MTVA Unscripted: Empowering the Move to Value Based Healthcare

Moving to Value Alliance
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MTVA Unscripted: Empowering the Move to Value Based Healthcare

The Moving to Value Alliance (MTVA) engages in open and honest conversations with disruptors in healthcare, discussing the transition to value-based care. A 501(c)(3) nonprofit, MTVA is dedicated to cultivating a healthcare ecosystem that prioritizes high-quality outcomes at affordable costs for employers and consumers. We serve as a dependable source of timely and thought-provoking information, education, and resources to advance value-based healthcare at state and national levels. Visit our website (www.movingtovalue.org) to learn more! Join our email list: www.movingtovalue.org/community

  1. “YOU Are the Customer”: Fixing Healthcare from the CEO’s Desk w/ Darrell Moon

    5 DE JUN.

    “YOU Are the Customer”: Fixing Healthcare from the CEO’s Desk w/ Darrell Moon

    “I really do think it's as simple as waking up the buyer, because if the buyer is going to define what they want and hold people accountable, everything else will happen naturally.” One often overlooked stakeholder in the U.S. healthcare system is business leaders. Our guest this week, Darrell Moon, is on a mission to mobilize these decision makers. Darrell is the CEO and Founder of Orriant and Aspirational Healthcare. As a hospital administrator, Darrell saw the profound misalignment between the health system and its customers. For the last 30 years, he’s been advocating for a different approach – based on the Nuka System of Care in Alaska and Deming’s principles – and coaching executives on how they can too! His recent book “Make Healthcare Work for You” is a pragmatic guide for how CEOs can get better healthcare for HALF the price. Darrell and MTVA discuss his new book and how CEOs can lead the movement to better healthcare! More from MTVA Unscripted: ​Webinar Series for Employers​Wake-up Call: The Johnson & Johnson Prescription Pricing Scandal​From ERISA to CAA: How Has Employer’s Fiduciary Responsibility Changed Over Time?​What Employers Need To Do Now to Comply With CAA by End of Year : MTVA Talks to Chris Deacon​PBM Problems (Part 1): Who do Brokers and Consultants Really Work for? Risks for Plan Sponsors w/ ERISA attorney Paul Holmes​Retail Health Failures: Misaligned Incentives and Misunderstanding Primary Care w/ Brian Klepper Other Sources Referenced: ​Scott Conard, MD blog post re Health Literacy ​Dr. Marty Makary’s book Blind Spots   ———————————— All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠. | Sign up for our email list here. Thank you to our MTVA Trade Members and Ally Members whose support helps make this podcast possible!   As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. For more information and to join us, visit our website: https://www.movingtovalue.org/membership.

    47min
  2. Transforming Dermatology Through Value-Based Virtual Care w/ Zest Founder Olivia Deitcher

    15 DE MAI.

    Transforming Dermatology Through Value-Based Virtual Care w/ Zest Founder Olivia Deitcher

    Thinking about Dermatology may bring to mind Botox injections and commercials for anti-aging skincare products, but behind the scenes, it’s one of the most broken specialties in healthcare. Long wait times for short visits, some of the most expensive drugs on the market, and a system that too often overlooks patients with chronic autoimmune skin conditions. In this episode, we sit down with Olivia Deitcher – Founder and CEO of Zest Health and one of Slice of Healthcare’s “50 under 50" leaders transforming our health system. A “patient founder” living with psoriasis and a veteran of the biopharma startup world, Olivia launched Zest to build the dermatology experience she wished for: high-touch, data-driven, and value-based. “I am candidly very optimistic about where dermatology as a field can go if we can put in place value-based care rails.”  Zest is a virtual-first dermatology clinic designed for patients with chronic autoimmune conditions like psoriasis and eczema. Zest patients are seen within days (not months), and get continuous follow-up care with frequent engagement (30-60 minute visits every 4-6 weeks). Through what Olivia calls the “de-prescription paradigm”, Zest helps patients reduce unnecessary medication use and better manage their conditions — saving tens of thousands of dollars per patient. “We bring a very vast toolkit of therapeutic interventions into the analysis of what is appropriate for the patient. It may be that that patient should change their laundry detergent… see if that helps alleviate things. Just moving to a $6 unscented laundry detergent, before we initiate that patient onto a $90,000 therapeutic where they’re going to have to be at home, injecting a drug into themselves, managing the side effects, and feeling like that’s the only answer.” Olivia and her team are serious about the movement to value – Zest only enters value-based arrangements that pay for improving their patients’ quality of life.  Listen to hear why 91% of their patients said Zest is a better approach to dermatology care – and how Zest accomplishes this while saving patients and their employers hundreds of thousands of dollars on unneeded prescriptions.  To learn more about the link between environment, lifestyle and health, check out our episode with Dr. Elizabeth Boham. Listen to our episode with Pramod John to learn how his company VIVIO Health helps match patients to the right drug at the right price.  Sources Referenced: ⁠Episode 458 of Relentless Health Value w/ Komal Bajaj, MD⁠"Biosimilars in the United States 2023–2027,” IQVIA (Jan. 31, 2023).———————————— All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠. | Sign up for our email list here. Thank you to the MTVA Trade Members and Ally Members whose support makes this podcast possible!  As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. For more information and to join us, visit our website: https://www.movingtovalue.org/membership.

    49min
  3. Value-based Primary Care: Payment Models that Reward Providers w/ Mary Tracy Mock

    29 DE ABR.

    Value-based Primary Care: Payment Models that Reward Providers w/ Mary Tracy Mock

    “Right now, the value-based care reward is coming into the payers far more than it’s coming into the providers.” A primary care provider shortage is on the horizon. Between resolving coverage disputes, trying to get reimbursed for services, and limited time with patients, PCPs are burnt out. But what if we reimagine the primary care payment model to work better for providers and patients?   In this episode, we sit down with Mary Tracy Mock to tackle one of the most urgent and complex issues in healthcare today: the state of primary care and the payment arrangements shaping its future. Mary is a seasoned healthcare executive and veteran of value-based arrangements.  We break down the pressing primary care workforce crisis, and how outdated reimbursement systems are contributing to provider burnout and could soon lead to primary care “deserts.” Mary makes a compelling case for a radical reimagining of how we value and pay for primary care — from capitation to Direct Primary Care (DPC) and beyond. Whether you’re a policymaker, provider or patient, this conversation will challenge your assumptions — and offer real solutions! Sources Referenced: Episode 462 of Relentless Health Value w/ Scott Conard, MD https://pubmed.ncbi.nlm.nih.gov/35029652/  VBC Venn Diagram from Mary Mock ———————————— All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠. | Sign up for our email list here. Thank you to our MTVA Trade Members and Ally Members whose support helps make this podcast possible!   As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. For more information and to join us, visit our website: https://www.movingtovalue.org/membership.

    49min
  4. How eConsults Empower Primary Care, Expand Access for the Underserved & Unlock Savings w/ ConferMED’s Dr. Daren Anderson

    14 DE ABR.

    How eConsults Empower Primary Care, Expand Access for the Underserved & Unlock Savings w/ ConferMED’s Dr. Daren Anderson

    From geography to network adequacy and endless waitlists, getting seen by a specialist can be tricky. And the challenges are even more pronounced for underserved communities – who may be hours away from the provider they need to see, or whose insurance might not be accepted by specialists. Then, after waiting months for an appointment, it may turn out to be one of the many specialist referrals that are unnecessary.  There’s a better way: eConsults. In this episode, MTVA sits down with Dr. Daren Anderson, the President and Founder of ConferMED, a not-for-profit telehealth company that connects primary care practices across the country with specialists through virtual “eConsults”.  “Using an eConsult platform like ConferMED allows you to bring the specialist and the subspecialist into that care team virtually.” Dr. Anderson shares his journey – from primary care provider at a federally qualified health center, to leading the Weitzman Institute, and eventually founding ConferMED, which now helps improve access to specialists across 32 states.  With eConsults, primary care providers are empowered to provide better care without unnecessary referrals, specialists can support more patients efficiently, and patients get answers more quickly. Dr. Anderson and his team have also published research showing that eConsults can generate cost savings for the healthcare system.   “We’re seeing more and more primary care practices looking for eConsult solutions because it makes sense for everybody, not just the underserved. And I kind of like that story, because we figured out something for the underserved that actually makes great sense for everybody else as well, and the underserved got it first!” To learn more about the proposed cuts to Medicaid, check out our episode with Stephanie Noriea. Studies on eConsults referenced by Dr. Anderson: https://www.mathematica.org/news/econsults-can-lower-costs-and-improve-access-to-specialty-care https://pubmed.ncbi.nlm.nih.gov/26951588/ https://pubmed.ncbi.nlm.nih.gov/30633678/ https://pubmed.ncbi.nlm.nih.gov/29350511/ http://pubmed.ncbi.nlm.nih.gov/33719584/ https://pubmed.ncbi.nlm.nih.gov/29061478/ https://pubmed.ncbi.nlm.nih.gov/37753619/ https://pubmed.ncbi.nlm.nih.gov/37864170/ ———————————— All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠. | Sign up for our email list here. Thank you to our MTVA Trade Members and Ally Members whose support helps make this podcast possible!   As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. For more information and to join us, visit our website: https://www.movingtovalue.org/membership.

    44min
  5. What’s up with Medicaid? Proposed Cuts, Impact on States, and Opportunities for Value w/ Stephanie Noriea

    3 DE ABR.

    What’s up with Medicaid? Proposed Cuts, Impact on States, and Opportunities for Value w/ Stephanie Noriea

    We’re just a couple months into the second Trump administration, and already we’re seeing a massive push to reduce federal spending. One program that seems to be on the chopping block: Medicaid.  In late February, House Republicans passed a budget resolution that would drastically reduce federal funding for Medicaid. What’s really going on in Washington? How would proposed cuts impact states – and the millions of Americans who are covered by Medicaid? How can we harness this attention on Medicaid to advance solutions that cut costs AND improve outcomes?  In this episode, Stephanie Noriea joins MTVA to help us make sense of the current situation with Medicaid. Stephanie is an attorney and Managing Director at Mercury LLC who has spent the past 9 years working at the intersection of Medicaid and value-based care. She shares her experience working with startups to bring innovative solutions to Medicaid, breaking down how to navigate the complex landscape and enact meaningful change.  “I have never met a single legislator or governor who says ‘I hate medicaid.’ That’s not what I hear. What I hear is how do we effectuate change? How do we do this better? How do we engage better? And they don't know. And it’s up to us, the practitioners on the ground, the thought leaders, etc to bring these solutions.” MTVA and Stephanie agree: NOW is the time to bring value-based solutions to Medicaid! It is possible to generate cost savings while simultaneously improving access and quality of care.  Tune in to learn what’s on the horizon for Medicaid, and how we can leverage ideas from the value movement to help transform the program! ———————————— Sign up for our email list here. As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. Tax-deductible membership contributions help us enrich the healthcare environment with quality content – including this podcast – and robust platforms to fuel discussion, collaboration, and advocacy that lead to ground-breaking solutions.  For more information and to join us, visit our website https://www.movingtovalue.org/membership.   All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠.

    49min
  6. Achieving the Best Clinical and Financial Outcomes with Optimal Medical Therapy w/ Dr. Bill Bestermann

    20 DE MAR.

    Achieving the Best Clinical and Financial Outcomes with Optimal Medical Therapy w/ Dr. Bill Bestermann

    Managing chronic diseases like diabetes and hypertension is one of the most pressing challenges facing our health system. And Dr. Bill Bestermann has a solution: Optimal Medical Therapy.  Optimal Medical Therapy is a comprehensive, evidence-based approach with the power to prevent adverse events, improve patient outcomes, and dramatically reduce healthcare costs.  A board-certified internist and expert in preventive cardiology, Dr. Bestermann has been singing the praises of Optimal Medical Therapy for decades. In this episode, Dr. Bestermann and the MTVA Board discuss what Optimal Medical Therapy is, the data supporting its effectiveness, and how a “high-tech, high-touch” system can ensure more patients receive the care they need. “Optimal medical therapy is a product. And if you set up your systems to produce that product, you do much better.”  Dr. Bestermann writes extensively about Optimal Medical Therapy on his substack. He is also Chief Medical Officer of Epigenex Health and Chief Medical Advisor for Congruity Health.  References: Read the article “How Our Current Medical Care System Fails People With Diabetes” View the CDC’s map of heart disease mortality by state, showing Minnesota has the lowest rateFor more on GLP-1s, listen to our episode with Al Lewis and our episode with Sloan Saunders. Check out our episode with Dr. Scott Conard about his WHY? ———————————— Sign up for our email list here. As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. Tax-deductible membership contributions help us enrich the healthcare environment with quality content – including this podcast – and robust platforms to fuel discussion, collaboration, and advocacy that lead to ground-breaking solutions.  For more information and to join us, visit our website https://www.movingtovalue.org/membership.   All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠.

    43min
  7. Innovative Payment Models & Plan Designs: Decentralization, Transparent Pricing, and Episodes of Care w/ Steve Wiggins

    4 DE MAR.

    Innovative Payment Models & Plan Designs: Decentralization, Transparent Pricing, and Episodes of Care w/ Steve Wiggins

    “I’d like to leave an infrastructure behind that is better than the one I encountered when I came in, because we're stifling innovation, we're stifling creativity, we’re stifling advance.” How can decentralization and transparent pricing reshape American healthcare? In this episode of Moving to Value, the MTVA Board sits down with Steve Wiggins, a healthcare entrepreneur with 40 years of experience at the intersection of healthcare and technology. Steve has founded and led multiple companies driving innovations in payment models and care management—and today, he’s on a mission to transform the system with his latest ventures: Oxbridge Health and OpenNetworks. Steve’s involvement in healthcare began in college, when his best friend suffered a life-changing injury that left him paralyzed. Since then, he has dedicated his career to creating solutions that improve access, affordability, and outcomes.  Steve shares how innovative plan designs and payment models based on episodes of care can break the cycle of rising costs and realign payment with how patients experience healthcare. He also explores how policies like the Transparency in Coverage Rule and the No Surprises Act are pushing the industry toward greater transparency. “To me, if you’ve been in my seat, you look at this and you say, ‘This is the beginning of a profound change. It’s all going to be different.’”  With Oxbridge Health, he introduces “Episode Benefit Plans,” which use bundled payments to lower costs while preserving broad provider choice. Open Networks is pioneering America’s first health network cooperative—leveraging pricing transparency and data to offer patients predictability on their out-of-pocket costs. ———————————— As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. Tax-deductible membership contributions help us enrich the healthcare environment with quality content – including this podcast – and robust platforms to fuel discussion, collaboration, and advocacy that lead to ground-breaking solutions.  For more information and to join us, visit our website https://www.movingtovalue.org/membership.   All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠.

    48min
  8. “Right Drug, Right Patient, Right Price” - Using Data to Deliver Value w/ Pramod John

    13 DE FEV.

    “Right Drug, Right Patient, Right Price” - Using Data to Deliver Value w/ Pramod John

    Drug spending continues to escalate, accounting for an even bigger portion of total U.S. healthcare spend each year. Why do we pay so much for medications? Are the drugs we buy truly worth the price we pay? How can we figure out the real value of a medication?  Pramod John joins the MTVA Board to help answer these questions and more. Guided by cold, hard data, Pramod expertly demystifies the drug market and pharmacy benefit ecosystem. His straightforward approach to pharmaceuticals is a stark departure from the overcomplicated acronyms and jargon common in the PBM space – in this episode, Pramod proves that you reallyCAN explain health care value in a straightforward way!  “It’s not the drug that you’re paying for, it’s the outcome.”  Pramod John is the Chairman and CEO ofVIVIO Health, a public benefit corporation using data to disrupt the typical PBM model. VIVIO’s mission is simple: to deliver the right drug for the right patient at the right price.  We discuss what drug data really mean, why Americans are overpaying for prescriptions, and how to move beyond our current broken system.  ———————————— To learn more about topics discussed including the J&J lawsuit, PBMs and GLP-1 weight loss drugs, check out these other episodes of MTVA Unscripted: J&J lawsuit Wake-up Call: The Johnson & Johnson Prescription Pricing Scandal From ERISA to CAA: How Has Employer’s Fiduciary Responsibility Changed Over Time? PBMs PBM Problems (Part 1): Who do Brokers and Consultants Really Work for? Risks for Plan Sponsors w/ ERISA attorney Paul Holmes PBM Problems (Part 2): Transparency and Disrupting the Status Quo w/ Mutual Rx CEO Roy Wilkinson PBM Problems (Part 3): Monopoly Power in Prescription Drug Markets w/ Luke Slindee PBM Problems (Part 4): Challenges & Solutions for Independent Pharmacies w/ National Community Pharmacists Association Market Forces Created Our Dysfunctional Health System. Now We Must Harness Them to Drive Change with Ge Bai, PhD, CPA GLP-1s GLP-1s Aren't Right for Everyone: Wiser Healthcare Consumption w/ Al Lewis GLP-1 RA’s - Treating Obesity, the Potential, the Cost, and Coverage ———————————— We’re excited to welcome like-minded organizations and individuals to join the MTVA Membership program!  As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. Tax-deductible membership contributions help us enrich the healthcare environment with quality content – including this podcast – and robust platforms to fuel discussion, collaboration, and advocacy that lead to ground-breaking solutions.  For more information and to join us, visit our websitehttps://www.movingtovalue.org/membership.   All episodes of MTVA Unscripted can be found⁠⁠here⁠⁠.

    55min
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Sobre

The Moving to Value Alliance (MTVA) engages in open and honest conversations with disruptors in healthcare, discussing the transition to value-based care. A 501(c)(3) nonprofit, MTVA is dedicated to cultivating a healthcare ecosystem that prioritizes high-quality outcomes at affordable costs for employers and consumers. We serve as a dependable source of timely and thought-provoking information, education, and resources to advance value-based healthcare at state and national levels. Visit our website (www.movingtovalue.org) to learn more! Join our email list: www.movingtovalue.org/community

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