Cooperating for better care.

Hal Teitelbaum

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Practice group CEO discusses cost-shifting


Here’s a Modern Healthcare interview with Hal Teitelbaum, M.D., the CEO of Crystal Run Healthcare, a very interesting and fast-growing multi-specialty physician practice in Upstate New York that has won praise for its embrace of value-based care of a wide range of patients.

The company  recently launched an insurance arm and has partnered with a leading New York City academic medical center, Mount Sinai, to get into Manhattan.

Among his comments:

“It’s relatively easy to take care of the affluent population. It’s much harder to create a sustainable healthcare system where we are part of the safety net where we take care of everyone….We focus on creating a single approach to healthcare for everyone. We are agnostic as to whether individuals are better or less well-off financially. ”

We have been very involved with, and are proponents of, healthcare transformation and value-based care, and at the same time, have taken Lean approaches to our operations.”

“The fragmentation of the healthcare system means that there tends to be a lot of cost shifting between providers of inpatient care, outpatient care, pharmacy and post-acute care. If we are successful in lowering the cost of care and improving the quality, somebody is paying that price. When it’s fewer hospitalizations, some hospital administrators may be upset. Or, it may be more appropriate use of medications. So pharma may be upset. We have our own health plan now. So payers may be concerned that disintermediation is occurring. With healthcare transformation, and provider systems doing more of the analytics, they’re concerned (about) what value they bring to the system. ”

“Our approach to working with providers as a payer {insurer} is, let’s partner in value. Let’s work together. If we can do things together that improve value in terms of health outcomes and lower cost, let’s share in that. We’ve had some hospitals and hospital systems that have said, ‘That sounds great. We’re all in.’ And we’ve had other hospitals that have said, frankly, ‘Not on your life. We’re going to milk fee-for-service until we can’t do it anymore.’ Overall, it’s been a very positive experience for us.”

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(617) 230-4965

Wellesley, Mass