Can design be a determinant of health?

We often think about the quality of the clinical care patients receive in our hospitals, the outcome metrics that determine funding and quality and safety rankings, the readmission rates that tell us how well we’re helping people get healthy and stay that way. But one thing we overlook is the quality, accessibility, and care in the buildings those same patients visit, the parking lots, the cafeterias, the sights, the sounds, the space as a whole.

Our guest today is an architect who looks at existing and possible solutions through a unique lens: Who was this designed for? Abbie Clary is CannonDesign’s Executive Director of Health for All where she leads strategy at the intersection of design, health equity and systems change. She has spent nearly 30 years impacting the healthcare system most directly across over $5 Billion in healthcare projects, including work with Memorial Sloan Kettering, University of Chicago Medicine, MD Anderson, Fred Hutch, Kaiser Permanente Shirely Ryan AbilityLab and more.

Her perspective that “design is bigger than buildings” is changing healthcare by creating opportunities for health in and around the spaces we as people inhabit in our daily lives. By building in those opportunities on the front end, Abbie believes there will be greater access, better outcomes, and an overall shift in health and wellness for all.

Let’s talk PBM’s.

What even is a P-B-M? Pharmacy benefit managers have been around since the 1960’s, although back then, they were basically claims processors. Things changed in the 80’s and 90’s following the first iteration of ERISA when employers saw PBMs as potential cost containment strategies. The industry continued to explode until 2007 when CVS acquired Caremark, and now the market is really consolidated into just three major players.

Why does this matter? Well, PBMs control just about everything drug-related in the US these days, and that includes the cost. Given that we have not seen the promised drop in drug prices, Americans and employers are still bearing the burden of this bloated and broken system.

To unpack how this works and what folks are doing about it, we invited back Shawn Gremminger, the President and CEO of the National Alliance of Healthcare Purchaser Coalitions. His organization works with regional coalitions of employers to help them advance health policy, leverage their collective power, and drive market change.

Ambulatory Surgical Centers (ASCs) have been around in concept for the past fifty years, but their recent explosion has caught the attention of healthcare systems and, frankly, patients. Why?

Today’s guest, Adnan Qureshi, is a Managing Director with the Mergers and Acquisitions practice at Kaufman Hall. He provides strategic advisory services for healthcare providers and investors around the merger or acquisition of ASCs. The benefit he’s seen in partnership with his clients perhaps explains the answer to this question.

The “DNA”, as Adnan puts it, of the ASC is rooted in independent physicians who, as an extension of their practice, saw the benefit of doing lower acuity surgeries in an outpatient setting. As pain management and technology improved over time, the use case also evolved to the point where there are now few specialty areas where uncomplicated surgeries cannot be performed in an ASC. Without the overhead and operating costs of a hospital, ASCs allow for far more transparent pricing, lower costs, greater efficiency, and often better outcomes, all driving towards higher patient satisfaction. And that’s a win we should all be paying attention to.

Adnan Qureshi has over fifteen years of healthcare transaction experience. Prior to joining Kaufman Hall, he was a Director of Development at SCA Health, a subsidiary of Optum/UnitedHealth Group. In that role, Mr. Qureshi led market entry strategy across several geographies, and sourced, structured, and executed ambulatory surgery center acquisitions.