Simplifying Healthcare and Rebuilding Trust with Dr. Amy Compton-Phillips

0:00Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year, those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit Becker'sHospreview.com and click on the events tab in the upper right. Hello, everyone. This is Jacob Emerson with the Becker's Healthcare Podcast. Thrilled today to be joined by a special guest. Dr. Amy Compton Phillips is the Executive Vice President and Chief Medical Officer at CVS Health. Dr. Compton Phillips, thank you so much for taking the time to be with me on the podcast today. What a pleasure to be here. Thank you for asking me, Jacob. Absolutely. Amy, it's a pleasure to get to speak with you.

1:01And before we dive into everything we want to talk with you about today, can you first tell us a little bit more about yourself, your background in healthcare, and what it is that you do today at CVS Health? Sure. Well, I am an internist and started out straight out of residency with Kaiser Permanente and lasted there over two decades. I went from being a frontline doctor through a variety of roles and came up as the chief quality officer nationally for the organization. I then moved over to be for service, care delivery system, Providence, health up and down the west coast, where I started out as chief medical officer and ended up running clinical operations, including having the first patient with COVID. After that did a very brief stint, a little touch and go in consulting, being the chief physician executive with Presckini and went from there straight over to CVS Health, where I am now delighted to be involved with helping simplify healthcare.

2:01Wonderful. We'll appreciate that quick overview there, Amy. And that's where I actually want to get started by talking a little bit about your career, working for some of the largest health systems in the country. And that's such an interesting anecdote that you added there, the first COVID case. I'm sure that was a very scary experience at the time, but you spent over two decades at Kaiser Permanente, you led clinical operations across 51 hospitals at Providence. So, you know, given all of that experience, how did that shape how you're approaching your current role at CVS? Yeah, it directly relevant at Kaiser Permanente. It's a unique model in American health care. It was accountable care before anybody knew what value-based care was, where the traditional way Kaiser Permanente is paid for is an employer will pay one price, a subscription fee for health care, and then it's all you can eat, right? It's like buffet that you get great outcomes that way by focusing on prevention and wellness because Kaiser Permanente and patients do better if they stay healthy well and out of the hospital.

3:08And so I really cut my teeth on a model of care where we were focused on improving health outcomes and keeping people the best health they could possibly be. When I went over to Providence Health System, and I got recruited in because our CEO at the time really wanted to understand how KP did what KP did to be able to get the kind of quality outcomes that they did and bring that kind of knowledge into more traditional US health care as delivered by Providence, which is in the way the 97% of the country gets health care, right? And the really interesting thing at Providence was the incentives were not necessarily aligned with the way people wanted to be receiving care. That fee for service medicine, doctors and hospitals get paid to take care of people when they get sick. And so the incentives are to do a fantastic job with really complex care when people get very sick, but there's less of a demand to focus upstream in care, which is what most people want.

4:13So while it was really a wonderful place to learn how to how do we coordinate the highly complex specialty care people need when they really need it. It was it didn't really scratch the itch of my my personal goal in my career, which is to make great health and compassionate care available for all. So the opportunity at CVS is to actually go back to my roots to say, how can we leverage this incredible system that we have with 9,000 retail stores with 40,000 clinicians, including pharmacists and physicians and nurses. And we've together a system where we can make easy access to compassionate care with high quality and clinical integrity available for all. So that's that's the goal at CVS health, you know, have have no small goals understood. Yeah, you wanted to make a bigger impact by by moving to an organization with a bigger footprint and makes a lot of sense.

5:15And you know, we've talked with a lot of leaders at CVS recently, Amy and certainly over the years about how the company has really wanted to focus on building a more connected consumer centered healthcare experience across all your different assets to your point, a larger footprint. You have Etna with insurance benefits, minute clinic in the retail stores, Oak Street Health, the pharmacy benefits under care mark. So I wonder, given all of that, what what does bringing that more connected experience actually look like in practice on the ground for for all the different kinds of individuals that you serve. Ultimately, where where you seeing this all work for people. Yeah, you know, Jacob, I want to go back to something you just said, it's not just a bigger footprint that CVS has. It's a different footprint. It's a different set of assets. It's assets close to where people live work and play. And because of that, because of all those assets, having information about about cost and outcomes and quality at the same time as clinical care, we can actually weave together an experience for consumers and patients and members that's very different.

6:27When you think about the things that people have to deal with and healthcare today that are frustrating as in, I can't get in to see anybody. Well, we have minute clinic, we have virtual care, we have Oak Street Health clinics for people on Medicare that allow us to help solving for access in a different way in a more expanded way. You can actually access care through our CVS health app, right. There's navigation and the connected tools, the digital tools can actually help with navigation saying, who's in my network. What's their phone number? How can I see them? Do I need a referral? Oh, I did need a referral or I need a prior authorization. Here's where it is in process. So I can actually see what's needed. And then so access navigation and the third big one is payment. People hate not knowing what things cost and healthcare. We know how expensive it can be and that nobody wants a surprise bill out of the blue. And so we actually have things like accumulators and estimators that actually allow people to understand what the cost is.

7:31And by weaving together that entire journey, the ability to get access, the ability to navigate care and the ability to understand cost, we think that we're creating a much more integrated ecosystem that helps really simplify the entire journey for something that nobody wants to have to do, but we all do at some point have to do, which is navigate the healthcare system. Absolutely. And it's so clear that there's so many amazing tools right now out there for consumers to take advantage of even just from the cost perspective, Amy, to know what the final cost might be at the pharmacy counter. And so I wonder how do you balance that all the amazing innovations that have been made at even just a single company like CVS with the reality on the ground of what we of what we and I'm sure you were hearing from patients about the healthcare system more broadly. The course ensures specifically as well about the low trust that a lot of the public has right now in the healthcare system.

8:33I know you spent a part of your career communicating public health guidance during the pandemic in national media sources, so trying to instill trust in healthcare institutions and in some of the data coming out during obviously a major health crisis. So I wonder how do you think about rebuilding trust now post pandemic within the wider healthcare ecosystem and what role does CVS play in all of that. I think you've really hit on a critically important and to be honest with you painful reality in US healthcare today. The time magazine and Gallup did a survey, it's been about two years ago now that showed roughly 70% of people in the US do not believe the healthcare system has its best interest at heart. As the ultimate service industry that's incredibly sad that 70% of people in the US don't trust that we're working in their best interest.

9:37So it's 100% critical for us to rebuild that trust through consistency and transparency and clinical integrity. During the pandemic, we learned that being the smartest person in the room, being right all the time, being 100% positive, it's our way or the highway, that is not the way that you build trust. It's being open and honest and actually listening to what people care about and then ensuring we can meet them where they are. What we're very much focused on doing right now is ensuring we know what people care about, ensuring that they have the information to allow them to navigate to what they see is important for their health. And that we can actually do what we say we'll do we can connect people through touch points where we earn trust over time and when care feels coordinated and predictable. It starts feeling more trust worthy and that's exactly what we want to do is we want to be trust worthy because we understand what's important to our members and our patients and our consumers and then we deliver on that if we say that we can.

10:42Absolutely no it's a great it's a great message Amy and I wonder extending that message and talking a little bit more about trust with hospitals specifically given that that is a large piece of the individuals listening in right now the executives leading the largest health systems across the country. What do you want them to know what do you want the leaders of our nation's largest hospitals to know about how CVS specifically is thinking about the future of care delivery and you know we hear so much right now all over the country certainly a lot of local media sources about the friction between health systems and ensures. So so where do you think are some of the best opportunities for these systems and for insurers broadly like CVS to work together rather than consistent conflict. Yeah the friction is real and it's painful it's painful for for etna it's painful for care mark and for CVS it's painful for every physician out there and it's painful for every health care system out there.

11:46And so we are 100% committed to working to reduce the friction we're working on redesigning the way we have things like prior authorizations that we're minimizing any the number that have prior authorization required and only having things to require prior off that can be misused or could put patients at risk and so we're really trying to streamline and simplify how often we do it. And then when we do have a prior authorization trying to make it manageable and visible ideally having things like electronic data transfer so that we can automatically fill in things rather than requiring clinicians or health systems to fill in information can really help streamline and simplify but using that shared data and evidence can guide decisions in a much more effective way. The reason we can't just do away with prior authorization is you would be shocked at the amount of fraud waste and abuse in the system and so the reason it's there is to protect patients and keep costs low but I think that we have real capacity to take a lot of the friction out as we do the right thing for patients and members and health systems.

12:57And it is so clear Amy of the investments that the CVS is making in this space with with just prior authorization improvements alone. I know there's been a lot of investments made in care navigation for for members and for patients and just from our perspective talking with leaders at CVS we talked to that in his president just a few weeks back about his his commitment to improving that pair provider friction so it's it's very obvious of what's coming out from the company that this is a focus for leadership. So really really fascinating to get your perspective on all of this as well. Before we go what else are we missing is there any final thoughts or final bits of advice that you want to offer the audience while you have the ears of a lot of other colleagues from around the country. Just that we believe that the industry is in the midst of a significant transformation and that the future will be one that keeps patients and the clinicians who care for them at the center of every decision and so ensuring that we continuously and relentlessly simplify the administrative complexity so that the person who needs help and the person who can help gets to actually have the relationship that matters.

14:10We're going to keep doing that with evidence with empathy with transparency and that we want to be the most trusted name in American health care and we can only do that if we're working tightly together with all the rest of the partners and health care ecosystem. Wonderful. Well, Dr. Compton Phillips, thank you so much for taking the time to be with me here on the podcast and for sharing your insights with our audience, we truly appreciate it. It was a pleasure, Jacob, thank you so much for having me. Likewise, and to our audience, if you'd like to listen to more podcasts from Becker's Health Care, you can visit Becker's Hospital Review.com.