Aug 12, 2021
Recently I was talking to someone, a civilian not in health care, and I mentioned something about how patients don’t always get a treatment plan (a care plan) based on the best evidence or sometimes even any evidence. Here’s how I explained it to him—what this looks like in the real world: Let’s say two patients, patient 1 and patient 2, with the exact same clinical needs and zip code … both these two patients see the exact same doctor. The only difference between these two patients is that they’re two different colors.
And let’s add a third patient into this mix: say, ME. Let’s say I have the exact same profile and zip code as those first two patients. I see a different clinician in the same exact practice, though. In all these circumstances, evidence is evidence, right? There should be one care plan that all three of us get when we show up at that same care setting. Until the evidence changes, that is, right?
But the reality is that it’s just as likely that those other two patients and I, we all get various shades of different care plans.
The civilian I was having the original conversation with about evidence-based medicine and this care planning? He literally recoiled in surprise. He was shocked. He said he thought medicine was more science than that.
I’m going to take that anecdote as a data point to suggest that there is a disconnect between what patients think is going on and what is actually going on relative to how care plans tend to happen in health care. Alex Akers from Health Catalyst in episode 176 and Clint Phillips from Medici in episode 201 get into this in detail.
You can listen to full episodes and learn more about this week’s guests at relentlesshealthvalue.com.
Jeffrey Hogan is the northeast regional
manager for Rogers Benefit Group, a national benefits marketing and
consulting firm. Jeff has been with Rogers Benefit Group for 30
years. Additionally, Jeff operates a consulting firm, Upside Health
Advisors, where he provides expert witness services on health
care–related litigation, is a consultant to payers and large
provider groups for product development and launch, and is a
resource to employers desirous of implementing strategies to manage
their health spend. Jeff is focused on health care payment reform,
health policy, care coordination, value-based health care, health
care quality, and precision medicine.
Jeff regularly appears on national forums focused on moving to value-based health care and is actively working to promote health care–related transparency measures in the market. He serves as the group’s liaison to the National Alliance of Healthcare Purchaser Coalitions. Jeff is the regional leader for The Leapfrog Group. He is also one of the coordinators of Connecticut’s Moving to Value Alliance.
Darrell Moon founded
Orriant in 1996 to change the dynamics of health care and give
employers some control over the ever-increasing costs of the health
care benefits they offer their employees. Darrell believed that
engaging individuals in the management of their own health was a
key that had to be inserted back into the economic equation of
health care. Darrell received both his bachelor’s degree in finance
and his master’s degree in healthcare administration from Brigham
Young University. As the CEO, COO, or CFO, Darrell managed medical
and psychiatric hospitals throughout the country for over 10 years
prior to creating Orriant. He also has more than a decade of
experience managing insurance and managed care products. Darrell is
a Forbes leadership contributor.
Grace E. Terrell, MD, MMM,
is CEO of Eventus WholeHealth, a company focused on integrated
value-based behavioral medicine and primary care in the long-term
care space. She is a national thought leader in health care
innovation and delivery system reform and a serial entrepreneur in
population health outcomes driven through patient care model
design, clinical and information integration, and value-based
payment models. She is the former CEO of Cornerstone Health Care,
one of the first medical groups to make the “move to value” by
lowering the cost of care and improving its quality for the
sickest, most vulnerable patients; the founding CEO of CHESS, a
population health management company; and the former CEO of
Envision Genomics, a company focused on the integration of
precision medicine technology into population health frameworks for
patients with rare and undiagnosed diseases. Dr. Terrell currently
serves on the US Department of Health and Human Services
Physician-Focused Payment Model Technical Advisory Committee and
the board of the AMGA (American Medical Group Association), is a
founding member of the Oliver Wyman Health Innovation Center, and
is the coauthor of Value-Based Healthcare and Payment
Models.
Rich Klasco, MD, FACEP,
has focused throughout his career on rendering evidence-based
medicine operational—that is, making the right thing the easy thing
to do. He has pursued this goal in academia, in industry, in
policy, and in the press.
In addition to publishing extensively in both peer-reviewed journals such as JAMA and lay publications such as The New York Times, Dr. Klasco has taught at leading academic medical centers, including Harvard, Stanford, Mayo, and the University of California, San Francisco; served on the executive committee of Brigham and Women’s Hospital Center for Patient Safety Research and Practice; testified before the United States Congress on evidence-based practices; and won CMS (Centers for Medicare & Medicaid Services) approval for an officially designated compendium of evidence-based oncologic drug information. Dr. Klasco previously served as chief medical officer and editor-in-chief for the Thomson Reuters group of health care companies, where he had editorial responsibility for companies including Micromedex, the Physicians’ Desk Reference (PDR), and the United States Pharmacopoeia (USP) Drug Information.
For the past 15 years, Dr. Klasco has served as chief medical officer for Motive Medical Intelligence, where he provides clinical leadership for the development and deployment of solutions that quantitative assess physician performance for payers, providers, and patients, and integrate scientific knowledge into workflow systems where it can be accessed and applied in real-time.
Dr. Klasco received his medical degree from Harvard Medical School. He completed his internship and residency in internal medicine at Brigham and Women’s Hospital, and he completed his residency in emergency medicine at the Denver Health Residency in Emergency Medicine, where he served as chief resident.
Nicole Bradberry is the
founder and chief of growth and innovation officer for MIND 24-7.
MIND 24-7 runs mental health crisis centers with a focus on
immediate access, quality care, and the understanding that mental
health and substance abuse drive significant health cost. She is
also the founder of ValueH Network, which aggregates
high-performing value-based care network providers in order to
enable the best performance in new innovate contracts. In addition,
she is currently the chief executive officer and chairman of the
board of the Florida Association of ACOs (FLAACOs). FLAACOs is the
premier professional organization for accountable care
organizations (ACOs) throughout Florida which provides education
and collaboration in the fee for value health care space.
Nicole spent 16 years leading operations and information technology programs for UnitedHealth Group and Cigna HealthCare. While there, she served as business lead for the technology transformation of the country’s largest dental and vision services company, led the national deployment of health care quality and affordability programs, and was responsible for the successful integration of many major health plans.
Nicole holds a bachelor’s degree in statistics from the University of Florida. She has been recognized for her personal and professional achievements many times, recently as the nation’s Outstanding Midmarket IT Leader of the Year and one of the Business Journal’s “Women of Influence.” She is often found on the speaker faculty for health care conferences focused on ACOs, population health, and value-based care. She is passionate about changing health care and enabling physicians to provide high-quality, cost-effective, and consumer-focused care.
Kelly A. Conroy is
director of Pinnacle Healthcare Consulting and brings more than 30
years of health care finance, management, and leadership experience
with significant experience in value-based care. As a leader in the
field, she’d contributed through multiple start-up health care
companies with a leading-edge focus on advancements in care
delivery and alignment.
Kelly started the first Medicare ACO in the country, which delivered nearly $40 million in savings in its first year and has gone on to manage some of the most profitable ACOs in the country. She is now sought after as a senior advisor and consultant, having developed a reputation as one of the most experienced and effective ACO professionals in the country. As a true catalyst driving the shift in health care culture toward physician leadership, her understanding and strategic vision are unmatched, along with her comprehension of the latest government-proposed valued-based agreements.
From starting health care organizations to serving in multiple senior executive leadership roles, Kelly is a seasoned executive with a career record of negotiating and increasing revenues through new product offerings while optimizing efficiency and productivity in the medical field.
02:10 Jeff Hogan (EP309) talks about the consequences
of when there’s a disconnect between what the patient
thinks is happening and what is actually
happening in a care plan.
03:48 EP315 with Bob Matthews.
03:58 Merrill Goozner’s
perspective on successful population
health.
04:55 Why did Darrell Moon (EP305) give up being a hospital
administrator because of care plans?
08:02 “It’s a myth that population medicine … and precision
medicine are incompatible or opposites.”—Dr. Grace Terrell
(EP319)
11:28 Dr. Rich Klasco (EP321) explains “noncognitive”
medicine and why it bogs physicians down.
14:45
What is at the core of appropriateness for care?
16:33 “You start to bring that data to the physician, and it really
does open their eyes.”—Nicole Bradberry (EP324)
16:51 Nicole Bradberry and Kelly Conroy (EP324) discuss how to really change
the way physicians work.
You can listen to full episodes and learn more about this week’s guests at relentlesshealthvalue.com.
Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
What are the consequences when there’s a disconnect between what the patient thinks is happening, and what is actually happening in a care plan? Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
Why did Darrell Moon give up being a hospital administrator because of care plans? Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
“It’s a myth that population medicine … and precision medicine are incompatible or opposites.” Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
What is “noncognitive” medicine, and why does it bog physicians down? Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
What is at the core of appropriateness for care? Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
“You start to bring that data to the physician, and it really does open their eyes.” Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
How do you really change the way physicians work? Jeff Hogan, Darrell Moon, @gracet22, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy discuss #careplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth
Recent past interviews:
Click a guest’s name for their latest RHV episode!
Dr Tony DiGioia, Al Lewis, John Marchica, Joe Connolly, Marshall Allen, Andrew Eye, Naomi Fried, Dr Rishi Wadhera, Dr Mai Pham, Nicole Bradberry and Kelly Conroy, Lee Lewis, Dr Arshad Rahim, Dr Monica Lypson, Dr Rich Klasco, Dr David Carmouche (AEE15), Christian Milaster, Dr Grace Terrell, Troy Larsgard, Josh LaRosa, Dr David Carmouche (EP316), Bob Matthews, Dr Douglas Eby (AEE14), Dr Sheldon Weiss, Dan Strause and Drew Leatherberry, Dr Douglas Eby (EP312), Ge Bai, Sumit Nagpal, Dr Vikas Saini and Shannon Brownlee