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.