Why ‘Systemness’ is the Key to Better Quality
Dr. Will Shrank makes the case for “systemness”— cohesive, integrated care that runs on aligned incentives, measuring meaningful outcomes and thoughtful implementation of value-based care.
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Our Guest
William Shrank, MD, MSHS Venture Partner, Andreesen Horowitz
William Shrank, MD, MSHS, is a Venture Partner at Andreesen Horowitz. He was previously the Chief Medical Officer at Humana, where he lead and implemented the company’s integrated care delivery strategy affecting 16 million Humana plan members. During his tenure, he lead Humana’s senior focused primary care business, clinical operations, population health strategy, health equity and government affairs teams. Previously, Dr. Shrank held leadership positions at UPMC Health Plan, CVS Health, and Center for Medicare & Medicaid Innovation at CMS. He began as a practicing physician with Brigham Internal Medicine Associates at Brigham and Women’s Hospital in Boston and as an assistant professor at Harvard Medical School, researching medication prescribing and adherence.
Episode Description
In this episode of Quality Talks With Peggy O’Kane, NCQA President Peggy O’Kane has an energizing, constructive conversation with Dr. Will Shrank, a Venture Partner at Andreessen Horowitz.
Will shares his vision for a more cohesive health care system that works based on aligned incentives, meaningful measurement of patient outcomes and savvy implementation of value-based care.
Peggy and Will discuss:
- The ‘Systemness’ Solution: Will emphasizes that while American health care has the right components—technology, talent and intent—it lacks the integration to make them work together. Systemness means aligning care delivery, data and incentives to function as a cohesive whole.
- Measurement Makeover: Current quality metrics often miss what matters most to patients and providers. Will calls for fewer measures that are focused on outcomes, not just process checks. Digital measurement can help, but fragmented data remains a challenge.
- Reimagined Reimbursement Prioritizes Primary Care: Will envisions a future where primary care providers take on meaningful financial risk for the cost and quality of care. This approach could help simplify incentives, foster collaboration with specialists and drive better outcomes.
- From Waste to Wellness: Health care wastes billions of dollars on administrative complexity. Meanwhile, prevention—arguably the most cost-effective strategy—struggles to gain traction due to delayed ROI. Will argues that aligning incentives around long-term health is essential to reducing waste and improving outcomes.
Will concludes by assessing Medicare Advantage as a model of high-value care. Listen to the whole conversation for a warm, witty tour of quality’s accomplishments and prospects.
I think most people would agree, a model where primary care docs have some meaningful accountability for the populations they serve would be better than what we have today.
And if we as a system decided that’s the direction we’re going to go and make that the North Star, I think we, in a much shorter time, could get efficient, higher quality, and deliver better outcomes at lower cost, and deliver more equitable care for all Americans.
Timestamps
(01:06) A Systematic Approach to a Better Future
(04:12) Challenges in Quality Measurement
(09:24) Payment Models and Primary Care
(13:55) Addressing Waste
(24:49) Medicare Advantage and Value-Based Care
(28:43) Peggy’s Final Thoughts
