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 equity or with billing departments gone wild.
Who will be our knight in shining armor when it comes to fixing health care in the United States today? Will it be legislators? Will it be our current crop of large health care stakeholders? Will it be a self-proclaimed disrupter like Amazon or Haven Healthcare, that Amazon, Chase, and Berkshire Hathaway collaboration?
In this health care podcast I speak with Brian Klepper, PhD. Brian has opinions on these questions.
Spoiler alert: Some of the entities that Brian points to as intrinsic to the mission of fixing American health care are brokers who are not compensated in secret by insurance carriers. He also calls out primary care physicians and new primary care models as crucial.
If you’re looking for brokers of this kind, go to healthrosetta.org for a list of them. You could also listen to my podcast with David Contorno (EP186). On the primary care side of the equation, listen to my chat with Jed Constantz (EP209) and also the one with Alex Lickerman (EP184).
In case you haven’t heard of him, Brian is a health care analyst, commentator, and also an entrepreneur. He’s executive vice president at the Validation Institute, executive analyst and editor at the Health Value Institute, and principal of Healthcare Performance, Inc, a health care strategy and business development practice. He’s also principal of Worksite Health Advisors, a benefits consultancy. Formerly, Brian served as the CEO of the National Business Coalition on Health.
You can learn more at careandcost.com, by emailing bklepper@gmail.com, and by visiting validationinstitute.com.
Brian Klepper, PhD, is executive vice president of the Validation Institute, principal of Worksite Health Advisors, and a nationally prominent health care analyst and commentator. He speaks, writes, and advises extensively on high-performance health care, primary care clinics, and the management of clinical and financial risk.
His current consulting focus is on health care organizations that consistently deliver better health outcomes at lower cost than conventional approaches in high-value niches. In his role at the Validation Institute, he spearheads programs that identify, validate, celebrate, and promote true high-performance health care programming.
02:54 How solving the health care crisis can be done within the marketplace.
04:13 “Half or more of everything that we do in health care is unnecessary or inappropriate.”
04:29 “We have come to depend upon doing the wrong thing.”
04:39 How we fix health care when the vested interests have no incentive to do so.
08:50 Money on the table vs doing the right thing.
10:24 What we should be doing right now to fix this before we price ourselves out of health care.
12:34 Why the health industry does have a marketplace.
18:29 Laser focusing initiatives to fix health care by fixing the biggest costs of health care and following the money.
19:37 “We’re not just talking about managing care; we’re talking about managing health care, clinical, and financial risks.”
22:34 EP186 with David Contorno.
22:50 Lee Lewis of Gallagher.
24:25 How the Validation Institute identifies high-performance vendors.
25:54 Why working with a broker is essential for employers in order to find health providers they can trust.
28:05 Health Rosetta, founded by Dave Chase.
28:17 An outcomes-accountable health care place.
28:30 Brian’s advice on what one of the “BUCAs” should be doing right now.
29:18 “Are they willing to make less money?”
30:53 “Big change is coming.”
31:15 Brian’s advice to organizations to prepare for and fix health care’s coming inflection point.
34:11 Places to watch that are ahead of the rest of the nation in making these changes: the South.