Creating a New Healthcare

“… If it’s garbage in, it’s gonna be garbage out.” Boy, am I familiar with that truth. And it prevails across so many areas of healthcare, but maybe none more so than the data we generate and our ability to distill something useful and usable out of that data. 

On this episode of Creating a New Healthcare, I talk with Dr. Mitesh Rao, the Founder and CEO of OMNY Health. Dr. Rao is a Board-Certified Emergency Medicine Physician and Assistant Professor of Emergency Medicine at Stanford. He founded OMNY to revolutionize how healthcare organizations collaborate and advance science through the common language of data. Integrating real-world data from direct partnerships with IDNs, AMCs, specialty networks, and other providers across the US, OMNY Health’s proprietary platform provides the foundation for stakeholders across the healthcare ecosystem to compliantly and efficiently share data, as well as pursue broader data-driven partnerships. 

The core themes seem simple but are somehow still roadblocks:

Dr. Rao and his colleagues at OMNY are working to combat these challenges by scaling the  harmonization of healthcare data across providers, payers, and other stakeholders to create a platform built specifically for collaboration and innovation. It’s a noble goal and one that could prove critically useful in advancing equity, improving patient safety, and powering research on new care pathways and treatment approaches. But the roadblocks won’t disappear on their own, so there’s definitely more work to do.

On the show today is Mike Murphy, a distinguished growth leader with over 30 years experience as a C-level executive, specializing in healthcare and insurance. Mike’s expertise spans M&A due diligence, post-merger integration, and turnaround strategies, consistently improving earnings and gross profit. Examples of some of his significant achievements include propelling a new insurance division from a cold start to $435M in revenues and $22M in EBITDA in four years and guiding successful product launches, most notably UnitedHealthcare’s inaugural national dental product portfolio. His leadership, strategic acumen, and deep industry knowledge make him a transformative force in high-performance teams and change management.

Our conversation took a lot of twists and turns today, but in Mike’s words, here’s the 30,000 foot view. We covered the following:

I so enjoyed talking to Mike. His approach is down-to-earth, practical, and incredibly humanistic. There are so many organizations in healthcare today that could benefit from “looking under the hood”, as Mike says, ask the tough questions, and then crowd source the solutions from all levels of the organization, not just the C-suite. This is a must-listen episode about the current business of healthcare from someone who’s seen it from all sides.

When your guest starts a business in healthcare with the adage “Go where the competition isn’t”, you know it’s going to be an interesting conversation.

On the podcast today, I’m honored to have Dan McDonald, Founder and CEO of 86Borders and Lauren Barca, VP of Quality for 86Borders. Dan co-founded the company in 2014 with a clear mission: to revolutionize communication dynamics within and beyond corporate confines.

By 2018, he catalyzed a strategic pivot, channeling the company’s energy exclusively into healthcare. As a former nurse, Lauren is deeply passionate about enhancing the quality of care for economically disadvantaged and medically underserved populations, a passion reflected in the “empathy first” model they use to train care coordinators.

86Borders works with health plans to offer a service and a SaaS platform that puts the member at the center of the healthcare ecosystem. Their platform logs every encounter with a member, and connects members with the same care coordinator every time so that a trusting relationship can be built. Care coordinators help address social determinants of health to remove the day-to-day barriers that get in the way of preventive care and chronic care management. 

With this model, 86Borders is highly successful at improving quality metrics like medication adherence and reducing expensive healthcare utilization like ER or urgent care visits for the health plan, but they prioritize an even more important outcome. Human-to-human connection. 

This type of service is invaluable for our most under-resourced populations, but it is not only their work that has me so impressed. It is also their approach to leadership. It’s clear that Dan and Lauren care not only about the wellbeing of their members, but also about the wellbeing of their team. That is the type of humanistic leadership we need more of.

To find out more, visit https://www.86borders.com/

Zack Cooper is a health economist whose work is focused on producing data-driven scholarship that can inform public policy. He currently serves as an Associate Professor of Public Health and Associate Professor of Economics at Yale University in addition to being the Director of Health Policy at Yale’s Tobin Center for Economic Policy. Zack’s research has been published in leading economics and medical journals including the Quarterly Journal of Economics and the New England Journal of Medicine and presented at the White House, the Department of Justice, the Federal Trade Commission, and the Department of Health and Human Services.

My first reaction after reading Zack’s most recent article, “Who Pays for Rising Healthcare Prices?: Evidence from Hospital Mergers”, was – how is this information not all over the news??  Most people are aware of the untenable costs of healthcare but I doubt anyone is aware of what’s revealed in this most recent study.

Zack first points out that the biggest driver of rising healthcare costs is increasing hospital prices. But then he goes on to discuss that when hospital prices rise, it leads to higher insurance premiums for local employers. Employers then have to either reduce wages or lay off workers, and those most likely to be affected are those making the least. This conversation highlights the stark contrast between the healthcare experience of those earning well over $100,000 compared to the majority of working Americans. I suspect that most healthcare executives are insulated from the real-world impacts of high healthcare costs on working families. We must do better. And that starts with being fully educated on the topic, so please join us for this enlightening and critically important conversation. 

Our guest today is Naama Stauber Breckler, Co-Founder and CEO of Better Health, a medical supply and support platform that bundles peer coaching, education, and delivery of medical supplies to help people manage their chronic conditions at home. Naama is a true humanistic rebel leader dedicating her entire entrepreneurial journey to creating human-centric solutions that cater to underserved populations. Naama started her career as a software engineer in the Israeli military. She holds an MBA from Stanford GSB and a B.Sc in computer science from MTA, Israel.

Better Health is a fascinating model that pairs something we typically see as mundane and transactional, the acquisition of medical supplies for patients with chronic conditions, with a real opportunity to connect with them on a personal and humanistic level. Through their services, Better Health aims to:

During our discussion, we talk about real-life examples of how the peer-to-peer relationships built into their model have helped members identify ways to utilize certain or different medical supplies to not only improve their health, but also their quality of life.   

As with many of the #HRL’s we talk with, Naama’s personal and familial story of resilience has served as a guiding light in her work. She graciously shares the story of her grandmother, a Holocaust survivor, and how she risked her life to help others. 

Better Health and Naama herself are such pivotal examples of how we have an opportunity to humanize every aspect of healthcare, even down to medical supplies. I encourage you to take a listen. I promise you will be inspired by this story. 

To find out more about Better Health, please visit their website at www.joinbetter.com.

Our expert guest on this episode is Brian Esterly, who was appointed CEO of TimeDoc Health in August 2023. Brian brings more than 25 years of healthcare leadership experience to this role. Prior to this he served as the Chief Growth and Strategy officer at Centria Healthcare. 

Working with healthcare systems, primary care providers, FQHC’s and Medicare Advantage plans, TimeDoc Health provides virtual care management services primarily targeting the Medicare population. Their three main services include:

During our discussion, Brian made it clear that TimeDoc Health serves as a seamless extension of the primary care provider and their team. In that role, however, they can help address some major challenges within our healthcare system. Brian shares some examples of how they provide chronic care management and behavioral healthcare services in between provider appointments, relieving the provider group from having to manage that in-between visit care. Additionally, by screening for and addressing quality care gaps and social determinants of health gaps, their services improve patient care outcomes. Finally, their outcome data suggests utilization of TimeDoc reduces ED visits and readmissions, thereby improving quality scores, and providing health insurers and Medicare Advantage plans with the opportunity to improve their STARS ratings. 

From a patient care perspective, chronic disease management, particularly for our older Americans, is a growing challenge, especially as the number of primary care providers continues to decline. Services like TimeDoc Health could literally be a lifeline to address some of the most common and insipid conditions plaguing Seniors. 

To find out more about TimeDoc’s services, please visit their website at https://timedochealth.com/. 

Ann Somers is the Director of Health Care at the Clayton Christensen Institute. Her research focuses on drivers of health (a.k.a. social determinants of health), maternal health, and the pathways to improve them. Ann Somers holds an MSPH in Health Policy and Management from UNC-Chapel Hill and a BS in Commerce from the University of Virginia. 

Last year, she authored a report for the Clayton Christensen Institute on the state of maternal health in the United States. The full report can be found here. 

In our discussion today, Ann Somers talks about the alarming findings from that report including the systemic barriers that are contributing to poor maternal health outcomes. She explains the need for a shift from viewing maternal health as an individual problem to a systemic issue that requires collective solutions, rather than relying on individual self-care or asking for help.

Our focus with this podcast is both to bring awareness to important topics like this, but also to offer tangible, real ways that we can address the problem. So what can we do? Ann Somers explains the potential for employers to play a significant role in creating supportive systems and policies for working mothers, such as flexible work hours, shortened work weeks, and on-site childcare. But more globally, she impresses on us that we must catalyze a societal shift towards a culture of respect for caregiving that will push the implementation and standardization of policies that support working mothers and other caregivers.

Mothers are the backbone of our families, communities, and societies. And yet, we are not putting our money, resources, or attention towards supporting them. This issue needs to be discussed broadly, and the solutions Ann Somers shares need to be funded and deployed.

Addition: Recently, the U.S. Surgeon General published a report entitled Parents Under Pressure talking about the Mental Health and Well-Being of parents in the United States. We asked Ann Somers to comment on their findings and recommendations. Her thoughts are also included in this episode. A full version of the report can be found here. 

Resources:

Moms First

Chamber of Mothers

Piali De, PhD is a talented physicist who started her career developing artificial intelligence systems for the United States defense departments. In 2010, Dr. De founded Senscio Systems, a digital health company redefining chronic care management with the nation’s first AI-powered home-to-clinic digital therapeutics platform called Ibis. Senscio’s Ibis platform is being used by leading ACO’s and was named one of the “10 Most Promising Population Health Management Solution Providers – 2017” by “Healthcare Tech Outlook” magazine. 

In this interview, we discuss the personal journey that motivated Dr. De to launch Senscio Systems and how she adapted her AI expertise inr defense systems to healthcare with the creation of Ibis. Highlights from this episode include:

To learn more about Senscio Systems and Ibis, please visit www.sensciosystems.com. 

Money. Not always the most inspiring or sexiest topic in healthcare, but one that is critical if we are going to change the system for the better. Today on the podcast, we welcome David Kirshner, Managing Partner at LogicSource, to talk about their approach to helping health systems improve efficiency and decrease costs so they can redirect funds where it’s needed most…clinical care. David’s background is impressive. As the former CFO of several major healthcare systems, David is credited with engineering the remarkable financial turnaround for Boston Children’s Hospital, the primary pediatric teaching affiliate of Harvard Medical School, where he spent nearly fifteen years as the Senior Vice President, Treasurer, and Chief Financial Officer. 

In this conversation, we discuss:

This may seem like a nuts and bolts episode to those in direct clinical care, but David and LogicSource’s focus on building trust and delivering measurable financial impact is an important example of how humanistic change is needed on every level of the health organization. 

We’re airing this interview on the podcast as a means of introducing you to the type of conversations you can hear over on the #HRL, our new membership platform. To learn more, go to zeevhealth.com/membership.