The Future of Healthcare: “Leaders across all aspects of civic society need to be more outspoken about our health care delivery system that hasn’t lived up to its potential” with Dr. Chris Dodd of ConcertoHealth

…leaders across all aspects of civic society, particularly those who deliver primary care services to those most in need, need to be more outspoken about the root etiology of a health care delivery system that hasn’t lived up to its potential. Asa part of my interview series with leaders in health care, I had the […]

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…leaders across all aspects of civic society, particularly those who deliver primary care services to those most in need, need to be more outspoken about the root etiology of a health care delivery system that hasn’t lived up to its potential.

Asa part of my interview series with leaders in health care, I had the pleasure to interview Dr. Chris Dodd, chief clinical officer at ConcertoHealth. Dr. Dodd’s leadership focus on the quadruple aim in health care (promoting joy in work, enhancing patient experience, data-driven quality improvement, and right care-right place-right time-right-care team member) has been critical to driving improved results for the vulnerable, frail and elderly patients ConcertoHealth serves on behalf of its provider group/health plan partners, cementing ConcertoHealth as a leader in the successful transformation of the U.S. health care system. As chief clinical officer, he leads the development of enterprise-wide clinical strategy and programs, including accelerating the integration of ConcertoHealth’s direct delivery and care management teams through the expansion of field-based care for the highest-utilizing, highest-cost patients, aka “hot spotters.”

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

Meeting and learning from the social medicine clinicians during my time in medical school, from those working in poor communities in urban Boston to those working in Central America, is the reason I became a public health practitioner practicing internal medicine.

Can you share the most interesting story that happened to you since you began leading your company?

The most interesting and powerful story that is being told at ConcertoHealth since I arrived has been about our Care Team’s ability to demonstrate real-life, industry-leading impact for the most medically and socially complex patients living in our communities. See impact analysis below.

PTMPY: Per thousand members per year

Can you tell our readers a bit about why you are an authority in the health care field?

I have more than a decade of experience caring for vulnerable populations as a practicing internal medicine physician and public health practitioner. I’ve worked in some of the world’s most challenging settings, including Mozambique and Nicaragua, as well as in underserved communities across the U.S.

I earned my Doctor of Medicine from the Boston University School of Medicine and completed the Program in Clinical Effectiveness at the Harvard T.H. Chan School of Public Health as part of my residency training in Internal Medicine & Global Health Equity.

I credit my training as a community health worker in Nicaragua, where I lived and worked in the remote northeastern part of the country, and continued to care for those most in need. This has had the greatest impact on my potential as a leader in health care delivery transformation.

What makes your company stand out? Can you share a story?

ConcertoHealth is the leading full-risk provider of specialized primary care and supporting clinical services for vulnerable, frail and elderly patients. We equip primary care providers (PCPs) in health plan networks with “wraparound” clinical and administrative resources and a proprietary population health data analytics platform called Patient3D that helps PCPs successfully manage their most vulnerable patients. Instead of patients bouncing around from doctor to doctor, or clinic to emergency rooms, ConcertoHealth acts as the quarterback for the patient, PCP and health plan, coordinating all the players to ensure the best possible health care outcomes.

In fact, we’ve achieved a 49% reduction in hospital readmissions, a 37% reduction in inpatient bed days and a 23% reduction in ER visits for those patients identified as “hot spotters.”

A good example is JC, a patient we consider a “hot spotter.” JC is a 53-year-old male who made 84 emergency department (ED) visits in the last 12 months. Some of the visits were for minor health issues. JC is also diagnosed with paranoid schizophrenia and methamphetamine substance use disorder. His episodes of paranoia often present at night, and he’ll leave his caregiver’s home and end up at the ED. Often, his care team had difficulty getting in touch with his PCP and caregiver, and ConcertoHealth stepped in to provide solutions to open up the lines of communication among all of his medical providers.

ConcertoHealth’s Patient Engagement Team has been meeting with JC three times per week. Since February, JC has only visited the ED five times. He’s also scheduled with a PCP and attending his follow-up appointments instead of going straight to the ED.

What makes ConcertoHealth stand out is our ability to identify the white space that results from health care delivery bottlenecks and to partner across the health care ecosystem to overcome those bottlenecks through an innovative approach to delivering care to the population, particularly those with the greatest needs.

Can you share with our readers about the innovations that you are bringing to and/or see in the health care industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?

The ConcertoHealth team understands that there is no one magic bullet to successfully transform the health care delivery system for the nation’s most costly patient population. First and foremost, it requires the best human capital — an innovative, committed and gritty group of people that understand how critical it is to work as a team. Second, technology and systems that support that team’s ability are necessary to deliver exceptional care. Third, a care model that not only excels at the delivery of high-quality, evidence-based medical care, but understands deeply that it is more often the social, behavioral and logistical determinants of health that have the greatest impact on this patient population.

It is the constellation of the above factors that is allowing us to successfully reimagine health care delivery for this population, and doing it in a way that is not replacing the existing delivery system, but instead is complementing it, and empowering it to transition from a transactional, fee-for-service system to a value and outcome-based one.

Additionally, we are laser-focused on empowering the primary care delivery system in particular. Primary health care in the United States continues to get the short end of the stick (huge understatement) economically, receiving only ~5% of all health care resources. This is what we believe is the critical weakness of the system and the pain point we are working to alleviate.

What are your “5 Things I Wish Someone Told Me Before I Started” and why.

  1. How wild of a ride it would be, e.g., working for a startup company with the lofty goal of transforming the health care delivery system.
  2. How incredibly satisfying and cool it would be to partner with an amazing group of dedicated, innovative, gritty individuals to accomplish this goal.
  3. Change is a lot slower than you think.
  4. How critical it is to have “the right people on the bus” and that you need to develop critical processes to recruit and hire to protect the company from bringing on the wrong people in the midst of rapid scaling.
  5. How essential it is to ensure that each member of the team understands the goals of the company, i.e., our True North, and how the valuable work they do on a daily basis contributes to that True North.

Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the U.S. health care system is ranked as the worst among high-income nations. This seems shocking. Can you share with us 3–5 reasons why you think the U.S. is ranked so poorly?

  1. The payment model is wrong, e.g., transactional fee for service vs. value/outcome-based.
  2. We’re shortchanging primary care (~5% of all health care dollars).
  3. Lacking focus on the social, behavioral and logistical determinants of health.

You are a “healthcare insider.” If you had the power to make a change, can you share 5 changes that need to be made to improve the overall U.S. health care system? Please share a story or example for each.

  1. Accelerate the transformation of the value/outcome-based payment model.
  2. Increase reimbursement for primary health care providers (including the mental health system), across all roles.
  3. Shift more resources and emphasis to care vs. compliance for populations most in need.
  4. Increase the number of lay health professionals (health coaches, community health workers) in the health care workforce.
  5. Increase resource provision to partnering with patients for behavioral change, e.g., support for smoking cessation, etc.

Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?

In addition to the above, leaders across all aspects of civic society, particularly those who deliver primary care services to those most in need, need to be more outspoken about the root etiology of a health care delivery system that hasn’t lived up to its potential.

What are your favorite books, podcasts or resources that inspire you to be a better health care leader? Can you explain why you like them?

A podcast from the Institute for Healthcare Improvement — an inspiring social movement that unites health professionals around the world to improve the quality of health care delivery.

The book “Pathologies of Power: Health, Human Rights, and the New War on the Poor” by Paul Farmer. This was the pivotal book for me during medical school that challenged me to dedicate my professional and personal toolkit to those most in need.

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