Latest / Becker’s Payer Issues Podcast / Transforming Healthcare Affordability at Ascendiun with Paul Markovich

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Transforming Healthcare Affordability at Ascendiun with Paul Markovich · Becker’s Payer Issues Podcast

0:02
This is where health insurance leadership comes together.
0:05
Becker's fourth annual spring payer issues roundtable brings
0:09
together over 400 payer and health plan executives
0:12
and more than 100 speakers to Chicago April.
0:16
This year's event includes keynote conversations with the
0:19
industry's top leaders and former president George W.
0:23
Bush. For the full agenda and event details,
0:25
visit beckershospitalreview.com
0:27
and click on the events tab in the
0:29
upper right. We're looking forward to hosting you
0:31
here in Chicago.
0:33
Hello, everyone. This is Jacob Emerson with the
0:36
Becker's Payer Issues podcast.
0:38
Thrilled today to be joined by a special
0:40
guest. Paul Markovich serves as the president and
0:43
CEO of Ascendiant. Ascendiant is the parent company
0:46
of Blue Shield of California, the clinical services
0:49
firm Altais, and the health services business Stellaris.
0:53
Paul, thank you very much for taking the
0:55
time to be with me on the podcast
0:57
today.
0:58
It's my pleasure, Jacob. Thanks for having me.
1:00
Likewise. And, Paul, before we dive into everything
1:02
we wanna talk with you about, can you
1:04
tell us a little bit more about your
1:06
career over these last couple of decades at
1:08
Ascendiant and at Blue Shield of California?
1:11
And for our audience who might not be
1:13
familiar, what is Ascendiant? And, ultimately, what are
1:15
you trying to accomplish with this new parent
1:18
company?
1:19
Well, let's maybe start with that, and then
1:21
I'll work my way backwards. It's,
1:23
just over a year ago,
1:25
we decided to take Blue Shield of California
1:28
and,
1:29
create a new corporate structure for it, which
1:31
was to have a nonprofit parent called Ascendiant.
1:35
And that allowed us to actually create the
1:37
two other companies that you mentioned in the
1:38
introduction,
1:40
both Stellaris and Altais, which are are not
1:43
health plan companies, and I think are more,
1:45
likely to be able to attract capital and
1:47
achieve a level of scale,
1:50
in this new structure than they would have
1:52
under the traditional one with Blue Shield of
1:54
California. So
1:56
we're hoping this structure will help help us
1:58
accelerate our attempts to create a health care
2:00
system as we describe it that's worthy of
2:02
our family and friends and sustainably affordable.
2:04
And I'd say in terms of my career,
2:06
that's what's really driven all of my decisions.
2:08
I got started in in New York, working
2:11
for Booz Allen and Hamilton. I started out
2:13
in financial services, but then got recruited over
2:16
to the healthcare side and and really felt
2:18
like,
2:19
the possibility of taking a system that was
2:22
clearly not functioning at its apex for everybody
2:32
great cause. And so I just started to
2:34
focus my energy on that. And so when
2:36
I moved out to the Bay Area,
2:38
the first job I found in 1995 was
2:40
with Blue Shield of California. And
2:42
and,
2:43
I did have about a two and a
2:45
two and a half year, what I call
2:46
entrepreneurial
2:47
sabbatical,
2:49
in the early two thousands, but came back,
2:51
to Blue Shield in 2002
2:53
and and just haven't looked back.
2:55
Wonderful. It must be a great place to
2:57
work to keep you there for that long.
2:59
So appreciate, that overview of of, what you've
3:02
been up to over that amount of time.
3:04
Paul, I wanted to get started today by
3:06
talking about,
3:08
what certainly was one of the bigger stories
3:11
to start the year within the health care
3:13
industry,
3:14
when you were,
3:15
one of five
3:17
total health insurance CEOs,
3:19
who testified
3:20
before congress,
3:22
over
3:23
the broad topic of rising health care costs,
3:26
rising health insurance costs.
3:28
Obviously, as you know, there's a lot that
3:30
was touched on during those hearings, nine hours
3:32
or more so, more than nine hours in
3:34
total.
3:36
I we heard about industry consolidation.
3:38
We heard about prior authorization,
3:40
executive pay.
3:42
I I guess, first, Paul, how was that?
3:44
I mean, what was it like to be
3:46
summoned to Washington and have to testify in
3:48
in front of lawmakers for so long about,
3:51
a myriad of of complicated topics?
3:54
Well, prior to the this all happening, I
3:57
had one colleague tell me he thought I
3:59
was the only one who was actually looking
4:01
forward to being there. And
4:03
I can't speak for anyone else, but that
4:05
was certainly true for me. And
4:07
and, Jacob, the reason is that
4:09
we're passionate about trying to transform the health
4:11
care system. We think it's
4:13
dysfunctional and broken and bankrupting us, and we
4:16
we need structural systemic change. And frankly, we
4:19
need help from the government. That's one of
4:20
the things I said in my testimony was
4:23
that,
4:24
I didn't see the health care system
4:27
willing to fix itself, and so it needed
4:29
some it needs some tough love and direction.
4:31
And I think the federal government is in
4:33
the best position to provide that. So,
4:36
I I saw it as an opportunity. Certainly,
4:38
there were tough questions, but there should be.
4:40
We're we should all be accountable to the
4:42
American people for the the product we deliver,
4:45
and it costs too much right now. So
4:47
I think those questions should come with the
4:49
territory and I felt comfortable
4:51
responding to them as best I could on
4:52
behalf of our organization. But I think the
4:54
opportunity
4:56
was to talk about
4:58
not just what's wrong with the system, but
5:00
what needs to change, the bold reforms that
5:02
need to happen. And I I really appreciated
5:04
the opportunity to do that, and my sense
5:06
was that those messages resonated.
5:09
Absolutely. And that really was what came across
5:12
at least on our end watching these hearings,
5:15
and and watching you testify was,
5:18
the candidness of your message, I think, compared
5:21
to some of the others because
5:23
you you flat out called the the health
5:25
care industry broken.
5:27
You called for collective accountability,
5:30
among some of these companies that, of course,
5:32
oversee the management of a lot of tax
5:34
payer dollars.
5:36
So can you can you expand on that
5:37
for our audience in terms of what were
5:39
you trying to communicate to lawmakers,
5:42
to the broader public?
5:43
And
5:44
have any conversations been sparked since either,
5:48
at your company alone or with colleagues across
5:50
the industry?
5:52
Well, I just believe fundamentally that you can't
5:54
fix a problem unless you see it and
5:57
identify it clearly.
5:59
And
6:00
and and glossing over it doesn't help. Avoiding
6:02
it doesn't help. If you just look at
6:05
the fact that our system costs too much,
6:07
the costs are growing at a rate faster
6:09
than everything else.
6:11
Our quality scores lag other countries. We're not
6:13
covering everybody, and most Americans don't have confidence
6:16
in the system. I don't see how you
6:17
can look at that and say there isn't
6:18
a fundamental problem. And also that it's systemic
6:18
in nature.
6:19
A fundamental problem.
6:21
And also that it's systemic in nature,
6:24
that there's just
6:25
the way that the system works, how we
6:28
pay all the players to do more rather
6:30
than to to get better outcomes,
6:32
The fact that we're not digital, we keep
6:34
using fax machines.
6:35
The fact that everybody who distributes drugs gets
6:38
paid more when we and when they sell
6:40
and administer a higher volume of more expensive
6:42
drugs, those are systemic issues that require
6:46
systemic fixes. And so I think
6:49
if if you're really gonna try to get
6:50
to the change, you gotta be straightforward, clear,
6:52
and candid about what the problems are, take
6:55
accountability
6:56
for
6:57
your what we own,
6:59
and then to,
7:00
to offer the opportunity or offer to cooperate
7:03
and collaborate to to fix it. So I
7:06
called for eliminating kickbacks in the pharmacy distribution
7:09
system and then finally putting the health care
7:10
system on a budget. And so, again, I
7:13
think those messages were clear and resonated as
7:15
potential constructive solutions. And, frankly, I was incredibly
7:18
happy to see that shortly after that, congress
7:21
actually passed a law
7:23
that changed,
7:25
how pharmacy benefit managers can price. And that
7:28
was,
7:30
directly related to one of the things I
7:32
was advocating for.
7:34
Yeah. I'm absolutely. I mean, to to what
7:36
you just said, we've we're already seeing major
7:39
updates in the PBM space and and some
7:41
of these,
7:42
this latest settlement deal with Express Scripts and
7:44
the FTC.
7:46
But I I do wanna ask you just
7:48
because you've been in this industry for for
7:51
so long, you are a very, respectable name.
7:54
Leaders across this industry,
7:56
recognize you and and know what you've done
7:58
over these over these decades.
8:01
And and and I think given
8:03
just the the sheer amount of news that
8:05
has happened in this last year from from
8:07
HR one last summer
8:08
to the expiration of the enhanced subsidies,
8:11
at the start of this year,
8:14
what led up to these hearings? How should
8:16
we be framing
8:18
the pressure
8:19
and and why lawmakers wanted an individual like
8:22
yourself to come to Washington to talk about
8:24
this kind of thing? How should the leaders
8:26
listening into this recording today, how should we
8:29
be framing this current moment in health care
8:31
from your perspective?
8:33
Well,
8:34
we have a fundamental problem
8:37
right now in that the average American cannot
8:40
afford the average health care premium without a
8:42
subsidy.
8:43
That subsidy comes from government or employers generally,
8:46
and neither of them can continue
8:48
to subsidize
8:49
at the level,
8:51
at that they do today, let alone where
8:53
it's moving in the future. And so
8:57
one of the things I tell industry leaders
8:58
all the time is you cannot have a
9:01
sustainable business
9:03
in an industry that is not sustainable.
9:06
And this industry is just not sustainable.
9:09
And I think what we're seeing with h
9:11
r one and Medicaid with without extending the
9:14
tax credits, with the the recent
9:17
call, or the recent,
9:19
announcement on on Medicare Advantage and the the
9:22
pricing that's gonna be available,
9:24
the reimbursement that's gonna be available on Medicare.
9:27
I mean, the government's starting to say we
9:29
cannot afford this,
9:31
and we're gonna have to figure out a
9:32
way to to make ourselves afford it, which
9:34
means that we as an industry have to
9:36
stop showing up and asking for more money.
9:38
We need to figure out that we have
9:41
a we have a cost problem, not a
9:43
revenue problem, and figure out how to tackle
9:45
it. So, you know, my message for the
9:47
industry is
9:49
this is our new normal.
9:50
We have to, as many other industries have,
9:52
figure out how to make
9:55
make an impact
9:56
and do better
9:58
with
9:59
fewer resources and just figure out how to
10:01
be more productive. And that has not been
10:03
the mindset of the industry for most of
10:05
my career.
10:07
No. Certainly. And I I think it it
10:09
really goes to a point you were making
10:11
in your your testimony,
10:13
talking about sustainability overall,
10:16
really for for Blue Shield.
10:18
And you were talking about capping
10:20
how the company caps its income at at
10:22
2% of revenue.
10:23
Your your five year net margin is just
10:25
point 23%.
10:27
And, you know, that really goes against, I
10:29
think, what is a very pervasive narrative about
10:31
a lot of health insurers, especially those that
10:34
operate, on the nonprofit side, those within the
10:36
Blues ecosystem.
10:38
So
10:39
overall, Paul, how are you thinking about balancing
10:43
financial sustainability at Ascendiant
10:45
with with your overall mission of trying to
10:48
keep coverage affordable,
10:50
trying to tamp down on some of these
10:52
rising costs?
10:53
Well, we we certainly have to figure out
10:55
how to bring in more revenue than our
10:57
costs,
10:58
in order to be able to provide a
11:00
product. And so that's fundamental. And we for
11:03
our purposes, we've figured that 2% margin is
11:07
the right number, and we have been falling
11:09
short of that over the last several years.
11:11
So that's certainly fundamental and important, but we
11:13
have to do that in a way
11:15
where the ultimate price that we're charging is
11:18
affordable
11:19
to the end customer, which which means we
11:21
have to get the cost, cost everywhere,
11:23
our own administrative costs,
11:26
which have been coming down, but also the
11:28
cost that we incur on the system. And
11:31
that's where I think health plans have the
11:33
biggest responsibility
11:34
and haven't
11:36
delivered on that responsibility
11:37
the way that they should have, and that
11:39
is
11:40
the the way we set up the rules
11:41
of the system for things like prior authorization
11:45
put a lot of burden and administrative
11:47
tasks and frustration
11:49
on
11:50
clinicians and health care providers and on the
11:53
and on the patient in the end.
11:55
I mean, it really is mind boggling to
11:57
me that the the most common communication mechanism
12:01
still today
12:03
for doing things like getting information for prior
12:05
authorization is a fax machine.
12:07
And, you know, the idea that that would
12:09
be
12:10
a customer and physician friendly mechanism
12:14
to be communicating back and forth and and
12:17
and making decisions that have huge impact on
12:19
people's lives.
12:21
I mean, really, shame on us as health
12:23
plans for not having figured out
12:25
yet how to solve for that. The good
12:28
news is we are now stepping forward and
12:30
solving for it. But I think there's a
12:32
whole series of things like that Jacob where,
12:36
we need to as health plans, but not
12:38
just as health plans as an entire industry,
12:41
figure out how to
12:43
make ourselves more productive. Like, we've had over
12:46
the last five decades, maybe a 150 to
12:49
200% increase in the number of physicians and
12:51
a more than 3000%
12:53
increase in the number of,
12:55
administrative jobs in health care. And so there's
12:58
a there's an opportunity here and an absolute
13:00
need for us
13:02
to drive those costs out of the system,
13:04
not just for the health plan, but through
13:06
the entire health care system. And since the
13:08
the health plans like ours
13:10
control the rules of the system,
13:12
we have the best chance to try and
13:15
change things in a way
13:17
that allows us all to be financially viable,
13:20
but in a way that's affordable to the
13:22
customer.
13:23
It's so funny. You really do hate the
13:25
fax machine, because I remember you you you
13:28
talked with us about this a few years
13:30
ago.
13:31
But I also think that points to the
13:32
fact that this is this is a topic
13:34
that just continues to stick around or or
13:37
a concept that continues to stick around that
13:39
so much of the health care system
13:41
is using a technology that I believe started
13:44
in the eighteen hundreds, the the core of
13:46
it.
13:47
And it's something we hear about from executives
13:50
constantly. They everyone hates the fax machine. So
13:53
I guess, Paul, educate me, educate our audience.
13:56
Are we getting close to a time where
13:58
that actually goes away? I mean, what's what's
14:01
the barrier here to getting rid of,
14:03
this this antiquated tech? Well, first first thing
14:06
you should know, if you really wanna see
14:08
how much I hate a, a fax machine,
14:10
there's actually a YouTube video of me smashing
14:12
one to smithereens, and the interesting story there
14:15
I'll have to watch that. Yeah. Well, the
14:17
interesting story there story there is that we
14:18
actually went to use one of the fax
14:20
machines that we had in the office, but
14:22
the team wouldn't let me because they were
14:24
using it. So we actually had to buy
14:26
a fax machine,
14:28
to to bash it up. But, you know,
14:30
the fact is what we need to do
14:32
what the fundamental driver here is we need
14:34
every American
14:36
to have
14:37
access to a real time comprehensive digital health
14:39
record
14:40
that they can access and use, that their
14:42
treating clinicians can access and use, and that
14:45
health plans can for administrative purposes such
14:48
as putting together quality scores and and submitting
14:51
risk adjustment. As soon as you do that,
14:53
then you bring health care into the digital
14:55
world.
14:55
And and and you can be exchanging information
14:59
in real time, and you don't have to
15:00
have these antiquated
15:02
mechanisms
15:04
to to send information back and forth that's
15:07
just highly unreliable
15:09
and slow and inefficient and
15:11
just puts a whole bunch of friction into
15:13
the system. So there's just no reason,
15:16
frankly, for these things not to be fully
15:18
automated and in real time. The technology has
15:20
been there not just for years, but for
15:22
decades. But the foundation of it is
15:24
we have to be able to know all
15:26
the digital information that's
15:28
related to that particular patient in those circumstances
15:32
so that all of the information that needs
15:35
to be used
15:36
to
15:37
prior authorize, settle a claim,
15:40
do risk scores, do quality scores, and figure
15:43
out payments,
15:44
all of that could be done in a
15:45
real time and automated basis. But foundationally,
15:48
the technology is there. But if you don't
15:50
have the information available in a usable format
15:53
in a timely way,
15:54
then you end up having to find alternatives
15:57
for sending that information back and forth, which
15:59
is where we are today. Absolutely. And I
16:01
know there's,
16:03
prior authorization
16:04
policies that are underway starting this year, going
16:07
into next year that, look to hopefully alleviate
16:11
some of that. So I I suppose we'll
16:12
see how this shakes out in the in
16:14
the next few years. But but speaking of
16:17
antiquated
16:18
models overall, Paul, I thought something that really
16:22
has stood out to me over these last
16:24
few years in terms of hard news announcements
16:27
was when Blue Shield of California
16:29
announced your unbundled
16:31
PBM model. And I know that went into
16:34
that started to roll out last year, so
16:36
we're just over a year now into that.
16:38
And you launched this with with Amazon Pharmacy,
16:41
with Prime Therapeutics,
16:43
some other big players,
16:45
and really trying to replace that traditional single
16:48
PBM approach and and take more control of
16:51
your your drug spending.
16:53
So so like I said, now that that's
16:55
been up and running for over a year
16:57
now, can you update us on on how
16:59
that's going? What's been working?
17:02
Anything harder than than expected?
17:05
Well, I'd say the there's sort of three
17:07
three parts to this, and one has gone
17:09
really well, and the other two have been
17:11
more of a struggle. The first part was
17:13
just being able to
17:15
put together all these different players
17:17
and and be able to administer the benefit.
17:19
I mean, we literally had a 143,
17:22
I think, data integration points that we had
17:25
to put together
17:26
to
17:27
piece together the ability to administer this program.
17:30
And
17:31
we managed to do that,
17:33
and and our members are getting their prescriptions
17:35
and getting really good service, and,
17:38
and we've saved some money from that and
17:40
the about the money that we expected to
17:42
in that first phase.
17:44
The other two things we needed to do
17:45
was first
17:46
we're first to
17:48
contract directly with pharmacy manufacturers and try to
17:51
get into a net price scenario rather than
17:54
all these rebates and fees and and back
17:56
and forth.
17:57
The good news there is the deals that
17:58
we have done have demonstrated there's, I think,
18:01
savings to be had and and a lot
18:03
simple a a lot simpler and clearer model
18:05
to the to the patient.
18:07
But we only have about 10 of them,
18:09
and we need thousands.
18:11
And so that has been slow going. And
18:13
then the other is to
18:15
really phase out and eliminate
18:17
the spread pricing that happens, not just with
18:20
pharmacy benefit managers, but with others like physicians
18:23
and hospitals.
18:25
And that has also been slow going. It's
18:28
been one negotiation at a time. So
18:30
we,
18:31
what we'd like to see accelerated, and we
18:33
are looking for ways to do this, or
18:35
how do we how do we get
18:38
to truly eliminating spread price pricing across the
18:41
board
18:42
and getting to direct net price,
18:45
for paying for for drugs,
18:47
so that we don't have all of these
18:49
rebates and fees,
18:51
sloshing through the system and potentially costing patients
18:54
more than they need for their for their
18:56
drugs.
18:58
Understood. Understood. And I like I said, any
19:00
any updates that you can consistently share with
19:02
us there, Paul,
19:04
we'd love to hear them because I know
19:06
our audience of health care executives has been
19:08
very interested in in how your company has,
19:10
really pioneered
19:12
this unbundling PBM,
19:14
a model.
19:16
But I also wanted to ask you about
19:18
some other recent news from the company late
19:20
last year as well.
19:23
You had
19:24
the Blue Cross affiliates in Hawaii and then
19:26
in Kansas join Blue Shield California as cofounders
19:29
of Stellaris.
19:31
Can you give us an update on where
19:33
that all stands, and and what's the vision
19:35
for this this company overall? Do you hope
19:38
to have more
19:39
Blue Cross plans join you in this?
19:42
Yes. Well, the the new structure that we
19:44
created with Ascendiant as a nonprofit parent,
19:47
and then creating Stellaris where we we moved
19:50
the technology
19:51
and other strategic capabilities
19:53
into Stellaris
19:55
so that
19:56
they could be available and sold to other
19:59
blue plans.
20:01
And the idea there was by having plans
20:04
like Hawaii and Kansas that
20:06
that joined as both investors and customers in
20:09
September
20:11
is that,
20:12
we can
20:14
jointly invest in these things,
20:16
and all get access to
20:19
more cutting edge and modern
20:21
capabilities
20:22
that help us serve our missions,
20:24
but at a lower cost
20:26
and not requiring
20:27
us to merge and change any of our
20:30
governance,
20:32
and independence
20:33
that each of the plans has. And so
20:36
that was, I think, the appeal of the
20:37
model to those two plans. I believe it's
20:39
a model that will appeal to other plans
20:42
as well.
20:43
And what it's going to allow us to
20:45
do is is to for example, once we
20:47
do have a digital health record, is to
20:50
to use the technology so that we don't
20:52
have to use fax machines, and we can
20:54
fully automate things and get a lot of
20:56
cost out of the system and move to
20:58
new payment models and effectively,
21:01
have a health plan that is capable of
21:02
doing the things that I said need to
21:04
happen across the industry
21:06
nationally in my, testimony to congress. So
21:10
that's that's what
21:12
Stellaris
21:13
is doing, and that's why
21:15
both Hawaii and Kansas joined. And that's why
21:17
I certainly hope that there will be others
21:19
that do the same.
21:20
Certainly. So you're trying to preserve the independence
21:23
of of these blues companies,
21:25
their their own corporate structures, but
21:28
lend them resources,
21:30
help them scale,
21:31
with these new technologies,
21:33
to
21:35
remain competitive, I imagine, among some of the
21:37
more, the national for profit rivals. Is that
21:39
correct? Precisely.
21:41
These, a lot of these capabilities are not
21:44
inexpensive to develop. And so the ability to
21:48
to get highly competitive,
21:51
scale sensitive
21:52
capabilities
21:53
to your members and be able to do
21:54
that in a trusted environment with another nonprofit
21:57
blue plan is is what we're offering.
21:59
Sure. Sure. It makes a lot of sense.
22:02
I you mentioned the digital health record,
22:05
the universal health record, which is something that
22:07
you laid out as a as a top
22:09
priority in your in your testimony last month.
22:11
You also mentioned moving away from fee for
22:14
service,
22:15
eliminating
22:16
PBM rebates and spread pricing,
22:18
and then putting the health care system on
22:20
a budget to create more affordability,
22:23
more predictability, and then, of course, like what
22:25
we discussed earlier, more sustainability for the entire
22:28
system.
22:29
Obviously, some of those are are massive goals.
22:32
Paul,
22:33
because we saw one of these, directly addressed
22:36
just in these last these last week, do
22:39
you have any thoughts on this this landmark
22:41
PBM bill that has now passed congress and
22:44
and, ultimately,
22:45
what it will mean and how it will
22:46
trickle down the effects of it for for
22:48
your members and for patients
22:50
everywhere?
22:51
Well, I I I'm really encouraged by the
22:53
bill and also by the settlement
22:56
between the Federal Trade Commission and Cigna Express
22:59
Scripts,
23:00
which had some of the some similar,
23:02
changes that are required
23:05
in terms of pricing and the distribution of
23:07
pharmaceutical drugs. I think what you're seeing, frankly,
23:10
is the death knell of a business model
23:13
where
23:14
the pharmacy benefit managers and their affiliates
23:18
tie their compensation to the price of a
23:20
drug.
23:21
I think what you're going to see is
23:22
that whole system is is effectively going away
23:25
now or is going to go away,
23:27
and
23:28
everyone's gonna have to figure out how to
23:30
get reimbursed in a very different way. And
23:33
so
23:34
that, I think, is highly encouraging and is
23:36
what
23:37
prompted us to move to the new model
23:38
and to advocate for these changes is that
23:41
it's there's no way
23:42
to get to a health care system that's
23:44
worthy of our family and friends and sustainably
23:47
affordable
23:48
if,
23:49
if a whole series of companies see selling
23:52
and administering drugs as a profit center and
23:55
effectively are collecting kickbacks to
23:59
sell and administer those drugs. I mean, that's
24:01
just it's not what's best for the patient,
24:03
and there's no way you get to an
24:04
affordable system. So I'm very encouraged by the
24:06
law.
24:07
There's been some other changes going on,
24:10
as well, and I think all of it
24:11
just adds up to
24:14
we're gonna have to move to a different
24:16
system.
24:17
Well, Paul, before we run out of time
24:19
here, I know we've touched on a lot
24:20
today, a lot of big topics.
24:22
Anything else we're missing? Anything else you wanna
24:24
share with our audience
24:25
or any other,
24:26
bits of advice you wanna offer,
24:29
all the other health plan leaders listening in
24:32
from across the industry?
24:34
Well, I I we didn't talk much about
24:36
the idea of putting the system on a
24:38
budget, and I think it's worth saying that
24:40
I've always believed that necessity is the mother
24:42
of invention. And so the idea of saying,
24:46
yes. There's a way to improve the health
24:49
of Americans
24:50
and do it
24:51
with health care cost trends that are at
24:53
or below price and wage inflation.
24:56
I'm absolutely convinced that is
24:59
possible.
25:00
We're not on a trajectory to do that
25:02
right now, and right now the mindset is
25:04
what needs to shift. I think the mindset
25:06
of most leaders in health care is to
25:08
just explain to everybody
25:10
why health care costs more than everything else
25:13
and why it trends at a higher late
25:15
at a higher rate than everything else.
25:17
And we as an industry have
25:20
to realize
25:21
explanations
25:23
aren't
25:23
gonna cut it, not for the American people,
25:27
not for Congress.
25:28
And,
25:30
and we have to get into a mindset,
25:32
a different mindset.
25:33
How do we make health care affordable? We
25:35
all have to be financially viable, but how
25:37
do we make health care affordable
25:38
and worthy of our family and friends? And
25:40
that means we have a cost problem that
25:42
we need to address.
25:44
And I'm hopeful that creating that kind of
25:46
budgetary top down pressure
25:49
is something that helps
25:50
create that mindset
25:52
and gets us into a much more innovative
25:54
phase in health care
25:56
and,
25:57
one where we we really are focused on
26:00
how to make things better for the patient
26:02
and more efficiently.
26:04
Well, it it's very clear to us here
26:06
at Becker's that Ascendiant and and Blue Shield
26:08
are at the forefront of of putting forth
26:10
things
26:11
into fruition that, that will tackle some of
26:15
those goals. So, Paul, I wanna thank you
26:17
for for taking the time to chat with
26:19
us,
26:20
and and for sharing your insights about all
26:22
these topics with our audience. We really appreciate
26:25
it. You're most welcome, Jacob. Thanks for the
26:27
time. And to our audience, if you'd like
26:29
to listen to more podcasts from Becker's Healthcare,
26:31
you can visit beckershospitalreview.com.