Ep 110 – Defeating Political Sectarianism to Achieve Analytics-Based Value Innovation, with Michael Millenson

What this episode covers

As we talk about the current zeitgeist moving us towards value and equity, we also have to think about how polarized our country is politically. Democrats and Republicans live in separate worlds, or “echo chambers,” with each side prone to bias or “motivated reasoning.” This has created an existential threat of tribalism where partisanship has turned Americans against one another.  The term that best describes our strife is “political sectarianism,” or the tendency of political groups to align on the basis of moralized identities rather than shared ideas or policy preferences.  However, the promise of value-based care is something that we should all agree on in a bipartisan way.  The Race to Value is both an economic and a moral imperative, and it can be actualized through relationship-based care, collaborative health models, and the power of advanced analytics. In this week’s episode, we interview Michael L. Millenson, an internationally recognized expert on making American health care better, safer and more patient-centered. As a leading expert on health policy, quality improvement, and patient-centered care, he provides a deeply informed and unfiltered perspective on how to defeat political sectarianism to achieve analytics-based value innovation.  This intellectual conversation leaves nothing unsaid and will provide you with an enhanced understanding of the political challenges of value transformation and how analytics will drive collaborative health in the Information Age. Episode Bookmarks: 01:30 Introduction to Michael Millenson 03:30 The “Race to Value” — is this a revolution? 06:00 “Value-based care is the ethically right thing to do.” 06:45 Confusion about value in health. (Public perception equates the term “value-based care” to fast food.) 07:30 Referencing Walter McClure, Ph.D and the ‘Buy Right’ strategy of health care reform 08:00 “Value-based care is the most important transformation of American medicine in our lifetimes.” 10:30 The dilemma of VBC (you must first recognize that poor quality exists currently to realize the potential for value) 12:00 Political sectarianism – how tribalism and entrenched interests hinder health policy 13:30 Winners and Losers in health policy reform and how “motivated losers” fight back! 15:30 How social media and suspicion stifles value-based payment innovation and the promise of bipartisan reform 16:30 Authentic healthcare leaders realize the need for value (there is hope!) 18:30 How do you engage providers to root out clinical variation and unnecessary care? 20:00 The need for Patient Safety and Quality Improvement in Healthcare 21:00 Referencing Michael’s book, “Demanding Medical Excellence: Doctors and Accountability for the Information Age” 22:00 “Hospitals often do not do what it takes to be as safe as possible because there is no return on investment.” 24:30 Referencing Michael’s article “Why We Still Kill Patients: Invisibility, Inertia, and Income” 26:00 The moral challenges of bureaucratic medicine and misaligned economics and how it creates preventable harm 29:00 The disconnect between Cost and Quality 31:00 The ethics of value-based care and the travesty of physicians not speaking up (Referencing Michael’s article “The Silence”) 33:30 The promise of “Analytics” in the future of healthcare (and the similarities to the “Plastics” scene in The Graduate) 34:30 Enhancing clinical outcomes through semantic interoperability, AI, and predictive analytics 37:30 The misperception that population health analytics will impinge on clinical autonomy 39:30 Smart phone technologies and “proactive benefits” to eng...