B-Time with Beth Bierbower

The term “payvider” is being used with increasing frequency.  A “payvider” is a provider that also serves as the health plan, taking on risk directly from employers, Medicare, or state Medicaid agencies.  Banner Health is one such payvider.  Founded in 1999 as the result of a merger, Banner Health is headquartered in Phoenix, AZ and owns and operates thirty hospitals including three academic medical centers across six states.   Over the years, Banner Health has morphed into a fully integrated delivery system with its own network and medical groups.  Banner Health offers its own Medicare Advantage, commercial and Medicaid Plans, but also has a joint venture with Aetna and through that JV, has competing plans. 

 

With us today is Donna Sickler the Division CFO for Insurance Operations at Banner Health.  Donna will help us understand the advantages and challenges of being an Integrated Delivery System and an insurer, and she’ll walk us through how the organization manages the relationship with a JV partner which is also a competitor.

Show notes:  Book: The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race by Walter Isaacson, Kathy Mazur, et al.

Many of our guests on B-Time are focused exclusively on a B2B model.  Today, we are changing it up a bit and are focusing on the direct to consumer model.  Trillions of dollars are spend out of pocket by consumers on health and wellness goods and services. 

 

One company, Intrinsic, is taking full advantage of this consumer spend and is buying smaller consumer wellness companies to become a Brand powerhouse.  With us is Yadin Shemmer, the founder and CEO of Intrinsic and he’ll share his view of the market and what he sees as emerging trends in this space.  Yadin has a bachelors from the University of Pennsylvania and an MBA from the London Business School. 

I am excited for Yadin to share his thoughts because as we all know, consumer behavior eventually makes it way into the more traditional areas of healthcare.  Over time some of this direct spend will find its way into health plan coverage. 

Show Notes: Favorite Book: What You Do Is Who You Are By Ben Horowitz; The Attributes: 25 Hidden Drivers of Optimal Performance by Rich Diviney.

Our guest today needs no introduction to most of you.  With us is Sam Glick, Global Leader of the Health & Life Sciences Practice at Oliver Wyman.  Many of us have spent time with Sam and his colleagues discussing everything from industry opportunities and challenges to new business models and more.  Today Sam is going to share his thoughts on where the industry is headed and how we, as leaders, should be thinking about these changes and their potential impact on our businesses.

Sam has been with Oliver Wyman for 16 years and works with health plans, providers, biotech manufacturers and more and has spoken at all the top industry conferences.  He is an economist by training.  He was raised on a citrus farm and his newest side hustle is co-owner along with his wife Emily (who really deserves all the credit) of the charming Stavrand Inn located in California wine country’s Russian River Valley. 

Show Notes:  Favorite Books:  You’re Not Listening by Kate Murphy; Favorite Magazine: McSweeney’s (specifically Issue #65 Titled “Plundering”); Favorite Podcasts:  Post Reports from The Washington Post. 

The pandemic placed a spotlight on employee wellbeing.  Many employees have been under increased stress and duress over the last two years.  In survey after survey, employers are sharing that they are altering their benefits programs to include services that move beyond traditional physical and mental health and into total wellbeing. 

 

As with any market shift, there are players including new market entrants ready to fill in the gaps.  One such player is SoulBeing which offers complementary and alternative medicine services through a network of providers.  Their belief is that the divide between tradition and complementary medicine is closing and that many people, including providers and consumers alike, are focused on integrative medicine.

 

With us today to dive deeper into integrative medicine is Colleen Kavanagh, CEO of SoulBeing.  Colleen will share SoulBeing’s vision and how it is creating momentum around the need for integrated medicine.  Prior to joining SoulBeing, Colleen spent 9 years working in GE’s healthcare division.

 

Show notes:  Favorite Books: The Blue Zones By Dan Buettner  The Blue Zones Kitchen by Dan Buettner, Better Than Before by Gretchen Rubin, Atomic Habits by James Clear.    Favorite Podcasts:  B-Time with Beth Bierbower, The Meditative Story Podcast, Willis Towers Watson Cure for the Common Co.

 

With us today is the co-founder and COO of Equip Health –  Dr. Erin Parks.  Erin and her co-founder – Kristina Saffron, have created a home-based program (a real departure from the very traditional facility-based programs) to help people recover from eating disorders.  Today we’ll learn more about these devasting issues and how the Equip Health team is changing the treatment delivery and recovery in this area.

 

Show Notes:  Favorite Book:  Essentialism by GregMcKeown.  Podcasts:  The Essentialism Podcast; Work/Life with Adam Grant; Startup from Gimlet Media, In Depth from First Round Review.   Contact the team at Equip Health in one of the following ways:

• B: https://www.facebook.com/joinequip
• Twitter: @joinequip and @erinparksphd
• Instagram: @equiphealth and @drerinparks
• Linked In: @Equip (https://www.linkedin.com/company/equip-behavioral-health) and @erinparksphd

Susan Dentzer is one of the nation’s most respected health policy experts and thought leaders and is the Senior Policy Fellow at the Robert J. Margolis Center for Health Policy at Duke University.  Based in Washington, DC, she works on a range of health policy issues including health system transformation, the use of artificial intelligence and related technologies in health care, biopharmaceuticals policy, and improving cancer care as well as maternity and infant care. She is the editor and lead author of the book "Health Care Without Walls: A Roadmap for Reinventing U.S. Health Care."  

Show notes:  Book:  Uncontrolled Spread by Scott Gottlieb.  Podcasts: Hacks on Tap. 

Strategic Business Transformation: The 7 Deadly Sins To Overcome by Mohan Nair is a guidebook to help your business create a secret sauce for longer-term success.  Nair has a lot of business experience in Innovation and Operations.  He takes his direct experience and combines it with pieces of business strategy from well-known business gurus to present tangible and actionable tactics for success.  Nair uses examples of textbook companies like Southwest Airlines but manages to add some insights that may have been overlooked by others.  

 

Here is a quick list of the 7 deadly sins:

 

1. Ignoring the new principles of business transformation
2. Driving without a cause
3. Missing market momentum
4. Ignoring the two orders of value
5. Overlooking transformational servant leadership
6. Mistaking capability for strategic competence
7. Expecting flawless execution without a performance platform

At its core, Nair has given leaders a playbook to reference repeatedly as they face continuous change in the marketplace.  A good add to your bookshelf.

With me is Daryl Risinger, President & Cofounder of Soda Health, a healthcare technology company focused on building solutions that eliminate health inequities.  The team at Soda Health work with Health Plans to turn ideas around SDOH benefits into reality.  Daryl will share with us some learnings and insights around SDOH and how his company is making a difference in this area.

Show Notes: Boos: Little Bets: How Breakthrough Ideas Emerge From Small Discoveries By Peter Sims.  Podcasts: B-Time with Beth Bierbower; Hidden Brain with Shankar Vedantam; UnSILOed with Greg LaBlanc.

Pramod John is the CEO of VIVIO, a company that has built an autonomous solution that allows employers and other healthcare payers to take control over their specialty drug spend.   VIVIO is a Public Benefit Corporation that operates with a transparent business model.  Their only form of compensation is an administration fee allowing them to focus just on the question of cost benefit at the individual patient level. We’ll hear how VIVIO’s approach differs from that of the traditional PBM and the impact this approach has on both health outcomes and costs.

Show notes:  Suggested Books:  Talking To Strangers by Malcolm Gladwell; Uncaring: How The Culture Of Medicine Kills Doctors And Patients by Robert Pearl.

 Health plans and providers alike are focused on population health and ensuring that members are getting the care and support they need to keep chronic conditions in check.  However, often, these entities encounter challenges in obtaining actionable data or insights that allow the organization to intervene in the care process earlier.

 

Myia Health is tackling this issue and helping both providers and health plans better manage individuals with chronic conditions.  With us is Myia’s CEO and Co-founder, Simon MacGibbon.  Simon has a background in strategy, CRM technology, and large-scale digital transformations.  He has worked for companies such as McKinsey and IBM and he was co-founding Partner of the Boston Consulting Group’s Digital Ventures business.

 

Show Notes:  Books:  Crossing the Chasm by Geoffrey Moore; What You Do Is Who You Are: How To Create Your Business Culture by Ben Horowitz; Competing Against Luck by Professor Clay Christensen.  Podcasts:  Relentless HealthValue Podcast; Dylan Johnson – cyclist – on YouTube.