HFMA’s Annual Conference: Zeev Neuwirth says a reframing of healthcare is happening, and not a moment too soon

• The costs of senior care, complex chronic conditions and heath inequities are among the increasingly unsustainable aspects of the U.S. healthcare industry, keynote speaker Zeev Neuwirth said Sunday.
• Such forces require a reframing of the industry, which is well underway and has already affected other parts of society.
• Finance leaders can play a major role in guiding this reframing.

DENVER — Even with notable assets in the form of people, technology, research and financing, U.S. healthcare has glaring issues that can’t be solved without a “reframing” of the industry, said clinical executive, author and podcast host Zeev Neuwirth during Sunday’s opening keynote presentation of HFMA’s 2022 Annual Conference.

“Despite all of that amazing input, we continue to deliver a mediocre customer experience,” said Neuwirth, chief clinical executive for care transformation and strategic services at Atrium Health. “We continue to deliver suboptimal outcomes and gross inequities in care. We continue to deliver an unsustainable cost burden, and the market is just not able to tolerate it anymore. And we see signs of the market beginning to break.”

Neuwirth cited a report from the National Academy of Science, Engineering and Medicine that found primary care in the U.S. isn’t providing the caliber of preventive and chronic care that the country needs. And he quoted Warren Buffet as saying, “Healthcare is the hungry tapeworm” in corporate America.

Neuwirth described ongoing “tsunami” forces that illustrate why a reframing of the current system is necessary:

Senior care and chronic disease care. By 2034, more Americans will be over 65 than under 18, Neuwirth said. “This is a fundamental inversion in the demographics of our nation.” And by 2030, more than 90 million Americans will have at least three chronic conditions.

Inequities and social determinants of health. Just in the past week, he noted, Deloitte released a report that pegged the cost of health inequities at $320 billion, with the potential to reach $1 trillion by 2040.

The concept of reframing

In addition to his day job at Atrium Health, Neuwirth has spent the past six years interviewing several hundred healthcare entrepreneurs whose ideas have been transforming segments of the industry. What started out as an information-gathering project transformed into a podcast and a book.

The interviews formed Neuwirth’s concept of “reframing” healthcare.

“I know in this conference, you’re going to talk about reimagining and rethinking healthcare,” he said. “I actually found out that it was something even more specific than that: In order to rethink [and] reimagine healthcare, these people were reframing healthcare.”

Much of the reframing came down to orienting their business around their consumers: “How do we do it so it’s the right thing for the customer?”

The basic reframing roadmap consists of:

• Reorienting thinking
• Redefining the problems
• Redirecting strategies, tactics and resources

Advanced phases entail embracing a marketing mindset that allows for:

• Rebranding or redefining the value proposition from a customer perspective
• Redesigning the customer experience to make it easy, engaging and relevant
• Reorganizing business units to be sustainable through segmentation and modularization

The reframing approach has led to profound changes throughout society, as illustrated by companies and products like Airbnb, Uber, Facebook, TikTok, Tesla and Peloton. Transformation began with content (such as allowing people to look things up via Google), then swept into communication and commerce.

How reframing can apply to healthcare

Reframing in healthcare is exemplified by three trends, Neuwirth said.

One is that the concept of the medical home increasingly is synonymous with the patient’s home. This trend has been going for about a decade, though undetected by many, with stakeholders such as Humana and Optum spending billions of dollars to create a new ecosystem of home-based care.

A related trend is that the concept of the point of care has moved to what Neuwirth calls “the point of need.”

“There’s going to be a huge movement, a decentralization of healthcare delivery,” Neuwirth said. “Hundreds and hundreds and hundreds of companies are bringing care literally to you through your phone, through your laptop, through your iPad right when you need it.”

The third trend, also related, is that essentially all healthcare is digital care.

“It’s more connected, more continuous, more contextual, more customized and more cost-effective,” Neuwirth said.

Digital care doesn’t mean virtual care, such as video or phone visits. It’s about taking reams of data and feeding them into increasingly sophisticated software algorithms that guide care.

“There’s nothing futuristic about this,” Neuwirth said, referring to the various sweeping changes. “The future is already here.”

Finance leaders must show the way

Neuwirth said CFOs and other healthcare finance leaders are in a unique position to spur necessary changes.

“The core problems in American healthcare are not technological,” he said. “They are not clinical and they are not operational. They are largely financial.”

Costs are unsustainable, payment models are inefficient and the business model needs an overhaul, he said.

“The good part is the core solutions will come out of the financial realm,” Neuwirth told the audience. “American healthcare needs your financial expertise, but even more than that, it needs your financial transformation leadership.”

Neuwirth understands there may be a reluctance to push for substantial changes during a challenging time for the industry. Then again, when times are better, people are averse to changing the status quo.

And change can’t wait, he said.

“There is the risk of being disrupted, but more importantly, we have to realize that the way we’ve been doing things is unsustainable,” Neuwirth said. “Even more important than that, for ourselves, for our families, for our friends, for our communities, for the country, we have to actually do the right thing.”

He concluded by asking the audience:

“How are we going to be lobbyists for a better future, for a more humanistic future in healthcare? How are you going to be more mindful financial leaders? How are we going to transform healthcare before the hole gets too deep — before we’ll really require some draconian interventions?

“We need your financial expertise, but we also need your bold, courageous and humanistic leadership.”