Population Health, Value-Based Care, & The Engaged Digital Consumer – An Executive Leadership RoundTable

By | AHIP, analytics, Executive Leadership Roundtable, HCEG Top 10, Nashville, Population Health, Social Determinants of Health, Value-Based Care, Value-Based Payment | No Comments

On the 2018 HCEG Top 10 list, Clinical and Data Analytics, Value-based Payments and The Engaged Digital Consumer were ranked #1, #3 and #10 respectively by health plan, health system and healthcare provider executives who participated in identifying and ranking the 2018 HCEG Top 10. It seems fair to say that these three topics are front and center on the mind of executives and thought leaders in the healthcare industry.

Leverage Your AHIP Event & Nashville Connection

If you’re attending AHIP’s 2017 Consumer Experience & Digital Health Forum in Nashville or if you’re a healthcare leader in Nashville the afternoon of Thursday, December 7th, consider joining other healthcare executives and thought leaders at our Executive Leadership Roundtable. A panel of prominent healthcare leaders will meet at Nashville’s Center for Medical Interoperability at 1:00pm CT to accelerate the seamless exchange of information to improve healthcare for all by exploring emerging and high-priority healthcare opportunities at the intersection of population health, value based care, and the engaged digital consumer.

Join Healthcare Leaders & Forum Attendees in a Boardroom-like Setting

HCEG Executive Leadership Roundtable events are held in an intimate, informal and free-flowing setting where the free exchange of ideas, questions and comments are encouraged. This roundtable event will be moderated by Dr. David Diloreto with three distinguished panelists sharing their unique perspective and insight:

Dr. David Diloreto Ben Leedle Ferris Taylor David Gallegos
Senior VP of Healthcare-Population Health at General Electric President & CEO at Blue Zones and former President & CEO of Healthways HCEG Board Chair and COO/Consultant at Arches Health Plan Senior VP of Consulting Services at Change Healthcare

Timely Topics for Healthcare Leaders

A timely and valuable set of topics – with a special focus on Social Determinants and Clinical Data Impacting Population Health – are planned for panelists and attendees:

  • Innovative strategies health plans, health systems and provider organizations are using to reduce downstream spending while improving overall health outcomes by addressing social determinants of health.
  • How state-of-the-art data and technologies and opening new opportunities to move consumer health forward.
  • Opportunities to work with community leaders to identify the factors having the most influence on individual health and quality of life.
  • Considerations for tailoring specific approaches and investment to address the needs of health plan members and healthcare patients in their communities.
  • How ground-level community stakeholders can guide health plans and health systems to where funding creates the most effective SDOH improvements.

Extend the Value of Your AHIP Consumer Experience & Digital Health Forum Attendance

In addition to the value described above, this Executive Leadership Roundtable event will include a tour of the Center for Medical Interoperability, lunch and the opportunity for professional networking with roundtable panelists and participants. The Center for Medical Interoperability is a ten-minute ride from the AHIP Consumer Experience & Digital Health Forum being held at the Music City Center in Nashville, TN.

Reserve Your Seat Today!

Attendance at the roundtable is free for current and former HCEG members, attendees of the AHIP Consumer Experience & Digital Health Forum and local healthcare executives.  If you have any questions, please contact us.

Healthcare Executive Leadership Forum at Guidewell Innovation Center

Recap of Webinar: ‘Care Redesign: Lowering Costs While Improving Patient Outcomes’

By | HealthEdge, Sponsor, Value-Based Care, Webinar Series | No Comments

As more Accountable Care Organizations (ACO) are formed and as value-based reimbursement arrangements between payers and providers expand, the need for assessing non-traditional drivers of health outcomes, leveraging payer, provider and community resources and enhancing collaboration between patients, providers and payers are becoming key to improving outcomes and managing costs.

Our Thursday, October 26, 2017, Harry Merkin, VP of Marketing at our sponsor partner HealthEdge teamed up with Barbara Berger, VP of Care Management at First Care Health Plans, to present “Care Redesign: Lowering Costs While Improving Patient Outcomes,” HealthEdge’s entry in this month’s HCEG Webinar Series.  The webinar presented innovative, real-world examples of how First Care Health Plans is improving member outcomes and lowering their cost of care via three primary approaches:

  1. Collaborating with providers and health systems
  2. Partnering with community resources
  3. Making critical information available to key stakeholders

Addressing Discontinuances of Care

Barbara shared that, while the high volume, time-sensitive nature of healthcare delivery often leads to a discontinuance of care delivery and management between the silos in which payers and providers often operate, the increased data sharing associated with the emergence of ACO’s and value-based reimbursement and care models are helping to align care provided by providers and health plan payers. Examples of balancing the proper people, processes and technologies were shared.

Population Assessments and Social Determinants of Health

Barbara emphasized the importance of carefully and thoroughly assessing an individual’s health care, behavioral and social needs as part of a periodic, recurring population assessment and how doing so can have a key, beneficial impact to healthcare outcomes.  And with “Social Determinants of Health” forming the basis (bottom) of Maslow’s Triangle of Needs, First Care is starting to include an assessment of member’s social determinants of health in their population assessment program. Factors such as the following are included in the population assessment:

  1. Access to Healthcare Services
  2. Access to Food
  3. Access to Local Community Resources
  4. Access to Transportation Options
  5. Public Safety
  6. Financial Status

After Barbara shared her insight on this currently popular topic, Harry Merkin stated: “The phrase ‘social determinants of health’ is no longer a buzzword!”

Addressing Social Determinants of Health

Barbara shared an overview about First Care’s “Expecting the Best Maternity Program” that combines case management and utilization management to complement care provided by physicians while guiding and supporting members – and their family – through member pregnancies; particularly high-risk pregnancies.

Besides services such as assistance with locating medical providers, toll-free 24/7 access to a clinician and a package of select products and services aimed at supporting pregnant women, the program also includes an innovative “Nurse-Family Partnership” where a First Care nurse is paired with an expecting family to help the patient and her immediate family members understand and manage the pregnancy. First Care nurses regularly reach out to ask questions on how the pregnancy is progressing and answer any questions the patient and family may have.

The program has resulted in a significant per decrease in NICU maternity admissions.

The Recording, The Content and More Insight from HealthEdge

The webinar presented three considerations for payer-provider population health programs:

  1. Be methodical about population assessment
  2. Integrate People, Process and Technology with Providers
  3. Use value-based contracts to align vision of member/patient care

You can learn more about how collaborating with providers and health systems, partnering with community resources and making critical information available to key stakeholders can improve outcomes and lower costs by checking out this recording of the webinar and these few slides from the presentation. If you would like more information or if you have any questions on the content of this webinar, please feel free to contact HealthEdge too.

More Information

HealthEdge Website

HealthEdge on Twitter

First Care Website

First Care on Twitter

If you’re not a HCEG member and would like more information on becoming a member, please see this page or email Juliana Ruiz.

Announcing the 2018 Industry Pulse Research Survey

By | Annual Forum, HCEG Top 10, Healthcare Reform, The Industry Pulse | No Comments

HealthCare Executive Group Announces 2018 Top 10 Industry Issues List Industry PulseMany people familiar with the HealthCare Executive Group (HCEG) know that the HCEG Top 10 list has been a keystone of the HealthCare Executive Group for over a decade – 13 years to be exact. The HCEG Top 10 identifies the current opportunities, challenges and issues that HCEG members and their healthcare organizations face during this era of healthcare reform and transformation. The items on the yearly HCEG Top 10 serve to encourage continuous and evolving dialog and drives HCEG’s programming, webinars, blogs, whitepapers, research and discussion throughout the coming year.

HCEG Top 10 as Basis for the Industry Pulse

The HCEG Top 10 also serves as the framework for the Industry Pulse – an annual research survey conducted jointly by HCEG and Change Healthcare. The Industry Pulse research survey collects additional insight, experiences and opinion on specific items of the HCEG Top 10 list. Healthcare executives, thought leaders and other industry participants serving all areas of healthcare may participate. The results of the Industry Pulse can provide valuable, relevant data-driven advice and end-to-end industry insights to help healthcare leaders navigate the complexities of our rapidly evolving healthcare system.

Share your Insight Today!

HCEG and Change Healthcare would like to invite healthcare leaders from across the nation to participate in the 2018 Industry Pulse research survey and to backdrop and contrast their own perspectives against the 2018 HCEG Top 10.Please consider sharing your insight, experiences and opinion as your perspective will help define the issues facing healthcare, and reveal how the industry is responding.

Everyone who completes the 8th Annual Industry Pulse Survey will be among the first to receive survey results as well as exclusive access to future webinars, content and events that will be delivered over the new year; expounding on survey results and providing additional insight and value to all healthcare constituents.

Healthcare Executive Group Supports National Health IT Week – October 2-6, 2017

By | Annual Forum, HCEG Top 10, Healthcare Reform | No Comments

NHITWeek National Health IT Week HealthIT healthtech HIMSS HCEGToday marks the start of National Health IT Week (#NHITWeek,) a collaborative and partner-driven event whose purpose is to promote the awareness and demonstrate the use of information technology in:

  • Supporting Healthcare Transformation: The many ways in which health IT is driving transformation in healthcare delivery including improvements in quality and safety, interoperability, advances in innovation, and patient and consumer activation and engagement.
  • Expanding Access to High Quality Healthcare: Use of innovative technologies including telehealth and remote patient monitoring to improve healthcare access, coordination and outcomes.
  • Increasing Economic Opportunity: Highlighting the importance of a robust, diverse health IT workforce and health IT’s role in supporting economic growth.
  • Making Communities Healthier: The fundamental role health IT plays in supporting population and public health

As a group of executives, thought leaders and advisory partners serving health plans, health systems and provider organizations throughout the United States, the Healthcare Executive Group (HCEG) is proud to partner with and to support National Health IT Week and the above points of engagement – this week of October 2 – 6, 2017 and throughout the year. You can learn more about #NHITWeek and related events here.

The 2018 HCEG Top 10

To kick of National Health IT Week, the Healthcare Executive Group is pleased to announce the formal release of the 2018 HCEG Top 10 list of opportunities, challenges and issues facing executives of health plans, health systems and provider organizations in the United States.

The HCEG Top 10 has been a keystone of the Healthcare Executive Group for over 13 years and provides insight into the most current, pressing priorities facing their industry. Based on HCEG member input and sponsor partner research, the HCEG Top 10 serves as a framework for continuous and evolving dialog among healthcare executive members on the critical opportunities, challenges and issues facing their organizations. Educational programming including periodic Executive Leadership Round Tables, research initiatives, monthly webinars, whitepapers, blog posts and ongoing member discussion are all driven by the HCEG Top 10.

For more information on the 2018 HCEG Top 10, see today’s press release and visit our web site.

Help Spread the Word About National Health IT Week

Never before has the digital transformation of healthcare been so pervasive and rapid. Health information technology is key to advancing the imperative points of engagement emphasized during National Health IT Week. Please join the conversation on social media by using the #NHITWeek hash tag. Share how you and/or your organization is using health information technology to transform points of healthcare and health outcomes.

HCEG will be participating in NHIT Week by sharing content via its social channels, member LinkedIn pages, and via this blog. For more information, insight, ideas and commentary about National Health IT Week, healthcare, healthcare information technology and the digital transformation of healthcare, consider following us on Twitter, LinkedIn and Facebook – and subscribe to our eNewsletter.

Healthcare Executive Group’s 2017 Annual Forum – Social Media Highlights

By | Annual Forum, Executive Leadership Forum, HCEG Top 10, Healthcare Reform, The Industry Pulse | No Comments

healthcare executive group hceg digital transformation annual forumThe 29th Annual Forum of the Healthcare Executive Group held in Nashville last week included nine sessions lead by healthcare industry leaders. These industry veterans and thought leading panel members provided forum participants with a wealth of information and insight into key areas of healthcare reform, innovation and digital transformation.  As might be expected, insight, ideas, opinions and concerns surrounding the areas of Consumer Engagement, Transparency, Population Health, Health Plan-Provider Data Exchange, and Merger & Acquisition activity within the digital healthcare space were common across nearly each of the nine sessions presented at the forum.

As noted in this previous post, content from these sessions will be shared over the coming days and weeks.  In this post, highlights from each of the above referenced areas shared by forum participants via social media are presented. Special thanks to all those who shared via their social channels. To receive other information shared during our 2017 Annual Forum, consider subscribing to our newsletter and following us on our social channels: Twitter, LinkedIn and Facebook.

Consumer & Patient Engagement

“Doctors working at the ‘Top of their license’ will address most of the provider shortage.” – Mark Stryker @themarkstryker of @Leverage_Health quoting Dr. Karen DeSalvo @KBDesalvo

“We’re working w/ our retail pharmacy partners to help them to better help consumers.” – Jim Sheninger of @GoodRx

“Engagement starts w/ developing culturally sensitive trust of providers treating patients.” – Hugh Lytle @equalityceo of @EqualityHealth1

“Need time to develop trust w/ others; it typically takes 30 days of near daily engagement.” – Rich Rakowski of Medically Home

“Coins term ‘Co-vider’ where healthcare consumer serves as 1st provider identifying (diagnosing?) medical condition.” – Steve Sisko @ShimCode quoting David Vinson of @DHXGroup

“We’re trying to put the pharmacist in front of the counter – to more easily interact with consumers.” – William Resnick of  EmpiRx Health

“Many health plans have lost sight that they’re essentially a community of people that must be regularly engaged.” – Torben Nielsen @TorbenSNielsen of Premera

“Near unanimous consensus by participants that technology is not the problem; rather policy, inertia & politics.” – Steve Sisko

Population Health

“What’s your one ‘dashboardable metric?” Rich Rakowski: “A 30-50% savings for the payer for patient condition.” – Ben Leedle of Blue Zones, LLC asking  “What was Missed in Two Decades of Population Health – Today’s Opportunities for Disruptive Innovation” panel

“Cognitive behavioral therapy is becoming first line treatment for insomnia; not drugs.” – Joe Jennings, CEO at BeHealth Solutions @behealthsolns

HCEG Annual forum healthcare executive group healthtechSocial Determinants of Health

“Katrina lesson: sensitive extreme collaboration. Social determinants become real.” – Chuck Martel @cmartel on Dr. Karen DeSalvo keynote

“Our zip code affects our health more than our genetic code.” – Richard Lungen @rlungen of @Leverage_Health quoting Dr. Karen DeSalvo

“Healthcare spend and trend is crowding out other essential social investments. Agree?” – Mark Stryker on Dr. Karen DeSalvo keynote

Accountable Care Organizations

“First step to ACO success: providers and payers agree to ‘put down their weapons’ with data.” – Chuck Martel quoting John Poelman @JHPoelman of Leavitt Partners @leavittpartners

“Panelists note there is no clear correlation between #ACO financial results and quality measurement outcomes.” – Steve Sisko quoting panelist in “Value-Based Reimbursement/Relationships” session

Digital Health

“Data is the single most important element we’re just beginning to exploit.” – Chuck Martel quoting Torben Nielsen in “Healthcare & Consumers Going Digital – Is HIT a Disruption or Opportunity?” session

“The unabated proliferation of healthcare apps is “Appageddon.’” – Steve Sisko quoting David Vinson

“I work in healthcare during the day. And then I go home to the 21st century.” – Torben Nielsen

“Technology and Technology companies’ are re-creating what health looks like.” – Mark Stryker paraphrasing Dr. Karen DeSalvo keynote

Transparency of Price & Quality

“Need to differentiate between price transparency & transparency of clinical efficacy & potential interactions.” – Blake Slansky of Walgreens

“Are we going to try to compete w/ Amazon on cost? Or quality of service? How will we protect our position?” – Forum Attendee asks panel addressing “Pharmacy Costs / PBM and Rx Transparency”

“Only two countries allow Direct to Consumer marketing of prescription drugs: United States & New Zealand.” – Nichole (Nikki) White of Medica

Mergers & Acquisitions in Healthcare

“What are some of the things that are going well or not so well in healthcare M&A?” – Justin Roth of Triple Tree Investments @TripleTreeLLC asks “Technology Innovation and M&A Market Trends” panel

“Need to move cultural due diligence upstream in the M&A process.” – Tom McEnery of Change Healthcare @Change_HC

“Having a designated liaison for each functional area. And be sensitive to culture of each area.” – Paul Wallace of Heritage Group USA

hceg annual forum digital health annual forumPlan Provider Data Mgmt

“Providers view data updates as a misplaced burden & something that disrupts patient care.” – Charlie Falcone of Aperture Credentialing during “Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives” panel

“The proliferation of networks – especially ACO’s – has exacerbated provider directory data accuracy issues.” – Ian Gordon of Regence/Cambia Health Solutions @Cambia

“Working w/ data originators to co-develop data exchange processes vs. dictating requirements can improve data.” – Ian Gordon

“Differing state regulations & mandates hamper ability to develop shared plan-provider data mgmt processes.” – Steve Sisko paraphrases Charlie Falcone

“Provider data management is not a strategic act but an ongoing tactical & operational activity.” – Russ Thomas of @Availity

“Plan-provider data management is not a technology problem; it’s an engagement challenge.” – Ian Gordon

“Health plans generally don’t view provider data management as an area where they need to compete.” – Russ Thomas

“Panel members all agree that #ACA should have mandated plan-provider data requirements, standards & update processes.” – Steve Sisko paraphrases “Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives” panelists

Innovation

“Innovation without integration will not yield sustainable results.” – Donato Tramuto @DonatoTramuto of Tivity Health @TivityHealth

“Fail to succeed…glean something from every mishap and mistake.” – Donato Tramuto (Via @Tivityhealth)

“Core competencies are transferrable. Don’t confuse what people do with what they are good at.” -Tom McEnery

There’s More Coming!

We’re just getting started with sharing content from last week’s 29th Annual Forum of the Healthcare Executive Group. We’ll be sharing recaps from individual sessions, participant interviews, pictures from the forum and more.  So stay connected and in the loop by subscribing to our newsletter and following us on our social channels. Better yet, consider becoming a member today!

A Unique Event and Exclusive Group for Healthcare Executives

By | Annual Forum, Executive Leadership Forum, Member Benefits, Sponsor, The Industry Pulse, Top 10 | No Comments

Our 2017 Annual Forum came to a close at noon this past Wednesday. Over 110 healthcare executives, nationally known healthcare speakers and industry thought leaders gathered in Nashville, TN – Music City and the Healthcare Capital of the United States – to share their insight, ideas and concerns about healthcare reform and digital transformation during these rapidly evolving, uncertain times in healthcare.

The 29th Annual Forum featured three keynote speakers, nine sessions covering the latest topics of interest to executives leading health plans and health systems and three nighttime events structured to support networking between forum participants. All in all, the two and half days of our 2017 Annual Forum added up to one incredible opportunity for those leading the digital transformation of healthcare reform in the United States to come together on an intimate basis , to share and learn with each other collaboratively.

The 2018 HCEG Top 10 List

As has taken place during each of the last seven HCEG Annual Forum events, participants selected and voted on the Top 10 Opportunities, Challenges and Issues facing health plan and health system executives over the coming months and year. This new 2018 HCEG Top 10 list will drive the focus of Executive Leadership Round Tables, webinars, content development and other collaborative opportunities throughout the remainder of 2017 and the coming new year.

What We’ll Be Sharing From Our 2017 Annual Forum

Over the next few weeks, insight, ideas, opinions and concerns generated during the forum will be shared with members and the public at large. We’ll recap forum speaker and participant insight and opinion into how healthcare in the United States will be impacted by healthcare policy reform, digital transformation initiatives and both national and state-level actions. Readers of this blog, our friends on social media, attendees of our webinars and round tables and subscribers to our newsletter can look forward to how speakers, panelists and participants at our 2017 Annual Forum shared insight on the following:

  • How Clinical and Data Analytics leverage clinical evidence to segment populations, manage health and drive decisions
  • How the emergence of Population Health Services Organizations are operationalizing population health strategy, chronic care management, driving clinical integration, and integrating social determinants of health
  • How Value-Based Payments are being used to target specific medical conditions to manage cost and quality of care
  • How Cost Transparency is inevitable due to growing legislation and consumer demand
  • And more certain topics that can help healthcare leaders address transformation during these uncertain healthcare times

How We’ll Share

The Healthcare Executive Group will share the following via its web site, blog, social channels – including Twitter, LinkedIn an Facebook, and via other channels including member LinkedIn accounts, sponsor partner media and healthcare industry media. Look for the following:

  • Quotes from Keynote Speakers & Panelists
  • Session recaps including Presentation Materials
  • Thoughts from Forum Participants including social media shares
  • Audio Soundbites
  • Pictures and more

How to Stay Connected

To have this valuable information pushed to you, subscribe to our newsletter, follow the Healthcare Executive Group on LinkedIn, Twitter and Facebook; and consider becoming a member of our unique organization of Healthcare Executives. Learn more about the Healthcare Executive Group here.

Healthcare Leaders Identify Top 10 Opportunities, Challenges & Issues at HCEG Annual Forum in Nashville

By | Annual Forum, Executive Leadership Forum, The Industry Pulse, Top 10 | No Comments

Certain healthcare organizations at the forefront of healthcare research and thought leadership have an information product they’re known for:

Gartner has its Magic Quadrant and Hype Cycle rankings

KLAS Research has its Best in KLAS reports

Forrester has its Forrester Wave

Chilmark Research has its Market Trends Reports.

And the Healthcare Executive Group has the HCEG Top 10 List.

To be sure, the Healthcare Executive Group (HCEG) isn’t on the same plane as these healthcare research firms listed above. The Healthcare Executive Group doesn’t have sales people balancing objective analysis with the need to generate revenue to keep the doors open. HCEG is a relatively small (by design), membership-based organization of mid-market healthcare executives in a national network who gather together physically and virtually throughout the year to learn from each other as they navigate the strategic and tactical issues facing they face as health plan and health system leaders. The concept is really quite simple and powerful:

HCEG’s mission is to promote healthcare innovation, to provide innovative knowledge support and to help sustain the development of life-long relationships through real-life and virtual relationships.

For almost 30 years, the Healthcare Executive Group has served as a channel for the open exchange of ideas, providing content, channels and opportunities for collaboration, and ongoing support for transformational dialogue among its members. The HCEG Top 10 List helps focus and drive this content development, member dialogue and knowledge exchange.

What’s the HCEG Top 10 List?

While each HCEG member and the healthcare organizations they represent are unique, all face common opportunities, issues and challenges. Technology, healthcare reform initiatives and innovation opportunities are moving quickly. The longevity of our member companies and our members own livelihood depends on their ability to identify and sufficiently address opportunities, issues and challenges; as they are presented; and as quickly as possible.

The HCEG Top 10 represents the top 10 opportunities, issues and challenges that HCEG members – health plan and health system executives at the forefront of healthcare reform – collectively identify as the most important and urgent to address over the following year. Our members consider the Top 10 items as having significant and lasting impact in the way health plan members, healthcare consumers and patients all become engaged, digital consumers and responsible healthcare stakeholders.

How is the HCEG Top 10 List Developed?

About two months in advance of HCEG’s Annual Forum, an initial list of approximately 25-30 opportunities, challenges and issues are identified by HCEG members via a survey process.

Then a set of questions intended to refine and clarify each of the 25 – 30 items are defined. These questions are intended to help members better understand each item and encourage well-measured responses. To the greatest degree possible, the questions for each topic are designed to elicit discrete, standardized responses; common industry terminology and pick lists of potential responses are used wherever possible.

These topics and their supporting questions are then entered into a survey tool and shared with all HCEG members. At the HCEG Annual Forum, members review and discuss each topic and associated questions. A series of rankings take place to winnow the list down to the Top 10 items. Members have the opportunity to question each item, each other and to rank each item publically or privately. At the end of the second day of the Annual Forum, the new Top 10 List is formally defined and shared with all forum participants and other HCEG members who may not be in attendance at the Annual Forum.

How is the HCEG Top 10 List used?

The HCEG Top 10 List is used for two general purposes, each of which are intended to address the so-called Triple Aim of Healthcare.

1. Content Development & Programming

The HCEG Top 10 list serves as the basis for HCEG’s ongoing content development and educational programming opportunities throughout the year. Each of the Top 10 items is explored at various levels of depth and breadth throughout the year and delivered to HCEG members via various mechanisms and channels including:

2. Development of The Industry Pulse

In addition to guiding the overall thought-leadership, content development, and knowledge exchange initiatives throughout the year, HCEG’s Top 10 Priorities, Issues & Challenges list serves as the basis for The Industry Pulse– a national, industry-wide survey where healthcare leaders across the nation are invited to participate in additional research to backdrop and contrast their perspectives against the items on the Top 10 list.

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 2018 HCEG Top 10 List

Our 2017 Annual Forum will be held on September 18 – 20th in Nashville, TN at the Thompson Hotel and the 2018 HCEG Top 10 list will be developed during this three day forum. Developing the latest HCEG Top 10 List is an exciting part of our Annual Forum and we expect lively and thought-provoking discussion experienced in previous forums.

For more information on the Annual Forum including how to register and be a part of defining the 2018 HCEG Top 10 List, see this page.

For more information on HCEG and to learn what ends up on the 2018 HCEG Top 10 list, be sure to subscribe to our newsletter and follow us on our social channels: Twitter, LinkedIn and Facebook.

Related Posts

Previous HCEG Top 10 lists 

Collections of Information on HCEG’s 2017 Top 10 List

Opportunities, Priorities & Challenges Facing Healthcare in 2017

The HCEG Top 10 List – Innovating and Transforming the Healthcare Industry

How Predictions About Healthcare in 2017 Compare to HCEG Top 10 List

Change Healthcare and The HealthCare Executive Group Announce Results from 7th Annual Healthcare Industry Pulse Research

“Specialty Networks and Risk Sharing at Scale” – A Session at HCEG’s Annual Forum

By | Annual Forum, Risk-Sharing, Value-Based Care | No Comments

“Specialty Networks and Risk Sharing at Scale” – Monday, September 18th at 3:15PM – 4:30PM

At this year’s 29th Annual Forum in Nashville, TN, Dr. Richard Popiel, EVP & Chief Medical Officer at Cambia Health Solutions, moderates a panel presenting and discussing the current needs, opportunities, and challenges associated with improving the appropriateness, outcomes and affordability of specialty care services; specifically the clinical decision support mechanisms and other solutions that risk-sharing, value-based environments need to simplify, encode and utilize complex clinical content into a standardized, repeatable, evidence-based system for making decisions supporting an organization’s clinical programs.

Dr. Popiel and other healthcare industry experts will present how we as a healthcare system can improve healthcare outcomes and reduce costs by shifting to value and risk sharing arrangements. Insight into how disruptive analytics and analytical approaches to cost trend monitoring and containment will be shared and interactive opportunities to engage will be available.

Healthcare Thought Leaders Share Valuable Insight at HCEG Annual Forum

Panel Moderator – Richard Popiel MD MBA 

Dr. Richard Popiel, Cambia Health Solutions

Richard Popiel, M.D., MBA, Executive Vice President, Healthcare Services & Chief Medical Officer, Cambia Health Solutions & Regence Health Insurance Company

Dr. Richard Popiel leads medical strategy for Regence health insurance plans and provides executive leadership on care initiatives and cost management activities across the corporation. He came to Regence from Horizon Healthcare Innovations, where he was president and chief operating officer. Dr. Popiel earned a B.S. in biology and his M.D. at The George Washington University in Washington, D.C. He also holds an M.B.A. from Northwestern University Kellogg School of Management. He is board-certified in internal medicine.

Panelists include: (Additional panelists are pending confirmation)

Brandon Cady

Brandon Cady – President/CEO at AIM Specialty Health

Brandon Cady is the President and Chief Executive Officer of AIM Specialty Health® (AIM). Brandon joined AIM in 2002 and executed top line growth initiatives that expanded the business into one of the largest and most successful specialty benefits management companies in the United States.

Brandon has held a variety of leadership positions within hospital systems, health plans, and emerging technology companies. Brandon earned his master’s degree in Health Services Administration from the University of Michigan in Ann Arbor and a Bachelor of Business Management from the University of Iowa.

Dunston Almeida

Dunston Almeida – Executive VP of M&A Strategy and Business Development at Evicore

Dunston Almeida serves as an Executive Vice President of M&A Strategy and Business Development at eviCore healthcare, LLC. Dunston focuses on new strategic initiatives and partnerships, driving inorganic growth via mergers and acquisitions (M&A) and working with the Board and Executive Team on the company’s Strategy Council. He also supports the formulation of eviCore’s public policy and regulatory efforts. He has more than 20 years of experience in technology.

 

The 2017 HCEG Annual Forum

The HCEG Annual Forum provides the setting and platform for senior level executives from across the healthcare spectrum to come together for 2-3 days each year to discuss the continuous innovation, evolution and transformation of the industry. Attendees are granted direct access to approximately 100 peers, thought-leaders and solutions providers from around the country; all facing similar obstacles and providing opportunities, while engaging in real, relevant and productive dialog.

This year’s 29th Annual Forum takes place in Nashville, TN on September 18th -20th. For more information on this years annual forum, see this page.

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

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2017 HCEG Annual Forum Speaker & Agenda Information

By | Annual Forum, Member Posts, Sponsor, Top 10 | No Comments

Thompson Hotel Nashville (Image Thompson Hotels)

To succeed in today’s uncertain and tumultuous healthcare environment, health plans, health systems and provider organizations must develop a clear strategic identity supported by a distinctive portfolio of platforms, products, and services that transform their chosen strategy into a winning business model. Change, Innovation and Growth are imperative to survive in today’s healthcare environment.

This September 18th though the 20th, the 29th Annual Forum Healthcare Executive Forum takes place in Nashville, TN at the Thompson Hotel Nashville. Leading experts in health care policy, operations, reimbursement and digital health will examine the opportunities, challenges and issues healthcare executives must face in 2017 and beyond. This blog post provides some details on the speakers and presenters, more detail on the opportunities, challenges and issues that will be discussed, and more on what participants in our 2017 Annual Forum can expect to enjoy.

Keynote Speakers at 2017 Annual Forum

Karen DeSalvo Opening with Interactive Q & A

A great line-up of keynote speakers, moderators and panelists are on tap for the Annual Forum.  On Monday the 18th, Karen DeSalvo, Assistant Secretary for Health at U.S. Department of Health and Human Services, will provide the opening keynote address which will be immediately followed by an interactive Q & A session as lunch is served. The interactive Q & A format offers forum participants a unique opportunity to interact among themselves and with a leading healthcare policy executive.

Open discussion on important topics with a diverse set of peers all actively working to address healthcare outcomes and costs in the United States is a distinctive feature of all HCEG events – particularly the Annual Forum.

Donato Tramato, CEO of Tivity Health, Life’s Bulldozer Moments

During breakfast on Tuesday, Donato Tramato, CEO of Tivity Health (formerly Healthways), will provide a motivational keynote address: “Life’s Bulldozer Moments:”How Adversity Leads to Success in Life and Business.” Donato will recount business and life lessons learned and show that adversity can lead to success – how anyone bulldozed by life can pull themselves out of the rubble, dust themselves off and find meaning and purpose.

Later on Tuesday, another Nationally and Internationally recognized healthcare executive speaker will address forum participants as dinner is served.

As with all HCEG forums and executive leadership events, participants will be able to interact with speakers and other forum participants – asking questions and sharing viewpoints, with the objective to develop actionable strategies to each of their organizations.

Unparalleled Mix of Moderators & Panelists

In addition to the keynote speakers, a select group of healthcare industry leaders which includes some HCEG members will serve as moderators and panelists sharing their unique insight and perspective on a number of carefully selected topics.  Some of these individuals include:

A complete list of these moderators and panelists can be found here.

Certain Strategies for Uncertain Healthcare Times

The following are a sample of the sessions planned for the Annual Forum:

Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives

Recent CMS call letters, proposed mandates and new state and federal level regulations regarding provider networks underscores the value and importance of addressing data quality via effective communication and collaboration between health plan payers and providers. Hear from panel members on approaches for ensuring network adequacy, complying with real-time provider directory updates and related impact of No Surprise Bill legislation sweeping the country.

Leading Edge Technology / Disease Management / Population Health

Disease management and Population Health has struggled in the past and now is giving way from identifying and matching people living longer with multiple chronic conditions to providing cost-effective, scalable mitigation and support services/products needed by this rapidly changing population. Panelists will discuss opportunities, challenges, and issues for improving clinical and costs via services and technologies addressing access to care, supporting interaction among constituents, and reducing costs via analytics, artificial intelligence and alternative/virtual reality services.

Pharmacy Costs / PBM and Rx Transparency

Prescription drugs are a fast-growing part of most large employers’ total medical spend and the increasing prevalence of high-deductible health plans have put on spotlight on the importance of Rx price transparency, benefit design and pharmacy benefit management practices. This panel will examine opportunities for managing the financial and non-financial/clinical aspects of prescription drugs, working in revolutionary ways with PBM’s, while ensuring optimal outcomes and member/patient satisfaction.

Specialty Networks and Risk Sharing at Scale

Value-based care programs and risk-sharing in accountable care organizations are core components for delivering and paying for care more effectively and efficiently. This panel will discuss and explore how opportunities and issues with specialty networks and support for risk-sharing at scale.

Precision Medicine and Behavioral Health Aspects of Substance Abuse/Opioids

As the use and abuse of opioids skyrockets, precision medicine technology that successfully stratifies patient risk by analyzing genetic and non-genetic (environmental & lifestyle) risk factors to accurately predict prescription opioid abuse show promise of helping physicians choose more effective treatments and reduce addiction risk while lowering cost. This panel will explore how health plans and providers can utilize precision medicine to achieve a new standard in healthcare delivery based on evidence-based insights and predictive analytics.

Digital Health & Consumer Engagement

Certain digital health technologies are rapidly becoming an integral way of connecting to and engaging with the healthcare consumer. Though still being decided, this panel will explore the digital technologies most likely to gain consumer acceptance, engagement and lead to real improvements in overall well-being, outcomes and cost-reductions.

Technology Innovation and Healthcare M & A Market Trends

Achieving scale via M & A deals and through dedicated ‘innovation programs” have been a popular way for health plans and health systems to create “quick-win” value.  And health plan/health system leaders must employ a smarter, more sophisticated scale equation to derive the most value from these approaches. This panel will review current trends in healthcare innovation and M & A activity and discuss risks and benefits of various value creation strategies.

Additional Forum Events and Opportunities

In addition to a knowledgeable group of healthcare visionaries and thought-leaders exchanging information, ideas and opinions with forum participants, participants at the 29th Annual Forum will enjoy other critical networking and perspective sharing events and opportunities including:

  • Meet and Greet at Thompson Hotel – Sunday night
  • Off-Site Reception with great Nashville music on Monday the 18th
  • Catered breakfasts, lunches and dinners each day of the forum
  • Nashville Late Night Party – Tuesday the 19th
  • Participate in identifying and selecting the 2017 HCEG Top 10*
  • Networking and open discussion with all speakers, moderators, panelists and forum attendees

For more information on the 2017 Annual Forum of the Healthcare Executive Group including registration, visit this page.