Jay Bhatt, D.O., M.P.H., M.P.A., who previously served as senior vice president and chief medical officer at the American Hospital Association (AHA), recently was named executive director of the Deloitte Center for Health Solutions and the Deloitte Health Equity Institute. In a wide-ranging interview with Healthcare Innovation, Bhatt spoke about some AHA initiatives he is most proud of and some of the things he will focus on at Deloitte.
Even besides his role at AHA, Bhatt has had a varied and illustrious career in healthcare. He was previously on faculty at Northwestern Medicine, served as chief health officer of the Illinois Health and Hospital Association, and was managing deputy commissioner and chief innovation officer for the Chicago Department of Public Health.
In addition to his leadership roles at Deloitte, Bhatt will continue practicing medicine at local community health centers in Chicago and Cook County while serving in his leadership role at Deloitte.
The son of South Asian immigrants, Bhatt said his father was a pharmacist on the South Side of Chicago and his mother was a factory worker. “Growing up I felt like I had a front-row seat to healthcare and the challenges that communities face. Then when I was in college at the University of Chicago, I really understood what it meant to meet patients where they are. Some doctors I worked with put a clinic in the back of a barber shop, and said if you want to get your hair cut for free, then you’ve got to be seen by the doctor,” Bhatt recalled. “Things like that really can lead a community to change how they think about health, their engagement with it, and then it can help them think about jobs and economic mobility. It taught me that I wanted to be a doctor in underserved communities as a vehicle for social change, and partner with communities to change their future, because I saw it happen.”
Bhatt said there were a number of initiatives during his tenure at AHA that he is proud of.
“At the top of the list is organizing 1,700 hospitals in 34 states, in partnership with CMS to reduce readmissions by 12 percent, and hospital-acquired conditions by 20 percent,” he said. That involved mobilizing state hospital associations, hospitals and health systems in both urban and rural communities, and providing tools, insights, lifting up practices that worked and scaling them across that network, he added. “That ultimately saved lives, with estimates that suggest thousands of lives saved and nearly a billion dollars in savings over the course of that work of the Hospital Engagement Network and the Hospital Improvement Innovation Network.”
Another initiative he pointed to was deploying an age-friendly health system in partnership with the John A. Hartford Foundation and the Institute for Healthcare Improvement. “We worked with over 2,000 sites of care to deploy a model called the Four M's — mentation, mobility, medication management, and what matters to you, which is really the anchor around patient and family preferences.”
Bhatt left AHA in the spring of 2020. After working at a Medicaid ACO and helping the State of Illinois Department of Health with COVID response, he was intrigued by the opportunity at Deloitte to influence and impact at scale, again. “Deloitte really supportive and recognizing the value of front-line clinical experience in developing research insights, and having those conversations for impact,” so he is able to practice clinically one day a week and bring that perspective to his work.
Lots of organizations are currently focused on health equity, including CMS. I asked Bhatt what some of the challenges are in building equity into the fabric of health systems and into payment schemes.
“It starts fundamentally with defining health equity and what that means for you. For us, health equity is a fair and just opportunity for everyone to fulfill their human potential in all aspects of health and well-being,” he said. “From there, it's developing a credible health equity strategy, and then measures to support that strategy and understand where you're making progress and where you're not,” Bhatt added. “It's one thing to talk about it; it's a harder thing to actually create an action plan that's measurable around it. Access to data also is a barrier. We don't have all the right data we need to be able to then measure some of the outcomes we want to drive toward.”
Health equity is at the intersection of structural systemic issues, the healthcare system and the drivers of health, Bhatt added. “We focus on three primary action levers: activating key decision makers, advancing equitable communities through place-based change, and driving health equity innovation and learning across the country through the assets and the platform and work we have in play.”
When it comes to place-based change, policy, systems and environment all have impact, he said. “Partnerships are important. We did some survey research through the Center for Health Solutions recently, which showed that the vast majority of health plans and health systems regularly screen their members and patients for social and environmental factors that could negatively impact health, but just 35 percent of the respondents said that they've established community partnerships to address the needs identified by their members and patients. It could be that these healthcare stakeholders don't know where to start, and that there isn't enough trust. The element of trust is so important. How do you build and sustain trust with that group of stakeholders, and particularly with the community and their lived experience?”
I noted that we're seeing lots of digital health startups getting venture capital money. I asked Bhatt what things Deloitte is going to be studying in terms of whether those will actually prove valuable to clinicians and patients.
“The point of view that Deloitte has around the future of health is that digital capabilities have the path to fundamentally transform the relationship that healthcare organizations have with consumers and that consumerism over the next five to seven years is going to be a critical trend to address that,” Bhatt replied. “The questions are: what are the digital capabilities that work and do they have to be deployed as part of a continuum of services? What literacy do both care teams as well as patients need to use it effectively in the workflow and as part of care management?”
He stressed that digital health needs to be integrated with virtual health and in-person care at home or in the clinic to help achieve optimal health outcomes. “While we know that the digital transformation journey is long, we also know that COVID has been a catalyst for digital transformation,” he added.
Another area that Bhatt will focus on at Deloitte is the impact of life sciences and research & development in terms of how it will impact diversity in clinical trials, with more clinical trials happening in the community, as well as issues around pricing and affordability. He said they will be watching where retail comes together with other partners in healthcare delivery to provide access, convenience, and quality. “The other important thing that that we're going to be watching is the work within the government sector. We know that the public sector is prioritizing health equity and innovation, so public/private partnerships are going to be critical to accelerate impact there.”
