Inside Angle

Employers are fed up with the current health care system. They recognize that high quality care means a healthier workforce and are looking to hospitals, health systems and health plans to move faster on health reform. Elizabeth Mitchell, president and CEO of the Purchaser Business Group on Health, discusses her organization's innovative work redesigning care delivery and driving affordability.

Why are health care costs so much higher in the U.S. compared with other countries? In his new book "Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win," investigative reporter and author Marshall Allen shares stories from real people dealing with high medical bills and details concrete steps for how individuals and employers can challenge the system.

Care guidelines and protocols are designed to address discreet aspects of health, not necessarily the complexities of the human condition. When Dr. Elvin Geng of Washington University in St. Louis realized standard rules and practice were preventing him from addressing a complicated issue for a patient, he recognized the situation called for more discretionary decision making, evidence of what our second guest, author Michael Lipsky, discusses in his seminal book "The Street-Level Bureaucrat." Find out how this concept relates to health care and how it is now shaping the way care is delivered.

At its core, health care is fundamentally about relationships. Yet, over the last several decades, care delivery has evolved into a transactional model reinforced by EHR tick boxes, shift work and the notion that clinicians are interchangeable. Dr. Christine Sinsky, Vice President for the American Medical Association, discusses her research on physician burnout and the connection between better patient outcomes and patient-clinician relationships based on trust and continuity.

Our nation's health care delivery system falls short when it comes to disease prevention and health promotion. Can we embrace the idea of health "holism" -- treating the whole person, not just the physical symptoms of a disease -- into our modern care delivery and payment systems? In this episode, Wayne Jonas, MD, describes how to bring primary care back to the forefront of the U.S. health care model.

How do we provide physicians with the right resources to meet the needs of the people they serve? What will it take to ensure the best possible care when social factors hinder successful outcomes? In this episode, Dr. Bob Phillips, Executive Director of The Center for Professionalism & Value in Health Care with the American Board of Family Medicine, discusses the value of using community vital signs to identify at-risk populations, and advocates for payment redesign that accounts for social determinants of health (SDoH), which would enable more resources to meet the intensity of work for people with greater needs.

Among the many lessons learned from the COVID-19 pandemic, one thing is clear: Whether it's gaps in our public health system or obstacles to adoption of telemedicine, the way we finance health care in the U.S. doesn't always match what we want from health care. Rebecca Etz, Ph.D., a cultural anthropologist with Virginia Commonwealth University and a leading expert on integrating mental and behavioral health into primary care practice, joins the Inside Angle podcast to discuss how outdated health care finance policies don't necessarily help people be well, prevent disease or avoid a hospital stay.

What might a better value-based payment model look like and what tools do we need in order to create that model? Dr. Gordon Moore discusses a vision for the future of value-based care with Kenton Johnston, PhD, MPH, dissecting the topics of risk adjustment, quality measures, accountable care organizations and more.

How can small physician practices be supported in their work? In what ways can practices grow their voice to get the attention of payers and ultimately realize the goals of value-based care? In this episode, Dr. Jen Brull discusses taking her practice in Plainville Kansas on a journey of continual improvement that led her to a national role as vice president of clinical engagement for Aledade, a company that helps geographically disparate primary care practices form accountable care organizations and deliver successful value-based care.

Better patient outcomes depend on high quality primary care, but primary care providers often don't get the data they need to fully understand the unique needs of their patients. In this episode, Beth Bortz, president and CEO of the Virginia Center for Health Innovation, explores how the right data in the hands of PCPs can move the needle on payment and delivery system reform.