PODCAST

The Race to Value Podcast

Accountable Care Learning Collaborative

We are in a race to make health value work. Join Dr. Eric Weaver and Daniel Chipping of the Accountable Care Learning Collaborative as they interview top executives, physicians, and entrepreneurs leading the transformation to health value.

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Preparing the Workforce for the Future of Population Health Equity, with Dr. Jim Walton, Christina Severin, Joy Doll, and Dr. Richard Walker
Today
Preparing the Workforce for the Future of Population Health Equity, with Dr. Jim Walton, Christina Severin, Joy Doll, and Dr. Richard Walker
While there have been meaningful improvements in healthcare delivery over the last decade, they have not catalyzed the transformation necessary to advance health value and equity. The promulgation of health policy and the implementation of new alternative payment models have created a landscape for experimentation in value-based care, yet the seismic shift needed to facilitate long-term and sustainable improvements has yet to occur. The key enabler for the future of our industry is workforce readiness to deliver on the promise of high-value, high-quality care that delivers equitable outcomes for all. This week on the Race to Value podcast, you are going to hear from a distinguished panel of industry experts on the importance of workforce development in value transformation.  Workforce development will drive success in value-based care by ensuring industry capability, and it will help underserved communities thrive through population health interventions that improve societal outcomes and reduce inequities. As you listen to this discussion with Dr. Jim Walton, Christina Severin, Joy Doll, and Dr. Richard Walker, think about how the scale and impact of workforce skill and knowledge is either a force multiplier or an impedance for change. If you want to learn more about affordable educational pathways for reskilling and upskilling in preparing for risk-based payment after hearing this discussion, please reach out to the Institute for Advancing Health Value – your partner in developing a competent workforce to win this Race to Value! Episode Bookmarks: 01:30 The key enabler for the future of our industry is workforce readiness to deliver on the promise of high-value, high-quality care that delivers equitable outcomes for all. 02:00 Workforce development will drive success in value-based care by ensuring industry capability, and it will help underserved communities thrive through population health interventions. 03:00 The Institute for Advancing Health Value – your partner in developing a competent workforce for the future of value-based care 03:30 Introduction to expert panelists:  Dr. Jim Walton, Christina Severin, Joy Doll,and Dr. Richard Walker 06:00 The imperative to ensure health equity and reduce disparities in our most vulnerable populations 07:00 Dr. Walker shares the vision to serve underserved populations through reengineered primary care 08:45 How TVP-Care access to care with both a “high touch” and “high tech” model that reaches patients in their homes 09:30 Dr. Doll on how CyncHealth addresses health equity through data democratization within a longitudinal health record and community-based SDOH support ecosystem 10:30 Dr. Walton speaks to the importance of building an engaged ecosystem and how GPG realizes that “equity is a valuable business model for the future of private practicing physicians” 11:00 The impact of burnout and moral injury and how that will become a “self-fulfilling prophecy” without a value-based business model and workforce strategy 12:00 “We must have an ROI attached to social interventions; otherwise, we are just tilting at windmills.” (Harnessing AI/ML for predictive risk stratification of the patient population) 13:00     Christina Severin on how C3 approaches team-based care, social interventions, behavioral health in its FQHC network 14:00 Establishing a diversity, equity, and racial justice committee and building a data infrastructure to drive health equity 16:00 How CMS is integrating health equity in every stage of payment model development, including the new ACO REACH program 17:30 Christina Severin discusses on ACO REACH is a great step forward in program redesign to have a more adequate benchmark that represents the complexity of the population 18:30 Taking the time to understand the legacy of white supremacy in this country and how it impacts healthcare delivery 20:00 Dr. Walker on the importance of developing trust with pa...
Preparing the Workforce for the Future of Population Health Equity, with Dr. Jim Walton, Christina Severin, Joy Doll, and Dr. Richard Walker
Today
Preparing the Workforce for the Future of Population Health Equity, with Dr. Jim Walton, Christina Severin, Joy Doll, and Dr. Richard Walker
While there have been meaningful improvements in healthcare delivery over the last decade, they have not catalyzed the transformation necessary to advance health value and equity. The promulgation of health policy and the implementation of new alternative payment models have created a landscape for experimentation in value-based care, yet the seismic shift needed to facilitate long-term and sustainable improvements has yet to occur. The key enabler for the future of our industry is workforce readiness to deliver on the promise of high-value, high-quality care that delivers equitable outcomes for all. This week on the Race to Value podcast, you are going to hear from a distinguished panel of industry experts on the importance of workforce development in value transformation.  Workforce development will drive success in value-based care by ensuring industry capability, and it will help underserved communities thrive through population health interventions that improve societal outcomes and reduce inequities. As you listen to this discussion with Dr. Jim Walton, Christina Severin, Joy Doll, and Dr. Richard Walker, think about how the scale and impact of workforce skill and knowledge is either a force multiplier or an impedance for change. If you want to learn more about affordable educational pathways for reskilling and upskilling in preparing for risk-based payment after hearing this discussion, please reach out to the Institute for Advancing Health Value – your partner in developing a competent workforce to win this Race to Value! Episode Bookmarks: 01:30 The key enabler for the future of our industry is workforce readiness to deliver on the promise of high-value, high-quality care that delivers equitable outcomes for all. 02:00 Workforce development will drive success in value-based care by ensuring industry capability, and it will help underserved communities thrive through population health interventions. 03:00 The Institute for Advancing Health Value – your partner in developing a competent workforce for the future of value-based care 03:30 Introduction to expert panelists:  Dr. Jim Walton, Christina Severin, Joy Doll,and Dr. Richard Walker 06:00 The imperative to ensure health equity and reduce disparities in our most vulnerable populations 07:00 Dr. Walker shares the vision to serve underserved populations through reengineered primary care 08:45 How TVP-Care access to care with both a “high touch” and “high tech” model that reaches patients in their homes 09:30 Dr. Doll on how CyncHealth addresses health equity through data democratization within a longitudinal health record and community-based SDOH support ecosystem 10:30 Dr. Walton speaks to the importance of building an engaged ecosystem and how GPG realizes that “equity is a valuable business model for the future of private practicing physicians” 11:00 The impact of burnout and moral injury and how that will become a “self-fulfilling prophecy” without a value-based business model and workforce strategy 12:00 “We must have an ROI attached to social interventions; otherwise, we are just tilting at windmills.” (Harnessing AI/ML for predictive risk stratification of the patient population) 13:00     Christina Severin on how C3 approaches team-based care, social interventions, behavioral health in its FQHC network 14:00 Establishing a diversity, equity, and racial justice committee and building a data infrastructure to drive health equity 16:00 How CMS is integrating health equity in every stage of payment model development, including the new ACO REACH program 17:30 Christina Severin discusses on ACO REACH is a great step forward in program redesign to have a more adequate benchmark that represents the complexity of the population 18:30 Taking the time to understand the legacy of white supremacy in this country and how it impacts healthcare delivery 20:00 Dr. Walker on the importance of developing trust with pa...
Black Health Matters:  Improving Population Health Equity within African American Communities, with Dr. Richard W. Walker
Jun 28 2022
Black Health Matters: Improving Population Health Equity within African American Communities, with Dr. Richard W. Walker
It’s no secret that the Black community tops the list of groups afflicted by hypertension, stroke, diabetes, heart disease, kidney failure, and cancer. What the statistics do not show is the pain, misery, and despair that these conditions create—not only for the individual, but also for family and friends. As an African-American doctor, Dr. Richard Walker has studied these conditions among his patients for many years. Now, in his new book, “Black Health Matters”, Dr. Walker offers a number of commonsense ways to prevent, manage, and possibly eliminate these killers, turning the tide of African-American health. And he not only provides us with a construct for thought leadership in population health equity, he practices this type of care at his home-based primary care practice TVP-Care in Houston, Texas. Dr. Walker has spent considerable time in researching the health and healthcare journey of African captives into slavery and understands what current African Americans now to need to do to survive nutritionally and culturally. He is truly on a mission to overcome the chronic ill health and early death that is so pervasive in Black communities. Most importantly, however, Dr. Walker is a leader in the value movement that believes traditional medicine should be merged with lifestyle medicine. He understands that African Americans can turn their health around by understanding and incorporating better nutrition, nutritional supplements, exercise, and regular healthcare checkups into their lives. In this important podcast discussion, we you will learn from a leading clinician and entrepreneur how we should go about improving Population Health Equity within African American communities in this Race to Value! Episode Bookmarks: 01:30 Introduction to “Black Health Matters” and the work of Dr. Richard Walker in the health value movement 03:30 What does the use of the word “value” mean when it comes to community health? 05:00 Dr. Walker discusses his upbringing in Spanish Harlem and how that experience led him to become a physician leader seeking to advance health equity 07:00 The “mystery” of excessive hospitalizations due to sugar consumption and how that led to an epidemic of Type 2 Diabetes in the African American community 09:00 The misperception in the African American community that most common chronic diseases are genetic (instead of caused by environmental of lifestyle factors) 10:00 Dismantling the informational disadvantage that leads to a misunderstanding of Social Determinants of Health 12:00 The impact of the murder of George Floyd and the BLM social justice movement and how that inspired Dr. Walker to write “Black Health Matters” 14:30 How the collective experience of African Americans over the last 400+ years has been based on “waiting” (e.g. slavery, citizenship, civil rights) 16:00 “Taking care of your own life is all about taking charge of the environment by understanding the root causes that lead to disease.” 16:30 How poor nutrition in the African American community stems from the slavery era and persists to this day 17:30 The inadequate training of the healthcare workforce further exacerbates preexisting issues of poor health among African Americans 18:30 “Black Health Matters” is all about understanding the progenitors of chronic disease that are not genetic, and how to mitigate them in African American communities. 19:00 Environmental hazards and chemical toxicities are more common in underserved, minoritized communities 20:30 Research that confirms the presence of systemic issues in the healthcare industry related to institutional racism 22:00 “The concept of value-based care is transformational because it has the potential of changing the course in healthcare by recognizing the true value of the individual.” 23:30 Will value-based care bring us to the “Quintuple Aim” that includes health equity? 24:30 How the founding vision of Dr. Walker’s value-based,
Reclaiming Trust: Addressing Cardiovascular Health Disparities in Rural, Underserved Communities through CHW-Led Interventions, with Dr. Jessica Barnes and Chip Purcell
Jun 20 2022
Reclaiming Trust: Addressing Cardiovascular Health Disparities in Rural, Underserved Communities through CHW-Led Interventions, with Dr. Jessica Barnes and Chip Purcell
A bright future for the nation depends on the health and prosperity of rural America, and unfortunately, we are at a moment in time where life is not ideal in the rural heartland.  Although most rural Americans are generally satisfied with the overall quality of life and see their communities as safe, we are reaching a crisis when it comes to financial insecurity, trouble accessing affordable, high quality health care, a lack of high-speed internet access, housing problems, and isolation/loneliness. When it comes to health care, even though most rural Americans have health insurance, about one-quarter say they lack adequate health care access, as they have not been able to get the care they needed at some point in the past few years. Consequently, potentially preventable deaths from the five leading causes are consistently higher in rural counties, especially with heart disease.  (Nearly half of deaths from heart disease in rural counties are preventable, compared with 18% in large metropolitan areas.)  All of this has culminated into a mistrust of the traditional, fee-for-service dominated healthcare system and created a “shadow population” of underserved minorities and the socially isolated who are dealing with significant cardiovascular metabolic disease. The Arkansas Lincoln Project is an important population health program focused on improving cardiovascular health in highly underserved, under-resourced areas of the Arkansas Delta Region where economic and health disparities have life altering consequences for rural residents.  Joining us this week, we have two population health leaders sharing their insights about their work in deploying community-based cardiovascular health interventions led by community health workers. Chip Purcell is the director of cardiology research at the University of Arkansas Medical Sciences and the principal investigator of the Arkansas Lincoln Project.  Joining him is Dr. Jessica Barnes, the co-founder and CEO of 20Lighter, LLC – an award winning cardiometabolic health program, delivering dramatic reductions in inflammation and visceral fat.  Together they are winning the “Race to Value” by fighting cardiovascular metabolic disease in the Arkansas Delta, the worst region in the nation for healthcare quality and population health outcomes. Episode Bookmarks: 01:30 The challenges of obesity and cardiometabolic disease disparities in Rural America 02:00 Rural Americans facing financial insecurity, poor healthcare access and hospital closures, a lack of high-speed internet access, housing problems, and isolation/loneliness 02:45 “Nearly half of deaths from heart disease in rural counties are preventable, compared with 18% in large metropolitan areas.” 03:30 Introduction to Dr. Jessica Barnes (CEO of 20Lighter, LLC) and Chip Purcell (UAMS Cardiology Research and the principal investigator of the Arkansas Lincoln Project) 05:00 “Rural Americans tend to have higher rates of cigarette smoking, hypertension, and obesity, and report less leisure-time physical activity than their urban counterparts.” 06:20 The US News & World Report ranks Arkansas 50 out 50 states for overall healthcare quality with higher-than-average obesity rates and overall preventable hospital admissions 07:00 “Arkansas is the worst of the worst in health outcomes, and that is where we can make a difference.” 08:00 Mistrust of the healthcare system is pervasive in the Arkansas Delta Region 09:30 The exponential growth curve in building trust through improvement in individualized patient outcomes 10:00 Studying out-of-hospital, premature natural deaths as a proxy for determining population health needs in Eastern Arkansas (how the Lincoln Project began) 12:30 The use of geospatial mapping to identify the highest risk communities to target with cardiovascular health interventions led by community health workers 16:30 The economic challenges of Phillips County,
Bending the Arc of the Future Towards Person-Centered, Value-Based Care, with Dr. Mark McClellan
Jun 13 2022
Bending the Arc of the Future Towards Person-Centered, Value-Based Care, with Dr. Mark McClellan
The arc of the future bends in the direction of person-centered care. While payment reform is critical, our nation must also deliver whole-person care models that are exquisitely attuned to both medical and non-medical needs and intentional about addressing unique problems facing racial and ethnic minorities. The entrenched interests perpetuating the status quo of the fee-for-service, medical-industrial complex are immense; however, the pandemic is a catalyst for consumer-driven, value-based payment reform. In this week’s episode of Race to Value, you will hear from Dr. Mark McClellan, former CMS Administrator and current Director of the Duke Margolis Center for Health Policy.  As one of the leading physician economists and health policy leaders in our country, he discusses the future of health reform and value-based care. We cover such topics as health policy and alternative payment models, COVID-19 impacts on healthcare, advanced primary care that goes upstream in the detection and treatment of chronic disease, technology-enabled care delivery transformation, health equity and social determinants of health, specialist integration in person-centered care models, and the path forward to comprehensive value-based care in our country. Episode Bookmarks: 01:30 Introduction to Dr. Mark McClellan 03:00 Launching Medicare Part D, Medicare Advantage, and the ACLC (now the Institute for Advancing Health Value) 04:00 “While payment reform is critical, there are other essential steps that go along with it.” 05:30 “In this journey to value that we need to bring all patients along. That means explicit and intentional attention to equity and the special problems facing racial and ethnic minorities.” 06:00 Achieving a whole-person approach to health reform through patient engagement and “going upstream” 07:30 Upstream opportunities to address the prevention and management of cardiovascular disease 09:00 The impact of the COVID-19 pandemic on Value-Based Care and the recent advancements in biotechnology and clinical treatment 12:00 The parallel transformation in care delivery and organizational culture that happens in value-based payment reform 14:00 How innovation in through emerging medical technologies and virtual care technologies will delivery value (even if costs increase) 15:00 Digital apps, home based care, and community-based care to address upstream non-medical factors that the social drivers of poor health 16:00 The limitation of current reimbursement models in addressing the social factors that influence health 16:40 “Payment reform remains an important component of making faster progress in achieving value and achieving equity in our health care system.” 17:00 The work that Drs. McClellan and Mark Harrison from Intermountain are doing as co-chairs of the Health Care Payment Learning Action Network (HCP-LAN) 18:30 The current pace of the value movement and how “accountability for results and value at the person level is really the core theme behind payment reform” 19:20 “The arc of the future for medical care bends in the direction of person-centered care.” 20:00 Perspective on value-based reform success between Medicare, Medicaid, and Commercial plans 20:45 The importance of measuring race and ethnicity reliably and then incorporating a focus on equity for traditionally underserved populations 21:30 Healthcare revenue disruptions during the pandemic as a recognition for the need of value-based payment reforms 23:30 How organizations that were further along in adopting advanced payment reforms experienced less financial disruption during COVID-19 24:30 The newfound appreciation that the American public has for convenient, virtually-enabled, person-centered care models 26:20 Referencing the Duke Margolis Center for Health Policy report, “Value-Based Care in the COVID-19 Era” 27:30 The new CMMI Strategy Refresh that focuses on both Accountable Care and Healt...
Defeating Political Sectarianism to Achieve Analytics-Based Value Innovation, with Michael Millenson
Jun 6 2022
Defeating Political Sectarianism to Achieve Analytics-Based Value Innovation, with Michael Millenson
As we talk about the current zeitgeist moving us towards value and equity, we also have to think about how polarized our country is politically. Democrats and Republicans live in separate worlds, or “echo chambers,” with each side prone to bias or “motivated reasoning.” This has created an existential threat of tribalism where partisanship has turned Americans against one another.  The term that best describes our strife is “political sectarianism,” or the tendency of political groups to align on the basis of moralized identities rather than shared ideas or policy preferences.  However, the promise of value-based care is something that we should all agree on in a bipartisan way.  The Race to Value is both an economic and a moral imperative, and it can be actualized through relationship-based care, collaborative health models, and the power of advanced analytics. In this week’s episode, we interview Michael L. Millenson, an internationally recognized expert on making American health care better, safer and more patient-centered. As a leading expert on health policy, quality improvement, and patient-centered care, he provides a deeply informed and unfiltered perspective on how to defeat political sectarianism to achieve analytics-based value innovation.  This intellectual conversation leaves nothing unsaid and will provide you with an enhanced understanding of the political challenges of value transformation and how analytics will drive collaborative health in the Information Age. Episode Bookmarks: 01:30 Introduction to Michael Millenson 03:30 The “Race to Value” — is this a revolution? 06:00 “Value-based care is the ethically right thing to do.” 06:45 Confusion about value in health. (Public perception equates the term “value-based care” to fast food.) 07:30 Referencing Walter McClure, Ph.D and the ‘Buy Right’ strategy of health care reform 08:00 “Value-based care is the most important transformation of American medicine in our lifetimes.” 10:30 The dilemma of VBC (you must first recognize that poor quality exists currently to realize the potential for value) 12:00 Political sectarianism – how tribalism and entrenched interests hinder health policy 13:30 Winners and Losers in health policy reform and how “motivated losers” fight back! 15:30 How social media and suspicion stifles value-based payment innovation and the promise of bipartisan reform 16:30 Authentic healthcare leaders realize the need for value (there is hope!) 18:30 How do you engage providers to root out clinical variation and unnecessary care? 20:00 The need for Patient Safety and Quality Improvement in Healthcare 21:00 Referencing Michael’s book, “Demanding Medical Excellence: Doctors and Accountability for the Information Age” 22:00 “Hospitals often do not do what it takes to be as safe as possible because there is no return on investment.” 24:30 Referencing Michael’s article “Why We Still Kill Patients: Invisibility, Inertia, and Income” 26:00 The moral challenges of bureaucratic medicine and misaligned economics and how it creates preventable harm 29:00 The disconnect between Cost and Quality 31:00 The ethics of value-based care and the travesty of physicians not speaking up (Referencing Michael’s article “The Silence”) 33:30 The promise of “Analytics” in the future of healthcare (and the similarities to the “Plastics” scene in The Graduate) 34:30 Enhancing clinical outcomes through semantic interoperability, AI, and predictive analytics 37:30 The misperception that population health analytics will impinge on clinical autonomy 39:30 Smart phone technologies and “proactive benefits” to engage patients in getting well 41:15 “Analytics is the key to the Information Age of Medicine.” 43:00 The limitations of human cognition in healthcare and how unleashing analytics can foster empathy and compassion in medicine 44:30 How open APIs and the FHIR interoperability standard will emp...
Effective COPD Management to Achieve Value-Based Care Goals, with Dr. MeiLan Han
May 31 2022
Effective COPD Management to Achieve Value-Based Care Goals, with Dr. MeiLan Han
Healthcare costs due to Chronic Obstructive Pulmonary Disease (COPD) is in excess of $32 billion due to high rates of re-hospitalizations and ED visits, complex and inefficient clinical pathways during transitions of care, and intensive resource burden on clinical and administrative staff. The average cost per COPD patient readmission in the U.S. typically falls between $9,000 and $12,000. Unlike other high cost chronic conditions like CHF and diabetes, it seems that many ACOs are not as purposeful in their targeting of COPD as part of their population health playbook. This is a massive unmet need with many COPD patients experiencing fragmented and inconsistent care that drives poor clinical outcomes and high economic burden. Consequently, COPD now represents the 3rd leading cause of death and the 5th most costly chronic disease in the US. What is it about this particular chronic condition that makes it so less prone for population health management with ACOs and other risk-bearing entities?  Why is this chronic disease so universally undiagnosed? How can we implement chronic care management programs that actually make an impact on patient lung health and clinical outcomes? For anyone that wants to know more about “Effective COPD Management to Achieve Value-Based Care Goals”, look no further than this week’s episode with Dr. MeiLan Han. She is Professor and Chief of Pulmonary and Critical Care Medicine at the University of Michigan who is widely known for her expertise on Chronic Obstructive Pulmonary Disease. Dr. Han is a leading pulmonologist, researcher, lung health advocate, consultant, and national volunteer spokesperson for the American Lung Association. She is also the author of the new book, “Breathing Lessons: A Doctor's Guide to Lung Health.”   Episode Bookmarks: 01:30 Introduction to Dr. MeiLan Han (pulmonologist, COPD researcher, lung health advocate, author, and speaker) 05:30 Origins in rural, small town America that led to a career in pulmonary medicine and research 07:00 “Many people that have lung damage and don’t know it. We don’t do a good job of diagnosing lung disease in this country.” 07:30 Only half of the 25-30M Americans with COPD even have a diagnosis! 08:00 Undiagnosed lung disease led to server morbidity and increased mortality during COVID-19 pandemic 08:30 Research continues to be under-funded due to lack of awareness of lung health importance 09:20 11M Americans suffering from long-haul COVID 09:40 Societal threats to lung health (ex: air pollution, hazardous chemicals, plastic microparticles in lungs) 10:00 “The pandemic was a golden opportunity to raise awareness for lung health, but now people are starting not to listen.” 12:00 The impact of race and socioeconomic status on COVID death rates, and overall poor lung health in marginalized communities 13:30 COPD is more common in rural communities where there is less access to care 14:20 Virtual care is not a perfect solution in areas where there is a “digital divide” 16:00 Half of adult Americans have at least one chronic condition and more than two thirds of Medicare patients have two or more. 17:00 Ambulatory Care Sensitive Conditions as an opportunity for ACOs to achieve cost savings 18:30 The challenges of developing and implementing COPD Quality Improvement Measures 19:00 Difficulties in collecting data from spirometry and PFTs in the Electronic Medical Record 20:00 Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations and the difficulties of tracking symptoms and exacerbations 22:00 The lack of reporting requirements on COPD has limited progress of health systems and EHR companies 23:00 The relative ease of collecting Blood Pressure and A1c results and why capturing data related to COPD is so much more difficult 24:45 Diagnosis gaps of COPD in the early stages due to “therapeutic nihilism” 26:15 Lack of spirometry testing possibly due to the ...
The Hero’s Journey to Health 3.0, with Dr. Zubin Damania (“ZDoggMD”)
May 23 2022
The Hero’s Journey to Health 3.0, with Dr. Zubin Damania (“ZDoggMD”)
This week we are talking about how value-based care transformation is related to the “Hero’s Journey” monomyth that was initially described by Joseph Campbell, an intellectual known for his work in comparative mythology and religion. Campbell studied religions, all of the greatest literary achievements, mythologies, folklores, and fairytales and discovered that they all involve a hero who goes on an adventure, is victorious in a decisive crisis, and comes home changed or transformed.  Leaders in healthcare transformation are on a Hero’s Journey, not unlike Jesus, Buddha, Krishna, Apollonius of Tyana, Odysseus, Superman, Luke Skywalker, and Harry Potter! We all have one thing in common -- we follow our bliss in becoming captivated by population health and health equity and then reach for the stars! Joining us this week in the Race to Value is the one and only Dr. Zubin Damania.  Dr. Damania (aka “ZDoggMD”) is a physician Leader, internet personality, and healthcare influencer with 2.5M Facebook followers and 75M YouTube views.  In this special podcast episode (a recording from the closing keynote at the Advancing Health Value Summit), Zubin discusses the transition to Health 3.0 through the monomyth of the Hero’s Journey. In this podcast, we pay special attention to the issues of burnout and moral injury in the healthcare workforce and how we forge a new way for delivering care that is compassionate, relationship-based, and technology-enabled.  Can our nation’s healthcare industry successfully make the transition from Health 2.0 to Health 3.0 in this Hero’s Journey?  Will health leaders heed the call for adventure and come back home completely transformed?  Meet Dr. Damania, your mentor in this journey to provide you (the Hero) with guidance and inspiration to dispel your doubts and fears, while also giving you strength and courage to begin the quest. Episode Bookmarks: 03:00 Introduction to ZDoggMD (and how Eric first met him at a 6-day silent mediation retreat!) 05:00 “We are all trying to forge a new way of being in the world when it comes to health care.” 05:20 COVID-19, system fragility, and workforce burnout 06:20 An opportunity for optimism and the two sides of “hero’s work here” 07:30 The Hero’s Journey in healthcare (Health 1.0 à Health 2.0 à Health 3.0) 08:20 Zubin explains “Health 1.0” as a way physicians practiced holistic medicine based on relationship and intuition 10:15 Physician paternalism in Health 1.0 began the Hero’s Journey (just like Luke Skywalker on Tattooine deciding to forge a new path forward) 11:00 The excessive utilization, care variation, and escalating costs of Health 1.0 12:00 The dominator physician hierarchy of Health 1.0 and how that relegated nurses to a lower status 13:30 The origins of “Health 2.0” – a technology-enabled, data-driven business model 15:30 Right-brain (holistic care) vs. Left-brain (reductionist care) that led to a clash in medicine between 1.0 and 2.0 16:30 The shadow side of Health 2.0 (reductionist de-humanization, commodification, and de-personalization) due to the dominator administrator hierarchy 17:30 “Burnout is like renal failure. You are being dialyzed due to chronic moral injury.” 18:00 What is moral injury and how does it apply to healthcare? 19:00 The suffering created by Health 2.0 and how looking inward can help the workforce find equanimity (Awakening) 20:00 The negative feedback loop caused by a flawed system and how that contributes to moral injury 20:20 The Empire of 2.0:  How de-personalized EHR systems defeat healthcare heroes by turning them into data entry clerks 22:00 How Zubin reached the apex of 2.0 due to pressures to practice medicine on an assembly line 23:30 Health 1.0 is the old shore, Health 2.0 is the boat we're in, Health 3.0 is the shore we're trying to get to. 24:00 How Zubin found inspiration from “The Happiness Hypothesis” by Jonathan Haidt
The Truth Agenda: Overcoming Tribalism for a Better World and the Superiority of Medicare Advantage for Value-Based Care, with George C. Halvorson
May 16 2022
The Truth Agenda: Overcoming Tribalism for a Better World and the Superiority of Medicare Advantage for Value-Based Care, with George C. Halvorson
George Halvorson is a retired American healthcare executive who served as CEO of six health plans over the last 30 years.  From 2002-2013, he was the CEO of Kaiser Permanente and was listed several times on Modern Healthcare‘s “Most Influential People in Healthcare”. During his tenure at Kaiser Permanente, he led the nation's largest nonprofit health plan and hospital system, which is also a leader in the adoption of technology to advance community health outcomes and reduce health inequities.  Under Halvorson's leadership, Kaiser Permanente's investment in electronic medical records and physician support systems resulted in diminished infection rates and scalable population health outcomes within partnering communities. Since his retirement from Kaiser, George Halvorson has devoted his time to promoting the benefits of early childhood education and to addressing social difference and tensions through his own Institute. George Halvorson is currently the Chair and CEO of the Institute for InterGroup Understanding, a nonprofit organization that works on issues of racism, prejudice, discrimination and intergroup stress and conflict by facilitating a collective understanding of what children need to achieve safe and productive lives. George is someone who leads with a passion to help create intergroup Peace for our nation so that we may intellectually overcome our more negative and damaging instinctive behaviors. In this episode, you will learn the truth about the Medicare Advantage program from one of the leading intellectuals in healthcare.  We also discuss Health IT transformation and the power of organizational culture to reshape care delivery. In the last 20 minutes of the interview, George Halvorson also discusses his mission to improve the culture of our world by helping others overcome negative and instinctive behaviors that lead to intergroup conflict.  This is a powerful discussion about the impact of tribalism in our world and how we have a collective and ethical obligation to help each child from every ethnic, economic, cultural, and racial group in America to overcome the hardwiring of societal conditioning that leads to “us versus them” intergroup conflict. “We need to steer ourselves away from the easy abyss of anger through tribalism, into a higher level of interaction. This is a just-in-time learning opportunity.”   Episode Bookmarks: 01:20 George Halvorson’s legacy as a healthcare executive and former CEO of Kaiser Permanente 02:20 The Institute for InterGroup Understanding, a nonprofit organization that works on issues of racism, prejudice, discrimination and intergroup stress and conflict 03:10 George’s extensive experience in international healthcare reform and his authorship of several books related to healthcare reform and intergroup peace 04:20 “The fragmented nature of care delivery and siloing of data creates an expensive plethora of uncoordinated, unlinked, economically segregated, operationally limited microsystems, each performing in ways that too often create suboptimal performance” 06:30 “We are on the cusp of the golden age of healthcare delivery, and it’s going to be made golden by information, data, and systems.” 07:15 Innovation at Kaiser Permanente led to a 40% reduction in congestive heart failure crisis events 08:15 Leveraging biometric data and predictive algorithms for disease detection and prevention 09:45 George Halvorson as a national leader in mitigating health disparities and his 2013 book, “Ending Racial, Ethnic and Cultural Disparities in American Health Care” 11:15 Medicare Advantage has become a successful social services program for millions of people (and our most important vehicle to reduce health inequities) 12:15 How Kaiser Permanente reduced prostate cancer death rates for Hispanic Americans 13:30 “I believe that we should deliver better care to every single American, and we have done a pretty miserable job for many subsets of ou...
Speaking for Those Who Can’t: The Role of Nurses in Advocating for Vulnerable Populations, with Sharrica Miller, Ph.D., RN
May 9 2022
Speaking for Those Who Can’t: The Role of Nurses in Advocating for Vulnerable Populations, with Sharrica Miller, Ph.D., RN
This week is Nurses Week – a time for all of us to reflect on the contributions that nurses make to our society. During this important time of observance for one of our most valued professions in caring for those most in need, we invited Dr. Sharrica Miller to join us for an important conversation.  Dr. Miller is a Cal State University, Fullerton nursing professor who teaches several nursing classes, including pediatrics, writing, research, and mentoring. But she brings more into her classroom than just her vast knowledge and experience in nursing; Dr. Miller also shares the 12 years she spent in the foster care system. This period left an indelible impression on her, and she decided that once she made it out of the foster care system, she would reach back and help others.  To that aim, she has become a national leader in helping nurses use their platform to advocate for vulnerable populations in the community. Casey Family Programs recently awarded Dr. Miller with the 2021 Casey Excellence Award, a national recognition for her work with foster youth in several organizations, including California Youth Connection. Dr. Sharrica Miller is not only a nurse educator, renowned public speaker, and DEI strategist --- she is a servant leader and advocate for the most vulnerable in our society.   Episode Bookmarks: 01:25 Reflections on Nurses Week and Introduction to Sharrica Miller, PhD, RN 02:25 National recognition for her service in helping children transition out of foster care 03:25 The hardship and instability of Dr. Miller’s childhood and how she broke the intergenerational cycle of disadvantage 05:35 Determination to take control of her life once emancipated from the foster care system 06:20 A mission in service to others as an advocate began when gaining custody of her siblings as a young adult 07:30 Lessons in mentorship that inspired her to “speak for those who can’t” and how COVID-19 impacted the foster care system 09:20 The promise of education in breaking the cycle of poverty and despair (“Education was my ticket to freedom.”) 11:00 How the learning environment and minority representation at Howard University propelled her to success 12:00 The importance of mentorship and creation of “safe spaces” on college campuses for minority nursing students 12:40 “Nursing programs need to be actively anti-racist to identify structural barriers.  It is not enough to just value diversity.” 14:00 Why representation from minorities is so important in Higher Education 15:00 Overcoming a victimhood mindset brought about by old emotional pain through hardship 16:30 “You must develop an internal locus of control.  You can either change your perspective of a problem or change your situation.” 18:40 Inspiration from Eckhart Tolle in overcoming a victim mentality by stopping "pain-bodies"that control our thinking. 19:40 The dangers of over-internalizing success or failure 21:30 “In preparing to lead transformational change, you must first do the work inside. That allows you to show up with the stamina to fail forward.” 23:20 Using failure as a learning opportunity to adapt one’s approach to change management 24:30 The plight of racial injustice in our society and the disparities that are built into the American healthcare system 26:00 “Minorities are expected to be majority by 2050.  We need to think about this in preparing the healthcare workforce for tomorrow.” 28:00 “Teaching nursing students about Social Determinants of Health can actually do harm if we only teach at the surface level.” 29:00 “Racism is a social determinant of health.” 30:00 A recent study confirming that racism exists in nursing (63% of nurses have experience acts of racism in the workplace) 31:30 Dr. Miller discusses the history of racism in nursing and how leadership should addresses reported incidents of “Nursing while Black” 35:00 Addressing the “race card” response when attempting to...
Transforming “Sick Care” to Health Care through Lifestyle Medicine, with Dr. Sean Hashmi
May 2 2022
Transforming “Sick Care” to Health Care through Lifestyle Medicine, with Dr. Sean Hashmi
As leaders in the value-based care movement, we must think about the synergism between lifestyle medicine and traditional Western medicine. The tenets of lifestyle medicine force us to think more holistically about medical treatment and prevention.  Under this construct, “Sleep is Medicine” because poor sleep is linked to obesity, heart disease, stroke, cancer, and dementia.  “Exercise is Medicine” because of its impact on a healthy heart, mind, and body.  “Love is Medicine” because mindfulness and gratitude is the key to peace and equanimity. And lastly, “Food is Medicine” because a whole food plant-based diet is proven to improve every aspect of health.  These four time-tested tenets encompass the SELF Principle of lifestyle medicine promoted by Dr. Sean Hashmi. Sean Hashmi, MD, is the adult weight management lead for Southern California Kaiser Permanente. He is a board certified Internist, Nephrologist and Obesity Medicine Specialist practicing at Kaiser Permanente, Woodland Hills, California. In this role as Regional Director for Clinical Nutrition and Weight Management at Kaiser Permanente, Southern California, he’s responsible for developing a comprehensive obesity management strategy involving lifestyle medicine and obesity medicine for the 4.6 million members that Kaiser Permanente serves. He is driven by a lifelong commitment to be of service to others. He also provides evidence-based health, nutrition, and wellness research through his nonprofit organization, SELF Principle. In this episode, you will learn how Sleep, Exercise, Love, and Food (SELF) translate into hope. And hope is the most powerful thing we can possibly have in health care. With hope, we can transform our broken “sick care” system to a true health care system.  And in doing so, we will win this Race to Value.   Episode Bookmarks: 01:30 Background and Introduction to Dr. Sean Hashmi 04:30 Life-defining experiences and personal challenges that led to the practice of lifestyle medicine 06:30 Dr. Hashmi’s Personal Why:  HOPE 08:30 “The greatest way to be selfish is to do something kind for someone.” 09:00 How a lack of financial resources led to a lack of healthcare access for Dr. Hashmi’s sister 09:45 Lessons in lifestyle medicine learned from his own wife’s health issues 10:45 The American College of Lifestyle Medicine and Dr. Hashmi’s SELF Principle 11:00 “Sleep, Exercise, Love, and Food translate into hope. And hope is the most powerful thing we can possibly have in health care.” 13:30 “Lifestyle medicine needs to be looked at synergistically with Western Medicine.  Everything in health begins and ends with lifestyle.” 14:30 The impact of lifestyle medicine on chronic disease (ex: dialysis treatment coupled with plant-based eating) 16:30 Healthcare providers need to learn more about evidence-based lifestyle medicine 17:00 How lifestyle medicine can improve life’s “moments” (quality of life and longevity) 17:45 Incorporating lifestyle medicine into everything we do (instead of it being a standalone program), e.g. prevention of 30-day rehospitalizations 22:00 Is the heart healthy benefit of eating vegetables only when they are consumed in raw form? 24:20 The Healthy Plate Model:  50% fruits and vegetables, 25% complex carbohydrates, and 25% protein (tofu, beans) 25:20 Consumption of whole fruits will lower HgbA1c results in diabetics in the long-run. 26:20 “Healthy” plant-based eating lowers incidence and prevalence of kidney disease. 27:00 The problems with plant-based meats and why whole vegetables are always preferable 28:20 Why the Blue Zones have such healthier people that live longer 31:00 Dr. Hashmi explains his work in obesity management at Southern California Kaiser Permanente 32:00 How clinicians can effectively counteract societal influences that lead to poor eating and other unhealthy lifestyle choices 34:00 The benefits of bariatric surgery will be undermined ...
Leveraging Autonomous AI to Close Care Gaps and Improve Quality and Equity, with Dr. Michael Abramoff and Seth Rainford
Apr 25 2022
Leveraging Autonomous AI to Close Care Gaps and Improve Quality and Equity, with Dr. Michael Abramoff and Seth Rainford
Have you ever had an idea that you just had to make real? No matter what it took… no matter what obstacles were in your way… no matter how many times people told you no… you just couldn’t stop until it existed? Well, this is one of those stories. It begins with an idea in 1988 and leads to the first-ever autonomous AI to be approved by the FDA for diagnosis without physician input. Dr. Michael Abramoff, MD, Ph.D. is the Founder and Executive Chairman of Digital Diagnostics, the autonomous AI diagnostics company which was the first in any field of medicine to get FDA authorization for an autonomous AI.  Dr. Abramoff is a neuroscientist, a practicing physician, and holds a Ph.D. in Artificial Intelligence and Machine Learning. In 1988, Michael was working on artificial intelligence during his residency and began to think a computer could diagnose diabetic retinopathy. Given the technology available at the time, this idea may have been a bit of a stretch. Still, Michael set out to prove it could be done. Joining him in this interview is Seth Rainford, the President and COO at Digital Diagnostics.  Seth focuses on expanding market opportunities and driving operational excellence within the company. He brings more than a decade of executive experience to Digital Diagnostics including the successful management of large-scale P&L’s, strong organic & inorganic business development expertise, as well as complex multi-site operations leadership within the healthcare industry. In this episode, we talk with Dr. Abramov and Seth about the 30-year journey that led to the founding of Digital Diagnostics, and the first-ever FDA-approved Autonomous AI in healthcare. Plus, we explore the challenges they continue to work through as they commercialize their product to support organizations looking to win in value-based care! Episode Bookmarks: 01:30 Introduction to Dr. Abramoff and Seth Rainford and how the first-ever autonomous AI solution became FDA-approved for diagnosis without physician input 03:30 The scalability of Artificial Intelligence in healthcare and the recent failure of IBM Watson Health 06:00 “We are at an inflection point with AI…specifically with Autonomous AI.” 06:30 The parallel paths between AI and the discovery of DNA and its eventual use in the courtroom. 07:45 Why should we limit diagnosis to human cognition when autonomous AI has been proven to be safe and effective? 08:45 An overview of the history of AI, from advancements in neuroscience and sensory processing, ML, artificial neural networks, to autonomous AI in healthcare. 10:45 Where IBM Watson failed – it started with “glamour AI” (i.e. winning at Jeopardy) instead of trying to solve problems in healthcare 12:00 Most of what we hear about in healthcare is assistive AI -- not autonomous AI. 13:20 There is no need for human oversight in autonomous AI for making FDA-approved diagnoses in healthcare. 15:15 Referencing a recent NEJM Catalyst Op-Ed that criticizes autonomous AI in healthcare 16:30 Lessons learned from the challenges of assistive AI and how the develop of a completely autonomous AI solution started with FDA approval 18:30 “In considering the best ways to improve population health outcomes, we must include autonomous AI.” 19:00 Humans are not necessarily better than AI when it comes to diagnosis of diabetic retinopathy 19:20 Referencing NEJM study using assistive AI diagnosis of breast cancer and how radiologist involvement with AI didn’t improve outcomes 22:00 Health inequities with diabetic retinopathy in various minoritized populations 23:00 Recent CMMI focus to advance health equity in value-based care 23:45 “Diabetic Retinopathy is the main cause of blindness and this is disproportionately impacting minorities and rural populations due to lack of access to care.” 25:00 The importance of the diabetic eye exam and how to make testing more accessible through autonomous AI
Private Equity Investment for Value Transformation: Magnificent or Mephistopheles?, with Don McDaniel
Apr 18 2022
Private Equity Investment for Value Transformation: Magnificent or Mephistopheles?, with Don McDaniel
The impact of investment activity on our industry cannot be overstated, with the velocity of capital pouring into the health sector reaching stratospheric proportions. The valuation of private equity deals in the US health care sector is nearly $100 billion dollars—a twentyfold increase from 2000 (when it was less than $5 billion). Before COVID-19, we were already seeing mass provider consolidation, expansive funding in digital health, and significant M&A activity…and the appetite for capital investment in healthcare has only increased in recent years. The amount of capital being poured into the health sector, and the velocity at which it has been deployed, is reshaping the landscape and a driving force in the future of value-based care. Joining us this week is Don McDaniel, the CEO of Canton & Company. Don engages with pioneering healthcare firms across the industry, all striving to win in the new health economy. A true market-maker, he focuses on advancing innovation, elevating market positions, and connecting complementary players to disrupt and reshape the industry.  Don McDaniel is a healthcare visionary, master economist, serial entrepreneur, and lover of a good debate.  In this episode, he will provide insight into the continued increase in the appetite of private equity and other institutional investors.  He will discuss whether this interest is good or bad for consumers, patients, providers, payers and other stakeholders.  He will also overview the interest level and forecast of investment activity, explore pros and cons from various stakeholders’ perspectives, and consider the implications of such investment on the value movement.  If you are a business leader trying to understand current investment trends and whether or not institutional equity actually improves the overall industry health of healthcare, this episode is for you! Private equity (PE) has been ramping up investments in healthcare over the last several years. Read this brief to learn more about the intersection of PE and value-based care, including potential negative and positive impacts, and recommendations for industry stakeholders.   Episode Bookmarks: 01:30 The valuation of private equity deals in the US health care sector is nearly $100 billion dollars—a twentyfold increase from 2000 (when it was less than $5 billion). 02:45 Introduction to Don McDaniel, the CEO of Canton & Company 04:45 The number of healthcare services deals among institutional investors has more than doubled in the last six years, with 356 deals in 2015 and a whopping 733 deals in 2021. 06:30 “The system is broken.” – Investment fervor is based on the “train wreck” that is American healthcare. 07:20 The arbitrage opportunity for capital investment based on historical spending and inefficiencies 08:10 Referencing Jim Collins: Confront the Brutal Facts (from Good to Great) 08:30 How negative labor productivity in healthcare contributes to dysfunction 09:30 “If the airline industry had the safety record of healthcare, no one would get on a plane.” (iatrogenic errors creating bad outcomes) 10:00 “Healthcare lacks true consumer sovereignty.” 10:30 Adam Smith’s “invisible hand” has been missing from healthcare since 1965. 11:30 Consumer dissonance drives system inefficiencies and how that is attractive to investors. 12:10 “Healthcare is a credibly inefficient business backed by massive tailwind demand.” 12:30 The impact of an aging population on our nation’s healthcare system 13:45 Opportunities with massive consumerization and privatization of Risk 14:30 Private Equity investment activity at an all-time high 15:20 The international opportunity for healthcare disruption across the globe as the American system undergoes transformation 15:40 Early indications of inflationary pressures and other macroeconomic factors on private equity investment activity
The Moral Determinants of Health: Physician Culture and the Power of Sacred Healing Relationships, with Dr. Faisel Syed
Apr 11 2022
The Moral Determinants of Health: Physician Culture and the Power of Sacred Healing Relationships, with Dr. Faisel Syed
ChenMed is a family-owned, physician-run organization that was created to better serve low-moderate income elderly patients. Starting in 1985, Dr. James Chen created ChenMed as a one-stop shop where physicians are held accountable for their patients, and now ChenMed operates over 100 senior health centers across the US. The full-risk, capitation model of ChenMed aligns economic incentives where preventative value based care is the foundational framework.  However, what really allows ChenMed to transform care delivery in the U.S. is how they honor the sacred nature of the physician-patient relationship. The ChenMed model for primary care exemplifies the power of the provider-patient relationship and realigns physicians with their altruistic calling.  In doing so, clinicians are able to address the moral determinants of health that lead to improved health equity and social justice in our society. Joining us this week is Dr. Faisel Syed, the National Director of Primary Care at ChenMed. Dr. Syed believes a physician-led culture can improve primary care influence and lead to a new era of transformation in the United States.  He is on a mission to restore the intimate and sacred nature of the doctor-patient relationship and, in doing so, create care models that can replicate at scale.  In this episode, Dr. Syed discusses how ChenMed honors seniors with affordable, VIP care that delivers better health. He shares how this moral consensus has an enormous impact on patients and the health of communities.  A physician-led culture in primary care, coupled with trusting relationships, can truly change the world! Episode Bookmarks: 01:30 Background on Faisel Syed, M.D. and the full-risk capitation model of ChenMed 03:30 The ChenMed model as “old-fashioned medicine with technology that treats patients like family” 04:30 How family influence and emerging technologies created a calling to practice medicine 07:15 “We should restore the intimate and sacred nature of the doctor-patient relationship.” 09:20 Don Berwick’s article on “The Moral Determinants of Health” 10:20 “ChenMed starts with the mission to honor seniors with affordable, VIP care that delivers better health. That is our moral consensus.” 11:00 Healthcare as a right – everyone deserves access to primary care, especially those in underserved communities 12:45 Referencing Michael Marmot’s book, “The Health Gap: The Challenge of an Unequal World” and the impact of income inequality on health 14:30 “Understanding pathophysiology alone is not enough to improve health. We must address social determinants of health.” 15:30 Faisel provides an excellent overview of SDOH and how ChenMed’s relationship-based care model improves population health outcomes 18:30 1 out of 5 Americans (over 51 million) are living with a behavioral health condition and 20 million individuals have a substance use disorder 19:30 How a holistic (non-transactional) approach to primary care with aligned financial incentives impacts behavioral health outcomes 22:00 The sacred nature of healing relationships that goes back to the roots of shamanism (and how transactional economics limits healthcare effectiveness) 24:00 Reflections on how the ChenMed model supports healing through trusting relationships 25:00 How openness and trust between a doctor and a patient prevents avoidable ER visits 28:30 How a famous clip from “I Love Lucy” sums up physician burnout that results from the culture of a fee-for-service system 29:30 How ChenMed allows physicians to truly fulfill their purpose in practicing medicine (and how that prevents the burnout all too common in FFS) 32:30 Referencing the article “Primary Care, Specialty Care, and Life Chances” and how PCPs in a given geography correlate with lower mortality and improved societal health 34:00 Primary care doctors need “influence and leadership” to catalyze a national transformation of healthcare in our country
Celebrating 100 Episodes of the Race to Value, with Dr. Eric Weaver and Daniel Chipping
Apr 5 2022
Celebrating 100 Episodes of the Race to Value, with Dr. Eric Weaver and Daniel Chipping
We have reached a milestone moment, as we are celebrating 100 episodes of the Race to Value – the nation’s leading podcast on value-based care transformation in the country! In this special episode, Dr. Eric Weaver and Daniel Chipping conduct a countdown of the Top 10 episodes so far, playing select clips from the most downloaded Race to Value episodes. They also discuss the recent launch of the Institute for Advancing Health Value (formally known as The Accountable Care Learning Collaborative). The Race to Value and the Institute bring together the nation’s leading accountable care organizations, top performers, and industry leaders who know what it takes to succeed in the value-based care environment.  We are committed to advancing health value, not only through industry collaboration but through education and workforce development as well! Episode Bookmarks: 01:30 Eric and Daniel reflect on the 100th Episode milestone of the Race to Value 02:20 The announcement of the newly-launched Institute for Advancing Health Value (formerly the ACLC) 03:10 Register now to attend the Advancing Health Value Virtual Summit on May 5th, 2022 04:00 #10:  “Creating Optimal Post-Acute Care Networks in the New Value Paradigm” with Ian Juliano 06:30 Other PAC insights in prior episodes featuring Dr. Stephen Bekanich, Andrew Croshaw, and Dr. Tim Ihrig 07:00 #9:  “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity” with Susan Hassmiller and Janelle Sokolowich 11:00 Other VBC workforce insights in prior episodes featuring Christina Severin, Cheryl Lulias, Lisa Trumble, and Dr. Gordon Chen 12:00 #8: “The Path of Hope for Human-Centered Care Delivery” with Dr. Zeev Neuwirth 14:40 Other “Big Thinkers” in prior episodes featuring the Honorable Dr. David Shulkin, Dr. Robert Pearl, and Dr. Elizabeth Teisberg 15:00 #7: “The Role of Direct Primary Care in the Value Movement” with Dr. Gaurov Dayal 17:40 Other transformational insights in prior episodes featuring Dr. Tom Davis, Farzad Mostashari, and Harris Rosen 18:10 #6:  “Care Beyond Medicine: Addressing SDOH and Health Inequities in Marginalized Communities” with Mike Radu and Dr. Greg Foti 19:40 Other Health Equity insights in prior episodes featuring Dr. Lerla Joseph, David Smith, Dr. Jesse James, Akil McClay, and John Bluford 21:00 #5: “The Future of Value: Lifestyle Medicine and the Reversal of Chronic Disease” with Dr. Dean Ornish 24:30 Other unique insights in prior episodes featuring Dallas Ducar (gender-affirming care), Ginger Hines and Dr. Sheryl Morelli (pediatric VBC), Dr. Keith Smith and Sean Kelley (cost transparency), Dr. Debra Patt (oncology VBC), Dr. Angelo Dilullo (mindfulness and resilience) 25:40 #4: “Analyzing the New ACO REACH Model” with Rick Goddard and Joe Satorius 27:50 Other health policy insights in prior episodes featuring Jeff Miklos, Michael Leavitt, Dr. Mark McClellan, Micky Tripathi and Liz Fowler 28:20 #3: “The Geisinger Value Journey” with Dr. Jaewon Ryu 30:50 Other insights from industry leaders in prior episodes featuring Dr. Clive Fields, Jen Moore, Dr. Stephen Klasko, Dr. Tim Peterson, Dr. Paul Grundy, Dr. Mark Gwynne, and Dr. David Carmouche 31:30 #2: “COVID-19 & SARS-CoV-2 Delta Variant: Scientific Insights from a Leading Virologist” with Dr. Rodney E. Rohde 33:50 #1:  “Value-Based Care: A Superior Technology to Create Trusting Relationships” with Dr. Griffin Myers 37:40 Parting thoughts on the future of the R2V podcast and the launch of the Institute for Advancing Health Value.  Thank you for tuning in and supporting us!
The Long Road to Health Care Transformation: Aligning the Public and Private Sector in Value, with Jeff Micklos
Mar 28 2022
The Long Road to Health Care Transformation: Aligning the Public and Private Sector in Value, with Jeff Micklos
Jeff Micklos is the Executive Director of the Health Care Transformation Task Force, an industry consortium that brings together patients, payers, providers and purchasers to align private and public sector efforts to clear the way for a sweeping value transformation of the U.S. health care system. Under Jeff’s leadership, the Task Force provides a critical mass of business, operational and policy expertise from the private sector that, when combined with the efforts of the Centers for Medicare & Medicaid Services and other public and private sector stakeholders, can accelerate the pace of delivery system transformation. Jeff is a great ally in this Race to Value, and the Task Force is doing its part to catalyze value-based payment adoption.  In January 2015, the task force was formed based on a commitment to the triple objective of better care, better health and lower costs. As a unique private sector coalition under Jeff’s executive leadership, the task force has an unrelenting vision to accelerate the pace of value-based care transformation.  Consequently, they have set the goal for payer and provider members in the Task Force to have 75% of their business in value-based payment arrangements by the end of 2025. Listen to this episode to learn everything you need to know about the health policy landscape, strategic implications for payment and delivery transformation, and how redesigned payment models will help us seek sustainable improvements in health equity, patient outcomes, and consumer experience. Episode Bookmarks: 01:40 Introduction to Jeff Micklos and the Health Care Transformation Task Force 03:30 The grim stats on the U.S. health system and the need to accelerate value-based care transformation 05:00 “Change is hard. And change is even more difficult when the status quo is so lucrative in fee-for-service medicine.” 05:30 30% of fee-for-service healthcare is related to low-value care (changing this is a major opportunity to sustain in the long-term!) 05:45 Changes to payment models and the market-driving force of Medicare reforms in healthcare transformation 06:00 HCTTF Transformation Goal: 75% of members operating under value-based payment arrangements by 2025 (progress made by reaching 61% in 2020) 06:55 CMS Innovation Center (CMMI) Strategy Refresh Target Goal:  All Medicare FFS beneficiaries in a accountable care relationship by 2030 07:15 “A financial spend metric (in and of itself) is not an indicator of success in value transformation.” (qualitative measures just as important!) 08:20 COVID-19 has only emphasized the need for significant payment and delivery transformation 09:30 The uncertain political climate and how that is shaping current delivery system reform efforts and private sector momentum for value-based transformation 10:00 Extension of the MACRA 5-percent Advanced APM incentive payment (currently scheduled to sunset in 2024) 11:00 The Build Back Better Act and its potential impact on improving health care and lowering costs 11:30 Increased coverage in the ACA marketplace exchanges as a success of the Biden Administration 11:50 The impact of the Russia-Ukraine situation on advancing health policy objectives in the near term 12:00 The upcoming midterm election and how the projected electorate change towards full GOP control may shift the political dynamics of the value movement 12:45 The CMMI Strategy Refresh as a guidepost for the future direction of the value movement 15:00 Reflecting back on the 1st 10 years of the CMS Innovation Center and lessons learned from theMedicare Shared Savings Program (MSSP) 15:50 “ACOs overall have played a key role in transforming the health care system by creating incentives for providers to deliver high quality, cost efficient care.” 16:10 Leveraging MSSP as a platform to scale provider adoption of other APMs 16:45 The failure to reach rural areas with APMs and the need for continued investmen...
The Enablement of Localized Solutions to Improve Care Outcomes, with Dr. Tim Peterson and Kendall Cislo
Mar 22 2022
The Enablement of Localized Solutions to Improve Care Outcomes, with Dr. Tim Peterson and Kendall Cislo
The Physician Organization of Michigan Accountable Care Organization (P.O.M. ACO) is a statewide ACO in the Medicare Shared Savings Program that has saved the Medicare Trust Fund more than $199 Million to-date. It is a physician-led partnership in operation since 2013 that supports more than 5,000 providers serving approximately 60,000 Medicare beneficiaries.  P.O.M. ACO aligned with the University of Michigan Health System, whose Faculty Group Practice participated in a Medicare demonstration project that paved the way for ACOs under federal health care reform years ago.  This is an outstanding Accountable Care Organization led by Dr. Tim Peterson and Kendall Cislo who are featured in this week’s episode of the Race to Value. In this interview, you will learn how P.O.M. ACO has been successful by enabling localized solutions, in partnership with their provider network and beneficiary population, to improve care outcomes.  We discuss how the ACO engages their beneficiaries through committee and Board participation, how primary care providers and specialists work together to build “localized” population health programs, and how care management interventions can provide meaningful outcomes in both rural and urban settings.  This is an important interview for ACO leaders to listen to who are looking to establish improved relationships with both providers and patients to drive more effective care management interventions in caring for seniors and underserved populations. Episode Bookmarks:  02:00 Physician Organization of Michigan Accountable Care Organization (P.O.M. ACO) --  a statewide ACO that has saved more than $199 Million 02:40 Introduction to Dr. Tim Peterson (Population Health Executive for Michigan Medicine and ACO Executive and Chairman for P.O.M. ACO) and Kendall Cislo (Chief Operating Officer at P.O.M. ACO) 05:30 How ACO success has been determined by collaboration between a faculty academic practice and groups of independent physicians 10:00 Dr. Peterson discusses some of the unique public health and chronic disease challenges facing urban and rural Michiganders and how medical management programs of P.O.M. ACO meets patient needs 12:00 “Part of our ACO success has been the enablement of local solutions to address local problems.” 12:45 Recent study on patient perceptions of ACOs: Only 7 percent of 55- to 64-year-olds and 4 percent of those over 65 reported ever hearing about value-based care! 13:40 How beneficiary engagement and “the voice of the beneficiary” impact quality improvement and the Triple Aim 15:30 Why the economics of value-based payment shouldn’t matter to patients (focus on quality care and out-of-pocket burden most important) 17:30 Utilizing a beneficiary engagement advisory committee as a key strategy for performance success 21:40 “The goal of our ACO is not to build a centralized infrastructure – it is instead to build localized solutions with our network of providers.” 24:30 Engaging patients to raise awareness of high cost (low value) specialists in the area 25:40 Partnering with dialysis centers to more effectively engage patients with kidney disease 28:30 “The key message to remember in healthcare is that we do everything for the patient.  What would you do for a patient if it was your Mom.” 31:20 Engaging physicians to more effectively collaborate with them in population health and quality improvement strategies 34:30 Collaborative conversations to improve risk adjustment coding documentation to more adequately reflect burden of illness in the patient population 38:00 Building local market capabilities for pharmacy integration in rural primary care practices 40:30 Annual Wellness Visits as opportunities to address what is most important in a patient’s life and how that has transformed the ACO 44:30 The importance of clinical integration in improving care coordination and why specialist participation in an ACO is a performance adva...
Analyzing the New ACO REACH Model, with Rick Goddard and Joe Satorius
Mar 15 2022
Analyzing the New ACO REACH Model, with Rick Goddard and Joe Satorius
On February 24th, the Centers for Medicare & Medicaid Services (CMS) revealed the highly-anticipated fate of the Innovation Center’s (CMMI) Direct Contracting model options, announcing a redesign of the Global Professional Direct Contracting (GPDC) Model and the permanent cancellation of the Geographic Direct Contracting (“Geo”) Model. The revamped and rebranded GPDC model—now called Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)— aims to better reflect the agency’s vision and Administration’s priorities for system transformation.  The new ACO REACH model has incorporated stakeholder feedback to alleviate the concerns of GPDC’s critics while maintaining the key features of the model and building on the momentum of the accountable care movement. ACO REACH also adds in exciting new components aimed at closing health equity gaps in keeping with the Innovation Center’s Ten Year Plan released late in 2021. This special podcast episode offers a short background on the model’s history and recent controversies leading up to the announcement, summarizes the major provisions of the new ACO REACH Model, outlining the key changes from the GPDC design, and considers potential implications for the Direct Contracting Entities (DCEs) currently participating in the GPDC model as well as the broader value movement. Joining this week we have two leading strategists in value-based care, Joe Satorius and Rick Goddard. They come to us from Lumeris - an accountable care delivery innovation company that enables health systems to deliver value-based care through advanced technology, risk-management, and outcome-based managed services. The ACLC and Lumeris have partnered to bring you the most in-depth information on the ACO REACH model. In addition to this episode, please download our free Intelligence Brief. Episode Bookmarks: 02:00 Background on the new ACO REACH payment model and its focus on health equity 03:00 Don’t forget to download the Intelligence Brief on ACO REACH released by the ACLC in conjunction with this podcast episode! 04:00 Background on Joe and Rick and their work at Lumeris 05:00 The complete redesign of the Global Professional Direct Contracting (GPDC) model 07:00 Rick and Joe provide perspective on the future of the Value-Based Care movement and the unsustainability of fee-for-service 08:30 CMMI’s Goal to have all Medicare beneficiaries in an accountable care relationship by 2030 11:00 Joe discusses CMS’ newly-refined eligibility criteria and why that matters when it comes to advancing health equity, promoting provider leadership and engagement, and enhancing beneficiary protections 12:00 The new ACO REACH requirement for 75% board representation from participating providers. 13:00 How ACO REACH incentivizes providers to address social disparities with underserved beneficiaries 15:00 The progression of capitation options in the ACO REACH model 16:30 Rick provides an extensive overview of the professional and global tracks of ACO REACH and the various capitation options that drive economics 20:00 The strategic implications of Total Care Capitation (TCC) and how network curation and design can support performance success and aligned behavioral economics 22:00 The Primary Care Capitation (PCC) + Advanced Payment Option (APO) 22:45 The importance of assessing risk appetite and value-based care readiness 25:00 Rick discusses the Health Equity Benchmark Adjustment – a new change to benchmarking methodology in the ACO REACH model 29:00 Providing greater and more equitable access to underserved communities, while leveraging telehealth and other value levers 32:00 Joe discusses risk adjustment methodology within ACO REACH and addresses concernsabout risk score gaming and over-coding 34:00 The 3% cap, the coding intensity factor, and demographic adjustments that serve as guardrails to inappropriate risk score increases
Breaking the Rules to Reshape Healthcare in the Post-Pandemic Era, with Dr. Robert Pearl
Mar 7 2022
Breaking the Rules to Reshape Healthcare in the Post-Pandemic Era, with Dr. Robert Pearl
This week, we have as your guest the legendary Dr. Robert Pearl, a Stanford University professor, Forbes contributor, bestselling author and former CEO of The Permanente Medical Group.  Coming off of his bestselling book, “Uncaring: How the Culture of Medicine Kills Doctors and Patients” and a series of articles in Forbes about “Breaking the Rules of Healthcare”, Dr. Pearl describes the key economic and cultural forces that will reshape healthcare in the post-pandemic era. He highlights the flawed system design of our fragmented industry and how that has perpetuated economic status quo in the decades preceding the pandemic.  Dr. Pearl describes a better future for our healthcare system once we move from fee-for-service to capitation. In this podcast he provides thought leadership and sets a bold direction for a better tomorrow, while sharing lessons learned from his leadership experience at Kaiser Permanente and how COVID-19 will serve as a strategic inflection point to bring scalability to value-based care. Episode Bookmarks: 01:45 Introduction to Robert Pearl, M.D. 03:50 COVID-19 as a strategic inflection point and how rules of industry (and society) are changing 05:40 System vs. Culture in medicine and the impossibility of separation 06:00 The consequences of cottage industry design and fee-for-service incentives in American healthcare 08:00 The trajectory of rising healthcare costs over the next decade and missed opportunities for social investment 09:45 How COVID-19 will change the rules of physician culture 11:00 A medical history lesson (ex: Ignaz Semmelweis and the pioneering of antiseptics) and how it relates to lack of progress in the modern-day 14:00 Why medical culture is holding back innovations that improve care outcomes (and how COVID-19 has exposed cultural flaws in the profession) 16:45 The positive aspects of physician culture and the heroism of physicians during COVID-19 19:30 The need to value primary care and prevention (over specialty care and intervention) and the impact on primary care on life expectancy 20:00 Why were Black patients 2-3X more likely to die from COVID-19 than White patients? 21:00 How physician culture tolerates low value care and the high frequency of personal bankruptcies of patients seeking care 23:00 How COVID-19 accelerated the adoption of virtual care (and why the culture of medicine continues to oppose it) 26:00 Why capitation is a better economic model to improve care outcomes 27:00 The impact of Private Equity on value-based care and digital transformation 29:00 How post-pandemic economic pressures will reshape care delivery and support VBC adoption (i.e. virtual systems of care, employer-led initiatives) 32:00 Dr. Pearl reflects on the Haven venture and future steps to be taken in healthcare by Amazon 33:00 The anger, denial, bargaining, and depression that will be experienced during the process of reshaping American healthcare 34:00 “Acceptance of change will be the opportunity to make American healthcare once again the best in the world.” 36:00 How digital transformation, AI and interoperability can eliminate friction in the healthcare value chain and create a new era of patient consumerism 39:00 The advancement of medical devices and wearables that will support advanced analytical capabilities in diagnostics 43:00 “The key step to reshaping healthcare will be moving from fee-for-service to capitation.” 50:00 Lessons from Kaiser Permanente’s success and why their full-risk model hasn’t shown scalability at a national level 52:30 How post-pandemic disruptions and virtual care models will bring scale to value-based care 53:30 Dr. Pearl explains how the government push towards value-based care actually began in 1932! (and how the AMA quashed the move to capitation)
Solving for Population Health: The New Era of Consumer-Centric Care Delivery, with Dr. Clive Fields
Mar 1 2022
Solving for Population Health: The New Era of Consumer-Centric Care Delivery, with Dr. Clive Fields
Joining us on the podcast this week is Dr. Clive Fields, the Co-Founder and Chief Medical Officer for VillageMD. Dr. Fields is a leader of high influence in the value economy, having been named to Modern Healthcare’s lists of the 50 Most Influential Clinical Executives and the 100 Most Influential People in Healthcare.  His company, VillageMD, is a leading, national provider of value-based primary care services that partners with physicians to deliver high-quality clinical care and better patient outcomes, while reducing total cost of care. In the years since Dr. Fields co-founded the company, VillageMD has grown to 15 markets and is responsible for more than 1.6 million patients. In 2021, VillageMD received a $5.2 billion investment from Walgreens Boots Alliance, which is looking to expand its healthcare offerings with VillageMD as a partner. This significant multi-billion investment will accelerate the opening of at least 600 Village Medical at Walgreens primary care practices in more than 30 U.S. markets by 2025 and 1,000 by 2027, with more than half of those practices in medically underserved communities. The Race to Value is honored to have Dr. Fields share his perspective on the opportunity for consumer-centric care delivery in our country.  We discussed important issues such as health equity, digital transformation, integrated pharmacy, home-based care delivery, multipayer contracting, health policy, and employer healthcare costs. Don’t miss out on this important interview so you can learn what it takes to succeed for the future of value-based care! Episode Bookmarks: 01:40 Introduction to Dr. Clive Fields and VillageMD 05:00 The intersection between value-based care delivery and consumerism 07:00 “Value-based health care success requires affability, availability and ability.” 08:40 Using a team-based, proactive, risk-stratified approach to care to deliver the best outcomes 09:00 Are we using the term “value” incorrectly in the industry? 10:00 VillageMD’s recently announced partnership with Walgreens and how it will provide scalability 12:00 How outcomes-based reimbursement can improve health equity in underserved communities 13:00 The transformative impact of the value movement on primary care 16:00 The acceleration of virtual care and the role it plays in a consumer-centric care delivery 18:00 What will virtual care look like in the post-pandemic era? 18:45 How the economics of global capitation drives improved health outcomes 20:00 The role that pharmacy integration plays in value-based care 21:45 Dr. Fields discusses how pharmacists should be utilized in the ambulatory care setting 23:00 Lessons learned from pharmacy integration and how that informed VillageMD’s collaboration with Walgreens 24:20 How pharmacist intervention can improve both provider and consumer experience by switching to formulary-equivalent drugs 26:45 Referencing recent McKinsey & Company study that projects up to $265B in facility care shifting to the home setting by 2025 27:45 Village Medical at Home – a leading example of home-based care delivery 28:40 “The lack of home-based care is partly related to the hubris of physicians.” 29:30 Dr. Fields reflects on how office-based care contributes to a misinterpretation of social barriers 31:45 Care in the home as the safest and most comfortable option 34:00 How VillageMD has cares for all patient populations (not just particular high-risk segments) 36:20 “We built a model that actually expands doctors’ panels – not limiting them to a certain product or payer.” 37:45 Managing risk across different populations with segregation by SDOH and risk determination (not payer status) 39:30 Referencing Dr. Fields’ most recent Op-Ed in Modern Healthcare addressing the criticisms of the Direct Contracting model 40:30 Dr. Fields provides commentary on the hyper-politicized debate related to public-private partnerships in the Medica...
Unlocking the Digital Front Door: Patient Relationship Management in Driving Value-Based Outcomes, with Dr. Anil Jain and Alex Lennox-Miller
Feb 22 2022
Unlocking the Digital Front Door: Patient Relationship Management in Driving Value-Based Outcomes, with Dr. Anil Jain and Alex Lennox-Miller
Patient Engagement is of paramount importance in value-based care.  Healthcare organizations are increasingly turning to solutions that promise more targeted patient outreach, more coordinated care management, and more potential for patient self-support in between care episodes. These solutions fall under a broad umbrella that can be described as patient relationship management, or PRM – and despite its name, it’s much more than a rebranding of customer relationship management for healthcare. True PRM is not just a “CRM for healthcare.” It focuses on patients’ needs outside of the healthcare facility setting --in between care episodes -- as they live their everyday lives. It is more than improving engagement at the hospital bedside, more than making phone calls after hospital discharge, and more than launching a “portal of portals” to provide a unified engagement experience. A comprehensive PRM strategy can support value-based payment models by bridging the gap between the care setting and the patient’s home. In this episode, we interview Dr. Anil Jain (Chief Innovation Officer for Innovaccer) and Alex Lennox-Miller (Senior Analyst with Chilmark Research) to discuss how C-Suite executives should plan their future journey in PRM and digital transformation.  Patient Relationship Management is key to unlocking the digital front door in the Race to Value! Episode Bookmarks: 01:45 Does patient engagement have more of an impact in value-based care than SDOH?  What is Patient Relationship Management (PRM)? 04:45 The current state of dysfunctional patient engagement 05:30 How can a unified data platform create a more effective omnichannel approach to engaging patients? 06:30 Siloes of data and lack of consumer-orientation creating a less than ideal care journey for patients and families 07:15 PRM is not just for value-based care.  Billable events in FFS are also an opportunity for providers. 08:00 More engaged patients have better clinical and cost outcomes, with providers seeing improved quality measure performance. 08:40 The positive impact of a PRM platform on providers, nurses, and staff (i.e. lower burnout, higher satisfaction) 09:45 “The use of actionable clinical information within a robust PRM solution can help interdisciplinary care team members practice to the top of their license.” 11:00 Understanding the “full context of a patient”  (looking beyond the single patient record) 12:15 The use of clinical data in PRM (and how that differs from traditional CRM systems used in business) 12:45 Developing a patient engagement strategy for Congestive Heart Failure (based on clinical data and risk stratification) 13:45 “Clinical data can help create stratifications around risk.  However, that data needs to also be coupled with non-clinical data to determine how best to motivate and engage patients.” 16:00 Only 15% of hospital patients and 30% of medical practice patients access their health records electronically! 17:00 Will the 21st Century Cures Act create a more vibrant ecosystem of information exchange brought about by native APIs? 18:30 The limitations of legacy patient portals due to lack of robust data consumption and integration 19:45 How COVID-19 has reshaped patient engagement through experiments in virtual care 20:45 “A platform with rich APIs is critical to building a comprehensive Patient Relationship Management strategy.” 22:00 Patient recognition during COVID-19 that care delivery is grossly deficient in managing effective consumer relationships 25:30 Effective Patient Engagement versus Ineffective Patient Inundation (the need to integrate communications within provider organizations) 28:30 The potential for PRMs to revitalize patient engagement and provide more consumer-centric care based on optimal data integration. 31:00 Using non-clinical factors to develop open APIs, systems, and algorithms to match patients to resources in the community