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In today’s episode, Rich Powers educates us on the status of value based care in the industry today.  Rich has deep expertise in provider contracting, managing risk-based relationships and value based care.  He spent the bulk of his career at Humana and worked at Alignment Health before joining P3 Health Partners.  Rich will provide his perspective on the role of primary care and will introduce us to P3 Health Partners as well.   Show Notes:  Books: The Bad Guys Won: A Season of Brawling, Boozing, Bimbo Chasing, and Championship Baseball with Straw, Doc, Mookie, Nails, The Kid, and the Rest of the 1986 Mets, the Rowdiest Team Ever to Put on a New York Uniform and Maybe the Best  By Jeff Pearlman ; The Splendid and the Vile: A Saga of Churchill, Family and Defiance During the Blitz by Erik Larsen.

We have a special episode today recorded live at Quest Analytic's annual conference -- Vision Quest.  Dr. Caroline Carney, Chief Medical Officer of Magellan Health joins me to discuss networks, behavioral health, collaborative care and more. 

Our guest today is an accomplished senior healthcare executive, an innovator, and business transformation leader.  With me is Mohan Nair, CEO of Emerge Inc.,a company that help’s companies find the Innovator’s Mojo, the driving force for business transformation.   Mohan is the former SVP/ CINO (chief Innovation officer) Of Cambia Health Solutions in Portland, Oregon and is an Edmund Hillary Fellow, New Zealand where he helps others bring cause-centered ideas to practical solutions .  Mohan was the founder of transparency company HealthSparq, is the author of three books, one if which we will focus on today.  He is also a musician with twenty copyrighted original songs and has spoken TedX and done much more. Show notes:  People that Mohan follows: Marc Benioff, Tony Robbins, Daniel Kraft, Arianna Huffington, Stefano Bini

You have heard the term “Digital Therapeutics” which the Digital Therapeutics Alliance defines as medical interventions delivered directly to patients using evidence-based, clinically evaluated software to treat, manage, and prevent a broad spectrum of diseases and disorders. Digital therapeutics is offered across a growing number of medical conditions with demonstrated success.  Our guest today is Aaron Gani, Founder and CEO of BehaVR a company that uses virtual reality to help individuals with mental and behavioral health challenges.  I think you will be blown away when you learn how these tools can make a real difference in both outcomes and costs. Show notes: The Digital Therapeutics Alliance.  Aaron’s company is BehaVR.com.  Book:  The Content Trap: A Strategists Guide to Digital Change by Bharat Anand. 

The term “payvider” is being used with increasing frequency.  A “payvider” is a provider that also serves as the health plan, taking on risk directly from employers, Medicare, or state Medicaid agencies.  Banner Health is one such payvider.  Founded in 1999 as the result of a merger, Banner Health is headquartered in Phoenix, AZ and owns and operates thirty hospitals including three academic medical centers across six states.   Over the years, Banner Health has morphed into a fully integrated delivery system with its own network and medical groups.  Banner Health offers its own Medicare Advantage, commercial and Medicaid Plans, but also has a joint venture with Aetna and through that JV, has competing plans.    With us today is Donna Sickler the Division CFO for Insurance Operations at Banner Health.  Donna will help us understand the advantages and challenges of being an Integrated Delivery System and an insurer, and she’ll walk us through how the organization manages the relationship with a JV partner which is also a competitor. Show notes:  Book: The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race by Walter Isaacson, Kathy Mazur, et al.

Many of our guests on B-Time are focused exclusively on a B2B model.  Today, we are changing it up a bit and are focusing on the direct to consumer model.  Trillions of dollars are spend out of pocket by consumers on health and wellness goods and services.    One company, Intrinsic, is taking full advantage of this consumer spend and is buying smaller consumer wellness companies to become a Brand powerhouse.  With us is Yadin Shemmer, the founder and CEO of Intrinsic and he’ll share his view of the market and what he sees as emerging trends in this space.  Yadin has a bachelors from the University of Pennsylvania and an MBA from the London Business School.  I am excited for Yadin to share his thoughts because as we all know, consumer behavior eventually makes it way into the more traditional areas of healthcare.  Over time some of this direct spend will find its way into health plan coverage.  Show Notes: Favorite Book: What You Do Is Who You Are By Ben Horowitz; The Attributes: 25 Hidden Drivers of Optimal Performance by Rich Diviney.

Our guest today needs no introduction to most of you.  With us is Sam Glick, Global Leader of the Health & Life Sciences Practice at Oliver Wyman.  Many of us have spent time with Sam and his colleagues discussing everything from industry opportunities and challenges to new business models and more.  Today Sam is going to share his thoughts on where the industry is headed and how we, as leaders, should be thinking about these changes and their potential impact on our businesses. Sam has been with Oliver Wyman for 16 years and works with health plans, providers, biotech manufacturers and more and has spoken at all the top industry conferences.  He is an economist by training.  He was raised on a citrus farm and his newest side hustle is co-owner along with his wife Emily (who really deserves all the credit) of the charming Stavrand Inn located in California wine country’s Russian River Valley.  Show Notes:  Favorite Books:  You’re Not Listening by Kate Murphy; Favorite Magazine: McSweeney’s (specifically Issue #65 Titled “Plundering”); Favorite Podcasts:  Post Reports from The Washington Post. 

The pandemic placed a spotlight on employee wellbeing.  Many employees have been under increased stress and duress over the last two years.  In survey after survey, employers are sharing that they are altering their benefits programs to include services that move beyond traditional physical and mental health and into total wellbeing.    As with any market shift, there are players including new market entrants ready to fill in the gaps.  One such player is SoulBeing which offers complementary and alternative medicine services through a network of providers.  Their belief is that the divide between tradition and complementary medicine is closing and that many people, including providers and consumers alike, are focused on integrative medicine.   With us today to dive deeper into integrative medicine is Colleen Kavanagh, CEO of SoulBeing.  Colleen will share SoulBeing’s vision and how it is creating momentum around the need for integrated medicine.  Prior to joining SoulBeing, Colleen spent 9 years working in GE’s healthcare division.   Show notes:  Favorite Books: The Blue Zones By Dan Buettner  The Blue Zones Kitchen by Dan Buettner, Better Than Before by Gretchen Rubin, Atomic Habits by James Clear.    Favorite Podcasts:  B-Time with Beth Bierbower, The Meditative Story Podcast, Willis Towers Watson Cure for the Common Co.  

With us today is the co-founder and COO of Equip Health –  Dr. Erin Parks.  Erin and her co-founder – Kristina Saffron, have created a home-based program (a real departure from the very traditional facility-based programs) to help people recover from eating disorders.  Today we’ll learn more about these devasting issues and how the Equip Health team is changing the treatment delivery and recovery in this area.   Show Notes:  Favorite Book:  Essentialism by GregMcKeown.  Podcasts:  The Essentialism Podcast; Work/Life with Adam Grant; Startup from Gimlet Media, In Depth from First Round Review.   Contact the team at Equip Health in one of the following ways: B: https://www.facebook.com/joinequip Twitter: @joinequip and @erinparksphd Instagram: @equiphealth and @drerinparks Linked In: @Equip (https://www.linkedin.com/company/equip-behavioral-health) and @erinparksphd

Susan Dentzer is one of the nation’s most respected health policy experts and thought leaders and is the Senior Policy Fellow at the Robert J. Margolis Center for Health Policy at Duke University.  Based in Washington, DC, she works on a range of health policy issues including health system transformation, the use of artificial intelligence and related technologies in health care, biopharmaceuticals policy, and improving cancer care as well as maternity and infant care. She is the editor and lead author of the book "Health Care Without Walls: A Roadmap for Reinventing U.S. Health Care."   Show notes:  Book:  Uncontrolled Spread by Scott Gottlieb.  Podcasts: Hacks on Tap. 

Strategic Business Transformation: The 7 Deadly Sins To Overcome by Mohan Nair is a guidebook to help your business create a secret sauce for longer-term success.  Nair has a lot of business experience in Innovation and Operations.  He takes his direct experience and combines it with pieces of business strategy from well-known business gurus to present tangible and actionable tactics for success.  Nair uses examples of textbook companies like Southwest Airlines but manages to add some insights that may have been overlooked by others.     Here is a quick list of the 7 deadly sins:   Ignoring the new principles of business transformation Driving without a cause Missing market momentum Ignoring the two orders of value Overlooking transformational servant leadership Mistaking capability for strategic competence Expecting flawless execution without a performance platform At its core, Nair has given leaders a playbook to reference repeatedly as they face continuous change in the marketplace.  A good add to your bookshelf.

With me is Daryl Risinger, President & Cofounder of Soda Health, a healthcare technology company focused on building solutions that eliminate health inequities.  The team at Soda Health work with Health Plans to turn ideas around SDOH benefits into reality.  Daryl will share with us some learnings and insights around SDOH and how his company is making a difference in this area. Show Notes: Boos: Little Bets: How Breakthrough Ideas Emerge From Small Discoveries By Peter Sims.  Podcasts: B-Time with Beth Bierbower; Hidden Brain with Shankar Vedantam; UnSILOed with Greg LaBlanc.

Pramod John is the CEO of VIVIO, a company that has built an autonomous solution that allows employers and other healthcare payers to take control over their specialty drug spend.   VIVIO is a Public Benefit Corporation that operates with a transparent business model.  Their only form of compensation is an administration fee allowing them to focus just on the question of cost benefit at the individual patient level. We’ll hear how VIVIO’s approach differs from that of the traditional PBM and the impact this approach has on both health outcomes and costs. Show notes:  Suggested Books:  Talking To Strangers by Malcolm Gladwell; Uncaring: How The Culture Of Medicine Kills Doctors And Patients by Robert Pearl.

 Health plans and providers alike are focused on population health and ensuring that members are getting the care and support they need to keep chronic conditions in check.  However, often, these entities encounter challenges in obtaining actionable data or insights that allow the organization to intervene in the care process earlier.   Myia Health is tackling this issue and helping both providers and health plans better manage individuals with chronic conditions.  With us is Myia’s CEO and Co-founder, Simon MacGibbon.  Simon has a background in strategy, CRM technology, and large-scale digital transformations.  He has worked for companies such as McKinsey and IBM and he was co-founding Partner of the Boston Consulting Group’s Digital Ventures business.   Show Notes:  Books:  Crossing the Chasm by Geoffrey Moore; What You Do Is Who You Are: How To Create Your Business Culture by Ben Horowitz; Competing Against Luck by Professor Clay Christensen.  Podcasts:  Relentless HealthValue Podcast; Dylan Johnson – cyclist – on YouTube.

How do you help a company pivot and emerge stronger?  How do you chose what to prioritize versus not?  How do you engage your employees in the company’s future vision?  We discuss these issues and more with Matt Levin, CEO of Benefitfocus as he talks about leading his company through a time of change.   Show Notes: Podcasts: Smartless; The Rewatchables with Bill Simmons; Hacks on Tap with David Axelrod & Mike Murphy; Hell & Highwater with John Heilemann.  Books:  Team of Rivals by Doris Kearns Goodwin; Books by Michael Lewis or James B. Stewart; Biographies of Michael Jordan or Walter Peyton.

We are talking today with Patrick Quigley, the Founder and CEO of Sidecar Health, a company that is offering personalized, simplified coverage to individuals and equipping these consumers with cost information to help them make good decisions about their healthcare.  I am excited to learn more about what Sidecar Health is doing to simplify and create affordable coverage and provide price transparency that’s meaningful by removing the intermediary as we know it today.  Patrick is no stranger to healthcare as he was formerly the CEO of HealthPlans.com.   Show notes:  The Price We Pay by Marty Makary, MD.  Podcasts:  The Cleveland Browns Daily Podcast.

Today we are going to discuss the impact of cellular carriers sunsetting their 3G networks this year.  You may wonder why the sunsetting of 3G is an appropriate topic for a podcast focused predominantly on healthcare, so here’s the answer.  The sunsetting of 3G networks has a significant impact on the elderly and low-income populations.  Many devices such as older phones, personal emergency response systems and home alarm systems including carbon dioxide alarm systems will cease to work. Many individuals cannot afford to replace these devices.  In addition, COVID has significantly slowed the ability for service workers to upgrade systems in the home.  As healthcare leaders, is this issue on our radar screen?  Will we find it more difficult to contact chronically ill members whose phones no longer work?  Will we see increased costs due to the failure of a PERS device to signal for help?  With us today to educate us on the 3G sunset issue and what is being done to help people upgrade is Janet Dillione, CEO of Connect America which brings digital health connected solutions into the home to improve the safety, care and quality of life for the elderly who want to remain living independently as long as possible. Janet has a long history in digital health serving in the past as President & CEO of Siemens Medical Solutions, EVP & GM of Nuance Communications Healthcare Division and President and CEO of  Action Management Technologies and Bernoulli.  Show Notes:  Books The Leadership Moment by Michael Useem.  Podcast: The Spycast Podcast.

:  Approximately 800,000 people in the US have a heart attack every year?  1 in 4 people have had previously had a heart attack.  When an individual is recovering from a heart attack or has a serious heart problem, Cardiac rehabilitation can be an instrumental part of not only the individual’s recovery, but also in preventing future heart attacks.   Today we are going to hear from Ade Adesanya, Co-founder and President of Moving Analytics, a company that offers Cardiac Rehabilitation in the comfort of the patient’s home.  We’ll learn exactly what Cardiac Rehabilitation entails, and why many people fail to participate despite the demonstrated success of these programs.  Show notes: Favorite Book:  Crossing The Chasm by Geoffrey Moore.  Podcasts: Tim Ferris Podcast; Access & Opportunity with Carla Harris.

The Price We Pay: What Broke American Health Care And How To Fix It by Marty Makary, MD is a book that takes a hard look at aspects of the US healthcare system that drive up the costs of premiums and other patient out-of-pocket costs.  Makary looks at PBMs, broker payments, hospital billing and financial recovery practices and inappropriate procedures to name a few.  Regardless of where you work in the healthcare system, you may find yourself getting defensive one moment and nodding your head in agreement in another. What Makary is after at the end of the day is price transparency which he believes will help bring healthcare costs down.  The author makes many good points in the book about hidden costs that drive significant profitability for one party while the other party is in the dark.  Typically, price transparency levels the playing field between seller and buyer and enables new market entrants to redefine a business model that offers service at a lower cost.  Price transparency isn’t exactly a thrilling topic but Makary is a brilliant writer whose writing and storytelling is on par with exceptionally good journalists.  I couldn’t put the book down.  The reader will not agree with every point that Makary makes.  However, many would agree that we are at the tipping point for price transparency, some of which will come about due to regulation and other aspects will be driven by market competitiveness.  Health care leaders must rethink their business models due to transparency changes and it’s prudent to take a close look at major areas in need of an overhaul.  The Price We Pay by Makary is an informative book to read to level set on how we operate today and to remind us how costly, continuing many of these practices can be in the future.