Maria Ansari, MD, FACC, named among Top 10 Health Care CEOs in America

The CEO Forum Group recently named Maria Ansari, MD, FACC, CEO and executive director, The Permanente Medical Group, among The Top Ten CEOs Transforming Healthcare in America in the exclusive category of Leadership.  

The CEO Forum selected Dr. Ansari for her organization’s unique, integrated value-based health care model, and for sharing her philosophy of wisdom and fortitude to do the right thing and take risks during challenging situations. In an interview with The CEO Forum’s founder and publisher, Dr. Ansari shared her vision for the future of health care and views on physician leadership.  

“I strongly believe [value-based care] is the model of the future,” Dr. Ansari said, “and it’s also the model we’ve been using at Kaiser Permanente for 75 years.”  

Related value-based care story: Dr. Maria Ansari: Tipping point for value-based care is now  

Value-based health care is a model of prepaid care delivery that aligns the incentives of health care organizations and patients to achieve the highest quality outcomes at an affordable cost.

In contrast, she said, “in a fee-for-service model, you get paid for delivering care, you get paid for a procedure, you get paid for surgery, but you don’t actually get paid for the patient doing better.”

Why value-based care gets it right

Dr. Ansari said that during a health care conference she attended earlier this year, many CEOs focused on what was broken in American health care. Top challenges cited were prior authorizations, lack of a digital health record, misaligned payment incentives, not rewarding positive health outcomes, and not investing in prevention. 

“As I sat in that room and looked around, I thought, ‘Kaiser Permanente has it right,’” Dr. Ansari said. “Our physicians typically do not need a prior authorization. Their job is to take care of the patient and get the best outcome possible while working to keep health care as affordable as possible. We’re fully integrated. We are in a digital health system. We’ve actually been in medical informatics for more than 75 years, so we have data going back on our patients for decades. Our incentives are fully aligned. As I mentioned earlier, if the patient is doing well, they are going to want to continue to be our member, and it’s a win-win situation.”

Dr. Ansari said Permanente physicians, clinicians, and staff also focus on prevention. “We spend a lot of effort on health education and population disease management, and we bring patients in [for care],” Dr. Ansari said. “You go in to see your dermatologist at Kaiser Permanente and, if appropriate, we will remind you that you’re due for your mammogram and book it on the spot.”

Physician leadership plays an essential role

Physician leadership is another essential component in this value-based health care system. In many other health care organizations, Dr. Ansari said, “the physician’s voice has been lost … so a lot of decisions are made by the insurance company.”

Related physician leadership story: Permanente Federation co-CEOs talk health care innovation, quality, and physician leadership  

The agreement Permanente Medical Groups have with their health insurance partner, Kaiser Foundation Health Plan, is to “let the physicians run the care delivery and the insurance company sell insurance,” Dr. Ansari said. “And let’s remember who’s doing what because when we allow insurance companies to decide whether a patient should get an MRI or not, that’s not always in the best interest of the patient. As practicing physicians, we have no incentives one way or the other except the best outcome for that patient.”

However, Dr. Ansari said Permanente physicians also remain mindful of resources because health care needs to be affordable for patients to have equitable access to care.

“If we miss something, and that patient has a condition that gets worse because we didn’t catch it early on, or we didn’t do the MRI, that’s bad for the patient and bad for the system,” she added. “Being physician-led means that we are going to be advocates for the patient, and we’re going to work collaboratively using evidence-based tools and clinician decision support tools in a group practice to drive the best outcomes for our patients.”

To read the full story, check out the fall issue of The CEO Forum magazine. Subscription may be required.

To see a summary of The CEO Forum list, visit Becker’s Hospital Review.