1 00:00:00,080 --> 00:00:02,000 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,000 --> 00:00:04,879 Becker's Payer Issues podcast. Thrilled today to be 3 00:00:04,879 --> 00:00:07,200 joined by doctor Rishi Tawar, who is a 4 00:00:07,200 --> 00:00:09,599 medical director in the office of episodes of 5 00:00:09,599 --> 00:00:13,025 Care Population Health at Vanderbilt Health. Doctor Talwar, 6 00:00:13,025 --> 00:00:14,625 thank you so much for taking the time 7 00:00:14,625 --> 00:00:16,324 to be with me on the podcast today. 8 00:00:17,024 --> 00:00:19,664 Thank you. I really appreciate the opportunity to 9 00:00:19,664 --> 00:00:21,345 share a bit more about the work we're 10 00:00:21,345 --> 00:00:22,404 doing here at Vanderbilt. 11 00:00:22,945 --> 00:00:24,545 Absolutely. And glad you could take the time 12 00:00:24,545 --> 00:00:26,170 to be with us. Before we dive into 13 00:00:26,170 --> 00:00:27,690 everything we wanna talk with you about, can 14 00:00:27,690 --> 00:00:29,289 you tell us a little bit more about 15 00:00:29,289 --> 00:00:31,850 yourself, your background in health care, and what 16 00:00:31,850 --> 00:00:33,870 it is that you're doing today at Vanderbilt? 17 00:00:34,409 --> 00:00:34,909 Absolutely. 18 00:00:36,010 --> 00:00:38,030 I in addition to 19 00:00:38,524 --> 00:00:41,245 having a role in population health as you, 20 00:00:41,645 --> 00:00:44,365 alluded to, I also have an active clinical 21 00:00:44,365 --> 00:00:46,625 practice. I am a urologic oncologist 22 00:00:47,164 --> 00:00:48,545 here at Vanderbilt Health. 23 00:00:49,325 --> 00:00:51,344 I see patients I I do predominantly 24 00:00:51,885 --> 00:00:53,425 cancer surgery for 25 00:00:53,770 --> 00:00:55,549 prostate cancer, bladder cancer, 26 00:00:56,409 --> 00:00:57,469 and kidney cancer. 27 00:00:58,329 --> 00:01:00,590 In addition to that, my background, 28 00:01:01,369 --> 00:01:04,510 especially during my training, was in health policy 29 00:01:04,650 --> 00:01:05,150 research. 30 00:01:05,689 --> 00:01:08,650 So my role at Vanderbilt is sort of 31 00:01:08,650 --> 00:01:09,555 a natural fit, 32 00:01:10,194 --> 00:01:12,674 that bridges both of those worlds. I get 33 00:01:12,674 --> 00:01:16,114 to treat patients with urologic cancers. And at 34 00:01:16,114 --> 00:01:19,075 the same time, in my role within episodes 35 00:01:19,075 --> 00:01:21,895 of care under our population health umbrella, 36 00:01:22,435 --> 00:01:25,015 I get to rethink how we deliver, 37 00:01:25,689 --> 00:01:27,229 pay for, and experience 38 00:01:27,769 --> 00:01:30,670 specialty care in our health care ecosystem. 39 00:01:32,329 --> 00:01:35,290 Part of my role as medical director within 40 00:01:35,290 --> 00:01:36,509 episodes of care 41 00:01:36,890 --> 00:01:37,790 is to, 42 00:01:38,409 --> 00:01:39,390 help operationalize, 43 00:01:40,090 --> 00:01:41,310 lead, and support 44 00:01:41,825 --> 00:01:44,465 the MyHealth bundles program, which I'm sure we'll 45 00:01:44,465 --> 00:01:46,224 be talking more about in just a few 46 00:01:46,224 --> 00:01:46,724 minutes. 47 00:01:47,664 --> 00:01:50,384 But more broadly, I, essentially, am the medical 48 00:01:50,384 --> 00:01:53,765 director for all of specialty value based care, 49 00:01:53,905 --> 00:01:56,709 which includes some of the Medicare models that 50 00:01:56,709 --> 00:01:59,510 are set to go into effect as of, 51 00:02:00,069 --> 00:02:02,810 July first of twenty twenty five in addition 52 00:02:03,430 --> 00:02:05,829 to January first of twenty twenty six. So 53 00:02:05,829 --> 00:02:07,670 it's it's been a really fun ride here 54 00:02:07,670 --> 00:02:09,129 at Vanderbilt getting to, 55 00:02:09,514 --> 00:02:11,594 you know, sort of bridge both of my 56 00:02:11,594 --> 00:02:13,375 worlds and both of my interests. 57 00:02:14,395 --> 00:02:16,395 Fantastic. Well, like I said, we appreciate you 58 00:02:16,395 --> 00:02:18,094 taking the time to be with us. And 59 00:02:18,474 --> 00:02:20,474 you work for one of the country's leading 60 00:02:20,474 --> 00:02:22,314 health systems, but you're here with us on 61 00:02:22,314 --> 00:02:25,110 our insurance podcast to talk about how 62 00:02:25,590 --> 00:02:28,889 employers nowadays are really seeking new and innovative 63 00:02:28,949 --> 00:02:31,610 ways to manage their health care expenses 64 00:02:31,990 --> 00:02:32,969 for their employees. 65 00:02:33,509 --> 00:02:35,430 As you know, we're seeing on our end 66 00:02:35,430 --> 00:02:37,530 that health care costs for employers 67 00:02:37,944 --> 00:02:40,605 are set to rise by nearly 8% 68 00:02:40,824 --> 00:02:43,385 this year alone. So maybe you could start 69 00:02:43,385 --> 00:02:46,425 us off by explaining what provider led bundle 70 00:02:46,425 --> 00:02:47,564 programs are, 71 00:02:47,944 --> 00:02:50,205 how they offer a new model for addressing 72 00:02:50,425 --> 00:02:53,165 high cost health conditions within the employer sponsored 73 00:02:53,439 --> 00:02:54,259 health care space? 74 00:02:54,560 --> 00:02:55,939 And why is Vanderbilt's, 75 00:02:56,800 --> 00:02:58,659 interested in this kind of thing? 76 00:02:59,360 --> 00:03:00,259 Sure. Sure. 77 00:03:01,120 --> 00:03:02,099 You know, I think, 78 00:03:02,800 --> 00:03:03,300 understanding, 79 00:03:04,000 --> 00:03:06,414 exactly the point you just alluded to is 80 00:03:06,414 --> 00:03:09,715 critical to understand why Vanderbilt wants to disrupt 81 00:03:09,775 --> 00:03:10,514 this space. 82 00:03:11,134 --> 00:03:12,974 You know, you alluded to this. Health care 83 00:03:12,974 --> 00:03:15,534 costs for employers continue to rise. And as 84 00:03:15,534 --> 00:03:17,634 we know, if we look at the proportion 85 00:03:17,854 --> 00:03:19,715 of employers who provide, 86 00:03:20,650 --> 00:03:21,949 employer sponsored insurance, 87 00:03:22,409 --> 00:03:25,129 more and more of them are becoming fully 88 00:03:25,129 --> 00:03:26,349 self self insured. 89 00:03:27,209 --> 00:03:29,229 And and so they are very engaged 90 00:03:29,530 --> 00:03:31,709 and very in tune with understanding, 91 00:03:32,650 --> 00:03:35,145 their employees' health care related needs. 92 00:03:35,544 --> 00:03:38,844 To that end, they're very astute in noticing 93 00:03:38,985 --> 00:03:41,944 where their spend is particularly high. And here 94 00:03:41,944 --> 00:03:43,724 at Vanderbilt, we have incredible 95 00:03:44,025 --> 00:03:45,724 partnerships with our employers. 96 00:03:46,504 --> 00:03:49,064 We ourselves are self insured, you know, the 97 00:03:49,064 --> 00:03:51,629 medical center. And we have a a great 98 00:03:51,629 --> 00:03:55,949 relationship with Metro Nashville Public School System, another 99 00:03:55,949 --> 00:03:57,650 local self insured employer. 100 00:03:58,189 --> 00:03:58,689 And 101 00:03:59,629 --> 00:04:01,489 it was this partnership that really, 102 00:04:01,949 --> 00:04:04,370 you know, served as the foundation 103 00:04:05,175 --> 00:04:05,914 for our 104 00:04:06,614 --> 00:04:07,114 now 105 00:04:07,495 --> 00:04:08,634 wildly successful, 106 00:04:09,414 --> 00:04:11,354 provider led bundle programs. 107 00:04:12,055 --> 00:04:14,215 What we did was we looked at the 108 00:04:14,215 --> 00:04:16,454 areas that were the biggest pain points for 109 00:04:16,454 --> 00:04:16,954 them, 110 00:04:17,254 --> 00:04:20,055 both as it relates to increased spend, but 111 00:04:20,055 --> 00:04:20,555 also 112 00:04:21,060 --> 00:04:22,600 predictability of spend 113 00:04:22,980 --> 00:04:25,080 or their employees' experience 114 00:04:25,540 --> 00:04:28,120 in getting care related to that condition. 115 00:04:28,899 --> 00:04:29,720 And we, 116 00:04:30,339 --> 00:04:32,279 you know, partnered with our 117 00:04:32,660 --> 00:04:34,964 leading clinical teams here. You you said it 118 00:04:34,964 --> 00:04:37,125 yourself. We're one of the nation's leading health 119 00:04:37,125 --> 00:04:37,784 care systems. 120 00:04:38,164 --> 00:04:39,544 And we said to our providers, 121 00:04:40,404 --> 00:04:41,865 okay. This is an area, 122 00:04:43,125 --> 00:04:45,925 of increased spend and and significant, you know, 123 00:04:45,925 --> 00:04:48,340 pain for our employers that are in our 124 00:04:48,340 --> 00:04:50,020 Nashville area, the ones that we have great 125 00:04:50,020 --> 00:04:50,920 relationships with. 126 00:04:51,540 --> 00:04:54,100 Tell me, what in a perfect world, in 127 00:04:54,100 --> 00:04:55,000 a perfect scenario, 128 00:04:55,300 --> 00:04:57,620 if we didn't have the burdens of prior 129 00:04:57,620 --> 00:04:58,120 authorization, 130 00:04:58,660 --> 00:04:59,160 utilization 131 00:04:59,460 --> 00:04:59,960 management, 132 00:05:00,925 --> 00:05:01,725 worrying about, 133 00:05:02,444 --> 00:05:05,185 patient facing cost or out of pocket costs, 134 00:05:05,644 --> 00:05:06,384 put together 135 00:05:06,764 --> 00:05:09,805 an algorithm that lets you take the best 136 00:05:09,805 --> 00:05:12,444 possible care of the patient and sets us 137 00:05:12,444 --> 00:05:14,949 up to get the best possible outcomes. 138 00:05:15,490 --> 00:05:19,089 And so we really centered our bundled payment 139 00:05:19,089 --> 00:05:19,589 programs 140 00:05:20,050 --> 00:05:22,850 on the patient. The patient is first. The 141 00:05:22,850 --> 00:05:24,470 patient is front and center. 142 00:05:25,410 --> 00:05:28,175 By doing so, we were able to 143 00:05:28,555 --> 00:05:31,754 ensure that we're providing optimal outcomes. But, you 144 00:05:31,754 --> 00:05:33,514 know, as a as a clinician myself, I 145 00:05:33,514 --> 00:05:34,875 wanna call out the fact that we were 146 00:05:34,875 --> 00:05:37,774 also able to make sure our provider teams 147 00:05:37,995 --> 00:05:39,834 didn't have to deal with their own pain 148 00:05:39,834 --> 00:05:41,375 points, such as prior authorization, 149 00:05:42,449 --> 00:05:43,910 burdens, things like that. 150 00:05:45,329 --> 00:05:46,229 For our employers, 151 00:05:46,769 --> 00:05:49,110 we have packaged all of these services 152 00:05:49,490 --> 00:05:50,949 at a single price 153 00:05:51,250 --> 00:05:53,810 that allows them to achieve all of the 154 00:05:53,810 --> 00:05:55,189 care related to that condition, 155 00:05:55,654 --> 00:05:58,074 one single price. You know, it it accomplishes 156 00:05:58,134 --> 00:05:58,875 that predictability 157 00:05:59,415 --> 00:06:00,475 that people value. 158 00:06:01,495 --> 00:06:04,154 And we take risk on our own outcomes. 159 00:06:04,215 --> 00:06:06,314 So I'll I'll give you a couple examples. 160 00:06:06,935 --> 00:06:08,795 Our oldest and most popular 161 00:06:09,160 --> 00:06:11,319 bundle right now is the my maternity health 162 00:06:11,319 --> 00:06:14,139 bundle. And we start the clock, 163 00:06:15,160 --> 00:06:17,240 the day the patient has their first dating 164 00:06:17,240 --> 00:06:17,740 ultrasound. 165 00:06:18,199 --> 00:06:20,860 We cover all care related to the pregnancy, 166 00:06:21,720 --> 00:06:22,220 throughout 167 00:06:22,835 --> 00:06:25,975 the the the patient's pregnancy related journey. 168 00:06:26,514 --> 00:06:28,535 And then we also cover 169 00:06:29,074 --> 00:06:31,314 care related to the pregnancy up to ninety 170 00:06:31,314 --> 00:06:32,134 days postpartum. 171 00:06:32,675 --> 00:06:34,995 We do all of this as at one 172 00:06:34,995 --> 00:06:36,775 single cost for our employers, 173 00:06:37,769 --> 00:06:40,250 And we take risk. We take risk on 174 00:06:40,250 --> 00:06:42,329 things like our c section rate. And that 175 00:06:42,329 --> 00:06:44,329 has paid off because our c section rate 176 00:06:44,329 --> 00:06:46,990 is lower than market, and our patient experience 177 00:06:47,129 --> 00:06:48,810 is off the charts. 178 00:06:49,129 --> 00:06:51,769 Our NPS scores, our net promoter scores are 179 00:06:51,769 --> 00:06:54,705 often in the high eighties to to even 180 00:06:54,705 --> 00:06:56,944 nineties for some of our programs when we 181 00:06:56,944 --> 00:06:58,705 all know the average in health care is 182 00:06:58,705 --> 00:07:00,965 is often in the 30 to 40 range. 183 00:07:02,145 --> 00:07:04,305 Understood. And I I appreciate those real world 184 00:07:04,305 --> 00:07:07,980 examples, doctor Tawar, and and clearly very beneficial 185 00:07:08,439 --> 00:07:10,860 model for for the employer, for the provider, 186 00:07:11,160 --> 00:07:12,620 and and the patients, of course. 187 00:07:13,319 --> 00:07:16,120 For our listeners who might be unfamiliar with 188 00:07:16,120 --> 00:07:18,360 these kind of programs, can you break down 189 00:07:18,360 --> 00:07:21,100 for us how a bundled payment model differs 190 00:07:21,134 --> 00:07:23,475 from that traditional fee for service arrangement 191 00:07:24,095 --> 00:07:25,694 and what you're hearing from employers on the 192 00:07:25,694 --> 00:07:27,855 ground in terms of why they they might 193 00:07:27,855 --> 00:07:29,154 prefer something like this? 194 00:07:29,775 --> 00:07:30,595 Yeah. Absolutely. 195 00:07:30,895 --> 00:07:32,654 I I mentioned this, but let's dig in 196 00:07:32,654 --> 00:07:34,660 a bit more. So first of all, our 197 00:07:34,660 --> 00:07:35,879 bundled payment models, 198 00:07:36,580 --> 00:07:37,879 have one single price. 199 00:07:38,500 --> 00:07:40,339 And so I I alluded to this, but, 200 00:07:40,339 --> 00:07:43,000 you know, our employers really appreciate the predictability. 201 00:07:43,540 --> 00:07:45,620 When you're a self insured employer and you're 202 00:07:45,620 --> 00:07:47,540 carrying a lot of that financial risk for 203 00:07:47,540 --> 00:07:48,600 health care costs, 204 00:07:49,044 --> 00:07:49,544 particularly 205 00:07:49,845 --> 00:07:50,485 in the, 206 00:07:51,044 --> 00:07:52,024 financial environment 207 00:07:52,485 --> 00:07:54,745 and economic environment that we're in now, 208 00:07:55,285 --> 00:07:57,444 predictability is key, and it allows you to 209 00:07:57,444 --> 00:08:00,164 plan for the future and understand where your 210 00:08:00,164 --> 00:08:01,384 spend is gonna go. 211 00:08:02,759 --> 00:08:05,479 And and we cover again, the the way 212 00:08:05,479 --> 00:08:07,240 that this is different from fee for service 213 00:08:07,240 --> 00:08:09,099 is our bundled price 214 00:08:09,479 --> 00:08:11,019 covers all of the care 215 00:08:11,399 --> 00:08:13,259 related to that patient's condition. 216 00:08:14,120 --> 00:08:15,500 Fee for service arrangements 217 00:08:16,175 --> 00:08:17,475 require clinicians 218 00:08:17,775 --> 00:08:21,555 to bill for specific services that are provided. 219 00:08:21,855 --> 00:08:24,895 I gave an example of maternity care. Within 220 00:08:24,895 --> 00:08:26,435 a woman's pregnancy journey, 221 00:08:27,214 --> 00:08:28,915 you know, she may require 222 00:08:29,295 --> 00:08:30,355 several ultrasounds 223 00:08:30,735 --> 00:08:31,235 or 224 00:08:31,560 --> 00:08:33,340 perhaps genetic testing, 225 00:08:34,360 --> 00:08:37,799 or perhaps other sorts of tests that blood 226 00:08:37,799 --> 00:08:39,500 tests, things like that, imaging, 227 00:08:40,279 --> 00:08:41,340 outside of ultrasound. 228 00:08:42,200 --> 00:08:45,399 All of that is covered in our single 229 00:08:45,399 --> 00:08:47,754 price. Whereas in a traditional fee for service 230 00:08:47,754 --> 00:08:50,714 arrangement, that would be billed product by or 231 00:08:50,714 --> 00:08:52,254 service by service rather. 232 00:08:52,875 --> 00:08:53,375 Similarly, 233 00:08:54,074 --> 00:08:54,894 she may 234 00:08:55,674 --> 00:08:57,834 be required to pay a co pay at 235 00:08:57,834 --> 00:08:59,294 each specific visit. 236 00:08:59,970 --> 00:09:00,709 Our program, 237 00:09:01,490 --> 00:09:03,089 one of the big perks and one of 238 00:09:03,089 --> 00:09:05,809 the the big patient satisfiers is the fact 239 00:09:05,809 --> 00:09:08,049 that if you enroll in our program, we 240 00:09:08,049 --> 00:09:10,850 waive all co pays. So for many patients, 241 00:09:10,850 --> 00:09:11,750 that significantly 242 00:09:12,129 --> 00:09:12,629 reduces 243 00:09:13,125 --> 00:09:15,845 the out of pocket cost burden and financial 244 00:09:15,845 --> 00:09:18,904 toxicity associated with getting care. 245 00:09:19,605 --> 00:09:21,764 You know, I use the pregnancy model, but 246 00:09:21,764 --> 00:09:23,865 to address why these, 247 00:09:24,485 --> 00:09:27,125 sorts of programs are becoming increasingly popular with 248 00:09:27,125 --> 00:09:27,625 employers, 249 00:09:27,980 --> 00:09:29,600 I'm gonna use another example. 250 00:09:30,460 --> 00:09:31,519 We have a program 251 00:09:31,980 --> 00:09:35,019 that we offer to our employers that centers 252 00:09:35,019 --> 00:09:35,920 around osteoarthritis 253 00:09:36,379 --> 00:09:36,879 care. 254 00:09:37,420 --> 00:09:39,420 And it's one of the only programs of 255 00:09:39,420 --> 00:09:41,519 its kind that actually allows 256 00:09:42,235 --> 00:09:43,695 employees who enroll 257 00:09:44,154 --> 00:09:46,735 to opt for medical management 258 00:09:47,915 --> 00:09:48,575 of osteoarthritis. 259 00:09:49,355 --> 00:09:51,514 So what that means is we are, 260 00:09:52,394 --> 00:09:54,575 taking risk on our rates of surgery 261 00:09:55,035 --> 00:09:57,450 and and making sure that those are 262 00:09:57,769 --> 00:10:00,970 done only when clinically appropriate and allowing patients 263 00:10:00,970 --> 00:10:01,870 to have access 264 00:10:02,250 --> 00:10:04,269 to non operative options, 265 00:10:04,730 --> 00:10:08,490 such as injections, for example. Those injections can 266 00:10:08,490 --> 00:10:10,029 otherwise be pretty costly. 267 00:10:10,730 --> 00:10:13,034 But employers love the fact that they can 268 00:10:13,034 --> 00:10:14,815 keep their workforce healthy 269 00:10:15,195 --> 00:10:18,315 and, you know, avoid a major surgery by 270 00:10:18,315 --> 00:10:21,054 getting them access to these sorts of injections, 271 00:10:22,075 --> 00:10:22,894 for osteoarthritis 272 00:10:23,434 --> 00:10:24,975 care. That keeps 273 00:10:25,860 --> 00:10:28,100 employees healthy. It keeps them out of the 274 00:10:28,100 --> 00:10:30,839 hospital. It keeps them at work functional, 275 00:10:31,379 --> 00:10:33,139 and they love the fact that they can 276 00:10:33,139 --> 00:10:35,399 have quality of life improvements 277 00:10:36,100 --> 00:10:38,600 that don't require an invasive procedure. 278 00:10:38,955 --> 00:10:41,274 So that's just one example of why these 279 00:10:41,274 --> 00:10:44,235 sorts of programs are becoming really popular with 280 00:10:44,235 --> 00:10:44,975 our employers. 281 00:10:45,595 --> 00:10:47,995 You know, I think the mindset around health 282 00:10:47,995 --> 00:10:48,735 care spending, 283 00:10:49,754 --> 00:10:51,754 is is shifting a bit, and people are 284 00:10:51,754 --> 00:10:52,254 realizing 285 00:10:52,839 --> 00:10:55,399 with time that in general, health care spending, 286 00:10:55,399 --> 00:10:57,480 you know, continues to trend upward, and it 287 00:10:57,480 --> 00:10:58,860 is becoming unsustainable. 288 00:10:59,559 --> 00:11:02,200 And so what I find really rewarding and 289 00:11:02,200 --> 00:11:04,539 what I know our our employers really appreciate 290 00:11:05,014 --> 00:11:05,914 is the opportunity 291 00:11:06,294 --> 00:11:08,615 to work with with really a a center 292 00:11:08,615 --> 00:11:10,315 of excellence in town 293 00:11:11,014 --> 00:11:13,654 and and and to to ensure that their 294 00:11:13,654 --> 00:11:16,394 patients are getting excellent care. 295 00:11:17,174 --> 00:11:19,894 But removing some of the hassles as it 296 00:11:19,894 --> 00:11:20,340 relates 297 00:11:20,820 --> 00:11:23,460 to making sure that that clinician is in 298 00:11:23,460 --> 00:11:23,960 network 299 00:11:24,420 --> 00:11:24,920 or, 300 00:11:25,379 --> 00:11:27,460 you know, again, I'll I'll refer to those 301 00:11:27,460 --> 00:11:30,279 co pays. Some of our programs have enhanced 302 00:11:30,340 --> 00:11:33,225 telehealth services. So, again, it may not require 303 00:11:33,304 --> 00:11:35,065 someone to take an entire day off of 304 00:11:35,065 --> 00:11:36,365 work and drive downtown 305 00:11:37,065 --> 00:11:38,605 just for a doctor's appointment. 306 00:11:38,985 --> 00:11:40,824 So we we really try to try to 307 00:11:40,824 --> 00:11:42,444 address some of those specific 308 00:11:42,904 --> 00:11:45,485 areas of of annoyance and and, 309 00:11:45,944 --> 00:11:48,490 you know, the areas that can be really 310 00:11:48,490 --> 00:11:48,990 inconvenient 311 00:11:49,690 --> 00:11:51,870 for our patients, for our employers. 312 00:11:53,129 --> 00:11:56,669 Absolutely. And from your clinical perspective, doctor Tauro, 313 00:11:56,730 --> 00:11:58,250 what what are some of the long term 314 00:11:58,250 --> 00:11:58,750 implications 315 00:11:59,129 --> 00:12:01,389 of these models for both the employer 316 00:12:01,995 --> 00:12:03,995 and and for the provider in terms of 317 00:12:03,995 --> 00:12:06,575 improving care efficiency and health outcomes 318 00:12:07,035 --> 00:12:09,674 for the employees under under a program like 319 00:12:09,674 --> 00:12:10,815 the My Health bundles. 320 00:12:11,914 --> 00:12:14,154 Yeah. And and, again, my lens as a 321 00:12:14,154 --> 00:12:16,179 clinician, this is this is really what I 322 00:12:16,179 --> 00:12:17,879 love most about this program. 323 00:12:18,259 --> 00:12:19,700 So, you know, I'll go over some of 324 00:12:19,700 --> 00:12:22,519 our recent results that we've seen and analyses 325 00:12:22,740 --> 00:12:23,720 that we've done. 326 00:12:24,340 --> 00:12:26,740 You know, for patients who enrolled in our 327 00:12:26,740 --> 00:12:28,899 My Weight Loss Health program, which is a 328 00:12:28,899 --> 00:12:29,399 bariatric 329 00:12:29,779 --> 00:12:30,279 surgery 330 00:12:30,845 --> 00:12:31,665 bundled payment, 331 00:12:32,605 --> 00:12:33,585 we had over, 332 00:12:34,285 --> 00:12:35,725 640 333 00:12:35,725 --> 00:12:37,024 bariatric procedures 334 00:12:37,485 --> 00:12:39,425 with over 40,000 335 00:12:39,644 --> 00:12:42,365 pounds lost. And and what I love about 336 00:12:42,365 --> 00:12:43,529 that is, you know, 337 00:12:43,930 --> 00:12:46,570 wildly successful, but we actually had less than 338 00:12:46,570 --> 00:12:49,629 a one percent reoperation rate. Again, we guarantee 339 00:12:50,090 --> 00:12:51,389 high quality care. 340 00:12:52,170 --> 00:12:54,910 Patients who un who enrolled in our MySpine 341 00:12:55,050 --> 00:12:55,550 Health 342 00:12:56,035 --> 00:12:57,815 program, who underwent surgery, 343 00:12:58,674 --> 00:13:00,915 eighty six percent of them returned to work 344 00:13:00,915 --> 00:13:02,215 within ninety days. 345 00:13:02,754 --> 00:13:05,575 Across all of our surgical programs, we had 346 00:13:06,035 --> 00:13:08,115 an average of a one percent surgical site 347 00:13:08,115 --> 00:13:09,299 infection rate. 348 00:13:09,700 --> 00:13:11,940 And that just, again, goes to show the 349 00:13:11,940 --> 00:13:15,059 the excellent outcomes that we're able to ensure 350 00:13:15,059 --> 00:13:15,559 here. 351 00:13:16,419 --> 00:13:16,919 And, 352 00:13:17,459 --> 00:13:19,940 you know, I again, my lens tends to 353 00:13:19,940 --> 00:13:22,659 be clinical there, but I can tell you 354 00:13:22,659 --> 00:13:23,620 that there's been, 355 00:13:24,100 --> 00:13:24,600 incredible 356 00:13:25,184 --> 00:13:28,625 financial impact too. I mentioned that we partnered 357 00:13:28,625 --> 00:13:29,764 with one of our, 358 00:13:30,465 --> 00:13:30,965 local 359 00:13:31,345 --> 00:13:34,004 employers, Metro Nashville Public Schools. 360 00:13:34,625 --> 00:13:37,184 And, you know, through participating in our my 361 00:13:37,184 --> 00:13:40,799 maternity health bundle, we were able to significantly 362 00:13:41,019 --> 00:13:43,179 cut the amount of money that they spent 363 00:13:43,179 --> 00:13:46,700 on neonatal care. In fact, an analysis done 364 00:13:46,700 --> 00:13:48,160 in 2024 365 00:13:48,299 --> 00:13:49,200 actually showed 366 00:13:49,740 --> 00:13:51,100 a $1,000,000, 367 00:13:51,975 --> 00:13:52,475 reduction 368 00:13:52,934 --> 00:13:53,434 in, 369 00:13:53,815 --> 00:13:57,815 NICU spending and 50 NICU admissions that were, 370 00:13:58,134 --> 00:14:01,914 avoided. So really a clinical success that translates 371 00:14:02,214 --> 00:14:04,075 into a financial success. 372 00:14:04,534 --> 00:14:07,649 So in my opinion, that's truly, you know, 373 00:14:07,670 --> 00:14:09,029 a a win win win, I like to 374 00:14:09,029 --> 00:14:11,210 call it. It's a win for for patients 375 00:14:11,269 --> 00:14:13,509 first and foremost. It's a win for our 376 00:14:13,509 --> 00:14:14,009 employers, 377 00:14:14,389 --> 00:14:16,629 and it's a win for Vanderbilt because we 378 00:14:16,629 --> 00:14:19,190 we we're doing what we know best, and 379 00:14:19,190 --> 00:14:21,634 that's providing really high quality care. 380 00:14:22,335 --> 00:14:23,934 You know, if you look at all of 381 00:14:23,934 --> 00:14:26,654 our employers that participate in this program in 382 00:14:26,654 --> 00:14:27,154 aggregate, 383 00:14:27,535 --> 00:14:29,795 they've saved about 16% 384 00:14:29,934 --> 00:14:31,315 on health care spend. 385 00:14:32,189 --> 00:14:34,529 And tying that back into my clinical lens, 386 00:14:34,669 --> 00:14:36,209 we've been able to avoid, 387 00:14:37,069 --> 00:14:37,569 variations 388 00:14:38,029 --> 00:14:40,589 in care and and improve the quality of 389 00:14:40,589 --> 00:14:41,089 care 390 00:14:41,470 --> 00:14:43,629 that our community gets. And that that is 391 00:14:43,629 --> 00:14:44,850 really what I find 392 00:14:45,184 --> 00:14:46,004 most rewarding. 393 00:14:47,024 --> 00:14:49,924 Absolutely. And those are certainly some impressive statistics 394 00:14:49,985 --> 00:14:52,544 that that you've accomplished through this program, doctor 395 00:14:52,544 --> 00:14:53,044 Talwar. 396 00:14:53,664 --> 00:14:55,985 Before we go, anything else that we're missing? 397 00:14:55,985 --> 00:14:58,500 Any final thoughts you wanna share with our 398 00:14:58,500 --> 00:15:00,179 audience, while you have the ears of a 399 00:15:00,179 --> 00:15:02,340 lot of other health system and health plan 400 00:15:02,340 --> 00:15:03,800 leaders around the country? 401 00:15:04,580 --> 00:15:05,559 Yeah. Absolutely. 402 00:15:06,019 --> 00:15:08,340 You know, I think that this program really 403 00:15:08,340 --> 00:15:08,840 demonstrates 404 00:15:09,220 --> 00:15:11,000 the ability to innovate, 405 00:15:11,394 --> 00:15:14,054 to disrupt, and to improve the quality 406 00:15:14,674 --> 00:15:15,414 of care 407 00:15:15,794 --> 00:15:18,595 while reducing the costs of care for our 408 00:15:18,595 --> 00:15:21,634 local communities. And so when people think about 409 00:15:21,634 --> 00:15:24,754 value based care or bundled payments, I think 410 00:15:24,754 --> 00:15:25,735 a lot of times, 411 00:15:26,710 --> 00:15:28,410 we can we we we 412 00:15:28,950 --> 00:15:31,990 think about the national level initiatives such as 413 00:15:31,990 --> 00:15:33,529 some of those Medicare models, 414 00:15:33,910 --> 00:15:36,070 some of which have been really successful and 415 00:15:36,070 --> 00:15:38,490 others, you know, we're still trying to understand 416 00:15:38,870 --> 00:15:41,495 the the success and financial implications of of 417 00:15:41,495 --> 00:15:42,875 some of those Medicare innovations. 418 00:15:43,574 --> 00:15:45,574 But that doesn't mean that we can't work 419 00:15:45,574 --> 00:15:46,475 right at home, 420 00:15:46,934 --> 00:15:49,894 in our backyards to partner with our own 421 00:15:49,894 --> 00:15:50,394 employers 422 00:15:50,934 --> 00:15:51,434 to, 423 00:15:52,054 --> 00:15:53,595 implement some of these programs. 424 00:15:53,960 --> 00:15:56,779 And so I'd encourage all of the payer 425 00:15:57,000 --> 00:15:59,799 leaders on this on this podcast who are 426 00:15:59,799 --> 00:16:02,200 listening and a lot of the health system 427 00:16:02,200 --> 00:16:02,700 leaders 428 00:16:03,399 --> 00:16:06,120 to take a look and see if some 429 00:16:06,120 --> 00:16:07,179 of these innovations 430 00:16:07,639 --> 00:16:08,299 are applicable 431 00:16:08,679 --> 00:16:09,660 within your, 432 00:16:10,404 --> 00:16:11,785 within your communities. 433 00:16:12,325 --> 00:16:14,904 Because I think it's really it's really incredible, 434 00:16:15,605 --> 00:16:17,384 to see how local partnerships 435 00:16:18,085 --> 00:16:21,144 can improve the health of our patients 436 00:16:21,605 --> 00:16:22,345 and also, 437 00:16:22,965 --> 00:16:23,625 you know, 438 00:16:24,009 --> 00:16:26,829 pave the way for innovations in specialty 439 00:16:27,449 --> 00:16:30,169 value based care, you know, especially especially in 440 00:16:30,169 --> 00:16:32,250 specialty care, which has been a a source 441 00:16:32,250 --> 00:16:32,750 of 442 00:16:33,129 --> 00:16:34,829 a lot of health care spending. 443 00:16:35,690 --> 00:16:38,009 And and, you know, Vanderbilt's just one of 444 00:16:38,009 --> 00:16:38,829 many systems 445 00:16:39,154 --> 00:16:41,075 who are thinking about these kinds of problems, 446 00:16:41,075 --> 00:16:42,835 but I I really think that, 447 00:16:43,715 --> 00:16:45,495 our My Health Bundles program 448 00:16:46,035 --> 00:16:47,014 provides a lens 449 00:16:47,394 --> 00:16:48,455 for specialists 450 00:16:48,835 --> 00:16:51,075 to take an active role in these sorts 451 00:16:51,075 --> 00:16:53,095 of, value based care initiatives. 452 00:16:54,070 --> 00:16:56,870 Fantastic. Well, thank you so much for taking 453 00:16:56,870 --> 00:16:58,549 the time to sit down with us and 454 00:16:58,549 --> 00:17:00,710 for sharing your insights with our audience. We 455 00:17:00,710 --> 00:17:01,850 really appreciate it. 456 00:17:02,549 --> 00:17:04,809 No problem. I appreciate the the, 457 00:17:05,269 --> 00:17:07,509 opportunity to chat with you today. Thanks so 458 00:17:07,509 --> 00:17:07,964 much. 459 00:17:08,365 --> 00:17:10,284 Of course. And for our audience, if you'd 460 00:17:10,284 --> 00:17:12,444 like to listen to more podcasts from Becker's 461 00:17:12,444 --> 00:17:15,904 Healthcare, you can visit beckershospitalreview.com.