Look, we wonks, meaning you and me, you're listening to this, so I am on to you. But we wonks in the Relentless Tribe, we move like lightning on Relentless Health Value. We tend to cover lots of ground pretty fast. So, sometimes I like to, with great intention, sum up what's been said—really lock into the big revelations, the big points made, the through lines.
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I like to do this so that points stick in my mind and I remember them and can build on them later. I am thinking you like this, too, because actually our through line shows in the past have been pretty popular.
But this, today, is not your average through line show. I am trying something new and actually playing clips of earlier episodes so that you can recall what a guest may have said exactly and specifically and also really see the ways that episodes may interlock.
So, to that end, let me just get to it and tell you the four core concepts to buy or deliver the highest-value healthcare that we will cover today.
Core Concept 1: Buy healthcare. And by the way, health insurance is not healthcare. Jonathan Baran talks about that, and then Cynthia Fisher, Mark Newman, and Justin Leader cover the why, which is billions of dollars.
Core Concept 2: When buying said healthcare, avoid the myth of less expensive healthcare. What is the myth of less expensive healthcare? Well, there's a lot of them, actually. One myth is that low price means low quality. Wrong. Most of the time there is actually no correlation between price and quality, but sometimes less expensive is higher quality.
Also, low quality can be the most expensive care irrespective of the cost. Also, the same exact healthcare service or product can cost wildly different prices. Just keep that in mind.
You'll hear Elizabeth Mitchell; Sam Flanders, MD; Shane Cerone; Jerry DiMaso; Ivana Krajcinovic, PhD, talk about this, this whole idea of when buying healthcare, avoid the myth of less expensive healthcare.
Core Concept 3: So, of course, at this point, direct contracting enters the building. Because direct contracting between ultimate buyers of healthcare (meaning plan sponsors like self-insured employers etc.) and the actual purveyors of healthcare (meaning clinicians) is a fairly obvious strategy if we're going to try to get high quality at a fair price.
I mean, get the beginning and the end of the road together. When you do that, it not only can spotlight—and thereby help eliminate—who might be low value that's sitting in the middle of the road collecting tolls like a toll booth, but it also enables collaboration in other ways, really, between the ultimate purchasers and the ultimate deliverers of care. Because there can be conversations about integration. There can be goals and then work out issues together, right? Collaboration is the next breakthrough innovation.
So, that's our Core Concept 3: Consider direct contracting or even just, you know, as a start, go talk to, if you're a self-insured employer or you're a purveyor of care, go just find somebody to have a conversation with. Go talk to each other. Just have a chat.
And I might include pharmacies, actually, in that mix. It's amazing what can happen, actually, when those buying care and selling care sit in the same room.
In this number three core concept, consider direct contracting, we hear again from Ivana Krajcinovic but then also from Ryan Jacobs, Adam Stavisky, and then lastly, we have a quote from Ryan Wells.
Core Concept 4: When direct contracting, or otherwise purchasing healthcare, buy the highest-value healthcare. How is that for an aspirational goal? But really, what do you want a direct contract for? What do you want your partners to be accountable to deliver?
And what's rolled up into all of that? What is value? What is value, right? We go there, and when I say we, I mean we hear from Mick Connors, MD; Dr. Siva, otherwise known as Ahilan Sivaganesan, MD; and then we have Kenny Cole, MD, to bring us home. We finish up really at a very human level for why all of this matters.
So, in summary, here's our four concepts. When you buy healthcare, buy healthcare. Focus on what you're actually getting for your money and how you are buying it. When you do that, direct contracting starts to make some sense. Just make sure the care that you are buying is truly high value. That's the whole shebang in a nutshell.
One more thing before we kick into this. So, yeah, while I was quietly contemplating the vast universe of things gone wrong and right in the healthcare sector, Tom Nash, our producer extraordinaire, wandered in and asked me to try out his new Relentless Health Value Chatbot that he's been working on possibly 18 hours a day, including weekends ever since the incident with Michelle Bernabe and the AI futurist philanthropist, which you can hear all about in Inbetweenisode 46.
But anyway, with Tom's Relentless Health Value Chatbot, you can ask a question and have it answered by me and/or one or more of the 500 guests we've had on Relentless Health Value so far.
I am not sure if I am more concerned about my impending obsolescence or thrilled to report that this thing actually works. And I will admit I did use it with, I'm going to say, a light to medium touch to help out with the episode today.
At the end of the show, if you are interested, I will tell you how to get access to said Relentless Health Value Bot. But right now, let's do this thing that we have set out to do.
Featured Experts by Core Concept
Concept 1: Buy Healthcare, Not Insurance
Jonathan Baran, CEO, Self Fund Health (EP483)
Cynthia Fisher, founder and chairman, PatientRightsAdvocate.org; co-founder and chairman of Power to the Patients (EP457)
Mark Newman, co-founder and CEO, Nomi Health (EP496)
Justin Leader, founder and CEO, BenefitsDNA (EP433)
Concept 2: Avoid the Myth of Less Expensive Healthcare
Elizabeth Mitchell, president and CEO, Purchaser Business Group on Health (EP436)
Sam Flanders, MD, senior advisor, Kada Health (EP490)
Shane Cerone, CEO, Kada Health (EP492)
Jerry DiMaso, co-founder and CEO, Payerset (EP506)
Ivana Krajcinovic, PhD, former vice president for healthcare delivery (retired), UNITE HERE HEALTH (EP501)
Concept 3: Consider Direct Contracting
Ivana Krajcinovic, PhD, former vice president for healthcare delivery (retired), UNITE HERE HEALTH (EP501)
Suhas Gondi, MD, MBA, chief medical officer, HealthStrategy (EP404)
Ryan Jacobs, senior vice president of health plan strategy and partnerships, Marathon Health (EP504)
Komal Bajaj, MD, professor of obstetrics and gynecology, Albert Einstein College of Medicine (EP458)
Adam Stavisky, business advisor, Stavisky LLC (EP503)
Cristin Dickerson, MD, founder and CEO, Green Imaging (EP485)
Stan Schwartz, MD, chief medical officer, ZERO.health (EP486)
Leo Spector, MD, MBA, CEO, OrthoCarolina (EP503)
Ryan Wells, founder and CEO, Health Here (EP503)
Concept 4: Buy the Highest-Value Healthcare
Mick Connors, MD, pediatric emergency medicine physician, Dayton Children's Hospital (EP495)
Ahilan Sivagenesan, MD, neurosurgeon, Hospital for Special Surgery; Head of Quality and Value, Mishe Health (EP505)
Kenny Cole, MD, System VP, Clinical Improvement, Ochsner Health (EP473)
00:00 Introduction to this episode and guests.
01:38 The four core concepts to buy or deliver highest-value healthcare: a summary.
06:01 An exciting show announcement.
07:32 Core Concept 1: Why buy highest-value healthcare, not "best" coverage?
11:28 Core Concept 2: Will employers fall victim to the myth of inexpensive care?
13:00 Why better-quality care vs. more affordable care is a false choice.
17:09 Core Concept 3: Direct contracting.
17:58 Why demand curve matters in healthcare cost.
22:08 How Centers of Excellence play into all of this.
22:54 Core Concept 4: How do you conceive of and buy high-value healthcare?
23:48 The value equation in healthcare.
25:35 What is value?
28:20 What whole-person care looks like.
30:24 Relentless Health Value Chatbot sneak peek announcement.
32:14 Coming up: looking at the episodes ahead.
Recent past interviews:
Click a guest's name for their latest RHV episode!
Jerry DiMaso; Dr Ahilan Sivaganesan; Ryan Jacobs; Stacey Richter (INBW46); Ryan Wells, Dr Leo Spector, and Adam Stavisky; Brian Machut; Ivana Krajcinovic; Dr Jacob Asher (Take Two: EP398)