Ep 38 – Helping Communities Thrive with Primary Care for All, with Dr. Christopher Crow

When Thomas Edison created the electric light bulb, he didn’t stop with that one incredible invention. He took the next step and created the industry that would maximize the benefit of that light bulb, the infrastructure needed to make that light bulb become a permeating and permanent piece of society.

This is the type of vision needed for the health care system as a whole, and the type of vision that is occurring in Dallas Texas. Catalyst Health Network’s physicians are intent on the vision of “Primary Care for All”, serving communities that are mired in a systemic, multi-generational crisis—where one in three children in Dallas lives in poverty, the third-highest rate of child poverty in the nation.

This week’s guest, Dr. Christopher Crow, President of Catalyst Health Network, has connected and aligned a network of more than 1,000+ Primary Care Providers with nearly 1 million lives across North Texas, to build a better care model for patients that improves health and lowers cost. His work with Catalyst led them to be the first North Texas physician network to hold value-based contracts with the top four major carriers: Aetna, UnitedHealthcare, BCBSTX, and Cigna. To date, Catalyst has saved an impressive $100 million for the communities they serve. Dr. Crow and Catalyst are a bright example of leadership in the race to value!

Episode Bookmarks:

04:00 Thomas Edison’s signature invention of the light bulb was a little more than a parlor trick without a system of electric power generation and transmission

05:00 How Catalyst you’ve been able to imbue a full spectrum of innovation with its value attempts

06:00 The origin story of Dr. Crow and Catalyst Health Network

07:20 Systems thinking design and strategy as a leading force to payer collaboration

08:20 Dr. Crow’s A-Ha moment when seeing Catalyst’s performance data and how value design and PCMH really does lowers cost and utilization

09:30 How growing up in the small town of Hillsboro, Texas inspired Dr. Crow to help communities thrive

10:50 The three pillars to helping communities thrive are health, education, and business.

11:20 Building a healthcare system to deliver more value starts with team-based primary care.

12:45 f an independent primary care practice can thrive (not just survive), the data shows that the community will thrive as well.

13:30 Centralization of population health management with deep personalization

15:00 Leveraging trust of the physician-patient relationship by extending it to the entire care team at scale

15:35 The concept of relationship compounding in value-based care and how it leads to lower costs and better health

16:40 The income and public health disparities in Dallas, Texas and how life expectancy differs by 24 years between neighboring zip codes!

18:10 Dallas is a tale of two cities – affluence and poverty.  What is Dr. Crow’s vision to help everyone in the community thrive?

19:30 Dr. Crow’s vision for “Primary Care For All” to improve longevity and prosperity

21:00 The impact of COVID-19 on building virtual care and telehealth capabilities within the practice

21:30 The importance of telehealth in addressing issues with Behavioral Health and “healthcare deserts”

23:00 Creating the Catalyst Community Foundation to provide access to affordable, quality care, starting with COVID-19 testing and vaccinations

25:15 “If you really want to create impact with high leverage, go upstream with primary care and social services”.

26:20 Building a business model for a self-sustaining, community-based foundation that will ultimately lead to Primary Care For All

27:30 Private Equity investment and provider consolidation – what does this mean for the future of primary care?

31:00 How Catalyst helps small primary care practices build the table stakes for value-based care from a technology and service standpoint

34:45 Catalyst receiving URAC’s full accreditation in Clinical Integration and how they were able to build a CIN with a network of independent physicians

38:30 Engaging physicians with a playbook for clinical integration

39:00 Joining forces with another prominent CIN (Baylor Scott & White Quality Alliance) to bring even a higher level of innovation and integration to the Dallas market

40:20 Developing a health insurance product for individuals and small employers that offers Primary Care for All in a subscription-based model with prospective payment

43:00 The exploding costs of employer-sponsored health insurance with ‘poor health’ costing employers $530B on top of the $880B they already spend in premium dollars!

45:30 Collaboration with employers and how “Relationships Matter” is the #1 core value of Catalyst Health Network

46:45 How Catalyst generated $100M in savings primarily with a commercially-insured population (not Medicare or Medicare Advantage)

48:30 The thought leadership of Dave Chase and “How Healthcare Stole the American Dream”

48:55 Unnecessary spending and low value healthcare deprives future prosperity of communities

51:00 Redesigning employer plan benefits with an emphasis on Primary Care and prospective payment

52:45 COVID-19 as a wakeup call for large employers

54:40 Medicare Advantage with prospective payment and shared risk

56:00 The new CMMI Direct Contracting model

56:30 How PPOs are the wrong model for value (the “PPO Buffet”) and the HMO backlash

57:24 “If you want a longitudinal model for primary care, with the benefits of relationship compounding, you must pay for it prospectively.”

59:30 How Integrated Pharmacy with a focus on medication adherence can reduce healthcare costs through reduced inpatient hospital stays and emergency visits

1:00 40% of drugs purchased in healthcare are not even taken!

1:02 Integration of pharmacist with a care team to help providers and patients make the right decisions

1:03 “90-day refills are bad for your health!”

1:05 Moving adherence rates for patients with chronic diseases – from 60% to 90%.

1:07 “The Infinite Game” mindset for leadership in primary care transformation

1:08 Winning in America is stock prices and EBIDTA.  Not a different purpose-driven game based on relationships leads to a better future.