Cambia's Ganz: Why population health isn't the 'virtuous' approach

Mark Ganz isn't a fan of healthcare's fixation on population health.

Ganz, who recently left the role of CEO of Cambia Health Solutions, told Fierce Healthcare in a recent interview that looking at health through a population lens creates distance between the healthcare system and the patient that doesn't allow for digging into their individual needs.

Population health comes from a place of good intentions, he said. But prescribing solutions to populations without first getting to know people in an individual way is an "elitist" way to help them.

"It's a distancing thing when you talk about a population because then you don't have to get into the nitty-gritty of an individual person's life and an individual family's journey," Ganz said. "And yet, the only way you can serve that individual in that family is if you do get into the nitty-gritty, and you get your hands dirty."

"It's looking down your nose at the very people who are paying for the goods and services you provide," Ganz said.

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Ganz retired from the CEO position at Cambia on Jan. 1 after 18 years in the role, where he was the country's longest-tenured Blues plan CEO.

Under his leadership, Cambia significantly broadened its reach as a "total health solutions company" and launched Echo Health Ventures, Journi, the Cambia Health Foundation and a slew of other initiatives.

Jared Short, previously Cambia's chief operating officer, stepped into the CEO role with the new year.

Ganz said people get into healthcare for "virtuous" reasons but end up in an "unvirtuous" industry that they're forced to adapt to and is backed by an "echo chamber" that reinforces it. The industry is "shockingly out of sync" with how patients want to receive the goods and services they need, he said. 

In a population model, for example, people who have diabetes are grouped into collectives of other diabetics, as if defined by their condition, he said. But each of these patients has their own individual experience with disease, which can impact their mental and spiritual health as well as physical.

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As such, Ganz said whole-person health, at an individual level, is the more valuable paradigm for considering care, rather than grouping people into broader populations. Part of his work at Cambia has focused on better integrating behavioral health with physical health, along with putting a spotlight on palliative care.

"If I look five years ahead, palliative care will be available to everyone. And it will be competent, and it will go hand-in-hand with curative care from the moment of diagnosis or injury or whatever the presenting issue is—and then it will be understood that both are equally important," he said. "Number two would be that mental and physical health are no longer Balkanized. They're no longer viewed as separate and treated separately."

He said one of the key goals of his tenure at Cambia was to turn it into an "agent of change" rather than a force that resists necessary adaptation to meet patients' expectations. And that meant a top-down cultural change, from the boardroom to front-line workers.

The company is now focused on building a better experience for its members by breaking down the old models, Ganz said.

"If there's one of the legacies that I hope will be a long-lasting one, it's that Cambia is an utterly different company than the one I inherited … and culturally different in its capacity for innovation," Ganz said. "We're not doing what I call fake innovation, which is working with the model and learning how to manipulate the model to make more money."

"And there's plenty of that going on in healthcare," he said.