What We Learned at HLTH this Year from 10 Leading Health Care Innovators

Since the beginning of the pandemic, we’ve experienced a tectonic shift in health care. The plates have moved, and we have an opportunity to rebuild our healthcare system to be more patient-centered, affordable, equitable, and accessible. In 2021, I had the honor of interviewing 10 of the nation’s top health care innovators on the CareTalk Podcast to discuss how we can seize this moment.

My co-host David Williams and I spoke with digital health start-up founders, forward-thinking health plan executives, and health data experts during HLTH , an event that brings together leaders across the healthcare ecosystem each year. We learned a great deal from our guests, but these were our five biggest takeaways.

1. The focus is finally on better health outcomes and fewer wasted services.

We all know the U.S. spends more and gets less on health care than any country in the world. With the incentives on volume of services and a fragmented system, we end up with too much waste across the board.

Jonathan Bush , CEO of Zus Health, told us waste happens in even the simplest health care encounters. “You look in the claims data, what percentage, not of dollars, but of claims is just doing that first layer establishment again, and again, and again. That initial triage, we're doing a bazillion times.”

Dan Mendelson , CEO of Morgan Health, talked to us about the new venture’s priorities. “The first that we're focused on is accountable care and really bringing a lot of those concepts of accountable care into the employer context, where they've proven successful in Medicare.”

According to Dan, the goal is “improvements in outcomes as measured by standard measures, diabetes, cardiovascular, cancer screenings, and the like, the ones you're familiar with.”

This focus on outcomes is paired with a healthy dose of reality: improving outcomes is not going to automatically drive costs way down. Dan noted that Morgan Health wants to achieve “a mitigation in the rise in cost, so we’re not looking, necessarily, to see the total cost of care plunge.”

“I think we're all jaded enough to not believe that that's going to happen in the immediate future,” he added.

Mark Clein , Co-founder and CEO of Precision Medicine Group, noted that the same is true when it comes to developing more personalized, targeted treatments. “I think we're going to be seeing a world where increasingly there's less waste, meaning there's less treatments prescribed by doctors that don't work. There's more treatments that work at higher cost because I think we're moving to a world where these types of diseases will reduce cost by reducing the amount of treatment that's necessary over time. But prices will probably be higher per prescription.”

2. We have the data. The challenge is unlocking the insights.

With more digital tools, medical devices, and remote patient monitoring capabilities, health care data is more abundant than ever before, but we still struggle with quality and interoperability.

Dr. Amy Abernethy , President, Clinical Studies Platforms at Verily Life Sciences, told us that to answer some of the biggest and most pressing questions in health care, we need to better harness data insights.

“We're going to leverage all available data to answer questions confidently, like, ‘Is this vaccine safe?’ or ‘Should we get a booster?’ Then, we're going to need to make sure that we understand the characteristics of the data and when we can reliably use them, which is essentially understanding and solving for data quality.”

Blythe Adamson , Director of Quantitative Sciences for Flatiron Health, discussed how this data quality challenge impedes our response to public health emergencies like COVID-19.

“Well, I would say that this has definitely revealed vulnerabilities within our public health data infrastructure. And there were other countries that really came out of this winning. Looking at the UK and some of the studies that they were able to put out really quickly using electronic medical records from their entire population— that's astounding. And we did not have those same capabilities within the United States. But what gives me hope is that, in the before times, it was always really difficult to make a compelling argument why investment was needed to modernize the data that CDC had access to. Now we can see for national security reasons, and for economic security reasons, we need this type of data infrastructure in place so that we don't have the same types of threats.”

3. Lowering drug costs isn’t rocket science — it just requires better coordination.

How drug prices are determined is a hot topic in Washington, and we have heard from guests that better coordination could bring down prescription drug costs for most Americans. As Dan Mendelson put it, “I think when it comes to drugs, we are more concerned about how they fit into the care map and whether the distribution costs are reasonable than we are how the prices are actually being set.”

Carm Huntress , CIO at RxRevu, told us the company had a major realization about drug costs. “We actually realized as a company that the person who makes your purchasing decision for your drugs is not you, but your doctor.”

Carm explained how that revelation has helped RxRevu achieve a significant return on investment for its customers by coordinating prescribing across the continuum. “Imagine you're in the exam room with your doctor, and they're about to pick a new drug for you … and route it to your preferred pharmacy. We take that drug and your insurance information, and then we transact that with your payer or your PBM. We bring that real-time drug cost right in front of the doctor. We say, ‘Hey, it looks like this drug isn't covered. It's going to cost hundreds of dollars … [but] it turns out there's a covered drug that's just a different version of this drug.’ Maybe it's a generic; maybe it's a different manufacturer ... It's maybe a $20 or $50 copay.”

4. To improve health equity, we have to think locally.

Marcus Osborne , Senior Vice President for Walmart Health, posed a great question during our conversation: “As I look at a lot of these innovators on the digital health side, I wonder, ‘Who are they designing solutions for?’ And it feels, to me, like many of them have solutions designed for those individuals who are already well served.”

We couldn’t agree more, and the key to solving some of the major health disparities lies at the community level.

“You look at the numbers of people who are saying, ‘I haven't gone and gotten a checkup in five, 10 years. I haven't been able to get a teeth cleaning in years or ever. Or I haven't gotten my eyes checked. I haven't got my hearing checked. I probably need to do that.’ For us, it is about us creating solutions that enable us to have people who have needs they are deferring ... to get them taken care of now. When I describe what we're doing, it resonates, and it certainly comes from the $4 [generic drug] program. It's about building community health solutions that are accessible, that everybody can access, can get their needs addressed today — not have to defer or delay.”

Pat Geraghty , President and CEO of GuideWell and Florida Blue, told us that to advance equity, they are “doubling down” on local solutions.

“We understand what's happening in that community, and we're deeply engaged with the things that make a difference for the people we're serving, either by the ethnic makeup or the cultural norms in a given part of our state ... We really understood what mattered to them. We worked through churches, community-based organizations. We really deeply embedded in our communities.”

5. Health happens at home.

Our guests confirmed what we, at CareCentrix , have believed for a long time: If going into local communities advances health equity, going a step further — into the home — helps address some of the biggest health disparities.

Andrew Parker , Founder and CEO of Papa, has built his company to send “pals” into the home to help the people who need it most. “We're helping with social determinants, so food insecurity, loneliness, isolation. If you have issues with those things, your health is going to be negatively impacted ... We drive people to the doctor, help them around the house, teach them how to use technology.”

Alicia Stokes , VP, Strategy & Performance, Government Markets for Blue Cross & Blue Shield of North Carolina, told us that health plans are recognizing the importance of health care in the home in treating the whole person.

“Number one, we know that health goes beyond the physical care in the doctor's office, and we must get better at integrating physical and behavioral health and really addressing those non-medical drivers of health.”

Coming out of the pandemic, it was uplifting to hear bold visions for the future of health care and some indications that a more patient-centered healthcare system is closer than we think.

For more, you can find the entire CareTalk Podcast series on YouTube , Apple Podcasts , Spotify , and other major podcast providers.