Latest / Becker’s Payer Issues Podcast / Lawrence Hamilton, Executive Vice President, The Permanente Medical Group

Transcript

Lawrence Hamilton, Executive Vice President, The Permanente Medical Group · Becker’s Payer Issues Podcast

• 0:00
  Evernorth brings the power of wonder and relentless
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  innovation to create world class pharmacy, care, and
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  Barriers to care can lead to gaps in
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  and prevention of health care's most complex conditions
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  easier and more accessible as we drive organizations
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  and people forward.
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  Hello, and welcome to the Becker's Healthcare podcast.
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  My name is Chanel Banger recording live at
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  the Becker's
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  and sitting down with Lawrence Hamilton,
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  the executive vice president at the Permanente Medical
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  Group. Lawrence, thank you so much for joining
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  me today. It's my pleasure. Good good to
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  be with you. Perfect. Well, to get us
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  started out, can you please introduce yourself and
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  share a bit about your organization?
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  Sure. So the Permanente Medical Group is part
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  of Kaiser Permanente.
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  We care for in
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  the Permanente Medical Group, we care for 4,600,000
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  members in Northern California,
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  and we do that through 55,000
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  colleagues, including 10,000 physicians
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  across 21 hospitals.
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  Perfect. And moving forward into the meat of
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  the podcast a bit,
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  balancing affordability and quality is a constant challenge
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  for health plans. How is your organization innovating
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  to manage the cost of care while maintaining
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  or improving member outcomes?
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  I actually think the framing of,
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  tension between
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  quality and affordability is a symptom of,
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  the relate when the relationship between payers and
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  the delivery system is
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  contractual and transactional,
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  it tends to reduce very quickly to,
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  we want you to do more in this
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  area that will improve quality,
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  and the delivery system says this is what
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  it will cost, and you get into this
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  spiral of who's gonna pay for what.
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  I think a much more advantageous way to
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  is to seek alignment between payers and the
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  delivery system so that together, you're
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  all focused on how do we provide the
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  best quality,
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  equity,
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  access,
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  care experience,
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  and provider and clinician
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  satisfaction
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  at the lowest possible cost for the communities
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  that we serve.
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  When you frame it that way and you've
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  got genuine
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  alignment and you've got hospital systems and medical
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  groups that are
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  see success as population health,
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  then the trade off
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  reframes dramatically where we know that when you
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  provide great preventive care, that's
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  best for the patients, and it also avoids
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  downstream costs of more hospitalizations.
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  When you avoid a patient having to say
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  to the emergency room because of care that
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  you've done upstream,
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  better for the patients and avoids,
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  the most costly parts of the health system.
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  So when we've got genuine alignment,
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  we're aligning,
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  quality and affordability
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  much more often than they're at a trade
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  off of one another.
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  Absolutely. And now kinda switching gears a bit,
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  addressing health equity has become a critical focus
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  for many health plans. Can you share an
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  overview of a key initiative here
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  that you're involved in or particularly
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  excited about? And what are you hoping to
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  achieve with that?
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  Yeah. So
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  I'm really proud that our members have a
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  20% less chance of dying from cancer and
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  thirty three percent less chance of dying from
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  cardiac related diseases.
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  Our sister organization, Mid Atlantic, did research showing
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  that our members,
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  on average, live six years longer, and African
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  Americans live nine years longer than people who
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  don't benefit from our health system.
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  In certain areas, we've managed to close and
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  eliminate
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  racial health care gap, particularly around colorectal cancer
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  screening,
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  some of the diabetic prevention measures,
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  and we know that we've got a ton
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  more work to do.
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  If you ask me what what am I
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  most proud of in addition to closing some
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  of those gaps,
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  I'll just a couple of areas. One is
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  our board
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  follows just five KPIs,
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  relates to quality,
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  to care experience,
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  to
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  physician satisfaction and engagement,
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  making our care affordable, and then the one
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  is around health equity.
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  So that commitment from board level throughout the
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  organization,
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  I think, is really important.
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  And then secondly,
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  often our health equity efforts have been very
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  focused on on prevention
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  in primary care, which is the core of
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  our organization.
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  But we've actually challenged all of our service
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  lines
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  to look at health equity gaps.
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  I was really proud the other day. I
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  was in one of our medical centers in
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  San Francisco,
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  and they'd, taken our TAVR program.
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  That's a program that I think very seldom
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  gets viewed through an equity lens, and they
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  looked at the national data and found that
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  that,
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  different racial groups just don't get access to
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  TAVR at all for a myriad of reasons
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  around health system design,
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  around care that doesn't connect
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  culturally with with different groups.
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  And so now that we've got that data
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  and then we've managed we've looked at our
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  own data, which isn't as
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  exaggerated as the national data,
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  but it's given us absolute clarity about a
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  gap that we need to close. So doing
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  that, we've got about a 120 service lines.
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  Doing that in every service line, means that
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  we'll get completely clear about the gaps that
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  we need to close and then work through
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  what we need to do to close that
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  gap.
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  Got it. Got it. Now
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  moving forward,
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  member satisfaction is essential to thrive in today's
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  competitive health care market. What experience or engagement
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  strategies have proven effective for organization, and how
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  are you measuring success?
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  Yeah. This is an area where we've changed
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  dramatically in the last,
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  eighteen months.
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  Previously, we'd had a paper based survey that
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  were mailed to people's homes,
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  and so we are only able to sample
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  a small proportion of patients, and we got
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  an even smaller response rate.
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  In the last year and a half, we
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  moved to a digital platform,
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  where we can survey
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  everybody that comes in with care for care.
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  We still get a low response rate, although
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  compared to many other surveys,
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  it's about two to three times the response
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  rate.
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  But instead of having survey feedback patient feedback
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  in the,
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  tens of thousands, we're now getting it in
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  the in the tune of millions.
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  And the volume of data has enabled us
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  to get much, much more
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  precise around,
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  seeing where we have gaps. So we know
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  that our overall net promoter score is 87.
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  But when we break down by age, there's
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  almost a 30 gap between different groups, just
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  as one example.
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  So that's enabling us to get much more
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  focused and targeted
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  on
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  where is our service,
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  not landing in the way that we'd like
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  it to.
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  Now the area is what we call closed
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  loop resolution,
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  where when we get
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  feedback where we could have done better,
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  that immediately routes to the operational leaders, physicians
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  and administrative leaders in those areas
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  so that we're able
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  to, wherever we can, immediately respond.
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  And we've got some great examples of being
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  able to,
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  catch patients before they've reached their car
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  and call them back to rectify the problem
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  they had or or examples where patients have
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  been
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  initially very unhappy.
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  And then as they've seen us take action
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  to respond,
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  they've then taken upon themselves to sort of
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  re regrade their response to us.
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  So like every health system, we've got plenty
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  of opportunity to get better in our daily
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  interactions.
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  And this the closed loop feedback's giving us
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  some enabling us to be much more agile
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  in responding to patients',
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  patients' needs.
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  Absolutely. Well, Lawrence, I wanna thank you for
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  your time today. But before I let you
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  go, I have one more question. Looking ahead,
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  what do you see as the biggest opportunity
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  for payers to lead the change in transforming
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  care delivery and driving better outcomes for all
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  stakeholders?
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  And how can leaders take a step in
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  this direction now?
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  Yeah. It really goes back to what I
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  said at the beginning that
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  so often our provider,
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  the delivery system, and payer is stuck in
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  a cycle
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  of,
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  who's gonna get paid for what.
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  And, of of course, the the flow of
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  resources is important,
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  but the real breakthrough comes
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  when we've got, the delivery system,
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  medical groups, hospital systems, all aligned around using
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  limited resources as we know affordability for our
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  patients is probably the biggest challenge that we
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  face in The US,
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  and trying to use those limited resources,
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  make care more affordable,
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  and provide great quality equity experience access. And
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  we know with shortages
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  in in health professions, it's also gotta work
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  for health professionals.
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  When we get that alignment, I think we
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  can do extraordinarily better. We know that The
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  US health system was spending $5,000,000,000,000,
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  18% of the entire economy,
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  and we're getting the worst outcomes of any
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  developed,
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  developed economy on the globe.
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  So it's not through lack of resources, but
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  the way that we're using resources just isn't
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  delivering population health. So where we get that
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  alignment and where we really
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  enable
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  medical groups and hospitals,
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  to be successful
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  by delivering population health,
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  that I think is the brightest hope for
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  how we can improve the care of our
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  nation.
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  Absolutely. Well, that's a great spot. And, Lawrence,
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  I wanna thank you once again for your
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  time today and for joining me on the
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  Becker's Healthcare podcast. Thanks. It's been a privilege.