EP270: COVID-19—How to Save Primary Care Practices With the Marshall Plan for Prospective Payment Models, With Dave Chase, Cofounder and CEO of Health Rosetta

Let’s talk today specifically about primary care physicians (PCPs) and family medicine doctors. Data was reported in USA Today, saying that an estimated 60,000 family practices will close and 800,000 of their employees will lose their jobs by the end of June. It’s hard for any practice to just snap its fingers and transfer patients over to telemedicine regardless of the reimbursement rate and/or how many payers are actually paying any reimbursement for telemedicine or remote patient monitoring. It’s a thing to go virtual. It requires new processes, different staffing training, different workflows. Plus, a lot of what a PCP does (ie, fielding phone calls with quick questions, for example) aren’t reimbursable; and if they were, no one’s gonna, like, spend half an hour trying to send a bill for $12.

What are the consequences of all, let’s just say, independent PCPs going out of business? Well … first, logically, all patients served by these doctors and their teams now no longer have a place to go to get care, right in the middle of a pandemic.

Second, let’s just say in a thought experiment that a lot of independent physicians do go out of business and do wind up going to work in an employed model. That might very well happen. Private equity and payers like Humana and Optum have been buying up PCP practices all over the place. Why? So they can have captive populations. Patients come in the door at their PCP, and everywhere they go from there can be controlled by the vertically integrated entity. This has been stated openly. It’s also pretty clear at this point that that model increases costs for any ultimate purchaser of health care like, for example, an employer.

There’s also other, let’s just say, more unseemly motivations if you start to think about what a company who owns patient relationships with their PCPs can manage to perpetuate. It’s great if you’re a shareholder. It might be less great if you’re a citizen of this country.

In this health care podcast, I speak with Dave Chase, cofounder and CEO of Health Rosetta. Health Rosetta empowers community-owned health plans like, for example, employers and states’ and town governments. Dave talks about Health Rosetta’s Marshall Plan, which is an action plan right now to minimize the negative impact of COVID-19 by ensuring that family and primary care practices can stay in business. The Marshall Plan is a call to action for self-insured employers and commercial health plans.

You can learn more about the Marshall Plan at healthrosetta.org/marshallplan. You can also connect with Dave on Twitter at @chasedave and follow Health Rosetta at @HealthRosetta. 

Dave Chase leads the vision for Health Rosetta, which is to empower community-owned health plans. Health Rosetta’s blueprint and platform power the health plans of your dreams: high-quality, trustworthy, local, affordable care—that you thought had disappeared forever—from caregivers we know and trust. They free up compassionate, well-trained, community-based caregivers to rediscover love in medicine so they can do what they have always been called to do: serve their patients not just in disease but toward their fullest health. A trusted and sacred caregiver-patient bond is built through transparency and openness that equips and empowers patients wherever they can best achieve their unique health goals—at home or any setting best optimizing their well-being. By avoiding the 50% wasted health care spending, we can ensure our caregivers have the independence and resources to address the psychosocial and medical issues their patients face. Human-centered health plans restore health, hope, and well-being.

Through best-selling books and The Resident (on FOX), where Dave serves as a consultant, collateral damage from the Extractive Era of health care is highlighted as well as the tremendous successes and opportunities with Health Rosetta–type health plans. The books, writing for various media outlets, TED Talk, and TV/film have reached over 10 million people, with the goal of informing, enraging, empowering, and activating a broad grassroots movement designed to restore hope, health, and well-being to our communities. Dave proudly received the Health Value Awards’ Lifetime Achievement for Health Benefits Innovation at the 2020 World Health Care Congress.

Dave cofounded Avado, which was acquired by and integrated into WebMD/Medscape, and founded Microsoft’s $2 billion, 28,000-partner health care ecosystem.

Outside of work, Dave Chase is an oxygen-fueled mountain athlete and volunteer high school track and cross-country coach. Once upon a time, Dave was a PAC-12 800 meter and 4x400 competitor. Most importantly, his devotion to faith, family, and friends underpins a desire to be a servant leader to the four million lives (and growing) stewarded through the Health Rosetta community.

03:15 The state of independent fee-for-service PCPs during COVID-19.
03:57 CMS and telehealth, and why these aren’t really aiding PCP revenue.
05:52 Worst-case scenario of where COVID-19 is going to leave our PCPs.
06:58 Looking to Optum’s PCPs and what’s happening there.
08:46 “There’s a biological virus that’s running rampant in our country, but there’s been a metaphorical virus running through our health care system.”
09:33 The incredibly fast transition to digital health because of COVID-19.
10:56 CMS’s prospective payment model.
14:43 “In my view, we are not returning to normal.”
15:21 Dave’s call to action for saving PCPs during COVID-19.
22:07 Dave’s advice for what PCPs should be doing right now.
24:01 “Here’s the egg; crack it open.”

You can learn more about the Marshall Plan at healthrosetta.org/marshallplan. You can also connect with Dave on Twitter at @chasedave and follow Health Rosetta at @HealthRosetta. 

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