Latest / Becker’s Healthcare Digital Health + Health IT / Greg Poulsen, Senior Vice President and Chief Policy Officer at Intermountain Healthcare

Transcript

Greg Poulsen, Senior Vice President and Chief Policy Officer at Intermountain Healthcare · Becker’s Healthcare Digital Health + Health IT

• 0:00
  This is Laura Dierda with the Becker's Healthcare
• 0:02
  podcast. I'm thrilled today to be joined by
• 0:04
  Greg Poulson, senior vice president and chief policy
• 0:07
  officer at Intermountain Health. Greg, it's a pleasure
• 0:09
  to have you on the podcast today.
• 0:11
  Great to be with you, Laura.
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  Now I'm really looking forward to our conversation
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  because I know Intermountain is one of the
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  most innovative health systems out there and truly
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  is on the forefront of a lot happening
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  not only in technology and innovation, but also
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  in how you're growing your system and thinking
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  about health care as a whole.
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  So, you know, I'm excited to learn more.
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  But before we dive in, I'm wondering, could
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  you tell us a little bit about Intermountain
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  as it is today and what makes it
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  unique?
• 0:37
  Sure.
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  I'm not sure we're really unique, but I
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  think we may be a little bit unusual
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  in the sense that, although we're a a
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  relatively large hospital organization with 33 hospitals across
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  five states, I think, and,
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  and a large number of of physician practices
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  that participate with us
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  and a broad
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  array of ancillary services.
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  We've been in the
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  health insurance business now for about forty years,
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  and we're the the the largest,
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  insurer in
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  our
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  primary communities.
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  And that, makes us think about the world
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  somewhat differently and has given us some focus
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  around,
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  when we talk about, providing value, it gives
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  us some additional,
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  both some additional thoughts, but also some additional
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  tools
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  that, that that have given us, I think,
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  a different kind of focus that maybe some
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  would have.
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  Absolutely. And I think that's just such a
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  really great point because
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  having that ability to understand the provider side
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  as well as the health plan side,
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  puts you in a a spot where you
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  can make,
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  progress towards what I know we've been talking
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  about for years and years now. We need
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  to think about value, think about,
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  caring for populations,
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  and really truly
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  figuring out how to find that happy medium
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  where everybody is,
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  able to work up to the best of
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  their abilities, it seems like.
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  I think that's right. And, at least from
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  my perspective, one of the
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  really lovely,
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  components of that is that for for so
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  many of our friends,
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  the relationship
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  between the payer and the provider is one
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  of of tension as opposed to one of
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  coordination
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  and focused cooperation. And
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  I think we find that there are tremendous,
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  innovative opportunities,
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  when the two sides are able to bring
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  their collective strength together
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  and be able to, take a a focused
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  approach on helping people live the healthiest lives
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  possible, which is both our our mission and
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  our tagline.
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  Absolutely. Oh, you know, and what a great
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  segue into, you know, thinking about from the
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  strategy down to, you know, the the
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  execution level. What is the accomplishment that you're
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  most proud of from the last year or
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  so?
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  Well, you know, we've, we've we've not done
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  anything that's a radical departure from our history
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  in in the last year.
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  We continue to focus on proactive
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  care, which is the the term that we
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  use for sort of value based care. But
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  but value based care has morphed in, so
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  many different ways in terms of what what
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  people mean when they say it and when
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  they hear it.
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  And so we wanted to, to to have
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  a term that
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  we could,
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  understand at least within our own internal discussions.
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  And so,
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  we've we've used the phrase proactive care,
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  as as a
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  definition of what it is that we really
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  want to, want to do, which is to
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  help people proactively,
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  to be as healthy as they can and
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  avoid the need for some of the very
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  expensive and unpleasant,
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  health care experiences that, that otherwise would would
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  be coming their way.
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  I guess,
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  what the the other thing that I would
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  well, let let me stay with that for
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  just a second and say that, you know,
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  that that happens not only when we have
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  people who are within our own insurance world,
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  but it also happens with, other Medicare patients,
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  other commercial patients that come to us.
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  And it helps us, I think, to,
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  have a more
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  holistic view of what we might be able
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  to do that would be effective in their
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  lives and and help them to move forward.
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  So that's sort of,
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  you know, a continuation of what, what we've
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  been doing. Something that we've been trying to
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  do in the last year with, with with
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  some good results
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  is simplify,
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  the the whole health care process,
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  both for our, our members and patients, but
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  also for our caregivers.
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  And we see enormous complexity
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  serious approach. Our our CEO, Rob Allen,
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  has
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  decided that, the the one of the legacies
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  he'd like to leave behind is a is
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  a simpler organization,
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  easier to navigate, easier to understand,
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  easier to participate in. And so those are
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  our two big foe OSI this last year.
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  That's helpful to know and understand. I I
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  know no easy task really to, make the
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  complexity of health care simpler in bringing you
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  into a space where, you know, you're really
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  able to care for patients and and make
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  the experience better for them.
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  From looking ahead, where do you see some
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  of the big growth opportunities in the next
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  twelve months or so?
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  Oh, you've you've kind of hit a hot
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  button for for me at least.
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  And and and let me just head down
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  this path, and and I I hope that,
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  that I there won't be too controversial here,
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  but I think that it's really important to
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  note that growth should never both be a
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  primary goal or strategy in at least my
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  perspective, and I think our organizational perspective.
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  Goals and strategies should be built around value
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  enhancement for stakeholders,
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  you know, those that we serve and those
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  that help us to do so, our patients'
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  members, the community broadly, and the caregivers that,
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  that we work with.
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  So I think the statement that if you're
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  not growing, you're dying is extremely common, but
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  I think it's extremely wrong.
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  I think it's caused a remarkable amount of
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  over the last couple of decades, and the
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  road to growth for its own sake is
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  is, as we all know, littered with wreckage.
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  The wise and virtuous strategies that we should
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  be building are around value creation for patients,
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  beneficiaries, and caregivers.
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  And at least my perspective is that such
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  strategies may well include growth
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  either as a component part of the strategy
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  or as an outcome of the successful implementation
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  of that strategy.
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  But to speak of growth as the strategy,
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  I think, is neither wise nor virtuous.
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  I do wanna be clear that
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  growth is very often both necessary and beneficial,
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  but only as part of the goals and
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  strategies that create value.
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  This is why I'm disturbed when growth is
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  discussed as the goal.
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  I think that misses the mark both strategically
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  and consequentially
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  leading to outcomes that serve
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  neither the organization or its stakeholders, and I
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  think we've seen lots of examples of that
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  over the last decade or so.
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  Let me give you an example, though, that
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  I think may may focus it for for
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  some of us, and at least it focuses
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  it for us at Intermountain.
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  I think, some of your listeners may be
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  aware of Civica,
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  which is an innovative value adding generic drug
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  company.
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  It was created
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  to provide generic drugs that are overpriced or
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  in short supply or often both at the
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  same time.
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  If Intermountain
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  had viewed the provision of generic drugs to
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  the market as a growth opportunity rather than
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  as a way to increase value for shareholders
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  and stakeholders,
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  shareholders meaning broadly the communities and people we
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  serve,
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  we would have approached the development in a
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  much different way and I believe a much
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  less desirable way, and the overall outcomes would
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  have been far less. So I think that
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  that we always need to put,
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  growth into a perspective of what it's doing
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  to further our mission,
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  further our ultimate goals, and further the value
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  that we provide. Otherwise, we can get distracted
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  and head off in,
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  in ways that, are not contributory to to
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  the overall benefit of the, folks that we
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  have responsibilities for.
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  And that's, you know, a really fascinating way
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  to look at it. And, I appreciate your
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  thoughts on growth here because, you know, you're
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  right. Having that ability to focus in on
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  what's creating value for those stakeholders, especially the
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  patients, but, you know, really, everybody,
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  who's involved in the process makes a big
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  difference. And that example of Civica two is
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  so prudent right now, especially as,
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  so many organizations are finding it challenging to,
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  keep their,
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  supplies seeing their expenses rise and those kinds
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  of things. And so, you know, when you
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  look at it through that lens of value
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  creation,
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  and from your role as,
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  being the chief policy officer.
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  What does that look like for you? How
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  do you,
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  navigate
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  the the world around you when you're trying
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  to, primarily stay focused on creating value for
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  the patients and caregivers,
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  involved in the health care delivery process?
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  Well, it's a it's as as you,
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  certainly imply,
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  it's enormously challenging to not be distracted by,
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  by by many of the the factors that
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  can,
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  dilute our focus on on value for the
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  folks that we care for.
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  The the biggest advantage that that that I
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  have seen is our board,
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  and I hope boards,
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  across the across the country,
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  who are there to represent,
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  at least in the case of not for
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  profit organizations, hopefully, through there to represent the,
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  the folks that we serve, the patients, the
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  members, the communities.
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  And
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  though the our board has been very effective
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  at constantly
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  requiring of us that we report the benefits
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  that we're achieving with our strategies in terms
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  of helpfulness to the communities, helpfulness to the,
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  to the individuals that we care for, and,
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  hopefully, good stewardship with the resources that have
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  been entrusted to us. So,
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  certainly, our board is is very, very helpful,
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  and and that trickles into our daily reports
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  that that that come up when we're looking
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  at what are we providing to the to
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  the folks that we're caring for. Are we
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  being as as cost effective as we can
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  be? Are we being value effective in in
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  helping people to avoid the need for,
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  what what could be rendered unnecessary
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  services if if appropriate interventions are taken earlier.
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  And that oftentimes,
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  is not compatible with revenue generation. So there's
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  there again,
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  having having a board that represents the, the
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  the community interest, the, the interest of the
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  patients that we see is is a is
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  a good help and a reminder,
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  to to keep us from always believing that
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  the bottom line is the bottom line.
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  What an excellent point. Thank you so much
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  for digging in a little bit deeper there.
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  Now I know a lot of opportunities ahead,
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  but challenges as well. What are the the
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  challenges or potential headwinds that you have your
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  eye on most closely right now and and
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  anticipate navigating through over the next year or
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  two?
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  Well, we're certainly seeing dramatic changes or potentials
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  for dramatic changes in federal policy, and I
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  think they're evolving in ways that are at
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  least are not yet clear to me.
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  And so being light on our feet and
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  being able to be responsive
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  to to changing
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  dynamics at the regulatory level, at the payment
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  level, at the,
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  particularly in the Medicare world and
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  very likely in the Medicaid world,
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  being ready to, to to adjust the way
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  that we think so that we can work
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  effectively
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  and
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  effectively meet the needs of the beneficiaries that
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  that depend on us, I think is going
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  to be a big challenge over the next
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  particularly, probably the next eighteen months or so.
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  On a more very
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  specific one, I think rationalizing
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  the expanding pharmaceutical
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  expense is is one that I think is
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  enormous. I mentioned civica early, and for,
• 12:48
  generic drugs, that's at least a a tool
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  that
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  we and others, have now shared in creating
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  to to to be beneficial there.
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  But in terms of the,
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  drugs that are are not generic, that are
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  are,
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  increasingly capable I mean, wonderful technology, wonderful capabilities,
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  capabilities, wonderful new opportunities
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  that can help people to have healthier and
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  better lives.
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  But we need to also find ways to
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  make that cost effective and and cost beneficial.
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  It's our constant hope. It's my constant hope
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  that we can find ways to bring Moore's
• 13:27
  Law or some analog of that to bear
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  in health care so that we can take
• 13:32
  very invasive and expensive procedures that we provide
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  today, replace them with something that is much
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  less invasive, much less risky,
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  and hopefully also lower cost that'll allow people
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  to, to live effective, healthy lives,
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  with less medical what what we think of
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  as medical intervention,
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  but allow us to, to actually
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  liberate them from some of the, the the
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  burden that they face with disease
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  and some of the the the high impacts
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  that they may have to go through through
• 14:04
  our current health system.
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  But we need to find ways to do
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  that that that really
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  also meet with the financial imperatives that, that
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  we're seeing in in our country,
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  really throughout the world
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  where the cost of health care is increasingly,
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  becoming
• 14:24
  challenging
• 14:25
  as populations
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  age and,
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  we have greater
• 14:30
  numbers of people with chronic diseases.
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  There need to be ways that we can
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  meet those needs technologically,
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  much like we have in computer and communications,
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  with Moore's Law.
• 14:44
  Absolutely. I think that's really helpful to understand
• 14:47
  and,
• 14:48
  great to
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  kind of think through things on that lens
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  because, you know, you're right. There's not really
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  a clear picture of how, some of these
• 14:56
  federal policies will change. But, ultimately,
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  you know, looking at where the health system's
• 15:00
  at right now in providing that, pathway for
• 15:04
  as much as possible the financial stability,
• 15:07
  to continue operations and serving the community is
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  a huge
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  challenge.
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  So, you know, I think there's a lot
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  there and a lot to unpack, but especially,
• 15:16
  you know, from of the leadership perspective, being
• 15:18
  able to look ahead, but also,
• 15:21
  not too far ahead so you can still
• 15:22
  make sure you've got the problem solved for
• 15:24
  today to keep you, stable for the future.
• 15:27
  Absolutely.
• 15:29
  Excellent. Well, before we wrap up here, I'm
• 15:31
  wondering, could you talk a little bit about
• 15:33
  the number one thing that you're doing right
• 15:35
  now in order to set Intermountain up for
• 15:37
  that long term success?
• 15:41
  Well,
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  I'm going to to morph the one thing
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  into two things because I think that, again,
• 15:47
  keeping a focus on proactive care, which we
• 15:50
  think is is at the very core of
• 15:52
  what,
• 15:53
  what what
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  what we're expected to do by our community
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  and what,
• 15:59
  what we should be expected to do, I
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  think, is essential. But
• 16:03
  in order to do that in a in
• 16:04
  a more effective way and to make it
• 16:07
  easier for both our our patients and members
• 16:10
  and caregivers,
• 16:12
  the simplification
• 16:13
  processes that we're trying to, pursue right now,
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  that we are pursuing right now, I think,
• 16:19
  are are key. So I really would put
• 16:21
  it in both of those two areas, proactive
• 16:24
  care and simplification.
• 16:27
  Absolutely. Well, Greg, thank you so much for
• 16:29
  joining us on the podcast today. This has
• 16:31
  been just a really helpful and insightful conversation,
• 16:34
  and I look forward to connecting with you
• 16:36
  again soon.
• 16:37
  Well, thank you.