Relentless Health Value

Are patients consumers? Defining the terms patient and consumer will get us started here and also provide the insight and common understanding that we need to tackle this seemingly elusive question. Patient (adjective): able to accept or tolerate delays, problems, or suffering without becoming annoyed or anxious. Synonyms: forbearing, uncomplaining, tolerant, long-suffering, resigned, and stoical....

"If operating on the wrong leg is called a 'medical error,' what do we call operating on someone who doesn't need surgery?" That is a quote I have heard attributed to Jack Wennberg. It also crystalizes a theme I have been hearing a lot lately—the idea that quality metrics in this country today assess care from basically a patient safety standpoint but they don't consider whether the patient actual...

I am working on a collaborative endeavor right now where the BAA (business associate agreement) signing has literally taken a year. The whole project will likely take 2 weeks. I know I'm likely not going to shock anyone listening, but the legal side of any sale or install or collaboration or proposed interoperability can be a serious impediment when every venture takes literally months or even yea...

We have gotten ourselves into this pickle: Americans—all of us as taxpayers, as patients, as employees, as employers—spend exorbitantly for highly variable results. Great work, great health care in some areas by some great physicians and their teams, and then voluminous other areas rife with overtreatment, errors, abysmal chronic care management, predatory pricing by entities owned by private equi...

Bad things have a propensity to occur in health care when patients are placed on a trajectory and then simply follow the yellow brick road—to an Oz potentially filled with unnecessary surgeries, MRIs that cost 10 times what they should, low-quality providers chasing RVUs (relative value units) like their paychecks depended on it … I could go on. Today I speak with Derek Winn, cofounder at Distille...

In this podcast, Liliana Petrova, CEO/Founder at The Petrova Experience, translates her experience as director of customer experience at JetBlue to the health care industry. Her advice is practical and designed to actually work in environments as complex and regulated and driven by safety concerns as the airline industry—and also, coincidentally, health care. In the past in health care, some have...

Here's a vital question, "How do you make sure that the physicians your employees or members are seeing are high quality in a given area of focus?" Getting to the right doctor matters when you consider that something like 70% of back surgeries are unnecessary and medical errors are the third leading cause of death in this country. And also because, as Suzanne DelBanco put it in EP224 , if a payer...

Today I speak with Claire Sporton. Claire is SVP of customer experience innovation over at Confirmit. Since we did this interview, the 2019 Edelman Trust Barometer came out. And it showed that trust in US hospitals has nose-dived 8 points. Pharma and biotech held steady since last year, or slight increases, but the bar is pretty low. Same with insurance. In this conversation, Claire and I discuss...

Last week I was invited to attend and present at a Rare Disease Roundtable hosted by Health Catalyst and McDermott Will & Emery in Boston. A colleague from Aventria Health Group and I were there to talk about ways to enlist stakeholder collaboration throughout the rare disease patient journey. When not hosting the show, Stacey is co-president of Aventria Health Group, a marketing agency and consul...

The Society for Integrative Oncology recently completed a systematic evaluation of peer-reviewed randomized clinical trials for patients with breast cancer. The researchers assigned letter grades to therapies based on the strength of the evidence. Meditation got an A; it had the strongest evidence supporting its use. Music therapy, yoga, and massage received a B grade. Hypnosis got a C. By the way...

It is pretty much inarguable that happy customers are a prerequisite for business success. And that's true in health care as much as it's true in every other industry—although in health care, sometimes the customer is also called a patient. Provider organizations like Cleveland Clinic are really walking the walk when it comes to creating amazing patient/customer experiences; so are other leading p...

Will the Health and Human Services (HHS) proposal materially impact Pharma's ability to "pay to play" on pharmacy benefit manager (PBM) formularies? We have that HHS proposal that is now at the stage where they're trying to figure out how to implement it. What's at stake right now is that implementation flowchart and who exactly is involved in adjudicating the something like $186 billion in potent...

Today I'm talking with John Lynn, founder of Healthcare Scene as well as two conferences, Expo. Health and HITMC. If I was going to frame out an overarching theme, I would suggest that it is this: Organizational culture eats strategy for breakfast, lunch, and dinner. Let's consider the scope of this statement: Ambulatory patients spend about 84 minutes on average in clinic. Of those, 7-12 minutes...

No one denies that it's a tough world out there for health start-ups. Finding a customer is tough, financial models are tough to figure out, operationalizing is tough. But the same is true for those other health care stakeholders attempting to purchase and implement the innovations start-ups are creating. Here's another unassailable truth: Everything is just easier within a supportive community. Y...

Let's talk about the opioid crisis for a moment. When we say the words "opioids crisis," as a general broad stroke, many people immediately picture somebody who lives under a bridge. But that actually wouldn't be your average profile of someone with a substance misuse/opioid problem. The average profile of someone with an opioid/substance misuse profile looks exactly like an employee. In fact, 75%...

There's a great video of Steve Jobs responding to an audience question that is, at a minimum, let's just say strident. Jobs kind of ignores the aggressive nature of the query and offers a thoughtful response which is super relevant to health care. He says, "One of the things I've always found is that you've got to start with the customer experience and work backwards to the technology. You can't s...

If you don't know the nuts and bolts of the current Health and Human Services (HHS) proposal to nix Pharma's ability to pay pharmacy benefit manager (PBM) rebates, then it's possible you might want to listen to EP216 with Chris Sloan first. In this episode, we don't talk much about the impact of the HHS proposal on patient premiums or drug costs. That's EP216 . What we do talk about today is the i...

Today I speak with Devon Herrick, PhD, who is an expert in surprise billing. Devon is a health care economist and public policy analyst who has authored many articles on surprise billing. You'll find some links in the show notes. Devon is also an adviser to the Heartland Institute, which is a free-market think tank. I find it incredibly thought provoking that a free-market think tank, for reasons...

It turns out, patient-centric care that produces outcomes patients care about is usually less expensive than care that is not. The Patient-Centered Outcomes Research Institute (PCORI), an independent nonprofit, nongovernmental organization in Washington, DC, was authorized by Congress in 2010. PCORI was established to fund research that can help patients make better-informed decisions, guided by c...

"Those who say it cannot be done are usually interrupted by others doing it." That's a James Baldwin quote to keep in mind while considering employers ginning up real change in the health care industry. Generally speaking, employers who still don't believe they could have an impact helping their employees get better health care at lower prices, don't listen to this podcast. But if they did, I'd su...

Last time I looked this up online, there were more than 5000 companies offering digital medicine tools. Which ones worked? Which ones are less good than others? Which ones have not been tested? How were they tested: apples to apples or a whole fruit basket of standards? If you're a clinician or the head of population health or an insurance carrier and you're trying to figure out whether a digital...

Say you're a provider, an insurance carrier, a pharma company … and you've realized that you need to innovate to reduce costs and deliver better care. Or hedge against an upstart showing up on the scene and disrupting your good thing. Or ensure that your risk-based contracts go well. It's one thing to cerebrally decide to be innovative and another thing to get your organization to actually do inno...

"Dr. Google" has a bad rap in some health care circles. If you doubt my words, go on Instagram and do a search for "Doing battle with Dr. Google." But let me give you a tip: Pretending Dr. Google doesn't exist or telling patients to quit it with the internet—these are tactics that are always followed by #doomed. The best way to help your health care brand, organization, and clinicians and patients...

Today we're talking episodes of care payment models, otherwise known as bundled payments. Just to catch you up if you're unfamiliar, this type of payment model means that a health care provider packaging together all the services needed during an episode and charges a guaranteed price for guaranteed quality of care. If we're talking about government payments, about 50% of, for example, knee surger...

Arshad Rahim, MD, MBA, FACP, is a practicing physician and a health economist at his core. He enjoys a track record of building innovative health care businesses, including Mount Sinai Health Partners, Healthgrades, and Sg2. As the senior medical director for population health at Mount Sinai Health System, Dr. Rahim is responsible for driving physician performance for 3000 physicians within the Mo...