Look to other industries for solutions. Healthcare is behind in tech, finance, customer experience, you name it. The learning curve of our industry’s acronyms and idiosyncrasies can be a huge barrier to entry, which slows innovation by outsiders. If you’re already on the inside, use this to your advantage by finding the best from other industries and adapting them to healthcare.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Ben Quirk. Ben began his career as an analyst, working for an Independent Practice Association (IPA) in northern California. He played a key role in the company’s successful effort to win a major contract with the California Public Employee Retirement System (CalPERS), helping merge that organization’s technology and business operations. Discovering an aptitude for this transformative work, Ben founded Quirk Healthcare Solutions in 2005 to help develop strategies and systems in support of government initiatives and healthcare trends. His clients enjoyed remarkable success, receiving millions of dollars in Meaningful Use incentives as well as the coveted Medicare Advantage 5-star rating. Quirk Healthcare Solutions joined South Florida’s Care Holdings Group in 2016 as CareOptimize, where Ben, as Chief Strategy Officer, was able to continue developing solutions to help practices, providers, health plans, and patients. CareOptimize’s groundbreaking concepts to maximize efficiency and reimbursements and improve patient care delivery are modeled in eight medical centers through a strategic partnership with CareMax Medical Centers, a full-risk primary care provider.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
The experiences of my grandparents, Edward Joseph Quirk and Ruth Mary Mouquin, largely influenced my values and goal.
While still a young father of seven, my grandfather spent months in the hospital enduring treatment under a false diagnosis. Hours upon his hospital release, he suffered a fatal appendix burst. His appendicitis had been overlooked.
My grandmother raised her seven children alone. She was struck with rapid onset dementia before her 70th birthday. While hospitalized for multiple fractures and several strokes, her health rapidly deteriorated. Declining medical advice, my family decided to bring Ruth home. Amazingly, her health improved, and Ruth spent the next 20 years of her life swimming in the ocean every morning.
Taking inspiration from my grandmother’s perseverance and ability to embrace life, I decided to confront the healthcare system, making changes so more people could have a life like my grandmother’s.
Can you share the most interesting story that happened to you since you began leading your company?
We had a competitor aggressively sully our name with some of our most important clients in order to take the business from us. We were sure good work and results would win the day, and the competitors’ actions would be seen for what they were — until two major contracts were canceled. We didn’t miss a beat, and I forbade our team from speaking poorly about the competitor; rather, we decided to double down and let our work speak for itself. Within 18 months, both clients recontracted with us, and we are doing more work with them than ever. Was it painful? Absolutely, but our relationship with our clients is stronger as a result.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I have seen so much in my two decades in healthcare. Things are changing faster and faster, and it’s difficult for those on the clinical side to keep up with all the regulatory changes. I saw this happening early on and knew there had to be a way to satisfy all players. I was lucky to get to work with the visionaries in the value-based care paradigm 15 years ago — a paradigm that is just now finally taking hold. Folks like Steve McDermott at Hill Physicians, who had the crazy idea of linking together disparate providers and incentivizing them for cost effective care, or Benjamin Leon, Jr. who led Leon Medical Centers to capture the hearts of their members through tremendous service, knowing they’d then “Call Leon First” and receive their care in the centers rather than the hospital. I learned the premise of value-based care well before that term existed, and it is woven into my DNA. Aligning patients, providers, and health plans is second nature to me, and I can pull from that decade and a half of experience to make it work in almost any circumstance.
What makes your company stand out? Can you share a story?
Our team has a wide variety of expertise, which allows us to help clients with varying challenges. What started out as more of an EHR consulting company has now grown into a company of healthcare industry thought leaders. We don’t just talk the talk, though. Through our strategic partnership with CareMax Medical Centers, we run eight Medicare Advantage clinics across South Florida. We are able to model our innovations in full-risk value-based environments — a major advantage.
As an example, one of our clinics used to be a family-owned medical center serving a senior population in the Hialeah, Florida area. The family was very well-liked, trusted, and admired by the community and maintained great relationships with their patients. To keep up with the competitive healthcare landscape in the Hialeah community, however, they needed to add services and expand their patient population, which they found increasingly less feasible. They had many strengths, especially in their relationships with their patients, and drew the attention of CareMax Medical Centers. After discussing some of the value-added and competitive advantages CareMax and their affiliates could bring on board, especially the regulatory expertise and experience of CareOptimize, the ownership was interested, and it soon became CareMax Medical Center — Hialeah. With a desire to maintain and even better the health of their Medicare Advantage population while also running a profitable business, Hialeah center turned to our experts. In less than a year, their HCC/RAF scores improved, their workflow was optimized, and their reimbursement increased. These factors continue to be extremely important to the center, allowing them to increase their membership, provide even more services, and thrive as a business that has become a model for other MA centers throughout the country.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
When it comes to the morass of healthcare regulations, we’re very focused on making the difficult easier. We realized in our consulting there was a tremendous need to lessen the administrative burden for physicians at point-of-care, along with impacting the income of health plans to receive higher coding and quality bonuses. This win-win posit led to the creation of Analitico, a provider engagement web-based program that translates between health plans’ and physicians’ priorities, making more money for both, while the patient wins by receiving higher quality, less distracted care.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
- Lack of aligned incentives
- Financial rewards for the status quo rather than innovation
- Overregulation focused on process rather than true clinical outcomes
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system?
- Always align yourself with the patient. If your goals are the same as the patient — keeping them the healthiest for the lowest cost — you’ll win. The common denominator in winning healthcare organizations is they put the patient first, be it value-based care, quality programs, or patient experience.
- Learn from outside of your local community. Healthcare is currently incredibly localized in its thinking, but problems in your local community have probably been solved by someone in another community. Grab what works from across the country, adapt it to your local flavor, and pilot it. Many won’t work, but those that do will more than make up for it.
- Data is only as good as you can make actionable. There is such a fascination with big data and population health, but so many dollars are wasted every year with reports no one will run and new population health “toys” no one will use. Let the business need dictate the solution (and don’t create a new need just because you like a solution). Start small and pilot. Measure the results and ROI. Then deploy.
- Look to other industries for solutions. Healthcare is behind in tech, finance, customer experience, you name it. The learning curve of our industry’s acronyms and idiosyncrasies can be a huge barrier to entry, which slows innovation by outsiders. If you’re already on the inside, use this to your advantage by finding the best from other industries and adapting them to healthcare.
- Remember your mission. Lose track of why you joined this industry to your own peril. Healthcare is tough work. When patients become faceless numbers, or worse an annoyance, remember the impact your skills are making in the lives of other human beings.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
Modern Healthcare for news, and the CMS proposed rules — no, seriously. Outside of that, I prefer to see things firsthand by touring the country and seeing thought leaders in action on their own turf. Healthcare is local, and it is amazing to see how innovators across the country are adapting to their markets’ specific challenges.
How can our readers follow you on social media?
I have a very active Linkedin page, and we have Twitter and Facebook pages for both CareOptimize and Analitico Health. Our webinars can be found on our CareOptimize YouTube page, and our websites are www.careoptimize.com and www.analiticohealth.com.
Thank you so much for these insights! This was so inspiring!