BP2 Health

We need more unicorns in healthcare. Meet my unicorn shoes. Today was the first day I wore them out in the wild. I figured no better time than today when I had the pleasure of being onstage with unicorn John D. Couris to kickoff the inaugural TGH Innovation Week 2024 #TGHIW and TGH Ventures Summit this week. We talked about “Courage to Fail - The Power of Innovative Mindset” in an On The Road Edition of The Reverse Mullet Healthcare Podcast with BP2 Health. Thanks to the amazing Tampa General Hospital executive team for such a fantastic kickoff. There is a lot of symbolism involved with these shoes - I used to wear only the most classic of pumps and I used to work on only the most traditional approaches to value based care. It’s going to be quite a week with panels and events featuring Scott Arnold, Andrew Bouldin partner, FCA Venture Partners, Stacey Brandt , Tyler, Devin Carty (sorry I missed you!) CEO, Martin Ventures, Peggy Wendi Goodson-Celerin Drew Graham co-founder and managing partner, Ballast Point Ventures and chairman, Tampa General Board of Directors, Thomas C. Hawes, M.D., MBA managing director, Sandbox Ventures, Brian Kalis managing director and strategy lead of health, Accenture, Allison Massari international keynote speaker, entrepreneur and award-winning visual artist, Ezra Mehlman Mehlman, managing partner, HEP Fund, Tim Moore CEO and founder, Vū Technologies, Mark Mosely, executive vice president and president, USF + Tampa General Physicians, Mark Runyon, CPA , executive vice president and chief financial officer, Tampa General, Thomas Sequist MD, MPH, chief medical officer, Mass General Brigham, Jack Shields founder, Shields Health Solutions, Adam Smith and Jason Weida secretary at the Agency for Health Care Administration Now back into my birkenstocks to meet Erin W. Martin in Colorado for more work on payment transformation and value based care leveraging emerging models of care including #foodishealth and #regenerativeagriculture and American College of Lifestyle Medicine Like I said we need more unicorns!

A hospital c-suite got it today. There are big $s here. I’ve been boiling the ocean for months believing this day would come, but lately doubting it. If you take financial risk and/or insurance risk for the cost of care of a population it’s so simple. This doesn’t belong in the box of a “nice to have” community outreach program or point solution. This is a model of care. Over half of seniors have metabolic syndrome (heart disease, stroke, type II diabetes). Reverse metabolic syndrome vs treating it and save 40-70% in cost of care on average. When coded correctly those seniors are yielding $20-25k on average in revenue to whomever holds the insurance risk. When you reverse metabolic on 1,000 of those people = $8M to $18M of savings That’s a 4-5x on the investment. You can reverse metabolic disease. Use those 6 pillars of lifestyle medicine (it’s a board certification not “woo woo”) and start with the pillar of nutrition. Martin Tull Padmaja Patel, MD, FACLM, Dip ABLM, LMI Give them access to nutritionally dense food, not just food as a prescription, teach them how to cook the food, get them hooked on the food. They get the added bonus of a community based on shared principles of health also on the journey (hint that’s a pillar of health). FreshRx Oklahoma Erin W. Martin Then teach them about the other 5 pillars of health. You know the saying - “Teach a man to fish”. Maybe some will even buy themselves an ŌURA Tom Hale (okay truth I can’t wait for the day a medicare advantage plan can make this a benefit!) People want to be healthy they just don’t know how. C’mon healthcare, it’s time we step up and teach them. We can do so much better than just #foodismedicine with 1115 waivers and grants. It’s a great start but we have such a vast opportunity. Tagging some of my favorite healthcare unicorns working in the traditional healthcare sickcare system to drive change that’s just as hard as boiling the ocean! Feby Abraham John D. Couris Neil M. Meltzer, MPH, MHA Andrew Toy Adam Carewe MD John Beadle Richard Mulry Ajay Joseph MD FACC DipABLM Erin Booker, LPC Dariush Mozaffarian Paul Markovich Sachin H. Jain, MD, MBA

Spitball Sunday - Give back $1b in spending power to employees and individuals. How? Published self-pay fee schedules with mandated HCFA 1500s and UB40s if requested. Yeah I know - nothing new to see here. But I’m talking about a $2b segment so least hear me out before you go. Its the mandated forms that matter here. Sometimes we have to rethink the fundamentals if we want to see disruptive change take hold. Employees (and individuals) need to be empowered regarding their health and healthcare $s. $2b is being paid on their behalf towards their health insurance and over half of that is now in high deductible health plans. Imagine if people had the power to negotiate that $1b to begin to reallocate their healthcare dollar. In todays world we can try to negotiate with providers and sometimes get the self pay rate (even when insured) but even if you manage to succeed you won’t be getting that sacred form to submit to your insurance so you have to decide… Is there enough savings to just pay out of pocket or do I suck it up and pay the extra $$ so I can make a dent in my massive deductible? Let’s say you have a high deductible health plan and haven’t met your deductible for the year and let’s say your kid hurts a body part in a sport In todays world 🩼You go to the primary care ($150-$400) to get a referral 👨⚕️You go to Ortho for eval ($200) who orders an MRI 🩻 MRI is completed ($2500) Your OOP cost and cost to insurer = $3k give or take In spitball land - you can negotiate and the provider is required to simply print out a HCFA1500 or UB40 before you leave the office so that YOU can submit the claim yourself 🩼You have a OneMedical membership for primary care ($9 for the month) unlimited visits you get referral 👨⚕️You go to ortho who has a $125 self pay rate 🩻You get the MRI who has a $300 self pay rate Your OOP cost and cost to insurer = $400 give or take If I had the second option, I have $2500 to invest in my health as I so choose. I know this spitball is a landmine and opens pandora’s box regarding the convoluted cross subsidization of our healthcare costs that is required for providers to stay afloat. But more importantly what I want it point out is that we have taken the skin in the game away from individuals. It’s why it’s easier and more afffordable in most people’s minds to just be sick. I thought this random picture of me on the Buzz Lightyear game at Disney that is my favorite because of the laser shooting game was fitting because in that game it’s all about finding the targets that have the most points!

My Mom suddenly needs a walker. But good luck figuring out why. Me to Neurologist office “My Mom has taken a sudden precipitous cognitive decline and needs to see Dr. C because she now needs a walker” Neurologist office: “We are booked the rest of the month” This happened to me this week along millions of other people around the country. Yet her neurologist is largely going to order tests, there is very little he will do at this juncture. If the best is the enemy of the good why are we not working to break down the barriers for AI in medicine vs arguing the risks. I’m aware of why it can’t gap fill care delivery now but by now everyone knows I’m a Polyanna focusing on solutions despite their level of disruption. AI could fill so many gaps and add so much efficiency in the future. I will go so far as to say it WILL. I don’t hear people jumping to conclusions about GLP-1s based on the contraindications emerging before they inject it. I will lift my fizzy water to celebrate all those out there doing the work to get AI to its fullest potential for healthcare. Please tag all those who deserve a nod in the comments! Peter Cranstone Kris Narayan Michael Mircea Bidu Marten den Haring Amy Bucher Adam Carewe MD Brendan Keeler Josh Erndt-Marino Robert Sundelius, FACHE Max Marchione Oh and thankfully there was a cancellation and I’m taking Mom today.

Wait, what? Now that EPIC announced they will begin allowing people to have their own health data released to health apps of their own choice, what does that mean? What are the first questions that come to mind? Add them to the comments below. And if you do, listen for a callout tomorrow. We will do our darndest to credit you and discuss directly tomorrow on our LinkedIn Live podcast episode tomorrow at noon ET with guests Adam Carewe MD and Brendan Keeler along with BP2 Health on The Reverse Mullet Healthcare Podcast with cohosts David Pavlik and Justin Politi Link to event will be in the comments shortly but it’s easy to find on any of our LinkedIn pages.

Spitball Sunday - a healthcare system not just a sickcare system. We have to get there. We are the out of runway like the picture I took as we summited a mountain recently (a “14er” - IYKYK) Lifestyle disease is bankrupting us. 75% of our $4.5t healthcare spend comes from 8 conditions that are traced back to mitochondrial disorder or in simplistic terms metabolic disorders thank you Robert Lustig for your episode on Andrew Huberman from December 2023 (btw obesity and metabolic disease are not synonymous) But I bet you haven’t worn a CGM yourself We need to realign our payment models - VBC 1.0 isn’t cutting it We need to rethink our primary care model and embrace new tools that can reduce bricks and mortar requirements and help with behavioral change We need to stop the silo between food and health We need to turn on the light for our society. You can’t fix a system predicated on sickness and lifespan we can only try to better align the two. We also need a healthcare system predicated on healthspan. I applaud the scores of people in the tribe creating this in all forms and fashions because it’s the incremental and the disruptive that we need. I’m grateful to be one of the tribe now with BP2 Health Health and having The Reverse Mullet Healthcare Podcast passion project as a platform to keep giving it a voice. If any Primary Care physicians want to be part of something in January we have a hail mary up our sleeves but our runway is almost up for this too…so reach out like now. Feby Abraham Martin Tull Neil M. Meltzer, MPH, MHA Gebre Nida MD, FACE, DipABLM Erin W. Martin Peter Njongwe Katie Stebbins Carter Williams Clint Brauer Robert Sundelius, FACHE Brie Lowry Cox John Beadle Manju Dawkins, MD Eric Smith Colby Schaeffer Arumani Manisundaram Padmaja Patel, MD, FACLM, Dip ABLM, LMI John D. Couris

I take myself too seriously. I think we all do, especially in healthcare. It is life or death afterall. For 20 years the 4th of July in my beloved Breckenridge is a once a year kind of day. It centers around a 50 mile mountain bike race that our husbands, friends, sometimes ourselves and now some of our kids participate in, the race is actually the lead off for the true hometown parade (the racers ride down main street to cheers), our own “make the parade great again” float with candy music and smiles and then we make it a full day bbq that culminates in a bunch of those fireworks you buy on the side of the road that are set off in our friends driveway. I’m just myself for the day. I’m not a healthcare executive. I’m not someone unable to stop iterating how to create a healthcare system to be alongside our sickcare system. I’m not someone that is driving VBC 2.0, new models of care delivery meeting people where they are and better efficiency and outcomes. Erin W. Martin Carter Williams Clint Brauer Katie Stebbins Robert Sundelius, FACHE Martin Tull Eric Smith Courtney Younglove, M.D., FOMA, FACOG, DABOM Colby Schaeffer Harriette Brainard Gottlieb W. Keller Erin Booker, LPC Padmaja Patel, MD, FACLM, Dip ABLM, LMI Zuzanna Zielińska I’m just Ellen and I’m grateful. I hope others get a chance to have a day (at least) to do the same. Photo credit to my friend who captured an important part of the real me. Thankfully my BP2 Health partners David Pavlik and Justin Politi, our The Reverse Mullet Healthcare Podcast along with a number of our clients past and present embrace it too.

Spitball Sunday - Healthy Kraft Heinz creates a “Healthspital” My husband would be proud, he coined the phrase - “healthspital” a while ago. Because it’s such a strange word it’s allowed to be amorphous. When I read about the new Heinz leader (he's a self-professed health nut) I feel equal parts brother from another mother destined to be besties, wow this could be a white knight for healthcare and this is a PR ploy don’t fall for it. But as I always say I’m a polyana and hope springs eternal for me so I’m sticking with the first two. Here is the article https://lnkd.in/exSwBFnP So we have a food giant that could turn the “interior” grocery food options on their heads and the funds to make a play in the health (not sickcare!) space or partner with someone and at least blur the lines. So who in my sphere is up for imagining and operationalizing a “healthspital”? Food in lieu of a bunch of meds, walking before discharge instead of infirming, taking a cooking lesson while admitted but stable and preparing for discharge, having a grocery list sent to instacart being delivered to your house in pereration for discharge instead of just a home visit by a nurse? Who can get me (and everyone else) in touch with Carlos Abrams-Rivera? Which of my healthcare unicorns want to give this a go? This is legacy stuff - well beyond heads in beds. Bueller? When people ask my what effecting REAL change in actionable terms for me means - this right here is an example. BP2 Health doing the hard work to figure it out. I hope this doesn’t end in “Call me maybe”… How about “Duel of the Fates” from the Phantom Menace instead. Nicholas Moriello Andrew Toy John Whyte Feby Abraham Neil M. Meltzer, MPH, MHA Terry Shaw Daryl Tol Alexander Olesen John Beadle Carter Williams Katie Stebbins Lee Bowers Erin Booker, LPC John Gorman Michael Muntner John D. Couris Eric Smith foodishealth #foodismedicine

Spitball Saturday - Hospital for the Healthy. Hospitals keep sick people alive. How about we have something to get healthy people who are sick get healthy again. Part of the hospital is designated for this. Patients are encouraged to walk, they can pick fresh produce to be cooked from the atrium veggie garden on their walks, they are told what is needed to go home and helped to achieve it. Babylon Micro-Farms and Centra Health Alexander Olesen Amy Carrier are already integrating part of this into CENTRA LYNCHBURG GENERAL HOSPITAL. You have criteria that designates someone as healthy at admission. It’s based on their markers before admission. E.g. they were exercising regularly, their A1c was within certain levels, they were mobile, etc. Instead of watching your previously healthy loved one wither away while trying for 12 hrs daily to talk to the hospitalist who you are told holds the key to discharge (but failing at ever having said conversation) you are empowered to keep them healthy during this bump in the road. I somehow thought hospitals were improving. But they are when it comes to brass tacks safety and not much else. After the better part of my week with my Mom in every setting of care from ER to ICU to surgery, my image of improvement is shattered. I realized we have completely disregarded healthy people who are sick. They need healthcare not sickcare. Duh you say? Well try to unpack that statement in granular executable terms. Not so easy? Which is why I decided to spitball this fine Saturday morning now that my Mom is safely at home and my mind isn’t being numbed by beeps and moans and despair. Once again tagging some that I know are more open to spitballing and/or leading facilities that have opportunities into disruptive approaches. Apologies in advance for the tag but your thinking and risk taking is commendable. Carter Williams Feby Abraham Randy Haffner Daryl Tol Marc Harrison Erin Martin, MASM Kelly Springer MS, RD, CDN Sara Torrence RDN, LD Amit Rastogi, MD, MHCM John D. Couris Scott MacLean Neil M. Meltzer, MPH, MHA Tampa General Hospital AdventHealth LifeBridge Health Jupiter Medical Center Memorial Hermann Health System and Elizabeth Candelario (think this is right up your alley)