36 episodes

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.

Healthcare is Hard: A Podcast for Insiders LRVHealth

    • Health & Fitness
    • 4.3 • 23 Ratings

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.

    The Retailers are Coming (Part 3): Walmart’s Chief Medical Officer

    The Retailers are Coming (Part 3): Walmart’s Chief Medical Officer

    Walmart is the world’s largest retailer with revenues surpassing $120 billion and more than 10,000 locations across the globe. With nearly 5,000 locations in the United States, 90% of Americans live within 10 miles of a Walmart store.

    No conversation about the role retailers are playing in healthcare disruption would be complete without including Walmart. So to close a thee part series of retail interviews that also included the Chief Medical Officer at Walgreens and Chief Strategy Officer at CVS Health, Keith Figlioli spoke with Walmart’s Chief Medical Officer, Dr. John Wigneswaran, for this episode of Healthcare is Hard.

    Dr. Wig, as he‘s known, says he never expected to be working at Walmart when he was in medical school. And in fact, even though his father was a pediatrician, a career in medicine seemed to be a remote possibility early in life when he was following his passion for music and signing a record deal. But since then, Dr. Wig has led an impactful career with a variety of roles in the pharmaceutical, medical device and healthcare services industries, after more than a decade of clinical experience as a practicing nephrologist.

    Before joining Walmart this year, Dr. Wig was CMO at Express Scripts. He also served as CMO at DaVita Rx, VP of Market Development at Fresenius Medical Care, and Medical Director in medical affairs at Johnson & Johnson (Scios Inc.), among other roles.

    Dr. Wig’s conversation with Keith Figlioli about Walmart’s growing role in healthcare covered a number of topics including:
    Meeting people where they are. Dr. Wig says that finding ways to fit health care into peoples’ day to day activities is a core focus for Walmart. This allows people to avoid rearranging their lives around traditional healthcare structures, and also expands the type of care available to them. Walmart’s omnichannel capabilities can provide the flexibility that people need – especially when it comes to complex and costly interventions around chronic diseases. For example, this could include a person with diabetes being educated about healthy foods or a telepharmacy encounter for someone with an educational need.Building community trust. Most retail settings are about more than just shopping, according to Dr. Wig. People go to their local Walmart store for many reasons, some to simply walk indoors for the exercise, but overall for a sense of community. Dr. Wig says trust is becoming much more local and recognizes the opportunity and responsibility Walmart has to be a place where people can turn for their healthcare needs.The power of data. Walmart has long been known as a pioneer in the way it uses data to improve operations and better serve customers. The company can apply that same know-how and discipline to using data in way that can improve healthcare. Dr. Wig says the company is very focused on the privacy and security aspects of healthcare data and determining how to bring its many sources of data to bear in a safe and responsible way.To hear Dr. Wig and Keith talk about these topics and more, listen to this episode of Healthcare is Hard.

    • 39 min
    The Retailers are Coming (Part 2): CVS Health’s Chief Strategy & Business Development Officer

    The Retailers are Coming (Part 2): CVS Health’s Chief Strategy & Business Development Officer

    In the United States, 85% of the population resides within 10 miles of a CVS Pharmacy. Through continued growth and expansion since its founding as a health and beauty products retailer in the early 1960s, CVS Health has now become America’s largest health services company. That expansion accelerated over the last two decades through acquisitions of companies like MinuteClinic, Caremark and Aetna that embedded CVS even more deeply into the U.S. healthcare system and communities across the country.

    Josh Flum has played key roles in CVS Health’s transformation and healthcare strategy for nearly 20 years. After Yale Law School and a few years as a white-collar criminal defense attorney in Washington, DC, Josh decided on a career change and landed a job at Boston Consulting Group where he first crossed paths with CVS. In this episode of Healthcare is Hard, Josh tells Keith Figlioli about one project at BCG where he was begrudgingly selected to spend two weeks virtually living at CVS pharmacies learning everything there is to know about how they operate. That assignment proved invaluable for the rest of Josh’s career. Since joining CVS in 2004, he has held several senior roles including leading pharmacy operations and overseeing Enterprise Product Innovation and Development teams. He also co-founded and leads CVS Health Ventures, and is currently CVS Health’s Chief Strategy & Business Development Officer.

    Josh and Keith covered several pressing topics during this Healthcare is Hard interview including:
     The next evolution in pharmacy. Josh talks about fundamental shifts in the pharmacy business that have occurred in his career and what he thinks is in store for the future. While the deeply personal connection between people, families and pharmacists has always persisted – and will be integral for the future – the pharmacy business has moved from being about medication fulfilment, to clinical pharmacy care including medication adherence, to other aspects of medical care such as testing and immunizations. Josh says the future will be about pharmacists practicing at the top of their license and balancing clinical care interventions with new technology and the consumer relationships that pharmacists have always maintained.The retail threat. Keith posed the same question to Josh that he asked Walgreen’s CMO on last month’s Healthcare is Hard episode: how should incumbent healthcare delivery players think about the emerging role of retailers? To Josh, it comes down to how a company fits into three trends: patient as consumer; care in community, home and virtual settings; and technology. Josh says CVS feels very well positioned to play a big role in the future of healthcare as these trends continue to evolve, while recognizing that the company still has much more to do and will need to work in partnership with the broader healthcare system to make the kind of change that is necessary.The flip side of innovation. Through his role at CVS Health Ventures, Josh sees many of the exciting developments that are going to make care easier and more ubiquitous, but sometimes wonders if the pace of advancement could overwhelm consumers. Putting himself in the consumer’s shoes, he says it’s all about trust. He believes consumers will turn to the people and organizations they know and trust to help navigate new experiences – organizations like CVS Health. For its part in the innovation ecosystem, Josh says CVS Health Ventures is currently focusing on investment themes including care delivery, consumer centric healthcare, whole person care and disruptive tech enablement that crosses all these domains.To hear Josh and Keith talk about these topics and more, listen to this episode of Healthcare is Hard.

    • 44 min
    The Retailers are Coming: Walgreens CMO On the Future of Community Care

    The Retailers are Coming: Walgreens CMO On the Future of Community Care

    Since its first store opened in 1901, Walgreens has been embracing innovation in the retail pharmacy space, fueling its expansion to become a neighborhood health destination with more than 9,000 locations. As the healthcare industry navigates major structural changes – and a global pandemic – Walgreens is staying true to its roots of innovation and guiding what the future of healthcare looks like in America.

    Kevin Ban joined Walgreens as Chief Medical Officer in January 2020, and by the end of February was already being thrust into pandemic planning and response. In the short time since, he’s implemented guidelines to ensure customer and team member safety, launched and expanded COVID-19 testing services across thousands of stores, and rolled out COVID-19 vaccinations, all while focusing on Walgreens’ long term goals for the strategic role it will play in healthcare.

    During this episode of Healthcare is Hard, A Podcast for Insiders, Kevin draws on these experiences – as well as past roles including time spent as CMO at Beth Israel Deaconess Medical Center, CMO at AthenaHealth, and Professor at Harvard Medical School – in a wide-ranging discussion with Keith Figlioli. They touch on a number of topics including:
    Decades of VBC Lessons – While value based care in America is still in its early days, Kevin has been a student of value-based arrangements for two decades. He describes time he spent in Italy in the early 2000s where he was exposed to the single-payer model, and what he calls the epitome of value based care. For example, he remembers the Italian health system being exceptionally good at delivering care outside of the hospital in a way that the U.S. health system would have never imagined. He also talked about how that background prepared him to become involved with one of the nation’s first VBC experiments – Blue Cross Blue Shield of Massachusetts’ Alternative Quality Contract – at a time when his peers showed little interest. (for more on AQC, listen to the Healthcare is Hard Episode with Pat Gilligan, Chief Commercial Officer at BCBSMA)Pairing primary care and pharmacy. In his time at Beth Israel, Kevin says he was amazed at how often plans for patients fell apart because of the challenges with medication management after discharge. These experiences formed Kevin’s beliefs about the imperative for getting medication reconciliation right. He says that any time you can pair primary care and pharmacy together thoughtfully, it will drive better outcomes, and talks about different strategies for ensuring synergy in the future.Community care and retail’s role. Kevin knows how important the last mile of care is and says that connecting with people outside of the hospital was a continued source of frustration during his time at Beth Israel. However, that paradigm is completely different at Walgreens. People trust their pharmacist because they’re accessible and deeply knowledgeable, but overall, they’re an underutilized resource within the health system. While not long ago, it’s even difficult for Kevin to remember a time before pharmacies administered flu shots. And now, people go very comfortably to their local pharmacy for vaccines and testing, making them an important new site for primary care – just as Walgreens is delivering through its investment in and partnership with VillageMD.To hear Kevin and Keith talk about these topics and more, listen to this episode of Healthcare is Hard. 

    • 49 min
    Digital Health Hype Vs. Reality: How KLAS Cuts Through With the Voice of the Customer

    Digital Health Hype Vs. Reality: How KLAS Cuts Through With the Voice of the Customer

    Investments in digital health hit an all-time high in 2020, only to surpass the new record within the first six month of 2021. Needless to say, there’s never been more attention placed on digital health innovation. But it makes for a crowded market, putting providers and health system CIOs in a challenging position where it’s impossible to vet the wave of new technologies and determine what will really help reduce costs and improve care.

    For 25 years, KLAS has helped providers navigate the increasingly complex healthcare IT landscape through research that’s focused on amplifying their voice in the market. With a rigorous process of collecting and assembling feedback from the people who actually use healthcare technology, KLAS forces technology vendors to face, act on, and improve from critical feedback, and gives providers a venue to seek advice from their peers.

    In this episode of Healthcare is Hard: A Podcast for Insiders, Keith Figlioli talks to the CEO and co-founder of KLAS, Adam Gale. They discuss his firm’s role in the digital health industry over more than two decades, and touch on topics important for providers, vendors, investors and others playing a role in the industry’s future. They cover a number of issues, such as:
     The beginning of health tech innovation. KLAS was established at what might feel like the beginning of digital health innovation – even before Meaningful Use was implemented – but once again Adam feels like things are just getting started. He talks about being in the right place, at the right time, to be a trusted voice during the nationwide rollout of electronic health records, and the uncertainty KLAS felt for the future once EHRs were in place. But he also talks about how being at the front edge of technology right now reminds him of those early days, and the limitless possibilities that lie ahead.Forcing change through public policy or private markets. Touching on a theme from the last Healthcare Is Hard podcast with ONC’s Steven Posnack, Keith and Adam discuss the levers for implementing change in healthcare IT. Adam shares a conversation he once had with Secretary for Health and Human Services, Mike Leavitt, where they both expressed envy for the other’s ability to help implement change. While Adam pictured government as a body capable of setting the course, Secretary Leavitt revealed how difficult this actually is. A slight move in any direction, according to Leavitt, creates waves of pushback from multiple angles. But as a private organization with influence over both vendors and providers, KLAS is in a unique position to drive change and improvements across the industry.Advice for entrepreneurs. Adam shares insights throughout the interview that are valuable for digital health startups and entrepreneurs, while providing direct advice at times too. For example, he talks about the strategic importance for early-stage companies to invest in their first customer relationships to develop one or two health system customers that will become good references. He says this might be a slower path to success, but stresses the power that word-of-mouth has in the healthcare industry and how this approach builds real value.To hear Adam and Keith talk about these topics and more, listen to this episode of Healthcare is Hard.

    • 45 min
    A Market-Driven or Policy-Driven Approach to Health IT Innovation? ONC’s Deputy National Coordinator on the Path Forward

    A Market-Driven or Policy-Driven Approach to Health IT Innovation? ONC’s Deputy National Coordinator on the Path Forward

    The accelerated pace of innovation in digital health, record-breaking investments in the sector and even some of the technology developed to navigate the pandemic wouldn’t have been possible without groundwork laid by The Office of the National Coordinator for Health Information Technology (ONC). And there’s probably no one who understands ONC’s past, present and future role better than Steve Posnack.

    Steve is a fixture at ONC, joining a year after it was formed in 2004 and serving for the past 16 years in various capacities through four administrations. Since 2019, Steve has served as Deputy National Coordinator, playing an integral role in policy development, technology initiatives and investments, budget prioritization and industry-wide coordination.

    In this episode of Healthcare is Hard, Steve gives a background and history of ONC, explaining how it fits into the Department of Health and Human Services and the overall role it plays in the federal government. He shares insights that anyone in the healthcare innovation ecosystem should understand and his conversation with Keith Figlioli covers a number of topics including:
    Wins and regrets of ONC. As someone who has been at ONC for nearly its entire history, Steve has a rare vantagepoint to reflect on initiatives that have gone smoothly and lessons-learned for those that haven’t. For example, he discusses successes and challenges of Meaningful Use, recognizing its imperfections, but all the innovation that it made possible as well.Cybersecurity in healthcare. Steve entered ONC after earning a dual master’s degree in cybersecurity and health policy from Johns Hopkins University, giving him a unique skillset to address the security issues with healthcare IT that are becoming increasingly more critical. He talks about the need for better cyber hygiene industry-wide and shares thoughts about meeting that goal. But he doesn’t predict any federal mandates for security in the near future.Improving data quality. According to Steve, poor data quality is a sore point for public health professionals and an area where the private sector can help in order to benefit everyone. He says the people tasked with tracking and consolidating data spend precious time doing “data detective work,” and it’s been especially challenging through the pandemic. This requires looking upstream to know where data is coming from and where it’s going to figure out how gaps occur and how to address them.The future role for ONC. Taking all of ONC’s accomplishments into account, Keith and Steve discuss if there’s more work to be done, or if the public sector should start taking over. From Steve’s perspective, there’s a lot for the private sector to build on, but he also says there’s a lot the industry is still asking ONC to push forward. As just two examples, he talks about how work around the social determinants of health and the convergence of clinical and research operations still need broader coordination.To hear Steve and Keith talk about these topics and more, listen to this episode of Healthcare is Hard.

    • 44 min
    When Consolidation Isn’t About Pricing Leverage: How Ballad Health Merged Two Systems to Reduce Costs and Reinvent Rural Healthcare

    When Consolidation Isn’t About Pricing Leverage: How Ballad Health Merged Two Systems to Reduce Costs and Reinvent Rural Healthcare

    In the United States, more than 90% of the landmass is rural. And in rural communities from coast to coast, the challenges in delivering healthcare can be very different than the urban and suburban centers that get most of the attention.

    There’s untapped opportunity in reimagining healthcare business models and the technology that will enable them in rural areas, according to Ballad Health CEO, Alan Levine. And he should know – in the three years since Ballad was formed by merging Wellmont Health System and Mountain States Health Alliance, it has had exceptional success rewriting the rules of rural healthcare.

    Among some of its visible and measurable improvements, Ballad Health has decreased pricing by an average of 17% for urgent care and other physician-based services, cut its mortality rate for trauma in half, reduced low acuity admissions by 16,000 per year, and saved the region in which it operates more than $200 million per year in healthcare costs. And it’s doing this with only a 20% commercial payer mix.

    In this episode of Healthcare is Hard, Alan talks to Keith Figlioli about how Ballad Health is achieving these milestones by better understanding the dynamics of rural healthcare and making big structural changes to address them. He shares specifics about many of the changes Ballad has already implemented and his plans to continue down this revolutionary path. Their conversation covers topics including:
    Trading competition for regulation. In the areas of Tennessee, Virginia, North Carolina and Kentucky where Wellmont and Mountain States operated, only 50% of hospital beds were occupied and rates were declining. To survive and give it stability, Wellmont looked to be acquired by an outside system, until Mountain States stepped in with a unique solution to merge. But the FTC opposed the merger every step, forcing legislation in Virginia and Tennessee followed by approval from both states’ governors, attorneys general and health commissioners. Against significant odds, the merger was approved with Ballad agreeing to cap pricing and price increases at a rate well below the hospital consumer price index (CPI).Eliminating duplication. Many of the structural changes at Ballad Health revolved around reducing duplicate services. Intense competition between Mountain States and Wellmont forced one system to always keep up with the other. As a result, a small town like Greenville, TN had two hospitals a little over a mile apart which had both lost $70 million at 30% capacity in the years leading up to the merger. One of Ballad’s key goals is to implement a more rational approach and business model that makes sense for rural areas.Transforming from hospitals to health improvement. While reducing duplication, Ballad is thoughtfully applying the resources it saves to improve the health of its communities upstream. For example, in one region where it consolidated hospitals, it converted one building into a residential facility for women who are pregnant, homeless, drug addicted or have other needs. It gives these women housing security, food security and resources to help ensure their babies are born into a healthy situation.The new competitive landscape. Alan says his biggest competition is no longer the health system or physician group down the street. It’s the tech-enabled company across the country or a retail chain that could provide primary care. And unlike health systems in urban areas that can offset the loss of a patient with populated growth, there’s nothing to replace that loss in a rural area. This is why technology will play a significant role in the transformation of rural healthcare.To hear Alan and Keith talk about these topics and more, listen to this episode of Healthcare is Hard.

    • 38 min

Customer Reviews

4.3 out of 5
23 Ratings

23 Ratings

JoshCrist ,

Entertaining, insightful and actionable! 🔥

Whether you’re well established as a healthcare innovator, or just getting started as a catalyst for change - this is a must-listen! Keith does an incredible job leading conversations that cover a huge breadth of topics related to the ins and outs of building a thriving healthcare ecosystem - with leaders who’ve actually experienced success themselves. Highly recommend listening and subscribing!

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