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Dr. Rakesh Pai Dr. Rakesh Pai COURTESY PHOTO

Crystal Ball 2019 Outlook Q&A: Dr. Rakesh Pai, Metro Health

BY Sunday, December 23, 2018 04:08pm

Dr. Rakesh Pai joined Metro Health – University of Michigan Health System in October as medical group president and chief population health officer. He came to the health system with experience in two major drivers in health care today: value-based contracts between insurers and care providers and population health. Dr. Pai, a cardiologist, previously served as associate chief medical officer for two years at Cambia Health Solutions in Portland, Ore., where he ran Regence Blue Cross Blue Shield of Oregon. Dr. Pai looks at 2019 as a year for Metro Health to further build on the two-year-old affiliation with U-M Health System.

As you’ve settled into the new position, what do you need to work on at Metro Health in 2019?

Number one, how do we continue to innovate, differentiate and grow? We’re not going to ever be Spectrum. They’re many billions of dollars down the road compared to us. Nor do we really want to become that. What we’re really talking about is how do we maintain that unique culture that historically has been very primary-care focused?

Metro has brought on many new physicians since the affiliation began two years ago. Are you still in that recruitment mode?

Along with innovate, differentiate and grow, this is my co-number one – physician recruitment. We really want to grow our medical group. We think there’s a huge primary-care access issue in West Michigan. Grand Rapids is just growing and we just really anticipate a rather significant population increase over the next decade or so. We think preparing for that next 10 years, or five to seven years, is really important, and we do think recruiting and affiliating with the University of Michigan is a differentiator for us.

How aggressive will you be and what clinical areas are important to you?

The aggressiveness is a little bit predicated on actual space to put people into practice. We have about 20 or so neighborhood operating clinics where you can have a family practice, a pediatrician, maybe an internal medicine physician and some specialists rotating in and out of those. We really are to the point where most of our clinics are staffed up pretty considerably, and in order to bring on new physicians, we might need a new number of sites. We’re actively working through the process of where will the next phase of sites be deployed. Where does it make sense geographically? Where does it make sense to shore up our base down in the southern part of Grand Rapids? Recruiting is huge, but space and capacity planning are important so they will need to be in step.

What’s your biggest opportunity next year?

Continuing to leverage the affiliation, and continuing to bring services that historically haven’t been as commonly performed here in West Michigan to Metro and to the system in West Michigan. Things like epilepsy surgery. We have a neurosurgeon coming over from the University of Michigan who’s kicking off our functional neurosurgery program. Growing service lines that are pretty much in high demand, such as endocrinology and rheumatology and neurology, will be really important areas of growth for us. We have some of those types of docs now, but after we got a few of them, it became pretty clear that we have demand for much more, so we want to grow to meet that demand.

What are the biggest trends in health care that will affect Metro Health in 2019?

Transparency is going to be a very important trend. We need to do a better job of providing price discovery and transparency to patients. In health care, there is just so much surprise billing that is aggravating. We need to evolve to being able to put sort of what an average knee replacement cost is. It could be subject to different payers having different rates which could affect your personal pricing as a patient or a consumer, but at least some ballpark that’s something and that’s transparent.

What in health care will gain traction in 2019 and be a bigger issue a year from now?

What’s to get the biggest traction is more and more patient-generated data. How do physicians use it better? The Apple Watch and this new EKG app are really phenomenal for patients and doctors. We have to have the ability to intake this data from your FitBit or your Apple Watch, from your diabetes glucose sensor, or whatever. We need to be able to take this data that’s more real-time in patients and be able leverage it to get them better outcomes. The Apple Watch and other devices are really going to be game changers.

What’s one prediction you have for 2019?

I see probably more and more unusual partnerships like CVS-Aetna (and) delivery systems and insurance companies coming together. I see more of that consolidation.

Interview conducted and condensed by Mark Sanchez. 

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