Dr.Luke’s vision is Geisinger’s reality: Value based care has arrived at healthcare futurists panel

Dr. Josh Luke exploded onto the health system executive conference speaking circuit with passion in 2014 and a provocative message to health system executives "Change or Die".

This hypothesis was based on his practical experience as both a hospital administrator and family caregiver combined with his knowledge of health policy. The resistance to his message by incumbent system executives was palpable to anyone in the room at the time. As the son of a complex care patient his Mom, through his experience as a former serial hospital administrator, and before that as a post acute facility executive, Josh brings to bear the whole personal and professional perspective from the entire continuum of care with him. Josh is on a mission. You see: America spends far more than any other country on health care. Though our outcomes are below average compared to other developed countries on many key health care quality indicators. U.S. Health care spending outpaces both GDP and inflation growth to boot.

"Hospitals are no longer intended to be a profit center in America and that has been a tough pill to swallow for many," said Dr. Luke, who serves as faculty at the University of Southern California's Sol Price School of Public Policy. "Value based care under Obama and now Trump, is an insurance model that has transitioned hospitals’ business models. America has reached a tipping point where access to care, whether mandated or not, must outweigh profits in the healthcare sector to ensure a healthy nation. We have reached the tipping point and the evidence is now all around us."

In 2014 it would have been hard to find the likes of Geisinger Health System and USC Keck Medicine on the same page on the same stage singing the same tune with respect to where healthcare is going towards a more efficient and effective future.

Fast forward to May 4, 2016 and having earned the respect of the thought leaders from top health systems over the last years, Dr. Josh Luke proudly hosted Dr. David Feinberg, CEO at Geisinger Health, Rod Hanners, CEO at USC Keck Medicine and other notable health system and physician executives including Dr. Zeev N. Kain, President, American College of Perioperative Medicine from UCI School of Medicine to share the same stage. These leaders were co-hosted by The National Readmissions Prevention Collaborative founded by Dr. Luke and the USC Sol Price School of Public Policy at the California Endowment. Attendees agreed that there's no denying that from purely economic and employer perspectives, healthcare will continue to move towards a system of results over activities, irrespective of politics.

Confirming Dr. Luke's hypothesis, just two days before hosting Geisinger and USC, May 2, 2017 – A national partnership led by two business organizations representing some of the largest employers including through the Pacific Business Group on Health announced a campaign. Their goal is to accelerate economic growth by controlling health costs and improving quality through the rapid adoption of value-based health care. The group sent a letter directly to President Donald Trump and U.S. Health and Human Services Secretary Dr.Tom Price, urging targeted deregulation and market-based purchasing strategies to drive health care efficiency and effectiveness.

It’s absolutely critical for the health of Americans and our economy that value-based care is quickly embedded in the health care system,” said David Lansky, President and CEO of the Pacific Business Group on Health. “Policymakers must focus on what works to achieve these goals, and we know that value-based care helps to drive down costs and improve patient outcomes.”

Forbes Books, the Publisher recruited Dr. Josh Luke to be the first healthcare innovator to write for Forbes books, which will be the third book in their healthcare series. This has solidified Dr. Josh Luke’s standing as the leading authority on health system reform and teaching business executives how this complex system works.

A highlight of the invitational held at the California Endowment was Dr. David Feinberg returning to his hometown, L.A. Here, he described the stark differences between his prior home in Beverly Hills to when he left his CEO post at UCLA to take the top job at Geisinger Health system in Pennsylvania. You can try to imagine a patient panel as a physician or population of patients as a hospital administrator, whose entire identity and health status is marked by dismal multi generational poverty, hunger, and unemployment rates. Dr. Feinberg courageously agreed to lead this health system which was once the industrial heart and economic engine of the U.S. Once upon a time rail lines connected cities of industry kings that were home to manufacturers of heavy industrial materials and large consumer products like cars and trucks. Today, the giants of industries of the past that once dominated and defined these areas are mostly gone, leaving behind a dilapidated shadow of their former selves.

With this backdrop, Geisinger serves diabetics who are food insecure with diabetes out of control.

What was Geisinger's goal? To disrupt themselves before someone else does.

They've instituted their groundbreaking program in Central Pennsylvania: "Whole Grain to Whole Genome". They're doing whole exome sequences and they've enrolled patients in a fresh food pharmacy. All diabetics get food prescribed to them, Geisinger is serving millions of pounds of foods. How can Geisinger be 2-3 years ahead of most anyone else and a decade ahead of most? They can do this because they're both the provider and payer, thereby providing excellent alignment of incentives.

"Its been awesome to observe the progress Geisinger has made toward personalized medicine and true value based care since Dr. Feinberg arrived as CEO," said Dr. Luke, who after serving ten years as a hospital CEO became the best selling author of 2015 for the American College of Healthcare Executives after his first book was published. "It takes a leader willing to challenge his board, insist on excellence and trust that the financial benefits and return will emerge from healthier communities and Geisinger is the first nationally to prove this model. Kudos to Dr. Feinberg, hopefully there will be many more health systems nationwide to follow them down this path."

Geisinger's food cost costs $20 a week per patient. They have reduced what has been a cost of $220K over four years to $1200 per year cost for medical care for a diabetic patient.

"Geisinger patients are learning to cook and becoming more social as a benefit of the program. Because they're being treated by teams, the patients are highly accountable to maintain their great diet." reports Dr. Feinberg. He advised executives looking for support in transforming their health systems to get their board of directors to move through patient stories. Dr. Feinberg advised further to have the patients to tell the story themselves. Geisinger board members have to round and see patients, which provides a North Star for planning patient care.

The population has the lowest breast cancer risk in history. They've lowered readmissions and premature deaths. Dr. Feinberg advocates listening to patients, taking care of them, and letting them have input. His team returns results from genomics only when they're medically actionable. 100% weight, blood pressure, blood sugar has decreased, A1C has decreased, and heart patients have better survival rates.

On an expert panel dubbed the “Healthcare Futurists” and moderated by D. Josh Luke, while in a different place in their journey, Rod Hanners CEO at USC Keck Hospitals described how they were able to start on the Geisinger model --a "prepaid model" by managing the health of their own employees.

Dr. Zeev Kain joked that you could never get all the team members responsible for a knee replacement in one place because all the physician specialties have their own tribes and conferences.

All the attendees including health system executives and a sprinkling of vendor partners left the invitational optimistic for what is not just possible, but what must be done.

As CEO of Medigram, a company bringing reliable, timely, and secure information on mobile to healthcare, we are further inspired by the steps that both health system leaders and business leaders are taking to evolve our healthcare system. The reason why Medigram is backed by so many serial Fortune 500 executives and board members is because they wish for a more efficient and effective health system to help them take care of their employees and families, and in turn their bottom lines. We would not have thrived in our journey if it weren’t for Dr.Luke’s willingness to challenge the status quo and share foresight about what is happening now in healthcare.

About Author, Sherri Douville:
Sherri Douville is CEO and board member for Medigram, an intelligent mobile enterprise solution for healthcare. She brings over a decade in healthcare consulting, product development, sales, marketing, and entrepreneurial experience to her leadership at Medigram. She serves as a frequent moderator and panel coach at Health IT conferences. Prior to this, she founded a healthcare technology consulting practice. As CEO for Medigram, Sherri has successfully planned and executed on the development, design, and build of the enterprise grade version platform, Medigram 2.0, which is based on an independent, secure and scalable database. Sherri has experience in over a dozen disease states from over 9 years in clinical sales at Johnson & Johnson where she participated in the management development program, won a number of awards, and was recognized as an industry leader by Standard & Poor's Vista Research division while it was part of McGraw-Hill. Sherri now serves on the Board for HIMSS Northern California where she is the 2017 Co-Chair for the Innovation conference, Co-Chair for program panels, and contributes to the newsletter. She is an advisory board member for the National Bundled Payment Collaborative, serves as a member of Santa Clara University’s Board of Fellows, and as Co-Chair of the mentoring team at TiE’s (The Indus Entrepreneur) youth entrepreneurship program. She earned her BS degree in Combined Sciences from Santa Clara University and three IoT and data analytics certificates through MIT.

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