In this episode of Relentless Health Value, Stacey Richter summarizes 4 core concepts for getting highest-value healthcare and we hear from 15 experts who weigh in on the following concepts:
(1) "Buy healthcare," not insurance, by focusing on unit prices and avoiding administrative extraction like spread pricing and layered fees, illustrated by examples from Jonathan Baran, Cynthia Fisher, Mark Newman, and Justin Leader;
(2) avoid the "myth of less expensive care," emphasizing that price often doesn't correlate with quality and that better, safer care can cost less, with support from Elizabeth Mitchell, Dr. Sam Flanders, Shane Cerone, Jerry DiMaso, and Ivana Krajcinovic, plus transparency-file rate disparities;
(3) consider direct contracting and collaboration between plan sponsors and clinicians (and pharmacies), including centers of excellence, to reduce middlemen and align incentives, with clips from Krajcinovic, Ryan Jacobs, Adam Stavisky, and Ryan Wells; and
4) buy true value—outcomes over cost—measured across the care journey and grounded in patient goals, with Dr. Mick Connors, Dr. Siva, and Dr. Kenny Cole.
=== LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP507
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Featured Experts by Core Concept
Concept 1: Buy Healthcare, Not Insurance
Jonathan Baran, CEO, Self Fund Health (EP483)
Cynthia Fisher, founder and chairman, PatientRightsAdvocate.org; co-founder and chairman of Power to the Patients (EP457)
Mark Newman, co-founder and CEO, Nomi Health (EP496)
Justin Leader, founder and CEO, BenefitsDNA (EP433)
Concept 2: Avoid the Myth of Less Expensive Healthcare
Elizabeth Mitchell, president and CEO, Purchaser Business Group on Health (EP436)
Sam Flanders, MD, senior advisor, Kada Health (EP490)
Shane Cerone, CEO, Kada Health (EP492)
Jerry DiMaso, co-founder and CEO, Payerset (EP506)
Ivana Krajcinovic, PhD, former vice president for healthcare delivery (retired), UNITE HERE HEALTH (EP501)
Concept 3: Consider Direct Contracting
Ivana Krajcinovic, PhD, former vice president for healthcare delivery (retired), UNITE HERE HEALTH (EP501)
Suhas Gondi, MD, MBA, chief medical officer, HealthStrategy (EP404)
Ryan Jacobs, senior vice president of health plan strategy and partnerships, Marathon Health (EP504)
Komal Bajaj, MD, professor of obstetrics and gynecology, Albert Einstein College of Medicine (EP458)
Adam Stavisky, business advisor, Stavisky LLC (EP503)
Cristin Dickerson, MD, founder and CEO, Green Imaging (EP485)
Stan Schwartz, MD, chief medical officer, ZERO.health (EP486)
Leo Spector, MD, MBA, CEO, OrthoCarolina (EP503)
Ryan Wells, founder and CEO, Health Here (EP503)
Concept 4: Buy the Highest-Value Healthcare
Mick Connors, MD, pediatric emergency medicine physician, Dayton Children's Hospital (EP495)
Ahilan Sivagenesan, MD, neurosurgeon, Hospital for Special Surgery; Head of Quality and Value, Mishe Health (EP505)
Kenny Cole, MD, System VP, Clinical Improvement, Ochsner Health (EP473)
00:00 Introduction to this episode and guests.
01:38 The four core concepts to buy or deliver highest-value healthcare: a summary.
06:01 An exciting show announcement.
07:32 Core Concept 1: Why buy highest-value healthcare, not "best" coverage?
11:28 Core Concept 2: Will employers fall victim to the myth of inexpensive care?
13:00 Why better-quality care vs. more affordable care is a false choice.
17:09 Core Concept 3: Direct contracting.
17:58 Why demand curve matters in healthcare cost.
22:08 How Centers of Excellence play into all of this.
22:54 Core Concept 4: How do you conceive of and buy high-value healthcare?
23:48 The value equation in healthcare.
25:35 What is value?
28:20 What whole-person care looks like.
30:24 Relentless Health Value Chatbot sneak peek announcement.
32:14 Coming up: looking at the episodes ahead.