The Future of Healthcare: Why we need to shift to ‘Value-based care’, with Christian Fletcher CEO of LifeBrite
Value-based care. We must continue to create incentives for performing quality services that keep patients well and get them better faster, rather than encouraging high service volumes. In tandem, we must ensure greater reimbursement transparency for patients and providers alike. Patients certainly should know how much a service will cost them, but providers should be able to alleviate the stress of not getting reimbursed for care rendered.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Christian Fletcher. Christian serves as CEO of Atlanta-based LifeBrite, a multi-specialty healthcare company with holdings that include hospitals, skilled nursing facilities, clinics, and clinical laboratories (LifeBrite Labs). As both an investor and operator of startup businesses, Fletcher leverages his adaptive business acumen to create successful ventures in challenging markets such as healthcare. At LifeBrite, he emphasizes the importance of vertical integration — driving value for patients, uncovering cost effective solutions, and building multiple revenue streams to overcome reimbursement pressures. Fletcher holds a bachelor’s degree in Administration of Justice from the University of Southern Mississippi and is one semester away from completing his master’s degree in Business Administration from George Washington University.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
As an entrepreneur, I’m fascinated by industries with opportunity for disruption. I started my first business — a marketing firm — as a college freshman at the age of 18. I was actually on a path to law school, but then my company started taking off to the point where I sold it, tried my hand at a few smaller companies, and eventually turned my attention to healthcare. Thus, LifeBrite Labs was born.
What struck me most was the fragmentation of U.S. healthcare. It’s the largest single industry in the world, yet it’s so siloed. Compounding that problem, the operational systems that manage our healthcare are antiquated relative to other industries. Combined, these things have a profound impact on patient outcomes.
I truly believe that we must do better for patients, and we must do better for providers. So, I set out to build a multi-faceted healthcare company with two goals: 1) save the system money, and 2) save patient lives.
Can you share the most interesting story that happened to you since you began leading your company?
I don’t know if “interesting” is the right word, but the most impactful moment for me since founding LifeBrite was an impromptu conversation with an employee at one of our hospitals (LifeBrite Stokes). She pulled me to the side after a group meeting simply to tearfully express how grateful she was that LifeBrite Hospital Group had saved her job subsequent to a bankruptcy filing by our predecessors.
It was humbling for me, and having that conversation also allowed me to reflect on how much that one situation represents so much more. The fact is, the business of healthcare is unique, and every decision has the power to impact people’s lives in critical ways. It is rewarding to work within the industry that impacts all of us and to have sight on how a simple business decision can change one person’s life.
We have an obligation to do right by our patients and our communities, whether that means swift, accurate, and clinically actionable medical laboratory testing or keeping open the doors of a community’s critical access hospital. That one moment with our employee stands out to me because it shows just how impactful our mission is to everyone.
What do you think makes your company stand out? Can you share a story?
I think LifeBrite stands out for several reasons. First is the continuous evolution and integration we’re embarking upon. Instead of being characterized singularly as “a rural hospital” or “a medical laboratory company,” we’re fighting fragmentation by building our own healthcare ecosystem to consolidate service lines. Our goal is to one day be one entity that cares for all needs of all patients.
I also truly believe LifeBrite has some of the best physicians, technologists, and overall talent in the industry. We’ve won several clinical-based awards and undertake conservative, ethical practices that have ensured our ability to deliver a quality product. These things exemplify our commitment to R&D not simply through a financial lens, but to deliver high-quality, relevant products and services for practices and for patients.
What advice would you give to other healthcare leaders to help their team to thrive?
In today’s market, I would advise any healthcare leader not only to have a clear and concise purpose, but also to thoughtfully communicate that purpose to their collective team. When an industry experiences as much transition as healthcare is experiencing today, it’s important for everyone to see and understand your forward vision. Challenging the status quo and navigating change can be emotionally and mentally draining if you’re not driven by a clear sense of “why.”
Ok, thank you for that. 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?
I think the crucial issues rest not so much with the provision of care itself, but with the business side of healthcare. In no particular order, I’d say three key reasons for the low ranking are:
- The U.S. healthcare system lacks clear direction and oversight of commercial insurance payers. Premiums for patients continue to increase, yet providers rarely are the recipients of those increases and somehow patient out-of-pocket is simultaneously increasing.
- Many great minds are deciding to pursue other professions because rising medical school debt and decreasing salaries are making it harder, financially, to become a doctor. Unfortunately, this could start to affect care as it reduces the optimal provider pool.
- Finally, despite — and in some cases because of — the move toward value-based care, clear conflicts of interest between payers and providers currently remain in day-to-day operations. Providers need to generate encounters for financial viability, and payers hope providers decrease encounters to increase profitability. As a result, patients get caught in the middle without ideal coverage.
You are a “healthcare insider”. If you had the power to make a change, can you share 3 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
The first change I’d promote is one we at LifeBrite are already moving toward: value-based care. We must continue to create incentives for performing quality services that keep patients well and get them better faster, rather than encouraging high service volumes. In tandem, we must ensure greater reimbursement transparency for patients and providers alike. Patients certainly should know how much a service will cost them, but providers should be able to alleviate the stress of not getting reimbursed for care rendered.
Second, healthcare would benefit from tighter oversight of commercial insurance providers to ensure a level playing field for independent providers in contract negotiations and network participation. Relative to that, I would disallow payers from becoming providers. At the end of the day, I believe healthcare can benefit from healthy competition and alignment on one simple mission — doing what is best for the patient.
Lastly, I’d like to see student loans forgiven for those who choose careers in much-needed fields of medicine. This would incentivize top talent to pursue healthcare careers in areas of high impact.
Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
It’s extremely difficult for individuals and communities to enact the type of systemic change needed to catapult an entire industry as large as the U.S. healthcare system into entirely new approaches. Realistically, such transformation falls to both the leaders of our country and business leaders.
However, we can start with an overhaul to the way providers are reimbursed. Federal entities have clear transparency through fee schedules, which is good. But commercial payers have different agreements with all providers. This opacity allows larger health systems to receive preferential contracting opportunities — which in many ways helps preserve the status quo. I believe reimbursement transparency is a good first step toward positive, disruptive change in U.S. healthcare.
I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
The Mental Health Parity Act sets a clear precedent that mental health conditions are to be viewed as any other health-related illness. The problem we still confront is the stigma that prevails around topics of mental health. That’s far too great a cultural issue to overcome with just one legislative change.
One suggestion is to ensure the same insurance coverage for mental health treatments as for any other illness treatments. Over time, as mental healthcare is treated like physical healthcare, hopefully the general public will also begin to understand that mental illness is no more a matter of choice than poor vision, Type 1 diabetes, or a broken bone.
Additionally — since we are discussing the intersection between mental/behavioral health and general health — I think there is a lot more the system and healthcare providers can do to meaningfully address the U.S. opioid epidemic. More than 16,000 Americans die each year of unintentional opioid overdoses, and with access to genetic testing and precision medicine, providers can now better understand how patients both react to these drugs as well as monitor patient use. I think it is important to utilize new genetic testing solutions in the fight against opioids.
How would you define an “excellent healthcare provider”?
Excellent healthcare providers are those who put the needs and well-being of their patients first, and their practice’s financial well-being second. Some like to call it “patient-centered care,” but it boils down to what we all want from our providers — someone truly focused on our needs. In my opinion and experience, if you take care of the patient, the finances will fall in place. Word of high-quality care spreads fast.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“All change is hard at the beginning, messy in the middle, and gorgeous at the end.”
It’s a quote attributed to Canadian author and leadership expert Robin Sharma. It’s especially relevant for me, as well as for LifeBrite, as we’ve experienced enormous challenges in our quest to transform the status quo. Yes, it’s hard and messy, but we’re striving to achieve results that are “gorgeous at the end.” We’re as excited as ever about the future of the company and the lives we’re impacting.
Are you working on any exciting new projects now? How do you think that will help people?
Yes! For starters, I’m tremendously excited by the transformative potential of a proprietary Chronic Care Management medication reconciliation panel developed at LifeBrite Labs. It’s my hope it will forever change the way medications are reconciled for chronic care patients nationwide. Our aim is to help make the medication reconciliation process easier and more accurate for providers, and thus safer for patients. We’re also validating some new additions to our medical laboratory offerings that are in line with more progressive patient medication pathways, such as cannabidiol (CBD).
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I read Becker’s quite often to review healthcare trends and shortcomings. The challenges outlined inspire me to consider transformative solutions.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
I would love to help end childhood obesity. It creates challenges not just in childhood, but throughout an individual’s life. Statistics show that childhood obesity is linked to wide-reaching issues in adulthood such as lower levels of gainful employment and higher mortality rates. As we dissect the rise in childhood obesity, it becomes quite apparent that we can become more responsible as a society to overcome this trend.
How can our readers follow you on social media?
The best way for readers to follow me is on LinkedIn
Thank you so much for these insights! This was so inspiring!
I enjoyed the conversation! Thank you for having me.