What Darwin Never Knew—And What We’re Just Learning Now

About Value-Based Healthcare In U.S. healthcare now, just as in natural science 180 years ago, missing puzzle pieces are being fi tted in

O Mark Hagland

ne of the most enlightening popular science- focused documentaries I’ve ever seen is the NOVA documentary “What Darwin Never

Knew,” fi rst broadcast on PBS on December 21, 2011, and readily available now on YouTube. Charles Darwin has universally been recognized as one of the greatest scientifi c minds in history. Based primarily on observation—including his observations of fi nches, iguanas, and other species during the trip he took to South America aboard the S.M.S. Beagle

from December 1831 to October 1836—he developed his theory of evolution and natural selection, which turned science—and global knowledge in general—on its head. Though Darwin was able to achieve an understanding of evolution that was astonishing considering the lack of modern scientifi c tools at his disposal, he was not able to fi gure out how evolution occurred; that was the key missing piece of the puzzle—the “how.” As evolutionary biologist Sean Carroll of the University of Wisconsin said in the documentary, “He didn’t know any of the mechanics of that process. He didn’t understand the physi- cal forces that would actually change the way species appeared.” “But today,” the docu- mentary pointed out, “we can answer the questions that Darwin could not. We can look under the hood of evolution, and see exactly how this mysterious process gives rise to such astounding diversity. ”

And, speaking of Darwin’s extensive study of embryos under microscopes, Darwin was able to deduce tremendous revelations, including that humans “must be descended from fi sh. And so Darwin arrived at an astonishing conclusion: one that would become central to his understanding of the diversity of life,” and became the core of his “Tree of Life” theory and to evolutionary theory. Importantly, the documentary noted, “Scientists can now do something Darwin never could: they can “look inside the animal’s DNA. The study of DNA is one of the great triumphs of modern science. It has taken our understanding of how creatures evolve and develop, to a level that Darwin could never have dreamed of.” I thought about Darwin’s development of the theory of evolution while writing this issue’s cover story on the leveraging of data and analytics to support value-based health- care delivery and payment. Well do I remember the earlier incarnation of managed care in the 1980s and 1990s, which exhibited some fundamental fl aws: among them a lack of true alignment between payers and providers in what remained a largely discounted fee-for- service environment; and the lack of available data and information. And that’s one of the key things that’s changed in the past 20 years: we now have the information technology to provide providers and payers with the key data points continu- ously needed to support the delivery and payment of value-based healthcare. We also now have a far better alignment of shared incentives under accountable care organization (ACO) and other models than we ever did 20 years ago. And thus, we now have genuine, authentic payer-provider collaboration, with data- sharing to support the population health management and clinical performance improve- ment. And that is a huge thing. In reporting for the cover story, I spoke to senior leaders at health plans including Anthem, Blue Cross and Blue Shield of Minnesota, and L.A. Care, and provider organi- zations, including Mercy Health (St. Louis), Nemours Children’s Health, and Advocate Aurora Health. All those executives and their teams are drilling down intensively right now to fi nd the truth behind the data—and are developing highly successful initiatives based on what they’re learning. So in U.S. healthcare now, just as in natural science 180 years ago, missing puzzle pieces are being fi tted in. Darwin the scientist would be fascinated. EDITORIAL

Editor-in-Chief: Mark Hagland 917-275-2426

Managing Editor: Rajiv Leventhal 212-812-1418 Senior Editor: David Raths ADVERTISING SALES

Publisher: Amy Mularski 615-270-1573

Associate Publisher: Matt Raynor 561-776-0015

Sales Director: Anita Brodersen 847.744.2884 Sales Director: Stefanie Angeli


Events Program Director: Stephen McCollum

Events Program Manager: Christian Saa

SERVICES Graphic Artist: Patti Connors

941-388-7050 ext. 102, List Rentals/Ad Contracts Mgr: Laura Moulton

Ad Traffi c Manager: Norma Machado

eProduct Coordinator: Mary Haberstroh

Single Back Issues/Subscriptions:


Chris Ferrell, CEO Scott Bieda, EVP, CRO | June Griffin, CMO

Tracy Kane, VP, General Counsel, HR | Patrick Rains, COO Angela Rex, VP Accounting | Kristine Russell, EVP

2477 Stickney Point Rd., Suite 221B Sarasota, FL 34231 Phone: (941) 388-7050 Fax: (941) 388-7490

Healthcare Innovation content is also available from PROQUEST Information and Learning, 300 N. Zeeb Road, Ann Arbor, MI 48106 USA, 313-761-4700. Copyright Clearance Center, Inc. 978-750-8400.

Publishers of this magazine assume no responsibility for statements made by their advertisers in business competition, nor do they assume responsibility for statements/opinions expressed or implied in the columns of this magazine. Printed in the USA.

HEALTHCARE INNOVATION formerly Health Management Technology

(ISSN 2641-7502)

Published bi-monthly by Endeavor Business Media, LLC., 2477 Stickney Point Rd., Suite 221B Sarasota, FL 34231, (941) 388-7050.

Subscription rates: $52.80 per year in the United States; $64.90 Canada/ Mexico; International subscriptions are $95.15 per year. Current single copies (if available) are $15.40 each (U.S), and $19.80 each (international). Back is- sues (if available) are $17.60 each (U.S.) and $22 each (International). Payment must be made in U.S. funds on a branch of a U.S. bank within the continental United States and accompany request. Subscription inquiries: subscriptions@

Title registered U.S. Patent Offi ce. Copyright 2019 by Endeavor Business Media, LLC., All rights reserved. No part of this publication may be reproduced

Offi ce of publication: Periodicals Postage Paid at Nashville, TN 37209 and at additional mailing offi ces. Postmaster: Send address changes to Omeda (Healthcare Innovation), PO Box 3257, Northbrook, IL 60065-3257.

Media, LLC., All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, includ- ing photocopy, recording, or any information storage-and-retrieval system, without permission in writing from the publisher.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28