EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A Review Podcast By cover art

EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A Review

EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A Review

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Look, we wonks, meaning you and me, you're listening to this, so I am on to you. But we wonks in the Relentless Tribe, we move like lightning on Relentless Health Value. We tend to cover lots of ground pretty fast. So, sometimes I like to, with great intention, sum up what's been said—really lock into the big revelations, the big points made, the through lines. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. I like to do this so that points stick in my mind and I remember them and can build on them later. I am thinking you like this, too, because actually our through line shows in the past have been pretty popular. But this, today, is not your average through line show. I am trying something new and actually playing clips of earlier episodes so that you can recall what a guest may have said exactly and specifically and also really see the ways that episodes may interlock. So, to that end, let me just get to it and tell you the four core concepts to buy or deliver the highest-value healthcare that we will cover today. Core Concept 1: Buy healthcare. And by the way, health insurance is not healthcare. Jonathan Baran talks about that, and then Cynthia Fisher, Mark Newman, and Justin Leader cover the why, which is billions of dollars. Core Concept 2: When buying said healthcare, avoid the myth of less expensive healthcare. What is the myth of less expensive healthcare? Well, there's a lot of them, actually. One myth is that low price means low quality. Wrong. Most of the time there is actually no correlation between price and quality, but sometimes less expensive is higher quality. Also, low quality can be the most expensive care irrespective of the cost. Also, the same exact healthcare service or product can cost wildly different prices. Just keep that in mind. You'll hear Elizabeth Mitchell; Sam Flanders, MD; Shane Cerone; Jerry DiMaso; Ivana Krajcinovic, PhD, talk about this, this whole idea of when buying healthcare, avoid the myth of less expensive healthcare. Core Concept 3: So, of course, at this point, direct contracting enters the building. Because direct contracting between ultimate buyers of healthcare (meaning plan sponsors like self-insured employers etc.) and the actual purveyors of healthcare (meaning clinicians) is a fairly obvious strategy if we're going to try to get high quality at a fair price. I mean, get the beginning and the end of the road together. When you do that, it not only can spotlight—and thereby help eliminate—who might be low value that's sitting in the middle of the road collecting tolls like a toll booth, but it also enables collaboration in other ways, really, between the ultimate purchasers and the ultimate deliverers of care. Because there can be conversations about integration. There can be goals and then work out issues together, right? Collaboration is the next breakthrough innovation. So, that's our Core Concept 3: Consider direct contracting or even just, you know, as a start, go talk to, if you're a self-insured employer or you're a purveyor of care, go just find somebody to have a conversation with. Go talk to each other. Just have a chat. And I might include pharmacies, actually, in that mix. It's amazing what can happen, actually, when those buying care and selling care sit in the same room. In this number three core concept, consider direct contracting, we hear again from Ivana Krajcinovic but then also from Ryan Jacobs, Adam Stavisky, and then lastly, we have a quote from Ryan Wells. Core Concept 4: When direct contracting, or otherwise purchasing healthcare, buy the highest-value healthcare. How is that for an aspirational goal? But really, what do you want a direct contract for? What do you want your partners to be accountable to deliver? And what's rolled up into all of that? What is value? What is value, right? We go there, and when I say we, I mean we hear from Mick Connors, MD; Dr. Siva, otherwise known as Ahilan Sivaganesan, MD; and then we have Kenny Cole, MD, to bring us home. We finish up really at a very human level for why all of this matters. So, in summary, here's our four concepts. When you buy healthcare, buy healthcare. Focus on what you're actually getting for your money and how you are buying it. When you do that, direct contracting starts to make some sense. Just make sure the care that you are buying is truly high value. That's the whole shebang in a nutshell. One more thing before we kick into this. So, yeah, while I was quietly contemplating the vast universe of things gone wrong and right in the healthcare sector, Tom Nash, our producer extraordinaire, wandered in and asked me to try out his new Relentless Health Value Chatbot that he's been working on possibly 18 hours a day, including weekends ever since the incident with Michelle Bernabe and the AI futurist philanthropist, which you can hear all about ...
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