Payments power healthcare ecosystems

I'm Matt Nesto, Editor-In-Chief at PYMNTS.com.

I'm joined today by Elmahdi Erraji.

He is the head of product development for Instamed which is
a J.P.Morgan company.

Elmahdi, thanks for coming on PYMNTS. Appreciate it.

And talking about, well, payments and how it applies to
health care these days.

Well, thank you for having me. Pleasure.

So one of the things that people talk a lot about now in
health care, in this kind of post, COVID things will presumably post COVID,
knock on wood.

Is that, you know, tightness of staff, labor shortages.

We see that in lots of quadrants in the in economy.

But talk to me about how it's playing out in health care and
how sort of like payments ties it to that to sort of maybe mitigate those pinch
points.

You know, like in health care.

You know, unlike other industries, famous conversations that
happen they happen to date is also vastly paper based processes, which results
in a lot of confusions for the consumers.

So when you add to it labor shortages, it's only making the
problem worse.

What that means is when you engage patients digitally, early
and often in the health care or throughout the health care visit lifecycle, it
increases the patient's likelihood of paying and.

Reduces the burden on the administrative staff.

 

What does that mean? Right.

So when it means we need to provide excellence, you know,
engagement from consumers that aims to optimize the consumer experience.

And you do so by one support in multiple communication
channels.

That's not just the consumer forms them throughout their
payment journey.

By having a digital first approach that suppresses
statements, accelerates the information exchange between providers and
consumers, as well as providing convenience payment options like tax to pay,
Apple Pay, Google Pay.

So by meeting the patients where they are and offering them
convenience and choice, we are able to eliminate those barriers that would
otherwise have resulted in a phone call or in-person visits to the provider
office.

 

So I think in general, the more digital financial
engagements, the touch points an organization can offer its patients, the more
efficient the organization can operate.

It's interesting, too, because, you know, you're talking
about the more that we have.

And it's also interesting that you point out that this is
patient driven, affecting, you know, labor shortages, making less work basically
for the limited hands on deck.

But talk me about this sort of integration of payments
everywhere concept.

I mean, for a health care provider, is that not a bit
daunting?

Yeah, no. You know, one integration payment.

And there is no doubt that payment integration significantly
reduces or decreases the manual steps.

 

And in essence, it allows organizations to focus on doing
what they do best, which is providing the best service for the consumers.

 

So having payments capabilities, you know, also having those
payments capabilities and different patient touchpoints is crucial for consumer
engagements.

So the best way an organization can make integrating payments
everywhere less daunting is to consolidate the vendors that are involved in the
payments process.

So selecting by choosing solutions that are that have broad
integration into the appropriate health care ISE vs across multiple channels,
the organization can lessen the burden on themselves.

They should also look at solutions that have deep
integrations with the appropriate Ellmers EMR, but also meet the consumers
where they are via omni channel experience.

What are some of the different touch points?

I mean, and also eBay and different payment methods.

You mentioned textured pay.

I think you said Apple Pay as well.

But like what are some of the touch points and methods that you're
seeing deployed now that appear to be delivering results?

Yeah, I mean, so you when you ask that, you got to look at
the full payments journey that the consumer goes through.

Right? So it starts by making the phone call to set up a
tool to schedule a patient's visits.

That's a touchpoint.

That's an opportunity to engage with the consumer.

It goes into, okay, I'm walking into the doctor's office and
I'm paying my co-pay.

And, you know, that's another other touchpoint that we want to
have a point of sale solution.

And, you know, the journey carries on as you can inform
them, not just throughout the throughout the cycle as we're trying to get the you
know, we have better understanding of the patient's responsibility as we're
trying to collect, you know, having a digital thing. So different consumers like
to interact differently.

And the idea is whether they want to pay the bond, then you
meet them there.

If you want to know if they want to pay via website, you
meet them and you want to pay your tax to pay you meet them that if they want
to use that Apple pay Google wallet, you can do that as well so that those are
the touchpoints.

And you know, like consumers, health care providers,
practices and such also like different methodologies.

How do you kind of answer the put my eggs all and all my
eggs in one basket kind of a thing.

But when vendors are worried about that sort of consolidated
payment process, it's sort of a pros and cons approach.

Imagine that's a it's a valid point. I think.

I think about it's it's kind of two different settings.

I think, one, having a, you know, one vendor in in charge of
the payments processes.

From a consumer standpoint, it's a unified consumer
experience, right? So throughout that journey, you the consumer has one
consumer experience which results in higher consumer engagement from a provider
organization.

There are many benefits.

Efficient efficiency is one simplified payments post plan
and ability to have.

It provides an ability to have better automation throughout
the journey.

Also, from a security standpoint, it reduces the hands off in
the payments, processes and innovation.

When you have one partner for the entire payments process,
it means faster innovation as well as compliance within your industry
regulations.

What about maybe like large organizations that have all
kinds of medical disciplines offered? What about integrating them?

Because they may have very, very different payment
touchpoints and, you know, using.

All right.

Radiology versus dentistry, for example, under one of the
same broad groups, so to speak.

How do those different disciplines kind of merge and work
together?

Yeah.

I think that is one thing that's common across the
difference, you know, health care organization,

which is patients.

But that's right. That's an industry that's across the
health care industry.

You know, however, like different specialties may indeed
view the problem with different levels of severity.

So if one internal medicine, for example, patient's responsibility
is not understood at time of service.

So it's important to set expectations throughout the payment
journey with the patients. Whereas for dentistry or vision as well as elective
specialties, there is better clarity around patients responsibility.

But there is a need there to simplify, to have simplified
solutions for recurrent engagements, you know, based on the nature of those
specialties.

So they benefit from capabilities like digital wallets.

We find that also like in physical therapy, it's another
specialty that has that recurring engagements and solutions like digital
wallets can can simply simplify that experience, no doubt.

You know, you mentioned patient responsibility, and I'm just
thinking of the cost.

Everything in payment plans we've seen bnpl emerge and all
kinds of different things emerge slowly into the health care area to try to
make it all more affordable for the end user, the patient, the consumer.

Clearly payments plan, big role, the affordability equation.

Yeah, absolutely.

I think with the higher deductibles, I think what's
important is to offer tools, that is the payments burden for consumers.

What does that mean?

So I think payment plan is a great way to ship payments
insurance for healthcare organizations, but without overburdening the patients
themselves.

So it's a you know, they enable consumers to smooth out the
spend over time.

And I think also it's important for health care
organizations to, as they offer those solutions like payments plan, that they
can leverage self service features as well as automation in that self
self-service features, as well as automation to enable consumers to have the
ability to set up those plans without impacting their staff quality look
awesome.

Elmahdi Erraji, thanks for coming on. It's great to meet
you.

Head of product development for Instamed.

Appreciate your insights and look forward to catching up
sometime in the new year.

Thank.

Thank you. It's my pleasure.

Health care is changing in a very, very dynamic way. Today, we're in a state of chaotic innovation. 

Never before, on the other hand, have we had a greater opportunity to leverage connection architecture, enabling technologies, new HX strategies, human experience strategies, to be able to deliver improved access to care, improved patient quality, and ultimately, doing it all at a lower cost. 

But here's the thing, we really need to look at the nucleus, the core that makes all this work. We've got to find ways to be able to leverage payments across the patient's journey. We truly need to know them from the perspective of their persona, what do they love and what do they hate, how can we communicate and connect to them, what is their unique difference, what's the difference of the communities that we're serving? 

And when we take payments and we take the financial dynamics of health care and humanize it and institutionalize it in a way that actually fuels the future of health care, well, then we're really on to something. 

Everybody within the health care ecosystem all house the opportunity to improve the way in which they deliver care and the way in which they deliver value to their organization by really looking at this concept around the nucleus of payments. 

Well, listen, I hope this quick primer gives you some things to think to be able to improve access and quality. Thanks so much, I really appreciate it. 

Thanks to all of you for taking the time

to listen in on an important conversation

about payments

and the new business models

that are powering value based health care.

 

Tim Bensley,

the CFO of agilon, a total care platform

for seniors, and Jeff

Lin, managing director and co-head of J.P. Morgan's health
care payments practice.

 Thanks to both of you for making the time.

 

I can say I've been looking forward to having this chat with you for for quite some time, so ready to dig in.

 

Thanks again.

 

So let's start with a little preamble.

 

The conversation about value

based health care isn't a new one.

 

It's been happening for quite a long time,

although it is very hard

to pinpoint

exactly when the conversation started.

 

A little known fact

when I was doing my own digging around

is that the American Academy

of Pediatrics claims

that it introduced

the concept way back in 1967,

when it introduced this idea

of coordinating data across providers

so that sick children delivered

or had better outcomes delivered to them.

 

So if we assume that that is

the unofficial official starting point.

 

Fast forward 50 plus years.

 

How much progress has been made

since then in using digital

to break down the information silos

that seem

to be very critical in delivering

this idea of value based care?

 

Tim, you want to start us off?

 

Look,

I've been in the health care industry

and working for Agilent

for about three years now, so I can't be

 

I can't speak to what happened

that's happened over the last 50 years.

 

But I can tell you that being successful

in value based care,

which is to be successful, is essentially,

you know, improving the outcome

for all the patients that are basically

been in the value based care environment

is all about how you leverage information.

 

And by

the way, you know, more

and more leveraging information means

leveraging disparate information

across from many different sources.

 

So, you know, your term

data silos is probably a good term.

 

And by the way, the information that comes

from each of those areas, be it

payers names, information from the NCOs

or HIPAA information

that we can access or EMR information

from the providers themselves.

 

You know, all of that

now is that none of that data is perfect

and you sort of have to be able to use

information from all of those sources

to be truly successful

in a value based care environment.

 

So that I can give you a great example

of how that works and how that's

probably much different today

than it used to be.

 

And by the way, at Agilent,

probably the the biggest area

that we invest in on a day in and day out

basis is in the technology to be able to

ingest condition and leverage information

to basically be able to drive outcomes.

 

So an example that I like

use is like almost too obvious,

but is one of the biggest drivers of how

you can be successful in value based care.

 

As it turns out,

as we've been able to mine this data

and it really does take information across

multiple sources to get to this answer,

we reach a conclusion which might

seem obvious

but now can be proven from data.

 

Is that the more one of the biggest

indicators of success and value

based care,

meaning one of the biggest indicators

that you're going to be improving

the health outcome of your patients

is the number of quality

touchpoints that you can have

with the primary care physician.

 

In the past,

the model was really disincentive.

 

Primary care physicians

have a bunch of touchpoints

because they weren't

getting reimbursed enough

to really even pay back their own time

or the resources that that

that the practice was investing in it

under value based care.

 

They actually have the opportunity

to actually make it economic for them.

 

It's important

for them to have multiple touchpoints.

 

Well, the problem is,

if you're a primary care physician

that's got literally hundreds

of Medicare Advantage patients

and probably hundreds

more of Medicare fee for service patients,

and then you probably have multiple

even hundreds more of that of commercial

patients on your panel.

 

How do you figure out how to do that?

 

And so one of the things

that we've been able

to do with multiple sources of data

coming through our technology

is really carefully outline

for the most complex,

most critical senior patients

that are going to get the most value

out of multiple touchpoints.

 

And so we can put in front of the PCP

through this technology.

 

You know, here's

exactly the subset of your population

that you really should be focusing on

instead of seeing once a year

for an annual wellness visit,

seeing four or five or six times a year.

 

And then as importantly, we can

then also track

how are those physicians

complying with that?

 

You know, how many times

are they seeing these patients?

 

And the last thing is now through the kind

of looking across

those different sources of data,

we can then actually track longitude,

really longitudinally.

 

How well are those patients

actually doing?

 

So are they actually are the outcomes

improving or are we actually generating

lower costs,

more health outcomes for those patients?

 

So it's just really

data is really at the center

of everything that we do to be able

to drive that value based care model.

 

Yeah, I mean, your model is interesting.

We'll get to that in a minute.

 

How you've also created incentives.

 

But but Jeff, I want to kick it to you.

 

The role of digital in breaking down these

these these data information in silos

so that, you know,

there is in the best interest

of the patient

the ability to deliver the right care.

 

Yeah. No.

 

And I echo a lot of things that Tim said.

 

But, you know, I think we're

still in the first inning for this.

 

You know, 50 years ago,

the concepts of mobile APIs, going

digital platforms, you name it, that's

that was a foreign concept back then.

 

So the fact that these data silos,

they were paper silos back then,

we still have those digital silos

that exist today.

 

And I think where, you know,

especially if I look at the employer space

where there's 150 members,

150 million covered lives tied to that,

where we're in the early stages of this,

even if I look at the commercial space,

only 12.7% of the spending

there in the commercial space

is actually value based care.

 

And you could contrast that with the 35.2%

in the Medicare Advantage space

where where we have a lot

to go to achieve the scale

and the benefits of this digital sharing

that has to exist in order for value

based

care to see those outcomes be fruitful.

 

I think, you know, the point

that you just made, Jeff and Tim too, is

that technology is an enabler,

but it's not the only thing.

 

And that sort of brings me to

the to the part of the conversation

where we get to incentives.

 

And if you go back to, as I've done again,

getting prepared to go back

to what people have written about this,

I mean, decades ago,

 

Harvard Business School professor

Michael Porter wrote something in 2006

where he talked about creating competition

in health care, which is kind of

a foreign concept, competing for patients

on the on the virtue of value for service,

where costs come down, patient

satisfaction goes up is is a great idea,

but it comes down to

how do you and sent the right behaviors

across the ecosystem.

 

And Tim what what what Agilent has done to

to do what you described, which is incent

providers to have more touchpoints

with those patients

instead of churning through patient

after patient day after day

in order to deliver financial

value for the practice

is something that you guys have cracked.

 

Tell us

a little bit more about the business model

and how the incentive structures work.

 

Yeah, absolutely.

 

Can you now that I mean,

the model was basically broken

and it still is broken in many areas

where the Medicare fee for service model,

where a primary care physician

is really disincentive to spend the time

that they need with the patient

to improve the helpfulness

and to improve the outcomes

for those patients.

 

In fact, they're incented

to cycle through as many Medicare patients

as quickly as they can.

 

And in many cases, you know,

they're obviously not going

to get the same quality of care

because they're not spending the time

to really understand

what the needs of the patient are.

 

So what we do is

we go into a market and enter that market

by going into a partnership with a skilled

primary care physician group

in that market and essentially form

a 20 year partnership with that group.

 

So the first part of the incentive is

we are tied together in this partnership

with the primary care

physician group for for 20 years, which is

a big commitment for everyone to make.

 

And essentially what we do is go in

and say for all of the at least

initially Medicare Advantage patients

that we can attribute to that, to those

to those primary care physicians in that

partnership for all of those patients,

we're going to go out

and essentially facilitate

contracts

with the with the payers in that market,

with all the payers in that market.

 

So therefore,

for all the Medicare Advantage patients

in that market,

for that primary care physician group

in partnership

with us to take full risk for them.

 

So we're going to go in and say,

Hey, payer a in that market, we'd like to

for you to give us 85% of the premium

that you're receiving for that

a plan for this patient

that is seeing our primary care physician

and we'll take that 85%

and we'll take the risk for all the costs.

 

What happens

then is we work with

we leverage our platform,

we leverage our unique processes,

we leverage the knowledge

and the strength of our network.

 

And of course, we leverage

all of the technology and information

that we have to work with that

with those primary care physicians

to actually then improve the outcome

for these for these patients.

 

They're incented to do that now

because instead of getting 100

and something bucks per visit for that

for that Medicare patient visit,

they're essentially going to get

the economic benefit of whatever surplus

they can generate from that premium

or receiving and those that are going out.

 

And the better the health outcome

they can generate for that patient,

the larger that surplus is going to be.

 

As we generate that surplus,

which we do pretty much in every market by

by year or two,

that we're in a market most,

many markets in year

one half of that surplus is going back

to the primary care physician and half of

it is coming to us.

 

So that that I think the physician,

the primary care

physician is already incented

by their choice to get into this business

to want to do the best thing

for their patients.

 

This actually aligns

the economics with the desire to do

what they already want to do,

which is practice, which is practice

medicine the right way. So

yeah, so I think that that new model

and all the resources that we bring

to make that model successful really turn

the turn the entire process

back on that on its head

and make it the way that it should be,

which is the primary care

physician as the quarterback for,

for the care of the patient

and the primary care physician

essentially driving improved outcomes

and driving unnecessary

utilization out and costs down.

 

But but it's not like it's more than just

seeing patients on a more regular basis.

 

It's more about the decisions

that they're making

with respect to the care

that they're recommending patients get.

 

Can you talk a little bit

about how that aligns with the right

incentive for quality of care,

but also the financial incentive for that?

 

Yeah, absolutely.

 

So the other thing that we can do

that would be difficult to do

and this is kind of the power

of the Avalon Network that now we have

partnerships with

 

33 different partners across the country.

 

And, you know, many states

now around the country with over 2700

physicians that are in that network,

 

26 payers with 96 payer contracts.

 

And it's a really big network now.

 

And one of the things that we can do with

that amount of scale is to start going

into creating clinical programs

that can also be adopted by each of these

by each of these provider groups that

they would not be able to do on their own.

 

They can also significantly help drive

positive outcome for their members.

 

A great example is you're

not surprisingly, there's a predominance

of various levels of diabetes illness

among seniors, and it's a pretty large

percentage of costs of care

for the senior population.

 

We have the scale to be able to go in

and partner

with some large national renal

care vendors that can help.

 

Now that and then we can use the data

and working with our providers

to understand who are the right patients

who should be enrolled in this program,

get them into the program

and actually use UC scale programs

that we can generate to improve the health

wholeness of these renal patients.

 

And it can be a matter of making sure

that they're

getting the right amount of treatment

on a more regular basis, affordably,

 

It can be making sure

that they're getting that treatment

in the right side of service

so they're not having to go into

a hospital or an emergency room when they

but they're actually getting it

in their home.

 

I mean, that's the kind of

clinical program that we can bring

an employee across our network

that has a significant impact on cost

because it has significant impact

on the on the actual health wellness

and how how the patient is being treated.

 

And also obviously on the

on the patient quality of life

in addition to the quality of care.

 

Jeff, I want to

I want to kick it over to you because

you know what Tim

and the Agile on platform are doing

is they're investing for the long term,

you know, long term

payback, a kind of a captive

group of providers and patients.

 

But in the employer

market, it's very different.

 

You talk about a critical mass,

150 million employees

who are part of a part of these programs.

 

But the tenure at employers

is not 20 years.

 

So how do you how do you manage the value

based care proposition in a

in a in an employer employee population

that's really quite transient.

 

Yeah.

 

And I think that's a unique thing.

 

And as I hear him speak about 20

plus 20 year contracts there,

you know, we talk about quality

affordability and outcomes

and it'd be great

if you could actually measure

the marginal value of health care

and the outcomes over 20 years.

 

But with departmental labor

outside that employee's

average tenure is 4.1 years.

 

So what kind of outcomes,

what kind of things can you do

to actually incent or drive the consumer,

the member, the patient?

 

They're all the same entity here

to actually drive these healthy behaviors

here.

 

And that's either in terms of

we've we've seen this done in the past

before, which is high deductible plans

many years ago, driving, putting more onus

and on the consumer

to choose their health care

as they're owning more of the cost.

 

That hasn't solved everything.

 

Accessibility and sharing telehealth

and other options

to access care beyond the

day to day.

 

That's important here, but I think

incentives are going to be more and more.

 

We see that becoming a bigger factor

for driving consumers.

 

And, you know,

we know that about 70% of employees,

employers

actually offer incentive programs.

 

And so as you kind of look for the long

term view of this, which is that's

not only for wellness checks

and so on or chronic disease management,

what else can you be doing to drive

those healthy incentive behaviors

about care management

or how are you managing medications?

 

Or how about actually how you're eating

and which are lifestyle

to generate

sort of those healthy behaviors.

 

You see more and more aspect of

this health care becomes an ever present,

omnipresent view of the life

of ensuring the healthy consumer

in order to really drive

the better outcomes are exciting outcomes

that we talked about earlier.

 

What are the practical tactical steps

and and where does the employee get

worried that the employer

is crossing the line a little bit,

get it getting a little bit

too much into sort of the the health care

side of the employee versus

the work side of the employee.

 

Yeah.

 

You know, I you know,

I think I think in many ways

a lot of employers are almost every

company is now a health care company.

 

And I think that that I think is

is the core crux in many companies.

 

You've seen the investments

and the spend on health and benefits,

even outweigh some of the other products

that they're that they're building.

 

Right.

 

And so I think if you look at the long

term success of a healthy

employee population, it's incumbent

upon a lot of those employers

to ensure they're doing the right thing

for the employer's employees as well.

 

So I do think here that is that

state of where

the employer has to look out for.

 

The employee exists today,

and it's going to be even more present

as we look toward the future.

 

Yeah, it's actually and by the way,

it's interesting, in most cases

it's not even us saying it to a provider.

 

It's providers that we already

have contracts with in of recruiting.

 

One of the best ways we have to expand

our network is by physician groups

that are thinking about and partnering

with us, talking

to physician groups

that have already partnered with us.

 

You know, success kind of breeds success.

 

But, you know, at the end of the day, it's

not that difficult of a conversation

when you think about the dynamics

in health care today, where

obviously the population is aging.

 

So a bigger and bigger

mix of our physicians panel is going to be

in seniors, the Medicare Advantage

or Medicare fee for service.

 

And we do have,

you know, about a third of our partners.

 

We participate with

about a third of our partners in the CMS,

 

CMI acreage program as well.

 

So it's not just May,

but with

more and more going in that direction

and where there are more and more pressure

on rates in the commercial side

of their of their business, it's

really important for them to think about

how can I turn an uneconomic

senior panel into something that's

actually going to be economic for me.

 

So it's a pretty

almost like the in the dynamics of health

care are driving them in this direction.

 

And then it's just a matter of, well,

how do you want to go about that?

 

And, you know, I think time and time again

it's been proven out

that the most successful way

to get into a value based care scenario,

if you can do it

and you have the capability to do

it, is to go to full risk.

And so we're one of those

you know, we're we're an organization

that actually partnered with

with a group to get them to full risk,

value based care for seniors.

 

So, you know,

the incentive is pretty straightforward

because they're going to get you know,

they're going to turn something

that was uneconomic into something.

 

We're actually get economics

out of that out of that panel,

and they're going to do it in a way that

drives better output, doing it

by driving better

outcome for the patients,

which is the whole reason they probably

got into medicine in the first place.

 

So it's not it's

not that difficult to sell.

 

What is the role

largely of insurers now in driving

these value based care care programs?

 

And I'm curious to get to your thoughts

and Jeff, yours as well on on that.

 

Yeah, I mean, it's interesting for us.

 

And so we're so the

you know, we have contracts

with 26 different payers

now, you know, around the country.

 

So all the big nationals and in each area

that we're in, all the regionals

because we do, you know, we're payer

agnostic when we go into a market.

 

So we essentially get contracts

with every payer in the market

that has that is,

you know, running and made plans that

that to patients

that are seeing our physicians.

 

So those those payers

are basically looking at us as, hey,

you know, we're basically representing

a scale player in this market.

 

If they want access

to that physician group, then

obviously they're going to want to do that

through the program that we're offering.

 

I think a lot of the big payers

are also looking at it as,

 

Hey, they need to diversify

how they're taking risk through their M.A.

program

and one of their sort of supply chains

for their May program

is to have a certain amount

of their of their policies

in these in these

for risk, you know some capitated

for risk in areas like they have with us.

 

So a lot of the big payers are saying hey,

you're a great part of our supply chain

and you know, we'd love

to have you continue to look for,

you know, we'd love you to go continue

to go

in other markets and partner with us there

so we don't start with payer.

 

You know,

we start with the physician group

and go in and get the contract

there first and then go.

 

But the pair has become

a very important partner in that.

 

You know, it's working for them.

 

They're obviously,

you know, getting their guaranteed

basically margin on the business.

 

They're getting

access to the to the patients in that

position grouping and kind of guaranteeing

or getting their fair shot at market

share in that market.

 

And, you know,

they're going to get it in a way that,

you know, they're going to make sure

that the revenue

that they're getting out of that contract

is going to be maximized

through the processes that we bring in.

 

So it's I think it's a pretty good

winning situation.

 

We have joint operating committees

with all of our payers in our markets

and work work really closely with them

to make sure that we're executing a way

that works for them and works for us

and our provider partners as well.

 

If your thoughts on on the role of

of payers

and and the ROI and around the value

based health care proposition.

 

Yeah.

 

You know, so as I was listening to him

speak, you know it's

this is so complex and health care

you have so many stakeholders

that are involved and getting consensus

to ensure that everyone is moving

in the same direction

and actually have a shared

vision of an outcome is really tough.

 

Right.

 

And so I do think here insurers, just like

the providers and

employers,

all need to play a key part in this.

 

And and we've seen this occurring

in the market there, right.

 

Which is you have these integrated

delivery nodes

where whereas providers, insurers,

health care systems all coming together

and actually kind of trying to create

a shared vision across the board,

cutting down the administrative costs,

making sure they're sharing data

better,

they better able to control reimbursement.

 

You have talking about health information

exchanges.

 

How do you share data

with all these parties here?

 

How do you how do you ensure that the data

that's being shared across

all the constituents is being done

in a holistic manner across the board?

 

So you're creating a truly,

truly a network or a platform

that could actually see the launch channel

to a view

of that particular patient

as they're getting care there.

 

And so so I do think here

insurers are a critical component of this

along with every other entity

that exists out there.

 

Jeff, you mentioned payments,

our favorite topic, care payments.

 

So so how in fact

does payments play a role

in the enablement of the incentives

and the other money movement

that that is crucial

to the delivery of value based care?

 

Yeah, You know,

you know, as I look at this,

the core construct here,

especially as you're paying,

is earnings on the network

is is the data that triggers that.

 

So upon data on these outcomes

that you're measuring and ensuring that

that delivers a payment to some entity

there

that is driving that value

or that outcome there.

 

And so if I look look through that is

it's a broad view in terms of that trust,

and I call it the ability

to deliver those payments across the board

especially takes

a mixed level of complexity

when you're dealing with

incentives to the consumer,

 

Right?

 

How do you trust that consumer?

 

Who is that?

 

And once the consumer actually

has a wallet or has money

to manage a balance

and you're actually paying that

that consumer,

how are you managing that balance?

 

What's the fund management

company tied to that?

 

How are we actually going to be able to

how is that consumer

going to be able to use

that as they're looking to to pay

and actually deliver that payment

payout perspective there?

 

So if you kind of look at this from a

from a Antwon perspective, the

it starts off with the data

that thinks about the healthy outcome

of of of that patient here

and then it results into money

that moves from one entity

to another, that exchange of value there.

 

And so I actually think about this

in terms of the money in the data

have to be connected

end to end,

and there has to be trust on both ends

in order to deliver the data

and the money together.

 

So so I think this is a

this as a cross insurers, health systems

providers, employers

if you think how complex that is

by itself in each silo we might be this

this this becomes exponentially

more difficult as you connect

all the different players in the market.

 

Are there other frictions

that we haven't talked about where you see

this combination of digital and payments

becoming a really important

unlock to something

that's getting in the way of of

of changing the dynamic between quantity

of care to quality of care.

 

Yeah.

 

I gather that I think data

at payments is critical here

and I'll kind of look at this from a

employer perspective, right

sometimes that the data, even

the medication that Tim was talking about,

if you switch every four years,

you have to go find a new PCP, if at all.

 

And and I can't kind of

look at that, that digital divide

that could occur every four years

is really difficult to look

at the locked in tune or view of that.

 

And so if I have a 20 year relationship

with a PCP,

it's much tougher if I'm changing that PCP

every four years as well.

 

And so, you know, as I look to this

is that I call it the the quarterback.

 

As Tim highlighted this, I kind of like

this is that can digital help

bridge that divide and be a quarterback

as well as you think through

the we've heard out in the industry

talking about what if the consumer

actually own their healthcare data

and as transportable

and they actually could actually take that

to the next PCP or to any provider.

 

So there is a holistic end to end view of

that particular consumer's

medical history as well.

 

And so you

you potentially have put the ownership

into the hands of the consumer

as you do that by doing that actually

allows that data to be shared across

all that it is across the board here.

 

We're not there yet,

but I think the noble ambition

of empowering the consumer to own that

and have that seamless exchange across

all that is is a powerful thing here.

 

And I think that that data

is going to be more so,

especially as we move toward

more digital needs across the board.

 

Tim and Jeff, thanks

so much for all the great insight

and I hope we can have another one

on this topic at some point very soon.

 

Thanks again

for your time. Thanks so much.