Relentless Health Value

Today I speak with Fred Goldstein. Fred knows a lot about population health. His credentials, in fact, are about as long as my arm, so I'm just going to call him president and founder of Accountable Health, LLC and also co-founder and lead co-host at PopHealth Week —a podcast you should check out. Today Fred and I get into not just what 'good' looks like when it comes to population health, but als...

In this health care podcast, Josh LaRosa from the Wynne Health Group is back to give us an update on the snowball of drug pricing initiatives zigzagging their way around Washington right now. For the details, listen to episode 243 . That's where we really drill into the details. This conversation is more of a status report. (Note: This episode was recorded on February 6.)   You can learn more at w...

Rahul Dubey is the founder of Percynal Health Innovations. He's also the former chief innovation officer at AHIP—that's America's Health Insurance Plans. AHIP is a trade group for insurance carriers, health systems, best-in-breed solution providers, and others. Rahul has created what he calls strategic working groups, in which he gets together essential stakeholders within a regional geography to...

In this health care podcast, seven thought leaders talk about the areas of promise they see in health care in 2020. Seven thought leaders include: Kimberly Noel, MD, from Stony Brook Medicine Eric Weaver, from Innovista Health Solutions Suzanne Delbanco, from Catalyst for Payment Reform Sue Schade, from StarBridge Advisors Naomi Fried, from Health Innovation Strategies Joe Grundy, from Grundy Cons...

In this health care podcast, I talk with Karl Bilimoria, MD. Dr. Bilimoria is a surgical oncologist and a VP of quality over at Northwestern Medicine. Plus, he is also a John B. Murphy professor of surgery. The second I heard that Dr. Bilimoria and his colleagues had worked on an initiative to "rate the raters" of hospital and physician quality, I reached out to get him on the show. I had just had...

You know how in JAMA recently it said that 25% or more of health care spending is frittered away wastefully? Some of that wasteful spending comes from unnecessary care. And some of that unnecessary care happens when a patient is misdiagnosed and then, based on that misdiagnosis, gets care for the wrong thing. And "wrong thing" care obviously isn't going to fix the actual problem because its intent...

Dr. Richard Zane is the chief innovation officer at UCHealth. He's also the executive director of emergency services there. Besides that, he chairs emergency medicine at the medical school and he's a professor at the business school and at the medical school. At the recent NODE Digital Medicine Conference, I asked Dr. Zane to talk about the 2019 innovations that he is most proud to have rolled out...

Everybody knows about evidence-based medicine, especially evidence-based medicine around the use of pharmaceuticals—and especially in oncology. Provider and payer organizations, many of them, strive to standardize care pathways around that evidence-based medicine. Here is the thing: I've heard it said that doctors and patients at the point of care are not particularly interested in evidence-based...

I was asked by a group of students from Michigan University's Ross School of Business to identify what I would consider companies or areas of promise in health care. It's a good question. I'm going to take a stab at the answer in this health care podcast, but let me foreshadow coming up next month, there'll be a second episode of Relentless Health Value dedicated to this same exact topic. I have a...

Right now, I am in the middle of rereading The Innovator's Dilemma —that seminal work by Clayton Christensen. I'm at the chapter right now where he talks about resources (human and otherwise), processes, and values. These three things are the trifecta that determines what any organization can manage to achieve—or not achieve, as the case may be with disruptive technologies. Here's where this is re...

Musculoskeletal issues, otherwise known as MSK issues, account for something like 20% of the cost to any given health plan or employer or anyone else who is paying the bill for health care. That's like one in every five dollars, which is meaningful when you consider million-dollar drugs and diabetes and all the other things that a purchaser of health care can write checks for. MSK is a big cost ka...

I was listening to The #HCBiz Show!, featuring hosts Don Lee and Shahid Shah, earlier this year—specifically, their two-part series entitled "Selling Into Health Systems" [ part 1 and part 2 ]. Besides being co-hosts of The #HCBiz Show!, Don Lee is the founder of Glide Health and VBP Forward [which stands for value-based payments], and Shahid is a serial entrepreneur; one of his companies is Netsp...

In this podcast originally published early last year, Alex Akers and I had a chance to speak with Dr. Robert Pearl about his book Mistreated: Why We Think We're Getting Good Health Care—And Why We're Usually Wrong. Besides being an author, Dr. Pearl is former CEO of the Permanente Medical Group; he's a frequent keynote speaker; and he is also the host of a podcast called Fixing Healthcare.  Here's...

There are four pillars that contribute to readmissions: ensuring patients are equipped to self-manage and properly take their medications; follow-up (usually by PCPs); managing transitions of care and care coordination, which might be known as interoperability; plus avoiding medical errors. Dr. Kim Noel and I discuss each of these pillars and how telehealth and other digital tools can close gaps a...

Patients, families, caregivers are generating data outside of the health care setting. They are tracking exercise, symptoms, blood pressure. And they're coming in for their appointments bearing stacks of printouts or their username and password on a little piece of paper and asking their clinicians to log in to their accounts and check out the goings on. Clinicians, meanwhile, struggle to understa...

The North Carolina State Employees Health Plan (SEHP) crafted a proposal called the Clear Pricing Project. The Clear Pricing Project proposed to pay network hospitals based on a transparent price schedule. Considering that SEHP purchases benefits for something like 720,000 people in North Carolina at a cost to taxpayers of billions of dollars, this seems reasonable. When you're the fiduciary for t...

In this health care podcast, I speak with Mark Blum from America's Agenda. When I was talking with Mark, I kind of pictured him bearing a flag with a peace sign on it. His point for unions and employers alike is this: Instead of ripping each other into shreds at the bargaining table over health care, maybe work together proactively. Clip the reasons for rising health care costs in the first place....

In this health care podcast, I speak with John Gorman, who is a government-sponsored health programs guru. He's also the founder of a newly minted organization called Nightingale that (spoiler alert) we discuss toward the end of our conversation. I just want to interject right here that I, for one—but I'm sure John would agree—do not believe that Medicare Advantage (MA) is, as is, perfectly terrif...

In this health care podcast, Pam Arora, SVP and CIO at Children's Health in Dallas, talks about the work she and her team are doing. Spoiler alert: It's pretty visionary. They have integrated telemedicine solutions in schools and in patients' homes. They've also been monitoring adherence to vital transplant meds by putting chips on the capsules. They have initiatives happening with voice and GPS t...

I want to talk about the wellness industry today. In the parlance of the famous (or infamous, depending on where your revenue is coming from) Al Lewis, traditional "to employee" types of wellness programs are health care done  to employees, not for employees. They're like forced health care. Generally, these programs tout cost savings to the employer. And also generally, these programs aren't opti...

In this health care podcast, I speak with Lee Lewis, who is the newly minted chief strategy officer at the Health Transformation Alliance, otherwise known as the HTA. The HTA is a group of 50 major corporations that have come together in an alliance to do one thing: fix our broken health care system. Anyone who knows Lee knows he knows a lot about how to improve health care benefits for large empl...

Here's one fact of life that's always true: It will always be the desire of big vested interests to maintain and stick with the status quo. This applies to all of the various parties in the drug supply chain as much as it does to any other industry. So, here's the $106-billion-a-year question: In 2019 or 2020, will all of the drug pricing proposals and legislature popping up all over the place in...

In this health care podcast, I speak with Dr. Marty Makary about his new book, which is entitled The Price We Pay: What Broke American Health Care—and How to Fix It . I could not recommend this book more highly. It's a page turner for hospital execs trying to do the right thing, employers trying to do right by their employees, insurance carriers looking for better ways to actually drive health car...

There are 65,000 community pharmacies in the United States today, and the total cost to locate, staff, and operate these pharmacies is about 9% of our total national drug spending. That's less than 1% of our national health expenditure—and falling. This is despite the fact that about 85% of our nation's something like 6 billion prescription fills are unbranded generics, and unbranded generics are...