45 – Advancing Health Equity with Jay Bhatt, MD
Episode Notes
Join Marcus & Vic as they speak with Dr. Jay Bhatt, Managing Director at Deloitte.
Jay Bhatt, D.O., MPH, MPA, is a physician executive, internist, and public health innovator. As Managing Director of the Deloitte Center for Health Solutions (DCHS) and the Deloitte Health Equity Institute (DHEI), Dr. Bhatt directs the research agenda across the life sciences and health care industry leading to actionable insights for executives and their teams. Dr. Bhatt also drives high-impact collaborations and investments to influence key decision-makers, address place-based inequities, and innovate to advance health equity. He also serves on the Deloitte Purpose Office leadership team. He is a prominent thought leader on the issues of population health, health equity, health care transformation, public health, and digital health. Passionate about patient care, Dr. Bhatt practices medicine for the historically underserved while serving in his leadership role at Deloitte.
Dr. Bhatt’s work has earned the attention of top media outlets seeking his expertise and perspective. He is a recipient of the Crains Chicago 40 Under 40 Award, the Harvard Kennedy School Alumni Award, a Presidential Leadership Scholar, and part of the Aspen Global Leadership Network.
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Episode Transcript
Marcus: [00:00:00] Series here at health further. And today we’ve got, uh, a fellow, uh, from the Aspen health innovators fellowship. Who’s an OG. I’m still going through the, through the process, but he’s an OG, uh, and someone who’s super respected in the world of healthcare innovation and health equity. Dr. Jay Bott. Jay, how are you, man?
Jay Bhatt, MD: Good. Thanks Good to see you, man. That’s a wonderful to be here with you. No, great.
Marcus: Great to have you. Great to have you on, on, on the show, my partner, Vic, and I, we did a little bit of research on you and, um, there’s a, there’s a lovely video, uh, that Deloitte put out on, on your backstory. That was, you know, not too long and really helpful to kind of get a sense of how you got into health equity and into this space, uh, as a physician yourself, just sort of growing up in the, in the household of a pharmacist in Chicago.
Marcus: Can you just share a little bit about that for the audience, just so we can [00:01:00] set the foundation as we get ready to talk a lot about health equity.
Jay Bhatt, MD: Sure. Uh, just thrilled to be here with you and Vic. And, uh, I’m the son of two South Asian immigrants. My dad, a pharmacist on the South side of Chicago, my mom, a factory worker.
Jay Bhatt, MD: And so I spent a lot of time with dad growing up in communities, in people’s homes, seeing the day to day trade offs that they were making between their health and their ability to have food, housing, caring for their kids, it really struck a chord with me about why are those choices needed to be made when it comes to.
Jay Bhatt, MD: The health of an individual or family and then the health of a community. And so I really got interested in, um, how we make that better and how we address the inequities that I saw as a kid. Uh, and then continued that journey when I was a college student, uh, in Hyde Park on the south side of Chicago, you know, working with the community there.
Jay Bhatt, MD: And, uh, so I’ve always been moved by this notion that [00:02:00] health is something that everyone should have a fair shot. To achieve optimal health and well being and their systems and structures and policies, uh, and just models that don’t necessarily make that, um, so easy to happen. And so it’s been a big part of my journey to say that, you know, health inequity is America’s chronic condition.
Jay Bhatt, MD: We can actually address the band aids that have repeatedly put out and say, let’s go upstream to re imagine a future of, uh, equitable health forever.
Vic: Yeah, excellent. Well, that, that’s great, uh, context. Help me understand how you define health equity, or maybe for the listeners, how should we think about health equity?
Vic: Uh, from your frame of reference
Jay Bhatt, MD: to what we define health equity is the fair and just opportunity for everyone to achieve their full potential, every aspect of their health and well being regardless of race, gender, ability, status or zip code. This includes considering a [00:03:00] person’s holistic health needs and caring for the upstream drivers of health or the drop that some determinants of health that have an enormous influence on health outcomes to the tune of 80 percent and moreover, believe that health equity is a moral and business imperative.
Jay Bhatt, MD: Health inequities that limit access to affordable, high quality care cost the U. S. health system approximately 320 billion in annual spending. And if we do nothing different in 2040, that’ll triple to 1 trillion. It’s 1, 000 for every American today, 3, 000 for every American in 2040. And so it adds up. You talk about a family.
Jay Bhatt, MD: And I would say it’s also broadening the aperture. So it’s not just race and ethnicity, although disproportionately impacts, uh, this issue, but it’s people in rural communities. It’s veterans. It’s people with disabilities. It’s the LGBTQIA plus population. It’s women. It’s, you know, can, can be looked at with a broader aperture.
Jay Bhatt, MD: Uh, when we think about. That’s it’s you, you know, and those that you love.
Vic: [00:04:00] Yeah, that’s, that’s two things. I want to just circle back on one, a thousand dollars for every man, woman, and child in the U S every year. And, and tripling is, is kind of an amazing. Stat, um, we could do a lot if we if we spent that thousand dollars maybe more more wisely In giving people the tools to advance their own health or have make progress in their own health.
Vic: Is that fair?
Jay Bhatt, MD: Yeah that I think that’s I think that’s fair in its part, but I also think there’s systems and structures Uh, and the environment that makes it harder to have those individuals be able to achieve, uh, health and, uh, health span, which is longer, longer life and better quality of life. And, um, I would say the other thing that’s important is that particularly for the audience of health further is there is opportunity and [00:05:00] value creation opportunity when you lean into unmet need.
Jay Bhatt, MD: And with this issue, there is significant unmet need, whether it be. Access points on virtual and digital, whether it be addressing, uh, triple negative breast cancer in women or what we just saw recently innovate, innovated around sickle cell disease and treatments there. Um, so what we’re also building the evidence around is.
Jay Bhatt, MD: That when you lean into unmet need and into health equity, you can create economic opportunity and value and better outcomes. And actually, you know, save the country a lot of money. I mean, we’re paying more and getting less as a nation when it comes to health.
Vic: Yeah. So that, that’s a good segue into what I was going to ask your opinions on, which is, uh, there’s a lot of innovators and entrepreneurs that listen in our audience.
Vic: What, what do you think is one of the two, three best opportunities? that need focus in 2024 where we are right now that the opportunity is in place if someone would just [00:06:00] grab it and try to make a difference.
Jay Bhatt, MD: So I’d say one, uh, our research suggests that there’s a premium on getting closer to patients, consumers, and providing them with more personal service and meeting them where they are.
Jay Bhatt, MD: So in our recent data, uh, through our consumer survey, Three and four consumers with Medicaid or on the health insurance exchange would use virtual half health for mental health visits and that retail clinics, virtual health and community health centers could bridge care delivery gaps for populations have been historically underserved.
Jay Bhatt, MD: So that’s one area. The other area I would say is, uh, emerging technology. Um, in terms of generative AI, we’re seeing consumers wanting to use that for their health. Either it’s to become more educated to help them manage their own health to access information. Um, I think that that is another important area.
Jay Bhatt, MD: The other is as consumers gain access to increasingly insightful data about their health, they’re [00:07:00] likely to feel more empowered to make decisions about their own care and exert more pressure on the system. So we’re starting to see a little bit of where consumers are challenging the status quo. And our recent piece and point of view on this is consumers can become CEOs in their own health.
Jay Bhatt, MD: And, um, when we look at even issues like food as medicine, uh, more than half of those surveyed say that they are willing to pay a premium for foods that contribute to their health and wellness. And so when you see that, there’s like this reassembly that happens in the industry, uh, where consumer may or patient may be outside looking in is now inside, uh, that set of stakeholders and all the stakeholders are aligned around helping achieve the best health for everyone.
Jay Bhatt, MD: And we also think that employers could take on a bigger role in keeping workers healthy and our. Research over the summer indicated that the average lifespan of Americans could increase by [00:08:00] 12 years and their health span, which is the time living in good health, could increase by nearly 20 years. And we have the tools and the science to do it today.
Vic: So talk about how we can build a bridge for people to make this, make this change. I mean, I think I certainly want to be more healthy. I’d like to. Live 12 years longer, but it’s sometimes hard to know what to do or to get the there’s a lot of data out there But I don’t necessarily have the best information And three of us are, you know, well educated.
Vic: We’re on on the higher income scale and still it’s complicated. How do you think about getting? uh easy to navigate Uh data sources or inside information to the right people at the right point so they can make those choices
Jay Bhatt, MD: I would say that we’re seeing some of that happen now, certainly through virtual care, remote monitoring and digital health tools, and I think that will continue to grow part of what I think about that’s important.
Jay Bhatt, MD: That’s, um, uh, a companion to that [00:09:00] is like, uh, walking genius bar. You know, you think about literacy and how people can access and make sense of the information that we have. that comes through in various ways. I mean, I, I’m a primary care physician on the south side of Chicago now in a community health center.
Jay Bhatt, MD: And I have patients that are very interested in the information that comes through their portal and, but need help in making sense of it. Because when you see something, um, that maybe isn’t within range, it may not be of concern because the It has to be correlated with clinical findings, but they don’t, you know, as individuals may not understand that, um, and can create a sense of, of challenge and anxiety.
Jay Bhatt, MD: So then it’s helping navigate through. So, so I would say one is the wearables, the digital health and road health. You know, offers people some of that tool, but then paired with that is is, um, gonna co pilots and community health workers and clinical teams that help them make sense of it to take the appropriate [00:10:00] actions.
Jay Bhatt, MD: Um, the other is misinformation and disinformation, you know, that’s continuing to impact, uh, particular behaviors or decisions. And, um, I think that that’s important to address as well. And then, um, how do you design intent? So equity centered design. So that we’re making the thing that’s, um, going to drive towards health, the easier thing to do, uh, for individuals.
Jay Bhatt, MD: So one of the things that we’re doing, particularly in the employer space with the American Heart Association and the Society for Human Research Management Foundation is health equity in the workforce. We’re trying to impact positive health outcomes for 10 million workers by 2025. And we’ll have tools for employers to deploy, um, whether they’re self insured or fully insured, um, to do this.
Jay Bhatt, MD: But part of this comes down to messaging and how we communicate as well and say, um, navigating through a journey of saying, where do you start? What are the, what are the things that are going to [00:11:00] be the most impactful cardiovascular or mental health, you know, in addressing Those, uh, to begin with.
Marcus: Jay, you’ve said we a lot.
Marcus: And I think the, we here, uh, is, is Deloitte. And one of the things that I’ve, I just find to be really interesting is that somebody, uh, like you, uh, is working at an organization like Deloitte. And I think, you know, for for a lot of our listeners, they’re trying to figure out like how to make an impact and certainly being able to work at a platform like Deloitte, uh, you know, gives you the opportunity to to make an impact.
Marcus: But can you talk a little bit about why this matters for Deloitte? Like they didn’t just hire you and put you in a corner like that. There’s been an entire Health Equity Institute that’s been established. You’re talking about some major partnerships. Like, in addition to the goodwill, there has to also be some, uh, some partnerships, some client demand for this kind of work.
Marcus: Uh, and so just talk a little bit about that because [00:12:00] Deloitte is not sort of the first name I would have thought of to be, uh, at the forefront of, of thinking and research on this, on this, this important topic. But it’s great because I think it adds legitimacy to it.
Jay Bhatt, MD: Yeah, I would say that often the public may think of Deloitte as a accounting firm, but Deloitte is much broader than that.
Jay Bhatt, MD: Deloitte is a firm that advises clients in the market about how to be successful in business that may be consumer oriented, that may be policy and government, public sector, that may be energy, that may be in technology or media, telecom. And, and we can go down the list of the very financial services.
Jay Bhatt, MD: Would say that health equity is everybody’s business. When we think about health, it has such convergence across consumer industries, technology industries, financial, even if you think about the wealth gap that has an impact on the health gap. Uh, and [00:13:00] the reason why Deloitte has really invested in this over the last several years.
Jay Bhatt, MD: Is, um, one, the inequities that were laid bare by COVID made it very clear that there are differences that need to be addressed that are systemic, structural and could be accelerated by the impact of those Fortune 100, Fortune 500 clients we serve, including the government public sector clients we serve.
Jay Bhatt, MD: And then the other is that there is a role business has to play, and that’s basically what we showed by employers catalyzing healthy aging, that this notion that when people thrive, businesses thrive is important, but also that we have a leadership role to play, particularly with the social unrest that we saw during the summer of 2020, the pandemic and, and that this issue touches everyone in some fashion or way.
Jay Bhatt, MD: And, and, um, So we are really excited about that. And what we’re seeing in [00:14:00] the data, even our most recent health equity outlook is a more than 80 percent of C suite executives and life science and health organizations see health equity being improved as a top 10 goal for 2024. And that 50 percent are seeing a doubling of investment in health equity.
Jay Bhatt, MD: And so, so it’s not an issue that’s been going away. And what I would say is when it’s not considered a side hustle, when it’s not considered a side gig, when it is embedded into the strategy, finance and operations. To help meet the need of your organizations to help extend your, um, uh, business, uh, to address unmet need.
Jay Bhatt, MD: There is opportunity, uh, for both citizenship, uh, in the community, but also impacting business. So we see this as also work that we do within our own house. We have a D. E. N. I. Transparency report. We’re having metrics that we’re tracking against and making very public [00:15:00] about policies, please. Representation, governance, you know, within our own organization, as well as products and services we may impact.
Jay Bhatt, MD: So we’re working with our consulting teams around embedding health equity, uh, perspectives into their work, uh, as they. Work with clients. And then there is a social impact work that we do on. That’s in communities. And then the ecosystem you can catalyze to come together. You know, for example, in San Francisco.
Jay Bhatt, MD: Yes, San Francisco brought together public and private sector actors to address sustainability there. Or, you know, We came together in Philadelphia with public and private sector players to address maternal health because they together wanted to do that. So I also think that the convening opportunity and the ability to share and move, um, and accelerate action at scale is just one of the important reasons that Deloitte’s done this.
Jay Bhatt, MD: And not just in the U. S. We’ve got a health equity institute in Europe. In [00:16:00] Africa, in India, in Latin America, this is a global endeavor, and we work with our global health equity network with the World Economic Forum, which has got over 50 multinational companies that are are engaged in that work, uh, that that deliver services across the products and service across the globe and 100 CEOs that have signed on to a zero health gaps pledge.
Jay Bhatt, MD: So there is real interest, um, across industries and across the globe to try to take this issue on, uh, as part of core business, uh, in addition to social impact.
Vic: And Jay, it strikes me that there’s a chance this is very well aligned across many sort of degrees of focus. Like I want to be more healthy and have a longer lifespan myself, but I also want my organization.
Vic: As a whole, to have more healthy employees. I want to offer, um, you know, health equitable choices to all kinds of communities. And then that also, uh, the places [00:17:00] where you can get a better return on the investment of time or money or resources, you might get a better impact in places that really have, have a big need.
Vic: Is that, is that. Is that right, that you can sort of get this, I don’t know how many of this, three or four things aligned together?
Jay Bhatt, MD: Yeah, you get a domino effect, and it’s catalytic, and you know, across these different domains, you say that people, um, clients, and society, uh, but We’ve demonstrated and continue to build the evidence that if employers lean into this for their people, not only does it create, um, uh, this impact on healthy workforce that is more connected to your organization and to the work there, there’s also opportunity, for example, for our people to be involved in this work creates a sense of connection around purpose and meaning.
Jay Bhatt, MD: Um, so we’re not just only doing, um, Work that is impactful from a [00:18:00] purpose orientation for clients, but also for society. And I think that’s a powerful thing around the health of individuals in your organization. And I would say that we’re seeing just real excitement among people within our organization.
Jay Bhatt, MD: And others where they’re leaning into this work. And for your audience, I would also say that the other thing that’s interesting is the demographic shifts. You know, we’re seeing very real changes in, um, people in this country and, and their, the backgrounds and the things that they’re interested in, and then more science and emerges about what people need and could benefit from based on, you know, where they live, whether it’s the environment or what they have.
Jay Bhatt, MD: Um, their background to be, but we’re seeing, for example, startups and innovators engage around services for black women or Latinos with diabetes. Y a plus [00:19:00] or women, you know, we produced a piece, uh, that showed women pay 15. 4 billion more out of pocket on healthcare expenses, employed women than men, um, and in maternity care, isn’t the thing that’s driving that.
Jay Bhatt, MD: Uh, it is really about. design intention. Um, and and so there, there, I think a lot of angles, um, for innovators and for investors to think about, um, the value creation opportunity and the impact opportunity when you lean into health equity
Vic: with Deloitte’s global reach. Do you, uh, can you observe opportunities that, that maybe You’re seeing a real impact in another country that you could bring to the US or things that are in a, in a slice of the US population or demographics that you could bring to a different one.
Vic: Is that is there an opportunity in there?
Jay Bhatt, MD: Yeah, I think that is definitely, uh, this notion of, um, global advantage where we, you know, learn from interventions and actions happening [00:20:00] globally. Now, Uh, for example, our health equity in the workplace guide, uh, that we work on with the American Heart Association and Sherm Foundation is, um, U.
Jay Bhatt, MD: S. But also global in terms of the strategies in that guide of what can be done. So think about community health workers. They work very effectively in the developing world in terms of helping be accompaniment or partners, uh, collaborators to individuals in their health journey. We’re seeing some build of that here.
Jay Bhatt, MD: We’ve got the evidence here. But because of workflow care models integration, it’s harder, but that’s an example of like evidence based high impact opportunity. The other is around life sciences. You know, globally, we see a lot of interest in R and D and innovation around life sciences and biotech that I think can be brought here.
Jay Bhatt, MD: You know, I would say an example is the pulse ox, which we saw in, um, Yeah. In the pandemic wouldn’t register for black communities, the [00:21:00] level of, um, uh, understanding around their oxygenation as it did with other populations. But I haven’t seen yet that be addressed from a med tech standpoint. And there’s.
Jay Bhatt, MD: An opportunity there to get to the next level of that device. So, and then when it comes to maternal health, cancer, mental health, those are global, um, issues that I think we can all collectively work on and learn from each other. And and then there’s the work we did with johnson and johnson and delay digital called illustrate change less than 5 percent of people with darker skin tone.
Jay Bhatt, MD: Or let me repeat that. Less than 5 percent of medical images represent people with darker skin tone, which has an impact on diagnosis and treatment, but also people of color seeing themselves in science and in medicine. And so we’re working to build a large digital library of these images that could be used by those in healthcare.
Vic: Yeah, I know [00:22:00] you saw that live, but I just think that maybe it’s It’s seeing themselves, but also just engagement and understanding their own, their own diagnosis. It’s, it’s easier to engage and learn if you, if you see someone that looks similar to you. It’s more engaging, I think.
Jay Bhatt, MD: Yeah.
Marcus: Yeah. Well, I mean, I, I wanted to, um, you, you went there with the, the illustrate change, uh, uh, initiative.
Marcus: And I, I wanted to talk about that because I, I did see it at Aspen health. Um, you know, the, the whole installation that you all did there. And I, I was struck by just the, the beauty of the art. Right. I mean, it wasn’t just a bunch of medical pictures. I mean, it was, it was art and I, I sort of walked away from it with, with a completely different view on the kind of work that we can do to communicate healthcare issues.
Marcus: You know, I, I think we’re very stuck in the healthcare space around how we communicate around these topics. Um, you know, it’s either, you know, Hyper technical, [00:23:00] um, hyper policy oriented, you know, very, very wonky. Um, and, and it doesn’t really speak to people in any way that’s going to resonate, make them feel something deeply.
Marcus: And also I would say level the playing field where people who are experts, but people who are also laymen can all look at something and appreciate it and pull away pretty much the same thing from it. Um, so I, I thought that the illustrate change initiative was. Groundbreaking in that way to two questions about that, you know, one who came up with it, uh, and then, and then to why did Deloitte and you and, and johnson johnson decide this was something to actually do.
Marcus: I mean, I know that organization sponsor this kind of stuff all the time, um, but this to me did feel, you know, groundbreaking and felt like it could be a model for how we can change the way we’re communicating, you know, meaningful health care issues.
Jay Bhatt, MD: Hey, Marcus, I think this point about communication is so important and how we, [00:24:00] um, demonstrate and illustrate, uh, technical issues in a way that they touch the heart.
Jay Bhatt, MD: It’s, uh, in a way that helps people understand them. I think this is really around a discussion with Deloitte, Deloitte Digital, And J and J is around the race to health equity initiative. They where is a gap? Where is there a gap that if we did something, it would have a meaningful impact at scale quickly.
Jay Bhatt, MD: And so the data suggested that there just isn’t these illustrations of people of darker skin tone. And we know that has an impact on on diagnosis and outcomes. But also this point that, um, Was made about just how people see themselves in this, um, and see themselves in science. And not only from a patient consumer perspective, but also as a professional.
Jay Bhatt, MD: So, um, there, there, you know, have been a number of illustrators. [00:25:00] Uh, it should have very, uh, one of them, but, uh, There are a host of illustrators that are looking at this topic. And so one of the ideas is that we don’t have enough of these illustrators. And so working with an organization, uh, an association of medical illustrators also supported scholarships to help build, uh, the training and capacity of illustrators to, to be able to contribute to that.
Jay Bhatt, MD: So is that kind of, it’s, you know, a gap workforce? And, uh, an opportunity to communicate and, and quite literally illustrate in a way that can be accessible by the public, uh, but also by clinicians and, and by the industry.
Vic: Yeah, I agree. I mean, the illustrate change. Set of drawings that I saw online. They are beautiful as Margaret said, but they also are really informative and there’s a [00:26:00] lot of educational content there that you, you don’t have to look into.
Vic: But if you choose to sort of dig into it, you not only do you see black and brown folks in the, in the illustrations, but then you also can learn a lot and you sort of get this multi level. Uh, aspect of it, which was really, really powerful,
Jay Bhatt, MD: you know, these things that that’s the other point from this is that health equity is, um, in an integrated endeavor.
Jay Bhatt, MD: And it’s, you know, having different perspectives and points of view that are coming at a single mission to make health better for everyone, uh, to think about these kind of innovative ideas. Uh, and so, It takes a team and it takes people with different perspectives and vantage points.
Marcus: Yeah, we were, we were looking, uh, at the 2024, uh, healthcare, U.
Marcus: S. healthcare outlook that Deloitte published. Uh, it looked a lot like sort of our, our year end, uh, review and, and, and look forward into [00:27:00] 2024. You know, durable labor issues, policy issues, um, A. I. And M. L. From a technology perspective, you know, kind of the general things that people think about, but, um, I’ve recently read a read an article that was talking about the challenge that we’ve sort of gotten ourselves into, uh, with language right where it’s very difficult because of the political environment to say something That is meaningful without it being, uh, you know, taken as being incendiary, right?
Marcus: Um, and so I’m just sort of wondering, uh, what is, what is your view on how we can integrate this very important Issue that has real economic implications for all of us, uh, regardless of how you sort of process these words, a word like equity, right? You know, how do we communicate that? And how do we infuse that, uh, against all of the backdrop of all these other issues that people would say are more important, right?
Marcus: You know, workforce [00:28:00] issues or policy issues or the changes in medicare advantage. How does how does health equity as an as a Overall initiative, uh, make its way through there and navigate. I think the additional challenge it has, uh, of, of working through the word war.
Jay Bhatt, MD: Yeah. Well, I, I can, I think we need to continue to demonstrate, uh, and, and build the evidence that there is an economic and value case, uh, with health equity and that’s resonated, um, well, the other is framing the language.
Jay Bhatt, MD: I’m just. You know, where you live and and your genetic code and a number of other factors impact outcomes. And and when we talk about this across broad populations about the zip code and where people live as an impact on their health outcomes, that seems to Resonate and that this question of are you going to say you don’t want to have a healthier future for everyone or the potential for that, um, or even just this notion of like a living wage for your family, you know, [00:29:00] for family, like, would your family want to have a living wage?
Jay Bhatt, MD: So I think it’s also to the point I made earlier about broadening the discussion. It’s it’s when we think about health equity, we think about People may think about a segment, uh, or, uh, a particular set of population, but it actually, you zoom out, it has place based implications, you know, 60 million in rural communities that have challenges, access to care, or, um, you have people with, With disabilities or veterans, uh, you know, or women or I mean, I can go down the line of different circumstances and ways that it shows up.
Jay Bhatt, MD: The other thing I’d say is when you when leaders start from the frame that it’s a something separate. Um, we’re already behind the eight ball because of the issues you mentioned. Health equity is embedded in, in [00:30:00] the notion of just better health. For everyone, and that recognizing that some people, because of circumstances in the environment or economic gaps, uh, may just need more support than others, um, to have that opportunity for health and well being.
Jay Bhatt, MD: And so. I think that he alone should inspire innovators and businesses to create products. And it’s interesting. We’re seeing a big discussion around fresh food is medicine and grocers becoming health organizations in some way technology providers that, you know, like instacart and others, um, you know, across Using various tools, you know, around health.
Jay Bhatt, MD: Uh, so I just think we’re gonna continue to see this kind of convergence more and more. We did a piece, um, not too long ago on accessible banking for people with disabilities. [00:31:00] You know what I’m saying about people with disabilities may have challenged having banking, which has a material impact on their economic mobility and their health.
Jay Bhatt, MD: That’s a health equity issue.
Marcus: No question.
Jay Bhatt, MD: Yeah. I mean, health equity in that way.
Vic: The politics can be toxic, certainly, and we’re in election year, so I’m not going to dispute that. But I think there’s an opportunity in health equity to, um, kind of help people. Resonate with our common interests. Like I’m scared of getting old and dying even as a rich white guy in nashville, and I think everyone has the the understanding that I want to be healthy.
Vic: I want my kids or my parents to have healthy lives And that’s true no matter what your background or socioeconomic situation or race And if we can frame it in where we see the commonalities And then, I love the way you, I’m not gonna get into it, but give everyone the opportunity to have the [00:32:00] best health.
Vic: That’s something that I think everyone should opt into. Whether they do or not, I don’t know, but I certainly do. And it can be more constructive than sort of like, setting things on fire and yelling around. Which, I don’t know, at least for me, I’m tired of. Yeah.
Jay Bhatt, MD: Yeah. Navigation is the other thing that’s so interesting.
Jay Bhatt, MD: Like, I think even people that may have means and operate, you know, and economically, uh, advantage still have challenges with navigating through needs that they or their family members or loved ones may have.
Vic: Yeah. I don’t care who you are. Marcus and I were talking about this a week ago off camera, but we both in the last two months have had to call friends of ours in health systems to figure out how to navigate the system or, or.
Vic: Find a way to get our loved one in and it’s not necessarily a money basis You happen to have someone’s cell phone number and you and that’s not that’s not fair and it [00:33:00] shouldn’t be that hard to navigate For for anyone.
Marcus: That’s
Vic: right.
Marcus: Jay give us give us a note of Hope, but maybe also motivation for us as, as investors and also for innovators, uh, just kind of a departing note.
Marcus: We, you know, look, some of the categories that you mentioned, we, we’ve already made investments in that space. Um, you know, uh, both Vic and myself and, and at our precede fund as well. So, uh, we, we understand the. the importance of this, but I would also say quite frankly, sometimes some of these issues, uh, you know, no one’s working on you, you, you highlighted, uh, you know, the pulse ox, uh, dark skin issue, right?
Marcus: I mean, and no one’s working on it, right? So there, there are opportunities. I didn’t
Vic: know about that issue till right now. So that’s how bad it is.
Marcus: Yeah. And I could have told you that, but it would be one of a million issues that I deal with that you don’t. Uh, but anyway, you know, just, just, uh, give it, give us a little bit of inspiration around, um, you know, the things you’re seeing out there and the real [00:34:00] opportunities, uh, and why it is important for investors and innovators to come together and partner to, to address some of these, you know, unaddressed issues.
Jay Bhatt, MD: Yeah, I’m really, I would say, I would say I’m encouraged by what I’m seeing in terms of the kinds of innovators and investors coming into the space, you know, in our work with social entrepreneurs, we’re just seeing people of color and women and all sorts of individuals, uh, of backgrounds, traditional investors, uh, and new ones, um, to think about, hey, there is an opportunity where I can not only be.
Jay Bhatt, MD: Invest and contribute, uh, to driving growth, but I could actually an impact society in a really meaningful way. Uh, and, you know, we’ve just seen even a recent months, like some of this, some of the activity in the life sciences realm, uh, and even in health care delivery. And, and I would say that the winds of regulatory support, um, for this are just continuing to grow, um, to try to give, [00:35:00] I think, innovators, investors, tools, um, to help.
Jay Bhatt, MD: And we’ve, I think, done some of that, uh, in our work with making the economic case. And so I, I think. That, um, there are bright spots. There continues to seem to be, um, energy and investment interest in the issue. Uh, and I think we need to continue supporting those exemplar, continue supporting those exemplars to showing progress and help them scale because that’s going to be a snowball effect and make a big difference, uh, to, to kind of accelerate the impact in this area.
Jay Bhatt, MD: And I, and I just think to Vic’s point, there’s a lot to learn about, uh, from the globe, uh, to bring to bear here, uh, whether it’s from an innovator investment standpoint or interventions and tools that can advance, uh, a healthy future for everyone.
Marcus: Awesome. Well, man, thank you so [00:36:00] much. Uh, I want to,
Vic: I want to talk about this book.
Vic: Oh yeah. Yeah. So you have a book that recently came out, right? Let’s talk about that for a minute and sell some copies. Yeah. Uh, talk about your book. Yeah.
Jay Bhatt, MD: So this is a passion project. Uh, you know, as we continue to think about, uh, opportunities to make health care better quality and safety, uh, is one is an area that my colleague, Dr Argyle, and I talk about work on.
Jay Bhatt, MD: And we know that, uh, there’s been a lot that’s changed COVID. Um, The health equity issue, the opioid epidemic, uh, how health systems engage in care delivery with the kinds of teams and, uh, the team based interdisciplinary care approach. And so we thought we would, um, bring the voice of experts and experience together to create a case based playbook on, uh, continuing to move the ball forward on quality and safety, kind of patient safety, uh, next [00:37:00] level and, um, embed.
Jay Bhatt, MD: Some of these issues, uh, that we experienced in health care delivery through that, including navigating the system, specialty care, uh, care delivery in various parts of the health system. So got a good response. We’re excited about these cases of experience being put to use and ones that, uh, You know, work, uh, continue to get scale.
Vic: Yeah, I love the case kind of, uh, design of it because I find that I learned best by sort of watching and reading about a case, um, as opposed to sort of more of a textbook based thing.
Jay Bhatt, MD: Yeah, I think we found, um, to your point about communication message, like, um, being able to tell a story. And say, here are the actions that teams took, leaders took to get to these outcomes and illustrating that I think is a very meaningful, um, way to go about learning.
Marcus: All right. Thanks for the reminder, Vic. [00:38:00] We did need to cover the book. Uh, but, but Jay, we’re going to let you go. Thank you so much, man. Keep up, uh, all the good work. We’ll be tracking what you’re doing over the course of the year and hopefully. You’ll come back on the show and give us some good updates about what’s going on in the field.
Jay Bhatt, MD: Thanks, Marcus and Vic. Appreciate your leadership and just an honor to be part of your show. It’s a fantastic work that you all do to lift these stories and perspectives up. So thank you.
Marcus: Thank you, man. Thank you. All right. Have a good one. So we just got done talking to Jay Bhatt. What’d you think? It was
Vic: great.
Vic: I mean, it was really impressive and you said it during the interview, but Deloitte has a huge reach, uh, and it’s really. Wonderful to see them using it in this way.
Marcus: Yeah. Massive platform. Um, and certainly they’re known for their accounting products, but also as a major, major consultant to, you know, the biggest companies in the world, uh, biggest organizations in the world, not just companies, but biggest organizations in the world, governments, et cetera, et cetera.
Marcus: Um, I, you know, [00:39:00] I was just struck by the. Breath of information he was able to just spout off that I think was very relevant. Like he could, he could be a regular appearance on our show, just in our regular conversations, just talking about the numbers, the dollar impact. Uh, what did he say? 460 million, uh, billion dollars, uh, today that could, that could, uh, shoot up to over a trillion, uh, by 2040.
Marcus: Was that? Yeah, I don’t know. Were those the numbers there?
Vic: I don’t know, but it was, it was a lot. I mean, it’s in hundreds of billions of dollars. And tripling in the next 20 years, 15, 20 years.
Marcus: Yeah, I think the mental note that I made when he was shooting off the numbers was it’s more than 10 percent of the current total spend.
Marcus: Yeah. Uh, could, you know, could be shaved off, right? If you, if you address this particular segment, which is that’s, I mean, from an investor perspective, you, it seems like you should be able to have a totally dedicated fund, uh, if the economic impact is [00:40:00] actually 10 percent of the overall healthcare industry.
Marcus: Yeah.
Vic: It’s, it’s a huge market opportunity, but also I think it’s under, it’s under built out. So, so I think there’s, there’s a lot of dollars at stake, but also there are not many innovative solutions that are in market right now. So definitely it could be an opportunity and I, it’d be great to have him back on.
Vic: I think there’s a lot to talk about. We could have gone on much longer and we could circle back every quarter, every couple of quarters or whatever, and just see. See what they’re doing and, um, you know, we might have different questions to ask them too. I think Medicaid, you know, is related to this. It’s not exactly the same.
Vic: Sure. But it’s a huge financial opportunity that I’m looking at investing in too. So it’s all integrated together.
Marcus: Well, from the U. S. market perspective, Medicaid most closely tracks to this issue, right? If you start talking about a lot of the financial social determinants of health, you know, the the things that are not Related to a particular diagnosis or code, um, but that definitely impact health equity [00:41:00] Medicaid is the that’s the that’s the market, right?
Marcus: That’s the payer market for it Speaking of of medicaid one of the things that I liked that he did that I think will stick with me as a mental model Is drawing a direct line? From the global health issues from a, uh, from an investable market perspective in terms of where they actually can influence the United States.
Marcus: So pointing out life sciences, pointing out, you know, certain things like maternal health, right? There are, there are these things. We talk a lot about how the payer markets are different in the US than they are in Europe than they are in Africa, et cetera, et cetera. So it’s, it’s kind of hard to translate those things.
Marcus: And he pointed that out, but he did, I think, highlight those areas and those aspects. And that’s something you get from a global organization like Deloitte, those areas where you can draw a straight line, um, between what’s happening globally and actually bringing that, that, uh, that innovation, that care model into the United States.
Marcus: So I thought that was, that was helpful. Cause I usually spend more time mentally on the negative side of that, just kind of thinking, Oh, you know, here’s all the reasons why it won’t [00:42:00] work. And it was just kind of cool. I
Vic: think there are some parts globally where. The US is probably last like public health, public health, for instance, he talked about community health workers.
Vic: Which is, I think, is a piece of public health where community health workers in other countries are much more impactful. I think they’re probably supported and invested in more, not just in dollars, but in people, time, resources, attention.
Marcus: Well, they’re also closer to the baseline, right? Because he was talking about community health workers in the third world being very, very, very impactful third world.
Marcus: And as he said that what I thought he was going to say is that’s easily translatable to our lower income, uh, you know, towns and cities. Here in the United States. He didn’t say that he said it’s actually harder because the payer models here don’t necessarily support it And we’ve been talking about how in the latest Round of health care policy updates that the White House has pushed through with CMS that in the [00:43:00] physician fee rule They’ve you know throttled down Uh, dollars to physicians and throttled up dollars to community health workers to caretakers, right?
Marcus: Yeah, they’re trending, they’re trending in that direction, but I
Vic: think we’re still way behind, way behind and I’m, I don’t want to put words in his mouth. I will say, I don’t think the incentives are set up the same way, but like the, the developing world. They don’t have as many high dollar diagnostic tools or really fancy, um, kind of procedural tools, but their public health and their community health and just like the hands on helping folks navigate the day to day life.
Vic: I think we could learn a lot from that.
Marcus: Yeah.
Vic: And then, but we need to change some of the incentive structure. CMS is working towards that, but I think we have more to do. The other thing I was really surprised about, pleasantly surprised, is he seemed really interested in AI and trying to [00:44:00] figure out where it should be used to educate people, to engage with people, to help them understand where they are today and how they could affect their health span.
Vic: Yep. Which is pretty interesting.
Marcus: Well, I, I think generally speaking, he was very technology forward. Yeah. In terms of areas that could create more health equity opportunities. Right. Yeah. It’s,
Vic: I think it’s kind of impact, like you can impact a lot of people.
Marcus: Yeah. Well, I mean, yes. And also it just sort of struck me as one of those things that culturally, he didn’t say it, we didn’t talk about it, but as, as he was saying it, I was sort of thinking, people generally seem to associate, uh.
Marcus: Populations that are in a lower socioeconomic band with being less technology capable, like less technology aware, having less access to technology. And we know like cell phones are ubiquitous, right? I mean, that’s the delivery mechanism and everyone’s got one, and I don’t care if you’re on Medicaid or not, like you’ve got a cell phone.
Marcus: So I did like hearing him sort of leaning in with those, like, no, leveraging tech and leveraging the latest [00:45:00] tech. Um, and, and this actually goes back to the, to the third world stuff. You know, we’ve, we’ve seen how in, uh, still developing countries where, because they don’t have all the existing built out infrastructure that we have in the United States, they were able to just sort of go, you know, leapfrog directly into cell phones, right?
Marcus: They don’t have to have
Vic: all that
Marcus: sunk cost. Right, exactly. And, and I feel like it’s the same thing with the community health workers, right? Because they don’t have all these hospitals built up everywhere, right? With the lobbying and all that other kind of stuff. They’re just going right back to, well, why don’t we just You know, have the people in the community who know the community and already care about the community, serve the community in an official capacity.
Marcus: Like for, for us, that’s a huge leap because we have structured the health system as the epicenter of community care, not people actually living in the community that know people in the community. So I just thought that wasn’t interesting
Vic: and we have this employer based health payer structure that worked for the U.
Vic: S. for a [00:46:00] long time, but, but puts this weird artificial wall up between the overall public that needs health care services and the, the employers. And I understand why we did that historically, but other countries that don’t have that just have a huge advantage. They, they just can hire community workers that’s a lot more effective.
Marcus: All right. Well, look, great episode. We’re going to put a link to Jay’s book and also to the, um, the health equity Institute that Deloitte, uh, has that he is the executive director on and the show notes.
Vic: I want to show people the change, the, uh, illustration thing,
Marcus: illustrate change, we’ll put a link to that as well.
Marcus: Uh, and just generally, you know, great episode. So we’ll, we’ll have Jay back on. Yeah. All right,
man. Thanks. Bye.