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Submit ReviewFriends, This interview should be required listening for every chief experience officer, every marketing officer, every chief medical officer and every chief executive officer in American healthcare.
Why? Because – when benchmarked against other public and private healthcare systems the VA outperforms on patient experience and consumer trust metrics.
And, if you want to understand ‘how’ – listen to this interview. I would suggest listening to it more than once – to capture the principles, strategies and tactics that John and his colleagues are deploying to achieve a world-class healthcare experience. Keep in mind that the VA provides care to over 9 million Veterans annually, at over 150 hospital-based medical centers and over 1400 ambulatory centers.
We cover so many profound topics, but here are a few:
This is one of many interviews I’ve conducted that demonstrates how far ahead the VA system is in so many respects. The VA is a hidden gem in the American healthcare system.
There are so many pearls of wisdom and sophisticated approaches that are shared in this interview. My hope is that it reaches the audience that needs to hear them. Zeev Neuwirth, MD
Friends, This is a remarkable journey – of a physician who has gone from burnout to creating positive ‘ripples of change’ in our healthcare system. He went from being a casualty of our healthcare system to being a courageous leader. In listening to Dr. Otten’s story, I was moved from anger to elation, and I suspect you will be as well.
What’s profoundly disturbing is that this physician’s experience of anguish and burnout reflects that of the majority of clinicians and healthcare staff.
What’s inspiring is that this physician made a decision to turn the dismal dilemma of American healthcare into a positive movement to humanize it. What I also admire is his collaborative approach and the inclusion of patients – coupling his initial effort, Ripple of Change, with Medicine Forward and other advocacy/activism groups.
One takeaway is that we need to change the narrative and the fundamental construct of our healthcare delivery system. We need a renewed sense of purpose & mission, and actually live it – in our policies and procedures – in our organizations – in our payment – in our daily delivery of healthcare.
What Todd and others are doing is critical and urgent. Over half of US doctors experience burnout. One quarter of the current nursing workforce are planning to leave the system in the next three years. We aren’t at a tipping point. We’ve already tipped over.
On a very personal human level, Dr. Otten had to first save himself before he could save others. There’s a profound lesson in there for all of us.
Zeev Neuwirth, MD
Friends,
This dialogue is a Master Class in Care Transformation – likely owing to our guest’s unique background, which includes preventive medicine, public health, and clinical informatics. It should be required listening for all healthcare executives and managers – both clinical and administrative – as well process/quality improvement professionals. Our guest, Dr. Cole Zanetti is an insightful and brilliant process improvement and care transformation expert. He has a broadly empathetic perspective and a practical humanistic vision that is the foundation for his work and his leadership.
Dr. Zanetti currently serves as a Senior Advisor for the Veteran Affairs National Center for Care and Payment Innovation – focusing on value-based care delivery and payment innovation pilots as well as emerging technology innovation pilots. He also serves as the Chief Health Informatics Officer for the Ralph H. Johnson VA Medical Center in Charleston South Carolina, and as the Director for Digital Health at Rocky Vista University College of Osteopathic Medicine. Dr. Zanetti was trained in Family Medicine and Leadership Preventive Medicine at Dartmouth Hitchcock Medical Center. He is triple board certified in family medicine, preventive medicine, and clinical informatics – and has a Masters in Public Health from the Dartmouth Institute for Health Policy. He has also served on the National Quality Forum’s Physician Advisory Committee and as a technical expert for the Centers for Medicare & Medicaid Services.
A few months prior to this interview I heard Dr. Zanetti speak about the cutting-edge, digital-tech innovations being deployed within the VA. My intention going into the interview was to do a deep dive on those care delivery innovations. But, this conversation went in an unexpected direction, which I’m truly grateful for. We ended up exploring the philosophical underpinnings of transformation and the approaches Dr. Zanetti has had to adopt in order to do this work. In short, we discussed the ‘why’ and the ‘how’ of care transformation.
Some of the areas we covered include:
This interview uncovers another example of how the VA is one of the most innovative and transformational healthcare systems in the country. I continue to be astounded by the “hidden gems” – the forward-thinking, nationally leading expertise and initiatives within the VA, and the unique factors that make the VA ideal for ideating, piloting, deploying and studying care transformation.
Towards the end of our dialogue, I promised that I would follow up with a part 2, which I will – in which we’ll dive into the specific digital tech innovations being deployed in the VA.
In the meantime, I hope you have a chance to glean the wisdom and humanity of Dr. Cole Zanetti.
Until Next Time, Be Well Zeev Neuwirth, MD
Friends, This is Part 2 of an interview that is one of the most startling I’ve posted over the past 8 years. The revelation here is that the pulse oximeters we’ve been using for decades, to measure oxygen in the blood, are not always accurate in people of color. They may overestimate the amount of oxygen in the blood and miss low oxygen levels – potentially leading to delayed treatment and adverse outcomes. What’s shocking to me is that this has been documented in the medical literature for nearly two decades and little to no action has been taken. The implications are profound, especially given the disparity in deaths we witnessed along racial lines during the Covid pandemic, and the on-going widespread utilization of pulse oximetry in the post pandemic era.
Our guest, the esteemed Dr. Kryger, provides us with his expert perspective on this still emerging situation. In this episode we’ll discover:
This is one of those critically important and urgent issues that we need to learn more about and do more about. As our guest points out, the magnitude of this problem is enormous in that nearly 40% of the people who pulse oximeters are used on are people of color.
My purpose here is to create awareness and motivate positive action. Along those lines, I would urge you to read and respond to the FDA’s recently released discussion paper (the public is invited to respond up until Jan 16, 2024); as well as attend the FDA’s upcoming virtual public advisory meeting on Feb 2 2024.
I would also urge you to forward this podcast to your clinical colleagues as well as hospital and healthcare executives.
Zeev Neuwirth, MD
Friends, Primary care for seniors is different from care for younger patients. Yet, very few providers across the country have a different and distinct strategy to care for their aging senior patients. In this interview, we’ll be introduced to an organization that has made taking care of seniors a priority.
It’s remarkable to hear Dr. Vivek Garg discuss the multi-year strategy and tremendous commitment that has gone into the CenterWell Brand at Humana. One of the things I appreciate about Dr. Garg is his humility and transparency – about what Humana has achieved as well as what more we ALL need to achieve in order to provide the type of care that the aging senior population requires. As I mention in the closing comments of this interview, we need the type of leadership that Dr. Garg manifests – a leadership focused on outcomes that truly matter to people and communities.
Wishing you all the best of health and wellness in the New Year!
Zeev Neuwirth, MD
Friends, This interview is one of the most startling I’ve posted to date. In this episode, we discover that pulse oximeters – which measure blood oxygen levels – are not always accurate in people of color. Mounting evidence suggests that they’re far less accurate in people of color than in white people. They can overestimate the amount of oxygen saturation in the blood and miss low oxygen levels. As a result, people of color may be underdiagnosed and undertreated for low blood oxygen – in conditions ranging from pneumonia and flu, to numerous chronic lung conditions, to asthma, and heart failure. The clinical implications are profound. If low oxygen levels are not detected, people may not be provided appropriate monitoring and medical treatment – in their homes, in doctor’s offices, and in emergency departments, hospitals and intensive care units.
As long-time listeners of this podcast know, my approach is not to focus on what’s wrong in American healthcare; but instead, to identify what’s right – so we can adopt, scale and spread positive change. What’s right here is that one solution to this disparity already exists. Our guest, Neil Friedman and his colleagues have developed a pulse oximeter, Circul Pro, that is more accurate in people of color, as well as in white people. It’s been scientifically validated and approved by the FDA. You can learn more about it at www.circul.health.
Another positive development – two days after I recorded this interview, the Center for Devices & Radiological Health (CDRH) within the FDA released a discussion paper for public feedback entitled, “Approach for Improving the Performance Evaluation of Pulse Oximeter Devices Taking Into Consideration Skin Pigmentation, Race and Ethnicity”. They also scheduled a virtual public meeting on Feb 2, 2024 to discuss this issue. Both announcements can be accessed here.
This interview raises more questions than answers. For example:
This is one of those critically important issues that we need to learn more about and do more about. As our guest points out, the magnitude of this problem is enormous in that nearly 40% of the people who pulse oximeters are used on are people of color.
My purpose here is to create awareness and motivate positive action, not to lay blame. Along those lines, I would urge you to read and respond to the FDA’s recently released discussion paper (the public is invited to respond up until Jan 16, 2024); as well as attend the FDA’s upcoming virtual public advisory meeting on Feb 2 2024. The paper is well researched and it’s a call-to-action to advance the research – with very specific questions.
I would also urge you to forward this podcast and write up to your clinical colleagues – especially those with expertise in pulmonary, critical care, and sleep medicine.
As always, wishing you the best of health, Zeev Neuwirth, MD
Friends,
As we’ve described and discussed before in this podcast, Primary Care in the US is on life-support and the prognosis does not look good. The implications for all of us is dire – as we look at what is nothing less than the demise of primary preventive care in our country. Our guest today has devoted his career to trying to revive and save primary care. And in this episode we’ll discover what he and his colleagues are doing.
Our guest today, Dr. Neil Wagle, earned his MD at Harvard Medical School and his MBA at Harvard Business School. He trained in Primary Care Medicine at the Brigham & Women’s Hospital. As the Chief Medical Officer at Devoted Health, Neil has led the build of an advanced primary care model that complements the traditional care that people receive from their primary care providers.
In this interview, we’ll discover:
Neil is one of the emerging superstars in our healthcare system. It’s inspiring to hear his humanistic leadership principles and the consumer-centric, service-oriented culture that he and his colleagues have created at Devoted Health. This episode is a masters class in advanced primary care and another not-to-be-missed dialogue.
Wishing you all the best of health and wellness!
Zeev Neuwirth, MD
Friends,
In this episode we’re going to discuss the opportunity we have, collectively, to live longer and healthier lives – and the underlying transition that’s required in the healthcare industry to make that a reality over the next few years.
The specific topics at hand include: (1) The economic imperative for why the American healthcare industry must move toward wellness; (2) the profound life-saving and cost-saving benefits of such an industry shift; (3) the central role that employers can play in wellness and longevity; and (4) some of the challenges and headwinds in this shift.
Our expert guest today is Neal Batra, who is a principal in Deloitte’s Life Sciences and HealthCare practice which is focused on the redesign of business models and commercial operations. He also heads Deloitte’s Life Sciences Strategy & Analytics practice, leading the way on next-gen enterprise strategy, analytics and technology. Neal has more than 15 years of experience advising health care organizations and businesses in biotech, medtech, health insurance, and retail health care. He is the coauthor of Deloitte’s provocative ‘Future of health point-of-view’ – forecasting on the healthcare ecosystem in 2040, and the business models and capabilities that will matter most. He holds an MBA from London Business School and a BBA from the College of William and Mary.
In this interview, we’ll discover:
The foundational issue that Neal and his colleagues start off with is that our healthcare system, as amazing as it is – is focused on the ‘break it and fix it’ model. It is a system that largely waits for disease and illness, and then dedicates tremendous resources and expertise toward dealing with that disease and illness burden. This is what he and many others refer to as a ‘sick-care’ system. This is in stark contrast to a system that is focused on proactive prevention of disease and illness. And Neals points out that this is not an either-or decision. What he recommends is a widening of the aperture – a diversion of some of the current healthcare spend to proactive and preventive well-care.
Neal opens up our discussion with a sobering revelation. For most Americans, the time of life when their health begins to erode corresponds to the time that they’re getting ready to retire. As he puts it, “Your healthiest years went to your employer, and in a time that was meant to be the ‘golden years’, or the years in which you had a financial foundation that allowed you to do different things with your life, your healthspan declines to a point where your quality of life declines.”
A second revelation – that Neal and his colleagues have published on – is that if we transitioned to a wellness industry, Americans could add an additional 12 years to their lifespan and nearly 20 years to their healthspan, by 2040. His team has also projected that the American healthcare system could save $3.5 Trillion per year – what he refers to as a whopping ‘well-being dividend’. Neal’s point, not to be missed, is that the cost dilemma in American healthcare will not be solved through cost reduction in a sick-care system, but rather through cost prevention through a well-care system. In his own words, “I’d like to shift to a ‘cost-of-avoidance’ narrative versus a ‘cost-of-care’ narrative. The cost-of-care narrative is a trailing economic measure, and there is no amount of innovation that will ever make it cost-effective to address the population in this break-fix modality. The only way out of the economic death spiral we are in when it comes to healthcare is to jump in front of illness, and invest ferociously on disease avoidance, and early as well as real-time diagnosis.”
A critical finding – that Neal and his colleagues have also published – is that approximately $1Trillion of the $3.5 Trillion in savings will come from the elimination of the disparities and inequities in healthcare. One statistic he mentioned is that white Americans live on average, 78 years, while for black and native Americans, the ages are respectively, 72 years and 68 years. And while these and other disparities are unconscionable in and of themselves, the calculations add an economic imperative to the ethical arguments for eliminating the structural racism in our healthcare system.
A third revelation and shocking forecast that Neal shared – which again, his analytics & actuarial team have published – is that, by 2040, 60% of healthcare spend in the US will go to well-care, not the treatment of disease and illness. He and his colleague predict that, by 2040, we are going to witness a “new health economy” with “new business models” which will drive 85% of all healthcare revenue. This new health economy will also be driven by a shift from a ‘rule-of-thumb’ to a ‘rule-of-one’ medicine – that is, the hyper-personalization of care – enabled by the digital and AI revolution in healthcare.
To balance out the dialogue, we did discuss the very real obstacles and headwinds to this sort of healthcare transformation. For starters, wellness care does not align with the current, predominant, industry business models. Neal’s counter-argument is that no industry has ever been transformed by incumbent stakeholders. It’s only through external pressure that the incumbents either respond and change, or they go by the wayside. His point of view is that hospital systems have two options: (1) continue to solely pursue the acute care/sick-care business model, and contract into an acute care focused factory; or (2) engage and expand into wellness care and the corresponding business models.
I don’t want to lose sight of Neal’s ‘both-and’ perspective, which is that it’s not that we have to choose between sick-care and well-care. Instead, we need to create a more balanced healthcare system that includes a significant well-care component. But, as Neal points out, we’ve got a long way to go to reach that balance. “If you held our sick care capabilities constant over the next decade and flowed everything into wellness and wellbeing, I think the yield on the American health system would be enormous economically, as well as from a health outcomes perspective”.
I’ll end with this personal observation. In my career, I’ve seen us accomplish miraculous things – creating space-age interventional cardiac labs, life-saving hemodialysis centers, and tele-stroke units. But here’s the rub. Wouldn’t you rather have the healthcare system focus a significant amount of resources and expertise on you NOT having that heart attack, kidney failure, or stroke in the first place? I know I would.
Wishing you all the best of health and wellness!
Zeev Neuwirth, MD
Friends,
I’ve had the great privilege of interviewing and interacting with Glen Tullman a number of times over the past few years. The last time we spoke in a formal interview was episode #121, which was posted on Sept 22, 2021. That episode was entitled, “A master class in building a healthcare consumer experience company”. And it was exactly that – a master class. My experience is that this episode is a continuation of that master class in humanizing healthcare and in achieving markedly improved health outcomes.
Glen Tullman is the Chief Executive Officer of Transcarent and the former Executive Chairman, Chief Executive Officer, and Founder of Livongo Health. He previously ran two other public companies. During his time as
Chief Executive Officer of Allscripts, the Company was the leading provider of electronic prescribing, practice management, and electronic health records for physician practices. Prior to Allscripts, he was Chief Executive Officer of Enterprise Systems, the leading resource management systems for hospitals, which he also took public and then sold to McKesson/HBOC. Glen is also one of two Founding Partners at 7wireVentures, one of the highest- returning venture capital funds in Illinois. He is the author of On Our Terms: Empowering the New Health Consumer, in which he proposes new solutions to address the chronic condition epidemic facing our country. A strong proponent of philanthropy, Glen was honored in 2019 with a Robert F. Kennedy Human Rights ‘Ripple of Hope’ Award for his career focused on improving the safety, empathy, and efficiency of our healthcare system. He also serves as a Life Director of the Illinois Chapter of JDRF, the leading organization advancing life-changing breakthroughs for Type 1 Diabetes. Glen has three amazing children and a new granddaughter who inspire him every day.
In this interview, we’ll discover:
Before we go any further, it’s important to briefly point out that Transcarent is inserting itself into the employer healthcare space as an alternative to the large BUCAH insurance companies that are acting as third party administrators (TPA’s) for self-insured employers – large, mid-sized and even relatively small employers. Transcarent is in what we refer to as the ‘direct-to-employer’ market. For those who are unfamiliar with the acronym, BUCAH stands for Blue Cross, United Healthcare, Cigna, Aetna (now CVS Health), and Humana.
This episode is a master class in humanistic consumer-oriented care. In the previous podcast we recorded, Glen outlined 3 major needs people have when it comes to healthcare delivery. Briefly stated, these are: unbiased information, unbiased referrals, and support navigating the system. In this podcast he expands upon those to articulate five major value propositions that Transcarent is offering. These 5 are all embedded within the Transcarent app, and include:
Transcarent is partnering with home health companies, such as Dispatch Health, to deliver care into the home or directly to the individual via telehealth and digital options.
Transcarent is partnering with the Cleveland Clinic in offering literally world-class 2nd opinions when an individual has been recommended to have surgery. The reason being that a significant percentage of recommended surgeries are unnecessary and potentially harmful. And once the 2nd opinion is rendered, Transcarent can provide options for the best surgeons and hundreds of sites across the country to have the procedure. One thing to note here is that Transcarent is working with employers to provide surgical care without any payment or co-payment to employees. The way this works from a financial perspective is that by reducing inappropriate surgeries and suboptimal outcomes, Transcarent plans to save employers enough money to provide the needed and appropriate surgeries for free.
Glen quotes a stat that nearly one quarter of all cancer diagnoses and cancer care in this country is being done without the latest information or being provided at the lowest cost high quality sites. Transcarent’s platform approach utilizes state-of-the-art information and expertise to assist employees in obtaining the best care and the best value option.
Transcarent is utilizing a relatively new business/tech model, which is called a platform. Examples of well known platforms include Amazon, Uber and Airbnb. The model is different from the typical business model in that the platform doesn’t necessarily build, create or produce products and services. Instead, it hosts or convenes them in one place and provides highly consumer-oriented services to make them accessible to the consumer. Platforms are, essentially, virtual digital marketplaces, but they provide customized and personalized information and convenient access that isn’t available in brick & mortar market places. For example, the well-known, “people like you bought” or “people who bought this also bought…” The customers on the Transcarent platform are self-insured employers, with the ultimate consumer being employees. The vendors supplying the products and services would include healthcare systems, provider practices, and digital health companies.
One of the lessons I’ve learned from this conversation with Glen is that Transcarent is not only a platform but it’s a platform plus, or what Glen calls a “convener plus”. Glen explains that unlike Amazon, Transcarent not only provides the product or service, but it assists the customer in navigating through the experience. As he eloquently puts it, “It’s not just to, it’s through”. For example, Transcarent not only provides a 2nd opinion of whether to have a specific surgery, the platform will also recommend the highest quality, highest value option, and it will also make the referral. Not only that, it will follow up in the surgical as well as post-surgical care.
And, one advantage of this platform approach is that the services that any given employer is looking for can be accessed on the platform without having to purchase the entire bundle of services. It’s a truly ‘choose your own journey’ type of business model – highly customized for any given employer customer. Another related advantage of the platform model is that if an employer has a product or service they like, Transcarent can place that on the platform instead of forcing the employer to switch. As Glen states, most vendors require that you “rip out and replace” the current product or service you’re using. Transcarent’s platform and approach avoids that.
What I’d like to conclude with is an issue that is, in my opinion, the most root cause in healthcare today. In Glen’s own words: “What I’m looking for in healthcare is more leadership – that’s what we need… And, when I think about leadership, I think about creating systems that put the healthcare consumer front & center – improving the quality and experience of care, and reducing costs.”
I’ve written extensively about Glen and about Transcarent in my recent book – Beyond The Walls – and for good reason. Glen is one of the most accomplished healthcare leaders in the world. But, even more than that, he is a humanistically disruptive and consumer-obsessed healthcare leader. There are very few leaders I’ve met who possess his unrelenting focus on the actual experience of care from the point of view of the individual healthcare consumer. Glen is brutally straightforward on his take of the American healthcare experience. He calls it like it is. As he states so clearly – “healthcare is more confusing, more complex, and more costly than it’s ever been before… [and the situation] is getting worse, not better”. He also makes the point that a major cause is “maximizing profits over care”. It’s Glen’s objectively truthful sensibilities and his integrity which has fueled his incredibly disruptive and positively advancing achievements.
When I asked Glen what message he would want to share with healthcare leaders and employer leadership, he responded with two questions. First – what are you doing now that is really different and better – actually innovating rather than incrementally improving? Second – why would you not at least try this new approach – given the reality that the current approaches we’ve been rehashing for decades is clearly not working and in fact, is making things worse?
I’ll leave you all to ponder and respond to those two questions.
Until Next Time,
Zeev Neuwirth, MD
Friends,
The central role that Medicare, and CMS, play in our healthcare system can not be overstated. There are approximately 64 million Americans in the Medicare program, with annual payments of $1 Trillion, comprising over 20% of the healthcare spend in our country. In addition to its size and scope, CMS, through the Medicare program, is leading the nation in advancing value-based care, and has been deploying landmark historic initiatives at an accelerated pace. This is a unique interview in that we will be hearing directly from the impressive and highly accomplished leader at CMS who is leading Medicare. And, as I promised during the interview, I’ve attached a few links to cms.gov at the end of these notes.
Our guest this episode is Dr. Meena Seshamani who currently serves as Deputy Administrator and Director of the Center for Medicare, at the Centers for Medicare & Medicaid Services. Since joining CMS, Dr. Seshamani has led her team of nearly 1,000 through a critical agenda of initiatives to advance health equity; expand access to coverage and care; drive innovation for high-quality, whole-person care; and promote affordability and sustainability of the Medicare program for generations to come. She is the senior official responsible for CMS’s implementation activities under the Inflation Reduction Act, which is the largest change to the Medicare program since the enactment of Part D in 2003. Dr. Seshamani is a Hopkins trained surgeon and an economist, having obtained a doctorate in economics at Oxford. Prior to joining CMS, she served as Vice President of Clinical Care Transformation at MedStar Health – a multi-hospital system – where she developed & implemented population health and value-based care initiatives. She also cared for patients as a head & neck surgeon at MedStar Georgetown University Hospital and at Kaiser Permanente in San Francisco. Dr. Seshamani served on the leadership of the Biden-Harris Transition HHS Agency Review Team. Prior to MedStar Health, she was Director of the Office of Health Reform at the US Department of Health and Human Services, where she drove strategy and led implementation of the Affordable Care Act across the Department, including coverage policy, delivery system reform, and public health policy.
In this interview, we’ll discover:
One of the most landmark initiatives we discussed in this interview was the historic ‘Medicare Drug Price Negotiation Program’. This is the first time ever that Medicare will be negotiating directly with pharmaceutical manufacturers for the prices of some of the highest cost drugs in the Medicare program. It’s fascinating to hear Dr. Seshamani describe the thoughtful and thorough preparation, as well as the ongoing research and assessment that is going into architecting the negotiation process. It’s also compelling to hear that CMS is focused not only on optimizing costs but also on evaluating the real-world effectiveness of these medications. In its first year, the program will focus on ten of the highest cost medications, but those numbers will increase rapidly to cover many more high-cost medications. The law will also cap medication costs for any individual Medicare beneficiary to no more than $2,000 per year.
Another landmark initiative we discussed is the ‘intensive outpatient program’. As Meena eloquently puts it, “We have made some of the most significant changes in behavioral health in the history of the Medicare program – creating entirely new benefits…” For example, these new benefits allow licensed marriage & family therapists, mental health counselors, addiction counselors, and care navigators to become billable Medicare providers – so that beneficiaries receive more whole-person, team-based care, radically improving the way that mental healthcare can be delivered.
I came away from this interview awed by the sheer number of historic, value-based initiatives that CMS is launching – enhancing affordability and equity of care and advancing care in critical areas such as behavioral health. I was also impressed by the transparency and level of engagement that CMS is enabling with providers and the public at large. Another facet that I have to call out is the focus CMS is placing on studying the effectiveness of their efforts, with an emphasis on actual health outcomes in the real-world setting.
There is so much more happening at CMS that we did not have the time to cover. What CMS is doing, and importantly, how they’re doing it, is a manifestation of their courageous, humanistic, conscious leadership. It’s also a reflection of the capability, commitment and integrity of their teams, and their overall palpable dedication to public service.
I came away from this interview hugely inspired and hopeful about the future of American healthcare. We have extraordinary leaders and sophisticated, dedicated teams at CMS – public servants who are advancing and transforming healthcare delivery in unprecedented ways. Their pace, productivity, and impact is remarkable. Their purpose is exemplary. I hope you come away from this interview as catalyzed to engage with CMS as I am. To that end, please take a moment to click on the cms.gov links below – and join in enhancing CMS’s mission. Until Next Time,
Zeev Neuwirth, MD
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