Strategic Partnership Announcement

Spring Street Exchange (SSX) and PascoAdvisers are pleased to announce a strategic alliance that complements the services each firm brings to the healthcare industry. Spring Street Exchange has driven strategic and operational change in healthcare since 2016. Since 2019, PascoAdvisers has provided risk-related and revenue accelerating advisory services to health plans and startup healthcare companies.

Having informally collaborated on successful client projects throughout 2022, today the two firms are publicly announcing their formal strategic partnership. Working together they will leverage their deep healthcare expertise to better serve their clients. They also share a mission to advance the strategic, operational, and actuarial underpinnings of the healthcare system by helping their clients sustainably evolve toward the future healthcare landscape. “Our partnership has developed organically,” said Nancy Wise, president of Spring Street Exchange. “We continue to discover how the expertise that we each bring to clients is delivering greater combined value to the industry.”

“Healthcare companies deserve the best thinking available to overcome the challenges they face in serving the needs of individuals and families. This strategic partnership presents an opportunity to provide a unique, integrated offering that hasn’t been available.” said Keith Passwater, Managing Director of PascoAdvisers.

Spring Street Exchange (www.springstreet.exchange) has a mission to ensure a sustainable role for values-driven leadership in the healthcare landscape of the future. SSX works with boards and leadership teams around innovation, long-term visioning, strategic planning, and market analysis. The firm has developed expertise and specialized tools in addressing social drivers of health and health equity.  

PascoAdvisers (www.pascoadvisers.com) helps healthcare companies increase revenue growth and improve risk performance through executive advisory services, analysis, and its proprietary Risk Performance Assessment. Pasco also works with healthcare startups on ensuring value-add and sustainable revenue models.  

ChatGPT and the Future of Healthcare

ChatGPT, Dr. Seuss, Soup, and Internal Innovation Studios 

Like most curious futurists, I’ve been enjoying exploring what ChatGPT can do. For those who haven’t tried it yet, ChatGPT is a Chatbot prototype that was launched by Open AI in November 2022. It is a ‘generative pre-trained transformer (GPT)’ which has been programmed / trained to mimic human conversation. Its many capabilities include writing and debugging computer programs, writing student essays, answering test questions, and even writing poetry and songs. I have used ChatGPT for a soup recipe I can make with the ingredients in my fridge, and it suggested a plan to take my son on college tours. ChatGPT has even described social determinants of health (SDOH) in the style of Dr.Suess (you can view at my LinkedIn post here).  

At Spring Street Exchange, we have working with future-thinking healthcare organizations to prepare for what’s next. When we look at planning in short-term cycles, we tend to assume that the future will be similar to the past. This makes it easy to dismiss the very real breadcrumbs of change on the horizon. When we suggest that the next ten years will include more change than the past thirty, I have sometimes felt like the woman crying wolf. However, with the disruption spurred by the pandemic and more immediate competitive threats, many healthcare organizations are now embracing longer-term strategic planning.  

Looking at longterm change can be a daunting task. After all, the fastest adoption of any innovation in the history of humanity, ChatGPT, was something that, until recently, most of us didn’t even know could be possible. Robert Pearl’s vision for how ChatGPT could transform healthcare suggests how this functionality could be used to emulate the way clinicians make decisions and to provide ongoing care outside of the medical office. As technology improves, and as our thinking catches up with its capabilities, it seems certain that the greatest impact that an AIChatbot could have in healthcare has not yet been envisioned. After all, it’s only been a few months.    

So, I thought I’d ask ChatGPT about the future of healthcare; ‘it’ answered me with some meta thoughts that you can see it in the response below. ChatGPT has an “I” identity, even though ‘it’ doesn’t have a name like the helpful ‘Siri’ and ‘Alexa.’ ChatGPT included Artificial Intelligence in its list of anticipated changes in the industry, but didn’t have the self-awareness to identify itself in this category.

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Me: What will healthcare be like in 2033? 

ChatGPT: Answer pulled on February 22, 2023, from https://chat.openai.com/chat 

As an AI language model, I cannot predict the future with certainty, but I can provide some insights based on current trends and technological advancements.  Can

Here are some potential ways healthcare could change by 2033: 

1. Personalized medicine: By 2033, healthcare may become more personalized, with doctors using advanced genetic testing and analysis to tailor treatments to individual patients based on their genetic makeup. 

2. Virtual healthcare: With the advancements in telemedicine and remote healthcare, healthcare in 2033 could become more accessible and convenient for patients. People may be able to access medical consultations, diagnoses, and treatments from the comfort of their own homes. 

3. Artificial intelligence and machine learning: The use of artificial intelligence and machine learning algorithms will likely become more prevalent in healthcare in 2033. These technologies may be used to analyze patient data and provide more accurate diagnoses, develop personalized treatment plans, and even help with medical research. 

4. Nanotechnology: Nanotechnology has the potential to revolutionize medicine by allowing doctors to deliver medications and treatments more precisely to targeted areas of the body. By 2033, nanotechnology could be used to develop advanced drug delivery systems that are more effective and have fewer side effects. 

5. Genomic medicine: By 2033, genomic medicine could become more widespread, with doctors using genomic data to make more accurate diagnoses and develop personalized treatment plans. 

6. 3D printing: 3D printing has already been used in the medical field to create customized prosthetics and implants, and by 2033, it could become more common in other areas of healthcare, such as tissue engineering and drug development. 

7. Wearable technology: Wearable technology, such as smartwatches and fitness trackers, has already been used to monitor physical activity and health indicators. By 2033, wearable technology could become even more advanced, allowing for continuous monitoring of vital signs and providing real-time feedback to doctors. 

   Overall, healthcare in 2033 is likely to be more personalized, accessible, and technology-driven. However, it's important to note that many factors, including economic, political, and social factors, can impact the future of healthcare. 

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Much of our current understanding of computing capabilities is informed by the pace of development to date, often driven by our own understanding of Moore’s Law. However, in the 2010s, AI developers began working with a network model more similar to the many connection points of neurons in the human brain. The new structure of networks enabled computing capacity to accelerate further, leading to advanced AI chips and quantum computing.  

A quantum computer tested by Google in 2019 was more than 1 billion times faster than a traditional computer. It was able to perform a computing test in 200 seconds that would have taken a computer at that time hundreds of thousands of years to perform. We cannot yet comprehend what this type of analytic, computing, and intelligence capability could bring to our world. (Note that my understanding of developments in quantum computing are informed by The Exponential Age by Azeem Azhar).  

Like any change, these developments have the potential to create new advantages for economic leaders in healthcare. But they could also spark an opportunity for a more level playing field, or even strategic advantage for nimble and focused healthcare organizations. Indeed, rather than ‘deep pockets’, perhaps the path to ensuring that an organization’s mission is fulfilled in the healthcare landscape of the future is to develop an ongoing channel to monitor and explore the evolving landscape. 

Many healthcare organizations have had protected markets and revenue streams for so long that they have enjoyed the luxury of foregoing an innovation function. In fact, many of the ‘innovations’ on a strategic portfolio may be new to the organization but are really catching up with an evolving industry standard. With virtually every sector in our economy exploring the role it can play in healthcare, we cannot assume that our market protection will continue into the future.  

Most of us didn’t see ChatGPT coming, but with an internal innovation function there could be a channel and organizational muscle memory for recognizing and exploring the implications. Such an ‘Innovation Studio’ would include monitoring the landscape, organizing innovations in a way that they can be prioritized, and exploring how they could be an opportunity, risk, or adjacent insight. At Spring Street Exchange, we provide this service to enable a healthcare organization to stay current without becoming overwhelmed.  

No one is too busy to think about the future. The future is here every day. Let’s welcome the opportunity as a means to drive healthcare to what it could be.  

SDOH Spectrum of Impact

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At Spring Street Exchange, we developed the SDOH Spectrum of Impact framework because we found ourselves articulating this concept so often in meetings and conversation that we decided we needed a visual representation. The discussion of where to focus social interventions is frequently presented in a linear model, starting with point of care and then the shift to moving ‘upstream’ to address social gaps at the root cause. We agree with this trajectory but had also been seeking a way to more clearly represent interventions at different points of impact from the perspective of a health plan or health system.  

The Spectrum of Impact provides five points of impact, each with its own goal(s) and outcomes. They are not arranged in a hierarchical manner because there is a critical need for support at each point. The ideal point for intervention depends upon the organizational strategy and the goal of the initiative. While we share the goal of shifting resources upstream with a preventive focus, there are still social risks and social needs  throughout.  

Point of Care 

Provide immediate relief for pressing social needs during clinical and social interactions of care through either direct services or referral. This includes providing food, transportation, or housing support directly to individuals currently in need. This can also refer to identification of needs at non-clinical intersections, such as at the time of enrollment.   

Actively Managed 

Augment the care for those already receiving support through care management, case workers, or other services to address their social as well as medical needs. 

In Need But Not in Care Management 

Identify those who have health and social care needs or may even be in crisis, but who have some barrier to interacting with the healthcare system. Social analytics can help to identify those who may be falling through the cracks while providing a point of intervention for engagement. Advanced analytics through segmentation and person-centered profiles can help focus supports to those in greatest need.  

At-Risk, Pre-Crisis 

Intervene upstream, before greater health needs emerge. Identify individuals who are at risk for health issues by using social screening and data, partner referrals, and other forms of identification or forecasting.  

Community-level prevention 

Provide support and prevention by addressing social risks and needs at the community level. This could involve housing, food, sanitation, safety, green spaces, and other means of strengthening community health.  

What's in a Name? Spring Street Exchange

Names can be powerful.

We use them to identify, understand, and engage with the world around us. Names convey identity and meaning; they reveal and affirm. I am often asked about the name of our company, Spring Street Exchange. Our name reflects our corporate philosophy as well as our mission.

To start, spring is a rich word infused with meaning and brightness. Spring as a season is a time of renewal and new life, filled with possibility. This is the mindset we bring to our work in healthcare.

In nature, a spring is a source of water. It begins as a small trickle from the earth that can flow into mighty rivers and lakes. A spring can provide nourishment and help the world around it bloom. We feel that information is a spring which, when distributed with clarity and expert care, can help the landscape grow and foster creativity and innovation. We hope to offer this to our clients and colleagues.

In engineering, a spring is a coiled mechanism that harnesses energy and channels potential. Springs are resilient and flexible. We bounce back in adversity and still provide strength and support.

The second part of our name reflects our mission to be a destination, not just an advisory firm. A street is fixed and grounded and can be located when needed, but it is also indicative of a journey. Together we are moving toward something, on a pathway leading to a common goal. We walk forward together to become stronger and successful in our aims. While we are aspirational in our goals, streets can also be gritty and real. It is important that our work is both aimed toward the future and grounded in the realities of here and now.

Finally, and perhaps most importantly, we are an exchange. The work of healthcare is too large, complex, and important for any of us to tackle it alone. Progress is dependent on exchanging information, exploring perspectives, aligning on values and vision, and communicating with others. Therefore, truly advancing healthcare can only come as the result of an exchange. We truly listen, reflect, offer perspective, and work with others to drive the industry to a better place.

When we talk about Spring Street Exchange, we’re talking about something that’s meaningful and rich with connection. We have heart and purpose, and we are not just committed to the outcome of our work, but also how we get there. We want everyone who collaborates with us to feel respected, invigorated with purpose, and connected to each other as we advance toward a greater aim.

Most of us came to work in healthcare because we wanted to help drive the system to a better place. For me, Spring Street Exchange sits at this intersection between aspirational goals and the expertise and grit to do the hard work of getting things done.

It’s a true honor to be on this journey with so many of you.

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Why Do We Focus on Social Drivers of Health (SDOH)?

When I founded Spring Street Exchange (SSX) back in 2016, it was with the goal of bringing a fresh, respectful approach to consulting services in healthcare and also to have the freedom to pursue mission-aligned work. Most of us chose to work in this industry because we want to be part of impacting people’s lives in a positive way. Our goal was to help change the incentives, reduce the insanity, and drive healthcare to be a human-centered, compassionate industry that truly reflects the needs of those it serves. 

In a great collective irony, the industry often defines consumer-driven care in ways that expose patients to more out-of-pocket costs, which many cannot afford. There is nothing consumer-centered about putting patients in a quandary as to whether they should forego care or put off some other critical expense such as rent, food, and utilities.[1]

Any meaningful consumer-centered healthcare needs to embrace a broader definition of care, one which acknowledges the social context of an individual, their personal history, their social circumstances, and the community in which they live. The added benefit for the industry is that, when done well, socially informed healthcare and aligned incentives save money for the system overall.

Looking at healthcare in the context of social drivers of health (SDOH) does not mean fixing all social ills through the healthcare system. Instead, by taking a comprehensive view of individuals, families, and communities, we can work to reduce barriers to health, safety, and well-being and increase accessibility of healthcare diagnosis and treatment.

Addressing social barriers to healthcare is also a critical step in reducing disparities in healthcare. The impacts of poverty are disproportionately experienced by people of color and other historically marginalized populations. Providing social support to bridge this gap is essential on any path to health equity.

Our strategic and operational work has always been about a consumer-centric approach that allows us to align with our values and deliver savings for the industry. In 2018 we started working on our first SDOH Benchmark Assessment, some form of which has now been delivered to over 60 organizations. From here our work expanded to supporting SDOH strategy, market analysis, inventory, program development, and establishing community partnerships.

Our approach is at once visionary and practical. We work with healthcare organizations to establish a common vision, align on values and priorities, and to take a structured and sustainable approach to addressing social needs. Our work is grounded by data and driven by common sense. As a result of our SDOH Benchmark Assessments, we have the only national database documenting the progress payers and providers have been making in addressing SDOH. This intelligence source includes both quantitative and qualitative insight on organizational decisions, challenges, funding, member identification, programs and partnerships, and measurement and outcomes. 

With something as important and fast-moving as the shift to address social needs in healthcare, we need to keep our eyes on long-term ROI and cost-benefit analysis, but we cannot wait for these studies to be complete to take action. Spring Street’s approach to knowledge-sharing and benchmarking brings this insight into the present. This reduces risk and accelerates action.

Our firm’s work in SDOH informs our work in strategic planning and industry transformation. All of the enterprise analysis and strategy work we have undertaken in recent years has included exploring new boundaries of healthcare, whether for scope of service, location of care, and other expanding guard rails.

Our SSX team is on this journey because it is a critical transition needed in healthcare for the lives of individuals needing care, for those working in the healthcare system, and for society as a whole. We stand firm in this quest because of the inspiring work of our industry colleagues – those who have been leading the way for decades and those who are just getting started. The tenacity and creativity fuel us and propel the work forward.

It is an honor for us to tackle these challenges as part of our daily work. Interested in hearing from you – why do you work to address SDOH?

Spring Street Exchange's ACTIONS you can take in 2022 toward better healthcare

As we launch a new year, at Spring Street Exchange we would like to propose seven actions healthcare leaders can take as part of their everyday work to drive positive change in healthcare. While pundits share common summary of trends to watch, we see our role in this dialogue as one of action.  

The actions we suggest cut across trends and are intended to support both immediate work and long-term planning. We recognize the urgent demands and real limitations faced by healthcare leaders who must do more each year with less. And yet, we know that stepping back to look forward can recalibrate and invigorate thinking and shift how we solve near-term problems. 

We hope these ideas resonate with you and look forward to hearing your additions. As always, we are honored to walk alongside you on this journey.  

We’d love to hear your thoughts on any of these. Let’s connect!

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