Published on June 13, 2017
By Andre L’Heureux, COO
- General theme: the healthcare system is broken, with no practical solutions for fixing it
- Politics are not helping to solve anything… government regulations hinder innovation
- Value-based care is not going away, and both providers and payers want to work under that model
Wednesday, June 7
Eric Topol, author and Director of the Scripps Translational Science Center, discussed precision medicine, saying that imprecision is one of the largest drivers of unnecessary cost. For instance, 75% of patients on drugs don’t respond, and we waste huge amounts of money on pharma.
He also said that the average wait time across US for a doctor is 3.4 weeks, showing a lack of access to timely care and a system with strained capacity. Using technology to enhance and expand MD capabilities is crucial to efficiency, but “big data” is not currently useful because it doesn’t get used; deep learning AI will change that over time. He suggested it will not replace the human relationship, but instead enhance it.
Mike Leavitt, former governor and Secretary of HHS, believes we are 25 years into a 40-year healthcare transition. He said that there are two conflicting human values, human compassion vs. global economic dispassion, and that both are driving healthcare reform. The problem is we must do both, so political solutions are slower to come but are inevitable because the vast increase in healthcare spending is not sustainable.
His opinion was that regardless of the political climate, VBP initiatives will continue to happen. There is too much momentum, and value is the only way to get the results we all want out of the system, so while it will take time to resolve, the general theme of pay for value will prevail.
Dr. Patrick Conway, CMO of CMS, spoke about the progress made in Value Based Care which he said is ahead of targets. He finds that health systems want to deliver care under that model, and pay for value is not going away.
Thursday, June 8
In an interesting talk, PatientsLikeMe CEO Jamie Haywood said that he was not working with anyone in the room because “frankly, your system is broken”. He believes that the current focus is on Sick Care, and that patients need to take ownership of their own care and behaviors to drive Health Care. He said precision medicine “kinda sucks” right now, and much more needs to be done to help patients help themselves, because they are the only ones who really care about them at the end of the day.
From the questions the audiences asked in the sessions I attended, I have the distinct impression that payers seek data and recognize there is a lot of opportunity to reduce spend or improve outcomes, but they also understand the importance of changing behaviors which are the underlying root causes of much of the spend to begin with. Identifying those cohorts or individuals who are in highest need of change is the key first step, and many are just beginning down that road.
Friday, June 9
Interesting discussion with the CEO of Whole Foods, John Mackey. Of course he talked about the impact of diet on health, but beyond that it was interesting to see how down to earth and mission driven he is. He is under pressure from activist investors to be more profitable, and while he believed profitability is important, it’s not the only reason to be in business. He takes a $1.00 salary because he has enough money, and he believes it’s important to know when it’s enough. It was refreshing to hear from a CEO who had more at heart than just the bottom line.
Healthcare has become a big business at 19% of GDP, but we can’t lose focus on the individual the system is supposed to serve. A consistent theme throughout the conference was that the healthcare system is not delivering the quality care we would like and is doing so at a price we can’t sustain.
When I talk to healthcare executives individually, I often hear about their desire to serve their customers, but they express frustration with organizational inertia, a broken political system with regulations that often prevent innovation, and the basic perverse incentives of healthcare financing. As John said, “my body makes red blood cells and I need them to live, but that is not why I exist”. Profits are necessary, but not sufficient. I’m hoping we find our way to a system that works for everyone.