Relentless Health Value

There is a transparency zeitgeist kicking off right about now. In June was the biggie, the one where health systems now have to divulge their contracted rates with insurance carriers starting January 1, 2021. But this zeitgeist is flowing into drug prices as well. Surescripts just released their real-time prescription price transparency tool. This price transparency tool allows detailed cost and a...

At the end of the day, health care should be about helping patients find their way to health while doctors, nurses, and other clinicians don't burn out in the process. It's becoming increasingly indisputable that the way to get to this North Star efficiently is through human-centered health care. Human-centered health care is a term coined by Dr. Sylvia Romm, and it's a play on the term customer-c...

This past March, I was looking forward to giving a keynote at the Arizona Technology Council. Unfortunately, that didn't happen. COVID happened. But in the process of figuring out what I was going to talk about during my keynote, I came up with an idea and I wanted to share it. It's the idea of how to measure value in health care delivery, because might as well go big or go home, right? The metric...

In the April issue of Value-Based Cancer Care (that's a journal), there's an article talking about a keynote presentation and a study highlighting a big problem for patients with cancer: toxicity. It's a fact that some chemo agents are pretty toxic, but in this health care podcast I am talking about financial toxicity. The financial burden of cancer care has a seriously negative influence on patie...

You know what the second biggest cost line item is on most health systems' profit and loss report: supplies—buying things like artificial knees, stents, service contracts. It's estimated that an average hospital can save more than $12 million a year if they manage their supply chain better. And interestingly, oftentimes care actually improves as a result. For context, that wasted $12 million could...

In this health care podcast, I am talking with Yauheni Solad, MD. Dr. Solad is one of the top minds in data and data exchange. He's medical director of digital health and telemedicine at Yale New Haven Health, and he has a mission to lead digital transformation toward accessible and affordable high-quality care that's enabled by technology. Dr. Solad also does a lot of work with NODE—the Network o...

Let me explicitly state an implicit theme that's been running through a bunch of the latest Relentless Health Value podcasts talking about if and how the COVID-19 pandemic could possibly serve as a flash point in the health care industry—a flash point where egregious and self-interested financial pursuits take such a toll that politicians notice. Why do these legislators notice? Because the patien...

In this health care podcast, I'm speaking with Maura Calsyn from the Center for American Progress—or CAP—and we're talking about value-based drug pricing and the impact that COVID-19 may have on its definition, operationalism, and broad adoption. I remember a situation (kind of years ago, actually) where a pharma company decided to lower its price on an infused product. Normal supply and demand wo...

Look, bottom line, value-based care has to be the future of health care delivery in this country. That's just inarguable at this point. Nobody disagrees except for health care industry stakeholders trying to reap as much reward as possible while the going is good. And they've been really successful with their reaping thus far. Here's the thing, though: There's speculation that health insurance pre...

In this health care podcast, I talk with Brian Scott. Brian has a background which is perfect for the question of "Will employer health care costs go up or will they go down as a result of this pandemic?" First, Brian was an underwriter at United. Then he was in a dedicated complex claims group for Lockton that managed self-funded plans. And now he's at Point6 Healthcare, where he works to put tog...

I have the same burning question that I think many of you have: If I am a self-funded employer, as a result of this pandemic, will my health care costs go up? This question boils down to an equation that has two parts: the additions and then the subtractions. In the Additions column, how much will an employer spend on COVID-19 treatments—you know, both the ICU visits but also employees who haven't...

Everybody's talking about the surge in telehealth usage. I wanted to talk to someone who has been ramping up their telehealth capabilities for a while to get a sense of what it takes to do it well. And, as has been said by many, doing telehealth isn't just about technology. It's about training clinicians, patients, and accounts receivable and other staff. It's about rearranging workflows and proce...

Everybody's been talking about the surge in telehealth usage—how it would have taken, like, ten years to get as far as we've gotten in the past ten days. I wanted to talk to somebody who has been ramping up their telehealth capabilities for a while to get a sense of what it takes to do it well. As has been said by many, doing telehealth isn't just about technology. It's about training—clinicians a...

A lot of people are wondering why independent PCPs are furloughing nurses and talking about shuttering their practices in the middle of a pandemic. Conventional wisdom would assume that PCPs would be just fine if they stand up telehealth and can take some sort of majority of their patient visits virtually. After all, it would make a lot of sense that a lot of patients are calling their doctor righ...

In this health care podcast, I'm talking to Al Lewis from Quizzify. This episode also guest stars Rachel Miner from Thrive Benefits, David Contorno from E Powered Benefits, and Doug Aldeen, a health care attorney in Texas. This episode started out being about surprise billing in the emergency room (ER) and a potential defense strategy that patients and employees can use to protect themselves from...

Let's talk today specifically about primary care physicians (PCPs) and family medicine doctors. Data was reported in USA Today , saying that an estimated 60,000 family practices will close and 800,000 of their employees will lose their jobs by the end of June. It's hard for any practice to just snap its fingers and transfer patients over to telemedicine regardless of the reimbursement rate and/or...

The first wave of this COVID-19 pandemic has been totally reactionary. Don't get me wrong: That does not detract from the Herculean effort made by hospitals and clinicians who have thrown everything they have at this—and more. But I don't think that anyone would disagree that if we had enough PPE (personal protective equipment) and ventilators—you know, like, proactively—we'd be in better shape. S...

On Friday, March 27, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act—otherwise known as CARES. This CARES Act covers the whole $2 trillion megillah stimulus package, but in this health care podcast episode, we're talking quickly about a provision in that Act. I speak first with Doug Aldeen, an attorney specializing in helping employers settle hospital bills....

The reaction of some hospitals and health care systems to the COVID-19 pandemic has been truly breathtaking. Doctors, nurses, first responders, other staff at hospitals and elsewhere have worked hard—so hard—to support the national effort. The same can be said to some tech entrepreneurs and other businesses who have snapped into action in order to provide PPE (personal protective equipment) and ar...

Marty Makary, MD, MPH, is a surgeon at Johns Hopkins. He's a professor of surgery and health policy and management at Johns Hopkins University. And he's also the author of The Price We Pay and Unaccountable . I had the honor of speaking with Dr. Makary last week, and I learned a lot. For one, the worst is between now and June. For two, it's all about ramping up capacity as fast as possible in our...

This episode was recorded prior to COVID-19 hitting our shores. Irrespectively, it is incredibly relevant. Right now, more than ever, we need physician leadership and we need partnership across organizations and within organizations so that good decisions can be made as fast as possible. Look, we don't have time to mess around right now. We need to be making good decisions—and fast. And these deci...

There is a lot going on with digital health tools these days. Which ones are the good ones and which ones are nothing burgers packaged up in beautiful marketing? That's a good question, and it would be nice to have a go-to source for such information. Some parties — mainly PBMs [pharmacy benefit managers] and to some extent payers and providers — recognize that this actually would be nice, and the...

It's kind of a vicious cycle. Payers don't trust providers to do the right thing and provide appropriate care. And OK, there's some logic there considering that 25-ish% of health care delivered is low-value or unnecessary. On the other hand, some patients actually need the care and now it's painstaking for them to get it—and that painstaking part of the sentence is borne by providers, at least log...

Here's the thing: All the top-performing Medicare Advantage plans are using, today, right now, some form of advanced analytics and artificial intelligence (AI) to risk-stratify their populations and predict which members will, without intervention, become high cost in the near term. The idea is then to intervene to mitigate risk and stop bad things from happening—bad things that stink if you're th...

The World Bank had a revelation a few years back. Some very smart people working there realized that countries that were easy to do business with thrived. Within these countries' business ecosystem, the best and the brightest entrepreneurs and investors grew not only their own businesses but also positively influenced other businesses and the community around them. Brian Van Winkle and Rishab Shah...