Relentless Health Value

There was great hope for consumerism. By pushing the burden onto patients/employees to find high-quality care at a fair price, we assumed that health care delivery would level up. But anyone seeking to validate this hypothesis would be pretty hard pressed to claim any sort of broad-stroke success beyond cost shifting by brute force.

It turns out that providers wield a lot of influence. And if we want to create high-value health care—high quality at a fair price—we need to contemplate the recommendations that providers are making. These recommendations especially matter because a patient’s entry point into the health system—where they go first—can make all the difference. Today I speak with Ashok Subramanian, CEO and founder of Centivo, a new kind of self-funded health plan.

You can learn more at centivo.com.

Ashok founded Centivo in 2017 after observing the inefficiency in the health care system and the pain that has resulted for employers and employees.

Prior to Centivo, Ashok co-founded Liazon, operator of the nation’s industry-leading private benefits exchange for active employees. Liazon was acquired by Willis Towers Watson in 2013, and after the acquisition, Ashok served as managing director for Willis Towers Watson’s Group Exchange business. Prior to Liazon, Ashok was an associate principal at McKinsey and Co., where he served as a leader in the firm’s health care and private equity practices.

​In addition to his role at Centivo, Ashok serves as an independent Board director at Artemis Health as well as a senior adviser to Silversmith Capital, a growth equity firm.

Ashok received his undergraduate degree from Princeton University, a master’s degree from Stanford University, and an MBA from the Stanford Graduate School of Business.

01:34 Background for this conversation—the entry point for where a patient enters the health system.
02:40 “Broad open access, on-demand health care simply doesn’t work.”
03:05 “What people really do do is they listen to their provider.”
03:36 Putting more emphasis on the primary care team, as opposed to putting the burden on the employee.
03:48 High-deductible plans as blunt instruments.
04:13 Creating transparency around pricing, and the reality behind this.
04:27 “People aren’t very good at [discerning] low-value care from high-value care.”
06:16 Why people don’t challenge their doctors.
06:51 The primary care provider (PCP) as the gateway into the health care system.
07:39 Two reasons why health care is so tricky.
08:00 “People can only control [what they] can control.”
09:46 “There is no single awesome source of data.”
12:28 The importance of thinking of population segments individually, and turning that into insightful data.
15:09 What is the PCPs’ charge?
15:53 PCPs as the change agents in health care for employers.
19:00 How do you discern who the high-value specialists are?
19:28 Building the network right the first time and making it dynamic.
21:19 Narrow networks and what’s important to focus on.
23:18 Redefining “access.”
23:35 “None of us need 40,000 doctors in our network.”
26:12 Driving better total cost.
29:18 Negotiating with the biggest health care players and operating a network with or without them.

You can learn more at centivo.com.