During his 14 years as president and CEO of Geisinger Health, Glenn D. Steele, Jr., M.D., Ph.D. led the Danville, Pa.-based integrated health system forward to become one of the most respected and admired health systems in the United States, as he pursued a path of quality, transparency, and accountability that won the organization many awards, and created innovations—including Geisinger’s pioneering ProvenCare program—that are being replicated nationwide.
Then, in April 2016, Dr. Steele announced his retirement from Geisinger, along with announcing his being named chairman of xG Health, a Geisinger-affiliated consultancy designed to spread the organization’s principles across the U.S. healthcare system. He also announced at the same time that he had been named vice chairman of the Health Transformation Alliance (HTA), a group comprised at that time of 25 leading U.S. corporations seeking to help change the healthcare delivery system nationwide HTA now counts 47 members).
Dr. Steele recently spoke with Healthcare Informatics Editor-in-Chief Mark Hagland regarding all the activities he’s been involved in, and the ongoing evolution of the value-based healthcare delivery and payment concept within U.S. healthcare. Below are excerpts from their interview.
How are things going at xG, in terms of spreading the gospel of what you and your colleagues had achieved at Geisinger?
In fact, I’m at an XG innovations conference at Baltimore right now. What’s involved in all this is a scaling effort, an attempt to generalize the innovations we worked on at Geisinger. I’m always gratified by being around committed providers and payers, and now, through the Health Transformation Alliance, committed purchasers, as well. And it’s important to understand that whatever environment you’re in, you’ve got to fundamentally change how care is given. And you can’t do that without lots of trial and error, without lots of commitment, without trying a lot of different things, similar to what we were trying to do, with some peculiar advantages, at Geisinger. So I enjoy the challenge; it’s not an easy aspiration to generalize. But I think it’s a worthy effort. And I get juiced doing what I do.
Glenn Steele, M.D., Ph.D.
Congratulations on all these successes. In looking at the overall U.S. healthcare system, and the proverbial one-thousand-mile journey that the system is moving through on its way to becoming a truly value-based system, it seems to me that we’ve reached an inflection point, where we’ve moved beyond the very early experimental phase, and are somewhere beyond that, with ample examples of success in innovation to point to, even as we have a long way yet to go. Your thoughts?
I agree completely with you on that. There are four or five reasons we can’t go backwards. Number one, the expectations of consumers are changing—what they can do in other industries, is what they’ll expect in healthcare. And if we continue to be hospital-centric and physician-centric, organizations that continue to engineer away from that will win market share.
Number two, we’ve got physician issues, and if we continue to ask physicians to do the same things over and over and faster and faster, we’ll have burnout. So that’s a compelling issue—physician life satisfaction; and that has to be linked to changes in how care is given. Number three, whether you’re in a fee-for-service environment and getting pounded by payers that want to reduce pay per unit of work, or in a shared-risk environment, you have to change how care is given and what it costs—that’s fundamental.
And fourth, most organizations are fundamentally driven by the potential for change, to better serve their communities. Back in the 1990s, when we were arguing about “Hillarycare,” there was this idea that you could choose between cutting costs or improving quality; but that’s a false choice. When you rework care delivery, you get lower costs and better outcomes.
You’re the absolutely perfect healthcare leader with whom to converse about the changes needed in physician culture to accomplish transformational change. I remember 30 years ago on healthcare, how most physicians, and certainly most medical-professional associations, were dead-set against change. And yet some fundamental cultural changes are having to take place in order to allow for the clinical transformation needed to transform the overall healthcare system. Your thoughts?