Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here. Our guest this week is Dr. Chris Chen, who is the CEO of ChenMed.  Dr. Chen is a board-certified cardiologist and internal medicine physician. HIs professional journey and the story of ChenMed is a remarkable one – a story of the compassionate redesign of healthcare for the older, the poorer and the sicker.  You can hear more about their story in a previous interview I recorded with Dr. Chen – Episode #38 (May 17, 2018) on ‘Creating a New Healthcare’. There are a number of critically important implications for US healthcare that emerge from this interview.  What’s clear from this conversation is that ChenMed has developed and honed a sophisticated, comprehensive model of care that is allowing it to thrive in the current pandemic – while most other primary and specialty care practices are struggling.  What’s also clear is that this model provides a VIP care experience for those with complex medical and psychosocial conditions, and delivers health and cost outcomes that are superior to the vast majority of provider groups and hospital systems across the country. What’s most critical to take away from this conversation, IMO, is the understanding that the capitated payment model that ChenMed has been built upon has allowed it to develop a proactive, preventive, primary care approach that is best-in-class, resilient, remarkably innovative, and most importantly – relationship-centered and humanistic.  What’s also critical to take away from this conversation is the understanding that the predominant fee-for-service payment model has: (1) decimated primary care; (2) led to severe disparities; and (3) limited the ability of well-meaning professionals to deliver the type of compassionate, competent care they were trained to and want to deliver.  What I realized during the course of this conversation is that you can’t put a CPT code on ‘caring’ – and that is the fundamental flaw with fee-for-service payment in primary care.  Another important lesson to be gleaned from this interview is that fee-for-service payment has rendered our system of healthcare fragile, vulnerable, and inequitable – all of which have been revealed and exacerbated by the COVID-19 pandemic. It will be important to translate these understandings into meaningful action. Healthcare leaders must (in the aftermath of the pandemic surge) address this issue of payment; and push for a more rapid conversion to value-based payment models. This will not only serve our patients and our public health; but also allow providers and healthcare systems to be less vulnerable in the future. This is not the only fix, by any means. It’s apparent that there are other reframes that need to occur, such as redesigns in clinical care models – in the use of virtual & digital health technologies; in the use of remote patient monitoring; in the use of data analytics & machine learning; in the deployment of other less costly, more accessible approaches to healthcare; and in the adoption of a consumer-centric mindset.  It’s apparent that our business models and operational approaches will require reframing as well.  Having said all that, payment is still the fundamental “but” that has prevented us from unleashing the tremendous value locked up in our healthcare system for the past many decades.  If this pandemic has taught us nothing else, it’s taught us that we must remove the fee-for-service “but” from our primary care and public healthcare lexicon. In ‘Reframing Healthcare’ I wrote, “It’s clear that the current predominant system of payment – fee-for-service – provides a perverse incentive to do more” [unnecessary, costly and potentially harmful testing, procedures & surgeries]. What’s also now clear to me is that fee-for-service payment provides a perverse incentive to do less – less caring & compassion, less proactive outreach, less prevention, less equitable care, less of all the right things that we would want for ourselves, our families, our communities, and our patients. The need to transition out of fee-for-service should be one of the first lessons discussed, and one of the first set of responses deployed in the post COVID-19 era. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking two questions: (1) How is the COVID-19 pandemic immediately changing the way you’re delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? Our guest this week is Dr. Anthony Slonim, President and Chief Executive Officer of Renown Health in Reno, NV.  Over the last four years, he and his colleagues have created one of the most innovative and progressive health services organizations in the country. Dr. Slonim is a nationally recognized thought leader. Modern Healthcare has named him one of the “50 Most Influential Clinical Executives” of 2019. He has also been named a “Physician Leader to Know” every year, since 2014, on the Becker’s Hospital Review. A board-certified pediatric intensive care doctor by training, Dr. Slonim has authored more than 15 textbooks and published more than 60 academic journal articles. Before joining Renown Health, Dr. Slonim served in executive leadership roles at Barnabas Health in NJ, Carilion Clinic in VA and Children’s National Medical Center in DC. Dr. Slonim currently chairs the American Hospital Association’s Systems Council, representing more than 300 integrated health systems nationwide. In this interview, we’ll cover a number of topics including: How the public health mindset/model is augmenting and perhaps superseding the medical mindset/model in the COVID-19 era How the current pandemic is pushing many more Americans into an existence of extreme scarcity, and the economic effect on the social determinants of health and health outcomes How Renown Health’s unique approach and operating structure – which is focused on prevention and health as well as healthcare – have prepared and positioned it to address the current situation. The escalation of behavioral and mental health conditions – a lesser talked about consequence of the pandemic, which can easily overwhelm our healthcare system, unless we find new ways to assist people. How we must use this opportunity to methodically, systematically and cautiously reframe our approach – to be prepared for not only the shock waves of this current crisis; but to be prepared for future such events by focusing on health and establishing a prepared public healthcare system. The importance of leadership at this point in time, especially at a time of widespread uncertainty and anxiety, which can cause individuals and organizations to recede into a vegetatitve mode of self-preservation. Dr. Slonim is an exceptional CEO.  In addition to being a seasoned HC executive, he is a seasoned physician and an expert in public health. In a previous interview we conducted I mentioned that we needed more CEO’s with these sorts of credentials. That was true then, but even more so now, in this COVID-19 era.  Our interview ended up going into a discourse on the type of intentional leadership that will be required in this time crisis and its aftermath. He has a perspective that I hope others leaders can be inspired by and benefit from. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking two questions: (1) How is the COVID-19 pandemic immediately changing the way you’re delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be speaking with a colleague of mine, Dr. Ifeyinwa (Ify) Osunkwo, MD, MPH. Dr Ify Osunkwo – or Dr. Ify, as her patients refer to her – is the Director of the Sickle Cell Disease (SCD) Enterprise at Levine Cancer Institute at Atrium Health.  She is a Professor of Medicine at Atrium Health and a Clinical Associate Professor of Medicine at UNC Chapel Hill.  Dr. Ify earned her MD from the University of Nigeria and a Masters in Public Health from Johns Hopkins University.  She completed a pediatric residency at the University of Medicine & Dentistry of NJ, followed by a pediatric hematology-oncology fellowship at Columbia University.  She founded the SCD program at Atrium Health.  This program has been instrumental in improving the quality of life of persons living with SCD in North & South Carolina; and has also demonstrated positive health outcomes in terms of reduced mortality rates, reduced health care costs and hospital readmission rates, and increased patient engagement and satisfaction with care.  Dr Osunkwo has dedicated her career to providing equitable, comprehensive, compassionate and evidence based care for individuals living with SCD.  She serves on numerous national committees for the American Society of Hematology and is the Editor-In-Chief of Hematology News. I felt compelled to share this interview because Dr. Ify is offering a number of humanistic approaches to her patients that are especially important in the COVID-19 era.  They are important from a provider/patient relationship perspective in that they directly address the issues of social isolation, loneliness and anxiety that people with chronic medical conditions are experiencing.  They are important because they address the concrete issue of chronic disease management, which are disproportionately affected by the social distancing and sheltering-in-place public health efforts.  There is little doubt that people with chronic medical conditions and people who are socio-economically vulnerable are impacted upon much more severely than others. I’m posting this interview with the intention and hope that providers from across the country will be inspired by Dr. Ify’s example and adopt these and/or other similar offerings for their patients; and that healthcare systems across the country will support these providers with resources.  All of this is said with the grateful understanding that so many providers and healthcare systems are focused right now on emergency preparedness for the pandemic surge and on treating patients with COVID-19.  What I’m sharing in this interview is what I would call 2nd, 3rd and 4th wave issues – addressing the pandemic’s impact on social determinants of health and on the mental health of patients – which, as Dr. Ify points out, has a significant impact on the course and treatment of chronic disease.  But, these are issues that we need to begin to address now, even as we battle the 1st wave of the pandemic. I’ve known Dr. Ify for a number of years.  She is a wonderful physician who has a refreshing public health perspective that she applies brilliantly in her practice of medicine.  It’s clear that Dr. Ify is incredibly devoted to her patients and is an exemplary role model.  Her accomplishments and her positive impact are also a credit to the Levine Cancer Institute and the Atrium Health system that support her in this critically important, meaningful and innovative work. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking two questions: (1) How is the COVID-19 pandemic immediately changing the way you’re delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing Michellene Davis, an Executive Vice President at RWJBarnabas Health – the largest healthcare system in New Jersey.  Michellene leads Social Impact and Community Investment across RWJBarnabas Healthcare.  She oversees the areas of Policy Development, Governmental and External Affairs, Community and Employee Wellness, and Global Health. Ms. Davis is the first woman and first person of color to serve as an Executive Vice President in Barnabas Health system’s history. She is a lawyer and trial litigator who also has extensive experience in senior levels of state government. Michellene is nationally recognized for her contributions to healthcare. In 2018, she received Modern Healthcare’s Top 25 Most Influential Minorities in Healthcare award. This dialogue is filled with more expertise, wisdom, humanity and hope than I could ever begin to describe.  It’s also an eye-opening description and depiction of one of the current epi-centers of the COVID-19 pandemic. Michellene shared her incredible experience and expertise on a range of topics, including: The brave work that healthcare providers & staff are doing in our hospital systems The physical & psychological toll of the COVID-19 ‘battlefield’ on healthcare providers & staff The severely negative and disproportionate impact of COVID-19 on the expanding segment of our population who are socio-economically vulnerable – and the impact that will have on everyone in our society A list of recommendations for the work we must immediately begin, in order to mitigate the ‘2nd wave’ of the pandemic tsunami.  This is not an infectious disease wave, but a tidal wave of repercussions from the social determinants of health – such as lack of income and food, and the lack of a strong national public health infrastructure. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking two questions: (1) How is the COVID-19 pandemic immediately changing the way you’re delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be speaking with Dr. David Shulkin.  Dr. Shulkin served as the 9th Secretary of the US Department of Veterans Affairs, as a member of President Trumps’ cabinet.  Previous to that he served as Under-Secretary for Health, having been appointed by President Obama. Prior to entering the government, Secretary Shulkin was a widely respected healthcare executive.  He has been named as one of the Top 100 Physician Leaders by Becker’s Hospital Review and one of the “50 Most Influential Physician Executives in the Country” by Modern Healthcare and Modern Physician.   Dr. Shulkin is an amazing leader and it’s always a privilege and pleasure to speak with him as he describes the principled-based, data-driven leadership we’ll need in the COVID-19 and post COVID-19 era.  In this dialogue he speaks to a number of issues, including: The renewed recognition of the critical role of government in preparing and maintaining a public health system The need for a more integrated national public healthcare system – that recognizes & addresses the disparities and inequities in healthcare The impact and fall-out of this pandemic on the social determinants of health, which Dr. Shulkin believes could be its most devastating consequence The changes in our daily lives – including some positive ones – such as a sense of kindness and generosity, as well as shared responsibility, adaptiveness and resilience The social awareness and consciousness being raised, especially amongst the younger generations, who may, for years go come, be motivated to enter into public health service These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions: (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing Dr. Paul Offit, an internationally recognized expert and scientific pioneer in the field of virology and immunology; and the leading virology expert in the U.S.  He is the co-inventor of the rotavirus vaccine recommended for universal use in infants by the CDC, which is credited with saving hundreds of childrens’ lives each day. He is a professor in the division of Infectious Diseases at the Children’s Hospital of Philadelphia, and a professor of Vaccinology at the University of Pennsylvania School of Medicine  (See abbreviated Bio below). My dialogue with Dr. Offit was incredibly hopeful, hugely informative and beyond inspiring.  He is clearly a brilliant medical scientist and a courageous humanitarian. We covered a range of topics including: His perspective on the COVID-19 surge curve and social distancing The 3 major lessons (reframes) he believes we need to learn from this current pandemic His expert thoughts regarding the amount of time it will take to develop a COVID-19 vaccine His views regarding the impact of our public health response on the social determinants of health These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD Paul A. Offit, MD, is Director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children’s Hospital of Philadelphia.  He is the Maurice R. Hilleman Professor of Vaccinology at the Perelman School of Medicine at the University of Pennsylvania.  Dr. Offit has published more than 150 papers in medical and scientific journals in the areas of rotavirus-specific immune responses and vaccine safety. He is also the co-inventor of the rotavirus vaccine, RotaTeq®, recommended for universal use in infants by the CDC. For this achievement, Dr. Offit received the Luigi Mastroianni and William Osler Awards from the University of Pennsylvania School of Medicine, the Charles Mérieux Award from the National Foundation for Infectious Diseases, and was honored by Bill and Melinda Gates during the launch of their Foundation’s Living Proof Project for global health. In 2009, Dr. Offit received the President’s Certificate for Outstanding Service from the American Academy of Pediatrics. In 2011, he received the David E. Rogers Award from the American Association of Medical Colleges, the Odyssey Award from the Center for Medicine in the Public Interest, and was elected to the Institute of Medicine of the National Academy of Sciences. In 2012, Dr. Offit received the Distinguished Medical Achievement Award from the College of Physicians of Philadelphia and the Drexel Medicine Prize in Translational Medicine from the Drexel University College of Medicine. In 2013, he received the Maxwell Finland award for Outstanding Scientific Achievement from the National Foundation for Infectious Diseases, the Distinguished Alumnus award from the University of Maryland School of Medicine, and the Innovators in Health Award from the Group Health Foundation. In 2014, he was elected to the board of trustees at the College of Physicians in Philadelphia, and in 2015, he was elected to the American Association of Physicians and the American Academy of Arts and Sciences as well as being named as a Fellow for the Pediatric Infectious Diseases Society and the American Academy for the Advancement of Science. In 2016, Dr. Offit received the Franklin Founder Award by the City of Philadelphia, The Porter Prize from the University of Pittsburgh School of Public Health, and the Jonathan E. Rhoads Medal for Distinguished Service to Medicine from The American Philosophical Society. In 2017, he received the Defensor Scientiae Award and an Honorary Doctor of Science degree from The University of the Sciences in Philadelphia.

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions: (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing Andrew Parker, the founder & CEO of Papa.  I recently interviewed Andrew and would encourage you to listen to this amazing entrepreneur and amazing new venture.  You can find that dialogue here.  Although I had recently posted that interview, Andrew was one of the first people I thought to reach out to in this limited series because of how critically important and relevant his service is in this time of social distancing, sheltering-in-place, and lockdowns. Papa is  an on-demand service designed to deliver companionship and non-clinical services to seniors and  families. These non-clinical services are delivered through so-called ‘Papa Pals’ who are college age students who assist in a number of ways including household activities, transportation, shopping, filling out forms… Another reason I reached out to Andrew was to learn how Papa had dramatically pivoted its service model to adapt to COVID-19.  It’s such a delight speaking with Andrew. His energy, enthusiasm, and vision; as well as his accomplishments and outcomes with Papa are uplifting, and provide us with tremendous hope for the future. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions: (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing two digital innovation superstars from Providence – Sara Vaezy & Maryam Gholami.  Providence is one of the most progressive and innovative integrated delivery systems in the country.  As a result of their long-term investments in healthcare transformation, they are incredibly well prepared for the current situation, and also well prepared to be highly adaptive and agile over the next few months and years.  Lots of lessons to learn from this organization! What you’ll hear in this interview will include: A ‘consumer hub’ which includes a chatbot “Grace” that assesses and navigates patients to appropriate care – and how that’s been adapted for COVID-19. How Providence has pivoted the use of their online ‘on-demand’ platform “Express Care”, which includes ‘virtual video visit’ services that have now also been adapted to deliver chronic disease management in addition to the already existent urgent-care visit use. The greater than 10-fold increase in the number of virtual visits that Providence has been able to scale up to in the past few weeks!  (A fact that is highly illustrative of the rapid shift, Providence has conducted more virtual visits in the first 3 weeks of March 2020 than in the entire year of 2019) The accelerated advances Providence is deploying in home-monitoring of higher risk patients; as well as their focus on the behavioral health of patients and providers. How diligently the Providence digital development and marketing teams are listening to the continuously shifting needs and expectations of their healthcare consumers/patients; and how rapidly they are iterating their products and services to accommodate. Providence is a not-for-profit Catholic health system comprising 51 hospitals as well as 1,085 clinics and other health services, with over 119,000 caregivers serving communities across seven states. Sara Vaezy leads the overall development of the digital strategy, digital partnerships, new business commercialization and business development.   Maryam Gholami is the Chief Product Officer for digital innovations. She leads product development, commercialization, and growth of the consumer digital portfolio. She is also responsible for leading the applications of advanced technologies such as AI and machine learning. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here. In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions:  (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare? (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’re interviewing Dr. Erik Vanderlip, the Chief Medical Officer of Zoom+Care. Zoom+Care is a pioneering healthcare company based in the Pacific Northwest.  It’s mission is to create an innovative, patient-empowered, on-demand health ecosystem for the 21st Century.  At ZOOM+Care, Dr. Vanderlip & his colleagues are integrating behavioral health, urgent care, primary care, telemedicine and specialty care services that utilize advanced chronic care models to engage patients and promote health behavior change. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear friends & colleagues, In the three months since the Chinese government notified the WHO of the emergence of a new viral pneumonia, we appear to be on the rising ‘surge curve’ of a pandemic that threatens to overwhelm our healthcare system’s capacity. Despite the stark realities of the present moment and the unknowns that lie ahead, there has been another surge – a surge of humanitarian mission and innovation, of empathy and hope, of teaming and transformation. I am awestruck by the creativity, ingenuity, dedication and collaboration I’ve been witnessing and am privileged to be a part of. It’s difficult to express the gratitude that I and others have for the frontline providers and staff who are seeing patients in the clinics, emergency rooms and hospitals. As I observe the herculean efforts around me, I feel compelled to contribute and use my podcast platform to shed light on how this pandemic is accelerating the reframing of American healthcare… in real time. To that end, I am launching a limited podcast series entitled,‘How COVID-19 is Reframing Healthcare in America’.  In this series, I reach out to interview future-facing healthcare leaders and entrepreneurs, and ask them two questions: (1) How has the COVID-19 pandemic immediately changed the way you are delivering healthcare? (2) How will COVID-19 reframe healthcare in America for years to come? I am awed and inspired by the responses I’ve gotten in the interviews I’ve already begun recording for this series. I can’t wait to share them with you! Friends – I hope you’ll join me in this historic window of opportunity that’s been thrust upon us. The first episode in this limited series is now available for download on the ‘Creating a New Healthcare‘ podcast. I urge you to listen, share, and please reach out with your response. Until next time, be safe and be well. Zeev Neuwirth MD