June 4, 2025 • 14 mins
Ever wondered how a physician-led organization achieves exceptional results in one of healthcare's most challenging environments? Join us for a fascinating conversation with Dr. Eliza Ng the Chief Medical Officer of CAIPA, a New York-based Independent Physician Association managing 500,000 lives with remarkable success.
Dr. Ng shares her journey from delivering babies as an OBGYN to transforming healthcare delivery for 350,000 lives under value-based care arrangements. With 85% Medicaid enrollment, COIPA has achieved what many consider impossible: MLRs in the high 70s and shared savings of $80-100 million. The key? Access to care and relationship-building that creates patient "stickiness" where others struggle to even locate their members.
We explore the real-world business case for lifestyle medicine in value-based care settings, addressing both opportunities and barriers. Learn how organizations can demonstrate both direct revenue and indirect benefits from lifestyle interventions, with each 1% reduction in A1C potentially saving $500-2,000 per patient annually. Dr. Ng candidly discusses the challenges of convincing financial decision-makers of lifestyle medicine's value when most contracts operate on 12-month cycles while interventions require years to show full impact.
Whether you're a clinician looking to incorporate lifestyle medicine into your practice or a healthcare leader navigating value-based transformation, this episode delivers actionable insights on maintaining the "mom-and-pop" feel patients crave while operating within sophisticated risk-bearing arrangements.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Justin Politti (00:02):
Welcome to the Reverse Mullet Healthcare
Podcast from BP2 Health.
We are live here at the ACLMConference in Orlando, Florida.
I'm your host, Justin Politi.
I'm Dave Pavlik.
Ellen Brown (00:13):
And I am Ellen Brown, and we are here at the
American College of LifestyleMedicine Conference and we have
our special guest, liza, andbefore we got started, we were
talking about our shared passionin payment, transformation,
value-based care and all ofthose fun things so clearly we
have a lot to talk about, but weonly have 15 minutes.
So yeah, so tell us, tell usabout your work, tell us about
(00:35):
yourself, sure.
Eliza Ng (00:36):
So a little bit about myself first.
I am an OBGYN by training,delivered tons of babies, but
really spent my last two decadesin the business, or in the coat
, of managing risk and managingpopulation, the entire
value-based care and ACOproliferation.
(00:58):
I moved over to the providerside, because I see that's where
innovation and transformationcan occur.
I'm currently a chief medicalofficer of COIPA, Coalition of
(01:18):
Asian American IPA.
We are a 1,200 physicians groupin New.
Dave Pavlik (01:23):
York City.
Eliza Ng (01:29):
IPA.
We are a 1,200 physicians groupin New York City managing over
500,000 lives, out of which350,000 of them are under a
continuum of value-based care.
We also have a CMS, mssp.
Justin Politti (01:37):
I know them well because Oxford Health Plans
actually was.
That's where I started mycareer.
Ellen Brown (01:43):
Oh, Gason Yep, yep, oh there, yes, yeah, it was.
I need to switch chairs, yeahwe started taking risk right.
Eliza Ng (01:51):
That was before my time certainly, uh, 26 years ago
and so I'm passionate aboutvalue-based care and I processed
your claims.
I did that?
Dave Pavlik (02:04):
Okay, don't worry.
Yeah, you went through.
Don't even get me started.
Justin Politti (02:08):
There was Pulse and PIC.
Those were the systems thatdidn't talk to one another, but
yeah, anyway, there was LeVonthere.
Ellen Brown (02:14):
Inside baseball.
Dave Pavlik (02:15):
Yeah talk about inside baseball.
I'll start going on about it.
Eliza Ng (02:18):
So, in the context of pay or mix, 85% of all
populations under and the restare Medicare and very small.
Wait, 85% Medicaid.
Yes, and we are one of the mostsuccessful Medicaid ACO in New
York State.
Overall, our share savingsbonus is in the upwards of $80
(02:39):
to $100 million.
That is amazing.
Wow On what?
Ellen Brown (02:42):
kind of revenue or on what kind of benchmark.
Eliza Ng (02:45):
I should say Well, you know of an MLR basis.
Our population is quite uniqueand I could talk a little bit
about why, but our MLR isusually in the high 70s.
Wow, now people will always say, well, maybe it's your
population, it's low risk.
Certainly I think our diseaseburden is not as high as some of
(03:07):
the other cohorts.
By the way, my previous life Iwas a senior medical director at
Montefiore ACO, oh wow.
And we managed a very differentpopulation where the MLR is in
the 90s right, where the diseaseburden is tremendous.
Ellen Brown (03:23):
But the benchmark reflects that, though so fine,
the disease burden is less butthe benchmark's lower as a
result of that.
So I mean so the MLR says thattells the story.
Eliza Ng (03:35):
Yeah.
So if someone were gonna cometo me, especially from the
provider side, and said how canI manage a population?
Yes, you can talk about theinfrastructures.
You can talk about the dataanalytics, you can talk about
the data analytics andinnovation, but I would say one
thing access.
Throughout my career, Idefinitely see a large
correlation between access tocare, especially primary care,
(03:57):
and population and medicalexpenditure.
So give you some benchmarkexamples A typical Medicaid
patient sees our doctors sixtimes a year.
Wow.
A typical Medicare patient seesour doctor eight times a year.
Ellen Brown (04:13):
Yeah, so we're able to Very different.
To even be able to find yourMedicaid patient is a feat on
its own.
That's one of the biggestthings that we hear from health
plans is I't even find mypatients.
Right, they've been assigned tome, but I can't even find that
contact there.
Justin Politti (04:29):
Yeah, but it's really unique in the populations
that you know you're workingwith here in that it's so
ingrained like again, I wouldsee, because when again we
worked at united healthcareafter oxford purchased, you know
um, I mean after unitedpurchased oxford and it I mean
after United purchased Oxfordand it was just an eye-opening
to me around like just howunique the access is within the
(04:51):
population that you're workingwith.
Eliza Ng (04:53):
I understand and you're right, our patients have
certain cultural affinity.
That lends itself to a hugestickiness with their doctors.
However, I do really believe,having worked in the Bronx for
instance, that we can createenvironmental opportunity to
create that stickiness Totallyagree.
That's when consumerism comes in, that's when you want to
(05:15):
delight your patients and that'swhen you really want to build
the trust with them so that theyknow right, if I have a fever
or my child has a high fever, Ican go to my doctors, I can call
my doctors instead of going tothe emergency yes, which is your
access point 100%.
That's hard, but I think that'sreally critical.
Justin Politti (05:36):
It is.
That's very I can see it in thewaiting room.
I mean, honestly, I've been inmany offices and I was like this
is just, it's just different.
You know, and you could tellI'm passionate about, you know
about this, because I was likehow do we deliver this or how do
we implement this throughoutthe health care system to have
that type of, I guess,engagement from your with your
provider.
Eliza Ng (05:55):
Boots on the ground.
I mean technology is very hardto replace that.
You have to have presence inyour community.
Justin Politti (06:02):
Yes, yes.
Eliza Ng (06:03):
And it's very mom and pop.
So I think the opportunitiesfor especially large
corporations or entities is youneed to deliver the same mom and
pop type of practice.
Feel you can corporatizemedical practices.
It's the high-touch touch,community based.
Ellen Brown (06:23):
It's the relationships.
It's the third time in a rownow that we've heard the
importance of relationships withthe clinician in lifestyle
medicine.
So so two questions.
One I'm going to go back to theMedicaid ACO piece.
So are you, do you have an ACOthat works with the Medicaid
MCOs in New York, yes, or do youhave a direct ACO relationship
(06:45):
with the state?
So, new York?
Eliza Ng (06:46):
state we have both.
Okay, we are one of the fourwhat's called New York state
innovators.
That allows us to take fullrisk, delegated risk one of the
four, but I would say in newyork, not california, it's very
difficult.
Ellen Brown (07:02):
oh to to get health plans to agree to delegate
functions, yeah yeah, yep, no,so 100 and the state is not
really doing a lot to pushtowards a direction that's, and
that's why you caught myattention when you said medicaid
acl is like wait.
So what's going on with thestate, like I have to know, are
you?
Justin Politti (07:18):
agnostic as to which ones you're doing.
So, in other words, are yougoing across the spectrum or
will you align with one payer ortwo.
Eliza Ng (07:24):
No, no, we have multiple payers.
We certainly have coupledpredominant payers because of
large volume.
Justin Politti (07:30):
Right, that's the thing that I would be if I'm
on the payer side.
I'm like I want you know Idon't want you to sign.
Eliza Ng (07:34):
But one out of eight Medicaid patients are taken care
of by our doctors in downstate,so we have to play with all
payers and payers have to playwith us, so we have multiple
contacts directly through ourown ACL state.
Ellen Brown (07:51):
ACL.
So thank you for answering thattechnical question.
So now I'm going to go to moreof the global question of so
tell us how you came intolifestyle medicine, how you
bring this into such a massscale, et cetera.
Eliza Ng (08:06):
Sure.
So it's really through mypersonal journey and my through
my own personal struggle as asomeone who tries to manage my
career, my family, my, mypersonal health that I stumbled
upon lifestyle medicinesprinciples and started learning
a lot about it and practice it,and I see the tremendous
outcomes not only on my health,but also on my productivity and
(08:29):
lifestyle changes are veryaccessible, and so it becomes my
mission to democratizelifestyle medicine to my
population and also to my peerswho also struggle in many ways
like I do.
Dave Pavlik (08:43):
Yeah, Tell us about your.
You're going to be on the stagetomorrow at some point.
Tell us about what is yourtopic and what.
Eliza Ng (08:49):
Sure, I am part of a work group called Under the
Business of Lifestyle Medicineand there are two parts to it.
There is a part that aims tohelp folks who want to start a
lifestyle medicine practice andgive them the tools and support
from a fee-for-service piece,and my talk, or my session, is
(09:12):
really on how to integrate orstart a lifestyle medicine
practice within a system ormedical groups that participates
in value-based care.
Ellen Brown (09:21):
Yep that's where we are big champions with you of
that is how do we bring we workwith so many health systems and
health plans that are veryfee-for-service centric and
maybe they've tried value-basedcare some but those especially
those that have that are fullyintegrated, that have health
plans that that have or are verycommitted to reducing the
expense on their own employeesright is, how do you help them
(09:45):
see lifestyle medicine as notjust a clinical service line but
as an actual way to improveoutcomes and pair into those
outcomes-based contracts, thosevalue-based contracts that right
now are very chronic diseasemanagement centric?
You know, like, just let's goafter that one.
You know what I'm saying.
It's a night and day differencein terms of the focal point and
(10:06):
opportunity.
Eliza Ng (10:08):
Yeah, so for me, right , if there were two?
Separate line from this isnumber one.
If you want to start a programor start to practice lifestyle
medicine within a system ormedical group, you don't want to
be a cost center.
However, you may not need tofully have a full, top-line
revenue-driven program.
(10:28):
The indirect benefit, the valueof lifestyle programs include
improving quality right, shedoes quality that are in every
single value-based contractBlood pressure measurement,
hemoglobin A1C lowering.
These are very focused measuresthat almost all payers are
focused on.
You can improve the total costof care of a certain subgroup
(10:49):
population rising risk.
I think it's the best suitablefor.
So you have to really createthat revenue model from a direct
but also from the indirect.
So me, as a decision maker, orone of the decision making
groups within my group, willlook at what is the revenue line
.
Okay, you barely can cover yourcosts, but hey, based on
(11:11):
evidence and based on theintegrity of your program, I
believe and it's been, you know,let's say, shown in other areas
that you can decrease cost ofcare for that population.
Let's say diabetes, forinstance for every 1% hemoglobin
A1C lowing, you can lower totalcost of care from $500 to
$2,000 per year.
So those are the P&Ls that youneed to include in your program.
Dave Pavlik (11:34):
Do you talk at all about barriers that somebody
wanting to start a lifestylepractice within a group or
within a system talk about anyof the barriers that they're
going to face?
I?
Eliza Ng (11:43):
do and these are realistic right.
Many, many decision makers,whether it's your CFO or your
CEO, might not be able to agreeright on especially indirect
value that lifestyle medicinecan bring in, because it has.
No, the RV is not there, Right,Exactly Right.
So that's number one.
And number two, that timehorizon most value-based care
(12:05):
contracts are 12 months Exactly.
Many lifestyle medicineprograms are multiple year Right
.
That's why, to be honest,diabetic prevention program is
really hard to make a businesscase, Absolutely.
Ellen Brown (12:16):
Because it's a three to seven year horizon and
it's prevention, so it'savoidable cost.
Eliza Ng (12:22):
Yes, super hard, yeah.
So these are realisticchallenges, yeah.
Ellen Brown (12:26):
No, I always say to people.
I don't want to have the debateabout wellness and prevention.
I understand the economics ofit, but this is insurance and an
insurance company, yourhomeowner's insurance.
It doesn't pay to keep yourroof fixed right.
It pays when the roof blows off.
It's your responsibility tomake sure that you caulk the
roof and you get new shinglesand so this whole thing of like.
(12:49):
Well, I let myself go for 20years and now you have to pay
for it.
It's that 20 years that we.
It's funky, so I feel like.
But now we've gotten to thistipping point where we have 2
trillion in lifestyle diseasecosts.
That's a big opportunity to goafter that nobody's disagreeing
over, right.
It's like that we can solve andthat we can share.
Eliza Ng (13:11):
And redistribute 100%, especially with the aging of
the population.
You're going to see right.
Dsnp is the next frontier, inmy opinion, around value-based
care.
You're going to get them allfired up again.
Justin Politti (13:22):
Yeah.
We're fully integratedde-snipped in Massachusetts.
Senior Care Options.
Eliza Ng (13:34):
Okay, let's talk, because waiver is here now in
New York, everyone's justscrambling.
Massachusetts has startedearlier than us, so we'd love to
learn from you.
Dave Pavlik (13:38):
Wait for him to wean off the caffeine.
Justin Politti (13:40):
He's ready when it comes to de-snips, I'm happy
that I heard an acronym that Ihaven't heard in almost 20 years
.
Dave Pavlik (13:48):
No.
Ellen Brown (13:48):
KIPA and CAPIPA.
Justin Politti (13:49):
KIPA and CAPIPA.
That was the ones that you know.
There you go Well.
Ellen Brown (13:53):
I know that we only had 15 minutes and it's 15
minutes, so we're going to haveto say goodbye for now.
Dave Pavlik (13:58):
Thank you so much for being here.
Ellen Brown (13:59):
Thank you, this is definitely worthy of a much
longer conversation, becausethis is the stuff that I think a
lot of people everything we'vetalked about this week is
important, but there's a wholegroup of folks that really want
to understand this at a realdetailed level.
So thank you, okay.
Dave Pavlik (14:13):
Thank you, have a great day, all right.
Welcome to the Reverse Mullet Healthcare
Podcast from BP2 Health.
We are live here at the ACLMConference in Orlando, Florida.
I'm your host, Justin Politi.
I'm Dave Pavlik.
Ellen Brown (00:13):
And I am Ellen Brown, and we are here at the
American College of LifestyleMedicine Conference and we have
our special guest, liza, andbefore we got started, we were
talking about our shared passionin payment, transformation,
value-based care and all ofthose fun things so clearly we
have a lot to talk about, but weonly have 15 minutes.
So yeah, so tell us, tell usabout your work, tell us about
(00:35):
yourself, sure.
Eliza Ng (00:36):
So a little bit about myself first.
I am an OBGYN by training,delivered tons of babies, but
really spent my last two decadesin the business, or in the coat
, of managing risk and managingpopulation, the entire
value-based care and ACOproliferation.
(00:58):
I moved over to the providerside, because I see that's where
innovation and transformationcan occur.
I'm currently a chief medicalofficer of COIPA, Coalition of
(01:18):
Asian American IPA.
We are a 1,200 physicians groupin New.
Dave Pavlik (01:23):
York City.
Eliza Ng (01:29):
IPA.
We are a 1,200 physicians groupin New York City managing over
500,000 lives, out of which350,000 of them are under a
continuum of value-based care.
We also have a CMS, mssp.
Justin Politti (01:37):
I know them well because Oxford Health Plans
actually was.
That's where I started mycareer.
Ellen Brown (01:43):
Oh, Gason Yep, yep, oh there, yes, yeah, it was.
I need to switch chairs, yeahwe started taking risk right.
Eliza Ng (01:51):
That was before my time certainly, uh, 26 years ago
and so I'm passionate aboutvalue-based care and I processed
your claims.
I did that?
Dave Pavlik (02:04):
Okay, don't worry.
Yeah, you went through.
Don't even get me started.
Justin Politti (02:08):
There was Pulse and PIC.
Those were the systems thatdidn't talk to one another, but
yeah, anyway, there was LeVonthere.
Ellen Brown (02:14):
Inside baseball.
Dave Pavlik (02:15):
Yeah talk about inside baseball.
I'll start going on about it.
Eliza Ng (02:18):
So, in the context of pay or mix, 85% of all
populations under and the restare Medicare and very small.
Wait, 85% Medicaid.
Yes, and we are one of the mostsuccessful Medicaid ACO in New
York State.
Overall, our share savingsbonus is in the upwards of $80
(02:39):
to $100 million.
That is amazing.
Wow On what?
Ellen Brown (02:42):
kind of revenue or on what kind of benchmark.
Eliza Ng (02:45):
I should say Well, you know of an MLR basis.
Our population is quite uniqueand I could talk a little bit
about why, but our MLR isusually in the high 70s.
Wow, now people will always say, well, maybe it's your
population, it's low risk.
Certainly I think our diseaseburden is not as high as some of
(03:07):
the other cohorts.
By the way, my previous life Iwas a senior medical director at
Montefiore ACO, oh wow.
And we managed a very differentpopulation where the MLR is in
the 90s right, where the diseaseburden is tremendous.
Ellen Brown (03:23):
But the benchmark reflects that, though so fine,
the disease burden is less butthe benchmark's lower as a
result of that.
So I mean so the MLR says thattells the story.
Eliza Ng (03:35):
Yeah.
So if someone were gonna cometo me, especially from the
provider side, and said how canI manage a population?
Yes, you can talk about theinfrastructures.
You can talk about the dataanalytics, you can talk about
the data analytics andinnovation, but I would say one
thing access.
Throughout my career, Idefinitely see a large
correlation between access tocare, especially primary care,
(03:57):
and population and medicalexpenditure.
So give you some benchmarkexamples A typical Medicaid
patient sees our doctors sixtimes a year.
Wow.
A typical Medicare patient seesour doctor eight times a year.
Ellen Brown (04:13):
Yeah, so we're able to Very different.
To even be able to find yourMedicaid patient is a feat on
its own.
That's one of the biggestthings that we hear from health
plans is I't even find mypatients.
Right, they've been assigned tome, but I can't even find that
contact there.
Justin Politti (04:29):
Yeah, but it's really unique in the populations
that you know you're workingwith here in that it's so
ingrained like again, I wouldsee, because when again we
worked at united healthcareafter oxford purchased, you know
um, I mean after unitedpurchased oxford and it I mean
after United purchased Oxfordand it was just an eye-opening
to me around like just howunique the access is within the
(04:51):
population that you're workingwith.
Eliza Ng (04:53):
I understand and you're right, our patients have
certain cultural affinity.
That lends itself to a hugestickiness with their doctors.
However, I do really believe,having worked in the Bronx for
instance, that we can createenvironmental opportunity to
create that stickiness Totallyagree.
That's when consumerism comes in, that's when you want to
(05:15):
delight your patients and that'swhen you really want to build
the trust with them so that theyknow right, if I have a fever
or my child has a high fever, Ican go to my doctors, I can call
my doctors instead of going tothe emergency yes, which is your
access point 100%.
That's hard, but I think that'sreally critical.
Justin Politti (05:36):
It is.
That's very I can see it in thewaiting room.
I mean, honestly, I've been inmany offices and I was like this
is just, it's just different.
You know, and you could tellI'm passionate about, you know
about this, because I was likehow do we deliver this or how do
we implement this throughoutthe health care system to have
that type of, I guess,engagement from your with your
provider.
Eliza Ng (05:55):
Boots on the ground.
I mean technology is very hardto replace that.
You have to have presence inyour community.
Justin Politti (06:02):
Yes, yes.
Eliza Ng (06:03):
And it's very mom and pop.
So I think the opportunitiesfor especially large
corporations or entities is youneed to deliver the same mom and
pop type of practice.
Feel you can corporatizemedical practices.
It's the high-touch touch,community based.
Ellen Brown (06:23):
It's the relationships.
It's the third time in a rownow that we've heard the
importance of relationships withthe clinician in lifestyle
medicine.
So so two questions.
One I'm going to go back to theMedicaid ACO piece.
So are you, do you have an ACOthat works with the Medicaid
MCOs in New York, yes, or do youhave a direct ACO relationship
(06:45):
with the state?
So, new York?
Eliza Ng (06:46):
state we have both.
Okay, we are one of the fourwhat's called New York state
innovators.
That allows us to take fullrisk, delegated risk one of the
four, but I would say in newyork, not california, it's very
difficult.
Ellen Brown (07:02):
oh to to get health plans to agree to delegate
functions, yeah yeah, yep, no,so 100 and the state is not
really doing a lot to pushtowards a direction that's, and
that's why you caught myattention when you said medicaid
acl is like wait.
So what's going on with thestate, like I have to know, are
you?
Justin Politti (07:18):
agnostic as to which ones you're doing.
So, in other words, are yougoing across the spectrum or
will you align with one payer ortwo.
Eliza Ng (07:24):
No, no, we have multiple payers.
We certainly have coupledpredominant payers because of
large volume.
Justin Politti (07:30):
Right, that's the thing that I would be if I'm
on the payer side.
I'm like I want you know Idon't want you to sign.
Eliza Ng (07:34):
But one out of eight Medicaid patients are taken care
of by our doctors in downstate,so we have to play with all
payers and payers have to playwith us, so we have multiple
contacts directly through ourown ACL state.
Ellen Brown (07:51):
ACL.
So thank you for answering thattechnical question.
So now I'm going to go to moreof the global question of so
tell us how you came intolifestyle medicine, how you
bring this into such a massscale, et cetera.
Eliza Ng (08:06):
Sure.
So it's really through mypersonal journey and my through
my own personal struggle as asomeone who tries to manage my
career, my family, my, mypersonal health that I stumbled
upon lifestyle medicinesprinciples and started learning
a lot about it and practice it,and I see the tremendous
outcomes not only on my health,but also on my productivity and
(08:29):
lifestyle changes are veryaccessible, and so it becomes my
mission to democratizelifestyle medicine to my
population and also to my peerswho also struggle in many ways
like I do.
Dave Pavlik (08:43):
Yeah, Tell us about your.
You're going to be on the stagetomorrow at some point.
Tell us about what is yourtopic and what.
Eliza Ng (08:49):
Sure, I am part of a work group called Under the
Business of Lifestyle Medicineand there are two parts to it.
There is a part that aims tohelp folks who want to start a
lifestyle medicine practice andgive them the tools and support
from a fee-for-service piece,and my talk, or my session, is
(09:12):
really on how to integrate orstart a lifestyle medicine
practice within a system ormedical groups that participates
in value-based care.
Ellen Brown (09:21):
Yep that's where we are big champions with you of
that is how do we bring we workwith so many health systems and
health plans that are veryfee-for-service centric and
maybe they've tried value-basedcare some but those especially
those that have that are fullyintegrated, that have health
plans that that have or are verycommitted to reducing the
expense on their own employeesright is, how do you help them
(09:45):
see lifestyle medicine as notjust a clinical service line but
as an actual way to improveoutcomes and pair into those
outcomes-based contracts, thosevalue-based contracts that right
now are very chronic diseasemanagement centric?
You know, like, just let's goafter that one.
You know what I'm saying.
It's a night and day differencein terms of the focal point and
(10:06):
opportunity.
Eliza Ng (10:08):
Yeah, so for me, right , if there were two?
Separate line from this isnumber one.
If you want to start a programor start to practice lifestyle
medicine within a system ormedical group, you don't want to
be a cost center.
However, you may not need tofully have a full, top-line
revenue-driven program.
(10:28):
The indirect benefit, the valueof lifestyle programs include
improving quality right, shedoes quality that are in every
single value-based contractBlood pressure measurement,
hemoglobin A1C lowering.
These are very focused measuresthat almost all payers are
focused on.
You can improve the total costof care of a certain subgroup
(10:49):
population rising risk.
I think it's the best suitablefor.
So you have to really createthat revenue model from a direct
but also from the indirect.
So me, as a decision maker, orone of the decision making
groups within my group, willlook at what is the revenue line
.
Okay, you barely can cover yourcosts, but hey, based on
(11:11):
evidence and based on theintegrity of your program, I
believe and it's been, you know,let's say, shown in other areas
that you can decrease cost ofcare for that population.
Let's say diabetes, forinstance for every 1% hemoglobin
A1C lowing, you can lower totalcost of care from $500 to
$2,000 per year.
So those are the P&Ls that youneed to include in your program.
Dave Pavlik (11:34):
Do you talk at all about barriers that somebody
wanting to start a lifestylepractice within a group or
within a system talk about anyof the barriers that they're
going to face?
I?
Eliza Ng (11:43):
do and these are realistic right.
Many, many decision makers,whether it's your CFO or your
CEO, might not be able to agreeright on especially indirect
value that lifestyle medicinecan bring in, because it has.
No, the RV is not there, Right,Exactly Right.
So that's number one.
And number two, that timehorizon most value-based care
(12:05):
contracts are 12 months Exactly.
Many lifestyle medicineprograms are multiple year Right
.
That's why, to be honest,diabetic prevention program is
really hard to make a businesscase, Absolutely.
Ellen Brown (12:16):
Because it's a three to seven year horizon and
it's prevention, so it'savoidable cost.
Eliza Ng (12:22):
Yes, super hard, yeah.
So these are realisticchallenges, yeah.
Ellen Brown (12:26):
No, I always say to people.
I don't want to have the debateabout wellness and prevention.
I understand the economics ofit, but this is insurance and an
insurance company, yourhomeowner's insurance.
It doesn't pay to keep yourroof fixed right.
It pays when the roof blows off.
It's your responsibility tomake sure that you caulk the
roof and you get new shinglesand so this whole thing of like.
(12:49):
Well, I let myself go for 20years and now you have to pay
for it.
It's that 20 years that we.
It's funky, so I feel like.
But now we've gotten to thistipping point where we have 2
trillion in lifestyle diseasecosts.
That's a big opportunity to goafter that nobody's disagreeing
over, right.
It's like that we can solve andthat we can share.
Eliza Ng (13:11):
And redistribute 100%, especially with the aging of
the population.
You're going to see right.
Dsnp is the next frontier, inmy opinion, around value-based
care.
You're going to get them allfired up again.
Justin Politti (13:22):
Yeah.
We're fully integratedde-snipped in Massachusetts.
Senior Care Options.
Eliza Ng (13:34):
Okay, let's talk, because waiver is here now in
New York, everyone's justscrambling.
Massachusetts has startedearlier than us, so we'd love to
learn from you.
Dave Pavlik (13:38):
Wait for him to wean off the caffeine.
Justin Politti (13:40):
He's ready when it comes to de-snips, I'm happy
that I heard an acronym that Ihaven't heard in almost 20 years
.
Dave Pavlik (13:48):
No.
Ellen Brown (13:48):
KIPA and CAPIPA.
Justin Politti (13:49):
KIPA and CAPIPA.
That was the ones that you know.
There you go Well.
Ellen Brown (13:53):
I know that we only had 15 minutes and it's 15
minutes, so we're going to haveto say goodbye for now.
Dave Pavlik (13:58):
Thank you so much for being here.
Ellen Brown (13:59):
Thank you, this is definitely worthy of a much
longer conversation, becausethis is the stuff that I think a
lot of people everything we'vetalked about this week is
important, but there's a wholegroup of folks that really want
to understand this at a realdetailed level.
So thank you, okay.
Dave Pavlik (14:13):
Thank you, have a great day, all right.
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