Having worked in academic medicine and for a large insurer, Dr. Harold Paz has a unique view of the healthcare industry. That should serve him well as the chancellor for health affairs at Ohio State University. Paz took over the newly created position earlier this year, after serving for five years as executive vice president and chief medical officer for Aetna. Prior to that, he ran Penn State University’s Milton S. Hershey Medical Center. At OSU, Paz oversees a nearly $4 billion medical enterprise that includes seven hospitals, seven colleges and more than 20 research institutes. Paz spoke with Modern Healthcare Managing Editor Matthew Weinstock. The following is an edited transcript.
MH: Why do you think this role was right for you and Ohio State at this point in time?
Paz: Healthcare and health sciences reflect over 50% of the total revenue of the university, and I think we’re heading toward 60% in the not too distant future. That’s just the rate of growth at Wexner Medical Center, where I serve as CEO. We also have seven health science colleges located on a single campus. The thinking from the leadership and the board was, this is a unique opportunity to create alignment.
For me, after having spent about 20 years in leadership roles in academic medicine and then going over to industry for five years where my main focus was working on clinical strategy and figuring out how to create a transformation around personalized health, I thought this was a unique opportunity to create alignment where we would actually have an academic health system and university focused on creating innovation and even disruption as we educate the next generation of health professionals. We’re thinking about how we move care from the traditional patient bedside in a hospital setting, to literally moving it into a home in the local community.
We have this unique responsibility to give (the next generation of practitioners) education on a clinical platform and delivery platform that is forward looking, not looking into the past.
I believe the model for the next century is a clinical platform that has the ability to care for individuals before they become patients by impacting all five of the determinants of health, not just healthcare, but behavioral, social, environmental, genetic determinants of health, beginning that experience in the home and in the community.
MH: There were significant executive departures at Wexner the past couple of years, partly resulting from faculty expressing no confidence in the leadership. How are you working to rebuild that confidence?
Paz: First, this is a different role. Second, I wasn’t here at the time, so I wouldn’t be the best authority to give you information on what transpired, but I would say this, and this has been my style pretty consistently at three universities. I want to focus on what that vision is and then create and implement a strategy to achieve it.
I described that vision, and this is now the opportunity to engage faculty and staff, the community, the board, leaders in industry across this region in defining a strategy that is achievable and we can implement. My approach has always been let’s have the data, let’s be analytical about it, let’s set goals and milestones, let’s identify individuals who we’re going to hold accountable to achieve it.
MH: Can you talk about the unique challenges facing AMCs, especially with the move to value-based reimbursement?
Paz: Part of it is a similar strategy to what I had at Penn State, which is to double down on ambulatory care and to use technology and people to drive care in to the home; to focus on mobile vans, to focus on telehealth and to identify healthcare professionals who literally can go into homes, much like we did at Aetna, and identify opportunities to improve health and well-being, in partnership with physicians and other health professionals and using that team-based approach.
I think that’s extraordinarily important. It’s something we have to do; it’s our responsibility to do it. One, because that’s what I would argue patients expect, but also frankly, because if we don’t do it, somebody else will. We have this special responsibility to educate students of all types on these new innovative types of approaches. The other piece is really being able to take risk and to participate in value-based contracting.
I’m a big fan of value-based contracting. The opportunity for physicians and other clinicians … to be able to manage that risk as they manage the health and well-being of a population through a personalized approach is exceptionally important. And it’s where we’re heading. It’s never a straight line and it probably is never as fast as people expect it to be, but I believe we’re going to get there.
MH: Do you have a target for a percentage of revenue that you would like to eventually see tied to risk-based contracts?
Paz: I wouldn’t put a number out there right now because I think there are so many dependent variables and I can see this from both sides. We have a notion of where we want to go and how we want to get there. That’s going to require us working with payers. It’s going to require us working with employers and being mindful of what else is going on in our market.
MH: I want to shift to talk about opioids. OSU has been leading a consortium that’s helped reduce overdose deaths by a reported 40% over three years. And in April you got a $65 million federal grant to help with those efforts. What are the plans going forward?
Paz: This is something that resonated very strongly for me. I led Aetna’s enterprisewide opioid initiative and we made this a very high priority. Ohio is probably No. 2 in the nation in terms of opioid overdose deaths and there are huge opportunities to address this tragic epidemic.
Ohio State has been working toward identifying opportunities around prevention, treatment and support. This grant, one of only four in the nation, is extraordinarily important for us to create this network across the state where we can focus on those three initiatives.
And it’s about how we can continue to look at our educational programs in terms of our future health practitioners and how we are optimizing outreach across the systems that we have.
We have to continue to focus on addiction. This is an epidemic and it’s a tragedy that we have to address along with many others, quite frankly.