The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
The Race for Better Healthcare & What Exactly is the annual JP Morgan Healthcare Conference - with Memorial Hermann’s Feby Abraham
What makes an event worthy of an invite only $10,000 price tag with the local Holiday Inn charging $1500 per night? Apparently the JP Morgan Healthcare Event is worthy, and you will hear from Feby and Ellen about the 2024 edition.
Next, imagine a world where healthcare does more than just treat illness, where it's reshaped into a system that truly prioritizes health. It's a topic we're passionate about with our clients at BP2 Health, and we're thrilled to share our latest conversation with Feby Abraham from Memorial Hermann Health System, who's helping to lead the charge toward this transformative vision. Our dialogue spans the nature of the JPMorgan Health Care Conference, exposing its behind-the-scenes dynamics, and extends into how risks in healthcare innovation can lead to significant advancements, despite the occasional setback.
What does the intersection of healthcare and the Oscar-winning film 'Ford v Ferrari' look like? It's about the drive for excellence, something Abraham knows well, from his mechanical engineering background, his passion for motorsports and his work in value-based healthcare. Our discussion veers into the personal lanes of our lives too, sharing tales from the silver screen to the joy of parenting and the thrill of travel. These stories bring humanity back into the world of healthcare and remind us that beyond the policies and strategies, it's the individual experiences that truly define our approach to health and well-being.
As we navigate the future of healthcare, the road is paved with innovation and partnerships. We examine Memorial Hermann's strategic mission to build healthier communities and how broadening healthcare assets and integrating technology can connect patients more effectively to the care they need. This episode isn't just about brainstorming the next big idea; it's about ensuring these innovations are adopted and make healthcare more accessible, affordable, and democratized. Join us for this invigorating exploration that promises to keep you engaged and perhaps even inspire you to be part of the change.
Welcome to the Reverse Mullet Health Care Podcast from BP2 Health. Today we are talking with our guest Febbi Abraham, chief Strategy Officer of Memorial Herman Health System, about the infamous JP Morgan Health Care Conference. More importantly, the idea that the sick care system is not sustainable and how he is shifting towards actual health care by leveraging value-based care and innovation. But first, who are we and why are we here? Why do we name our show the Reverse Mullet Health Care Podcast?
Ellen Brown:I take credit because I did come up with the idea, although I didn't formally come up with the name. But we want to be relevant, informative and creative, but more importantly, we also want to be entertaining and have fun. So it's party in the front, business in the back, a mullet, only reversed. I'm Ellen Brown.
Justin Politi:I'm.
Dave Pavlik:Justin Palletti and I'm Dave Pavlik. We are passionate, innovative and collaborative and are committed to solving our industry's most important issues together with our clients. We have combined 90 years of experience.
Ellen Brown:Which makes us sound super old. And in each episode we dig into a hot health care topic and dig into each other.
Justin Politi:Be gentle on me.
Ellen Brown:Never, never be gentle on you.
Justin Politi:Okay, we have two big things to talk about, the first of which stemmed from Ellen making her first pilgrimage to San Francisco for JP Morgan this year. We all wanted to create an episode that started with the basic question so many people have what the heck makes the JP Morgan health care conference an invite only event worthy of a $10,000 price tag that enables the local Holiday Inn to get $1,500 at $1,500.
Ellen Brown:Yes, justin, it's like that, did not just read that.
Justin Politi:Holiday Inn $1,500 a night. The.
Ellen Brown:Holiday Inn the Motel.
Justin Politi:During conference week.
Ellen Brown:The second part of our discussion is one that I'm so unbelieving. This has been such a great day for me, by the way, feve, I have gotten to talk about two really exciting things that I've had way too much energy but I'm excited to talk about, which is we at BP2 are committed to affecting real change in health care, and we have been, and it's not lip service. We spend a lot of time finding examples of people that are really moving the needle, and that's when you popped up on our radar Last year. I have to admit last year really soured me on whether or not in our system and my confidence in whether or not in our system that we had the ability to re-engineer the system.
Ellen Brown:We watched a good friend, client and well-known innovator in the industry take the fall for a concept and an idea that could have been a real game changer and eliminated a tremendous amount of redundancies. However, it didn't work out as planned, as a lot of innovation doesn't, and he ended up taking a fall and it just it really got under my skin because if we don't take risks, we're not going to re-engineer this system, and so, at about the same time that I was feeling rather down about that whole situation, you really popped onto my radar and I started really paying attention to what you were doing and it wasn't just a one off. And then, once we connected, I just realized that you really are leading this fantastic journey of a well-known, long-standing health system. You're helping them move towards healthcare, not just basically watching it wither and just staying fixated on sick care and which is a completely unsustainable model for the long run, and it just really it's exciting to me, and so I'm excited to talk more about that today on our episode.
Dave Pavlik:And I get to introduce our guest I'm introducing to myself at the same time. February Abraham is the executive vice president and chief strategy officer at Memorial Herman Health System. He also happens to have a PhD in mechanical engineering with a focus on applied mathematics. In his current role, he's responsible for leading strategy and strategic planning for the organization and driving its strategic investments, corporate development, strategic market insights and innovation efforts. He is leading value based care transition, total cost of care reduction, expanding alternative sites of care, driving physician alignment strategies, leveraging data and analytics, orchestrating partners and joint ventures and identifying strategic direct equity investments across the continuum of care. That's a lot. I said it all in one breath. Thank you, he has a super underachiever.
Ellen Brown:I know, I know we had an earlier MIT grad, but I'm not even done yet I'm looking in the mirror when I get home.
Justin Politi:I know and you're not done, Dave.
Dave Pavlik:And I'm not done. No, he was a partner at McKinsey and Company, a research investigator, postdoctoral research scientist and engineer. He sits on multiple boards and, not surprisingly, was named one of modern health care's top 25 innovators of 2023. It's also been recognized by Becker's among the top CSOs to know in 2022 and 2023. And we are delighted to know you as well.
Ellen Brown:And he's also a really good guy, so I'm super excited for this.
Justin Politi:February. This is the part where we do the party in the front and have a few laughs. I have a bunch of questions. You're a man of a lot of interest, as we've learned. Most importantly, you still want to be a movie director and a race team owner when you grow up. First off, you love motorsports and have watched pretty much every single live show available. Over the last 23 years, regardless of the day or night. You've watched over 15 races live and in person. Please tell us more about this.
Feby Abraham:Ellen, justin and Dave. First of all, thank you for having me and thank you and your listeners providing me the opportunity to share some of my perspectives and appreciate the kind introduction, dave. Just to dig into your question, justin. As Dave mentioned, I have a PhD in mechanical engineering and grew up as an aerodynamicist, and the passion for that came through my dad, who was in the Indian Air Force, and I grew up around fighter jets and was just amazed by all the things that those wonderful pieces of machinery stood for and that translated into beautiful things called fast cars as well. So I've been very passionate about building a career in either aerospace or a Formula One team. But that was my intention to do my undergrad in India and then moved to do my PhD in the same topic and obviously I moved on to healthcare.
Feby Abraham:But I've kept my passion and in motorsports still and particularly, I'm very fascinated by Formula One. It's incredible engineering that goes behind those machines and both the aerodynamics and the mechanical design and how those are impacted by regulations, amazing attention to safety. There's been an incredible, significant reduction in fatal accidents over the last 20 years that you all know about. And there's those gladiators called the racers who put their life at stake and taking those cars at over 200 miles per hour and different courses globally. There are about 24 races in the calendar, so I just find it fascinating to go through that engineering, the strategy, the drivers and the race craft.
Ellen Brown:Do you have a favorite race that you went to out of the ones that you've gone to live?
Feby Abraham:Yeah, I love the Grand Prix in Austin. It's an amazing design of the track and there's some several DRS zones, which are called the Drag Reduction System zones, where you can have incredible racing. But that as well as the British Grand Prix in Silverstone, which is like some really amazing fast corners that I enjoy watching, so those would be my two favorite race tracks.
Ellen Brown:All right, all right. So now I get to go into, because I know absolutely nothing about cars other than the fact that I grew up near Daytona Beach, and so the Daytona 500 was like the thing we would talk about. It's Daytona 500 weekend. We can't go anywhere near Daytona this weekend.
Justin Politi:Yeah, our place in Loudoun actually was the same thing to Stockhart racing. Yeah, it's like a thing right. Oh, it's a huge thing.
Ellen Brown:Oh, a huge thing. I know, I know Our neighbor has a. Oh, anyways, we could spend a whole episode on this, which would probably be more entertaining than what we're going to talk about, but not as interesting. After your second career of movie director, I just love getting to know people and learning things that are so unexpected that you have actually watched every single Oscar, best picture director and foreign film ever made, along with most of the ones nominated. And, like Justin, that creates so many questions. But first of all, how. I can't even comprehend how that's humanly possible, given how much effort and energy you and passion you have for the industry and what you're doing and all that contains. And then, do you have any standouts and are you going to make any predictions?
Feby Abraham:Yeah, there's a lot to pick from. It's taken me obviously 20 plus years of intentional watching to be able to do that and I usually pick it based on a director or a theme and then it's just gone through a lot of this. But going to your standout question, couple of ones that stand out. One that did not win is a movie called Ford v Ferrari. I want to build on the Daytona connection, ellen, just dovetailing from your comment there. A fascinating movie.
Feby Abraham:But the one that won the Oscar was one called Rashomon, early 1950s Japanese movie by famous director Kira Kurosawa, which talks about a murder from a handful of wanted points, including the murderer, the person who got murdered in a spirit actually and a couple of couple of onlookers, and how they were completely contradictory. It was so well made and standout cinema from the early 50s. Yes, I do wager on making my prediction. I've done that at least for the last 10 years. I got to say my odds of reverse engineering with the Academy selects is no better than flipping a coin. So I've got 50% of my nominations in there and, yes, I am nominated. I am in the course of picking through all of the movies that have been nominated this year. I'm a big Christopher Nolan fan and I'm secretly rooting for Oppenheimer this year.
Justin Politi:Outside of Oscars, though. Have you watched the entire Fast and Furious series, Because I would imagine most of them yes.
Feby Abraham:Good question.
Dave Pavlik:So, on top of all of this, I know yeah, on top of all of this. You also have time to spare time to read nonfiction books, so based on the themes of the month. So what are you reading right now?
Feby Abraham:I picked up from the holidays and on to 24. I think I've the theme around ancient history from the onset of humankind to the beginning of the common era. I felt like I've spent a lot of time digging into the last couple of hundred years of human history over the last several years of reading, but I've not spent so much intentional time in the sort of the onset of humankind and where we are from and there are a couple of themes that stand out. In this day and age we talk about nationalism and religion and drawing walls, but when we look at the fact that we all come from a potential common ancestor, the human eve, which roughly about 300,000 years ago, and most of us out of Africa being from a single parent roughly about 70,000 years ago, and for most of humankind we've been migrants moving from land to land, I'm just so fascinated by all the history that goes behind it. There are a couple of books that you know from that theme that I've read once the early Indians, which talks about the country I come from, the Indians and the waves of migrations that led to the Indians as of today, written by Tony Joseph, a journalist from India, and another one which was basically talks about the DNA evolution of the genetic history of humankind, combining archaeological, literary and, most currently, genetic evidence by David Reich to talk about the history of all of us and where we come from, the genetic pickup. So that's one theme.
Feby Abraham:And the second theme that I've picked up around the same broader theme, around ancient history to the current era, is on having the story of the lion and not the hunter be told. And particularly I've zoomed in on the Persian Empire, great book by Lloyd Levalon Jones called the Persians, which talks about the history of the Persians from the vantage point, not only Herodotus and the Greeks, from which we've got to know, for example, the wars of Marathon and Thermopylae and all that, but to really understand it from the perspective of the history that has been left behind, persepolis and the great Persian cities but also from the Old Testament Bible. Believe it or not, if you look at the book of Esther and so how they talk about this Persian history and such a favorable light, which today is unfathomable given the Israel and Iran relationships but if you look at that point of history, how favorably the Old Testament talks about the Persian Empire, and I personally went and read the whole book of Esther after that. But this book called the Persians is an amazing read. So those are a couple of books that stand out and I'll build on that theme for at least the first quarter of this year.
Feby Abraham:Dave, to answer your question, I have, I have.
Ellen Brown:I'm not going to go into the details of all of it, like I'm not nearly to the impressive nature of how you just outlined that, but I have a pretty diverse when I do read. I have a pretty diverse mattering of topics and the book sapiens was one that I enjoyed as well. I like going down.
Ellen Brown:I definitely just yeah, I know where you're saying I love rabbit holes, so those kinds of books just really they help me with my rabbit hole needs. And so last quick party in the front question is I know that you're a kindred spirit with a love of travel and family. When we got together at JP Morgan it was fun talking about your family and we're ahead of you in. I'm ahead of you with my daughter and age and just talking about the dynamic of parenting. You're in that seventh grade, going right into it, and I'm now at the 19 year old in college, so it was fun talking about that. But on the travel front, anything coming up that you're either something you that really stood out to you and travel that you've done, or anything that you're looking forward to on the horizon.
Feby Abraham:Yeah, recently I, over Thanksgiving that a trip with the family to Japan, really impressed by everything that it stood for from its history, from the food, the culture and a lot of amazing artifacts in nature, with their gardens and Mount Fuji and so much to see across the cities. And what was particularly, we've been traveling to a variety of places with our kids, but particularly fascinating this time to just see how my 12 year and 10 year old are starting to break into doing long walks and exploring culture and history and maybe even for the first time showing an openness to spend a tad bit little more time on in museums, which they resented for a long time. But it was great to get ourselves immersed into the culture.
Dave Pavlik:They come around.
Ellen Brown:Super cool. I, dave and Justin probably this is not probably their their favorite part about me, but I love international travel and I have the exact same reaction to your statement and about kids and travel and for us as a family, we went to China a few years. We also went to Japan in the summer, so we also were there last year as a family, which was super fun. But our first foray into international travel outside of Europe was China and Hong Kong, and it was very. We did some things. We went to a propaganda museum, for example.
Ellen Brown:It was super eye-opening for my kids and I would say I think they were similar ages at the time, febi, to your kids and it was that first trip where I was like, wow, this is impactful. And then fast forward. My daughter had an experience this week where she was adulting as a college student and she sent us a text and said all the experiences that you have given us through international travel have really positioned me to be able to succeed in this kind of stuff and it really it was cool, it was cool to see. So, anyways, but I know we have to move into our topic.
Justin Politi:So, justin, take us on, Take us into the business. I was going to digress for a second, but that's all right. Ok, now to dive into our first topic for today, JPMorgan. First question how would you even describe JPMorgan Health Care to someone that's never been to the JPMorgan Health Care Conference?
Feby Abraham:Yeah, jpmorgan has a rich history of over 40 years of bringing together pretty much every single point in the value chain of this complex industry that we've created called health care. That includes hospitals and payors, and health services companies, innovative startups, life sciences and pharmaceutical companies, investors, management consultants, investment bankers who's who working to shape how the future of health care will look like have an opportunity to assemble together literally after the holidays and stemming into the New Year. So it's typically in the first or second week of January every year where all of us get together in San Francisco to mutually learn from each other, brainstorm, solve problems, get to know each other, engage in common themes and potentially even strike deals. So it is thousands of people descending into San Francisco, and you touched on the ramifications of that and hotel and flight prices is when you kicked off. But that's what JPMorgan is.
Ellen Brown:No, it's wild, I will say I thought I had. I don't even know what my expectation was, going into it this year. It was my first time going and it was exactly like you said it was. I have never there is not another event that has a convergence of so many players. I do. I feel like it was international.
Ellen Brown:I went one night to a Korea night event and met, like this kind of the Elon Musk of pharmaceuticals from Korea and it was just to me it was. It's just such a reminder that when you bring all these different aspects together and it was also very collegial it's one of the few things that we do as an industry where we engage in conversation. Everybody doesn't just have I know everybody has an agenda, but there's definitely a larger tolerance. I feel like a lot of conferences executives come in and out, right, they come, they do their presentation, maybe they walk around for a day and then they leave. It's like they're not really there for the conference. They, their teams, are more there for the conference. This, you have everybody and they're there to be right and it's just, it's totally different.
Justin Politi:It's not just about the partying.
Ellen Brown:No, that drove me crazy. It is all about the partying, but I got to tell you I went to all different types of events and the ones that really stood out to me are the ones where you can have an actual conversation. I feel like I want to tell every event planner for JP Morgan I know it feels really cool to do it at this bar. That's like divey and it's like retro. But I don't need to relive my college glory days while trying to talk about changing healthcare, like it's just too much. I don't want to scream and yell and yeah, I don't know how people can throw down what they throw down. Drink wise at that and have conversation. But I'm a lightweight now, so, anyways.
Dave Pavlik:February describe a day in the life for you at the JP Morgan conference. It's a lot of what.
Feby Abraham:Ellen just touched on, which is meeting a lot of engaging stakeholders across the value chain. So I spend a lot of time with my peers that are the health systems Think about the common topics we are working on. We should be working on learnings from the things we have worked on. Meet a lot of innovative companies that are trying to address novel solutions to solve pain points and unmet needs type of the themes I am focused on and meet investors who are shaping deals and themes to invest in, to support these innovations be successful and how we could partner together in some of these opportunities. Most importantly, I also learn a lot from engaging, as Ellen said, from other points in the value chain. Particularly, I had some great dialogues with people from the life sciences industry to talk about where medicine is growing and how that could help shape the future of healthcare, learn from international stakeholders and how we could all collectively work together.
Feby Abraham:So there's a lot that goes in the day in the life of would include some of the social and party events that Ellen mentioned, where you get to engage and see a lot of these colleagues or potential colleagues as humans in a room and get to know each other, because so much of this is human touch getting to know each other and jointly working on problems. A lot of one-on-one discussions with many of the types of individuals I mentioned on several group discussions, some orchestrated among ourselves, some orchestrated by think tanks like consulting firms, to bring together and brainstorm, find, jam together to find solutions to common unmet needs or problems that we're all working on. It's a lot of steps. I carry an Apple watch and I gotta say that I almost tripled the number of steps I take a day just by the sheer amount of walking going from meeting to meeting or event to event.
Dave Pavlik:I bet you never expected to wear a reverse mullet wig.
Feby Abraham:I was the first. I really enjoyed it. Thanks for that, Ellen. I think I saw pictures have you played along.
Ellen Brown:I stalked him. He was actually he was speaking at a management consulting he was. It was what he was saying. There's actually layers upon layers. That's the other thing. It's because everyone's out there, all these other people tap into having an audience of all these folks. And there was one group that did a. They did a speaking panel and Febby was on it, and so I showed up and I said I'm stalking you and I was joking.
Ellen Brown:Of course I was very interested in the panel that he was on, but then afterwards I was like you gotta put the reverse mullet healthcare wig on, because Dave and Justin started a trend, they dared me.
Ellen Brown:they dared me that I wouldn't do it, that I they're like you should bring the wig and see if you can get anybody to wear it. And I got multiple people. People really thought it was a lot of fun. So thank you, febby, for being a good sport and proving my partner's wrong, that I could pull off getting people to wear the mullet.
Feby Abraham:You certainly have the charm, Ellen, to make anyone do it. Oh, thank you.
Ellen Brown:Oh, there you go, thank you. So I'm just gonna ask you because I wanna make sure we save enough time to talk about all the interesting work that you're doing at Memorial Herman. But what do you was what was the most interesting thing or a epiphany or a person from the event for you? Are there anything, any real stand-ups? I know a lot of people have posted on LinkedIn these are the top this and the top that and was there anything of particular interest that really stood out to you?
Dave Pavlik:She means aside from her Right the woman with the reverse mullet.
Ellen Brown:I was the most bizarre.
Justin Politi:Febby, be honest, there's no way in the world that you would have ever thought that you would have come out of the JPMorgan Conference wearing having worn a reverse mullet before going in.
Feby Abraham:That certainly was a great epiphany for me as well. So I'll take but, ellen, to answer your question. I think it's been almost a decade plus that we continue to keep hearing how healthcare as an industry is one of the least digitized, how AI as a trend is still a long ways to go, and now just the intensity of the conversations has exploded a lot through generative AI and chat, gpt and some of these new technologies that are getting adopted. But I think it was great to have the reaffirmation that there is AI is broader than generative AI. Right, you've got those new generative kind of solution sets that are building up and clearly there is a lot of utility to that. But there is just so many other sort of pointers to how you could leverage data analytics and AI and solving critical points of how you reduce total cost of care, expanding access, bringing more efficiency into how healthcare is accessed, experienced and delivered great experiences for consumers and providers.
Feby Abraham:I was refreshing to continue to see that, in spite of all the market volatility around the tech sector that we've gone through over the last couple of years, there's just such a reaffirmation from an innovator's perspective of doubling down on creating those innovations and a real hunger from healthcare players in the value chain, be it providers, be it payers, be it life sciences, to be very intentional in identifying those solutions and how they solve specific pain points. So it was a reaffirmation it's not a fad and it's just gonna. It's here to come, it's here to stay and it's all of us, behooves on all of us to intentionally focus on scaling these innovations.
Ellen Brown:So one of the things that always I get miffed about there's so much out there, there's so much swirling out there and I think, are we gonna actually be able to get it into the system? And then what's gonna push it in? And to me I feel like there's maybe a little bit more traction around value-based care or maybe a little bit more of a buy-in that it's inevitable that we are headed, that we aren't gonna be able to stay and feed for service forever. I don't know. But it's like, how do we package it all together? Because I hear what you're saying, but is there this underlying push now that we okay? So I'll actually let me step back for a second.
Ellen Brown:As part of the on the road for the reverse mullet of healthcare podcast, as Feve knows, I talked to a ton of people and asked them if they could affect real change. How would they? What do they think could affect real change? And I said to them it doesn't have to be what you do. I don't want you to just start from the point of what you do in your. I want you to think about healthcare at large and think and say it.
Ellen Brown:And what surprised me was I had at least three people, unrelated conversations, unrelated to each other. That answered my question by saying we have to move away from sick care and move into healthcare, like we, because health systems are not sustainable over the long run If they stay entrenched in sick care and they have to redesign to account for that. And it was the first time that I heard so many people on that, like it was just, it was different. So my point being, I feel like maybe this why it's going to stay like what you were talking about, fabi, with all this innovation, is that there's this acknowledgement that we have to change right and so if we don't adapt the innovation, we don't figure out how to put it into our workflows and all of that, that it's not going to work. I don't know.
Feby Abraham:Yeah, no, absolutely, and we learned rather than further as we go through the dialogue. But there's clearly, as you noted, if you take the headline, we're spending four and a half trillion on healthcare in the United States and, as healthcare inflation is still continuing at robust levels, we spend about 20% of GDP on healthcare. Most other industrialized nations spend roughly half of that as a percent of GDP. So in some level in the United States that four and a half trillion dollars spend is unsustainable. Clearly, we do have at the back of it a lot of innovations that have expanded our life, expanded our living, our longevity, but also the quality of life we had. But it all comes down to how do you generate the next generation of high quality outcomes and continue to expand the lifespan and quality of life, but do that at a reduced total cost of care and value based healthcare, which has several meanings and will come to it as the conversation involves, is a critical enabler of that. That's one we talk about the second headline, which is that, no matter which journal, you read the supply demand arbitrage that exists in healthcare workforce be it in PCPs or specialists or, more critically, nurses and you think about how do you reduce the supply demand arbitrage. Historically, if you've looked at any other industry that has come through the expansion of labor, productivity and the use of technology, how do we significantly scale that through the use of technology and completely bought the supply demand arbitrage? We talk about demand growth, but how do we effectively create more supply through technology and improve that? That's another component that we'll explore.
Feby Abraham:We talk about third thing is access right. There's just such a lack of access in healthcare. We talk about equity and how different segments of the population don't have equitable access. How do you expand that? Access to healthcare will be a critical component of what drives digitization and AI and makes it an easy button for everyone to access healthcare at any point. We talk about efficiency across all points in the value chain. We spend so much on administrative expenses, but also operational expenses and more expensive clinical expenses that could have been made less expensive if you had taken a health mindset versus a sick care mindset. How do you unlock that some of those efficiencies through the use of technologies and other area that comes in? So there's just so much of an opportunity and in full potential. I think it has really an opportunity to deliver on the quintuple lane around having great outcomes reducing the total cost of care, doing that at great provider experience, patient experience, and doing it in an equitable and access enabling way.
Ellen Brown:So, Dave, you want to take us into. I think that's a really good segue into this next piece of discussion.
Dave Pavlik:Yeah, as you can tell, we are passionate about affecting real change at BP2. So you really popped on a radar with your innovation bets and investments. Memorial Hermann if I have my facts straight, through you and your team's work at Memorial Hermann, you've partnered with over 15 companies that are changing the way healthcare is being accessed and delivered, including new tech models leveraging AI and analytics. You've created an innovation hub with more than a dozen innovation pilots, some ready to fully launch, and invest it in over 30 innovation companies or innovative companies that provide critical solutions across your themes of focus. Can you tell us how that journey began?
Feby Abraham:Yeah, absolutely. And it goes back to some of the things we were just discussing, which is we know the problems in healthcare and sick care as described, but then what should be the portrait of the future? If you had to reimagine how health should work in the future, what should that entail? And it comes down to the tagline of thinking about expanding from a health system, a vantage point, our mandate to developing significant assets, critical assets that are required, the expensive assets for the sickest of the sick care, to having a mandate or a mission to creating healthier communities, which is Memorial Hermann's strategic vision and mission. And so, as we think about that as the overarching sort of end state vision, you start to ask the question all right, what would take you from here to there? And there are several components of what will need to happen in order to go from here to there.
Ellen Brown:Okay, so I have to interrupt first and say this is Super Bowl number two for me today, of how you just described that, febby. I am like I'm over the moon to have a guest on our podcast that's so entrenched in this system. Speak to it the way you just did, because it's yes, we can do this. Justin's literally rolling his eyes in me right now.
Justin Politi:He's like rolling his eyes, but I spent the morning with you and understanding like Ellen walked in floating on a cloud with just the topics and the people that we've had today. So that is a background. She's used analogies of Super Bowl, christmas morning and everything.
Ellen Brown:It's my happy day. It's my happy day. So I'm really sorry because if it was me I'd be annoyed right now that you cut me off in my train of thinking. But hopefully you can get back to where you were gonna go.
Dave Pavlik:But I just I needed to take a minute and say Discussion over you ruined it.
Feby Abraham:Let me try hard now to come back. No thanks for that, ellen and Justin. So just going back. So you've got this vision and in order to go from where we are today to where you need to go, we have to reimagine a few different components. One we need to create a broader set of assets that provide the connective tissue between the patients and the healthcare ecosystem in order to be able to do that. So we clearly have created great, trustworthy and phenomenal brands at a local level.
Feby Abraham:Most health systems have with their hospital assets. But what you also need to do is to think about the right sending the right patient to the right individual. I wanna reframe the patient conversation to consumer conversation the right consumer to the right site of care at the right time. So, whether it be an ambulatory location, a retail location, a digital location, an urgent care care at home where you need it, so you have remote patient monitoring, remote patient healing all those technologies and solutions and services that go beyond the four walls of the hospital. It's a critical enabler to reduce the cost of care calculus and providing access to patients at the right site of care. So that's one component. Then you gotta have, as ULN mentioned earlier, to think about value-based care, which ultimately it's about shepherding individuals, depending on their healthcare symptoms and conditions, to have, through the leveraging population health analytics and their personalized information, to come through a care pathway. And if they are significantly diseased, how are you managing their condition? Say, for example, they have CHEF, which is a coronary heart failure, or you have some advanced kidney condition. How are you managing those patients through right services so that you could keep and maintain their health appropriately to ones that require lower touch? Perhaps they are in the younger cohort and not yet exposed to diseases yet how are you gonna manage them so that they don't get to that disease condition? Perhaps through healthy living? How are they gonna manage their diet, exercise, nutrition, et cetera to do effectively well? So value-based care is another theme. We talked about technology and it's all of its applications into healthcare as a theme Supplier, how do you create the healthcare workforce and its supply to be done in a much more engaged way so that you can reduce the supply demand arbitrage on the workforce? How are you gonna bring biology and medicines into sort of deriving a lot of this care? So there are a lot of these themes that are coming and we'll go into more detail as needed on many of these themes.
Feby Abraham:But, going back to the fundamental questions, we have a vision that says that what is required to go from point A to point B is a set of capabilities, that all of these things that I mentioned go beyond the traditional remit of most health systems to just focus on inside the four-walled infrastructure. We believe that a lot of that inside the four-walled infrastructure is still required as people age and require more complex care, which is the sick care calculus. But we also need to expand our investment to all of these additional areas that will drive value creation. And now you look at all of this and you say there's the third point, which says is that what made us special to date and what's our right to win in building these capabilities? We've run great infrastructure of through our leveraging our clinical infrastructure, clinical network and being specialists and driving inside the four walls, but requires a lot of new capabilities to do all of the things I mentioned. Value-based care, for example, will require us to have great analytics capabilities, great care management capabilities, great data and analytics capabilities, great actuarial capabilities, different types of sites of care. That requires retail and consumer-facing capabilities.
Feby Abraham:So when you think about all of these capabilities that need to be built, which are not your core competence to date, you'll have to start thinking, hey, we cannot do it alone.
Feby Abraham:We'll have to do it in partnership with a lot of other entities that have the right to win in a lot of these capabilities, while leveraging what we are known for best, which is that the patients and providers think about us as the brands for clinical excellence, and stitching a lot of this together, being the quarterbacks of healthcare and having the trustworthiness just for patients to do, or consumers to give their care to, and so we need to stitch a lot of these, and so the recognition was we need to really have partnerships at the center of it, and that was what led us to this vision of both creating a partnerships umbrella to drive a lot of these innovations, some of them being big bang innovations, and therefore you go all in at it.
Feby Abraham:For example, our partnerships or joint ventures with urgent care and ambulatory surgical center and care at home models, which we did through joint ventures In some cases. We wanted innovation bets to try out a new access enabling or efficiency enabling capability at a small scale, pilot it, prove it out and then scale it, as well as to invest in some of these companies so that we can support their next horizon of growth and be strategic thought partners, and how they develop products tied to my first point of creating the future we wanna jointly enable.
Feby Abraham:So, that was the vision that led us to down this journey.
Justin Politi:Justin's biting at the bit I was gonna go off script just for a second because no, you should.
Ellen Brown:We could stop the script now and just.
Justin Politi:Because I'm fully aligned with everything that you're talking about here, and the thing that we keep running up against collectively across the country is this issue of access. Whether it be in a rural area or whether it be in an urban area, you can create the best system, a very efficient system, but if people can't get an appointment to their provider, it's super problematic and I guess where I'm going to because my wheels are spinning, is like someone is innovative as yourself. What specifically is Memorial Herman doing to and your ideas on improving or addressing that complex?
Justin Politi:issue of access.
Feby Abraham:Yeah, the great question, justin. And ultimately, if you dig deeper into what creates an access barrier, it's about thinking about supply of labor, which is care providers, such as a primary care physician, a specialist such as a cardiologist or a nurse, and the supply of physical infrastructure, like a hospital, and comparing that to demand, which, as you said, there is a lot of demand. Patients come from various areas, rural and urban, different age, points of the age or disease spectrum, different set of needs, so you have the supply demand arbitrage. So that's the fundamental reframe of the problem statement, building on your question. Now, how do you solve that supply demand arbitrage? You could solve that by increasing supply of labor, which is to say, how do we make it easier for there to be more physicians, more nurses?
Feby Abraham:Hey, there is a lot of AI-driven innovations happening in a lot of industries. That's leading to a perceived shortening of the demand of workforce in several industries. Say, take manufacturing. The number of manufacturing workforce that is required today versus, say, 50 years ago, is fundamentally different. With the advent of robotics and automation, could you get a lot more of workforce in the future to match up to provide more supply? Those things will take time, but that has to be a lever that one thinks about Most notably in the near term. What you have to think about is how do you think about using your supply of physical and labor infrastructure more effectively in matching up to demand in the near term, and how do you do that?
Feby Abraham:You could do that by reimagining sending the right consumer or patient to the right site of care. Hey, does this patient really need to be in the hospital? Perhaps not. This patient can be taken very easily through a virtual care visit. Some of those virtual care visits can even be enabled by AI. Maybe you have a flu symptom and that flu symptom, once it's validated very quickly by a physician, again complimented through AI, could you provide the right type of script to that patient? You don't require that patient to be consuming either a hospital or even a PCPs time.
Feby Abraham:So sending the right patient to the right site of care, or right consumer to the right site of care, and reimagining all the supply infrastructure can create a broader reimagining of that supply demand arbitrage, but will also mean that we are in reinvesting, or purposefully investing, in other points of infrastructure that are not built out. For example, we at Memorial Herman have invested a lot in care at home models, urgent cares we have tripled our urgent care footprint in the last 18 months because we believe that is enabling that We've created a pretty at scale care at home model right now, so that we could see the patient at home, whether it's home health, hospital at home or virtual offerings. That's another side of improving the supply demand or arbitrage. And finally, sorry, go ahead, ellen.
Ellen Brown:You're on your final point, then I'll make my comment.
Feby Abraham:Yeah, you'll have to keep me constrained here, because I could keep talking forever.
Ellen Brown:And I could keep talking forever, it's a good thing.
Justin Politi:I'll take the bumpers here.
Feby Abraham:Exactly.
Justin Politi:The guardrails.
Feby Abraham:But I think the final point is around how we can read and this is where I think the supply of technology and the use of AI can further unlock it which is can AI and technology and digital be an enabler in doing all of this?
Feby Abraham:How can AI better help us?
Feby Abraham:triage and create more supply.
Ellen Brown:So I have two things I want to say, and then I want to make sure just to David. Then I do want to make sure we save time because we're pushing the end of our hour. I do want to save time to ask our kind of two more key questions. But I have something. I'm going to be a little bit controversial here. Two things Nothing that anybody needs to worry about with my controversial here. I just want to say. But the first is risk is so.
Ellen Brown:We had a previous episode and somebody who invests heavily, like you do, in startups and he said eight out of 10 startups fail. With the space that you're in of really looking at the future of healthcare, what? And then I have a follow-up question on what you just closed out as it relates to cost. But so I don't forget that Dave and Justin can help keep me honest as the bumpers here. To go back to that, but what sort of guidance would you throw out there to others in the industry of how to?
Ellen Brown:I feel like you've been really effective with the board and the leadership of moral hormone, of making the case that innovation is really important and then doing it in a manner where you feel safe to make those investments? What advice would you give others in the industry or thoughts do you have around? How do you do that in a way so that the board understands that this is still these are still startups right, things can fail Like you could invest in a startup even with all the due diligence that you do, and it's a great idea on paper, but then it just doesn't go well, and that's part of this strategy is that you have to continue to look at innovation. Do you have any thoughts on that?
Feby Abraham:Yeah, certainly it's a great question. It's often a conundrum that exists in innovation teams, regardless of industry, and especially in an industry which cannot boast itself of huge R&D expenses, at least on the provider side. Obviously, there's much more R&D expenses that happen in other points in the value chain, as well as in the technology industry, as an example. We have to be much more purposeful, especially as we're going through significant major trends in healthcare around rising costs, lower margins. You've all seen the headline around the margin evolution in the industry and so I think your question is sport on.
Feby Abraham:I would answer it by again going back to three points. One, intentionally aligning all the things you do to strategy and a vision for what you're trying to do. That's obviously a pretty self-evident truth. I think everybody gets it, but, like, I think it's restating the obvious. But the more critical component of it comes down to two additional things. One is there are known knowns, which really helps us all be very articulate about hey, there are some industry wide trends or solutions that we know is working very well in the enablement of value-based healthcare, reducing total cost of care. What is required is capital allocation to prove those ideas or scale those ideas out. So, beyond pilot that need to be scaled. So this whole theme I mentioned about sending the right patient or the right consumer to the right side of care. There are several components of that which I would argue are pretty well established, at least at a conceptual proof, of concept level, and just need to be scaled in terms of infrastructure.
Feby Abraham:That will require some level of thoughtful capital allocation and adequate sort of careful financial diligence and making sure you're being a silly student in doing that and understanding the total valuation of the healthcare ecosystem.
Feby Abraham:But that falls in the bucket of deploying capital towards innovations that have gone beyond people concept to think late state startup or early state private equity or growth equity company that can be failed to bring those innovations that start at scale. And then the second component of it is thinking in terms of that, those ideas that have tend to be more innovative in nature and the failure mode can be high. And I think the piece of advice I'd have for that is, rather than think about the specific innovation that one is betting on, think about what are the few unmet needs and pain points you want to solve. The start problem first is supposed to solution first, so that you're not thinking in terms of hammers and such of nails, but really thinking about the nails you want to solve for and what specific innovations that's in each of those nails, or what are those hammers that you want to create that solves those innovations.
Ellen Brown:So I'm going to make one comment and then we'll do our last, probably one question. You and Dave can do some sort of intuitive connection right now, since he's remote, and figure out which of the two marquee questions you're going to ask. But first I just want to make one comment. This is really important.
Ellen Brown:When we talked about change recently, I made this, the comment that if we're going to really do this right, we have to actually take cost out of the system, and a lot of these innovations are perceived as added costs and added complexity, which then adds cost. What I really appreciate is that you're viewing the health system, like you said is the quarterback and you're relying on all the other pieces, acknowledging that you don't necessarily need the costliest thing for everything. You need the right thing for everything. That, to me, is super key and super important because, do you disagree? We do have to take cost out of the system. It's untenable the way that it is, and so if we start injecting, when we talk about, I really think you focus on the supply and demand arbitrage as opposed to the margin, because they're totally related. But it's too cost intensive right now and I would say supply intensive and using this technology and these innovations to pull that out.
Justin Politi:It's out of balance is really what it is, Because it's what we've talked about too. Some areas cost out, but from my perspective it's balancing things out like where behavioral health has been woefully underfunded for years.
Ellen Brown:It's finally being discussed as part of the whole.
Feby Abraham:No, you have to part on. I think ultimately one has to be the health system very articulate about the value creation driver for the community, for the failed and equal system and for all the health. And the value creation driver comes from a few different things. One that you mentioned is becoming more efficient and things that you do with the recent clinical, administrative or operational workflows Now do you unlock technology to be more efficient than what you do within the four walls and how care is delivered? That obviously unlocked margins that you can read about the communities and further improve your mission and mandate.
Feby Abraham:But second, it's really about thinking about how do you reduce the total cost of care for the entire ecosystem. You should not just be thinking about each individual point in the value chain. I can't just think about cost for the health system as a whole, but I should really go back to the consumer and the payer as we at health systems to start thinking about it from that perspective. You create consumer value, patient value and have appropriate mechanism to get to participate in that. Then I create economic and revenue models that are beyond people's service to then through the space contract, then you have created a win scenario for doing the right thing for the entire ecosystem and therefore creating more for the people to be assessed, to broaden the industry.
Ellen Brown:So you just bought the world of Coke. I feel like Febby just bought the world of Coke. It's not that far off.
Justin Politi:Because that's what we've argued, because that goes to my waking up at three o'clock in the morning and the fee for service system has to just be explode.
Ellen Brown:So it's your. You and Dave decide whether you're going to go buy the world, Justin's in the room.
Justin Politi:Go for it, you just got that or legacy. I'm going to go with the legacy. If you could leave a legacy in healthcare or feel like you've made a big difference, what would that be?
Feby Abraham:It's a great question, I think, when I think about, as you've discussed, the future of healthcare, there are several things that need to come together to make all of this happen. One is obviously the concept of creating the innovation, but more importantly, it's about driving up adoption to quarterbacking or bringing those innovations, because one of the big failure modes, I think, in healthcare has been not the lack of great ideas but the lack of great adoption, and I think I would see my legacy as bringing both great, being participating in both, bringing great ideas, but, equally importantly, also driving up adoption or quarterbacking of those ideas to create the last thing change and drive and all of those mission drivers I mentioned to make healthcare more accessible, affordable, so that people can live longer, people can do that in a more democratized way and such as we are experiencing in a lot of other industries, and so that I would see, as they're like a big spieling I will.
Justin Politi:I will just say it is inspiring to be able to have people that think like you within the healthcare system, because so often we're brought in. We help people solve problems on a regular basis, but as you bring it up a level and where things where we need to be as a society, minds like yours are critically important for us to be able to help implement these ideas. I just want to say thank you for your time. We really appreciated the discussion today.
Justin Politi:So, thank Alan, I'm going to thank Alan for finding you and stalking you and stalking.
Ellen Brown:Yes, in a nice way, not in a weird way, but all right. Thank you, february, I enjoyed our time together.
Feby Abraham:Alan, Justin, Dave Really enjoyed the time and Alan thanks for having me and thank you for all the listeners to your podcast and bearing with me as well, and hopefully some of these ideas are relevant for each of you as well.
Ellen Brown:Yeah, and you know that you'll be. You will be asked again Like this is this will not be the only conversation that we have with you. You have too many great ideas, but thanks again. I'm Ellen Brown.
Justin Politi:I'm Dave Pavlik and I'm Justin Politi. We are the partners at BP2 Health. Your best chance for real change.
Ellen Brown:And, as you can tell, we could talk all day about healthcare, but drop us a line through our site, bp2healthcom. The reverse mullet healthcare podcast is produced by MMG Studios in Tampa Florida.