Friends,

The focus of this interview is an approach to primary care that is divergent from the mainstream approach. It’s different in a number of ways and it’s creating outstanding outcomes for patients, payers, and providers.

Our guest today, Dr. Chris Crow, has a compelling story to tell. He is an inspiring leader and a bold reframer of healthcare. I’ve had the privilege of speaking with him a number of times, and am impressed by his personal story, as well as what he and his colleagues have accomplished.

Christopher Crow M.D. is the CEO and Founder of the Catalyst Health Network.  He is a nationally recognized healthcare innovator with numerous recognitions & awards; but more importantly he has spent the past 20 plus years focused on helping communities thrive through improving the delivery of healthcare.

In this episode, we’ll discover:

• Some of the underlying problems that greatly sub-optimize the performance of our healthcare system.
  
• The three major stakeholders in healthcare, which Chris and his colleagues have built their approach around.
  
• The “extended care team” approach that Chris and his colleagues have taken to create an ‘Advanced Primary Care’.
  
• The critical distinction between ‘Direct Primary Care’ and ‘Advanced Primary Care’.
  
• How Chris is organizing a sustainable financial model that can support this enhanced model of primary care.
  

Early on in our discussion Chris points out that although American consumers demand outstanding customer service, convenience and quality in every other facet of their lives; when it comes to healthcare they have been gripped by what he terms “the tyranny of low expectations”. He goes on to state that the underlying problem is the status quo and inertia of legacy stakeholders, whom he describes as having turned the American health system into a ‘wealth system’ – that is, a system that creates wealth for the few at the expense of the majority of Americans who can not easily access or afford healthcare. One of the major root cause problems is the strong pull to maintain Fee-For-Service payment, which incentivizes volume (visits, procedures, tests, imaging & hospitalizations) over preventive care. Another is the preferential payment afforded to subspecialty and acute-based care over primary care.

Chris has been, admittedly, frustrated with the American healthcare system because, as he bluntly states, we know the solution. The “prescription for America” as Chris puts it, is “advanced primary care” – primary care that is accessible, affordable, effective, equitable, and sustainable for both patients and providers.

The mechanism behind advanced primary care is through a tech-enabled, virtual, “extended care team” of pharmacists, care managers, social workers and care coordinators. This extended care team is particularly focused on more complex conditions and situations. Some of the services they offer include: (1) medication management and adherence programs; (2) managing formulary-specific medication changes; (3) a referral management and tracking system that maintains network integrity and helps patients and providers navigate to higher value specialists and surgeons; and (4) addressing social determinants of health.

In this advanced primary care model, patients derive tremendous benefit in terms of greater connectivity and continuity of care, as well as more preventive care and improved outcomes.  Providers derive benefit through the additional support and the reduced administrative burden, as well as the support they receive in improving clinical quality. Payers derive benefit through more cost effective care and the reduction in total costs of care.

There are numerous metrics and stats that demonstrate the outcomes Chris and his colleagues have achieved. One example that Chris shared is around access. The Healthcare Catalyst Network has reduced average waiting times to see a specialist from approximately 28 days down to 4 days. Chris also shares some of the massive cost reductions his network has achieved.

The approach that Chris and his colleagues are taking is incredibly mission driven. They consider healthcare to be critical for communities to thrive; and they believe that a value-based, prospective-payment model of primary care is critical in delivering the health outcomes that patients, providers and payers all want. As Chris states, “We’re trying to leave the world a better place and we believe that ‘advanced primary care for all’ in America is the prescription.”

Until Next Time, Be Well.

Zeev Neuwirth, MD