"So I talked to Amy about it, and she was incredibly angry. But then after four days she came back to me and said, 'If they're really creating an entrepreneur-in-residence job at HHS, it's your national duty to take that job. And as much as I can't believe I'm saying this, I'll move back to the East Coast -- which I hate -- with our baby, to be there with you.'"
And with that, without even moving into the house they'd just purchased a few weeks before -- the house where they planned to spend the rest of their lives -- the two picked up and moved to Washington, D.C. Since that move, Park has been working to answer one question, a question that defines his entire job at HHS: Can he turn the agency into the NOAA of health data, and, in the process, ignite a technological revolution in the health care industry?
Park's propensity to attack immensely complicated problems dates back to his early childhood. Born in 1973, he grew up in Ohio and was the son of a chemical engineer who emigrated from South Korea and then spent several decades working for Dow Chemical Company. "I think my father was the most decorated engineer in that company except for Dr. Dow himself," he recalled. Park's father had a profound influence on him, both for his tendency to be analytical and his gift for invention. "He basically created this life in America for his family starting with virtually nothing. They were moving from Korea, where he grew up in great poverty. He was a life entrepreneur, if you will. He really inspired me on a very fundamental level." Given all the Amy Chua-induced focus on Asian parenting, it may come as a surprise that Park's father often told his son he was working too hard; he was afraid that his son would work himself into the ground and often encouraged him to relax. "A kid never listens to what his parents tell him to do," Park argued. "The parents actually act as an example of what their kids themselves do. He worked non-stop. He worked day and night. And he worked weekends. He would take us to a fishing hole at the Dow Chemical research center in Ohio so he could keep working. He'd come out just to make sure we weren't falling in the lake or anything like that.... He was an example to me and my brother of a person who was genuinely consumed by his work."
In 1990, Park enrolled in Harvard, majoring in economics. While there, he took a course by a professor named David Cutler called "Public Sector Economics." It was in this class that he first became intrigued by the myriad problems in the health care industry. "I was very attracted to it because it's a very important problem, and a very fundamental problem," he said. "How do you deliver the best possible and affordable health care to maximize health?" It was Cutler who first turned him on to the entrepreneurial opportunities in the industry, showing how it was a lack of innovation in the payment systems and delivery of care that was creating so much waste. The person who could solve these efficiency issues could reap millions or even billions of dollars.
Like many health care economists, Park considers the method in which American insurance companies pay for and incentivize medical care to be the underlying problem with the current system. The way the model works now, insurance pays for health care on a per-service basis. Each individual treatment has a specific cost associated with it, creating a model in which doctors have an incentive to provide more procedures in order to capitalize on the system. In his studies, at Harvard and after, Park has focused on the innovative leaders who have turned this model on its head, focusing more on long-term care as a way of driving down costs. In a recent New Yorker article, for instance, Atul Gawande covered "hot spotters" -- medical professionals who target the one percent of patients who drive the overwhelming majority of health care costs by assigning an entire team geared solely toward driving down those costs with preventive care. During interviews with Park, he made several references to that one article.
"In a world where Farmville goes from zero to 70 million users, I think the person who starts 'Healthville,' that person will be one of the most important figures in the 21st century."
Park first got a taste for the massive blockades hindering payment reform when he and his partner launched Athenahealth. Before it became a software company, Athenahealth was focused on maternity care. The team wanted to scale a model where instead of assigning a doctor to a pregnant mother, you also assign her a midwife, a nutritionist, and a case manager. Though the upfront costs are slightly higher, studies found that this type of care radically reduces the chances of costly complications with the mother, which drives down costs overall by as much as 20 percent. So representatives of Athenahealth approached the major health insurance companies and proposed a new payment model: Instead of paying for professional services, the insurers would pay a global fee for all care -- hospital care, physician care, lab care -- so that if Athenahealth could keep the mother healthy, lower the rate of complications, and therefore lower costs, it would be able to more than cover the cost of the additional upfront preventive care, benefit financially, and in the process drive down the total amount of money the insurers had to pay out. A win-win for all. "The insurers said, 'Look, we completely agree with your math,'" Park said. "'We agree with the five-year study that shows this model will work, but we can't rewire our systems to pay you differently from everyone else. We have to keep paying you on a per-service basis, even though we completely believe that this lowers cost for higher value.' And that was my first fundamental lesson regarding the principles of how you pay for health care dictates how health care gets delivered. Because this model can't scale, can't become widespread, if it's not supported by the payment system."
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