INBW21: Different Views on How to Drive Value in Health Care—Disruption vs Incrementalism

Today's episode features the following guests: Ross Bjella, MBA, is the founder and CEO of Alithias, a patient advocacy and population health analytics company serving self-insured employers, insurance companies, networks, and third-party administrators. (EP163) John Lynn is the founder of the HealthcareScene.com network, which currently consists of 10 blogs containing over 11,000 articles, with John having written over half of the articles himself. These EMR and health care IT-related articles have been viewed over 18 million times. (EP124/171) Gary Frazier is a disrupter and founder of OM Healthcare, Inc., a health care technology start-up established in 2015. He has over 18 years of business development experience and over 13 years of executive-level hospital and health system strategy expertise. (EP168) David Smith is from Avia and founder of Third Horizon Solutions. He is chief development officer, where he is responsible for expanding the firm's influence in the health care market. (EP135) Alex Jung is global strategist at Ernst and Young. She is a partner/managing director in Parthenon-EY, where she works primarily on growth strategy projects. (EP189) Joe Murad is president and CEO at Pokitdoc. He most recently served as managing director and head of individual exchange solutions for Willis Towers Watson, where he was responsible for the largest private health insurance exchange. (EP183) Frazer Buntin is president of value-based services from Evolent Health. He has worked in strategic and operations leadership positions for the past 17 years. He is responsible for managing the operational performance of Evolent Health's partners. (EP202) A.G. Breitenstein is a partner at Optum Ventures. She was most recently the co-founder and chief product officer at Humedica, one of the earliest big-data analytics companies in health care. (EP207) 02:21 Ross Bjella's short list—5 action items—for employers to get the most for their money out of the health care system. 03:05 Take control of employer health care costs by gaining access to their health care data. 03:18 Offer an incentive-based plan design. 03:32 Create virtual narrow networks. 03:46 Offer live care navigators. 04:10 The importance of controlling health care costs. 04:43 The emotional component behind what an employer must do to maximize the value of their health care. 05:10 Disruptive vs incremental change, and what's really happening in health care. 06:17 John Lynn of HealthcareScene.com, and why it's so tough for disrupters to break into the health care system. 07:26 The weird dynamic of the false market that is health care. 08:46 Health care regulations making it difficult to disrupt the market. 13:15 Gary Frazier's opinion on connecting value-based care and empowered patients. 15:20 What value-based care is really about. 16:17 David Smith elaborates on the problem with assuming empowered patients change health care. 18:21 Rational decision making and how that isn't always present in health care. 19:19 Alex Jung and the "messy middle" of the economic side of health care. 19:44 How the economic model, not the business model, of health care is broken. 21:36 "Is [this] necessary?" 22:13 Joe Murad and the "messy middle" in medical services pricing. 23:11 Frazier Buntin and where we are in the transition from fee for service to value-based care. 24:09 Is this change driven from the health system or major employers? 25:00 A.G. Breitenstein and the power of consumers en masse to move markets.