The Pathway of Innovation
No matter what issue Chopra is tackling, he always tries to remember that innovation is the key to problem solving. This is a lesson he learned at a young age, from watching one of his father’s peers, Sam Pitroda, transform India’s telecommunication landscape.
“Problem solving to Sam, who inspired me, was about finding a third pathway, an innovative pathway,” Chopra shared.
That attitude has been especially valuable for Chopra as someone working in healthcare, where many of the biggest issues are highly politicized.
“As I looked to problems that needed solving, there had to be opportunities to apply the same lessons. It’s the left versus the right on traditional arguments, but can we all rally around a more innovative approach when it comes to solving a problem?” he explained. “If you believe in the path of innovation to solve problems, as it relates to healthcare, there are some specific things that the government can do.”
Why Provider Directories Matter
One of the key problems Chopra has spent the last few years working on is improving provider directory data.
“You’re looking to buy a health plan. You want the best network possible for your loved ones, and you’re willing to pay whatever you can afford to get there. And you get frustrated when 30-40% of the information about the network you thought you were buying was wrong,” Chopra explained. “The doctor’s not at the address they promised, so now it’s less convenient for you to go find that doctor, or they’re not accepting new patients. Something got lost in translation.”
The government has recently accelerated their efforts to make sure all providers have accurate data, but most people view this issue as a database problem. Chopra, however, flipped the problem on its head when he started thinking about it as a search problem.
“What if we could get all the doctors that have websites to apply a certain amount of information within the webpage, called metadata?” he started to ask. “If we get it right, all the doctor has to do is update their webpage, and we could use that same information to fuel accurate provider directories, and hopefully lower the administrative burdens on the physician groups.
Chopra and his collaborators are currently working to standardize the metadata that providers would need to use, in hopes of creating a solution that simplifies the process for both patients and providers.
The Benefits of ACO Reach vs. Medicare Advantage
Beyond just improving provider directories, Chopra also wants to see a world where patients can easily find the doctor who isn’t just within their network, but is also best equipped to meet their needs.
There are two different pathways to reach this goal. One is a tightly integrated but narrow network that works hard to make sure you can get everything you need without going outside the network. This is difficult to scale, however, and many people are hesitant about this kind of approach because they like to have as much choice as possible.
The second pathway, which is the one Chopra believes has the most potential, is a new program called ACO Reach. With this pathway, patients can see any doctor they choose, but they also have a primary care doctor they can trust to look out for their best interests an make recommendations.
“We have more choice, but a quarterback primary care doctor whom we trust, that can help us navigate within that field,” Chopra explains. “It’s a ‘cake and eat it too’ dream.”
ACO Reach improves upon one of the biggest issues with Medicare Advantage, which is that you may not be able to purchase a Medigap Plan once you’ve enrolled.
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