Jeff Smith became CEO of Bamboo Health in 2023, after serving as president of the value-based care enablement business at Lumeris, a provider of value-based care and technology-enabled population health services. In a wide-ranging interview with Healthcare Innovation, he offered up some predictions about the role of pharmacies, value-based care, and the impact of artificial intelligence for 2024.
Before his roles at Bamboo and Lumeris, Smith was the founder of an electronic prescribing company that was eventually acquired by Allscripts. He also held several roles at CVS Health, including overseeing population health management.
Healthcare Innovation: What interested you in taking this leadership position at Bamboo Health?
Smith: When you look at Bamboo, we have this intelligent care coordination network, where we're actually upstream connecting several stakeholders, including prescribers and pharmacists where they're interacting with these individuals. That, to me, was really appealing. Not only is this pervasive scaled network of great appeal, but what it's doing from a mission perspective was very appealing to me because it aligns well with my passion for driving positive healthcare change — especially in the realm of behavioral health. Approximately 5 percent of patients drive 50 percent of healthcare costs. And many of these individuals have behavioral health issues, along with co-morbidities. When I looked at what Bamboo had to offer, I saw this intelligent care network that's in place coast to coast, connecting with all of these different stakeholders, and saw an opportunity for us to seize on what I think is a significant mission and business opportunity to impact positive change for those individuals.
HCI: Bamboo grew through acquisitions. First it was Appriss Health, and they acquired PatientPing, and then they added OpenBeds. So has that melded into a cohesive company and offering?
Smith: You’re absolutely correct in terms of the different acquisitions that were pulled together. Each of those acquisitions contributed to a set of what I would call unprecedented capabilities as you bring them together into our network. We're delivering actionable insights about a patient as a whole person as they move through those different stakeholders, and it's really empowering those different providers of care with more information about that patient as they engage with them.
Here is a tangible example: In Delaware, we have a major project working with the state around behavioral health care coordination. We leverage our OpenBeds solution, all of our statewide admit, transfer, and discharge information, and our pervasive point-of-care prescribing platform. This is enabling crisis teams to go out to the home to stabilize individuals. It's allowing behavioral health providers to have coherent and up-to-date information that's very timely around the patients that they're engaging with. And it's creating real coordination across those different stakeholders.
HCI: Who are some other types of customers or potential customers for this?
Smith: Other states are very interested in this offering. As we think about our go-forward strategy, we’re thinking about how we can pull together this overall platform to help states, providers and payers who are trying to provide better outcomes for those with behavioral health needs. How do we actually help all of these different stakeholders be better informed, and then also help pivot those individuals into the right next step in their care?
HCI: I saw before the new year that you had made some interesting predictions for 2024, and I was hoping you could elaborate on a few of them. The first is the idea of “Information Assist” preceding AI. What do you mean by that?
Smith: There’s this incredible spotlight on artificial intelligence, and particularly in healthcare, we're seeing it as a great opportunity. However, I would say the journey toward true artificial intelligence in healthcare is going to be first mastering this concept of information assistance. So unlike AI, IA prioritizes the synergy of humans understanding other humans and applying that artificial intelligence. Where AI is going to provide all of these insights, it’s going to be very important that we are thoughtful and we integrate it into that actual healthcare event in a very high-quality way. And I believe that's going to start with AI informing humans to do this information assist to other humans. I think that will be the primary movement in 2024.
HCI: Could you give an example of what you are talking about from your own platform?
Smith: We are going to provide information about a particular patient based on the data we have, and through artificial intelligence we will serve up information that a patient may have not only substance use disorder, but could have chronic kidney disease or could have diabetes. And it's going to be really important for that provider of care to have that information served up to them. But that interaction between the human and the human is going to help us precisely clarify that the information is correct, and then take the right next step.
It will require a human to have the empathy to allow that that other human to disclose information about their condition. That won’t come just through reading the artificial intelligence. I think that IA will lead to better interactions between humans, which will lead to better outcomes. I think we all need to think about how we empower that human through the intelligent assist, to get to the better care versus circumventing that important engagement.
HCI: Another prediction was that drug chains and other retailers will continue to focus on end-to-end care delivery. You have some experience in that area from working at CVS Health. Could you talk a little bit about this prediction?
Smith: Prescription dispensing represents a real-time and regular engagement opportunity between a pharmacist and an individual. Many of these patients with chronic conditions are engaging with pharmacists more than they're engaging with their physicians.This represents a really significant opportunity to drive outcomes and consumer behavior change. I think you're going to see large retail pharmacies further leaning into that as they create a vertical integration with everything from insurance to physician care. These retailers that are also insurers that are also providers of care will be rethinking how the overall value chain will be organized, and how they can best drive outcomes in the communities that they're in to drive better outcomes and cost trends.
HCI: The final prediction involves value-based care continuing to scale up and the need for providers to take on downside risk in order for it to really take off.
Smith: Sometimes I may be on an island suggesting that value-based care is seeing momentum, but I do believe it will continue to see more scale and be more relevant, particularly in the government programs, and I think it's for three reasons. One is you're going to continue to see a significant increase in the number of people covered by Medicare as the Boomer generation ages into retirement. Second, CMS has this goal of 100 percent of Medicare beneficiaries and a majority of Medicaid enrollees to be in value-based arrangements by 2030. Third, the increasing percentage of providers’ patient panels being in government insurance. Value-based care is relevant in those government-funded programs and populations. For providers to participate in the value-based care financial model, they will need to eventually take downside risk if they're going to drive really material outcomes for their respective businesses going forward. The reason is that payers are only willing to share material upside with providers that are willing to take downside risk.
I think that as more health systems see a larger percentage of their patient panel being in government pay, you're going to continue to see their clinically integrated networks embracing value-based care in a way that's going to drive better outcomes.
