Bringing Clinicians, Patients, and Financial Administrators into a Common Conversation about Affordable Care

It all started a few years ago with an out-of-the-blue e-mail:

Neel – I saw the work you are doing via the article in the journal ‘Leadership’.  Congratulations as this is a great area of focus to pursue – the need to take down the complexity as it relates to cost/charge/reimbursement is a tough and an important issue.  There may be some interesting ways we can collaborate.  Best, Dan”

That e-mail would lead to a major initiative, a National Story Contest called The Best Care, The Lowest Cost: One Idea at a Time that we are launching this week.  More on that below, but first a little more background.

At the time, Neel was finishing his clinical training as a physician and about to join the faculty at Harvard Medical School. Despite all that training, there was something that no one taught him: how his decisions were impacting what patients had to pay. Dan, who was leading Strata which is a company that helps hundreds of healthcare delivery systems with financial analytics, realized that most of these organizations didn’t have any access to cost data – they were flying blind.

Our conversation started the way most conversations about healthcare costs start, talking about a gargantuan, $3 trillion problem that requires serious muscle to wrangle. The interesting twist was that while we both agreed that muscle needed to come from policymakers in the halls of Congress, we felt there was a much bigger opportunity in the halls of hospitals and physicians practices, especially when you consider 80% of treatment decisions (translation: spend) come from clinicians.

Those of us who spend time on the frontlines of healthcare delivery see routine opportunities to deliver better care at lower cost every day: the 5AM lab draw that happens on almost every medical/surgical ward in every hospital in the country even though it is often unnecessary, the 5PM turf that lands a patient in the emergency room because the community practice is oversubscribed.

Ultimately, Neel started a non-profit called Costs of Care to help clinicians and patients share their stories.  Yet while hundreds of stories have been submitted over the past few years outlining the problems, together we felt that now was to the time to broaden this conversation to a wider audience and focus on solutions and ideas that can make a difference.

With that as a background, today we are excited to launch aNational Story Contest called The Best Care, The Lowest Cost: One Idea at a Time. In partnership with the Healthcare Financial Management Association, the top association for financial managers, and Yale New Haven Health System, one of the top academic medical centers in the county, as well as Cost of Care and Strata, the objective is to collect and “open source” ideas to start a national conversation on creating a healthcare system that truly delivers value.

While sky-rocketing healthcare costs have many drivers, we believe bringing together shared insights from both clinical and financial leaders is a critical element of making care affordable. We are calling upon clinicians, administrators, and patients to submit essays and videos about experiences and ideas that reduce unnecessary cost while providing better care for individuals and families. (If you have a good idea, send it our way by September 28 –

Neel Shah, MD, is the Founder of Cost of Care and an Assistant Professor at Harvard Medical School

Dan Michelson, MBA is the Chief Executive Officer of Strata Decision Technologies