Healthcare Executive Group’s 2017 Annual Forum – Just Right!

By | Annual Forum, Healthcare Reform, Member Benefits, Top 10 | No Comments

The Annual Forum hosted by the Healthcare Executive Group (HCEG) is the Goldilocks of Healthcare Gatherings. It’s not too big like the HIMSS Conference and the AHIP Institute. It’s not too small and too narrowly focused like so many of the single topic, function-specific events taking place all over the United States on any given week of the year. HCEG’s Annual Forum is a well-crafted gathering covering an agenda presented by credible industry leaders to a manageable group of attendees in an intimate and comfortable setting. HCEG’s Annual Forum is Just Right.

The 2017 HCEG Annual Forum – It’s Just Right!

This year’s Annual Forum takes place in what’s arguably the Healthcare Capital of the United States: Nashville, TN! Healthcare executives and thought leaders representing health plans, health systems, provider organizations and physicians – along with a select set of healthcare vendors – will gather at the Thompson Hotel Nashville on September 18th through the 20th to participate in this Just Right event.

Here’s a sneak peek at the topics, speakers and valuable activities planned for the 2017 Annual Forum in Nashville. (*Sessions and Presenters Subject to Change)

Certain Topics in an Uncertain Healthcare Environment

Based on the HCEG Top 10 and recent survey’s completed by healthcare executives and others, HCEG board members have identified the following topics that will be addressed in various sessions during the forum:

  1. Value-Based Relationships leading to Payer/Provider Integration
  2. Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives
  3. Specialty Networks and Risk Sharing at Scale
  4. Pharmacy Costs / PBM and Rx Transparency
  5. Precision Medicine and Behavioral Health Aspects of Substance Abuse/Opioids
  6. Leading Edge Technology / Disease Management / Population Health
  7. Technology Innovation and M&A Market Trends
  8. Total Consumer Health
  9. Harnessing Digital Health Technologies

Keynote Speakers

A number of well known AND well qualified individuals will be presenting at the Annual Forum and participating in various panels. While speaker arrangements are still be finalized, attendees can expect the following roles and industry focus to be represented:

  1. CEO of well known, nationwide health and wellness company
  2. Chief Marketing Officer of a Fortune 50 technology company
  3. Former executive director of national healthcare association
  4. Former leading official from the Centers for Medicare & Medicaid Services
  5. CEO of large multi-state healthplan
  6. Chief Medical Officer of large BCBS licensee
  7. President of national health care intelligence and policy consultancy

Evening Receptions

Besides the wonderful breakfasts and lunches catered each day of the forum, and the plentiful snacks and drinks available each day of the forum, a few other special events – all fueled with great food, drink and conversation – are part of the Annual Forum.

  • Sunday Evening: Meet and Greet at The Thompson Hotel
  • Monday Evening: Offsite Sponsor/Partner Reception
  • Tuesday Evening: “Late Night Nashville” Party

Come Join Us in Nashville This September!

For more information on the 2017 Annual Forum including membership in the healthcare executive group and registering for the Annual Forum, see this page. We hope you’ll join us.

Healthcare Executive Leadership Forum at Guidewell Innovation Center

‘Next Gen’ Data Strategy, Architecture and Technology to Achieve Innovation & Growth

By | AHIP, analytics, Sponsor | No Comments

marklogic ahip institute Operationalize Before You Analyze: Innovation and Growth Powered by DataMany of our sponsor partners participated in the 2017 AHIP Institute & Exhibition in Austin, Texas earlier this month – sharing info on their healthcare products and services; and sharing information via informal and formal presentation sessions.

Bill Fox, VP of Healthcare and Life Sciences of our sponsor MarkLogic, moderated a panel titled “Operationalize Before You Analyze: Innovation and Growth Powered by Data.” The panel of business and technical leaders discussed how they have used “next gen” data strategy, architecture and technology to achieve innovation, growth and modernization results.  Panel members included:

Sunil Godbole, Senior Director, Application Development at Aetna Inc.

Glen Schuster, Consultant, former CTO at Centene Corp

Shahran Haider, Managing Director of Enterprise Data Strategy and Analytics at L.A. Care

Analyzing Data and Operationalizing Data Are Not the Same Thing

Bill Fox began the panel discussion by offering that analyzing data and operationalizing data are not the same thing and that many health care organizations have focused their innovation and growth investment on the “shiny ball” of analytics — the end stage of the data journey — instead of first improving the agility and speed at the beginning “operational” stages of the data journey.

Save Time on Operations – More Time for Innovation

Glen Schuster: “When companies try to do operations and analytics at same time, it’s operations that almost always ‘wins’”

Sharan Haider: “Now is the time to innovate. And to do that, organizations have to free up time and iterate through faster execution cycles that add more value to operations while improving member and consumer experience.”

Sharan Haider: “If we shorten the amount of time needed to get data together, we can innovate and do analytics better and faster.”

Flexible, Secure, Multi-Model Database Systems are Key

Bill Fox: “Next generation systems must be able to provide users with what they want, how they want it, and when they want it. Data can’t be siloed across numerous legacy systems but must be virtualized in a multi-model database capable of supporting multiple data models against a single, integrated back end where structured and unstructured data in multiple formats are all supported by a flexible and secure infrastructure.”

Glen Schuster: “Value-based reimbursement and managing risk demand that healthcare firms deal with their legacy architecture and employ the resources necessary to facilitate change. Data is classically under reported. A company that can gather data and improve its quality will be in a better position to manage its risk and gain a significant competitive advantage.”multi-model database data models integrated backend structured unstructured marklogic hceg ahip institute

Rapid Implementation with Proven Business Case

Glen Schuster: “It’s easier now to create a hard dollar business case for operationalizing data. Do you know where your data is? How difficult is it to collect, combine and operationalize your data? Over-analyzing cost vs. worth can be an unproductive conversation.”

Sharan Haider: “I know I have a problem. I come to conferences and get excited at what I see. But I’m also a realist. I need to be able to implement solutions from my point of view. To be able to collect, merge and manage my data better and faster.”

Sharan Haider: “We are working to develop a 360 view of our provider customer service, appeals and grievances data in 4-6 weeks. What was a long-term pain and seemed unsolvable was suddenly doable.”

Centers of Excellence and Scaled Agile Framework

Sunil Godbole: “We had an impossible data problem and started our journey 2 ½ ago. We strive to make whatever we build with reusable assets. We established a Center of Excellence (COE) and got the best resources available on market. Our COE performs governance, builds frameworks (ex. Logging, alerts, ingest and egress methods, etc.) that we can extend to all lines of business, affiliates, and other data centers.”

Sunil Godbole: “Code quality has to be present. We employ a Scaled Agile Framework (SAFe) and consistently enforce its use. We do brown bags with scrum teams, new developers and business stakeholders to maintain and grow our skills based and data agility-focused culture.”

Learn More About Healthcare Innovation & Transformation

For more insight and ideas on digitally transforming your healthcare operations and analytics, check out our sponsor partners and consider following the Healthcare Executive Group and our sponsors on social media.

Change Healthcare –> @Change_HC
Cumberland Consulting Group –> @CumberlandCG
GuideWell Connect –> @_GWConnect
HealthEdge –> @HealthEdge
MarkLogic –> @MarkLogic
McKesson –> @McKesson
Softheon –> @Softheon
Virtual Health –> @VirtualHealth_

Part 2 of Health System & Health Plan Innovation, Change & Growth During Uncertain Times

By | AHIP, Health Literacy, Healthcare Reform, payer, Waste & Abuse | No Comments

health systems health plans focus for 2017 health reform outcome literacy members consumers #HITsmIn Part 1 of this series of posts, we shared some insight, ideas and opinions on the first of six topics shared in last week’s Health Information Technology Social Media (#HITsm) tweetchat Health System & Health Plan Innovation, Change & Growth During Uncertain Times.” A total of 72 participants tweeted over 650 times in the chat co-hosted by the Healthcare Executive Group, @_GWConnect and @_GuideWell.

In this second post, select insight, ideas, comments and opinions on Topic #2: What must health systems & health plans focus on over next 8 to 18 months regardless of health reform outcome? are shared. The remaining topics will be addressed in future posts.

Insight, Ideas and Opinions on Topic #2

Connect with Members, Consumers & Patients

  1. Create a connection with the patient that goes beyond the office visit.
  2. Identify, understand & work with ‘impactable members’ to help them make good, cost-effective decisions about their healthcare.
  3. Health systems & plans need to engage w/ patients & members on a more meaningful & regular basis. Not just via EOB’s.
  4. Find out what’s going on in patients’ homes and determine the services they need to keep them healthy.
  5. Include the patient in everything – from the patient’s own care to the growth of the health plan/system. Act on what they hear.
  6. This’s the ‘Hatched, Matched & Dispatched’ cycle. Health plans only ‘engage’ at enrollment, w/ claim EOB’s & at termination.

Address Waste & Abuse

  1. At #AHIPInstitute, Eric Topol said ‘75% of top 10 high cost drugs are prescribed to non-responding patients.” STOP the waste!
  2. Waste and overtreatment, heard from @DocLazris #ErikRifkin are on a mission against it. Video here: https://t.co/OvfS9zjFAW
  3. IMHO it’s important to educate people about how to use their insurance effectively to control their costs. Price Transparency too

Help Consumers Become Better Patients

  1. Focus must be on enable patients to take control of their own care and to be more involved through easy integration of tech.
  2. Universal language – like, “Do you accept my health plan?” Simple question but so often answered wrong.
  3. When these languages are translated into HIT, all those stakeholders interpret associated rules & allowances differently
  4. If you adopt universal languages, IMHO, you will see some of these issues disappear or at least some clarity enter
  5. Smaller, more often, more meaningful. I have to write stuff that’s specific, timely, and actionable – why does H/C bury me in dross?
  6. Anthem has a monthly health plan summary to members that contains ‘personalized and actionable’ health & wellness insights.
  7. “Self-Care Shows Promise In Keeping Individuals w/ Behavioral Health Needs Out of the ER” – Video here: https://t.co/y4As4wkwkY

Don’t Ignore the Masses – Invest in Preventive Services

  1. Insurance! Invest now to save later is a motto that not many want to hear but need to have more faith in.
  2. Need to focus on treating the largely ignored ‘healthy people’ to prevent them from becoming the 5% of patients consuming 22%
  3. I am going 2 go there. Inclusion. No high risk pools. The One-Plan Plan. With a focus on prevention and wellness to mitigate risk
  4. We need to start providing preventive treatments to the masses vs. spending lion’s share of resources on the few sick.
  5. Such a good question. I think prevention costs are minimal compared to the other side of heart surgeries or chemo…
  6. I know a plan that’s feeding care gaps to physicians, so they can stay ahead of the gaps. Also helps scheduling.

Focus on Core Mission & Quality

  1. Shedding/outsourcing operations not core to their mission – like moving data centers to the cloud are long overdue.
  2. All #healthcare needs to focus on quality of care, especially since value-based care and payments look like they will stay

Smartphones – Everyone Has One – Leverage Them!

  1. IMO, health systems & plans must enable consumers and patients to use those things they’re always staring at: Smartphones.
  2. Our President Dr Rene Lerer suggests smartphones will be the “most important part of your body” for health

Interoperability

  1. No matter the #ACA result, plans and providers must get along, and have systems/infrastructure to enable real-time data exchange.
  2. Also interoperability among healthcare tech platforms to provide better utilization of collected patient data

More on the Remaining Four Topics Coming Soon

Check back later this coming week to learn what chat participants shared on the remaining four topics:
      T3: Who’s most likely to disrupt healthcare: insiders or outsiders? And what barriers do each face – right now or in near future?
      T4: What technologies will do the most to move healthcare supply-side toward improving outcomes, lowering costs & enhancing equity?
      T5: Incentives drive innovation. How can they be aligned to meaningfully support innovation that improves outcomes & lowers costs?
      Bonus: What are examples of innovative healthcare programs, processes, people and organizations – U.S.-based or elsewhere?

One More Time!

Thanks again to our co-hosts @_GWConnect and @_GuideWell, John Lynn (aka. @TechGuy) of Healthcare Scene and to all those who participated in the chat.  A complete transcript of the chat can be found here.

For more about opportunities, challenges, and issues impacting healthcare plans, health systems and payers, consider following @HCExecGroup on Twitter and join us on LinkedIn and Facebook too.

Health System & Health Plan Innovation, Change & Growth During Uncertain Times – Part 1

By | 2-Total Consumer Health, AHIP, Healthcare Reform, payer, quality measures | No Comments

Healthcare-innovation-change-growth-executives-HCEG

Last week’s Health Information Technology Social Media (#HITsm) tweetchat was co-hosted by the Healthcare Executive Group, GuideWell and GuideWell Connect from the 2017 AHIP Institute & Exhibition in Austin, TX.

The theme of the chat was “Health System & Health Plan Innovation, Change & Growth During Uncertain Times” and following six topics were discussed:

T1: What specific ‘areas of opportunity’ must health plans/systems address to improve health outcomes, lower costs & improve equity?
T2: What must health systems & health plans focus on over next 8 to 18 months regardless of health reform outcome?
T3: Who’s most likely to disrupt healthcare: insiders or outsiders? And what barriers do each face – right now or in near future?
T4: What technologies will do the most to move healthcare supply-side toward improving outcomes, lowering costs & enhancing equity?
T5: Incentives drive innovation. How can they be aligned to meaningfully support innovation that improves outcomes & lowers costs?
Bonus: What are examples of innovative healthcare programs, processes, people and organizations – U.S.-based or elsewhere?

Thanks to Hosts & Participants!

Special thanks to John Lynn (@TechGuy) of Healthcare Scene, our co-hosts @_GWConnect and @_GuideWell and all the 70+ who participated in the chat.  A complete transcript of the chat can be found here.

Insight, Ideas and Opinions on Topic #1

This post shares insight, ideas and opinions shared by #HITsm chat participants on Topic #1. We’ll share more on the other topics in future blog posts.

Precision Medicine – aka. Personalized Medicine

  1. Precision medicine (aka ‘personalized medicine) was a hot topic at this week’s #AHIPInstitute in Austin.
  2. Patients with complex needs require a custom approach. Personalized medicine promises to improve outcomes at lower cost.
  3. Be excited when we get to the point where #AI effective for health plans. We’re still collectively digging for gold in claims data.
  4. Implementing positive changes in the healthcare industry that give clinicians the opportunity to view #PatientCare in a new light
  5. We definitely need this for #UX — the difference b/t changing your bank profile and your payer profile is enormous

Patients, Consumers & Health Plan Members

  1. It wasn’t that long ago that HC plan leaders were saying “HC plan members aren’t consumers,” LOL
  2. Addressing the healthcare needs of the #aging population of the country will need to take a seat in the front row
  3. Taking advantage of the data we are given to visualize the patient condition and identify at-risk patients earlier
  4. Getting members engaged and empowered in understanding, maintaining, and improving their own health journey
  5. Consumerism has been making inroads into healthcare, patients are acting like consumers about their healthcare options
  6. Until patients “get it” health outcomes can only improve so much

Importance of Basic Health Education, Literacy & Preventive Care

  1. Improving basic health education & literacy through active & coordinated outreach to members & patients is a big opportunity
  2. Improving education & literacy can be as simple as adopting universal languages so plan members aren’t constantly confused
  3. More focus to prevention & wellness. Reach patients before they get ill or have a major medical event.
  4. We need to focus more on prevention – spending too much on too few people – and often late in life.

Customer Relationship Management

  1. Customer service is an area of opportunity, healthcare needs to accept the change and adapt accordingly
  2. Before the healthcare industry dives into AI – they should incorporate basic CRM functions into #EHR systems. Huge communication disconnect!
  3. Addressing the need for clinical decision support and getting the right information available at the right time

Data is Critical to Healthcare

  1. Challenge w/ personalized medicine starts w/ lack of ability to accurately identify correct patient some crazy % of time…
  2. And, of course, standardizing data (#interoperability) to encourage cooperation between all #healthcare entities
  3. Systems that can use unstructured data to inform decisions. AI and machine learning?
  4. Real-time data sharing, especially clinical data, with providers and especially patients
  5. Absolutely! RTI approach needs to be incorporated from data driven perspective
  6. Systems need 2 embrace outcome-driven & SDOH/BDOH-driven ops to lower costs & affect outcomes. Walk the walk; we’ve heard the talk

The Importance of Home & Social Determinants of Health

  1. Health data taken from the home of the patient using this technology can be shown to doctors for perhaps better, tailored care
  2. Another area to take advantage of is using technology to bring healthcare to the home of patients.
  3. It is the space between heart beats where we live – IE not an “area” but care coordination between areas and with patients

Quality Measures & Measuring Outcomes

  1. How about better assessment & collection of what matters to members/patients? Instead of fancy analytics from quants?
  2. How do we measure feelings and happiness? Or are outcomes more quantifiable?
  3. System wide outcome driven treatment and outcome measures to tailor individual client centered care. Educate for prevention
  4. Analytics allows for effective clinical assessments by providing better patient outcomes
  5. We’re trying to do this now, in way, with HCAHPS/CAHPS, right? Don’t believe currently effective, but CAN be quantified.
  6. Do you see a worthwhile set of quality measures worth aligning to?
  7. Great idea: patient-centric measures. What outcomes do patients/members want to achieve, and what data do we need to drive them?
  8. We do this in OT for quality of life/ perceived ‘happiness’ with what is most valuable. All valid reliable and evidence based measure

Look for More on the Other Topics in Following Posts

Check back for more insight, ideas and opinions from the #HITsm chat. Thanks again to John Lynn and our co-hosts @_GWConnect and @_GuideWell and all those who participated in the chat.  A complete transcript of the chat can be found here. You can also follow @HCExecGroup to learn more about opportunities, challenges, and issues impacting healthcare plans, health systems and payers.

An Executive Leadership Forum at GuideWell Innovation Center

By | analytics, Executive Leadership Forum, Security | No Comments

Executive Leadership Forum at GuideWell Innovation Center hcldr hitsm innovationOur Executive Leadership Forum held at the GuideWell Innovation Center on Monday, May 8th was attended by 21 healthcare executives and solution provider thought leaders. The three-hour event – titled Operationalizing Before Analyzing: Healthcare’s Modern Journey Powered by Data – focused on some of the underlying challenges and issues regarding how healthcare data and analytics technologies impact consumers, providers and health plans.

The forum included lively discussion on real world use cases for healthcare data and analytics, a demonstration of live 3D interaction possibilities and a tour of the GuideWell Innovation Center. The forum was capped off by a happy hour for participants to network with each other and forum sponsors: MarkLogic and Intel.

In this post, highlights of the discussion between forum participants and key takeaways will be presented. In future posts, an overview of the 3D interaction demo and tour of the GuideWell Innovation Center will be shared.

HCEG Board Chair Ferris Taylor shared some information on the tour of the GuideWell Innovation Center and Live 3D Collaboration in this post on LinkedIn.

Demand for Real-time Data and Transactions

A lot discussion during the forum centered around current complexities and how demand for real-time data and transactions—across clinical, administrative and financial operations–is increasing exponentially every day and putting significant demands on service model / operations and legacy infrastructure, which are mostly batch / file transfer oriented.  Several issues were identified as current concerns:

  1. Many underlying data challenges
  2. Lack of agility in quickly responding to opportunities
  3. Inadequate data governance/provenance with ETL approaches in the legacy data pipeline

All audience members agreed they wanted faster time to market and better ability to respond to clients / market / regulations and be more agile when it comes to data. There was broad agreement that “data integration” is a journey that should follow a new data integration pathway instead of the legacy Extract-Transform-Load (ETL) approach:

Real World Use Cases

Over the course of the discussion there were a number of data capture and analytics use cases shared between forum participants. One use case described enrollment data submitted to the IRS on the 1095-B Health Coverage forms sent to individuals noting their qualified health coverage during each month in the year.

One participant described how the IRS had reported back to the health plan that 40% of the records submitted by the health plan to the IRS had errors in name, social security number and/or dependent status; basic required enrollment data elements that the plan was not able to validate or authenticate during the initial enrollment process and remained that way throughout the entire year. Garbage-In-Garbage-Out.

This “1095-B use case” elicited feedback from one forum participant having recent experience at the Census Bureau with the participant describing how government agencies often don’t have complete, accurate data. Just because CMS might have data of one quality level, they don’t always share that data with related agencies so the IRS or the SSA or state Medicaid administrators likely have different data.

Leverage All Data Types & 3rd Parties

Forum participants shared unique perspectives and a Q&A ensued on the example of how the Census Bureau uses associated data to significantly improve the timelines, accuracy and overall value of census data by editing it against 3rd party sources.  This Census Bureau use case and another use case described by forum participants of a BCBS plan emphasized that 3rd party data sources and unstructured data are very important to service improvement, member/patient experience, innovation and growth-oriented project investments.

Primary Investment Areas: Data Improvement & Integration Projects

Forum members identified the following investment areas for data improvement and integration projects that healthcare executives may implement over the next 12-18 months to modernize healthcare data and applications:

healthcare-data-integration-investment-areas-ELF-Blues-MarkLogicThought Leader Presentations

This Executive Leadership Forum was co-sponsored by MarkLogic and Intel. The information shared by these two sponsors are made available here:

    “Healthcare ‘Next Gen’ Data Projects”Bill Gaynor, U.S. Healthcare Director – MarkLogic, Inc.

    “Intel Healthcare Security Readiness Program Overview”Joan Hankin – Global Director of Marketing & Business Development – Healthcare & Life Sciences at Intel Corporation

In addition to information shared by MarkLogic and Intel, Constance Sjoquist, former Research Director at Gartner, also participated:

    “Disrupting the Status Quo in Healthcare” – By Constance Sjoquist, Chief Content Officer – HLTH, LLC.

Three Basic Tenets Unanimously Agreed

At the end of the forum, participants unanimously agree on three basic tenets:

  1. Complete and accurate data – especially basic demographic and social determinants – MUST begin with the first member/consumer/patient-provider interactions at the point of service
  2. Data needs to be authenticated, validated, verified and ENRICHED against other sources – then normalized across other supportive partners and their ‘systems of record’
  3. Today’s technology can support the capture, validation and use of healthcare data on a relatively inexpensive basis.

Join Other Healthcare Leaders

For more information on the Healthcare Executive Group and how you can become more ‘in the know’ and effective as a healthcare executive or thought leader, check out this information about becoming a member. You can also follow us on Twitter, friend us on FaceBook and follow us on LinkedIn.

Operationalizing Before Analyzing: Healthcare’s Modern Journey Powered by Data

By | Executive Leadership Forum | No Comments

Operationalizing analyzing data in healthcare organizations innovation programsOperationalizing data and analyzing data are not the same thing. Some healthcare organizations have made the painful and expensive mistake of focusing their innovation programs and growth investments on the “shiny ball” of analytics – the end stage of the data journey – instead of first improving the agility, speed and quality of the initial “operational” stages of the data journey: combining, enriching, indexing, searching, harmonizing, and alerting data. When it comes to operationalizing data and using information to help run the business, healthcare organizations must not fail to address numerous data silos, point-to-point integrations and other significant data-related challenges exacerbated by the lack of enterprise features such as security, transactional support, performance, and governance.

An Executive Leadership Forum Event

On Monday, 5/8/17 at 3:00 to 5:30 pm EDT, healthcare business and technology executives will meet at the GuideWell Innovation Center (Orlando, FL) to hear from healthcare business and technology leaders who’ve used “Next Gen” data concepts, strategy and technology platforms to fuel their industry innovation programs and digital transformation. This special healthcare executive leadership forum event is hosted by the Healthcare Executive Group (HCEG) and supported by HCEG’s sponsor MarkLogic and Intel. The event is open to all HCEG members and healthcare leaders, is free of charge and will be followed by a networking happy hour reception. Attendees of the 2017 Blue Cross Blue Shield National Summit may find this forum to be a great way to leverage their attendance at the Blues Summit.Healthcare Executive Leadership Forum at Guidewell Innovation Center

Who Should Attend?

Any healthcare executive with mission critical projects that require improved data agility and faster time to delivery should consider attending this unique leadership event:

  • Business Executives (operations, administrative, clinical) responsible for business “digital” modernization & improving experience / satisfaction initiatives.
  • Technology Executives (integration, architecture, infrastructure, development, security) charged with implementing and supporting operational and analytical data integration platforms to achieve business goals.healthcare executive leadership forum event - national blues summit orlando florida

What Business Executives Will Take Away

  • More insight into the competitive advantage and cost-savings a 360-degree view of Anything – member/patient, provider, etc. – can bring to a healthcare organization.
  • How creating profiles / preferences enhance engagement and experience while improving Net Promoter Scores (NPS).
  • Understanding of the business advantages and opportunities associated with ‘Next Gen’ data architecture and technology.
  • An understanding of use cases that increase business agility and improve time to market.
  • How continuous security, governance and sharing of data that’s usable and actionable is key to enabling growth and innovation.

What Technology Executives Will Take Away

  • An understanding of modern, multi-model “platform” approaches for integrating disparate data silos into a single operational and analytical infrastructure (secure, ACID compliant, etc.).
  • Awareness of the landscape of data technology vendors offering data platform solutions.
  • Why standalone, point solution “apps” or data “tools” present significant vendor lock-in risk.
  • How a metadata search approach supports rapid enterprise integration of structured and unstructured data.
  • Better understanding why top national healthcare organizations are implementing “Next Gen” data hub Centers of Excellence (CoE) to power their innovation programs and digital transformation.

More on Healthcare’s Modern Journey

For more information on leading the modernization and transformation of healthcare in 2017 and beyond, consider joining the Healthcare Executive Group and following us on our digital channels: Facebook, LinkedIn and Twitter. You can also subscribe to our bi-weekly newsletter.

Opportunities, Priorities & Challenges Facing Healthcare in 2017

By | Healthcare Reform, The Industry Pulse, Top 10, Uncategorized | No Comments

The HCEG Top 10 list of healthcare priorities, challenges and risks faced by healthcare industry executives is developed each year at HCEG’s annual forum. For the past seven years, the HCEG Top 10 list has served as the keystone for industry wide analysis, and subsequent research: The Industry Pulse, an annual survey initiative, conducted over the past seven years in partnership with Change Healthcare – a sponsor partner of the Healthcare Executive Group.

The Industry Pulse research survey is designed to gather additional insight on priorities and challenges facing healthcare industry constituents across the country and provide stakeholders across the healthcare spectrum real-world, actionable insight into near term obstacles and opportunities. Combined, the HCEG Top 10 list and The Industry Pulse encourage continuous and evolving dialog on the main issues and concerns facing member organizations.

The 7th Annual Industry Pulse Research Survey

On March 29th, a webinar provided an overview of highlights from The Industry Pulse was shared here to help industry leaders better understand the current healthcare environment, as well as to prepare for, and navigate, change. The webinar offered an initial interpretation of research survey results across the following topic areas:

  • The Current State of Clinical & Data Analytics (HCEG Top 10 Item #3)
  • Privacy & Security in a Data Driven Environment (HCEG Top 10 Item #4)
  • Customer Service: Cost vs Quality Transparency (HCEG Top 10 Item #5)

This post presents a recording of that webinar including the entire slide deck presentation and an infographic presenting some key findings from the 7th Annual Healthcare Industry research survey.

Webinar Recording

Presentation

Infographic

Healthcare industry insight recording healthcare industry pulse presentation deck healthcare industry pulse infographic

More Insight, Trends & Analysis

Over the following weeks and months, additional analysis and insight will be gleaned from The Industry Pulse and shared by HCEG and Change Healthcare. To stay abreast of the unique insight offered by the Healthcare Executive Group, the HCEG Top 10 list and The Industry Pulse research survey, be sure to subscribe to our newsletter and follow HCEG on Twitter, Facebook and LinkedIn.

How Total Consumer Health is Impacted by Technology and the Human Touch

By | 2-Total Consumer Health, 5-Transparency, Member Posts, Top 10, Value-Based Care | No Comments

healthcare executive group hceg medica healthedge total consumer health MACRA MIPS APM social determinants of health“Total Consumer Health” means improving ones overall medical, social, financial, and environmental well-being and was identified by HCEG members as the second item on the 2017 HCEG Top 10 list of priorities, challenges and opportunities facing healthcare executives.

Leveraging Medical, Social and Other Data

As value-based care continues to impact the provision of key healthcare services, health plans and providers are seeing an urgent need for improved collaboration centering on the individual member. Total consumer health increasingly relies on innovative technology systems to incorporate data based on life issues and social determinants of health. Providers and care givers must assess, capture and integrate key information that goes beyond mere observation.

By leveraging a mix of actionable data insights and on-the-ground support, health plans are in position to integrate critical technology with a high touch and hyper local approach to care coordination. Total consumer health outcomes are improved when key social determinants are combined with important medical information.

Learn more on Wednesday, April 19th at 2:00pm EDT

 

Join Dr. Alan Spiro, MD, MBA, Chief Medical Officer at Medica, and Harry Merkin, Vice President of Marketing at HealthEdge to learn:value based care total consumer health social determinants of health

  • The appropriate balance between high and low tech options for care coordination
  • How to incorporate innovative tools and methods to address social determinants of health and other factors
  • Real-world examples of innovative collaborative arrangements that are making a positive impact on outcomes

Presenters

Dr. Alan Spiro, MD, MBA – Chief Medical Officer, Medica

As Chief Medical Officer, Dr. Spiro has overall responsibility for the work of Medica’s Health Management segment. This includes working with Medica’s provider partners to develop new models of collaboration aimed at improving quality, patient experience and value. It also includes working with Health Management staff and leaders from other Medica segments to build on the work currently underway to improve the quality and cost of health care.  Follow Medica on Twitter.

Harry Merkin – Vice President, Marketing, HealthEdge

Harry Merkin is a senior marketing executive and is responsible for the company’s demand generation programs, strategic partnerships, product marketing and thought leadership initiatives. He also frequently represents HealthEdge as a speaker at industry conferences and events. Harry has collaborated with many transformative entities across the healthcare landscape including both payers and providers. Follow HealthEdge on Twitter.

Advancing Together: Healthcare Innovation in Wine Country

By | Healthcare Reform, The Industry Pulse, Top 10, Value-Based Care | No Comments

Healthcare innovation forum unitedag hceg hcexecgroup napa ca topics value-based-care

Note: This post was first published by Ferris Taylor on LinkedIn

It could have been the combination of a beautiful day in California’s Wine Country or just the extraordinary and varied perspectives of healthcare executives representing a true cross-section of American healthcare – payers, providers, vendors, purchasers and UnitedAg partners – that elicited deep discussion about value-based relationships and made the jointly sponsored Healthcare Executive Group (HCEG)-UnitedAG Health Innovation Forum such a successful event.  But whatever it was, the forum’s theme – Advancing Together – was clearly a spot-on phrase used to describe an informative and inspiring event.

UnitedAG’s hospitality and the diverse cross-section of attendees at UnitedAg’s Annual Meeting and Conference could not have set a more congenial and thought-provoking setting. Led by Kirti Mutatkar, UnitedAg CEO, Mike DeMore, Superior TPA’s Managing Director and Christopher McDonald, UnitedAg’s Director of Underwriting, the Health Innovation Forum kicked off an open dialogue of the critical issues and opportunities facing healthcare in 2017 and beyond.

The Healthcare Industry Pulse

After 30+ participants introduced themselves to each other, Ferris Taylor, HCEG Office of the Chair and Change Healthcare consultants, Chris Link and David Gallegos, presented highlights from the 7th Annual Industry Pulse Research survey. As is commonly said, a picture is worth 1000 words and Eris Weaver, a graphic recorder meeting facilitator captured many key points throughout the fast moving discussions.

Key research insights among the participants were shared on the impacts that clinical and data analytics can have on stakeholder interactions, workflows and especially on population health.  The transitions from more traditional risk management (disease and care management) to more 21st century tools and technologies were explored. Measures of success for the transition to value-based relationships were considered, especially those that will best serve consumers, healthcare providers and payers.  The Industry Pulse research also highlighted the roles that both cost and quality transparency will play in the future of healthcare.

Alignment of Incentives is Key

As revealed in the excellent graphics created by Eris Weaver as the discussions unfolded, “trust” was a key word arising multiple times.  Dr.  David DiLoreto, SVP at GE Healthcare and HCEG member, facilitated dialogue on the importance of more detailed innovations that value-based relationships demand. Dr. DiLoreto shared some insight experienced in Scandinavia and Denmark versus here in the U.S.

Population Health & Value-based Care

Dr. Arjun Chanmugam, Vice Chair of Johns Hopkins’ Integration and Health Care Transformation, Dr. David Nace, Chief Medical Officer at HCEG sponsor partner MarkLogic and Dr. Craig Brandman, CEO of StepOne Health, contributed their unique insights about the challenges and secrets of value-based health care.

More on Wednesday, March 29th, 2017

The morning of discussion in Wine Country was just the start of innovative thinking around value-based relationships.  Those discussions and more details from the Industry Pulse Research Survey will be shared via a webinar presented by HCEG and Change Healthcare on Wednesday, March 29th at 2:00 PM Eastern.

Free registration is available here.

Highlights from Day 1 of 2017 AHIP National Health Policy Conference

By | AHIP, Healthcare Reform, Healthcare Revolution, payer, Risk-Sharing, Value-Based Care | No Comments

The 2017 AHIP National Health Policy Conference kicked off today in Washington, DC.

Political, business, and health care leaders from across the nation gathered to dive deeply into our nation’s top policy priorities in an effort to move forward in today’s uncertain healthcare environment.

What a period for healthcare reform in the United States!

In addition to some general comments about healthcare policy and politics, today’s sessions addressed topics such as the following:

  • Risk-sharing and Cost Control
  • Value-based Care
  • Pharmacy Costs
  • Medicaid Exchanges
  • Importance of Social Determinants of Health

Social shares from conference attendees

As is happening more and more at many of today’s top healthcare conferences, conference proceedings, insights and other information were shared on Twitter – among other social channels. Here’s a sample of some interesting shares from Day 1 of the 2017 AHIP National Health Policy Conference.

Thanks to all those noted below who took the time to share with those who were unable to attend the conference.

General Stuff

Handle Tweet
@ajmc_journal There’s still a basic misunderstanding of how health insurance works, says @AHIPCoverage’s Tavenner
@rpalme01 @MD_Insurance @al_redmer ACA “status quo is not an option, status quo is not a solution”  #ACA
@nancyrwise Newt Gingrich sure that SOME bill will be passed this session…  but no direction on what it will include.  #AHCA
@nancyrwise T. Nickel, thank you: “Association Health Plans are awesome… until they are not”  @NAIC_News

Cost of Healthcare & Risk-Sharing

Handle Tweet
@ajmc_journal The only cost containment strategy that works is cost sharing but it can be such a burden that it takes care away–@chipkahn
@avercloud Healthcare payers: Make the move from pilot to full-scale bundled payment adoption. Let’s discuss at #AHIPPolicy
@leah_a_brown The discussion a few years ago was about coverage, now healthcare 2.0 is about cost.
@mahphealth Good point by MD Comm. Al Redmer Jr on NAIC panel Can’t do anything on premiums unless moderate cost of delivering #healthcare
@nancyrwise Great quote: “Pay for value = transferring risk to providers.” M. Chernew
@nancyrwise If health orgs are bigger & more integrated, they are better positioned to own market power: unlikely to lower costs. M. Chernew
@suemontgomery2 Cost of premiums is all about the cost of delivering care. – Ted Nickel at #AHIPPolicy

Value-based Care & Reimbursement

Handle Tweet
@ahipcoverage Consumers want affordable coverage & high-quality care – that’s what value-based care delivers.
@avercloud Debate the policy, but value-based healthcare is here to stay. Let’s discuss bundled payment success at upcoming #AHIPPolicy

Pharmacy

Handle Tweet
@springstex Prescription drug costs pass physician services as biggest slice of health insurance premium
@rpalme01 Keep talking to your local pharmacist and sharing what he tells you.

Medicaid Exchanges, Access & Importance of Social Determinants of Health

Handle Tweet
@ajmc_journal Healthcare reform is a question of access vs true availability. The devil is truly in the details, said @AndyGurmanMD
@nancyrwise Interested in continuing conversations about potential intersection of #Medicaid and Exchange markets in #healthcare #simplicity
@ahipcoverage From transportation, housing & environmental health, plans are addressing social determinants of health

Keep on Top of More Insight on Healthcare Reform

Be sure to follow the Healthcare Executive Group on Twitter, Facebook and LinkedIn where we share insight into the challenges, opportunities and issues facing healthcare executives and others in today’s fast-changing healthcare environment.