2017 Top 10 Challenges & Issues Discussed on the #HITsm Tweetchat

By | Healthcare Revolution

2017 Top 10 Challenges & Issues Discussed on the #HITsm Tweetchat

The #HITsm tweet chat is a popular Twitter chat about healthcare information technology and related topics.  The chat is sponsored by @HealthStandards and is held every Friday at 9:00am PT. This week, the theme of the #HITsm chat will be the Top 10 Challenges for Healthcare Executives and the chat will be moderated by HCEG’s very own Ferris Taylor, COO of Arches Health Plan.

The HCEG Top 10 list is developed by HCEG members each year and forms the basis for examining critical priorities, challenges and issues faced by health plans and healthcare providers in the post-reform era. The #HITsm chat will present five topics intended to support and compliment the 2017 Top 10 Challenges & Issues list.

Topics for the #HITsm Tweetchat

Topic 1: What do you think are the main issues and concerns facing healthcare organizations?
Topic 2: What are some ways to identify and prioritize challenges and issues specific to your healthcare organization?
Topic 3:  How can you establish an environment that communicates the importance of change and welcomes opinions and new ideas?
Topic 4:  What are some ways to inform & engage others – in your firm & broadly across industry – in large transformational initiatives?
Topic 5:  Why do you think healthcare innovation lags that of other industries? And what can be done to ameliorate that?

Background on the HCEG Top 10 List

Based on HCEG member input and sponsor research, the HCEG Top 10 list serves as the basis for continuous and evolving dialog on the main issues and concerns facing healthcare payers, providers and other constituent organizations. The Top 10 list has been published every year for the last decade and you can find more information on this year’s list and previous year’s Top 10 lists here.

What’s Next for the HCEG Top 10 List?

In addition to serving as the basis for a wealth of research, white papers, webinars, blogs, and formal and informal discussion opportunities available throughout the year, the Top 10 list serves as the basis for The Industry Pulse: a research survey project executed via a partnership between HCEG and Change Healthcare.  This survey will be available October 31st and all #HITsm tweet chat attendees are encouraged to take the survey:  IndustryPulse

Reading Material

The following are some additional materials on opportunities, challenges and issues facing the healthcare industry:
Why Health Care Innovation Lags (And What To Do About It)
What are Healthcare Executives Focusing on for 2017
Top 10 healthcare issues to watch in 2016
Disruptive Innovation in Healthcare: What to Expect in 2016
2016 Industry Pulse
Healthcare Innovation and the Four Key Digital Health Trends Expected for 2016 (Part 1)
Healthcare Innovation: How 2016 trends are already evolving (Part 2)

Come Join the #HITsm Tweetchat!

Come join the #HITsm tweet chat this Friday, 10/28 at 9:00am PT to discuss the Top 10 Challenges for Healthcare Executives. And check back here after the chat for a summary of the information shared on the topics discussed. Also, consider following HCEG on Twitter.


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

By | Healthcare Revolution

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

Each year for the past 12 years, the Healthcare Executive Group ideates and defines a list of the top 10 challenges, issues and impacts that its healthcare executive members think will be their primary focus for the following year. The HCEG Top 10 list is intended to drive healthcare innovation and transformation throughout the industry by serving as the basis for continuous and evolving dialog on the critical healthcare issues and concerns facing HCEG’s member organizations.

Creating the 2017 HCEG Top 10 List

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David Gallegos SVP of Consulting Services for Change Healthcare helps drive the discussion around the 2017 HCEG Top 10.

Over 100 HCEG members and sponsor partners developed the 2017 Top 10 list during its Annual Forum held on Sep 11th through the 13th in New York City. As Ferris Taylor, HCEG Office of the Chair and COO of Arches Health Plan noted: “This year’s Top 10 list was derived from an initial list of 27 topics, and reflects the incredible transformation taking place (and needing to take place) in customer-centric services provided by health plans. As discussed at our Forum, technology and innovation are moving quickly. Our members see these 10 trends having lasting impact in the way we all become engaged, digital consumers and responsible healthcare stakeholders.”

The Prioritized 2017 HCEG Top 10 List Includes:

  1. Value-based Payments: Targeting specific medical conditions to manage cost and quality of care
  2. Total Consumer Health: Improving member’s overall well-being – medical, social, financial, and environmental
  3. Clinical and Data Analytics: Leveraging big data with clinical evidence to segment populations, manage health and drive decisions
  4. Cybersecurity: Protecting the privacy and security of consumer health information
  5. Cost Transparency: Growing legislation and consumer demand
  6. Harnessing Mobile Health Technology: Improving disease management, member engagement, and data collection and distribution
  7. Addressing Pharmacy Costs: Implementing strategies to address growth of pharma costs versus benefits to quality of care and total medical costs
  8. Care Redesign: Leveraging team-based care models, focusing on behavioral health and social needs
  9. Accessible Points of Care: Telehealth, retail clinics and micro-hospitals vs. large, integrated systems
  10. Next Generation ACOs: Additional programs in bundled payment, episodes of care-shared savings, and growing participant base

What’s Next for the Top 10?

surveyIn addition to serving as the basis for a wealth of research, white papers, webinars, blogs, and formal and informal discussion opportunities available throughout the year, the Top 10 list serves as the basis for The Industry Pulse: a research survey project executed via a partnership between HCEG and Change Healthcare.  The survey will be available October 6th through October 31st to an expanded group of healthcare executives, analysts and industry though leaders. Joint research between the HCEG and Change Healthcare will be conducted to expand on the list and to detail how certain healthcare organizations address the Top 10 items via different trajectories.  This research will enable participants to benchmark how their own organization is tracking against these varying approaches and consider alternative strategies. A white paper containing comprehensive survey results and analysis will be available in early December. Take the survey today.

For more information on the HCEG Top 10 list and the Healthcare Executive Group, check out our website or contact us. You can also follow us on Twitter where we tweet as @HCExecGroup, check us out on Facebook  and/or follow us on LinkedIn.


Designing Digital Commerce Distribution for the Healthcare Revolution

By | Healthcare Revolution

Last week, HCEG’s marquis sponsor, Softheon, hosted a webinar “Digital Commerce Distribution: Driving Value in the Age of the ‘Digital Payer’.” The hour long webinar, available here as an MP4, was presented by Michael Hendershot, Business Development Director at Softheon and Dana Franke, Director of Operations at Softheon.

As the title implies, the webinar presented information on digital health and how health plans can utilize digital commerce programs to remain competitive in today’s healthcare market. The presenters also offered various ideas and approaches for developing a digital commerce strategy. There was a Q & A session at the end where participants raised some good questions.

The Digital Commerce Distribution Agenda

The agenda for the webinar included the following topics (each starting at the time noted)

  1. How does digital commerce differ from traditional channels? (12:07)
  2. What are the main components of digital commerce distribution? (14:04)
  3. How has digital commerce revolutionized traditional payer approaches? (15:28)
  4. What role does digital commerce play in customer experience strategies? (16:45)
  5. What steps should payers take to design their digital commerce strategy? (19:38)
  6. In what ways can digital commerce provide insight into member behavior and trends? (21:21)
  7. Can digital commerce be optimized to help generate a greater portion of total revenue? (23:25)
  8. How can payers incorporate a greater portion of their business into digital commerce? (25:14)

Additional Insight from the Webinar

The webinar provided a lot of statistics, information and actionable ideas for webinar attendees. The reader is urged to view the webinar where they will be presented with informative slides, information, ideas and comments like the following:

  • “Health plans need not only provide the tools prospects and members need to interact with the health plan but also launch marketing strategies through the digital tools they make available”
  • “Digital tools have revolutionized sales and enrollment, administrative functions like provider searches, premium payment, claims status and other common customer service activities.”
  • “Payers need to be able to provide a balance of customer experience strategies depending on their target market. Medicare members may be more focused on one on one communication and education in an advocate role via traditional channels while digital tools may be the point of first contact for younger families and recent college graduates.”

What must payers understand about digital commerce?

  • “Health plans must understand their member population and how these members prefer to communicate with the health plan. Then the plans must use that information to design an online experience focusing on minimizing the amount of time that customer service interactions take.”
  • “Digital commerce is not just an IT challenge but a company-wide initiative.”
  • “If your core claims administration system can accept 834 transactions, then you are well-positioned to work with technology providers like Softheon”
  • “When you’ve seen one 834 (enrollment transaction), you’ve seen one 834”

Some Questions from the Audience

The following were some of the questions raised during the Q & A. Listen to the recording to hear the responses.

  • “Are some of the newer carriers like Oscar and Harken pushing the older carriers to take more of an active role or movement toward digital commerce?” (33:18)
  • “What are you seeing from your clients as the top challenges in moving to digital commerce?” (34:34)
  • “What is your definition of a payer?” (36:34)

To learn more about Softheon and its cloud-based Exchange solutions, contact John Saunders: [email protected], (631) 216-7491

The HealthCare Executive Group

The HealthCare Executive Group (HCEG) is a national network of select executives from across the entire healthcare spectrum; coming together to continually learn, grow, share and reshape the healthcare industry. HCEG periodically sponsors webinars. For more information on becoming a HCEG member, see Why Join HCEG? on the HCEG website. You can also follow HCEG on Twitter and like them on Facebook.

 

“ACA: The Road Ahead in Transitioning from “Accessible” Care Act to the true “Affordable Care Act”

By | Uncategorized

Last week one of HCEG’s sponsor partners, HealthEdge, co-hosted a webinar “Payment Reform: Exploring Technology Implications for Health Insurers” with Medica. The hour long webinar, available here on YouTube, was presented by Andrew Davis – VP & GM of Medica’s Medicare segment  and Harry Merkin, VP of Product Marketing at HealthEdge.  The webinar addressed the move from fee-for-service to value-based reimbursement models; specifically the underlying technology systems health insurers are using or will soon need to use to avoid left behind. The impact of new MACRA legislation was another topic discussed throughout the webinar and during the Q & A period at the end of the webinar.

Value-Based Reimbursement is Big – And Getting Bigger

The move to value-based reimbursement (VBR) and other business models based on quality and value is dramatically reshaping the U.S. healthcare system and is happening faster than anyone could have anticipated even just a couple years ago. Currently, CMS is on track to have 30% of its reimbursements under value-based arrangements this year in 2016. And CMS is targeting 50% of all its reimbursements to be value-based by 2018 and 75% by 2023.

Agility – Efficiency – Transparency

A survey by McKesson – Journey to Value: The State of Value-Based Reimbursement in 2016 – reveals that 61% of payers and 41% of hospitals expect VBR reimbursement to positively impact their organizations.  In order for payers and hospitals to realize positive benefits from VBR, or at least avoid being unduly impacted by new value-based systems in a negative way, these healthcare organizations need to focus on three technology imperatives

Agility – health plans must be able to adapt to new payment models and rollout new benefit designs and lines of business quickly. And they must be willing and able to rapidly share relevant, actionable information with their provider networks.

Efficiency – the increase in administrative and reporting processes demanded by value-based reimbursement dictate that health plans automate key processes to enhance their competitive position.

Transparency health plans must be able to provide a patient-centered, 360 degree view of their members to the entire care team. Member experience and engagement should no longer be nice to haves.

Additional Insight from the Webinar

 The webinar provided a lot of statistics, information and actionable ideas for webinar attendees. The reader is urged to watch the webinar on YouTube where they will be presented with information and ideas like the following:

“MACRA raises a concern about ensuring adoption across all provider types. MACRA is ‘Meaningful Use on steroids’”

“There is widespread concern about conflict and misalignment between quality measures under Medicare FFS and the quality measures proposed MACRA”

“There will be a significant administrative burden managing multiple measure sets needed to comply with existing quality measure reporting programs and MACRA’s new Merit-Based Incentive Payment System (MIPS)  – at least as far as these programs are defined today.”

“Larger provider organizations working w/ ACO’s have a significant advantage under MACRA”

“Medicare Advantage is gold standard for effective risk-based contracting in today’s healthcare marketplace”

healthcare“Providers must treat all Medicare beneficiaries the same regardless as to whether they’re reimbursed via FFS, Medicare Advantage risk or new MACRA reimbursement”

“MACRA brings a bigger set of carrots and sticks that payers can with providers.”

“MACRA will enable Medicare and Medicaid programs to keep providing healthcare for generations to come”

Other Webinars by the HealthCare Executive Group

The HealthCare Executive Group (HCEG) is a national network of select executives from across the entire healthcare spectrum; coming together to continually learn, grow, share and reshape the healthcare industry. HCEG periodically sponsors webinars such as the one described in this post. For more information on becoming a HCEG member, see Why Join HCEG? on the HCEG website.

A Snapshot of the HealthCare Executive Group

By | Uncategorized

Ferris Taylor has been around healthcare for a long time – for almost 30 years now. Over these 30 years, Ferris has seen the ebb and flow of healthcare from multiple angles.  He’s been on the inside of healthcare working for health plans and providers and on the outside working for vendors and consulting firms that serve health plans and providers.

For most of his 30 years in healthcare, Ferris has been involved with the Health Care Executive Group; a 26 year old organization of health care executives having a desire to share information, ideas and challenges that impact the regional, state-wide and area-wide HP’s and provider groups of which its executives are associated.

Ferris was recently interviewed by IntrepidNow where he shared his perspective on healthcare over the last three decades, the sea change that began in healthcare about five years ago, and three specific benefits the Health Care Executive Group provides to its members. Introducing the Healthcare Executive Group Podcast

Benefits of the Health Care Executive Group

  1. Exposure and access to a broad spectrum on industry participants: payers, providers, pharmacy, medical device and other companies that serve the healthcare industry.
  1. A select, non-competitive network of executives that HCEG members can interact with on a day-to-day basis to help address immediate issues and and look to the future to explore what the healthcare industry could be facing the following year and years beyond.
  1. A vetted group of vendor sponsors that take off their sales hat and participate with the HCEG members as thought leaders who share their perspective rather than pitching their solutions.

2016 HCEG Annual Forum

Ferris also shared some information about HCEG’s upcoming 2016 Annual Forum including details on its three areas of focus, what attendees can expect from their participation at the forum and what sets the HCEG Annual Forum apart from other healthcare conferences.

Listen to this podcast to hear what Ferris has to say and check out this page for more information on the 2016 HCEG Annual Forum held September 12-14 at the Renaissance New York Midtown Hotel in New York City. You can learn more about the Health Care Executive group on the Web and follow them on Twitter, Facebook and LinkedIn!

The HCEG 2016 Annual Forum

By | Uncategorized

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Healthcare Executive Group 2016 Annual Forum, Sep 12-14 in New York City

TheHealthCare Executive Group(HCEG) is a 26-year old national network comprised of select executives from across the entire healthcare spectrum health plans, health systems, providers and a handful of vendors that join together to learn, share and reshape the healthcare industry. HCEG was founded by healthcare organizations as a grassroots organization to serve healthcare executives by providing a forum for open discussions regarding the dynamic healthcare eco-system.

Thought Leadership, Education & Information

HCEG members benefit from a rich thought leadership, educational resources and information sharing opportunities throughout the year. In additional to enjoying access to an exclusive group of leading healthcare executives, HCEG members have continuous access to webinars, virtual panels, white papers and other content specific to their roles as high-ranking healthcare executives.

2016 Annual Forum – Sep 12 – 14 in New York City

HCEG’s Annual Forumbrings together 80-100 executives from across the healthcare spectrum for two days of transformative and compelling dialogue; focused on the continuous innovation in healthcare, as the marketplace becomes every day more and more dynamic with technology both leading and lagging what the patient consumer, the payers and the providers all demand. These topics and issues, which originate from the HCEG Top 10 (more below) will be extensively discussed throughout the Annual Forum, and are illustrated in the HCEG Integrated Strategy

This year’s theme HealthCare Innovation: The New Norm is not only timely and relevant, but promises to not only encourage, but deliver thought provoking group discussions.The close-knit networking environment the Annual Forum is widely known and appreciated for, provides HCEG members an ideal relationship building environment, with industry thought leaders presenting captivating sessions that effortlessly align on HCEG’s Top Ten Issues in Healthcare as voted by HCEG members during each Forum.

These Top 10 issues are:

unnamed1. The Consumer Experience: Omni-channel business, mHealth, HIX, social media and telehealth.

2. Payment reform: ACOs, P4P, value-based care and value-based reimbursement.

3. Population health: managing total health, including social and environmental determinants.

4. Provider/Plan integration: combining functions of care delivery and financing in a single organization.

5. Transparency: triple aim price, quality and service measures to support customer decisions.

6. Retail health care: established consumer companies disrupt traditional care providers (Tied).

7. Pharmacy: cost, compliance, convenience & specialty health (Tied).

8. Big data and advanced analytics: identifying patterns, opportunities in vastly detailed data sets.

9. Cybersecurity: protecting the privacy and security of customer information.

10. Genomics: customizing prevention and treatment to individual DNA.

HCEG is currently registering attendees for its Annual Forum in New York City on September 12-14th. HCEG leadership extends an invitation to join its organization and attend its Annual Forum in New York. See here for more information on the HCEG Annual Forum. To register, click here. Please contact Juliana Ruiz at[email protected]or 954.361.5236 for membership and/or information on the 2016 HCEG Annual Forum.