This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
Greg Poulson, senior vice president and chief policy
officer at Intermountain Health. Greg, it's a pleasure
to have you on the podcast today.
Great to be with you, Laura.
Now I'm really looking forward to our conversation
because I know Intermountain is one of the
most innovative health systems out there and truly
is on the forefront of a lot happening
not only in technology and innovation, but also
in how you're growing your system and thinking
about health care as a whole.
So, you know, I'm excited to learn more.
But before we dive in, I'm wondering, could
you tell us a little bit about Intermountain
as it is today and what makes it
unique?
Sure.
I'm not sure we're really unique, but I
think we may be a little bit unusual
in the sense that, although we're a a
relatively large hospital organization with 33 hospitals across
five states, I think, and,
and a large number of of physician practices
that participate with us
and a broad
array of ancillary services.
We've been in the
health insurance business now for about forty years,
and we're the the the largest,
insurer in
our
primary communities.
And that, makes us think about the world
somewhat differently and has given us some focus
around,
when we talk about, providing value, it gives
us some additional,
both some additional thoughts, but also some additional
tools
that, that that have given us, I think,
a different kind of focus that maybe some
would have.
Absolutely. And I think that's just such a
really great point because
having that ability to understand the provider side
as well as the health plan side,
puts you in a a spot where you
can make,
progress towards what I know we've been talking
about for years and years now. We need
to think about value, think about,
caring for populations,
and really truly
figuring out how to find that happy medium
where everybody is,
able to work up to the best of
their abilities, it seems like.
I think that's right. And, at least from
my perspective, one of the
really lovely,
components of that is that for for so
many of our friends,
the relationship
between the payer and the provider is one
of of tension as opposed to one of
coordination
and focused cooperation. And
I think we find that there are tremendous,
innovative opportunities,
when the two sides are able to bring
their collective strength together
and be able to, take a a focused
approach on helping people live the healthiest lives
possible, which is both our our mission and
our tagline.
Absolutely. Oh, you know, and what a great
segue into, you know, thinking about from the
strategy down to, you know, the the
execution level. What is the accomplishment that you're
most proud of from the last year or
so?
Well, you know, we've, we've we've not done
anything that's a radical departure from our history
in in the last year.
We continue to focus on proactive
care, which is the the term that we
use for sort of value based care. But
but value based care has morphed in, so
many different ways in terms of what what
people mean when they say it and when
they hear it.
And so we wanted to, to to have
a term that
we could,
understand at least within our own internal discussions.
And so,
we've we've used the phrase proactive care,
as as a
definition of what it is that we really
want to, want to do, which is to
help people proactively,
to be as healthy as they can and
avoid the need for some of the very
expensive and unpleasant,
health care experiences that, that otherwise would would
be coming their way.
I guess,
what the the other thing that I would
well, let let me stay with that for
just a second and say that, you know,
that that happens not only when we have
people who are within our own insurance world,
but it also happens with, other Medicare patients,
other commercial patients that come to us.
And it helps us, I think, to,
have a more
holistic view of what we might be able
to do that would be effective in their
lives and and help them to move forward.
So that's sort of,
you know, a continuation of what, what we've
been doing. Something that we've been trying to
do in the last year with, with with
some good results
is simplify,
the the whole health care process,
both for our, our members and patients, but
also for our caregivers.
And we see enormous complexity
serious approach. Our our CEO, Rob Allen,
has
decided that, the the one of the legacies
he'd like to leave behind is a is
a simpler organization,
easier to navigate, easier to understand,
easier to participate in. And so those are
our two big foe OSI this last year.
That's helpful to know and understand. I I
know no easy task really to, make the
complexity of health care simpler in bringing you
into a space where, you know, you're really
able to care for patients and and make
the experience better for them.
From looking ahead, where do you see some
of the big growth opportunities in the next
twelve months or so?
Oh, you've you've kind of hit a hot
button for for me at least.
And and and let me just head down
this path, and and I I hope that,
that I there won't be too controversial here,
but I think that it's really important to
note that growth should never both be a
primary goal or strategy in at least my
perspective, and I think our organizational perspective.
Goals and strategies should be built around value
enhancement for stakeholders,
you know, those that we serve and those
that help us to do so, our patients'
members, the community broadly, and the caregivers that,
that we work with.
So I think the statement that if you're
not growing, you're dying is extremely common, but
I think it's extremely wrong.
I think it's caused a remarkable amount of
over the last couple of decades, and the
road to growth for its own sake is
is, as we all know, littered with wreckage.
The wise and virtuous strategies that we should
be building are around value creation for patients,
beneficiaries, and caregivers.
And at least my perspective is that such
strategies may well include growth
either as a component part of the strategy
or as an outcome of the successful implementation
of that strategy.
But to speak of growth as the strategy,
I think, is neither wise nor virtuous.
I do wanna be clear that
growth is very often both necessary and beneficial,
but only as part of the goals and
strategies that create value.
This is why I'm disturbed when growth is
discussed as the goal.
I think that misses the mark both strategically
and consequentially
leading to outcomes that serve
neither the organization or its stakeholders, and I
think we've seen lots of examples of that
over the last decade or so.
Let me give you an example, though, that
I think may may focus it for for
some of us, and at least it focuses
it for us at Intermountain.
I think, some of your listeners may be
aware of Civica,
which is an innovative value adding generic drug
company.
It was created
to provide generic drugs that are overpriced or
in short supply or often both at the
same time.
If Intermountain
had viewed the provision of generic drugs to
the market as a growth opportunity rather than
as a way to increase value for shareholders
and stakeholders,
shareholders meaning broadly the communities and people we
serve,
we would have approached the development in a
much different way and I believe a much
less desirable way, and the overall outcomes would
have been far less. So I think that
that we always need to put,
growth into a perspective of what it's doing
to further our mission,
further our ultimate goals, and further the value
that we provide. Otherwise, we can get distracted
and head off in,
in ways that, are not contributory to to
the overall benefit of the, folks that we
have responsibilities for.
And that's, you know, a really fascinating way
to look at it. And, I appreciate your
thoughts on growth here because, you know, you're
right. Having that ability to focus in on
what's creating value for those stakeholders, especially the
patients, but, you know, really, everybody,
who's involved in the process makes a big
difference. And that example of Civica two is
so prudent right now, especially as,
so many organizations are finding it challenging to,
keep their,
supplies seeing their expenses rise and those kinds
of things. And so, you know, when you
look at it through that lens of value
creation,
and from your role as,
being the chief policy officer.
What does that look like for you? How
do you,
navigate
the the world around you when you're trying
to, primarily stay focused on creating value for
the patients and caregivers,
involved in the health care delivery process?
Well, it's a it's as as you,
certainly imply,
it's enormously challenging to not be distracted by,
by by many of the the factors that
can,
dilute our focus on on value for the
folks that we care for.
The the biggest advantage that that that I
have seen is our board,
and I hope boards,
across the across the country,
who are there to represent,
at least in the case of not for
profit organizations, hopefully, through there to represent the,
the folks that we serve, the patients, the
members, the communities.
And
though the our board has been very effective
at constantly
requiring of us that we report the benefits
that we're achieving with our strategies in terms
of helpfulness to the communities, helpfulness to the,
to the individuals that we care for, and,
hopefully, good stewardship with the resources that have
been entrusted to us. So,
certainly, our board is is very, very helpful,
and and that trickles into our daily reports
that that that come up when we're looking
at what are we providing to the to
the folks that we're caring for. Are we
being as as cost effective as we can
be? Are we being value effective in in
helping people to avoid the need for,
what what could be rendered unnecessary
services if if appropriate interventions are taken earlier.
And that oftentimes,
is not compatible with revenue generation. So there's
there again,
having having a board that represents the, the
the community interest, the, the interest of the
patients that we see is is a is
a good help and a reminder,
to to keep us from always believing that
the bottom line is the bottom line.
What an excellent point. Thank you so much
for digging in a little bit deeper there.
Now I know a lot of opportunities ahead,
but challenges as well. What are the the
challenges or potential headwinds that you have your
eye on most closely right now and and
anticipate navigating through over the next year or
two?
Well, we're certainly seeing dramatic changes or potentials
for dramatic changes in federal policy, and I
think they're evolving in ways that are at
least are not yet clear to me.
And so being light on our feet and
being able to be responsive
to to changing
dynamics at the regulatory level, at the payment
level, at the,
particularly in the Medicare world and
very likely in the Medicaid world,
being ready to, to to adjust the way
that we think so that we can work
effectively
and
effectively meet the needs of the beneficiaries that
that depend on us, I think is going
to be a big challenge over the next
particularly, probably the next eighteen months or so.
On a more very
specific one, I think rationalizing
the expanding pharmaceutical
expense is is one that I think is
enormous. I mentioned civica early, and for,
generic drugs, that's at least a a tool
that
we and others, have now shared in creating
to to to be beneficial there.
But in terms of the,
drugs that are are not generic, that are
are,
increasingly capable I mean, wonderful technology, wonderful capabilities,
capabilities, wonderful new opportunities
that can help people to have healthier and
better lives.
But we need to also find ways to
make that cost effective and and cost beneficial.
It's our constant hope. It's my constant hope
that we can find ways to bring Moore's
Law or some analog of that to bear
in health care so that we can take
very invasive and expensive procedures that we provide
today, replace them with something that is much
less invasive, much less risky,
and hopefully also lower cost that'll allow people
to, to live effective, healthy lives,
with less medical what what we think of
as medical intervention,
but allow us to, to actually
liberate them from some of the, the the
burden that they face with disease
and some of the the the high impacts
that they may have to go through through
our current health system.
But we need to find ways to do
that that that really
also meet with the financial imperatives that, that
we're seeing in in our country,
really throughout the world
where the cost of health care is increasingly,
becoming
challenging
as populations
age and,
we have greater
numbers of people with chronic diseases.
There need to be ways that we can
meet those needs technologically,
much like we have in computer and communications,
with Moore's Law.
Absolutely. I think that's really helpful to understand
and,
great to
kind of think through things on that lens
because, you know, you're right. There's not really
a clear picture of how, some of these
federal policies will change. But, ultimately,
you know, looking at where the health system's
at right now in providing that, pathway for
as much as possible the financial stability,
to continue operations and serving the community is
a huge
challenge.
So, you know, I think there's a lot
there and a lot to unpack, but especially,
you know, from of the leadership perspective, being
able to look ahead, but also,
not too far ahead so you can still
make sure you've got the problem solved for
today to keep you, stable for the future.
Absolutely.
Excellent. Well, before we wrap up here, I'm
wondering, could you talk a little bit about
the number one thing that you're doing right
now in order to set Intermountain up for
that long term success?
Well,
I'm going to to morph the one thing
into two things because I think that, again,
keeping a focus on proactive care, which we
think is is at the very core of
what,
what what
what we're expected to do by our community
and what,
what we should be expected to do, I
think, is essential. But
in order to do that in a in
a more effective way and to make it
easier for both our our patients and members
and caregivers,
the simplification
processes that we're trying to, pursue right now,
that we are pursuing right now, I think,
are are key. So I really would put
it in both of those two areas, proactive
care and simplification.
Absolutely. Well, Greg, thank you so much for
joining us on the podcast today. This has
been just a really helpful and insightful conversation,
and I look forward to connecting with you
again soon.
Well, thank you.