Latest / Becker’s Healthcare Digital Health + Health IT / Scaling Value-Based Care Through Strategic Partnerships with Shelby Decosta

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Scaling Value-Based Care Through Strategic Partnerships with Shelby Decosta · Becker’s Healthcare Digital Health + Health IT

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  - upper right.
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  - This is Laura Dierdo with the Becker's Healthcare
• 1:01
  - Podcast. I'm thrilled today to be joined by
• 1:03
  - Shelby DeCosta, senior vice president and chief business
• 1:06
  - development officer at Kaiser Permanente.
• 1:08
  - Shelby, it's a pleasure to have you on
• 1:09
  - the podcast today. Thanks for having me, Laura.
• 1:12
  - Absolutely. Now I'm excited for our discussion. I
• 1:14
  - know we're gonna talk about a variety of
• 1:16
  - things that you're doing at Kaiser Permanente, a
• 1:17
  - lot about value based care and some of
• 1:19
  - the different,
• 1:20
  - partnerships you've made over the last several months.
• 1:22
  - But before we dive in, I I'm curious.
• 1:25
  - Can you tell me a little bit more
• 1:26
  - about yourself and and what you do at
• 1:27
  - Kaiser Permanente?
• 1:30
  - Happy to. So if I were to just
• 1:32
  - sum up my career, it's really been for
• 1:35
  - me about building partnerships that drive meaningful growth
• 1:39
  - in health care. And in fact, my career
• 1:42
  - began right here at Kaiser Permanente. My first
• 1:45
  - professional
• 1:46
  - exposure was as an intern
• 1:48
  - in the Southern California Permanente group.
• 1:51
  - And when I think about the partnerships that
• 1:53
  - I worked on back then, you know, just
• 1:56
  - having finished school in Los Angeles,
• 1:58
  - it was all about how to work with
• 2:00
  - physicians as partners
• 2:02
  - to increase access
• 2:04
  - and to meet our members where they were.
• 2:06
  - So, that was really formative for me early
• 2:09
  - on and I took that into
• 2:11
  - what was then Catholic Healthcare West
• 2:14
  - and,
• 2:15
  - was in the transition to becoming Dignity Health
• 2:18
  - for the purpose
• 2:19
  - of partnering with others more broadly.
• 2:22
  - And a lot of the work that I
• 2:23
  - did in strategy there had to do with
• 2:25
  - growing our ambulatory presence, you know, working with
• 2:29
  - ambulatory surgery operators,
• 2:31
  - starting imaging
• 2:33
  - companies, working with academics,
• 2:35
  - building
• 2:36
  - physician foundations
• 2:37
  - and partner models,
• 2:39
  - and that was a lot of fun. What
• 2:41
  - I realized was
• 2:43
  - for me, it was not just about the
• 2:45
  - transaction itself, which is, you know, probably one
• 2:49
  - of the best
• 2:50
  - and most creative parts of strategy, but it
• 2:52
  - was also about the people that were behind
• 2:55
  - the organizations
• 2:56
  - leading that work and driving to make impact
• 3:00
  - in the communities. And so that story sort
• 3:02
  - of unfolds, you know, from what was then
• 3:05
  - dignity. I moved to Trinity Health,
• 3:07
  - where there was a pretty significant
• 3:10
  - mission that we
• 3:11
  - had, which was to save Catholic health care.
• 3:15
  - I think even today,
• 3:16
  - you know, forty percent or so of hospitals
• 3:19
  - are at risk of closure.
• 3:20
  - That's been the case for a while given
• 3:22
  - all the pressures and so at Trinity, I
• 3:24
  - worked really on bringing
• 3:26
  - like minded
• 3:27
  - organizations
• 3:29
  - into
• 3:29
  - a system of care where they could,
• 3:31
  - drive efficiencies and and bring scale to benefit
• 3:35
  - those communities by keeping the hospitals open.
• 3:38
  - And then I had a different experience going
• 3:40
  - to UCSF on the academic side. You know,
• 3:43
  - similarly, their mission
• 3:45
  - was really to work on the most difficult
• 3:48
  - cases and to continue research, continue training, and
• 3:51
  - they needed to have a network of patients
• 3:54
  - to access.
• 3:55
  - They couldn't possibly do it all on their
• 3:57
  - own. And when UCSF looked around,
• 3:59
  - there were several community health systems throughout the
• 4:03
  - Bay Area that really were like minded.
• 4:05
  - And so I spent my time building that
• 4:07
  - network
• 4:08
  - of care to really expand their mission and
• 4:11
  - create more
• 4:12
  - tertiary access
• 4:14
  - for the Bay and for the West Coast.
• 4:16
  - Now at Kaiser, it's sort of all of
• 4:18
  - those things. So, you know, I lead business
• 4:21
  - development here, which means I'm focused on
• 4:24
  - helping Kaiser expand our mission, which is to
• 4:27
  - improve the health
• 4:28
  - of our members and the communities that we
• 4:30
  - serve.
• 4:31
  - And a big part of how we're trying
• 4:33
  - to do that is through partnerships.
• 4:34
  - So partnerships
• 4:36
  - with other health systems, partnerships with community,
• 4:39
  - partnerships with other providers,
• 4:42
  - and and also partnerships in our investment space
• 4:45
  - to make sure that innovation continues to thrive.
• 4:47
  - And so,
• 4:48
  - it's been almost two years here and I
• 4:50
  - think it's been a great, great ride for
• 4:54
  - me so far in just, you know, determining
• 4:56
  - how we can actually bring some of these
• 4:58
  - goals to life for ourselves and for partners.
• 5:01
  - I love that. I think being able to
• 5:03
  - have that partner focused mindset, really brings a
• 5:06
  - a lot to the organization, and then it
• 5:07
  - continues to drive value overall. And speaking of
• 5:10
  - value, I know value based care has become
• 5:12
  - one of the most talked about concepts in
• 5:14
  - health care, but it can mean different things
• 5:16
  - to different people.
• 5:17
  - When you hear that term value based care,
• 5:19
  - how do you define it? And just as
• 5:21
  - importantly, what do you think people get wrong
• 5:23
  - about it?
• 5:25
  - Yeah. It is definitely a popular term and,
• 5:28
  - you know, I think
• 5:30
  - everyone means something different when they talk about
• 5:32
  - value. For some people, it's just a payment
• 5:34
  - model. It's just a risk arrangement
• 5:38
  - or it's a contracting strategy. I think for
• 5:41
  - us, you know, for Kaiser, we kind of
• 5:42
  - boil it down to
• 5:44
  - it is health care delivery that is simple,
• 5:48
  - which we know in a lot of cases
• 5:49
  - is not what
• 5:51
  - patients experience in trying to access care.
• 5:55
  - It's affordable
• 5:56
  - and because we know that's one of the
• 5:57
  - biggest barriers to actually getting in
• 6:00
  - to
• 6:01
  - any of the appointments that you need or
• 6:04
  - care that you need
• 6:05
  - and it's evidence based which I think is
• 6:07
  - really critical. You know, one of the things
• 6:09
  - that we are very centered in here at
• 6:12
  - KP is exactly
• 6:14
  - what,
• 6:15
  - care pathways are proven and have shown results.
• 6:19
  - And then, you know, it's equitable, which means
• 6:21
  - everyone gets the specific care that you need.
• 6:24
  - And for that to happen,
• 6:26
  - the health care system actually needs to know
• 6:28
  - who you are. And so as we think
• 6:30
  - about value based care, it's those components
• 6:34
  - that for us at the end of it
• 6:35
  - are about keeping people healthy
• 6:37
  - and getting them to the right
• 6:40
  - place at the right time. And then it's
• 6:42
  - much more about how we make sure all
• 6:45
  - the incentives along the way are aligned
• 6:48
  - from the payer to everybody who participates in
• 6:51
  - that care. And I think that's something that
• 6:53
  - we are uniquely positioned to do because of
• 6:56
  - how we're structured at KP.
• 6:58
  - That makes a ton of sense. And, you
• 7:00
  - know, really cool to have an understanding of
• 7:02
  - all the different ways that one can define
• 7:04
  - value based care, but then really narrowing into
• 7:07
  - the ways that you think about it and
• 7:08
  - how, you've been going about developing that strategy.
• 7:11
  - I know for years Kaiser Permanente has demonstrated
• 7:13
  - value based care delivers measurably better results and
• 7:17
  - lower costs. If the real challenge now is
• 7:19
  - scaling that impact beyond your own system, how
• 7:22
  - are partnerships helping you bring those principles
• 7:25
  - to more communities without simply trying to replicate
• 7:28
  - the Pfizer model?
• 7:30
  - Yeah. You're bringing up a good point, Laura.
• 7:32
  - We've been doing this model of care for
• 7:34
  - eighty one years,
• 7:36
  - and
• 7:37
  - this model
• 7:38
  - works. Right? I mean, when you look at
• 7:40
  - KP
• 7:41
  - compared to the outcomes that are present in
• 7:45
  - in other insured groups,
• 7:47
  - our members are twenty percent less likely to
• 7:49
  - die prematurely of cancer, thirty three percent less
• 7:53
  - likely to die prematurely of heart disease, you
• 7:55
  - know, thirty five percent lower mortality
• 7:58
  - overall.
• 7:59
  - And so as we think about our partnerships,
• 8:02
  - it is how do we get those same
• 8:04
  - outcomes
• 8:06
  - by really bringing the best of what KP
• 8:08
  - has
• 8:09
  - and the best of what others have. And
• 8:12
  - and the goal is not really to make
• 8:13
  - everybody
• 8:15
  - Kaiser Permanente,
• 8:16
  - but it's to figure out for each community
• 8:19
  - how can we express those outcomes?
• 8:22
  - How do we bring, you know, what I
• 8:23
  - mentioned the evidence based protocols? I think we
• 8:26
  - have over 9,000.
• 8:27
  - How do we bring that to other like
• 8:29
  - minded organizations
• 8:31
  - so that we together can figure out how
• 8:33
  - that works? And it's different. It's different in,
• 8:36
  - you know, the way that we work with
• 8:38
  - health systems. It's different in the way that
• 8:40
  - we think about new organizations
• 8:43
  - and new companies that can still get to
• 8:45
  - those outcomes and we're flexible.
• 8:47
  - But at the end of it, we wanna
• 8:48
  - make sure that those outcomes are really what
• 8:51
  - we're expressing
• 8:52
  - in partnership and one of the things that
• 8:54
  - we found is there are many many other
• 8:57
  - systems,
• 8:58
  - other providers
• 8:59
  - across the country
• 9:01
  - who think about value the same way that
• 9:03
  - we do and so I think there's huge
• 9:05
  - opportunity for us ahead.
• 9:07
  - I love that. And, you know, really exciting
• 9:10
  - to hear all of the ways that you've
• 9:12
  - been able to shift and grow and find
• 9:13
  - those partners who make a lot of sense
• 9:15
  - for you and then think about what's gonna
• 9:18
  - be impactful in their communities as well. So
• 9:20
  - let's talk about the different ways that you're
• 9:22
  - approaching this and starting with Kaiser Permanente in
• 9:24
  - Nevada. Can you tell us a little bit
• 9:26
  - more about the Renown Health Partnership, why that's
• 9:28
  - significant, and how, what other organizations can learn
• 9:31
  - from it?
• 9:33
  - Absolutely. We are so excited about the Kaiser
• 9:36
  - Permanente partnership,
• 9:39
  - in Nevada that we have with Renown Health.
• 9:41
  - You know, stepping back, Nevada's
• 9:44
  - been a region that Kaiser Permanente has really
• 9:47
  - wanted to serve.
• 9:49
  - And actually, one of the places where we
• 9:51
  - have received the most calls from employers,
• 9:54
  - from former members to say, can you bring
• 9:57
  - the integrated care that we know and love
• 10:00
  - to this region?
• 10:02
  - But the bottom line is to do it
• 10:04
  - on our own would take a lot of
• 10:06
  - time
• 10:07
  - and would take a lot
• 10:09
  - of resource and, you know, as part of
• 10:11
  - our mission, we're really trying to think about
• 10:13
  - how we bring affordable care.
• 10:16
  - We got a call from Renown Health understanding
• 10:18
  - that they were looking for a partner
• 10:21
  - for their, health plan called Hometown Health. And
• 10:24
  - that was really intriguing to us because as
• 10:26
  - we studied Hometown Health and looked at what
• 10:28
  - they were doing, they were a high quality
• 10:30
  - plan. They had been around, you know, since
• 10:33
  - the early nineties.
• 10:34
  - And really, what they hadn't been able to
• 10:36
  - do was bring all the capabilities
• 10:38
  - to that plan
• 10:40
  - for the benefit of the members in terms
• 10:42
  - of digital capabilities, you know, national network and
• 10:46
  - all the things that a national plan does
• 10:48
  - have in place. And so we saw a
• 10:50
  - good fit between the capabilities that exist here
• 10:53
  - at Kaiser's National Health Plan and what they
• 10:56
  - had already done with great quality and great
• 10:58
  - member satisfaction.
• 11:00
  - And basically,
• 11:01
  - we broke down what the whole member experience
• 11:05
  - was like
• 11:06
  - and who would be best served to provide
• 11:09
  - each part of that member's care. And so
• 11:11
  - I talked about, you know, on the health
• 11:13
  - plan side, lots of capabilities.
• 11:15
  - There was also a great team at Hometown
• 11:17
  - Health
• 11:18
  - that,
• 11:19
  - had done a lot of work to put
• 11:20
  - infrastructure in place. They're continuing on as we
• 11:23
  - have launched
• 11:24
  - our partnership earlier this year.
• 11:27
  - And then we looked at where are all
• 11:28
  - the places
• 11:29
  - that these members receive care within the Renown
• 11:32
  - system and made sure to keep that as
• 11:34
  - part of the experience. So while this is
• 11:37
  - a joint venture plan between Kaiser Permanente and
• 11:40
  - Renown Health, all of the hospital care is
• 11:43
  - still provided by Renown Health.
• 11:45
  - Much of the outpatient care that, was provided
• 11:49
  - before this partnership remains in place.
• 11:52
  - KP is bringing more primary care to the
• 11:55
  - market, which is something that it needs.
• 11:57
  - And then we're working with the renowned medical
• 11:59
  - group to provide specialty services in new medical
• 12:03
  - offices that we set up. And so it's
• 12:06
  - really a joint collaboration
• 12:08
  - around what both organizations
• 12:10
  - have to offer. And then in each of
• 12:12
  - these settings, we have joint operating committees that
• 12:15
  - help to coordinate the care and ensure that
• 12:17
  - those same outcomes I talked about earlier will
• 12:20
  - be expressed
• 12:21
  - over time for this population.
• 12:24
  - You know, it is,
• 12:26
  - it is a work in progress for us
• 12:27
  - to really bring all of the capabilities
• 12:31
  - together and we're still working
• 12:34
  - on really making sure all of our systems
• 12:35
  - talk to each other so that also these
• 12:37
  - members when they're traveling to other KP regions
• 12:40
  - can access KP care, which is something that
• 12:43
  - was really important to Renown as they were
• 12:45
  - seeking a partner.
• 12:46
  - We're moving quickly. Our medical offices are going,
• 12:50
  - live now,
• 12:51
  - and we'll be ready with the KP
• 12:54
  - fully branded,
• 12:55
  - fully integrated product as of January 1.
• 12:58
  - That's incredible to hear. And one huge accomplishment
• 13:01
  - in being able to bring all those parts
• 13:03
  - together and then, you know, have a a
• 13:05
  - really meaningful product to launch in the Nevada
• 13:07
  - market. And I know Nevada isn't your only
• 13:09
  - approach. So,
• 13:11
  - you also have Habitat Health and Resent Health
• 13:13
  - as well. How should people think about all
• 13:15
  - of these efforts? How do they all tie
• 13:17
  - together?
• 13:19
  - Yeah. I think the way to think about
• 13:21
  - them is, you know, there are multiple pathways
• 13:24
  - to get
• 13:25
  - to the outcomes
• 13:26
  - that we all want for everyone, for ourselves,
• 13:28
  - for our members, for our communities.
• 13:31
  - So, you know, the keeping up out of
• 13:33
  - model is one way. It's really centered on
• 13:35
  - working with a like minded
• 13:37
  - high quality organization.
• 13:40
  - You know, Habitat Health is a little bit
• 13:41
  - of a different model in that
• 13:44
  - we looked within Kaiser Permanente and saw that
• 13:47
  - there were vulnerable
• 13:48
  - elderly members
• 13:50
  - that were not getting the precise
• 13:52
  - level of care that they needed from our
• 13:54
  - current system. And so we built a best
• 13:57
  - in class PACE program, you know, with Town
• 14:00
  - Hall Ventures called Habitat Health to really focus
• 14:04
  - on this vulnerable population.
• 14:06
  - And the results have been absolutely amazing even
• 14:09
  - early on where we, today just have two
• 14:12
  - centers that are live.
• 14:14
  - Those same members are getting day to day
• 14:16
  - care that have significantly,
• 14:18
  - you know, increased their compliance
• 14:20
  - with their care regimen and decrease their readmissions
• 14:24
  - to the hospitals.
• 14:25
  - We love this model because, you know, in
• 14:27
  - the same way that in Nevada,
• 14:30
  - we maintain access to the renowned hospitals for
• 14:33
  - those members.
• 14:34
  - That's what we're doing here within Habitat Health.
• 14:37
  - So even though a lot of primary care,
• 14:39
  - physical therapy,
• 14:41
  - specialty care is happening
• 14:42
  - within the Habitat Health system,
• 14:45
  - if those members need hospital care, they are
• 14:48
  - still
• 14:49
  - coming back to Kaiser Permanente, the hospital that
• 14:52
  - they're familiar with, and they're seeing the specialist
• 14:54
  - that they're familiar with too.
• 14:56
  - So we're looking not just, you know, at
• 14:59
  - new populations
• 15:00
  - and new communities that we can better serve.
• 15:02
  - We're also looking
• 15:04
  - within our own membership to see what else
• 15:06
  - we can do to better serve their needs.
• 15:08
  - And then you mentioned Rizent. We're really excited
• 15:10
  - about Rizent. You know, it's a newer part
• 15:13
  - of Kaiser Permanente.
• 15:15
  - And that model is really about
• 15:17
  - how do we support those
• 15:19
  - community health systems
• 15:21
  - that see, you know, everyone through their community
• 15:24
  - from all payers
• 15:26
  - in doubling down on value based care. So
• 15:29
  - Geisinger
• 15:30
  - Health in Central Pennsylvania was our first member.
• 15:34
  - They've,
• 15:35
  - implemented a series of different tools and capabilities
• 15:39
  - that's already bringing benefit
• 15:42
  - to both the members of the Geisinger Health
• 15:44
  - Plan, but also members of the community.
• 15:47
  - We're bringing our, you know, care without delay
• 15:49
  - program that helps to get members and patients
• 15:52
  - in and out of the hospital into the
• 15:53
  - right setting as early as possible.
• 15:56
  - We have navigation tools for primary care
• 15:59
  - and for patient directed care so that we
• 16:02
  - can enable
• 16:04
  - and more appropriate direction of care in a
• 16:07
  - faster way
• 16:08
  - and eliminate what tends to be long wait
• 16:11
  - times and so some of our capabilities
• 16:13
  - have driven down
• 16:15
  - demand for specialty,
• 16:16
  - demand for inpatient care,
• 16:18
  - which really means,
• 16:20
  - not that that care goes away,
• 16:22
  - but that the people who need it can
• 16:24
  - get in sooner, because we know there's an
• 16:26
  - incredible amount of demand for all parts of
• 16:29
  - the health care system.
• 16:31
  - And then Cone Health is our second member
• 16:34
  - for Ryzant Health. They're in Greensboro, North Carolina.
• 16:37
  - They're seeing similar results as we're bringing our
• 16:40
  - value based platform
• 16:41
  - to the rise in orgs. And the goal
• 16:44
  - for us really is to get to, you
• 16:45
  - know, five or six systems over the next
• 16:48
  - couple of years so that we can have
• 16:50
  - a meaningful impact on millions of lives.
• 16:53
  - The criteria for Verizon is pretty stringent and
• 16:56
  - so there's a short, you know, list of
• 16:58
  - health systems
• 16:59
  - where this model makes sense.
• 17:01
  - But what we love about it is we
• 17:03
  - are able to work with systems
• 17:05
  - that are very connected to their community,
• 17:07
  - that are actually helping us think about how
• 17:10
  - to serve broader groups than just our members
• 17:13
  - and translating
• 17:14
  - many of the things from KP that have
• 17:16
  - been successful into these new communities. So we
• 17:19
  - hope to share more about the future members
• 17:22
  - of RISE and Health two,
• 17:23
  - but we are we are making great progress
• 17:26
  - with the two,
• 17:28
  - founding members for Verizon.
• 17:30
  - That's great to hear. I know it's been
• 17:32
  - so fun to see Verizon grow and develop
• 17:35
  - over the years, and,
• 17:36
  - certainly, we'll be excited to hear about what
• 17:38
  - comes next when the time comes.
• 17:40
  - Now, for organizations that are listening to this
• 17:43
  - conversation, what qualities do you look for in
• 17:45
  - a potential partner?
• 17:47
  - Well, for partnership, you know, across all,
• 17:50
  - dimensions, I think mission is where we start.
• 17:54
  - You know, what is this organization
• 17:57
  - looking for? And does it align with what
• 17:59
  - we are hoping to do, which is improve
• 18:01
  - outcomes,
• 18:02
  - affordability,
• 18:03
  - and community health? There are so many wonderful
• 18:06
  - systems across the country.
• 18:09
  - And as we have these conversations, we're seeing
• 18:11
  - a lot of alignment.
• 18:12
  - We're also looking for those systems who are
• 18:15
  - willing to do the incentive alignment
• 18:18
  - and to embrace accountability for what this means
• 18:21
  - long term. And and a lot of that
• 18:24
  - becomes very obvious. Right? These are the organizations
• 18:27
  - that are known to be the leaders
• 18:28
  - in their communities. They're the highest quality
• 18:31
  - organizations and in many cases, they are the
• 18:34
  - systems that have invested
• 18:36
  - across the continuum. You know, they have a
• 18:38
  - robust primary care
• 18:40
  - network. They have specialists. They have ambulatory
• 18:43
  - and post acute care services.
• 18:45
  - And so then what the Kaiser Permanente partnership
• 18:48
  - can do is help them to tie all
• 18:50
  - those pieces together and to further align
• 18:53
  - all of the care under
• 18:55
  - a payer model
• 18:56
  - that, you know, help allows you to do
• 18:59
  - the right things long term.
• 19:02
  - And again, as we think about
• 19:04
  - what we're looking for in terms of doubling
• 19:06
  - down on value based care,
• 19:08
  - it's not about turning these organizations
• 19:10
  - into Kaiser. In fact, we often
• 19:13
  - shy away from that and we'd prefer to
• 19:15
  - lean into the local brands where there's much
• 19:18
  - more,
• 19:19
  - value already inherently there in the community.
• 19:22
  - But really thinking about how do we look
• 19:25
  - at the opportunities
• 19:26
  - that they have
• 19:27
  - to accelerate
• 19:28
  - value, to accelerate,
• 19:30
  - some of those outcomes with the capabilities
• 19:32
  - that we have.
• 19:34
  - That makes a ton of sense. You know,
• 19:36
  - it really gets back to health care being
• 19:38
  - local and and what an important asset is
• 19:41
  - the community,
• 19:42
  - and the brain share within those organizations.
• 19:44
  - Now what have these partnerships taught you?
• 19:47
  - Oh, so many things. I think, you know,
• 19:49
  - as we
• 19:50
  - are spending more time in partnerships and reflecting
• 19:53
  - on the ones that have gone very well
• 19:56
  - for us, I think it's a couple of
• 19:57
  - things. As long as you are still committed
• 19:59
  - to your mission, there are things that, you
• 20:02
  - know, may need to change
• 20:04
  - between the day to day operation. And so
• 20:07
  - having
• 20:08
  - core leadership structures, whether that's a board, whether
• 20:11
  - that's a steering committee to help shepherd that
• 20:13
  - is really critical,
• 20:14
  - especially when you're thinking about long term partnerships.
• 20:18
  - I think aligning incentives in critical is critical.
• 20:22
  - We talked about with,
• 20:23
  - Kaiser Permanente Nevada, the need for a long
• 20:26
  - term payer contract. You know, this is a
• 20:29
  - multi decade contract. That means
• 20:31
  - we are jointly looking for the same
• 20:34
  - outcomes versus thinking about
• 20:36
  - transactional
• 20:37
  - value in short term, tranches. And so
• 20:41
  - thinking about what that means in some of
• 20:43
  - these relationships and articulating them to ensure that
• 20:46
  - we are both aligned is really critical.
• 20:49
  - I think the other thing is,
• 20:51
  - as we design the partnership, we have to
• 20:54
  - be really thoughtful about what it means to
• 20:56
  - operationalize
• 20:57
  - it. And so I mentioned again, in Kaiser
• 20:59
  - Permanente Nevada, we know there was a need
• 21:02
  - for more primary care. We had to think
• 21:04
  - about how we do that, but how we
• 21:06
  - connect it to the rest of the system
• 21:08
  - of care that already exists. Some of that
• 21:10
  - is, you know, through technology,
• 21:13
  - but some of that is really through conversations
• 21:15
  - and getting the right people
• 21:17
  - at the table together to help make those
• 21:19
  - decisions.
• 21:20
  - I think,
• 21:21
  - leaning back into
• 21:23
  - evidence based care is really critical and bringing
• 21:26
  - some of those
• 21:27
  - elements into any partnership
• 21:30
  - and then making it really simple both for
• 21:32
  - the clinicians that are providing care and for
• 21:35
  - the members that are accessing care.
• 21:38
  - Those are all critical to having a a
• 21:41
  - partnership that works. And then we've also learned,
• 21:44
  - you know, we really need to trust each
• 21:46
  - other. These are big decisions
• 21:48
  - with the potential for significant
• 21:50
  - outcomes.
• 21:51
  - And so having that shared accountability,
• 21:54
  - knowing who's on the other side and the
• 21:56
  - type of organization
• 21:57
  - accepts us up for long term success,
• 22:00
  - reflecting on the shared purpose, and then regularly
• 22:03
  - communicating
• 22:04
  - not just, you know, what the deal is,
• 22:06
  - but what the impact is and what we
• 22:09
  - need to do better together.
• 22:11
  - We're excited to continue to have this journey,
• 22:13
  - you know, with Verizon,
• 22:15
  - with KP Nevada,
• 22:16
  - with some of our other health system partners
• 22:18
  - in the KP regions and to keep iterating
• 22:21
  - together.
• 22:23
  - I love that. I I think it's so
• 22:25
  - helpful to understand the partnership and and really
• 22:27
  - what it means to you,
• 22:29
  - to take what exists and then make the
• 22:31
  - strong part stronger,
• 22:32
  - innovate where it makes sense. Now, before we
• 22:35
  - wrap up here, I just have one more
• 22:37
  - question. If you could leave health system leaders
• 22:39
  - with one message, what would it be?
• 22:42
  - I guess the takeaway message for me is,
• 22:44
  - you know, as as KP is expanding,
• 22:47
  - we don't believe every organization
• 22:50
  - needs to
• 22:51
  - be Kaiser Permanente.
• 22:53
  - But what we do believe is that value
• 22:55
  - based care
• 22:56
  - is the right way to impact
• 22:58
  - health outcomes
• 23:00
  - in communities and so we're open to the
• 23:03
  - ways that we think about how to deliver
• 23:05
  - that. You know, we've given examples here today,
• 23:08
  - Kaiser Permanente Nevada, Habitat,
• 23:11
  - Horizons,
• 23:12
  - and the message is that we believe this
• 23:14
  - collaboration
• 23:15
  - is really powerful
• 23:18
  - and that there are opportunities
• 23:19
  - to partner. And if we do so, we
• 23:21
  - think we can
• 23:23
  - get,
• 23:23
  - to these outcomes faster,
• 23:25
  - we can lower cost, and we can bring
• 23:28
  - the benefits of value based care to more
• 23:30
  - communities who deserve it.
• 23:33
  - I love it. Shelby, thank you so much
• 23:34
  - for joining us on the podcast today. This
• 23:36
  - has been such a fun conversation, so informative
• 23:38
  - and inspiring too to hear about what you've
• 23:41
  - been doing and what you see in the
• 23:42
  - future. I look forward to connecting with you
• 23:44
  - again soon, and we'll have to keep the
• 23:45
  - conversation going. Thank you, Laura.