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David Carmouche

4 Podcast Episodes

Latest 5 Jun 2021 | Updated Daily

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AEE15: A Sidebar Conversation About the Importance and Challenges for Health Systems to Collaborate With Pharma Manufacturers, With David Carmouche, MD, From Ochsner, a Large Health System

Relentless Health Value

When I was talking with Dr. David Carmouche from Ochsner in EP316 about the importance of collaboration amongst anybody trying to actually pull off value-based care, we took a little detour, which I wound up cutting out, into the potential and challenges for health systems to collaborate and do value-based contracts with pharmaceutical manufacturers. It’s a really interesting sidebar, though, that I wanted to share with you—especially on the heels of the recent interview with Troy Larsgard from Johns Hopkins (EP318) on how Pharma can better meet the needs of their health system customers.  Here’s an interesting point that Dr. Carmouche makes in the sidebar that I thought was worth highlighting. Chalk this up as one of the challenges when trying to create some kind of risk-share agreement with a pharma company to get the manufacturer to put their money where their mouth is when they say that downstream costs will be saved or complications avoided or better outcomes attained. The challenge comes in assembling enough patients to make it worth everyone’s while. As we’re considering the assemblage of patients, we have to first consider who’s paying for the drugs. It’s a payer, usually, who contracts with a PBM (pharmacy benefit manager). So, any given health system is going to have to have enough patients not only on that one particular payer in its payer mix but also on that one payer with a plan design that uses that one PBM. As I consider this, I still have questions. Dr. Carmouche is executive vice president of value-based care and network operations at Ochsner. You can learn more by visiting Dr. Carmouche’s LinkedIn page or by reading From Competition to Collaboration by Tracy Duberman and Robert Sachs.  David Carmouche, MD, views health care from three distinct perspectives: as a physician provider, an executive for an insurance company and as a leader in a health system. Specifically, he built a large, multidisciplinary internal medicine and preventive cardiology practice in Louisiana; served as the chief medical officer for Blue Cross Blue Shield of Louisiana; and currently has a triad of responsibilities with Ochsner Health, the largest nonprofit academic health care system in the Gulf South. He was recently promoted to serve as executive vice president of value-based care and network operations in addition to his duties as president of the Ochsner Health Network and executive director of the Ochsner Accountable Care Network. He is known as an expert in value-based care. He led one of the top 25 performing accountable care organizations in the United States, managing billions in care spend and generating millions in year-over-year shared savings. Dr. Carmouche earned a bachelor’s degree from Tulane University and a medical degree from Louisiana State University School of Medicine in New Orleans. He completed his residency in internal medicine at the University of Alabama at Birmingham. 01:57 Why has creating collaboration across Pharma been difficult? 03:10 “Is it better over an episode of care to add a more expensive drug … or would we be better served using less expensive drugs?” 03:51 Why has it been difficult for health systems to execute agreements directly with pharma companies? 04:36 “The question is really just whether or not there’s enough value that’s created to make it worth our while.” You can learn more by visiting Dr. Carmouche’s LinkedIn page or by reading From Competition to Collaboration by Tracy Duberman and Robert Sachs.  @CarmoucheMd discusses #healthsystem #collaboration with #pharmamanufacturers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #pharma Why has creating collaboration across Pharma been difficult? @CarmoucheMd discusses #healthsystem #collaboration with #pharmamanufacturers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #pharma “Is it better over an episode of care to add a more expensive drug … or would we be better served using less expensive drugs?” @CarmoucheMd discusses #healthsystem #collaboration with #pharmamanufacturers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #pharma Why has it been difficult for health systems to execute agreements directly with pharma companies? @CarmoucheMd discusses #healthsystem #collaboration with #pharmamanufacturers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #pharma “The question is really just whether or not there’s enough value that’s created to make it worth our while.” @CarmoucheMd discusses #healthsystem #collaboration with #pharmamanufacturers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #pharma

5mins

4 May 2021

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EP316: Unexpectedly Talking About Employers, With David Carmouche, MD, From Ochsner, a Large Health System

Relentless Health Value

I don’t know what I thought we were going to talk about during my interview with David Carmouche, MD; but I’m glad it turned out exactly as it did. Lately, we’ve had a number of guests on Relentless Health Value talking from the point of view of the employer: what a self-insured employer wants and needs from the large, and small, providers in their network. In this episode, we’re flipping the script and talking about what a large provider organization wants and needs from the commercial side of its payer mix. If value-based care or risk shares are to be a thing, we can’t have, as Troy Larsgard has put it, all risk and no share. In this health care podcast, I had the honor and pleasure of speaking with Dr. David Carmouche. Dr. Carmouche started out as a physician in a multi-specialty group. He practiced there for about 15 years before leaving to become chief medical officer at BCBS (Blue Cross Blue Shield) of Louisiana. Five years ago, Dr. Carmouche transitioned to Ochsner Health, where he is currently executive vice president of value-based care and network operations. At Ochsner, Dr. Carmouche helps lead the value-based care agenda—that’s everything from managing strategic partnerships with payers, as well as managing risk in value-based contracts for Ochsner and affiliated network partners across their ACO (accountable care organization) and CIN (clinically integrated network). Highlighting one point that Dr. Carmouche makes early in our chat, there’s four things that have to come together for meaningful value creation for providers: (1) willingness of providers and provider leadership to think and do things different than they have historically; (2) they have to be able to affect payment for those things; (3) they have to have data and be able to access it; and then (4) some control over steering patients. This kind of sets the stage, actually, for our fast dive, in this conversation, right into employer and commercial collaborations. Three of the four things on that list—affecting payment, data, steering patients—are right in the wheelhouse of forward-thinking employers, or commercial payers/TPAs (third-party administrators) trying hard to compete for or serve employers. Just a quick heads-up here: Coming soon, we’re going to release a second episode with Dr. Carmouche giving some great advice for the leadership of provider organizations who are trying to figure out their transition away from FFS (fee for service) to a more risk-based, value-based model. One quick point that I thought was also relevant to the show here: It was super interesting to me how quickly Dr. Carmouche got from “transition to value” to “knows how to collaborate with other organizations.” Here’s the pretty obvious inference: You can’t transition to value if you don’t know how to play well with others to co-create value and share the rewards of such an endeavor. There might be a broader lesson in here for whoever you are in the health care ecosystem. And I’m looking at you, pharmacy, Pharma, tech, societies, BUCAs, etc. Thanks so much to Brian Klepper for the introduction to Dr. Carmouche. You can learn more by visiting Dr. Carmouche’s LinkedIn page or by reading From Competition to Collaboration by Tracy Duberman and Robert Sachs.  David Carmouche, MD, views health care from three distinct perspectives: as a physician provider, an executive for an insurance company and as a leader in a health system. Specifically, he built a large, multidisciplinary internal medicine and preventive cardiology practice in Louisiana; served as the chief medical officer for Blue Cross Blue Shield of Louisiana; and currently has a triad of responsibilities with Ochsner Health, the largest nonprofit academic health care system in the Gulf South. He was recently promoted to serve as executive vice president of value-based care and network operations in addition to his duties as president of the Ochsner Health Network and executive director of the Ochsner Accountable Care Network. He is known as an expert in value-based care. He led one of the top 25 performing accountable care organizations in the United States, managing billions in care spend and generating millions in year-over-year shared savings. Dr. Carmouche earned a bachelor’s degree from Tulane University and a medical degree from Louisiana State University School of Medicine in New Orleans. He completed his residency in internal medicine at the University of Alabama at Birmingham. 04:15 Who needs to be working together to create value-based success? 04:31 “I think the most important partnerships that are likely to lead to value are those between payers or purchasers … and providers.” 04:45 What four things have to come together for meaningful value? 06:02 “We’re focusing specifically on payer employers today. We think that’s where there’s the biggest opportunity.” 07:23 What’s the overarching reason for health systems to want to grow their commercial market share? 14:00 Is the competition moving upstream? 16:20 “In all honesty, we’re competing for pieces of the business.” 16:23 What’s the ultimate competition? 18:36 “There is a consumer experience that is available inside these … collaborative efforts.” 20:53 “We really haven’t changed the paradigm of benefit design as it comes to drugs.” You can learn more by visiting Dr. Carmouche’s LinkedIn page or by reading From Competition to Collaboration by Tracy Duberman and Robert Sachs.  @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare Who needs to be working together to create value-based success? @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare “I think the most important partnerships that are likely to lead to value are those between payers or purchasers … and providers.” @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare What four things have to come together for meaningful value? @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare “We’re focusing specifically on payer employers today. We think that’s where there’s the biggest opportunity.” @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare What’s the overarching reason for health systems to want to grow their commercial market share? @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare Is the competition moving upstream? @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare “In all honesty, we’re competing for pieces of the business.” @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare “There is a consumer experience that is available inside these … collaborative efforts.” @CarmoucheMd talks #employers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthsystems #vbc #valuebasedcare

22mins

1 Apr 2021

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13 - Interview with David Carmouche, Senior Vice-President and President of Ochsner Health Network

Health Ecosystem Leadership Model (HELM™) Podcast Series

About this Episode David Carmouche is a recognized visionary leader in the arenas of healthcare delivery, population health, and payer systems with a keen focus on both patient care and outcome metrics. Dr. Carmouche has demonstrated talent for strategic partnerships with C-suite leaders and Boards and is known for his demonstrated success in achieving operational results through cross-functional teams in complex environments. He is a trusted leader of diverse groups with competing business interests through collaborative initiatives. Currently Dr. Carmouche serves as Senior Vice-President and President of Ochsner Health Network. In this role, he is responsible for executive oversight and management for the rapidly growing, statewide network. Dr. Carmouche is also the Executive Director of Ochsner Accountable Care Network, a regional accountable care organization (ACO), comprised of an extensive network of providers, hospitals and health centers coordinating the healthcare of approximately 35,000 of Louisiana’s Medicare fee-for-service beneficiaries. Prior to joining Ochsner in August 2015, he served as the Executive Vice- President of External Operations and Chief Medical Officer at Blue Cross Blue Shield of Louisiana in Baton Rouge where he designed and deployed a physician-friendly, comprehensive primary care population health program and several commercial ACO contracts. In this episode Tracy Duberman, PhD and Bob Sachs sit down with David Carmouche to discuss the experience and lessons learned from leading a health system in a major hot spot through the COVID-19 Pandemic. Show Notes- David Carmouche COVID-19 has shown a bright light on the need for health systems to take an active role in addressing population health, delivering proactive healthcare, and removing barriers to access care. As Ochsner has grown in its size and influence within the state of Louisiana, the system has intentionally shifted its mindset from being a health system in Louisiana to taking responsibility for the state’s overall health status. The forced closing of brick-and-mortar clinics due to the pandemic has greatly accelerated the adoption of telehealth and telemedicine solutions. For HELM leaders this demonstrates an important lesson on how seemingly insurmountable barriers can be very quickly overcome when there is common vision, stakeholder alignment, and a willingness to act and learn. A common purpose, such as the need to support community physicians through the existential threat posed by COVID-19 or the desire to drive improved population health, is a powerful unifying force when it comes to forging meaningful collaborative partnerships and driving desired outcomes. The challenges facing the US health system as we transition to value-based care are rarely black and white. It is important for HELM leaders to not become too deeply entrenched in their own belief system and remain open to the benefits of the natural tensions that exist within the health system in its current state. The specific leadership capabilities that the health ecosystem calls for are unique due to the multi-stakeholder engagement and collaboration required to drive solutions in a complex environment. A deep community-centric culture, and a dedication to intentionally evaluating and growing leaders within the system has propelled Ochsner’s ability to respond to the unique challenges posed by today’s healthcare environment.

38mins

24 Sep 2020

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David Carmouche, President of Ochsner Health Network and Senior Vice President of Community Care at Ochsner Health

Becker’s Healthcare Podcast

This episode features David Carmouche, President of Ochsner Health Network and Senior Vice President of Community Care at Ochsner Health. Here, he discusses the current status of COVID-19 in his area,  his path to his current role, and more.

16mins

17 Jul 2020

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