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The Future of Healthcare: “We need to end the system we currently have where quality, cost, and outcomes are irrelevant” with Chris Klomp, CEO of Collective Medical

For one, we need to stop requiring and enabling providers to dip their toes into value-based care and put down a hard time line with hard requirements. Fundamentally, we need to end the system we currently have where quality, cost, and outcomes are irrelevant. It’s unfair to providers to have them shift from volume to […]

For one, we need to stop requiring and enabling providers to dip their toes into value-based care and put down a hard time line with hard requirements. Fundamentally, we need to end the system we currently have where quality, cost, and outcomes are irrelevant. It’s unfair to providers to have them shift from volume to value-based care in tiny increments where 90% of their day is still fee for service and only 10% is value. That’s a level of dissonance that most humans can’t manage. And just dipping a toe in isn’t enough to reorganize the system or build new processes and workflow that allow doctors to be successful in a value-based care setting. From a policy prospective, we need to make it easier for good people to make the right decisions. From a tort perspective, we need to enable physicians not to order the 100th confirmatory test just to CYA.


Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Chris Klomp is CEO of Collective Medical, the nation’s most effective network for real-time care collaboration. Collective helps clinicians collaborate to support their most vulnerable patients — those whose needs cannot be met in any single care setting. Chris has led the company’s transformation from a single-product offering in a single state to a multi-product company that spans 31 states and counting.


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

Growing up in Boise, Idaho (or “Les Bois” for the Francophiles in the house!), I dreamed of becoming a physician just like my dad — my personal hero — so that I could help people. But my path changed when I took a two-year leave from Brigham Young University to serve a religious mission to Romania and Moldova. When one of our missionaries fell severely ill, I was bewildered by how disorganized the Romanian medical system was: finding a qualified physician who had the training and resources necessary to accurately diagnosis and treat this missionary was challenging, especially when the diagnosis would relate to something as complicated as Meningococcal Meningitis. After being airlifted to a hospital in Germany, the missionary thankfully made a full recovery — but the experience of navigating a constrained medical system left a powerful impression. After a mentor suggested that if I really wanted to change the situation I should instead learn to organize and manage people, I decided to do just that. I switched my major to Economics, and later added English as a second major, upon my return from Romania. After graduating, I spent three years at Bain & Company as a strategy consultant, and later an additional seven at Bain Capital as a member of the firm’s private equity team. It was a marvelous experience getting to learn from brilliant leaders and operators of world-class companies.

After my first two years at Bain Capital, I took a firm-sponsored leave to earn an MBA from Stanford GSB. At the same time, I co-founded an AI-based deception detection systems company, BlackSwan Neuroscience, which ended up winning Stanford’s 2009 university-wide start-up competition. Before attending Stanford, I’d made the commitment to return to Bain Capital in Boston, and I honored that commitment. I returned and later became VP of North American Private Equity.

I enjoyed my work in private equity but I had a huge desire to create something that could have meaningful impact. My childhood friends and college roommates, Adam Green and Wylie van den Akker, had been working on Collective Medical starting in 2006, having been inspired by Adam’s mom Patti, an emergency department social worker who noticed that some of the patients with whom she was interacting were visiting other hospital emergency departments besides her own and slipping through the cracks of the fragmented healthcare system.

I began helping Adam and Wylie with Collective Medical in an advisory role in 2010 while at Stanford and just as the company was getting its first customers (it was a slow start and took several years to gain first customers), and the company began picking up steam with hospitals in Washington State by 2012. Adam and Wylie knew that they needed someone with a different background to help them grow the company. So, when they asked if I’d lead Collective Medical in 2014 — around the time my wife Elise was due with our first child, I knew I wanted to make the jump.

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

Not sure if it’s the most interesting thing that happened, but this experience definitely stands out. When I first joined Collective as CEO, I had an opportunity to meet with a major health plan and pitch their chief medical officer on our vision of bringing all healthcare stakeholders — providers and payers — together to collaborate.

During our meeting, I started talking with him about how providers and health plans could work together, collaboratively, to better care for patients (years ago, this was a very foreign concept!). As I was talking about the benefits of doing so, and really hitting a passionate crescendo in my pitch, I noticed that he was full on sawing logs across the table. It was pretty awkward because it was just the two of us. He was asleep for a solid ten minutes. Absolutely out cold. And I didn’t know what to do! He was obviously tired, so I didn’t want to wake him. If I bailed early and he woke up to an empty room, he might be offended and our chance to work together could be gone. So I just sat there, rustling around a bit, until he woke up — and when he did, he told me our vision would never work and that providers and payers would never trust one another enough to care collaborate together.

Today, that health plan is one of our biggest customers and most ardent supporters. And we’re approaching nearly 1,000 hospitals, tens of thousands of providers and every major national health plan in the country, all working together and using our network to collaborate. I think about that situation a lot — not just because it’s sort of hilarious, but because it goes to show how you can push through and make things happen even when others tell you it can’t be done.

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

Not really; I’m not even an authority on anything to my three kids aged four and under. Ugh! But I think any authority in healthcare I may have gained has come from exposure to the incredible healthcare leaders that have signed on to our vision. We’re quietly working behind the scenes alongside state and federal government, large health systems and major health plans to enable a level of collaboration that most in healthcare didn’t think feasible given the competitive dynamics in the industry.

Together, we’re demonstrating that there’s value to be had from aligning efforts to prioritize individual patient needs. So, while others are focused on technical interoperability (which is essential), we’re really pushing the bounds of clinical interoperability.

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

While much of healthcare is “non-profit,” we’re for-profit. Despite that, we’ve managed to prioritize our company mission and values in such a way that we continue to make decisions that are often not based on how much money we’ll make, but rather, based on whether it’s the right thing to do. I love that about Collective, our team, and our investors.

For example, we were once contacted by a Department of Child Protective Services (CPS) who had recently completed a study in which they found that in the majority of the child abuse-related deaths in their particular region, those same children had presented in a hospital emergency department in the preceding 4–6 weeks with indications of being in an abusive situation. Because there was no effective way for the clinicians to report this information to CPS, CPS missed opportunities to proactively investigate and try to protect the child in a safer environment. Given that closing this information asymmetry could otherwise prevent these deaths, the department asked us if there was a way that we could use our emergency department network and the real-time awareness it enabled to help these children.

Even though this was never going to make money for the company — it was actually going to be quite costly — it took me all of 300 milliseconds to commit and offer Collective’s full resources to tackle the problem. How refreshing not to have to seek permission from my partners or the board to make such a decision, already knowing that every individual within our organization would already be aligned to try to help solve this problem for such a vulnerable population.

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?

Most efforts within the digital health space have been focused on how to align clinical pathways within an organization or its closest affiliate. But we are convinced that even the most highly integrated health systems in the country require involvement from many distinct and unaffiliated stakeholders across a community of care providers — and they all need to collaborate. We’re entirely focused on enabling a level of cooperation among healthcare organizations for the greater good of a single patient, even if they would otherwise be competitors. Over time, we expect the business models to change to incentivize care collaboration approaches like this — take value-based care for example. Healthcare organizations are paid by the outcomes, not the number of procedures billed or patients seen. This can help address major barriers to care like undue competitive dynamics as well as redundant and medically-unnecessary patient interventions.

Are you working on any exciting new projects now? How do you think that will help people?

One of our more exciting projects is focused on an extremely complex patient population — and is another example of Collective doing the right thing, regardless of financial gain — helping care teams support infants born with neonatal abstinence syndrome (NAS). Babies born from opioid addicted mothers can start to go through withdrawal and not all hospitals are equipped to deal with that, so many times the baby will need to be transferred to a specialty hospital to get the proper care. That’s where the importance of care coordination comes in. If a baby is born with NAS and then moved to a specialty hospital, recovers and is sent home, they will likely go to their local hospital if they have any issues in the future. Alternatively, it might be that a baby goes home before exhibiting symptoms of withdrawal and then ends up in the emergency department showing symptoms, but the emergency department doesn’t have the information it needs to figure out what is actually going on.

In these cases, it could take doctors much longer than needed to figure out the issue and treat the infant. By helping these hospitals and health systems better coordinate, they can greatly reduce the amount of time the infant is dealing with withdrawal without appropriate treatment. Our software is well positioned to speed provider time to identification and engagement.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

I didn’t know that how all-consuming my role would be — it literally sucks all the oxygen out of the room (usually in a great way). But, leading a company like Collective, in its growth phase and with such an emotionally-charged mission — truly takes up nearly all of my time and mental energy some 18–20 hours per day. People probably did tell me that and I just didn’t believe them. Oops. But our mission is so compelling and personal, it drives you to give it your all.

The other thing I didn’t fully realize is how dysfunctional healthcare is as an industry, in spite of the fact that it is full of some of the brightest minds on the planet. This can be incredibly aggravating — like, ram your head into a brick wall fifty times a day because the answer is so obvious yet the path so bureaucratic, complex, and slow. For this reason, I feel incredibly compelled to try to make a dent in it for the better. Every time I hear a patient story about someone who fell through the cracks and how our technology helped our provider partners restore that individual to a better state of health, it completely justifies the effort.

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?

We continue to beat ourselves up about being the worst of high-income nations, but there’s nowhere you should rather be if you have cancer, a complex cardiac situation, or high-risk obstetric need, for example. There’s nowhere you’ll receive better care — full stop. Yes, we spend an extraordinary amount of money on healthcare and we have to flex the cost curve down to a sustainable level. But many of these costs are related to zip code — not genetic code — manifest as a complex combination of social determinants and lifestyle choices, and decisions that we, as a nation, have made as to how much we are willing to spend on our care, particular at end of life. That’s more about policies and priorities and less about the quality of the healthcare system in our country.

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.

For one, we need to stop requiring and enabling providers to dip their toes into value-based care and put down a hard time line with hard requirements. Fundamentally, we need to end the system we currently have where quality, cost, and outcomes are irrelevant. It’s unfair to providers to have them shift from volume to value-based care in tiny increments where 90% of their day is still fee for service and only 10% is value. That’s a level of dissonance that most humans can’t manage. And just dipping a toe in isn’t enough to reorganize the system or build new processes and workflow that allow doctors to be successful in a value-based care setting. From a policy prospective, we need to make it easier for good people to make the right decisions. From a tort perspective, we need to enable physicians not to order the 100th confirmatory test just to CYA.

Second, the pharma world has created extraordinary value in offering a better quality of life, extending life, and mitigating pain. But so many of our problems cannot be solved with another pill. And at the moment, pharma and the rest of the medical world aren’t working hand-in-hand to provide cost-effective prophylactics. As David Feinberg from Google Health recently said, we need to give people access to broccoli and other healthy food, not more medications, to meaningfully lower the rate of diabetes (approaching 30% in the next decade!) and, therefore, the cost of healthcare in our country.

Third, we need to think about the care of a person from a whole person perspective. We know this already, but we need our policies and laws to catch up with this. Why are we siloing mental, behavioral, social, and physical health information, all the while charging our primary care providers with the gatekeeper keeper role for the entire health of the information. It’s like running a marathon blindfolded on one leg; that sounds tough. Let’s get them all the information they need to make good decisions and call all the shots.

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?

Many of these changes will require policy level changes to remove barriers. As individuals and communities, we need to reach out to our appointed and elected leaders to encourage them to drive policy changes that create the pathways needed for good people to do the right thing. It’s about enabling an economically viable path toward a systemic model in which we pay for outcomes, not just tests and procedures.

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

John Steinbeck’s Cannery Row. In it, Steinbeck empowers you, the reader, to insert yourself into the daily lives of a group of derelicts with whom you would likely never otherwise interact. And rather than judge or resent them, you develop empathy for and kinship with them. This is the same set of attributes that any healthcare leader worth their salt should possess. You can’t fully solve someone’s problem if you don’t understand who they are and how they got there in the first place. That requires understanding and empathy. To me, Cannery Row is a manual and a model for developing these attributes.

How can our readers follow you on social media?

I can be followed on Twitter at @1klomp or on LinkedIn.

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