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November 25, 2022: As a part of their mission to revolutionize America's healthcare system, Dr Chris Chen, CEO of ChenMed and his brother Gordon Chen wrote the book The Calling: A Memoir of Family, Faith and the Future of Healthcare, to shine a light on how an expensive, uncoordinated, and confusing system works for itself at the expense of suffering patients. The Calling tells the story of how ChenMed, a physician-led, mission-driven company, is transforming care of patients from forgotten and underserved communities by taking a proactive and preventive approach to care.

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Today on This Week Health.

ChenMed is revolutionizing healthcare and it's to bring light to some of the darkest and most marginalized and forgotten communities in America. You know what most people don't realize is in any given city in America today, you have a zip code in which the average life expectancy is 20 to 30 years less than the wealthiest neighborhoods in that exact same city.

Thanks for joining us on This Week Health Keynote. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a channel dedicated to keeping health IT staff current and engaged. Special thanks to our Keynote show sponsors Sirius Healthcare, VMware, Transcarent, Press Ganey, Semperis and Veritas for choosing to invest in our mission to develop the next generation of health 📍 leaders.

All right. Today we're joined by Dr. Christopher Chen, CEO of Chen Med. Dr. Chen, welcome to the show.

Hey, bill, God to be. Yeah, I'm looking

forward to it. Just finish your book and I'm looking forward to talking about the book. I'm also looking forward to talking about value based care. So much is going on in healthcare right now. A lot of challenges, and there are some that are struggling to make transitions. They're saying they're trying to make a transition to value based care and they're making it's real challenging. So, we're gonna talk that, we're gonna talk a lot of things, but before we get there the book is called The Calling, A Memoir of Family, faith, and the Future of Healthcare. And you and your brother wrote this book. What was it like to write a.

I tell you what, right. I'm trained as a doctor, heart doctor, and I love to build businesses. And so writing has never really been a part of things I've been trained to do. But we really wanted to get the story out there of what's really possible when it comes to healthcare transformation.

And the journey that our family went from being homeless at one period, to the point right now where we can have a company that most people in healthcare know about. We were also recently honored that our book just was awarded the Global Book Award. So that's certainly exciting and unexpected, but we're really humbled by.

it, it's an amazing book. We're gonna walk through some of it cause I think it lays the foundation for value-based care conversation I wanna have with you. But let's start with where's Chen Med today? Tell us about Chen Med, what you do, what's the foundation and where you guys are at in terms of the growth of the organization.

ChenMed is revolutionizing, healthcare and it's to bring light to some of the darkest and most marginalized and forgotten communities in America. You know what most people don't realize is in any given city in America today, you have a zip code in which the average life expectancy is 20 to 30 years less than the wealthiest neighborhoods in that exact same city, sometimes separated only by three miles.

And the reason is because we actually have health deserts, we have places that are forgotten. In this country that leads to that 20 to 30 year life expectancy. So Chen Med builds centers there. we operate over a hundred senior medical centers in about 15 states in, around somewhere between 30 and 40 cities.

We're adding about roughly 25 to 30 new medical centers every year. Our patients, as you'd expect given because they live in these communities, are amongst the oldest, the sickest, the poorest senior citizens in America with 70 to 80% of those seniors being underrepresented minorities. And so on average, our patients are over 70.

They have five or more major chronic conditions. They're on fixed incomes and they don't have great access to care. And so we honor these seniors with what we call affordable vip. care That delivers better health. and here's the, here's the results for the patients that we take care of. We reduce our hospitalization rates by 30 to 50%, almost in half.

And That helps 'em live. On average, we believe, five years or more or longer, and and, there's some early evidence that could even be up to nine years longer. So we're adding life and because of these results that we are achieving, not just in one geography, but in all of these geographies, we are either achieving these results or on path to achieving these results.

Fortune Magazine named us on there change the world list. There was 55 companies in the world, big companies. You heard about Google, Amazon, Tesla. We were on that list amongst the 30 companies in the US and only one healthcare provider was on that list. And so the other thing that we were recently awarded as well is Newsweek Magazine comes.

With a list of the most love, America's most love workplace. So if you think about Fortune magazines, about the impact you can make, right? To change the world list on Newsweek Magazine, they wanna say, well, how do your employees like? Being there at Chen Med for the second year in a row, we are the number one healthcare provider on that list, and we moved up to some in the thirties where we were in the first year, still number one in healthcare to this year being number eight in, of course, still number one in all of healthcare. So certainly proud of what the team has been able to accomplish.

So Dr. Shay, can I call you Chris? Chris, please. Okay. So Chris , poor, underserved, underrepresented aging population with multiple comorbidities. This is not what they teach you in business school, right. And, and, and somewhat. This gets back to the title of the book, the Calling.

But you know, it's Forbes. It's. All these accolades are kind of interesting given the foundation for this. They wouldn't teach it in Harvard Business School. So tell, tell us about the foundation. Actually. What I'd like you to do is tell us about the foundation of faith that, that drove ChenMed.

Yep. So our goal wasn't to build a company that was gonna change the world, that wasn't our initial ethos. We realized that there was a, a big problem in healthcare. When I was training to be a doctor, I was in New York at the time, finishing my cardiac training in, in at Cornell, in Manhattan.

And I got a call from my mother, and my mom says, you. Son, come home. Your dad has two months to live. And so when my dad was diagnosed with cancer, our family actually experienced what healthcare is and what healthcare isn't and the fact that it just doesn't work. We actually suffered at the he hands of healthcare system where the healthcare business succeeds when patients.

The sicker people are, the more challenges they have, the more complications they have, the more covid the more cancer, the more heart disease, the better the the economics are for healthcare. And so we got to experience what that was. And quite honestly, we realized that healthcare was expensive.

People keep raising prices. We realize the right hand doesn't know what their left hand is doing. In my dad's body at the time, and he was getting treated for all this cancer. Shoot, don't the lungs and the heart work together? Well, how come they don't work together in, in, in healthcare, in our healthcare system?

And then we also realized it's in general very ineffective. And all of these things I just talked about, expensive on, coordinated, ineffective. It's far worse for those who are under. If you don't have great access, you live in the wrong neighborhood, you have one parent instead of two parents, you have the color of your skin is not correct.

You have a have a blue collar background. It doesn't work for you and for your families, and it gets worse as you get older. And so we were determined to help others avoid the suffering. You started with one medical center and we wanted to demonstrate could we change? The way the healthcare is delivered, rather than waiting for people to get really sick and almost dying, and then rush in there and try to rescue them and then charge 'em a whole bunch of money.

that's, that's existing healthcare today. Right? Could I, could we create a system in which we didn't just look at pills, procedures, and referrals? Could we look at the whole. Could we think about their lifestyle, their behaviors, exercise, diet? Are they getting their Social security checks stolen?

Are do they have access to healthy food? Can they read the literature that they get from doctors? And then what we also say is, can we then start thinking about prevention, waiting for people to have a heart attack? They already have heart disease before you have a heart attack.

They've had it for 10 or 20 years. So can we move upstream? And prevent these things from happening. And the answer is yes. And that's the reason why we're so proud about reducing hospitalization rates by 30 to 50%.

it, it's amazing. You actually see these patients more often. In fact, you tell a story in the book. Which actually doesn't reflect on you all that well, but it's essentially that you saw a patient and you're like, Hey, yeah, I'll see you in a couple of weeks. And you did the normal thing like, Hey, here's your meds. I'll see you in a couple weeks. And that didn't turn out so well. And I, and I think it was just your front desk person essentially looked at you and said, Hey, that's not the way we do things here,

it's an amazing story. I think of what I wanna come back to is why does this work? Again, this is in a fee for service model. It is sick care and the sicker you are, the more money we make. Why does this work? Seeing the patient more often fixed income, actually worrying about where they live. Are they getting their social security checks? Do they have a family that cares for that? How do you incorporate all that and still not lose money? Cause that's, that's what traditional healthcare's struggling with.

ChenMed works because we focus on prevention rather than sick. care I mean, just exactly what you just said, and, we're talking about a 3.8 trillion industry that really in general is working only for a few folks the grand minority of people.

And so ChenMed turned away from that traditional sick care model because it promotes a culture of sick care. And it's like it celebrates when the country is sick and it operates on a currency of. billing Success is based on profit. And so instead of prioritizing tests, imaging, referrals, we prioritize doctor patient relationship.

Now, there's nothing wrong with profit, but when you tie profit, that is, you know that that goes up when people get sicker. You got a problem. And so our model's very different. Our PCPs, because they're incentivized to prevent problems, they have smaller patient panel size. They spend on average more time with patients.

The recent data that I looked at is we actually spend more than 10 times the amount of patients time with patients than the average primary care provider does for Medicare patients 10 times. And then we build trusting relationships with them and we focus on. Yes, they're medications but also their lifestyle changes.

They're what we call these other social factors that can dramatically impact their health, and this is what we call transformative care. So there's traditional primary care. There's advanced primary care, which is what most folks are, are trying to accomplish, where they're moving along the value-based care continuum.

And then there's where we are, which is the furthest along. We are the tip of the spear in this value-based care continuum. And we call that transformative care because quite frankly, we have evidence for years that we've been able to transform patients families. Their communities, how medical training is done.

And we've even been able to transform doctors doctors today have a high burnout rate, but we actually transform the way doctors practice medicine by moving them into a preventative world and asking them to look at the whole patient and focusing on the fewer, sicker patients than delivering healthcare to the mass.

And so we can't expect a few who profit from this system's wealth to change it. I mean, it's, it's amazing thing like you if, if large hospital systems today own healthcare, which they do, they're the largest employer, the largest voting entity in most cities in America today. And they basically controlled that much revenue.

And you said, Hey, can you create a system that fundamentally disrupts. Healthcare in the United States today. And by the way, this disrupts your your revenue model. The answer is they won't be able to do it. And I, and also they're consolidating, so they're getting more complex as well, so that makes it even more difficult for them to transform.

But it's up to a few and a small group of courageous people who are gonna take on a system that right now, I mean, at least the data that I looked at, US healthcare is what, four times the size of. Right. And so it's our moral imperative we believe at ChenMed to fundamentally disrupt that system and to, and to figure out a way to show a path to better healthcare that actually leads patients and people to be healthier. And that's in the book as well,

📍 📍 Conference season is upon us and our this week, health team and I will be at the Chime Fall forum celebrating their 30th year in San Antonio. And we're also gonna be at the HLTH conference, HLTH in Las Vegas the following week. While at these events, we're gonna be recording our favorite show on the road, which is interviews in action. And as you know, what we do is we grab leaders from health systems, healthcare leaders from across the country. And we capture 10 to 15 minute conversations with them to hear what's going on, what they're excited about, what are their priorities, and those kinds of things. It's a great way for you to catch up very quickly on what other health systems are thinking and doing across the industry. We actually air this on the community channel this week, Health Community. It's the green one. So if you go out onto your podcast listener of choice and do a search. This channel is also where community members like yourselves have been invited to do interviews of their peers. So check those out as well. You can subscribe wherever you listen to podcasts. Look forward to catching you on our interviews and action. 📍 📍

so you have to partner with acute care systems and you, you talked about the story with your father, and I mean, obviously having physicians in the family, you were able to identify some things, and that's one of the biggest frustrations when people are sitting there in the hospital and they're like, I, I, I don't know what to do, how I don't know what to do.

I don't even know how to represent the, the my family member who's sitting here. And you, you're looking at it, you're going, man, they're just not spending a lot of time here and it's hard to get the person that's supposed to be here. And that's how you're experiencing it as a doctor. You're sitting there, you have more knowledge.

You're going, Hey, look, we, we need to see the car. I mean, people don't even know the, the names. And you're saying, Hey, no, we need to see this person, this person, and you're doing research and, and that kinda stuff. How do you represen. How do you partner with acute care hospitals? Cuz you don't run acute care facilities I don't think at this point.

And then, and how do you represent your patients in those situations?

there is, I mean, acute care hospitals are just absolutely critical. Absolutely critical. I mean in my book I talk about how my dad had a near death experience with his fight with cancer. I talk about my near death experience.

I, I got covid at an early stage in the, during the pandemic. And which is weird because I was like a extremely well trained semi, almost a heat triathlete when I got sick, and I found myself within a week. Fighting for my life and an intensive care unit in a hospital. And, and let's be clear, that hospital saved my life.

So we need acute care hospitals. They're so important. CHED needs acute care hospitals. We cannot prevent every bad thing from happening to people or to our patients. We can't prevent them. People getting car accidents, they still have heart attacks. They still have strokes. We just cut them down Substantial.

Right. And so we do work very closely with acute care organizations. When our patients do get sick, we're deeply connected with them. We do not. It's unfortunately healthcare we have, we call it dropping the ball because everybody just drops the ball. They, every time you go to see a hospital, you go to a different specialist.

It's nmp not my problem, it's somebody else's problem. So the balls are being dropped. We do not do that, and we work closely. Now what's happening now is hospitals are kicking our doctors outta the hospital. Sometimes you have, you have good hospitals that are like, Hey, let me figure out how we can work together in taking better care of your patients.

What's more coordinated? We can prevent people from getting admitted again. And you're doing a great service to the community. And then there are hospital systems that are saying they come to us and they say, Hey, we know what you're trying to do. We know that you're trying to prevent people from, from getting really sick and coming to the hospital and when they get here, we really don't want any part of you coordinating that care.

And they're kicking our doctors out of the hospital. We're certainly not okay with that. Very little we can do because hospitals are so big. But, but there are great hospitals out there that are making a huge difference and they're trying to transform. I just think it's gonna be hard for them to t.

Yep. Well, the, the model scaling and that that obviously brings up a whole host of new challenges. How do you ensure that same model of care is happening across the entire organization?

We have one of the key people at Chick-fil-A, the former cfo buck McCabe on our board. And so let me just use this as a, an example. And also we have the founder of the Ritz Carlton as well on our board. And like the Ritz like chick-fil-A, if you've seen one. You can and you'll get the exact same sandwich and you get a similar experience no matter where you go. And that's, that's what we do here to men.

We were, I was in the book, we talk about that. I was told not to try to scale healthcare because healthcare is always local and you can't get a replicable result. And you can't get a replicable experience more importantly for that patient. And the answer is you can. We, we put a medical center in these most underserved, in these highly underserved communities, and we get the same v I P care that delivers better health.

We keep our patients healthy, and when you keep our patient healthy, it creates more revenue for us to grow. And then we also have a scalable culture. Our culture is based on three important themes, love, accountability, and passion. People say, Chris, it's like a cult. And I go, yeah. Where do you think the word cult comes from?

Comes from culture, and we're in insane about love, accountability, and patient passion for our patients. And then we have a shared vision, mission, and service standards, and we literally repeat them every day. I don't mean figurative. We start the day reminding ourselves what our vision is, what our mission is, and what our values are, and then we have an outcomes based approach that works.

Each physician goes through tremendous training and retraining. To, to learn how to practice this system, and then we actually hold our doctors accountable for delivering great results. So in a typical fee for service environment, this has been studied by the general me American Medical Association surgeons who have more complications, make more money in fee for service, and ChenMed doctors who have better patient.

They are more successful. It's exactly the opposite. And so we train them rigorously. We, we reward them for being better doctors, and then we also then give them incredible enabling technology. We have an entire technology stack that supports those doctors and their care teams all around that environment that is mission driven and laser focused on the.

All right. I'm gonna come back to the technology cuz that's my background as a cio. Yeah. But I do wanna ask, how do you hire, cause it's interesting what you're describing is a place where the clinicians are happy but but. if you hire from some of those areas, you probably really do have to reprogram almost

I've been told not to use the word reprogram, so, okay. But, but but great concept, and I know you have a technology background and I, I'm crazy about tech as well, so I love the word programming, but you know, in reality selection is absolutely critical. I mean, the number of people that wanna join the ChenMed organization, we are America's most loved workplace two years in a row, in healthcare Where love is supposed to be really critical. Okay? And so being number one in the country, two years in a row means you have to select for the right people. And so we are absolutely looking for the right people. We're looking for mission-driven people, people who, who really care about bringing light to the darkness, not just talking about it, not ignoring it, but actually bringing light every day to the darkness.

We want people who wanna win when patients. win Okay, so we, we have this concept in our visions. We say everyone wins. And so we're looking for those kind of people. We're looking for humble people that can learn and help us learn. Why? Because we're inventing a new kind of healthcare. We are inventing preventative care.

It doesn't exist today. I, I had it at 1.5 board certifications in cardiac vascular diseases, and I never even took a 30 minute class on how to fundamentally heart disease through lifestyles and behaviors. And so when a doctor joins ChenMed they first need to unlearn, we call it sort of decoding, so I'm allowed use that word, decoding.

Everything they've learned in training in terms of the way that you manage healthcare is by rescuing people from dying. Rescuing from people from dying is critical, but the way you make the biggest impact is you gotta move upstream and you gotta focus on outcomes. So let me talk about that for a. second I have four kids.

They all play sports. When they're young, they play soccer. They're so cute. They kick the ball in the wrong goal. They lose every single game. And you know what? They get the end of the season. A trophy. That's right. But when they turn eight or nine years old, I sit them all down and I said, I'm sorry. That's not the way the world works.

The reason why you didn't get a trophy this last season is because in the real world, you only get a trophy for winning for a result unless you stay in. healthcare If you're in fee for service healthcare, you get a trophy for showing up. A doctor, a hospital system gets paid. You're a surgeon, whether they make a mistake, they kill your mom, or they fix you, it doesn't matter.

Gets a multi-thousand dollars trophy and the hospital gets a $20,000 trophy. And by the way, they get a second trophy, each of them if there's a complication. Hmm. So we've gotta stop that type of methodology. So number one. We gotta move upstream, teach our doctors how to prevent bad things from happening, which we're like one of the few organizations in the world today, or at least in the country today, that is really focusing on creating that style of medicine, number one.

And number two, you gotta start holding people accountable. Doctors and their care teams accountable for results. And you know what? That's doctors want. that They were like top of their in undergraduate class, they had best grades straight A's they were competing in medical school. And they love that validation of being, having their patients win and having them win as well.

And so, in my opinion, if you wanna know one of the reasons that there's huge burnout in healthcare today, it's because nobody thinks what they do, they do really makes a difference. And in reality, they may be. correct They may be correct. We have a problem in this country where the average life expectancy is going down.

That means we're doing a worse job in improving health every year. And that was before Covid. During Covid, it made it worse. And number two. Healthcare is getting worse for the poor communities. So we have a massive divide. The rich people are living longer, poor people are living shorter. Even though the whole average is coming down, rich people are suddenly living longer.

Poor people living shorter. So we have massive inequities being created in healthcare and getting worse. And then number three, during a time where costs are going up, prices are going up, you're in the tech of business tech. Every year you get more for your. You look at your flat screen TVs for $600, you can get this massive big screen, flat screen TV that used to cost $10,000 for something that was a quarter of the stop.

📍 📍 All right. We'll get back to our show in just a minute. We have a webinar coming up on December 7th, and I'm looking forward to that webinar. It is on how to modernize the data platform within healthcare, the modern data platform within healthcare. And I'm really looking forward to the conversation. We just recorded five pre episodes for that. And so they're gonna air on Tuesday and Thursdays leading up to the episode. And we have great conversation about the different aspects, different use cases around the modern data platform and how agility becomes so key and data quality and all those things. So great conversation. Looking forward to that. Wednesday, December 7th at one o'clock. Love to have you join us. We're gonna have health system leaders from Memorial Care and others. CDW is going to have some of their experts on this show as well. So check that out. You can go to our website thisweekhealth.com, top right hand corner. You'll see the upcoming webinars. Love to have you be a part of it. If you have a question coming into it, one of the things we do is we collect the questions in the signup form because we want to make sure that we incorporate that into the discussion. So hope to see you there. Now, back to the show.

📍 📍 We've talked about this on the show, healthcare is the only place where we've invested more and more money in technology and we get less and less efficient for whatever reason. And actually the, the experience for the clinicians gets worse and worse. I do wanna talk to you about the technology cuz as I was reading your book, proprietary EHR System, And that that sets off a few things as I think about it.

One is it's probably the least expensive option out there. Cause I've seen some of the contracts from some of the EHR providers who are out there. Let me just start with this, with the one word question, which is why, why a proprietary EHR system?

At 10 med technology is the fuel that drives our ability to disrupt healthcare and. It's really critical and compared to anybody else out there who is also trying to transform care, we're differentiated in that we. Probably spend 10 x on technology development and some of those other sort of disruptive companies out there. And and I think that's the approach that we've taken that, that actually sets us apart in terms of outcomes as well.

But as you mentioned, we have a homegrown electronic medical record system, but it's not just an electronic medical records, it's an entire technology stack. And what that technology stack allows us to do is, It basically requires doctors to do less documentation and it allows physicians to make concise notes, which enhances their productivity.

In addition to that, we are able to customize the right information at the right time directly into the workflow. What workflow? Workflow that we create. Let me explain this. If you pull something off the shelf, all the technology providers that are delivering electronic medical or electronic health records, all, all their clients, or the majority of them, 99% of them are fee for service clients.

And so if you are going to charge somebody, Hundred million, 500 million, a billion dollars for electronic health record system. Every single CFO of that company is gonna go to their board and say, here's the roi, here's the return on investment. And the way that fee for service systems make money is by making care more expensive.

So what do you think the EHR is designed to do? It's designed to facilitate workflows that make care more expensive, less coordinated, more complex, which increases revenues for the health system, which thereby allows them to afford this technology. We do exactly the opposite, right? We're trying to make care higher outcomes, lower the total cost of care, and we have a brand new set of workflows that, by the way, hasn't even been fully invented yet.

We're just ahead of everybody else, but we think we've only figured out about 20% of the answer. So we have to create those workflows, embed them into the tech, and then get the comp, get all of this other data from the home, from insurance companies. Public data, whatever it is, chew it up, give us insights, and inject it into that proprietary workflow that's enabled by technology at the right place, at the right time.

You know what, that's so far away from how any technology provider these days are thinking. And so therefore we took the painstaking effort to actually go and create our entire technology stack. We had this looked at by a third party global leading consulting firm, and they said, Chris, an EHR is only one of the important pillars of technology that is necessary to delivering better outcomes in a value based care.

We've actually looked at all seven of those pillars. And, and, and yes, you have an ehr, but it turns out you also have a leading sort of position in all of the other six pillars. And I said, oh my gosh, that's great news. And they go, no, that's not the great news, Chris. I go, oh, oh, then what's the great news?

It's integrated. Okay, so you're, you're a cio so you get it. We have the only fully integrated stack cuz at the end of the day, Technology doesn't talk to technology. It's very hard to get technology companies to get along cuz they're all trying to manage their own proprietary information and logic and workflows.

So getting them fully integrated is almost impossible. So that's the reason why we had to create our own stack.

And that's, and that's why if patients are listening to this, that's why when you go, you're in the same health system and you go from one spot to the next, to the next, even though it's the same ehr, it's, I mean, some of that information is flowing just, just nicely.

But some of the other information is not because it's in different systems and the it, the integration work is, is so difficult. But I guess the question is, Have you been able to integrate with the rest of healthcare? Right? So we have the we have 21st Century Cures, we have open notes and all these other things and, and whatnot. Have you been able to integrate with the rest of healthcare?

So so first of all, let me, let me be clear that a lot of these health systems have these complex EHR s They're not bad people. They're incredible people. They, they saved my. And they're full of heart. The problem is, is that the incentives are fundamentally flawed and therefore the technology that is designed to enable that, that purpose if you will, that sort of process is also subsequently flawed.

There's nothing wrong with the technology. Technology, it enhances what you're trying to accomplish. Yeah. And so, well,

I think that's what I hear too. It's, it's good people being plugged into a bad system. Yes. It's, it's just frustrating and, and that's why I think we're having so much clinician burnout and whatnot in the system.

Yeah, I mean, listen, if you go to work every day, even as a technologist, and you said, my goal is every day is to come in here to make sure that this hospital system can bill more money and charge more dollars and put more people in, in bankruptcy, that doesn't feel good, they're gonna burn out. All right?

And it's, you're not gonna work long hours to do that. And so it, it's just, it's really, really difficult. Now, back to your question about getting healthcare things the, the different systems to talk, there are systems that are great out there. They, they, they're, they, they're trying to do a great service to the community.

They, they were formed for the right reasons. They still are doing it for the right reasons. They're letting our doctors in their, in their hospitals, we're coordinating the care and even our technology stacks are talking. So when they leave the hospitals, we get information. When they go in the hospital, we give them information.

It's wonderful. And then there are systems out there that are tend to be a heck of a lot less attached to a mission. Delivering better care for their communities. And what we found is they will kick out our doctors. They don't want to integrate their information with our information. They use that information as they keep patient information hostage.

We ask for medical records. We have to call them four times, not because they're inefficient. They're clearly highly efficient. Some of these organizations, and they're very well run, they just, we just never get them. And so the answer is it's high. There's a high degree of variability. Because there's a high degree of variability of health systems that we work with in the 30 plus, I think 33 or 34 cities that we work in, we at Chen, me can't be highly variable.

We have to be steady Eddie and deliver an incredible experience and an incredible health model to our patients. And, and so do we want information from hospital systems Yes. And from others? Yes. Does it help us deliver better care for the patients? Does it prevent us from delivering superior outcomes?

Absolutely not. Even in our worst neighborhoods where we have no partners and nobody's trying to help us, and actually some of them are even trying to prevent us, we are still able to deliver incredible results. 30 plus percent reductions of hospitalization rates, 20 plus percent reductions of stroke and be, I mean, here's another statistic we just got recently.

Do you know we double cancer survival rates at six months? If we came up with a. And I said to you, bill, I'm on your show. I have a drug here that doubles cancer survival rates at six months. That would be a trillion dollar drug. I didn't just say one. Cancer. Cancer as a whole, we double cancer survival rates.

At six months, it would be a trillion dollar drug because it would so many people would need it. That's what we are doing today. We are able to substantially impact. The outcomes of our patients in a scalable fashion, despite having to work with highly variable healthcare in every system in America today.

Do health system leaders and payer leaders seek you out to find out what you're doing?

Oh, absolutely. We have payer systems, they. Love working with us. We deliver top tier everything for them and for their, for, for patients that we share in common. And and it's, it's been a blossom. They have great data and they're, in general, our relationship with payers have been very positive.

with health systems they are reaching out to. We've never seen before, which is just incredible. The number of systems that have called us in the last six months to a year. We've always had a large number of people calling. Now our phones are ringing off the charts of saying, Hey, can you help us think about how to transform care?

And that's what gives me hope. Bill, I'm so hopeful about this, cuz for the first time they looked at their, they looked at their models and they said it failed during. It's getting worse now. Many of these hospital systems have negative margins in this last quarter. They don't see a good long term future.

They don't, I mean, I don't know a single hospital CEO that's excited about being a hospital ceo. It, it's, it all looks grim. So they, so they're looking for like something else. And quite frankly, they're all amazing people. So they realize that there's a system isn't working. They're, it's not working for people.

It's higher cost, worse outcomes. So they're calling us, and you know what? We're taking those calls and if there's anything we can. To sort of help help them on their journey. We are certainly open to exploring those things. I mean, bill, even the majority of all our competitors, we inspire them, possibly even a hundred percent of those competitors.

We inspire them, some of which we even gave them a playbook to some extent, right, to help them because quite frankly, checked cannot deliver care to the number of people that need this care. I mean, we have a multi-year plan that gets us to three. And so my board brings up this point, they gimme a hard time.

They go, Chris, you have a solution here. Does many things. But just take for example, your cancer thing. You, you, you, you double cancer survival rates, or how about the fact that we believe that we extend life by five, seven or nine years? So tell me you now have a cure to add life and, and it's. So tell me how you're distributing it to the people who need it and are dying Every day and I go, yeah, over the next five years I might get to 3% and they look at me and they go, how do you, how do you sleep at night?

And I go, well, not well now. So this is the concept of we gotta get the word out. Oh, that, that's the reason why we wrote the book. I mean, the book is full of intellectual property full. Absolutely. And, and she's like, Chris, are you kidding me? You went and published like how you, how you guys did what you did. For everybody to read and understand, the answer is yes. American,

If I were on your board, I'd be pushing you to partner with some of these national IDNs. Yes. I'm gonna take, I'm gonna take you there in a minute, but it's interesting cause I just, I just got back from the health conference, HLT Conference in Vegas and a significant number of panels on health equities, I think cuz the pandemic.

Absolutely just displayed the health inequity that we have across the country. So I think this is the right solution at the right time. But two closing questions here. The first is faith-based organizations spend a ton of time, a ton of energy. I, I was actually in a. Catholic health system in Southern California and we, we went through foundation formation for about a year as a leader, and then we went through another three year program after that to make sure that we understood the foundation in the traditions of the founders.

How is Chen Med going to sustain that culture and its mission into the next century? Have you thought about that?

So first of all we are absolutely intentional about passing this along. Mom and dad started this on this journey the right way. My brother and I and and our wives believe it is our job to pass it on to our kids, but not even just our kids.

The reason why we wrote the book is cuz we wanted to pass it on to others. The reason why we are working with health systems and we're talking with them and, and even potential competitors. Why? Because this needs to pass on and it needs to pass on broader and it needs to pass on. In our family's generation to generation, we've never wavered from our family purpose.

Our vision and our. And the reason why we created is we wanted to glorify God by spreading more love and promoting better health, all that come in contact with us, and we stay very true to that. And so we've continued to grow. We grow 30 to 40% per year. In the coming years, our intention is to hire thousands of primary care physicians and again, retrain them in this new model.

Perhaps even start to do that for other institutions. Right. Who can fundamentally benefit from this. We just recently gave contributed a lot to the University of Miami to help create a, a leader and a leadership program in health equity and in population healthcare. So we can continue to drive things in that direction.

We wanna partner in our, continue to partner with other academic institutions as well. So, But I guess the next phase of sort of our life is not just to continue to grow the business, but how do we grow the impact of what we've learned from the business in through America. Down through our own children and the people that God has asked us to raise as our children.

and then propagate this sort of generation to generation mission to taking care of the most underserved people.

3% is not enough. Wow. That's a, that's a tough call. It's interesting as you were talking there. I was thinking do I remember it's to extend the healing ministry of Jesus Christ in the tradition of the Sisters of St.

Joseph to the communities and the underserved in our communities. And actually the last end, I don't get, but the first part I do remember because I was in meetings. Where we were talking about sharing data and I, I, I said yeah I don't think that that's a bad business decision to share data in that way.

I was one of those evil people saying, I'm not sure we should share the data, and the sisters just looked at me and said, is it the right thing for the community? I, and I said, yeah, absolutely. They said, then do it. I mean, it was like there was, because this is, this is our mission. We are serving this community in the tradition of the sisters to extend the healing ministry of Jesus.

You do it If it's best for the community, don't talk to me about the, the business outcome. And it's that foundation. I, I'll remember that meeting for the rest of my life, cuz. As, as a follower of Jesus, for me it was, let's just, like, it smacked me across the face. Like, what were you thinking to even say those words?

Anyway I do wanna give a hypothetical for you if you were I'm gonna make you the CEO of a, of a faith-based idn, let's say 50 to 75 hospitals across the country. How would you envision the path to get to value based care? You have, you have all these outcomes that you're looking at. You know what you know, and we just made you the CEO of this large idn. What path would you take?

Well, the first thing is I, I would create a path to transformative care, just like we did at Chen Med. Now I get it. It's easier to build something from scratch and make it big than it is to take something really big and try to transform it. But listen, transformation. Requires courage and it is not something that happens overnight.

Okay? And you gotta be intentional about it. And you gotta be steadfast. Just like when you got that positive feedback like, Hey, do you remember what our mission is, what we're trying to accomplish? Everybody wants to win, but we have to make sure that we're winning in the right way. And so getting everybody focused on winning in the right way and on a path to transformation is really critical.

A faith-based hospital system is a. Place to start. And there are, there's a great deal of variability, right? Some faith-based health systems do not operate like faith-based systems. They have business practices that would not honor their faith. In any way, shape or form. And then there are faith-based systems where, by the way, there is a sense of accountability in that organization that when there's drift, that will always occur, that you can bring it back together like the story that you just brought up.

And so we we also need policy makers to align incentives for better health outcomes. We've gotta start putting people at. When you take financial risk, the speed at which people can move and are willing to move dramatically changes trying to get people to move along in transformation without that massive incentive, upside and downside.

Is just not going to work. And so what you do is you, you create the environment that says, Hey guys, we must solve this. It is not an option for us to not solve this because we have downside risk, so we're gonna solve this. And then you realign people to those mission vision values that that created the organizations.

That's number one. Number. And then the next thing I do is you gotta engage doctors and, and the care providers you got to, you cannot continue to treat them like short order chefs where you know, here's your order, bring the bell. I don't care if it's good or not. Just do your job. Give me volume. You've got to start to get caregivers involved in creating the outcome and giving them the tools and feeling empowered to create that outcome.

And the best way to do that is you gotta take the bottom today and move it to the top pcp. The reason why Chen Med is such a beacon of hope for primary care doctors, why so many of them wanna join us is because primary care doctors are at the bottom. They're at the bottom of healthcare today. They feel like second or third class citizens who's at the top, the highest revenue producers, orthopedic surgeons or neurosurgeons or whatever surgeons they're at the.

If you want a system that is focused on delivering better outcomes, you can't have it led by the specialists. You have to have 'em led by the generalists, the P c P. So at Chen Med, PCPs are at the top. That's why they wanna work for us. That's why that, that we get tons of applications and calling people, calling us and saying, we wanna join you guys because A, you're not working for an insurance company and you're not working for a health system in which you're at the bottom of the barrel. Yep. Okay. So that's sort of in my, and we lay this out a lot of the book actually.

Yep. Dr. Chen, I wanna thank you for taking the time. I wanna thank you for writing the book and I appreciate it on, on, on a lot of different levels. And I do believe that it gives us hope, gives us hope for the future of what healthcare could be for all of us across the board.

Bill, thank you so much. This was a pleasure. 📍 I'm inspired.

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