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 employers. He’s pretty much the perfect guy to be the chief strategic officer at the HTA. The most amazing thing that I always find about improving health care, the structure of health care benefits, and health care benefits for an employer is that it’s like having your cake and eating it, too. On one hand, both the employer and the employee save money. On the other hand, employees get better care and they spend less time away from work struggling to navigate the health care jungle all by themselves.
Lee has a playbook for improving the structure of health care benefits or health care benefits for large employers, and this playbook consists of three chapters, which we get into in this podcast. The first chapter covers the “how” of health benefits, including what Lee calls the “administrative superstructure.” The second chapter in Lee’s playbook is the “what,” which usually comprises drug spend and then, on the medical side, how care is delivered for specific clinical conditions like musculoskeletal, cardiometabolic, etc. There are a few conditions that tend to rack up the most costs categorically, and those are the ones that Lee focuses on. The last chapter in Lee’s playbook is the “who,” meaning where employees are steered to for care—and that also includes an emphasis on PCPs (primary care providers).
You can learn more by visiting htahealth.com and by connecting with Lee on LinkedIn.
Lee Lewis is an innovator and strategist helping large, national, self-funded employers save millions on health care through leading practices, vendor partnerships, and member engagement. He pioneers methods around the convergence of digital health, medical consumerism, biomedical supercomputing, and system reengineering.
Lee runs Gallagher’s Innovation Lab practice, a mission-driven group devoted to improving the cost, quality, and design of American health care. Lee advises several health start-ups working to solve meaningful health care problems.
The Innovation Lab has a track record of breakthroughs. It leads the effort to bring sophisticated health plan audits to private employers. It pioneered specialty drug direct purchasing without using a PBM. His team led a grassroots effort to identify all independent freestanding emergency rooms in Texas. The Innovation Lab developed the first HSA-compliant model for back and joint pain prevention and is piloting the first-ever ultra-high-value virtual networks in two major US cities.
His current and past clients include American Airlines, Comcast NBCUniversal, Albertsons grocery stores, The Home Depot, Abbott Laboratories, and dozens of other large and jumbo employers.
Lee is a Rhodes Scholar nominee. He graduated second in his class, magna cum laude with university honors in accounting from Brigham Young University.
02:30 A playbook to reduce health care spend and achieve better outcomes.
02:47 The “how,” or “administrative superstructure.”
04:11 What Lee typically does when working with companies.
09:41 The “what” of delivery—connecting the “what” to the “clinical.”
11:42 Overseeing the pharmacy benefit manager (PBM).
13:46 EP241 with Vinay Patel.
13:59 Looking at the medical side of health.
17:02 Improving spend and improving quality simultaneously.
19:30 EP240 with Olivia Ross.
20:13 Why centers of excellence make sense.
25:13 The “who”—who is providing the care.
27:27 Enabling and empowering PCPs and improving PCP pay to compensate for that.
30:45 Where the HTA is headed.
32:26 Lee’s advice for brokers.
33:15 Lee’s advice for provider organizations, hospitals, and centers of excellence.
34:48 “Hospital systems are not monolith.”