Dr. Bruce A. Meyer: Committed to Hiring People with Disabilities

Welcome to Disability Matters with your host Joyce Bender. All comments, views, and opinions expressed on the show are solely those of the host, guest, and callers. Now the host of Disability Matters, here's Joyce Bender.

Hi everyone, welcome to the show. To everyone in the United States and around the world, around the world, from China to Australia, to Finland, to Iceland. Can you believe it? You are all great, you know that? You're all awesome, how you listen to this show and share it with other people. Thank you so much. You all know I work with the U.S. State Department and Richard Roberts. Oh, it's getting close now. I first met Richard with the State Department in South Korea, then Japan, and now I'll be visiting Richard and Carla in Brazil next month. So excited. So when I go there, we go throughout the country speaking to businesses and universities about employing people with disabilities and quality of life. So it is a wonderful thing. So special hello to Richard. You know I love you. Gyeongyoung in South Korea. You're so awesome. Cheryl Smith in D.C. with the State Department from Beaver, Pennsylvania. How about that? And Venyamin in Kazakhstan. And there are so many more, but I just wanted to mention some people I became very close to. Actually, I met Cheryl when I did a virtual program for Tunisia, and now we have her back here with us. So I want to also thank everyone in the United States. Where would I be without all you great listeners helping me spread the news about the employment and quality life of people with disabilities? It's for 20 years now. Can you believe that? 20 years. 20 years. Yoshiko Dart, I almost can't forget to give you a shout out. Wish you could be here and see my Disability Pride tree with Justin and you on the tree on ornaments. You know I love you, Yoshiko. And I love Highmark, who is the sponsor of this show for the past several years, lead sponsor. I love that company. They've been with me. Well, they were with me when I started the company and every CEO from that point on up through to David Holmberg. So, and as my listeners know, he starts off every year in January. He's the kickoff. And we already have him secured for next year because, believe it or not, do you know that we are almost booked through the whole year? It's amazing. And Voice America has been so great to work with. So, love HIMARC, and that's why I'm excited to have with us today Dr. Bruce Meyer, the Executive Vice President and Western PA Market President for Highmark Health and someone that David Holmberg told me that I just had to meet him, had to meet him. So here we are, Dr. Bruce, we're meeting on the air, but at least we're meeting.

Well, thank you. It's really a pleasure to be here. I really appreciate the invitation.

Well, Dr. Bruce, I am thrilled to have you with us today. But as you heard about all the 17 countries with listeners of this video show, I would get emails in the past, oh, your guest is great, I wish I knew more about that person. So would you mind sharing your story, like where you grew up and went on to school and, uh, what made you want to become a doctor? And now here you are with this executive leadership role. So how did that all happen? I bet you could tell me that in 2 minutes, right, Dr. Bruce?

You challenge me in 2 minutes.

No, no, no, I don't want 2 minutes. I want you to take your time and tell us because that's a wonderful story. So, go ahead.

Super. Well, my dad was in the Public Health Service. So I was born on a Native American reservation here in South Dakota. My brothers were both born on Native American reservations. And until I was about 10 years old, we moved every year to a different reservation here in mostly in the Midwest and Southwest United States. So moved around a lot when I was little. My— we then moved to Chicago and ultimately to San Antonio, Texas. A bit of a culture shock there moving from Chicago to San Antonio. So I graduated from a San Antonio high school. My family has a tradition in healthcare. I am a 7th generation physician. My daughter is an 8th generation physician. Although I am surrounded by psychiatrists, my great-grandfather studied with Freud in Vienna. My grandfather, my father, my brother, and my daughter are all psychiatrists. But I'm the black sheep of the family. I'm an OB-GYN with a subspecialty in maternal fetal medicine, so high-risk obstetrics. I'll admit that I tried to resist the sort of the family business of medicine for a while. I wanted to be an actor in New York, but recognized that I didn't have the kind of passion that my peers did. That was, you know, it's one of those things where that, to be successful, it has to be the only thing that makes you happy, to be an actor, where there are lots of other things that make me happy. Was fortunate enough to get into medical school, had a terrific experience there. I've had just a fairly remarkable career. I delivered over 10,000 babies. I still have the largest series of published deliveries of triplets in the United States. And 'cause I did a lot of— of multifetal gestations, twins, triplets, quadruplets. I've delivered a set of septuplets, two sets of sextuplets. And, but over the last 15 years, I've really sort of focused my career more on trying to look at bigger picture issues and trying to think about how do we create a better healthcare system in this country because One of the ironies of healthcare in this country is it's much more about sick care than about health. And it rarely is very systematic. There's lots of variation and lots of frustration in trying to receive care in this country. So I've done a bunch of different things to run hospitals and run physician practices, and ultimately was fortunate enough to be given an opportunity here in Pittsburgh with Highmark Health.

Wow, you have such a fascinating background. I mean, I'm over here shaking my head. Unbelievable. Your great-grandfather studied with Freud. You know, that right alone is amazing when you think about that. But then I know the federal The national disability rights community would want to be having you speak right away to senators or different people. Why? Because there is an extremely high unemployment of Native Americans with disabilities. Extremely high. And we're trying to work on, you know, what could we do in that area. And boy, do you ever have a background. I'm sure you would have a lot of great ideas, but I'm sure that living on those reservations had an impact on you and that you also saw poverty.

Yeah, we in this country have not done right by the Native Americans. Pretty much on any level that you can name. Maybe the rare partial exception might be the weird economics of gambling in this country where we— because they are sovereign nations, they can have casinos, and that has brought a lot of money to the reservation. Unfortunately, that has not altered the poverty dynamic on the reservation because the money, much like a lot of money in this country, has been concentrated in And rather than spreading it around to all of the population, it has been concentrated in just a few individuals and families. So that's unfortunate. It is— the reservations have startling poverty, have startling rates of alcoholism, tremendous rates of diabetes as well. Almost 35% of our Native American population is a Type 1 diabetic. Which is pretty remarkable. And you are right about disability issues. We— I mean, candidly, finding jobs and working your way out of poverty is tough on the reservation for the able-bodied, but it is— the barriers are just extraordinary for folks with disabilities on the reservation. And as a society, we have not done a great job of, you know, finding ways to help people out of poverty, and that is amplified significantly for the Native American population because they tend to be geographically isolated on the reservation.

Now, do a lot of the Native Americans, do they leave and go to other universities and colleges, or do they go somewhere on the reservation?

Yeah, I think one of the struggles that we have with the Native American population is that education is tough in terms of getting opportunities. And the communities are very, very tight. You know, the people think of family, you know, we think of family as sort of the nuclear family, father, mother, son, grandparents, you know, those kinds of things. On the Native American reservation, everyone is family. And people have a hard time leaving their culture and their family to go off to school. There are cultural issues, there are financial barriers, there are geographic barriers, et cetera. And so it is a relatively smaller proportion of Native Americans go to college than other communities, including African American, Hispanic, and whites. And so one of the struggles has been that it is tough to get people off the reservation, and we don't have tremendous educational, secondary and post-secondary education opportunities on the reservation. So in order to get a college education, you have to leave the res. And in order to get a graduate school education, you have to leave the reservation. And that's tough for people when they have lived in such a small community that they are very tightly connected with, and their whole support system is inside that community, and that community is then a significant geographic distance away. So, lots of barriers, unfortunately.

Yeah, that is something we have to work on because, you know, I said this somewhere, "If we don't, who will?" Who has? No one. So, I'll be remembering your advice for us in that area, Dr. Bruce. Then when you said about 10,000 babies, but the record for triplets, you know, I want to know how the heck does someone have 3 human beings inside of them and be able to function?

It is pretty remarkable. Look, it is— I am a spiritual person. I think of pregnancy as sort of proof of God. It is remarkable that most pregnancies wind up in a good outcome. Outcome. And that is not to say we don't have complications and people don't have tragic outcomes, because they absolutely do. And, and, you know, part of my role as a clinician has been to try to prevent those things or mitigate those things. But I— but the human body is not designed to carry more than 2 babies at a time. And so the things that we have done within fertility treatments that have added to the complexity of, you know, producing triplets and quadruplets and higher-order multiple gestations, as they're described, really has tremendous healthcare consequences for the mother, but it also has tremendous consequences for the family. In fact, one of the studies that one of my partners and I did was looking at the divorce rate. If you have triplets and above, the divorce rate within 5 years of the birth of those children is about 75%. Wow. It is a remarkable stressor for families. Remarkable stressor for families.

Wow. Oh, I do— does this ever happen where the person doesn't know they're going to have triplets? Well, do they always know?

I think the answer to that is, you know, in a modern day and age with ultrasound, it's extremely rare that people don't know. I have twice in my career had a situation where somebody thought they were having twins and actually had triplets. But most of the time, because of ultrasound and our ability to do imaging, you know, the vast majority of time, people are fully aware and know it ahead of time. And know it well ahead of time because generally speaking, naturally occurring triplets are very rare. Very, very rare. About 1 in 10 million births. So—

Wow.

Very, very rare. But if any— if you get prenatal care of any kind, you will receive an ultrasound in this country. And when you get an ultrasound, generally speaking, the ultrasound is done, you know, well, and we image all of the— the entirety of the uterus, and we can tell if they have triplets pretty straightforwardly. And then the complication is how do you manage that pregnancy so that you can have a successful outcome for mom and for all 3 babies?

Well, you know what? I mean, I just, I wanna tell you, I too am a person of faith, so I agree with it. It is just a miracle. It really is a beautiful miracle. And I'm so glad that Highmark made the great choice of having you As I said, it's one of my favorite companies in the world because they helped me get started in 1995 with the employment of people with disabilities, and they have stayed with me. Every CEO and at Highmark, from Karen Hanlon to Deb Rice to Mick Malek to Larry Kleinman, Dan Honorato, You, Jim Benedict. I mean, I could go on and on. I'm so worried I'm forgetting someone. I don't want to forget anyone. But what a great company. So, what is your role at Highmark? When did you join? What will you be doing for us?

So, I agree with you. Highmark is a remarkable place and a remarkable organization. I joined in December of last Last year. year, so 9 months ago. Um, my role is fundamentally around both the provider side of the organization, so I have responsibility for the Allegheny Health Network, um, and all of the care that it provides to citizens in Western Pennsylvania. But I also have responsibility around the health plan side of the world. So, um, the different kinds of plans that we offer in Medicaid, in Medicare Advantage, in the ACA market—that's the individual market where you can purchase your own insurance individually—as well as commercial insurance and self-insured businesses. So the idea is to create what's called— to have a blended organization where we are looking at how do we both finance the care that people need and provide the care that people need and create a long-term sustainable model that— and to me, the reason I came is really because Highmark offered a unique opportunity. There are very few places in this country where you have a very enlightened health plan side of the world that is really thinking heavily about not just how to make money, not just how to create a long-term sustainable business, because healthcare in this country is a business, but but primarily around how do we improve the health of our community and the health of our members at Highmark in a way that we can prevent people from having highly complex situations where they have to come to the hospital? How do we prevent people from needing to come to the ER? How do we find ways to improve people's health and longevity? I mean, one of the things I have talked about during my entire career is that We want to make sure as clinicians that people have the highest quality of life for the longest duration of life. But we're not always successful at that. And so our— I talked about healthspan, how long can you be healthy and do the things that you want to do in your life and not have your health interfere with what you want to accomplish with your life, versus lifespan, where if your health is interfering with your ability to accomplish those things, and to have a high quality of life, then what can we do to improve that so that we can reverse that problem? It is common that clinicians and providers of healthcare think about that. It is unusual that healthcare plans think about that. And Highmark is remarkable, and the leadership at Highmark is remarkable, in that that is a primary focus, and really around the mission of the organization is You want to have a sustainable business, but the business is about trying to provide health and letting people live their best lives.

Well, I think that's wonderful. And I think that's wonderful what you are doing for them. So, how large is AHN? And now, are you like over all of this? I mean, what is your role?

Yeah, so AHN is 14 hospitals here in Western Pennsylvania, about 120 ambulatory sites, and pretty much extends the breadth and depth. We're all the way up in Erie, we're all the way down south in Canonsburg here in Western Pennsylvania. It's a big system. You know, we do something in the neighborhood of 100,000 hospitalizations a year, so very busy. We do about 14,000 births a year across the enterprise, so very busy. My role is both to oversee the care that's provided there. I have a whole team of people who, you know, who do day-to-day operations at every site, and some remarkable, remarkable folks doing that work. And then I've got responsibility around how do we blend the healthcare plan side of the world with the healthcare provider side at AHN and other organizations here in Western Pennsylvania? Because obviously Highmark members go to many other organizations here and many other hospitals, many other physicians here in Western Pennsylvania. How do we make sure that we are, when we spend money for people's health, that we're doing things that are valuable to them. And like I said before, allow them to live their best life from the health plan side, as well as from the health provider side, as physicians, nurses, advanced practitioners, non-physician providers, et cetera. Well, you got a big job there, Dr.

Bruce.

Yeah, I mean, but it's, it is, like I say, it is a remarkable, remarkable opportunity. There are very few places in this country where this kind of blended organization exists. And I feel very fortunate and very privileged to have the opportunity to try to do some great work here and to serve a community. We have lots of challenges here in Western Pennsylvania. And we were talking about poverty earlier. We have lots of challenges related to poverty, related to homelessness. Now we call it the unhoused, but we have tremendous challenges around addiction. In our community. But we also have tremendous challenges in what I think of as the common diseases, respiratory issues. One of the remarkable things about the Pittsburgh area is, you know, we have kind of moved from a lot of the manufacturing, but we still have lots of steel plants and lots of coal and that kind of thing. And those have health effects on people. We, you know, one of the One of the wonderful things that Highmark does is send out air quality information to everybody with— who has asthma or other kinds of respiratory diseases so that they can make good decisions about what they do during the day. It's part of our goal around health is if we know the air quality is going to be poor today, then, hey, let's make sure that you're taking your meds appropriately. Let's make sure you avoid exposure to the unhealthy air, that kind of thing. We're trying to extend that concept into lots of other kinds of disease situations so that people, like I said, can avoid exacerbations of chronic disease and be able to do the things they want to do with their life.

Yeah, and that's an example of what you're talking about, you know, getting ahead of everything. And that one thing, just that one thing is so awesome. I'm wondering Where were you during COVID What organization were you with?

So I was with Jefferson Health in Philadelphia. Jefferson is a slightly larger health system, 18 hospitals all throughout the city of Philadelphia and the region around Philadelphia. And I led the COVID response there. Doing, I mean, a tremendous amount of work. I mean, everybody was profoundly affected. We, you know, I hope and I pray that it is the most unique experience of my life, 'cause I certainly don't want to go through another pandemic as a provider or just as a human. But truly the most remarkable experience of my career and my life, trying to guide an organization to be able to provide care in extraordinary circumstances. That, I mean, there were days when I came home early in the pandemic and had to change clothes in the garage and go take a shower so I wouldn't expose my family to anything I had been exposed to that day. And just some remarkable personal experiences and was witness to some truly heroic work by other providers, our nursing staff, our physicians, physician assistants, nurse practitioners, et cetera, even our transport staff and all the people who supported them in the hospitals. I don't think it was, you know, was any different in Philadelphia than it was here in Pittsburgh or in any other place across the country or the globe in that sense. It's just that, you know, we witnessed some tremendous heroic acts and some tremendous tragedies. That I think none of us will ever forget and all of us, you know, were profoundly affected by.

That is and always will be for those of us that, you know, lived through this the most reprehensible, horrible thing that ever happened. And I Thank you and all of the healthcare workers that saved lives during that time and put your own life at risk. So thank you, Dr. Bruce, for everything you did.

I am one among thousands, millions of care providers. So, I mean, it's humbling to be able to, you know, work with a team doing remarkable work to try to save people's lives. But like I say, truly the most profound experience of my career and one that I hope we do not ever have to endure again.

Yeah, I agree with that. Hey, if you just joined us, before we go to news break, we're talking to Dr. Bruce Meyer, Executive Vice President and Western Pennsylvania Market President for Highmark Health and just a wonderful person. And after newsbreak, not long after, we're going to be talking about his personal connection to disability. But right now it's time for our newsbreak with Perry Jude Radesik. Perry, how are you today?

I'm fine, Joyce. I'm enjoying the cooler and drier weather.

In Harrisburg. Oh, yeah, you're fortunate.

It was really hot here yesterday. Hot and humid. So good for you. Well, Perry, what news do you have for us today?

Well, Joyce Bender, earlier this month, the U.S. Access Board— now, just to remind our advocates listening, Access Board is an independent federal agency, and they develop ADA accessibility guidance. That's the Americans with Disabilities Act. So they're extremely important to our lives. The Access Board was originally established in 1973, uh, and their job originally was to ensure access to federally funded facilities. Now the Access Board's, uh, mission includes Guidelines for the Americans with Disabilities Act.

So, that's who they are.

Earlier this month, they issued a final rule on public right-of-way. Now, this rule is a major step forward in addressing the barriers that we as people with disabilities face when using sidewalks, crosswalks, curbs, on-street parking, or other public rights-of-way. These guidelines are going to instruct federal, state, and local governments on how to make these rights-of-way accessible to people with disabilities. Just to remind everyone, public rights-of-way are covered by the Americans with Disabilities Act under Title II. Now, these guidelines are just guidelines right now. They won't be mandatory until they are adopted for enforcement by two agencies, the U.S. Department of Justice, and the Department of Transportation. This has been a long time coming, Joyce. The U.S. Access Board has been working on public rights-of-way since the ADA was passed, and they issued interim guidelines in 1994. So, they've been working on this for at least 24 years or longer, and in 1999, the Access Access Board organized a Public Rights-of-Way Advisory Committee. So, long time coming, finally have a final rule from the Access Board. So, here's what's important. We know advocacy matters. The equal access to public rights-of-way increases employment opportunities for people with disabilities as well as full inclusion into society. If we could think about the more accessible streets and curbs and our rights-of-way are, the more access people have to employment opportunities. So we should review the rule, understand how access routes, pedestrian signals, crosswalk, transit stops, and other areas will be impacted. How do you find this? You go to disabilityrightspa.org. That's disabilityrightspa.org. Click on today's advocacy matters segment for all of this information and links to that final rule, Joyce. It's all right there. Let's go check it out.

Oh, good. Thanks. Hey, Patti, now I have a couple questions here. First, the ADA— this is already a right under the ADA. That every, you know, the accessible sidewalks, et cetera. And right now, people could sue if it wasn't. Is that correct?

That is correct. That's absolutely correct. But these, it's been a long time coming to have a final rule that is also approved by, or it will be enforced by, the Justice Adapted for Enforcement by the Justice Department and Transportation.

You mean it isn't enforced, it hasn't been enforced prior to this? It has, but they have been guidelines.

They've been guidelines.

I see. I see. Wow, look how long that took for that to happen. Yeah. Oh my goodness. I know. Because I was with your friend Chris Griffin last week, and we were at a parking garage in Boston, and she was in her power wheelchair, and when she went to go up to get in, they had like a strip up that if you had— if she had been in a manual wheelchair, it would have been impossible. And she said to me, look how long they have had, look how long they've had. And isn't that the truth? Well, that's good information, and I would tell everyone go to Disability Rights PA and go to that Advocacy Matters and read that and get involved, because if you don't get involved, remember, it can impact you also someday. Hey, thanks, Perry. I look forward to talking to you next week. Hey, thanks, Joyce. Take care. That is such— so horrible when people are in a wheelchair and can't get in a building that's a newer building. You know what I mean, Dr.

Bruce? I do, and I've had some personal experience. My mother was in a wheelchair for the last 7 years of her life, and it is, it is astounding, despite all the laws that have been passed in this country and all the work that has been done, how remarkably limited access remains in this country. It is really, you know, there is work to be done. Much work to be done. So I am really pleased to hear from Perry about that new definitive rule. And as you said, advocacy is crucial. You know, if we are not talking about these issues, if we are not displaying the problems that are being created and the barriers that we're putting in front of people that prevent them from taking advantage of, and, you know, all of their skills and talents, then we never make change.

Right. That is right. Well, Dr. Bruce Myers, you are also a person of great passion about the employment of people with disabilities and equity. In life and in the workplace. That's my life, as you know, as a woman living with epilepsy. I started this with Highmark in 1995 because people with disabilities have the same rights that people without disabilities do. And that's what our fight is. But you too have a passion for personal reasons. Could you talk about that for a minute?

Sure. So my, my wife and I are fortunate to be the parents of 7 amazing children, but 2 of those kids are kids with special needs who are neurodiverse. And that neurodiversity has led us, you know, both the diagnosis and, you know, trying to understand how to to help our kids in the world. And, you know, sort of learning about, you know, the bigotry of the world against the neurodiverse and folks with all kinds of disabilities is sort of a personal— both a personal experience and a personal passion. I, you know, it is remarkable that we continue in this country and in this world to not recognize that when we're not taking advantage of the skills of the disabled, we are actually harming our ability to manage in our community. There is fantastic data from colleagues of mine that shows that patients in clinical arenas, and whenever they encounter a care provider, if you encounter a care provider who has a who looks like you and talks like you and has a similar situation to you, that your outcome is actually better when that occurs. And so when we don't hire the disabled, we basically say to the disabled that we are caring for, "Hey, we care about you less than we care about the rest of the population." And that's— and nobody wants to send that message. That's not a, you know, a message that that I think we're intentionally sending, but it is the unintentional consequence of those kinds of things. It is really, you know, it's a tragedy in this country that needs to be rectified. And it's a personal passion of mine to try to ensure that people with disabilities of all varieties get an equal opportunity in the workplace, particularly in healthcare.

Well, yes, that disparity in healthcare was certainly seen during COVID and what happened, for example, with different minority groups. But I am glad that you have this passion because I always say, give me the parent of a child with a disability and look out. That's all I have to say. Look out. So I'm glad we have you to help us and to lead in this way. Have you seen a difference in how your children are treated that do have a disability versus your children that do not?

So I would say without question, both in schools and in— we have an adult child on the spectrum now. There's no question that he is treated differently in terms of the workplace, both in terms of opportunities in the workplace, but also even in terms of what I think of as sort of the adaptability of the workplace to individual needs. He has struggled really to find a manager and a worksite where people can understand the accommodation that he needs in order to be productive in the job. And so that has led to him struggling to find a job. It has led to him struggling in terms of his educational opportunities where it's just a different experience in college for folks with disabilities. And it shouldn't be, but it is. In this country. And so, have experienced that personally and how that has affected his life. It's harder. Stress is greater. And it makes us, as a parent, you know, this is where you hurt for your child kind of thing. It makes the uncertainty of his future much greater. And And that's hard, hard on the whole family, but especially hard on him. And I think that's one of the things that, you know, I, as an educator in healthcare, I've taught thousands of medical students and hundreds of residents, and one of the things I always talk to them about is that you have to take care of the person who has a medical issue and not just the medical issue itself. Because if you're not taking into account how that medical issue is affecting their life and how they live their life, then you're not treating them fully. And I think that's especially true of folks with disabilities. It isn't just the disability or the, you know, or the issue that they are facing. It is how that affects their— the entirety of their life. Their home life, their professional life, their ability to, you know, to maximize their potential and all those kinds of things. If as care providers and as a society we are not paying attention to those things, then we're doing a disservice to all of those individuals.

Yeah, and a lot of times that problem at college is due to not just ableism but not understanding accommodations. So as I said, it's great to have a leader nationally that understands this. So I'm just so glad we have you and have you right here in my favorite city, Pittsburgh, Pennsylvania. Well, you know, earlier when you were talking about the changes in healthcare that Highmark is allowing you to have, I was talking to someone about this how you're trying to go through this transformative process. I call it from fee-based to preventative-based care. And I was wondering if you could explain that to our listeners, how that is different.

Certainly. So for more than 50 years in this country, we have been on what's described as a fee-for-service payment structure, which means that whenever— and I'll just use doctors as an example— but whenever a doctor provides a service to a patient, that doctor generates a bill for that specific service. And the insurance company, which— or the federal government in Medicare or Medicaid as an example— has a contract with that provider that says they will pay them a certain amount of money. For that service. The difficulty with the fee-for-service structure is that the subtle incentive for every provider is that if I want to have more revenue, I want to make more money, I got to do more things to people. And obviously the greater the complexity of the thing that you do with someone, that the more you get paid for it as a general rule. And so what happens is that The cost of care has gone up fairly radically in this country because of that. We have what I describe as an unsustainable economic trajectory for the cost of healthcare in this country. And the best example of that is that if healthcare— if the cost of a dozen eggs had risen at the same rate that the cost of healthcare in this country has since 1985, then a dozen eggs would cost $65 today. Wow. Exactly. I do not know anybody who is going to be buying a dozen eggs at $65 per dozen eggs. Oh, my goodness. Right? And so, that kind of economics has been driven by that fee-for-service structure. And the subtle piece of that fee for— the other subtle piece of that fee-for-service structure is that it says, hey, If I'm choosing between two kinds of therapies, and one of them pays me more than the other, it is more likely that I will choose the therapy that pays more, if I don't think there's any difference in the outcome. In a value-based world, and this is what we're moving to here in Western Pennsylvania, but in other parts of the country as well, in different ways. We pay people— instead of paying them sort of a click fee based on what they do for every individual thing that they encounter a patient with, we pay them based on the outcome of that patient. And we pay them on the quality of that outcome. We pay them on the experience of the care of that individual. And we pay them based on the access that that individual has to care. So We want people to have prompt access. We want people to have preventive care. We want people to stay out of the hospital if possible. I mean, there are things you don't have a choice about in the hospital, but generally speaking, we want to get what I call upstream and try to do more and more preventive care so that we can catch diseases at an early state, so that for chronic disease, we keep it at a low level without exacerbations that interfere with people's lives. And some stuff that, you know, is random, like that we cannot predict. You get in a car wreck, or you fall off a ladder, or things like that. Well, we need an emergency room, and we need a hospital to take care of you. But, so it's not that hospitals are going away, but we want the incentives in the system to move away from, I got to do more stuff to people, and towards where I got to do more stuff to prevent people from becoming ill. Yeah. That's sort of the gist of it. Now, there's complexity in how do we make the economics work. There's a lot of complexity. So I don't want to underestimate that. But we— but I think if we're not committed to saying, hey, what we want to do is have people have longer lives, have healthier lives, get appropriate preventive care so that we catch diseases early, and that we have the kind of relationship with our members and our patients that is such that everybody is involved in their care, and we are trying to prevent you from having situations that force you to come to a hospital. And so we've got to align the financial incentives with our kind of— with our goals around the health of our community. And that's what we're really trying to do here in Western Pennsylvania.

Well, it's a complex thing, but it's certainly moving in the right direction, Dr. Meyer. So that's really a wonderful thing. Well, hey, it's time for What's Going On at Bender. So Gerald, do we have you with us? Gerald Homi?

Yes, I am here, Joyce Bender.

How are you? I'm good. How are you today?

Oh, I'm doing very wonderful, especially since I'm here with Dr. Bruce here at AHN. Thank you, Dr. Meyer. I appreciate all the for the great work that you're doing.

Oh, thank you.

That's very humbling. So, what do you have for us today, Gerald? What's going on?

Well, I wanted to make our listeners aware, you know, I think they're very aware that we specialize in the competitive employment of people with disabilities here at Bender. But, you know, over the years in helping employers advance their efforts to bring people with disabilities into their organization, We've developed a lot of great strategies to help those companies build out their infrastructure and their planning and their support to make sure their environments are more inclusive for people with disabilities. So I wanted to just make everyone a little bit more aware of one of our more innovative products here at Bender Consulting Services, our strategic planning product to help companies look at their environments to help make them more inclusive for people with disabilities. Because as we bring people with disabilities in the companies, often they find they need to adjust things to make them more inclusive for those folks, whether that be changing things about their accommodations process or their interview process to make it more inclusive, or their emergency preparedness plan, their procurement process. Everything we can help companies from the top down look, really dive deep and help them figure out what they can do to make them move from where they are to being not only just compliant with including people with disabilities, but being leaders in this space of disability inclusion. And it's really exciting because it has a big impact not only on the people with disabilities you bring in from Bender, but the people with disabilities you already have within your organization that may have hidden disabilities and not have yet raised their hand to self-ID, or may just be applying for jobs out in the market.

Oh, yes. That untapped talent, that untapped labor pool of talent, how true that is. Well, Gerald Homme is our manager of talent programs where we have opportunities across the United States from compliance at a pharmaceutical company to IT to healthcare, um, really procurement. You name it, we're working in that area. Uh, Gerald, if someone is looking for employment or a company to find people with disabilities for them, how do they reach you?

They can reach out to me at ghomme@benderconsult.com or info@benderconsult.com comes to me as well, if that's easier to spell out. And you can apply to any of our jobs if you're a candidate looking for work at benderconsult.com/jobs.

Okay, thank you. And thank you for calling. Thank you for calling in, Gerald.

And thank you, Joyce. And thank you again, Dr. Meyer, for all that you're doing.

Thank you. So, Dr. Meyer, look at you. You've accomplished— you're one of those people that you have accomplished so much in your life. So, I have to ask you, who was your role model? Like, who impacted you? Wow.

That is a complicated question. I would say as a clinician, I had a mentor in medical school. His name was Paul Weinberg. He was an OB/GYN. And Paul was really the one who taught me to always look at the person who has an illness and how that illness affected their lives and their loved ones and their community rather than just the illness itself. And that had a tremendously profound effect on my career and, you know, how I practice as a clinician. I think as a businessman, because healthcare is a business, you know, when I was in high school, I read a book by Sun Tzu called The Art of War. And I would say that Sun Tzu, even though he lived hundreds of years ago, was probably the greatest strategist that I have ever heard about or encountered. And his teachings and readings were pretty profound for me in terms of trying to understand how to think about strategy and having not just a plan B, But really doing, thinking about decision tree analysis where what if you do this and somebody else does that or the market does this or those kinds of things. And then I would say, just as a human being, I mean, I think Abraham Lincoln is a tremendous role model. He was somebody who was not afraid to listen to people who disagreed with him, who was somebody who saw injustice and basically committed his whole life to changing the world and solving that injustice. And I, you know, I think— I know I'm not up to that, but I aspire to that in whatever little ways I can figure out how to do it in my own life and my own career. And so that's probably at least a starting point. I've been fortunate to benefit from some incredible mentors and just be able to work with remarkable, remarkable people in my career. I would not in any way be where I am in terms of my career without the work of, you know, hundreds and hundreds of other folks who just, you know, profoundly influenced how I think. And I think all of us at some level have, whether we acknowledge it in a conscious way or not, have been influenced by dozens and dozens and dozens of other humans that we have encountered and readings that we have done from other people and speeches that we have seen and read and and those kinds of things. Well, Dr.

Bruce Meyer, Dr. Bruce Meyer, Executive Vice President, Western Pennsylvania Market President of Highmark Health. And if you're listening to the show and you're thinking, oh, I wish other people could hear this, they can. These shows are on demand, uh, from Spotify to Apple to Voice America joycebender.com, benderconsult.com. And I see we have a lot of listeners on demand, and thank you for that. But feel free to share this show with others. I want to thank you again for being with us, Dr. Meyer, and I want to tell you I can't wait to get together in person because you have definitely encapsulated A leader that serves. Thank you very much for being with us.

No, thank you so much. It's very humbling and truly an honor to be here, and I've really enjoyed the conversation. It's really been excellent. That's good.

Well, we end every show with a quote, and I know Dr. Meyer is going to love this quote. We make a living by what we get, but we make a life by what we give. Said Winston Churchill. This is Joyce Bender, America's Voice, where disability matters, at voiceamerica.com. Talk to you all next week. And in the words of Mary Brooker, remember, when you go out today, choose joy.

Voice America would like to thank you for tuning in. Please join us next Tuesday at 11 AM Pacific Time and 2 PM Eastern Time for another installment of Disability Matters right here on the Voice America Variety Channel. We are the leader in live internet talk radio. VoiceAmerica.com.