January 11, 2023 • 33 mins
Dr. Prakash Patel, CEO of MaxHealth, has made big leaps in his career, from orthopedic surgery residency to the business side, and from a large, well-established organization to an entrepreneurial leadership role. Along the way, he has pushed through burnout and stayed the course while keeping in pursuit of improving access to care. Join Prakash as he shares what needs to change for transformation to happen and how MaxHealth is taking value-based care to the next level.
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S1 (00:04):
And.
S2 (00:07):
Hello. Welcome to Prophets Healthcare Transformers podcast, where we'll be
talking to leaders in healthcare who are focused on transforming
their organizations to drive the next level of growth for
their business and for health care. Hosted by Priya in Asia,
Lindsay Moseby Paul Shrinks and Jeff Gordy. Transformation is one
of those terms that has a lot of layers to it.
(00:29):
Sometimes it's about innovation. Sometimes it's about shifting the way
you do business. Sometimes it's to your overall operating model
and other times it's to a specific department or function.
It's also about people helping them navigate the discomfort that
comes with change, but also motivating them to engage in
the journey of transformation from the CEO to the newest employee.
(00:52):
It's a journey, and that's why we created this podcast
to break down this multidimensional, dynamic topic of transformation one
story at a time. Are you ready to dive in?
S3 (01:07):
Hi, this is Jeff Gore. I am the host of
today's episode. We are thrilled to have Prakash Patel, the
CEO of Mass Health, on the podcast.
S1 (01:17):
It's wonderful to be here. Thank you for inviting me, Jeff.
S3 (01:19):
So, Prakash, start, if you could, to introduce yourself and
to our listeners and tell us about your, you know,
your professional profile. But certainly give us one fun fact.
We often open our podcast this way. Tell us one
fun fact about you that cannot be found on your
LinkedIn profile.
S1 (01:36):
Yeah, absolutely. And I'll start with the with a fun fact.
I am a curiosity streaming app nerd. I love that.
I watch that almost as much as I watch ESPN.
It's a really cool app. If you don't have a Jeff,
it's for me. It teaches me so many things I
never learned. I was very science focused and in college
and went to medical school on the East Coast and
(01:57):
went into orthopedic surgery. So for me, it's opening up
all kinds of areas and it's nice because it's in
small bites. So I can watch 10 minutes, 15 minutes
and really learn about things from space to history and
culture and so many different things that I've always wanted
to take in. And it's done in a really simple
way for somebody like me to understand. So I really
(02:17):
enjoy that.
S3 (02:18):
It is and it is a fun fact, and maybe
if I get into it, I could waste less time
on Twitter. So the benefit there of Twitter, I'll check
it out. All right. So back to back to you.
Tell us about yourself and you started to a little
bit there.
S1 (02:28):
Absolutely. Well, I wish I could tell you that I
had planned out my career, you know, from the beginning.
And where I am now is exactly how I thought
I would what it would be. I certainly wasn't that
smart enough, certainly not that thoughtful and knowing that. Exactly.
But I will tell you that I've been very, very
fortunate in a you know, last 25 years. I made
a decision when I was in my orthopedic surgery residency.
(02:52):
And this is the same time that President Clinton and Mrs.
Clinton were talking about how they were going to change
health care. If you recall, Jeff, they the health care
panel was put together and Hillary Clinton was was chairing it.
And a huge push in how they're going to restructure
the whole entire health care environment. And it really made
(03:13):
me think about what role do I really want to play.
And that really led to a number of conversations that
I had with a wide variety of folks, friends of
mine who had gone in the business side and were
in health care systems. And I made the decision 25
years ago that I wanted to really be on the
business side of health care. I was always interested in it.
(03:33):
In fact, I almost didn't go to medical school, so
I had some interest and I took a leave of absence.
They were kind enough to give me a two year
leave of absence, and I never went back and started
my career working with David Shear, actually a chair and company,
really a wonderful experience there, spinning out assets from pharma
and then ultimately device companies and realized I really enjoyed
(03:56):
running things. And over the years I ended up running
panels and having greater responsibilities across the health care ecosystem.
And I think I might be one of the few
senior health care executives, I think, in leaders that actually
have a tremendously broad background in terms of size of companies,
scope of roles, range of health care industries. It's been really,
(04:19):
really fortunate. I wish I could have told you I
planned it all out, but it's given me a pretty
interesting perspective and insight, you know, all the way through
execution in health care, especially with this intersection of payer,
provider and tech and the whole ecosystem, health care ecosystem,
just a you know, very well that's emerging here in
health care. So, you know, I've been very fortunate and really,
(04:40):
really pleased at how my career has evolved, even though
it was unplanned.
S3 (04:44):
Yeah. So are you never a practicing orthopedic surgeon?
S1 (04:47):
Never practice? I did three years and never went back.
And I did have some sleepless nights. You know, quite candidly,
our first year as a got Am I really making
a good decision? Half the people thought I was crazy.
Has people thought I was less crazy? I don't think
anybody thought I wasn't crazy at all. But but you
know it. You had a fall. I think one thing
I can tell my kids, you and I were talking
about kids. I can tell my kids quite directly that
(05:08):
I walk the talk about following your passion in life
and taking hopefully smart risks. And I'm pleased with that.
S3 (05:14):
Yeah, well, that's great. You and I first met Prakash.
I don't know, gosh, several years ago now, when you
were executive a gainwell Blue Cross Blue Shield in Florida.
And we have stayed in touch as you went and
took on a pretty senior role at the company formerly
known as Anthem before taking your current role with with
Max Health. So we'll talk about that. But tell us
(05:36):
about just from that last move. Tell us about the
leap from one of the biggest, most established, influential health
care organizations in the country to something more entrepreneurial.
S1 (05:47):
To me, it was always around that inflection point of growth, restructuring, repositioning,
bringing the assets and people together and taking it through
escape velocity. And, you know, 10 billion is pretty big
now within $100 billion company. It's still small, pal, but
it was obviously pretty sizable. And to me it was
I really like taking things and building them out. And
(06:11):
when they get to a certain size, is that what
I want to continue to do now? Is it enjoyable? Absolutely.
Going to continue to do that? Absolutely. But I felt
today with what's happening in the provider side was really
exciting and I wanted to be a part of that.
I started in April and, you know, the reason I
chose to work at Max Health, in fact, they will
(06:32):
tell you that I actually said no several times initially,
including in the reason I said no is not because
something was fundamentally wrong with the company. Quite the opposite.
I just felt, you know, I just resigned. I wanted
to do I wasn't among some board seats and working
with private equity groups. You know, I was kind of
you know, partly I was a little burned out to
to be to be quite candid, Jeff. And and especially
(06:55):
with that kind of growth in a short period of
time and transforming big you know, transforming companies within a
large company is not easy. So it does take a
lot of energy out of you. And I was going
to take it easy for a few months, but I
really liked what they were, what they were doing and
what's unique about them in my perspective and maybe we'll
talk more about this, is, you know, all of their
(07:15):
business is within Florida. They didn't go into the usual areas.
We think about Florida, we think about South Florida, Miami
Dade in the south, all the all the usual areas. Well,
what this group had done is they had actually built
out the west coast of Florida. And if you're familiar
with the West Coast, there's a tremendous amount of growth
happening from and around Naples all the way up to
(07:36):
Tampa and then across the what we call the I-4
corridor from Tampa to Orlando and Daytona. So this group
had really been building out clinical assets, primary care led
value based for risk kinds of deals along those areas
and gotten quite deep and it proven that they could
actually manage fully capitated relationships. So a really strong foundation.
(07:58):
Great private equity group behind it and just felt that
it was a it was an a nice inflection point
where we could take what the teams have done a
tremendous job with and building to the next level. And
that that's exciting for me.
S3 (08:11):
This is, I think, really interesting. As you know, we
call this the Health Care Changemakers Podcast, right? And we
and that's why we're so happy to have this conversation
with you because you clearly been that. But we also
have a health care industry that is as a whole
massively burnt out. And you know, the statistics and turnover
and people leaving the profession and professional suicide rates and
all kinds of things with doctors, with nurses across the profession.
(08:33):
But you were you, you said you were burnt out. Right.
And you had the luxury of taking some time and
to figure out what you want to do next. A
lot of people don't, right? Maybe even most people don't
have that opportunity. We need we the health care, larger
world that I'll include you and I both in need
change makers to thrive. What has to change? What does
this all say and what does it say about the
(08:55):
state of health care? What needs to change to allow
for the transformation that we all know needs to happen?
S1 (09:00):
You know, this is a fantastic question and one that
I think that we as leaders often feel that in
in this kind of comes back even from my orthopedic
days to to acknowledge that your burned out is a
sign of weakness to some. And and I think one
of the most important things we have to do is
just be honest and have open conversations. And it's funny
(09:21):
how many you hit it on the head. Jeff, you
talked about so many of the studies coming out and
the conversations we're finally having, and I think it's really great.
It's healthy that we're finally acknowledging it's like mental health, right?
During COVID, everybody's talking about, you know, mental health. This
is though it should have been this separate area from
physical health. It's just health. We are whole person beings.
(09:41):
We're not just ankles and brains and muscles and hearts. Right.
And I think the same thing goes with having this
honest conversation. And we were having honest conversations with people
in our organizations. I was having them with all layers
of my teams and and talking about this with others.
And then I realized, well, wait a minute, I'm actually
burned out. I'm actually feeling pretty exhausted from, you know,
(10:05):
launching the first of my business group. And I need
to take a step back and think about what how
do I recharge and get back to what super jazz
is me. And so I think the first thing is
just having that open dialogue and just being honest with
each other. And then then, you know, some of the
things that I think are really important, it should be okay.
And I didn't ask for this, so I can't say that,
(10:27):
you know, this organization wouldn't have done this, but I
it's I should be okay for people to take a
short sabbaticals. You know, here's your two weeks of sabbatical.
Go and think. Don't do any calls, do anything. And
now a lot of this is my fault. I am
the kind of person I would work during vacations and
make the calls, and that's my fault. But I think
that's important to have. Just And the other thing we
(10:47):
can do is change a lot of our travel and
meetings in so much nonproductive kinds of things we do
throughout the day that we just do because you're part
of a big company or you're part of an organization,
you feel like you have to do it in a
way so a lot of time and waste a lot
of energy. So I think we have to also reflect
on the workflows that we have. And so, you know,
(11:09):
we could go on on this topic. But Jeff, I
think it's a fantastic area probably for future discussions. We
don't talk enough about senior leaders going through this. We're
talking about providers. It's a massive issue that we still are.
We really haven't grasped yet and we don't have great
solutions yet for that either.
S3 (11:28):
Well, to your point, we could we could talk about
this forever. So thank you for scratching the surface of
that with me. And I obviously was made note of
the comment that you made. So thank you for sharing
that kind of personal reflection. Okay. So let's go back.
Before we talk about MassHealth, which I definitely want to do,
just give us your sense of like what is the
state of primary care today and what days is at
(11:48):
work and what ways might it be the best in
the world. But then also, you know, I assume the
thesis behind the organization is there's some stuff that's broken
and that will kind of take us to our to
our story about myself. Yeah, the.
S1 (11:59):
State of primary care. I actually look at primary care
in the lens of phases. You know, I'm old enough
to remember in especially in rural areas, underserved communities. Primary
care providers used to do everything. And I don't know,
just if you've seen this in your in your analysis,
in your exposure and health care. But primary care docs
(12:19):
did a little bit of, you know, minor surgery. They
deliver babies in many communities. They treated from mental health
all the way to fractures. I mean, they they would
stitch certain contusions and other things. So they actually played
a really critical role in almost did so many things
that today would just go right to a specialist. And
so that was sort of the first phase. And then
(12:41):
then we went to this super specialty referral triage, primary
care environment, where primary care doctors became essentially triage. You know,
you come in, you see your primary care doc, if
you had a skin issue, they send you to dermatology,
you had a cardiac heart issue, they send you cardiologist.
And now I think we're in the third phase of
primary care, which is the primary care provider. He or
(13:04):
she is the captain of a team, an interdisciplinary team
that includes, in some cases, dieticians, pharmacist, certainly mid-levels, social workers,
really a team environment and non-clinical teammates trying to provide
care for individuals that are in their office and individuals
(13:26):
that are not even they haven't even seen but are
being identified through analytics as needing, you know, support. And
it could be all kinds of issues. Potential high risk
for admissions or E.R. visits or, you know, medication support,
all kinds of things. So they've become that captain of
our team. That's, I think, where we are today. And
(13:47):
and I you know, in terms of what works today,
I think what's starting to show is no one is
saying no one. I mean, I really don't hear give
me more fee for service. Let's go back to more
fee for service. I don't hear that. And hopefully you're
not either. So I do think we're starting the tipping
point is already there where from CMI to, you know,
local providers in the primary care space are saying, hey,
(14:10):
how do I how do I do this value based?
Now there's a huge range for success and an expertise
in value based care for providers, primary care in particular.
But there is no debate that this is a place
that they also want to go. And and so what's
working is the transformation of the payment model. And I
think that's really critical. We sometimes don't want to talk
(14:32):
about it, but form follows Function actions follow payments in
health care. So the payment models have come a long way.
S3 (14:40):
So tell us about tell us about Max Health and
tell us about its unique proposition. And I'm particularly curious
because there seems to be, from what we can tell here,
a lot of innovation in primary care and that obviously,
you know, one medical's been in the news, VillageMD has
been the news for health has been in the news.
I'm curious, like where the max health proposition is and
(15:00):
why this is the one that you said I want
to be part of this one.
S1 (15:02):
I think I may have started pre-empting. You wasn't sure
you were going to go there, but, you know, you know,
for Max health and you're right, there's been a lot
of activity, especially from the strategics. I think the primary,
the private equity teams kicked it off. And recently we've
seen a lot of activity from the strategic buyers and partners. And,
you know, like I said, one of the reasons I
(15:23):
left is I saw this coming. So, Jeff, I may
have gotten a trend, right? I don't know.
S3 (15:27):
Let's say we'll have you back in a few years
and we'll reflect.
S1 (15:31):
Reflect. Yeah. You know, I do see the momentum shifting
towards the providers and there's a whole different role I
think the payers will play in the future. This is
something else we can talk about in the future. But
you know, in terms of max health, I like that
they were heavily, heavily focused on being a really darn
good risk based value based provider. So, you know, we
(15:52):
look at our business, we're not taking non value based care.
It doesn't mean we don't have some commercial. But most
of that is because, you know, these are folks aging
into two senior products or we were. We were requested
to do so on behalf of some of the payers
that have our Medicare lives. But 99% of our revenue
(16:12):
and profits are being driven through full risk contracts and
in the government side. The other thing I was very
impressed with and we just saw the data come out
actually is on the ACO new entrant is we'll reach
the old DC. We are one of the two of
our both of our D.C. plans are the top seven
(16:33):
or eight in the whole the whole country. So we
are really this is a group that's walking the talk.
I liked the geographic focus I was mentioning earlier. West
goes to Florida, where everybody else is weaving. You know
where we're going the other way, where everybody is going
to South Florida. We've got this tremendous 80 clinics spread
throughout west, west part of Florida, across I-4 corridor, where
(16:54):
double digit growth is happening in our seniors, in many
of our counties. And then we're profitable. You know, one
thing you just mentioned, some of those groups. You know,
there's others that are publicly traded we could talk about,
but we're profitable. So we're growing profitably. We're managing at risk.
And the other thing I would mention I liked about Mack,
(17:14):
I think I think it's unique is they started with
a tech stack versus some of the groups who retroactively
fit a tech stack in. It's really hard to do that.
I think you know this really well. You just can't.
It's so hard where you're already on going to come back,
especially if you have Tuesdays in three sites spread across
(17:37):
the country. You don't even have critical mass to negotiate
with payers and get that that margin to cover the
expenses that go with that and disruption. So I think
those are things we're all and I we're really was very,
very attractive to and they have a very strong retention
of their senior members high end peers score the scores
for us are in the eighties mid eighties too to
(17:58):
be precise which is pretty good.
S3 (18:00):
So let me make sure I understand how it works.
So the senior on Medicare Advantage chooses you, right? Maybe
because they've heard from a friend who had a great
experience and the NPS speaks to maybe it's because your
clinic is in their neighborhood. They wander in there, they
have to be on Medicare Advantage. I assume before you're
you're working with them.
S1 (18:18):
Yeah, there may. So there are Medicare Advantage. Some are
traditional fee for service Medicare now going into the acreage program.
And then we have some just traditional Medicare, but the
vast majority are in Medicare Advantage plans, both HMO, PPO
and plans.
S3 (18:32):
Okay. And then do you ever see a model I'm
just agreeing about, you know, forward health this morning in
particular right there, they don't take insurance. I'm just curious,
like if essentially health care becomes a subscription, Right. I
go to Ford Health or I go to max Health
or I go to wherever and they say, here's what
you pay. We take care of all your health needs.
(18:53):
And our incentive is not to cut corners because we
want to keep you and your friends coming back. But
our incentive is also to keep you healthy overall as
the insurer or play, What role does the insurer need
to play in the future? Today is maybe a little
more clear.
S1 (19:06):
Yeah. No, I first of all, I think we should
welcome all models because no one's figured out. We certainly
haven't figured it out completely. No one has. So I
think we should completely welcome different models. You mentioned a few.
There is others coming out there. You know, it's interesting
when you look at what's happening, even with the self-insured.
I'll start with that on the employer side before we
go to the government, even you're seeing the migration. You know,
(19:29):
large companies were already doing this. What you're seeing going
down to mid and even smaller companies where they're migrating
from being fully insured, self insured. Now we're seeing going
from this ASO fee structure to say, you know what,
I can go to a TPA next generation tech oriented TPA.
I don't really need that that health plan, that payer.
And I think that momentum is going to continue. When
(19:51):
you think about seniors, for example, where you have more
complex and chronic conditions, you need more coordinated care. You
got to think about whole person care in a different way.
You know, we have some very, very ill members and patients.
They need a tremendous amount of support. You know, the
subscription model doesn't work as well there. It doesn't mean
you can't have some of that. And now there's some
(20:13):
issues of being you can't, you know, Bill that way
and bill Medicare. But even if let's say you didn't
have traditional Medicare, you wouldn't take any of the seniors.
You really would be talking about a slice of our population.
And fundamentally, one of the big reasons I went into
the business added health care, is I do want us
to change access to care. I'm one of those believers
that care and health care is just a human right
(20:35):
for us in our country. You know, I would like
to believe it everywhere. It's an equity right at this point.
So I think you can only address a sliver of
our population if we're going to have that approach only
and when. Now is what's happening in our economy, there's
there's a lot of financial pressure. And remember, seniors, many
seniors are on fixed incomes. So we have to think
about the broader access issue. Having said that, if you
(20:57):
go to your fundamental question, your central question of health
care payers, I can see a world where you don't
need the traditional. Here's why. Because if you look at
it even as primary care groups, as we get large
and you look at some of them out in the country,
you can absolutely cover regions in the in the country
where you can do direct to consumer and direct to
(21:18):
employer contracting. And you take on reinsurance, other ways to
manage those catastrophic costs like we do today, frankly. And
you downstream contract with a specialist and hospitals can get
paid it at Medicare rates. You can absolutely do that
and not need to go through all of the administrative expenditures,
(21:40):
15 to 20% of every dollar that health plans pay
in for administrative. I believe health plans can be disrupted.
And I think they're going to be disrupted quite significantly
in the future. In the role today they play. Is
this aggregator right? I have I have all these networks
and contracts and I have these financial strength and I
have the administrative ability to execute on the requirements that,
(22:04):
you know, the government has or or other payers in
the ecosystem. I think a lot of that is stuff
that shouldn't be done anyway in the first place. And
if we were using more technology and getting things right
the first time and having more direct connectivity provider and
patient and without all these inter interceding areas, we cut
(22:26):
out tremendous amount of expenditures.
S3 (22:28):
Well, you know, again, I'd love to talk about this forever,
but I know my my simplistic view of the world
is that says historically payers added value by managing risk. Right?
And by and large they've ceded that responsibility to employers, right?
They've added value by managing a vast, broad, all everyone
in network and increasingly that that's not the future. It
(22:50):
could be another premium that costs that comes with it.
And I see them kind of trying to add value
now in this idea of employee experience, employee engagement. And
let's face it, they haven't been very good at that either. Right.
So really begs the question of what role do they
play and how do they rightsize themselves in a way
to add value that they can they can exist and
play an important role in ecosystem going forward. And there's
(23:11):
as many questions as answers. I think to your point.
S1 (23:13):
I think it's a great point. But, Jeff, look, I mean,
one of the things that you can see that is
changing is look at their actions. What are they buying?
They're buying provider groups. So that tells you right there
where they're seeing the value going.
S3 (23:26):
That's right. All right. So let's come back to Max Health.
So I asked you the question, why would you find
it attractive? And I loved your answer. You talked about
the growth, about the proposition around the geography, about, you know,
some of the funding, some of the success in terms
of that NPS score. Let me ask you the question
a different way. Why, if your mother and maybe she
is was a citizen of West Florida, what's the consumer proposition?
(23:50):
Why should your mother or my mother come to max
health rather than whatever the alternative might be?
S1 (23:56):
If my mom came to my clinic, her value proposition
is she would call me about everything and expect me
to solve it. So but, you know, jokes aside, I
think what we want to do is create this whole
person personalized experience, but not a concierge payment models. So
here in South Florida is a great example. You know,
I tried to get a I tried to get a
(24:16):
primary care doc in all of the primary care doctors
that contacted or concierge doctors. So I had to pay out.
And it just struck me, you know, I can afford
to pay. You can, too. But I was like, That
doesn't strike me as the way I want it. That's
not the way I think. It took me a long
time to find a primary care when I'm healthy, I'm
a senior, yet I'm certainly older, but I'm a senior yet.
(24:36):
So I think one of the things we're really trying
to do in the value prop for our members and
we're not there yet. I'm not you know, we're just
not we haven't done enough to be there yet. We're
on a journey, but we have a ways to go.
And this is personalized experience. What does that feel like?
That feels like the people that I interface with know me.
They know they know me, they know my family. They
(24:57):
know my issues, not just my health issue or my
drug I'm taking. But they know my environment. They know
about the climate that I live in. They also know
when I miss certain things, they're proactively reaching out to
give me information. And when I call, I don't go
through a tremendous decision tree and get frustrated. I end
(25:18):
up hanging up. I get first contact resolution. I'm getting
this personalized experience about me where I feel it's one
of those things you you also have to feel right.
You and I both know when we feel a great
customer experience and we feel a tremendously bad customer experience, right?
And that also includes the tone of how people greet
(25:38):
you and speak with you with respect. So that's what
we're trying to create. That's really what we can do
when we're not worried about seeing 25 patients in a day.
You know, our doctors on average see somewhere in the
range of 12 to 13 patients. That's it a day
that allows you to spend time. And we have a
you know, and I'm a subject where alone there are
other groups that also have centralized groups that are looking
(26:00):
at data and saying, you know what, Mrs. Jones needs
a follow up conversation. Mrs.. Jones. You should send somebody
to the house, see if she's she's okay. By the way,
you know, you got a survey result back and somebody
was very unhappy about interaction. Follow up, solve the problem.
You know, so this is the kind of thing that
we're trying to do here. And and I think you're
(26:21):
going to get there, especially when you have a payment
model that gives us the freedom to do that and
and punishes us if we don't do a good job right.
Patients can walk and they will. And they and they should.
And also our own payments will go down because, you know,
we won't be closing care gaps. We won't be doing
a good job and member experience and the health plans.
This is a role that can help play. They have
(26:41):
a lot of data. They can also help us with that.
And also if we're not doing a good job, they
should the health plan should call us out on that, too.
And so it's a partnership, that ecosystem partnership. That's what
we want to do. We want to bring it all together,
be that point of personalized experience for our members.
S3 (26:57):
I think it's fascinating and I'm actually perfectly working with it,
working with a client now that has led to the
same conclusion, not in Florida and a more big traditional
health system, the same conclusion that says what consumers really
want is personalized health care. And we define that as both,
not just the customized component that you hear with with personalized,
but also the kind of human component, the hearing, listening, understanding,
(27:21):
which is the front end of it. Because I can't
personalize and I understand what you want, right? And then
the ability to deliver against that. Yeah.
S1 (27:27):
And respect people in a sometimes is condescending environment that
we all have. And so yeah, I agree with you
jump in. That's you know people have to feel it.
You can talk about it. Our surveys can show we're
doing great. But unless you know, our patients truly feel it,
you just haven't succeeded.
S3 (27:41):
Well, and so the challenge that I see and it's
not for for your organization particular, but for the system
as a whole, it says in a world of demographics
where there are not enough human beings being born to
take care of all the human beings that are going
to need to be taken care of. And there's a
shortage of doctors. Is it sustainable and scalable to say
doctors are going to spend more time with patients, which
(28:03):
I think I at least pull out of what you said.
But correct me if I'm interpreting the wrong way.
S1 (28:08):
Yes, time, your time matters, but it can't just be
measured in minutes. It has to be measured in effectiveness,
and it goes with the human contact with solving the problem.
You have to be highly competent as well, Right? Our
job is to help people live the healthiest lives in
their environment as opposed to the hospitals and other places.
(28:29):
So I think time is a part of that. It's
having the right kind of information so you can have
quality time, you can spend 30 minutes not solving a
problem where you can spend, spend 15 getting to the
heart of the issue and supporting that member. But it's
also thinking outside of your box and we still have
a ways to go there. So, for example, you know,
(28:49):
one of the things I think we're going to start
talking more about, you know, in this social drive, we
talked a lot about social drivers of health, but one
of the biggest social drivers, health and I saw this
at Magellan when in Arizona where, you know, people didn't
have air conditioners. So where were they show up when
the heat was there. They showed up in the air
now because they were having an issue, but because they
didn't have air conditioning, a unit at home unbearable. So
(29:12):
we could solve the problem by looking at the home environment.
And so, you know, water, your air quality, these things matter, too.
So this is what I mean about having the right
information about that member and then being able to have
truly whole person execution steps. That's what I'm excited by.
One of the reasons I joined here is because I
feel like you're really close to that. That's what we
(29:34):
want to create. We want to create that personalized whole
person experience here. And I feel like, you know, where
we started that journey, if there's a baseball game, we're
probably in the second inning. It could be a doubleheader.
S3 (29:45):
Just Yeah, right. So I don't know how many years
it'll take you to get to nine innings, but let
me just say three years out, put three years out
or five years out, if you prefer. Where will max
health be with the vision, in fact?
S1 (29:56):
Well, in 3 to 5 years, we're going to be
a significant larger in our own environment. So scale, I
would expect us to more than double our business in
three years and five years. We probably will triple our business.
So we'll have more scale, which gives us more resources,
but it will again be very strategic geographically place. The
other part is we will have a much more full
fledged integrated digital capability, not just for telemedicine but actually
(30:20):
digital therapeutics. It'll be embedded. We won't even talk about
was this a digital visit? Was this a video? It
was a telephonic. Was this in-person? We're going to talk about, hey,
this was a this was a care episode. So we're
not going to be we're not going to talk about
that would be success to me, where it's just part
and parcel of the way we deliver care. We're going
to have a integrated home strategy that is being executed today.
(30:44):
We use partners, but it's not it's not integrated enough.
We will have a mechanism for our members to be
able to get drug spend and appropriate drugs at a
cost of inflection and much better than we can do today.
And I think you'll see us with non. Traditional sort
(31:05):
of just starting areas of whole person care. So, for example,
you should expect us to be putting in air conditioner,
looking at each fact for safety, food as medicine. We
are now investigating food as medicine, and that is a
huge role. We know for our congestive heart patients, our
recalcitrant diabetic patients, our brittle, hypertensive food has got a
(31:29):
tremendous impact and we just don't look at it. But
everybody eats and it has a tremendous impact on drug metabolism,
tremendous impact on their on their health. And food insecurity
is not just not having enough to eat. It's having
the wrong kinds of foods which can really harm you
for especially the kind of diseases I just mentioned. So
you'll see we'll be prescribing food as medicine, and that
(31:52):
is something I think you can expect. And then finally,
you're going to see us having big box retail partnerships
that we don't have today.
S3 (31:59):
That is an exciting future. Last question for you. You
and I not only first met, but shortly after we
first met, we spoke for when I was writing my book,
making the health care shift, the transformation of consumer centricity.
And somewhere after it published, you hinted to me that
you you had a book in your future that I
read to see on the shelves anytime soon.
S1 (32:20):
You know, Jeff, I need to work with you.
S3 (32:23):
Well, I'm never writing one again, so I'm not sure
if I can help, but.
S1 (32:27):
Well, is that all right, Saucepan? You know, that may
not be something I want to take on. I have
enough challenges I'm working on.
S3 (32:33):
Fair enough. Fair enough. Group So pleased to have you.
Prakash Patel, the CEO of Max Health. Thank you for
being on the podcast.
S1 (32:41):
Thank you.
S2 (32:47):
And. Thanks for listening to Prophet's Health Care Transformers Podcast.
This podcast is produced by Jared Johnson and his wonderful
team at Shift Forward Health and a big thank you
to our hosts Priya NASIR, Lindsay Moseby, Paul Shrimp and
Jeff Orji. If you like today's episode, you can find
more great content like this at profit dot com slash thinking.
(33:09):
I'm Anna Kuno, the senior editor of this podcast. Thank
you for listening.
And.
S2 (00:07):
Hello. Welcome to Prophets Healthcare Transformers podcast, where we'll be
talking to leaders in healthcare who are focused on transforming
their organizations to drive the next level of growth for
their business and for health care. Hosted by Priya in Asia,
Lindsay Moseby Paul Shrinks and Jeff Gordy. Transformation is one
of those terms that has a lot of layers to it.
(00:29):
Sometimes it's about innovation. Sometimes it's about shifting the way
you do business. Sometimes it's to your overall operating model
and other times it's to a specific department or function.
It's also about people helping them navigate the discomfort that
comes with change, but also motivating them to engage in
the journey of transformation from the CEO to the newest employee.
(00:52):
It's a journey, and that's why we created this podcast
to break down this multidimensional, dynamic topic of transformation one
story at a time. Are you ready to dive in?
S3 (01:07):
Hi, this is Jeff Gore. I am the host of
today's episode. We are thrilled to have Prakash Patel, the
CEO of Mass Health, on the podcast.
S1 (01:17):
It's wonderful to be here. Thank you for inviting me, Jeff.
S3 (01:19):
So, Prakash, start, if you could, to introduce yourself and
to our listeners and tell us about your, you know,
your professional profile. But certainly give us one fun fact.
We often open our podcast this way. Tell us one
fun fact about you that cannot be found on your
LinkedIn profile.
S1 (01:36):
Yeah, absolutely. And I'll start with the with a fun fact.
I am a curiosity streaming app nerd. I love that.
I watch that almost as much as I watch ESPN.
It's a really cool app. If you don't have a Jeff,
it's for me. It teaches me so many things I
never learned. I was very science focused and in college
and went to medical school on the East Coast and
(01:57):
went into orthopedic surgery. So for me, it's opening up
all kinds of areas and it's nice because it's in
small bites. So I can watch 10 minutes, 15 minutes
and really learn about things from space to history and
culture and so many different things that I've always wanted
to take in. And it's done in a really simple
way for somebody like me to understand. So I really
(02:17):
enjoy that.
S3 (02:18):
It is and it is a fun fact, and maybe
if I get into it, I could waste less time
on Twitter. So the benefit there of Twitter, I'll check
it out. All right. So back to back to you.
Tell us about yourself and you started to a little
bit there.
S1 (02:28):
Absolutely. Well, I wish I could tell you that I
had planned out my career, you know, from the beginning.
And where I am now is exactly how I thought
I would what it would be. I certainly wasn't that
smart enough, certainly not that thoughtful and knowing that. Exactly.
But I will tell you that I've been very, very
fortunate in a you know, last 25 years. I made
a decision when I was in my orthopedic surgery residency.
(02:52):
And this is the same time that President Clinton and Mrs.
Clinton were talking about how they were going to change
health care. If you recall, Jeff, they the health care
panel was put together and Hillary Clinton was was chairing it.
And a huge push in how they're going to restructure
the whole entire health care environment. And it really made
(03:13):
me think about what role do I really want to play.
And that really led to a number of conversations that
I had with a wide variety of folks, friends of
mine who had gone in the business side and were
in health care systems. And I made the decision 25
years ago that I wanted to really be on the
business side of health care. I was always interested in it.
(03:33):
In fact, I almost didn't go to medical school, so
I had some interest and I took a leave of absence.
They were kind enough to give me a two year
leave of absence, and I never went back and started
my career working with David Shear, actually a chair and company,
really a wonderful experience there, spinning out assets from pharma
and then ultimately device companies and realized I really enjoyed
(03:56):
running things. And over the years I ended up running
panels and having greater responsibilities across the health care ecosystem.
And I think I might be one of the few
senior health care executives, I think, in leaders that actually
have a tremendously broad background in terms of size of companies,
scope of roles, range of health care industries. It's been really,
(04:19):
really fortunate. I wish I could have told you I
planned it all out, but it's given me a pretty
interesting perspective and insight, you know, all the way through
execution in health care, especially with this intersection of payer,
provider and tech and the whole ecosystem, health care ecosystem,
just a you know, very well that's emerging here in
health care. So, you know, I've been very fortunate and really,
(04:40):
really pleased at how my career has evolved, even though
it was unplanned.
S3 (04:44):
Yeah. So are you never a practicing orthopedic surgeon?
S1 (04:47):
Never practice? I did three years and never went back.
And I did have some sleepless nights. You know, quite candidly,
our first year as a got Am I really making
a good decision? Half the people thought I was crazy.
Has people thought I was less crazy? I don't think
anybody thought I wasn't crazy at all. But but you
know it. You had a fall. I think one thing
I can tell my kids, you and I were talking
about kids. I can tell my kids quite directly that
(05:08):
I walk the talk about following your passion in life
and taking hopefully smart risks. And I'm pleased with that.
S3 (05:14):
Yeah, well, that's great. You and I first met Prakash.
I don't know, gosh, several years ago now, when you
were executive a gainwell Blue Cross Blue Shield in Florida.
And we have stayed in touch as you went and
took on a pretty senior role at the company formerly
known as Anthem before taking your current role with with
Max Health. So we'll talk about that. But tell us
(05:36):
about just from that last move. Tell us about the
leap from one of the biggest, most established, influential health
care organizations in the country to something more entrepreneurial.
S1 (05:47):
To me, it was always around that inflection point of growth, restructuring, repositioning,
bringing the assets and people together and taking it through
escape velocity. And, you know, 10 billion is pretty big
now within $100 billion company. It's still small, pal, but
it was obviously pretty sizable. And to me it was
I really like taking things and building them out. And
(06:11):
when they get to a certain size, is that what
I want to continue to do now? Is it enjoyable? Absolutely.
Going to continue to do that? Absolutely. But I felt
today with what's happening in the provider side was really
exciting and I wanted to be a part of that.
I started in April and, you know, the reason I
chose to work at Max Health, in fact, they will
(06:32):
tell you that I actually said no several times initially,
including in the reason I said no is not because
something was fundamentally wrong with the company. Quite the opposite.
I just felt, you know, I just resigned. I wanted
to do I wasn't among some board seats and working
with private equity groups. You know, I was kind of
you know, partly I was a little burned out to
to be to be quite candid, Jeff. And and especially
(06:55):
with that kind of growth in a short period of
time and transforming big you know, transforming companies within a
large company is not easy. So it does take a
lot of energy out of you. And I was going
to take it easy for a few months, but I
really liked what they were, what they were doing and
what's unique about them in my perspective and maybe we'll
talk more about this, is, you know, all of their
(07:15):
business is within Florida. They didn't go into the usual areas.
We think about Florida, we think about South Florida, Miami
Dade in the south, all the all the usual areas. Well,
what this group had done is they had actually built
out the west coast of Florida. And if you're familiar
with the West Coast, there's a tremendous amount of growth
happening from and around Naples all the way up to
(07:36):
Tampa and then across the what we call the I-4
corridor from Tampa to Orlando and Daytona. So this group
had really been building out clinical assets, primary care led
value based for risk kinds of deals along those areas
and gotten quite deep and it proven that they could
actually manage fully capitated relationships. So a really strong foundation.
(07:58):
Great private equity group behind it and just felt that
it was a it was an a nice inflection point
where we could take what the teams have done a
tremendous job with and building to the next level. And
that that's exciting for me.
S3 (08:11):
This is, I think, really interesting. As you know, we
call this the Health Care Changemakers Podcast, right? And we
and that's why we're so happy to have this conversation
with you because you clearly been that. But we also
have a health care industry that is as a whole
massively burnt out. And you know, the statistics and turnover
and people leaving the profession and professional suicide rates and
all kinds of things with doctors, with nurses across the profession.
(08:33):
But you were you, you said you were burnt out. Right.
And you had the luxury of taking some time and
to figure out what you want to do next. A
lot of people don't, right? Maybe even most people don't
have that opportunity. We need we the health care, larger
world that I'll include you and I both in need
change makers to thrive. What has to change? What does
this all say and what does it say about the
(08:55):
state of health care? What needs to change to allow
for the transformation that we all know needs to happen?
S1 (09:00):
You know, this is a fantastic question and one that
I think that we as leaders often feel that in
in this kind of comes back even from my orthopedic
days to to acknowledge that your burned out is a
sign of weakness to some. And and I think one
of the most important things we have to do is
just be honest and have open conversations. And it's funny
(09:21):
how many you hit it on the head. Jeff, you
talked about so many of the studies coming out and
the conversations we're finally having, and I think it's really great.
It's healthy that we're finally acknowledging it's like mental health, right?
During COVID, everybody's talking about, you know, mental health. This
is though it should have been this separate area from
physical health. It's just health. We are whole person beings.
(09:41):
We're not just ankles and brains and muscles and hearts. Right.
And I think the same thing goes with having this
honest conversation. And we were having honest conversations with people
in our organizations. I was having them with all layers
of my teams and and talking about this with others.
And then I realized, well, wait a minute, I'm actually
burned out. I'm actually feeling pretty exhausted from, you know,
(10:05):
launching the first of my business group. And I need
to take a step back and think about what how
do I recharge and get back to what super jazz
is me. And so I think the first thing is
just having that open dialogue and just being honest with
each other. And then then, you know, some of the
things that I think are really important, it should be okay.
And I didn't ask for this, so I can't say that,
(10:27):
you know, this organization wouldn't have done this, but I
it's I should be okay for people to take a
short sabbaticals. You know, here's your two weeks of sabbatical.
Go and think. Don't do any calls, do anything. And
now a lot of this is my fault. I am
the kind of person I would work during vacations and
make the calls, and that's my fault. But I think
that's important to have. Just And the other thing we
(10:47):
can do is change a lot of our travel and
meetings in so much nonproductive kinds of things we do
throughout the day that we just do because you're part
of a big company or you're part of an organization,
you feel like you have to do it in a
way so a lot of time and waste a lot
of energy. So I think we have to also reflect
on the workflows that we have. And so, you know,
(11:09):
we could go on on this topic. But Jeff, I
think it's a fantastic area probably for future discussions. We
don't talk enough about senior leaders going through this. We're
talking about providers. It's a massive issue that we still are.
We really haven't grasped yet and we don't have great
solutions yet for that either.
S3 (11:28):
Well, to your point, we could we could talk about
this forever. So thank you for scratching the surface of
that with me. And I obviously was made note of
the comment that you made. So thank you for sharing
that kind of personal reflection. Okay. So let's go back.
Before we talk about MassHealth, which I definitely want to do,
just give us your sense of like what is the
state of primary care today and what days is at
(11:48):
work and what ways might it be the best in
the world. But then also, you know, I assume the
thesis behind the organization is there's some stuff that's broken
and that will kind of take us to our to
our story about myself. Yeah, the.
S1 (11:59):
State of primary care. I actually look at primary care
in the lens of phases. You know, I'm old enough
to remember in especially in rural areas, underserved communities. Primary
care providers used to do everything. And I don't know,
just if you've seen this in your in your analysis,
in your exposure and health care. But primary care docs
(12:19):
did a little bit of, you know, minor surgery. They
deliver babies in many communities. They treated from mental health
all the way to fractures. I mean, they they would
stitch certain contusions and other things. So they actually played
a really critical role in almost did so many things
that today would just go right to a specialist. And
so that was sort of the first phase. And then
(12:41):
then we went to this super specialty referral triage, primary
care environment, where primary care doctors became essentially triage. You know,
you come in, you see your primary care doc, if
you had a skin issue, they send you to dermatology,
you had a cardiac heart issue, they send you cardiologist.
And now I think we're in the third phase of
primary care, which is the primary care provider. He or
(13:04):
she is the captain of a team, an interdisciplinary team
that includes, in some cases, dieticians, pharmacist, certainly mid-levels, social workers,
really a team environment and non-clinical teammates trying to provide
care for individuals that are in their office and individuals
(13:26):
that are not even they haven't even seen but are
being identified through analytics as needing, you know, support. And
it could be all kinds of issues. Potential high risk
for admissions or E.R. visits or, you know, medication support,
all kinds of things. So they've become that captain of
our team. That's, I think, where we are today. And
(13:47):
and I you know, in terms of what works today,
I think what's starting to show is no one is
saying no one. I mean, I really don't hear give
me more fee for service. Let's go back to more
fee for service. I don't hear that. And hopefully you're
not either. So I do think we're starting the tipping
point is already there where from CMI to, you know,
local providers in the primary care space are saying, hey,
(14:10):
how do I how do I do this value based?
Now there's a huge range for success and an expertise
in value based care for providers, primary care in particular.
But there is no debate that this is a place
that they also want to go. And and so what's
working is the transformation of the payment model. And I
think that's really critical. We sometimes don't want to talk
(14:32):
about it, but form follows Function actions follow payments in
health care. So the payment models have come a long way.
S3 (14:40):
So tell us about tell us about Max Health and
tell us about its unique proposition. And I'm particularly curious
because there seems to be, from what we can tell here,
a lot of innovation in primary care and that obviously,
you know, one medical's been in the news, VillageMD has
been the news for health has been in the news.
I'm curious, like where the max health proposition is and
(15:00):
why this is the one that you said I want
to be part of this one.
S1 (15:02):
I think I may have started pre-empting. You wasn't sure
you were going to go there, but, you know, you know,
for Max health and you're right, there's been a lot
of activity, especially from the strategics. I think the primary,
the private equity teams kicked it off. And recently we've
seen a lot of activity from the strategic buyers and partners. And,
you know, like I said, one of the reasons I
(15:23):
left is I saw this coming. So, Jeff, I may
have gotten a trend, right? I don't know.
S3 (15:27):
Let's say we'll have you back in a few years
and we'll reflect.
S1 (15:31):
Reflect. Yeah. You know, I do see the momentum shifting
towards the providers and there's a whole different role I
think the payers will play in the future. This is
something else we can talk about in the future. But
you know, in terms of max health, I like that
they were heavily, heavily focused on being a really darn
good risk based value based provider. So, you know, we
(15:52):
look at our business, we're not taking non value based care.
It doesn't mean we don't have some commercial. But most
of that is because, you know, these are folks aging
into two senior products or we were. We were requested
to do so on behalf of some of the payers
that have our Medicare lives. But 99% of our revenue
(16:12):
and profits are being driven through full risk contracts and
in the government side. The other thing I was very
impressed with and we just saw the data come out
actually is on the ACO new entrant is we'll reach
the old DC. We are one of the two of
our both of our D.C. plans are the top seven
(16:33):
or eight in the whole the whole country. So we
are really this is a group that's walking the talk.
I liked the geographic focus I was mentioning earlier. West
goes to Florida, where everybody else is weaving. You know
where we're going the other way, where everybody is going
to South Florida. We've got this tremendous 80 clinics spread
throughout west, west part of Florida, across I-4 corridor, where
(16:54):
double digit growth is happening in our seniors, in many
of our counties. And then we're profitable. You know, one
thing you just mentioned, some of those groups. You know,
there's others that are publicly traded we could talk about,
but we're profitable. So we're growing profitably. We're managing at risk.
And the other thing I would mention I liked about Mack,
(17:14):
I think I think it's unique is they started with
a tech stack versus some of the groups who retroactively
fit a tech stack in. It's really hard to do that.
I think you know this really well. You just can't.
It's so hard where you're already on going to come back,
especially if you have Tuesdays in three sites spread across
(17:37):
the country. You don't even have critical mass to negotiate
with payers and get that that margin to cover the
expenses that go with that and disruption. So I think
those are things we're all and I we're really was very,
very attractive to and they have a very strong retention
of their senior members high end peers score the scores
for us are in the eighties mid eighties too to
(17:58):
be precise which is pretty good.
S3 (18:00):
So let me make sure I understand how it works.
So the senior on Medicare Advantage chooses you, right? Maybe
because they've heard from a friend who had a great
experience and the NPS speaks to maybe it's because your
clinic is in their neighborhood. They wander in there, they
have to be on Medicare Advantage. I assume before you're
you're working with them.
S1 (18:18):
Yeah, there may. So there are Medicare Advantage. Some are
traditional fee for service Medicare now going into the acreage program.
And then we have some just traditional Medicare, but the
vast majority are in Medicare Advantage plans, both HMO, PPO
and plans.
S3 (18:32):
Okay. And then do you ever see a model I'm
just agreeing about, you know, forward health this morning in
particular right there, they don't take insurance. I'm just curious,
like if essentially health care becomes a subscription, Right. I
go to Ford Health or I go to max Health
or I go to wherever and they say, here's what
you pay. We take care of all your health needs.
(18:53):
And our incentive is not to cut corners because we
want to keep you and your friends coming back. But
our incentive is also to keep you healthy overall as
the insurer or play, What role does the insurer need
to play in the future? Today is maybe a little
more clear.
S1 (19:06):
Yeah. No, I first of all, I think we should
welcome all models because no one's figured out. We certainly
haven't figured it out completely. No one has. So I
think we should completely welcome different models. You mentioned a few.
There is others coming out there. You know, it's interesting
when you look at what's happening, even with the self-insured.
I'll start with that on the employer side before we
go to the government, even you're seeing the migration. You know,
(19:29):
large companies were already doing this. What you're seeing going
down to mid and even smaller companies where they're migrating
from being fully insured, self insured. Now we're seeing going
from this ASO fee structure to say, you know what,
I can go to a TPA next generation tech oriented TPA.
I don't really need that that health plan, that payer.
And I think that momentum is going to continue. When
(19:51):
you think about seniors, for example, where you have more
complex and chronic conditions, you need more coordinated care. You
got to think about whole person care in a different way.
You know, we have some very, very ill members and patients.
They need a tremendous amount of support. You know, the
subscription model doesn't work as well there. It doesn't mean
you can't have some of that. And now there's some
(20:13):
issues of being you can't, you know, Bill that way
and bill Medicare. But even if let's say you didn't
have traditional Medicare, you wouldn't take any of the seniors.
You really would be talking about a slice of our population.
And fundamentally, one of the big reasons I went into
the business added health care, is I do want us
to change access to care. I'm one of those believers
that care and health care is just a human right
(20:35):
for us in our country. You know, I would like
to believe it everywhere. It's an equity right at this point.
So I think you can only address a sliver of
our population if we're going to have that approach only
and when. Now is what's happening in our economy, there's
there's a lot of financial pressure. And remember, seniors, many
seniors are on fixed incomes. So we have to think
about the broader access issue. Having said that, if you
(20:57):
go to your fundamental question, your central question of health
care payers, I can see a world where you don't
need the traditional. Here's why. Because if you look at
it even as primary care groups, as we get large
and you look at some of them out in the country,
you can absolutely cover regions in the in the country
where you can do direct to consumer and direct to
(21:18):
employer contracting. And you take on reinsurance, other ways to
manage those catastrophic costs like we do today, frankly. And
you downstream contract with a specialist and hospitals can get
paid it at Medicare rates. You can absolutely do that
and not need to go through all of the administrative expenditures,
(21:40):
15 to 20% of every dollar that health plans pay
in for administrative. I believe health plans can be disrupted.
And I think they're going to be disrupted quite significantly
in the future. In the role today they play. Is
this aggregator right? I have I have all these networks
and contracts and I have these financial strength and I
have the administrative ability to execute on the requirements that,
(22:04):
you know, the government has or or other payers in
the ecosystem. I think a lot of that is stuff
that shouldn't be done anyway in the first place. And
if we were using more technology and getting things right
the first time and having more direct connectivity provider and
patient and without all these inter interceding areas, we cut
(22:26):
out tremendous amount of expenditures.
S3 (22:28):
Well, you know, again, I'd love to talk about this forever,
but I know my my simplistic view of the world
is that says historically payers added value by managing risk. Right?
And by and large they've ceded that responsibility to employers, right?
They've added value by managing a vast, broad, all everyone
in network and increasingly that that's not the future. It
(22:50):
could be another premium that costs that comes with it.
And I see them kind of trying to add value
now in this idea of employee experience, employee engagement. And
let's face it, they haven't been very good at that either. Right.
So really begs the question of what role do they
play and how do they rightsize themselves in a way
to add value that they can they can exist and
play an important role in ecosystem going forward. And there's
(23:11):
as many questions as answers. I think to your point.
S1 (23:13):
I think it's a great point. But, Jeff, look, I mean,
one of the things that you can see that is
changing is look at their actions. What are they buying?
They're buying provider groups. So that tells you right there
where they're seeing the value going.
S3 (23:26):
That's right. All right. So let's come back to Max Health.
So I asked you the question, why would you find
it attractive? And I loved your answer. You talked about
the growth, about the proposition around the geography, about, you know,
some of the funding, some of the success in terms
of that NPS score. Let me ask you the question
a different way. Why, if your mother and maybe she
is was a citizen of West Florida, what's the consumer proposition?
(23:50):
Why should your mother or my mother come to max
health rather than whatever the alternative might be?
S1 (23:56):
If my mom came to my clinic, her value proposition
is she would call me about everything and expect me
to solve it. So but, you know, jokes aside, I
think what we want to do is create this whole
person personalized experience, but not a concierge payment models. So
here in South Florida is a great example. You know,
I tried to get a I tried to get a
(24:16):
primary care doc in all of the primary care doctors
that contacted or concierge doctors. So I had to pay out.
And it just struck me, you know, I can afford
to pay. You can, too. But I was like, That
doesn't strike me as the way I want it. That's
not the way I think. It took me a long
time to find a primary care when I'm healthy, I'm
a senior, yet I'm certainly older, but I'm a senior yet.
(24:36):
So I think one of the things we're really trying
to do in the value prop for our members and
we're not there yet. I'm not you know, we're just
not we haven't done enough to be there yet. We're
on a journey, but we have a ways to go.
And this is personalized experience. What does that feel like?
That feels like the people that I interface with know me.
They know they know me, they know my family. They
(24:57):
know my issues, not just my health issue or my
drug I'm taking. But they know my environment. They know
about the climate that I live in. They also know
when I miss certain things, they're proactively reaching out to
give me information. And when I call, I don't go
through a tremendous decision tree and get frustrated. I end
(25:18):
up hanging up. I get first contact resolution. I'm getting
this personalized experience about me where I feel it's one
of those things you you also have to feel right.
You and I both know when we feel a great
customer experience and we feel a tremendously bad customer experience, right?
And that also includes the tone of how people greet
(25:38):
you and speak with you with respect. So that's what
we're trying to create. That's really what we can do
when we're not worried about seeing 25 patients in a day.
You know, our doctors on average see somewhere in the
range of 12 to 13 patients. That's it a day
that allows you to spend time. And we have a
you know, and I'm a subject where alone there are
other groups that also have centralized groups that are looking
(26:00):
at data and saying, you know what, Mrs. Jones needs
a follow up conversation. Mrs.. Jones. You should send somebody
to the house, see if she's she's okay. By the way,
you know, you got a survey result back and somebody
was very unhappy about interaction. Follow up, solve the problem.
You know, so this is the kind of thing that
we're trying to do here. And and I think you're
(26:21):
going to get there, especially when you have a payment
model that gives us the freedom to do that and
and punishes us if we don't do a good job right.
Patients can walk and they will. And they and they should.
And also our own payments will go down because, you know,
we won't be closing care gaps. We won't be doing
a good job and member experience and the health plans.
This is a role that can help play. They have
(26:41):
a lot of data. They can also help us with that.
And also if we're not doing a good job, they
should the health plan should call us out on that, too.
And so it's a partnership, that ecosystem partnership. That's what
we want to do. We want to bring it all together,
be that point of personalized experience for our members.
S3 (26:57):
I think it's fascinating and I'm actually perfectly working with it,
working with a client now that has led to the
same conclusion, not in Florida and a more big traditional
health system, the same conclusion that says what consumers really
want is personalized health care. And we define that as both,
not just the customized component that you hear with with personalized,
but also the kind of human component, the hearing, listening, understanding,
(27:21):
which is the front end of it. Because I can't
personalize and I understand what you want, right? And then
the ability to deliver against that. Yeah.
S1 (27:27):
And respect people in a sometimes is condescending environment that
we all have. And so yeah, I agree with you
jump in. That's you know people have to feel it.
You can talk about it. Our surveys can show we're
doing great. But unless you know, our patients truly feel it,
you just haven't succeeded.
S3 (27:41):
Well, and so the challenge that I see and it's
not for for your organization particular, but for the system
as a whole, it says in a world of demographics
where there are not enough human beings being born to
take care of all the human beings that are going
to need to be taken care of. And there's a
shortage of doctors. Is it sustainable and scalable to say
doctors are going to spend more time with patients, which
(28:03):
I think I at least pull out of what you said.
But correct me if I'm interpreting the wrong way.
S1 (28:08):
Yes, time, your time matters, but it can't just be
measured in minutes. It has to be measured in effectiveness,
and it goes with the human contact with solving the problem.
You have to be highly competent as well, Right? Our
job is to help people live the healthiest lives in
their environment as opposed to the hospitals and other places.
(28:29):
So I think time is a part of that. It's
having the right kind of information so you can have
quality time, you can spend 30 minutes not solving a
problem where you can spend, spend 15 getting to the
heart of the issue and supporting that member. But it's
also thinking outside of your box and we still have
a ways to go there. So, for example, you know,
(28:49):
one of the things I think we're going to start
talking more about, you know, in this social drive, we
talked a lot about social drivers of health, but one
of the biggest social drivers, health and I saw this
at Magellan when in Arizona where, you know, people didn't
have air conditioners. So where were they show up when
the heat was there. They showed up in the air
now because they were having an issue, but because they
didn't have air conditioning, a unit at home unbearable. So
(29:12):
we could solve the problem by looking at the home environment.
And so, you know, water, your air quality, these things matter, too.
So this is what I mean about having the right
information about that member and then being able to have
truly whole person execution steps. That's what I'm excited by.
One of the reasons I joined here is because I
feel like you're really close to that. That's what we
(29:34):
want to create. We want to create that personalized whole
person experience here. And I feel like, you know, where
we started that journey, if there's a baseball game, we're
probably in the second inning. It could be a doubleheader.
S3 (29:45):
Just Yeah, right. So I don't know how many years
it'll take you to get to nine innings, but let
me just say three years out, put three years out
or five years out, if you prefer. Where will max
health be with the vision, in fact?
S1 (29:56):
Well, in 3 to 5 years, we're going to be
a significant larger in our own environment. So scale, I
would expect us to more than double our business in
three years and five years. We probably will triple our business.
So we'll have more scale, which gives us more resources,
but it will again be very strategic geographically place. The
other part is we will have a much more full
fledged integrated digital capability, not just for telemedicine but actually
(30:20):
digital therapeutics. It'll be embedded. We won't even talk about
was this a digital visit? Was this a video? It
was a telephonic. Was this in-person? We're going to talk about, hey,
this was a this was a care episode. So we're
not going to be we're not going to talk about
that would be success to me, where it's just part
and parcel of the way we deliver care. We're going
to have a integrated home strategy that is being executed today.
(30:44):
We use partners, but it's not it's not integrated enough.
We will have a mechanism for our members to be
able to get drug spend and appropriate drugs at a
cost of inflection and much better than we can do today.
And I think you'll see us with non. Traditional sort
(31:05):
of just starting areas of whole person care. So, for example,
you should expect us to be putting in air conditioner,
looking at each fact for safety, food as medicine. We
are now investigating food as medicine, and that is a
huge role. We know for our congestive heart patients, our
recalcitrant diabetic patients, our brittle, hypertensive food has got a
(31:29):
tremendous impact and we just don't look at it. But
everybody eats and it has a tremendous impact on drug metabolism,
tremendous impact on their on their health. And food insecurity
is not just not having enough to eat. It's having
the wrong kinds of foods which can really harm you
for especially the kind of diseases I just mentioned. So
you'll see we'll be prescribing food as medicine, and that
(31:52):
is something I think you can expect. And then finally,
you're going to see us having big box retail partnerships
that we don't have today.
S3 (31:59):
That is an exciting future. Last question for you. You
and I not only first met, but shortly after we
first met, we spoke for when I was writing my book,
making the health care shift, the transformation of consumer centricity.
And somewhere after it published, you hinted to me that
you you had a book in your future that I
read to see on the shelves anytime soon.
S1 (32:20):
You know, Jeff, I need to work with you.
S3 (32:23):
Well, I'm never writing one again, so I'm not sure
if I can help, but.
S1 (32:27):
Well, is that all right, Saucepan? You know, that may
not be something I want to take on. I have
enough challenges I'm working on.
S3 (32:33):
Fair enough. Fair enough. Group So pleased to have you.
Prakash Patel, the CEO of Max Health. Thank you for
being on the podcast.
S1 (32:41):
Thank you.
S2 (32:47):
And. Thanks for listening to Prophet's Health Care Transformers Podcast.
This podcast is produced by Jared Johnson and his wonderful
team at Shift Forward Health and a big thank you
to our hosts Priya NASIR, Lindsay Moseby, Paul Shrimp and
Jeff Orji. If you like today's episode, you can find
more great content like this at profit dot com slash thinking.
(33:09):
I'm Anna Kuno, the senior editor of this podcast. Thank
you for listening.
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