Tom Robertson, Executive Director of the Vizient Research Institute, and David Randall, Chief Strategy Officer, UAB Medicine, discuss the vulnerability of the traditional health system business model, driven by a payment system that creates unintended consequences. The conversation then turns to how things could change, and David describes a unique experiment underway involving a completely different funding method for indigent care.

Guest speaker: David Randall, MBA Chief Strategy Officer, UAB Medicine CEO Cooper Green Mercy Health Services Authority Moderator: Tom Robertson Executive Director Vizient Research Institute

Show Notes:

[01:00] Provider operating margins affected by increasing Medicare population

[03:45] Diversifying revenue

[04:50] Global spending budget allows provider organizations to be more innovative and think about capacity differently

[07:18] Current payor system based on sickness and volume does not incentivize preventive wellness care

[09:36] If price wasn’t an issue, it may help payors and providers to focus more on care processes

[10:47] Example of shifting from unit price to episodic cost – cancer care

[11:36] Would be good to have a national discussion between the payers and providers focused on optimizing episodes of care

[12:48] UAB’s fund-flow model is relatively payer agnostic.

[14:55] Have to figure out how to get paid for services outside the four walls of the hospital, such as community outreach programs for mental health

[16:47] Even if we are paid more money, there’s still a capacity issue

[18:44] Global payments example: Jefferson County Indigent Clinic

Links | Resources:

David Randall's biographical information

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