In this special Speaker Series, Becker's Healthcare caught up with John Kontor, MD, executive vice president, Clinovations, Optum Advisory Services.
Dr. Kontor will speak on a panel at Becker's Hospital Review 7th Annual CEO + CFO Roundtable titled " Advancing Patient Care Through Collaboration; Leveraging Technology for Integrated Care" at 10:10 a.m. on Wednesday, Nov. 14. Learn more about the event and register to attend in Chicago.
Question: What keeps you excited and motivated to come to work each day?
Dr. John Kontor: It's exciting to be a part of an industry that is in its most rapid transformation phase in a century. I believe the evolution of real financial incentives to promote quality and efficiency in healthcare has picked up critical momentum, rapidly altering the way we think about the value of care and how to manage its cost.
Secondly, the advances in genomics and personalized medicine are pushing us to explore the next generation of therapies. Already, we're close to understanding the full human genome, which opens the door to genome editing to treat genetic diseases. Physicians are already applying genomic data to customize therapy for both acute and chronic diseases. These treatments range from customization of anti-coagulant therapy based on genetic markers, to CAR-T therapy — targeting certain cancers with patient-specific engineered immune cells based on malignant cell genomes and surface proteins. On the bleeding edge, science is building on this genomic research to advance regenerative medicine, like the work we're beginning to see around generated islet cell transplants to treat diabetes or skin transplants for burn victims.
Lastly, and perhaps most practically impactful across all parts of healthcare and medicine in the near term, is the application of information technology to care. Provider organizations are harnessing the power of aggregated large and diverse data sets, and effectively positioning the emergence of meaningful machine learning to help providers deliver on the promise of value-based care and genomic medicine.
Q: How can hospital executives and physicians ensure they're aligned around the same strategic goals?
JK: More than ever before, the current regulatory environment and reimbursement models are requiring physicians and hospitals to work more closely and effectively together. Despite the clear incentives for collaboration, bridging the gap between these two groups is still one of the biggest challenges that we see in the industry after years of placing these players at odds, or at least in "coopetition".
As the incentives have grown more compelling, leading payer/provider organizations have aligned against business objectives that include structured and contractual goals for physicians. An obvious example is an ACO that may provide physicians with a formal business structure with direct financial upside.
Even when that's not possible in more fee-for-service models, it's possible to structure individual physician incentives to align with larger hospital incentives, such as including non-RVU compensation in payment models, and tying that component to things like risk-adjusted panel size and metrics around quality measures like HEDIS or star ratings.
However, these tactics aren't enough to move the dial without enablement tools. Even with perfect alignment and incentives, the role of physicians in the value-based world is so complex and often at odds with the prevailing fee-for-service footprint. Hospitals that employ capital, expertise, and technology assets to invest in tools and human resources to make it easier for providers to align against strategic goals are more likely to succeed. At the end of the day, hospitals must appeal to physician goals by aligning with their hearts, minds, wallets and watches:
- Enable physicians to fulfill the drive that drive to care for people — the primary driver for most physicians to enter the field
- Adhere to evidence-based care guidelines
- Empower clinicians to be successful financially alongside hospitals
- Deliver on this promise efficiently so they providers can maintain a sustainable work/life balance
Q: What is one piece of professional advice you would give to your younger self?
JK: My time as a practicing physician has been essential, and the true foundation I built on to drive my career in healthcare forward. But my advice to my younger self would be to take risks earlier so that I can spend time working on what really drives me day-to-day: exploring how to use technology to improve patient care and efficiency. Even prior to medical school, I knew I wanted to be at the center of innovation in this industry, because I believe that how we apply technology will truly transform patient care. So I would tell my younger self, "Take the plunge and jump in; don't wait."
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