EP316: Unexpectedly Talking About Employers, With David Carmouche, MD, From Ochsner, a Large Health System

In Episode 316, Stacey Richter talks with David Carmouche, MD, executive vice president of value-based care and network operations at Ochsner Health, about what a large provider organization actually wants and needs from commercial payers and self-insured employers. WHAT YOU'LL LEARN ✅ The four things that have to come together for meaningful value-based care creation ✅ Why payer-provider-employer partnerships may be the most important collaborations for value ✅ Why health systems want to grow their commercial market share ✅ Whether competition among health systems is moving upstream ✅ Why collaboration skills are essential to any organization's transition away from fee-for-service WHY THIS MATTERS Dr. Carmouche flips the usual script on this show: instead of employers explaining what they need from providers, a large health system explains what it needs from commercial payers and employers to make value-based care work. His four ingredients — willingness to change, the ability to affect payment, access to data, and some control over steering patients — put employers and payers squarely at the center of provider transformation. The broader lesson applies well beyond Ochsner: no organization can transition to value without knowing how to collaborate and share the rewards with everyone else in the ecosystem. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page 🔗 Healthcare Industry Acronyms and Terms ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction. 04:15 Who needs to be working together to create value-based success? 04:31 "I think the most important partnerships that are likely to lead to value are those between payers or purchasers … and providers." 04:45 What four things have to come together for meaningful value? 06:02 "We're focusing specifically on payer employers today. We think that's where there's the biggest opportunity." 07:23 What's the overarching reason for health systems to want to grow their commercial market share? 14:00 Is the competition moving upstream? 16:20 "In all honesty, we're competing for pieces of the business." 16:23 What's the ultimate competition? 18:36 "There is a consumer experience that is available inside these … collaborative efforts." 20:53 "We really haven't changed the paradigm of benefit design as it comes to drugs."