Relentless Health Value

In a special Thanksgiving edition, the host reflects on gratitude and collaboration in healthcare. She expresses thanks to those who maintain respectful dialogue even amid disagreements. Listeners are celebrated for their mentorship and community spirit, with a focus on the importance of paying it forward. The discussion includes the need for a 'demand curve' in healthcare markets and appreciation for various contributors, including donors and volunteers who help sustain the podcast's mission.

Olivia Ross, an experienced leader in employer-centered healthcare programs, dives into the world of high-value networks and Centers of Excellence. She explains how these networks allow self-insured employers to deliver predictable pricing while improving care quality. Olivia highlights the benefits of coordinated care with local providers and the importance of rigorous quality metrics when selecting surgeons. With innovative strategies for engaging patients, she demonstrates how employers can leverage their buying power to drive competition and enhance healthcare outcomes.

In this discussion, John Quinn, CEO of Wellness City, shares insights on how employer CEOs are waking up to the realities of healthcare spending. He discusses the impact of health benefits on corporate earnings, and why traditional cost-shifting to employees is unsustainable. John advocates for accountability in vendor contracts and the need for real-time data to tackle high-cost claimants effectively. He emphasizes integrating finance and medical expertise in benefits teams to manage healthcare spend more strategically.

Shane Cerone, a health system executive and co-founder at KADA Health, teams up with Dr. Sam Flanders, a chief quality and safety expert, to delve into elevated hospital management models. They discuss creating a model to thrive at 150% of Medicare, highlighting how reducing inefficiencies can enhance care without compromising quality. Their strategies include Toyota-style continuous improvement and empowering clinicians through Kaizen methods. The duo urges employers to reclaim pricing power to foster market competition, envisioning a healthcare landscape that's more affordable and efficient.

In this engaging conversation, Elizabeth Mitchell, CEO of the Purchaser's Business Group on Health, dives into the PBGH Transparency Demonstration Project. She reveals how this initiative aims to empower jumbo employers with critical data on healthcare costs and quality. Elizabeth discusses the surprising lack of correlation between price and quality, the importance of the Consolidated Appropriations Act, and how transparency can reshape market competition. She also shares insights on improving employer strategies and the potential benefits for high-quality providers.

Shane Cerone, a healthcare executive from Kada Health, and Dr. Sam Flanders, a quality improvement physician, tackle three pervasive healthcare myths. They argue that a true healthcare market is non-existent due to lack of price transparency. Both share insights on how hospitals can thrive on Medicare rates, countering the belief that lower prices mean poorer quality. They emphasize that operational improvements can enhance care while reducing costs, setting the stage for future discussions on actionable solutions.

Dan Greenleaf, CEO of Duly and a seasoned healthcare executive, dives into the crucial balance between mission and margin in healthcare delivery. He discusses how Duly retains patients and leverages diversified revenue while negotiating payer rates. Dan highlights the role of technology, such as Ambient AI, in enhancing clinician efficiency and patient experience. He emphasizes the importance of physician ownership in aligning incentives and shares insights on how to communicate the organization's mission to investors effectively.

In this discussion, Dan Greenleaf, CEO of Duly, a Chicago-based multi-specialty medical group, dives into mission-driven care. He emphasizes how aligning healthcare accessibility and affordability can enhance patient experiences while ensuring financial sustainability. Dan showcases Duly's innovative pricing strategy, demonstrating significant savings on services. He also highlights the importance of transparency and measurable quality metrics that directly impact community health outcomes. This fusion of care and mission proves crucial in today's healthcare landscape.

Mark Cuban, entrepreneur and owner of Mark Cuban Cost Plus Drugs, and Cora Opsahl, director at the 32BJ Health Fund, tackle healthcare's complexities. They discuss the pitfalls of high deductible plans that leave patients effectively uninsured and burden providers with debt collection roles. The duo advocates for direct contracting and transparency, emphasizing how streamlined pricing can empower both patients and employers. They also envision a bold future with simplified healthcare pricing, urging for trust and ease in the ultimately convoluted system.

In episode 487, part two, host Stacey Richter interviews Kevin Lyons, a former police detective and current Executive Director of the New Jersey State Police Benevolence Association about the application of detective skills to analyze healthcare spending. Following a discussion on the barriers driving up healthcare costs in part one, Lyons delves into techniques such as statement analysis and facial recognition to identify deceit and uncover where healthcare dollars are going. Lyons emphasizes the need for preparation, persistent questioning, and the importance of following the money, thereby encouraging a fearless approach to advocating for transparency and better healthcare management. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP487Part2 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth/ 00:00 Introduction and Episode Overview 00:25 Recap of Part One: Barriers to Reducing Healthcare Costs 03:01 Introducing Kevin Lyons: Detective Skills in Healthcare 03:52 Detective Techniques Applied to Healthcare 06:41 Challenges and Solutions in Healthcare Transparency 12:15 Final Thoughts and Acknowledgements 13:10 Closing Remarks and Podcast Information