Insurance Captives: Innovation & Cost Savings for Providers

Gautam Shrikhande, MD, Chief Executive Officer of Pelvic Rehabilitation Medicine and Brian Rath, Partner, Lorient Capital join Business of Healthcare to explore the role of private equity in physician services.

Physicians want to serve patients with the highest value care at the best cost while being fairly compensated.  Growth is a sign of a healthy, well-run practice. Ethical medical groups attract patients and increase revenue per patient by providing better outcomes, patient experience, and value as compared to local alternatives. 

Some practices of these practices are choosing private equity to fund growth. As a source of capital, is private equity better at supporting growth?  Does a practice taking PE investment run the risk of overly aggressive patient recruitment and billing? Do private equity partners help practices engage the right patients for growth?

We learn how one of these practices, PRM, partnered up with a PE firm to achieve velocity and growth.  We look at the investment hypothesis, how they find the right patients for their services, how outcomes are measured and the role PE has with physician leaders.

You may think Patient Experience is a straightforward discipline. Cathy Lee, Corporate Vice President for Patient Experience, joins BOH host Matthew Hanis to explain the lenses of a modern patient experience program and her innovations in the space.

Digital ethnography observes healthcare decision making on community message boards. These insights bring a more distinct ‘voice of the customer’ to shape marketing and service delivery. Health system marketing leader Jeff T. House and digital ethnography Dean Browell, Ph.D. join BOH host Matthew Hanis to explain how digital ethnographic research is applied and some of the surprising insights which have emerged.

Why are marketing tools, techniques and approaches so important to transforming healthcare? In his BOH interview, Zeev Neuwirth, MD says, “The field, in my estimation, that really understands what people want and need is the field of marketing.” An Atrium Health clinical executive and author of recently published Reframing healthcare - roadmap for creating disruptive change, Neuwirth describes the ‘marketing mindset’, stages systems go through embracing these techniques, the threat marketing experts Google, Amazon and CVS bring and the implications for payment reform, digital health and chronic disease management.

Interview filmed in partnership with the Society for Healthcare Strategy and Market Development (SHSMD) and sponsored by MedChat. MedChat provides LiveChat, Bots and text tools for a modern digital front door www.medchatapp.com

Can health systems engage consumers digitally to improve quality, cost and satisfaction? According to Mark Jannone, Senior Director, Banner Health’s Banner Innovation Group, the answer is a solid, “Yes.” He is helping to pilot digital ED triage and chatbot tools. Jannone reports the tools achieve a 35% reduction in inappropriate ED cases with 92% triage accuracy, decrease the time patients are in the ED by about 50% and increase net promoter scores by 40%. Full interview at BOHseries.com.

This Business of Healthcare interview sponsored by MedChat: improving patient access with secure LiveChat, Bots & text tools. See www.medchatapp.com.

“No outcome, no income,” says Dr. David Nash, Founding Dean Emeritus, Jefferson College of Population Health. JCPH is the nation’s first graduate school of population health. Nash describes the emergence of the population health movement, why fixing the US healthcare system is so important for our economy and our society, and concrete interventions such as going at risk with supply chain partners such as pharma.

See YouTube for video highlights and Full video interview

Karen L. Smith MD, FAAFP kept discovering opioid addiction in the families she served in her independent, rural primary care practice. With growing need and few referral options, Smith began providing medication-assisted treatment. MAT uses medication, counseling and behavioral therapies to treat substance use disorders and sustain recovery. Smith shares patient stories which led her to take on this challenge and the barriers a physician must overcome to provide MAT.

In 2016, Wilmington, NC had the highest concentration of opioid use disorder among US cities. Community leaders including regional health system chief physician executive Philip M. Brown, MD, FACS helped intervene in this public health epidemic. Brown describes the moment a national report triggered awareness of the local opioid epidemic. He and his fellow leaders undertook multi-faceted interventions to change prescribing habits, impact social determinants and, most importantly, de-stigmatize addiction.

When a med mal claim emerges from patient injury, we may debate who’s liable but we can agree something undesirable happened. Mark Reynolds leads CRICO, the Risk Management Foundation of the Harvard Medical Institutions, a captive insurance program. CRICO, in addition to serving its members’ medical professional liability insurance and other needs, also provides a comparative database with 30% of U.S. MPL claims. Reynolds shares insights from this 30+ year dataset of clinical and financial data which CRICO uses to identify & propagate root cause interventions. What insights do medical malpractice claims offer to improve the Mission & Margin of healthcare? These data are one of the richest insights into U.S. healthcare quality & safety.

Physician entrepreneur Brian Alper, MD explores shared decision making as an intervention improving patient safety, patient satisfaction and financial outcomes. John Gillean, MD, MHA, EVP & Chief Clinical Officer for CHRISTUS Health shares his perspective on the patient safety and quality implications.