How Trusted Primary Care Relationships Keep Patients Out of the ER — and Lower Plan Costs. EP473

I'm revisiting, in a Take Two, this episode with Dr. Kenny Cole because I'm listening to it this time with a new focus — the theme that keeps coming up over and over on Relentless Health Value these past few months: if care teams don't build a trusted relationship with plan members and patients, then in a moment that really matters, the patient will suboptimally wind up in the ER. Across an entire plan sponsor's member population, all these pilgrimages to the ER come at great cost — ER spend is about 6% of average plan spend. As Denise Wiseman, PhD, MBA, CPXP, put it on LinkedIn, "Primary care is absolutely an investment in health and wellness, not a cost…Trust is the foundation. Without trusted relationships between patients and care teams, we're not investing—we're just reacting." Dr. Kenny Cole of Ochsner Health System joins Stacey Richter again for a conversation that has lessons for plan sponsors, clinic managers, and anyone trying to reinvent a business model so that best-practice clinical pathways and financial viability actually align. WHAT YOU'LL LEARN ✅ Why clinical teams have to deliver care in such a way that they are accountable for the outcomes generated — not just activity, but the actual result ✅ Why clinical teams need to see with their own eyes and believe that a clinical goal that's been set is actually achievable before they'll commit to it ✅ Why care flows are critical: getting everyone on the same page about what best-practice care looks like, then operationalizing how that clinical excellence gets achieved day to day ✅ Why building trust with patients and connecting with them cannot be underestimated — and why care flows need to both standardize care for speed and ease and facilitate the patient relationships that make that care stick ✅ How Dr. Cole splits his own week — seeing patients one day and serving as system VP the other days — to design and develop new care models, including Ochsner 65 Plus, built around aligning clinical outcomes with financial viability WHY THIS MATTERS This concept — a trusted relationship with a primary care team — can feel soft and squishy, and it's easy for someone looking at a spreadsheet to cross it off as wasted time. But without it, good primary care falls victim to the very real perverse incentives to drive commercial ER volume or volume to high-revenue service lines. If plan sponsors don't get their members a trusted advisor who will be there for them when it matters, someone else is going to steer that member — based on their own financial incentives, not the patient's. Dr. Cole's work at Ochsner is a real-world example of what it takes for primary care to live up to its potential as an investment rather than just another line-item cost. MENTIONED IN THIS EPISODE EP412 with Robert Pearl, MD: Apple Podcasts | Spotify | Other Apps EP315 with Bob Matthews: Apple Podcasts | Spotify | Other Apps EP242 with Marty Makary, MD: Apple Podcasts | Spotify | Other Apps EP427 with Rik Renard: Apple Podcasts | Spotify | Other Apps EP466 with Vivian Ho, PhD: Apple Podcasts | Spotify | Other Apps EP415 with Rob Andrews: Apple Podcasts | Spotify | Other Apps EP391 with Scott Conard, MD: Apple Podcasts | Spotify | Other Apps EP455 with Beau Raymond, MD: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify 📺 Subscribe to our YouTube channel === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 07:35 Is there an optimal care pathway where there might be a lot of treatment variability? 12:32 Why is it important to start with the end in mind? 15:44 How do you scale clinical excellence? 21:29 Why is it important simply to demonstrate what's possible for better health outcomes? 23:18 How do we reinvent the business model of healthcare? 34:22 Dr. Cole is published in various healthcare journals; check out his most recent article.