Business Of Healthcare

Carteret County is a coastal North Carolina community of approx 70,000 residents which swells to 200,000 during the summer beach season.  Carteret had a big overdose problem, ranked in the worst quintile in North Carolina.That’s where Consolidated Health and Human Services Director Dr. Randall Williams and Post Overdose Response Team Manager Brook Lane come in.  In only two years, they reduced overdoses by 90%, overdose deaths by 80%, and overdose-related ER visits by 50%.  In this episode of the Business of Healthcare, we explore how these two leaders helped dramatically reduce the overdose crisis in their county, saving lives and money.

Gautam Shrikhande, MD, Chief Executive Officer of Pelvic Rehabilitation Medicine and Brian Rath, Partner, Lorient Capital join Business of Healthcare to explore the role of private equity in physician services. Physicians want to serve patients with the highest value care at the best cost while being fairly compensated.  Growth is a sign of a healthy, well-run practice. Ethical medical groups attract patients and increase revenue per patient by providing better outcomes, patient experience, and value as compared to local alternatives.  Some practices of these practices are choosing private equity to fund growth. As a source of capital, is private equity better at supporting growth?  Does a practice taking PE investment run the risk of overly aggressive patient recruitment and billing? Do private equity partners help practices engage the right patients for growth? We learn how one of these practices, PRM, partnered up with a PE firm to achieve velocity and growth.  We look at the investment hypothesis, how the

You may think Patient Experience is a straightforward discipline. Cathy Lee, Corporate Vice President for Patient Experience, joins BOH host Matthew Hanis to explain the lenses of a modern patient experience program and her innovations in the space.

Digital ethnography observes healthcare decision making on community message boards. These insights bring a more distinct ‘voice of the customer’ to shape marketing and service delivery. Health system marketing leader Jeff T. House and digital ethnography Dean Browell, Ph.D. join BOH host Matthew Hanis to explain how digital ethnographic research is applied and some of the surprising insights which have emerged.

Why are marketing tools, techniques and approaches so important to transforming healthcare? In his BOH interview, Zeev Neuwirth, MD says, “The field, in my estimation, that really understands what people want and need is the field of marketing.” An Atrium Health clinical executive and author of recently published Reframing healthcare - roadmap for creating disruptive change, Neuwirth describes the ‘marketing mindset’, stages systems go through embracing these techniques, the threat marketing experts Google, Amazon and CVS bring and the implications for payment reform, digital health and chronic disease management. Interview filmed in partnership with the Society for Healthcare Strategy and Market Development (SHSMD) and sponsored by MedChat. MedChat provides LiveChat, Bots and text tools for a modern digital front door www.medchatapp.com

Can health systems engage consumers digitally to improve quality, cost and satisfaction? According to Mark Jannone, Senior Director, Banner Health’s Banner Innovation Group, the answer is a solid, “Yes.” He is helping to pilot digital ED triage and chatbot tools. Jannone reports the tools achieve a 35% reduction in inappropriate ED cases with 92% triage accuracy, decrease the time patients are in the ED by about 50% and increase net promoter scores by 40%. Full interview at BOHseries.com. This Business of Healthcare interview sponsored by MedChat: improving patient access with secure LiveChat, Bots & text tools. See www.medchatapp.com.

“No outcome, no income,” says Dr. David Nash, Founding Dean Emeritus, Jefferson College of Population Health. JCPH is the nation’s first graduate school of population health. Nash describes the emergence of the population health movement, why fixing the US healthcare system is so important for our economy and our society, and concrete interventions such as going at risk with supply chain partners such as pharma. See YouTube for video highlights and Full video interview  

Karen L. Smith MD, FAAFP kept discovering opioid addiction in the families she served in her independent, rural primary care practice. With growing need and few referral options, Smith began providing medication-assisted treatment. MAT uses medication, counseling and behavioral therapies to treat substance use disorders and sustain recovery. Smith shares patient stories which led her to take on this challenge and the barriers a physician must overcome to provide MAT.

In 2016, Wilmington, NC had the highest concentration of opioid use disorder among US cities. Community leaders including regional health system chief physician executive Philip M. Brown, MD, FACS helped intervene in this public health epidemic. Brown describes the moment a national report triggered awareness of the local opioid epidemic. He and his fellow leaders undertook multi-faceted interventions to change prescribing habits, impact social determinants and, most importantly, de-stigmatize addiction.

When a med mal claim emerges from patient injury, we may debate who’s liable but we can agree something undesirable happened. Mark Reynolds leads CRICO, the Risk Management Foundation of the Harvard Medical Institutions, a captive insurance program. CRICO, in addition to serving its members’ medical professional liability insurance and other needs, also provides a comparative database with 30% of U.S. MPL claims. Reynolds shares insights from this 30+ year dataset of clinical and financial data which CRICO uses to identify & propagate root cause interventions. What insights do medical malpractice claims offer to improve the Mission & Margin of healthcare? These data are one of the richest insights into U.S. healthcare quality & safety.

Physician entrepreneur Brian Alper, MD explores shared decision making as an intervention improving patient safety, patient satisfaction and financial outcomes. John Gillean, MD, MHA, EVP & Chief Clinical Officer for CHRISTUS Health shares his perspective on the patient safety and quality implications.

CHRISTUS chief clinical officer John Gillean, MD, MHA, among his many responsibilities, guides his organization’s insurance captive to reduce operating costs and improve patient safety. While supporting the system’s core patient care mission, this lowered total system cost of risk from $100 million to $50 million. Now focused on emerging risks such as natural disaster, cyber security, active shooter and pandemic, Gillean is helping wrestle the tsunami of data created in patient care to further advance mission & margin goals.

Larry Smith and Rachel Leyko of MedStar Health explain Early Intervention, their journeys to advocacy and evidence of lowers costs and better outcomes for patients, families and clinicians.  Medical error resulting in patient injury may lead healthcare personnel to withdraw from patients and withhold information for fear of litigation.  Early Intervention is an alternative approach in which physicians and health system staff quickly acknowledge an injury has occurred.  By providing immediate assistance (without accepting blame) when not clearly at fault, patients are more collaborative than adversarial, and prompt medical care lessens future harm.

Becky Gernon, MD of Blue Cross and Blue Shield of Kansas City and Peggy DeCarlis, recently retired from New Directions Behavioral Health, report on integrating behavioral health into primary care clinics and their recently published results showing 10.8% population health cost savings. Deployed through Blue KC's Spira Care Clinics, the project also showed reduction in physician burnout which Gernon attributes in part to the integrated behavioral health clinicians helping with medically complex patients.

Medical professional liability insurance premiums may rise and cyber security may become a factor.  Leading MPL underwriting expert Nat Cross, Beazley Group’s Healthcare Leader, forecasts premium trends and explains the drivers.  Cyber security may be an emerging MPL risk as internet-connected biomedical devices such as infusion pumps become subject to cyber-attacks.  Compliance and information security expert Jon Moore explains this emerging MPL risk. Interview underwriters include Cayman International Insurance, host of the Cayman Captive Forum, Clearwater, a provider of cyber risk management solutions, and EBSCO Health, an evidence-based provider of clinical decision support solutions.

Michelle Johns, Chief Risk Officer of IU Health and Bob Chaput, Executive Chairman of Clearwater discuss their innovative work benchmarking risk within and between large health systems.  They also explore why insurance captives have become so strategically important to patient safety innovation. 

Mike Hakimian explains a hardening market in medical malpractice insurance.  He describes current conditions and evidence suggesting premiums will rise. Brian Alper, MD describes patient decision aids which could elevate patient satisfaction and relieve some pressure insurance premiums by reducing the likelihood of claims. Recorded at the Cayman Captive Forum hosted by the Insurance Managers Association of Cayman.    

Dr. Jim Stefansic of Raiven Healthcare describes how payers and providers can use artificial intelligence algorithms to optimize treatment plans, medical spending and patient outcomes. Raiven’s AI algorithms, based on a large patient database from Centerstone and AI technology from Indiana University, assists providers in making treatment decisions and then uses resulting patient outcomes in a continuous learning cycle.

Wilmington Health CEO Jeff James describes how they help large employers achieve better cost and quality in self-funded employee health plans.  Recorded as part of a series underwritten by the North Carolina Medical Group Management Association and Mako Medical Laboratories.

Mako Medical Laboratories Founder & CEO Chad Price describes how his company came to serving physicians and take on LabCorp and Quest in the $75 billion lab services industry. MGMA members may receive CEU credit by watching, listening or reading the full interview.