The Race to Value Podcast

Today Ashley sat down and talked with Dr. Edwin Estavez.  Edwin is the founder of the Altacair Foundation.   He Previously, served as Market President of Value Based Care at Prominence Health, a leading health care company that provides high quality, cost-effective care to diverse populations. Edwin, has over 30 years of experience in health care and higher education administration, risk management, and business development, with a PhD in Administration and an MSW. He is passionate about organizational transformation. From health care delivery and outcomes through value-based care tactics, to patient engagement programs, and care coordination models.  Join as we chat about the mission of Altacair, how he ensures the foundation stays true to its mission and vision, and the collaboration between Altacair and The Leavitt School of Health on the Accelerator Conference.

Altacair Foundation:  About Us – Altacair Foundation

Accelerator 2024:  https://www.eventbrite.com/e/accelerator2024-advancing-value-for-health-equity-tickets-951490021267?aff=oddtdtcreator

On today’s episode of The Race to Value, Ashley sits down with her colleague and friend, Dr. Melissa McLaren to discuss the importance of DEI in Healthcare and Education, and why building inclusivity is not just a buzzword, but something that is vital for the future.

Dr. McLaren is an Associate Dean and Academic Program Director at the Leavitt School of Health at Western Governors University.  She graduated with her BSN from The Ohio State University and her Doctor of Nursing Practice from the University of Minnesota. She received her master’s in management and leadership and an MBA from Western Governors University. Melissa and her family have engaged with lawmakers at the local and state level, as well as the Congressional LGBTQ Equality Caucus and the US Department of Health and Human Services in support of gender-affirming care and other LGBTQIA+ rights. They have spoken at state and national conferences to educate on the importance of family support when raising a transgender child. Dr. McLaren has partnered with organizations such as the Human Rights Campaign, Welcoming Schools, PFLAG, the ACLU, TransOhio, Equality Ohio, and many others to advocate for transgender youth.  Dr. McLaren currently serves on the Human Rights Campaign Parents for Transgender Equality National Council. She is a board officer for Equality Ohio and was an inaugural board member of her local LGBTQ+ organization. She is a member of the AACN DEI Leadership Network Communications Committee. She lives in Ohio with her husband of 20 years, 19-year old twins, 2 dogs, and several entitled cats.

Previous Episode: Ep 137 – Authentic Truth, Love, and Compassion: A Family’s Journey in Gender-Affirming Care, with Melissa and Conner McLaren – The Race to Value Podcast™

0:50: Defining Diversity and Inclusion

24:00: How diversity enriches the learning experiences in educations settings

On today’s episode of Race to Value, Ashley sits down with Mark Young, CEO of MyCHN to discuss how MyCHN launched a partnership with Wysa, an AI-driven mental health platform. We discuss how this collaboration aims to bolster the well-being and mental health of MyCHN’s Crisis and Behavioral Health patients by providing them access to Wysa’s innovative AI personal mental health companion at no cost.

Mark Young has worked in health services since 1989 and in community health since 1998. He has a Master’s in Business Administration from Trident University and a Master’s in Organization Management from the University of Phoenix. Over his career of 30-plus years, Mr. Young has worked with initiatives in the Rio Grande Valley, northeast Texas, and south Texas. Projects he has developed include outreach and engagement with colonia residents, residential treatment services for pregnant women and children, a tuberculosis intervention program, multiple chemical and alcohol dependency programs, behavioral health programs, and many outreach, education, and intervention projects.

Timestamps:

In today’s episode we chat with Geoffrey Roche, MPA. Geoffrey is the son of a nurse, future of work and education expert, diversity, equity, inclusion, and belonging advocate, champion for transforming health equity, and the host of the Ed Up Health Up podcast. His professional career includes over nine years in hospital administration as a strategic advisor to the President and CEO and department director of various departments, including Business Development and Planning, Government Affairs, Community Health, and Public Relations, for Lehigh Valley Hospital-Pocono. At Lebanon Valley College and Harrisburg University of Science and Technology he held senior leadership roles focused on strategic partnerships, organizational strategy, and business development. As Senior Vice President, Business & Workforce Development at Dignity Health Global Education, he led a diverse team focused on developing institutional relationships with leading health systems while simultaneously championing national conversations and initiatives to develop innovative diversity, equity, and inclusion solutions for the healthcare workforce.

“We expected to see a drop in enrollment before the pandemic for all healthcare programs. Why did Healthcare and Education not come together to combat this?” – Geoffrey Roche

“We have made bad decisions as a society when taking care of our healthcare workforce.” – Geoffrey Roche“We have five generations of people in the workforce, and this is the first time we have had this.” – Geoffrey Roche“As Leaders we need to harness the creativity and passion for all generations in the workforce.” – Geoffrey Roche

2:25: What is happening in the nursing workforce?

8:00: Millennials in the workforce and creating a culture that allows people to be the best they can be by creating a community and culture that allows them to thrive. This means they must be valued and heard.

Welcome back to Race to Value! In this episode we introduce our new host, Ashley Schwartz and discuss the rebranding of the Institute for Advancing Health Value and how we are expanding our work.

Today’s guest is Dr. Keith Smith (M.A., Ed.D., MBA, L.M., RMHC (ret.)) serves as the Executive Dean and Senior Vice President for Michael O. Leavitt School of Health at Western Governors University. He has strategic leadership experience in the business, nonprofit, and higher education sectors. His 26-year career in higher education comprises holding faculty, dean, vice-provost, vice-president, and now senior vice-president positions, at five universities prior to coming to WGU, inclusive of leading schools of health, business and IT, and arts and sciences. He has taught courses and given presentations domestically and internationally on leadership and organizational change, higher education innovation, and personal growth and development. Smith has supervised educational programs in Europe, the Middle East, and Asia. He has played a lead role in both regional and programmatic accreditations. His teams have developed a wide spread of programs from the microcredential through doctoral levels, as well as partnerships with business, government, military, and community colleges across the nation.

0:19: Introduction to Keith Smith, SVP of WGU’s Leavitt School of Health.

1:42:  Upcoming changes you can expect to see with the Institute for Advancing Health Value and it’s rebrand.

2:52:  Expansion in content- we will be continuing our work in Value Based Care, but are expanding into workforce, health equity, diversity and inclusion and workforce development.

4:50:  Health Equity Convening in the Rio Grande Valley of Texas.   This is a new area of work that we are continuing to expand and explore in different areas of the United States

8:00:   Discussion of the Programs that the Leavitt School of Health currently offers.

11:40: Discussion of WGU’s strategic pillars and how they will benefit the general public and the current workforce.

“We want to set a greater tone out in the Healthcare Industry, in terms of thought leaderships and opportunities to partner with those in different systems, and opportunities to be a resource center for them.”  – Dr. Keith Smith

“Educational Equity feeds into Health Equity.  By providing education to everyone, it opens the door for health equity and having trained, qualified and a culturally competent workforce that mirrors the diverse population that they are caring for.” – Ashley Schwartz

In this episode of the Race to Value podcast, we are sharing inspiration for a more optimistic future in the value transformation of our country. This week’s interview brings a message of hope, compassion, and human connection balanced with the business success of value-based care within a national leading health system.

Albert Einstein once said that “Only a life lived for others is a life worthwhile” and no one better captures that spirit of servant leadership than our guest this week. Philip Eaves is the President and CEO of Ascension Seton ACO | Ascension Seton Health Alliance and the Vice President of Population Health at Ascension Texas, and he is a leader in the value movement that you should know about. In this interview we focus on change management, leadership, and the human side of healthcare economics. Overseeing the value-based care strategy and operations for one of the largest clinically integrated networks in Texas, Philip is leading the ACO to outstanding success…and transforming the lives of people along the way.

Bookmarks:

01:30    The human side of healthcare economics – compassion is the currency; empathy is the language.

02:00    Introduction to Philip Eaves, President and CEO, Ascension Seton ACO and VP of Population Health, Ascension Texas

02:30    Ascension Seton ACO is the largest clinically integrated network in Texas with 3,600 providers with 300K value-based lives.

04:45    “Only a life lived for others is a life worthwhile” — Albert Einstein

05:30    Philip shares how a humble, faith-based upbringing fueled his ambition, work ethic, and compassion as a healthcare leader.

07:30    “Healthcare is about serving others.”

08:30    Occupational medicine as a stepping stone to value-based care.

09:45    Team-based care that enables providers so they can build meaningful patient relationships.

11:00    $24M in MSSP Shared Savings for 23,000 Medicare beneficiaries to achieve a top 7% performance ranking of all ACOs in the country (#32 out of #482).

12:45    Valuable partnerships with independent practices (e.g. Austin Regional Clinic, Capital Medical Clinic).

13:00    “Physician engagement is the overall key to ACO success.”

14:00    The impact of Annual Wellness Visits (AWVs) in practice transformation.

15:00    HCC recapture for documentation accuracy as an area of educational focus.

15:45    Centralized versus Embedded Care Management.

16:30    Analytical insights to drive high risk CM interventions.

17:15    Quality campaigns to close care gaps and improve population health outcomes.

18:00    Refining a Post-Acute Care network for optimal transitional care.

18:30    An after hours program as an effective ED diversion strategy.

20:00    Change management to improve team culture and reinvent the business model for VBC.

22:00    Phillip shares his experience leading an inflection point for the ACO business.

23:30    Applying the principles of the Kübler Ross Change Curve in organizational change.

24:30    Inspiration from John Kotter (“Leading Change”) – Leadership versus Management.

25:00    Recognizing the need for change in shifting a new strategic direction.

26:00    Communicating the vision and creating short-term wins.

26:45    New initiatives: a new ACO for early adopters, Medicare Advantage risk, and Direct-to-Employer partnerships.

28:00    Financial toxicity as a driver of Direct Contracting between employers and providers in value-based care.

30:00    Employer frustration with rising medical spend and the lack of solutions from their brokers.

30:45    Designing an ACO value proposition based on employer pain points.

31:00    Leveraging network adequacy and CIN care infrastructure for commercially insured populations.

32:45    PBM transparency to reduce extreme spending on pharmacy drugs.

34:00    Forging a new partnership with Signify/CVS to support practice transformation.

37:00    Accessing capital within a landscape where there is mass provider consolidation.

39:00    Financial distress in both the hospital and independent PCP sectors.

40:30    Determining cultural fit with potential partners to support capital needs.

43:00    Understanding the business model and risk track record of potential partners.

44:00    More information on the Signify/CVS partnership with Ascension Seton.

45:45    “Change is the law of life and those who look only to the past or present are certain to miss the future.” – John F. Kennedy

46:45    Parting thoughts on effective change management strategy and why we need to prioritize people in VBC business decisions.

48:45    Hope for the future. 😊

49:00    “The patient-provider-care team relationship is where the life change really occurs.”

The World Health Organization has declared climate change as “the greatest threat to global health in the 21st century.” As our planet grapples with the accelerating impacts of climate change, it is crucial that we adopt a climate lens in the value transformation of our healthcare industry. The repercussions of climate change extend far beyond environmental shifts; they manifest in various health issues, including challenges with clean water access, increased allergens, respiratory diseases, heat induced illnesses, and the proliferation of infectious diseases. It’s essential to acknowledge that while climate change affects everyone, the burden falls disproportionately on historically marginalized populations, highlighting the interconnectedness of climate impacts and social determinants of health in underserved communities.

In our pursuit of delivering safe, effective, and efficient care amid the climate crisis, we as healthcare leaders also bear the responsibility to address the substantial greenhouse gas emissions generated by the sector. Accounting for nearly one fifth of the U.S. gross domestic product, the healthcare industry possesses considerable purchasing power that can be harnessed to steer the nation toward cleaner energy and a low carbon supply chain. Beyond mitigating environmental harm, embracing preventive models of care and enhancing care quality that lowers excess utilization naturally aligns with lower carbon footprints. Value-based care, therefore, can become a powerful catalyst in propelling us toward a net zero carbon future that will build a sustainable, resilient future for our planet.

This week we are  interviewing Dr. Vivian Lee, a healthcare executive dedicated to the advancement of value-driven transformation in health and tackling climate change. Author of the acclaimed book,The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone, she is an Executive Fellow at Harvard Business School and Sr Lecturer at Harvard Med School. Prior to her Executive Fellowship at Harvard, she was the founding President of Verily Health Platforms, an Alphabet company combining a data-driven, people-first approach to precision health.  Dr. Lee is also a former health system CEO, medical school Dean and member of the National Academy of Medicine. She is regularly listed among Modern Healthcare’s Most Influential Clinical Executives as well as Modern Healthcare’s Most Influential People in Healthcare.

Episode Bookmarks:

01:30  The World Health Organization has declared climate change as “the greatest threat to global health in the 21st century.”

02:00  Climate change burden falls disproportionately on historically marginalized populations.

02:30  The responsibility to address the substantial greenhouse gas emissions generated by the healthcare sector.

03:00  Introduction to Vivian Lee, M.D.

04:30  One in four deaths can be attributed to preventable environmental causes…and climate change is exacerbating these risks.

06:00  Climate change resilience as a lens for value-based transformation.

06:45  The irrefutable scientific evidence about the unprecedented levels of carbon dioxide in our atmosphere.

07:00  What are health care leaders going to do about this?  (The need to manage the crisis through an empowered workforce.)

08:30  Exposed vulnerabilities in our supply chain as a complication to address climate-related crises.

09:00  The healthcare industry is responsible for 8-10% of the overall carbon footprint of the country (more than twice the #2 country!)

10:00  How do we decarbonize healthcare in order to “do no harm”?

11:45  Pollution from health care–associated energy use results in an estimated 405,000 disability-adjusted life years annually (a burden comparable to that of preventable medical errors).

12:30  The strong business case for health care organizations to reduce their carbon footprint.

13:00  Tax credits offered by the Inflation Reduction Act to decarbonize hospitals.

14:30  “Renewable energy actually costs less than fossil fuel energy.”

14:45  The Inflation Reduction Act will cover about 30% of the capital needed to invest in a renewable energy system.  (Add another 10% each for serving underserved regions and buying American made!)

15:00  ROI in the tens of millions for health systems going green! (“doing good and doing well”)

16:00  Non-productive energy use (e.g. ~60% of energy consumed by MRI and CTs occur when offices are closed on evenings and weekends!)

17:00  Putting high intensity imaging machines in idle mode would reduce the carbon footprint at a level equivalent to the NHS!

18:45  Kaiser Permanente became carbon neutral.  (Referencing Kathy Gerwig article co-written with Dr. Lee – “Decarbonizing Healthcare“)

19:30  Boston Medical Center reduced carbon emissions by more than 90%.

20:00  Resources: Kathy Gerwig’s book, “Greening Health Care: How Hospitals Can Heal the Planet”, the AHRQ Climate Change Primer, and Health Care Without Harm, Medical Society Consortium on Climate & Health

22:00  “There are so many opportunities for aligning with the decarbonization effort that are completely synergistic with value-based care.”

22:45  “Primary care has a much lower carbon footprint than high intensity tertiary or quaternary care.”

23:20  How can we utilize telehealth and telenursing to reduce patient and clinician transportation needs?

24:30  Referencing the influence of Don Berwick in medical waste elimination. (see article “Eliminating Waste in U.S. Health Care“)

25:30  “Eliminating health care waste will do good for the planet, do good for the communities, and actually make ourselves financially healthier as well…all in the spirit of bringing more value to our health care system.“

26:45 The AMA is encouraging physicians to assist in educating patients and the public on sustainable practices and to serve as role models in providing environmental sustainability (see AMA Code of Medical Ethics Opinion on Climate Change)

28:00  Dr. Lee discusses the role of clinicians to advocate for eco-friendly practices in patient communities.

30:00  An example of how a pediatrician conducts climate change counseling (see Dr. Andrew Lewandowski’s study)

34:00  The tech-based application of AI, data, and analytics to combat climate change through value-based care delivery.

35:45  Using a health meter to advise patients on how best to deal with extreme heat and bad air advisories.

37:00  Lowering the health care carbon footprint through supply chain optimization.

39:00  The need for more engineering and technical innovation to support innovation in climate resilience.

39:30 The White House and HHS launched the Health Sector Climate Pledge to cut greenhouse gas emissions by 50% by 2030 and net zero by 2050.

40:00  “Solving the climate crisis is the greatest and most complex challenge that Homo sapiens have ever faced. The main solution, however, is so simple even a child can understand it. We have to stop our emissions of greenhouse gases. And we either do that or we don’t.”  — Greta Thunberg

41:00  Parting thoughts from Dr. Lee on value-based care and climate change resilience. (“It doesn’t matter what political party or what socioeconomic class you are.  We can’t escape this issue of climate change.  We are all on this planet together.”)