1 00:00:00,160 --> 00:00:02,399 This is Laura Dierdahl with the Becker's Healthcare 2 00:00:02,399 --> 00:00:04,480 Podcast. I'm thrilled today to be joined by 3 00:00:04,480 --> 00:00:06,960 doctor Bill Raymond, chief medical officer at Ochsner 4 00:00:06,960 --> 00:00:08,800 Health Network. Doctor Raymond, it's a pleasure to 5 00:00:08,800 --> 00:00:10,880 have you on the podcast today. Pleasure being 6 00:00:10,880 --> 00:00:12,179 here. Thanks for having me. 7 00:00:12,585 --> 00:00:15,244 Absolutely. Now I'm excited for our conversation because 8 00:00:15,464 --> 00:00:17,304 I know you are doing some very innovative 9 00:00:17,304 --> 00:00:19,785 things at Ochsner, and, it's certainly exciting to 10 00:00:19,785 --> 00:00:21,704 think about, you know, what the future may 11 00:00:21,704 --> 00:00:23,945 hold. But before we dive in, can you 12 00:00:23,945 --> 00:00:25,625 tell me a little bit more about yourself 13 00:00:25,625 --> 00:00:27,085 and Ochsner Health Network? 14 00:00:27,730 --> 00:00:28,230 Sure. 15 00:00:28,769 --> 00:00:30,369 So first of all, I'm the chief medical 16 00:00:30,369 --> 00:00:31,750 officer for Ochsner Health Network. 17 00:00:32,369 --> 00:00:33,350 In that role, 18 00:00:33,810 --> 00:00:35,030 my job is to 19 00:00:35,489 --> 00:00:38,450 oversee the population health management for as as 20 00:00:38,450 --> 00:00:40,674 a physician leader on that group. Our group 21 00:00:40,674 --> 00:00:42,755 manages, like, all the value based contracts that 22 00:00:42,755 --> 00:00:43,414 we have, 23 00:00:43,795 --> 00:00:44,695 the MA capitation, 24 00:00:45,075 --> 00:00:47,954 at risk MA, our enhanced tracked ACO. We 25 00:00:47,954 --> 00:00:50,054 even have an an upside only ACO, 26 00:00:50,754 --> 00:00:51,814 as well as commercial, 27 00:00:52,434 --> 00:00:54,674 and MA shared savings and a commercial p 28 00:00:54,674 --> 00:00:55,655 for p contract. 29 00:00:56,170 --> 00:00:58,250 Together, all that's roughly about 600,000 30 00:00:58,250 --> 00:00:58,750 lives. 31 00:00:59,130 --> 00:01:02,510 OHN, Oshunov Network, that's our CIN that has 32 00:01:02,729 --> 00:01:04,650 about, over 3,500 33 00:01:04,650 --> 00:01:05,629 MDs in it, 34 00:01:05,930 --> 00:01:07,709 and over 2,600 APPs. 35 00:01:08,575 --> 00:01:11,135 Ocean, which is our enhanced tracked ACO, includes 36 00:01:11,135 --> 00:01:12,355 nearly 5,000 37 00:01:12,495 --> 00:01:13,555 MDs and APPs. 38 00:01:14,174 --> 00:01:16,895 And taking a step back, so Ochsner is, 39 00:01:16,895 --> 00:01:18,355 you know, based in New Orleans, 40 00:01:18,734 --> 00:01:19,875 over 40 hospitals, 41 00:01:20,255 --> 00:01:23,155 manage over a million patients throughout Louisiana, Mississippi. 42 00:01:24,579 --> 00:01:25,799 And when we include 43 00:01:26,260 --> 00:01:28,680 OHN, which includes partners and the like, 44 00:01:29,219 --> 00:01:31,700 as well as within Ocean, which are the 45 00:01:31,700 --> 00:01:34,260 Enhanced Right KCO I mentioned, we then go 46 00:01:34,260 --> 00:01:37,060 even more geographically to parts of Texas and 47 00:01:37,060 --> 00:01:39,344 even into Alabama a bit within those groups. 48 00:01:39,825 --> 00:01:41,505 So we have a significant impact on the 49 00:01:41,505 --> 00:01:43,344 communities that we take care of through those 50 00:01:43,344 --> 00:01:45,444 different, arrangements that we have in place. 51 00:01:46,224 --> 00:01:47,745 That's great to hear. And I know being 52 00:01:47,745 --> 00:01:49,025 able to have all those different, 53 00:01:49,424 --> 00:01:50,484 contracts and arrangements 54 00:01:50,784 --> 00:01:51,284 really 55 00:01:51,905 --> 00:01:54,120 pulls through a lot of the principles and 56 00:01:54,120 --> 00:01:56,040 values when you're thinking about value based care 57 00:01:56,040 --> 00:01:58,040 and and how to really make the most 58 00:01:58,040 --> 00:01:59,020 of the quality, 59 00:01:59,400 --> 00:02:01,079 care you're able to provide as well as, 60 00:02:01,400 --> 00:02:03,240 the dollar. And so it seems like, you 61 00:02:03,240 --> 00:02:04,859 know, having all of those different, 62 00:02:05,560 --> 00:02:07,560 plans in place in different things that you're 63 00:02:07,560 --> 00:02:09,955 doing really gives the health system a great, 64 00:02:10,275 --> 00:02:12,995 window into, you know, how they can control 65 00:02:12,995 --> 00:02:14,594 more of that quality as well as cost 66 00:02:14,594 --> 00:02:15,254 of care. 67 00:02:16,034 --> 00:02:18,855 Yeah. Real quickly on that. It's interesting because, 68 00:02:19,235 --> 00:02:20,675 you know, you bring up a a a 69 00:02:20,675 --> 00:02:22,694 part about us having the value based contracts. 70 00:02:23,509 --> 00:02:24,949 The reality of what we have to do 71 00:02:24,949 --> 00:02:27,750 more so nowadays is is think about how 72 00:02:27,750 --> 00:02:29,349 we're taking care of patients that even aren't 73 00:02:29,349 --> 00:02:32,090 in those contracts because, you know, looking at 74 00:02:32,229 --> 00:02:34,090 how total cost of care is provided, 75 00:02:34,389 --> 00:02:36,789 how how we're getting reimbursed as a health 76 00:02:36,789 --> 00:02:39,674 system and everything else, it kinda changes dynamic 77 00:02:39,814 --> 00:02:42,375 a good bit from just being looking at 78 00:02:42,375 --> 00:02:43,894 a contract side of things and how we 79 00:02:43,894 --> 00:02:45,894 can, you know, do things across a more 80 00:02:45,974 --> 00:02:47,114 a broader population. 81 00:02:48,055 --> 00:02:49,814 For example, if you think about it, you 82 00:02:49,814 --> 00:02:52,360 know, within the hospital system, when somebody gets 83 00:02:52,360 --> 00:02:54,680 admitted and it's a preventable illness, I mean, 84 00:02:54,680 --> 00:02:57,800 that's that's sort of us missing an opportunity 85 00:02:57,800 --> 00:02:59,879 to try to keep people healthier and keeping 86 00:02:59,879 --> 00:03:01,080 them well and keeping them out of the 87 00:03:01,080 --> 00:03:01,580 hospital. 88 00:03:02,439 --> 00:03:03,879 One is the right thing to do. And 89 00:03:03,879 --> 00:03:05,400 so that's what the interesting thing is value 90 00:03:05,400 --> 00:03:06,919 based care has kinda gotten a little bit 91 00:03:06,919 --> 00:03:09,104 about what does value mean and everything else. 92 00:03:09,104 --> 00:03:10,944 And so it's more of, you know, let's 93 00:03:10,944 --> 00:03:12,885 do the right thing for for people. 94 00:03:13,504 --> 00:03:15,264 And if you have people who are getting 95 00:03:15,264 --> 00:03:17,284 into your hospital facilities because 96 00:03:17,824 --> 00:03:19,665 you could have done something differently to take 97 00:03:19,665 --> 00:03:21,264 care of them differently and help prevent that 98 00:03:21,264 --> 00:03:23,870 illness, prevent that condition, whatever else, We need 99 00:03:23,870 --> 00:03:25,550 to be more proactive about how we do 100 00:03:25,550 --> 00:03:26,849 that. And so I think 101 00:03:27,150 --> 00:03:28,669 that's kinda where we need to be going 102 00:03:28,669 --> 00:03:30,590 more and more is not looking specifically at 103 00:03:30,590 --> 00:03:32,590 the contract aspect of it, but what are 104 00:03:32,590 --> 00:03:33,250 we doing 105 00:03:33,550 --> 00:03:35,949 from a holistic aspect of how we're managing 106 00:03:35,949 --> 00:03:38,724 patients regardless of who their payer is and 107 00:03:38,724 --> 00:03:40,965 how we're doing thing things right across the 108 00:03:40,965 --> 00:03:42,965 board to help prevent those sorts of things 109 00:03:42,965 --> 00:03:43,625 from happening. 110 00:03:44,645 --> 00:03:46,004 I love it. That makes a lot of 111 00:03:46,004 --> 00:03:47,604 sense. And, you know, it's really helpful to 112 00:03:47,604 --> 00:03:49,844 understand about your mindset and mind frame going 113 00:03:49,844 --> 00:03:50,344 into, 114 00:03:50,724 --> 00:03:52,885 those types of arrangements and and thinking through, 115 00:03:52,885 --> 00:03:54,960 you know, quality care for all patients. 116 00:03:55,500 --> 00:03:56,860 Now what are some of the trends that 117 00:03:56,860 --> 00:03:58,479 you're watching most closely currently? 118 00:04:00,060 --> 00:04:03,819 Trends currently would be whatever CMMI is pushing 119 00:04:03,819 --> 00:04:06,159 out this week. It feels like it happens 120 00:04:06,219 --> 00:04:07,180 a lot right now. 121 00:04:07,580 --> 00:04:09,405 I mean, if you think about it, at 122 00:04:09,405 --> 00:04:10,664 the end of the year, 123 00:04:11,525 --> 00:04:13,784 LEED, ACCESS, Maha Elevate, 124 00:04:14,164 --> 00:04:16,185 all those were pushed out as well 125 00:04:16,644 --> 00:04:19,365 as looking at payment aspects for Medicaid and 126 00:04:19,365 --> 00:04:19,865 pharmacy. 127 00:04:20,644 --> 00:04:22,964 They're even still talking about expanding the ahead 128 00:04:22,964 --> 00:04:24,990 programs. So there's a lot coming out of 129 00:04:24,990 --> 00:04:27,550 CMMI. So I feel like a good part 130 00:04:27,550 --> 00:04:29,149 of my job and other people who are 131 00:04:29,149 --> 00:04:30,370 similar to me is 132 00:04:30,670 --> 00:04:32,830 trying to keep pace with that and understand 133 00:04:32,830 --> 00:04:35,310 exactly what those different models mean and how 134 00:04:35,310 --> 00:04:37,230 we can try to participate in them and 135 00:04:37,230 --> 00:04:38,129 try to improve, 136 00:04:38,645 --> 00:04:40,004 the health care of the community that we 137 00:04:40,004 --> 00:04:42,085 serve using these different models that are out 138 00:04:42,085 --> 00:04:42,585 there. 139 00:04:43,045 --> 00:04:45,444 I think everything that CMMI is putting out 140 00:04:45,444 --> 00:04:47,064 right now is very innovative. 141 00:04:47,525 --> 00:04:50,404 I'm very encouraged by it because it looks 142 00:04:50,404 --> 00:04:52,025 like they're trying to change 143 00:04:52,645 --> 00:04:53,145 how 144 00:04:54,149 --> 00:04:56,250 health care is paid and including 145 00:04:56,550 --> 00:04:58,889 new innovative care models as well. 146 00:04:59,750 --> 00:05:01,370 So it's not just gonna be 147 00:05:01,670 --> 00:05:02,970 regular fee for service 148 00:05:03,589 --> 00:05:04,089 medicine 149 00:05:04,389 --> 00:05:06,389 where the more you do, the more you 150 00:05:06,389 --> 00:05:07,129 get paid. 151 00:05:07,670 --> 00:05:09,854 It's it aligns very much with, you know, 152 00:05:09,854 --> 00:05:12,414 our core values here, which is, you know, 153 00:05:12,414 --> 00:05:14,175 trying to make sure that we're doing the 154 00:05:14,175 --> 00:05:15,694 right things for patient and how do we 155 00:05:15,694 --> 00:05:18,175 help manage them outside the walls of our 156 00:05:18,175 --> 00:05:20,495 institution so they're not having to come in. 157 00:05:20,495 --> 00:05:22,654 So I think it's great where they're going. 158 00:05:22,654 --> 00:05:24,334 I think it's gonna be interesting when we 159 00:05:24,334 --> 00:05:25,474 find out more details, 160 00:05:26,009 --> 00:05:28,490 but, certainly, that is a lot of our 161 00:05:28,490 --> 00:05:30,810 time, effort, and energy right now is trying 162 00:05:30,810 --> 00:05:33,149 to understand exactly what those opportunities are. 163 00:05:34,009 --> 00:05:35,529 That makes a lot of sense. And, you 164 00:05:35,529 --> 00:05:37,930 know, it's just, it seems like a lot 165 00:05:37,930 --> 00:05:40,305 as you mentioned. It's coming out of the 166 00:05:40,305 --> 00:05:43,504 government policy changes and thinking through, you know, 167 00:05:43,504 --> 00:05:46,404 how you're, going to transform the health system, 168 00:05:46,944 --> 00:05:49,904 alongside many of these change changes are important 169 00:05:49,904 --> 00:05:51,519 too. And so when you look at, you 170 00:05:51,519 --> 00:05:53,680 know, the teams that you're building, whether it's 171 00:05:53,680 --> 00:05:55,939 clinical, administrative, across the board, 172 00:05:56,319 --> 00:05:57,839 how do you make sure that, you know, 173 00:05:57,839 --> 00:06:00,479 the the team culture is so flexible that 174 00:06:00,479 --> 00:06:01,439 you're able to, 175 00:06:02,079 --> 00:06:04,240 you know, be nimble and make changes as 176 00:06:04,240 --> 00:06:06,475 they come and really not only be thinking 177 00:06:06,475 --> 00:06:08,475 about, you know, the near term, but as 178 00:06:08,475 --> 00:06:09,694 far term as well, 179 00:06:10,314 --> 00:06:12,555 in, you know, your broader mission and vision 180 00:06:12,555 --> 00:06:13,375 for the future. 181 00:06:14,235 --> 00:06:16,154 Yeah. So I think if you keep in 182 00:06:16,154 --> 00:06:17,214 mind that you're, 183 00:06:17,514 --> 00:06:19,819 you know, taking care of patients is number 184 00:06:19,819 --> 00:06:21,819 one. Right? So patients come first. That is 185 00:06:21,819 --> 00:06:22,879 our our first 186 00:06:23,339 --> 00:06:25,579 objective and and keeping them at the center 187 00:06:25,579 --> 00:06:26,479 of what we do. 188 00:06:26,860 --> 00:06:28,720 And so if you think about that, 189 00:06:29,339 --> 00:06:31,819 these are opportunities for us to help align 190 00:06:31,819 --> 00:06:33,839 with how we want to manage patients, 191 00:06:34,714 --> 00:06:36,795 and how we wanna help the communities that 192 00:06:36,795 --> 00:06:37,454 we serve. 193 00:06:37,754 --> 00:06:38,415 And so 194 00:06:38,795 --> 00:06:41,454 just keeping focus on that aspect of it, 195 00:06:41,514 --> 00:06:43,675 that end goal of trying to actually improve 196 00:06:43,675 --> 00:06:44,814 the health of the community, 197 00:06:45,834 --> 00:06:47,915 that aligns with a lot of what's going 198 00:06:47,915 --> 00:06:49,214 on right now and 199 00:06:49,769 --> 00:06:52,410 allows for trying to do things differently and 200 00:06:52,410 --> 00:06:54,509 be innovative in how you manage patients. 201 00:06:55,129 --> 00:06:57,149 If you're currently focused on 202 00:06:57,529 --> 00:06:59,689 the regular fee for service payment model, for 203 00:06:59,689 --> 00:07:02,704 example, then, you know, you are driven to 204 00:07:02,704 --> 00:07:04,384 make people come in and see you within 205 00:07:04,384 --> 00:07:05,925 your four walls and everything else. 206 00:07:06,464 --> 00:07:07,285 Well, access 207 00:07:08,464 --> 00:07:09,444 is a challenge, 208 00:07:10,464 --> 00:07:12,944 as well as, you know, our system 209 00:07:13,664 --> 00:07:14,485 the hospitals, 210 00:07:14,865 --> 00:07:16,485 we have lots of people in the ED, 211 00:07:16,819 --> 00:07:18,579 people that are waiting for beds, there's demand 212 00:07:18,579 --> 00:07:20,979 for transfers, all these things. So if we're 213 00:07:20,979 --> 00:07:23,060 able to help manage patients and keep them 214 00:07:23,060 --> 00:07:24,979 healthier and keep them out of the hospital, 215 00:07:24,979 --> 00:07:26,660 that means the people that actually need to 216 00:07:26,660 --> 00:07:27,560 be in the 217 00:07:27,939 --> 00:07:28,439 costliest 218 00:07:28,995 --> 00:07:31,875 aspect of our system inside the hospital can 219 00:07:31,875 --> 00:07:32,855 get that access, 220 00:07:33,314 --> 00:07:35,074 and get that great care that they need 221 00:07:35,074 --> 00:07:37,074 when they need it. So let's do what 222 00:07:37,074 --> 00:07:38,214 we can to try to 223 00:07:38,915 --> 00:07:41,795 manage patients in very different ways, think about 224 00:07:41,795 --> 00:07:43,975 things differently, have the right mindset about 225 00:07:44,730 --> 00:07:46,650 what does the patient want. Does the patient 226 00:07:46,650 --> 00:07:48,569 really wanna be in the hospital? Probably not, 227 00:07:48,569 --> 00:07:50,490 unless they actually need the care that's there. 228 00:07:50,490 --> 00:07:52,490 Right? So let's focus on how we can 229 00:07:52,490 --> 00:07:54,410 take care of patients in different ways to 230 00:07:54,410 --> 00:07:55,850 meet their needs and the way that they 231 00:07:55,850 --> 00:07:56,745 wanna be met. 232 00:07:57,625 --> 00:07:59,384 I love that. I think it's so critical 233 00:07:59,384 --> 00:08:01,544 to have that type of framing when you're 234 00:08:01,544 --> 00:08:03,544 looking at, you know, what is the day 235 00:08:03,544 --> 00:08:04,824 to day? What what do we need to 236 00:08:04,824 --> 00:08:06,285 do differently, and how do we, 237 00:08:06,745 --> 00:08:08,604 evolve is to just have that patient 238 00:08:08,904 --> 00:08:10,044 mindset and centric 239 00:08:10,569 --> 00:08:12,250 view. You know? It seems like it would 240 00:08:12,250 --> 00:08:15,150 make things a lot, more provide more clarity, 241 00:08:15,449 --> 00:08:17,629 amid amid some of the chaos. So, 242 00:08:18,170 --> 00:08:19,689 I I'm curious. Could you tell us a 243 00:08:19,689 --> 00:08:21,449 little bit about something you're most proud of 244 00:08:21,449 --> 00:08:23,050 from the last six to eighteen months or 245 00:08:23,050 --> 00:08:23,550 so? 246 00:08:24,214 --> 00:08:26,134 Yeah. So I'll I'll I'll break out a 247 00:08:26,134 --> 00:08:26,875 few things. 248 00:08:27,495 --> 00:08:28,875 So last year, 249 00:08:29,654 --> 00:08:30,375 is actually 250 00:08:30,855 --> 00:08:32,695 we we we're still waiting right now for 251 00:08:32,695 --> 00:08:34,455 last year. So let's go back to '24. 252 00:08:34,455 --> 00:08:35,595 For '24, 253 00:08:35,894 --> 00:08:38,490 our group, the employee group at here at 254 00:08:38,490 --> 00:08:38,990 Ochsner 255 00:08:39,290 --> 00:08:41,850 within the Blue Cross Blue Shield contract, there's 256 00:08:41,850 --> 00:08:44,750 a a primary care pay for performance contract, 257 00:08:45,129 --> 00:08:46,889 and we got four diamonds out of four 258 00:08:46,889 --> 00:08:49,389 diamonds. In that contract, there are 259 00:08:49,769 --> 00:08:50,990 20 different measures, 260 00:08:51,794 --> 00:08:53,475 and so you have to do well across 261 00:08:53,475 --> 00:08:55,634 the board on all those. And I'll just 262 00:08:55,634 --> 00:08:57,875 hit some highlights. I mean, this is 80,000 263 00:08:57,875 --> 00:08:59,475 people we're talking about that are attributing this 264 00:08:59,475 --> 00:08:59,975 contract. 265 00:09:00,274 --> 00:09:02,514 So ninety three percent of the patients got 266 00:09:02,514 --> 00:09:03,815 their breast cancer screening. 267 00:09:04,120 --> 00:09:06,360 There are fifteen percent fewer emergency department visits 268 00:09:06,360 --> 00:09:07,259 than were expected, 269 00:09:07,800 --> 00:09:09,800 and eighty seven percent of the patients had 270 00:09:09,800 --> 00:09:11,480 their a one c under control. Like, those 271 00:09:11,480 --> 00:09:13,420 are just highlights from that one contract. 272 00:09:13,960 --> 00:09:15,420 And then on the 273 00:09:16,054 --> 00:09:18,554 on the Enhanced Track ACO side of things, 274 00:09:18,774 --> 00:09:21,014 we actually ended up being the number three 275 00:09:21,014 --> 00:09:22,954 in the country for care coordination, 276 00:09:23,815 --> 00:09:25,754 based on patient surveys. And 277 00:09:26,294 --> 00:09:29,115 I was astounded when that came out because 278 00:09:29,480 --> 00:09:32,360 these are what patients are saying. So that 279 00:09:32,360 --> 00:09:35,639 is huge accolades for our group and and 280 00:09:35,639 --> 00:09:37,879 part of what our my team has to 281 00:09:37,879 --> 00:09:38,539 help manage, 282 00:09:39,079 --> 00:09:40,679 making sure that people are getting the right 283 00:09:40,679 --> 00:09:42,120 care at the right place, and they're getting 284 00:09:42,120 --> 00:09:44,139 the coordination that we're looking for. 285 00:09:44,495 --> 00:09:44,995 And 286 00:09:45,375 --> 00:09:47,394 being touted as number three in the nation 287 00:09:47,615 --> 00:09:49,615 was a little humbling and but I think 288 00:09:49,615 --> 00:09:50,894 that goes a long way to talk about, 289 00:09:50,894 --> 00:09:52,334 you know, what we're doing, try to make 290 00:09:52,334 --> 00:09:54,434 sure people are take well taken care of. 291 00:09:54,654 --> 00:09:57,375 So there's there's a couple on that side 292 00:09:57,375 --> 00:09:59,375 of things. But I think that's really based 293 00:09:59,375 --> 00:10:01,310 on you know, it comes down to doing 294 00:10:01,310 --> 00:10:02,769 the right blocking and tackling, 295 00:10:03,389 --> 00:10:05,870 on a regular basis. And so within our 296 00:10:05,870 --> 00:10:06,370 system, 297 00:10:06,990 --> 00:10:08,430 we have if you attribute to one of 298 00:10:08,430 --> 00:10:11,070 our primary care physicians, we're looking at certain 299 00:10:11,070 --> 00:10:12,670 types of measures and seeing how we're doing 300 00:10:12,670 --> 00:10:15,075 performance wise regardless of what the payer is. 301 00:10:15,154 --> 00:10:16,355 So going back to what I was talking 302 00:10:16,355 --> 00:10:19,315 to before. And within that, you know, 85 303 00:10:19,315 --> 00:10:20,674 of the people with hypertension have their blood 304 00:10:20,674 --> 00:10:23,495 pressure controlled. Eighty two percent of diabetic diabetics 305 00:10:23,634 --> 00:10:25,715 have their a one c controlled. Ninety percent 306 00:10:25,715 --> 00:10:27,875 of people got their breast cancer screenings. Eighty 307 00:10:27,875 --> 00:10:30,830 seven percent had their cervical cancer screens. And 308 00:10:30,830 --> 00:10:32,830 eighty four got their co operative cancer screenings 309 00:10:32,830 --> 00:10:35,470 as recommended. So those are all basically what 310 00:10:35,470 --> 00:10:36,590 you need to be doing on a regular 311 00:10:36,590 --> 00:10:38,049 basis to help manage patients, 312 00:10:38,350 --> 00:10:40,590 which then helps out with further downstream things 313 00:10:40,590 --> 00:10:42,429 that you're trying to prevent from a chronic 314 00:10:42,429 --> 00:10:43,410 condition standpoint. 315 00:10:44,004 --> 00:10:46,804 So, you know, at this moment, we're trying 316 00:10:46,804 --> 00:10:49,204 to like I said, we're gonna go beyond 317 00:10:49,204 --> 00:10:51,384 just our value based care agreements 318 00:10:51,764 --> 00:10:53,605 because it's the right thing to do as 319 00:10:53,605 --> 00:10:54,985 to how we manage patients. 320 00:10:55,524 --> 00:10:56,024 So 321 00:10:56,720 --> 00:10:58,639 the more we do about taking care of 322 00:10:58,639 --> 00:11:00,879 patients, doing it in innovative ways, I mean, 323 00:11:00,879 --> 00:11:02,480 and taking care of people outside the walls, 324 00:11:02,480 --> 00:11:04,580 this involves, like, care model redesign, 325 00:11:04,960 --> 00:11:07,220 constantly looking where you can do things differently, 326 00:11:08,000 --> 00:11:10,000 as well as, you know, I have I've 327 00:11:10,000 --> 00:11:11,360 waited all the way till now to mention 328 00:11:11,360 --> 00:11:13,565 it, how you use AI to help enable 329 00:11:13,565 --> 00:11:14,544 those sorts of things, 330 00:11:15,404 --> 00:11:17,085 because that is a way for us to 331 00:11:17,085 --> 00:11:18,445 try to do things a little bit differently 332 00:11:18,445 --> 00:11:19,184 too. So 333 00:11:19,565 --> 00:11:20,764 a lot of that about some of the 334 00:11:20,764 --> 00:11:22,384 things that we've we've done lately, 335 00:11:23,404 --> 00:11:24,225 I will say 336 00:11:25,190 --> 00:11:27,269 we have a huge focus right now on 337 00:11:27,269 --> 00:11:28,330 care model redesign, 338 00:11:28,789 --> 00:11:30,629 and the goal of that is to decrease 339 00:11:30,629 --> 00:11:33,190 variation of care. And, again, with the end 340 00:11:33,190 --> 00:11:34,409 goal of being preventing 341 00:11:35,190 --> 00:11:38,070 people from having complications and even preventing people 342 00:11:38,070 --> 00:11:40,070 from getting chronic conditions in the first place. 343 00:11:40,070 --> 00:11:41,245 So if 344 00:11:41,884 --> 00:11:43,745 we have a focus right now on CKD 345 00:11:43,804 --> 00:11:44,464 and CHF. 346 00:11:44,845 --> 00:11:47,245 So both of those, the big drivers are 347 00:11:47,245 --> 00:11:49,845 diabetes, hypertension, obesity. So the more we can 348 00:11:49,845 --> 00:11:51,745 do to keep people under control, 349 00:11:52,204 --> 00:11:54,625 then the less people end up getting CKD. 350 00:11:54,845 --> 00:11:56,789 But then also once they get it, what 351 00:11:56,870 --> 00:11:58,649 what are we doing to prevent that progression? 352 00:11:58,949 --> 00:12:01,429 Because the slow the slower they are progression 353 00:12:01,429 --> 00:12:04,070 wise, that means the likelihood of getting dialysis 354 00:12:04,070 --> 00:12:06,070 or needing transplant, I think that is greatly 355 00:12:06,070 --> 00:12:06,570 diminished. 356 00:12:07,029 --> 00:12:09,029 So let's just do those things right and 357 00:12:09,029 --> 00:12:11,204 do that across the board, and let's make 358 00:12:11,204 --> 00:12:13,144 sure that we're doing everything we can. 359 00:12:13,445 --> 00:12:14,804 So that's a lot that we're doing right 360 00:12:14,804 --> 00:12:17,125 now regarding the care model. There's some other 361 00:12:17,125 --> 00:12:19,284 aspects of that. We're making sure everybody gets 362 00:12:19,284 --> 00:12:20,345 all the right things, 363 00:12:20,804 --> 00:12:21,625 as a patient. 364 00:12:22,245 --> 00:12:23,684 And so a lot of things being done 365 00:12:23,684 --> 00:12:24,345 that way. 366 00:12:25,269 --> 00:12:27,429 Fantastic. I mean, I think that's so helpful 367 00:12:27,429 --> 00:12:29,370 to understand and being grounded in, 368 00:12:29,750 --> 00:12:31,990 you know, what that care model redesign looks 369 00:12:31,990 --> 00:12:33,589 like. And and I I love the idea 370 00:12:33,589 --> 00:12:35,049 of going back to more prevention, 371 00:12:35,509 --> 00:12:38,629 how you work within the community and, reaching 372 00:12:38,629 --> 00:12:41,004 patients in different ways than ever thought possible. 373 00:12:41,164 --> 00:12:43,345 Is there any kind of partnerships or, 374 00:12:43,725 --> 00:12:45,725 you know, things that you've been doing recently 375 00:12:45,725 --> 00:12:48,065 on that side, on the care model redesign 376 00:12:48,205 --> 00:12:49,825 side and the preventative care, 377 00:12:50,205 --> 00:12:51,105 that have really, 378 00:12:51,644 --> 00:12:53,584 shown through that you're really excited about? 379 00:12:54,660 --> 00:12:55,160 So 380 00:12:55,779 --> 00:12:57,299 I will say a lot of this is 381 00:12:57,299 --> 00:12:58,360 is looking 382 00:12:58,660 --> 00:13:00,500 inward as to how we can do things 383 00:13:00,500 --> 00:13:02,740 differently. So the things that we're building inside 384 00:13:02,740 --> 00:13:06,100 Epic to ensure that and we'll we'll I'll 385 00:13:06,100 --> 00:13:08,120 pick on patients with diabetes. 386 00:13:08,595 --> 00:13:10,514 How are we making sure that their blood 387 00:13:10,514 --> 00:13:12,834 pressure is controlled, their diabetes controlled, that they're 388 00:13:12,834 --> 00:13:13,414 a nonsmoker, 389 00:13:13,954 --> 00:13:14,674 that they, 390 00:13:15,074 --> 00:13:17,475 are on the right statin, that their that 391 00:13:17,475 --> 00:13:19,634 their LDLs echo all those things? How can 392 00:13:19,634 --> 00:13:21,475 we make sure that's happening across the board? 393 00:13:21,475 --> 00:13:23,299 And so we're looking at that. So we're 394 00:13:23,299 --> 00:13:24,440 actually in a transition, 395 00:13:25,299 --> 00:13:26,820 not this year, but next year. We're in 396 00:13:26,820 --> 00:13:30,179 transition from just what what is our control 397 00:13:30,179 --> 00:13:32,820 rate for diabetes to what's our percentage of 398 00:13:32,820 --> 00:13:34,839 patients that are getting all these things done. 399 00:13:34,899 --> 00:13:36,740 And so that's a lot of where our 400 00:13:36,740 --> 00:13:39,754 focus is. We do work with some others, 401 00:13:40,134 --> 00:13:42,054 regarding helping take care of people outside the 402 00:13:42,054 --> 00:13:42,794 four walls. 403 00:13:43,414 --> 00:13:45,815 We we've been working with a company called 404 00:13:45,815 --> 00:13:47,195 MyLaurel, which has 405 00:13:47,654 --> 00:13:49,654 paramedics go and check on patients so we 406 00:13:49,654 --> 00:13:52,054 can, make sure that they're doing well and 407 00:13:52,054 --> 00:13:53,355 help prevent those readmissions. 408 00:13:53,654 --> 00:13:56,269 We have our own program regarding nurse practitioners 409 00:13:56,269 --> 00:13:57,709 that go to that home as well for 410 00:13:57,709 --> 00:13:59,709 those that need to have a nurse practitioner 411 00:13:59,709 --> 00:14:01,730 go to their home. We have our own 412 00:14:02,110 --> 00:14:04,350 digital medicine company, so that's, 413 00:14:04,909 --> 00:14:07,949 how we manage patients with hypertension, diabetes, and 414 00:14:07,949 --> 00:14:09,570 even chronic kidney disease, 415 00:14:10,125 --> 00:14:12,205 where basically they're sending readings to us, and 416 00:14:12,205 --> 00:14:14,365 we make adjustments without them having to come 417 00:14:14,365 --> 00:14:16,304 in. So there's a lot that we're doing 418 00:14:16,845 --> 00:14:19,085 ourselves. A lot some things are certainly with 419 00:14:19,085 --> 00:14:21,825 partners. But the goal is, like I said, 420 00:14:21,965 --> 00:14:23,950 how do we how do we make sure 421 00:14:23,950 --> 00:14:25,950 people are getting everything that they need and 422 00:14:25,950 --> 00:14:27,410 preventing those later complications? 423 00:14:28,669 --> 00:14:30,269 That makes a lot of sense. Thank you 424 00:14:30,269 --> 00:14:32,769 for, sharing a little bit deeper there. Now 425 00:14:32,830 --> 00:14:34,370 before we wrap up our conversation, 426 00:14:35,070 --> 00:14:37,309 what advice would you give to evolving and 427 00:14:37,309 --> 00:14:39,514 emerging leaders today in the health care space, 428 00:14:39,735 --> 00:14:41,975 especially given all of the changes that are 429 00:14:41,975 --> 00:14:43,835 occurring and, you know, what's gonna be critical 430 00:14:44,134 --> 00:14:45,995 to caring for communities in the future? 431 00:14:46,695 --> 00:14:47,514 Yeah. So 432 00:14:48,134 --> 00:14:50,795 advice that I would give is, number one, 433 00:14:50,855 --> 00:14:51,355 listen. 434 00:14:51,909 --> 00:14:53,049 You have a 435 00:14:53,509 --> 00:14:55,929 lot of smart people around you. 436 00:14:56,470 --> 00:14:59,110 You also should be listening to patients, listening 437 00:14:59,110 --> 00:15:00,950 to other people in your community to understand 438 00:15:00,950 --> 00:15:03,029 what the needs are and how you can 439 00:15:03,029 --> 00:15:04,490 try to better serve them. 440 00:15:05,054 --> 00:15:07,875 I that's also you should surround yourself with 441 00:15:08,575 --> 00:15:09,955 good people. So 442 00:15:10,975 --> 00:15:12,495 don't feel like you need to be the 443 00:15:12,495 --> 00:15:14,274 one who comes up with all the solutions. 444 00:15:15,054 --> 00:15:16,495 It's better for you to sit there and 445 00:15:16,495 --> 00:15:19,054 listen and hear what's happening and engage other 446 00:15:19,054 --> 00:15:19,554 leaders, 447 00:15:20,009 --> 00:15:23,610 frontline folks, patients, all those people. And then 448 00:15:23,610 --> 00:15:25,870 your job should be helping connect the dots, 449 00:15:26,250 --> 00:15:28,190 seeing where those opportunities are. 450 00:15:28,730 --> 00:15:31,149 And then from there, you facilitate collaboration. 451 00:15:32,090 --> 00:15:32,590 So 452 00:15:33,290 --> 00:15:35,149 you can't feel like it's all on 453 00:15:35,514 --> 00:15:37,914 an individual to make this happen. Health care 454 00:15:37,914 --> 00:15:39,294 is a highly complex, 455 00:15:40,154 --> 00:15:40,654 system, 456 00:15:41,434 --> 00:15:43,834 and so you cannot be working on an 457 00:15:43,834 --> 00:15:45,995 island. You have to learn from others. You 458 00:15:45,995 --> 00:15:47,294 have to engage with others. 459 00:15:47,730 --> 00:15:49,649 And your job as a leader should really 460 00:15:49,649 --> 00:15:51,730 be, let's figure out what we can do 461 00:15:51,730 --> 00:15:54,129 differently. What are the opportunities? How do you 462 00:15:54,129 --> 00:15:56,370 identify those opportunities? And then how do you 463 00:15:56,370 --> 00:15:57,889 get the right team engaged to make a 464 00:15:57,889 --> 00:15:59,509 difference and take it and 465 00:16:00,049 --> 00:16:02,309 address those opportunities that you find? 466 00:16:03,404 --> 00:16:04,845 I love that. It it makes so much 467 00:16:04,845 --> 00:16:06,605 sense. Doctor Raymond, thank you so much for 468 00:16:06,605 --> 00:16:08,365 joining us on the podcast today. This has 469 00:16:08,365 --> 00:16:10,684 been such a fun conversation and a window 470 00:16:10,684 --> 00:16:12,285 into some of the things you're doing at 471 00:16:12,285 --> 00:16:14,365 Ochsner Health Network. And, you know, I'm looking 472 00:16:14,365 --> 00:16:15,485 forward to seeing you as well at our 473 00:16:15,485 --> 00:16:17,080 annual meeting. I know you'll be speaking on 474 00:16:17,080 --> 00:16:18,919 a panel, and we'll dig deeper into many 475 00:16:18,919 --> 00:16:21,000 of these themes as well as, you know, 476 00:16:21,000 --> 00:16:23,879 share additional perspective about going forward. So it'll 477 00:16:23,879 --> 00:16:25,580 be great to connect and see you there. 478 00:16:26,040 --> 00:16:28,040 That was great. Appreciate the opportunity. Thanks so 479 00:16:28,040 --> 00:16:28,540 much.