EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD

This episode is with Dr. Scott Conard, founder of Converging Health, who you might remember from an earlier episode (EP391). Right now, Dr. Conard is doing a bunch of work with Mike Adams from 7-Eleven, helping their plan members. A lot of this work is centered on a few pretty striking but very common insights that many plan sponsors will find in their own data: it turns out about 70%, give or take, of people who wind up costing the plan whatever the high-cost threshold is in any given plan year didn't fall out of the sky unexpectedly — they were actually high-risk but low-cost in prior years. So the trick is to find these individuals and help them not fall into the high-risk, high-cost part of the graph before it happens.

WHAT YOU'LL LEARN

✅ Why roughly 70% of members who become high-cost claimants in any given plan year were already identifiable as high-risk, low-cost members in prior years — and why that's the actual opportunity for population health management

✅ How to think about population health data correctly, and why the common approach to interpreting that data leads plan sponsors astray on where healthcare spend is actually headed

✅ What needs to happen with population health data once it's collected — identification alone doesn't change outcomes without a concrete intervention pathway

✅ A real, successful case study of community-run primary care in Rhode Island — where a community pays for primary care for its members the same way it pays for the fire department and police department, with Michael Fine, MD, part of that effort

✅ Why avoiding prevention in primary care only harms you later — the cost of skipping it now shows up, with interest, in the high-cost claimant numbers a few years down the road

WHY THIS MATTERS

The plan sponsors who get ahead of high-cost claimants aren't the ones with the best crisis response — they're the ones who correctly read their own data to find high-risk, low-cost members before the cost curve bends upward. Dr. Conard's Rhode Island case study is proof that community-funded primary care, treated as basic infrastructure rather than a discretionary benefit, is one of the more durable ways to intervene before that curve turns.

MENTIONED IN THIS EPISODE

EP449 with Marty Makary, MD, MPH: Apple Podcasts | Spotify | Other Apps

=== LINKS ===

🔗 Show Notes with all mentioned links and articles: Episode Page

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00:00 Introduction.

07:10 How do we think about data wrongly, and how does that affect our healthcare spend in regard to population health?

09:43 What needs to be done with population health data once it's collected.

14:48 Community in Rhode Island doing effective proactive care.

16:44 A real, successful case study.

24:08 How do we define high-cost patients?

24:14 What do we know about high-cost patients in regard to population health spend?

29:02 Why avoiding prevention in primary care only harms yourself in the future.