Creating a New Healthcare

Chelsea Ryckis is the award winning founder and president of Ethos Benefits, a firm dedicated to advancing health insurance strategies for employers nationwide. Their approach effectively eliminates fraud, waste and abuse from employer healthcare plans while increasing savings for both employers and their employees. Chelsea is the co-host of the Ethos Effect Podcast with her husband, Donovan, and producer of the documentary “It’s Not Personal, It’s Just Healthcare”. Chelsea regularly speaks on the industry’s most coveted stages including: ALM Benefits Pro Expo, SHRM HR Florida, and the ISCEBS Symposium.  This is one of the most important episodes we’ve ever aired, especially for employers. During this conversation, Chelsea and I discuss how traditional health insurance brokers profit from ever-increasing premiums, and how that traps employers and, subsequently, employees, in a broken system. The downstream effects of astronomical health care costs will inevitably get passed down to consumers when employers are unable to absorb the increase, resulting in lost wages, layoffs, and an inability for workers to contribute to their retirement. This system is unsustainable but it does not have to operate this way.  At Ethos Benefits, Chelsea and her husband, Donovan, have implemented a revolutionary approach to healthcare consulting. An approach that prioritizes transparency and fiduciary responsibility and which results in significant cost savings. Listen in as they share their methodology and how they can create a system that benefits employers and employees.  Healthcare will not change until the business of healthcare does, and Ethos Benefits is paving the way. 

On the show today, we are honored to have Dr. John Halamka, the Dwight and Dian Diercks president of the Mayo Clinic Platform, a digital initiative that brings together solution developers, data partners and healthcare service providers to transform healthcare. Trained in emergency medicine and medical informatics, Dr. Halamka has been developing and implementing healthcare information strategy and policy for more than 40 years. He continues to practice emergency medicine and is Professor of Emergency Medicine and the Michael D. Brennan, M.D., President’s Strategic Initiative Professor at Mayo Clinic College of Medicine and Science. Dr. Halamka has written 15 books and hundreds of articles. He and his wife run Unity Farm Sanctuary in Sherborn, Massachusetts, dedicated to the lifetime care of ill, disabled, senior, orphaned and surrendered farm animals. The work John and his team at the Mayo Clinic Platform are doing is nothing short of extraordinary. Leveraging their access to Mayo’s massive data set and employing the full breadth of AI capabilities, they have been able to create a platform that allows rapid innovation by de-identifying and sharing medical data while still protecting patient privacy. To give you a sense of the magnitude of this project – the platform currently has 250 predictive algorithms and 8 foundation models in production with a goal of impacting the health of four BILLION people by 2030. As you’ll realize by the end of this interview, Dr. John Halamka is an extraordinary individual, physician, informaticist and leader. He has a tremendous platform and influence but my hope is that his humanitarian influence expands as far, as wide, and as deep as possible within the national and international healthcare domains. If there is anyone I would trust to guide us into the future of AI in healthcare, it would be Dr. Halamka.  

Our guest today is Jasmine Bhatti, the founder and CEO of Navi Nurses, a rapidly growing, private-duty nursing company that’s redefining at-home care. Navi Nurses has been recognized as one of the top startups to watch in Arizona. Jasmine herself was named Phoenix Female Founder of The Year, a Healthcare Hero of Nursing by the Phoenix Business Journal, and was the recipient of the prestigious Jeannine Rivet award from the American Nurses Association. She was also granted a $1.5 million grant to study her work through the Re-Imagining Nursing Initiative from the American Nurses Foundation.  At-home care is such a salient issue for many of us these days. In fact, the inspiration for Navi Nurses came from Jasmine’s own experience with her grandmother’s cancer care journey where she recognized significant gaps in the hospital-to-home care transition. NaviNurses offers flexible nursing care, from simple one-hour check-ins to 24/7 in-home support with hospital-based nurses, often the same nurse that worked with the patient during their hospital stay. Beyond just reducing hospital readmissions, NaviNurses aims to support caregivers by quickly and accurately identifying issues so they can be addressed before they become more significant. The service is currently self-pay, but Jasmine and her team are conducting research to demonstrate the cost savings of this type of program. Beyond the obvious benefit to the patient and their family, I was intrigued by Jasmine’s data regarding the impact on the nurses themselves. Through research with their own nursing staff matched with similarly skilled hospital nurses, Jasmine found that NaviNurses report burnout on the mild end much more frequently than the hospital-based nurses. By providing a more flexible and engaged work environment that demonstrates the full value of nurses, Jasmine hopes to retain more nurses in the workforce. Jasmine’s data-based approach is both smart and admirable and her enthusiasm for this work is palpable. I look forward to seeing this model make its way across the country.   

Rob Andrews currently serves as the CEO of the Health Transformation Alliance (HTA). The HTA member companies collectively are responsible for more than 8 million employees, dependents, and retirees with an annual healthcare spend of $30+ billion. Through Andrews’ leadership, the HTA has launched value-driven solutions specifically designed to improve patient care and add economic value through world-class data and analytics, pathbreaking pharmaceutical solutions, high-quality medical networks, and robust consumer engagement initiatives. To date, the cooperative has saved its member companies well over $2 billion in healthcare costs. Prior to joining HTA, Rob served as a Member of the United States House of RepresentativesUpon his departure from Congress, President Barack Obama praised Andrews’ service as “an original author of the Affordable Care Act…and a vital partner in its passage and implementation.”  In our conversation today, Rob and I revisit what feels now like an age-old argument – the move to value-based care, that is, incentivizing outcomes over the number of patients seen or services provided. What’s unique here is that for the past decade, the HTA has been working with its member constituents to demonstrate that this approach is not only economically feasible, but also better for employees and their families.  Rob points out that while HTA members are certainly interested in lowering healthcare costs, their most immediate concern is employee recruitment and retention. Robust healthcare benefits packages play an important role in being able to attract and keep good talent, so members are invested in being able to provide the most competitive plans and pricing. Rob believes, and I agree, that healthcare is going to have to become less like Kmart and more like Amazon – what you want delivered in a way that’s convenient and affordable. Pulling together the collective power of these large employers is one way to nudge the market in that direction.

Susannah Fox is a highly accomplished health strategist and technologist. . Her book, Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care, was recently published by MIT Press. She is a former Chief Technology Officer for the U.S. Department of Health and Human Services, where she led an open data and innovation lab. She has served as the entrepreneur-in-residence at the Robert Wood Johnson Foundation and she directed the health portfolio at the Pew Research Center’s Internet Project. As someone who firmly believes that we all have to become rebels when it comes to our own health and healthcare, I was excited to talk with Susannah about her new book. In this episode, we discuss how real rebels are creators, not just passive consumers. Susannah feels strongly, and I agree, that the revolution we need in healthcare should be one where patients and caregivers take an active role in research, treatment, and innovation. She brilliantly identifies four key archetypes that can help guide this patient-led change. These roles remind us that we can all be actors in bettering our own experience of healthcare and the experiences of those we love. As Susannah so aptly says, “Don’t bury your light.”  Susannah’s message is one of hope, empowerment, and positive action.. I encourage you to listen and proudly take on the role of rebel in your healthcare.

Dr. Farzad Mostashari is the Co-Founder and CEO of Aledade. He has spent his career at the forefront of healthcare policy and health information technology. Dr. Mostashari is the former National Coordinator for Health IT at the Department of Health and Human Services, and served as a distinguished expert at the Brookings Institute’s Engelberg Center for HealthCare Reform. In addition to his work at Aledade, Dr. Mostashari is the chair of the board of directors for Resolve to Save Lives – a global health organization that aims to save millions of lives from cardiovascular disease and infectious disease epidemics. He has spoken and written extensively on issues affecting health IT, ACOs, and health care policy and delivery with publications in the New York Times, the Journal of American Medical Association, and Health Affairs, among others. Dr. Mostashari received his MD from Yale University School of Medicine and his Masters in Population Health from Harvard T.H. Chan School of Public Health. With such an esteemed background across so many different sectors, I was excited to talk with Farzad not only about his work with Aledade, but also his take on the larger challenge of primary care in this country. In this episode, we discuss the following: The fundamental problem in the healthcare system, namely misaligned financial incentives that do not deliver the desired outcomes. How bringing primary care providers together in a different business model creates shared accountability for the total cost and quality of care while resulting in substantial savings across all invested parties. The use of proprietary technology platforms to integrate data, make predictions, and surface insights to help practices identify and care for their most vulnerable patients. One of the things I most respect about Farzad’s approach is that he values outcome measures that make a real difference in patient lives – decreasing hospital admissions, improving clinical outcomes, enhancing patient experience and engagement. And the results speak for themselves – $800 million in Medicare savings and $548 million in savings shared across their provider groups! Farzad is an intensely outcomes driven, accomplished leader, and Adelade demonstrates the powerful potential of a value-based care platform. This is a wonderful example of creating a new healthcare. To find out more about Aledade’s services, please visit them at www.aledade.com.

In this engaging conversation, Erica Olenski, a patient care advocate and PR strategist with 15 years in healthcare tech, shares her harrowing journey as a caregiver to her son, a survivor of brain cancer and stroke. She emphasizes the crucial balance between technology and human connection in healthcare, and the often-overlooked needs of caregivers within hospital environments. Erica's insights into the healing power of art and storytelling reveal how creativity and narrative can profoundly transform the patient experience, inspiring hope amidst adversity.

David W. Johnson, founder and CEO of 4sight Health, discusses transformative changes needed in healthcare. With over 28 years in healthcare investment banking, he emphasizes that we should push for revolutionary rather than incremental reforms. He outlines a vision for decentralized, integrated health care accessible in communities and homes, pushing back against the inefficiencies of the current system. Johnson also draws insights from Portugal's community-based model, advocating for innovative approaches and improved payment policies to enhance care quality and accessibility.

This is the last episode of our Fall 2024 Season, and it’s a powerful one. On the show today is Andrew Molosky, the President and Chief Executive Officer of Chapters Health System. Under Andrew’s leadership, Chapters has redefined its position to become the nation’s largest not-for-profit, end-of-life care organization and a leading community-based, population-health organization. Andrew has served in executive leadership positions for over 20 years. He is a fellow in the American College of Healthcare Executives, a Home Care 100 advisory board member, and on the board of directors for the National Partnership for Hospice and Health Innovation.  When Andrew told me Chapter’s motto, “There are only two jobs here – taking care of patients or taking care of those that do,” I couldn’t help but think if every healthcare organization adopted this, we would be light-years ahead of where we are now.  What a powerful north-star.  Examples of how this motto drives their business include: Solving for the disease state first and then finding appropriate payment models. Prioritizing building a workforce that is scalable, adaptive, and responsive to new and innovative ideas – including the social determinants of health.  An explicit focus on longitudinal care, that is, staying with patients throughout their journey. Andrew even coins a new term for this…longevically. Utilizing outcome metrics that measure what’s meaningful to patients and their families, like ‘days-at-home’. Chapters and their technology subsidiary, CareNu, have been flying a bit under the radar until now, but that’s been on purpose. Andrew knows they’ve created something special. That is evident in his response when asked what problem he’s solving today: “Throttle control.” It would be easy to let this train run full steam ahead, but Andrew’s understanding of the need to balance their “yes” with equally strategic “no” underlies his tremendous leadership. This is an organization to watch and learn from.  To find out more, visit https://www.chaptershealth.org/

“… If it’s garbage in, it’s gonna be garbage out.” Boy, am I familiar with that truth. And it prevails across so many areas of healthcare, but maybe none more so than the data we generate and our ability to distill something useful and usable out of that data.  On this episode of Creating a New Healthcare, I talk with Dr. Mitesh Rao, the Founder and CEO of OMNY Health. Dr. Rao is a Board-Certified Emergency Medicine Physician and Assistant Professor of Emergency Medicine at Stanford. He founded OMNY to revolutionize how healthcare organizations collaborate and advance science through the common language of data. Integrating real-world data from direct partnerships with IDNs, AMCs, specialty networks, and other providers across the US, OMNY Health’s proprietary platform provides the foundation for stakeholders across the healthcare ecosystem to compliantly and efficiently share data, as well as pursue broader data-driven partnerships.  The core themes seem simple but are somehow still roadblocks: Healthcare data is critical for driving innovation, quality improvement, and better patient care, but the industry has historically struggled with accessing and using data effectively. Healthcare data is often siloed within individual provider organizations or systems, hindering collaboration between different healthcare stakeholders who could benefit from sharing and analyzing the data together.  Even when data can be accessed, it is often not in a clean, standardized, or usable format for research or it does not meet regulatory requirements. The available data does not adequately represent the full diversity of the patient population, limiting the ability to conduct inclusive research and develop equitable care solutions.  Dr. Rao and his colleagues at OMNY are working to combat these challenges by scaling the  harmonization of healthcare data across providers, payers, and other stakeholders to create a platform built specifically for collaboration and innovation. It’s a noble goal and one that could prove critically useful in advancing equity, improving patient safety, and powering research on new care pathways and treatment approaches. But the roadblocks won’t disappear on their own, so there’s definitely more work to do.