Ep 184 – The Activation of an Ecosystem: Overcoming “The Cost Conundrum” Through Equity-Based Co-opetition, with Edwin Estevez

The Race to Value Podcast

25-09-2023 • 39 min

Fourteen years ago, surgeon, writer, and public health researcher, Atul Gawande wrote his landmark article, The Cost Conundrum, about the healthcare challenges of the Rio Grande Valley (RGV) of South Texas. Gawande showcased the challenges that health systems confront when dealing with public and private insurers and the paradox between high-cost treatment options and low-quality outcomes. His careful assessment of McAllen, Texas, a small city on the border, found that it had the most expensive healthcare system in the nation.  This “cost conundrum” in the Rio Grande Valley inspired President Obama to pass the Affordable Care Act and begin a national movement to value-based care. Now that ACOs have reached a critical mass in the Rio Grande Valley we must now ask ourselves “to what degree can value-based care accelerate health equity?” Value-based care is the seed from which health equity transformation can bloom, nurturing a system that values every life, cultivates well-being, and harvests a future where health disparities are but a distant memory. Health equity transformation in underserved regions (like the RGV) is not just a matter of providing medical care; it's a testament to our commitment to justice, compassion, and the recognition that the well-being of every individual, regardless of their circumstances, is a reflection of our shared humanity. Equity transformation is currently underway in the Rio Grande Valley, one of the most underserved regions in the entire United States. The RGV – a 50-mile stretch of towns that span the border of Texas and Mexico – is home to 1.4 million people (almost twice the population of El Paso), nearly 90% Hispanic, and has some of the poorest counties in the country. Issues like poverty and lack of access to healthcare burden the Valley. These factors are the leading cause of health problems like diabetes, obesity, and cervical cancer. Our guest this week is Dr. Edwin Estevez, a nationally-recognized value-based care leader and champion for health equity in the RGV.  His vision is to activate the local health ecosystem to expand access and promote inclusivity through the power of co-opetition. It involves competing organizations in the same market, working together on something that is mutually beneficial while simultaneously competing in other areas. Coopetition in healthcare is the catalyst for transformative change, where the pursuit of collective well-being transcends individual interests, and collaboration becomes the cornerstone of a healthier local ecosystem. If you want to be a part of the health equity transformation in the Rio Grande Valley, register today for Accelerator2023 on October 17th!  (Attendees can attend in-person in Mission, Texas or virtually).  More information at www.equity-accelerator.org https://vimeo.com/decibelrocks/accel?share=copy Additional Resources: WGU Aims to Transform Rio Grande Valley’s Healthcare A Vision of Pioneering Co-opetition for Health Equity Episode Bookmarks: 01:20 The landmark article, “The Cost Conundrum” about the healthcare cost crisis and how it inspired a national movement to value-based care. 01:45 Obama’s Favorite New Yorker Article led to the passage of the Affordable Care Act and the development of ACOs. 02:00 Edwin Estevez returns to the Race to Value!  (Episode #1 with Edwin) 02:30 The underserved region of the Rio Grande Valley (RGV) as a focal point to create a replicable convening model of equity-based co-opetition. 04:30 Advancing health equity through a community-based ecosystem – Eric and Edwin discuss their upcoming collaboration in the RGV. 05:45 “Value-based care is a platform to shape policy, redirect programs, and understand services better through the lens of health equity.” 06:00 Edwin’s prior VBC success with RGV ACO, one of the earliest (and most successful) physician-led MSSP ACOs in the country. 06:30 Edwin discusses AltaCair,

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