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Our connected health services make the treatment, prediction, and prevention of health care's most complex conditions easier and more accessible as we drive organizations and people forward. Hello, and welcome to the Becker's Healthcare podcast. My name is Chanel Banger recording live at the Becker's and sitting down with Lawrence Hamilton, the executive vice president at the Permanente Medical Group. Lawrence, thank you so much for joining me today. It's my pleasure. Good good to
be with you. Perfect. Well, to get us started out, can you please introduce yourself and share a bit about your organization? Sure. So the Permanente Medical Group is part of Kaiser Permanente. We care for in the Permanente Medical Group, we care for 4,600,000 members in Northern California, and we do that through 55,000 colleagues, including 10,000 physicians across 21 hospitals.
Perfect. And moving forward into the meat of the podcast a bit, balancing affordability and quality is a constant challenge for health plans. How is your organization innovating to manage the cost of care while maintaining or improving member outcomes?
I actually think the framing of, tension between quality and affordability is a symptom of, the relate when the relationship between payers and the delivery system is contractual and transactional, it tends to reduce very quickly to, we want you to do more in this area that will improve quality, and the delivery system says this is what it will cost, and you get into this spiral of who's gonna pay for what.
I think a much more advantageous way to is to seek alignment between payers and the delivery system so that together, you're all focused on how do we provide the best quality, equity, access, care experience, and provider and clinician satisfaction at the lowest possible cost for the communities that we serve.
When you frame it that way and you've got genuine alignment and you've got hospital systems and medical groups that are see success as population health, then the trade off reframes dramatically where we know that when you provide great preventive care, that's best for the patients, and it also avoids downstream costs of more hospitalizations.
When you avoid a patient having to say to the emergency room because of care that you've done upstream, better for the patients and avoids, the most costly parts of the health system. So when we've got genuine alignment, we're aligning, quality and affordability much more often than they're at a trade off of one another. Absolutely. And now kinda switching gears a bit, addressing health equity has become a critical focus
for many health plans. Can you share an overview of a key initiative here that you're involved in or particularly excited about? And what are you hoping to achieve with that? Yeah. So I'm really proud that our members have a 20% less chance of dying from cancer and thirty three percent less chance of dying from cardiac related diseases.
Our sister organization, Mid Atlantic, did research showing that our members, on average, live six years longer, and African Americans live nine years longer than people who don't benefit from our health system. In certain areas, we've managed to close and eliminate racial health care gap, particularly around colorectal cancer screening, some of the diabetic prevention measures, and we know that we've got a ton more work to do.
If you ask me what what am I most proud of in addition to closing some of those gaps, I'll just a couple of areas. One is our board follows just five KPIs, relates to quality, to care experience, to physician satisfaction and engagement, making our care affordable, and then the one is around health equity. So that commitment from board level throughout the organization, I think, is really important.
And then secondly, often our health equity efforts have been very focused on on prevention in primary care, which is the core of our organization. But we've actually challenged all of our service lines to look at health equity gaps. I was really proud the other day. I was in one of our medical centers in San Francisco, and they'd, taken our TAVR program.
That's a program that I think very seldom gets viewed through an equity lens, and they looked at the national data and found that that, different racial groups just don't get access to TAVR at all for a myriad of reasons around health system design, around care that doesn't connect culturally with with different groups.
And so now that we've got that data and then we've managed we've looked at our own data, which isn't as exaggerated as the national data, but it's given us absolute clarity about a gap that we need to close. So doing that, we've got about a 120 service lines. Doing that in every service line, means that we'll get completely clear about the gaps that we need to close and then work through what we need to do to close that gap.
Got it. Got it. Now moving forward, member satisfaction is essential to thrive in today's competitive health care market. What experience or engagement strategies have proven effective for organization, and how are you measuring success? Yeah. This is an area where we've changed dramatically in the last, eighteen months.
Previously, we'd had a paper based survey that were mailed to people's homes, and so we are only able to sample a small proportion of patients, and we got an even smaller response rate. In the last year and a half, we moved to a digital platform, where we can survey everybody that comes in with care for care. We still get a low response rate, although compared to many other surveys, it's about two to three times the response rate.
But instead of having survey feedback patient feedback in the, tens of thousands, we're now getting it in the in the tune of millions. And the volume of data has enabled us to get much, much more precise around, seeing where we have gaps. So we know that our overall net promoter score is 87. But when we break down by age, there's almost a 30 gap between different groups, just as one example.
So that's enabling us to get much more focused and targeted on where is our service, not landing in the way that we'd like it to. Now the area is what we call closed loop resolution, where when we get feedback where we could have done better, that immediately routes to the operational leaders, physicians and administrative leaders in those areas so that we're able to, wherever we can, immediately respond.
And we've got some great examples of being able to, catch patients before they've reached their car and call them back to rectify the problem they had or or examples where patients have been initially very unhappy. And then as they've seen us take action to respond, they've then taken upon themselves to sort of re regrade their response to us. So like every health system, we've got plenty of opportunity to get better in our daily interactions.
And this the closed loop feedback's giving us some enabling us to be much more agile in responding to patients', patients' needs. Absolutely. Well, Lawrence, I wanna thank you for your time today. But before I let you go, I have one more question. Looking ahead, what do you see as the biggest opportunity for payers to lead the change in transforming care delivery and driving better outcomes for all stakeholders? And how can leaders take a step in this direction now?
Yeah. It really goes back to what I said at the beginning that so often our provider, the delivery system, and payer is stuck in a cycle of, who's gonna get paid for what.
And, of of course, the the flow of resources is important, but the real breakthrough comes when we've got, the delivery system, medical groups, hospital systems, all aligned around using limited resources as we know affordability for our patients is probably the biggest challenge that we face in The US, and trying to use those limited resources, make care more affordable,
and provide great quality equity experience access. And we know with shortages in in health professions, it's also gotta work for health professionals. When we get that alignment, I think we can do extraordinarily better. We know that The US health system was spending $5,000,000,000,000, 18% of the entire economy, and we're getting the worst outcomes of any developed, developed economy on the globe. So it's not through lack of resources, but the way that we're using resources just isn't
delivering population health. So where we get that alignment and where we really enable medical groups and hospitals, to be successful by delivering population health, that I think is the brightest hope for how we can improve the care of our nation. Absolutely. Well, that's a great spot. And, Lawrence, I wanna thank you once again for your time today and for joining me on the Becker's Healthcare podcast. Thanks. It's been a privilege.