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On today’s episode, Ashley sits down with with Keith Somers. CRO at HealthCorum. Keith is an entrepreneur with a finance background who co-founded HealthCorum after a series of frustrating experiences navigating the healthcare system as a patient and caregiver. As CRO at HealthCorum, he leads the sales/marketing team on all market interactions while maintaining responsibility for company operations.
HealthCorum is a company that provides data analytics and insights focused on the healthcare industry. They specialize in analyzing data on healthcare providers, such as hospitals and physicians, to assess their quality, efficiency, and overall value in comparison to other similar providers. HealthCorum's platform and underlying data helps healthcare organizations, insurers, and employers identify high-performing providers, reduce costs, and improve the quality of care. -
Today Ashley sat down and talked with Dr. Edwin Estavez. Edwin is the founder of the Altacair Foundation. He Previously, served as Market President of Value Based Care at Prominence Health, a leading health care company that provides high quality, cost-effective care to diverse populations. Edwin, has over 30 years of experience in health care and higher education administration, risk management, and business development, with a PhD in Administration and an MSW. He is passionate about organizational transformation. From health care delivery and outcomes through value-based care tactics, to patient engagement programs, and care coordination models. Join as we chat about the mission of Altacair, how he ensures the foundation stays true to its mission and vision, and the collaboration between Altacair and The Leavitt School of Health on the Accelerator Conference.
Altacair Foundation: About Us – Altacair Foundation
Accelerator 2024: https://www.eventbrite.com/e/accelerator2024-advancing-value-for-health-equity-tickets-951490021267?aff=oddtdtcreator -
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On today’s episode of The Race to Value, Ashley sits down with her colleague and friend, Dr. Melissa McLaren to discuss the importance of DEI in Healthcare and Education, and why building inclusivity is not just a buzzword, but something that is vital for the future.
Dr. McLaren is an Associate Dean and Academic Program Director at the Leavitt School of Health at Western Governors University. She graduated with her BSN from The Ohio State University and her Doctor of Nursing Practice from the University of Minnesota. She received her master’s in management and leadership and an MBA from Western Governors University. Melissa and her family have engaged with lawmakers at the local and state level, as well as the Congressional LGBTQ Equality Caucus and the US Department of Health and Human Services in support of gender-affirming care and other LGBTQIA+ rights. They have spoken at state and national conferences to educate on the importance of family support when raising a transgender child. Dr. McLaren has partnered with organizations such as the Human Rights Campaign, Welcoming Schools, PFLAG, the ACLU, TransOhio, Equality Ohio, and many others to advocate for transgender youth. Dr. McLaren currently serves on the Human Rights Campaign Parents for Transgender Equality National Council. She is a board officer for Equality Ohio and was an inaugural board member of her local LGBTQ+ organization. She is a member of the AACN DEI Leadership Network Communications Committee. She lives in Ohio with her husband of 20 years, 19-year old twins, 2 dogs, and several entitled cats.
Previous Episode: Ep 137 – Authentic Truth, Love, and Compassion: A Family’s Journey in Gender-Affirming Care, with Melissa and Conner McLaren – The Race to Value Podcast™
0:50: Defining Diversity and Inclusion
4:52 Why is diversity and inclusion so important in today’s society?
9:34: How the impacts of disparities and health inequities affects absolutely everyone
13:30: How treatment of patients differs based on insurance status
21:00: Education related healthcare burdens, and how education has an impact.
24:00: How diversity enriches the learning experiences in educations settings
33:24 Stories about successful inclusive educational initiatives
38:00 Shifting policies and practices
39:30: Dr. McLaren’s personal story -
On today’s episode of Race to Value, Ashley sits down with Mark Young, CEO of MyCHN to discuss how MyCHN launched a partnership with Wysa, an AI-driven mental health platform. We discuss how this collaboration aims to bolster the well-being and mental health of MyCHN’s Crisis and Behavioral Health patients by providing them access to Wysa’s innovative AI personal mental health companion at no cost.
Mark Young has worked in health services since 1989 and in community health since 1998. He has a Master's in Business Administration from Trident University and a Master's in Organization Management from the University of Phoenix. Over his career of 30-plus years, Mr. Young has worked with initiatives in the Rio Grande Valley, northeast Texas, and south Texas. Projects he has developed include outreach and engagement with colonia residents, residential treatment services for pregnant women and children, a tuberculosis intervention program, multiple chemical and alcohol dependency programs, behavioral health programs, and many outreach, education, and intervention projects.
Timestamps:
3:00: Discussion on how MyCHN created this partnership with WYSA and the benefits it has brought to their patients.
6:00: How this tool is used to help patients
7:30: Tools and Resources that WYSA offers
11:30: Breaking the Stigma around using AI in Healthcare
16:00: Discussion on the current state of Behavioral Health
19:00: Discussion on younger populations and if they are more likely to opt into utilizing AI for healthcare -
In today’s episode we chat with Geoffrey Roche, MPA. Geoffrey is the son of a nurse, future of work and education expert, diversity, equity, inclusion, and belonging advocate, champion for transforming health equity, and the host of the Ed Up Health Up podcast. His professional career includes over nine years in hospital administration as a strategic advisor to the President and CEO and department director of various departments, including Business Development and Planning, Government Affairs, Community Health, and Public Relations, for Lehigh Valley Hospital-Pocono. At Lebanon Valley College and Harrisburg University of Science and Technology he held senior leadership roles focused on strategic partnerships, organizational strategy, and business development. As Senior Vice President, Business & Workforce Development at Dignity Health Global Education, he led a diverse team focused on developing institutional relationships with leading health systems while simultaneously championing national conversations and initiatives to develop innovative diversity, equity, and inclusion solutions for the healthcare workforce.
“We expected to see a drop in enrollment before the pandemic for all healthcare programs. Why did Healthcare and Education not come together to combat this?” - Geoffrey Roche
“We have made bad decisions as a society when taking care of our healthcare workforce.” - Geoffrey Roche“We have five generations of people in the workforce, and this is the first time we have had this.” - Geoffrey Roche“As Leaders we need to harness the creativity and passion for all generations in the workforce.” - Geoffrey Roche
2:25: What is happening in the nursing workforce?
4:30: The Supply and Demand Gap Challenge and addressing culture in healthcare organizations.
5:30: The Gig Economy is now in healthcare, and we have to get used to this model.
8:00: Millennials in the workforce and creating a culture that allows people to be the best they can be by creating a community and culture that allows them to thrive. This means they must be valued and heard.
14:00: What do we need to do as healthcare leaders to invest in our people?
17:30: Why you need to listen to your workforce, instead of just hiring consultants.
20:30: If we do not have a healthcare workforce, it will impact education, clinical placements and preceptorships.
22:50: Apprenticeships, why they are important and why healthcare has been slow to implement them
29:27: We need to do more work in the K-12 Landscape to promote and encourage people to go into healthcare careers. It is important to learn that there are jobs in healthcare that aren’t being a doctor or a nurse. -
Welcome back to Race to Value! In this episode we introduce our new host, Ashley Schwartz and discuss the rebranding of the Institute for Advancing Health Value and how we are expanding our work.
Today’s guest is Dr. Keith Smith (M.A., Ed.D., MBA, L.M., RMHC (ret.)) serves as the Executive Dean and Senior Vice President for Michael O. Leavitt School of Health at Western Governors University. He has strategic leadership experience in the business, nonprofit, and higher education sectors. His 26-year career in higher education comprises holding faculty, dean, vice-provost, vice-president, and now senior vice-president positions, at five universities prior to coming to WGU, inclusive of leading schools of health, business and IT, and arts and sciences. He has taught courses and given presentations domestically and internationally on leadership and organizational change, higher education innovation, and personal growth and development. Smith has supervised educational programs in Europe, the Middle East, and Asia. He has played a lead role in both regional and programmatic accreditations. His teams have developed a wide spread of programs from the microcredential through doctoral levels, as well as partnerships with business, government, military, and community colleges across the nation.
0:19: Introduction to Keith Smith, SVP of WGU’s Leavitt School of Health.
1:42: Upcoming changes you can expect to see with the Institute for Advancing Health Value and it’s rebrand.
2:52: Expansion in content- we will be continuing our work in Value Based Care, but are expanding into workforce, health equity, diversity and inclusion and workforce development.
4:50: Health Equity Convening in the Rio Grande Valley of Texas. This is a new area of work that we are continuing to expand and explore in different areas of the United States
8:00: Discussion of the Programs that the Leavitt School of Health currently offers.
11:40: Discussion of WGU’s strategic pillars and how they will benefit the general public and the current workforce.
“We want to set a greater tone out in the Healthcare Industry, in terms of thought leaderships and opportunities to partner with those in different systems, and opportunities to be a resource center for them.” - Dr. Keith Smith
“Educational Equity feeds into Health Equity. By providing education to everyone, it opens the door for health equity and having trained, qualified and a culturally competent workforce that mirrors the diverse population that they are caring for.” – Ashley Schwartz -
In this episode of the Race to Value podcast, we are sharing inspiration for a more optimistic future in the value transformation of our country. This week’s interview brings a message of hope, compassion, and human connection balanced with the business success of value-based care within a national leading health system.
Albert Einstein once said that “Only a life lived for others is a life worthwhile” and no one better captures that spirit of servant leadership than our guest this week. Philip Eaves is the President and CEO of Ascension Seton ACO | Ascension Seton Health Alliance and the Vice President of Population Health at Ascension Texas, and he is a leader in the value movement that you should know about. In this interview we focus on change management, leadership, and the human side of healthcare economics. Overseeing the value-based care strategy and operations for one of the largest clinically integrated networks in Texas, Philip is leading the ACO to outstanding success…and transforming the lives of people along the way.
Bookmarks:
01:30 The human side of healthcare economics – compassion is the currency; empathy is the language.
02:00 Introduction to Philip Eaves, President and CEO, Ascension Seton ACO and VP of Population Health, Ascension Texas
02:30 Ascension Seton ACO is the largest clinically integrated network in Texas with 3,600 providers with 300K value-based lives.
04:45 “Only a life lived for others is a life worthwhile” -- Albert Einstein
05:30 Philip shares how a humble, faith-based upbringing fueled his ambition, work ethic, and compassion as a healthcare leader.
07:30 “Healthcare is about serving others.”
08:30 Occupational medicine as a stepping stone to value-based care.
09:45 Team-based care that enables providers so they can build meaningful patient relationships.
11:00 $24M in MSSP Shared Savings for 23,000 Medicare beneficiaries to achieve a top 7% performance ranking of all ACOs in the country (#32 out of #482).
12:45 Valuable partnerships with independent practices (e.g. Austin Regional Clinic, Capital Medical Clinic).
13:00 “Physician engagement is the overall key to ACO success.”
14:00 The impact of Annual Wellness Visits (AWVs) in practice transformation.
15:00 HCC recapture for documentation accuracy as an area of educational focus.
15:45 Centralized versus Embedded Care Management.
16:30 Analytical insights to drive high risk CM interventions.
17:15 Quality campaigns to close care gaps and improve population health outcomes.
18:00 Refining a Post-Acute Care network for optimal transitional care.
18:30 An after hours program as an effective ED diversion strategy.
20:00 Change management to improve team culture and reinvent the business model for VBC.
22:00 Phillip shares his experience leading an inflection point for the ACO business.
23:30 Applying the principles of the Kübler Ross Change Curve in organizational change.
24:30 Inspiration from John Kotter (“Leading Change”) – Leadership versus Management.
25:00 Recognizing the need for change in shifting a new strategic direction.
26:00 Communicating the vision and creating short-term wins.
26:45 New initiatives: a new ACO for early adopters, Medicare Advantage risk, and Direct-to-Employer partnerships.
28:00 Financial toxicity as a driver of Direct Contracting between employers and providers in value-based care.
30:00 Employer frustration with rising medical spend and the lack of solutions from their brokers.
30:45 Designing an ACO value proposition based on employer pain points.
31:00 Leveraging network adequacy and CIN care infrastructure for commercially insured populations.
32:45 PBM transparency to reduce extreme spending on pharmacy drugs.
34:00 Forging a new partnership with Signify/CVS to support practice transformation.
37:00 Accessing capital within a landscape where there is mass provider consolida... -
The transformation of healthcare is a seemingly insurmountable challenge, yet overcoming any obstacle in the journey begins with the belief that it is possible to win! It's not about the magnitude of the task; it is about the collective will to prioritize the wellbeing of every person we serve in our population. Perhaps when approached with the audacity to imagine a healthier and more equitable future for all, we'll actually get there. And that is just what the Physicians of Southwest Washington (PSW) is realizing as they navigate a successful transition from volume to value.
Our guest on the Race to Value this week is Melanie Matthews, the dynamic, creative, and innovative CEO of PSW. She leads a population health company that has been around for three decades. Melanie is not only leading their ACO and managing their progression in the adoption of full-risk Medicare Advantage delegation; she has become a nationally recognized voice for value-based health policy. In listening to this interview, you will hear from a leader that has a real personal capacity for leadership and a clear focus on excellence. If you want to hear from someone that is at the absolute forefront of risk-based contracting and innovation, who understands the issues at a granular level, this episode with Melanie is a must-listen!
Episode Bookmarks:
01:30 Introduction to Melanie Matthews and the Physicians of Southwest Washington (PSW)
04:30 PSW has evolved over the last three decades from an IPA to a diverse business that includes a national leading ACO and risk-bearing entity for MA.
06:00 "PSW is a story of independent physicians who, in a time of market consolidation, want to remain independent and focus on the patient relationship."
06:45 Achieving success in delegated risk and taking accountability for both quality and total cost of care.
07:00 The impact of MACRA on the long-term value-based care strategy of PSW.
08:30 Building an infrastructure and developing capabilities to move a value-based agenda.
09:00 Developing a business model for agility in responding to new rules ("a kayak in a sea of cruise ships") and engaging all types of physicians in the landscape.
09:30 "The value-based movement is important as the fee-for-service chassis is not realistic, has poor quality and outcomes, and rising costs."
10:00 Taking risk with physician partners and providing them with MSO services, leveraging a technical infrastructure and population health platform.
10:45 The glacial pace of scaling payment model transformation at CMS and CMMI's bold goal for 2030.
12:00 The increasing shift to home-based care delivery and the use of generative AI in reshaping care delivery.
13:00 How the flawed economic design of the fee-for-service system creates industry inertia.
14:00 Diverting to the known (i.e. fee-for-service care delivery) in times of stress is an unsustainable path forward.
15:00 Convincing the Board room on the tenets of VBC when it hasn't historically delivered on its promises.
16:00 Trends in consumer cost-shifting and the challenges of private insurers cross-subsidizing provider losses from public payers.
16:30 Unsustainable economics in employer-based healthcare and the looming insolvency of Medicare.
17:00 What does the CMMI 2030 Goal mean for future of the value movement?
18:30 An overview of the extensive services offered by PSW that empowers success in VBC.
19:30 The explosive growth of strategic transactions of physician groups and how mass consolidation is impacting the landscape.
21:00 Aligned incentives and access to a population health platform as keys to VBC success.
22:00 PE investment impacts on competition in an independent physician ecosystem.
23:00 Generational differences in the approach to the business of practicing medicine.
23:30 "Organizations that are convened with independent physicians are able to show better costs of care." (vs. employed or vertically integrated systems) -
We have a broken healthcare system. Too often, individuals today experience care that is fragmented, duplicative, wasteful, and confusing. Through value-based care, we can improve the health care experience by coordinating care, creating care teams that communicate with one another, and supporting individuals in their care journey with services that address their medical and non-medical needs.
Accountable for Health is a nonpartisan national advocacy and policy analysis organization accelerating the adoption of effective accountable care. Their members are advocating for value-based care on Capitol Hill so policymakers can understand how best to move American healthcare towards a model that achieves better outcomes, improved care experiences, increased access, and lower costs. Joining us on the podcast this week is Mara McDermott, the Chief Executive Officer for Accountable for Health. She is an accomplished healthcare executive with deep expertise in federal healthcare law and policy, including delivery system reform, physician payment and payment models.
Take this opportunity to learn from a leading expert on accountable care as she translates the truth in building a bridge towards a more broad-based understanding of health value. And make sure to tune in to Mara's special announcement about Health Care Value Week at the end of the interview so you don't miss out on important educational events occurring January 29th thru February 2nd.
Episode Bookmarks:
01:30 The need for accountable care policies that create better health outcomes and patient experiences.
02:00 Introduction to Accountable for Health (A4H) and its Founder/CEO Mara McDermott, JD, MPH
03:00 Interview topics discussed (e.g. the meaning of VBC, MSSP vs. MA, MACRA 2.0, advanced APMs, integrated specialty care, Medicaid transformation, and the upcoming Health Care Value Week event).
06:00 How A4H is translating thought leadership to action in the advocacy arena.
06:30 Accountable care as the solution to fragmented, uncoordinated care.
07:00 Political turnover in D.C. has made VBC a "new" health policy solution.
07:30 Educating the Hill comes down to conveying enthusiasm for health care transformation.
08:00 Accountable for Health Members are shaping the national conversation for payment and delivery system reform.
09:00 The health policy controversy of the Global and Professional Direct Contracting model (the precursor to ACO REACH).
11:30 If Direct Contracting was the natural evolution of a series of advanced ACO options, why was there such strong criticism?
12:00 The need to overcome misunderstandings about what ACOs are trying to achieve.
13:00 Providing education to dispel the myth that ACOs can actually limit services.
14:00 How uninformed policy decisions could potentially create a catastrophic blow to the value movement.
14:45 "Accountable care is integral to care delivery system reform."
15:45 Confusion with the term "value-based care" and why it will fail unless people understand the truest aims of the movement.
17:00 The need for effective storytelling to advance care delivery transformation.
18:00 Prioritizing care experience over cost reforms (delivery innovation will address costs!)
20:00 The topline takeaways from CMS model evaluations and whether or not programs should be expanded.
21:00 What do most people think when they hear the word "value"? (the need to reframe the conversation with more precise language)
22:00 The MSSP and the Medicare Advantage programs as two distinct approaches to healthcare delivery and reimbursement.
24:00 Mara provides a brief comparison between MSSP and MA (e.g. beneficiary assignment, risk adjustment, benchmarking).
25:30 How strong relationships between MA plans and provider networks (underpinned by capitation) drive value.
26:30 Understanding provider compensation in MA value-based payment and the synergies between managing MSSP and MA populations. -
The World Health Organization has declared climate change as "the greatest threat to global health in the 21st century." As our planet grapples with the accelerating impacts of climate change, it is crucial that we adopt a climate lens in the value transformation of our healthcare industry. The repercussions of climate change extend far beyond environmental shifts; they manifest in various health issues, including challenges with clean water access, increased allergens, respiratory diseases, heat induced illnesses, and the proliferation of infectious diseases. It's essential to acknowledge that while climate change affects everyone, the burden falls disproportionately on historically marginalized populations, highlighting the interconnectedness of climate impacts and social determinants of health in underserved communities.
In our pursuit of delivering safe, effective, and efficient care amid the climate crisis, we as healthcare leaders also bear the responsibility to address the substantial greenhouse gas emissions generated by the sector. Accounting for nearly one fifth of the U.S. gross domestic product, the healthcare industry possesses considerable purchasing power that can be harnessed to steer the nation toward cleaner energy and a low carbon supply chain. Beyond mitigating environmental harm, embracing preventive models of care and enhancing care quality that lowers excess utilization naturally aligns with lower carbon footprints. Value-based care, therefore, can become a powerful catalyst in propelling us toward a net zero carbon future that will build a sustainable, resilient future for our planet.
This week we are interviewing Dr. Vivian Lee, a healthcare executive dedicated to the advancement of value-driven transformation in health and tackling climate change. Author of the acclaimed book,The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone, she is an Executive Fellow at Harvard Business School and Sr Lecturer at Harvard Med School. Prior to her Executive Fellowship at Harvard, she was the founding President of Verily Health Platforms, an Alphabet company combining a data-driven, people-first approach to precision health. Dr. Lee is also a former health system CEO, medical school Dean and member of the National Academy of Medicine. She is regularly listed among Modern Healthcare's Most Influential Clinical Executives as well as Modern Healthcare’s Most Influential People in Healthcare.
Episode Bookmarks:
01:30 The World Health Organization has declared climate change as "the greatest threat to global health in the 21st century."
02:00 Climate change burden falls disproportionately on historically marginalized populations.
02:30 The responsibility to address the substantial greenhouse gas emissions generated by the healthcare sector.
03:00 Introduction to Vivian Lee, M.D.
04:30 One in four deaths can be attributed to preventable environmental causes...and climate change is exacerbating these risks.
06:00 Climate change resilience as a lens for value-based transformation.
06:45 The irrefutable scientific evidence about the unprecedented levels of carbon dioxide in our atmosphere.
07:00 What are health care leaders going to do about this? (The need to manage the crisis through an empowered workforce.)
08:30 Exposed vulnerabilities in our supply chain as a complication to address climate-related crises.
09:00 The healthcare industry is responsible for 8-10% of the overall carbon footprint of the country (more than twice the #2 country!)
10:00 How do we decarbonize healthcare in order to "do no harm"?
11:45 Pollution from health care–associated energy use results in an estimated 405,000 disability-adjusted life years annually (a burden comparable to that of preventable medical errors).
12:30 The strong business case for health care organizations to reduce their carbon footprint.
13:00 Tax credits offered by the Inflation Reduction Act ... -
A new era in value-based care is emerging where employers are no longer sleeping giants willing to tolerate a broken fee-for-service healthcare system. ‘Poor health' costs employers $575B in lost productivity on top of the $880B they already spend in premium dollars annually. Employers (and their employees) continued to get fleeced by unsustainable double-digit premium increases every year, with hospitals using that excess spend in commercial insurance to their subsidize losses on the public pay side. The paradigm shift to value-based purchasing is underway in employer-based health insurance; however, it will not achieve the aims of population health unless a similar transformation occurs in workforce wellbeing.
Joining us this week in the Race to Value is Dr. Richard Safeer, the Chief Medical Director of Employee Health and Well-being at Johns Hopkins Medicine, where he leads the Healthy at Hopkins employee health and well-being strategy. Dr. Safeer is a highly influential thought leader on building a culture of health and is the author of the groundbreaking new book, “A Cure for the Common Company: A Well-Being Prescription for a Hopper, Healthier, and More Resilient Workforce.” In this interview you will hear from one of the leading experts on employee health in our country about what it takes to cultivate a healthy workforce.
Episode Bookmarks:
01:30 Introduction to Richard Safeer, M.D. and “A Cure for the Common Company”
04:45 Developing a holistic view where we look at individuals as both patients and employees.
05:15 “Until we integrate a strategy that includes the workplace, we are not likely to optimize population health."
06:00 The economic and cultural imperatives for workforce well-being.
06:30 A key factor in achieving health goals is the support of people you are closest to at home and at work.
07:45 Connecting the spectrum of employee health from well-being to chronic disease.
08:30 Why have attempts at corporate wellness failed so often in the past?
09:30 “Our health and well-being are greatly influenced by the relationships we have in the workplace.”
10:00 Most employers do not fully leverage the social sciences to optimize the support of their workforce.
10:45 Innovative self-funded health insurance as a requisite component of a corporate wellness strategy.
12:30 How a company benefits from a healthy workforce.
13:45 Innovations to create access to high quality primary care and lifestyle medicine (e.g. Direct Primary Care and onsite clinics).
17:00 Employers must fully leverage all resources (e.g. data from health insurers, EAPs, collaboration with local health systems).
18:30 The 6 Building Blocks of a Wellbeing Culture.
20:45 Making it easier for employees to make healthy choices.
21:30 The influence of social climate in the workplace.
22:30 The plight of healthcare workforce burnout and moral injury.
23:45 We need supportive work environments to produce good health (not paternalism).
25:00 “Employers who demonstrate genuine care and back it up with genuine resources to support health and well-being will be the ones to attract and retain talent.”
25:30 Resiliency does not rest solely on the individual!
26:00 Employees cannot maintain mental health if their work doesn’t align with education and skill set.
27:00 Social connections to team and trust in management improves resiliency.
29:00 70-80% of employees are willing to take a pay cut to get a job that better supports their mental health (see UKG study)
30:00 Balancing the need for social connection with remote work.
31:30 Referencing the new book, “Culture Shock: An Unstoppable Force is Changing How We Work and Live.”
32:00 One-size fits all decisions about onsite work doesn’t make sense for all employees.
33:30 Cisco Systems as an exemplar of a workplace culture for health and well-being.
36:00 The role of technology in health is superseded in importance by the workplace, home, and community settings. -
The future of health will be shaped by consumer expectations for a mobile-centric experience with personalized insights and care services. Information is determinant of health, where people already search for health information on Google hundreds of millions of times a day. Additionally people view YouTube videos about health conditions 100 billion times globally in a year. As consumers seek information ubiquity in their online experience, health information will also become more personalized through wearables and other mobile devices.
Our future in health will also be enabled by AI. Artificial Intelligence has the potential to transform the health of people on a planetary scale akin to the discovery of penicillin. If developed boldly and responsibly, AI will be a powerful for health equity on a global scale. It will also bring the joy back to practicing medicine by reducing cognitive burden and giving providers more time to spend with patient.
In this week’s episode, we explore health tech consumerism and AI enablement with Dr. Karen DeSalvo, Chief Health Officer at Google. Dr. DeSalvo is an internist and health leader working at the intersection of medicine, public health, and information technology. She has dedicated her career to improving health outcomes for all with a focus on solutions that address all the determinants of health. Dr. DeSalvo continues to be a powerful voice and advocate for eliminating inequities and improving the public’s health. Under her watch, Google has optimized search and YouTube to better answer common health questions, updated its consumer health wearables to function more like medical devices and built artificial intelligence products to meet industry demands.
This episode covers various topics in the realm of healthcare technology innovation from consumerism, Generative AI and LLMs, health equity by design, and various initiatives underway at Google to connect and bring meaning to health information. In the interview, we also discuss the role of technology in mitigating the health impacts of climate change and addressing the epidemic of loneliness and isolation at a global level.
Episode Bookmarks:
01:30 Introduction to Karen DeSalvo, Chief Health Officer at Google.
03:30 How Google understands “information as a determinant of health.”
05:00 “We see heavy consumer orientation to the way we see our opportunity to improve the health of everyone everywhere.”
05:30 The evolution of healthcare businesses to meet people in an increasingly virtual world with ever-changing consumer expectations.
06:00 Informing health empowerment through high quality information and personalized insights.
06:30 Personal reflections from clinical practice when the flow of information was not enabled by technology automation.
07:30 Modern-day tools for patient education and personal health tracking and measurement.
08:00 The optimization of Google search results to convey trust in the provision of health information.
08:30 “The conveyance of information through trusted messengers is an important way we address information as a determinant of health.”
09:00 Patients showing up with more knowledge and power – a priority goal for Google Health.
09:30 How AI can improve health for everyone everywhere. (Karen’s recent blog on the future of AI as a transformational path forward in population health.)
10:00 Leveraging AI at Google Health to advance medical research, improve accuracy and efficiency of diagnostic processes, and improve health information quality.
11:00 A future world were everyone has access to the best quality care on their phone (e.g. AI-enabled health agents combined with the human care team).
12:00 Developing health technology for the entire world. (“A billion people on the planet don’t have access to primary care.”)
12:15 AI can address workforce challenges by reducing cognitive load to address burnout and filling capability and capacity gaps. -
In caring for our communities, a carefully designed Care Continuum Blueprint becomes the roadmap to enhanced population health outcomes—a testament to the profound impact of integrated care and strategic coordination. There has never been a more compelling time to adopt a system of care based on population health management. The COVID-19 pandemic revealed substantial health disparities and compels us to take action. The population is aging, and the Medicare insolvency crisis is looming. Now is the time to move away from fee-for-service care and toward an approach that prioritizes quality, outcomes, and affordability for all populations.
In this week’s episode, we interview Dr. Mark Angelo, a senior administrator of a large accountable care organization and a leader in population health and palliative medicine. He is the author of the new book Caring for Our Communities: A Blueprint for Better Outcomes in Population Health, that provides tactical guidance for developing effective population health programs and explores value-based care models. Dr. Angelo is an inspirational leader to the health value movement, providing a road map for creating an equitable, outcomes-focused system, using the right resources to nurture the health of our communities.
Dr. Mark Angelo currently serves as CEO and President for the Delaware Valley ACO (DVACO). In this role, he oversees clinical strategy and operations, including quality, population health pharmacy, clinical integration, care coordination, post-acute networks and practice transformation. In addition to serving patient communities as an executive with the ACO, he is a practicing palliative care doctor who continues to see patients. DVACO has participated in the MSSP since 2014 and also works with commercial and Medicare Advantage payers in an effort to grow and expand the mission of value-based care in the Greater Philadelphia area.
Episode Bookmarks:
01:30 Introduction to Delaware Valley ACO and Mark Angelo, MD, MHA, FACP.
04:30 Referencing Dr. Angelo’s new book Caring for Our Communities: A Blueprint for Better Outcomes in Population Health.
05:00 “Never doubt that a small group of thoughtful committed citizens can change the world; indeed, it is the only thing that ever has.” -- Margaret Mead
06:00 Dr. Angelo provides his perspective on population health underpinned by his clinical practice of palliative care.
07:30 A care continuum strategy that ensures care continuity, collaborative planning, and case management for complex patients.
09:30 The post-acute care journey at DVACO that began in 2014.
10:30 The Skilled Nursing component of DVACO’s post-acute care strategy.
11:30 Using claims data and real-time readmission tracing to monitor performance of SNF partners.
12:30 Graduating from a post-acute care focus to an overall care continuum strategy.
13:45 Optimizing home health to prevent avoidable hospitalizations.
14:30 How to identify suboptimal hospice care (e.g. length of stay greater than 180 days).
16:30 Home-based therapy as part of the care continuum to reduce TCOC in a frail elderly population.
18:00 An optimal zone of therapy between 12 and 32 therapy units over the course of a year.
19:00 Medicare reimbursement differentials across the different settings in a post-acute care continuum.
20:30 Building a population health playbook in post-acute care begins with SNFs.
22:00 Assessing performance data in developing a small SNF network to guide steerage decisions.
23:30 Applying the SNF assessment strategy in the vetting of preferred providers in home health and hospice.
26:00 Are partnering PAC facilities communicating with you in a meaningful way?
26:45 “Discharge planning shouldn’t happen in the last 24 hours of discharge. It should be happening all along. This is an important factor when it comes to creating partnerships across the care continuum.”
28:00 DVACO (in partnership with Main Line Health) developed a palliative care program that red... -
With 1 out of every 3 U.S. health care dollars emanating from Washington, the federal government is the single largest payer of health services in the United States and accounts for nearly half of all national health spending. As our country ages, these forces are accelerating, with Medicare spending alone projected to increase by 7.5% annually through 2031. Healthcare companies that depend on government revenue – or are downstream from it – must begin to view policymakers as among their most important customers. Impactful organizations that will succeed in the new era of value-based care will learn how to leverage the unparalleled value of internal advocacy. By creating extraordinarily powerful messaging for policymakers to understand what is needed for value-based innovation, we exercise our right to form a more perfect union. While healthcare will never be perfect, we must still strive for perfection – that is at the heart of value-based care transformation in our country!
On the Race to Value this week, we interview Andrew Schwab – a value-based care leader, an intentional strategist, and a master of Washington’s internal game. He brings a bold, brash, no-holds-barred approach to government affairs by coaching and mentoring forward-thinking organizations ready to invest in their internal policy teams so they can thrive in a new era of value-based care. Prior to establishing his own firm, Platform Government Strategies, Andrew advocated in-house on behalf of both nonprofits and private sector organizations. Most recently, Andrew established Oak Street Health’s first government affairs function that put them at the center of the national value-based care conversation and contributed to their recent acquisition by CVS Health.
Episode Bookmarks:
01:30 The federal government is the single largest payer of health services and accounts for nearly half of all national health spending.
02:00 Healthcare companies that depend on government revenue must begin to view policymakers as among their most important customers.
02:30 Introduction to Andrew Schwab and his public affairs consulting firm, Platform Government Strategies.
05:30 The glacial pace of the value-based care movement. Is there truly bipartisan consensus on the aims of health value?
07:00 2030 Medicare VBC Goal (“The government is putting its thumb on the scale for value-based care.”)
08:15 The 1st Amendment right to petition government for redress of grievances (“Advocacy and lobbying are quintessentially American.”)
09:00 “Elected officials and appointed regulators in Washington D.C. and in state capitals react to a different set of incentives.”
10:00 Explosive growth of the Medicare Advantage program.
11:00 Consumer-centric innovation and higher quality of care in MA plans.
11:30 Political controversy with MA (e.g. PE-backing, overpayment concerns, risk adjustment gaming, “perverse business model”)
13:00 Critics of MA ranging from physicians and hospitals protecting the “sanctity of fee-for-service" to those leery of privatization.
13:30 The incredible popularity of MA and the research showing it has superior outcomes.
14:00 Mitigating the potential for upcoding with the new V28 risk adjustment methodology being implemented over next 3 years.
15:00 MA is paid more than Traditional Medicare, but it offers more in terms of benefits (e.g. hearing, dental, vision, population health interventions).
16:00 Private equity investment and payvider innovation (e.g. Oak Street Health, VillageMD, Centerwell, Archwell).
17:00 The importance of Patient-Reported Outcome Measures since process measures alone don’t achieve patient-centeredness.
19:00 “Outcomes should be the most important metric by which we judge the health of our healthcare system.”
20:00 “We need to put providers that participate in value-based relationships at the center of advocacy pushes in Washington and in state capitals.”
21:00 If we are incentivized to keep patients healthy and out ... -
The future of care is not confined by walls; it thrives in the heart of homes, where compassion meets innovation, and healing becomes a daily experience. Home-based primary care with full-risk Medicare Advantage is a transformative model that not only brings health care to the doorstep of our seniors but also places the responsibility for their well-being squarely in the hands of dedicated providers, creating a proactive and patient-centered approach to aging with dignity and comprehensive care. By making primary care easier to access for our nation’s seniors, we can deliver personalized care that meets their needs; help them stay healthy and feel better; and live well with existing conditions so they can prepare for what’s ahead.
This week we are joined by two executive leaders from WellBe Senior Medical -- the largest and fastest growing independent home-based medical group in the country. WellBe is a global risk medical group that provides longitudinal geriatric care to underserved, frail, complex, and homebound Medicare Advantage beneficiaries. In this episode, we feature Dr. Jeffrey Kang, Chief Executive Officer and Mike Stuart, Chief Growth Officer from WellBe Senior Medical.
Dr. Kang is a geriatrician with extensive experience in global risk and primary care for frail, elderly, and disabled populations. Mike Stuart has extensive experience in fostering partnerships with health plans, health systems, and provider groups and leads commercial strategy and partnership development for WellBe Senior Medical. In this interview you will learn about the home-based care continuum, primary care innovation, mission-driven leadership, Medicare Advantage risk, and the future of value-based primary care.
Episode Bookmarks:
01:30 An overview of WellBe Senior Medical – a global risk primary care group providing longitudinal geriatric care in the home.
02:30 Introduction to Dr. Jeffrey Kang, WellBe CEO (formerly served as ChenMed President, Walgreens SVP, Cigna CMO, and CMS CMO).
03:00 Introduction to Mike Stuart, WellBe Chief Growth Officer (formerly served in executive leadership roles at Somatus and Evolent).
05:00 An overview of the home care continuum (e.g. acute, post-acute, custodial, longitudinal primary care, DME, home infusion).
08:00 How WellBe is helping patients navigate and coordinate the fragmentation of home care point solutions.
10:30 A mission to help senior patients “lead healthier meaningful lives by delivering the most complete care”.
11:30 Opportunities to make care in the home more multidisciplinary, personalized, and SDOH-responsive.
12:00 Proactive vs. Reactive Care (leveraging analytics and unique provider skillsets for population health).
13:30 The clinical persona of the “frail elderly” and why WellBe focuses on this target population.
14:30 “Everything done in a primary care office can actually be done at home.”
15:30 “Home-based primary care is the best thing to do. You get better outcomes and better patient satisfaction.”
15:45 Is it possible to deliver high quality primary care (like ChenMed or Oak Street) in the home setting?
16:30 Referencing Marcus Welby, M.D. as an example of an empathetic approach to delivering care in the home (see Season 1 Trailer)
17:00 Care Fragmentation Challenges - NEJM found that the average Medicare patient sees a median of two PCPs and five specialist physicians per year.
18:00 “Quality of Life” is more important than “Quantity of Life” (why empathy and compassion matter most in caring for frail seniors).
19:30 Patients define a good doctor by bedside manner and respect given.
20:30 How the economics of full global risk enable complete care models for seniors.
20:30 Scalable home-based primary care is a new approach in value-based care.
23:00 WellBe’s results (e.g. >50% neighborhood engagement, patient satisfaction is at 95%, and MLR improvement >40% in 3yrs).
23:30 The importance of reaching a 4 Star Rating in a Medicare Advantage plan. -
Many factors impact our health beyond genetics and aging. Collectively, these are called social determinants of health and include factors such as education, housing, income, occupation, hunger, language, literacy, where we live, and access to affordable healthcare services. However, there is a gap in the current list of social determinants of health, and that is the influence of “information” or an “information ecosystem” on patients’ behavior, engagement, and health outcomes. It is critical to consider “information” as another social determinant of health since it can be used to drive positive patient health outcomes. How we deliver it, where we deliver it, and who delivers it is crucial to value-based health care transformation and patient-centeredness.
So, how do we harness this idea that information can change health outcomes? To answer this question, we have invited Debbie Welle-Powell back to the Race to Value! As a 30-year healthcare executive veteran, value-based care thought leader, and educator, she is committed to the empowerment of change management principles to drive population health at the intersection of patient engagement and information sharing. In this episode, we discuss what is needed to empower the patient and clinician, technology-enablement and value-based payment to fine tune the delivery system, and the information ecosystem needed to drive healthy outcomes.
As a companion to this podcast, make sure to read Debbie’s new article on this topic. It is available for download on the Race to Value webpage for this episode!
Information as a Social Determinant of Health
Episode Bookmarks:
01:30 Introduction to Debbie Welle-Powell, a healthcare executive veteran whose work focuses on delivering affordable and accessible high quality care.
02:45 Reference previous R2V episode - “Climbing the Mountain: Reaching New Heights for a Transformative Future”)
03:00 Read the companion article to this interview on the Race to Value episode website!
03:45 Debbie provides a brief update on her professional work in value-based care (and her mountain climbing adventures!)
05:30 The influence of “information" or an "information ecosystem” on patients’ behavior, engagement, and health outcomes.
06:30 Should we consider information as another Social Determinant of Health (like transportation, education, housing, and food security)?
07:30 “Information only really matters if it helps patients change behaviors. The delivery of information is crucial to empowering health outcomes.”
08:30 “The American healthcare system is not as patient-centric as it claims to be because of a failure to provide empowering information.”
09:00 The roles of clinicians and patients to improve health literacy.
10:00 Patient noncompliance – Ex: 20-30% do not pick up prescriptions, 30-40% do not follow-through on referrals.
10:45 The challenges of interpreting and addressing SDOH challenges to avoid unnecessary utilization.
12:00 The importance of the patient-provider relationship. (Eric shares insights from his healthcare trip to Cuba.)
14:30 Technology enablement and health system evolution to better address patient information needs.
15:00 Improving patient engagement through the online user journey (i.e. the digital front door).
15:45 Debbie shares a personal example from her cancer journey where the care team failed to provide adequate information.
17:00 Half of patients seeking receive misleading information when independently searching online sources.
17:30 The opportunity for clinicians to provide trusted and reliable online educational resources.
18:00 The hyper-saturation of online content (e.g. 500 hours of content uploaded to YouTube per minute!)
18:30 How the value-based care movement provides incentives for improving patient engagement.
19:30 The use of Generative AI in the clinical setting to help patients better navigate their care journey.
20:45 Merging the science of medicine with the art of informat... -
A revolution is imminent in American healthcare, and “the revolution will not be televised” for passive observation. Value-based care transformation, like any other important movement, requires the active participation of all leaders on the frontlines. However, for these leaders to make the right decisions, they need to embrace innovation in order to realize the fullest potential of generative AI and predictive analytics. Through the reengineering of care delivery, we can achieve a more personalized, proactive, and efficient outcomes-based model that can ultimately transform population health.
As we navigate this transformative journey, data will play a pivotal role in reshaping the landscape of care delivery. And no one knows this better than Nassib Chamoun, Founder President & CEO of Health Data Analytics Institute (HDAI), our guest this week on Race to Value. In this episode, you will hear from a leader and primary inventor of a broad-based population health data analytics platform, enabling healthcare providers to make informed decisions based on real-time information. Tune in to an informative conversation covering such topics as data aggregation, predictive analytics, digital twinning, network management, generative AI in clinical care, and future advancements in technology-enabled value-based care.
Episode Bookmarks:
01:30 The Imminent “Big Data” Revolution in Value-Based Care
02:00 Introduction to Nassib Chamoun of Health Data Analytics Institute
03:00 As a teenager living in Beirut, Nassib experienced the horror of a civil war.
04:00 The inventor of Bispectral Index monitoring – a technology standard in operating rooms around the world.
05:00 Nassib discusses the pivotal moments in his life that shaped a passion for data analytics in healthcare.
07:00 80% of health information in EHRs is unstructured and entirely unusable unless converted to discrete data.
07:45 CMS provided HDAI a highly coveted Innovator’s License that allows the company access to data on 100 million Medicare beneficiaries.
09:00 How Big Data drives powerful AI algorithms and predictive models in healthcare.
10:00 “If you can’t measure something, you can’t improve it.”
11:00 Understanding the intersection between cost, outcomes, and utilization.
11:30 Making data actionable in order to effectuate change in care delivery.
11:45 Data overload can actually lead to clinical inefficiencies if it isn’t curated appropriately.
12:30 The artful curation of data to drive operational improvements at point-of-care.
14:00 The limitations of claims data in making timely clinical decisions and treatment interventions.
15:00 Interpretation of unstructured EHR data to extract potential new conditions and HCC coding opportunities.
16:00 The importance of clinical judgement in augmenting AI-based recommendations in value-based care.
17:00 Combining behavioral, psychosocial, and biometric data with the existing sciences of epidemiology and clinical medicine.
18:00 Generalized clinical use cases of AI at the point-of-care to improve costs, outcomes, and utilization.
19:00 “To be successful in value-based care, you must operationalize two separate goals: Prevention and Avoidance of Complications.”
20:30 “The goal of AI is to very simply do what a clinician does, but do it repeatedly and do it continuously for every patient in their cohort.”
21:00 How staffing limitations and an aging populations necessitates a more optimal use of technology in VBC.
22:00 In 2032, U.S. healthcare spending will reach $8 trillion (ahead of the economy of Japan) making it the third largest economy in the world!
22:45 Leveraging predictive models to drive more effective care coordination and interdisciplinary team-based care.
24:30 Patient engagement as one of the more challenging aspects of value-based care.
26:30 The integration of predictive analytics and digital twinning for individualized patient care.
28:45 Using multiple predictors to serve every comp... -
Everyone needs access to quality, affordable health care regardless of health status, social need or income. To reach this paradigm shift, healthcare leaders must evangelize within industry and communities they serve. There is a better path forward for American health care – one that is people-centered and transformational; however, to get there we must unite the power of one at the intersection of people, policy, and politics. By listening to people’s needs, jointly developing policy solutions, and partnering with others, we can ensure our health care system works for everyone.This week on the Race to Value, we bring to you Natalie Davis and Dr. Venice Haynes at the United States of Care, a nonprofit organization focused on an ambitious goal to achieve universal access to quality and affordable healthcare for all Americans. It brings together stakeholders from various backgrounds, including healthcare experts, patients, policymakers, and advocates, to develop and implement practical, bipartisan solutions to improve the healthcare system in the United States. By fostering dialogue and collaboration, conducting research, and advocating for policies that enhance access, lower costs, and improve healthcare outcomes, the organization finds common ground and works across party lines and ideological divides to address the healthcare challenges facing the nation.As CEO and Co-Founder of the United States of Care, Natalie Davis is on a mission to reshape and implement American health care policies that improves the lives of all people. Dr. Venice Haynes, the Director of Research & Community Engagement for United States of Care, is a social and behavioral scientist focused on an overarching research agenda to address social determinants of health and health disparities in underserved populations using qualitative and community-based participatory approaches. In this episode we talk about the tenets of patient-first care (a.k.a. value-based care) including affordability, dependability, personalization, and understandability. We also have an in-depth conversation on the power of storytelling in health care transformation and the imperative to overcome structural barriers in the creation of health equity.Episode Bookmarks:01:30 United States of Care, a nonprofit organization focused on an ambitious goal to achieve universal access to quality and affordable healthcare for all Americans.02:00 Introduction to Natalie Davis, Chief Executive Officer and Co-Founder.02:45 Introduction to Venice Haynes, PhD, Director of Research & Community Engagement.05:00 Natalie shares her personal story that led her towards an entrepreneurial career path in health care policy transformation.07:30 Mentorship from Andy Slavitt and his advice to get out of Washington, D.C. to make an impact on health policy.08:30 Venice discusses how her science and public health background inspired her to lead people-centered health care change.11:45 Inspiration from Camara Phyllis Jones, a physician, epidemiologist, and anti-racism activist who specializes in the effects of racism and social inequalities on health.14:30 When offered an alternative, by a 4:1 margin, people favor a model that compensates providers for improving overall health, delivering superior care, and coordinating patient care.15:30 What it means for United States of Care to be at the intersection of people, policy, and politics in health care transformation.16:00 Research and listening to people as a way to overcome tribalism and build an agenda of reform for the whole country!16:45 The 4 goals and 12 solutions of United States of Care to meet the needs of people across demographics and can drive collection action to build a better health care system.18:30 “The 4 goals of United States of Care – Affordability, Dependability, Personalization, and Understandability – comprehensively cannot be done in a fee-for-service model.”
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In the Race to Value, we must recognize that quality of life is the ultimate currency of healthcare, and this aim is all the more important in senior living facilities. Transforming health outcomes for skilled nursing and senior living populations is not just a goal; it's a commitment to providing the care and dignity our elders deserve. This week, we profile a leader in the value movement who leads a company on a mission “to improve the health, happiness, and dignity of senior living residents”. We are joined by Mark Price, CEO of Curana Health – a leader who lives by the mantra that “extreme passion” is the single most important ingredient to reform the American healthcare system.
Curana Health is a provider of value-based primary care services exclusively for the senior living industry, including in nursing homes, assisted/independent living facilities, CCRC/life plan communities and affordable senior housing communities. Curana Health serves more than 1,100 senior living community partners across 30 states and participates in the MSSP ACO, ACO Reach and Medicare Advantage programs with CMS. Backed by more than $300M in venture capital funding, the organization is poised to disrupt care delivery in senior living on a meaningful scale through innovative care models and applied analytics.
In this episode, you will learn about how to transform health outcomes for skilled nursing and senior living populations through extreme passion. We cover such topics as how to leverage APMs such as MSSP and ACO REACH in the senior living setting, the performance results of Curana Health across their value-based portfolio, technology innovation, palliative care, the state of the nursing home industry, and future trends in the shift to home-based care delivery.
Episode Bookmarks:
01:30 Introduction to Mark Price, CEO of Curana Health.
03:45 An estimated 27M more people are aging into the 75+ cohort through 2050, resulting in rising age and higher health acuity levels of residents moving into senior living.
05:00 Curana Health has achieved a 39% reduction in 30-day hospital readmissions and a 37% reduction in total hospital admissions among Medicare Advantage I-SNP members.
06:00 “There are many subsectors in the industry where value-based care can succeed. The important thing is ensuring that your people have an extreme amount of passion for making it work.”
07:00 Founding story of Curana Health based on how we would want our loved ones to be cared for at the end of life.
08:45 The majority of Americans will spend some time in senior living or skilled nursing in the final years of their life.
10:00 Elite Patient Care ACO performed in the top 1% of ACOs in its first year of operation, achieving PBPY savings amount of $2,235—the highest PBPY for any first-year MSSP ACO since 2012.
11:30 Curana Health also has one of the top performing ACO REACH and risk-based MA I-SNP programs in the country.
11:45 “Our core business is not a payment model. It is a clinical model that produces health outcomes which, in turn, enables affordability as well.”
13:00 Developing a population health playbook for the senior living space.
14:00 Success in developing a level of clinical integration within a senior living facility that is now owned by the company.
15:00 MA Institutional Special Needs Plans (I-SNPs) are designed to meet the needs of people living in long-term care settings such as long-term care nursing, skilled nursing facilities, and inpatient psychiatric facilities.
16:45 Facilities are taking an ownership position of MA plans for senior living and skilled nursing residents.
17:00 Mark provides perspective on I-SNPs and how the Curana Health clinical model is achieving results to improve clinical outcomes.
18:30 Performing well by recognizing the commonality between MSSP, ACO REACH, and Medicare Advantage.
20:00 How CMS and CMMI is incorporating innovation to value-based payment models (e.g.SNF 3-Day Rule Waiver). -
Connecting the health and wellbeing of patients of patients directly to the bottom line isn’t just good business; it is a visionary approach that shows how healthier outcomes can actually drive healthier profitability. Continued success in demonstrating the correlation between clinical and financial outcomes will be a catalyst for generating societal wellbeing that paves the way for others to adopt value-based care. And in doing so, we create a more sustainable and effective healthcare ecosystem. In this Race to Value, the true race isn’t about speed; it is about the journey to improved outcomes. Strategic and transformational partnerships guided by an enabling vision to improve population health will ultimately create a healthcare system that we can be proud of.
In this episode, you will hear from Kyle Wailes, the Chief Executive Officer and Board Member of value-based care company, Wellvana. Kyle Wailes is someone on a mission to demonstrate how fully-capitated models in primary care, empowered by the right partnerships to create enablement, will ultimately drive patient behavior change. Under his leadership, Wellvana is an industry-leading example of a company that is connecting the healthy outcomes of patients directly to healthier profitability. With the tools, technologies, analytics, and resources for healthcare providers to successfully and seamlessly transition to value-based care, Wellvana is getting outstanding results and growing at an exponential rate for such a young company. This is highlighted by the recent announcement of their partnership with AdventHealth to revolutionize primary care in the state of Florida. Don’t miss this important interview to learn more about VBC enablement, high-touch primary care and clinical integration, the power of storytelling, patient behavior change, lifestyle medicine, and the current state of private equity investment in healthcare!
Episode Bookmarks:
01:30 Connecting healthy outcomes of patients to healthier profitability. (A High-Touch Approach for High Performers)
02:00 Introduction to Kyle Wailes, Chief Executive Officer and Board Member at Wellvana.
04:00 Big Announcement -- AdventHealth partners with Wellvana to transition its Florida primary care network to VBC
05:00 Wellvana is the first value-based care enablement organization in the country to partner with a multi-state/national health system.
06:00 Kyle provides more details on how Wellvana’s recently announced partnership will impact the delivery of healthcare in Florida.
06:30 “Building clinically integrated primary care networks across the country requires flexibility.”
07:00 Expanding primary care impact through interdisciplinary roles (e.g. case management, care coordination, pharmacy integration, social work, coding)
07:45 Health systems across the country are extremely distressed with expenses growing 2X as fast as Medicare payments.
09:30 “The pandemic has been an accelerant overall to drive the adoption of value-based care.”
09:45 The opportunity to reposition primary care in the health system setting, taking it from loss leader to profit center, as a strategic cornerstone for transformation.
10:00 A health system focused only on fee-for-service can lose up to $200-300K per employed PCP.
10:30 “Clinically integrated primary care networks can drive better clinical outcomes, but they can also drive profit and growth as well.”
11:00 Flexibility in growing a PCP network through either an employed or affiliated model.
11:30 Kyle’s personal journey as a professional athlete, student of neuroscience, and value-based healthcare executive.
12:30 “The Story of the Chinese Farmer” – a parable that illustrates the idea that events that initially seem bad or good can lead to unexpected outcomes.
14:00 Kyle provides perspective on the highs and lows of life and how that translates to theculture at Wellvana.
15:00 Lessons learned from playing competitive sports (discipline, hard work, - Mehr anzeigen
