Written by Brandi Harless, MPH and Natalie Davis, MD
Definition of “Moonshot Thinking”
A type of thinking that aims to achieve something that is generally believed to be impossible. – Macmillian Dictionary
Moonshot thinking motivates teams to think big by framing problems as solvable and encouraging “anything is possible” dialogues around how to solve the challenge.
We Put A Man on the Moon
In May 1961, President John F. Kennedy announced the seemingly impossible goal of putting a man on the Moon by the end of the decade. Nobody knew at the time how it would get done. The technology wasn’t even remotely ready. Yet this first “Moonshot” was achieved in eight years’ time.
Modern Moonshot Thinking
Peter Diamandis, of X-Prize fame, uses his friend Astro Teller’s definition to explain an entrepreneurial or corporate Moonshot. Astro Teller is the current head of X (formerly Google X). Astro Teller defines it as going 10X bigger, while the rest of the world is trying to grow 10%. Mr. Teller goes on to describe WHY moonshots matter:
- When you try and do something radically hard, you approach the problem differently than when you try to make something incrementally better.
- When you attack a problem as if it were solvable, even if you don’t know how to solve it, you’ll be shocked with what you come up with.
- Aiming for something that is 10x better vs 10% better is 100 times more worth, but is never 100 times harder.
Health Moonshot Thinking
We are proud to be part of an incredible group of entrepreneurs working to solidify 10 discrete HealthCare Moonshots at Startup Health. When Joe Biden was our Vice President, we all kicked off the Health Moonshot concept, at the Cleveland Clinic Summit back in 2016. Mr. Biden was particularly interested in the cancer moonshot but we think his comment applies to any moonshot.
“The Moonshot is all of us who understand the urgency and need to reimagine the cancer fight for the 21st century. It’s the spirit of discovery that defines this country. And it gives me every confidence that we are going to make enormous progress,” said Vice President Biden. “The Moonshot is fundamentally about two things, it’s about injecting the urgency of now into this fight. Not tomorrow, not in two hours, now! And it’s about changing the culture. Coming up with a new strategy for this fight. Not the strategy left over from 1971.”
What Makes a Great Moonshot?
According to many who promote moonshot thinking, there are three main components to a moonshot: 1. A clearly defined problem; 2. A radical proposal to fix the problem; 3. A scientific reason to believe the problem can be solved.
Applying Moonshot Thinking to Primary Care and Disease Prevention
- Clearly define the problem: Approximately 88 million American adults have pre-diabetes; of these, only 15% are aware of their condition. Incidence of prehypertension, a precursor to heart disease and stroke, stands at a concerning 36.3% of the U.S. population. With the recent COVID-19 pandemic, and its serious disruption of preventive healthcare services, healthcare professionals anticipate accelerated development of these diseases into an unprecedented increase in diabetes and hypertension. Apart from the disease burden, there is also a significant cost burden to the U.S. healthcare system. Seventy-five percent of the (now) $4.0T healthcare costs in the U.S. stem from these preventable diseases.
- A radical proposal to fix the problem: Empower and enable the highest value, lowest cost provider in the care system to solve the largest problems in both prevalence and cost.
- Scientific Reasons to believe the problem can be solved: The science has been around for a long time. We know what needs to be done to prevent chronic conditions, and how humans adapt and improve their behaviors over time. It’s not a matter of knowing what, it’s a matter of how we choose to do it. For a long time, we’ve overlooked the primary care provider (PCP) in this conversation. Products and programs for prevention are targeting self-insured employers, health plans, and even consumers directly. How do we reach the patients with sore throats or gallbladder pain? We reach them through a PCP. Why should primary prevention be any different?
Primary Care and Health Moonshots
We can also have a big impact on other health moonshots with a focus on primary prevention in primary care.
- Access to Care Moonshot
By utilizing the extensive reach of the primary care provider (PCP) and arming them with tools and financial support to intervene with pre-disease patients, we are able to access our most vulnerable Medicare and Medicaid populations.
- Cost to Zero
Largely preventable and highly manageable chronic diseases account for 75 cents of every dollar we spend on healthcare in the U.S. In contrast, we spend less than 5 cents on prevention, even though the World Health Organization and the Centers for Disease Control and Prevention have estimated that 80 percent of heart disease and type-2 diabetes, could be prevented by doing three things: exercising more, eating better and avoiding tobacco. Utilizing the highest value, lowest cost provider to implement evidence-based upstream primary prevention interventions within primary care creates the greatest possible cost reductions in our system.
- Disease Prevention and Cure Disease
Primary care providers (PCP) are the only providers who have access to patients over the many years and health stages of their lifetime. PCPs treat a splinter here, and sinusitis there. Patient are in and out of PCP offices constantly, making the primary care provider the front lines of healthcare. This is where we prevent disease and ultimately curing disease by catching it before it starts.
As Biden put it in Cleveland at the launch of the Startup Health moonshots initiative, “It’s about injecting the urgency of now into this fight. Not tomorrow, not in two hours, now! And it’s about changing the culture. Coming up with a new strategy for this fight.” He was addressing cancer, but it means the same when we apply it to the huge problem of preventable diabetes, hypertension and heart disease.
PreventScripts Moonshot Mission
At PreventScripts we believe the most drastic cost reductions and biggest Moonshot Health outcome can be had with a focus on the primary care provider (PCP). We know the chronic disease problem is enormous. We know the scientific, medical and behavioral practices that can make an impact. And we know the primary care provider is already the highest value and lowest cost provider in healthcare. But unfortunately, today, the PCP is not being optimally utilized to solve these large problems. Existing products on the market that focus on the prevention of disease are primarily created for insurance companies, hospital systems, or employers, are leaving the primary care provider out of the preventive circle of care.
There is opportunity to FURTHER accelerate the value of the primary care provider with a proactive population health approach. If chronic diseases like diabetes and hypertension are intervened upon in their early stages prior to onset, all of the downstream costs like specialist visits and hospital associated costs go away. This is the 10X power of Healthcare Moonshot Thinking. Secondary prevention and tertiary prevention create incremental change and 10% gains in our healthcare system. Primary prevention of disease through the primary care system gives us the 10x kind of Moonshot we are looking for.
The mission of PreventScripts is to launch the primary care provider to the moon. By enabling PCPs with tools and financial resources to tackle primary prevention, we will EXPAND ACCESS to CARE , bring the COST to ZERO and CURE CHRONIC DISEASES by preventing them in the first place. PreventScripts identifies, intervenes, and systematically creates iterative behavior change in populations while bringing meaningful and much needed revenue to primary care offices.