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Today in health, it who I'm watching for disruption in healthcare and what I'd be doing about it. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health. I said, have channels dedicated to keeping health it staff current and engaged. We would have think our show sponsors we're investing in developing the next generation of health leaders, Gordian dynamics, Quill health tau site nuance, Canon medical, and current health.

Check them out at this week. health.com/today. All right. Somebody sent me an interesting article yesterday. It was a CIO and said, Hey, have you seen this? And I have seen this, but I it's a updated. From the last time I took a look at it, me. AMD changes, name to Walmart health virtual care. EMD, which was acquired by Walmart one year ago has changed its name.

To Walmart health virtual care. When Walmart acquired BMD in may of 2021, the deal expanded the retailers healthcare services to urgent behavioral and primary care nationwide. Via telehealth. The company recently launched the Walmart health virtual care diabetes program, a virtual program to help patients with type one type two diabetes and assist employers.

And other institutions. In this next evolution of BMD, we are excited to begin officially delivering services. As Walmart health, virtual care, bringing affordable high quality tele-health options to as many organizations as possible. Bill Goodwin, head of Walmart health virtual care said in a statement.

This is also a win for our current patients and employers who will have access to a wide range of additional health offerings. Under the Walmart health umbrella, the telehealth provider provides enterprise level organizations and groups nationwide with access to telehealth services, which compliment Walmart's brick and mortar Walmart health centers for in-person care.

Walmart virtual care will be available in Florida. Walmart health centers and expand to existing centers over the next several months. The company stated. So there you go. Walmart health virtual care has 30,000 corporate institutional and health plan partners. Nationwide covering more than 5 million members.

All right. So as you remember, the title of this is who I'm watching for disruption and what I'd be doing about it. There's really four areas I'd be watching for disruption. Those who can create a model for care that is not encumbered by high costs. Right. And so this is one of those cases where you have a virtual player coming in. They're not standing up massive campuses with very expensive.

, specialized equipment for doing surgeries or any other types of procedures. They are sitting at a level that is, , fairly easy. To provide care. And if needed,

they can refer to other entities to do higher acuity care. So the players in here that can create a model for care. That's not uncovered by high cost. This is Amazon care. This is Walmart care. , there are probably some others. If I thought about it, transparent is sort of a little bit like this.

But they can create a new model. They can go to the people who are paying for the care. Which in most cases is the employers for the commercial payers and whatnot, but they can also go to other players. There's creative partnerships that can be had here at the end of the day. They are, ,

Unencumbered by high cost models. So they're breakeven on number of patients they see every month is lower and their ability to utilize. , models that drive higher efficiency., is rewarded as opposed to not rewarded as is the case with most health systems. And so that is one of the models I'm going to go through the models and I'll come back to each of them.

, those who have other revenue streams that can benefit from customer pool through this is the CVS and the Walgreens of the world. You know, you bring people into the location and then you sell them. , some other things. , now CVS obviously has a health plan attached to it. So they overlap a couple of

these models. But there is a. If you have other services and other things, other durable goods that you can sell, , or even health products or other things to that effect that you can sell. There's a benefit to standing this up. , those that have a steady income stream to support more efficient care delivery. This is where the payers really come in. They are, pushing and pushing and pushing tele-health.

And the reason is because when you don't go to your primary care physician first, or when you don't go to. The local health system first. That saves them money. They're getting a steady income stream, regardless of if you go to the health system or not. And so if they can do a $25 visit instead of a $50 reimbursed visit, they just made money. So those that have a steady income stream.

To support more efficient care delivery models. And I think the last one is those that have a brand that can charge a premium. And this is fellow health systems, but this is the health systems. That when somebody says, Hey, if I have cancer, I'm going to go to X or Y or Z. Those are brands, right? If I have diabetes, I'm going to go here. If I have a heart problem, I'm going to go here. Those are brands and brands can charge a premium and people are willing to drive a certain distance or even fly a certain distance to go to those brands.

Because when you're in need, you want to go to, , the place that has the best reputation. For outcomes, right. So if I were trying to compete with each of these. You'd have to think through the different models. I think clearly that the. Health systems that have figured out how to be payer and provider.

Are going to do better than others. Those that have figured out a way to take on risk, understand their costs. And I think that's the foundational item. They have to know the cost of delivering care. If you know the cost of delivering care, there's a lot you can do to be more effective and understand the levers for the cost of delivering care.

There are so many health systems that if you went in and said, what is the cost of this? Or that, or whatever procedure. They would not know. What the costs are now they're generating a bill and an invoice for it, but they would not know their costs. And , that's a losing proposition. Long-term so.

I would say, you have to know your costs. You have to figure out a way to get a population that is committed to you on an ongoing basis. That's delivering to you a revenue stream, that revenue stream and that. Managed care population that you were overseeing is going to give you the ability to experiment with tools.

That are going to be critical. , down the road, right? It's going to be critical to drive down your cost of delivering Medicaid and Medicare. And so that's going to be very important for you. To have that foundation of, even if it's a 500,000. Patients or 200,000 patients or a million patients. , that you have a benefit of delivering care more efficiently, more effectively.

And you can create those models within your health system. And then as the government models change, you can adapt because you're going to have those skills. You're going to have built those things out. If you don't have those skills and things change. That's when it becomes really hard. When you have to change on a dime.

That becomes very hard. So you're going to want to build out these capabilities. And This new muscle, if you will, for your health system. And so the other revenue streams, you're going to compete by going directly. , at them by picking up some of those patients and creating your own population that is.

Relying on you to deliver health for them. And you're taking risk on that. , those who have a steady income stream. ,

Those that have other revenue streams that can benefit from customer pool through, , we are looking at as health systems. We are looking at other revenue streams. I just don't think we're looking at it correctly. We're standing up services that other health systems will purchase. Right? So we're standing up service organizations, we're standing up.

, revenue cycle companies were standing up, , various, , investments into health technology, hoping that other health systems will purchase those. And we'll get the big payout on the other end. , to be honest, I don't think we're that good at venture capital. , I think we're going to have a win every now and then, but, , for the most part, we're just not that good at it.

And so, I don't know, maybe we could get better at it, but I think that's a skill in and of itself. , I think if you're looking at other revenue streams, you've got to look at the customer at the end of the day. , it's the health system that develops , a strong, sticky relationship with the customer. When I have health needs, I go to this healthcare provider. That's going to be.

A winning. , play over time. And then finally those that have a brand can charge a premium I'd work on your brand and your brand is based on a lot of different things. It is based on marketing. It is. Us news and world report. Rankings and those kinds of things. , you know, there's, there's just a whole host of rankings out there that can improve your overall brand, but understand that brand is in the perception.

That the public has of your house or something. So you're going to want to improve outcomes and whatnot, but you're going to want to get that message out there. At the end of the day, when somebody says, Hey, I have a cardiac issue. , I could either go to that brand or I can stay local. They have to feel good enough about the local brand to stay local. And so we should always be working on our brand, highlighting our brand and making it.

More, , I don't know, polished as we move along.

So, those are just some of the things

I know this is kind of scattered. But I think if you look at your markets, who are the disruptors in your markets, is it those that have a model for care that's has low costs. They have other revenue streams that they're benefiting from their customers. They have a steady income stream. , to support more efficient care delivery or they have a brand, or do those exist in your market? Are there others in your market?

And then develop the plans that you believe are going to be able to compete. I believe brand is going to be key. Moving forward. You just have to continue to work on your brand. And make sure that you are considered a high quality. Place of care. I believe you're going to have to build a, , at-risk population that you are managing their health. Long-term.

Give you the ability to build out tools. , I believe you're going to have to look at other revenue streams, whatever those might be. And those could be health streams. I'm not really sure at this point, but, and it might depend on your market where those other revenue streams come from. And then you're going to have to figure out a way to Perry, the efficiency and the access benefits that some of these new care models have, , be thinking about taking those populations that you may not have served that well and rethinking.

The overall experience, think about , the diabetes patients, the oncology patients and the others. Those are just some of the things that are top of mind for me, that's all for today. If you know someone that might benefit from our channel, please forward them a note they can describe on our website this week health.com or wherever you listen to podcasts.

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