A 360 view inside Innovaccer’s one-stop platform for better patient care

Episode transcript

Find episode transcript below.

JENNY COLAPIETRO:

00:00:04:02 Welcome to HRIs Next in Health podcast, I'm Jenny Colapietro PwC’s Vice Chair for Health Industries, working across pharmaceuticals, MedTech payers and providers.

IGOR BELOKRINITSKY:

00:00:14:20 And I'm Igor Belokrinitsky, a principal with PwC strategy and where I get to work was leading health organizations on their strategies and operating models. 

00:00:24:02 And on this podcast, we talk a lot about how our health industry is evolving to more of an ecosystem that is more connected, more value oriented, and more equitable. 

00:00:37:05 And there's an organization that we'll talk about today, Innovaccer, that holds a very big piece of the puzzle in this industry transformation that's underway.

00:00:47:11 And we're very excited today to have with us Amy Stevens and Dr. Brian Silverstein. Amy is a nationally known health care leader and she's the general manager of Provider Performance and value innovation at Innovaccer. 

00:01:02:05 And Dr. Brian Silverstein is also a leader in value based care delivery. And he's the chief population health officer at Innovaccer. And so, Amy and Brian welcome to the podcast.

BRIAN SILVERSTEIN:

00:01:13:05 Igor thanks so much for having us, really delighted to be here. Also, Jennifer, thank you as well to the whole PwC team.

AMY STEVENS:

00:01:19:10 Thank you.

IGOR BELOKRINITSKY:

00:01:20:10 Brian and Amy, Innovaccer has been in the news a lot and is receiving some great industry recognition as a leading data and analytics platform. But just in case some of our listeners are not familiar, would you tell us briefly what does Innovaccer do? 

00:01:36:08 What does it, what value does it create for the different healthcare stakeholders? 

BRIAN SILVERSTEIN:

00:01:41:02 Absolutely, I think everyone's familiar with when they have different health care experiences, how disconnected they are and how there's information that's contained in so many different sources.

00:01:50:16 But it's very challenging to bring those together. So what Innovaccer does at its core is fundamentally solves the problem of disparate data sources so that patients are able to get better care.

AMY STEVENS:

00:02:02:18 So what that looks like for those that use the Innovaccer platform, is they have the ability to see health care and demographic data across the entire spectrum of the patient. 

00:02:14:03 We call that the 360 degree view. So when you think about a patient day, in some systems, you can only see their financial data. In other systems, you can really only see their clinical information.

00:02:26:04 Or you may have to go to another system to get enhanced demographic information, the ability to see a person from all those different angles at once, no matter what type of care provider or even administrative person you are working with, that patient and their family becomes really critical. 

JENNY COLAPIETRO:

00:02:42:06 Amy that's great, I think that 360 degree view is critical. Let's drill down on that a little bit. What does it mean to truly put patients in the center of the health care ecosystem? And how are different value based care models doing this? 

AMY STEVENS:

00:02:56:08 Sure. What we see often is that patients are a secondary effect, meaning we're so busy documenting the things that we're doing at the patient in front of us.

00:03:08:06 We're so busy making sure that we've checked off the different gaps in care; getting taking care of did they have their colonoscopy screening? Have they had their annual exam? 

00:03:17:05 Have they refilled their scripts, we think about how we document in order to build and in order to prove quality outcomes, but to instead say, if I were the patient, what would I need to be able to direct my own health care?

00:03:32:13 What would I need to be plugged into? What would be of convenience for me? What would the right type of communication be to me? Am I somebody who likes texting, but I rather have a phone call? 

00:03:44:01 And how would that information be fed at the workflow point, if you are the provider or if you were, for instance, a care manager. So having a platform that is able to accommodate those different needs of the patient becomes really important.

IGOR BELOKRINITSKY:

00:03:59:10 Brian Obviously your end was both feed into value based care and value based delivery by most health systems and health organizations out there still have a very significant part of their enterprise that very much operates and thinks in fee for service terms. 

00:04:17:05 And so how do you think about the transition? Can fee for service remain the foundation? Can you still achieve things through fee for service or should we completely blow it up and go completely into value based care or is there some interim kind of position here? 

BRIAN SILVERSTEIN:

00:04:33:06 You know, Igor this is probably one of the most interesting questions that we're facing today when you think about value based care delivery. And, you know, this is going back several decades. Part of this is, I think at times there's an expectation that things are going to move a lot quicker than they do in reality.

00:04:49:21 And so part of this is just a calibration exercise where while the people who are involved in value care delivery and see the benefits to patients and providers say, why not have this all happen today? 

00:05:01:04 There's a whole host of components that really need to be developed and integrated to be able to make that happen. So I think the time horizon for change is going to be longer than what people might expect.

00:05:12:12 So we're maybe at best a decade into it, and it's possible for some markets it's going to be even a decade or further. And if you say, well, what's holding back? Part of what's holding back is when you look at a vast majority of health care systems, even though they may have value contracts, still a vast majority of their revenue is coming from fee for service.

00:05:31:23 So appropriately, they need to focus on that. And when you look at the systems that are required to actually implement and deliver value care delivery appropriately, it really requires different infrastructure than what's being used for fee for service. 

00:05:45:01 So as a result for that, you have kind of a natural conflict point between I'm in the clinic, I've got 25 patients I'm seeing today, a couple are in value contracts, they're in different value contracts. And so it's really confusing to know what to do. I can't do things differently for different patients. 

00:06:01:04 It's too complicated and so I'm going to fall back and fundamentally default to my fee for service. And this isn't necessarily a conscious stream of thought as much as just what organically happens.

00:06:12:00 So that being said, there's a lot actually in fee for service where you could start to build the infrastructure and the muscle memory, where you're going to be able to actually deliver value at the same time. 

00:06:23:02 So specifically, if you think about, for example, in Medicare, you have your annual wellness visits. So that's a great way where you're still billing fee for service, but it's starting to set some of that foundation up for value.

00:06:33:00 You have advance care planning, which again is a paid time based code unlimited doesn't even have to be the physician and so an amazing way that you can start to think about some value. You know, there's a whole host of gaps in care and the challenge is each different contracts going to define different gaps. 

00:06:49:05 So there's some things that are fairly universal regarding some of the cancer screenings, things of that nature, but how they're calculated and what really needs to be done is actually quite different contract to contract.

00:06:59:13 So that's really where you have to have some back end infrastructure, can't put this on the backs of the front end providers to have to figure it out for each patient. Referral management, another great way to keep people in the system and in doing so better able to coordinate their care. 

00:07:13:06 Risk coding is obviously a third rail because patients need to be coded correctly to ensure that the documentation is there. But at the same time there's concerns regarding up coding things of that nature, certainly no one wants to do that. I don't know any physicians that want to do that. 

00:07:28:08 But it's important though to accurately code. And then there's different chronic care management codes as well and transitions of care codes. The way that I look at this is that within fee for service, there's all of these things you could do that are going to start to lay that infrastructure for value.

00:07:44:16 And then eventually over time, as the infrastructure gets better, as well as more contracts start to come over, then we're going to see more of a transition.

JENNY COLAPIETRO:

00:07:53:11 So Brian, that makes sense that we're on this evolution to continued value based care and patient centered care. Can you share a little bit about what specifically some new programs that are being developed to continue that momentum towards value and any key decision factors that you can share for deciding which programs to engage in?

BRIAN SILVERSTEIN:

00:08:13:05 Absolutely Jennifer, so I think right now we're in this era where although at times we might think we're far along, I really think we're still at that beginning inflection point. And as a result of that, there's a lot of programs that are going to come out and not all of them are going to work. 

00:08:28:03 And when the programs don't work, that doesn't mean that value care delivery doesn't work. What it means is that the specifics of that program don't work for a variety of reasons. 

00:08:37:05 So within CMS, there's a separate group CMMI and CMMI, they're charge essentially is to develop these programs, see what works and when it works, figure out how to scale. And as you can imagine, and by definition, as an innovation group, a lot of the programs fail, but there's a lot of great learnings from the programs. 

00:08:55:19 And the people within CMMI, they really do an amazing job of trying to balance out how can we have the program rules be something that are going to be favorable enough so that people will enter these programs. 

00:09:07:15 But at the same time ensure we're achieving the outcomes that we need to. And what that means is we either need to improve quality for the Medicare beneficiaries, reduce costs and maintain quality, or ideally do both.

00:09:18:18 So the home run is we are improving quality and reducing costs. The good news is there are programs that do do that and over time these programs have been evolving. One of the more recent programs and this is time where the DCE program is sun setting and the new program is ACO REACH. 

00:09:34:04 What's interesting with REACH is that the percent of people who applied to get accepted in the program, priced some of the lowest rates ever I've seen of any of the CMMI programs.

00:09:44:02 And it's interesting, there's a lot of elements in the program where they're trying to look at how do we actually start to think about different disparities that exist within the ecosystem, and how can we actually create some type of financial systems to be able to manage that? 

00:09:58:01 So, I think it's a very interesting, innovative model. And the other thing too, that I think is probably more significant is within the MSSP and the new rule that Perry just closed on, there's updates to the core Medicare shared savings program that are the most significant updates since the genesis of the program.

00:10:16:14 And so I think that what we're seeing really is the regulators are doing, I think, an amazing job of kind of keeping tabs on the industry. And if you read the commentary, certainly the updates and the rules, everyone's not excited about them. 

00:10:30:06 So let's recognize that this is not where everyone's sitting there saying this is amazing, but what they're doing is really trying to balance out how can we do something that's going to be the right thing for the Medicare Trust Fund, the right thing for providers?

00:10:42:12 And then in addition to what's happening on the Medicare side, a lot of the commercial programs, Medicaid, there's just a ton of innovation going on and trying to figure out how can we modify and create different ecosystems that are ultimately going to give patients better outcomes? 

IGOR BELOKRINITSKY:

00:11:00:01 That's very helpful and it's exciting that there are more and more different opportunities and models to participate in value based care.

00:11:08:06 I guess for a health organization that's looking to make that leap of faith and get involved, how do they figure out which program is right for them? How do they find an arrangement or multiple arrangements that play to their strengths and where they're going to be positioned to succeed even as they build new capabilities and participate in these programs.

BRIAN SILVERSTEIN:

00:11:28:04 I love how you asked that question Igor because one thing that I observe is at times people take a binary approach to value care delivery either like I'm for it or against it, as opposed to saying what you just articulated, which is how do you decide which one is right for you? 

00:11:44:01 And so what I'd suggest is this is something where each market, each location is going to move differently. There are some organizations that are already there. That's by far the minority. A vast majority are either just getting started or haven't necessarily started yet. 

00:12:00:00 And that's, I think, where it's a very amazing opportunity to then say, okay, in my local marketplace, who are the big payers and what programs do they have? And so look on the commercial side; also look within your state from a Medicaid point of view, as well as major employers.

00:12:16:17 Sometimes major employers will have different programs as well as, of course, the programs that are being offered through CMS and CMMI. There isn't going to be one program that's right for everybody. 

00:12:27:04 There's incredible diversity in our country, and that diversity is one amazing strength. And so it allows us to innovate and do things that would otherwise not be possible.

00:12:37:03 At the same time that will then create challenges for standardization as well as there is not necessarily a one size fits all solution here. In general, though, what I would suggest is that when you're making this move from fee for service to value, its pick one program to start with. 

00:12:54:08 Don't try and start with multiple programs because the logistics of doing multiple is very challenging. Next thing you want to do is rather than try to get everybody engaged, pick the people that are more interested. 

00:13:05:08 And here's why, if you try to get everybody, there's always going to be people that are going to be resistors. And the energy you're going to put into those resistors is going to impede you from actually moving forward.

00:13:16:22 So instead, say, you know what? Everybody doesn't have to do this. We're going to pick the people that really want to get them engaged, support them. Figure out also how to make it easy. 

00:13:28:02 Because anytime you add complexity to anyone's workflow, that's where things are going to grind to a halt. So it's how can we make this easy and then how can we make it self-sustaining?

00:13:38:17 And some of what I shared before and articulated before were great ways that you can look at being in a volume world and using that revenue from some of those activities to then start to fund the value. 

00:13:52:08 Because ultimately the value needs to be something that you're creating a financial funds flow so that it's going to get supported and grow.

JENNY COLAPIETRO:

00:14:00:18 So Amy how will data readiness or connectivity of data across the different segments of a provider organization play a role in value based care? 

AMY STEVENS:

00:14:09:08 We actually think data readiness is the trip wire really to be able to get into many of the business models, the reimbursement models that allow organizations to have a new way of managing their business and doing well, we certainly are seeing that, that is of high importance to providers at this stage.

00:14:31:07 From a data readiness standpoint, we kind of think of three things in particular. One is that data is trapped. Right now, it sits in thousands of individual systems, products, records, pieces of equipment, and it's across the entire enterprise thing in a lot of different functions managed by many different people. 

00:14:50:04 So you think of clinical data, claims data, lab, pharmacy, and equipment at the bedside, HR and talent supply chain. And every one of those functions seems to have its own processes, its own software products, its own ways of collecting data and using data. 

00:15:07:07 So it's sort of stuck with those who are using it in very narrow ways. The other is that data in the United States is very nonstandard. We find that even if you have one EMR in a health system, if you have multiple hospitals, physician offices, etc., each you will often find has its own instance or its own customizations that has been done.

00:15:30:01 And by not having a standard, that means we don't have a common language by which systems, technology systems as well as processes. People can share information in ways that make sense to each other because we are essentially speaking different languages. 

00:15:44:07 The other thing that has really hampered us in data readiness is that it is actually illegal or has been and still is at this point to have a single identifying number for each person in our country as it relates to health care.

00:15:58:11 And so knowing that one person is the same person who went to a retail pharmacy, who went to their community center to have a flu shot, who is sitting in a PBM getting a specialty pharmacy script, to sitting in three different providers, 

00:16:15:02 Their specialist, their primary care, their behavioral health. To know that's all the same person is extraordinarily difficult. So what it's taking is a new type of technology, one that Innovaccer has certainly been a key pioneer, and that is to how do you unify all of those different records? 

00:16:35:08 How do you take records from across a variety of processes, products and different companies and get them to the point that you understand and extract from that each individual human's full 360 view.

00:16:50:04 It's a concept that we talk about is platforming and that is how do you put together a variety of complex processes, technologies, products into one connected platform, as we call it, which is a connective tissue concept? 

00:17:08:01 How do those organizations, those products, etcetera, exchange store and integrate data at scale? That's data readiness. It's the ability to create and capture new data, to share data that already exists and to do it in a multidirectional way.

00:17:25:03 And one that has high confidence and trust that the data that you're getting as the end user is reliable so that you can make very important life and death often decisions off of it.

BRIAN SILVERSTEIN:

00:17:37:21 Amy, as you describe this unification of data and putting it on the platform, it's really exciting to think about what might be possible once you do that. And so one of the implications seems is that for the populations that are most complex, most vulnerable, most underserved, you'll start seeing the disparities. 

00:17:58:05 You'll start seeing the unmet needs. You'll start seeing areas where you could potentially intervene and improve the health of these complex and vulnerable populations, which seems like a big part of being successful in value based care.

00:18:13:02 And so, again, going back to this health organization that is looking to become more involved and participate more of these programs, how should they be thinking about these complex and vulnerable populations that they serve and engaging them more effectively down the road?

AMY STEVENS:

00:18:29:02 It is one of the most exciting use cases. Honestly, when you think about how we can advance health in the United States. I adopted both of my children and they were both born to Medicaid moms. 

00:18:39:07 And when I think about the services that needed to be wrapped around them all the pregnant mother as well as the newborn infants and the visibility that their providers did or did not have into their health circumstances.

00:18:54:17 It's a really personal for me as well as when I think about how as a leader, we can change the systems of care that we have. And when we think about that, the role that data has is the ability to even know which people are in the plans that you have. 

00:19:11:04 Often how to find them by being able to pull in demographic information far outside of the clinical data sets, one of the biggest issues we have, for instance, Medicaid populations is even being able to find them and contact them.

00:19:25:02 And many systems don't hold unusual types of datasets, such as phone numbers. So being able to get to and find them a population becomes really important. It's that important to be able to say, okay, have they been sort of serving different providers? 

00:19:43:01 Have they been going to a variety of different emergency departments? And one health system doesn't know that the other health system has been filling scripts, providing maybe just in essence, saves overnight housing.

00:19:55:14 How do we see that? What other providers are doing without having access to often what are even competitors data in the market? 

00:20:05:01 There's then the application as it comes to care managers and case managers, those in the health systems that are trying to understand and identify who these people are and what they need. 

00:20:16:02 So for instance, within our platform, we have a social determinant index that is algorithmically fed a set of data points that can make an estimation of what type of social determinant issues may need to be addressed food, housing, etc., and can make a closed loop referral inside of the platform in order to take care and make those referrals.

00:20:39:03 It also can lead health systems to be able to put programs in place that they may not have been able to before. We have a great example of an MSL, management services organization that has value based care contracts that does what they call an ED token protocol for those that they see frequently end up in the emergency room over the weekend.

00:21:00:15 Oftentimes seeking food, seeking shelter some may even come just truly because of loneliness. But oftentimes also they've gotten to the end of the week and they suddenly realize they're not going to make it through to the other side without medication, etc. 

00:21:15:07 They have an automated way to estimate those that are most likely to use an ED over the weekend and on Thursday night. There are automated functions that reach out to those potentially ED utilizers to see if they need anything to be tucked in for the weekend.

00:21:33:04 So that they won't have to reach out for expensive services that could be much more easily handled in an outpatient or virtual environment. It's those type of changes that can be made both in a large population like the ED token. 

00:21:50:04 But then can go down to the individual like a social determinant index that then directly matches very specific needs to that one person.

JENNY COLAPIETRO:

00:22:00:05 Brian you and Amy have shared some exciting examples of both the ACO REACH and other very impactful value based care programs. In your mind, how do you feel that these programs are driving a new era of technology adoption for providers to really grow and scale in this new digital age?

BRIAN SILVERSTEIN:

00:22:17:10 Jennifer I think that's probably one of the key things that's going to help make these programs actually work and come to life. And ultimately why it's a slower but a very worthwhile transition of our health care system and kind of share that there's a segment of organizations that all they do is risk. 

00:22:35:08 And these are not your hospital systems, these are typically larger physician groups or larger entities such as that. And what you see in those organizations is they use a very different technology stack than the hospital based systems. 

00:22:52:01 And why is that relevant? Well, it's relevant because if all you're doing are these risk based contracts, then you have to get really good at it. So you develop the workflows, you develop the systems; you develop the processes to really ensure that you're ultimately delivering the highest quality care for those patients and you make it easy to do so.

00:23:11:14 The systems are set up to do so. If you look at our health care systems today, part of the challenges that EMRs are designed for billing and collecting, they're designed for fee, for service. 

00:23:22:01 And when you take that system and try and use it for value, you end up with a whole host of challenges. And so it makes it harder and so we're adding work to the physicians and other clinical care team that are already stressed out, already overburdened. 

00:23:37:05 And so what I see happening, though, is that as there's more and more programs, then that creates more energy around that. And as that occurs, it becomes increasingly more important to have the electronic infrastructure to make it easy. 

00:23:53:08 So we're on this evolution here where the more programs there are that are favorable, that different provider and health systems see benefit in participating in, the more likely there's going to be investments made in the systems that both the human as well as electronic systems to deliver on the programs. 

00:24:12:04 And then as we get more and more eventually, you do get to that tipping point. Some organizations, a minority have gotten there today. A vast majority are looking at it more as a debate of, oh, is value care delivery real or ACO is going to work? And again, I encourage everyone, reframe it. So this is not about, oh, is this real or is this going to work?

00:24:32:00 It's about how can we think about in our market, given our organization and our capabilities, which program is going to be the best one for us to get started? And how can we, in a thoughtful and sustainable way, begin to participate in these programs and put the infrastructure in place. 

00:24:50:04 Because ultimately it's going to make care better. It's going to give better outcomes to patients as well as the other key piece here is it's going to make the caregivers lives better.

00:25:00:12 We can't implement programs and then make it harder for the people that are delivering care. What we have to do is deliver programs that are going to make it easier for them to deliver care. And I think that's really where the magic is going to happen. 

IGOR BELOKRINITSKY:

00:25:13:04 Brian Let's dive into the magic a little bit more. You already mentioned this notion that we have to look at this through the lens or against the backdrop of this high burnout among the clinicians.

00:25:25:03 And so we talked a little bit earlier about what becomes possible when you create a 360 view of the patient of the individual family or community. 

00:25:34:05 It seems like there are some health organizations out there that don't have a 360 view of their own organization in terms of how their people are doing, how their operations are performing, how well their supply chain is operating, what volumes they should be expecting to come in. 

00:25:51:02 And what demand they need to be meeting, as well as how they're performing financially and then from the quality lens, from the equity lens, all of those things that they care about. 

00:26:00:00 And it seems like once you let this data unification genie out of the bottle, once you make the platforms possible, you could get to a more 360 view of the health system and start making better choices and better decisions and hopefully making it a better work environment. Any thoughts on that Amy and Brian?

AMY STEVENS:

00:26:19:24 Yeah, I think that concept of having a 360 view of the organization is the Holy Grail. Having been a chief operating officer before, I can tell you I was greatly hampered by my ability to understand some of the most basic things. 

00:26:34:03 And we certainly saw this, for instance, during COVID, when media for instance would ask questions, well, how many beds are available? And we've discovered that's just not an answer. That's as easy as it sounds like to solve, because what type of beds, what type of equipment needs to be at the bed, what type of staff needs to be at the bed? 

00:26:52:04 And those type of complexities have really hampered our ability to get overall coordinated operating views. Many health systems now, for instance, are using a platform that can look at multiple facilities at the same time. 

00:27:09:01 Can really describe what type of beds they have in real time, what type of staffing they have, an expertise at the bedside they have, what type of supplies they need, how quickly patients are moving.

00:27:22:08 For instance, from an ED up to an observation or admitting status, what's the average time and what types of equipment might be needed to discharge a patient more fully. 

00:27:34:01 While having the data, what you can do is you can start hot spotting, as we call it, which is looking for areas where it's actually working. You know, oftentimes as health system leaders or clinical leaders, we often look for where it isn't working.

00:27:47:06 But what seems to be even more impactful is where it is working. So if you have, for instance, an anesthesiologist that seems to prep their patients faster and yet still get the same type of quality outcomes. 

00:28:00:05 And you know that because you've been able to tie time sensitivity to actual clinical outcomes, you can then really look at how anesthesia practices are being done for that type of procedure, not just in one hospital, but in all the ORs across your portfolio in the enterprise.

00:28:19:04 So you start to see that when you can tie these data sets together differently and you can look for those areas where higher efficiency is already taking place, you can move those best practices out into the organization. 

00:28:33:08 Similarly, this concept of, you know, workforce, when you talk to any leader, when you talk to any worker inside of health care, especially direct health care delivery these days, you'll find that the work environment has felt like it is appreciably degraded.

00:28:48:22 And so where we think in using a platform about things like productivity for sure, how much work each person can produce for us. But when you have a data like you see on a platform such as ours, you're able to think about the amount of work, the type of work, the quality of the output. 

00:29:07:07 So not just did somebody process 200 claims today, but were they able to do them in essence with a single touch, meaning they're not having to go back to the same frame four times to keep a pending information or correcting errors, because there's already a degree of automation to it.

00:29:24:21 About 25% of all labor in the U.S., whether you're a payer or provider, is considered administrative, which really honestly just takes the joy right out of all of their work. 

00:29:35:05 And so how do you think about automating it, for instance, for a care manager much of their time is spent tracking down patient, trying to literally get a hold of them, to follow up post-surgery, to see how they're doing. 

00:29:48:17 With our platform, we've been able to help the care managers determine not just what day of the week they are most likely to get a hold of that person, but what time of day and what modality or they more likely to respond by text or by phone? 

00:30:06:03 So having that type of information that then is fed up for the next time and you can start to sort of run algorithms against the type of people who are most likely to want to be contacted in that way.

00:30:17:23 What happens is that care manager actually contacts more patients over the course of his or her day. They have a better exchange with them and they're able to contact those that are at highest risk or greatest need of exchange to understand how they are doing. 

00:30:34:07 And what resources could be applied to them. That is, in fact, what people want to do when they come to work, they want to actually help the right people at the right time in the right way. 

JENNY COLAPIETRO:

00:30:44:04 Well said, Amy. Just going to wrap us up here and I think just to end it, it would be great to hear, Amy, what are the three things that you are most excited about in health care's transformation and their transition to value? 

AMY STEVENS:

00:30:56:02 Well, first, I'd say I'm jealous. I would say of all the times being in health care, well this is a hard moment to be. It's also one of the best moments because we have tools that I never had access to earlier in my career and would have made a huge difference. 

00:31:13:01 And because of that, the things that I have a lot of excitement about are the ability to have hyper personalized care. Now, one of the things that people think about with value based care is managing populations and that's true. 

00:31:25:08 You know, an early stage of value based care is being able to think of an entire cohort of people with a certain chronic disease or people who are going through the same health pattern, such as pregnancy. But what we can do is go beyond that now.

00:31:39:12 We can go from one to many, meaning one care manager, for instance, being able to manage hundreds of diabetics to that care manager, being able to give 1 to 1 hyper personalized care and engagement. 

00:31:53:04 Because automation allows a lot of the exchange to happen in ways that are still convenient. But for instance, the patient can just, you know, on an app, take a picture of their wound three days post-surgery discharge.

00:32:06:00 The application can convert that into alerts if there's swelling, if there's discharge, etc., if there's pain and if there's not, the care manager can move on. 

00:32:16:02 But it's very personalized to that one particular person, even though they are in fact part of that cohort. I think the other thing I'm really excited about is that people are getting closer and closer to having their own data.

00:32:29:08 And if you think about the ability to go backwards longitudinally, if you had a medication reaction five years ago, but you moved towns and you have a new pharmacy and you have a new physician, shouldn't that pharmacy and physician know that that's in your medical record somewhere? 

00:32:47:07 But right now those would not be connected. The other would be to just plain make it easier to take care of those who most need it.

00:32:57:20 The ability to really think about access differently, access that has virtual, access that is closer to where people are in terms of geography, access that is more tied to what they actually need, such as social determinants support. 

00:33:14:04 More than they might need other types of more X-rays, more medication. If we started by giving them the right nutrition and the right housing, etc., they may often have a lesser need for some of those other more clinical services.

00:33:29:24 So the ability to really change what access looks like and therefore the outcomes of so many people becomes to me, the holy grail of fixing and improving care.

IGOR BELOKRINITSKY:

00:33:40:09 Amy and Brian, thanks for a tremendous conversation. Particularly appreciated that you're able to talk to us about the system level and ecosystem level perspectives. 

00:33:51:04 But also bring it down to the level of the individual patient or family or caregiver and then all the stops in between. So very helpful conversation and very exciting to watch Innovaccer and as the value based care train keeps chugging along. 

00:34:07:08 You're out front, they're laying the rails for it so it can continue moving forward. Really appreciate the conversation. Thank you.

AMY STEVENS:

00:34:15:06 Thank you for hosting us.

IGOR BELOKRINITSKY:

00:34:17:04 For more on these topics and other health industry insights driven by policy, innovation and care delivery changes, please visit our website at pwc.com/HRI. Until next time, this has been Next in Health.

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