Healthcare Is Hard: A Podcast For Insiders podcast

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#644: AI-augmented human recommendations for retail customers with Noah Zamansky, Stitch Fix 27:12

cách đây 6 ngày trước27:12

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27:12

We are here at eTail Palm Springs and seeing and hearing the latest and greatest in e-commerce and retail. Question: Do you need to choose between AI and human recommendations as a customer? Why not have both? After all, don’t each have their strengths? AI in the retail experience is all the rage these days, but today I’m talking with someone from a brand that has been incorporating AI-personalized experiences and shopping combined with expert human recommendations for over 14 years, and continues to innovate today. Today we’re going to talk about how AI-based personalization plus human creativity and input makes an amazing customer experience at Stitch Fix. To help me discuss this topic, I’d like to welcome Noah Zamansky, Vice President of Product and Client Experience at Stitch Fix. About Noah Zamansky Noah Zamansky serves as the Vice President of Product and Client Experience at Stitch Fix, where he leads cross-functional teams spanning Product, Design, Engineering, Algorithms, and Platform Development. A seasoned leader, Noah has a proven track record of shaping product vision and strategy, designing exceptional user experiences, and spearheading the launch of new business ventures. Before joining Stitch Fix, Noah held the role of Senior Director of Product Management at eBay, overseeing Fashion and Vertical Experiences. Resources Stitch Fix: https://www.stitchfix.com eTail Palm Springs: https://etailwest.wbresearch.com/ Connect with Greg on LinkedIn: https://www.linkedin.com/in/gregkihlstrom Listen to The Agile Brand without the ads. Learn more here: https://bit.ly/3ymf7hd Don't miss a thing: get the latest episodes, sign up for our newsletter and more: https://www.theagilebrand.show Check out The Agile Brand Guide website with articles, insights, and Martechipedia, the wiki for marketing technology: https://www.agilebrandguide.com The Agile Brand podcast is brought to you by TEKsystems. Learn more here: https://www.teksystems.com/versionnextnow The Agile Brand is produced by Missing Link—a Latina-owned strategy-driven, creatively fueled production co-op. From ideation to creation, they craft human connections through intelligent, engaging and informative content. https://www.missinglink.company…

Healthcare is Hard: A Podcast for Insiders

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Healthcare is Hard: A Podcast for Insiders views healthcare transformation through the lens of prominent leaders across the industry. Through intimate one-on-one discussions with executives, policy advisors, and other “insiders,” each episode dives deep into the pressing challenges that come with changing how we care for people. Hear the unique perspectives of these industry leaders to get a better understanding of what is happening today, the challenges across the healthcare ecosystem, and how innovation is really shaping the future of healthcare delivery.

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#Fitness #Business #Medicine #LRVHealth #Healthcare #Health and Well-Being #Healthcare Innovation #Digital Health #Venture Capital

Healthcare is Hard: A Podcast for Insiders

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updated cách đây 13 ngày trước

Chia sẻ

Trang chủ series•Feed

75 tập

#Fitness #Business #Medicine #LRVHealth #Healthcare #Health and Well-Being #Healthcare Innovation #Digital Health #Venture Capital

Tất cả các tập

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Opportunities in Oncology (Part 2): Balancing Cutting-Edge Research and Community Care 40:47

cách đây 13 ngày trước40:47

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Dr. Harlan Levine began his career practicing internal medicine but soon moved into business leadership roles at national healthcare organizations to help improve the dysfunction with payer-provider relationships that he experienced firsthand as a physician. At United Health Group, Dr. Levine joined as clinical lead of the team that launched Optum, where he subsequently served as chief medical officer for more than six years. He also led the health management practice at Towers Watson and served as executive vice president of comprehensive health solutions at WellPoint, among other roles. In 2013, Dr. Levine joined City of Hope, one of the country’s largest and most advanced cancer research and treatment organizations. City of Hope’s uniquely integrated model spans cancer care, research and development, academics and training, and a broad philanthropy program that powers its work. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and cancer treatment centers and outpatient facilities in the Atlanta, Chicago and Phoenix areas. In addition to currently serving as president of health innovation and policy at City of Hope, Dr. Levine is also chair of the board of AccessHope. A spinout from City of Hope, AccessHope partners with the nation’s most prestigious cancer research centers to help make leading-edge cancer care available to all, regardless of geographical location. Dr. Levine joined Keith Figlioli for the second episode of a Healthcare is Hard series exploring opportunities in oncology. Some of the topics they discussed include: Community practice vs. academic medical centers . Delivering personalized care and giving patients access to cutting-edge treatment is equally important, yet historically difficult to balance. In the first episode of this series, Dr. Stephen Schleicher from Tennessee Oncology shared how one of the nation’s most successful community oncology practices is tackling the challenge. In this episode, Dr. Levine discussed City of Hope’s model of putting academic research at the center and connecting it with community practices. He described how City of Hope is changing the direction of cancer care – not just delivering it – by giving patients faster access to emerging science. Defining value in oncology . Dr. Levine calls himself an outlier when it comes to value-based care in oncology because he thinks the industry missed a critical first step – defining what the term means. In most circumstances, discussions around value are centered around reducing cost. But Dr. Levine points out that a cancer patient defines value very differently. They define it as survival. They think about whether or not they returned to normal functionality in normal life, and what their experience was through the entire treatment process. He says the industry needs to recognize and customize models for these unique aspects of cancer care before the term VBC should be used in oncology. AI in oncology . Dr. Levine shared his outlook for the many ways artificial intelligence will change oncology – from drug discovery to care delivery. He believes AI will completely disrupt the approach to cancer care and that the revolution will happen quickly – not in seven to 10 years, but in three to five. He talked about the ways he sees AI changing how doctors deliver care, and why he’s even more optimistic about its ability to accelerate research. To hear Dr. Levine and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Opportunities in Oncology (Part 1): The Intersection of Clinical Care, Business and Policy 48:19

cách đây 6 weeks trước48:19

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There’s been a massive gap in oncology where people who have been responsible for a dramatic increase in the standard of care have lacked a solid understanding of the business, payment and policy constructs required to deliver it. Dr. Stephen Schleicher has spent the early part of his career working to fill that gap. Dr. Schleicher entered medical school with an interest in oncology, anchored by an appreciation for the psychological toll cancer can have on a person, their family and caregivers that he gained from parents who were both psychologists. During his internal medicine residency at Brigham and Women’s Hospital, Dr. Schleicher also worked at McKinsey and earned his MBA at Harvard Business School as part of a fully-funded fellowship. Through this combined experience, he started to develop a niche in the oncology space where clinical, business and policy decisions intersect, at a time when value-based care was just starting to gain momentum. After a fellowship at Memorial Sloan Kettering Cancer Center, Dr. Schleicher joined Tennessee Oncology, one of the nation’s largest community-based cancer care practices, and shortly after became medical director of value-based care at OneOncology, a large community oncology network founded by Tennessee Oncology that spans multiple states. He subsequently returned his focus to Tennessee Oncology where he served as chief medical officer for two years and still practices as a breast cancer medical oncologist. Dr. Schleicher is also a board member and executive committee member at the Community Oncology Alliance. To set the stage for a Healthcare is Hard series focused on Oncology, Dr. Schleicher talked to Keith Figlioli about both the clinical and business trends influencing cancer care. Topics they discussed include: Community providers vs. health systems . For Dr. Schleicher, the ultimate goal is to give cancer patients the personal feel of a community clinic with the resources – including access to precision medicine and clinical trials – that have historically only existed at academic medical centers. While Dr. Schleicher firmly believes that nearly all cancer care should be delivered outside the hospital, he recognizes the expertise for certain conditions – like rare sarcomas – that only exists at academic medical centers and discussed the dynamics of “coopetition” that exists between health systems and community providers in markets across the country. Oncology’s cost center. Drugs already account for a significant portion of spending on oncology care, and with dozens of new FDA approvals for cancer therapies each year – some with extremely high costs – this trend will continue. But there are many other variables contributing to the large percentage of spending that goes towards drugs, including the shift from infusions to more oral medication. Dr. Schleicher explains how reliance on oral medication introduces PBMs and specialty pharmacies into the equation, which can add cost and complexity, and sometimes slow the speed of critical care. The value based care dilemma. Dr. Schleicher talked about how successful The CMS Oncology Care Model (OCM) was at optimizing care for Tennessee Oncology’s patients. He says hospitalizations and ER visits went from 20%-30% of costs before OCM to less than 10% now. The remaining 90% of costs now goes towards drugs – even when used appropriately following pathways. The dilemma is that there isn’t too much more room for cost improvement in care delivery. Dr. Schleicher discussed how payers need a better understanding of how to incentivize providers around costs they can control, while allowing for expensive therapies if they’re the right drug at the right time to improve costs and outcomes in the long run. To hear Stephen and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Election Implications (Part 4): Forecasting For Healthcare As The Second Trump Administration Takes Shape 36:09

cách đây 12 weeks trước36:09

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Elements of the new Trump administration are coming into focus as announcements of key healthcare appointments and nominations provide indications for what the market can expect starting in January. To dissect the impact these changes might have, Wall Street Analyst Jeff Garro joined Keith Figlioli to wrap up a four-part series of episodes on election implications. Previous episodes featured conversations with JP Morgan’s Lisa Gill , Canaccord Genuity’s Richard Close , and Maverick Health Policy’s Julie Barnes . Jeff Garro is Managing Director and an equity research analyst covering Healthcare IT for Stephens, a family of privately held, independent financial services firms founded in 1933 that’s focused on building value for companies, state and local governments, institutions and high-net-worth investors. Prior to joining Stephens in September 2022 Jeff held research analyst roles at Piper Sandler and William Blair. During this conversation, Jeff discussed the policy changes and broader market signals he’s watching to advise clients on investments in the healthcare IT market. Some of the topics he discussed with Keith include: Balance in management teams . When discussing elements he looks for in a good investment, Jeff talked about the lessons he’s learned evaluating management teams. He says companies need leaders that are great storytellers who can convey their vision and bring more investors under the tent. But cautions to stay vigilant for executives who might believe in their own narrative a little too much and in turn, don’t implement the right sets of checks and balances within their organization. Predictions by payer type . One way Jeff is assessing the market in light of pending regulatory and policy changes is by breaking it down by payer type. For example, he expects minimal change in employer-sponsored coverage and a more favorable environment for Medicare Advantage, when comparing the first Trump term to the last few years of the Biden administration. He says Medicaid markets will be harder to predict because potential for decreased federal funding could create market pressures, but could also create opportunities where technology can help. Lastly, he’s considering the individual market and the potential for ACA subsidies to not be renewed. Public vs. private markets . While Jeff’s primary role is analyzing public markets, he talked about how essential it is to understand innovation and activity occurring in private markets so he can ask the right questions and avoid being blindsided as new companies and technologies evolve. He also discussed the different mentalities of public versus private investors, and how those in private markets generally have the ability to be more patient – an advantage as we’re waiting for the new administration’s nominees to be appointed and confirmed. The post-COVID reset . There are a lot of problems to solve in healthcare – as there always have been – but Jeff also believes there are a lot of good companies, both public and private, positioned to solve them. He sees a favorable backdrop for healthcare investors following the challenging environment from the global pandemic, and is hopeful that the market has hit a reset from a performance perspective. He sees a shift from “growth at all costs” to a more reasonable approach to sustainable growth and healthy profit margins. To hear Jeff and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A…

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Election Implications (Part 3): JP Morgan’s Read on Trump 2.0 and What’s Next for Healthcare 45:44

cách đây 15 weeks trước45:44

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Healthcare was not a major focus during the 2024 election where other key issues drove most of the discussion. This left a vacuum around specific healthcare policies and what to expect from a second Trump Administration. With few details available and political capital to spend from the ‘red sweep’ this election, healthcare stakeholders are pondering how much of the incoming administration’s preference for disrupting the status quo will extend to the healthcare industry. For the third episode in a four part series on election implications – and the first one since votes were counted and winners declared – JP Morgan analyst Lisa Gill joined Keith Figlioli on the Healthcare is Hard podcast to analyze the outcome. Lisa has more than three decades of healthcare industry experience and has spent most of her career at JP Morgan where she has been covering the healthcare services industry for the last 27 years. In this episode, Keith talked to Lisa about the lessons she’s learned covering healthcare for several decades, and asked her to share her outlook for what to expect in the months and years ahead. A few of the topics they discussed include: Cycles of innovation . Thinking about how the industry has evolved over time and how healthcare organizations have had to continuously reinvent themselves, one of the main observation Lisa makes is that common themes and trendlines often repeat themselves. She cites the pharmaceutical industry as an example, comparing the cycle of pharmacy innovation when she started as an analyst in the late 1990s to the current wave of innovation that’s occurring now. Consolidation and diversification . With a philosophy that leans towards deregulation and loosening oversight, one expectation of the incoming administration is that it will create more opportunity for M&A. Lisa talks about the trends driving consolidation in the industry and how it’s not just about diversifying earnings and revenue. She says it’s about broadening the touchpoints organizations have with patients in order to reach the goal of finally being able to deliver truly integrated care. Optimism for managed care . If early returns in public markets after the election are an indication of what’s to come, managed care organizations are in a good position to thrive under the second Trump administration. Lisa points to the fact that managed care companies outperformed the day following the election, rising 5.8% while hospitals fell more than 4%. With a friendlier environment for reimbursement rates and STAR ratings, and a lower bar for M&A, she expects this trend to continue. Previewing the 43rd Annual JP Morgan Healthcare Conference . This venerable event sets the stage on what to expect in healthcare for the year to come. And while it takes place before the presidential inauguration, signals from the Trump transition team, including announcements about appointments to cabinet positions and healthcare agencies, will drive the conversation. However, Lisa believes the industry won’t have a clear view into the new administration’s focus and priorities for healthcare until well into the first quarter of 2025. To hear Lisa and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Election Implications (Part 2): This Wall Street Analyst Agrees, “Healthcare is Hard” 30:42

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With the White House and Congress up for grabs this election, anticipation in the healthcare industry is high. Shifts in healthcare policy will influence how care is paid for and delivered, which will of course influence the flow of investment dollars in both public and private markets. During the first episode of a four-part series on election implications, beltway insider Julie Barnes laid out potential scenarios for the direction healthcare policy might take depending on election outcomes. With that background, Part 2 of the series zooms in on healthcare investing. For more than 20 years – and now six presidential election cycles – Richard Close has covered the healthcare space as a Wall Street analyst. He was one of the first analysts covering healthcare technology and as Managing Director, Digital and Tech-Enabled Health Equity Research at Canaccord Genuity, he focuses on introducing the investment community to disruptive and innovative companies that are leading the digital transformation in healthcare. In this episode of Healthcare is Hard, Richard talked to Keith Figlioli about the election and how it could impact investments in the healthcare sector. A few of the topics they discussed include: Predictions on priorities . Healthcare has not been a major focus this election cycle and Richard doesn’t believe either candidate has shared many specifics about their plans for health policy. But he discussed general expectations like an increase in Medicare drug price negotiations under a Harris Administration, or giving states more control of Medicaid under a Trump Administration. Regardless of who takes the White House, he sees an increasing focus on addressing employer health costs, driven by forecasts for an 8% increase next year – the highest jump in more than a decade. Contrasts in public vs. private markets . Richard says healthcare investors in public markets tend to “paint with a broad brush” and are focused on the short-term. Because of this, he says struggles at large-cap managed care companies in recent years have influenced overall investor sentiment. Once these companies get beyond current challenges and start hitting their numbers, he believes it will open the market and drive improved valuation for smaller and mid-cap companies. On the other hand, Richard says investors in private markets look more deeply into sub-sectors and are placing bets for the long run. Optimism for health tech . With healthcare accounting for 20% of the economy and continuing to grow, Richard sees technology as a primary lever to help bend the cost curve. He’s optimistic about the future opportunity for investors in both public and private markets, and sees an opportunity for the IPO window to potentially open up after the election. He says there are a handful of companies that are profitable and have been growing revenue that may be ready to test the IPO market in 2025. To hear Richard and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Election Implications (Part 1): Angst, Uncertainty and an Urge for Calm from Maverick Health Policy’s Julie Barnes 45:42

cách đây 23 weeks trước45:42

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Julie Barnes has made a career helping health plans, tech vendors, investors and others in the healthcare space decipher health policy. She’s a former Hill staffer who earned her law degree and spent a decade in corporate law serving healthcare clients before moving to policy think tanks, business consulting, and founding Maverick Health Policy. At Maverick, she provides strategic advice on federal health policy to private companies and industry coalitions, with particular focus on health data and value-based care. With the U.S. presidential election less than two months away, Julie is kicking off a series of Healthcare is Hard episodes that will explore the implications of the shifting power structure in Washington. Next year, there will be a new administration and a new makeup of the U.S. Congress – that much is certain. How these changes will impact health policy and healthcare investing in public and private markets is a much bigger question. During the next few episodes, both before and after votes are cast in November, Keith Figlioli will shed light on these topics with an expert panel of guests. A few of the topics Keith and Julie discussed during the first episode of this series include: The alphabet soup of healthcare policy . One of the things that surprises Julie’s clients the most is the myriad of federal agencies that play a role overseeing healthcare – from HHS and CMS, to the FDA, CDC, NIH, FTC, NIST and many others beyond the big, well known organizations. With Healthcare accounting for nearly one quarter of the federal budget, there is a massive public sector infrastructure behind it, which is a big reason why healthcare policy takes so much effort to navigate. Julie offers advice for organizations looking to better understand healthcare policy, and for the people driving it. For example, she says the wonks, lawyers and lobbyists all talk funny. She admits to being part of this group, and says they need to reduce the lingo for the sake of those not so intimately involved. AI changing everything . When discussing the modernization of the healthcare system, Julie talks about artificial intelligence (AI) being the main focus right now. She believes it has the potential to dramatically change everything because of the far-reaching impact it could have on areas ranging from workforce shortages to clinical decision support, user experiences for providers and patients, and more. She says healthcare AI policy can’t be written fast enough because of the speed with which the technology is developing, but there are many problems to navigate. One is that the public sector lacks experts who fundamentally understand this new technology, which will create challenges with ensuring that regulations are thoughtful enough to create a level of trust around AI without grinding innovation to a halt. White House hysteria . While the country is fixated and divided on an historical race for the Presidency and the impacts of the outcome, Julie is quick to point out that changes in healthcare policy will not be fast, and will not be sweeping. There are broad brush policy changes you can expect based on party philosophies, like Democrats being more skeptical about the influence of private money than Republicans. But major legislative changes require bipartisan effort, no matter who controls the White House, Senate, and/or House. But one major area where Julie thinks many people are underestimating the potential for change is the impact of the Supreme Court’s recent decision on the Chevron Doctrine. She talks about how this will open the floodgates on a wave of litigation. To hear Julie and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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What’s the Difference Between Innovation and Performance Improvement? 38:00

cách đây 27 weeks trước38:00

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OSF HealthCare stands as a model health system for those who want to do innovation right. One of the defining characteristics of the Peoria, Illinois-based system is how it aligns innovation with operations for everyone – all 24,000 employees across 159 locations, including 16 hospitals. Becky Buchen is responsible for driving innovation at OSF HealthCare. As SVP of Innovation Operations she works to engage and educate people on the innovation process, leveraging the eco-system for innovation built at OSF, including simulation, analytics, OSF Ventures, Innovation Studio, Digital Innovation Development and Performance Improvement. Becky’s background in performance improvement has been a major influence in OSF HealthCare’s approach to innovation. Prior to her role leading innovation, she served as VP of Performance Improvement where she focused on implementing methodologies to monitor, assess and improve patient experience, patient outcomes, and overall operations. In this episode of Healthcare is Hard, Becky talked to Keith Figlioli about how OSF HealthCare formalized its vision for innovation more than a decade ago and the thoughtful approach to ensuring that it would be fully integrated – not simply a “bolt on.” The goal was to truly make an impact and transform how care was delivered across the organization, and to do so, OSF HealthCare recognized that it had to apply the same level of rigor for exploring, testing and measuring innovation initiatives as it historically had to performance improvement. In her conversation with Keith, Becky discussed specifics about OSF HealthCare’s approach to innovation that both digital health entrepreneurs and other health systems can learn from. Some of the topics they discussed include: Integrating innovation into culture . Perhaps the most visible example of OSF HealthCare’s commitment to integrating innovation into every aspect of its operations is the physical footprint. At its main campus, OSF HealthCare has an entire building dedicated to innovation, including two floors built for simulation, allowing clinicians to test and understand new approaches in a safe space, two floors housing its healthcare analytics division, and much more. What health systems are getting wrong (and right) . To approach innovation successfully, Becky says health systems need to first have a fundamental understanding of the problems they’re trying to solve. She warned of dedicating resources towards solutions that are looking for problems. OSF HealthCare learned to avoid this trap early, but Becky says it’s still an area of caution for some systems. She talked about how critical it is to pick problems that are big enough to make a significant impact when they’re solved in new and different ways. Retooling and reskilling due to artificial intelligence . Becky talked about the healthcare industry being “data rich and information poor,” and described efforts to centralize data and improve data quality as a critical step to driving value from innovation. While tools like those being explored with generative AI will ultimately allow healthcare organizations to operate more efficiently, data quality and proper governance are essential to establish first. And after that, healthcare organizations should be thinking about how they will need to retool and retrain frontline operators and clinicians. To hear Becky and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Help or Harm? How CHAI is Mitigating the Risk of AI in Healthcare 54:30

cách đây 33 weeks trước54:30

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With great power comes great responsibility and in healthcare, those words may have never held more meaning than they do with the advent of artificial intelligence. AI most certainly has the power to transform healthcare, and those in the industry working to develop and use it have an immense responsibility to shape principles that ensure these technologies help, not harm. The Coalition for Health AI (CHAI) was created with a mission to be the trusted source of responsible AI in health that serves all. CHAI was founded in early 2021 by a small group of industry stakeholders and has quickly grown to now encompass more than 2,500 participants representing health systems, technology providers, government agencies, advocacy groups and others. Dr. Brian Anderson is one of CHAI’s co-founders and now serves as its first CEO. Before CHAI, Dr. Anderson was the Chief Digital Health Physician at MITRE, a nonprofit corporation that manages federally funded research and development centers (FFRDCs) supporting various U.S. government agencies. At MITRE he led research and development efforts across major strategic initiatives in digital health alongside industry partners and the U. S. Government. Prior to MITRE, Dr. Anderson led the Informatics and Network Medicine Division at athenahealth. He has also served on several national, and international, health information technology committees in partnership with the Office of the National Coordinator (ONC), the National Institutes of Health (NIH) and the Organization for Economic Cooperation and Development (OECD). In this episode of Healthcare is Hard, Keith Figlioli spoke with Dr. Anderson about the origins of CHAI, its intended role ensuring responsible use of AI in healthcare, and the complex issues already emerging as the industry navigates the early stages of AI adoption. Some of the topics they discussed include: Aligning AI with values . Dr. Anderson admits there’s General agreement around principles like transparency, safety, privacy, and reliability when it comes to responsible use of AI. But says the industry needs a clearer definition for what that actually means at a technical level for the people and companies writing code. He says vendors fundamentally can’t do this on their own, which is why independent entities with appropriate skills, tooling, technology, and data are needed. AI assurance. Nearly every other industry has independent organizations that test and evaluate products. From the star rating system for automotive safety, to the stickers validating consumer electronics, we take these rating systems and their existence for granted. Healthcare AI does not yet have a similar system, but that’s what Dr. Anderson eventually wants CHAI to be known for. Giving everyone a voice . Being inclusive is fundamental to CHAI’s mission and Dr. Anderson stresses that everyone’s perspective is legitimate, especially since healthcare AI is such a new space where no one has definitive answers. He recognizes that listening to every perspective is critical in order to build AI that will serve everyone. For example, this includes ensuring that voices from the startup community are represented just as much, if not more than big tech. To hear Dr. Anderson and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Live from DHIS East: Mass General Brigham CIO, Christopher Coburn 44:17

cách đây 37 weeks trước44:17

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Chris Coburn has been driving health system innovation for decades. He is currently chief innovation officer at Mass General Brigham (MGB), the nation’s largest academic research enterprise with over $16 billion in annual revenue, 1.5 million patient visits and more than $2.4 billion in research expenditures. MGB also has a managed care organization, out-patient facilities and community hospitals. 7,000 of its faculty are appointed at Harvard Medical School. As head of innovation, Chris leads a team of nearly 150 people tasked with the worldwide commercial application of the unique capabilities and discoveries of Mass General Brigham’s 85,000 employees. His unit’s business development responsibilities include investing, company creation, international consulting, innovation management, industry collaborations, and licensing. Commercialization revenue exceeds $160 million annually and more than 300 companies have been spun-off from Mass General Brigham in the last decade. Prior to joining Mass General Brigham, Chris was founding director of Cleveland Clinic Innovations and served for 13 years as its executive leader. During his tenure, Cleveland Clinic spun off 57 companies that raised more than $700 million in equity financing. There were none before his arrival. In this special episode of Healthcare is Hard, recorded live at the Digital Health Innovation Summit (DHIS) in Boston, Keith Figlioli led a keynote discussion with Chris about the current state of healthcare innovation. Some of the topics they discussed include: Embracing innovation from inside and outside of MGB . Chris described how his organization is tasked with supporting innovation that will help achieve strategic objectives, regardless of where it originates. With the realization that most health systems are large organizations not known for their nimbleness, he shared advice for innovators looking to partner with or sell to them about how buying decisions are made. Corporate venture capital in healthcare . With a steady growth in the number of health systems creating their own venture arms over the past several years, Chris shared best practices from being in the space for decades. For example, he talked about balancing the commitment to both strategic and financial goals, and how his organization catalogs the unmet needs of MGB’s leading faculty. For entrepreneurs, he suggests getting to know the growing number of people in corporate venture roles, in addition to health system operators. Getting operators to embrace digital innovation . Fielding a question from the live audience, Chris discussed strategies for getting operators to adapt digital health innovation into established workflows, and how important it is to create a culture around innovation to achieve that goal. On one hand, he talked about how part of his organization’s job is to get doctors to proactively and continuously think about new ways for how they might optimize their work. On the other hand, he talked about listening to unmet needs and addressing them directly as a way to ease adoption from the start. To hear Chris and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Reinventing Pharmacy (Part 3): Optum Rx CEO, Dr. Patrick Conway, Brings the PBM, Provider and Payer POV 40:32

cách đây 41 weeks trước40:32

40:32

Optum Rx serves more than 62 million people, processes 1.6 billion prescriptions and generates more than $110 billion of revenue annually. Dr. Patrick Conway, CEO of Optum Rx, is the third and final guest in a series of Healthcare is Hard episodes exploring the transformation of the pharmacy business – following conversations with Mark Cuban and Dr. Troyen Brennan . Dr. Conway brings an expansive view of the healthcare system to this discussion and his role leading one of the most influential organizations in the pharmacy space. He became CEO of Optum Rx in August 2023 and before that, served as CEO of Care Solutions at Optum for more than three years. He was president and CEO of Blue Cross and Blue Shield of North Carolina for two years and spent more than six years at the Centers for Medicare and Medicaid Services where he held several positions including Chief Medical Officer, Director of CMMI, and Deputy Administrator for Innovation and Quality. Before joining CMS, he oversaw clinical operations and quality improvement at Cincinnati Children’s Hospital Medical Center, and he is still a practicing pediatrician in Boston where he occasionally works at an area medical center on weekends. Some of the topics Dr. Conway discussed with Keith Figlioli in this episode of Healthcare is Hard include: VBC – A way or THE way . As someone who has spent a significant portion of his career focused on improving cost and quality in the U.S. healthcare system, Keith starts the interview asking Dr. Conway for his perspective on value-based care. Dr. Conway says we can either figure out VBC, or raise taxes and reduce benefits, noting that the American public would not be happy about the latter. He firmly believes that VBC is THE way through. He discussed the positive impacts he's witnessed from VBC, and how he believes it’s been a major contributor to slowing the growth of healthcare costs over a significant period of time. However, he’s concerned about how the transition to VBC has slowed. Affordable innovation . When discussing the extremely high cost of new specialty drugs, Dr. Conway points out that innovation is useless if it’s unaffordable and inaccessible to people. He shared personal stories contrasting very difficult conversations he’s had with parents in the past about the failing health of their children, and a more recent experience where Optum Rx delivered a new gene therapy to a child with a rare disease who will now live a full life. With therapies like that one costing $3 million, Dr. Conway discussed his views on some of the public and private financing options that could help improve access to life-changing therapies while still rewarding the innovators. Choice and transparency . Dr. Conway explains some of the solutions Optum Rx has brought to market to serve its customers, and areas where the company is exploring new solutions to keep customer satisfaction high. While customers are happy with Optum Rx, he makes it clear that continuously developing new solutions to stay ahead of a fast-evolving market is essential. During this discussion, customer choice – for both patients and the employers who fund their benefits – is a recurring theme and a major focus. To hear Dr. Conway and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

1
Reinventing Pharmacy (Part 2): Dr. Troyen Brennan Disputes the False Narrative of Good vs. Bad Actors 42:49

cách đây 46 weeks trước42:49

42:49

In the first of a series of episodes exploring opportunities for innovation in the pharmacy space, Mark Cuban offered perspective from an outsider intent on disrupting the status quo. In this, the second episode, Dr. Troyen Brennan gives an insider point-of-view from someone who has studied and worked in the space for decades. Dr. Brennan was Chief Medical Officer at CVS Health for nearly 14 years, and before that, Chief Medical Officer at Aetna for two years. He was also a practicing physician at Brigham and Women’s Hospital for 15 years where he was president of Brigham and Women’s Physician Organization. During that time, he was also Professor of Medicine at Harvard Medical School and Professor of Law and Public Health at the Harvard T.H. Chan School of Public Health. He is the former Chair of the American Board of Internal Medicine and has published six books and more than 600 articles offering his insight into the American healthcare system, and his ideas on how to improve it. With extensive knowledge of how the industry has evolved, and an understanding for why many of the complexities in the industry exist, Dr. Brennan offers a unique viewpoint about where and how disruption in the pharmacy space can succeed. In his eyes, the idea of good and bad actors in the pharmacy space is a false narrative. With an historical perspective, he explains how industry processes were all sensible when they were first implemented, and how that viewpoint is critical to understanding and addressing some that may have become seemingly senseless over time. A few of the topics he discussed with Keith Figlioli in this Healthcare is Hard episode include: Six ways PBMs have lowered cost. Dr. Brennan provides a history of pharmacy benefits managers (PBMs), why they were created in the late 1950s and how they have helped the pharmacy industry. He discussed his thoughts on the six things PBMs have done – and are still doing – to help control costs. These include expanding the use of mail order pharmacies, sourcing generic drugs, introducing tiered pricing, implementing prior authorization and utilization management, assembling pharmacy networks, and negotiating rebates. Flexibility of PBMs. When discussing the future role PBMs may or may not play in the industry, Dr. Brennan says he’s confident in the ability for big PBMs to adapt. He believes they’ve proven to be more flexible than other parts of the healthcare system and will continue to have significant influence as regulations evolve and disruptors enter the market. He says that Mark Cuban is having a good influence on the industry overall with Cost Plus Drug Company, but would bet on the ability of PBMs to adapt. The path to greater affordability. With new, life-changing therapeutics being introduced regularly and specialty pharmacy expected to become a significant portion of healthcare spending, Dr. Brennan discusses some of the potential options for ensuring these treatments are affordable. He believes entrepreneurs disrupting the space can help contribute, but regardless of the role they play, says government will ultimately have to step in with price controls. He points to the role government plays controlling the costs of hospital services and says it will eventually have to play a similar role in the pharmacy space. To hear Dr. Brennan and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Reinventing Pharmacy: Mark Cuban Says Trust Is Missing Across Healthcare. Here’s What He’s Doing About It 43:34

cách đây 50 weeks trước43:34

43:34

Mark Cuban built a career disrupting industries and creating new ones. Now, his sights are set on healthcare. There’s no secret ingredient to Mark’s success. As the world sees very publicly on Shark Tank, his style is the opposite of keeping secrets. It’s based on providing respectful, but direct, honest and unvarnished opinions. He’s bringing that style to healthcare in order to inject what he says the industry is lacking most. Trust. To kick-off a series of Healthcare is Hard podcast episodes that will dive deep into all aspects of reinventing the pharmacy space, Keith Figlioli sat down with Mark to discuss his vision and strategy behind Mark Cuban Cost Plus Drug Company, and many other healthcare-related topics. With Cost Plus Drug Company, Mark is bringing radical transparency to what he says is the most opaque industry he’s ever been involved in. He’s doing it by pricing every single product the same way – the cost of a drug, plus 15% markup, plus pharmacy fee (if any), plus shipping – and publishing these details for everyone to see. Through this model, Mark aims reduce costs and improve access to drugs, while rebuilding trust in the industry. With 2,400+ drugs now available, he’s off to a fast start and talked to Keith about other evolving elements of the business including wholesale operations for providers, partnerships with grocery and pharmacy chains, and more. Some of the other topics Keith and Mark discussed include: The Netflix model for specialty drugs. With revolutionary precision medicine coming to market at high costs that can reach millions of dollars per treatment, how will employers and consumers afford them? According to Mark, that’s the wrong question. He’s looking at the challenge through the manufacturer’s lens, asking how much they’ve invested in drug development and at what dollar value can they make reasonable returns. He discussed conversations he’s having with manufacturers about creating subscription services that could cover a wide range of high-cost, specialty drugs. Transparent, direct contracting. Mark now self-insures his employees and their family members, contracts directly with providers on payment rates, and – following the Cost Plus philosophy – publishes everything for the world to see. He shared a personal story that helped lead him to this decision where he paid a provider directly when his son needed an X-ray and realized it was a fraction of the cost of agreed upon rates with his insurance company. He talked about how this decision cuts other costs while improving employee wellness, removing burdens on HR, and ultimately helping providers by removing the risk they take and helping them get paid faster. Millions of AI models. Mark is a big believer that there will be millions of AI models and everyone will have one. He says 100 years from now you’ll be able to ask him questions through a model trained on all his emails and data. But AI in healthcare will be more segmented. He talks about how there’s no way leading research hospitals with respected brands will feed their data into one large language model unless they get paid an extreme amount of money. They may even stop publishing “anything and everything” to prevent their research from being ingested into someone else’s model. To hear Mark and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Is Innovation Stuck in Healthcare? Two Brothers Get to The Bottom of It 46:21

cách đây 1 year trước46:21

46:21

In most industries, innovation leads to an improved product or service while ultimately helping to lower cost. Healthcare is the exception. Despite a constant pursuit of new science, technology, operational efficiencies, business models and more, healthcare expenditures in the U.S. have continued to increase for decades with little sign of bending the cost curve downward. What causes this phenomenon in U.S. healthcare, and what can we do about it? In their book, Why Not Better and Cheaper?: Healthcare and Innovation , twin brothers James B. Rebitzer and Robert S. Rebitzer offer answers to those questions. Jim and Bob’s book brings together research on incentives, social norms, and market competition to argue that the healthcare system generates the wrong kinds of innovation. They contend that U.S. healthcare makes it too easy to profit from low-value innovations and too hard to profit from innovations that reduce the costs of care. As a result, we get a system where innovation abounds, but finding ways to deliver increased value at lower cost is remarkably ineffective. In this episode of Healthcare is Hard , Keith Figlioli talked to Jim, a professor at Boston University’s School of Business, and Bob, National Advisor at Manatt Health, for an in-depth discussion about their work. Their conversation explored topics including: Misaligned incentives . Understanding how incentives work inside and between organizations has been a large focus of Jim’s career in economics, and he now applies that work to the complex world of healthcare. As an example of that complexity that’s all too common, Bob shared a story of a scientist and entrepreneur he advised who had developed a quick and inexpensive way to change how people walk in order to reduce pressure on the knee. While this could defer or obviate the need for common and expensive knee replacement surgeries, he discussed how difficult it would be to turn this idea into a profitable business since organizations across the healthcare ecosystem lack proper incentives to pay for it. He discussed why gain sharing would be the solution in every other part of the economy, and why it doesn’t work in healthcare. The fourth vital sign of healthcare . People generally think of the healthcare system as having three vital signs – cost, quality and access. But Jim and Bob see a fourth vital sign that, so far, hasn’t been recognized. In the long sweep of history, they say innovation matters just as much as the other three vital signs and stress that part of a healthy system should be the ability to produce innovations that increase value to patients while lowering costs. Innovation vs. irrational finance . In order to truly unlock innovation does the country’s irrational finance and insurance system need to be fixed first? Bob and Jim share their thinking around this debate and their ultimate conclusion: not necessarily. Bob compares healthcare innovation to walking uphill in a fog… you never know when you’re going to reach the top, but all you can do is place your foot in a somewhat higher place than it was before. To hear Keith, Bob and Jim discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Putting Trust at the Center of Healthcare Transformation: Press Ganey CEO, Pat Ryan 36:20

cách đây 1 year trước36:20

36:20

Through its work with more than 41,000 healthcare facilities and the industry’s largest database of patient feedback, Press Ganey gives organizations the data and insights they need to put the human experience at the center of healthcare. Since it was founded nearly 40 years ago by Professors Press and Ganey at the University of Notre Dame, the company has built a reputation for being the prominent source of patient feedback, but it hasn’t stopped there. Its solutions capture the voice of the patient, physician, nurse, and employee to keep healthcare focused on people by enabling organizations to address safety, clinical excellence, patient and member experience, and workforce engagement. Pat Ryan became CEO of Press Ganey in 2012 after more than 30 years working with healthcare leaders and providers, including a dozen years as a Press Ganey client. Pat has served on several health system boards and has worked throughout his career to improve the quality and safety of care while lowering cost and achieving caregiver resilience to deliver truly patient-centered experience. In this episode of Healthcare is Hard, Pat spoke with Keith Figlioli about the increasing focus on human experience in healthcare transformation. Drawing knowledge from his career and from Press Ganey’s unrivaled understanding of patients and the professionals who serve them, Pat shared his perspective on topics including: The link between patient experience and financial success . Pat shared what he says is a little known fact – that health systems across the country with the highest margins also have the highest patient scores. He talked about how the two are linked and how value leads to long term community loyalty. He cited his time on the board of Beth Israel Deaconess Medical Center where they looked at patient data first and financial data second. He says health systems today need a comprehensive view that also includes safety and employee engagement data in order to identify opportunities for improvement. Redesigning healthcare from the outside in. Any consumer business would start with the needs of the customer first and work backwards to design systems that add value. But healthcare wasn’t created that way and was built from the inside-out. Pat discussed the need for healthcare organizations to continue the long journey of recognizing that consumers comes first, and talked about how workforce engagement will be an important component of that as the industry evolves. The trust factor . Pat describes how organization can map trust in order to understand where it breaks down by identifying friction points within the customer journey. He talks about how important it is to build and maintain trust in all relationships – not just a patient or family’s trust in an organization, but also nurse, clinician and employee trust in their organization and leadership. He mentions how important this is for payer organizations that are especially susceptible to unfair or inaccurate perceptions. Opportunities for innovation. When discussing areas where healthcare organizations can improve, and where innovators in the space can help them, Pat’s focus during this conversation was mostly on two issues – home care and the shift towards value. He says figuring out how to care for more people at home is going to be critical and sees opportunity around redesigning the healthcare workforce for the gig economy. He also talks about how slow the movement to value-based contracts has been and how a major break in the system may finally force congress to act if adoption doesn’t pick up. To hear Keith and Pat discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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Deciphering the New Normal (Part 4): Blue Cross Blue Shield of Massachusetts’ Chief Strategy Officer, Sukanya Soderland 37:02

cách đây 1 year trước37:02

37:02

This is the final episode in a four part series with heads of strategy at providers and payers from across the healthcare ecosystem to explore “the new normal” in a post-COVID operating environment. For this episode Keith Figlioli welcomed Sukanya Soderland, Chief Strategy Officer at Blue Cross Blue Shield of Massachusetts, to explore how a regional payer is adapting. This follows previous episodes that offered a diverse perspective from heads of strategy at: A regional health system, OhioHealth (Episode 58) A national health system, CommonSpirit Health (Episode 59) A national payvider, Humana (Episode 60) To wrap up this series, Sukanya provides a glimpse into the strategy at BCBS MA, the largest health plan in Massachusetts and a mostly commercial-focused payer that serves nearly three million members across New England. Unlike most not-for-profit organizations, BCBS MA pays significant federal, state, and local taxes and assessments. Without soliciting or receiving charitable donations, or benefiting from tax-exempt financing, BCBS MA stays competitive by generating a small margin from operations that it reinvests in its business, people, and technology, and by remaining deeply focuses on the community its serves. In her discussion with Keith, Sukanya shared her outlook on issues including: Shared empathy between operations and innovation . For any head of strategy, serving the immediate needs of an organization is equally as important as anticipating and planning for future demands and market forces. Sukanya discussed how business leaders can sometimes view innovation leaders as out of touch with current realities, while innovation leaders might view business leaders as “dinosaurs.” She talked about the importance of developing a culture of empathy and trust between these groups. Building vs. buying vs. co-designing . To stay competitive against larger, national organizations, regional payers must recognize what they do well and where they should partner with other like-minded entities to augment their capabilities. Sukanya talked about making decisions to partner or co-develop capabilities with others, including sister companies across the Blue Cross Blue Shield Association, as a way of advancing sustainable, non-profit healthcare. She also recognized the challenges with driving meaningful change in affordability, quality and consumer experience without being intimately involved in care delivery, and discussed creative ways of partnering with incumbent health systems or new and innovative care delivery models to make that happen. Changing dynamics in how people access care . One of the biggest changes Sukanya sees occurring over the next decade is the way people access care. She discussed several of the market factors driving this change from the supply and demand of primary care physicians, to Generation Z aging into adulthood. She talked about how healthcare is losing the “quarterback” function as young adults turn to social media, trusted contacts and convenience in place of a strong relationship with a primary provider, and how that impacts strategy. To hear Keith and Sukanya discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.…

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