Preconference Workshop, “Taking Back Your Plan: A Practical Guide for Effective Policy Development,” run by Spring Consulting Group, helped employers navigate federal, state, and local leave laws as they build or update internal policies. We also explored benchmarking strategies and outlined the changes employers need to get their benefit programs back on track.

– In “Recent Jury Verdicts Involving Leave and Accommodation Issues,” a legal expert reviewed real court outcomes to help employers better understand risk and strengthen their policies.

– A panel-led session, “Getting Alice out of Wonderland: How to Address the Realities of Accommodations Management,” shared tactical guidance on how to navigate tricky and often ambiguous accommodation requests.

Final Thoughts

The DMEC 2024 Annual Conference in Nashville was a resounding success, filled with opportunities to learn, connect, and share best practices. From deep dives into compliance and mental health to exploring the latest technological innovations, the conference offered something for everyone. As always, it was a pleasure to reconnect with industry leaders and bring back fresh ideas to enhance our consultative offerings. We’re already looking forward to what next year’s conference will bring!

Title:

AVP – Absence and Disability

Joined Spring:

I joined Spring in January 2024

Hometown:

Chesterfield, MA (near Northampton)

At Work Responsibilities:

I help employers navigate complex absence and disability laws and develop customized absence and disability programs that are both compliant and strategically aligned with their goals. Simultaneously, I support absence and disability vendors in developing and launching new products, from drafting policy forms to creating marketing collateral.

Outside of Work Hobbies/Interests:

Cycling, pickleball, gardening

Fun Fact:

In high school, my summer softball team made it to nationals 2 years in a row. I was an academic all-American squash player in college.

Do You Have Any Children?

Two amazing adult humans, ages 28 and 25 – and 3 equally awesome grandchildren with a 4^th arriving at the beginning of 2026!

Favorite Band/Musician:

I have loved Melissa Etheridge since I played frisbee with her and her band on the lawn of my dorm at Smith College in 1990 and she signed my cassette of her first album! I have seen her in concert at least 20 times.

Favorite Book:

A Gentleman in Moscow