Executive Leadership Interview with Ian Laird and Dorothy Fisher, MD
Vively Health announced the addition of two new leaders in the summer of 2019: Ian Laird and Dorothy “Dody” Fisher, M.D.
Ian joined in April of this year as National VP of Growth. He has spent nearly 20 years inside health plans including Anthem, Empire and Oxford, working across all lines of business, most recently as staff vice president of business development at CareMore Health.
Dody recently joined this summer as National Medical Director. She brings 18 years of experience translating clinical pathways into workflows and ensuring proper implementation for maximum efficiency and has quite a bit of experience with Medicare Advantage and Programs of All-inclusive Care for the Elderly (PACE) programs, which are home-based programs for seniors. She most recently served as a medical director at Geisinger Health Plan.
What inspired you to join Vively Health?
Ian: When I was approached about joining the team I was impressed by the level of maturity of the solutions offered to payors. The model of care has been honed over 15+ years to be very effective and continues to improve with each iteration. We are so confident in the efficacy of the model that we take full risk on its performance. That is rare and very inspiring. The other thing that inspired me to join is DaVita’s overall vision of patient care and moving upstream from dialysis to take full accountability for each patient’s total care. Vively Health is an important part of that vision.
Dody: Unlike many, I had the opportunity to know what I was getting into before I joined. I was a member of the Clinical Advisory Board and thus had firsthand knowledge of both the standards and the workings of the team. When I had the opportunity to join as a permanent member it was a natural fit. Being from Geisinger, I know what clinical precision is and that is what Vively Health is all about. The evidence-based rigor by which the clinical pathways are developed will be the envy of the field.
How do you think Vively Health is embracing risk and driving innovation?
Ian: Vively Health is what I would call a risk innovator. We do not get paid until we create value for our payor partners by improving the health of our patients. This is not a common practice in health care today, although I wish it were. Our performance-based pricing stands out in the industry.
Vively Health is driving innovation in the industry through our predictive analytics. One of the challenges with high-risk care models is how do you know the model of care reduced cost. Most models that identify patients based on historic costs end up showing “savings” because the targeted patients had a spike in costs the year before and simply returned to a normal level of spend, and not because they got healthier. Vively Health has built an innovative model to target patients who will be expensive next year. We believe this is better for patients because we are focusing on those with the most needs. It is also fairer for our payor partners so they are not paying out for “savings” that were really just patients returning to a normal level of expense. This does make it harder for us, and even more impressive to take full risk on performance, but it means that when we generate savings it is truly due to improvement.
Dody: The saying "put your money where your mouth is" is a closely held concept at Vively Health. How can we expect a partner organization to be "at-risk" if we are not willing to have skin in the game also? To that end Vively Health will prove itself to the partner before any value-based savings sharing is triggered. This is because we are confident we can do what we say we can do...keep members happier, healthier and out of the hospital – all while decreasing overall health care cost. Everybody wins. This also helps drive innovation as we "think outside the usual box" in an effort to re-imagine care with a more cost-effective end in mind.
Where do you think Vively Health is on the road to value-based care?
Ian: The U.S. health care system has a long way to go to be truly value-based, but Vively Health is dead-center in that path. The first order shift to value-based care is well underway with Accountable Care Organizations taking responsibility for the cost and quality of care for their patients across their Commercial, Medicare, and Medicaid populations. Now we are starting to see the shift toward second order changes like downside risk. Establishing a model of care and providers dedicated to high-risk patients the way Vively Health does is a second order action on the road to value-based care and is exactly the type of thing the industry needs to adopt as part of the progression to delivering true value to consumers.
Dody: We are truly light years ahead. By hard coding evidenced-based, best practice care excellence into detailed clinical work flows, it allows Vively Health to advance more nimbly into the value-based arena.
Why do you believe your leadership experience is influential to the team?
Ian: One of the things I think I bring to Vively Health is the payor perspective. I spent nearly 20 years inside health plans working across all lines of business. As the move to value-based care progresses, care delivery organizations and payors will need to work together in new and innovative ways. The fee-for-service walls between the two types of organizations will need to be replaced by collaboration and cooperation. It will be important for there to be cross pollination of perspectives so they understand each other and can share ideas to develop solutions for consumers.
Dody: I know how to translate clinical pathways into work flows and ensure that they are implemented properly for maximum efficiency. I come from one of the original value-based programs, PACE, which was approved by Medicare in 1997 and has had a proven track record ever since, and from Geisinger, which was a pioneer in value-based, guaranteed, care called ProvenCare. Vively Health is about bringing all the right care team players to the table and I have been doing that for 18 years.
If you had the power to change one thing in our health care system, what would it be?
Ian: If I could change one thing it would be to rebuild the U.S. health care system to be based on the value delivered to the end consumer – the level of health they are getting for what they are spending. This would reorient our care around preventing diseases and address consumer education, not just fixing sickness.
Dody: I would make sure that each patient had a care manager advocate who could help them navigate this current fragmented health care system and who would be there to coordinate the often disparate resources needed to survive well in the current system. We include this type of service to coordinate with non-Vively Health resources, in addition to the robust interdisciplinary care team that manages the complexities of chronic disease.