Admit that medicine is a continuing clinical trial. There is so much we don’t know, and entrenched interests are good at keeping certain treatments the standard. We have tossed out enough of what we thought was correct that we might benefit from a more expansive, yet humble approach to exploration, trial and roll-out of new treatments and therapies.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Steve Wiggins. Steve is Founder and Chairman of Remedy Partners, Inc, a health care company based in Norwalk. Steve is also presently a Senior Advisor of EW Healthcare, a private equity investment firm. Steve previously founded seven other health care companies including Oxford Health Plans, which grew into a Fortune 300 company under his leadership.
Steve is a Director of Accessible Space, Inc, a non-profit organization he founded in 1978, which operates residential facilities for individuals with mobility impairments and brain injuries. Steve graduated from Macalester College in his native Minnesota and has an MBA from Harvard Business School.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
The short version of what is a long story is that I got into health care when my best friend broke his neck in a diving accident and became a quadriplegic. I started a non-profit organization called Accessible Space Inc. (A.S.I.) that built residential facilities and provided support services for people who needed that kind of specialized care, just like my friend. A.S.I. now operates over 146 residential settings for people with physical disabilities. While building A.S.I., I worked part-time in what became a large hospital chain, as the only person who could use a computer! That gave me additional exposure to operational health care challenges. I then started a HMO (Health Maintenance Organization) because I believed in the power of health maintenance and disease prevention, and it grew to a Fortune 500 company. I’ve always been keenly focused on innovation. It’s all got to start with ideas.
Can you share the most interesting story that happened to you since you began leading your company?
My latest company, Remedy Partners, is my sixth start-up, and it had an interesting start. I volunteered to work in government to help implement the part of the Obamacare program related to bundled payments. During that time, I was encouraged to expand my work in the industry to help hospitals and physician groups implement these programs. That’s actually how Remedy began.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I first worked in the health care industry as a long-range planner and went on to build a large non-profit organization serving the disabled that touches most parts of Medicare and Medicaid. I then built six health plans, from scratch, in what was a start-up called Oxford Health Plans, which grew to be a Fortune 500 company. I also served on President Clinton’s health care commission and spent 10 years as a co-head of a health care private equity firm. My experiences throughout my career have given me a close-up look under the hood of the health care industry and from that vantage point, of really rolling up my sleeves, I’ve been able to see what’s working, and what isn’t.
What makes your company stand out? Can you share a story?
At Remedy, we are solving one of the most important challenges facing health care — how to make it more affordable for patients and how to make it less complicated for physicians and other health providers to deliver it effectively. It sounds logical and simple, but the truth is that most people know more about the cars they buy than the health care they purchase, which is a pretty shocking reality.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
Remedy is working to match the way health care is paid for with how it’s actually consumed. Most health care is consumed episodically. We have a diagnosis, or a sudden onset of a condition, and we then enter an ‘episode of care’ that is most often a 30 to 90 day chapter in our lives. If we pay for health care around patient episodes, it forces health care to be organized around a patient’s episode. We can also measure health care around patient episodes. That allows patients and consumers to compare and purchase health care with the benefit of more transparency. We believe people should know how much their care will cost, who will perform those services and how they measure up. That’s the type of transparency we’re advocating and achieving it will be truly transformative for the industry.
Are you working on any exciting new projects now? How do you think that will help people?
We believe our work is making a profound difference for the whole country; both for everyday people and for governments and businesses. Our mission is singular: to build software and deliver services that enable health care payers and providers to organize and finance health care around patient episodes. That’s all we do! It’s a straight forward vision, but when you see it in motion, the results are pretty powerful. By using bundled payments for episodes of care, we are making a difference. And bundled payments are relevant in most countries of the world. That will be the next conversation; how this model and technology can be utilized in emerging economies and developing countries elsewhere.
What are your “5 Things I Wish Someone Told Me Before I Started” and why.
• Just start walking in the direction of your dreams. You’ll figure it out and make adjustments along the way. Don’t let the quest for perfection be the enemy of good when deciding to launch a business. All businesses morph in the early days. You never accomplish anything if you don’t take the first steps towards your dream and start making progress every day.
• Hire slowly and fire quickly. The most important work of a founder is to find really talented people, pursue them vigorously, get them into your company and then demonstrate your confidence in them.
• Don’t underestimate the power of purpose. If you have a business that makes a real difference in the world, keep your focus on that purpose. It inspires people to buy from you, to work with you and to invest in you. It also leads to a more meaningful life, which has a big impact on your overall happiness.
• Make sure everyone knows what the company does, how you create value and what you specifically expect from them as it relates to that. The clearer you are, the better.
• Stay curious, always. The most successful people seem to always be learning new things and exploring new horizons. Foster your curiosity through always starting interested in what’s out there and leadership gets easier.
Let’s jump to the main focus of our interview. According to this studycited by Newsweek, the US healthcare 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 US is ranked so poorly?
The meta-analysis cited in the question is a combination of multiple other measures and studies highlighting that, despite spending more money than any other country, the U.S. ranks last in health outcomes. With that information at our fingertips, it’s impossible to ignore the elephant in the room: we are clearly not getting our money’s worth.
The study also points to the solution, which I agree with; “The U.S. may need to pursue different approaches to organizing and financing the delivery system,” the report reads. “These could include strengthening primary care, supporting organizations that excel at care coordination and moving away from fee-for-service payment to other types of purchasing that create incentives to better coordinate care.”
That is precisely what bundled payments accomplish. Bundled payments for episodes of care provide new tools to primary care physicians to make informed referrals. They also foster greater coordination of care between and within organizations, and they move away from ‘fee for service’ towards ‘fee for value.’ There’s a huge difference between the two.
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 US healthcare system? Please share a story or example for each.
• Make structural changes that make the U.S. health care system look more like Swiss or German health systems. They have vibrant, competitive health care insurance and delivery system markets, yet they find a way to assure near-universal coverage, which is what we should be striving towards. Part of the Swiss success is due to the fact they pay 17% of total health care costs, whereas Americans pay 12% and we still feel that’s too much.
• Embrace payment reform to drive competition, transparency and improved outcomes. Bundled payments are the best example of that. We can leverage private markets and companies to save the Medicare Trust Fund, state Medicaid programs and employer insurance programs.
• Take a cue from the NICE (A U.K. Health Agency) approach to managing drug spending. Pharmaceutical pricing is out of control and the U.S. model of regulation encourages price gouging. We can achieve massive savings from a new regulatory approach.
• Adopt the SEC model of regulating health care providers and payers. American regulation has evolved into an overburdensome strategy of micromanagement — of everything. The securities markets provide a perfect model of ‘disclosure based’ regulation, which could make health care delivery and insurance less expensive and far less cumbersome. SEC-style regulation relies on people voluntarily doing the right thing, making everything transparent and severe punishment for wrongdoing.
• Admit that medicine is a continuing clinical trial. There is so much we don’t know, and entrenched interests are good at keeping certain treatments the standard. We have tossed out enough of what we thought was correct that we might benefit from a more expansive, yet humble approach to exploration, trial and roll-out of new treatments and therapies.
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?
Accelerating the use of bundled payments as a way to pay for episodes of care requires health plans to embrace this innovative new payment arrangement with as much conviction as Medicare has shown in moving over $18 billion of spending into this approach.
State governments in some states are already embracing this model and others should strive to learn how their own states could follow a similar path towards lower costs and better outcomes. Hospitals and physician groups are beginning to embrace this model, but we’re still in early days and the reluctance to try new approaches — even when everyone can see that the established system is broken — is still strong in health care.
We need enlightened, progressive leaders who see the merits of this path and then we need to support them as they forge a new path. That’s the opportunity!
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
My favorite recent book is “Thank you for being late,” as it captures the important forces driving the ‘age of accelerations.’
My favorite podcast is Simon Senek’s “How Leaders Inspire Action.” I’m also listening to the WSJ’s ‘The Future of Everything’. I’m always interested in hearing from people who are committed to shaping our future in better, more positive ways.
How can our readers follow you on social media?
They can’t yet! Keep an eye out for it though, because we’ll be bringing Remedy into the social media landscape in the coming months.
Thank you so much for these insights! This was so inspiring!