Relentless Health Value

Relentless Health Value

American Healthcare Entrepreneurs and Execs you might want to know. Talking. Relentless Health Value is a weekly interview podcast hosted by Stacey Richter, a healthcare entrepreneur celebrating fifteen years in the business side of healthcare. This show is for leaders in pharma, devices, payers, providers, patient advocacy and healthcare business. It's for health industry innovators, entrepreneurs or wantrepreneurs or intrapreneurs. Relentless Healthcare Value is the show for you if you want to connect with others trying to manage the triple play: to provide healthcare value while being personally and professionally fulfilled.

Episodes

June 17, 2021 37 min

Here’s the context, friends: As you may have noticed over the past few episodes, we have been digging into value-based care here at Relentless Health Value corporate work-from-home headquarters. Many lessons have been learned, and it’s important that we sit back and think hard every now and then about how we are going to use these learnings to improve.

While this show tackles the Hospital Readmissions Reduction Program (HRRP)—and w...

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First of all, a shout-out to all of you listeners who have shared this show with colleagues and LISTSERVs—really appreciate it. It’s because of you and your efforts to share that Relentless Health Value maintains its spot as one of the top podcasts reaching health care executives, executives who take the insights shared by our guests to drive actual change and transformation across our industry. So, thank you. Leaving a rating and/...

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Recently, the University of Pennsylvania Leonard Davis Institute of Health Economics, or LDI, put out a white paper called “The Future of Value-Based Payment: A Road Map to 2030.” Spoiler alert: Next week’s show is with Dr. Mai Pham, an author of that paper; and it’ll be a great show—so, tune back in next week. But, in the meantime, that paper made some really interesting points about ACOs (accountable care organizations). For exam...

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This episode seemed particularly relevant right now because it gives insight into how large self-insured employers are prioritizing their efforts to disrupt health care revenue streams that do not provide adequate health outcomes for dollars spent.

This episode’s conversation is with Lee Lewis. This is an encore episode. The original was recorded when Lee was the newly minted chief strategy officer at the Health Transformation Alli...

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One way to spot a flash point is to notice when people are using different words to describe the same concept. Throughput is one example of this.

On one side of the table, you have those who grasp that if a provider organization is concerned about patient outcomes, with few exceptions, building relationships with said patients is essential. It’s not entirely clear to anyone anywhere how you manage to build relationships and trust w...

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Imagine if innovators in other businesses operated in the way that some health care status quo doomsayers finger wag. So much for failing fast, iterating, and folding learnings into something that might work better. I don’t like to see screeds that seem to advocate an approach of “try it a few times at a minimum half-heartedly, fail, and then just quit, because obviously anything worth doing should be that easy.”

Pieces fell into p...

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If you listen to this show on the regular, you probably have a pretty good bead on a couple of things I’ve been really into lately. One of them is high-value care versus low-value care. These are terms that are really easy to throw around. You also can get pretty much everybody to agree with a plan to deliver only high-value care and quit it with the low-value care … in theory. But the wheels fall right off the bus when it comes to...

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When I was talking with Dr. David Carmouche from Ochsner in EP316 about the importance of collaboration amongst anybody trying to actually pull off value-based care, we took a little detour, which I wound up cutting out, into the potential and challenges for health systems to collaborate and do value-based contracts with pharmaceutical manufacturers. It’s a really interesting sidebar, though, that I wanted to share with you—especia...

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If you want to hear what my mom and dad, both Medicare Advantage patients in their late 70s, have to say about telehealth (or teleconferencing, as my dad puts it), you’ll have to listen to the episode. They are not and have never been health care professionals, but they fully get that the question “What’s better—telehealth or in-person care?” asked like it’s some kind of winner-takes-all cage fight doesn’t serve anybody’s needs. An...

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I’ll tell you what I wanted to figure out: How does care improve in SNF (skilled nursing) or assisted living facilities? My starting point in contemplating a possible path toward this goal was advanced primary care. There is so much talk and evidence these days about advanced primary team-based care and how much patients like it, the low-value care it could potentially prevent downstream, and the patient outcomes it can create. But...

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I heard someone say the other day, “Practicing medicine without pharmaceuticals is like running to the ten-yard line, putting down the ball, and walking off the field.” So, it’s pretty imperative that providers and Pharma know how to work together to get the best outcomes for patients. In this context and in this podcast, when I say “get the best outcomes for patients,” I kinda mean it. There’s a sweet spot in the middle of “won’t ...

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Let’s get a fast bead on what’s going on with drug pricing reform, shall we? Every time I wade into these waters, my head about explodes. So, I very much appreciate the opportunity to quiz Josh LaRosa from the always-well-informed Wynne Health Group.

Here’s the goings-on in a nutshell: There’s goings-on. This infrastructure bill that’s in all the news all over the place right about now? You know what the plan is to fund all those b...

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I don’t know what I thought we were going to talk about during my interview with David Carmouche, MD; but I’m glad it turned out exactly as it did. Lately, we’ve had a number of guests on Relentless Health Value talking from the point of view of the employer: what a self-insured employer wants and needs from the large, and small, providers in their network. In this episode, we’re flipping the script and talking about what a large p...

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Medicine is complex. It’s getting more complex. We double what we know in medicine every 73 days. There’s 800,000 journal articles published every year. It is impossible for any human to keep up. It’s just impossible. There’s a lot of talk about amazing technology to help humans manage the 26,000 variables in heart failure treatment or what have you. And, yeah, I’m a huge fan of technology doing what technology is good at doing. Bu...

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Have you never heard of the Nuka System of Care? If that’s the case, it is an award-winning and really remarkable health system in Alaska. In this 5-minute “An Expert Explains,” Dr. Douglas Eby, medical director over at Nuka, gets directly to the point. A key component to making sure that the people/customers in your plan get the best care is to make sure that they have access to a team of providers who know them well enough to hav...

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This episode is for anyone as curious as I have been about pharmaceutical supply chain goings-on in long-term care facilities like skilled nursing facilities, otherwise known as SNFs. There are a lot of players in the mix: You have your PBMs. You have your wholesale pharmacies. You have your LTC (meaning long-term care) pharmacies. You have the facilities themselves. You also have Medicare Part A and Medicare Part D and, in some ca...

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Let’s talk about one aspect of health care that’s not talked about possibly often enough: big national health care players siphoning money out of local communities—potentially a lot of money depending on where you are and considering that health care is inching toward about 20% of the GDP. But besides the money leaving the community, another downside of large national players is that sometimes problems—even kind of seemingly simple...

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This episode is a master class in raising health outcomes at lower costs from an award-winning health care system in … Alaska?! Who knew? In fact, I learned about the work of the Southcentral Foundation and the Nuka System of Care only because I happen to listen to Swedish health care podcasts and heard about them on one of those shows. Color me surprised when the interview suddenly switched to English and the guest was from Alaska...

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This episode might be about local providers getting disintermediated not by virtual front doors like I discussed with Jeff Hogan in EP309 but by entities providing virtual continuous care at home. Predictivae and proactive, the idea is to help reduce acute events requiring on-premises care. But if someone does wind up needing ramped-up care, they can get it hospital at home or SNF (skilled nursing facility) at home instead of them ...

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In this health care podcast, Ge Bai explains GoodRx’s business model and how PBMs and pharmacies fit in to that business model. Here’s the short version: GoodRx takes advantage of the dysfunction in the pharmacy supply chain. And while they help patients save money, their master plan only works because pharmacies would be charging cash pay patients too much in most circumstances. Why, you might ask? Well, one reason is the big PBMs...

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