December 13, 2018 Episode 002

Insider Glenn Steele’s Take on Redefining Value, Aligning Providers and Payers, and Driving Innovation

Insider Glenn Steele’s Take on Redefining Value, Aligning Providers and Payers, and Driving Innovation

Changing our complex healthcare system from within is a difficult proposition, but one that Glenn Steele, MD, has embraced in multiple capacities over a decades-long career. After treating patients for 24 years and serving as CEO of one of the nation’s most innovative health systems for 14 years, Steele personifies the term “healthcare insider.”

Through his experience, Dr. Steele has come to understand “value” in a slightly different light than its traditional definition, placing a higher emphasis on the patient’s perspective instead of simply considering outcome and dollars spent. He defines value as achieving the best and highest possible outcome while decreasing the amount of aggravation for patients and their families – which in most cases, he points out, reduces costs as well. For the past 20 years, he’s been working to convince providers that they have to become more efficient in how they treat patients, regardless of whether they’re in a fee-for-service or population-based reimbursement market, and fundamentally change patient-provider interactions.

In the second episode of Healthcare is Hard: A Podcast for Insiders, LRVHealth’s Keith Figlioli shares his conversation with Dr. Steele to offer an insider perspective on a wide range of topics including:

The Game Plan for Balancing Clinical and Financial Risks

When Dr. Steele arrived at Geisinger Health in 2001, most observers and industry consultants were recommending that provider-owned payers be separated and sold. But Dr. Steele saw an advantage in the fact that Geisinger had both a provider and a payer under the same fiduciary structure, with both holding significant market share. While there were internal struggles, just as there are between any payer and provider, Geisinger used its unique position to bring both sides together to mutual benefit, and the benefit of patients.

The provider and payer sides of Geisinger worked together to decrease total cost of care and provide better outcomes for patients over time. Then they developed systems for transferring the cost savings from payer to providers that had actually changed how they cared for patients.

Nearly two decades later, Geisinger is now known as one of the nation’s most innovative health services organizations, serving more than 1.5 million patients in Pennsylvania and New Jersey through 13 hospital campuses, a nearly 600,000-member health plan, two research centers, and the Geisinger Commonwealth School of Medicine.

Where to Start Aligning Value

To start delivering greater value according to Dr. Steele, leadership on both the provider and the payer side needs to first agree on shared goals and what both view as the best outcome for members or patients, especially the highest utilizers. Once that is established, they can then determine what information needs to be shared – from claims data and predictive modeling on the payer side, to real-time care information on the provider side.

Putting these data together and having the leadership of both sides work together is a big cultural shift. But it’s a critical first step to be able to transfer payment incentives and reward those who deserve to be rewarded, according to Dr. Steele.

The Foundation for Innovation

Any company that is committed to innovation and exploring new ideas must learn to deal with and absorb failure. Dr. Steele talks about how it becomes very difficult for healthcare organizations to take chances on innovation if they’re not building up their balance sheet. In many markets, getting an operating margin that’s significantly above zero is incredibly tough. And as a prerequisite for driving innovation, it explains the rush of many organizations to scale and become a leader in their market so they can then become the driver of innovation in their market as well.

Employer Influence – Before Amazon, JP Morgan, and Berkshire

The collaboration between Amazon, JP Morgan, and Berkshire Hathaway was big news when it was announced earlier this year, for good reason. As vice chair of the Health Transformation Alliance (HTA), Dr. Steele has already been working with major employers in the US on similar issues to improve costs and efficiency. In fact, JP Morgan and multiple Berkshire Hathaway companies are members of HTA, along with other employers including American Express, Verizon, IBM, FedEx, and many more. Dr. Steele talks about how HTA relates to the new joint venture and how the two organizations could eventually collaborate on shared goals.

To hear Dr. Steele talk about these topics and more, listen to the second episode of Healthcare is Hard: A Podcast for Insiders.