The Quintuple Aim of Value Based Care Enabled by The Garage

Hard to resist the opportunity to go to a user conference that includes attending the F1 Miami race in Miami which also became the theme for the conference.  The Garage’s recent user conference did just that as they leveraged some of the learnings from F1 racing to illustrate how they’re racing to enable value based care in organizations.

Throughout the event I captured a number of the insights that were shared on stage at the conference.  I was only able to go to part of the event, but below you’ll find some of the key perspectives along with a little additional commentary.

One of the things that the FUSE 2026 organizers from The Garage deserve credit for is the opportunity they provided for attendees to be able to connect with each other.  We hear all the time that one of the most valuable things at conferences is connecting with other attendees.  The Garage did a great job helping those in attendance to meet and connect with each other.  The F1 Race helped and this breakfast by the water helped as well.  Nothing like connecting with other attendees and I’m sure The Garage benefitted from that time too.  Plus, those connections reframed the rest of the conference experience because we were already familiar with each other.

As mentioned, the racecar theme drove a number of the topics of discussion at the event.  That included Sabré Cook, one of the most successful female drivers on the circuit, sharing some insights from her experience as a female driver.  I loved when she said that “Doing whatever it takes isn’t always comfortable”, but then acknowledged that pushing yourself into the uncomfortable is the way to grow and do the very best for patients.

Hearing about Sabré Cook’s struggle to survive in a sport that’s really expensive was inspiring.  Particularly when she shared how it’s important to bet on yourself even when the outcome is not guaranteed.  Lots to chew on there, but it’s powerful to trust in yourself even when something seems hard or even impossible.

In a world where most startup companies are trying to become unicorns overnight (rarely happens), The Garage actually illustrates the path that most of the best health IT companies take.  14 years in to their journey and they’re just getting started.  I’m sure there are lots of reasons why Pranam Ben said they’re just getting started, but it definitely illustrates how far both value based care and technology have come.  It does feel to me like we’re at a really interesting confluence of policy, data, and technoogy that is going to push value based care in new and novel ways.

I love when companies take a good thing like the triple aim and are even more ambitious with their goals.  Far too many in health IT code their product to the standard.  That’s not a bad thing, but it usually doesn’t end up well to just code to the bottom of what’s required.  It’s much more powerful to push far beyond what’s required.  That’s what I feel about The Garage’s Quintuple Aim.

What do you think of Pranam Ben, CEO of The Garage’s assertion that healthcare will be human centric?  There are a lot of people out there shouting about how the robots are going to take over parts of healthcare.  Will human centricity in heatlhcare change?  I personally agree with Pranam that it will always be out the human.

One thing that’s unique about F1 is that the cars are optimized for performance and much of the competition is about those optimizations.  Sabré Cook shared that she’s learned over time that when optimizing the car, it’s better to optimize it for the driver’s style and preferences rather than making it a tenth faster regardless of driver.  Feels like there’s a lesson there as we customize value based care efforts to clinicians and healthcare organizations.

Another great analogy from car racing is making sure that the right systems are in place for the driver to respond with the right decision quickly.  That is exactly what we need for clinicians.  They need the right data at the right place and the right time to be able to treat the patient in the most effective way possible.  We don’t always do that in healthcare, but it was great to hear how The Garage is helping more clinicians live this reality.

Everyone loves seeing the stats for companies.  This was really true for the above stats that The Garage shared at the event.  Most of these numbers are hard to comprehend, but the clinical data that they have available is particularly powerful.  I’ve often said that the future of healthcare is built on the back of data.  Having this much data in a usable format enabling the AI solutions The Garage is rolling out is a powerful value proposition.

The stats on what it takes to make an impact in healthcare are useful.  However, it’s great to see that all that data, LLMs, and AI are actually moving the needle on measure that matter like ACO savings and reduced hospitalizations.

I’m pretty sure this approach to AI is what is happening at many health IT companies.  However, Pranam Ben was the first I’ve seen articulate it.  Plus, having talked to The Garage CTO on the bus back from F1, I can confirm that they’re not just layering a few AI features on to their product.  They’re being thoughtful in how they roll out AI, but they’re integrating AI deeply into their product.

It was great to see even critical access hospitals being successful with value based care efforts.  This was even more profound in the context of Jodi Nelson’s comments about the importance of cirtical access hospitals to their communities.  Is value based care a key to saving rural health?

Dr. Meera Kanhouwa was impressive in her description of the various stages of AI.  The big challenge right now is that most of what’s being done with AI in healthcare is still in the summative AI category.  This is exciting because we’re already seeing impact from the AI that’s being implented, but it also illustrates we’re just getting started in unleashing the value of AI.

There were a few callouts to the Kobe Bryant Mamba Mentality, so Isaiah Nathaniel created a Kobe Bryant analogy based on the offense he played in called the Triangle Offense.  He compared healthcare to a triangle between primary care, the specialty system, and hosptials.  Much like the Triangle Offense requires players to work effectively together.  We need that same coordination in the team sport that is healthcare.

I was intrigued how at an event that was largely focused on value based care, there were still a lot of people talking about the value that ambient clinical documentation is having on improving the lives of clinicians.  As Nathaniel said, reducing the burden on providers allows them to better focus on the patients.  One of those focuses could be spending time addressing the value based care initiatives for that patient.

Kanhouwa was pretty direct with the reality that cost avoidance isn’t as powerful as revenue.  That’s a common phrase in business, but can be challenging for provider organizations.

This satement from Pranam Ben from The Garage may be one of the most profound of the event.  We’ve all heard the statement, Garbage In leads to Garbage Out.  However, Pranam added that the real challenge is that with AI, many are starting to believe the garbage out that many AI solutions are producing.  That’s a challenge very healthcare AI vendor will face.

As I said in the social share above, I don’t think we’re going to need regional models.  However, we are going to need data from all of the regions or we’ll be doing a disservice to a lot of populations.  What do you think?

I really loved reading these predictions.  Peter DiFondi’s prediction that we’re going to have utilization constraints is profound.  There are a lot of ways to take that comment and it will have good and bad impacts.  I think these constraints are likely to sneak up on us faster than we think.

At the core of value based care is trust.  Without trust, patients won’t do the actions they need to do to stay healthy.  AI has the opportunity to grow that trust or hurt that trust.  It depends on how we implement it.

Pawan Shah nailed it when he gave these 2 challenges to value based care.  I think the later can actually be more challenging.  Especially because in many ways its an unclear or moving target.  What other challenges would you add to the list?

I’ll admit that I’m not an expert on all the models, so I’ll take Shah’s word that ACOs have been the most stable

Scale really does impact so many aspects of value based care.  Much of what’s needed to be successful requires scale.  Look back at the numbers that The Garage shared.  Now try and imagine every healthcare organization trying to replicate that kind of scale.  It’s not going to happen, so it’s great that The Garage can bring that scale to providers organizations in a wide variety of sizes.

I wish I’d been able to stick around for more of The Garage  FUSE 2026 conference, but I was really impressed by the practical dicsussions that happened at the event.  Value based care really has come a long way and in many ways is coming into its own.  Plus, all of those value based care efforts are being infused with technology and AI to improve the entire process.