What is the top challenge or obstacle facing health care today?
When medical expenses are the top reason people file bankruptcy in America, that’s a pretty solid indication that something has to change. How we consume and pay for healthcare in the US requires fundamentally rethinking what we expect in return for our investment. Systemic changes are required to provide patients with excellent care at a reasonable cost while ensuring that providers are fairly compensated for their various services, especially preventive ones. Payment models and actual costs are too confusing and convoluted throughout the supply chain. At the same time, healthcare insurance costs are rising, putting pressure on consumers and employer sponsors while shifting costs back to the patient. This unsustainable pattern often forces people to choose between seeking the healthcare they need or literally keeping their lights on.
What has you most optimistic about the future of health care?
We are living in a golden age where we are witnessing major advancements in medical care, therapies, and technology that have the potential to save lives, increase lifespans, and improve the quality of life. Additionally, leaders and organizations are willing to disrupt the status quo to improve care delivery, accessibility, and cost. So too, federal and state governments are establishing novel laws to shed light on and correct for the opaque practices that drive up costs while also seeking ways to expand access to care. In short, there is no lack of opportunities to improve our healthcare system so we can all benefit from longer, happier lives (without going bankrupt while doing it).
What motivates you to keep doing the work that you do?
When I was in high school, my mother became very ill. We had a family business, and the insurance carrier we had declined most of our claims based on what they said was a preexisting condition. This put us in severe financial straits, and it took my parents years to pay off the medical debt. Given that we had insurance, I always thought it was absurd for us to end up in that situation. In my work at Capital Rx, I contribute to our mission of delivering a new model to the market that injects price transparency into the drug supply chain and improves operational efficiency via technology (JUDI®, our claim adjudication platform for commercial, Medicare, and Medicaid plans). We’re helping drive down costs for employers and patients and ensuring everyone receives a fair and equal price for their prescriptions. That’s a great reason to get up in the morning!
What’s the one piece of advice you would give to an aspiring healthcare leader?
Healthcare is probably the most complex and sometimes frustrating industry you can join. At times, you might be drained and feel like giving up due to the red tape, misaligned incentives, and other issues plaguing this industry. But know that you are entering a career path that has the potential to impact the health and wellness of real people, no matter what your role is. What other career offers such a great opportunity? The advice I’d provide would be to ensure that you’re bringing value to the market and are solving a problem that must be solved to have a positive impact. Too often, I see executives bring great ideas to the market that they think – but do not know – the market needs.
What does healthcare disruption mean to you?
Healthcare has historically been one of the slowest sectors to embrace change. Whether it’s antiquated technology, outdated payment models, or rigid service protocols, there is no lack of examples where one could look to disrupt healthcare. For me, disruption means rejecting practices that don’t work well for patients, providers, or payers and embracing common-sense solutions that align with today’s economic realities and the promise of incredible treatment breakthroughs. Unfortunately, plenty of people and entities working within healthcare don’t want their cheese moved. However, we all must be willing to step beyond our own narrow space and work toward the greater good.