For a full transcript of this episode, . I want to kick off this show with a clip from  with Rob Andrews, wherein he so very eloquently sets the stage here: We think that one of the core problems here is that too many intermediaries and providers in the system, their compensation is not in any way dependent on the outcome. So, let’s think about this NICU baby problem again. Looking at the hospital system—and I’m not at all implying or suggesting any hospital system tries to do this—but I think it is clear that they actually benefit commercially from more babies spending more days in the NICU. NICU’s usually a pretty good margin business. It’s expensive. Lots of money is paid, and margins run pretty well there. So, I don’t think there’s a hospital system in the country that intentionally says, “Oh, good … let’s go out and try to fill up the NICU every day.” But when it gets filled up, they benefit. On the other hand, if the hospital invests significantly in early effective intervention prenatal or even pre-pregnancy, there’s no upside to that financially. They don’t get rewarded for that. They might win an award from some magazine for best practices, but their margin suffers. Then if you look at the intermediaries, the carriers, and PBMs [pharmacy benefit managers], their outcomes are irrelevant to their performance. If an employee of a self-insured employer has a significant risk prenatal or pre-pregnancy and the carrier does a great job identifying that problem and solving it, they make the same amount of money off that patient or that consumer that they would if they did nothing. So, it’s a bit harsh to say this, but the carriers make the same amount of money if every child is born healthy and there’s not a day spent in the NICU as if they do if every child’s born with severe crises and winds up in the NICU. It's not a big mystery in the US economy that people do what you pay them to do. And if you have a system, which we do now, where the case of maternal health, diabetes management, musculoskeletal management, cholesterol and cardiac management … when you have a system where many, many players in the system, at best, make the same amount of money for bad outcomes as they do for good ones and, at worst, they prosper from the bad outcomes, that explains the problem. So, is this show about improving maternal health outcomes in the US, where it is relatively deadly to have a baby compared to other industrialized nations? Yes. But improving maternal health is also a great case study for what needs to be done to just improve health. You could apply it to primary care. You could apply it to chronic care management. It is a fairly broad-spectrum solution, as it were. I’m thinking right now about how Dave Chase, co-founder of Health Rosetta—how does he put it?—he says every big problem in healthcare already has been solved. The existing challenge is how to massively replicate proven solutions. So, yeah … keep that in mind when we talk about what Jodilyn Owen has accomplished with her team in Washington State with their birth and health center. Also, as you consider how you might replicate, keep in mind the struggles she has faced getting contracts from self-insured employers or payers to pay her clinic and a very interesting encounter she had with a VC/PE (venture capital/private equity) funded maternal health start-up. It’s just interesting where the money is flowing and where it’s not flowing. But let’s talk about Jodilyn’s clinic’s outcomes. Their zip code is one of the most diverse in the nation. There are 79 languages spoken. There is lots of social determinants of health going on. It is a medically underserved area. It is a federally designated provider shortage area. So, this community has every right to have horrible outcomes. Meanwhile, nearby, there is a wealthy community. In that zip code, they live 17 years longer than in Jodilyn’s clinic’s zip code. But if...

EP421: Wildly Improving Outcomes When the Patient Is, for Reals, in the Center—For Maternity and Beyond, With Jodilyn Owen

Interview segment with Lisa Hirsh president and CEO of Accurate Box Co about manufacturing in America impaired by healthcare costs. Echoes TED talk (http://bit.ly/TEDxChase): "Healthcare Stole the American Dream - Here’s How We Take it Back." Full interview at http://the1a.org/shows/2017-01-25/made-in-america

NPR 1A - Lisa Hirsh president and CEO of Accurate Box Co

Our next installment of the 2017 McKesson Pharmacy Systems Podcast Series is an interview with Pharmacy Owner Paul Fulmer, PharmD and&nbsp;Mary Gregory VP Customer Experience at McKesson Pharmacy Systems.&nbsp; We discuss the importance of Customer Care &amp; ensuring the pharmacy owner has accessible resources to maximize the effectiveness of the technology platforms.&nbsp; About Paul Fulmer, PharmD: Paul graduated from UNMC in 2007 and began working at Noble Drug alongside his father, Kim, that same year. Paul is the Pharmacist-In-Charge and has operated Fulmer U-Save Pharmacy since it’s purchase in 2011. Paul enjoys spending time with his family, sports, and hunting. Mary Gregory is a 20+ year McKesson patient &amp; customer advocate champion. Mary currently serves as the Vice President of Customer Experience at McKesson Pharmacy Systems.&nbsp; About the Pharmacy Podcast Series: McKesson Pharmacy Technology &amp; Services (MPTS) partnered with the Pharmacy Podcast Network to produce a special Podcast Series during the 2017 McKesson ideaShare in New Orleans, La. This series will include 12 podcast episodes featuring interviews from MPTS customers, as well as thought leadership from industry experts. https://marketing.mckesson.com/2017-MPTS-Pharmacy-Podcast-Series.html&nbsp;

Pharmacy Technology Enhanced by Customer Experience Assurance - PPN Episode 531

American Healthcare Entrepreneurs and Executives You Might Want to Know. Talking.

Relentless Health Value is a weekly interview podcast hosted by Stacey Richter since 2014. A dynamic healthcare entrepreneur and innovator, Richter has spent more than twenty years mentoring clients and colleagues in the shared pursuit of healthcare value. Subscribe to the podcast and spend an hour with us every Thursday.

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Relentless Health Value is for business leaders working in payer and provider organizations, as well as for pharma, medical device, patient advocacy and other healthcare businesses. It’s an ideal resource for health industry innovators and entrepreneurs or aspiring entrepreneurs, who strive to improve healthcare every day. “No outcome, no income,” is the mantra we live daily.

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EP421: Wildly Improving Outcomes When the Patient Is, for Reals, in the Center—For Maternity and Beyond, With Jodilyn Owen

Relentless Health Value

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