Encore! EP206: Turns Out, High‑Deductible Plans Do Not Drive High‑Quality, Cost‑Effective Care, With Ashok Subramanian, CEO and Founder of Centivo
Relentless Health Value™November 26, 202032:3244.67 MB

Encore! EP206: Turns Out, High‑Deductible Plans Do Not Drive High‑Quality, Cost‑Effective Care, With Ashok Subramanian, CEO and Founder of Centivo

There’s lots going on these days with transparency. Three cost transparency rules, as a matter of fact, just came out of CMS, for example. These rules demand that hospitals and payers make available cost information so patients can shop and employers can also shop. That last part there, about employers and/or payers being able to shop … that might wind up actually being the part of these transparency rules that has the most impact.

It all goes back to kind of a first-principle assumption that many made—including me, by the way—which is turning out to be arguable. It’s the great hope for consumerism through high-deductible health plans. The thought originally was that by pushing the burden onto patients/employees to find high-quality care at a fair price, we assumed that health care delivery would level up. We assumed that prices would come down, driven by the weight of consumer demands.

But anybody seeking to validate this hypothesis would be pretty hard pressed to claim any sort of broad-stroke success beyond cost shifting by brute force. The vast majority of patients don’t have medical degrees. This is why they went to a doctor to begin with. So, it’s unsurprising to learn that providers wield a lot of influence. If a doctor tells a patient to go here for an MRI or there for surgery, patients have a tendency to go, without questioning.

So, logically, if we want to create a high-value health care system and high-value health care—high quality at a fair price—we need to contemplate the recommendations that providers are making. These recommendations especially matter because a patient’s entry point into the health system—where they go first—can make all the difference. This is also a particularly relevant point these days with all the discussion about digital front doors.

Earlier, I spoke with Ashok Subramanian, CEO and founder over at Centivo. Centivo is a novel self-funded health plan centered around robust primary care. And I thought this episode had particular relevance given what is going on in the health care industry today.

You can learn more at centivo.com.

Ashok Subramanian founded Centivo in 2017 after observing the inefficiency in the health care system and the pain that has resulted for employers and employees.

Prior to Centivo, Ashok cofounded Liazon, operator of the nation’s industry-leading private benefits exchange for active employees. Liazon was acquired by Willis Towers Watson in 2013, and after the acquisition, Ashok served as managing director for Willis Towers Watson’s Group Exchange business. Prior to Liazon, Ashok was an associate principal at McKinsey and Co., where he served as a leader in the firm’s health care and private equity practices.

In addition to his role at Centivo, Ashok serves as an independent Board director at Artemis Health as well as a senior advisor to Silversmith Capital, a growth equity firm.

Ashok received his undergraduate degree from Princeton University, a master’s degree from Stanford University, and an MBA from the Stanford Graduate School of Business.


02:58 Background for this conversation—the entry point for where a patient enters the health system.
03:56 “Broad open-access, on-demand health care simply doesn’t work.”
04:18 “What people really do do is they listen to their provider.”
04:47 Putting more emphasis on the primary care team, as opposed to putting the burden on the employee.
05:01 High-deductible plans as blunt instruments.
05:20 Creating transparency around pricing, and the reality behind this.
05:38 “People aren’t very good at [discerning] low-value care from high-value care.”
06:57 Why people don’t challenge their doctors.
07:06 The primary care physician (PCP) as the gateway into the health care system.
07:45 Two reasons why health care is so tricky.
09:09 “There is no single awesome source of data.”
11:00 What is the PCPs’ charge?
11:43 PCPs as the change agents in health care for employers.
14:47 How do you discern who the high-value specialists are?
15:15 Building the network right the first time and making it dynamic.
17:05 Narrow networks and what’s important to focus on.
19:03 Redefining “access.”
19:22 “None of us need 40,000 doctors in our network.”
21:57 Driving better total cost.
25:02 Negotiating with the biggest health care players and operating a network with or without them.

You can learn more at centivo.com.


Check out this week’s encore episode with Ashok Subramanian, founder and #CEO of @Centivo_Health, revisiting high-deductible plans for #quality #healthcare. #healthcarepodcast #podcast #digitalhealth

“Broad open-access, on-demand health care simply doesn’t work.” Ashok Subramanian, founder and #CEO of @Centivo_Health, discusses. #healthcarepodcast #healthcare #podcast #digitalhealth

“What people really do do is they listen to their provider.” Ashok Subramanian, founder and #CEO of @Centivo_Health, discusses. #healthcarepodcast #healthcare #podcast #digitalhealth

“People aren’t very good at [discerning] low-value care from high-value care.” Ashok Subramanian, founder and #CEO of @Centivo_Health, discusses. #healthcarepodcast #healthcare #podcast #digitalhealth

“There is no single awesome source of data.” Ashok Subramanian, founder and #CEO of @Centivo_Health, discusses. #healthcarepodcast #healthcare #podcast #digitalhealth

How do you discern who the high-value specialists are? Ashok Subramanian, founder and #CEO of @Centivo_Health, discusses. #healthcarepodcast #healthcare #podcast #digitalhealth

“None of us need 40,000 doctors in our network.” Ashok Subramanian, founder and #CEO of @Centivo_Health, discusses. #healthcarepodcast #healthcare #podcast #digitalhealth

digitalhealth,healthcare,healthcareoutcomes,healthcaretransparency,

Recent Episodes

Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter
February 06, 202535:0132.05 MB

Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter

I am drowning in all things Q1 right now. So, this week we’re going with an encore. But this is a great show to go back and reflect upon, as it’s about carriers and how shareholders impact the actions of said carriers. For a full transcript of this episode, click here . If you enjoy this podcast, b...

EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD
January 30, 2025
462
33:3430.73 MB

EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD

Hello, Tribe. I hope everyone is holding up in this Q1 where there is so much going on. I feel like I’m juggling 10 plates while running on a treadmill that keeps stopping and starting at random intervals. How you doing? For a full transcript of this episode, click here . If you enjoy this podcast,...

INBW42: A Philosophical Rabbit Hole of Considerations for Plan Sponsors and Others
January 23, 202527:3925.31 MB

INBW42: A Philosophical Rabbit Hole of Considerations for Plan Sponsors and Others

There have been two episodes lately that have sent me down a rabbit hole that I wanted to bring to your attention. Now, disclaimer: I know you people; you’re busy. You listen on average to, like, 26 minutes of any given episode. So, yeah … look at me being self-aware. I say all this to say welcome ...

EP461: Pick Only One, Plan Sponsors: Do You Want to Control GLP-1 Volume or Control GLP-1 Unit Cost? With Chris Crawford of RxSaveCard
January 16, 2025
461
22:4220.78 MB

EP461: Pick Only One, Plan Sponsors: Do You Want to Control GLP-1 Volume or Control GLP-1 Unit Cost? With Chris Crawford of RxSaveCard

This episode with Chris Crawford, CEO of RxSaveCard, is not about the when, why, or how of GLP-1s for weight loss or best-practice prescribing; and we do not wade into anything about lifestyle changes or who is adherent or clinical considerations and needed support. There are a plethora of shows on...

EP460: Rushika Fernandopulle, MD’s Theory of Change Starts With Status Quo Healthcare
January 09, 2025
460
41:0437.6 MB

EP460: Rushika Fernandopulle, MD’s Theory of Change Starts With Status Quo Healthcare

This is one of those episodes where we consider top-line strategic imperatives and key drivers. I thought there was no better person to do this with than Rushika Fernandopulle, MD, who, in case you were unaware, was the founder of Iora Health, an advanced primary care group that was sold to One Med...

EP459: Cost Containment by Co-Pay Maximizer or Co-Pay Accumulator: Points to Ponder, With Bill Sarraille
January 02, 2025
459
39:4736.41 MB

EP459: Cost Containment by Co-Pay Maximizer or Co-Pay Accumulator: Points to Ponder, With Bill Sarraille

If you have zero clue what co-pay maximizers and/or co-pay accumulators are and the financial incentives involved for PBMs (pharmacy benefit managers) and plan sponsors here, after you’re done listening to this episode, go back and listen to the show with Joey Dizenhouse ( EP423 ). Also, the episod...

INBW41: End-of-Year Wrap-Up and My Personal Charter Encore: Where the Rubber Hits the Road
December 26, 202425:5223.67 MB

INBW41: End-of-Year Wrap-Up and My Personal Charter Encore: Where the Rubber Hits the Road

Okay, so, we’re gonna go with personal charter. Just, yeah, given everything going on right now, yeah. It is a charter, not a manifesto. Because of the end-of-the-year status of this episode, I just want to kick this off by giving a big thank you to everyone listening. But this isn’t a thank you fo...

Listen and Follow

Sponsored by Aventria Health Group
©2025 BD Bridges LLC. All Rights Reserved.