September 29, 2025 • 33 mins
What if the key to fixing care delivery and performance isn’t another portal or reminder, but a brain-first approach that restores purpose for clinicians and empowers patients to live a healthier life?
In this episode, we sit down with Dr. Michael Barr, former senior leader at NCQA and the American College of Physicians, now founder of MEDIS, to explore how value-based care, behavioral science, and practical digital tools can relieve pressure on Medicare and Medicaid without losing the human touch.
Together with our hosts, Dr. Barr unpacks the forces reshaping the landscape — surging enrollment, budget constraints, access bottlenecks, and underinvestment in primary care, and discusses how we can make changes to return joy in practice for clinicians and expand access and improve outcomes for patients.
Listen and Learn:
- The biggest forces driving stress in Medicare & Medicaid today
- How clinician and patient motivation drive engagement
- Practical ways to design tech-enabled programs that feel personal
- How behavioral science can build trust and confidence in hard-to-reach populations
If you work in Medicare or Medicaid performance, lead a population health team, or simply want to see how digital health can drive real behavior change, this episode is your roadmap.
Guest
- Michael S. Barr, MD, MBA, President & Founder of MEDIS, LLC
Hosts
- Bob Gold, Chief Behavioral Technologist, GoMo Health
- Shelley Schoenfeld, Chief Strategist, GoMo Health
Thanks for tuning in. Subscribe today to receive alerts of new episodes, comment with questions for our hosts/guests and follow @GoMoHealth on social for the latest in healthcare engagement.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_01 (00:05):
So I think that everybody goes into healthcare,
whether you're any member of thehealthcare professional team,
whether the administrative team,to do well, to be a
professional.
And I believe sincerely that weundervalue the appeal to
professionalism in healthcare.
And it's not just for physiciansor clinicians for the entire
team.
(00:25):
I believe that engagement ofpeople in their own healthcare
to achieve better outcomes isexactly what people go into
healthcare to do.
And the disconnect is ourcurrent system doesn't allow
them to feel thatprofessionalism in what they do.
SPEAKER_00 (00:44):
Sometimes something new intercepts our life and
changes the way we're able tolive, work, or care for
ourselves and others.
Hi, I'm Shelly Schoenfeld, ChiefMarketing and Client Services
Officer at GOMO Health.
SPEAKER_02 (00:57):
Hi, I'm Bob Gold, founder and chief behavioral
technologist at GOMO Health.
SPEAKER_00 (01:03):
And together we're diving into the real stories and
science behind whole personhealth, what that means, why it
matters, and how it can make adifference for people who need
it most.
Welcome to season two of HumanResilience, Changing the Way
Healthcare is delivered.
Today we're going to beexploring some significant
swings in Medicare and Medicaidprograms.
(01:25):
Everybody's reading the papers,and we all see and hear that our
current healthcare landscapefeatures a combination of
federal budget constraints andthings that are going on in the
news and around our world thatare impacting our healthcare
landscape.
We're looking at everything fromrising healthcare costs and
growing enrollment in publicprograms.
(01:46):
And these things are all puttinga strain on our healthcare
system, both financially and theway that healthcare is being
delivered across the board.
Specifically, predictions aretelling us that in by the year
2030, Medicare enrollment isprojected to exceed 80 million
people.
(02:06):
So Medicaid programs are alsogrowing.
We have Medicare enrollmentthat's going to be just off the
charts by 2030 based onpredictions.
And all of these things lead tostrains on our system.
And we're forced to look at waysthat we can continue to deliver
quality, cost-effective care toeverybody and keep patients
(02:29):
happy and their experiencespositive and keep our providers
happy too.
So today we're going to betalking to Dr.
Michael Barr, who's a physicianleader and founder of MEDIS.
Michael previously heldleadership positions at the
National Committee for QualityAssurance, the NCQA, and the
American College of Physicians.
(02:50):
Michael spent decades helpinghealth systems rethink their
health care delivery models.
And he has a primary focus onquality improvement, innovation,
and patient experience.
So, Michael, you're really theguy to talk to when it comes to
the value of digital engagement,and we're we'll hear from Bob
about that as well.
And also when it's guided bybehavioral science.
(03:12):
So, how can we combine thatdigital engagement and still
make it a personalizedexperience for the healthcare
consumer?
And of course, today we're goingto focus on Medicare and
Medicaid programs and how theycan achieve better outcomes
while we're considering all ofthese strains on our system.
So let's get started.
SPEAKER_02 (03:34):
Wonderful.
So, Michael, what motivates youand drives your passion in this
area?
And you know, tell us a littlebit about that vis-a-vis your
background.
SPEAKER_01 (03:50):
Thanks, Bob and Shell.
It's great to be both with bothof you today and Gomo Health.
So thanks for that intro.
My career has always been aboutdoing the most good for as many
people as possible by workingwith organizations such as Gomo
that try to make a difference.
After my residency in Chicago atRush, I spent four years in the
Air Force as a physician andthen went to Vanderbilt, where I
(04:11):
had a great internal medicinepractice.
And from there to BaltimoreMedical System, a federally
qualified health center as chiefmedical officer.
And so I went from growing, uhgoing from treating individuals
to supporting communities.
And there, from there to theAmerican College of Physicians,
where lead the patient centeredmedical home advocacy efforts
and supported our United Statesand international members
(04:31):
through programs and services.
So growing from individuals tocommunities to our professional
societies and professionals, andthen from there to NCQA, which
as you mentioned covers millionsof lives through their programs
and help them expand the medicalhome movement and digital
quality measures.
And now I enjoy working withcompanies like Goma who are
trying to make a difference andhelping them achieve their
visions for the patients andmembers that they take care of
(04:53):
through their programs andservices.
So great to be with you today.
Thanks for that question.
Great to have you, Michael.
SPEAKER_00 (05:00):
So based on everything that you just shared
and all these differentenvironments where you've been
exposed to different populationmodels, different populations,
different care models, differentcare delivery models, what can
you share with us about each ofthose environments and the
challenge that they might beexperiencing given today's
(05:23):
landscape?
How are those models going tokeep up with everything that
we're facing in today'shealthcare market?
SPEAKER_01 (05:30):
Well, as you mentioned, Shelley, there's a
lot of challenges out there.
But let's first acknowledge thatthere are very dedicated
clinical teams, practices,health systems, payers
delivering and organizing greatcare despite these challenges,
right?
So whatever we talk about interms of the negative, let's
acknowledge that some great careis going on and we're trying to
make it better.
So what are those challenges?
(05:51):
First, growing complexity ofcare that comes with an aging
population.
We, and despite access, we havecontinued health care
disparities, access and costissues for patients, uh,
unfortunately, anunderinvestment in primary care
and public health, and theshifting health care policies
you mentioned earlier thataffect coverage, reimbursement,
(06:11):
creating lots of pressure acrossthe entire system, in addition
to the pressure to improvequality while reducing cost
across all payers.
I know we're focused on Medicareand Medicaid, but let's
acknowledge private insurancepayers, commercial payers have
the same motivations.
So those those are some of thechallenges.
If you get into Medicare andMedicaid specifically, they
(06:33):
address this issue somewhatdifferently due to their
financing methods.
But essentially, value-basedcare is taking hold.
Um, and that aims to enhancequality and reduce cost and
reward those who optimize thatvalue equation, quality divided
by cost, with incentives andadditional reimbursements for
their efforts.
And so we can talk a little bitabout that, a little bit more
(06:53):
about that, but that's wheresome of the challenges come in
trying to optimize care whileperforming in this mixed system
of value-based care and stillsignificant amount of fee for
service.
And why, no matter what systemyou're operating under, what
population you're handling,there still remains this need to
connect with the patients ormembers if you're a plan to
really help them achieve theirgoals and in doing so help the
(07:17):
clinicians, the health systems,and the payers achieve their
objectives.
SPEAKER_00 (07:22):
And as we talk about that human impact and the human
cost, uh cost quote, I'mair-quoting here the human cost.
How can we continue, Michael andBob, from both of your
perspectives, to keep thathealthcare consumer motivated,
engaged, feeling like they'regetting what they need out of
(07:43):
the healthcare system so thatthey reciprocate in kind and
they're taking good care ofthemselves and taking care of
what they can do in their owncapabilities to manage their own
care.
SPEAKER_02 (07:54):
Yeah, so for those of you who don't know, so my
background is in the science ofhuman motivation, activation,
resiliency, it's mostly part ofcognitive neuroscience and
behavioral psychology.
But to play on the point, Shellyand Michael, that you made, you
know, aging population, morepeople, and to Michael's point,
(08:16):
the healthcare professionals aretrying to do as best job they
can.
You know, things that have beenlearned and in the last 10 years
and the amount of changes goingon require a different way to
attack the problem that you knowGomo's doing.
(08:36):
Let me give you an example.
So to your point, is people areliving longer, there's aging
populations, right?
At the same time, we definitelydiscovered that just direct
disease management tellingpeople about their COPD or
diabetes and expecting them tochange, you know, hasn't worked,
(08:58):
right?
The amount of obesity has goneup, the amount of diabetics have
gone up, the amount of mentalstress in the last 10 years has
gone up, not only for patients,for nurses, doctors,
pharmacists, you know, the wholesystem.
So we have more people livinglonger, even if we had more
(09:22):
providers, the issue is what isthe strategy in the system to
reverse an issue or to helpminimize negative progression of
a disease or something likethat.
And like so, an example is justto be concrete so you're dealing
(09:46):
with, let's say, an agingpopulation, X have some
cognitive levels of impairment,right?
And it could be Alzheimer'sdementia, just so let's say one
of those issues is I don't haveuh short-term memory.
So did I take my pill?
Did I do that?
Did I do you know?
(10:06):
So what's the strategy?
And they're not with the so ifthey're with the doctor for half
an hour to visit, they go back.
So is the strategy to work withtheir son and daughter, like as
an example, like is how do I getsomeone with cognitive
(10:27):
impairment to do the things andremember they did it and
practice it in their livedenvironments, not what you're
taught in med school per se,right?
Like so, or nursing school orpharmacy school.
So what Gomo does to help boththe patient and the professional
is to change the engagementpathways to achieve the clinical
(10:55):
care plan objectives, right?
Because you have to approach theproblem differently, right?
So that's you know what I wantto say.
And doing the same thing justdoesn't work, right?
That so I'm just pointing outthat one little example with
people with someneurochallenges, but you could
(11:16):
extrapolate that across alltypes of people and places.
And Michael, I don't know if youhave some thoughts on comments
on what I just said.
SPEAKER_01 (11:25):
Absolutely.
And I'll add to this youmentioned stress across the
health system, right?
So the clinicians, especiallythose in primary care practices,
are often overwhelmed within-person encounters, and that
creates a lot of issues, evenwith those with excellent health
insurance, people can't getaccess because appointment
delays and so on.
So complicating the clinicalsituation is the lack of access
(11:47):
to good care, even when theyhave good health insurance.
And depending on where somebodylives, they may not have primary
care or even specialty care tohelp them achieve their clinical
goals.
Um, and then even if they're inthe clinical practice, the care
teams themselves are overwhelmedand can't engage everyone.
So trying to find the person youmentioned, let's say the person
with cognitive deficit or aperson who doesn't have a
(12:09):
support network who needs thatsupport, they they have no way
of understanding that.
And even if they did, there's noway to stratify the population
accurately in terms ofpopulations, so that they
dedicate the appropriateresources to manage those people
effectively.
Um, and the tools they havegenerally are telephone
outreach, email, and so on.
Nothing of the sophisticationthat Gumo has.
(12:31):
So that's where I think there'sa great opportunity to reach
people, and it plays right intothe value-based care equation,
which we can talk about.
But when you do good care, youdo better on whatever measures
are in there system in thoseprograms, and that turns into
better reimbursement to supportinvestment and the systems they
need.
So it's kind of a positivecircle if you get it going, and
(12:53):
sort of that patient engagement,outreach, and help is so
critical, far beyond what mostsystems and plans realize,
because maybe the measuresthey're assessed on could really
be improved by the level ofengagement you've been
describing.
SPEAKER_02 (13:08):
Yeah, you know what's interesting, and there
are positive developments inthat arena, like even going back
10 years ago or so, the Centerfor Medicare, Medicaid said,
hey, we need to increase theamount of reimbursements
payments based on outcomes, notjust fee for service, right?
Because, you know, we have tohave some correlation to
(13:30):
success.
And, you know, and now I thinkmore recently the NCQA is going
to a strategy of not justauditing for accreditation that
you have these policies andprocedures, but that you're
gonna report on outcomes too,right?
Like, so what I've noticedthough, and so those are good
(13:52):
positive steps.
And what I've noticed where Gomofills the gap is how do you
close those gaps?
You know, it's like one thing tosay, okay, you're gonna be from
a behavioral economics, you'regonna be reimbursed more or less
based on some outcomes, reducedreadmissions or ED visits or
(14:14):
adherence to a medication,whatever those outcomes are.
But the staff typically is nottrained on how do I deal with
Betty Joe and Johnny at home,work, and play when I'm not with
them, because that's where thosemeasures are going to happen, or
not, not in the 15 minutes in avisit.
(14:37):
So there's no real training onfor a practice on how to do
that.
So, what Gomo does is weactually do both sides.
We help bring back a little joyin practice, because even though
our solution is geared towardhealth at home programs, and
arguably we have the largestlibrary in the world of health
at home programs, uh, it alsogives a foundational engagement
(15:04):
strategy for the practice or thehealth plan or even the life
science company trying to keeppeople on their device or
procedure or whatever it is.
And that's what's kind ofneeded, right?
It's like how practice.
How do they practice and developtechniques to achieve that goal,
(15:28):
not just clinical, here's sixthings, right?
So that's I think a key factor.
Um, and that's where we need toget to.
So the first step was at leastthe industry starting to
recognize that, hey, paymentsand the behavioral economics
should be based on some form ofoutcome measures, not just on
(15:49):
fee for service or policies andprocedures.
And then the second, which we'regetting to, is now how do we
really help that happen?
And that's what I think youknow, GOMO has demonstrated.
SPEAKER_01 (16:02):
I think one of the important outcome measures that
is difficult to uh uh achieve ispatient-reported outcome
measures and making sure whatwe're measuring matters to the
people and that they are gettingthe care they need and achieving
the goals they set forth.
And that's I think somethingGOMO could help with immensely.
Uh so because as we look at someof the measures and some of the
(16:24):
standard measures, you know,blood pressure, improvement,
diabetes care, uh, vaccinations,cancer screenings, depression
management, well child checkups,adherence to medication
management, all those requireengagement of people to either
obtain the service or follow therecommendations and help them to
follow the recommendations orthe prescriptions, so to speak.
That's really critical toimproving on the measure.
(16:47):
There's a whole nother level ofoutcome measures, which is are
they getting to where they needto be from their perspective?
And I think that's so important.
And it's difficult to measure,and I'll just get into it a
little bit because it's tied topayment.
There's an opportunity, thesystem, right?
So you want to have meaningfuloutcomes for patients and from
(17:07):
their perspective, not justoutcomes that are achieved so
that the system could get paiddifferently.
And I think we need to separatethe accountability measures
using outcome measures from theimprovement that we want to
achieve, again, through thepatient's eye.
SPEAKER_02 (17:22):
Like if you look at the general stats in the US, if
you just Google it across allethnicities and stuff, it's
about 30% of men don't go toprimary care, don't go to a
doctor, and about 20% of women.
And then if you look at someethnicities, like Hispanics or
(17:45):
African American, black, youknow, it indexes a little bit
higher than that.
So what we tend to do when we'redealing with certain folks, we
will ask a lot of times what'syour relationship with your
primary care, you know, and itcould be I don't go because I
don't like the person, right?
(18:06):
Like, okay, well, we havesomeone else for you.
Right?
I maybe I'm not going like, whatdoesn't someone ask me why I
don't go?
Whatever those reasons are.
So one of the interesting thingswe do is we try to nurture
people to help change theiroutlook, their trust and
(18:29):
credibility of both the systemand themselves that they should
be doing these things, right?
Like uh so to get them to go,right?
And and that's an importantcomponent of what we do.
Like, if you look at some of ourdata, like let's just say in
Medicaid, we've closed whetherit's well child visits or
(18:53):
mammogram screenings, this by10x of what our clients at
hospitals and plans were doingbecause we focused on the root
cause in our digital engagement,learn that, and then got them to
think differently, change theiroutlook to even go, right?
(19:13):
To even go.
So there's levels of this.
Like a lot of people justassume, okay, how are we gonna
help diabetic patients live abetter life?
That's assuming they go to someform of health that you know
that, right?
But there's a big populationthat you don't know, and those
(19:34):
are what also drives cost up.
It's like the 80-20 rule, right?
20% of people could drive 80% ofthe cost, and that doesn't help
the whole system.
So, what Gomo tries to do ishelp the entire population
nurture those who you don't knowanything about because they're
not going to anything, and thennurture those who are going to
(19:57):
help them improve, right?
So there's an interestingstrategy that needs to take
place.
SPEAKER_01 (20:03):
Two great points, Bob.
Uh, in addition to your practiceyou outlined, when I was at the
community health center, wefound that when men and young
boys and children, uh, men youngchildren, they get their care
because they're getting thewell-child checks usually.
But then women continue whenthey get the GYN checks, and the
men drop off for about 30 years.
During that period of time, theyare accumulating hits to their
(20:26):
physiology and getting intothose bad behaviors that will
result in the hypertension, thediabetes, the obesity, and so on
and so forth.
So, to your point, I think thatthat's exactly right.
The other is understanding thepopulation back to population
health.
And in an accountability model,the attribution, so systems need
to understand who are the peoplethey're responsible for.
(20:46):
And there's always a littleconfusion about that, the way
the data are are shared from CMSand so on.
But let's assume that that getscleared up.
You know, reaching out to thosepeople, understanding them,
getting them engagedproactively, kind of waiting for
them to show up in the emergencydepartment.
So I know Shelly, apologize.
You wanted to jump in there.
Go ahead.
SPEAKER_00 (21:03):
Well, thank you.
Thank you both, Bob.
You you just gave some great umperspective from the lens of the
consumer and how we can be morepersonalized and focused on who
we're talking to, how we'redelivering in the way that the
end user, the patient, themember needs it.
Michael, from your perspective,from a clinical perspective,
what's what's the kind of theselling point or the benefit
(21:26):
from the provider perspectiveabout integrating this digital
engagement to improve the caredelivery, to still keep it
personalized, but scale thatglobal delivery and support to
the patient populations?
How does a provider see thatbenefit?
How do they feel it like intheir daily life?
SPEAKER_01 (21:44):
Sure.
So just the terminology, I'mgonna use physician when I refer
to physicians and clinician whenI refer to anybody who delivers
health care as a professional.
So providing providers to me arethe systems that deliver the
care, the health system, not theindividual clinicians.
I'm gonna talk about cliniciansspecifically.
So I think that everybody goesinto healthcare, whether you're
(22:05):
any member of the healthcareprofessional team, whether the
administrative team, to do well,to be a professional.
Um, and I believe sincerely thatwe undervalue the appeal to
professionalism in healthcare.
And it's not just for physiciansor clinicians for the entire
team.
I believe that engagement ofpeople in their own healthcare
(22:27):
to achieve better outcomes isexactly what people go into
healthcare to do.
And the disconnect is ourcurrent system doesn't allow
them to feel thatprofessionalism in what they do.
The opportunity with a digitalhealth app like Gomo that can
handle multiple differentconditions and situations to
engage people and reflect thatinformation to back to the
(22:49):
clinical team so that they seethe benefit of what's going on,
both A reduces the amount ofwork they have to do to get to
people, and secondly, appeals totheir professionals that they're
actually helping people.
They're seeing the benefits ofthe outreach, they're seeing the
benefits of the programs, andthey're seeing the benefits in
the numbers that they have toreport for any of the quality
measures that they're assessedupon.
(23:10):
So I think it's it's a win-winfor the patient, people who are
getting care, and theprofessionals who are delivering
the care when these systems areput into play.
SPEAKER_00 (23:20):
Okay, and question kind of spinning that a little
bit or evolving that a littlebit, we're talking about
introducing all of this digital,digital tools and digital uh
resources into the healthcaredelivery model, the traditional
model, right?
We're gonna move and we'reintegrating all these different
things.
How would you recommendencouraging the clinician who's
(23:45):
always done it a certain way toconsider more of these digital
supplements, digital ancillarsto the way that they're
delivering the care, gettingthem open to that from the
clinical perspective?
And then, Bob, I'm gonna spin itover to you and ask what would
be like the number onemotivational tip to get a
consumer, a healthcare consumer,motivated to take that action
(24:10):
and engage with the digitalresources that are available to
them.
But Michael, let's start withyou from the clinical
perspective.
SPEAKER_01 (24:17):
Sure.
Um, most health systems,clinicians, and practices are
pitched digital solutions allday long, every day, right?
And one of the challenges is howto separate those that work from
those that do not.
So I think the first thing ispresenting evidence, right?
This is not vape aware, this isnot something that just got
developed.
We want to try it with yourpractice.
(24:38):
This is something that works andhas worked in populations such
as yours or populations likeyours.
And we believe it'll be it'llwork.
And here's the science behindit, right?
I think appealing to thescientific credibility, the
evidence, and demonstrating howit's worked for people that they
care about, that they're caringfor, is the first step.
(24:58):
Let them use the technologythemselves, let them see how it
works for themselves, let themembrace it and use it and see
how it generates some.
I mean, you guys let me use Gomofor a few days too, and that was
really eye-opening.
So I think that's a very specialpart of sort of the onboarding,
letting them letting themunderstand how it works and why
it works, because then they'llbe more engaged about getting
(25:18):
their patients engaged.
Bob?
SPEAKER_02 (25:21):
Yeah, you know, I'm very passionate about this
answer.
So we've been using the termkind of digital engagement, but
just like any company in theworld, and true in healthcare,
there's some that are betterthan others in what they do, you
know, and and just like anyother human, there's certain
clinicians that are better ornot what they do.
(25:45):
And in technology, there's alsogood, bad, and ugly.
There's not one thing.
Now, a lot of the approach inthe past was taking what
clinicians do, understanding thesix steps to how to improve.
Here's six things I gotta do,something this and that, and
(26:05):
just putting that into an appand giving it to people.
Basically, taking what aclinician would say and giving
it to them.
So go um philosophy is thefollowing that we're focused, no
matter what your issue is, we'refocused on your brain first.
(26:27):
Right?
So your brain decides if you'regonna eat pasta all day and not
exercise.
You know, your brain decideswhether you trust your doctor,
you trust yourself.
Your brain decides, you know,how you react.
Your brain is the one thatcauses anxiety, not your arm or
(26:49):
your leg, right?
No matter what your problem is,we get to understand what's in
someone's head, right?
So now that's a science initself.
So we understand, you know,what's your confidence level to
follow to improve yourself, youknow, with your condition.
(27:14):
What's do you trust yourself tofollow these things?
Do you find yourself crediblecredible?
What what are the causes whyyou're not?
And then what we do is weaddress those things, and all we
simply do is then take theunderlying five, six, four,
(27:36):
eight clinical things that aclinician wants you to do, and
we figure out how to motivateyou to do it.
It's not a matter of oh, we senda reminder to take your med.
Okay, well, they're not takingit.
You have no idea why.
Like, oh, we give that anarticle on sleep, they say
(27:57):
having trouble.
Okay, but how do they practicethat?
How do they do it?
Like do you reading an articleis not doing it, right?
So our system we call mild, it'smicro learning and micro-doing.
We give people things topractice and help them and
reflect in their environmentbecause if you got to figure out
(28:19):
what's upstairs here, andhealthcare for a lot of for a
lot of it separated the brainfrom the body in terms of how it
goes about it.
So I just want to, I know thatwas a long-winded answer, but
um, I think it's reallyimportant.
All clinicians are taught we gotto get to the root cause.
The issue is a lot of these rootcauses of why you're not getting
(28:40):
better, have nothing to do withthe clinical issue, right?
So, how do we discover theperson's root cause?
That's kind of the net at net.
If you could discover theperson's root cause, you could
solve a problem.
But one crisp clear example.
So we run for Montana, we runthe drug court treatment program
(29:02):
along with the behavioral healthorganizations involved.
We're the digital caremanagement for discharge
prisoners, people picked up bypolice, and people in intensive
care outpatient.
The biggest factor in reducingrelapse, ED readmissions was
getting people back to full-timeappointment.
(29:25):
That was the biggest number onefactor.
We got 50% of the people back tofull-time appointment.
They felt more confident, theywere productive, they felt good.
All the data started gettingbetter.
Everything started gettingbetter.
So, what did we focus on?
Helping them do that.
How to dress, how to interview,what to do, how to deal with day
(29:47):
to day coping stress.
It wasn't about here's youraddiction.
Yes, we did that underline.
So, my point is there are rootcause things that if you can
figure out You can solve theproblems, start reversing
trends.
SPEAKER_01 (30:04):
You just said something that strikes a chord
from what I said earlier aboutprofessionalism, right?
In a way, that's getting thephysicians and the clinicians
back to work, back to what theyreally want to do.
And you just described the thepatient getting back to work as
the solution to some of theproblems they were facing.
So it's it's it's not exactlythe same, but I think it's
related.
SPEAKER_02 (30:24):
Yeah, it's very interesting, right?
So um it's sort of changing alittle bit how you develop a
clinical pathway or how youdevelop a care plan.
How clinicians are taught inmotivational interviewing uh
Goma would love to participatewith university training on that
and CMEs.
(30:45):
Like they're they're touchingthe surface, but if we modify a
little bit how they eveninterview in person, how they
quote, interview when they'renot present at work, home, and
play, how how do they use thatto adjust a care plan formulary,
medication formulary, all typesof things?
It's really fascinating what thepotential is here.
(31:08):
So it's not just taking what youdo in person and building a
digital engagement system.
It's thinking about thecustomer, the patient, and
yourself, the pro you know, theorganization that's helping, and
how do we get to the real rootcause quickly to resolve issues?
SPEAKER_00 (31:31):
Great.
Thank you both for answeringthat question that actually came
from our audience.
And really, if you think aboutit as I'm listening to you both,
it's about getting back to thecore.
Bob, you talked about getting tothe core.
What's the what's the trigger inthat human that they're really
worried about that's reallyhanging over their head?
It might not be the obvious.
You have to get to theunderneath.
(31:52):
Michael, you talked from theclinical perspective.
Clinicians just want to get backto the core.
They want to practice medicine,they want to help people, they
want to make the world a ahealthier place.
There's all these things thatare flying out them that are
precluding them from being ableto do that.
And there's a lot of hills toclimb and barriers to chop
through and paperwork they needto get to.
(32:12):
They just want to get back totaking care of human beings and
making them healthier.
So we we all need to focus ongetting back to our core,
getting back to the baseline andum focusing on what's really
important.
So thank you both again foranswering that question from our
audience.
And we want to continue to getquestions from our audience.
So please submit your questionsfor future guests by commenting
(32:35):
and DMing direct messaging onour social channels to at Gomo
Health.
On behalf of Bob Gold andmyself, thank you, Michael, for
joining us and for all of ourlisteners for listening to us
today about the future ofMedicare, Medicaid, and
incorporating digital tools intoour current care delivery
(32:55):
models.
And listeners, if you've enjoyedwhat you've heard, please
subscribe, submit yourquestions, and be sure to like
and comment on this episode.
For more expert insights intothe world of healthcare, visit
us at gomohealth.com and be sureto tune in on Thursday to catch
our latest content.
Thank you for joining us andthank you all for listening.
So I think that everybody goes into healthcare,
whether you're any member of thehealthcare professional team,
whether the administrative team,to do well, to be a
professional.
And I believe sincerely that weundervalue the appeal to
professionalism in healthcare.
And it's not just for physiciansor clinicians for the entire
team.
(00:25):
I believe that engagement ofpeople in their own healthcare
to achieve better outcomes isexactly what people go into
healthcare to do.
And the disconnect is ourcurrent system doesn't allow
them to feel thatprofessionalism in what they do.
SPEAKER_00 (00:44):
Sometimes something new intercepts our life and
changes the way we're able tolive, work, or care for
ourselves and others.
Hi, I'm Shelly Schoenfeld, ChiefMarketing and Client Services
Officer at GOMO Health.
SPEAKER_02 (00:57):
Hi, I'm Bob Gold, founder and chief behavioral
technologist at GOMO Health.
SPEAKER_00 (01:03):
And together we're diving into the real stories and
science behind whole personhealth, what that means, why it
matters, and how it can make adifference for people who need
it most.
Welcome to season two of HumanResilience, Changing the Way
Healthcare is delivered.
Today we're going to beexploring some significant
swings in Medicare and Medicaidprograms.
(01:25):
Everybody's reading the papers,and we all see and hear that our
current healthcare landscapefeatures a combination of
federal budget constraints andthings that are going on in the
news and around our world thatare impacting our healthcare
landscape.
We're looking at everything fromrising healthcare costs and
growing enrollment in publicprograms.
(01:46):
And these things are all puttinga strain on our healthcare
system, both financially and theway that healthcare is being
delivered across the board.
Specifically, predictions aretelling us that in by the year
2030, Medicare enrollment isprojected to exceed 80 million
people.
(02:06):
So Medicaid programs are alsogrowing.
We have Medicare enrollmentthat's going to be just off the
charts by 2030 based onpredictions.
And all of these things lead tostrains on our system.
And we're forced to look at waysthat we can continue to deliver
quality, cost-effective care toeverybody and keep patients
(02:29):
happy and their experiencespositive and keep our providers
happy too.
So today we're going to betalking to Dr.
Michael Barr, who's a physicianleader and founder of MEDIS.
Michael previously heldleadership positions at the
National Committee for QualityAssurance, the NCQA, and the
American College of Physicians.
(02:50):
Michael spent decades helpinghealth systems rethink their
health care delivery models.
And he has a primary focus onquality improvement, innovation,
and patient experience.
So, Michael, you're really theguy to talk to when it comes to
the value of digital engagement,and we're we'll hear from Bob
about that as well.
And also when it's guided bybehavioral science.
(03:12):
So, how can we combine thatdigital engagement and still
make it a personalizedexperience for the healthcare
consumer?
And of course, today we're goingto focus on Medicare and
Medicaid programs and how theycan achieve better outcomes
while we're considering all ofthese strains on our system.
So let's get started.
SPEAKER_02 (03:34):
Wonderful.
So, Michael, what motivates youand drives your passion in this
area?
And you know, tell us a littlebit about that vis-a-vis your
background.
SPEAKER_01 (03:50):
Thanks, Bob and Shell.
It's great to be both with bothof you today and Gomo Health.
So thanks for that intro.
My career has always been aboutdoing the most good for as many
people as possible by workingwith organizations such as Gomo
that try to make a difference.
After my residency in Chicago atRush, I spent four years in the
Air Force as a physician andthen went to Vanderbilt, where I
(04:11):
had a great internal medicinepractice.
And from there to BaltimoreMedical System, a federally
qualified health center as chiefmedical officer.
And so I went from growing, uhgoing from treating individuals
to supporting communities.
And there, from there to theAmerican College of Physicians,
where lead the patient centeredmedical home advocacy efforts
and supported our United Statesand international members
(04:31):
through programs and services.
So growing from individuals tocommunities to our professional
societies and professionals, andthen from there to NCQA, which
as you mentioned covers millionsof lives through their programs
and help them expand the medicalhome movement and digital
quality measures.
And now I enjoy working withcompanies like Goma who are
trying to make a difference andhelping them achieve their
visions for the patients andmembers that they take care of
(04:53):
through their programs andservices.
So great to be with you today.
Thanks for that question.
Great to have you, Michael.
SPEAKER_00 (05:00):
So based on everything that you just shared
and all these differentenvironments where you've been
exposed to different populationmodels, different populations,
different care models, differentcare delivery models, what can
you share with us about each ofthose environments and the
challenge that they might beexperiencing given today's
(05:23):
landscape?
How are those models going tokeep up with everything that
we're facing in today'shealthcare market?
SPEAKER_01 (05:30):
Well, as you mentioned, Shelley, there's a
lot of challenges out there.
But let's first acknowledge thatthere are very dedicated
clinical teams, practices,health systems, payers
delivering and organizing greatcare despite these challenges,
right?
So whatever we talk about interms of the negative, let's
acknowledge that some great careis going on and we're trying to
make it better.
So what are those challenges?
(05:51):
First, growing complexity ofcare that comes with an aging
population.
We, and despite access, we havecontinued health care
disparities, access and costissues for patients, uh,
unfortunately, anunderinvestment in primary care
and public health, and theshifting health care policies
you mentioned earlier thataffect coverage, reimbursement,
(06:11):
creating lots of pressure acrossthe entire system, in addition
to the pressure to improvequality while reducing cost
across all payers.
I know we're focused on Medicareand Medicaid, but let's
acknowledge private insurancepayers, commercial payers have
the same motivations.
So those those are some of thechallenges.
If you get into Medicare andMedicaid specifically, they
(06:33):
address this issue somewhatdifferently due to their
financing methods.
But essentially, value-basedcare is taking hold.
Um, and that aims to enhancequality and reduce cost and
reward those who optimize thatvalue equation, quality divided
by cost, with incentives andadditional reimbursements for
their efforts.
And so we can talk a little bitabout that, a little bit more
(06:53):
about that, but that's wheresome of the challenges come in
trying to optimize care whileperforming in this mixed system
of value-based care and stillsignificant amount of fee for
service.
And why, no matter what systemyou're operating under, what
population you're handling,there still remains this need to
connect with the patients ormembers if you're a plan to
really help them achieve theirgoals and in doing so help the
(07:17):
clinicians, the health systems,and the payers achieve their
objectives.
SPEAKER_00 (07:22):
And as we talk about that human impact and the human
cost, uh cost quote, I'mair-quoting here the human cost.
How can we continue, Michael andBob, from both of your
perspectives, to keep thathealthcare consumer motivated,
engaged, feeling like they'regetting what they need out of
(07:43):
the healthcare system so thatthey reciprocate in kind and
they're taking good care ofthemselves and taking care of
what they can do in their owncapabilities to manage their own
care.
SPEAKER_02 (07:54):
Yeah, so for those of you who don't know, so my
background is in the science ofhuman motivation, activation,
resiliency, it's mostly part ofcognitive neuroscience and
behavioral psychology.
But to play on the point, Shellyand Michael, that you made, you
know, aging population, morepeople, and to Michael's point,
(08:16):
the healthcare professionals aretrying to do as best job they
can.
You know, things that have beenlearned and in the last 10 years
and the amount of changes goingon require a different way to
attack the problem that you knowGomo's doing.
(08:36):
Let me give you an example.
So to your point, is people areliving longer, there's aging
populations, right?
At the same time, we definitelydiscovered that just direct
disease management tellingpeople about their COPD or
diabetes and expecting them tochange, you know, hasn't worked,
(08:58):
right?
The amount of obesity has goneup, the amount of diabetics have
gone up, the amount of mentalstress in the last 10 years has
gone up, not only for patients,for nurses, doctors,
pharmacists, you know, the wholesystem.
So we have more people livinglonger, even if we had more
(09:22):
providers, the issue is what isthe strategy in the system to
reverse an issue or to helpminimize negative progression of
a disease or something likethat.
And like so, an example is justto be concrete so you're dealing
(09:46):
with, let's say, an agingpopulation, X have some
cognitive levels of impairment,right?
And it could be Alzheimer'sdementia, just so let's say one
of those issues is I don't haveuh short-term memory.
So did I take my pill?
Did I do that?
Did I do you know?
(10:06):
So what's the strategy?
And they're not with the so ifthey're with the doctor for half
an hour to visit, they go back.
So is the strategy to work withtheir son and daughter, like as
an example, like is how do I getsomeone with cognitive
(10:27):
impairment to do the things andremember they did it and
practice it in their livedenvironments, not what you're
taught in med school per se,right?
Like so, or nursing school orpharmacy school.
So what Gomo does to help boththe patient and the professional
is to change the engagementpathways to achieve the clinical
(10:55):
care plan objectives, right?
Because you have to approach theproblem differently, right?
So that's you know what I wantto say.
And doing the same thing justdoesn't work, right?
That so I'm just pointing outthat one little example with
people with someneurochallenges, but you could
(11:16):
extrapolate that across alltypes of people and places.
And Michael, I don't know if youhave some thoughts on comments
on what I just said.
SPEAKER_01 (11:25):
Absolutely.
And I'll add to this youmentioned stress across the
health system, right?
So the clinicians, especiallythose in primary care practices,
are often overwhelmed within-person encounters, and that
creates a lot of issues, evenwith those with excellent health
insurance, people can't getaccess because appointment
delays and so on.
So complicating the clinicalsituation is the lack of access
(11:47):
to good care, even when theyhave good health insurance.
And depending on where somebodylives, they may not have primary
care or even specialty care tohelp them achieve their clinical
goals.
Um, and then even if they're inthe clinical practice, the care
teams themselves are overwhelmedand can't engage everyone.
So trying to find the person youmentioned, let's say the person
with cognitive deficit or aperson who doesn't have a
(12:09):
support network who needs thatsupport, they they have no way
of understanding that.
And even if they did, there's noway to stratify the population
accurately in terms ofpopulations, so that they
dedicate the appropriateresources to manage those people
effectively.
Um, and the tools they havegenerally are telephone
outreach, email, and so on.
Nothing of the sophisticationthat Gumo has.
(12:31):
So that's where I think there'sa great opportunity to reach
people, and it plays right intothe value-based care equation,
which we can talk about.
But when you do good care, youdo better on whatever measures
are in there system in thoseprograms, and that turns into
better reimbursement to supportinvestment and the systems they
need.
So it's kind of a positivecircle if you get it going, and
(12:53):
sort of that patient engagement,outreach, and help is so
critical, far beyond what mostsystems and plans realize,
because maybe the measuresthey're assessed on could really
be improved by the level ofengagement you've been
describing.
SPEAKER_02 (13:08):
Yeah, you know what's interesting, and there
are positive developments inthat arena, like even going back
10 years ago or so, the Centerfor Medicare, Medicaid said,
hey, we need to increase theamount of reimbursements
payments based on outcomes, notjust fee for service, right?
Because, you know, we have tohave some correlation to
(13:30):
success.
And, you know, and now I thinkmore recently the NCQA is going
to a strategy of not justauditing for accreditation that
you have these policies andprocedures, but that you're
gonna report on outcomes too,right?
Like, so what I've noticedthough, and so those are good
(13:52):
positive steps.
And what I've noticed where Gomofills the gap is how do you
close those gaps?
You know, it's like one thing tosay, okay, you're gonna be from
a behavioral economics, you'regonna be reimbursed more or less
based on some outcomes, reducedreadmissions or ED visits or
(14:14):
adherence to a medication,whatever those outcomes are.
But the staff typically is nottrained on how do I deal with
Betty Joe and Johnny at home,work, and play when I'm not with
them, because that's where thosemeasures are going to happen, or
not, not in the 15 minutes in avisit.
(14:37):
So there's no real training onfor a practice on how to do
that.
So, what Gomo does is weactually do both sides.
We help bring back a little joyin practice, because even though
our solution is geared towardhealth at home programs, and
arguably we have the largestlibrary in the world of health
at home programs, uh, it alsogives a foundational engagement
(15:04):
strategy for the practice or thehealth plan or even the life
science company trying to keeppeople on their device or
procedure or whatever it is.
And that's what's kind ofneeded, right?
It's like how practice.
How do they practice and developtechniques to achieve that goal,
(15:28):
not just clinical, here's sixthings, right?
So that's I think a key factor.
Um, and that's where we need toget to.
So the first step was at leastthe industry starting to
recognize that, hey, paymentsand the behavioral economics
should be based on some form ofoutcome measures, not just on
(15:49):
fee for service or policies andprocedures.
And then the second, which we'regetting to, is now how do we
really help that happen?
And that's what I think youknow, GOMO has demonstrated.
SPEAKER_01 (16:02):
I think one of the important outcome measures that
is difficult to uh uh achieve ispatient-reported outcome
measures and making sure whatwe're measuring matters to the
people and that they are gettingthe care they need and achieving
the goals they set forth.
And that's I think somethingGOMO could help with immensely.
Uh so because as we look at someof the measures and some of the
(16:24):
standard measures, you know,blood pressure, improvement,
diabetes care, uh, vaccinations,cancer screenings, depression
management, well child checkups,adherence to medication
management, all those requireengagement of people to either
obtain the service or follow therecommendations and help them to
follow the recommendations orthe prescriptions, so to speak.
That's really critical toimproving on the measure.
(16:47):
There's a whole nother level ofoutcome measures, which is are
they getting to where they needto be from their perspective?
And I think that's so important.
And it's difficult to measure,and I'll just get into it a
little bit because it's tied topayment.
There's an opportunity, thesystem, right?
So you want to have meaningfuloutcomes for patients and from
(17:07):
their perspective, not justoutcomes that are achieved so
that the system could get paiddifferently.
And I think we need to separatethe accountability measures
using outcome measures from theimprovement that we want to
achieve, again, through thepatient's eye.
SPEAKER_02 (17:22):
Like if you look at the general stats in the US, if
you just Google it across allethnicities and stuff, it's
about 30% of men don't go toprimary care, don't go to a
doctor, and about 20% of women.
And then if you look at someethnicities, like Hispanics or
(17:45):
African American, black, youknow, it indexes a little bit
higher than that.
So what we tend to do when we'redealing with certain folks, we
will ask a lot of times what'syour relationship with your
primary care, you know, and itcould be I don't go because I
don't like the person, right?
(18:06):
Like, okay, well, we havesomeone else for you.
Right?
I maybe I'm not going like, whatdoesn't someone ask me why I
don't go?
Whatever those reasons are.
So one of the interesting thingswe do is we try to nurture
people to help change theiroutlook, their trust and
(18:29):
credibility of both the systemand themselves that they should
be doing these things, right?
Like uh so to get them to go,right?
And and that's an importantcomponent of what we do.
Like, if you look at some of ourdata, like let's just say in
Medicaid, we've closed whetherit's well child visits or
(18:53):
mammogram screenings, this by10x of what our clients at
hospitals and plans were doingbecause we focused on the root
cause in our digital engagement,learn that, and then got them to
think differently, change theiroutlook to even go, right?
(19:13):
To even go.
So there's levels of this.
Like a lot of people justassume, okay, how are we gonna
help diabetic patients live abetter life?
That's assuming they go to someform of health that you know
that, right?
But there's a big populationthat you don't know, and those
(19:34):
are what also drives cost up.
It's like the 80-20 rule, right?
20% of people could drive 80% ofthe cost, and that doesn't help
the whole system.
So, what Gomo tries to do ishelp the entire population
nurture those who you don't knowanything about because they're
not going to anything, and thennurture those who are going to
(19:57):
help them improve, right?
So there's an interestingstrategy that needs to take
place.
SPEAKER_01 (20:03):
Two great points, Bob.
Uh, in addition to your practiceyou outlined, when I was at the
community health center, wefound that when men and young
boys and children, uh, men youngchildren, they get their care
because they're getting thewell-child checks usually.
But then women continue whenthey get the GYN checks, and the
men drop off for about 30 years.
During that period of time, theyare accumulating hits to their
(20:26):
physiology and getting intothose bad behaviors that will
result in the hypertension, thediabetes, the obesity, and so on
and so forth.
So, to your point, I think thatthat's exactly right.
The other is understanding thepopulation back to population
health.
And in an accountability model,the attribution, so systems need
to understand who are the peoplethey're responsible for.
(20:46):
And there's always a littleconfusion about that, the way
the data are are shared from CMSand so on.
But let's assume that that getscleared up.
You know, reaching out to thosepeople, understanding them,
getting them engagedproactively, kind of waiting for
them to show up in the emergencydepartment.
So I know Shelly, apologize.
You wanted to jump in there.
Go ahead.
SPEAKER_00 (21:03):
Well, thank you.
Thank you both, Bob.
You you just gave some great umperspective from the lens of the
consumer and how we can be morepersonalized and focused on who
we're talking to, how we'redelivering in the way that the
end user, the patient, themember needs it.
Michael, from your perspective,from a clinical perspective,
what's what's the kind of theselling point or the benefit
(21:26):
from the provider perspectiveabout integrating this digital
engagement to improve the caredelivery, to still keep it
personalized, but scale thatglobal delivery and support to
the patient populations?
How does a provider see thatbenefit?
How do they feel it like intheir daily life?
SPEAKER_01 (21:44):
Sure.
So just the terminology, I'mgonna use physician when I refer
to physicians and clinician whenI refer to anybody who delivers
health care as a professional.
So providing providers to me arethe systems that deliver the
care, the health system, not theindividual clinicians.
I'm gonna talk about cliniciansspecifically.
So I think that everybody goesinto healthcare, whether you're
(22:05):
any member of the healthcareprofessional team, whether the
administrative team, to do well,to be a professional.
Um, and I believe sincerely thatwe undervalue the appeal to
professionalism in healthcare.
And it's not just for physiciansor clinicians for the entire
team.
I believe that engagement ofpeople in their own healthcare
(22:27):
to achieve better outcomes isexactly what people go into
healthcare to do.
And the disconnect is ourcurrent system doesn't allow
them to feel thatprofessionalism in what they do.
The opportunity with a digitalhealth app like Gomo that can
handle multiple differentconditions and situations to
engage people and reflect thatinformation to back to the
(22:49):
clinical team so that they seethe benefit of what's going on,
both A reduces the amount ofwork they have to do to get to
people, and secondly, appeals totheir professionals that they're
actually helping people.
They're seeing the benefits ofthe outreach, they're seeing the
benefits of the programs, andthey're seeing the benefits in
the numbers that they have toreport for any of the quality
measures that they're assessedupon.
(23:10):
So I think it's it's a win-winfor the patient, people who are
getting care, and theprofessionals who are delivering
the care when these systems areput into play.
SPEAKER_00 (23:20):
Okay, and question kind of spinning that a little
bit or evolving that a littlebit, we're talking about
introducing all of this digital,digital tools and digital uh
resources into the healthcaredelivery model, the traditional
model, right?
We're gonna move and we'reintegrating all these different
things.
How would you recommendencouraging the clinician who's
(23:45):
always done it a certain way toconsider more of these digital
supplements, digital ancillarsto the way that they're
delivering the care, gettingthem open to that from the
clinical perspective?
And then, Bob, I'm gonna spin itover to you and ask what would
be like the number onemotivational tip to get a
consumer, a healthcare consumer,motivated to take that action
(24:10):
and engage with the digitalresources that are available to
them.
But Michael, let's start withyou from the clinical
perspective.
SPEAKER_01 (24:17):
Sure.
Um, most health systems,clinicians, and practices are
pitched digital solutions allday long, every day, right?
And one of the challenges is howto separate those that work from
those that do not.
So I think the first thing ispresenting evidence, right?
This is not vape aware, this isnot something that just got
developed.
We want to try it with yourpractice.
(24:38):
This is something that works andhas worked in populations such
as yours or populations likeyours.
And we believe it'll be it'llwork.
And here's the science behindit, right?
I think appealing to thescientific credibility, the
evidence, and demonstrating howit's worked for people that they
care about, that they're caringfor, is the first step.
(24:58):
Let them use the technologythemselves, let them see how it
works for themselves, let themembrace it and use it and see
how it generates some.
I mean, you guys let me use Gomofor a few days too, and that was
really eye-opening.
So I think that's a very specialpart of sort of the onboarding,
letting them letting themunderstand how it works and why
it works, because then they'llbe more engaged about getting
(25:18):
their patients engaged.
Bob?
SPEAKER_02 (25:21):
Yeah, you know, I'm very passionate about this
answer.
So we've been using the termkind of digital engagement, but
just like any company in theworld, and true in healthcare,
there's some that are betterthan others in what they do, you
know, and and just like anyother human, there's certain
clinicians that are better ornot what they do.
(25:45):
And in technology, there's alsogood, bad, and ugly.
There's not one thing.
Now, a lot of the approach inthe past was taking what
clinicians do, understanding thesix steps to how to improve.
Here's six things I gotta do,something this and that, and
(26:05):
just putting that into an appand giving it to people.
Basically, taking what aclinician would say and giving
it to them.
So go um philosophy is thefollowing that we're focused, no
matter what your issue is, we'refocused on your brain first.
(26:27):
Right?
So your brain decides if you'regonna eat pasta all day and not
exercise.
You know, your brain decideswhether you trust your doctor,
you trust yourself.
Your brain decides, you know,how you react.
Your brain is the one thatcauses anxiety, not your arm or
(26:49):
your leg, right?
No matter what your problem is,we get to understand what's in
someone's head, right?
So now that's a science initself.
So we understand, you know,what's your confidence level to
follow to improve yourself, youknow, with your condition.
(27:14):
What's do you trust yourself tofollow these things?
Do you find yourself crediblecredible?
What what are the causes whyyou're not?
And then what we do is weaddress those things, and all we
simply do is then take theunderlying five, six, four,
(27:36):
eight clinical things that aclinician wants you to do, and
we figure out how to motivateyou to do it.
It's not a matter of oh, we senda reminder to take your med.
Okay, well, they're not takingit.
You have no idea why.
Like, oh, we give that anarticle on sleep, they say
(27:57):
having trouble.
Okay, but how do they practicethat?
How do they do it?
Like do you reading an articleis not doing it, right?
So our system we call mild, it'smicro learning and micro-doing.
We give people things topractice and help them and
reflect in their environmentbecause if you got to figure out
(28:19):
what's upstairs here, andhealthcare for a lot of for a
lot of it separated the brainfrom the body in terms of how it
goes about it.
So I just want to, I know thatwas a long-winded answer, but
um, I think it's reallyimportant.
All clinicians are taught we gotto get to the root cause.
The issue is a lot of these rootcauses of why you're not getting
(28:40):
better, have nothing to do withthe clinical issue, right?
So, how do we discover theperson's root cause?
That's kind of the net at net.
If you could discover theperson's root cause, you could
solve a problem.
But one crisp clear example.
So we run for Montana, we runthe drug court treatment program
(29:02):
along with the behavioral healthorganizations involved.
We're the digital caremanagement for discharge
prisoners, people picked up bypolice, and people in intensive
care outpatient.
The biggest factor in reducingrelapse, ED readmissions was
getting people back to full-timeappointment.
(29:25):
That was the biggest number onefactor.
We got 50% of the people back tofull-time appointment.
They felt more confident, theywere productive, they felt good.
All the data started gettingbetter.
Everything started gettingbetter.
So, what did we focus on?
Helping them do that.
How to dress, how to interview,what to do, how to deal with day
(29:47):
to day coping stress.
It wasn't about here's youraddiction.
Yes, we did that underline.
So, my point is there are rootcause things that if you can
figure out You can solve theproblems, start reversing
trends.
SPEAKER_01 (30:04):
You just said something that strikes a chord
from what I said earlier aboutprofessionalism, right?
In a way, that's getting thephysicians and the clinicians
back to work, back to what theyreally want to do.
And you just described the thepatient getting back to work as
the solution to some of theproblems they were facing.
So it's it's it's not exactlythe same, but I think it's
related.
SPEAKER_02 (30:24):
Yeah, it's very interesting, right?
So um it's sort of changing alittle bit how you develop a
clinical pathway or how youdevelop a care plan.
How clinicians are taught inmotivational interviewing uh
Goma would love to participatewith university training on that
and CMEs.
(30:45):
Like they're they're touchingthe surface, but if we modify a
little bit how they eveninterview in person, how they
quote, interview when they'renot present at work, home, and
play, how how do they use thatto adjust a care plan formulary,
medication formulary, all typesof things?
It's really fascinating what thepotential is here.
(31:08):
So it's not just taking what youdo in person and building a
digital engagement system.
It's thinking about thecustomer, the patient, and
yourself, the pro you know, theorganization that's helping, and
how do we get to the real rootcause quickly to resolve issues?
SPEAKER_00 (31:31):
Great.
Thank you both for answeringthat question that actually came
from our audience.
And really, if you think aboutit as I'm listening to you both,
it's about getting back to thecore.
Bob, you talked about getting tothe core.
What's the what's the trigger inthat human that they're really
worried about that's reallyhanging over their head?
It might not be the obvious.
You have to get to theunderneath.
(31:52):
Michael, you talked from theclinical perspective.
Clinicians just want to get backto the core.
They want to practice medicine,they want to help people, they
want to make the world a ahealthier place.
There's all these things thatare flying out them that are
precluding them from being ableto do that.
And there's a lot of hills toclimb and barriers to chop
through and paperwork they needto get to.
(32:12):
They just want to get back totaking care of human beings and
making them healthier.
So we we all need to focus ongetting back to our core,
getting back to the baseline andum focusing on what's really
important.
So thank you both again foranswering that question from our
audience.
And we want to continue to getquestions from our audience.
So please submit your questionsfor future guests by commenting
(32:35):
and DMing direct messaging onour social channels to at Gomo
Health.
On behalf of Bob Gold andmyself, thank you, Michael, for
joining us and for all of ourlisteners for listening to us
today about the future ofMedicare, Medicaid, and
incorporating digital tools intoour current care delivery
(32:55):
models.
And listeners, if you've enjoyedwhat you've heard, please
subscribe, submit yourquestions, and be sure to like
and comment on this episode.
For more expert insights intothe world of healthcare, visit
us at gomohealth.com and be sureto tune in on Thursday to catch
our latest content.
Thank you for joining us andthank you all for listening.
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