Latest / Becker’s Healthcare Podcast / Nishant Anand, MD, FACEP, President and CEO of Altais

Transcript

Nishant Anand, MD, FACEP, President and CEO of Altais · Becker’s Healthcare Podcast

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  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
• 0:08
  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
• 0:14
  - That's not a complaint. It's a structural reality.
• 0:17
  - And it's why the most effective c suite
• 0:19
  - leaders are deliberate about where do they go
• 0:21
  - to pressure test their thinking.
• 0:22
  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm
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  - Scott King. Thrilled today to be joined by
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  - a very special guest, doctor Nishant Anand,
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  - president and CEO of Altais. Doctor Anand, how
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  - are you doing?
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  - I'm doing great, Scott. It's great to be
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  - here with you. Thanks so much for joining
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  - us. You know, we we were just talking,
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  - really looking forward to, have you speak with
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  - us in November at the Bayer Issues roundtable
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  - as well.
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  - Yeah. I'm looking forward to it too. I
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  - love the I love the exchange of ideas
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  - that happens at the conferences, so I'm I'm
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  - excited for the upcoming one. No. Yours should
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  - be a great, conversation in particular. And, you
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  - know, I I kinda wanna pick your brain
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  - about some of the the big things going
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  - on in healthcare and with health plans, but
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  - of course, I wanna dive into your
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  - background and your career journey. You know, I
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  - know you came to Altais from a large
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  - hospital system role at BayCare, what made you
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  - wanna shift from running a physician group inside
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  - a health system
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  - to leading a company built specifically
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  - to support independent and affiliated phys physicians?
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  - Yeah. It was,
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  - interesting. I've, you know, I've I've been very
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  - fortunate in my career. I've I've, you know,
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  - did my training for medical school up at
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  - Mayo. I did my residency in emergency medicine
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  - in the Bay Area. I've worked at several
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  - health systems, and
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  - and I
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  - am just really passionate about helping improve our
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  - health care delivery system
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  - and helping improve more so the delivery system
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  - health outcomes for people.
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  - And I think, you know, as I was
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  - evaluating
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  - I I was at BayCare during COVID, and,
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  - you know, we,
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  - just were able to help support the community
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  - during a difficult time. And coming out of
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  - it after several years, I started realizing
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  - that in order to get true health care
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  - transformation,
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  - we needed to take the best aspects of
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  - payers
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  - and providers
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  - and service organizations and put them together. And
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  - so that's what led me to Altais. It
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  - it's that ability to enact change and to
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  - actually make a meaningful difference,
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  - in in the environment that we're in for
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  - the benefit of others.
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  - Absolutely. You know, it's always so great to
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  - kinda hear positive things that that came out
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  - of COVID. Obviously, try and sign for everyone,
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  - and, you know, health care is no different
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  - there.
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  - Now your corner current organization is owned by
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  - Blue Shield of California, which makes it kind
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  - of an unusual hybrid, you know, part physician
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  - enablement company, part payer adjacent entity.
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  - How do you navigate that dual identity, and
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  - does it ever create tension
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  - with the physicians you're trying to serve?
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  - Yeah. It's it's an interesting,
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  - journey. So Altais was formed as a subsidiary
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  - of Blue Shield of California back in June
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  - 2019, and Paul Markovich was the CEO
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  - of Blue Shield at the time, had this
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  - vision that in order to really enact
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  - meaningful,
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  - sustainable health care change,
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  - with improved outcomes, you had to take the
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  - components of a payer and a provider and
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  - put them together.
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  - So just just to kinda fast forward a
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  - couple years, we were actually, spun off from
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  - Blue Shield of California and are now under
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  - a parent company, nonprofit
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  - parent company called Ascendiant, of which Blue Shield
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  - of California is a sister company
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  - of ours. And
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  - part of what that's allowed us to do
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  - is
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  - actually take the aspects of, you know, having
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  - that history as a payer and having roughly
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  - 15,000
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  - providers that are part of our network,
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  - just in California alone, and now we've we've
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  - got networks in Hawaii and in Arizona,
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  - we're able to try to
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  - integrate the health care delivery system in ways
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  - that it's not been able to be done
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  - before. Now is there tension at times?
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  - Of course, in in any industry, there's always
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  - gonna be tension when you have the components
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  - of it. But I actually think there's more
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  - opportunity
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  - to take the components because when we're acting
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  - as a payer, we understand what it's like
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  - to be a provider. And when we're acting
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  - as provider, we understand what it's like to
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  - be a payer. And so we we seek
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  - out those win win opportunities
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  - that lead to seem sustainable, meaningful change.
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  - You've spoken about value based care as a
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  - core
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  - mission at Altais.
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  - What does holistic value based care actually mean
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  - in practice for a physician
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  - using your platform day to day?
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  - Yeah. It's kinda Scott, I think it's funny.
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  - I've been,
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  - involved in health care for twenty plus years,
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  - and value based care has kind of taken
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  - a bunch of evolutions. And if you ask
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  - 10 people, you'll probably get 10 different answers.
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  - And so when I when I think about
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  - value based care, holistic value based care,
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  - I really think about
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  - really focusing and centering on that patient and
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  - provider relationship to improve
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  - long term health outcomes, make health care affordable
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  - and accessible.
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  - And so what we do for our physicians,
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  - you know, who are practicing on a day
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  - to day basis is
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  - we give them the tools,
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  - we give them the payment model, and we
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  - give them the information,
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  - and support services necessary
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  - to provide
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  - care, not just when you're seeing a patient
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  - in front of you for fifteen minutes, but
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  - throughout the the whole year or several years
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  - that you're taking care of a patient. Now
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  - that's a fundamental shift when you think about
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  - it. Most patients and most of us have
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  - had experiences where we're really in front of
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  - the the physician or the the advanced care
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  - provider for fifteen minutes, maybe thirty minutes, maybe
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  - an hour, but the rest of the time,
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  - we're left to our own accord to navigate
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  - health care system.
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  - So we give our providers information that they
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  - would not necessarily have. We collate it all.
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  - We aggregate it, and we present it in
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  - a meaningful way so that they can actually
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  - act on that.
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  - We help,
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  - build compensation models, so it's not just one
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  - patient after another after another after another. It's
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  - actually
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  - compensation that gets tied to improving outcomes.
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  - And third, we wrap around the physician,
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  - because physicians are busy. They they have a
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  - a lot going on. They have genuine empathy
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  - for their patients.
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  - But there's a lot of care programs that
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  - we have that can help support them and
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  - their patients, and I think that's what really
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  - makes it meaningful for that practicing physician on
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  - a day to day basis.
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  - MBNAi
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  - and dictation tools have become central to Altais'
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  - pitch to physicians.
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  - What's been the real world impact you've seen
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  - on physician time and burnout
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  - versus the promise
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  - of the technology?
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  - Yeah. It's a it's an interesting question. So
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  - I I I
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  - I basically refer to ambient,
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  - ambient listening or ambient dictation as the new
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  - stethoscope of,
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  - for the provider. It's just something that's that's
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  - going to be there. It's gonna be just
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  - commonplace.
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  - And it's interesting. We we did, pilots early
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  - on when we were rolling out ambient listening.
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  - And what we found is that prior to
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  - the pilot, our physicians were documenting,
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  - for more than two hours of every day.
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  - After seeing patients, they were documenting for an
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  - additional two hours 90 plus percent of the
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  - time.
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  - So if you imagine, I mean, in a
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  - week, that adds up to about ten hours
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  - extra documentation.
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  - That's what we call pajama time where they're
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  - where they're doing that. What we found after
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  - rolling out ambient listening
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  - is that that most physicians were actually done
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  - within an hour. 90 plus physicians were actually
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  - done at the end of their day within
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  - an hour. And some physicians,
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  - and I'd say a majority of physicians were
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  - actually able to focus on the conversation with
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  - the patient,
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  - instead of focusing on the computer and dictation.
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  - So I think this is this is something
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  - that's gonna become very commonplace. It's a great
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  - example
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  - of reducing the burnout.
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  - It helps make it easier for the physicians
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  - to practice and focus on what they're really
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  - good at, which is diagnosis and treatment and
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  - empathy.
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  - Absolutely. It should certainly help with with burnout
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  - and just kinda day to day efficiency.
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  - Now, you've held CMO roles at AdventHealth, Banner
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  - Health, and BayCare before coming to Altais.
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  - How does sitting on the physician enablement side
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  - of the industry change how you think about
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  - the problems you spent years trying to solve
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  - from inside a hospital system?
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  - It it's interesting. When I was on the
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  - hospital system side, I'd you know, and I
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  - still have, quite a few of colleagues that
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  - work in several of those facilities. It's and
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  - they're amazing organizations.
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  - What what I found is,
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  - at least at the time,
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  - you know, there was more focus on reactive
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  - care.
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  - And reactive care applies when someone is sick,
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  - they come to you. That's why in health
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  - systems, they're called patients.
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  - Well,
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  - what's happening in those organizations and several organizations
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  - is this whole concept of
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  - of really being proactive,
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  - with care man with managing of conditions and
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  - managing patients.
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  - As part of that, physicians and especially independent
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  - physicians are a growing influence, a growing part
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  - of that, and
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  - they're
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  - a they're a key constituency in order to
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  - deliver great health outcomes.
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  - And so I think as I was thinking
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  - about it early in my career, it was
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  - let's focus on reactive care. People will come
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  - to us. We'll just provide great time a
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  - moment in time care for that patient, and
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  - then they go on their lives.
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  - Now as I've kind of evolved into this
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  - physician enablement world, it's really about supporting the
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  - physician and taking care of patients throughout their
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  - entire time with them, which could be a
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  - year, could be several years as they go
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  - forward. And I think that's a very subtle
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  - pivot that I'm I'm seeing across the industry.
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  - Some organizations are health systems are further along
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  - in that journey, and I just highly encourage
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  - that because that that's what I believe fundamentally
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  - that health care is going towards.
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  - Other organizations,
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  - I've I still see are kind of, locked
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  - in the fee for service mindset and trying
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  - to get bigger, more hospitals
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  - and beds, and and I I worry a
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  - little bit about that. So this is a
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  - great opportunity to really deliver that holistic
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  - health outcomes that are really meaningful and important
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  - for people.
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  - Independent physicians are under enormous pressure.
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  - Things like reimbursement,
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  - administrative burden, consolidation.
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  - What's the biggest misconception
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  - health system leaders have about what independent physicians
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  - actually need to survive and thrive?
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  - Yeah. I'm I'm you know, we have several,
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  - thousand independent physicians, and and I, you know,
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  - I I think there there are so many
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  - independent physicians that just provide great care, but
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  - you're you absolutely nailed it.
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  - You know, having to deal with the reimbursement
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  - challenges, having to look at, you know, making
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  - sure you have enough staff, having to look
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  - at running your practice, having to look at
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  - which electronic medical record you use, it it's
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  - it's overwhelming for practices.
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  - And what we're seeing across the industry is
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  - independent physicians are becoming fewer and fewer.
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  - Most most residents now are, looking at larger
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  - groups and looking at, employed
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  - practice options on there. But I think I
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  - think the misconception is that independent physicians
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  - are
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  - not as as good at providing health outcomes
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  - as as some of the ones that are
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  - more integrated. And I think that's that that
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  - in today's day and age with technology,
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  - independent physicians can be tied,
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  - and can be more connected
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  - to whether it's a health systems, whether it's
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  - other physicians, whether it's ancillary providers.
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  - I think it's that coordination and collection of
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  - care that can actually help improve that. And
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  - I think that's that's a misconception, and that's
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  - why we see a lot of health systems
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  - trying to constantly employ
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  - physicians because there's a belief that that's the
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  - only way that can be achieved. And I
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  - think they those health systems are missing out
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  - on this unique opportunity to galvanize the independent
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  - physicians.
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  - The last question I have for you, Doctor.
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  - Anand, it might kind of tie into that
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  - holistic approach that you mentioned earlier, but looking
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  - into your crystal ball here,
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  - looking down the road, what does success for
• 12:24
  - Altaste look like in five years? And how
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  - will you know if you've actually made a
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  - meaningful difference in physician well-being,
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  - not just built up a bigger platform?
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  - Yeah. Yeah. I mean, I'm excited. You know,
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  - when you say five years now in health
• 12:37
  - care, it's like dog years, so you have
• 12:38
  - to multiply it by seven. So it seemed
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  - it's it's, things are moving quickly and see
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  - I had a lot of good conversations and
• 12:44
  - momentum out there. But for Altais,
• 12:46
  - we we will know we're successful,
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  - when we have seen true health care fundamental
• 12:52
  - transformation, and that means seeing improved long term
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  - outcomes for our patients and members.
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  - It means making health care affordable.
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  - Right now, I have a I have a
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  - a daughter who just got her driver's license
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  - and a car, and it is shocking that
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  - health care costs for a family right now
• 13:09
  - are more than buying a car in a
• 13:11
  - given year. And so you need to make
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  - health care affordable. And lastly,
• 13:16
  - we need to help bring back physician vibrancy
• 13:19
  - because at the end of the day, physicians
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  - provide that care
• 13:22
  - to patients. And so I fully anticipate we'll
• 13:25
  - continue to grow across the country, add more
• 13:27
  - states, more locations. We'll grow from 15,000
• 13:31
  - to 25, 30,000
• 13:33
  - providers. But it's really about making sure that
• 13:36
  - we can demonstrate those longitudinal health outcomes are
• 13:39
  - improved, making sure that health care is affordable
• 13:41
  - so people can continue to maintain access to
• 13:44
  - it. And three,
• 13:46
  - that the providers who deliver it are supported
• 13:48
  - in that journey.
• 13:51
  - Doctor. Nhan, thanks so much for joining the
• 13:53
  - podcast. It was great speaking with you and
• 13:54
  - and learning more about your work with Voltas
• 13:57
  - and and its mission, and looking forward to
• 13:59
  - working with you in November. Yeah. Yeah. Me
• 14:01
  - too, Scott. I really appreciate your time, and,
• 14:03
  - thanks for the questions and, and the thoughtful
• 14:05
  - discussion.
• 14:06
  - Absolutely.