Episode #146: Addressing our national healthcare needs at scale – with Dr. Patrick Conway, CEO of Care Solutions at Optum Healthcare

Friends,

I have to tell you that each time I have the opportunity to speak with Dr. Patrick Conway, it’s a treat. He is an erudite and accomplished healthcare executive – having served as the CEO of Blue Cross Blue Shield of North Carolina and previous to that as the deputy administrator for innovation and quality at the Center for Medicare and Medicaid Services, as well as the agency’s Chief Medical Officer. He also brings an incredibly grounded perspective from his many years of clinical practice as a pediatric hospitalist (which he continues to do), and in his previous role overseeing clinical operations and quality improvement at Cincinnati Children’s Hospital. Of note, at one point he also practiced in a federally qualified healthcare center, serving the most undeserved families in our healthcare system.

I’m not at all surprised at the accolades he’s received – being elected to the National Academy of Medicine in 2014 and receiving the President’s Senior Executive Distinguished Service Award. But, what impresses me the most about Dr. Conway is his never ending pursuit to create better healthcare – better healthcare for children, for the elderly, for individuals on Medicaid and dual eligible patients with disabilities and complex chronic conditions, and for those suffering with mental illness. I could have easily titled our conversation, ‘Caring for the underserved in American healthcare’. Patrick is a highly experienced and practical executive who can quote stats, facts, policies and payment models with the best of them; but what he can also do is share with you the real life stories of patients he’s seen and continues to see – stories that reveal the critical need to transform American healthcare. 

In this episode, we’ll hear about:

• The vast portfolio of care solutions that Dr. Conway oversees which includes home and community care, post-acute care, mental and behavioral health, specialty care, complex chronic care, senior care, and federal health services.
  
• A dive into the behavioral health “crisis” and what Optum Healthcare is doing to address it.
  
• A discussion on the challenges of rural health and senior care, with examples of the solutions and partnerships that Optum is assembling, including a recent partnership with Walmart. 
  
• A couple of recommendations Dr. Conway has for hospital system leaders.
  
• Some reflections regarding the impact CMS and CMMI has and are continuing to have on American healthcare.

The scope and scale of what Dr. Conway and his colleagues are building is remarkable, and yet, he will be the first to admit that his organization is not flawless and they are still figuring it out. He’ll also be the first to point out the awesome potential for good and the possibilities at scale they are striving for. What inspires me the most about Patrick are the underlying values he brings to this work.  In this interview he notes that competition is a fact of life; but, we can and should be more collaborative. He is an ardent, long-time champion for the accelerated transition to value-based care. And finally, he talks about the selfless risks that leaders must be willing to take in order to manifest their mission – financial risks, cultural risks and leadership risks.  

I expect that there will be some listeners and readers who will be critical of my lauding Optum. Look, while there are valid criticisms that can be directed at UnitedHealth Group and its insurer arm, UnitedHealthcare, I don’t know many stakeholder groups in American healthcare that are immune from serious critique and in need of significant reformation. Folks, my purpose in this podcast is not to critique, but to discover positive transformative change and to share that with others – to learn from, to emulate and to collaborate with positive deviance, so that we can humanize our healthcare system.  

The reality is that we can’t continue on the path and trajectory we’ve been on for the past few decades. We are at numerous existential crossroads in healthcare, and in the health and welfare of our public. We need to figure out how to reframe, redesign and reorganize our healthcare system so that it delivers what we all want and need for our families, our communities and our country. And that means we’ll have to figure out how to relate to one another differently. 

So, I hope you perceive this dialogue in the way it was intended: as an inspiring message about possibilities. The message I hope you hear is one that transcends what you think of payers or retailers or big tech or any other stakeholder in the healthcare industry. The message I hope you hear is a shared collective mission.  And, my friends, we must rally around that mission, if not for our sake, then for the sake of the generations that follow us. 

Until Next Time, Be Well.

Zeev Neuwirth, MD