INBW36: Will Healthcare Stakeholders Who Don't Collaborate Wind Up With a Business Problem?

Will Healthcare Stakeholders Who Don't Collaborate Wind Up With a Business Problem? (INBW36)

Stacey Richter recaps the "why collaborate" argument from two earlier inbetweenisodes, then makes the financial case: real-world examples from ChenMed, the Nuka System of Care, and others show that paying for health instead of sick care improves outcomes, patient satisfaction, and the bottom line.

WHAT YOU'LL LEARN

✅ Why multi-morbid Medicare patients seeing 5 to 13 doctors makes coordination essential, not optional

✅ Real-world proof points from ChenMed, Johns Hopkins, and the Nuka System of Care showing coordinated care improves outcomes and cuts costs

✅ Why physicians in pay-for-health models report less burnout than those stuck in fee-for-service's "two canoes messy middle"

✅ Financial evidence that taking on risk pays off, from Ochsner's Medicare Advantage strategy to One Medical's Iora-driven revenue

✅ Why CMS is pushing traditional Medicare toward 60% risk-based accountability by 2024 and 100% by 2030

WHY THIS MATTERS

The case for healthcare stakeholder collaboration isn't just moral — it's financial. From reduced hospitalizations at ChenMed to Nuka's 96% patient satisfaction rate, the evidence shows that aligning payers and providers around paying for health, not sick care, improves outcomes, reduces burnout, and increasingly pencils out for the organizations willing to take on risk.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction

05:03 When physician practices get paid to deliver health and not paid for sick care, does patient health actually improve?

05:46 What is the ChenMed Case Study?

06:26 Can a care coordination model be associated with improved outcomes, including substantial cost reduction?

06:38 Are there examples of really great patient results when care is coordinated and payers are aligned to pay for health?

07:29 Do patients actually want this stuff?

07:46 Are employees choosing lower-cost plans just as much for the lower premiums as for the care coordination?

08:29 What is the Nuka System of Care in Alaska?

09:25 "Any physician practices looking to take better care of patients…get aligned with payers (CMS or otherwise). That's step one."

10:45 Are doctors happy in these models where payers are paying for health?

11:16 "Burnout reduces here because burnout is moral injury in a cheap Halloween costume." —Physician leader

13:25 "There's a world of difference between a well-functioning accountable care model and a very terrible one."

13:59 "Life can get really hard for PCPs…they get to be care gap cowboys and cowgirls while, at the same time, having to do all of the FFS coding."

14:43 Is taking on risk worth it from a financial standpoint?

16:05 "There's likely a downside to making zero effort on the accountable care front and banking on FFS being a forever cash cow."

17:11 "I have never seen my entire career more CEOs of Fortune 500 companies…who are actively taking a role in their employee health benefits."

17:54 "Only high-performing docs are in network — and this includes specialists."