As we talk about the current zeitgeist moving us towards value and equity, we also have to think about how polarized our country is politically. Democrats and Republicans live in separate worlds, or “echo chambers,” with each side prone to bias or “motivated reasoning.” This has created an existential threat of tribalism where partisanship has turned Americans against one another. The term that best describes our strife is “political sectarianism,” or the tendency of political groups to align on the basis of moralized identities rather than shared ideas or policy preferences. However, the promise of value-based care is something that we should all agree on in a bipartisan way. The Race to Value is both an economic and a moral imperative, and it can be actualized through relationship-based care, collaborative health models, and the power of advanced analytics.
In this week’s episode, we interview Michael L. Millenson, an internationally recognized expert on making American health care better, safer and more patient-centered. As a leading expert on health policy, quality improvement, and patient-centered care, he provides a deeply informed and unfiltered perspective on how to defeat political sectarianism to achieve analytics-based value innovation. This intellectual conversation leaves nothing unsaid and will provide you with an enhanced understanding of the political challenges of value transformation and how analytics will drive collaborative health in the Information Age.
01:30 Introduction to Michael Millenson
03:30 The “Race to Value” — is this a revolution?
06:00 “Value-based care is the ethically right thing to do.”
06:45 Confusion about value in health. (Public perception equates the term “value-based care” to fast food.)
08:00 “Value-based care is the most important transformation of American medicine in our lifetimes.”
10:30 The dilemma of VBC (you must first recognize that poor quality exists currently to realize the potential for value)
12:00 Political sectarianism – how tribalism and entrenched interests hinder health policy
13:30 Winners and Losers in health policy reform and how “motivated losers” fight back!
15:30 How social media and suspicion stifles value-based payment innovation and the promise of bipartisan reform
16:30 Authentic healthcare leaders realize the need for value (there is hope!)
18:30 How do you engage providers to root out clinical variation and unnecessary care?
20:00 The need for Patient Safety and Quality Improvement in Healthcare
21:00 Referencing Michael’s book, “Demanding Medical Excellence: Doctors and Accountability for the Information Age”
22:00 “Hospitals often do not do what it takes to be as safe as possible because there is no return on investment.”
24:30 Referencing Michael’s article “Why We Still Kill Patients: Invisibility, Inertia, and Income”
26:00 The moral challenges of bureaucratic medicine and misaligned economics and how it creates preventable harm
29:00 The disconnect between Cost and Quality
31:00 The ethics of value-based care and the travesty of physicians not speaking up (Referencing Michael’s article “The Silence”)
33:30 The promise of “Analytics” in the future of healthcare (and the similarities to the “Plastics” scene in The Graduate)
34:30 Enhancing clinical outcomes through semantic interoperability, AI, and predictive analytics
37:30 The misperception that population health analytics will impinge on clinical autonomy
39:30 Smart phone technologies and “proactive benefits” to engage patients in getting well
41:15 “Analytics is the key to the Information Age of Medicine.”
43:00 The limitations of human cognition in healthcare and how unleashing analytics can foster empathy and compassion in medicine
44:30 How open APIs and the FHIR interoperability standard will empower personalized care delivery
47:00 The National Academy of Medicine estimates that moving “upstream” could cut health care expenditures by 20% and save $800 billion a year!
48:00 Building deeply contextualized algorithms with consumer, behavioral, psychosocial, and biometric data
51:00 Understanding the research on SDOH and Lifestyle Medicine and applying analytics to drive clinical innovation and patient activation
55:00 “Collaborative health” to for shared accountability that goes beyond patient-centered care
59:00 Overcoming information asymmetry to actualize the collaborative health model
62:00 Focusing on relationships and trust will help us overcome the issues of cost and quality