What They’re Watching: Ralph Prows

Ralph Prows, the chief medical officer at Adventist Health Medical Group, joins us in this edition of What They’re Watching, to talk about switching to population healthcare.

It’s a whole cultural shift from doing fee for service medicine to doing population-based healthcare and figuring out how to build systems within the organization that will do that really well, deliver better healthcare with better outcomes, and not do it on a just onesy-twosy basis. We’ve got to figure out how we’re going to actually deliver preventative healthcare services to a really challenging demographic, where we are, in our area of Portland, East Portland. It’s a lower socioeconomic group. We have about a 23 percent Medicaid population out there. Forty percent of our patients right now are Medicare. So we have a really small actual commercial population and these people are in general not real literate around healthcare. We’ve got a lot of culturally specific issues to deal with. One of our doctors has 300 Russian-speaking patients alone in her practice and they’re all Medicaid.

So we’ve got to figure out how do we reconfigure healthcare within our system to deal with these populations, Medicare, commercial, and Medicaid, and in our neighborhood, these are poor people. They’ve got a lot of healthcare needs, have been pinned up for a long time, and they don’t have the wherewithal to do the sorts of things that many of us have had the luxury of doing for a long time.