The Race to Value Podcast

In the Race to Value, we must recognize that quality of life is the ultimate currency of healthcare, and this aim is all the more important in senior living facilities.  Transforming health outcomes for skilled nursing and senior living populations is not just a goal; it’s a commitment to providing the care and dignity our elders deserve.  This week, we profile a leader in the value movement who leads a company on a mission “to improve the health, happiness, and dignity of senior living residents”. We are joined by Mark Price, CEO of Curana Health – a leader who lives by the mantra that “extreme passion” is the single most important ingredient to reform the American healthcare system. Curana Health is a provider of value-based primary care services exclusively for the senior living industry, including in nursing homes, assisted/independent living facilities, CCRC/life plan communities and affordable senior housing communities. Curana Health serves more than 1,100 senior living community partners across 30 states and participates in the MSSP ACO, ACO Reach and Medicare Advantage programs with CMS. Backed by more than $300M in venture capital funding, the organization is poised to disrupt care delivery in senior living on a meaningful scale through innovative care models and applied analytics. In this episode, you will learn about how to transform health outcomes for skilled nursing and senior living populations through extreme passion.  We cover such topics as how to leverage APMs such as MSSP and ACO REACH in the senior living setting, the performance results of Curana Health across their value-based portfolio, technology innovation, palliative care, the state of the nursing home industry, and future trends in the shift to home-based care delivery. Episode Bookmarks: 01:30 Introduction to Mark Price, CEO of Curana Health. 03:45 An estimated 27M more people are aging into the 75+ cohort through 2050, resulting in rising age and higher health acuity levels of residents moving into senior living. 05:00 Curana Health has achieved a 39% reduction in 30-day hospital readmissions and a 37% reduction in total hospital admissions among Medicare Advantage I-SNP members. 06:00 “There are many subsectors in the industry where value-based care can succeed.  The important thing is ensuring that your people have an extreme amount of passion for making it work.” 07:00 Founding story of Curana Health based on how we would want our loved ones to be cared for at the end of life. 08:45 The majority of Americans will spend some time in senior living or skilled nursing in the final years of their life. 10:00 Elite Patient Care ACO performed in the top 1% of ACOs in its first year of operation, achieving PBPY savings amount of $2,235—the highest PBPY for any first-year MSSP ACO since 2012. 11:30 Curana Health also has one of the top performing ACO REACH and risk-based MA I-SNP programs in the country. 11:45 “Our core business is not a payment model. It is a clinical model that produces health outcomes which, in turn, enables affordability as well.” 13:00 Developing a population health playbook for the senior living space. 14:00 Success in developing a level of clinical integration within a senior living facility that is now owned by the company. 15:00 MA Institutional Special Needs Plans (I-SNPs) are designed to meet the needs of people living in long-term care settings such as long-term care nursing, skilled nursing facilities, and inpatient psychiatric facilities. 16:45 Facilities are taking an ownership position of MA plans for senior living and skilled nursing residents. 17:00 Mark provides perspective on I-SNPs and how the Curana Health clinical model is achieving results to improve clinical outcomes. 18:30 Performing well by recognizing the commonality between MSSP, ACO REACH, and Medicare Advantage. 20:00 How CMS and CMMI is incorporating innovation to value-based payment models (e.g.SNF 3-Day Rule Waiver). 22:00 Building a technology enablement ecosystem within a high-touch, integrated care model for senior living communities. 23:00 Value-based care technology adoption starts with the input from the clinical care teams. 24:00 Seeking technology enablement for both common and specialized challenges. 26:00 Developing technology partnerships with intentionality. Augmenting those partnerships with internally-developed customized analytical and educational solutions. 28:45 A survey by Leavitt Partners and NAACOs shows that only a 10% of ACOs selected palliative care as a top priority for improving efficiency and lowering costs. 30:00 Mark provides perspective on the importance of palliative care and advanced  care planning in their senior-focused care model. 33:00 Many nursing home providers operate on thin margins and have been squeezed tighter as they’ve struggled with occupancy. 34:00 Chapter 11 bankruptcies among nursing homes and senior living operators continue to increase and show no signs of abating going into next year. 35:30 The impact of the pandemic on the senior living industry. 36:30 The workforce challenges faced by nursing homes. 37:00 Financial impact of rising variable interest rates on nursing homes attempting to service their facility debt. 38:00 CMS-imposed staffing mandates on Skilled Nursing Facilities. 38:45 The impact of aging baby boomers on distressed SNFs and senior living facilities. 40:45 Collegiality and information sharing is important to advance value-based care transformation across the country. 41:30 Skilled Nursing and Senior Living communities traditionally ignored value-based care (and how they are now waking up!) 43:30 Success in the future requires us to think differently than we did in the past. 44:30 Up to $265 billion worth of care currently delivered in traditional facilities for Medicare FFS and MA beneficiaries could shift to the home by 2025. 46:45 Post-acute skilled care will increasingly move to the home in the future. 48:00 The significant demand for senior resident models in the future. 49:30 Mark discusses why technology won’t disrupt the senior living space like it will other sectors in care delivery. 52:00 CMS’s goal of having every Medicare beneficiary in an ACO or ACO-like model by 2030. 53:00 Americans aged 65 and older will more than double over the next 40 years —  reaching 80 million in 2040. 53:45 Parting thoughts of optimism on the imperative for value-based care transformation in the country.

Connecting the health and wellbeing of patients of patients directly to the bottom line isn’t just good business; it is a visionary approach that shows how healthier outcomes can actually drive healthier profitability. Continued success in demonstrating the correlation between clinical and financial outcomes will be a catalyst for generating societal wellbeing that paves the way for others to adopt value-based care.  And in doing so, we create a more sustainable and effective healthcare ecosystem. In this Race to Value, the true race isn’t about speed; it is about the journey to improved outcomes. Strategic and transformational partnerships guided by an enabling vision to improve population health will ultimately create a healthcare system that we can be proud of. In this episode, you will hear from Kyle Wailes, the Chief Executive Officer and Board Member of value-based care company, Wellvana.  Kyle Wailes is someone on a mission to demonstrate how fully-capitated models in primary care, empowered by the right partnerships to create enablement, will ultimately drive patient behavior change.  Under his leadership, Wellvana is an industry-leading example of a company that is connecting the healthy outcomes of patients directly to healthier profitability. With the tools, technologies, analytics, and resources for healthcare providers to successfully and seamlessly transition to value-based care, Wellvana is getting outstanding results and growing at an exponential rate for such a young company.  This is highlighted by the recent announcement of their partnership with AdventHealth to revolutionize primary care in the state of Florida.  Don’t miss this important interview to learn more about VBC enablement, high-touch primary care and clinical integration, the power of storytelling, patient behavior change, lifestyle medicine, and the current state of private equity investment in healthcare!   Episode Bookmarks: 01:30 Connecting healthy outcomes of patients to healthier profitability.  (A High-Touch Approach for High Performers) 02:00 Introduction to Kyle Wailes, Chief Executive Officer and Board Member at Wellvana. 04:00 Big Announcement — AdventHealth partners with Wellvana to transition its Florida primary care network to VBC 05:00 Wellvana is the first value-based care enablement organization in the country to partner with a multi-state/national health system. 06:00 Kyle provides more details on how Wellvana’s recently announced partnership will impact the delivery of healthcare in Florida. 06:30 “Building clinically integrated primary care networks across the country requires flexibility.” 07:00 Expanding primary care impact through interdisciplinary roles (e.g. case management, care coordination, pharmacy integration, social work, coding) 07:45 Health systems across the country are extremely distressed with expenses growing 2X as fast as Medicare payments. 09:30 “The pandemic has been an accelerant overall to drive the adoption of value-based care.” 09:45 The opportunity to reposition primary care in the health system setting, taking it from loss leader to profit center, as a strategic cornerstone for transformation. 10:00 A health system focused only on fee-for-service can lose up to $200-300K per employed PCP. 10:30 “Clinically integrated primary care networks can drive better clinical outcomes, but they can also drive profit and growth as well.” 11:00 Flexibility in growing a PCP network through either an employed or affiliated model. 11:30 Kyle’s personal journey as a professional athlete, student of neuroscience, and value-based healthcare executive. 12:30 “The Story of the Chinese Farmer” – a parable that illustrates the idea that events that initially seem bad or good can lead to unexpected outcomes. 14:00 Kyle provides perspective on the highs and lows of life and how that translates to theculture at Wellvana. 15:00 Lessons learned from playing competitive sports (discipline, hard work, and preparation in winning…while also overcoming losses). 16:00 Wellvana has raised $140 million in capital since 2021 and is now in 22 states, reaching more than 100K lives through multiple payers, Medicare Advantage and ACO REACH. 17:30 Building large high-touch primary care networks at scale requires behavior change. 18:15 Aligning a high-quality specialty network with tech-enabled primary care to achieve appropriate procedural utilization and lower costs. 19:00 Merging High-Touch with High-Tech (“Technology as a standalone solution doesn’t work well in healthcare today. You have to wrap services around it to drive behavior change.”) 19:45 Building Capabilities to Improve Care for High-Risk Patients (“The ability to transition into fully-capitated risk is impossible for a doctor to do on their own.”) 20:30 The connection between improved patient outcomes and higher profitability — a patient success story showing how high-touch care management reduced avoidable ED utilization. 22:00 The power of effective storytelling in value-based care transformation. 24:00 Kyle discusses how Wellvana utilizes storytelling to revitalize care teams and provider partners in creating positive change. 26:00 The Challenging Politics of Value-Based Care (differing ideologies, debates about government involvement, conflicting interests and lobbyists, uncertainty about implementation, economic concerns, partisan politics). 27:30 Kyle shares insights from his involvement in advocating for value-based care on Capitol Hill. 28:30 The evidence that fully-capitated models work despite low market penetration in Medicare (e.g. MA <10% full-risk, ACO REACH). 29:00 How Wellvana educates legislators on the importance of frontloading savings payouts and provider aggregation in networks to drive success in fully-capitated risk. 30:00 Advocacy in patient communities is just as important as political advocacy. 31:00 How Wellvana engages and educates patients on the purpose of value-based care and care planning. 32:00 “To win long-term in this industry, you’re going to have manage medical spend more effectively. We do this by engaging patients in way that can drive behavior change.” 33:30 Wellvana co-founder, Charlie Martin:  “Building a Sustainable Economic Model for Lifestyle Medicine” 34:45 Kyle discusses the importance of Lifestyle Medicine in creating a holistic, patient-centered wellness model. 35:45 Wellvana is conducting a clinical trial study on LM with the goal of applying broader findings that drive behavior change at scale. 37:30 Are investors placing more bets on value-based care enablement? 38:30     The runway for value-based care companies in the current investment landscape and why PCPs relationships are so critical to success. 39:30 Digital health and AI solutions will support primary care value transformation. 40:00 Nashville as the epicenter of healthcare investment. 41:00 ACO REACH as an inflection point for adoption of fully-capitated risk in the primary care setting? 42:00 How fully-capitated models will strengthen the connection between improved SDOH interventions and Health Equity outcomes. 43:45 Kyle discusses the future of Wellvana in terms of continued growth and sustained high performance. 46:00 “Success in value-based care is not about the speed; it is about overall outcomes and finding the right partners to take risk.”

Dr. Dexter Shurney discusses the bridge between Lifestyle Medicine and Social Determinants of Health, using Blue Zones as a blueprint for wellness. Topics include addressing chronic diseases and social disparities, the connection between stress and inflammation, disparities in disease among minority communities, innovative approaches to chronic condition management in the workplace, and shifting towards lifestyle medicine and creating supportive environments.

Data interchange and interoperability are the keystones of a united ecosystem for value-based care, where information flows seamlessly, connecting patients, providers, and payers to drive better outcomes, lower costs, and improved patient experience. Overcoming siloed information is the key to breaking down the barriers that fragment care delivery, and in doing so, we unlock the potential for a healthier future for all. While health data interoperability has arguably become an industry buzzword over the past decade, the concept’s importance for digital health transformation cannot be understated. The benefits of optimal interoperability in healthcare includes improved care coordination for patients and reduced administrative burden for healthcare payers and providers. Interoperability also supports public health surveillance and population health initiatives that are so critical to value-based care transformation. In this podcast episode, you will hear from two executives on a mission to unlock greater value in American healthcare by aggregating, normalizing, and unifying data.  Venkat Kavarthapu and Dr. Summerpal Kahlon are the Chief Executive Officer and Chief Medical Officer for Edifecs, a Best in KLAS interoperability platform that serves as the foundation for the solutions that eliminate stakeholder friction to overcome healthcare’s biggest challenges. We discuss how interoperability will accelerate value-based payment adoption and help providers obtain more complete and accurate care funding for alternative payment models. We cover such topics as the future of AI, the potential for automated prior authorization, how ACO REACH will drive population health management, and the collaboration that is enabled by technology. Episode Bookmarks: 01:30 Introduction to Venkat Kavarthapu and Dr. Summerpal Kahlon and their company Edifecs that provides a leading interoperability platform. 04:00 Industry struggles to implement interoperability requirements of the CMS Interoperability and Patient Access Final Rule. 04:30 The benefits of interoperability and how it serves as a foundation for value-based care. 05:30 Venkat discusses how value-based care is the only path forward in creating a sustainable healthcare system. 06:30 The need for data to improve patient experience and quality of care. 07:00  “True value-based care can only be accelerated if information is available to all entities in all three dimensions – clinical, administrative, and financial.” 08:00 Exchanging information across organizations and between systems without friction, while ensuring privacy and security. 09:00 How data siloes create healthcare dysfunction. 10:00 Extreme data siloing increases data management costs (25-30% of total cost spent to ensure data accuracy). 10:30 Payer-provider collaboration supports value-based care but is still limited by interoperability adoption. 12:00  “Driving interoperability is not a burden on the industry, but a true competitive advantage for the industry.” 12:30 How interoperability reduces administrative burden and the cost of human capital. 13:45 “An interoperability framework can drive a meaningful dialogue, and communication is key to driving good patient outcomes.” 14:30 Summer describes how an overly-fragmented healthcare system that still relies on fax machines contributes to data inaccuracy. 16:00 Emphasizing data accuracy within an interoperability framework ensures patient safety. 16:30 How Natural Language Processing and AI can provide context and improve communication at the point-of-care. 19:00 CMS Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule 20:00 The need for fully automated Prior Authorization (PA) enabled by EDI processing, FHIR-based APIs, AI/ML, and NLP. 21:45 Electronic PA will foster payer-provider collaboration and drive clinical decision support. 23:30 PA transactions are only automated 30% of the time at present (compared to 90% or more for claims eligibility, enrollment payment, etc.) 24:30 The value of PA automation in alleviating physician workflow burden. 26:00 Implementing an electronic Prior Authorization system will enhance clinical decision support (without adversely impacting UM metrics). 27:45 Correcting physician perspectives on value-based technology adoption following bad prior experiences in EHR adoption. 29:00 Venkat discusses the challenges facing providers as they look to adopt technology to drive value-based care performance. 31:00 Physicians can only succeed in value-based care when empowered by information at the point-of-care. 33:00 “Providers need systems and technology to participate in the value-based care revolution.” 34:45 Summer provides a physician perspective about the friction posed by documentation in EHRs. 36:00 Structured data vs. Unstructured data 36:45 The potential for Natural Language Processing in extracting information from EHR notes to tell a story. 37:30 “As we transition to value and look to enhance communication through technology, NLP is going to be front and center.” 38:00 ACO REACH as inflection point for the value movement. 40:00 The transfer of financial risk to ACOs and Risk-Bearing Entities. 42:00 The need for real-time data exchange from payers to providers. 43:00 Making it easier for technology to integrate into the value-based care ecosystem. 45:00 Applying lessons learned in the development of new alternative payment models. 46:00 The evolution towards full risk prospective payment/capitation and disease-specific models. 47:30 Developing a Population Health Management platform that accommodates both existing and new payment models. 49:30 The explosion of ChatGPT and the potential for Generative AI to drive healthcare transformation. 51:00 Venkat shares his optimistic perspective on the future of AI in transforming care delivery. 53:00 “By leveraging interoperability, AI and workflow optimization, the industry has a potential to lower costs and save Medicare from insolvency.” 54:45 AI works best when it runs behind the scenes and is invisible to the end user. 56:00 AI has a role to play in eliminating the noise from extremely large, disparate datasets. 58:00 Summer discusses a successful use case for effective AI and NLP in the risk adjustment environment. 60:30 Leveraging AI to mitigate inconsistencies with human-based coding (upwards of 15% observed variance between two coders). 65:00 4 characteristics of Industry transformation: 1) Existential Threat to current model, 2) Regulatory Environment favorable to transformation, 3) Technology advancement, 4) Consumerism 66:00 Why you should be optimistic about the future of value-based care!

Innovation and partnership are the twin engines that propel us into a new era of healthcare. The fusion of cutting-edge technology and clinical innovation, empowered by collaborative relationships, can revolutionize primary care.  This cohesion of innovation and partnership makes primary care more accessible, effective, and patient-centered than ever before. There is no better example of primary care modernization than Central Ohio Primary Care (COPC), the largest physician-owned primary care group in the United States with over 480 physicians and 83 locations in central Ohio. Rooted in a long history of clinical excellence and a commitment to the highest ethical standards, COPC is building a new holistic model for primary care that gives physicians time to build relationships with their patients and one another. Through ACO REACH, full-risk delegated capitated Medicare Advantage Plans, and direct-to-employer value-based arrangements, they are able to engage their entire team in the innovation of their primary care model.  Furthermore, through partnerships they are able to share risk and build a pathway to sustainability in the provision of value-based care for decades to come. Joining us on the Race to Value this week is Donald Deep, M.D., the CEO of Central Ohio Primary Care.  In this episode, we discuss the modernization of primary care that is underway at COPC – including technology-enabled care efficiency, 24/7 access, care management, and post-discharge follow-up. We explore the successes of their Extensive Care Center and Comprehensive Home and Palliative Care programs.  There is also in-depth discussion on low value care, the importance of payer partnerships, direct-to-employer strategies for commercial populations, accessing capital partnerships in full-risk MA, and collaborative leadership for success in VBC. This episode is sponsored by Agilon Health, a company that partners with independent primary care practices that are leaders in their markets and helps them transition to value-based care success in the Medicare program. https://vimeo.com/870324462?share=copy Episode bookmarks: 01:30 Introduction to Donald Deep, M.D., the CEO of Central Ohio Primary Care (the largest physician-owned primary care group in the U.S.) 02:45 Referencing prior episode featuring Dr. Bill Wulf (“The Value Game”: Achieving Success with Capitated Risk and Patient-Centered Primary Care) 03:00 This week’s episode is brought to you by Agilon Health 04:30 COPC has directing 2,200 employees across 90 locations covering six counties and has been on a value journey since 2010. 05:30 The modernization of primary care at COPC. 06:30 Patient care coordination that includes technology-enabled care efficiency, 24/7 access, care management, and post-discharge follow-up. 07:30 “We are responsible for the care of our patient population, even outside of the exam room.” 07:45 Empowering PCPs to spend more time with patients and engage patients and families in the care process. 08:00 Addressing prevention and SDOH requires a modernized primary care model. 08:45 Extensive Care Center (ECC): A Novel Approach to Reducing Emergency Department Visits and Observation Unit Utilization 10:00 The Extensive Care Center at COPC returns 95% of patients to the home (ER Avoidance) and prevents 2-3 hospital admissions each week. 11:00 Scaling the ECC model in co-location with Same Day Centers at COPC to provide immediate access for emergent primary care needs. 12:00 Addressing chronic disease in the extensive care center avoids unnecessary ER visits and hospitalizations. 13:30 Payer recognition of the ECC model, with high levels of patient satisfaction. 14:45 The Comprehensive Home and Palliative Care (CHPC) program at COPC provides primary and palliative care in the home setting. 15:30 Palliative care in ACOs have demonstrated reductions in 30-day readmissions, avoidable hospital admissions, and ED visits. 15:45 Advanced illness programs can consistently provide high patient and family satisfaction, reduce hospitalization by nearly 50%, and decrease costs in the last year of life by 20% to 25%. 16:30 The difference between palliative care and hospice. 17:30 Dr. Deep reflects on his experience as a hospitalist that repeatedly saw patients readmitted to the hospital due to poor symptom management. 18:00 “Palliative care is invaluable in primary care, and we must take it into the patient’s home.  Poor symptom management leads to unnecessary ER visits and inpatient stays.” 20:00 The composition of the interdisciplinary team that provides comprehensive home and palliative care services. 21:30 Spending on low-value care range from $100 billion to $700 billion each year. 23:30 Identifying waste in the provision of primary care and defining clinical pathways that define value. 24:30 Patient advocacy for services provided outside of the practice in the promotion of high value care. 25:00 Demanding risk-adjusted outcomes for specialists seeing COPC patients. Providing RFPs to specialists to ensure accountability to expectations for high value care. 25:30 How PCP-led global capitation and compensation redesign incentivizes high value care. 27:00 Referencing a recent Morgan Health study that shows extreme variations in clinical quality for employer-sponsored health plans (e.g. statin medication adherence for CAD). 27:45 COPC’s partnership with JP Morgan Chase to provide onsite health clinics, health coaching, behavioral health services, and after-hours access to care. 28:30 Dr. Deep explains COPC’s advanced primary care model that is provided on a direct-to-employer basis. 29:30 Direct-to-employer care that is convenient, longitudinal, preventative, and consistent. 30:00 How partnering with Vera Whole Health expanded behavioral health services at COPC. 30:30 Providing an advanced primary care access point to large employers as a critical success strategy for VBC. 33:00 Dr. Deep discusses how the ECC model has allowed them to forge more collaborative partnerships with payers. 34:00 “Shifting of financial risk to prepayment (instead of Shared Savings) allows us to engage our entire team in the innovation of our care model.” 35:00 Assessing data to identify high-risk patients.  Developing win-win payer-provider partnerships. 36:30 The history of COPC’s partnership with Agilon Health. 37:30 The COPC-Agilon partnership with COPE Health Solutions that led to the development of a primary care Advanced Practice Provider (APP) Fellowship Program. 39:00 The exciting potential of a new value-based care fellowship for APPs. 40:00 “The old way of delivering care where a physician does everything is not sustainable. Team-based care will ensure that we are sustainable decades into the future.” 41:30 How the partnership with Agilon Health enabled value-based care transformation at COPC. 42:30 Finding a VBC enablement partner that truly believes in partnership (beyond just the provision of capital). 43:30 Parting thoughts from Dr. Deep on the importance of collaboration in value transformation. 45:00 “Leaders in healthcare must ensure that both their organization and the community they serve is strong. Doing that through trusted partnerships will make a lasting impact.”

Edwin Estevez, an expert in healthcare challenges and equity-based co-opetition, discusses the potential for health equity transformation in the Rio Grande Valley. They explore the challenges of accessing healthcare, the shortage of doctors and nurses, and the impact of COVID-19 on labor dynamics.

The plasticity of primary care, in the new value-based era, embodies remarkable adaptability, innovation, and responsiveness to evolving community health needs. As our understanding of health and well-being expands, primary care stands as the first line of defense, ready to transform and customize its services to address the unique challenges faced by diverse populations. This flexibility allows primary care providers to pivot swiftly, whether it’s in responding to public health crises, addressing disparities in healthcare access, or integrating innovative technologies into daily practice. In embracing this plasticity, primary care not only becomes a cornerstone of community health but also a powerful catalyst for positive change, driving us closer to the goal of a healthier, more equitable society. In this week’s episode of the Race to Value, we are joined by R. Shawn Martin, Executive Vice President and Chief Executive Officer for the American Academy of Family Physicians. The AAFP is the medical specialty organization representing 129,600 family physicians and medical students nationwide. Shawn Martin works with the AAFP Board of Directors on the mission, strategy and vision for the AAFP and provides representation to other organizations, including medical, public, and private sectors. He is nationally recognized for his thoughtful leadership on a range of healthcare and workforce issues. While his career portfolio has focused on numerous health care and public-policy issues, he is best known for his extensive work on the development and implementation of primary care delivery and payment models. In this episode, we discuss such things as payment reforms in primary care, the industry impact of primary care consolidation, physician-led ACOs, the new Making Care Primary (MCP) payment model and the need for multipayer collaboration, health equity, rural healthcare transformation, physician workforce challenges, and the future implications of AI on the medical profession. With leadership from Shawn and his constituents throughout the primary care ecosystem, we are well-positioned for transformation in the race to value! Episode bookmarks: 01:30 The plasticity of primary care and how it can evolve to meet community health needs in the new value era. 02:30 Introduction to R. Shawn Martin, the Executive Vice President and Chief Executive Officer for the American Academy of Family Physicians. 04:45 People who have access to advanced primary care tend to have better health, receive timelier diagnoses, and get more prompt treatment when it is needed. 05:30 The U.S. spends only 5-7% of its healthcare dollars on primary care — less than half of the 14% average in Western European countries. 06:00 AAFP Advocacy Priorities:  Fighting for Family Medicine! 07:00 Shawn discusses the need for additional investment in primary care at a national level. 08:30 The misalignment of fee-for-service in the primary care setting. 09:00 “Appropriate investment in primary care, coupled with a prospective payment model, will transform both patient experience and care team performance.”   09:45 PCP Infrastructure Investments + Rapid Transition to Value-Based Care = Primary Care Transformation 10:45 Vertical integration of primary care can lead to higher prices and costs, including insurance premiums, without improving care quality or patient outcomes. 11:30 Site-of-service payment differentials create uneven playing field between independent practices and hospital-owned primary care. 12:00 Shawn’s congressional testimony to the Senate Finance Committee on the “Consolidation and Corporate Ownership in Health Care” 13:00 The Medicare program created siloed benefits between hospitals and physicians, and these design flaws created incongruencies in system economics and patient health outcomes. 14:30 The inability of independent physician practices to survive on the regulatory framework of the modern healthcare system. 15:30 Community-based primary care innovation empowered by partnerships. 16:30  The explosion of IPAs and clinically integrated networks and how these models are applied to population health management. 17:00 Data sharing and interoperability empowering chronic care management and transitional care pathways. 17:30 The trend of provider consolidation within “payvider” platforms offered by major payers (e.g. Optum, Centerwell). 17:45 Wall Street interest in primary care that led to additional capital infusion in the absence of public payer support. 18:30 “Private equity investment has created a necessary lifeline of capital for primary care to survive the onramp of value-based care.” 19:00 “It is difficult to focus on primary care transformation when you are seeing 30-35 patients a day, 6 days a week, for 48-49 weeks out of the year.” 19:30 How investments in primary care created the physician mindshare needed to transform their practices. 20:45 On average, physician-led ACOs produce almost 7 times the amount of Medicare savings per beneficiary than hospital-led ACOs. 22:45 Shawn discusses how the autonomy of physician-led ACOs leads to them having better Shared Savings results than their hospital counterparts. 23:00 “The empowerment of PCPs with the autonomy to be patient-centered at the point-of-care has shown what is possible with value-based care.” 24:00 “The challenging occupancy-dependent model of hospitals is not insurmountable if you create collaborative, community-based physician networks.” 24:45 Overcoming the toxicity of fee-for-service in primary care. 25:00 “Primary care is built upon the foundation of a trusting, longitudinal relationship between a patient, their caregivers, and the primary care team.” 25:45 Leveraging virtual care and telemedicine to enhance relationships in the primary care setting. 26:00 “The combination of primary care autonomy with risk-based payment models will help us overcome the toxicity of fee-for-service.” 26:30 The new state-based multi-payer model from CMMI, “Making Care Primary” (MCP), supporting primary care practices in the transition to prospective value-based payment. 27:00 Recent AAFP Press Release: “Primary Care-focused APM Checks AAFP Advocacy Boxes” 27:30 Shawn discusses how the multipayer MCP model construct (Medicare/Medicaid) will serve to eventually bring value to primary care at scale. 29:30 The rationale behind making MCP a 10-year transformation project (instead of a 3-4 year evaluation cycle). 30:00 The imperative for CMMI to transition providers to more sophisticated payment models with downside risk over time. 31:00 Referencing Shawn’s recent article: “How Moneyball can teach us to invest in primary care” 32:00 A recent AAFP member survey that indicated while 85% of surveyed physicians believe social needs are directly related to poor health, 80% are not confident in their ability to address their patients’ social needs.   33:00 Inspiration from Michael Lewis regarding the applicability of Moneyball in healthcare transformation. 34:00 “The single best investment to improve health equity in our system is primary care. It is a main street discipline of care in our communities that is not confined to a building.” 34:30 The plasticity of primary care to meet community health needs and why equity must start with empowered, community-based PCPs. 35:00 The AAFP formed the Center for Diversity and Health Equity to address social determinants of health with The EveryONE Project. 35:30 “You cannot even begin to change the trajectory of health inequities in our health system without primary care.” 36:00 Meeting the workforce goals having access to primary care in every community. 37:00 Mortality rates are 23% higher for people living in rural communities than those who live in urban communities. 38:00 “The movement to prospective, capitated payment models is nowhere more important than in rural communities.” 38:45 How trusting relationships and localized interventions drive patient engagement in rural communities. 39:00 Shawn shares the lessons learned from his father who was a primary care physician in a rural area. 40:00 The relationship between the physician workforce and critical access hospitals and the opportunity to reinvent the rural healthcare ecosystem. 41:30 Physicians have higher levels of satisfaction when practicing in a value-based environment. 42:30 U.S. health is threatened by a primary care workforce shortage, and the country will need up to 48,000 more primary care physicians by 2034. 43:00 Shawn shares his perspective on the physician workforce and the how the AAFP is working to ensure that we have an adequate physician workforce in the decades to come. 45:00 The “infatuation of specialization” that favors procedural intensity. 46:30 The multi-faceted roles of primary care are not fully understood in medical schools. 47:30 How specialty economics contribute to the shortage of primary care. 49:00 The transformative potential of AI in family medicine. 49:45 AAFP recently adopted a policy on the “Ethical Application of Artificial Intelligence in Family Medicine.” 50:30 The need for transparency in the development and implementation of AI in healthcare. 51:30 How AI can be used to reduce administrative burden in primary care practices (e.g. documentation, prior authorizations, utilization management, chart reviews) 52:00 Using AI to decompress the knowledge management of specialization in medicine in order to support more comprehensive primary care. 53:00 The future of AI-enabled, comprehensive primary care. 53:00 Empowering patients with AI through lifestyle-based knowledge transfer and improvement of health literacy. 55:45 Parting thoughts of optimism on the future of primary care and how the value movement will drive us to improved population health. 58:00 The presence of primary care increases life expectancy. 59:00 Stay connected with Shawn on social media and find out more about the work of the AAFP.

Democratizing access to value in healthcare through primary care enablement is the compass guiding us toward a future where health is a universal right, not a privilege, and where the promise of value-based care is accessible to all. It represents a fundamental shift in our approach to healthcare delivery. By prioritizing primary care and leveraging technology, we can extend the reach of healthcare services, making them more affordable and accessible to diverse populations. This approach emphasizes preventive care, early intervention, and patient education, reducing the burden on emergency rooms and hospital admissions. Ultimately, primary care enablement has the potential to transform the healthcare landscape, promoting healthier communities and improving the overall well-being of individuals while also making healthcare a more equitable and sustainable system for everyone. Joining us this week on the Race to Value is Michael Kopko, the CEO of Pearl Health – a company that is on a mission to democratize access to value in healthcare. More than 800 primary care providers across the country partnered with Pearl to align payments with patient health and leverage emerging data and technology to achieve better outcomes more efficiently. And earlier this year, they closed on a $75M Series B funding round to bring even more capability to the health value economy, by empowering providers to transition to a more proactive care model, enabling them with a technology solution that surfaces urgent cases before they become emergent, and rewarding them for outcomes aligned with value. This is a company that you need to know about, and it is my pleasure to have Mike on the podcast this week to discuss the challenges facing our industry and how Pearl Health is accelerating the development of innovative solutions that place providers at the center of healthcare delivery and cost management. Episode Bookmarks: 01:30 Introduction to Michael Kopko and Pearl Health — a company that is on a mission to democratize access to value in healthcare. 03:30 After more than a decade of value-based care efforts, the U.S. still pays about twice as much for healthcare than any other country, despite underperforming in quality and outcomes. 04:00 How do we reach a critical mass with ACOs and other APMs to save the Medicare Trust Fund from insolvency by catalyzing care delivery transformation? 05:45 There is reason for optimism for healthcare in the long-term, e.g. R&D in the health sector, the steady march to value since Michael Porter coined the term in 2006. 07:00 The increasing adoption of Medicare APMs and value-based Medicare Advantage (see HCP-LAN APM Measurement Effort). 07:30 “The underlying infrastructure and operating system for healthcare is positioned well for value.” 07:45 More work needs to be done, e.g. Medicare negotiations with pharma companies to lower drug costs, further realignment of incentives. 08:00 Medicare cost growth has abated.  (See recent NYT article: “A Huge Threat to the U.S. Budget Has Receded. And No One is Sure Why.”) 08:30 The need to balance ACO Shared Savings performance over time with the democratization of data to improve population health outcomes. 09:00 “We are starting to get the highways and freeways established for data interoperability to be very proactive in creating health value.” 09:30 “Our healthcare system has so much money that with the right capability sets and incentives, we will solve any problem as long as we have the will to do so.” 10:00 Pearl has seen 10X year-over-year growth, expanding from 10 to 29 states, since its founding in November 2020. 11:00 Technology enablement requires the harmonization of the platform with the wisdom of experienced healthcare professionals. 12:30 Michael shares key learnings in his healthcare leadership journey and how that led to the founding of Pearl Health. 14:45 The realization that the missing piece of value transformation was the enablement of PCPs to visualize and understand how to better care for patients. 15:00 “VBC is no longer a gamble when the right physicians are plugged into the right enablement partners.” 15:45 The renaissance of primary care due to value-based care and business intelligence (and how that is addressing historically high levels of PCP burnout). 16:30 Predictive analytics in primary care (e.g. future diagnosis codes, ER admissions, missed medication moments). 17:30 Aggregation of data to power an Urgency Score, which prioritizes patients in need of outreach and creates holistic, longitudinal visibility. 18:30 The overburden of primary care (e.g. it would take 21.7 hours/day for a PCP to accomplish everything that he or she is expected to do to for patient care and maintaining a business.) 20:00 The assembly line of FFS compared to the “New World of Value” and how innovation can reduce administrivia and create cost effectiveness. 22:00 Using automation to streamline patient outreach efforts. 22:30 The delayed absorption of technology into healthcare as compared to other business sectors. 23:00 “The future of automation and AI in healthcare is just beginning, and that is a reason for optimism.” 23:30 Does the MIPS program really add to population health? (JAMA article: Time and Financial Costs for Physician Practices to Participate in the Medicare Merit-based Incentive Payment System) 23:45 How ACO REACH reduces the administrative burden of MIPS. (Reach for Simplicity: How ACO REACH Makes Quality Measurement Easy) 24:30 Since FFS favors procedural intensity over cognitive care, population health suffers. And the mental health of primary care physicians suffers too. 27:00 The crucible moment for PCPs to become elite practitioners in our healthcare system! 27:30 Getting “above the visit” by combining tools and technology to succeed in VBC. 28:00 A renewal of entrepreneurship and a willingness to change your business model. 28:30 An elite segment of the PCP landscape (5-10%) with business performance that surpasses FFS, along with impacts made in community health. 29:00 Solow Growth Model – the application of technology, labor, and capital to support long-run economic growth. 29:30 The enablement sector in value-based care is not feeling the pain of capital constraints. 30:00 “People are adopting and considering value-based models more rapidly than I’ve ever seen in a decade of working with and building networks in healthcare.” 31:00 The average PCP generally earns relatively little but influences ~$10M in downstream healthcare costs. 31:30 PCPs taking fully capitated risk must get specialists contracted into VBC arrangements and that requires overcoming friction due to oligopolistic market dynamics. 33:00 Recent Atul Gawande article in The New Yorker about the Costa Rica healthcare system (improved population health and longer life expectancy through primary care enablement). 33:30 The regression equation for healthcare – advanced primary care with optimal specialty management would address 60-80% of medical costs! 34:00 The changing business model for specialists due to advancements in VBC. 35:00 The tipping of the fulcrum – alignment of primary and specialty care is progressing due to data interoperability. 36:00 Democratization of access to value due to changes in enablement and economics. 37:00 Will advanced hospital systems have a role to play in the future of value? 38:00 Innovators and disrupters will be at the leading edge in VBC  because they will be more nimble, agile, and unconflicted. 39:30 15% of the insurance premium dollar goes to administration and profit.  (The shift of risk to providers will lower that admin cost to 4-5% or less!) 40:00 Upstarts can create real economic value.  (Just look at how AWS disrupted intensive server requirements for businesses.) 40:30 VBC enablement can be as revolutionary as cloud-based computing! 41:00 Michael’s advice to entrepreneurs: “Focus on creating value in a thesis of change.” 41:30 Other opportunities for disruption, e.g. Drug delivery and development, AI and automation, data interoperability. 42:00 Creating an escape velocity through TAM (Total Addressable Market) and Team. 43:00 ACO REACH is a gamechanger for value because it presents an opportunity for PCPs to increase and stabilize revenue with prospective payment. 44:30 Keys to success in models like ACO REACH: reducing the cost of access and improving intelligence capabilities. 45:30 “ACO REACH is a cheaper, faster path to an alignment shift.” 46:30 “Healthcare doesn’t have a data problem. The real test now is what data matters and when does it matter. How do you synthesize and distill information at the POC in a salient way that is actionable.” 47:00 Developing an urgency score,  promoting the patients that are most at-risk, and surfacing interventions through a suggestion engine. 48:45 The trend towards PCPs selling their practices to larger enterprises like hospitals and PE-backed physician aggregators. 49:30 The benefit of working within a larger primary care practice (more capabilities, risk protection, negotiation leverage). 50:00 Autonomy and independence of PCPs and how that can happen in a corporatized model. 51:00 Clinical integration – “Hospitals are a key ingredient in VBC when properly applied.” 52:00 Finding a business model that is aligned morally and ethically to what one wants to contribute to the world. 53:00 “The new practice of the future will be less capital intensive with these new value-based models becoming more proliferated.” 53:30 “Culture is what everyone says it is at that moment in time. It’s an evolving organism.”  (A Values-Based Culture: Principles at Pearl) 54:00 Creating a company with a strong value compass. 55:00 Transparency and Interoperability. 56:00 Recognition that you get what you pay for. (FFS rewards chronic disease.  We need to realign incentives to reward health.) 57:00 Technology, Automation, and Artificial Intelligence. 58:30 The value of health equity in value-based care transformation. 59:00 How ACO REACH finally put an emphasis on the importance of equity in the value movement. 59:30 “Start where the patient is, not where the business model begins.” 60:30 Multidisciplinary care to enhance the health of communities and how capital markets are the great unlock. 61:30 “The model of providing agency to the stakeholders generating high costs is a backwards model.  We need a more proactive, sentient system.” 63:00 Parting thoughts on transforming a complex system.

In the ever-evolving landscape of healthcare technology, humility is the compass that guides successful change management. It reminds us that the journey towards seamless adoption of health information technology is a collaborative one, where the wisdom of many outweighs the knowledge of one.  The humility to acknowledge one’s limitations fosters an environment where collaboration and learning thrive. In the context of clinical informatics, allyship and teamwork are indispensable. Effective clinical informatics demands a diverse skill set, often spanning healthcare providers, IT specialists, and administrative personnel. Allyship within this multidisciplinary team is essential, and applied clinical informatics can be the linchpin in the transition to value-based care.  Through successful HIT implementation, leaders can illuminate the path to better outcomes, reduced costs, and patient-centered excellence. A new era for Clinical Informatics is upon us and will empower healthcare with data-driven insights, AI capabilities, virtual care at scale, and precision medicine to ensure that quality triumphs over quantity in our pursuit of healthier communities. On the Race to Value this week, we are joined by Brittany Partridge, a national thought leader on health data management and informatics.  Brittany is passionate about implementing technology that impacts clinical workflow in a positive way and increases patients’ access to care. Join us for an informative discussion on Clinical Informatics, the importance of allyship to mitigate medical technology risk, the impact of Generative AI and virtual care on health system transformation, and change management best practices to lead your organization to successful healthcare innovation. Episode Bookmarks: 01:30 Introduction to Brittany Partridge, an industry leader in Virtual Care Technical Architecture and Informatics Implementations. 03:00 Recent book collaboration with Ed Marx – “Voices of Innovation:  Fulfilling the Promise of Information Technology in Healthcare” 04:30 The sub-disciplines of Health Informatics (e.g. Nursing, Pharmacy, Public Health, Biomedical, Medical, and Clinical Informatics). 06:00 AMIA: Why Informatics? –  “Informatics is the overarching field of study that pulls all these subdomains into one discipline focused on improving health and healthcare.” 06:30 Applied Clinical Informatics – the frontline of healthcare innovation with direct clinician interaction. 07:00 Early experiences in e-prescribing implementations that led to other care delivery innovations such as virtual care and remote patient monitoring. 08:00 The intersection of Clinical Informatics and VBC (ensuring tech usability to optimize care workflows for clinical quality improvement). 09:00 Best Practice Advisories (BPAs) – pop-up alerts to empower clinicians to make the best informed decisions at the point-of-care. 09:45 Leveraging technology innovations to improve patient access and affordability. 11:30 The importance of shadowing and workflow analysis as a catalyst for innovation. 13:00 How shadowing is incorporated into user validation, user design, and Lean (“Go to the Gemba”) 14:00 Simply asking clinicians to describe a workflow is insufficient in understanding the entire process. 15:00 “Get a robust current state workflow before you implement any innovation project because you need to know what you’re going to be replacing.” 15:45 How virtual interactions with providers can complement provider shadowing in an embedded CI model. 16:30 Non-judgement in applied clinical informatics is required to build trust. 17:30 “The most important part of rolling out any technology project is clinician trust. They need to know that you have their best interests at heart.” 19:45 Allyship is key to reducing medical technology risk because the inclusion of diverse perspectives yields the greatest rewards. 21:30 “Fail fast and iterate” and “Perfect being the enemy of good” philosophies don’t work in healthcare technology adoption because human lives are impacted. 22:30 Leaders should not surround themselves with “Yes People” – you need allies with a different focus or strength to help you fully understand the risks. 23:30 Finding allies with certain traits and behaviors such as listening, empathy, communication and transparency. 24:30 Medical technology risk increases when trust is lacking and people try to hide things. 25:30 The future impact of Generative AI in the field of clinical informatics. (With the explosion of ChatGPT, how can Generative AI provide transformative opportunities in healthcare?) 27:45 The difference between Generative and Predictive AI. 28:30 The need for clinician trust with Generative AI models in healthcare. 29:00 How Clinical Informaticists can create transparency with Generative AI models to support adoption at the point-of-care. 30:00 “The biggest opportunity for Generative AI in medicine is the reduction of physician administrative burden so they have more time to meaningfully interact with their patients.” 31:00 How UC San Diego Health is piloting Generative AI to support more efficient Provider Inbox messaging to patients. 32:00 The application of Generative AI in ambient listening during the provider-patient encounter and how that will improve information capture and care experience. 33:00 Additional uses of AI in the clinical setting (e.g. medical imaging analysis, diagnostic decision support, diagnostic accuracy). 34:00 The development of a framework and standards to enable trust with AI models. 35:00 The success story of how UC San Diego Health rapidly scaled their telehealth program during the height of the pandemic (i.e. 1,200 visits a day — a 1000% increase). 37:00 Teamwork during a time of crisis. 39:00 Agile governance to ensure rapid decision-making. 40:00 Training and tip sheets to enhance communication during technology adoption. 41:30 Current telehealth utilization at UC San Diego Health post-pandemic. 44:00 Humility as a foundation for communication and collaboration in medicine. 45:00 Why the foundational premise of humility is antithetical to how medicine has been structured in our country (e.g. Flexner Report). 47:30 The challenges of ego in attaching self-worth to what you produce, what you know, and how you earn. 48:45 “Humility and vulnerability in health tech requires you to look at what you’re creating to see if it this making a positive impact in the lives of an end user.” 49:30 “Radical curiosity” as a key to humility in healthcare innovation. 51:00 Knowing what you don’t know.  Seeking first to understand prior to being understood. (how this drive success health tech adoption) 52:45 “Having an open mind and getting radically curious will make health technology have a better impact.” 53:30 Lessons learned from the “Meaningful Use” adoption of Electronic Health Records. 55:30 Using The Kotter 8-Step Process for Leading Change to guide effective Change Management. 57:45 Generating short-term wins with the use of AI. 60:00 Follow Brittany on Twitter and LinkedIn for more thought leadership on clinical informatics, AI, and virtual care!

Crossing the Value-Based Healthcare Rubicon isn’t just a journey, it’s a revolution in care, where the currency is quality, and the compass is compassion. This transformation is both an economic and moral imperative, and in the alchemy of healthcare, transforming economics isn’t just about numbers; it’s the catalyst for transmuting care outcomes into golden results that enrich both lives and ledgers. This week you have access to two of the leading minds in value transformation. We are joined by Dr. Edward McEachern (Executive Vice President and Chief Medical Officer for PacificSource) and Jenni Gudapati (Value-Based Healthcare Program Director and Clinical Associate Professor at Boise State University). In this illuminating episode, we delve into the transformative realm of value-based healthcare with a diverse range of topics. Our insightful interview explores the value movement and its profound impact on economics and care outcomes. We unravel the intricate dynamics of care management, particularly in the context of chronic diseases, while shedding light on the crucial aspects of risk adjustment, Annual Wellness Visits, and Quality Improvement. We also investigate the concept of “Gold Carding” and the role it plays in healthcare transformation. Furthermore, we delve into higher education’s pivotal role in shaping the future of healthcare value, emphasizing the essential skills that healthcare leaders of tomorrow must possess. Tune in for an enlightening discussion that navigates the evolving landscape of healthcare, economics, and leadership! This week’s episode is brought to you by Edifecs – an EMR-agnostic, interoperable, and AI-enabled technology helps providers unify and utilize data for a more complete digital portrait of patient populations. The result: better clinical, financial, and compliance outcomes.  To learn how Edifecs’ applications can enhance prospective risk adjustment and value-based contract performance, visit edifecs.com today. Episode Bookmarks: 01:30 Introduction Edward McEachern, M.D. and Jenni Gudapati, MBA, RN 06:50 The slow uptake of accountable care (HCP-LAN: only 20% of healthcare payments flow through Categories 3B and 4 APMs). 07:20 Provider challenges: supply chain disruptions, labor shortages, high inflation, and the end of COVID-19 relief payments. 08:20 Congressional Budget Office projects insolvency of the Medicare Trust Fund by 2026. 08:50 The economic necessity of value-based health care to reduce unnecessary spending. 09:35 “In the shadow of COVID we have crossed this Rubicon where there is a push on the current paradigms of care delivery and payment.” 10:15 Stressor #1: The retirement of the Boomer workforce will create a 14% structural deficit in accessible labor. 10:30 Stressor #2: FFS infrastructure collides with APM adoption strategies and cannot support value transformation. 11:20 Stressor #3: Shift of hospital care delivery to the outpatient and home setting. (“It is never coming back.”) 11:50 “This chronic complex system of care that takes care of people in the post-acute setting is not adequately available in most communities.” 12:20 “LAN 3B and 4 payments will only help in the context of the operational reshaping of the health delivery system.” 12:50 Value-based consumer perspective needed: 46% cannot afford out-of-pocket healthcare expenses! 13:20 Low value services that do not track to best patient outcomes. 13:50 Revenue dependency on a sick-care model of fee-for-service medicine. 14:35 “Too many health inequities exist. We need to financially incentivize providers to take care of underserved populations.” 15:20 “Healthcare is the only industry that is Yelp proof.” (the dislocation between costs and consumerism) 16:20 What if we created a well-financed and integrated SDOH health system to work alongside the sick care health system? 17:50 The power of the Annual Wellness Visit (AWV) in patient-centered care. 19:20 Clinical intuition in assessing patient risk during the AWV (going beyond the diagnosis code). 21:35 Mapping the system of care to improve patient navigation. 22:20 Healthcare costs for chronic conditions totals $1.65 trillion—equivalent to nearly eight percent of the nation’s GDP. (Projected to be $6 trillion by 2050!) 24:50 PacificSource’s collaboration with Summit Health (ex: managing burden of illness through care management and gold carding.) 27:50 Scaling telehealth, RPM, and home-based CCM through financial incentives. 28:50 Lowering readmissions and ED utilization comes at the expense of lost FFS revenue. 29:35 Prevention programs are core to a clinician’s identity in the promotion of health and wellness. 30:50 PMPM-based prospective payment in the glidepath to value. 31:50 Systems of care for patients stratified in disease-specific high segments. 32:20 Payer-provider collaboration in gold carding. 32:50 The need for real-time bidirectional patient information. 33:50 92% believe quality of care will improve with VBP. (Recognition the care coordination is a critical success factor.) 34:20 Gold Carding as a way to streamline pre-authorizations between a provider and a health plan to support value based healthcare. 35:20 “CDS Hooks” (a HL7 specification that integrates clinical decision support and enables data exchange between payers and providers). 36:50 Dr. McEachern provides additional insights on gold carding, evidence-based PA adjudication, advanced CDS, and interoperability. 43:50 Risk adjustment is so much more than a RAF score and a lever for revenue. 45:20 Jenni expounds on the importance of risk-recapture and accurate charting strategy to reflect true burden of illness in a population. 46:50 Shared decision-making and reflective care planning as a risk mitigation strategy. 49:35 A RAF increase of 0.1 in a population of 1,000 patients = $1M 50:50 Boise State University’s Value-Based Healthcare Program – nationally-recognized education for preparing future healthcare visionaries. 52:50 Master of Population and Health Systems Management – “the juncture between actuarial science, epidemiology, and population health studies” 54:35 Partnership with HFMA – the marrying of Business with Higher Education to meet future workforce needs. 56:50 A vision for “creating a community of Healthcare Transformationalists”. 62:20 Future leaders in value transformation will need expertise in epidemiology, finance, and clinical operations. 63:50 Grit, passion, and optimism are the most important intangible attributes of future leadership success. 66:35 Parting thoughts from Dr. McEachern and Jenni Gudapati.