EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD

Jan 30, 2025

Dr. Scott Conard, founder of Converging Health, dives into the intricacies of population health management. He highlights that 70% of high-cost patients were previously high-risk yet low-cost, emphasizing the importance of early identification. Discussions revolve around aligning healthcare benefits with community needs for better access and proactive health management. Conard advocates for a holistic view of health, using comprehensive data to create a 'whole person risk score', illustrating that effective management can reduce costs while enhancing patient outcomes.

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INSIGHT

Whole-Person Risk Assessment

Healthcare data should focus on whole-person risk, not just individual body parts.
Treat patients as individuals with interconnected health factors, not as a collection of isolated conditions.

ANECDOTE

Margaret's Healthcare Journey

Dr. Conard shares Margaret's story, a high-risk patient with a whole-person risk score of 100 who improved dramatically through personalized care.
The program reduced her risk score to 41, resulting in significant cost savings and improved well-being.

ADVICE

Proactive Care for High-Risk Individuals

Don't solely focus on the 5% high-cost claimants; address the high-risk, low-cost population to prevent future high costs.
Proactive care for the high-risk group can prevent them from becoming high-cost claimants, leading to significant savings.

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This podcast today is with Dr. Scott Conard, founder of Converging Health. You might remember him from the earlier episode (EP391). First of all, I enjoyed how it came to be. Brian Uhlig, an employee benefit consultant of some acclaim, came to me and offered to sponsor a show for someone else. Not himself. I gotta say, it’s stuff like this that warms my heart. It’s this village that we have here, this tribe of Relentless folks trying so hard to stand up for and help patients. So, thanks again to Brian Uhlig.

Right now, Dr. Conard is doing a bunch of work with Mike Adams from 7-Eleven, helping their plan members. A lot of this work is centered on and about a few pretty striking but very common insights that many plan sponsors will find in their own data. It turns out about 70%, give or take, of people who wind up costing the plan whatever the high-cost threshold is in any given plan year.

These higher-cost claimants didn’t fall out of the sky unexpectedly, 70% of them. They were actually high risk but low cost in prior years. So, the trick is to find these individuals and help them not fall into the high-risk and high-cost part of the graph. If the goal is how to best manage a population of members, a lot of that is, again, identifying high-risk patients who are currently in the low-cost zone, who, any given plan year, are gonna go out of that zone and get into the high-cost area.

So, if we’re thinking about best practices to avoid this, I’m gonna run through Dr. Conard’s list that we mostly run through in the show that follows.

Lastly, we touch a little bit in the show today on community-run primary care. This is a community paying for primary care for community members, just like they pay the fire department and the police department. There’s a town in Rhode Island doing this that Dr. Conard talks about today. In fact, Michael Fine, MD, is part of this effort in Rhode Island.

=== LINKS ===

🔗 Show Notes with all mentioned links and articles: https://cc-lnk.com/EP462

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07:10 How do we think about data wrongly, and how does that affect our healthcare spend in regard to population health?

09:43 What needs to be done with population health data once it’s collected.

14:48 Community in Rhode Island doing effective proactive care.

16:09 EP449 with Marty Makary, MD, MPH.

16:44 A real, successful case study.

24:08 How do we define high-cost patients?

24:14 What do we know about high-cost patients in regard to population health spend?

29:02 Why avoiding prevention in primary care only harms yourself in the future.